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7437 SW ASHFORD STREET �V GJ E H i I ` II f JJ� I r i � I I 3 1 I r- 7437 SW ASHrORD 3rRf?rET CITE' OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hell Blvd I iparl.Oropon 97223.8199 1503)839.4171 I City of Tigard MECHANICAL PERMIT Plancl</Rec. # 13125 SW Hall Blvd. APPLICATION Pumit # _ PO Box 23397 Tigard, OR 97223 (503) 639-4171 _ escriphon Table 3A Mechanical Code 01 _PRICE AMT Job C '- 1) Permit Fee 0- 0- 10 00 Address _ ^( ;}� 9�0 2) Supplemental Permit 3.00 ' Furnace to r-,-L + 1) incl. ducts&vents __ 6.00 Furnace 100,000 Owner ��_�``� ' _ 2) incl.ducts&vents 7.50 Floor Furnance 3) incl. vent 6.00 Suspended eater,wa eater er 4) or floor mounted heater 6.00 Vent not incl.in Occupant 5) appliance permit 3.00 BP Repair of 1,aattng,,e nT g 6) cooling,absorption unit 6.00 n» Boiler or comp, eat pump,air con . I -7_0'o))/ 7) to 3 HP absorp unit to 100K BTU 6.00 !° i" Boiler or comp,heat pump,air Gond..— �� AITApi My J 8) 3.15 HP absorp unit to 50 9TU 11,00 C,ontfactor i er or comp, eetF pump,air cond. " 9) 15-30 HP absorp unit.5.1 mil BTU 15.00 SV•VA^No. Boiler or comp,heat pump,av con . 10) 30.50 HP absorp unit 11-1.75 mll BTU 22.50 hereby acknow ge at I nave read is application,that the Boiler or comp,heat pump,air con . information given is correct,that I e.m the owner or authorized agent 11) >50 lip absorp unit 1.75 mil BTU 31.50 oI the owner, that plans submitted are in compliance with State Air handling unit to laws,fliat I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50 that the number given is correct. (If exempt from State registration, Air an ing unit please give reason below.) 13) 10,000 CTM+ 7.50 Non portable 14) evaporate cooler 4.50 Vent fan connect 15) to a single duct 3.00 Ventilation system not 16) included in appliance permit 4 50 WM•(—nffr Ap-0 Hood served y 17) mechanical exhaust 450 Describe work new addition a teranon repair Commercial or industrial to be done residential 0 non-residential 0 18) type incinerator 30.00 Existing use of Other i.e.,woodstove,water building or property 19) heater,solar,clothes dryers,etc. 4 50 Proposed use of 2.0) Gas piping one to four outlets 200 building or property 21) More dTan 4-per outlet Type of fual-oil 0 natural gas 0 LPG Q electric Q NOTICE Minimum Fee$25.00 SUBTOTAL F' PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE J. N IF CONSTRUCTION OR WORK IS SUSPENDED OR — ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL AFTER WORK IS COMMENCED. — — TOTAL Special Conditions Date issued by 4 MF.CWPMT •adconM�r C 1YOF TIGi4R® RD ✓ COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hill Blvd. P.O.Box 23397,Tigard,Orwjon 97223(503)WO-4175 PERK I T 4. . . . . . . : PL01913-0031 639-4171 LIATE 155UED: 0.3/ J.0/93 074,67 SW ASHF-TIRD ST PARCE-1-9 a51. 12CO-101,00 RENAISSANLL' WOODS LONING: R-4. 