HomeMy WebLinkAbout1818 W 6th St - BuildingPREPARED 2/16/11 8 13 26 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/16/11
ADDRESS 1818 W 6TH ST SUBDIV
TENANT NBR JERRY MAUREEN REYNOLDS
CONTRACTOR PELLET HEAT CO PHONE (360) 457 4406
OWNER JERRY D MAUREEN L REYNOLDS PHONE (360) 461 4858
PARCEL 06 30 00 0 1 4820 0000
APPL NUMBER 11 00000065 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 2/16 JLL MECHANICAL FINAL TIME 01 00
February 9 2011 3 55 06 PM 1pangrle
1175eY— JERRY 461 4858 OR 452 4484
MECHANICAL FINAL PELLET STOVE
AFTERNOON
PLEASE CALL HIM 10 MINUTES BEFORE YOU GET THERE
ppt441
COMMENTS AND NOTES
C
Owner
Permit Fee Total
Plan Check Total
Grand Total
T:Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 11 00000065
Application pin number 765510
Property Address 1818 W 6TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 1 4820 0000
Tenant nbr name JERRY MAUREEN REYNOLDS
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 1050
Application desc
INSTALL A PELLET STOVE
JERRY D MAUREEN L REYNOLDS
1818 W 6TH ST
PORT ANGELES
(360) 461 4858
Qty Unit Charge
1 00
Fee summary
10 6500 EA
WA 983631722
Permit MECHANICAL PERMIT
Additional desc INSTALL A PELLET STOVE
Permit pin number 180570
Permit Fee 60 65
Issue Date 1/18/11
Expiration Date 7/17/11
Per
Charged
60 65
00
60 65
1 g. ,91%J& i
Contractor
PELLET HEAT CO
230 EAST 1ST SUITE C
PORT ANGELES WA 98362
(360) 457 4406
Plan Check Fee 00
Valuation 0
BASE FEE
ME STOVE /FIREPLACE /MISC APP
Paid Credited
60 65 00
00 00
60 65 00
Due
Date Print Name Signature of C ntractor or Authd ized Agent
Date 1/18/11
Extension
50 00
10 65
00
00
00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
oil
02
Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities private and public improvements This permit becomes
null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced or if required inspections have not been requested within 180 days from the
last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction
Signature of Owner (if owner is builder)
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls
Ceiling
FRAMING
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting 1 ESA.
Landscaping I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
FINAL Date Accepted by
C9
00
(FINAL Date Accepted 13\ 1 (n
1
Date Accepted By
01/18/2011 09 53 13604520503 SPA SHOP PELLET HEAT PAGE 01
Parcel Number O 3 D 141 Z t7 ne a a
ra Heat System
cq Other
Floor Areas
Basement
111 Floor
2 Floor
3( Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures
Max, height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E, Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
1 „5 -Lail
Existing (sq. ftj Posed (sa. ft.)
sq ft. Lot size
ft. Occupancy group
Occupant load
Construction type
BUILDING PERMIT APPLICATION Print in Ink
Applicant or Agent net f C.
Owner Xe.r Rey IV -O
Owners Address /t w G 7i& S d�•�r
Contractor /Engineer Pe.//44- /44.. Co
Contractor /Engineer's Address 2 3 o c E S
License PE IA. EI) $0M
Phone 3L0 9r7-vgegq,
Phone ja. y$/..Lr 8s8
(h.( 3LA SZ
Phone 6 7- '4' L
Expires i J i
PROJECT ADDRESS g i w w`s t rt. se e. A
Proiect Tvoe Brief Description. p Residential o Commercial
Check all that apply
New Construction
o Addition
o Remodel
c Repair
c Re -roof
Demolition
o Sign
r ,•a s f see
have read and completed this application and know it to be true and correct.
understand that it is my responsibility to determine what permits are required
projects.
Date 1 ii Print Name J
Signature
T Forms /Building oivislon /Bldg Permit AppL 2006 Code doc
For City Use Only
Date Received I S
Permit 11— Co 5
Date Approved
Lot c Zoning lZ
o Mu/tl- family c Industrial
N
o wall mounted o projecting o freestanding awning o other
Total sign area sq ft. Maximum allowed sign area so ft.
o Heat pump o wood- burning stove o gas fireplace 60 pellet stove o other
per sq ft.
TOTAL VALUATION /d 5-"
of bedrooms
of full baths
of half baths
sq ft. Lot coverage
I am authorized to apply for this permit ano
and to obtain permits prio r working on
Clallam County Assessor Treasurer Property Details 57019 JERRY D AND MAUR. Page 1 of 4
Clallam County Assessor Treasurer
Property Search Results 57019 JERRY D AND MAUREEN L REYNOLDS for Year 2011 2012
Property
Account
Property ID: 57019 Legal Description: LOTS 5 BL 148
Geographic ID: 0630000148200000 Agent Code:
Type: Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11
Open Space: N DFL N
Historic Property: N Remodel Property' N
Multi Family Redevelopment: N
Township' Section:
Range
Location
Address' 1818 W SIXTH ST Mapsco:
PORT ANGELES, WA
Neighborhood Cycle 5 Res Map ID' 3
Neighborhood CD: 10955130
Owner
Name: JERRY D AND MAUREEN L REYNOLDS Owner ID: 48389
Mailing Address: 1818 W 6TH ST Ownership: 100.0000000000%
PORT ANGELES, WA 98363 -1722
Taxes and Assessment Details
Property Tax Information as of 01/18/2011
Amount Due if Paid on:.
Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest Base Paid Amount Due
2010 40032 ST SCH STATE SCHOOL $201 10 $201 09 $0.00 $0.00 $402 19 $0 00
2010 40032 CC -GEN COUNTY CLALLAM $107.03 $107.01 $0 00 $0.00 $214 04 $0.00
2010 40032 PORT PORT OF PORT ANGELES $15 04 $15.04 $0.00 $0.00 $30.08 $0 00
2010 40032 PORT ANG CITY OF PORT ANGELES $247 78 $247 78 $0 00 $0.00 $495.56 $0.00
2010 40032 SD #121 SCHOOL DISTRICT #121 $260.48 $260.47 $0.00 $0 00 $520.95 $0.00
2010 40032 NTH OLY LIB NORTH OLYMPIC LIBRARY $31 10 $31.09 $0 00 $0.00 $62 19 $0.00
2010 40032 HOSP #2 HOSPITAL #2 843.90 $43.90 $0.00 $0.00 $87.80 $0 00
2010 40032 WSMET PK DIST WILLIAM SHORE MET PARK DIST $13.97 $13 97 $0.00 $0.00 $27 94 $0.00
2010 40032 CITYSTORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $72.00 $0.00
2010 40032 WEED_CONTROL WEED CONTROL $0.82 $0 81 $0.00 $0 00 $1.63 $0 00
2010 40032 TOTAL. 8957.22 $957 16 $0.00 80.00 51914.38 80.00
2009 570192008 ST SCH .STATE SCHOOL $230 79 $230.78 $0.00 $0.00 $461.57 $0.00
2009 570192008 CC -GEN COUNTY CLALLAM $116.79 $116 80 $0.00 $0.00 $233 59 $0 00
2009 570192008 PORT PORT OF PORT ANGELES $16.54 $16 55 $0.00 $0.00 $33 09 $0 00
CI
2009 570192008 PORT ANG CITY OF PORT ANGELES $256.18 $256.20 $0.00 $0.00 $512.38 $0 00
2009 570192008 SD #121 SCHOOL DISTRICT #121 $285.41 $285 40 $0.00 $0 00 $570.81 $0 00
2009 570192008 NTH OLY LIB NORTH OLYMPIC LIBRARY $33 94 $33 93 $0.00 $0 00 867 87 $0.00
2009 570192008 HOSP #2 HOSPITAL #2 $47.90 $47 90 $0.00 $0 00 $95.80 $0.00
2009 570192008 CITY STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $72.00 $0.00
2009 570192008 WEED_CONTROL WEED CONTROL $0.81 $0.82 $000 $0.00 81.63 $0.00
2009 670192008 TOTAL. $1024.36 $1024.38 $0.00 $0.00 $2048.74 50.00
Values
Improvement Homesite Value' N/A
Improvement Non Homesite Value: N/A
Land Homesite Value. N/A
Land Non Homesite Value: N/A Ag Timber Use Value
Curr Use (HS): N/A N/A
Curt Use (NHS)' N/A N/A
Market Value:
Productivity Loss.
