Permit (131) CITY OF TIGARD MASTER PERMIT
111 I ' COMMUNITY DEVELOPMENT Permit#: MST2019-00376
-FIG A R f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2019
Parcel: 1 S 133DD 10800
Jurisdiction:
Site address: 11958 SW 125TH CT
Subdivision: Lot: 145
Project: Anderson
Project Description: Solar photovoltaic.
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: $2,000.00 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
Other Fixtures: 0
Drywell-Trench Drain: 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: 0 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: Y Other Description: Solar PV System Roof Top 11.16 kW 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:
JESSICA ANDERSON PRO STAT SERVICES LLC Required Items and Reports(Conditions)
11958 SW 125TH C1' 8122 NE 91ST STREET
TIGARD,OR 97223 VANCOUVER,WA 98662
PHONE: 570-778-9051 PHONE: 360-521-5742
FAX: 360-859-3749
Total Fees: $367.19
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 re. 'es you t. follow thy les adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 1.01 i(0. You mabt rules or direct questions to OUNC by calling 503.232.1987 or 00.332.2344.
f , e � �s
//
Issued By: i , Permittee Signature: `%/!Y� /
Call 503.639.41 •by r:10 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 t SE O\I.,
City of Tigard Received r i
DateBy: --1 ID. l i" ST Permit No.ky)(a_ )cACt-6,,:s
]A
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: I .2 l.. /kik Other Permit:
l 1 c;A 1:t) Inspection Line: 503.639.4175 Date Ready/13y: 41+ Juris: See Page 2 for
Internet: www.tigard-or.gov ...C fied/M- ...: , '� /fVJI l ®Supplemental Information
L
-i Ii i : ;, t' t ° *I I f � :
❑New construction 0 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:SOLAR equipment,materials,labor,overhead,and the profit for the
* � � work indicated on this application. up
;
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ DOQ -
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
. %,.! +�< ,.' .,, 'i Total number of floors:
Job site address:11958 SW 125th Ct,Tigard,OR 97223 New dwelling area: square feet
City/State/ZIP: Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:ANDERSON Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
_ D4TA ,a t, t 3 ai<`s C cam"?E
Subdivision: 1 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
• i + work indicated on this application.
SOLAR PV INSTALLATION Valuation: $
11.16 kW Existing building area: square feet
New building area: square feet
�� r, .. . �. . >� .r. . - , V ,.. Number of stories:
Name:ANDERSON,JESSICA Type of construction:
Address:11958 SW 125th Ct,Tigard,OR 97223 Occupancy groups:
City/State/ZIP:11958 SW 125th Ct,Tigard,OR 97223 Existing:
Phone:(570)778-9051 Fax:( ) New: �y}
.:','''',0,-;02''a-k,,?'-n'''',,.,,,.;.r. '►'''', 3, ., r.' eF r= �`'3 � .t `pct f ►,n+'l+ 1 ! ` '+: s
Business name:PROSTAT ELECTRIC ;`
Structural plan review fee(or deposit):
Contact name:DALE KRUEGER
FLS plan review fee(if applicable):
Address:1721 NE 64THAVE
City/State/ZIP:VANCOUVER,WA 98661 Total fees due upon application:
- - —_
_�. _ -- - -__—.__._ _,— _.___.._.__..---- �...___ _ — _ -- .._ . .__Amountreceived:
P'tione:(503)539-7772 Fax::( )
E-mail:dale.krueger@comcast net ` 4e * *
', a ,,€ a� r s�' as a''
Commercial and residential prescriptive installation of
- ,...yr>' roof-top mounted Photo Voltaic Solar Panel System.
