Permit CITY OF TIGARD MASTER PERMIT
_ •n COMMUNITY DEVELOPMENT Permit#: MST2014-00081
Date Issued: 06/05/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111CD08100
Jurisdiction: Tigard
Site address: 15855 SW SERENA CT
Subdivision: KERWOOD ESTATES Lot: 6
Project: Kirkham
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 $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 0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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 add9 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:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 0
Owner: Contractor:
KIRKHAM,DANIEL L SOLARCITY CORPORATION Required Items and Reports(Conditions)
15855 SW SERENA CT 6132 NE 112TH AVE
TIGARD,OR 97224 PORTLAND,OR 97220
PHONE: 503-829-2404 PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $361.19
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-o 00. 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 v/1 / {, � Permittee Signature: /1�� �pPL i('ff�O�
Y
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.
• -J
Building Permit Application RECEIVED
Residential I ,,I. mil( I 1 ,i ,,,,I 1
City of Tigard MAY 2 7 2014rigla .
13125 SW Hall Blvd.,Tigard.OR 972 a�� �
r. Phone: 503.718.2439 Fax: 503.598.I TY OF TIGARD �i)►'►_I-,VRIE Other Permit
Inspection Line: 503.639.4175 lase - : . IM B See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION "fie
sdhod: l.r r..�t..
drh
TYPE OP WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New cansur c ion ❑Demolition Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
IN 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 El Commercial/industrial Valuation: S 5,610
❑Accessory building ❑Multi-family
Number of bedrooms:
❑Master builder ❑Other. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
lob site address: 15855 SW Serena Ct, New dwelling area: square feet
City/State2lP: Tigard OR 97224 Garage/carport area: square feet
Suite/bldgJapt.no.: I Project name: Kirkham, Daniel Covered porch area: square feet
Cross streeUdirections 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.
PV ROOF MOUNT 5.61 KW Valuation: S
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TF.NAP1 T Number of stories:
Name: Kirkham, Daniel Type of construction:
Address: 15855 SW Serena Ct, Occupancy groups:
City/State/ZIP:Tigard OR 97224 Existing:
Phone:( 503) 829 2404 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:SOLAR CITY / �"��
Contact name:MELISSA BENTLEY Structural plan review fcc(or deposit):
112TH FLS plan review fee(if applicable):
Address:6132 NE 112 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:ABENTI,EY(a�SOLARCITY.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:SOLAR CITY Submit two(2)sets of roof plan with connection details
Address:6132 NE 112TH 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 5180.00
and administrative fees):
Phone:(503)894-6903 I Fax:(1866)445-7459
State surcharge(12%of permit fee): $21.60
CCB tic.: 180498 `` Total fee due upon application: $201.60
Authorized signature:11 I • This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
IPrint name:A. MELISSA TLE Date: 05/23/2014 I *Fee methodology set by Tri-County Building Indu
Service Board. 1"---<0-1)
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I
' RECEIVED
Electrical Permit Application I Olt t l l I I( I I -.I (lN 1 )
City of Tigard MAY 2 7 2014 Received •i.�' �,r} .
IPII DateIB : �� �, Permit NO,f7 o/`/_(J••,
13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
Phone: 503 718.2439 Fax 503.59x",1 Y OF TIGARD Date/B : Other Permit:
Inspection Line: 503.639.4175 l 11 I Date Ready/By: turfs la See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: /t_ Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ®addition/alteration/replacement Please check all that apply(submit I,sets of plans w/i ems checked below):
El Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Balding over three stories.
where the available fault canon ❑Marinas and boatyards.
CATEGORY OF coromucnom cKCOCds 10,000 amps at ISO volts or ❑Floating buildings.
0 I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
less to ground,or installations.1 ns. ❑Commercial-use agricultural
rY 8 amps for all other instalWion:. baildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump ❑Installation of 150 KvA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger rely derived system.
