Permit CITY OF TIGARD MASTER PERMIT
1111 COMMUNITY DEVELOPMEN Permit #: MST2012 00247
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/25/2012
Parcel: 2S 111 DA01200
Jurisdiction: Tigard
Site address: 8627 SW LODI LN
Subdivision: APPLEWOOD PARK Lot: 8
Project: Deardorff
Project Description: Installation of solar photovoltaic system.
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: $0.00 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
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell- Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum > =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: 0
Ea add'I 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
asin N
Other: N Other Description: Ecom P 9
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R -3 0
Owner: Contractor:
DEARDORFF, DANA L & BARBARA J SOLARCITY CORPORATION Required Items and Reports (Conditions)
8627 SW LODI LN 6132 NE 112TH AVE
TIGARD, OR 97224 PORTLAND, OR 97220
PHONE: 503 - 639 -4375 PHONE: 503- 964 -0489
FAX: 503 - 926 -9101
Total Fees: $319.38
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. A 'TION: . =gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -4010 through OA', • . 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by ca 2.1987 or 1.800.332.2344.
Issued r : / / / � / Qw / ' �/' Permittee Signatur '
Call 503.639.4175 by 7:00 a.m. for the next available inspectio . • • e.
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.
I
Building Permit Application
Residential RECEIVED FOR OFFICE I S1- (1\1.,'
City of Tigard 2 6 2012 4 , ill ' " l Permit No.: rae:1 — 002 4 /7
13125 SW Hall Blvd. Tigard OR 97223
:� , , Plan Rev' �,
Phone: 503.7182439 Fax: 503.598.1$1tQ Date 3 : `A / Z (a Other Permit:
n I ,, A r, h Inspection line: 503.639.4175 �; j ' l dy/By: i ® See Page 2 for
Internet: www.tigard-or.gov gill[ DI'! i DIVISION Notified/Mennd / / -4 t Supplemental Information
TYPE OF WORK REQUIRED DATA 1- AND 2-FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® I- and 2- family dwelling Valuation: S L i 32D- ��
❑ Commercial/industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: s4,9...- C w Lod I LG,ne New dwelling area: square feet
City / State/ZIP: Ti J ^ n f-k t OR 9 22 Garage/carport area: square feet
Suite/bldg. /apt. no.: ^ Project name: r d o t - Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
1 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
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Oa Ifn D- Yac'i c - Type of construction:
Address: Occupancy groups:
City / State/ZIP: Existing:
Phone: (63S) 4 ?9- L. s Fax: ( ) New:
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: SolarCity Corporation e'}"dL lit/ 7/ -/&71
Structural o schedule)
• S truc t ura l p rev f ee (or deposit):
Contact name: Caitlin Horsley /9 eg-e
Address: 6132 NE 112 Ave FLS plan review fee (if applicable):
�7/ 4 7? 2V/7
City / State/ZIP: Portland /PVC- ISSl.C / i/� Total fees due upon application:
Phone: (503) 9560610 Fax: : (503) 5366513 Amount received: ���
E - mail: chorsley aQsolarcity.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted Photo Voltaic 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 review $180.00
and administrative fees):
Phone: (503) 9560610 Fax: (503) 4366513 Statc surcharge (12% of permit fee): $21.60
CCB tic.: 180498
Total fee due upon application: $201.60
Authorized signature: - i / This permit application expires if a permit is not obtained
- within 180 days after it has been accepted as complete.
t Fee methodology set by Tri- County Building Industry
Print name: Caitlin Ho ey Date: C� I ai ('� Service Board.
1:\Build ng\Permits\BUP- RESPermitApp.doc 02242011 440.4613T(11 /02/COM/WEB)
Electrical Permit Applicatio; E CRE a FOR OFFICE i s F ONLY
City of Tigard .;', 6 2012 Re ee /v ) 7 PennitNo / O0�
II
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie 1 Other Permit:
111
Phone: 503.718.2439 Fax: 503.59 � O F TIGti0D Date/B : ®See Pa
11 c 1: I Inspection Line: 503.639.4175 rr +. r n y Date Ready/By: ge 2 for
Internet: www.tigard- or.gov 9UILE1 !] DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit a sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14.000 ❑ Commercial - use agricultural
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations, buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
JOB SITE INFORMATION AND LOCATION 1 ❑ Addition of new motor load of ❑ A" "E" "1 -2" "I -3"
X7 2 e 2 7 5 w Lo et L yle Six or or more. occupancy.
Job no.: pa
�� Job site address: ❑Sue or more residential units. 0 vehicle rks.
City/$tate/ZIP: Ti C�/7 f .oR 9 2'�(� ❑ Health-care c ation s . ❑ Supply voltage for more than
J _ ❑ Hazardous locati 600 volts nominal.
Suite/bldg. /apt. no.: Project name: 11) ; ego 74 ----- v ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Oar. 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. R. or portion 33.92 I
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 and/or relocation _
200 amps or less / 100.70 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
Vl Q Dal (' ( C rt� 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: (;G3) G39 - L 3 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
(0 APPLICANT I . ® CONTACT PER above service or feeder fee, 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'! branch circuit 7.42 2
Address: 6132 NE 112 Ave Miscellaneous (service or feeder not included)
Each r on 97220 dwelling, and/or rf feeder City/State/ZIP: Portland, O dwelling, service and/or fader 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
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 112th Ave Additional inspection (I hr min) 66.25/ hr
Investigation (1 hr min) 6625/ hr
City/ State/ZIP: Portland, Oregon 9722
Industrial plant (I hr min) 78.18/ hr
Phone: (503) 9560610 I Fax: (503) 5366513 Inspections for which no fee is 90.00 / hr
specifically listed (14 hr min)
CCB Lic.: 180498 Electrical Lic.: C562 Suprv. Lic.: 5201S ELECTRICAL PERMIT FEES
Subtotal:
Suprv. Electrician signature, required: / i o
/ _ _ / _ / Plan review (25% of permit fee):
MP'
Print name: Derek Cropp Date: 9 /25/12 /12 State surcharge (12% of permit fee):
TOTAL PERMIT FEE:
Authorized signature: This permit application expires If a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: Caitlin Horst (iott;‘,4146,
I Date: 9 1251 i2 • Number of inspections allowed per permit.
I:eBuildnta'Permiti ELC- PermaApp.doc 07 01 940- 4615T( 1 I /OSICOM/WEB
To: Page 1 of 2 2012 -10 -01 14:00:48 POT 18668637258 From: Aaron Bank%
FAX COVER SHEET
TO
COMPANY
FAX NUMBER 15035981960
FROM Aaron Banks
DATE 2012 -10 -01 14:01:31 PDT
RE MST201200247
COVER MESSAGE
Hello, once payment is received please mail permit to 6132 NE 112th Ave. Portland, OR
97220. Thanks!
Aaron Banks I SolarCity I Phone: 971.678.7417 I Fax 866.863.7258 I
abanks@ solarcity. com<mailto:abanks@solarcity.com> �
www. solarcity .com<http: //www.solarcity.comh
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City of Tigard R. ECEP T7 0
• Building Division SE
Q 13125 SW Hall Blvd, Tigard, OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 C1TY
`� :lfl
T I G A R D Inspection Line: 503.639.4175 • �UlLI�11� � y '.,vi�N
www.tigard - or.gov
2010 Oregon Solar Installation Specialty Code
Check List for Prescriptive Installation of Roof - Mounted
PhotoVoltaic Solar Panel System
Property Information
Installation Address: S62:7 SW Lodi Lane
City: Ti.ord Zip: 97224
Owner's Name: fle ( 1%( - 6oc - W Date: 9125112
Contractor's Name: SolarCity Corporation CCB #: 180498
Design Parameters of the Property /Structure
If "Yes", does not
Flood Hazard Is the installation ❑ Yes qualify for the
Area Located in a flood prescriptive path, follow
plain/flood way? ® N OSSC or ORSC for
design requirements.
Wind Exposure Is the wind exposure ® Yes If "Yes ", qualifies for
"C" or less? ❑ N the prescriptive path.
