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Permit msr w2 oo►c q City of Tigard t 4 =D flEcE ' Building Division 1 , I. • 13125 SW Hall Blvd, Tigard, OR 97223 8 2r13 Phone: 503.718.2439 Fax: 503.598.1960 T I G A R D Inspection Line: 503.639.4175 CITY OF www.tigard-or.govIiVG DIVI;IO1`J 2010 Oregon Solar Installation Specialty Code Check List for Prescriptive Installation of Roof-Mounted PhotoVoltaic Solar Panel System Property Information Installation Address: 16840 SW Rockhampton Lane City: Tigard Zip: 97224 Owner's Name: Andrew Zepp Date: 05/05/23 Contractor's Name: Freedom Forever Oregon LLC CCB #: 234650 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? ® No OSSC or ORSC for design requirements. Wind Exposure Is the wind exposure ® Yes 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 ® 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? El "Yes", qualifies for structures other than Yes the prescriptive path. above ❑ No 1 1:/Building/Forms/PhotoVoltaic-Checklist02-01-11.docx 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? If"Yes", qualifies for Pre-engineered trusses. ® Yes the prescriptive path. n No Roof framing members Is the spacing 24 inches or less? ❑ If"Yes", qualifies for Nominal lumber. Yes 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 n 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 If"Yes", qualifies for ❑ No the prescriptive path. to the roof framing or blocking directly? 2 I:/Building/Forms/PhotoVoltaic-Checklist02-01-I I.docx ❑ Yes If"Yes", qualifies for Is the gauge 26 or less? n No the prescptive path. 115 lbs for 60 inch spacing or less? El Yes "Yes", qualifies for Yes the prescriptive path. n No Minimum Uplift rating of Clamps? 75 lbs for 48 inches spacing or less? If"Yes", qualifies for n 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 standing seam prescriptive path. 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 El Yes If"Yes", qualifies for fastener? the prescriptive path. ❑ No Is the roof decking of WSP min. '/2"thickness, n Yes decking connected to If"Yes", qualifies for framing members ❑ 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 solar modules module to the roof � Yes the prescriptive path. surface. n No 3 l:/Building/Forms/PhotoVoltaic-Checklist02-01-11.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: Freedom Forever Model Number: FF-MP-BBB-400 Listing Agency: 4 1/Building/Forms/PhotoVoltaic-Checklist02-01-11.docx to Prescriptive Solar Photovoltaic Installation Checklist ; 2019 Oregon Structural Specialty Code (OSSC) Compliance Use this checklist to demonstrate compliance with the prescriptive photovoltaic(PV)requir°. ' =nts4404ctions 3111.3.5.3 and 3111.3.4.8 of the Oregon Structural Specialty Code (OSSC). Separate elecgicAl firlth yJ,is tx required for the installations. auuz*IG DMSION PART I PROPERTY OWNER INFORMATION Property owner name: Andrew Zepp Phone number:503-837-9978 Installation address: 16840 SW Rockhampton Lane City:Tigard State: Oregon ZIP:97224 Structure on which modules are to be installed:Home Installer: • Contractor ❑ Owner(If owner, skip to Part III) PART II—CONTRACTOR INFORMATION Contractor name:FREEDOM FOREVER OREGON LLC Phone number:971-808-7776 Email address: PermitsPortland@freedomforever.com BCD business license#:C1612 Contractor's CCB#:234650 PART 111-STRUCTURAL CRITERIA Roof structure requirements If"No" is selected for any item below, or if the supporting structure is a manufactured dwelling, the project may not be submitted using the prescriptive path. Check the appropriate boxes for each item as it applies to the project. • Structure is classified