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Home My WebLink About1629 W 10th St - Building PREPARED 6/07/04, 12:41:28 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 1 6/07/04 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 1629 W 10TH ST M & C CONSTRUCTION INC MANGIAMELI, JOE/TERRY 06-30-00-0-3-0760-0000- 03-00000810 RES MANUFACTURED HOME SUBDIV: PHONE (360) 683-4571 PHONE : (360) 417-8056 PERMIT: BLM 00 BL MANUFACTURED HOMB REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BLM 01 10/09/03 10/09/03 JLL DA BUILDING FOUNDATION MONO SLAB manufactured home slab Jim M & C Const. 808-3281 install steel re-enforcement and BUILDING FOUNDATION MONO SLAB anchors and recall/jim 10/13/03 JLL 10/13/03 AP BL99 01 ~/0.7/04 ~LL BUILDING FINAL JIM 477-1737 CALL TO ARRANGE TIME SO CONTRACTOR CAN BE THERE -------------------------------------- COMMENTS AND NOTES -------------------------------------- BLM 02 Application Number 03- 00000810 Property Address 1629 W 10TH ST ASSESSOR PARCEL NUMBER 06 30 -00 0 -3 0760 0000 Application description RES MANUFACTURED HOME Subdivision Name Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 50000 Owner MANGIAMELI JOE /TERRY 1765 OLSEN RD SEQUIM (360) 417 8056 Structure Information Other struct info Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date Qty Unit Charge Per 1 00 76 3000 ECH EL -MANF HOME SERVICE FEEDER Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total T• \PLANNING\FORMS \1102.15 11/14/2003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98382 Contractor M C CONSTRUCTION INC 653 N 7TH AVE SEQUIM (360) 683 -4571 1226 SF MANUFACTURED HOME NUMBER OF UNITS ELECTRICAL NEW RESIDENTIAL MOBILEHOME SERVICE QUALITY ELECTRIC 76 30 Plan Check Fee 00 11/19/03 Valuation 0 5/18/04 SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE Charged Paid Credited 76 30 76 30 00 00 00 00 1774 50 1774 50 00 1850 80 1850 80 00 Date 11/19/03 WA 98382 1 00 Extension 76 30 745 00 4 50 1025 00 Due 00 00 00 00 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 ELECTRICAL LIGHT DEPT 417 -4735 CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL 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. INSPECTION TYPE DATE ACCEPTED COMMENTS FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE PELLET CHIMNEY HOOD DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER 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 DATE ACCEPTED YES I NO CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 PLANNING DEPT 417 -4750 BUILDING 417 -4815 T•\PLANNING\FORMS \1102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD YES NO N -4-03 140 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING FIRE DEPT PLANNING DEPT BUILDING ef-t0 I I I I BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY: Date Rec.: r-~-c:> "'5 Permit #: <M Ie Date Approved: Date Issued: The Building Permit application must be filled out completely. Please type or print in ink. ICyou have any questions, please call 417-4815 Phone: Licens.e #1J!.~OAJJ.