Permit q CITY OF TIGARD MASTER PERMIT
III 2: ' COMMUNITY DEVELOPMENT Permit#: MST2013-00192
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/29/2013
Parcel: 2S103CB08300
Jurisdiction: Tigard
Site address: 12373 SW QUAIL CREEK LN
Subdivision: QUAIL HOLLOW-EAST Lot: 32
Project: Yuzon
Project Description: Installation of solar photovoltaic 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: $0.00 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
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=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: 0
Ea add'I 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
Ecompasing: N
Other: N Other Description: P 9
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
YUZON,JASON B&KELSEY M SOLARCITY CORPORATION Required Items and Reports(Conditions)
12373 SW QUAIL CREEK LN 6132 NE 112TH AVE
TIGARD,OR 97223 PORTLAND,OR 97220
PHONE: 971-998-6635 PHONE: 971-201-5278
FAX: 866-592-2249
Total Fees: $327.38
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 '. _ - '- ce 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. •TTENTION: • =,on la requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 '01-0010 through OAR °s -0' .'20. You may obtains a copy of the rules or direct questions to OUNC by "'I'll' .1987 or 1.80'�-3 2344.
Iss ed B : , /'�Q�v/ Permi n /, t‘ ,�r �' ` `--�>
By: ttee Slg atur=• ■/
Call 503.639.4175 by 7:00 a.m.for the next available inspectlo •: e.
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 Applica',,,:'ECEIVED
Residential 1 i•(lu,(_ri,;Ic,iL til_:;A:sciD
City of Tigard AUG 1 5 2013 1�ed i W I E L O M Permit Na / j 3 t1O/7 r
° 13125 SW Hall Blvd.,Tigard,OR 97221_
Plan Review":�
`- „�N. Phone: 503.7182439 Fax: 503 59 TIGARD Dete/B: � � Other Permit:
' Inspection Line: 503.639.4175 BUILDING DIVISION Date Resd! : ludo: ®See Page 2 for
.� fi,_y'nl Notified/Method lntanet' www.tigardor.gov Supplemental Information
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/replacanent ❑Other. equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this applicati
I and 2-family dwelling Valuation: S ) �(�� r��
® Y 8 ❑Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other. Number of bathrooms:
JOB SITE INFORMATI N AND LOCATION Total number of floors:
Job site address: 17 ,3-8 J Jai 0 lei/. LA) New dwelling area: square feet
City/State2lP: t ry r4V/t r !1 Garage/carport area: square feet
Suite/bldgJapt.no.: J it
Project name: '117fl t ) Covered porch area: square feet
Cross streeUdirecttons to job site: v JiJ 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: ;
Existing building area: square feet
New building area: square feet
PROPERTY 0 • I ❑ TENANT Number of stories:
Name: .lit- t Type of construction:
Address: FML e.`!'/11■ Occupancy groups:
City/State/ZIP: 6,, , ER. _ Existing:
Phone:(l �r / Fax:( )
New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES'
Business name:SolarCity Corporation (Please nle►mlor,chesakl
d Structural plan review fee(or deposit):
Contact name + ,A C)t t,e_. Kr e
m FLS plan review fee(if applicable):
Address:6132 NE 112 Ave
City/State/ZIP:Portland,OR 97220 Total fees due upon application
Phoneg1 (�` 5 7 I Fax:: c l f t-59,-)6Q-1 9 Amount received:
E-mail: M 14 re II COD W"O i t., ,O�.� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES'
M t rt �l C Commercial and residential prescriptive installation of
CONTRACTOR 1 roof-top mounted Photo Voltaic Solar Panel System.
Business name:SolarCity Corporation Submit two(2)sets of roof plan with connection details
ra and fire department access,along with the 2010 Oregon
Address:6132 NE 112 Ave Solar Installation Specialty Code checklist.
City/State2ZP:Portland,OR 97220 Permit Fee(includes plan review 8180.00
f and administrative fees):
Phone:lq 71 (9 O 15'Q'7 " I Fax '(/(„ 5 4 M f State surcharge(12%of permit fee): $21.60
CCB lic.:180498 ``++ `1 1 q
��/ � I Total fee due upon application: 5201.60_
Authorized signature: / This permit application expires if a permit Is not obtained
within 180 days after It has been accepted as complete.
I Print name:/7)0 /j e g (1 -Date: Vol" *Fee methodology set by Tn-County Building Industry
Service Board.
I:,Building\Pennits\BUP-R ESPermitApp.doc 02124/2011 440-46131(1 I/02/COM/WEB)
Electrical Permit Application o //i li a I i,1<_1 ysE c.,:c L,V
City of Tigard Re«i"�
13125 SW Hall Blvd.,Tigard,OR 97223 �' g Mir/WI Permit No.: My �o/ --1)e, g
0 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 pare: Other Permit
1 lc,‘k i,: hupection Line: 503.639.4175 Date Read)By: buts: RI See Page 2 for
Internet: www.tigard-or.gov Nedra:di/dethod: Sepplementallnformatioa
r6 y—I ( RE,IE. !
❑New construction ®Addition/alteration/replacement Please cheek all that apply(submit I seta of plans wfuems decked below):
❑Service or feeder 400 amps or more ❑Balding over duce awria.
