Permit CITY OF TIGARD MASTER PERMIT
1,1 COMMUNITY DEVELOPMENT Permit#:: MST2014-00046
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04!17/2014
T I "' o 9 Parcel: 1 S 133DC03700
Jurisdiction: Tigard
Site address: 13150 SW FALCON RISE DR
Subdivision: MORNING HILL NO.1 Lot: 30
Project: KIENBORTS
Project Description: Solar photovoltaic system.
BUILDING
Floor Areas Reauired Setbacks Reauired _
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: $3,000.00 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
Drywall-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: 0
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:
OTR SF VB R-3 0
Owner: Contractor:
KIENBORTS,KRISTI L SOLARCITY CORPORATION Required Items and Reports(Conditions)
13150 SW FALCON RISE DR 6132 NE 112TH AVE
TIGARD,OR 97223 PORTLAND,OR 97220
PHONE: PHONE: 971-201-5278
FAX: 866-592-2249
Total Fees: $329.38
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 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 thro h OAR 95522--00011-0090. You may obtain a copy of the rules or direct questions to OUNC by calli B .232.1987 or 1.88000 332.2344.
Issued By�( t Permittee Signature: ■��
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.
Building Permit Application
Residential O FOR OFFICE I St:1)11.1
City of Tigard .�! j
1114
• 13125 SW Hall Blvd.,Tigard,OR ' t � R>/r • b
Phone: 503.718.2439 Fax: 503.5'�I\ E �a
Inspection I.ine: 503.639.4175 rt '.
I I li A It I ! tote edime Ready/By. See Page 2 for
Internet: www.tigard-or.goV Pets ^1'c Ndified/Method: Supplemental Information
TYPE OF WOR n\��4� REQl11RED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Derno' � J 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.
® I-and 2-family dwelling ❑Commercial/industrial Valuation: f 3,000
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Joh site address: 13150 SW Falcon Rise Dr New dwelling area: square feet
City/State/ZIP: Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: Kienborts, Kristi L. 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*arc 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
DESCRIPTION OF WORK work indicated on this application.
PV ROOF MOUNT 3 KW Valuation: S
Existing building area: square feet
New building area: square feet
Ell PROPERTY OWNER ❑ TENANT Number of stories:
Name: Kienborts, Kristi L. Type of construction:
Address: 13150 SW Falcon Rise Dr Occupancy groups:
City/State/ZIP: Tigard OR 97223 Existing:
Phone:(503 ) 951 8047 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
me Business name:SOLAR CITY / rues,*glee rrt<�
Structural plan review fee(or deposit):
Contact name:MELISSA BENTLEY
FLS plan review fee(if applicable):
Address:6132 NE 1121H AVE
Total fees due upon application:
City/State/ZIP:PORTLAND OR 97220
Phone:(503)894 6903 I Fax::(1866)445-7459 Amount received:
F-mail:ABFNTLEYnSOLARCITY.COM PHOTOVOLTAIC SOI.AR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:SOLAR CITY Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:6132 NE 112x"AVE Solar Installation Specialty Code checklist.
City/State/ZIP:PORTLAND OR 97220 Permit Fee(includes plan review
S180.00
and administrative fees):
Phone:(503)894-6903 I Fax:(1866)445-7459
State surcharge(12%of permit fee): 521.60
CCB lie.: 180498
Total fee due upon application: $201.60
Authorized signature:I II
, ' This permit application expires if a permit is not obtained
•
within 180 days after it has been accepted as complete.
Print name:A. MELISSA TLE Date: 04/04/14
j *F methodology set by Tri-County Building Industry
Service ee Board.
I\Building\Permits\BUP-RESPermilApp.doc 02/24/2011 440-46131(11/02/COM/WEB)
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Electrical Permit Application FOR 01 1 11 1 I ■1 (IN I ,
City of Tigard Received gr i Permit No
13125 SW Hall Blvd.,Tigard,OR 97223 fiTil plan Rest
Phone: 503.718.2439 Fax 503. Dale/B3r; Other Permit:I I(i.N 1:a) Inspection Line: 503.639.4175 Date Rently/By: twit . 65 See Page 2 for
Internet: www.tigard-or.gov Notified/hActhod: Supplemental Information
TYPE OF 1ti'ORR 1 PLAN REVIEW
❑New construction ®Addition/alteration/re ' mitt) Please check all that apply(submit j sets of plans w/items checked below):
1 1^ ❑Service or feeder 400 amps or more ❑Building over three stories
❑Demolition ❑Other: \1190 s1 where the availabk faith current ❑Marinas and boatyards
CATEGORN OF cscocak 10,000 amps at 150 volts or ❑Floating buildngs.
less to ground.or exceeds 14,000 ❑Commercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of ISO KVA or
JOB $�l SITE INFORMATION AND LOCATION ❑Emergency system larger separately derived system.
