Permit CITY OF TIGARD MASTER PERMIT
IIE" COMMUNITY DEVELOPMENT Permit#: MST2021-00170
Date Issued: 05/20/2021
T 1 i;A il.), 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109AB01100
Jurisdiction: Tigard
Site address: 13265 SW BULL MOUNTAIN RD
Subdivision: None Lot: None
Project: Palmrose
Project Description: Rooftop Solar PV
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: $2,000.00 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 0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywall-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types 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
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc!Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!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&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: Y Other Description: Roof Top Solar PV System 8.14 kW
Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
SONU,TERESA CHOLCHA PRO STAT SERVICES LLC Required Items and Reports(Conditions)
PALMROSE LIVING TRUST 1721 NE 64TH AVE STE 120
BY PALMROSE,GERALD W& VANCOUVER,WA 98661
CATHERINE TRS
13265 SW BULL MOUNTAIN RD
PHONE: PHONE: (360)859-3749
FAX:
Total Fees: $361.19
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.
7�LtCGLtt011
Issued By: Molly Va.n.'F)eiWeg OYV Apre Permittee Signature:
Call 503.639.4176 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.
•
B adding Permit Application
Residential RECEIVED FOR OFFICE LSE Oy1.1
City of Tigard Be 14 2122/ PitNo.:MST202/'6/170
111 13125 SW Hall Blvd.,Tigard,OR 97223 Alt: 1 5 202)Phone: 503.718.2439 Fax: 503.598.1960 pls,prtdgy;Review (11 2,1/14 ��other�1PPeerrmit:
1 I r /,,:r, Inspection Line: 503.639.4175 CITY OF TI GARD Date Ready/By: ` ) RI See Page 2 for
Internet: www.tigard-or.gov ediMetirod: ( ) ^ Supplemental Information
►`r/
TYPE OF WORK REQUIRED DATA:1-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 ®Other:SOLAR equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicatedapplication.
�� 1-and 2-family dwelling 111 Commercial/industrial Valuation: $2,000
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:13265 SW Bull Mountain Rd. Portland,OR 97224 New dwelling area: square feet
City/State/ZIP: Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt no.: Project name:PALMROSE 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.
SOLAR PV INSTALLATION Valuation: S
8.14 kW Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:PALMROSE,GERALD Type of construction:
Address:13265 SW Bull Mountain Rd. Portland,OR 97224 Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:(503)209-3269 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee sckedu J
Business name:PROSTAT ELECTRIC
Structural plan review fee(or deposit):
Contact name:DALE KRUEGER
FLS plan review fee(if applicable):
Address:1721 NE 641H AVE
Total fees due upon application:
City/State/Z1P:VANCOUVER.WA 98661
Amount received:
Phone:(503)539-7772 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:dale.krueger@comcastnet
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:PROSTAT ELECTRIC Submit two(2)sets of roof plan with-connection details
and fue department access,along with the 2010 Oregon
Address:1721 NE 64TM AVE Solar Installation Specialty Code checklist.
City/State/ZIP:VANCOUVER,WA 98661 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)539-7772 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:189902 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
,i &zn, _
within 180 days after it has been accepted as complete.
Print name:DALE KRUEGER Date:4/15/21 -I *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Application'EC E(V G®
FOR OFFICE l �f tl\L`.
City of Tigard AN: i 5 2021 Received
Date03 . Permit a:
74 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Related Permit 4:
8 Phone: 503.7182439 Fax: 503.598.I6)TY OF TIGARD Oatdl
ns Line: 503.639.4175 3UILDING DIVISION NotifiReadYed/Method: kris: Ea See Page 2 for
Supplemental information
T I ;n.R E) Internet: www.tigard-org0v
TYPE OF WORK ( PLAP.REVIEW
❑New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plant wlitems checked):
❑Service or feeder 400 amps or more 0 Building over duce stories.
QDemohlion 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY'OF CONSTRUCTION exceeds 10,000 amps at ISO volts or ❑Floating buildings.
less to ground or exceeds 14,000 ❑Cormnacialmse agricultural
❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑Multi-family � ❑Master builder 0 Other: ❑Fire pump. D Installation of 150 KV A or
JOB lIT E INFORMATION AND L TION - 0 Emergency system larger separately derived
�y(_ 0 Addition of new motor bad of "bleat
Job#: Job site address:r'7 ‹� a.51 Malt +� t00HY or more. "A, E•'t_2» l_9'
City/State/ZIP:/State/ZIP: (f_ ❑Six or more residential units occupancy.
} ty 1 ,�+ �,�f �f� ' �" o Health-care facilities. ❑Recreational vehicle parts.
1 Suite/bld rapt.#: 1 Project name: ` �Q(� e 0 Hazardous locations, 0 Supply voltage for more than
b J •'"� ❑Service or tecder 600 amps or more. 600 Suits nominal.
