Permit Ili CITY OF TIGARD MASTER PERMIT
N COMMUNITY DEVELOPMENT
Permit#: MST2022-00430
T i r A R.i7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/02/2022
Parcel: 2S104AA04200
Jurisdiction: Tigard
Site address: 12300 SW 127TH AVE
Subdivision: BELLWOOD Lot: 24
Project: Bamford
Project Description: Rooftop Solar PV System, Panel Upgrade, 2 circuits
BUILDING
Floor Areas Required Setbacks Reaulred
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left. 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 st Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: S47,480.00 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
Bckfw 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
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr. 2
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 Al
Other. N Other Description: EcomP 9 asin N
BUILDING INFO
Class of Work: Type of Use; Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 0
Owner: Contractor:
BAMFORD,NICOLE NATIONWIDE ENERGY Required Items and Reports(Conditions)
12300 SW 127TH AVE PO BOX 821959
TIGARD,OR 97223 VANCOUVER,WA 98682
PHONE: PHONE: 800-908-8992
FAX:
Total Fees: $492.09
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. ATTEN •N: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
o69_nnl_nn1 n lhrn„n g5Ann1_nnon ye, mmi Ain n rnnv *Iv Jae nr riirant ni ncctinne in ni INr by ralenn cro o l9 10A7p
nr I Ann 479 d
Issued By: ��I���-' Permittee Signature: Q 4
dr .
Call 3.639.4175 by 7:00 . .for the next available inspection date.
This permit card shall be kept in a cons ous place on the job she until completion of the project.
Approved plans are required on the lob site at the time of each inspection.
Building Permit Application
' Residential Prescription FOR OFFICE USE ONLI'
- City of Tigard Received
Date/By: Permit No.:
N 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /z,
IPhone: 503.718.2439 Fax: 503.598.1960�I'�y�e{�°/� y /r Date/By: /ZZ O herfIGARO InspectionLine: 503.639.4175 B E1 _F \!g^� Hate xeady/By: 1 / / runs: Ed See Page 2 for
Internet: www.tigard-or.goV , L�4-.�..ww� rIA1��1 �l Notified/Method: 4O Z7 Z 1 I Supplemental Information
TYPE OF WORK v v r 4 s
t .�( -(-6burl
REQUIRED DATA:1-AND 2-FAMILY DWELLING
O New construction ❑Demohlidn " c Permit fees*are based on the value of the work performed.
®Addition/alteration/replacement lacement BUILDING DIVISION Indicate the value(rounded to the nearest dollar)of all
ep ®Other:boner Install equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ❑Commercialindustrial Valuation: $47480.00
❑Accessory building El Multi-familyNumber of bedrooms:
❑Master builder ®Other:Prescriptive roof mounted Solar Install Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12300 SW 127th Ave New dwelling area: square feet
'17 City/State/ZIP: PORTLAND, OR, 97223 Garage/carport area: square feet
q
Suite/bldg./apt.no.: Project name: Nicole Bamford Solar Install Covered porch area: square feet
Cross street/directions to job site:SW 127th Ave and SW Karen St 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.: 2S104AA04200 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.
Installation of roof mounted 9.60 kW DC Valuation: $
Solar Photo-Voltaic generation system Prescriptive Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Nicole Bamford Type of construction:
Address: 12300 SW 127th Ave Occupancy groups:
City/State/ZIP:pORTLAND, OR, 97223 Existing.
Phone:( ) (503) 430-1392 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Nationwide Solar (Please refer to fee schedale)
Structural plan review fee(or deposit):
Contact name:Fabian Angobung
Address:6407 NE 117th Ave Unit B FLS plan review fee(if applicable):
City/State/ZIP:Vancouver, WA 98662 Total fees due upon application:
Phone:( )800 908 992 x 222 Fax: :( ) Amount received:
E-mail:fangobung@mynationwidesolar.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:Nationwide Solar Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:6407 NE 117th Ave Unit B Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver, WA 98662 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( )800 908 992 x 222 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:176918
Total fee due upon application: $201.60
Authorized signature: �� Arkhefr This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Fabian Angobung Date:10/25/2022 *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
. City of Tigard '. /0 :
-^ 13125 SW Hall Blvd.,Tigard,OR 97223IR 11 e ,pa Ycmtit#:
i. Phone: 503.718.2439 Fax: 503.598.1960 DalB EC�' Plan Review
: w Related Permit#:
Inspection Line: 503.639.4175
T I G A R D O C T 2 Ready Date/By: June- See Page 2 for
Internet: www.tigard-orgov Notified/Method_ Supplemental Information
TYPE OF WORK C)TY"C) PLAN REVIEW
0 New construction Q Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiitems checked):
El Demolition El Other: Prescriptive Solar Install Roof Mounted ❑Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or
❑ti 1-and 2-familydwellingP 0 Floating buildings.