~9WJtExP: /~/Q>SPhone: G83 -9'57/ City:..:5:.$ ~ vi;vt ~ fA.,,-/1 Zip: rB3t5 2-.. PROJECT ADDRESS, I ~ 9- t. r...I /0 TIt'- .. . ~ ZONING: f!.S -7 LEGAL DESCRIPTION: Lot: ~ ' Block: . ?oJ i/ ~ 08 Subdivision: E1..AbbAM~eaU~q'.Y~PAROEI/NUMBE~: 0;.10 00 ~~~07~Oredit Card Holder Name: Billing Address: City: Credit Card #: Exp. Date: Applicant or Agent: jJ?I5L 1I/?jt/pl{rc~cA./ Owner: Voe 4- TI;/tZJ2 Y /'4AN(;..I A-M g.. '-:L Addre~s: ! leer' O~d e/V .~,t) City: (5'E6L.v..r,v? Architect/Engineer: N / IT . Contractor J'ffC CCtiIS /fb.K.g~ JAL- Address: 6.j'" 3 /V 7 'T1L: Phone: Phone: {,83 - 4S7/ ~/? - 8OS~ Zip: 9,838 <.. W/I VISA MC SIZEN ALUATION: /Z2b SF.@$ /SF.=$ SF. @ $ /SF. = $ SF. @ $ /SF.'= $ TOTAL VALUATION $ SO )(J).(9~ .00 TYPE OF WORK: pi[ Residential 0 New Constr. o Multi-family 0 Addition o Commercial o' Remodel o Repair ORe-roof o Move o Demolition o Sign o Wood-stove o Garage o Deck o BRIEF DESCRIPTION OF THE PROJECT: IV E (A../ ..,vI AtVC/ ~A c...77:/~ /-/c;-A4/ COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: L Lot Size: lOC/C) .>~ % Lot Coverage: J. 7 05 % . L Existing Lot coverag. ., (') /'q. ft. + Propo,.d Lot Cov""'g" I 9- ?-(~ /'q. ft. = TOTAL LOT COVERAGEJc9Q,~ fl. PLANNING USE ONLY: APPROVALS:: PLAN Notes: '. BLDG. . . DPW FIRE ESAlWetland(s):.O Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be filled out completely to be accepted for review. The Building Division can provide you with more detailed information on the application and plan ~ubmittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitted to th~'Building Division. " VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. ~ This figure will be reviewed and may be revised by the Building Divisio~ to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other permit fees are due at the time. of permit issuance. EXPIRATION OF PLAN REVIEW: Ifnopermitjs issued within 180 days o~the date of application, this. application will expire. The Building Official can extend the time for action by the 'applicant up to 180 days upqn written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended mo~ethan once. I hereby certify that I have read and examined this application and know the same to be true and correct, and if am authorized to apply for this permit. J understand it is not the City's legal responsibility to determine wha{'permits are requireci,. it remains the applicant's responsibility to determine what permits are required and to obtain such. ,/' : Applicant: ~ ~ ..e::::: Date: . 8'/S-~3 T:\FO RMS\APPSIBuildingpermi t .. .or "- DEPARTMENT OF PUBLI,C WOR~S.BUILDING DIVI~ION APPLICANT: /'11/ ,4N6J"',4 ~ p, ~~. 'PROJECT/DEVELOPMENT ADDRESS: PHONE: <f/? - BODe. CU It) r/~ . For more information call 417-4815 , r .. . 4 \, ~.J ~r ,~ -;- .. .. ." ' , . . IT . .- ~~ X ~ , .... I ' .\i , - '. . . A ' \ ~-- .:~,~~~ ,tit.... i'- tt,;;v.~ .....1,,:';~ ,~.'<;; '~'P,,-! \ - 7 :1.A I J ~ / ... 7 I' , .. Ao w-- ~ . r#-7 I "'- 11 I." fA. / -... I':J' Ci'.. .Jl ,fA !.a.. ..... ,. 'I' - - \\l II J. ., I '. -- ~-, \ I ~ - , ~\ ~ \ "- \ r->" .1 . 