Permit III CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2022-00085
T f(3 A IZ I] 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/11/2022
Parcel: 2S 111 CB00600
Jurisdiction: Tigard
Site address: 14820 SW 103RD AVE
Subdivision: DEL MONTE SUBDIVISION Lot: 5
Project: Raybourne
Project Description: Rooftop Solar PV 7.2kW
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: $5,000.00 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 l 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 7.2 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:
RAYBOURN,CHRISTOPHER D&LISA UNITY ELECTRICAL SERVICE LLC Required Items and Reports(Conditions)
14820 SW 103RD AVE 15715 NE 42ND ST
TIGARD,OR 97224 VANCOUVER,WA 98682
PHONE: PHONE: 971-379-7380
FAX:
Total Fees: $357.69
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 ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
ac9-nnLnn1n thrnnnh CIA OR') nt-nnon pu m nhtain a rnn a rnlac nr rlirart nnaetinna to(ll IIJC by Tallinn gm QR7 nr 1 RM 449 91.1.1.,p
f711
Issued By: Z Permittee Signature: dZ(7Q.' y
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 lob site at the time of each inspection.
. . . . .
Building Permit Application 44W M-'a/22312,
Residential IVE FOR OFFICE t SE O\Ll
Received �1 ' �� Permit No.: 11/4/S'T2022.C00eS
IN City of Tigard MAR 2 8 7072 Date/B : S�iJJ Cif!
C ' 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revs rz j A�/ Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Plan Re: I I'l
ITYOF i1GANli Date
T I G A R I) Inspection Line: 503.639.4175 Ready/By: L,Z _ / lu HI See Page 2 for
Internet: www.tigard-or.gov 11 III niNG DIVISIOr\ etified/Met .-- Supplemental Information
11 r
TYPE OF WORK REQU 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.
Valuation: 5000.00 $
® 1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building El Multi-family Number of bedrooms:3
❑Master builder 0 Other: Number of bathrooms:2
PJOB SITE INFORMATION AND LOCATION Total number of floors:1
lob site address:14820 SW 103rd Ave New dwelling area: square feet
City/State/ZIP:Tigard, OR 97224 Garage/carport area: square feet
f Suite/bldg./apt.no.: Project name:OR-Raybourne Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
i REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
1 no.: Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Installing a 7.2kW Renewable Energy System on the residence of roof Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Chris Rayboume Type of construction:
Address:14820 SW 103rd Ave Occupancy groups:
City/State/ZIP:Tigard, OR 97224 Existing:
Phone:(503 )798-5938 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer ro fee schedule)
Business name:Smart Solar Energy
Structural plan review fee(or deposit):
Contact name:Angie Olesen
FLS plan review fee(if applicable):
Address:10940 SW Barnes Rd#250
Total fees due upon application:
City/State/ZIP:Portland, OR 97225
Amount received:
Phone:(3604488207 Fax::( )
E-mail:projects@smartsolarenergy.co PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Smart Solar Energy Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:10940 SW Barnes Rd#250 Solar Installation Specialty Code checklist.
City/State/ZIP:Portland, OR 97225 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 360)-448-8207 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:234657 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
:q� within 180 days after it has been accepted as complete.
Print name:Angie Olesen(/ Date:3/7/2022 *Fee methodology set by Tri County Building Industry
g Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Applicatio!ECEIr V/ED R ve FOR OFFICE I.SE ONLY
City of Tigard Date B
Ili, • 13125 SW Hall Blvd.,Tigard,OR 97223' AR 2 8 2022 Plan Review �'
■ Phone: 503.718.2439 Fax: 503.598.194 Date/ Related Permit#:: —��� •
Inspection Line: 503,639.4175 JI f Y OF TIGARL) Notified/Method: tuns_ ® See Page 2 for
T I T'A P 1) Internet: www.tigard-or.gov Supplemental Information
TYPE OF Y� INC DIVISIOr PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑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
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building cps for all other installations. buildings.
❑Multi-family ❑Master builder ❑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 it:OR-Rayboume Job site address:14820 SW 103rd Ave 100nP or more. ❑"A"."E» 1-2» `I-3»
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard, OR 97224 ❑Health-care facilities. 0 Recreational vehicle parks.
ID Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt #: Project name:OR-Rayboume 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'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Installing a 7.2kW Renewable Energy System on the residence of roof (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Chris Raybourne 200 amps or less 100.70 2
Address:14820 SW 103rd Ave 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:( )503-789-5938 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:raybournrocket@hotmail.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
Branch circuits—new,alteration,or extension,per panel
® APPLICANT ® CONTACT PERSON A.Fee for branch circuits with
Business name:Smart Solar Energy above service or feeder fee, 7.42 2
each branch circuit
Contact name:Angie Olesen B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:10940 SW Barnes Rd#250 branch circuit
City/State/ZIP:Portland, OR 97225 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( )360-448-8207 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:projects@smartsolarenergy.co Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Unity Electrical Service Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address:15715 NE 42nd St panel,alteration,or extension.
Each additional inspection over allowable in any of the above
Ciry/State/Z1P:Vancouver, WA 98682 Additional inspection(1 hr min) 66.25/hr
Phone:( )360-605-6586 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:projects@smartsolarenergy.co Inspections for which no fee is
90.00/hr
CCB Lic.:234553 Electrical Lic.:c1599 Suprv.Lic.:4619S specifically listed(Y2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: phut Qi1 g•b6 IL, Subtotal:
Print name:Daniel Broughton
Dat :3R/2022 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature: D�
;�� This permit application expires if a permit is not obtained within 18(1
Print name:Angie Olese`�I Date:3/7/2022 days after it has been accepted as complete.
g * Number of inspections allowed per permit.
L\Bui(ding\Permits\ELC_PermitApp_ELREREdoc Rev 06/17/2015 440-4615T(l l/05/COM/WEB
iirimmummummismiesw
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00RenewableDescription
I QtY. Each I Total I
R
)' Renn ewwable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 1 133.56 135.56 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
[1 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
n Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n Other: Each additional inspection is 6625/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: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page I): 135.56
Fee for each commercial system: $75.00
y ' Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
[1 Boiler Controls
n Clock Systems
n Data Telecommunication Installation
Fire Alarm Installation
I ( HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015