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Home My WebLink About1638 W 14th St - BuildingApplication desc RCP #10 18 Owner BARRY J /DOLLY L BURNETT 1638 W 14TH ST PORT ANGELES Permit Additional desc Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date Qty Unit Charge Permit Fee Total Plan Check Total Grand Total Signature of Contractor or Authorized Agent Date T' \Policies \I 102 15 [10/08] WA 983636808 RIGHT OF WAY RCP 10 18 168120 EXCEL UTILITIES 150 00 6/28/10 12/25/10 Per CITY OF PORT ANGELES PUBLIC WORKS UTILITIES 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 10 00000653 Application pin number 680526 Property Address 1638 W 14TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 4 0745 0000 Tenant nbr name QWEST Application type description PUBLIC WORKS UTILITES Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Contractor OWNER CONSTRUCTION Plan Check Fee 00 Valuation 0 1 00 150 0000 ECH PW RW CONST EXCAVTION OTHER Special Notes and Comments Installation per attached City Detail Traffic control per attached plan Notify City Inspector proir to start of work by calling 360 417 4831 Fee summary Charged Paid Credited Due 150 00 150 00 00 00 00 00 150 00 150 00 00 7-134 Date 6/28/10 Extension 150 00 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 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 authorit 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 CALL 417 -4831 FOR UTILITY INSPECTIONS PLEASE PRO\'IDE A MINIMUM 24 HOUR NOTICE IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND 4CCEPTED POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE T ,Policies \1102 15 [10/08] RESIDENTIAL CONSTRUCTION R.W PW/ ENGINEERING 417 -4831 FIRE 417 -4653 I I PLANNING DEPT 417 -4750 I BUILDING 417 -4815 PERMIT INSPECTION RECORD YES I NO I I I I I I I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO CONSTRUCTION R. 1W PW ENGINEERING FIRE DEPT PLANNING DEPT I BUILDING I I I 1 I I I I PREPARED 8/25/06 8 08 44 INSPECTION TICKET PAGE 27 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 8/25/06 ADDRESS 1638 W 14TH ST SUBDIV TENANT NBR BURNETT RES CONTRACTOR DAVE S HEATING COOLING PHONE (360) 452 0939 OWNER BARRY J /DOLLY L BURNETT PHONE PARCEL 06 30 00 0 4 0745 0000 APPL NUMBER 06 00000905 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME99 01 8/25/06 MECHANICAL FINAL TIME 13 00 jeannie 452 0939 08/24/2006 12 26 PM DYASUMUR COMMENTS AND NOTES Application Number 06 00000905 Date 8/21/06 Application pin number 046195 Property Address 1638 W 14TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 4 0745 0000 Tenant nbr name BURNETT RES Application type description MECHANICAL APPL PERMIT P`it/ Subdivision Name ��VV Property Use �Z j 6 Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 9615 Owner Contractor BARRY J /DOLLY L BURNETT 1638 W 14TH ST PORT ANGELES WA 983636808 T•\Policies \1102_15 building permit inspection record05.wpd [1/4/2005] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Signature of Contractor or Authorized Agent Date DAVE S HEATING COOLING PO BOX 413 PORT ANGELES WA 98363 (360) 452 0939 Permit MECHANICAL PERMIT Additional desc Permit pin number 84970 Permit Fee 64 70 Plan Check Fee 00 Issue Date 8/21/06 Valuation 0 Expiration Date 2/17/07 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 14 7000 ECH ME INSTALL 100 FAU 14 70 Fee summary Charged Paid Credited Due Permit Fee Total 64 70 64 70 00 00 Plan Check Total 00 00 00 00 Grand Total 64 70 64 70 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 goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not pres 'me to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of c•,,> lion. Signature of Owner (if owner is builder) Date CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. CALL 417 -4807 FOR PUBLIC WORKS UTILITIES 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 1 NO FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS 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 SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT BUILDING PERMIT INSPECTION RECORD 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 FINAL DATE ACCEPTED BY. FINALS Zj /,.5/O b DATE rI L.-- SEPA. ESA. SHORELINE: ACCEPTED BY. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES 1 NO 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION RW PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 I 1 1 I FIRE DEPT I 1 1 PLANNING DEPT 417 -4750 I i t 1 1 1 PLANNING DEPT I 1 1 BUILDING 417 -4815 1 4 /G /a6 1 ih- 1 1 BUILDING 1 1 1 T• \Policies \l 102_15 building permit inspection record05.wpd 1/4/2005] Aug 17 06 09:35a Applicant or Agent: -Pave 5 H-eek+1 n 7s Owner Doi( t 15 -e-f Address: S City Po r-i ..ca_s Architect/Engineer Contractor 3)a t/e Address: 10 .e oar (3 PROJECT ADDRESS. PLANNING USE ONLY DAVE'S HEATING COOLING LEGAL DESCRIPTION Lot: Block: CLALLAM COUNTY PARCEL NUMBER. Y v COMMERCIAL/RESIDENTIAL. Occupancy Group No. of Stones: Lot Size: Existing Sq. Ft. Total lot coverage BUILDING PERMIT APPLICATION 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 Phone: 74 (C. 99 Kc. State ce se ri c YY Exp So7 Phone: 1 15a- O139. City Povq- Zip: '7R 3�a 3 g W e-s-f (q±h- 5+r=e -e-+ ZONING Credit Card Holder Name: Billing Address: City- Credit Card Type VISA MC TYPE OF WORK. Residential New Constr. Re -roof Stove Multi family Addition Move Garage Commercial Remodel Demolition Deck 0 Repair Sign Other BRIEF DESCRIPTION OF THE PROJECT s fi JJ o o,,, an k aaj Du D /ow vo 4.1%.2.4'rs, n:sr ESA/Wetland(s): 0 Yes No SEPA Checklist required? Yes 0 No Other Subdivision. cfi- 1 Occupant Load: Proposed Sq. Ft. p1 FOR OFFICIAL USE ONLY Date Rec. C/ /l 7 /O( Penn it is 4 f I Ar i'; Date Approved Date Issued: Phone: O 9 Phone: .e 7 5 7 F Zip $3G Exp. Date: SIZE/VALUATION SF /SF SF /SF SF /SF TOTAL VALUATION cre k e_(,z,_c f-n C.. --R rv+0.csz Construction Type: TOTAL Sq. Ft APPROVALS. PLAN BLDG. DPWU FIRE. OTHER: VALUATION OF CONSTRUCTION. In all cases, a valuation amount must be entered by the applicant This figure will be reviewed and maybe revised by the Building Division to comply with current fee schedules Contact the Permit Coordmator at 417 -4815 for assistance. PLAN CHECK FEE. IF a plan check fee is die it must be submitted at the tune 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 If no 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 R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. thereby certify that 1 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 ,nof the City's, and that 1 must obtain such permits prior to work. TARVESSU3LDG forms brochures12004 Buildingperrrtitwpd Applicant: 1 Date: i7/ r s~ ~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION J2\ EAST 5TH STREET. PORT ANGELES. WA 98J62 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning Application valuation Owner 8/25/06 06-00000905 Date 046195 1638 W 14TH ST 06-30-00-0-4-0745-0000- BURNETT RES MECHANICAL APPL PERMIT RS7 RESDNTL SINGLE FAMILY 9615 Contractor BARRY J/DOLLY L BURNETT 1638 W 14TH ST PORT ANGELES WA 983636808 DAVE'S HEATING & COOLING PO BOX 413 PORT ANGELES WA 98363 (360) 452-0939 ~II EmOEt I S-Jc,.()711 I I I 1'--... II~ II\.N Ie}) I I I t I I I ':--.... ~ ~~ I I u i\ I Permit Additional desc Permit p~n number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL EXTRA MILE/ HP+OUTLET 85340 EXTRA MILE 48 10 8/25/06 2/21/07 TECH & ELECT , LLC Plan Check Fee Valuation 00 o Qty 1. 