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Home My WebLink About2445 Arbutus Ln - Building #.f- 'S ~~ CITY OF PORT ANGELES , ' DEPARTMENT OF coM1vlUNITY DEVELOPMENT - BUILDING DIVJSION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ' , , ' " 'Application Number pin number . . . . Property Address , ASSESSOR" PARCEl. NUMBER: Application description Subdivision Name ' Property Use . . . . Property Zoning . . . Application valuation 04-00000105 '- Date .853360 2445 ARBUTUS ~ 06-30-01-5~5~0670-0000- RES NEW sn 4/09/04 RESIDENTALSl? ~OOO RS9 RESDNTI. SINGLE FAMILY 74944' Owner Contractor ,:..:.....:."...:...,. ------------------------ BOYER, CHRISTOPHER/DEZIREE 23()1 W 18TH ST, #E-3 PORT ANGELES 'WA 9,8363 (360) 460-4230 Structure Information Construction Type Occupancy Type . Other'struct info OWNER NEW 1372 SF SFRW/ATT 528 SF GARAGE TYPE V NON-RATED SINGLE FAM & CON.GREGATES TOTAL % LOTCO\l;iilRAGE CONSTRUCTION TYPE NUMBER OF STORI:B~ EXISTING LOT COVERAGE LOT,SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE' NUMBER OF UNITS 21.00 V-N 1.00 1.00 9002.00 1900.00 1900.00 1.00 68.75 Plan Check Fee 4/09/04 ' Valuation 10/06/04 .00 o ~ ~' 1i. --------------------- -~----------------------------------------------------- Permit . . . . Additional desc Permit Fee Issue 'Date Expiration Date MECHANICAL PERMIT Qty Unit Charge Per Extension 47.00 21.75 BASE FEE 3.00 7.2500 ECH ME-VENT FAN 132.00 4/09/04 10/06/04 Plan Check Fee Valuation .00 o ,~~ .....,.. ~tr ~<: '::t- C;i I-A "I V'! , .C' , -------------~----~---------------~----------------------~--~-----~:~'---~--- Permit . . . . Additionaldesc Permit Fee Issue, Date . . EXpirat.ion Date PLUMBING PERMIT Qty Unit Charge Per 7.0000 ECH 7.0000 ECH 15.0000 ECH 7~0000 ECH BASE FEE PL- EA. FIXTURE ON ONE TRAP PL- EA. INST~LWATER PIPE PL- EA. BLDGSEWER PL- EA. WATERHEATBR Extension 47.00 56.00 7.00 15,.00 7.00 ,~,I ~' 8.00 1.00 1.00 1.00 , ' ' - - - - - - .,.- - ~ - -:....... - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - -~-:- - :..... - -..-.- - - -.- - - - - - - - - -'-~ -- - -'- --....- Permit . . . . BUILDING PERMIT -RESIDENTr,Ar. , Additional desc Permit Fee Issue Date Expiration Date 842.25' 4/09/04 10/06/04 Plan .c.:hl!,ck ll'ee Valuation .00 74944 Qty Unit Charge Per BASE FEE Extension 667.25 Separat~ .Permlts are required fo~ electrical work,~~Pe-.~ho,~line.5SA,utilities, p,rivate and public imprpv~~.ep~~'!hi~fie~mlt becomes null and void if work or construction authorized isnotcX"rl1I11,~'~in-1~0 ~ays!jfCC)~!;tfuc9on or\vO~.I~:~u,.~9~'~otabandoned for a',periodof 180 days after the work as commenced, or:ifl..req,~I~j....spectlonshave nolbeen requestEid~tfiil'ht80;C!a,ysfrom the last Inspectlo'n~ I herebYCertity that I hav~ read and ~xarnil1,ed thi~,l;ipglicationand know the salTl~tol>e,true:c:lI'd correc:i.A1lprovisionsof laws and ordina!'Jces governing this typebfworkwllll>e compH~dW,ithwhether specjfjedherein,ornotTheg~ntiflg()fa,permitdoesl'\ot presume to ,give authority to violate or cancel the provjsigps,ofany state, or, local law regulating 'construction or the 'performance of constru 'on. Signatu~of6wner (if owner is builder) Date T:\PLANNING\FORMS\II02.15 [11/1412003] r I >..,_.{..~..",. :i:r!.. >" ~ BUILDING PERMIT INSPECTION RECORD ~-. CALL 417,4815 FOR BUILDING ,INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPEcrIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVE~lNSULATe OR CONCEAL ANY WORK BEFORE' INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. , ,KEEP PERMIT CARD AND APPROVED PLANS AT JOSSITE .. I INSPECTION TYPE DATE ACCEPTED . COMMENTS J I YES 'I NO , FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGEIDOWN SPOUI'S " ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I i '. ; PLUMBING , -:- ',' " UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLOG) GAS LINE " , BACK FLOW I WATER AIR SEAL " WALLS I CEIUNG FRAMING JOISTS 1 GIRDERS SHEAR WALUHOLD DOWNS '. W AJ-LSI ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) , T-BAR " ! INSULATION SLAB WALL I FLOOR I CEILING I I MECHANICAL ! HEAT PUMP GAS LINE WOOD STOVE I PELLET I CHIMNEY i HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #.s: WATERLINE I METER SEWER CONNECTION . I I ., SANITARY , .. STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKlNGlLIGHTING ESA: .