HomeMy WebLinkAbout704 Georgiana St - BuildingPREPARED 10/22/10 8 12 24 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/22/10
ADDRESS 704 GEORGIANA ST SUBDIV
TENANT NBR LILLIAN BERG
CONTRACTOR ALL WEATHER HTG COOLING INC PHONE (360) 452 9813
OWNER LILLIAN BERG PHONE (360) 457 5733
PARCEL 06 30 00 5 1 3950 0000
APPL NUMBER 10 00001148 MECHANICAL APPL PERMIT
PERMIT
TYP /SQ
ME99 01
ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
COMPLETED RESULT RESULTS /COMMENTS
10/2/10
MECHANICAL FINAL
October 21 2010 11 44 21 AM pbarthol
jeanni 452 9813
October 21 2010 11 46 48 AM pbarthol
COMMENTS AND NOTES
Application desc
2 ton heat pump 10 kw furnace
Owner
LILLIAN BERG
704 GEORGIANA ST
PORT ANGELES
(360) 457 5733
WA 983623510
Permit
Additional desc
Permit pin number 175653
Permit Fee 78 70
Issue Date 10/18/10
Expiration Date 4/16/11
ELECTRICAL ALTER COMMERCIAL
INSPECTION TYPE DATE.
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number 10 00001200
Application pin number 673600
Property Address 704 GEORGIANA ST
ASSESSOR PARCEL NUMBER 06 30 00 5 1 3950 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Contractor
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457 9270
Plan Check Fee
Valuation
Qty Unit Charge Per Extension
1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER 73 50
2 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT 5 20
Fee summary Charged Paid Credited Due
Permit Fee Total 78 70 78 70 00 00
Plan Check Total 00 00 00 00
Grand Total 78 70 78 70 00 00
RESULTS
/0/-2,1 /w 47
16/21 /0 AV
Date 10/18/10
WA 98363
0 0
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR
Date
a
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/ElectricalInspections 1
321 East Fifth Street P.Q. Box 11501 Port Angeles Washington, 9836�ECTRICRi
Ph: (60) 417 -4735 Fax: (360) 417 -4711 INSPECTION
Owner Information n
Name: 1 11 11 r R
at, er
Mailing 1 0'1 G-
City: Site: 7V 9 -n.,a 4
phone: 2 7 S2j3 Fax
Ucense II Exp.
SenficelFeeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401.600 Amp
Service/Feeder 601 -1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/0 Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service/Feeder 201 -400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601 -1000 Amp
Portal to Portal Hourly
Sign/01.41k a Lighting
Signal Circuit/ Limited Energy First 1500
Note: $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy 18, 2 Family Dwelling
Signal Circuit/ Limited Energy Multi-Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
Thermostat
VIEW CONSTRUCTION ONLY:
First 1300 Square Pt.
Each Additional 500 Square FL or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
LL
Date: )5
1 2 Single Family Dwelling Mufi- Family or Commercial' Commercial Addition Alteration 1 Remodel Repair=
Plan Review May Be Requited, Please Complete Electrical Plan Review Information Sheet
Job Address: 9 0 4 f (et- e 0 r t
Building Square Footage: ti
Description of above '7"U 47 C1 //it
Contractor information
Nama; �S r) &/e 7k'. e GC
Mailing re�s Oj 1n
CCity Add 7s: State: L 'JB Lp: i Z
Phone: 4.5 9 ..7 Fad;
License ti Exp.. '1 X 1 `2
pit Charge 9yt Total r Multiplied by Unit Charge
3119.90
$145.50
204.60
26220
5 372.50
2.60
73.50 I "7
2.60 -7 rte. .Q
92.70
5110.30
148.70
167.90
95.90
88.20
sf Commercial 95.90
63.90
$63.90
$119.90
3 102.30
56.00
$110.30
35.20
$73.50
$110.30
$_D e 7 Total
Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two year after this electrical permit is finalized. (i I Owner is required
to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that 1 am the owner of the above named property or a licensed electrical con rector I am making
the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19,28, WAC. Chapter 296 The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signaju of owner, electrical contractor or electrical administrator 0 cash 0 chi
credit curd '12". BtQd: jit
01l0112d7Q
Owner
LILLIAN BERG
704 GEORGIANA ST
PORT ANGELES
(360) 457 5733
T Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
HEAT PUMP INSTALLATION
WA 983623510
Permit MECHANICAL PERMIT
Additional desc HEAT PUMP INSTALLATION
Permit pin number 175018
Permit Fee 64 80
Issue Date 10/07/10
Expiration Date 4/05/11
/O// PA.✓l Yndr...
