Permit CITY OF TIGARD MASTER PERMIT
:III CITY
DEVELOPMENT Permit MST2021-00310
Date Issued: 09/16/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106D607400
Jurisdiction: Tigard
Site address: 17476 SW CLEMENTINE ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 74
Project: Van Der Hoest
Project Description: Rooftop Solar PV 11.16 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: $9,597.00 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 SrvclFeeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr. 0
Ea adds 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 11.16 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:
VANDERHOEST,ROBERT VINCENT CONDUIT ELECTRIC Required Items and Reports(Conditions)
MACCHIA,CRISTINA 19461 SW 89TH AVE
17476 SW CLEMENTINE ST TUALATIN,OR 97062
BEAVERTON,OR 97007
PHONE: PHONE: 503-692-1428
FAX: 503-692-3652
Total Fees: $356.19
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: HcaY Vc iiDe'We9e Permittee Signature: Dvi.Applf.e..axfl
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 Applicatiolt CEIVED
_ , _
Residential A NV
FOR OH ICI 1 SI-.OA11
City of Tigard Received p f),/ „.?
g Date/By:DO�F�`Y^'ZQ� � Permit No. C�LOL-/-00�1 0
IN,- • 13125 SW Hall Blvd.,Tigard,OR 97 43TY OF TIGARD plan Review can /Z 1
II Phone: 503.718.2439 Fax: 503.5 Date/By: ( r other Permit:
F, Inspection Line: 503.639.4175 ILU1NG DIVISION Date ReadyBy: / ® See Paget for
Internet: www.tigard-or.gov IyW3jI'd/Method: ( ( f)i ! Su,.Iemeotai Information
c TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® I-and 2-family dwelling ❑Commercial/industrial Valuation: $9,597.t)0
❑Accessory building 0 Multi-family Number of bedrooms:
ElMaster builder D Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:17476 SW Clementine St New dwelling area: square feet
10 City/State/ZIP:Beaverton, OR 97007 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Van Der Hoest Solar Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Off of SW Satsuma Ave on SW Clementine St Other structure area: square feet
IiEQ[JpATACOI,;iERE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed
Tax map./parcel no.:Could not find 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.
PV Solar Roof Mount 3 Circuit Valuation: $
1 l e t tf \ J Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Robert Van Der Hoest Type of construction:
Address:17476 SW Clementine St Occupancy groups:
City/State/ZIP:Beaverton, OR 97007 Existing:
Phone:(503 )6863999 Fax:( ) New
Pi APPLICANT 21 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Conduit Electric (Please refer mfee schedule)
Structural plan review fee(or deposit):
Contact name:Matthew Kelly
Address:
19461 SW 89th Ave FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP:Tualatin, OR 97062
Amount received:
Phone:(509)5056812 Fax: ( )
E-mail:robin.Van.der.hoest@gmalLCOm PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Conduit Electric Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:19461 SW 89th Ave Solar Installation Specialty Code checklist.
City/State/ZIP:Tualatin, OR 97062 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(509)5056812 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:109669 �i Total fee due upon application: $201.60
Authorized signature:�L2,GfI',A This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Matthew Kelly Date:8/3/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits 1BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB)
1 - -
.I
1
Building Permit Application Checklist
One- and Two-Family Dwelling FOH OFFICE 1'SF O\l.l
City of Tigard Received7
pale ay: vernut No.,
• 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone. 503.718.2439 Fax: 503.598.1960
I l r t n R I) 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing CIMechanical
Internet: www.tigard•or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les \o N/A
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
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 . 0 0 0
6 Sewer permit. 0 ❑ 0
7 Water district approval. 0 0 ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 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 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
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 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 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 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. D 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 ❑ 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 0 0 0
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 0 ❑ ❑
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 0 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 ❑ 0
architect licensed in Ore•on and shall be shown to be .,y.licable to the .ro"ect under review.
