9601 SW WASHINGTON SQUARE_TI 9601 SW WASHINGTON SQ RD TI P48879 P-48314
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DEPARTMENT OF LAND USE&TRANSPORTATION
e WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
-'�� CO1 INT' INSPECTION REQUESTS: 503/640-3561/693-4415
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OREGON Page : ] of 1
Date : 05/09/95
Time . 0'/: 35
If detmit Type : Commercial Eleetr. c'tl Permit Permit # : 0506't964
,'ermit Status : APPROVED Applied : 04/04/95
Oi
.,ituc Address : 9601 SW WASHINGTON SQUARE RU '1'i Issued : 04/04/95
ot PEttmtt Title WARNER BRO.: 5'1'0010 STORE Completed
c'ermi t Uescr .. : .JOB 5472/ 5 SERVICES/105 CIRCUITS To Expire : 10/01/95
.'roject Title : WARNER BROS S'i'UU1.O STORE Project # : P0048879
Project Descr . : JOB 54 /2-/ 5 SERVICES/105 CIRCUITS * EROSION *
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Parcel Number . 2511'1 -- Land Use District :
Valuation 0
Legal De cr.
Owner . INSPECTION - 'i1GARU Construction : UTH •
Applicant Name : t'RAHLER ELECTRIC Classification : 900
Applicant Addr . : 11861 SW GRI•.ENBURG RU occupancy
'1'1GARU, OR 97223 Validated by : PH
Applicant Phone: 639- 4t2) Inspector Area : U •
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Fee description Units Fee/Unit Ext fee Data
Service/Feeder: 200 amps or .less S 60 . 00 300 . 00
tach Branch W! Feeder [Enter #J 105 5 . 00 525. 00
Limited Energy/Alter. /Exten:Zion 1 40. 00 40 . 00
Subtotal Electrical Fee:. : 865 . 00 .
:,tate Surcharge of 5% 43 . 25
:'oral Electrical Fees:
908. 25
AAA tee. Required *** AAA Fee:: collected & Credits ***
Method Check A kerc•:.pt No. Date Payment
LK 20.325 :4/04 '95 865 . 25
CK .:04J`.i /08/95 42 . 00
Fees : '.108. 2'7 ,
AuJUStment:s : . 1)0 T,.-)tai CLed:ts : . 00
total Fees: 908. 25 ,,: al p.ty;:,,nt .-; : 908. 25
L'<ii..ince LIUe : . Uta
•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 Me information presented by the applicant and
Ms agent or.,;+tits In support of this p4rmit 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 stru:.:dre will be complied with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
the grantiet,ar a permit does not grant authority to access private property or to use easements. I further acknowledge that the us*or occupancy of
the structure or b,ilding permitted depends upon my calling for Inspections at""arious times during the process of construction and the building
inspection staff veri'ving 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 acknowiWge that a lien may be paced on the title of the property upon which the permit is issued }
spsciying that the use or occupancy of the building or structure is provisional end revocable until the satisfaction of all inspection requirements.
APPLICANT'S SI(INATUIIE
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�► NGTON COUNTY ELECTRICAL PERMIT
1 Departmentn p Land Use i Transportation
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Electrical Inspection Section
155 North First Avenue,#350-12 APPLICATION 1
. Hillsboro, Oregon 97124
r Information: (503)640-3470 Fax: (503) 6934412 permit /
PLEASE PRINT Number ' �9C0-/ Date f- /
Please complete all sections, 1 through 5. 4, Complete Fee Schedule below
Number of Inspections per permit allowed
• 1. Location of installation
Address 9601 S W WASHINGTON S Q . ROAD Service included: Items Cost(ea.) Sum
T I G A R O Building A. Residential-per unit I
city Suite No.
