Permit (144) CITY OF TIGARD MASTER PERMIT
■ COMMUNITY DEVELOPMENT
T f c;; It f, 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: MST2016-00462
Date Issued: 11/29/2016
Parcel: 1 S 133CD01200
Site address: 11756 SW SWENDON LP Jurisdiction: Tigard
Subdivision: COTSWALD MEADOWS
Project: WELLS Lot: 10
Project Description: Solar photovoltaic system.
BUILDING
Stories: 0 Floor Areas
Bedrooms: 0 Required Setbacks Reed
First: 0 sf Basement 0
a sf Left Parking Spaces: 0
Height 0 Bathrooms: 0
Dwelling Units: 1 Second: 0 sf Garage: 0 sf
Front 0 Smoke
Third: 0 sf
Right 0 Detectors:
Total: 0 sf Value: $11,321.00
Rear 0
PLUMBING
Sinks: 0 Water losets: 0
Washing Mach: 0 Laundry Trays: 0
Lavatories: 0 Dishwashers: 0 Rain Drain: 0
Floor Drains: 0 Sewer Lines: 0 Urinals: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 SF Rain
Water Lines: 0
Drains: 0 Storm Sewer 0
Footing Drain: 0 Ice Maker: p Catch Basins: 0
Hose Bib: 0 Backwater Value: p Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvges Air Conditioning: N
Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0
FOther Units: 0
urn<100K: 0
Vents: 0 Woodstoves: 0
Furn>=100K: 0 Gas Outlets: 0
ELECTRICAL
Residential Unit
Service Feeder Tem g SrvFeeders
1000 sf or less: 0 Branch hdrdr:
0-200 amp: 0 0-200 amp: 0
Ea add!500 sf: 0 W/Svc or Fdr: 0
201-400 amp: 0 201-400 amp: 0
Mfd Home/Feeder/Svc: 0 401-600 W/O Svc/Fdr: 0
amp: 0 401-600 amp: p
601-1000 amp: 0 601+am -
p 1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N
Security Alarm: N Vaccuum System: N
Other: N Other Description: Roof top PV system Garage Opener N All
Ecompasing: N
BUILDING INFO
Class of Work:
Type of Use:
ALT SF Type of Constr: Occupancy Group:
VB Square Feet:
Owner: R-3 0
Contractor:
WELLS,DANIEL C&DEBORAH A BLUE RAVEN SOLAR LLC
11756 SW SWENDON LOOP Required Items and Reports(Conditions)
TIGARD,OR 97223 1220 S 630 EAST,STE 430
AMERICAN FORK,UT 84003
PHONE: PHONE: 385-498-4408
FAX:
Total Fees: $376.69
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 h 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 B %� I i ,
�""ice' Permittee Signature
Call 503.639.4176 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
t= 1 FOR OFFICE USE ONLY
INCity of Tigard €0 'v. -''tVed
13125 SW Hall Blvd.,Tigard,OR 97223 DateiB : // Permit No.: Ai -
_ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
T I G A R D Inspection Line: 503.639.4175 I a3 Date/B , Other Permit:
Internet: www.tigard-or.gov �� Pi l -!ate Ready/By:
otified/Method:
// l/ See Page 2 nr
„�.�� ”:
� F 3(., 1.4 .-1)
�w ` Supplemental Information
nl
.. ! @ I r t l _! �•
❑New construction I �w I • c �� — �t .n.
0 Demolition * the
a 3
NI , Permit fees are based on the value of the work performed.
ddrtron/alteration/replacement 0 Other: Indicate the value(rounded to the nearest dollar)of all
ft
w equi ment,materialsprofit for the
,labor,overhead,and the
P
a se,:... .iii, : work indicated on this application.
II/ and 2-family dwelling
EtCommercial/industrial Valuation: $1111,321
0 Accessory building
0 Multi-family Number of bedrooms:
❑Master builder
0 Other:
Number of bathrooms:
• -, .., 41.-it :AVAnklinatktloistt Total number of floors:
Job site address:11756 Southwest Swendon Loop
City/State/ZIP:Tigard , Oregon 97223 New dwelling area: square feet
Garage/carport area: square feet
Suite/bldg./apt,no.: Project name: (i
Lki Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
;.aal- t„ ' t so1k . f
Subdivision: !ta :: 1 !� .!4.0 1,-.�a ,
Lot no.: .. rk ,:
Permit fees*are based on the value of the work performed.