❑Commercial/industrial El building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
El amps for all other installations. buildings.
Multi-family ❑Master builder INI Other: Solar Install ❑Fire PAP ❑Installation of 150 KYA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately derived
Job#: Job site address:12300 SW 127th Ave ❑Addition of new motor load of system.
100HP or more. ❑"A" `E" "l-2""l-3"
❑Six or more residential units. occupancy.
City/State/ZIP:PORTLAND, OR,97223
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Nicole Bamford Solar Install ❑Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
SW 127th Ave and SW Karen St °e8pnpti°nr or. I Each I Tatar I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#:2S104AA04200 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea.add'l 500 sq.ft.or portion 33.92 1
Limited energy,residential
Installation of roof mounted 9.60 kW DC solar Photo-voltaic generation system (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0See Page 2 0 PROPERTY OWNER 0 TENANT
Services or feeders installation,alteration,and/or relocation
Name:Nicole Bamford 200 amps or less t 100.70 2
Address:12300 SW 127th Ave 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:PORTLAND, OR,97223 601 amps to 1,000 amps 301.04 2
Phone:( )(503)430-1392 Fax:( ) Over 1,000 amps or volts 552.26 2
Email:nikipeterson@hotmaitcom 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 I
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,eer panel
0 APPLICANT 0 CONTACT PERSON
A.Fee for branch circuits with
Business name:Nationwide Solar above service or feeder fee, 2
each branch circuit 7.42 2
Contact name:Fabian Angobung B.Fee for branch circuits without
Address:6407 NE 117th Ave Unit B service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98662 Each add'l branch cite t 7 az 2
Miscellaneous(service or feeder not included)
Phone:( )800 908 992 x 222 Fax::( ) Each manufactured or modular
Email:fangobung@mynationwidesolar.com
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Nationwide Solar Sign or outline lighting 67,84 2
Signal circuit(s)or limited-energy Address:6407 NE 117th Ave Unit B ❑ See Page 2 2
panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Vancouver,WA 98662
Additional inspection(I hr min) 66.25/hr
Phone:( )800 908 992 x 222 Fax:( ) Investigation(I hr min) 90.00/hr
Email:fangobung@mynationwidesolaccom Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.:176918 Electrical Lic.:C 1646 1 Suprv.Lic.:4216 S specifically listed('z hr min) 9000/hr
Suprv.Electrician signature,required: 7t9 Y 7 „ ELECTRICAL PERMIT FEES
Subtotal:
Print name:Todd Hester I Date:10/25/2022 ❑Plan Review Required(25%of permit fee):
Fize I State surcharge(12%of permit fee):
Authorized signature: a. - TOTAL PERMIT FEE:
(/ This permit application expires if a permit is not obtained within I80
Print name:Fabian Angobung Date:10/25/2022 days after it has been accepted as complete.
' Number of inspections allowed per permit.
rlauildiogtPermits\Et.C_permilApp_ELRERE.d°c Rev 06/17/2015 440.4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY (- r= ' FEE SCHEDULE
Fee for all residential systems combined: $75.00 Description I an. I Each Total
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
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
❑ with OAR 918-309-0040) 55226 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: Prescriptive Solar array Roof Mounted Solar Install Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
speclficall hsted %hr nun)
COMMERCIAL WORK ONLY: h TRIC.'AL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 11
(SEE OAR 918-309-0000) • Number of 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
I:AhaldineltermitslELC_PermitApp_ELR ERE.doc Rev 06/17/2015
N
a
3608591753 NATIONWIDE
IONWDE SOLAR 1 LBS PAK 1 OF 1 N
VANCOUVER 6407 NE WA98662 ElED
DWT:17,13,1 N
N
IJ
SHIPTOO: W
CIY OF TIGARD K
13125 SOUTHWEST HALL BOULEVARD
PORTLAND OR 97223
TrieF5i. OR9709 40
S
MI III
UPS 2ND DAY AIR 1
TRACKING #: 1Z 952 77F 02 9914 1049
Cr
O
c
Q
v
0 •
77
BILLING:P/P
s'7
..i tomit TM
XOL 22,10.12 0IV4544.0A 10/2022,