The URL can be used to link to this page

Permit City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Request for Permit Action TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 . 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division MAY 2 8 2020 13125 SW Hall Blvd.,Tigard,OR 97223 .7;11.1 y OF I tGARD Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPRey/ m r N FROM: Owner x❑ Applicant ❑ Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) TESLA -7 Mailing Address: 6132 NE 112TH AVE City/State/Zip: PORTLAND OR 97220 Phone No.: 971 271 0577 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ❑ CANCEL/VOID PERMIT APPLICATION. X REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). Permit#: / S7 2&O —t. JCS$3 Site Address or Parcel#: 10504 SW Naeve St,Tigard,OR 97224,US Project Name: ANN TRAN Subdivision Name: Eri L/,(S /-iZ13* Lot #: y EXPLANATION: DOWNSIZED SIZE Signature: Date: 05.28.20 Print Name: A. ELISSA FARIAS Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. ;3 1 6 r)3 !04 .70 12- 32 f, f- 3,9S _ 3( C/ FOR OFFICE USE ONLY Route to Sys Admin: Date$ By ,9 Route to Records: Date /7 2-/ B l Refund Processed: Date / z/ Bye° Invoice Processed: Date By Permit Canceled: Date/1/ By Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_120518.doc Ill q TIGARD City of Tigard August 13,2021 Tesla Energy 6132 NE 112th Ave Tigard, OR 97223 Re: Permit No. MST2020-00083 Dear Applicant: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 10504 SW Naeve St Project Name: Tran Job No.: N/A Refund: ® Check#240260 in the amount of$36.81. ❑ Credit card"return" receipt in the amount of$ . ❑ Trust account"deposit"receipt in the amount of$ . Notes: Reduced scope of work resulted in overpayment of permit fees;refund difference. If you have any questions please contact me at 503.718.2430. Sincerely, ,&i t{(3.4---P-,-Q._- _4—--) Dianna Ornelas Building Division Services Coordinator Enc. I:\Building\Refunds43dh sAWniL fi&Y4eri ayIlg%fl4s,Qregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov " City of Tigard T I G A RD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Tesla Energy DATE: 8/10/2021 6132 NE 112th Ave Tigard, OR 97223 REQUESTED BY: Dianna Ornelas TRANSACTION INFORMATION: Receipt#: 428593 Case#: MST2020-00083 Date: 3/11/2020 Address/Parcel: 10504 SW Naeve St Pay Method: CreditCard Project Name: Tran EXPLANATION: Change in scope of work resulted in reduced permit fees. Refund overpayment amount. i REFUND INFO KMA'I ION. _. F p Es"V( 1." ' F tw�. .,.� �. .�,.ee nI�rom Rtcei v e Aceor7�,t J 0, i e.fund w lm(.1,tin t Cash Over 100-0000-48001 $36.81 TOTAL REFUND: $36.81 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff If under$12,500 Division Manager K 604/1.tpfa.-,i If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: 5'//>/2j Bti>: 42/) I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD RECEIPT 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Tran Site Address: 10504 SW NAEVE ST 4 Receipt Number: 435813 - 08/13/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2020-00083 $-36.81 Total: $-36.81 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 240260 DHOWSE 08/13/2021 $-36.81 Payor: Tesla Energy Total Payments: $-36.81 Balance Due: $36.81 Page 1 of 1 CITY OF TIGARD RECEIPT 11111 al 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 i I GARI) Project Name: Tran Site Address: 10504 SW NAEVE ST /1— ikS--Tb Receipt Number: 428593 - 03/11/2020 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2020-00083 Solar Photovoltaic System 230-0000-43104 $180.00 MST2020-00083 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $5.00 11x17) MST2020-00083 12% State Surcharge-Building 100-0000-24001 $21.60 MST2020-00083 Misc Administration Fee 230-0000-45319 $5.00 M5T2020-00083 5 kva or less 220-0000-43103 $100.70 MST2020-00083 12% State Surcharge-Electrical 100-0000-24001 $12.08 MST2020-00083 Cash Over 100-0000-48001 $36.81 t- Total: $361.19 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 6159440 PUBLICUSER107 03/11/2020 $361.19 Payor: Total Payments: $361.19 Balance Due: $0.00 Page 1 of 1 II � q IICITY OF TIGARD RECEIPT 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Tran Site Address: 10504 SW NAEVE ST 0 I� C e(tNi Al--c - Receipt Number: 428593 - 03/11/2020 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2020-00083 Solar Photovoltaic System 230-0000-43104 $180.00 MST2020-00083 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $5.00 11x17) MST2020-00083 12% State Surcharge-Building 100-0000-24001 $21.60 MST2020-00083 5.01 to 15 kva 220-0000-43103 $133.56 MST2020-00083 12% State Surcharge-Electrical 100-0000-24001 $16.03 MST2020-00083 Misc Administration Fee 230-0000-45319 $5.00 Total: $361.19 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 6159440 PUBLICUSER107 03/11/2020 $361.19 Payor: Total Payments: $361.19 Balance Due: $0.00 III I. CITY OF TIGARD MASTER PERMIT I I. COMMUNITY DEVELOPMENT Permit#: MST2020-00083 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/11/2020 Parcel: 2S110DA05400 Jurisdiction: Tigard Site address: 10504 SW NAEVE ST Subdivision: ERICKSON HEIGHTS Lot: 15 Project: Tran 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: $5,000.00 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 Drywall-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum>=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 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. Y Other Description: Roof top PV system 7.56 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: VO,TRUNG TUYEN TESLA ENERGY Required Items and Reports(Conditions) TRAN,ANN 6132 NE 112TH AVE 10504 SW NEAVE ST PORTLAND,OR 97220 TIGARD,OR 97224 PHONE: PHONE: 503-894-6903 FAX: 866-445-7459 Total Fees: $361.19 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 la requires you to •low the rul adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OA -0 -0090. Yo ay•'l; ules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: - �/ / / / -ermittee Signature: (CinC.. c/,// L'CG Call 503.6 .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 FOR OFFICE USE ONLY City of Tigard RECEIVED RReeceivved 3 111 _-° 13125 SW Hall Blvd.,Tigard,OR 97223 y: 5 ,�v v' 'd9 7�, .0 j �Ap Phone: 503.718.2439 Fax: 503598.196IMAR �� Date/By:PlanRevrew 3 I Ii2/7) 1 Other Permit: TIGARD Inspection Line: 503.639.4175 _Y' ✓�t"� Date Ready/By: hms. ® See Page 2 for Internet: www.tigard-or.gov CITY OF q��t1SiD Naeified,Meth - Supplemental Information TYPE OF WORK Ali` t) fill, r �t`ATA: 1-AND 2-FAMILY DWELLING a it�� 10 �.r t!I 1 ❑New construction ❑Demolition Permit fees*are horsed on the value of the work performed Indicate the value(rounded to the nearest dollar)of all N Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ 5000 I-and 2-family dwelling IIICommercial/industrial ElAccessory building El Multi-familyNumber of bedrooms: ❑Master builder El Other. Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 10504 SW Naeve St, New dwelling area: square feet City/State/ZIP: Tigard,OR 97224,US Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Ann Tran Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area. square feet REQUED'DATA:COMMERCIAL-ESE CHECKLIST Subdivision: Lot no.: Permit lees`are based on the value of the work perlivmed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the !]' work indicated on this application. DESCRIPTION OF WORK pp PV ROOF MOUNT Valuation: $ 7.56 KW Existing building area: square feet New building area: square feet [N PROPERTY OWNER ❑ TENANT Number of stories: c— Name: Ann Tran Type of construction: Address: 10504 SW Naeve St, Occupancy groups: City/State/ZIP: Tigard,OR 97224,US Existing: Phone-( 1 Fax.I I New: 51 APPLICANT .1 CONTACT PERSON BUILDING PERMIT FEES* Business name. TESLA (Please refer(n fee.schedule) Structural plan review lee(or deposit): Contact name: Melissa Farias FLS plan review fee(if applicable): Address: 6132 NE 112th Ave, Total fees due upon application: City/State/ZIP: Portland OR 97220 Phone:(503 ) 894 6903 Fax: :(1$66)445 7459 Amount received: E-mail: AFARIAS@TESLA.COM ( OLT A1C SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of ', ^'1, J, '1 ' ( i i'. {I II roof-top mounted PhotoVoltaic Solar Panel System. Business name: TESLA 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/ZIP: Portland OR 97220 Permit Fee(includes plan review $180.00 and administrative fees): Phone:( 503 ) 894 6903 Fax:(1866) 445 7459 State surcharge(12%of permit fee): $21.60 CCB lie.: 180498 Total fee due upon application: $201.60 Authorized signature This permit application expires if a permit is not obtained V within 180 days after it has been accepted as complete. *Fee methodology set by Tn-County Building Industry Print name: A. Meliss arias Date: 03/04/20 Service Board. I:\Building\Permits 1BUP-RESPermitApp,doc 02/24/2011 440-4613T(I 1/02/COM/WEB) I Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE LSE ONLY of Received illigCitySWTigard Date/By: Permit No. 13125 S W Hall Blvd.,Tigard,OK 97223 Associated permits. I Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanic d l IGAKD Internet: www.tigard-or.gov 0 Other. THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. 0 ❑ El 4 Fire district approval required. Name of district: • 0 ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 0 ❑ ❑ 6 Sewer permit. ❑ El ❑ 7 Water district approval. 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be 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. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;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 ❑ ❑ El and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 El ❑ 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- 0 El El floor,wall construction,roof construction. More than one cross section may be 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. ❑ ❑ ❑ 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;for non- 0 ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 ❑ El locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ El El over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ El ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or El El El architect licensed in Ore.on and shall be shown to be applicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". El ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 El ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. El ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ El El 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ El 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:\Building1 Penn its\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) l Electrical Permit Applicatid CEtVED l OR OF! ICE I SF O\l., City of Tigard ) Received �O[„�l Datei6 Permit No.: III • 13125 SW Hall Blvd.,Tigard,OR 97223 MAR Plan Review 0 Phone: 503,718.2439 Fax 503.598.1960 /} ` q rq''� p,,tetg Other Permit: Inspection Line: 503.639.4175 ;ITV CIE IbC�,iry�u Date Re,d.:By. turfs: ® See Page 2 for TIGARD ;.gin t-'+E s`c Internet wnvty.ttgard-or.gov ., Noufied,Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ® Addition/alteration/replacement Please check all that apply(submit2 sets of plans willows checked below). LI Service or leerier 400 amps or mote ❑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. less to ground,or exceeds 14,000 ❑Commercial-use agricultural 1-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building snips 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","1-2",'"1-3", Job no.: Job site address: 10504 SW Naeve St, 100HP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: Tigard,OR 97224,US ❑Health-care facilities. ❑Supply voltage for more than LI Flazardnus locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: Ann Tran ❑st,,t lae or Rocks We amps nr more FEE SCHEDULE Cross street/directions to job site: ors„ nm, _ _ I Qty. I Fee 1 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 ION Oh' WORK (with above sq.ft_) Limited energy,mold-family 75.00 2 PV ROOF MOUNT residential(with above sq ft) Renewable Energy ❑ See Page 2 7.56 KW Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 LI PROPERTY OWNER ❑ TENANT:n` ,, _— ' 201 amps to 400 amps 133.56 2 Name: Ann Tran 401 amps to 600 amps 200.34 2 Address: 10504 SW Naeve St, 601 amps to 1,000 amps 301.04 2 Tigard,OR 97224, 1JS Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or Phone:( 503 )621 2075 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 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 2 Owner signature: Date: Branch circuits—new,alteration,or extension,per panel KI APPLICANT I CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: TES LA each branch circuit B.Fee for branch circuits without Contact name: MELISSA FARIAS service or feeder fee,first 56.I S 2 branch circuit �� Address: 6132 NE 112TH AVE, Each add'I branch circuit 7.42 1 = 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: AFARIAS(,TESLA.COM Pump or irrigation circle 67.84 2 CON'FRAC'TOR Signor outline lighting 67.84 2 Business name: TESLA 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 Additional inspection(1 hr min) 66.25/hr City/State/ZIP: PORTLAND OR 97220 Investigation(I hr mint 66.25/hr Phone:( 503 ) 894 6903 Fax: (1866)445 7459 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 180498 Electrical Lic.: C562 Suprv.Lic.: 5873S specifically listed('a hr min) ELECTRICAL PERMTI o_ Suprv.Electrician signature,required: N,e,_.� Subtotal Print name: NICK ARMSTRONG Date:3 1 -2—D Plan review(25%of permit fee) p �J State surcharge(12%of permit fee)_ Authorized signature: MIrD TOTAL PERMIT FEE: Print name: A.MELISSA FARIAS Date: 3— —DAD permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. ' Number of inspections allowed per permit. I:lauilding\Permits\ELC_PermitApp_ELR_ERE.doc Rev05/21/2013 440.4615T(I I/05/COM/WEB 11/4 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 Desn iptian I Qip. I Fee I Tetnl * 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 n Audio and Stereo Systems* ]s.ol to zs kva 200.34 2 nBurglar 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 ❑ Heating, Ventilation and Air Conditioning OAR 918-309-0040) * Solar generation systems in excess of 25 kva: System 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: Other: Each additional inspection is charged at an hourly(1 hr min) 66.25!hr 1 Inspections for which no fee is 90 00!hr specifically listed(t%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 nAudio and Stereo Systems days after it has been accepted as complete. e Number of inspections allowed per permit. U Boiler Controls n Clock Systems Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC ❑ Instrumentation Intercom and Paging Systems Li Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 Building Permit Application Residential pp gV C FOR OFFICE USE ONLY City of Tigard ll E � C 'DaleBy: �f��y/ 1 6 / 'ermit No.