Business name:PROSTAT ELECTRIC Submit two(2)sets of roof plan with connection details
64TH and fire department access,along with the 2010 Oregon
Address:1721 NE AVE
City/State/ZIP:VANCOUVER,WA 98661
Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)539-7772 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:189902
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:DALE KRUEGER Date:9/17/19 *Fee methodology set by Tri County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
' Electrical Permit Application FOR 01 FILE I SF, Oy1.1
City of Tigard ReceivedIZIIIPIZNMJEEIIIII
III q 13125 SW Hall Blvd.,Tigard,OR 97223 Plane Review
Phone: 503.718.2439 Fax: 503.598.1;960; ;- e., -`; Date/B : Related Permit#:
Inspection Line: 503.639.4175 .' ' c Ready Date/By: Juris: H See Page 2 for
TI G A P.D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ®Other:SOLAR 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CTE ,, 13 S v # , « exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
r l* A N9 A 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:11958 SW 125th Ct,Tigard,OR 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:ANDERSON,JESSICA 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
Description �� f Qty. 1 Each I' Total 1
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'1500 sq.ft.or portion 33.92 1
"� - �`-. � .r. "` • r.= Limited energy,residential
SOLAR PV INSTALLATION (with above sq.ft.) 75'00 2
Limited energy,multi-family
11.16 kW residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
_,� : -_m. �� ..° ' ' - • i, Services or feeders installation,alteration,and/or relocation
Name:ANDERSON,JESSICA 200 amps or less 100.70 2
Address:11958 SW 125th Ct,Tigard,OR 97223 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:(570)778-9051 I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
, t ,� A� �� ti Branch circuits—new,alteration,or extension,per panel
�``° "`� �, '. � � A.Fee for branch circuits with
Business name:PROSTAT ELECTRIC above service or feeder fee, 7.42 2
each branch circuit
Contact name:DALE KRUEGER B.Fee for branch circuits without
service or feeder fee,first
Address:1721 NE 64TH AVE branch circuit 56.18 2
City/State/ZIP:VANCOUVER,WA 98661 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)539-7772 I Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:dale.krueger@comcast.net Reconnect
Pump or irrigation circle 67.84 2
- _ � _ _ � _-- .
_ ._- _ — _ - _ " w2-7 -
Address: 1721 NE 64TH AVE Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:VANCOUVER,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)539-7772 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:dale.krueger@comcast.net Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
ectficall fisted A hr mm 90.00/hr
usp
CCB Lic.: 189902 Electrical Lic.: C597 S
prv.Lic.: 22755 .�
Suprv.Electrician signature,required: h.' � : Subtotal: 133.56
Print name: BRUCE LEIBY Date: 9/17/19 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 16.03
Authorized signature: \} 14r�r11. TOTAL PERMIT FEE: 149.59
""� This permit application expires if a permit is not obtained within 180
Print name: DALE KR GER Date: 9/17/19 days after it has been accepted as complete.
$ Number of inspections allowed per permit.
I:\Building\Permits1ELC_PermitApp ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
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 = Description 1 QtyEach -r Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 1 133.56 133.56 2
❑ Audio and Stereo Systems* 15.01 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 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
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
66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90,00/hr
seecifcalli listed c(2hr mm)
Fee for each commercial system: $75.00Subtotal(Enter on Page 1): 133.56
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ 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\Rennits\ELC_PennitApp_ELR ERE doe Rev 06/17/2015
City of Tigard
N Building Division
,11111. 13125 SW Hall Blvd,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960
Inspection Line: 503.639.4175
TIGARD .�. .. .. ,
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: l`( 7 a S.4) 1'2 C'S"
City: '-ck , 04g72'L.3 Zip: `
`r�
Owner's Name: ,s2,�..lya�v�- Date: 1f (1
Contractor's Name: pms i t c c( CCB #: L q,0+L—
Design Parameters of the Property/Structure
If"Yes", does not
Flood Hazard Is the installation ❑ Yes qualify for the
Area Located in a flood prescriptive path, follow
plain/flood way? cgrNo OSSC or ORSC for
design requirements.
cgT
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
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 0 Yes the prescriptive path.
above
❑ No
1
I:Building/Forms/Photo V oltaic-Checklisto2-o 1-11.docx
Is the construction
material wood and does Yes
Type of If"Yes", qualifies for
Construction the construction qualify
as conventional light ❑ No the prescriptive path.
frame"construction?
Is the spacing 24 inches
or less?
Pre-engineered trusses. n Yes If"Yes",qualifies for
the prescriptive path.
❑ No
Roof framing
members Is the spacing 24 inches
or less?
If"Yes",qualifies for
Nominal lluAmber. pit Yes the prescriptive path.
No
Is the combined weight pc Yes
of the PV modules and If"Yes", qualifies for
racking less than or 0 No the prescriptive path.
Solar equal to 4.5 psf?
installation Is the solar installation
layout in accordance Yes
with Section 305.4(3)of If"Yes", qualifies for
the 2010 Oregon Solar ❑ No the prescriptive path.
Code?
0 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.
shingle.
Is the roof mounted ;g1 Yes
Connections of solar assembly If"Yes", qualifies for
the solar assembly connected to roof 0 No
to the roof framing or blocking the prescriptive path.
directly?
2
I:Building/Forms/PhotoVoltaic-Checklist02-01-11.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,
IN??
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.
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/Photo Voltaic-Checklist02-01-1 l.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: t
Model Number: SCA (0
Listing Agency:
4
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