1"-' ~ "" ~ .. p ') 11d (S. ~ , ..... ~ :s ~ '. ~ \ " \ ,. 1~ r-...... J ~ -l b ( J I r---.... ........ I \ \ I ~ 1_. Ilj~ ~t.- ~ \ I 1M:. / , 1\ ( \ ....1 :1 \ ~, J \ :/ v I . 1 ~ ~ I \ r 'lJ 1 Il IJE w 4:d. Ih' c I-~ o!:' . .... 1.-, \ I t.. See Page 4 for instructions on completing the site plan \ 00' -0 " It) 711 ~r t in the footing and centered beneath the pier locations (See Figure 303.7); (9) A minimum of 4 inch (10 cm) nominally thick con- tinuous footings. not less than 48 inches (121 cm) wide, reinforced with approved fibers or with 10 gauge 6 inch (15 cm) by 6 inch (IS cm) wire fabric centered vertically within the continuous footing and no closer than I inch (3 cm) from the edge of the continuous footing. (See Fig- ure 303.8); .1rO) A minimum 4 inch'(lO cm) nominallY-thick slab nO}. less in area than the manufactured.dwelling.and.cabana, 1einfor,c.ed_~ith.apP'r.Q~e_d.fi.b,erslbr with 10 gauge 6 inch ( IS cm) by 6 inch (IS cm) wire fabric centered vertically within the slab and no closer than 1 inch (3 cm) from the edge of the slab. (See Figures 303.9 and 303.10); ( II ) Tested and listed prefabricated footings; (12) Footings designed by an Oregon licensed professional engineer or architect and approved by the Division; or ( 13) Other equivalent materials approved for the intended use by the authority having jurisdiction. (b) Piers. Piers shall be placed on footings and shall not exceed the size of the footing. Piers shall be: (I) 8 inch (20 cm) by 8 inch (20 cm) by 16 inch (41 cm) concrete blocks (See Figure 303.11); d llIull . ll~ :91 - MINIMUM 256 SQUARE INCH PL '!WOOD fOOTING PRESSURE TREATED ON All. SIX SIDES llilIE; nELO TREATMENT Of CUT EDGES IS NOT ACCEPTABLE Figur~ 303.5 Single LayerRlywood Footing 16 - ELES _ construction Pla~s CITY Of pORT ANG , d upon these plans, speCl~.1 1 thO permit base '\d'ng offiCla 1he Issuance 0 IS t hall not prevellt the bUI I . said cati~n~h:~a~:rerr:~U~ri~g the cor~:~:o~r o~::o~e~enti~g 1~~ans, specilica~ions b:~:g :;~ed o~ thereu~der r:~~~ building operations d ordinances 01 tillS iu II codes an :., violation 01 a3l \ Unilorm Building Cod~ .1:J \.L ~'M lSEC1\ON30 c/o ~'Zl..C~B ~K t.pprova\ Date a ~lltlJllull ;;1 FILE MINIMUW 256 SQUARE INCH DOUau: Pl '!WOOD FOOTING PRESSURE TREATED ON ALl. SIX SIDES :> liQIE; nELO TREATMENT Of CUT EDGES IS NOT ACCEPTABU: Figure 303.6 Double Layer Plywood Footing .. ""~"" iii 10" .:; MIN. t (2) CONTINUOUS *4 REBAR CONTINUOUS POURED-IN-PLACE CONCRETE fOOTING W/f.CINIf.CUf.C 2500 PSI' IN 2B OAYS, Fi.gure 303.7 Continuous Concrete Footing . -,;.~ ;'" :,., ~', ;",. lilt] ...- ........~" .. .. ~.. ..... I" " /. ~ .. -- .. .. .. . . .. . .. . . . .. . . . . it t , . ~ . >> . ~ I ~ M'N'MUM NOM'NAL 4" CONTINUOUS CONCRETE FOOTING 2500 PSI IN 28 DAYS REINFORCED PER SECTION 303 OF THE STANDARD ., \\, L 48" MINIMUM liQIE; SEE TABLE 304 FOR REQUIRED PIER SPACING '. Figure 303.8 Continuous Concrete Footing Isometric X ,)'<... ...... ............. ",'" """,,, "....... " ""x" ""X,... "..."