Permit t e CITY OF TIGARD BUILDING PERMIT
'E'! III.• ' COMMUNITY DEVELOPMENT Permit#: BUP2020-00220
Date Issued: 11/13/2020
TIGr1..RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: T-Mobil Subdivision: None Lot: None
Project Description: Modification of existing wireless facility.Remove(6)antennas, (6)RRUs and(3)cabinets. Install(6)antennas,(6)
RRUs and(2)cabinets.
Contractor: MASTEC NETWORK SOLUTIONS LLC Owner: CLEAN WATER SERVICES
1203 114TH AVE SE 2550 SW HILLSBORO HWY
BELLEVUE, WA 98004 HILLSBORO, OR 97123
PHONE: 425-214-9727 PHONE:
FAX: 503-210-1001
FEES
Specifics:
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IA Permit Fee-Additions,Alterations, 11/10/2020 $377.90
Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 11/10/2020 $45.35
Dwelling Units: 0 Plan Review 11/10/2020 $245.64
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 11/10/2020 $102.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 11/10/2020 $24.00
Value: $20,000 11x17)
Info Process/Archiving-Sm$0.50(up to 11/10/2020 $12.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $806.89
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 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 yf� /�2il.vel:ri- Permittee Signature: 6.`,1r1 e'/!''`. t C.,f j JC i
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 OrSL\'
d Permit No.:
City of Tigard DatcBReceive, 0 !(p / L/J g((Pj 422.6
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ,ill Related Permit:
.- ' Phone: 503-718-2439 Fax: 503-598-1960(J I i j 7 2020 Deem : d -, - �Inspection Line: 503-639.4175 Date ReadyBy: lam: B See Page 2 for
TIGARD tp� Notified/Method: I
(o 41 Supplemental information
Internet: www.tigard-or.gov
F tient— _77-1S'T/r`+
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY 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.
Valuation: $
❑ I-and 2-family dwelling ®Commerciallindustrial
ElAccessory 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: 16580 SW 85th Ave New dwelling area: square feet
City/State/ZIP: Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: P001263A SW Hall&Durham Covered porch area: square feet
Cross street/directions to job site: See page T1.0 of plans Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#: 2S113B0006O0 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Modification to an existing wireless facility. Remove (6) antennas, (6) Valuation: $ 20,000
RRUs,and (3) cabinets. Install (6) antennas, (6) RRUs, and(2) Existing building area: square feet
cabinets. New building area: 0 square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name: Clean Water Services Type of construction: U
Address:2550 SW Hillsboro Hwy Occupancy groups:
City/State/ZIP:Hillsboro,OR 97123 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT Da CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:Md7 LLC on behalf of T-Mobile
Structural plan review fee(or deposit): 05:
Contact name: Justin Causey
FLS plan review fee(if applicable):
Address: 10590 West Ocean Air Drive Suite 300
CA 92130 Total fees due upon application:
City/State/ZIP: San Diego, Amount received:
Phone:(858 )291-1869 Fax::( )
E-mail: jcausey@md7.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: TBD Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: /`74s 7_Ate774/Q4-4-_ fo(�4.4_.7-7cm Solar Installation Specialty Code checklist.
City/State/ZIP:/. D3 //y . -z"�sb ZGr/ll� 6d/4- "Ir!`GV V Permit fee(includes plan review $180 00
and administrative fees):
Phone:tiros o1/j/-9,7�7 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: jig f 70 S Total fee due upon application: $201.60
Authorized signature: J l yl/CGL 44ey This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: CauseyJustin Date: 09/15/20 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\BuildingtPemutstBUP_COM_PemtitApp.doc Rev.04/21/2014 440-4613T(I1/02/COM/WEB) /�Q v40
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: 802,0 W-0022 O
Site Address: I(Qrj SUJ 55'1 yi Suite/Bldg#:
Project Name: 1=1knp(n i0
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: ReVIclek e aru{ reface on+anac f&TUc , and ca_brn.c n-fs
Existing Business Activity: W IreA IS CIYYIh 11Ah1CG1�� TDIaL tl'(
Proposed Business Activity:
Verify site address/suite# exists and active in permit system.
