Permit CITY OF TIGARD ELECTRICAL PERMIT
7 4 1 `° .. COMMUNITY DEVELOPMENT Permit #: ELC2011 -00365
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/08/2011
WARD 9 Parcel: 1S 136AA08400
Jurisdiction: Tigard
Site address: 10025 SW 70TH PL
Project: KEIDEL Subdivision: VENTURA ESTATES Lot: 6
Project Description: Solar photovoltaic system.
Contractor: SOLARCITY CORPORATION Owner: KEIDEL, JEREMEY & TRICIA R
6132 NE 112TH AVE 10025 SW 70TH 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 - Those rul- - set forth in OAR
952- 001 -0010 through OAR -00 -UU i. You may obtain a copy of the rules or direct questions to OUNC by calling 5' z 1.800.332
...4? 0
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
Ci of Ti and y Received
g ® Date /B : / ifs Permit No.: I f - ( _ "1•
I I
111
13125 SW Hall Blvd., Tigard, OR 7 ''' ® Plan Review
Phone: 503.718.2439 Fax: S9 t9. x O�� Date /B : Other Permit: `Oct /Li
� u i
TI Ci A'R l7 Inspection Line: 503.639.417 l� Date Ready /By: ® See Page 2 for
c� r �� g
Internet: www.tigard or.gov J Notified/Method: Supplemental Information
TYPE OF: W ,�j \��. PLAN REVIEW
❑ New construction n ®Addition /alterat�nt 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: \Y where the available fault current
y ❑Marinas and boatyards.
-
exceeds 1 0,000 amps at 150 volts or Floating buildings.
OF CONSTRUCTION ' ' ' P ❑ Floatin buildin s.
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 INFORMATIUN. AND l OCATION - Emergency system. larger separately derived system.
_ _ . .. u _ - 0 Addition of new motor load of ❑ "A" "E" "1 - "1 -
Job no.: q 724 33 Job site address /00 5 (S'� 7Q t-1 etc 100HP or more. occupancy.
G ❑ Six or more residential units. ❑ Recreational vehicle parks.
�'
City/State /ZIP: 1 g curd OR. q7 22 3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ke r d e l ❑ Service or feeder 600 amps or more.
` - F SCHEDULE_ .
Cross street/directions to job 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
. . O DESCRIPTI OF WO RK - - (with above sq. ft.) 75.00 2
I Pre O
' - ' Limited energy, multi - family 75.00 2
Roof Mount PV System l L1 n l/f I/ j p -h \( .e,\ residential (with above sq. ft.)
pre C t l 1 t ) Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
®' PROPERTY '.OWNER, ' -. ❑ . TENANT ! 201 amps to 400 amps 133.56 2
Name: (I ) l p j C 'p / 401 amps to 600 amps 200.34 2
/C l 1 1. r 601 amps to 1,000 amps 301.04 2
Address: ( ram/ I Over 1,000 amps or volts 552.26 2
f r � ` 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 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
. ' 4 : above service or feeder fee,
❑ APPLICANT. ®'CONTACT PERSON each branch circuit 7.42 2
Business name: SolarCity Corporation B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Caitlin Horsley branch circuit
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 or modular 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
Sign or outline lighting 67.84 2
= CONTRACTOR -z , Signal circuit(s) or limited - energy
anel, alteration, or extension. Page
Business name: SolarCity Corporation P ge 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
City/State /ZIP: Portland, OR 97220 Investigation (1 hr min 66.25 / hr
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 Lic.: 180498 Electrical Lic.: C562 Suprv. Lic.: 5201S ' ELECTRICAL - -
P PERMIT, FEES
Suprv. Electrician signature, required: 1
Subtotal:
(�7rS.-,.CfLP J " �j Plan review (25% of permit fee):
Print name: Derek Cropp Date: 0/241//7 State surcharge (12% of permit fee):
TOTAL PERMIT FEE:
Authorized signature: / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Caitlin Horsley Date: /z/fi * Number of inspections allowed per permit.
•
I:\ Building \Permhts1ELC- PermitApp.doc 07/01/10 440 - -461 ST(t I /05 /COM /WEB