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Permit
City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT i III0 T I G A R D Building Permit Review — Commercial - No Land Use a) 111111111111111.111011111111 Building Permit #: &if/ e)-Grids Site Address: 1. 1 (p 55 SvJ (p h Avse___ Suite/Bldg#: Project Name: AT 2T 5 G V Qdc (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: ' yls-Etn.R 3 att14C rtVtCtS }3 rad t.013 On ex 1s` i hg -hotr. lace 1 Existing Business Activity: Mau ?At." _.Wirt 1.€ s F7A.C4 t Proposed Business Activity: MilleLQ 17tAtt h %Verify site address/suite#exists and active in permit system. siirRiver Terrace Neighborhood: ❑ Yes A No `Zoning: &rG Permitted Use: )fr Yes ❑ No ❑ Spec Space Confirm no land use required. usiness License: Exists: ❑ Yes ❑ No,applicant was provided a business license application Notes: _N0 kat/0 Ilk_ Cr- tS4 )•0??19• P1-GUeid.C/ Approved by Planning: Date: 4(2 ) I2 Revisions (after Building Submittal �only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: D Approved 0 Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: rater building [[! permi #above. - Workflow Routing: 2 nning "'" er it Coordinator wlilding Workflow Sign-off: i� off for Planning(include notes from planning review) Route Application Documents: LW'Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: rly:?p I:\Building\Forms 1BldgPermitRvw_COM_NoLandUse_111819.docx Permit Coordinator Review PcConditions "Met"prior to issuance of buildingpermit ❑ 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: . SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 14 N/A Tigard Trans SDC: ❑ Yes tEi N/A Parks SDC: ❑ Yes ).,{ N/A OK to Issue Permit Approved by Permit Coordinator: ik Date: 13 1:\Building\Fonns\BldgPennitRvw_COM_NoLandUse_111819.docx CITY OF TIGARD BUILDING PERMIT 41 •. COMMUNITY DEVELOPMENT Permit#: BUP2020-00089 Date Issued: 05/27/2020 T i f;A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136AD06300 Jurisdiction: Tigard Site address: 11655 SW 65TH AVE Project: AT&T Subdivision: None Lot: None Project Description: Installing(3)antennas and (3)radios on existing tower;Replacing(1)cabinet and reconfiguring batteries. Contractor: ERICSSON INC Owner: PORTLAND GENERAL ELECTRIC COMPAN 6300 LEGACY DR 121 SW SALMON ST PLANO,TX 45024 PORTLAND, OR 97204 PHONE: 972-583-0000 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 04/30/2020 $301.85 Demolition Occupancy Grp: Occupancy Load: 12%State Surcharge-Building 04/30/2020 $36.22 Dwelling Units: 0 Plan Review 04/02/2020 $196.20 Stories: 0 Height: 0 ff Info Process/Archiving-Sm$0.50(up to 04/30/2020 $19.00 Bedrooms: 0 Bathrooms: 0 11x17) Value: $15,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $553.27 Required: Required Items and Reports(Conditions) 1 Special Inspection-High Fire Sprinkler: Parapet: Strength Bolting 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: ermittee Signature: �.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 1(lit 01'11( 1 1 Psd 41\P 'p ' City of Tigard .s...,..,,,.,i. t.4,, Pi ECEIVEUR..iew ri ' PermitNo.: 4' r Ill ,..-4.... I.' a.. p '''' 13125 SW Hall Blvd.,Tigard,OR 97223 ih , 11` Phone: 503.718 2439 Fax: 503.598.1960 Doe: ; I 7,02.0 i'1 Other Permit: inspection Line. 503.639.4175 MAR 3 0 2020 D,,,t.Retly/By: Avis: ta See Page 2 tor Internet: www.tigard-or.gov NoriSediMothod: _ .Supplemental information ,---, ' •.,: 1 ioARL. • .' ''_. ' ., --,: . 1 '„- - :: t-CMGDIVISION L.,1 r-s' New construction 6 1;:;t011,tion Permit fees*are based on the vtdne of the work performed. Indicate the value(rounded to the nearest dollar)of all 11)2 f.14 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the -1 work indicated on this application. ValllahOn: S ® 1-arid 2-family dwelling 10.Commercial/industrial Number of bedrooms: 0 Accessory building 0 Multi-fannly 0 Master builder 0 Other: Number of bathrooms: Iiti5C-'464-:0''00114000.4.