,Nr River Terrace Ne hborhood: ❑ Yes No
,lEl Zoning: 1—
Permitted Use: Yes ❑ No ❑ Spec Space
EA Confirm no land use required.
'Business License:
Exists: ❑ Yes ❑ No, applicant was provided a business license application
Notes: 'KCh4l?- fctm L-An lug. pet •d3o.
Approved by Planning: ACIv.--1 / Date: 10 t 'ZO
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: / /7 /a20
Site Plans: # 3
Building Plans: # 3
Building Permit#: Ile-Enter building permit# above.
Workflow Routing: d`Planning ❑ Permit Coordinator �Buildin
g
Workflow Sign-off:gn Qr.-Sign-off for Planning (include notes from planning review)
Route Application Documents: ['Building: original permit application, site plans,building plans,engineer and
beam calculations an. trust details,if applicable, etc.
Notes: /
By Permit Technician: Ar/AW, Date: _ /G 2P20
1:\BuildingWorms\BldgPemiltRvw_COM_NoLand Use_111819.docx
Pe Coordinator Review
❑ Condition - "prior to issuance of building permit
❑ Approved, NOT R: ed: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to A, 1cL
Revision Notice 2: Date Sen Ay .: ant:
Revision Notice 3: Da en .applicant:
❑ SDC Fees Entered: Co Trans Dev Tax: 0 Yes
Tigard Trans SDC: 0 Yes 0 N
Parks SDC: 0 Yes 0 N/A
❑ 0 ePermit
A t . .ved by Permit Coordinator. Date:
I:1 Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx
Justin Causey
From: #Building Permit Technicians <TigardBuildingPermits@tigard-or.gov>
Sent Wednesday,September 30,2020 6:49 PM
To: Justin Causey
Cc: Britney Budiman
Subject: RE:Commercial Building Permit Application I P001263A 116580 SW 85th Ave.
Attachments: Permit Delivery Location.pdf
Importance: High
Categories: Blue Category
Hi Justin,
My apologies for the delayed response. This submittal came in when we were closed for the week due to the fires, and
we have been doing our best to catch back up ever since. Unfortunately,this submittal exceeds our printing limit of(50)
pages. We will need you to either mail or deliver it to our Permit Center drop box (see attached aerial shot). If
delivering in person,the submittal may be dropped off between the hours of 8:00 a.m. and 5:00 p.m., Monday through
Thursday. We are closed on Fridays. No appointment is necessary. Please let me know if you have questions.
Thank you,
Branden Taggart
■ City of Tigard
s Senior Permit Technician
- Community Development
TIGARD
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or.gov
From:Justin Causey<jcausey@md7.com>
Sent: Wednesday, September 30, 2020 11:11 AM
To: Britney Budiman<bbudiman@md7.com>;#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>;
Branden Taggart<brandent@tigard-or.gov>
Subject: RE: Commercial Building Permit Application I P001263A 116580 SW 85th Ave.
Hi Branden,
I hope all is well, I wanted to follow up on this application and see if there were any questions your team may have.
Could you also provide an expected date for the completed review?
Regards,
® Justin Causey
d: 858.291.1869 m: 858.291.1869
e: jcausevCa�md7.com
III 1111 n
1
From: Britney Budiman<bbudiman@md7.com>
Sent:Tuesday,September 15,2020 12:56 PM
To:tigardbuildingpermits@tigard-or.gov; Branden Taggart<brandent(«ltigard-or.gov>
Cc:Justin Causey<jcausey@md7.com>
Subject:Commercial Building Permit Application I P001263A 116580 SW 85th Ave.
Hello Branden,
I am emailing to submit a commercial building permit application for an existing wireless facility located at 16580 SW
85th Avenue,Tigard, OR 97224. In the larger document attached, please find:
- Commercial Building Permit Application
- Structural Analysis
- Plans
I've also attached a separate copy of the plans in the case that you need to print them. Please let me know if any
additional materials are needed!
Best wishes,
Britney Budiman
Land Use I
d: 858.799.0880 m: 925.858.2915
a: 10590 West Ocean Air Drive, Suite 300
San Diego, CA 92130
e: bbudiman(@md7.com
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