Permit '• MASTER PERMIT
q CITY OF TIGARD
Ph
8 COMMUNITY DEVELOPMENT Permit#: MST201300225
T EGAFCD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07!2013
Parcel: 2S 109AB 18000
Jurisdiction: TIGARD
Site address: 13205 SW HOODVISTA LN
Subdivision: HIGHLAND HILLS ESTATES Lot: 9
Project: Karussos
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
Other Fixtures: 0
Drywell-Trench Drain: 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 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
Ecom asin N
Other: N Other Description: p g
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
KARUSSOS,STACE&HEIDI SOLARCITY CORPORATION Required Items and Reports(Conditions)
13205 SW HOODVISTA LN 6132 NE 112TH AVE
TIGARD,OR 97224 PORTLAND,OR 97220
PHONE: 503-312-7282 PHONE: 971-201-5278
FAX: 866-592-2249
Total Fees: $326.88
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 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 Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 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 B Permittee Signature:
Ca 5 by 7:00 a.m.for the next available inspection ate.
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 Applicati n ''-
p 'd -Tire Ti-- .-1- .c tai ail
� �_--
Residential �� _�����,���
2013 -
City of Tigard QQ�I 2 d ,o iv _� P eroilsNo.: y 5T /7-4;351.2 S'
13125 SW Han Blvd.,Tigard,OR 97223 nn Plan Review 4
�'_1 Si `,- Phone: 503.718.2439 Fax: 503.598,1996®�11UfkF1� mug • �1` Q Other Permit:
rip!.r,'.'∎ki l Inspection Line: 503.639.4175 d1� ►,,i r- n t;1. ...%"` Dale Reed; RI Page i for
Internet: www.ligard or.gov ! i t� , Notlf elbod: 7/ zf 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.
®Additio;.attc o;ia t/rplscerrtent ❑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 Valuation: $ _ 17771
'7
® Y g ❑Commercial/industrial
❑Accessory building ❑Multi-family Numbrofbedrooms:
❑Master builder ❑Other Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: \ 3 O� 'W \.UUC t 1 *Pc- L New dwelling area: square feet
TCity/State/ZIP: 1 c� GZ�- a v 7 zii Garage/carport area: square feet
Suite/bldgJapt.no.: Project name: V.,\ICNI V 1 I c c()� 1 'uG e, 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:
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: -��G[(p Cal Type of construction:
Address: I3a OF, SvJ iOO(. V `S�-4 L ) Occupancy groups:
City/State/27P: ,Ira Of q aDt- 1 Existing:
Phone:(1 ME Fax:( )
New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES'
Business name:SolarCity Corporation
fPlamrnte►mteeachadrrte)
` � Structural plan review fee(or deposit):
Contact name: AAolliE- Kra
to FLS plan review fee(if applicable):
Address:6132 NE 112 Ave
City/State/ZTP:Portland,OR 97220
Total fees due upon application:
Phoned t'f nt 58 7 I Fax:: (n Li'.540 90%.4 l [ 9 Amount received: l„ejo
E-mail: l'\/\V re I` (C �A 0 r (t Li e l ar\ "l r PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
` �t Commercial and residential prescriptive installation of
CONTRACTOR 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/ZIP:Portland,OR 97220 Permit Fee(includes plan review $18000
f� and administrative feet_
Phone:Iq 7 I S o 5 Q Fax i/(„ 5 4 ) ' State surcharge(12%of permit fee):
CCB tic.:180498 `, "1 1 Total fee due upon application: $201.60
Authorized signature: loll et ii This
within permit 0 days after It expires if a
accepted Is not o, .
//// f 3 •Fee methodology set by Tri-County Building Industry
Print name:MC) Date: �.,�, ' ri Service Board.
1:,BuildingWennitsBBUP-RESPermitApp.doc 02/242011 440-46131(11/02/C4 /WEB)
Electrical Permit Appl e# oV I u4 ED ))t o1 IC Isis c1:sL�.
City of Tigard o a
• 13125 SW Han Blvd;Tigard,06U-1232 4 2013 Received l°Q��.. U�d el -� /I
'' I ` Phone: 503.7182439 Fax: 503.598.1960 Plan Review Other Permit:
np Date
i ;Y�, I, Inspection Line: 503.639A173rI�f OF TIGARD lam RC0d),37': : lB see Page 2(or 1
Intend: www.tigard-otgov V �i `` p Notified/Method: Supplemental Information
r+t ni pllalf ''t i tii�s
—---. '-- - - - 'YP,Ea URl ' --I-I, '—! s ---;- A AR—ITaviIEW� ' •—i
❑New construction ®Addition/alteration/replacement 1 Please cheek ell dm apply(submit it a acts of plans w/tems checked-below):
❑Service or feeder 400 amps or more ❑Building over dune stories.
