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9422 SW WASHINGTON SQUARE (1) 94LL SW Washington Square 1S1 26C retail aelea I'opps & Troweers #3051 i M*4)10:0406 4,41 r 3051 N .I Z I WHITE Iny»cto r Com, to PPSY /� �w t/ J YELLOWPermittee PINK Cothler GOLDENROD Cifculot'On "'"" NO. APPLICATION FOR BUILDING PERMIT GREEN Temporary Elle •WASHINGTON COUNTY ADDaEss �_ DEPARTMENT OF PLANNING „..5 f LOC ALITv : YAWN UILDING DIVISION NEAREST CROSS ST C€N/U/ LAND uSF 0 4d ITYPF PRO EEt.'T FOR APPLICANT TO FILL IN . r. CODE CONST C( RVILDINO STATISTIC A=CLASSIPICATION ZONE ADDRESS • j • -• •IC�t� 'Ar CLASS NO DWELL UNITS 3 LEGAL DESCH F'T 10..I C 1 d& 62 C SPECIAL CONDITIONS J NO SE/L D!! •REA OF L.OT NOM OW l0• ZONING •I'PROVED •C DA TF El Ir ,i USE of i 1L •MA."i4.E - I L TEL TYPE OF SANITATION DIST. OWN R ' t ' (.. . NO p SATER SUPPLY MST, ADDRESS i_r}�EEI? INDO SITS•tR FROM FRONT PROP Owe 01 _ 1 CITY c/ [%C V a f' �F.cE{c_ 1 lV� _�__._.� �,s�t�- E1Jyj` T L� (� nu.INt +t rRACF wl[NWAr TAPE TOTAL •RCI REein 1� NOL/ / 3 • • re.re _ ►NOINE[R + - ADDRESS 0 • • /.De ft T/ACt ►ROM TEL 1 01 PLOP .I NI OF -- TO 11 CON TEA CTOE NO Tref 01 111/TIM/ /['/AGA wl/NW•v + TARO TOTAL ADDRESS H /NMA` WID!S IROM C CITY DESCRIPTION OF WORK CORNER CuEOPF YES II NO • 1Nti14\ RE LEER REPAIR Df HOLISM LlGI+F NEW ADOSEE REVERSE SIDE FOR SFECIAL APPROVALS • ET T NO OF NO OF SIZE T RI FAM' IFS NO. REOI.00UTS / NO. OF R.TNROOM AN Use OP STRUCTURE VOW NC) O EMPL OrFF J `� NATURE OF AP U / // %Ef(1111' A PCANI ,(�L.T APFROV ALS DATE IM/IIC TORS/IIt MATUwL IDLINOATION LOCATION VALUATIONS , • •00 PORUS MATERIALS 'NAME AlI ,i '/ PC I Ailliiilraalli BRACING 6UlTS FFF,� • • IIRFPLACI HtPERV •FPN,WI tont toil, HASP READ TN'S AP'l CATION AI DOVE STATE THAT THE AOVC IN TCOONECT ANO AGREE TO COMPLY WAIL. BOARD W;TH •LL COUNT' OROINANC[S ANO STAT[ OUL•TINO SUILDING CONS,RUC,. SIGNATURE Of ides, HOL/SE NUMBER CORRECT PEISMITTEE ---. NO P•ST ADDRESS__------- ----- —_— FINAL Arta - PLAN CHECK V ALIDATIQN/• mo uR PERMIT VALIDATIOL,N} M o /H I � DATE//.../Rf-7 3 P 6 � V11.1.101 NO ■ I'IA•E///if /T IS I i I FIRE PREVENTION BUREAU 99A '1. OFFICE OF FIRE MARSHAL 6 J i 4 1 INSPECTION NOTICE OWNER1..VI14!Qr' T !L• T-*t . _- DATE_ . - / ./4 OCCUPANT '" 4-. P4L{477}'4 OCCUPANCY„,.'•_•_4A`h 0l LOCATION ��.. 2f:) ..2�_1�lt' r; 'S/✓/I'(��Ql� .,/,,/,1_A :•• I OVR AF lab,TIOH 15 CALMS TH,H.Ht I.(7W I0,14 IMi 6•vuosorrorn.It ra..Ie ST _ '9/1+ _ _. , i.•--i u"_s_ Q/ '40" '-zi i t S,1 xa/1P, --- - -. /.:, .tri! t,! Lif •57.1,--,1,- J_S fr/• r FAILURE TO CORRECT THE A/OVE CONOITION/ WITHIN OA vs Wu MANE VOu LIA/LE TO PROSECUTION. SHOULD FIRE RE/ULT FROM SUCH CONCITIONA YOU MAY /E LIAPLE FOR OAMAGEL TO PEI NS OR PROPER TV u901E94 PROVISIONS OF ORS 479 190 � J 1 ' 4? . I/ ,-- WASHINGTON COUNTY FIRE DISTRICT !11 FtRL MARSHAL 14480 S W JENIKINS ROAD { �, BEAVERTON OREGON 646-1101 PRESENTED TO -._. c 1 /2 ---- ..•SZF, 71X Washington County ' Fire District No. 1 14480 S W Jenkins Roao I Beaverton, Orogon 9700f, '' `r N �. . Bureau of F.re Prevention 646-1101 Extension 245 Plans Examina.t:.ars Report NO. 244 Fire Station Sotle :,U^t l► len aril. 4127 Run Distance building, Tare ♦ Tre weere tore Occupancy f-: ner7set tle Fire Zane Address "tier ..,_rre Kid, ',110Ninrtoet Snupr. Construction Type ::I..y Architect/Designer rennsth 1. butts — Address , nrino. 