Permit 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.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
_ il II Transmittal Letter
T I G;A l n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: City of Tigard DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: Christine Stamper,Permit Coordinator RECEIVED
COMPANY: Elemental Energy LLC NOV 31
PHONE: 503-967-5786 CITY OF TIGAR�By
BUILDING DIVISION
EMAIL: permits@elementalenergy.net
RE: 13141 SW Bouneff St MST2021-00420
(Site Address) (Permit Number)
David Sauer Solar
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. 2 Revisions: Change solar module
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: We have changed the solar module that is being installed:
Original: REC SOLAR REC370AA(370VV)MODULES Updated: REC SOLAR REC365AA(365VV)MODULES There is no change to the layout NOR the wiring.
But the overall system size went down a little bit and we updated the module model labelling in all pages where it is shown.
FOR OF CE USE ONLY
Routed to Per . Technician: Date: jj(� 7� Initials:
Fees Due: Yes ❑No Fee Description: Amount Due:
`.Do
IA() �'�-�1 d-Ar. $ (fS
I I ? 1.45,....F7 $
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done
Applicant Notified: Date: if //5—fA i Initials: `�
CITY OF TIGARD MASTER PERMIT
NI * COMMUNITY DEVELOPMENT Permit#: MST2021-00420
Date Issued: 10/05/2021
T[GAR.D 13125 SW Hall Blvd,Tigard OR 97223 503.718.2439 Parcel: 2S104AC08900
Jurisdiction: Tigard
Site address: 13141 SW BOUNEFF ST
Subdivision: MORNING HILL NO.9 Lot: 232
Project: Sauer
Project Description: Rooftop Solar PV 7.03 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: $5,510.00 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
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Bckflw Prevntr: 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
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+arnp-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 7.03 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:
SAUER,DAVID E&JULIE E ELEMENTAL ENERGY LLC Required Items and Reports(Conditions)
13141 SW BOUNEFF ST 1339 SE 8TH AVE#B
TIGARD,OR 97223 PORTLAND,OR 97214
PHONE: PHONE: 503-967-5786
FAX:
Total Fees: $355,19
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
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Issued By: 1-10-{.L3 Vaw De-\Ake& Permittee Signature: ntv Ap- iisA f-Lc-v.
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.
Building Permit Application ECEIVED
CO
Residential SEP 17 2021 FOR OFFICE USE ONLY
City of Tigard
Received ,
Date/By: v' 2� 2021 t Permit No.: s QZ��
13125 SW Hall Blvd.,Tigard,OR 9722cITY OF TIGARU
261
Plan Rev
: Phone: 503.718.2439 Fax: 503.598} LDING DIVISION Date/By:1eW of 3alu l.'1�' Other Permit:
T it n R t� Inspection Line: 503.639.4175 Date Ready/By: l ! / Jyu WI See Page 2 for
Internet: www.tigard-or.gov otified/Met .l /_ ( /C�� ( 1�77 Supplemental 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
]Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 5510
(X 1-and 2-family dwelling ElCommercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
{ db JOB SITE INFORMATION AND LOCATION
Total number of floors:
f Job site address: 13141 SW BOUNEFF ST New dwelling area: square feet
r City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: David Sauer Solar Covered porch area: square feet
r Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
t
'€, 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.
5.51 kWAC Solar PV prescriptive roof mount install Valuation: $
--7. b•- (%BI) .1)L Existing building area: square feet
New building area: square feet
1)31 PROPERTY OWNER ❑ TENANT Number of stories:
Name: David Sauer Type of construction:
Address: same as above Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
U APPLICANT q CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: ELEMENTAL ENERGY Structural plan review fee(or deposit):
Contact name: CHRISTINE STAMPER 503-522-9190 (CELL) FLS plan review fee(if applicable):
Address: 1339 SE 8TH AVE STE B
Total fees due upon application:
City/State/ZIP: PORTLAND, OR 97214
Phone:( ) 503-967-5786 Fax: :( )
Amount received:
E-mail: PERMITS@ELEMENTALENERGY.NET PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ELEMENTAL ENERGY Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 1339 SE 8TH AVE STE B Solar Installation Specialty Code checklist.
