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Home My WebLink About1701 W 10th St - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Owner MANGIAMELI JOSEPH /TERESA P 0 BOX 2832 PORT ANGELES (360) 417 8056 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date T•\Policies \1102.15R [1/05] Qty Unit Charge WA 98362 Fee summary Charged Permit Fee Total Plan Check Total Grand Total RIGHT OF WAY 80 BURRIED CABLE 81885 70 00 7/13/06 1/09/07 Per BASE FEE 70 00 00 70 00 CITY OF PORT ANGELES PUBLIC WORKS UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 06 00000721 630683 1701 W 10TH ST 06 30 00 0 3 -0895 0000 WAVE BROADBAND PUBLIC WORKS UTILITES RS7 RESDNTL SINGLE FAMILY 0 Contractor EXCEL UTILITIES CONSTRUCTION 54 MISTY LN PORT ANGELES (360) 452 1110 Plan Check Fee Valuation Paid Credited 70 00 00 00 00 70 00 00 Date 7/13/06 WA 98362 Due 00 00 00 00 0 Extension 70 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 authority to violate or cancel the provisions of any state or local law regulating construction or the performance of constructi Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date 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. PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE T\Policies \1102.15R 1/05] RESIDENTIAL CONSTRUCTION RW PW/ 417 -4807 ENGINEERING FIRE 417 -4653 PLANNING DEPT 417 -4750 BUILDING 417 -4815 PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED YES I NO I I I I I I I I I 1 I I I I I I 1 I I I I 1 I 1 I I I 1 1 I I I I 1 I I I 1 1 I I I 1 1 I I I I 1 I 1 CONSTRUCTION RW PW ENGINEERING 1 FIRE DEPT I 1 PLANNING DEPT I BUILDING FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES 1 NO COMMENTS I I I I 1 I 1 I ~ VORT """ $~O~~~ ~ "-~ ~ '4>:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIV~SION 321 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 04-00000529 Date .355290 1701 W 10TH ST 06~30-00-0-3-0895-0000- RES MANUFACTURED HOME 9/07/04 RS7 RESDNTL SINGLE FAMILY 62000 Owner Contractor WA 98362 M & C CONSTRUCTION 653 N. 7TH AVE SEQUIM (360) 683-4571 NEW MANFACTURED HOME 1280SF TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS INC MANGIAMELI, JOSEPH/TERESA P. O. BOX 2832 PORT ANGELES (360) 417-8056 Structure Information Construction Type Occupancy Type Other struct info WA 98382 18.20 1. 00 7000.00 1280.00 1280.00 1. 00 \' \1- (~ t~ '-. .........0 ---------------------------------------------------------------------------- Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL SERVICE/FEEDER QUALITY ELECTRIC 78.70 Plan Check Fee 9/07/04 Valuation 3/07/05 .00 o ~ '\ "- ~ '\.l ~ <:; _. , 0' S::-' ,... f',. --. C) ~ ,.... ~ Qty 1. 00 Unit Charge Per 78.7000 ECH EL-MANF HOME SERVICE & FEEDER Extension 78.70 ---------------------------------------------------------------------------- Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. Manufactured home must be pit set so that no more than 12" of skirting is visable above grade. A residential fire sprinkler system shall be installed per NFPA 13D will be required. 