Permit •
1 ' CITY OF TIGARD MASTER PERMIT
J 4
.• COMMUNITY DEVELOPMENT Permit#: MST2015-00212
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/23/2015
fD
T WARD 13125 25111 BA09000
Jurisdiction: Tigard
Site address: 9515 SW ELROSE ST
Subdivision: 1994-019 PARTITION PLAT Lot: 2
Project: ELLIS
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
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 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
Ecompasing: N
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF VB R-3 0
Owner: Contractor:
ELLIS,TRINITY&HOA SOLARCITY CORPORATION Required Items and Reports(Conditions)
9515 SW ELROSE ST 6132 NE 112TH AVE
TIGARD,OR 97224 PORTLAND,OR 97220 -
PHONE: PHONE: 503-894-6903
FAX: 866-445-7459
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 Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344
Issued By: 00: Signature: P r
• 03.639.4175 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
Residential FOR 01'El CE USE(.)NLl
ligCity of Tigard `� >>� .. i/,.
n 13125 SW Hall Blvd.,Tigard,OR 97 2 Plan Revi-L�
0 Phone: 503.718.2439 Fax: 503.598.1960 \I 1 1 2.015 Date/13 : ai�i �/ r 1�C7 Other Permit:
TI G A R l7 Inspection Line: 503.639.4175 NQ V S Datc Ready �/ See Page 2 for
Internet www.tigard-or.gov Af]Q Notified/Method: .10/1111smirisSupplemental Information
TYPE OF 1., i DM REQUIRED DATA:1-AND2-FAM1LY DWELLING
vs Ilt
❑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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSI'RUCTIOV work indicated on this application.
® I-and 2-family dwelling 0 Commercial/industrial
Valuation: $ 3000
0 Accessory building 0 Multi-family
Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9515 SW Elrose St, New dwelling arca: square feet
City/State/ZIP: Tigard OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ELLIS Covered porch area: square feet
Cross street/directions to job site: Deck arca: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees'arc based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
PV ROOF MOUNT Existing building area: square feet
New building area: square feet
El PROPERTY OWNER ❑ TENANT Number of stories:
Name: ELLIS, HOA Type of construction:
Address: 9515 SW Elrose St, Occupancy groups:
City/State/ZIP:Tigard OR 97224 Existing:
Phone:( ) (503) 381-7625 Fax:( )
New:
2 APPLICANT , CONTACT PERSON BUILDING PERMIT FEES*
Busincssname:SO)arClt CorpMuse referrojetaehe&ule)
y p 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::(1866 445-7459
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Melissa.Farias@SolarCity.com
Commercial and residential prescriptive installation of
CON'rRAC'I'OR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:SolarCiIy Corp. 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: Permit Fee(includes plan review
Portland OR 97220 and administrative fees): $180.00
Phone:( 503) 894-6903 Fax:(186(1 445-7459 State surcharge(12%of permit fee): $21.60
CCB lic.: 180498Total fee due upon application: $201.60
Authorized signature: 1 a This permit application expires if a permit is not obtained
r within 180 days after it has been accepted as complete.
Print name: Melissa Fari11.05.15 *Fee methodology set by Tri-County Building Industry
., Date:
• Service Board.
I:\Building'Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
i' •Electrical Permit Application ^ p\1E�' FOR Ort ICE USE ONLYa,: R City of Tigard k aFiffilffiriala71111251
INY 13125 SW Hall Blvd.,Tigard,OR 97223 O'15 Plan Review
2 Other Permit:
' C Phone: 503.718.2439 Fax: 503.598.11w '. Datc/Dy: •
Inspection Line: 503.639.4175 ran Date Ready/By: hair. El See Page 2 for
1'IGARD C z1
Internet: www.tigard-or.gov (����� OF. �C c•r Notifted/Method: Supplemental Information
• TYPE OF 1 AY,e���1 J' PLAN REVIEW •
0 New construction ®Addition/a eration/replacement Please check all that apply(submit 2 acts of plans',villeins checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑Multi-family El Master builder 0 Other: 0 Fire pump. 0 Installation of ISO KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition ofnew motor load of ❑"A","C","I-2","I-3",
Job no.:9723068 Job site address: 9515 SW Elrose St, frmnre, occupancy.