Installations on detached Is the Ground Snow
single/two - family Load 70 psf or less?
dwelling/single /two- If "Yes ", qualifies for
family townhomes ® Yes the prescriptive path.
and/or their accessory
Ground structures. ❑ No
Snow Load Is the Ground Snow
Installations on all Load 50 psf or less?
structures other than Yes If "Yes ", qualifies for
ID
above the prescriptive path.
❑ No
1
k/Building/ Forms /PhotoVoltaic- Checklisl.docx
Is the construction •
Type of mate wood and does ® Yes If "Yes ", qualifies for
the construction qualify
Construction "conventional light ❑ No the prescriptive path. •
as frame" construction?
Is the spacing 24 inches
or less?
Pre - engineered trusses. Li Yes If "Yes ", qualifies for
the prescriptive path.
❑ No
Roof framing
members Is the spacing 24 inches
or less?
If "Yes ", qualifies for
Nominal lumber. ❑ Yes the prescriptive path.
❑ No
Is the combined weight ® Yes .
of the PV modules and If "Yes ", qualifies for
racking less than or ❑ No the prescriptive path.
Solar equal to 4 psf?
installation Is the solar installation
l
CZ
ayout in accordance Yes If "Yes ", qualifies for
with Section 305.4(3) of
. the 2010 Oregon Solar ❑ No the prescriptive path. .
Code? '
❑ Metal
Single layer If roofing material is
Roofing • Check the type of ❑ of wood one of the three types
material roofing material shingle/shake checked, qualifies for '
the prescriptive path.
(v_ Max. two layers of composition
shingle.
Is the roof mounted ® Yes
Connections of solar assembly
the solar assembly connected to roof If "Yes ", qualifies for
framing or blockin ❑ No the prescriptive path.
to the roof g g
directly?
i
2
I J Building / Forms /PhotoVoltai c- Checklist.docx
❑ Yes If "Yes", qualifies for
Is the gauge 26 or less?
❑ No the prescriptive path.
115 lbs for 60 inch •
spacing or less?
If "Yes ", qualifies for
❑ Yes the prescriptive path.
❑ No
Minimum Uplift rating
of Clamps? 75 lbs for 48 inches
spacing or less?
If "Yes ", qualifies for
❑ Yes the prescriptive path.
❑i No
Attachment of
roof mounted Minimum 24 inches If the spacing falls
solar systems Spacing of clamps? within 24 inches and 60
directl to in ches inches, qualifies for the
y Maximum 60 inches prescriptive path.
standing seam
metal panels Width of roofing If the width of the panel
panels? 18 inches or less is less than 18 inches,
inches qualifies for the •
prescriptive path.
Minimum #10 at 24
inches o /c?
Size and spacing of ❑ Yes If "Yes ", qualifies for
fastener? the prescriptive path.
❑ No
Is the roof decking of
WSP min. %z" thickness, ❑ Yes
decking connected to If "Yes ", qualifies for
framing members ❑ No the prescriptive path.
w /min. 8d nails @
6 "/12" o /c?
Is the height less than or
Maximum 18 inches equal to 18 inches?
Height of the from the top of the If "Yes ", qualifies for
solar modules module to the roof ® Yes the prescriptive path.
surface. ❑ No
3
1:/ Building /Fomu/Photo Voltaic- Checklist.docx
Submittal Documents required for Prescriptive Installations
Show the location of the PV system in relation to buildings, structures,
property lines, and, as applicable, flood hazard areas.
Site Plan Details must be clear and easy to read. •
Minimum size of the plan is 8.5 x 11 inches.
Attach a simple structural plan showing the roof framing (rafter size, type, and
spacing) and PV module system racking attachment.
System must be shown in sufficient detail and clarity to assess whether it
Structural Plan meets the prescriptive construction requirements as listed earlier above in the
matrix.
Minimum size of the plan is 8.5 x 11 inches.
PV Modules
Manufacturer: 1 r cokar
Model Number: 'Ts M _ ago( )
Listing Agency: UL1703
4
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