<.... )......... ....x" ....X.... ')<.... /<... ...'X, "", ......" ......', ......, ....,.............. ........"......." "'x'" 'x'" ......'><, ........." ......" ......', ...... ", ......, ... ", ...... "......... 'x'" ',>-:..... '...-:..... ...'<, ..."', ... , "", "', ......, ... "......... ','........... ',y...... ',>-......... ',>...... ......'>.;, , ...... " ...... ", ......... ", ......... ", ,><... ':;............ ><, ...><, ,;' ........., ....,"':. '....... ,...'- ........v....... ..... ......""..., ....,...."'......... ........' ......... ..........101... '........ ,... ........., ......,-,...... ...........v....... "..- .......... - =-:,...... ~- ~ -- - - ~ -.s:-N0MINAL;;!.~ :. P.OURED-IN-PLACE-;"' - CONCRETE SLAB FOOTING) 2500 PSI IN 28 D~y"S_ - - - - - --- ~~ 10 GAUGE 6" X 6" WIRE FABRIC CENTERED VERTICALLY IN .SLAB OR 1REINrORCED-WITR~ ,APPROVED FIBER PER JSECTION 303 QE-mE ~ -S~A~D_ _ . Figure 303.9 Poured-In-Place Concrete Slab 17 , ---_.--_._'_._~...,- Figure 303.10 Poured-In-Place Concrete Slab Isometric ~ (2) Tested and listed prefabricated piers (See figure 303.12); (3) Designed by an Oregon licensed professional engi- neer or architect and approved by the Division; or (4) Of other equi valent materials approved for the intended use by the authority having jurisdiction. Exception: Concrete pier blocks may have wood placed between each block to absorb shock if the wood is equal in area to the block and is one of the approved materials identified in Section 303(c)(2), (3) and (4) of this standard. (c) Pier Caps. Each concrete pier shall be capped with a pier cap equal in area to the pier blocking (i.e., 8 inches (20 em) x 16 inches (41 cm) or 16 inches (41 cm) x 16 inches (41 cm)). Pier caps shall be (See Figure 303.13): (I) A 4 inch (10 cm) nominally thick solid concrete block; (2) A I inch (2.5 cm) nominally thick group 2 or 3 paral- lel laminated veneer wood plate; (3) One 1-1/4 inch (3.18 cm) piece or two 3/4 inch (19 mm) pieces of plywood; (4) One 2 inch (5 em) nominally thick Number 2 or better grade board lumber; (5) One 2 ineh (5 cm) nominally thick wood polymer com- posite; 18 \r:--, . 4- NOMINAl . . .. '-"'POURED-JN,-Pt,ACE'" "' If' [CONCRETE SLAB~FOOTING 2500 PJ'.IN'28 DAYS - (6) Tested and listed prefabricated pier caps; (7) Designed by an Oregon licensed professional engi- neer or architect and approved by the Division; or (8) Of other equivalent materials approved for the intended use by the authority having jurisdiction. Exception: Wood and wood product materials specified in Subsections (2), (3) and (4) of this section shall be pressure treated on all six sides when placed in an area subject to excess moisture (i.e. outside the undertloor enclosure or below open deck areas). (d) Pier Shims. Where shim material is used between the top of the pier cap and the bottom of the main frame, the shimming material shall not exceed 9 vertical inches (23 cm). Pier shims shall not be used with prefabricated piers unless the shims are included in and installed according to the pier's