HomeMy WebLinkAbout1233 E 3rd St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Detached garage with 8 circuits
Owner
DOYLE DENNIS MICHAEL
1233 E 3RD ST
PORT ANGELES
Permit
Additional desc
Permit pin number 144253
Permit Fee 73 50
Issue Date 4/14/09
Expiration Date 10/11/09
Qty
8 00
1 00
Unit Charge Per
2 0000 ECH
57 5000 ECH
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983627818
09 00000327
468429
1233 E 3RD ST
06 30 00 7 9 0155 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
Contractor
OWNER
ELECTRICAL ALTER RESIDENTIAL
73 50
00
73 50
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
Date 4/14/09
Plan Check Fee 00
Valuation
EL ECH ADDNT BRANCH CIRCUIT
EL R OUTBD /DTCH GAR IN /SEP
Paid Credited
73 50 00
00 00
73 50 00
Due
DATE RESULTS
aiff 1 47
W ?l,<�i /d c7
0
Extension
16 00
57 50
00
00
00
Signature of owner or Electrical Contractor X Date
INSPECTOR.
f 0,
Iv
City of Port Angeles Permit Application
Building Division /Electrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 417 -47,5 Fax: (360)417.4711
Date: /1 y l
2 Single Family Dwelling
Multi Family or Commercial*
Commercial Addition Alteration Remodel Repair*
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address:
Building Square Footage.
Description of above 17TflC_ F
Owner Info ation
Name.
Mailing A
City
Phone. 4AS 7--
License Exp.
Unit Charge
93.75
$113.75
$160.00
$205.00
$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
Owner as 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 licensed electrical contractor I am making the electrical
installation or alteration in compliance with the electrical laws, N.E.C. RCW Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and
Utility Specifications.
Signs ure of owner electrical contractor or electrical administrator
be
33 if
r' State.
iQn Fax:
Q
V Date: T (Y
RECEIVED
APR 14 2009
UGHT DEPT
Loarz»
Contractor Information
Name:
Mailing Address:
City
Phone:
License Exp
Total (Qtv Multiplied by Unit Charge)
Cash
Check
Credit Card
l' i zc_, t TS
State Zip*
Fax:
Service /Feeder 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/O Service Feeder
°a 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 /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
G 7 P Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
3S Total
CITY OF PORT VO y
BUILDING NG D DIVISIISION
0 G 101 5 7
G04 G Is Sk
0 Al .5 call irw
RECEIVED
APR 0P200 :I50
P 7✓t'i i
oG �d S
m f y rusian p.er/kur
p ki(34 q;
�n l< d d� vvr c, i Ce
n y
r
PREPARED 4/10/09 8 33 09 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/10/09
ADDRESS 1233 E 3RD ST SUBDIV
TENANT NBR DENNIS DOYLE
CONTRACTOR PHONE
OWNER DOYLE DENNIS MICHAEL PHONE
PARCEL 06 30 00 7 9 0155 0000
APPL NUMBER 06 00001035 RES DETACHED GARAGE
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 4/10/09 J L PLUMBING ROUGH IN TIME 01 00
April 9 2009 8 33 09 AM 1pangrle
1.• j�Y DENNIS 457 1902
ROUGH IN PLUMBING
AFTERNOON
COMMENTS AND NOTES
Ptiq Ff2i4AA
PREPARED 3/20/08 10 54 26 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/20/08
ADDRESS 1233 E 3RD ST SUBDIV
TENANT NBR DENNIS DOYLE
CONTRACTOR PHONE
OWNER DOYLE DENNIS MICHAEL PHONE
PARCEL 06 30 00 7 9 0155 0000
APPL NUMBER 06 00001035 RES DETACHED GARAGE
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BLFS 01 2/06/07 PB BLDG MONO SLAB
2/06/07 DA March 7 2008 11 59 18 AM pbarthol
March 7 2008 12 00 53 PM pbarthol
02/06/2007 04 02 PM PBARTHOL
NO PLUMBING DETAIL SUBMITTED NO PLUMBING PERMIT ISSUED NO
FURTHER WORK UNTIL ALL NESSECARY PERMITS ISSUED
March 7 2008 12 00 15 PM pbarthol
inpetion put in origanlly as a manuf home mono slab
BLM 01 2/06/07 PB BLDG MFG HOME MONO SLAB
2/06/07 DA 02/06/2007 08 46 AM PERMITS
DENNIS 457 1902/460 0342
ALSO REQUESTED A PLUMBING INSPECTION NO PLUMBING
PERMIT ISSUED
02/06/2007 04 02 PM PBARTHOL
NO PLUMBING DETAIL SUBMITTED NO PLUMBING PERMIT ISSUED NO
FURTHER WORK UNTIL ALL NESSECARY PERMITS ISSUED
BL9 01 3/20/08 JLL BLDG SHEARWALL
March 20 2008 8 30 35 AM 1pangrle
DENNIS (NO PHONE NUMBER WAS LEFT)
SHEATHING FOR GARAGE
THE PERMIT IS ON THE ELECTRICAL PANEL INSIDE THE GARAGE
COMMENTS AND NOTES
OF VORL
toe
