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Permit Support Document (16) FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: dZ�-4 / Z r JUN 9 2015 CITY OF TIGARD COMPANY: BUILDING DIVISION PHONE: 5 BY� RE: n, 15i.J �Avle— MMe Address) nmt um er roject name or subdiMion name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: FCopies--1 Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: FOR gfFICF USE ONLY Routed to Permit Technician: Date: (L <--- Initials: Fees Due: Yes o Fee Description: Amount Due: $ Special Instructions: Reprint Permit (per PE): ❑ Yes I ❑No ❑ Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 ,r CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2015-00155 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2016 Parcel: 2S1136000600 Jurisdiction: Tigard Site address: 16580 SW 85TH AVE Project: T-Mobile Subdivision: ROSEWOOD ACRE TRACTS Lot: D Project Description: Replacing(3)existing panel antennas. Contractor: EXCEL CONSTRUCTION INC Owner: BURLINGTON NORTHERN INC 35858 N HONEYMAN RD PROPERTY TAX DEPT SCAPPOOSE, OR 97056 PO BOX 961089 FORT WORTH,TX 76161 PHONE: 503-944-9817 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: llg Permit Fee-Additions,Alterations, 02/04/2016 $377.90 Demolition Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 02/04/2016 $45.35 Dwelling Units: 0 Plan Review 06/01/2015 $245.64 Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 02/04/2016 $10.00 Bedrooms: 0 Bathrooms: 0 11 x17) Value: $20,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $678.89 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: " Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available in Iion date. This permit card shall be kept in a conspicuous place on the job site until completion of a project. Approved plans are required on the job site at the time of each inspection. r _ti BuildinI4 Permit Application Commercial FOR OFFICE USE ONLV City of Tigard Received Date/B : I j Permit No.: 13125 SW Hall Blvd.,Tigard,OR 9722 `'�� , �Plan Review # Phone: 503.718.2439 Fax: 503.59 CE,I �/ Date/B : uOther Permit: Inspection Line: 503.639.4175 Date Ready/ : _ Juris. 0 See Page 2 for 1 ' Internet: www.tigard-or.gov 1 M5 Notified/Method: `p /S Supplemental Information TYPE OF T� �� REQUIRED DATA:1-AND 2-FAMH.Y DWELLING ❑New construction 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: Antenna modi f i cat i0liquipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑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: 16580 SW 85TH AVE. New dwelling area: square feet City/State/ZIP: Tigard OR G Garage/carport area: square feet Suite/bldg./apt.no.: Project name: ai'r &IaE iam—aiid Heri 1 Covered porch area: square feet Cross street/directions to job site: 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. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Remove 3 panel antennas and replace with 3 new Valuation: $ 20, 000 Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: CLEAN WATER SERVICES Type of construction: Address: 2550 SW HILLSBORO HWY. Occupancy groups: City/State/ZIP: Hillsboro 97123 Existing: Phone:( ) Fax f ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Businessname: T-Mobile c/o CascadiaPM leasereerto feeschedu/e Structural plan review fee(or deposit): Contact name: Noah Gl:'OdZin Address: 5 5 O 1 NE 109TH Court Suite A2 FLS plan review fee(if applicable): City/State/ZIP: Vancouver WA 98662 Total fees due upon application: Phone:(9 71) 285-6645 Amount received:Fax::( ) E-mail: noah.grodzin@cascadiapm. com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photovoltaic Solar Panel System. Business name: Out to bid L-X6'rl e©A,yam v Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Sef 8 `(/ Solar Installation Specialty Code checklist. Permit fee(includes plan review City/State/ZIP: C „ /z �OS and administrative fees): $180.00 Phone:(SO ) — / Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 6 -21,2(f/ Total fee due upon application: $201.60 Authorized signature: \ '� ---- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Noah Grodz i n Date: 5/2 7 2 015 * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 16580 SW 85TH AVE, TIGARD, OR, 97224 Commercial - Building 299 Final inspection PASS - No C of O BUP2015-00155 Jeff Grove Violation Summary: Inspector Contractor