Permit (111) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2018-00241
"77
3111:'-
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2018
f'cl� Parcel: 1 S136AD06300
Jurisdiction: Tigard
Site address: 10955 SW 65TH AVE
Project: AT&T Subdivision: None Lot: None
Project Description: Replacing(5)antennas,removing(2)antennas,adding(6)radioheads,removing(4)amplifiers,adding(1)surge
protector with feeders,and adding radiohead mounts to existing cell tower.
Contractor: VELOCITEL INC Owner: PORTLAND GENERAL ELECTRIC COMPAN
4004 KRUSE WAY PL, SUITE 220 121 SW SALMON ST
LAKE OSWEGO, OR 97035 PORTLAND, OR 97204
PHONE: 503-636-2500 PHONE: 206-336-7414
FAX: 503-636-2501
FEES
Specifics:
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIA Permit Fee-Additions,Alterations, 10/09/2018 $453.95
Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 10/09/2018 $54.47
Dwelling Units: 0 Plan Review 08/30/2018 $295.07
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 10/09/2018 $18.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $25,000 DC Provision Review,COM TI-Ping 10/09/2018 $98.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $919.99
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 - other applicable law. 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 i ore he 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility No' - 'on Cente Those rules - - set forth OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC .• callin. • 232.198 or 1.:44.3 . 4�
Issued By: Permittee Signature: 1 I I I —'�,%l, ,, '
.0' Apr A - .i
.0' ll 503.639.4175 by 7:00 a.m.for the next available i -.actio• ,. ce`— W
This permit card shall be kept in a conspicuous place on the job site until c.,. pletion of the proje . `,�►j
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial FOR OFFICE USE ONLY
City of TigardDateBan Reed e) '
/ o (1 1 PermitN:.0pz "�� /
L/
111 13125 SW Hall Blvd.,Tigard,OR 97223 Au r' n q 3 PlYview
Phone: 503.718.2439 Fax: 503.598.1960 `l `�
Date/By: I 'b-
Other Permit:
Inspection Line: 503.639.4175Date Jus
See Page 2 forTIGnKu Internet: www.tigard-orgov otified/Metho G /
Supplemental Information
a a s a Baa a l
0 New construction 0 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
;® ...
A work indicated on this application.
❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ®Other:Cell Tower Number of bathrooms:
t o>>' ; ► 1+ g Total number of floors:
Job site address:10955 SW 65th Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:PT87 Tigard NE FN 5C . l T.
Covered porch area: square feet
Cross street/directions to job site:99W to SW 65th Ave,north to site Deck area: square feet
Other structure area: square feet
." ® a Ja= a a a aIa a
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 15138AD06300 Indicate the value(rounded to the nearest dollar)of all
, equipment,a i t,a o ', ' work ndica indicated this lapplication.ead,and the profit ofit for the
SWAP OUT(5)ANTENNAS,REMOVE(2)ANTENNAS,ADD(6)RADIOHEADS, Valuation: $$25,000.00
REMOVE(4)AMPLIFIERS,ADD(1)SURGE PROTECTOR WITH FEEDERS,AND Existing building area: N/A square feet
NEW RADIOHEAD MOUNTS TO EXISTING CELL TOWER New building area: square feet
' 1 s ` ' ►I > 010 Number of stories:
Name:Crown Castle Type of construction: IIB
Address:1505 Westlake Ave N#800 Occupancy groups:
City/State/ZIP:Seattle,WA 98109 Existing: U
Phone:(206)336-7414 Fax:
New:
Business name:Velocitel,LLC
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:(971)303-1568 Fax::( )
Amount received:
E-mail:NErlund@Velocitel.com ,,,. OL � r ! 3 .".•
® °0 Commercial and residential prescriptive installation of
i ;;I: ," 3 ,. .,_ ,.Ot44.1 roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Velocitel,LLC 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.
City/State/ZIP:Lake Oswego,OR 97035 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(971)303-1568 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:218854
�' ff Total fee due upon application: $201.60
Authorized signature: 7"":/ y- ) This permit application expires if a permit is not obtained
f44[ within 180 days after it has been accepted as complete.
Print name:Natalie Erlund Date:8/22/18 * 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)
City of Tigard
1111 111
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
r.
Building Permit #: /' u;20/ ir-a , f1
Site Address: (09SS SL/ 6S-5 4-40. Suite/Bldg#:
Project Name: AT&
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: rt..aP cs)
ant ln&i ruutt tiva aIl (I) P4
44 rt-"O' Cci)
d CI Sv cAclJ ,�% AL.. t MC/ Q,�
Existing Business Activity: Vic rd(,(1 Coow-VA;(0if iCi r;i'y (` 4wV•
Proposed Business Activity:
Eitrify site address/suite# exists and active in permit system.st
ver Terrace Neighborhood: 111 Yes 121 No
R^ g
�oning:
Ltd
ermitted Use: Yes ❑ No ❑ Spec Space
LuJ Confirm no land use required.
Business License:
Exists: El Yes El No,applicant notified to obtain,Jbusiness license
Notes: TQC 18.1S0,030,A - Sys 4 01' 13 f r ur Cf-GM `‘ [ Vs{
Approved by Planning: jf4bbtLL Date: 3- 3O i '
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: 5700/7r
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning 7E Permit Coordinator -Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: 12f Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: A4 /'" Date: ?/,?()///1--
I:\Building\Forms\BldgPermitRvw COM_NoLandUse_060116.docx
Permit Coordinator Review
Cl 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:
ySDC Fees Entered: Wash Co Trans Dev Tax: CIYes '! /A
I/ Tigard Trans SDC: ❑ Yes lig: N/A
Parks SDC: ❑ Yes N/A
ZrjbK to Issue Permit
Approved by Permit Coordinator: /7"krIc-ate: //5/121—
./ 12
I:\Building\Forms\B1dgPermitRvw_COM NoLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10955 SW 65TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2018-00241
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor