Permit (140) CITY OF TIGARD MASTER PERMIT
I ' COMMUNITY DEVELOPMENT Permit MST2023-00574
Date Issued: 11/09/2023
T r C AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S106DC10000
Jurisdiction: Tigard
Site address: 13790 SW 175TH AVE
Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 100
Project: Ostrom
Project Description: Rooftop solar PV system. 11.6 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: $8,676.00 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
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 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 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: Rooftop solar array 11.6 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:
OSTROM,JERAME TML INTERNATIONAL LLC Required Items and Reports(Conditions)
PELOSI,SARAH R 6405 E MILL PLAIN BLVD
13790 SW 175TH AVE VANCOUVER,WA 98661
SHERWOOD,OR 97140
PHONE: PHONE: 800-364-0470
FAX:
Total Fees: $356.19
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: n nnn Permittee Signature: / r Y 'f 1 J i `ii
Call 503.639.4175 b :00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
i Building Permit Application
Residential -ten„ �'s _ FOR OFFICE USE ONLY
fives d 'iE °"�• Received �1 y�yt p,t�t,, ^fit ''t
City of Tigard Date/By: I‘Iti(1r0'L3' Ah Permit No.: MJ t ✓ v$ OO5 14
li • 13125 SW Hall Blvd.,Tigard,OR 97223 °r 1 Plan Review J
a Phone: 503.718.2439 Fax: 503.598.19QC i 3 2023 DateBy: )) - 7• other Permit:
l 1('A I:D Inspection Line: 503.639.4175 Date Ready/By p �r tans. El See Page 2 for
r Internet: www.tigard-or.gov CITY OF TIGARD Notified/ tethod'.if //! I Supplemental Information
{{;�,, t 7 .2 , !_1.7.!'S L!- . a% �11 t r fjfi�r
6Wi4taliv'.+
TYPE OF WORK NW' 13T REQU D 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
El Addition/alteration/replacement ❑� Other:Solar equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $8676.00
❑t I-and 2-family dwelling ElCommercial/industrial
Number of bedrooms:
❑Accessory building El Multi-family0 Master builder IDOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:13790 175th Ave New dwelling area: square feet
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Solarinstall-JOstrom 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.
Indicate the value(rounded to the nearest dollar)of all
Tax maplparccl no_: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Installation of 29 solar panels in 4 arrays on a roof-mounted 11.600kW PV System Valuation: $
Existing building area: square feet
New building area: square feet
It PROPERTY OWNER ❑ TENANT Number of stories:
Name:Jerame Ostrom Type of construction:
Address:13790 175th Ave Occupancy groups:
City/State/ZIP:Sherwood,OR 97140 Existing:
Phone:( )503-841-9034 Pax:( ) New:
IN APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:TML International LLC Structural plan review fee(or deposit):
Contact name:Mary Dinsmore-Smith FI,S plan review fee(if applicable):
Address:6405 E Mill Plain Blvd
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98661
Amount received:
Phone:( )(360)326-0650 Fax: :( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:permit@infinitysolarusa.com
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:TML International LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:6405 E Mill Plain Blvd Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver,WA 98661 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( )(800)818-0598 Fax'( ) State surcharge(12%of permit fee): $21.60
CCB lie.:223690 Total fee due upon application: $201.60
Authorized signature: T7'7� This permit application expires if a permit is not obtained
Z7e;td1'jt92�--51 e / within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Mary Dinsmore-S Date:10/23/2023 Service Board.
1:1Building\Permits\BUP-RESPermitApp_doc 0224/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Application CE VE FOR OFFICE USE ONLY
.11
City of Tigard 202 Received
3
III 41 OCT 31 Dana : METINEMITIMIM
13125 SW Hall Blvd.,Tigard,OR 97223 Plann Review
6 Phone: 503.718.2439 Fax: 503.598.1960 DateB : Related Permit k:
TIGARO Inspection Line: 503.639.4175 f'+iT1',rt,^.Ty "!ti '?� Date/By: VIReady Jaris. See Page 2 for
Internet' www.tigard-or.gov Notified/Method: Supple mental Information
TYPE OF WORK PLAN REVIEW
❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans whtems checked).
