Permit CITY OF TIGARD MASTER PERMIT
_ COMMUNITY DEVELOPMENT Permit#: MST2021-00388
Date Issued: 10/05/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 103BC03200
Jurisdiction: Tigard
Site address: 12270 SW ALBERTA ST
Subdivision: CANOGA PARK Lot: 6
Project: Shaffer
Project Description: Installation of 35 solar panels in 1 array(s)on a roof mounted 10.85kW PV system.
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: $6,675.00 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+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 10.85 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:
SHAFFER,THOMAS A&EILEEN TML INTERNATIONAL LLC Required Items and Reports(Conditions)
12270 SW ALBERTA ST 6405 E MILL PLAIN BLVD
TIGARD,OR 97223 VANCOUVER,WA 98661
PHONE: PHONE: 800-364-0470
FAX:
Total Fees: $357.69
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: Ho{l y Vaw De WZ[j2 Permittee Signature: Ow A�
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.
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Building Permit Applicati2ECEIVE
Residential SEP 7 2111
�j
City of Tigard Received
I�y OF TIGARG Date/By: ///3/2./ -ye) Permit N $j'�f)
13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review x V
■ Phone: 503.718.2439 Fax: 503.5983j1„DING DIVISION Dat RBey: 9�(� / fek Other Permit:
T I c;A R D Inspection Line: 503.639.4175 Date Ready/By' I���� /f ps VI See Page 2 for
Internet: www.tigard-or.gov No]yN�d/Method: �j ( f//j/ I I� Supplemental Information
!/7ri C2.f
TYPE OF WORK REQUIRED DATX:1-AND`3-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:Solar equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ID 1-and 2-family dwelling ❑Commercial/industrial Valuation: $6,675
❑Accessory building ❑Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:12270 Sw Alberta St New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Solar Install-TShaffer 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.
Installation of 35 solar panels in 1 array(s)on a roof mounted 10.85kW PV System Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Tom Shaffer Type of construction:
Address:12270 Sw Alberta St Occupancy groups:
City/State/ZIP:Tigard, OR 97223 Existing:
Phone:( 1(503)480-9247 Fax:( ) 'New:
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:TML International LLC
Structural plan review Ice(or deposit):
Contact name:Maggie Ludden FLS plan review fee(if applicable):
Address:6405 E Mill Plain Blvd
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98661
Amount received:
Phone:( )(360)836-1729 Fax:: ( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:permit@infinityd2d.com
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:TML International LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:6405 E Mill Plain Blvd Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver,WA 98661 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( )(800)818-0598 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:22360 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.
*Fee methodology set by Tri-County Building Industry
Print name:Maggie Ludden Date:9.7.21 Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WEB)
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Electrical Permit Applicatibd `✓EIVE FOR OFFICI: ISF ONI.I
Received
City of Tigard SEP 7 2'2r Permit#:
III
• 13125 SW Hall Blvd.,Tigard,OR 97223 TIGARD Date/B I t Sr�fi Ii �i
1'>a �� OF Plan Review Related Permit#:
Phone: 503.718.2439 Fax: 503.598. Date/B
Inspection Line: 503.639.4175 Ready Date/By: Juris, fa See Page 2 for
i 1<;AR° ga g BUILDING DIVISION Supplemental wvvw.ti rd-or. ov Notified/Method: Su lemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ❑Addition/alteration/replacemenl 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:Solar where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
Q 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 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑
Job#: Job site address:12270 Sw Alberta St 100Hoo of new motor load of system.
00HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard, OR 97223 0 Six or more residential units. occupancy.
y g ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Solar Install-TShaffer 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: , 4L 1 itt(; Zingir' a F3 V
Description Qty. Each Total *
New residential single-or multi-family dwelling unit.
Subdivision: 1,ot#: 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
(with above sq.ft.) 75.00 2
Installation of 35 solar panels in 1 array(s)on a roof mounted 10.85kW PV System Limited energ
y,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Tom Shaffer 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:12270 Sw Alberta St
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)480-9247 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:tomtom2222@msn.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, !er panel
A.Fee for branch circuits with
Business name:TML International LLC above service or feeder fee,
each branch circuit 7.42 2
Contact name:Maggie Ludden B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:6405 E Mill Plain Blvd branch circuit
City/State/ZIP:Vancouver, WA 98661 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( )(360)836-1729 Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:permit@infinityd2d.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:TML International LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address:6405 E Mill Plain Blvd panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/state/ZIP:Vancouver,WA 98661 Additional inspection(1 hr min) 66.25/hr
Phone:( )(800)818-0598 Fax:( ) Investigation(1 hr min) 90.00/hr ,
Industrial plant(1 hr min) 78.18/hr
Email:permit@infinityd2d.com inspections for which no fee is
CCB Lic.:223690 Electrical Lic.:C1556 Suprv.Lic.:
specifically listed('/z hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:S Cott LeDuc
Subtotal:
Print name:Scott LeDuc Date:9.7.21 ❑Plan Review Required(25%of permit fee):
,�/� State surcharge(12%of permit fee):
Authorized signature: 'U"✓� TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name:Maggie Ludden Date:9.7.21 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 440-4615Tt11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIftENTIAL WORK ONLY: >r exu><
Fee for all residential systems combined: $75.00 Description I Qty. I Each Total *
y Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 01 133.56 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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener*
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ 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
specifically listed(A hr min),
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Fee for each commercial system: $75.00 allowed le permnter t.o Pagel).
y * 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
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I\Building\Permits\ELC_PernuIApp_ELR_ERE_doc Res 06/17/2(115