- - - - to00 sq.ft.or less $110.00 4
Tenant Name W A R N E R 3 R O S S T U D I O S T O R L Each additional 500 sry,ft
(if commercial)
--- or portion thereof __ $25.00 -- _
Limited Energy ___ $25.00 1
Map No._ -Tax Lot - - Each Manuf'd Home or Modular
Dwelling Service or Fender __ $68 00 2
Thomas Map Book: Page -_ Section:
Directions __-___-___._. -- -- B. Services or Feeders
--- Installation,alterations or relocation
300 . 00
f-1 200 amps or loss $60,002
Commercial'Xi Residential L-J 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
1 2a. Contractor installation onl : 601 amps to 1000 amps --- $180.00 2
Y Over 1000 amps or volts $340.00 2
Electrical Contractor F RA H L E R E L ECT R I C C O . Reconnect only -- $50.00 _ 2
Address 1 ]866(1 Sw GRFENBURG_
City
T RState_K 2 7 9/213 C. Temporary Services or Feeders
Date 4/3/95f{
Job Number _ Installation,alteration or relocation
Property Owner - 200 amps or loss $50.00 - 2
Contractor's License No. 3 4-1 3 C _ 201 amps to 400 amps _-- $75.00 2
Contractor's Board Reg. No. 314 I U 401 amps to 600 amps -_- $100.00 2
7471/31e411,
/�� Over 600 amps to 1000 volts see'B'above I
Signature of Sur. Elec'n /4 i/32e;, D. Branch Circuits
License No..1,1 t6 S Phone No. 6 1 1 New•alteration or extension per panel
a) The foe for branch circuits with
purchase of service or fordo(fee.
2b. For owner Installations: Each branch circuit !)f $5.00 5 2 • 0 0 _ 2
Print Ov.ner's Name
b) The fee for branch circuits without
APP L ATIONpurchase of service or feeder fee. ,
rdaT
PSS. - - - First branch circuit _ $35.00 _ 2
Each add'nl branch circuit $5.00 2
City 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 intended for sale, lease or rent. Signal circuit(s)or a limited
energy panel,alteration
Owner's Signature _-_. - or extension -_ $40.00 2
F. Each additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection __- $3500
Per hour $55.00 _
Please check appropriate Item and enter fee in section 5B. In Plant $55.00
4 or more residential units in one structure 5. Fees
Service and feeder, 800 amps or more
_System over 600 volts nominal A. Enter total of above fees $ 825 . 00
_-Classified area or structure containing special 5% Surcharge(.05 X total fees) $ 4 1 . 2 5
occupancy as described in N.E.C. Chapter 5 Subtotal $
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review it required (Section 3) $ ---
above apply. Not required for temporary construction Subtotal $H -
services. Trust Account $ ,
Balance Due $ 866 . 25
For inspections call Thl.Perm"becomes null and void H Ibe worts authorized by the perm"le nal commenced
640-3561 or 693-441 5 wdhin 140 day•horn date of l..u.nc.of such peat"or It the work.ulhorlted le
euepend.d or.bendoned.1 any lime atter work I.commenced for.period..150 day.
24-hour recorder, one working day in advance of need Electrical Promote ere non refundable and non hamster/able.
8/94
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TEMPORARY 5/5/95 - 5/ 11 /95
• WASHINGTON COUNTY ELECTRICAL. PERMIT
Department of Land Use & Transportation
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Electrical Inspection Section
155 North First Hillsboro, Oregon v 97124#350-12enue, APPLICATION
Information: (503)640-3470 Fax: (503) 693-4412 ADDITIONAL TO : •,� '
Permit
PLEASE PRINT Number 05065964 Date —(-7-4
Please complete all sections, 1 through 5. 4. Complete Fee Schedule below
Number of Inspections per permit allowed
1. Location of Installation
Addt ass 9 601 S .W . WASHINGTON SQUARE ROAD Service included: Items Cost(ea.) Sum
Building A. Residential-per unit
City TIGARD Suite No.
1000 sq ft.or less $110.00 4
Tenant Name Each additional 500 sq.ft
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(if commercial) WARNER B R O S STUDIO STORE or portion thereof $25.00
MapNo. Limited Energy -_- $25.00 _ 1
Tax Lot
Each Manuf d Home or Modular
'')welling Service or Feeder ___ $68.00 2
Thomas Map Book: Page: Section:
Directions B. Services or Feeders
Installation,alterations or relocation
I 200 amps or less $60.00 — 2
Commercial Residential I_i 201 amps to 400 amps $80.00 2
401 ornps to 600 amps ___ $120.00 2
2a. Contractor installation only: 601 amps to 1000 amps $!80.00 2
Over 1000 amps or volts __ $340 00 , _ 2
Electrical Contractor F R A H L E R E L E C T P.I C Reconnect only .__ $50.00 2
Address _11860 SA. GREENBURG ROAD
City— T I GA R D State_)QZIP 9 7 2 2 3 C. Temporary Services or Feeders
Date 5 1 5/95 Job Number 54727 Installation,alteration or relocation
Property Owner 200 amps or less S50 00 2
Contractor's License No. 34-13C 201 amps to 400 amps $75.00 2
Contractor's Board Reg. No. 3 7 4 1 0 401 amps to 600 amps $1J0.00 2
Over 600 amps to 1000 volts see'8'above
Signature of Supr. Elec'n :✓dil,�,e.. .
