HomeMy WebLinkAbout1724 W 14th St - BuildingPREPARED 12/07/07 10 26 22 INSPECTION TICKET
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY
ADDRESS 1724 W 14TH ST SUBDIV
TENANT NBR BRET MCGUIRE
CONTRACTOR PHONE
OWNER MCGUIRE BRET A PHONE (360) 461 1890
PARCEL 06 30 00 0 4 0628 0000
APPL NUMBER 07 00000386 RES DETACHED GARAGE
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/22/07 JLL BLDG FOUNDATION FOOTING
5/22/07 AP 05/21/2007 08 59 AM LPANGRLE
REED 460 4561
FOOTING (ANYTIME)
05/22/2007 03 55 PM JLIERLY
BLRI 01 5/30/07 JLL BLDG REBAR INSPECTION
5/30/07 AP 05/29/2007 09 32 AM LPANGRLE
REED 460 4561
REBAR
05/30/2007 04 43 PM JLIERLY
BL99 01 12/07/07 JL
Dec FINAL 7E 04 00
December 7 2007 8 51 51 AM 1pangrle
REED 460 4561
BLDG FINAL DETACHED GARAGE
LATE AFTERNOON
THE DOOR IS LOCKED BUT THE KEY IS ABOVE THE GARAGE DOOR ON
THE TRIM
COMMENTS AND NOTES
l'o..4
c AiTk O
b\s)
PAGE 3
DATE 12/07/07
\-2A-10
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application. valuation
Owner
MCGUIRE BRET A
1724 W 14TH ST
PORT ANGELES
(360) 461 1890
Otherr struct info
Permit
Additional desc
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
WA 98363.6810:
COMMENTS /ACTION NEEDED
CITY OF PORT-ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES. WA 98362•
07 00000386
956356
1724 W 14TH ST
06 30 00 0 4 0628 0000
BRET MCGUIRE
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
12600
Contractor
OWNER
TOTAL LOT COVERAG
CONSTRUCTION `T.XPE
HARD SURFACE AREA
NUMBER OF .STORIES.
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED '.LOT .COVERAGE;`
TOTAL, :LOT COVERAGE:
,NUMBER- OF UNITS
ELECTRICAL NEW RESIDENTIAL
JEDI/ 200A SVC TO GARAGE
105742
JEDI ELECTRIC
75 00 Plan Check Fee
7/30/07 Valuation
1/26/08
Qty Unit Charge Per
1 00 75 0000 ECH EL RM 0 200 1ST SRV FEEDER
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/02/2007 04 35 PM SROBERDS Proposal will allow a
detached garage in the RS 7 for a total of 22% lot
coverage Noland use issues anticipated
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical load 'calculations and elctrical permits are
required
Any modifications to the City s electrical facilities will
be at the customer s expense
Public Works Utility Engineering has no requirements for
this plan review
Other Fees STATE SURCHARGE
Charged Paid Credited
/5 00 75: 00
00 00
4 50 -4 50
00
00
00
Date 7/30/07
3'21 10
N
0
1608 00
11614 00
840 00'
2448 00
1 00
Due
00
0
Extension
75 00
4 50
00
00
00
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
DITCH
ROUGH -IN COVER
SERVICE
FINAL
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED
YES NO
COMMENTS
AY -I Ioi.Us [i/961
CITY OF PORT ANGELES,
PUBLIC WORKS ELECTRICAL DIVISION.
321 EAST 5TH STREET -PORT ANGELES. WA91i362
Page 2
Application Number 07 00000386 Date 7/30/07
Application pin number 956356
Grand Total 79 50 79 50 00 00
COMMENTS/ACTION NEEDED
4.
