Permit (4) ,� CITY OF TIGARD BUILDING PERMIT
I ' COMMUNITY DEVELOPMENT Permit#: BUP2019-00287
Date Issued: 10/24/2019
TR;G 1 R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD
Project: AT&T Subdivision: None Lot: None
Project Description: Replacing(3)radios(RRH),(1)DC cable,and(1)power cabinet,Adding(3)diplexers,(3)SDAR remotes,(1)CD
cable,and(1)FLX21 cabinet.
Contractor: CROWN CASTLE USA INC Owner: PPR WASHINGTON SQUARE LLC
1220 AUGUSTA DRIVE SUITE 600 PO BOX 847
HOUSTON, TX 77057 CARLSBAD, CA 92018
PHONE: 724-416-2000 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 10/24/2019 $377.90
Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 10/24/2019 $45.35
Dwelling Units: Plan Review 10/14/2019 $245.64
Stories: Height: ft Info Process/Archiving-Sm$0.50(up to 10/24/2019 $12.50
Bedrooms: Bathrooms: 11x17)
Value: $20,000 DC Provision Review,COM TI-Ping 10/24/2019 $102.00
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $783.39
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 '01-0090. ou m tain a copy o 'e' rules direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
dr i'- ;__
Issued By: % ,/ Permittee Signature: J
Call 503.639.4175 by 7:00 a.m.for the next available inspecti. • . __....--k--J
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial FOR OFFICE USE ONLI
City of Tigard RECEIVED nate/By. /v ltr 74ri P . � �5-'0a02-87
IN _ a 13125 SW Hall Blvd.,Tigard,OR 97223 2019 Plan Review
Phone: 503.718.2439 Fax: 503.598.19 C T 1 4 L J Date/By: j Q ) Mitypaq, o v3
Inspection Line: 503.639.4175
F I GARD Date Ready/By: / Iuris: See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD otified/M..: ` / I Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
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 ❑Other: equipment,materials,labor,overhead,and the 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 El Other: Number of bathrooms:
. 30* JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9685•SW Washington Square Rd. [ New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:879570 AT&T 482306 Covered porch area: square feet
Cross street/directions to job site:SW Blum Rd.and SW Palmblad Rd. Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:1 S1260000300/R220106 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
s DESCRIPTION OF WORK work indicated on this application.
Replace(3)radios(RRH),(1)DC cable,and(1)power cabinet.Add(3)dip- Valuation: $$20,000.00
lexers,(3)SDAR remotes,(1)CD cable,and(1)FLX21 cabinet. Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ® TENANT Number of stories:
Name:PPR WASHINGTON SQUARE COM SITE Type of construction:
Address:PO BOX 847 Occupancy groups:
City/State/ZIP:CARLSBAD CA 92018-0847 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES*
Business name:Crown Castle (Please refer to fee schedule
Structural plan review fee(or deposit):
Contact name:Zach Phillips
FLS plan review fee(if applicable):
Address:5111 N.Bowdoin St.
City/State/ZIP:Portland,OR 97203 Total fees due upon application:
Phone:(503)708-9200 Fax::( ) Amount received:
E-mail:zach.phillips@crowncastle.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Crown Castle Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:203500 Total fee due upon application: $201.60
Authorized signature: /I r Win. 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:10/10/19 * 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
IIIIII COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: 5A,(,)02 0,?(
Site Address: 7t �l,�,a uJoSLN„5.pr) 7cc„ g,Suite/Bldg#:
Project Name: 4' i NO ,�p,-- 7
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review ,
Proposal: 6)//DCCi �-,/ Girl er/1-1�.= coke��', i;v ' �l 05.- 0‘;&)/e07 acee5-�l,,-‘
Ca j,r� e '
Existing Business Activity: r re'Q 5-5
Proposed Business Activity: tit) : rC.1 e55
2"-Verify site address/suite# exists and active in permit system.
O''River Terrace Neighborhood: ❑ Yes CSo
.I-Zoning: 4'l6)G
IQ Permitted Use: Cees E No ❑ Spec Space
Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
A roved b Plannin c`”- .. �
Date: d0/(4///,
PP Y g� ,� Ce_-.
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 7./.Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: sr nter building permit#above.
Workflow Routing: •► lanning ermit Coordinator _l„ -Building
Workflow Sign-off: 1111. Sign-off for lanning(include notes rom 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: /fir /4 j, Li Date: l 4(
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_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:
. SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes
Tigard Trans SDC: ❑ Yes �LJ�N
Parks SDC: ❑ Yes L�N/A
L.Y OK to Issue Permit
Approved by Permit Coordinator: / fate:1v'
I:\Building\Forms\B1dgPermitRvw_COM_NoLandUse_070915.docx
UN'
, CROWN
1505 Westlake Ave N Phone: (503) 708-9200
Seattle,WA 98109 Fax
,r,,, CASTLE wwwcrowncastlecom
October 10, 2019 RECEIVED
CITY OF TIGARD, OR ®CTI 4 2019
13125 SW Hall Blvd.,Tigard, OR 97223 CITY OF TIGARD
BUILDING DIVISION
RE: Eligible Facilities Request to modify equipment on a communications tower located at:
9585 SW Washington Sq Rd,TIGARD, OR, 97223
Crown Site Number: 879570/ Crown Site Name:WASHINGTON SQUARE MALL
Customer Site Number: PWii/Application Number: 482306
Crown Castle USA Inc. ("Crown Castle")on behalf of New Cingular Wireless PCS, LLC("AT&T
Mobility") is submitting the attached Eligible Facilities Request application to replace transmission
equipment on a telecommunications tower located at 9585 SW Washington Sq Rd,TIGARD, OR 97223
in CITY OF TIGARD, OR(the"WASHINGTON SQUARE MALL Tower").
Section 6409 of the Middle Class Tax Relief and Job Creation Act of 2012,commonly known as the
"Spectrum Act"(Pub. Law No. 112-96, 126 Stat 156),mandates that state and local governments"may
not deny, and shall approve, any eligible facilities request for a modification of an existing wireless
tower or base station that does not substantially change the physical dimensions of such tower or base
station." Additionally,if"the reviewing State or local government determines that the application is
incomplete" [they] "must provide written notice to the applicant within 3o days of receipt of the
application,clearly and specifically delineating all missing documents or information." Under federal
law, an Eligible Facilities Request is deemed granted with written notification in sixty(6o)days after an
application is filed with a local jurisdiction, excluding tolling. Based on the submittal date of October
14, 2019,3o days will expire on November 13, 2019; 6o days will expire on December 13, 2019.
AT&T Mobility proposes to modify the"WASHINGTON SQUARE MALL Tower" as follows:
• Replace(3) radios(RRH), (1) DC cable, and(1)power cabinet.
• Add(3)diplexers, (3)SDAR remotes, (1)CD cable, and(1) FLX21 cabinet.
Itemized list of submittal documents:
• Building Permit Application
• Construction Drawings
The Foundation for a Wireless World,
CrownCastle.com
• Structural Analysis.
AT&T Mobility is committed to working cooperatively with all jurisdictions around the country to
secure expeditious approval of requests to modify existing personal wireless service facilities. If you
should require more information regarding the Spectrum Act,please do not hesitate to contact me with
your questions.
Sincerely,
. Of, ,
Zach Phillips
Zach.Phillips@crowncastle.com
(503) 708-9200