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9665 SW WASHINGTON SQUARE (1) 9665 SW Washington Square Raod 50342 ,67194 p7522 9665 SW Wasnington square Road 1S1 26C retail store (Foxmoor Store) 50342 1 WHITF. Imp.cror COPY S U 3 2 YELLOW P•rrnirt•• PINK Temporary Frw PERMIT No. APPLIC TI N FOR BUILDING PERMITOREEN Circui.tlor, IauiLOING WASHINGTON COUNTY ADDRESS___ ---- OFPARTMENT OF PLANNING I OCAI.ITv BUILDING DIVISION --" NEAREST INSPECTIONS 648-6761 IAFTFR4 30 646356, CROSS ST CENSUS Q�.'- T�/E ZONE FOR APPLICANT TO FILL IN TR i . CDNs "A LUILDING L- • MIN/SE TEACK F S a 11. ADDRESS _ a . r • i APYD.EY D1ir LEGAL DESCRIPTION - ZONING • - - PLAN EXAMINATION If ( 31 AREA OP LOT No OF SLOGS. STRUCT.ENOR.W I �� pp NOON LOT ll1I$ INJJG SLOG - TYPE __ TY/E OF SANITATION UU - ,_-- OWNER/A. 1/ 4 NiL COMMENTS R ,Art Q ADORES�I �� o W r' 41 p - -2J�L f[�—— - CITYNILIAL lir _ ) Q f� �e�]►I7ddi� ARCHITECT LI�L TEL. Si ENGINEER NO. 4 '--`- ADDRESS 20 CON f Fl t 6.a.st141)125,43 71 T7 , ADDRESS . y_q tN _ CITY . •, � - F, r • DESC'IP OF WORK NEW ADO `tsjjA- _ REPAIR pp ppDEMOLISH - N.).BEDROOMS NO.OP BATHROOMS a t--7+.,,p„ / -VALUATIONI / �� PEE PON AMOUNT RECEIPT NO. DATE as -P.C. PEEy{y!Ej)OQe fEETE ZONING COMPLIANCE APPL CAt ONAAND STATEGTHATA THE ASOVRE/IS Al: FIRE MARSHAL NC' �S9D i/ RECO AN() AGREE Tp COMP`v WITH Al.,COUNTY OR SVSTEM of NT IIIIII DINANCES AND STATE LAWS REGUL A.TING BUILDING - CON!' UCTIONA LICE IND. -•aG r`�.�_ SIo NAT��IlRE Of 1 PERMITTEE ,I ADOREES/ ,,s/AF ll��_ .. - / IF IN AL INSPECTION I•l , ILS 111a[LL/tl-OAri .4. fit$r PLAN CHECK VALIDATIO j M.o CASH PERMIT VALIDATIO M/10 LAS �9S RE CF I PT NO. DALE RECEIPT NO.M 78Ip D A IF � / 94::1g9,2 / 747i'X all rt 1363 I INSPECTION CARD WASHINGTON COUNTY' PLANNING DEPARTMENT BUILDING DIVISION 846-8781 (After 4:30 p.m.6403561! ADDRESS -- —•---_— vEPmiT NO ---- — CALLaU BY OWNER ---- ji l Not App�•;ved Residential °Commercial !)Other i i Approved 0 Ftg 0 Fdn.Wall L 1,eplace ET] Cover l i Nailing final OTHER --- I Inspector's Remarks: _-- - – + – ')ate— Inlpeetor—......... L--,...—..------___—__.---- 0 OM I' 20665 S W Blanton St. 03' . 1. P.O Box Y Aloha,Oregon 97006 ,' 503/649-8577 ' DIST. *°. February 13, 1981 Mr. Richard Edwards Capital Construction Cc. 4211 N. E. 44th Avenue Vancouver, WA 98661 Dear Mr. Edwards: Re: Foxmoor at Washington Square 9665 S. W. Washington Square Rd. The plans for the currently proposed renodelinc of this tenant space have been examined with reference to fire safety regulations. As a result, we lied the proposal as shown OA the submitted drawings to ue a • • • . . Accordingly, the ans are hereby approved. Very ly yours, WA NGT UNTY FIRE U 1 NO. 1 40°1 ie Wilburn dge lire Prevention Bureau b cc: Washington Snuare Corp. Washington County Euilding Dept. (2) Inspector Jeffri,1s Fire prevention does not cost it pays dl 4. 