INSPECTION TYPE DATE
DITCH
ROUGH -IN COVER
SERVICE
FINAL l/..1 -07- 47
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
n
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
ACCEPTED
YES I NO
COMMENTS
PW- 116.1511
Job wired by
Electrical contractor name
Je tee- ri t'�
Purchaser's mailing address
Q,(-9 ac-,x
City
1' r I tr1 e tee
Telephone number
Inspection
Date
Z�d
RECEIVED
u t A A nr4 -r
u iii i Lu
*tl
e..,.A
lectrical Contractor 0 Owner
State ZIP
FAX number
2-1-i) Ai 4li} pi 49. a s Ai ,tAA i9 Ilc,
9L 6 6 (09£)
License number Date Expires
i, DI 7C Z
ELECTRICAL WORK PERMIT APPLICATION
v V
\(nstallation description
0 Commercial 3rResidential
New AlterediAddition
i✓ 6�,,� i I cl t In
Tca�_ Service_
L/ c c >SSL" t-I 1 7 7
Pri mises owner's name
i, (-t-' I O C. i Lt l Ire
Address of inspection
7.?, t-1 k)�j i y t 1 1
City
Phone number to schedule inspection
Owner as defined by RCW 19 38.261 0) Owner will occupy the structure for two
years after this electrical permit is finalized. (2) Owner is required to hire an electrical
contractor if above said property is for sole, rent or lease.
After reading the above statement, I hereby certify that I am 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
Ltility Specifications.
/Signature of o er, electrical contractor electrical administrator
7Z,....
ter Date.
Electric: Load Additiotfnd or subtractions
NO LOAD CHANGES
Baseboard KW Voltage
Furnace KW Overhead Service Phase 1 3
Heat Pump Ton LAR D Temp Service Service Size:
Fan -Wall KW Underground Service Feeder Size
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360- 417 -4735
g,47
ROUGH IN THERMOSTAT 1 SERVICE
c Approve Hy El At. Approved By Date
FINAL DITCH ir oi
Date Ap roved By D ate Appr veZ By
0 Cash 0 Check
0 Credit Card Visa Mastercard Discover
Card
Expiration Date
Aofcard
C
Service Information
Approval By I
}ELDER
Dale Approved By J
Area, Building or Equipment Inspected Action Taken
I
Electrical
Inspector
l
i ezwiN per d0£.60 LO 9Z unr
0\
PREPARED 5/30/07 9 01 41 INSPECTION TICKET PAGE 6
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/30/07
ADDRESS 1724 W 14TH ST SUBDIV
TENANT NBR BRET MCGUIRE
CONTRACTOR PHONE
OWNER MCGUIRE BRET A PHONE (360) 461 1890
PARCEL 06 30 00 0 4 0628 0000
APPL NUMBER 07 00000386 RES DETACHED GARAGE
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/22/07 JLL BLDG FOUNDATION FOOTING
5/22/07 AP 05/21/2007 08 59 AM LPANGRLE
REED 460 4561
FOOTING (ANYTIME)
05/22/2007 03 55 PM JLIERLY
BLRI 01 5/30/07 L BLDG REBAR INSPECTION
t 05/29/2007 09 32 AM LPANGRLE
REED 460 4561
REBAR
COMMENTS AND NOTES
PREPARED 5/22/07 8 06 42 INSPECTION TICKET PAGE 7
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/22/07
ADDRESS 1724 W 14TH ST SUBDIV
TENANT NBR BRET MCGUIRE
CONTRACTOR PHONE
OWNER MCGUIRE BRET A PHONE (360) 461 1890
PARCEL 06 30 00 0 4 0628 0000
APPL NUMBER 07 00000386 RES DETACHED GARAGE
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/22/07 LL BLDG FOUNDATION FOOTING
05/21/2007 08 59 AM LPANGRLE
REED 460 4561
FOOTING (ANYTIME)
COMMENTS AND NOTES
Application Number 07 00000386
Application pin number 956356
Property Address 1724 W 14TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 4 0628 0000
Tenant nbr name BRET MCGUIRE
Application type description RES DETACHED GARAGE
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner Contractor
MCGUIRE BRET A
1724 W 14TH ST
PORT ANGELES
(360) 461 1890
Other struct into
Other Fees
Fee summary
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
WA 983636810
RS7 RESDNTL SINGLE FAMILY
12600
OWNER
Date 5/03/07
TOTAL LOT COVERAGE 21 10
CONSTRUCTION TYPE V N
HARD SURFACE AREA 0
NUMBER OF STORIES 1 00
EXISTING LOT COVERAGE 1608 00