listing. Pier shims, when used, shall be one or more of the following (See Figure 303.13): (1) 2 inch (5 cm) nominally thick solid concrete block equal in area to the pier cap; (2) I inch (2.5 cm) nominally thick group 2 or 3 parallel laminated veneer wood plate equal in area to the pier cap; (3) 3/4 inch (19 mm) or greater plywood equal in area to the pier cap; - I - . . .. .. .. .. .. .. .. e.. -' . .. ~."".." "f' '... " 'I _ , '._._ " '.r.,(r ,if:' .5 - 0 :2 04: 0:2 PM T J TIN C SA L EM j'~)-lUDllfRlj 11:0) lIt DOB E~CI~HR\~C IiiiiI -.. 503 393 6134 \r~X)~~~ ~~~ O~G\ P.06 ~, ~G; / . ',NSTALLATION INFORMATION ' I Patio Slab Anchor :1-CancrafB- Anch~'~ -""--~ 1'1 This anchor Is de510nod 10 be Inserted through a 3/~' 110\0 drilled or tormed Into 1m exlsllng concrele alab. · Concrete m~t be a 2500 PSI minimum smb wIth 4" mInimum thlcknus and Ell! )( 10/10 wire mesh or UbI( mOih l(1itill1t~. The MIJ2 Is designed lo Da In,tall~t1In1o ;) conm\~ 61ab a\ the time the COflCr61D Is b&/na pour9d. · Concrete must bo . 2500 F S I . I minimum slab with 4' minimum thickness and 5/5 x 1011 0 wire me sh or '~f fIber mllst1lnstalfed. · Concretll Slab musl allow 4725 'bE cl vertloal tenG Ion on line ho r wltho 1,.1 lItt1ng. This a~ume8 thilt the concrete _ welghs'~ I,b.s pur cu. ft. · MinImum dl5tilnCe (rom the anchor aha" to one edoe of the 'lab 15 4 In lrom OM odoe Dna 2 1t. fTMl any ottler llaac. · If Initalled In [l 4. slao at mln: mil rf' dIStances from adges, an addltion;1\ ~yer of 5/5 or tOnO mash Is recommended. · Concrete slab mUBt allow 4725 Ibs of vertical tension on l/'lohor without nttinQ. This IIsume, that tl1e QOfwele \'\c\Ohs 150 Ibe per cu, ft. · Minimum dlsrance fram the anchor shaft to one e~ge or tin $/lIb Is 4 In. tram ona edge and 2 rt. from an>, athur "dec. · SIDb mLl5t be B In. minImum lhit:kn&S8 al locatloll under any ol'tClhor to "lIow Sin. IImbedmant 01 anchor 'J' roc. Concrete Slab Anchor ~ ~ ~ ~ I This l!l nr:;hor Is d an llxlG\lng cOncrale .leb. · After revl.wlng rClurlclIons DSloa to lJ\ll r~n~ CrUI :I ole In x 3 In. ho~ In the .Iab whClrl tho anchor h8i1d In 10 be loo.ned. · Coner.le must be . 2500 PSI minimum sllJb ....lltl 4' mlnlmum thlckT14n ind 6/5 x 1011 0 wirtl ma5~ or rtcr /l'UUI rft.llUI a ct. . Plac. f1eel exparulon .Inovo OVOf boll and placll into Ihe drUlcd hole. · Concralo ~ab mUlit allow 4725 Ib& 01 ~ortl~1 tOt'lsio n on iltIchor wllhaul liftin{) , 'I'hl, ~nvmOl lh~l 1110 conCrClD wl1lghs , 50 Ib~ per cu. II. · PlJco tho w~hQr onlo the GXpi1tlslon boll · Thread nut onlQ uxplulvlon bait and tIglllon until m~lmum .xpanclcl/'l oflltl8l,xp111c1on 11M.... 1Rl, b,an aoh\cved. · Mlnlmum d!!tance from the anch::>r 5hafllO MC odQc or Illll 'I~b il; 4 in. from on. tag. lllQ 2 It. lrom any othor edgo. , Removi nul and wuhor and ploco anchor hand C~Dt exposed boll. · It In'lallid In , 4. 5'_Q ~l mlnJmiJm Cim.r.cos rrc m Ildges, iln oddUlon3l1ly.r 01 e/6 or 10fiO 'l'rlre mc!/\ or nbDr mosh I' MCDmmended, · ?liCi mihQr i1nd nul onto bon 10 :lllilch aMhor h~d, tlQh~cn nut. .J ~. _ " I I .. . ~ .. 