9720 SW WASHINGTON SQUARE (1) 97 '0 SW WashUr10ton_Square P34820 30895, 66741 : 68815
9720 SW Washington Square
1S1 26C
retail - Dalton Bookseller
#30895
3 n P q Boc / w i. 6 r 6 5,2 WHITE Inspect,, COPY
J tom..M/ ,/'1 YELLOW Permittee
PINK Coshrer
PERMIT NO
GOLDENROD TemuIo?on
Foie
APPLICATION FOR BUILDING PERMIT
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1IASHINGTON COUNTY ADORE'.` ?,eD ). cl/ /4 L(/, -SCJ AC/A
DEPARTMENT OF PLANNING rT
BUILDING DIVISION ry LOC LIrTNEAREST
CROSS ST
N U L N GROUP TYP[ ►A �! 16' .
720 FOR APPLICANT TO FILL IN CODE • � CONST I/�
SUILOINO / `L//�'_ !TA ISTICAL CLASSIPIC 1TION ZONE
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ADDRESS �� i/iI(71'?1 SG'L�A/L :LASS NO DWELL UNI•S a Z.-
..AL. DE ICRs PTION /5/.-e2 , C - .��
50 01 SLOES
SPECIAL CONDITIONS
♦RSA ,1 LOT S
a NOW ON LOT / .I
USE OI ZONING APPRI.VEX BY DA TEs' /(.f7�
EXIITINO ALOE I/
E Rig:L'AIl 7l nc cA'.1 ll bl:L TTt.F OF !IA r. TATs ON
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AODR �?�{/ SLOE SETS•CM PROM
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ADDRESS
JAME::- •••moo etreac■ room
COrPAcrOk . Njr.42yi/11Z40L_1_ )/T •I'
TIOt roOP LIMt or -- IT1 R[t'1
TTrI UI r1i STIME SITSACIt NISAw•T + LAID 7 TOTAL
A DOW ESSf,'L',llii,it/'L'(A MI IMW Ar AMT.. 'IOM C L ,�........ �
CITY .1:11%fi I. ./Li
DESCRIPTION OF WORK CORNER cuTor• Y[I ❑ NO ❑
RPA•P I
NEVI V Apr ALTER REPAIR DEMOLISH SEE REVERSE SIDE FOR SPECIAL APPROVALS
SO.ITNO OP / NO OP
�2E S ...r G ST WRIER / IAMILIIS
NO. SICROOMS NO. OF RA THROOMS —
U!R OF
ft uCtuRE i) / i/i.
NC). OF 11411 0.F E S
BIONATURE 'r
APPLICANT APPROVALS : ATE IAS►ICTOS'/SIGNATURI
VALUATIONS 7 C. t .00 ICA IF RMVDA ht,NMLOC•YlSIOr:S A TERIA
SRAM( tI
P C _ PM• �t tR AC '. P_' ____- ��
ICES 7% rag: y -- 1
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HIRr S. INOVILCOOI 'MAT , H•ve Rt•O Tr IS •►PLICATION
•Nn S'•TI TN•T 'Mt •SOVI IS CORRItT ANC AORES TO CONPI.T NALL SOAR() 1
wITP. •LL COUNT• UROINAPCIS AHO S LAWS RtOUI•TINO , . _.
EVILoINO CONSTRUCTION
_-----
fIONATURE Or
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PEIMItt[ .�._1L'�" " ♦ n '" AND PMT(D
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AODWEss <,,, - - iFINAL ______ /l-2yf1{j7
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PLAN CHECK VALIDATION/AEiBL r 0 cASN PERMIT VALIDATION lN O CASH
IIr I.r,. .,C.it 7z-hz O•r12//IAY RECEIPT NO.1 '2 L 7DA TS /..7/
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PLANS CHECK AND PERMIT APPLICATION (
WASHINGTON COUNTY 1 0 66,815 - -- xi
DEPARTMENT OF LAND USE AND TRANSPORTATION _'_ ei I
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LAND DEVEI OPMFNT SERVICES DIVISION PERMIT NI IMBI-H J -
CONSTRUCTION INSPECTION SECTION p•
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150 NORTH FIRST AVENUE
HILLSBORO OREGON 97124 6488761 C,
�/V�� 0
PLANS CHECK NUMBER I.,,
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OD n
PROJECT LOCATION _ LAND USE _.
