Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2020-00279
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/09/2020
T l i AR[) 9 Parcel: 2S111 DA01000
Jurisdiction: Tigard
Site address: 8620 SW BRAEBURN LN
Subdivision: APPLEWOOD PARK Lot: 6
Project: GIBSON
Project Description: Solar photovoltaic system.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $10,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr. 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: Y Other Description: Roof Top Solar PV System 8.16 kW Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr. Occupancy Group: Square Feet:
OTR SF VB R-3 0
Owner: Contractor:
GIBSON,PATRICK MORGAN TESLA ENERGY Required Items and Reports(Conditions)
8620 SW BRAEBURN LN 6132 NE 112TH AVE
TIGARD,OR 97224 PORTLAND,OR 97220
PHONE: PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $363.19
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: 1, V co" Permittee Signature: OY\ M'T' C.CO-1 CY".‘
Call 503. .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.
Dianna Ornelas
From: #Building Permit Technicians
Sent: Friday, November 6, 2020 3:47 PM
To: 'Melissa Farias'
Subject: RE: MST2020-00279 - Gibson - 8620 SW Braeburn Ln
Hi Melissa,
$5.00 mailing fee added. Please let us know when all fees are paid and we will get this issued and in the mail next week.
Thank you and have a great weekend!
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 503-718-2439 Permits
From: Melissa Farias <afarias@tesla.com>
Sent: Friday, November 6, 2020 3:36 PM
To: #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject: Re: MST2020-00279 -Gibson - 8620 SW Braeburn Ln
Caution!This message was sent from outside your organization.
Yes please add mail fee
From:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Sent: Friday, November 6, 2020 3:35:02 PM
To: Melissa Farias<afarias@tesla.com>
Subject: MST2020-00279-Gibson - 8620 SW Braeburn Ln
Hello Melissa,
This permit is ready to issue and the balance due is$358.19 (see attached invoice).
Please let us know if you would like us to mail this permit so that we can add the$5.00 mailing fee BEFORE you pay the
current fees due.
The fees can be paid online at https://aca-prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record
number MST2020-00279 under the Building tab. Payment can be made by 'card' for a 3%service fee or select the
'check' payment option and there is no service fee.
Please email the permit technicians at TigardBuildingPermits@tigard-or.gov once the fees are paid so that we can
issue the permit.
Thank you.
1
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct I 503-718-2439 Permits
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
2
I' ,
Building Permit Application
Residential FOR OFFICE USE ONLY
t.'If l
City Of Tigard Date By: Permit No.. q
"I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
C` ' c)
Phone: 503.718.2439 Fax: 503.598.1960 ��t, i k J 2 Q[U Date/BY: t I 7.✓!w AftOther Permit.
T I G n I.U Inspection Line: 503.639.4175 Date Ready/By: • n 7udr ra See Page 2 for
Internet: www.tigard-or.gov Notified/Method:/V�(� e) NlA�. �A I Supplemental Information
CM*/I.- c-ssi4- fr _
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑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
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ \ 0 0 0 0
ER I-and 2-family dwelling ❑Commercial/industrial 1
ElAccessory building ❑Multi-family Number of bedrooms:
_l ❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address L,;;y - _. , New dwelling area: square feet
City/State/ZIP: It,1DA; , 1 9-1" -�-LJ- Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:G i,65-:1)\fl 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: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
- PV ROOF MOUNT Valuation: $
... Existing building area: square feet
• New building area: square feet
a PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: `O('j •VV F Y-t21 Vj uN VA. W) Occupancy groups:
City/State/ZIP: 1,01 cA-{ 0 rJ c.1—1 '-' Existing:
Phone' I Fax:( ) New:
51 APPLICANT la CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: TESLA
Structural plan review fee(or deposit):
Contact name: Melissa Farias
FLS plan review fee(if applicable):
Address: 6132 NE 112th Ave,
Total fees due upon application:
City/State/ZIP: Portland OR 97220
Amount received:
Phone:(503 ) 894 6903 Fax: :(1866)445 7459
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: AFARIAS@TESLA.COM
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: TESLA Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 6132 NE 112th Ave, Solar Installation Specialty Code checklist.
City/State/ZIP: Portland OR 97220 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 503 ) 894 6903 Fax:( 1866) 445 7459 State surcharge(12%of permit fee): $21.60
CCB tic.: 180498 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.
Y *Fee methodology set by Tri-County Building Industry
Print name: A. Meliss arias Date:I 0 ) �U Service Board.
11Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1l/02/COM/WEB) S*'
, } '
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received Permit No..
111 13125 SW Hall Blvd.,Tigard,OR 97223 Auona:
Date a Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
TIGARD 24-Hour Inspection Line: 503.639.4175 - 0 Electrical ❑ Plumbing 0 Mechanical
Internet: www.tigard-orgov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1.c. .0u y/:v
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ■ 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ El
3 Verification of approved plat/lot. ❑ ❑ 0
4 Fire district approval required. Name of district: ❑ El 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0
6 Sewer permit. ❑ 0
CI
7 Water district approval. 0 El0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 El El
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ El 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑
and location.
1 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ 0 ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- El ❑ El
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 El ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 El
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered El 0 El
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ ❑ El
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ El
El
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. El 0 ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. El 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. El ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9,1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
1a
•
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
.� Date/By: Permit NotlE.r 24(v,2f,`._00 2_79
� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1r lJ
3: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: kris: I H See Page 2 for
Internet www.tigard-or.gov Nntified/Method. Supplemental Information
TYPE:OF WORK , , PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked below):❑New construction N Addition/alteration/replacement
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other:
where the available fault current El Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building am
ps for all other installations. buildings.
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived system.
❑Addition of new motor load of ❑`A","E","1-2","1-3",
100HP or more. occupancy.
Job no.: Job site address:
-`•y - • , - - ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: n ❑Health-care facilities. ❑Supply voltage for more than
I ['Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. I Fee. I Total (
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no,: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family
3-i-'. U
Lp A7 PV ROOF MOUNT residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
t a - Services or feeders installation,alteration,and/or relocation
® PROPERTY OWNER ` ( ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
Address: l2,L( . 601 amps to 1,000 amps 301.04 2
l� Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tl l f -a- 'I `"�^I'd'' Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
In APPLICANT E CONTACT PERSON A.Fee for branch circuits wall
above service or feeder fee, 7.42 2
Business name: TESLA each branch circuit
B.Fee for branch circuits without
Contact name: MELISSA FARIAS service or feeder fee,first
branch circuit 56.18 2
Address: 6132 NE 112TH AVE, Each add'l branch circuit 7.42 2
City/State/ZIP: PORTLAND OR 97220 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
(503 ) 894 6903 (1866) 445 7459 dwelling,service and/or feeder
Phone: Fax:
Reconnect only 67.84 2
E-mail: AFARIAS@TESLA.COM Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: TESLA Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: 6132 NE 112TH AVE, Each additional inspection over allowable in any of the above
City/State/ZIP: PORTLAND OR 97220 Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:( 503 ) 894 6903 Fax:(1866)445 7459 Industrial plant(I hr min) 78.18/hr
CCB LIC.f Inspections for which no fee is
180498 Electrical Lic.: C562 Suprv.Lie.: 5873E specifically listed(%hr mop 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: tilers—is Subtotal
Print name: NICK ARMSTRONG Date: I ` 1 O ) Plan review(25%of permit fee).
��y State surcharge(12%of permit fee).
Authorized signature: .rylyw,p TOTAL PERMIT FEE:
"� This permit application expires if a permit is not obtained within 150
Print name: A.MELISSA FARIAS Date: 10 1 -j I'71 ) days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:t Budding\PermitseELC_PermitApp_ELR ERE.doc Rev 05/21/2013 440-4615T(1 l/05/COM/WEB
V
• I
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: "lit' r`.4.' 19"' "" _, FEE SCHEDULE
Fee for all residential systems combined $75.00 -,siti„'1°^ I Qa- I fee I fatal I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to15kva \ 133.56 \J3-Sly 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
❑ Heating, Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 00 3
Each additional inspection over allowable in any of the above:
El Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90 00/hr
specifically listed( hr min)
COMMERCIAL WORK ONLY: ELL(rRlCA1. PERMIT FEES
Fee for each commercial system $75.00 Subtotal.
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee)-
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE.
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
' Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\BLC PermitApp_ELR_ERE.doc Rev 05/2 112 0 1 3