-. . LANDSCAPING " SHORELINE: " , " , .; .: ,;, FJ1W;;'~SP,:cTJq~s REQUIRED PRIOR T() OCct!~~gIUSE ", ." RESIDENTIAL DATE.-' YES ,NO COMMERCIAL ,DATE Aq:JtrrEri : H, e. . YES;,'" 'Ii NO", -c- 'Ei.E6RICAL ELECTRICAL - UGHT DEPT. 4174735 " UGHT DEPT CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W. . ENGINEERING 4174807 .,W l ENGINEERING " FIRE 417-4653 'FIRE DEPT. , PLANNING DEPT. 4174750 '. PLANNJlIlQ DEP.T. . BUILDING 4174815 Bun.DIIilG . , T:\PLANNING\FORMS\II02.15 (11/1412003) '~..... .~.. ;,~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DMSION 321 EAST 5TH STREET, PORT ANGELES; W A 98362 , 'I ':. -, ~ -. ,~App1ication .Number I?;.innumber ~. . . 04-00000105 . .853360. Unit Charge Per 7.0000 THOU BL-SO.001-100K (7.00 PER K) Page 2 Date 4/09/04 Extension 175.00 '-'-n'_. -. - -., ,-'f--:~-- - - - - - ~--- - - - - --- --- - - - - -----~:- - ~ - - - - - ~ - - - - - - - - - - - - - - - - - - -... - - - - - - -- - ;.~ _~. "---'J- -!I~ -_.~..:.. - - - - - - - - ___.___'~':.,.;~,.;.;,..,_:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~ .00 .00 .00 .00 .00 .00 .00 .00 Sepa~te Permits are required for electrical work,SEPA. Shqr~line. ESA. utilities. private and pl,lblic improvements. Thispermit b,~omes n~.1i an~void ifwqrkor construction authorized is. not coml1lel)ced within 180 days, if construction orworkJs suspended or abandoned for a period of 180 days atter the work as commenced. or if required inspections have not been requested within 180 days from the last Jnspectiqn.1 ~erebycertifythat I have read and eXamined this applicatic:>nand know the sam~ to be truecmd. porrecLAII provisiQns of laws and ordinances goveming tIlis type of work will be complied with whether specified herein or not.. The grantifl9 ofa permit does not presume to give authority to violate or cancel the provisions of any state.or local law regulating construCtI~n or the performance of . construction. ecialNotes and Comments . i. .. '1'hesite is located within the Madrona Woods Subdivision. eThe. residential structure may NOT be finaleduntil infrastructure improvements for the subdivision are ,installed and approved. .':Building address sign shall not be less than6a. & not more " :than ~2. in height. Numbers colors must contrast with wall :4')'" color they are mounted on. (Ord. 14 .36. 050-E) '.When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. New subdivision outside the four minute response time shall be equipped with a residential sprinkler system. that is installed and maintained in accordance with Uniform Fire Code (UFC) and National Fire Protection Association(NFPA) standards. SEWER SYSTEMDELV CHARGE STATE SURCHARGE 1?W.WATER SYSTEM USE FEE Credited . Due Chaxged Paid ~~~~-~---- .-~~~------- ;.,;,;;>;>-, Signature.of Contraci9ror Authorized Agent Date . .,.T;\PJ.ANNIIIIG\FORMS\lt01:!.s(1W~OO3l:.. . ,-- ,-' -' "-"";"'" '.' - '- " 745.00 4.50 1025.00 Signature of OwnerJif owner is builder) . Date ",co... :.. ., BUILDING PERMIT INSPECTION RECORD ..,.. , CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 F:OR ELECTRlCAL,INSPECTIONS. , ' PLEASE PROVIDE A MINIMUM24 HqUR NOTIC;E. IT IS UNLAWFUL TO COVER, IN~ULATE OR COf'lCEAL ANY WORKBEFORB INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMITCARD AND APPROVED PLANS ATlOB SITE. . " INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO ! FOUNDATION: FOOTINGS 5-1. ':-D4 _l'i L WALLS fl)'-J 'l-o ~J ( 'v ! FOUNDATION, DRAlNAGE/DOWN SPOUTS ,J;:9 ..J -()J./ l~ V , ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: /I ROUGH-IN I , PLUMBING ~n,d ,J.}- {}.6 -::~IS J'->-, f)f> UNDER FLOOR 1 SLAB , ROUGH.IN I J- ",,.oJ.l 'I. L WATER LINE (METER TO BLOG) f..oS-F1~ _-, .1 GAS LINE BACK FLOW 1 WATER, AIR SEAL WALLS 1I-t'J ...Dr' TJ CEILING FRAMING JOISJSI G~ERS SHEAR WAUltHOLD DOWNS , W AiLs 1 ROOF j CEILING J - fJ -t9r- J.L DRYWALL (iNTERIOR BRACED PANEL ONLY) , , TfBAR. " i INSULATION SLAB l WALL 1 FLOOR 1 CEILING II-~~,fr" I _J. !, MECmNlCAL ,...' 