ADDRES04 4`-`4
`-ciK c/s-..�..I‘"
-- - DEVELOPMENT DIST ___-_-.
NEAREST CROSS ST. NSEW- - CENSUS TRACT
TAX MAP _ _ - LAND USE CASE `
LEGAL DESCRIPTION LOT/SEC -__ YARDS MIN FRONT
BLOCK/TOWNSHIP - -_-_—_ MIN REAR MIN SIDE
SU:-3DIVISION/RANGE - _ --_ TOTAL SIDE YARDS
PARCEL NO _ NOTES –
WHAT BUILDINGS ARE ON THE LOT? 1`44al Wel /1/.. 1 dJ e
HOW ARE THEY USED? ----. ALL,__. 6c-re,------- a/ICIL 4,Q /S Q
OWNERSHIP -�"� u---�fi- -
II PROPERTY OWNER tt-r-T--LQ"Yag--- -- `
ADDRESS u r I Nil1Q . P4C.( FEES — — - -
-- -----_-- - __
••-
PHONE --___-----.__---- ESTIMATED VALUE i.
l/410'
PROJECT DESCRIPTION PC FEE A
NEW I 1 ADDITION TER 0 REPAIR FM FEE • — 24 HOUR
DEMOLISH Cl MOBILE HOME _- -- INSPECTION
AREA SO FT HEIGHT FT. TOTAL FAIN /I'. /�i 640-3561
HEIGHT --STORIES USE OF STRUCTURE WILL BE — _ "�.-
��s.,41!lf ��..L.c__ ------ - DUE -- 1 l/,./
OTHER c gam— PLEASE
BLDG D ii( ed CALL FOR
-- -- INSPECTION
oo ONE WORKING
ELECT a
ESTIMATED MARKET 1M1LUE i I i Q DAY IN ADVANCE
DESIGNER/BUILDER — — MECH, F
_.—_ _ _ _ OF NEED
LSE_.. PLUMB — --^ ----
DE SIGNER /---
ADDRESS 17.#0.) .7:421,7Dr 2440.e R6 f0,Cr' S.TOTAL mai I
/'T' O---
STATE TAX 14%0E S.TOTAL) 3 • dZo
TRAFFIC IMPACT FEE 4 �,.
ADDRESS ---. PH._.__-
BUILDER DEVELOPMENT COMP REV. s
ADDRESS PH ADDRESS a MIMI
APPLICANT — APRON/SIDEWALK 1
NAME IPIInII ' 6148 j OTHER • -�
ADDRES*! (7 YGc '2",4441 ,9 4 P G_ PH G r-4113 irVIAL Mw ft•446;310
REPRESENTING 'L`I 24p
I HIVE READ THE NOTES AND CONDITIONS ON THIS PERMIT AND
ACCOMPANYING PLANS I AGREE TO MEET OR EXCEED ALL
APPLICABLE CODES AND L •WHETHER OR NOT REPRESENTED
SIGNED X ._. DATE 01?yt, IN OR ON MY A TION ANS AS SUCH
PRELIMI4A&
S CHECK FEE SIGNATOR- >
PLANS CHEC4 FEE $ l L ___._ PRINT NA L O G r-K S DATE A�7
FIRE S LIFE FEE f D . Co PRELIMINARY PLANS CHECK RECEIPT
TOTAL DUE $ 1 i�I ri� (h � 1 f '
V
09kWASHINGTON
°AI" COUNTY,
OREGON
February 2 , 1987
Ed Gause
17460 Treetop Lane
Lake Oswego, Oregon 97034
RE : Euilding Permit #166815
Touch of Country
Washington Square
Plans on the referenced project have been reviewed by this
office and are approved subject to the following:
1 . Plans for the installation or alteration of the
automatic sprinkler system mus'- be provided to
and approved by fire marshal 's office having
jurisdiction and this office prior to
installation or alteration
Sr
Donald W. Howick
Plans Examiner
c : Washington County Fire District *1
Building Inspector
Permit File
Department of Lend Use And Transportation, Land Development Services Division
150 North First Avenue Hillsboro.Oregon 97124 Phone 5 13/648-8761
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WASHINGTON COUNTY FIRE DISTRICT NO. 1
20665 S.W. Blanton St. • Aloha, Oregon 97007 • 503/649.8577
February 3 , 1987
Mr. Ed Gause i
17460 Treetop Lane
Lake Oswego, OR 97034
1
Dear Ed ,
RE: Touch of Country
• Washington Square, A .8 (A-9)
Bldg. Permit 066815
A fire and rife safety plan review was conducted on the above-noted
plans . These plans are approved subject to the location of automatic
sprinkler heads. The heads shall not be closer than 6 feet to each
other nor further than 7 1/2 feet ma,:imum distance off of •galls and
not more than 15 feet between.