D. Branch Circuits
License No. 1 6 1 6$ Phone No. 6 3 9-4 6 2 7 New,alteration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder fee.
Each branch circuit $5.00 2
Print Owner's Name i b) The fee for branch circuits without r
54/1-5— i
4 1� )/: purchase of service or feeder fee.
Address --
[7:!7Nu
First branch circuit $35.00 2
Each add'nl branch circuit $5.00 2
City ?;tate- Zip E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle 540 00 __ 2
The installation is being made on properly I own Each sign or outline lighting $40.00 2
which is not intended foRIVPLIMEGRININNAL Signal circu t(s)or a limited
energy panel,alteration
Owners Signature _ _ APPLICATION .- .__ or extension 1 _ $40.00 40. 00 2
F. Each additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection _ $35.00
Per hour $5500
Please check appropriate Item and enter fee In section 58. In Plant ^— $55.00
4 or more residential units in one structure
Service and feeder, 800 amps or more 5. Fees
_System over 600 volts nominal A. Enter total of above fees $ 0 . 0 0
Classified arta or structure containing special 5% Surcharge (.05 X total fees) $ 2 .00
occupancy as desciibed in N.E.C. Chapter 5 Subtotal $
B. Enter 25% 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 Subtotal $ a'
services
1_1 Trust Account $
Balance Due $4 2
For inspections call
IM•permit becom.s null end void II the wore.uthortr.d by the permlt I.not r.omw.no.d
640-3561 or 693-4415 wdhm 180 d.y.Iron,d.1.of issuance of Such permit or if the wore.uthortr.d 4
24-hour recorder, one working day in advance of need E�.e.iPenS.abandoned
dr non-Ir;,N;,y;;id1nr p"'OddtS0dry►
8/94
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DEPARTMENT OF LAND USE & TRANSPORTATION -
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'WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
1 COUN,IY, ISi NORTH FIRST, HILLSBORO, OR 97124
y PIi MI.:: 503/640-3470
OREGON INI.PECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
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Permit 0 : 05065964 Project 0 PU048879 Status APPROVED Page 1 of 1 '
Applied : 04/04/95 Issued 5 '.
0404/95 Expires 10/01/95 04/28/95 001
COMELEC
Permit Title WARNER BROS STUDIO STORE OTH
Description JOB 54727 5 SERVICES/105 CIRCUITS Begun: 04/04/95
Job Address 9601 SW WASHINGTON SQUARE RD TI
Owner Name INSPECTION - TIGARD Region D
Applicant Name FRAHLER ELECTRIC
Phone number 639-4627 Valuation 0 Approved /
Inspector Comments �t4 `�''�� CSA Re lected l7_ _•
Ole-- Ch3 Gl12h `G d►!^ lg 14 -s �s�+ur v, VI -RE i I L T:. .
S(c 1 .. cfr) _ja—�- __ REQUEST ERROR' •
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Plumbing
Mechanical : -_-
Electrical :
