Permit (44) CITY OF TIGARD BUILDING PERMIT
1 . ` COMMUNITY DEVELOPMENT Permit#: BUP2018-00001
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/05/2018
1 ��'�heI g Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9755 SW WASHINGTON SQUARE RD D03
Project: T-Mobile Subdivision: None Lot: None
Project Description: Installing(15)nodes,(1)19"rack and new routers inside existing equipment room.
Contractor: PAJ TELECOM INC Owner: PPR WASHINGTON SQUARE LLC
PO BOX 522 PO BOX 847
GLADSTONE, OR 97027 CARLSBAD, CA 92018
PHONE: PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 01/24/2018 $453.95
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 01/24/2018 $54.47
Dwelling Units: 0 Plan Review 01/08/2018 $295.07
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 01/24/2018 $10.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $25,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $813.49 i
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: e �:.• ,? Permittee Signature: !�
fff
Call 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.
Building Permit Application
Commercial
City of Tigard fiErxs Received
1111 DateB y Permit No.: 0 j`' j f ,.,„T,.,i
M 13125 SW Hall Blvd.,Tigard,OR 9722 a.ef+t— plan R y.rew ' fir"� j"(/�`o` 'l
_ ' Phone: 503-718-2439 Fax: 503-598-1960 =� T►' - Related Permit:
DateBy: l ,
I I G 1 R 1) Inspection Line: 503-639-4175 JAN 8 2 01 it Date Rea �� Juris: B See Page 2 for
Internet: www.tigard-or.gov N 'fied/Method: t / 4 Supplemental Information
C.:ITY Or. h htthj ,.
TYPE OFRISEDING DIVISION REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction 0 Demolition Lt 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.
El1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
175r1� OB SITE INFORMATION AND'LOCATION
Totalnumber of floors:
Job site address:! SW Washington Square Rd New dwelling area: square feet
City/State/ZIP: Portland,OR 97216 Garage/carport area: square feet
Suite/bldg./apt.#: Project name,_ re Covered porch area: square feet
Cross street/directions to job site: 1N,C la 1 Le Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: 1 S 1260000300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OFWORK work indicated on this application.
Install (15)nodes. (1) 19"rack and new routers inside existing Valuation: $ 25,000
equipment room Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:
Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( )
New:
al APPLICANT €f CONTACT PERSON BUILDING PERMIT FEES*
Business name: T-Mobile °x8> °1° acit�d ''
Contact name: Structural plan review fee(or deposit):
Chelsi Monihan — _
Address: 7117 SW Beveland Rd Suite 101 FLS plan review fee(if applicable):
City/State/ZIP: Tigard,OR 97223 Total fees due upon application: d14t7,..l
Phone:(503) 593-0282 Fax::( ) Amount received:
E-mail: chelsi.monihan@taec.net
PHOTOVOLTAIC SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: PAI Telecom Inc.
Address: and fire department access,along with the 2010 Oregon
PO BOX 522 Solar Installation Specialty Code checklist.
City/State/ZIP: Gladstone,OR 97027 . Permit fee(includes plan review $180.00
Phone:
( 503)481-1669 Fax:( ) and administrative fees):
State surcharge(12%of permit fee): $21.60
CCB Lic.: 211132
Total fee due upon application: $201.60
I i
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Print name:Chelsi Monihan Date: 1-5-18
Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(I 1/02/COM/WEB)