9586 SW WASHINGTON SQUARE (1) AIIIIIIIMMIIIIIII
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•40% DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH MRST,HILLSBORO,OR 97124
COUNT i t INSPECTION REQUESTS: 5(3/640-3561/693-4415
CaOI r PHONE: 503/646-9761 Pette : 1 of 1
ORE
Date : 07/09/93
Time : 10 : 09
Permit 'Type : Commercial Electrical Permit Permit N : 05042260
Permit Status : APPROVED Applied : 07/07/93
k, situs Address : 968s SW WASHINGTON SQUARE RD TI Issued : 07/09/93
n, Permit Title : 9 WEST-G 13-ELEC/SRVC, 16 CKTS Completed :
Permit Descr . : JOB *5.2393 '1•o Expire : 01/05/94
Project Title : 9 WEST-G 13-•ELEC/SRVC, 16 CKTS I: oject n : P0032690
. Project Uescr . : JOB Us2393 * EROSION *
."4 Parcel Number : 251'1'1 - Land Use District :
Valuation 0
Legal Descr .
I Owner : INSPECTION - TIGARD Cotruction : EPR
Applicant Name : FRAHLER ELECTRIC Classification : 900
Applicant Addr. : 11860 SW GREENBURG RU Occupancy •
TIGARD OR 97223 Validated by : KF
Applicant Phone: 639-4627 Inspector Area :
CON'1'RA':TOR : I'RAHLER ELECTRIC Lic. C 34-13C 639-4627
Fee description Units Fee/Unit Ext fee Data
bervice/Feeder: 200 amps or less 1 50 . 00 50 . 0r
Each Branch W/ Feeder ( Enter *) 16 2 . 00 32 . 00
Subtotal Electrical Fees: 0 82 . 00
State Surcharge of 5% 0 4 . 10
Total Electrical Fees: 0 86 . 10
*** Fees Required *** *** Fees Collected h Credits ***
Receipt No. Date Payment
07/07/93 86 . 10
Fees : 86 . 10
Adjustments : . 00 Total Credits : . 00
Total Fees : 86 . 10 Total Payments : 86. 10
Balance Due: . 00
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)..' t NOTI':S: This gem*becomes null and void it the work or conetructlon for which It Is' -Al Is not commenced within ISO days. Once construction has started,
ale parr*bendier,null and void if oonstnrctlon le interrupted fora period o1 .110 days. I certify that Ms Information prss.MW by the applicant and
• Ms WE or agents In support of this permit is true and correct to the best of our knowledge. I aclmowl.dg•that the Building Department's reliance
3, • upon Mas and misleading lnfor merlon may InwNds'sthis permit. All provisions of applicable laws and ordinances governing Me construction and use
" of this Milan or structure MN be compiled with whether or not apeotfled on the plans or noted on the plans correctbo sheets. I acknowledge that
the vital St a parr*dose not gran!authority to moan private property or to ue•easements. I further acknowledge that the use or occupancy of
Ms Structure or building psrrr*ted depsods upon my calling for inspection M venous times during the process of construction and the building
k.pr'lon Main verifying compliance with the various nodes. Use or occupancy of the building or structure pertnMed prior M approval by Ins
1 MIIMMhg DOp rtment is solely M the Ask of us applicant and such use or occupancy is revocable until all inspection resuksnn•.ts ere satisfied and
approval N MUsn by the Mulidlog Official. I further acknowledge that a Nen wiry be Owed on the title of the property upon which the permit is issued
pacifying NM the use or uocupancy of the building or stnwctun►is provisional end revocable until tie satisfaction of all Inspection requirements
,) APPUCANT'$SIGNATURE
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WASHINGTON COUNTY ELECTRICAL PERMIT
, • Department of Land Use Or Transportation 1/ ,
Electrical Inspection Ssclon
155 North First Avenue,1350-12 APPIsrU ATU
Hillsboro, Oregon 97124 - U.2 t7L 0
ktf.rrnation: (503)610-.470 Fax: (403) 693-4412 Project/Permit (/ /�
IPL�ASE PRINT Number ,3,nry WIV Date �'D y13
Pl&ase'hpitiplete 1111 sections. 1 through 5. 4. Complete Fee Schedule below
1. Location of Installation
Number of p«perm.t Wowed 4., ; /
Address 9585 WASHINGTON SQUARE ROAD Service included: Items Cost(ea.) Sum /
Building _
City T I G A R D Suite No. Q- 1 3 A. Residential -per unit
S
Tenant Name
9-WEST 1000 sqn.or leas
(if commercial) , _ Each additional 500 W ft $65. 4
or portion thereof $15.00
Tax Lot_ Map No.
