Permit a CITY` ®F TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00206
COMMUNITY DEVELOPMENT DATE ISSUED: 7/28/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135BB-00300
SITE ADDRESS: 10185 SW CASCADE AVE ZONING: C - G
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: CLEARWIRE
Project Description: Co - location
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: U2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: 116 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 20,000.00
Owner: Contractor:
PORTLAND GEN ELECTIC CO M & A CONTRACTING INC
121 SW SALMON ST 1366 LEE ST SE
PORTLAND, OR 97204 SALEM, OR 97302
Phone:
Contact #: PRI 503 - 581 -6125
Reg #: LIC 177866
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 6/17/2008 $124.28
[BUILD] Permit Fee 7/28/2008 $191.20,
[TAX] 12% State Surch 7/28/2008 $22.94
Total $338.42
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 than 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 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued d2.2� Permittee Signature:) / _...11 i ■•. /A110
Call 503.639.4175 by 7:00 a.m. for an inspection that bu mess day.
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 Applicati S L
Commercial 01/E0 ‘, O
, FOR OFFICE USE ONLY
City Tigard JON Received p No.: / , • 1
° Tigard, O ' 13125 SW Hall Blvd., Ti 1' � Q DateB . �Q �, OP i;,. 1 -s
o g '. Q Plan Revie
P hone: 503.639.4171 Fax pi '8.' 90p Date/B : it_mo Other Permit:
TIGARD Inspection Line: 503.639.4175 r / �� Date Ready/By: ® See Page 2for
Internet: www.tigard- or.gov N G p�� Notified/Method: i z/ A. A.4. C���LM Supplemental Information
TYPE OF WORK, REQUIRED'DATA:,1 AND 2- FAMILYYDWEL°LING
❑ 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
- . OF CONSTRCT
UION' i work indicated on this application.
dwelling Valuation: $
❑ I- and 2-family g ❑Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ® Other: Unmanned Number of bathrooms:
° . - JOB SftE.:INEORMATION aAND ',LOCATION' °:-.,, ,: Total number of floors:
Job site address: 10185 SW Cascade Avenue New dwelling area: square feet
City /State /ZIP: Portland, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: POR228- Washington Square Covered porch area: square feet
Cross street/directions to job site: South of SW Scholls Ferry Road inside Deck area: square feet
PGE substation Other structure area: square feet
REQUIRED DATA:, COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 1S135BB00300 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
- ' . , DESCRIPT ` WORK, work indicated on this application.
Install panel antennas, microwave antennas, and GPS antenna on existing Crown- Valuation: $20,000.00
owned monpole and locate ground equipment inside the existing fenced compound Existing building area: 0 square feet
New building area: 0 square feet
` ' ❑ PROP.ERTY'OWNER -' . .. 4,®;TENANT ° Number of stories: 0
Name: Clearwire LLC, Kevin Maki Type of construction:
Address: 4400 Carillon Point Occupancy groups:
City /State /ZIP: Kirkland, WA 98033 Existing: 2C
Phone: (425)766 -7195 Fax: (425)216 -7195 New: 2C
° ❑ °APPLICANT.. ' , ` ® CONTACT PERSON ' " ° .N OTI - ` -
Business name: Powder River Development Services, LLC All contractors and subcontractors are required to be
Contact name: Dan Dutton licensed with the Oregon Construction Contractors Board
. under ORS 701 and may be required to be licensed in the
Address: 13220 SE Multnomah Court jurisdiction in which work is being performed. If the
City /State /ZIP: Happy Valley, OR 97068 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 756 -3888 Fax: : (503) 432-8032
E -mail: duttondan @comcast.net
M
. - a - , CONTRACTOR: _ ,1 - • , .
