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Permit • 14 CITY OF TIGARD ELECTRICAL PERMIT ,ts ti COMMUNITY DEVELOPMENT Permit #: ELC2011 -00408 TJ� 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/11/2011 . Parcel: 2S105DA16100 Jurisdiction: Tigard Site address: 13375 SW SANDRIDGE DR Project: Bradley Subdivision: Lot: Project Description: Installation of solar photovoltaic system. Contractor: SOLARCITY CORPORATION Owner: BRADLEY, CHRIS N & VALERIE 6132 NE 112TH AVE 13375 SW SANDRIDGE DR 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 08/11/2011 $100.70 Specifics: amps or less 1 crt Branch Circuits w /Purchase 08/11/2011 $7.42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 08/11/2011 $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 in OAR . 952- 001 -0010 through • • R 9 01 -009'. You may obtain a copy of the rules or direct questions to OUNC by calling 5 .. - 232.1987 or 1.800.33 ` 4.. Issued By: t i Permittee Signature: t ,/C1il'i'"O :: 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 of Tigard RECEIVED Received �t� � �,L'�D/ -D. Date /B 7 I P erm it • No. I lk 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review , I Phone: 503.718.2439 Fax: 503.598.1960 JUL 21 ? fl'I 1 Date /B : 4iin // , L Other Permit: l' 1 4 R h Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for Internet: www.tigard- or.gov Notifi /Method : j a' � Supplemental Information - - CITY T IG ARD TYPE OF WO Ii .QING DIVISI9 h ( (� , t yv `PLaN REVIEW ❑ New construction ®Addition /alteration /replac Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more 12 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 ® I- 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 0 Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.:G - 722 I Job site address: I 1 100HP ormore. occupancy. 1 / � l) Y V lil Y 11 d� I����j Dr. ❑ Six or more residential units. ❑ Recreational vehicle parks. �� City /State /ZIP: 'T curd t l/ 72 2 J ❑ Health -care facilities. ❑ Supply voltage for more than 1 ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: f Project name: l J rod I p I j ❑ Service or feeder 600 amps or more. Vt I :FEE 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 DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 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 ! 100.70 / 2 ' 7O 2 0 PROPERTY OWNER - ' . TENAN 201 amps to 400 amps 133.56 2 / + („ r rnp r r B� 1 401 amps to 600 amps 200.34 2 Name: t Y l l ` 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 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 2 Branch circuits — new, alteration, or extension, r er panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ',1 ' 181 CONTACT -. PERSON , ' above service or feeder fee, each branch circuit 7.42 2 Business name: SolarCity Corporation B. Fee for branch circuits without service or feeder fee, first Contact name: Caitlin Horsley branch circuit 56.18 2 th Each add'I branch circuit I 7.42 - 7, II II)._ 2 I I Address: 6132 NE 112 Ave Miscellaneous (service or feeder not included) Each manufactured or modular City/State /ZIP: Portland, Oregon 97220 dwelling, service and/or feeder 67.84 2 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 l CONTRACTOR ,i • 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 (I hr min) 66.25/ hr . City/State /ZIP: Portland, OR 97220 Investigation (I hr min) 66.25/ hr 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 ('h hr min) CCB Lic.: 180498 Electrical Lic.: C562 Suprv. Lic.: 5201S ELECTRICAL PERMIT.. FEES ' - — Suprv. Electrician signature, required: C' Subtotal: �f)�'Sv P. Plan review ( 25% of pennit fee): _ Print name: Derek Cropp Date: Z' /l / State surcharge (12% of permit fee): 17 q Authorized signature: 64.1 ,.,� / / / TOTAL PERMIT FEE: tut 0 1 This permit application expires if a permit is not obtained within 180 I / d after i t has been accepted as complete. Print name: Caitlin Horsley Date: 7 /2 / ( * Number of inspections allowed per permit. 1: \ Building \ Permits \ELC.PermitApp.doc 07/01/10 440- 4615T(11/05/COM /WEB