10855 SW FONNER STREET 1.0855 SW mNNIER STREET --
CITY OF TIGARD -' 7..t',7
DEVELOPMENT SERVICES PMT "
13125 SW Hall Blvd.,llSard,OR 91223 (503)639.4111
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;:;F CR LE"S. » . . 0 :77'qj0 amrr. . . . . . . .. 0 '+(_1M!7' IRRAli fiTION. . » :
ADD' L_. r'' osrl". . . . 0 201 40 , am.p. » . . . . . wti r ".!. 'OUT i.. Y"'F LTG. r .
L. RMITFl1 ENERGY. . . . . . 0 401 "- EeO amp. . . . . . . „ 0 "'rl(-4L./PANE=E... . . . . . .
MANF". HM1,7`r�OV(C.'r-T.) ?. . : 0 t:,C1 + afllpii
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�?{fr rrr i�. « , .. » « » 1 W I;rr Ry AI CE, OR FEEDER. 0 N ar E rT:r ON. . . . .
.`0t 400 .imp. . . . . . a 0 1,; W/O CiRVC OR FDR. : 0 r,r R '40'(.)R. . . . . ,. . . . . . .
4.01 FDC) AMP„ . , . . a 0 C'A F1DT3" 1., 3nNIM! rTr,?C0 0 Tr„ 1711_nl'r4T. . . . .
L-01 1.000 AMP r 0 _ _._ ... ........,....._w.—_F'rI-ON RF'V T r, W c;.'CT I•CIN..._......_..._..... .,..
100011 amp" '0 It . . . . . 0 ) z::r, R171 UNITS. . . . . . . . . rloi,,+ VOLT r+(10111,4l4. .. ,
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Pl,rii,r * : C,24-_'1C;34 EXPIRED
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This pe-lit i> issued 7wbjtct tc the regulations contained in the Tigard " wal Code, State of Dregan Specialty Codes arid all
applicable laws. All work will Qe done in actirdance with approved plans. - perait wiI' erp; c work is not star'tet withir
days of issuance, or if work is suspended for lore than IV days. ATTLNTION; ;Yelton law requila ,:7; to follow the rules aduptre
the hrej'en Jtility Notification Center. Thole rules Are set forth in CAA r",- You may obta;
of thus rules or direct questions to am by cal'ing
Pot-mil: WC.0 ;.,i.gnckt;' 4r'e „
._.OWNER 1 rMTri= i PTI CIN ONL.
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alai Cir' r"wty't. r
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DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND 15DEVELOPMENT SERVICES DIVISION
5 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: W3/MO.3561/693-4415
4D
OREGON Page : 1 Date 05/30/97
Time 15 : 48
Peimit Type Permit .10 05095463
Permit Status AkIPROVED Applied 05/30/1997
Site Address 10855 SW FONNER ST TI Issued 1 05/30/1997
Permit Descr. SFR — 200 AMP Completed :
PUTTING IN MAIN SWITCH To Expire 11/26/1997
Project # t PUU69096 Valuation $ . OU
Parcel Number : 2S1 03AD 00600
Leqal Descr. ACRES . 35 IROM A&T105/10/96 )
Owner BRADFORD, ERIC AND DANICAConstruction OOH
Applicant Name BRtiiDFORD, ERIC AND DANIClass:Ltication 900
Applicant Addr, I0855 SW FONNER STREET Occupancy
Val"Idated by TLM
TIUARD OR Inspector Area
Applicant Phone 1 624-1614
Applicant Fax I
Permit Fee Obligation. . . . . . Permit Account Status . . . . . .
Liect.r1c.,ai Fee . . . . I.) Fees IL:alcuiate(i %;b J , 00
Fees Due �63 . utj
tjtate Surcliarge . . . 3 . UU Paymeats to Date: $63 . 0(1
PERMIT BA1,ANCE 0o
EXPIRED
NOTICE: This pon"ll:becomes null and void if the work or construction for which it is Issued Is not commenced within 180 days. One#conafteflon his oftrw,
the p-emit 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 cir knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permit. All provisions of applicable laws and ordinances governing the ccristruction and use
of this building or structure will be compiled with whether or not specified on the plans or noted an the plans correction shoots. I Acknowledge that
the granting of a permit does not grant authority to access private prop"or to use easements. I further acknowledge that the use or occupancy of
thy,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 cod". Use or occupancy of the building or structure permitted prior to appraval by the
Building Deportment Is solely at the risk of the applicant and such use or occupancy Is revocable unill PH Inspection requirements are istlaflod and
approval Is given by the Building 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 b-illdIng or structure Is proviolo,,al and revocable until the satisfaction of all Inspection requirements.
