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Permit Support Document RECEIVED OCT 13 2021 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENtITY OF TIGARD ' _ Request for Permit Action BUILDING DIVISION TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov • TO: CITY OF TIGARD V 0 I 0 Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ® Contractor ❑ City Staff Check(1)one REFUND OR Name: INVOICE TO: (Business or Individual) Blue Raven Solar, LLC Mailing Address: 1403 N Research Way, Building J City/State/Zip: Orem, Utah 84097 Phone No.: 385-482-0045 PLEA.$E_ZAKE ACTION FOR THE ITEM(S) CHECKED (✓): g CANCEL VOID PERMIT APPLICATION. ERMIT FEES (attach copy of original receipt and provide explanation below). INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). r Permit#: MST2021-00434 Site Address or Parcel#: 8630 SW Greensward Ln-Tigard, Oregon 97224 Project Name: Subdivision Name: Lot#: EXPLANATION: Customer is no longer moving forward with solar installation Signature: (2GC..C, Date: 10/13/2021 Print Name: Erica Christensen Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. /v07.— /SS cc-z FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date/+ 2-3/1/ By./ Refund Processed: Date/{/ By 49 e Invoice Processed: Date /0/j-jy/ By 490 Permit Canceled: Date/0 2-3/ / By.4 C Parcel Tag Added: Date By I:\Building\Forms\RegPennitAction_l 02 518.doc Dianna Ornelas From: #Building Permit Technicians Sent: Saturday, October 23, 2021 5:57 PM To: Permitting Department Cc: #Building Permit Technicians Subject: MST2021-00434 - 8630 SW Greenward Ln - Deal - Cancelled Permit Fees Due Attachments: MST2021-00434_Original_Invoice.pdf; MST2021-00434_Revised_Invoice.pdf Hello Erica, We received your request to cancel this permit, however the plan review had already been completed and the permit was ready to issue prior to request to cancel,therefore a minimum of$40.32 is due (20%)to cover plan review and administrative costs to cancel the permit. Please see the attached original and revised invoice. The fees due can be paid online at https://aca-prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number MST2021-00434 under the Building tab. Thank you. Dianna L. Ornelas Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits 1 CITY OF TIGARD FEE AND PAYMENT HISTORY 11111 !t 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD /G- eS C.7.7 S MST2021-00434 - 8630 SW GREENSWARD LN, TIGARD, OR 97224 Deal Fee Description Revenue Fee Amount Invoiced Paid Date Paid Payment Receipt# Due Account Number Method 12%State Surcharge-Building 100-0000-24001 $4.32 $4.32 $0.00 $4.32 Building Permit-RES 230-0000-43104 $36.00 $36.00 $0.00 $36.00 Totals for Fees $40.32 $40.32 $0.00 $40.32 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount Total Payments: Balance Due: $40.32 CITY OF TIGARD FEE AND PAYMENT HISTORY IIII I ` 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD __ / .`-'-m✓ /A -?7_,y..,. MST2021-00434 - 8630 SW GREENSWARD LN, TIGARD, OR 97224 Deal Fee Description Revenue Fee Amount Invoiced Paid Date Paid Payment Receipt# Due Account Number Method 12%State Surcharge-Building 100-0000-24001 $21.60 $21.60 $0.00 $21.60 12%State Surcharge- Electrical 100-0000-24001 $16.03 $16.03 $0.00 $16.03 5.01 to 15 kva 220-0000-43103 $133.56 $133.56 $0.00 $133.56 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $12.00 $12.00 $0.00 $12.00 11x17) Solar Photovoltaic System 230-0000-43104 $180.00 $180.00 $0.00 $180.00 Totals for Fees $363.19 $363.19 $0.00 $363.19 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount Total Payments: Balance Due: $363.19 \1/4,/ n I D Building Permit Application '. I2b 2.1 Residential RECEIVED FOR OFFICE USE ONLY City of Tigard Received M 0 O� / Permit No. STZO2/^00 , � cf.', 3 7.079 Date/By: �Cl 13125 SW Hall Blvd.,Tigard,OR 97223 SO' F^ ` Plan Review II It Phone: 503.718.2439 Fax: 503.598.1960 Plan Review i�,i Z A. Other Permit. Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Ia ® See Page 2 for TCGAKI� Internet: www.tigard-or.gov N ed/Method: I / , , Supplemental Information BUILDING DIVISION TYPE OF WORK •E ti i RE 11, -I ATA: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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION 4 work indicated on this application. Valuation: $ $4,736.55 ❑ I-and 2-family dwelling El Commercial/industrial Number of bedrooms: E]Accessory building ❑Multi-family ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 8630 SW Greensward Ln,Tigard, Oregon,97224 New dwelling area: square feet City/State/ZIP: Garage/carport area: square feet ISuite/bldg./apt.no.: Project name: Beth Deal Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet I REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit lees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Rooftop Solar PV 45 Z-5 14W Valuation: $ '' Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name: Beth Deal Type of construction: Address: 8630 SW Greensward Ln,Tigard,Oregon,97224 Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT elCONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedulel Business name: BRS Field Ops, LLC Structural plan review fee(or deposit): Contact name: Jeffrey Lee FLS plan review fee(if applicable): Address: 1403 N Research Way Total fees due upon application: City/State/ZIP: Orem, UT 84097 Amount received: Phone:( 385)482-0045 Fax: :( ) ermittin de arment blueravensolar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: P g P Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: BRS Field Ops, LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 1403 N Research Way Solar Installation Specialty Code checklist. City/State/ZIP: Orem, UT 84097 Permit Fee(includes plan review $180.00 and administrative fees): Phone:( 385 f82-0045 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 227185 Total fee due upon application: $201.60 Authorized signature: ,// IF permit application expires if a permit is not obtained tj . 4/ within 180 days after it has been accepted as complete. Print name: Jeffrey ee Date: 09/13/2021 *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/201 1 440-46I3T(I I/02/COM/WEB) rlVhij Electrical Permit Applicat a -J -- FOR OFFICE USE ONLY City Of Tigard 7 �: 3 A. 1 .L Received j. ©D i Date/By: Permit#: ; • 13125 SW Hall Blvd.,Tigard,OR 97223 g Plan Review Phone: 503.718.2439 Fax: 503.59 y� (X OF T IGARL) Date/By: Related Per it#: Inspection Line: 503.639.4175 3UILDING DIVISION Ready Date/By: Juris: EdSee Page 2 for IIC,Aki7 Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction El 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. El1-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#: Job site address: 8630 SW Greensward Ln,Tigard,Oregon,97224 ❑Addition of new motor load of system. 100HP or more. ❑"A","E","]-2","1-3", City/State/ZIP: 0 Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Beth Deal 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 Description 1 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 (with above sq.ft.) Rooftop Solar PV Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 El PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: Beth Deal 200 amps or less 100.70 2 Address: 8630 SW Greensward Ln,Tigard,Oregon,97224 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 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: BRS Field Ops, LLC above service or feeder fee, 7.42 2 each branch circuit Contact name: Jeffrey Lee B.Fee for branch circuits without Address: 1403 N Research Way service or feeder fee,first branch circuit 56.18 2 City/State/ZIP: Orem, UT 84097 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 385)182-0045 Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: permitting.department@blueravensolar.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: BRS Field Ops, LLC Sign or outline lighting 67.84 2 Address: 1403 N Research WaySignal circuit(s)or limited-energy El See Page 2 2 panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Orem, UT 84097 Additional inspection(1 hr min) 66.25/hr Phone:( 385)182-0045 Fax:( ) Investigation(1 hr min) 90.00/hr blueravensolar.com Industrial plant(I hr min) 78.18/hr Email: Permittin de artment 9 P @ Inspections for which no fee is 90.00/hr CCB Lic.: 227185 Electrical Lc.: C1493 Suprv.Lic.: 6394S specifically listed('/hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: r Subtotal: Print name: Shan Whittaker Date: 09/13/2021 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: ,AVTOTAL PERMIT FEE: j/ ' This permit application expires if a permit is not obtained within 180 Print name: Jeffrey L / Date: 09/13/2021 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Budding\Permits\ELC_Pern,5App_ELR_ERE.doc Rev 06/1712015 440-4615T111/05/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 Fee for all residential systems combined: $75.00 Description Qty. Eaeh Total * Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 1 133.56 2 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 Garage Door Opener* 50.01 to 100 kva 552.26 2 >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 specifically listed('/2 hr min) 90.00/hr COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 aSu llowe ai(Enter on Page 1): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: Audio and Stereo Systems Boiler Controls Clock Systems I I Data Telecommunication Installation Fire Alarm Installation HVAC I I Instrumentation 1 I I Intercom and Paging Systems I I Landscape Irrigation