The URL can be used to link to this page

Home My WebLink About526 S Liberty St - Building ~ pORT ~ $'4.0~~~ ha ..... -==>r ~ 'l.oii:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32\ 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 04-00000506 Date .843250 526 S LIBERTY ST 06-30-11-5-4-0060-0000- ELECTRICAL ONLY 6/08/04 RS7 RESDNTL SINGLE FAMILY o ~. c~ - Owner Contractor ELLIOTT, PATRICIA 526 S LIBERTY ST. PORT ANGELES OWNER WA 98362 Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL FURNACE TO HEAT PUMP COLEMAN ELECTRIC 46.70 Plan Check Fee 6/08/04 Valuation 12/05/04. .00 o \j\ ~ ~ Qty Unit Charge Per 1.00 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 46.70 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 46.70 46.70 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 46.70 46.70 .00 .00. L/\ , c-. eft ~ U ~ 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 sal11e 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 T:IPLANNfNGlFORMSI1102.15 [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 UNLA WFUL TO COVER, INSULA TE 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 FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I PLUMBING UNDER FLOOR/ SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CHIMNEY I HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARA ToE PERMIT #'5 SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 U?/- j JIi) ELECTRICAL II n4" LIGHT DEPT I CONSTRUCTION R.W. / PW/ -, -, CONSTRUCTION - R.W. \ ENGINEERING 417-4807 PW / ENGINEERING \ FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\ 1102.15 [11114/2003] .... CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 4/19/2002 PERMIT NO: 13369 OWNER/APPLICANT PROPERTY LOCATION 526 LIBERTY S MIKE & NANCY MALLEI{ 526 SO LIBERTY Lot: D Port Angeles, WA 98362 Block: 1 [] Long Legal 360/452-5129 Subdivision: CRESTHAVEN T: S: Parcel No: 063011540060000 CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 360/000-0000 PROJECT INFO Project Value: $10,000.00 SFD Units: 0 Commercial: 0 Project Type: ADDN/REMODEL SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: PROJECT NOTES CONVERT SECOND STORY DECK TO OFFICE, ADD SHOWER ENCLOSER RECEIPT~:8971 FEES ASSESSMENT Building Permit: $181.25 Misc Fee 1: $0.00 Plan Check: $72.50 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: $285.25 Plumbing: $27.00 AMOUNT PAID: $285.25 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions ot laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance ot construction. Signature of Contractor or Authorized Agent Date Signature of Ownetr (if owner is builder) Date T:\PLANNING~OKMS\1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES t NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PEI~MIT: # PLUMBING UNDER FLOOR / SLAB WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING 5~--~- GE ~.. ~/~t DRYWALL T-BAR INSULATION W^LL PLOOR/CEILING I MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD/ DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'$ SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQU1RED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGENEERING FIRE 417-4653 FIRE DEPT. BUILDING 417-4815 . BUILDING T:\PLANNINGXFORMS\I 102.15 [4/2002] pORT ,~, ] FOR OFFICIAL USE ONLY: BUILDING PERMIT - APPLICATION P mit : Date Issued: The Building Permit Application must be filled out completely. Please type or print in ink. If you have any questions, please call 41%4815 Applicant or Agent: ~O~ ¢C~4U ~ Phone: Owner: ~1[~- ~ ~ ~ ~ Phone: ~' 2 - Address: ~ ~,. ~l&~ City: ~A . Zip: Mchitect~ngineer: Phone: Contractor &~ ~D{ License ~: g~ ~0V~ ~ ~/~p: Phone: Address: City: Zip: LEGAL DESC~PTION: Lot: / Block: ~ _ ,& Subdivision: C~6F H ~ CL~L~ COUNTY P~CEL NUMBER: ~- ~O- [ I 2~q~Q~edit Card Holder Name: Billing Address: City:. Credit Card ~: Exp. Date: ~SA MC T~E OF WO~: SIZE~UATION: ~ Residential ~ New Cons~. ~ Re-roof ~ Wood-stove [q¢ SF. ~ $ /SF. =$ ' /~ ~ Multi-h~ly ~Addifion ~ Move ~ Garage SF. ~$ /SF. =$ ~ Co~ercial ~ Remodel ~ Demolition ~ Deck SF. ~ $. /SF. = [ ~ Repair H Sign ~ TOTAL VALUATION $ BmEFDESCmPTIONOFTHEPROJECT: ~fififC~ ~00[ T/~ /2 '~ [2 ~ COMMERCI~SIDENTI~: Occupancy Group:. Occupant Load: Cons~ction T~e: No. ofStories: ~ LotSize: ~ % Lot Coverage: ~ % Existing Lot Coverage: )~O~ /sq. fl. + Proposed Lot Coverage ~ /sq. ff. = TOTAL LOT COVE~GE: PLANING USE ONLY: ~PROV~S: PL~ Notes: BLDG. DPW FI~ ES~etland(s): ~ Yes eNo SEPA Checklist requked? ~ Yes ~ No O~er: OTHER BUILDING PE~IT APPLICATION SUBMITT~: Your application and site plan must be filled out completely to be accepted for review. %e Building Division can provide you with more detailed Mfo~ation on the application and plan sub,ual requirements. Your completed application, site plan (for additions) and building cons~ction plans are to be submaed to the Building Division. V~UATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. ~is figure will be reviewed andmyberevisedbythe Building Divisiontocomplywithcuaent fee schedules. Contactthe Pe~t Coordinator at 417-4815 for assistance. PL~ CHECK ~E: Yo~ plan check fee is due at &e t~e ~e building pe~t application and cons~cfion plans are subdued. All other 'pemt fees are due at ~e t~e ofpemt issuance. EXPIATION OF PL~ ~VIEW: If no pemt is issued wi~M 180 days of the date of application, ~is application will expire. ~e BuildMg Official can extend the time for action by the applicant up to 180 days upon ~i~en request by ~e applicant (see Section 107.4 of · e UMfom Building Code, cu~ent edition). No application can be extended more ~an once. I hereby cert~ that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for this permit. I understand it is not the Ci~'s legal responslbili~ to determine what permits are required; it remains the applicant's responsibili~ to determine what permits are required and to obtain such. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ._~/~ ~7--- Time Received by /~ ~/' (phone, person) Location of Work to be inspected 5_~_~ Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Permit No. Sewer Foundation~ Chimney~, Plumbing Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date ~ ' ~ Time By .,' ~'', Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel []Asphalt [~PCC []Other [] Repaired by City Work Order # I--IRepaired by Permittee [] COMPLETE ~'] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~' --~'-~, Time Received by ~'~'~' (phone, person) Location of Work to be inspected ~,'~,6 S ~, t [,~'~v Name of person requesting inspection / Address of person requesting inspection Phone No. ZT/6~..~ Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing Fi~ Sewer Excav. Other INSPECTION NOTES: ~,' Inspected: Date ~ · '~ ' ? ~ Time. By .~;~..