Permit (2) •
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2023-00190
Date Issued: 05/25/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S104CC00600
Jurisdiction: Tigard
Site address: 14183 SW MISTLETOE DR
Subdivision: HILLSHIRE ESTATES NO.2 Lot: 111
Project: Ikeda
Project Description: Rooftop solar PV system 4.8 kW and (1)circuit.
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: $3,360.00 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: 1
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 4.8 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:
IKEDA,KENNETH R ION DEVELOPER LLC Required Items and Reports(Conditions)
14183 SW MISTLETOE DR 3214 NORTH UNIVERSITY AVE
TIGARD,OR 97223 503
PROVO,UT 84604
PHONE: PHONE: 888-781-7074
FAX:
Total Fees: $412.31
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. ATTENTIO . Oregon law req r s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc9_nn1_nnln thrniinh aril_ 1_nn0n Vn au nhtain a nsi nftha r,,la r dirart nitactinnc to(11 ICI(`FA/Tallinn Fn'2 '27,1OA7 nr 1 Rnn 3'27 9144.
Issued By: Permittee Signature: A/4'G%
Call 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 job site at the time of each inspection.
Building Permit Application
MAY 2 2023
Residential CITY OF FOR orrlCG Usl/O l
te�l I � a� ' Received 511 1 1 �1 P MgT1613.60 qo
Cityof Tigard § q y g p�,}} D Permit No.:
g PUILD1 U Ult f' Date/ ey:
13125 SW Hall Blvd.,Tigard,OR 972 + .��1 a.."7� Plan Review A
Phone: 503.718.2439- Fax: 503.598.1960 Date/By: 5 ' • _3 pc- Other Permit:
IGARD D Inspection Line: 503.639.4175 Date Ready/By: 5I /> e
ris: El SeePage2for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
Sl
x F TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILVVWELLING
❑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.
ID1-and 2-family dwelling ❑Commercial/industrial Valuation: $3,360
❑Accessory building El Multi-familyNumber of bedrooms:
! ❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION.,. Total number of floors:
Job site address: 14183 SW Mistletoe Dr New dwelling area: square feet
City/State/ZIP: Tigard, Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Ikeda Solar Install Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED-DATA 4IMERCIAL-USE CHECKLIST
Subdivision: Hillshire Estates Lot no.: 111 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 2S104CC00600/R2041051 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: $
4.8 kW.Addition of 1 0-30A circuit. Existing building area: square feet
New building area: square feet
PROPERTY OWNER [ TENANT Number of stories:
Name: Kenneth Ikeda Type of construction:
Address: 14183 SW Mistletoe Dr Occupancy groups:
City/State/ZIP: Tigard, Oregon 97223 Existing:
Phone:((503))887-9918 Fax:( ) New:
® APPLICANT E CONTACT PERSON., BUILDING PERMIT FEES*
(Please refer to fee schedule) ;
Business name: ION Developer LLC Structural plan review fee(or deposit):
Contact name: Dustin Davidson
FLS plan review fee(if applicable):
Address:4801 N University Ave#900
Total fees due upon application:
City/State/ZIP: Provo, UT 84604
Phone:( 888) 781-7074 Fax::( )
Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: permits@ionsolar.com ,..
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: ION Developer LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 4801 N University Ave#900 Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review
Y Provo, UT 84604 and administrative fees): $180.00
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: 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: 04-27-2023 Service Board.
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•
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard MAY 2 2023 Receid
Date/Bea Permit#: MSl ().1, • oo
1114 U 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
_ Phone: 503.718.2439 Fax: 503.598 196ITy Related Permit#:
Inspection 503.639.4175 �' � t � Date/B
P BUILDING D I t/I . I N Ready Date/By: finis: ® See Page 2 for
3 f'ARP Internet: www.tigard-or.gov ( Y Notified/Method: Supplemental Information
TYPE OF"WORK ;:: I5L*N REVIEW ,
0 New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more El Building over three stories.
El Demolition ®other: PV Solar where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION , rs; v exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-famil dwellin less to ground,or exceeds 14,000 0 Commercial-use agricultural
y g ❑Commercial/industrial ❑Accessory building
amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB t:SITE INFORMATION AND LopAnI 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 14183 SW Mistletoe Dr 1001IP or more. ❑"A","E","i-z","1-3",
City/State/ZIP: Tigard, Oregon 97223 ElSix or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Ikeda Solar Install 0 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 SCBEDIJLE
Description I Qty. I Each I Total 1
New residential single-or multi-family dwelling unit.
Subdivision: Hillshire Estates Lot#: 111 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: 2S104CC00600/R2041051 Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK' Limited energy,residential
75.00 2
(with above sq.ft.)
Installation of solar panels on existing residential roof. Limited energ
y,multi-family 75.00 2
4.8 kW.Addition of 1 0-30A circuit. residential(with above sq.ft.)
Renewable Energy 0 See Page 2
I PRDPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: Kenneth Ikeda 200 amps or less 100.70 2
Address: 14183 SW Mistletoe Dr 201 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:((503))887-9918 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: finelytreaded@yahoo.corn 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
/ APPLICANTinCONTACT PERSON. Branch circuits-c 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 56.18 56.18
Address: 4801 N University Avebranch circuit
#900 1 2
City/State/ZIP: Provo, UT 84604 Each add'l branch circuit 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.." 5"„.:, 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(1 In min) 78.18/hr
permits@ionsolar.com Inspections for which no fee is
CCB Lie.: 230394 Electrical Lic.: C 1524 Suprv.Lie.: 6098S specifically listed(/2 hr min) 90.00/hr
ELECTRICAL PERMIT FEES;
,1
Suprv.Electrician signature,required: r lj C/ rf Subtotal: 156.88
Print name: David S Conrad Date: 04-27-2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 18.82
Authorized signature: Patitic._Pao/4:4v TOTAL PERMIT FEE: 175.70
This permit application expires if a permit is not obtained within 180
Print name: Dustin Davidson Date: 04-27-2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
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� a ►
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
SthtAT ,; R:K fl v., y, i
Description I Qty. Each 1 Total 1 *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 100.70 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
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>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
specificall listed(V2 hr min) 9J1o.00i hr
..YSrRVI tn`1i ONIart: ;�� ,..N4 .: �:. " .:'°
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): 100.70
(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
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