9020 SW WASHINGTON SQUARE (1) MON
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DEPARTMENT OF LAND USE&TRANSPORTATION
419101 WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO.OR 97124
COUNTY, INSPECTION REOUESTS: 503/640-3561/693-4415
PHONE: 503/6481781 _...> 64O-.14"/U
OREGON Page : 1 at
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Date • 98/2'+ ,
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Per tlt:t :yUr : i.Grti ei,_ act: Electric i. Pet m1t permit M : U`tU`.,'/h4tt
I permit ,tatu:l : Ai'L'HOVLU Applied : 08/29/94situs: Address PP
SW WASHINGTON SVUAPE HU '1'l issue.' . 08/29/94
Permit Title : HuIJ::;'1'UN GEN LIFE: INS c'!8C111'1'S Completed .
I t o:ml t tleHscr . : 4 IHCill'I S. o txpi t : 2/25/5`.
Fr„fir-._ t 'lit.le HOU...1UN GEN LltE: LN.. C1HC(J]. i :, i'iitjr.•ct * P0043423
Pio lect De scr . : 4 C lRc:Cl:.'i's x LUUI.t:i 1 UN A
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Parcel Num: .t . 1141'1'1 • Lei :ti ;1'.::e L'i::t1 lrt .
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At.,p.. lcant Name : HF:k:.,E s, LLEL-::k tf t_'.<,s:..;;t_c:iI 1 :ri : 900
Apl. iir".int Addl. . : lr,jiU H:ioN:. fu ,'t.C,..u, y .
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11OTICE This permit becomes null and void If the work or construction for which It Is Issued is not commenced within 160 days Once construction has startrd.
the permit becomes null and void if construction is Interrupted for a period of ISO days. I certify that the Information presented by the applicant and
Ms agent or agents in support of this perms Is true and correct to the beet of our 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 construction and use '
of this building or structure will be compiled with whether or not specified on the plans or noted on the plans correction sheets I acknowledge'hat
the granting of a permit does not grant authority to access private properly or to use easements I further acknowledge that the use or occupancy of
the structure or Pudding psrmltted depend,upon my calling for inspections at various times during the process of construction and the building
inspection staff vertlying compliance with the various codes. Use or occupancy of the bu9ding or structure permitted prior to approval by the
Building 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 t,y the Building Official I further acknowledge that a lien may be placed on the title of the pro sty upon which the permit is issued
specifying that Mu use or occupancy of the building or structure Is provistonal and revocable until the salist ion of all inspect'., /mimeo,
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WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section
155 North First Avenue, N350-12 APPLICATION
Hilloboro, Oregon 97124
Information: (5C'3)6403470 Fax: (503) 893-4412
Project/Permit , J 5 9q->r
i PLEASE P' NT Numb 3r __ 7'11 y Date
Please coin•lete all sections, 1 through 5. 4. Complete Fee Schedule below
Number of Inspections per permit allowed
1. Loc.tion of Install.tion - I.
Address _ .
A Pi Service included: Items Cost(es.) Sum
,,/
:lidding A. Residential- per unit
City i j, ace/ Suite No. L1 Lit, - —
'� 1000 sq ft or loss $11C 00 4
Tenant g me / r Each additional 500 sq h '
(f commercial) f/i9£4,54)Al OPIletrii- 1.1 )L°jf_I.iitfra.v y or pc rtion thereof _— $25.00 —
Limited Energy - $25 00 1
Tax Lot Map No. Each Manufd Home or Modular
Dwelling Service or Feeder —_ $68.00 2
Thomas Map Bgpk: Page __action:
Thom int{. . /-.4- Page:
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- B. Services or Feeders
Li ii, il*_________ Installation,alterations or relocation
200 amps or less $60 00 - 2
Commercial Residential I 201 amps to 400 empn __ $80 00 2
401 amps to 600 gimps - $120 00 2
1 2a. Contractor 1p,stallation only: 601 amps to 1000 amps $180 00 _ 2
Y Cher 1000 amps or volts $34i,oo _ 2
Electrical C ractor - - - , , , ____r_z? Reconnect only _-___ $50 00 _—__ 2
Addresg I = i'
r Date ';1-_...,1 1 - Job Number f C. Temporary Services or Feeders
Property Owner ,0 - :j A e-Ti.a Lam? Installation,alioration or relocation
Contractor's License No. - .. - _ - . 200 amps or less .___ $50 00 __ 2
Contractor's Board Reg. No. ' , z — 201 amps to 400 amps _____ $75.00 2
401 snips to 600 amps $100.00 —_ - 2
Signature of Sr p . leen - �- ,_ Over 600 amps to 1000 volts see'8'above
License No.J/ S Phone Nn. ZZt--5•14G 3 0. Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or feeder fee.
print Owner's Name — — Pians No, Each branch circuit $5 00 2
hl The foe for branch circuits without
Address purchase of service or feed lee. r
1 — First branch circuit r $35 00 3�J�-•a at 2
pity State Each add'nl branch circuit3_ $5.00 J ';f9(. -
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 rent. Each sign or outline lighting _, $40 00 2
Signal cur_uitlsl or a limited
i Owner's Signature __-- ... energy panel,alteration —
or extension $40 00
F. Each additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection $3500 _
Please check appropriate Item and enter fee In section 5B. Per hour $55 00
'n Plant $55 00 -�
_ 4 or more residential units in one structure
___Service over 800 amps;feeder 800 amps or more 5. Fees
_System over 600 volts nominal A. Enter total of above tees $ _
--__Classified area or structure containing special 5% Surcharge(.05 X total fees) $ .
ocr'Ipancy as described in N.E.C. Chapter 5 Subtotal $
B. Enter 25% of fine A for
Submit 2 sets of plans with application where any of the Plan Review it required (Section 3) $
above apply. Not required for temporary construction Subtotal $
,? services.
Less Bulk Label Fee $ .
Balance Due $ 4- ii L
For inspections call ,Me and becomes null end void r the*null evlhn.t»d the
640-3561 or 693-1415 �r �` swinek eu m�commenced
r wehln,I10 deye Iron dads.e.efoer.re nl fu.h perrnll.rr x IM wnr�fulhtxllM N
PI suspended o4 ebendnned el env lune OW.woe%IS 0.1.1.,•••001i foo•p..kd n411110ds.
24-hour recorder, one working day m advance of need eler4.1..:perrnde ere non.emnde,,ae and n.,,,,ran.rer.ble.
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350.12
gOiJNTYTH , HIL , OR 9'7REGON PHONE: 503/640-3470
INSPECTION155NORFIRSTREQUESTS (24LSBOROhours): 503/640-3561124 or 693-4415
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
155 NORTH FIRST, HILLSBORO,OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION X350-12
COUNTY, 155 NORTH FIRST, HII.L.';BORO, OR 97124
PHONE: 503/640-3470
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OREGON INSPECTION REQUESTS (24 hours): 503/640-3581 or 893-4415
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION X350-12
COUNTY, 155 NORTH FIRST, HILLSBORO, OR 97124
OREGON PHONE: 503/640.3470
-_` INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
1'err�it : 05057648 hr. ..�e.,t # PO04.342s 3t.�ru I.F'Yx. Vii i a3, I f 2
Applied 08/29/94 Issued 08/29/94 Exir •s 4/:i �/�' O3/30/9S OS
CLMELEt
Permit Title HOUSTON GEN LIFE INS C I RCU J T.-, CATH
Description 4 RCUITS Begun O8/- ,.- . .
Job Address 4SW WASHINGTON S HARE RL T1
Owner Name I PECTION - TTGARD Region D
Appl4cant Name REESE & SONS ELECTRI '
Phone number 760- 3903 Vaivat , : ', 0 Approved
Inspector Comments V`I IjO*t" Rejected _
(7:::2)
i __.. -------.--__. �__ REQUEST ERROR'
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M»r:hanical
Electrical
Structrual
General
Inspected !:yLata 3-Jo 4S
2,4:04.41"Inspection Requested
• Final Electrical Al:' DN , max
03/30/95 QI MJ- G .
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