10 00001148
971744
704 GEORGIANA ST
06 30 00 5 1 3950 0000
LILLIAN BERG
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
12818
Contractor
Plan Check Fee
Valuation
Qty Unit Charge Per
BASE FEE
1 00 14 8000 EA ME FURN /HP /FAU OR 5 TON
Fee summary Charged Paid Credited
Permit Fee Total 64 80 64 80 00
Plan Check Total 00 00 00
Grand Total 64 80 64 80 00
Date 10/07/10
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452 9813
Due
Extension
50 00
14 80
00
00
00
00
0
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
IRhCG •ef
b -ZZ_
Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities private and public improvements This permit becomes
null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
2
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Inspection Type
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow/ Water
AIR SEAL.
Walls
Ceiling
FRAMING-
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
T Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Date
Inspection Type
Electrical 417 -4735
Construction R W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
Accepted By Comments
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting 1 ESA.
Landscaping 1 SHORELINE.
FINAL Date Accepted by
FINAL Date 1 Acc by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
—C-
oo
Applicant 1 L 1 I'VMS WOANP01 kc:c r\Ct
Property Owner 1, 'Y
Property Owner's Address i_�iai-i F. i
Contractor \M[(1 ir i. IEli A
Contractor's Address 1 Mr TAB r
License Ti n
PROJECT ADDRESS
Parcel Number
BUILDING PERMIT
CITY OF PORT ANGELES
Attn. Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
Expires 9 I I I t I
101/ Penrgiana
Protect Noe Brief Description: XResldentlal Multi- family
Check all that apply 4P0 C p I v tW [a o4 b New Construction ,I l� r
a Addition
Af2emodel
a Repair
o Demolition
o Re -roof
,Meat System
o Other
House o garage o other tear off re -roof o lay over one layer
)Meat pump o wood- burning stove o gas fireplace o pellet stove a other
Floor Areas Exlstina (sq. ft.) Pr000sed (sa. ft.),
Basement
1' Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures sq. ft. Lot size
Site Coverage the amount of impervious surface on a parcel, including
and other impervious surfaces. (see PAMC 17 94 135 for exemptions)
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
170/Z0 39Gd 9NI1 ~3H a3H1V3M 71V
APPLICATION Print in ink
Phone
Phone
Phone
E -mail
For City Us Onl
Date Received 10 (2
Permit f) --_k`1k%
Date Approved
u�, 5z�3
L7 5 63
Lot Zoning
Commercial o Industrial
per sq. ft.
TOTAL VALUATION M
sq. ft. Lot coverage
structures, paved driveways, sidewalks, patios,
Site coverage
of bedrooms
#.of full baths
of half baths
I have read and completed this application and know if to be true and correct. am authorized to apply for this permit and understand
that it is my responsibility to determine what permits are required, and to obtain permits prio t ing onrp ojecfs.
Date (0 Print Nam Signat ala
T:FormslBullding Division /81dg Permit.doc
J
�;_TSZSb09£T 60 £T 0107 90 01
Clallam County Assessor Treasurer Property Details 61660 LILLIAN BERG for Ye Page 1 of 6
Clallam County Assessor Treasurer
Property Search Results 61660 LILLIAN BERG for Year 2010 2011
Property
Account
Property ID 61660 Legal Description. SMITH, NORMAN R N2
LOTS 8 &9 BL 39
Geographic ID
Type
Tax Area:
Open Space
Historic Property N
Multi Family Redevelopment: N
Township
Range
Location
Address:
Neighborhood
Neighborhood CD
Owner
Name
Mailing Address.
Taxes and Assessment Details
Property Tax Information as of 10/07/2010
Amount Due if Paid on
Year
0630005139500000
Real
0010
N
704 GEORGIANA ST
PORT ANGELES WA
Cycle 5 Res
10955130
LILLIAN BERG
704 GEORGIANA ST
PORT ANGELES WA 98362 3510
Statement ID Taxing Jurisdiction
44359 ST SCH STATE SCHOOL
44359 CC -GEN COUNTY
2010
2010
2010 44359
2010 44359
2010 44359
2010 44359
I2010 44359
1 2010 44359
,2010 44359_
44359
PORT PORT
PORT ANG PORT ANGELES
S D #121 SCHOOL DISTRICT #1214
NTH OLY LIB NORTH OLYMPIC LIBRARY
HOS_P #2 HOSPITAL #2
WSMET PK DIST WILLIAM SHORE MET PAR
CITY STORMWATER CITY STORMWATER
WEED CONTROL WEED CONTROL
2010 44359 TOTAL.
1 2009 616602008 ST SCH STATE SCHOOL
2009 616602008 CC -GEN COUNTY
2009 616602008 PORT PORT
1 2009 616602008 PORT ANG PORT ANGELES
2009 6 6 #121 SCHOOL DISTRICT #121
Agent Code.
PA 121 PORT ST CNTY H2 L Land Use Code 11
DFL N
Remodel Property N
Section:
Mapsco
Map ID
Owner ID
Ownership
Exemptions:
2
13653
100 0000000000%
SNR /DSBL
NOTE If you plan to submit payment on a future date make sure you enter the
click RECALCULATE to obtain the correct total amount due.
First Second
Half Half
IBase Base
Amt. Amt. Penalty I Interest
$43.62 $43 62 $0 00 $0 00
$3.26 $3.27 $0 00 $0 00
$46 76 $46 76 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00
$6 74 $6 75 $0 00 $0 00
$9 52 $9 53 $0 00 $0 00
K DIST $3 03 $3 03 $0 00 $0 00
$36 00 $36 00 $0 00 $0 00
$0 82 $0 81 $0 00 $0 00
$172.96 $172.99 $0.00 $0.00
$43.27 $43.27 $0 00 $0 00
$21 91 $21 89 $0 00 $0 00
$3 10 $3 10 $0 00 $0 00
$41 07 $41 07 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00
Base Paid A
$87.24
$46 43
$6 53
$93 52
$0 00
$13 49
$19 05
$6 06
$72.00
$1 63
$345.95
$86 54
$43 80
$6.20
$82.14
$0 00
http. /vpn. clal lam. net. 8084 /propertyaccess /Property. aspx ?cid =0 &year= 2010 &prop_id =61 10/7/2010
Application Number 10 00001146
Application pin number 710018
Property Address 704 GEORGIANA ST
ASSESSOR PARCEL NUMBER 06.30 00 5 1 3950 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
2 ton heat pump
Owner
BERG LILLIAN
704 GEORGIANA ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
-Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
WA 983623510
ELECTRICAL HEATPUMP
174995
56 00
10/07/10
4/05/11
56 00
00
56 00
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
Contractor
1 00 56 0000 ECH EL LVT THERMOSTAT
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES
(360) 452 9813
Plan Check Fee
Valuation
Paid Credited
56 00 00
00 00
56 00 00
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Date 10/07/10
DATE. RESULTS
do 11 L0 -AY
10 gilt()
WA 98362
0 0
0
Extension
56 00
Due
00
00
00
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
Date:
(31;
City of Port Angeles Permit Application
ti
Building DlvlslonlElectrical Inspections
321 East Fifth Street P.O. Sox 1150 j •i�
Port Angeles Washington, 98362
Ph: (360) 417.4735 Fax: (360) 417-4711 CC C 6 2000
Date. ID 10
ELECTRICAL
X 1 2 Single Family Dwelling INSPECTIONS
Multi- Family or Commercial*
Commercial Addition Alteration Remodel Repair*
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 1c v)t f O r
Building Square Footage:
Description of above ,h�' lit latiOA CA PCi'
Owner of r anon Contrac or information
Name: K} r' Name: 4 eccV l
Mailin Address: Mailing Address: 9D2 1
City' State. Zip: City State: Pc Zi L
D'
Phone: Fax: Phone: Fax
License Exp. License I`k I Exp. 11Je11\hA
Unit Charne
93.75
$113.75
$160.00
5205.00
$291.25
2.00
57.50
2.00
72.50
86.25
$116,25
$131,25
75.00
69.00
75.00
50.00
50.00
93.75
80.00
86.25
27.50
57,50
86.25
43.75
iZ0 3
Signature of ow r electrical contractor or electrical administrator
Datiolo o
Total (Qtv Multiplied by Unit Charnel
Service/Feeder 200 Amp,
Service /Feeder 201 -400 Amp.
Service /Feeder 401 600 Amp,
5 Service /Feeder 601 1000 Amp.
ServlcelFeeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/0 Service Feeder
5 Eech Additional Branch Circuit
Temp. Service/ Feeder 200 Amp,
Temp. Service /Feeder 201 -400 Amp.
Temp. Service /Feeder 401 -600 Amp.
Temp. Service /Feeder 601 -1000 Amp.
