11958 SW 125TH COURT 125TH COURT
DEPARTMENT OF LAND USE&TRANSPORTATION
AllftkV1IASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST, HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-356'1/693-4415
PHONE: 503/648-8761
OREGON
Page 1 of 1
Date 03/05/93
Time 13 : 06
Pe- mit 'Type Residential Electrical Permit Permit- # 05038109
Permit Status APPROVED Applied 03/05/93
Situs Address 11958 SW 125TH CT Tl Issued 03/05/93
Permit Title SFR - ELEC/BURGLAR ALARM Completed
Permit Descr, LIMITED ENERGY To Expire 09/01/93
Project Title SF'K - ELEC/UP TO 1So0 SQ FT Project # P0023684
Project Descr. NEW HOUSE * EROSION
Parcel Number 251'TI - Land Use District
Valuati .f, U
Legal Descr.
Uwner INSPECTION - TIGARD Construction : OTH
Applicant Name PROTECTION ONE Classification 900
Applicant Addr. : 1S5U0 SW 72ND AV Occupancy R3
PORTLAND, OR 97224 Validated by KF
Applicant Phone : 624-0244 Inspector Area
CON'TRAC'TOR : PROTECTION ONE Lic . C 34-232C 624-0244
Fee description Units Fee/Unit Ext fee Data
----------------------------------------------------------------------------------
Limited Energy/Alter. /Extension 1 40. 00 40. 00
subtotal Electrical Fees : U 40 . 00
State Surcharge of 5% 0 2 . 00
TotalrElectrical Fees : U 42 . 00
*** Fees Required *** *** Fees Collected & Credits ***
------------------------------ --------------------------------------------
Receipt No . Date Payment
03/05/93 42 . 00
TOTAL THIS DATE ********* 42 . 00
Fees : 42 . 00
Adjustments : . 00 Total Credits : . 00
Total Fees : 42 . 00 'Total Payments : 42 . 00
balance Due : . UU
NOTICE Title permit becomes null and void 11 the work or construction for which 11 Is Issued In not commenced within 1 W days. Once construction has started,
the permit becomes null and void It construction Is Interrupted lot a period of 180 days. 1 certify that the Information presented by the applicant and
his agent or agent In support of this permit Is true and correct 10 the hest of our knnwiedge I acknowledge that the Building Deparlmont's reliance
upon false end mWooding Information may Invalidate this narmll All provisions of applicable laws and ordinances gnverning the construction and use
of this building or structure will be compiled wlln whether or nor specified on the plans or noted on the plans correction shoals I acknowledge that
the granting of a permit does not grant aulhnNly to access private property or to use easement I further acknowledge that the use or occupancy of
the structure or bullding permitted depends upon my calling Iv,Inspeetlons M various times during the process of construction and the hnllding
Inspection staff verifying compliance with the various codes Use or occupancy of the building or sloitture pprndtted prior to approval by the
Building Oepmrtment is solely at the risk of the applicant and such use or occupancy Is revocable until aft Inspection requirements are satisfied and
approval Is given by the Building Official I further acknowledge that s lien may be placed on the title of the property upon which the permit In Issued
specifying That the use or occupancy of the building or structure Is provisional and revocable until the satlstction of all Inspection requirements
APPIICANT'S SIGNATURE
i
WASHINGTON CUUNTY ®�
Department of Land Use & Transportation RESTRICTED
E=lectrical Inspection Section
155 North First Avonue, #350-12 ELECTRICAL ENERGY
Hillsboro, Oregon 5i124 APPLICATION
Information: (503)UO-j,117101 Fax: (503) 693-4412
"IPLEASF PRINT 067
Ple' - coTplete all sectiqqs, Project Na___ Permit Na.
1. Location of installationLabel No. Date
/��}�-� C � 6/' Issued ByOffice
Address�, _�(d( �:2
City zip, Code 4. Type of work:
Thomas Ma Book: Pae Section RESIDENTIAL Restricted Energy Fes $40.00
Map g (for all systems)
Directions_ Check type of work involved:
Commercial F1 Residential Audio and Steroo Systems*
'Tenant Name Burglar Alarm
(If commercial) _ _ Telephone Systems"
This permit 5ecomes null and void if the work authorized by the Garage Door Opener"
permit Is not commenced within 180 rays from date of Issuance Fire Alarm
of such permit or It the work authorized Is suspended or abandoned Heating,Vf ntilation and Air Conditioning Systems"
at any time after work Is commenced for a period of 180 days. Vacuum Systems"
Electrical Permits are non-refundable and nontransferable, (-Aher _
2. Contractor application:
Electrical Contractor Bim- -rIe�►J �tj` COMMERCIAL (s a for each system $40.00
(ase OAA 918-2.60 280)
Address ISSOO -7 e . FDX_97224 Check type of work involved:
Date Job Number
Property 7wner
Contr„�,cor's License No. 2-4 2'-2 C-L-.F Boller Controls
Contractor's Board Reg. No. S 7 01ol 00 _ Clock Systems
Phone No. Io Z 4-c Data Telecommunications Installations
Fire Alarm Installation
...i, 03 weer application: HVAC
Instrumentation
Print Owner's Name Phonc rJ" Intercom end Paging System
Landscape Irrigation Control" t
Address Medical
Nurse Calla
Mate TI, Outdoor Landscape Lighting*
Thle perry►Is Issued under OAR 918-320-3,7o. Tire applicant sprees Protective Signaling
to mai c, tly,restricted energy Installations(100 volt amps or less) Ottrer
and- hes permit and to do the following. - --
f. Only use electrical licensed perrons to do Installations where
required. (Certain residential and other transactions are exempt Number of Svstenls
from licensing. Thea.,have asterisk@(`). All others need Ilcena-
Ing.) — ---
2. Call for an inspection when all the installations under this permit *No licenses are required. Licenses are required for all other installations.
are ready for Inspection.
3. purchase separate permits tot all rnstahr'rons thaf are not ready 5. Fees oo
for It spection when the Inspector Is out to inspect under this
permit. Enter fees $ O
4. Assume responsibility for assuming the►ell corrections required O
by the Inspector are done,and 5% Surchar @ .05 X total above f
3. Assume responsibility for calling for a final Inspection when all of g )
the corrections are completed.
The person signing this permit must be the applicant or a person Total $ v
authorized to bind the applicant
Signature Space below reserved for validation.
Authority If other than applicant __,� v-7-, 7J11—F,
For Inspections call
640-3561 or 693-4415
24-hour recorder, one working day In advance of need