Tax map/parcel no 1 S 133CD01200 Indicate the value(rounded to the nearest dollar)of all
,4 , `''x }4'0 a:.. i re•.,`',.. •a 4I ,-, �,,r �. q •p ent,materials,labor,overhead,and the rofit for the
',: .., . 1 J_ ' •n*s• f•f �'^r '. ...,it e ur m p
x 1 work indicated on this a s s lication.
PV Solar Panels 5.22 kW Valuation: $
Existing building area: square feet
New building area:
square feet�1,' rt! ! i011- •�14 , .: r 441*-',.4'* ,
Number of stories:
Name:Debbie WellsType
Address:11756 Southwest Swendon Loop ccu of construction:
City/State/ZIP:Tigard, Oregon 97223 Occupancy groups:
Phone:( )503 750 7590 Exist g
Fax ( ) m
a �e ah37axr as mn New:
.. •r `!.: -. . .t..ir :,k* '�'';<. .' •r'•-�s 'Ali Il! I B I �v, , S.
Business name: Blue Raven Solar ”"' °
` ppte tr,-44 1— k ;„ , } a x-'3`•1 ua 1p
._.. ._ u
Contact name: Brittany Gardner -' •' - '-•
Structural plan review fee(or deposit):
Address: 1220 S 630 E STE 430 FLS plan review fee(if applicable):
City/State/ZIP: American Fork,UT 84003 Total fees due upon application:
Phone:( 855 ) 205-2530
Fax ( ) Amount received:
: .....::. • r
MiIt ?t alta toE mail Permitting@blueravensolar.com '- :;:teit .a • _:ti, ti t i 'Vims { � - h • : mkpro Commercial and residentialprescriptive installation of" wr r, w k , !i. ti, , = roof-top mounted Photovoltaic Solar Panel System.Business name: Blue Raven Solar
Submit two(2)sets of roof plan with connection details
Address: 1220 S 630E and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP: American Fork,UT,84003
Permit Fee(includes plan review
Phone:( ) and administrative fees): $180.00
Fax:( )
CCB lic.: #210112 State surcharge(12%of permit fee): $21.60
Authorized si gnature: �.� Total fee due upon application: $201.60
�
•
I .` This permit application expires if a permit is not obtained
Print name: Jeffery Lee within 180 days after it has been accepted as complete.
Date:11/1/2016 Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011
440-4613T(11/02/COM/WEB)
Electrical Permit Application
FOR OFFICE GSF.ONLY
City of Tigard , 4,1 m a Received
°I'k 13125 SW Hall Blvd.,Tigard,OR 97241 'S 83 . j Date/B :
II ` Phone: 503.718.2439 Fax: 503.598.196
i " Plan Review i �•
Inspection Line: 503.639.4175 Date/B : Related Permit#:
T 1 k t t� ReadyDate/By:
Internet www tigard or.gov o' Juris:
� � NOV /����� Notified/Method: Supplemental Information
4u• x_'" k ..it ;f a i i ° ws°'`�t tl< r r y...t. ;s;: k:t �.•, ,. _.
,�. �... __ � �.t.�•:.�,,, �•.•L�,,: ,� -:��r• :� a >°i:� � 14ok�.,.," k# s�_r NUJ x
O New construction 1� d- .:. ..m. :, fi+
Q Addltion/altera r eplV'e p n{t"' Please check all that apply(submit 2 sets of plans w/items checked):}
❑Demolition r " 7,+ 0 Service or feeder 400 amps or more 0 Buildingover three stories.
0Other r!rtia r l° �� z :I )
where the available fault current
0 Marinas and boaty
ards.fitrilrrms_ i• B . i •i ig.' x1, "Sx;°'' ' % ' exceeds 10,000 amps at 150 volts or 0 Floating buildings.1-and 2-family dwelling 0 Commercial/industrial
0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family amps for all other installations. buildings.
y 0 Master builder 0 Other:
xis .,,-� .; ,7 t f#t,-'t aj, i. t a ',,: " •4.1."�`li_` 0 Emergency system. Installation rr
0 Fire pump. ❑ of 150KVAo
••"' "A't ".�;' � ..? .s... ^krt�""";�. �:..,.w.ia-t� larger separately derived
Job#. �
Job site address:11756 Southwest Swendon Loo ❑100H Addition moew motor load of system."E",]OOHP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard, Oregon 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.SUite/bld
Suite/bldg./apt.#: I Project
name:Debbie Wells 0 Hazardous locations. ❑Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal.
ettors ,.s,.,.ow °gii tt a lok - y
Description Qty. r Each I Total I
Subdivision: New residential single-or multi-family dwelling unit.
