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Permit g(�?u •..¢.c!' i _ _ - Lea-4 ► �l �11�Q.._ _ "" E CTRI CAI HERMIT CITY O T A PERMIT #: ELC2005 -00588 DEVELOPMENT SERVICES DATE ISSUED: 9/7/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S 135AA - AC001 SITE ADDRESS: 10390 SW 90TH AVE/ ZONING: R - 4.5 SUBDIVISION: ASHBROOK CONDOMINIUMS LOT : 001 JURISDICTION: TIG Project Description: Building 4: Unit 19 of ai unit town house building RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 1.00 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 0 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: RCM HOMES DMS ELECTRIC INC 12670 SW 68TH PKWY #200 8502 SE STARK ST PORTLAND, OR 97223 PORTLAND, OR 97216-1140 Phone: 503 - 598 -7565 Contact #: FAX 503 - 252 -6611 PRI 503 - 209 -9298 FEES Description Date Amount Reg #: LIC 118073 [ELPRMT] ELC Permit 9/7/2005 $445.75 SUP 4542S [ELPLCK] ELC Pln Rev 9/7/2005 $111.44 ELE 37 -742C [TAX] 8% State Surcharge 9/7/2005 $35.66 (additional fees not listed here) REQUIRED ITEMS AND REPORTS Total $592.85 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -669 1 -800- 2 344. Issued By _ Permittee Signature j( � OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Ei Applictia A �' ' � t Iy � � R �� ' ' , � W A wFOR OFFICE USE ONLY gnu City of Tigard U It 9 Dat Received : j5-. i Permit No oo5 � j ” y Date /By: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1 rt a Phone: 503.639.4171 Fax: 503.598.1960 AUG 0 8 200 �, ' I'I� Date/By• yr; 1� Other Permit: Inspection Line: 503.639.4175 ,- +N'l I ' y : Date Ready /By: trio 0 See Page 2 for Internet: www.ci.tigard.or , Notified /method. '�) Supplemental Information rrYV nF TIGARD / TY r iVISION - 11MMOlYRY.. P 1V R EYI> VV " l l - _ N ew construction ❑ Addition /alteration /replacement Please check all that apply ❑ Demolition III Other: ❑Service over 225 amps, comm'I 01-lazardous location Service over 320 amps rating Buildng over 10,000 sq. ft., CATEGORY OF°i'.CONSTRUCTION - '.= , r s � F of 1- and 2- family dwellings 4 or more new residential woo,, ,$ , ;- »,:, .,,a..:_4 w *...,.s esm� , - ca ,4.:w, arse . _ s..,,.z_ ., ._.,.. - - ;*- , a ='._._ 7- °- - .- . ❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building System over 600 volts nominal units in one structure (� Multi- family Ill Master builder ❑O ther: ['Building over three stories [Weeders, 400 amps or more -,- a ;` ,_ a:-. ;ms, x - •::,»� builder F :, #fix L i Other: :::.:' =" ['Occupant load over 99 persons EManufactured structures or q ''i "'' -t; Egressllightin Ian RV park JOB:SITES.IN ORD4l.,,TQNiQNDtLOGATION' = �x' . P � 1'z �.i °.r. - 1 ; : �Z .*_•ee:�, -_ •- ,:.....:. „ , w.;._.� ,,.. ... -_ .... ,aa5. �.�, =a.., ;,,:;xi�i.'�• ?2`��•.'.5:'v:`;' � `i, ^x'�'? .� ..- ❑ o o g P G - -� El Health-care facility ❑Other: Job no.: r lT site a ddress: 3�0 . 