City/State/ZIP: PORTLAND OR 97214 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) 503-967-5786 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 195141
Total fee due upon application: $201.60
Authorized signature: 4- ��f'� This permit application expires if a permit is not obtained
r�"� �` y"Y� within 180 days after it has been accepted as complete.
Print name: CHRISTINE STAMPER Date: 09/17/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard ReceivedDate BY: l�eTmit No.:
74 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
U Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
'' it l Internet: www.tigard-or.gov
0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No \/,%
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 El
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑plan 0 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 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 ❑ ❑ ❑
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.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑
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- ❑ ❑ ❑
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,roofmg,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 ❑
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 ❑ ❑
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 ❑ ❑ ❑
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. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 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 ❑ ❑ 0
architect licensed in Oregon and shall be shown to be .,•licable 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 I 1"or 11"x 17". ❑ ❑ ❑
24 Two(2)sets each are required for Items 16,19,20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
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, ❑ ❑ ❑
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\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Electrical Permit ApplicatifitECEIVED FOR OFFICE USE ONLY
CityofTigard Received ��+,�M��41 go
g Permit#: ` �G
13125 SW Hall Blvd.,Tigard,OR 97223 SEP 1 7 VJ2 Date/B
1. Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit 5:
1.l G R.1) Inspection Line: 503.639.4175 CITY OF TIGARL Ready Date/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov (JI' n AID+ Notified/Method: Supplemental Information
TYPE OF ,A44�ING DMVISIO� PLAN REVIEW
0 New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more El Building over three stories.
❑Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
1-and 2-family dwelling ❑Commercial/industrial El Accessory building
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 13141 SW BOUNEFF ST 100HP or more. ❑"A","B", 'i-s","l-3",
City/State/ZIP: Tigard, OR 97223 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: David Sauer Solar ❑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
Description I Qty. I Each I Total I *
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#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
5.51kW AC Solar Photovoltaic Install. (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
D PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: David Sauer 200 amps or less 100.70 2
Address: same as job site 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 1,000 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 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: ELEMENTAL ENERGY above service or feeder fee, 7.42 2
each branch circuit
Contact name: CHRISTINE STAMPER, 503-522-9190 (CELL) B.Fee for branch circuits without
service or feeder fee,first
Address: 1'3 3 9 SR 8TH A VF. STF R branch circuit 56.18 2
City/State/ZIP: Each add'l branch circuit 7.42 2
PORTLAND OR 97214 Miscellaneous(service or feeder not included)
Phone:(5o3)967-57R6 I Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: PERMITS@ELEMENTALENERGY.NET Reconnect only 67.84 ' 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: ELEMENTAL ENERGY Signor outline lighting 67.84 . 2
Address: 1339p STE
circuit(s)or limited-energy ❑ See Page 2 2
SE 8TH AVE S 1'Ei B panel,alteration,or extension. g
Each additional inspection over allowable in any of the above
City/State/ZIP:
PORTLAND OR 97214 Additional inspection(1 hr min) 66.25/hr
Phone:( 503 967-5786� Fax:( ) Investigation(1 hr min) 90.00/hr
PERMITS ELEMENTALENERGY.NET Industrialspeco s plant(1 hr min) 78.18/hr
Email: Inspections for which no fee is
specifically listed(''/z hr min) 90.00/hr
CCB Lie.: 195141 Electrical Lic.: C 1228 Suprv.Lic.: 4894S
Suprv.Electrician signature,required: qy_ ELECTRICAL PERMIT FEES
- Subtotal:
Print name: David Gehrke Date: 09/17/2021 ❑Plan Review Required(25%of permit fee):
,r-� State surcharge(12%of permit fee):
Authorized signature: VAwit- /45y� TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: CHRISTINE STAMPER Date:09/17/2021 days after it has been accepted as complete.