❑Service or feeder 400 amps or more 0 Building over three stories.
El Demolition ❑■ Other: Solar
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
■ 1-and 2-familydwellingCommercial/industrialless to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ El 0 Accessory amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑building Other: ❑Fire pump. ❑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:13790 175th Ave IOOHPormore. ❑"A","E","l-2","l-3",
❑Six or more residential units. occupancy.
City/State/ZIP:Sherwood,OR 97140 ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Solarinstall-JOstrom ❑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 I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot is Includes attached garage.
1,000 se.ft.or less 168.54 4
Tax map/parcel#: Ea add'l 500 sq.ft.or portion 33.92 l
•
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Installation of 29 panels in 4 arrays on a roof-mounted 11.600kW PV system Limited energ
y,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
mg PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Jerame Ostrom 200 amps or less 100.70 2
Address:13790 175th Ave 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Sherwood,OR 97140 601 amps to 1,000 amps 301.04 2
Phone:( )503-841-9034 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:jerameostrom@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
0 APPLICANT .CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:TML International LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name:Mary Dinsmore-Smith B.Fee for branch circuits without
service or feeder fee,first Address:6405 E Mill Plain Blvd branch circuit 56.18 2
City/State/ZIP:Vancouver WA 98661 Each add'!branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( )360-326-0650 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:permit@infinitysolarusa.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:TML International LLC Sign or outline lighting 67.84 2
Address:6405 E Mill Plain Blvd Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:( )360-326-0650 Fax:( ) Investigation(I hr min) 90.00/hr
Email:permit@infinitysolarusa.com
Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00%hr
CCB Lie.:223690 Electrical Lie.:C1556 Suprv.Lie.:4434S specifically listed('/hr min)
� n ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: �9i /r 9GLd2 Subtotal:
Print name:Todd Rouse Date:10/23/2023 0 Plan Review Required(25%of permit fee):
��+� 7-� �/ State surcharge(12%of permit fee):
Authorized signature: /�'1Gtire/ F/LfZdJ'YL82�'��YPf.I�CIL TOTAL PERMIT FEE:
tfY1T This permit application expires if a permit is not obtained within 180
Print name:Mary Dinsmore-S ith Date:10/23/2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev D6/17/2015 440-46 I ST(I I/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
Description I Qty. I Each [ Total I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or Tess 100 70 2
5.01 to 15 kva 1 133.56 133.56 2
❑ Audio and Stereo Systems* 15.01 10 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) 552.26 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 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00i hr
specifically listed('A hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 anbmdale perms.nter Page 1).
y ' 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
❑ 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.\Building'Permits\ELC PermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
'' Building Division RECENT:E�� ,n,
El13125 SW Hall Blvd,Tigard, OR 97223 t
Phone: 503.718.2439 Fax: 503.598.1960 OCT 3 1 2023
TIGARD Inspection Line: 503.639.4175
www.tigard-or.gov CITY OF TIGARD
BUILDING DIVISION
2010 Oregon Solar Installation Specialty Code
Check List for Prescriptive Installation of Roof-Mounted
PhotoVoltaic Solar Panel System
Property Information
Installation Address: 13790 175th Ave
City: Sherwood Zip: 97140
Owner's Name:Jerame Ostrom Date: 10/23/2023
Contractor's Name:TML International LLC CCB #: 223690
Design Parameters of the Property/Structure
If"Yes", does not
Flood Hazard Is the installation ❑ Yes qualify for the
Area Located in a flood prescriptive path, follow
plain/flood way? 0 No OSSC or ORSC for
design requirements.
Is the wind ex osure ❑ Yes
Wind Exposure p If"Yes", qualifies for
"C"or less? ❑ No the prescriptive path.
