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NN " 0\0\ ri o '" 0\ ~ :;: III rl k 01 <: <1l 0. .-< 0. ~ '" .-< o .c: +J III k.-< <1l.o .o<1l 0..-< 'rl <1l :;: ;. '" <1l III .-< k 01 t: <1l 0. .-< E-< 00; ~ :I: ~ It N o '" 0\ "' :;: 00 ~ E-< o Z o ~ 00 E-< Z ~ :;: :;: o U CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32\ EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning , . . Application valuation 07-00001406 Date 12/05/07 404550 829 E 8TH ST 06-30-00-0-2-2495-0000- RALSTON & RALSTON INSUR. MECHANICAL APPL. PERMIT COMMERCIAL NEIGHBORHOOD 9764 Owner Contractor JOHN M RALSTON PO BOX 898 PORT ANGELES (360) 452-8415 WA 98362 ALL WEATHER HTG & COOLING INC 302 KEMP ST PORT ANGELES WA 98362 (360) 452-9813 Permit MECHANICAL PERMIT Additional desc INSTALL HEAT PUMP Permit pin number 116673 Permit Fee 64.80 plan Check Fee .00 Issue Date 12/05/07 Valuation 9764 Expiration Date 6/02/08 Qty Unit Charge Per Extension BASE FEE 50.00 1. 00 14.8000 ECH ME- INSTALL 100- FAU 14,80 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 64.80 64.80 .00 .00 plan Check Total .00 .00 .00 .00 Grand Total 64.80 64.80 .00 .00 ~ ~?:/ ~ /~ O/: ~ Separate Permits are required for electrical work, SEP A, Shoreline, ESA, utilities I 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 for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. T:Forms/Building DivisionlBuilding Permit (10101/07). wpd Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD 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 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. o ,...J , INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS SHEAR WALLS I WALLS FOUNDATION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLDGS,) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALL/J-IOLD 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 FINAL DATE ACCEPTED BY: . COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO (t) ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL ~ LIGHT DEPT CONSTRUCTION R,W,/ PWI CONSTRUCTION - R,W. ENGINEERING 4 I 7-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. C PLANNING DEPT. 417-4750 PLANNING DEPT, 3 BUILDING 417-4815 BUILDING I () _ fJHJR- fA -0 ...c o 0' ~ ~ ~ C\; to J: ~. T:Forms/Building Division/Building Permit (1010 I/07).wpd 70 C- rt ~ T.l\\. \;)~ V) ;t- ~ kI .V), Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . , . Application valuation 07-00001417 Date 12/03/07 135119 829 E 8TH ST 06-30-00-0-2-2495-0000- ELECTRICAL ONLY COMMERCIAL NEIGHBORHOOD o Owner Contractor JOHN RALSTON ET AL,TTE PO BOX 1405 PORT ANGELES WA 983620259 SIMPSON ELECTRIC 243036 W HWY 101 PORT ANGELES (360) 457-9270 WA 98363 Permit . . . , . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date ELECTRICAL ALTER COMMERCIAL 116855 58.00 12/03/07 5/31/08 Plan Check Fee Valuation .00 o Qty 1. 00 Unit Charge Per 58.0000 ECH EL-COMM ALT <5 CIRCUITS Extension 58.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 58.00 58.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 58.00 58.00 ,00 .00 DO ~ ~ IT, C{J t V1 ~ INSPECTION ELECTRlCAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH - IN 12.ltI/Ol ffy' ~ FINAL COMMENTS: Nov 29 07 01 :34p p.1 PROJECT ADDRESS 82~ CITY C?~ PORT.ANGE.L.ES (), :\S Le For City Use Only: Attn: BUJ!dlng Permit TechnICIan. ,,~\\,--a-: (0" Date Received~1:-?'O -0, 321 ~. Fifth St., Port Angeles, WI'<. 98362 ~'\\t?- t.,u Permit # (\'1- l'-tab- (360) 417-4815 fax (360) 417-4711 W7 \~ -1A' Date Approved Applicant or Agent~\O\~ 6i~f~~O...