9410 SW WASHINGTON SQUARE (1) 9410 SW Washington Sq. Rd. P24049 30218,46414,58625
9410 SW Washington Sq. Rd.
151 26C
Clothing (The Blade)
#30218
store remodel
#46414
k
i
M
4 6 414 WHITE Inspector Copy
YELLOW Pnrm.ttoo
PINY, Temporary FII•
PERMIT No. APPLICATION FOR BUILDING PERMIT Temporary
BUILDING
WASHINGTON COUNTY ADDRESS ..
-
DEPARTMENT OF PLANNING LOCALITY A ,/
BUILDING DIVISION NEAREST
CROSS ST
CENSUS G / TYPE PRO BY
FOR APPLICANT TO FILL IN OTR• __-i--__-i-- -_ICONS I
13UILOI Nt+9, 5 /���L �� j DWELLING UNITS JNEDATE
ADDRESS 7/�u ( /L_,�•I r—
LEGAL DESCRIPTION ZONING APPROVED BY
der
TYYPEPE OF
F SANITATIO f
ill 1 *:?__i___-4,-, .,--___L_4_1-__L___ — •SLOG.SETBACK FROM
I ill:1QMMT P I E OF--_- 22Nt1
AREA OF LOT NO Of SLOGS TYPs of Existing WhackI Highway • Yard • Total.
NOW ON LOT Highway WIdM C
From L 11
_� - From C ---- --
EXISTING LOO_ ---�-
TEL. SLOG.SETBACK FROM (IMAM)OWNER NO. SIM
OE PROP_LINE OF
_—.-_------- - '" 'Typo of Ebtinp Ssthsck HL/hwaV • Yard - Total
ADDRESSHighway Width Floras CL
CITY ___ __ --- - ---- "-
ARCHITECT TEL. CORNER CUTOFF YES NO
o•ENGINEERe�T1�_ NO. � 44-404t4---
CON
''e�i�J J
ADDRE$5
CONTRACTO (//L NO. t 2/ . -,f)
ADDRESS V .i . z 1 TEL A �IALl /100-.011r--
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR - - DEMOLISH
1S,,fT ;tures naill1ES FEE rOR AMOUN4RECEIPT NO. DATE
1ZENO,BEDROOMS NO,OF BATHROOMS _
9TRUGTURE ZONING COMPLIANCE
:-y� —
USE OF ��
hemf/ 1SIGN DESIGN REVIEW
_-..__ -- -
VALUATION$
FIRE MARSHAL
bet) .00 _-.�--
F E allar FEE 3 )40 ►•:.% `y
SSt T / .i
S TAx ADDRESS
`
ce--.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS SYSTEM DEVELOPMENT - _
APPLICATION AND STATE THAT THE ABOVE IS COR ----+------ --
'SECT AND AGREE TO COMPLY WITH ALL COUNTY OR
DINANCES ANU ST LAWS REGU TING SUILOINC,
C91i9T PI
.._.Vg7 ION, - —
----
,-.
^ `
SIGNATURE O / f
�� t -" - I11PERMITTEf
FINAL INSPFCTION .; DATE
_ 4022
PLAN CHECK VALIDATION cK MO CASH PERMIT VALIDATIO CK IMA CASH
NEC'IPT NO. 'A ft RECEIPT NO.9:7 DATE ,
9 ,16 '~ rg
N
7 3021 ;, < 9 $6
WHITE Inspector COPY
YELLOW Permittee
r• PINK CO/Mier e
p`"""* ' AP �GA 10;FOR BUILDING PERMIT GREEN
Circulation
Elle
WASHINGTON COUNTY SUILDIN:, /J ,, ,
ADDRESS . �/ Li Lt4 a. p. `1
k
DEPARTMENT OF PLANNING/� /D , OCALITr
BUILDING DIVISION NEAREST
CIIOSS ST
,,fFN/US LANs USFr
COOT_ O UP TYPE PRO S sE9.5Y
FOR APPLICANT TO FILL IN L[oNST `C
I ✓ -
EUILOINO r{ L, r� STATES TIC AL CLASSIPICATION /ONE
AO0N[SS [ D/1 `— 3
1�/ `CLASS NO 011/ELL UNITS
1.E GA. :.PI.CIAL CUNDifIONS
ANI A UI ,Oi� NO OP ELD// _—~ ► //L
MOW 011 lOT `
I
USE OP 1 ZONING APPROVED 5r Y . ,7 i9
i[d19TIN0 SLOG
TEL 1 vPE OF SANITAtIon/ 015T,
O�NER� NO
ADDRESS 'WA WATER S4pPl v WIT,
/t MASA CR /ROM -'
CIT. �dLjLHIJ� p2 PSONT 5505 LINE OP I I
ANCNITECT R f r).,5/� TEL.. 4�VPI or -UI/TINS OCiSACR NIINMAY 4- VARD = TOTAL
ENG'NE ER�Il____ fit 1,4[$4 NO 4.0_ 11 s �1/NWAV W1D70 IROM C L
ADC NESS I777 `l tiL4,..5A,igf / T'*' +
�1 UNIAi 1FL >' /l0/ /ET/ACR FROM
CONT A NO ��•i00 L ..._EIDE P505 LINE 01 -V -- ILUILIELL.
