Permit CITY OF TIGARD BUILDING PERMIT
11111 III „ COMMUNITY DEVELOPMENT Permit#: BUP2012 -00189
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Dat I ssue d : 11/19/2012
Parcel: 2S 102CC01100
Jurisdiction: Tigard
Site address: 13680 SW PACIFIC HWY
Project: Clearwire Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Adding (1) antenna and (1) transceiver to existing array.
Contractor: WESTOWER COMMUNICATIONS INC Owner: TIGARD - ORENOMAH LODGE NO.207 OF
405 EVANS BLACK DR PO BOX 230184
TUKWILLA, WA 98188 TIGARD, OR 97281
PHONE: 206 - 373 -1229 PHONE:
FAX
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Other Permit Fee - Additions, Alterations, 11/19/2012 $164 96
• Demolition
Occupancy Grp: U Occupancy Load: 12% State Surcharge - Building 11/19/2012 $19.80
Dwelling Units: 0 Plan Review 10/10/2012 $107.22
Stories: 0 Height: 0 ft Info Process /Archiving - Sm $0.50 (up to 11/19/2012 $2.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $5,500 DC Provision Review, COM TI - Ping 11/19/2012 $67.00
DC Provision Review, COM TI - LRP 11/19/2012 $10.00
Floor Areas:
Total Area 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch. 0
Deck: 0
Garage 0
Mezzanine: 0
Total $371 48
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work wilt
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance. or if work is suspended for more the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 001 -0010 through OAR 9952- 001 -0090. You / m - ay obtain / a copy of the rules or direct questions to OUNC by calling 503 2321987 or 1.800.332.2344
Issued By: ,4 4 f , 1J , IA f /1lr"" Permittee Signature: �1 11-P0.464 ,i �"►►►"' �" CCC C a l l l 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
B Permit Applicati Q t2 - Inf
Co E D FOR OFFICE: I. SF ON
Received
Ci o f T ig ard n r Dace/s !0/ 9.2 Permit No.: pl u �/2 - DD /rj
13125 SW Hall B lvd., Tigard, OR 972481. T 0 9 20 Plan Rev' +) r
g Phone: 503.718. Fax: 503 .5 9 8.1960 Date /s ! I l l i ( Z Ot Permi
I c 1 n Ins Line: 5 03.639.4 17 5 C ITYOFTIG ARD Date Read y: / l ua s: ® See Page 2 for
I w or B DNI Notifed/Method: t �(� (�7 "�� Supplem orm ation
sPD(c�c.. c� roK,� r. L� r3 � � � f
T YP[l: OF ril'�ORiC REQUIRED DA$ I -1 D FAIR .Y
❑ N construction ❑ D emolition Permit fees' are based on the va of the work pe rfo rm ed
Indicate the value (rounded to th nearest dollar) of all
A 2°9°6
Other: equipment, materials, labor, ove and the profit for the .
C A T EGOR Y OF CONSTRUCTION work indicated on this ap
❑ 1- an 2- fami dw el l ing ® Commercial /in dustri Valuation: S
❑ A bu ❑ Multi - family Number of bed
El Master builder ❑ Other: Number of bathroom
JOB SITE INFORMATION AND LOCATION Total number of floors
Job site address: 13680 SW Pacific Highway, New dwelling area: square feet
City/State /ZIP: Tigard, OR 972 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project n O POR065S2.1 Covered porch are square fee
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
R EQUIRED D CHECKLIST
Subdivision: Lo t
al no.: Permit fees' are based on the value of the work en p
Indicate the value (rounded to the nearest dollar) of al l
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WO work indicated on this application.
Adding (1) antenna and (1) transceiver to existing array. Valuation: $$5,500.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name: SAC for Clearwire Wireless Type of construction:
Address: 9801 W. Higgins Road,Ste• 200 Occupancy groups:
City/ State/ZIP: Rosemont, IL 60018 Existing:
Phone: (847)993 -9659 Fax: (847)692 -2856 New:
❑ APPLICANT ®CONTACT PERSON DU]T�DING FF,I,gr
Business name: SAC for Cleawire Wireless QNw.rrr�fr'ar�ir'eAalatr)
Structural plan review fee (or deposit):
Contact name: Tony Phillips
Address: 9801 W. Higgins Road,Ste. 200 FLS plan review fee (if applicable):
City/State/ZIP: Rosemont, IL 60018 Total fees due upon application:
Phone: (847) 993 -9659 Fax:: (847) 692 -2856 Amount received: 107.22
E -mail: ton hilli s PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Y•P clearwire.com
P @
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photovoltaic Solar Panel System.
Business name: WesTower Communications Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 22263 68th Ave S. Solar Installation Specialty Cale chec
City /State /ZIP: Kent, WA 98032 Permit fee (includes plan review
and administrative fees):
Phone: (206) 373 -1229 Fax: ( ) State surcharge (12% of permit fee): �$2kb9
CCB lie-: (.,1 0 41 Total fee due upon application:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Tony Phillips Date: lA / 4 I/y * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -COM PermitApp.doc 02/24/2011 440 4613T( I /02 /COM /WEB)
III o Building Division
Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
j l l
Building Permit No: P P go/ a. -00 / g9 ❑ Expedited Review
Plan Submittal Date: /o /9//9-.