S.t ructrua l • —.�.— — - — - --- ------- --- - ----
General _
Inspected by _. r - -- -__-__.----- r'a1-e .l-1Z -S l5
Inspection Requested
4 Wall Cover 0413 E AP PN 1vf. .
04/28/95 RI PH BACK ROOM & FLR BOXES i
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INWIVI T�.l;l'.i'" fYQf1.'Y' 1Li.lt4. fE
t. uw'ri.ic _.::i:uY6e,:�� LS-:• -
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I DEPARTMENT OF LAND USE :. TRANSPORTATION
WASHINGTON LAND Ci:VELOPMENT SERVICES DIVISION#350-12 IIN
155 NORTH FIRST, HILLSBORO,OR 97124
COUNTY, PHONE• 503/640-3470
OREGON INSPECTION REQUESTS (24 flours): 503/640-3561 or 693-4415
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Permit it U�065964 Prc:Jrct 11 PC 4889 .,tatu.E: APPROVED Page 1 0.w
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Applied 04/04/95 issu,ti 04 04/95 Expires . 10/U1/95 OS/04/95 05 :01
COMELEC
Permit. Title WARNER HROE, STUD O STORE OTH •
Description JOA 54727 5 SEK ICES/105 CIRCUITS Begun . 04/04/95
Job Address 9601 SW WASHINGTO SQUARE RD TI
Owner Name INSPECTION - TIGA I> Region 1)
Applicant Name FRAHLER ELECTRIC
Phone number 639-4627 Valuation : 0 Approved
Inspector Comment= LU (,So52, Re jectod "K
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C>L 'f0 Cesar ht.* 4-StIVA-411 Strip& a - IVU-RECIILT
— .- _—•- _ .f-____ --- _v. .._.-__. _._._._._ REQUEST ERk(.►R I :
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Plumbing ..— r - G.- 131-4•-4-
Mechanical - —, �_----- ._. �- _ ._.
E l e c c r i c a l _ &is-0 G y_ ►Nrc. cGc.Q_ ., 4Jtov ..S - - Cal,404, y
L ti to'Aid
StructrualC� OIL 907 j 311
General .,_. , .--- _
Q
S-N-I-5•
Inspected by -_- ___. - Date ________________
Inspection Requested
0
* Cover :)404 t: AP UN IVk
05/05/95 RI JM
05/04/95 PI /
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION X350-12
COUNTY 155 NORTH FIRST, HILLSBORO, OR 97124
OREGON PHONE: 503/640-3470
INSPECTION REQUESTS (24 hours): 703/640-3561 or 693-4415
NINF
Permit * : 05065964 Project. * P0048879 Status : APPROVED Parr I of 2
Applied 04/04/95 Issued 04/04/95 Expires 10/01/95 05/05/9:i 0n (,2
Permit Title WARIJER BROS STUDIO STORE COMELEC
OTH
Description JON 54727 5 SERVICES/105 CIRCUIT: Bequn : 04/04/9!;
Job Address • 9601 LW WASHINGTON SQUARE Ru TI
Owner Name : INSPECTION - TIGARD Region 0)
Applicant Name FRAHLER ELECTRIC
Phone number 639-4627 Valuetic,n 0 Approved
Inspector Comment., Rejectedb<
___ -_�_- _� TVR-RESULTS
.0- .- --
.-- P61)114_41.41/ 1./i 1#W‘4-ei 41L..._----• v_ 401)- -GX02---
Plumbing ___
. Mechanical __________ :.. —__ __-__-_ - --. --.__. ' /
Electrical
Structrual
General -- -�--•--
Inspected by: Date : S'-S'-
Inspe_tion Requested
* Cover 0404 E AP DN IVR
05/05/95 RI .IM e
05/04/95 RI JM r
05/04/95 DN cat, DNIVR LUT6 I g:,
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DEPARTMENT OF LAND USE b TRANSPORTATION17.
,;i
I WAST iING'I��N LAND DEVELOPMENT;CERVICES DIVISION 5350-12 1` ,.�Fic'
,.A155 NCRTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE. 503/640-3470
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OREGON INSPECTION REQUESTS (24 hours): 503/64(-3561 or 693-4415
Permit S . 05065964 Pr.:,je.t # P0046879 Statue APPROVED Paye 1 (It 2 .;'
Applied 04/04/95 Issued 04/04/95 Expires 10/01/95 05/19/95 05. 01
COMELEt:
I Permit Title WARNER RRr);; STUDIO STORE OTH
Description JOB 54727 G, SERVICES/105 CIRCUITS BAgun 04/04/95
Job Address 9601 SW WP_...{INc;T(:N Sc IJARE RD TI 1
':,canes Name INSPECTION - TIGARD Region D
• Applicant Nara FRAHLER ELECTRIC
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Ph,:.ne numb..r 539-4tk7 Valuation 0 Approved_—_ _— \1
LV = 5 6SOSL— X I \.
