Permit (13) CITY OF TIGARD MASTER PERMIT
IIII2:. COMMUNITY DEVELOPMENT Permit#: MST2023-00584
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/16/2023
Parcel: 2S109AD02600
Jurisdiction: Tigard
Site address: 14658 SW 130TH AVE
Subdivision: WOODFORD ESTATES Lot: 18
Project: Zibolski
Project Description: Rooftop solar PV system. 7.56 kW with(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: $5,292.00 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 Bckltw 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'I 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
Other: Y Other Description: Rooftop solar array 7.56 kW N
Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 0
Owner: Contractor:
ZIBOLSKI,CHANCE ION DEVELOPER LLC Required Items and Reports(Conditions)
STONER,MIKAELA 3214 NORTH UNIVERSITY AVE
14658 SW 130TH AVE 503
TIGARD,OR 97224 PROVO,UT 84604
PHONE: PHONE: 888-781-7074
FAX:
Total Fees: $422.42
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. ATTEN ION: Oregon law requires to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: Permittee Signature: �� .ee-re 1 ' � � �'�7
all 503.639.4175 b :00 a.m.for the next available inspection date.
This permit card shall be kept in 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
Residential RECEIVE a 1,1)R OFFICE USE ONLY'
Received
' City of Tigard DateB : 1� • j, Permit No.: T%B���T`&�,I�
111 131 SW Hall Blvd.,Tigard,OR 97223 o Plan Review r rr 1f
3 Phone: 503.718.2439 Fax: 503.598.1960 NOV +t 2023 Date/B : t1 MAMMA
I Other Permit:
1 1 C ^h 1) Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Ii 3 r OM Supplemental Information
BUILDING D VISION tip R„,,..> t
I
TYPE OFWORK 2v RE.= ? 5ATA:1-AND 2, W E,LLI Gx ,.. ', s. ... . ; r; , i .v:, <r ; ,,. - .
❑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
'`' .
�A'I'EGOR *5QF CQPI `i'iiCJC'TIQ ' work indicated on this application.
"
El1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 5,292
ElAccessory building El Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 14658 SW 130TH Ave New dwelling area: square feet
City/State/ZIP: Tigard, Oregon 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Zibolski Solar Install Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
QU-.P7DATA C4 .._R ",UJSE"C KLIS
Subdivision: Woodford Estates Lot no.: 18 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
2S109AD02600/R2022156 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WO ' " work indicated on this application.
Installation of solar panels on existing re
sidential roof. Valuation: $
7.56 kW.Addition of 2 circuits. Existing building area: square feet
New building area: square feet
1, ; FROPERTY OWNERf" ,,," 0 TENANT Number of stories:
Name: Chance Zibolski Type of construction:
Address: 14658 SW 130TH Ave Occupancy groups:
City/State/ZIP: Tigard,Oregon 97224 Existing:
Phone:((503))449-7041 Fax:( ) New:
'i PLICAN
.r"; " ❑ CONTACT X' 1Ct
... v. SON �� • BUILDt PERMItFEES* "t
''' i (Please`re}er le fee schedule) .',"„;
Business name: ION Developer LLC - '
Structural plan review fee(or deposit):
Contact name: Dustin Davidson
FLS plan review fee(if applicable):
Address: 44 East 800 North
Total fees due upon application:
City/State/ZIP: Orem, Utah, 84057
Phone:( 888) 781-7074 Fax: ( ) Amount received:
PD TVOLTA"I OLAR P NEL SYSTEM FEES*
E-mail: permits@ionsolar.com ,a.:" f z-"
rwbn
CO1TtACTO1 ,' Commercial and residential prescriptive installation of
., ., ' 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:44 East 800 North Solar Installation Specialty Code checklist.
City/State/ZIP: Orem, Utah, 84057 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 888) 781-7074 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 230394 Total fee due upon application: $201.60
Authorized signature: 'la This permit application expires if a permit is not obtained
.J within 180 days after it has been accepted as complete.
Print name: Dustin Davidson Date: 11-07-2023 *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)
Document Ref:L9KFP-DOR5X-2ETVB-RYJNF Page 1 of 7
RECEIVED
Electrical Permit Application FOR OFFICE USE ONLY City of Tigard NOV 9 2023 Date Received O�/�v S1"
Q B Permit#:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.6151Y OF TIGARD Date/B : Related Permit#:
1 I(,n Il )
Inspection Line: 503.639.4175 BUILDING DIVISION Read Date/BY.
Jnris: El See Page 2 for
l Internet: www.tigard-or.gov Noti led/Method: Supplemental Information
„ , TYPE OF WORK., i1 - „4 , k„
�� PLAN ,,�'IE
❑New construction 0 Addition/alteration/replacement 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.
❑Demolition ®Other: PV Solar
v,,. �,,. "„ where the available faultcunent Marinasand boatyards.
wx , CA/IE ORY OR CONSTRUCTIOft(. '' :iffF exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-familydwellingCommercial/industrialless to ground,or exceeds 14,000 0 Commercial-use agricultural
0 0 Accessory building
amps for all other installations. buildings.
0 Multi-family 0 Master builder ❑Other: ❑Fire
�r, pump. El Installation of 150 KVA or
�`r 1 „ , .,JOB : TE INFoRMA1rloN AND,LO IL'IONx ,, ❑Emergency system. larger separately derived
Addition of new motor load of system.
14658 SW 130TH Ave ❑
Job#: Job site address: 100HP or more. ❑"A","E","1-2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP: Tigard,Oregon 97224 ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Zibolski Solar Install 0 Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 1 EltSCHEDULE
Description I Qty. I Each I Total I * ;
New residential single-or multi-family dwelling unit.
Subdivision: Woodford Estates Lot#: 18 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:2S109AD02600/R2022156
Ea.add'l 500 sq.ft.or portion 33.92 1
,t,;:DERCRIPTI ST OIL=WORT{ „" Limited
< . ... energy,residential
Installation of solar panels on existing residential roof. (with above sq.ft.) 75.00 2
Limited energy,multi-family
7.56 kW.Addition of 2 circuits. residential(with above sq.ft.) 75.00 2
TEhiiT Renewable Energy 0 See Page 2
� R01; 33 0 Services or feeders installation,alteration,and/or relocation
Name: Chance Zibolski 200 amps or less 100.70 2
Address: 14658 SW 130TH Ave 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Tigard,Oregon 97224 601 amps to 1,000 amps 301.04 2
Phone:((503))449-7041 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: chance.zibolski@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
t2/ API' 4r.AN1' Branch circuits—new,alteration,or extension,per panel
" IZ „ 1 `; 0 CONTACT PERSON; 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
Address: 44 East 800 North service or feeder fee,first 1 56.18 56.18 2
branch circuit
City/State/ZIP: Orem, Utah, 84057 Each add'l branch circuit 1 7.42 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
,,i1,„, . .:i; " vCOl FRAO1 R ,.x ,," i. , 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: 44 East 800 North panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above City/State/ZIP: Orem, Utah, 84057
Additional inspection(1 hr min) 66.25/hr
Phone:(888) 781-7074 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
permits@ionsolar.com Inspections for which no fee is
CCB Lie.: 230394 Electrical Lie.: Suprv.Lie.: specifically listed(A hr min) 90.00/hr
C1524 p 6098S EL1✓ c�
.N.X'7.1 C .-..,ER13IT
Suprv.Electrician signature,required:_tiadaio �r /7 Subtotal: 197.16 Q
Print name: David S Conrad -� a�GDate: 11-07-2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 23.66
Authorized signature: .PisaOcalir,. TOTAL PERMIT FEE: 220,82
This permit application expires if a permit is not obtained within 180