Limited Energy $20.00 1
-- Each Manufd Horne or Moduiar
Thomas Map Boole: Page: Section:._ Dwelling Service or Feeder $40.00 2
Directions__ B. Services or Feeder
� 2 InsOle genera «iebcati9n 5 0 , 0 0
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Commercial IX.,. Residential F-1 201 amps to 400 amps __ $50.00
0.0000 22
401 amps to 600 amps . $100.00 2
60' emits to 1000 amps $130.00
2a. Contractor installation oo l y: Over 1000 amps«volts -- $30000 2 , ,
.00
Electrical Contractor F R A H L E R ELECTRIC Reconnect only ya 2
Address 1 1 8 6 0 SW G R E E N D U R G. TI G A R D C. Temporary Services or Feeders
Date 7/6193 Job Number 52393 In.tsCation,alteration or relocation
i Property Owner __ ?Vamps or I••s $40.00 2
Contractor's License No. - 34-13C 201 amps to loo amps $55.00 2
Contractor's Board Reg. No. . 3 14 1 0 101 °6000 w 60 1 2
OWN 600 amps to 1000 volts see'(3'above
Signature ui Supr. Elec'n _ D. Branch Circuits
License No. 3046$ Phone No. - New,alteration or extension per panel
a) The fee for branch Qircuits with
pu2b. For owner installations: Ea h branch of service or a..
Ee.:h circuit x•00 32 .00 2
b) The tee for branch circuits without
Print Gwr>er's Name Phone Nc. purchase of service or feeder fee.
First branch circuit $35.00 _ 2
Address -- — Each•dd'nl branch circuit $2 00 2
__ E. Miscellaneous (Service or Feeoer not included) •
CityState Zip --- Each pump or irrigation circle L10.00 _ _ 2
Each sign or outline INhtinn y40.00 2
,4' The installation is being made on property I own Signal circuit(s)or•limitedenergy _
which is not intended for sale, lease or rent. or extension alteration
I « $40.00 _ 2
• , Owner's s+g^• • _ F. Each additional Inspection over the alfoweble
in any of the above,per Inspection
3. Plan Review section (If required) $35.00
L Q �i' 5. Fees t
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i /® A. Enter total of above fees $ 32 . 00 . t.
5% Surcharge(.05 X total fees) $ 4 , 1 0
Subtotal $
B. Enter 25% of line A for
For Inspections call Plan Review if required `
i
640-3561 or 693-4415 Subtotal (section 3) $ •
24-hour recorder, Less Bulk Label Fee $ ,
one working day In advance of need Balance Due $ 86 . 10
This permit be A.-:71•8 void If 1M work•uM prized by the permit le not commenced within 1$0 days from date of Issuance
permit or it
the work authorized is suspended or abandoned at any time after work is commenced ft• a period of 1$a days.
r
r''' Electrical Permits are non-refundable and non-transferable.