5 fALCA",K. LOT. . . . . . . . . . . . . ..e.7 L'LVI'55 OF WORK. ADD 6ARSPUE WS1*'USALS. MOLAILL HOME SPACE B. I Y PE CIF U5-E. . . :GF Wf15H1NG MACH. . . . . . . .. BACKFLOW PR E.10 N I R,H). . . I iC'-'UUPAN1:V GRP. RI' FLOUR DRAINS. . . . . . . 3 TRAPtEl. , "s 1, , * * . . . . . . . . . . . . . . WE-)'TER HEA"FERS. . . . . . . C-AILI-1 ;.A . . . . . . . .. LAUNDRY TRAYS. . . . . . I c3F, WIN DR0114S. . . . . . 1 kw Is. . . . . . URINALS. . . . . . . . . . . . .. GREPE I RHWS. . . . . . . .* 1-11)A1 OR I KS. . . . . OTIALR F1 X TUREtS. . . . . T UH/SHOWERS. . . . : SEWER LINE' (ft ) . . . . WH 1 ER LLOSF* FS. . : WATFH LINT (ft ) . . . . Dl.aHWASFIEHB. . . . -, RAIN DHAIN ( ft J'ALlq MILLER type aniotint by date a pi; -i.'l SW ASHFORD PRIV11- ii 15. 00 PA 03/10/93 0. "15 JH 03/ 10/93 (jR 972r.,4 l�ilorle 9k: HOODY ENFFTRPR IGF 420454 bPRINGWATER fill OR 97OL3 f='1101.1 e 4: (,:31 -29 1© a 15. 75 10 TAL ked ft. . ; 597,31. RLUU I RE L, INSPLCTION'S this permit is issued sub-ioct to the regulations contained in the rap-akit Irisp byard Municipal Code, State of Or#. Specialty t.odv and all other V i na I 1115 pett 10;1 applicable laws. All work will be done in accordance with approved plans, 1his permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 160 days, ei-niittep itjnatt..Ave * 1-101.1 Fly CITYOFTIFARD PLUMBING PERMIT CnYOFMM 2­07- COMMUNITY DEVELOPMENT DEPARTMENT PERMTT #' ' ' ' ` ' ' : MST9, 12. 13126 SW HjW1 Blvd. P.O.Box 23397,TipW,Onigon 972M (SM)&1"176 DATE ISSUED" 07/08/13,:� SITE ADDRESS. . I Y-+317 SW ASHFORD ST PPP(.:LL- ._,S112CA---10k00 SUBDIVISION. . . . A RENAISSANCE WOODSI► ZONING- R-4. 5 BLOCK. . . . . . . . . L_0 T.. . . . . . . ... . . . . 127 ----------- CLASS OF WORk. . iNEW GARBAGE DISOOSALS. . 11 TYPE OF USE. . . . i SF WASHING MACH. . . . . . . . I BACYFLOW PREVNTRS. . :0 OCCUPANCY ORP. . :R2, FLO(-JR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . .0 STORIES. . . . . . . . :2 WATER HEATERS— . . . : 1 cA,rrH BASINS. . . . . . . -.0 LAU14DRY TRAYS?. . . . . . ! I SF RAIN DRAINS.. . . - - : 1 SINKS. . . . . . . . to . . . . . . . . . cl GiREASE I.-AVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0 TUB/SHOWERS. . . . : SEWF-R I INE (ft ) . . . . :0 WATER CLOGETS. . :3 WATER LINE T)191 IWASHJ'RS. . I RAIN DRAIN (ft ) .1. 10 Rem%rksc PATH I OWNER: ___._....._...-..._-......_____.._.FEES___. .....__ SAM SARICH CONSTRUCTION INC TTF 1380. 00 JH 07/08/92 645`5 SW NYSE RG LN 1-103 IAPRT 4 5 IS. 00 JH 07/08/9.? IAF L C, it 336. 70 JL.H '36/15/12 2058:18 IJJI:,Lo-t I IN OR 97062 B5r-'C 25. 90 ITH 07/013/`)c: -Phone #! 503-692-7c'E'08 S6D(_ is 280. 00 JH 0 7 IQIAICO2 - P A R V $ 500100 JI-1 07/08/42 Plumbing Contract tit, c PIPRT $ 40. ',50 Jl4 07/08/92 MF.,L.(- f 10. 13 JH 07/08/9c' Nam IV 1 03 J11 117/IAS/9 Addw_e t,� I 9-0, ev;( - 1501 PPP 1 15!.). 00 JH 07/'OS/92 I t v Sk,.j ritat P a 7. 