00 Unit Charge Per 48 1000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48 10 Perm~t Additional desc . Permit p~n number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW DAVE'S/ T-STAT 85225 DAVE'S HEATING 36.40 8/25/06 2/21/07 RESIDENTIAL & COOLING Plan Check Fee Valuation 00 o Qty 1 00 Unit Charge Per 36 4000 ECH EL-LVT-FIRST THERMOSTAT Extension 36 40 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 84 50 84.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 84 50 84 50 00 .00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER. INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES I NO UITCl1 ROT IhH-lN I CUV~K SERVICE FINAl IIb.'- p-~ I kIF':) I GENERAL COMMENTS: PW.II02.U (4'961 ~61 CITY OF PORT ANGELES. DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT FEE RECEIPT NUMBER . /k~ /H..'-!.~"" ,. ~ ~//t;:.,9' TOTAL FEE /f z..C-L. CONT. LIC. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY , ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT Site Address / t. "3 B- I-V I 1,1 T J, CORRE ADDRESS IS RESP~~SlBILlTY OF APPll~ANT PERMITS WITH WRONG ~.o!WE~SjS ARE CANCELLED r- J Owner F F tl> ~ '" c:: 10\. Installation By /y{, /~,..,,.., 4 A..../.-S J;:.. /~.c. Owner'sAddress /t;. ~ f? LA../ / LJ TJ, Installers Address :2:38 L....J 8 n Day Phone Installers Phone o/'.s-- .? ~ k t? 9 Application is herebY}Tlade for Permit to install Electrical Equipment as follows: 1...LJr J i? tIP ~ ~d /' T; b -.J ~ Wiring Method ~x. . NUMBER AMP 120V 240V NUMBER AMP 120V 240V USE OF CIRCUIT PEA 100R FEE USE OF CIRCUIT PEA 100R FEE CIRCUITS CIA 10 30 CIRCUITS CIA 10 30 LIGHT / /f SIGN LIGHT 50 VOLTS OR LESS CONVENIENCE MOTOR CONVENIENCE MOTOR APPLl.A.NCE . MOTOR DISHWASHER FIRE ALARMS . DISPOSAL BURGLAR ALARM RANGE: MISC. OVEN WATEFI HEATER LAUNDRY DRYEF: . REINSTALLATION LIGHT FIXTURE # FURNACE . SUB TOTAL FEE GAS - OIL FURNt,CE ENERGY FEE ELECTRIC BASIC FEE / / -;;;6 ~ ELECTRIC HEAT /0- TOTAL FEE ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.C. UI'.IlT AMP PHASE FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICE AW.G. I SUB. TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH Date Application made /Yf,cy ( ? fl'~ ,19 I certif~1 that the work to be performed under this permit will be done by the installer and' . 'CONTRACTO OR OWNER (OR AUTHORIZED AGENT) Permi~sion is hereby given to do t!1e above described work, according to the conditions hereon and according to the approved_plans and :::':~~:~~:""'".;; J;"o,"m.'''"''.''"m':ilil1J~"' ,. Notify Department of City Light by Street Address and Permit Number when ready'for inspection. Work must not be cove.red or current turned on before inspection and O.K. for covering or service has been given by Inspector in Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158. I WA,RNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER - WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report OLYMPIC; PAINTERS, INC. REPORT OF INSPECTOR DATE OF VISIT MADE BY REMARKS . ,. . . ',. . " - , , , " , <- .. . , , - '- " - .......' , '. . , . S'/~I~~ A .~ O.K. FOR COVERING I , I. . . 1.,/ r ! 1(1-.(. l~\ , y FINAL O.K. \ \ ' \. . z Cl a: cl: :::E ~ J: I- Z W l- . I- o Z o Q . L- - lIIUIW CITY OF PORT ANGElES LIGHT DEPARTMENT ELECTRICAL PERMIT -.~ N~ 18220 . .---., Lj._ /-7 N port Angeles, Washlngtonn.n:;:..n...mnu...n...mm......m.m....mmn.. 19.000.... In accordance with the City Ordinance to regulate the Installation, extensIon. or repair of elec- trical equIpment In, on. or about any buildIng or other structure In the City of Port Angeles, per- mission is hereby granted to d6 electrical work as Hsted below. . j l J .r-- - L-.' j -. / c.j Address .nn......m.mn....nm.n..!.mn.....nnnn..n..n..nn.nn.nnn..mn... Occupancy.n..n.....n..................nnn........n ~::~~.~=~:~:::::~:Q~~~~~::~~~;~~:~:~~~;~::::::::::::::....~..:::::::::=::::::::::::::::::::::::::::::::::::::: /)r)A~u Service, volts ......_..........___.................. ~ No. wires n_.........._.__........_............. a tL J Size wlres...::..............................__. LIght Outlets...____..............__......._.._.....~... Rl~ceptacle Outlets......______............____... Type at Wiring: Armored Cable ...___m.......hm_........ Dryer, KW........__nu.......___.....___._.....___ Non.MetalUc ........___.............___..___. ....--..-........----------..----...........---........-... Main fuse .........._........._____....h........ Knob & Tube..........................._..,:: ---- RIgid Conduit ............................... Metallic Tubing ............h..._......... Raceway nnn..........___............__..._ CIrcuits, Llght__.......___.............__............ Utility ..........n..........nh.............._n.. Range, KW huh_.h__.___......____ ""ater Heater: KW...........___......__.....________ Ht~at: KW........................_..........u........ Motors: size, volts and phase: Heat ....____..............._..............._..___ n.......__..__.....____.........................___....... Range .....______..........______.........__.__.... Water Heater _._.._.......mnu........... Motor ............__.._._.......................... h....hh.......___nn..................._.............. .....--.---..............---.................__........__n .-----...-----.........-----.............................- Dryer ..........n........................_..........._ Furnace .........................'_................... Remarks: n.. ...n--pun.n-nnn...n.n...nnn._n.hn__nn._nn.n..n.n.n...nn____nn..-.u--..nn.--..nu.._n___....nn.n_n.nnnu.._nu..._n.._.nnn..._n -n.-n-h-n-pnn-__nun____u__u_un._n_uuu_nuun__u..___nn...._.unuh..unnnu-_n...u_nn...nn_n.n__u.nu...n_nu_nn....nnn._..n_n.... Permit Fee Treas. Receipt ~ ~ $..!..:~t:.C<-c:.m....m.... No../.:2.2./.2..?...... By ..-%:..:.~m..m.......m....7d':...~ NOTICE-Current must not be turned on unttI Certificate of Inspection has been issued. If work is to be con- ce::lled due notice must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION N~ 18220 ELECTRICAL PERMIT I ro 3 f- - tJ -- / cj L/_ / 1- F? Address............_......_._..........._..........._..........................................__....._.......................................Date..._b...._.._.._.._.........._._...._...._._......... O.mer ..a.g.e.?::':::.~.....d.g~-:(...........n...........n... Tenant..-::..l~~:.-:J.___......___....... Q. ~ ;;//~ WIring Contractor......................C~...~...._........\._.._..........._.........b........_............................. By.-.:f-.~-!.j..........:........:.~.................... NOTICE-Current must not be turned on untll Certificate of Inspection has been issued. If work is to be con- cell-led due notice must be given the Inspector so that work may be inspected before concealment. 1M Olympic Printers, Inc. "I ELECTRICAL WORK PERMIT APPLICATION " Job wired by o Electrical Contractor 0 Owner Installation description [J Commercial 0 Residential Ele . cal contractor name 1.1"11/~' ~ '" P;rchaser's mailing address ) L120. Iir?r 4/ I.j. :~f~;'~u!:,Vl~~J 3 0 - <f~:;J- ot}~ LRn_se number In ..J}fIVI.