Permit CITY OF TIGARD MASTER PERMIT
�.: ' COMMUNITY DEVELOPMENT Permit#: MST2022-00482
T I GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/29/2022
Parcel: 2S110DD08900
Jurisdiction: Tigard
Site address: 15830 SW HIGHLAND CT
Subdivision: SUMMERFIELD NO.6 Lot: 305
Project: Kirsner
Project Description: Rooftop solar PV system 5.32 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: $3,724.00 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 Tvpes 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: 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: 2
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
Roof to solar array 5.32 kW N
Other: Y Other Description: p Y Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 0 •
Owner: Contractor:
KIRSNER,GISELE ION DEVELOPER LLC Required Items and Reports(Conditions)
15830 SW HIGHLAND CT 3214 NORTH UNIVERSITY AVE
TIGARD,OR 97224 503
PROVO,UT 84604
PHONE: PHONE: (888)781-7074
FAX:
Total Fees: $457.42
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 requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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4 Issued By: w / 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 lob site at the time of each inspection.
L , ,
Building Permit Application
Residential R E G FOR OFFICE USE ONLY
City of Tigard •'4 eceived
ilh1 „ Date/By: Pemtit No.: � ` Z r� �
13125 SW Hall Blvd.,Tigard,OR 97223 !VNOV / Plan Review 11
C �` P^� Ocher Permit:
' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: t(/Z)/ZZ
TIGARD Inspection Line: 503.639.4175 '�)T`i ui Ti GA\(5�.' Date Ready/By: ���S
�� kris: I ® bee Page 2 for
Internet: www.tigard-or.gov t)ILDI1�l1a !IIVISI�`' 'NotifiediMethod: Supplemental Information
V �rK>''L+°� I72-ri4iZ h0SrlYt
TYPE OF WORK REQUIRE 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
❑Addition/alteration/replacement ®Other: pV Solar equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
IN1-and 2-family dwelling ElCommercial/industrial Valuation: $ 3,724
0 Accessory building ❑Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 15830 SW Highland Ct New dwelling area: square feet
City/State/ZIP: tigard,Oregon 97224 Garage carport area: square feet
�? Suite/bldg./apt.no.: Project name: Kirsner Solar Install 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: Summerfield No 6 I Lot no.: 305 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 2S 110DD08900/R498385 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 solar panels on existing residential roof. Valuation: $
5.32 kW.Addition of 2 0-30A circuits. Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name: Gisele Kirsner Type of construction:
Address: 15830 SW Highland Ct Occupancy groups:
City/State/ZIP: tigard,Oregon 97224 Existing:
Phone:((408))335-3515 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: ION Developer LLC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name: Dustin Davidson
FLS plan review fee(if applicable):
Address:4801 N University Ave#900
Total fees due upon application:
City/State/ZIP: Provo, UT 84604
Phone:( 888) 781-7074 Fax::( )
Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: permits@ionsolar.com
Commercial and residential prescriptive installation of
CONTRACTOR
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ION Developer LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 4801 N University Ave#900 Solar Installation Specialty Code checklist.
City/State/ZIP: Provo, UT 84604 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 888) 781-7074 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 230394 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
n-,W e-.e.., within 180 days after it has been accepted as complete.
•Fee methodology set by Tri-County Building Industry
Print name: Dustin Davidson Date: 11-16-2022 Service Board.
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Electrical Permit Application FOR OFFICE USE ONLY
. City of Tigard Received �Date B : Permit ft: � ._bout r6Z
-st 13125 SW Hall Blvd.,Tigard,OR 97223 IIIII
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit If:
_ Inspection Line: 503.639.4175 Ready DateBy: runs: Ed See Page 2 for
7IGARD.. Internet: wwwctigard-or.gov Notified/Method: 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):
❑Service or feeder 400 amps or more CIBuilding over three stories.
0 Demolition ®other: PV Solar
where the available fault current 0 Marinas and boatyards.
CATEGORY.OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
E 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 El Commercial-use agricultural
amps for all other installations. buildings.
• El Multi-family ❑Master builder ❑Other: ['Fire pump. 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: 15830 SW Highland Ct 1001i1'or more. ❑"A "E",'l-2","1-3
City/State/ZIP: tigard, 97224 El Six or more residential units. occupancy.
Oregon0 Health-care facilities. ❑Recreational vehicle parks.
❑Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name: Kirsner Solar Install 600 volts nominal.
El Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCHEDULE
Description 1 Qey. I Earls I Total
New residential single-or multi-family dwelling unit.
• Subdivision: Summerfield No 6 Lot#: 305 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
2S110DDD89DD/R498385 Ea.add'I500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Installation of solar panels on existing residential roof. •
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
5.32 kW.Addition of 2 0-30A circuits. residential(with above sq.ft.)
Renewable Energy 0 See Page 2
® PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: Gisele Kirsner 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address: 15830 SW Highland Ct 401 amps to 600 amps 200.34 2
City/State/ZIP: tigard,Oregon 97224 601 amps to 1,000 amps 301.04 2
Phone:((408))335-3515 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: seneca1994@sbcglobal.net 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
® APPLICANT ❑CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: ION Developer LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Dustin Davidson B.Fee for branch circuits without
service t feeder fee'first 1 56.18 56.18 2
Address: 4801 N University Ave#900 branch circuit
City/State/ZIP:Provo, UT 84604 Each add'l branch circuit 1 7.42 7.42 2
Miscellaneous(service or feeder not included)
Phone:(888) 781-7074 Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: permits@ionsolar.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: ION Developer LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy CI See Page 2 2
Address: 4801 N University Ave#900 panel,alteration,or extension.
City/State/ZIP: Provo, UT 84604 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr '
Phone:(888) 781-7074 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(I hr min) 78.18/hr
permits@ionsolar.com Inspections for which no fee is
CCB Lie.: 230394 Electrical Lic.: C1524 Suprv.Lie.: 6098S Y hr
listed( r min) 90.00/hr
• ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: A ,,zdrz�r�, �J Subtotal: 197.16
Print name: David S Conrad Date: 11-16-2022 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 23.66
Authorized signature: -se.ru TOTAL PERMIT FEE: 220.82
This permit application expires if a permit is not obtained within 180
Print name: Dustin Davidson Date: 11-16-2022 days after it baa been accepted as complete.
* Number of inspections allowed per permit.
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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: `,: CEDULE
Fee for all residential systems combined: $75.00 Des ��. F:aeh Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 1 133.56 133.56 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) 552.2E 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
charged at an hourly(I hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
specifically listed(%z hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page I): 133.56
Fee for each commercial system: $75.00 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
E Intercom and Paging Systems
rl 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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