LOT SIZE 11614 00
PROPOSED LOT COVERAGE 840 00
TOTAL LOT COVERAGE 2448 00
NUMBER OF UNITS 1 00
Permit BUILDING PERMIT RESIDENTIAL
Additional desc 840 SQ FT DETACHED GARAGE
Permit pin number 99564
Permit Fee 249 75 Plan Check Fee 99 90
Issue Date 5/03/07 Valuation 12600
Expiration Date 10/30/07
Qty Unit Charge Per Extension
BASE FEE 95 75
11 00 14 0000 THOU BL 2001 25K (14 PER K) 154 00
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/02/2007 04 35 PM SROBERDS Proposal will allow a
detached garage in the RS 7 for a total of 22% lot
coverage No land use issues anticipated
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical load calculations and elctrical permits are
required
Any modifications to the City s electrical facilities will
be at the customer s expense
Public Works Utility Engineering has no requirements for
this plan review
STATE SURCHARGE 4 50
Charged Paid Credited
Due
Permit Fee Total 249 75 249 75 00 00
Plan Check Total 99 90 99 90 00 00
Other Fee Total 4 50 4 50 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
Data Signature of Owner (if owner is builder) Data
FOUNDATION:
FOOTINGS
SHEAI+ WALLS WALLS
FOUNDATION DR,v1NAGE/ DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
I AIR SEAL
WALLS
CEILING
I FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
I INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -IN
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
BUILDING PERMIT INSPECTION RECOkD
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 ANT WORK BEFORE
INSPECTED 4ND 4CCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE
ACCEPTED
YES I NO
I I
I
FINAL
FINAL
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS I
SKIRTING I
PLANNING DEPT SEPARATE PERMIT #1's SEPA.
PARKING /LIGHTING I I ESA.
LANDSCAPING I J SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL DATE YES NO COMMERCIAL
ELECTRICAL LIGHT DEPT
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
I FIRE 417 -4653
I PLANNING DEPT 417 -4750
I BUILDING 417 -4815
T: \Policies \l 02 1.5 building permit inspection record05.wpd [1/4/2005]
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW /ENGINEERING
I FIRE DEPT
I PLANNING DEPT
I BUILDING
COMMENTS
DATE ACCEPTED BY.
DATE ACCEPTED BY.
DATE
ACCEPTED
YES I NO
I I I I
I I I
I I I
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
Page 2
Application Number 07 00000386 Date 5/03/07
Application pin number 956356
Grand Total 354 15 354 15 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 \Policies \1102_15 building permit inspection record05 wpd [1/4/2005]
ELECTRICAL LIGHT DEPT
CALL 417 -481 FOR BUILDING INSPECTIONS CALL 41 FOR ELECTRICAL INSPECTIONS
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFILL TO COVER INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND 9CCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
CONSTRUCTION R.W PW/
ENGINEERING
I FIRE
I PLANNING DEPT
BUILDING
INSPECTION TYPE DATE
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DPYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -IN
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
T \Policies11102 15 building permit inspection record05 wpd (1/4/2005]
BUILDING PERMIT INSPECTION RECORD
ACCEPTED
YES I NO
1 5/22/67- I jV- I
417 -4807
417 -4653 I I
417 -4750 I I
417 -4815 I —ea I T L I
COMMENTS
Rip 5/30164 L;
FINAL
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING /LIGHTING ESA.
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL DATE YES NO COMMERCIAL
417 -4735 ELECTRICAL
LIGHT DEPT
DATE ACCEPTED BY.
I FINAL DATE ACCEPTED BY.
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
I PLANNING DEPT
I BUILDING
DATE I ACCEPTED
I YES NO
1 1 l
I I I I
I I I I
Owner
TYPE OF WORK.
