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Permit
• • IN CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2021-00307 Date Issued: 09/07/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S714AB02700 Jurisdiction: Tigard Site address: 9240 SW MILLEN DR Subdivision: KNEELAND ESTATES Lot: 14 Project: Holzwarth 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: $24,375.00 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 Other Fixtures: 0 Drywell-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 Fum<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. NI All N Other: Y Other Description: Roof Top Solar PV System 8.6 kW Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: OTR SF VB R-3 0 Owner: Contractor: HOLZWARTH,BENTON 8 CAROLINE VANEIL KELLY CO INC Required Items and Reports(Conditions) 9240 SW MILLEN DR 804 N ALBERTA ST TIGARD,OR 97224 PORTLAND,OR 97217 PHONE: PHONE: 503-335-9240 FAX: Total Fees: $354.19 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 Q59JfM-Min lhrninh fAR Q<9-ne1AnQn Vnu mow nhfain o rnns,of fho niloe nr dirorf m,actinne}n re imr h.,roIlinn sn?9?9 10R7 nr 1 Ron'?9?IAA Issued By: Hotly Van /De/We-0e Permittee Signature: OVli Al3pki,Catio-n 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 job site at the time of each inspection. DocuSign Envelope ID:50CC7575-488E-4564-B9B2-03944F5A7160 Building Permit Applicatio ECEI V E E- 7/2.f'lzi Residential FOR OFFICEsF USE ONLY �1n ' City of Tigard JLI! 2 8 2021 Receive:D p o3 ZOl/ -4 Permit No.:113r2 2J"W 3)7 Plan Rev 0 13125 SW Hall Blvd.,Tigard,OR 97223. Plan Review Phone: 503.718.2439 Fax: 503.598.1 QF (IGARD DateBy: 5 21 prior Other Permit: TIGARD Inspection Line: 503.639.4175 3UILDING DIVISION Date Ready/By. tuns: la See Paget for InInternet: www.tigardor.gov N ed/Method: ///./ ;1`0 7"/_. Supplemental Information TYPE OF WORK .'^ REQUIRED DATA:1-AND 2-FAMILY DWELLING L< ❑New construction ❑Demolition Permit fees*arc 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. ElI-and 2-family dwelling 0 Commercial/industrial Valuation: s 24,375 t e ❑Accessory building El Multi-family Number of bedrooms: K. ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 9240 Sw Mi 1 l en Dr New dwelling area: square feet City/State/ZIP: Tigard OR 97224 Garage/ea/port area: square feet Suite/bldg./apt.no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet SW 92nd Ave & Millen Dr 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 fax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. 8.6kw Roof mounted Pv w/Auto transfer switch Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Benton Holzwarth Type of construction: Address: 9240 Sw Millen Dr Occupancy groups: City/State/ZIP: Tigard OR 97224 Existing: Phone:(503-545-2610 Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: Neil Kelly Co. (Please refer to fee schedule) Contact name: Robert Romanin Structural plan review fee(or deposit): FIS plan review fee(if applicable): Address: 804 N Al be rta St city/State/ZIP: Portland , OR 97217 Total fees due upon application: Amount received: Phone:( 503. 335 .9247 Fax::( ) E-mail: Robert.Romanin@neilkelly.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: Neil Kelly co. Submit two(2)sets of roof plan with connection details 804 N Albe rta St and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Portland , OR 97217 Permit Fee(includes plan review $180.00 and administrative fees): Phone:( 5031. 335 .9247 Fax:( ) cCB lie.: 1663 State surcharge(12%of permit fee): $21.60 Total fee due upon application: $201.60 Authorized signature: P4U4P4WWLIIA, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Robert Romatl t rlF-8E0A099A9418... 7 21 *Fee methodologyset byTri-Count BuildingIndust Print name: Date: / �2021 Y Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) DocuSign Envelope ID:50CC7575-488E-4564-B9B2-03944F5A7160 Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY - .. City of Tigard Receivedl'e!imt No • 13125 SW Hall Blvd.,Ti ard,OR 97223 y g Associated permits Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical ❑ Plumbing El Mec umical TIGARD Internet: www.tigard-ocgov • ❑ Other. THE FOLLOWING ITEMS ARE. REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. ❑ 0 ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0 6 Sewer permit. 