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Permit (207) CITY OF TIGARD BUILDING PERMIT II --II'' ' COMMUNITY DEVELOPMENT Permit#: BUP2019-00193 T i t A It I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/21/2019 Parcel: 2S 101 DD00800 Jurisdiction: Tigard Site address: 14020 SW 72ND AVE Project: T-Mobile Subdivision: None Lot: None Project Description: Replacing panel antennas and RRU's on existing monopole.Replacing(2)equipment cabinets with(3)equipment cabinets on existing concrete pad within ground lease area. Contractor: Owner: I S PROPERTIES LP BY FISCHER&COMPANY URI GALLERIA NORTH TOWER II 13727 NOEL RD, STE 900 DALLAS, TX 75240 PHONE: PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: OTR Type of Const: Other Permit Fee-Additions,Alterations, 08/21/2019 $377.90 Demolition Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 08/21/2019 $45.35 Dwelling Units: 0 Plan Review 08/06/2019 $245.64 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 08/21/2019 $102.00 Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 08/21/2019 $18.00 Value: $20,000 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $788.89 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: 1 Special Inspection(see plans) r--_ - _ Firn . ��A13r11'�-_ __ _ _- 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. Y may obtain a copy offtthe c/rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ,G�%c��i) Permittee Signature: �� ����i �j1/f KK// �� Call 503.639.4175 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. Building Permit Application Commercial RECEIVED FOR OFFICE USE ONLY' City of Tigard Received ii II • 13125 SW Hall Blvd.,Tigard,OR 9722 i I q Date/By: 1 'kC;I k-� Permit No.�-` �v1c1 N'�\k(';l m Phone: 503.718.2439 Fax: 503.598.IA O- 3 1 LO 9 Plan ReviewQ ` W"� DateBy: C Other Permit: TIGARD Inspection Line: 503.639.4175 ate Read B �� Internet: www.tigard-or.gov CITY OF TIGARD Notifie.Ready/By: �/6 � /, runs I SeePage2for BUILDING DIVISION Supplemental Information = TYPE[Or NVORK;T ` iAT_ E _ { REi7LIIRED DAA 1 AND 2 FAMILY DWELLINt; 0 New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY bil'ti5Niiii116115WiTvg5 ttk,mrs.matoming work indicated on this application. II] 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 11:1Accessory building ❑Multi-family Number of bedrooms: 0 Master builder 0 Other: Number of bathrooms: _ Pf JOB SHE INFORMATIO N'i ND=LOCATION n Total number of floors: Job site address;, 9ITSW 72nd Ave New dwelling area: square feet City/State/ZIP: Tigard,OR 97224 Garage/carport g arport area: square feet Suite/bldg./apt.no.: I Project name:T-Mobile P001316D 1-5&Hwy 217 Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet Arta IRED_DA FA COMMERCL&L L SE CHECKt IST_ Subdivision: I Lot no.: Permit fees*are based on the value of the work performed Tax map/parcel no.: 25101 DD00800 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the rDESCRIPTION,OF WORK s work indicated on this application. replacing panel antennas and RRUs on an existing monopole.Replacing(2)equipment Valuation: $20,000 cabinets with(3)equipment cabinets on existing concrete pad within ground lease area Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER 9 I]'TENAN_7 - _ Number of stories: Name: IS Properties LP Type of construction: Address: PO Box 87908 Occupancy groups: City/State/ZIP: Vancouver,WA 98687 Existing: Phone:( ) Fax:( ) New. ©�APPLIC NT [] CONTACT PER SON BUILDING PERMIT FEES* Business name: Crown Castle on behalf of T-Mobile (Pteaseseferto.;tee'schedu[e ;= Contact name: Amanda Nations Structural plan review fee(or deposit): Address: 1505 Westlake Ave N,Suite 800 FLS plan review fee(if applicable): City/State/ZIP: Seattle,WA 98109 Total fees due upon application: Phone:(206 ) 336-2889 I Fax::( )�rIiAmount received: � _ -mail: an a.nations.contractor@crowncastle.com `CONTRACTOR - - Commercial and residential prescriptive installation of roof-top mounted Photovoltaic Solar Panel System. Business name: TBD Submit two(2)sets of roof plan with connection details Address: and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP: Permit fee(includes plan review $180.00 Phone:( ) I Fax:( ) and administrative fees): CCB lic.: State surcharge(12%of permit fee): $21.60 ( Total fee due upon application: $201.60 Authorized signature: ' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: n�1 ��T I��S I Date: `-4 12 ( „4 IT I * Fee methodology set by Tri-County Building Industry J` b W Service Board. I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) RECEIVED City of Tigard JUL 31 2019 11111 COMMUNITY DEVELOPMENT DEPARTMENT CITY OF TIGARD BUILDING DIVISION TIGARD Collocation - Supplemental Questionnaire PROPERTY ADDRESS Pia Cr FOR STAFF USE ONLY Location of collocation: �` W 72nd Ave i Name of provider: T-Mobile Zone: 11.. gf Amanda Nations,Crown Castle Approved Contact name: Not Approved p� / Collocating antennas on: By: iT ' Date: U /6/1 0 I] Existing tower Reason not approved: ❑ Existing non-tower structure Is this a new provider? ❑ Yes E No Other providers currently collocating on same tower or structure: I:\Community Development\Land Use Applications\02_Forms and Templates\Land Use Applications\Future Farms Rev.12/14/2017 yes Indicate the previous approval: (SDR,MMD#) ANTENNA INFORMATION Existing: New: Height of antenna(s): goo (sq. ft.) 1o0' Height of antenna(s): (sq. ft.) paint to match monopole Color of antenna(s): paint to match monopole Color of antenna(s): paint to match