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Permit (18) CITY OF TIGARD BUILDING PERMIT 1111111 lis COMMUNITY DEVELOPMENT Permit#: BUP2019-00299 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/14/2019 Parcel: 1 S 135CB00200 Jurisdiction: Tigard Site address: 10250 SW NORTH DAKOTA ST Project: AT&T Subdivision: None Lot: None Project Description: Site Development Review for new monopole located at 10250 SW North Dakota Street. Contractor: VELOCITEL Owner: PASCUZZI INVESTMENT LLC 1150 FIRST AVE SUITE 600 10250 SW NORTH DAKOTA ST KING OF PRUSSIA, PA 19406 TIGARD, OR 97223 PHONE: 484-804-4500 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: NEW Type of Const: VB Permit Fee-Additions,Alterations, 11/14/2019 $1,105.95 Demolition Occupancy Grp: U Occupancy Load: 0 Plan Review 10/30/2019 $718.87 Dwelling Units: Info Process/Archiving-Sm$0.50(up to 11/14/2019 $27.50 Stories: Height: ft 11x17) Bedrooms: Bathrooms: DC Provision Review, COM New-Bldg 11/14/2019 $203.00 Value: $100,000 12%State Surcharge-Building 11/14/2019 $132.71 Floor Areas: Total Area: Accessory Struct: Basement: Carport: Covered Porch: Deck: Garage: Mezzanine: Total $2,188.03 Required: Required Items and Reports(Conditions) 1 Special Inspection (see plans) Fire Sprinkler: Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: 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 , - me rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. T Issued By: Permittee Signature: PrVar iiVUS tall 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. ` BaildinE Permit Application Commercial FOR OFFI(E t SE O\l,A `7 +'—", Received City of Tigard I Permit No.: n 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Date/By: C(�6 r r` a" �� ' Phone: 503-718-2439 Fax: 503-598-1960 Date/By: jO 3� - � r Related Permit: Inspection Line: 503-639 4175 2019 Date Read/B Juris. T1G.ARD p Ready/By: ® See Page 2for Internet: www.tigard-or.gov /l1otified/Meth :`! II ;V -4--) �. Supplemental Information �� °:)F TIGARD IG DIVISIO TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 0 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 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 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:10 2 5 0 SW North Dakota St New dwelling area: square feet City/State/ZIP:T i g a r d, OR 97223 Garage/carport area: square feet Suite/bldg./apt.4: Project name: PD 81 G r e e nb u r g Covered porch area: square feet Cross street/directions to job site:SW Teton Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot 4: Permit fees*are based on the value of the work performed. Tax map/parcel 4: 13135 C B—0 0 2 0 0 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Construction of a new wireless facility w/100 ' Valuation: $ 100, 000 monopole and associated equipment in a 28 ' x15" Existing building area: square feet fenced lease space New building area: 425 square feet E4 PROPERTY OWNER 0 TENANT Number of stories: Name: Pascuzzi Investments LLC Type of construction: II—B Address:10250 SW North Dakota St Occupancy groups: U City/State/ZIP:Tigard, OR 97223 Existing: Phone:( ) Fax:( ) New: ® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Businessname:J5 0/B of New Cingular Wireless/AT&T (Please refer tofee schedule) Structural plan review fee(or deposit): Contact name:S a r a Mitchell FLS plan review fee(if applicable): Address: 1410 E 9th St Total fees due upon application: 7/`( 7 City/state/ZIP:Newberg, OR 97132 Phone:(971) 281-1422 Fax::( ) Amount received: E-mail: samitchell@J5IP. com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name:Ve 1 O c i t e 1 Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 115 0 First Ave, Suite 600 Solar Installation Specialty Code checklist. City/State/ZIP:King of Prussia PA. 19406 Permit fee(includes plan review $180.00 and administrative fees): Phone:(5 41) 864-0818 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB Lic.:218 8 5 4 • Total fee due upon application: $201.60 Authorized signature: /,>`/p.