Permit CITY OF TIGARD MASTER PERMIT
a COMMUNITY DEVELOPMENT Permit #: MST2013 -00254
T I G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/31 /2013
Parcel: 2S 104C 600900
Jurisdiction: Tigard
Site address: 13299 SW ASCENSION DR
Subdivision: HILLSHIRE WOODS Lot: 25
Project: Cavoretto
Project Description: Installation of roof mounted solar photovoltaic system
BUILDING
Floor Areas Reauired 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: $3,858.00 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: 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 Tvoes 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
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temo Srvc/Feeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add9 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:
CAVORETTO, JOHN & ROBIN SOLARCITY CORPORATION Required Items and Reports (Conditions)
13299 SW ASCENSION DR 6132 NE 112TH AVE
TIGARD, OR 97223 PORTLAND, OR 97220
PHONE: 971 - 219 -1543 PHONE: 971 - 201 -5278
FAX: 866 -592 -2249
Total Fees: $319.38
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through 0: - 9'1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling �50 1.800.332.2344. /
Issued By: • r P / Permittee Signature: ///l/ (97 / ( 1 SON
Call 503.639.4176 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
Building Permit Application, CEIVED
Residential FOR 01.11( V USE ("I.\
City of Tigard j 6 2013 Da /$ �/3 (1—.(1—.),--k, t<- PermitNo.: A-/f- ., ,/f ec),2
" 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Date/B : ..Other PermiC
Phone: 503.718.2439 Fax: 503.598.1960 r� ' �;��/� `
, it; A h D Inspection Line: 503.639.4175 `l'l' Y OF TIGARD Date Read; - : - Omit la Sec Page 2 for
Internet: www.tigard- or.gov Notified/method: / L /� / / /,3 Supplemental Information
:3UILDING DIVISION A)/kto /,-IS
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.
® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ " �
building Number of bedrooms:
❑ Accessory t
ry g ❑ Multi - family
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ( t J,, A- Ser. N•a r 1 - New dwelling area: square feet
City/State/ZIP: - 174 0(9 ,,, g (` Z Garage/carport area: square feet ii)
Suite/bldgJapt. no.: Project name: g (_ au c0 l I 1 c Covered porch area: square feet
Cross street/directions to job site: � r 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: 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 ❑ TENANT Number of stories:
Name: ' C \I1 ( A' c .- c, Type of construction:
Address e} \
� " 1 � ��f�5� 6 � Occupancy groups:
e te/ 7P: \m
.. 0 7 J Existing:
Phone: Phony. (tf i 4 , 4 Fax: ( )
New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: SolarCity Corporation (Please refit roJee schedule)
Structural plan review fee (or deposit):
Contact name • ,An a \ l K
t6 FLS plan review fee (if applicable):
Address: 6132 NE 112 Ave
Total fees due upon application:
City/ StatefLIP: Portland, OR 97220 `
• Phonegl t 7� 5-(.5 7 Fax:: I OD 1
_ - !r� Cl ,9l ( L-( G3 Amount received: j� f (
E -mail: re 1' �\ (i rC I A. j t OCrr\ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
!' l
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
to and fire department access, along with the 2010 Oregon
Address: 6132 NE 112 Ave Solar Installation Specialty Code checklist.
City/ State/ZIP: Portland, OR 97220 Permit Fee (includes plan review
I and administrative fees): $180'00
Phone: 1q 71 (90 " 5 Q' C Fax WI(' 5 g94aq q State surcharge (12% of permit fee): 521.60
CCB lic.: 180498 r
Total fee due upon application: $201.60
a
Authorized signature: I il T his permit application expires ifa permit is not obtained
d k� within 180 days after it has been accepted as complete.
Print name: MO / t - , ( Date: ME ( S * Fee methodology set by Tri- County Building Industry
Service Board.
I: Building \Pennits \BUP- RESPennitApp.doc 02/24/2011 440-46137111/0 /COM /WEB) / V / / 1 L (.)--CA/ i
/ Pc 1
■
Electrical Permit AppliCEIVEI) 1 :e,iz t,, , ,( , ( , c,\ l ,
City of Tigard Received /A i PamieNo.: t15 , - •10,,
13125 SW Hall Blvd., Tigard, OR 1 6 2013 Pan Review
Phooc: 503.718.2439 Fax: 503.598.1960 Debt Odor Penn:
Inspection Line: 503.639.4175-� Date Read) By: e Saa/Is�W Warman. .
lotenset: www.tiglud -or.gov l l l' OF T 1 G A R
Y D NotirndMethod:
1 SIQN W ` wry; -
❑ New construction ® Addition/alteration/replacement Please check all tilt apply (submit' sets of plans Wheats checked below):
❑ Demolition ❑Other ❑ Service or fader 400 sops or more ❑ braiding over duet stories.
where the available bolt cancer ❑Marion and booty/nil.
CATEGORY OF CONSTRUCTION exceeds 10.000 saps at ISO volts or ❑ Floating buildings.