0k • Y. INSP. F.M._ WASHINCTON COUNTY BUILIIING DEPARTMENT CONTR. NON STRUCTURAL PLAN (,HECK ARCH. CTY FILE. DATE MAILED AUILDINC foxmoor store, Washington Sque.re AD1RESS 9665 S.W. Washington Square Road OWNER TELEPHONE NO. -_ ADDRESS 410k1ojitejIX CONTR: Capitol Construction TELEPHONE NO. 653 1717 AULRESS 4211 N.E. 44th, Vancouver WA PERMIT# PLAN CHECK 01363 OCCUP. 8-2 CONST. IVN FIRE DISTRICT __ WaSh.Cty #1 LOCATION ON PROPERTY: North _ South East West REQUIRED FIRE RESISTIVE RATING: Exterior Wall, MATERIALS: Structurctural Member? Roof Exterior walls cover Interior Walls Ceilings - Floors BASIC MAXIMUM AREA: Max. Height Max. No. Stories Max. tncresase for Yards Sprinklers X TOTAL ALLOWABLE (No Revised plans shown) BUILDING USE: Retail no structural chviges BUILDING AREA: 3,12.0 square feet 'd1 i and 500 square feet storage Basement 1st Floor _ 2nd Floor ,620 3rd Floor AREA SEPARATION _HR RATINGS OPENINCS HR RATINGS_ OCCUPANCY SEPARATIONS _HI; '(ATINGS OPENINGS HR RATINGS COPRIDOR CONST._ ATTIC DRAFT STOPS FLOOR CalLING DRAFT STOPS STAIRS WIDTH ENCLQSED O-iHER VERTICAL SHAFTS ENCLOSED EXITS REQUIRED: Number NO Width 3 feet 0 inches EXITS PROVIDED: Number T1ri0 width 3, feet 0 inches �_ EX FI 1,LLUM INATM3N REQU hREt Yes SEPARATE CIRCUITS EXIT SIGN REQUIRED Yes ILLUM._Yes SEPARATE CIRCUITS TWO POWER SUPPLY HANDICAPPED ACCESS REQUIRED ELEVATORRAMPS HEATING Existing FUELCOOLING SYSTEM - The plans for this project were received by this o"face on 1/22/81 and examined for the non-structural , Fire and Life Safety portion of the plans review on ?/6/A1_ . listed below are the Items we find to be in voilation of, or for which we find no pro- yisiuns for the requirements of the 1379 Edition of the State Uniform Building Code. ;.** **, a*,t **** 4** **:r era* tele* a** :k** *** lr** **!r *** AM* f: ;; **tr le** *!4* *** *** Rear exit through storage aria (existing). Exit doors to be openable from the inside without the use of a key. Plans Chow moving fitting roams and relocating display counters and false ceiling. Ray Wo ::. Plans Examiner r.....--........................_.__._____ _ 17 ��� - • i'' • • • • • i ifi'"'••SRR' • • • • • ;* • PLANS CHECK AND PERMIT APPLICATION )67194,--,;,,c_ Mawr.) 00 DEP.Rt4EN0 OF L ANO USE AND.RANSPDPTATION RERMIf NUMRFH 0 cos Oft.LOP-ENT SEROUS flON l CONSTRUCTIDN:NVE 1 WN 3iCtIDN , NRfTP/Em seem ,,,mac. 7545 ; MILLISOT • PaOJECr IDCATIoN_ _...____L-_ill — _...1" 6 use 644 ADDRESS 9665 S.W. Wa,E,hineton S_g_Rd. _ OEVELORM[NT DIST NEAREST CROSS ST_----_NS[W CENSUS TRACT-- V TA%MAP __ _.._ �- LAND USE CAM ..�� kLEGAL DESCRIPTION LOT/SED �_.—__---- TAROS MIN FRONT ` _, MIN R[M _ MIN SIDE _ r SLOC�ITOWNSMIP SUeDIVISION,PAHUS ___ _ TOTAL SIDE MRO[ MES WHAT5010I505AREONTHELOT' _�6µtl' ..04.4. ,VOWEL-- T,,,...,N.-,3' TOW ARE THEY USED, (.4144'L Sw4e1N ___T(,x,,,,,-- „,...=CZ 1 ) - _OWNERSHIP _ _ 7 J PROPERTY OWNER ___ (/ Washin ton S uare - -� _ ADUPESS g ,�.--.—_ --- PEEB -.__ P0Ct1,aDdA aCIL= 91223__PHONE nfill6.0__ IFnMATEDVALUEI _.