Permit CITY OF TIGARD MASTER PERMIT
!PI • COMMUNITY DEVELOPMENT Permit MST2014-00084
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/05/2014
Parcel: 25111 DC06900
Jurisdiction: Tigard
Site address: 9440 SW BRENTWOOD PL
Subdivision: SUMMERFIELD NO.9 Lot: 495
Project: Welch
Project Description: 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
Bckftw 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
Fumes=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 VB R-3 0
Owner: Contractor:
WELCH,KATHRYN Y TR STELCOR ENERGY LLC Required Items and Reports(Conditions)
9440 SW BRENTWOOD PL 9150 SW PIONEER CT.STE D
TIGARD,OR 97224 WILSONVILLE,OR 97070
PHONE: PHONE: 503-381-6187
FAX:
Total Fees: $321.88
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cen e rules are set forth in OAR
952-001-0010 through OA 52-001-0090. Y•u may obtain a copy of the rules or direct questions to OUNC by calling 5 . .1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 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
� FUR (,I I It I I ,I ()\I l
City of Tigard MAY 2 9 2014 Date/B : Permit N sZ2/ ,/
51111
4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie ir,
Phone: 503.718.2439 Fax: 503.598.1 ��/ WARD pat�gy r 5 I A Other Permit:
Inspection Line: 503.639.4175 D I1(�'�O(^�n (1n Date Ready :y: (/ / curs 6... ® See Page 2 for
I IC .\I.11 g g BUILDINP�I .ISIOP' 'q / 4"v pP
Internet: www.ti azd-or. Ov �I Notified/Method: J � Supplemental
£2 tfl- '
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work perormed.
Indicate the value(rounded to the nearest dollar)of all
p zAddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
41-and 2-family dwelling ❑Commercial/industrial
Valuation: $
❑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: 4440 S w 9 him}rte Do 0 pi__ New dwelling area: square feet
City/State/ZIP: ¶' I„ .e_No of.... t`�Jci��-22 A Garage/carport area: square feet
Suite/bldg./apt.no.: -1 Project name: w EiLC t.1r 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.
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.
1.)\) 5 L ST EA 1 NS-1-4-1-A.-All DfJ Valuation: S
— ,p o Dl:: AA NI- Existing building area square feet
��Ul New building area: square feet
PROPERTY OWNER I ❑ TENANT Number of stories:
Name: ��/� /L7LG// Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: _ ---L- All contractors and subcontractors are required to be
Contact name: \ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be lcensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: C LN t'l2.4, L�C
(Please refer to fee sckednk)
\ Permit fee:
Address: Cl i.5--X (,\ P 1 ONtev- (--17 SrE• O.
,% State surcharge(12%of permit fee):
City/State/ZIP: V/1 ,s DA) J l(..l E ( 2._ 1q- VI-
I-
FLS plan review(40%of permit fee):
Phone:(V) 3 i ., tp is-4_ Fax:( ) (Due upon application.)
CCB lic.: '2 'L2 I Z 3 l4 I l(P Total permit fees:
Authorized signature: �/Q Amount received:
(/W�'7 This permit application expires if a permit is not obtained
Print name: ethe:.E iv, go c'e3 ec Tc• Date: c/z 9 J 1 y within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board
1:)Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration El 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A,B&C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
I:\Building\Permits\FPS_PermitApp.doc Rev 01/05/2012 2
Electrical Permit Application RECEIVED FOR OFFICE USE ON I 1
City of Tigard Received Permit a:ir jS
13125 SW Hall Blvd.,Tigard,OR 97223 MAY 2 9 2014i`/ODD�y
III Plan Review Related Permit k:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
Inspection Line: 503.639.4175 Ready Date/By: m.is Fa See Page 2 for
T I G A R O Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE or vAiliLDING BIVISIO
❑New construction 1. Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
1 CATEGORY OP CONsYAUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
—
®'1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
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
Job#:1n)E L C� Job site address: el 4 4 0 S w Tg Q��0� ❑Addition of new motor load of system.
r � 100HP or more. ❑••A,,,••E,,,••l_2,•,••I_3,,,
Cif /State/ZIP' � ,,..() �y,� ❑Six or more residential units. occupancy.
y ��G1/ t`� V K-' �Z�a ❑Health care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Wet.C ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: nE SCHEDULE
Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 7500 2
residential(with above sq.ft.)
Renewable Energy e Page 2
%PROPERTY OWNER I ❑ TENANT Services or feeders installation,a eration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address: •
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
❑ APPLICANT I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.l8 2
branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 _ 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Crl'LCD ��) � t��C, Sign or outline lighting 67.84 2
q���ll p� Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: . -! I 5✓J 7) D!�)(r'FL CT S f tc• 1V' panel,alteration,or extension. g
City/State/ZIP: t VS vN J 1�1 9 Each additional inspection over allowable in any of the above
vG b� l-70 1/5 Additional inspection(1 hr min) 66.25/hr
Phone:(96) 3Q�A - ,,,` 1151- Fax:( ) Investigation(I hr min) 66.25/hr
Email: `� Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 9000/hr
CCB Lic.:WILA t, Electrical Lic.:CI 0 3.5 Suprv.Lic.:5 O3 2.6 specifically listed(Vs hr min)
grierlralcm_PE)
Suprv.Electrician signature,required:"-ptrtn,.., --i,, . . Subtotal:
Print name: ( O/V U) JS v Date: S—Zt),...) , ❑Plan Review Required(25%of permit fee):
7 State surcharge(12%of permit fee):
Authorized signature: 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\Permits\ELC_PermitApp_ELR_ERE.doe Rev 04/2I/2014 440-46I5T(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
Description I Qty. I Each I Total I •
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 l 2
5.01 to 15 kva 133.56 2
El 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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
El Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
El Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr l
Inspections for which no fee is 90.00/hr
specifically listed('/l hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
n Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9440 SW BRENTWOOD PL, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
July 17, 2014 at 9:20:40 AM
MST2014-00084
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9440 SW BRENTWOOD PL, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
PASS
July 17, 2014 at 9:18:20 AM
MST2014-00084
Jeff Grove
Violation Summary:
Inspector Contractor