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ry; DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIJISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
`•••*� OREGON PHOIIE: 503/84G-8761
Faye : 1 of 1
Uate 01/21/93
'Time 09 : 26
Permit 'Type ileside:i , ; a1 Electrical Permit Permit # 0503b849
ijer'snil- StY3tL1 ; APPROVELU Applied 01/2U,,193
Situs Address s 8ZU3 SW LANU'1'REE 'Tl issued 01/20/93
Permit 'Title 6FR - ELEC/BURGLAR ALARM Completed a
Permit Uescr. L1M1'rEU ENERGY To Expire s U'//19/93
Project 'Title 51''R - ELEC/13UHGLAR ALARM Project # P0028542
Pro-ject Uescr. LiMi'1'ED ENERGY * EROSION
Parcel Number 2b 1'1'1 - Land Use District �
Valuation U
Legal Uescr ,
uwner INSPECTION - TIUARU construction O'.l'H
Applicant Nate 8RINK' S HOME SECURi'TY Classification 90U
Applicant Addr . : 12150 SW GARDEN PL Occupancy RJ
PORTLAND, OR 9/223 Validated by KF'
Applicant Phone : t)84-3b'/9 Jnspector Area
WN'1'RAC'TUR : 6R1NKS HOME SEC'URl'1'Y Lic , C 34-166C 084-35'/9
nee description Units Fee/Unit Ext fee Data
---------------------------------------------------------
-----------------
Limited Energy/Alter, /Extension 1 4u , 0ll 4U , U0
Subtotal Electrical Vees : a 4U , UU
r, _,+tate Surcharge of b'% ( 2 , UU '
1'otal r lectric.al Nees : U 42 . 00
*** ores Required *** *** Ir'ees Collected & Credits ***
--------------------------- -------------------------------- -------------
Receipt No , Date Payment
ment
U1/20/93 42 , 00
r'ees : 42 . UU
AdIust Ment : . U 'Tottti Credits : . U0
Total e'es : 42 . UU 'Total Payments , 42 . 00
8,:ilance Due : , UU
NOTIC' This permit becomes null and void If the work or construction for which h Is Issued Is not commenced within 100 days. Once construction has started,
the perm"becomes null and void 11 construction In Interruptod for a period of 100 days r%artily that the Information presented by the applicant and
his agent or agents In support of this peirmit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this perm". All provisions of applicable laws and ordir,anc9s governing the construction and uen
of this building or structure will be compiled with whether or not$pact fled on the plans or nosed on the plans correction sheets :ncl,nowledge that
the granting of a perm"does not grant authority to access private property o-to Use easements. I further acknowledge that thle use jr occupancy of
the structure or building permitted deperds upon my coiling for Ins
pectlons of various times during the plvr;eas of constnutlon asst the bulldPrg
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely of the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval Is given by the Building Official. I further acknowledge that s 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 revocablo until the satisfaction of all Inspection requirements.
i
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APPLIUMT'S SIGNATURE
WASHINGTON COUNTY RESTRICTED
Department of Land Use dr Transportation
Electrical Inspection Section ELECTRICAL ENERGY ` al
155 North First Avenue,#350-12
Hillsboro, 3470Oregon 97124 APPLICATION
lnforma�ion: (503)640 3470 Fax: (503)693-4412
PLEA.5E PRINT
s
Pledse
coniplete all sections, • ' Project N �._ T__ Permit No. •I
1. Location of Installation Label No. _ Date
-I Issued By . Office
Address 820'-S SbQ Lana.rc.e �f. •
cin;_ gr ��_ zip code a q 4. Type of work:
Thomas Map ' -ok: Page Section RESIDENTIAL ENTIAL Restricted Energy Fee $40.00
_
(tor all systems) �
Directions ___..._..__ Check type of work; involved:
Commercial [_1 Residential �j, Audio and Stereo Systems"
Tenant Name lourglar Alarm
(if commercial) _ Telephone Systems"
This permit becomes null and void If the work authorized by the Garage Door Oper
permit is not commenced within 180 drys from date of Issuance Fire Alarm "
of such permit or if the work authorized is suspended or abandoned Heating,Ventilation and Air Conditioning Systems
at any time after work Is commenced for a period of 180 days. Vacuum Systems"
Electrical Permits are non-refundable and non-transferable. Other
2. Contractor application:
IG'` COMMERCIAL Fee for each system $40.00
Electrical Contractor �Rrlr) S 4jorvle jet,urli (see OAR 918-260-260)
Address — 2AS SW Cis'Xian P(- :M)y97 23
Date _1��=_�?_ Job Number ZL6.9 C+ Check type of work involved:
Property Owner Je��_Cam &y
Contractor's License No. _Sfil letQ_Szl.� Boiler Co,trols
Contractor's /B_o�a.�r1d Reg. No. _�`f .__ Clock Systems-)hone
ystemshone No. ��-s: S-_�.q _ Data Telecommunications Insteltatiuns
Fire Alarm Installation
3. Owner application: HVAC
6 Z,L _ 815Z Instrumentation
Print Own( s Name Phone No.
– Intercom and Paging System
Landscape Irrigation Control"
Address Medical
Nurso Calls
Outdoor Landscape I-ighting"
This permit is Issued under OAR 918-320-370. The applicant agrees Protective Signaling
to make oily restricted energy Installations(100 volt stupe or less) Other
under this permit and to do the following:
1. Only use electrical licensed persons to do Installations where
required. (Ce(ta'v residential and other transactions are exempt Number of Systems
from licensing. These have,asterisks("). All others need llcens-
Ing.) •No licenses are required Licenses are
2. Call for an Inspection when all the Installations under this permit r'4 required for at/other installations.
i are ready for Inspection.
3. Purchase separate permits for all Installations that are not ready 5. Fees
for Inspection when the Inspector.s out to Inspect under this Enter fees $
permit. --
4. Assume responsibility for assuming that all correctlens required
by the Inspecforare dotm,and 5% Surcharge (.05 X total above) $
5. Assume responsibility for calling for a final Inspection when all of —— --
the corrections are completed.
The person signing this permit must be the applicant or a person Total $ `
authorized to bind the applicant.
I Signature Space below ref erved for validation.
Authority H other than applicrnt
For inspections call
640-3561 or 693-4415
24-hour recorder,one working d-Iy In advance of need
t
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