'eliforn a Owner inmate acute Inv. Address ',t7 $. . ash. s:. O. Stories 1 Main Area»lt /basement Area none Attic Height - .../Stops Fire Walls ^r^• Fire Escapes nye Exits 1+ /Total Width . ft. Stairs "o'ne closed - Other Vertical Shafts nnee° /Enclosed Sprinklers Ps Area Covered S*+tIre 'tees Man. Alarm no S.P. • Ext. nos,/Class - /No. - Combustion Detection?L',j ype - _/Area Covered - Floor_ concrete _ Ceiling *et. Tile (mineral) Roof Atilt up Sir. Members noel Wall Cover none oyo.berd tns+rred sir Exterior Interior Heating Systemp�uel sleet. Cooling System 'creed .ir! central The plans for the above described structure were referred to this office l 1 `" end reviewed 10, ;t for oarlfortQity with State and District fire safety lays and regulations. The following itemized oasments describe changes in the plans required :'or conformance with such laws and regulations and recotmsenoations for enhanoement for the general fire safety of the occupancy. 1. all besting, ventilation, els cnr+4itioninc and electrical wriaaent and ariliencw-. ere required to be eooroveo by wwerwriters Laiv,retories Inc. es other notionally recognised testin; money's soecificstione. (serfs ase. 102 U.S.C. inc vo14*as I I) T. All door finish hardware, i.e. lee e,'lstchee suet Os eoenshl• from the *nolo. et ell tines fir immediate emit without the Jef of a key, special knowledge es •f tart. (rot: me. 33J3 n1.Y.0. 1970) (•.ver) Janald K.,Mol�rq Fire Marsha.),' , 111 / t/% _ A . Plans Baer art I'd Magriit en meshote.91 dp.D*At. lemeeeter liwtte Pons k sed�3373 FIRE PREVENTION DOES NOT COST—IT PAYS 1. hotiflcrtlee of this Wimp for inspecttpr a• esnet,uetisn is required prig to occupancy of the state. (reef .s. 1.711 (Miters Ilse Code) 4. riot t occupancy cf the store s Certificate of Occuoiwtcy free the Je•hingtan c ounty "Mrildtnq t.• sttmeni 1a required. t T I_T jarj4T221 the exit refsrreo t• in the above dsucriptlon Ss • doer out the root. i.e. the as1I entrance will be served by A roll up grill. IK etandpitNs leacatlon• pls.sse refer to the rite @v,,-:aa icn cyst", plan. Fr- INORIPS-"-- ____ _... __ _ I 1 0 11 1 1 . DEPARTMENT OF LAND USE&TRANSPORTATION ' WASHINGTON 1. W w SHINGTON LAND DEVELOPMENT SERVICES DIVISION 1 �1 41.14 COUNTY,i f 155 NORTH FIRST,HILLSBORO,OR 97124 INSPECTION REQUESTS: 503/640-3581/693.4415 , ik OREGON AXXXA XXX- (140-J4 /u Page : 1 of 1 Date : 0W:/11/95 Time : 13 : 04 Permit Type : Commercial Electrical Permit Permit # : 050bb211 Permit Status : APPROVED Applied : 04/11/95 situs Address : 9422 SW WASHINGTON SQUARE RU 1'1 Issued : 04/11/95 Permit Title : BIAGIU - ELEC/10 CIRCUITS Completed : Permit Uescr. : JOB #54/44 To Expire : 10/08/95 Project Title : BIAGIO - ELEC/10 CIRCUITS Project # : P0049048 Project Uescr. : JOB #54/44 * EROSION * • Parcel Number : 251'1'1 - Land Use District : Valuation U ' Legal Uescr . .• Owner : INSPECTION - TIGARD Construction . OTH Applicant Name : FRAHLER ELECTRIC Classification : 900 Applicant AUdr . : 11bb0 SW GREENBURG RU Occupancy '1'1GARD, OR 972Z3 Validated by : KKP Applicant Phone : b39-4b2 / Inspector Area : Fee description Units Fee/UnitExt fee Data 1st branch W/out Feeder [Enter # 1 1 35 . 00 35 . 00 Addl . Branch W/out Feeder [Enter e ] 9 5 . 00 45 . 00 Subtotal Electrical Fees : 80 . 00 state surcharge of 5' 4 . 00 I Total electrical Fees : 84 . 