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11887 SW ASPEN RIDGE DR
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11887 SHASPEN RIDGE DR
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspect;n Line: 639-4175 P,u;incss Phone: k)39-4171
Date Requested: _ _ lo q c A M. _ P.M MST:
Location: . �_ ;�� �. BUP:
Tenant 1 _ _ Suite:_ _Bldg: NEC:
Contractor: � _._�_.•_ _ Phone:
_ PLM:
O ncr:__:.
Phone: —_ ELC:
ELR:
IT• _
BUILDING BLDG(con't) PLUMBING MECHANICAL I, LECTRICAL SITE
SIC Post/Beam Post/Beam Post/Beam Cov�ervrce Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Farming Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer flood/Duct Reconnect Vault
Bsmt Damp I)rywall Storm Furnace Temp Servire MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spkir/Alm Crawl/Found IN Pleat Pump Low Volt
Approved Approved ApprovedApproved Approved
Appr/Sdwlk Not Approved Not ApproviA Not Approved ved Not Approved
FINAL FINAL FINAL FINAL. FINAL
1 Call for reinspection inspection fee of S _reyui before text inspection l)nable to inspect
4 xxtor: r� '•
In I _ _�._ Datc .`tG' 7— Page-----of --
CITY OF TIGARD �
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: EL_C97-: 308
13125 SW HaV Blvd,, Tigard,OR 97223 (503)639.4171 DATE ISSUED: 05/x_7/97
PARCEL: 2S 1 t OBD-05900
1_;1 TE ADDRESS. . . : 11887 SW ASPEN RIDGE DR
13UBDIVISION. . . . :ASPEN RIDGE ZONING: R-4. 5,
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :026 JURISDICTION: TIG
F'ro j ect De scr-i pt i on: instl 1 branch circuit // .job f ?
---.-RESIDENTIAL UNIT--•___.._. _-_JEIhF' SRVC/FEEDF_Rc--•-- -- ---hiISCELLANEIlUS----
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . .- 0
EACH ADD" L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/C)UT LINE {-`►'3. . : 0
L_ IMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL_/PANEL. . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
------F'_RVICE/FEEDER-- -_._ ---_-BRgNCH CIRCUITS--- -.-_ -___ADD' I- INSPECTIONS--
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEE:10r R: 0 F'ER INSPECTION• . . . . : 0
201 - 400 amp. . . . . . 0 1st W/C' SRVC i3R `DR. : 1. F'ER IAOUR. . . . . . . . . . . 0
401 600 amF.. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . 0-
Fol - 1.000 amp. . . . . : 0 ----- - -------- -- -FLAN REVIEW
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > _ 225 AMT'S. . : CLASS AREA/SPEC OCC. :
Owner-: - - -- ---- - - _._..__.__---__._______-------- _._--__-•-- FEES ----------------._
OUI-BUT type amai_tnt by date recpt
11887 SW ASPEN RIC..,E PRMT $ 3`x. 00 TAT 05/2'7/97 97-29510£1
TIGARD OR 97224 5PCT t 1. 75 'TAT 05/'27/97 97-295108
1='hone #:
Contt-act or --___. _.---------------.____--------------•--•-----. ___._____-_._.. ..._
JF'C ELECTRICAL SERVICES INC $ 36. 75 TOTAL
4040 SE INTERNATIONAL WAY
-- -- --- REQUIRED 1 NSF' :CT TONS - --
MILWAUKIF OR 97222 Ceiling Covet, Under-gr,oi_tnd Cove
Phone #: 654--3325 Wali Cover Elect' l Ser-vice
Reg #. . : 000937
Thi-, permit is issued subject to the regulations contained in the .
Tigard Municipal Code, Stare of Lire. Specialty Codes and all other Term • ttes Fignwturr"
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within IN days of issuance, or if work is suspended for more _ /�
_._
than IN days. I s s Lied By
_.__.-----•---____._---..___--______.OWNER INSTALLATION ONLY-----� ----------------- --- _.
The installation is being made on proper^ty I own which is not intended for-
sale, lease, or rent.
OWNER' S SIGNATURE: —__-- DATE:
--- -- - CONTRACTOR INSTALLAT (ON
SIGNATURE OF SUPR. ELEC' N: Ly�2 � >!��^ __— _ DATE: C' Z17-
LICENSE
_L_ICENSE NO:
Call for inspection 6319--4175
Community Development ELECTRICAL PERMIT APPLICATION
I[ 13125 SW Hall Blvd.
Tigard, CR 97223 Planck/Ric. #
Permit #
4OFTIGAIRD
Phone (503) 639-4171 Date IssuedFAX (503! 684-7297 Issued by � ----
TDD No. (503) 684-2772
Inspection (503) 639-4175
Job Address: 4 Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
TV-1
,-
Address �] `�V� 1 5 k,r Q fieri IZt d I Service included Items Cost(ea) Sum
City/State/Zip__T 0
P, ��y 4s. Residential• per unit
e�
1000 s,t it or leas $11000
r7 Foch additional 500 eq if or
t
Name (or name of business)---c)u i Dkl ponronthereof $2500
Limited Energy $2500
Commercial❑ Residential CR Each Manul'd Home or Modular
Dwelling Service or Feeder fee 00
2a. Contractor installation only: 4b.Services or Feeders
Instnllation.alieralron.or relocation 2
Electrical ontractor-sP G k. l e(jr l C u l 5 r✓. 200 amps or less fee 00 2
U T WCtM 54✓ A w 201 amps to 400 amps fee 00 2
Addresss'�T 5.E. -1 rl 4e✓n a-4+uyw 401 amps to 600 stripe $12000
City 1 r t' r W G L4 f:t fr' State U 2 Zlp c) 1 -j,z, 3 601 amps to 1000 amps $18000 _ _ 2
Phone N0. (n.. y - 33.1 S Over 1000 affirm or volts 134000 2
Contractor's License No. 3 q- 3 1,;l C- Reconnect only $5000
Contractor's Board Reg. No. 0 9 3 7 -)14 �. 4c.Temporary Servires or Feeders
Installation,afleration.or relocation `
Sigrature of Supr. Elec'n �_, ' 200 amps or less $75 oa s
'o I �-- " p� 201 amps to 400 amps 175 00
License No.__�_ .ne No. (o 5'l -33 a S .. 401 amps to 600 amps �— $10000
Over 600 amps to 1000 volts
2b. For owner Installations: 1111, 1X19 see•b*above
4d.Branch Circuits
Print Owner's Name _ ___. — _ New alteration or extension per panel
Address `_ _ a)The fee for branch circuits with
pul"han or rtwvke or b-der tb.
City State__._ Zip_ -. Eadt branch circuit $600
Phone No. b)The lee for branch circuits without
urcP+N of"tyke or boder tee. . 2
The installation is being made on property I own which is p,m,branch citcurl �— $35.00 3 a� y U 2
not intended for sale, lease or rent. Each additional brand,circuit $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
Each pump or imgahon cirds $4000
2
3. Plan Review section (if required): Each sign or outhre lighting 140 00 _
Signal cimult(s)or a limited energy 2
Please check appropriate item and enter fee in section 58. panel,sheration or extension $4000
4 or more residential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more 41. Each additional Inspection over
_ System over 600 volts nominal
Classified area or structure containing Special occupancy the allowable in any of the above
.�_ Per nepection 135 00
as described in N E C Chapter.5 Per hoar $5500 _
In Plant $5500
Submit 2 sets of plans with application where any of the abor a
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ UCi
NOTICE 5%Surcharge(.05 X total tees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Sublofal $
AUTHORIZED IS NOT CC!IMENCED WITHIN 160 DAYS, OR IF Sb.Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 160 DAYS AT ANY TIME AFTER WORK IS S;ibtotol $ -------
COMMENCED. CJ Trust Account# $ _v
Balance Due $
(.1%ki' IFICATE OF
CITY OF T I GARD PEFM!T #. COCUPANCY
. . . . . . : MST95-- 0114
COMMUNI"Y DEVELOPMENT DEPARTMENT DATE Tg:.,UED: 02/21/96
13125 SW Hall i;lvd.Tigard,Oregon 97223*8199 (503)639-4171
PARCELli 2S 1 10F1D---01p900
91 TE. ADDRESS. . . : 11887 SW ASPEN PIDGE DFt
SUBL)I V T i�ION. . . . 2 ASPEN RIDGE Z019 I NG i R--4. 5-
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . .
CLASS OF WOR,',. NEW
TYPE OF USE. . . S)F
OCCUPANCY ORF'.`` 4fl�
OCCUPANCY LOAD-.2
1'renjarkss PATH I
THE Or:PEN GROUP
Qhone #t 297--3644
Contractor:ontractort
1..HAR"rE',n 1JOME.G3
1070t, SW 152RO PL
3FAVEPTON OR 97007
Phone #: 879--W0
!leg 0. . : 64938
This Certificate grants oci:k.1pancy of the above V`Pfet'enf-.VC1 bUildiny (W portion
1:hereof and confirms that the bl.tilding hath been inspected for compliance with
I:he State of Orep n FiperialtV Codes for the grol..ip, OCCLIpanCy, and USP Undet'
t-jhich the refernnQed permit was issued.
( L kOF'F'ICIAL.
J) D I4G I�pECTOI BUII-DIN
POST IN CONSPICUOUS) PLAUE.
MASTER PERMIT
C11Y � TIGARD
P[RMIT #. . . . . . . :DATE ISSUED: 04/03/95
COMMUNITY DEVELOPMENT DEPARTMENT
/31xsuwHall Blvd.Tigard,Oregon 9722398199 (503)639-4171 PARCEL : 2S1 10BD-059N0
4bDkLb8 / W A5PB� R16L bR
SUBClVI5ICN. . . . : ASPEN RIDGE ZONING: R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :N26
-------------------------------- BUILDING
RETSSUE: DWELL DWELLING UNITS: 1 BASEMENT. . . . . . . . :N sr
CLASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . :809 s/
TYPE OF USE. . . :SF FLOOR AREAG-------- -- REQUIRED SETBACKS------
TYPE OF CONST. :5N FIRST. . . . : 15N9 sf LEFT. . x20 ft RIGHT. : 13 f |
OCCUPANCY GRP R3 SECOND 1824 Sf FRONT c-.6 ft REAR -0 t /
PLUMBING
WATER CLOGETS. . :3 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 10171 OTHER FIXTURES. . . . . .lb
MECHANICAL. FEES
MAX TNPUT:0 FTU VENT FANS.. . :4 SWM `11 1130. 00 TDCA 1214/03/93
GAS OUTLETS: 1 PARK $ 500. 00 IDA 04/1213/95
rHE ASPEN GROUP
M5PC $ 2 25 JJA 04/03/95
� ~.m"e #; 297-3844 E Ru' $ uu wm Ju* 04/0 /9z
_-' - - --A 04/03/95
�:H',n / LHunE5 uRv17 $ C-TAm JDA 0+/03/y5
� 1&705 SW i�_3RD PL
3EPVE.1�1'011\1 ON 97007
Phone #: 579-0216
4065. 56 TOTAL
This permit is issued subject to the regulations containild in the — REPUIRE-1) TNSPECTI0Nzr)'
%gard Municipal Code, State of Ore. Specialty Codes and all other Footing Insp PIl-mb Top Ol.tt
applicable laws. A:: kark will be done in accordance with !ppro!)d Fni.inclat ion Insp Framing Insp
plans. This pervit will expire if murk. is not started within 'lost /Peam Str-Lt"Lt Fii-eplace Insp
days of iss-jance, or if work is sus nded f r mo 811. S, st/Peam Mechan Gas Line Tnsp
� |
-- _ -
SEWER CONNECTION
CITY OF TIGARD PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . . G W R c.)I- 0 1—,3
13125 SW Hall Blvd.TigaFd,Oregon g7223*81QQ,_450q)j6;%41l71 DATE ISSUED. 12�4/03/95
PARCEL. ES11ODD-1215900
SITE ADDRESS. . . : 11867 SW ASPEN RIDGE DR
SUBDIVISION. . . . : ASPEN RIDGE ZONING: R-4. 5
Remarks : PATH I
jWne)-: FEES
PRMT $ 2200. 00 JDA 04/03/95
� '
CONTRACTOR NOT ON FILE'.
