Permit IIa CITY OF TIGARD MASTER PERMIT
= COMMUNITY DEVELOPMENT Permit#: MST2022-00037
Date Issued: 02/15/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 106DA10100
Jurisdiction: Tigard
Site address: 16899 SW BIRDSONG ST
Subdivision: RIVER TERRACE EAST Lot: 101
Project: Ngo
Project Description: Rooftop Solar PV 9.120 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: $10,500.00 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
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 9.120 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:
NGO,WILLIAM FREEDOM FOREVER OREGON LLC Required Items and Reports(Conditions)
NGUYEN.THUY 15943 NE CAMERON BLVD
16899 SW BIRDSONG ST PORTLAND,OR 97230
TIGARD,OR 97007
PHONE: PHONE: 971-808-7776
FAX:
Total Fees: $358.69
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: X.X./�l7 Permittee Signature: - f 1�-c�1 1 f
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 Applicatio E( �� _ / a 22.
Residential
FOR OFFICE use ONLY
City of Tigard JAN 3 1 NU Received A Date/By:V ' ��,/ Permit No. $I 20 00037
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review a� "/ 2Z r
Phone: 503.718.2439 Fax: 503.598.1464 Y OFI IUHI ILr Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: ett� 14 Juirie ® See Page 2 for
Internet: www.ti ard-or. ov BUILDING DIVISION No ed Method: i '�
g g / Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-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: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 10 500
❑Accessory building ❑Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
15 Job site address: 16899 SW Birdsong St New dwelling area: square feet
City/State/ZIP: Tigard/OR/97007 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: NGO, WILLIAM -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: RIVER TERRACE EAST Lot no.:101 Permit fees*are based on the value of the work performed.
2S 106DA10100 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.
9.120kW PV Roof Mount Valuation: na $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
0 Name: William Ngo Type of construction:
0 Address:
16899 SW Birdsong St Occupancy groups:
City/State/ZIP: TIGARD/OR/97007 Existing:
Phone:(408) 637-9796 Fax:( ) New:
19,
® APPLICANT IN CONTACT PERSON BUILDING PERMIT FEES*
Business name:Freedom Forever Oregon LLC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Leann Malloy
Address:15943 NE Cameron Blvd FLS plan review fee(if applicable):
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 PhotoVoltaic 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 lic.:234650 Total fee due upon application: $201.60
Authorized signature: Leadidt, ?f 2G7_ 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:
Leann Malloy Date: 1/25/2022 Service Board.
L\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
•
Electrical Permit Application ,. G FOR OFFICE USE ONLY
el
City of Tigard d Date/By:
13125 SW Hall Blvd.,Tigard,OR 97223 Received
III
JAN 3 12022 Plan Review Permit#:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#:
T 1 G A R D Inspection Line: 503.639.4175 J Jy OF. fGA'{L Ready Date/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
11LTYPE OF WORK> ��t19� �t�fib?Itd PLAN REVIEW
❑ New construction El Addition/alteration/replacement Please check all that app..(submit 2 sets of plans writems checked).
❑ ❑Demolition 0 Service or feeder 400 amps or more ❑Building over three stories.
Other' where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® I-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 ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#:201654 Job site address:
16899 SW Birdsong St I00HP or more. ❑"A °E","1-2",°`1-3",
0 Six or more residential units. occupancy.
City/State/ZIP: TIGARD/OR/97007ID vehicle El Health-carefacilities. parks.
Suite/bldg./apt.#: Project name: NGO, WILLIAM - Solar ❑Hazardous locations 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 colts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total )
New residential single-or multi-family dwelling unit.
Subdivision:RIVER TERRACE EAST Lot#: 101 Includes attached garage.
Tax map/parcel#: 2S106DA10100 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
9.120kW PV Roof Mount (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: William Ngo 200 amps or less 100.70 2
Address: 16899 SW Birdsong St 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: TIGARD/OR/97007 601 amps to 1,000 amps 301.04 2
Phone:(408-637-9796 Fax:( ) Over 1,000 amps or volts 552.26 2
Email:
Temporary services or feeders installation,alteration,and/or
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
El APPLICANT ® CONTACT PERSON
A.Fee for branch circuits with
Business name:Freedom Forever Oregon LCC above service or feeder fee, 7.42 2
each branch circuit
Contact name:Leann Malloy B.Fee for branch circuits without
Address: 15943 NE Cameron Blvd berviceor feeder fee,first 56.18 2
branch circuit
City/State/ZIP:PORTLAND/OR/97230 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(971 ) 808-7776 Fax: :( ) Each manufactured or modular
/ Email:
dwelling,service and/or feeder 67.84 2
PermitsPortlanda,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. ❑ See Page 2 2
City/State/ZIP:PORTLAN D/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
r.com Industrial plant(I hr min) 78.18/hr Email:PermitsPortland@freedomforeve
Inspections for which no fee is 90 00/hr
CCB Lie.:234650 Electrical Lie.:C1612 Suprv. Lic.:6576S specifically listed('ri hr min>
�` ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: ^Z. -4�92
Subtotal:
Print name:Greg Albright Date: 1/25/2022 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: /11.414 TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print name:Leann Malloy Date: 1/25/2022 days after it has been accepted as complete.
* Number of inspections allowed per permit.
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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 I Qh. Each Dotal i
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
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n 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
❑ 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('/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
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:
n Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
Li Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
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