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 Contractor
DOYLE DENNIS MICHAEL
1233 E 3RD ST
PORT ANGELES
Other struct info
Other Fees
T• \Policies \1102.15R [1/05]
WA 983627818
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
06 00001035
925515
1233 E 3RD ST
06 30 00 7 9 0155 0000
DENNIS DOYLE
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
21296
OWNER
TOTAL LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
Date 4/17/07
28 60
1 00
2042 00
10500 00
968 00
3010 00
1 00
Permit SANITARY SEWER HOOK UP
Additional desc GARAGE CONNECTION TO EXISTING
Permit pin number 99309
Permit Fee 40 00 Plan Check Fee 00
Issue Date 4/17/07 Valuation 21296
Expiration Date 10/14/07
Qty Unit Charge Per
1 00 40 0000 EA SAN SEW REPAIR
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/12/2006 03 31 PM SROBERDS The proposal will result
in a detached garage for total lot coverage of 29% in the
RS 7 zone Rear setback must be at least 10 from property
line
Electrical load calculations and elctrical permits are
required
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
Extension
4-0 00
STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 40 00 40 00 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 44 50 44 50 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 o be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whethe .ecified herein of ot. a granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or I. al law regulatii c truction or the performance of
construction.
S. c.-7 6 7
Signature of Contractor or Authorized Agent Date Signature of Owner (if oy 1)r is builder) Date
v
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653 I
PLANNING DEPT 417 -4750 I
BUILDING 417 -4815
T \1102.15R [1 /05]
RESIDENTIAL
PERMIT INSPECTION RECORD
CALL 417 -4807 FOR UTILITY 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 1 NO
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
PLANNING DEPT
BUILDING
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
DOYLE DENNIS MICHAEL
1233 E 3RD ST
PORT ANGELES
Other struct info
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty
1 00
Permit
Additional
Permit pin
Permit Fee
Issue Date
Expiration
Qty
2 00
1 00
1 00
00
Unit Charge Per
BASE FEE
7 2500 ECH ME VENT FAN
desc
number
Date
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Unit Charge Per
7 0000
7 0000
15 0000
7 0000
WA 983627818
PLUMBING PERMIT
ECH
ECH
ECH
ECH
Signature of Contractor or Authorized Agent
T \Policies \1102 15 building permit inspection record05 wpd [1/4/2005]
06 00001035
925515
1233 E 3RD ST
06 30 00 7 9 0155 0000
DENNIS DOYLE
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
21296
Contractor
OWNER
TOTAL LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
MECHANICAL PERMIT
95265
57 25 Plan Check Fee
4/17/07 Valuation
10/14/07
95273
86 00 Plan Check Fee
4/17/07 Valuation
10/14/07
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/12/2006 03 31 PM SROBERDS The proposal will result
in a detached garage for total lot coverage of 29% in the
RS 7 zone Rear setback must be at least 10 from property
line
Electrical load calculations and elctrical permits are
required
Date 4/17/07
28 60
1 00
2042 00
10500 00
968 00
3010 00
1 00
0 0
0
Extension
50 00
7 25
00
0
Extension
BASE FEE 50 00
PL EA FIXTURE ON ONE TRAP 14 00
PL EA INSTALL WATER PIPE 7 00
PL EA BLDG SEWER 15 00
PL EA WATER HEATER 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 withi
inspection. I hereby certify that I have read and examined this application and know the same to b: rue and
laws and ordinances governing this type of work will be complied with whether sp ified herein or not. e gr
presume to give authority to violate or cancel the provisions of any state or Ice law regulating c
construction
Date Signature of Owner (if owner is b
Ek/961
y -13 -1
0 days from the last
ect. All provisions of
g of a permit does not
or. or the performance of
Date
I MANUFACTURED HOMES
CALL 417 -4515 FOR BUILDING INSPECTIONS. CALL 417 -473' 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 l4 "ORK BEFORE
INSPECTED 4ND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT .10B SITE.