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON -- I LAND DEVELOPMENT SERVICES DIVISION 4350-12
'J. �' COUNTY, ( 155,\',"_IRTM FIRST, H:LLSBORO,OR 97124 /-/�
PHONE: 503/640-3470
OREGON / INSPECTION REQUESTS (24 hours): 503/640-3561�r 693-4415 1�L
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Job Addrars •,-,,3 y. eW 113..• F, f N 'T N .. . UAP. 41
Owner Name N. i'. r, h • :I •ii kLk"'4J I1 r ..
App11•--aru Na1ma .:1.1.:•: LA . G..7TR. I'
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-...........-...„. -....- 74;le///./PI . ................-..........-.............................. —- .-. . ... --....- ..... .. ....... .".....•••-.... • •
` .C: Inspected LI Da t• 7e0 f/3
Inspection Req;. .
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1 •z 07/20/93 Ri .ii AM PL::
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DEPARTMENT OF LAND USE & TRANSPORTATION .,',.
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 6350-12
0.COUNTY,
155 NORTH FIRST, HILLSBORO,OR 67124
PHONE: 503/640-3470
OREGON INSPECTION REGUESTS (24 hours): 503'840-3561 or 683-4416 •
P.rmit
Applied �+ \ /
Permit
` Doscr. : 'Vt..
Job A .
Own•pr N.,
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'r(� yl ' ( EPARTMENT OF LAND USE & TRANSPORTATION
WAS Tr.r b,� ildi "I ND DEVELOPMENT SERVICES DIVISION 6350-12
fID ( (
COUN (; ,------------:
155 NORTH FIRST, HILLSBORO, OR 97124
OREGON od PHONE: 503/640-3470
INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
P.rmlt fl SC4,_. r .]sct 4.PPRI ',-•, .
App: ).s.i 1/•� . 'i •_,1*' i /: E/'' '
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DEPARTMENT OF LAND USE 4 TRANSPORTATION
WASHINGTON 5OTHRH DIVISION5 NORTH FISTu SERVICES
97
COUNTY, INSPECTION REQUESTS: 503/540-3561/6934415
111
OREGON PHONE: 603/646-6781 W
Page : 1 of 1
Date : 02/14/94
Time : 08: 12
Permit Type : Commercial Electrical Permit Permit 8 : 05049776
Permit Status : APPROVED Applied : 02/11/94
Situs Address : 9586 SW WASHINGTON SQUARE RD T1 Issued : 02/11/94
Permit Title : BROOKSTONE - SERVICES/CIRCUITS Completed :
Permit Descr. : JOB 53223 To E:cpire : 08/10/94
Protect Title : BRUOKS'TONE - SERVICES/CIRCUITS Project N : P0038028
Pro]ect Descr. : JOB 632:.3 * EROSION *
Parcel Number : 2S1T1 - Land Use District :
valuation 0
Legal Descr .
owner : INSPECTION - TIGARD Construction : OTH
Applicant Name : FRAHLER ELECTRIC Classification : 900
Applicant Addr. : 11860 SW GREEN8URG RD Occupancy
TIGARD, OR 97223 Validated by : PH
Applicant Phone: b39-462"/ Inspector Area :
CONTRACTOR : FRAHLER ELECTRIC Lic . C 34- 13C 639-4627
Fee decription Units Nee/Units Ext fes Data
Service/Feeder: 200 amps or less 2 60 . OJ 120 . 00
Each Branch W/ Feeder ( Enter XJ 68 5 . 00 340. 00
Subtotal Electrical Fees : 460 . 00
State Surcharge of S1; 23. 00
Total Electrical Fees : 483. 00
*** Fees Require:. *** *** Fees Collected & Credits ***
Method Check X Receipt No. Date Payment
CK 18633 02/11/94 483. 00
Fees : 483 . 00
Adiustments : . 00 Total Credits : . 00
Total Fees : 483 . 00 Total Payments : 483. 00
Balance Due: . 00
NOTICI: TMo permit become null and void N Me work or construction for widen N N Issued le not oamrnneed MNMn 110 days. Oroto construction has MaAnd,
M.permit bosoms.nuN and void N eonaln,odon le kMsmydW for a period of 110 days. I cantly MM Ina Information presented by the applleam and
