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PFI2021-00036 n City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENV Request for Permit Action 6/,=, ) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor ❑x City Staff Check(V')one REFUND OR Name: INVOICE TO: (Business or Individual) Mailing Address: City/State/Zip: Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): © CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). Permit#: PF12021-00036 Site Address or Parcel#: SEG 877 Project Name: SGF, LLC Subdivision Name: Lot#: EXPLANATION: ODOT jurisdiction. New permit submitted under PF12021-00129. Signature: Date: 6/8/2021 Print Name: Agnes dnQr Refund Policy t. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR • ONLY Route to Sys Admin: Date By Route to Records: Date yi Refund Processed: Date By Invoice Processed: Date B Permit Canceled: Date &4Vy By,(/j) Parcel T ridded: Date B I:\Building\Forms\RegPemtitAction_1205 8.doc I City ofTigard 6/ 4d PFI #: 2021-00036 ENGINEERING DEPARTMENT Public Facilities Improvement (PFI) Permit For use by Utility Providers (Small Cell) PROJECT INFORMATION TYPE OF WORK Project name: SQF, LLC—Tigard Small Cell Wireless Facilities ® TYPE 1 — Small Cell Technology Node Description of project: See attached Project Description Installation ❑TYPE 4—Utility mergization performed by PGR or utility agency What utility services will the facilities provision? PERMITTING - APPLICANT SHALT. See attached Project Description Apply for&obtain PFI Permit.Pay all required fees. SITE INFORMATION Permit will be issued to applicant by City staff and Location (address if available): SW Corner of SW Pacific Highway will expire after 90 days. &SW Main Street SEG 877 INSPECTION - CONTRACTOR SHALL Notify rowpermits@tigardor.gov,within 5 days of APPLICANT INFORMATION (Service Provider) beginning installation. Name: SQF, LLC Notify rowlx rnits(otigard-or.gov,within 5 days of completion of installation. Mailing address: 16 Middle Street,4" Floor Notify rowpermits(ri,tigard-ocgov,5 days before City/State: Portland, ME Zio: 04101 connecting Of energizing facilities. Phone: (207)671-0893 Contractor must call 503-639-4175 to schedule inspections before 7 a.m.(at the latest)on the day Email: nbournakel@tilsontech.com Phone: (207)671-0893 of inspection.Use code 738 Contact name: Nicholas Bournakel Phone: (207)671-0893 )=,mail. nbournakel@tilsontech.com ROW License Number: 2020-00039 CONTRACTOR INFORMATION ❑ Same as applicant Name: Tilson Technology Management, Inc. CCB Number: 212930 Mailing address: 16 Middle Street,4th Floor City/State: Portland, ME Zip: 04101 Phone: (207) 591-6427 Email: prolicensing@tilsontech.com City Business License Number:02519(This is SQF's business license#.Tilson is an affiliate of SQF.) ENGINEER INFORMATION Name: Emad Badiee,Tilson Technology Management, Inc. Mailing address: 16 Middle Street, 41h Floor City/State: Portland, ME Zip: 04101 Phone: (404)480-5555 Email: ebadiee@tilsontech.com City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 1 ADDITIONAL INFORMATION Estimated value of work:$ $14,500(does not include the cost to run power and does not include any 4G /5G equipment. Is work related to a LAND USE DECISION? ❑ Yes ® No Land Use Case number: APPLICANTS NOTE: Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for work,if required by the