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Permit (261) CITY OF TIGARD MASTER PERMIT a COMMUNITY DEVELOPMENT Permit#: MST2019-00330 Date Issued: 08/19/2019 T I(1 A It[) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S133DA04600 Jurisdiction: Tigard Site address: 12590 SW GLACIER LILY CIR Subdivision: AMART SUMMER LAKE Lot: 68 Project: WOLD 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: $8,721.18 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: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 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: Y Other Description: Roof Top Solar PV System 3.72kW Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: OTR SF VB R-3 0 Owner: Contractor: WOLD,RACHEL&TYRONE BLUE RAVEN SOLAR LLC Required Items and Reports(Conditions) 12890 SW GLACfER titY CfR TIGARD,OR 97223 AMERICAN FORK,UT 84003 PHONE: PHONE: 385-498-4408 FAX: 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. Yo ay obtaiina cc of the rules or direct questions to OUNC by callin! 03.23. •87 0 00.332.23,4. // Issued By: �' -�i �f /'://:'—'..----'--� '\_ Permittee Signature: _ FF Call 603.639.4175 by 7:00 a.m.for the next available inspect'.- a ate. �' 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. Building Permit Application Residential s.,, 4.. t # t FOR OFFICE USE ONLY City of Tigard C Received / r - a 4 )r1°(1 Date/By: 1 7 Gt Permit No.: r—- 13125 SW Hall Blvd.,Tigard,OR 97223 H' d 'y 4`'•I' Plan ReviewQf�,� ` �/1—(2,-„,-)'''),,:‘, Phone: 503.718.2439 Fax: 503.598.1960 DateBy: V 11 r1� Other Permit: TIGARD Inspection Line: 503.639.4175 (:'11"V s '- '. --pate Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov I e ttaif 1 ; ..`fied/Metho /�j Ie� V„t i` /�G / Supplemental Information iii TYPE OF OW., ; REQUI 4 D 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: equipment,materials,labor,overhead,and the profit for the CATEGORY`OF CONSTRUCTION work indicated on this application. ID1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 8,721.18 ❑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: 12590 Southwest Glacier Lily Circle, Portland, Oregon, 97223, United New dwelling area: square feet City/State/ZIP: Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Ty Wold Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA COMMYIERCIAL-USE CIIECKLIST ' Subdivision: I Lot no.: Permit fees*are 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 OE 3w oiu i work indicated on this application. Rog�flop Solar PV Valuation: $ 3' , 7.D- )(NV Existing building area: square feet New building area: square feet 2,PROPERTi( OWNER '❑''EN ,NSI Number of stories: e; � Name: Ty Wold Type of construction: Address:12590 Southwest Glacier Lily Circle,Portland,Oregon,97223,United States Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax ( ) New: 0 APPI:IICAN 7 CONTACT PERSON tUILDING'PERMITTEE*,' Business name:Blue Raven Solar �, (Pdfosr=ejerictfii i:ketlitte} -„�” Contact name: Lesly Bee Structural plan review fee(or deposit): FLS plan review fee(if applicable): Address: 1403 N Research Way City/State/ZIP: Orem, UT 84097 Total fees due upon application: one: :_,_{-._, .—„_.__ - Fax::( ) Amount received: E-mail: permitting.deparment@blueravensolar.com , THOTOVQ4TAIC SOLAR PA4T SYSTEM ES1 CONTI2ACi<'ok Commercial and residential prescriptive installation of W ' ' ' �� `' - ` � roof-top mounted PhotoVoltaic Solar Panel System. Business name: Blue Raven Solar Submit two(2)sets of roof plan with connection details Address: 1403 N Research Way and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP: Orem, UT 84097 Permit Fee(includes plan review $180.00 Phone:(385}482-0045 Fax:( ) and administrative fees): 210112 State surcharge(12%of permit fee): $21.60 CCB lic.: Total fee due upon application: $201.60 Authorized signature /L - /1This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Print name: G g l_li Date: ? % / Fee methodology set by Tri-County Building Industry �.f�d I �t d 6 < Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : 't f CEINEBRNIME 12. Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/B Related Permit#: TIGARD Inspection Line: 503.639.4175 ReadyDate/By: Internet: www.tigard-or.gov loris: S See Page 2 for Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition 0 Other: -- "� CONSTRUCTION ❑Service or feeder 400 amps or more ❑Building over three stories. � �" CATEGORY OF CQNSTRUC Z ION where the available fault current ❑Marinas and boatyards. exceeds 10,000 amps at 150 volts or 0 Floating buildings. ©1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercialuse agricultural ❑Multi-family ❑Master builder amps for all other installations. buildings. Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION , „ ❑Emergency system. larger separately derived Job#: I Job site address: 12590 Southwest Glacier Lily Circle, ' ❑Addition of new motor load of system. 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name: Ty Wold ❑Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal. FEE SCHEDULE Description I Qty. I Each 1Totals I * New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 DESII#TIOI+I OF UttOI21� Limitedn 33.92 1 Ea add'1 500 sq.fr or portio energy,residential Rooftop Solar PV (with above sq.ft.) 75.00 Limited energy,multi-family residential(with above sq.ft.) 75.00 Renewable Ener. 0 See Pa!.e 2 OWNER 1 .r.,N Services or feeders installation,alteration,and/or relocation Name: Ty Wold 200 amps or less 100.70 2 Address: 12590 Southwest Glacier Lily Circle, Portland, Oregon, 97223, Unite 201 amps to 400 amps 133.56 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 , I --APPLICANT' E Q , , 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: Lesly Bee each branch circuit 7.42 2 B.Fee for branch circuits without Address: 1403 N Research Way service or feeder fee,first branch circuit 56.18 2 City/State/ZIP: Orem, UT 84097 Each add'l branch circuit 7.42 2 Phone:( 385}182-0045Miscellaneous(service or feeder not included) Fax: :( ) Each manufactured or modular Email: permitting.department@blueravensolar.eom dwelling,service and/or feeder 67.84 2 CULRApI Reconnect only 67.84 2 --- ��<',� Pump or irrigation circle 67.84 2 " ign or oullineTigFitmg 67.84 Signal circuit(s)or limited energy panel,alteration,or extension. 0 Page 2 Address: 1403 N Research Way 2 Each additional inspection over allowable in any of the above City/state/ZIP: Orem, UT 84097 (385 X482-0045 I Fax:( ) Additional inspection(1 hr min) 66.25/hr Phone: Investigation(I hr min) 90.00/hr Email: permitting.department@blueravensolar.com Industrial plant(1 hr mm ) 78.18/hr Inspections for which no fee is CCB Lic.: Electrical Lic.: C1214 I Suprv.Lic.: 6097S specifically listed(%hr min) 90.00/hr 210112 Suprv.Electrician signature,required: ELFjCTIFIAIP> RN[T11 FE Sam Collier Subtotal: Print name: I Date: 07/30/2019 0 Plan Review Required(25%of permit fee): JeffState surcharge(12%of permit fee): Authorized signature: ���t �7 TOTAL PERMIT FEE: Print name: Jeff Lee I This permit application expires if a permit is not obtai ied within 180 I Date: 07/30/2019 days after it has been accepted as complete. Number of inspections allowed per permit. I:\Building\Permits\ELCPermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615TQ 1/05/COM/WEB Electrical Permit Application—City of Tigard P tge 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description I Qty. I Each I Total I 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 n 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 50.01 to 100 kva 552.26 2 Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 Li Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: E Other: Solar PV system Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(/2 hr min) COMMERCIAL.WORK ONLY: ELECTRICAL PEI MIT FEES 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 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 City of Tigard q Building Division 13125 SW Hall Blvd, Tigard, OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 TIGARD Inspection Line: 503.639.4175 AUG 0 !) Z019 www.tigard-or.gov 2010 Oregon Solar Installation Specialty Code Check List for Prescriptive Installation of Roof-Mounted PhotoVoltaic Solar Panel System Property