Risk Category I or II in accordance with OSSC 1604.5: ❑■ Yes ❑ No • Structure is of conventional light frame construction: ® Yes ❑ No • Supporting roof framing is one of the following: ® Yes ❑ No (check one) ® Pre-engineered trusses spaced<24 inches o.c.;or ❑ Rafters spaced<24 inches o.c.and spans comply with OSSC 2308.7.2 or ORSC R802.5,respectively • Ground snow load does not exceed maximum load: 0 Yes ❑ No (check one) ❑ <50 psf for structures under the ORSC,or ® <70 psf for structures under the OSSC • The basic design wind speed does not exceed the following: ® Yes ❑ No (check one) ® < 120 mph in Wind Exposure Category C for structures under the OSSC;or ❑ < 135 mph in Wind Exposure Category B for structures under the OSSC;or ❑ < 135 mph in Wind Exposure Category C for structures under the ORSC • Roofing materials are metal, single-layer wood shingle or shake, or not more than two layers of composition shingle: 0 Yes ❑ No • Module height is less than 18 inches from the top of the module to the roof surface and complies with Figures 3111.3.5.3(1)and 3111.3.5.3(2): ® Yes ❑ No BCD I Budding Codes Division Published by Building Codes Division—Aug. 18, 2021 Department of Consumer PART III-STRUCTURAL CRITERIA(continued) Loading requirements Check the appropriate boxes for each item associated with the selected attachment method. ❑ Attachment 1: PV modules or racking is attached directly to the roof framing or blocking: • Combined weight of PV modules and racking is not more than 4.5 psf: ❑■ Yes ❑ No • Spacing of PV modules or racking complies with one of the following: ® Yes ❑ No (check one) ® <48 inches in any direction;or ❑ <24 inches in any direction where the following are true: • Ground snow load is more than 36 psf • Panels are located within 3 feet of a roof edge,hip,eave,or ridge • Basic design wind speed is greater than 120 mph in Wind Exposure Category B • Basic design wind speed is greater than 110 mph in Wind Exposure Category C *If this is the appropriate attachment method and "No" is selected for any of the items above, the project may not be submitted using the prescriptive path. ❑ Attachment 2: PV modules or racking is attached directly to standing seam metal panels: • Combined weight of PV modules and racking is not more than 4.5 psf: ❑ Yes ❑ No • Clamps comply with the following requirements: • Provide the following, allowable uplift capacity: ❑ Yes ❑ No (check one) ❑ Not less than 115 pounds and spaced at 60 inches o.c.or less;or ❑ Not less than 75 pounds and spaced at 48 inches o.c.or less. • Spacing between metal panel seams is not more than 24 inches ❑ Yes ❑ No • Spacing along a metal panel seam is not more than 60 inches ❑ Yes ❑ No • Metal roofing panels comply with the following requirements: • Panel thickness is 26 gauge steel, minimum ❑ Yes ❑ No • Panel width is 18 inches or less ❑ Yes ❑ No • Attached with at least#10 screws at 24 inches o.c. ❑ Yes ❑ No • Installed over minimum 1/2-inch nominal wood structural panels attached to framing with 8d nails at 6 inches o.c. at panel edges and 12 inches o.c. field nailing ❑ Yes ❑ No *If this is the appropriate attachment method and "No"is selected for any of the items above, the project may not be submitted using the prescriptive path. PART IV-ROOF DESIGN SITE PLAN Roof design requirements • Attach a simple structural plan showing the roof framing(rafter size,type,and spacing)and PV system racking attachment. • System must be shown in sufficient detail to assess whether the requirements of Section 3111.3.5.3 have been met. • The structural plan must be on 8.5-inch x 11-inch or larger paper. PART V-PV MODULES