city pursuant to TMC 15.04.140. I,the applicant,certify that: To the best of my knowledge,all the information provided within this application package is complete and accurate. The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject property. If the application is granted,I will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. Applicant and Contractor acknowledge receipt of all the City's regulations and TMC and agree to abide by all regulations contained therein. Application and Contractor acknowledge receipt and agree to abide by the permitting process and all other City of Tigard regulations listed on this application. I hereby certify,on behalf of Applicant,that to the best of my knowledge and belief this information is true and correct as of the date hereof. Licensee agrees to comply with the provisions in the Tigard Municipal Code, including,but not limited to Chapter 15.06. By executing this application,the undersigned affirms that she/he is an authorized representative of the Applicant with the authority to execute the application and bind applicant to all provisions of the Tigard Municipal Code C` ;V__A_�A Nicholas Bournakel 1/22/2021 Applicant's or authorized agent's signature Print name Date Property owner's signature (if required) Print name Date STAFF USE ONLY PFI No: 2021-00036 Permit fee: Received by:AL Date: 1125/2021 Approved by: Date: Notified by: Date: City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www..tigard-or.gov • 503-718-2421 2 DEVELOPMENT ENGINEERING FEES All Public Facility Improvement(PFI)Permit fees due upfront INITIAL PFI PERMIT FEE- Part 1: Required submittal fee is 10%of the Net PFI Permit Fee.See below for calculations. Minimum of$300. NET PFI PERMIT FEE Part 2: All non-water system improvements calculated from engineer's estimate x 7%(less the initial PFI Permit Fee). O. APPLICANT FOR APPLICANT TYPE 1 PFI: SMALL WIRELESS TYPE 4 PFI: CHECKLIST FACILITY CHECKLIST NOTE:Applicant must have a ROW License with Is all applicable small cell equipment installed? the City of Tigard VLior to applying for the PFI (Check box) ❑ Yes ❑ No Does applicant have a right-of-way license? (Check box) ® Yes []No Date of Completion: ROW License Number: 2020-00039 Contractor must provide photos of the location of the Small cell installation site from all angles: (N,S,E,Wti Under the wireless facilities standards,is the proposal considered? (check all that apply) ® Small Cell ❑ Macro How many install sites are proposed as part of this permit application? i The proposed equipment is located on which of the following: (Check box) ® Public Right-of-Way ❑ Private Property If equipment is to be located on private property, describe the type&use: Who will be using the facilities to provision services? Wireless cellular companies for siting small cell antennas. Will the facilities allow other providers to use capacity?---Yes City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 www.tigard-or.gov 503-718-2421 3 Yui c" i Edge of Pavement Ditch StreetlightIFL— .N ..........