Permit (78) IICITY OF TIGARD MASTER PERMIT
R a COMMUNITY DEVELOPMENT Permit#: MST2023-00350
Date Issued: 08/01/2023
T lc Art O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S134CA00717
Jurisdiction: Tigard
Site address: 11930 SW SUMMER CREST DR
Subdivision: BURLWOOD NO.3 Lot: 6
Project: Ziebach
Project Description: Rooftop solar system 7.2 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: $2,000.00 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
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 WI Svc or Fdr: 0
Ea addl 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+amplvolt: 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 7.2 kW Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
ZIEBACH,TOM M PRO STAT SERVICES LLC Required Items and Reports(Conditions)
11930 SW SUMMER CREST DR 1721 NE 64TH AVE STE 120
TIGARD,OR 97223 VANCOUVER,WA 98661
PHONE: PHONE: (360)859-3749
FAX:
Total Fees: $367.69
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 Notification Center. Those rules are set forth in OAR
ocAnM-nntn e.r ()AD oc,nn1-rf Vn i mm,nhtnin Q rnnu of the mlee nr rlirert nnncfinne In('U IM(`by ralllnn cn4 999 10R7 nr 1 fAnn Ill 9''AA
issued By: - Permittee Signature: ✓ �� l t 1r a
Call 50 639.4175 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 iob site at the time of each inspection.
Building Permit Application
Residential RECEIVED FOR OFFICE SE ON .V
Cityof Tigard 7 �� � pe,4 •_ 3 -0b35 C
' 13125 SW Hall Blvd.,Tigard,OR 97223�UL 2 y 2023 Plan Review
m Phone: 503.718.2439 Fax: 503.598.1gg� Date.B : �r� other permit:
T1GARD Inspection Line: 503.639.4175 OF TIGARD Date ReadyBy: "� funs. S pagelfar
Internet: www.tigard-or.gov CITY ,t* NotifiediMel}wd: / Supplemental Information
ESA ie
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
N Addition/alteration/replacement N Other:SOLAR equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
N 1-and 2-family dwelling 0 Commercial/industrial
Valuation: $2,000
0 Accessory building 0 Multi-family
Number of bedrooms:
❑Master builder
❑Other: Number of bathrooms:
JOB SUE INFORMATION AND LOCATION Total number of floors:
Job site address: 11930 SW Summer Crest Drive Tigard,OR 97223 New dwelling area: square feet
City/State/ZIP: Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:ZIEBACH 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: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 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.
SOLAR PV INSTALLATION Valuation: $
7.2 kW Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name:ZIEBACH Type of construction:
Address:11930 SW Summer Crest Drive Tigard,OR 97223 Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:(541)610-7643 Fax:( ) New:
N APPLICANT N CONTACT PERSON BUILDING PERMIT FEES*
Business name:PROSTAT ELECTRIC (Heave refer ro fee.rcheAid0
Structural plan review fee(or deposit):
Contact name:DALE KRUEGER
Address: 1721 NE 64TH AVE FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP:VANCOUVER,WA 98661
Amount received:
Phone:(503)539-7772 Fax::( )
E-mail: dale.krueger(comcast net PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:PROSTAT ELECTRIC Submit two(2)sets of roof plan with connection details
Address: 1721 NE 64Tu AVE and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:VANCOUVER,WA 98661 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)539-7772 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:189902 Total fee due upon application: $201.60
Authorized signature: Z7a4-• / ph, This permit application expires if a permit is not obtained
(/ within 180 days after it has been accepted as complete.
Print name:DALE KRUEGER Date:7/17/23 *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
T
Electrical Permit Application r(1k orER-I: I'SE:ONI S
CityofTigard Received
5 g .x 6:5T�ua3� pp 3 5 r,
13125 SW Hall Blvd,Tigard,OR 97223 w
' Phone: 503.718.2439 Fax: 503.598.1960 RECEI � Related Permit 4:
Inspection line: 503.639,4175 Ready Date/By: Jens: ® See Page 2 for
f 1''R.i.i). Internet: www-tigard-or-gov JUL2 /, fa:drMethad: Supplemental Information
TYPE OF WORK J�Uhl T PLAN REVIEA
New construction ®Addition/alteration/teplaceWCpy OF T'IGARD Please check all that apply(submit2 sets of pleas wluems efiecked):
D0 BUILDING DIVISI ❑Service or feeder 400 amps w more ()Building over three stories.
