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10791 SW KABLE STREET 3 0 - N K3 r1 it Ci V S 00407'53" E 211.67' wI-- �► �- W � 44.00' �� w .� C14 LL jl� IN Z I WI/ - 101 .00' Lbw— -- g.QO' j / �..� I3q•Co' i --------- m c 00 F_ ; �,. N 4. 00 00 5,00 S�+V ►i� • Vj W ' N N 3 "S�•��080 mum j .rppZ M - SGALE DRAWINGLOT �- ��54 ERICKSON HEIGHTS • S.E. 1 4 SEC. 10, T.2S., RAW., W.M. CITY OF TIGARD WASHINGTON COUNTY, OREGON MAY 22. 2000 Centerline [SCALE RAWN BY: MSG CHECKED BY_ WG`10III Concepts Inc . 1 X20' ACCOUNT 115 M: MLI L54ERICK 640 82nd Drive Gladstone, Oregon 97027 503 650-0188 fox 503 650-0189 'p k 4. �,I, � I NOTICE: IF THE PRINT OR TYPE ON ANY I I I I I I111111I [ I IT I I I L 111 1 111 1 1 r ri� � I i I I � � C ��� � 1 1 ( lll 11� 1 ` If1 � 1111111 lIrfr�.l 1I�.�_IL.I 11lll1l , 11I1I ! f , IMAGE IS NOT AS CLEAR AS THIS NOTICE, �_ 1 2 8 1 10 11 IT IS DUE TO THE QUALITY OF THE No.38 �,` "' ORIGINAL DOCUMENT E 6 Z S Z L Z 8 Z 9 Z Z 99 1 Fog T Z O Z 6 T 8 T L 't 9 T 2 fi t el Z T 11 16 8 L 8 9 fi ^ E Z II rl ' IIII IIII IIII IIII IIII IIII ill! Illi llll llllJll l 1.11ll 111 ILll .Ill►. IIIILI�LI II(i IIII IIII ILII IIII IIII IIII .aIII IIIc IIII IIII ��II iII� IIIA IIII IIiI l�Il � .�l�.l l� Illi Ll_�I lill.11lllI i ;a 0 J V1 t7d r CrJ V� H 9 t 10791 SW KABLE ST CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour inspection Line: 639-4175 Business Line: 639-4171 MST ���"�� _ � 09 � Date RequestedBUP AM PM BLD Location f (� 9 ' oaf !�� S�7` Suite« , MEC _ Contact Person �!} — P". PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR FooTng Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab — SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation T Drywall Nailing Firewall Fire Sprinkler --- Fire Alarm Susp'd Ceiling — Roof -�•+w�;"*''�"' Misc: - Final P PART FAIL — �r ) Post&Beam — Under Slab Top Out Water Service Sanitary Sewer Rain Drains S PART FAI MIMTiANICAL Post&Beam -- -- -- Rough In i Gas Line — Smoke Dampers FinalPASS PART FAIL ECTRICAL Servic_ Rough In 1a o UG/Slab Low Voltage Fire Alarm tPASV PART FAIL SI E Backfill/Grading — ---- Sanitary Sewer Storm Drain [ ]Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RF: [ ]Unable to inspect no access ADA Approach/Sidewalk Other Date / _ Inspector _Ext _ Fi ial f PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- BLIP Date Requested 2 AM PM BLD Location �C� %y l S /��G'�J Suite MEC Contact Person Ph PLM Contractor Ph SWR UILDIN Tenant/Owner ELC —_ taming Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post& Beam Ext Sheath/Shear Int Sheath;Shear - Framing �� _ - i Cird _ i,�,.�� il. '�' 71 c"�.� 1 -♦ % - CSL Ta.�.y Insulation Drywall Nailing 5xe�-I Firewall nn Fire Sprinkler !��5� I'LL l„ L (/1 i-', /- i 7- e/ -771 Fire Alarm Susp'd Ceiling �J — Roof - nal T FAIL ----- -- P UMBING Post& Beam ---�- ulnrlFr Slab Top Out Water Service Sanitary Sewer — — Rain Drains Final -----_ —_-�_--.- — — — PASS PART FAIL _ - - ECHANI _ Post R Beam - - - -------- - — [Rough In Gas Line --- -------- --- _ _-- Srnnke-Dawpers F i rial --- ----- _ _ART FAIL ELECTRICAL -- -- - `-- — -- Service Rough In ----- ---- - ------------ - —_ .— UG/Slab _ Low Voltage -- -�-- - ____ -- ----- — Fire Alarm Final PASS PART FAIL SITE — ----� - -- - Backfill/Grading - --- - — - --- ------ Sanitary Sewer Storm Drain [ J Reinspection fee of$ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: -- _ [ J Unable to inspect-no access ADA 1,4 Approt chlSidewalk Other nate /y--C'/ _Inspector - Ext Final _PASS PART FAIL DO NOT REMOVE this inspection record from the job site. i CITY OF TIOARD Residential Certr ficate of' Occupancy Permit No.: --- Address: ���r 1 44 Owner/Comractor: Date of Final Inspection: 2_14'_pLInspector: This structure has been found to be in substantial comnliance with the provisions of the State of Oregon One& Two Family Duelling A►ecialty Code and is hereby approved for occupancy. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE RF,C1;1 F,- ) GAGE ENTERPRISES INC JUL 2 ?000PO BOX 1429 CLACKAMAS, OR 97015-1429 Electrical Signature Form Permit #: MST2000-00170 DaTc. Issued: 7110100 Parcel: 2S110DA-EH054 Site Address: 10791 SW KABLE ST Subdivision: ERICKSON HEIGHTS Block: Lot: 054 Jurisdiction: TIG Zoning: R-3.5 Remarks: SIF PATH I Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from YOU company sign k,elow and return this Electrical Signature Form prior to the start of the work to the addres.,; above, ATTN: Building Dept. No electrical inspections wt'll ",e authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: RENAISSANCE DEVELOPMENT GAGE ENTERPRISES INC 1672 WILLAMETTE FALLS DR PO BOX 1429 WEST LINN, OR 97068 CLACKAMAS, O!': 97015-1429 Phone #: 557-8000 Phone #: 503-657-0142 Req #: SUP 8188 LIC 34544 ELE 3-128C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervisinctrician 11 you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. !-TALL BLVD. EU'L TIGARD, OR 97223 IMPORTANT PERMIT NOTICE __� ! CRAFTWORK PLUMBING INC 7736 SW NIMBUS AVE BEAVERT ON, OR 97008 Plumbing Signature Form Permit #: MST2000-00170 Date Issued: 7110/00 Parcel: 2S110DA-EH054 Site Address: 10791 SW KABLE ST Subdivision: ERICKSON HEIGHTS Block: Lot: 054 Jurisdiction: TIG Zoning: R-3.5 Remarks: S/F PATH I Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: RENAISSANCE DEVELOPMENT CRAFTWORK PLUMBING INC 1672 WILLAMETTE FALLS DR 7736 SW NIMBUS AVE WEST LINN, OR 97068 BEAVERTON, OR 97008 Phone #: 557-8000 Phone #: 644-8698 Reg #: I I(; 79666 PI M 20-148PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signature of Authorized Piumber If vau have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD MASTER PERMIT PERMIT#: MST2000-00170 DEVELOPMENT SERVICES DATE ISSUED: 7/10/00 .;,.I-I I 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10791 SW KABLE ST PARCEL: 2S11013i,=-EH054 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 054 JURISDICTION: TIG REMARKS: S/F PATH I BUILDING REISSUE STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: '4 FIRST: 1,673 sf BASEMENT: of LEFT: 1 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND- 1,775 sf GARAGE: 768 of FRONT: 24 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS i FINBSMENT: at RIGHT: 7 VALUE: 6 255.502 30 OCCUPANCY GRP: R1 BDRM: 4 BATH: 3 TOTAL: .7,39800 at REAR: 99 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS. I FLOOR DRAINS: SEWER LINES: 100 SF R41N DRAINS: t CATCH BASINS: TUBISHOWERS: 3 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR 1 GREASE TRAPS OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100KBOIL/CMP<AHP: VENT FANS: 5 CLOTHES DRYER: 1 (,AS FURN>*100K. 1 UNIT HEATERS: HOODS: I OTHER UNITS: 1 MAX INP btu FLOOR FURNANCES: VENTS: I WOODS10VES: GAS OUTLETS: 1 ELECTRICAL _ RESIDENTIAL JNIT SERVICE FEEDER TEM;'SRVCIFEEDERS_ BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 200 amp: WISVC OR FOR: I PUMPIIRRIGATION: PER INSPECTION. EA ADD'L 500SF: 7 201 - 400 amp: 201 400 amp: 1st WIO SVCIFDR: 00 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 - 600 arnp. EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FDR: 601 - 1000 amp: 601+amps•1000v: MINOR LABEL: 1000•amp/volt PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS. SVCIFDR>=226 A.'