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Permit
IIIII v CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2015-00026 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/25/2015 TIC;r\Rp g Parcel: 2S110BD01500 Jurisdiction: TIGARD Site address: 14680 SW 117TH PL Subdivision: SHADOW HILLS Lot: 6 Project: ANNENBERG Project Description: Installation of 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 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 Fume100K: 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.'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: ANNENBERG,ROBERT F SUNRUN INSTALLATION SERVICES INC Required Items and Reports(Conditions) 11430 SW PINTAIL LOOP 3360 SE 20TH AVE BEAVERTON,OR 97007 PORTLAND,OR 97202 PHONE: PHONE: 503-501-6377 FAX: Total Fees: $356.19 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 rh_rul s or direct questions to OUNC by calling(/5003.232.1987 or 1.800.�3322.2�3�44. Issued By:. Permittee Signature: '�\/`� z/VC/L_-_ Ca . 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 FOR OFFICE USE ONLY Irri Received City of Tigard CEwE, DateB : �„ Permit No.: STav/s- 0. " 13125 SW Hall Blvd.,Tigard,OR 972.,11 G G Plan Review Phone: 503.718.2439 Fax: 503.598.1 ►.i DateB : 40n�a IMO Other Permit Inspection Line: 503.639.4175 FEB g 2a15 Date Reap Elf See Page 2 for TIGARD Internet: www.tigard-or.gov GD J Notified/Method: / �� r Supplemental Information Aer TYPE OF WO niviSIQN REQUIRED DATA:1-AND 2-FAMILY DWELLING pi fILDING Permit fees*are based on the value of the work performed. ❑New construction emolition 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 Valuation: $ ❑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:Milt SW19111ttintuttabrilD. j Ll6gO .Li) //7 PL.,_ New dwelling area: square feet City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: g401 0,) bf,2d 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. Installation of a 9.88KW solar photovoltaic system Valuation: S Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Robert Annenberg Type of construction: Address:Same as jobsite Occupancy groups: City/State/ZIP:" Existing: Phone:(503)747-7724 Fax:( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:Sunrun Installation Services Inc. (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:Evan Fessler FLS plan review fee(if applicable): Address:3380 SE 204 AVE Total fees due upon application: City/State/ZIP:Portland,OR 97202 Phone:(503)880-3549 Fax::( ) _ __.–e**-- Amount received: E-mail:evan.fessler�`sunrunhome.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name:Sunrun Installation Services Inc. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:same as above Solar Installation Specialty Code checklist. City/State/ZIP:" Permit Fee(includes plan review S180.00 and administrative fees): Phone:(") Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.:180464 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained ..A._.....„.._____72.. ..)›..4„,..._ within 180 days after it has been accepted as complete. Print name:Evan Fessler Date:2/20/15 *Fee methodology set by Tri-County Building Industry Service Board. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB) 4:55-6 - r Building Permit Application Residential FOR OFFICE USE ONLY Received City of Tigard Reece/Hived:: o, k„ Permit No.. �l �aiUlS—r- " 13125 SW Hall Blvd.,Tigard,OR 972ECE►V ED Plan Review-r-519101� Other Permit: Phone: 503.718.2439 Fax: 503.598.1 a Date/S : �!/� Inspection Line: 503.639.4175 Date Re-. ��1H See Page 2 for TIGARD Internet: www.tigard-or.gov FEB 2 3 2015 Notified/Method: � Supplemental Information s ' ■ - � 'ice Permit fees*are based on the value of the work performed. ❑New construction • demolition Indicate the value(rounded to the nearest dollar)of all ®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the „ ,_. CATS RY Olt CONSTRUL7 i work indicated on this application. ®1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 1:3 Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: b ' Total number of floors: ,,,0'4": 1 w70 sw iii Muw . 