\lt1OJ ~ (CiO Ii nC) Phone .. Z - 1 Owner M\q) V'I f, () . oc. Phone ~ 0(\ -4'57 - 6'-1 IS Owner's Address _ .0. ~ox 140':; Contractor/Engineer - 11\\ L111?Ci~tfi~ ~ eY11 ~ \)~ Phone ~ - 4> 7 -:::~!i Contractor/Engmeer's Address ,) - p ~,;;-. } \11- Av1c:;-e IP~, A. "'/5 License # PtLL lAJ ~ lA)W' -lese \L\J Expires --!1:-1- oP.> 1Y\(A E8*' BUILDING PERMIT APPLICA TION Print in ink Parcel Number Pro;ect TV/Je & Brief Description: o Residential )l::f(ommercial o Multi-family o Industrial Clleck all tllat apply o New Construction o Addition o Remodel o Repair :J Re-roof o Demolition o Sign o wall-mounted o projecting o freestanding Dawning o other Total sign area SQ. ft. Maximum allowed siqn area sa, ft. )(fieat System )(Heat pump 0 wood-burning stove 0 gas fireplace c pellet stove 0 other o Other '.lC'~ ~ Loning Floor Areas Existinq (SQ. ft.) Pro/Josed (sQ. ft.) Basement @$ per sq. ft. = $ 151 Fioor 2nd Floor 3rd Floor Garage CarpOr1 Covered Por~h Deck Shed Other TOTAL VALVA TION $ q,l L,W ZO Total 700tprint of structures sa. ft. . Lot size sq, ft. = lot coverage % Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? ft. Occupancy group Occ'-'pantload Construction type # of bedrooms # of full baths # of half baths ( have read and completed this application and know it to be true and correct. (am authorized to apply for this permit and understand that it ;s my responsibility to determine what permits are required, and 0 projects. . 0 Date-UfZ.~ t01 Print Name.(ajVIeflrw nnuld-e", Signature T:FolmsiBuilding Di'JisioniBJdg Permit Ap:>I.-2006 Code.doc ti L -=- ~ "'<~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application description Subdivision Name Property Zoning . . . Application valuation 03-00000602 Date 6/20/03 829 E 8TH ST 06-30-00-0-2-2495-0000- GRENNWAY, GAY I TULLOCH SIGNS 1700 Owner Contractor JOHN RALSTON ET AL, TTE PO BOX 1405 PORT ANGELES WA 983620259 JACKSON SIGNS 472 MOUNT PLEASENT RD PORT ANGELES WA 98362 (360) 457-)703 Permit Additional desc Permit Fee Issue Date Expiration Date SIGN 30.00 6/20/03 12/17/03 Plan Check Fee Valuation .00 1700 Qty Unit Charge Per 1.00 30.0000 PER S- SIGN ALL 25- Extension 30.00 0( ~ -' Fee Bununary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Penni t Fee Total 30.00 30.00 .00 .00 plan Check Total ,00 .00 .00 ,00 Grand Total 30.00 30.00 ,00 ,00 ~' , ~ '1 ~ 01 "i Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvemenls, This permit becomes null and void if work or conslruction 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 requesled 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 correc!. All provisions of laws and ordinances governing this type of work will be complied wilh whelher specified herein or no!. 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 ~-12~:;Yl. tJf~ Signature of Owner (if owner is builder) (,[20 I 0 2, Dale T:\PLANNING\FORMS\I 102.15 [4/2002J BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS, PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 FOlJNDATlON: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARA IE PERMIT: # ROUGH-IN I I I PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW I WATER AIR SEAL WALLS I I CEILING I I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYWALL I-BAR INSULA nON SLAB I I WALL I FLOOR / CEILING I I I MECHANICAL HEAT PUMP WOOD STOVE / PELLET I CHIMNEY HOOD / DUCTS PW lJTlLlTIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'s: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE 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 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BU1LDING 1/ III ':1 T:\PLANNTNG\FORMS\1102.15 [4/2002J . ~ ",--,------=,./. BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONl.Y: 0... Roo.. <;; -I /3-Cf~ Ponnit#: ~Ci7.