00 4 ► ** Fees Required *** *** Fees Collected & Credits * ** i Method Check # Receipt No. Date Payment • CK 20349 04/11/95 84 . 00 r TOTAL THIS DATE ********* 84 . 00 Fees : 84 . 00 Adjustments : . 00 Total Credits : 00 I Total Fees : 84 . 00 Total Payments : 84 . 00 Balance Due : . 00 NOTICE This permit becomes null and void if the work or construction for which it is issued is not commenced within 1110 days Once construction has started, the permit becomes null and void If construction is Interrupted fora period of 160 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 compiled with whether or not specified rn the plans ur 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 easement 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 1 Building Department is solely at the risk of the applicant and such use or occupancy is revocable until all inspection requirements are satisfied and 1 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 APPUCANT'S SIGNATURE 1 1 kliills F._ ,.....„______ ______ _ _ _ _ ___ _ _ 7 a,s.aueerscaa►.asf qtr sa. ,.owr...lalw.w.r.n - C 111 r TEMPORARY - 4/ 11 /95 - 4/ 16/95 1 ` WASHINGTON COUNTY ELECTRICAL PERMIT II , Department of Land Use & Transportation • . I iectrical Inspection Section APPLICATION Illi S5 North First Aven•.ie, #350-12 1 Hillsboro.. '''rec1on 97124 lnfc:•rrtati n: (503) 640•:4 '70 Fax: (503) C93-4412 Permit /C� 1 v_,../„., r,', PLEASE PRINT Number tO r Date Please complete all sections, 1 through 5. ' 4. Complete Fee Schedule below I Number of inspections per permit allowed 1. Location Of installation Service included: Items Cost(ea.) Sum Adoress_y42Z SW WASHINGTON SQ . RD _ Building A. Residential-per unit City T I G A R D Suite No. . u sq tt.or loss ._ $110.00 4 ` Tenant Name E,i..h additional 500 sq.tt (if commercial) - 13 1 A G I U or portion thereof -^ $25.00 -•- Limited Energy -- $25.:X.1 1 Map No.- Tax Lot --- Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 .-. 2 Thomas Map Book: Page: __ Section: _- Directions--TSV A N T I il P R O VE`M� ^-- B. Services or Feeders Installation,"Iterations or relocation � 200 amps or loss - - $60.00 2 L^J Commercial Residential Li 201 amps to 400 amps $80.00 _ 2 ' I 401 amps to 600 amps ____ $120.00 2 j 2a. Contractor installation only: 601 amps to 1000 amps - $180.00 -- 2 Over 1000 amps or volts 5340.00 .- 2 t Electrical Contractor F R A H L E R E L E C T R I C CO . Reconnect only ---- $50.00 2 Address L 1860 SW GRLENBURG KURU City T ARD State 0 4 ZIP C. Temporary Services or Feeders Date 4/ 1 (0 i 9 5Job Number 54 /4 4 r Installation,alteration or relocation-- - . _ Property Owner 200 amps or less --_- $50 00 _ 2 3 4- 1 3C 201 amps to 400 amps $75.00 2 Contractor's License No. 401 amps to 600 amps __ $100.00 ______ 2 Contractor's Board Reg. No. 17 4 1 Q Over 600 amps to 1000 volts see'B'above Signature of Supr. Elec'n - ►' t,. D. Branch Circuits • License No. 3 046$ Phone No. 6 3 9-4 6 2 Now,altoiation or extension Der panel a) The fee for branch circuits with 2h. For owner installations: purchase of service or feeder fee. Each branch circuit -- $5.00 2 - purchase ofb) The foe for branch circuits without ) r Zwner's Name I/(_\_0• tb�ene� purchservice or feeler fee. I,rs35 . 00 t branch circuit $35.00 2 Address -/d_ 95 Each add nl branch circuit_l___ $5.00 4 5 . U 0 2 • Cry ty State Zip E. Miscellaneous (Service or Feeder not included) Each pump or irrigation circle $40.00 -, 2 The installation is being made on property I own Each sign or outline lighting .