Permit CITY OF TIGARD MASTER PERMIT
= COMMUNITY DEVELOPMENT Permit#: MST2021-00437
T[ AR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2021
G T)
Parcel: 1 S134CB10100
Jurisdiction: Tigard
Site address: 12550 SW EDGEWATER CT
Subdivision: MILL VIEW Lot: 1
Project: Blanding
Project Description: Rooftop Solar PV 4.32 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: $4,320.00 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
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=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 N
Other: Y Other Description: Roof Top Solar PV System 4.32 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:
BLANDING,MARK&ROXANNE ELEMENTAL ENERGY LLC Required Items and Reports(Conditions)
BLANDING,RANDA 1339 SE 8TH AVE#B
12550 SW EDGEWATER CT PORTLAND,OR 97214
PORTLAND,OR 97223
PHONE: PHONE: 503-967-5786
FAX:
Total Fees: $318.38
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: H04 41 Vo-K,Pe-We9- Permittee Signature: OI',Ap-p-blza4io-vt,
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.
Building Permit Application E C E I VE D
E-a1122. 21
Residential 8EP 2 8 2021 FOR OFFICE USE ONLY
City of Tigard CITY Received/D ex/
S1 2o ��y
OF TIGARL) DateBy: PermitNo.� 21- U I/
r 13125 SW Hall Blvd.,Tigard,OR 31.241r'� Plan Review _I
Ilk 11 Phone: 503.718.2439 Fax: 503.5DING DIVISION DateBy: 113 (� A Other Permit:
T 1 GA R C Inspection Line: 503.639.4175 D. "eadyBy:� t ® See Page 2 for
Internet: www.tigard-or.gov • .d/Method/G I �� Supplemental Information
F 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.
cst 1-and 2-family dwelling ❑Commercial/industrial
Valuation: S 4� 320
gill ❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12550 SW EDGEWATER CT New dwelling area: square feet
1 City/State/ZIP: Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Blanding Solar 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
j Subdivision: I 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.
4.32kWAC Solar PV prescriptive roof mount install valuation: $
Existing building area: square feet
New building area: square feet
IN PROPERTY OWNER ❑ TENANT Number of stories:
Name: Mark Blanding Type of construction:
Address: same as above Occupancy groups:
City/State/ZIP: Existing:
Phone:( )619-318-2813 Fax:( ) New:
NI APPLICANT a 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.
Submit two(2)sets of roof plan with connection details Business name: ELEMENTAL ENERGY
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 lie.: 195141
Total fee due upon application: $201.60
Authorized signature: V,m -" Y)f t This permit application expires if a permit is not obtained
t^ Y^ within 180 days after it has been accepted as complete.
Print name: CHRISTINE STAMPER Date: 09/28/2021 *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)
1
1
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Building Permit Application Checklist
3
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
Date/By: PermitNo.:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
m Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical ❑ Plumbing 0 Mechanical
T 1 G A R n Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ 0
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 ❑ El
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 ❑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 ❑ ❑ ❑
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. ❑ ❑ ❑
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 ❑ ❑ ❑
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 ❑ ❑ ❑
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 ❑ ❑ ❑
architect licensed in Ore.ton and shall be shown to be a plicable 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". ❑ ❑ ❑
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, ❑ ❑ ❑
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(11/02/COM/WEB)
.. RECEIVED
Electrical Permit Application FOR OFFICE USE ONLY
rer
SEP ( (it 9 Received d /S1 j/ll OJ . 7
City of Tigard Date/By: Permit#.Y�A1 LILJ V t
;Il w 13125 SW Hall Blvd.,Tigard,OR 97223sirt, L3U Plan Review
Phone: 503.718.2439 Fax: 503.598.1 OF rl Date/By: Related Permit#.
Inspection Line: 503.639.4175 3UILDING DIVISION Ready Date/By: Loris: ® See Page 2 for
f I G AR 1) Internet: www.ti ard-or.gov Notified/Method:
$ Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction E Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ill Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
]K 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
''J ❑Addition of new motor load of system.lob#: Job site address: 12550 SW EDGEWATER CT 100HP or more. ❑ "E",
City/State/ZIP: Tigard, OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Blanding Solar ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
II 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'I 500 sq.ft.or portion 33.92 1
I DESCRIPTION OF WORK Limited energy,residential
4.32kw AC Solar Photovoltaic Install. (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Mark Blanding 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
Same as job site 401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) 619-318-281 3 Fax:( ) Over 1,000 amps or volts 552.26 2
Email: mark.dwain.blanding@gmail.com Temporary services or feeders installation,alteration,and/or
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
11 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
Address: service or feeder fee,first 56.18 2
1'3 39 SF, RTH A VF STF R branch circuit
City/State/ZIP: PORTLAND OR 97214 Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(5f'3.)967-57R6 Fax: :( ) Each manufactured or modular 67.84 2
Email: dwelling,service and/or feeder
PERMITS(er�,ELEMENTALENERGY.NET Reconnect onl 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: ELEMENTAL ENERGY Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 1339 SE 8TH AVE STE B panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP: PORTLAND 0197214 Additional inspection(1 hr min) 66.25/hr
Phone:( 503'967-5786 Fax:( ) Investigation(1 hr min) 90.00/hr
al
(1
Email: PERMITS(a1ELEMENTALENERGY.NET Inspections plant which no 78.18/hr
Inspections for no fee is 90.00/hr
CCB Lie.: 195141 fElectrical Lie.: C 1228 Suprv.Lie.: 4894S specifically listed(rz hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: -1a Subtotal:
Print name: David Gehrke Date: 09/28/2021 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: WI.eit, �+yt--,
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: CHRISTINE STAMPER Data:09/28/2021 days after it has been accepted as complete.
* Number of inspections allowed per permit. `
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(l1/05/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
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
I I 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
50.01 to 100 kva 552.26 2
n G• arage Door Opener* >100 kva(fee in accordance
552.26 2
with OAR 918-309-0040)
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('/hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial $75.00 Subtotal(Enter on Page 1):system:
y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n D• ata Telecommunication Installation
PI F• ire Alarm Installation
f 1 HVAC
n Instrumentation
I I Intercom and Paging Systems
n L• andscape Irrigation Control*
PI M• edical
n Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
]:\Building\Permits\ELC_PermitApp_ELR_ERE.dos Rev 06/17/2015
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