If 1 can he of any further service to you , please feel free to call me
at 649-8577 .
Sincerely,
WASHINGTON C UNTY FIRE DISTRICT NO. 1
— .......4_ N)
Gene Bir;:hill
Plans Examiner
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cc: Washington County Bldg. Dept. (2)
Inspector Ray
1
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STOP FIRES - SAVES LIVES
- - -
OWASHINGTON COUNTY INSPECTION r:"RD /�� ���
DEPARTMENT OF LAND USE AND TRANSPORTATION PERMIT NO. �__
f OR INSPECTIONS LALL: t4u-3;,t1 . 24 HOUR'
FOR INFORMATION CALL: 640-3470 DATE ,� S — e7
ADDRESS .S G I J..0.014 QS/'1 .c7 ' PERM!TE / ,I/ .,? /11 4 R-
D I
Z.DI RE CT IONS /2_,:1,44L-46A2/ L '/ PHONE NO.
1NSP1. 1ION : STRUCf OPLUMB IDMECH 0ELECT _ T/i !/ ;l _
CALLED IN BY
APPROVED. lfr( �0 C.ia.+-L,[�_,wl sn ice:g QS
jREQUESTED INSPECTION APPROVED
HOLVLRNOTL , a
ni NOT APPROVED:
REPAIR OR REPLACE AND RE-INSPECT: • ,.
STOP WORK UNTIL:ll,
D t 3 - 5 67? -- ---- i 1-
INS PEC 10R __— _
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AftWASHINGTON COUNTY INSPECTION CARD �.
DEPARTMENT OF LAND USE AND TRANSPOR1 4TIC Ii PERMIT NO. Z‘:
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FOR INSPECTIONS CALL: 640-3561 . 24 HOURS
FUk INWNMAI ION CALL: 640-3470 DATE
ADDRESS -_&c,)C _ [''L 12_04-d2 _ PE RMI TEE— ---
QIRECTIONS PHONE NO.
INSPECTIONS: 21STRUCT DUMB OMECH ]ELECT ---
CALLED IN 3Y
2APPROVED. ----- - -- -
REQUESTED INSPECTION APPROVED
HOWEVER NW F :
:JOT APPROVED.
_.REPAIR OR REPLACE AND RE-INSPECT:
OSTOP W UNTIL: - - ----- --- -- -
DATE -
INSPECT° ? ler
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..........�... r.,rneutw•,rrnnn ur.r.+■rr
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FIRE PREVENTION BUREAU
OFFICE OF rPRE MARSHAL 34213
INSPECTION NOTICE
OWNER -- — --- DATE -- - ---.