*0701011.,' !..k'171-,t7-- --141,..: Total number of floors: ....1 Job site address_1081SW 65TH AVE New dwelling area: square feet City/State/ZIP:TIGARD,OR 97223 GarageJearport area: square feet Suite/bldg./apt.no.: Project name:874135 AT&T 5G Upgrade Covered porch area: square feet Cross street/directions to job site:See T-1 of Construction Drawings Deck area: square feet Other structure area: square feet LliiKul 1 tiliitY6 lii't;.44i1rafit ,iliiiA. Subdivision: Lot no.: Pennit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.:142144057 equipment,materials,labor,overhead,and the profit for the ' r- ''''' ' ' ' work indicated on this application. OE'W(111F,St - '' ' ''-----' ' - ' - . Install(3)Antennas and(3)Radios on existing tower.Replace(1)Cabinet Valuation. 5815,000.00 A . i•and Reconfigure Batteries within existing lease area. _building area: 322 square feet New building area: 322 square feet P.10f41'1' , Number of stories: NA Name: PORTLAND GENERAL ELECTRIC CO Type of construction: UB Address:121 SW SALMON ST Occupancy groups: City/State/ZIP:PORTLAND OR 97204 Existing: U Phone:( ) New: U - ' -'-'17 '''' '63N°4617P1Itheli ` :. BUJ:LADING PERI‘drilEA*""''''_ :L_ , Y girf 4PA.147 i ': -‘. ' If.e/i -getb'e;kirinfeer'Eitt,s- Busint'ss name:Crown Castle,on behalf of AT&T Structural plan review fee(or deposit): Contact name:Natasha Montalvo FLS plan review fee(if applicable): Address:1505 Westlake Ave N Suite 800 Total fees due upon application: 301.85 City/State/Z1P:Seattle,WA 98109 Amount received: Phone:(206)336-2886 Fax::( ) E-mail:Natasha.Montalvogerowneastle.eom titii#45t0."5:46$91iit.i.7?;4**114:::.434414:0,1°"!." Commercial and residential prescriptive installation of ppisrrizAorpR - ' , ,- , - -7,l'''' ''' roof-top mounted PhotoVoltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name:TRU .9- r b'Cs,s e...)in_ inc. and foie department access,along with the 2010 Oregon Address: 63 oD L_r 64,$_. 10 r Solar Installation Specialty Code checklist. Permit fee(includes plan review S180.00 City/State/Z1P: to/414(2 c-fg-0,2-t 1 and administrative fees): Phone:(7?0,1 <7 3 -ie-0,20 Fax:( ) State surcharge(12%of pezmit fee): $21.60 CCB lie.: i,g if:7 3 / Total fee due upon application: 5201.60 Authorized signature: A.,2a&e...4./.tei„ 7// ,,rpAy. ,,eca.,g This permit application expires if a permit is not obtained within 180 days atter it has been accepted as complete. 8 L Date:3/25/2020 Fee methodology set by TO-County Building Industry Print name:Natasha AllOatahs0 Service Board. I.1Butichng\Permits 1 BHP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) 1111. Building Division Accessibility: Barrier Removal Improvement Plan T I GARD 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 he deemed disproportionate to the overall alteration when the cost exceeds twenty-five per-cent(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 03/03/2011 Building Division Plan Submittal Requirements TIGARD Commercial& Multi-Family-New,Additions or Alterations 1. SITE PLAN (fully dimensional,drawn to scale) labeled with: A. LI map&tax lot# ❑ project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ 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. • 4. EXTRA SET OF THE FOLLOWING: A. Two (2) copies of site plan to include vicinity map. B. One (1) copy of erosion control plan with details. C. Fire Department Building Survey, and full set of architecture drawings. I:\Building\Permits\BUP-COM PerraitApp.doc 03/03/2011 'an% CROWN Seat Phone (206) 336-2886 Westlake Ave N, � Seattle,WA 98109 www.crowncastle.con v CASTLE March 26,2020 RECEIVED MAR 3 0 2020 CITY OF TIGARD,OR 13125 SW HALL BLVD. CITY OF TIGARD BUILDING DIVISION TIGARD,OR 97223 RE: Eligible Facilities Request to modify equipment on a communications tower located at: 10955 SW 65TH AVE,TIGARD,OR,97223 Crown Site Number:874135/Crown Site Name:West Portland Customer Site Number:PT87/Application Number:511775 Crown Castle USA Inc. ("Crown Castle")on behalf of New