9500 SW WASHINGTON SQUARE (3) 11
1
y WASHINGTON DEPARTMENT OF LAND USE&TRANSPORTATION
LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
lib COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON xxxxxxxxx---.> 640-34 /0
Page : 1 of 1
Date : 02/01/95
Time : 07 : 54
Permit Type : Commercial Electrical Permit Permit ti : 05063447
Permit Status : APPROVED Applied : 01/31/55
Situs Address : 951'0 SW WASHINGTON SQUARE RD '1'1 Issued : 01/31/95
Permit Title : PENNY 'S •- 3 CIRCUITS Completed :
Permit Uescr. . : CHILLER HOOK UP To Expire : 07/30/95
Project Title : PENNY ' S — 3 CIRCUIT., Project * : P004/206
Project Uescr . : CHILLER HOOK UP * EROSION *
Parcel Number : 251'1'1 - Land Use District :
Valuation 0
Legal Uescr , 1
Owner : INSPECTION — TICGARD Construction : OTH J
Applicant Name : ST. JOHNS ELECTRIC Classification : 900
Applicant Addr . : 3-02 NE 65TH AV Occupancy
VANCOUVEct, WA 98bb3 Validated by : PH
Applicant Phone : 206—b93-5100 Inspector Area :
Fee description Units Fee/Unit Ext fee Data
1st branch W/out Feeder [Enter a) 1 35 . 00 35 . 00
Addl . branch W/out Feeder [Enter tar ) 2 5 . 00 10 . 00
Subtotal Electrical Fees : 45 . 00
State Surcharge of SI 2 . 25
Total Electrical Fees : 4.7 . 25
*** Fees Required *** ** * Fees Collected & Credits ***
Method Check N Receipt No. Date Payment i
CK 13650 01/31/95 47 . 25 1,
Fees : 4 / . 25
Adjustments : . 00 Total Credit:: : . 00
Total Fees : 4'/ . 25 'Total Payments : 47 . 25
balance Due: . 00
f NOTICE: This permit becomes null and void if the work or construction for*tech It is Issued Is not commenced within 100 days Once construction has started,
the permit becomes null and void If construction Is Interrupted for a period of 160 days. I certify that the Information presented by the applicant end
his agent or agents In support or this permit Is true and correct to the best of our I inwi.dge. I acknowledge that the Building Department's reliance
upon false and misleading Ink motion may Invalidate this permit. All provision'."f applicable laws and ordinances governing the construction and use
of this building or structure will be compiled with whether or not specified on the Diana or noted on the plans correction sheets I acknowledge that
the granting of a permit does not gyri.,t authority to'ccess private property or to use easementi further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for inspections at various three during the process of construction and the building
inspection staff verifying compliance with the various codes US.ur occupancy of the building or struc•ura permitted prior to approval by the
Building Department is solely at the risk of the applicant and ouch use or occupancy Is revocable until all inspection requirements are satisfied anti
approval is given by the Building Official I further acknowledge That a lien may be placed on the title of the property upon which the permit Is Issued
specifying that the use or oc.upancy of the building or structure Is provlsh,nal and revocable until the satisfaction of all Inspection requirements
APPLICANT'S SIGNATURE
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41
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OWASHINGTON Department
of C°d ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section
155 North First Avenue, #350-12 APPLICATION '
Hillsboro, Oregon 97124
•
• Information: (503) 640-3470 Fax: (503) 693-4412 Permit
PLEASE PRINT Number 5y 7 J Date /- -�-h
w
Please complete all.sections, 1 t rough 5. 4. Complete Fee Schedule below
Number of Inspections per permit allowed
1. Location of Installation //
Address `1500 �1 s.( '6,1Z/124;1/21i ' y /4.‘'4 _ Service included: Items Cost(ea.) Sum
BuildingC
� A. Residential - per unit
CityA.:14,1a, , lin.' Suite No.