14Iipg6 Qo-�cx� //7 pt� Job site address: New dwelling area: square feet City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:60r ''Aw f tiJ £ift er, Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:CJOI AL-USA CHECKLIST Subdivision: I I.ot no.: Permit fees*are 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. Installation of a 9.88KW solar photovoltaic system Valuation: $ Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER 1 ❑ TENANT Number of stories: Name:Robert Annenberg Type of construction: Address:Same as jobsite Occupancy groups: City/State/ZIP:" Existing: Phone:(503)747-7724 Fax:( ) New: © APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* eese refer Business name:Sunrun Installation Services Inc. � �fte wheal* Structural plan review fee(or deposit): Contact name:Evan Fessler FLS plan review fee(if applicable): Address:3380 SE 206 AVE City/State/ZIP:Portland,OR 97202 Total fees due upon application: Amount received: Phone:(503)880-3549 Fax::( ) 1 E-mail:evan.fessler(nirsunrunhome.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name:Sunrun Installation Services Inc. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:same as above Solar Installation Specialty Code checklist. City/State/ZIP:" Permit Fee(includes plan review $180.00 and administrative fees): Phone:(") Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 180464 Total fee due upon application: $201.60 Authorized signature: ( F This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Evan Fessler Date:2/20/15 *Fee methodology set by Tri-County Building Industry Service Board. l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) �/s�� - , Electrical Permit Application I.OR()FFi( l,: I tit.0vI.1 City of Tigard RECEIV „c;y 05 /5-- (.... .1). Permit No.:�L�i ,/6-- 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review r Phone' 503.718.2439 Fax 503 598.1960 FEB 2 3 2C 15ate/By: Other Permit: T I c i A R I1 Inspection Line: 503.639.4175 ate Ready/By: ' Juris ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WOR1I UILDING DIVISION PLAN REVIEW Please check all that apply(submit 2 sets of plans w/items checked below) ❑New construction pp Addition/alteration/replacement ❑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 'l-2","1-3", 100HP or more. occupancy. r 1• Ul t>~ i 0 Six or more residential units. ❑Recreational vehicle parks. \ I} 1 1 t a I��O� // F!' {JL• ❑Health-care facilities. ❑Supply voltage for more than b CJV-� ! r ❑Hazardous locations. 600 volts nominal. -- "��. D2 9 7 7�1 ❑Service or feeder 600 amps or more. / G' FEE SCHEDULE Cross street/directions to job site: Description l Qiy. L Fee. I Total I Subdivision: Lot no.: 168.54 4 Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion 33.92 I Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) - • Limited energy,multi-family I I .V6 KV) c J io l -,L residential(with above sq.ft.) 75.00 2 Pt Renewable Energy ❑ S5skv'" ❑ PROPERTY OWNER I ❑ TENANT 100.70 2 201 amps to 400 amps 100.76 2 Name: Rae,rk t_ti ti>c.A)1..c...? 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2�� ,�6 5t Over 1,000 amps or volts 552.26 Owner installation:This installation is being made on property that I own which is not - intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Owner signature: Date: Branch circuits—new,alteration,or extension,per panel ❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7 42 2 Business name: H rCdV� ti 5 11 t Sr f v‘(-E- ��c each branch circuit B.Fee for branch circuits without Contact name: ` .‘j-- 7 c 1 C` service or feeder fee,first 56.18 2 E branch circuit Address: ` n 1 l 33(6O SE ,vim £ Each add'I branch circuit 7.42 2 KJ`I PL1�C 1 0 „ J{o). Each manufactured or modular 67.84 2 Phone:(W)) % O _ ' 5L \ Fax::( ) dwelling,service and/or feeder rr Reconnect only 67.84 2 E-mail: {VuV� 4 . -c$S 1C J`® 5 &.,,NAv,LA".--1_r CJv" Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: SC.t.\ntv\.. 1, ,t,. TJ.n S..eN∎ce5 �• Signal circuit(s)or limited-energy See panel,alteration,or extension. - Page 2 2 Address: M„c._ u5 c4,\,,JVc, 66.25/hr Investigation(1 hr min) 66.25/hr Phone:( ) 4000 — 3 SLA 9 Fax:( ) Industrial plant(1 hr min) 78.18/hr { � Inspections for which no fee is 90.00/hr CCB Lie.: i<'(�L4bl.i Electrical Lie.: [L4 ) Suprv.Lie.:y 1 I?—5 specifically listed('/z hr min) . ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: , ,,,_,,,,, :,--/- Print name: S S f U e4,„, Date: 1.1.'6 ) i 5 Plan review(25%of permit fee): Authorized signature: 10 —T-f TOTAL PERMIT FEE: CC� Date: Print name: 1 This permit application expires if a permit is not obtained within 180 �vG� rS5 le�` C+( () f S days after it has been accepted as complete. Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 0521/2013 440-461571 I 1/05/COM/WEB 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 Qty. I Fee I Total I Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 • ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 El 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 918-309-0040) System* Solar generation systems in excess of 25 kva: Each additional kva 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 at an hourly(I hr min) 66.25/hr 1 Inspections for which no fee is 90.00/hr specifically listed('/:hr min) COMMERCIAL WORK ONLY: ELECTRICAL 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 PERMIT FEE: This permit application expires if a permit is not obtained within 180 ❑ 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 ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 City of Tigard RECEIVED FEB 2 3 2015 q Building Division • C CITY OF TIGARD 13125 SW Hall Blvd,Tigard,OR 97223 BUILDING DIVISION Phone: 503.718.2439 Fax: 503.598.1960 TIGARD Inspection Line: 503.639.4175 www.tigard-or.gov 2010 Oregon Solar Installation Specialty Code Check List for Prescriptive Installation of Roof-Mounted PhotoVoltaic Solar Panel System Property Information Installation Address: 1 R /I/6, gp /17�°' Pt City: Portland Zip: 97224 Owner's Name: Robert Annenberg Date: 2120/15 Contractor's Name: Sunrun Installation Services CCB #: 180464 Inc. Design Parameters of the Property/Structure If"Yes", does not Flood Hazard Is the installation El Yes qualify for the Area Located in a flood prescriptive path, follow plain/flood way? ® No OSSC or ORSC for design requirements. Is the wind exposure ® Yes If"Yes", qualifies for Wind Exposure "C"or less? ❑ No the prescriptive path. Installations on detached Is the Ground Snow single/two-family Load 70 psf or less? dwelling/single/two- If"Yes", qualifies for family townhomes ® Yes the prescriptive path. and/or their accessory Ground structures. ❑ No Snow Load Is the Ground Snow Load 50 psf or less? Installations on all If"Yes",qualifies for structures other than ® Yes the prescriptive path. above ❑ No 1 I:Building/Forms/PhotoVoltaic-Checklist.docx Is the construction material wood and does Yes Type of the construction qualify If"Yes", qualifies for Construction ❑ No the prescriptive path. as"conventional light frame"construction? Is the spacing 24 inches or less? Pre-engineered trusses. ® Yes If"Yes", qualifies for the prescriptive path. ❑ No Roof framing members Is the spacing 24 inches or less? Nominal lumber. ❑ If"Yes",qualifies for Yes the prescriptive path. ❑ No Is the combined weight ® Yes of the PV modules and If"Yes", qualifies for racking less than or ❑ No the prescriptive path. Solar equal to 4.5 psf? installation Is the solar installation layout in accordance Yes If"Yes", qualifies for with Section 305.4(3) of ❑ No the prescriptive path. the 2010 Oregon Solar Code? ❑ Metal Single layer If roofing material is Roofing Check the type of ❑ of wood one of the three types material roofing material shingle/shake checked, qualifies for Max. two layers the prescriptive path. ® of composition shingle. Is the roof mounted ® Yes Connections of solar assembly If"Yes", qualifies for the solar assembly connected to roof ❑ No the prescriptive path. to the roof framing or blocking directly? 2 I:Building/Forms/PhotoVoltaic-Checklist.docx } ❑ Yes If"Yes", qualifies for Is the gauge 26 or less? ❑ No the prescriptive path. 115 lbs for 60 inch spacing or less? If"Yes", qualifies for ❑ Yes the prescriptive path. ❑ No Minimum Uplift rating of Clamps? 75 lbs for 48 inches spacing or less? If"Yes",qualifies for ❑ Yes the prescriptive path. ❑ No Attachment of roof mounted Minimum 24 inches If the spacing falls solar systems Spacing of clamps? within 24 inches and 60 directly to inches Maximum 60 inches inches, qualifies for the standing seam prescriptive path. metal panels Width of roofing If the width of the panel panels? 