2nd option is to install an out side alarm bell that is eletronicly connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" The site is zoned RS-7. Setbacks and lot coverage are good. No land issues are noted. Sidewalk to City standards required for school walking route. ---------------------------------------------------------------------------- Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 745.00 4.50 1025.00 Fee summary Charged Paid Credited 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 ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit d es not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performa e of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) T:\PLANNING\FORMS\ 11 02.15 [11114/2003] 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 A T JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDA TlON DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKING/LlGHTlNG 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 BUILDING T:IPLANNINGIFORMSII102.15 [11114/2003] _~ ~~;:,,?-,''''i'.~,.~ ~ VORT ~ $~O~~~ ". "-~ ~ '4>:",w;;:.<' CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000529 pin number . . .355290 Page Date 2 9/07/04 Permit Fee Total Plan Check Total Other Fee Total Grand Total 78.70 .00 1774.50 1853.20 78.70 .00 1774.50 1853.20 .00 .00 .00 .00 .00 .00 .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 T:IPLANNINGIFORMSI1102.15 [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 NO FOUNDATION: FOOTINGS WALLS FOUNDA TION DRA1NAGE/DOWN SPOUTS ELECTRICAL (LlG!;JT DEPT) SEPARATE PERMIT: # r\ " 1f,17M 5ue/'/- ~Lk~/ ~f, <A:OUO~ vIA / -ll c::;A.:..-r Ci_ ;;L(J -oJ 'L-t --C l/'\ / , PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR / CEILING I I MECHANICAL HEA T PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 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 9-.1/(- of( VL/C 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 BUILDING T:\PLANNINGIFORMSI1102.15 [11114/2003] - ~ VORT ~ ....4..0~.(( ~ 't'rtiii'" -- ~ ~ ~~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 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 04-00000529 Date .355290 1701 W 10TH ST 06-30-00-0-3-0895-0000- RES MANUFACTURED HOME 7/23/04 RS7 RESDNTL SINGLE FAMILY 62000 Owner Contractor MANGIAMELI, JOSEPH/TERESA P. o. BOX 2832 PORT ANGELES (360) 417-8056 Structure Information Construction Type Occupancy Type Other struct info WA 98362 M & C CONSTRUCTION 653 N. 7TH AVE SEQUIM (360) 683-4571 NEW MANFACTURED HOME 1280SF TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS INC WA 98382 18.20 1. 00 7000.00 1280.00 1280.00 1. 00 Permit Additional desc Permit Fee Issue Date Expiration Date BL MANUFACTURED HOME HOMEBUILDERS NORTHWEST#48724 230.00 Plan Check Fee 7/23/04 Valuation 1/20/05 .00 62000 BASE FEE Extension 230.00 ......:l ~ - \\ E: Z Y r G' "1. '^ ':i Qty Unit Charge Per Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. Manufactured home must be pit set so that no more than 12" of skirting is visable above grade. A residential fire sprinkler system shall be installed per NFPA 13D will be required. 2nd option is to install an out side alarm bell that is eletronicly connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" The site is zoned RS-7. Setbacks and lot coverage are good. No land issues are noted. Sidewalk to City standards required for school walking route. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 745.00 4.50 1025.00 Fee summary Charged Paid Credited 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 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 . nature of Owner (if owner is builder) T:\PLANNING\FORMS\I 102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 4]7-48]5 FOR BUILDING INSPECTIONS. CALL 4]7-4735 FOR ELECTRICAL 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 FOUNDATION: FOOTINGS WALLS FOUND A TION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN 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 (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEAT PUMP GAS LINE 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 #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\1102.15 [11114/2003] ^,;:,:.,-,~\,.,.