HomeMy WebLinkAbout1521 W 5th St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
LARSON SHIRLEY
1521 W. 5TH ST
PORT ANGELES
COMMI_NT /ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
07 00000816
997472
1521 W 5TH ST
06 30 00 0 1 2655 0000
RES REMODEL
RS7 RESDNTL SINGLE FAMILY
40000
Contractor
LAWRENCE ENTERPRISES
26821 137TH PL SE
WA 983631810 KENT
Date 7/30/07
WA 98042
Permit ELECTRICAL NEW RESIDENTIAL
Additional desc JEFF NELSON/ 200A CIRCUITS,
Permit pin number 107763
Sub Contractor JEFF NELSON ELECTRIC
Permit Fee 75 00 Plan Check Fee 00'
Issue Date 7/30/07 Valuation 0
Expiration Date 1/26/08
Qty Unit Charge Per Extension
1 00 75, 000,0' ;ECH 'EL.RM 0 ,200 1'ST FEEDER 75 00
•i
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 75 00 75 00 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 79 50 79 50 00 00
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVED
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
DITCH
ROUGH -IN COVER
SERVIC$
FINAL
INSPECTIONTYPE
GENERAL COMMENTS:
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
DATE
ACCEPTED
YES I NO
va,z3zzaP-1
.I I
1 1
1 1
1 I
COMMENTS
rw -I 16.1514'96)
FROM
N.
"N�Installation description
Job wired by ,leetried Contractor O Owner O Commercial 1irRetadentlal
Electrical contractor name License number Date Expires
JEFF 4/P-V I e P FA/g/ ftWir
Purchaser's mailing address
_1L<- A/RSNiwM Ad oe/Or
State ZIP
City
/v /til
T number
Premises owner's name
5i1 /4 e s f
Address of inspection
i$
City 44'& -s1_C$
Phone slumber to schedule Inspection:
Owner as defined by RCW.19.28.261 •(l) Owner will occupy the structure for two
years alter this electrical permit is finalized. (2) Owner is required to hire an electrical
contractor (f above said property fs for sale rent or lease.
After reading the above statement, 1 hereby certify that 1 ton the owner of the above
named property or a licensed electrical contractor. I am making the electrical instal-
lation or alteration in compliance with the electrical laws, N.E.C. RCW Chapter
19.28. WAC. Chapter 296.463, The City of Port Angeles Municipal Code, and
Utility Specifications.
Signature of owner, electrical coot ractor or electrical administrator
Date: 7/Z347
X
El cal Lod Additions and cgiOtractiong
-a LOAD CHANGES
O Baseboard KW
O Furnace KW
Hest Pump Ton LAR
0 Fan -Wall KW
SAME DAY INSPECTION. CALL BEFORE
ROUGH.IN
inspection
Date
R E6-MALE t.)
JUL 2 3 2007
LIGHT DEPT.
FAX number
gay
FAX NO. 6814254
r`
.4215vorhead Samice
0 Tamp Service
0 Underground Service
7:00 AM 360- 417 -4735
THERMOSTAT
Arca, Building or Equipment Inspected
ELECTRICAL WORK PERMIT APPLICATION
O New
,S..41/.422. DA- Ow S77 SS
//P, 2px t 7-a) sF
�/1+t1EL 1- 4CVMEa'P"'
O Cash O Check
.Z6edit Clad Visa Mastercard Discover
Card w
Expiration Date
of card
Dare
Page
Jul 23 2007 09 05AM P1
O Altered/Addltlon
..$�75: ov
fitadmuniammum
Voltapa Z tf0
Phase% 1 0 3
Service Size:
Feeder Size:
SERVICE
Anwevw ey J
*FEDER 1
Action Takeo
A peeved 6y
Electrical
Inspector
4aA- k.„0
PREPARED 10/18/07 9 30 17 INSPECTION TICKET PAGE 13
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/18/07
ADDRESS 1521 W 5TH ST SUBDIV
CONTRACTOR LAWRENCE ENTERPRISES PHONE
OWNER LARSON SHIRLEY PHONE
PARCEL 06 30 00 0 1 2655 0000
APPL NUMBER 07 00000816 RES REMODEL
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 8/29/07 PB PLUMBING ROUGH IN TIME 09 00
8/29/07 AP 08/28/2007 10 38 AM LPANGRLE
STEVE 253 261 5375
ROUGH IN PLUMBING
JIM OK D THEIR REQUEST FOR A MORNING INSPECTION SINCE THEY
ARE COMING FROM OUT -OF TOWN
08/29/2007 11 59 AM PBARTHOL
PL99 01 10/17/07 PB PLUMBING FINAL TIME 01 00
10/17/07 DA October 15 2007 2 23 42 PM 1pangrle
STEVE 253 261 5735
PLUMBING FINAL
EARLY WED AFTERNOON INSPECTION
October 17 2007 4 40 31 PM pbarthol
air gap for dishwasher
PL99 02 10/18/07 L PLUMBING FINAL TIME 01 00
October 17 2007 3 16 15 PM 1pangrle
STEVE 253 261 5735
PLUMBING FINAL
AFTERNOON
COMMENTS AND NOTES
PREPARED 10/17/07 9 27 37 INSPECTION TICKET PAGE 15
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/17/07
ADDRESS 1521 W 5TH ST SUBDIV
CONTRACTOR LAWRENCE ENTERPRISES PHONE
OWNER LARSON SHIRLEY PHONE
PARCEL 06 30 00 0 1 2655 0000
APPL NUMBER 07 00000816 RES REMODEL
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BAIR 01 8/29/07 PB BLDG AIR SEAL TIME 09 00
8/29/07 AP 08/27/2007 11 26 AM LPANGRLE
STEVE 253 261 5375
AIRSEAL
REQUESTED A MORNING INSPECTION HE IS COMING FROM KENT WA
08/29/2007 11 59 AM PBARTHOL
BLI 01 8/29/07 PB BLDG INSULATION TIME 09 00
8/29/07 AP 08/27/2007 11 30 AM LPANGRLE
STEVE 253 261 5375
INSULATION
REQUESTED A MORNING INSPECTION HE IS COMING FROM KENT WA
08/29/2007 11 59 AM PBARTHOL
BL99 01 10/17/07 JLL BLDG FINAL TIME 01 00
October 15 2007 2 21 58 PM 1pangrle
STEVE 253 261 5735
BLDG FINAL
EARLY WED AFTERNOON INSPECTION
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
MEF 01 8/29/07 PB MECHANICAL FURNACE TIME 09 00
8/29/07 AP 08/28/2007 10 36 AM LPANGRLE
STEVE 253 261 5375
HEAT PUMP
JIM OK D THEIR REQUEST FOR A MORNING INSPECTION SINCE THEY
ARE COMING FROM OUT -OF TOWN
08/29/2007 11 59 AM PBARTHOL
ME99 01 ;0/1 /07 JL L MECHANICAL FINAL TIME O1 00
/y October 15 2007 2 23 08 PM 1pangrle
STEVE 253 261 5735
MECHANICAL FINAL
EARLY WED AFTERNOON INSPECTION
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
I
PL2 01 8/29/07 PB PLUMBING ROUGH IN TIME 09 00
8/29/07 AP 08/28/2007 10 38 AM LPANGRLE
STEVE 253 261 5375
ROUGH IN PLUMBING
JIM OK D THEIR REQUEST FOR A MORNING INSPECTION SINCE THEY
ARE COMING FROM OUT -OF TOWN
08/29/2007 11 59 AM PBARTHOL
PL99 01 10/17 07 J PLUMBING FINAL TIME O1 00
October 15 2007 2 23 42 PM 1pangrle
STEVE 253 261 5735
PLUMBING FINAL
EARLY WED AFTERNOON INSPECTION
I COMMENTS AND NOTES
PREPARED 8/29/07 9 07 20 INSPECTION TICKET PAGE 17
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 8/29/07
ADDRESS 1521 W 5TH ST SUBDIV
CONTRACTOR LAWRENCE ENTERPRISES PHONE
OWNER LARSON SHIRLEY PHONE
PARCEL 06 30 00 0 1 2655 0000
APPL NUMBER 07 00000816 RES REMODEL
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BAIR 01 8/29/07 JLL
BLI 01 8/29/07 JLL
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BLDG AIR SEAL TIME 09 00
08/27/2007 11 26 AM LPANGRLE
STEVE 253 261 5375
AIRSEAL
REQUESTED A MORNING INSPECTION HE IS COMING FROM KENT WA
BLDG INSULATION TIME 09 00
08/27/2007 11 30 AM LPANGRLE
STEVE 253 261 5375
INSULATION
REQUESTED A MORNING INSPECTION HE IS COMING FROM KENT WA
MEF 01 8/29 07 JLL MECHANICAL FURNACE TIME 09 00
08/28/ 2007 10 36 AM LPANGRLE
STEVE S 253 261 5375
HEAT PUMP
JIM OK D THEIR REQUEST FOR A MORNING INSPECTION SINCE THEY
ARE COMING FROM OUT -OF TOWN
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 8/29/07 JLL PLUMBING ROUGH IN TIME 09 00
08/28/2007 10 38 AM LPANGRLE
STEVE 253 261 5375
ROUGH IN PLUMBING
JIM OK D THEIR REQUEST FOR A MORNING INSPECTION SINCE THEY
ARE COMING FROM OUT -OF TOWN
COMMENTS AND NOTES
doe Ponr,�,y�c
Sw F
I v_
't 'el/C V0
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
