HomeMy WebLinkAbout1811 W 12th St - Building
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CITY OF PORT ANGELES
DEP AR TMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Applicatio~ Number
pin number . . . . . .
Property Address . . .
ASSESSOR P~CEL NUMBER:
Application' description
Subdivision Name
Property Use
property zoning . . .
Application valuation
04-00000373 Date
.008431
1811 W 12TH ST
06-30-00-0-3-6165-0000-
RES NEW SFR
5/19/04
RS7 RESDNTL SINGLE FAMILY
89795
Owner
Contractor
------------------------
------------------------
RYKER CONST & ENGINEERING
3558 DEER PARK RD.
PORT ANGELES
(360) 417-6619
Structure Information
Construction Type
Occupancy Type
Other struct info
OWNER
WA 98362
NEW 1510 SF SFR WITH 953 SF
TYPE V NON-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
GARAGE
22.30
V-N
2.00
1. 00
7000.00
1561.50
1561.50
1. 00
-.
~
----------------------------------------------------------------------------
Permit MECHANICAL PERMIT -1)
Additional desc -
Permit Fee 86.65 Plan Check Fee .00 ~
Issue Date 5/19/04 Valuation 0
Expiration Date 11/15/04 --
Qty unit Charge Per Extension
BASE FEE 47.00
4.00 7.2500 ECH ME-VENT FAN 29.00
1. 00 10.6500 ECH ME-GAS PIPE 1 TO 5 10.65
-
-.
t
----------------------------------------------------------------------------
Permit PLUMBING PERMIT 'f>
Additional desc
Permit Fee 139.00 Plan Check Fee .00 ..:::;
Issue Date 5/19/04 Valuation 0
Expiration Date 11/15/04
Qty Unit Charge Per Extension
BASE FEE 47.00
9.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 63.00
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00
1. 00 15.0000 ECH PL- EA. BLDG SEWER 15.00
1. 00 7.0000 ECH PL- EA.WATER HEATER 7.00
----------------------------------------------------------------------------
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit Fee 947.25 Plan Check Fee 378.90
Issue Date 5/19/04 Valuation 89795
Expiration Date 11/15/04
Qty Unit Charge Per Extension
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 hav, ot been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and knoW t e same be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether speyifi herei or ot. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or lo~al ~w g arconstruction or the perfo anc of
construction. I . ~
. I .
Signature of Contractor or Authorized Agent Date Signature of Own (if owner is builder)
T:\PLANNING\FORMS\1102.15 [11/14/20031
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TION DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS I
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DR YW ALL (INTERlOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I
MECHANICAL
HEA T 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 OCCUPANCYIVSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRlCAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERlNG 417-4807 PW / ENGINEERlNG
FIRE 4]7-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMSIII02.15 [11114/2003]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
04-00000373
.008431
Page
Date
2
5/19/04
----------------------------------------------------------------------------
40.00
BASE FEE
7.0000 THOU BL-50,001-100K (7.00 PER K)
Extension
667.25
280.00
Qty
Unit Charge Per
special Notes and Comments
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.
The proposal will result in the construction of two story
single family residence with attached garage in the RS-7 for
atotal lot coverage of 22.3%. Maximum height is 30'. No
land issues are noted.
Electrical load calculations and elctrical permits are
required.
----------------------------------------------------------------------------
Other Fees
CITY DRA %
DRA FEES PLUS INTEREST
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
54.88
1575.86
745.00
4.50
1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ------.---- ----------
Permit Fee Total 1172.90 1172.90 .00 .00
Plan Check Total 378.90 378.90 .00 .00
Other Fe.e Total 3405.24 3405.24 .00 .00
Grand Total 4957.04 4957.04 .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 Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4]7-4735 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
YES NO
FOUNDATION:
FOOTINGS (y' - ~.S-~.J-{ 121/
WALLS 1;-1 fJ.--OJ-j I
FOUNDA TlON DRAINAGE/DOWN SPOUTS '/ - Jt, .' 0,-/ _ .L.
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN /
PLUMBING h~/ 1/111t) rl A-o Jf~L
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG) Cf- I-o~ ) Lt
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS --'" .....)..J I
CEILING l'f/ -/ I " 'j-'j I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS Iq... ? -(1) I.} .1 LL
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERlOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I {J- 6 -0 J../ I '. J
MECHANICAL f'l/ti'l I j/j;,~6J /Jf ./U-
HEA T PUMP
GAS LINE ~ -0 i-f)).} ,.) ).)....
,
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKING/LIGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIVSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRlCAL
LIGHT DEPT
CONSTRUCTION RW. 1 PWI I'?." -!.).ii-oS- -..., CONSTRUCTION - R.W.
ENGINEERlNG 417-4807 J l'" PW 1 ENGINEERlNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 .. J PLANNING DEPT.