Information Installation Address: 12590 Southwest Glacier Lily Circle, Portland, Oregon, 9722 City: Zip: Owner's Name: Ty Wold Date: 07/30/2019 Contractor's Name: Blue Raven Solar CCB #: 210112 Design Parameters of the Property/Structure If"Yes", does not Flood Hazard Is the installation ❑ Yes qualify for the Area Located in a flood prescriptive path, follow plain/flood way? p No OSSC or ORSC for design requirements. Is the wind exposure L2 Yes Wind Exposure If"Yes", qualifies for "C" or less? ❑ No the prescriptive path. Installations on detached Is the Ground Snow single/two-family Load 70 psf or less? dwelling/single/two- If"Yes", qualifies for Yes the prescriptive path. and/or their accessory Ground structures. ❑ No Snow Load Is the Ground Snow Installations on all Load 50 psf or less? structures other than Mi Yes If"Yes", qualifies for above the prescriptive path. ❑ No 1 I:/Building/Forms/Photovoltaic-Checklist02-01-11.docx r_ ' Is the construction Type of material wood and does Yes the construction qualify ❑ No If"Yes", qualifies for Construction as "conventional light the prescriptive path. frame" construction? Is the spacing 24 inches or less? Pre-engineered trusses. n Yes If"Yes", qualifies for the prescriptive path. n No Roof framing members Is the spacing 24 inches or less? Nominal lumber. Yes If"Yes", qualifies for the prescriptive path. ❑ No Is the combined weight p Yes of the PV modules and If"Yes", qualifies for racking less than or ❑ No the prescriptive path. Solar equal to 4.5 psf? installation Is the solar installation layout in accordance 0 Yes with Section 305.4(3) of If"Yes", qualifies for 111the 2010 Oregon Solar No the prescriptive path. Code? ❑ Metal Single layer If roofing material is Roofing Check the type of ❑ of wood yh one of the three types material roofing material shingle/shake checked, qualifies for Max. two layers the prescriptive path. n a shingle. Is the roof mounted p Yes Connections of solar assembly the solar assembly connected to roof If"Yes", qualifies for to the roof framing or blocking n No the prescriptive path. directly? 2 I:/Building/Forms/Photovoltaic-Checklist02-01-11.docx n Yes If"Yes", qualifies for Is the gauge 26 or less? n No the prescriptive path. 115 lbs for 60 inch spacing or less? If"Yes", qualifies for n Yes the prescriptive path. Fl No Minimum Uplift rating of Clamps? 75 lbs for 48 inches spacing or less? If"Yes", qualifies for n Yes the prescriptive path. ❑ No Attachment of roof mounted Minimum 24 inches If the spacing falls solar systems Spacing of clamps? within 24 inches and 60 directlyto inches inches, qualifies for the Maximum 60 inches prescriptive path. standing seam metal panels Width of roofing If the width of the panel panels? 18 inches or less is less than 18 inches, inches qualifies for the prescriptive path. Minimum#10 at 24 inches o/c? Size and spacing of El Yes If"Yes", qualifies for fastener? the prescriptive path. n No Is the roof decking of WSP min. '/2"thickness, ❑ Yes decking connected to If"Yes", qualifies for framing members [ No the prescriptive path. $d nails@ 6"/12" o/c? Is the height less than or Maximum 18 inches equal to 18 inches? Height of the from the top of the If"Yes", qualifies for solar modules module to the roof Yes the prescriptive path. surface. n No 3 I:/Building/Forms/Photovoltaic-Checklist02-01-11.docx Submittal Documents required for Prescriptive Installations Show the location of the PV system in relation to buildings, structures, property lines, and, as applicable, flood hazard areas. Site Plan Details must be clear and easy to read. Minimum size of the plan is 8.5 x 11 inches. Attach a simple structural plan showing the roof framing (rafter size, type, and spacing) and PV module system racking attachment. System must be shown in sufficient detail and clarity to assess whether it Structural Plan meets the prescriptive construction requirements as listed earlier above in the matrix. Minimum size of the plan is 8.5 x 11 inches. PV Modules Manufacturer: Model Number: JKM 310M-60L Listing Agency: UL 4 IlBuilding/Forms/Photovoltaic-Checklist02-01-11.docx