. >600 V NOMINAL: CLS AREA/SPC OCC: _ El ECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B COMMERCIAL _ AUDIO&STEREO: VAC JUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: 01;+ BOILER: HVAC LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL OTHR: HVAC: DATAITF-LE COMMS NURSE GALLS: TOTAL 0 SYSTEMS. Owner: Contractor: TOTAL FEES: $ 6,420.92 This permit it sub)ect to the reg dations contained in the PFNAISSANCE DEVELOPMENT RENAISSANCE DEVELOPMENT Tigard Municipal Code,State of OR Specialty Codes and IG72 WILLAMETTE FALL`:DR 1672 SW WILLAMETTE FALLS DR all other applicable laws All work will be done in WFST LINN. OR 97068 WEST LINN,OR 97068 accordance with a - pprovl;d plans This permit will expire if work i5 riot started within 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION Phone �\ Phone: Oregon law requires you to follow rules adopted by the v Oregon Utility Notification Center Those rules are set Rea e: LIC 49966 forth in OAR 952-001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 ` REOUIRED INSPECTIONS Erosion 844-8444 Underfloor insulation Mechanical Insp Shear Wall Insp Rain drain Insp Final inspection Footing Insp Crawl Drain/Backwater Plumb Top Out Low Voltage Water Line Insp Building Final Foundation Insp Footing/Foundation Dr Electrical Service Gas Line Insp Electrical Final PosUBeam Structural PLM/Underfloor Electrical Rough In Gas Fireplace Mechanical Final Po earn Mechnnica Mechanical Insp Framing Insp Insulation Insp Plumb Final Ass ad By // Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00130 40, 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/10/00 SITE ADDRESS; 10791 SW KABLE ST PARCEL: 2S110DA-EH054 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 054 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Owner: FEES RENAISSANCE CUSTOM HOMES INC Typo Rv Date Amount Receipt 1672 WILLAMETTE FALLS DR _ WEST LINN, OR 97068 PRMT DEB 7/10/00 $2,300.00 0003595 INSP DEB 7/10/00 $35.00 0003595 Phone: Total $2,335.00 Contractor: Phone: Reg#: Required Inspections Sewer Inspection ov� 1 GqA This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date issued The total amount paid will be forfeited if the permit expires The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral ATTENTION: Oregon law requires you to follow rules adopted by the' Oregon Utility Notification Center Those rules aie set forth in OAR 952-001-0010 through OAR 952-001-0080. Yq may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued by: „� ,� ��� [ Permittee Signature:. =--- Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CIVY OF TIGARD L o/ lit Application Plan Check# 13125 SW HALL BLVD. 1 Recd By CL h� Date Recd-roti -� TIGARD, OR 91-223 - 1ed Date to P E G•- /? -N- V 503-6�9-4171 (`� Date to DST 4.-/y G rJ F 503-684-7297 "ti Permit# l✓1=f-' �„ 7 61 Print o. I ype �/ Called a-v;s wfz�/ .ow Incomplete or illegible applications will not be accepted _ Name of Project --- Nam -- 7 Job dM lin Address Address Site Address Architect g _ , �'.