0 0 0 7 Water district approval. ❑ ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 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 0 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 ❑ 0 ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 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- 0 0 ❑ 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 0 0 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- ❑ ❑ ❑ 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 0 ❑ ❑ 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 ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 ❑ 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ 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 ❑ ❑ 0 architect licensed in Ore•on and shall be shown to be .,..Iicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ 0 ❑ 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. ❑ 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 0 ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 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 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\BLIP-RESPermi1App.doc 02/24/2011 440-4613T(I1/02/COM/WEB) DocuSign Envelope ID:50CC7575-488E-4564-B9B2-03944F5A7160 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received Date/ByPermit#: • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: kris. ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK ' ' VIEW El New construction Q Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑ Demolition ❑ Other: ❑Service or feeder 400 amps or more ❑Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. I-and 2-family dwellingCommercial/industrialless to ground,or exceeds 14,000 0 Commercial-use agricultural © ❑ ❑Accessory building yaps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑Other: Ohre pum p.p. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived 21 71 7039 ❑Addition of new motor load of system. Job#: Job site address: 9240 Sw Millen e n Dr I00HP or more. ❑"A","E","l-z","13", gard Ti and OR 97224 0 Six or more residential units. occupancy. ❑Health-care facilities. ID Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: . . FEE SCHEDULE SW 92nd Ave and Millen Dr Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: includes attached garage. Tax map/parcel 4: 1,000 sq.ft.or less 168.54 4 Fa.add'I 500 sq.ft.or portion 33.92 DESCRIPTION OF WORK IMIIII Limited energy,residential 75.00 2 8.6kW Roof mounted Pv w/Auto transfer switch (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) "'[ PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: Benton Holzwarth 200 amps or less • 100.70 2 • Address: 9240 Sw Millen Dr 201 amps to 400 amps 133.56 2 to City/State/ZIP: Ti gard OR 97224 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( 5031545-2610 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: benton@siletzbay.com 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: Nei 1 Kelly Co. above service or feeder fee, 7.42 2 each branch circuit Contact name:Robert Romanin B. Fee for branch circuits without Address: 804 N Al be rta St service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Portland , OR 97217 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503). 3 3 5 .9247 Fax::( ) Each manufactured or modular 67.84 2 Email: Robert.Romanin@neilkelly.com dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Nei 1 Kelly Co. Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 804 N Al be rta St CI See Page 2 2 panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZiP: PO rtl and, OR 97217 Additional inspection(I hr min) 66.25/hr Phone:( 503 , 3 3 5 .924 7 Fax:( ) Investigation(I hr min) 90.00/hr Robert.Romanin@nei 1 ke C Industrial plant(1 hr min) 78.18/hr Email: p / // ��/ � {t26 Inspections for which no fee is CCB Lie.: 1663 Electrical Lic.: C984 v..Lic.: 5126S specifically listed('A hr min) 90.00/hr Docdy. ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: c-,„):".44Subtotal: Kick Methvin Print name: 85FDSFenocte4E7/21/2021 0 Plan Review Required(25%of permit fee): "—Download by: State surcharge(12%of permit fee): Authorized signature: 1p,l.. KeWi w TOTAL PERMIT FEE: Robert ROmr.�'l lf`r�t f`� This permit application expires if a permit is not obtained within 180 Print name: "O=2FF8EOAD99A941e... Date: 7/21/2021 days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE_dor Rev 06/17/2015 440-4615T(1 I/OS/COM/WEB DocuSign Envelope ID:50CC7575-488E-4564-139B2-03944F5A7160 Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qtv. I Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 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: n B• urglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 n H• eating, 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 any 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(Yr hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems El Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC ❑ Instrumentation n Intercom and Paging Systems Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I\Building\ermitslELC PermitApp_ELR_ERE.doc Rev 06/17/2015