Permit CITY OF TIGARD MASTER PERMIT
� � N
It COMMUNITY DEVELOPMENT Permit#: MST2014-00180
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/23/2014
Parcel: 2S104DA03700
Jurisdiction: Tigard
Site address: 12959 SW GALLIN CT
Subdivision: QUAIL HOLLOW-WEST Lot: 23
Project: Ma
Project Description: Install 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: $3,825.00 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
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,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:
LAU,JOHN CHUN YU SOLARCITY CORPORATION Required Items and Reports(Conditions)
MA,YILAM GINN 6132 NE 112TH AVE
15549 SW STONERIDGE CIR PORTLAND,OR 97220
BEAVERTON,OR 97007
PHONE: 971-998-2589 PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $319.38
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 through OAR 952-001-0090. You may obtain a opy of the rules irect questions to OUNC by calling •3.23 98 • 1.800.332.2344.
Issued By: ! !`.1<." Permittee Signature:
. 175 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 i,It , I I( I I •I
City of Tigard Recaive1 /v ► Pewit No.: L 'O
• nate�6 . ® /(il
13125 SW Hall Blvd.,Tigard.
14 plan R �. 1]
II
Phone: 503.718.2439 Fax: 503.59 .IQtjQ 2 0 2� Han it : O' �\ other palm-
I
,.I: Inspection Line: 503.639.4175 /kite Ready :y_ � )wn 0 See 2 for
Internet: www.tigard-or.gov V• " � ' Notit«�ettnd: (� }3 �c, Soppleweohl Ltormatioa
G, 11�//��°° ui eat 4(i,# "at fJ a
TYPE • •4 i,,;. \' REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction • Demolition Permit fees'are based on the value of the work performed.
®Addition/alteretion/replacement ❑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.
® I-and 2-family dwelling Valuation: S 3,825
y g ❑Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Ott: Number of bathrooms:
JOR errs INFORMATION AND LOCATION Total number of floors:
Job site address: 12959 SW Gallin Ct, New dwelling area: square feet
City/State/ZIP: Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: MA 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.
PV ROOF MOUNT 3.825 KW Valuation: S
Existing building area: square feet
New building area: square feet
® raorF.a7Y OWNER I ❑ TENANT Number of stories:
Name: MA, YILAM Type of construction:
Address: 12959 SW Gallin Ct,
Occupancy groups:
City/State/ZIP: Tigard OR 97223 Existing:
Phone:(971 ) 998 2589 Fax:( )
New:
® APPLICANT ® CONTACT PERSON BUILDING ruRMIT FEE$'
re A Business name:SOLAR CITY M '� **
Contact name:MELISSA BENTLEY Structural plan review fee(or deposit):
T" 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: —tf,
F.-mail:ABENTLEYQ SOLARCITY.COM �LTAIC>S�•�PANEL SYSTEIM 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 112T"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 SI80.00
and administrative fees):
Phone:(503)894-6903 I Fax:(1866)445-7459
State surcharge(12%of permit fee): $21.60
CCB lie.: 180498 .
Total fee due upon application: $201.60
I Authorized signaprrc:( t i 0 r This permit application expires if a permit is not obtained
I Service
within ISO days after it has been accepted as complete.metho
Print name:A. MELISSA TLE, I 10/16/14 I 'Fee doloBoard.gy set by Tri-County Building Industry
1:\Building\Permits\BUP-RESPermiIApp.doc 02/24/2011 440-4613T(11/02. OM/WEB)
I. •
Electrical Permit Applica ' M/----1-1 ,, ,I i I. 1 1 NI ,0 ,1 ,,
III
City of Tigard (* Pallid S D/ d
13125 SW Hall Blvd.,Tigard,OR 9 23 ti
Plan Review
Phonc: 503.718.2439 Fax: 503.598.IT 2 0 2O I� l)ate/B : Other Permit:
Inspection Line: 503.639.4175 r��qQ
Date Ready/By: Jude m See Page 2 for
Internet: www.tigard-or.gov ^��/(�11♦,a1111v Notified/Me hod: Supplemental Infarmedoa
TYPE O�V� n t' PK,AN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plea w/items checked below):
Demolition Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
❑ ❑ where the available fault current
0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps to ground.or installations.1 ns, ❑Commercial-use agricultural
rY g amps for an other imtallations. builditlga.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of ISO KVA or
JOB SITE INFORMATION AND LOCATION
13 Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A,"E', 1.2" l-3"
Job no.: 9722198 I Job site address: 12959 SW Gatlin Ct, 1ix or or more. Recreation.
❑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: MA ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: tlmreriptiaa I Qty. I Fee. I Tarr I •J
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1.000 sq.fl.or less 168.54 4
Ea add'I 500 sq.IL or portion 3192 1
Tax map/parcel no.:
Limited energy,residential
DESCRIPTION OF WORK (with above sq.fl.)
75.00 2
Limited energy,multi-family 75.00 2
PV ROOF MOUNT 3.825 KW residential(with above sq f1)
Renewable Energy leSes 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: MA. YILAM 401
amps to 600 amps 200.34 2
Address: •12959 SW Gallin Ct, 601 amps to 1,000 amps 301 04 2
Over 1.000 amps or volts 552.26 2
City/StateJZIP: Tigard OR 97223 Temporary services or feeders installation,alteration,and/or
Phone:( 971 )998-2589 Fax:( ) relocation
200 amps or less 59.36 I
Owner installation:This installation is being made on property that 1 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 ex_tension,per panel
® APPLICANT I ,_■ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee. 7.42 2
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 Eachadd'I 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 I Fax::(1866)445-7459 an
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail:ABENTLEYQSOLARC1TY.COM Pump or irrigation circk 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
City/State/ZIP:PORTLAND OR 97220 Additional inspection(I hr min) 66.25/hr
Investigation(1 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 90,00/hr
CCB Lic.: 180498 Electrical Lic.: C562 Suprv.Lic.: 52015 specifically listed 04 hr min) _
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: DEREK CROPP Date: 10/16/14 Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
Print name: A. MELT A : p t Date:
This permit application expires if a permit is not obtained within 180
�i 10/16/14 days after It bra bees accepted as complete.
• Number of inspections allowed per permit.
11B uildireamiaeEl.C_PaaraApp_ELR_ERE doe Rey OS/2 1/2013 440.46151(11/03,COMRVEB
a
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
sc#0.0tE
Fee for all residential systems combined575.00 oe,crrnlr:a I QsY I Fea I rw 1•
Renewable electrical energy systems:
Check Type of Work Involved: 5 Icvu or less 1 100.70 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems*
15.01 to 25 less 200.34 2
❑ Burglar Alarm 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 552.26 2
❑ Heating,Ventilation and Air Conditioning OAR 91 8-309-0040)
System* Solar generation systems In excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 ivrt 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(I hr min) /hr 1
Inspections for which no fee is
90.00/hr
specifically listed(:S hr min)
COMMERCIAL WORK. +Y.
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review.if required(25%of permit fec):
Slate surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This pre d i application expires if a perish Is sot obtained within ISO
❑ Audio and 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
El Nurse Calls
[Ti Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 with terrius ELC_PnmiApp_ELIt l-RIi doc Res,0.5/21/2013
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
12959 SW GALLIN CT, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2014-00180
Chip Barnett
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
12959 SW GALLIN CT, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
MST2014-00180
Chip Barnett
Violation Summary:
Inspector Contractor