1-~-~~ oJ 1-1-' /tp -\ I J'\.c(., f HEAT PUMP , . GAS LINE l WOOD STOVEl PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTIUTIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT/I's: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT /I's SEPA: PARKINGlLIGHTlNG , ESA: LANDSCAPING ", SHORELINE: , J?lNAL INSPECTIO~S REQUIRED PRIOR TO OCCUPANCYIUSE ,,' RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED , YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL , LIGHTDEPT , CONSTRUCTION R. W.I PWI .~- !)E? M ff CONSTRUCTION. R. W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 " , FIRE DEPT. , PLANNING DEPT. .417-4750 , PLANJI!lNG DEPT. BUILDING 417-4815 S'A-(lJK \ II . BUILDING " T:\PLANNING\FORMS\II02.15 [11/1412003] \ '0> "PREPARED 4/25/05, 13:22:51 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 2445 ARBUTUS LN INSPECTION TICKET INSPECTOR: JAMES L LIERLY BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR SUBDIV: PHONE PHONE : (360) 460-4230 PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS 5/05/04 5/05/04 5/11/04 5/11/04 5/21/04 5/21/04 1/07/05 1/07/05 1/07/05 1/07/05 1/13/05 1/13/05 BL99 01 4/25/.05 ~ ----------------------------------- CONTINUED BL1 01 BI2 01 BLFD 01 BAIR 01 BL3 01 BLWS 01 JLL AP RV AP RV AP JLL AP JLL AP JLL AP JLL ,..,.. BUILDING FOUNDATION FOOTING BUILDING FOUNDATION WALL BRUCE 477-1243 BUILDING FOUNDATION DRAINAGE BRUCE 477-1243 BUILDING AIR SEAL BRUCE 477-1243 BUILDING FRAMING BRUCE 477-1243 BUILDING INSULATION WALL/FLOOR BRUCE 477-1243 BUILDING FINAL TIME: 17:00 04/25/2005 01:04 PM JLIERLY TIME: 17:00 PAGE DATE 25 4/25/05 ONTO NEXT PAGE ----------------------------------- "bO~ #-s u,,~A- p -Of...t ~_ ~.;.U t 14u~Lr t , f7~ r:1Lt~( Jl( '.PREPARED 4/25/05, 13:22:51 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR: JAMES L LIERLY PAGE DATE 26 4/25/05 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 2445 ARBUTUS LN SUBDIV: PHONE PHONE : (360) 460-4230 BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 .rt~:.l~r ~ MECHANICAL FINAL TIME: 17 :00 ~ ~~ .. 04/25/2005 01:04 PM JLIERLY ---------------------------- ----------------------------------- CONTINUED ONTO NEXT PAGE ----------------------------------- .. . PREPARED 4/25/05, 13:22:51 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR: JAMES L LIERLY PAGE DATE 27 4/25/05 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 2445 ARBUTUS LN SUBDIV: PHONE PHONE : (360) 460-4230 BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL2 01 11/10/04 JLL PLUMBING ROUGH-IN TIME: 17:00 11/10/04 AP John 460-6902 PL6 01 1/25/05 JLL PLUMBING WATER SUPPLY TIME: 17:00 1/25/05 AP BBRUCE 477-1243 PL99 01 . 1::_::_/,0055 ~w _ :L g PLUMBING FINAL TIME: 17: 00 ~ ~ 04/25/2005 01:05 PM JLIERLY ---------------------------- -------------------------------------- COMMENTS AND NOTES -------------------------------------- PREPARED 5/03/05, 16:00:21 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 2445 ARBUTUS LN INSPECTION TICKET INSPECTOR: JAMES L LIERLY PAGE DATE 1 5/03/05 BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR SUBDIV: MADRONA WOODS PHONE PHONE : (360) 460-4230 PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 5/05/04 JLL 5/05/04 AP BI2 01 5/11/04 RV 5/11/04 AP BLFD 01 5/21/04 RV 5/21/04 AP BAIR 01 1/07/05 JLL 1/07/05 AP BL3 01 1/07/05 JLL 1/07/05 AP BLWS 01 1/13/05 JLL 1/13/05 AP BL99 01 4/25/05 JLL 4/25/05 DA BUILDING FOUNDATION FOOTING BUILDING FOUNDATION WALL BRUCE 477-1243 BUILDING FOUNDATION DRAINAGE BRUCE 477-1243 -,!:BUILDING AIR SEAL {BRUCE 477-1243 BUILDING FRAMING BRUCE 477-1243 BUILDING INSULATION WALL/FLOOR BRUCE 477-1243 BUILDING FINAL TIME: 17:00 04/25/2005 01:04 PM JLIERLY ---------------------------- 04/25/2005 04:20 PM JLIERLY ---------------------------- house numbers/duct connecting range hood/ electrical fina1/jll BUILDING FINAL 05/03/2005 03:59 PM TIME: 17:00 BL99 02 UfUfl~_- JLL ~~r -------------------------------------- COMMENTS AND NOTES -------------------------------------- JLIERLY ---------------------------- PREPARED 1/25/05, 13:07:17 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 3 1/25/05 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 2445 ARBUTUS LN SUBDIV: PHONE PHONE : (360) 460-4230 BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS 11/10/04 JLL PLUMBING ROUGH-IN 11/10/04 AP John 460-6902 PL6 01 II~~~Y fP=L PLUMBING WATER SUPPLY ~ BBRUCE 477-1243 ----------------------- ------------- COMMENTS AND NOTES -------------------------------------- PL2 01 TIME: 17: 00 TIME: 17:00 PREPARED 1/13/05. 