ELECTRICAL LIGHT DEPT
INSPECTION TYPE DATE
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
ROUGH -IN
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
I PLANNING DEPT 417 -4750
1 BUILDING 417 -4815
BUILDING PERMIT INSPECTION RECORD
T' \Policies \1102 15 building permit inspection record05 wpd [1/4/2005]
YES
SEPA.
ESA.
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
DATE YES NO COMMERCIAL DATE I ACCEPTED
1 YES I NO
417 -4735 ELECTRICAL
LIGHT DEPT
ACCEPTED COMMENTS
NO
FINAL
FINAL
CONSTRUCTION R.W
PW ENGINEERING
1 FIRE DEPT
PLANNING DEPT
1 BUILDING
DATE ACCEPTED BY.
DATE ACCEPTED BY.
1 1 1
1 1 1 1
1 1 1
of F0 Ta
UGV
CG�
Application Number
Application pin number
Other Fees
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
06 00001035
925515
Special Notes and Comments
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
T• \Policies \1102_15 building pennit inspection record05 wpd [1/4/2005]
Page 2
Date 4/17/07
STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 143 25 143 25 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 147 75 147 75 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 Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 41 7 -48 15 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 UNLA14FUL TO COVER, INSULATE OR CONCEAL ANY PORK BEFORE
INSPECTED 4ND ACCEPTED. POST PERMIT IN 4 CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE 1 ACCEPTED COMMENTS
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
W 4LLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -1N
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
1 1
13 -a0 -OS IPn
o 0 1 ru-
4- io 09 3" 1
YES NO
FINAL
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
DATE YES NO COMMERCIAL
ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL
LIGHT DEPT
SEPA.
ESA.
SHORELINE:
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW /ENGINEERING
I FIRE 417 -4653 I I I I FIRE DEPT
I PLANNING 1
BUILDING DEPT 417 -4815 l� Jt N 1�r
1 BUILAN I NG DEPT
TAUoli 15 building permit inspection record05.wpd[I /4/205)
DATE ACCEPTED BY.