04:07 PM TJT INC SALEM n\r~ll 11:U TIE DOi~ UGI~EER1NG iii I ~ i I $ :50~ 39~ 61~4 tfAX)4U~ 3~~ U~Ul P.:22 ~.Ul~ 0') -~, I a; , = ~ ~ ~~ ~ 5P : i w~i Ln .3 t;. i ~ ~ ~ cJ ~~ ;! ~ ~ J .9 i ~ I i. = >cv)~"" .~ ~i ! T '! ~ )( ~.~ wl i l'J ~~81"~~ ~I ~ :<~, n 4\.A~ a ill ~ ~ 3&",,,, I. d'- J e @) i ,,1;: 1 ~ I It ... i I ~ 5( III < ! ~ il::2 I x C'U e ~ 01/25/02 16:25 TX/RX NO.2045 P.022 .. -.J }. ,.,,:1 City of Port Angeles Applicant Project Review Sheet Applicant: Jr.;e .f ~1i!P7 Jf/"'~A4IStL. Owner: S,fM 4- Property Address: W' Proposed Use: j2J1SJIf1~~L I (j Tit- Zoning: ~ Is the proposed use listed as a "permitted use" or an "accessory use" in this zone? Is this the only use (business, residence, etc.) on this site? Has there ever been a subdivision, shortplat, or PRD approved for this site, or has one been submitted and is pending approval? Does the proposed use require a new buisiness license? Does the project extend into any required setbacks or cross any lot lines (interior or exterior)? Does the project exceed the permitted height allowance or cause the property to exceed the allowed lot coverage in this zone? Does the project require any additional parking or special design/landscape improvements in this zone? Does the project eliminate any existing parking spaces? Is the project located within 200' of the shoreline? Are there any environmentally sensitive areas on or within 200' of the property, including: . wetlands or areas of standing water (year round or seasonal); . streams (year round or seasonal); . areas with a slope of 40% or greater; or . areas that have evidence of past ground movement or erosion? Have all the required submittals been provided by the applicant? o Site Plan 0 Construction Drawings o ParkinglDrainage Plan 0 Civil Drawings o Energy Calc 0 Supporting Engr. Calc o LandscapelLighting Plan 0 Other W yes: ok o no: requires PD revIew pg yes: ok o no: requires PD revi ew "yes: requires PD ~ no: ok revIew I o yes: requires CC PO' no: ok reVlew o yes: requires PD ~ no: ok reVlew o yes: requires PD pQ no: ok reVl ew o yes: requires PD Pl1 no: ok review o yes: requires PD Pf no: ok reVlew o yes: requires PD W no: ok review o yes: requires PD J8f ha: ok reVlew P4 yes: ok o no: mark required item(s) If Planning Department review is required, the processing time may be extended. If it is determined a separate Planning Department permit(s) . is needed, the Planning Department permit(s) must be approved prior to the issuance of any other permit. . The information provided above is true to the best of my knowledge, J understand that in the event that any {)fthisi1iforinationis determined by the City to be incorrect, this project willbestopped unti/such time the Citydetem'/inesthe correct information is provided and any sUbsequem:;z;.7~proval~ are completed andgrantede/ Jfc3 Applicant Date < .. ... Permit Category # (see reverse side) Building Permit # Master Tracking # Route to: OBD OCC oFD OLD oPD oPW o File o Other , Staff Initials Date Completion of this form is required for all category J b, 2 & 3 permits. Completion is not required for category J a permits unless they result in a potential change of use or occupancy. I -48'0" r-5'8" 15'4" I q'O" 46x58Y 46x56Y 0 ~ Beaoom 3 :! Master Beaoom ~ ~ f1rn UlnlhJ Room 6eaoom 2 1---12'0" 5'4"-t-6'8" I I 48'0" Model: HB-48S08 1,226 5q. Ft. LMlg Room 46x56Y 46x56Y 20'0" POrch ~ ~ ~;-. .... 