Permit (2) MST' zo22-60i l.Z.
City of Tigard wa 2; 3
e Building Division
C
13125 SW Hall Blvd,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960
T l G A R D Inspection Line: 503.639.4175
www.tigard-or.gov
2010 Oregon Solar Installation Specialty Code
Check List for Prescriptive Installation of Roof-Mounted
PhotoVoltaic Solar Panel System
Property Information
Installation Address: 15930 SW Century Oak Cir
City: Tigard Zip: 97224
Owner's Name: Kristi Modell Date: 04-24-2023
Contractor's Name: ION Developer LLC CCB ##: 230394
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 x❑ 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
❑ Yes the prescriptive path.
above
❑ No
1
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Document Ref:6WGUH-KMC22-FSESD-BGYMM Page 4 of 7
Is the construction
Type of material wood and does El Yes
the construction qualify If"Yes", qualifies for
Construction as "conventional light ❑ No the prescriptive path.
frame"construction?
Is the spacing 24 inches
or less?
Pre-engineered trusses. X❑ Yes If"Yes", qualifies for
the prescriptive path.
❑ No
Roof framing
members Is the spacing 24 inches
or less?
Nominal lumber. If"Yes", qualifies for
❑ Yes the prescriptive path.
❑ No
Is the combined weight X❑ 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.
E of composition
shingle.
Is the roof mounted yes
Connections of solar assembly
the solar assembly connected to roof If"Yes", qualifies for
El N0 the prescriptive path.
to the roof framing or blocking
directly?
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ooument Rif sWWUH xMC22: SESD-BGYMM ;
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❑ 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
❑ Yes the prescriptive path.
❑ No
Attachment of
roof mounted If the spacing falls
solar systems Spacing of clamps? Minimum 24 inches
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 Yes If"Yes", qualifies for
fastener? ❑ the prescriptive path.
❑ No
Is the roof decking of
WSP min. '/2"thickness, ❑ 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 0 Yes the prescriptive path.
surface. ❑ No
I:/Building/Forms/Photovoltaic-Checklist02-01-11.docx 3
Y9ocument Refs 6 GUH-K C FS SD83G''1M:# ,` i
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:
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Signature Certificate
❖:
,•'••: Reference number:6WGUH-KMC22-FSESD-BGYMM 0
:�: Signer Timestam ••••
♦'♦� P Signature ,••,
•♦• Dustin Davidson ;•;•'
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••••, Email:dustin.davidson@ionsolar.com ♦:♦.
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.•i•: Signed: !••:'
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:••••• IP address:136.41.65.14 i is
� . Location:Provo,United States •
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CITY OF TIGARD MASTER PERMIT
. ' COMMUNITY DEVELOPMENT Permit#: MST2023-00192
Date Issued: 05/25/2023
T['GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111CC05100
Jurisdiction: Tigard
Site address: 15930 SW CENTURY OAK CIR
Subdivision: SUMMERFIELD Lot: 74
Project: Modell
Project Description: Rooftop solar PV system 3.2 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: $2,240.00 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: 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 3.2 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:
MODELL,KRISTI ION DEVELOPER LLC Required Items and Reports(Conditions)
15930 SW CENTURY OAK CIR 3214 NORTH UNIVERSITY AVE
TIGARD,OR 97224 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. ATTENTION: Oregon law re ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
o59-nn1-n(1in thrni,nh flAP OR M- n V i may nhtai rnnv of tho rulee nr rlirprt ni iaetinne to(ll INC by Tallinn col 919 1 QA7 nr 1 Ann 119 94d4
Issued By: Pe?mjttee Signature: /fC)5
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.
L
Building Permit Application d A = I— x
Residential FOR OFFICE USE ONLY
MAY2 2023
Cityof Tigard Received n •
/� Q �y /�/)
b DateBy: I L I O L Permit No.:MJT�t/ �,3 O�I�'1 L
13125 SW Hall Blvd.,Tigard,OR 97223 "�+ "F
i ,J I Plan Review �' Other Permit:Phone: 503.718.2439 Fax: 503.598.1 4 1 ,', Date By: IS
i c A�,i) Inspection Line: 503.639.4175 '-''�i-' ° `.1 - t ''l' ' Date Ready/By: Jun.. ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: ((II ,,T Supplemental Information
W
vVf2Q[e4 _ ;Yl>, �. ,two �.. �"
`' TYPE OF WORK 1.
••�_:: REQUIRED DATA:1 AND�RAMIL�°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
❑Addition/alteration/replacement ®Other: PV Solar equipment,materials,labor,overhead,and the profit for the
,; r CATEGORY OF CoNSTRUCTI� ' "
work indicated on this application.
NI-and 2-family dwelling ElCommercial/industrial Valuation: $ 2,240
0 Accessory building ID Multi-familyNumber of bedrooms:
El Master builder ID Other:
Number of bathrooms:
;SOB SITE INFORMA31<i7N AND LOATI(1!N
Total number of floors:
Job site address: 15930 SW Century Oak Cir New dwelling area: square feet
City/State/ZIP: Tigard,Oregon 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Modell Solar Install Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CUE KLIS'T ':
Subdivision: Summerfield Lot no.: 74 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.: 2S111 CC05100/R505153 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: $
3.2 kW.Addition of 1 0-30A circuit. Existing building area: square feet
New building area: square feet
ig] PROPERTY OWNER 0 TENANT.• Number of stories:
Name: Kristi Modell Type of construction:
Address: 15930 SW Century Oak Cir Occupancy groups:
City/State/ZIP: Tigard, Oregon 97224 Existing:
•
Phone:((503))407-0853 Fax:( ) New:
'1 APPLICJ14T ❑ CONTACT PERSON BUILDING:;PERNIIT FEES*
(Please rijer 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:
E-mail: permits@ionsolar.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details Business name: ION Developer LLC
and fire department access,along with the 2010 Oregon
Address: 4801 N University Ave#900 Solar Installation Specialty Code checklist.
