Permit n CITY OF TIGARD MASTER PERMIT
''7 11 COMMU DEVELOPMENT Permi #: MST2012 -00202
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/19/2012
Parcel: 2S109DD10200
Jurisdiction: Tigard
Site address: 12682 SW REMBRANDT LN
Subdivision: BELLA VISTA Lot: 32
Project: Perry '
Project Description: Photovoltaic Solar Panel 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: $6,000.00 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 Storm Sewer: 0
Drains: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 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
Furn <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: 1 0 -200 amp: 0 W/ Svc or Fdr: 1
Ea add" 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
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R -3 0
Owner: Contractor:
PERRY, DALENE M SOLARCITY CORPORATION Required Items and Reports (Conditions)
12682 SW REMBRANDT LN 6132 NE 112TH AVE
TIGARD, OR 97224 PORTLAND, OR 97220
PHONE: 503- 620 -5148 PHONE: 503 - 964 -0489
FAX: 503 - 926 -9101
Total Fees: $332.19
This ermit 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
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 ility — No1'n enter. Those rules are set forth in OAR
952- 001 -0010 through OA • . r . -0090. You may obtain a copy of the rules or direct questions to a NC by call •• � • 987 or 1.800.332.2344.
sued By: _ _ / . Pe rmittee Sig :lure: L �':��
Call 503.639.4175 by 7:00 a.m. for the next available ins . _ • • • . e.
/
This permit card shall be kept in a conspicuous place on the job site until compl: • of the project.
Approved plans are required on the job site at the time of each inspection.
, .
Building Permit Application
R CE
Residential ? ' H 01 20i
City of Tigard (,]'('Y O TIO
13125 SW Hall Blvd., T' n t,! t ! te a - Permit Nog p
1111 rgard, OR 97223 � 1tt ttttrr '! ®t)1 Y 1S' f . - it ►Y/ �.
Phone: 503.718.2439 Fax: 503.598.1960 Dui D :: i ...ti ►�_. EG' • Permit:
I nspection Line: 503.639.4175 hate Rn ® p 2 for
rig,, ;1..n dy:•.
Internet: www.tigard- or.gov N. � &Me �� ' Supplement
br ,
• TYPE OF WORK . ' t UIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
® Addition/alteration/replacement ❑ Other: - Indicate the value (rounded to the nearest dollar) of all
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: $ G O. CO
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION
L CATI ON Total number of floors:
lob site address: 12 682 5 W i fYlb -a - 1+ ylp New dwelling area: square feet
City/State/ZIP: Ti prf) i R T722/4 Garage/carport area: square feet
Suite/bldg. /apt. no.: Pro p ject name: r. r y 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: 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. .
Roof Mount PV System Valuation: S
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Oct iPtl1P pp, r. t Type of construction:
Address: / Occupancy groups:
City/State/ZIP: Existing:
Phone: (503) (.9O- S I L AS Fax: ( ) New:
❑ APPLICANT
® CONTACT PERSON - BUILDING PERMIT FEES*
Business name: SolarCity Corporation �
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:
Phone: (503) 9560610 I Fax: : (503) 5366513 Amount received:
E-mail: chorsley@solarcity.com PHOTOVOLTAIC SOLAR SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: SolarCity Corporation Submit two (2) sets of roof plan with connection details
m and fire department access, along with the 2010 Oregon
Address: 6132 NE 112 Ave Solar Installation Specialty Code checklist.
City /State/Z1P: Portland, Oregon 97220 Permit Fee (includes plan review $18000
and administrative fees):
Phone: (503) 9560610 I Fax: (503) 4366513 State surcharge (12% of permit fee): $21.60
CCB lie.: 180498 / Total fee due upon application: $201.60 ,...)
Authorized signature: ` — / - / / This permit application expires if a permit is it t obtained
/. c �. 1 /K within 180 days after it has been accepted as complete.
