Permit (4) IN41 CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2020-00176
T l i;:', I, rn 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2020
Parcel: 2S109DA11300
Jurisdiction: Tigard
Site address: 12972 SW BLACK WALNUT ST
Subdivision: SUMMIT RIDGE NO.2 Lot: 102
Project: RAZAYEE
Project Description: Solar photovoltaic system.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Lek: 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: 510,080.00 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
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 st or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 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 10.08 kW Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VS R-3 0
Owner: Contractor:
BESSED,MIRAL ELEMENTAL ENERGY LLC Required Items and Reports(Conditions)
RAZAYEE,SULAIMAN 1339 SE 8TH AVE#B
12972 SW BLACK WALNUT ST PORTLAND,OR 97214
TIGARD,OR 97224
PHONE: 971-666-0187 PHONE: 503-967-5786
FAX:
Total Fees: $353.19
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. his permit ill ex•ire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Orego law requires • to foll�' th=/rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through O 2-001-0090. Y. ay ob -c•; of the rules or direrr n��estions to OUNC by calling 503.232.198 1.800.332.2344.
Issued By: � 1'`� / PermiUee Signature:
Call 503.630.4175 by 7:00 a.m.for the next available inspection date. L 1/!P
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 RECC P
\=s� FoliorFICE I SE o\I.)
City of Tigard Received
g MAY2 9 2020 PlateBy: � i. ..0 17 G
q 13125 SW Hall Blvd.,Tigard,OR 97223 Date/BY Review cip
(a
Phone: 503.718.2439 Fax: 503.598.1960 ,, DateBy: D 2.02b a ' Other Permit:
1.Ili l I I Inspection Line: 503.639.4175 '+')Date ReadyBy: 1 . is: VI See Page 2 for
Internet: www.tigard-or.gov Not.!./Meth/Meth D - 'i Suppkmental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
5 0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Ul Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION` work indicated on this application.
t Valuation: $ 10,080
Ca 1-and 2-family dwelling ❑Commercial/industrial
ElAccessory building ❑Multi-family Number of bedrooms:
❑Master builder
ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION
Total number of floors:
Job site address: 12972 SW BLACK WALNUT ST New dwelling area: square feet
City/State/ZIP: TIGARD,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: REZAYEE SOLAR 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.
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.
10.08 kW AC Solar Photovoltaic Prescriptive Roof mount Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Sulaiman Rezayee Type of construction:
Address: 12972 SW BLACK WALNUT ST Occupancy groups:
City/State/ZIPTIGARD,OR 97224 Existing:
Phone:( )(971)666-0187 Fax:( ) New:
IDa APPLICANT la CONTACT PERSON BUILDING PERMIT FEES*
Business name: ELEMENTAL ENERGY (Please refer Wee sckedulr,)
Structural plan review fee(or deposit):
Contact name: CHRISTINE STAMPER 503-522-9190(CELL)
Address: 1339 SE 8TH AVE STE B FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP: PORTLAND,OR 97214
Amount received:
Phone:( ) 503-967-5786 Fax: :( )
E-mail: PERMITS@ELEMENTALENERGY.NET PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ELEMENTAL ENERGY Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 1339 SE 8TH AVE STE B Solar Installation Specialty Code checklist.
City/State/ZIP: PORTLAND OR 97214 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) 503-967-5786 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 195141
Total fee due upon application: $201.60
Authorized signature: ,r_ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
CHRISTINE STAMPER *Fee methodology set by Tri-County Building Industry
Print name: Date: 05/29/2020 Service Board.
I:1Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling Ft1R ()MCI: 1-SE ONLY
Received
CI Of Tigard Permit No.:
`� g Date/By:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
S Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
I IGARD Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 5 es No `/.v
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 0
3 Verification of approved plat/lot. 0 ❑ 0
4 Fire district approval required. Name of district: . ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity 0 ❑ 0
6 Sewer permit. 0 ❑ 0
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 ❑
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 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 0 0 0
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 ❑ 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 ❑
fumace,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 0 0
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. 0 0 0
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 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 0 0
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 0 ❑ 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 ❑
architect licensed in Ore on and shall be shown to he a licable to the ro'ect under review.
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑
24 Two(2)sets each are required for Items 16,19,20 and 22 above. 0 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ ❑
and protection measures must be drawn to scale and must include the project arhorist'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.
1:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(II/02/COM/WEB)
Electrical Permit ApplicationRECFIVED FOR OFFICE IISE ONLY
City of Tigard Received 4:
111 • 13125 SW Hall Blvd.,Tigard,OR 97223 MAY hs Date/B L020 Plan Review
U Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permits:
Inspection Line: 503.639.4175 ! '.GAR!] ReadyDate/By: ® See Page 2 for
peC GIT„r - Ririe:
I l l'1 I`ll Internet: www.tigard-or.gov 7-1 ILDIN 3 DIVSION Notified/Method: Supplemental Information
PLAN•REVIEW ,,:,
❑New construction B]Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑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 0 Floating buildings.
In 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived
Job#: I Job site address: 12972 SW BLACK WALNUT ST ❑Addition of new motor lead of system.
IOOHP or more. ❑"A" "E" ,•1-2" "1-3"
City/State/ZIP: Ti ard, OR 97224 ❑Six or more residential units. occupancy.
g 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: Rezayee Solar ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: .:,.FEE SCHEDULE.
-Desrriplion I Qly. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.R.or less 168.54 L
Ea.add'l 500 sq.ft.or portion 33.92 1
4,SCRIPTION OF WORK,',, Limited energy,residential
10.08kW AC Solar Photovoltaic Prescriptive Roof Mount install (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
.4 ., Renewable Energy 0 See Page 2
r: ® PROPERTY OWNER ). [,],.,TEN 4.,a+�`' Services or feeders installation,alteration,and/or relocation
Name: Sulaiman Rezayee 200 amps or less 100.70 2
Address: 12972 SW BLACK WALNUT ST 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Tigard,OR 97224 601 amps to 1,000 amps 301.04 2
Phone:( ) (971)666-0187 Fax:( ) Over 1,000 amps or volts 552.26 ' 2
Email: onyxbird@gmail.com Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
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
10
APPLICANT CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: ELEMENTAL ENERGY above service or feeder fee,
each branch circuit 7.42 2
Contact name: CHRISTINE STAMPER, 503-522-9190(CELL) B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
1339 SE 8TH AVE STE B branch circuit
City/State/ZIP: PORTLAND OR 97214 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)967-5786 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: PERMITS@ELEMENTALENERGY.NET Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: ELEMENTAL ENERGY Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy CI Page 2 2
Address: 1339 SE 8TH AVE STE B panel,alteration,or extension. g
City/State/ZIP: PORTLAND OR 97214 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 503)967-5786 Fax:( ) Investigation(I hr min) 90.00/hr
Email: PERMITS@ELEMENTALENERGY.NET In al pan hr min) 78.18/hr
•
Inspections for which no fee is 90.00/hr
CCB Lie.: 195141 Electrical Lic.C1228 Suprv.Lic.:5925S specifically listed(V:hr min)
% - - - ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: — %` /��//✓ Subtotal:
Print name: NATHAN MILLER Date: 05/29/2020 , 0 Plan Review Required(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: CHRISTINE STAMPER Date 05/29/2020 days after it has been accepted as complete.
Number of inspections allowed per permit.
I:1Building\Pernats\ELC_PermitApp_E[R_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:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 oe Qt.. Each Total
3' Renewable electrical energy systems:
Check Type of Work Involved: 5 kvaorless 100.70 2
5.01 to 15 kva 1 133.56 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
50.01 to 100 kva 552.26 2
n Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ 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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('h hr min)
COMMERCIAL WORK ONLY: 141
ELECTRICAL !VOW FEES
Subtotal(Enter on Page I 1Fee for each commercial system: $75.00 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\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015