Permit (2) CITY OF TIGARD MASTER PERMIT
: ■ . ' COMMUNITY DEVELOPMENT Permit#: MST2023-00154
Date Issued: 05/16/2023
T I[;A R n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134DD02100
Jurisdiction: Tigard
Site address: 11445 SW 107TH PL
Subdivision: ALEX ESTATES Lot: 3
Project: Anderson
Project Description: Rooftop solar PV system 5.6 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: $5,052.32 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 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 5.6 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:
ANDERSON LIVING TRUST BRS FIELD OPS LLC Required Items and Reports(Conditions)
BY VIRGINIA ANDERSON TR 1403 NORTH RESEARCH WAY
11445 SW 107TH PL OREM,UT 84097
TIGARD,OR 97223
PHONE PHONE: 855-205-2530
FAX:
Total Fees: $357.19
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. ATTE ION: Oregon law requi ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: ;2 Permittee Signature: ���(�a
Call 503.639.4 5 by 7:00 a.m.for the next available inspection date.
This permit card shall be ke 'n 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.
huildin2 Permit Ap lication s�
Residential `� ,� FOR OFFI( E 11SE()nl.ti
City of Tigard APR 9 �} Received4 /� , Y1 MS72o 23-OC115�4
BtJ DateBY: I) l L, 1'J Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review (� n
Phone: 503.718.2439 Fax: 503.598.19 ' Date/By: L Z /�3 �'� Other Permit:
Inspection Line: 503.639.4175 tITY OF TIGAR
T((;1!t t> p v R�„ a r Date ReadyReady/By: Juris: See Page 2 for
Internet: www.tigard-or.gov BU1 epi 1 tf; 1*a,)�\ Notified/Method: 1 12023 * R? Supplemental Information
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❑New construction ❑D molition 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: equipment,materials,labor,overhead,and the profit for the
r
a � k ��� ,� � , � � � t, iI, 4 Vr , work indicated on this application.
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❑ 1-and 2-family dwelling ElCommercial/industrial Valuation: $ 5,052.32
IDAccessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
q ',, r `� r t, > t,, t Total number of floors:
Job site address: 11445 SW 107TH PL,Tigard, Oregon,97223-4199 New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Virginia Anderson Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
t ! tdsl! i ( si t tsi l° r9ill4 .J
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 map/parcel no.:
equipment,materials,labor,overhead,and the profit for the
r r `at iaf A ✓ work indicated on this application.
Rooftop Solar PV Valuation: $
Existing building area: square feet
New building area: square feet
i`f f Y / N. / l
Number of stories:
Name: Virginia Anderson Type of construction:
Address: 11445 SW 107TH PL,Tigard,Oregon,97223-4199 Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax ( )
New:
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Business name: BRS Field Ops, LLC :''. � ` fl`
Structural plan review fee(or deposit):
Contact name: Courtnie Hougaard
FLS plan review fee(if applicable):
Address: 1403 N Research Way
Total fees due upon application:
City/State/ZIP: Orem, UT 84097
Phone:( 385)482-0045 Fax::( ) Amount received:
Phone:
E-mail: permitting.deparment@blueravensolar.com � O � ,. „,, „.� �,' ,,,
� V fi Commercial and residential prescriptive installation of
, . , L ., ,, ..,.. , , �� y ` , r,..,. r ., u ti f, r, roof-top mounted PhotoVoltaic Solar Panel System.
Business name: BRS Field Ops, LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 1403 N Research Way Solar Installation Specialty Code checklist.
City/State/ZIP: Orem, UT 84097 Permit Fee(includes plan review
and administrative fees): $180.00
Phone:( 385)482-0045 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 227185
Total fee due upon application: $201.60
Authorized signature: �.�+� This permit application expires if a permit is not obtained
�r i*n i f l rd Permitting Coordinator within 180 days after it has been accepted as complete.
Print name: Courtnie Hougaard / Date: 04/14/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
'. eiv,,x `Ili>il-3
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Date/ByPermit#: Mil.813-60164
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: turfs: 0 See Page 2 for
T I( 1 R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
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❑New construction ®Additiol>/alteration/replacement Please check all that apply(submit 2 sets ofplans wiitems checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑Floating buildings.
e 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
O Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
t erived
5a . :.,, , F,.� �, 91 1 0 /// Emergency system't sepam ely d� �' � larger
. .a �,., .„.K./r. �' ' Addition of new motor
o or load of system.
Job#: Job site address: 11445 SW 107TH PL,Tigard, Oregon, 97223--11�irIP or more. ❑•`A",°'E","1-2","1-3",
City/State/ZIP: ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Virginia Anderson ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: t, - 1
Description Qtv. I Each f Total' I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel# EOO aO sq. 168.54 d 'I 0 d0 sq to
ft.or portion 4
,. ..,:
,. i , .ei ., , i, ,�,,: �.. 2, ' _..., Limited energy,residential 75.00 2
Rooftop Solar PV (with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
%4. ' " is' .., 777,,...,. r. g ., „. v. ` `- a _. v`` x.q. Services or feeders installation,alteration,and/or relocation
Name: Virginia Anderson 200 amps or less 100.70 2
Address: 11445 SW 107TH PL,Tigard,Oregon,97223-4199 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 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 59.36 1
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
tgilir Branch circuits—new,alteration,or extension,per panel+ �,w.,r, ...,;, .�,., ,.., • A.Fee for branch circuits with
Business name: BRS Field Ops, LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Courtnie Hougaard B.Fee for branch circuits a irhout
Address: 1403 N Research Way branch
or feeder fee,fast
b circuit 56.18 2
City/State/ZIP: Orem, UT 84097 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: ( 385)482-0045 Fax: :( ) Each manufactured or modular
dwelling,service and or feeder 67.84 2
Email: permitting.department@blueravensolar.com Reconnect only 67.84 2
,�.,.�, „r�.,.,., ,.,,, ,,,.. , *„.. . f „ s, i �egi �,, �F W
. _ . Pump or irrigation circle 67.84 2
Business name: BRS Field Ops, LLC Sign or outline lighting 67.84 2
Address: 1403 N Research WaySignal circuit(s)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Orem, UT 84097 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 385) 482-0045 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: permitting.department@blueravensolar.com Industrial plant(lhrmin) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 227185 Electrical L'c.: C1493 Suprv.Lic.: 6394S specifically listed(1 hr mm) 4,
Suprv.Electrician signature,required: tf,64 Subtotal:
Print name: Shan Whittaker Date: 04/14/2023 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: tour ltte i4" and Permitting Coordinator TOTAL PERMIT FEE:
f This permit application expires if a permit is not obtained within 180
Print name: Courtnie Hougaard Date: 04/14/2023 days after it has been accepted as complete.
" Number of inspections allowed per permit.
I:\BuildingTermits1ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 410-4615T(I l,05/COM/WF.B
• Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
1 `
Fee for all residential systems combined: $75.00 Des Renewable electrical energy sy y temty. ,,'" Tutst
stems.
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 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) 552.26 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specificull
listed(X2, hr nfir9,
rfiyg@�
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Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* 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
L\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015