Permit CITY OF TIGARD MASTER PERMIT
1 ' COMMUNITY DEVELOPMENT Permit#: MST2022-00144
Date Issued: 06/13/2022
T f 1 i:a F:I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S110BD02600
Jurisdiction: Tigard
Site address: 14921 SW 116TH WAY
Subdivision: HELM HEIGHTS Lot: 3
Project: Weber
Project Description: Solar photovoltaic system 5.2 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: $4,691.44 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
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes 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 WIG 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 5.2 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:
WEBER,DANIEL E BRS FIELD OPS LLC Required Items and Reports(Conditions)
14921 SW 116TH PL 1403 NORTH RESEARCH WAY
PORTLAND,OR 97224 OREM,UT 64097
PHONE: PHONE: 855-205-2530
FAX:
Total Fees: $357.19
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
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Issued By: /" \ � Permittee Signature: ij�/U1 i�/I&
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.
Bui1din Permit Application
Residential RE C E I "df E L FOR OFFICE USE ONLY
Cityof Tigard Received ,i/
g MAY 18 Z012 Date/B : / „�i�� - - - ,• -
t 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �✓ (� Other Permit:
Phone: 503.718.2439 Fax: 503.598.1 §01' Date/Sy: 5 (i'j / r"'
Inspection Line: 503.639.4175 I I 1 OF TIGARD Date Ready/Sy: tw'is: 0 See Page 2for
I tC.AtLD / Supplemental Information
Internet: www.tigard-or.gov ��i lolt•+lAi(� (�!\/ini,1 r,�, �Ietified/Melh ��,/� � / PP
-/' --el.-
TYPE OF WORK '4 QUIRED 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 4691.44
❑ 1-and 2-family dwelling ❑Commercial/industrial 1
❑Accessory building ❑Multi-family Number of bedrooms:
Number of bathrooms:
❑Master builder ElOther:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 14921 sw 116th place, Portland,Oregon,97224 New dwelling area: square feet
\ City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Dan WEBER 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.
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.
Rooftop Solar PV g.-1,4V Valuation: $
I Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Dan WEBER Type of construction:
Address: 14921 sw 116th place,Portland,Oregon,97224 Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax: ( ) New:
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
please refer to fee schedule
Business name: BRS Field Ops, LLC
Structural plan review fee(or deposit):
Contact name: Spencer Fong
FLS plan review fee(if applicable):
Address: 1403 N Research Way
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 Specially 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 lie.: 227185 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
Spec ewer Foil Permitting Coordinator within 180 days after it has been accepted as complete.
Print name: Spencer Fon C frC� V�I Date: 05/ 17/2022 *Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) A
Electrical Permit Application"'/;::: c;\r` FOR OFFICE USE ONLY
t i,a., IV
City of Tigard Received
Date/B Permit#:
13125 SW Hall Blvd.,Tigard,OR 97223 OM 1 8 702Z Plan Review
Phone: 503.7 1 8.2439 Fax: 503.598.1960 Date/B Related Permit#:
OFInspection Line: 503.639.4175 _ Y -if '�^ry
i I I, ',I�I�, �� Ready Date/By: lnris: ® See Page 2 for
Internet: wwwtigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK '{ PLAN REVIEW
❑New construction ❑V 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 ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
Q 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
El Multi-family ❑ Master builder 0 Other: 0 Fire
JOB SITE INFORMATION AND LOCATION ❑Emergency system. 0p. Installation re ato 150 KVA or
`..; ,. gar separately derived
]Addition of new motor load of system.
Job#: Job site address: 14921 sw 116th place , Portland, Oregon,9''LLg00Hp or more. ❑"A","E","I-2","1-3",
City/State/ZIP: 0 Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Dan WEBER ❑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.
Tax map/parcel#: 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
RooftopSolar PV 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
® PROPERTY OWNER 0 TENANT Renewable Energy El See Page 2
Services or feeders installation,alteration,and/or relocation
Name: Dan WEBER 200 amps or less 100.70 2
Address: 14921 Sw 116th place, 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
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
CV APPLICANT CI CONTACT PERSON
A.Fee for branch circuits with
Business name: BRS Field Ops, LLC above service or feeder fee,
each branch circuit 7.42 2
Contact name: Spencer Fong B.Fee for branch circuits without
Address: 1403 N Research Way service or feeder fee,first 56.18 2
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
Email: permitting.department@blueravensolar.com dwelling,service and/or feeder 67.84 2
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
Address: 1403 N Research Way Signal circuit(s)or limited-energy El See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Orem, UT 84097 Each additional inspection over allowable in any of the above
Additional inspection(1 hr true) 66.25/hr
Phone:( 385) 482-0045 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: permitting.department@blueravensolar.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 227185 Electrical L'c.: C1493 Suprv.Lic.: 6394S specifically listed Ohhr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ,fA Subtotal:
Print name: Shan Whittaker Date: 05/17/2022 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: Sp �. Foil Permitting Coordinator TOTAL PERMIT FEE:
/_ This permit application expires if a permit is not obtained within 180
Print name: Spencer Fong Date: 05/17/2022 days after it has been accepted as complete.
* Number of inspections allowed per permit.
IiBuilding\Permits1ELC_PermitApp EIR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WED
P
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: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 1 133.56 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
rl 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
n 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
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(1 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* 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
n Intercom and Paging Systems
n 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
1'1nuildingtPermits\P.LC_PermitApp_ta.R_IiRli.doc Rev 06l17/2015