Permit �� CITY OF TIGARD BUILDING PERMIT
``��1 11.: COMMUNITY DEVELOPMENT Permit#: BUP2016-00060
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/08/2016
Parcel: 2S102AD03450
Jurisdiction: Tigard
Site address: 8777 SW BURNHAM ST
Project: AT&T-Downtown Tigard Subdivision: None Lot: None
Project Description: Remove and replace(3)panel antennas,install(3)RRH units on existing tower,and remove(1)GSM cabinet
inside shelter.
Contractor: VELOCITEL INC Owner: TIGARD, CITY OF
4004 KRUSE WAY PL, SUITE 220 13125 SW HALL BLVD
LAKE OSWEGO, OR 97035 TIGARD, OR 97223
PHONE: 503-636-2500 PHONE:
FAX: 503-636-2501
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 02/22/2016 $453.95
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 02/22/2016 $54.47
Dwelling Units: 0 Plan Review 02/22/2016 $295.07
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 03/08/2016 $88.00
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-Ping 03/08/2016 $88.00
Value: $25,000 Info Process/Archiving-Sm$0.50(up to 03/08/2016 $20.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $999.49
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: e71—ef-7—....„...,..-- Permittee Signature:
(� II 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.
7
Builetng Permit Application
Commercial FOR OFFICE I'SE O\I.l
City of Tigard RECEIVED VED Received
•2,Z / ,rf, o
Date/By: �!� t� Permit N ,�2,6—40V4,1,
111111 4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re .
as Phone: 503.718.2439 Fax: 503.598.1960 FEB 2 2 2016 Date/By: �I �1 �`j �,, Other Permit:
T I R D Inspection Line: 503.639.4175 Date Readfylll'y: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: 3 /� I Supplemental Information
BUIWIN( DWI A' ••,
}
TYPE'OF,4WORK i M ---,-,7,,,,- I i I, A ' tri;t it
0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY.OF,CONSTRUCTION work indicated on this application.
1:11-and 2-family dwelling ®Commercial/industrial Valuation: $
0 Accessory building 0 Multi-familyNumber of bedrooms:
ElMaster builder ®Other:Wireless Number of bathrooms:
` JOB SITE INFORMATION`AND LOCATION Total number of floors:
Job site address:8777 SW Burnham Street New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:AT&T-Downtown Tigard Covered porch area: square feet
Cross street/directions to job site:West of Hall Street and east of SW Main Deck area: square feet
street,north side of the street Other structure area: square feet
RE(,UI ED_o1JATA,CORCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S102AD03401 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.
On existing tower: Remove and replace(3)panel antennas,Install(3) Valuation: 0$25,000.00
RRH units. Inside of shelter: Remove(1)GSM cabinet. Existing building area: 325 square feet
New building area: 0 square feet
~'®.PROPERTY OWNER ❑'TENANT Number of stories: I
Name:City of Tigard Type of construction: IIB
Address: 13125 SW Hall Boulevard Occupancy groups:
City/State/ZIP:Tigard,OR 97223
Existing: Unoccupied
Phone:( ) Fax:( ) New: Unoccupied
APPLICANT ` , - 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:FDH Velocitel,Inc.,for AT&T Mobility (PleaserejertojeesrhedukJ
Structural plan review fee(or deposit):
Contact name:Dan Dutton
FLS plan review fee(if applicable):
Address:4004 Kruse Way Place,Suite 220
Total fees due upon application:
City/State/ZIP:Lake Oswego,OR 97035
Amount received: 809.43
Phone:(503)756-3888 Fax: :(503)636-2501
E-mail:Dan.Dutton@FDHVelocitel.com PHOTOVOLTAIC SOLAR SYSTEM FEES*
,,,-/. ev R , Commercial and residential prescriptive installation of
1 ° CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Velocitel,Inc.,Jay Telford Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4004 Kruse Way Place,Suite 220 Solar Installation Specialty Code checklist.
City/State/ZIP:Lake Oswego,OR 97035 Permit fee(includes plan review $180.00
and administrative fees): _
Phone:(503)636-2500 Fax:(503)636-2501 State surcharge(12%of permit fee): $21.60
CCB lic.:200980
Total fee due upon application: $201.60
Authorized signature: c\c4_44,____ 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:2-18-16 * 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)
r
City of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Commercial - No Land Use
TIGARD
Building Permit #: Qii`',2 p/‘ - 000 6 0
Site Address: 89?? `S) £uni S4 Suite/Bldg#:
Project Name: X9'7.4 7--
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: n7ev-e -1 r� ac:Q o^ Pn .2s /1? ? // 3 £&-/ Girl/Ys/
Tein y-e / c5--' 7/4 y:�-71-- f
Existing Business Activity: `{ )j/..el!'s S -7kneymm
Proposed Business Activity: /1 /I i
Verify site address/suite# exists and active in permit sy�s,t .
t• er Terrace Neighborhood: ❑ Yes LIS No
//, oning: RR _
mitted Use: IdAr Yes ❑ No ❑ Spec Space
Cofirm no land use required.
Business License:
Business
Exists: V Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: r Date: /902//(a
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: c.2/2-2//�o
Site Plans: # 3
Building Plans: # 3
Building Permit#: Ga Enter building permit# above.
Workflow Routing: Planning el Permit Coordinator Tuilding
Workflow Sign-off: 0-Sign-off for Planning(include notes from planning review)
Route Application Documents: ,0—Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: 4C2) -c-- Date: .2A2Alifo
1:\Building\Forms\BldgPermit Rvw_COM_N oLandUse_070915.docx
1 7
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes Ms /A
Tigard Trans SDC: ❑ Yes ►: N/A
Parks SDC: ❑ Yes VN/A
OK to Issue Permit
Approved by Permit Coordinator: XDate: -2/2-2/1/46'
I:\Building\Fonns\B IdgPennit Rvw_COM_NoLand Use_070915.docx
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
8777 SW BURNHAM ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2016-00060
Chip Barnett
Violation Summary:
Inspector Contractor