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Home My WebLink About115 W 11th St - BuildingPREPARED 6/29/09 8 59 27 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/29/09 ADDRESS 115 W 11TH ST TENANT NBR BURTON B /ROSA PIERCE TTE CONTRACTOR EVERWARM INC OWNER BURTON B /ROSA M PIERCE TTE PARCEL 06 30 00 0 3 2775 0000 APPL NUMBER 09 00000415 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS SUBDIV PHONE (360) 452 3366 PHONE (360) 457 5500 ME6 01 5/28/09 JLL MECHANICAL GAS LINE TIME 01 00 5/28/09 AP May 28 2009 8 40 25 AM 1pangrle BURTON 457 5500 GAS LINE AFTERNOON May 28 2009 4 09 48 PM jlierly ME99 01 6/29/09 y.LL� MECHANICAL FINAL June 29 2009 8 41 34 AM 1pangrle BURTON 457 5500 MECHANICAL FINAL GAS FIREPLACE COMMENTS AND NOTES PREPARED 5/28/09 8 43 00 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/28/09 ADDRESS 115 W 11TH ST TENANT NBR BURTON B /ROSA PIERCE TTE CONTRACTOR EVERWARM INC OWNER BURTON B /ROSA M PIERCE TTE PARCEL 06 30 00 0 3 2775 0000 APPL NUMBER 09 00000415 MECHANICAL APPL PERMIT SUBDIV PHONE (360) 452 3366 PHONE (360) 457 5500 PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 01 5/28/09 MECHANICAL GAS LINE TIME 01 00 May 28 2009 8 40 25 AM 1pangrle BURTON 457 5500 GAS LINE AFTERNOON COMMENTS AND NOTES ;r:g' r ;;4 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Application Number 09 00000415 Date 5/08/09 Application pin number 262770 Property Address 115 W 11TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 3 2775 0000 Tenant nbr name BURTON B /ROSA PIERCE TTE Application type description MECHANICAL APPL PERMIT Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 4500 Application desc INSTALL GAS FIREPLACE Owner Contractor BURTON B /ROSA t PIERCE TTE EVERWARM INC 115 W 15TH ST 257151 HWY101 PORT ANGELES WA 98362 PORT ANGELES (360) 457 5500 (360) 452 3366 Fee summary Charged Paid Credited Date T:FormsBuilding Division/Building Permit WA 98362 Permit MECHANICAL PERMIT Additional desc INSTALL GAS FIREPLACE Permit pin number 145540 Permit Fee 121 30 Plan Check Fee 00 Issue Date 5/08/09 Valuation 0 Expiration Date 11/04/09 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 10 6500 EA ME STOVE /FIREPLACE /MISC APP 10 65 1 00 10 6500 EA ME FUEL GAS PIPING 1 5 OUTLETS 10 65 1 00 50 0000 HR ME INSPECTION MIN 1 HR 50 00 Due Permit Fee Total 121 30 121 30 00 00 Plan Check Total 00 00 00 00 Grand Total 121 30 121 30 00 00 1-' /01 62 90 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 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 s esume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance truction. l4 Print Name Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION Footings Stemwall Foundation Drainage Downspouts 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 Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting T.Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. FINAL Date Accepted by FINAL Date (0— /4ccepted by -3—Le- 0 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By A Electrical 417 -4735 Construction R W PW Engineering 417 -4831 TA Fire 417 -4653 4 Planning 417-4750 Building 417 -4815 Floor Areas Project Type Brief Description. Check all that apply New Construction Addition Remodel Repair Demolition Re -roof )(Heat System Other Total footprint of structures Site Coverage the amount of impe and other impervious surfaces (see Max. height of proposed structu Will a lawn sprinkler system Will a fire sprinkler syste BUILDING PERMIT CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant t3 Property Owner 5P4 Property Owner's Address w it s j` Contractor I- Alg,ti Contractor's Address License Expires PROJECT ADDRESS J w t( 5 Parcel Number Residential 'Multi- family House garage other tear off re -roof lay over one layer Heat pump wood burning stove 1gas fireplace pellet stove other Existing (sq. ft.) Proposed (sq. ft.) Basement 1 Floor 2 Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other s installed? e installed? Occupancy group Occupant load Construction ty e I have read and completed this. application and know it to be true and correct. I am a that it.is my responsibility to determine what permits are required, and to obtain permits Date S J oc Print Name Bco UR l- (3 Qti iZ Signa T Forms /Building Division /Bldg Permit.doc APPLICATION Print in ink Phone 3`o 4,s7cOO Phone. Phone E -mail Lot For City Use Only Date Received -09 Permit# (�Q —N lr4 Date Approved Zoning Commercial o Industrial TO per sq ft. C�J��7 TAL VALUATION S s• T Lot size sq ft. Lot coverage `'lo ace on a parcel including structures p ed driveways -walks patios C 17 94 135 for exemptions) coverage apply fo Orkin #of be. of full baths of half baths uth s ized to nor t• "t and understand d~ CITY OF PORT ANGELES '_ .(~[~1 PUBLIC WORKS - ELECTRICAL DIVISION ELECTRICAL PERMIT ISSUED: 1/03/2003 PERMIT NO 7~ OWNER/APPLICANT PROPERTY LOCATION BURT PIERCE 115 11TH STW 115 W 11TH STREET Lot: 327 Port Angeles, WA 98362 Block: 17 ~i~ Long Legal 360/457-5500 Subdivision: TPA T: S: Parcel No: 063000032775000 CONTRACTOR ARCHITECT OLYMPIC ELECTRIC N/A 4230 TUMWATER PORT ANGELES, WA 98362 , 98360-0000 360/457-5303 360/000-0000 PROJECT INFO Project Type: RES. MISC. Project Value: $0.00 Occupancy Type: Construction Type: H. P./FURNACE -~----. Occupancy Group: Zoning Use: Electrical Heat: ~ Baseboard 0 KW I Riser I Underground Service ~:~ Furnace 15 KW I I Overhead Service Voltage: 0 ~ HeatPump 10KW ~1 TempService Phase: [~ Fan Wall 0 KW Service Size: 0 Feeder Size: 0 PROJECT NOTES FURNANCE AND HEAT PUMP. RECEIPT # 10038 FEES ASSESSMENT Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $46.70 Temp Service: $0.00 Misc Fee: $0.00 TOTAL FEE: $46.70 AMOUNT PAID: $46.70 BALANCE DUE $0.00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO CO VEIl, INSULATE OR CONCEAL ,4NY WORK BEFORE IT IS INSPECTED AND ,4CCEPTED. KEEP DITCH ROUGH-IN / coVER SERVICE FINAL GENERAL COMMENTS: Pw-~ l ea.~5 ~5:v~ CITY OF PORT ANGELES ~('~y~ ~'~'-- ~ DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION ~ 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Property Address ...... 115 W llTR ST A~qSESSOR PARCEL N~ER: 0630000327750000 Application description . . . ELECTRICAL ONLY Property Zoning ....... Application valuation .... 0 Property owner ....... PIERCE TTE BURTON B/ROSA M Owner address ........ 108A N LAKE DR JESUP GA 315461919 ( ) Contractor ......... OLYMPIC ELECTRIC Permit ...... ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee .... 46.70 Plan Check Fee . . .00 Issue Date .... 1/03/03 Valuation .... 0 Qty unit Charge Per Extension BA~E FEE 46.70 Fee summary Charged Paid Credited Due Permit Fee Total 46.70 46.70 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 46.70 46.70 .00 .00 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 previsions of laws and ordinances governing this tTpe 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~FOKMS\ 1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 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. ~EP ~ER~I~ CA~ AND APPROVEO PLANS AT JoB SiTE ~P ~ -0'7 INSPECTION TYPE I DATE ACCEPTED , COMMENTS I YES ] NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (L1GHT DEPT) SEPARATE PERMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL FRAMING JOISTS / GIP~DERS ELECTRICAL - LIGHT DEPT. 417-4735 /.