`6 ,r,t450 (n/TINE /E/SACR NI/NMAT + TARO = TOTAL
ADCRE `•
SS Pad./
G 1,555A, AIOTA ROOM C •
I CITY Pa Q../Law)b C) L ` / T +
DESCRIPTION OF WORK CORNED CUTOIP TES L, NC []
NEE/ AOD Ill.TER ! REPAIR DEMOLISH,. SEE REVERSE SIDE FOR SPECIAL APPROVALS
SQ.PT 0 OP NO OP
0....W STORKS FAMILIES
1
NO. SEDNOOMS __f BA THROO� IL
M(SS r
!T*SJ TUNE �t� C1ttEs .]WL
NO OP fMPLOCI l
SIGNATURE •
A►/LIC INT /tE APPROVALS DATE INSPECTOR'S SI/NATUNE
VALUATION$ tNDATION LOCATION .--
...Z.,
Q "� O .00 (IUEQAMS MATERIALS
1 Mb (SAME EIIIF StU►5LS
„E$ /j 7 *//, y PMT ,' UD BRACING BOLTS �_I
Je ►EES /
i1Rf PLACt
I N(S[5Y AC MNOW Ll06f THAT • NAVE ROAD THIS •►PLIC AVON
ANO STATE THAT THE •5051 I/ CO ICT ANO AOS(( TO COMPLY WALL BOARD
WITH •LL COUNTY 0S0INAN TI LAWS NIOULATINO I
•IUILOINO CONSTRVCT'O
PERMITTEE . / �I'' /�,`4_ .1 LII;[ NUME[R CORRECT
P[QMETTEE w I AND PQ}TtES
A0ORtSS-----_ ----_--'"' -- GI NAL L r,:;.7 7.7y �/
PLAN CHECK VALIDATION CN MO SH PERMIT VALIDATION C,; Mo,
, I
,. r ,r t NU 75-redU•TE r >� 1TP IP� G� L.Are 3
FIRE: PREVENTION BUREAU
OFFICE OF FIRE MARSHAL .o 1 3' I
INSPECTION NOTICE
OWNER Li) /N tk l�e J,C Cor DATE __
.00CUPANTT "f Z,/•i L{c OCCUPANCY /r /4..:4 C
•
_ ''
LOCATION /o/ src r
. UN ATTENTION IS CALLED TO THE FOLLOWING FIIIE TV DEFICIENCIES,
I
/
--- 1 _ A ..• c 0 led. .''':d #4091,44 -O L/... 0 L L 4•;110.4..• •r
.. -0 rc Q. •e Co", , .•,-- -
1
,AILJFE TO CONFECT THE ALOVE CONDITIONS WITHIN nAvS WILL MAKE VOU LIASL , PROEECV+ION SHOULD FIRE
O PIFFTV,UNDER.E.O.CLIn STONE OF
�.ESULT FOIA SUCH CONDITIONS YOU MAT DF L,ANL ! I1:F SPMA GI" TO PERSONS DN 'PO,
JFS 473 .plyBY -------- -
WASHINGTON COUNTY FIRE DISTRICT : 1 FIRE MARSHAL
14480 S W JENKINS ROAD �{ �;
BEAVERTON, OREGON 646-1101 PRESENTED TO ---
INSPECTION CARD Washington County Dept.of Planning
BUILDING DIVISION
648-8761
Permit No.
Address —_
Called By Owner
Ftg L J Fdn Wall Fireplace
I J Cover E Nailing Final
Other
Inspector' s Remarks:
------------
Date Building Inspector
.74
/AJ r
Washington County
Fire District No. i
I. F D
11 ,, , At14480 S.W.Jenkins Red
o Bea Ion,Oregon 97005
_ • `r �.
Bureau of P'.re Prevention
646-1'01 Extension 245
Plats Elimination Report No. •� P--re Station "Ar":
Run Distance
wilding, Me ••y fled. Occupancy r-' letcantile Piro Ems_
Address Gluck K ashln,ten ;Jar 141.1 'n :. _• re- Construction type 111.°
Arohiteot/Designer ittie . enQ "menr• Address 377, t•t.!lilwwkie. ''attlafL
owner f rue r nrl!is tnc. _ Address ')0"' ' • .5th 7 vw., 'stigma 47 04
Stories Main Area '*• /baaement Area "m" Attic Height n•s• /Stop -
Pire Walls "ane Fire Escapes_°' Exits r• _/total Width 31
Stairs,"tine /inclosed - Other Vertioal Shafts /Enclosed Sprinklere_ `'
Area Covered oh*.lr' arc, Man. Alarm ns S.P. • Ext., "' /C1aas - /NO. -
C..oaoustion Detection TM' /'type /Area Covered -
Floor '• rgtn Celli singe' tile Roof •
ng
Str. Mss sec t{ Wall Cover • g� / a)p.board
fer-oe lir electrrir���
Heating System Fuel Cooling System are;1 "e
The plans for the',Ase described structure were referred to this office Viet"-p
and reviewed for conformity with State and Distriot fire safety lawn
and regulctiors. The following itemtaed comments describe changes in the plans required
for conformance with such laws and regulations and recommendation for enhancement for the
general fire safety of the occupancy.
1. .4t mets are renuired to se fitted with fiwieh ~endears, tee. lsoke/letcnee
hewing M Ssevislens fir leeki% pelmet egtese, being s .n.Ile 'tow tnw rosins.,
et ell time* foe lwmwdiete end' without the use of e key, special knovleoo,, u:
•ffe.te
(tela lee. 3143 sere:. 19?0)
Donald E. Mo:• or ,
/Firs Mfr. Att'
t. .`/
ass l r M
't' .+arrtvvten
aeh.re.•fleip." .,t.
Ineeeeter Putts
FN+ovised 3373 FIRE PREVENTION DOES NOT COST—IT PAYS
?. All heating, ventilation, alt sawltlonin% •nu electrical e.yripsent and
epplionses ere rewired to he appreve.t by uneer.rltetr laisor•tariat lnc.
es ether netianallr reseSnired tooting agency sews Installed we oet the
testing ewers y s e epeeltfeetian•.
(re/' es. $37 W.O.C. 1970 teltree 11)
14 '.ptiflcation of Mie office for Inspection enc. st.proval of censtrn.ction to
required prior to essua^ney. i.e. prier to oOonl"q for sutinees.
(refs 'oc. 1.207 U.I.C . 1271)
4. -riot to acrahehoy of the shoo a Certificate •f :eauPsnev oust 60 ebtslned
frets the •ehingten County 9wildtnn naoettnent.
(rrh': . `''d U.t.f. 197e)
INot.ae to lnspiet3r1 This shop will iee..:ry » space 1^ "y1e K" of the mall
thepe trop a4js4ert to the mete. ant Freak 3Mss. The
wain entre/tee .gill he evuiausr. witn • 14 feat Aloe
‘rwohly? tell down Aril.. heuevsr, there le a etemeari
exit out theeu3b the roar 3f the shop.
9410 S W Washington Square Road
1S1 26C
alter/ tenant
space Teddy Bear Trends
.58625 /.:yet i 3
58621/ WHITE Inµt.cto,Copt/
YELLOW '.rm+tt..
PINPERMIT NO APPLICATION FOR BUILDING PERMIT GRE Temporary F.I.
GREEN Circulation
WASHINGTON COUNTY ADDRESI71LD ,& ZIRSA, _S4 RLI.
DEPARTMENT OF PLANNING
BUILDING DIVISION LOCAL+TYIL/4Sh, S4 SOT m'�Jl,t/!
♦
NEAREST
INSPECTIONS 648-8761 (AFTER 4 30 640-3561) CROSS ST
CENSUS GR _;., ,�TYPE tj ZONE
FOR APPLICANT))�I !
TO FILL IN TR r CONST �T'
AUILDING
DDRESS flip � ' C MIN/SETBACK f S
LEGAL.DESCRIPTION / APP'D BY DATE
ZONING
PLAN EXAMINATION 4.-
AREA OF LOT No OF SLOGS STRUCT.ENGR.
Ulf pp NOW ON LOT ---�
EXIf71NO BLDG.Rel/!_ ..__SIA/_es TYPE OF SANITATION
�— No_Glunss-e —
OWNER wisitA_ 4601-43. f1F11VEWAY PMT.
ADDRESS I//./xt IF '•
yot
c1 "1111414�
- --- t;AMMENTB: ' . -
e N<.INEER�JC/ 1'�.Y/11.11_ _O�Px32�.F7252 QM1ttf L1_" A �SL .--
ADORES r1Z.[� , f _ 4-r f2�c ---- i 7 --
CON�ppR TEL
e1 1'5c
ADDRESS/®/S #A) 4f�f JK i= _— — — —
—
CITV Iltr's L1e.SbaE J
DESCRIPTION OF WORK - Nit_---- -- —
NEW ADD ALTER REPAIR DEMOLISH
asp_ ---
R
812E T. �!Sp
--_E�oKS ate EB --- -- _—_ _-._
NO.BEDROOMS NO.OF BATHROOMS
USE OF
._. - - -----
/STRUCTURE RC ti4; I SALc
VALUATIONS .00 PEE FOR AMOUNT RECEIPT NO. L'ATE
F . - t
1C111 � 'Pas ?�'1 0 STtFAX 1?
ZONING COMPLIANCE -
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS _ L:�
!IRE MARSHAL
APPLICATION AND STATE THAT TTHE IIBOVF IS coR � t
RECT AND AGREE TO COMPLY WITH AI L COUNTY OR --- -
DINANCES AND STATr LAWS REOULAT+NA BUILDING SYSTEM OFVELOPMENT
CONSTRUCTION AND i ICENSING.
SIGNATURE .... �. ---
PERMITTEE"'''
ADDRESS =INAL INSPECTION DATE
PLAN CHECK VALIDATION CK. M,O. CASH PERMIT VALIDATION 0 CASH RECEIPT NO. [)ATI RECEIPI NO. / 4 `� `/ DATE 2-A2.4s ,
h' )4k'. Ct�lcoP (4699
I 1 `,�
6� \ WASHINGTON COUNTY BUILDING PLUMBING INSPECTION CARDiN ' y &<-4--(ii
— / /V -6eparLment o Land Use Tl ansportaion
`� 648-8161/8:00a.m. to 4:30p.m. 640-3561/4:00p.m. to 8:00a.m.
1 Gas /
6 rA (45 4 5iIii ►1bg I
Called By _ ...mm'i! Owner B 1 dq I l✓ i
141]0tno R,.ld. 41r Nlscellameous Plumbin_ Resid. Com) `)J�
fft,' mall mobile Anse ground rain drain kAPPROVPD
apron/ wood storeUVi� � l• +et•ms1 Is
fon crow simnel, Post/beam storm serer T�..►+ro
solar n.ct.r.er
top-out final brrvtw
slab instil Final get test
,,�,�9 �� // / D NOT APPNOVED
._.rr.feloi
ex.
–idiP71_42.../
iNSPECTED II ,. OATta ..
3l /l� WASHINGTON ;Ol1NT1' - BUILDING DIVISION - (NSPLCT CARD 0_____
�
p r Dew ent oTTi TTr`•nspor tion Vs
A
648.11761/11:004.m. to 4:JOp.m. 640-356)/4:30p... to $:D0•...
f �.
Aldres s �7 ' 0 r�1 �'�' • /. `.' ,/ �� PI boa / ,�-p/ -�
Cal led By ' /. ' 'Tls��iat4�7%' - if r r Ti L . / �K .. Bldg I -2%/J �i
Bn11111oo_ Resod. Co.'1 stelianeous PI .Ing Resid. Ca.•)
Itq post/beamnail mobile home ground rain drain APPROVED
•ppppro•cn/ wood stove past/bsaw storm serer y.n� �
/dm framedrivc�ar t It ctrtael
so.•r
top-out final M'rl•rwa
Slab instil (TI-f;71.'1 gas tem. NOT APPROVED
_,_! INSPECTED Br _ GATE '3 Ye-'S
CAR
IINGTON ouNTN • B1IILDINC IYISION P CTld—l O
/a IIA IDamao icr.. and Use I Transppot. Mt i ___
magi �/ bill-0761/11.00a.m, to 4 mom. 640-3561/410D.m. to a.m....Address mac, u s
e_i
i , /
----
Called By y�i21'1 �jr
(�d 4......� (i`nir ��.%.re's' --oe-�►.-J —7-7:. is- mil I- �v` s
Ittildlf9 Resid. , Nistel lanais x1104 11.__ Pesid. 0m0
CM ' mobile home ground rain drain NAPPROVED
fig post/bmam
r r wood stove
SLOVR p.,st/heaat storms sever ri1.S
fon /ram solartlKatcsl
slab instil final ;vs test top-out
finalatirlatm
NOT APPROVED
INSPfCTCo sr V . ___`DATE 7--/Z2/4F-1—
J
FIRE PREVENTION BUREAU e
OFFICE OF FIRE MARSHAL 2.3708
• r� INSPECTION NOTICE
OWNER � [n H1.4.2..,:: Lel'. _,
DATE—- % r INT-
OCCUPANT U .! ' 1 701%• r' OCCUPA CY ie",:74•••lit 4 i ..
LOCATION fyif ) L1 J l�'S(ti Al r/ t (.1.--4 Z4 fit)/.
VOUP •T/EN/ION IR ed..,EO TG t.r .OLLOPIN0 FIRE E•CE1 D RNCIE .
/4-,-;‘,„„„,,,,,,d , " C(. %r.1�'-lic T/ /4;,,,...6h/....
c_s
-)itaidis.,-470 s 4 ppe(x
x � jj
E•,LUmp TO CORRECT TME •Wo VE COND.T.ONI *;7......, n•.7 *,LI_ MAR 90\�h./wl.r TO c ECUTIPN 112VLC' r•RE
:E:ULT .POM IOC. COND,T'ONI 'OU M•v SE Li•S'_E 70P n•M•Gt7 to En1t1•;"911"bwM4( v UNE•ER a v11,0N/Or
ORS 471 Ier. e /, '/l/yi E r
WASHINGTON COUNTY FIRE DISTRICT 01 / R .1ANSMA
20665 S.W. BLANTON STREET PgfEENTED TO
I ALOHA,OREGON 97006 649.8577
/ORM POO 40 `._
FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL
INSPECTION NOTICE
OWNER rJ l.1 it 04(.4 :,/~, :_,Z..2t-- ------ — DATE L___ - ..'1____--_2..t....—_
44
OCCUPANT .A:........._....,.......- _____. `.. 00CUPANCY ` 1 (t.k:1. .-.44,
LOCATION ! r '� (.fi.//�l`3'424 __IJ -#/ t1 4.1‘2f`f i
J
Ouw
ION .1 C•LLEO Tn .• POLL0IPINS RIPE TV DC:le
.._. ./P 14 — - . ....—_-----.-4,0-.....-........-...4......... A )14.
7• /41C-
'4414644"C
.4I 4I 111 Izc _ - - ,/f 4i4141kAI/-
.;1 AP... /41 ' 1t�---.1:.,
f li `. G/kd ✓ ip�
...Lunt TO 40nnt ./t
1 •• R ONDI TIONf M.r4./ O.v wlll M E CDU 1 ►NOI ww
rO/EfV ION /� r' t
ND.110M11 VOL, M•v SE L.1 SLE .OR D�M•OE I^�1�(9',15NA OA TwQ w / UN EP nw• 111�N1 Or
RIE 7Ul f PROM 1UCN , 1 '
I '-
FiMMINAL
WASHINGTON COUNTY FIRE DISTRICT 01
20665 S.W. BLANTON STREET F1gFSENTEL TC, '
ALOHA,OREGON 97006 8404577 ,,s {r
.ORM 100 40 ()/'r A ('.ilkp4/,
7 (,--.,,,-,i,
(,,,
L ;.: WASHINGTON COUNTY FIFE DISTRICT NO. 1
' e�� 20665 S W Blanton St. • A.oha. Oregon 97007 • 5031649 8577
February 7, 1985
Goforth/West Design
822 S. W. 21st Avenue
Peet'iand, Oregon 97205
l;en t'I emen:
Re: Teddy Bear Trends (PC 4699)
9410 S. W. Washington Square Road
The plans for the remudei 'ng at this address to accomodate the aforecited
tena.-,t have been examined with reference to currently applicable fire safety
reguations. Generally sneaking, we find the proposal shown on the draw-
ings to be acceptable.
However, the automatic sprinkler protection must he altered to coincide
with the remodeling work. That is, full sprinkler coverage is required.
No automatic sprinkler head should be located closer than 1 foot nor more
than 7-1/2 feet from any wall , partition, or other bulkhead.
Inspection and approval of construction by a representative of this office
is required prior to the cover of any new framing elements following the
installation of utility runs which will be concealed within wall and par-
titioned cavities. One set, of approved plans must be maintained on the
project site throughout all phases of construction and mist be made avail-
able to building and fire inspectors for reference during required
construction inspections.
Upon completion of construction and prior to opening for business, a
Certificate of Occupancy or other written instrument of approval must be
obtained from the Washington County Building Department.
Subject to the foregoing stipulations the plans are hereby approved. I
trust this letter will assis in cle.ring the way for the project's further
develop-r�nt. If I can be , servi,;e in any other way, please let me know.
Sin. -r ly yours, �/
t 'AS NGTI '1JNTY FIR Pr /rRIC NO. 1
o
1 . rn •dge //
Fire Prevention Officer
c • : Ruyrr Ott
Amer:can Pacific Projects
L Wash. Co. Bldg. Dept. (2)
Inspector Jeffries
STOP FIRES— SAVES LIVES
-• 4
c. — x
I
9410 SW Washington Sq. Rd. P24049 30218.46414,58625
Amp, Aumummemaiminill11110111
alidimmusamummumanallilisilmainimmmislailer
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•
P DEPARTMENT OF LAND USE A TRANSPORTATION
, illp% WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 603/640-3661/493.4415
I PHONE: 503/6494/61
. 411W OREGON Page : 1 of 1
Date : 06/U3/92
Time : 11: 57
Permit Type : commercial Electrical Permit Permit * : 05030551 '
Permit status : APPROVED Applied : Ob/03/92
situs Address : 9410 SW WASHINU'1'ON SQUARE RU TI Issued : 06/03/92 1
Permit Title : SUNCOAST COMELEC Completed :
Permit Uescr. : JOti * CS3ti65 To Expire : 11/30/92
Project Title : SUNCOAST CUMELEC Project M : P0024049 i
Project Uescr. : JOB 0 CS38b5 * EROSION *
j Parcel Number : 1S126C0-U1'/00 Land Use District : C-U
Valuation : U
Legal Uescr. : ACRES 5. 30, SEE STREET LIEN DOCKET (FROM A6T:02/08/92)
Owner : WASHINGTON SQUARE, INC Construction : OTH I
{ Applicant Name : CHANDLER ELECTRIC Classification : 9('0
I Applicant Addr. : 3521 SW CARSON Occupancy :
PORTLAND OR 9/219 Validated by , VO
Applicant Phone: 245-7774 Inspector Area :
CONTRACTOR : U.W. CHANDLER Lic. C 26-524C 245-7774 1
tee description Units t'ee/Unit Ext fee Data
200 amps or less 1 35.00 35.00
auLtotal Electrical tees: 35.00
state Surcharge of 511 1.75
I Total Electrical tees: 36.75
*** tees Required *** *** tees Collected 6 Credits *** i
Receipt No. Date Payment
06/03/92 36.75
, tees: 36.75
A,llustments: .00 'Total Credits: .00 1
Total tees: 36.75 'Total Payments: 36.75
balance Due: .00
1
NOTICs: TWa permit booms nue and vela Nag visit or usnstruollon for Mitch M is Issued Is nal eaMwhaed MOM ISO days. Ona smob ekMh Inas slatted,
the permit Ia cease null and sold N wlrYwren is lasin+Md for I period o:ISO days. I civilly MM the NNafl.Mlenn prowled W b appeaMM sod lil.)
Me pert a agents Ni support of Mie Reit M alas and sassed lo Ni.MM of our knowledge I aelmostedga MM/Ie Sig ripest sties eiMlss
upon Wee and mlaleadkg Mae:allen may IwaliaMe Mie panne. AN provisions of appNeaON Mee and adMwea gave tnq the.Maaeen and use
of tum big or a nneu a eat be sempaed,lei ofiuNnar or nal epeWMd on Ni.plans or cooled on the plans a leseL..ahsds. I molmesNep Oal
the emoting of a putt does nal giant auMaiy lo seams print prop.ty or to use aaMNads. I napier aameraladp MM the um or deoapMey of
:rte tlruotrs or building mermaid depends upon my caMng for Mspedlons M imam aims during Ms premiss el senallueaon and til building
Inspection sled verifying comparhes with ahs venous codes. Use or oeahpsnoy of the building or assWiMIe ponsime prior lo approval by the
Wilding Depermnrd le solely M the risk of the applicant and such tea or occupancy Is mimosa,unit all IllapesNall eftuhemets ars satisfied and
approval le given by the Mullane Oeblal. I bathe aknoeladge that a Nen may be placed an she alae al Ms prepafly upon which Ine Ramp Is Issued
specifying ewe Pus use or occupancy of Ni.building or structure la proalalenal ail mroeeile mal Me aalleLMIa.al M klapallon requirements. +
APPUCANT'S SIOIIATUna
r
I
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WASHINGTON COUNTY0
ELECTRICAL PERMIT
Department of Land Use& Transportation
Ele155 Inspection Section
APPLICATION
155 North First Avenue,#350-12
Hillsboro, Oregon 97124 n x,_
Information: (503)64034%0 Fax: ($03) $173-4412 Prom Permit -\��.),5 /
mberPq1249_ Numbr7
PLEASE PRINT' _
1 Please complete all sections, 1 through 5. 4. Complete Fee Schedule below
Iii 10` 1 w/t<.5 S9 Number of Inspections per permit allowed
1. LOCat ro of Stella Ion `r l ck, Service included: Items Cost(ea.) Sum
Address _. as a - : fie . Al A. New residential-single or multi-family
'T t&1k� Building ' per dwelling unit.
City ` _Suite No.
Tenant Name or 1500 sq.ft.or lass _— $85.0n 4
(if commercial) ( t SI- portonthereofEach additional 500p n $15.00
' Each Msnd Homs or Modular
Dir i nS W Service or Feeler —_ $35.00 - 2 f
tiC �r Is - B. Services or Feeders(10 branch circuits included)
-- _ ketaNetion,alterations or relocation -
t G0 amps or lass $35.00 2
Commercial Residential[-I101 wipeb 400 amps $80.00 2
401 amps b 600 amps $80.00 2
r 14 - i 1—)CI ) ...1 amps to 1000 amps _______ $130 CO _ 2
2a. Contractor it tallati 7n Over 1000 amps or yolk --- $300.00 00 2
Electrical 'ontractor •P�r t only -- $452
Address a "'TEarGr;aL' _ C. Temporary Services or Feeders
•Date lob Number i& t Installation,alteration or relocation
• Property mer 200 amps or leas $3500 2
'— 201 amps to 400 amps $40.00 2
Contractor's License No. — 401 amps to 800 amps -_-- $8000 2
Contractors Board Rey.N. /, s Over 800 amps to 1000 volt.nee•8a'nve
Signature of Su lec'n /r'1/ D. Branch Circuits
Ucense No. Phone No. -111i� New,alteration or extension per.
One circuit $35.00 35 s-10 2
Two to ten circuit, $50.00 2
t' , 2b. For owner installations: Each additional ton circuits
or part tereof Amor) 2
Print ON�er's NY11e — -- —dna No. E. Miscellaneous(Sorvice or Feeder not included)
A/ a -- —_ Each purr $3
p or Irrigation circle _ OS 8 00 2
Each sign or outline lighting $38 00 2
MY gists -----T— Signal circuit(s)or a 4m.ted
anergy panel,alteration
or srlension --
$36 00 _ 2
The installation is being made on property I own
which is not intended for sale, lease or rent. F. Each additional inspection over the allowable
in any of bte above,per inspection
1 Owners Signature _ ___ 635.00 _ _
\I n 3. Plan Review section (if required) _ 5. Fees
A. Enter total of above fees $
5% Surcharge(.05 X total fees) $
Subtotal $ 1 J
l B. Enter 25% of line A for
i.--- — Plan Review if required(Section 3) $
For inspections call Subtotal $
640-3561 or 693-4415 Loss Bulk Label Fee $ —
24-hour recorder, Balance Due $ r
one working say In advance of need
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This permit becomes null and void if the work authorised by the permit Is not commenced within 110 days from date of Issuance
of such permit or If the work authorized le suspended or abandoned at any time shin work is commenced for a period of ISO days.
' Doctrinal Permits ere non-refundable end non-trsneler.bls 7/91
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