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Home My WebLink About1421 S Pine St - BuildingPREPARED 2/04/10 8 09 20 INSPECTTON T CKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMB— L ERLY DATE 2/04/10 ADDRESS 142 S PINE ST TENANT NBA JERRY /JANE JACOBS CONTRACTOR PELLET HEAT CO OWNER JERRY /JANE JACOBS PARCEL 06 30 00 0 4 1950 0000 APPL NUMBER 09 00001166 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 01 11/10/09 PB MECHANICAL GAS LINE 11/12/09 DA November 10 2009 8 22 00 AM 1pangrle GARY 457 4406 GAS LINE November 12 2009 8 54 42 AM pbarthol no pressure in gasline repair recharge and recall inspeciton ME6 02 11/12/09 PB MECHANICAL GAS LINE TIME 09 00 11/12/09 AP November 12 2009 9 14 19 AM 1pangrle GARY 457 4406 GAS LINE November 12 2009 4 05 48 PM pbarthol ME99 01 2/04/ 0 'LL MECHANICAL FINAL TIME 01 00 .rte /,1 February 1 2010 2 18 58 PM 1pangrle JANE 452 3905 MECHANICAL FINAL GAS FIREPLACE AFTERNOON SUBDIV COMMENTS AND NOTES PHONE (360) 457 4406 PHONE (360 452 3905 PREPARED 11/12/09 9 54 44 INSPECTION TICKET PAGE 13 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 11/12/09 ADDRESS 1421 S PINE ST TENANT NBR JERRY /JANE JACOBS CONTRACTOR PELLET HEAT CO OWNER JERRY /JANE JACOBS PARCEL 06 30 00 0 4 1950 0000 APPL NUMBER 09 00001166 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 02 11/12/09 JLL /t /L I SUBDIV ME6 01 11/10/09 PB MECHANICAL GAS LINE 11/12/09 DA November 10 2009 8 22 00 AM 1pangrle GARY 457 4406 GAS LINE November 12 2009 8 54 42 AM pbarthol no pressure in gasline repair recharge and recall inspeciton MECHANICAL GAS LINE TIME 09 00 November 12 2009 9 14 19 AM 1pangrle GARY 457 4406 GAS LINE COMMENTS AND NOTES PHONE (360) 457 4406 PHONE (360) 452 3905 PREPARED 11/10/09 8 30 26 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 11/10/09 ADDRESS 1421 S PINE ST SUBDIV TENANT NBR JERRY /JANE JACOBS CONTRACTOR PELLET HEAT CO PHONE (360) 457 4406 OWNER JERRY /JANE JACOBS PHONE (360) 452 3905 PARCEL 06 30 00 0 4 1950 0000 APPL NUMBER 09 00001166 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 01 11/10/09 JLL MECHANICAL GAS LINE November 10 2009 8 22 00 AM 1pangrle 171;0 fr GARY 457 4406 cY GAS LINE COMMENTS AND NOTES /1/ z 4✓ e Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc INSTALL A GAS FIREPLACE INSERT Owner JERRY /JANE JACOBS PO BOX 1688 PORT ANGELES (360) 452 3905 Permit MECHANICAL PERMIT Additional desc GAS FIREPLACE INSERT Permit pin number 156299 Permit Fee 121 30 Issue Date 11/09/09 Expiration Date 5/08/10 Qty Unit Charge Per 1 00 1 00 1 00 Permit Fee Total Plan Check Total Grand Total Date CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 10 6500 EA 10 6500 EA 50 0000 HR Fee summary Charged T:FormsBuilding D Permit WA 98362 121 30 00 121 30 09 00001166 801364 1421 S PINE ST 06 30 00 0 4 1950 0000 JERRY /JANE JACOBS MECHANICAL APPL PERMIT 3257 TANK LINE Contractor PELLET HEAT CO 230 EAST 1ST SUITE C PORT ANGELES WA 98362 (360) 457 4406 Plan Check Fee Valuation BASE FEE ME STOVE /FIREPLACE /MISC APP ME FUEL GAS PIPING 1 5 OUTLETS ME INSPECTION MIN 1 HR Paid Credited 121 30 00 00 00 121 30 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 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 ape does not presume to gi o' to violate or cancel the provisions of any state or local law regulating construction or the performa e of constru t'on. Signature of Contractorfor Authorized ,Agent Date 11/09/09 Due 0 0 0 Extension 50 00 10 65 10 65 50 00 00 00 00 Signature of Owner (if owner is builder) 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 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 (3 Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. 