Permit (13) CITY OF TIGARD MASTER PERMIT
1 COMMUNITY DEVELOPMENT Permit#: MST2023-00412
T I G A R i7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/05/2023
Parcel: 2S104AD01900
Jurisdiction: Tigard
Site address: 12625 SW 128TH AVE
Subdivision: BELLWOOD Lot: 46
Project: Torres
Project Description: Rooftop solar system 4.4 kW, (1)200 amp feeder upgrade.
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: $14,300.00 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: 1 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: V Other Description: Roof top solar array 4.4 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:
MONTOYA,ALICIA BOTTELO LUMIO HX INC Required Items and Reports(Conditions)
TORRES,ROSENDO HERNANDEZ 2500 MOTTMAN RD SW STE 100
12625 SW 128TH AVE TUMWATER,WA 98512
TIGARD,OR 97223
PHONE: PHONE: 360-777-6681
FAX:
Total Fees: $436.67
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 ' 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: Ore Permittee Signature: �` .yJn� it G2 1"/Call 503.639 175 by 7:00 a.m.for the next available inspection date.( �� I t�
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 ApplicationRECEIvED
Residential FOR OFFICE USE ONLY
AUG J 7 7023 Received 7r�
Cityof Tigard ` Pere
Date/By: . l 3 iJ eiT ./3•- co f( -
13125 SW Hall Blvd.,Tigard,OR 97223 - Plan Review (�
_ Phone: 503.718.2439 Fax: 503.598.196u OP(� C ��� Date/By: '17 �ii 1/�j ' Other Permit:
p I D,N(� DIVISION Date Ready/By: Jurist I ® See Page4 for
1'IGARD Inspection www.: 503.639.4175 � l�i ll1`r y y` ��
Internet: www tigard or gov Notified/Method: Supplemental Information
r TYPE OF WORK . ,,, v $; x ' REQUIRED 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
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
' CATEGORY OFgCONSTRIUCTION i ,: work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $143QQ,QQ
❑Accessory building ❑Multi-family Number of bedrooms:
III Master builder I:Other:
Number of bathrooms:
'; JOB SITE INFORMATION AND LOCATTQIV ,:, 4y Total number of floors:
Job site address:12625 Southwest 128th Avenue New dwelling area: square feet
City/State/ZIP:Tigard, Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Solar project-Torres 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.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK r '' work indicated on this application.
4.4kwdc rooftop photovoltaic system and main panel upgrade Valuation: $
Existing building area: square feet
New building area: square feet
iz PROPERTY OW f'❑i `ANT f ' 4", Number of stories:
Name:Rosendo Torres Type of construction:
Address:12625 Southwest 128th Avenue Occupancy groups:
City/State/ZIP:Tigard, Oregon 97223 Existing:
Phone:( 503) 577-5954 Fax:( ) New:
l r,® APPLICANT' 12 CONTACT PEI(SOel x , BUILDING PERMIT FEES* x „�
w_, . a'leu refertofeeschedul r,,,
Business name:LUMIO HX Structural plan review fee(or deposit):
Contact name:Jessica Paxton
FLS plan review fee(if applicable):
Address:1550 W Digital Dr.
Total fees due upon application:
City/State/ZIP:Lehi/UT/84043
Amount received:
Phone:( 360)777-6681 Fax::( )
E-mail:PNW.PERMITTING@LUMIO.COM PHOTOVOLTAICSOLARPA'NELSYSTEMES* .
Commercial and residential prescriptive installation of
y;, CONTRACTOR lot' , ' 41 4 ''' p P
,,,, I ., v ,va„b. „ . . ,s4; b, ,m.0, „ ,. roof-top mounted PhotoVoltaic Solar Panel System.
Business name:LUMIO HX Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1550 W Digital Dr. Solar Installation Specialty Code checklist.
City/State/ZIP:Lehi/UT/84043 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360 )777-6681 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:242553 Total fee due upon application: $201.60
Authorized signature: 7-� This permit application expires if a permit is not obtained
� � f/eW ota, within 180 days after it has been accepted as complete.
Print name: Tearua Downs Date:8/15/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
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r
Electrical Permit ApplicREtr
../EIVED FOR OFFICE USE ONLY
City of Tigard Received Pe
13125 SW Hall Blvd.,Ti ard,OR A 1 7 2023 Date/B : O} �+ I l —
g Plan Review
3 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 CITY OF�tilllitJ p RD Ready Date/By: Juris: Fa See Page 2 for
TIGARD
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE.OF WORK: ,': PLAN.;REVIEW .
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other:
where the available fault current El Marinas and boatyards.
-CATEGORY":0F CONSTRUCTION "` exceeds 10,000 amps at 150 volts or ❑Floating buildings.
dwelling ❑Commercial/industrial® 1-and 2-family ❑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. 0 Installation of 150 KVA or
JOB SITE"INFORMATION,AND'LOCATION ❑Emergencyf yst sem. larger separately derived
Job#: Job site address:12625 Southwest 128th Avenue ❑100'HP or more.motor load of system.
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard, Oregon 97223 0 Health-care facilities. ❑Recreational vehicle parks.
❑Hazardous locations. ❑Supply voltage for more than
Suite/bldg./apt.#: Project name:Solar project-Torres ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: f ,FEE.=SCHEDULE a ;, '
Description I Qty. I Each ] Total
, New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
r r=;DESCRIPTION,OF,WORK Limited energy,residential 75.00 2
(with above sq.ft.)
Main panel upgrade Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
PROPERTY OWNER 0 TENANT-. ".-- Services or feeders installation,alteration,and/or relocation
Name:Rosendo Torres 200 amps or less 1 100.70 2
Address:12625 Southwest 128th Avenue 201 amps to 400 amps 133.5E 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)5775954 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:popo3176@gmail.com 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
�` "
'CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
® APPLICANT
�• A.Fee for branch circuits with
Business name:LUMIO HX above service or feeder fee,
each branch circuit 7.42 2
Contact name:Jessica Paxton B.Fee for branch circuits without
service or feeder fee,first
Address:1550 W Digital Dr. branch circuit 56.18 2
City/State/ZIP:Lehi/UT/84043 Each add'l branch Circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( 360y77-6681 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:PNW.PERMITTING@LUMIO.COM Reconnect only 67.84 2
" F, CONTRACTOR ,- 1` Pump or irrigation circle 67.84 2
Business name:LUMIO HX Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ® See Page 2 2
Address: 1550 W Digital Dr. panel,alteration,or extension.
City/State/ZIP:Lehi/UT/84043 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 360)7776681 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:PNW.PERMITTING@LUMIO.COM ,1 II Mc, /16�►`�S Industrial plant(l hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.:242553 Electrical Lic. CI,/S Suprv.Lic.: 0
1 I(0 S specifically listed(/5 •hr min)`� . . .0 ELECTRIC L'PEWIT FEES .'
Suprv.Electrician signature,required: ,e974,6rfri, Subtotal:
Print name: Bryson Jeffs ate:8/15/2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: � � TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Jessie axton Date:8/15/2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: „ FEE SCHEDULEd.; , .:' ,
Description Qty. 1 Each I Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s 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
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
El 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 I
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Y2 hr min)
COMMERCIALWORK ONLY r
.'ELECTRICAL:PERMIT FEES.,°; ;-
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 PermitAppELR_ERE.doc Rev 06/17/2015