Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2022-00112
T I C.:,A P.17 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2022
Parcel: 2S 108DB00600
Jurisdiction: Tigard
Site address: 15250 SW PEACE AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 4
Project: Setiawan
Project Description: Rooftop Solar PV 16.79 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: $8,074.00 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,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 array 16.79 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:
GORE,BRIAN TML INTERNATIONAL LLC Required Items and Reports(Conditions)
SETIAWAN,MARIA 6405 E MILL PLAIN BLVD
15250 SW PEACE AVE VANCOUVER,WA 98661
TIGARD,OR 97224
PHONE: PHONE: 800-364-0470
FAX:
Total Fees: $435.98
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 w• is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. hose - are set forth in OAR
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Issued By: 2 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 Ap IListiECEIVEID
Residential [{ FOR OFFICE 1 SE("INCity of Tigard APR .1 �LLggq Date/By:Received Perntit No
III 1 (22 Ms�2�22-0��1 a
lig • 13125 SW Hall Blvd.,Tigard,OR 9722 I IY�F l lU/al tip Plan Review L( n� A.A...„
r Other Permit:
Phone: 503.718.2439 Fax: 503.598.19 DIVISION
PlanDate/By:
L� 22-
Ti G A R D Inspection Line: 503.639.4175 1,.1 I LDI N C [�IVI S ION Date Ready/By: / 'Jaris. ® See Page 2 for
Internet: www.tigard-Oi.gOv 1d/Method: / 7SupplementalInformation
TYPE OF WORK REQUIRED DA fA: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
ElAddition/alteration/replacement Other:Solar equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $8,074
❑■ 1-and 2-family dwelling 0 Commercial/industrial
ElAccessory building El Multi-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:15250 SW Peace Ave New dwelling area: square feet
City/State/ZIP:Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Solar Install-MSetiawan 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.
Installation of 46 solar panels in 4 array(s)on a roof mounted 16.79kW PV System Valuation: S
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:Maria Setiawan Type of construction:
Address:15250 SW Peace Ave Occupancy groups:
City/State/ZIP:Tigard, OR 97224 Existing:
Phone:i )(415)606-2215 Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:TML International LLC (Please refer to fee scbedule)
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
Phone:( )(360)836-1729 Fax::( ) Amount received:
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 $I80.00
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
within 180 days after it has been accepted as complete.
Print name:Maggie Ludden Date:4/14/22 *Fee methodology set by Tri-County Building Industry
Service Board.
C\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
qECEIVED
-Electrical Permit Application l OR OI 1 is 1 I sI 0y1.1
City Of Tigard APR 1 4 2022 Received Permit#.
Date/B :
111 " 13125 SW Hall Blvd.,Tigard,OR 97223
i IPhone: 503.718.2439 Fax: 503.598.1969'I I Y OF l IGArLt Plan
to/Be: Related Permit#: M ?oL .
Inspection Line: 503.639.4175 2I I (� AI(� p Ready Date/By: Juris ® See Page 2 for
!' TIGARD Internet: www.tigard-or.gov WILDING DIVISION' Notified/Method: Supplemental Information
i
TYPE OF WORK PLAN REVIEW
❑New construction ❑Addition/alteration/replacement Please check all that apple(submit 2 sets of plans v,items checked)
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑■ Other:Solar where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-family dwelling ❑Commercial/industrial❑ 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
bu
ngs.
0 Multi-family ❑Master builder 0 Other: ampsireform all other installations. Installation pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
AddJob#: Job site address:15250 SW Peace Ave ❑100HP on of new motor load of system.
or more. ❑"A","E","1-2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard, OR 97224 0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Solar Install-MSetiawan 0 Hazardous locations. 0 Supply voltage for more than
❑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 75.00 2
Installation of 46 solar panels in 4 array(s)on a roof mounted 16.79kW 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:Maria Setiawan 200 amps or less 100.70 2
Address:15250 SW Peace Ave 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:( )(415)606-2215 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
1 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
`4ii ApJA It j , $ CONTACT PIERSON 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
oj Address:6405 E Mill Plain Blvd service branch cit feet
fee,first 56.18 2
t
City/State/ZIP:Vancouver, WA 98661 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:
( )(360)836-1729 Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
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
Address:6405 E Mill Plain Blvd Signal lte ati n or limited-energy
0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver, WA 98661 Each additional inspection over allowable in any of the above
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 Lic.:223690 Electrical Lia:C1556 Suprv.Lic.:6210S
specifically listed(''A hr min) 90.00/hr
Suprv.Electrician signature,required:S Cott L eDuc ELECTRICAL PERMIT FEES
Subtotal:
Print name:Scott LeDuc Date:4/14/22 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name:Maggie Ludden Date:4/14/22 days after it has been accepted as complete.
Number of inspections allowed per permit.
1:\Building\Permits 1ELC_Permit App_ELR_ERE.doe Rev 06/17/2015 440-4615T(1l/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:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ A• udio and Stereo Systems* 15.01 to 25 kva 01 200.34 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
❑ G• arage Door Opener* >100 kva(fee in accordance
552.26 2
with OAR 918-309-0040)
❑ 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:
El 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('/:hr min)
COMMERCIAL WORK ONLY: E1.EC"I'ttlCAi,?MAW
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
❑ Instrumentation
❑ Intercom and Paging Systems
❑ L• andscape Irrigation Control*
❑ Medical
n N• urse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015