Print name: Dustin Davidson Date: 11-07-2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELCPennitAppELR_ERE.doe Rev 06/17/2015 440-4615T(l l/05/COM/WEB
Document Ret:L9KFP-DOR5X=2ETVB-RYJNF Page 2 of 7
• •
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
$ .s- Each .. TO
I al Description t
Fee for all residential systems combined: 75.00 Renewable electrical energysystems:
Q E stems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 1 133.56 133.56 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
❑ 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
charged at an hourly(1 hr min)
[ Inspections for which no fee is
s eciftcally listed(A hr min)
0 00/hr
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): 133.56Number 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 PermitApp ELR_ERE.doc Rev 06/17/2015
Qocurrta ti Ref:y1P b0R5) . ETVB-RYJNF
., , KF ,.. �.. ;fage;3:0f 7
MS1'�ti3 bo5ss21
•
RECEIVED
City of Tigard Nov 9 2023
Building Division CITY OF TIGARD
• . 13125 SW Hall Blvd,Tigard,OR 97223 BUILDING DIVISION
Phone: 503.718.2439 Fax: 503.598.1960
T I GA 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: 14658 SW 130TH Ave
City: Tigard Zip: 97224
Owner's Name: Chance Zibolski Date: 11-07-2023
Contractor's Name: ION Developer LLC CCB #: 230394
Design Parameters of the Property/Structure
If"Yes", does not
Is the installation Yes qualify for the
Flood Hazard Located in a flood prescriptive path, follow
Area plain/flood way? X❑ 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?
If"Yes", qualifies for
structures other than
❑ Yes the prescriptive path.
above
❑ No
1
I:/Building/Forms/PhotoV oltaic-Checklist02-01-11.docx
Document Ref L9KFP-DOR5X-2ETVB-RYJNF Page 4 of.7;
Is the construction
material wood and does 0 Yes
Type of If"Yes",
Yes , qualifies for
Construction the construction qualify ❑ No the prescriptive path.
as "conventional light
frame" construction?
Is the spacing 24 inches
or less?
Pre-engineered trusses. ❑ 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. n Yes the prescriptive path.
x❑ 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 El Yes
If
with Section 305.4(3)of "Yes", qualifies for
No the prescriptive path.
the 2010 Oregon Solar
Code?
n 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 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
I:/Building/Forms/PhotoV oltaic-Checklist02-01-11.docx
'Doc urn ef.L9KFP-DOR5 =2ETVB-RYJNF 4 0 7
❑ 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 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 Width panels 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 If"Yes", qualifies for
fastener? ❑ Yes the prescriptive path.
❑ No
Is the roof decking of
WSP min. 1/2"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
3
I:/Bui lding/Form s/PhotoV oltaic-Checklist02-01-11.d ocx
D c uiient Ref:L91K0 3. X-2ETV RY 1NF page 6 of 7 ,;.
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-420 HC+
Listing Agency:
4
I:/Building/Forms/PhotoVoltaic-Checklist02-01-11.docx
Document Ref:L9KFP-DOR&X-2ETVB-RYJNF ,Page 7 of 7
Signature Certificate
4.4
:O•:• Reference number:L9KFP-DOR5X-2ETVB-RYJNF •••:::.
.•••
0.110,
:*••`•' 'i•i i
�•�•�. Signer Timestamp Signature �••�.�;
Dustin Davidson �_..__.
:: Email:dustin.davidson@ionsolar.com ;.�•�;;
%i.•••, ss4 r... ' ,•❖.
; Sent: 07 Nov 2023 19:55:58 UTC ;•�•;
:4 Si• gned: 07 Nov 2023 19:55:59 UTC — ._____._.._._ I y•••.
i•iV
•`i IP address:8.33.47.146 .•••;
.•'; Location:Midvale,United States ;•�•;•
�•..� Document completed by all parties on: *':•`':,.. 07 Nov 2023 19:55:59 UTC •;;�
0'4' ,•O•.
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