1 FINAL DATE ACCEPTED BY.
DATE
ACCEPTED
YES 1 NO
O
6
W
PREPARED 2/06/07 9 09 01
CITY OF PORT ANGELES
ADDRESS 1233 E 3RD ST SUBDIV
TENANT NBR DENNIS DOYLE
CONTRACTOR PHONE
OWNER DOYLE DENNIS MICHAEL PHONE
PARCEL 06 30 00 7 9 0155 0000
APPL NUMBER 06 00001035 RES DETACHED GARAGE
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
4 NSPECTION TICKET
INSPECTOR JAMES L LIERLY
BLM 01 2/06/07 JLL BUILDING FOUNDATION MONO SLAB
02/06/2007 08 46 AM PERMITS
7. DENNIS 457 1902/460 0342
tf/ /tt ALSO REQUESTED A PLUMBING INSPECTION
PERMIT ISSUED
COMMENTS AND NOTES
PAGE 5
DATE 2/06/07
NO PLUMBING
•sue �;,u
BUILDING DIVISION
CITY OF PORT ANGELES
Correction Notice
Job Located at
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdictio
X (2 1)EM-7/.._ S
i
�,f_f AJ711 f) /»/7 L G,'9,Ge
Date c /61D 7
DO NOT REMOVE THIS TAG
li 5c'6/
4 111.1v O ,M /Ae,
W- ��L
Al() h rz� (a (,),/r74—
These corrections must be made and are not to be
covered until reinspection is made. When c .rrections
have been made, please call AV/ 7- fq /c
for inspection
Inspector for Building Division
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Ntewso
Application Number 06 00001035 Date 10/19/06
Application pin number 925515
Property Address 1233 E 3RD ST
ASSESSOR PARCEL NUMBER 06 30 00 7 9 0155 0000
Tenant nbr name DENNIS DOYLE
Application type description RES DETACHED GARAGE
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 21296
Owner Contractor
DOYLE DENNIS MICHAEL
1233 E 3RD ST
PORT ANGELES
Other struct info
Qty Unit Charge Per
Other Fees
Fee summary
WA 983627818
T \Policies \1102_15 building permit inspection record05 wpd [1/4/2005]
OWNER
TOTAL LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
Permit BUILDING PERMIT RESIDENTIAL
Additional desc
Permit pin number 87387
Permit Fee 375 75 Plan Check Fee 150 30
Issue Date 10/19/06 Valuation 21296
Expiration Date 4/17/07
BASE FEE
20 00 14 0000 THOU BL 2001 25K (14 PER K)
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/12/2006 03 31 PM SROBERDS The proposal will result
in a detached garage for total lot coverage of 29% in the
RS 7 zone Rear setback must be at least 10 from property
line
Electrical load calculations and elctrical permits are
required
Public Works Utility Engineering has no requirements for
this plan review
STATE SURCHARGE
Charged Paid Credited
28 60
1 00
2042 00
10500 00
968 00
3010 00
1 00
Due
Extension
95 75
280 00
4 50
Permit Fee Total 375 75 375 75 00 00
Plan Check Total 150 30 150 30 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 530 55 530 55 00 00
Separate Permits are required forelectrical 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 orwork is suspended or abandoned
fora 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 r1u1 ting nstruction or the performance of
construction. 1
Signature of Contractor or Authorized Agent Date Signature of Owner (if #ivner is bu 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 (INTEIVOR BRACED PAN 'ONLY)
T -BAR
INSULATION m,
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
CONSTRUCTION R.W PW/
ENGINEERING
FIRE
PLANNING DEPT
417 -4807
417 -4653
417 -4750
BUILDING PERMIT INSPECTION RECORD
BUILDING 417 -4815 1
T• \Policies \I 102_15 building permit inspection record05.wpd [1/4/2005]
1 1
1 1
1 1
1
I 1
1 1
1 1
1 1
1 1
1 1
1 1
I 1
1 1
1 1
1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
FINAL
FINAL
SEPA.
ESA.
SHORELINE.
DATE ACCEPTED BY.
DATE ACCEPTED BY.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
PLANNING DEPT
I BUILDING
1 1 1
1 1 1
I I I
Applicant Agent:
Owner
Address. a
Architect/Engineer:
Contractor
Address:
PROJECT ADDRESS /oZ A c
State License
LEGAL DESCRIPTION Lot: IBC Block.
TYPE OF WORK.
Residential New Constr Re roof Stove
Multi- family Addition Move /Garage Cito
D Commercial Remodel Demolition Deck
Repair Sign Other
BRIEF DESCRIPTION OF THE. PROJECT
PLANNING USE ONLY
ESA/Wetland(s). Yes No SEPA Checklist required? Yes No Other.
I hereby certify that J have read and examined this appy
apply for this permit and understand the is my respon,
must obtain such permits prior to work.
TAFOFMS\BidgPennitform.wpd Applicant:
ity
1
(20NOP 1 ITin ri
l
BUILDING PERMIT APPLICATIGN
Fill out COMPLETEL\ and in WK. I' our application and site plan MUST B
COMPLETE to be accepted for review If von have any questions. call
PERMITS (360) 417 -4815 FAX(360)417 -4711
ST7,F/VALUATION
SF @'S /SF S
SF /SF L/, `7-C/
SFr /SF
TOT VALUATION k`
ate: 9 Do 6
FOR OFFICI DSE S
Date Rec. O G
Perunt 1035
Dat., Approved:
Date Issued:O
-z
Phone.
O arr Ph one T 1 0 City F
zip 90 G P-
Phone:
Exp Phone:
Zip
ZONING
PS 7
Subdivision. l a lh S u Outs 04`
CLALLAM COUNTY PARCEL NUMBER. h (3 n U 0 a Q CC 6000
uLo r6qp, (or l� 1
t!
COMMERCIAL/RESIDENTIAL. Occupancy Group Occupant Load. Construction Type:
No. of Stories 1 Lot Size: ctaxisting Sq. Ft. `�0S<- Proposed Sq Ft. pp,, 6 TOTAL Sq Ft. Of
Total lot coverage
nd know the same to be true and correct. I am authorized to
o determine what permits are required not the City's, and that I
APPROVALS
PLAN
BLDG
DPWU•
FIRE.
OTHER.
VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the apphcant.
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 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 wntten request by the applicant (see Section
R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
1217
7
1227
40
Feet
Verti al Datum =NA VD 88
.lo nonfat Datum NAD 83/91
1L233
Area Map
0)
N
1234
Th map 01 into ded to he cd legal desc pti
Th mop/dr g produ d by the City of Port Angeles fo as owr use rd purposes.
Any oth use of th map/dr tg shall ot be the spot ibility of th City.
va_Itoipsunf_siq}fo.saou <pao- pue- apoa- ifa uo:jeioiA
w JefM lapuna.aayf uo pa! °u!aq <.112Jedo 3uipfflq
3uEmoA21d 11101} !o slop aim pu sual}eaiflu ads aid
-ples u1._saolla }o- uog;,alaoo- ay;- 3uulni;aa- .;;fsaaagt ww
lelallo'ulpllnq a!It ;us ad to!. Begs 62 lagfapue ;u,, }ea
ds surd asagt uodn paaeq i!ut.L.ct sly} ,o aau aqi
CITY OF P ty ANGELES ConstruttiOn pns
The Issuance of thisermit based upon these s, specifi-
cations and other data all not preventtl eliding official
from thereafter -requiring the- correction -of errors -in -said.
plan, specifications and oa, or from preventing
building operation bei carried bn,thereunder when in
violation of -ail s -and ordinances -of.this jurisdiction.
(SECTION c) Uniform Building Code.)
Ry
0
"Yi
d $3 __61 ?4 tO
JO- .“.Ii-
77 9Q I
G
k)
1.'";•-•
3. t
A
l
vet
1
BUILDING NO 1 OF 1
APPRAISER 06
CONTACT
YR BUILT 1937
TYPE HOUSE
COMPLETE
MKT MODIFIER
EFFECTIVE AGE 70
CONDITION GOOD
STYLE 1 STY
MOBILE HOME
MAKE
MODEL
SKIRTING LENGTH
SERIAL NO
PARK
BUILDING SIZE
1ST FLOOR 1722
2ND FLOOR
3RD FLOOR
ATTIC
LOFT
MOBILE
TOTAL AREA
°_PORCH
AREA
TYPE
QUALITY
ROOF
CEILING
CONC FLOOR
IRON RAIL
METHOD
2 E
(0 N w
CLASS
1 111 11 3 11
2 III II II
3 H II
4 1 1
5 1
6 III 1 1
FAIR MARKET
1
2
2
1722
100%
#1
110
DECK
AVG
CARPORT /PATIO #1
AREA
QUALITY
COVER
DEP
REPLACEMENT VALUE
GOOD
COMPLETION
ADJUSTED VALUE
ADDITIONAL IMPS
TOTAL BUILDING
REMARKS 7/01 106000
LAND
a w o CODE
r
w W 2 z
O a Z
iL O
1113
TABLE YEAR 2007
APPR. DATE 5/18/07
RENTER
YR. MODEL
NO OF UNITS 1
LUMP SUM
DEP GOOD 95
OBSOLESCENCE
QUALITY AVG
TYPE
YEAR
SIZE
BEDROOMS
FULL BATHS
HALF BATHS
FOUNDATION
EXT WALLS
INT WALLS
ROOFING
FLOOR CONST
#2
110
DECK
AVG
1
1
#2
QUANTITY
TIMBER
1
X
BUILDING CHARACTERISTICS
3 FLOOR COVER #1
1 FLOOR COVER #2
HEAT /COOL
CONCR PLUMBING FIXT
SIDNG ROUGH -IN
TUB ENCLOSURE
KITCHEN QUALITY
FIREPLACE #1
FIREPLACE #2
#3 GARAGE
ATTACH AREA
BUILT -IN AREA
DETACH AREA 320
INT FIN
BSMT GARAGE
DET EXTERIOR SIDNG
ROOFING COMP
DET QUALITY FAIR
DET DEP 25
OTHER
ASPHALT
CONCRETE
FENCE
168 807 NEW CONSTRUCTION
95 UNWRK. BUILDINGS
PLUS /MINUS
160 367 ADJUSTED IMPS
29 590 TOTAL LAND
189 957 TOTAL VALUE
RATE ADJ
79500
00 ACRES
PARCEL 063000 790155 0000 F/B PAGE 503 411
DOYLE, DENNIS MICHAEL DOYL1000
CAIN SUBD OF SUBURBAN LOT 18
E 75 LTS 23 -26 BL 1
TAX DISTRICT 0010 BLDG USE CODE 1113
NEIGHBORHOOD CHANGE DATE 9/25/07
CHANGE REASON NEW CONSTRUCTION
TAX STATUS TAXABLE REVAL AREA 5
SITUS ADDRESS PORT ANGELES
1233 THIRD ST E
ZONING SF Res 7000 sf
INDIV INT TOTAL ACRES
VALUE
79 500
0
BASEMENT
50 CARPT TOTAL AREA 600
50 HRDWD FIN AREA
BBE QUALITY
6
ANNUAL REVAL.
AVG PROP CLAS 140
IMPS F 1 0000
LAND F 1.0000
#1 #2
ADDITION
AREA
YR. BUILT
TYPE
QUALITY
EXTERIOR
ROOFING
FLOOR CVR.
INT WALLS
EFF AGE
1936
2007
GARAG
AVG
PLYWD
OTHER
DEP 1
280 COMP 50
WATERFRONT
w
0
z
Y Y Y N W
Z Q a a a Z O
Q m m m S J
w t7 0
Z 2 E 2 m F U
189 955
79 500
269 455
VIEW TOPOG. AMEN.
0
0 Z
J O 1-' (J LL
O w J
O 3 3 m o
H Q
3 w D
3 a
--1
OLfMPIC PRINTERS (360) 452 1381
08 INQUIRY Appraisal Field Sheet
Parcel 063000 790155 0000 Building 01 of 01
Base Rate
Foundation
Int Walls
Roofing
Floor Cyr
Heat
Adj Rate
Flr 1 Cons
Plumbing
Kitchen
Firepl 1
Firepl 2
CMD 1 Auto Dup
CMD 3 Review
CMD 4 Delete
CMD 7 End Job
82 03
2 67-
00
1 83
6 96
34-
87 81
0
2,295-
2,675
0
0
Attic
Loft
Mobile
Basement
Porch 1
Porch 2
Porch 3
Att Garage
B/I Garage
Det Garage
Bsmt Gar
CMD 8 Calcs
CMD 9 Restart
CMD 13 Chain
CMD 16 Recover
0
0
0
9,844
2,053
3,924
0
0
0
—=>7,702
'N 0
Auto Dup OFF
Review ON
Table Yr 2007
M/H Skirt 0
Carport 1 0
Carport 2 0
Asphalt 0
Concrete 1,397
Fence 0
Addition 1 21,888
Addition 2 0
Repl Value 168,807
Adj Value 160,367
Lump Sum 0
Total Bldg 189,957
CMD 20 Mobile Home
CMD 21 Building 1
CMD 22 Building 2
CMD 23 Land
CMD 24 Master
pO Rrg1, C
et 'kits
Application Number
Pin number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
DOYLE DENNIS MICHAEL
1233 E 3RD ST
PORT ANGELES
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
ANGELES ELECTRIC
524 E 1ST ST
983627818 PORT ANGELES
(360) 452 9264
ELECTRICAL ALTER RESIDENTIAL
200A ALTER SERVICE
ANGELES ELECTRIC
64 90 Plan Check Fee
3/03/04 Valuation
8/30/04
WA
T \PLANNING\FORMS \1102.15 [11/14/2003]
04 00000169 w d Date
693225
1233 E 3RD ST
06 30 00 -7 9 0155 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
Contractor
Charged Paid Credited
64 90 64 90 00
00 00 00
64 90 64 90 00
3/03/04
WA 98362
00
00
00
00
0
Qty Unit Charge Per Extension
1 00 64 9000 ECH EL -R OR RM 0 200 ALT SRV FDR 64 90
Due
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 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
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
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT
ROUGH -IN
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
T rA LINE
!i) FLOW WATER
Aft SqL
41 Allis
4EILING
f; FLING
JOTS' S GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
ALL (INTERIOR BRACED PANEL ONLY)
--BAR
INSULATION
SLAB
VALL FLOOR CEILING
I1 E I ;NICAL
HEAT PUMP
GAS LINE
WOOD STOVE PELLET CHIMNEY
HOOD DUCTS
PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE METER
SEWER CONNECTION
SANITARY I
STORM I
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING/LIGHTING ESA.
LANDSCAPING I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
ELECTRICAL LIGHT DEPT 417 -4735
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653 I
PLANNING DEPT 417 -4750
BUILDING 417 -4815 I
T \PLANNING \FORMS \1102.15 [11/14/20031
1.0/0
I I I
I I I
I I
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
PLANNING DEPT
BUILDING
I I I
I I I
I I I I
.... CITY OF PORT ANGELES
I2; DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDiNG DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
I~UIIL~IIV~ I'~.J~Mll ISSUED: 9/20/2002 PERMIT NO: 13667
OWNER/APPLICANT PROPERTY LOCATION
1233 3RD ST E
DENNIS DOYLE
1233 E. 3RD STREET Lot: 18 E 75' LOT 23-26
Port Angeles, WA 98362 Block: 1 [] Long Legal
360/457-1902 Subdivision: N.SUB OF SURBURBAN
T: S: Parcel No: 063000519015500
CONTRACTOR ARCHITECT
OWNER N/A
VARIOUS
Port Angeles, WA 99360 , 98360-0000
206/000-0000 360/000-0000
PROJECT INFO
Project Value: $3,000.00 SFD Units: 0 Commercial: 0
Project Type: RE-ROOF SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0 ~'"~
Construction Type: MFD SQ FT: 0 ~'J
Zoning Use:
PROJECT NOTES
TEAR OFF/RESHEET/REFELT ADD 5X 20 REAR PORCH/3TAB
FEES ASSESSMENT
Building Permit: $83.25 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: $87.75
Plumbing: $0.00 AMOUNT PAID: $87.75
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 ~,orrect. ~}11 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
a~w ~or/,~f//~ performance of
presume to give authority to violate or cancel the provisions of any state or local? regulating constructio
construction. ~ "J ~"~ ~S ~~ ~D:te~0
Signature of Contractor or Authorized Agent Date Signature of Owner (i ow build
T:\PLANNING\FORMS\I ]02,15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 41%4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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 I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PEKMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW ! WATER
AIR SEAL
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PWUTILITIES/ SITEWORK (EngineeringDivlsion) 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 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.
ENGINEEKING 417-4807 PW / ENGINEEKING
FIRE 417-4653 FIRE DEPT.
