Permit (3) CITY OF TIGARD MASTER PERMIT
` I COMMUNITY DEVELOPMENT Permit#: MST2022-00215
T I C;A I2 T.) 13125 SW Hat Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/04/2022
Parcel: 2S104BA10800
Jurisdiction: Tigard
Site address: 13627 SW LIDEN DR
Subdivision: CASTLE HILL NO.3 Lot: 138
Project: Grajeda
Project Description: Solar photovoltaic system. 6.4 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: $5,774.08 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 6.4 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:
GRAJEDA,JOSE A BRS FIELD OPS LLC Required Items and Reports(Conditions)
CASTRO,ALEJANDRINA 1403 NORTH RESEARCH WAY
13627 SW LIDEN DR OREM,UT 84097
TIGARD,OR 97223
PHONE: PHONE: 855-205-2530
FAX:
Total Fees: $356.69
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. T •s permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: law requir y to follow e rules adopted by the Oregon Utility Notification Center, Those rules are set forth in OAR
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Issued By: i Permittee Signature: l �G
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 EC ` +
Residential JUL 12 2022 FOR OFFICE USE oNiA
City of CI
TigardCITYO (�AH�� Received / I� 4 lc-
g 23@JILDING DIVISION Date/By:
SW Hall Blvd.,Tigard,OR 97 Date
Plan Review
' 111 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 7 I ?j2 AA- Other Permit
T I C A R[) Inspection Line: 503.639.4175 Date Ready/By: I hvis EdSee Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED 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
E Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
dwellingValuation: $ 5774.08
❑ 1-and 2-family 0Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13627 Sw Liden Dr, Portland, Oregon,97223 New dwelling area: square feet
k. City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Jose Grajeda 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 if.li Valuation: $
1 Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name: Jose Grajeda Type of construction:
Address: 13627 Sw Liden Dr, Portland,Oregon,97223 Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: BRS Field Ops, LLC (Please refer ro fee schedule)
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
Phone:( 385)482-0045 Fax: :( ) Amount received:
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 Specialty 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
-�` !J/�/er rovy„ Permitting Coordinator within 180 days after it has been accepted as complete.
Print name: Spencer Fong G+VIs�r V 4t Date: 07/05/2022 *Fee methodology set by Tri-County Building Industry
Service Board.
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Electrical Permit ApplicationRECEIVE - -
aFOR OFFICE USE ONLY
Received
City of Tigard Date/B : Permit#:
0 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 1 2 2011 Plan Review
III
a Phone: 503.718.2439 Fax: 503.598.1960 Date/B-: Related Permit#:
T i G A}t D Inspection Line: 503.639.4175 ���OF�'� ` Ready Date/By: iiiim H See Page 2 for
Internet: www.tigard-or.gov RI!J. Ir' 1} Notified/Method: Supplemental information
TYPE OF WORK PLAN
v�1�4
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 ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
0 1-and 2-family dwellirig ❑Commercial/industrial
amps for all other installations. buildings.
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job.#: Job site address: 13627 Sw Liden Dr, Portland, Oregon, 97223 I00HPormore. ❑ .�,• °`E', l-2',`1-3',
City/State/ZIP: ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Jose Grajeda ❑Hazardous locations. ❑Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. 1 Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Lott 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
75.00 2
Rooftop Solar PV
(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: Jose Grajeda 200 amps or less 100.70 2
Address: 13627 Sw Liden Dr, Portland, Oregon,97223 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
Temporary services or feeders installation,alteration,and/or
Email: 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: BRS Field Ops, LLC above service or feeder f'ee, 7.42 2
each branch circuit
Contact name: Spencer Fong B.Fee for branch circuits without
sAddress: 1403 N Research Way branche it feederitfee,first 56.18 2
branch circuit
City/State/ZIP: Orem, UT 84097 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: ( 385)482-0045 Fax: : ( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: permitting.department@blueravensolar.com 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 0 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 min) 66.25/hr
Phone:( 385) 482-0045 Fax: ( ) Investigation(1 hr min) 90.00/hr
Email: permitting.department@blueravensolar.com Industrial plant(thrmin) 78.18ihr
Inspections for which no fee is 90,00/hr
CCB Lie.: 227185 Electrical L'c.: C1493 Suprv.Lie.: 6394S specifically listed(',';hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature.required: e
Subtotal:
Print name: Shan Whittaker Date: 07/05/2022 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: Spec y- FOR, Permitting Coordinator TOTAL PERMIT FEE:
// This permit application expires if a permit is not obtained within 180
Print name: Spencer Fong Date: 07/05/2022 days after it has been accepted as complete.
* Number of inspections allowed per pennit.
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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 I Each I Totet '
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
❑ 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(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
❑ 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
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