* Number of inspections allowed per pennit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/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
Description I Qty. I Each I Total I h
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01to15kva 1 133.56 2
n A• udio 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
50.01 to 100 kva 552.26 2
n G• arage 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:
n 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('/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotallowed r permterit.
t.o Page 1):
y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
r Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
L\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015
RECEIVED
Oregon Solar Installation Specialty Code SD 17 2 2
4 Checklist for Prescriptive Photovoltaic Installations in CITY OF TIGARD
accordance with Section 3111.5.3
BUILDING DIVISION
Department of Consumer and Business Services
Building Codes Division
1535 Edgewater NW,Salem,Oregon
Mailing address:P.O.Box 14470, Salem,OR 97309-0404
Phone: 503-378-4133•Fax: 503-378-2322
Web:bcd.oregon.gov
PROPERTY OWNER INFORMATION
Property owner name:David Sauer
Installation address:13141 SW BOUNEFF ST
City: Tigard State: OR ZIP: 97223
Structure on which modules are to be installed:roof of house
Day phone: ( )971-563-3494 Evening phone: ( )
Email address:davidesauer@fastmail.net
Contractor:Elemental Energy LLC CCB#:195141
Day phone: ( )503-967-5786 Evening phone: ( )
Email address:permits@elementalenergy.net
SITE PLAN
• Attach a simple site plan showing the location of the PV system in relation to buildings,
structures,property lines, and,as applicable, flood hazard areas.
• System must be shown in sufficient detail to assess whether the requirements of Section 3111.4.8
or one of the exceptions have been met.
• The site plan must be on 8.5-inch x 11-inch or larger paper.
STRUCTURAL INFORMATION
All structures:
• Is this conventional light framed wood construction?
Yes El No ❑ (check one)
• Does the structure have pre-engineered trusses?
Yes ❑ No ■❑ (check one)
OR
• Does structure have roof framing members spaced at 24 inches on center maximum?
Yes E No ❑ (check one)
• Is the weight of the PV modules and racking less than 4.5 pounds per square foot?
Yes 0 No ❑ (check one)
• Is the roofing material metal, single layer wood shingle, or not more than two layers of
composition shingle?
Yes E No ❑ (check one)
DEPART ENT
CC�OBBNUSUME
I)LSERVICES
440-4910(9/15/COM)
STRUCTURAL INFORMATION (continued)
Standing seam metal roofs:
• Is the metal gauge 26 or heavier?
Yes ❑ No ❑ (check one)
• Clamp design:Are clamps designed to withstand uplift of at least 115 pounds for clamps spaced at
60 inches on center or less or at least 75 pounds for clamps spaced at 48 inches on center or less?
Yes ❑ No ❑ (check one)
• Is the spacing of the clamps as measured along the seam less than or equal to 24 inches on center?
Yes ❑ No ❑ (check one)
• Is the roofing panel width 18 inches or less?
Yes ❑ No ❑ (check one)
• Will the roofiria.panel attachments be at least#10 screws at 24 inches on center?
Yes ❑ No (check one)
• Will the roofing panels be installed over minimum '/2-inch nominal wood structural panels
attached to framing with 8d nails at six inches on center at panel edges and 12 inches on center
field nailing?
Yes ❑ No ❑ (check one)
If no, on any of these requirements, the project may not be submitted using the prescriptive path.
ROOF DESIGN AND ATTACHMENT
• Attach a simple structural plan showing the roof framing(rafter size,type,and spacing) and PV
system racking attachment.
• System must be shown in sufficient detail to assess whether the requirements of Section 3111.5.3
have been met.
t • The structural plan must be on 8.5-inch x 11-inch or larger paper.
WIND DESIGN
• Does the project site exceed 95 mph in exposure C or 105 mph in exposures A or B?
Yes ❑ No ❑� (check one) If yes, the project may not be submitted using the prescriptive path.
• Is the module height less than 18 inches above the roof in accordance with section 3111.5.3?
Yes ❑■ No ❑ (check one)
PV MODULES
Manufacturer: Rec Solar
Model number: REC370AA (370W)
Listing agency: UL 1703
Christine Stamper Christine Da'ea'202g0707Y,3021 07.00' 09/17/2021
Applicant name(please print) Applicant signature Date
440-4910(9/15/COM)