— _ in paDmin'a ! Existing House II Existing .r Driveway , d� I u'i _ TI >� C/a I 1 o Existing Shop � i Povverpole i I \� 0 1 I I� gs' Property Line OI Fire Hydrant(FH) � � I Scale: '1"=30' � I I TYPE 1 AND TYPE 4 PFI MINIMUM SKETCH REQUIREMENTS (Put N/A if not applicable) � I I I I � � I North arrow Property lines& dimensions Existing utilities locarions (sewer,storm,water) Street&street names All existing structures Proposed work Existing curb or edge of pavement Utility&street light poles Existing S/W or D/W apron Slope of property Trees City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.dgard-or.gov • 503-718-2421 4 GglSTRUI=N p NG PREPI F➢ SQF , LLC SQF, LLC SITE NAME: SQFCH-CON1003_TIGARD_OR 02 =9N9,R�GN�, PROPOSED WI-FI SMALL CELL NODE PREPMEY Gl: PACIFIC HIGHWAY WEST TILS 0 N TIGARD,OR 97223 On a Mission WASHINGTON COUNTY Is"IFORTAND'm w oR00R' LAT:45°25'58.68"(N)/45.4329670 T:(2m)ss.-Ru> RsanE CHCCM*I OWCNcoN LONG: 122°46'02.69" (W)/-122.767413° STAMP OLD PNOJECT LOCITIONIL -• • • �/ ... .T REMSION HISTORY. mm. PWIP 09/11/20 MED FOR PERMIT EM I le 200 0 100 200 SATELLITE IMAGE STREET MAP SITE NAME: PROJECT SUMMARY PROJECT INFORMATION SHEET INDEX SWCH-OON1003_TIMRD-OR_02 THE PURPOSE OF THIS DOCUMENT IS TO PROVIDE SIZE NAME: SOFCH-CON10G3-TIOARO-OR-02 w�t _ SHEET 1mE PACIFIC HIGHWAY WEST GENERAL INFORMATION IN REGARDS TO LOCATION AND TIGARD, OR 97223 SIZE OF THE PROPOSED WI-R SMALL CELL EQUIPMENT STE ADDRESS: PACIFIC HIGHWAY WEST T-1 TITLE SHEET ARRANGEMENT. THIS DOCUMENT IS ISSUED FOR TIGARD,OR 97223 WASHINGTON COUNTY PERMITTING PURPOSES ONLY,AND SHALL NOT BE USED WASHINGTON COUNTY co-T GENE10E Hills FOR CONSTRUCTION. STRUCTURE OWNER: SOP,LLC m-2 PRgVYO NODE LOCNI011 PVN sn POLE NUMBER: 2170 �] [NUP;EO NODE LOOJ,IKK1 PVN ELECTRIC UTILITY: PGE SERVICE TERRITORY: ELETEUPHONE - FRONTIER a-9 PIKE MATKIN TITLE SHEET PHONE: (503) 771-3817 APPLICANT: SOF,LLC co-s IgIE dNUN[NO WID xTNNC TELEPHONE COMPANY: FRONTIER ROW OWNER: STATE 00-5 EGIIPTENE OETNLS ORNNY: FU SNEET NO.: REN. PHONE: (800)-921-8106 CHEM s0wcrurrE TYPE: PROPOSED INTEGRATED POLE T-1 A APPTttWEO: CONSTRUCTION MANNING PISPMEo EMM: SQF, LLC GYINSTRUC-Ul o.P l PRCP4i_C BY'. GENERAL NOTES: I O N i. ALT.UNEROMWO 0IURY INFORMATION PLOGATE ED HEREIN WD CON BAB BY PRIOR To FROM SURFI#EVIDENCE MO PLANS W RELOAD. Ill UNDERGROUND M MINI UM W RE LOGMO N THE PLAN D COxIPACZOR PRIOR T1 CWYElNM11EHI W ILL SITE WOiN.CONIR1Ci012 SHALL K UWSAPE A MINIMUM O T<NDURB HIM IN i0 PLANNED Col ALL GA I ACTIVITY. E S d M TH RJOD, 2 Ill WORN BY ENGINEER COAFLEIEO BY CONTPALiCA IN KYORDKXE WIN Kl OAWUNE6 ANp REWUlDNS DURING N YAWIN FEPoNB I6 YIDOM STREET,IM fLOOt, NRNISxEO NT BEPEPOOIIMO,ME 64101 3, NL WORN MALL BE PERFORMED IN MATERIALS EMAWM MPA-70, ONS {UTST COMPLETE I,AND ILL LOLL B SHMLINING CON KD PLANS ADS. l:(A7)591-&21 1. THE IFIEV HI SHALL RE IURNIT F T ESE SPECI EORP4ENT,AND SINGSI O PROAK SYSTEMS SNIWE AR NESE PVNS AN NMTL�NIECH.WY lY15ORECH COY 9PSIBE HEEREIN TIE INDICATED R 116E SPECEIUTDIVS KID LISTING CONTRACT DMNNCS 5 10)6 FUR MAL(SHED CE ME VARIOUSBES1SRA8 SHALL HOT HEREIN OND L IN ED W MESE 1.HOT d ANY ISEING OR INDICATIONRDEM OF GENS FURNISHED I OR WORN IP BE PERFORMED SHALL NOL BC M. TO CIE N WE AND 1I HOT IRI➢THE L AND F LLYFANAENIS.iC NRN6X AN0 NSTPLL EQUIPMENT,KKEBSONES, STAIMP WE CONT,ETC.,LO LWP.EIE WE LONIRACF Vl A SUBST.WIYL AND FULLY ND AND ALL.BE. S WE CONTRACTOR SHALL NAE WE SITE WRH NWS MJ BE PERFORMED IN WE CONTRACTOR OND RAL ➢XOR PRHLYIM TO IUARCOM NCI KLMINT, WHAT SjNS UNDER WHKN AS BE II TIONWE.AUDILES NLL BE PEANY,NOT. TIE REPORTTHE EIB PMCLA i0 FOR IBORAG WARN THAI,MA EAKN AND HAS BEEN NODE AND INFIRMITIES VIT E VES NOTED AND