19612 SW WASHINGTON SQUARE_TI 19612 SW WASHINGTON SQ RD TI P12170
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DEPART MENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT sEnVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 57124
„1%1� COUNTY/ INSPECTION REOUES'S: 503/640-3561/693-4415
V T PHONE: 303/648-8761
'” OREGON Page : 1 of 1
Date : 10/24/90
Time : 14:43
Permit Type : Commercial e;.,ec:rical Permit Permit * : 0501582/
Permit :status : APPROVED Applied : 10/24/90
Situs Address : 19612 SW WAS4IN3TON SQUARE RD TI Issued : 10/24/90
Permit Title : TCP KAPI ELECTRIC Completed :
Permit Descr. : CIRCUITS Tc. Expire : 04/22/91
Pro ec : Title : TOP KAPI ELECTRIC Project N : P0012170
Projece Descr. : CIRCUITS
* EROSION *
Parcel Number Land Use District :
Valuation 0
Legal Descr.
• Construction : OTH
Owner F.ppClassification : 900
lizant Name : ROSE CITY ELECTRIC Classification
Applicant Addr. : 4012 NE CULLY BLVD OcValidated sic
ipaned by : EJ
PORTLAND OR 97213
Applicant Phone: 287-6164 Inspector Area t
CONTRACTOR : ROSE CITY ELECT. Lic. C 26-113C 287-6164
Fee deir_ription Ur:its Fee/Unit Ext te Data
1 Two to Ten Count [Enter 0] 1 .0 50.00 50.00
Subtotal. Electrical Fe's: 50.00
State Surcharge of 5% 2.50
Total Electrical Fees: 52. 50
*** Fees Required **0 *** Fees Collected & Credits + + •
am
Receipt No. Date Payment
' 10,E24/90 52. 50
Fees: 52 . 50 00
Adiustments: . 00 Total Credits:
Total gees : 52. 50 lotal Payments: 52.50
Balance Due: .00
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NO r 1 C k Vile pandit uecomes null and void It the work of construction for...filch n is Uau.ld le not commenced w thin 150 n..ya Once co-•a,ruciIon has darted.
the permit becomes null and mid II construction le Interrupted fur•;wind of lea days I certify Ihel the In'ormal'on;..*cited by Ifapplicanli rel t andd
his agent or agents In support of this pa hl'le Ines end correct to IM best of our knowledge I scknowN 1ge that the l 'ling Dep e
ofate this panne All
ot
applicable lows•nd
truction and
p his false log or structure will be eading compiled withdi
whether or not specified onthe clans or noted on the les rc.rrection t.m.4 •ecknauao
cwtsdge the
i
the[• ..ng M a penatl don not grant authority to*cress Pits N property or to ma easements I huff.r erkriotMedge that the is.at occupancy of
the structure or bulidlnn permitted depends upon my calling ItImpactions at various limes during r'a process of conefruciloc and the building
inspection staff verifying compliance with th•various codes Use or occuper•v„Int building or• ,,.'.,r•permled prior to appinvel by the
Building Department Is solely an the rtsk bf the applicant aid such use or oc.upancl is reviles. .nti'all Inspection,eglaremente are satisfied and
approval U glven by the Cullding Official I'urther acknowledge that a'on may be placed on th fills of the property:moo red fl the ',nil Is issued
specifying this the use M occupancy of the bo cling M nmclure U prov!sMr.d and revocable,nlil its sail Moo t all rHpurre rsnls
CANT'S%lowTA U11E
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/�% WASHINGTON COUNTY ELECTFUUCAI_ PERMIT
I�C� Department of Land Use& Transportat'•on
Inspection
155 North Firs', Avenue,4350-12APPLICATION
Hillsboro, Oregon 9712•1 Pro c ct/Permit
Number rI
Information: (50J)640.3470 Fax ('c3) 693-401? I r - //:).`; J Date -