monopole Color of equipment: Color of equipment: paint to match monopole N/A N/A Accommodating equipment: Accommodating equipment: (i.e.dishes) (i.e.dishes) Will new accessory equipment be installed? © Yes ❑ No Location of new accessory equipment? x❑ Within previously approved fenced area ® Within existing structure ❑ Other location: (Please describe) Will landscaping be removed to accommodate the accessory equipment? ❑ Yes No If yes,describe here: 01, 1' 113144 P4p, ivi\-nGL1-177(41,01 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 ELIGIBLE FACILITIES REQUEST CERTIFICATION FOR NON-SUBSTANTIAL CHANGES TO A WIRELESS TOWER NOT LOCATED WITHIN A PUBLIC RIGHT OF WAY 1) Address of the Wireless Tower: _14020 SW 72nd Ave, Tigard, OR 97224_ 2) The height (measured in feet above ground level) of the existing Tower as originally approved, including any modifications approved prior to February 22, 2012: 98'-0"_ 3) What is the height (measured in feet above ground level) at which the modifications to the Transmission Equipment will occur on the Tower? 98'-0" 4. What will be the height(measured in feet above ground level) of the existing Tower after the modifications to the Transmission Equipment are installed? 98'-0" 5)Effect of modifications of Transmission Equipment on Tower height: (A)Will the modifications in Transmission Equipment (addition, removal or replacement of Transmission Equipment) result in increasing the height above ground level of the existing Tower? ❑ Yes M No (B) Will the modifications in Transmission Equipment result in increasing the height above ground level of the existing Tower by more than: (i) 10% of the height of the existing Tower, as originally approved, including any modifications approved prior to February 22, 2012; or(ii) twenty feet above the height of the existing Tower, as originally approved, including any modifications approved prior to February 22, 2012, whichever height increase is greater? n Yes M No 6) Will the modifications in Transmission Equipment (measured at the height above ground level where the Transmission Equipment will be attached to the tower) result in any Transmission Equipment protruding horizontally from the edge of tower by more than twenty(20) feet or by more than the existing width of the tower at that height, whichever of these dimensions is greater? n Yes M No _ .: • • - s - excavation-or plaeementof new equipment outside the existing Tower site or outside any access or utility easements currently related to the site? n Yes 11 No 8) Will the proposed modification in Transmission Equipment involve installation of more than the standard number of new equipment cabinets for the technology involved, but not to exceed four? ❑ Yes I No Non-Substantial Change Certificate for Towers Not Within A Public Right of Way National Development 2015.3 9) Will the proposed modification in Transmission Equipment defeat the existing concealment elements of the Tower? ❑ Yes ®No (10) Prior Conditions of Approval (A)Will the proposed modification in Transmission Equipment comply with conditions of approval imposed on the Tower prior to February 22, 2012? FJ Yes ❑ No (B)If the answer to 10(A) is "No," is the non-compliance due solely to any of the conditions addressed in questions 5-9 above? n Yes n No If the answer to either question 5A or 5B is "No", and the answers to questions 6-9 are "No", and the answer to either 10A or B is "Yes" then the proposed modifications do not substantially change the physical dimensions of the existing Tower. Please provide a brief explanation, if necessary, to clarify any answer. Explanatory Comments (If Needed): Question No. Comment: This certification is dated this 26 day ofJuly, 2019. VV �titAkeAsi Signature p� -- Name & Title • Non-Substantial Change Certificate for Towers Not Within A Public Right of Way National Development 2015.3 11111 City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT rlcaRo Building Permit Review — Commercial - No Land Use Building Permit #: , t uCt_ \Ct? Site Address: 19 0 2-0 S iv 7 2 net- a v`e.... Suite/Bldg#: Project Name: T- ) n0 rI (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning R view Proposal: 1 01(.L PC1 ielLk, G r)f-e r-I r C/1 3 (a lax-61'i oh e)Ci ti tn.,, VVI Nevo ea(L, Existing Business Activity: CX.II till() 00 (Ali n(�P_ Proposed Business Activity: f ScVerify site address/suite#exists and active in permit system. River Terrace Neighborhood: ❑ Yes ❑ No 911 Zoning: L.- Permitted Use: 7 Yes CINo CISpec Space Confirm no land use required. Husiness License: Exists: ❑ Yes ❑ No,applicant notified to obtain business license Notes: Approved by Planning: ("\i9 ' 1"-N----.... Date: J g b r i c Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: k ict -Site Plans: Building Plans: ## Building Permit#: dd Enter building permit#above. Workflow Routing: ['Planning 2/Building Workflow Sign-off: 0 Sign-off for Planning(include notes from planning review) Route Application Documents: Er/Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: 2L �_.--A........_ Date: SSA.k.k IS I:\Building\Forms\B1dgPermitRvw_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 A .licant: Revision Notice 2: Date Sent t. pplicant: Revision Notice 3: Date Se to Applicant: ❑ SDC Fees Entered: Wa Co Trans Dev Tax: ❑ Yes E] N/A gard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A ❑ OK to Issue Permit Approved by Pe ' it Coordinator: Date: I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 070915.docx