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10025 SPS GARRETT ST
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSFORO,OR 97124
G�UNT� INSPECTION REQUESTS: 503/640-3561/693-4415
PHONE: 503/64841741i1 -
OREGON T
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Par cel Number 2S1'1'l - Land Use 1)is tr ict
Vaivat.ion 0
Uwrior. .1 NSPEC,'1'lUN - '1'1GARL) Construct ion oTH
Antall cant Name TML CONSTRUC'i(W.'n LNC Clar,sit icat ion 0f)
Ar)olit-.:crit: Addr , t835 SW C'ANYUN LN 408 Occupancy
PUY ;'LAND UF2 9'/2::' Vaiidated 1-Y
Apralicrint Phortr! : 29;:) -7981 1ns ,nct.r.,1' Ari•.I
(_UNTkAC 1'UR . '.1'ML C CIN:i'1'L;UC 1'Uki;_, , 1NC: . Llc . f.' h S1j4: L41 - 11 / i U
k'C r descr r!;)t ion UI11tS F,e /13t1. l t Ext f r,rp 1.)clt a
;;crrVice/t•'eed r : 2UU amps of Jr: nl, 1 6U , Ul) Gt) , UO
E'c,c:h t3ranch W/ h'eeder I Entc-�r n 1 ] 5 , 00 ;, . UU
.i 1.1btot.a1 h:Jtict r lcai k•'eP-s : C, 01)
;tate t,urcharcle cit bl,
'I't1tal Electricra1. !•'eec, .
* * trees iiequireo tt A k•'ees Collected b, credits .,
Methc,: Uieck rt htc r ei r,C No . Dat.r Ilavn,;,!
CK ,ta;'tt U4/1',/9 4
1.
h'e e
A(0%A: trnents a 'I'r;tai Cred; '
Tot:aI 1,'P r— ,;1 1"f t ,aa Paynter. r. ,
NOTICE This permit becomes null slid void If the work or construction for which It Is Issued Is not commenced within 180 days Once constmetlon has slanted,
the permit becomes rwll and void If construction Is Interrupted for a per:nd of 180 days 1 certify that the Information presented !re jpplicanl and
his agent or spents In support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building De:a,+ rent's rellance
upon false and misleading Information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will be compiled with whether or not speciflea ^th.dans or noted on the plans correction sheets i 2cknowledge That
the granting of a permit does not grant authority to access p-ivsle property or to use e�-.emenb I further acknowledge that the use or occupancy of
the structure or building perml9ed depends upon my ca:•!ng for Inspections a!various tlmbi curing the process of construction and the building
Inspection staff verifying compllance with the various codes. Use or occupancy of the build og or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy I_.evccable until all Inspection requirements are satisfied and
approval Is given by the Building Official. I further acknowledge that a lien may be pin ced on the title of the property upon which the permit is iss:,ed
specifying that the use or occupancy of the building or structure la provisional and revocable until the satisfaction of all Inspcetion requirements
APPLICANT'S SIONAI URE
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
�`..� electrical In'=Pp-tion Section A P�LI C,p►,T I O I`e
;SS North Firs! Avenue, #350-12
Hillsboro, Oregon 97124
Information: (503) 640-3470 Fax: (503) 6934412
Projec:tJPermit C ,� .1 U� l
Number -----,�,�" JaS d� Date _
PLEASE PRINT
Plopase complete • •
4. Complete Fee Sci7edule below
Number of inspections per permit allowed
1. 1_ocation Qf�sllaxiDnl -I- Service Included: Items Cost(ea.) Sum
Address — -
O Buil
ing A. Residential-per unit
:.its Suite N0. �-
1000 sq.ft.or less --- $110.00 - 4
Tenant NT -a a Each additional io0 sq.ft
(if commercial) _ or portion thereof $25.00 -- --
Umiled Energy $2500 - 1
Tax Lot Map No. Eacn Manuf d Home or Modular
Dwelling Service or Feeder $66.00 __--- 2
Thomas Map B a ' fon:
Directions - - B. Services or Feeders
r_— Installation,alterations or relocation
200 amps or less $60.00 2
Comrnercial �.I Residential 201 amps to 400 amps $8000 2
401 amps to 600 amps $120.00 — 2
on nl 601 amps to 1000 amps $180.00 2
2a. Contractor instal ti
y 1 Over 1000 amps or volts $340.00 2
Electrical ntractor � l _ _ Recnnnect only $50.00 2
Address � r
Date - I I - Job Number _ C. Temporary Services or Feeders
Property Owner A Installation,alteration or relocation —
Contractor's License No. � 200 amps or lase �_ $50.00 _ _ 2
Contractor's Board Reg. N 201 amps to 400 amps _-401 amps to 600 amps $100.00$7500 _ -- z
— 2
Over 6amps to 1000 volts see'B'above
Signature of Supra rt"
License No. Pito o. D. Branch Circuits
00
- - New,alteration or extension per panel
2b. For owner, installations: a) The fee for branch circuits with 4-v
purchase of service or lesr.+erlee.
-- --- ------ -- --- Each branch circuit ___J.__ $5.00 2
Print Owner's Name hone o. b) The fee for branch circuits without
Address - purchase of service or feeder fee.
First branch circuit $35.00 2
City - ate- Zip Each add'nl branch circuit $5.00 2
E. MiAxellaneous (Service or Feeder not included)
The installation is being made on property 1 own Each pump or irrigation circle $40.00
which is not intended for sale, lease or rent. Fach sign or outline lighting $40.00 _
Signal circult(s)or a limited
Owner's Signature -____. - - -._-. energy panel,alteration
or extension $40.00
F. Erich additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection _ $35.00 _
Please check appropriate Item and enter fee In section 5B Per hour _.. $55.00
!n Plant —_._. . $55.00 _
4 or more residential units In one structure
Service over 800 arnps; feeder 800 amps or more 5e Fees
System over 600 volts nominal A. Enter total of above fees $
_Classified area or structure containing special 5% Surcharge (.05 X total fees) $ _
occupancy as described in N.E.C. Chapter Subtotal $ -
B. Enter 25% M line A for
Submit 2 sets of plans with application where any of the Plan Revie,v if required (Section 3) $ -
above apply. Not required for temporary cur19truction Subtotal $ -
services. $
Less Sulk Label Fee
Balance Duma $ `--�
For inspections call This rermh b«omsa null end void M the work authorfred by the pernh Is not cnmrn•nced
640-3561 or 693-4415 within 190 days from date of Iseusmee or such permit a h the work suthodredle
suspended ot abandoned at any time eater weak Is common d Ion a perlod of 190 days.
24-hour recorder, cne working day in advance of need Etedrl.alpermetsare non refu"Weand non translatable,
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