To the Applicant:
If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
> If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Pla ng Review (contact at 503-718- or @tigard or.gov)
In Zonin g �' G1 Permitted Use Yes No ❑
L9' Land Use Required: Yes ❑ No LN" (explain below)
Notes: i /
- A p , , 2- / a ww,
Approved ❑ Not Approved Date: iD 'V --
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov)
Notes: J
/' /
Routed back to Building Division Date:
I: \CURPLN 1
Building Division
0
Accessibility: Barrier Removal Improvement Plan
TIGARD
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] $ 5,500
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 0.00
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be
g P P tY 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 -COi\I Pcrmiu \pp.doc 03 /03/2011
CLEAR
R ECEIVED
OCT 09 ,�.,
October 4, 2012 B CI
City of Tigard UILDINGDIVISION
Planning & Engineering Department
13125 SW Hall Blvd.
Tigard, OR 97223
503- 718 -2421 RECEIVED
OCT 09 2012
RE: Clearwire Upgrade — OR- POR065 —13680 SW Pacific Highway
CTPYOFTIGARD
BUILDING DIVISION
Dear Permitting Official;
SAC Wireless, on behalf of Clearwire, is requesting the necessary approvals to add one (1) additional
Antenna and one (1) additional Radio Transceiver, to the existing Clearwire Wireless Facility at 13680
SW Pacific Highway. Clearwire RF Engineers have determined this modification is required to help
increase the data and call capacity at this existing location.
Clearwire is a division of Sprint. The upgrades will be beneficial to Clear Wireless WiFi and Sprint
customers in the Tigard area by offering faster data transfer speeds and less dropped calls.
Attached please find the following:
Building Permit Application
Collocation Supplemental Questionnaire
3 Sets of drawings
Deposit check of $107.22
We greatly appreciate your help with this proposed Clearwire upgrade. Please let me know if you
have any questions.
Best Regards,
Tony hillips
SAC Wireless for Clearwire
Zoning & Permitting Lead
9801 W. Higgins Suite 200
Rosemont, IL 60018
847 - 993 -9659
tony.phillips @clearwire.com
-- P012-0(9
RECEIVED
SA=P 202012
CITY OF 4
COLLOCATION PLANNING /ENGINE RING
Supplemental Questionnaire
TIGARD Ciyof7igard, 13125SWVF Id/ Bind,Tigrnl,OR 97223
Phone :: 503.718.2421 Fax: 503.598.1960
IF YOU ARE APPLYING FOR A PERMIT TO COLLOCATE ANTENNAS,
PLEASE COMPLETE THE INFORMATION BELOW.
Name of Provider: Clearwire
Property Address /Location of Collocation: 13680 SW Pacific Highway
Zone:
Collocating antennas on: ® Existing tower ❑ Existing non -tower structure
Is this a new provider? ❑ Yes ® No
If yes, list other providers cin7 n/ /y collocating on same tower or s/ruchar, if any:
If no, indicate the previous approval (SDR, MMD or 13UP #): BUP2007 -0040
Height of antenna(s): 65 ft.
Color of antenna(s) and accommodating equipment (i.e. dishes):
.
Grey
Color of existing tower or structure: Grey
Will new accessory equipment be installed? ❑ Yes ® No
if yes, please answer the fallowing
Location of accessory equipment: ❑ Within fenced area previously approved
❑ Within existing structure
❑ Other location (Please describe below.)
Will landscaping be removed to accommodate the accessory equipment?
❑ Yes (Please dest,ibe below.) ® No
ApPlicant's Signature: 11. late: 9/20/2012
Name Printed: Tony Phillips - authorized Representative Phone: 847 - 993 - 9659
FOR OFFICE USE ONLY
N i 01 issue pertpit ❑ l)o not issue permit. Refer to planner.
. Planning Staff S turc Date ___
RECEIVED
NOV 15 2012
CLEAR CITY OFTIGARD
BUILDING DIVISION
November 13, 2012
City of Tigard
Community Development
13125 SW Hall Blvd.
Tigard, OR 97223
Attn: Shirley Treat
RE: Balance Due - Clearwire — OR- POR065 —13680 SW Pacific Highway
Ms. Treat;
Enclosed please find a check for the $264.26 Balance Due on Permit # BUP2012 -00189 per your e -mail
(attached). We greatly appreciate your help with this proposed Clearwire upgrade. Please let me know
if you have any questions.
Be rds, op
Ton illips
SAC Wireless for Clearwire
Zoning & Permitting Lead
9801 W. Higgins Suite 200
Rosemont, IL 60018
847- 993 -9659
tony.phillips@clearwire.com
Tony Phillips(Contractor)
From: Tony Phillips(Contractor)
Sent: Tuesday, November 06, 2012 11:40 AM
To: Tony Phillips(Contractor)
Subject: OR- POR065 Balance Due Verification - Building Permit #BUP2012 -00189
From: Shirley Treat [mailto:shirleyfttigard- or.gov]
Sent: Tuesday, November 06, 2012 10:38 AM
To: Tony Phillips(Contractor)
Subject: Building Permit #BUP2012 -00189
The above mentioned permit, for work being done at 13680 SW Pacific Highway, is ready for pick up. Outstanding fees
are $264.26. If you have any questions, please give me a call at 503 - 718 -2449. Thank you.
Shirley Treat
w Building Permit Technician
• a DIRECT 503- 718 -2449
I( n E I � EMAIL shirley @ tigard- or.gov
WEB www.tigard- or.gov
Cil■ of Tigard I (:OMMI I IWF:VFI.OPMEN
13125 SW Hall Boulevard, Tigard, OR 97223
DISCLAIMER: E -mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E -mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule."
1