Permit CITY OF TIGARD MASTER PERMIT
''1 I. COMMUNITY DEVELOPMENT Permit#: MST2021-00255
T t G A R T) 13125 SW Flail Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/22/2021
Parcel: 2S103DA04400
Jurisdiction: Tigard
Site address: 10630 SW PARK ST
Subdivision: FANTASY HILL Lot: 3
Project: Noles
Project Description: Solar PV installation 7.4 kW
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: 52,000.00 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 Drains: 0 Storm Sewer: 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 Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
FurnelaOK: 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 addl 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 N
Other: Y Other Description: Roof Top Solar PV System 7.4 kW Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
NOLES,DAVID R AND PRO STAT SERVICES LLC Required Items and Reports(Conditions)
MARGARET L 1721 NE 64TH AVE STE 120
10630 SW PARK ST VANCOUVER,WA 96661
TIGARD,OR 97223
PHONE: PHONE: (360)859-3749
FAX:
Total Fees: $359.19
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
g50_pn1-0Mn fhrm,nh ruiP ox7_nnljlnOn Vn„ma.,nhta in a rnm,of the mlec nr dirert m,ecfinnc}n(11 INr`h.,rollinn 5n't 94910R7 nr 1 Rnn'IR9 9%16
Issued By: 1-1 Ay Van,De,Werge Permittee Signature: w Appl,ca tLon
Call 503.639.4175 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 iob site at the time of each inspection.
Building Permit Applicatic ECEI V ED
Residential JUN 2 12021 tt/u (0 tit I I <f ()NI l
Received/,,
City of Tigard OF T1GAR0 Date./By: CO tZq z 1 � PamitNo.. \ V2.p21-00255
13125 SW Hall Blvd.,Tigard,OR 9722�i Pfau Review
Phone: 503.7182439 Fax: 503.598 D1NG DMS1ON DateBy: 7 7 ?�/ � oast it
Inspection Line: 503.639.4175 Date Ready/By: , K/ hats ® gee Page 2 tar
Internet: www.tigard-or.gov Notified/Method: '/ Al� Supphmental lefonaatioo
047tr- -.6P/-
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
®Addition/alteration/replacement ®Other:SOLAR equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION wont indicated on this application.
® I-and 2-family dwelling ❑Commercial/industrial Valuation: 52,000
El Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10630 SW Park St Tigard,OR 97223 New dwelling area: square feet
City/State/ZIP: Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt no.: Project name:NOLES 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.
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.
SOLAR PV INSTALLATION Valuation: S
7.4 kW Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:NOLES,DAVID Type of construction:
Address:10630 SW Park St Tigard,OR 97223 occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:(503)544-9241 Fax:( )
New:
® APPLICANT 21 CONTACT PERSON BUILDING PERMIT FEES*
Business name:PROSTAT ELECTRIC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:DALE KRUEGER
FLS plan review fee(if applicable):
Address:1721 NE 641"AVE
City/State/ZIP:VANCOUVER,WA 98661 Total fees due upon application:
Phone:(503)539-7772 Fax::( ) Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:dale.kruegerratcomeast.net
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:PROSTA1'ELECTRIC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1721 NE 64T"AVE Solar installation Specialty Code checklist
City/State/ZIP:VANCOUVER,WA 98661 Permit Fee(includes plan review S1S0.00
and administrative fees):
Phone:(503)539-7772 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lie.:189902 Total fee due upon application: $201.60
Authorized signature: x - This permit application expires If a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:DALE KRUEGER Date:6/21/21 •Fee methodology set by Tri-County Building Industry
Service Board. $�L '/ I
1:1BuddinglPermits\BlJP-RESPennitApp.doc 02/24/201I 440-4613T(11/02/COM/WEB) C�
, — _.._ _
Electrical Permit Application 1 ,!,I tl i 1" I t ,". '.
City of Tigard CEIVED t , r „-0,A
,r ' 13125 SW Hall Blvd,Tigard,ORI:32C Pier Renew- Related Permit i.
