Permit II v CITY OF TIGARD MASTER PERMIT
11::`• COMMUNITY DEVELOPMENT Permit#: MST2013 00185
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2013
Parcel: 28 104CA03400
Jurisdiction: Tigard
Site address: 13648 SW LAUREN LN
Subdivision: HILLSHIRE Lot: 34
Project: MAI
Project Description: Solar photovoltaic system installation.
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
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
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
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF R-3 0
Owner: Contractor:
MAI,MICHELLE&MATTHEW WILLAMETTE CREST PROPERTIES Required Items and Reports(Conditions)
13648 SW LAUREN LN 14775 SE 82ND DR
TIGARD,OR 97223 CLACKAMAS,OR 97015
PHONE. PHONE: 503-635-0117
FAX: 503-635-0157
Total Fees: $318.88
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 • : •re.•• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0• -0010 through OAR 952-go -1091 V. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
C
Is-ued By: t/, •�i.4- �amaIi Permittee Signature:
I Call 503.639.4175 by 7:00 a.m.for the next available Inspect on d� e.
This permit card shall be kept In a conspicuous place on the job site until corn.etlon of the project.
i
Approved plans are required on the job site at the time of each Inspection.
Building Permit Application
CNISP
Residential Aso 0�3 FOR ortILI: I SE ONLY• City of Tigard ®��' DaCe1°ed ; , ��� Permit No.: I, • I —O s
13125 SW Hall .2 39 Tigard,OR 97223 P�G �1' 8 N
'� C Phone: 503.718.2439 Fax: 503.598.1960 0�* \�N. �. R411111/
Other Permit:
r I G A h D Inspection Line: 503.639.4175 G�'``� ��� Date Ready/By: 13 See Page 2 for
Internet: www.tigard-or.gov �`Q`�NC31 No�tifi�ed/Met�hod: ?j�a* Supplemental Information
TYPE OF WORK C '.QUIRED 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
El Addition/alteration/replacement ®Other:PV Solar equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® I-and 2-family dwelling ❑Commercial/industrial Valuation: $
El Accessory building 1=I Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13648 SW Lauren Lane New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Mai Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
_ REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.
2.97 PV Solar System on roof- Valuation: $
Existing building area: square feet
New building area: square feet
p_PROPERTY OWNER ❑ TENANT Number of stories:
Name: t--I A I , 1 C-L#4,t!I- . of �--1„giE.t" tv Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Willamette Crest Properties,LLC (Please refer to fee schedalt�
Structural plan review fee(or deposit):
Contact name:Julia
FLS plan review fee(if applicable):
Address: 14775 SE 82od Dr
City/State/ZIP:Clackamas,OR 97015 Total fees due upon application:
Amount received:
Phone:(503)635-0117 Fax::(503)635-0157
E-mail:julia PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
@advancedenergyoregon.com
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Willamette Crest Properties,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:14775 SE 82"1 Dr Solar Installation Specialty Code checklist.
City/State/Z1P:Clackamas, OR 97223 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)635-0117 Fax:(503)635-0157 State surcharge(12%of permit fee): $21.60
CCB lic.:180882
Total fee due upon application: $201.60
Authorized signature: r - �) This permit application expires if a permit is not obtained
�L�c�(/l/l within 180 days after it has been accepted as complete.
Print name:Mike Werner I Date:8t2/13 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
Electrical Permit Application � FOR oFFlcl Ls[, ONLY
City of Tigard �� B : ..e.
0 6 / .Permit No.: / —OU t
a 13125 SW Hall Blvd.,Tigard,OR 97223 <y �� r� r .t► . S
II. Phone: 503.718.2439 Fax: 503.59 1� c �4 Other Permit:
r I G A R D Inspection Line: 503.639.4175 ®1 ON. 4 .... RI See Page 2 for
Internet: www.tigard-or.gov P,\V G'\ �� Supplemental Information
(?
TYPE OF WORK k ,A, PLAN REVIEW
t ' Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction ❑Addition/alteration/repla
❑Demolition ®Other:PV Solar
❑Service or feeder 400 amps or more ❑Building over three stories.
�p� where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUGION 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 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E,"I-2","1-3",
Job no.: Job site address: 13648 SW Lauren Lane IOOHP or more. Occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard, OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Mai ❑Service or feeder 600 amps or more.
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'l 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.)
2.97 PV Solar
Limited res dential((with above sq ft.) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
- 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
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
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
❑ APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name:Willamette Crest Properties LLC each branch circuit
B.Fee for branch circuits without
Contact name:Julia service or feeder fee,first
branch circuit 56.18 2
Address: 14775 SE 82°d Dr Each add'I branch circuit 7.42 2
City/State/ZIP:Clackamas, OR 97015 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503)635-0117 Fax: :(503)635-0157 dwelling service and/or feeder
Reconnect only 67.84 2
E-mail:julia @advancedenergyoregon.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:MJ Electrical Inc Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: PO Box 1673 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP: Brush Prairie, WA 98606
Investigation(I hr min) 66.25/hr
Phone:(360)859-3316 Fax:(360)882-7450 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 182623 Electrical Lie.: C423 Suprv. Lie.: 5375S specifically listed(%:hr min) - -
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal:
Print name: Mike Lipe Date: Plan review(25%ofpermit fee):
a/4413
State surcharge(12%of permit fee):
Authorized signature: is TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Pennits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-46151(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
,RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined ... $75.00 Description 1 Q1'. I Fee 1 TotoI I •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less I 100.70 /60.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
El Heating, Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
111 Other: additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1-
Inspections for which no fcc is 90.00/hr
specifically listed(%f hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal: /00.70
(SEE OAR 9 1 8-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee): / o3
Check Type of Work Involved: TOTAL PERMIT FEE: /( 2-t 7g
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
. ❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
(:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013