Permit n CITY OF TIGARD MASTER PERMIT
• ., I' COMMUNITY DEVELOPMENT Permit#: MST2015 00147
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2015
Parcel: 2S110CB10600
Jurisdiction: Tigard
Site address: 15492 SW SUMMERVIEW DR
Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 94
Project: Nasongkhjla
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: $8,500.00 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
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:
NASONGKHLA,EDINA SOLARCITY CORPORATION Required Items and Reports(Conditions)
15492 SW SUMMERVIEW DR 6132 NE 112TH AVE
TIGARD,OR 97224 PORTLAND,OR 97220
PHONE: 503-536-2633 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. ATTENT Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0 through 95 1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 0 1.800.332.2344.
1 •�
Issued B 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 proje
Approved plans are required on the job site at the time of each inspection.
Buildinr` Permit Application �I�
AL
ResidentialC"'IVEP F(,IC(11-1:1(.1 t NE: (1v
City Received ^.f��/le /(1�� 5e7 S
Ci`J of Tigard pII Decay : b / Permit No.:/7 /
• 13125 SW Hall Blvd.,Tigard,OR 97243 G 1 1 2015 plan Rorie
11111 Phone: 503.7113.2439 Fax: 503.548.1960 Date/B : IMO& V OBI Other Permit:
I ,i ).,,.l Inspection Line: 503.639.4175 CITY OF TIGARD •• J rr` lure: RI See Page 2 for
Internet: www.tigard-or.gov Supplemental Information
BUII.UINC DIVJSl4!‘ ctg Vii. . .i�
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: t 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: $ 8500
❑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: 15492 SW Summerview Dr, New dwelling area: square feet
City/State/ZIP: Tigard OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Nasongkhla,Edina 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: [ot no.: Permit tees*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
DESCRIP'T'ION OF WORK work indicated on this application.
._ -_ Valuation: S
PV ROOF MOUNT Existing building area: square feet
New building area: square feet
El PROPERTY OWNER I� ❑ TENANT Number of stories:
Name: Nasongkhla,Edina Type of construction:
Address: 15492 SW Summerview Dr, Occupancy groups:
City/State/ZIP: Tigard OR 97224 Existing:
Phone:( 503) 536-2633 Fax'( )
New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Plan retry,fea uAestmiej__._-____
Business name:SolarCity Corp
Structural plan review fee(or deposit):
Contact name: Melissa Farias
FLS plan review fee(if applicable):
Address: 6132 NE 112th Ave. ---
Total fees due upon application:
City/State/ZIP: Portland OR 97220 -
Amount received:
Phone:(503)894-6903 Fax::(1868 445-7459
r-mail:Melissa.Farias @SolarCity.com PIIOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: SolarCity Corp. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 6132 NE 1 12th Ave .Solar installation Specialty Code checklist.
City/State/7..1P. Permit Fee(includes plan review
Portland OR 97220 _ ._ and administrative fees): 5180.00
Phone:( 503) 894-6903 Fax:(186 445-7459 State surcharge(12%of permit fee): $21.60
CCB lie.: 180498 Total fee due upon application: $201.60
Authorized signature: ilt►,. /t This permit application expires if a permit is not obtained
V within 180 days after it has been accepted as complete.
Print name: Melissa Fad *Fee methodology set by Tri-County Building Industry
. Date:
08/10/15 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOi2 OFFICE USE ONi.VV
City of Tigard Rcce,cd
`, Uatc/Dy: Pcrnnl No.:
UPI
13125 SW Hall Blvd.,Tigard,OR 97223 Associated ern»ts:
Phone. 503.718.2439 Fax: 503.598.1960 P
1 16 i.R 7 24-Hour Inspection Line: 503.639.4175 ❑ 81ectrical ❑ Plmnhieg ❑ Mechanics/
Internet: www tigard-orgov ❑ Oilier:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No \•
I Land use actions completed. See jurisdiction criteria for concurrent reviews. r I •
2 7..oning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ■ U •
3 _Verification of approved plat/lot. • ! ■
'
4 Fire district approval required. Name of district: U j •
5 Septic system permit or authorization for remodel. Existing system capacity . • •
6 Sewer permit. • • ••
7 Water district approval. R .
8 Soils report. Must carry original applicable stamp and signature on file or with application. • •
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- • • •
basin protection,etc,
I0 Complete sets of legible plans. Must be 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 he completed if
cops'right violations exist.
I i 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-ft.elevation differential,plan must show contour lines at 2-f1.intervals);location of casements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage arca;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 ❑ 0 ❑
and location.
13 Floor pians. 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- ❑ Cl ❑
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. ❑ 0 ❑
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 cngineering.standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing in ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rcbar. For engineered ❑ ❑ ❑
systems,sec item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code desiim values for all beams and multiple joists ❑ 0 ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 [J E
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 ❑ Q ❑
architect licensed in Ore_on and shall be shown to be a r licable to the 'rn'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x II"or 1 1"x 17". ■ ■ ■
24 Two(2)sets each arc required for Items 16. 19,20 and 22 above. ■ • ❑
25 Building plans shall,not contain red lines or tape-ons. "Mirrored"buildi»j plans will not be accepted. p • •
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Feex dcscun>.ent. ' ❑ •
27 "Drawn to scale"indicates standard architect or engineer scale. t
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ Ei
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 Aran 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.
