Permit „ ,, CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2011 -00206
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/05/2011
Parcel: 2S103DC00500
Jurisdiction: Tigard
Site address: 13705 SW 110TH AVE
Project: Rogers Subdivision: FAIRHAVEN COURT Lot: 4
Project Description: Installation of solar photovoltaic system.
Contractor: ADVANCED ENERGY SERVICES Owner: ROGERS, MARK W
14755 SE 82ND DRIVE 13705 SW 110TH AVE
CLACKAMAS, OR TIGARD, OR 97223
PHONE. 916- 521 -0533 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: SF Solar Photovoltaic System 09/23/2011 $180.00
Class of Work: ALT 12% State Surcharge - Building 09/23/2011 $21.60
Dwelling Units: 0
Stories: 0 Height: 0 ft
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 $201.60
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 wit
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. A TIO • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -0010 through OA 952- 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1 800 332 2344
•
Issued y: / / • Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available in tion 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. .ti f
Building Permit Application
Residential RECEIVED FoR. OFFICE USE ONLY ,
City of Tigard Date/By. 0 UI // / Permit No l� /- e x,2,0
III - ° 13125 SW Hall Blvd., Tigard, OR 97223 S E P 2 3 201 Plan Review . I� . L G
'
Phone: 503.718.2439 Fax: 503.598.1960 DDate/By. { ` I Other Permit
.
Inspection Line: 503.639.417 Date ReadyBy // Juns la See Page 2 for
T1c t�RU CITY OFTIGARD Notified ��1�� +fr Supplemental Information
Internet: www.tigard-or.gov BUILDING DIVISION & L,u,Jn Tar?(
TYPE OF WORK REQUIRED 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 ❑ Other: equipment, materials, labor, overhea , and the profit for the
CATEGORY OF `CONSTRUCTION
work indicated on this application.
Valuation: $ I
® 1- and 2- family dwelling ❑ Commercial/industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE ,INFORMATION "AND, LOCATI Total number of floors:
Job site address: 13705 SW 110 Ave New dwelling area: square feet
City/State /ZIP: Tigard/OR/97223 fiV Garage /carport area: square feet
Suite/bldg. /apt. no.: . Project name SW '2 V Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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.
Installation of 4.5kW solar electric system located on engineered canopy Valuation: $
attached to home. Existing building area: square feet
New building area: square feet
® PROPERTY OWNER • • ❑ TENANT Number of stories:
Name: Type of construction:
Address: 13705 SW 110 Ave Occupancy groups:
City/State /ZIP: Tigard/OR/97223 Existing:
Phone: ( ) Fax: ( ) New:
. ® APPLICANT ❑ CONTACT PERSON - , BUILDING. PERMIT FEES*
Business name: Future City Solar LLC (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: Jordan Weisman
FLS plan review fee (if applicable):
Address: 1631 NE Broadway #320
City/State /ZIP: Portland /OR/97232 Total fees due upon application:
Phone: (503) 407 -6820 Fax:: ( ) Amount received:
E -mail: jordan@futurecitysolar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
-- . - Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System.
Business name: Advanced Energy Services Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 14755 SE 82 Drive Solar Installation Specialty Code checklist.
City/State /ZIP: Clackamas/OR/ Permit Fee (includes plan revi
and administrative fees): $180.00
Phone: (916) 521 -0533 Fax: ( ) State surcharge (12% of permit fee): $21.60
r
CCB lie.: 180882
Total fee due upon application: / $201.60
Authorized signature: L . — This permit application expires if a per ' 's not obtaine
within 180 days after it has been accepted as complete.
Print name: Jordan Weisman Date: 8/24/11 * 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)