Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2022-00338
Date Issued: 09/20/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S102CD05700
Jurisdiction: Tigard
Site address: 13940 SW 95TH AVE
Subdivision: FLETCHER WOODS Lot: 7
Project: Hiersche
Project Description: Solar PV system 12.4 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: $1.00 . 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
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 Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 WI 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 12.4 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:
HIERSCHE,R DAVID LIVING TRUST A AND R SOLAR CORP Required Items and Reports(Conditions)
HIERSCHE,SUSAN D LIVING TRUST 19636 SW 90TH CT—BLDG 4
13940 SW 95TH AVE TUALATIN,OR 97062
TIGARD,OR 97224
PHONE: PHONE: 503-420-8680
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. 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 Noti ati Center. Those rules are set forth in OAR
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Issued By: `�j ,4- 3 Permutes Signature:
all 503.639.4175 by 7:00 a.m.for the next available inspection d
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.
r
Building Permit Application RECEIVED
p,,Ckii hhq I RE SEP 0 S 2022 FOR OFFICE USE ONLY
Cityof Tigard Received �7 ��
- g Date/By: Permit No.:/)/1,5 20L2-'0D
11 " 13125 SW Hall Blvd.,Tigard,OR 97223 Y 0F'GIGAR
,lan Review Q 2 of t
Phone: 503-718-2439 Fax: 503-598-1960 C1T G DIVIS\�l - 1 JJ`2 �� Related Permit:
11 r,1 atc'By: !!
TIGAAD Inspection Line: 503-639-4175 BUILDING Date Ready By: / /t,yt , mrls: El See Page 2 for
o Internet: www.ligard-or.goy Notified/Method: �/ (3 ��i /7W' 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 peifonned.
Indicate the value(rounded to the nearest dollar)of all
El Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
■ 1-and 2-familydwelling Valuation: $
❑ ❑Commercial/industrial
IIIAccessory building ❑Multi-family Number of bedrooms:
❑Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13940 SW 95th Ave New dwelling area: square feet
City/State/ZIP: Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: HIERSCHE Covered porch area: square feet
Cross street/directions to job site: SW McDonald St and SW 95th Ave Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: 2S 102CD05700 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.
Valuation: $
Rooftop install of a 12.4 KVA photovoltaic system
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name: Susan D Hiersche Type of construction:
Address: 13940 SW 95th Ave Occupancy groups:
City/State/ZIP: Tigard.OR 97224 Existing:
•
Phone:( 503 )351-0205 Fax:( ) New:
l l APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:
A and R Solar SPC dba A&R Solar (Please refer to fee schedule)
Structural plan review Fee(or deposit):
Contact name: Lara Worcester
FLS plan review fee(if applicable):
Address: 19636 SW 90th Ct Bldg 4
Total fees due upon application:
City/State/ZIP: Tualatin, OR 97062
Phone:(5031 420-8680 x 4 Fax: :( 1 Amount received:
E-mail: permits@a-rsolar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: A&R Solar Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 19636 SW 90th Ct. Bldg 4 Solar installation Specialty Code checklist.
City/State/ZIP: Tualatin, OR 97062 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)420 8680 x 4 Fax:( 1State surcharge(12%of permit fee): $21.60
CCB Lic.: 207641
Total fee due upon application: $201.60
Authorized signature:/ '. / This permit application expires if a permit is not obtained
Lzit� �92!' ti within 180 days after it has been accepted as complete.
Print name: Lara Worcester Date: 9/8/2022 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP_COMPennilApp.doc Rev.04/21/2014 440-4613T(Il/02/CO MAW II)
Electrical Permit Application REGENT I FOR OFFICE USE ONLY
City of Tigard s! O Q )O Received �M
1111
st 13125 SW Hall Blvd.,Tigard,OR 97223 t O L aare/I3y: Pe1Y°u p I'-5� �2 G��i�'�j
n Review
_ Phone: 503.718.2439 fax: 503.598.1960 �F TIGp"�te/ y. Related Petmit#:
Inspection Line: 503.639.4175 Ca Datet6 Juris.
TIGARD (r,'(lws. y' Fa See Paget for
a Internet www.tiBard-or.guv ` 7'R Notifled/Method:
R�1�`_ Supplemental Information
TYPE OF WORK PLAN REVIEW
0 New construction O Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiilems checked):
❑ Demolition ❑Other: D Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑� l-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑Other: ❑Fire n
p tnp. 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#: Job site address: 13940 SW 95th Ave IOOHP or mom. ❑ A', E", 1.2 , t-3
City/State/ZIP: Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: I1IERSC HE ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: SW McDonald St and SW 95th Ave 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#: 2S IO2CD05700 Ea addl 500 sq.ft.or portion 33.92
DESCRIPTION OF WORK Limited energy,residential
75.00 2
(with above sq.ft.)
Rooftop install of a 12.4 KVA photovoltaic system Limited energy.multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
Q_PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Susan D Hiersche 200 amps or less 100.70 2
Address: 13940 SW 95th 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 1,0oo amps 301.04 2
Phone:( 503 )351-0205 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: Dhierscheuoutlook.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 •
OE APPLICANT ® CONTACT PERSON Branch circuits-new,alteration,or extension,per panel •
A.Fee for branch circuits with
Business name: A and R Solar Sl'C dba A&R Solar above service or feeder fee. 7.42 2
each branch circuit
Contact name: Lara Worcester B.Fee for branch circuits without
service or feeder fee.first
Address: 19636 SW 90th Ct Bldg 4 branch circuit 56.18 2
City/State/ZIP: Tualatin,OR 97062 Each addl branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503 )420-8680 ext 4 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: permits@a-rsolar.com Reconnect only 67.84
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: A&R Solar Sign or outline lighting 67.84 2
Address: 19636 SW 90th Ct Bldg4 Signal circuit(s)orlextension. 0 See Page 2 2
paneh alteration,or extension.
City/State/ZIP: Tualatin,OR 97062 Each additional inspection over allowable in any of the above
Additional inspection(f hr min) 66.25/hr
Phone:( 503 ) 420-8680 ext 4 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: permits@a-rsolar.corn
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00'hr
CCB Lie.: 207641 Electrical Lie.: C1179 Suprv.Lic.: 54945 specifically listed(`/hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ' _0—__ Subtotal: 133 56
Print name: Robert Nieman Date: 9/7/2022 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 15.96
Authorized signature:L 4, 6,64..4.. ...4.4. 4, TOTAL PERMIT FEE: 149_52
This permit application expires if a permit is not obtained within 180
Print name: tare Worcester Date: 9/8/2022 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I'BuildingiPermitssELC_PermitApp_ELR_ERE.doc Rev 06/172015 440-4615Tp1/05/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
Description I Qty. I Each I Total I '
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 1 133.56 133.56 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
n G• arage Door Opener* I00 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 V• acuum 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 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90,00/hr
specifically listed('h hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial $75.00 Subtotal(Enter on Page I): 133.56 system:
y • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
Ft B• oiler Controls
n C• lock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
0 Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
• n O• ther:
Total number of commercial systems: _
*No licenses are required. Licenses are required fur all
other installations
I:'Baitdimg/Permits1ELC_PermitApp_ELR_ERE.doc Rev 06/172015