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Permit
;tilt . .. . is 1111 CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2022-00058 Date Issued: 03/17/2022 T(G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109AC06900 Jurisdiction: Tigard Site address: 13193 SW MADDIE LN Subdivision: MADELINE HEIGHTS Lot: 7 I Project: Clark j Project Description: Rooftop Solar PV 9.2 kW BUILDING Floor Areas Required Setbacks Required Stones: 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: $5,115.00 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 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>=100 K: 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 9.2 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: CLARK,JERRY&BETH REVOCABLE BRS FIELD OPS LLC Required Items and Reports(Conditions) LIVING TRUST 1403 NORTH RESEARCH WAY 13193 SW MADDIE LN OREM,UT 84097 TIGARD,OR 97224 PHONE PHONE: 855-205-2530 FAX: Total Fees: $363.19 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 0c2.nnl nnln lhrn,inh nAR cic9..nnl_nf10n Yell,mow nhfnin n rnmo of fha rnlac nr riirarf nilacfinnc in nl INIC Ihu rnninn cri 9'0 10R7 nr 1 AM 139 9144 Issued By: Edga-r o-too -' Permittee Signature: 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 RECEIVED B 4 Residential FOR OFFICE USE ONLY FEB 2 4 2022 City of Tigard �a�is d ZD i �P erinit No.:{vI cSf?OZZ'C � 4 13125 SW Hall Blvd.,Tigard,OR 97223 L;ITY OF TIGAR Plan Review 3// 7 1j2 Other Permit: f Phone: 503.718.2439 Fax: 503.598.19( ILDING DIVISION Date/By: r 1 1 tGA It I) Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for Internet: www.tigard-or.gov £ fied/ td:5 S � Supplemental Information TYPE OF WORK QU ED 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: $ 5115.20 ❑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: 13193 sw Maddie lane, 14;4464544D,Oregon,97224 New dwelling area: square feet City/State/ZIP: / l ry/fee Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Jerry Clark 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. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Rooftop Solar PV 9 '_ pt.) Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Jerry Clark Type of construction: Address: 13193 sw Maddie lane,PORTLAND,Oregon,97224 Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT ©CONTACT PERSON BUILDING PERMIT FEES* Business name: BRS Field Ops,LLC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name: Jeffrey Lee Address: 1403 N Research Way FLS plan review fee(if applicable): 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* Commercial and residential prescriptive installation of CONTRACTOR 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 lic.: 227185 If Total fee due upon application: $2 t.60 Authorized signature: i// This permit application expires if a permit is not q' — within 180 days after it has been accepted as cv Print name: Jeffrey Lee ! 1 Date: 02/23/2022 *Fee methodology set by Tri-County Building Ind Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I l/02/COM/WEB) / Electrical Permit Application FOR OFFICE USE ONLY City of Tigard RECEIVES DateBed Permit#: -M 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review # Phone: 503.718.2439 Fax: 503.598.1960 FEB 2 4 2022 Date/B : Related Permit#: Inspection Line: 503.639.4175 ry v Ready Date/By: Juris: Pi See Page 2 for 1ICiARD. Internet: www.tigard-or.gov �' III 1 OFTIGARV Notified/Method: Supplemental Information TYPE OF Wa1ED1tLDING DIVISION PLAN REVIEW ❑New construction 0 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 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground,or exceeds 14,000 0 Commercial-use agricultural Q 1-and 2-family dwelling 0 Commercial/industrial El Accessory building 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 p Addition of new motor load of system. Job#: Job site address: 13193 sw Maddie lane, PORTLAND, Orec on, 9m44,or more. ❑"A","E "1-2","I-3 ❑Six or more residential units. occupancy. City/State/ZIP: ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Jerry Clark ❑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: 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 (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 tg PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: Jerry Clark 200 amps or less 100.70 2 Address: 13193 sw Maddie lane, PORTLAND,Oregon,97224 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 LEIA.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 service or feeder fee,first 56.18 2 Address: 1403 N Research Way branch circuit 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 dwelling,service and/or feeder Email: permitting.department@blueravensolar.com 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(I 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 CCB Lic.: 227185 Electrical L'c.: C1493, Suprv.Lic.: 6394S specifically listed CA hr min) k/,{'/ ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: , j Subtotal: Print name: Shan Whittaker Date: 02/23/2022 ❑Plan Review Required(25%of permit fee): /� State surcharge(12%of permit fee): /i TOTAL PERMIT FEE: Authorized signature: 1j'"CCJJ j This permit application expires if a permit is not obtained within 180 Print name: Jeffrey L / I Date: 02/23/2022 days after it has been accepted as complete. * Number of inspections allowed per permit. l:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(Il/05/COM/WEB 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 I * 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 n A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: LI Burglar 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 I Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n O• ther: Each additional inspection is 66.25/hr 1 charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically listed(%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 n Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n H• VAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* ❑ M• edical n N• urse Calls n O• utdoor Landscape Lighting* n P• rotective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_Permit App_ELR_ERE.doc Rev 06/17/2015