Phone 503.7182439 Fob: 503398.1960 Welly.
tnepeetial liar 503.639.4175 JUL 1 2021 Reedy➢otelly. fora 15 See.P. 2 for
7 still 7,k21T. Wend: worweig.rd-or.gly horifed 4aih Suppliants'Wormer/tat
TYPE p wh ltEY OF TIGARG V RAN REVIEW
❑New construction Addilil d W IJION Please check JI Ow apply(aim*leas ofors%wlhrnu chorine.*
°Service n sans 460 maps a mac O Building uxf three uwics.
❑Demolition ►1 Other: when do osaihh4 rash enema 0 Marco end ho,rya.de.
CA rs.rY OF CONbS'CRt1C>zt).� exceeds 10.000 imps at 1S0 solo Or o Floating building.
.-
ter rn grem4 or crowds 14,000 °Commercial-use N kagywl
1-and 2-family dwelling 0 CanmlerciaVindn.9trial 0Accessary building too
for all rear imaltvioru baildinp.
Multi-family 0 Master builder 0 OHair. °Fat pump. ❑installation of 150 Kv'A or
70B BETE INFORMATION AND A7'fpp�yl °F^a.��sy gstcm lager sensately derived
�,)�30 _GN \ f nnrtirltoones mnmr lord of Vela
Job it: lob site address: \ U) CLA - ST lnnfn.ar men, r
r{,�,1 rn q +2LL3 os.or more r'cdml.l luas. o +D y.
Cily!$IeIGZIP: `C� -') ( f4f(L—(b� [(' OlienkbLr=trims. ❑Mueanuwl,ehKk pies.
�4�J 7 ❑rrarnn vie 6xtilem. o Sr4Ply roses rm more Ilan
$ultelbldg_.dpt II: �Projeei name: °service or kola 600 mops or roe.. 600 w14 nominal.
} Cross Streethreetio0S 10 job sin: :dram sci'wui�E
Dorrrii� I or.. 1 Ertl I Tens I •
' New residential single—or asald-fami3 dereffiey anise
Subdivision. Lot A: loeladm sumacs]garage..
beet).i.B.of Imo 1 168.54 J 4
Tax map/parcel I: Ea.sari 500 sq.R.or pnniaE 13..92 I
DESCIUP11019 OF'WORK Limhal energy,resldemlal 7500 2
/ r , r ,rjf (ittid alone, lti
V }� u-icr Limitwl warp,multi-family 73.00 2
4+ K-,-( residential(sell►above nl.ft.)
- Renewable Energy CaSae Page 2
$cruces or feeders installation,atteratlon,and/or refutation
' *lame: 0 0 TENANT NIB\e- . �1 t,'Y-�f 200 amps a tns 100.70 2
(
__._. clip 70 E L"l S'� 201 amiss io 400 amps 133.56 2
Address: 401 props to KO Amps 200.14 2
(:ity/$tatrJZIP:1 vl.- 601 tramps to 1,000 amps 301,04 2
Phone.:(5(}7j) .�t.(-� - C7 I Fax-:( ) . Over I,000imps or r olh St' 6 2
Temporary services or feeders installation,alteration,andlor
email: relocariDa
Owner Installation:This installation is being made on property that l own which is not 200 amps or lea 5936 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201=ape to 400 amps 125.0a 2
( oner signalers: _ Date: Br maps to 599 amps alleraRoo.or eaten land 69.54 2
rry CON[ACT PERSON Blanch dentin-rxw,
si AP yp��fin. - A.Fee Rd branch circuit*arch
Business name: 4 E 79r'7. Lria `tat,�i""""" abase scarce or Berkr fee, 7,42 2
each brunt,comb
.- a u.F.,...-4.Pe Crouch Waits Macaw
Cantactnarnr. y.�,s�ar►._ t
�e - r fcr.ux or Roder frs,fast 56,1 R 2
Address: i (� /dG �1-1. 0e-- � brunch circuit
�sJ -�,� A- Each add'l branch dam it 7.42 2
i City/Snug/ZIP: �p (y[,QwlL1JR. ry Miscellaneous(service orRederootIncluded)
Phone:(. J 3) ilia- / L/ V.. Pam:( ) Each rramFacaanl or modular 67.94 2
1' ,�.a {� y. dwelling,.l an4'or-Rader
Email: gil . Pkt '�, Ce `teas)- (t..\ Reconnect oily 47.84 2
