15735 SW OAK MEADOW LANE-1 41
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DEPARTMENT OF LAND USE&TRANSPORTATION f
WASHINGTONLAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
;• , CII11 IA1W' INSPECTION REQUESTS: 503/640-3561/693-4415
CREGUN XXXXXXXXX--> -3410of 1
Date U2/08/9b � w
'1'ime 14 : 3'
Permit 'Type Residential Electrical Lermit hermit # 05063'/54
hermit Status APPROVED .Applied 02/0'//95
S1tus Address : 15'/35 SW OAKMEADOW LN '1.'1 issued 02/07/95
Permit 'Title SN'R - BURGLPR ALARM L. V. Completed :
Permit llescr. 1'o Expire 08/06/95
Project 'Title 51'H - BURGLAR ALARM L.V. Project # P0047397
Project llescr. * EROSION
Parcel Number, 251'1'1 - Land Use District :
-t Valuation 0
�! Legal llescr .
Uwner INSPECTION - '1'luARU Construction 01'H
Applicant Name CEUCKSHANK, MICHELLE Classification 900
Applicant Addr. : 2403 31TH AVE S . E. Occupancy R3
PUYALLUP, WA 98374 Validated by LG
Adplicant Phone: 8I0-5742 Inspector Area :
t'ee description Units b'ee/Unit Ext fee Data
-------------------------•---------------------------------------------------
Limited Energy/Alter./:Extension 1 40 . (, ' 40 . UU
bubtotal Electrical P'ees : 40 . 00
State Surcharge of 5% 2 . 0U
Total Electrical Nees : 42 . 00
*** k''ees i.tequired *** *** E'ees Collected & Credits rr**
--------------------------------------------
-----------------------
Method Check # Receipt No. Date Payment
CK 3:358 02/0'1/95 42 . 00 �
Fees : 42 . 00
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Adjustments : 00 'Total Credits : . 0U
Total Nees : 4 Z . U U Total Payments : 42 . 00
Balance Due: . UU
NOTICE: This pe.-nit becomes null and void If the wo-k or construction for which It Is Issued Is not commenced within 1811 days Once construction has started,
the permit becomes null and vold If construction Is Interrupted for a period cf 18C days. I certify that rhe Inform atlon,,resented by the applicant and
his agent or agents In suoport of this permit is true and correct to the best of our knowledge. I acknowledge that_:re BulldIng Department's reliance
upon false and misleading Informstlon 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 specified on the plans or noted on the plans correction sheets. I acknowledge that
the granting of a permit r'nes not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or bu!'dinc permitrad depends upon my calling for Inspections at various times during the process of construction and the building
Inspsctlnn staff verlfylr J compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval ay the
Building Departmeni Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are aatlsffed and
approval!a given by the Building Official. I further acknowledge that a lien may he placed on the title of the property upon which the permit Is Issur-1
specifying that the use or occupancy of the building or structure is provisional and revocable until the satisfaction of all'•ispectlon requir emantr
APPUCANt'S SIGNATURE
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WASHINGTON COUNTY
RESTRICTED
Department of '. and Use &Transportation
Electrical Inspection Section ELECTRICAL ENERGY
155 North First Avenue,11350-12
Hillsboro, Oregon 97124 03)693-441 APPLICATION
a + Information: (503)540-3470 Fax: (5
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a . PRINT
Permit No.Pleaie comp.16te all sections, I through 5.
1. Location of install/ati n ��, L ate _d-rj_ ____- - ------- '►
t Address �V A�< /=�Ch*�yl�, N,
� �/ 4. Type ofwork:
1 City_ /16 AA_ � Zip Code _ _ 7
---' .,
Map No. � Tax Lot — RESIDENTIAL Restrluted Energy Fee $40.00
(for all system.)
I Thomas Map Book: Page Section Check type of work involved:
Directions �____�_
Audio and Stereo Systems"
-- — Burglar Alarm
Commercial L] Residential Telephone syutems"
Garage Door Opener'
Tenant Name Fire Alarm
(if -ommercial) —_. ---- — -- - Heating,Ventilation and Air Conditioning Systems'
Vacuum Systems`
2, Contractor a p ica Iopj Other
Electnca ont ctorAdd
City s
R ti S r COMMERCIAL Fee for each system $40.00
Ci � Stat - Zip�C (see OAR 91e-260-200)
City. � '
Date / S ob C mberr Check type of wori•. Involved:
Property Owner
Contractor's License No. _ L L_LJ Boiler Controls
Contractor's B
oa
'rd eg. �. - Clock Systems -
Phone No. ( ---- Data Telecommunications Installations
Fire Alarm Insiallat on I r
3. Qwner application: HVAC
C�/ S 1 r' � ,�t�j C� �/ Instrumentation
/�I lY Phone No. Intercom and Paging System
Print Owner's Name LandscapP Irrigation Control'
--- — -- Medical
Address Nurse Cells I
— --- ----
Clty Outdoor Landscape Lighting
Zip �
Protective Signaling
1 t eonly restricted is mit Is Issued rd energy installations(loo volt amnde,OAR 916-320-370. The ps oor less)
Other
under this permit and to do the fellowrng:
1. Only use electrical licensed pe:---.ons to do installations where " •-~,oer of Systems
required. (Certain residential and other transactions are exempt _
from licensing. These have asterisks(*). All others need licens-
ing.) "/Uo licenses are required. Licenses aro required for all other installations.
2. Call for an Inspection when all the installations under this pe•mlt
are ready f-ir Inspection.
3. Purchase separate permits for all Installations that are not ready
for inspection when the Inspector is out to inspect under this Enter fees
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permit.
4. Assume responsibility for assuming that all corrections required n/'�
by the inspector are done,and 5°' Surcharge (.O5 h total above) $ lJ
5. Assume responsibility rcr calling for s final inspection when all of
the corrections are completed, Trust Account $
The person signing this permit must be the applicant or a person
authorized to bind the applicant. $ C{� Q 0
Total —.—..-
Signature
Authority If other than applicant This permit becomes null and void It the work authorized by the
_- permit Is not commenced within ISO days from date of Issuance
of such permit or It the work authorized is suspended or abandoned
For Inspections call
at any time after work is commenced for a period of 1 e0 days.
640-3561 or 693-4415 Electrical Permits are non-refundable and non-transferable.
24-hour recorder, onn v ig day In advance of need BL24-114
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