12:37:59 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 2445 ARBUTUS LN BOYER. CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR INSPECTION TICKET INSPECTOR JAMES L LIERLY PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS SUBDIV: PHONE PHONE : (360) 460-4230 BL1 01 5/05/04 JLL BUILDING FOUNDATION FOOTING 5/05/04 AP BI2 01 5/11/04 RV BUILDING FOUNDATION WALL 5/11/04 AP BRUCE 477-1243 BLFD 01 5/21/04 RV BUILDING FOUNDATION DRAINAGE TIME: 17:00 5/21/04 AP BRUCE 477-1243 BAIR 01 1/07/05 JLL BUILDING AIR SEAL 1/07/05 AP BRUCE 477-1243 BL3 01 1/07/05 JLL BUILDING FRAMING 1/07/05 AP BRUCE 477-1243 BLWS 01 ~~ BUILDING INSULATION WALL/FLOOR BRUCE 477-1243 PAGE DATE 4 1/13/05 -------------------------------------- COMMENTS AND NOTES -------------------------------------_ PREPARED 11/10/04, 12,32,53 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER, 2445 ARBUTUS LN INSPECTION TICKET INSPECTOR JAMES L LIERLY BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR PERMIT, PL 00 PLUMBING PERMIT REQUESTED INSP TYP/SQ COMPLETED RESULT DESCRIPTION RESULTS/COMMENTS PL2 01 ttt~~~~~, JLL PLUMBING ROUGH-IN ~ ~~ John 460-6902 -------------------------------------- COMMENTS AND I SUBDIV, PHONE PHONE , (360) 460-4230 TIME: 17,00 PAGE DATE 2 11/10/04 NOTES -------------------------------------- PREPARED 1/07/05, 12:39:18 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: INSPECTION TICKET INSPECTOR JAMES L LIERLY 2445 ARBUTUS LN SUBDIV: PHONE PHONE : (360) 460-4230 BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5c0070-0000- 04-00000105 RES NEW SFR PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 5/05/04 JLL BUILDING FOUNDATION FOOTING 5/05/04 AP BI2 01 5/11/04 RV BUILDING FOUNDATION WALL 5/11/04 AP BRUCE 477-1243 BLFD 01 5/21/04 RV BUILDING FOUNDATION DRAINAGE TIME: 17:00 5/21/04 AP BRUCE 477-1243 BAIR 01 1/07/05, ~ BUILDING AIR SEAL BRUCE 477-1243 BL3 01 t - 1-0 BUILDING FRAMING /07/05 JLL \-')-0(" ~r BRUCE 477-1243 PAGE DATE 2 1/07/05 -------------------------------------- COMMENTS AND NOTES -------------------------------------- I- I ~ 1(, Tlf 5'1 tZ <Z. t.".- ..;;-? ( 1387R ').11 ( <:o'V ':); 1(j -r- 'f~' \: 1~ ~ )..'o.~~ X> 1,?'O' -t 0 I ~~. 8' I 8' \,a Qt l ~"8' ;~I I ~ 0:: ~ o a. I )/iLl- ~~~6~ I ( -ro 6'f1l 't. r ~1/ \ r--------------~------ --------------1 )C! ~ ~ t:J :G /' I '< :~ 'w I :((l l~ .. I /:9 ~ '5 ., 181 lID , I : j" I ~' ~ G-~~ ~ ~ 3.f1J.7) ~ ' I ~ / ::; ~ / ) ~~'?'1 ...: < ...I vi vi _-+-__fJ:ff!.~~.:L_______ SCALE: I" = 20' I I I I o 30 r 13ofoc T1TLE:MADRONA WOODS SUBDIVISION SCALE: "" lOll 1" = 20' JOB NO: 02030 CLIENT: FILE: HOUSING AUTHROlTY OF THE COUNTY OF CALL AM LOT7.DWG 2603 S. FRANCIS STREET DATE: "- PORT ANGELES. WA 98362 11-25-03~ PREPARED 5/21/04, 13:25:54 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: INSPECTION TICKET INSPECTOR ROGER VESS 2445 ARBUTUS LN SUBDIV: PHONE PHONE : (360) 460-4230 BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 5/05/04 JLL BUILDING FOUNDATION FOOTING 5/05/04 AP BI2 01 5/11/04 RV BUILDING FOUNDATION WALL 5/11/04 AP BRUCE 477-1243 BLFD 01 5/21/04 W BUILDING FOUNDATION DRAINAGE TIME: 17:00 Ar BRUCE 477-1243 PAGE DATE 1 5/21/04 " -------------------------------------- COMMENTS AND NOTES -------------------------------------- PREPARED 5/11/04, 13:19:03 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 2445 ARBUTUS LN INSPECTION TICKET INSPECTOR ROGER VESS BOYER, CHRISTOPHER/DEZIREE 06-30-01-5-5-0070-0000- 04-00000105 RES NEW SFR PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BI2 01 5/11/04 ;ll~ RV RtI BUILDING FOUNDATION WALL BRUCE 477-1243 SOODIV: PHONE PHONE : (360) 460-4230 PAGE DATE 1 5/11/04 -------------------------------------- COMMENTS AND NOTES -------------------------------------- .j. ,,-"'dr. .~~ ,.-.,~~...-:. t~,-) ~-----f \-;:~"'-'~-'-'~7'J' ~--._~ BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY: Date Rec.:'2 - S -O~ ' Pennit#: 04 - '0 .. DateApproved:~ Date Issued: Fill out COMPLETELY and bi INK. Your application and site plan MUST BE COMPLETE to be accepted for review. Hyou have any questions, call (360) 417-4815 Applicant or Agent: Jio VSIN <; AV1'HO~'Th C()iJ NTY Or Ct-.9-i..JAt11 Phone: lJ S J.. - 7 t 3' I U tf I Owner: c)f((t 5"'-0 P H~ tf J:>2..Zf 1<2-i.- t3 0 Y U - . Phone: '7 b 0,- Cj ~3 0 Address: ,;2301 lJ. ./$'ill 5.1": I:J; f,-:J-7 ~ty: fbRtr ~tf-rJ..l:5 Zip: 18 3t ~ ArchitectlEngineer: HAec.. / '2<l!VOV1C. t( Ifssoe. Phone: ~ 17 - 6so1 Contractor /-I/t- c C. State License #: Exp: Phone: Address: p.{,CJ~ So. rt~eJ~ Sf" City: fOf(rr A7V6VJ..-z..$ Zip: f 3'3(:2.. PROJECf ADDRESS: :)'l/ f..jJ A (( (3 u~ us 1-&/ $., , P. /1 . ZONING: f( S - 9 I LEOALDESCRIPTION:Lot: .,iF 7 Block: IJ~AurV5' Subdivision: /l'1M>(OJ/VIt Wc>OD S CLALLAM COUNTY PARCEL NUMBER: 0 b.3 DO / s.s" - 0070 / Credit Card Holder Name: Billing Address: City: Credit CardType VISA Me ## Exp. ~.te: TYPE OF WORK.: SIZE/V ALUATION: ' . Residential KNew Constr. 0 Re-roof 0 Stove /37 'J.. SF; @ $ 'l/ 3 . ISF. = $ o Multi-family 0 Addition ,0 Move )rGarage .5;; 3' SF. @ $ .30 -22 ISF. = $ o Commercial 0 Remodel ," o. Demolition ODeck SF. @ $' , ,lSF. = $ o Repair 0 Sign . 0 Other , TOTAl VAU1ATION $ BRIEF DESCRIPTION OF THE PROJECT: Nf:.vJ 'l"5Ir1C:-J..'t.FArnJj..y(<.tz;SI1jvy~g. - . oA!- srroRy W J1}f',,(Yf 17fC:}-fEO:J. - eRf(.. G,(JP~E~ . . _ . COMMERCIAURESlDENTIAL: · OccUpancy GrouP: 'occuPant Uad: ", .' '". CoiistriiCtiOD. Type: " No. of Stories: -L Lot Size: ? 0 0 ~ Existing Sq. Ft. ~. & Proposed Sq. Ft. / ?OO ' = TOTAL Sq.Ft. /Iao Existing lot coverage ~ %' & Proposed lot coverage ~% :: Total lot coverage ;:2 I % , APPROdk. : PLANNING USE ONLY: PLAN: I BLDG: DPWU: FIRE: 01HER: S-8', ~~t 15/, sf' 7Yj ?'IY ESAlWet1and(s): 0 Yes. 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUBMI1TAL: The Building Division can provide you with infonnation on the application and plan submittal requirements if you have questions. ___ VALUATION O~ CONSTRUCTION: In aD cases, a valuation amount must be entered by the applicant. This figure Will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contactthe Pennit Coordinator at417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it DlQSt be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of pemiit issuance. EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the ,date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of the Unifonn Building Code, current edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be troe and correct. ,I am authorized to apply for this pennit' and understand that it is my responsibility to determine w~at pennits are required ,not. he City's, d that I ust obtainsucl1 permits pn to work ' ':i~~:;::it;;~~~t,; '~'.:l{""::'-' . ...' "," r I'. ~~ '.~_!,I_:"U T-' ~':;" ";:,;?",:.,.-., - , '/>'~-;:f'~, ::c;;,;:'0~ ,'; ;_,: criY OF PORT ANGELES . . I' ,,' '.' , DEP ARTMENT.OF CO~ pEVELOPMENT - BunnING DNlSION 321 EAsT stf(S':r.R.EE't. . PORT ANGELES, W A 98362 . " '_ . Application Number "'<.,; pin number . . . .' ... ,I?rope'rty Address ..' ASSESSOR PARCELNOMBER: . Application 'description Subdivision, Name ' property Use Property Zoning . . . Application valuation Special Notes and. Comments 'l'hesite is looatedwithin the MadrOnaW~ds Sub.division. 'fhere,sidentialstructure, may NOT be finaled1m~il infrastructure improvements for thesubdiv'isionare installed andapproved~ . . Building address ,sign shall not be less than i;a&notmore than 12 II in. he,ight. . Numbers colors must,.. contras.t with wall color they are mounted on. (Ord.. 14~36.050:'E). , Wllenroofgutters are installed, drains . will located inl;iry wells or piped toapprl;>ved stormdra.inl6'cations. , ..... New.subdivision.outside the four minute response times'hall be equipped with a-residential sprinkler system that is installed and maintained in accordance with Uniform Fire Code (UFC) and National Fire ,Protection Association{NFPA). standaz:-ds. ., '\ " ,-' '. ,-,: ,---,<-'-:, '''- '> - .', ,,' ,'-.' --'- ",:',:'-, - -.... ~- -'--- -'- - .;.;,,- - - - - -....