~---- -- :'('VO~T~ t4.0~~~ ". .. ~ ~ ~-;--~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 32] EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000529 Pin number . . .355290 Page Date 2 7/23/04 Permit Fee Total Plan Check Total Other Fee Total Grand Total 230.00 .00 1774.50 2004.50 230.00 .00 1774.50 2004.50 .00 .00 .00 .00 .00 .00 .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 T :\PLANNING\FORMS\ 1102.15 [11 II 4/2003] BUILDING PERMIT INSPECTION RECORD CALL 4 I 7-48] 5 FOR BUILDING INSPECTIONS. CALL 4] 7-4735 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 A T JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: Plock cj 'T ~do~ r) Cf-'l-i>f IH) JJ.I. FOOTINGS _" I,. J.. R'-II ON . \.1- WALLS FOUNDA TION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DR YW ALL (INTERJOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LlGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI jJ-:" CONSTRUCTION - R.W. ENGINEERING 417-4807 I u.. ..()..')(.~{)" PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 'Il _ I (; '-0,;.) J.L BUILDING T:\PLANNING\FORMS\1102.15 [11/14/2003] to to to >-l '" i;;;:;~8E; (J'U t-< t-< t-< >< ~ H:O '" to '" 'U 'U:OZZtJ >-lOJ '" >-l Ul -.... t-<(JOJ>-l:O ><'U Ul H OJ:O:OOJ ;I> 0 0 0 0 >-l Zt-< ;l>Ul 0:0 H H H !i. (JUl "'OJ >-l tJ tJj to 0 '0 n:o~ OJ. :0. OH ~ :0 :0'" "". 00 00 OOJ >-l-"" -....-....-.... -....-.... 3:0 H 00 HH 'UC::O OO~3:""" ~~ "'0000 HH , t-<OJO ...'" ..., -....-....-.... -....-.... , OJUl I I R"o Glo 000 00 , >-l>-ltJj OWGl H OJ'" ......... ...... , OJOJt-< COHn t-<- , tJtJ ~~~()~ OJ , GiHi UlH , o otIj 0...... 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I ~ L 5> pee f-, 0/) V 29:/ v' p -~ '1. v INS TION NOTES' Inspected: Date R/ II (uc ( Remarks: i 70/ LU .J "tYJ I cJ tf'J Time (j-{Vj By :rrC- RESTORATION REQUIRED. . . . .. YES NO ~<? SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE 01 , >oJ 'tl ~~~8E; ()'O t:-< , "' ~ H", "J , '0 'O",ZZO >oJ 01 Ul , " t:-<o01>oJ", ",'0 , Ul H 01","01 ;.> 0 , 0 >oJ Zt:-< ;'>Ul 0"' H , iii. ()Ul "J01 , >oJ 0 , tll 01 0 '0 l O"'~ 01' ",. 0 "' ",CD 001 >oJ...... "" , 3:0 H , 'OqO OO~3:1-' ~~ H' t:-<010 ""'" -..J ...... , O1Ul I I l('lO "'0 >oJ>oJtll ow", H 01"" , 0101," COHn t:-<- tlO ~~~(1 :>: 01 ~Hi UlH ootI1OI--' 10 ~ Ul , t:-<Zo t'VOHU)f-3 "" '" , - >oJ;!: w gj~~ w " "' , ,-<qUl Ul t:-<'O tljoQ()1-j 0 >oJ U)CP(f)t-3 "'01H ~ ~LntOO 'II:Z 0...... 3:,-<01 ",0= C:::Ot-3H o ""'-c:: 01010 l'1:jott1Z " 3 H gj~~ po::on ~ t:-< () , 01 f-'. 0 t:-<"' >oJ Ul ~ Z >oJH ~ ;.> lQ , Ul'O () '" ......>oJ 01 0 '0 OH 0 H 3: 0 ..., 00 HZ 3: " CDO 3:Z II: ZUl 01 " 00 3: 0 Ul'O Z CD >oJ 01 3: '001 >oJ Z 01 010 Ul " w...... >oJ ()>oJ (1) 10Ul Ul >oJH ~ .0 CDt:-< 00 " H;'> ",Z 0 (1) 01 '" '-<>oJ Z r' ~8 0 'O'OUl >oJ f-'. >oJ 1313lii 01~ 01 ~ H UlO1 Ul '" 3: ZZO >oJ '0 01 O101H t:-< (1) <: n t:-< r' H H f-'- -..J 01 0 ww "' ~ 0 "'''' t:-< 0 00 "' .... 0 " ""'" HCD -..Jw , , 0 00"" 0 OUl Ul-..J ;.> "'H 3: 0'0 ;.>;.> >oJ'" 0101 CD ...... H H ...... 0 ""Ul o ~ ~ ~ DATE: To: FROM: SUBJECT: ~ORTANGELES WAS H I N G TON, U. S. A. PUBLIC WORKS & UTILITIES DEPARTMENT June 15,2004 Roger Vess - Permit Counter Gail McLain - Electrical Engineering Building Application Review 1 & 2. 