D-I IED O THE HAVE BEEN OWES FOR ENO➢ COST DE P VD9R ILOUCL AM ELUPYFNT IEWRED FOR ANY OETICCNES ENCOUNTERED WNICN CAN HAVE BFFN FORESEEN NLL NOT BE C ,fiDNdPE RECIX.ONTRA 6. WE EQUIPMENT ANL VERIFY ON ITIONSDIMENSONS AND CONDOM EPRTED NINE 911D"IN PFIOR i0 EObIW:AiN1N Np/DR EISCIIgI OF ANY YATAWv OR ECONTRACT ANY UNUELW.AND REMOVE 514LLL RE ND SEN N ME"IN"ON. .EISA ). WE E WAYS AWL CUBAN AND RENGVL DEBNS AND SI MAN DEPoSIED ON AGARIC SHEETS,SDEWNM.MYLEM MFRS,OR DINER PURTIL WATS W E 70 AM 6NSNLCMS OCIMIY IN E TYELY MANNER. & MARTIN OR S'Wl NCORPCAG PRQ'RUOIR (0.5 CONTRACTOss-IR IN RERU A L PROTECT QtSNG SMDITION AN AS KR BMNtES.KW (Af4G ypSj�Ow BUNTAIN SIZE SYNLGY DURING CDMBMUCTpN. CONTRACTOR SHALL EESTORE All MFRS i0 CRN:INK CONDITION AND M[AFCTFD BY PVNS B. THE CONTRACTOR SWLL iK(E RLL RE6ROMS81-ATY POR NN CHIGOES AND WNAINN FROM APPROVED PIANS IDL.WIHOIIZEO 6T ME (VIAE. ENGINEER It MAN SHOWN ARE INTENDED i0 o T END RESULT 9r5ED ON AND PRI O AYWIf1GIKK1 i0 SUR FOLD N4ENSIOXS MOOR CEFORT W SNVL ff ACCEPTANCE Tp TIE ENGINEER FOR RENEW)R MLLREM PRIOR ID ANY WORN. RE1A511)N HISTORY: 11. BENRE OR FINAL I6MERBY BE TIE YHAVEPROJECT, D DAMAGED OR STALL RCNPIC ALL CWIPYENI KIO W.TFWS.REPAIR OR REPUCE qr Al AGNATE OR PUBLIC PROPERTY KHMINCH MAY HAVE BEEN DAYBED OR ER OPER➢DIKING CLMA TION.CLEAN ILL MEAS AND AND 09/11/20 ISSUED FCq PERMIT [M THE ENGINEER TO lff PROJECT WHEN HAD BEEN OBSTRUCTED NT H6/NEP OPERATONS MO LOVE ME PRO.IECT SITE NEAT MD ILCfiRMI£TO ME ENGIIEER. 17. ABOUNLESSNENS 0E EMAROIFIED, L RDNAT DMID MN T Bf ANY MA ONIT E TAXE JUROD�CWION LE DA)WILL BE SURMED BY ETHERS Id CHIMPS OTHERWSf SPECIFIED,LWRO'NAM MD EIEVATNIN INFCAW1pN TAE iK(fN FROM GOODIE(MIH AND NO SURrEY NM ffUI ca4lurzD. MATERIAL NOTES: 1. ALL EQUIPMENT,RACEWAYS L'dES,AND LOMWCIWS SIULL BE PROPERLY ANCHORED TO ME UNI ROLE M LIGH NG FANRE PER NOW REOIAREYENI5 AND LOCAL.BEAUTY SPECIDU MS, 2. AL BROWNING AWL BE IN ACCORDANCE NN NESC REWNEYENS AND L001 UI SCLRIf1dN116. EAWMD MORMONS AWL HOT BE SWLER TANK 16 AWC COPPER,UNLESS OMEIPNSE SPECIFIED. J. SKI BOOM RANI BE PUNCHED DR ORLIED. TI-ARE BUT HOLES K2 HOT AMEMAELE. SITE NAME: 4. WI All EQUIPMENT AND REVILES PLUMB AND L L,ACCURATELY WITTED.AND FREE FRIM DISIORIIONS AND/CR DEFECTS 30FCH—CON1003_TARD_011_02 5. NOTFY ME ENGINEER PRM TO FIELD CUTTING OR YODEY➢IG APPROVED EQUIPMENT. 6. All BO115.WHIMS.AND IELFIlMEOS HKd1PARE SHALL BE GALVANIZED N AMMOANO£NN ASN AIM-ERC COATING(HOT-DIP)ON PACIFIC HIGHWAY WEST IRM mu STEEL HAR MARE ). ALL EIECMM MURPYEM SWI BE HOSED IN NEW SR EN:ID&MES, TIGARD, OR 97223 & WREN A%IN'AfAE,ALL PROPOSED NEW WOW MOTY WLES SWNL BE CONSTRUCTION MOE C ON KTTEA. 9. NEN KRIXGU ,Ill PROPOSED NEW WODO TTTILTIY ROLES SHALL BE CCAS 2,UNLESS OIHERNFf SPUCIFED WASHINGTON COUNTY GENERAL NOTES DPM: EAA SHEET No.: ND. ® CDA A NWD.'FD: CONTRACTOR NOTES: X - \ \ec LEGEND PREPARmW roR N0 1. R swi w OOVTTeVTI RESPONSSX1 TO mMa E>SII C FEA:iI M 111 IND 10 I l O OR E SCOPE OF INV ARF D1MrGF0,DESIIROYED — OR HIERED ADA RE41)W ON IRE SCOPE OF EI) OF at— S QF, LLC 2. ALL SIOEWMN AND PAMTCII SUIEACES M1F1ED WRING CDSOxICINI ro RE 9Rv WeRM oa4x — REGMRED PER THE LDCl1 ANISDICIIGTS REWIREMEM IND MF NPUTRoW OE TRNSPURIAIIOX. Bk \ '.4+ IS, XAWIIr Ix —P/L— O. BEFORE COW ENCNG ANY E%GWIp16,C CTOR'D IOTNY DICH UDNY — MER MONG IIICEAff101M RRCNES EO MIN THE PROJECT UNITS NOT \ '¢ R{, \ xOx —ryv uNaPmMw TxFLAx -- LESS TENT TND a RNFE TIEN 10 mBxw OPs mm ro srANlw. LNf <aalRu.DNAMMN b,-I NOT[FSS FINN 1 WS ESS DWS REEORE NONE CCIEENCES. \ O 4. wIEWI CPRWICIOR NN IQSlR11CINX mmv&FR INE TO POIII0.E N pma rIa RRM PRFPNED m: TO ECpIE ALL COSTING UMIDES AIN THEN DEPTHS PROF,TO®O■IG NI OPEN ^REwTILSON S C EI THE F TRENCHES ATN Nttu PRC I S HERE D O NORC MfIE3 \ INAm Tar RMilt ww x,axR wv nuaAva ,wn uoss THE FRENCH.THEr swu BE PNmECHTD.SUPPORTED AxD MINUNED N i /e ral6 6a rNa 0 Ixxra,A . On a Mission SERME AM RESF(IREO TO THE CLNAIb4 M WHICH TI WRE F0191D. AF.�C •U. N ■ ■ 4 ® O rye�' 16 MCI SHEET,IM ROM 6. WMED POKER I NOUO TO BE PULED A MI4IMI:M OF 2'-0-X10W GR �\ PORIWC,NO MIUI BI CONCUR TO NMTAIu A MINIMUM HOF?17 T&CLURMICF OF 2'TO INT ) ` // EXISTING UNDERCFOUNO UT ITIR AHO I'SRM!!CI EMWES FOR MN SO 19SMOECN.CW1 VT RIF CJI.COY 7. PRCPCSED BLINII CONDUIT TO 9E A MINIMUM OF H TO P11:. I JN \ ��gP a NI PRMM.EWIPNENT MC C NETS SHVU 40T I4MKE UPON A / `~ simp ACCE55I&UIY GUIORINES p Rt a 9. PPGR15Ff.LIXBIRIIC1pN a W-N FACERY MID UNDEFGP TRENCHING 5 0 O NOT TO IMVECt ON RECfSIIEW ILCF59. Sbc Opp SOO sop / � $ REVISION ASTORY, PROPOSED W-11 9WL CRL WINDIN \ /•k 09/11/3D 159JF0 Fa+PfRWT EIA (SEE\J FOR ENIIRGED IDGIRIN PVN) /„I, Q 97'-0 :x JB � TO ROC RNx � 41 � �� � � I eRON:I EFaIENMx �/ 8 I SITE NAME: lob'�` I � I J § SaFCH-CON10D3_T G6RD_gL02 M J l PACIFIC HIGHWAY WEST TIGARD, OR 97223 �e � 8 WASHINGTON COUNTY z oxf M �j�o g / am Ime ems' PROPOSED NODE ,00 LOCATION PLAN 2 JD � --- DOE CO D wN: EW BEET NO. BEV NOTE: POWER ROUTE IS PRELIMINARY IN NATURE AND IS SUBJECT TO CHANGE PROPOSED NODE LOCATION PLAN cHECNED ® CD-2 A 1:.10 APPRp'Ep: CONTRACTOR NOTES: LEGEND PRFnMaD Far OCj 1. rt ACT BE THE OENOIats RFSPONCRepRr ra PROTECT EXISTRTc r&,iuNEs coesrEUCTEN Dw.INc J (HAnwH)RAND TO REPAY OR RESTORE ANY PCA,CAE CANOED.pESmprcD / _ ort ALTERED As N ErtsOLr a aE srnPE a WqM. ` Ix — — oAE 3. ALL VI ME RAED WR FMEMT SURFAUS ALIERING CONSTRUCTION TO RE J NM BI'. —I-ED— sA.MRY¢Wu -- 5 QF LLC REPMP.ED PER.THE LOCAL AIRSDOMICS REIXWLMEKI AND THE DEPM1VEAf CS savR sM sMn,oMx1 —en BEFORE CCM N. J. BEFORE COMNENCBD PITY E11GWA1CN5,LdRHALTOR 10 IDPFY EM]I UNM HNVN�v urt —P/�— uEelrw�aEK —_ —_ (AIME WING UNOERGROUNV UIIUPES LOCATED IN THE PMJECT UNITS NOT ANNE I,w flrinb[ I THAN TWO OR NYRE THAN 10 WORKING PRS PRIOR TO SIANING. CALL anR za+E wmvn -. vmNR NaTAnox O CDx ,CPN NAININc B-1-1 NOT FEE HAN TZ BUSINESS LAYS BEFORE WORK COMGDEs ePne PREPARED BY. 4, GENUINE COOHAOTOt AND CONSTRUCTION MANICER ARE TO MIIKRE N ORDER TO LOCATE ILL EJCSTNG UIN16 INE THEIR DEPTHS PRIOR i0 KIM OR OPEN •AT uIE aanro suuxw TNETIINI TILS0N 5 N EXCAVATING IIIENCHES AND INSTALLK CONDUIT,WHERE MY COSTING UTBJRES Mnm INNcvam uan TBMfF w,nw Bmlmx olaom CROSS THE TRENCH,THEY SHALL BE PROTECTED,SUPPORTED AND RAI INP� P P� fIN•I eAs ,Fmwnr uM� NBI On d Mission SOME AND Ks ONED TO THE"WON IN MACH THEY NNE FOUND. �+ Cl ® ®N 4 m D • 16 MAI sINEEf,4FN Raw S. BURIED I R CONCUR TO BE%ACED A MINION A 3-0'BELOW GRIDS FORRMC.K 041DT BURIED CONDUIT TO MNNTAN A NNIWN HORQONTM O-DAMICE OF 3TO ANY i'(207)591-613) EXISTING ONDERGROUND URINES,AND T'OR CLEMMICES NR MY /1 INF09Pl,SOMECl1C0Y 11LSOMECHCON CRO 4S 5. ). % ED BUTIED CONDUIT TO BE A MINIMUM OF 90H.40 PKE SlImp B. Al PROPOSED EDUINENT ART CABINETS SHIT L NOT INFRINGE"ABA Icamlle GDIDEDBEs. S. PROPOSED Ca XTION OF w-G Mtn ANn I NnmGROUND TIENCHM G NET TO RrEDE ON PETRI ACCESS. Boc NPS TO UE SVV TS REVISION HISTORY. 