OCCUPANT /O) 7 c' ! �Ov.��f� OCCUPANCY_
LOCATION /`I 7_;; •moi t <!/f;; ,. f //,, -- -- — .----
VOVA ATTENTION IS CALLED TO THE TOLLOWING FIRE SAFELY DEFICIENCIES:
......;/,' :..-
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F A'LU'1[ TO CORRECT t-IE ABOVE COND,T ON$ w'r..'N, OAYS *ILL MAKE YOU LIABLE TO r OSfCVT,•/N SHCVIC F'41r
RESULT "ROM SUCH CONDITIONS YOU MAY !1E LIABLE FOR DAMAGES TO PERSONS 050.0114WORERTT ylIttN 4gOVIS'ONS OF
ORS 479 '90 - /. �'�V
By / —
� WASHINGTON COUNTY FIRE DISTRICT #1 ill t MARSHAL
20665 S W. BLANTON STREET !
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ALOHA,OREGON 97006 649.8577 PRESENTED 1'0
FDRV 900 40
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ONWASHINGTON COUNTY INSPECTION CARD Yy/liv DEPARTMENT OF LAND U8E AND TRANSPORTA,TI PERMIT NO. Sv O U/S
"P IYSPCCT IONS CALL: '^O 3561 , ?4 !!OUR � c- �'r! �Li/"
FOP INFORMATION CALL: 640-3470 'f DATE �-= c:/�i
ADDRESS _ y! 01-L^1 \- /4 A/9 5A /".-1 ' —-_7 PERM!TEE . "G /4
/ _______,r' .v
DA .S /e_<__,,
DIRECTIONS_ _-- PHONE NO.
TNS°ECT!ONS: 0_CTRUCT �PLUMR El tit- ID ELECT . — / -W. <1
CALLED IN BY —
APPROVED. 3no ) —_-- —_---
REQUESTED INSPECTION APPROVED `12 A r�1 Ir N !1(C w STD (Y is
HOWEVER NOTE: - I
(]NOT APPROVED: r�n1"(-7- - -- ----
` LJREPAIR OR REPLACE AND RE-INSPECT: (C) , 777 C-� J✓ ,�,
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IISTOP WORK UNTIL f�7
DATE - - - - - - -
(: 24 )
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FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL15r?j�5 33 �2 ...s.M
INSPECTION NOTICE I
OWNER
DAIE _
OCCUPANT 494/71e3i. %. GOTS ,5 -c OCCUPANCY
LOCATION 72 JU �j �lJ u/,/,,j�_74...
vOUR ATTENTION 1! CALLED TO THE FOLLOWING FIRE SAFE Tv OEriC IE '_IESt
1 (1(..., A-c/f L'i /• • ."'r'//,'
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F•ILURE to CORRECt tHE •ROVE CON',IT.ON! WITIIIN nAv! WILL MAKE YOU LIA11LE TO rRCSECU?ION !•I
f.ULC ',sir
RESULT FROM SUCH CONOITIO4•a YOU MAY RE LIABLE. POW OAM•GE! TO PERSONS Os II• tWt Y UNCF.R PROVIIION! Or
OM OTO Ion �+ ! ,
WASHINGTON COUNTY FIP.E DISTRICT Ni 'car L
20885 S.W. tiLANTON STREET •
/ '
ALOHA, OREGON 9708849 8577 RESENTED TO I/�l
FORM SOO �O '
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PLANS CHECK ANC. PERMIT APPLICATION (. �p rf it!
wASHING ON COUNTY ^ C�I, f
DEPARTMENT OF LAND USE AND, 1ANt'PORTATION (j
LAND DEVELOPMENT SERVICES DIVISIONPERMIT NUMBER
CO50N FIRS INSPECTION SECTION
150 NORTH FIRST AVENUE /� n/�
HILLSBORO.OREGON 97.24 548-8'F.1 `,6 2 6
PLANS CHECK NUMBER
PROJECT LOCATION ' LAND USE _
7_7.2A95
ADDRESS �_ n7J I�p DEVELOPMENT DIST .--
NEAREST CROSS 8T._._ _- N S E W ......6,...-.'" ....
CENSUS TRACT
304 -TAX MAP sk V ' ,,moo LAND USE CASE _.