14'0"~ I ~ m 1 PLNl IU-ElI!R, H8-S08 ffiBl I1illJ HOMEBUILDERS NORTHWEST, INC. 1650 Salem Industrial Drive Salem. Oregon 97303 Telephone 503-391-0936 Fax 503-391-0900 I'PFRI:IVI'L. Sf AHP. ~ ~ N DRN1H ""'. James e. BlaGk PAt!! DRN1Ho Febr"uar- I. 2000 ~ PAt!!""" ~I'L. IHSTRI)G. TIOHSo (II' N'PL1G.o.ell!.I ~H6 nTU!. r-tOPEl tu-eER. H8-48508 , .' .~., o'if'~~~-'l.....o ....~ F' <""'~a ~ '1J!1 . ~~ ,,"tilC-Q "9.\'a._-~{fJ "'~ '" ?-t>~~..., ~SAtloO'" ELECTRICAL PERMIT APPLICATION .~"\ FOR OFI'!CV\L USE OI'.'L Y 'I DalvRec l'enml#: Dale Approved Datclssued- " The Electrical Permit Application must be filled out complete Iv. Please type or reprint in ink. If you have any questions, please call (360) 417-4735 Fax number: (360) 417-4711 HTf- *8 \ C> Owner or Elec. Contractpr Agent: Property Owner: Giile, 1'+'1 J Sleet PhoneL/bO -3,[>// Fax: Phone: Address: City: Zip: Electrical cont:actor ~:~~;~-\-~ E \ eC -/--. Address ~'-..C::;7, ~ d , I City: License #: ,,'?e5'" f ,,~- Exp: Phone: ~ IJ Ii\ Zip 9 cr 3cP J, I I NSTALLA TlON WIREDiSY: 0 OWNER 0 ELECTRICAL CONl}<ACTOR Credit Card Holde~ Name: ~) 0 <:, e f \" "j - K, r > C' (" ,.. Billing Address: \) S '7 c", IS .R rj City: '- \; e;?,) I '-"'. ~ / Zip: ;:7 r Jd" .J.. VISA: V MC: PROJECT ADDRESS: /r;;~~ u. 161=h Check all that apply: Ii New 0 Alteration/Addition TYPE OF WORK: o Residential 0 ~ulti-family o Commercial )<< Mobile Home Sq. Ft I o Remote Meter [[] Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump Number of Circuits added or altered: o Low Voltage 0 Telecom. 0 S;~ \-\0 11'"",,-- ...... -S'~OiO \y J I Se: rue C-IZ to r );1,r,6/ / ( DESCRIPTION OF THE ELECTRICAL PROJECT: , Electrical Heat Load Additions and or Subtractions I , Service Information o Baseboard -m Furnace o Heat Pump o Fan-Wall _:KW 6.t:...,KW 'TON -'KW LRA o Overhead Service o Temp Service i"ZUnderground Service --- VOltage: /..;JoA t./ 0 Phase: )(1 ' 0 3 Service Size: ~<7~) 4- Feeder Size: I , I hereby certify that I have read and examined this application and knDw that same to be true and correct, and I an authorized to apply, for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants responsibility to d termine what permits are required and to obtain such. Credit Card Holder's Signature: Date: j J - / 7-0::: Owner or Elec. Cont. Signatur . Date: , I6l:A!l~~ 8AP~e>l-r'1 ~C~)\-I'O~o> C :/ELECTRtCALPERMIT APPLICATION , , Df-'i d;J l\{IqJ.,O'a PERMIT FEE: $,$ T({g , 30 1 , " ~V1+~ o \ ~ C ../ (I \;\ ;:: II o o Q, -:+- 0, ;; o q-, ~ " -\-- 'I l ~ '" h " o k ..r '< ~ '" '> I'" \ \ ~\ ~ II -, (SJ ~ \ <\.- 'C: .. " I' s;} ~ C), Q-, - r' ~. 1f:- '" ~ o 0- o , <L t\ c\1 ~. (\ -l-., ,.. "I