5, _ _ 0 Submit 2 sets of plans with any of the above. City /State /ZIP: 1 aedl OR The above are not applicable to temporary construction service. Suite /bldg. /apt. no.: Project name: II [_ I _ C I „_.. ,.... - . . , ..; �. ...... ...:.:.: , of ++' ". .4s nor O ok La/mon/OM /Au Description l Qty. f Fee. Total Cross street/directions to job site: qa44 he. 00.k -51, New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less % 145.15 MS ,15 4 Subdivision: Lot no.: # II Ea. add'I 500 sq. ft. or portion C I 33.40 3ma t 1 Limited energy, residential 75.00 2 Tax map /parcel no.: energy, rest 75 00 2 k; DE" I , I ON.:�OF: WORK t :, .;t4- ,`, -„1, ,,,•• t.,.,:..b., Limited non en ra • '�:��, >sa ,• >,)E.� " "� �a:.,:,..._-,.....,;.<��, .,,n ,.�:<,�. „.,° b _ ....._ �;,,.'� __--�_ ,�_ Each manufactured or modular � )) � -•m. dwelling, service and /or feeder 90.90 2 /t/C.C.a) CQ&bT (UC41 Oil) Services or feeders installation, alteration, and/or relocation 201 amps to 400 amps 106.85 2 e + OP - oa�79 200 amps or less 80.30 2 Sc " � �. N� �� . ! " , r �',� -� ' °a� �vV J � :�. � - ' °� � �< : .:� ._; �'` PRORERT Y° 0�3'I�rER� =i;: °:...:..�.:o 'kF`� :TEN�1NT�t<.` Y y_= *� :.- . > -. -. _ = -� _,t..µ. _. mss.•, ` '" 401 amps to 600 amps 160.60 2 Name: C I Y , �ome..5 601 amps to 1,000 amps 240.60 2 Address: ' a C:70 s u,) r r � g am . PK(A) Y .2W Over 1,000 amps or volts 454.65 2 I Reconnect only 66.85 2 City /State /ZIP: 120f l tlx \A , O R. q' 72*%.3 Temporary services or feeders installation, alteration, and /or Phone: (G ) Q b -� I Fax: (� ) relocation 1 p ' t 15� 5 l �� ��`� 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133 75 _ 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel , t,;r:` r..; ; " a' R"� ,,'r," r:;t: ,� >;`s , :;,}w A. Fee for branch circuits with -;,. ...; , ,.; _ CONT�iCT PER X F °n_ _ . H. ,., ?`h': ... .._ . _,: >.,. ._ . service or feeder fee, each Business name: RCM NpeMeS branch circuit 6.65 2 B. Fee for branch circuits Contact name: V CAA.) e_ LA.) 1'S O without service or feeder fee, 46.85 2 each branch circuit Address: add'l branch circuit • 6.65 2 City /State /ZIP: S67")-i e Miscellaneous (service or feeder not included) Phone: ( ) lax j�p'/� Pump or irrigation circle 53.40 2 v JJ Sign or outline lighting 53.40 2 E -mail: _- ucvue_@ @ row,ti5 ie kovvies,i(ieT Signal circuit(s) or limited- z ? :`• t ; a =,rte `,i .. " 3 i ;, >' , : ;'.;:.;.,;,tic energy panel, alteration, or .• � _ ,£�� GOIVTRACTOR� < >� , r >=. gY P '�' =s..;t -,�. ,•,•�: "�:u; «. ��: "�i.:�. Y :d�.c'•s��<> . -:��,. ....... ,, 5.x :,......<, . ..,a:'i:`..,;� a-�== : -:; ,.- .,..:� °a. �� �1_4_Q I 1 extension. Describe: Page 2 2 Business name: V Address: g'A Q Each additional inspection over allowable in any of the above r \` 'L , Per inspection 62.50 City /State /ZIP: :0 OP. q ? to .. /140 Investigation per hour (1 hr nun) 62.50 Phone: ( ) 9,0[t 1 Ci' 2q g Fax: ( ) 9 t I Industrial plant per hour 73.75 , *' :r , � f s : L EGTItiIGAL PE1214itilKM ` i 4 :, : • CCB Lie.: 113073 Electrical Lic.: ?42. 1L Suprv. Lie:: 451/ 2.. 