Permit CITY OF TIGARD MASTER PERMIT
' I' '. COMMUNITY DEVELOPMENT Permit#: MST2022-00523
T I(.3A R.U.) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/29/2022
Parcel: 2S102BA02301
Jurisdiction: Tigard
Site address: 10005 SW JOHNSON ST A
Subdivision: NORTH TIGARDVILLE ADDITION,AMENDE Lot: 15
Project: Hillenburg
Project Description: Rooftop solar PV system 6.08 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: $8,512.00 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
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
p. 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
Other: Y Roof topsolar array6.08 kW N
Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 0
Owner: Contractor:
HILLENBURG,LENA K ION DEVELOPER LLC Required Items and Reports(Conditions)
• 10005ASWJOHNSON ST 3214 NORTH UNIVERSITY AVE
TIGARD,OR 97223 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. ATTENTION: 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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Issued By: Yermittee Signature:
all 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
Residential RECEIVED FOR OFFICE USE ONLY
CityReceived
13125Ili ofTigard DECq Date/B : Permit No.:
• SW Hall Blvd.,Tigard,OR 97223 C 2 / 2022 Plan Review � YrS �D
Phone: 503.718.2439 Fax: 503.598.1960 211j3 : „Ae _ j Other Permit:
T I G A RD Inspection Line: 503.639.4175 CITY OF TlGAAL Date Ready By: lur : ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISiON Notified/Method: Merl 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 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.
ll 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 8,512
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
c Job site address: 10005 SW Johnson St v.r.t 1- New dwelling area: square feet
City/State/ZIP: Tigard, Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Hillenburg 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: North Tigardville Addition . Lot no.: 15 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S102BA02301 /R2200027 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: $
6.08 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: Lena Hillenburg Type of construction:
Address: 10005 SW Johnson St Occupancy groups:
City/State/ZIP: Tigard,Oregon 97223 Existing:
Phone:((909))913-3371 Fax:( ) New:
El APPLICANT ❑ 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
City/State/ZIP: Provo, UT 84604 Total fees due upon application:
Phone:( 888) 781-7074 Fax: :( ) Amount received:
E-mail: permits@ionsolar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: ION Developer LLC
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: _PL(dlul'i This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Print name: Dustin Davidson Date: 12-22-2022
Service Board.
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' Electrical Permit ApplicaCEIVED FOR OFFICE USE ONLY
City of Tigard nnC[/+ Received
• 13125 SW Hall Blvd.,Tigard,OR 9t2Q31. 2 2022 Date/B i e ,
i Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : IMEPZIM
Related Permit#:
TIGARD Inspection Line: 503.639.4175 CITY OF'TIGARC) Ready Date/By: Ions: Ei See Page for
Internet: www.tigard-or.gov BUILDING DIVISION NotifiedMethod. Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction 0 Addition/alteration/replacement Please check all that apply(subsoil 2 sets of pions w/items checked):
❑Service or feeder 400 amps or mole 0 Building over three stories.
❑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.
® I-and 2-family dwelling ❑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 0 Other: ['Fire u
p sop. ❑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: 10005 SW Johnson St lootiP or more. ❑"A","E","1-2","1-3",
City/State/ZIP: Tigard,Oregon 97223 0 Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Hillenburg Solar Install 0 Hazardous locations. 0 Supply voltage for more than
O Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
FEE SCHEDULE
Description I Qty. I Each 1 Total I ^
New residential single-or multi-family dwelling unit.
Subdivision: North Tigardville Addition Lot#: 15 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: 2S102BA02301 /R2200027 Ea.add't 500 sq.ft.or portion 33.92 t
DESCRIPTION OF WORK Limited energy,residential
75.00 2
Installation of solar panels on existing residential roof. (with above sq.ft.)Limited energ
y,multi-family 75.00 2
6.08 kW.Addition of 2 0-30A circuits. residential(with above sq.ft.)
. . ... 0 TENANT Renewable Energy 0 See Page 2
®PROPERTY OWNERServices or feeders installation,alteration,and/or relocation
Name: Lena Hillenburg 200 amps or less 100.70 2
Address: 10005 SW Johnson St zol amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Tigard,Oregon 97223 601 amps to 1,000 amps 301.04 2
Phone:((909))913-3371 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: lenahillenburg@gmail.com 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 or feeder fee,first 2
branch circuit
Address: 4801 N UniversityAve#900 1 56.18 56.18
City/State/ZIP: Provo, UT 84604 Each add'1 branch circuit 1 7.42 7,42 2
Miscellaneous(service or feeder not included)
Phone:(888) 781-7074 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
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
Address: 4801 N University Ave#900 panel,alteration,or extension. 0 See Page 2 2
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 Lie.: C1524 Suprv.Lic.: 6098S specifically listed HAhr min) 90.00/]r
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ,tai J G/rT,....._ 7 Subtotal: 197.16
Print name: David S Conrad Date: 12-22-2022 inPlan Review Required(25%of pennit fee):
State surcharge(12%of permit fee): 23.66
Authorized signature: L, TOTAL PERMIT FEE: 220.82
This permit application expires if a permit is not obtained within 180
Print name: Dustin Davidson Date: 12-22-2022 days after it has 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: FEE SCHEDULE
Description Qlr. Each Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s 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
❑ Garage Door Opener* 50.01 to too kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
n 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(1 hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1): 133.56
Fee for each commercial system: $75.00 dumber of Inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
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