HomeMy WebLinkAbout804 E 3rd St - BuildingPREPARED 9/18/06 11 45 49 INSPECTION TICKET PAGE 18
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 9/18/06
ADDRESS 804 E 3RD ST
TENANT NBR YMCA
CONTRACTOR B &B ENTERPRISES
OWNER LYKKEN EUGENE V
PARCEL 06 30 00 7 7 0405 0000
APPL NUMBER 06 00000268 MECHANICAL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
SUBDIV
PHONE
PHONE
ME99 01 9/18/06 JLL MECHANICAL FINAL TIME 13 00
COLTON 417 0436 CHIMNEY LINER
09/15/2006 02 55 PM DYASUMUR
COMMENTS AND NOTES
(360) 417 0436
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
LYKKEN EUGENE V
804 E 3RD ST
PORT ANGELES
Qty Unit Charge
1 00 13 7000
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
Signature of Contractor or
WA 983623824
Permit
Additional desc
Permit pin number 73312
Permit Fee 63 70
Issue Date 3/23/06
Expiration Date 9/19/06
Per
ECH
63 70
00
63 70
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
constructi
MECHANICAL PERMIT
orized Agent
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
06 00000268
328152
804 E 3RD ST
06 30 00 7 7 0405 0000
YMCA
MECHANICAL PERMIT
PUBLIC BUILDINGS PARKS
1500
Contractor
B &B ENTERPRISES
520 ROSE ST
PORT ANGELES WA
PORT ANGELES
(360) 417 0436
Plan Check Fee
Valuation
BASE FEE
ME REPAIR /ALTER /ADD APPL
Paid Credited
63 70 00
00 00
63 70 00
3 21 3 /C
Date
Date 3/23/06
WA 98362
00
0
Extension
50 00
13 70
Due
00
00
00
4-=)(
o'03-10
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 I NO
FOUNDATION:
FOOTINGS
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
I I
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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 I NO
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW ENGINEERING
FIRE 417 -4653 I I I I FIRE DEPT
PLANNING DEPT 417 -4750 I /7 I I lid 3 I I PLANNING DEPT
BUILDING 417 -4815 I x i 4 I 't q113 d I BUILDING
T•\Policies \1102_15 building permit inspection record05.wpd [1/4/2d05]
I I I
I I I
I I I
Applicant or Agent: Co LTo rt BO cia/ Phone:
Owner 1 f im G
302SF Cit qr►Gis
Address. y PO /T f}) 9 -Pees
Architect/Engineer
Contractor
Phone:
1 t 13 En re- ✓T! l S t5 State License B E/11 T21= -d i f 3 Exp I /D7 Phone: y 17
5 go R05 -e-- ST City P6 r11-0 -g BL S Zip 9 6 342
ZONING
Address:
PROJECT ADDRESS Ss N 0 3 ri
LEGAL DESCRIPTION Lot: Block:
CLALLAM COUNTY PARCEL NUMBER.
TYPE OF WORK.
Residential New Constr
Multi family Addition
Commercial Remodel
Repair Sign
BRIEF DESCRIPTION OF TH
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
Re -roof
Move Garage
Demolition
Other
ROJECT
COMMERCIAL/RESIDENTIAL. Occupancy Group
No. of Stories: Lot Size. Existing Sq Ft.
Total lot coverage
PLANNING USE ONLY
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
T•\FORMS\B1dgPennitform.wpd Applicant:
Phone:
Subdivision.
SIZE/VALUATION
SF /SF
SF /SF
SF /SF
TOTAL VALUATION
'1 17 -0 3 --C
1 44 Z -42.
Zip 18
Date: 3/13/04
FOR OFFICIALUSEE ONLY
Date Rec. 3 5/06-
Permit 067 -.24,g
Date Approved: 3 23 /0 L.
Date Issued: 3 3 /O(_
I son
Occupant Load. Construction Type:
Proposed Sq Ft. 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 may be revised by the Buildmg 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 buildmg 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.