-__ $40.00 _- 2 which is not inten�/� Signal circuit(s)or a limited ` ` -4 , i fl�>Ji�Ct' energy panel,alteration Owner's Signature 11 1; '1 a..tCA ION or extension _-- $40.00 -- 2 F. Each additional inspection over the allowable in any of the above 3. Plan Review section (if required) Por irisoection __- $35.00 __.__._ Per hour -____ $55.00 - . Please check appropriate Item and enter fee In section 5B. In Plant _____ $55.00 - .-- 4 of rrore residential units in one structure 5. Fees _Service and feeder, 800 amps or more R 0 . 0 0 __System over 600 volts nominal A. Enter total of above fees S __Classified area or structure containing special 5% Surcharge (.05 X total fees) $ 4 . 00 occupancy as described in N.E.C. Chapter 5 Subtotal $ -B. Enter'.5% 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 Subtota $ -- services. [ ] Trust Account $ ---- - Balance Due $ .'L► - u u For inspections call This permit beetling a null and void If the watt e.dtorlted by Ilw permit I.not commenced 640-3561 or 693-4415 within ISOdaled d.ye from d . issuance of pins*o.it 1M wwo N ortt.ubrlr. .yepended I...Mn..onsd et any tons.Mgr watt le commenced la.period d t W days 24-hour recorder, one working day in advance of need fiedru.IPermits.e non retund.bi.end nonlrsnel.reble 9-'9a 1 1 I 1 1 mmmilmsmov DEPARTMENT OF LAND USE & TRANSPORTATION LAND DEVELOPMENT SERVICES DIVISION #350-12 WASHINGTON 155 NORTH FIRST, HILLSBORO, OR 97124 COUNTY, PHONE: 503/640-3470 + I OREGON INSPECTICN REQUESTS (24 hours): 503/640-3561 or 60:s-4415 Permit it : 05066211 Project * : P0049048 Status APPROVED Pagt 1 at 1 Applied : 04/11/95 Issued 04/11/95 Expires 10/08/95 04/18/9S 0.+ . 01 Permit Title BIAGIO - ELEC/10 CIRCUITS OTH Description JOB *54744 Bequn . 04/11/95 Job Address 9422 SW WASHINGTON SQUARE RL) TI Owner Name INSPFCTION - TIGARD Region 1) ' Applicant Name FRAHLER ELECTRIC Phone number 639-4627 Valuation, 0 Approved �G4-o r r 1"4 kt t.5cl),cl4(r Rejected 74.- , Inspector Comments VR-RESULT _— --� ------ __----- __-___ _-----_._--__.—. -.._ -___ _ ok.-- _ --- --- ---- __ REQUEST ERi2OR1 --moi_-.�.. - 1 P 1 umb i n q -- — — ----. . Mechanical --- -.- _ ____.-_-- _._.-- ___. Electrical ____ - _ __ Structrual . - - -- _-- _.--- General • --- _ . Inspected by Dater Lf-/rSS Inspection Requested (4.44. 41 6.11,t-�-� * Cover [ ". --V ' " 4` 1404 E AP ON IVR 04/18/95 RI KKP I I I I 7, . ` . _. . _ . - . .. , I 1 1 PROJECT NO. y J O lie WASHINGTON COUNTY INSPECTION CARD DEPARTMENT OF LAND JSE AND TRANSPORTATION PERMIT NO. - 4,2./r FOR INSPECTIONS CALL: C40-3561 24 HOURS / , C I Cf FOR INFORMATION CALL: 640-3470 DATE --ii--q. --- 1I 13 /G /Q - --------- PERMITEE F".{ Lt-,-LrZ- ti Cs- ce_i- //ADDRESS 1 --------- DIRECTIONS (.�-�C-1 Q___— ----------•--- _ PHONE NO._6 3, -v 4 Z 7 -- BUILDING MISCELLANEOUS - PLUMBING ELECTRICAL ftg post/beam nail mobile home ground rain drain temp service fdn frame apron/ wood stove post/beam storm sewer cover & service sidewalk slab insul HVAC top-out FINAL FINAL FINAL gas test sewer USA No. OTHER �II APPROVED AVED INSPECTION STOP WORK IJNT�❑ EirkT1R ANU RE-INSPECT JREOUESIED APIpRONED HOWEVER NOTE: D I F[U Q /24Gc4 __� p 1 4 je l' ______. S- sSs INtiPsCT'D By LI DATE 1 7 . , ................. 7 '1....7..... ...... 