Cross street/directions to job site: FEE SCHEDULE
- Dmerfptiaa I oir. I Each I Thiel 1 •
New residential single-or multi-family dwelling unit
Subdivision: Lot#: Includes attached garage.
000 sq.R.or less 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 I
.DESCRWIION OF WORK ,r� Limited energy,residential
5 (2„ / k,.,1 IT to� (with above sq.0-) 75.00 2
Si.' lick Tan d energy,multi-familyabeq. 75.00 2
residential(with above sq.R)
Renewable Energy ❑ See Page 2
&PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: (>� �y 200 amps or less 100.70 2
{ • � ��•� I �� 201 amps to 400 amps 13356 2
Address: t L.�S f'� �wl\ /V�Yw "4
_ n m 201 amps to 400 amps 20034 2
City/State/ZIP: 6t 6 111t�.^Qt ' MI- -l?2Z. 601 amps to 1,000 amps 301.04 2
Phone:(3) 3J1 - 3� l Fax:( ) Over 1,000 amps or volts 55226 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 5936 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
I Owner signature: Date: 401 amps to 599 amps I68.54 2
CONTACT PERSON Branch circuits-new,altered° or extension,per panel
A.Fee for branch circuits with
�,_�{�AC � 1rj c y.-(. i c„ above service or feeder fee, 7.42 2
Business name: i ►ire 7 tr 41�" -
each breach circuit
Contact name: V"` - B.Fee for branch circuits without
�" - `�y� 4'��[ �� "� service or feed's'fee.first
Address: +7� ryG �L�r+"kdtt.- branch circuit 56.18 2
O�-„A ) _ t /1 Qf' L1 Each add'I branch circuit 7.42 2
City/5tate2lP: j�tYY"�.a w i1 ( [ ) Miscellaneous(service or feeder not included)
Phone:(614) f 3Cie 7 77 Fax::( ) Each manufactured or modular 67.84 2
� dwelling,service and/or krder
Email: 1 ..W a►,,,,Qu CcJ {.
cis- • WA Reconnect only 67.84 2
A CONTRACTOR Pump or irrigation circle 67.84 2
'(j5 A w f" r. ' 1 "c �� Sign or outline lighting 67.84 2
Business name: t��l.k�`•—
r_ `, Signal circuit(s)or iimikd-cnergy 0 ��e 2 2
Address: VI Ti panel.alteration,or extension
kfa• r L Each additional inspection over*Bearable in any of the above
Cityi$tateLIP: ( tL�--' (� q�1�4 Additional inspection(I hr min) 66 251 hr
Phone:( r�3 543?... Z7 2, .. Fax:( ) i Investigation(1 lumin) 90.002 hr
yl / Industrial plant(1 hr min) 78.1&i br •
Email: d��e ` ia.+1r a City�- - ' ik ivb c Inspections for which no fee is 90-00:!hr
CCB Lie.: 174gaza Electrical)i . Suprv.Lie.: 724 T specifically listed(l hr thin)
i o ELECTRICAL PERMIT FEES
Suprv.Electricj�¢r signer u d: t"),.....11
Suit fen): i 3 ,
Print Warne:
(f~jq fop r. e- ❑Plant Review Required(25%of permit fee):
,� State surcharge{12%of permit feel: _ _
TOTAL PERMIT FEE:
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: Date: 1 # i`J 'Z1 days after it has been accepted as complete.
(ot • Number or inspections allowed per permit.
I:'89iW'at'Permas,ELC_ecanitApp_EtR_PAE.doe Rev 06.172015 44 611T(11 'GOWNED
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCIREDULE
Description 1 Ow 1 Each I Total I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
s kva or less 100.70 2
Check Type of Work Involved: „
5.01 to 15 kva f 133.56 �
❑ Audio and Stereo Systems* 15,01 to25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* n100 kva(fee in accordance 2
with OAR 918-309-0040) 552.26
❑ Heating, Ventilation and Air Conditioning solar generation systems in excessof25 kva:
System* Each additional kva over 25 7.42 3
❑ Vacuum Systems* >I00 kva-no additional charge 0,0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 6625/hr
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed('h hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES -
Subtotal(Enter on Page I):
Fee for each commercial system: $75.00 * Number of inspections allowed per punt
(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
❑ Landscape Irrigation Control*
❑ Medical
U Nurse Calls
❑ Outdoor Landscape Lighting*
E Protective Signaling
❑ Other:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
1!.buildine,PermBELL Permi.Arp,_ELR_EREdoc Rev06'172Di5
City of Tigard RECEIVED
■ Building Division
• • 13125 SW Hall Blvd,Tigard, OR 97223 AK 15 202)
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION
www.tigard-or.gov
2010 Oregon Solar Installation Specialty Code
Check List for Prescriptive Installation of Roof-Mounted
PhotoVoltaic Solar Panel System
Property Information
Installation Address: 13265 SW Bull Mountain Road
City: Tigard, OR Zip: 97224
Owner's Name: Gerald Palmrose Date: 4/15/2021
Contractor's Name: Pro-Stat Solar & Electric CCB #: 189902
Design Parameters of the Property/Structure
If"Yes", does not
Flood Hazard Is the installation ❑ Yes qualify for the
Located in a flood prescriptive path, follow
Area plain/flood way? ❑x No OSSC or ORSC for
design requirements.