N/A
N/A
Subtotal N/A
Senior Appraised Value: N/A
Non Senior Appraised Value: N/A
Total Appraised Value' N/A
Senior Exemption Loss: N/A
Exemption Loss N/A
Exemptions:
NOTE. If you plan to submit payment on a future date, make sure you enter the date and
click RECALCULATE to obtain the correct total amount due.
First Second
Half Half
Base Base
http. /websrv8 clallam. net propertyaccess /Property.aspx ?cid =0 &year =2011 &prop_id =57019 1/18/2011
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362 .
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Zoning . . .
Application valuation
03-00000744 Date 8/04/03
1818 W 6TH ST
06-30-00-0-1-4820-0000-
ELECTRICAL ONLY
o
Owner
-'d' .
Contractor
JERRY D/MAUREEN L REYNOLDS
1818 W 6TH ST
PORT ANGELES WA 983631722
ELECTRIC SERVICE
82 DRAPER RD
PORT ANGELES
(360) 452-6424
WA 98362
Permit
Additional desc
Sub .Contractor
Permit Fee
Issue Date
Expi'ration Date
ELECTRICAL ALTER RESIDENTIAL
HEAT PUMP FURNACE HOOK-UP
ELECTRIC SERVICE
46.70 Plan Check Fee
8/04/03 Valuation
2/01/04
.00
o
"
\}3
"-
~
Qty Unit Charge Per
1.00 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS
Extension
46.70
Fee summary , Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 46.70 46.70 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 46.70 46.70 .00 .00
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~
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~
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Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not.been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction. .
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\1102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUND A TION DRAINAGE
ELECTRICAL; (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN ,
WATER LINE
GAS LINE
BACK FLOW / WATER,
AIR SEAL
,
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB ,
WALL / FLOOR / CEILING I ,
.--
MECHANICAL
HEAT PUMP "
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER I
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DA:TE ACCEPTED
I YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 7 Jg I In';! fJl) ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W./ PW/ I I CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
, I
T:\PLANNING\FORMS\II02.15 [4/2002]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES,WA 98362
'J
I
1
Applic:fl~ic:m~er; . .
PiOpertyAddress . I. . .
ASS.BSSOR .P,ARCBL NUMBER:
Tenan~ nl);r" paille . . .
Application description
Subdivision Name . "
, . , I
Property Zoning . '. .
Application valuation .
03-00000761 Date 8/08/03
1818 W 6TH ST
06-30-00-0-1-4820-0000-
HEAT PUMP /T-STAT
MECHANICAL PERMIT
4500
Owner
Contractor
JERRY D/MAUREBN L REmOLDS
.1818 .W6TH ST I
PORT ANGELES KA 983631722
DAVE'S HEATING & COOLING
991 FRESHWATER PARK RD.
PORT 'ANGELES KA 98363
(360).928-0245
~~~-~~~----------------I~---------------------------------------------------
Permit . . . . MECHANICAL PBRMIT
Additional desc
Permit Fee
Issue Date
Expiration Date.
