Permit (27) pr. CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00091
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/18/2016
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD
Project: AT&T Subdivision: None Lot: None
Project Description: Replacing(6)antennas,adding(9)radioheads,adding(2)surge protectors with feeders,adding(2)3/4"fiber
feeders on existing shrouded monopole. Existing shroud to be replaced with modified shroud. Monopole location
is between Dicks and Macy's Furniture off of Blum Rd.
Contractor: VELOCITEL INC Owner: PPR WASHINGTON SQUARE LLC
4004 KRUSE WAY PL, SUITE 220 PO BOX 847
LAKE OSWEGO, OR 97035 CARLSBAD, CA 92018
PHONE: 503-636-2500 PHONE:
FAX: 503-636-2501
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: Permit Fee-Additions,Alterations, 04/18/2016 $729.45
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 04/18/2016 $87.53
Dwelling Units: 0 Plan Review 03/28/2016 $474.14
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 04/18/2016 $25.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $50,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,316.12
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 Notifica Center. Those rules - set forth in OAR
952-001-001 ough O•' 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by callin. 03.232.1987 or 1.800.
•
Issued /
, Permittee Signature:
y� � -,L � � 9
-� -
Call 503.639.4175 by 7:00 a.m,for the next available inspection date. NM'
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.
e.
Building Permit Application
Commercial FOR OFFICE USE 01'1..1
City of Tigard i te/By: 3 Arho Permit No.: Q L,at%. q
1312 SW Hall Blvd.,Tigard,OR Y7223 ^,1 plan Re / �
Phone: 503.718.2439 Fax: 503.598.196 R �� Date/By: `i' k'.DUCm. Other Permit:
Inspection Line: 503.639.4175 � �4 �� Date Rea. Juns. El See Page 2 for
�cnlzt�
Internet: www.tigard-or.gov a 'A ��� Notified/Method: 7 /4/ tI Supplemental Information
--mak �.l
� �t�l�'. ---
❑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
7.771 r =. 1 , work indicated on this application.
t .-�.. ,a .>.: _ F - - Iili ----
❑ Valuation: $
1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building ElMulti-familyNumber of bedrooms:
❑Master builder ®Other:Cell Tower Number of bathrooms:
" r ''Y r Total number of floors:
Job site address:9585 SW Washington Square Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project nam . on quare Ort Covered porch area: square feet
Cross street/directions to job site:OR-217 to exit#5/Greenburg Rd.North on Deck area: square feet
Greenburg Rd,left on SW Washington Square Rd Other structure area: square feet
�i�x E� sft ) q�N+ ryJ�l � j✓
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1S1260000300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
Swap out(6)panel antennas,add(9)radioheads,add(2)surge protectors with Valuation: $50,000.00
feeders,Add(2)3/4"Fiber Feeders on existing shrouded monopole. Existing building area: N/A square feet
• Existing shroud to be replaced with modified shroud New building area: square feet
i` s" rr -: Number of stories:
Name:ESS VRS Type of construction: IIB
Address:2795 E Cottonwood Pkwy,Suite 400 Occupancy groups:
City/State/ZIP:Salt Lake City,UT 94121 Existing: U
Phone:( ) Fax:( ) New: U
S �.'-
44440. :
�1 ,za Clleiil 31'c��ti,d^l51u r�'--
-4bs.M' -.� ,��-:- � r t
Business name:FDH Velocitel,Inc
Structural plan review fee(or deposit):
Contact name:Natalie Erlund
FLS plan review fee(if applicable):
Address:4004 Kruse Way Place#220
Total fees due upon application:
City/State/ZIP:Lake Oswego,OR 97035
Phone:(503)539-9247 Fax::( ) Amount received:
E-mail:Natalie.Erlund@FDHVelocitel.com
. s ®,� .., �y . ; Commercial and residential prescriptive installation of
47. ��z . �® v.t ,5 ;n.i'•s;+ Y:50- : , roof-top mounted Photo Voltaic Solar Panel System.
Business name:FDH Velocitel,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4004 Kruse way Place#220 Solar Installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP:Lake Oswego,OR 97035 and administrative fees): $180.00
Phone:(503)349-2149 Fax:( ) State surcharge(12%of permit fee): $21.60 .
CCB lic.:200980 Total fee due upon application: $201.60
Authorized signature: / #1 / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Natalie Erlund Date:3/28/16 * 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)
v .
City of Tigard
i 111
COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: 3(,fPP6/G—(c9
Site Address: ci'SS S') lo, g ,e4eSuite/Bldg#:
Project Name: ,4r t T J
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review // �f G�
Proposal: S .� o ici- 6' "Q 'Z1L2.0 �"�L �1a-c- ( 7 /-(1.2‘31M ki- /
•
/ o? S l/ �t?yDler'
Existing Business Activity: ��P.SS Qn711g1 . 12,4.1
sed Business Activity:
Prop // /1
C
Verify site address/suite# exists and active in permit syste //
i -er Terrace Neighborhood: ❑ Yes IIQ No
/Zoning:
"ermitted Use: Yes ❑ No ❑ Spec Space
C nfirm no land use required.
Business License:
Exists: Yes ❑ No,applicant notified to obtain business license
Notes: Ak S'/ /' //7 C /h Y/ i rcn�-
Approved by Planning: 40""3"-- ��s2:4,
Date: �/02040
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: ?P`61/6
Site Plans: # 4
Building Plans: # 'j
Building Permit#: building
,��p,ermmi�it��#above.
Workflow Routing: ling L'�Permit Coordinator ®"8uifding
Workflow Sign-off: tgn-off for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: e--------'' Date: 00(/
I:\Building\Forms\BIdgPermitRvw COM NoLandUsc 0709I5.docx
v
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:
7
DC Fees Entered: Wash Co Trans Dev Tax: El Yes �—�/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ YesJ/A
;K:eK to Issue Permit �Approved by Permit Coordinator: n// 3 /w
I:Building Forms,BIdgPennitRvw_COM_NoLandUse_0709I5.docx
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
1114 Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.p'v
TO: ii, DATE IICEJ D: ,
DEPT: BUILDING DIVISION
JI i._ 2 ' ?Li61
FROM: Natalie Erlund
COMPANY: FDH Velocitel
PHONE: 503-539-9247 By:ij
RE: 9585 SW Washington Square Rd BUP2016-00091
(Site Address) (Permit Number)
PW11 Washington Square
(Project name or subdivision name and lot num. r)
1
ATTACHED ARE THE FOLLOWING ITE
.�
,Copies Description .' optes . Descriptiala:
3 Additional set(s) of plans.
U ,4 V Revisions:
Cross section(s) and details. A111 Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
2 Other(explain): Antenn, shroud modification design and passing structural analysis
REMARKS: The existing ante rd a shroud was found to be too short to accommodate the proposed
antennas. Drawings originally d bmitted for building permit did include enlarging the shroud - this revisic
enlarges it further(in length, ► t not in diameter)
u „ =TO OF ICE'USE:ONLY ' .
Routed to Permit Tee,' ician• ate: e ,, (c, Initial ;.
Fees Due: ❑ Yes [ o Fee Description: Amo In sue:
$
$
$
Special
Instructions:
Reprint Permit(per PE): I 1 Yes n No I I Done
Applicant Notified: -J /,r Date: ,'//i//U, Initials: Q'.
I:\Building\Forms\TransmittalLetter-Revisions.doe 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9585 SW WASHINGTON SQUARE RD, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Building BUP2016-00091
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor