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Permit
Building Permit Application g- 11 j i p i a 0 - Residential RECEIVED FOR 01 lICE USE ONLY Received ��/� p City of Tigard , 0 V 1 0 2020 DateB : l/ 120 ? Permit No.' sT2O20 (X 3/0 13125 SW Hall Blvd.,Tigard,OR 972.. Plan Review '' Phone: 503.718.2439 Fax: 503.598_1.9611. , Date/B : �t�� t 1 e Other Permit: Inspection Line: 503.639.4175 ui' of (I CARD Date Ready/By: J ® See Page 2 for " ""' BUILDING DIVISION t » � Supplemental Internet: www.tigard-or.gov Date Ready/By: So lemage 2 Information TYPE OF WORK REQUIRED DATA:1-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 n ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 2-family dwellingValuation: $ $5,903.43 ❑ 1-and ❑Commercial/industrial ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 14399 SW 88th Ave,Tigard, Oregon, 97224 New dwelling area: square feet City/State/ZIP: Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Les Johnson Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square abet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: 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. Rooftop Solar PV Valuation: $ 5 01 7/ 4.0 I Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Les Johnson Type of construction: Address:14399 SW 88th Ave,Tigard,Oregon,97224 Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT ®CONTACT PERSON BUILDING PERMIT FEES* (Please refer le fee schedule) Business name:Blue Raven Solar Structural plan review fee(or deposit): Contact name: Grayson Beck Address: 1403 N Research Way FLS plan review fee(if applicable): City/State/ZIP: Orem, UT 84097 Total fees due upon application: Phone:(385482-0045 Fax: :( ) Amount received: F-mail: permitting.deparment@blueravensolar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: BRS Field Ops, LLC Submit two(2)sets of roof plan with connection details Address: 1403 N Research Way and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP: Orem, UT 84097 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(385}482-00455 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 227185 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: Jeffrey LeeDate: 10/27/2020 *Fee methodology set by Tri-County Building Industry y Service Board. 1:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Application 'a) i f ED FOR OFFICE USE ONLY kg„,., 31 �I City of Tigard Received Date03y: Permit#:MS T24120-(j 3/p ■ �0 13125 SW Hall Blvd.,Tigard,OR 9%41 0 Z020 Plan Review Phone: 503.718.2439 Fax: 503.5 Date/By: Related Permit#: T 1 G AR D Inspection Line: 503.639.4175 £ ,t, +r,Aq t) Ready Date/By: luris !a See Page 2 for -. Internet: www.tigard-or.gov Notifie l'Method: Ira Supplemental Information TYPE OF. WORK PLAN REVIEW' ❑New construction ©Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/itenO checked): 0 Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ©1-and 2-family dwelling IIICommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 El Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑lnstallatio❑of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 14399 SW 88th Ave, Tigard, Oregon, ! ❑Addition of new motor load of system 100HP or more. ❑"A" "E" '9-2" `1-3" CI /State/ZIP: 0 Six or more residential units. occupancy. ry 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Les Johnson 0 Hazardous locations. ❑Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. l Cads I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel 0: _ Ea.add'l 500 sq.ft.or portion 33.9..o I ,., DESCRIPTION OF WORK Limited energy,residential Rooftop Solar PV (with above sq.ft.) 75"Ohl 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 PROPERTY OWNER - ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: Les Johnson - 200 amps or less 100.70 2 Address: 14399 SW 88th Ave,Tigard, Oregon,97224 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone: ( ) Fax: ( ) Over I,o00 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ®APPLICANT 0 CONTACT PERSON" Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Blue Raven Solar above service or feeder fee, each branch circuit 7.42 2 Contact name: Grayson Beck B.Fee for branch circuits without Address: 1403 N Research Way service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Orem, UT 84097 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 385)482-0045 Fax: :( ) Each manufactured or modular 67.84 2 Email: permitting.department@blueravensolar.com dweu ng,service and or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: BRS Field Ops, LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy El See Page 2 2 Address: 1403 N Research Way panel,alteration,or extension. City/State/ZIP: Orem, UT 84097 Each additional inspection over allowable in any of the above Additional inspection(1 hr mint) 66.25/hr Phone:G85)482-0045 Fax: ( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: permitting.department@blueravensolar.com Inspections for which no fee is CCB Lic.: 227185 Electrical Lic.:C1493 Suprv.Lic.: 6394S specifically listed('ti lu•min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Shan Whittaker Date: 10/27/2020 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Jeff Lee Date: 10/27/2020 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\BuildingPermitsTLC PermitApp_ELR ERE.doc Rev 06/17/2015 440-4615T(II/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description I Qty. I Each Total I II Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 00.70 2 5.01 to 15 kva 1 133.56 2 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 El Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in an of the above: ❑ Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(',4 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: S75.00 Subtotal Enter on Page I): • Number of inspections allowed peer permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* ❑ Medical ❑ 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:1Building\Permits\ELC PermitApp_ELR_F:RE doc Rev 06/I7/2015