12156 SW GARDEN PLACE �' �pa,aRy4M'�"� Mw,WMhevM'I'"hF�„ rr� -.We;m w.wt«rr
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DEPARTMENT OF LAND USE&TRANSPORTATION Ir
WASHINGTONLAND DEVELOPMENT SERVICES DIVISION
15'i NORTH FIRST,HILLSBORO,OR 4;7124
COUNTY,
INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON xxxxxxxxx---> 640-34'/0
Page : 1 of 1
Date : 04/04/96
Time . 13 : 46
Permit Type : Commercial Electrical Permit Permit # : ObU65965
Permit Status APPROVED Applied . 04/04/96
Situs Address 1215b SW GARUEN ''L 'I'I issued : 04/04/96
Permit 'l'itle ADVANCED DIGITAL IMAGING - LV Completed :
Permit llescr. JUEi 509-5199 'To Expire : 10/01/96
Project # : P0018881
Project 'Title ADVANCED DIG1'PAL 1MAGING - LV J
EROSIUN
Project llescr . JUH 609-5199
Parcel Number 251'1'1 -
Land Use District
Valuation 0
Legal llescr .
e Construction O1'H
Uwner lNEPECT1UN - '1'1GARll
,f
Applican,: Name CHRls'1'ENSON ELEC'i'R1C Classification 900
Applicant Addr. : ill SW COLUMBIA, SUITE 480 occupancy
PORTLAND, OR 9'/201--588b Validated by PH
Applicant Phone : 241-4812 lnspector Area
F ry.
Fee description Units r'ee/Unit Ext fee Data
-- -----------------------------------------•----------------------------------
'` Limited Energy/Alter ./Extension 1 40 . U0 401 . 00 r;
Sut,total Electrical Fees : 40 . 00
State Surcharge of b`b 2 . UU
'Votal Electrical E'ees : 42 . 00
*** Nees Required * ** *** tees Collected 6 Credits ***
.--.----.------------------------- -----— ---------------------------- ----------
Method
--------.— -------Method Check # Receipt No. Date Payment '
. CK 63649 04/04/96 42 , 00
TOTAL THIb LWEE ********* 42 . UU
Fees : 42 . 00
.a. Adjustments : . 00 'Total Credits : . 00
Total Fees : 42 . UU 'Total Payments , 42 . 00
balance Due : . l�U
i
NOTICE: This permbecomes null and vold If the work or construction for which It Is Issued is not commenced within 180 days. Once construction hes started,
the permit becomes null and vold 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 heat of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permlt. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will be compiled with whether or not speclfiet:on the plans or noted on the pians 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 tines during the process of construction and the building
Inspection staff�arifying compliance with the various codes. Use or oecupanry of the ouilding or structure permitted prior to approval by the
Building Department Is solely at the Isk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval In given by the Building Official. I further acknowledge that a Ilan may be placed on the title 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 requiremonra.
APPLICANT'S SIGNATURE
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X11
WASHINGTONCOUNTY ELECTRICAL PERMIT
Departmentmentofof Land U:;e & Transportation 4
Electrical Inspection Section APPLICATION
d
155 North First Avenue, #350-12 !
Hillsboro, Oregon 97124 `
Information: (503) 640-3470 Fax: (503) 693-4412
Permit �� L
r -l-S~lh
PLta PRINT
Number Date
• • 4. Complete Fee Schedule below
Number of Inspections per permit allowed
1. Location of installation
Address 1.2156 SW GARDEN PLACE Service included: Items Cost(ea.) Sum
,
Buildingg A. Residential-per unit
City TIGARD 97223Suite No._
1000 sq.ft.or less $110.00 4
Tenant NameEach additional 500 sq.ft
(if commercial) ADVANCED DIGITAL IMAGING or portion lhereM $25.00 -�
Limited Energy $25.00 1
Map No.- Tax Lot Each Manuf'd Home or Modular
Dwelling Service or Feeder - $68.00 2 1 4
Thomas Map Book: Page: Section:
1
Directions_ - B. Services or Feeders r
IN OFFICE CONTACT AT CE WAYNE GRI ESENAUE"t Installation,alterations or relocation
200 amps or less $60.00 2
Commercial L a. Residential❑ 201 amps to 4n0 amps $80.00 2
401 nmps to 600 amps -_-- $120.00 2 1
601 amps to 1000 amps $140.00 - 2
2a. Contractor installation on
Over 1 L, amps or voltP $340,00 2
Electrical Contractor CHRISTENSON F1,EC RIC ING Reconnect only _- $50.00 -- 2
Address 111 SW CO B ,5
City_ POR ND State OR ZIP 79 201-5886 C. Temporary Services or Feeders
Date_ 4/3/95 Job Number 50 -5199 Installation,alteration or relocation
Property Owner -- _ 200 amps or legs `_ $50.00 _ 2
26 34 C 201 amps to 400 amps $75.00 2
Contractor's License No. - 401 amps to 600 amps $100.00 �_- 2
Contractor's Board Reg. No. L1CL15R -� Over 600 amps to 1000 volts see•B'above
Signature of Supr. D. Branch Circuits
License No. Phone No. _- :812 New,alteration or extension per panel
a) The fee for branch circuits with
1 2b. For owner installations: purchase of service or feeder fee.
Each branch circuit $5.00 2
b) The fee for branch circuits without
not ner s TTame Phone No. purchase of service or feeder fee.
i __ First branch circuit $35.00 -�
i1 ess rFach add'nl branch circuit $5.00 2
I vry .stat-�-e- p E. Miscellaneous (Service or Feeder not included a
Each pump or iWgation circle $40,00 _- 2
The installation is being made on property 1 own Each sign or outline lighting $40.00 - 2
which is not intended for sale, lease or rent. Signeroircuile,al aationd
energy panel,alteration 40.00
or extension 1 $40.00 _ 2 r`
Owner's Signature _ -------- F. Each additional inspection over the allowable
in any of the above
Per ins3. Plan Review section (if required)' Per hour�ctlon $55.00
Please check appropriate Item and enter fee In section 5B. In Plant $55.00 �--
-4 or more residential units in one structure 5. Fees
_Service and feeder, Boo amps or more 40.00
-System over 600 volts nominal A. Enter total of above fees $
Classified area or structure containing special 5% Surcharge (,05 X total fees) $ 2.00
occupancy as described in N.E.C. Chapter 5
Subtotal $ ___T2__.00
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan r'eview if required (Section 3) $
above apply. Not required for temporary construction Subtotal $ 42.00
services. [A Trust Accol int $ - �I
Balance Due $ 42.00 I
For inspections call This permit becomes null and void If the work suthorl:ed by the permh Is net commenced
640-3561 or 693-4415 within 160 days from dale of Issuance of such permit or 11 the work authorized Is
suspended or abendcnsd N anytime atter work is oommenced fa a per lod of 160 days.
24-hour recorder, one working day in advance of need Electrical Permits ars non-refundable and non-transferable.
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