4............., . _ ., . , 1 1 _.......,..,.. • . . . . . . . DEPARTMENT OF LAND USE & i HANSOORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIV!;;ION X1350-12 COUNTY,OREGON 155 NORTH FIRST, HILLSBORO, OR 97124 PHONE: 503/640-3470 INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415 i i) -5 s- 67a5�3 Permit Ii . 05066211 Projekt P . P0049048 Status Applied 04/11/95 Issued 04/11/95 APPROVED pay, 1 of 2 Expires 10/08/95 05/09/95 05 : 02 COMELEC Permit Title BIAGIO • ELEC/10 CIRCUITS (rTI{ j Description JOB 1154744 Job Address 9422 SW WASHINGTON SQUARE RD TI Bhgun: 04/11/95 4 Owner Name INSPECTION - TIGARD Region D Applicant Name FRAHLER ELECTRIC Approved ed Phone number 639-4627 Valuar ��n 0 App . d � ( Inrpectar C.�Jnar,Entf. SS d ,-. ( � - _ Refected demb i --- — — _ REQUEST ERROR ! ig - agh9 re,,,, tri4P E-400%.? / ' 51 • _. _.... Mechanical El e c t r i c a 1 Stru�_trual --_— . --- - ______ - General _. --•_ __ _. ._-__. . -- . ._-.—._._ Inspected by bet a —51-57-4 Inspection Xequerted '(9it Final Electrical" 05/09/95 RI MJF 0499 E AN N 1VR 05/05/95 RI PH fI 05 /0S/95 DN Gi f,NIVX LUTE T R 1 1 / . . _ _.. T_ _'T- _ 411 r 1 1 I _— WASHINGTON DEPARTMENT OF LAND USE&TRANSPORTATION LAND DEVELOPMENT SERVICES DIVISION 155 NORTH FIRST,HILLSBORO,OR 9712A ON • COUNTY, INSPECTION REQUESTS: 503/840.3581/693-4415 Mr I , OREGON ' xxxxxxxxx---> 64U-34 /o Page : 1 of 1 Date 04./28/95 Time : 1 3 : 21 Permit Type commercial Electrical Permit Permit # : 050e7053Permit Status (=al Applied 04/28/95 Situs Address : 9422 SW WASHINGTON SQUARE KU TI Issued : 04/28/95 : BIAGIO - SIGN CIRCUIT � Permit TitleCompleted J Permit Uescr, To Expire : 1.0/25/95 Project Title : BIAGIO - ELEC/1U CIRCUITS Project # : P0049048 Project Uescr. : Job #54744 * EROSION * Parcel Number : 251'1'1 -- Land Use District Valuation • U Legal Uescr . owner : INSPECTION - '1'IGARU Construction : UTH Applicant Name : MUL'1'l-LIGHT bROADWAY SlGr: CO Classification : 900 J Applicant Addr . : 3255 NE BROADWAY Occupancy • 1 PORTLAND, UR 9'/232 Validated by : PH j nrr-ticanthone : 281-3083 Inspector Area : tee description Units Pee/Unit Ext fee Data Sign or Outline Lighting 1 40 . 00 40 . 00 Subtotal Electrical Pees : 40 . 00 State Surcharge of 51 2 . 00 Total Electrical Pees : 42 . 00 *** Fees Required * ** *** tees colla;-ted ht Credits ** Method Check # Receipt No. Date Payment 4 CK 22168 04/28/95 42 . 00 i 7 TOTAL THIS DATE ** ****** * 42 . 00 i-'ees : 42 . 00 Adjustments : . U( Total Credits : . 00 Total Pees : 42 . 00 Total Payments : 42 . 00 balance Due : . 00 NOTICE: This perms 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 10 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 sto.cture or building permitted depends upon my caping 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;s solely at the risk of the applicant and such use or occupancy is revocable until all inspection requirements are satisfied end approval is given by the Building Official I further acknowledge that a lien may be placed on the title of thero specifying that the use or occupancy of the building or structure is provisional and revocable until the satisfaction ofrty t aP/nspectionn which requirements it is ued APPLICANT'S SIGNATURE 1 4 I 1101111111111, i WASHINGTON COUNTY D tq of nerLand Use & Transportation ELECTRICAL PERMIT Electrical Inspection Section APPLICATION 155 North First Avenue, #350-12 Hillsboro. Orel tor+ 97124 Q Fax: 503 693-4412 J O� i '?:-''''n ��/c�� Infomtatlon: 503 840�4Y ProjectlPermit ate = j PLEASE PRINT ,I4 Number il Please complete all sections, 1 through 5. 