Cingular Wireless PCS,LLC("AT&T Mobility")is submitting the attached Eligible Facilities Request application to add transmission equipment on a telecommunications tower located at 10955 SW 65TH AVE,TIGARD,OR 97223 in CITY OF TIGARD,OR(the"West Portland Tower"). AT&T Mobility proposes to modify the"West Portland Tower"as follows: Install(3)Antennas and(3)Radios on existing tower.Replace(i)Cabinet and Reconfigure Batteries within existing lease area. Itemized list of submittal documents: • (1)Cover Letter • (1)Commercial Building Permit Application • (1)Construction Application Checklist • (i)Collocation-Supplemental Questionnaire • (3)Construction Drawings Stamped by Oregon State engineer-11"x 17" • (2)Structural Analysis Stamped by Oregon State engineer • (I)Check for Fees Based on Valuation($301.85) Section 6409 of the Middle Class Tax Relief and Job Creation Act of 2012,commonly known as the"Spectrum Act" (Pub.Law No. 112-96,126 Stat 156),mandates that state and local governments"may not deny,and shall approve,any eligible facilities request for a modification of an existing wireless tower or base station that does not substantially change the physical dimensions of such tower or base station." Additionally,if"the reviewing State or local government determines that the application is incomplete"[they]"must provide written notice to the applicant within 3o days of receipt of the application,clearly and specifically delineating all missing documents or information." Under federal law, an Eligible Facilities Request is deemed granted with written notification in sixty(6o)days after an application is filed with a local jurisdiction,excluding tolling. Based on the submittal date of March 26,2020,30 days will expire on April 25,2020;6o days will expire on May 25,2020. The Foundation for a Wireless World. CrownCastle.com CROWN1505 Westlake Ave N, �/�/ 'v Seattle,WA98109 Phone: (206) 336-2886 %.rl CASTLE www.crowncastle.com AT&T Mobility is committed to working cooperatively with all jurisdictions around the country to secure expeditious approval of requests to modify existing personal wireless service facilities. If you should require more information regarding the Spectrum Act,please do not hesitate to contact me with your questions. Sincerely, Natasha Montalvo Natasha.Montalvo.Contractor@crowncastle.com (206)336-2886 The Foundation for a Wireless World. CrownCastle.com City of Tigard 2 COMMUNITY DEVELOPMENT DEPARTMENT TIGARDCollocation - Supplemental Questionnaire PROPERTY ADDRESS .A II(.055 IOR srnrrrsr ON Location of collocation: ; :"""SW 65TH AVE / AT&T Wireless Zone: l r� Name of provider: Natasha Montalvo,Crown Castle Approved Contact name: ❑ Not A�p AC' '� Collocating antennas on: By: �` Date: 420 0 Existing tower Reason not approved: ElExisting non-tower strutE C E I V E® Is this a new provider? ❑ Yes MAR 3 0 2020 © No CITY OF TIGARD Other providers currently collocating on same tower or st1NG DIVISION l:\Community Development\land Use Applications\02_Forms and Templates\rand Use Applications\Future Forms Rev.12/14/2017 yes Indicate the previous approval: BUP2018-00241 (SDR,MMD#) ANTENNA INFORMATION Existing: New: Height of antenna(s): 103 (sq ft.) 103' Height of antenna(s): (sq. ft) manufactured color-light grey grey color-light Color of antenna(s): Color of antenna(s): g g y manufactured color-light grey manufactured color-light grey Color of equipment Color of equipment: Accommodating equipment: N/A Accommodating equipment: N/A (i.e.dishes) (i.e.dishes) Will new accessory equipment be installed? ® Yes ❑ No Location of new accessory equipment? ❑ Within previously approved fenced area ❑ Within existing structure ® Other location: Within existing equipment shelter (Please describe) Will landscaping be removed to accommodate the accessory equipment? ❑ Yes ®No If yes,describe here: /l9a&e4 ?e ztr Natasha Montalvo, Crown Castle 3/25/2020 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