12260 SW GLACIER LILY CIRCLE s•
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DEPARTMENT OF LAND USE&TRANSPORTATION
WASHNGTON LAND DEVELOPMENT SERVICES DIWSION
155 NORTH FIRST,HILLSBORO,04 97124
COUNTY, INSPECTION REQUESTS: 503/640.3561/693-4415 r
...� PHONE: 503/648-8761
OREGON Page 1 of 1
Date Ub/'26/94 !
'Time 15 : ?b
vexmit 'Type Lleside tial Electrical Permit Permit # UbObJ873
Permit btatus APPROVED Applied Ob/26/94
51tus Address 1ZZ60 SW GLACIER LILY Cl 'l'1 Issued Ob/Z6/94
Permit 'Title bFR - ELEC/UNE CIHCUl'1' Completed
Permit UeE—r. '1'o Expire : 11/'ZZ/94
Project 1'itle St''k - ELEC/UNE CIPCUl'1' Project # P0040862
Project Descr . : >r EROSION * �
• i�
rarc:el Number 251'1'1 - Lund Use District
Valuation
regal Uescr .. 46
Owner INSPECTION - '''1GA11D C:onstr•_•ction U'1'H
Applicant Name PAHK1N ELEC'1'Ri(- Classification SUU
Applicant Addr . : ZUZbO S MULALLA AVE Occupa.acy R3
OREGON C.L'1'Y 014 97045 Validated by K�'
Applicant Phone : bb'/-4968 Inspector Area
CON'TRAC'1'UH : PAL�.KIN ELECT. INC. L1.c . C 34-4C 246-1301
1 Fee description Units 1'ee/Unit Ext Lee Data
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1st branch Wiout Feeder. [Enter # J 1. 36 . 00 3b . 00
Subtotal Electrical Nees : 36 . 00
state Surcharge of b% 1 . 75
Total Electrical r'ees : 36 . 75
*** Nees Required *** *** E'ees Collected & Credits *frrr
Method Check # Receipt No . Date Payment
CK 464 U5/Z6/94 36 . 7b
l'OTAL 'THIS DA'Z'E *******rr* 36 . '/b
ees : 36 . '/b
Ad ILLStments : 00 'Total Credits ., . 00
Total Fees : 36 . '/b 'Total Payments : J6 . '/b
Balance Due: UU
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NOTICk5: This permit becomes null and void It the w••rk or construction for which It Is Issued Is not commenced within 160 days. Once construction h^s started,
the permit becomes null and void If construc.'on Is Interrupted for a period of 180 days. I certify that the Information presented by the appll.00al and
his agent or agents In support of this permit Is true and correct to the test of our knowledge. I acknowledge that the B.iliding Department's reliance
upon false and misleading Information may Invalidate this perm". All provisions of applicable lawn 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 acknowl edge that
the granting of a permit does not grant authority to accost private property or to use essementu. I further acknowledge thtt'he use or oc.upancy of
the structure or hullding permitted depends upon my calling for Inspo tions at various times during the process of const L:c Ion si.a the'hullding
Inspection staff verifying compliance with the vrrious codes. Use or occupancy of the building or structure permlttod p;lor b approval t the
Building Department Is solely at the risk of the applicant and such use or occupancy is revocable until all ln,pectlon relukamenis are tatlsfied and
approval Is given by the Building Official. I further acknowledge that a lien may be placed on the title of the property um-fn wtilch the permlt Is Issued
specifying that the us, nr occupancy of the building or structure Is provisional and revocable tmtll Ito@ satisfaction of all inspection requirements.
APNLICANT'S SIGNATURE _
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WASHINGTON COUNTY
Department of Land Use & Transportation ELECTRICAL PER1111IT
Electrical Inspection Section t
15 alortH5 l book Oregon t v 97124 359-12 APPLICATION ; r
Information: (503)640,74'0 Fax: (503) 693-4412
Project/Permit
Number ,�� Date /
Please
sections, 4. Coml)lete Fee Schedule below
1. Locatio o i s a lation 1 e Number of Inspections per permit allowed
Address _ I �Z 5lV C•�j r r Service included: Items Cost(ea.) Sum
C� Building A. Residential- per unit 4
c�ty� suite Vol. ,
1000 sq.ft or less _ $110.00 4 1
Tenant Namb Each additional 500 sq.ft
(if commercial) or portion thereof $25.00
Limited Energy $25 X — 1
Tax Lot _ Map No, Each Manurd Home or Modular
ThorTlas Map Book: Page:_ Section:_.__.___ Dwelling Service or Feeder $68.00 2
Directions._._... ._____.__ ------ B. Services or Feeders
Installation,alteraticns or relocation
r- 200 amps or less $60.00 —
Commercial I- Residential 201 amps to 400 amps __— $80.00 2 '
401 amps to 600 amps ___ $120.00 2
2a. Contractor installation onlv: 601 amps to 1000 amps ---_ $180.00 2
Ovcr 1000 amps or volts _____ $340.00 2
Electrical Contractor_ _ Reconnect only —_ $50.00 --- —
Address _ PARKIN ELL.jrllC. INC.
to Job Nurnba0250 S. MOLhLLA AVENUE C. Temporary Services c. Feeders
Property Owner=r CiUGON-CIM,M-97C45 im;tallation,alteration or relocation l
Contractor's License No - C -1 200 amps or less $50.00 _i 2
Contractor's Board ,"Ieg. No. _ �' ?01 amps to 400 amps $75.00 _ 2
—' 401 amps to 600 amps $100.00 2
Signature of
Over 600 amps to 1000 volts see W above
License No. ,r EI 'n_ Phone No. D. Branch Circuits
Idew,alteration or extension per panel
2b. For owner installations: n) The fee for branch circuits with C
purchasA of service or feeder fee. T.
'print Owner's Name T' Phone No. Each branch circuit `_ $5.00 ___ 2 '.
b) The fee for branch circuits without _
Address -- purchase of service or feeder fee.
First branch circuit —I__ $35.00 2
i — Slate Zip Each add'nl branch circuit $5,00 2
E. Miscellaneous (Service or Feeder not included)
The installation is being made on property I own Each pump or irrigation circle $4J.00 2
which is not intended for sale, lease or refit. Each sign or outline lighting $40.00 _ 2
Signet circuits)or a limited
Owner's Signrture _ _ —_�._.. energy panel,alteration
or extension $4000 __ 2 I
F. Each additional inspection over fl-e allowable I �
in any of the af.,u:re
3. Plan Review section (if required) Per insp.ction $35.00
Please check appropriate Item and enter fee In sc.:tlon 58. Per hour _�_ $55.00 _
In Plant $55.00
m 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 fees
___Classified are,,or structure containing special 50o Surcharge (05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $
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Submit 2 sets of plans with application where any of the B. Enter 25% of line A for
Pian Review if required (Section 3) $
above apply. Not required for temporary construction $Subtotal services.
Less Bulk Label FPP $ _
Balance hue $ ��(r r
Fir inspections call This permit becomes null and void H the wcr:authorized by the,wrmsf:.not commenced
640-3561 or 693-4415 within 190 days from date of lesuanc,of such permit or It the work r Ahorized Is
f auapende� or abandoned at any time after work Is coce
mmand for a period of IPM days.
24-hour recorder, one worKog day in advance of need Electrical Permits are non relundebla and non-transferable.
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