❑Addition of new motor load of
❑..A. ..F._ ..t 2.. ..1_t..
Job no.: 9721880 l Job site address: 13150 SW Falcon Rise Dr St oP or more residential Recreational❑Six or more midential units. ❑Reereataonal vehicle parks.
City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal
Suite/bldg,/apt.no.: Project name: Kienborts, Kristi L. ❑Service or feeder 600 amps or more_
FEE SCHEDULE
Cross street/directions to job site: Desert Iisa
v.
Ql I
I Fee. I Rid i •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq ft.or less 168.54 4
Fa.add'l 500 sq.B.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.f1.)
PV ROOF MOUNT
Limited r sidentiiag(with above ft)
3KW � 75.00 2
Renewable Energy &<See Page 2
Services or feeders installation,alteration,and/or relocation
® PROPERTY (ANNEX i ❑ TENANT 200 amps or less 100 70 2
201 amps to 400 amps 133.56 2
Name: Kienborts. Kristi L. 401 amps to 600 amps 200.34 2
Address: '13150 SW Falcon Rise Dr 601 amps to 1,000 amps 30104 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard OR 97223 Temporary services or feeders installation,alteration,and/or
Phone:(503 ) 951 8047 Fax:( ) relocation
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,per panel
® APPLICANT I ® CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee. 7.42
Business name:SOLAR CiTY each branch circuit
B.Fee for branch circuits without
Contact name: MELISSA BENTLEY service or feeder fee,first
56.18 2
branch circuit _
Address:6132 NE 112TH AVE Each add'l branch circuit 7.42 2
City/State/ZIP:PORTLAND OR 97220 Miscellaneous(service or feeder not included)
Each manufactured or modular
Phone:(503)894-6903 l Fax::(1866)445-7459 dwelling,service and/or feeder 67 84 2
Reconnect only 67 84 2
E-mail:ABENTLEY®SOLARCITY.COM Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:SOLAR CiTY Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:6132 NE 112-111 AVE Each additional inspection over allowable in any of the above
City/State/ZlP:PORTLAND OR 97220 Additional inspection(I hr min) 66 25/hr
Investigation(1 hr min) 66.25/hr
Phone:(503)894-6903 l Fax:(188)445-7459 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90,00/hr
CCB Lie.: 180498 Electrical Lie.: C562 Suprv.Lie.: 5201S specifically listed('V,hr min)
EI.F:(TRI(:Al. PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: DEREK CROPP Date: 04/04/14 Plan review(25%of permit fee):
_ State surcharge(12%of permit fee):
Authorized signature: ' TOTAL PERMIT FEE:
, .
Print name: A. MELI A : t Date: 04/04/14 This permit application expires if a permit is not obtained within ISO
days after It has been accepted as complete.
• Number of inspections allowed per permit
I lauitding\PermasuELC PeenrlApp_ELR_ERE doe Rev 05/21/2013 440-46151(I I/OS/COM/WEIt
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESW NTIAL W +Q1 S . i1 F:s [i 1uA.lt
Fee for all residential systems combined575.00 tkscrfntw r Qtr. r Pee I..._Mal ( •
Renewable electrical energy systems:
Check Type of Work Involved: s kva ix less 1 100,70 $100.70 2
5 01 to 15 kva 133.56 2
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
n Burglar Alarm Wind generation systems in rims of 25 kve:
25.01 10 50 kva 301.04 2
I Garage Door Opener* 50.01 to 100 kva 552.26 2
`100 kva(fee in accordance with 552.36 3
❑ Heating, Ventilation and Air Conditioning OAR 918-309-0040)
,� Solar generation systems In excess of 25 kva:
System
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva no additional charge 0.(1 3
Each additional inspection over allowable in any of the above:
n Other: Each additional inspection is 6625/hr
charged at an hourly(1 hr min)
Inspections for which no fee is g0,tq/hr
specifically listed t:i hr min) r
GU�RCIAL WORK ONLY; 1LLCIRICAL, PERMIT KKE$?
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review.if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT PEE:
This permit application espires if a permit is not obtained within 180
ElAudio and Stereo Systems days after it has heen accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
Fl Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number ot'commercial systems:
*No licenses are required. Licenses are required
for all other installations
I11)uddingPenn its1iLC_Pnme App_LLK ERIi toe Rev C15/2I/2011
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13150 SW FALCON RISE DR, TIGARD, OR,
97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
May 1, 2014 at 11:11:59 AM
MST2014-00046
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13150 SW FALCON RISE DR, TIGARD, OR,
97223
Residential - Master Permit
199 Electrical final
PASS
May 1, 2014 at 11:13:00 AM
MST2014-00046
Jeff Grove
Violation Summary:
Inspector Contractor