Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00342
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011
Parcel: 1 S136AD01700
Jurisdiction: Tigard
Site address: 6875 SW PINE ST
Project: Blume Subdivision: VILLA RIDGE Lot: 2
Project Description: Installation of solar photovoltaic system.
Contractor: SOLARCITY CORPORATION Owner: BLUME, JULIE E & HENDRIK A
6132 NE 112TH AVE 6875 SW PINE ST
PORTLAND, OR 97220 TIGARD, OR 97223
PHONE: 503 - 964 -0489 PHONE.
FAX: 503 - 926 -9101
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 06/30/2011 $201.40
Specifics: amps or less
2 crt Branch Circuits w /Purchase 06/30/2011 $14.84
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 06/30/2011 $25.95
Electrical
Type of Const:
Occupancy Grp:
Total $242.19
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through • e R 952- 001 -0090. You i. - • • - copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application FOR OFFICE USE ONLY •
City and Received / fin A n n
`J Of Tigard JUN 2 Date /B OHO` �� lyil Permit No.: el.. d AolI -4f✓ • __
13125 SW Hall Blvd Ti OR 97223 Plan Review
` 13 Phone: 503.718.2439 Fax: 503.598.1960 Date /B Other Permit:
T I Ci AR h Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: Juris: 65 See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
BUILDING DIVISION -
TYPE OF WORK ; P-L4$ REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
'CATEGORY OF CONSTRUCTION ' ' ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND L " - 13 Emergency system. larger separately derived system.
- - ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 3 ",
tog Q 7 5 5^ I /t / �% N p Six or or more. occupancy.
Job no.: Job site address: (f(U (J �/ �/ ' [ 1. 0 vehicle
❑Six or more residential units. parks.
City/State /ZiP: Porn tit,/ t d / D �J � ❑ Health -care facilities. ❑ Supply voltage for more than
/�J ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more
Cross street/directions to job site:
Description . _ FE SCHEDULE'
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
Tax map /parcel no.: add' 500 sq. or portion 33.92 1
Limited energy, residential
a q. r portio
. •. ' - DESCR IPTION OF WORK. • . l (with above s ft.) 75.00 2
•
Limited energy, multi- family
stem 75.00 2
Roof Mount PV S
Y residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less G 100.70 2
® 'PROPERTY OWNER ., ❑ TENANT - ' 201 amps to 400 amps 133.56 2
S/� 401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts . 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: Fee for branch circuits w ith
X
APPLICANT 1 above
e service o feeder fee, 2
. . ❑ APP
.CONTACT PERSON } : 7.42 2
each branch circuit
Business name: SolarCity Corporation B. Fee for branch circuits without
service or feeder fee, first
Contact name: Caitlin Horsley branch circuit 56.18 2
Each add'` branch circuit 7.42 2
Address: 6132 NE 112 Ave Miscellaneous (service or feeder not included)
City/State /ZIP: Portland, Oregon 97220 Each manufactured or modula 67.84 2
dwelling, service and/or feeder
Phone: (503) 9560610 Fax: : (503) 5366513 Reconnect only 67.84 2
Pump
E - mail: chorsley @solarcity.com or irrigation circle
_ . .. - 'CONTRACTOR . , _ l circuit(s) O r limited-energy 67.84 2
mp o rrigat 67 84 2
Sign o r outline lighting
._ • w, . . . �. . Signa it s o
Business name: SolarCity Corporation panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 6132 Ne 112 Ave Additional inspection (1 hr min) 66.25/ hr .
Investigation (1 hr min) 66.25/ hr
City/State /ZIP: Portland, OR 97220 .
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 9560616 Fax: (503) 3566513 Inspections for which no fee is 90.00 / hr
specifically listed (/ hr min)
CCB Lie.: 180498 Electrical Lic.: C562 Suprv. Lie.: 5201S .. .._ -
-_ ..
p
ELECTRICAL `PERMIT. FE
/�
Subtotal:
Suprv. Electrician signature, required: `� � LS - , C Plan review (25% of permit fee)):
Print name: Derek Cropp ` Date: State surcharge (12 % of permit fee):
40/22/// TOTAL PERMIT FEE: . '� •
Authorized signature: ( � Th is permit application expires if a permit is not obtained 7, hin 180
Q 22, ^ days after it has been accepted as complete.
Q GG
Print name: Caitlin Horsley Date: / * Number of inspections allowed per permit. r
1:\ Building \ Permits \ELC- PcrmitApp.doc 07/01/10 440- 4615T( I 1 /05 /COM /WEB