Permit a „ CITY OF TIGARD BUILDING PERMIT
PERMIT : BUP2008 -00051
COMMUNITY DEVELOPMENT DATE ISSUED: 3/6/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134DC-00600
SITE ADDRESS: 11355 SW TIGARD ST ZONING: R - 4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: VERIZON WIRELESS
Project Description: Concrete pad for backup generator.
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: UNK TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: 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: $ 15,000.00
Owner: Contractor:
ANDERSON, LARRY R AND TECHNOLOGY ASSOCIATES INTL. CORP.
CYNTHIA M 6 SW. CENTER POINT DR #420
11355 SW TIGARD ST LAKE OSWEGO, OR 97035
TIGARD, OR 97223
Phone:
Contact #: PRI 503 - 549 -0001
Reg #: LIC 172067
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 12% State Surch 2/20/2008 $18.65
IBUPPLN] Pln Rv 2/20/2008 $101.04
[BUILD] Permit Fee 2/20/2008 $155.55
Total $275.24
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 B y��Li.i __ A A l� 411111 ' Permittee Signaturelli ` 1,�
Call 503.639.4175 by 7:00 a.m. for an inspection th. •usiness day.
This permit card shall be kept in a conspicuous place on the job , ite until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Pots 1( <c(.3 76 ,
, Building Permit Application
� Commercial REQE VER' FOR OFFICE USE ONLY
City of Tigard - _B ` ® 2008 et / O d g Permit No . J/
. q DateB Received v'
13125 SW Hall Blvd ,Tigard, OR 97223 ^ Plan Re . IMF, C Phone: 503.639.4171 Fax 503 598.1601Y Oi' WARD Date /B i/'/` ��j
'f� 2 Other Permit
T 1 G n R D Inspection Line 503.639 gUILD11vC ®IUISIO` I Date Ready/by V Jun ® See Page 2 for Internet www tigard -or gov Notified/Method• �� j d� y ,� 6 , / 7 . ce supplemental Information
LI/r i,v % Ut CC1 V 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
dition/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 ommercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION . Total number of floors:
Job site address: I ` �sS 5 - lit) — ri 9 4 �/ D ., - New dwelling area: square feet
City /State /ZIP: 7-94,,,e4 0 9- 9 2-13 Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: 'PO Pc,U Covered porch area: square feet
Cross street/directions to job site: 5, 6 , 1 /1 0 , A , Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
���� Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: L
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK 1 work indicated on this application.
- 3,„ 10 T2. -w .I I 1 - a <° 1. "44/Gj $«w u -, CA t • Valuation: $
�(�_ �� /\
6 ✓ ,/ Existing building area: �sgquare feet
New building area: square feet
PROPERTY OWNER ❑ TENANT - Number of stories:
Name: A v Li e '/` . / ( t � S V Type of construction:
Address: l l 7 1K " S 1 LJ. — 1;7 3 Ai e l T) v` Occupancy groups:
City /State /ZIP: Ty v d , bit 9 -).,z,3 Existing:
Phone: () Fax: ( ) New:
• ,t12 PPLICANT ❑ CONTACT PERSON • NOTICE
Business name: .-1-3. . � / l
5 6c, am J ( d All contractors and subcontractors are required to be
Contact name I licensed with the Oregon Construction Contractors Board
'I"'-..vi under ORS 701 and may be required to be licensed in the
Address: _ 5 , 1.J _ �,' .— p p „ (,....41) J •i I-124 jurisdiction in which work is being performed. If the
City /State /ZIP: VS 6� C 3 applicant is exempt from licensing, the following reasons
y a apply:
Phone: (6 5 k — OOo1, .1 c ( Fax::(
)
E -mail: Wv�e -ae1 - 1,..e71- 44 i i e I /t
CONTRACTOR ! `� /�
•
•mousiness name: E1") /TA-T-K BUILDING PERMIT FEES*
Address: �- S,( i , C _,^'{z;� ;)-1_,14.)4v ' -�� (Please refer rojeeschedule) 1 p a Structural plan review fee (or deposit):
City /State /ZIP: 1...,„1 O a
� V " plan review fee (if applicable):
6 J _
Phone: ( Fax:
CCB lic.: I "-2...C-i= Total fees due upon application: 47,5: ail
- -- Amount received: )..7,^
Authorized signature: This permit application expires if a pe it is not obtaine
within 180 days after it has been accepted as complete.