( J rT2o DIN,3 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review III • Phone: 503-718.2439 Fax: 503.598.1960 MAY 1 9 2020 Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By: loos: 0 See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information r, .i. ,�'':-NI TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑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 CONSTRUCTION work indicated on this application. [1 I-and 2-family dwelling ❑Commercial/industrial Valuation: $ 3000 ElAccessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 10504 SW Naeve St, New dwelling area: square feet City/State/ZIP: Tigard,OR 97224, US Garage/carport area: square feet Suite/bldg./apt.no.: Project name: tran 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*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. 3.78 kw PV ROOF MOUNT Valuation: $ Downsized from: 7.56kw Existing building area: square feet New building area: square feet i a PROPERTY OWNER 0 TENANT Number of stories: Name: ANN TRAN Type of construction: Address: 10504 SW Naeve St, Occupancy groups: City/State/ZIP:Tigard,OR 97224,US Existing: Phone:( ) Fax:( ) New: [d APPLICANT ll CONTACT PERSON BUILDING PERMIT FEES* Business name: TESLA (Please refer tafeesehedule Structural plan review fee(or deposit): Contact name: Melissa Farias FLS plan review fee(if applicable): Address: 6132 NE 112th Ave, Total fees due upon application: City/State/ZIP: Portland OR 97220 Amount received: Phone:(503 ) 894 6903 Fax: :(1866)445 7459 E-mail: AFARIAS@TESLA.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: TESLA 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. Permit Fee(includes plan review City/State/ZIP: Portland OR 97220 $180.00 and administrative fees): Phone:( 503 ) 894 6903 Fax:( 1866) 445 7459 State surcharge(12%of permit fee): $21.60 CCB lie.: 180498 Total fee due upon application: $201.60 Authorized signature: ' 1 This permit application expires if a permit is not obtained 1 it within 180 days after it has been accepted as complete. • Print name: A. McIissill arias Date: 5.17.20 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling • FOR OFFICE USE ONLY �.. 14City of Tigard Received Date/By. Permit No.: ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits. ■ Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639 4175 ❑ Electrical ❑ Plumbing ❑ Mechanical ' V2L) Internet: www.tigard-or.gov El Other THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No NI 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ El El 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ El 9 Erosion control ❑plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- El El El basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state El ❑ ❑ building codes. Lateral design details and connections must he 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. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ El there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;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 ❑ El ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ 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 be 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. El ❑ ❑ 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;for non- ❑ 0 0 prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ 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." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists El El El over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 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,roof truss)shall be stamped by an engineer or 0 0 0 architect licensed in Ore on and shall he shown to be applicable to the •ro"ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ El ❑ 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"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 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 ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ 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, ❑ 0 ❑ 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:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Application RECEIVE FOR OFFICE USE ONLY City of Tigard Received • 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 19 2020 DateB : r I I / Plan Review Phone: 503.718.2439 Fax: 503.598.1960 MM Date/B : Other Permit: 1. c,4121� Inspection Line 503 639 4175 CITY OF TIGARD Date Ready/By. taris: Di See Page 2 for Internet