Manufacturer:Freedom Forever Model number:FF-MP-BBB-400 Listing agency: [2] PART VI— PATHWAYS AND CLEARANCES Pathway and clearance requirements • Using the grid below or an attached 8.5-inch x 11-inch or larger paper, provide a simple drawing, indicating the location of the PV system in relation to buildings, structures,property lines, and, as applicable, flood hazard areas. • The drawing must be shown in sufficient detail to assess whether the pathway requirements of Section 3111.3.4.8 or one of the exceptions have been met. [3] CITY OF TIGARD MASTER PERMIT ' COMMUNITY DEVELOPMENT Permit#: MST2023-00194 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/25/2023 Parcel: 2S107AA23500 Jurisdiction: Tigard Site address: 16840 SW ROCKHAMPTON LN Subdivision: ROSHAK RIDGE Lot: 235 Project: Zepp Project Description: Rooftop solar PV system 19.2 kW and(2)circuits. 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: $40,500.00 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 W/Svc or Fdr: 0 Ea add'l 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 N Other: N Other Description: Roof top solar array 19.2 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: ZEPP,JAMILYN M&ANDREW FREEDOM FOREVER OREGON LLC Required Items and Reports(Conditions) 16840 SW ROCKHAMPTON LN 15943 NE CAMERON BLVD TIGARD,OR 97224 PORTLAND,OR 97230 PHONE: PHONE: 971-808-7776 FAX: Total Fees: $505.71 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 re ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR ac9_nn1-nnln thrni,nh nA 9_nn1 nQn V max,nhtain a nm,of tha rulac n irarr ni lacfinnc to nl INR h,Tallinn Tina 9 1Q527 nr 1 Sinn 199 9144. Issued By: Permittee Signature: T—C''' /t'� Call 503.639.4175 by 7:00 a.m.for the next available inspection date. i v 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. Building Permit Application it Residential FOR OFFICE I1SE ONE City of Tigard and Received 9 0 — OO III el g `' Date/B Permit No.: S) 13125 SW Hall Blvd.,Tigard,OR? ECEI�E to Plan ReviewMarlPhone: 503.718.2439 Fax: 503.5'98.' DateB : Other Permit: T I G A fZ D Inspection Line: 503.639.4175 MAY 2023 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified Method: S Tj Supplemental Information r% "�r''rFN' !` ;�'.,'F f r !yr,f tY+,^ i s` f;J 5 FV'' 4. -_ L'C-a44]61 f' e,'F r n ., f F r� ,'r k r f ,rr r r ; N i vy'/ f -' `F "`f z„ uvoto`sw;wfr ;,fr'r'` ..,,, r,.,;.z;ii llrf�l o .i, .41 „ry, 1 , f r r f4'.�4fJ.�t.d' fe tr i f r Ir I i ^ '`,,...„ 3 ° # I �" �`"� , -:^ ' ,3,�, .,ram„G rr "�., ,� .r,.,,.,:;..v ❑New construction 'j 1,-� i 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 0 Other: equipment,materials,labor,overhead,and the profit for the E ftFy r,`r,.r,, r �.., x6 �' *r Farr ,?` '" r.`f, ,' F ,r,f r'r'r r 0 �F;65 f� t*Al f { Or,,N V f t {'r ` work indicated on this application. �` ?£, rl',�./„rfr, r r."'rf`..;` �F.,r^�,,., ,rr fX,.,Jf/� ,: rv::✓r fi',er�lr' :� rti� w'�F'`�i. ��u,�,fa,i,i,u� Valuation: $ 40 is1-and 2-family dwelling ❑Commercial/industrial 500 0 Accessory building 0 Multi-family Number of bedrooms: n ❑Master builder ❑Other: Number of bathrooms: r, ,%f r,r rrr r: r f✓ ,g ,r r s f ,r4 , f 'r f a fr' eAl' iml t ' i J f 1. !9 tw:;,A,Am / Total number of floors: ,,.. �r ,,,r a�'`y r s� �,,,, , r rrr r,:v`r%Z J t, ,rir,.t �a.,C. „�/,?,f�F�� z,,rv„ �✓�. �'ra,,� /.J.;i,.,�.f, il Job site address: 16840 SW Rockhampton Lane New dwelling area: square feet City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Andrew Zepp-Solar and Derate Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet r r fry' G','F '.r'f r r ' ti,F, .,thy! 1 < 1 dl ac ,, s�W :j Subdivision: POLYGON AT ROSHAK RIDGE I Lot no.: 235 Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S 107AA235OO Indicate the value(rounded to the nearest dollar)of all 'a '' - f l - rrs .r ✓ f.