47.00
8/08/03
2/05/04
Plan Check Fee
Valuation
.00
o
. Qty Unit Charge Per
BASB FEB
Extension
47.00
Fee swmnary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 47.00 47.00 .00 .00
Plan .. Check Total .00 .00 .00 .00
Grand Total 47.00 47.00 .00 .00
--
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Date
Signature of Owner (if owner I!) builder)
Separate Permits are requir~d for electrical work SEPA, Shoreline, ESA, utilities, private and public impl"Ovements.,l"ttispeOTlI(I),~,qrO's
rlWkandvold,ifworkor construction authorized is not commenced within 180 days, if construction or work Is suspend,!d'or,a~andoned
fora'p~ri?clpf180 days after the work as commenced, or ifrequlred Inspe~tions have not been requested \\lith in 180 days from the last
Inspe~tlon,. I h~reby c~rtity; that I have read and examined this application and know thE{same to be true and co'Tect"f'll.pr<?\,I~i()risof.
law~ and ordinances governing this type of work will be complied with whether specified herein or not. The granting of apehnlt does not
pre' ~ to give authority to v'olate or cancel the provisions of any state or local law regulating construction or the performance of
cnst ction . .
T;\PLANNING\FORMS\1102.15 [412002]
I
I'
I
i,:~
BUILDING PERMIT ~PEeTION RECORD
'.
'CALL 417-4& 15 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE; 'IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION:
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
~, ".
L,,'1'"
INSPECTION TYPE DATE ACCEPTED COMMENTS '"
YES NO "
FOUNDATION: ,
FOOTINGS
WALLS ,
FOUNDA nON DRAINAGE . ,
ELECTRICAL (LIGHT DEPT) SEPARATE ~ERMIT: II
ROUGH-IN " I
, j "
PLUMBING ,
UNDER FLOOR I SLAB ,
, ,
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW IWATER
'" ",
AIR SEAL Cc
WALLS
, CEILING I I
':,- FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
'~) T-BAR
INSULATION
SLAB
) WALL / FLOOR / CEILING I
MECHANICAL , <{!r~/P3 VA- .J, J-.
HEAT PUMP ~ ""S"I--IM Cf-IS-05 R'P
WOOD STOVE / PELLET / CHIMNEY
.. HOOD I. DUCTS
PW UTILlTIESJ SITE WORK (Engineering Division) SEPARATE PERMIT II's:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT II's SEP A:
P ARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
, , ....IN~iINSPE<:rIONS REQUIRED PRIOR TO OCCUP,ANCY(f.J~If" .;....i. ..,' ',' , . '
JRESIDENTIAL DATE :.,YES NO C9MME;RCIj\L \f,1': ;.1;.PATE .~. ,Ac;..qEP1EP" I
- ' . " 1 :~,r;{f!' " ..., ',., lVEs\' ,'NO'
", , ~, h ' 1;:,'" . ' ,".-~ --'-';" : ',: ..: , ',. " I'",','':.
ELECT!UCAL - LIGHT I?EPT. 417-4735 ELEcTIuCAL'; ,
~_.I . LIGHT,DE"'" , '..
CONSTRUCTION R. W./ PW/ . '. .~ ,-,' t...:h:.J:."., .,',' .
CONSTRUCTION -RoW.-, I
ENGINEERING 417-4807 PW / ENGINEERING \ I.
"
FIRE 417-4653 FIRE DEPT. \ . "
I, .:, .
, , 'f1'... ',-. - ',t:ll/ PLANNINdDEPT. ,. i". 1'''--.:;)'''' ."
PLA~~G DEPT. .. 417-4750,. ....n i./J'L . ',.:i: , It...."
:,' ' ':~ ,',
BUILDING 417-4815 1"'- ..... ./ ft/~ ,
BUILDING
Ci:'-",
T:\PLANNING\FORMS\1 102.15 [412002]
CITY OF PORTiANGElES
DEPARTMENTO~PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date <9'( fi.,/o~ Time Received bV~ ~person)
Location of Work to be inspected ~;: ~ fA ~~ HI ..,-t---r · . .
Name of person requesting inspection 11 t -e. O~'> . ~f
Address of person requesting inspection Phone No. f.!SJ ~ Cfif<(
Type of Inspection (circle appropriate one): Permit No. . 761
f
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
/i
V1
INSPECTION NOTES: ~~D
Inspected: Date . .'7
Remarks:
Time~1IlI\
f7'f
By
RESTORATION REQUIRED . ..... YES
NO
~
~
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~"' ~ ~ t o-cJj",
~if .~ (" V\ ~~~ G
~~~
..