5 Subtotal 44 5 75° Suprv. Electrician signature, required: Plan review (25% of permit fee) t 11 s 14 q Print name: Date: State surcharge (8% of permit fee) 35' , 6 6 TOTAL PERMIT FEE 5' 2, j 5 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board * Number of inspections per permit allowed. i:\ Building \Permits \ELC- PermitApp.doc 12/03 440- 4615T(I0 /02 /COM/WEB PtUG - 05 - 2005 11 57 F r om : DMS ELECTRIC INC 5032526611 T o : 503 620 9965 P . 1 / 4 s . Aug 05 G5 1159a BROWNSTONE HOMES 503-620-9965 P • 5 1 • .1 Permit Application - • . , — - , . ,Fott \ LA- City of Tigard itet,civeJ Permii Wrs , Is 25 SW ltall Blvd.. 'Figard, OR r223 in , . Ohm. 503 &3 t 71 :: 503.50.14(.0 4 ' ' Ci , ii i P Daleilly- Other l'irttizit impi,tlion 1 e: 5,01.n ID 41'/:, irri ! . );e7 -, j - d . ..7i:1 - 7. ---------------- N. a j W lift Pate ? I, 1 ■111;1 , 11, I' /v/v, cl.tiit.o .1,,t 1 utill lefty'. Sueldi*W11121 lilfireiltiallon .----.. . . ....____ TYPE 4)1 WORK —..-- -- .' .14■Ixt rori.:AiIICT■01 .. : Cii i I . q. : ,,,,4:, ..'3 ' hill ' ` lit't 311 WI.VIFw ID usinwition H LI Of:Ict: . ' FIStIvice tito 2 Pi ampi, Catran'l 311.1..aolJuN loca'.00 .. —....i . .. , r 0 ..e i V 1 c c over 320 amps - :v1 ing Otiii(ItItte wry ?kW() sq. ft . of I - and 2 4 oi me c 'Inv Iniden1141 [J I - und 2 lianiil y dwdling ET Cowmen enlitinduSiT101 0 Accessot y boild int: 115, Q vis. 630 volts itontilli) O i n ( " I Sguk DliUillitte I)Vel ihrty stol l ei Ortetios. 400 inapt', or mon! 0 Mmter buil:ivy 0 Othcr "t . r .. • .1 , .„. ... 4 , „ r 4 . .. 44 r r r r rr... 4, . 0 OC" ,, Pil ni 104 0 V 0 V9 n". ...- 1Maniffot It o •rtf stio ;nireg or '.'..i:?"':'-'.1:"::'"';'...:'':.''100.3!**047i3liftPts.7:100i;g4,00,g1''Y:::1`':''''' o paw t±Vcsitlitslitlisls Piot I2V poli, Job no : Job Site address. 10 01-lealtn-,:mc facility :Dr.alo.i- Swami+ 2 EOM of Mans with any of the abco.c. C4ty;Stalt/Z,IP r4___ C3 , The o {Inv°. any not appltetthy to tenvorayy eArtitfiielitv Ltervicr. .. .. -- — ... ____ .„,_ s„.._. .,-,.. •tt Li .., t i■.-lo-'. ,. ... h TITIT, . 414q,;',.'4 0,1;TL Suitc/bIdg./aps no. Project name. /I L L .01.sri Qr Oitt if-, CCurislosehiti.i iJ -.— Buttlia:i• Ott' Pin. } Tina I '• crtwei M to jt g itc: 7 , ,.,. New rtsideinCel ringlc• or llitiiIi4initly dwng elli null • - • - -- - Includes striteiteill r.,..Vge. 1 ----- -1- I ,000 34. ft. or lrxx f 145.15 l 4 I SolialtOISIOnl ---- 1 - 1.110 : 4 , !2A. a<icrl 50ci Lc. (1. III ptn11011 _ 33 40 • 2 Tax rtnalitpar i . --- -- 1.4rlard energy, residential I 7t;.00 ed energy, non-tesidtattial ! -I ,. .i. ', .± " iil'i i *: - ..14 ' i . #hdikifq . Iiet Erwh Limit •t , b. „ .i.clured „. „■„Tloin, r ..... A2r.j.,.. (2_19.82 L•L‘,hif2A/ ilw;t1li_____IiLiervicc and'or fteder 75 00 1 90.90 1 Sawletia oi ferdiox tiolutaolon, ohetatiiiiI, end/Oli telUenlltni 2 1 • e.g.. 1 4 .. ir 0/0,-;200s - arn)77 200 yisr,.. or legit ,,. 80.)0 ''• ' ':'.' - /441,044. lh;::'iiiiitytie - ' ' 717 , z; -''.:',., .!: ki;,. ,'.' ..:', 201 mps to 400 amps _ 106.Sa ) ._ ".•:•-,•••••-' . -:•°: " a ., - ;1 :, • • • ..., ,...??aC ''''L-- % ' ',- ' '''' .7; f‘.:: ',..:.:- ' .411'1.1....i.* 4p) „ t , 500 .„I, !GOA& 2 . Name. R cm 40 i amp; to 1.000 amps A 40.00 2 Addrem: c:7 0 s -ti. rk ..4p,2 ,.., ,,,,,,t.OW amps ci volt% 454.bf: ...... Reconnect only 00.85 _ . j .t City C 0 ii , r t-lek Aj OR . 