~ ~ ~ LIGHTELECIPdCALDEPT CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILD/NG DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT IssuED: 12/30/2002 PERMIT NO 13931 OWNER/APPLICANT PROPERTY LOCATION BURT PIERCE 115 11TH ST W 115 W 11TH STREET Lot: 327 Port Angeles, WA 98362 Block: 17 [] Long Legal 360/457-5500 "Subdivision: ' ' TPA T: S: Parcel No: 063000032775000 CONTRACTOR ARCHITECT ALL WEATHER HEATING & COOLING N/A 302 KEMP STREET PORT ANGELES, WA 00009-8362 , 98360-0000 360/452-9813 360/000-0000 PROJECT INFO Project Value: $10,799.00 SFD Units: 0 Commercial: 0 Project Type: HEAT PUMP ADD SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: PROJECT NOTES HEAT PUMP, LOW VOLTAGE THERMOSTAT, FIRE PLACE INSERT, LINES, TANK RECEIPT#10029 FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: THERMOSTAT $35.30 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 ManufaCtured Home: $0.00 Sign: $0.00 TOTAL FEE: $104.45 Plumbing: $35.00 AMOUNT PAID: $104.45 Mechanical: $34.15 Radon: $0.00 BALANCE DUE: $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 cancel the provisions of any state or local law regu at ng construction or the performance of construction. Signlat'ur~ of ContractO~r or/~uth~rized Agent / I~e- Signature of Owner (if owner is builder) Date T:\PLANNING~,FORMS\ I 102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD '~ CALL 417-4815 FOR BU1LDING INSPECTIONS. PLEASE PROV1DE A M1N1MUM 24 HOUR NOTICE. IT IS UN£A WFU£ TO COVER, INSULATE OR CONCEA£ ANY WORKBEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE ] INSPECTION TYPE DATE ACCEPTED COMMENTS YESI NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: g PLUMBING UNDER FLOOR / ~LAB ROUGH-IN WATER LINE BACK FLOW / WATER AIR SEAL cWE IA~SG I I I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION MECHANICAL y.~/g/ WOOD STOVE / PELLET / CHIMNEY HOOD/ DUCTS PW UTILITIES ! SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PEKMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTKICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEFT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIKE DEPT. PLANNING DEPT. 417-4750 ~'~/~ PLANNING DEPT. BUILDING 417-4815 [~ ~)~~-'~ BUILDING T:~,PLANNING\FORMS\ 1102.15 [4/2002] FROM : ALL WEATHER HEATING & COOLING FAX NO. : 360 452 5177 Dec. 30 2002 09:29~qM P3 BUILDING PERMIT - APPLICATION ~ ~_~ , . ~ ~e Bu~i~ F~t - ~e~pl~ca~o~ m~ ~d o~ Comp~y. Ple~ ~ ~ p~t in I~ If you ~ve any qu~flo~ ~e~e ~ 417~15 ~ C~ e~ Exp. D~: .. ~ ~C o ~ ~ S~ o ~T~V~UA~ON $ ~Y~O~,~'~ ~O~~m~: ~cy ~: Oc~p~t ~: ~m~T~: Ne. ~: .... ~ ~: , % ~ ~v~e: % .... ~ ~t ~e: /~. ~ + ~,~s~ Lot Covmsc: /sq, ~ ~ ~ L~ ~GE: ~.~ · ~G ~ ~Y: ~OV ~ =: .... ._. m.~, r~. ~ ~ ~vbi~ ~ ~vi~ ~u wi~ mom ~ed ~o~fion ~ ~e appMca~ ~ pl~ ~! ~u~m~, Yo~ c~d a~ a~ p~ (~ a~fio~) ~ bu~g colorlon p~ ~ m be su~d to ~ Bu~ Divi~i~- ~ ~y ~ m~ ~ ~ B,,~d~E ~i~ to c~ly ~ c~t fee B~ ~ ~ =x~ ~ ~ for at,on by ~c a~licmt up W 1 $0 d~ upon ~mn ~quest by ~e a~cmt (~ S~ IO~A of · e Ud~ Bufl~ ~e, ~t edi~). No applicafi~ c~ be extended ~re *h.n once. th~ ~. I ~e~nd it ~ ~t thg ~'s legal ~tbili~ to dete~ine what pe~i~ are require; II remat~ the appli~nt's ~ibilio ~ d~ine w~t ~i~ ~e ~quired a~ to obtain CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date /- ~- ~)~ Time Received by (phone, person) Location of Work to be inspected i ! Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbin~ewer Excav. Other INSPECTION NOTES: Inspected: Date / --Z -~) ~ Time By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved {~Gravel r-']Asphalt []PCC [~]Other [] Repaired by City Work Order # ~] Repaired by Permittee [] COMPLETE ~} No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 Site Address: Installed By: Owner/Business: Owner/Business Address: o RESIDENTIAL o COMMERCIAL o BASEBOARD KW _ o FURNACE KW o FAN/WALL KW o HEAT PUMP KW_ o SIGN Details/Description: ELECTRICAL PERMIT I/~ ~ PERMIT NO. "'Y// c. S-~31f'"3" / I DATE o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Phone: Sq. Ft. o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION 'S{ REMODEL fj' ADD/ALTER CIRCUITS ~ SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) gl.' OVERHEAD SERVICE o UNDERG'QU~EP.VJCE VOLTAGE: Z-L/.;;?. U J?r SINGLE PHASE rO THREE PHA~ SERVICE SIZE AMPS . :;~~~ W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER A 0 Ditch Inspection O.K. 1~ Rough-in/cover O.K. 1~O.K. to connect service ~Final O.K. Site Address: Installer: New Meters Notify Port Angeles City Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT 1~ $ Electncal Inspector . 7<'~jt:: WHITE - File by address YELLOW - file by number GREEN - Top: Meter Dept., Bottom: City Hall OLYMPIC PAINTERS LNC. PINK - Top: Eng, Bottom, Customer 12/30/2002 11:49 FAX 3604575303 OLYMPIC ELECTRIC I4i 01 ;~~O<.l,7.,j711 . _ '" 1/ t/7l: -IT .......,;...;;....,...:..; I...! ':',..;_I'JI;,-::I'[' '-'~:;.-li <:...I~G~LI:::.';:" ~ 'tj ELECTRICAL PERMIT APPLICATION JOil OR'\CtAL lJSLCltllL1'" OouotlJlc,;: ......." tIIf~ "PPT'...-c:d; """,- The EI~ PlilliTln. AflptutiCl"l muSt be f1uea out l::I:HnDA.tatv. (:I:' ? 95V _ _ 0< ...prin'ln Ink. U ~ _ ...y q_.. p""''' call (3150. .11-4735 P:III pumliler: (300)417-4711. Qwne, orEte<, CoIUJacTo(Agent Olympic Electric P,opeltyOWref JJvH 11t/?-c- AddnJ$5; / /? W / / rH Co., Inc. ~nDn.; 457-5303 F~ "52-3498 7 ->S-oo Ph<N: Clly: Zip: ~""l''''' 457-5303 98363 Zio: INSTALLATION WIRED BY: DOWNER Woe_': OLYMPEC28~; 3131/03 CI1y; Port Angel~s: WA / ~ ELECTRICAl. CONTRACTOR /' Burkhardt, Olympic Electric Co., Inc. / , Eloclrk.olCo1lrat:lor Olympic Electric Co., Inc. _8"': 4230 Tumwater CredIt Carr! Holder Ntrmfl' Charles T. Bil/1rt9 At1rit'8a: ~board ~':~ ~tPu"'Q o F~"..Wall KW KKW ~ r3" _t<W (,,~ _KW o Ovemeod Sftrvic8 n T8mp SoIMc& o Urde'1Jl'Ound Sol rvice Servle>e Information Voll"~: L7()/UV Phase; ~1 ' 0 J Servlco Siz..: FuoodBr Si%o: EIeGtrlcaI Heat Loed Addition. PW.90'9 Credit CtIn1 Holder'. Slgnlllu,.: Owner or EIec. Cont, SI!jlnlltu,.: 0....,: /2-/?O 0ut8= ?k c bL__ /PO~"L \f FROM ;... ALL WEATHER HEAT! NG & COOLI NG FAX NO. 350 452 5177 Dec. 30 2002 09:30AM P4 . Distribution System Planning and Engineering Load and Voltage Analysis Date / z!)~/ O~ CustornerName: Barl- PLL-ru Service Address: (/5 u) riM 51- .i PH1- fi111elt'S HV AC Contractor: fill WfJ):/1uf Phone No: ,}ltrJ-'!51-5507J Phone No: J'it(}-Il~ Z- -'If I J Fax No: ?f 5 2- -5171 Manufactures of Equipment: C ?Gvnj r Tonnage of Equipment: 7' f01 LRA:_J <S Y. b Remarks: Engineering Department Analysis Results Mitigation Required: Customer Mitigation Costs: Engineer Name: Date: