Permit 14 R' CITY OF TIGARD BUILDING PERMIT
'' COMMUNITY DEVELOPMENT Permit #: BUP2011 -00190
Date Issued: 10/04/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 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
Specifics: Description Date Amount
Type of Use: SF Solar Photovoltaic System 08/30/2011 $180.00
Class of Work: ALT 12% State Surcharge - Building 08/30/2011 $21.60
Dwelling Units: 0 Info Process /Archiving - Sm Sheet (up to 08/30/2011 $6 50
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $0
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement 0
Carport. 0
Covered Porch: 0
Deck: 0
Garage 0
Mezzanine. 0
Total $208.10
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet
Fire Alarm: Protected Corridors
Smoke Detectors: Manual Pull Stations
Accessible Parking 0
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 acc• • -. e 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 ATT ITION Or - =on law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 001 -• 110 through OAR • •2 -0 1 90 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344.
I w
Issued B• • / '. �f i/r ) Permittee Signature: k" 1
�L /I C all // 5503.639.4175 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.
Building Permit Application
-
Residential �,''% \. D OR OFFICE USE ONLY
City of Tigard \' \ •''" � � 11 Received a Permit No.. f
Iii t: • 13125 SW Hall Blvd , Tigard, OR 97223 aW r ® Q Plan Rev Q 'y'` a1 � " r� 'll.--(X)1.
Phone: 503.718.2439 Fax: 503.598.19.1 n` \ Date /By: V Other Permit.
TI G RD , Inspection Line. 503.639.4175 Nv ^ t N: 1 7 ,, M ,Date Ready /By. kris BI See Page 2 for
Internet' www.tigard -or gov . p \ , N ot i fied /Method. 1 3/ it - ✓� Supplemental Information
CS".— :�, -i VN 1 ri t- a . __ .: ' 0
TYPE OF WORK � , : � e � 1 - ! - - P � _ 1 . 7 ' • D DATA: 1- AND'2- FAMILY DWELLING /
❑ 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 El Other: 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: $ 32 Z.5
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder 1=1 Other: Number of bathrooms:
JOB SITE: INFORMATION AND LOCATION Total number of floors:
Job site address: 132(O 5\N v i t o ( l _n.m D New dwelling area square feet
City/State /ZIP: �Ti q • jt y(',t DE. a 22`� Garage /carport area: square feet
Suite/bldg. /apt. no.: J "` Project name: CO ✓W Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:- COMMERCIALLUSECHECKLIST .
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, matenals, labor, overhead, and the profit for the
• DESCRIPTION OF .WORK work indicated on this application.
Roof Mount PV System
Valuation: $
Existing building area: square feet
New building area: square feet
PROPERTY OWNER ,; ❑TENANT• Number of stories:
Name: I v l a l Ck.A D.. C w n0 / Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
' ❑ APPLICANT ANT. , ., ; 1 , . S 'CONTACT PERSON . _. . • BUILDING PERMIT'FEES *' ,,
Business name: SolarCity Corporation (Please refer to fee sctieeu(e�`
Structural plan review fee (or deposit):
Contact name: Caitlin Horsley
Address: 6132 NE 112 Ave FLS plan review fee (if applicable):
City/State /ZIP: Portland Total fees due upon application: (id' /0
Amount received: td
Phone: (503) 9560610 Fax: . (503) 536651
E - mail: chorsley @solarcity.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
- - Commercial and residential prescriptive installation of
CONTRACTOR , - : - roof -top mounted Photovoltaic Solar Panel System.
Business name: SolarCity Corporation Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 6132 NE 112` Ave Solar Installation Specialty Code checklist.
City /State /ZIP: Portland, Oregon 97220 Permit Fee (includes plan revie $180.00
and administrative fees):
Phone: (503) 9560610 Fax: (503) 4366513 State surcharge (12% of permit fee): $21.60
CCB lic.. 180498
Total fee due upon application: $201.60
Authorized signature: — / ) / .- /, This permit application expires if a permit is not obtained
r fAIL within 180 days after it has been accepted as complete.
.Z * Fee methodology set by Tn- County Building Industry
• Print name: Caitlin Ho ey / Date: g� [�, J 1 Service Board
l•\ Building \Permits \BUP- RESPermitApp doe 02/24/2011 440- 4613T(1 1/02 /COM/WEB)