„ r ar r r equipment,materials,labor,overhead,and the profit for the r i! I€:4 i Es ,rr x � �� r / r , � f,, ,�`�f��f �',�','� ,ter r � work indicated on this application. ,,, �;,. ,„ ,. ��„ ,cf am,,,.,. ,cf,�.� r ... t� ,�!,r�f/.,r'r i, f�,,,.', r `f,,,.M 19.20kW PV Roof Mount - Solar Valuation: na $ tie in solar at (N)80A breaker and derate main breaker Existing building area: square feet to (N)175A main breaker New building area: square feet r `� ! r ,ff f f l' r`f /% f (sa f " r"t r !„4 f'` f ��fr ; � �r Number of stories: Name: Andrew Zepp Type of construction: Address: 16840 SW Rockhampton Lane Occupancy groups: City/State/ZIP: Tigard, OR 97224 Existing: Phone:( ) 503-837-9978 Fax:( ) New: f r . `./ ,� llfr ��.�? Business name:Freedom Forever Oregon LLC J�' t Structural plan review fee(or deposit): Contact name:Leann Malloy FLS plan review fee(if applicable): Address:15943 NE Cameron Blvd Total fees due upon application: City/State/ZIP:PORTLAND/OR/97230 Phone:( 971 )808-7776 Fax: :( ) Amount received LI P , E-mail:PermitsPortland@freedomforever.com ,, ,Fr ..L f ,,, N Commercial and residential prescriptive installation of Ri ,ti roof-top mounted Photovoltaic Solar Panel System. Business name:Freedom Forever Oregon LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:15943 NE Cameron Blvd Solar Installation Specialty Code checklist. City/State/ZIP:PORTLAND/OR/97230 Permit Fee(includes plan review and administrative fees): Phone:( 971 )808-7776 Fax:( ) State surcharge(12%of permit fee): CCB lic.:234650 Total fee due upon application: Authorized signature: ,12 /z/2a.�i This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Leann Malloy Date: 05/05/23 *Fee methodology set by Tri-County Building Industry Service Board. C\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) Electrical Permit Application FOR OFFICE F'SF ONLI City of Tigard Received Date/B Permit#: 413125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ': II Phone: 503.718.2439 Fax: 503.598 --)1 B Date : Related Permit#: Inspection Line: 503.639.4175 t E I V i Ready Date/By: funs H See Page 2 for T I G A R ll Internet: www.tigard-or.gov Notified/Method: Supplemental Information �`•f/.yrl �ii'.f .:::, r' '''..�. r..., -� .;r. ,,.v..,, ,r;.. rF,� r fr.+:r .,m$.: f, /%/%` �,�, ,ri'r"/'�'c..... .,'�., , rrr!',. ,r., :. a. rf�� r,� F...�.�' ..per.% 7,.+.`�.i....r rr r;.lr':,�f fj,. ' �,,,,..M,.. .:..,�,, � �`�,�r,r`F,% .xr s f..` s .'s'J'' r/�'�/f f , ...'N,!,,�.r; F..; .'' r ,.! l../F F f l / I J,! f/r ``"•i sf f.,./r�,, rr`�.;�..r ..:.,�r..�E,��i'�r;''"�...�i r...�rf�rr�,r�i" AY rif,' .�. tF�`r � �s':. �v i!" �,' �,,. ,<.`rFf err. ��'',�.'./;.,F�.,. � lift�,.rr, ,�'',,._f .,�.,.:".r,,.�, „r,' .� ,�,..,,,.,,,�rff,'�- ..,N.ri`rrr„'.rrGF�'%!�i:rf1J'�,.�t^ ,.;.;:, e;,.�Uf�..+�'�I%�.,�'/% .us r,3i�r 4..it � ',�'.� .,,,�.�i,!, �s�/,��,�� ❑New construction ®Addition/alterati0 Please check all that apply(submit 2 sets of plans w/items checked): � � � ❑Service or feeder 400 amps or more 0 Building over three stories. Li Demolition ❑Other: f where the available fault current ID Marinas and boatyards. , Zr , ram ,. i l . / fi .