LARSON SHIRLEY
1521 W 5TH ST
PORT ANGELES
Signature of Contractor or Authorized 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
07 00000816
997472
1521 W 5TH ST
06 30 00 0 1 2655 0000
RES REMODEL
RS7 RESDNTL SINGLE FAMILY
40000
Owner Contractor
LAWRENCE ENTERPRISES
26821 137TH PL SE
WA 983631810 KENT
Date 8/28/07
WA 98042
Permit MECHANICAL PERMIT
Additional desc HEATPUMP
Permit pin number 109686
Permit Fee 64 70 Plan Check Fee 00
Issue Date 8/28/07 Valuation 0
Expiration Date 2/24/08
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 14 7000 ECH ME INSTALL 100- FAU 14 70
Permit PLUMBING PERMIT
Additional desc TWO PLUMBING DRAIN VENTS
Permit pin number 109694
Permit Fee 64 00 Plan Check Fee 00
Issue Date 8/28/07 Valuation 0
Expiration Date 2/24/08
Qty Unit Charge Per Extension
BASE FEE 50 00
2 00 7 0000 ECH PL- EA REPAIR/ DRAIN VENT 14 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 128 70 128 70 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 133 20 133 20 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
constructlo
At
7 Dad Signature of Owner (if owner is builder) Date
CALL 417 -4815 FOR BUILDING INSPECTIONS CALL 417-4735 FOR ELECTRICAL INSPECTION S
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COWER, IA'SULATE OR CONCEAL ANY WORK BEFORE Q
INSPECTED AND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
W ALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -IN
(HEAT PUMP )FURN /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT 417 -4735
BUILDING PERMIT INSPECTION RECORD
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
I PLANNING DEPT 417 -4750 I
BUILDING 417 -4815 I
T' \Policies \1102 15 building permit inspection record05.wpd [1/4/2005]
YES
R 19 r
I I
I I
g l o L_L I
ACCEPTED COMMENTS
NO
FINAL l 0 `1r O r DATE
SEPA.
ESA.
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL
I ff
FINAL 10 1 R "O �L t-
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT
I PLANNING DEPT
I BUILDING
DATE
ACCEPTED BY
ACCEPTED BY.
0
C'
Lz 7
ACCEPTED
YES I NO
1
I-
•-s
F CITY OF PORT ANGELES
La DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
L..1/ 321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 07 00000816 Date 7/11/07
Application pin number 997472
Property Address 1521 W 5TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 1 2655 0000
Application type description RES REMODEL
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 40000
Owner Contractor
LARSON SHIRLEY
1521 W 5TH ST
PORT ANGELES
T \Policies \1102 15 building permit inspection record05 wpd [1/4/2005]
LAWRENCE ENTERPRISES
26821 137TH PL SE
WA 983631810 KENT
WA 98042
Permit BUILDING PERMIT NO PR FEE
Additional desc NEW INSUL /DRYWALL /HEATPUMP
Permit pin number 106799
Permit Fee 569 25 Plan Check Fee 00
Issue Date 7/11/07 Valuation 40000
Expiration Date 1/07/08
Qty Unit Charge Per Extension
BASE FEE 417 75
15 00 10 1000 THOU BL -25 001 50K (10 10 PER K) 151 50
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 569 25 569 25 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 573 75 573 75 00 00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned
fora period of 180 days after the work as commenced or if required inspections have not been requested within 180 days from the last
inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
constructio
�I 4/1-7'
s ignature of Contralor or Authorized Agent ate
7 7 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.