$#CP'I/t: V. <. ) Q38Lf iF Itf?, DrM State ZIP ---j, lA 11'1 q 8'3 K;S., Date Expires ? . DNew Q Altered! Addition FAX number .s-... '"-<.. Premises owner's na~ BtAr;re77 Address of inspection /t;.3'r (.jj /"I~ ~. CH~,..f #~UJ tv' ~ 7J??G.3 Phone number to schedule inspection: -'167 - 8& Owner as defined by RCW./9.28.261:(/) Owner will occupy the struclurefor 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 licensed electrical contractor. I am making the electrical instal- lation or alteration in compliance with the electrical laws, N.E.C, RCW. Chapter 19.28, WAC Chapter 296-468, The City of Port Angeles Municipal Code, and Utility S cifications. Sign or or electrical administrator o Cash 0 Check # o Credit Card Card # Visa Mastercard Discover x Date: Expiration Date of card Inspection fee $ Electrical Load Additions and or su Q NO LOAD CHANGES Q Baseboa,d KW o Furnace KW o Heat Pump Ton LAR o Fan-Wall KW Service Information o Overhead Service o Temp Service o Underground Service Voltage PhaseQ 1 Q3 Service Size: Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ".- ROUGH-IN ".- TIIERMOSTAT / SERVICE ..... Dale Approved By Dale Approved By " Date Approved By / ".- FINAL DrrCH FEEDER " Dale Approved By ../ ..... Date Approved By ./ Date Approved By Inspection Area, Building or Equipment Inspected Action Taken Electrical Date Inspector . /hf7 ~121hl'-- ,/ v AUG-23-21211216 1218:39 AM I ~.;I"'lrl<.1 Conlractor o AD.'UII Perlnlt lJ Alarm E.JANSSEN 36121 452 2982 P.I2I1 .. ELECTlUCAL WORK PERMIT APPLICATION 5"" , ..~ ... . DOwner 1''ii;;....:.r' Q Carnival 0 Commerdal 'l6tResldentla.1 CJ Relildentlat Malot. Q SiRnt D Thermo5tat 0 Teltcom. . , Cl Request Inspection lmHal1111j(ln descriplion e-,;L{..~ Jo w;r~d by Ja.EI..trlca. Contractor 0 Owner .J.L-j H^ ~ t r~_G.~ bt -<......k P..u.'\. F D ~I-~ . +0 LiC~Il~ numhcr ~t~t-~Il ~I <;. q..- tv .,u..) iAJ,J. o......rc;;; lJe Sl;ll~ ZIP vJ I} V~ ~ "z.. f.AX fHil'Tlber ..",... (J -<'{:~'-'-3 r' 5 B '-"- fl-."ds..t-t a!'of-< r D Cash D Check # I hcr~' by cl:rlify that' am !he owner of the abov\'" named propcl'ly L'j" " h.'ceosed U Credit Card CICCb'cal conlractor (or the finn's authorized. ilgent) and I.\m makin~ the electrical Insta atiol1 or-ahcraf;on in compliance wirh the ekelrical JlllV. (,haplcJ'19_2~ RC'W. Card # SlCblllurC! 0 uwner. l!ledl'lcal Cll1l1rRC1or nr eClt'lcllJ IIdmlnhrrlltnr X JD inspection Area, Building nl' FqllirmC'11T rn~pcctcd A.:tion T:J.kCI1 EI~ctric,,1 : DIle In'!;pl.lCIOr -. I //J1/_loJf. t::j, ,...... Jt /) AP /: / -- -- I _'o.--_~.____ ----_.-._---- : \l _~u --- -- , -- --- - WALLS hnullltion Only [Il,'~ AI'I'tU"~11 By Cover bMe 'f:'l~BY III N LOAD CHANGES Cl SA eboard KW o Fu nBee KW OH tPump Ton o Fa~-WEln KW . ~ BpsAt visa Discover Mastercard Ex.piration Date of card ,~ THERMOSTAT l),u~ ^1'j1"..~\llly D1TOI -- D'lle ^;m;:~l'tlfly SERVICE '\. D.I~ ^PfIruvlld By F'EEOEI{ I '\. D.11l Apprcvcli b~ .J' /, CEILING [nllu!lni(ln Only -n~ Cll\'l'r Al1l'rtlv"tll1Y -~I~- -Ailjlr1,~ ~1lleJn1QlDIIIlJll.D LAR c:J Overhead Service o Temp Service Cl Underground Serviee Volta.go Pha68 0 1 0 :] Service Size: __ Feeder SiZe: J ELECTRICAL INSPECTION ..~ ,. . ... WIRING REPORT 417-4735 ADDRESS tJ ~ APPROVED NOT APPROVED o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0 D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0 D. . . . . . . . . . .. . . . ... . . SERVICE. . . . .. . . . . .. . . . . . . . 0 D. . . . . . . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . . . 0 CORRECTIONS NEEDED: .(!) ~Uf/AJ ~ !fL A'7hV;;; ~~~./))>>tI:.. ~"L be- ~h~ tn.,-- 4//7 - ~73)' I"A-y?/ --' nt... er.e... / p .~ (:)tt.L<;7]D.N5 I A./~ jt?t.{ JMvIf , 41- . NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381