I Lot#: Includes attached garage.
Tax map/parcel#:1S 133CD01200 1,000 sq.ft.or less 168.54 4
+•
e 1 1 t .x t;.i s,i ! 1 tr a'1)''t, rr .i Ea.add'l 500 sq.ft.or portion 33.92
1
§ �' Limited energy,residential
PV Solar Panels 5.22 kW (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
;1:3( 1 1 t0d 'wat t ff( ' 'kg k xzAtiani
y
Name:Debbie Wells .r„ ServicesRenewable or feedersEnergy installation,alteration,❑ SeePa and/ore2 relocation
200 amps or less 100.70 2
Address:11756 Southwest Swendon Loop 201 amps to aoo amps 133.56 2
City/State/ZIP:Tigard , Oregon 97223 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:( )503 750 7590 I Fax:( ) Over 1,000 amps or volts 552.26
2
Email:dwellS44 @gmail.com Temporary services or feeders installation,alteration,and/or
relocatin
Owner installation:This installation is being made on property that I own which is not 200 amps or less
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 59.3651
Owner signature: 125.08
�... ne Date: 401 amps to 599 amps2
r";;,,." � k r 3 s ! 168.542
r _ ;'� 0 : a f Fps r f
4,_, 1, t, t 47 ? t ,gra! Branch circuits—new,alteration,or extension,per panel
Business name: Blue Raven Solar "'`" '` A.Fee for branch circuits with
above service or feeder fee,
Contact name: Brittany Gardner each branch circuit 7.42 2
B.Fee for branch circuits without
Address: 1220 S 630 E STE 430 service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP: American Fork,UT,84003 Each add'l branch circuit
7.42 2
Phone:(855 ) 205-2530 I Fax: :( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
dwelling,service and/or feeder
Email: Permitting@blueravensolar.Com 67.84 2
s a: Reconnect only 67.84
2Lt aWNS /rO3Vis? - iemtelo ha -r s x s.,,, .. .5 „ . ria . ,_. t ..k,:v v r?ra _• k' a » , Pump or irrigation circle 67.84 2 name: AP Electric
Sign or outline lighting 67.84 2
Address: 1220 S 630 E STE 430 Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: American Fork,UT.84003 Each additional inspection over allowable in any of the above
Phone:( 855 ) 205-2530 Additional inspection(1 hr min) 66.25/hr
I Fax:( ) 1 Investigation(1 hr min) 90.00/hr
Email: Permitting@blueravensolar.com D\I`I� p Industrial plant(1 hr min) 78.18/hr
CCB Lic.: 210112 C 1214 'l Inspections for which no fee is
Electrical Lie.: I Suprv.Lic.: 6097S • specifically listed(/2 hr mm) 90.00/hr
Suprv.Electrician signature,required:required: AI -r
Print name: Alex Petersen a Subtotal:
Date: 11/1/2016 I ✓ 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: /••��f l;
TOTAL PERMIT FEE:
Print name: Jeff Lee This permit application expires if a permit is not obtained within 180
Date:11/1/2016 I days after it has been accepted as complete.
1:\Building\Permits\ELC Pe m to * Number of inspections allowed per permit.
ppELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
`Ifs) 0 77/02-- _C-ct g h`- -=5 e.Y. / X7.291-4.tr'/2,9.-- ,---"../
Electrical Permit Application—City of Tigard
Page 2—Stupplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
MNAW:: _ Er a
v..o....»a: a... _.s ... ..®. .4xw:�
Fee for all residential systems combined: $75.00 Description Qty. Ewen Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva 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
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
El Vacuum Systems* >100 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(1 hr min)
Inspections for which no fee is 90.00/hr
s ecifically listed('V2 hr min)
:::::.. .;�,�:•._ :
W. .,,
Fee for each commercial system: $75.00
Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ 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:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELCPermitApp_ELR ERE.doc Rev 06/17/2015