Ms agent or apple In support of tele per net le true and owed b Na best of our knowledge. I aolerowtedg.NMI Hre budding Department's reliance
upon Mae and misleading Information may lnwleale Ml.well AM provisions of applicable Nova and ordMMnose gemming Na oomhvetlon and use
of MIs building or structure will be complied Mit~her or nal apeMlled an Ni.plena or noted on Na plans correction staale. I aolmawidge that
Na penkng of a permit dose not Brae authority le mosses prbcta property or to eras aaaann.nl.. Mariner er.obawledg.Mal Me use or:,ocupancy of
M.structure or building permitted depends upon my selling for kapsoNona M serious urns.during Me promos of oonsVuclon and die building
In peiYon.teff outlying comp Igoe wilt M.various mdse. the or occupancy of We building or sbucl re permAsd odor 1e approval by Yha
B uilding Department Is solely sl Me risk of Na applicant and such use or eeeuperMy le rsvooable unlit aN inspection,eyudrrm«w are satisfied and
approval le given by Na N,Ndine WSW. I furter sokn oat dge that a Nen may be Wooed on Na Iles of Na property upon MOM Na perm:, s issued
.pselfyl g test Me us.or 000upsnay of Ine buldbg or structure le provisional and revocable mid Na sail taction of eN Inspection requirements.
APPUCANril MOW WM -
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WASHINGTON COUNTYUse
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ELECTRICAL PERMIT
Department of Land Use & Transportation
NrInspection Section APPLICATION
155 North First Avenue,0350-12
Hillsboro, Oregon 97124
Information: 503 640-3470 Fax: 503 693-4412
PLEASE PRINT Project/PermitNumber 2-7 7 37/ Date f4-!Y
Please complete all sections, 1 through 5. —
1. Location of installation 4. Complete Fee Schedule below
Adaress 9565 S .W . WASHINGTON SQUARE Number of Inspections per permit allowed
Building Service included: Items Cost(e r►.) Sum
City TIGARD Suite No. SPACE 70
Tenant Name A. Residential-per unit
(if commercial) B R O G K S T O N E woo sq.ft.or less $110.00 4
Each additional 500 sq.ft
Tax Lot- Map No. or portion thereof $25.00
Limited Energy $25.00 1
Thomas Map Book: Page: Section: Each Manufd Home or Modular
Directions Dwelling Service or Feeder $68.00 — 2
�7 r L_l B. Services or Feeders
Commercial t� Residential installation,alterations or relocatio9 120 . 00
200 amps or less —( __ $60.002
201 amps to 400 amp* __ $80.00 2
28. Contractor installation only: 401 amps to 600 amp, $120.00 _ 2
Electrical Contractor FR A H L E R ELECTRIC 601 amps to 1000 amps —_ $160.00 — 2
Address 11860 S W G R E E N B U R G Over 1000 amps or volts $340.00 2
Date 2/10/94Job Number - 5 3 2 2 3 Reconnect only $50.00 2
Property Owner
Contractors License No. 34-13C C. Temporary Services or Feeder*
Contractors Board Reg. No. 3 7 4 1 0 _ Installation,alteration or relocation
200 amps or less $50.00 2
g p !`C J `L/•(4 201 amps to CO amps 100$75.00 _ 2
Signature of Su r. EIeC'n y,.� 401 amps to 600 amps __ $100.00 2
License No._1 8 1 68 Phot ie No. 639-4627 _ Over 600 amps to 1000 volts see•B•above
2b. For owner installations: D. Branch Circuits
New,alteration or extension per panel
print Owner'sNam* A a) The fee tor branch circuits with
purchase of s•rvlc•or kw*fee.
=PM -- Each branch circuit '2__ 55.00 340• 0 0 2
b) The fee for branch circuits without
State Zip purely**of Novice or leader h•.
