17585 SW PACIFIC HIGHWAY Otocords\microfIm\targets\building.doc
08/29/96 06:50 FRAHLER ELECTRIC 4 INSPECT TIGARD N0.275 P006
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DEPARTMENT OF!.'.ND USE&TRANS POR-i ATIUM
WASHINGTON LAND DEVEVOPMENT SERVICES DIVISION
155 NORTH FIRST,AILLSBORO,OR 97121
GOUNW, INSPECTION REQUESTS: 503/840-3561/633-4415
OREGON :v;�xxxxxx -> 640-3470
Page : 1 (-) 1
Date 04./2tt/9!:)
Time 10 , 08
Permit 'type (:ommercial Liect ic.al Permit Permit #4 ()1506'/044
Permit StatLIS AP1'tlUVEL) App I! ed 04/28/9b
5itu5 Address 17b8b L�w PAUIl '1(: Hw 'i'1 l0sued 04/2:3/96
Permit '.Cit.le RUAi ER'K 1tr�'1' R\/ !'n,;K-U!'!'.LC F' Completed
Permit Ue.scr , ANL) MANAC;ER ' ::i HOME 'Vo Exp:ire 1U/25/9'.)
PI:(,) j;�c't. '1'ttie ROAMl L:l S ktl '1' RV !'lliiC:-Uh't'.L(.'h. Project # : P004952 /
Pru-,ec't Deocr .. UL'k'1C L AND MANAI.,EW a HUMh: * EROSIUN
P ire_ l [at.moer 2L+1'1'1 - Lattcl (.Ice District
VdIlL3C1Ut1 (1
L.ey-i.L Des(-,t .
(Jwt1e1 1. PEC" 1UN - '1' LGAL;L- cort:_truce i c n U'1'H
t-►E plicant N<arrie L. SC;H1,U'1"1'MANN tLla l'L:1.c_ C:lae;sificat.ion 9UU
Applicata X1(1: 15bnU SE PUEBLO UccuYJMn(:y
HILL: ;BURR, UR �,'/1 Validated by "
Applicant Pi, ,:le : 64u 4'J'/ inspector Area
i,ee descr ipt 10n IIni t 1:,, 1''ee/Un I t Ext tee. lki
�yu_ire h'uotacc (Enter L .a . r '' ) iHUO 16U , 00
:�ut��total h i(ectz is tl hes--7: 160 . UU
:•,tate burcharge of '''t 8 . 00
Total blectr ical k'ees : 168 . U0
* * Nees htequired 1'eerl Collected tw CriedT-
Method (Ai ec-,k It ctor•cipt 110-) . Date Peyment
CK 1044 1,111 28,,'9 168 . (i0
1(J1'AL '1H1S L)A'iL' 168 , UU
A , ;ustmVW:Cj : UU 1.' ital Credits : 00
!'Pee _'I I;Fi , (.1(i i'Vt:ai. Payments . 1 b H . U 0
ticilarwe Due: 00
NOTICF 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 Intemnited for a perio f 180 days. I cortl(y that the Intormatlon presented by the applicant and
his agent or agents In support of this permit Is true and-irrt ct to the beet of our knowledge. I Acknowledge that'he Buhding Department's reliance
upon false and misleading Information may Invalidate this pe mit. All provisions of applicable laws 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 nn the plans correction sleets. I acknowledge that
the granting of a permit does not grant autherlty 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 Inapactlone at various tlm4s during the process of construotlon and the building
Insl ctlon staff verifying compliam:e with the various cc-des. Use or occupancy of the bolding or structure permitted prior�o approval by the
Building Deportment Is noinly at the risk or the applicant and such use or occupancy In revocable until all Inspection requlren,ents are satisfied a-,d
approval Is given by the Building Oficial. I further acknowledge that a lien may be placed on the title of the property upon which the permit Is Issued
apt cifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements.
�`ApPs�CAN SI�TUI-1E
WASHINGTON COUNTY ELECTRICAL PERMIT
Department Land Use & Trn ansportatio
Electrical Inspection
ection Section APPLICATION
155 North First Av-nue, #350-12Hillsboro, Oregon 97124
Information: (503)640-3470 Fax: (503) 693-4412
Permit
PfEASEPRINTNumber � _ Date
Plea.�e complete all sections, I.through 5.
