Permit CITY OF TIGARD BUILDING PERMIT
■ ' COMMUNITY DEVELOPMENT Permit#: BUP2018-00225
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/29/2018
TIGARD g Parcel: 1 S135BB00100
Jurisdiction: Tigard
Site address: 10185 SW CASCADE AVE
Project: T-Mobile Subdivision: None Lot: None
Project Description: Replacing(3)panel antennas and(3)RRU's on existing monopole;Installing FCOA equipment on existing
concrete pad at ground level.
Contractor: NORTH SKY COMMUNICATIONS LLC Owner: SUBURBAN PROPANE LP
11818 SE MILL PLAIN BLVD SUITE 410 ATTN: CARL J REMMES
VANCOUVER, OR 98684 240 RT 10 W
WHIPPANY, NJ 07981
PHONE: 360-254-6920 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VA Permit Fee-Additions,Alterations, 08/28/2018 $377.90
Demolition
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Building 08/28/2018 $45.35
Dwelling Units: 0 Plan Review 08/06/2018 $245.64
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 08/28/2018 $11.00
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 $679.89
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.
"4Issued By: .Gi • j
Or Permittee Signature: Sr' T (-ell
y�4
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. `%I'/ [—
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 CFIVEI) FOR OFFICE USE ONLY
a EEiewn/ '
rPermitNo.:ilig .'� 13125 SWHall Blvd,Tigard,OR 97223 f�t� ` P � �� �
Phone: 503.718.2439 Fax: 503.598.1960irLbRD DateBy: $ g IIs* ,,,)
Oth
er Permit:
I 1 G A R II Inspection Line: 503.639.4175 C1'[\ aa)r - Date Ready/By: Juris td See Page 2 for
Internet: www.tigard-or.gov t �, y O'i otified/Method: 6 /1 ellrif Supplemental Information
=/,..rr,: / PE r 4 e/ r /r`/'y r - 1:',107.6164484. 01,e"(. ' l LING'; ,
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❑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% /- , // //rte rr/ // rf /rear/ work indicated on this application.
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<, ,� of/�,,. r �r//r„/r� .',�� fr a�,� rr.f r�r% �' Valuation: $
❑ 1-and 2-family dwelling A Commercial/industrial
ElAccessory building LIMulti-familyNumber of bedrooms:
1=1 Master builder 1=1 Other:
Number of bathrooms:
rr�r / rr r i,. iY//1/J %r r7//////.0R {r' rf/4.,,,,,,(7///////, /.,
rF� 9 E,,M,/ �� �, Total number of floors:
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Job site address t i SW Cascade Blvd New dwelling area: square feet
City/State/ZIP: Tigard,OR 97008 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:T-Mobile PO01339B Tigard Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
r/sr //,,,,P'/% 1//)/J/ r” 1AL LI/ /fi f 6/?f.
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Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1 S 1-3566-003000 001 Indicate the value(rounded to the nearest dollar)of all
r/.' �,// �/i/r/r / / // f r�r� equipment,materials,labor,overhead,and the profit for the
i"i`'f , �' ESCI2, ( i /// / work indicated on this application.
,'r"r'rJri1ri/� "ga" :,,,.‘01/4,7,/ ,,,,,/fi „<F ff f".„/,,' ,'/,?' ,'"1.4",.,,�/'frr.//iy,..�,".r .;:.V ,,
replacing(3)panel antennas and(3)RRUs on an existing monopole;installing(1) Valuation: $20,000
new FCOA equipment on existing concrete pad at ground level. Existing building area: K,'/N. square feet
New building area: ti i A square feet
r GPERY Qy/r1rir74� %"% rrrTEANfi %
Number of stores:
/ f o ( ,rr', , " , ❑, N ,s, � � 'A
Name: Portland General Electric Type of construction:
Address: 121 SW Salmon Street Occupancy groups: V
City/State/ZIP: Portland,OR 97204
Existing: \)
Phone:( ) Fax ( ) New: U
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Business name:
Crown Castle on behalf of T-Mobile '/. 6, r//p' ie algia,C/dae%"%° Frf' ""r '
Structural plan review fee(or deposit):
Contact name: Amanda Nations
Address:
1505 Westlake Ave N,Suite 800 FLS plan review fee(if applicable):
City/State/ZIP: Seattle,WA 98109 Total fees due upon application:
Amount received
Phone:(206 ) 336-2889 Fax::( )
„
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E-mail: amanda.nations.contractor@crowncastle.com � .PHi9ia,) A -rrr1a ii� �rr
,..„„m,,,..„
� / .„ rfa,�p� / ,,,.. / ,, r,,,,,,,,,„//,,,/,,,,,,,,,,, .; ,;, Commercial and residential prescriptive installation of
�// . : gi', fq t /,;jV� a ,, it,r gF,f�
roof-top mounted Photovoltaic Solar Panel System.
Business name: 161, Submit two(2)sets of roof plan with connection details
Nd rfiti �UYvt Ni�N< az d H. c and fire department access,along with the 2010 Oregon
Address: /r li 1 5 2 ,�A i 7/ /0l4 f vV� �/l6 Solar Installation Specialty Code checklist.
City/State/ZIP:` V ���lir �� `��' �i Permit fee(includes plan review $180.00
`�' (N• and administrative fees):
Phone:s(od LL/_ / 427 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:02(.7 . (� 3 [[ /IRA Total fee due upon application: $201.60
Authorized signature: D This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:preipcoAlk N ,f�r:�(�S Date: r VI t 0 * Fee methodology set by Tri-County Building Industry
1�� t Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
~ COMMUNITY DEVELOPMENT DEPARTMENT
11 c A R D Building Permit Review — Commercial - No Land Use
,a_
Building Permit #: „05Z4,0,2 U%r e o
Site Address: _ /O/g ----- C- 61/1-/;-/ Suite/Bldg#:
Project Name: /—/i bi /<____
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Q 4a —'ovniehl�al�j' S ,E�ea.& D jvt �) > , ofi „e__.
/ns)// 1140 .0 rrlssh f' u ,r1�- A /n 4 ,1
Existing Business Activity: &.2/'/,le It �j� - C%//j
Propos Business Activity: A // //
Verify site address/suite#exists and active in permit syste
to er Terrace Neighborhood: ❑ Yes No
TI oning: /IA Z-(
lot rmitted Use: Yes CI No ❑ Spec Space
C irm no land use re wired.
Business License:
Exists: Yes ❑ No,applicant notified to obtain business license
Notes:
iApproved by Planning: � -- —- /,,/ _ Date: g �1
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: /6,//r 4 /'►u'ii
Site Plans: #
Building Plans: #
Building Permit#: M--EtT r building permit t##above.
arming Workflow Routing: Err ming --- mtt Coordinator ig
Workflow Sign-off - for Planning(include notes from planning review)
Route Application Documents: wilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: l
By Permit Technician: Date: �j7/jr
i /
I:\Building\Forms\BldgPennitRvw_COM_NoIandUse_060116.docx
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:
DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ► '/A >
Tigard Trans SDC: ❑ Yes "Of N/A
Parks SDC: ❑ Yes /! N/A
OK to Issue Permit
Approved by Permit Coordinator: Date:
7/9-x/
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10185 SW CASCADE AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2018-00225
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor