Permit CITY OF TIGARD MASTER PERMIT
rli s COMMUNITY DEVELOPMENT Permit#: MST2022-00229
T j G A P,D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/20/2022
Parcel: 2S109AC00300
Jurisdiction: Tigard
Site address: 14665 SW 133RD AVE
Subdivision: None Lot: None
Project: Bosley
Project Description: Solar photovoltaic system 7.6 kW. Electrical work on separate permit#ELC2022-00409.
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: $17,213.00 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'I 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: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF R-3 0
Owner: Contractor:
BOSLEY REVOCABLE LIVING TRUST NEIL KELLY CO INC Required Items and Reports(Conditions)
14665 SW 133RD AVE 804 N ALBERTA ST
TIGARD,OR 97223 PORTLAND,OR 97217
PHONE: PHONE: 503-288-7461
FAX:
Total Fees: $367.19
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: ,�C � 1 :� )
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 1
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
0
Residential ikSCS\,\IS FOR orrlcr: llsE ONLY
City of Tigard ,,r .�, Received s� Permit No.:M l
lii13125 SW Hall Blvd.,Tigard,OR 97223 ,UC)r/ scls. Date/B : %o ol, I'v��(�C ht� "
g p Plan Review �
II. Phone: 503.718.2439 Fax: 503.598.1960 �/ ,_ t,t�NR DateB : ■�'Jl rf all!7 Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 r, U D1v1Cj,O Date Ready/By: tens: ® See Page 2 for
Internet: www.tigard-or.gov UW-D\ � Notified/Method: Supplemental Information
8
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/altcration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
OJ ® 1-and 2-family dwelling El Commercial/industrial Valuation: $ 17,213
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 14665 SW 133rd Ave New dwelling area: square feet
City/State/ZIP: Tigard/OR/97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: David Bosley 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.
Install a 7.6 kW roof-mounted solar system Valuation: $
Existing building area: square feet
New building area: square feet
ID PROPERTY OWNER 0 TENANT Number of stories:
Name: David Bosley Type of construction:
Address: 14665 SW 133rd Ave Occupancy groups:
City/State/ZIP: Tigard/OR/97224 Existing:
Phone:( ) 503 799-1773 Fax:( ) New:
❑ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Neil Kelly Company Structural plan review fee(or deposit):
Contact name: John Wilson
FLS plan review fee(if applicable):
Address: 804 N Alberta St.
Total fees due upon application:
City/State/ZIP: Portland/OR/97217
Phone:( ) 720-227-2780 Fax::( ) Amount received:
E-mail: John.Wilson@NeilKelly.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Neil Kelly Company Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 804 N Alberta ST Solar Installation Specialty Code checklist.
City/State/ZIP: Portland/OR/97217 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) 720-227-2780 Fax:( ) State surcharge(12%of permit fee): S21.60
CCB lie.: 1663
Total fee due upon application: $201.60
r—DocuSigned by:
Authorized signature: This permit application expires if a permit is not obtained
'Il�i�oon within 180 days after it has been accepted as complete.
Print name: John Wilson `—F5E725E9ED8B445... Date: 6/22/2022 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-RESPemritApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of TigardIII DateBcd
Permit No.:
13125 SW Hall Blvd.,Ti ard,OR 97223 y
g Associated permits:
■ Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
II I CARD Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ 0 0
4 Fire district approval required. Name of district: • ❑ 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 ❑ ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 ❑ ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ 0 ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑
_ locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Oregon and shall be shown to be a',licable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 ❑
24 Two(2)sets each are required for Items 16,19,20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
1:\Building\Penults\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
W
DocuSign Envelope ID:4377F273-38C6-49F5-8CF1-A9AE8D5F1D5F
Electrical Permit Application FOR OFFICE I'SF ONI.I
CityofTigard Received ,..
g Date/By: Pf 19/ � 0 Permit#: \- ., 43�c�
r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review `� '
fi Phone: 503.718.2439 Fax: 503.598.1960 Date By: Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: luris: Id See Page 2 for
T 11,A R D Internet: www.ti and-or. ov Notified/Method: g
g g Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
0 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
0 Multi-familyamps for all other installations. buildings.
0 Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SiTE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
22-71-7137 14665 S W 133 rd Ave 0 Addition of new motor load of system.
Job#: Job site address:
100HP or more. ❑"A" "E" "]-2" `7-3"
occupancy.
0 Six or more residential units.
City/State/ZIP: Tigard, OR 97224 ❑Recreational vehicle El Health-care facilities. parks.
Suite/bldg./apt.#: Project name: David Bosley ❑Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
y 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
i DESCRIPTION OF WORK Limited energy,residential
Install 7.6 kW roof-mounted solar systel't (with above sq.ft.) 75.00 2
I Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 PROPERTY OWNER ❑ TENANT Services or feeders installation, ❑ See Page 2
alteration,and/or relocation
Name: David Bosley 200 amps or less 100.70 2
Address: 14665 SW 133rd 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:( ) 503 799-1773 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: bOSleyfam@aOI.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
0 APPLICANT ID CONTACT PERSON Branch circuits—new,alteration,or extension, a er panel
A.Fee for branch circuits with
Business name: Neil Kelly Company above service or feeder fee, 7.42 2
each branch circuit
Contact name: John Wilson B.Fee for branch circuits without
Address: 804 N Alberta St service or feeder fee,first 1 56.1 R 2
branch circuit
City/State/ZIP: Portland OR 97217 Each add'l branch circuit 7.42 2
7202272780Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: john.wilson@neilkelly.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Neil Kelly Company Sign or outline lighting 67.84 2
Address: 804 N Alberta St Signal circuit(s)or limited-energy El See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Portland OR 97217 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) 7202272780 Fax:( ) investigation(1 hr min) 90.00/hr
Email: john.wilson@neilkelly.com Industrial plant(1 hr mils) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 1663 Electrical Lie.: C984 Suprv.Lie.: 5126S specifically listed CA hr nmin)
� � ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: (= Subtotal:
' °f 7 1$ 2022
Print name: Rick Methvin e5Fo7F0296024E3. Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
oowagow by:
Authorized signature: pa.lea. TOTAL PERMIT FEE:
Fssrxseasoeeus... This permit application expires if a permit is not obtained within 180
Print name: John Wilson Date:7!18!2022 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Pemits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(l l/55/COM/WEB
DocuSign Envelope ID:4377F273-38C6-49F5-8CF1-A9AE8D5F1D5F
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. Each I Total
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 133.56 2
❑ A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n B• urglar 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
n Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ V• acuum 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
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 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ A• udio and Stereo Systems
✓ Boiler Controls
n C• lock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n 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