Permit CITY OF TIGARD MASTER PERMIT
N
COMMUNITY DEVELOPMENT Permit#: MST2014-00189
T[GA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2014
Parcel: 2S103CC07300
Jurisdiction: Tigard
Site address: 13620 SW 124TH AVE
Subdivision: WHISTLER'S WALK Lot: 20
Project: WEIBY
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: $7,140.00 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 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
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:
WEIBY,MICHAEL C SOLARCITY CORPORATION Required Items and Reports(Conditions)
13620 SW 124TH AVE 6132 NE 112TH AVE
TIGARD,OR 97223 PORTLAND,OR 97220
PHONE: PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $366.19
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 ugh OAR 952-001-0090. You may obtain a co s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. c-
Issued By: eat. _ _, ■ , Permittee Signature:
rrr0!9.4175 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 1 1( 1'. ( SE o1L'
City of Tigard Rome/tied.ee'v� Penn"No.:
•J g �1��filil Date/B , • �_ I—d I ,L• 13125 SW I tall Blvd,Tigard,OR 9722 Cr� Plan Review (►' �
■ Phone: 503.718 2439 Fax' 503.598.19 ��/ Date/B : ts�=i ��il_= Other Permit
I GARD Inspection Line: 503.639.4175 r-.te•- ® Page 2 for
Internet: www.tigard-or.gov 2114 Notifted/Method: 0 ` I fhamM Supplemental Information
aG123 1 i' • • . AL•
TYPE OF WORK QQ.���Jj Oc�iVh REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Delndlilidn TAVIS101i Permit fees*arc based on the value of the work performed.
,dt� tN0 fl Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑(1 ��`" equipment,materials,labor,overhead,and the profit for the
CATEGORY OF C'ONST'RUCTION
work indicated on this application.
® I-and 2-family dwelling ❑Commercial/industrial Valuation: 5 7,140
❑Accessory building ❑Multi-family
Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LO('ATION Total number of floors:
Job site address: 13620 SW 124th Ave, New dwelling arca: square feet
City/State/ZIP: Tigard OR 97223 Garage/carport arca: square feet
Suite/bldg./apt.no.: I Project name: Kumano, Fumie 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.
fax 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 Valuation: S
Existing building area: square feet
New building area: square feet
® PROPER'l'1 OWNER ❑ TENANT Number of stories:
Name: Kumano, Fumie Type of construction:
Address: 13620 SW 124th Ave, Occupancy groups:
City/State/ZIP: Tigard OR 97223 Existing:
Phone:(503 ) 329-2498 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:SOLAR CITY (Please refer le fee schedule)
Structural plan review fcc(or deposit):
Contact name:MELISSA BENTLEY
FLS plan review fee(if applicable):
Address:6132 NE 112TH AVE
City/StatefZIP:PORTLAND OR 97220 Total fees due upon application:
Phone:(503)894 6903 I Fax::(1866)445-7459
Amount received:
F-mail:ABENTLFY(a�SOLARCITY.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic 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 112TH AVE Solar Installation Specialty Code checklist.
City/State/LI P:PORTLAND OR 97220 Permit Fee(includes plan review $180.00
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: 1 t4 ' , 1 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
I *Fcc methodology set by Tri-County Building Industry
Print name:A. MELISSA ; " TLEY Date: 10/23/14 I Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440.46131(1 I/02/COM/WEB)
o
9 •
Electrical Permit Applicati '�C, FOR OFFICE ('SE ONI.\'
City of Tigard ���� _ .�:,
13125 SW Hall Blvd.,Tigard,OR 97223 t+` Cxhcr permit
Phone: 503.718.2439 Fax: 503.598.1960 0 c
Inspection Line: 503.639.4175 `��� teri, to See Page 2 for
Internet: www.ligard-or.gov A�� . A�1,� 65 Seemental information
TYPE OF WO id0 )7111��, PLAN REVIEW
❑New construction IN Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiitems checked below):
❑Service or feeder 400 amps or more ❑Budding 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.
Ices to ground,or exceeds 14,000 ❑Commercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations buildings
❑ Mulli-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 K VA or
JOB SITE INF'ORMA'TION AND LOCATION El Emergency system larger separately derived system
❑Addition of new motor load of ❑"A "F.","I-2 'l-3",
1
Job no.: 9722239 Job site address: 13620 SW 124th Ave, r or more ores. occupancy
r
❑Si Six or mo residential units. ❑Recreational vehicle parks
City/State/ZIP: Tigard OR 97223 ❑Health-care facilities. ❑Supply vohage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: Kumano, Fumie ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Descrh,tia.
I Qty. I Fee. 1 TeUI
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 14
Ea.add'I 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
PV ROOF MOUNT residential(with above sq Il.) 2
Renewable Energy El See Pale 2
Services or feeders installation,alteration,and/or relocation_
® PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
Name: Kumano, Fumie 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Address: 13620 SW 124th Ave, 601 amps to 1,000 amps 301.04 2
Over 1.000 atnpa or volts 552.26 2
City/State/ZIP:Tigard OR 97223 Temporary services or feeders installation,alteration,and/or
Phone:(503 ) 329 2498 Fax:( 1 relocation
200 amps or less 59.36 I
Owner installation:This installation is being made on property that I own which is not Y01 amps to 400 amps 125.48 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 0 CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42
Business name:SOLAR CITY CORP each branch circuit
13.Fcc for branch circuits without
Contact name:A. MELISSA BENTLEY service or feeder fee,first 56 18 2
branch circuit
Address:6132 NE 112"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 F'ax: :(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 CORP. 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(I hr min) 66.25/hr
Phone:(503)894 6903 I Fax:(1866)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.: 5873S specifically listed(h hr min)
EI.ECTRI(AI. PERMIT FEES
Suprv.Electrician signature,required: Subtotal: !i
— -
Print name: NICHOLAS ARMSTRONG Date: 10/23/14 Plan review(25% permit fee):
— State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is net obtained within 180
Print name: A. MELISSA BENTLEY 7 Date: 10/23/14 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I\auilding\Pamiti ELC Permi(App_FJ.R ERE doe Row 05/21/2013 440.461 ST(I IrtSiCOMAVEH
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Fee for all residential systems combined $75.00 o'rx;ipti. • I ov.1 ree r Toad •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or luss 100.7D 2
5.01 le 15 kva 1 133-56 133.56 2
0 Audio and Stereo Systems*
15.0110 25 kva 20034 2
Wird generation systems in excess of 25 kva:
Li Burglar Alarm
25.01 to 50 kva 301.04 2•
[1 Garage Door Opener* 50.01 to 100 kva 552_26 2
>100 kva(fee in accordance with
552.26 2
OAR 918-309-0040)
D Heating, Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
-
11 Vacuum Systems* >100 kva no additional charge 0.0 3
Each additional inneclion over allowable in any of the above:
0 Other: Each additional inspection is
66.25/hr 1
charged at en hourly(1 hr min)
Inspections for which no fee is
90001 hr
specifically fasted hr
Fee for wit commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review.if required(25%of persnit Tee):
State surcharge(12%of permit lea):
Check Type of Work Involved: TOTAL PERMIT PEE:
This permit application expires if a permit is sot obtained"Ws 110
ElAudio and Stereo Systems days after it has been accepted as conapkte.
• Number of inspect ions allowed per permit.
El Boiler Controls
El Clock Systems
fl Data Telecommunication Installation
0 Fire Alarm Installation
• HVAC
• Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
Medical
El Nurse Calls
El Outdoor Landscape Lighting*
fl Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
Muildimerennis\ELC I'crmitApp ELK EKE doe Rev 05/Z1/2013