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Permit (55) CITY OF TIGARD BUILDING PERMIT 2'' COMMUNITY DEVELOPMENT Permit#: BUP2018-00314 i [GARD RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued; 11/29/2018 Parcel: 2S102CC01100 Jurisdiction: Tigard Site address: 13680 SW PACIFIC HWY Project: Tigard-Orenomah Lodge 207 Subdivision: None Lot: None Project Description: Replace antenna canisters with tower extension at the same height at existing facility. Upgrade T-Mobile antenna facility: replace(3)antennas,add(3)additional antennas,replace(1)support cabinet. Contractor: EXCEL CONSTRUCTION INC Owner: TIGARD-ORENOMAH LODGE NO.207 OF 35858 N HONEYMAN RD PO BOX 230184 SCAPPOOSE, OR 97056 TIGARD, OR 97281 PHONE: 503-944-9817 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 11/29/2018 $804.75 Demolition OccupancyGrp: U OccupancyLoad: 0 12%State Surcharge-Building 11/29/2018 $96.57 Dwelling Units: 0 Plan Review 11/13/2018 $523.09 Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 11/29/2018 $14.00 Bedrooms: 0 Bathrooms: 0 11x17) Value: $60,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,438.41 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• the rulertrit.direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Lid C.50 .•39.4175 by 7:00 a.m.for the next available inspe ti• date. This permit card shall be kept in a conspicuous place on the job site unti .•mpletion oft e project. Approved plans are required on the job site at the time of each inspection. •Building Permit Applicata Commercial �� Q(; FOR orrlcl. 1s1�,()NEN City of Tigard NOV li Date/By, f �/�. Permit No �G�,�/} �E/ Plan //,f `r Js C7 T [v 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 99y I Phone: 503.718.2439 Fax: 503.59#:19t(1"., .a';° t $ g..-8,' f DateBy: /g f Other Permit: T I GA R D Inspection Line: 503.639.4175 Date Ready/By. �/ Jurs: PI See Page 2 for Internet: www.tigard-or.gov rp, p a $ , 1, ;. tifiedimethod ((hip-- ,� Supplemental Information TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING ❑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 CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: 13 6 ted JOB sn-E INFORMATION AND LOCATION Total number of floors: Job site addresJ. 38913W Pacific Highway New dwelling area: square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other 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.:25-1-02CC-01100-001 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK" work indicated on this application. Replace antenna canisters with a tower extension,which will be the same height Valuation: $60,000.00 as the existing facility. Upgrade T-Mobile's antenna facility:Replace(3) Existing building area: square feet antennas,add(3)additional antennas,replace(1)support cabinet. New building area: square feet r. ill PROPERTY OWNER 0 TENANT Number of stories: Name:TIGARD-ORENOMAH LODGE 207 Type of construction: Address:PO BOX 230184 Occupancy groups: City/State/ZIP:TIGARD OR 97281 Existing: Phone:( ) Fax:( ) New: ®; APPLICANT E',....4 CONTACT PERSON BUILDING PERMIT FEES* Business name:Crown Castle(Tower Owner) (Please rejerwjeeschedule) Structural plan review fee(or deposit): .52'. C)1 Contact name:Zach Phillips FLS plan review fee(if applicable): Address:5111 N.Bowdoin St. City/State/ZIP:Portlands,OR 97203 Total fees due upon application: Phone:(503)708-9200 Fax::( ) Amount received: -...S--;-;)... •L>J' E-mail:zach.phillips.contractor@crowncastle.com PHOTOVOLTAIC SOLAR PANEL SYSTEMFEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name:TBD two(2)sets of roof plan with connection details �� �►Gfi' and fire department access,along with the 2010 Oregon Address: �j n ```��� �.4" ,,,,.".0.,f �L 1.riii Solar Installation Specialty Code checklist. City/State/ZIP: S�.