Demolition Other: ON where the available fault amen ()Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ()Floating buildings.
aI-and 2-family dwelling ❑Commercial/industrial El Accessory building less to ground or exceeds 14,000 O Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: Q Fire pump. 0 installation of150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately derived
I Job#: Job site address: 11930 SW Summer Crest Drive ()Addition
10011P o rfmor new motor load of system.❑
1 City/State/ZIP: Tigard,OR 97223 ❑Six or more residential suits. occupancy.
Health-care facilities. ❑Recreational vehicle parks
Suite/bldg./apt.#: Project name: ZIEBACH ❑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
Dautiptioil 1 Qty. I Farb 1 Tomr 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'I 500 sq.ft.or portion 33.92 I
( DESCRIPTION OF WORK Limited energy,residential
s., 0 eV �./i(�•-A-1 f alil ov (with abovesq.ft,) y 75.00 2
13h g"' .J-� i�T 4�"S 1 aC/ Limited muhi-family
SOLAR PV INSTALLATION 7.2 KW residential(with above sq.ft.) 75.00 2
PROPERTY OWNER T ENA1�7T Renewable Energy Pale 2
Services or feeders installation,alteration,and/or relocation
Name: ZIEBACH 2D0 amps or less 100.70 2
Address: 11930 SW Summer Crest Drive Tigard,OR 97223 201 to 400 amps 133.56 2
401 amps to 600 amps 20034 2
City/State/ZIP: Tigard,OR 97223 601 amps to 1,000 amps 301,04 2
Phone:( 541)610-7643 Fax:( ) Over 1,000 amps of volt 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 5936 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
AP CANT )rJCONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Sills c above service or feeder fee. 7.42 2
each branch circuit
Contact name: ill— Vat t p�yr.L B.Fee for branch circuits withoutservice
first
Address: 17u ASS•7i¢.4t 44e../—�- branch irrcuit feeder lees 56.18 2
City/State/ZIP: V 6w ,- t.A A T e `3-"-% Each add'1 branch circuit 7.42 2Miscellaneous(service
Phone:(fS4) 5 I Tn.- Fax: ( ) t Each manufactured or odudrlfeerLer not included)67.84 2
� dwelling,service andfw feeder
Email: cleat[ -of�r GCr'ItC LLt'= (A42....k Reconnect only 67.84 2
/A�
[CCONTRACTOR Pump or arigatiw circle 67.84 2
Business name: I1_n"a _ .. ' t,(�� Sign or outline lighting 67.84 2
1 1 �`r 1 x ` `� pineal alteration or limited-energy 0 See e2 2
Address: } �,..�j(' anal,a)tecation,or extension. �
t Each additional ins over allowable in anyof the above
City/State/ZIP: f a_�t_ (=y� p1 hr
Additional inspection(1 hr min) 66.25/hr
Phone_(5051, Z 17 Z�- Fax:( ) f1 Investigation(1 hr min) 90.00/lu
cic,4Q_. ` i, a ,�1'n, y..- inspectio pleat(i hr min) 78.t8.'hr
Email: ` L K Inspections for which no fee is
specifically listed{!5 hr min) 90.00'hr
CCB Lic.: QQBL Electrical - supra.Lie.: [726 5 sF y )
ELECTRICAL PERMIT FEES
Suprv.Electric�t signature,r P /S f k "! ,
() d Subtotal:
Print.name: (`,J v- 43 Date: 7/17/23 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit feel:
Authorized signature: jj��,+�(�
TOTAL PERMIT FEE:
Print name: DALE K EG E R Date: 7/17/23 T7w t application
days aftr it lies beexpires n acc as ccopermit is not�nieed within too
" Number°finspections allowed per permit
1:i5addugtPeatus?ELC_Pcesd p_ELR ERE.doc Rev 05117/2015 440.4611T1111051COWWEn
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: " Qty.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 I 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 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(Y:hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(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',1Buildiog\Rermits\ELC PermitApp_ELR_ERE.doe Rev O617/2015