Permit %fY(HHartYHHYHiue:euwur utiewul.4 fx r Hu HFuuu •araaua a+•v.+ +xu.ruur HLHtIF. aYt/YHia1HYfAtitHu fltikeatYUFHf It f +a••+.. a tr+ i.riHuaul f!! ! s • if tl.i.f ltifruwti.+fuHfro xauaur i toura.x+ewss:..
CITY OF TIGARD MASTER PERMIT
' 111 • COMMUNITY DEVELOPMENT Permit#: MST2021 00523
Date Issued: 12/09/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 104CC05900
Jurisdiction: Tigard
Site address: 14370 SW MISTLETOE DR
Subdivision: HILLSHIRE WOODS Lot: 3
Project: Scoby
Project Description: Rooftop Solar PV 8.4 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: $4,670.00 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
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'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 8.4 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:
SCOBY,JILL ANNETTE REV LIVING TRUBRS FIELD OPS LLC Required Items and Reports(Conditions)
14370 SW MISTLETOE DR 1403 NORTH RESEARCH WAY
PORTLAND,OR 97223 OREM,UT 84097
PHONE PHONE: 855-205-2530
FAX:
Total Fees: $358.19
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
oc9-nni-Min fhrnnnh naP oc9-nni nn0n Vni i maw nhfain a nnnw of fhc ri ilce nr rdirerf nncefinne fn rll Mir hw ra llinn cm m,)10R7 nr 1 Ann Z79?IAA
Issued By: He4 ,y Va-vv I:)&Wege Permittee Signature: Ov 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 iob site at the time of each inspection.
Pudding Permit Application .w 5Residential RECEIVE I FOR OFFi%E USE ONLY
Cityof Tigard NOV e) O 2021 Received/ 'Al 2e'2en,".
MST2O2(-1 S23
g 3l Date/By: Permit No.:
MS
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review i 'I
' Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD Date/By: 1 ( � A
Other Permit:
lA1t C Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Not led/Method: 1 ? 2�6 11 6- Supplemental Information
,,, TYPE OF WORK fr 2FD AT; :t-AND 2-HAM ILYDWELLING
❑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: equipment,materials,labor,overhead,and the profit for the
`y CATEGORY OF CONSTRUCTION
work indicated on this application.
Valuation: $ 4670.40
r ❑ 1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other Number of bathrooms:
�< . ,_ > JOB SITE INFORMATION AND LOCATION Total number of floors:
1,-ti:mi d.
Job site address: 14370 Southwest Mistletoe Drive,Tigard,Oregon,97223 New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Jill Scoby 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DFSCRIP770N OF WORK work indicated on this application.
Rooftop Solar PV y ,� Valuation: $
Existing building area: square feet
New building area: square feet
r-{4 PROPERTY OWNER ❑ 'I'F:N,1.NT Number of stories:
Name: Jill Scoby Type of construction:
Address: 14370 Southwest Mistletoe Drive,Tigard,Oregon,97223 Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
APPLICANT Vi CON"I AC 1 PERSON Mil L DIN( PERMIT FEES*
JI
BRS Field Ops, LLC (Please r r ro 'e schedrde)
Business name: P
Structural plan review fee(or deposit):
Contact name: Jeffrey Lee
FLS plan review fee(if applicable):
Address: 1403 N Research Way
City/State/ZIP: Orem, UT 84097 Total fees due upon application:
Amount received:
Phone:( 385)482-0045 Fax: :( )
E-mail: permitting.deparment@blueravensolar.com PHOTOVOLTAIC SOLAR P111i',I SYS'I I \I FEES*
-- � � '.. Commercial and residential prescriptive installation of
psiginNiiiswaiiiil
w, °'' � � � 4 E, "q, `,a 2T 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)482-0045 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 227185
Total fee due upon application: $201.60
Authorized signature: I,ff, ' This permit application expires if a permit is not obtained
d ht'ri _Wit within 180 days after it has been accepted as complete.
