Permit oIa CITY OF TIGARD _. MASTER PERMIT
ril a .,- COMMUNITY DEVELOPMENT Permit#: MST2013-00226
T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2013
Parcel: 2S 104DA03400
Jurisdiction: Tigard
Site address: 13490 SW 129TH AVE
Subdivision: QUAIL HOLLOW-WEST Lot: 20
Project: Scott
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
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
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
F urn>=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:
ALT SF VB R-3 0
Owner: Contractor:
SCOTT,JAMES H&JUDITH A SOLARCITY CORPORATION Required Items and Reports(Conditions)
13490 SW 129TH AVE 6132 NE 112TH AVE
TIGARD,OR 97223 PORTLAND,OR 97220
PHONE: 503-521-8636 PHONE: 971-201-5278
FAX: 866-592-2249
Total Fees: $329.38
' 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. 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 OAR 952-001-0090. You may obtain a copy of the r ct questions to OUNC by calling 503.232.1987 or 1.800 332 2344_
1
Issued B Permittee Signature: ,G
Call . . y 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.
Building Permit Application
Residential A ED. \!City of Tigard 4. Received Permit 1/11."1„
c Da : . f o � , —49 p- 4�
Ivo ' Phone:S 03 7182439 Fax 5003%997822.1§60T 2 4 2013 • .m.rte , �
Da , ���INKU Other Permit:
------=,i .i �;� Inspection Line: 503.639.4175 Date Read)By".— ®See Pege 3 far •
internet: www.tigard.or.gov CITY OFTIGARD : it/s4/3.110 Supplemental Information
.., .-.,n,n nitPntirNill � '� 4— Ales-/- ,,o
TYPE OFAWORK' t'n v R."'... REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees'are based on the value of the work performed.
®AdditiotJaltt rationheplacenent ❑Other: Indicate the value(rounded to th'nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
.� 1-and 2-family dwelling Valuation: S 'C�
Y g ❑Commercial/industrial Z�
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMA'flON AND LOCATION Total number of floors:
Job site address: I (� C( O Su 7 C 4-t r t New dwelling area: square feet •
City/State/ZIP: �' �'/,A (� � q 1 , 3 Garage/carport area: square feet
Suite/bldgJapt.no.: Ui Project name: ,_ CUrr ` `O M LC S Covered porch area: square feet
Cross street/directions to job site:. U 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.
Roof Mount PV System Valuation: S
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of Dories:
Name: Sa)I- ' 1/�Sa r e S /� Type of construction:
Address: ,3 e 1 0 P
I J 9✓ Occupancy groups: —
City/State/ZIP: �a 11►a. Existing:
—
'' � 1�
Phone:( Fax:( )
—
New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES'
Business name:SolarCity Corporation (Please refer take aehedrrk)
Structural plan review fee(or deposit):
Contact name : ilA of k e_ Kr e l
Address:6132 NE 1121°Ave FLS plan review fee(if applicable):
City/Stater/JP:Portland,OR 97220 Total fees due upon application:
Phonegl t 7Qt 5,87 Fax:: — Gi�9c)) (Gj Amount received: of.4'
E-mail: M t�rp (` C \/t /1 (t-, t�1 � "l PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES'
1 x L 0l e, Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name SolasCity Corporation Submit two(2)sets of roof plan with connection details
1° and fire department access,along with the 2010 Oregon
Address:6132 NE 112 Ave Solar Installation Specially Code checklist.
City/State/ZIP:Portland,OR 97220 Permit Fee(includes plan review S 180.00
n and administrative fees
_
Phone:fR 71 (901 5 `78 I Fax 9-L rn 54& Q1(A State surcharge(12'lf,of permit fee): 521.60
CCB lic.:180498 '+ `1 1
Total fee due upon application: $201.60
Authorized signature: d f�� gii This permit application expires if a permit is not obtained
(� within 180 days after It has been accepted as complete.
IPrint name:m 0 /i e �f-,.e (( Date: to 7" 7613 Service B"Fee methodology oard. set by Tri-County Building Industry
(,(,11
I:,Buildingwennits\BUP•RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Applica'�ailiWn ra�11 .:(,,,,or,,,(,.,.:.,:,,-o ON LY
Ipil City of Tigard d«� H `° Received �•' Permit No.: -
° 13125 SW Hail Blvd,Tigard,OR 722� /�� y rib 3�a !�
® Phone: 503.718.2439 Fax: 503.198:19602 4 2 013 D to: . Other Permit:
iii:�;„y„ inspection Line: 503.639.4175 Date Readhgy: ,:
®See Page 2 for ;
intemet: www.tigard-orga„ {1 CITY OF TIIGA�R�U Notified/Method: ���j �p �pSupaemental Information
1. k S i L SF'C. _—_— - - _j .-— Y ---7--`-='6_' EL,,_r •
❑New construction ®Addition/alteration/replacesnerlt 11 Pose check all Om apply(submit 2 sea of plans wrlems checked-below):
❑Service or feeder 400 amps or more ❑Building over three stores.
