Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00487
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/16/2011
Parcel: 1S 133DC08000
Jurisdiction: Tigard
Site address: 11700 SW 134TH TER
Project: D'ALESSANDRO Subdivision: WINTER LAKE Lot: 11
Project Description: Solar photovoltaic system
Contractor: SOLARCITY CORPORATION Owner: D'ALESSANDRO, PRIMO
6132 NE 112TH AVE ROUSH, KENDAL
PORTLAND, OR 97220 11700 SW 134TH TER
TIGARD, OR 97223
PHONE: 503 - 964 -0489 PHONE
FAX. 503 -926 -9101
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 09/16/2011 $100 70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 09/16/2011 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 09/16/2011 $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 rul- = are set forth in OAR
952- 001 -0010 through O A 52- 001 -0090 You may obtai a-rnpy_nf the rule er-dt ift oie,ns to OUNC by calling 503 32.1987 •r 1 800 :32 2
Issued _ ermittee Signature: i s . - _. ... J •
WNER 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 FO'R OF Pi CE US zO \Y:1
" `J Tigard !
CI Of
C••• Received ( �Gt9O r ib 4 tl` /
i�C[ °�
r� Date /By i 7 0 (1C Permit No . 1
a 13125 SW Hall Blvd., Tigard, OR 9 L' ^ ddJJ O�\ Plan Review
II
C ° Phone: 503.718.2439 Fax: 503 598 ill'. ■ Other Permit:
c� 0 Date /By
TIC .A Ii 1 Inspection Line. 503.639.4175 �� J ��.�! ate Ready /By: 9��� C loos See Page 2 for
Internet' www tigard-or.gov P, 4c' �` c` otified/ ethodSS upplemental Information
TYPE OF WORK 1 1 ( ho ' iy l9/ th L EV
AN RIEW -
❑ New construction ® Addition/alteration/reg ent Pleas check all that apply (submit 2 sets of plans w /items checked below)
�v' ❑ 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 JOB system. larger separately derived system • ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: G Job site address: i ((�� C 4.44,,_ p �� IOOHP or more occupancy.
`� ��� ` 1 0(3 )W 3 cif_ ❑ S ix or more residential units ❑ Recreational vehicle parks
City/State /ZIP: tAA (� 1 J ICJ
1 (i `, V d 0t2 . 01 77 '2' ❑ Health -care facilities ❑ Supply voltage for more than
1 ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: i Project name: Da. I css d ❑ Service or feeder 600 amps or more
lv�.f L f I/v O FEE SCHEDULE
Cross street/directions to job site:
Description 1 Qty. 1 Fee. 1 total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I 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
® PROPERTY OWNER . I ❑ TENANT • •' , 20 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name N D p� �l
�' t� W l/t -I l-�1 vc 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: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
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: A. Fee for branch circuits with
above service or feeder fee
❑ APPLICANT I ®CONTACT PERSO 7.42 2
each branch circuit
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)
Each manufactured or modular
City/State /ZIP: Portland, Oregon 97220 dwelling, service and/or feeder 67 84 2
Phone: (503) 9560610 i Fax: : (503) 5366513 R econnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: chorsley @solarcity.com
CONTRACTOR - Sign or outline lighting 67.84 2
- . - . • - 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 ,
City/State /ZIP: Portland, OR 97220 Investigation (1 hr min) 66 25/ hr
industrial plant (1 hr min) 78.18/ hr
Phone: (503) 9560616 I Fax: (503) 3566513 Inspections for which no fee is 90.00 / hr
specifically listed (% hr min)
CCB Lic.: 180498 I Electrical Lic.: C562 I Suprv. Lic.: 5201S ELECTRICAL PERMIT PEES .
Subtotal: a /o`
Suprv. Electrician signature, required: C !!, C 3 Plan review (25% of permit fee): ^
Print name: Derek Cropp I Date: V 30 /l State surcharge (12% of permit fee) /A.97
Authorized signature: t
t/ / , v ( TOTAL PERMIT FEE / 0
. I !�[ a � A r This permit application expires if a permit is not obtained within 180 ■ / (3
Print name: Caitlin Horsley / Date: 0 it days after it has been accepted as complete.
* Number of inspections allowed per permit •
1 \Buitdmg \ Perms \ELC- Perm,App doc 07/01/10 440- 4615T( I 1 105 /COM /WEB