I hereby 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 not the City's, and that I
must obtain such permits prior to work.
~~~'\
t~~
. --
~
BdlLDnvG PCruVII'
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
ISSUED:
I-'~KMII NO:
13576
7/19/2002
OWNER/APPLICANT
GERE L YKEN
804 E. 3RD ST
Port Angeles, WA 98362
360/457-3889
T:
S:
PROPERTY LOCATION
804 3RD ST E
Lot: 10,11
Block: 4 ~ Long Legal
Subdivision: CAINS-LOT 21
Parcel No: 063000770405000
CONTRACTOR
PENINSULA HEAT
502 W. 8th Street
Port Angeles, WA 98363
360/457-2775
ARCHITECT
N/A
, 98360-0000
360/000-0000
PROJECT INFO
Project Value: $2,811.00
Project Type: ELECTRIC FURN.
Occupancy Type:
Occupancy Group:
Construction Type:
Zoning Use: RS7
SFD Units: 0 Commercial: 0
SFD sa FT: 0 Industrial: 0
Garage: 0
MFD Units: 0
MFD sa FT: 0
~
\?J
..L
PROJECT NOTES
INSTALL NEW ELECTRIC FURNACE AND LOW VOLTAGE THERMOSTAT
RECEIPT#9457
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$34.15
$0.00
\\j
Mise Fee 1: THERMOSTAT
Mise Fee 2:
Mise Fee 3:
w
~
$34.40
$0.00
$0.00
)
TOTAL FEE:
AMOUNT PAID:
BALANCE DUE:
$68.55
$68.55
$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 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 cancei the provisions of any state or local law regulating construction or the performance of
construction.
ON F I L c:;-
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. 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 A T JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEP ARA TE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS I
CEILING I I I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T~BAR
INSULATION
SLAB I
WALL I FLOOR I CEILING I I
MECHANICAL
HEAT PUMP q - ZI>-t5L LEI/.
WOOD STOVE I PELLET I CHIMNEY
HOOD I DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'s:
W A IERLINE I METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTlNG 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. I 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 [412002]
fI
~~
BUILDING PERMIT - PREAPPLICA nON
FORO
DaleRoo.:
Pcnnil M:
......Ap CoalplcU?
Dale Approwd:
The Building Permil - Preappliealion must befliJd oul completely.
Pleue type or pria! In Ink. U)'ou have an)' qu..tlo.... pleue caD 417-4815
Applicant andlor Agent: aL1 fu/n}k: An~OY\---
Owner: ~\f4~~L~~lJze~
Address: 0 rcJ c> . City: R) rtitv~rlpc,
ArchitectlEngineer:
ContractorPf'i'I i V1':"I.L~'~ (_ License#:{)P/l.JlrUi(Y~
Address: ~Dd-.. \AI ;q-ft] City:_.pMT-~p/~ <::,
PROJEcr ADDRESS: '7St..>tf ~ =6 r.q S+.
LEGAL DESCRIPTION: Lot: Bloclc:
Phone: l/57<i 77<'-
Phone: Ys 7 - 3~<;<q
Zip: q ~ t, ::J.-.
Phone:
Subdivision:
TYPE OF WORK: SIZE/V ALVA nON:
c Residential c New Constr. c Reroof c Woodstove SF. @ S /SF. ~ S
c Multi-family c Addition c Move c Garage '. SF. @ S /SF. - S
c Co=ial C Remodel 0 Demolition 0 Deck SF. @S /SF. - S
o Repair 0 Sign '0 TOTAL VALUATIO~ S ~ ~ ~ ---
BRIEFpESCRIPTIONOFTHEPROJEcr: JfJn: ..fiA<r'{"\(AfP IhC,,-j--rtq ///\\11I VhT~ /J
1M" YI.V"\~ 1
COMMERClAIJRESIDENTlAL: Occupancy Group: Occupant Load: Construction Type:
No. of Storics: _ Lot Size: % Lot Coverage: ~
Existing Lot Coverage: Isq. ft. + Proposed Lot Coverage: /sq. ft. - TOTAL LOT COVERAGE: /sq.1l
PLANNING USE ONLY:
Pcnnits Required:
Max. Height: Setbacks:
Site Plan and Use Approved by:
ESNWeUand(s): 0 Y OS 0 No SEP A Chccldist required? 0 Yes c No
APPROV AUl:
PLAN
BLDG
DPW
FIRE
OTHER
Notes:
ZOning:
Date:
Other:
PREAPPUCATION SUBMllTAL: YOIU' IIpp/ialtion and lite plan must befiJId outcomp/delJ1 to be acceptedfo, ,eview. The Building
Division can provide you with more detailed infonllation on the application and plan submittal requirements.