BUILDING 417-4815 Hlnlo~' JI..L. BUILDING
.
T:\PLANNINGIFORMS\1102.15 [11/14/2003]
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PREPARED 7/12/04, 12:37:49 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 7/12/04
ADDRESS 1811 W 12TH ST
CONTRACTOR
OWNER RYKER CONST ENGINEERING
PARCEL 06-30-00-0-3- 6165 -0000
APPL NUMBER: 04- 00000373 RES NEW SFR
PERMIT: BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 6/25/04
6/25/04
BI2 01 7/2/(4 J
RV
AP
4F-Dora DAA-;:ae-5
SUBDIV:
PHONE
PHONE (360) 417 -6619
BUILDING FOUNDATION FOOTING
Ryker 477 -0951
BUILDING FOUNDATION WALL TIME: 17:00
PARK RYKER 477 -0951
AS CLOSE TO 1:00 P.M. AS POSSIBLE. CONCRETE CALLED FOR AT
2:00P.M.
COMMENTS AND NOTES
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BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec.: 4- "27- a'f
Pennit#C4 ~ ~"7~
Date ApprovedS s-f t)
Date Issued:
Fill out COMPLETELY and in INK. Your application and site plan MUS
COMPLETE to be accepted for review. If you have any questions, ca
PERMITS (360) 417-4815 FAX(360)417-4711
PROJECT ADDRESS:
LEGAL DESCRIPTION: Lot:
I~ I (
/~
#7- 6'6/9
, -'
U/L. -~S-3- 3/2--927)
Zip: ~~.56 2---
,
<:~N7~
Exp: Phone: ~/'/7~
~r)e. Zip: ~/::.
/p, /071"'n"JT ZONING: RS~
Block: J.6 ) Subdivision: ;:W'J/? tJr %';&- $~.(f
n~~ OCfX-)..?~( "5 cx;~f:'J
Phone:
Applicant or Agent:
Owner:
Address:
Phone:
Contractor
Address:
City:
CLALLAM COUNTY PARCEL NUMBER:
Credit Card Holder Name:
Billing Address: City:
Credit CardType VISA MC # Exp. Date:
TYPE OF WORK: SIZEN. AL. UATlON~: "'~ "" -
J( Residential ~New Constr. 0 Re-roof 0 Stove ~ SF. @ $ - /SF. = $ ~ .J 00 --.-
o Multi-family 0 Addition 0 Move 0 Garage ~ SF. @$ . /SF. = $ ~ __~9.r
o Commercial 0 Remodel 0 Demolition 0 Deck SF. @ $ /SF. = $
o Repair 0 Sign 0 Other TOTN- VALU,e...:rION $ ~ 7QC; --
BRIEF DESCRIPTION OF THE PROJECT: ...s;"y' 17/..': ~~~ L< '-7 "J:::/...-.r/tO~rliii... r~
i~~t,6~~,~) 9C(.r~, 'tS5"ij P6.-C.~ 2;2.~ /
COMMERCIALIRESIDENTIAL: Occupancy Group: J2s.- /' Occupant Load: Constmction Type: ~ ~~
No. of Stories: 2. Lot Size: St)X /0.) Existing Sq.'~t. / & Proposed Sq. Ft._i56(t' $" = TOTAL Sq. Ft.l56./# S-
. 0 . t:?,( Total lot coverage---Z.2 t31-2:Q
r //I?277/k. ,t>.></Y'lTc
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BillLDING PERMIT APPLICATION SUBMITTAL: The Building Division 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 pemlit 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 tinle for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, cunent edition). No application can be extended more than once.
T:\FO RMS\APPS\Buildingpennit. wpd
Applicant:
I hereby certify that I have read and examined this application and know the same t
understand that it is my responsibility to determine what permits are required ,not t
WASHINGTON STATE ENERGY CODE
. I
TABLE 6-2
PRESCRIPTIVE REQUIREMENTS'** FOR GROUP R OCCUPANCY
CLIMATE ZONE 1 · HEATING BY OTHER FUELS
HV ACs Glazing Glazing U-Factor Door 10 Vaulted Wall Wall- Wall- SIab6
Option Equip. Area": Overhead' U-Factor Ceiling2 Ceiling3 Above int4 ext4 Floors on
Effic. % of Vertical Grade Below Below Grade
2
fJ/} Floor Grade Grade
I. Med. 10% 0.70 0.68 0.40 R-30 R-30 R-15 R-15 R-lQ R-19 R-lQ
.~ II. Med. 12% 0.65 0.68 0.40 R-30 R-30 R-15 R-15 R-lQ R-19 R-lQ
III. High 21 % 0.75 0.68 0.40 R-30 R-30 R-19 R-19 R-lQ R-19 R-lQ
IV.'" Med. 21 % 0.65 0.68 0.40 R-30 R-30 R-19 R-19 R-lQ R-19 R-lQ
V. Low 21 % 0.60 0.68 0.40 R-30 R-30 R-19 R-19 R-lQ R-19 R-lQ
VI.' Med. 25% 0.457 0.68 0.40 R-38 R-30 R-19 R-19 R-lQ R-25 R-lQ
VII. ' Med. 30% 0.407 0.68 0.40 R-30 R-30 R-19 R-19 R-lQ R-25 R-lQ
VIII. Med. unlimited 0.25 0.40 0.40 R-30 R-30 R-19 R-19 R-10 R-25 R-lQ
* Reference Case
*'" Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601.1.
