Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 ' 1 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00488
13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 10/04/2011
TIGARD Parcel: 2S102CA00923
Jurisdiction: Tigard
Site address: 13200 SW VILLAGE GLENN DR
Project: COSA Subdivision: VILLAGE GLENN Lot: 23
Project Description: Solar photovoltaic system
Contractor: SOLARCITY CORPORATION Owner: MATIA, LUCIAN & SIMONA
6132 NE 112TH AVE COSA, TEODOR & MARIANA
PORTLAND, OR 97220 8150 SW 80TH AVE
PORTLAND, OR 97223
PHONE• 503 - 964 -0489 PHONE.
FAX 503 - 926 -9101
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 10/04/2011 $201 40
Specifics: amps or less
1 crt Branch Circuits w /Purchase 10/04/2011 $7 42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 10/04/2011 $25 06
Electrical
Type of Const:
Occupancy Grp:
Total $233 88
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 ord 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 AT ENTION Oreg law re res you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 -001- 010 through OAR 9 -00 090 Y / a n y obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2
Issued Yom/ "`w/ ..? Permittee Signature: k a
I
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
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SIGNATURE OF SUPR. ELEC' ``' Ay • I. / tti' /( i Date:
I ME MI P
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.
Electrical Permit Application FOR oF,flcH USE ONLY
City Tigard Tl d ' Received
g u + Date /B . 1 i� Permit No • % - "9�( �+ or
N • C 13125 SW Hall Blvd , Tigard, OR 977 n Plan Review F
Phone. 503.718.2439 Fax. 503' 9�t196 Date/By. Other Permit.
Tvi .41: D Inspection Line- 503.639.4175 � l[y - 1/4� - + Date Ready /By. c. c ® ur See Page 2 for
Internet: www.tigard - or.gov ® '1011 \ , Notified/Method / // / J Supplemental Information
° TYPE OF'WORK / LAN R
9r ^ " S .5l ct. e..e check all apply (submit 2 sets of plans w /items checked below
❑ New construction ® Addition /alteratio. /,repla'cement I C 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: .-It y ( p below)
�1 t O a `N l a w� J ' / Pl hk ll th
❑ ervice or feeder 400 e!\ n�� where the available fault current ❑ Marinas and boatyards
C 11 ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
CATEGORY :OF CONSTRUCTIO - '
: P g
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ installation of 75 KVA or
JO SITE INFORMATION AND LOCATION ❑Emergency system larger separately derived system • • , - - . . ,' ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: (� l Job site address: 2 n Ion 1 OOHP or more. occupancy
�� ✓ 38 f I '120 L. �,l `e ► 0 or more residential amts ❑ Recreational vehicle parks
City/State /ZIP: lic d 1 / v q 122 ❑ Health -care facilities ❑ Supply voltage for more than
V ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: I Project name: C ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCH . ' • ,
J Description I Qty. I Fee. I Total
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'I 500 sq ft or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
-
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
Roof Mount PV System residential (with above sq ft )
Services or feeders installation, alteration, and/or relocation
200 amps or less 2. 100 70 Ay. Ito 2
El 'PROP - OWNER . • • • ❑ TENANT. , ` 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200 34 2
Name: \f] vj an a) 0
Wr 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
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
.. ❑ APPLICANT' • I - • ' ® CONTACT PERSON_ above service or feeder fee l 7.42
each branch circuit / • ` 2
Business name: SolarCity Corporation B. Fee for branch circuits without
service or feeder fee, first 56 18 2
Contact name: Caitlin Horsley branch circuit
Each add'I branch circuit 7.42 2
Address: 6132 NE 112 Ave Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State /ZIP: Portland, Oregon 97220 dwelling, service and/or feeder 67.84 2
Phone: (503) 9560610 Fax: : (503) 5366513 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: chorsley @solarcity.com Sign or outline lighting 67.84 2
- • C ONTRACTOR • ' . _ ' -
. . Signal circuit(s) or limited- energy
Business name: SolarCity Corporation panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 6132 Ne 112 Ave Additional inspection (I hr min) 66.25/ hr .
City/State /ZIP: Portland, OR 97220 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 9560616 Fax: (503) 3566513 inspections for which no fee is 90 00/ hr
specifically listed ('/r hr mm)
CCB Lic.: 180498 Electrical Lic.: C562 Suprv. Lic.: 5201S ELECTRICAL PERMIT FEES
) Subtotal dog • S�
Sup'. Electrician signature, required' < e ��C Plan review (25 % of permit fee):
—
Print name: Derek Cropp _ I / Date:�2?�. // I State surcharge (12% of permit fee): p1'j . �P
Authorized signature:
� � `� ` TOTAL PERMIT FEE. . 3.??
AM W
�!I/ r This permit application expires if a permit is not obtained within 180
I days after it has been accepted as complete.
Print name: Caitlin Horsley Date: � � (/ * Number of inspections allowed per permit.
' ng \Permits \ELC- PermnApp doc 07/01/10 440- 4615T(t I /05 /COM /WEB