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 FINAL Date 2-9 I o Accepted by p B FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By F T•Forms /Building Division /Building Permit Applicant or Agent a f &a Phone Owner j e-rr v "pacr d s 3 erru /,Sane 3 Owner's Address /42_, s .vim S-f, P-¢- P Box l clag Contractor /Engineer P /j kj Ca_ Phone Contractor /Engineer's Address 2 3 0 c gdc F- t cot r License LL E N LaS a Expires PROJECT ADDRESS Floor Areas Parcel Number C‘ 3 090 e y_es'pO a Project Type Brief Description. Check all that apply New Construction o Addition Remodel o Repair Re -roof o Demolition Sign t,Heat System o Other Basement 2nd Fkur 3 Flcc'r Garag Carpo Cover Poch Deck Shed Other NOV Total footprint of structures BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn Building Permit Technician 32.1 E, Fifth St. Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 1 2 S nr.e. Lot /t -i3 pc Residential o Commercial Multi family 4y ^/7—» Zoning wall- mounted projecting freestanding awning other Total sign area sq ft. Maximum allowed sign area sa ft. Heat pump wood- burning stove )(gas fireplace pellet stove other Fa,..,, Pme� as svi.,,ve -,�S LP TA k es L,'tie_ 3%, Existing (sq. ft.) Proposed (sa. ft.) per sq ft. 1 I__ Lr�i�l) Max height of proposed structures ft. Occupancy group Will a lawn sprinkler system be installed? Occupant load Will a fire sprinkler system be installed? Construction type For City Use Only Date Received 1 t —0 9 Permit* 01 Date Approved 36.0 36a eis-Z 3 9e,s 3 4a /S 7-ti` /o4 TOTAL VALUATION 3 z 5 7 sq ft. T Lot size sq ft. Lot coverage of bedrooms of full baths of half baths ❑.Industrial Ireire I C4-7 Ok I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required and to obtain permits prior f working on projects c 5 Da,e 2- c`1 Print Na ne /r1, e-A4 el D 12,-_,,_ Signature �9i Y F For is iIding Division/Bidg Permit Appi 2006 Code doc cf ~ORT ""'" l'~ r.. L~ =- ~C~ CITY OF PORT ANGELES 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 04-00000989 Date .256592 1421 SPINE ST 06-30-00-0-4-1950-0000- RES ADDITION 11/09/04 4200 Owner Contractor HIRSCHFIELD, LANA 1421 SPINE ST PORT ANGELES (360) 452-3437 Structure Information Construction Type occupancy Type Other struct info WA 983627525 KANDU ENTERPRISE 714 WEST 6TH PORT ANGELES (360) 565-8383 ADD COVER OVER EXISTING PATIO TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE CONSTRUCTION TYPE HARD SURFACE AREA NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98363 17.20 V-N 1 'I 1. 00 1762.00 12000.00 313.00 2075.00 1. 00 - -2::. 'P ""'"' ....... ?:. ~ -r \' e>;-..) .... ""' ....:. (t ~1 "1 Permit BUILDING PERMIT -RESIDENTIAL Additional desc ROOF COVER FOR EXISTING PATIO Permit Fee 134.75 Plan Check Fee 53.90 Issue Date 11/09/04 Valuation 4200 Expiration Date 5/09/05 Qty Unit Charge Per Extension BASE FEE 92.75 3.00 14.0000 THOU BL-2001-25K (14 PER K) 42.00 -------------------------------------------------------------------------~-- Special Notes and Comments When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. The proposal will result in a porch addition over an existing patio for total lot coverage of 17% in the RS-7 zone. No land use issues are noted. Electrical load calculations and elctrical permits are required. New roof must not interfer with service wire or meter location. Electrical load calculations and elctrical permits are required. Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permi t Fee Total 134.75 134.75 .00 .00 Plan Check Total 53.90 53.90 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 193.15 193.15 .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 jf 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 T:IPLANNINGIFORMSII102.15 [I 1114/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICALINSPECTIONS. 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 I YES NO FOUNDATION: FOOTINGS fl-)f) -'f..)H J. t. WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPn SEPARATE PERMIT: # ROUGH-IN 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 W ALLIHOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB I WALL 1 FLOOR 1 CEILING I I I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHJMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEP ARA TE PERMIT #'5 SEPA: PARKING/LIGHTlNG ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R. W. 1 PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. 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BUILDING PERMIT - APPLICATION Date Issued: Fill out COMPLETELY and 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_1)t' kJ !ScttU BA Owner:_[.rA~-A ++ (f2. <ScH- P (~L..-D Address:_Itf-1..1 <So. 'Pi I0E 'S \- City: Architect/EngineKu. n d.~ Contractor ~ ~-,oN-o 1 Phone: %2 - Cu~"f- Phone: lfb 2- ~ 34-;) 7 'Fbfl.T Nv&e-LeS Zip: ~r2;~ 2- Phone: State License #: Exp: Phone: Address: City: Zip: ZONING: PROJECT ADDRESS: LEGAL DESCRIPTION: LotStiSc6f r1-/3 Block: 1f11 CLALLAM COUNTY PARCEL NUMBER: 0 ~ 3 c (, 0 Subdivision: 0'1-/ '1[;0 , Credit Card Holder Name: Billing Address: Credit Card Type VISA TYPE OF WORK: ~ Residential 0 New CanstI'. 0 Re-roof o Multi-family .s:: Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: APD/ n'ON t1F fl:/LCf-f /2tJtJ F City: MC # Expo Date: o Stove o Garage o Deck o Other SIZEN ALUATION: ::]/ ~ SF. @ $ /SF. = $ 1-~() , SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ &o-e tJvCTl r?I-I ~rr tV&- fA T f tl COMMERCIAL/RESIDENTIAL: Occupancy Group: No. of Stories: Lot Size: j"2coo Existing Sq. Ft. 176 L T otallot coverage J '7 I '2- % Occupant Load: Construction Type: & Proposed Sq. Ft. 31 S = TOTAL Sq. Ft. 2 6/ s,- APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER: PLANNING USE ONLY: ESAIW etland( s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other: BUILDING 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 Pennit 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 pennit application and construction plans are submitted. All other pennit fees are due at the time ofpennit issuance. EXPIRATION OF PLAN REVIEW: Ifno pennit 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 Rl 05.3.2 of the International Building/Residential Code, 2003). 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 true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I must obtain m~? prior to work. T:\RVESS\BLDG-forms-brochures\2003-Buildingpermit.wpd Applicant: t~~~ .