1711 and 1715 West 10th St. - 2 new manufactured homes for Joe Mangiameli Electrical loads and permit required The polemount transformer requires upgrading and the pole must be reset to new grade - Mr. Mangiameli has paid the estimated amount and the job is ready for release to Light crew pending approval of building application. 3. 'd r6)-~ ~ :,_eJ r1rV itM. 1701 West 10th St. - new manufactured home for Joe Mangiameli Electrical loads and permit required Electrical service for this home will be underground from the existing pedestal in the 9/1 0 alley north of building site. The customers contribution to construction & late comers fee is $1,713.90. Installation and future maintenance of the underground service wire in conduit will be the customers responsibility. BUILDING PERMIT - APPLICATION FOR OFFICLA.L USE ONLY Date Rec.: (. - ;0 Permil#Ot.l- r-DLE Applicant or Agent: /!1-1 C. Co/1/sJ;eocZTcN J;1.C Phone: (;;8.5' - 457/ . Owner: J.Ot:=- /l/!,4/Vr?.?A rt"7 E br Phone: (~/- ~~9 " ) 0 /.2 -? ';) i'1 Ci T 1 (~ - -, Address:"""-,\ I uD)G Z <2> ::, C____ City: -r 'T Zip: L ~~b ~ Fill out COMPLETELY and in INK. Your application and site plan MUST B COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 Date Approved: Date Issued Architect/Engineer: Phone: Contractor/l1~C Co'A.1.5 ~("c-7fl;\../ State License #rtCC-otVI"- ~f /0/0 S- o I Address: 0153 /\./ 7 IJr City: :5.E6; v~#1 U/A PROJECT ADDRESS: 1'70 l W 10 ~ '" LEGAL DESCRIPTION: Lot: 20 Block: 3 0 8 (J6 ~C)ooO, '?o BC?o-OO oc; Phone:G'83 -437/ Zip:' 7A:582 ZONING: Subdivision: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: Billing Address: Credit CardType VISA MC # TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: City: o Stove o Garage o Deck o Other l=t/ 49iZ,Lj Exp. Date: SIZENALUATION: 60 /300 SF.@$..::t? -/SF.=$ 02/ CJCO , SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ C~ 0-00 c'" ----- oC Occupant Load: Construction Type: & Proposed Sq. Ft. t'1-~O = TOTAL Sq. Ft.~8' U _ APPROVALS: PLAN: BLDG: DPWU: Fillli: OTHER: PLANNING USE ONLY: ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. V ALUA TION 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 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 pemlit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: Ifno pemlit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the tinle for action by the applicant up to 180 days upon written request by the applicant (see Section] 07,4 of the Uniform Building Code, current edition). No application can be extended more than once, I hereby cerlify that I 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 responSibilit.y to detennine what permits are required ,not ~ and that I must obtain such permfls;z; to woek. r.\FORMS\APPS\BUildinil' .[d. ' APPh"n~ ._ . Dot" c:;,k4 ~ . ,1!. tv lu 7F <: -...::. joT P;20 J! /0 / / St1.JGfL cJ ~ Ai0. O~~ ~ ~e W I/\-l \'-.) P r \ Lc ' ~ -0 CJ S; \ \ O;---t~ I I i I I i ,l,,~ ___~q~~j ~Z~_"-<~_ L-__2lL ~-~J~"____*-- /1 r~'- I ~ I S-~ I ~ I tl I i I " - i ." j I vi I I' . , , \>; ~ I t i I I I ! I _ i \::'1 ' I ""'1 ,......\ ~~\. .. j \:!: \ i ~ ,'fj l._____ * I ~C' \, I ' '\',1 i ",,' " \~ ... '\J' )\J \ r C/ I ( rZ L Fu C'c' , / - <::,. ( ),c,,, ~/'...~ .,' ,..-\-", l I I ?l~ Se-f ; Wi yVIlU , ~Jb~\ crrv OF PORT ANGELES - Construction fl!':"'5 The Issuance of this p€~mit based upon these plans, speclfl' catwns and oiher data shall not prevent the building offiCIal Ire,m thereofter requiring the correction of errors in said piems, specifications and other data, or from preventing building operatiOns being camej on thereunder when in violatiOn of ail codes and ordinances of thiS 'Solctlon. (SECTION 303(c) - Unifor BUlldmg Code.] Approval Dale By ::J \..-'- \J " ... \.1 ~t ,,,I \~\! I~I V)1 , I i t--1 j I I 1, i I \~, \, ~ t<- V) ~ COO \~ '{D': '."~ i dl ~I '{I ~l 1- OL/Q..-J e .J- ~ ):,f y ?;Lm rQiL~y ~ I ~l s;, I ~ t-U0MiJ~t.~ ,-_.._-~~p. -1_. Ie- 1'- ~ ~ ~ ~ \...... ~ ~ ~ \ "4... .~~ ~ ~ k ~ ~ V\ '-\ "'t ~ ,-- - v ~ '\ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .. [ ~~ ..9 '~ ~ ~ V) ~ ~ 11;20 ~ ::t:.. ~~ t:Q. ~(V) CIQ t \ ~:~t~ S- II,vT??Z!! ~ c,J lZ"x.+~~ 12-e-Q D _ I' \~ \7G'Q ~ ~ \c-G" (Je: ~c.- J-cYL~ "q,cn;: "v,~1 I "vl~1 NJ<;'XOf. ^bfXvl ^q<;,xOf. I N In I ~ g 9 ~ ~ 9 N N t > 1lqO"''''''' , "IlqO"''''''' J ~~ Q ~ n- ~. :r t ~ D > J '~ ~ = . ~ N9 ~ :r ,~ ~ ~ Q -l '~ - - 0.; ~, , ,- sj 't ~ j N > = r-~ ~ ~ ~ dJLL 't ' 't ~ ~ I () 1 ~ ..\fl ~o "CldJ ON L -' ^bfXvl , . ~ in the footing and centered beneath the pier locations (See Figure 303.7); (9) A minimum of 4 inch (\0 em) nominally thick con- tinuous footings. not less than 48 inches (121 em) wide, reinforced with approved fibers or with 10 gauge 6 inch ( IS em) by 6 inch (IS em) wire fabric centered vertically within the continuous footing and no closer than I inch (3 em) from the edge of the continuous footing. (See Fig- ure 303.8); ( 10) A minimum 4 inch (10 em) nominally thick slab not less in area than the manufactured dwelling and cabana, reinforced with approved fibers or with 10 gauge 6 inch ( 15 em) by 6 inch (15 ern) wire fabric centered vertically within the slab and no closer than 1 inch (3 em) from the edge of the slab. (See Figures 303.9 and 303.10); ( 11) Tested and listed prefabricated footings; ( 12) Footings designed by an Oregon licensed professional engineer or architect and approved by the Division; or ( 13) Other equi valent materials approved for the intended use by the authority having jurisdiction. (b) Piers. Piers shall be placed on footings and shall not exceed the size of the footing. Piers shall be: (1) 8 inch (20 em) by 8 inch (20 em) by 16 inch (41 em) concrete blocks (See Figure 303.11); ~ JIoILJ~ , ~~ :91 - I,AINIUU'" 256 SQUARE INCH PL YWQOO fooTINC PRESSURE TREATED ON ALL SIX SIDES IiQIL FlELD TREATMENT or CUT EDGES IS NOT ACCEPTABLE Figure ,303.5 Single Layer Plywood Footing 16 TYP1CAL PIER BLOCK J..' JIoILJ~ /1~~ ;1 MINIMUM 256 SQUARE INCH ooUBLE PlYWOOD rooTiNG PRESSURE TREATED ON ALl. SIX SIDES llllIE; FlELD TREATMENT or CUT EDGES IS NOT ACCEPTABLE Figure 303.6 Double Layer Plywood Footing 18" f.4INIf.4Uf.4 10" .I~ t (2) CONTINUOUS H~ REBAR CONTINUOUS POURED-IN-PLACE CONCRETE rOOTING W/f.4INIf.4Uf.4 2500 PSI IN 28 DAYS Figure 303.7 Continuous Concrete Footing . .... , . /~ .. .. .. .. .. .. . . . . . . . . . J J , t >> t . ). -- ._'--- - -~J. -: I[l;::':"::-:~-::-~~... ",. ~.~ ., I , , MINIMUM NOMINAL 4" CONTINUOUS CONCRETE FOOTING 2500 PSI IN 28 DAYS REINFORCED PER SECTION 303 OF THE STANDARD L 48" MINIMUM 1::lQIE; SEE TABLE 304 FOR REQUIRgl PIER SPACING Figure 303.8 Continuous Concrete Footing Isometric , ~ ~~~" ~~><'" ~~)<'" ~ "",~ 'x~ :x: .x, /<, ................ ,...... -.. -... - ' ~ ,"'~'" .......~ ~,..'" '........"............ ............<~~ ":..'<" ...... x ... _ _ ~ " ~~', ~', ~~~'" ~,~ "- ~~~~ ", ~~~ " '.,'<..~ ':.'<: '...'^'.: >-:., ;"', ~':"<< /->", ~~ ", ~~' ", ,/~ '"...~~~ ",:,,<~ '->~~~ "....-:..~ ''><:', ~"""', ~,~ ", ,~~ ", ~~~ " ~~~ , " ~~ " , y '....~ '>~ ~~~" ,~~..", ~~' "... ~~~ "" ~~~ '... ........ .... ....... ...)0.... ...... ........<" ,...:.................... ....,.... ""... ............ ........... ~~~....~ ~~~ :v:... .... ... ........ ..., ........ ... :::w.:'... ..........._:..... ...... ........ ............v........ 4" NOMINAL POURED-/N-PLACE CONCRETE SLAB FOOTING 2500 PSI IN 28 DAYS 10 GAUGE 6" X 6" WIRE FABRIC CENTERED VERTICALLY IN SLAB OR REINFORCED WITH APPROVED 8BER PER SECTION 303 OF THE STANDARD ~~ yt<' Figure 303.9 Poured-In-Place Concrete Slab j' ,/ , J i I , j 1 17 Figure 303.10 Poured-In-Place Concrete Slab Isometric ~ (2) Tested and listed prefabricated piers (See figure 303.12); (3) Designed by an Oregon licensed professional engi- neer or architect and approved by the Division; or (..)) Of other equi valent materials approved for the intended use by the authority having jurisdiction. Exception: Concrete pier blocks may have wood placed between each block to absorb shock if the wood is equal in area to the block and is one of the approved materials identified in Section 303(c)(2). (3) and (4) of this standard, (e) Pier Caps. Each concrete pier shall be capped with a pier cap equal in area to the pier blocking (i.e., 8 inches (20 em) x 16 inches (41 em) or 16 inches (41 cm) x 16 Inches (41 em)), Pier caps shall be (See Figure 303.13): ( 1) A 4 inch (10 em) nominally thick solid concrete block; (2) A I inch (25 em) nominally thick group 2 or 3 paral- lel laminated veneer wood plate; (3) One 1-1/4 inch (3.18 em) piece or two 3/4 inch (19 mm) pieces of plywood; (4) One 2 Inch (5 em) nominally thick Number 2 or better grade board lumber; (5) One 2 inch (5 em) nominally thick wood polymer com- poslte; 18 ~ 4" NOMINAl POURED-iN-PLACE CONCRETE SLAB FOOTING 2500 PSI IN 28 DAYS (6) Tested and listed prefabricated pier caps; (7) Designed by an Oregon licensed professional engI- neer or architect and approved by the Division; or (8) Of other equivalent materials approved for the intended use by the authority having jurisdiction, Exception: Wood and wood product materials specified in Subsections (2), (3) and (4) of this section shall be pressure treated on all six sides when placed in an area subject to excess moisture (i.e, outside the underfloor enclosure or below open deck areas), (d) Pier Shims. Where shim material is used between the top of the pier cap and the bottom of the main frame, the shimming material shall not exceed 9 vertical inches (23 em), Pier shims shall not be used with prefabricated piers unless the shims are included in and installed according to the pier's listing. Pier shims, when used, shall be one or more of the following (See Figure 303.13): (1) 2 inch (5 em) nominally thick solid concrete block equal in area to the pier cap; (2) I inch (2.5 em) nominally thick group 2 or 3 parallel laminated veneer wood plate equal in area to the pier cap; (3) 3/4 inch (19 mm) or greater plywood equal in area to the pier cap; .. .. . .. .. .. .. .. .. .. .. .. .. .. - r~ --.- 4;'.' TIE DOWN ENGINEERING Engineered Tie Down System Manufactured home tie down ca!culations and schedules tor single/doubte/triple wides Dlt:\iQn Loods I \l,r tOO I So'l Be.a:mg , TIt Down Stn.p. \ Sc:mwc Zone 15 PSf 1 ()(X) PS F 3\50 t Worbna l..o..c 4 I Tie do'....r: >~s moot fMoral ~ctticl.tion3 QQ-S-781H forTytX- 1, \\'1-'\.\ R. Grade l srrapprng and bt a.t Jew 1.)/4" x .oJS. zinc plated, ! EMth I\Ugm 2962 ~ (T,~ to J.7S0 fJ rrummum) I , Cleu Dn~ I 717 ~ (UlC\JlAled) I Concrete Slab Anchors 1390 14 (CLl~t.ed) 1,\C'18 Mo..riJtw.f'rI soil rmJOrt 1.1 !COO P $. F ...