Permit (86) CITY OF TIGARD BUILDING PERMIT
712 COMMUNITY DEVELOPMENT Permit#: BUP2019-00162
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 '' F Date Issued: 07/25/2019
TIGARD 13125 r®I Parcel: 1S135DA01000
Jurisdiction: Tigard
Site address: 8530 SW PFAFFLE ST
Project: AT&T Subdivision: METZGER ACRE TRACTS Lot: 20
Project Description: Replace(3)antennas,(9)radios,and handrail. Update equipment on existing racks and cabinets in support room.
8/5/2019: REPRINTED permit for change of contractor.
Contractor: TKK LLC Owner: DALTON,JANET L& DAVID L
PO BOX 1341 19210 MAREE CT
FERNDALE,WA 98248 LAKE OSWEGO, OR 97035
PHONE: 360-746-8948 PHONE:
FAX:
FEES
Specifics:
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VA Permit Fee-Additions,Alterations, 07/25/2019 $301.85
Demolition
Occupancy Grp: S-2 Occupancy Load: 12%State Surcharge-Building 07/25/2019 $36.22
Dwelling Units: 0 Plan Review 07/08/2019 $196.20
Stories: 0 Height: 0 ft DC Provision Review, COM TI-Ping 07/25/2019 $102.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 07/25/2019 $17.50
Value: $15,000 11x17)
Misc Administration Fee 08/06/2019 $45.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $698.77
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet: 1 Special Inspection(see plans)
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: __..t.0.10,0, 7 Permittee Signature:
�ow
03.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD BUILDING PERMIT
;II '' COMMUNITY DEVELOPMENT Permit#: BUP2019-00162
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2019
Parcel: 1 S 135DA01000
Jurisdiction: Tigard
Site address: 8530 SW PFAFFLE ST
Project: AT&T Subdivision: METZGER ACRE TRACTS Lot: 20
Project Description: Replace(3)antennas,(9)radios,and handrail. Update equipment on existing racks and cabinets in support room.
Contractor: CROWN CASTLE USA INC Owner: DALTON, JANET L&DAVID L
1220 AUGUSTA DRIVE SUITE 600 19210 MAREE CT
HOUSTON,TX 77057 LAKE OSWEGO, OR 97035
PHONE: 724-416-2000 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VA Permit Fee-Additions,Alterations, 07/25/2019 $301.85
Demolition
Occupancy Grp: S-2 Occupancy Load: 12%State Surcharge-Building 07/25/2019 $36.22
Dwelling Units: 0 Plan Review 07/08/2019 $196.20
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 07/25/2019 $102.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 07/25/2019 $17.50
Value: $15,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $653.77
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet: 1 Special Inspection(see plans)
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: !� Permittee Signature: 40`4.
l t�
Call 503.639.4175 by 7:00 a.m.for the next available inspecti date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial FOR OFFICE USE ONLY
" - City of Tigard J U L 8 2019 Received 7 / igi�/��Zj/ P .,20/ 6-
Date/By: (f
.).
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review j 0
Phone: 503.718.2439 Fax: 503.598.1960 C ;' t' Other Permit:
DatelBy:
TI G A R D Inspection Line: 503.639.4175 ;4 i t (' v<a ( �' ,a r ��ate ReadyBy: /9 /"ris: la See Page 2 for
Internet: www.tigard-or.gov Notified/Methoy ` �� Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
0 Addition/alteration/re lac ement Indicate the value(rounded to the nearest dollar)of all
p� ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:8530 SW Pfaffle St. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:855861/Pfaffle/AT&T Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
82144058 REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:15-1-35DA-01100-001 Indicate the value(rounded to the nearest dollar)of all
s equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Replace 3 antenna,9 radios,and handrail. Valuation: $15000
Update equipment on existing racks and cabinets in support room. Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT e -V - Number of stories:
Name:MICHALE MUNCH Type of construction:
Address:18655 NORTHEAST CHEHALEM DRIVE Occupancy groups:
City/State/ZIP:NEWBERG,OR 97132 Existing:
Phone:( ) Fax:( ) New:
11 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Crown Castle(on behalf of New Cingular Wireless)
Structural plan review fee(or deposit):
Contact name:Zach Phillips
FLS plan review fee(if applicable):
Address:5111 N.Bowdoin St.