❑Addition of new motor load of ❑ A. E .-1-2","1-3",
Job no.: 9721972 Job site address: IOOHP or more. occupancy.
9 15855 SW Serena Ct, ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: Tigard OR 97224 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal
Suite/bldg./apt.no.: Project name: Kirkham, Daniel ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: oesrrwr I Qt,. I Fee. I rat 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
Ea add-1500 sq.fL or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
73.00 2
DESCRIPTION OF WORK (with above sq.fl.)
Limited energy,multi-family
PV ROOF MOUNT 5.61 KW residential(with above sq 0) 75-00 2
Renewable Energy . 1"See Page 2
Services or feeders installation.alteration,and/or relocation
® PROPERTY OWNER I ❑ TENANT 200 amps or less ' 100.70 2
201 amps to 400 amps 133.56 2
Name: Kirkham, Daniel 401 amps to 600 arras 200.34 2
Address: 15855 SW Serena Ct, 601 amps to 1,000 amps 30104 2
Over 1.000 amps or volts 552.26 2
City/State/ZIP:Tigard OR 97224 Temporary services or feeders installation,alteration,and/or
Phone:(503 ) 829 2402 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 amts 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 _
0 APPLICANT I 0 CONTACT PERSON A.Fee for brands 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
56.11 2
- branch circuit
Address:6132 NE 112111 AVE Each add'I branch circuit 7.42 _ 2
City/State/ZIP:PORTLAND OR 97220
Miscellaneous(service or feeder not inducted)
Each manufactured or modular 6781 2
Phone:(503)894-6903 Fax::(1866)445-7459 dwelling,service and/or feeder
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 112TH AVE Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 6625/hr
City/State/ZIP:PORTLAND OR 97220 Investigation(I hr min) 66.25/hr
Phone:(503)894-6903 I Fax:(188)445-7459 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 180498 I Electrical Lic.: C562 Suprv.Lie.: 5201S specifically hr
fically listed(14 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
1
Print name: DEREK CROPP Date: 05/23/2014 Plan review(25%of permit fee):
_ Stale surcharge(12%of permit f e):
Authorized signature: TOTAL PERMIT FEE:
� This permit application expires if a permit is oat.btained within 180
Print name: A. MELT A : . T Date: 05/23/2014 days after It las been accepted as c.mphte.
• Number of inspections allowed per permit.
1.1 BuildineermnsIEL(_PeramApp_ELR_ERE doc Rev 05/21/2013 440-4615T(1 Uo5/COM/WEH
M�iL �'.,1/T -� S'
•
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
IMN IAL`W Q :.: .:
Fee for all residential systems combined........ $75.00 Dow lipass 1 Q. I Fee t Trial i
Renewable electrical energy systems:
Check Type of Work Involved: s kva«less 100.70 2
5 DI to 15 kva 1 133.56 $133.56 2
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301 04 2
I I Garage Door Opener* 50.01 to 100 kva 552.26 2
100 kva(fce in accordance with 55226 2
❑ Heating, Ventilation and Air Conditioning OAR 918-309-0(140)
System* Solar generation systems In excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >IDOIva no additional charge 0.O 3
Each additional inspection over allowable in any of the above:
I Other: Each additional inspection is 66 25/hr
charged at an hourly(1 hr nm)
inspections for which no fee is
90.no!
specifically listed t!5 hr min)
tb1010.0Ati;#sOtoat Q Ii :' `::`;'::-::.: `: E LECIIUCAL 'PEWIT fEES
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 FEE:
This permit application expires if a perish is not obtained within 1811
❑ Audio and Stereo Systems days after it has been accepted as complete.
• Nurnber of inspections allowed per permit
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ I-1VAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I\melding J'crn'niELC_ee.me App_LLR_hRE doC Rr a5/2I 2nt]
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
15855 SW SERENA CT, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2014-00081
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
15855 SW SERENA CT, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
PASS
MST2014-00081
Jeff Grove
Violation Summary:
Inspector Contractor