~ Date: It, 2/' tf ,~ -K]!:) al{J /0 N.1J!q!suodsa.l al{J aq ]0l111V1fS 8U!MV.lp/duw Sfl{I/0 aS1l.lal{Jo AUY _~,i .sasod.lnd puv asn UMO S1! .lo/sa,a8uy J.lOc! /0 Nl:) al{J Aq p;;;JnpO.ld S.,8U!MV.lp/dVJu S,f{l '-t-h-/'," .UO!Jd.l.l:Jsap fV2a[ D SO paS" aq OJ papUalU! JOU S! dvw S!l{l dON Oi1.1J? [61fB UYN - flllIJOU IO/J1ozl,oH 88 U,1 YN ~ flllIJOU '''31/1',1 I laa;! ov S o. PIN E ST. t- ot ~ 80' 31'\1(": U1 :} lJ) -\ '}J m m -\ Z~G\~ :n ~ ~~!~ ~ ~ 8t~ij) !'? ~ij)ij)" I"" ~ ij) ~ " 1Il ij) " ~ CJ !;~ffi~ ~ m~~~ 5 ~ 5 0 5' ~ "~2~ ,," moo ~~~8tfiS~ ~~7'\~~ :1 "~~b" il ~~~ ~ ~ ~ m (1 U10 ~~ ~(1R &c o!D~ ,,]Jz ~~Q U'lZ ~" ~~ Z\J ~ <;::w Z ~ (1 f!! Z p o ~ o o ~ ~ SITE PLAN OL- -- 20 o }J ~ t;> ~ r---- --t- - I I I I I I I ------l (3 ili ~ " I i!:J-. :;25' SETBACK I I I I I I I I I I I I I I I-...J IV) I~ :~ 17'\ I I I ~ ~~ ~'t: 'fJ.. 9 ~ I L___~-I I I I I I I I I I I ~ J Gl o ,. ,,9-,9 l"o-l:L I ~f 1---1-- : I : I : I : I I I .. 9-.0<: I Gil V)I ~I ~i I I I I ~ o (I') ~~ lJ):::i IIZ .....G) U\ I -to ;DC '}JlJ) m ,,9-.0<: I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I i ~ ~G) i I lJ) I 111m I I I I I I I I -5" I I ,-" I c; i ~;H KL . i I~ .....~ iJt '" ;, E: ,,; I I V1 '" we::-" I ~~, fa ~ ~ ~7 J L_________ ClL~e_~--= .::c..-...i_______________________.J .. &~3W~~ , '3. '0 " "0 " .- 20 SETBACK ~ ~g;i~~:! r~"; ~ r ~ -' 2; .':?-. , I ~..... ~; :J C5. " ?::3 2: I I I I I 1- "OL-,OC .. 9- ,lo:Z. " ~ ~ o ~ --\ ~ """ ~ i= ... 80' EBz LANA HIRSCHFIELD DRAWN: OCTOBER 2004 DON SCHUBA 452-0207 1 4 2 1 S 0. PIN EST, PORT ANGELES. WA 98362 452-3437 I ~~ I I - I ., r- -:-:---=-t ~- ~ ~~ ,~ 'I . ij). ~~ .~ I , ~ ~ I ct- 1 - \ ~ ~ 11-;; I ~ 6\ ; ~ ~ .". ~!~ . ~~, ~ ~ ,- v.: !'\ ~ \}-l~~ ~ ~ : .. Jt_ ~~ ~~ - z:.. ~ J ~ , ~ :; \ ~z ;~ .~ 11 ../ '~~ . -1,- ~ ~ , :1 ~ ~ II~ "'1. ~ ~ ~ -~ r- ~ ~l~ ':' .~ i~ j ~' I.:; S -";~~..~,:....' '. ~.I ,: - ;;.. . ~. ~\~ 10.1 'to 1~ 't1~ c..!. ~, ~ 0' ~. 6 ~ t ~ 0 1- lo'-t" "" <:; ~ i: , '0 2" c:;," 7'-3 II (2 :...:3 .. ,..",,;~, I 2'-=1_ I I ~ . ~ -::: ~ T . I ~ J '\ \:5". z3"~ c ~ ,( _- 1 ':s> ~~..:. X :0 ~~ \N~ ~ tQ~ \ $.. -,. Q~ ~ f. .. ~~ \ \, \ -q- ~ - " ~ \ - ~ ::; \ \:) \1i I c: r I\:) ~~ ~ $'. <J' ~~ ~~ . ~~ , '<' ~ .. ;1"0' ~~Z' ~Mn ! \ , ~)I" Uf"";;2 ~#_____ , ~ ~ + ~ ~ ~ ~ ~~~ ~ ~ z~ ~ ~ '" ~. L ~ ;:;::.. "S' "I<. ~ . ~ '" 3 ~ IS' ~ (V ~ ~ ~ ~~ .~ ~ ) ~ ' i . "'.S' IV)! ------------- -- -- i I , }'. "J :;J z:; ~ / II ;-- I / I . . ~I ~~ 1 ~~ ~f! -- ~3 -~ 0\ if r ~(" 'Z:. \It , '" I' n :z: \)\ \:) 1= z:. ;' J 1I -' \ -\ -- ", '=-- --\~_i t I \ 1",-'- ~ - \ / .. \ '" __ _n_____ ;;:...._n___ ______-/' ___ ~ / \ ~ /1 \ . ' < \Y / / , ~ / g - T ~- I;)~ :)'-6" 7'. -; II l~" 0 1\ -- -- , \1 J---i I / I , / I ' / '" I I f ; I , -i- + ) -- . !~\ ~~ ~ ~ I- z:.-i.. , ~ ~ ~ _~ C I ~ . m I I - ------1 ! .---- --- ---- \ \-+- - \ i -I --=a \' rT 12 '. , J I --t ~1 ~ ~ ~~ - ~ ~ ~ CIT"r OF PORT ANGELES LlGHT DEPARTMENT ELECTRICAL PERMIT N~ 17603 port Angeles, washJngton.m~.==-.~_..~......m.m......m__.....m_.m, 19.Z:_J In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trl ~al equipment in, on, or about any building or other structure in the City of Port Angeles, per- m.ssion is hereby granted to do electrical work as listed below. A(ldress L4.mrbL__S..~_m__~~____m_..m__.__________m____. OccupancY__.m,~----------..--m--- O'vner .---..m-----..m-------"..m---o;;;J mm.m.m;;,__m-/'. -;-;".T.7.' Tenant.____mm_______m_.m.m.__.__m.____mm.___________...m.... ""''''1 .