Portal to Portal Hourly
SIgn /Outline Lighting
Signal Circuit/ Limited Energy Commercial
Signal Circuit! Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
13. Thermostat
$3 Total
9NI1'"3H c13H1C3M 1 1C
O Cash
Check
Credit Card b
Owner es defined by RCW 19.28.261: (1) Owner will occupy the structure for two years after this electrical permit Is finalized. (2) Owner is required to hire an
electrical contractor if above said property is for sale, rent or lease
After reading the above statement, I hereby certify that I am the owner of the above named property or a ticansed electrical contractor. I am making the electrical
Installation or alteration in compliance with the electrical laws, N.E.C. RCW. Chapter 19.23, WAC. Chapter 296.468, The City of Port Angeles Municipal Code, and
Utility Specifications.
r
L_TSGSb09Et EE bt 010E "90101
.... CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
~.,r-I-~..~..~i~ r'~-I~lVIll ISSUED: 11/26/2002 PERMIT NO: 13875
OWNER/APPLICANT PROPERTY LOCATION
LILLIAN BERG 704 GEORGIANA E
704 GEORGIANA Lot: N 1/2 8&9
Port Angeles, WA 98362 Block: 39 [] Long Legal
360/457-5733 Subdivision: N.R. SMITH
T: S: Parcel No: 063000513950000
CONTRACTOR ARCHITECT
AFFORDABLE SERVICES N/A
258663 HWY 101 W
SEQUIM, WA 98362-0000 , 98360-0000
360/452-5264 360/000-0000
PROJECT INFO
Project Value: $975.00 SFD Units: 0 Commercial: 0
Project Type: REROOF SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SCi FT: 0
Zoning Use:
PROJECT NOTES
TEAR OFF, FELT, COMP
RECEIPT# 9959
FEES ASSESSMENT
Building Permit: $38.75 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $43.25
Plumbing: $0.00 AMOUNT PAID: $43.25
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
Separate Permits am required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction acthodzed 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
:\PLANNrNG'~FORMS\ l 102, I 5 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO ~'OVER,~
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 I NO
FOUNDATION:
PLANNING DEPT. 417-4750 ~// PLANNING DEPT.
BUILDING 4174815 ~[ -~ - O~~,~'~ BUILDING
~o r ~
BUILD lNG/FIRE PERMIT APPLICATION ,.,.~, ~: : :~ ¢'z s-.
The Build, nE~Fire P~rmit Apph'cat~oa mu~t b~ ~lled out co~nplel~[y. , ,,
Please ~pe or p~n~ In ink. If you ~ave any quesflan~, pl~e call (J60) 41%4815
F~ nttmber: {360) 417~711
_ ~ ~/~ ~ City, . ....
Credit Card Numb.._ ' ' ~ ~p, Date. VISA ~ MC.,
CLALLAM COUNTY 2~C~L ~[R: ......
TYPE OF WORK;
: ResidenliaJ a Mulli-fi.mily t: Commer¢i,ql ~ Retool :
BL"~.IDINC FEJ~a'r .~PLICATION SUB~i['FrAL: ¥~,ar ~mptm~ ~ti~, ~teptm (tbt ~dtd~n~) ~d b~il~g ~n~m~ou
~ ma~ ~ r~s~ ~ ~e B~l~g Div. L0 ~mply ~ c~mt ~ SCb~ m. Cad,act ~e P~t Coor~mor m 417-4~15 Dr ~sia~i~
~I~TION OF PLAN ~VlEW: If no p~mit is i~u~ ~ I~0 day; of~e dat~ of ~Nicafiou, fli~ a~pll~Oon ~fl ~ir,
by limtal~i %e ~g ~dd ~ ~d ~e tim~ For ~ion by ~hc applier up to I~0 day~, ou ~.m r~umt by ~e ~li~t
~t~ S~on ]07.4 of~e Unifo~ ~il~ng ~de, cu~t ~iQaa). No application ~ be ~t~d~ more ~ once.
/ heret~v certeS, that I haue read and examined this agplicalmn a~d ~aw the sa~ ~o bs t~e and carrect, and I am authorla~d to ~Fplj,
for th~ pe~t [ undet~ta~d It (~ .or t~ C~6,'~ legal r~pa~s~bl'[~ ~ deferrable ~at peemit.~ v~'e ~qui~d; it ~m~l~ tlt~ applica~d'~
"~xpo:u'~btlfO' lo defgr~ttle ~t per~(f$ are reqtto'ed and to ~taltt such,