Permit III I. CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2015-00012
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/05/2015
T t t,t\Ft i� g Parcel: 2S103BA00114
Jurisdiction: Tigard
Site address: 11825 SW ANN ST
Subdivision: LERON HEIGHTS Lot: 14
Project: Eastman
Project Description: Installation of residential 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: $4,500.00 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
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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 Tema 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:
EASTMAN,DAVID G SOLARCITY CORPORATION Required Items and Reports(Conditions)
11825 SW ANN ST 6132 NE 112TH AVE
TIGARD,OR 97223 PORTLAND,OR 97220
PHONE: 503-747-8027 PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $321.88
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 opted 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 ruli+�y=questions to OUNC by calling 503 'f. 1• 1.800.332.2344.
Issued By: — -..im�i-' _ - •- ittee Signa • '
Call 503.639.41 1 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion. - •ject.
Approved plans are required on the job site at the time of each inspection.
l
Building Permit Application
Residential ir11ZOI I I( I I ',I trNI1
City of Tigard RECEIVED D / 84, , Permit No.: b` l5"-_,066
• 13125 SW Hall Blvd.,Tigard,OR 9 Ras Review
Phone: 503.718.2439 Fax: 503. 6 2015 paserg : A 1 Omer Permit:
i i Inspection Line: 503.639.4175 Data R- •"-• 5 Pars: 5 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD r L. .: ! ,. s :,AI s.tmple.a.latLar..ian
BUIW1NG DIVISION_ iiic,.,v,; /het,3 . i-c"it.f..4
TYPE OF WORK REQUZD DATA:I-AND 2-FAMILY DM K
❑New construction ❑Demolition 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 coloRtrum work indicated on this application.
® I-and 2-family dwelling ❑Commerciabindustriat Valuation: S 4,500
❑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: 11825 SW Ann St, New dwelling area: square feet
City/State/ZIP: Tigard OR 97223 Garage/carport area: square feet
Suite/bldgJapt.no.: I Project name: Eastman, David Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CCIU.IST
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 Valuation: S
4.3 KW Existing building area: square feet
PRESCRIPTIVE New building area: square feet
lI PROPERTY OWNER I 0 TENANT Number of stories:
Name: Eastman, David Type of construction:
Address:11825 SW Ann St, Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing:
PhonO:(503) 747 8027 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES"
r*near Business name:SOLAR CITY M � i0
Contact name:MELISSA BENTLEY Structural plan review fee(or deposit):
Address:6132 NE 112TH AVE FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP:PORTLAND OR 97220
Phone:(503)894 6903 I Fax::(1866)445-7459
Amount received:
E-mail:ABENTLEY@SOLARCITY.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES'
1�9'OR 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:,( . 0 Tills permit application expires ifs permit is not obtained
ai within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry 14 Print name:A. MELISSA • " TLE Date: 1.22.15 I Service Board.
l:\Building\Permils\BUP-RESPermiiApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling you (ii'Fici•: USE OM.1'
City of Tigard Received
Dardny: Permit No.:
1111 * 13125 SW I hill Blvd.,'Tigard,OR 97223 Associated txnnits
-M Phone: 503.718.2439 Fax 503.598.1964
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ !lambing U Mechanical
Internet: www.tigard-or.gov ❑ other:
THE FOLLOWINC ITEMS ARE REQUIRED FOR PLAN REVIEW 1es no N/%,
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ in
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district.etc. ❑ ❑ ❑
3 Vera fication.of approved plat/lot. ❑ ❑ n
4 Fire district approval required. Name ofdistrict: . 0 ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ' ❑ 0—'
6 Sewer permit. Q ❑ U
7 Water district approval. f ❑ 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. LT Q ILI
9 Erosion control D plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 ❑
basin protection.etc_
10 3 Complete sets of legible plans. Must he drawn to scale.showing conformance to applicable local and state ❑ ❑ 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
I I Site/plot plan drawn to scale. The plan must show lot and building setback dimensions:property corner elevations(if ❑ 0 ❑
there is more than a 4-R.elevation differential,plan must show contour lines at 2-it.intervals);location of easements
and driveway; footprint of structure(including decks):location of wells/septic systems;utility locations;direction
indicator:lot area building coverage urea;percentage of coverage:impervious area;existing structures on site:and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details;vent size ❑ ❑ 1 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size, location of smoke detectors,water heater, C ❑ ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑
floor,wall construction,roof construction. More than one cross section may he required to clearly portray
construction. Show details of all wall and roof sheathing,roofing.roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation.etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ T j] ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations:fo-non- ❑ ❑ ❑
prescriptive path analysisprovide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing.spacing,and bearing 0 ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems,see item 22."Engineer's calculations."
I9 Beans calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and/or any beam/joist carry a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e..shear wall,rool'truss)shall be stamped by an engineer or 0 ❑ ❑
architect licensed in Ore on and shall be shown to be a licable to the project under review.
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x I I"or 11"x 17". ❑ ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 []
25 Building plans shall not contain red lines or tape-ons. "Mirrored"buildingj,lans will not be accepted. ❑ n ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. , ❑ 0 ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ Li 0�
Street'Free list,
29 Site plan to include trees and tree protection measures as required by conditions of approval. Trcc locations,driplines, ❑ ❑ 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9. 1995.
