Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2020-00123
Date Issued: 06/01/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S102AD03450
Jurisdiction: Tigard
Site address: 8777 SW BURNHAM ST
Project: AT&T Subdivision: None Lot: None
Project Description: Removing(8)antennas,(3)RRH's,and(8)TMA's;Relocating B25 RRH's;Installing(1)platform mount
reinforcement kit,(6)antennas,(1)squid,(1)fiber trunk,and(1)DC trunk on existing tower.
Contractor: ERICSSON INC Owner: TIGARD, CITY OF
6300 LEGACY DR 13125 SW HALL BLVD
PLANO,TX 45024 TIGARD,OR 97223
PHONE: 972-583-0000 PHONE:
FAX:
FEES
Specifics:
Description Date Amount
Type of Use: COM Permit Fee-Additions,Alterations, 05/29/2020 $564.15
Class of Work: ALT Type of Const: Other Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 05/29/2020 $67.70
Dwelling Units: 0 Plan Review 05/29/2020 $366.70
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 05/29/2020 $12.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $35,000 Building Misc Fund(copies/prints) 05/29/2020 $62.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total 51.072.55
Required: Required Items and Reports(Conditions)
Fire Sprinkler. Parapet:
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 ermit will expire it work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you follow th rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 9 1-0090. You m tam a of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee 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 FOR OFFICE USE ONLY
City of Tigard aW�r' 1 itetched Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 " ' Ian Review
�. Phone: 503-718-2439 Fax: 503-598-1960 �AY Date/By: -2 ^+ Z, — Related Permit:
i'IUAKU Inspection Line: 503-639-4175 iJ 2020 Date Ready/By: c saris: El See Page 2 for
Internet: www.tlgard-Or.gov - ed/M od:J / Supplemental Inrurmatinn
TTPE OF WOi'co i 6} ft .- p(r' t : .-.:-.7...: ,-.
' - AMILY DWELLING
❑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 ❑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 ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
�^ JOB SITEB INFORMATION AND} aq = Total number of floors:
Job site address: mhat7rSt. --O New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.#: Project name:879526 Tigard-AT&T FirstNet Covered porch area: square feet
Cross street/directions to job site:On 15 North from YMlsonville to Tiga d ake exit 292B for K use Way tows d 72nd
Ave Ilse right 9 hone to a im dgtrt onto OR 217NMruee Way In 4 mlles take Deck area: square feet
exit 7 for 72nd Ave.In.2 mmiles tam left onto SW 72nd Ave.Tum right onto SW
Hunziker st.In-7 miles tum left onto SW Hall Blvd.In 3 miles tum right onto SW Other structure area: square feet
Bumham St.Site Is in back of Municipal work yard,entrance is 1 mile ahead on
the not. REQUIRED DATA:CONLMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#:d�2�4357.3 l�Z f�Dp 340( 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.
AT&T proposes to remove(8)antennas,(3)RRH's,and(8)TMA's;relocate B25 RRH's;and
Valuation: $35,000
install(1)platform mount reinforcement kit•(6)antennas, 1)squid, 1Yflbertrunk,and(1)DC Existing building area: iaaes Area- square feet
trunk on existing tower AT&T also proposes to install(1) nnveler gyctera - •. sion k11Jn
existing raycap,and(1)5G growth kit within existing shelter. New building area: No change square feet
0 PROPERTY OWNER ® TF,NANT , Number of stories: I
Name: AT&T Type of construction: IIB
Address: 19801 SW 72nd Ave Occupancy groups:
City/State/ZIP: Tualatin,OR 97062 Existing: Unmanned
Phone:( ) Fax:( ) New: No change
' ;Z! APPLICANT,. , . ®.-CONTACT PERSON BUILDING PERMIT(''A. '
Business name:Crown Castle on behalf of AT&T (Please refer to fee schedril¢I''
Structural plan review fee(or deposit):
Contact name: Sarah Baird
FLS plan review fee(if applicable):
Address: 1505 Westlake Ave N,Ste 800
Total fees due upon application:
City/State/ZIP: Seattle,WA 98109
Amount received.
Phone:( 206 )336-3204 Fax: : ( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: sarah.baird@crowncastle.corn
Commercial and residential prescriptive installation of
CONTRACTOR_ roof-top mounted Photo Voltaic Solar Panel System.
