Permit N CITY OF TIGARD MASTER PERMIT
1111 s COMMUNITY DEVELOPMENT Permit#: MST2014 00179
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/23/2014
Parcel: 1 S134CA05200
Jurisdiction: Tigard
Site address: 11775 SW BURLCREST DR
Subdivision: BURLWOOD NO.2 Lot: 25
Project: Bean
Project Description: Install 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: $7,140.00 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
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=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,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: _ _ _
BEAN,JAMES R&DEBRA A SOLARCITY CORPORATION Required Items and Reports(Conditions)
11775 SW BURLCREST DR 6132 NE 112TH AVE
TIGARD,OR 97223 PORTLAND,OR 97220
PHONE: 503-579-9814 PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $356.19
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 e rules or direct questions to OUNC by calling 5 3.2 2.1 or 1.800.332.2344.
Issued By: r..—. Permittee Signature:
3.639.4175 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 ADDlica ED
Residential OCT 2 2014 �i ' " ' i( I I '
City of Tigard w e !e /L'm%' Permit No.: A, - , , _DQl7
13125 SW Hall Blvd.,Tigard,OR 9 r s'
Phone: 503.718.2439 Fax: 503.59 �'/•* � nD (0 Other Panic Date/I3 •
•I I k, i, Inspection Line: 503.639.4175 � i ..1— i►1,"l�'') late R- • -. ,03//111 t 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Soppleseatat tat r.ado■
fk C ■l.k4t tnrdi.klA
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
®Addition/alteration/replacement El Other Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® I-and 2-family dwelling CI Commercial/industrial Valuation: S 7,140
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
lob site address: 11775 SW Burlcrest Dr, New dwelling area: square feet
City/State/ZIP: Tigard OR 97223 Garage/eatport area: square feet
Suite/bldgJapt.no.: I Project name: BEAN 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.
PV ROOF MOUNT Valuation: S
Existing building area: square feet
New building area: square feet
® ',smarty OWNER 1 ❑ TENANT Number of stories:
Name: BEAN,JAMES Type of construction:
Address:11775 SW Burlcrest Dr, Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing:
Phone:( 503) 579 9814 Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:SOLAR CITY /rlrrttrrrrltrMJbrsatatllyl
Contact name:MELISSA BENTLEY Structural plan review fee(or deposit):
112TH FLS plan review fee(if applicable):
Address:6132 NE 112 AVE
City/State/ZIP:PORTLAND OR 97220
Total fees due Icon application:
Phone:(503)894 6903 I Fax::(1866)445-7459
Amount received: __le--
E-mail:ABENTLEV(D SOLARCITV.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:SOLAR CITY Submit two(2)sets of roof plan with connection details
Address:6132 NE 112TH AVE and fire department access.along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:PORTLAND OR 97220 Permit Fee(includes plan review
and administrative fees): 5180.00
Phone:(503)894-69413 I Fax:(1866)445-7459 State surcharge(12%of permit fee): $21.60
CCB lic.: 180498
•`` Total fee due upon application: $201.60
Authorized signature:(1 It 1111 • This permit application expires if a permit is sot obtained
within 180 days after it has been accepted as complete.
I Print name:A. MELISSA a TLE% I Date: 10/17/14 I *Fee methodology set by Tri-County Building Industry
Sery Board.
1:\3uildinglPennits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB)
• •
Electrical Permit Applic WE , ,it i,1 1 h ■ , ,, k, 1 ,
gl
City of Tigard i Received: l ��' lbrmit No.: , 5r Z �D �.
13125 SW Hall Blvd.,Tigard,OR 2 0 2014 °it ;e1A/ �, ' 7
Phone: 503.718.2439 Fax: 503.5 patdg ; Other Pia
Inspection Line: 503.639.4175 ' o 0 2014 Date Ready/By. Saris: B g«Page 2 Internet: www.ligard-0r.gov �7
Notified/Method: Supplementallefirmatian
TYPE auitallitMelON PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please cheek all that apply(submit j sets of plans wfuems 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.