BUILDING 417-4815"~-~)~L~- ~ ~ ~/ BUILDING
T:\PLANNING~FORMS\1102.[5 [4/2002]
2-27-204 5,44PM
4~'~~.\~~
~';t~?' .~ TI,,, ~"!(""C'" Po,,,,,, Appl,c"hOI1 !!'usl bc tlU"d oul comolo'oIV,
~~;;":l' ~,,jJA 0<./ // Q
1,- ~ .\t'"" - Ple;1S(' IYJ)f' or rep"nl In Ink. If you ha"p~n)'qut'5Ih)n5. please c~" (360. 417--4135 I - b I
f /1/ V fa" flumhp.r. (360) 411--4711
(~ ,. REQUEST INSPECTION 0
FROM ANGELES ELECTRIC INC 360 452 9265
eLeG I HIt;,lIL !J~RMrr APPLICATION
P.l
.
. 'fl' VI ,,'~ ,,,,, 11M. \11\1. Y
Ih'clR...~
"~""j, ."
U.,. "r"'l"~r'"
"~Itl,......tl:____
\
0""., 'J< Elae, COnlr3cl0l A9cnl:-----.ANGEJ..ES-El..~.c_
P,ol'en~ Owncr: l:Y-I1I1/.S /)1'1 L...E::-
/23~ P, 3~
Phon,e:4 ~7-q2(,4
Fa" 4 'l;l-q;l/;C;
Phone: ~6'7-/~Z.
Zip: 9~z:
Addles$;;
S7cily
PA
IINGF.LEl460RS
U(:mISl:l II: Exp:
Phone' ~ <;7-Q;I/;4
Zip: 98362
Eleclncal Conl'aclor: ANGELES F.LT::C1'RIC INC.
Address: 524 EAS'I' FIRST
Cily: PORT ANGELES, WI;
'NSTALl,ATION WIRI:D BY:
UOWNER
xli'lECTRICAL CONTRACTOR
Credit Card Holder Name:_---.:J'prl <: i mp"...,n
BI/Jing Address: City:
Credit Card Number:. Exp. Date:
~,
Zip:
VISA:_MC: ~
PROJ~CT ADDRESS:
/233 e. ~Ln
TYPE OF WORK: Check alllhat apply: (J New ~tion/Addition
~Sidenlal 0 Multi-family 0 Commercial . 0 Mabile Home
Sq. Ft.
Number of CircuilS added or altered:
o Remole Meier 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump 0 Low Voltage o Telecom, 0 Sign
DESCRIPTION OF THE ELECTRICAL PROJECT:
200 AwIf ~~ t!srMJ ~,..~t:.€:.-
$~ifh-
o Baseboard
:J F umaco
:J Hoal Pump
:J Fan-Wall
_,KW
_KW
_KW
_KW
I/O .-(il)C
Elecirlcal Heal Load Addillons
o Overhead Service
o Temp Service
LJ Underground Service
Servke Informal/on
Voilage: ~-ftff
Phase: 0 3
Service Sizo: ~~
Feeder Si2:e:
:lAMe 14.05.060(8): For industrial, commercial. & residenlial projects larger than a duplex, a one -line drawing ollhe Electrical Service &
::'eeders. building size (sQ. ft.), load caIC'Jlations. and the lype & or conduclors andlor raceway is required and shall acoompany fhe
:lectrical Permit application.
, hereby certify that I have read and flxamined this application and know that same to be Irue and correct,. and I am
wthorized to apply for this permit, I ,:mderstand it is not the City's legal responsibility to determine what permits
~re rerz ants responsibil to determine what permits are required and to obtain such.
3r-/~<t-. . . '.
Date: P/zPi
Date: ~h?4r(
s702.-ikt W-,{r ~~.
-ro ttlU::;- 7d f}A7S ('~ .e::A~A;-vt<t. ~ O~S - _
(2'=cOM.,tI\,~O a(..oc..~ "'tZ> G;~A-EijL
T~)C -JaM
4( _
--rT Owner or ElllC. ConI. Signature: .
W-9019 /lflf-. IfA€.-.T~tr"'O~ ~I> ~v,
Credit Card Holder's Signature:
4tJC
3;; hi