Permit n CITY OF TIGARD MASTER PERMIT
''1 COMMUNITY DEVELOPMENT Permit#: MST2015-00127
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/27/2015
Parcel: 2S112CA12800
Jurisdiction: Tigard
Site address: 15610 SW 76TH AVE
Subdivision: RENAISSANCE WOODS NO.2 Lot: 52
Project: CHURCH
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: $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
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 addl 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:
CHURCH,HALEY E ELEMENTAL ENERGY LLC Required Items and Reports(Conditions)
15610 SW 76TH AVE 14500 SW 92ND AVE
TIGARD,OR 97224 TIGARD,OR 97224
PHONE. PHONE: 503-967-5786
FAX:
Total Fees: $355.19
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 i •. ce 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. • TENTION: • -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rule are set forth in OAR
952-•01-0010 through OA- 9 •01-•494. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987
Issu By: _.� I# Lam.&4.s.—_ Permittee Signature: ,ate'`
Call 503.639.4175 by 7:00 a.m.for the next available inspection`da e.
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.
BuildinE Permit Application
Residential V A FOR OFFICE USE ONLY' 'Received /)City of Tigard Date,B : ® Permit No.. a,, —
13125 SW Hall Blvd.-Tigard,OR ittetiN
23 Plan Review��
Phone: 503.718.2439 Fax: 503.598.1960 1 A 415 Date/B : ii`u II Other Permit:
T 1 G A R D Inspection Line: 03.63 84175 ,u� y�X Date Ready : i�r 6i! Pee Page 2 for
Internet: www.tigard-or gov Notified/Method: , /i y�Itrl.0 Su lemental Information
TYPE OF
sit:�• �`p{� 3%V 1J�O R •UIRED DATA:I-AND 2-FAMILY DWELLING •
❑New construction LI • olition Pe it 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. _
-and 2-family dwelling ❑Commercial/industrial Valuation: S
[I 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: f S C/ () S w -7-&-h New dwelling area: square feet
City/State/ZIP: en-3,;,..c{ t 0 i q 7 2 7'1 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: wt.js 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.
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.
kW Prescriptive Roof-Mounted Solar PV Installation Valuation: $
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Va.ley y ei ii rJ Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Elemental Energy,LLC (Pleusrrejerra fee schedule)
Structural plan review fee(or deposit):
Contact name: John Grieser
Address: 14500 SW 92nd Ave FLS plan review fee(if applicable):
City/State/ZIP: Tigard,OR 97224 Total fees due upon application:
Phone:( 503 )967-5786 Fax::( )
Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: john @elementalenergy.net
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: Elemental Energy, LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 14500 SW 92nd Ave Solar Installation Specialty Code checklist.
Tigard,PR 97224 Permit Fee(includes plan review
City/State/ZIP: 9 $180.00
and administrative fees):
Phone:(503 )967-5786 I Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 195141
Total fee due upon application: $201.60'
Authorized signature: /t/l/ A.---' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: John Grieser Date: *Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB)
r
i':lectrical Permit Application FOR OFFICE USE ONLY
• ivied
City of Tigard j� Pemm
• 13125rSW Hall lvd.,Tigard, 97223 ClJ ' f t/B : 7 1� ��T �IS —�j(U!'Z�
gar Plan Review
r 2 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I Ci A K D 141
Inspection Line: 503.639.4175 Date Ready/By: Juns: ® See Page 2 for
Internet: www.tlgard-or.gov l 4 7,,\! td,:-..=4?Noti tied/Method: j� Supplemental Information
TYPE OF WORK „l ll➢�`" � PLAN REVIEW
❑ NCw construction ❑Addition/alteration/repLa ►l Please check all that apply(submit 2 sets of plans w.-items checked below l:
>«i�151/4��1p1� ❑Service or feeder 100 amps or more ❑Building over three stories.
❑ Dcmoli m ❑Other: r 11iT r where the available fault current ❑Marinas and boatyards.
U J exceeds 10.000 amps at 150 volts or ❑Floating buildings.
CATEGORY OF CONSTRL ION P g
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
I-and 2-family(Ix elling ❑Commercial/industrial ❑ Accessory buil(lin= amps for all other installations. buildings.
