14757 SW 109TH AVENUE r
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14757 SW 109th AVE --
DEPARTMENT OF LAND USE b TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON XXXXXXXxx- 640-34'/U
Page 1 of 1
Date 02/13/95
Time 16 : 48
Permit 'Type Residential Electrical Permit Permit # U51063983
Permit Status APPRUVED Applied : UZ/13/93
51tus Address 14'/3'/ 5W 1U9TH AV '1'l ..ssued UZ/13/95
c'ermit 'Title Sk'R - bURULAR ALARM L.V. Completed
Permit Uescr , To Expire : Ud/12/93
tr,roject Title : Sk'R - 8URULAR ALARM L.V. Project # RUU473'i4
Project Uescr. * EROSIUN
v.t cel Number lS1TI - Land Use District
valuation U
Legal Uescr.,
uwnc.i , 1NSPEC:'l WN - Tl GARD Construction t UTH
Applicant Name : AUT classification : 9UU
ApjI.)Iicant Addr .. : /03 NE HANCUCK Occupancy R3
PURTLANU, UR 97;412 Validated by : LV
Applicant Phone : 284-3'L63 XJb Inspector Area
e'ee description Units r'ee/Unit Lxt fee Uat:a
Limited hnergy/Alter . /Lxtension 1 40 . 00 4U , UU
:Dubt.otal Electt ical Fees : 4U , UU
6tate Surcharge of b% 2 . f)U
iutal Electrical r'ees : 4Z , ()U
>t� * r'ees Hequirecl *** *** !'ees collected 6 Credits ***
__.-------------------------- --------------------------------------------
Method r.heck # Receipt No, Uate Payment
'URP ' UZ/13/93 42 . UU
TUTAL TH15 U!'.'TE ********* 4 2 . U U
yeas t 4l , UU
Adjustmen -Sl , UU 'Total credits : . OU
Total t''ees t 42 . U0 'Total Payments : 42 . UU
valance Due : • UU
NOTICE This permit hecohiar,cull and void If the work or construction for which It Is Issued Is not rommnnced within 100 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 age.1t or agrnts in suppor of this permit Is true and correct to the best of our knowledg-r. I acknowledge that the Building Department's reliance
upon false and motleading Inf)rmstlon may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure wJl be complied with whether or not specified on the plans or noted on the plana t orrectlon sheets I acknowledge that
the granting of a permit don not grant authority to access private property or to use easements I further acknowledge that the us-or occupancy of
the structure or building permitted depends upon my calling for Inspections at various limes during the process of constriction and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to Ili by the
Bull,ling 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 Bultding Official, I further acknowledge that a Ilan may be placed on the title of the property upon which the permit Is issued
specifying that the use or occupancy of the bul'.:Ing or structure Is provisional and revocable until the satisfaction of all Inspection requirements.
A►RUGANT'S SIGNATURE
WASHINGTON COUNTY RESTRICTED
Department of Land Use & Transportation
`�---� i rt Inspection Section
155 N ELECTRICAL
155 North First Avenue, 1/350-12 ENERGY
Hillsboro, Oregon 97124
Infoirmation: (503) 640-3470 Fax: (503)693-412 A P P�'�AT i`�
• , . . s�
Please Complete • • Permit No.
1. Location of installation Date
Address S it /Cl�� �t _U -xt --
ciNzip Cade22 V_ 4. Type of work:
Map No. ' j 1 Tax Lot — RESIDENTIAL Restricted Energy Fee $40.0r.)
Thomas Map Book: Page _ Section (for all systems)
Directions',t Ii � p r�
Check type of work invulved:
ATIr�
!/ ,I •, Audi o.and Stereo Systems'
m
Cornercial ❑ Relsldential _ urglar Alarm
Telephone Systems*
Tenant Name Garage Door opener*
(if commercial) ! Fire Alarm
Heating,Ventilation and Air Conditioning Systems*
2, Contractor application: Vacuum sys,ems•
Other
Electrical Contrarior f ---------_..._____—_-_
cs
ity State ip
i COMMERCIAL Fee for each system $40.00
tY State�Z /see OAR 918-260-260)
Date_.�_! �` ,lob Dumber
Property Owner , / .[),�+r-� � Check type of work involved:
Contractor's License No.
Contractor's Board Reg, No. ri 9yV Boiler Controls
Phone No. _ � -�i, c Clock Systems
Data Telecommunications Installations
3. Ownor application: Fire Alarm Installation
HVAC
Instrumentation
Prn,t Owner il;,rnE' Phone No, Intercom and Paging System
-- -- Landscape Irrigation Control*
Address
— Medical
--- - -------- -- Nurse Cells
City State 'ip Outdoor Landscape Llghtmg•
This permit Is issued under OAR 918.320.370. The applicant agrees Protective Signaling
to mbna Only restricted energy installations(too volt amps or less) Other
under this permit and to do the following:
1. Only use electrical licensed crersons to do installations where
requires. (Certain residential and other transactions are exempt Number of Systems
front licensing. These have asterisks(•I. All others need licens-
Ing.)
z Call for on inspection when soft the installations under this permit 'No licenses are required Licenses aro required for all other installations.
are ready for inspection.
3. Purchase separate permits for all installations that are not ready 5. Fees
Ii for inspection when the Inspector is out to inspect under this
permit. Enter fees $
4. Assume respon.+Ibility for assuming that all corrections required
by the inspector are done,and
S. Assume responsibility for calling for a final Inspection when all of 5% Surcharge 1;06,4 total above $
the corrections are completru
.
The person signinhis permitat be the oppNr or n person Trust Account $
cWhorized to bind-the apyllcanf.
Signaturet r
Total 7
r rrr r:r, r akar than appiicgnr �.__.�- _ This permit becomes null and void If the work outhorized by the
permit Is not commenced within 1e0 days from date of Issuanc:
/�
For Inspections call /�/� r of such permit or It the work authorized Is suspended or abandoned
640-356 or 693-44 5 at any time after work Is corninenc�d for a period of tR0 days
Electrical Petinits ate non-tefundable and non-transferable.
24 hour recorder, one working dny it, ndvance of need
E1124 114