❑Six x oor momore residential units. 0 Recreational vehicle parks.
City/State/ZIP: Tigard OR 97224 0 Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ellis 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Tout I .
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'I 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential
DESCRIPTION Or WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
PV ROOF MOUNT residential(with above sq.It.)
Renewable Energy ID See Page 2
Services or feeders installation,alteration,and/or relocation
1173 PROPERTY OWNER ❑ T'ENANT. 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2 I
Name: ELLIS, HOA 401 amps to 600 amps 200.34 2
Address: 9515 SW Elrose St, 601 amps to 1,000 amps 301.04 2
Ti and OR 97224 Over 1,000 amps or volts 552.26 2 City/$tate/ZTP: g Temporary services or feeders installation,alteration,and/or
Phone:( ) (503) 381-7625 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
4 APPLICANT IN CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name: each branch circuit
SOIarCLty Corp. B.Fee for branch circuits without
contact name: Melissa Farias service or feeder fee,first 56.18 2
branch circuit
Address: 6132 NE 112th Ave Each add'l branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Portland. OR 97220 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:Melissa.Farias@SolarCitv.cotn Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Signal circuit(s)or limited-energy See
$OlarCity Corp- 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_9_72.?0.. Investigation(1 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 90.00/hr
CCB Lie.: 180498 Electrical Lie.: C562 Suprv.Lie.: 5873S specifically listed(v:hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:kyk-A,,,........—x.-�'- Subtotal:
Print name: Date: 11/05/15 Plan review(25%of permit fee):
Nicholas Armstrong State surcharge(12%of permit fee):
Authorized signature: ; v . TOTAL PERMIT FEE:
Phis permit application expires if a permit is not obtained within 180
Print name: Melissa Faria� Date: 11/05/1 5 days after it has been accepted as complete.
• Number of inspections allowed per permit.
INluitdingWermits\ELC_PermitApp ELR ltRE.doc Rev 0521/2017 440.405T(I 1/05/CO61/wt•D
'l
Electrical Permit Application—City of Tigard
Page 2--Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESmENTIAL WORK:ONLY'.: Pi:F:.JGtil 7�liR:
Fee for all residential systems combined $75.00
llecrriptlon I Qt,, I Fre I Terni
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or lass 1 100.70 100.70 2
5.01 lo 15 kva 133.56 2
n Audio and Stereo Systems*
15.01 to 25 kva 200.34 z
❑ Burglar Alarm
Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
ri Garage Door Opener* 50.01 to 100 kva 552.26 2
.100 kva(tcc to accordance with
El Heating, Ventilation and Air Conditioning
OAR 918-309-0040) 552.26 2
System* Solar generation systems In excess of 25 kva:
Tach additional kva over 25 I 7.42 3
n Vacuum Systems* >100 kva—no additional charge 0.0 3
ElOther:
additional inspection over allowable in any of the above:
Other: Oath additional inspection is 66.25/hr 1
charged at an hourly(I hr min)
Inspections for which no fec is
spccifiollly lislull(h hr min) 90.00•hr
COM.MER cLAL WORIC ONLY: <. i�tcemi�i ,�t rrvteiyrirz t„s'::
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 f'ee):
Check Type of Work Involved: TOTAL PERMIT IEE:
This permit application expires if o permit is not obtained within 180
J I Audio and Stereo Systems days after it baa been occepic+l no complete,
* Number of inspaaions allowed per permit.
n B• oiler Controls
n C• lock Systems
❑ Data Tel Installation
❑ Fire Alarm Installation
❑ 1-IVAC
1 I Instrumentation
❑ Intercom and Paging Systems
❑ 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:VSuildng PamUaIELC.Pamtinpf CLR ItRE dor Rev 05/212013