❑Multi-family El Master builder ❑ Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION
0 Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","l-2","l-3",
Job no.: Job site address: / �y • / I OOor or more. R occupancy.Recreational�'rU��� L` 74� ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: C ❑Health-care facilities. ❑Supply voltage for more than
�/ GI l / , ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: rt' Prroject name: ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qtr. 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.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
kW Prescriptive Roof-Mounted Solar PV Installation residential(with above sq.f.) -
- - -- Renewable Energy ® 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: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1.000 amps 301.04 2
Over L000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 5936 I
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
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,
Business name: Elemental Energy, LLC each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name: John Grieser service or feeder fee,first 56.18 2
branch circuit
Address: 14500 SW 92nd Ave Each add'I branch circuit 7.42 2
City/State/ZIP: Tigard,OR 97224
Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
Phone:(503 )967-5786 Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: john @elemetalenergy.net Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Alameda Eletric Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: 3415 NE 44th Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP:Portland,OR 97213 Investigation(1 hr min) 66.25/hr
Phone:(503 )319-2192 Fax:( ) Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: C923 Electrical Lic.: 199188 Suprv.Lic.: 3133S specifically listed('4 hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required C Subtotal
Print name: Ernest Singer Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
L\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 05/21/2013 440.461 ST(II/05/COM/WEB
i
.•
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 1 Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 1 133.56 2
❑ Audio and Stereo Systems* 1501 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm
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
El Heating, Ventilation and Air Conditioning OAR 918-309-0040) 552.26 2
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
n Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
111 Other: Each additional inspection is 66.25/hr
charged at an hourly Ii hr min)
Inspections for which no fee is 9000/hr
specifically listed('z 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
I.\Building\Permits\ELC_PermnApp_ELR_ERE.doe Rev 05/21/2013
I
City of Tigard RECEIVED
Building Division
= 13125 SW Hall Blvd,Tigard, OR 97223 JUL 1 4 2015
Phone: 503.718.2439 Fax: 503.598.1960
T I G A R 17 Inspection Line: 503.639.4175 CITYOFTIGARD
www.tigard-or.gov BUILDING DIVISION
2010 Oregon Solar Installation Specialty Code
Check List for Prescriptive Installation of Roof-Mounted
PhotoVoltaic Solar Panel System
Property Information
Installation Address: I S&I v S 44t A-02—
_
City: 9 po-A Zip:
Owner's Name: Jp S ( ► ,n Date: - / /
Contractor's Name: Elemental Energy, LLC CCB #: 195141
Design Parameters of the Property/Structure
If"Yes", does not
Is the installation qualify for the
Flood Hazard Yes
Located in a flood ❑ prescriptive path, follow
Area plain/flood way? gi No OSSC or ORSC for
design requirements.
Wind Exposure Is the wind exposure Yes If"Yes", qualities for
"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 g Yes the prescriptive path.
and/or their accessory
Ground structures. ❑ No
Snow Load Is the Ground Snow
Installations on all Load 50 psf or less?
If"Yes", qualifies for
structures other than ❑ Yes the prescriptive path.
above
❑ No
1:/Building/Forms/PhotoVoltaic-Checkl ist.docx
Is the construction
material wood and does Yes
Type of the construction qualify If"Yes", qualifies for
Construction El No the prescriptive path.
as"conventional light
frame"construction?
Is the spacing 24 inches
or less?
If"Yes", qualifies for
Pre-engineered trusses. j' Yes the prescriptive path.
❑ No
Roof framing
members Is the spacing 24 inches
or less?
Nominal lumber. If"Yes", qualities for
n Yes the prescriptive path.
n 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.
tEr of composition
shingle.
Is the roof mounted Yes
Connections of solar assembly If"Yes", qualifies for
the solar assembly connected to roof No
framing blockin ❑ the prescriptive path.
to the roof g or g
directly?
2
1:/Building/Forms/PhotoVoltaic-Checklist.docx
Is the gauge 26 or less? Yes If"Yes", qualifies for
❑ 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,
IA— inches qualifies for the
Y •• prescriptive path.
Minimum #10 at 24
inches o/c?
Size and spacing of If"Yes", qualifies for
fastener? l Yes the prescriptive path.
No
Is the roof decking of
WSP min. %z"thickness, ❑ Yes
decking connected to If"Yes", qualities 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 321, Yes the prescriptive path.
surface. ❑ No
3
I:/Building/Fors/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 1 1 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 1 1 inches.
PV Modules
Manufacturer: Co•tA a ck-k G w■ 3o l�I
Model Number: C S C12 - 2 Co O
Listing Agency: UL
4
1:iBuilding/Forms/PhotoVoltaic-Checklist.docx
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
15610 SW 76TH AVE, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00127
Chip Barnett
Violation Summary:
Inspector Contractor