Total fees due upon application:
City/State/ZIP:Portland,OR 97203
Amount received:
Phone:(503)708-9200 Fax::( )
E-mail:zach.phillips@crowncastle.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
i,-.r C .1--1,,z Submit two(2)sets of roof plan with connection details
Business name:TBD C Y� � `�,
and fire department access,along with the 2010 Oregon
Address: 7-0 -5-1.014 SL7Ct. I' r Solar Installation Specialty Code checklist.
City/State/ZIP: (pi/ Q) �; Permit fee(includes plan review $180.00
Phone: P and administrative fees):
(���) Fes'( ) State surcharge(12%of permit fee): $21.60
CCB lic.: (10`75-(90
Total fee due upon application: $201.60
Authorized signature: ��— This permit application expires if a permit is not obtained
.t within 180 days after it has been accepted as complete.
Print name:Zach Phillips Date:7.1.19 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
t
City of Tigard
iiiq COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: 6 k, / - CiG ',
Site Address: 6 - I0 0QIZYJ / Suite/Bldg#:
Project Name: '2T 7-
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 'epi 'S -2/4 pro-g/ 9 l42dib c , ..7-4d cia-1
AA) /r taA in v'111'4-/ 1 irp w/.
Existing Business Activity: / /4" C(S� C�nrn�ti 'k� e,Ij
Proposed Business Activity: 7/ // I/
erify site address/suite# exists and active in permit syste ye
t 'veroning
er Terrace Neighborhood: ❑ Yes M N o
10,......-
J
lid1' tted Use: LST Yes ❑ No ❑ Spec Space
OP Co firm no land use required.
IQ Business License:
Exists: 1GT Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: — Date: O.
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 2 Jr
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: Planning rmit Coordinatortilding
Workflow Sign-off: Sign-off for P nntng(include notes from planning review)
Route Application Documents: Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
/By Permit Technician: /er.,,...4".r
Date: 7! ((7 ,
I:\Building\Fonns\BldgPermitRvw_COM_NoLandUse_060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
1DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes �/A
Tigard Trans SDC: ❑ Yes
Parks SDC: El Yes I. N/A
70K to Issue Permit �'� �7
Approved byPermit Coordinator: /q`'"( Date: �" /jq
PP
I:\Building\Forms\BldgPermitRvwCOM NoLandUse_070915.docx
City of Tigard
1,1 COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Collocation - Supplemental Questionnaire
PROPERTY ADDRESS FOR STAFF USE ONLY
Location of collocation: 8530 SW Pfaffle St 0 f)
Zone:
Name of provider: AT&T(New Cingular Wireless)
Approved
Contact name: Zach Phillips w/Crown Castel ❑ Not Aproved
Collocating antennas on: By: Date:
0 Existing tower
Reason not approved:
❑ Existing non-tower structure
Is this a new provider?
❑ Yes
® No
Other providers currently collocating on same tower or structure: \Community Development\Land Use Appliications\02_Forms and
Templates\Land Use Applications\Future Forms Rev.12/14/2017
none
Indicate the previous approval: BUP2011-00183
(SDR,MMD#)
ANTENNA INFORMATION
Existing: New:
Height of antenna(s): 88'-6" (sq. ft.) Height of antenna(s):88'-6" (sq. ft.)
Color of antenna(s): Off white Color of antenna(s): Off white
Color of equipment: Off whiteColor of equipment: Off white
Accommodating equipment: Accommodating equipment:
(i.e.dishes) (i.e.dishes)
Will new accessory equipment be installed? 0 Yes ❑ No
Location of new accessory equipment?
❑ Within previously approved fenced area
❑ Within existing structure
k1 Other location: on the tower
(Please describe)
Will landscaping be removed to accommodate the accessory equipment? ❑ Yes E No
If yes, describe here:
AL.1 ( 7
Applicant's signature Print name Date
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of 1