14750 SW 72ND AVE WASHINGTON
COUNTY,
OREGON DEPARTMENT OF LND USE&TRANSPORTATION RTATION
T SERVICES DIVISION
s5 NORTH FIRST, O,OR97124
INSPECTION REQUESTS: 503/640-3561/693-4415
XX/ XXXXXX___;
Page : I of
Date 05/3 )/' ,
Time : 08 : 23
Permit type : Commercial Electrical Permit Permit # : 050b8Z y
Permit Status : APPROVED Applied : 05/26/95
Situs Address : 14750 SW 72ND AV TI issued : 05/26/95
Permit Title : RYDER TRUCK RENTAL - LV Completed. .
Permit Descr. : JOB 21842 FIRE ALARM INSTALLATION CIRC To Expire : 11/22/95
Project Title RYDER TRUCK RENTAL - LV Project # : P0050329
Project Descr . JOB 21842 FIRE ALARM INSTALLATION * EROSION .
Parcel Number . 2S1'1'1 - Land Use District .
Valuation 0
Legal Descr. ,•
,owner . INSPECTION -- TIGARD Construction
Applicant Name : HONEYWELL Classification
\' licant Addr. : 15495 SW SEQUOIA PK #100 Occupancy
PORTLAND, OR 97224 Validated by : P
_ ,_clicant Phone : 968-3333 Inspector Area .
F e e description ;1nit_. Fee/Unit Ext fee
Limited Energy/Alter ./Extension 1 40 . 00 40 . 00
subtotal Electrical Fees : 40 . 00
State Surcharge of 5% 2 . 00
Total Electrical Fees : 42 . 00
*A;* Fees Required *** *** Fees Collected & Credits
Method Check # Receipt No . Date Payment..'
'DEP ' 05/26/95
Fees : 42 . 00
Adjustments : . 00 Total Credits :
Total Fees : 42 . 00 Total Payments :
Bala
NOTICE: 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 interrupted for a period of 180 days. I certify that the information presented by the applicant and
his agent or agents in support of this permit 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 permit. All provisions 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 the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority 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 inspections at various times during the process of construction and the building
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 at 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 a lien 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 revocable until the satisfaction of all inspection requirements.
APPLICANT'S SIGNATURE
WASHINGTON COUNTY RESTRICTED
Departmentrof Land Use &Transportation
lipElectrical Inspection Section ELECTRICAL ENERGY
555 North First Avenue, #350-12
Hillsboro, Oregon 97124 APPLICATION
Information: (503)640-3470gFax: (503)693-4412
PLEASE PRINT L()
Please complete all sections, 1 through 5. Permit No.
1. Location of installation Date
Address /4.10 . 1 72., 1
city 71:60V-0 Zip Code 9 4 4. Type of work:
Map No. Tax Lot RESIDENTIAL Restricted Energy Fee $40.00
Book: Y (for all systems)
Thomas MapPage -7�_� Section
Check type of work involved:
Directions
— A• udio and Stereo Systems*
Commercial Residential - - Burglar Alarm
—
T• elephone Systems*
Tenant Name p ` Garage Door Opener*
(if commercial) _ � Z � — F• ire Alarm
— H• eating,Ventilation and Air Conditioning Systems*
2. Contractor application: — V• acuum Systems*
,r_ _ Other
Electrical Contractor-t,�//`) W O
Addre. r 4.2 ' ,A • f% � ) COMMERCIAL Fee for each system $40.00
City Ij11171Z T 1Ill Stat=s' Zip (see OAR 918-260-260)
Date -71 - Job Number aK`.,4- Check type of work involved:
Property Owner
Contractor's License No. a4 — 2-07g• oiter Controls
Contractor's Board�•Reg. No. 57g.P.�- — Clock Systems
Phone No. (�t�J " '� � ^ Data Telecommunications Installations
Fire Alarm Installation
3. Owner application: HVAC
— Instrumentation
Print Owner's Name Phone No. —" Intercom and Paging System
— Landscape Irrigation Control*
Address — Medical
— Nurse Calls
City State Zip — Outdoor Landscape Lighting*
This permit is issued under OAR 918-320-370. The applicant agrees — Protective Signaling
to make only restricted energy installations(100 volt amps or less) Other
under this permit and to do the following: —
1. Only use electrical licensed persons to do installations where
required. (Certain residential and other transactions are exempt I Number of Systems
from licensing. These have asterisks(*). All others need licens-
ing.)
2. Call for an inspection when all the installations under this permit *No licenses are required. Licenses are required for all other installations.
are ready for inspection.
3. Purchase separate permits for all installations that are not ready 5. Fees
for inspection when the inspector is out to inspect under this
permit. Enter fees $ 4D OO
4. Assume responsibility for assuming that all corrections required o ` ��
by the inspector are done,and
5. Assume responsibility for calling for a final inspection when all of 5% Surcharge (.05 X total above) $
the corrections are completed.
The person signing this permit must be the applicant or a person Trust Account $ '0 i DO
authorized to bind the pplicant.
Signature f Total $
Authority if other than app scant This permit becomes null and void if the work authorized by the
permit is not commenced within 180 days from date of issuance
For inspections call of such permit or if the work authorized is suspended or abandoned
640-3561 or 693-4415 at any time after work is commenced for a period of 180 days.
Electrical Permits are non-refundable and non-transferable.
24-hour recorder, one working day in advance of need BL24-114