Permit IN CITY OF TIGARD MASTER PERMIT
I COMMUNITY DEVELOPMENT Permit#: MST2014-00106
Date Issued: 07/15/2014
T[G AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 134CA00530
Jurisdiction: Tigard
Site address: 11665 SW MANZANITA ST
Subdivision: PANORAMA NO.2 Lot: 36
Project: Trombley
Project Description: Installation of solar photovoltaic system.
BUILDING
Floor Areas Required Setbacks Required
Stones: 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: $5,750.00 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
Furn<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!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:
ALT SF VB R-3 0
Owner: Contractor:
TROMBLEY,ALESYA SERGEEVNA SOLARCITY CORPORATION Required Items and Reports(Conditions)
8745 SW MAVEREICK TER#604 6132 NE 112TH AVE
BEAVERTON,OR 97008 PORTLAND,OR 97220
PHONE: 503-729-3033 PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $359.19
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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By r - Pecmittee Signature:
3 P
r
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
i OR 01 I II 11 `,I 11\; Y
Received
111 City of Tigard n�! � � ����
• 13125 SW Hall Blvd.,Tigard,OR 9 Dateiv : /U :
IN Plan Re ' tti-
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : , tit•• Other Permit:
I I \1 I, Inspection Line: 503.639.4175 O14 Dale Rcady: : J tuns: 0 See Page 2 for
Internet: www.tigard-or.gov _, 3 Notificd/Method: - q ' , Supplemental information
TYPE OF W� �""AA"D REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 45dN ,��� 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.
® 1-and 2-family dwelling ❑Commercial/industrial I Valuation: S 5750
❑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: 11665 Sw Manzanita St New dwelling area: square feet
City/Slate/ZIP: Tigard/OR/97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Trombley 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: Lot no.: Permit fees*arc 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 5.75Kw Valuation: S
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Alesya Trombley Type of construction:
Address: 11665 Sw Manzanita St Occupancy groups:
City/State/ZIP: Tigard/OR/97223
Phone: 503 729-3033 Existing:
( ) Fax:( ) New: ---I
® APPLICANT ® CONTACT PERSON PERMIT PERMIT FEES*
Business name:SOLAR CITY
(Please refer p�fnracAravla/i)
Structural plan review fcc(or deposit):
Contact name:MELISSA BENTLEY
Address:6132 NE 1127"AVE KS plan review fee(if applicable):
City/State/ZIP:PORTLAND OR 97220 total fees due upon application:
Phone:(503)894 6903 Fax::(1866)445-7459 Amount received: f
F-mail:ABENTLEY@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
and lire 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 S180.00
and administrative feesL
Phone:(503)894-6903 Fax:(1866)445-7459
State surcharge(12%of permit fee): $2 .60
CCB lie.: 180498
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
Iwithin 180 days after it has been accepted as complete.
i Print name:A. MELISSA IiEN'1'LEY Date: 6/2 5/14 I *Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPcrrnitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
I
. lectrical Permit Application FOR OFFICE USE ONLY
` City of Tigard ■ ('EtVFD hate 2, , �M Permit No.: y! w �0`6
13125 SW Hall Blvd.,Tigard,OR ''"4 t Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.5':.l :t • Date/B
11 G A R l) Inspection Line: 503.639.4175 JUN 3 0 2014 Date Ready/By: kids. Ri See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WOIIIIIMIIIIIIMIIIIIIIIIIIIIII PLAN REVIEW
El New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current ❑Marinas 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
® 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.:9721939 Job site address: 11665 Sw Manzanita St IOOHPormore. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard/OR/97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Trombley ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qn. 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
Ea.Will 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
5.75Kw Roof Mount PV system residential(with above sq.ft.)
Renewable Energy 1ll1 See Page 2
Services or feeders installation,alteration,and/or relocation
® PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:Alesya Trombley 401 amps to 600 amps 200.34 2
Address: 11665 Sw Manzanita St 601 amps to 1,000 amps 301.04 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)729-3033 Fax:( ) relocation
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. 401 amps to 599 amps 168.54 2
Owner signature: Date:_ _ Branch circuits—new,alteration,or extension,per panel _
❑ APPLICANT ® CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name:SolarCity Corporation 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 67.84 2
Phone:(503)894-6903 Fax: :(1-866)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:SolarCity Corporation 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(1 hr min) 66.25/hr
City/State/ZIP:Portland/OR/97220 Investigation(1 hr min) 66.25/hr
Phone:(503)894-6903 Fax:(1-866)445-7459 Industrial plant(1 hr min) 78.18/hr _
� Inspections for which no fee is 90.00/hr
CCB Lic.: 180498 Electrical Lic.: C562 pry Lic,;�587d39'glad)?� specifically listed('/hr min) _
Suprv.Electrician signature,required: kil IN ELECTRICAL PERMIT FEES
p � e9 Subtotal:
Print name: Nick Armstrong Date:G i/> Plan review(25%of permit fee):T
'I State surcharge(12%of permit fee):_
Authorized signature: TOTAL PERMIT FEE:
Print name: G�y Davis Date: b( I1 '1 f,'' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Number of inspections allowed per permit.
I\Building\Permits\ELC_PermitApp_EIR_ERE.doc Rev 05/21/2013 440-4615T(I I/05/COM/WEB
4
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
•
Fee for all residential systems combined $75.00 Description I city. f Fee i Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva X 133.56 133.56 2
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
ElAlarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with
OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
El
Systems* >100 kva-no additional charge 0.0 3
❑ Each additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr I
Inspections for which no fee is 90.00/hr
s. cifcall listed '/2 hr min
COMMERCIAL WORK ONLY 3 ' t
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 permit is not obtained within 180
Eland Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11665 SW MANZANITA ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
July 24, 2014 at 12:27:16 PM
MST2014-00106
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11665 SW MANZANITA ST, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
MST2014-00106
Jeff Grove
Violation Summary:
Inspector Contractor