City/State/ZIP: Provo, UT 84604 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 888) 781-7074 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB tic.: 230394 Total fee due upon application: $201.60
Authorized signature: .elrr Pa 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: 04-24-2023 Service Board.
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Document Ref:6WGUH-KMC22-FSESD-BGYMM Page 1 of 7
Electrical Permit Application ' ' , 1 ,—
FOR OFFICE USE ONLY
City of Tigard 2023 Received
rr 12 Date/B : Permit#:
• 13125 SW Hall Blvd.,Tigard,OR 972/4'
_ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/B : Related Permit#:
Inspection Line: 503.639.4175 ( -7: ,- Read :
3 I('A R II Internet: www.tigard-or.gov 1 y o turfs: ® See Page 2 for
6 .,o NNotified Method:
Supplemental Information
' ' TYPE:OF WORK , J AN REVIEW - 3.
❑New construction 0 Addition/alteration/replacement "Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ®Other: PV SolarService or feeder 400 amps or moreBuildingover a
0
0 0 three stories.
where the available fault current 0 Marinas and boatyards.
CATEG,QR`OF"CONSTRUCTION.
s ., ;= N exceeds 10,000 amps at 150 volts or 0 Floating buildings.
E 1-and 2-family dwelling 0 Commercial/industrial El Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family ❑Master builderamps for all other installations. buildings.
" 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB.SITE INFORMATION AND*,LOCATION 0 Emergency system. larger separately derived
Job#: I Job site address: 15930 SW Century Oak Cir ❑Addition of new motor load of system.
1001-IP or more. ❑"A",`E","1-2","1-3",
0Six or more residential units. occupancy.
City/State/ZIP: Tigard,Oregon 97224
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: Modell Solar Install 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: 0 Service or feeder 600 amps or more. 600 volts nominal.
FKE;SCHEDULE .
Description I Qty ( Each i Total i *
New residential single-or multi-family dwelling unit.Subdivision: Summerfield Lot#: 74 Includes attached garage.
Tax map/parcel#: 25111 CC05100/R505153 1,000 sq.ft.or less 168.54 4
DESCRfPTJON OF"WORK Ea.add'!500 sq.ft.or portion 33.92 1
N
Limited energy,residential
Installation of solar panels on existing residential roof. (with above sq.ft.) 75.00 2
Limited energy,multi-family
3.2 kW.Addition of 1 0-30A circuit. residential(with above sq.ft.) 75.00 2
21 f RQPTRTY OWN r'
FR,,.; I]"�TENANJ Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: Kristi Modell 200 amps or less 100.70 2
Address: 15930 SW Century Oak Cir 201 amps to 400 amps 133.56 2
City/State/ZIP: Tigard,Oregon 97224 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:((503))407-0853 I Fax:( ) Over 1,000 amps or volts 552.26 2
Email: krls.modell@gmaiLCom Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 25.08 1
P P 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54
2
APPLICANT CONTACT PERSON " ABranchFeefor circuitsbranch—circuit news,alteration,with or extension,per panel
" .
Business name: ION Developer LLC above service or feeder fee,
Contact name: each branch circuit 7.42 2
Dustin Davidson B.Fee for branch circuits without
Address: 4801 N University Ave#900 service or feeder fee,first 1 56.18 56.18 2 branch circuit
City/State/ZIP: Provo, UT 84604 Each add'!branch circuit 7.42 2
Phone:($$$) 781-7074 I Fax: :( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
permits@ionsolar.com
Reconnect only 67.84 2
v, ' CONTRACTOR Pump or in'igation circle
67.84 2
Business name: ION Developer LLC
p Sign or outline lighting 67.84 2
Address: 4801 N University Ave#900 Signal circuit(s)or limited-energy
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 I Fax:( ) Investigation(1 hrmin
g ) 90.00/hr
Email: permits@ionsolar.com Industrial plant(lhrmin) 78.18/hr
CCB Lie.: Inspections for which no fee is
230394 I Electrical Lie.: C1524 I Suprv.Lie.: 6098S specifically listed(%a hr min) 90.00/hr
Suprv.Electrician signature,required: . .., , ELECTRJc u PERMIT' FEES
.,0,.�.44,2,.t.,,......P ... .1
subtotal: 156.88
Print name: David S Conrad Date: 04-24-2023 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 18.82
Authorized signature: att66, � TOTAL PERMIT FEE: 175.70
Print name: Dustin Davidson This permit application expires if a permit is not obtained within 180
Date: 04
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB
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Page 2 of 7
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Fee for all residential systems combined: $75.00 Description I Qtr. (_ Each I Total j *
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 1 100.70 100.70 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
ssecificall listed('%hr min) 90 00/hr
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
1:03161ding\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015
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