73 11-1 07/0E3/')c 7 1 p. 705'5 --Phone#, Reg #: RFOUIREL) INSPECTIONS This permit is issued iubject to the reg­ t.jlptioris contained in the Tigard ML1ntCipMl Footjfound Infr) Rain drain TT15r) Codif, State of Ore. Specialty Codes and all Post/Beam Sltruct Water Line T , other applicable law,,. All work will be done Post, /Beam Piet-her, #4ppv- /qdwlk in accordance with appt-ovod plans. This Plm,'undslab Tnsp Plechanical .R.ej_:msit will expire if work is not started PLM/Underf 1 vor Plumb Final within 180 days of issuance, or If work is Mechanical Insp Building Final q-tspended fore more than 180 days. Plurith 70r) Out Erosion control. Framing Insp (,raw I Dv A I n Fireplace Intp Gas Line Insp ....... Insulation In5r) 0 Gyp Board Insp .-17V 90 P1 M Illy tractor Signature Call for itispo(-tion - 639­4475 artor Nf)tp!-, - ----------- r CRYOF 116ARD CITYOFTIGARD C,OMMI.)NfTY DEVELOPMENT Di.;')ARTMENTi oRaoo« MASTER PERMIT' 13126 SW I W1 Blvd. P.O.Box 23397,Tipad,Onpon 9'223 (603)639.4176 PERM I T ??I. . . . . M 5 T 9 c --id 1.C-,. DATE ISSUED: 07!08/9=' S I TF ADDRESS. . . : 7437 SW ASHFORD ST PARCEL.: SUND1VISION. . . . : RENAISSANCE WOODS ZONING: R-4. 5 I BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :2'7 --------_...______._____._ BUIL.DING RE ISi:.)UE: DWELLING UN1TS: 1 DASE.MEN1 . . . . . . . . :0 �sf--- CLHSS OF WORK. .-NEW BEDRMS:3 PATHS:3 GARAGE. . .. . . . . . . . :480 sf TYPE: OF L15E.. . . -SF FLOOD. AREAa _.__. _.__.._...._ REQUIRED aFT»FICKS______....,.--,-•-- `IYE-+, OF CONST. :5N FIRST. . . . : 1407 sf LEFT. . :5 ft RIGHT. t23 ft OCCUPANCY GRP. :R'3 SECOND. . . .- 13i6 sf FRONT. :20 ft READ. . :,_(� int STORIES. . . . . . . :c T'H I RD. . . . :0 s f REQUIRED--------------------- HE EQUIRED--________________---- HE I GNI.. . . . . . . . :71 f t -r(ITAI...- _ _ —:27,23:27,23 s f SMOKE DET E;:CT ORS. :Y FLOOR LOAD. . . . 940 psf VALUE. . . . . 133898 PARKING SPACES. . :0 Remarks : 1=IATH I _.-.._---.-_-_.-_--___--_._-___-_.___-_-- PLUMPING SINKS. . . . . . . . . . : 1 FLOOR TDRAM3. . . . 0 BACKFLOW PREVNTRS. . :0 LAVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . 10 T0B/SH0WC:RS. . . . :3 LAUNDRY TRAYS. . . : I CATCH BASINS. . . . . . . :0 WATUR CLOSETS. . 93 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0 DMI WF'aSHERS. . . . : 1 WATER LINE (ft ) . r 1 017.1 UTFIFR F I XTURES. . . . . t 0 UA..(LAGE U1SP. . . ti RAIN DRAIN (ft ) . :0 WASHING MACH. . . : 1 SF pA T N DRAINS. . : 1 -------------- MECHANICAL ---___.__.__.____ _ __ ._.__ ____._.___._ FEES _._ ..-____.__----- FUFL TYPES_-.._._._--.._.__._.. I1NIT HTRS. . :N type amount by date ►^ec:pt /GAS/ / / VENTS . . . . . :0 TIF' $ 1380. 00 JH 07/08/92 - MAX INPUT .-O STU VENT FANS. . :4 l3PRT $ 518. 00 JH 07/08/92 - FLIi N ( 100K . . :0 HOODS. . . . . . : i BF'L-C f 3:36. "70 JLH 06/15/92 225818 F L)PN 1 =100K . . : 1 WOgrlSTC)VE::T. :lb BfiPC $ 2 ?ky .JH 07/08/92 - FLOOR 1-URN. . . .. :0 CLO DRYERS. : 1 SSDC $ 280. 