Permit f y CITY OF TIGARD MASTER PERMIT
III a COMMUNITY DEVELOPMENT Permit#: MST2013 00217
TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503 718.2439 Date Issued: 10/22/2013
Parcel: 2S103DA05700
Jurisdiction: Tigard
Site address: 10634 SW COOK LN
Subdivision: FANTASY HILL Lot: 11
Project: SHOLES
Project Description: 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 $7,000 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
Tubs/Showers 0 Garbage Disp 0 Water Heaters 0 Water Lines. 0 Drains. 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 SrvclFeeders 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 Secunty 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:
SHOLES,LANCE M&KRISTIN A SOLARCITY CORPORATION Required Items and Reports(Conditions)
106334 SW COOK LN 6132 NE 112TH AVE
TIGARD,OR 97223 PORTLAND,OR 97220
PHONE PHONE 971-201-5278
FAX: 866-592-2249
Total Fees: $328.38
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 in acco dance 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 TION gon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-00 010 through OAR. 2-0 090 You may obtain a copy of the rules or direct questions to OUNC •y -y1 3. 32 1987 or 1 80s 332.2344
Issu By: Permittee Signature: r ai O/) r 464.—. �
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.
f
Building Permit Application i
Residential ��
— City of Tigard Received
j ° 13125 SW Hall Blvd..Tigard,OR 97 T 20 3 Da : : I / fj= V 7 _
® , ARD ( 1 02 1 :.
u : ' Phone-. 503.718.2439 Fax: 503.598.1'960 Pr:again i ►� that Permit:
lnl ,rl� Inspection Line: 503.639.4175 T�0�TIG Date Read;By two ®See Page 2 for
_-__ ____ a Internet: www.ligard-or.gov Oki GD4"ISO% Notified/Method: /O.f'/'!j`! 1� �/o 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/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 7 DO 0
® 1-and 2-family dwelling ❑Commercial/industrial I
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors.
Job site address: Iv 1431 51/0 COL`. 1.,k) New dwelling area: square feet
City/State/ZIP: Tf! 6-1z., q'7PJ Garage/carport area: square feet
Suite/bldg./apt.no.:,J Project name: 5%W()I f 5 Covered porch area: square feet
Cross street/directions to job site: J Deck area: square feet i
I
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: l 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,materials,labor,overhead,and the profit for the
1
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 El TENANT Number of stories:
Name: L C )•1016 r Type of construction:
Address: __(2V311 Sw C(o - IA). Occupancy groups: '
City/State/ZIP: I I gj°f 6 '"176),Z7 Existing:
Phone:(50' 53 1049., Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:SolarCity Corporation (Preaur�errn fee,eaednt)
Contact name ' Jv`o \k k ` Structural plan review fee(or deposit):
to FLS plan review fee(if applicable):
Address:6132 NE 112 Ave
Total fees due upon application:
City/State/ZIP:Portland,OR 97220 _
��j� 1
1 PhoneC'1 ZD1 5 7 Z<l!!b- �ja�o9 [ q Amount received:
Fax:: c�/� �/ r v `'[ t 1
E-mail: l' 1 (�e (( ` SOS /r/) (i- t l �r)•, PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
V t (l (, Commeicial 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
Address:6132 NE 11215 Ave and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:Portland,OR 97220 Permit Fee(includes plan review $180.00
(4, and administrative fees):
Phone:1q 7( D 5.Q'7 " Fax �� 5 q �l(G) State surcharge(12%of permit fee): S21.60 •
CCB lie.:180498 �I 1
Total fee due upon application: $201.60
� r
Authorized signature: l� I This permit application expires if a permit is not obtained
Q of Et-
_ within 180 days after It has been accepted as complete.
Print name: kr..e t' Date: *Fee methodology set by Tri-County Building Industry
�� �l e ��� 2D1 Service Board.
I:,Building\Permits\BUP-RESPennitApp.doc 02/24/201 I 440-4613T(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE. I SE ONLY
City of Tigard r � DateeBe� _ Permit No ,
• 13125 SW HaII Blvd.,Tigard,OR ' r. 2',,,,* Plan Review /- • l
III I Phone: 503.718.2439 Fax: 503. ';`:.V.s ''' Date/By. Other Permit:
1 t i A k u Inspection Line: 503.639.4175 li 4 1013 Date Ready/By lams 65 See Page 2 for
I
Internet: www.tigard-or.gov OC\ ,,q--% Notified/Method: T�—O Supplemental Information
TYPE OF WOR �-y 6` u�IA P \OV PLAN REVIEW
❑New construction fit, �!e� Please check all that apply(submit 1 sets of plans w/items checked below).