�
2235. 00 TOTAL
Reg
------- REQUIRED INSPECTIONS
This Applicant Appl`cant uUr ,, to comply w±h all the 'vlos and regulations Sewer Inspection
,f the Unified Sewage A]»nc The po,wd expires 180 days h^ow
the date issued. The total =~ ',�,t pad will be forfeited if th,
nmwit expires. Th, Agency does not guarantee the accuracy of toe -------------------side sewer ewvr latemlv. If the awo" /s not located at the meam,pmont
gi,qn/ the installer shall p,osoort ] feet in all directions frow
th^ distance given. If not so located, the installer h ll '
^ ''rap and Side Sewer"
� —��------------- '--'----'-------
/'ermittee S —�---------------- -----'-------'-----
T7supd By :
L� Call ;nr inspect ion — 639-4175
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
1 OrYf L �� G�sp... •+�R -
(503) 639-4171 1 (-`141/
Jobsite Address:�/ �"7_ S) -
Office Use Om
Aubdlvlsion: Z f?, , •-e Lot#
v Planck/Rec #
Valuation: G �y
1,1 1-0
N Permit #177
7t
Corner Lot?
/`� Reissue of
Flag Lot? Y rte'
Map & Tl. # G 152 1O('1
Owner: f� t t At va� )e, Approvals Required
Address: _ Planning
Engineering Y
Phone: Z `�_� — - Other
Contractor: to Items Required
Address;: y .5 S t.v r_� ._
1 �z I S 3 �• -�' Subcontractors
13 t4 R rte- __ Truss Details
11,1011e: ___q2_9 -- OCOther --
Contractor's License # Z y 1 3
(attach copy of current Oregon license)
Contact N2me & Phone: A-)I lbL4-
Te,
; r,.,,rliY
SLbcontractors: ,/$�" �! Architect/Engineer: c/•--
� ler
Y /L•-PO.L 6,`-- Address:
Mechanical: Jr
(attach copy of current OR Contractor's Lice e)
Phone: � -12-5 9
JOB DESCRIPTION: _ 1
p icant Signature & hone numher
Received by: _ �� Date Received.
N 1WORUCOMOEV\RESAPP
J
Permit# Account Description Amount Amt. Pd. Bal. Due
U/ z Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) ..2 2 •�J �/
Mech. Permit (MECH) q
State Tax (TAX) S / Y 2� ,
Bldg: 7 Y
Plumb:
Mech: 2 Z >
Plan Check (PLANCK) ,So Z•3 3 C-
Bldg: / U 95
Plumb:
Mech:
3 S Sewef Connection (SWUSA) �:�y� 1 2-
Sewer
Sewer Inspection (SWINSP) 3 )/ _
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL.)
Water Quar.0ty (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT) �
Erosion Planck/USA (ERPLAN)
Erasion Planck/COT (EROSN)
TOTALS. G1 9
2289A
ORIGINAL 6Y
CHARTER HOMES
CITY OF TIGARD
ASPEN MIDGE
LOT 26
1,5J4 SO. fT
12' PRIVATE ACCESS AND
PRIVATE UTILITY EASEMENT
51'_0=. ------ ,
5g.-2•--- --- — 380
IS� 390' S 96'40'58'
.. or—..= — 1 .86'
/ rn 383'
OR1VEWAY
xi
l13500 pSll. /
N _ — =: i__ � _ e
J
GARAGE /
s -MAIN FL00g-.1
380 ::• EL.■363.0` ....... ?U `�-
1 76•
;I . w
O
O
' ' X76• ,.
CONTOURS
Go ,......
Z 376 I fXfS/1VC GRAAE
-—- (2' NV7£RYN.5) �.
(2'WIC171ALti1 ``
REGRW
� . . ' WSW am'-
C� �.
(RF.GRN.IED pmwm YJ K
0000
/ 370' P
03/17/95 MRR
dW •
370 / 5'
Jam_ /i
�J II
tan nAICORD Df 10n a / 10C1AICf Inc
05 NW. 18TH AVENUE. PORTLAND. OREGON 97209 (503) 225-9161 S C A L E 1 ' 2 0 ' - 0
I
;`,.UMB I NG P[-;'RM I T
#. . . . . . : I)5-014'.