LEGAL DESCPIPTION Leti � 3O � ~�� YARDS MIN FRONT
IOS ;416e46/
--. p �P. 400_CSO BLOCK/TOWNSHIPGrec !LO MIN REAR MIN SIDE '
SUBDIVISIONiRANGE 0 :LO IA • y TOTALSIDE YARDS1#4 —
PARCEL NO ——per EV iJ&ES .� �Ct
t,Tn�
WHAT BUILDINGS ARE ON THE‘1921 - ,.ARf �VI�j.L __ .Qn-
HOW ARE THEY UBEDT_ CY�.i
OWNERSHIP - -- ---- Uillifil)4
k•Sre`^^1 --
PROPERTY OWNER J2L_& rZLJr ;.-
ADDRESS ..0J4 L AA�FF 'N ' ! �7YSQ_6. FEES
/ /Y PHONE 6I.
I 27 ESTIMATED MI LUE$. /��
PROJECT DESCRIPTION _ PC FEE A
j 73. 3 ___
NEW I I ADDITION )(ALTER f 1 REPAIR FM FEE s 24 HOUR
o
DEMOLISH I !MOBILE HOME — I _— -- 57 y INSPECTION
AREA 5 512 SO.FT HEIGHT / FT TOTAL (A a sl 1.
. ._f',93 640-3561
HEIGHT { STORIES USE OF STRUCTURE WILL BE __-___.__—___ .__ ��ay• y3 ___
JacDid ` t''L golvD> DUE - - — ---,--
_
• 6-2 7 -An OTHER c leii,- PLEASE
BL00. o CALL FOR
/4112,f0 INSPECTION
eio Cr ESTIMATED MtigKEt VALUE i 7� ELECT E �if1S e�A ONE WORKING
DAY IN ADVANCE
DESIGNER/BUILDER MECH. F "--"••--"""'"
OF NEED
- - _- .,Ono^►•
DESIGNER rc /Vr2-cin/y,, 4-1--4 PLUMB. o ��_y
ADDRESSX.f. 4 ,;�! .4gV) pow- a ANAL(cos L2a, j O
7' yy�►,LNJul Tv.Nc T,0 N STATE Ax(4%0F-s.TOTALS _' , _ 5= Y
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�1� TRAFFIC IMPACT FEE
1 ADDRESS 720 iv of-06, riatel v/''4 P 9 'eh �-
BUILDER
• �t / // .s74 144.0 DEVELOPMENT COMP REV s .�
AT)DRFS. ;0/ ft it illG' '' I' ,. i •#► ' $. it' P RI ADDRESS . —e w ..
APPLICANT II `�L` 0, APRON/SIDEWALK t
NAME(Pt nI) .� /• i OTHER s .40
./, ,. y ,
1 ADDRESS 1' . o ' ' l' ______..___. . _ .
'""Y PFI / TOTAI (Linea�a) — ..,I/ µ -—
REPRESENTING 13, 04e_ '1� vA ; L --- >' 33_r 6/.-_ __
I i I HAVE READ THE NOTES Ai CONDITIONS ON THIS PERMIT AND I
I "1 ACCOMPANYING PIANS I AGREE TO MEET OR EXCEED ',LI
�7 APPLICAHL:.CODES AND AWS WHE THER OR NOT REPRESEI.'FU
SIGNED X / I —r DATE? ' 9A IN OR ON M r APPLICr�T AND PLANS AS SUCH
PRELIMI SCHECK FEE SIGNATURE
PLANS C11[CK - $ 3 6 3 PRINT NAME DATE
FIRE 8 LIFE FEE $ I . ''4- 0PRELIMINARY PLANS CHECK RECEIPT
TOTAL DUE a:22 i 1 1
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'•••P'mei
` TAIME M,
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Oft WASHINGTON
Ih0
COUNTY,
OREGON
January 12, 1987
. , I
Molly Baker
Construction Manager
B Dalton pookseller
1 Corporate Center9-9 ,--
7505 Metro Building �
Minneapolis, Minnesota 55435
Dear Ms. Baker:
This letter is to confirm our telephor: conversation of
Tuesday, January 6th, in which you regtS t the extension of
the life expectancy of Plans Check' 06626 for remodeling of
the WPshington Square B Dalton Bookseller tenant space.