j *Fee methodology set by Tri-County Building Industry
Print name: Jeffrey Lee Date: 11 /24/2021 Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
w,
Electrical Permit Application RECEIVED FOR OFFICE USE ONLY
City of Tigard NOV 3 0 2021 Date/By:
III Permit#:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.196
tITY OF TIGARD Date/By: Related Permit#:
-" Inspection Line: 503.639.4175 Ready Date/By: lam. El See Page 2 for
I Ri A 1t 11 Internet: www.tigard-or.gov 3UILDING DIVISION Notified/Method: Supplemental Information
�3 ZP`` v x y sy �,`+r5 r ri x�+ F v c s
av 1 t,...c,1;.t f%i,1``> La it ;: ?' ` i +Ji ft 1 #r:4 s xs iF,� t k , ';€r5.:�' t :1.455 s i• w'� r a��. -*I g,''.". .'ts<€.r�
❑New construction El Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked).
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
8' f fi `e L3 "S ft?3'%hr= r Y' S� r
tt $�J'�C�f{�® • 1EJ� � \ § 4 ,� � exceeds 10,000 amps at I50 volts or El Floating buildings-
:1 4{� rr{ j{t€�4'#$$�rf Fn.3e_s�Iv R¢ 3A&i. x, , �S� s�Z� vasty i. �'>�T
0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations, buildings.
❑Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
( e zit s ( t' t S f t t I '' y; ❑Emergency system. larger separately derived
` I. �m � " 3 "�' ` `.'. ❑Addition of new motor load of system.
Job#: Job site address: 14370 Southwest Mistletoe Drive,Tigard, D►ego/a047 re. ❑"A","E","1-2'","I-3",
❑Six or more residential units. occupancy.
City/State/ZIP:
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: Jill Scoby ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: ;). >, z>, .. 4.�y, ';4 .< , ?,
Description Qtv. Each Total
New residential single-or multi-family dwelling unit.
Subdivision: I 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
n i Limited energy,residential
(with above sq.ft.) 75.00 2
Rooftop Solar PV
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
,,.;=?m,n t I,,.. , . t� Services or feeders installation,alteration,and/or relocation
Name: Jill Scoby 200 amps or less 100.70 2
Address: 14370 Southwest Mistletoe Drive,Tigard,Oregon,97223 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:( ) I 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
Branch circuits—new,alteration,or extension,per panel
" `t t 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 56.18 2
branch circuit
City/State/ZIP: Orem,UT 84097 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( 385)482-0045 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: permitting.department@blueravensolar.com Reconnect only 67.84 2
. > ° )' t r Jti,, 115 t'; ` `- # t ' / r 34 / `7t . a. i' Pump or irrigation circle 67.84 2
Business name: BRS Field Ops, LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy El Page 2 2
Address: 1403 N Research Way panel,alteration,or extension.
City/State/ZIP: Orem, UT 84097 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 385) 482-0045 Fax: ( ) Investigation(1 hr min) 90.00/hr
Email: permitting.department@blueravensolar.com Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 227185 Electrical L'c.: Cl493 Suprv.Lic.: 6394S s.ectficau listed('�,yhrmin { y
.I`k t,r Y.3f f�L..+ SSS., >Yt• 3k�Ti`......1 Tt'lt..,,r t ,
Suprv.Electrician signature,required: // Subtotal:
Print name: Shan Whittaker Date: 11 /24/2021 ❑Plan Review Required(25%of permit fee):
/ State surcharge(12%of permit fee):
Authorized signature: ,//1 „ TOTAL PERMIT FEE:
/ �R This permit application expires it a permit is not obtained within 180
Print name: Jeffrey L Date: 11 /24/2021 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits/ELC_PermitApp_ELR_ERE.doc Rev 06/t 7/2015 440.4615T(I I/05/COM/WEB
Electrical Permit Application —City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
.� . C:q . ;_
Description Qty. I Each 1 Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
n Heating,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:
ID Other: Each additional inspection is 66.25/hr
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
s.ecificall listed('/2 hr min
Fee for each commercial system: $75.00 Subtotald perpermEnter t.o Page 1):
y ' Number of inspections allowed permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n A• udio and Stereo Systems
n Boiler Controls
n C• lock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ H• VAC
❑ Instrumentation
L Intercom and Paging Systems
❑ L• andscape Irrigation Control*
n M• edical
n N• urse Calls
❑ Outdoor Landscape Lighting*
Protective Signaling
I I Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
l:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015