4. Complete Fee Schedule below 1A Location of installation Number of Inspections per Permit allowed Address BService Included: Items Cost(ea.) Sum_ City_1 , JL.I �? SuiIdinpO' A. Residential - per unit Tenant Name I 1000 xi.tr.or less $110.00 4 (it commercial) Each addition&500 sq.ft $25.00 1 or portion thereof - Tax Lot Map NO. Limited Energy S25.00 SeCtiott:�-- Each Manufd Home or Mooular $68.00 _ 2 Thomas Map Book: Page. - Dwelling Servae or Feeoer Dirr�:tions-_---- __ B. Services or Feeders - Installabon,alterations or relocation $60.002 Commercial r Residential 200 amps or less 2 201 amps to 400 amps --- S80.00 401 amps to 600 amps $120.00 2 Ele Contractor installation only: $180.00 2 ‘ .. 601 ams•to 1000 amps $180.00 2 Address CO(tir8Ctof $! ' ak- Over 000 amps or volts $50.00 2 Address ' Job � ,��— Reconnect only Date - �� ,�Q Services or Feeders Property Owner No. .i m C. Temporary Contractor's License No. cl5,11.0------ Installation,alteration or relocation $� 2 Lt 1 c�-I 200 amps or less $50.00 2 Contractors Board Reg. No. 201 amps to 400 amps _ 401 amps to 600 amps $100.60 _-- 2 \ Signature of Supt. Elec'n �.- ► k- Over 600 amps to 1000 eau see•B'above License No._21.1.. .L_____ Phone-NW .. D. Branch Circuits 2b. For owner Installations: New,alteration or extension per panel ��— a) The fee for branch circuits with ir — Purchase of service or feeder fee. 2 not • Each brancr.circuit $5.00 !I_ b) The fee for branch circuits without purchase of service or feeder fee. >aS.W 2 ty Dista —7.4P First branch circuit Each add'nl branch cmrcwt,— $5.00 --- 2 The installation is being made on property 1 own E. Miscellaneous (Service or Feeder not included)� which is nog intended for sale, lease or rent. Eacn rump or rngetion circle�--- '� �g2 Signal circumtls)or a limited = + Each sign or outline lighting _L- 140 pwrters Signature. panel.alteration 2 3. Plan Review section (if required) energy extension -- Please check appropriate nem and enter in sert►on 5B. F. Each additional inspection over the allowable __ 1 & 2 family dwellings over 320 amps sic meter in any of the above 4 or more residential units in one stricture Per inspection $35.00 m — Service over 225 amps; feeder 400 arr,ps or mare Per hcur n Plant --- $55.00 — System over 600 volts nominal Building over 3 stories in height , $, Fees Building over 10,000 sq. ft. A. Enter total of above fees �* - Occupant load over 99 persons 5% Surcharge (.05 X total fees) $ . Manufactured Structures Park or ��ecreational Subtotal — Vehicle Park; n rw, addition or alteration B. Enter 25% of line A for Classified area or structure containing special Plan Review it required (Seaton 3) — occupancy as described in N.E.C. Chapter 5 Subtotal $ Submit 2 sets of plans with 'police:loll where any of the Less Bulk Label Fee $ Not required for temporary construction Balance Due ��'��' above apply services. ryr e�Weill It Ose..rh wn.M=d by the pool r~s••••� ��/� .�Foe�+ •r al Oehl MOOR/N terse delete mwrww./.••s r+tr c.r Newest wb.ud tis w. 640-`?�7�� J�.15 ii�we.Me.sr1►•�"""""'t"•MM. w•~w 24-ha. 'recorder,or»wOrltlnC V i ..- �d nssdl SieS, • 1 r . -