Residential New Constr
Multi- family Addition
Commercial Remodel
Repair Sign
BRIEF DESCRIPTION OF TAT'•
oZ If X 30
PLANNING USE ONLY
BUILDING PERMIT APPLICATION
Fill out COMPLETELI and in INK. I our 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
Applicant or Agent: /jiQ ,,,..2G
I, r
Address. /2.2 Y l./ 1r
roc
Arclutect/En gineer
Contractor
Address:
PROJECT ADDRESS /7 of'/
LEGAL DESCRIPTION Lot:
CLALLAM COUNTY PARCEL NUMBER.
City
State License
City
/5"`
Block.
Re roof Stove
MoveA Garage
Demolition Deck
Other
PROJECT
(4R (r'A4L4cre
Phone: O ?Q
Phone.
PORT F,e
Phone.
;Tet'eEr
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
Subdivision.
Exp
Phone:
Zip
ZONING
SIZE/VALUATION
YO SF 15 /SF 1Z1 (200
SF /SF
SF /SF
TOTAL VALUATION )e 17 C 0
Cos ciP)
FOR OFFICIAL USE ONLY
Date Reel
Pennit ti•
Date Approved:
Date Issued: 7
Zip f 7d "4.2
I
APPROVALS
PLAN
BLDG
DPWU
FIRE.
OTHER.
COMIVIERCIAL/RESIDENTIAL. Occupancy Group U Occupant Load. Construction Type: 4/oo0 aME
//!off
No. of Stones: .Z. Lot Size: ,r Existing Sq. Ft. i R, Proposed Sq Ft. f7o =TOTAL Sq Ft. o
Total lot coverage
VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and maybe 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 Building/Residential Code, 2003). No apphcation 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. 27
T•\FORNS\BldgPermiteorm.wpd Apphcant: i.L� r`�
A I 6(A Date: 7 0
8
725
e r
I
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o
01-3
vro a
ecS
1-*
1,01 /720...111
e la
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CITY OF PORT ANGELES
DEP AR1MENT OF COMMUNITY DEVELOPMENT - BUIT..DING DMSION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
pin numbet . . . .
property fress . . .
ASSESSOR P CEL NUMBER:
Applicatio description
Subdivision Name
Property Use
Property Zoning .
Application valuation
04-00000391 Date
.620713
1724 W 14TH ST
06-30-00-0-4-0628-0000-
ELECTRICAL ONLY
5/17/04
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
LAUSCH JEREMY D
1724W 14TH ST.
PORT ANGELES
OWNER
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
4 CIR. BATH RM. /MUD RM. FREEZER
46.70 Plan Check Fee
5/17/04 Valuation
11/13/04
.00
o
<::)
-+:-
I
W
"" -0
-
L'
-
..J .....s
.!'J
)J ,...
--..
~ t:
J
(:) ...
(J\
-
-C.
~
~
WA 983636810
Qty Unit Charge Per
1.00 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS
Extension
46.70
Fee swmnary 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 provisions of
laws and ordinances governing this type of work will be complied with whether specified hereinor not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any st teor local law regulatin construction or the performance of
construction. . .
Sign'ature of Contractor or Authorized Agent Date
T:\l'LANNJNG\FORMS\II02.IS [11/1412003]
BUILDING PERMIT INSPECfION RECORD
"1
I
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, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTEDAND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ' ACCEPTED COMMENTS
I YES I NO
FOUNDATION:
FOOTINGS ,
W ALI:S
FOUNDATION DRAINAGEIOOWN SPOUTS .
ELECTRICAL (UGHT 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 r
FRAMING
JOISTS / GIRDERS
SHEAR W ALLlHOLD DOWNS .
WALLS/ ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION ,
,
SLAB
WALL / FLOOR/ CEILING "
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS \
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'5:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
",' "" r',h.
, FINAL INSPECTIONS REQUIRED .PIU.QR TO ~CUPANCYIUSE -:;-
. "
RESIDENTIAL DATE YES NO COMMERCIAL DATE .. ACCEPTED
- I- , ;'YES 7NO
l(~, ,. .. .-, , ' ' '..~.