(, r';'2 r*,, exceeds 10,000 amps at 150 volts or ❑Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or 1 � s a „: �.,.. >,f, „ r„� ,;. F',r r,' s ' ` ❑Emder enc s stem. larger separately derived /, r"<• �'rr`r�� / � �., �r#f�,��r/nr<�"A''�� g Y Y g P Y ❑Addition of new motor load of system. Job#: Job site address: 16840 SW Rockhampton Lane 100HP or more ❑"A",°`E","1-2","1-3", City/State/ZIP: Tigar, OR, 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: Andrew Zepp-Solar and Derate 0 Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: 721Pr , "rt,„ k,,.ass i a` t `in 'l Description Qty. I Each 1 Total i Is New residential single-or multi-family dwelling unit. Subdivision: POLYGON AT ROSHAK RIDGE 1 Lot#: 235 Includes attached garage. Tax map/parcel#:2S107AA23500 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 l r'' f6»{ ;.' 'r Fr r / J r'rr :ff/ ""�" ,1r „^f '',.,. `fl :io m d i i i) r,,r �`I rr /%`.VIS y Limited energy,residential �.. b.,r ,, r�.,r 75.00 2 19.20kW PV Roof Mount-Solar (with above sq.ft.) Limited energy,multi-family 75.00 2 (N)80A pv breaker and (N)175A derate main breaker residential(with above sq.ft.) ONVIO �; Renewable Energy ❑ See Page 2 �� rr '`� � r �«• ` -� `F=�- { ' '� Services or feeders installation,alteration,and/or relocation Name: Andrew Zepp 200 amps or less 100.70 2 Address: 16840 SW Rockhampton Lane 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:( 503-837-9978 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 F i� Branch circuits— alteration,or extension,per fF�, �,:, .,,.x <, ,.��. k.;,f`,g f.,. '':.'XF ;, 4, `',i ,"..• U _ Fnew, panel �� u/; A.Fee for branch ci with Business name:Freedom Forever Oregon LCC above service or feeder fee, 7 42 2 each branch circuit Contact name:Leann Malloy B.Fee for branch circuits without service or feeder fee,first Address:15943 NE Cameron Blvd branch circuit 1 s6.18 2 City/State/ZIP:PORTLAN D/OR/97230 Each add'1 branch circuit 1 7.42 2 Miscellaneous(service or feeder not included) Phone:(971 ) 808-7776 Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: PermitsPortland aefreedomforever corn Reconnect only 67.84 2 r... llna. ..... ,:/Otgr 7 .,,, - s.. , ,. ..., ,.MA,,-, M;,,,NKI Pump or irrigation circle 67.84 2 Business name:Freedom Forever Oregon LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:15943 NE Cameron Blvd panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP:pORTLAND/OR/97230 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( 971) 808-7776 Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:PermitsPortland@freedomforever.com Inspections for which no fee is specificall listed rt hr mm 90 00/hr ,_ CCB Lie.:234650 Electrical Lic.:C1612 Suprv. Lie.:6576S ) r ��f-- ,:' Suprv.Electrician signature,required y-44r 4�'2.e Subtotal: ` Print name:Greg Albright ((// Date: 05/05/23 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: kia-1 TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name:Leann Malloy Date: 05/05/23 days after it has been accepted as complete. Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE_doc Rev 06/17/2015 440-4615T(I I/05/COM/WEB Electrical Permit Application—City of Tigard 'Wage 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: /a a p�.'� :^"a't� 3„r 3 J �' ,( fi'x',""vr J {.'!�'�%/irl ,;,.; . .,. ,r.7T17 ..m ,�,. , r,'"'e: ,.:;:,J'�r,(,rF 'rs'fr 7f y JJ'J/..l"/.,g . ��f i`r"'r'-F`f> Fee for all residential systems combined: $75.00 Description Qty. Each Total able electrical energy systems: 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 1 200.34 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: Prescriptive Roof Mounted PV System Each additional inspection is 66 25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr g p� specifically listed(%hr min) MOEWIL � Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * 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 C\Building\Permits\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015