❑Demolition ❑Other: where the available Ball ewieat ❑Marinas and boatyards.
i _ - 'G(►7iFI(Tlfi CONSiRUOT1O ' .__-- - i exceeds 10.000 amps at i50 volts or ❑Floating buildings.-
® 1-and 2-famil dwellin less to ground.or exceeds 14.000 ❑Commercial-use agricultural
y g ❑Commercial/industrial ❑Accessorybuilding amps fin all other imallatimu. buildings.
❑Multi-family ❑Master builder ❑Other. ❑Fire pump. ❑Installation of 75 KVA or
LI B 1�E s� Ot�l. O@ MT— ' ~ _ ❑Facer Mb= larger separately derived omens.
-=°--- -'- -' - `i. � = i- . _� ❑Addition drew motor bad of ❑"A","E","I.2","1.3'•.
Job no.: _ Job site address: I q3 1) pC i" 100HPurmore. oaupa,ry.
❑Si:or more residential units. ❑Recreational vehicle parts.
City:StaterZIP: 1 • G2 7 j t_ ❑Heallhsare facilities. ❑Sappy voltage tbrnwre than
❑itansrdous locations. 600 volts nominal.
Suite/bldgJapt no.: J Project name: �• #m e ❑Service or feeder 600 amps or more.
-Cross street/directions to job site: = �FEESCBI�FAU" 1T.E� _"`-'-
ninc ipslon I Qty. I Fr. I Toni I-•
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'1500 sq.it or portion 33.92 i
Tax mep/pareei no.: __ Limited energy,residential
--------_ tDESGRP170lV1 OF jWORI�j • (with abovesq.ft.) 75.00 2
Roof Mount PV System �rasiden (with �) 75.00 2
Services or feeders Installation,alteration,and/or relocation
_ _ 200 amps or less 100.70 2
J-PROPER ,TY OJ �,iIL---• �,pi1 Ef!1ANfi' 201 amps to 400 amps 133.56 2
Name: . 0(y\,e S S 401 amps to 600 amps 200.34 �2
601 amps to 1,000 amps 301.04 2
Address: f Q SO \'7a Ja i e�
`� Over 1,000 amps or volts 552.26 2
n V` /,r 7 7Z...3 Temporary services or feeders Installation,alteration,and/or
City/State/ZIP: ( relocation
Phone:(�n I d�.� a Fax:( ) 200 amps or less 59.36 1
/ vvv 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 m 599 amps 16654 2
Branch draft-new,alteration,or extension,per panel
Owner signature: A Date: A.Fee for branch circuits with
-_--._ __. -1_�TAf•P �";`,' . - -_�.___i iII .'�jl�, /t 7�.(f �.• �_7 above aerVlee or feeder fee, 7.42
each brmleh cirnrit 2
Business name:SolarCity Corporation B.Fee far branch circuits without
i
t service or feeder fee,first 56.18 2
Contact name;. 4O1t i` k C t.(i
- branch circuit
���,VVVV\\\\ Each add'1 branch circuit 7.42 2
Address:6132 NE 112th Ave Miscellaneous(service or feeder not included) -
City/State/ZIP:Portland,OR 97220 Each manufactured Of modular 67.84 2 I
dwelling,service and/or feeder
Phone:(971)90\547 K I Fax::(866)5-1Q aaU c Recormen only 67.84 2
E-mail:m (tlepolardty.com Pump or irrigation circle 67.84 2
• -_-- Sign cum lighting 67.84 2
7GON71tAGTOR ___�_—. signal l eircait(it(s)or limited-en . -
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(1 hr rnin) 66.25/hr
City/State/ZIP:Portland,OR 97220 investigation p hr min) 66251 hr
Industrial plant(1 hr min) 78.18/hr
Phone:(971); I Fax:(866) Inspections for which no fee is
specifically listed(F hr min) 90.00/hr '
CCB Lic.: 180498 I Electrical L/t C562 Suprv.Lic.: 520]S i✓.:_.._._ 'E1:ECTRICALT�PERMJTr FEES1"._ f
Suprv.Electrician signature,required: J/�,�/� /` permit feel '
I ` ����%r� � Plan review(25%of permit fee)
Print name: Derek Cropp , Date: State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
—
This permit application expires If a permit is not obtained within 180
Date 3• days atter it has been accepted as complete.
Print name: .
a �{ �` Number of impeclioels allowed per permit
1:Building Permits ELC•PermaApp.dor 0-01.10 440.461STt11 OS COM WEB