Business name: IBC). Submit two(2)sets of roof plan with connection details
U✓r "YC� and fire department access,along with the 2010 Oregon
Address: 6309 � r� �ri C.- Solar Installation Specialty Code checklist.
City/State/ZIP: 41 /C L/c.2.6/ Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCBLie.:o2p53G`/ 3if
Total fee due upon application: $201.60
Authorized signature:____,,,,a.,,,A `--t'n This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name; Sarah Baird,Crown Castle,on behalf of AT&T Date: 4/24/2020 * Fee methodology set by Tri-County Building Industry
Servicen Board.
I:1Building1 Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB) Wr"y Cff f •- in
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
111111
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: $
(0 Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Bullding\Permits\BUP_COM_PermitApp.doc Rev.03/05/2019
r
City of-Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
. " 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 ❑ 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.
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
114 COMMUNITY DEVELOPMENT DEPARTMENT
It
T I G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: 040,2-g�—c0/ze
Site Address: 3.-77 7 SIN Burnham at. Suite/Bldg#:
Project Name: AT R-1"
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: �t� an-lein osi 12(2.4s j Nike,. Ins-}A« reirrl 1Ycema4'lt ?- vid add
Sst?1 Q. )L pPhMYL+
Existing Business Activity: WWraecS-
Proposed Business Activity: t 6 J
Verify site address/suite# exists and active in permit system.
I River Terrace Neighborhood: ❑ Yes V,1 No
11
`5( Zoning: MLIIbI)
Permitted Use: Yes 0 No 0 Spec Space
Confirm no land use required.
1§41A Business License:
Exists: g Yes 0 No,applicant was provided a business license application
Notes:
Approved by Planning: / V /-- Date: 51«/70
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: 51 /a.,tj
Site Plans: # 3
Building Plans: # j
Building Permit#: nt building permi #above.
Workflow Routing: t 1 ing �Ypernvt Coordinator KI-Building
Workflow Sign-off: tgn o for Planning(include notes from planning review)
Route Application Documents: uflding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: 5�/rj/2j
l:\Building\Fonns\BldgPermitRvw_COM_NoLandUse_111819.doc x
Permit Coordinator Review
onditions "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:
)R-SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ,l N/A
Tigard Trans SDC: ❑ Yes- 'N/A
Parks SDC: ❑ Yes N/A
OKto Issue Permit
Approved by Permit Coordinator: VQL— Date: S/201e
En51.Hzrri 1- __
/1-yrrArr .1: 17._______, 571,2tha 0
5/5AtG11.7.ifr ea.
I:\Building Worms\B1dgPermitRvw_COM_NoLandUse_111819.docx
it rE Cp
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT MAY i, 2029
Tlt; ,R„a Collocation Supplemental Questionnaire ;f- T'tip:t,-r..
SITE INFORMATION
Collocating antenna is on: ® Existing tower ❑ Existing non-tower structure
Address: City/State: Tigard, OR zip: 97223
PROVIDER INFORMATION
Name of provider: AT&T Has this provider previously served Tigard? ®Yes El No
Contact name: Sarah Baird, Crown Castle Phone: 206-336-3204
List other providers currently collocating on same tower or structure: Sprint
Approved land use case number: (CUP)96-0004
ANTENNA INFORMATION
Existing: New:
Height of antennas: 76 ft Height of antennas: 76 ft.
Color of antennas: Paint to match monopole Color of antennas: Paint to match monopole
Color of equipment: Paint to match monopole Color of equipment: Paint to match monopole
Accommodating equipment: Accommodating equipment:
Will new accessory equipment be installed? ® Yes ❑ No
Location of new accessory equipment:
❑ Within previously approved fenced area
® Within existing structure
❑ Other location:
Will landscaping be removed to accommodate the accessory equipment? ❑ Yes ® No
If yes, describe here:
coQ� Sarah Baird, Crown Castle,on behalf of AT&T 4/24/2020
Applicant's sig re Print name Date
taQ- Sarah Baird, Crown Castle 4/24/2020
Pole/structure nez s signature Print name Date
STAFF USE ONLY
Zone C'P72 g Approvcd ❑ Not approved Received by: k' Date: .S 5 20
Reasons for denial:
City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-otgov • 503-718-2421 • Page 1 of1