BUILDING PERMIT APPUCATlON SU~MrrrAL: Your completed application, site plan (for additions) and building construction
plans are to be submitted to the Building Division, AD)' addition larger than 500 .q. n. will Deed. PreappUcatlon Review.
VALUATION OF CONSTRUCIlON: In all cascs, a valuation amOWlI must be entered by the applicant T!iis figure will be reviewed IIId
may be revised by the Building Div. to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: Your plan chccl:: fee is due at the time the building pennit application and constrUCtion plans are submitted. All olhcr
permit fees arc due at the time of permit issuance.
EXPIRATION OF PLAN REVmw, If no pc:rmit is issued within 180 days of the date of application. this application will expire by
limitations. The Building Official can extend the time for action by the applicant up to 180 days, on written request by the applicant (see SccIiCXI
J04(d) of the Unifonn Building Code, current edition). No application can be e),1ended more than once.
1 hereby cel1i/;l thaI I have read and examined Ini. appliealion and know Ine .ame 10 be lrue and camel, and 10m aulhorized 10 apply fo,
lhis permit. I understand it is not the City's legal respolZsibility 10 deltmline what permits are required,' it remains the applicant',
""poTl3ibility 10 delermine whal permiu are required and 10 oblain .uen. j};1 ~
APplicant0'4'ttt'-1 ~..J Date: 7,ijzk
pu:C:\DATA\WPlKEEPERS\BLOAPP.FRM . 'pw.II02.OJ[IWV.2IP6J
. . . . .
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT . . . . . .
REQUEST:
Date C{-l <;3 '- 0 L
Time
Received by
!?L/
(phone, person)
Location of Work to be inspected 90 L{
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final
~ '3vct
Time
Phone No. LfS-7- :5'8Ef9
Permi I 7 k:,
E/ecf,,~~
,,-..
f-uv L1c..C<2-
"6-
Du..cJS
INSPECTION NOTES:
Inspected: Date '-1 . ? D
Remarks:
^ ..
u (..
By
/)
, "
'. .,.-,",.
L/'
t:--
RESTORATION REQUIRED . . . . .. YES
NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
[] Repaired by City
o Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
LIGHT DEPARTMENT
Ph.
ELECTRICAL PERMIT
N~ 18365
Port Angeles. washlngton...........m.m....t.1.8Ymm...I.4.:::mm.m.. 19.~i.
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 do electrical work as listed below.
Address ..m....St2~......nE....__.;;t?'!.uu.uuu.uuu.m.mmm__...u Occupancyu.um6?~-.!/a~l.!t.~uu.__
Owner uou.GLE'A./..c:.mu,?..JL./'SJt.c:nL____u.uuumuo TenanL.....)~L--.nnu.-.uuui&u--. c.1.m.mu.C1
l' /~ ~ /.. c:::) ~ . / :X
Wiring Contractor u.__-I~?:.lJ{)}_'_4Lj).mt;-,~t.~uu BY--5:;r.???-C<m2.1t..: ( 421Lk(JZu__u.___
Light Outlets...............__.............._.._..... Service, volts ..................................:.... Type of Wiring:
Receptacle Out1ets.............~............. No. wires ........m.................~...... Armored Cable .............................,
Dryer, KW........................__................
Size wlres...__.............................._..