Addition/altcrati �� :�r�ttG t
❑Demolition ❑Other: j� ❑Service or feeder 400 amps or more ❑Building over three stories
where the available fault current ❑Mannas 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
J] 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address: )OU C ` ❑Six or more m oreresi dential units. occupancy.
0
Recreational vehicle parks.
City/State/ZIP: 1\I, /J ❑Health-care facilities ❑Supply voltage for more than
ty �� CI � ? _ ❑Hazardous locations. 600 volts nominal.
Suite/bldg/apt.no.: Project name: 5{�e1[/,,5 ❑Service or feeder 600 amps or more.
Cross street/directions to job site: ` Description FEE SCHEDULE
I Qty. -I Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168 54 4
Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion 33.92 1
Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family
,4 • 7-00c. residential(with above sq ft) 75.00 2
3 Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
lin PROPERTY OWNER ❑ TENANT 200 amps or less li 100.70 10)1"]0 2
201 amps to 400 amps 133.56 2
Name: 1tic_e_ 540\ 401 amps to 600 amps 200.34 2
Address: 10( „' -A (_;kA) C(0� 0, 601 amps to 1,000 amps 301.04 2
Ott _ Over 1,000 amps or volts 552 26 2
City/State/ZIP: r� 0 C?_ q I a,3 Temporary services or feeders installation,alteration,and/or
Phone:(0j3)I53(. 2f}('� 2 Q Fax:( ) relocation
44..t�t 200 amps or less 59 36 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
Owner signature: Date: Branch circuits-new,alteration,or extension, ter panel
(p APPLICANT CONTACT PERSON A Fee for branch circuits with
- above service or feeder fee,
Business name: mar C 1 .�Corr C,
AO each branch circuit 7.42 2
�[T' B.Fee for branch circuits without
Contact name: AD%i 4_.1!`, service or feeder fee,first 56 18 2
branch circuit
Address: I 1 3� n�, v1�`'� f� of A......\0 hG Each add'I branch circuit 7.42 2
l 1J U� Miscellaneous(service or feeder_not included)
City/State/ZIP: ( 67.84 2
�iZ� Each manufactured or modular
Phone:6 it ) �i (54-)K I Fax: :( (0)542 �a�{5 dwelling,service and/or feeder
M�C `` Reconnect only 67.84 2
E-mail: 11 ` der i,,\Q(t Si,( N.('F Pump or irrigation circle 67.84 2
CONTRACTOR Signor outline lighting 67.84 2
,
Cc/cilia-0'1 Signal circuit(s)or limited-energy See
Business name:
tC.1't-`'t panel,alteration,or extension Page 2 2
Address: (j'(3Q L� I tir AIL" 4\or, Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66 25/hr
City/Blatt/ZIP: CZ n 7��0 Investigation(I hr mm) 66.25/hr
Phone:(7() 'lo( 5;176 I Fax:("' i) 9_09041 Industrial plant(1 hr min) 78.18/hr
F Inspections for which no fee is
CCB Lic.: (066 LiC r I Electrical Lic.: 191 S I Suprv.Lic.: 05109 specifically listed(94 hr min)
90.00/hr
`� ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:�� .� Subtotal:
L ► I
Print name: '���e k a ate: Plan review(25%of permit fee)
u.0 State surcharge(12%of permit fee):
Authorized signatur ' / • TOTAL PERMIT FEE:
1 ,This permit application expires if a permit is not obtained within 180
Print name: ` _ f Date: —11 0 0 days after it has been accepted as complete.
Number of inspections allowed per permit.
11Buiding1PernrolEt.C_PermitApp_ELR_ERE doe Rev 05/21/2013 440-4615T(I I/05/COM/WEB
To: Pat1a 1 OP 4 2013-10-22 20 5S 15 C3MT '16664457459 From Malissa BanSlOy
FAX COVER SHEET
TO
COMPANY
FAX NUMBER 15035981960
FROM Melissa Bentley
DATE 2013-10-22 20:55:04 GMT
RE 10634 SW Cook Lane-
COVER MESSAGE
Credit Card Auth App
Melissa Bentley! Oregon Regional Coordinator I Customer Account Management I T:
503.894.6903 I Fax: 1.866.445.7459 I
abentley@ solarcity.com<mailto:abenley @solarcity.com> I
www.solarcity.com<http://www.solarcity.com/> 1.888.7652489 for Customer Care.
SolarCity Customers:View your project status or system production at any time through
your online My SolarCity Account. Login
Now<httpi/solarguard.solarcity.com/kiosk/login/> >
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