7575 SW PINE STREET , ADDRESS:
hrecards\microilrn\;sr6,r ts\building.doc
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DEPARTMENT OF LAND UL &TRANSPORTATION
WASHINGTON LAND 155 NORTH DEVELOPMENT DIVISION
FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/840-3561/693-4415
XXXXXXXXX---> 640-341/0
OREGON Page : 1 of 1
j Date : 12/05/94
Time : 09: 32
Permit 'Type Aesidential Electrical Permit Permit # : 05061457
Permit Status APPROVED Applied : 12/05/94
Situs Address 75/5 SW PINE ST TI IssuF:d : 12/05/94
Permit Title SN'R - ELEC/ONE CIRCUIT Completed :
Permit Descr . I To Expire : 06/03/95
Project Title Sl'R - ELEC/UNE C.LRCUI'T Projert # : P0045930
Project Descr . * EROSION
Parcel Number 251'1'1 - Land Use. District
Valuation ►)
Legal Descr.
Owner INSPECTION - 'riUARD Construction O'l'H
Applicant Name WEST SIDE ELECTRIC Classification 900
Applicant Addr. : 7518 SW MACADAM AVE Occupancy R3
POR'T'LAND, OR 97219 Validated by KN'
Applicant Phone : 245-3385 Inspector Area
k'ee description Units Fee/Unit Ext fee Data
1st branch W/out r'eeder [ Enter #] 1 35. 00 35 , 00
Subtotal Llectrical Fees: 35 . 00
State Surcharge of 5`k 1 . 75
Totai E:,.ectrical Fees : 36, 75
*** r'ees Required *** *** Fees Collected & Credits ,�**
---------------------------- --------------- -----------------------------
Method Check # Receipt No . Date Payment
'DEP' 12/05/94 36 . 75
TOTAL THIS DATE ********* 36 . 75
Fees : 36 . 75
Adjustments : . 00 'Total Credits : . 00
Total Fees : 36 . '/5 'Total Payments 36 . 75
balance Due: . 00
NOTICE: This permit becomes null and void If the work or construrtlon for which It Is Issued Is not commenced within 180 days. Once construction has stayed,
the oermlt becomes null and void if construction Is Interruoted for a period cf 180 days. I certify!hat the Information presented by the applicant and
his egent or agents In support of this permit Ii true and correct to the beat of our knowledge. I ackt;nwledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permit. All prnvinlons of applicable laws and ordinances joverning the construction and usa
of this building or structure will be compiled wilt,whether or not specified on the plane or noted on a.j pians correction sheets. I acki,owledge that
the granting of a permit does not grant authr.rfty to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
Inspection staff verifying compliance with the various codes. Use or nccupancy of the hoeing or structure permitted prior to approval by the
Building Department is solely at the risk of the applicant and such use or occupancy Is res ocable until all Inspection requirements are satisfied and
approval Is given by the Building Official. !further acknowledge that a Ilan may be placer'on the title of the property upon which the parmdt Is Issued
specifying that the use or occupancy of the hullding or structure Is provisional and revor able until the satisfaction of all Inspection requirements.
APPLICANT'S SIGNATURE
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WASHINGTON COUNTY �as.CT R!CAL PERMIT
Department of Land Use & Transportation E'� s.
Electrical Inspection Section
155 North First Avenue, #350-12 APPLICATION
Hillsboro, Oregon 97124
Information: (503)640-3470 Fax: (503) 693-4412
Permit Lig Date o
' PLEASE PRINr
-Please coihplete all sections, 1 through 5. 4. Complete Fee Schedule below
1. Location of lnstallat' n _ Number of Inspections per permit allowed
Address 7 �t`c% U.
TT. Service Included: Items Cost(ea.) Sum
Building A. Residential-per unit
City� i'C _ Suite t&
1 J00 sq,ft.or less $110.00 4
Tenant Name Each additional 500 sq.ft
(if commercial) Ior portion thereof $25.00
Ma No. ��l �f' �' !� Tax Lot _ t Limited Energy $-25 00 1
p r Each Manuf'd Home or Modular
Dwelling Service or Feeder _ $68.00 2
Thames Map Book: Nage: Section:
Directions__ — B. Services or Feeders
installation,alterations or relocation
200 amps or less $60,00 2
Commercial ❑ Residential 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
2a. Contractor i s,tal at'on on! 601 amps to 1000 amps --- $180.00 2
1 ' �G/, Over 1000 amps or volts $340.00 2
Electrical Contractor - ') ' F3econnectonly $50.00 --- 2
Address fire
City r 4r 'et- State ZIP 2 C. Temporary Services or Feeders
Date f )ob Number '- > 7 / Installation,alteration or relocation
Property Owners U.'7 . i 1,01.,fle l dr�r 200 amps or loss $50.00 2
Contractor's License No. 201 amps to 400 amps $75.00 2
. No. („ 401 amps to 600 amps - $100.00 2
Contractor's Board Reg. --� Over 600 amps to 1000 volts see W above
Signature of Su r. Elec'n D. Branch Circuits
License No. 0. 3 Now,alteration or extension per panel
a) The fee for branch circuits with
`'b. For owner installations purchase of service or feeder fee.
Each branch circuit $5.00 2
rent wrier s amePhone No. b) The fee for branch circuits without
purchase of service or feeder tee.
First branch circuit $35.00 2
Each add'nl branch circuit $5.00 _ 2
.iy
Stale Zip ip - E. Miscellaneous (Service or Feeder not Included)
Each pump or irrigation circle $40.00 2
i lTe installation is being made on property ! own Each sign or outline lighting $40.00 2
wh;ch is not intended for sale, least'' or rent. Signet circuits)or a limited
energy panel,alteration
Owner's Signature or extension �.v_ $40.00 2
F. Each additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection _ _ $35.00
Per hour �__.. $55.00
Please check appropriate Rem and enter fee in section 58. in Plant _ $55.00
___._4 cr more residential units in one structure
__Service and feeder, 800 amps or more Jr. Fees
,System over 600 volts nominal A. Enter total of above fees $ 3 __
Classified area or structure containing special 5% Surcharge (.05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $
B. Enter 25%, of line A for _
Submit 2 sets of plans with application where any of the Plan Review If required (Section 3) $
above apply. Not required for temporary construction Subtotel
aprvices. [_1 Trust Account $ �4
------------ Balance Due $ �
For inspections call This permit becomes null and void If the work•uthoritet by th-r permit Is not commenced
640-3: 61 or 693-4415 within 180 days from date or Issuance of such permit or I the work authorized Is
suspended or abandoned at any lime after work Is oormaencod for a period of/eo days.
24-hour recorder, one working day in advam;e of need Eledrical Permits at*non-refundable and nondraneferabls.
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