❑Demolition ❑Other where the naileba fault current ❑Marines and boatyards.
Imo,_ -_ ___ C�►7iFCOR g:(OF ; LI- �_ ( excceds 10.000 amps at 150 volts or O Floating buildings.
®1-and 2-family dwelling ❑Commercial/industrial less to ground.or exceeds 14.000 ❑Co dings.e4ure agricultural
❑Accessory building amps for a0 other irotalbuosn. buildings.
❑Multi-family ❑Master builder ❑Other. ❑Firs Punta. ❑Installation of 75 KVA or
LL — ��lZ E ilV �R(V A 0 f rAI fb OGa •vN O fmageney OM= larger separately derived system.
_.._�.� _. _ " F se rate
�— ❑Addition of new motor toad of ❑"A",'E","1.2",°I.3'•,
Job no.: Job site address: (7 t) 5A) Hood IO31ll'or more. oceupeisy.
Cl y~i 0 Six or more residential units. ❑Recreational vehicle parts.
City:State/ZIP: 1 -1-7 7'f l�� ❑tfeelth<are facilities. ❑Supply voltage for more than
( "1 ❑Hazardous Madam 600 vote nominal.
Suite/bldg./apt.no.: O service or feeder 600 amps or more.
Cross street/directions to job site: _. __1FEE SCHFA.UI.E�
I Qty. I Fee. I • TOW 1 •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1.000 sq.ft.ar less 168.54 4
Ea.edd'I 500 sq.fl or portion 33.92 1
Tax map/parcel no.:
Limited
energy,residential
- - --- .— iDESCRIPT1OP11 AWOR1Cj- _- - _ (with above sq.ft)
75.00 2
Roof Mount PV System Limited r siden multi-family b e.ft.)
I 75.00 12
— Services or feeders lostatlation,alteratioa,and/or relocation
_ 200 amps or less 100.70 ((r t 4
,l -.71:3111 OPI I'YTY�tfOWf1ER1' 7 jr- _ -__Lb ie fgryp '': L J 201 amps to 400 amps 133.56 2
Name: ..t-G G<- l��Y 11 S� ao 1 amps to boo amps 200.34 2
1 601 amps to 1400 amps 301.04 2
' Address: ) �d C)5 SW II � t--�.1 N' Over 1,000 amps or volts 552.26 2
City/State/ZIP:-----1-71 ��,nn //� /I �++.�1 Temporary services or feeders installation,alteration,and/or
�1 fG� C�� v(7 Z ZiI relocation
Phone:(50 15 ZL 7th�� Fax:( ) 200 amps or less 59.36 1
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. 40i amps to 168.54 2
Owner signature: Daft~ Branch circuits-new,alteration,or extension,per panel
_ t A.Fee for branch circuits with
--_ ��®zp CAN_. , d l rocs, A P" p_-lei _ - ' above service or feeder fee,
1t } i each branch ctrcuh 7.42 2
Business name:SolarCity Corporation B.Fee fbr branch circuits without
J service or feeder fee,first 56.18 2
Contact name:. A A Oat(� K-�(( branch chant
VV� Each add'I branch circuit I 1 7.42f J 2
Address:6132 NE 112th Ave Miscellaneous(service or feeder not Included)
City/State/L1P:Portland,OR 97220
Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:(971))\54:7 I Fax::(866)5 1 Q o?au cl ,Pump or on1Y 67.84 2
Putap or irrigation circle 67.84 2
t mail:rn/( lardt ty. one r Sign or outline liighttng 67.84 2
_. -`: iltfigc7.OI : -_.•_--------•:- Signal ciratit(a)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(1 hr min) 1, 66.25/hr
City/State/ZIP:Portland,OR 97220
investigation(lhr min) 66 251 M !
industrial plant(I be min) 78.18/hr
Phone:(971): Fax:(866) Inspections for whirl no sec is
specifically listed(h hr min) 90.00/hr
CCB Lic.: 180498 I Electrical L' • C562 I Suprv.Lic.: 5201S F-17,72-1 iEL'ECPRICAL9PERM TTFEESj w7'.7.--',:, '
Suprv.Electrician signature,required: /� Subtotal: '
I` � Plan review(25%of permit feet I
Print name: Derek Cropp ! Date: State surcharge(12%of permit fee): ■
Authorized signature: 4 g
TOTAL PERM ff FEE:
L�•1i' _ 1_ ��
This permit application expires Na permit la not plate. within 180
dayt amen it bas Deea accepted as Complete.
Print name: . Date: Number of impecriom allowed per permit
i SU,iairrg Permits ac-PermitApp.doe 0"dt.la 440-4613 MMteS-COM WEB