.
...
SURFACERESTORA TION:
SURFACE TYPE: 0 Unimproved o Gravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TEl
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N<!
17416
Port Angeles, washlngton____.__/L._=..L.Z__________._______.._._.____., 19_~
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to do electrical work as listed below.
Address .u../___'(.l_r..__u~__,$-u_______u______________ Occupancy___,4.e~~uuu--.--------------
Owner u_L~__.r..P~-----d------n-----u-u-------------- TenanL.______n______........_________u___nnn_.uun..n______.......___
Wiring C;ntra&or ~ff.-~~-~n.~~--n------- By._uu_______________n___....nuu___nnn________u__________....
Light out1et.........._..~..~._.._.._..... Service, volts L..:l.-._I2-/-..~__tt!... Type at Wiring:
Receptacle out1ets___~~.........__.... No. wires .....3--....--........7J.------ Armored Cable .............---....----...--.
~ Si I ~ / ~ Non-Metallic .........-.-..-..---...---.-.....
Dryer, KW.-------7n -"'in.-------n--------.-..-.--.,,-. ze w res...__~.:!~-..............-..
..,L. .. C1I"'QIO I!I::. Knob & Tube......._......._................_
~:::~ K:~~~~.;~___..___;________m: :::~o::::.:::S::::::::~::_:.:::::::.:::: RIgid Conduit ....----.............--....---
~.:> ... Metallic Tubing ......__._._____.........:..
Kw.----.--I----3--iF'-J7..-t\i.~. Type of wiring: Raceway ...........~.-.................-_...-
Heat: KW.__m _._.....tfl!.,,~__f...m..... Entrance Cable ......._......m..... Circuits, Light.m._..~.............__........_..
t; -
Utlllty .___...............___.......___....____.....
Heat .._._....~.......................-......
;2
Range ....._...___._..__.__........................
Water Heater ....~..._....m.._.......
Motor ________..f:!"........___.._____..__.......
..-
Dry" .......-..-,f5/..--....................--.---..-
Motors: size, }jts and phase:
f.rW;;.;t::.I!-,,;r.::~Y.I'(-1d'~
Rigid Conduit __mmm_
Metallic Tubing h__m
Current transformers:
___IL.L_____________._______...____....
/___r.Rk.4j.l.............................
INo. & Size......._....__~.____._.......
{
~ Ser. No......--........;..:-.............-...........
Ser. No._____..______.....____..._.........._____....
Furnace ..........._.........._.._.___.____._._......
#-;/
Total Load_______...._____.._......_... Ser. No. ____.__.__.______________..________.h______ Total .....-..---..--------.---...............
Remarks: .._._._..a.g~"'_._~d._.._.~~,....__.~-&,L~JY......i!:.-'t._.._~~__d!!.."'=~:J:~~.-
'V - (j /' ''1''- .
___.__._______.____.._.____._.__u____.__._________._____....___._..___...___.__________.___._._______....___.-.--..---.-----..----.----.--.---.-----------.-.--.---------------
Ser. No..._....____________.______.____._._____..____.
-;~_~~~~-.~__-._-_-.-_____-n-_~.-mmn::~_~_~:_~~~.~_~~.~_~__~.~.-..----u-m.-m---:~-ygl:;;.L2:.~~
NOTICE-:--Current must not be turned on until Certificate of Inspection has been issued. It work is to be con-
cealed due not,lce must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N<!
17416
Address._.:____________..._._.___.._...................................................................._................_._._.._..._..___....Date..._......_.._.._.._..........-.-....-......-.--...-..
Owner.______............................__....._.._.............._....._.._........................_.______________._________..__Tenant...__...............................................................
WlrlngContractor._______._____._..______...._...._....................._..._............................_.............._..........___.___By____........._...._..............-............................
NOTICE-Current must not be turned on untll Certificate ot Inspection has been issued. If work 1~ to be con.
cealed due notice must be given the Inspector so that work may be inspected before concealment.
