Permit Ipil CITY OP TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2023-00262
Date Issued: 09/05/2023
T EGAR.D 13125 SW Hall E lvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103DC01900
Jurisdiction: Tigard
Site address: 13890 SW 114TH AVE
Subdivision: VIEWMOUNT Lot: 7
Project: Clark
Project Description: Rooftop solar system 2.6kW 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: $17,213.00 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!600 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: Rooftop solar array 2.6 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:
CLARK FAMILY TRUST NEIL KELLY CO INC Required Items and Reports(Conditions)
BY CLARK,THEODORE DAVID& 804 N ALBERTA ST
CLARK,PATRICIA GAIL TRS PORTLAND,OR 97217
13890 SW 114TH AVE
TIGARD,OR 97223
PHONE: PHONE: 503-288-7461
FAX:
Total Fees: $380.81
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: regoh law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: i li'J'L ew Permittee Signature:
o- 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.
DocuSign Envelope ID:47789B58-8662-4AC5-A94E-F41 C7511 F684
Building Permit Application
Residential RECEIVED
City of Tigard JUN 0 2 Received /�-
ah 13125 SW Hall Blvd.,Tigard,OR 97223 2023 Date/By:migi),E1, 1
3 Perlv�' 7?� l/�
Plan Review /'3 a oF1a
Phone: 503.718.2439 Fax: 503.598.191� Date/By: / Other Permit
Inspection Line: 503.639.4175 OF TIGARD Date Ready/By: ti 14
j n J`s: ®See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION N � � )1J P • 11�_ Supplemental Information
tIlvl�� 1
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 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 OF CONSTRUCTION work indicated on this application.
® 1-and 2-familY dwelling Valuation: $ 17,213
❑Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
AJob site address: 13890 SW 114th Ave New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Ted Clark 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 work indicated on this application.
Install a 2.6 kW roof-mounted solar system Valuation: $
with battery backup Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Ted Clark Type of construction:
Address: 13890 SW 114th Ave Occupancy groups:
City/State/ZIP: Tigard, OR 97223 Existing:
Phone:( ) 503 799-1773 Fax:( )
New:
0 APPLICANT
0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: Neil Kelly Company (Please refer m fee schedule)
Structural plan review fee(or deposit):
Contact name: John Wilson
Address: 804 N Alberta St. FLS plan review fee(if applicable):
City/State/ZIP: Portland/OR/97217 Total fees due upon application:
Phone:( ) 720-227-2780 Fax::( ) Amount received:
E-mail: JOhn.WIISOnClNeIIKeIIy.COm PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: Neil Kelly Company Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 804 N Alberta ST Solar Installation Specialty Code checklist.
City/State/ZIP: Portland /OR/97217 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) 720-227-2780 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.: 1663
Total fee due upon application: $201.60
Authorized signature: """
g Tt4L... This permit days after
expires if a permit is not obtained
within 180 days after it has been accepted as complete.
FSETYSEBEDlB,<5...
Print name: John I son Date: 6/2/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
rpoc iSigri Envelope ID:47789B58-8662-4AC5-A94E-F 1C7 11 6
Electrical Permit Application H EIVE I run,orl:I( I: 1,sl:()NIA
City of Tigard ReceivedB pe T` 372, 00
;� 0 13125 SW Hall Blvd.,Tigard,OR 97223 ,D Dan/By: �O
JUN U 1 2fl2� Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#:
Inspection Line: 503.639.4175 Ready Date By: Suns: ®See Page 2 for
I 1 1"\I I) Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method:
BUILDING DIVISIO Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction IE Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition ❑Other: ElService or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
X❑ 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other:
❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: 22-71-7213 Job site address:13890 SW 114th Ave ❑Addition of new motor load of system.
100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP: Tigard, OR 97223 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Ted Clark 0 Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total 1 *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Install a 2.6 kW roof-mounted solar system (with above sq.ft.) 75.00 2
Limited energy,multi-family
with battery backup residential(with above sq.ft.) 75.00 2
Renewable Energy See Page 2
0 TENANT
] PROPERTY OWNERServices or feeders installation,alteration,and/or relocation
Name: Ted Clark 200 amps or less 100.70 2
Address: 13890 SW 114th Ave 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Tigard, OR 97223 601 amps to 1,000 amps 301.04 2
Phone:( ) 503-860-4209 Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
theoddclark@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
Branch circuits—new,alteration,or extension,per panel
® APPLICANT El CONTACT PERSON
A.Fee for branch circuits with
Business name: Neil Kelly Company above service or feeder fee, 7.42 2
each branch circuit
Contact name: John Wilson B.Fee for branch circuits without
Address: 804 N Alberta St service or feeder fee,first X 56.18 2
branch circuit
City/State/ZIP: Portland, OR, 97217 Eachadd'lbranchcircuit 7.42 2
720 227 2780 Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular
Email: John.wilson@neilkelly.com
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Neil Kelly Company Sign or outline lighting 67.84 2
804 N Alberta St Signal circuit(s)or limited-energy
Address: panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP: Portland, OR, 97217
Additional inspection(1 hr min) 66.25/hr
Phone:( ) 720-227-2780 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: John.wilson@neilkelly.com Industrial plant(1 hr mm ) 78.18/tlr
Inspections for which no fee is 90.00/hr
CCB Lic.: 1663 Electrical Lic.: C984 Suprv.Lic.: 5126S specifically listed(%hr min)
Suprv.Electrician signature,required. .°7, :'
ELECTRICAL PERMIT FEES
[�HC Subtotal:
Print name: Rick Methvin Ex- Date: b/1/1013 0 Plan Review Required(25%of permit fee):
000 ..sr.
State surcharge(12%of permit fee):
Authorized signature: C' TOTAL PERMIT FEE:
F5E725Ew008445... 6/2/202 3 T permit application expires if a permit is not obtained within 180
Print name: John Wilson Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
DocuSO Envelope ID:47789B58-8662-4AC5-A94E-F41C7511F6B4
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Description Qry. Each I Total
Renewable 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 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 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
O Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
O Instrumentation
❑ Intercom and Paging Systems
O Landscape Irrigation Control*
O 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
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
DocuSign Envelope ID:47789B58-8662-4AC5-A94E-F41 C7511 F6B4 RECEIVED
l ICI U Z 2023
City of Tigard CITY OF TIGARD
14 Building Division BUILDING DIVISION
= 13125 SW Hall Blvd,Tigard,OR 97223
Phone: 503.718.2439 Fax:503.598.1960
TIGARD 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: 13890 SW 114th Ave
City: Tigard, Zip: 97224
Owner's Name: Ted Clark Date: 6/2/23
Contractor's Name: Neil Kelly Comapny CCB #: 1663
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? x❑ No OSSC or ORSC for
design requirements.
Is the wind exposure Is If"Yes", qualifies for
Wind Exposure "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
I:Building/Forms/PhotoVoltaic-Checklist02-01-11.docx
DocuSign Envelope ID:47789B58-8662-4AC5-A94E-F41C7511F6B4
Is the construction
material wood and does ❑x Yes
Type of If"Yes",qualifies for
the construction qualify
Construction as"conventional light No the prescriptive path.
frame"construction?
Is the spacing 24 inches
or less?
Pre-engineered trusses. 0 Yes If"Yes", qualifies for
the prescriptive path.
❑ No
Roof framing
members Is the spacing 24 inches
or less?
If"Yes", qualifies for
Nominal lumber. ❑x 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
III
layout in accordance Yes If"Yes",qualifies for
with Section 305.4(3) of
the 2010 Oregon Solar ❑ No the prescriptive path.
Code?
❑ Metal
Single layer If roofing material is
Roofing Check the type of El 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 x❑ Yes
Connections of solar assembly If"Yes", qualifies for
the solar assembly connected to roof ❑ No
to the roof framing or blocking the prescriptive path.
directly?
2
1:/Building/Forms/PhotoVoltaic-Checklist02-01-11.docx
DocuSrgn Envelope ID:47789B58-8662-4AC5-A94E-F41C7511F6B4
❑ Yes If"Yes", qualifies for
Is the gauge 26 or less?
❑ No the prescriptive path.
115 lbs for 60 inch
spacing or less?
0 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 Minimum 24 inches If the spacing falls
solar systems Spacing of clamps? within 24 inches and 60
directl to inches inches, qualifies for the
y Maximum 60 inches prescriptive path.
standing seam
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 0 Yes If"Yes", qualifies for
fastener? the prescriptive path.
❑ No
Is the roof decking of
WSP min. Y2"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 ❑x Yes the prescriptive path.
surface. 0 No
3
I:/BuildingfForms/Photovoltaic-Checklist02-01-1 1.docx
DocuSign Envelope ID:47789B58-8662-4AC5-A94E-F41C7511F6B4
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: Q.CeII
Model Number: Q.Peak DuoBLK ML-G10+ 400W
Listing Agency: UL1703
4
I:/Building/Forms/PhotoVoltaic-Checklist02-01-11.docx