® I-and 2-famil dwellin less to ground,or exceeds 14,000 ❑Commercial-use agricuhural
y g ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑lnstallaion of 150 KVA or
JOB SITE E INFORMATION AND LOCATION
['Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2""1-3",
Job no.:9722235 I Job site address: 11775 SW Burlcrest Dr, I ix or or morn. Recreational❑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/bldgJapl no.: I Project name: BEAN ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Dere.ladm I Qtr. I tae. I Taal I •
New residential single-or multi-family dwelling snit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.R.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy.residential
75.00 2
DESCRIPTION OF WORK (with above sq.R.)
Limited energy,multi-family 75.00 2
PV ROOF MOUNT residential(with above sq R.)
Renewable Energy ® See Page 2
Services or feeders installation,alteration,and/or relocation
® ntormiry OWNER I 0 'I}21(A1n' 200 amps or less 100.70 2
Name: BEAN, amps to 400 amps 133.56 2
BEAN,JAMES _ 401 amps to 600 amps 200.34 2
Address: 11775 SW Burlcrest Dr, 60l amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard OR 97223 Temporary services or feeders installation,alteration,and/or
Phone:( Fes'( ) relocation
( 503 ) 579 9814 200 amps or less 59.36 I
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 _
® APPI.K'.AN ' I ® CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name:SOLAR CITY CORP each branch circuit
B.Fee for branch circuits wflhoru
Contact name:A. MELISSA BENTLEY service or feeder fee,first 56.18 2
branch circuit
Address:6132 NE 112111 AVE Each add'I branch circuit 7.42 _ 2
City/State/ZIP: PORTLAND OR 97220 Miscellaneous(service or feeder not Included)
Each manufactured or modular 67.84 2
Phone:(503)894 6903 Fax: :(1866)445 7459 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:ABENTLEY®SOLARCITY.COM Pump or irrigation clack 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:SOLAR CITY CORP. Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:6132 NE 112Th AVE Each additional inspection over allowable in any of the above
City/State/ZIP:PORTLAND OR 97220 Additional inspection(1 hr min) 66.25r hr ' -
Investigalion(I hr min) 66.25/hr
Phone:(503)894 6903 I Fax:(1866)445 7459 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 180498 Electrical Lie.: C562 I Suprv.Lie.: 5873S specifically hr
fically listed('h hr min)
ELECTRICAL PERMIT FIRS
Suprv.Electrician signature,required: Subtotal:
Print name: NICHOLAS ARMSTRONG I Date: 10/17/14 _ Plan review(25.6 of permit fee):
State surcharge(12%of permit fee):
Authorized signature: _1� TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: A. MELISSA BENTLEY -I Date: 10/17/14 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I lawldingWon:a1ELC_PaiiApr_Brn_ERE doe Rev 05/21/2013 MOK1 57(1 I p52OMM6a
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Fee for residential systems combined $75.00 Description I oir.1 Fee I Teat I •
Renewable cketrieal energy systems:
Check Type of Work involved: 5 kva or less loam 2
5.DI to 15 kva 1 133.56 133.56 2
L Audio and Stereo Systems*
ism to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
[1 Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fce in accordance with
552.26
Heating,Ventilation and Air Conditioning OAR 918-309-(1040)
System* Solar generation systems in excess of 25 WE
Each additional kva ovcr25 7.42 3
Li Vacuum Systems* >IGO kva no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is
66.25/hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.001 hr
COMMn�=�*t�. specifically listed(Y,hrmin)
RWAI:r.: - .. trF.(.' 111C'AI.
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a peratit is nut obtained within 181)
❑ Audio and Stereo Systems days after it has been accepted as complete.
• Numb of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
n D• ata Telecommunication Installation
❑ Fire Alarm Installation
❑ H• VAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
Fl O• utdoor Landscape Lighting*
❑ Protective Signaling
❑ O• ther , . ..
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I Build aL'Permus\ELC PcrmitApp ELR EREdoc Rev OS/1/?017
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