Permit CITY OF TIGARD MASTER PERMIT
III 1 ' COMMUNITY DEVELOPMENT Permit*: MST2022-00510
Date Issued: 12/15/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S114AB15300
Jurisdiction: Tigard
Site address: 16056 SW 93RD AVE
Subdivision: 2003-031 PARTITION PLAT Lot: 1
Project: Mason Blake
Project Description: Roof mount solar PV system 8.76 kW
BUILDING
Floor Areas jteauiredSetbacks 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: $8,760.00 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 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
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'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 All N
Other: Y Other Description: Roof top solar array 8.76 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:
MASON,BLAKE J ELEMENTAL ENERGY LLC Required Items and Reports(Conditions)
MASON,MELISSA N 1339 SE 8TH AVE#B
16056 SW 93RD AVE PORTLAND,OR 97214
TIGARD,OR 97224
PHONE PHONE: 503-967-5786
FAX:
Total Fees: $355.89
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 retuires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: —11iL2 1 l Permittee Signature: c �
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 Checklist
One- and Two-Family Dwelling ..- FOR OFFICE USE O\I l
City of Tigard Received
iPermit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
I Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T I G A R C) Internet: www.tigard-or.gov Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW )es `° ''A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . 0 ❑ ❑
6 Sewer permit. 0 0 ❑
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 ❑
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 ❑ 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 ❑
architect licensed in Ore_on and shall be shown to be applicable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑ 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB)
Electrical Permit Application RECEIVE FOR OFFICE USE ONLY
. City of Tigard 'y PlanReceived
t 13125 SW Hall Blvd.,Tigard,OR 97223 DEC C 14 2022 Date/By: Permit tvt 129Z�.—e rj J
B Plan Review Related Permit 4:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
Inspection Line: 503.639.4175 CITY OF TIGAR Ready Date/By ® See Page 2 for
TIGARD Internet: www.tigard-or.gov BUILDING DI VISII'Nolified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction In Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition El Other: ❑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 0 Floating buildings.
El I-and 2-familydwellingCommerciallindustrial less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ El building
0 Multi-family El Master builder 0 Other: ampsforall other installations. buildings.❑Firere pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
AddJob#: R22-1404 Job site address: 16056 SW 93rd Ave ❑100H ion of new motor load of system
OOFIP or more. ❑"A""E""1-2""1-3"
City/State/ZEP: Tiigard OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parka.
Suite/bldg./apt.#: Project name: Blake Mason Residence ❑Hazardous locations. 0 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 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#: Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2 �1
Blake Mason pv roof solar system prescriptive,8.760kw (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy t`] See Page 2
CI PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Blake Mason 200 amps or less 100.70 2
Address: 16056 SW 93rd 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 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
503 7�0 dR Temporary services or feeders installation,alteration,and/or
Email:blakem.biz86@gmail.eom 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
o ` - I �' l� CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
iw , „ ;a. 4 APPLICANT
A.Fee for branch circuits with
Business name: Elemental Energy LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Alec Sommer B.Fee for branch circuits without
Address: 6800 NE 59th Ave brache ciorfurcuit fee,first
bra nnch 56.18 2
t
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( 503)9675786 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: permits@elementalenergy.net Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Elemental Energy LLC Sign or outline lighting 67.84 2
Address: 6800 NE 59th PI Signaln olre atio)or limited-energy
0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Portland OR 97218 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 503 9675786 Fax:( ) Investigation(I hr min) 90.00/hr
Email:permits@elementalenergy.net
Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 195141 Electrical Lie.: C1228 vsuprv.Lie.: 4894S specifically listed(Va hr min)
Suprv.Electrician signature,required: p6,,a,t ELECTRICAL PERMIT FEES
P > , eq
Subtotal:
Print name: David Gerke Date:12/12/2022 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Molly Beckel Date: 12/12/2022 days after it has been accepted as complete.
" Number of inspections allowed per permit.
I:'9uilding\Pennits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 4404615T(l1/05/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
Fee for all residential systems combined: $75.00 nes I �r Each Total I
y 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
50.01ID Garage
to 100kva(fee
kva 552.26 2
Garage Door Opener* >100 ee in accordance 552.26 2
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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Y2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
SubtFee for each commercial system: $75.00 allowed
per(Ent on Page 1): $133.56
y * Number of inspections allowed 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
1:113uildmg\Pennils\ELC PermitApp_ELR_ERE.doc Rev 06/17/2015