Permit CITY OF TIGARD MASTER PERMIT
g COMMUNITY DEVELOPMENT Permit#: MST2021 00539
Date Issued: 12/21/2021
T tGAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103CC06300
Jurisdiction: Tigard
Site address: 13775 SW 124TH AVE
Subdivision: WHISTLER'S WALK Lot: 10
Project: Cha
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
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'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
i SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: Y Other Description: Roof Top Solar PV System 8.4 kW Y
p Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 0
Owner: Contractor:
CHA,JOYCE BRS FIELD OPS LLC Required Items and Reports(Conditions)
13775 SW 124TH AVE 1403 NORTH RESEARCH WAY
TIGARD,OR 97223 OREM,UT 84097
PHONE: PHONE: 855-205-2530
FAX:
Total Fees: $361.19
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: Natty Vain, D6.Wege 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 iob site at the time of each inspection.
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Building Permit ApplicatioECEIVE o '
Residential �+ e qn� FOR OFFI('i;USE ONLY
Cityof Tigard DEC 6 '1 Received p 7�' s 9
g Date/By: Q! 2� Permit No.:M T��'VV
11,, '. 13125 SW Hall Blvd.,Tigard,OR 9722c0L'v OF TIGARD Plan Review U „
Phone: 503.718.2439 Fax: 503.598.19 Date/By: , I 21 1:1-1-C-7--i
they Permit:
114rlitt) Inspection Line: 503.639.4175 BUILDING DIVISION Date Read/By: t et ris: ® See Page 2 for
Internet: www.tigard-or.gov Notifie e :/ ��l // Supplemental Information
TYPE OF WORK 'Q ,D DATA:1-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.
0 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 4670.40
V0 Accessory building ❑Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13775 SW 124th Ave, Portland,Oregon,97223 New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Joyce Cha 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: I 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.
Rooftop Solar PV- 8-Li I..W Valuation: $
Existing building area: square feet
New building area: square feet
R PROPERTY OWNER 0 TENANT Number of stories:
Name: Joyce Cha Type of construction:
Address: 13775 SW 124th Ave, Portland,Oregon,97223 Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( )
New:
0 APPLICANT ®CONTACT PERSON BUILDING PERMIT FEES*
Business name: BRS Field Ops, LLC (Please refer to fee schedule)
Contact name: Jeffrey Lee Structural plan review fee(or deposit):
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::( ) _
E-mail: permitting.deparment@blueravensolar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
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// This permit application expires if a permit is not obtained
ii within 180 days after it has been accepted as complete.
Print name: Jeffrey L e / Date: 12/03/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
ill City of Tigard C I V E DateBed Permit#:
Ill13125 SW Hall Blvd.,Tigard,OR 972 y
.-�' g Plan Review
Phone: 503.718.2439 Fax: 503.598.196 Date/By: Related Permit#:
Inspection Line: 503.639.4175 'DEC 6 2021 Ready Date/By: Juris: la See Page 2 for
I I t' `1 11 Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF w, PI/VISION PLAN REVIEW
❑New construction Q Addition/alterAHM/VISION Please check all that apply(submit 2 sets of plans wlitems checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
Q 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 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Addition of new motor load of system.
Job#: Job site address: 13775 SW 124th Ave, Portland, Oregon, 972 100HP or more. ❑"A","r: 'l-2"."l-3",
City/State/ZIP: 0 Six or more residential units. occupancy.
❑Health-care facilities. Cl Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Joyce Cha 0 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 ( 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't 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Rooftop Solar PV (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Joyce Cha 200 amps or less 100.70 2
Address: 13775 SW 124th Ave,Portland,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: ( ) 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 ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
[EliA.Fee for branch circuits with
Business name: BRS Field Ops, LLC above service or feeder fee,
--- each branch circuit 7.42 2
Contact name: Jeffrey Lee B.Fee for branch circuits without
servAddress: 1403 N Research Way branche it feederitfee,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)482-0045 Fax: : ( ) Each manufactured or modular 67.84 2
ermittin .department dwelling,service and/or feeder
Email: P 9• P 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
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 1403 N Research Way 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) 482-0045 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: permitting.department@blueravensolar.com Industrial plant(1 hr min) - 78.18/hr
Inspections for which no fee is 90.00/hr
CCI3 Lic.: 227185 Electrical L'c.: C1493 Suprv.Lic.: 6394S specifically listed(vz hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Shan Whittaker Date: 12/03/2021 0 Plan Review Required(25%of permit fee):
/ State surcharge(12%of permit fee):
# TOTAL PERMIT FEE:
Authorized signature: ` �,
/ I ' This permit application expires if a permit is not obtained within 180
Print name: Jeffrey L '� Date: 12/03/2021 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:iBuilding'Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I1/05/COM/WEB
a ... .. s
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty. I Each I 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 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
El B• urglar 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)
❑ 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed eh hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
3 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n A• udio and Stereo Systems
❑ Boiler Controls
❑ C• lock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n H• VAC
E Instrumentation
❑ Intercom and Paging Systems
E Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
LI Outdoor Landscape Lighting*
LI Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
i l3uilding\Permits\ELC_PermitApp_E1R_ERE.doc Rev 06/17/2015