~ .' ci VI" ;ring Contractor __/1k__...m_~__ ..ldjLT__~C.'-'_M.t:m. By________.m___.mm_.__.mm__...m__mm.___.__m_______.m L: frht Outlets.......___.........__.........._.._..... R 'ceptacle Outlets..._......._____........_...... Dr :,er, KW _nun..n_.n.u..nnnn._a...nnn_ R, 1ge, KW nn.....n_.n___n.n 'Water Heater: KW..___.....mmmmm.............m..__. H,," Kw...!'i........f.{,I;)U,,<"'"'!?... I Motors: size, volts and phase: Total Load_______.......__._______..... Service, volts Jit,..!-!...:...?:".'cLld..... No. wires ..n.......2__.........._..____... Size wires.....;;4:i..../1....L"".._.. Main fuse ."J...d.....-1:=:..._ Enclosure n......___________....... Type of wiring: Entrance Cable __...._____n____..... Rigid Conduit ......._______mp._____ MetaUic Tubing .______m......_..__ Current transformers: No. & Size_...........__nn.____.....__ Ser. No.______.....____.___..........._.__............ Ser. No..--__._....._.._._______...........__.____.... Ser. NO..______....._______.__................____n.. Ser. NO._.....____n____..........___._n____........ Type of Wiring: Armored Cable ...___..___.....______........ Non-Metallic ................__n........_..__ Knob & Tube__.....______.._._._______........ Rigid Conduit ............................___ Metalllc Tubing .......................__.. Raceway _........___._.................._......_ Circuits. Light........______..____.___.........__.... Utility ...................---......,...........----- lIeat ___n__.....__........................._...... Range ........___........_____........__........... Water Heater ....._......__.......___....... Motor .._........_.._.___......____.__.....___..... Dryer __.__....._____......_..._....._......_n........ Furnace ........._._..........__..___.__._.......___. Total ..........._..__.........___._........_ Remarks: ____..))L.~~___.______m______.m______..____mm._.__m..m__._mm...m.mmmm_..m.mm......mmm....m _..~.__._~._..~.____________.._____..._...~..~..~_..........___._.._..._.._.uu._........__.__.._u...~.~._........_..__..___.u.........~.._._..u..._....___u.._..~....___u Permit Fee ....nn_n.nnnu.n__n.nn.n__n..nn.n.._n__~~.n.n~..un__uu.nu____n~hnd__Uu.__n...._n.UUU__.____n~.uu.u.u__~u...d.~..____u..n_..u___un $;,___._....._____.___.___.______..___.. Treas. Receipt NO._.___..m.................. By u{(J:~________..___m________umm.____ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con. c~aled due notice must be given the Inspector so that work may be inspected betore concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N~ 1 7 6 0 3 1!.ddress....._..____._..........._._____............__n..._.........__._............___.....................__...........................__....Date..._......_______.._......._____....._......_n_____.. C wner ___..._.____._............__.......___.._....._......____..._.._..............-.--..-.......-------..........-...--.....-- Tenant..._..._....____..n____........__.._______..........._..__n.._____ '"/iring Contractor ....___...........____....._................______._._......____........___._..___._....._......_.._____.___......--....-. By____..._____............___.____...................._......... NOTICE--Current must not be turned on until Certificate of Inspection has been issued. It work is to be con- e llaled due notice must be given the Inspector so that work may be inspected betore concealment. 1M Olympic Printers, Inc.