-733:0-0 C' PROJECl'DESCRIPTION_ — I PC FEE W NEW ADDITION WALTER n11ePMI ; PM FEE_ F `_- _ 24 HOUR .DEMOLISH 2.MONl[NOME - -- INSPECTION FT TDru ... 226,01/ e40.3551 AREA 57 X1) EO FT INION" __ — PC PD Y I y 7 SO 211 HEIGHT _/ mimes USE Of STRUCTURE WILL SE ___..___ f'!". _ _. - titik SL 17 SIA ,1' _ _-- _A.;.v.' •Z 1NL1�frf, I OTHER....L. �, PLEASE _-_.__-_------—_..- _. _. el.DD f_ JZ/9.•sv CALL FOR tact r� r) I INSPECTION UL- 0 O I�fFNI' OAYONE INWORMINGI ADVANC ESTIMATED MARKET WWII._./..3.!....1_00 _..V DESIO4ERL$U1LDfR—^ MICH �..O� OF NEED PLUMS a Kenneth L. Butts, Architect I Canoga Park, California S L'C0' '} ,231.'' ADnREEe --"- -- PH — —.� I STATE TAAI4•taFa TOTAL! . /p •.�i ENGINEER __..... —.. - TRAFFICIMPACTEEE •I ...w.ADDRESS PN _ ._ 4 E _-_.__ _.9,IRDEP DEVELOPMF.NTCOMP REV / , • , '- "— -- � ADDRESS _— -- APR ISI ...=•,APPLICANT_ _ _ __ -- --- - HAM eIwIIRr Specialty-fl[mOdelinrt L�„w_ ' —L4 .....2„,k,„1.... •AoDRe>• 118.25 S.W._ Greenburg R1. PHO10-"'1It __.�_ V - — .„-,.fNtTNO B[R.g._and D`L,la_ �._.._--� WOMAN'_ 97•x5 queen[ Blvd. Rego Park 'LY, ,I c AlI1EATN NS y', ii 1 ' UD I • ESf', IN ICA, 'NS Aa I%H SIGNED ____—__.___._ _._ DATE PRELIMINARY PLANS CHECK FEE � IONATURE LP�i'1' .f - --- I U 1 (_< - PPM,NAME('.111• .� t OOM�r: 8,0.......r..8,0.......r.. t 1 ' PRELIMINARY PLANS CHECK RECEIPT 1 HOE 4i 'OTAL DUE Al r- .- J'. .. rank — - ..-..v , 1 I 1 ASI ......,J �s l+Awer'oe4/rrrrrr • , . • AA. . WASHINGTON • COUNTY, ; ? ` OREGON ` March 27, 1987 Mr. Bill Barry Specialty Remodeling, Inc. 11825 SW Oreenburg Road - Suite A-1 Tigard, OR 0'223 RE: Plan Check *7545 Foxmoor Fashions • Washington Square Plans on the referenced project have been reviewed by this office and are approved for construction subject to the following: 1 . The required rear exi` from the sales are.' shall not pass through the stock room. A corridor 44 inches wide minimur shall extend through the stock room to the rear exit. Reference Section 3303(e) , S.E.C. 2. Provide illuminated exit signs as necessary ?o accommodate revision to exiting. Reference Section 3314, d.B.C. 3. Firestopping consisting of 2-inch (nominal) lumber, gyps'im plasterboard or equivalent material is required to r.ut off all concealed draft openings (both vertical and horizontal) and shall form an effective barrier between stories and between a top story and roof space. It shall be used in specific locations es flllcws: Department of Land Use And Transportation.Land De.eicpn,erit Services Divlaion 180 North First Aver If HII•;bnrc pr,:Ncr 9' :i4 Phone 503'548,8751 1 , l..r.. _l • :,L�r:Ltif"r q I �r a118sl • Plan Check 7545 Foxmoor Fashions Washington Square Page *2 a) In all wooc-framed walls and partitions at floor and ceiling lines. c) At maximum horizontal intervals of 10 feet in the case of double stud walls, partitions and furred spaces d) Penetrations made in this prescribed ' firestopping to a.commodate wiring, plumbing, duct work and similar utility runs must be packed, in a manner, which will effectively maintain the integrity of the firestopping and cut off all concealed draft openings which could afford a passage for flame. Reference Section 2516, 8 B.C. 4. Suspended ceilings and fixtures shall be supported and laterally braced as specified in UBC Standard 47-18. 