~-,/~, Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel []Asphalt [~PCC []Other [] Repaired by City Work Order # I--} Repaired by Permittee [] COMPLETE I--] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) Site Address: CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO. 7> .. ELECTRICAL PERMIT DATE Installed By: o READV FOR INSPECTION License Number: ~ WI LL CALL FOR INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: Sq. Ft. 9q Residential " Heat KW I S- [J BaseboardfKI Furnace/Boiler [J Heatpump 0 Other [J Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) ~ New Construction b' Remodel o Service update/alter/repair o Overhead IlC1' Underground Voltage 010 03.0 Service size -;J nn o Temporary o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) Amps Details/Description: teL - I rj~~ r /)~ .€.~r ../ W.S. No. Service Capacity: 0 OX 0 Not O.K. r Acvr~ Ditch inspection O.K. /\J'tp. Rough-in/cover O.K. J ^"~ O.K. to connect service .IIJf$inal O.K. , Size Comments Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Site Address: Installer: s ~ Permit/Receipt No. New Meters . Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Buiiding Permit. PHONE 457.0411, EXT.158 or EXT. 224. -r<; I Jp I Inspector NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ~. LfO,OO Amount paid GREEN - Top: Inspector, Bottom: City Hall ~ WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer OLY"'''IC PRINTERS. INC. W.S. No. Service Capacity: 0 O.K. 0 Not O.K. .~ 0 Ditch inspection O.K. o Rough-in/cover O.K. ~ ~ O.K. to connect service ~ ~ Final O.K. \ I I I \ , . . CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO g;(PSCj DATE ,<-tf-~() ELECTRICAL PERMIT Site Address: o READY FOR 0 WILL CALL FOR INSPECTION INSPECTION License Number: Phone: Installed By: Phone: OwnerfBusiness: Owner/Business Address: Sq. Ft. o Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction o Remodel o Service update/alter/repair o Overhead 'f! Underground Voltage 010 03.0' Service size o Temporary Amps o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) DetailslDescription: - { em p Size Comments Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending F Address: 5 {,2 (p 5 Ealler: Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. -r-S / Ii NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ;:10. 00 / Insp ctor Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLV"'''IC PRINTERS, INC. FROM : Electric~S FAX NO. : 4525424 Ma~. 09 2002 04:41PM P1 -...-I:~, : Ei~.,:t""L~.;o~ F~,. ~{J. J';2G.;.2.: ;:6 Z:Z:02 Jr'; J:!Cr~ ..~"'f ~ ',...~ -/ ' :~~ '-.\".-1'" ~~~~ ELEC-;::,C,l,'-. ::-';;:;'~, T ;"':'PL. CAi 01\, ~-:-:-5' ~ 10-':'-0 L. 7-~ 5 ':5 , _t.. . ~ ".'. ;~.l; ::leCl"';':'! ;;"~r-: ....?P'....:.~: )"' ~~ll I>e Ot.:1 (:.~~~lt!H....:i Pl.ei:Se type Q{ rlilpri~; in tl'\K If yo(,. ""ltft "'ly ~l.i,,"IJOI\S., 131e85oCl c.3:' (3&0, '"1413S FElJ I'holrn~' ~*') 4.n47" REQUeST INSPECTION ~ -">Coo "1<;'1..(......14 .~ '1"" ~ -lh -; 'I PrlO"61" ___ z"..c(1~' ~ ., /{-fJC'2- .hor..4~"'-"''"'i;~ . 2;0 .9'f;~ t, 2.. O...~el cr EI!::c ConlfOlC;10r A.~~.,1 f la f- A rl ,~ - \9 r,/'~tE p~i.r \"'~ p'epe~ OWl':cf ~..'.,,: 5'-1<- <;.L,L~ 0>1,' -r?..... .~ I. r' - E:ecu'I'C8ICQrt:'act::ll':'2:IGl (1'f'"ll-' 'li~,("',.r:'.p 1->')( l.t;~~." L- ~..[.E-.p A,o,." ~Q. Or",,:-,,'- Vc<II'rr2.& ,~~P~,-l ~J,,"" '~STAl.:..l1,0>-. WI~=D 6Y' c: C~INER 1f\E";': ;;AL C~NT,",<:'lO~ c:rsfllt CJrr! ;/o/der Narm>: or BI/fing Addr61''': ' City: &p, ORte: ~ Zip: VISA' vrMC/ P~IIJEGT ADDResS: 5;;2.6 0' L-/ t5 ,e.,e;rq / (;Mol< ~ lhat app'y: = New - TYPE 0' wo~~: , 7Residen'al ~!tA'18ra1ion/A /tion :JM.lti.!l<lT1ily ;:: CQmmereia C. Mobile kcmCl: s~, Ft :J r:o.e'TIo18 M~te" ;: 06~a!;1ed ~ara.ge = HOt ~'.ib N:';"n!:lGr oj C:r1;uits. a.dded aT a tel'ed: _9---_ _ I~ Pool '-' SIlp1IC P~"'P = LOJl Vo~age ~ ielecolTc. ::J SI; ceSCRI~ICN OF TH!> E~ECTRICA~ PFIOJ~; "J " ~.'~. .,/ ~,~ ,. ..~-, 1- f,f.,r.Tr,,\O..' - (<,O'/i':h,'!n EI.c1,;.;.1 ".,It Loecj Addition. !# if (, ('0 S.....le8 h'f....rnalIO~ ::;; Ovcrno..; Se-v... :: lilT'1p Servi=-e o UndtTgro:..;.1'\d SeNiee Voltag.: P"laSAl: CJ 1 :-:: 3 Ser'Yiee ~: ~mer$izs:_ :J ea~eboaro :JFLo'r~' C Heal ~mfJ o Faf'l~W_11 _KW _1<\\1 _KW _>'W ?AMe i4.06,060~Bj: For il'\d...slTlai ~ml'T'l.rciaL, &. ~sidl'n~il-l ~r1:.:t"l$ !c"gor !~an ~ dl.Jp~x. ~ one -liMe: dr;,wll"lg cf the Eiecrr,oa Sarv1c;Q &. Fliladllf~, b\,lid:~v; size ;SQ.. 1.), :oaO eat:l,..la::Qr'l5. Md the tyPe.!:. o.t con;j'.ictOt'5 a,,,,,Q!or ra~8111J.Y 1$ req.,Jlre:: a'\d s~ il~l;o~8flY ["6 Ele~t:1c:a~ Pfilr~\~ apptlcaton his epplicati and lenow th~r sams to bs INS and oorrec:~, ard I 3 aiJthorized /0 apply lor Inis permit I !j(lt;ersta"d illS nol t1>e City's legal rsspOllsibility 10 derermi/'t!l wnat permirs are required; It remains the applicants responsibJ/ity 10 dere/mins wh.:rt permits BII, 16qui~d and to obtain suer:. ~""'~"'.""'MN",~. . .~ oate: ~~/.& ;j f/oO/ Owner or 518", ConI. Signature: Oate: I ' ~W'5v1. Jun 04 04 05:59p \ Bobb~ O. Coleman 360-452-7594 p. I , ti / " 1-,'V ~ / ELECTRICAL PERMIT APPLICATION Th~ EIt:ctri~ Perm;t AppIiQtion must be "lied out comoleletv. P)fI: OF!'KV..!. US!; U"'1... ,. o.ldL<- _ P\::<nUt. (bl....~-_ t>~clu..""_ P~type orrvprint in ink. tfygu hav9antquestion&., pl8ase call (360) .417-4735 Fax nu:mb<<: (3&0) 4"-4711 CJlf-sOG =::~d.&A14t~~~_2'?NY .:2- 'hW A~,..s 0~ C:~~Pr: Ci~ ~1-4/.4;,Je5S Zop CjY]6 EJectrlcal Contractor. _~_2:._ ~-3A . license #: Exp. Phone: AIldrnss $.').2- 4) / C- ~ I.,. ....City jJ, /1- --? '..- Zip: INSTAUATION WIRED BY; 0 OWNER >-$lECTRlCAL CONTRACTOR Credit CaRl Holder Name: g~ L ~ (~? cP" / -tCh-?<7 , ... Billing AdrJlflSS: City: ZIp: Credit CaRl Number: Exp. Date: V1SA:_ Me: PRQ.JECT ADDRESS: ~.2& ~<) - u~ S~, ~ 0 ralion/Addition TYPE OF WORK; Check all that apply: U Residential 0 Multi-family o Commercial 0 Mobile Home Sq. FI o Remote Meter U Detached garage 0 Hot Tub 0 SWim Pool o Septic Pump 0 Low Voltage 0 Telecom. 0 Sign Number of Cin::uits added or anered: / 46 <;;/J/LJ -16 , ;:::;; C- .-u<f'I't/C c- A-'k j-;;; /..&J e~ DESCRlPnON OF THE ELECTRICAL PROJECT: Electrical Heat Load Additions and Of' Subtractions ~ Servicelnfonnatlon ;] Baseboanl C! Furnace 1'Heal Pump o F~WaU ~~ 2~TON_lRA _KW o Overhead SeMce o Temp SeMce o Underground Service Voltage: t.."{)~ Z-O Phase; ~ 1 'u 3 - S6rvice Size; 9.DO FoodQr Size: I hereby certify that I have read and examined this application and know that same to be true and correc/, and I am authorized 10 appty for thiS permit I understand it is not !he City's 1eg81 responsibIlity to determine what permilS are required; it remains the applICants responsibility to d~eerm- W"'~~~ and to obtain such 0~fd. CreditCanlHold....sSignalure: J> 7' ~ 0a1.~'--t!!J3~o'l. ( Owner or EJec. ConL Slgnatur.: Dale: k -;J (tPc.f(c-(-- crL ~ t; 5 '1k ~ ~ PERMIT FEE: $ C:JElECTRICALPERMITAPPLlCATION ~ACl. YI 'S K- "rJ 0r Ie'f/ 2~Tb 6/7 ;;r / / ~~/70 #A?f)V~t:) 1;'V.s~ HP ~