CONTRACTOR. Pump or irrigation circle 67.64 2
.+ Sign oreutlme liTtiie; 67.84 2
BLL511les5 Mime: + �� Signal or o l Of hmueilknn y _
Address: v�+v wL
1��c ,r. panel,oltmwnn,or ocn7ssian. ° S!! e 2 2
r L Each additional los tl 'Viewable oo ever fa any of the alcove
CitylSore2lP: `A__ W Additioal uryn'tion(I ltr out) 6625/br
Phone:( 3) 17 2,, I Fax:( ) Investiyrlemn(l lot mint) 90.041 br
Q.- Industrial pbai(I Vermin) 7R.I Sit br
Email: dap... "�;a-ff' C ""` it1•[ Inspections la w h cr nofca is90.OIli br
k + 72.4 ,, sp 6n0y lilted lf'•hr min) ,
CCB Lie.: 1 �� Eke cal SOpn'.Lie.: t ELLC7RlCr114 rE86UT 11°13 -/ i
Suprv.Elactookan s>Zns(ure, cgaKK> �'d /7�� i
Print name: "09 etc `k b Date: / 7j1 "1r1 °Plan Review Requimd(25%of scrum fee):
state sochar�e(t2%of n�!l!nt fee): _ t
~ `K-mil 6TAL PERMr1'.eel
Authorized signature: �— TmI.P„s vpe•-.n rv•R J•n�t i.oa.bt.�se.tr o ISO
1 " ' Dale: 1 Eons after 1 M tier)a .pled.ie vwmpled.
Print name: JYa • AYm6er Ur iNyledans alx.r ell per Fn Ut.
m.'10114-hre•r.e L_rcrmt ux.ua e.d,:Ken W,Ir2al5 440Jar it l ImrittalfwEll
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: scxst3ttt a.
Fee for all residentialsystems combined: $75.00 Renewable l Qty. : I rant l
Ronawabla electrical energy systems:
5 kva or less 100.70
Check Type of Work Involved: (
ism to 15 kva 1335 `6 1 )j.V NO
❑ Audio and Stereo Systems* 15.01 to25 kva 20034 2
Wind generation systelne 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* >100 km(fee in accordance
352?6 2
with OAR 918-309.00401
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in anyofthe above
▪ Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90 hr
specifically listed PA hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT TEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 • Number of u»peetions slowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
0 Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
E Intercom and Paging Systems
E Landscape Irrigation Control*
u 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:lauddmsPermts:Ee.C_Perm2APP_Et.R_ERE doe Rev 04•17t2013
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
illi City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
Tlt]AIZn 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503.718.2439 •www.tiaard-orgov
TO: DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: )4:9kr_ 1, JUL 1 2021
COMPANY: Ot-S-Ci ra \-1P— — CITY OF TIGARD
PHONE: S13 e- ct.''1 1 12_- BUILDING DIV S N dr,
EMAIL: ( ACrw sle e 0-1,-.k. 'AA .J,
M
RE: /000 9 Q A-vLtf-- � ANTu ,31-(X 53
(Site Addrgss)t 4 S
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. Revisions:
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: ,e-cci-,^` Q Agioa•.* AN c \C ,'A-'- 0
.9
2- I ? C
F71 OFFICE USE ONLY
Routed to Permit Technician: Date: "7 Or
-2 f Initials:
Fees Due: ❑ Yes 14� No Fee Description: Amount Due:
$
pDP $ p5"---
s
Special
Instructions:
Reprint Permit(per PE): ❑ Yes o 0 Done
Applicant Notified: Date: Initials: