Permit CITY OF TIGARD MASTER PERMIT
IIII : ' � COMMUNITY DEVELOPMENT Permit #: MST2011 -00201
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TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/20/2011
Parcel: 2S 104C B00700
Jurisdiction: Tigard
Site address: 13333 SW ASCENSION DR
Subdivision: HILLSHIRE WOODS Lot: 23
Project: MARSH
Project Description: Solar photovoltaic system. (Building & electrical)
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $3,055.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
r Heat Pump: N Hoods: 0 Other Units: 0
Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 1
Ea add' 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
601 -1000 amp: 0 601 +amp- 1000v: 0
1000 +amp /volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: N HVAC: N Security Alarm. N Vaccuum System: N Garage Opener: N All
Other: N Other Description:
Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF 0
Owner: Contractor:
MARSH, U GRANT & REBECCA S SOLARCITY CORPORATION Required Items and Reports (Conditions)
13333 SW ASCENCION DR 6132 NE 112TH AVE
TIGARD, OR 97223 PORTLAND, OR 97220
PHONE: PHONE: 503 - 964 -0489
FAX: 503 - 926 -9101
Total Fees: $329.19
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 - _ - - . • e with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspen• • • for more the 180
days. • ENTION: Ore• •n law - quires you to follow the rules adopted by the Oregon Utility Notification Center. Those r les : - set forth in OAR
952-011-0010 through OAR 9 s 11-009P ou may obtain a co y of the rules or direct questions to OUNC by calling 503.232.19837 • 1.830
Issue. By: / Permittee Signature: . A- 17116,-.41 A
Call 503.639.4175 by 7:00 a.m. for the next available inspect on d I 1
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.
Building Permit Application
Residential
J FOR OFFICE USE ONLY
City of Tigard <� \ \\ � li. Date/B 1 / /1y� Permit No.: / �� 5T „ / - d �.
• 13125 SW Hall Blvd., Tigard, OR 97223 1�,\ ' i Plan Review r
Phone: 503.718.2439 Fax: 503.598.19 .Z Date /B : Other Permit:
TI G �\ R D Inspection Line: 503.639.4175 ® Date Ready /By: El Page 2 for
" Internet: www.tigard Notified /Method: t Supplemental Information
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TYPE OF WORK ���� OS REQUIRED DATA: 1 =AND 2- FAMILY DWELLING
r Permit fees* are based on the value of the work
❑ New construction ❑ Demoli a * performed.
P
Indicate the value (rounded to the nearest dollar) of all
0 Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION," work indicated on this application.
® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ' ` 0 c j � - U
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SiTE INFORMATION AND /
D LOCATION
Total number of floors:
Job site address: /3333 (5-14/ 4 5 co L (�' /c 'l t Dr. New dwelling area: square feet
City/State /ZIP: Pa r t(i Ni r ^i 6/7223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ,a..-5 /^ , Covered porch area: square feet
Cross street/directions to job site: f �/ Deck area: square feet
Other structure area: square feet
REQUIRED•DATA: COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
. DESCRIPTION OF WORK - work indicated on this application.
Roof Mount PV System Valuation: $
Existing building area: square feet
New building area: square feet
d PROPERTY OWNER , ' ❑ -TENANT Number of stories:
Name: QJj b p ,_ � � /( ai - Type of construction:
Address: vii -1 Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax:( )
New:
❑ APPLICANT 0 CONTACT PERSON ' BUILDING PERMIT FEES*
Business name: SolarCity Corporation (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: Caitlin Horsley
FLS lan review fee (if applicable):
Address: 6132 NE 112 Ave P ( PP )
City/State /ZIP: Portland
Total fees due upon application:
Phone: (503) 9560610 Fax: : (503) 5366513
Amount received:
E -mail: chorsley @solarcity.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
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- Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: SolarCity Corporation Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 6132 NE 112' Ave Solar Installation Specialty Code checklist.
City/State /ZIP: Portland, Oregon 97220 Permit Fee (includes plan revie $180.00
and administrative fees):
Phone: (503) 9560610 Fax: (503) 4366513
State surcharge (12% of permit fee): $21.60
CCB lic.: 180498
T otal fee logy duset e upon applicati Building on: $201.60
Print name: Caitlin Ho Date:
Authorized signature: / 1:, This per mit application by expiTri -Counres if a permit is In not obtained
within 180 days after it has been accepted as complete.
j � / // , fl * Fee met hodoty dustry e y / (� {/ � Service Board.
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Electrical Permit Application I FOR OFFICE 'USE ONLY
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City of Tigard Received
5 g �� Plan y
/ Pe rmit No.:
° 13125 SW Hall Blvd., Tigard, OR 97223
'11111 Q ` Date /B : ei l acii— Ooda i
PP 1 ,
Pho ne: 503.718.2439 Fax: 503.598.1960 Date/By: 1 1 `� '' V F+ lsv Other Permit:
Inspection Line: 503.639.4175 +r�
T I A R D p � O\� Date Ready /By: t{ Juris: S See Page 2
Internet: www.tigard- or.gov Notified /Meth / i t '�� Supplemental Intormafor 6on til‘Ck°
- - OIR *0 . A�� .,` c., t (' 1 .�ab'11 -&-- : - .
_ �� • ' G , `�GP �(�`_ PLAN REVIEW •
❑ New construction ® Ad dition /alteration /replace tQp crt Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: C► c0 ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF .CONSTRUCTI* . ' , . - 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
0 Emergency system. larger separately derived system.
a JOB SITE INFORMATION :AMID LOCATION 0 Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.:
q721,541 Job s ite address: �p� / 3 3 3 3 cSVV 1 Dr ix o r occupancy.
`�► `2/ ❑Si or more or more. resi dential units. ❑ Recreational vehicle parks.
City/State /ZIP: port / ae , e -72z 3 ❑ Health -care facilities. El Supply voltage for more than
/ ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: H < C� h) ❑ Service or feeder 600 amps or more.
FEE SCHEDULE .
Cross street/directions to job site: 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] 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK . (with above sq. ft.)
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 i 100.70 100 :70 2
In PROPERTY OWNER' ❑' TENANT 201 amps to 400 amps 133.56 2
bL n t ^ J / a r-5;11 401 amps to 600 amps 200.34 2
Name: li(.fiV �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 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
❑ APPLICANT ® CONTACT PERSON . above service or feeder fee, f
each branch circuit 7.42 7 2. 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)
Each manufactured or modular 67.84 2
City/State /ZIP: Portland, Oregon 97220 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 - - *_ . Q . • - 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 (I hr min) 78.18 / hr
Phone: (503) 9560616 Fax: (503) 3566513 Inspections for which no fee is 90.00 / hr
specifically listed ('V hr min)
CCB Lie.: 180498 Electrical Lic.: C562 Suprv. Lie.: 5201S ELECTRICAL PERMIT FEES' , '
Ceje.I.S.,C Subtotal: I CS K-,1..)„,_ —
uprv. Electrician signature, required:
Plan review (25% of permit fee):
Print name: Derek Cropp Date: /71(o/if State surcharge (12% of permit fee): 1 )-. /7
Authorized signature: , / / I TOTAL PERMIT FEE I d �. (3c l
t„.... A. a' •P This permit application expires if a permit is not obtained within 180
4// days after it has been accepted as complete.
Print name: Caitlin Horsley Date: / / s Number of inspections allowed per permit.
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