; nsp�e�_tor Comments LV
_
------g----
_____________Iv_ ____4.. & . / LSI
--. IVt -kSU
<f,Q S REQUEST ERR)K ,
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_—-.___. ._.ffTh ±± 1....._- -- _
Plumbiu,g
Mechanical
Electrical :
3tructrual
GenAt a 1
I inspected by ._ Pr _57/5.-IS
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Inspect ico% Requested
* Cover 6 Srrvic• 0403 E AP r,N `VI: r
05/19/95 RI /1,1F CEJL e. SALES AREA
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. DEPARTMENT OF LAND USE & TRANSPORTATION
WAN ASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503/6404470
OREGON INSPE"TION REQUESTS (24 hours): 503/640-3561 or 693-4415
'ermit. $ . 05065964 Project 4 P0048879 Rt.atu- APPROVED Page. 1 of
Applied : 0 .':.4/95 Issued . 04/04/95 Expires : 10/01/95 05/23/905 . 0
COMELEC
Permit Title WAPNER BPC STUDIO :;TORE OTH
• Description JOB 54727 S SERVICES/105 CIRCUITS Bequn . 04/04/9
5.
Job Address 9601 SW WASHINGTON SQUARE RD TI ,
Owner Name INSPECTION - T I GARL Region 0
Applicant Name FRANLE1t ELECTRIC
• Phone number 639-4627 Valuation 0 Approved _
Inspector Comments Rejected_
.. _. -.._ __e _ ___ __/_[ ____r..y ii —__._ .VR- xEGULr.
1 7
_-_ _-�. REQUEST ERRO
_.(9. -_-_+ehauld_arra .....i.u. (ert•td -5-1(010.52 L--/ YO
Plumbing _ ___ _._.-._. ...__-..___ _ _ .. ____ _.__.. ..._
Mechanical ._._.._—._ _._...___ _ _____
Electrical ___.. ._.__..__ _____ _._....___- -_ ..�........ .r
�tructrual
general ---- _ .__- —._._ _—.•_--
Date
Ir,�pected by -_- - _ .._._. _ -
Inspect i. n Re,o.Fr.ed u`I•i''
, 4vrwr"-- --� 0 4 0 4 E A P ON I V 1:
05/23/95 RI 3F FRONT GOC>R SOFFIT
05/05/95 RI JM ,•
• 05/05/95 UN G5, T>NIVI4 LUTE i B
05/04/95 RI 3M
05/04/95 DN G:. DNIVN LUTE i 135
LassommammossiiiiMOOMMOWIT MIL
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DEPARTMEN f OF LAND USE & TRANSPORTATION
. 1 AIWASHINGTON AND PEVELJPMENT SERVICES DIVISION #1350-12
155 NORTH FIRST, HILLSBORO, OR 97124
' IU COUNTY. PHONE: 503/64G-3470
OREGON INSFECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
P4r:l.it •:,06'. cr-., )r:t:r .'0048879 Sate, AL'e Pakyild i vi
?,pplis3 4ieil, . . ia_uaa 14/',4/9 Ext ..c 0/ 06/07/95 OS 1
COMILEC1
'•trmit Title WARNE!. Bk..;,i STT. IO STORE OTH
4c,:rip:, ,n JOB 5472 !, SERVICES/105 CIRCUIT; Beyun: 04/O4/�'
ob Addr,ii, 9601 SU WASHINaTCN S;-UARE RD TI
;tn4r Name INSPECTION - TI'iARD Reglan D
I pplicant Name FRAHLER E1.ECT&i!'
11.. r 635-462'7 Valva* 1Qn f) Approv4d__
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DEPARTMENT OF LAND USE&TRANSPORTATION
Ali WASHINGTON TON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
4 Iiiiiir
OREGON XXXXXXXXX--) 640-34'/0
Page : 1 of t
Date : 03/15/95
Time : 14 : 29
Permit Type : Commercial Electrical Permit Permit # : 05065092
, Permit Status : APPROVED Applied : 03/14/95
Situs Address : 95135 SW WASHINGTON SQUARE RD Ti Issued : 03/14 '9`.
Permit Title : WARNER BROS. STUDIO STORES LV Completed :
Permit Descr. : PROTECTIVE SIGNALING To Expire : 09/10/9t.,
Project Title : WARNER BROS. STUDIO STORES LV Project # : P0048314
Project Descr. : PROTECTIVE SIGNALING * EROSluN *
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Parcel Number : 2S1T1 - Land Use District :
Valuation 0
Legal Descr . .