*---
Print name: _ Date: DL '2/4/52. * Fee methodology set by Tn -County Budding Industry
Service Board.
I• \Building\Permits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(I 1 /02 /COM/WEB)
V
-- — it
Building,Division
Accessibility: Barrier Removallinprovement Plan
T IGARD
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 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 PerrrutApp doe 10/30/07
/-0/z — rt c't N
COLLOCATION
Supplemental Questionnaire RECEIVE
T I G A R D Ct of Tigard, 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 FEB 2 0 20(J
IF YOU ARE APPLYING FOR A PERMIT TO COLLOCATE CITY� tl(� �.��
PLEASE COMPLETE THE INFORMATION BELOW.
y t, Ih�
Name of Provider: y r
Property Address /Location of Collocation: '1 7 z).-5
Zone: "j%' 'f -
, &` Collocating antennas on: n Existing tower 0 Existing non -tower structure
Is this a new provider? ❑ Yes ❑ No
Ifyes, list other providers currently collocating on same tower or structure, if any:
If no, indicate the previous approval (SDR, MMD or BUP#):
\J / Height of antenna(s): ft.
Color of antenna(s) and accommodating equipment (i.e. dishes):
Color of existing tower or structure:
j � Will new accessory equipment be installed? ' - -Yes ❑ No
T _ Ifyes, please answer the following: Li
Location of accessory equipment: a i c,—e uc� TO 2
q p [ Within fenced area previously approved
n Within existing structure
❑ Other location (Please describe below.)
Will landscaping be removed to accommodate the accessory equipment?
❑ Yes (Please describe below.) 6 No
r
� / / /
�
Applicant's Signature:
At, t y 7 ;1 -
Date: l z - ( ) 1
•
f
_,��,� �riY� � - �7 •.� �-L� Phone: �G-'� '' '' -" ( �
Name Printed: =
c ur S 1 .,_2 :0 y,R' I•j �� ..i�''{ rr® ; O at Q'�� e.: .'." r Fi'1 J Y W w , �••- >y@l°�.0 �<,.^�..,
permit. rmit.
i_� ❑ Do not issue permit. Refer to planner.
/-:-4,4,,,...,2',::: : -z, - ---' ' - /9 - 7
Planning Staff Signature Date
I \CURPLN \ Masters \Collocate.'\ntennas doc
CITY OF TIGARD �'
BUILDING DIVISION PERMIT #: F3UP2008- 00051
13125 SW Hall Blvd., Tigard, OR 97223 i DATE ISSUED: 3/6/2008
Phone: (503) 639 -4171 �°"°� l j o -f3
Inspection Requests (24 Hrs.): (503) 639 -4175 '"I.. . ,
INSPECTION WORKSHEET FOR DATE: 7/14/2008 TIME: 7:00AM PAGE: 35
SITE ADDRESS: 11355 SW TIGARD ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: . VERIZON WIRELESS
DESCRIPTION: Concrete pad for backup generator.
OWNER: ANDERSON, LARRY R AND, PHONE #:
CONTRACTOR: TECHNOLOGY ASSOCIATES INTL. CORP. PHONE #: 503- 549 -0001
Inspection Request Scheduled For: Date: 711412008 ii),! Pour Time: 12:0
Code # Inspection Description Confirm # Contact # Mes -ge
2 i0 F,oun walls 072559 -01 503.849 -3992 Y
. f
Corrections /Comment Instr ons:
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Afal : ( I -• %Ai . °'/K 5. t3.c.) --- 4-1) eir 1 ST 0A5 44 .
4/ CGC 0 )-4Po(9-- oa33S w s
• I _pr-Av,......
S ❑ PARTIAL APPROVAL El `
PAS ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
V ,.. cy -- c, In spector: i Date: -- 2A �" Phone #: (503) 718 - Z