17397 SW BRANDYSHIRE COURT ADDRESS.
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i\records\microflm\targets\building.doc
DEPARTMENT OF LAND USE&TRANSPORTATION
`/�' '� LAND DEVELOPMENT SERVICES DIVISION
tlYA�HI�'"'��� 155 NORTH FIRST,HILLSBORO,OR 97124
t COI,1N e i f INSPECTION REQUESTS: 503/640-3561/693-4415
OREC 7N XXXXXXXXX---> 640--3470
Fuge 1 Of 1
Date 05/25/95
Tame 09 . 15
Permit 'Type Residential Electrical Permit Permit # 05068137
Pe*1 t :;t.3�-.us APPROVED Applied 0°la/25/95
5i c Adc � .ss 173 .'7 SW BRANDYSH1RE CT Ti Issued : 05/25/95
Fe3r.ni ^.'a.r1 : SNR - 1 C1'::::UJ.'T' INSTALLAIWN Complexed :
F tic Vias .r, To Expire . 11/21/95
i-I.t ' ,ct Ti :le 5F'R UtRCUIT INSTALLATION Project # : PU05029t'I
Pr > , ct Tae•. : * EROSION
Pard , umber IT I Land LI.-;e District
Valu, n rI
Le:ral je,ci .
owner, LN.5PEC"P10N - TUALA'T1N Construction O'Tii
Applicant Name GHF ELECTRIC Classification `TUU
Applicant Addr .. : i 46U S T'ARAVISE. Occupancy R3
MULINO ON 97041. Validated by M:IC
Applicant Phone : 869--4146 Inspector Area
Fee description Units Fee/Unit Ext fee Data
�ist Branch W/out Feeder [ E::titei # 1 1 35 . 00 3"i . 00
'il.tbtOtal Electrical Fees : 35 . 00
State Surcharge of b% 1 . 175
'1'c:taI Eler::trical Fees : 36 . 75
*** Fees Required *f** *** Pees Collected & Credits ***
Method Check # Receipt Tho• Date Payment
CK 2433 Da/25/95 36 . 75
TOTAL THIS DA'T'E
Fees : 36 . 71
Adjustments : . 00 Total Credits : . 00
Total Fees : 36 . 75 'Total Payments : 36 . 75
Balance Due: . UU
NOTICE: I*tit permit becomes null and void If the work or construction for which It Is issued Is not commented within 180 days. Once construction has started,
the permit becomes null and void If construction la Interrupted for a period c, Itir days. I certify that the Information presented by the applica-et and
his agent or agents in support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permit. All provision- appilcable laws and ordlnancos governing the construction aid use
of this bully,I or structure will tw complied with whether or not specified on Lha it s or noted on the plans correction sheets. I acknowledge that
the granting cf a permit does not grant authority to access I. ivate property or, asements. 1 further acknowledge that the ties or mxupancy of
the structure or building permitted depends upon my calling for inspections at var.wie times during the process of construction and the building
Inspection staff vsrlfying compliance with the various code%. Usr or occupancy of the building or structure permitted prior to approval by the
Building Department la solely at the risk of the a,eplicsnt and such use or occupancy Is revocable until all Inspection requirements are satlefied and
approval Is given by the Building Officlil. I further acknowledge that a I:en may be placed on the title of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or structure Is provisional am revocable until the satisfaction of all lnauection mqulrements.
APPLICANT'S SIGNATURE
r //��
WASHINGTON COUNTY E LECTR i CAL PERMIT
Department of Land Use &Transportation
l Inspection Section
155 North First Avenue,#350-12 APPLICAIOR
Hi;lsboro,Oregon 97124
Information: 503 640-3470 Fax: 50:1 693-4412
PLEASE PRINT Permit 9
• - • • - • • • Nurnbel -'� /��� Date "'
1. Location of installation 4. Corr:plete Fee Schedule below
Address ___)_�_�_q--7___4 1-rte Ct Number of inspections per permit allowed
Buil dIN
Service included _—�Itum ( )
s Coit ea. Sum
�� -
City 4Y_,ki&rnn, Suite o. ------ -- -
Tempt Name A. Residential-per unitcauae
(if aroiel) --___--- __ --_--- 1000 sq.ft,or less ----- $110.00 a
Map No._—_..__--__ Tax Lot Each additional 500 sq.ft
_-. __ or portion thereuf -- $25.00
Limited Energy $25.00 1
Thomas Map Book: Page:—__ Section: Each Manuf'd Home or Modular
Dwelling Service or Feeder ___ $66.00
B. Services or readers
Commercial�� Residential Inrtallation,alterations or relocation
200 amps or less -- $60.00 —_— 2
2a. Contractor installation only: 201 amps to 400 amps ^.._ $60.00 2
Electrical Contractor _(�fL F Ll e�fir G 401 anrpsto 600 amps $120.00 _.___ 2
601 amps to 100u amps _ $100.00 _ 2
Address 1 Slav 5r f &t-& Over 1000 amps or volts _ $340.00 �- 2
City Ad te,lr'�+_a State__0A ZV�Z- Reconnect only $50.00 2
Date- _- Job Nu ber
Property Owner __�oh,n GE, ___-- ___ C. Temporary Services or Feeders
Contractor's License No. �—�,2 Cs . Installation,alteration or relocation
Contrector's Board Reg. No. / o 1 5 3 -_-_ 200 amps or less __— $50.00 _ 2
201 amps to 400 amps $7b.00 _ 2
Signature of Supr. Elec'n _ ovelam a amps oa 0ns to 600 00 volts see°B"above oo __
License No. ,fed _ Phon l No, kqz 1�t(p__-
D. Branch Circuits
2b. For owner installations: New,alteration or extension pir panel
a) The fee for branch clrcu is with
Print Owner's ameonce — purchase of service or.esder fee.
__ Erch branch circuit $5.00 ---_ -
Address b) The fee for branch rircults without
purchase of service or feeder fec.
Lity State _9p First branch circuli —4-_ $35.00 3S
Each add'nl branch circuit_— $3.00
The installation is being made on property I own E. Miscellaneous(Service or Feeder not included)
which is net intended fa;sale, lease or rent. Each pump or Irrigation circle $40.00 _
Owner's Signature Each sign or outline lighting __ $40.00
Signal circuft(s)or a limited
energy panel,alteration
3. Plan Review Section (if required) or extension _-___ $40.00
Please check appropricte Item and enter fee In section 59. F. Each additional Inspection over the allowable
4 or more residential units in one structure In any of tire above
s or more Per Inspection __-_ $35.00
Service and feeder, 800 arr
p Per hour -_. _ $55.00 -
_-System wer 600 volts nominal In Plnnt _____ $55.00
-Classified area or structure containing special
occupancy as described in N.E.C. Chapter 5 5. Fees
Submit 2 sets of plans witn application where any of the A. Enter total of abovo fees $
above apply. Not required for temporary constructloir 5% Surcharge (.05 X total fees) $
services. Subtotal $
This permit becomes null and void If the work authorized by the permit Is H. Enter 25% of line A for
nit c.mmenced within 1e0 days from date of Issuance of such permit or Plan Review if required (Section 3) $
If the wort,authorized Is suspended or abandoned at any time after work Subtotal $
Is commenced for a period of 1110 days, Electrirsl Permlts are non- $
refundable and non-transferable. ❑ Trust Account
For Inspections call Balance Due
681-3699 or 681-3698
24-hour recorder, one working day It, advance of need
BL2e • 3195