Print name: Caitlin Boy / Date: VI 112 * Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Buil ding1PermitABUP- RESPermitApp.doc 02/24/2011 440.4613T(11/02/COM/WEB) - — / //V j�E
•. /L &-�
T &2 /SS L< 6 '
Electrical Permit ApplicaticRECE1VED FOR OFFICE I SE 0\I.VV
City RGCt1Ved Permit N 19 13 125 of Tigard
.711 S W Hall Blvd., Tigard, OR 9722,1) G 0 2012 DateB : • �J/ — i
• ! Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 ^ Dave : Other Permit:
Inspection Line: 503.639.4175 C1TY QFef l('iA��
RtIll.I3�1OD9V1�lON Date Ready/By: : ® See Page 2 for
I ( I Internet: www.tigtud - or. ov Notified/Method: Supplemental Information
g
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Pkase check all that apply (submit b sets ofplans whims checked below):
❑ 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 ❑ Floating buildings.
less to ground. or exceeds 14.000 ❑ Commercial -use agricultural
® 1- 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
❑ Emergency system larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ 'A ", "E "I 2 ", "I - 3 ",
I OOHP or more. occupancy.
Job no.: 97'� 1 065 Job site address: 12 6s 2 SW vn lore nC r 1 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/L1P: Tt /�() �� ❑ Health-care facilities. ❑ Supply voltage for more than
(lard ! �J9-1221-1 ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: I Project name: ,CSC -- . ❑ Service or feeder 600 amps or more.
/ FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. I Fee. I Tool 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
DESCRIPTION OF WORK (with above sq. fl.) 75.00 2
Limited energy, multi- family
75.00 2
Roof Mount PV System residential (with above sq. ft.)
Services or feeders installation,alt atlon, and/or relocation
200 amps or less 100.70 MO .7C.) 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 0 eflE+ Pei f-y 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City / State/ZIP:
Phone: (603) 62O - 6 I L. $ Fax: ( ) 200 amps or less II` 5936 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
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 L tV
®.- APPLICANT I ® CONTACT PERSON above service or feeder fee, ( 7.42 2
each branch circuit
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)
Ci City/State/ZIP: Portland, Oregon 97220 dwelling, manufactured service and/or or r modular
ty d � dwelling, servia 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
. CONTRACTOR 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 112th Ave Additional inspection (I hr min) 66.25/ hr
City/State/ZIP: Portland, Oregon 9722 Investigation (1 hr min) 6625/ hr
Industrial plant (I hr min) 78.18 / hr
Phone: (503) 9560610 Fax: (503) 5366513 Inspections for which no fee is 90.00 / hr
specifically listed (h hr min)
CCB Lic.: 180498 I Electrical Lic.: C562 Suprv. Lic.: 5201S ELECTRICAL PERMIT FEES
Subtotal:
Suprv. Electrician signature, required: / e
_ / _ /,/� Plan review (25% of permit fee):
Print name: Derek Cropp Date: ( 1112 State surcharge (12% of permit fee):
TOTAL PERMIT FEE:
Authorized signature: This permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete. 4(""
Print name: Caitlin Horst y Date: Shill • Number of inspections allowed per permit.
I:Uluilding‘Pmoils ELC•PermilApp.doc 07 01/10 440.4615T(t I /OS /COM/WEB
I
City of Tigard RECEIVED
Buildin Division
i g
_ 13125 SW Hall Blvd, Tigard, OR 97223 AUG 01 2Q ?2
Phone: 503.718.2439 Fax: 503.598.1960 CITY OFTIGARD
T 1 G A R D Inspection Line: 503.639.4175 BUILDING DIVISION
www.tigard - or.gov
2010 Oregon Solar Installation Specialty Code
Check List for Prescriptive Installation of Roof - Mounted
PhotoVoltaic Solar Panel System
Property Information
Installation Address: I 2652 SW R brand+ Lane
City: ms op d Zip: 9122'
Owner's Name: Onie,ne P,,, Date: Si 1 012
Contractor's Name: SolarCity Corporation CCB #: 180498
Design Parameters of the Property /Structure
If "Yes ", does not
Flood Hazard Is the installation ❑ Yes qualify for the
Area Located in a flood prescriptive path, follow
plain/flood way? ® N OSSC or ORSC for
• design requirements.
I
Wind Exposure Is the wind exposure ® Yes If "Yes ", qualifies for I
"C" or less? ❑ N the prescriptive path.
Installations on detached Is the Ground Snow
single/two- family Load 70 psf or less?
dwelling/single/two - If "Yes ", qualifies for
family townhomes ® Yes the prescriptive path.
and/or their accessory
Ground structures. ❑ No
Snow Load Is the Ground Snow
Installations on all Load 50 psf or less?
structures other than If "Yes ", qualifies for
above ® Yes the prescriptive path.
❑ No
1
!:/Building/ Forms /PhotoVoltaic- Chceklist.docx
.