18 inches or less is less than 18 inches, inches qualifies for the prescriptive path. Minimum#10 at 24 inches o/c? Size and spacing of If"Yes",qualifies for fastener? ❑ Yes the prescriptive path. ❑ No Is the roof decking of WSP min. '/2"thickness, ❑ Yes decking connected to If"Yes", qualifies for framing members ❑ No the prescriptive path. w/min. 8d nails @ 6"/12"o/c? Is the height less than or Maximum 18 inches equal to 18 inches? Height of the from the top of the If"Yes", qualifies for solar modules module to the roof ® Yes the prescriptive path. surface. ❑ No 3 I:Building/Forms/PhotoVoltaic-Checklist.docx Submittal Documents required for Prescriptive Installations Show the location of the PV system in relation to buildings, structures, property lines, and, as applicable, flood hazard areas. Site Plan Details must be clear and easy to read. Minimum size of the plan is 8.5 x 11 inches. Attach a simple structural plan showing the roof framing(rafter size, type, and spacing)and PV module system racking attachment. System must be shown in sufficient detail and clarity to assess whether it Structural Plan meets the prescriptive construction requirements as listed earlier above in the matrix. Minimum size of the plan is 8.5 x 11 inches. PV Modules Manufacturer: REC Solar Model Number: REC 260 PE (BLK) Listing Agency: UL 4 I:Building/Forms/PhotoVoltaic-Checklist.docx -- .,. 6sA 6 _ . ' • Certificate of Comp-lance - - - ......Certificate: 2096477 ' : ' ..• : ' . -! • - ' .. :: . ...111iiter Contract: • . 173688 - ' • -: : ' ..,.. : .....:-. Project : : .26'82842 .. -... -*.-• .: . : ' ... :-: . r- : ,- :': --... . .. -.- Date Issue* ' - -. :* November 28,2013 : . . . .• Issued to ,* :. Power-One,Inc'. .*-. *:. • ' . . , .. :- . * ' . .. ' , * . . : * : r ... ..,. . - .1 1 ..-.• I , . . ....` .. . . .. ,. 3201lE Harbour bir''. . .-- 2 . ... : . -. z:. ...... . ...':. -: ...-.. ,..-....... -........: .- r 'z: .. - :". . z. ..'.;.:-' -: .•:, •-:::-.::..z:'I : -phoenix,AZ 85034,:. -.- ;.- .':: . -: :- -.- . •-:. :r..,' :'.-' -: .-... ;'. ' . . :-. 1: . '..: ': .• -':. . ::'-'-..: --.;-.: .1 :'' USA ' . .:l''- ... ...'-- ' ' T-- :. '- *-:' ... - -:* ---• ').* '.'....'......*:'.:: -:,..--.-:::-;'::'.-.,....:-.:-:: .."' -- • --. -:. ' --.:. ''.- -'-''.--.;*::••: r:.--! . . • ' , * - . * : Attention: Mr.Robert White ,.-:.::•...:.*:':::':--.' :.. ':-•"...••*::':. • '"1-1.:-.;* ....-::..-:;.`:::-''''-: .'*:';::-J.'''. :1 ' / The products listed below are eligible to bear the CSA Mark shown with adjacent indicators 'C'-and 'US'for Canada and US or with adjacent indicator 'US'for US only or without either indicator for Canada only. C16-Heill4P14°Cki Issued by: Rob I-Iempstock,AScT. C°4Y) g 1 1 C US PRODUCTS CLASS 5311 09 -POWER SUPPLIES-Distributed Generation Power Systems Equipment CLASS 5311 89 7 POWER StIPPLIES.-Distributed Generation-Power SYstems:Equiptnetit. . •- , . - .:*. -.. . , :. ,. . Utility Interactive Inverter,Model Pvi-4.2-otim-us;Pvir1.8-OUTD7US;.PVI-3.6-60TD-US,PVI3.07 . . . . . OUTD-US;PVI-4.2-OUTD-S,US,PVI-3.8-ouTps-us,pvt-3.6-OUTD:-.S-US,PVI-3:0-OUTD-S-US, PVI-4.2-OUTD.,S-US-A,PVI-3.8-OUTD-S-US7A,PVI-3.6-OUTD-S-US-A,PVI-3.0-OUTD-S-US-A,PVI-4.2- OUTD7US-W,PVI-3.8-OUTD-US-W, PVI73.-60UTD7US-W and PVI-3.07OUTD-US-W;provided with two DC input channels, permanently connected i - .-* • * i : .: .. • - -. Notes: 1. All above models in this series may include expansion board with wireless antennae option and will be identified with model designation including"7-Z"suffix. 2. For details related to ratings,reference should be made to the CSA Certification Record,Appendix 1 or the Descriptive Report. .. DQD 507 Rev.2012-05-22 Page:I CSA Group. Certificate: :.26964:77 Master.COntract t 7368$ ' �::�: .' • Project 2682842 Date Issued- November:28,2013 .: APPLICABLE REQUIREMENTS `; CSA-C22,2 No 1071 01 : General Use Power Supplies *UL Std14 t741 Second Edition Inverters,Convertors,Controllers alid In►terconneet s. for Use With Distributed Energy Resources(lanuary 28;2010) em Egettpment n UL.1:6991 ofinvestigation for Photovoltaic(PV)DC Arc-.Fault Circuit Protection(Issue Nurhber 2, January 14, 2013). :. CSA TIL M-07 - Interim Certification Requirements for Photovoltaic(PV)DC Arc-Fault Protection(Issue Number 1, March 11,2013) *Note: Conformity to UL 1741-Second Edition(January 28, 2010)includes compliance with applicable requirements ofIEEE 1547 and IEEE 1547.1 • • • DQD 507 Rev.2012-05-22 Page:2 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 14680 SW 117TH PL, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - No C of O MST2015-00026 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 14680 SW 117TH PL, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical final PASS MST2015-00026 Jeff Grove Violation Summary: Inspector Contractor