Business name: -✓mod.– �( or 4- (.p }) lido 1 1.) G , . :BUILDING,PERMIT FEES *'
' (Please refer to fee °sch°edule) '
Address: Z( e_f_ T ' 6f Structural plan review fee (or deposit): /jai St. / P
City /State /ZIP: L.rtN CiZ 4 730 9 –
Phone: ( 5p23 5 / - ep 1 a' Fax: ( ) FLS plan review fee (if applicable): —6
CCB lid.: 1 77 g(po Total fees due upon application: -4+498
Amount received: / 01( p - 15.411 --- 6 ckiv Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Dan Dutton Date: 6/17/08 * Fee methodology set by Tri -County Building Industry
Service Board.
l: \Building\Permits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(11 /02 /COM/WEB)
R C
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. 11 , 1 NI COLLOCATION 3UN 1 rocs
Of TIGP►go
Supplemental Question_ G DIVIS
T I GARD City of Tigard, 13125 SW Hall Blvd, Tigard, 0S'•+-' '
Phone: 503.639.4171 Fax: 503.598.1960
IF YOU ARE APPLYING FOR A PERMIT TO COLLOCATE ANTENNAS,
PLEASE COMPLETE THE INFORMATION BELOW.
Name of Provider: G LE i 1Z j 112-E L.L.C.-
Property Address/Location of Collocation: 1 IBS SW C.ASC.pE A.VI,.JUE
Zone: MUL
Collocating antennas on: I `'t1xistin tower
g H Existing non -tower structure
Is this a new provider? 1-..--"Yes ❑ No
Ifyes, list other providers currently collocating on same tower or .structure, if any:
T L ANt7 r -1 C V--
.
.
If no, indicate the previous approval (SDK, MMD or B UP #):
Height of antenna(s): t I r ft.
Color of antenna(s) and accommodating equipment (i.e. dishes):
1-1_ V 6S 4 'IOW , A 0 MS -rD C ' IPTE
Color of existing tower or structure: rod E.f'
Will new accessory equipment be installed? [ No
Ifyes, please answer the following.
Location of accessory equipment: rk<thin fenced area previously approved
I 1 Within existing structure
❑ Other location (Please describe below.)
Will landscaping be removed to accommodate the acres ry equipment?
❑ Yes (Please describe below.) No
-- D4, - ---- Applicant's Signature: IN
Date: /AA< 2 19t Z S
Name Printed: 171>ck -0 t, 1-17:4-1 Phone: 503 -
.a,$' •'m+�'}`, r ^ d j' t� n ®'ti t ,- ��..� h cu .: �, -.'". -'fib • :'S `"� L�; V'�'�:'�' 1'v 1 ifs+" S� a,*�.�
�t;G+i�a..r� -�.�x ,..csfsa ;.f'v�. ' �. �, du5����i�. SG��.�'�3stl,%v�����,u�,r,._.
x Issue permit ❑ Do not issue permit. Refer to planner.
la
g Staff Signature Date
I: \ CURPLN \Masters \ CollocateAntennas. doc
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: 13UP2008-00206
13125 SW Hall Blvd., Tigard, OR 97223 . A
DATE ISSUED: 7128/2008
Phone: (503) 639-4171 Atedlipv
Inspection Requests (24 Hrs.): (503) 639-4175 A. . -I.L.
INSPECTION WORKSHEET FOR DATE: 9/19/2008 TIME: 7:00AM PAGE: 2
SITE ADDRESS: 10185 SW CASCADE AVE:. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CLEARWIRE
DESCRIPTION: Co Oil
OWNER: PORTLAND OEN ELECTIC CO, PHONE #:
CONTRACTOR: IA & A CONTRACTING INC PHONE #: FJ03-581-6125
Inspection Request Scheduled For: Date: 9/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message i
299 Final inspection. 075707-01 503493-M24 Y 0
Ad
Corrections/Comments/Instructions:
Ce-5e (Pev, /
/PASS 0 PARTIAL APPROVAL 0 CANCEL F NO ACCESS
1 I FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: aS Date: 7,...Se Phone #: (503) 718- )?
. ., • . -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 3d p 6. 6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 _.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /0/8S SW f CA de- 4 ue CLASS OF WORK: 01 iZ
SUBDIVISION: LOT #: TYPE OF USE: C-oNl
PROJECT NAME: Clear IL) J e,
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
ate,
Corrections /Comments/ Instructions:
A L mac- Q, f ro ,fec) oct vvs
PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ZS Date: /%se.ee Phone #: (503) 718 -,2q2 3