Permit (2) CITY OF TIGARD MASTER PERMIT
3 ' COMMUNITY DEVELOPMENT Permit#: MST2019-00444
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/18/2019
T I t'A Ft o9 Parcel: 2S103DD00423
Jurisdiction: Tigard
Site address: 10915 SW FAIRHAVEN WAY
Subdivision: FAIRHAVEN COURT Lot: 10
Project: MELO
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: 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 7.56 kW 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:
MELO,DERECK C&TALIA D TESLA ENERGY Required Items and Reports(Conditions)
10915 SW FAIRHAVEN WAY 6132 NE 112TH AVE
TIGARD,OR 97223 PORTLAND,OR 97220
PHONE: PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $376.19
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 t. follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-I a' -0090. ou ma .btain a cop of the r es or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: 4 ___e_t Permittee Signature: S'C- - ��//e� 2 �i .
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 project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential gg .
yr F •„<-g4 Q
t Received � _
Cityof Tigard ", Permit No.:�/may 61)of i
g Date/By: Mil/ �� �f'f rLL° `�
III ■ 13125 SW Hall Blvd.,Tigard,OR 97223 (� (, Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 U E C 1 0 1019 DateBy: f 12 (1 Other Permit.
TIGARD Inspection Line: 503.639.4175 Date Ready/y: /jj/j�j Jona El See Page 2 for
Notified/Method t Supplemental information
Internet: www.tigard-ocgov �.Z /� „ `�f�%�� ifj PP
t ,' O €1` ,', i lit 1 6Y= 1 i,LV DWELLING
LI 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 LI Other: equipment,materials,labor,overhead,and the profit for the
I{ i to CoNS'ERU , i€ t work indicated on this application.
111-and 2-family dwelling ❑Commercial/industrial',
Valuation: $
`0 0 Accessory building ❑Multi-family Number of bedrooms:
0 Master builder LI Other: Number of bathrooms:
'ii' Total number of floors:
Job site address: I 0- 1 t 1 SW FA i y h pvv--e„,-, New dwelling area: square feet
City/State/ZIP: T 0 aN 0 n YL- -7,- 3 Garage/carport area: square feet
Suite/bldg./apt.no.: lJ I Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
'ffir' t '0
' a/, Other structure area: square feet
Subdivision: 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 OF WO`` A work indicated on this application.
PV ROOF MOUNT Valuation: $
t `D f V>< ✓' Existing building area: square feet
�Y N� New building area: square feet
Wri 51 PRQPiz'c;;g.!-J47. `- :! ❑ T iirT Number of stories:
Name: C/ :;,_, MCA/10
Type of construction:
Address: i ri1 1 S' � V Occupancy groups:
City/State/Z1P:Ti,.n.„--7)...y- \ 012 41-1-4- - Existing:
Phone:( ) Fax:( ) New:
. . ,' APPLICANT a ��.:, :::.Efl ,.N1 — y: .�I a' 1 ash ;DCI ' ,,f.
Business name: TESLA . +ilaesr a, ',
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 I Fax::(1866)445 7459
E-mail: AFARIAS@TESLA.COM '_ ry -
Alto Commercial and residential prescriptive installation of
t )� roof-top mounted Photovoltaic Solar Panel System.
Business name: TESLA 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.
Permit Fee(includes plan review $180.00
City/State/ZIP: Portland OR 97220 and administrative fees):
Phone:( 503 ) 894 6903 Fax:( 1866)445 7459 State surcharge(12%of permit fee): $21.60
CCB lic.: 180498 Total fee due upon application: $201.60
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: A. Meliss arias j .,,,R
Date: ^^��-' 1 pq ' *Fee methodology set by Tri-County Building Industry
dService Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Elcxtrical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard Date/B : Permit No.:
,71 .14 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
M• Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit:
TI GA RD Inspection Line: 503.639.4175 Date Ready/By: Juris: lil See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
ar.:,,Iii77-AVr':7-"AN*VII'''ll'i'':;'''':;''''''riil'illili';:`::71 ird
0 New construction 1Addition/alteration/replacement Please check all that apply(submit;sets of plans w/items checked below):
D Service or feeder 400 amps or more 0 Building over three stories.