�� /i, (f_. ' _- 4. ? Name—? City/Stale Zip Phone Owner M ilrn Address Nam Mail n Address --- —� City/State ._ ip Phone Engineer ' t�, General Name City/St te. ' Zip Phone Contractor Describe work New G4' Addition O Alteration O Repair O Mailing Address to be done. Prior to permit Additional Description of Work: _ issuance,a copy City/State Zip Phone of all licenses � -are required if Oregon Const. Cont Board Exp Date PROJECT expired in COT Lic.# (/ database VALUATION $ _ �/ y� ����C / Mechanical Name / NEW CONSTRUCTION ONLY: Sub- ` Sq. Ft. House: ^� Sq. Ft. Garage c Contractor Maih.,g Address Prior to permit�� iL�/��//1.� i �'l Indicate the restricted energy installation by the electrical ,ssuance,a copy Cit /State Zip Phgne� subcontractor in the following areas of all licenses /C+ ew�/Jj Restricted Audio/Stereo are required if Oregon Const Cont. Board Exp Date Fnergy _ System Alarms expired in COT Lic#/ y G- /J Installations Vacuum Irrigation _database •�C JJ 7 System System Plumbing Name , — g � (check all that A�Other: Sub- ..apply) ---- Cc ntractor Mailing Address Number of Units in Building Unit Number Designation e _--- Has the Subdivision Plat recorded? NIA ES NU Prior-lo permit Ci /State rp hone 1� issuance,a copy i ' L-ek-- � lF e,Cu --- ��1L� of ,II licenses are Oregon Const.Cont. Board Exp Date required if Lic.# / / expired in COT �(G-'ri database Plumbing Lic.# EXp.Date I hearby acknowledge that I have read this application, that the information given is correct,that I am the owner or authorized agent of the owner, and t plans submitted are in compliance with Oregon Stat Electrical �i/� _ Si gu o Ant Dat Sub_ Mailing Address Contractor2 9 Contact Person Name Pi`one# ity/St to Zip Phone ---- ---�-�1" L-5, of-ex t-57, z Prior to perm l Y765 issuance, a copy ?°;' FOR OFFICE USE ONLY: of all licenses are Oregon Const Coit. 9oard Exp. Date required if L _ Ma /TL# ic# G �� p expired in COT database Electrical)yc # Exp Date Setbacks: Zone: I✓lectricai Supervisor Li:; # Exp. Date Engineering Approval: Planning Approval: TIF: i\dsts\formslsfd-new doc 11/20/98 ELECTRICAL - CITY OF TIGARD RESTRICTED EN RIGY DEVELOPMENT SERVICES PERMIT#: ELR2001-00080 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/27/01 SITE ADDRESS: 10791 SW KABLE ST PARCEL: 2S110DA-09300 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 054 JURISDICTION: TIG Proiect Description: A.RESIDENTIAL B.COMMERCIAL AUDIO& STEREO: AUDIO&STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCAMP : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: Owner: Contractor: RENAISSANCE DEVELOPMENT GREENLINE INC '1672 WILLAMETTE FALLS DR PO BOX 230755 WEST L.INN, OR 97068 TIGARD, OR 97223 Phone: 557-8000 Phone: 968-1978 Reg#: LIC 103033 ELF 34-397CL FEES Required Inspections Type By Date Amount _ Receipt Low Voltage Inspection PRMT CTR 3/27101 $75.00 2720010000 Elect'I Final ' 5PCT CTR 3/27/01 $6.00 2720010000 Total $81.00 1 This Pemiit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Specialty Codes and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those mies are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. Issued by r --c ,. r, Permittee Signature OWNER INSTALLATION ONLY 'The installation is being ma a' roperty I own which is not intonded for sale. lease, or rent OWNER'S SIGNATURE: — ' ' DATE: 3 Z� _CONTRACTOR INSTALLATION ONLY _ SIGNATURE OF SLIPR. ELEC'N DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application [late received: Permit no..'