8645 SW GREENSWARD LANE i.
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8645 SW GREENSWARD LANE
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO.OR 97124
GOUNTy INSPECTION REQUESTS: 503/640-3561/693-4415
'
OREGON PHONE, 503/648-8:61
Re7s:icic nt.ial E:iecti jJ cai 1'c'rmit-
1',:?rmit 'Statue, APPROVED
Address st1 4 `.i .SW (`;kL:L':N'.,WAi1,D LN 'I'1.
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Permit Ue scar .
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CK :115 / 08/19/134 1.41
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of Il E'ceF, 141 . '15 '.1"ot.:31 Paymi tits . 141 . .
Lia laric-e Due : fe(1
NOTICE This permit berornes null end void If the work or construction for which It is Issued Is not commenced within 180 days Once construction hes started.
the permit becomes nuil and void If construction is interrupted for a period of 180 days. I certify tha"the information presented by the applicant and
his agent or agents In support of this permit Is true and correct to the best o1 our knowie,'ge I acknowledge 1ha1 The Building Department's reliance
upon false and misleading information may invalidate this permit. All provisions of appl cable laws and ordinsoces governing the L^nstruction and use
of this building or structure will be complied with whether or not specified on the pians or noted on the pians correction sheets I acknowledge that
the gra,",a of a permit does not grant authority fo access private property or to use easements I further acknowledge that the use or occupancy of
the structure or bulldi ig permitted depends upon my calling for Inspectlons at varlous times during the ptocass of construction and the building
inspection slat(yr rllyinp compliance with the various nodes. Um or occupancy of the building or structure permitted prior to fpprovat by the
Building Department Is sai9,y at the risk of the appiicont and such use or occupancy!a revocable until all Inspection requirements are satisfied and
approval Is given by the Building Official 1 further acknowledge that a lien may be placed on the title of the property upon which the permit is issued
specify Irig that the use or occupancy of the building or structure is provisional and revocabl a until the sstialaction of all Inspe n requirements
APPLICANTS SIGNATURE
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section
155 North ,
Hillsboro. Orr�gon enue97124#350-12 A P P LI '..TION
Information: 503 6403470 Fax: 503 693-4412 Project/Permit PLEASE PAINT t e c
Please complete Number
all • . .
', Location of installation 4. Complete Fee Schedule below
Address— 8645—�LW__G r r,P n s LJ ate_f n_ Number of inspections per permit allowed
Building
City Suite No. Service included: Items Cost(ea.) Surn _
-Tig a r d - — ----- —-- — -- - —_ _
Tenant Name A, Residential-per unit
(if commercial) _.___-_ _ 1000 sq.ft.or!css $110,00
Each additional 500 sq.ft
Tax Lot Map No. or portion thereof »__ $25 00
Limitod Energy $25.00 t
Thomas MapI B,�o'o'-k: Page: Section:_-,__-_ Each Manuf'd Home or Modular
DIfP.CtlonS.-JYCGI -B o11 7_=d & NX H ate`._,^- Dwelling Service or Feeder $68.00
F-1 B. Services or Feeders
Commercial
l 1 Rt sidentiai F Installation,alterations or relocation
200 amps or less $60.00 2
;
2a. Contractor ins i`alla#i )n or11 201 amps to 400 amps $80.00 2
Y 401 amps to 600 amps $120.00 2
Electrical Contractor Alliance Electric 601 amps to 1000 amps $18000 2
Address9 0 S W 51st T u a 897062_ Over 1000 amps or volts _� $340.00 p
Date— .lob NLlmber - Reconnect only -- -_ $5000 _ 2
Property Owner -jar r v -W-ej t f a 1 1 C. Temporary Services or Feeders
Contractor's License No. 3-31 p Y
Contractor's Board Reg. installation,alteration or relocation
200 amps or less $50.00 — 2
Signature of Supr. Erac,
,�Q 201 amps to 400 amps $75,DO 2
0 '�-- \. 401 amps to 600 amps $100.00 _ _` 2
License No. Phone No. r,91 _7 2 7 7 Over 600 amps to 1000 volts see V above
2b. For owner Installations: D. Branch Circuits
Now,alteration cr extension per panel
riot per's Name-- Phone - a) The tee for branch circuits with
purchase of service or I .
AaMest - Each branch circuit "Ifee
� $5,00 100 .00
n) The fee for branch circuits without
city —State --T - - purchase of service or Wder he.
First branch circuit $35.00 35 .00
The installation is being -rade on property 1 own Each add'n)branch circuit_— $5.00
which is not intended for sale, lease or rent. E. Miscellaneous (Service or Feeder not included
Each Pump or irrigation circle—_._ $40.00
Owner's Signature _—�____._-__ Esch,sign or outlire lighting _-, $40.00
Signet circuit(s)or a limited
3. Plan Review section (if required) energy panel,alteration
Please check appropriate item and enter fee In section 513. or extension $40 D0 2
1 &2 family dwellings over 320 amps sic meter F. Fach additional inspection over the allowable
4 or more residential units in one structure in any of the above
Per inspection $3500
Service over 225 amps; feeder 400 amps or more Per hour -�- $5500 �-
System ever 600 volts nominal In Plant $55.00
Building over 3 stories in height
Building over 10,000 sq. ft, S• Fees
Occupant load over 99 persons A. Enter total of above fees $
Manufactured Structures Park or Recreational 5% Surcharge (.05 X total fees) $ r _
Vehicle Park; new, addition or alteration Subtotal $ —L41—Z-5—
Classified
41 _ 7Classified area or structure containing special B. Enter 250,, of line A for
occupancy as described in N.E.C. Chapter 5 Plan Review if required (Section 3) $
Submit 2 sets of plans with application where any of the Subtotal $Less Bulk Label Fee $
above apply Not required for temporary construction Balance Due �' . 7 5 14 1
services.
For Inspections call This permit becomes null and void M the work authorized by the Permit Is not commenced
within IN days from date of issuance otsuch permit or It the work authorized
640-3561 or 693-441 is
suspended or abandoned at any time after work is commenced for•period M 160 days
24-h0ar ecorder,urs working,ay In advance of need F.lectrloat Permits are non-retundeble and non-tianHerable
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