CITY OF T I GARD DATEPEnmii"ISSUED: . 04/0MST5
3/9
COMMUNITY DEVELOPMENT DEPARTMENT
113125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)639-4171 PARCEL: 25 1 .1 ODD-05'j-00
3ITE
1- 1)6 L 1)R
P'L J�
Q
fA 1)D R L 5. . . 1 160 i `�W I'--i
:SUBDIVISION. . . . : ASPEN RIDGE ZONING: R-4. 5
BLOCK. . . . . . . . . . . L OT. . . . . . . . . . . . . :0.21G
CL AS S •OF WORK. . :NEW ("ARBAG)E DISPOSALS. . : 1
TYPE OF USE. . . . :Sr WASHING MACH. . . . . . . : I BACKFLOW PREvNTRS. . : I
OCCUPANCY GRP. . :R3 Fi-oorR DRAirir:). . . . . . . 0 T rR Ap,,.3. . . . . . . . . . . . . . :0
WATER HEATERS. . . . . . . 1
STORIES. . . . . . . . .2 CATCH LAASINS. . . . . . . :0
LAUNDRY TRAYS. . . . . . : 1 �:F PAIN DRAINS. . . . . : 1
3F-'93. . . . . . .INKS. . . . . . . . . . : 1 GREASE TRA
LAVqTOR I ES. . . . .. :4 OTHER FIXTURES. . . . . :0
r'UB/SHOWERS. . . . : SFWEr? LINE ( ft ) . . . . :0
WATER CLOSETS. . :3 WATEP I...INI:-- (ft ) . . - - -' 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks : PATH I
OWNEP:
THE ASPEN GROUP TIF $ 15501. 171171 JDA 04/03/95
SWM $ 180. 00 JDA 04/03/95
SWM 100. 00 JDA 04/03/95
PPRT 6 755. 50 IDA 04/03/95
2/27/95 95-26L264
Phone .97-3844 EAPLL $ 50 �.2* 33 JD
B5PC $ 37. 78 JDA 0.4/03/95
r:'] ..�M I)i T-)y C 0 11 t VaRC L C)1 500. 00 JDA (714/03/95
MPRT $ 45. 00 JDA 04/03/95
Name : MPLC $ .1 1. 75 JDA 04/03/95
2. 25 JDA V44/03/95
(�ddress :
M5PC $
C i t a G 3t gat e e7AO 313TH $ 225. 00 IDA Q64/03/95
Z i P: hone � l P5PC $ 11, 25 JDA 04/03/95P . r
Reg Acid i t ional fees not shown here. . . . . . . . .
REQUIRED INSPECTIONS
This psr-mit is issued subject to the reg-
ulations
-egulations contained in the Tigard Municipal Footing InsInsulation Ins[,
( ode, State of Ore. `:)pecialty Codes and ;.All Foundation In F) Gyp Board Insp
other applicable laws. All work will be done Post /Beam Stroct Rain drain Insp
in acco-f,dance with approved plan,.,. This, Post /Beam 1,19chan Water Line Insp
permit will expire if work is not started Crawl Drain Water Set-vice In
within 180 days of itS'AaTICe, Or if WCit-k j 5 F11m/umdslal-_, Insp Appr/'.')dw1k Insp
suspended for- mor-P than 160 days. PLM/Underfloor Mechanical Fi —I
Mechanical Insp Plumb Final
Plumb Top Out Building Final
Framing Insp Erosion Control
Fireplare Insp
X Gas Line Iqsp
C
t I �C—i-1 Eon rac or, Signature
A 1-1 1 z mbing
Call for inspection - 639-4175
r:.()ntractor
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): 503/540••3561 or 693-4415
pwrmit * . 05U61• Fez ,ect II P(!ri`. i}d'7:?
APO.ied 0rS/24/�0r, ir,vUowd {}S124
Fermat Title SFR ELLC./NEW HOU:',E
Jc,k A$dt E 11887 £,W Ac,PEN 1111)GE 144 '"t
CeWr'iex• Ndtnk TNePEC.TION - TIGARD
ApI;i i rant Narne NORTH 'VALLEY ELEC:TI4I C'
Ph..ne rrttrntic r 982-591.6 gra i u yt a; ti F, I rc,v.-
IrE.pei+r't:.>r C' ;rranrr:t:. Pe)e<.t.O'1 _,__... ..