~ a IQII.J flport G(}neraJ Notes The: cham shown ter:'JI l&r'e 10r the ~ o1.W'lber of lle QoWOJ 1 Of) the Sldes of the Manufactllrec.l Home. I -:. ':Ie dOWl4S ilI1: requlrtd at t.ach chas$ls bu.1\, u.ch end of each rratlq:>ortl\ble ~uon of the MUl\1fac~rtd Home 30M can ~ lUly o( tile cype~ tho'WD herein I 1"\ CornbiIutions of the dJl'fereDt typts of M do~'fl6 ClIl be used , , I 4 In tbc eYeDl Art O4!'ttllU fC1 c.lilOO( ~, 1Mtill.e& due to Ul ob&Lru;. I tJ)i:1, lW: of crms dlWC mcbo~ l~ ~mll~ provided 2 Cl'Os.~ driYe I LIlchorl Lre i.oJ~ for etch r~ ALJ~ that C<lI1not b~ lM taLlod , < for 3Jl Ue down Ulsull.1!lOn~. th~ Manuf~ HQIM cw~is r:1err:bcn lIe shown u T ~ for illwtntion purpo~s only, Lrrll..'lm beam. QJ1 ~w be "C" Ul;(ped os RFC shaped. i 16 End tie dowl1~ C2fl h<' located Wlthm IS" of ejther ~1cJ. of chum I b<,ml WS &$ a~wn OM e"Jd l~ down 'eQulrad \e,~ Cl\asSlB Beam ill UCI'\ 'I' Milm tlnCJ 1ft? The .~es, types. lengths, etc, of nuteriJls UlOWD. herein ue lr.l!'l i'; ":Ir:l luge<. lor-ice. t1elly~r rn.tW1a1s supplied by TIC Down EAgwOOlT\Og ma) be ~ a.: th( RIlle s-p9.cmg ana locatio II! J ho \NT! A.:tl:m:lt~ c.eVtC~> m.y bc &Ubslirured with enline.en approvah, _r;:---~.-~.~~.........,.._,..,____.... State Approval j1 I' ENGINEERED T1EDOW(~ 3Y Sir Ii I I A~PRCYED ~ C1 TO :OW Cil CM ~ ':'T(:' "',~" dm " """", " ~".~ ,", ,,",Ii dlYil~gn /t6,'\'l l~q~l~el:"\en\~ c: .,,;.o~J.:;lc $u:-: ,~, rel'Jlliboi~ ~e o~ ~~)f~~ ~ I ~OlK,).\;e~<I'd(QC'J:".J"~ ". - 1\ _} p~'\$~j OF CC~ S AU) S ~~'ffi;'"' b~.U'eH D,.<~7~~l' (;,,'o{lt II II I ~J"t'O _ ~7<; Ii L)___ I OOP~~j:l'Q..1 ~.i C: 2 -2. 'Z. --C :::, .1 --\'i, ~ .... -_._- --. .-J fh1l6 t.J~ ,!.OW" lty!Jt~"r'I rr,,,~e,.; '_~c r-c.),.'-.;,....,c-..t.'"' \ 1f(lCt..jOr11~D6~. SiL:t>~U~Vl1 (.I) I --I nE DOWN ENG/NEEA1NG 5901 Whoattln Orivl:1 Atlanta, GQorGia 3033e 404,~-o()(JO Fax 4().(,349.(40' E! _________1 --__' --- -=---==...:.::;.;;;:;;:- '" Y J' . to \ ' 'fr;)'{w'; lrrl I ;~-o::? 04: 02 PM 11', G) TJT INC SALEM ~lt DOl~ E~~\NELR\~C ~OJ> 393 6134 \H~l~M ~~~ ~~~\ P. C' 6 L Du-: Patio Slab Anchor Concrete Anchor This anchor Is desloned to be Inserted through a '314' 11010 drilleo or formed lr1to :In exlsllng concrete alab. The MIJ2 Is designed to bQ In_1alloCl Into ;:l conm\~ ~Iat a\ the lime Ih~ OOl'lcr6lo It? ~el"o poured, ~." ~, ~ . I \ ' IN 1 . Concrete m~t be a 2500 PSI minimum .lnh wtth 4' minimum thlcknalll and 8/~ )( 10/10 wire mesh or flblH m,oih Illit-ol1ed, . Concrete slab mUBt allow 4725 lbs of Y!lrtlc!lllel'\~lon on ."ohor without Uttinq. ThIs lIlSUrntJi thllt the Qonorete \'\Il\cha 150 lb~ per cu. ft. . MInimum distance from the anchor shaft to one o~ge of the $Ieb Is 4 In. trom cna erlge ond 2 It. from any other cdco. . Concrete must bo ~ 2500 PSI minimum slab with 4' minimum thickness and 515 x '0/10 \Vlr~ mesh or fIber mesh Instarred. . Oonwetil slab must allow 4725 'bJ; cl vertloal tensIon on anchor wlthou\ liftIng, This a~ume8 thilt the concretB weighs 160 Ib; pGr cu. ft. , MinImum df'tilnce from the anchor ~hlh to one edoe of Ihe ,lab II 4 If1 from one odae Dnd 2 ft. from any other adQo. . If Initllled In n 4. slao at mln mllr: dIStance; from tdO~, an addltl:Jn;l1 \Jycr of 6/5 or 10r10 m!Sh Is recommended. . Slob mll~ be B In. minImum IniekMS8 ar !OcilffOI1 under any or'll.1hor to Illlow Sin. ambedmant 01 anchor 'J' fOC. Concrete Slab Anchor e c:::::- ~ ~ I Tnla Bnchor Is d ilJ' O'l(I~\Ing concrele ,lab. . After reviewing rC&lrlcllonC c~loa to IhO rlQnc. crUI " 5/e In x 3 In. hole In the .Iab whore 1M QI1chor h&>1d l~ 10 be 10~8d. . ConcfI\e must tit . 