I:U 3uildingl Perm iis1BUP-RESPennitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WttR)
Electrical Permit Application 1 4,R 01 I I( 1 1 "I (11l 1
City of Tigard RECEIVED �.:�s _ ,,�Receimd
13125 SW Hall Blvd.,Tigard,OR 97223 pyn Review
Phone: 503.718.2439 Fax: 503.5 1 6 2015 DatdB : OtlrorPermit:
Irtspoction Line: 503.639.4175 v n Date Ready/By: ii B See Page 2 fir
Internet, www.tigard-ar.gov CITY OF TIGARJ) N01ifiedlMdhod:
Supplemental Information
TYJBINMSi DIVISION PLAN ItRVIEW
❑New construction ®Addition/alteration/replacement Please check all thole apply(wit I sets of plans w/rtems chedred below):
❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available melt current ❑Marinas and boatyards.
CATEGORY OF f<ONITIM1CTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building snips ground,e exceeds oas. 0 ❑bummercial-mse agricukmaat
amps for all other iruatallaticros. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB WIZ INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A"."E" "1-2","1-3»
Job no.: 9722384 I Job site address: 11825 SW Ann St, 10014P«more. occupancy.Six«more residential wits. ❑Recreational vehicle parks.
City/State/ZIP: Tigard OR 97223 ❑Health-cars facilities. ❑Supply voltage for more than
❑Hamden locations. 600 volts nominal.
Suite/bldgJapt.no.: Project name: Eastman,David ❑Service or feeder 600 amps or more.
PIE SCHEDULE
Cross street/directions to job site: Deserltism 1 Qty. I Fa. I Tarr I •
New residential single-or multi-family dwelling unit.
lnclrades attacbed garage.
Subdivision: I Lot no.: 1,000 sq.R.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential
2
DESCRIPTION OF WORK (with above sq.ft.) 75.00
Limited energy,multi-family 75.00 2
PV ROOF MOUNT residential(with above sq ft.)
Renewable Energy ® See Page 2
4.3 KW Services or feeders installation,alteration,and/or relocation
El PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
Nome: Eastman, 201 amps to 400 amps 133.56 2
, David
401 amps to 600 amps 200.34 2
Address: 11825 SW Ann 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) 747 8027 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 to400 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
® APPWCMIT I ® CONTACT PEON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name:SOLAR CITY CORP each branch circuit
B.Fee for branch circuits without
Contact name:A. MELISSA BENTLEY service or feeder fee,first 56.18 2
branch circuit
Address:6132 NE 112111 AVE Each add',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::(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 CORP. Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:6132 NE 112TM AVE Each additional inspection over allowable in any of the above
City/State/ZIP:PORTLAND OR 97220 Additional inspection(t hr min) 66.25 hr
Investigation(I hr min) 66.25/hr
Phone:(503)894 6903 Fax:(1866)445 7459 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 180498 Electrical Lie.: C562 Suprv.Lic.: 5873S specifically listed(14 hr min)
ELECTRICAL PERMIT WEIS
Suprv.Electrician signature,required: Subtotal:
Print name: NICHOLAS ARMSTRONG Date: 1.22.15 Plan review(25%of pennit fee):
- - State surcharge(12`%0 of permit fee):
Authorized signature: / or, TOTAL PERMIT FEE:
Print name: A. MELISSA BENTLEY Date: This permit application expires if a permit Is net obtained within 180
1.2 2.15 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I\BuildiaaVamit ELC_PvsApp_ELR ERE doe Rey On 1/2013 440-461 ST(I INS/COMlw6B
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
K) 3[AE TIALWOVC=ONLY s #igU[Ji.g
Fee for g_U residential systems combined ... $75.00 oereriadoa I a+r,1 Pet I Total
Renewable ckctrical energy systems:
Check Type of Work Involved: 5 kva or hams 1 10D70 100.70 2
3.01 le 15 kva 133.56 2
❑ Audio and Stereo Systems*
15 01 to2skva 20o-34 2
IllAlarm Wird generation systems in excess of25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 55126 2
X100 kva(fee in accordance with
❑ Heating,Ventilation and Air Conditioning
OAR 918-309-0040)
SS?26 2
System* Solar generation systems in excess of 25 kva:
Each additional kvu over 25 7.42 3
❑ Vacuum 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 of an hourly(I hr min) 66.25/hr
Inspections for which no fee is 90 00/hr
specifically listed(Y2 hr min)
COMMERCIAL.:WORKOMNI CAL PERMIT.':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 PERMrr :
mts permit application expires if permit is not obtained within 150
❑ Audio and Stereo Systems days after it has been accepted as coarpkte.
• 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'Buildidel'amoc\ELC PcondApp ELR ERE.doc Roy 0921/2013
CITY OF TIGARD FEE AND PAYMENT HISTORY
114 i a il 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
MST2015-00012 - 11825 SW ANN ST, TIGARD, OR 97223
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
Solar Photovoltaic System 230-0000-43104 $180.00 $180.00 $180.00
Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $7.50 $7.50 $7.50
11x17)
12%State Surcharge-Building 100-0000-24001 $21.60 $21.60 $21.60
5 kva or less 220-0000-43103 $100.70 $100.70 $100.70
12%State Surcharge-Electrical 100-0000-24001 $12.08 $12.08 $12.08
Totals for Fees $321.88 $321.88 $0.00 $321.88
Receipt# Payment Method Check# Pavor: Receipt Date Receipt Amount
Total Payments: $0.00
Balance Due: $321.8