First branch circuit _— $35 00 _ 2
The installation is beingmade on properly I own Each add'nl branch circuit__ $5 00 _ 2
which is not intended fr sale, lease or rent. E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle__— $40 00 2
Own.ws Signature _ Each sign or outline lighting . $40 00 . 2
Signal circuits)or a limited
3. Plan Review section (if required) sner,y panel,alteration
Please check appropriate Item and enter fee In section 5B. a extension $40.00 2
--
1 &2 family dwellings over 326 amps s/c meter F. Each additional inspection over the allowable
4 or more residential units in one structure in any of the above
-- Per inspection $36.00
__ Service over 225 amps; feeder 400 amps or more Per hour $55.00
System over 600 volts nominal In Plant $55 00
Building over 3 stories in height
__ Building over 10,000 sq. ft. 5. Fees
_ Occupant load over 99 persons A. Enter total of above fees $ 4 6 0 . 0 0
Manufactured Structures Park or Recreational 5% Surcharge ;.05 X total tees) $ 23 . 00
Vehicle Park; new, addition or alteration Subtotal $
_— Classified area or structure containing special B. Enter 25% of line A for
occupancy as described in N.E.C. Chapter 5 Plan Review if required (Section 3) $ —
Subtotal $
Submit 2 sets of plana with application where any of the Less Bulk Labe!Fee $
above apply. Not required for temporary construction
services. Balance Balance Due $ 483 . 00
For Inspections call ,—panlbil r.•a..•ora.,,e void 10 at•wadi e.AAerlr.d by so parr*Is.ad•saae.ew
640-3561 or 69' -4415 'ss dors he.MM 16•••••••al•wog «M a»wit.MMrY•/ko
arra
24-hour recorder,one working day In advance of need a r«�aa•6••••••••••
s.w neew al my
a d�.s aa,•Wer•. pedal al d~
5/93
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
155 NORTH FIRST, HILLSBORO,OP 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
Permit r I
p ' r �•1 ' 2/14 '44
Perm: t
1)encription 't :•B ,;:
ob Add:•Rr.r.. SIR .4*1 !'* ! N
Iwner Name N;. ', x
pp1 : cant Na,
1•hon• numk,ar
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02/24/94 RI PH
DEPARTMENT OF LAND USE &TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 6350.12
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
•resit Co
ppli.d G2/1
omit Tit1•
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ob Addre•
or Nathc.
pp1 i c'ar." NAtHr
hone euro:.. :•
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lhapsct•d by 3/9/91
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03/u4/•a4 d. K.
, DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 1350.12
COUNTY, PHONE:
NORTH FIRST, HILLSBORO,OR 97124
PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
••rmit
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o•script io
oob A3dr
owner NA1.4
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03/17/94
03/09/94 :. .
03/09/94 r
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0 DEPARTMENT OF LAND USE &TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 0350-12
155 NORTH FIRST, HILLSBORO,OR 97124
COUNTY, 5 PHONE: 503/840-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 683-4415
P.rmi t 0 0.50 4
Applied 4/ 1
permit 'P t r •
Descrtpti :1
JoL AIdr•e+
Dwner N.+f,11.
Ippti,:an'. NAM,
Intone rttArl wr , ` '
rt., rail
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--to ' 4,v1 1 1......-,4 a.. / Lep-- --
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Inspected i•y0
322 -5y
Inape r.ti , ,, ,._,.
* Fines! .