Range, KW..........................................
MaIn fuse ......__m.........__.................
Water Heater:
Enclosure ...____.__..............__.............
KW...nn________m__.__.m__.nm.
Hea', KW........n.f?__.__m....m....__..........m..
Type of wiring:
Entrance Cable .............................
Motors: size, volts and phase:
Rigid Conduit .....________..__
Meta1l1c Tubing ...........................
Current transformers:
No. &. Size...................____..__..__....__..
Ser. No.................................____..........
Ser. No. ...............................__.....__.....
Ser. No....................__...__...................
Non.Metalllc .................__..........__..
Knob & Tube______..__..______...______.n__..
RIgid Conduit ...............................
Metallic Tubing .___.__......______........
Raceway ...............................__..._
Circuits, Light......__.__.......__...................
Utility ......__..............._....................
I-Jeat ...............................................
Range .............................................
Water Heater ...............................
Motor ._____..........__.__....__..__.__..........
Dryer ...__.......__.................................._
Furnace .........................._...................
z 11c.<J
Total Load....__...__.................. SerA No....__.......__.___...__...__................ Total ........____._........................
~~--::::::::~~:::::::::::::<:::::::::~:::::::::::~~::::::::~:::::<:::::~~
..n____.____.h....__~__nnn.______uu____n..n_nn__nnu.__U.n.U.Uu__.un___h__hh~.nn_.nu_u__un.._u__h.h..nn__n________huh.h_u__n__nn____
::~j~~~~~~ ~.mu__ ::~.~.Q~~d~.Jm By uu~~...~~____...~ ~uo~ &-,
mm"" _ _ ~
NOTICE-Current must not be turned on untll Certificate of Inspection has been issued. It work is to be con.
cealed 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~ 18365
ELECTRICAL PERMIT
::;:5~=~=:~~~~f~
NOTICE-Current must n()t be turned on untU CertifIcate ot Inspection has been issued. It work is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
1M Olympic Printers, Inc.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16261
/' -- F ,,-~~
Port Angeles, Washlngtoll._mm___,___mn...______mm__m__mm..mn__m_, 19_/,('
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 listed below_
YrJ V r:' ~eP .
Address m_______________mmn~--nn------------n.m-nnn----m--mmnmmm-n Occupancy___m________________nmn______m..._______
~:::~-~~~::~~~-:::~:~:;.:p;.~=::f~:~~:::____~~:~~~;:::--:::::::::-_-_.::_~::::::::::=:::::::::::::::::::::::::::::::::::::::
(j
Light Outlets........m_........__._..........____u. Service, volts __mm._.__...___....m............. Type of Wiring:
Receptacle Outletsm_____.......................
1\0. wires .......................................
Armored Cable ............................_
Non.Metalllc ........._..n_..................
Knob & Tubem____m__...................._
Rigid Conduit _mmnmmnm_m___..n
Metallic Tubing .mm_..__...............
Dryer, KW.........___n...u...n___u_______n____
Size wlres.._n............u.__mm_......_..
Range, KW ___.un________....____._.
Water Heater:
Main fuse .......................................
Enclosure .......................................
KW.mnnnmnm_____________hmn_nnm
Type of wirIng:
Entrance Cable ._....._....
Motors: size, volts and phase:
Rigid Conduit ...___mm
MetalUc Tubing ......
Raceway u....................................._
Circuits, LIght.................................._..._
Utility nm_____mm_m_m_____nn_mn_nn_
Heat: KW.............___............._n....._.............
Heat __u__........._.:.....____..............._.
. Ser. NO....______m...._.._......___............_n_
Range .....__.._._.........__......__..............
Water Heater ............._.m.n..........
Motor ................__....._......_............._
Current transformers:
No. & Size........._..........m..
Ser. No. ._........._.............___............__...
Dryer ..........................__...._....._...__......
Furnace ....____..................____......_.._......
SerA No. ......._____.............___.................