www.tigard-or.govNotitied/Method: Supplemental Information TYPE OF WORK PLAN REVIEW New construction / Please check all that apply(submit 2 acts of plans w/items checked below): ❑ ®Add 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or El Floating buildings. less to ground,or exceeds 14,000 0 Commercial-use agricultural E I-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑ Other: ID Fire pump. 0 Installation of 150 KVAor JOB SITE INFORMATION AND LOCATION El Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A","E","1.2","1.3", Job no.: Job site address: 10504 SW Naeve St, IOOHP or more occupancy. ❑Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: Tigard,OR 97224,US ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: TRAN ❑Service or feeder 600 amps or mole. FEE SCHEDULE Cross street/directions tojob site: Description I Qty. 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 1 Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 3.78KW pV ROOF MOUNT residential(with above sq.ft.) _ Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation I PROPERTY OWNER 0 TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: ANN TRAN 401 amps to 600 amps 200.34 - 2 Address: 10504 SW Naeve St, 601 amps to 1,000 amps 301.04 2 Tigard,OR 97224,US Over 1,000 amps or volts 55226 2 City/State/ZIP: g Temporary services or feeders installation,alteration,and/or Phone:( ) Fax:( ) relocation 200 amps or less 59.36 1 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 2 Owner signature: Date: Branch circuits—new,alteration,or extension,per panel ID APPLICANT El CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: TESLA each branch circuit B.Fee for branch circuits without Contact name: MELISSA FARIAS service or feeder the,first branch circuit 56.18 2 Address: 6132 NE 112TH 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 67 84 2 Phone:(503 ) 894 6903 Fax: :(1866) 445 7459 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: AFARIAS@TESLA.COM Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Signal circuit(s)or limited-energy See TESLA panel,alteration,or extension. Page 2 2 Address: 6132 NE 112TH AVE, Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr City/State/ZIP: PORTLAND OR 97220 Investigation(1 hr min) 66.25/hr Phone:( 503 ) 894 6903 Fax:(1866)445 7459 Industrial plant(1 hr min) 78.18/hr CCB Lie.: Electrical Lic.: Inspections for which no fee is 90.00/hr 180498 C562 Suprv.Lic.: 5873S specifically listed(/hr min) ELECTRU2AL PERMfl A LS Suprv.Electrician signature,required: N. .+� Subtotal' Print name: NICK ARMSTRONG Date: 5.17.20 Plan review(25%of permit fee): W State surcharge(12%of permit fee): Authorized signature: MI:D TOTAL PERMIT FEE: Print name: A.MELISSAFARIAS Date: 5.17.20 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. " Number of inspections allowed per permit. C\Building1PermitsiELC_PermitApp_ELR_ERE.doc Rev 0521/2013 440-46I5T(I l/05/COM/WEB Electrical Permit Application—City of Tigard Page 2- Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: "HI" FEE SCHEDULE Fee for all residential systems combined ... $75.00 nGrartion I Qrs. I ree I I'ma1 I Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 1 100.70 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Burglar 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 ElHeating, 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 66.25/hr charged at an hourly(I hr min) Inspections for which no fee is 90 OW hr specifically listed('._hr nun) COMMERCIAL WORK ONLY: ;,j�1 . ,,114ggrRicm, PERMIT FEES Fee for each commercial system S75.00 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 ISO ❑ 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 is\Bsildigg\Permit6\ELC_Permi1App ELR_ERE.doc Rev 05/21/2013 FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT -1 ■ Transmittal Letter T c„\is n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: TIGARD DATE RECEIVE DEPT: BUILDING DIVISION r '.IV t) FROM: Melissa Farias , AY 2 8 2020 /5/7/� .,i-f)(OF f!aARD COMPANY: TESLA ' !ILD (3 Dilrlc'vhl PHONE: 971 271 0577 By:"J / . RE: 10504 SW NAEVE ST,TIGARD OR 97224 � �� c')a-3 (Site Address) (PermitNum eb r) TRAN (Project name or subdivision name and lot number) 1 ATTACHED ARE THE FOLLO ) E 1 Copies: Description: �� opi Description: 3+TSJ Additional set(s) of plans. Revisions: DOWNSIZED TOKW O Cross section(s) and details. Wall bracing and/or lateral analysis. ?J.' � r Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: DOWNSIZED FROM 7K ' TO 4KW ltv (2 . FOROFFICE USE ONLY /� Routed to Pe it Techni an: Date: G/i 1 Initials: I* Fees Due: Yes No Fee Descn ion: Amount Due: $ ,Do i/2 p �n C`LAI,e.L, $ cis • $ $ Special / Instructions: Reprint Permit(per PE): Yes ❑ No - ❑ Done 4,4 Applicant Notified: Date: 7,/Xf iij Initials: %�' 1:1Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012