Permit 1114 CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2022-00121
T l C.:',A It.1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2022
Parcel: 2S 106AD05600
Jurisdiction: Tigard
Site address: 16609 SW FRIENDLY LN
Subdivision: RIVER TERRACE EAST Lot: 163
Project: Setiawan
Project Description: Rooftop Solar PV 11.315 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: $5,717.00 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 PV 11.315 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:
SETIAWAN,MYRNA ANASTASIA TML INTERNATIONAL LLC Required Items and Reports(Conditions)
NAYDAN,GLENN DAVID 6405 E MILL PLAIN BLVD
16609 SW FRIENDLY LN VANCOUVER,WA 98661
BEAVERTON,OR 97007
PHONE: PHONE: 800-364-0470
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. Th r es are set forth in OAR
oc9_nnl_nnl n thrnnnh AR ac9-rinl nnor Volt maw htain a rnnw of fhc r,lac or rlirort nnoctionc to(ti ttgc:h,rallinn 5111 929 10 nr 29 9 dd
Issued By: 4 Permiftee 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
Residential ;RECEIVED FOR OFFICE USE ONLY
Received
Cityof Tigard Permit No.:
• 131 SW Hall Blvd.,Tigard,OR 97223 APR 2 5 2022 Plan Review MST2D2Z-COM i
1 Phone: 503.718.2439 Fax: 503.598.196¢, Date/By: 2�/ 7\f s Other Permit:
Inspection Line: 503.639.4175 l�l,Y OF TIGARD Date.eady/B : Ions ® See Page 2 for
TIGAKD g g BUILDING DIVISION a� ,41 1 supplemental Information
Internet: vvvvw.ti ard-or. ov .ified/Method: ,,//
TYPE OF WORK REQUIRED 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 ID Other:Solar equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
0 I-and 2-family dwelling ❑Commercial/industrial Valuation: $5,717.00
ElAccessory building ❑Multi-family Number of bedrooms:
❑Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:16609 Sw Friendly Ln New dwelling area: square feet
City/State/ZIP:Beaverton, OR 97007 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Solar Install-MGSetiawan 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.
Installation of 31 solar panels in 3 array(s)on a roof mounted 11.315kW PV System Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:Myrna Setiawan and Glen Naydan Type of construction:
Address:16609 Sw Friendly Ln Occupancy groups:
City/State/ZIP:Beaverton, OR 97007 Existing:
Phone:( )(408)203-8261 Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer tojee 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 ---1Fax:( )
State surcharge(12/o of permit fee): $21.60
CCB lie.:22360 Total fee due upon application: $201.60
Authorized signature: 1 This permit application expires if a permit is not obtained
Jet.`, within 180 days after it has been accepted as complete.
grir *Fee methodology set by Tri-County Building Industry
Print name:Maggie Ludden Date:4/25/22 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
RECEIVED
Electrical Permit Application FOR OFFICE l SE ONLY
City of Tigard APR 2 5 2022 DReceived
ate/B Permit#:
IN a 13125 SW Hall Blvd.,Tigard,OR 972 I YOF TIGARD
Plan Review
Phone: 503.718.2439 Fax: 503.598.1Y60 Date/B : Related Permit#: M � �,e
TIGARD Inspection Line: 503.639.4175 #:BUILDING DIVISION Ready Date/By: Juris. ® See Page 2for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ NCN4 construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked).
ElService or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ID Other:Solar
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
0 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
F
0 Multi-family 0 Master builder El Other: all other installations. nstdings.
❑Fire re s for pump.
p. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address:16609 Sw FriendlyLn ❑Add HP o of new motor load of system.
100HP or more. ❑"A" "E" "I-2" "1-3"
0 Six or more residential units. occupancy.
City/State/ZIP:Beaverton,OR 97007 El Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Solar Install-MGSetiawan
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 1 Total
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 31 solar panels in 3 array(s)on a roof mounted 11.315kW PV System (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:Myrna Setiawan and Glen Naydan 200 amps or less 100.70 2
Address:16609 Sw Friendly Ln 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Beaverton, OR 97007 601 amps to 1,000 amps 301.04 2
Phone:( )(408)203-8261 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: myrnasetiawan@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: 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
Address:6405 E Mill Plain Blvd Signalellle circuit(s)io 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
Email: Industrial plant(1 hr min) 78.18/hr
permit@infinityd2d.eom Inspections for which no fee is
CCB Lic.:223690 Electrical Lic.:C1556 Suprv.Lic.:6210S
specifically listed(%hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:S cott LeDUC
Subtotal:
Print name:Scott LeDuc Date:4/25/22 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: / J TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Print name:Maggie Ludden 1 Date:4/25/22 days after it has been accepted as complete.
" Number of inspections allowed per permit.
I\Building\Permits\ELC_PermitApp_ELRERE.doe Rev 06/17/2015 440-4615T(11/05/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
DescriptiFee for all residential systems combined: $75.00 on I Qty. I Each I Total I
Renewable Renewwable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 01 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 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
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ 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: 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('/z hr min)
COMMERCIAL WORK ONLY: ELECTRICAL 1tont'
Fee for each commercial system: $75.00 Subtotal(Enter . Page 1):
�' * Number of inspections alllowedowed per permitt.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ B• oiler Controls
❑ Clock Systems
n D• ata Telecommunication Installation
ri F• ire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse 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-doc Rev 06/17/2015