5. Plans for the installation or alteration of the automatic sprinkler system must be provided to and approved by fire marshal's office having jurisdiction and this office prior to installation or alteration. DonalL W. Howick Plans Examiner s c: Was'-ington County Fire District *1 District Building Inspector Permit File i 1 „()NC�� 4 WASHINGTON COUNTY FIRE DISTRICT NO. 1 ` 20665 S.W Blanton St. •Aloha,Oregon 97007•503,649.8577 i March 27 , 1987 A Mr. Bill Barry Specialty Remodeling 1825 SW Greenbury Road , Suite A- 1 Tigard , Oregon 97223 Re: Foxmoor Fashions (PC-7545) Washington Square Dear Mr. Barry: A fire and life safety plan review was conducted on tele ahu captioned project for compliance with the 1985 editions of toe uniform Building Code (UBC) , Uniform Mechanical Code fllMC) , and the Uniform Fire Code (UFC) as amended by Washington lounty Fire District' , Ordinance 86-1 . Plans are approved as submitted provided an additional exit light is added that can be seen frcm all places in the .tore around the handicapped dressing room. This exit sign hall be illuminated and have a directional arrow sign pointing towards the exit fire corridor leading past the storage room. Automatic 5.E-inkier Plans: Plans referred to and examined by this office contain no provisions for the alteration or instal - lation of an automatic sprinkler system. Not less than three sets ')f plans for the installation shall be submitted to this office for approval prior to installation. If I can be of any further service to you , please feel free to call me at 649-8577 . Sincerely , 1 WASHINGTON COUNTY FIRE DISTRICT NO.1 Gene Birchill Plans Examiner 9Pf cc: Washington County Building Department (2) District Inspector Bob Ray STOP floss--SAVES LIVES • � I f WASHING' F L COUNTY INSPECT ION CARD Z,7 y . 7 , OEPAFTRrENT Of l.ANO ISE AND TRANSPORTATION PERMIT NO._ � iirFU,: IN10NS At : r,40- •,61, 24 HOURS �__ 2 FOR INFORMATION CALL: 6440-/1410/ //; L / c DEVI (l rigni-----"6-88-yi ORESS)1 9 -r/dGS/ L( aYAlI'l f�T --5-7_.' /kitRMITEE -7 ' ---- RECTIONS re A r/J Co'{_ S;a cf--. (' - _-_ PHONENENO. �� __ SPEC;IONS: VISTRUCT OPLUMB C,MECH ELECT %/�`-'�n/e-- 7 r �� N�Oy�— CALLED IN BY _Q_ -- ca ► 50 641% w c'4 o p Cv /O t_v a ANi et VIED. lc• 1 H 4--L+N.ct S .i.442, �" OJESTED INSPECTION APPI,.,✓ED N'IA J% VER NOTE: t 4 ...f"Yl,,,,_.1 L. /mond I, �l fat r19Nr11/ ElNOT APPROVED (4).&444.471 W AA SO Q 0�S'114/ 1�L— REPAIR Ok REPLACE AND RE-INSPEC !'� lamed—,` rtc..1?r -- sT�jP WORK UNTIL w "1 DATE— A_4--,--g7 _ c 5v5dot cC( &t• w,_rk, Fidecitri Work 1Ot2AJI,o (n sporfaid INSPCC'oR `��� 'e- + / o ' boe„,rt Ce) ia.. Ce FIc. ih0.4'5141 �t'i�c 4-4- ri 2uIY'� N,. Ge .v oy. FIRE PREVENTION BUREAU /� . OFFICE OF FIRE MARSHAL 34 J 70 - INSPECTION NOTICE - ( WNER_ ._, DATE % C 'CUPO:-T irXA/arm_ OCCUPANCY j L OCAT ION iiEO 0 rd V/y•. r_ C.