10102 SW WASHINGTON SQUARE_TI 26692 SW Washington Square Rd TI P26692
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DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
,o COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
PHONE: 503/648-8781
OREGON
Page : 1 of 1
i Date : 10/05/92
Time : 15:03
permit Type 1 Commercial Electrical Permit Permit 0 1 0.,034312
Permit Status : APPROVED Applied s IJ/05/92
Situs Address t 10102 SW WASHINGTON SQUARE RD TI Isz.ued : 10/05/92
I Permit Title : GT€ PHONE MART - 2CKTS/J010-30 Completed 1
Permit Descr. s To Expire : 04/03/93
Project Title : GTE PHONE MART - 2CKTS/JM10-30 Project 0 : P0026692
Project Descr. : * EROSION *
:
Parcel Number t 2S1TI - Land Use District :
Valuation 1 0 f
rl
Legal Descr. :
owner : INSPECTION - TIGARD Construction : OTH
Applicant Name : ELECTRICAL CONSTRUCTION CO. Classification 1 900
Applicant ,4d.ir. : PO BOX 10286 Occupancy 4
PORTLAND, OR 97210 Validated by : KF
Applicant Phones 27.4-3511 Inspector Area
CONTRACTOR t ELECTRICAL CONST. CO. Lic. C 26-45C 2,4-3511
Fee description Units Fee/Unit Ext fee Data
/11 Subtotal Electrical Fees: 0 3'7.00
State Surcharge of 5% 0 1.85
Total Electrical Fees: 0 38.85
eas ieee Required RRR *aa Fees Collected & Credits *R* v
Receipt No. Date Payment
10/05/92 38.85
a TOTAL THIS DATE 38.85
Fees: 38.85
Adiustments: .00 Total Credits: . 00
Total Fees: 38.85 Total Payments: 38.85
Balance Duos .00
1.. N,TICi This permit b.comee null and void 11 IgM work or eonenucllon kr which Nle issued I.not commenced whhlr.ISO days. Once construction his started,
tr.pent becomsa nut and void if oon.lruatlon is interrupted br a perk,of ISO days. I certify that the Information presented by IM apparent and
Ma ager or agents k`support of this permit Is hue and correct tone beet of our knowisdge 1 acknowledge that the ttuliding Department's reliance v
upon'sae and misleading Infonnetlrt may Invalidate this perm!. Ail prove ions of applk-ble laws end ordlnsnces governing the rwnstruction and u.
of ml,butding or et/u:isM wit be nomp::ad with whether or not spe.lfted on the plans or noted on the plans coneetkM sheet. I acknowledge that
the yearling of.permit does not green namely b armee§peva,property orb use etrsamerds I further acknowledge that the ties or occupancy of
the Nnwtun or building permitted depends upon my calllg for inspections at-.roue lime.during the process of construction and Me building
inspection Wall rallying nompllsnos wilt,the various codes Us*cr occupancy of the building or structure pernrlNed prior to eppeovel by line
Wtdkng Departn,et Is sol ly el IM risk of the applicant and such taw or occupancy la revocable until.N inspection requirements sea stashed and
approval is given by the Wilding Official I fuller acknowledge mer s Iden may b.?laced on the 1114 of the properly upon which the puma is lesuro
epnrlfying that fid uee or orcup.ney of the building or Neter/um I.prtnfekrtal and revocable until the satlalacnon of all Inspection requirements
APPLICANT'S•:ONATUNI
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WASH�fIf3TON COUNTY ELECTRICAL PERMIT
Dspartmsnt of land Use i Trsnaportstlon
�' . Elsctrlcal 'ispectlon Section APPLICATION
. 155 North Post Avenue,0350-12
.. • Hillsboro, (, egon 07124 /�
Information: (503)640:A470 Fax: (503) 693-4412 Project/Permi�, ,.3) j moi,i el " 4
Numoer ,/-/ " 4,' Date (V
PLEASE PR/NF a —
Please copipleie all sections. 1 through 5. i 4. Complete Ftp Schedule below
Numbs`A In.pMMons per terms/.Mowed 4,
1. L.o.:atIon of installation Service licluded: Items Cost(es.► Sum
Addres?_ 11102 S,',1. WASHINGTON SQUARE ROAD A. Residential-per unit
Budding lowf86.004
City TIGARD Suite No. —. 1000Each sq ft.or additional 500 eq n _—
) Tenant Name or P«uor thereof --- $15.00 -
(if commercial) G.T.E. PHONE MART United Emmy1
' Each Minted Horne or Modular
pwwNl,q Service or Feeder $40.00 2
Directions --- -
B. Services or Feeders
ewta$ation,'iterations or relocation
se -
200.nips or I
Commercial Residential LI 201 Wipe b 400 amps $t0 00 — 2
401 amps b 000 amps $$50100.000G - -
___ 2— 2
001 rips to 1000 amps 1130.00 2
2a. Contractor Installation only: Peri"1
0
0
0
've or volts $300.00 2
Rwoonn0ns/nty $40 no 2
Electrical Contractor ELECTRICAL CONSTRUCTION COMPANY
Address P.O. BOX 10286. PORTLAND, OR 97210 C. Temporary Services or Feed..ra
Date. 09/29/92 Job Number . 10-30 Installation,alteration"r n locsOoi
Property Owner G.T•r. 200 anew or lee .__- $40 00 2
201 amps b 400 amps $56.00 d
Contractor's License Na. 26-45C empe to 000 amps _. $80.00 __ 2
Contractor's Board r:+q. No. 791 /4 Over too ampe w woo volts wee'8•ribose
Signature o1 Supr.Elec'n _ Y,rt _. D. Branch Circuits
License No. 29865 __ Pho'te No. 224-3511 Nee,""'rano'or extension per panel
a) The tee Ion branch circuits with
purchase of.srtibe or feeder Asa.
2b. For owner installations: Each branch Peri""" --`- $200
b) The fee for branch ciro its without
plumbs"of sob*or feeder 1b..
Print Comer's Name Phone No. Flet bi.molt°ork $35 00 _35 40— 2
Ease add branoh $2.00 __Ii
�u 2
l ...- - — E. Mlerrilaneou (Service or Feeder not included)
E.d+pun, or irrigation drab__ $40.00 2
Eanh sign or outline lighting $4000 ___— 2
Signs/*cultlb)orshriller,
The installation is being made on property I own energy dant.alteration
which is not intended for sale, lease or rent or a""""'°" -- $40 00 - _
r. Each additional inspection over the allowable I
Owner's Signature _..____.__.___ —_ In any of the above,per Inspection
$36 00 _____
3. Min Review section (Ito required) — I
5. Fees
A. Enter total of above fees $ _11,.4.9._._ 1
5%Surcharge(.05 X total fees) $ _ 1.85
Subtotal $ --3.9.85 —
B.Enter 25%of line A for
- _ For Inspections call Plan Review If required(Section 3) $ —
640-3561 or 693-4415 subtotal $ ,8-Hi
24-hour recorder, Lass Bulk Label Fee _
one working day In advance of need Balance Due $ 38.85
This pens/Wends mull and vela II the work authorized by the permit le nut oo nnterwsd within ISO days from dale of Imam, .
of ouch permit or N the work authorized Is suspended or abandoned er soy Mme after Werk le oarnmsneed for a period of 100 dr.ya
Electrical Permite are non-refundable and non.trsn f.rabie 10,c)1
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