15617 SW 76TH AVENUE a
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L5617 SW 76`1'H AVENUE. _
DEPAHTMENT OF LAND USE 8t TRANSPORTATION
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r�iNGT®N LAND DEVELOPMENT SERVICES 155 NORTH FIRST,HILLSBORO,ORDIVISION
mal11 N-FY, INSPECTION REQUESTS: 503/640-3561/693-4415
PHONE: 503,1648-8761
OREGON
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0(.:r.mlt '1VE•t rte:;icYerjtiai EiectricKal Permi lctnlli +, u:7i;:c6'«t0
Permit: ")tutus ANl'1WVEU Appiiet..l 01/04/93
Addre'dos lt;.61 / SW /6Th AV 1'i ls!:;ued 01/l14/1)3
i-,ei:injt.. '1':1tie S1•'R - b1)K(1,AL1 A1,ARM c_om�,letcd
L'111n.Lt UeScl O Expire 01,0:319.1
t'l o -je(-'t 'rit.le . BURGLAR ALAL:M hro�--ct # 1-'00'-8246
2t01-�ct D act k Elft-)Sit>N
1,and Use District
VaiLid r.I(it, U
mnei : t:uL1,1Nb , L.ALVIN/NAUTA Co.nstru('-'tic:)rL V'1'l1
A1)I:«iicarit Narnw b1i1NK ' b HOME EcUllil'y r.lassif icatiotl. uu
Applicant A(101: 111 ,1;) SW GAKIDE'N 1'L Occupancy 14
r'l)i2'1'LANO, Ue( Validated by H
NE. I. l1cr«nt. 1'Ytclti«> : nr34- 35/4 Lnopect.or Area
i1N.i-ltAl'llilt br�iNK. WANE .' E(-'IJRi'1"x" L1C , C i4-1L,)b(-: 684-:a4
SCL .LI�Llon �IrLit ret.:./Unit. Ext Lee I.)ata
L1r111t«+.1 trYtc:Iy/Altai ./l:XtE>riiorl l 40 . 00 40 ()U
.auL)tutai Eiectri.c•11 e'ees : U 40 . 011
tate :,Utchalge (.)L a`b 1.1 2 ' 00
'otal Electrliral !'ee,-i : U 42 . 00
� k 1•'ef--'s ke-q Lired '(m.ps Coile .t:ed 6 (.:-- dj t5 A**
Receipt No. Date ''_a.yment
01/04/93 4'L . 00
io'1A1, 'Itilb DATE 4l , t)1)
► ee 4Z , 01.)
H1ILiz;thlC:+rits : 00 ( otal. credit'] : 00
t-ii to«�•_:, :
4Z 00 1'c)re.L 1=ayrntants1 44 . U0
ci.`'tirince Due : UU
No rICE This permit becomes null and vcld If hre work nr construction for which It Is Issued Is not commenced within 180 drays Once construction has started,
Ino permit becomes null and void If construction Is Interrupted rm a perind of 180 days. I ceriily that the Information presented by the applicant and
his agent or agents In support of this permit Is true and corrocl to the best of our knowledge 1 acknowledge that the Building Depatiment's reliance
upon false and misteeding Information may Invalidate this permit. All provlslons of applicable laws and ordinances governing the construction and use
of this building or structure will be complied with whether or not specified on the plans or noted on Ilia plans correction shoals I acknowledgp that
the granting of a permit does not grant authority to occeer private property or to use easements f further acknowledge trial the use or occupancy of
the error'ire or building pormitted depends upon my calling for Inspections al various times during the process of comalrucllnn and the building
inspection staff vetifying compliance with the various codes. Use or occupancy of tete building or structure permitted prior to approval by the
Building Depattmenl Is safely at the risk of the apr dcat i a>••'ouch use or oc upancy Is revocable until all Inspect!on requirements are satisfied and
approval Is given by the Building Official I fu�hr,ackunwledge that a lien may be placed an the title of the property upon which the permit is issued
specifying that the use or occupancy of Ilia but Inn or structure Is provisional and revocable until the satisfaction of all Inspecllon requirements.
APPLICANT'S SIGNATURE
WASHINGTON COUNTY RESTRICTED
��
Department of Land Use & Transportation
Electrical Inspection Section ELECTRICAL ENERGY
155 North First Avenue,#350-12
Hillsboro, Oregon 97124 APPLICATION
Information: (503)640-3470640-3470 Fax: `503) 44
893- 12
PRINTPLEASE
Please
., complete •ns, 1 through 5. Project No-, Permit No.
Label No._— Date
1. Location of installation Issued By--_'� _ Office
Address, ��(� L3 Ii, t
City__T ciprd ,CW— Zip Code
4. Type of work:
Thomas Map Book: Page Section (for all
systems)RESIDENTIAL lEnergy Fee $4c,.00
(fix asystema)
Directions _ —___.-_ _-- -- - - Check type of work involved:
~� Audio and Stereo Systema`
Commercial [ Residential Burglar Alarm
Tenant Name
_____._____—___.�—___—.�----- Telephone Systems*
(if commercial)
(3arago[Mor Opener'
This permit becomes n all and void if the-work authorized by the Fire Alarm
permit Is not commented within 180 days from date of Issuance Heating,Ventilation and Air Conditioning Systems"
of such permit or If the work authc,rized Is suspended or abandoned Vacuum Systems"
at any time after work Is commenced for a porlod of 180 days.
Electrical Permits ate non-refundable and non•tranaterable. H Other
7. Contractor application: COMMERCIAL Fee for each system $40.00
Electrical Contractor I�,t-I "t� `� NQvY1 -Se q (see OAR 918-260-260)
Address 1 5Cr L,� =-r2�e-� �I Check type of work involved:
Date it _LLE2... Job Number
Property Owner _C at l� t k 1 C c 1` I nf_ __..-
Contractor's License No. . CLE. Boiler Controls
�� i Clock Systema
Contractor's Board Reg. No Data Telecommunications Installations
Phone No. �`�7 1 Fire Alarm Inatallatlon
HVAC
3. Owner application:pp Instrumw,lt4tlon
�5 7 b;tart.cm and Raging System
Print Owner's Name Phone No. Landscape Irrigation Control"
---- x 11hhT ( — Medical
Addrese Nurse Calls
----- Outdoor Landscape Lighting*
Protective Signaling
This perm:(Is Issued under OAR 918-..20-370. The applicant agrees
to make only restricted energy Installations(IiX1 volt amps or less) Olher
under this permit and to do the following:
1. only use electrical licensed persona to do Installations where
required. (Cerlaln residential and other trarrsac:1r r s are exempt Number of Systems
from licensing. These have asterisks r). All othst need licens-
ing.) `No licenses are required. Licenses are required for all other installations
2. Call tot an Inspection when e2 the Installations under this permit
are ready for Inspection.
3. purchase aape pro to permits for,1111nsto/to tion 9 that are not ready 5. Fees
for inspection when the Inspector is out to Inspect under this Enter fees $ -
permit.
4. Assume responslbilitY for assuming that all corrections required
by the Inspector are(Ions,and 5% Surcharge (.05 X total above) $ -
S. Alssume responsibility for calling for a final Inspection when all of
the cot ections ars completed. /1-`7
The person signing this permit must be the applicant or a person
Total $ —..J.0-�.�
authorized to bind the applicant.
Space below reserved for validation.
Signature
Authority If other than applicant
For Inspections call
640-3561 or C.93-4416
24-hour recorder,one working day in advance of need