1:1Build ngtPermitsU3UP-RESPcrmitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Electrical Permit Applicatit ECEIVEP 1 (IH (II I It i I ,I Ws 1
City of Tigard REIUSIIIIIIIIIP11
III • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revic� �"a
B Phone: 503.718.2439 Fax: 503.598.1 G 1 1 2015 Date/B : - `a'llial! Other Permit:
L7 Inspection Line: 503.639.4175 Date Ready/Cy:y: tiro: la See Paget far
Internet: www.tigard-or.gov Notified/Method: Supplemental tafarmattaa
TYPE OF : n!', a PLAN REVIEW
A ,t 1►'' kI lir 0 ' Please check all that apply(submit 2 sets of plans whims checked below):
❑New construction ®Addition/alttsr•�r - �� -� PP y P )
❑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 al ISO volts or 0 Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
El Multi-family ❑Master builder ❑Other: ❑Fire pump ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 f:mergcncy system. Larger separately derived system.
❑Addition of new motor load of ❑"A""F" "I.2" "l-J"
Job no.: 9722896 Job site address: 15492 SW Summerview Dr,
100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: Tigard OR 97224 ❑Health-care facilities. ❑Supply voltage for mote than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: Nasongkhla,Edina - ❑service or feeder 600 amps or more.
FEE SCHEDULE
_..__.._...... __- ....... _._..._.-._.
Cross street/directions to job site: Description I 'rte. I roe. l-- ret41 Tr-
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168,54 4
Ea.add'l 500 sq.fl.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.A.)
Limited energy,multi-family 75.00 2
PV ROOF MOUNT residential(with above sq.II.)
Renewable Energy ® Sec Page 2
Services or feeders installation_alteration,and/or relocation
24 PROPERTY OWNER l 0 TENANT 200 amps or less 100.70 j2....
_......_.._.__ -- 201 amps to 400 amps 133.56 2
Name: Nasongkhla,Edina
g 401 amps to 600 amps 200.34 2
Address: 15492 SW Summerview Dr, 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP:Tigard OR 97224 Temporary services or feeders installation,alteration,and/or
Phone:( )503 5362633 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,per panel
® APPLICANT I it CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: SolarClty Corp. each branch circuit -
B.Fee for branch circuits without
Contact name: Melissa Farias service or feeder fee,first 56.18 2
— branch circuit
Address: 613 2 NE 112th Ave Each add'l branch circuit 7.42 2
City/51ate1ZIP: Miscellaneous(service or feeder not included) Y
Portland, OR 97220 Each manufactured or modular 67.84 2
Phone:( Fax:;( dwelling,service and/or feeder
503 ) 894 6903 J 1866) 445 7459 Reconnect only 67.84 2
E-mail: Melissa.Farias @SolarCity.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Signal circuit(s)or limited-energy See
SOlarL1ty Cory, pi ael,circuits
panel,alteration,or extension. Page 2 2
Address: 6132 NE 112th Ave Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP: Portland_OR 97220 Investigation(I hr min) 66.25/hr
Phone:(503) 894-6903 I Fax:(1866) 445-7459 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 180498 Electrical Lic.: C562 Suprv.Lie.: 58735 specifically listed(:5 hr mint 90.001 hr
ELECTRICAL PERMIT FILES
Suprv.Electrician signature,required:1X1----\„........._a• -�
" Subtotal:
Print name: Date: 08.10.15 Plan review(25%of permit fee):
Nicholas Armstrong •
( State surcharge(12%of permit fee):
Authorized signature: CJ ¢ - TOTAL PERMIT FEE:
Print ""�t This permit application expires if a permit is tot obtained within 180
I rint name:
_Melissa Far' Date: 08.10.15 days after it has been accepted as complete.
1�'1 -
• Number of inspections allowed per permit.
l:l nuttdirigirennas\tLC_PermiiApp-/LR_l/RE.doc Rev 01/21/2013 440-4515'1(1 VU5/COM,WGO
et ittio
Electrical Permit Application—City of Tigard
Page 2--Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORT ONLY.
Fee for all residential systems combined........ $75.00 Description f tn.. I Pen I Tot 1 •
Renewable electrical energy systems:
Check Type of Work Involved: s kva ar less 100.70 2
5.01 to 15 kva 1 133.56 133.56 2
❑ Audio and Stereo Systems* 15.01 to 2$kva 200.34 2
❑ Burglar Alarm Wind generation systems In excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
5100 kva(ice in accordance with 553.26
❑ Heating,Ventilation and Air Conditioning OAR 918-309-0040)
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:
Other: Each additionol inspection is 66,25/}u
charged al an hourly(1 fir min)
Inspections for which no fee is
90.001 lir
spulfctlly haled('h hr min)
COMMERCIAL WORK ONLY ETLEEcTRItAt:PERMIT FEES::.
Fee for each commercial system. $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%o of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
❑ This permit application expires if a permit is Not obtained within l80
Audio and Stereo Systems days afler it ban been.crepleti as r.mplete.
Number of inspu:Iinas allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*Nn licenses are required. Licenses are required
for all other Installations
tAIluiWin8tPrrmu.4lE1.C.PamIApp 11.R.IiRli.dor Rev(5/2120)3