.11_ RISl)ICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-112"x 11"or 11"x 17". 0 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 0 _
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 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 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 ❑ 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.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
aECEIVE
Electrical Permit Apglica I FOR OFFICE USE ONLY
City of Tigard ,'�UC plj Received Permit#:
III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.59 . :'i r Related Permit#:
Inspection Line: 503.639.4175 OF RReeaadyDate/By: urn for
fI \III Internet: www.tigard-or.gov BUILDING DIVISION' Notified/Method: ® SeePent
G
Supplemental Information
❑New construction ®Addition/alteration/replacement Please cheek all that apply(submit 2 sets of plans w/items checked): - I
0 Service or feeder 400 amps or more ❑Building over three stories.
❑Demolilion ❑Other:
__ where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® I-and 2-family dwelling ❑Commercial/industrial Accessory building less to ground or exceeds1a,00o ❑Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-tarn ily ❑Master builder El Other: 0 Fire pump. 0 Installation of 150 KVA or
L_ JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
—"— ❑Addition of new motor load of system.
Job/t: Job site address:17476 SW Clementine St 100HPormore. ❑"A',"E","]•2","1-3",
City/State/ZIP:Beaverton, OR 97007 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Van Der Hoest Solar 0 Hazardous locations ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: v FEE SCHEDULE"'
Off of SW Satsuma Ave on SW Clementine St New
i residential single-or multi--family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map./parcel#:Could not find1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
'=? _, ESCRIPTION OF WORK _ Limited energy,residential
PV Solar Roof Mount 3 Circuit (wthabovesq.ft.) 7500 2
Limited energy,multi-family 75.00 2
residential(with above sq.fl.)
, r Renewable Energy ® See Page 2
,9 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Robert Van Der Hoest 200 amps or less 100.70 2
Address:17476 SW Clementine St 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Beaverton, OR 97007 601 amps to 1,000 amps 301.04 2
Phone:(503 )6863999 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:robin.van.derhoest@gmail.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 ®.CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
_ -- - - A.Fee for branch circuits with
Business name:Conduit Electric above service or feeder fee, 742 2
each branch circuit
Contact name:Matthew Kelly B.Fee for branch circuits without
19461 SW 89th Ave service or feeder fee,firs[ 56.18 2
Address:
branch circuit
City/State/ZIP:Tualatin, OR 97062 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(509)5056812 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:
permitting.wa@solgenpower.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Conduit Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:
19461 SW 89th Ave panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Tualatin, OR 97062 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(509)5056812 Fax:( ) ip/j 112,_ Investigation p hr min) 90.00/hr
Sb ^ Industrial plant(1 hr min) 78.18/hr
Email:permitting.wa@solgenpower.com a
/ J Inspechons for which no fee is 90.00i hr
CCB Lie.:109669 Electrical Lic.:26-905C Suprv.Lic.:rrr51 specifically listed(Vs hr min)
ELECTRICAL PERMIT.FEES
Suprv.Electrician signature,required: 11 Subtotal
Print name:Chuck Parker Date:8/3/2021 ❑Plan Review Required(25%of permit fee):
OJ��/q/ State surcharge(12%of permit fee):
Authorized signature: '2 /I TOTAL PERMIT FEE:
ILy
This permit application expires if a permit is not obtained within 180
Print name:Matthew Kelly Date:8/3/2021 days after it has been accepted as complete.
Number of inspections allowed per permit.
t:lBuildinglPenntis1ELC_Permi,App_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/EOM/WEB
_+t
Electrical Permit Application —City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL.WORK ONLY: FEE SCHEnui;�
•
Fee for all residential systems combined: $75.00 DescriptionQh' Each Total
y Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva x 133.56 133.56 2
❑ 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* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ 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 any of the above:
❑ 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
specificallylisted('%hr min)
ELECTRICAL' RMIT
:Fee for each commercial system: $75.00 Subtotal(Enter on Page 1)_• Number of inspections allowed per permit.
(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
❑ Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1.tBuildinslPermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015