00 JH 07/08/92 - RCJfL/(:Mfg ( :314P:O OTHER UNI 1 ', ,0 PARK T 500. 00 JH 0//0Ei/9c - UAS 00-FLEAS: 1 MPRT t 40. 50 JH 07/08/98 - Uwner MPI-C 1, 10. 13 ,JH 01/08/92 - SPM SARICH CONSTRUCTION INC M`)PC 4; 2. 03 JH 07/08/9'...-' - 64E-5 SW NYS-E'Rry LN 1 - 107 F'Pr•� $ 155. 00 JH 07/08/9r' - P15PC t 7. 75 JH 07/08/9E' TOP[ AT T N OP '17l;)62 Phone i1: 503-692-7208 FOAM SfaR I CH CONSTRUCTION INC rW NVREP�� 1_N 1..-103 I Uial_A1 1 N OR 9112%2 I'�t� . :,p the °ar7r3,-69c--7�V_r13 6126"1 !. 385f.,. 01TOTAL. This oerwtt is issued subject to the regulations contained in the ------- REDUIREI? INSPECTIONS ---- -- Tigard Municipal Code. State of Ore, Specialty Codes and all other Font/found Insp Fireplace Insp applicable laws, All work will be done in accordance with approved Post/Sec-Am Stt-uct bass Line Insp plans. This oerait will expire if wor* is not started thin 1N1 Fort/Beam Mecham Insulation Insr days of issuance. or if work is suspended W scref'', 15 ays. Plm/undslab Insp Gyp PoAr-d Insp PLM/Underfloor- Pain dt-ain I n u Hermtttt+e :.iirJn; ' " lwe,6—, Merhanlr::,sl ITIS , Water, Line Insp Plumb Top Out Appr-/Sdwlk Insr, T!ss�mer+ F i—imincl In=.p Mer_hanir ti I it -— 4 -ss+a--�,�r•e,r=-e ewe E ��—+w 1 z5 CITYOFTIFARDN COMMUNITY DEVELOPMENT DEPARTMENT 001100n SEWERAEOMTEC f IO 13126 SW►W I Blvd. P.O.Box 23307,Tigard,Oregon 97223(603)639-41 76 P E:R M I T #. . . . . . . . SWR 9--0-'.:�l 639-4171 DATE ISSUED: 07,108/92 ra 1 TE ADDRESS. . . : 7437 SW ASHFORD ST PARCEL: 251 12CA-.10100 SUBD I V I ;1 ON. . . . : RE14AISSANCE WOODS ZONING: R--4. 5 LAL.UC:K. . . . . . . . . . : LOT. . . . . . . . . . . . . :27 TENANT NAME. . . . . : r^ USA NCI. . . . . . . . . . : FIXTURE: UNITS. . . : CLASS OF WORK. . . :NEW DWEL.L..ING UNITS. . - I TYPE OF USE. . . . . :SF NO. OF BU I LD I NGS: 1 t INSTALL TYPE.. . . . :BU!:3WR fMPERV SURFACE. . : : sf Remarks : PATH I Owners _______. ____._______.____.__.___..______ ______._-•-----___._.. FEES SAM SARIC.'H CONS'TRUC.TION INC type amol.rni: by dAte, r-e(-pt 6455 SW NYBERG LN 1--103 PRMT f 2100. 00 .IH 07/08/92 -- INSP $ 35. 00 JH 07/08/92 - UPLAT IN OR 97062 r'llone #: 503-692-7208 i.,r�r�tr•ac:tar•: ____.______.._._..__._ _........... .._...._._ .._ _.._. SAM SARICH CONSTRUCTION INC "7 r,W NYSERG t..N 1-10,3 Ui LATIN OR 97062 ------__.__-_.___________________.-__..__ Ph or e # '03-652--7 EVA8 $ X21 35. 00 TOTAL Reg #. . t 61267 RFOUIRED INSPECTIONS This Applicant agrees to comply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit expires IN days from the date issued. The total amount paid will be forfeited if the permit eYDires. The A4encv does not guarantee the accuracy of the side sewer laterals, If the sewer is not located at the measurement given, the installer shall crospect 3 feet in all directions frew the distance given, If not to located. the instaiier sha ourchas! a 'Tar and Side Sewer" Permit and the Amc 11 in a teral. Call far, inspection 6,39-4175 r 13125Swltall Blvd. PLNCK/RECT # CITY 0I! I IGARID 1'0lk'x23397 PERMIT # COMMUNITY 1)LVI';1,O1'MEXI'I)ETARTMP,NT Tipr,,Oregon 97223 (503)63"171 DATE ISSUF_0 JOB ADD`?ESS: `7�I3� S� �`� �►� `� TAX MAP/LOT SUB: LOT: _ LAND USE: VALUATION: �� OWNER SPECIAL_ NOTES < +r Ic REISSUE OF: NAME: �i //C. �� y��/uG )�rl � � � - - ADDRESS: (,yC-6 S(J Ab/b , J " (`'3 _ LAST REISSUE: /!