Permit (3) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2022-00232
Date issued: 08/18/2022
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110BD02200
Jurisdiction: Tigard
Site address: 11964 SW WILDWOOD ST
Subdivision: SHADOW HILLS NO.2 Lot: 54
Project: Ford
Project Description: Solar photovoltaic system. 7.6 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: $6,856.72 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
Other Fixtures: 0
Drywell-Trench Drain: 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 Tema 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 201400 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 7.6 kW Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF 0
Owner: Contractor:
FORD,DAVID F&LUZ M BRS FIELD OPS LLC Required Items and Reports(Conditions)
11964 SW WILDWOOD ST 1403 NORTH RESEARCH WAY
TIGARD,OR 97224 OREM,UT 84097
PHONE: PHONE: 855-205-2530
FAX:
Total Fees: $362.19
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. ATTENTI N: Oregon law requi s y u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fo in OAR
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Issued By: Permittee 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
IV ) Received FOR OFFICE USE ONLY
City of Tigard Date/By: P
]3]25 SW Hall Blvd.,Tigard,OR 97223 JL j (j2022 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 Cl-fY OF T'IGAHL, Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: ij? A# Supplemental Information
9ULDING awvisiOry
TYPE OF WORK REQUIRED DATA:I 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.
1-and 2-family dwellin
❑ g ❑Commercial/industrial Valuation: $ 6856.72
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11964 Sw Wildwood St, PerlMm7d,Oregon, 97224 New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: David Ford 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.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Rooftop Solar PV Valuation: $
Existing building area: square feet
New building area: square feet
®PROPERTY OWNER ❑ TENANT Number of stories:
Name: David Ford Type of construction:
Address: 11964 Sw Wildwood St, Portland,Oregon, 97224 Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ®CONTACT PERSON BUILDING PERMIT FEES'
Business name: BRS Field Ops, LLC (Pk—ere'erto feeschedule
Structural plan review fee(or deposit):
Contact name: Spencer Fong
FLS plan review fee(if applicable):
Address: 1403 N Research Way
City/State/ZIP: Orem, UT 84097 Total fees due upon application:
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 lic.: 227185
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
Permitting Coordinator within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: Spencer Fon Date: 07/08/2022 Service Board.
]:ABuilding\Permits\BUP-RESPermitApp.doc 0224/2011 440-4613T(I 1/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received Permit#:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Junk: EI See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction F1 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 El Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑� I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building Tess to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOS SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Addition of new motor load of system.
Job#: Jobse address: 11964 Sw Wildwood St, Portland, Oregon, 9 141oHPormore. ❑"A","E'%"I 2","1-Y%
City/State/ZIP: ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite bldg./apt.#: Project name: David Ford ❑Hazardous locations. ❑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
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']500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Rooftop Solar PV (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
PROPERTY OWNER ❑ TENANT Renewable Ener ❑ See Pae 2
Services or feeders installation,alteration,and/or relocation
Name: David Ford 200 amps or less 100.70 2
Address: 11964 Sw Wildwood St, Portland, Oregon, 97224 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/Slate/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
401 amps to 599 am
Owner signature: Date: P Ps 168.54 2
Ea APPLICANT -❑ CON'T'ACT 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 fee, 7.42 2
each branch circuit
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
67.84 2
Email: permitting.department@blueravensolar.com dwelling,service and/or feeder
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 ❑ See Page 2 2
Y panel,alteration,or extension.
City/State/ZIP: Orem, UT 84097 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:( 385) 482-0045 Fax: ( ) Investigation(I hr min) 90.00/hr
Email: permitting.department@blueravensolar.com Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 227185 Electrical L'e.: C1493 Suprv.Lic.: 6394S specifically listed(�/i hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: / Subtotal:
Print name: Shan Whittaker Date: 07/08/2022 ❑Plan Review Required(25% of permit fee):
State surcharge(12% of permit fee):
TOTAL PERMIT FEE:
Authorized signature: Permitting Coordinator
This permit application expires if a permit is not obtained within 1811
Print name: Spencer Fong Date: 07/08/2022 days after it has been accepted as complete.
Number of inspections allowed per permit.
hABuildingVPermits\ELC_Pennli App_EI.R_ERE.doc Rcc 06/17/2015 440-4615TO1105/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
Total
Fee for all residential systems combined: $75.00 Description Renewable electrical Qtv. Each
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
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
552.26
with OAR 918-309-0040)
❑ 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 hour) (I hr min)
Inspections for which no fee is 90.00/hr
specifically listed(112 hr min)
COMMERCIAL WORD ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page I):
Fee for each commercial system: $75.00 �
(SEE OAR 918-309-0000) rrnmher or inspections allowed per permit.
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
CVBuildingVPemasTI-C_Pei mit App_ELR_ERE.doc Ree06/1i/2015