--, ` f ' .oun ••t+,NtioN.1 e•LLCO t0 Vur!OLLO*NO nestI SAYIt♦Ot•ICIINCItI, I Ft' ( U A- .Z.)C.-1. .(.'/' r•,Lunt ,O connect T.I. •NC yr CUNO,,ONS IT,...P1 ^•••NILL u•,t •Ou L'•I.,r ,O rnoltCVnON I..OULO ..'•t NCIUL' CNOM cue. CONOitiONl yOU M•v Pt Lt•PLt CON U•M•Or• ,O rrn4nu7 o.4N 50r14,7.UN OItt r...O,t'ONIOr ONI•,,•r, BY - -. ' 1-,.m ,,,,,. WASHINGTON COUNTY FIRE DISTRICT 41 FIRII'MARIMAL 20885 S.W.BI.ANTON STREET ALOHA,OREGON 97008 8198577 PRESENTED TO rn1.M ton •o ......._ ,�W.._... ,ter•_�:.�a��r. 41111% WASHINGTON COUNTY INSPECTION CARD .,2/Y9 �^ DEPARTMENT DI LANE) USE AND TRANSPORTATION PERMIT NO. FOR INSPECTM.': CLALL. 64o-J:,b1, 24 HOUR`, / p FOP INFORMATION CAII: 640-]110 DATE /(7A..' 7 J ADDRESS ,,, L k._` \ "E___'.,1 r = PERMITCF — -- - G _ 7yi/ DIRECTIONS - � -' ))L--C' •+- -i--.. °HONE NO. 1 INSPECTIONS: CKTRUCT OPLUMB DMECH EIELE(T 4.)//,L h (ALM) IN B -4_� �(.�� [ yl - C J APPROVED. .1111 E rr -Al ._ML 25--14-- MIL f T j-*4--- REOIatESTtD INspunION APPROVED 1/4.0 di1,r4-��aQ ��j �4t"4• ' 2 HOWEVER NOTE: ` /r' ' Al l ('i NOT A/t•RO'IItD tAJ! �_ = s T�Id>� 1 L_..JREPAIR OR 2EPLACE AND PE-I NSPE CT: FS TOP WORK CNNTILt 4 s r DATE —ill_ ------------ 0 I .SPELTOR ` - — - --- -- 1 I WASHINGTON COUNTY INSPECTION CARD / DEPARTMENT OF LANG USE ANO TRANSPORTATION PERMIT NO.--_.Sf 1 74 -_g- r. illirep i 1UR INSPECTIONS CA.I. 640-3661, 14 'HAIRS - w J `_7 7 Ip !OR INFORMATION CALL 640-34/0 DA'I w irF/ :J741 7 )1 4 04 `-- <_JU z ADDRESS �� 1, �__ PERMITEE. f DIRECTIONS_ �/A✓ 1.1-.6i.-i.•� e _ PHONE NO.INSPECTIONS: STRICT �`"_!Mb ElMECH ElELE': --,.-1,-44E----- __ '' I CAI-LED IN Br. �JLe;i _ J�IAPPROVED. ZFrilEoLSRTIii.::3PECTION QUEED APPROVED ---> ��,'/7,4-e ,� y. 6't- - - JLCo tiA. ,[r( '^'e. NOT APMIOVEpI S -G' �'/I �j(,,J� �"� ; REPAIR OR REPLACT AND RE-INSPECT: /q 51 - 1 /c -J-7 �7JV� ESTOP WORK UNTIL: ! - -- FIRE PREVENTION BUREAU Q OFFICE OF FIRE MARSHAL CONI_ INSPECTION NOTICE -----dAt OWNER . ___DATE --- A . -- -• OCCUPANT _ OCCUPANCY LOCATION - _ vO.JM ♦t,r4•1ON it C•r.•.EC to 'Mt 'Ot.LOW NO ',Re 1•rr tv ri,r,r ,•r,,rir, _-_--__-_-- ----_. 1 r•ir um, to CORRrC' t •14Ov1 CONC"• ,•.1 h n••1 M11t. M•rr •OU t'•R.1 to fan.,r,.tiON ,•., i r n. Mr11Vlt •RO•• 1 r.. fC'.n t'ON1 ." ••• ,.r • ,-R O•M116r1 to „IMIr1NI 0O mMor•rn•• ,Nr•,n Pt,,,, 11 nr OM1 ere lel WASNI`!O'ON COUNTY FIRE DISTRICT NI FIRE MARSHAL 20865 S.W.BLANTON STREET ALOHA,OREGON 97008 849.8517 PRESENTED to__-__ HORN SOC In I ..............]I _J 1 L ___ vr -_ _ , _ _ 9665 SW Washington 5qu»rr R^od 50342,67194 p7522 II/I III III 1111 H!iPIIU , "~MM~ ww*=.W~M. °ismorrobaliallinis"ar ~IMINEr . DEPARTMENT OF LAND USE 8 TRANSPORTt.IION WASHINGTON LAND DEVELOPMENT SERVICES DIVIO,( 150 NGRTH FIRST,HILLSBORO,OR 97124 COUNTY, INSPECTION REQUESTS: 503/640-3581 OREGON CONTV78 PHONE 503/8488781 NINVPage 1 f 1 Date . n4/09P" • Time . 