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -IN
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE /PELLET /CHIMNEY
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
BUILDING PERMIT INSPECTION RECORD
INSPECTION TYPE DATE ACCEPTED
YES I NO
k0,°1107
I I'
(3 17,5 1. 16.1 emu.
I
PLANNING DEPT 417 -4750 I
I BUILDING 417-4815 11 0 11 o I` r
'\I
T \Policies \1102 15 building permit inspection record05.wpd [1/4/2005]
FINAL
FINAL
SEPA.
ESA.
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL
417 4735 ELECTRICAL
LIGHT DEPT
COMMENTS
DATE ACCEPTED BY.
DATE ACCEPTED BY.
DATE
ACCEPTED
YES I NO
0
co
N
u)
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417-4807 PW ENGINEERING 3
FIRE 417 -4653 I I I I FIRE DEPT I I I p
I PLANNING DEPT I I I
BUILDING 1 I I I
Applicant or Agent: 57 J 1 R.,o
Cr
Owner
Address.
Architect/Eng veer•
Contractor
Address:
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
PROJECT ADDRESS i 7
LEGAL DESCRIPTION Lot:
CLALLAM COUNTY PARCEL NUMBER.
Block.
TYPE OF WORK.
esidential New Constr Re -roof Stove
Multi family Addition Move Garage
Commercial emodel Demolition Deck
Repair Sign Other
BRIEF DESCRIPTION OF THE PROJECT "7
COMMERCIAL/RESIDENTIAL. Occupancy Group.
No of Stones: Lot Size: Existing Sq. Ft.
Total lot coverage
PLANNING USE ONLY
T Applicant:
BUILDING PERMIT APPLICATION
City
Phone:
State License LA &f ()O/ xp
City
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
FOR OFFICIAL USE ONLY
Date Rec. 7- I I c-
Permit 07 1
Date Approved:.' 11 C.
Date Issued. 1 I k ^C�
Phone: 2 5 3 -26/ S' 7,
Phone. J O yc ?2/
Zip
Subdivision.
Phon .�S r- 6 ('_S 5-
Zip
ZONING
Ca,ll4 it win
SIZE/VALUATION P Io r''b'''�9 ?1 1i r
1 Arai P. Ve.4117c 4
SF /SF
SF /SF e Po
TOTAL VALUATION -4/0 400, ��c
4 4 L Q/
1- l� c4 t ti t u Lr r r (CO2 Q C
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 Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE. IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section
R105.3.2 of the International Buildmg/Residential Code, 2003). No application can be extended more than once.
I hereby certify 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 responsibility to determine what permits are required not the City's, and that I
must obtain such permits prior to work.
Date:
.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
PERMIT NO. 0 oz..D
DATE S--j/'l / y.3
.
Site Address: /0'';;? J .s-/4 o READY FOR o WILL CALL FOR
W. INSPECTION INSPECTION
Installed By: /T?..s ~/~(":..- I license Number: Phone:
Owner/Business: Phone:
Owner/Business Address: Sq. Ft.
~ RESIDENTIAL
o COMMERCIAL
o BASEBOARD KW _
o FURNACE KW _
o FANfWALL KW
o HEAT PUMP KW
o SIGN
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
o REMODEL
o ADDfALTER CIRCUITS
Ji'f SERVICE UPGRADE/REPAIR
o SPECIAL EQUIPMENT
(LIST BELOW)
~ OVERHEAD SERVICE
o UNDERGROUN~SEAVICE
VOLTAGE: ~.;:>& .;:z.~ L-J
,8J SINGLE HASE
o THREE PHASE
SERVICE SIZE dOt? AMPS
DetailsfDescription:
r::/&O /9-Jvl/) /Dffi,1c /
I f/
/19 ~W #1' ~,6'
7r 0 ): W ~ /J-<..<-rJ (;(
.
IA.J.<; h-//
~N>k/l
..-L;tI s 4//
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
o Ditch Inspection O.K.
o Rough-infcover O.K.
11J4flTflJ. O.K. to connect service
o Final O.K.
Site Address:
'S"'.;2! tv. ~
Et CC/e.; c-
Permit/Receipt No.
L//zO
5
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 ~u~ermit. PHONE 457-0411, EXT. 224. ~.
-- /~ NO OCCUPANCY OA USE ESTABLISHED UNDER THIS PERMIT $ Ij6 ~D
Electrical Inspector Permit Fee
WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept., Bottom: City Hall
OLYMPIC PRINTERS INC.
/J