11
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
-,,,e,:ii?-,10,zr11, -,ittrh,-:is , ,smeimesiv-anti exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
I ] 1-and 2-family dwelling 0 Commercial/industrial D Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
0 Emergency system, larger separately derived system.
1i;',"i'e f':. ,4:-'.:', F '6'":Mitt - '' ' '6 0 Add of load of 0"A","E","1-2","1-3",
..5
Job no.:/12.1k1S1 Job site address: I 0 9 1 c svv F OvOe howatrin Is°::::rreesidential units. 0 Zeccurpeaatticoyn.al vehicle parks.
City/State/ZIP: 11, 43 IA(X/s 09- ' 1-1-2-3 E Health-care foaccait'its: .Supply voltage for more than
600 volts nominal.
Suite/bldg./apt.no.: 1 Project name: t/ICArpt: Service or feeder 600 amps or more.
1 gal t:r FEE $ ' '.'.;'''.7.7-TAIV:41Fri "-
Cross street/directions to job site: Description Qty. Fee. Total 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 1
Tax map/parcel no.: Limited energy,residential
above sq.ft.)'
FT DEseta
ft*OW)-.RIC '; );:i.g 'f.:*;,:.; '''i:X_41 (with
I 75.00 2
Limited energy,multi-family
75.00 2
PV ROOF MOUNT residential(with above sq.It)
Renewable Energy 0 See Page 2
• 1-4Q -: Services or feeders installation,alteration,and/or relocation
1NANT -.-.7-12,5
T' 200 amps or less I 100.70 2
201 amps to 400 amps 133.56 2
Name: C ic, t\4{1 UO 401 amps to 600 amps 200.34 2
Address: 1110 01 t S s vv F at,c 12„1-kaAfe,„,--.1 601 amps to 1,000 amps 301.04 , 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: 11 101L..4—ak ()12--- 01122-3 Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
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 ampsto599amps 168.54 2
Owner signature: Date: Branch circuits-new,alteration,or extension,per panel
'' '- - ''011.' —4i;,..- 'f- A.Fee for branch circuits with
:,, :ill l'Eit,,U111.,,,, .
ce
7.42 2
above servor feeder fee,
Business name: TESLA each branch circuit
B.Fee for branch circuits without
Contact name: MELISSA FARIAS service or feeder fee,first
56.18 I 2
branch circuit
Address: 6132 NE 112TH AVE, Each add'l branch circuit 7.42 2
City/State/ZIP: PORTLAND OR 97220 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:(503 ) 894 6903 Fax::(1866) 445 7459 Reconnect only 67.84 2
E-mail: AFARIAS(&TESLA.COM , , _ Pump or irrigation circle 67.84 2
e'S"'4:'''''''' '''''!'"r(1:19'''!:',':'giZ;'41J11"‘",,CTOR ,-'6 M. ,;.:iiilti,7 1 6,7-77, Sign or outline lighting 67.84 2
Business name: TESLA Signal circuit(s)or limited-energy
panel,alteration,or extension. See
Page 2 2
Address: 6132 NE 112TH AVE, Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm ) 66.25/hr
City/State/ZIP: PORTLAND OR 97220 Investigation(1 hr mm ) 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
90.00/hr
CCB Lie.: 180498 Electrical Lic.: C562 1 Suprv.Lic.: 5873S s.ecificall listed(1/2 hr min)
.' '4W,E11:',F171011' FERMFC:;,i-ril.C , 52:4V;:' A
Suprv.Electrician signature,required: Nor.,—is Subtotal:
Print name: NICK ARMSTRONG I Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: i.'5 TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: A.MELISSA FARIAS I Date: 12_,-ei - ici days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORKIONLY: Eg scitpuLE
Fee for all residential systems combined ... $75.00 Description I Qty. I Fee I Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2_
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 20034 2
nBurglar 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
>100 kva(fee in accordance with 552.26 2
❑ 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
Li Vacuum Systems* '100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
ElOther: Each additional inspection is
charged at an hourly(1 hr mm) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL 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%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections 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*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:3Building\Permits\ELC_PermitApp_ELR ERE dor Rev 05/21/2013