- - Dale Approved: Date Issued: Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be aceepted for review. Uyou bave any questions. caB (360) 417-4815 Applicant or Agent: 0k.,f:ti.J/.fWrl::;. G/1'jc/--fMI"<'f./ Phone: '-15'.::>- ~3..J ;J...J Owner: U /f '" If.. Phone: i/. )'...2 -.:5 ? ..13 Address: X,;) '1 ;fAsf 9w.Jf-, City: ru/Z r ;}J{ q,cus (.'4 Zip: c/~3L L- A _ hit tIE . tI r pL~ne' l.rue ec ngmeer: nu . contractor;Ar IC~() ~ A-:'s StaleLicense#:T'1Gk~:S(;D.J1\~p: /-J'( -/J <;' Phone: Lf~J~'? -.!'1tJ.J -.." _7.:2 a~ ~-;J~ my, 1';;:td1~) ,.',t z", '7li1'.~ PROJECf ADDRESS: 'L~,~ _cL.._-.!~ ,,,,{ (. D _ _ _ _1...--11 WNING: LN 0." LEGAL DESCRIPTION: Lot: ock: Su IVlSlon: CLALLA.M COUNTY PARCEL NUMBER: Credit Card Holder Name: Billlog Address: Credit CanlType VISA TYPE OF WORK, o Residential 0 New Constr, 0 Re-roof o Multi-family 0 Addition 0 Move o CoDlJDercia! 0 Remodel 0 Demolition o Repair 0 Sign BRIEIi' DESCRIPTION OF THE PROJECT: -(~C?:JiA-;r0i? Ct?'oML COMMERCIAURESIDENTIAL: Occupancy Group: No. of SlOries: _ Lot Size: Existing Sq. Ft. E . ling I t overage % & Proposed lot coverage City: Exp. Date: Me # o Slove o Garage o Deck o Other / SIZElVALUATION: SF. @ $ ISF, = $ SF, @ $ ISF, = $ SF. @ $ ISF, = $ TOTAL VALUATION $ ~ / r( ()u y.1.5 t~ ,'f---j.U:, C;:',t'-c"l" J-la. \ \ ~C>UA.~ ,00 'X' ~~'* Occupant Load: & Proposed Sq. Ft % - Total lot coverage Constmction Type: = TOTAL Sq,Ft. OX XIS 0 c - 0 _D- O APPRO~ PLAl"lNING USE ONLY: ~~ /i/~~ \ A."oAnM~ ./>--1 i~t PLAN:S " !\ " fl-J....", J:"J Q ~(:\ BLDG: P-1s' , feR , I , ..-y", DPWU: I ESAlWetlaod(s): 0 Yes lRNo SEPA Checklist required? 0 Yes)i.:f No FIRE: Other: OTHER: I - .;{~ BIDLDING PERMIT APPLICATION SUBMIIT AL: The Building Division can provide you with inSonnatioll on the application and plan submittal requirements if you bave questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. TItis figure will be ",viewed and may be revised by the Building Division to comply with currenl fee schedules. Contact the Pennit 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 pennit application and construction plans are submitted. AD other permit rees are due at the time of permit issuance. EXPIRATION OF PLAN REVlEW~ Ifllo permit is issued within 180 days of the date of application, the application wUl npire. The Building Official can extend the time for action by the applicant 01' to 180 days upon written request by the applicant (see Section 107.4 of the Unifonn Building Code, current edition). No application can be extended more than once. 1 hlHUby cerllfy /hat I have read and examined this application and know the same to be true and cormct, I am authorized to apply for this permn and understand thai it is my fflspoosibitity to determine what permits are required ,not the Cily's. and at I must obtain such permits prior to worlf, T\FORMSIAPP5".BuilJiogpennii.wpd Appiicant: , ,4... ~/-thale: t; ~/ j- 0-;', Sign: 11/2" Single sided Cedar Sandblasted 96.0" x 33.0" 22 Sq. Ft. Lag Bolt and Washer ;[FAi'lfT'''' Greenaway, Gay, & T U och Sign Face Existing Wa . 829 E. 8th St. . Port Angeles, Wa Lag Bolt and Washer ~t4 Mounting Diagrarn ~ v CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . INSPECTION REPORT . . . . . . REQUEST: Date 0- 2D-D'3 Time Location of Work to be inspected 'r\ Z q Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Received by RV (phone, person) F 8 i-Ll Inspected: Date Remarks: INSPECTION NOTES: Phone No. Permit No. W)L ewer Excav. Other Time By -rr \../ RESTORATION REQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: D Unimproved o Gravel OAsphalt OPCC [] Repaired by City D Repaired by Permittee [] No Damage Found o Other Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) . CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO, ;2.3.5-3 ~ M6'#J7 ~ , ELECTRICAL PERMIT DATE Site Address: ~ D READY FOR INSPECTION D WILL CALL FOR INSPECTION Phone: Installed By: Owner/Business: Phone: Owner/Business Address: Sq, Ft. o Residenlial Heal KW o Baseboard 0 Furnace/Boiler o Healpump 0 Other o Commercial/lnduslrial load Tolal Connecled load (attach breakdown) Tolal Molor load (attach breakdown) o New Conslruction ~ Remodel o Service updale/aller/repair ~ Add/aller circuils o Auxiliary power (Iisl below) o Special equipment (list below) o Overhead o Underground Vollage 010' 03.0' Service size o Temporary Amps Delai Is/Descriplion: dJ: 9~-M A--c.~ . W,S. No. Service Size Capacily: 0 O,K, 0 NolOK Commenls o Ditch inspeclion O,K, ,~ )IS Rough-in/cover OK o O.K. 10 connecl service ~ Final O,K, Dale Hold for: 0 Easemenl 0 Letter o Signed up for service/meler o MeIer Deparlmenl nolified for inslallation o Fire Deparlment notified of inspeclion o Plan Review approved/pendi ng Site Address:~ '8 Installer: /~ Permit/Receipt No. ;;2. :r.S 3 . Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work musl nol be covered or eleclrically energized before inspeclion and O.K. for covering or service has been given by lhe Inspeclor in Writing on lhe Wiring Reporl or lhe Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. ~~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT / t, ~ Inspector Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMPIC PRINTERS. INC. 16945 r- / '> '7 Port Angeles, Washlngton___n__m______________-'_____mn._.n______m__m_______, 19:____/._ CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Nt.> 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- :::~s: i~_rl~__~~~:::-~-r~--~~-::-~~-~-d--~~IO:~cupancy---~~~!__ o~~er na4'.~~ooo-zi1~~~y Tenant____oooooonooon_ooo__mn_ooo_nn______ooo_ooo_oon.ooo____ooo___n Wll'lng Contractor ---.-'4:.----------0000000'0000--------000000000--------------- Bynnnnn-----.nooon-ooo-ooo--ooo----noooooo--------oo---oo--ooon Light outlets............:..!.._?::,..__.__.. Service, volls /-<?3'c>/,--,'!!:..!'!.C: Type of Wiring: Receptacle Outlets.......~~_Q.___........ No. wires .m..................._.______.___.... Armored Cable ..m......................... /j" /1" Dryer, KW......unn.........___._..__.uun.____ Range, KW ____h_____.H....n.__.. Water Heat; ,~...' M KW.m"'''~7/.."ed.1!-;"".. Hea" KW <'Jt?/.1I.&!...;a..., __ , ,- f *~~ii!:~i?~~~ /- f},p....j..,'l~,..___...... ;;. - ~..:Sr~.......f),,:,!:,~.....,...,... Size wires""';;';)o";;lr'--"-" Main fuse .........__h_____..n................. /5 Enclosure __............,.............__......... Type of wiring: Entrance Cable ......________________....... Rigid Conduit ___.___nn___n Metallic Tubing u___mmn Current transformers: No. & Size...........______m______... Ser. No.....................__.__.....__.............. Ser. No...................................__.......... Ser. No.....__........................................ Non.Metallic ................................. Knob & Tube................................_ Rigid Conduit 'm_mnnn...n....'h__'" Metamc Tublng h,n......m"''''h'_ Raceway ''''''l''' , ......m_......_...n.. </ Circuits, Light___. ..............---........... r ~ .., --~' UtIlity......... ....