Owner : INSPECTION - TIGARD Construction : OTH
Applicant Name : NATIONAL GUARDIAN CORP Classification : 900
Applicant Addl . : 5110 NE SANDY BL Occupancy
PORTLAND, OR 97213 Validated by : PH
Applicant Phone: 258-3430 Inspector Area :
tee description Units Fee/Unit Ext fee Data
Limited Energy/Alter./Extension 1 40. 00 40. 00
Subtotal Electrical Fees: 40.00
State surcharge of 54, 2. 00
1 Total Electrical Fees : 42.00
I *** Fees Required *** *** Fees Collected & Credits ***
ii
Method Check a Receipt No. Date Payment
CK 5329 03/14/95 42. 00
• Fees: 42 . 00
Adjustments : . 00 Total Credits: . 00
Total Fees: 42. 00 Total Payments: 42 . 00 ,
• Balance Due: . 00
NOTICE Thls 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 Hall 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 lays and ordinances governing the construction and use .
of this building or structure will be compiled 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 giant 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 build;ng 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
approve)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 p
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
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0 WASHINGTON COUNTY RESTRICTED
Department of Land Use & Transportation
Electrical Inspection Section ELECTRICAL ENERGY
155 North First Avenue,9350-12
Hillsboro, Oregon 97124 APPLICATION
Information: (503)640-3470 Fax: (503)693-4412
• PLEASE PRINT
Please complete all sections, 1 through 5. Project No.�_ Permit No.3 .-6'- ' 2..2- -
1. Location of Instal/atlonS-- z
Label No._ _— Date .1---.-Y-9-r—
Address 4-5-f5 GP/ snJA c H I NI 61-8ni . r RD. Issued By-- Office — —
City I'vi2.T 1.4100 Zip Code 1112-1-3 4. Type of work:
Tax Map Map No. ,RESIDENTIAL Restricted Energy Fee 940.00 ..•
Thomas Map Book: Page Section __ (ter all systems)
• A N., rc1 A�� Check type of work involved: •
Directions 1"./66 S ti i n.16 7-i' --
_ — Audio and Stereo Systema`
Commercial - Residential n Burglar Alarm
Tenant NameTelephone Systems*
(if commercial) t11''t`N i ec gig-6-c* S r1-'11.(1 ..-i r.0 . Garage Door Opener'
This permit become*null and void If the work authorized bythe
Fire Alarm
permit Is not commenced within 190 days from date of issuanceHeating•Ventiln±.on and Air Conditioning Systems'
of such permit or If the work authorized Is suspended or abandoned I Vacuum Systems*
al any time after work Is commenced for a period of 180 days.
Electrical Permits are non-refundable and nom•transferable. L Other __^___
2. Contractor application:
COMMERCIAL Fee for each system $40.00
Electrical Contractor I/4 T i r7.J pa_ Et tx'IA 0 r rki ( (see OAR 919-290-290)
Address .`i/l r' is/t- CF1nil)Y Ri-v Qt,prL4 972 13 •
Check type of work involved:
Date 3 I r -'If- Job Number NA bq LiN y
Property Owner _W Aga./Elm 620 TH.0,k
Contractors License No. a .- 5-11c i-E Boiler Controls
Contractors Board Reg.No. SS(' d _ Clock Systems
Data Telecommunication^Installations •
. Fire
Phone No. �.Qg-.� 4Alarm Installation
3. Owner application: HVAC
Instrumentation
Intercom arid Paging System
Print Owner's Name Landscape Irrigation Control"
Address HMedical
— Nurse Cells
riry— — State Zip Outdoor Landscape Lighting'
This permit Is issued under OAR 918-320-370. The applicant agrees Protective Signaling
to make only restricted anergy Installations(100 volt amps or less) Other 1
under this permit and to do the following:
1. Only use electrical lkenead persons to do Installations where
required. (Certain residential and other transactions are exempt Number of Systems r
from licensing. These have asterisks('). All others need licens-
ing.) 'No licenses are required Licenses are required for all other installations2. Call for an Inspection when all the installations under this',term'?
are ready for Inspection.
3. Purchase separate permits for ail Instillations that are riot ready 5. Fees L71
for Inspection when the Inspector Is out to Inspect under this Enter fees $ A.—
permit.
4. Assume responsibility for assuming that all corrections required .) --
by the Inspector are done,and 5% Surcharge (.05 X total above) $ _ _�_
S. Assume responsibility for calling for a final inspection when all of
the corrections are completed. .— •
_ Total $ ,...LL______-
j
The person signing this permit must be the applicant or a person
authorized to bind the applicant.
Signature _____ Space below reserved for validation.
Authority it other than applicant — I
For inspections call
640-3561 or 693-4415
24-hour recorder,one working day In advance of need 11192