Control* Medical Nurse Calls 1 t, Outdoor Landscape Lighting* l I Protective Signaling I Other: Total number of commercial systems: *No licenses are required. Licenses are required for all Ii other installations I. 1:,Building\Perm its\ELC_Pern,itApp_ELR_ERE.duc Rev 06/1 72 0 1 5 City of Tigard RECEIVED Building Division SEP 2 3 202/ • 13125 SW Hall Blvd, Tigard, OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD TIGARD Inspection Line: 503.639.4175 3UILDING DIVISION www.tigard-or.gov 2010 Oregon Solar Installation Specialty Code Check List for Prescriptive Installation of Roof-Mounted PhotoVoltaic Solar Panel System Property Information Installation Address: 8630 SW Greensward Ln, Tigard, Oregon, 97224 City: Zip: Owner's Name: Beth Deal Date: 09/13/2021 Contractor's Name: BRS Field Ops, LLC CCB #: 227185 Design Parameters of the Property/Structure If"Yes", does not Flood Hazard Is the installation I Yes qualify for the Located in a flood prescriptive path, follow Area plain/flood way? p No OSSC or ORSC for design requirements. El Yes Wind Exposure Is the wind exposure If"Yes", qualifies for "C" or less? i No the prescriptive path. Installations on detached Is the Ground Snow single/two-family Load 70 psf or less? dwelling/single/two- If"Yes", qualifies for family townhomes Yes the prescriptive path. and/or their accessory Ground structures. I No Snow Load Is the Ground Snow Installations on all Load 50 psf or less'? If"Yes", qualifies for structures other than 0 Yes the prescriptive path. above No I:/Building/Forms/PhotoVoltaic-Checklist02-0I-I I.docx Is the construction material wood and does Yes "Yes",of If Yes , qualifies for the construction qualify ve No the prescriptive path. Construction as "conventional light p p frame"construction? Is the spacing 24 inches or less? Pre-engineered trusses. p Yes If"Yes", qualifies for the prescriptive path. No Roof framing members Is the spacing 24 inches or less? Nominal lumber. Yes If"Yes", qualifies for the prescriptive path. No Is the combined weight Qv Yes of the PV modules and If"Yes", qualifies for racking less than or No the prescriptive path. Solar equal to 4.5 psf? installation Is the solar installation p Yes layout in accordance If"Yes", qualifies for with Section 305.4(3) of n No the prescriptive path. the 2010 Oregon Solar Code? ❑ Metal Single layer If roofing material is Roofing Check the type of of wood one of the three types material roofing material shingle/shake checked, qualifies for Max. two layers the prescriptive path. L2 of composition shingle. Is the roof mounted p Yes Connections of solar assembly the solar assemblyconnected to roof If"Yes", qualifies for ❑ No the prescriptive path. to the roof framing or blocking directly? <p 2 t I:/Buildine/Forms/PhotoVoltaic-Checklist02-0I-I I.docx • Yes If"Yes", qualifies for Is the gauge 26 or less? No the prescriptive path. 115 lbs for 60 inch spacing or less? If"Yes", qualifies for n Yes the prescriptive path. No Minimum Uplift rating of Clamps? 75 lbs for 48 inches spacing or less? If"Yes", qualifies for I I Yes the prescriptive path. No Attachment of roof mounted Minimum 24 inches If the spacing falls solar systems Spacing of clamps? within 24 inches and 60 directly to inches Maximum 60 inches inches, qualifies for the standing seam prescriptive path. metal panels Width of roofing If the width of the panel panels? 18 inches or less is less than 18 inches, inches qualifies for the prescriptive path. Minimum #10 at 24 inches o/c? Size and spacing of If"Yes", qualifies for fastener? n Yes the prescriptive path. (l No Is the roof decking of WSP min. 'h"thickness, Yes decking connected to If"Yes", qualifies for framing members I I No the prescriptive path. w/min. 8d nails @ 6"/12" o/c? Is the height less than or Maximum 18 inches equal to 18 inches? Height of the from the top of the If"Yes", qualifies for solar modules module to the roof ElYes the prescriptive path. surface. I I No 3 P�LG ,M_M_1 rinry Submittal Documents required for Prescriptive Installations Show the location of the PV system in relation to buildings, structures, property lines, and, as applicable, flood hazard areas. Site Plan Details must be clear and easy to read. Minimum size of the plan is 8.5 x 11 inches. Attach a simple structural plan showing the roof framing(rafter size, type, and spacing) and PV module system racking attachment. System must be shown in sufficient detail and clarity to assess whether it Structural Plan meets the prescriptive construction requirements as listed earlier above in the matrix. Minimum size of the plan is 8.5 x 11 inches. PV Modules Manufacturer: JinKO Solar Eagle Model Number: JKM375M-6RL3-B Listing Agency: CSA 4 l JRuildine/Forms/PhotoVoltaic-Checklist02-0I-I I.docx