9 / ).:c-2,3 .. . .. _ ompiw r's ol r scrvitel or feede innaitatiuu, 4111(111t1011. andrui• I Tuclocatioo Pllolw (5(I3) s q 25_6_5- 1 P. ( 53I - ci9C5- 204) :I1 3 , i I _ fin.K5 Owner inNuitation: 1116 inytuilatior. IS being mad d %Jo proper ry that I own which tz nol ' zoi ,.. li , a)a amp, 300 10 2 intetutA lot vok letkic, r■tot, ov exchange, according 10 ()Rs 447, 449, 670, and 701 401 ono; to WO ;owe 1.0.7's 2 Owner Si8881Ura: , . _ate, Branch circuits - ssr,w4, alteration, or tatetistost. toy Pund . . .. F,i......,..,,:i.:..2.0...0,;EavAw.i..t..0.4:t,4.;-.,.:,:.4.::•.:4;..1*pw4toti,: A . Ft l'u or tsrs f ilch eittniis wiTh — ..----- oder roe, each Business 00111c: ?CM ‘4COleS branctl :ireun 6.65 __....... . . .. e. Pec for branch GliVott:, CoM.rt3 name: .133 0 AA., f_ L..); I_SO A) wirhimi ox-c or Credo fee, 46 - .1t5. ' cacti branch ciA:ilit Address . ,--- _... . , . ach 8114`1 branch moon — 6:05 1 2 1 city/State/ZIP- 4"4---)-1 P4Itrellmoi.iiis (exa or feeder not Included) ..... Pump or itgigutturt click 3 4(1 . ____ Ptivnc: ( ) -. axatt: . - or oullinc ligittmg 5,t 40 2 _. E II* ■ . e_. . _ gr.. „,- i 7. % . , , - ' ' Siosatil eircuif(a) or limited- ' IMETANI!..79tr.ilttli'e-'-::•,:nEtY;i7liT, ______ •: ,., 1 - 7 7::-.7, - '',.A Cr•L'IY Pmf•-t a 4 IWIL 0 tmetisiaa, Onacribt. Page 2 liu name: • r • be_c4-.1--: C vt C_ • A ddr e ss : jfi- o 1-7 I E ( 11- ., , 1 j 4,- Each additional Inspection over allowattielat any of the above ---1------- Per Initrection 61.50 CityiStatc/VP: e't2)-'1 T C 7 --- 1 1 0 Investigation per Ivor 0 h. wan 62 50 1 ___ rtvanc: (<0 2 0., ._ 4z (,7 Fax: lItt.i ) 2 . .z _. (91330 I/ Indutoriul Tint per Ion. '7',1 ,5 - — Imillkxvii.1.47-Fiv,Tftgili2i:'53:137agYra-*',T-:141Nif cco Lk.. j ;073 Electrical Lit; ...:'1 -- (124 supiv. 1.it 91 S • Subtotal _ Suprv. Electrician sistintut e, requited: e.-,. i,.. 4 — -- ..,, s Ptxo review (2a'ea of pa (ee) .. t .-N-4ve, .... State torcharge (8% Of Verntit I.c) I ' _ Print name; Vi.. ‘ t . , L., pate: dic , i f Ill) I , --- I T — OTAL PERMIT FEE AtithOrikthi SiSnultle ' Th in Venni atngteatnnt ?morn U &pitman is nos obtained memo Ian I — flays Own au been accepted aa complete Print Caine I Dine: • Foc int vet by Tti•County Bolding fathotry Service Homo . - • -- N.,ok of i..iii-Ntioiu Ihi CA114111/. I ilkiVirA i 41 a:Ittite , Po.tokAtt.C.Poogioa,pi 40c ;Ins an: 401.1111cmoury)htwatu CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -OOSBB 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 917/2005 Phone: (503) 639 -4171 Ah1 �uV' Inspection Requests (24 Hrs.): (503) 639 -4175 _�� =__.. INSPECTION WORKSHEET FOR DATE: 7/112006 TIME: 7 :03AM PAGE: 3 SITE ADDRESS: 10390 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 001 TYPE OF USE: PROJECT NAME: ASHBROOK CONDOMINIUMS DESCRIPTION: Building 4: Unit 19 of a 5 -unit townhouse building. OWNER: RCM HOMES, PHONE #: 503 - 598 -7565 CONTRACTOR: DMS ELECTRIC INC PHONE #: 503 -209 -9298 Inspection Request Scheduled For: Dat / 7/1812006 Pour Time: Code # Inspection Description C.nfirm # Contact # Message 199 Electrical final 0. 