• " DEPARTMENT OP LAND USE&TRANSPORTATION
WASHINGTON
W^ASHIN !G ON LAND DEVELOPMENT SERVICES DIVISION
�J N 1 i/, 145 NORTH FIRST,HILLSBORO,OR 97124
INSPECTION REOUESTS: 603/640.3651/693.4416
!OREGON P�♦I�NE: 6o3/a�..s7s4 �p :3�� 1
Date : 03/11/`4
Time : 13 : 21
Permit Type : Commercial Electrical Permit Permit Si 05050839
Permit Status : APPROVED Applied : 03/11.'94
Situ's Address : 9585 SW WASHINGI'UV SQUARE MD Ti .issued : U3/11/94
Permit Title : UMUUKS'1'ONE CIRCUIT SIGN Completed :
Perm7t Descr . To Expire : 09/0//94
Project Title : bROOKS'1'ONE CIRCUIT SIGN Project Si : PU038151
Pro iect Descr. . * EROSION *
•
Parcel Number : 2S1TI - Land Use District :
Va l.uation0
Legal Descr . •
Owner : INSPECTION - 'l'IGAIw Construction : O'1'11
Applicant Name : MEYER SIGN CO ‘.:.lassitication : 900
Applicant Addr. : 7340 SW LANDMARK LN Occupancy
TIGARD OR 9722i Validated by ; MUF
Applicant Phone : b20-8200 Inspector Area
CONTRACTOR : MEYER SIGN COMPANY Lic. C 2.0-190CLS b20-800
Fee description Units Fee/Unit Ext tee Data
Jlgn or Outline Lighting 1 40 . 00 40 . 00
%ubtotal Electrical Fees : 40. 00
State Surcharge of S•. 2 . 00
Total Electrical Fees : 42 . 00 1
*** Fees Required *A * *** Fees Collected & Credits ***
------- ----- _- ----------------
Method Check N Receipt No. Date Payment
CK 13449 03/11/94 42. 0.)
TOTAL THl:: DATE ********* 42 . 00
Fees : 42 . 00
Adjustments: . 00 Total Credits : . Uu
Total Fees : 42 . 00 Total Payments : 42 . 00
Balance Due: . 00
I
NOTION: This pawl woonm.N nuN and veld If the wart M oemtrur jun for*awn N Is Isernmd le not co*nmanc.J Ahern 1S days. Once CMmatruction has stadad,
No puns NeNetnu nuN end void N construction Is IntsrrupbA for a parted of ls0 days. I codify that the Inkxrnslton brasMNsd by the sppliwrnl and
his apis or gena In sewn of pile permit Is hue and oor.cl to the ball of our knowledge. I armnovtedge this the Pudding Oepsnnmant's reliance
hes Nee and eteleMMq NIIMp./Mn ploy tmvsNdeie pie perm*. AN rwovlslons of r ppIloebie iron and ordinances governing the cCrnlrutlloh and vats
a1 this MiMNIg at eluelwe 011 be ewmplled wen whether or not apeWNed on Nee claw at noted en the pima oernalion elvtde. 1 actnrnAedge that
9wMang e1 a psimi MM 1101 pert aidhbrity lo aooeee pr-• 1e prgrny ec to use sasamsos. I hepmer eohnnwledge that the use at occunancy of
Ms someone es building pe ndled depends upon oily nailing ter Inspections at%elbus*nee during the woven of canabucllon and the bt.Ndl.ug
Pe speelofm Neff verifying WM/NMIee with the veno.trades. Use or aetweeney of eoa b Hdi g at atnmtwe per.MNd prior to approval by Qts
euNdIng OepM moll le Maly el the neh of the applicant and such use or occupancy le revocable until all!moment'omenn require mems are satisfied and
soprani M gl JI by the OuNwlg Moist I further eetnbwtedge that a Nan may he pieced on th?Lowly
upon onion the porno N levied
specifying that ma usa a•occupancy of the building or structure to prcadelo of and revao.oMs unliars of eN ulnm�e/ros..