1wo N. vIw V O � 09/11/20/I1 MED/10 EO FOR PFRNIi EM J'- 6/ S D n NPS TO DOC / 7 0 NPS TO W 9-0. PROPOSED NA-A SIMILE CELL LOCATION NPS TO W (SEE CD-3 FOR ENANOm LOCATION PIAN) v / N SITE NAME: MS0FCH-C0N1003-11OAM-OR-02 PACIFIC HIGHWAY WEST TIGARD, OR 97223 CD WASHINGTON COUNTY O HB,TRIG , ENLARGED NODE LOCATION PLAN IO p 5 10 6EESian 0ORMN. FM SNEEf NO.: REV. NOTE POWER ROUTE IS PRELIMINARY IN NATURE AND IS SUBJECT TO CHANGEcxEa®: ENLARGED NODE LOCATION PLAN CD-3 A 1:10 IPPRfA4D:Ea h a.IR-I'IML)2J9'-I'G16L) �cus'y LF11 LMwFR PREFORM MR; IDP a PNDRE u swu CELL MITEMIA 5mlwuw/SERuxs CnunnT Al WE EL=JB'G0.).20-01NRL)IS 36,MIN.RADIUS ELBOW S QF, LLC TOP ar PROPOSED sTEALTN FM w.6RNm�cr/APE.PER NEC PERMIMITED SHEET MEDLL SHROUD (SOMCE TRENCH ONLY) carvsmucrmn oRWAxc GOR FUTURE EN AL CELL SC CARRIER PREPARED BY AIFESS PRAPD",PROPOSED WIRELESS M,AND GF1 WRET. 24'MIN -- T I L 5 0 N 4Y MIN DOVER - ---- TRENGN y iMI Pyi' '-••� 1 On a Mission 16 YPORRSIREET,4T1 1 SELECT BICKFILL FOR CONDUIT PORDAND,ME 64101 l:(tar)591-912] SDpNO AND RIP PROIECDOH INPp01N5WaCX.CaM TLNKRECN.CDM SPURR 4A1RF NIGRAI T6MLN $y v Y F:HSPE � WAl NNGADEwnFIGRON s TAPE.PER NEC(SFRNfE .;7• TRENCH 011 1.:..: 7 NATNE BACKFILL 24"MIN TO TOP CONDOR OR 42' (NO LARGE ROCK FOR DIRECT IIRIED CA [WIRES J}LiiN�i 6 RAYCM STEALTH nLSJN SAC SELECT RACKFILLREVISION HISTORY: 12'STD.WE III A90)GR.B IRIELFAT6o METH LIGHT POLE FDR CONOUN 2,-6, enF ewm nWv JOB NUMBER:7119-01491101 PROTECTION TOP SECONDARY AND ler 64/11 ISSUED GOLV PERMIT EM FOLLOW MANUFACTURER 4 MIN SER'A10E UlERA1 SPECINGTNINS FOR INST41ATON 24'MAX CONDUIT OR DIRECT (COLOR:GREY) 24' CABLE MINOR METER ENCLOSED TRENCHING DETAILS 6E111No ACRfJC WNDOW Nol ro scALE iWXCI MCIMIUIE PROPOSE)INFDRMaTaN BON To RE C) SITE NAME: MWNTD TO POLE SIDE AT EYE LEVEL ENCLOSED BASE CABINET FOR MI POWER (SEE Dim C)-6 POR SDN)ETMs) Dfs NNECT AND DISFRIBUTDN ENCLOSED SQFCH-CAN1003_TIGARD-012_02 24•STD.RPE ASTM ANP w D ,,�'""� PACIFIC HIGHWAY WEST MMES To xxoxwE WASHINGTON COUNTY R TIGARD, OR 97223 -DPER 1n MI WLO M -RAIN 1D RE ROUTED FROM NNdNLE TO Poa BY LOIRWCid! a.o'-o' ,199'-D' ANL war 1Me A0 w°fq ON POLE ELEVATION PROPOSED FIIEnGiFO PONE AND ORIENTATION (2)SCH.a PMa wwwns GOR PDIRR AID FBER 4 ORAKN A ISHEET NG a4 PROPOSED ELEVATION W/OFroT IGNUE ALL CELL EQUIPMENT EQUIPMENTORIENTATIONSCAIFEPLAN CD-4 A MPRartD.La FNORE IG EOUIPMEM GSmUCitOn DR/M'IN° ENCLOSED IN SHROUD RMRMED fYlk 120/2 OV IODA SERVICE SQF, LLC PROPOSED 6 ESC EOUIPMEM O SERVICE CVMD �""� EMPTY SPACE RESERVED FOR PAOPGSTD GN OIR� FUTURE EQUIPMENT(TYP.) CONSTRUCTM DRAmnU PROPOSED RUCKUS T)50 AP Q �RAYCAP UNIT PREPMED V. .EN°DW4��WRCROUND GME 6WEDD E TILS 0 N OLif 120V/15A ( p ( �4 -1 R2�RA TOWUIILIIY PIXE)ECEVATIOGRONNDLOR CONDUIT 92E5 On d Mission 16 MDME SIRRT,AN BOOR, [D f21t12 An THIN k(I)/6 GROUND PORIINA YE"lot Q E TO UTLnY POLE ELEVATON FOR COMMIT SEES NHOxIiLSCNI2M W-OW W1.004 TUSOIPEIXWM NOTE MAIN BREAKER SHALL BE LOCKABLE IN OFF POSTW symp GEI W IL RECEPTACLE MIMiE EpMFM[xf(IYP.) Q •. ��''; ONE LINE DIAGRAM NOT TO SCAUE FUTURE EDUIPMEM RENSION HISTORY: pN,�11/10 ISSUE] FOR PERMIT Al162 GItDj F J %iWOSED METER SOCKET 7TIGARD, ROTE GRA SITE NAME: RLLORWAGM MATERIALSSHALLBEPROPOSED 76 GROUNDINGAND BO DINGE UL,NR. 