That (:xtension has been approved and will continue until (
7-22-87.
We hope that your construction in Washington County proves
to be a pleasant experience and look forward to helping you
in any way we can.
Yours very truly,
William E . Schlecht
Building Official
ja
lelrnrtmvnt of I and Use And lrensportetion,Lend Development Services Division
1517 North Feat Avenue
Hillsboro,Oregon 97124 Phone 503/1348-8/6 1
1
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iiIAPER --
CONSTRUCTION
Lic. No. 355487 720 Hundley Way Placentia, CA 92670 (714) 579-1666
Mr. Don Howick January 13,1987 �
Building Department
Dear Don,
Please find enclosed 2 sets of plans and specification for the
B—Dalton Bookstore remodel in Washington Square.
If you have any questions please contact Dale or Paul at
(714) 579-1666.
Thank ,
Dale Thayer
General Building Contractor
Thayer Construction
1 ! 'RfCEIVrb
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JAN141981 ,LAND USE USE & -2
L TRANSPORTATION
WASHINGTON cowui
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WASHINGTON
�--- _
COUNTY.
OREGON
January 19, 1987
Dale Thayer
THAYER CONSTRUCTION
720 Hundley Way
Placentia, CA 92670
RE: Plan Check #6626
6. Dalton Bookseller
Washington Square •
JJ
Revised plans on the referenced project have been revi(wed by this office
and are approved for construction as submitted.
Donald W. Howick
Plans Examiner
/sm
c: Washington County, Fire District #1
District Bu'lding Inspector
Permit File
Department of Lend Use And Transportation, Land Development Services Division
•
150 North First Avenue Hillsboro,Oregon 97124 Phone 503/648.8761
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WASHINGTON COUNTY FIRE DISTRICT NO. 1
20665 S.W. Blanton St. • Aloha, Oregon 97007 • 503/649-8577
•
January 20, 1987
Thayer ,:onstruction
720 Hundley Way
Placenta , CA 92673
Gentlemen:
RE: B. Dalton Book Celler (PC 6626)
9720 S.W. Washington Square Road
TheP lans fTr the minor remodel work and new store front at this occu-
pancy have been examined with respect to fire and life safety require-
ments and are approved as submitted.
If I can be of any further assistance to you, please feel free to call
me at my office.
Sincerely,
WASHINGTON COUNTY FIRE DISTRICT NO. 1
•
----Gene Birchill
Plans Examiner
ssw
cc: Washington County Bldg. Dept. (2)
District Inspector
STOP FIRES-- SAVES LIVES
•
FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL. ()i3743
INSPECTION NOTICE
OWNER f -- — — — — DATE
OCCUPANT �L' f/�Ii OCCUPANCY
LOCATION �' 7:•(.
YOUR ATTENTION IS CALLED TO tHE FOLLOWING FIRE DEFIf.IENCIESI A!
