Permit W
1 r q CITY OF TIGARD MASTER PERMIT
. •• I COMMUNITY DEVELOPMENTPermit#: MST2021 00511
Date Issued: 12/08/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 111 DA19500
Jurisdiction: Tigard
Site address: 8561 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 14
Project: Moon
Project Description: Rooftop Solar PV 5.84 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: $10,000.00 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'l 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+amplvolt: 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 5.84 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:
MOON,JANGWON&CRISTINA FREEDOM FOREVER OREGON LLC Required Items and Reports(Conditions)
8561 SW SCHMIDT LOOP 15943 NE CAMERON BLVD
TIGARD,OR 97224 PORTLAND,OR 97230
PHONE: PHONE: 971-808-7776
FAX:
Total Fees: $356.69
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 rf uires you to f ow the r es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: %ll Permittee Signature: � � 1 /bG17C1"1
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.
Building Permit Application
Residential C����{-1 FOR OFFRI:USE ONL
City of Tigard ,E L•J Received /�29 02/ �.- PermitNo.: �2!O5„
Date.y: �/
11,1
4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie
■ Phone: 503.718.2439 Fax: 503.598.1960 NOV 2 S Zan Date/By: I J/2_i I Other Permit:
T I li A R D Inspection Line: 503.639.4175 Date Ready/By: ) / ( Jurls: B( See Page 2 for
Internet: www.tigard-or.gov . TY OF TIGARD rfied/Metho; 1 O`I Supplemental Information
TYPE OF WORT.-"f -, •? ' ' `` 'M REQUIRED DATA: 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: S
® I-and 2-family dwelling ❑Commercial/industrial 10,000
0 Accessory building ❑Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:8561 SW Schmidt Loop New dwelling area: square feet
City/State/ZIP: TIGARD/OR/97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: MOON - 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:Heritage Crossing Lot no.: 14 Permit fees*are based on the value of the work performed.
2S DA19500 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.
5.84kW PV Roof Mount - Solar Valuation: na $
Existing building area: square feet
New building area: square feet
CI PROPERTY OWNER 0 TENANT Number of stories:
Name: Jangwon Moon Type of construction:
Address:8561 SW Schmidt Loop Occupancy groups:
City/State/ZIP:TIGARD/OR/97224 Existing:
Phone:(971) 400-1420 Fax: ( 1 _ New:
® APPLICANT El CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Freedom Forever Oregon LLC
Structural plan review fee(or deposit):
Contact name:Leann Malloy
FLS plan review fee(if applicable):
Address:15943 NE Cameron Blvd
Total fees due upon application:
City/State/ZIP:PORTLAND/OR/97230
Amount received:
Phone:(971 )808-7776 Fax: :( )
E-mail,PermitsPortland@freedomforever.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Freedom Forever Oregon LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:15943 NE Cameron Blvd Solar Installation Specialty Code checklist.
City/State/ZIP:PORTLAND/OR/97230 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 971 )808 7776 Fax.( ) State surcharge(12%of permit fee): $21.60
CCB lie.:234650 Total fee due upon application: $201.60
Authorized signature: Le.a.LiL 711G.�(,I7 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 11/22/2021 *Fee methodology set by Tri-County Building Industry
Leann Malloy Date:
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE [SSE oNI.y
City of Tigaard Received
i b Date/B : Permit#:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#
Inspection Line: 503.639.4175 Ready Date/By: Juris: H See Page 2 for
I I"'\It U Internet: www.ti and-or. ov Notified/Method:
g g 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):
❑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 ❑Floating buildings.
® 1-and 2-family dwellingCommercial/industrial less to ground,or exceeds 14,000 ❑Commercial-use agricultural
0 ❑ Accessory building g cultural
amps for all other installations. buildings.
❑Multi-family ❑ Master builder ❑Other:
❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
AddJob#: 194999 Job site address:8561 SW Schmidt Loop IOOH 0 100H P or more
ion ofo motor load of system.
. ❑"A","E","1-2","l-3",
City/State/ZIP: TIGARD/OR/97224 U Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:MOON - Solar ❑Hazardous locations. 0 Supply voltage for more than
0 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:Heritage Crossing Lot#:14 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:2S l I 1 DA 19500 .
Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
sq. 75.00 2
5.84kW PV Roof Mount - Solar (with above ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
® PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:Jangwon Moon 200 amps or less 100.70 2
Address:8561 SW Schmidt Loop 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:TIGARD/OR/97224 601 amps to 1,000 amps 301.04 2
Phone:( 971)400-1420 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
El APPLICANT �� CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Freedom Forever Oregon LCC above service or feeder fee,
each branch circuit 7.42 2
Contact name:Leann Malloy B.Fee for branch circuits without
service or feeder fee,first
Address:15943 NE Cameron Blvd branch circuit 56.18 2
City/State/ZIP:pORTLAND/OR/97230 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(g71 ) 808-7776 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: PermitsPortland(a�freedomforever.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Freedom Forever Oregon LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:15943 NE Cameron Blvd panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP:PORTLAND/OR/97230 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 971) 808-7776 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:PermitsPortland@freedomforever.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.:234650 Electrical Lic.:C1612 Suprv.Lic.:65765
specifically listed('y hr min) 90 00-hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: 44
2t
Subtotal.
Print name:Greg Albright Date:11/22/2021 0 Plan Review Required(25%of permit fee):
//// State surcharge(12%of permit fee):
Authorized signature: s�_-2laIZN.��lQ. 4,_ TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name:Leann Malloy Date:11/22/2021 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description DO, I Each 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 1 133.56 133.56 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
❑ 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: Prescriptive Roof Mounted PV System 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('/hr min)
COMMERCIAL WORK ONLY: MOM
Subtotal(Enter on Page 1).
Fee for each commercial system: $75.00 * 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
n 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:\Budding\Permits\ELC_PermitApp_ELRERE.doc Rev 06/17/2015