��/1�Q This permit application expires if a permit is not obtained f iOf t (/L/ within 180 days after it has been accepted as complete. Print name: ^ 6 Date: 10/22/2019 * Fee methodology set by Tri-County Building Industry '"v Service Board. I:\Building\Penmits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(l1/02/COM/WEB) i I City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT N Accessibility: Barrier Removal Improvement Plan Commercial & Multi-Family - Additions or Alterations TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov REQUIREMENT: OREGON REVISED STATUTE (ORS)447.241. (1) Every project for renovation,alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five percent(25%). VALUATION: Total of all renovation,alteration or modification being done, excluding painting and wallpapering: [1] $ MULTIPLIER(25%barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains:and, $ (g) When possible,additional accessible elements such as storage and alarms: $ TOTAL(shall equal line [2] of Valuation Computation): $ I:\Building\Permits\BUP_COM_PermitApp.doc Rev.03/05/2019 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1,1 Plan Submittal Requirements Commercial & Multi-Family - New, Additions or Alterations TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov 1. SITE PLAN (3) copies - fully dimensional, drawn to scale and labeled with: A. © map&tax lot# project name Et site address ❑ suite number ® zoning ® applicant name CZE phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Setbacks. F. Parking,including disabled access. G. Finished floor elevations. 2. EROSION CONTROL PLANS AND DETAILS. 3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of plans required based on submittal type (no redlines or tape-ons accepted). All details listed below shall be incorporated into the plans: A. Scale (architectural or engineering only). B. Foundation plan. C. Floor plan(s). D. Cross sections. E. Reflective ceiling plan. F. Seismic bracing detail for suspended ceiling. G. Roof plan. H. Exterior elevations. I. Structural calculations,plans, details and specifications. J. Accessibility barrier removal worksheet. K. Deposit-based on valuation of project. I:\Building\Permits\BUP_COM_PermitApp.doc Rev.03/05/2019 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Plan Submittal Requirements Matrix Commercial & Multi-Family - New, Additions or Alterations TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov Type of Submittal # of Plans (Includes new, additions and alterations.) Required at Submittal Demolition Permit 2 (site plan is required showing location and square footage of all buildings to be demolished,erosion control plan and tree protection,if applicable) Site Work 3 (must include location of all accessible parking) Plumbing (site utilities) 2 Building 3 Fire Protection System 3 Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Solar Photovoltaic 2 (Requires check list for prescriptive installation. If not prescriptive installation,engineering is required.) Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington County, and Tualatin Valley Fire &Rescue),if applicable. I:\Building\Permits\BUP_COM_PermitApp.doc Rev.03/05/2019 City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT TICARD Building Permit Review — Commercial - With Land Use Building Permit #: 66M0 00,2.7 9 Site Address: SW Ij 14tl Oak S�. Suite/Bldg#: — Project Name: AVT fog\ Cr €r Lirq (Name of commerciallbusiness occupying the space. If cant,enter Spec Space.) Planning Review ff Proposal: aliNsffuCI-Nrk a. rtt, A -k1++4 / oo' rtatople4Aoc;;ttot Qtpri I -- F,‘28' IV 'tnttlaid V&ct. fV 'fy site address/suite# exists and active in permit syste . kl/Ri,l ver Terrace Neighborhood: ❑ Yes No and Use Case#: So.alq-06062 Plans atch Approved Land Use: / Site Plankandscape Plan ❑ Other: 441=i ❑ Urban Forestry Plan E/Elevation Plan L , tulding Height: Maximum Height 10 .P,tcval Height I v ®/Conditions Met: ❑ Prior to SubmittalPrior to Permit Issuance tigkBusiness License: Exists: ❑ Yes ❑ No,applicant notified to obtain business license (Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake Notes: Approved by Planning: Date: (J- ' 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: /o/3 d/i i Site Plans: # Building Plans: # 3 Building Permit#: . Iter building permit#above. Workflow Routing: [ 1--1517nning gineering rnut Coordinator g Workflow Sign-off: ®'gn-off for Planning(include notes from planning review) Route Application Documents: [fig original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: �� t - Date: /0/36/i' I:\Bui lding\Fonns\BldgPennitRvw_COMW ith LandU se_060116.docx Engineering Review 21-Slope at building pad: g 3 ❑ PFI Permit#: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP) 2-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ErNo Assess Water Quantity Fee in-lieu: ❑ Yes 1:1---No LIDA Facility on lot: ❑ Yes [YNo ❑ NOT Approved by Engineering: Date Notes: Approved by Engineering: 4 Date: /42/Z1/5 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 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: 1lZ/SDC Fees Entered: Wash Co Trans Dev Tax: CiYes dd/N/A Tigard Trans SDC: ❑ Yes IJN/A Parks SDC: ❑ Yes %N/A OK to Issue Permit 1Approved by Permit Coordinator: Date: ))'2' / I:\Building\Forms\BldgPermitRvw COM_WithLandUse_070915.docx