® I - and 2- family dwelling ❑ Commercial/industrial 0 Accessory building , "to pes °r °tala 14.000
s. ❑�e'O""�1fC"B1Ctl at
antes f all other insulations. beald'mga.
❑ Multi - family ❑ Master builder ❑ Other. ❑ Fire wup• ❑ twlation of 75 KVA or
JOB 317'6 INFORMATION AND LOCATION ❑ system areersepmtey derived system.
❑ Addition of new moor load of ❑
Job no.: I Job site address (3.?R� W � � Al ), IOOBP more. °ec'pa
(� I +❑ Six or more residential snits. Reaeatioal vehicle perks.
City'State/ZIP: ' t ern exZ l 7 a s 3 ❑ Health -are facilities. ❑ Supply whop rbr more than
' ❑ Hazardous location 600 volts nominal.
Suite/bldg./apt. no.: Project name: CAV(Rfab ❑ Service or feeder 607 amps or more.
FEE SCHEDULE
Cross street/directions to job site: near sae I Qv. t Fee. I raw I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1.000 sq. f. or less 16834 4
Ea. adds 500 sq. ft or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. It) 75.00 2
Limited map, multi -family
Roof Mount PV System residential (with above sq. R.) 75.00 2
Services or feeders installation,. alteration, and/or las relocatio'
� j
200 amps or s I 100.70 l ant, 2
® PROPERTY OWNER I 1:1 TENANT 201 amps to 400 amps 13336 s 2
401 mops to 600 amps 200.34 2
Name: 3U� ce,,,,,.,4,, 601 amps to 1,000 naps 301.04 2
Address: 1 t ` 1 a3 it se f l j )
j 3 1 3 `� over 1,000 amps a volts 552.26 2
`
City/State/Z1P: �? qtr Temporary services or feeders installation, alteration, and/or
4 1 (Jl{1iii� / , �o(> relocation
Phone: (� `1 �) o i c j 4 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 2
Branch circuits new, alteration, or extension, per panel
Owner signature: Date: A. Fee fns breach circuits with
® APPLICANT 1 la CONTACT PERSON above service or feeder fee,
each branch circuit 7.42 2
Business name: SolarCity Corporation B. Fee for brash circuits without
t service or feeder fee, first
56.18 2
Contact name:: 64\ 1 K r e R 1 branch circuit
,� ` Each add baaach circuit ( ( 7.42 ( ( 2
Address: 6132 NE 112 Ave Miscellaneous (service or feeder not included)
City/State/Z1P: Portland, OR 97220 Each tomufacand or modal., 67.84 2
dwelling, servieeaaNnr feeder
Phone: (971) 90 , 5 3. , ' 7 , l I Fax:: (866) I Q 079,(1 d1 R00OA0gt only 67.84 2
E -mail: m A t ((Iolardty.eom - Pomp or urin f t i 67.84 2
Sign a airline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name:SolarCity Corporation
panel, Paget 2
Each additional inspection over allowable in any of the above
Address: 6132 NE 112' Ave Additional inspection (1 br mm) 66.25/ hr
City/State/ZIP: Portland, OR 97220 lave sligat,co p M erns) 6625/ hr
, (l Industrial plant (1 hr min) 78.18/ hr
I � O
Phone: (971) ; ( 59-7.g v I Fax: ( 866) Inspections for which no fee is 90.0W hr
specifically lined PA hr min)
CCB Lic.: 180498 I Electrical • • C562 I Suprv. Lic.: 5201S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, require d: , Subtotal:
`� �4 Plan review (25% of permit fee):
Print name: Derek Cropp ! Date: • er State surcharge (12% of permit fee):
Authorized signature: , / TOTAL PERMIT FEE:
This permit *Oran. expires Ha penult is nut ebMned widths 181
Print name:.. L � ` Date: (a in go 1 7j der after a bas ben .eeepad,<eaahpkle.
• Number of *MI iora albwed per permit.
I: Moine Perniu E1.C•PenaiApp.doc e 01 10 440 4SIS[tl I 03 COat VITA
CITY OF TIGARD RECEIPT
i
� � 13125 SW Hall Blvd., Tigard OR 97223
�
503.639.4171
TIGARD
Receipt Number: 194327 - 12/17/2013
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2013 -00254 12% State Surcharge - Building 100- 0000 -24001 $21.60
MST2013 -00254 Solar Photovoltaic System 230 - 0000 -43104 $180.00
Total: $201.60
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 400275 DADAMSKI 12/17/2013 $201.60
Payor: SolarCity Corporation
Total Payments: $201.60
Balance Due: $0.00
Page 1 of 1
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13299 SW ASCENSION DR, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
2014-02-12 00:00:00
MST2013-00254
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13299 SW ASCENSION DR, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
2014-02-12 00:00:00
MST2013-00254
PASS - No C of O
Violation Summary:
Inspector Contractor