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LdAPRINT 4. Complete Fee Schedule below
- leasee om complete all sections; 1 through 5. P
a6-
L Number of nspectfons per perm,'allowed n
1. Location of Installation 'r t"- Service Included: Items Cost(ea.) Sum
Address 14 1 a 'r ) Loo-JA'n,6) Si n A. New residential-'uncle or multi-family
��--� r per dwelling unit
City IAA� //- Code 1 /:)Z 3 .- 1500 sq n or less - -- $05 00 - --- 4
t{ (-J .at - LOA._a.I(•.t,n,it r' Each portoridiion
a,ai 500 sq ft
Directions or portion thereof — 41500
Etch Menurd Haas or Modular
t'`f LI Dwelling Service or Feeder . 435 00 - __
-- -- B. Services or Feeders(10 branch circuits included)
Commercial El Pesidential 0 Installation,ai1erations or rolocals.• —
100 ewe or less --- 435 00 _.— _ 2
Tenant Name 101 amps to 10)amps 480 00 _---.—_2
(if commercial) 'iA p 401 amnia to 600 amps $6(S 00 - 2
. r)( �
601 amus to 1000 amps 4130 00 __ 2
2a. Contractor Inst llation only: II__ Over 1000 amps or voile - 000.00 -- __
I ;,�. l v r Tr,l( Recce ieci only 435 00 - — --- 2
Electrical Contractor_
Address _'/L / ) Jt1t u/// /;'l i D �i1'r; % ' C. Temporary Services or Feeders
Date r t,,l/r/,'/' _ Job Number _40 L / - Installation.alteration Of rebutbn — ----- -
200 amps or Inns $35 00 2
Property Owner TAP /tea f�r ---- 201 amps to 400 amps 440 00 ----- 2
Contractor's License No. _= C. r i-3 C --- 401 stops to r,00 amps $110 00 -_ --_ 2
Contractor's Board Reg. No. 'j;L~! cher 600 amps to 1000 volts see'6'above
l(2/
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Signature of Supr. Eleen `'^ D. 3rdnch Circuits
1 new,alteration a errteneion per panel
LI? S PhoneNo. ..1-1/_/-1L V _ 1136.00 2
License No.J One circuit —� -�
Two to ten circwts 4_. $60.00 .=_:i— 2
2b. For owner Installations: Each additions ten circuits
or par.theroof $15.00 _—_— 2
hi(NMrigAMs--- w E. P iscetlaneow (Service or Feeder not lrcluded)
_-. a x
Each pump rigatfon circle $36.00 __ 2
Address ^— Each sign or outline fighting $36.00 — 2
Signal cfr.unls)or•limited
(;@y -mow -Tip • ..--------
energy penal,alteration
or extension 436()') -- 2
The installation is being made on property I own
F. Each additional inspection over the'Plowable
which is not intended for sale, lease or rent. in any of the above. per in.spectic n
f75'Kl
Owner's Signature
3. Plan Review section (II required) 5. Fees
A. Enter total of above fees $ _%o. 00 ,
5%Surcharge(05 X total fees) $ 4 `0
SubtJta1 $ . ,i J .
8. Enter 25% of line A for __
_ Plan Rehriew it required (Se:lion 3) $_
For Inspece:-ne cell Subtotal $ = 0
640-3561 or 693-4415 less Bulk I abel Fee $ — —
24-hour recorder, Balance Due $ ----+�
one working day in advance of need
This permit becomes null and void if tile work authorized by the permit Is not con-minced within 1110 days horn date of issuance
•d sorh psrmlt or if the work authorlrel Is suspended or abandoned at any time after wore is commenced for a period of 160 nays t f\rr 1
r'h�lrlcsl Permits are nor,refundable and non transferable.
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AlkDEPAI,TMENT OF LAND USE & TP.ANPORTATION
'"�1SNINGT01'1 LAND DEVELOPMENT:iERVICES DIVISION#350.12
155 NORTH FIRST,HILLSBORO,OR 971:4
"'1 COUNTY, PHONE. 593i640.3470
OREGON INSPECTION REOUEST;: (24 houre)• 503/640.3581 or 893-4415
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