❑Demolition ❑Other where the evailabk fault current ❑Marinas and boatyards.
f - _ ,_ C�II[LCOR. (Ole CONSTRU-fIO.I T - _.i exceeds 10.000 amps at 150 volts or ❑Floating buiidings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑A + less to ground.or exceeds 14.000 ❑Commercie4me agricultural
Accessory building amps for all other howl/aliens. buildings
❑Multi-family ❑Master builder ❑Other. ❑Firs pump. ❑installation of 75 KVA or
f. '---- _y-,,r,_ --- -_- ---t ❑Fmergettry tytlaa larger separately derived system.
OB S1 (tp] f iLOCaA�7 ___J ❑Addition of new motor toad of ❑..A `V,-I 2 "1-3'.
Job no.: [Job site address: I 3 SVV 100HPormme. occupancy.
\� \ ❑Six or more residential uniLr. ❑Recreational vehicle parks.
City.'State ZIP: f G 2, 4.7 -3 Le(1 1,,1 ❑Health-care fecdities. ❑Supply wttage fbr more than
W ❑Ffeardous locetiom 600 volts nominal.
Suite/bldg apt.no.: Project name: r )�j C Service or feeder 600 amps or more.
Cross street/directions to job site: V -----.._Y.AEISCHP�UI -�;_r
neaerisalon i Qty. I Fee. i Told I •
New residential single-or multi-family dwelling unit.
includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add'I500sq.fl.or portion 33.92 1
_ Limited energy,residential 75.00 2
_-_ )DESCR1pTIoN1cg�wo1RK1 _ . -. . ; __; (with above s9.11)
Roof Mount PV System Limited energy,multi-family I 75.00 12
residential(with above sq.ft.)
Services or feeders installation,niteratlon,and/or relocation
_ 200 amps or less / 100.70 `Z.le 2
LI -�i®141 OP TY oWN-1 ,_ '-,I7- --- ci TEN'AMT - ---1 201 amps to 400 amps ll 13336 2
Name: JU z-0) AeL5 n 401 amps to 600 amps 200.34 2
Address: 1 I 601 amps to 1,000 amps 301.04 2
Z2 &Jt� 0 r 1 1 Over 1,000 snips or volts 55126 2
City/State/ZIP: ' � � 114��� Temporary services or feeders installation,alteration,and/or
/� � 1 relocation
Phone:(q71) 6iqS( (Q Fax:( ) 200 amps- Iot_ 1--3936--517-3,112.-
r. 1
U 201 to 400 amps
Owner installation:This install on is being made on property that I own which is not °i"� 123.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps t0 168.54 2
Branch circuits-new,alteration,or extension,per panel
Owner signature: Date
_ _ _ _1(� A.Fee for branch circuits with
_ _ r_ `e: L _� _!Il ,�? lt.O,�Af PE Ql�J._- ___ above service or feeder fee, 7.42 2
each branch circuit
Business name:SolarCity Corporation B.Fee fbr branch circuits without
� ) f service or feeder fee,first
56.18 2
�V
Contact name:: A fl slot I.m-eU branch circuit
Each add'l branch circuit . I I 7.421 12
Address:6132 NE 112°i Ave Miscellaneous(service or feeder not included)
City/StateJZ1P:Portland,OR 97220 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:(971)Do\5'17 I Fax::(866)SR Q aa,(,I el r, 67.84 2
Pump or irri gation circle 67.84 22
E-mail:rn►((ti lardty.com Si orewtlhte
P^ - — - Sip lighting 67.84 2
- .Goli ac?ORI _-. -_ L1_ _ _ Signal eirc it(s)or limited-energy 1
Business name:SolarCity Corporation panel,alteration,or extension. Page 2 2 1
Each additional inspection over allowable in any of the above
Address:6132 NE 1126 Ave Additional inspection(1 hr min) . 66.25/hr
C
Investigation hr min) 6625/hr !
ity/State/Z1P:Portland,OR 97220
Industrial plant(I hr min) 76.18/hr
Phone:(971); Fax:(866) brspections for whicb no fee is
specifically listed eh hr min) 90.00/1x_,
CCB Lic.: 180498 Electrical Li • C562 Suprv.Lic.: 5201S i_:. : iFIECPRICAMP;ERIit1VFEE.Si::; :s"
Suprv.Electrician signature,required: . Q , Subtotal:
required: / C 1�`/lI Plan review(25%of permit fee): -
Print name: Derek Cropp , Date: State surcharge(12%e of permit fee):
Authorized signature: / ` TOTAL PERMIT FEE:
This permit application expires if a permit Is not obtained within 180
Print name: / of i `r{ Date: days alter it has been accepted as complete.
1 • Number of inspections allowed per permit.
l:Building Pesaro ELC-PamaApp.doc 0"0,10 440.4611TTI l 03 COM WEB
To: Pege 1 0}2 20'13-06-27 17:54:15 Qi iT '16665922249 From: Mollie Krell
RECEIVED
FAX COVER SHEET AUG 27 2013
TO CITY OFTIGARD
COMPANY BUILDtNG DIVISION
FAX NUMBER 15035981960
FROM Mollie Krell
DATE 2013-08-27 17:53:41 GMT+00:00
RE 12373 SW Quail Creek Ln-Yuzon,Jason-MST201300192
COVER MESSAGE
Sincerely,
Mollie
Mollie Krell I Permit& Inspections Coordinator I SolarCity I T: 971-201-5278 I
mkrell@ solarcity.com<mailto:mkrell@solarcity.com> I www.solardty.com
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