Permit tf / /3�� �P,�,w P r � � -/v , We tu,o(e__ - feec,kees o d CI) la2i c) , isi-
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
i ll COMMUNITY DEVELOPMENT Permit #: ELC2011 -00110
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/02/2011
Parcel: 1 S135DB05901
Jurisdiction: Tigard
Site address: 11475 SW 94TH AVE
Project: Middaugh Subdivision: MILLER Lot: 5
Project Description: Solar photovoltaic system. 4/13/11, Reprinted permit to include (2) feeders and (1) branch circuit.
Contractor: SOLARCITY CORPORATION Owner: MIDDAUGH, CHRISTOPHER L &
6132 NE 112TH AVE MIDDAUGH, PAULA R
PORTLAND, OR 97220 11475 SW 94TH AVE
TIGARD, OR 97223
PHONE: 503 -964 -0489 PHONE:
FAX: 503 - 926 -9101
FEES
Description Date Amount
Specifics: Services or Feeders - 200 amps or less 03/02/2011 $100.70
Branch Circuits w /Purchase Service or 03/02/2011 $7.42
Feeder
Type of Use: SF 12% State Surcharge - Electrical 03/02/2011 $12.97
Class of Work: ALT Services or Feeders - 200 amps or less 04/13/2011 $201.40
Total Number of Systems: Branch Circuits w /Purchase Service or 04/13/2011 $7.42
Feeder
12% State Surcharge - Electrical 04/13/2011 $25.06
Audio & Stereo: N
Security Alarm: N
Garage Door Opener: N
HVAC: N
Vacuum System: N
Other: N
Other Desc: Total $354.97
Required Items and Reports (Conditions)
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 requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 01 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 501232.1987 or 1.800.332
Issued B • ._ _ Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
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.
CITY OF TIGARD ELECTRICAL PERMIT
11 1 2 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00110
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/02/2011
Parcel: 1S135DB05901
Jurisdiction: Tigard
Site address: 11475 SW 94TH AVE
Project: Middaugh Subdivision: MILLER Lot: 5
Project Description: Solar photovoltaic system.
Contractor: SOLARCITY CORPORATION Owner: MIDDAUGH, CHRISTOPHER L &
6132 NE 112TH AVE MIDDAUGH, PAULA R
PORTLAND, OR 97220 11475 SW 94TH AVE
TIGARD, OR 97223
PHONE: 503 - 964 -0489 PHONE:
FAX: 503 - 926 -9101
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 03/02/2011 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 03/02/2011 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 03/02/2011 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
Required Items and Reports (Conditions)
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 requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through • ' - 001 -0090. You may obtain a co•y of th - _ - • direct questions to OUNC by calling i i..1987 or 1.800.332.2344.
Issued Permittee Signature: --- _ �.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
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.
r
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard 1 11 Received
Date/B : 1I u 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review /L, Phone: 503.718.2439 Fax: 503.598.1960 0Ce % Date/By: Ocher Permit`
1 1 i A 1 , 1 ) Inspection Line: 503.639.4175 1 �- Date Ready/By: J�; �� j / ® See Page 2 for
Internet: www.tigard- or.gov 1 �� ethal: / Supplemental Information
TYPE OF WORK � ����, �1 I PLAN REVIEW
❑ New construction dition/alteration/replaccreek `� � Please check all that apply (submit a sets of plans w /items checked below):
\ ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current Cl Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
g*I
Multi- family 0 Master builder 0 Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: J ob site address: ,(� occupancy.
9 ��3Y ( I / / `) , 1 U� 100HP or more.
CI or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: P NA OK 7 � "�23 ❑ Health - care facilities. ❑ Supply voltage for more than
['Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: ( Project name: / wA r v�..t--l. ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: "`�' DescDescription I V I Pee.
I Teti I .
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
75.00
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family 75.00 2
/^ 2 r .. _ �� , A residential (with above sq. ft.)