2S00 PSI minimum stJb y,lln 4' minimum lhlcknna and 6/6 x 10110 wirtl mas;h or ('t,cr INIn rr.'Wf\aO'. . Pl~, m,lllXpan.lon aloovg o~cr bolllnd place Inlo the ~rUlcd hole. . Oongroto ,Jab musl allow 4726 Ib& ot ...crtlt:.:lIIOf1SiOn on anchor without lillillQ, ihl, ~nvrr\D' lhOot 11\0 concreto ~IlIChs 1 SO Ib~ pcr cu. II. . P~co tho woutJar onto the GXp;vTslan boll . Thaad nut onlQ eXPlln~lon bolt IInd Ughlon uotil mV(lmurn expansIon 01 lllifllll<pll1c1on .tHYI on b.an ilohleY80. . M1nlmum d\~!nc.e Irom the i!.nc11:Jr shafllO MO cOQc ollhD 'l~b i~ 4 In. from on. t~. iOQ , tt. lrem any othar odgo. . It In.rallid In I ~. 51~b ~t mlnlmiJm (j}I\J.r.ces rrr:m lIclqn. iln oddlllonJllaYlr of 8/6 or 10/10 Y'ilrt meH" or nbcr ~sl\ I' reCDmmended, . RemoviJ nulllnd WiahDf lInd ploco anchor hand cyor oxpo51lcl boll. . Placi 't'R~QI Olnd nul onto boll b :.tlnch anchor hOild, tlohlen nut. IIJJ 01/25/02 16:25 TX/RX NO.2045 P,IJ06 . . . e4 :e7 PM TJT INC SALEM " n\r~\\ 11:H tiE DOH U~lHEER1HG ./ I I . L-r~l. elt' }-=3}- ~ . I 1 ~\: J ~I' i S ! It & , ~ ... i ; ; I ! ~ OJ ll~ I X C"U ':e e ~ III A oCt iii , @' ~e3 393 6134 ~iA~}4U~ 3~~ U~U\ P.22 ~,~l~ O'l .~, a ~, c::l .; cvJ ~ ~ ~ ~" r:1' % ~ .~i ~ ~ $ /DW rj ~ ~ ~ Cl ~~ . :-:.J~ -1 .~ !t:;Ji i ~~~t; ~~ 21' i'; ..,~>C. wJ ~ of1' M ~.~ OJ I c(, 81 i~ ~I 1oAC\i d~l[i~ > "'. w i as < )( . J.1\'" +I e: co~ '5~" ~ V; ~ ~8 ~~nJ I_ ll'.. )i e @ i ,sl iji J ~ ~ -;l 01/25/02 16:25 TX/RX NO,2045 P.022 . 1803 ~! 1.7t, ~& t. ~ q 'S -t-1 ~D* .- }- i'-' I'":::> 1003 t:':''' tl ,...Ult "~~I . ... .., t, ~~ ..~ FAX NO. : 3606830869 Aug. 31 2004 03:24PM P2 _V~n _W fA filH; nmm 1.M~ )," ,'u \ I FROM : KIRSCH ELECTRIC CVU""'H/U'H:~, U\',j~ m \Y- ~ 0' Ii ELECTRJCALPERMIT APPLICATION FOR O'fICl.IJ.lJS& ONl..Y rhl.~= _ 'llItIIlI': Dlle~: CIV.lYut&: The EI"ctt1cal Permlt AppllcatiOfl mU9t be fined out CQmr:Jletlllv. PlaSM t)'S)& or rlprtrrt In l~k: Ifyou'hIlVB an)" questiOn.. plUSI call (3fiiCU 417-473!5 Pax numtUM'l (:&80) ,417-471 f _ 07- S-c7 9 , , O\llllor.r Elec. c",,_ Agan~ q\JeJ. \ A'j [ ke- +~~:.>h.~O: ' ":lX' 1'r000Clty Owner. Add,,"": Phone: 'CI4r. ' Zig: ' 60clllcal Con~clgr. Ucense #; . E:rp: Pflone: ..' ; -Cily: . ,." Zig: Actdron: ,INSTALLATION WIRED BY: o OWNER ,l'E1.ECT,RICALP9ifIlACTOR Credit C.rd H"lrJtr N.m.: ,-J O.sc.r "^ ,,.J ", tS l.r-lI (' ,~ ' BOling AddTfl$5: Ci 5: 7 C. q, Y c.. i(1 City; S <;:-jU I ~ ,Cnld/t Cant Numb&r. Exp. Date: w~ Zip: , V1sA:_ Me: PROJECT ADDAe!ll: 170 \ \o~ "-'U .TYPE OF WORK: Check lIll thaI apply: ~New 0 A1teraUonlAlldition o Residential 0 MuUl-fllmRy Cl Commercial ~ MObile Home, ' Sq_ Ft. I;) RIIffiOlB Miller 0 Defached garage ' Cl Hot Tub crswlm pool 0 SeptIC Pump' o !.ow Voite1l9' 0 Telecom, 0 SIg, .. . , ,Number of Crouila added or elt8r9d: . D~R1PTION Of mE ELECTRICAL PRCJeCT, ' ~oo F\~f " , _c:. e r oj 1'- <..- i) ,~ lYJohlle ~ I;lllClric:al Heat lc>ad AddltJonf IIlId 01' 8ublmc:tlan8 , 'Service Information o Baseboard' 'WFumaea o Hem Pump o F...Wall _KW MKW " TON lRA =KW- o OIHlIhud Service [J Temp Selvlce '0 Underground S81V1ca Voll:age: Pha.e, [J' 0 3 , " Servioe Size: Feeder Size: 7"--:- nu --O'f-S:?O /1/s -,0'1- . S~ I I hereby certify th(tt I have read Bnd exemlned this application and know that same to be tl1JG end correct. BlId I am author/zM to apply for this permit, r understand it Is not the C1ty's legal responsibilIty to determine what permIts ere required; it remains the appli(;ll!Jts responsibility to d fermina what permits ars required and to obtain SUM. Crldlt Card Holller:s Signature: Dan.: g -J f, :Q'f _'_-. Owner or EJ8~ ~n',_SllJ~: , ' Date: ~ ~e;;~=, "~:~;eo~.f 0Pf:;{"77;;;t:~;+ FEE: $ 78. 70 b;/~lE;;i:h~TAPPLl~T}ON, ~2Jc:JJ C( /~/MC-~ ~, .