/
1M Olympic Printers, Inc.
,.
P~perty Owr.er:
\.~
h':
Jul. 31 2003 02: 15PM Pi . "-\;_
FRX NO. : 4525424
"OR OFFIC"AJ 'JSP. (11'>1.\
ELECTRICAL PERMIT APPLICATION ".t'''''n_
l'';(ITIII1/:___ _.
1Jo.t<: ~Prro".:;d: _ ,.__..~
OII(ISllt.tJ:_._.._
The EI.eetrical Perm;' t..pplieation must be fill,d om comDI6telv
PI....!)'pe or ....rtnlln Ink. ~ yO" 11."" ""1 q"oatlOft., pl..... coil (36D) 417-4135 ;IfL:# 7W
~... number: (3IlIl1417-471 1 '\
REQUEST INSPECTiON
(
Pilon.: 4n-u\l'2V Fo" l.\r~-G.~.L/.I
FRIDM Electric7S
-"c.'
~ '2k :#
(@' .
Owner or Elec. Contractor Agent.
Add,.s.: ~ I X" ~V - (i? City: ZI :
EJoetrlcaIContractor;; \Z1.e,-"",-,,,- ~ .....L_ liC8f1,.jj:~rr/11'r.;' O//~/,~
Address <t?J"IL.., l). '!",. v:~ ~& I City; 'K...... ~ ,vJ__ I
INSTALLATION WIRED BY: 0 OWNER ~L CONTR;l.CTOR
Cr9dlt Cllrd HOI~e5'...." 0' L nil.,,-fJi. 8'B ~ Ai:} :: " "rf
B/lling Address:: . U S '\..oh.t> ~ Kif" City: n,~ V' ca 0 ~ Zip:
Crsd;t Card Numb9/':
J e I g \ A), ~) 'r ""
.\1
..LL~
P~one:
'-15 2.-~4
?! 'R -~ h .-;
Phon.; 4 r 4.--(
Zip: "11''1......
'j&-2
V/SA:_~
,
P~OJECT ADDRESS:
~'.
TYPE"OF WORK: ,
Check all that apply:
CNew
o Altara~on/Addition
~eSJdental O. MultJ-famlly 0 Commercial 0 Mobile Home Sq. Ft
Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool c:) Septic Pump. 0 Low Voltage 0 Telecom. [
Number of Circuits added or altered: ::::z
.',",","ON 1',;"~"~C;;:";' ""me> ~ I ~: ~ p d p- v "1",
( (J in" iAj(l,r{ _.__-.e, 1.:.... '.:1.....1) rv"(\ )
Electricel Heat load Addition! PERMIT FEE::f1t, 70 Service Infonnatlon
o Baseboard
CJ Fumece
C} Heat Pump
o Fan-Wall
KW
KW
:;lZ-o.:rON
KW
LRA
[J Ovemead SelVice
:::J Temp Sel'\llce
Ll Underground Service
Vonaga: I '-::L ;;/CJ..,q.
Pheae: 0 1 0 3
Service Slze:__
Feeder Size:
PAMC 14.05.060(8): For industrial, commercial, & residential projects larger than a duplex, a ona-Iine drawing of the Electrical Service
Feed.."" b"ilding .iz. (oq. fi.), load calculations, and the type & of conductors and/or raceW8Y is required end shall Bccompa~y lha Elec
Perm~ appllca~on. .
I hereby certify that I have read and examined this application and know tl1afsame to be true and correct, and I
It is not the City's legal responsibility to determine what P6rmjt~
required; it remains the applicants responsibility to determine whet permits are required and to obtain such.
50K.\J A. '{FMf.-.- o/C it _ /7
/JCvJ/ sA I~?
Credit Cerd Holder's Slgnatl.lre'
Owner or Elec. Cont. Signature:
C:/ELECTRICALPERMIT APPLiCA TJON
& C~ ?-3vo-;s
W~(iLA.,,,~
Data: 7,12 I ~
I l./& ,70