Permit CITY OF TIGARD MASTER PERMIT
' 11
_ . ' COMMUNITY DEVELOPMENT Permit#: MST2023-00240
T I C;A IL T? 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/20/2023
Parcel: 1 S 134CC04100
Jurisdiction: Tigard
Site address: 12354 SW WINTER LAKE DR
Subdivision: CAPSTONE Lot: 8
Project: Edwards
Project Description: Rooftop solar PV system 3.69 kW addition to existing system.
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: $5,000.00 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
Fum<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: 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: Y Other Description: Rooftop solar array 3.69 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:
BALTAZAR,KELLY MARY SUNBRIDGE SOLAR LLC Required Items and Reports(Conditions)
EDWARDS,ELIOT WESLEY 421 C ST
12354 SW WINTER LAKE DR WASHOUGAL,WA 98671
TIGARD,OR 97223
PHONE: PHONE: 503-407-6820
FAX:
Total Fees: $324.88
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. ATTENT c I 'regon law require ou to follow the rules adopted by the Oregon Utility tification Center. Those rules are set forth in OAR
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N''Issued By: t��'� /14' Permittee Signature:
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 pro ct.
Approved plans are required on the lob site at the time of each inspection.
Building Permit Application" g '. K '
Residential ' it 7 i
FOR OFFICE USE ONLY
City of Tigard VW' '" ,r, Received 5 31 I 273. A p
Date/By: Permit No.: n 08
14 13125 SW Hall Blvd.,Tigard,OR 97223 �wS 14dZ� w Zq�
e Plan Review �1f/� � A„
Phone: 503.718.2439 Fax: 503.598 1�6 .t DateBy: ,L"1'Ip`� Other Permit:
I I t,A R D Inspection Line: 503.639.4175 i ' ;,r Date Ready/By: Jens: WI See Page 4 for
Internet: www.tigard-or.gov w« 1 L'o' ' ,,.1 TNotified/Me`thodd:: laIIi A �,p I Supplemental Information
TYPE OF WORK REQ D 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:solar equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1-and 2-family dwelling Commercial/industrial
Valuation:4- $5000
❑■ El❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:12354 SW Winter Lake Dr New dwelling area: square feet
City/State/ZIP:Tigard, OR 97222 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Edwards Solar Addition Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: solar square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.
3.69kW rooftop solar pv addition to existing system Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:Eliot Edwards Type of construction:
Address:12354 SW Winter Lake Dr Occupancy groups:
City/State/ZIP:Tigard, OR 97222 Existing:
Phone:(607 )343-6465 Fax:( )
New:
® APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES*
Business name:Sunbridge Solar LLC (Please refer m fee schedule)
Structural plan review fee(or deposit):
Contact name:Haley Polk
Address:421 C St Unit 5A
FLS plan review fee(if applicable):
City/State/ZIP:Washougal,WA 98671 Total fees due upon application:
Phone:860 )313-7190 Fax::( ) Amount received:
E-maii:haley@SUnbrldgeSOlar.COm PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:Sunbridge Solar LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:421 C St Unit 5A Solar Installation Specialty Code checklist.
City/State/ZIP:Washougal, WA 98671 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360 )313-7190 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:189787
Total fee due upon application: $201.60
Authorized signature: /4741/ C7/0DLX 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:Haley Polk Date:4/12/2023
Service Board.
I:\Building\Pennits\BUP-RESPermitApp.doc 01/25/2023 440-4613T(11/02/COM/WEB)
4-1
Electrical Permit Applicatio II
FOR OFFICE USE ONLY
City of Tigard i t 3 1 2023 Received `Date/B : "
II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
II Phone: 503.718.2439 Fax: 503.59819O
-„7 r' Date/B
1.I(i`1 1) Inspection Line: 503.639.4175 ' D Ready Date/By: Jam. iiil See Page 2 for
Internet: www.tigard-or.gov E. L;4,,,;Ci i V ISiON Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
El 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 ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling El Commercial/industrial El Accessory building less to ground,or exceeds 14,000 El Commercial-use agricultural
amps for all other installations. buildings.
El Multi-family ❑Master builder El Other:
❑Fire pump. El Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job site address:12354 SW Winter Lake Dr El Addition of new motor load of system.
100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard, OR 97222 0 Six or more residential units. occupancy.
El Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Edwards Solar System 2 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 I *
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
(with75.00 2
above sq.ft.)
3.69kW rooftop solar addition to existing system Limited en
ergy,multi-family 75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNER El TENANT Renewable Energy See Page 2
Services or feeders installation, ter ion,and/or relocation
NameEliot Edwards 200 amps or less 100.70 2
Address:12354 SW Winter Lake Dr 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard, OR 97222 601 amps to 1,000 amps 301.04 2
Phone:(607)343-6465 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:dredwardsnd@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 ® CONTACT PERSON
A.Fee for branch circuits with
Business name:Sunbridge Solar LLC above service or feeder fee, 742 2
each branch circuit
Contact name:Ha ley Polk B.Fee for branch circuits without
Address:421 C St Unit 5A service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Washougal, WA 98671 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360) 313-7190 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: haley@sunbridgesolar.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sunbridge Solar LLC Sign or outline lighting 67.84 2
421 C St Unit 5A Signal circuit(s)or limited-energy
Address: panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Washougal, WA 98671 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(360)31 3-71 90 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:h a ley@s u n b ridg eso l a r.co m Industrial plant(1 hr min) 78.18/hr
189787 Inspections for which no fee is
CCB Lic.: Electrical Lic.:C 1 1 Suprv.Lic.:3947s specifically listed('/z hr min) 90.00/hr
W.
n ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Dennis Patrick Date:4/12/2023 0 Plan Review Required(25%of permit fee):
�i State surcharge(12%of permit fee):
Authorized signature:71/4 /60�L.11 TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name:Haley Polk Date:4/12/2023 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 SCHEDULE
Description I Qty. I Each I Total I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 1 100.70 2
Check Type of Work Involved:
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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * 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
I:\Building\Permits\ELC_PermitApp_ELRERE.doc Rev 06/17/2015