Permit FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
r l i,,�Il n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Allyson Armstrong DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Maggie Ludden FEB 8 2022
I
COMPANY: TML International LLC CITY OF TIGARD
PHONE: (360)836-1729 3UILDING DIVISION By: .
EMAIL: permit@infinitysolarusa.com
RE: 10405 Sw Highland Dr MST2021-00519
(Site Address) (Permit Number)
Solar Install-KSiminski
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. X Revisions: See remarks below
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: The changes that were made are as follows:We updated the plans to reflect the as-built changes made during install.
We updated the panel type, panel count and inverters type.Also,please note the change to one line(second disconnect not needed).
FO OF ICE USE ONLY
Routed to Pe •' tct . '�- (-1 22 Initials: Airt
Fees Due: Ye [v�No _ ee Description: Amount Due:
./ $
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Special
instructions: �,
Reprint Permit(per PE): ❑ Yes No [' Done
Applicant Notified: �, Date: ��� Initials: /,
•
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infinity solar
Revision Narrative
Project: Solar PV Installation Date: 2.8.22
Permit#: MST2021-00519
Applicant:TML International LLC
Address: 10405 Sw Highland Dr
Tigard, OR 97224
Comments Addressing Updates to Site Plan
The changes that were made are as follows: We updated the plans to reflect the as-built
changes made during install. We updated the panel type, panel count and inverters type. Also,
please note the change to one line (second disconnect not needed).
I hope this addresses your comments, please let me know if there is anything else that I need to
update.
Thank you for your help,
Maggie Ludden
Permit Specialist
Phone: (360) 836-1729
Email: Maggie.Ludden@infinitysolarusa.com
6405 E Mill Plain Blvd
Vancouver, WA 98661
El)
infinity solar
CITY OF TIGARD MASTER PERMIT
III I COMMUNITY DEVELOPMENT Permit#: MST2021-00519
Date Issued: 01/03/2022
T f G A It D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S 111 CC 12200
Jurisdiction: Tigard
Site address: 10405 SW HIGHLAND DR
Subdivision: SUMMERFIELD NO.4 Lot: 173
Project: Siminski
Project Description: Rooftop Solar PV 6.84 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: $4,092.00 Rear: 0
PLUMBING
0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Sinks: 0 Water Closets: 0 Washing Mach:
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
Other Fixtures: 0
Drywell-Trench Drain: 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 6.84 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:
SIMINSKI,KEVIN&BARBARA LIVING TRTML INTERNATIONAL LLC Required Items and Reports(Conditions)
10405 SW HIGHLAND DR 6405 E MILL PLAIN BLVD
TIGARD,OR 97224 VANCOUVER,WA 98661
PHONE: PHONE: 800-364-0470
FAX:
Total Fees: $359.19
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
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Issued By: Eolga-rdo-M "-a Permittee Signature: Sze,aprtizoatio-vt,
Call 503.639.4176 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.
Building Permit Application
Residential RECEIVED FOR OFFICE USE ONLY
City of Tigard g q Received,2J !�,/ Permit No �"f
II 4 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 1 9 [OZi DateBy: !- �� ..ter7.202 J lj
an Review 1 /7/ �fl
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: /f/ Other Permit:
T I G A It D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: /}� Juni ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method:V,/7L4ti e- Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit tees*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.
ID1-and 2-family dwelling ElCommercial/industrial
Valuation: $4,092.00
❑Accessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10405 Sw Highland Dr New dwelling area: square feet
vi City/State/ZIP:Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Solar Install-KSiminski 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
DESCRIPTION OF WORK work indicated on this application.
Installation of 18 solar panels in 1 array(s) on a roof mounted 6.84kW PV System Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:Kevin Siminski Type of construction:
Address:10405 Sw Highland Dr Occupancy groups:
City/State/ZIP:Tigard, OR 97224 Existing:
Phone:( )(805)427-1236 Fax:( )
New:
❑ APPLICANT El CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:TML International LLC
Structural plan review fee(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
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic 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 lic.:22360 Total fee due upon application: $201.60
Authorized signature:/���� This permit application expires if a permit is not obtained
/L�-� within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Maggie Ludden Date:11.19.21 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
i
Electrical Permit Applicati ftECEJVED FOR OFFICE USE ONLY
Cl ofTigard 1 Received
II
g Date/B : Permit#:
" 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 1 9 1011 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Pennit#:
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARU Ready Date/By: ®Juris: See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
3UILDING DIVISION
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:Solar where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑� 1-and 2-family dwelling ❑Commercial/industrial El Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
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
Job#: Job site address: 10405 Sw Highland Dr ID Addition of new motor load of system.
g I00HP or more. ❑"A" "E" "]-2""1-3„
City/State/ZIP:Tigard, OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. IDRecreational vehicle parks.
Suite/bldg./apt.#: Project name:Solar Install-KSlminSkl ❑Hazardous locations. 0 Supply voltage for more than60o volts»nominal.
ID Service or feeder 600 amps or more.
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.
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
Installation of 18 solar panels in 1 array(s) on a roof mounted 6.84kW PV System (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:Kevin Siminski 200 amps or less 100.70 2
Address:10405 Sw Highland Dr 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:( )(805)427-1236 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: ksiminski@gmail.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: 11.19.21 401 amps to 599 amps 168.54 2
APPLICANT CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:TML International LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name:Maggie Ludden B.Fee for branch circuits without
service or feeder fee,first Address:6405 E Mill Plain Blvd branch circuit 56.18 2
City/State/ZIP:Vancouver, WA 98661 Each add'I branch circuit 7.42 2
Phone: Miscellaneous(service or feeder not included)
( )(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
Address:6405 E Mill Plain Blvd panel,alteration,or extension. ❑ See Page 2 2
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 Lie.:223690 Electrical Lie.:C1556 Suprv.Lic.:6210S specifically listed CAhr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:S Cott LeDUC
Subtotal:
Print name:Scott LeDuc Date:11.19.21 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of pennit fee):
Authorized signature: � 28,e,......„..„. ....„
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name:Maggie Ludden Date:11.19.21 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 440-4615T(I 1/05/COM/WEB
4 �
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 I Qty. I Each I 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
n A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n B• urglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n G• arage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
n H• eating,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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
SFee for each commercial system: $75.00 ll ed (Enter to Page 1):
a
3' * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n B• oiler Controls
n Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
❑ 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.dor Rev 06/17/2015