Remark:~ta:n~~~__{;._.!-!~;.::-~~::____~~_~~:;_a~:1Z_;_-____-:__~__:-__mmmmn______~:t::__~::~:__~_:~.._~:._~.:~::~:_~__
-:i_=_~~n~::-_-_~-____~n_~_~~_~-_-_~nm...-::~~_~:_~~~_~:~_~_~____~-___nnmn---nm-::-:_:~~:_:~~~~~:2~~
NOTIC~urrent must not be turned on until Certificate of Inspection has been Issued. If work is to be con-
cealed due noUce must be given the Inspector so that work may be Inspected berore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
16261
Address.__.___________..........................___....._...._......__.._....._____.._..........___._....................................._....Date..._.....__.._________........____..._.__..._...___...
Owner ..........__.......___..nn.......___nn_n........_..........___..................h_..._n___n.__n__________.......... Tenant.....__.n............._......................nn....___h.n..nn
,
Wirtnr Contractor ..................................._.........................................._.._.......____..____....__..____._____._. BY....'::_~----.-.--.---.--...n..--.........................__
N0TICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be COD-
cealed 'due noUce must be given the Inspector so that work may be inspected before conce'alment. .
\ ""'-, if"
1M ,~ Olympic Printers, Inc.
Jul 05 02 09:27a
Bobb~ O. Coleman
ELECTRICAl.. PERMIT APPLICATION
360-452-7594
&/Vl
p. I
(j.....'...
'd
...
The EIectricar P4mnit AppUca{iot. must be filtad our camrlllM.lv.
I ""~"'_'-'_I'!:r~~.._~. I
1 =r;...:.~~y-= I
:::::'7"~:
""die.. ,?lJ4 ~ ~~ C;1Jr.
Electrical Conbac"", /it. d,~uP....... r~.dk
Prease type or teprint 11'1 ink. If you have any questions. ~ call (J60) 411-
4735
Fax number: (3tiO) 417..c711
f;t;< REQUESTINSPI:CTION 0
P1-one.,;2. 7 S' <; Y F"", SH
/
Phone' 7 - ::5 f;- .r '7
.;0/1
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INsrAlLATlON WIRED BY: UOWNER AELECTRI~ CONTRA~
Credit Card Hohler Name: cS& J.r. h. -,>", . h/,q ..--.h,. c:
Zip.
BIlling Address'
City:
7IEXP.Date:
90 :3 /'~
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Zip:
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Credit Cant Number:
PROJECT ADDRESS'
~~ S.jL P.l!Me 1
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TYPE OF WORK' Check all that apply: 0 New
)I'ReSidential 0 Multi-lamily 0 Commercial
o Mobile Home
Sq. Ff
Ramole Meler 0 Detached _age 0 Hot Tub 0 Swim Pool 0 Septic Pump 0 low Voltage 0 Telecom. 0 Sign
Number 01 CiICUils added or "",,red:__
DESCRIPTION OF THE ELECTRICAL PROJECT: 44.</.:;260 ~-x;::' g/-? l.hcu-
/0 I\. to h/ In Yi" ...:- ..;J 7C ~ ~ j ~",--L7
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Electrlc:al Heat I """ A_lolls
PERMIT FEE:t.-.:s tfl.O
Service Information
U Baseboard
Oi'wnace
o Heal PlJmp
:J Fa"..Wall
-KW
_KW
- TON LRA
_KW-
00.""",,8<1_
o Temp SeMee
o UndeIgrounct SeNice
VoIlage:
Phase: 0 1 0 3
Service Size:
HJeder Size
t hereby certify that t have read and examined this application and know that same to be true and correct, and I am
authorized 10 apply for this permit. I undefStand il is not lhe City's I9gaJ responsibility 10 determine what permits
are required; it remains the applicants re$pOtlsibHity ro determine what permits are required and to obtain such.
Cr_, Card Holder's SIgnature:
.QPo21
Date: 6 --.::;'-.7 -c:) ~
Owner or Elec:. Conl Signature:
CJElECT~LPERMITAPPlICATION ,
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