Permit CITY OF TIGARD MASTER PERMIT
I q
s COMMUNITY DEVELOPMENT Permit#: MST2014-00201
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2014
T E�'AR D Parcel: 1 S 134CB10201
Jurisdiction: Tigard
Site address: 12476 SW EDGEWATER CT
Subdivision: MILL VIEW Lot: 2
Project: Jelinek
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
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 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
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 8 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:
JELINEK,GARY L SOLARCITY CORPORATION Required Items and Reports(Conditions)
DIERKING,HEATHER 6132 NE 112TH AVE
12476 SW EDGEWATER CT PORTLAND,OR 97220
TIGARD,OR 97223
PHONE: 503-679-8482 PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $363.69
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 • • - •irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
' —'—^ > [ t!
Issued B . . yi_ Permittee Signature: o-
cal��7 i L1�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
RECEIVEP
Residential FOIL 01 1.1( F 1 tit. ON I.1
City of Tigard NOV 10 2014 Received i,, Pennit N..
nate/B : ►i► S d� OJ
•1111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �7 �
Phone: 503.718.2439 Fax: 503.598.1960,g. , Date/13 C�'� r Other Permit:
I I li A It I Inspection Line: 503.639.4175 .d�T I OF TIGAk,. Dale Ready/By: ionic H See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Medrod: /I/14 AI �-- fie' Supplemental Information
&t2 t+-ot,lad nhea.-u
.:e Y _;.,_: MI O.1 ! 1111411111111D DATA:I-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
. 1151 c work indicated on this application.
® I-and 2-family dwelling ❑Commercial/industrial Valuation: 5 5355
❑Accessory building ❑Multi-family Number of bedrooms:
I0 Master builder ❑Other: Number of bathrooms:
tott Mt imwarMATION 11110.LOC.ATIO1' Total number of floors:
Job site address: 12476 SW Edgewater Ct New dwelling area: square feet
City/State/ZIP: Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Jelinek Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIEM BATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
fax 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
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Jelinek, Gary Type of construction:
Address: 12476 SW Edgewater Ct Occupancy groups:
City/State/ZIP:Tigard OR 97223
Existing:
Phone:( 503)679-8482 Fax:( )
New:
® APPLICANT III cow= PERSON BUILDING PERMITllll
Business name:SOLAR CITY
Sim refer to
Structural plan review fcc(or deposit):
Contact name:MELISSA BENTLEY FLS plan review fee(if applicable):
Address:6132 NE 1121"AVE .
Total fees due upon application:
City/State/ZIP:PORTLAND OR 97220
Phone:(503)894 6903 Fax::(1866)445-7459 Amount received:
E-mail:ABENTLF.Y(a)50LARCITY.COM PH LTACMMAS PANELSYSTiItl
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:SOLAR CITY Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:6132 NE 112Th AVE Solar Installation Specialty Code checklist.
City/State/ZIP:PORTLAND OR 97220 Permit Fee(includes plan review SI80.00
and administrative fees):
Phone:(503)894-6903 Fax:(1866)445-7459
State surcharge(12%of permit fee): 521.60
CCB lie.: 180498 `` Total fee due upon application: 5201.60
Authorized signature:11� , This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Print name:A. MELISSA i ' TLE Date: 1 1/07114 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(1 1/02/COM/WEB)
w
Building Permit Application Checklist
One- and Two-Family Dwelling Doti OFFICE: USE ONIA
City of Tigard Receivede
13125 SW 11011 Blvd.,Tigard,OR 97223 Datdti Associad permits:
. •• ' Phone: X03.718.2439 Fax: 503.598.1960 ❑ Electrical t` "trim; a,; C1 Mechanical
24-Hour Inspection Line: 503.639.4175
i IL ARI,
Internet' www.ligard-or.gov ❑ other.
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1 es No NiA,
l Land use actions completed. See jurisdiction criteria for concurrent reviews. _ ❑ ❑ •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑
3 Verification of approved plat/tot. ❑_ ❑ ❑
4 Fire district approval required. Name of district: . ❑ ❑ 0
5 Septic system permit or authorization for remodel, Existing system capacity . ❑ ❑ []
6 Sewer permit.
7 Water district approval. 0 ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ 0
9 Erosion control ❑plan ❑ permit required. include drainage-way protection,silt fence design and location of catch- ❑ ❑ 0-1
basin protection.etc.
10 3 Complete sets of legible plans. Must he drawn to scale.showing conformance to applicable local and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions:property corner elevations(if ❑ ❑ ❑
there is more than a 4-fl.elevation differential,plan must show contour lines at 2-f4.intervals);location of casements
and driveway;footprint of structure(including decks):location of wells/septic systems;utility locations;direction
indicator:lot arca;building coverage area;percentage of coverage:impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size, location of smoke detectors-water heater, ❑ ❑ ❑
furnace, ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing.roof slope,ceiling height,siding material.footings
and foundation,stairs, fireplace construction,thermal insulation.etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations: for non- ❑ ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of mbar. For engineered 0 ❑ ❑
systems,see item 22."Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 ❑ ❑
over 10 feet long and/or any beam/joist carry a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ ❑ ❑_
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ' ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e..shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑
architect Iicensed in Ore on and shall be shown to be a licable to the ro'ect under review.