(1� s s1, `\► 10o Permit fee(includes plan review ty �"�' 7 and administrative fees): $180.00 Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lac.: /40L4 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Zach Phillip Date:8.23.18 * 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) IN ° 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] $ 60,000 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 III Building Division Plan Submittal Requirements TI 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 /1 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 1 Building Division Plan Submittal Requirement Matrix TI G A R D Commercial&Multi-Family-New,Additions or Alterations Type of Submittal #of pians (Includes new,additions and alterations.) Required at Submittal 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 PennitApp.doc 03/03/2011 City of Tigard IIv COMMUNITY DEVELOPMENT DEPARTMENT ■ T1cARD Building Permit Review — Commercial - No Land Use Building Permit #: `yg 9/F-ô13(7 Site Address: I ?(Cb 0 S W Pgct 1`L !-W -) wry y Suite/Bldg#: Project Name: T- N10 bile (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: R-e-P I GI Ck- €X i S >1 Y1 GI n}-2,n r) t c 0 n ; 5--1 ey-s ( 3 / ) q d cl:i fi a in 0,--tc•\ r)g S , LI ) S v P p r-I-. C c i ;rI e-(- . Existing Business Activity: n 0 (I1)U y)c.�� Proposed Business Activity: (J AVerify site address/suite#exists and active in permit system. pi River Terrace Neighborhood: ❑ Yes )2 No Zoning: ci a xPermitted Use: "Yes ❑ No ❑ Spec Space E--Eenfirm no land use required. 0 Business License: Exists: ❑ Yes ❑ No,applicant notified to obtain business license Notes: Approved by Planning: M 0 v 1 _ 1 I© Date: ' 1 l 13 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: ////3// F' Site Plans: # :3 Building Plans: # ..3 Building Permit#: ,,6' , Enter building permit#above. Workflow Routing: %Planning ❑ Permit Coordinator uilding Workflow Sign-off: ,Sign-off for Planning(include notes from planning review) Route Application Documents: !Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: 7 75.C.,______., Date: s/.3AF - I:\Building\Forms\BldgPennitRvw_COM_NoLandUse 060 1 16.docx #4Z: Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: t.\\ Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Ape : ant: Revision Notice 2: Date Sent to :. .plicant: Revision Notice 3: Date Sent .. Applicant: ❑ SDC Fees Entered: Was Co Trans Dev Tax: 0 Yes 0 N/A gard Trans SDC: ❑ Yes 0 N/A Parks SDC: 0 Yes ❑ N/A ❑ OK to Issue Pe , it Approved by 'ermit Coordinator: Date: I:\Building\Forms\B1dgPermitRvw_COM NoLandUse_070915.docx City of Tigard r �1 COMMUNITY DEVELOPMENT DEPARTMENT V4�\ 3 3 r'ijlr . r TIGARD Collocation - Supplemental Questionnaire PROPERTY ADDRESS I oR Sr,U I I. ONLY 13680 SW Pacific Highway Location of collocation: �- Name of provider: T-Mobile Zone: C C Zach Phillips with Crown Castle (tower owner) ,Z Approved Contact name: ❑ Not Approved Collocating antennas on: By: 01 Date: 11/ (S f f ES Existing tower Reason not approved: ❑ Existing non-tower structure Is this a new provider? 0 Yes El No Other providers currently collocating on same tower or structure: L\Community Development\Land Use Applications\02_Forms and Templates\Land Use Applications\Future Forms Rev.12/14/2017 Sprint and T-Mobile are the carriers on the tower. BUP2013-00156 Indicate the previous approval: (SDR,MMD#) ANTENNA INFORMATION Existing: New: 96"centerline 96"centerline Height of antenna(s): (sq. ft.) Height of antenna(s): (sq. ft) Color of antenna(s): Standard white Standard white Color of antenna(s): Color of equipment: Gray Color of equipment: Gray Accommodating equipment: Hybrid cable/RRUs Accommodating equipment: Hybrid cables/RRUs/antenna mount (i.e.dishes) (i.e.dishes) Will new accessory equipment be installed? !1 Yes ❑No Location of new accessory equipment? Il Within previously approved fenced area ❑ Within existing structure ❑ Other location: (Please describe) Will landscaping be removed to accommodate the accessory equipment? ❑ Yes I7 No If yes, describe here: !i/7/i& App,icant's signature Print name V Date City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of 1