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This is an ACCESS POINT to an TIL 5 0 N area with nansmMng antennas. Ob"A pwbbsgn+meeYea�eliroc Y On a IH15510n In Enayam:E.3<Hwn,CA EGF,LLC n30T35b1b]. 16 NIDd£ o-M ATH BOOR, A wA1gi FOWIM'O,NE M101 T:(ECH)OM1-6AT/ SQF,LLC FRONT am 8 1 TNroeTEsaurEcx cau nEwrmcN.cou OMEN:FEET of M'IENNAS NOT TO smsEn TmA@E(D)1 FRT STAMP SIGN DETAILS RUCKUS T750 WIRELESS AP DETAILS NOT TO scaE 13.64"(L) X 9.47�W)XX 4"(H), 6.27 LBS e,Pe W E`F' `-'' lJfJ36W 0 ol REVISION HISTORY: whim Rv 09/11/10 1SAJED FOR PERMIT FAA Nor .O m N MWLCI NfO�MRM: SITE NAME: SQFCH-CONIO03_TIG -OR_02 PACIFIC HIGHWAY WEST TIGARD, OR 97223 WASHINGTON COUNTY nn` EQUIPMENT DETAILS RAYCAP "ALL-IN-ONE" P/N: RUSAC-1440-P-240-1 CD-6 A xm D xuE APPIRNEIL EH Small Cell Wireless Facility Project Description for SQF, LLC A Proposal Submitted to the City of Tigard Prepared for SQF, LLC Prepared by Tilson January 22, 2021 Table of Contents L PROPOSAL SUMMARY INFORMATION...................................................................1 II. INTRODUCTION ? III. PROJECT NARRATIVE .................................................................................................2 SQF —Small Cell Facility Application I. PROPOSAL SUMMARY INFORMATION SQF File No.: TIGARD 02 TIGARD_03 TIGARD_05 TIGARD_06 TIGARD 07 Applicant: SQF, LLC 16 Middle Street, 41h Floor Portland, Maine 04101 Phone: (207) 671-0893 Preparer for Applicant: Nicholas Bournakel, Staff Attorney Tilson 16 Middle Street, 4th Floor Portland, ME 04101 (207) 671-0893 Property Owner: City of Tigard (Public Right-of-Way) 13125 SW Hall Blvd Tigard, Oregon 97223 Request: Small Cell Facility Application to install new freestanding small cell wireless facilities in the right-of-way Location: Public right-of-way next to the following addresses: TIGARD_02 SW Corner of SW Pacific Hwy & SW Main St (next to Liberty Park) TIGARD 03 12176 SW Garden P1 TIGARD 05 10775 SW Cascade Blvd TIGARD 06 Across the street from 10487 SW Cascade Ave TIGARD-07 9640 SW Greenburg Rd IL INTRODUCTION SQF, LLC, an affiliate company of Tilson, is working to improve the infrastructure located in the right-of-way to facilitate wireless carriers' deployment of next generation wireless communications, including small cell/5G facilities and smart city solutions. SQF has a Right of Way License with the City of Tigard and is licensed by the state of Oregon as a telecommunications provider with a SQF, LLC 3 1/22/2021 SQF —Small Cell Facility Application certificate of authority to provide telecommunications service in Oregon to install small wireless infrastructure in the public right-of-way to facilitate the expansion of small cell/5G wireless technology. Tigard is one of the select few cities SQF has identified for early deployment of small cell facilities to position the City for the future in wireless communications. To accomplish this goal, SQF is proposing to deploy new freestanding Wi-Fi small cell poles, which would provide Wi-Fi service with the intent of supporting multiple small cell carriers in the near future. The benefit of SQF's proactive approach of deploying Wi-Fi small cells include: • Poles designed for multiple carrier which will reduce the number of new poles by minimizing the need for individual poles for each carrier. Typically each wireless carrier deploys their own small cell poles and doesn't share their facilities with other wireless carriers,resulting in the proliferation of poles in the right of way. • SQF always allows and encourages multiple wireless carriers to collocate on its poles whenever technically feasible. To help position Tigard for the future wave of small cell facility deployments, SQF has identified five proposed locations to deploy new freestanding small cell wireless facilities in the right of way designed to support multiple wireless carriers. The proposed facilities will be designed with a combination of fully integrated poles and wood utility pole designs,both capable of supporting future wireless carrier collocators at the top of the pole which will be permitted separately. IV. PROJECT NARRATIVE SQF proposes to install five new freestanding Wi-Fi small cell wireless facilities to improve the infrastructure located in the right-of-way and facilitate wireless carriers' deployment of next generation wireless communications, including small cell/5G facilities and smart city solutions in Tigard. As shown in the enclosed plans, the proposed freestanding small cell wireless facilities will be designed with a series of four steel integrated poles, and one wood utility pole, located in the right of way. The steel pole design will integrate the antennas and radio equipment within the poles for a clean design that blends with the surrounding built environment and existing infrastructure in the right of way. The design will utilize non-reflective materials and color to help blend in with the surrounding built environment. The proposed steel pole design is customary and common in the right of way, is similar to the existing steel light poles and traffic signal infrastructure in the right of way. The wood pole design will blend in with the nearby wood utility poles along Greenburg Road, and utilize non-reflective materials to help blend in with the surrounding built environment. The proposed wood pole design is customary and common in the right of way, is similar to nearby wood utility poles in the right of way. The wood pole design will blend in with the surrounding built environment and minimize any potential negative aesthetic impacts. The proposed freestanding small cell wireless facilities will be designed to accommodate the collocation of at least two future wireless service providers which reduces the number of new poles needed in the right of way by minimizing the need for individual poles for each carrier. SQF always SQF, LLC 4 1/2212021 SQF —Small Cell Facility Application allows and encourages multiple wireless carriers to collocate on its poles whenever technically feasible. For illustrative purposes, future small cell antennas are shown within an enclosure at the top of the pole, not to exceed three cubic feet, integrated into the pole design, and will be permitted separately. The proposed small cell facilities will be located outside of the roadways and will not alter vehicular circulation or parking within the right-of-way or impede pedestrian access or visibility along the right-of-way. The facility will comply with the ADA and other applicable regulations and will not cause unreasonable interference. The fiber and power utilities servicing the facility will be vaulted near the base of the pole to minimize visual impacts. SQF, LLC 5 1/22/2021