- - --~"""-""t~-:~-- - --;....... - - - - - - - - ----- - --....-.... - - _....;.. -.... -........ - -........ - _,.0;... - -- Other Fees, .. ..,??;;.. ::: :~~:LV CHARGE PW WATER SYSTEM USE FEE Charged Paid Due J;>ermitFeeTotal Plan.Cheek.Total Other Fee Total Separate Permits are required for electrlcalwork;SEip~,Shoreline" 1;SA.~titlll~e.s; privateand,publle improvelTlElnt$., This p,n.nllbecornes null and vold.1f work or construction authorized is nOt cort'llrienced withio/1 ~p"dayS, if Construction or worlds suspended or ab,andoned for aperfod of 180 days after the WOrk as commenced/or Ifrequired'lnspectlon, have hot been requested within 180 days num the last inspection. I hereby certify that I have read and e*,rilined.this applicatl()Jl ,a.nd knowthe same to be true and correct All provisions of laws and ordinanCes governIng this type of workwlJHje CoJ:l1plled .wittlwhethet specified herein or not The granting of a permit does not ~Iate or cancel the proviSions of any._ or local low regulating construcllon or the parfonnance of . . " fllil,,~ . Signature of Contractor or Authorized Agent Date BUILDING PERMIT INSPECTION RECORD IY ." I CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ./T 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. INSPECI10N TYPE . DATE ACCEPTED COMMENTS YES NO . .. FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGEJDOWN SPOUTS i ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH.IN I I PLUMBING . UNDER FLOOR I SLAB ROUGH.IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW I WATER . AIR SEAL WALLS I . 'f CEILING I I I FRAMING JOISTS I GIRDERS SUBAR WALLIHOLD DOWNS f WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INstJLATION . . SLAB I I W ALL I FLOOR I CEILING I I MECHANICAL . ! HEAT PUMP . GAS LINE WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATEPERMIT#'s: W A TERLJlIiE I METER SEWER CONNECTION SANITARY . . STORM PLANNING DEPT. SEPARATE PERMIT #'5 .. SEPA: PARKINGlLIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCVPANCYIVSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED . YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL . LIGHT DEPT CONSTRUCTION R. W.I PWI CONSTRUCTION. R. W. ENGINBERlNO 417-4807 PW I ENGINEERING FIRE . 417-4653 FIRE DEPT: PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 . BUILDING T:\PLANNING\FORMS\I 102.15 (1111412003) '9 ~~ CITYOF PORT ANGELES DEPARlMENTOF COMMUNITY DEVELOPMENT - BUll.DING DMSION 321 EAST 51H STREET, PORT ANGELES, W A 98362 Application Number pin number . Grand Total . . . . 04-00000105 . .853360 1774.50 1774.50 Page 2 Date 12/29/04 .00 .00 Separate Permits are required for electrical work. SEPA. ShoreU@.ESA, utilities. private and public Improvements. This perlnit becomes null and void if work or construction authorized is not commenc:edWithiri 180 days, ifcon~ction or work is suspended or abandoned for a period of 180 days after the work as commenced~ or.~.requlredlnspectlons have not been requested within 180 days frClmthe last Inspection. I hereby certify that I have read and examinEld this application and know the same to betrue.snd 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 ~r ume.to give authority to violate or cancel the provisions of any "state or local law regulating construction or the performance of co on." . l W05 " Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is. builder) Date .. T:\PLANNING\FORMS\II02.1S (1111412003] ,',t ,j<,,, '_'~,O~',i:'.""-' c~ ",,-,; _;.