El
Is the wind exposure Yes If"Yes", qualifies for
Wind Exposure "C" or less? ❑ No the prescriptive path.
Installations on detached Is the Ground Snow
single/two-family Load 70 psf or less?
dwelling/single/two- If"Yes", qualifies for
family townhomes I] Yes the prescriptive path.
and/or their accessory
Ground structures. ❑ No
Snow Load Is the Ground Snow
Installations on all Load 50 p or less?
If"Yes", qualifies for
structures other than
Yes the prescriptive path.
above ❑
No
1
I:Buildin g/Forms/Photo V oltai c-Checkl i st02-01-11.docx
Is the construction Type of material wood and does J Yes If"Yes", qualifies for
the construction qualify
Construction as"conventional light ❑ No the prescriptive path.
frame"construction?
Is the spacing 24 inches
or less?
If"Yes", qualifies for
Pre-engineered trusses. ❑ Yes the prescriptive path.
❑x No
Roof framing
members Is the spacing 24 inches
or less?
Nominal lumber. Yes If"Yes", qualifies for
the prescriptive path.
❑ No
Is the combined weight ❑x Yes
of the PV modules and If"Yes", qualifies for
racking less than or ❑ No the prescriptive path.
Solar equal to 4.5 psf?
installation Is the solar installation
layout in accordance ❑ Yes If"Yes", qualifies for
with Section 305.4(3) of ❑ No the prescriptive path.
the 2010 Oregon Solar
Code?
❑ Metal
Single layer If roofing material is
Roofing Check the type of ❑ of wood one of the three types
material roofing material shingle/shake checked, qualifies for
Max. two layers the prescriptive path.
x❑ of composition
shingle.
Is the roof mounted ❑x Yes
Connections of solar assembly If"Yes", qualifies for
the solar assembly connected to roof ❑ No the prescriptive path.
to the roof framing or blocking
directly?
2
I:Building/Forms/PhotoVoltaic-Checklist02-01-I 1.docx
•
Is the gauge 26 or less? n Yes If"Yes", qualifies for
❑ No the prescriptive path.
115 lbs for 60 inch
spacing or less?
If"Yes", qualifies for
❑ Yes the prescriptive path.
❑ No
Minimum Uplift rating
of Clamps? 75 lbs for 48 inches
spacing or less?
If"Yes", qualifies for
❑ Yes the prescriptive path.
❑ No
Attachment of
roof mounted Minimum 24 inches If the spacing falls
solar systems Spacing of clamps? within 24 inches and 60
directly to inches Maximum 60 inches inches, qualifies for the
standing seam prescriptive path.
metal panels Width of roofing If the width of the panel
panels? 18 inches or less is less than 18 inches,
inches qualifies for the
prescriptive path.
Minimum#10 at 24
inches o/c?
Size and spacing of If"Yes", qualifies for
fastener? ❑ Yes the prescriptive path.
❑ No
Is the roof decking of
WSP min. t/2"thickness, ❑ Yes
decking connected to If"Yes", qualifies for
framing members ❑ No the prescriptive path.
w/min. 8d nails @
6"/12" o/c?
Is the height less than or
Maximum 18 inches equal to 18 inches?
Height of the from the top of the If"Yes", qualifies for
solar modules module to the roof Yes the prescriptive path.
surface. ❑ No
3
1:Bui lding/Forms/Photo Voltaic-Checklist02-Ol-11.docx
Submittal Documents required for Prescriptive Installations
Show the location of the PV system in relation to buildings, structures,
property lines, and, as applicable, flood hazard areas.
Site Plan Details must be clear and easy to read.
Minimum size of the plan is 8.5 x 11 inches.
Attach a simple structural plan showing the roof framing (rafter size,type, and
spacing) and PV module system racking attachment.
System must be shown in sufficient detail and clarity to assess whether it
Structural Plan meets the prescriptive construction requirements as listed earlier above in the
matrix.
Minimum size of the plan is 8.5 x 11 inches.
PV Modules
Manufacturer: Silfab
Model Number: SIL 370 BK
Listing Agency: UL
4
I:/Building/Forms/PhotoVoltaic-Checklist02-01-11.docx