Installations on detached Is the Ground Snow
single/two-family Load 70 psf or less?
dwelling/single/two- If"Yes", qualifies for
family townhomes El Yes the prescriptive path.
and/or their accessory
Ground structures. ❑ No
Snow Load Is the Ground Snow
Installations on all Load 50 psf or less?
structures other than ❑ If"Yes", qualifies for
above Yes the prescriptive path.
❑ No
l
I:1Building/Forms/PhotoVoltaic-Checklist02-01-I I docx
I
Is the construction
material wood and does ■❑ Yes
Type of the construction qualify If"Yes", qualifies for
Construction ❑ No the prescriptive path.
as"conventional light
frame" construction?
Is the spacing 24 inches
or less?
Pre-engineered trusses. ❑■ Yes If"Yes", qualifies for
the prescriptive path.
❑ No
Roof framing
members Is the spacing 24 inches
or less?
Nominal lumber. ❑ Yes If"Yes", qualifies for
the prescriptive path.
❑ No
Is the combined weight ❑■ Yes
of the PV modules and If"Yes", qualifies for
racking less than or ❑ No the prescriptive path.
Solar equal to 4.5 psf?
installation Is the solar installation
layout in accordance ❑■ Yes
with Section 305.4(3) of If"Yes", qualifies for
❑
the 2010 Oregon Solar No the prescriptive path.
Code?
❑ Metal
Single layer If roofing material is
Roofing Check the type of ❑ of wood one of the three types
material roofing material shingle/shake checked, qualifies for
Max. two layers the prescriptive path.
■❑ of composition
shingle.
Is the roof mounted ❑■ Yes
Connections of solar assembly
the solar assembly connected to roof No If"Yes",e iqpti e path.for
framingor blockin ❑ the prescriptive
to the roof g
directly?
2
I Building/Fortes/PhotoVoltaic-Checklist02-01-I I.docx
❑ Yes If"Yes", qualifies for
Is the gauge 26 or less?
❑ No the prescriptive path.
115 lbs for 60 inch
spacing or less?
❑ If"Yes", qualifies for
Yes the prescriptive path.
❑ No
Minimum Uplift rating
of Clamps? 75 lbs for 48 inches
spacing or less?
If"Yes", qualifies for
El Yes the prescriptive path.
❑ No
Attachment of
roof mounted Minimum 24 inches If the spacing falls
solar systems Spacing of clamps? within 24 inches and 60
directly to inches Maximum 60 inches inches, qualifies for the
prescriptive path.
standing seam
metal panels Width of roofing If the width of the panel
panels? 18 inches or less is less than 18 inches,
inches qualifies for the
prescriptive path.
Minimum#10 at 24
inches o/c?
Size and spacing of If"Yes", qualifies for
fastener? ❑ Yes the prescriptive path.
❑ No
Is the roof decking of
WSP min. 11/a"thickness, El Yes
decking connected to If"Yes", qualifies for
framing members El No the prescriptive path.
w/min. 8d nails @
6"/12" o/c?
Is the height less than or
Maximum 18 inches equal to 18 inches?
Height of the from the top of the If"Yes", qualifies for
El
solar modules module to the roof Yes the prescriptive path.
surface. ❑ No
3
1:/Building/Forms/PhotoVoltaic-Checklist02-01-I 1 docx
•
Submittal Documents required for Prescriptive Installations
Show the location of the PV system in relation to buildings, structures,
property lines, and, as applicable, flood hazard areas.
Site Plan Details must be clear and easy to read.
Minimum size of the plan is 8.5 x 11 inches.
Attach a simple structural plan showing the roof framing (rafter size,type, and
spacing) and PV module system racking attachment.
System must be shown in sufficient detail and clarity to assess whether it
Structural Plan meets the prescriptive construction requirements as listed earlier above in the
matrix.
Minimum size of the plan is 8.5 x 11 inches.
PV Modules
Manufacturer:Silfab
Model Number:SIL-400 HC+
Listing Agency: UL 61730
4
I:/Building/Fonns/Photo Voltaic-Checklist02-O 1-11.docx