1000 sq ft.or less $110.00 4
Tenant Name -Chr t 14 r Each additions!500 sq ft
(if commercial) 1'4 r i r us Ar----
_' a 1_t J 14 ar,t. or portion thereof —_ $25 00
_ .3 C I rw'.►Y Limited Energy $25 00 — 1
Map No.— Tax Lot - Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 — 2 i
Thomas Map Book: Page: Section:
Directions —.— — --- B. Services or Feeders
—_— Installation,alterations or relocation
200 amps or less $60.00 2 '
Commercial X Residential 201 amps to 400 amps $80.00 2
401 amps to 600 amps -- $120.00 _ _. 2
2a. Contractor Installation onl : 601 amps to 1000 amps $140.00 2
� Y Over 1000 amps or volts
$340 00 2
Electrical Contractor Sf Sc hn4 E!<c/r -etc_ Reconnect only $50.00 2
Address Ca. Alt L-5^i d :2111 f!Li ee, L.en 'jSk.-
Date / 2 93 Job Number C. Temporary Services or Feeders
Property Owner 9C if-1rm4y /i1 ,The__., Installation,alteration or relocation
Contractors License No.
s 200 amps or less $50 00 2
Contractor's Board Reg. No. 201 amps to 400 amps $75.00 2
j 7 ,1?C�
401 amps to 600 amps $100.00 _ 2
Over 600 amps to 1000 volts see•B'above
Signature of Supr. Eisen _ - _ / .4 _—
License No. Je2YS P one No. _' if .t ( D. Branch Circuits
Now,alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or feeder lee.
Print Owner's Name -- Phone No. Each branch circuit ____ $500 2
b) The fee for branch circuits without
Address purchase of service or feeder fee. r
First branch circuit _L $35.0C 3! 00 2
City —Mete Zip Each add'nl branch circuit 2 $5.00 .yJ C1 c1 2
E. Miscellaneous (Service or Feeder not included)
The installation is being made al 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 circuit(s)or a limited
Owner's Signature — _—_ ._ . — _ energy panel,alteration
or extension ,___ $40.10 2
F. Each additional inspection over the allowable
i in any of the above
3. Plan Review section (if required) Per inspection _� $35.00
Pleise check appropriate hem and enter fee In section 5B. Per hour __ $5500
In Plant $55.00
_4 or more residential units in one structure
__Service and feeder, 800 amps or more 5. Fees
System over 600 volts nominal A. Enter total of above fees $ X5.0 C
Classified area or structure containing special 5% Surcharge (.05 X total fees) $ __j: ___
occupancy as described in N.E.C. Chapter 5 Subtotal $ 17 25
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $ -
above apply. Not required for temporary construction Subtotal $
services. $
Less Bulk Label Fee
Balance Due $ y1 2 5-
For
For inspections call This permit becomes null and ooM Nw erode w
t/ osuthItsd by the portrait Is not commenced
640-3561 or 693-4415 whin 1110 days from date of issuance of ouch purnin o M the work autholted Is
suspended nr abandoned at any time after work as commenced for a period of 160 days
24-hour recorder, one working day in advance of need E1edrlcal Permute are non-refundable and non-Vsnsterable
4'94
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 5350-12
COUNTY, 155 NORTH FIRST, HILLSBORO, OR 97124
PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
Pdr'i 063447 Project 6 : P0047206 Status : APPROVED Page 1 of 1
Applied 01/31/95 Issued : 01/31/95 Expires : 07/30/95 02/21/95 05 : 31
COMELEC
P.rwit Title CIVIL 3 CIRCUITS 0TH
Description 64' ER HOOK UP 8.gun : 01/31/95
Job Address 9500 SW WASHINGTON SQUARE RD TI
Owner Naw. INSPECTION - TIGARD Region D
Applicant Nam. : ST. JOHNS ELECTRIC
Phone number 206-693-5100 Valua*ion : 0 Approved
Inspector Comments : Rejected
IVR-SESUL
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115 REQUEST MOW
Plumbing
Mechanical :
{ Rlectrical : �
Structrual :_
General
InapeL ted by /./e/ ..,..„‘‘,--11--
.,,‘‘ Date : u _ls
Inspection Requested:
* 404 fi
/ AP DN IVR
�0�22//2211/95 RI PH ��
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