[4. Complete Fee Schedule below1e LocatLocation of InstallationNumber of Inspections per permit allowed
f —Addrecs_, ` ' r11 , 111)1vice included: Items Ccst(ea.) Sum
Buildingg A. Residential-per unit Y�
City 1 ' Suite No.
Tenant Nam 1000 sq.ft.or less $110.00 4
(if commercial) �'� �/)�,, Each additional of sq.P.
Y FYI'\[ Y� •�.__� � ` or portion thereof
Limited Energy $25.0'
Map No, Tax Lot Eacrl Manuf'd Home or Modular
Thomas Map Book: Page: _ Section: Dwelling Service or Foeder ___ $68.00 2
Directions— __,_ . s. Services or Feeders
Installation,alterations or relocatior
200 amps or less $60.00 2
Commercial 17-1
I Residential�_ 201 amps to 400 amps $80.00 ___ 2
401 amps to 600 amps _— $120.00 _ 2
2a. Contractor installation only: Over
amps to 1300 amps --- $180.00 —— 2
Over 1000 amps or volts __— $340.00 2
Electricol Contractor L.. Cx�uI7 /y1/1f\LV G� - TRI Reconnect only —__ $50.00 — 2
Address ��Lam" �.F, - L t u
City_1i�. - tic-PC, State o ZIP `l 7r L 3 C. Temporary Services or Feeders
Date /- ?R - y� Job Numb Installation,alteration or relocation
Property Owner d mc k l1��5 r ]�t7 FTR Rk 200 amps or less $50.00 _ 2
Contractor's License No. 3.1- 473 C 01 amps to 400 amps $75.00 _—. _ 2
Contractor's Board Reg. No. 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts see'B'above
Signature of Supr. Elec'n/ �r D. Branch Circuits ansa No. - i_,- Phon o. 6'f G-7.1-1 7 Now,alteration or extension par pane)
a) The fee for branch circuits with
2b. For owner Installations: purchase of service or feeder fee.
Each branch circuit —_.__ $5.00 2
--- b) The fee for branch circuits without
Print nes s Name lone o. purchase of servlse or feeder fee.
-- — — --- First branch circuit� —_ $35 00 "CTfaS3 y` --- '
Each add'nl branch circuit $5.00 2
E. Miscellaneous (Service or Feeder )ot included)
Each pump or irrigation circle—_p $40.00 2
The installation is being made on property I own Each sign or outline lighting _! $40.0) 2
which is not intended for sale, lease or rent signal circult(s)or a limiter
energy panel,alteration
'.owner's Signature _ _ _. or extension —_ $40.00 _—_ 2
F. Each additional inspection over the allowabtp
in any of the above
3. Plan Review section. (if required) Per Inspection — -- $35.00
Per hcur $55.00
Please check appropriate Item and enterfee In section 58. In Plant $55.00 _
4 or more rt:.ldential units in one structure �, Fees
Service and feeder, 800 amps or more
,System over 600 volts nominal A. Enter total of above fees g
__Classified area or structure containing special 5% Surchatje (.05 X total fees)
occupancy as described In N.E.C. Chapter 5 Subtotal $
B. Enter 259% of line A for
Submit 2 sets of plans with application where any of the Plan Review If required (Section 3) $ -- --
above apply. Not required for temporary construction I Subtotal $
services. I ❑ Trust Account $
J Balance Due $
F nr Inspections call Ihls per mll becomes null and vold It the work■uthorlssd by the permit Is not commenced
640-3561 or 69a-4415 14thin 180 days from dale of Insrnnnce of such permit or If Orr work suthorlt*1 Is
•suspended or absndonsd sf a y time after work Is commen:ad for a period of 180 days,
24-hour recorder, one working day in advance n! need EZrirei r errdle vie non tefu debts and non transferable
8134
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLGBORO, OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
Permit # 05067044 Pruie%:t. # . PO049527 Status APPROVED Pay.'-_ i of 1
Appliad 04/28/91 I!ifsuea 04/29/95 Expires 10/25/9 Or/05/9 # 05 02
COMELEC
Permit Title ROAMERS REST RV PARK-OFFICE OTR
Description (:FFICE ANI) MANAGER ;a HOME Bt.. ; un. 04/26/95
Job Address 17585 SW PACIFIC HW TI
Owner Name INSPECTION . TIGAR.D Region 1)
Applicant: Name L SCHLOTTMANN FLECTRIC
Phone number 649-'749'7 Valuation -
Inspector
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