1. Minimum requirements for each option listed. For example, if a proposed design has a glazing ratio to the conditioned
floor area of 19%, it shall comply with all of the requirements of the 21 % glazing option (or higher). Proposed designs
which cannot meet the specific requirements of a listed option above may calculate compliance by Chapters 4 or 5 of this
Code.
2. Requirement applies to all ceilings except single rafter or joist vaulted ceilings. 'Adv' denotes Advanced Framed Ceiling.
3. Requirement applicable only to single rafter or joist vaulted ceilings.
4. Below grade walls shall be insulated either on the exterior to a minimum level ofR-10, or on the interior to the same level
as walls above grade. Exterior insulation installed on below grade walls shall be a water resistant material, manufactured for
its intended use, and installed according to the manufacturer's specifications. See Section 602.2.
5. Floors over crawl spaces or exposed to ambient air conditions.
6. Required slab perimeter insulation shall be a water resistant material, manufactured for its intended use, and installed
according to manufacturer's specifications. See Section 602.4.
7. The following options shall be applicable to buildings less than three stories: 0.50 maximum for glazing areas of25% or
less; 0.45 maximum for glazing areas of 30% or less.
8. Reserved.
9. Minimum HV AC equipment efficiency requirement. 'Low' denotes an AFUE of 0.74. 'Med.' denotes an AFUE of 0.78.
'High' denotes an AFUE of 0.88. Minimum HV AC equipment efficiency requirement for heat pumps. 'Low' denotes an
HSPF of 6.35. 'Med.' denotes an HSPF of 6.8. 'High' an HSPF of 7.7. Water and ground source heat pumps shall be
considered as medium efficiency and have a minimum COP as required in Table 5-7.
10. Doors, including all fire doors, shall be assigned default U-factors from Table 10-6C.
11. Where a maximum glazing area is listed, the total glazing area (combined vertical plus overhead) as a percent of gross
conditioned floor area shall be less than or equal to that value. Overhead glazing with U-factor ofU=0.40 or less is not
included in glazing area limitations.
12. Overhead glazing shall have U-factors determined in accordance with NFRC 100 or as specified in Section 502.1.5.
38 7/01/01
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~ker Properties
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3588 Ow Park Rd.
Part AnStles, WA 98362
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CITY OF PORT ANGELES l~(4 2. ,,- I~? f..(2-l(
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
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
04-00000854 Date
.713490
1811 W 12TH ST
06_30_00_0_3_6165_0000-
ELECTRICAL ONLY
9/27/04
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
------------------------
------------------------
ELECTRIC SERVICE
82 DRAPER RD
PORT ANGELES
(360) 452-6424
WA 98362
RYKER CONST & ENGINEERING
3558 DEER PARK RD.
PORT ANGELES WA 98362
(360) 417-6619
----------------------------------------------------------------------------
Permit ELECTRICAL NEW RESIDENTIAL
Additional desc
Permit Fee 96 .40 Plan Check Fee
Issue Date 9/27/04 valuation
Expiration Date 3/27/05
Qty unit Charge Per
1.00 73.0000 ECH EL-R-SQFT FIRST 1300
1.00 23.4000 5C EL-R-SQFT ADDITIONAL 500
.00
o
""-
c..~
'-..
..........
Extension
73.00
23.40
\'\
~ (
1\
'-t,
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 96.40 96.40 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 96.40 96.40 .00 .00
........
~f\J
~li
V\
-(
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 Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
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
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # Ii' P C-"
ROUGH-IN fl' ... :</J.-()<i I VlV (; ('.ALA / ~ ;<.~.L(' /
J.
'-.
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERlOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/vSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT. 417-4735 1/", k; ftr~ ELECTRlCAL
LIGHT DEPT
, CONSTRUCTION - R. W.
CONSTRUCTION R. W. 1 PWI
ENGINEERlNG 417-4807 PW 1 ENGINEERlNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNINGIFORMS\1102.15 (11114/2003]
FROM
D4 ~ <354
'"
FAX NO.
Sap. 232004 08:16AM Pi
ELECTRICAL PERMIT APPLICATION
Fm.: nr.1'ICJAL lI:ic O!\:,l,."
Il..,,-IK~.
h:""ol~ _ .,.___. .~_____.
U""-""'r>i""..-dl __~~._.__~
1)i1" lrl.uool ._..__.__._ __._.
nll~ ElectrlC".4l! FJermi1 Ap~ljca:jcn mu101 be tined olJ't comp'eteh'.
Please type O( reprint In ink.. lfYOlJ havB any questions. please calt (360} 417-47~5
Fa. number: (360)417-4711
Owner or EI;u::. Cont.r.Jctor Ag:ent:
p'opertyowner:_f\..",T'\( ~~
Addr.ss, __ l q- u w...,.--J ~ Oly,
E~er;tricatcontractor'~~c... SOof'l1\''-JjJ r~hr_
Md,e's:~ \jn./1.'1; ...pl
'('-1. ~C~ Phone: H '5 .J - (,r/ 24Fax:
,
Phone:
Lt~ :L-~_'-f.:2.,t__
4rrl- O~-z(.L
Zip qg-3 ~ ~
Phone:::JS1~"~
ZIP... 9~.3 (., ~
loll!! ~~~r~xp '/~10-(;
A: '
City _y .
o-n
"Ji'-=CTRICAlo CONTRACTOR
~\ -
--- ~~
o
4:
INST ALLA TION WIR~D BY' OOWNEOR
Credit Card Holder Name:
,
Billing Address;
Credit Card Number:
Zip:...
.JJ
tJ1
Me: _-+:
VlSA:_
PROJECT ADDRESS:
\ 8 \ I \.J. \ 2~'"
Check all thai apply: )tNew IJ Alteration/Addition
TYPE OF WORK:
~Residential !:l Multi-family
D Remote Mele< 2 Detachad garage
o Commercial :J Mobile Home
SqoFl
~g-O()
; ,
C' Hol Tub :J Swim Pool D Septic Pump
;J Low Voltage :J Telecom.
CI Sign r
Number of Circuits added or alt.rod: _0..
fI~
roe-.s \ ~
DESCRIPTION OF THE ELECTRICAL PROJECT:
Electrical Heat Load Additions and or Subtractions
Service Information
[J Overhead Service
:l Temp Service
~ndergrOUnd Service
tJ~ - AJ ~'lI~\-'oi
I hereby 'certify that I have read and examir.ed this appiication and knolN that same to be true and correct. and / am
~uthorized to apply for this permit. I understand it is nol the City's legal responsibility to determine what pemlits
5re required; it remains the appiicants responsibifity to determine what permits are required and to obtain such.
CrllditCard Holder's Signature:-1/?~J1j>,u~ Date: Cj/n..~.f)Y'
flGfnd 71 (j? '-'- ;/ Date: ~h .... by I
:J Ba.eboard
:-1 Furnace
:J Heat Pump
::J Fan.Wall
KW
~~N_lRA
KW
Voltage: I "'J.() /-:J~t)
Phase: ~ 0 03
Service Size: -:2-C OQ
Feeder Size:
..
u.Y;:; qnLf
~rvf f C6-r e- .p
Owner or Elee. Cont. Signature:
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
~c 51/,
ADDRESS
/81/ W 1.2 6
APPROVED NOT APPROVED
o .................... DITCH.. ................. 0
D. . . . . . . . . . . . . . . . ROUGH IN/C ER............... 0
D. . . . . . . .. . . . . . . . . . .. SERVIC ...................0
D.. . . .. . . . . . . . . . . . . . . . FIN . . . . . . . . . . . . . . . . . . . .)aJ
~J
CORRECTIONS NEEDED: /Y"'''''-'d
"
~
~
6'.
7Z'
~~
r52
rPo:sr
c..A
.'. ,<~
#p,-e ;
. /Y'bv
(-I 17-'17~.;-)
W4c A!<;L.1~-
"
~.c-..,;NG Li~N= ."
P<-4~s
.Al4 c-P/V~~
/'H"-G~:reJt)
dJ-N N€~..J
/;V..T~ <
E'Z -""7 <'A €
DrS~~_~ r-.iV'
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360) 452-1381
-..
-0
f " ~ .
!ElECTRiCAL INSPECTiON
WilFUNG RlEI?OlRll
417-4735
APPROVED NOT APPROVED
~ . . . . . . . . . . . . . . . . . .. DITCH ................... 0
o .............. ROUGH IN/COVER. . .. .. . .. .. .. .ilR
o .................. SERVICE .................. {)f
o .................... FINAL. . . . . . . . . . . . . . . . . . .. 0
r<<l~"i~-;:~~A
~JJ/Y t&-<r-t~Qz (!)~A-;t,~~R'l
e---- 5^~ (/]~ ry ~
~ ~~~'f' ~.lL~
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPtC PRINTERS, INC. (360)452.1381