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Permit 11111 CITY OF TIGARDMASTER PERMIT E • COMMUNITY DEVELOPMENT Permit#: MST2021-00449 Date Issued: 10/27/2021 TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503.718.2439 Parcel: 2S104CD10200 , Jurisdiction: Tigard Site address: 13611 SW TRACY PL Subdivision: HILLSHIRE ESTATES NO.2 Lot: 101 Project: Cerbone Project Description: Rooftop Solar PV 5.76 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: $5,760.00 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 Furn<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: 1 0-200 amp. 0 W/Svc or Fdr: 5 Ea add'I 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 5.76 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: CERBONE,ROBERT REVOCABLE LIVINiELEMENTAL ENERGY LLC Required Items and Reports(Conditions) 13611 SW TRACY PL 1339 SE 8TH AVE#B TIGARD,OR 97223 PORTLAND,OR 97214 PHONE: PHONE: 503-967-5786 FAX: Total Fees: $518.02 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 Qc nn1-nnln thrniinh nap oc9-nnl-noon Vnii rnw nhmin n nnnv of tho n Joc nr riirArf mmctinne to ni'Mr by rollinn CM 7'17 1 QR7 nr 1 R1111'1'37 77Ad Issued By: Ho 1.. VA-w De, W6.,E- Permittee Signature: Of't/Ap-p-Lit.44-Lo-K. 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. i 1 Building Permit Applicati CENE 0 Residential FOR OFFICE USE ONLY EriCl of Tigard OCT 1 T 102� Retceeived / permit No c 13125 SW Hall Blvd.,Tigard,OR 97223�-�/ Pan Redd.o `Q�J�� �J����v 9 Phone: 503.718.2439 Fax: 503.598. 4 1 QFIUAKV DateBy D (� �/, Other Permit Inspection Line: 503.639.4175 I Date ReaReady/By: ® See Page 2 for TI GAR D Internet: www.tigard-or.gov "WILDING DIVISI01� Notif d Method Supplemental Information TYPE OF WORK REQUI' 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 j Addition/alteration/replacement ❑Other equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. l I-and 2-family dwelling ❑Commercial/industrial Valuation: $ 5760 0 Accessory building ❑Multi-family Number of bedrooms: / ❑Master builder El Other: Number of bathrooms: `� JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 13611 SW Tracy PI New dwelling area: square feet City/State/ZIP: Tigard OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Cerbone PV 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 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. 5.76 kWAC roof mount, non-prescriptive, grid interactive, pv, solar Valuation: $ solar system Existing building area: square feet New building area: square feet li:1 PROPERTY OWNER ❑ TENANT Number of stories: Name: Cerbone. Robert Type of construction: Address: 13611 sw tracy pl Occupancy groups: City/State/ZIP: 13611 sw tracy pl Existing: Phone( ) 503 3109300 Fax:( ) New: ❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name: Elemental Energy LLC (Please refertoJeescladark) Structural plan review fee(or deposit): Contact name: Molly Beckel FLS plan review fee(if applicable): Address: 1339 SE 8th Ave Suite B Total fees due upon application: City/State/ZIP: Portland OR 97214 Phone:( 503 9675786 Fax: :( ) Amount received: E-mail: permits@elementalenergy.net PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name: Elemental Energy LLC and fire department access,along with the 2010 Oregon Address: 1339 SE 8th Ave Suite B Solar Installation Specialty Code checklist. City/State/ZIP: Portland OR 97214 Permit Fee(includes plan review and 00 and administrative fees): Phone:( 503 9675786 Fax ( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 195141 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained —� within 180 days after it has been accepted as complete. Print name: Molly Beckel — Date: 10/14/21 *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) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY Received City of Tigard Date/By ''"°"`No 1411 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: a Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing ❑ \le,hinl,.d TIGARD 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. ❑ ❑ ❑ 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: ❑ CI CI 5 Septic system permit or authorization for remodel. Existing system capacity ClCI CI 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- 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. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendtuns 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 ❑ El ❑ 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 on and shall be shown to be licable to the ro'ect under review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ El 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"buildingplans 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. 1:'Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) • RECEIVED Electrical Permit Application OCT 14 2011 FOR OFFICE USE ONLY f g CITY OF TIGARU Received Cl O Tigard Permit# 11 • 13125 SW Hall Blvd.,Tigard,OR 972 A' Plan Review Phone: 503.718.2439 Fax: 503.59830/DING DIVISION Date/B : Related Permitii: Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for 1 i C'ARP, Internet: www.tigard-or.gov Notified/Method: Supplemental information TYPE OF WORK PLAN REVIEW ❑New construction ©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 ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. El 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. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: 21-2388 Job site address: 13611 SW tracyPI ❑Addition of new motor load of system. 100HP or more- ❑"A" "E" "1-2""1-3" City/State/ZiP: Tigard OR 97223 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Cerbone PV 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 Description I Qty. I Each I Total I . New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: - -_- 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK Limited energy,residential 75.00 2 5.76 kWAC roof mount, non-prescriptive, grid interactive, pv, Limited(with abovenergy,sq.ft.)multi-family solar system with a 200A generation panel and 4 batteries residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: cerbone, robert 200 amps or less 1 100.70 2 Address: 13611 SW tracy PI 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: tigard OR 97223 601 amps to 1,000 amps 301.04 2 Phone:( 503)310 9300 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email:bob(@,cerbone.net 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 will/ Business name: Elemental Energy LLC above service or feeder fee, 5 7.42 2 each branch circuit Contact name: Molly Beckel B.Fee for branch circuits without service or feeder fee,first Address: 56.18 2 1339 SE 8th Ave Suite B branch circuit City/State/ZIP: Portland OR 97214 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 503)9675786 Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: permits@elementalenergy.net Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Elemental Energy LLC Sign or outline lighting 67.84 , 2 Address: 1339 SE 8th Ave Suite B Signal t(s)orlimited-energy 0 See Paget 2 panel,alteration,or extension. City/State/ZIP: Portland OR 97214 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( 503 9675786 Fax:( ) investigation(l hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:permits@elementalenergy.net inspections for which no fee is 90.00/hr CCB Lic.: 195141 Electrical Lic.: C1228 ,.Suprv.Lic.: 4894S specifically listed(/hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: David Gerke Date: 10/14/21 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): •-_...(14:: Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Molly Beckel Date: 10/14/21 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PemrilApp_ELR_ERE.doc Rev 06/172015 440-4615T(1 I/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 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 X 133.56 2 ri A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ri 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 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 n V• acuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n O• ther: 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('h hr min) COMMERCIAL WORK ONLY: ELECIRICr ,PERftT 'FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page t): y * Number of inspections allowed per penmt. (SEE OAR 918-309-0000) Check Type of Work Involved: n A• udio and Stereo Systems n B• oiler Controls n C• lock Systems I I Data Telecommunication Installation n Fire Alarm Installation (� H• VAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* Medical n Nurse Calls n Outdoor Landscape Lighting* Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 ;,4