Nitce„ < Cee
i AILUR( TO COHfECT TNF •ROVE CONDITIONS WITHIN n*vi WILL MAYS YOU LIAR L TO FFIOSECU N f,,Oul. •'RE
RESULT T'IOM SUCH CONDI TION! "OU MAY NE UAILE TOR DAMAGE! TO RE111$0 TORR PgovIvON1 OF
OR! ATS ISY "
By
WASHING fON COUNTY FIRE D!S1 RICT#1 •T Alr%1 t
20665 S.W. BLAN TON STREET ;, , ,
ALOHA,OREGON 97006 649.8577 PRESENTED TO mike,
FORM •00 40
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1, 30895 6614 688 5
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usailinismeimmanimminommimmentsammir
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DEPARTMENT OP LAND UP 6 TRANSI ORT&TION
WASHINGTON
'W COUNTY,
ift
LAND DEVELOPMENT SERVICES L,1'�ION
166 NORTH FIRST,HILLRSORO,OR 07124
INSPECTION REOUE>lfTS: 601/640 J6A1/hos-4116
T HONE: 601/616-A761
OREGON Pare = 1
� Date 09/24/93
Time : 08: 52
Pycmit Type Comm
erc>al Electrical Permit Permit 0 : 05045045
Permit Status : APPROVED Applied : 09/23/93
Situs Address : 9720 SW WASHINGTON SQUARE RD TI Issued : 09/23/93
Permit Ti tie : B DALTON BOOK STORE - CIRCUIT Completed :
Permit Descr. : JOB 265-3-102 To Expire : 03/22/94
Project Title : B DALTON BOOK STORE - CIRCUIT Project N : P0034820
Project Descr. : JOB 265-3-102 * EROSION *
:
Parcel. Number : 2S1TI - Land Use District :
Valuation : 0
Legal Descr. :
Owner : INSPECTION - TIGAIID Construction : OTH 1 I
Applicant Name 1 BLESSING ELECTRIC Classification : 900
Applicant Addr. : 829 N RUSSELL Occupancy :
PURTL4ND, OR 97227 Validated by : PH
Applicant Phone: 284-1189 Inspector Area :
CONTRACTOR : BLESSING ELECTRIC Lic. C 26-151C 284-1+03
Fee description Units Fee/Unit Ext tee Data
let Branch W/out Feeder (Enter 01 1 35.00 35.00
Subtotal Electrical Fees: 0 35.00
State Surcharge of 5% 0 1 .75
Total Electrical Fees: 0 36 .75 j
*** Fees Required *** *** Fees Collected & credits *0*
Receipt No. Date Peyment
09/23/93 36.75
Fees: 36.75
Adjustments: .00 Total Credits: . 00
Total Fees: 36.75 Total Payments: 36.75
r Balance Due: . 00
I
" NOTICE: This remit bealnl.a nue and void N Vi.Bal at.s11uiv oilan/w INdoit N le Neuse I.non ss IgM within 1N days. Ones oonanucllon hal elided,
the
permit booms,nuN and veld It eeneev lla,M Loden qbl ter a paled et 1M dela.I savvy Met Vie leekeeiallen peewee by the ipollc.nt and
.gem .gang In eBppul IM►'1M penal M W1M ad esrfeN r Ne beat 1M M�I111Bdge. 1.o1mu.Ae/N Mat IIIc BuNdlrp Department's raNnce Z
rt upon ise and to N*M N Mily I �paM fa ni � governing the construction and use
ill rerepNd ale WNIMw at net an Vii plena re lead on the pians eorn.N.n shoes I scknCwI.rlga that
the granting of a wee does not grad aAladly Ie NOM p15W5 pnpuly win use&Oa11a1.. Minter.cknoulsdps VM We use or occupancy et
the et,ict re or buIlding permitted depend.upon my Nen per 11.p..NaM d vedette VIM.&Rale Ills proem el MR*Vulon and the building
Int:pea vI NO verifying intentional!with the imbue arts. Use or oeeupa ey et NM ItWIM w drwMal
e pJWd peer Is approval by the
rhe'Deportment Is safely el Me risk of Me applicant ad such use or eoagaMy le WN all InepMNen te1IMeneenia are satisfied and
approval le given by Ins Bulking Official I further acknowledge that.lien may be pined OR gat Na/M VIII wpM1y mese which the permit la issued
specifying that the use or occupancy ot the building or structure N provtekmal DM reve.eIJ.Mil Vie aelw/.oVa1 M M M.perlIo requirement.