-,0:............................ .y.. Heat ...........;..........................._...... % ::t:: ;::~.~~..~~~2~~~::~~~~~~~:~::~~~~~~ Motor ........................__................... Dryer ................................................_ Furnace ..........................~......_........... - Total Load......m...___......_.___... Ser. No. ................._.....___.....___.......... Total ......~....~................. Remarks: ____'ff___~_________L:d2.._~':!:7fooo~_~___u____ooo______ooon___n.ooo_________.ooo_________n.___oo -;:~;i=~---ooo------------u-n;~:~~.n~:~:;~~--------------h-------------Un9/fi~-~ooo~---ooo-------~---n , $_____~!__..___._._oo_______h___' NO.___nn______n___n..n__.. By _oo_..____..___oooooo_!..___{"'e_~oo___!f::1..dif!::I:~..::!-:!"'-- NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If' 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 ELECTRICAL PERMIT N'? 16945 \\ :::::s ,,:::::::::::::::::::~::::::::::::~::,:::~::~::::::~::::::~::~...::::::::::::::::::::::::::::::::..:.::::::::::":::"":n~::~=~,t~:':~::::::~::~:.~::~::::::::::~::::::~':::::~::::::::: .+ "} Wiring Contractor..........................................................._............................................................. By.............................................................. '\ NOTICFr-Current must not be turned on untU Certificate of Inspection has been issued. If work ifJ to be con- cealed due notice must be given the Inspector 80 that work may be inspected before concealment. 1M Olvmcic Printers. In",_ 12/02/2007 07:38 4579270 SIMPSON ELECTRIC PAGE 01 . J06 wIrmt bJl "j4 Electrical ClIIIltrn<(Or Llconse Dum '''lblUlltioe de8eriptiOO fi COID,,",rdol 0 .....mtlol t:I Now ~IAddl"'. . C) -J \ .J:- -- ~ 07-tY[7 ti ELECTRICAL WORJ(PEIlMlT APPLICATION Elllctriul contractor:lU'1 I::: Ie ~-C- .mlill!lllm Clty'j;303fO ~ lOr Will... ZIP lI'od 4tioe/ec;. Wit 08"3b3 TcIlaphone ftlambr:r 7 f PAX '!.l,",ber k ~- 7 ~ ".lIIlle. OW.1f'S ,.nlfe . () I I /'(aI5tE.n r rwS-ttJh JfIS~e.~ Add.... or I..~>>'II. t-rtii:. $-1, ~2C) €.. B--flt==- City Po~t Md C!.,'{ll!M- .. 3h f6n ~oo:f'lop UY/I+- /--b1YL if UA1,"f- P'one D'UlIIlbu to .d~tfhdt IIll IleuI: L/ 5 Ow,,~, 41 dejl,.!d by RCW./9.28.ldJ.'(lj Own~ wiIJ OtlCII,,' 1M IItrV1:Itlrf1/tJf Iwft ymn qfb!1' thb eh!r:IrJt:IJ{ f'WI'Jil ~ fiflClll01. (2) O...ner " ,.,,.Irwlto frlrJ! tiff c1~McQ} e"ml"dCfM if IJrova ;ttllrl prope,.". fs /tJr Itlft!, ":IIr or htmt. After radins 'die lIbcwe .~ J heft:b)' cClrtjfy that 1 am the owner or I1ae above Mmed P'opeI1y or I lictlJAOCi eleetriaaJ contrtlf'Jur. I mt'l mnklng the clcctritAI inat.l~ I..Jon or _herDt_ i.n c:ompUaace wilh the clecttiCJI.l tll""~l N,E.C.. fleW, Chllptllt 19.2&. WAC, CIUl.pl:1tr 296-460, Thlt City of Port "'"Bele" "h.lridpe.l Code, llInd Ur:Uity Speel king. S....a..n x t:I Ca9h [;) Check # [J CrcditCatd Q _ MAs"""an1 Discovor CIlI'd# _-f):J:L-~ _-______''____ ,,,~,,.r ... 1tll!I!ull!:III .""",alstratDr fJJtpimtion Date Date: /..2 - tJ3 -0 7 of card Imrper;tino ~ $58.- $JNlce InfotInIUbm EIAfttrl~1 t:I NO ~OAD CI1ANGES o a_board _Kw (;I)'umaoe KW \i!f _ Pump W.aJ<1n _ LAA t:I F.n-Wsw _ Kw t:I O",,,.,,d S.""O. 1:1 Temp Servtce o Underground SeMco VOllago P""...OlI:l3 ServIoe !lI:le: F_rS"'.: SAME DAY INSPECTION CALL BEFORE 7'00 AM 368-417-4735 . . ROUGR-lN / 11IERMOISTA1' sntVICE t7/:/~, --m-. '- 0- NtJl'lC'f'IIa Dy .... ^"""'.... Hy - '.k ~*~ .J /' JfEUJ.IIM. P4i:z.- FINAl, DITOI 1. '(. ""'FlJ\ . " B, ..... D_M !\rpIaMllAY/ "'~ ^ "/ In,peclion Area, Buildins or Equipmont Inopocled Electricel Data Acdcm 1'Iken JnJpCctor -.. - - - -