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11345 SW 95TH AVENUE
w u, L U� rt - t DEPARTMENT OF LAND USE&TRANSPOITATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 155 NORTH FIRST,HILLSBORO,OR 97124 upa I—M^S.- - COUNTY, INSPECTION REOUESTS: 503/840-3561/683-4415 OREGON XXXXXXXXX--> 640-347U Page 1 of 1 Date 11/21/94 Time 14 : 03 Permit 'Type Residential Electrical Permit hermit # 05061019 Permit :status : APPROVED Applied 11/21/94 bitus Address 1134b EW 95TH AV '1'1 Issued 11/21/94 Permit Title SE'R - 2 CIRCUITS INSTALLATION Completed Permit Descr. To Expire 05/20/95 Project 'title St'12 - 2 CIRCUITS INS'TALLA'TION Project # PUU45669 Project Descr. >f EROSION Parcel Number 251'1'1 - Land Use District Valuation. 0 Legal Descr. Owner : INSPECTION TIGARD Construction O`1'H Applicant Name : WEST SIDE ELECTRIC Classification 900 Applicant Addr. : 7`,i18l SW MACADAM AV Occupancy PORTLAND OR 97219 Validated by t MJF Applicant Phone : 245-3385 Inspector Area : 1''ee description Units Pee/Unit Ext fee Data ------•--------------------------------- 1st branch W/tout E'eeder ( Enter, #1 1 35 . 00 35 UU Addl . branch W/out N'e-.,der [Enter #J 1 5 . UU 5 . 0u Subtotal Electrical c'ees : 4U . U0 State Surcharge of 5% 2 . 00 Total ElEctrical Pees : 42 . 00 *** Pees Required *** *+t* E'ees Collected & Credits **rr _----___-----_-.--------------- Method Check # Receipt No. Date Payment 1UEP1 11/21/94 42 . 00 TOTAL THIS DATE rr*+r**rrtrrtr* 42 . 00 Pees : 42 . UU Act justments : . 00 Total Credits : U Total Pees : 42 . UU 'Total payments : 42 . 00 Balance Due: , 00 NOTICE: This permit becomes null and void If the wort or construction for which It Is Issued Is not commenced within 180 days. Once construction has started, the permit becomes null and void If construction Is Interrupted for a period of 180 days I certify that the Information presented by the applicant 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'&reliance 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 complied with whether or not specified on the pians or noted on the pians correction sheets. I acknowledge that the granting of a permit does not grant authority 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 occupancy of the building or structure permitted prior to approval by the Budding Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and approval Is given by the Building Official. 1 further acknowledge that a Ilan may be placed on the title of the property upon which the permit is 143ued specifying that the ties or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements APPLICANT'S SIGNATURE WASHINGTON COUNTY p ELECTRICAL PERMIT' Department of Land Use & Trans Transportation Electrical Inspection Section15 North First PLICATION r /� H5nue lisboro, Oregon e97124 35(3 -12 A f[�r- LICA TIO N Information: (503) 6403470 Fax: (503) 693-4412 Project/Permit PLEASE PAINtNumber _ �� I(_� _ Date iPlease _ complete all 4. Complete Fee Schedule below 1. Location of installationNumber of Inspections per permit allowed Address 7 l✓ "i �_ Service included: Items Cost(ea.) Sum --. Building A. Residential-per unit City Suite No. 1000 sq tt.or loss $110.00 4 Tenant Name Each additional 500•eq.ft (if commercial) _ or portion thereof $25.00 Limited Energy -- $25.00 1 Tax Lot i i Map No. ----- Each Manut'd Moric or Modular Dwelling Service or Feeder $6800 — 2 Thomas Map Book: Page: Section:-- Directions._________ __— __ B. Services or Feeders ---.-- Installation,alterations or relocation Residential Commercial F] 200 amps or less $60.00 2 L_ 201 amps to 400 amps $80.00 2 401 amps to 600 amps __ $120.00 2 2a. Contractor installs io onl sol amps to 1000 amps $160.00 2 Over 1000 amps or volts $34000 2 Electrical Contrac or i Reconnect only $50.00 2 Address nn /,'K ! lI Grr. 1.r j/' Date Jo N m er - .ay C. Temporary Services or Feeders Property Owner < _ Installation,alteration or relocation Contractor's License No, ' 200 amps or less $50.00 2 Contractor's Board Reg. No. 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts see'B'above Signature of SLIF. Elec'n License No, /S ' A 1 Ph a No. _GS=,..1 D. Branch Circuits New,alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or feeder tee. Print nera Name _ one No. Each branch circuit —_ $5.00 2 b) The foe for branch circuits without Address — --- purchase of service or feeder fee. c _ abranch circuli $35.00 2 �� state Zip �� Each Each edd'nl branch circ.pit $5.00 2 E. Miscellaneous (Service or Feeder not included) The installation is being made on property i own Each pump or irrigation circle $40.00 _ 2 which is not intended for sale, lease or rent. Each sign or outline lighting $4000 _ 2 Signal circulus)or a limited Owner's Signature .__ __� ___.� energy penal,alteration or extension $40.00 2 _ F. Each additional inspection over the allowable of 3. Plan Review section (if required) in©ri spe the above pction $3500 Please check eippropriate Item and enterfee In section 58. Per hour $55.00 In Plant _ $55.00 _ _4 or more residential units in one structure _Service over 800 amps; feeder 1300 amps or more 5. Fees VV over 600 'volts nominal $ V 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 5 Subtotal $ Submit 2 sets of plans with application where any of the B. Enter 25% of line A for Review if required (Section 3) $ above apply. Not required for temporary construction Subtotal Plan PlanR $ 3 services. $ Less Bulk Label Fee Balance Due $ For inspections cal; This pernmN boromaa null and void N the work outhodred by the permll is net rxfmmseoed 640-3561 or 693-4415 within 100 days hom date of ipwnce of such pormll a N the work outhorttad Is suspended or abandoned at any time#ter wait is oommen hila a psrtod all too daya 24-hour recorder, one working day In advance of need t:lenr"I psrmMa ars non.relunddils and non-hansterabta 1)94