/ / �� TT .--- Services or feeders installation, alteration, and/or relnratims
,,D3 _ _ 5 / ga ge I -- 42Q-.25//-- !O /) 0 Li 1 amps or less 7 100.70 )l e 2
❑ PROPERTY OW R ❑ TENANT F 1 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/ State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new alteration or extension 1 r ■ anel
Owner signature: Date: A. Fee for branch circuits with 7 ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, / . 7.42 /� 7
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City/State /ZIP: dwelling, service and/or feeder
Phone: ( ) Fax: : ( )
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited -energy
/� panel, alteration, or extension. Page 2 2
Business name:
�'���'�' L9R'9 • Each additional inspection over allowable in any of the abov
Address: //4/y5 6(A) �j "W ,4vj Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City / State/ZIP: O � / ) / �' , Industrial plant (1 hr min) 78.18/ hr
Phone: 5 )9zy _ / 7 Fax: ( ) Inspections listed w which n min) is 90 00/ hr
f l (
CCB Lic.: / 3OCIgr C ir Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES r
Suprv. Electrician signature, required: "
C -�`.�/ Su
Plan review (25% of permit ) $`e�
permit fee):
Print name: �J 1S0 Date: / , q State surcharge (12% of permit fee): x5,
7 TOTAL PERMIT FEE: 9
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: �� 7.71./`-c Date: 4 t .0/ *
days Li it has d per permit.
been accepted as complete.
' Y " � h� � j � � Number of inspections a llowed
I:\ Building \Permits\ELC - PermitApp.doc 07/01/10 15T(11/05 /COM/WEB
ec 'caI
E1 tri Permit Apphcat L
CEIVED
Received 1 ✓ 0D , �
Ci}� of Tigard DateiBy: q Permit No.:
`3 � O � / q / i ,
1/1 11
13125 SW Hall Blvd., Tigard, OR 972? D 9 Plan Review j /
969 ,- ' r I - ! / (l�� �/ Other Permit:
Phone: 503.6 39.4171 Fax: 503.598.1 D J
Inspection Line: 503.639.4175 Date Ready /By: ���� mrir ® See Page 2 for
1 Internet: www.tigard - or.gov CITY OF TIGARD Notified Method: J ( /1 7T -7 , Supplemental Information
2rr ►► G DIVISION �� "
, , ' � .. i 2:4, ❑ New construction [ TYPE: I9F' � !:i � - s � t,✓ wk.-Cr ti � � - a, Addition /alteration /replacement Please check all that apply (submit _ sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY Or CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural •
[[[ I- and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building amps t'or all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFOIFATIC3N 1Nll LOCATION ❑ Emergency system. larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ' l -2 ". "1 -3 ".
Job n0.. 602,341 Job site address: 1 ` (] f� R I OOHP or more. occupancy.
`� ✓ i 1 `� 41 �' `r q 1 �Vt 0 Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: P O YA !'1 Q y.. i ', 22 3 ❑ Health -care facilities. ❑ Supply voltage for more than
44ee t ! ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE. SCHEDULE
Cross street /directions to job site: Description I ptv. I Fee. I Total I *
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. tt. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF V. ORft (with above sq. ft.)
/ Limited energy, multi - family 75.00 2
6 .q 8 kW R.oO`(' �NumnA S 9 stun CP y `/ residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 1 100.70 100 .10 2
❑ PROPER TY OVi J ❑ TEN ANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits – new, alteration, or ex tension, . er panel
Owner signature: Date: A. Fee for branch circuits with
❑ above service of feeder fee,
each branch circuit 2 2
AMA_ ' ❑ CONTACT tom€ PERSON 7.42
Business name:
B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name:
branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
• City /$tate/Z1P: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 •
CONTRACTOR Signal circuit(s) or limited- energy
Business name: `� ^o' `R( /� ' t v n�, - Lt70A/ panel, alteration, or extension. Page 2 2
� �- 777 Each additional inspection over allowable in any of the above
Address: 6 r /.� fJffFF � I�l�l ( C Additional inspection (1 hr min) 66.25/ hr
!O - ? ?- 0 Investigation (1 hr mm) 6625/ hr
City /State/ZiP: /V _
_ Industrial plant (1 hr min) 78.18 / hr
Phone: S�3 -95(o ' �Q J o Fax: ( 503 5 2 � , f . 7 2 Inspections for which no fee is 90.00 / hr
specifically listed (1 hr inin) -
CCB Lic.: /a0y/fr Electrical Lic.: �( Supry. Lic.: ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Cits„,,,Vep Subtotal: I W+'� la- (1—
Plan review (25% of permit fee):
Print name: =7, (gnpr i 1 Date: State surcharge (12% 7
cccc1111GG�� viii( G
TOTAL PERMIT FEE: / • 07
Authorized signature: I
This permit application expires if a permit is not rained tvithin 180
�� w days after it has been accepted as complete.
�
Print name: C l U '�.t t p� Date: 2 1ZL� I' • Number of inspections allowed per permit.
I: Building Permits ELC- PennitApp.doc 07 01 10 440-4615T(11 05 COM WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:' Building \Permits\ELC- PermitApp.doc 07/01/10