-AMICANT'S SIGNATU1111111
De artmGTOfLanUCOUNTY ELECTRICAL PERMIT
DeNartment of Land Use&Transportation
ection Section
155 NorthectricallnsFirst Avenue, 350-12 APPLICATION
Hillsboro,Oregon 97124 +
Information: (503)640-3470 Fax: (503j 881-3993 G'PLEASE PRINT ! I 1
a , a , . •
Number Date ase
7. Location of Installation 4, Complete Fee Schedule below
Address 11191Y.55, ,5u) fOrf r)e y_Sy_ Number of Inspections per permit allowed
City
Building Service Included: Items Cost(ea.) Sum
Suite No..��9 Y� __ _ _ -
� A. Residential-per unit
Tenant Name
(If commercial) .._ _._____T_—- 1000 sq.ft.or less $110,00 ___— 4
1 Each additional 500 sq ft
Map No.—_—_ 1 �_ Tax Lot __ fig or portion thereof $zs.00
Limited Energy $25.00 1
Thomas Map Bouk: Page: -- Section:. Each Manurd Home or Modular
Directions____—.- -- Dwelling Service or Feeder $66.00 2
B. Services or Feeders
Commercial❑ Residential® Installation,alterations or relocation / o�'
200 amps or less -�- $60.00 y 2
2a. Contractor installation only: 201 amps to 400 amps $6o oo - - 2
401 amps to 600 amps $120.00 _ 2
Electrical Contractor - 601 amps to 1000 amps $1 ao oo
_ -_. z
Address __. __ Over 1000 amps or volts $340.00 _ 2
City __._ - _—_ State ZIP_ Reconnect only $50 00 2
Date—, _ Job Number _. __ —-
C. Temporary Services or Feeders
Property Owner
- -----
_ �nrf<nurnion,aAercss or relocation
200
Contractor's License No. less
Contractor's Board Reg. No. mpstc __ $so00 _ 2
201 amps 400 amps $75.00 __ —__ 7
401 amps to 600 amps _____ $100.00 _-.__- 2
Signature of Supr, Eler'n _. . . ._ .__ Over t-00 amps to 1 000 volts see"B"above
License No,__ _ Phone No.
FAX No, _ D. Branch Circuits
New,alteration or extension per panel
2b. For owner installab ns: a) rhe fee for branch circuits with
art. v(� r�I`� �b03) y,y63y purchase of service or feeder fee. c —
1�, /e,& ,D1-L iG Phone No, Each branch circuit - $_ '10 _ �_ 2
Pini wnr r-. in b) The fee for branch circuits without
l •�'c! �'Kn P� purchase of service or feeder fee.
Ad.fess
far / Q e r7v"'� First branch circuit -____._ $35,00 �— 2
ry L'I �i e Each add nl branch circuit.-_ $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 re t. Each sign or outline lighting —_ $40.00 ---_ 2
1 Signal circuitis)or a limited
Owner's Signnture a energy panel,afterstion
or axtension $4000 _-_ 2
3. Plan Review section (if required) F. Each additional Inspection over the allowable
Please check appropriate Item and enter fee in section 5B. In any of the above
4 or more residential units in one structure Per inspection $350.)
_ Per hour $5530
Service and feeder, 8LIL'amps or more In Plant $55.00
System over 600 volts nominal
Classified area or structure containing special 5. Fees
occupancy as described in N.E.C. Chapter 5 A. Enter total of above fees $ _
Submfr 2 sets of plans wird application where any of the abovo 5% Surcharge (,05 X total fees) $
apply. Not required for ternporary construction services._ Subtotal $ ---- -
This permit becomes null and void If the work authorized by the permit In not B. Enter 25% of line A for $ -
commenced within 1ao days from date at Issuance of such permit or if the Plan Review if required (Section 3) $ —
work authorized Is suspended or abandoned at any time after work is Subtotal --
commenced for a period of 180 days. Electrical Permits are non-refundable E] Trust Account $
and non-transferable.
For Inspections call Balance Due $
6131-3699 or 661-3698
24-hour recarder, one working day in advance of need BL28 • 8/95