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Permit
CITY OF TIGARD BUILDING PERMIT 74x: COMMUNITY DEVELOPMENT Permit#: BUP2017 00016 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/13/2017 Cal?°� 9 Parcel: 2S102CC01100 Jurisdiction: Tigard Site address: 13680 SW PACIFIC HWY Project: T-Mobile Subdivision: None Lot: None Project Description: Replacing(3)antennas and(1)radio inside cabinet;Adding(3)new TMA's,(3)diplexers,and(2)radios inside cabinet. Contractor: MASTEC NETWORK SOLUTIONS LLC Owner: TIGARD-ORENOMAH LODGE NO.207 OF 16259 SE 130TH AVE, STE 201 PO BOX 230184 CLACKAMAS, OR 97015 TIGARD, OR 97281 PHONE: 503-210-1000 PHONE: FAX: 503-210-1001 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 02/08/2017 $377.90 Demolition Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 02/08/2017 $45.35 Dwelling Units: 0 Plan Review 01/27/2017 $245.64 Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 02/08/2017 $30.00 Bedrooms: 0 Bathrooms: 0 11x17) 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 $698.89 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 ca ing 503.232.1987 or 1.800.332.2344. !"---- ;;;=) ii Issued By: Permittee Signature: ,4Zzet,... C .4175 by 7:00 a.m.for the next available in,pect•n date. This permit card shall be kept in a conspicuous place on the job site u it••mpletion of the project. Approved plans are required on the job site at the time of each inspection. k Building Permit Application Commercial CI Of Tigard REEL g Ø /i Permit No.: /y�13125 SWHall Blvd.,Tigard,OR 9 ,w �,� � Phone: 503.718.2439 Fax: 5 o Date/By: � (.7 Other Permit: 1 1 c n .I) Inspection Line: 503.639.4175 r \ tl �� Date Read Juris. ® See Page 2 for Internet: www.tigard-or.gov 0 e xc Notified/Method:. /7Supplemental Information 1" '' S\04° 6, 04° 0/ 5j TYPE OF ck Ora REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction pu tion Permit fees*are based on the value of the work pe,ormed. Indicate the value(rounded to the nearest doll. of all ®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and t profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ElAccessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors. Job site address:13680 SW Pacific Highway New dwelling are. square feet City/State/ZIP:Tigard,OR 97223 Garage/carpo area: square feet Suite/bldg./apt.no.: Project name:P004037C King City '�_�()h`LiCovere a .orch area: square feet Cross street/directions to job site:SW Pacific Hwy&SW Watkins Ave De, area: square feet I ther structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S102CC01100 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WOR - - work indicated on this application. Replace(3)antennas,add(3)new TMAs,add(3)new diplexers-all will be Valuation: $20,000 located in existing cannister. Ground:Replace(1)radio inside cabinet,add Existing building area: square feet (2)radio inside cabient. New building area: square feet © PROPERTY OWNER t'''''' TENANT Number of stories: Name:Crown Castle-Westlake Union Center Type of construction: Address:1505 West Lake Ave.N,Ste 800 Occupancy groups: City/State/ZIP:Seattle,WA 98109 Existing: Phone:( ) Fax:( ) New: t+< APPLICANT .' CONTACT PERSON BUILDING PERMIT FEES* Business name:T-Mobile c/o Technology Associates EC (please r to fee schedule) Structural plan review fee(or deposit): Contact name:Chelsi Monihan FLS plan review fee(if applicable): Address:7117 SE Beveland Street Suite 101 City/State/ZIP:Tigard,OR 97223 Total fees due upon application: , Usti Phone:(503)593-0282 Fax::( ) Amount received: E-mail:chelsi.monihan@taec.net PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTt38 Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name:TBD �. Submit two(2)sets of roof plan with connection details j?/ and fire department access,along with the 2010 Oregon Address: /6,e 5 Si„; /3f)&A/7, 4514e �/ Solar Installation Specialty Code checklist. City/State/ZIP: V q ,=70,5-- /`" Permit fee(includes plan review $180.00 fele, �i'ri�� (�3)a?/0 ejo /� and administrative fees): Phone: .�/c. Fax: ( ) State surcharge(12%of permit fee): $21.60 CCB lic.: QS Total fee due upon application: $201.60 Authorized signature: i T9404-1--- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: C \23 S\ 1, '0 n.�V)ojy) Date: 1'2 5/� * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BIIP-COM PermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB) 111 Building Division 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] $ 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 PermitApp.doc 03/03/2011 IN e Building Division Plan Submittal Requirements T I G A R D Commercial& Multi-Family-New,Additions or Alterations 1. SITE PLAN (fully dimensional, drawn to scale) labeled with: A. ® map&tax lot# ® project name ® site address ® suite number ® zoning ® applicant name ® phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Setbacks. F. Parking,including disabled access. G. Finished floor elevations. 2. EROSION CONTROL PLANS AND DETAILS. 3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of plans required based on submittal type (no redlines or tape-ons accepted). All details listed below shall be incorporated into the plans: A. Scale (architectural or engineering only). B. Foundation plan. C. Floor plan(s). D. Cross sections. E. Reflective ceiling plan. F. Seismic bracing detail for suspended ceiling. G. Roof plan. H. Exterior elevations. I. Structural calculations,plans, details and specifications. J. Accessibility barrier removal worksheet. K. Deposit-based on valuation of project. 4. EXTRA SET OF THE FOLLOWING: A. Two (2) copies of site plan to include vicinity map. B. One (1) copy of erosion control plan with details. C. Fire Department Building Survey, and full set of architecture drawings. I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011 Building Division Plan Submittal Requirement Matrix T G A R D Commercial& Multi-Family-New,Additions or Alterations Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 3 (must include location of all accessible parking) Plumbing (site utilities) 2 Building 3 Fire Protection System 3 Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington County, and Tualatin Valley Fire &Rescue),if applicable. I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011 Technology Associates January 25, 2016 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 RE: T-Mobile/ P004037C/ King City T-Mobile Wireless Communication Facility Modification Building Permit Submittal Dear Sir/Madam, Please find enclosed the City of Tigard Building Permit Application for the modification of an existing wireless communication facility located at the address of 13680 SW Pacific Hwy., Tigard, OR 97223 for T-Mobile. The following items are included in this submittal package: - Building permit application - Three (3)full sets of 17x11 Building Plans - Three (3) sets of structural calculations Please call the number below and we will pay BP fees with a credit card or check. If there are any specific questions regarding the modification proposal or missing submittal items, please let me know as soon as possible. Thank you. Technology Associates EC, Inc. Chelsi Monihan Real Estate Specialist (503) 593-0282 Email: Chelsi.monihan(ataec.net 7117 SW Beveland Road Suite 101 Tigard, Oregon 97224 www.taec.net