WR-RESULT:
,
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON
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
his agent or agents In support of this permit Is true and correct to the best of our knowiedgr. I acknowledge that the Building Department's reliance
upon Was and misleading Information may invalidate this permit. All provisions of applicable laws and ordinances governing the constrirtion and use
of this building or structure will be complied with whether or riot specified on the plans or noted on the plens correction sheets I icknnwledge that
the granting of a permit does not grant avthority 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 varlo•!s times during the process of construction and the building
Inspoction staff verifying compliance w'th the varlovs codes Use or occupancy of the building or.!ructure permitted prior to approval by the
Building Department Is solely at the rirk of the applicant and— :h use or occupancy is revocable until all inspection requirements are satisfied and
approval Is given by the Rullding Otflr,lal. I further ackn,wledge that a lien may be placed on the title of the property upon which the permit Is issued
specifying that the use or occupancy of the huliding or stricture is proviaio res and revocable until the satisfaction of all Inspection requirements
APPLICANT'S ilO ATURF- a
WASHINGTON COUNTYELECTRICAL PERMIT
Department of LanddUse & Transportation
Electrical llnspection Section
155 North First Av cr.tte, /t350-12 APPLICATION
Hillsboro, Oregon cl
Information: (503) 640-347C, Fax: (503) 693-4412 /`� �(
Permit �V Date 15_;q_
; r r)�~
PLEASE PRINT Number
Please complete A/ sections, 1 through 5.
4. Complete Fee Schedule below
1. Location of installs lon nn Number of Inspections per permit allovied
Address_�1 ;i. u' . i X rt, Service included: Items Cost(ea.) Sum
Y Bu Iding
City �Ite No. A. Residential-per unit
� r L _
1000 sq.If.or less $110.00 I l�0 4
Tenant rc e
(if commercial) sq.Each additional 500 It
-- — — or portion thereof �_ $2500
Limited Energy __ $25.00 �_—_ 1
Map No._—.— Tax Lot Each Manurd Homo or Modular
Dwelling Service or Feeder $68.00 _ 2
Thomas Map Book: Page:__ Lc�S Section:.
Directions i,,�,*ti d44_-�.„_l/�_]�_ B. Services or Feeders
— ---- Installation,alterations or relocation
CommercialI 200 amps or less $60,00 — 2
Residential I 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 -- $180.00 - 2
Y Over 1000
. ampss or volts $340,00 2
K TElectrical Contractor � � 1erkc Reconnect
only _.-_--- $5000 _--_ --• 2
Address U L c'� A3,.2- __
City ?( Uk- State C)L1 Z!P17o:LL C. Temporarl,Services or Feeders
DateJob Number _ Installation,alteration or relocation
Property Owner (_AA tk4e pc 200 amps or less —_— $5000
Contractor's License No. , 201 amps to 400 amps $7500 _ 2
Contractor's Board Rey. No. .3 Cd ao1 amps to soo amps �__ $100.00 _ 2
r Over 600 amps to 1000 volts see'B'above
Signature of Supr. Elec'n �� , � , Branch Circuits
License No. L -Phone No 5 / New,alteration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder fee.
Each branch circuit $5,00 2
hrinl ner s arae --- one�3n' — b) The fee for branch circuits wirhout
purchase of service or feeder fee.
Address First brar h circuit $3500 ?
_ Each adv i branch circuit $5.00 2
qty Mate- --- - E. Mlscelh lous (Service or Feeder not included)
Each pump 1 rigation circle $4000 2
The installation is being made on property I own Each sign or outline lighting $40.00 _ 2
which is not intended for sale, lease or rent. Signal clrcuit(s)or a limited
energy panel,alteration
Owner, Signature _-- -- ------_---s-- -- 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
Per hour _ $55 CXJ _
Please check appropriate hem and enter fee It,section 5B. In Plant �- $5500
_4 or more residential units in one structure
_Service and feeder, 800 amps or more J• Fees
—System over 600 volts nominal A. Enter total of above fees $
—Classified area or structure containing special 5% Surcharge (.05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $ _21-6-2--
B.
to " —
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if requil?d (Section 3) $
above apply. Not required for temporary construction Subtotal $
services. Trust Account $
Balance Due $ :� l< '
For inspections call
This permit becomes null end vold if the work authorized by the permit is not co,nmancad
640-3561 or 693-4415
within 180 days from data of issuance of such permit or if the work usithorized Is
%
spended or abandoned at any time*tier work is commenced for•period of 180 day►
24-hour recorder, one working day in advance of need ElectricalPermitsaranon-refundablsand non-lransferabts.
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