Permit CITY OF TIGARD ELECTRICAL PERMIT
;� COMMUNITY DEVELOPMENT Permit #: ELC2011 -00333
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/08/2011
TIGARD Parcel: 2S103AB05600
Jurisdiction: Tigard
Site address: 12125 SW SWEENEY PL
Project: Quadri Subdivision: WALNUT GLEN Lot: 14
Project Description: Solar photovoltaic system.
Contractor: SOLARCITY CORPORATION Owner: QUADRI, AMRULLAH
6132 NE 112TH AVE 12125 SW SWEENEY PL
PORTLAND, OR 97220 TIGARD, OR 97223
PHONE: 503 - 964 -0489 PHONE:
FAX: 503 - 926 -9101
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 07/08/2011 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 07/08/2011 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 07/08/2011 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
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
952- 001 -0010 through O • - 95 0f $i. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 32
Issued By: f� %'%r'h r -ar-' 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 Applicati+i 1 FOR OFFICE USE ONLY
Recei
}y g ved &liZ �'' i , / � j
CI of Tigard Permit No.: (�
Date /B
° 13125 SW Hall Blvd., Tigard, OR 97 AA'' 7 Plan Review
' II Phone: 503.718.2439 Fax: 503.5 t 3f1 1. I 2011 Date /B : / ,,, (/ Lit Other Permit:
T 1 C. A R D Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITY.OFTIGARD Notified/Method: Supplemental Information
%
TYPE 1 G DIVISION PLAN REVIEW .
Please check all that apply (submit 2 sets of plans w /items checked below):
El New construction ® Addition /alteration /replacement
❑ 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 El 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 LOCATION ❑ Emergency system. larger separately derived system.
' � El Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: 6172 414 Job site address: 12 I a 1 rS U pi � 100HP or more. occupancy.
/ ❑ Six or more residential units. • ❑ Recreational vehicle parks.
City/State /ZIP: d 1
� � �{ `1 4 ' l ❑ Haz facilities.
❑ Supply voltage for more than
( �/ ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: QuA cJvj ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to ob site:
J Description I Qty. I Fee. I Total
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
2
DESCRIPTION OF WORK (with above sq. ft.) 75.00
Limited energy, multi- family 75.00 2
Roof Mount PV System residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 100.70 I 0670 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: 4 maw 0 Z 401 amps to 600 amps 200.34 2
4 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City/State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with 1� ' 1
❑ APPLICANT 0 CONTACT PERSON above service or feeder fee I 7 42 r • `'t 2. 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'I branch circuit 7.42 2
Address: 6132 NE 112 Ave Miscellaneous (service or feeder not included)
City /State /ZIP: Portland, Oregon 97220
Each manufactured service and/or d/ r feeder 67.84 2
dwelling, service and/or feeder
Phone: (503) 9560610 Fax: : (503) 5366513 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: chorsley@solarcity.com
solarcity.com
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited-energy
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 (I hr min) 78.18/ hr
Phone: (503) 9560616 Fax: (503) 3566513 inspections for which no fee is
90.00/ hr
( specifically listed (' /z hr min)
CCB Lic.: 180498 Electrical Lie.: C562 Suprv. Lie.: 5201S ELECTRICAL PERMIT FEES
�
Subtotal:
Suprv. Electrician signature, required: C.. p ,- .- ^��C Pl)1 Plan review (25% of permit fee):
Print name: Derek Cropp Date: /�? `, State surcharge (i2% of permit fee):
,A4tioti (E/ ' N ■ 1 /,, Authorized signature:
if TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Caitlin Horsley Date: 62117 lit days * after it has been accepted as complete.
Number of inspections allowed per permit.
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