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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350••12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 50:3/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 6193-4415
b40-34'/;;
Page 1. of 1
f` Date 09/20/94
Time 10 : 21
Permi� Type Residential Electrical Permit Permit # 05058411
C Permit Status APP.RUVE:U Applied 09/20/94
Y Situs Address 11475 SW HALL bb Ti issued 09/20/94
Permit. Title 5E'k ELEC:/BURGLAR ALA14M Completed �•
Permit Uescr, HUME;()WNL'R 591--0524 TO E;xpi_-e 19/9b �
Project 'Title SFR - E:LE C/BURGLAN ALARM Project # 1' U• 389 3
Project Uescr. * EROSION
Parcel Number 251TI - Land Use District
1 Valuation 0
Le(jai Uesci: .
owner
INSPECTION -- T1GARD cornstl:uction : O1'H
Applicant Name BRINKS HOME SECURITY Classification 900 [
4� Applicant Addr . : 80,)9 SW C1141WS DR Occupancy R3
p' 8LAVER'I'ON, OR 9-/0U5 Vz lidated by KF
Ir s er tor. Area. :
s Applicant Phone : 641-05'74 A
:t
CUNTRACTUR : 88INKS HOME: SECURITY Lic. C 34•-166C 611-0196
Fee description Unitas Fee/Unit Ext fee Data
-------------------------------
Limited Energy/Alter./Extension 1 40 . 01) 40 . 00
:;ubtotal Electrical Fees : 40. 00 ,
State Surcharge o* Sts 2 . 0u
! Total Electrical Fees : 42 . UU
*k* Fees Required *** k* * Fc:;Rs Collected & Credits
Method Check # Rer.eipt No. Date Payment
CK 16:37 09/20/94 42 . U0
TOTAL '['117.5 [)ATE ********* 42 . 00
..:
Fees : 42 . 00
Ad:justment.s : . UU Total Credits : . 00
'Total Fees : 42 . 00 'Total Payments ! 4'L . 0C
Balance Due : ' 00
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WASHINGTON COUNTY RESTRICTED
Department of 1-and Use & Transportation
Electrical Inspection Section --•�a
155 North First Avenue, #350-12 ��.�CTF�ICA� ENERGY
Hillsbo•o, Oregon 97124
Information: (503)640-3470 Fax: (503)693-4412
APPLICATION
tPLEASE PRINT
Please complete all sections, 1 through 5. i
Permit No.
1, Locat'on of Inst 11 i n Date `�-1�
Address L Q_— ---- —
City �1 �� Zip Code �_3 _ 4. Type of work:
Map No. Tax Lot
RESIDENTIAL Restricted Energy Fee $40.00
Thomas Map Book: Page _ Section —__ (for all systems)
Directions Check type of work involved:
I
t�
---- - Audio and Stereo Systems*
Commercial [] Residential Burglar Alarm
Tenant Name Telephone Systems,'
(If commercial) -- - --- Garage Door Opener"
Th;s per •acomes null and vold It the work authorized by the Fire Alarm
permit I► : .r commenced within 180 days from date of Issuance
of such permit or It the:rork authorized Is suspended or abandoned Heating,Ventilation and Air Conditioning Systems'
at any time after wort,is commenced for a period of 180 days. Vacuum Systems'
Electrical Permits are non-refundable and non-transferable. Other _
2. Contractor application• —
r COMMERCIAL Fee for each rystem $40.00
Electrical C ntractor - ,�E�
— (ser.OAR 918-260-260)
AcdresUN A
Date _ 1 _��— Job Number Check ty;,e of work involved:
Property Owner C-M. E511 MAW
Contractor's License No. 33 4-" Boiler Controls j
Contractor's Board Re . No. �--�— Clock Systems
Phone No. >!,.(ri -- Data Telecommun;cations Installations
Fi,o Alarm Installation
3. Owner application: HVAC
IVI r Instrumentation
Print Owner's Name phone, Intercom and Paging System
Landscape Irrigation Control" `'
Address Medical
_ Nurse Calls
ity Mete —�.T. i ----_—. Outdoor Landscape Lighting*
This permit Is issued under OAR 918-320-370. The applicant agroes Protective Signaling
to make only restricted energy installations(100 volt amps or less) I T Other
under this permit and to do the following: —
1. Only use electrical licensed persons to do Installations where
required. (Certain residential and other transactions ere exempt Number of Systems
from licensing. These have asterisks(*). All others need llcens- �—
Ing.)
2. Call for an Inspection when all the Installations under this permit *No Ii senses are required. Licenses are required for all other installations.
are ready for Inspection.
3. Purchase separate permits for all installations that are not ready 5. Fees t
for Inspection when the Inspector Is out to Inspect under this `�
permit. Enter fees $ Or
a, Assume responsibility forassuming that all corrections required
by the Inspector are done,and
5% Surcharge .05 X total abo`/(? r
5. 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 $ LCAr�
authorized to bind the applicant.
! signature _ _ Space below reserved for validation.
Authority if other than applicant
For inspections call
6403561 or 693-4415
24-hour recorder, one work{ ay In advance of need
4/_44 ,
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