Is the construction
material wood and does ® Yes
Type of If "Yes", qualifies for
the construction qualify
Construction as "conventional light ❑ No the prescriptive path.
frame" construction?
Is the spacing 24 inches
or less?
If "Yes ", qualifies for
Pre - engineered trusses. ® Yes
the prescriptive path.
❑ No
Roof framing •
members Is the spacing 24 inches
or less?
If "Yes ", qualifies for
Nominal lumber. 1 ] Yes the prescriptive path.
❑ No
•
Is the combined weight ® Yes
of the PV modules and If "Yes ", qualifies for
racking less than or ❑ No the prescriptive path.
Solar equal to 4.5 psf?
installation Is the solar installation
Z
layout in accordance Yes If "Yes ", qualifies for
with Section 305.4(3) of ❑ No the prescriptive path.
the 2010 Oregon Solar
Code?
❑ Metal
Single layer If roofing material is
Roofing Check the type of ❑ of wood one of the three types
material roofing material shingle/shake checked, qualifies for
Max: two layers the prescriptive path.
® of composition
shingle.
Is the roof mounted ® Yes
Connections of solar assembly
the solar assembly connected to roof If "Yes", qualifies for
framing or blocking
0 No the prescriptive path.
to the roof g g
directly?
2
I:/ Building / Forms /PhotoVoltaic- Checklist.docx
Is the gauge 26 or less? ❑ Yes If "Yes ", qualifies for
❑ No the prescriptive path.
115 lbs for 60 inch
spacing or less?
If "Yes ", qualifies for
❑ Yes the prescriptive path.
❑ No
Minimum Uplift rating
of Clamps? 75 lbs for 48 inches
spacing or less?
If "Yes ", qualifies for
❑ Yes the prescriptive path.
❑ No
Attachment of
roof mounted Minimum 24 inches If the spacing falls
solar systems Spacing of clamps? within 24 inches and 60
directl to in ches inches, qualifies for the
Y Maximum 60 inches prescriptive path.
standing seam
metal panels Width of roofing If the width of the panel
panels? 18 inches or less is less than 18 inches,
inches qualifies for the •
prescriptive path.
Minimum #10 at 24
inches o /c?
Size and spacing of ❑ Yes If "Yes ", qualifies for
fastener? the prescriptive path.
❑ No
Is the roof decking of
WSP min. /2" thickness, ❑ Yes
decking connected to If "Yes ", qualifies for
framing members ❑ No the prescriptive path.
w /min. 8d nails @
6 "/12" o /c?
Is the height less than or
Maximum 18 inches equal to 18 inches?
Height of the from the top of the If "Yes ", qualifies for
solar modules module to the roof ® Yes the prescriptive path.
surface. ❑ No
3
1:/ Building /Fomu/PhotoVohaic- Checklist.docx
Submittal Documents required for Prescriptive Installations
Show the location of the PV system in relation to buildings, structures,
property lines, and, as applicable, flood hazard areas.
Site Plan Details must lie clear and easy to read.
Minimum size of the plan is 8.5 x 11 inches.
Attach a simple structural plan showing the roof framing (rafter size, type, and
spacing) and PV module system racking attachment.
System must be shown in sufficient detail and clarity to assess whether it
Structural Plan meets`the prescriptive construction requirements as listed earlier above in the
matrix.
Minimum size of the plan is 8.5 x 11 inches.
•
PV Modules
Manufacturer: 'Tr ;,nQ %lac
Model Number: - TSM- 2110PA05
Listing Agency: UL1703
4
l iBuilding/ Forms /PhotoVoltaic- Checklistdocx
To: Pafja 1 of 2 2012 -09 -19 15:12:12 PDT X8668637258 From: Apron B ®nlcs
FAX COVER SHEET
TO
COMPANY
FAX NUMBER 15035981960
FROM Aaron Banks
DATE 2012 -09 -19 15:12:25 PDT
RE 12682 SW Rembrandt Lane
COVER MESSAGE
The following is payment for the permits on 12682 SW Rembrandt Lane and the mailing
fees to have it mailed to 6132 NE 112th Avenue Portland, OR 97220.
Aaron Banks I SolarCity I Phone: 971.678.7417 I Fax 866.863.7258 I
abanks@ solarcity. com <mailto:abanks @solarcity.com> I
www. solarcity.com <http: //www.solarcity.com/>
WWW.EFAX.COM