>< , ",- '~~;:7,--' "'e.s'"'. . '- '<:.'::__,':,',0" BUILDING PERMITINSPECflON RECORD , ' ,. - n _ ", ,~, ' , " ~ " *' ,. , ' CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS: . ' " ,"":, ',' .'" "" '," PLEASE PROVIDE AMINIMt}M 24Ho1JR N()TICE. lTIS UNLAWFUL TOC()YER,~1f:(SULATll0!l C(j1VCEAL If NY WOR/fBEFORE . INSPECTED ANDA(JCEP:rED.POST'PERMIT1NACOl\fSPICUOUS.I..OCATlON.' KEEP PERMrTCARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE , . . F9uNDA!ION:.' . .FQOTIN(JS .. WALLS. FOuNDATION ,'DRAINAGFJDOWNSPOtITS> ..... ...... ". E~~AL (LIGHT DEn) SEPARATEPERMrr: # ROUGH-IN' ,:<t.. PLUMBING .,. UNDER FLOOR I SLAB ROUGH.IN .' . . COMMENTS. . . . I i , ., " : . . . . .. DATE ACCEPTED . " YES I NO I WATERLINE (METER TO BLDG) GAS LINE BACK FLOW I WATER AIR SEAL . ... wALLs CEILING :-- '. '.. ./ .. ..' . . '. . . . .. I .... .' .... .'. . ' . . FRAMING 10ISTS I GIRDERS SHEAR WALliHOLI> DOWNS wAILS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL. ONLY) T"BIdl' . . . : . INStlLAl1Pl'C sLAB . WALL I FLOOR I CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE I J'BLLET I CHIMNEY HOOD I DUCfS '. .'. . I . I . I . '. . " . '.' ... . PW unLmES I SITE WORK ~Divislon) :SEPARATE J>PRMIT #'s: WATERLINE I METER SEWER CONNECTION. SANITARY . ~ . . . STOItM '.. '. PLANNING DEPT. SBPARATE PERMIT #'s J>~~!GIlTING ..' LANDScAPING ": ..... . SEPA: 'ESA: RESIDENTIAL ...... ...;.1.....,.. ...~~:.....:; ..... FINAL INSPECl'lON~rtE9UIRED PRIOR TO OCCUPA!icy~SE" ;", CC DATE 'YES NO '~~CLU;--< : . .. . .. ... ..... . '. : .- .' ,:, .. .': /. .DATE' '. AC~ . ",:<;- \--'~'Y1t$:'.,"~~' :(,''-'NO:: .. . BLECTRICAL. LIGHT DEPT. 417-4735 . ...... j. ... : . . . . ELECriuCAL I,IGHT DEPT CONSrtmCTlON. R. W.. p\\fj~G . . .o'... . ,!:.-' .... FIRE Dmo:r; '. ~GD,~: . . . BUILDING' ,,'.. . CONSTRuCTION R.W.I PWI ENGINEERING FIRE.L ..' . 4174807 ........ 'o' ", ~ ' r.. }:1:-,~- . I.. . '" (, j '\". . . 417-4653 .. '... ' . 417-4750 , PLANNING DEPT. . BUILDING. T:\P 417-4ins QR}Mll02,15 [11114120(3) . "-.:~.;,::,,,,:~;,.,.,,',"/ . ,-- BUILDING PERMIT - APPLICATION -"- """ FQ~OFFIfIA!:Y~J:l_Q~L Y: Date Rec.:/'d--'f- 3..01 Permit #: a::nt.- 10"..<;' Date Approved: Date Issued: 11- -)..1-oJ./ Fill out COMPLETELY aud in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 Applicant or Agent: tv ~h./- Owner: (),y/j ~v Address: 2441" ~l;0~} Architect/Engineer: )! Fl. Contractor ~r.p . I ti/l~ f).i:?bI,O? /nc. / Phone: '1J7-p So( Phone: City: Zip: Phone: State License #: j:::iJ <- Exp: Phone: Address: City: 7-44- ,b 't>ol-u) PROJECT ADDRESS: S'1 Zip: ZONING: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Block: Subdivision: Credit Card Holder Name: Billing Address: Credit Card Type VISA TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: 'hf't. ~M~o/J City: MC # Exp. Date: o Stove o Garage o Deck o Other SIZEN ALUATION: SF. @ $ /SF. = $ SF.@$ /SF.=$ SF.@$ /SF.=$ TOTAL VALUATION $ 2)"2.G'O,.... COMMERCIAL/RESIDENTIAL: Occupancy Group: No. of Stories: Lot Size: Existing Sq. Ft. Total lot coverage Occupant Load: & Proposed Sq. Ft. Construction Type: = TOTAL Sq. Ft. % APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUBMITTAL: The Building Divisiou can provide you with information on the application and plan submittal requirements if you have questions. 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 Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted 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: Ifno permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see SectionRI05.3.2 of the International BuildinglResidential Code, 2003). No application can be extended more than once. I hereby cerlify that I have read and examined this application and know the same to be /I understand that it is my responsibility to determine what permits are required ,not the City's nd correct. I am authorized to apply for this permit and ha u 0 <<ifrll.Jch permits prior to work. _ ) Date:.l z..\~31c.t T:\RVESS\BLDG-forms-brochures\2003-Buildingpermit. wpd Applicant: ~--"' S '\4lr~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION .12\ EAST 5TH STREET. PORT ANGELES. W ^ 98J(,2 . Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . .. . Application valuation 04-00000105 Date .853360 2445 ARBUTUS LN 06-30-01-5-5-0070-0000- RES NEW SFR RESIDENTAL SF 9000 RS9 RESDNTL SINGLE FAMILY 74944 Owner Contractor BOYER, CHRISTOPHER/DEZIREE 2301 W 18TH ST #E-3 PORT ANGELES (360) 460-4230 Structure Information Construction Type Occupancy Type Other struct info OWNER WA 98363 NEW 1372 SFSFR W/ATT528 SF TYPE V,pON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE CONSTRUCTION TYPE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED.LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL 1830 SQ FT SFR ELECTRIC SERVICE 119.80 12/30/04 6/29/05 Plan Check Fee Valuation Qty 1. 00 2.00 Unit Charge Per, 73.0000 ECH 23.4000 5C EL-R-SQFT FIRST 1300 EL-R-SQFT ADDITIONAL 500 Special Notes and Comments The site is located within the Madrona Woods Subdivision. The residential structure may NOT be finaleduntil infrastructure improvements for the subdivision are installed and approved. Building address sign shall not be less than 6"\& not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped ,to approved storm drain locations. New subdivision outside the four minute response time shall be~quipped with a residential sprinkler systElm that is installed and maintained in accordance with Uniform Fire Code (UFC) and National Fire Protection Association(NFPA) standards. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE Fee summary Paid Credited Charged COMMENTS! ACTION NEEDED 12/30/04 .GARAGE 21. 00 V-N 1. 00 1.00 9002.00 1900.00 1900.00 1. 00 .00 o Extension 73.00 46.80 745.00 4.50 1025.00 Due ~ --t ~ V\ ~ ~ ~ t' ~ ELECTRICAL PERMIT INSPEqJON RECORD CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TOCOJ.'ER. INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE .INSPECI'ION TYPIt DATE ACCItPTItD COMMItNTS I YES I NO "T. .... ROUGH-IN I COVER .. S"'.K VII ....: . . I I GENERAL COMMENTS: PW-II02.IH4/96) IS "'lr ...-; CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DlVlSION 321 EAST 5TH STREET. PORT ANGELES. WA 98362 Application Number . . . . . 04-00000105 pin number . . .853360 Permit Fee Total Plan Check Total Other Fee Total Grand Total 119.80 .00 1774.50 1894.30 COMMENTS/ACTION NEEDED 119.80 .00 1774.50 1894.30 Page 2 Date 12/30/04 .00 .00 .00 .00 .00 .00 .00 .00 <:;J J .' ELECfRICAL PERMITINSPE~fJON RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONRPLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. .iiISUNLAWFUt'l'Ogq~R. },j INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED ANDACCEp!ED. .. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE COMMENTS GENERAL COMMENTS: PW-II02.IS (4196) . ) FROM FRX NO. Dec. 282004 06:11PM Pi / &,"1,'" " a Electrical Cont.acto. S a Own.. ~_7' ELECTRICAL WORK PERMIT APPLICATION o ReQuestInsnection OL/ - / () S- a Annual Permit 0 Alarm 0 Carnival 0 Commercial 0 ResldeDUal 0 Residential MalD.t. 0 Signs 0 Tbermostat Q Teleeom; Job wired by ~cal Contractor 0 Owner Installation deScription License number b\QC.'t"""~l \~7.:0""" H~.lrO ~,ff- oN - 11..... "l-DC>-r~ AD State ZIP \ Addre,.s of tns C1:IOD~ ..3....\"j~ .- Clly r:-l ~"-~ Z 'ic/S' N..dI-6Ti4..~ 1...R , >-- ----'. o Cash 0 Check # I hereby certify that I am lhe llwner of the above named prupc:=rty or a licensed electrical contractor (Of the finn's authorized agent) and am making the electrical installation or alteration in compliance with the cJecmcaJ law, Chapter 19.2g RCW., \ o Credit Card Card # Visa M~stercard Discover 6---F-:p,c,: r"----- $ '''-----.. ;gn.,." 0;&:' ,e~con".c'.r or ,leml,,1 .dmln.....'or Expiration Dare of card D.l~ Approvtld D)' DlIll< ~JUnd8y TIiERMOSTAT Ib.le Al'ProYcd Dy OrrcH n~o .o\ppNVGd By SERVICE Dale A.Il(l'O"cdBy / FEEDIiR / ,"- / "- Umtc A.pprovCCl By WALLS I J., l.:lation Only ~& Cnver CEILING ~InSUlillion Only A/1'J te ^ppJl.wcd 9,. Cover b'l u/~ Service Information Electrical Load Additions-and or subtractions Q NO LOAD CHANGES Q Baseboard KW o FurnacQ KW a Heat Pump ion LAR o Fan-Wall _ KW lJ Overhead Service o Temp Service CI Underg(Ound Service VoMge PhasaD1D3 Service Size: Feeder Sl28: Inspection Area, Building. or Equipment Inspected Action Taken Electrical Date h)spector ,dq/o~ ole- '-'-' / r?/f'JN I J/ /,.;. 13h75 - dJC7 ArXJ rllv'At . , . t:.-<Z-- I /j