23 'Three(3)site plans are required for Item 1 I above. Sitc plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑
24 Two(2)sets each are required for items 16, 19,20 and 22 above. ❑ 1=1--0—
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building]pans will not be accepted. ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ 0
27 "Drawn to scale"indicates standard architect or engineer scale. ❑l—❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9. 1995.
1:1Building\Pcrmils\BUP-RESPennitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WL:B)
'Electrical Permit Application RECEIVE
City of Tigard ,y
I 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 1 0 2014 Plan Review P�mnr/S�'�j7 ���Q!
Phone: 503.718.2439 8.2439 Fax: 503.598.1960 Da gy: Other Permit:
Inspection Line: 503.639.4175 (� Date RetldyBy: / . 0 See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGAR Nefitied/Method: Supplemental Information
TYPE P1AN REVIEW
❑New construction ®Addition/alteration/replacement 4 Please check all that apply(submit j,sets of plans wfitems checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATZOORy OR 00I110i1UCTION' exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,al of a exceeds 1 ns, ❑commercial-see agricultural
rY $ amps for all orbs installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of ISO KVA or
WE It BUFORMATION AND [�O[. 'AOIH ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2""1-3",
Job no.:9722 179 I Job site address:12476 SW Edgewater Ct 100HP 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.: I Project name:Jelinek ❑Service or feeder 600 amps or more.
FEB SCHEDULE
Cross street/directions to job site: or.erlau.. I QIY• I Fee. I T.11a 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'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIFT1ON IN WORK (with above sq.R.)
Limited energy,multi-family 75.00 2
PV ROOF MOUNT residential(with above sq.ft.) �/
Renewable Energy Ef See Page 2
Services or feeders installation,alteration,and/or relocation
® mammy.EIY OWNER l 0 TENANT 200 amps or less 100.70 2
Name: Jelinek, Gary 201 amps to 400 amps 133.56, 2
401 amps to 600 amps 200.34 2
Address: 12476 SW Edgewater Ct 601 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,altera-tion,and/or
Phone:( 503)679-8482 I Fax:( ) relocation
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,pe-r panel
Si APPLICANT I ® CONTACT MOON A.Fee for brunch circuits with
above service or feeder fee, 7.42 2
Business name:SOLAR CITY each branch circuit
B.Fee for branch circuits without
Contact name:MELISSA BENTLEY service or feeder fee,first 56.18 2
branch circuit
Address:6132 NE 112"AVE Eachadd'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 I Fax: :(1866)445-7459 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:ABENTLEY@SOLARCITY.COM Pump or irrigation circle 67.84 2
FACTOR Sign or outline lighting 67.84 2
Business name:SOLAR CITY Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:6132 NE 112Th AVE Each additional inspection over allowable is any of the above
City/State/ZIP:PORTLAND OR 97220 Additional inspection(I hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:(503)894-6903 I Fax:(188)445-7459 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 180498 I Electrical Lic.: C562 Suprv.Lic.: 5201S specifically listed(A hr min) 90.00/hr
Suprv.Electrician signature,required: �� . . - ''�!ER>1�P P>�
�"�` Subtotal:
Print name: DEREK CROPP _ I Date: I I i I Lt Plan review(25%ofpemtit fee):
)cf? State surcharge(12%of permit fee):
Authorized signature: 1 4 . 1 TOTAL PERMIT FEE:
This permit application expires if a permit Is not obtained within 180
Print name: A. MELT A s � T ! Date:11/07/14 days after It has been accepted as complete.
• Number of inspections allowed per permit.
11auiWing\PermiulELC_PerorkApp_ELK_EKE doe Rev 05/21/2013 4404615T(11105ICOM/WEB
• . ,
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
.. SirD►�1�T�".�G.�NrDRK I;?NLY,:.. :.. .._... ..: ,...:...: ,,:>�r s��.t�nu>>E: :: ::::::::::::::.`:_;::;:..:
Fee for all residential systems combined .. 575.00 1lenerintion LQty. I Fee I Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kvn or less 100.70 2
5.01 to 15 kva 1 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
n Burglar Alarm Wind generation systems in excess of 25 kva:
.tS.Oi to 50 kva 301.04 2
I I Garage Door Opener* 50,01 to 100 kva 552.26 2
100 kva(fee in accordance with
OAR 918-309-0040) 552.36
❑ Heating, Ventilation and Air Conditioning
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
Each additional inspection over allowable in any of the above:
El Other: Each additional inspection is t 66251 hr
charged at an hourly(1 hr mm)
Inspections for which no fee is 90,00/hr
specifically listed(1i hr min)
CO1�1119EkCML WORK ONLY.
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 permit is not obtained within 180
nAudio and Stereo Systems days.after it has been accepted as complete.
* Number of inspections allowed per permit.
171 Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I.Intrdding'Jbnnifs`ELC_PerriIApp_1LK_ERES doe Rea 05/21/2017
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
12476 SW EDGEWATER CT, TIGARD, OR,
97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2014-00201
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
12476 SW EDGEWATER CT, TIGARD, OR,
97223
Residential - Master Permit
199 Electrical final
PASS
MST2014-00201
Jeff Grove
Violation Summary:
Inspector Contractor