e NOVA ■
1
Depatm.n. oWASHINGTON COUNTY ELECTRICAL PERMIT
DepattmerK of Land Ue• & Treneportction
' Electricsi Inepectlon section
v. ri �. •
183 North First Avenue,�r3v0-r2APPLICATION
k ,.� Hillsboro, Oregon 97124
a, y. In/bn'nation: (503)640.3470 Fax: (503) 603.44 2 Proiect/Pertnit r-
- .P
- .— Date 5-il=9i(
F ,•7 PLEA, E PRINT Number ___ _.J=4,,,"10
Please cor4plete ilfscction. ,'1 through�. 4. Complete Fee Schedule below
Number of inspections s a«permit nrGottlad%I°1_ Location of Installation
Service included: Items Cost(ea.) Sum
Addres �5� 1 _
" 11�: ,let'a' 'p. A. Residential-par unit
_ / Building
•
City/ int/RA _Suite No. 1000 ave Ir.a•less $55.00 4
•
Tenant Name Each additions!500 aq ft
1 commercial) of portionthereof _ $15.00
V.
-C1 yr.a_�_ Limned Energy — $20.00 _
Each Manufd Home or Modular 1
Directions .-__-
Dwelling Service Feeder —_-_ $40.00 -- 2
--_..__
. B. Services or Feeders
Installation,alterations or relocation
200 amps or lees $50.00 2
Commercial ('�Residential l l 201 snipe to 400 amps _ se0,00 _ 2
401 amps to 600 amps $100.00 ____ 2
601 amps to 1000 amps $130.00 2
2a. Contractor lylitallatIon Orley: / � r 1 amps or` • $.100 00 2 1
Electrical Contractor_.__ t '�_ . . . i- 1 -
--- $40.00 2
Address ___-22_ ') . • . �� . . C. Temporary Services or Feeders
Gate_ 1 I %=1- Job Number .I Insraiation,akeraticm or relocation
Property Owner 1' 1' ,di_ 200 amps or lees __ y40.00 2
Contractor's Licensrt No 1 /.1) ‘,..1 _ 201 amps to 400 amps ^— $655.00 2
Contractor's Board Flog. No. _ /�r(D/�/ sot limp•to pe amp. __ _ $ao.00 _ 2
4 --' Over 600 amps to 1000 volts see'B'above
Signature of Supr. ElCt
ec'n _ .-(4_,------._____4.1--- ._______ D. Branch Circuits
License No. ii 441 (c Pf,one No. (per D-if...2 C p Her alteration or extension per panel
•
a) The feu for Manch circuits with
2b. For owner Installations: apurchase hf circuitservi ""''«ti..
Each branch circuit _ $2.00 2
bl The foe for branch circuits without
1 remit twnw'o IS iii ..^--- p�rchura of service or feeder fee.
°� --— Flret branch cit uk $35.00 —
_ 2
-----
___.�—._.—.__— _ Each add'nl branch cirruk� $2.00 2
E. Miscellaneous (Service or Fender not included)
z _________.....__________te0 -------- —---- - Each Pum o1 irrigation circle $40.00 _ 2•V:
Each sign or outline lighting .....L._ $40.00 2
The installation is beirg made on property I own Signal t ar�unl.) l a limited t
*neon r0•nM neallNatlOn
which is not intended for sale, lease or rent. or•xteri•4on — $40.00 2
l.
,Y'' F. Each additional Inspection over the allowable
In any of the above, per Inspection
.n • 3. Plan Review section (If required) $3600
5. Fees
A. Enter total of above foes •
5% Surcharge (.05 X total fees) $ —
Subtotal $
r •-- _._.__.-_.--.•_ B. Enter 25% of fine A for
For !rtspections cal" Plan Review if required (Section 3)
640-356.i or 693-4415 Subtotal $ -
24-hour recorder, Lass Faulk Label Fee s
* one working day in advance of need Balance Due
This permit becomes null and void If the work authorized by the pariah le not oormrrereac .,within ISO days from dal.of Issuance
of such permit or If the work authorized Is.uepended a abandoned at any time after work Is oommr o.d for a period of ISO days.
Beatrice/Permits are non-rehmdebie and not,-traneMable.
10/01
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