APPLICANT'.elONATVRs---------�
WASHINGTON COUNTY ELECTRICAL PERIVIIT
Department of Land Use !! Transportation
Electrical Inspectla, Eectlon
First
0350-12
3� 12 A P P LI C4T1 O NHillsboo, Oregon
information: 503 640-3470 Fax: 503 6934412
Pro ect/Permiti / Q
PLEASE PRINT lS y Date 7 - 3--Y
Please complete all,�ections,it through 5. Number 1,1� S 1
1. Local n o/in t lla L� 4. Corr►pl�to Fee Schedule below
Address. Z 0 !((� t.v 7/) Number of Ina
NNG p.otlone per permit allowed
Building Service included: Items Coat(ea.) Sum
City _ I ___ Su;te No _
Tenant Na TT�[— ///n����,,.. ( A. Residential-per unit
(t commercial) _ B ✓ rOvOk J 1000 sq h or less 1.10.00 _
Each additional 500 sq ft
Tax Lot------______- Map No. — or portio,thereof . 125.00
l imited Energy x.00 — 1
Thomas Map Book: Page: Section: Each Maimed Home or M)(Mar
., Dir3ctione —... Dwelling Service or Feeder --- $69.00 2
B. Service,or Feeders
Commercial__ Residential❑ Installation,alterations or relocation
200 amps or les. 160 00 _ 2
2a. Contractor 1 tallallon qpl 201 amps to 4`0 amps -- $80 no — 2
EI y' 401 amps to 60')amps ---- 1120.00 2
Electrical Contractor SSt4t 1% tai,c.. 601 amps to 1000 amps --_ 119000 — 2
Address ' Ar- SS ?7 10-Over i000 amps or volts __— 1340.00 —
Date - - J b Number S -j /Reconnect onnect only t.50 00 -- 2
Property Owner __ L4111._,c
Contractor's License No - C� C. Temporary Services or Feeder
Contractors Board Reg.No. Inatallellnn,alteration or relocation
— 200 amps or kris Ri0.00 . 2
r//�I. p 201 am to 400 amps
Signature of Slip.. Eleciry�� •t k 401 amps to 900 amps $`0700.0000 _ 2
_
License No._ SO S , Phone No. Over hp
900 si .to 1000 volts see•B•above —
2b. For owner Installations: D. Branch Circuits
New,alteration or eldension per panel
Print tSwrtda Noma ----Phone -- a) The lee for branch circuits whh
s purchase of service or feeder fee.
0 mama --- --- Each branch circuit __
$5.00 —
b) The fee for branch c6 cults without
City State ZIP — -- purchase of oarlike or feeder fee.
First branch rh suit / $35 00 _— 2
The installation is being made on property I own Each add'nl branch circuit_-- $5.00 2
which is not intended for sale, lease or rent. E. Miscellaneous (Service or Feeder not included)
Each pump or Irrigation circle___ $40.00 2
Owner'.;iignature ___________. Each sign,or outline lighting ._ $40.00 .__ - 2
( Signal circuit(s)or a limited
3. Plan Review section (if required) energy panel,eteretion
please check appropriate Item and enter fee In section 59. or eaten $40.00 2
i
1 &2 family dwellings over 320 amps 5,/c meter F. Each additional inspection over the allowable
4 or more residential units In one structure In any of the above
Pur inspection
1 _ Service over 225 amps;feeder 400 amps or more Per how 135.00
$55 00 I
i _ System over 600 volts nominal In Plant __, 155.00
_ Building over 3 stories in height
_ Building over 10.'100 sq. ft. 5. Fees �.+,y,�
_ Occupant load ever 99 persons A. Enter total of a►hove fees $ eJJ
_ Manufactured St uctures Park or Res reational 596 Surcharge(t.5 X total fees) $ j-�S-
) Vehicle Pad., new, addition or alterati .n Subtotal $ —
. Classified area or structure containing special P. Enter 25% of line A for
oc:upldncy as described in N E.C. Chapter 5 Plan Review if required(Section 3) $ __
Submit 2 sets of plana with application where any of the Subtotal $ __
above apply. Not required for temporary construction Less Bulk Laoel Fee
Services, Balance Due $ 30,7(
For Inspections rill rm.Mane Mc ono.null and void 1111»wort.uth.ulnd by era
la nal aafrusorwad
640-3561 or d93-4415 weld•ISO hong dale al I..uan°•al was Is
rrrwe«s M.wort nut/swim'.windnil
M
24-hour recorder,one working day in advance of need t «easeended ow ir aro
an ~al„�ndable Maw ins-e lranNeraeM d re •o. d d tao sera
1 5/91
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