263-05 503-209-7386 N Corrections /Comments /Instructions: ''..\/\ (. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ,,�� 11 QQ � Inspector: � t\ ' Q Date: 9 I stlot Phone #: (503) 718 -2 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005-00588 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005 Phone: (503) 639 -4171 a "dN�u�� "i't Inspection Requests (24 Hrs.): (503) 639 -4175 'I L. INSPECTION WORKSHEET FOR DATE: 7/12/2006 TIME: 7:05AM PAGE: 45 SITE ADDRESS: 10390 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 001 TYPE OF USE: PROJECT NAME: ASHBROOK CONDOMINIUMS DESCRIPTION: Building 4: Unit 19 of a 5 -unit townhouse building. • OWNER: RCM HOMES, PHONE #: 503-598-7565 CONTRACTOR: DMS ELECTRIC INC PHONE #: 503209.9298 Inspection Request Scheduled For: Date: 7/12/2006 Pour Time: . Code # Inspection Description Confirm # Contact # Message 199 Electrical final 032950 -05 503-209-7386 N Corrections /Comments /Instructions: ,,,I C Rc�•it in V'ii - P 6% 67 . e . I I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS k(I FAIL ACALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: T41 WC8 c., Date: r Phone #: (503) 718- ) CITY OF TIGARD _ ., • BUILDING DIVISION PERMIT #: ELC2005-' 00588 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/712005 Phone: (503) 639-4171 47,11/141111111?\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 4/17/2006 TIME: 7:06AM PAGE: 86 SITE ADDRESS: 10390 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 001 TYPE OF USE: PROJECT NAME: ASHBROOK CONDOMINIUMS DESCRIPTION: Building 4: Unit 19 of a &unit townhouse building. OWNER: RCM HOMES, PHONE #: 503-598-7565 CONTRACTOR: DMS ELECTRIC INC PHONE #: 503-209-9298 Inspection Request Scheduled For: Date: 4/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough-in 028123- 7 503-209-7386 Y Corrections/Comments/Instructions: PI i ' ---...-.... PASS 0 PARTIAL APPROVAL El CANCEL El NO ACCESS 0 FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: rACZA Niq3(.0 Date: 4 11 ill6C Phone #: (503) 718- VIO CITY OF TIGARD BUILDING DIVISION - PERMIT #: ELC2005-00588 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005 Phone: (503) 639-4171 4411 lilt\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 4/12/2006 TIME: 7:04AM PAGE: 94 SITE ADDRESS: 10390 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 001 TYPE OF USE: PROJECT NAME: ASHBROOK CONDOMINIUMS DESCRIPTION: Buildng 4: Unit 19 of a 5-unit townhouse building. OWNER: RCM HOMES, PHONE #: 503-598-7565 CONTRACTOR: DMS ELECTRIC INC PHONE #: 503-209-9298 Inspection Request Scheduled For: Date: 4/12/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 027807-12 503-209-7386 N Corrections Comments/Instructions: if < i i , . 01Mf Off ,i1 iii / //"K /AA / rria.mrA .1 / EP 14 A ._ ... .... N . . , . 01 0 iWei% S PARTIAL APPROVAL D CANCEL El NO ACCESS Xr.t`il, IL ALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: a . .... , , Date4 1 7 " --- 0 Phone #: (503) 718-I-IND