% x . � �'ity of Tigard ProjecUappl.no.: Expire date: ( rreuJ7igrtrd Address: 13125 SW Hall llivd,Tipard,O12 1)7111 --- — Phone: (503) 639-4171 Date issued_ By: Rrceipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 7Newly dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement ruction U Addition/alteration/rrplaccnienl U Other: U partial JOB SITE INFORMATION Jab address: �Q g hilly• n Suiie no.: Tax ma /tax IoUaccount no.: �T--- -- -- — -- map /tax Block: Subdivision: -- - _ �_4� N—.HTS_ Project name: Description and location of work on premises:Estimated date of completion/inspection - -- -- 1 1 Job no: ---- — 1-�C Fre Mat Business name: LL1Y- Description Qtv- (ea.) Total no.insp AddrCCs __ rNe"residential-single ormtdtl-familvper LPh Z - y __ dNellingunit.Includes attached garage, tiialr: I/II' q'�Z ji %er,iceincludcd: . Palnon n n less1no.: O �Elec.bus.lie.nn: �1 ,� _Each additional 500 sq.ft.nrportion thereof Limited energy,residential 2 City/ Ciro DIC.n0.: so Limited energy,non-residential - _- 2 Each manufactured home or modular dwelling Signature of su .rvising electrician(require(]) D1e Service andlor feeder 2 5up,elect.name(print). Licensem. f•ervicesorfeeders-Installation, alteration or relocation: ��/ 200 nnhps or less 2 Name(print): NA 16%" V 1Lu�e 5 201 amps to 400 amps 2 Mailing:I(Idrrss: Z Ci t „S V%_P" -j__�IIt�r401 amps to 600 amps 2 .7J4!J7s-i5 Eat- 601 amps to 1000 amps City: �,,. Slatc:� /,II`.a�7O`b 2 Ovcr1fH10ampsorvolts Phone: rax: E-mail- Reconnectonly 2 1 Qwner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocalion: ORS 447,455,479, n 7 1. 200 amps or less 2 201 amps to 4(x)amps — 2 ()++'nCr 5 signature: _ _ DatC: 1 1 401 m 600 mmns 2 Branch circuits-new,alteration, Name: nr extension per panel: �- - -- --- A. Fee for branch circuits with purchase of Address: _ service rr feeder fee,each branch circuit City: Stats: ZIP: Y B. pee farbranch circuits wilhuut purchase Phone: Fax: E-mall` of service or feeder fee,first branch circuit. 2 toolsEach addjljonnl branch circuit Mise.(Service or feeder not Included): U Service over 225 amps-c,)mmercjal U Health-care facility F.ach pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hn?,ardouslocatinn Each sign orodin—lighting - 2 familydwellings U Ruilding over 10,000 square feel four or Signal circuits)or a limited energy pnnel, U System over 60()volts nominal more residential units in nne structure alterntinn,orettension• _ 2 U nodding over three stnries U Feeders,4(x)amps or more *Description: -- U(ecu not land over�) _ Occupant persons U Manufactured slruclures or R V park FAch ndditional Inspection over the allowable In say of the al►ove: U F.gressAjghtingplan U Other. _ l --- I'er inspection Submit_nett of plans wish any of the above. Investigation fee --The above are not applicable to temporary construction service. other NM oil jurisdictions accept credit cards,please call jurisdiction rm mrne Information. Pelmit fee..................... Notice:'Ibis permit application U Visa U MasterCard expires if a permit is not obtained Plan review(at — 9h) $ rrer It cror nalnher:_ within 180(lays after it has Bern State surcharge(8%) ....$ --�-� -- _ Hspir, accepted as complete. TOTAL . ,$ Name of cwdhnl M s nwn nn cre it card ^•••••••••••••..••• ('"holder signature — Amount 440.4615(WW.OM)