12 :52 Per•uit Type : Commercial Elr't. t t 1'r t:;,i t Permit N : 0500977. Permit Status : APPROVED Applied : 04/05/90 Situs Address . 9665 SW WASHINGTON SQUARE RD TI Issued : n4/09/90 Permit Title : GAP KIDS SPACE C-2 Completed : Permit Descr. : NEAR NORDSTROMS To Expire t 10/03/90 Project Title : GAP KIDS SPACE C 2 Project $ : P0007522 Project Descr, : NEAR NORDSTROMS * EROSION A Parcel Number Linrl Use Di:-trict : Valuation 0 Legal De:;c r . Owner Cnnitruct ion : OTH Applicant Name : ROSE CITY ELECTR"' Classification ^^^ Applicant. Addl. : 4012 NE CULLY BLVD Ocr..upancy PORTLAND nR 97213 Validated by Applicant Phone: 287 6164 Tn::pr:rtor Area Fee description Unit:. Fee/unit Ext fee Data Feeders: 100 a Amperes e- 200 1 . 00 12 .00 32. 00 Two/ New Circuit Alter. or Extend 1 . 00 32.00 32.00 Subtotal Electrical Fees! 64 .00 State Surcharge of 51,: 3. 2n Total Electrical Feen: 67. 20 AAA Fees Required AAA AAA Fee: 110ef n.1 F fr eriit r f eeei4:t Nr Pitres Payment 04/n9/9n 67. 2.0 Fees: 67. 20 Adjustments . , nn Trrt.al Credit:-: , nn Total Fees : 67. 20 Tot--11 Payment: 67. 20 t1. tlarlce nue: . nn NOTICE This permit becomes null and void 11 the work or construction for which itis Issued la not commenced within ISO days Once cornu, lion has started lbs permit becomes null and void If construction Is interrupted to a period of ISO days I certify that the Information presented by the applicant and his agent or agents In anppor of MN permit N true and correct to the beet of ow knowledge I acknowledge that the suuding Department's reliance upas false and misleading Information may Invalidate the permit *11 provleter,s of applkabls laws and ordinances governing the co, ruction and use of this building or structure will be complied with whether or not specified on the plans or noted on the plane correction sheets I acknowledge that the granting of a permit does ntv grant suthrway.0 access private property or In use sesements I further acknowledge that the use or occupancy of Me structure or building permitted depends upon my calling for Inspections N wharf limes during the process of construction and the building Inspection stall verifying compliance with the various codes Use or occupancy of the building Of structure permitted odor to approval by the Mudding Department N solely N the risk r the applicant and such use on occupancy Is revocable unfit all inspection requirements are satisfied and approval N given by the Budding Official I further acknowledge that a len may be pieced on the Atte of the property upon which IM permit Is Issued specifying that the use or occupancy of the building or structure is provlslonal and revocaL•until the satisfaction of all Inspection requirements APPLICANT'S SIGMA TUNE WASHINGTON COUNTY , , 7 ,-6)'�� DEPARTMENTLANDDEVELOPMENT OF LAND�URVSEK ANDEB TRANSPORTATIONDIV18K)N ,>PERMIT NO. 1713 AC ELECTRICAL NBPECTION SECTION DATE V50_ ISO NORTH FIRST AVENUE --- HILLBBORO,OREGON 971:1 640 TEMP.PERMIT NO. 3170 ISSUED BY ,___ LABEL NO. / 7517_ EL CTRICAL PERMIT APPLICATION NAME OR FIRM LEA PRINT 40' 1/091 Z ite/ MAILING A DRESS 'FLl I,. VERT CONTRACTOR LICENSE NU E x/`13 G I A EG TE RED WITH THE BUILDER'S BOARD ORS 101 0 5 REGIS ZIIjJ�'I►_ LICENSE N—v� XPR ATE (�- SIGNATURE OF L� - LI PROPERTY OWNER I HEREBY CERTIFY THAT I AM THE OWNER OF THE PROPERTY DESCRIBED BELOW. AT WHICH LOCATION I PROPOSE TO MAKE AN ELECTRICAL INSTALLATION FOR MY OWN USE ANU THIS PROPERTY IS NOT BEING CONSTRUCTED FOR SALE LEASE OR RENT FOR THIS REASON I AM EXEMPT FROM BUILDER'S BOARD REGISTRATION UNDER ORS 701 055 THE ACTUAL INSTALLATION WILL BE MADE BY ME 3 I OR BY WHO IS A MEMBER OF MY FAMILY RELATIONSHIP _--_ OWNER'S SIGNATURE OWNER'S NAME / ,J l LOCATION OF INSTALLATION _ 2r-jL44.446.114. C�Et s�Dag�G ?lad w DIRECTIONS-----._— _ —_---- ______ -- -- — --FEE RESIDENTIAL RESIDENCE WIRING LESS THAN 1000 SO FT PS 32.00 RESIDENCE WIRING LESS THAN 200(1 SO FT P$ 53.35 RESIDENCE WIRING OVER 1001 SO FT Ps 14.70 EL ECTRIC HEAT INSTALLATION IN EXISTING RESIDENCE _ PS 21.34 _ SERVICES TEMPORARY SERVICE —__ P$ 21.34 -__- SERVICE CHANGE ONLY IN AN EXISTING RESIDENCE PS 21.34 _____ SERVICE NOT OVER 100 AMPERES P S '.00 __ iI 100 AMPERES BUT NOT MORE THAN 200 AMPERES P$ .35 OVER 200 AMPERES BUT NOT MORE THAN 400 AMPERES _ P S 14.70 OVER 400 AMPERES BUT NOT MORE THAN 600 AMPERES 05 106.70 SERVICE OVER 800 AMPERES 0$ 138.70 _ _ SERVICE OVER 600 VOLTS PS 320.10 FEEDERS INSTALLATION, NOT MORE THAN 100 AMPERES P$ ,'1. 34 ALTERATION OR RELOCATION OVER IOU AMPERES BUT NO7 MORE THAN 200 AMPERES 1/ P S 32.00 �_1 •C J OVER 200 AMPERES BUT NOT MORE THAN 400 AMPERES - P$ 52.35 OVER 400 AMPERES P S 64.00 _ FEEDER OVER 600 VOL TS P5 85.36 MISCEI1ANEOUS MOBILE HOME SERVICE21,34 MOBILE HOME FEEDER P S 71.34 EACH IRRIGATION PUMP *$ 71.34 EACH ELECTRIC SIGN OR OUTLINE LIGHTING *$ 21.34 _-__ EACH RESIDENTIAL SWIMMING POOL P S 21.34 -__ ONE NEW CIRCUIT ALTERATION OR EXTENSION P 5 21.34 TWO OR MORE NEW CIRCUITS ALTERATIONS OR EXTENSIONS f - P S 32.00 _,32-. ('i OTHER NOT LISTED ABOVE "'$ _ -_ I INSPECTION FEF i 4940 FONiiPECTICRIB CALL 840-36e7, 1 2 5%STATE TAX S 3•TO 24 HOIP WONDER,ONE WORKING DAY N ADVANCE OF NIL 3. PLANS CHECK FEE S — (1+2#3) TOTAL CHARGE t (, /, 2(1 THIS PERMIT BECOMES NULL AND VOID IF THE WORK AUTHORIZED BY THE PERMIT IS N( I COMMENCED WITHIN IBC ISSUANCE OF SUCH PERMIT OR IF THE WORK AUTHORIZED IS SUSPENDED OR ABANDONED AT ANY TIME AFTER Wnnk •• PERIOD OF 180 DAYS ELECTRICAL PERMITS ARE NON REFUNDABLE 0 NON TPANSFERA6L I DLL T/L0111-001 11/jS11 I - - r INSPECTION LOG DATE INSPECTOR SERVICE - -- - - -- --- COVER FINAL II DEPARTMENT OF LAND USE & TRANSPORTATION `i LAND DEVELOPMENT SERVICES DIVISION AliWASHINGTON 150 NORTH FIRST, HILLSBORO, OR 97124 �ooml% OUNTY, INSPECTION REQUESTS: 503/640-3561 (24 hours) OR GON PHONE: 503/640-3470 • i • ©/ /4 1( (11`s c Q,,4 'PP- ie. f 40 ,4e ; 1-,' Q �� g t-I i / 17