�G►IaAq 60? c77jy Z. FLOOD PLAIN/ PHONE: r9Z L)Y SENSITIVE LAND: CONTRACTOR / APPROVALS REUIRE QD w► qr�c �r ��✓tS�i«c,J JI-, .7 14 _ PLANNING: : NAME ADDRESS: 6Y44LI5 /,I " 7— l' _._ ENGINEERING: `0060- FIRE DEPT: PHONE: 'f2 ---- OTHER: CONTR. BOARD #: EXP DATE: � �, ITEMS_REQUIRED %�' �., SUBCONTRACTORS: PLUMB: 4 L- h�✓k^/�li?� I LIST/SUBCONTRACTORS: MFCH: A - [MQ ��r� - BUS TAX: —._— ARCH/[AGINEL CALCULATIONS: Y _ NAME: 1c %1 ��(< TRUSS DETAILS: ADDRESS: _ OTHER: --_ -- PHONE: _?z> W6l PROPOSED BLDG. USE: ------ COMMENTS: � — --- — — -- zvzz/. , KOPOOMT S GNAT RE / Received By: __ __ Date Received: r PERMIT N ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE j�15f -uit3 10-432 00 Bu Iding Permit Fees Sid'. _ -1-,( �/, _ 10-431 00 Plumbing Permit Fees T 10-431 01 Mechanical Permit Fees �?! 10-230 01 State Building Tax (5%) 3s• Gb' — S �° � Building �_3, 0 Plumbing 7 7� Mechanical 10-433 00 Plans Check Fee Building Plumbing _ Mechanical 10-230 06 Fire >aZy -OLld 30-202 00 Sewer Connection 30-444 00 Sewer Inspection 25-448--02 Commercial TIF Fees 25-448-04 Industrial TIF Fees 25-448-06 Institutional TIF Fees 25-448-03 Office TIF Fees 25-448-01 Residential Traffic Fees 25-448-05 Mass Transit TIF Fees 52-449 00 Parks System Dev Charge (PUC) -5 vv 5"y 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) 24-445-01 Water Quality (Fee in lieu of) 2.4-445-02 Water Quantity (Fee in lieu of) TOTAL - 1�� nn/3587P.WP1- J CITY OFTIGrARD CnYOFTWARD LA-.;.RTiFJLATL UF COMMUNrrY DEVELOPMENT DEPARTMENT MOON 0C.CUPAN(.'.Y 13126 SW HWI Blvd P.O.Box 73397,Tigard.O"Von 97223(SM)639-1175r T(Ji.-I - wl 1010:, . . . . . . . . . . . I CLASS OF' WJRRsNEW .T Yr+-- OF t ISC- - - 0W OC CUE 67PP. iH3 0("CUPANCY LOAD:031 4 110TH I SP11 �)PPTCH CONSTRIXTTON INC. 645 f;hl jqYjlr- R(; I''hl 1 -103 T001-firlN OR 9'7002 "rhrorie 40: srim mRTCH L*W37PUCTION INC, f-455 SW NYBERG LN I - IfA,j l (AlifillIN OR 97061 f-llone Upancy of the abt)vp rpfej,qncerj tpotilciint q -, ?; !;.t -en, And c_qrt ) jjqej the vomplialict? with the State Of Oretloll spqj--- j ,qittv Cocjp!:: f-01- tile tt-q)j.j Alit; ime under wh.tri, I'llp re, forfmcecl j-if2)•mit wqt, itirilp(j. F I RF Of-PI-IP TMENI T yl I f,� POST 114 0*)N,--0-.*,1C.Lj0UG PLACF. DEPARTMENT OF LAND USE&TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 155 NORTH FIRST,,HILL.SBORO,OR 97124 . L 1 COUNTY, INSPECTION REOUFSTS: 503/640-3561/693-4415 PHONE: 503/640-8761 OREGON Pagf 1 (,l L)ate : U4/26/'i:i 'Time 14 : 26 Permit Type Electrical Permit Permit # : U5U3982'/ Permit Status APPRUVEL> Applied 04/26/93 Situs Address 7437 6W AaHr'ORD S'1' 'FI issued 04/26/93 f Permit Title Sr'14 - ONE; C1kCU1'T Completed hermit. Uescr . To Expire 10/23/9.1 Project '.Title Sr'R - ONE CiRC'Uil' Project # NU03W/46 Project Uescr . * ERUS1UN Parcel Number 2S 11,1. - Lend Use District Valuation 0 Legal Descr .. Owner: 1NSPEC.'J'ION - '1'1GAHL? Construction 0'11i Applicant Name RED ' S ELE;CTRiC: CU INC Classification 3Ui1 Applicant Addr . : 2002 SE CL1N'VON Occupancy POWPLAND UR 'J'/202 Validated by _J r' Aj..,piicant Phone : 233-b46'/ Inspector Area (.;(-)N'1'kAC"1'OR : HEWS ELECT. CO. Lir . C l.b-i52( 233-b4b / tee description Units r'ee/Uni.t Ext tee Data 1st branch W/oul Veeder ( Enter # 1 1 3b . 00 35 . 00 Subtotal Electricri_t. r'ees : 0 35 . 00 o t:a t e S u r c h'_f t cg e o t ` 'b 0 1 . 71) Total Electrical r'ees : a 36 . 75 *** r'ee.s PE-quired teesCollected &-Crrdits ------------------------------ ----- Receipt- No . Late Payment 04/Z6/93 36 . '/'� '1'0'1'AL 'PHJ.S DA'JE r'ees : 36 . '/'i At! Iustmerfts : 0() 'Votal Credits : 00 'J'otal r'ees : 36 . '/: '.Total Payments : 36 . 75 balance Due : , 0O NOTICE This permit becomes null and void If the work or construction for which It Is Issued Is not commenced within 180 days. Once construction has started, the permit becomes null and void If construction Is Interrupted for a period of 180 days. I certify that the Information presented by the applicant and fila agent or agents In support of this permit Is Ince and correct to the beat of our knowledge I acknowledge that the Building Department's reliance upon Isles 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 that the granting of a permit does not grant authority to access private property or to use easements I further acknowledge that the use or occupancy of the structure or building permitted depends upon my calling for Inspections at various limes during the process of construction and the building Inspection staff verifying compliance with the various codes Use or occupancy of the building or structure permitted pilot 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 by Ih@ Building Official I further acknowledge that a lien may be placed on the line of the property upon which the permit Is issued specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements APPLICANT'S SIGNATURE WASHINGTON COUNTY ELECTRICAL PERMIT Department of Land Use & Transportation Electrical Inspection Section APPLICATION 155 North First Avenue, #350-12 Hillsboro, Oregon 97124 Information: (503)640-3470 Fax: (503) 693-4412 Project/Permit PRINTPLEASE Number ,�_ 1 Date �Z Please complete all sections, 1 through 5. 4. Complete Fee Schedule below Number of Inspections per perm"allowed y 1. Location of installation Service included: Items Cost(ea.) Sum Address A. Residential- per unit 1 Building City _ Suite No. — 1 000 sq.ft.or leas --- $85.00 ---- 4 Tenant Na Each additional 500" fl or portion thereof ____ $15.00 — (if commercial) — _ _ Limited Energy __— $20.00 __--m 1 '�, �, ,�,,, , (r Each Manufd Hoe or Modular Directions �'I��lh�l. Dwelling Service or Feeder ---- $40.00 ---- 2 B. services or Feeders ristallation,alterations or relocation — — -- -- 200 amps or less _—._ $50.00 --__-- 2 Commercial F] Residential 201 amps to 400 arnpa —__ 360.00 2 401 amps to 601 -v __— $100.00 _. 2 60'. amps to lo0. .rips $130.00 2 2a. Contractor i t flat o 1p/ Over 1000 amps or Vdta -- $300.00 __--- 2 dt• Reconnect only $40.00 ____ 2 Electrical Contractor 1eQ_ Address C. Temporary services &r Feeders Date Job Nu f _ Installation,alteration or relocation Property Owner f'I- ---`- 200 amps or less $40.00 —_----- ? Contractor's License No. ,–/ 201 amps to 400 amps _.-- $5500 ___..._ 2 401 amps to 600 amps $80 00 2 Contractor's Board Reg. No, _ _ over 600 amps to 1000 volts see'R'above Signature of=Supr. Ele ' D. Branch Circuits Flew,alteration or extension per panel License No. S_L hone No. q) The fee for branch circuits with purchsee of so vice or feeder lee 2b. For owner installations: Each branch circuit $2.00 b) The fee for branch circuits withait —- --- ----- - __.. purchase of servky or Iss. lir m iwvnerb deme Phone No First branch circuit $35.00yV 2 —..- - --- - -- Each add'nl branch circuit $2.00 _ 2 AddressE. Miscellaneous (Service or Feeder not included) Zip Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 Signal circulus)or a limited The installation is being made on property 1 own energy panel,alterotion which is not intended for sale, lease or rent. or extension _ _ $4000 —__ 2 Owners Signature F. Each additional inspection over the allowable in any of the above, per inspection 3. Flan Review section (if required) $3500 5, Fees a, A. Enter total of above fees $ _ 5% Surcharge (.05 X total fees) $ • Subtotal $ B. Enter 25% of line A for For inspections call Plan Review if required (Section 3) $ 649-3561 Or 693-4415 Subtotal $ _24-hour recorder,recorder, less Bulk Label Fee one working day in advance of need Balance Due $ - This permit becomes null and void If the work authorized by the perm"Is not commenced w:thin 180 days from date of Issuance of such permit or ft the work authorized Is suspended or abandoned ct any time after work Is commenced for a period of 180 days. Electrical Permits are non-refundable and non transferable 10/91 a > _o a V N G9 V -• O � O O O J ; IT MPV n N3 v a ° -70 Q y rb (D Z G. a d o� � a tJ fit n e ..j IT a O to to to vAi ryn to fn to r to to n to to r1a A c is n �s a 'o -o to ;O J a ti '��p N N 1 7 G r n C. J � 3 � cn V) n vii vii vii vii v�, a a a > > O O J J J J J J J J 1 d W et rf�0 F b 7 � b 5' co 91 o' 0 d m .. n I V m r A N ,J NO z z z z 0 0 0 0 o Q o 0 N CA 1 r. �* A a C) Z d A H R > � J ca < lin C