ELECTRICAL. LIGHT DEPT. 417-4735 7,~()- ~ ELECTRICAL
UGHT DEPT
'V
CONSTRUCTION R. W./ PW/ CONSTRUCTION - R. W. .
ENGINEERING . 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT. ,..
PLANNING DEPT. 417-4750 PLANNING DEPT: .
" " .' ,
BUILDING . 417-4815 BUILDING
T:\PLANNING\FORMS\1102.15 [11/1412003]
fi'ORT~
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~~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
App11cation Number
P1n number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Applicat10n valuation
04-00000419 Date
.563437
1724 W 14TH ST
06-30-00-0-4-0628-0000-
RES REMODEL
5/17/04
RS7 RESDNTL SINGLE FAMILY
1500
Owner
Contractor
f7tJ~
7/22-/CJ5
.JlL--
LAUSCH JEREMY D
1724 W 14TH ST
PORT ANGELES
OWNER
WA 983636810
Permit MECHANICAL PERMIT
Additional desc
Permit Fee 54.25 Plan Check Fee .00
Issue Date 5/17/04 Valuation 0
Exp1ration Date 11/13/04
Qty Unit Charge Per Extension
BASE FEE 47.00
1. 00 7.2500 ECH ME-VENT FAN 7.25
-:::l
~
..:L
Perm1t PLUMBING PERMIT
Add1t1onal desc
Permit Fee 75.00 Plan Check Fee
Issue Date 5/17/04 Valuation
Expiration Date 11/13/04
Qty Unit Charge Per
BASE FEE
4.00 7.0000 ECH PL- EA. FIXTURE ON ONE TRAP
.00
o
E
Extension
47.00
28.00
-
Perm1t BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit Fee 77.50 Plan Check Fee 31. 00
Issue Date 5/17/04 valuation 1500
Expirat10n Date 11/13/04
Qty Unit Charge Per Extension
BASE FEE 47.00
10.00 3.0500 HND BL-501-2K (3.05 PER C) 30.50
.J::
-t
::>
Other Fees STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Perm1t Fee Total 206.75 206.75 .00 .00
Plan Check Total 31. 00 31. 00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 242.25 242.25 .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 penod 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 authonty to Violate or cancel the provisions of any state r local law regulating construction or the performance of
construction
Signature of Contractor or Authorized Agent
Date
T \PLANNING\FORMS\I 102 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 UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH-IN
PLUMBING 1 ( '2-2-l 0;- :J"LL..
UNDER FLOOR / SLAB F\NA.L
ROUGH-IN ~-9-I-O ..., (o(\J
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS Iq - !l.- 0 J./ ALL
CEILING I I I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING C(-~-()~ JJ-I---
DRYW ALL (INTERIOR BRACED PANEL ONLY) .
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL Fl '" Ad- \, l"2-'2-l0S- TLL-
HEAT PUMP
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Englneenng 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
ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R W / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 4 I 7-4653 FIRE DEPT
PLANNING DEPT 417-4750 . PLANNING DEPT
BUILDING 417-4815 ., 1-22-/ ~\ ..:rt..L BUILDING
TlPLANNING\FORMS\1 10215 [11/14/2003]
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY
Dale Rec ::; - {-O~
Penl11t # 64 - t.{ {
Date ApplOved
Date Issued
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
ApplIcant or Agent'
Owner: -Sd<t..I"I I
Address / 7 P Y W
ArchItect/Engmeer:
Contractor
~ (2r1-Jh\/ J) .
J
i) . AA u.sCt./.
/47# sr
f ~ '2 tl (5 - '7"3'6 - e 2-"Z."l ,t;~
t.J~1<. ~60 4.52. $2./7
J..f),; ! CtJ Phone: .3 (" () '" 4 17 - 9, '811
Phone. cSA-I11l:-':+~ A13olJ~
CIty ?c:>ll7 A/Vt;ELE<; 4.JA.I ZIP' '1<2.3"3
Phone'
State LIcense #:
Exp:
Phone:
Address:
CIty:
ZIp:
ZONING: R-e..~
SubdIVISIOn. C/~ 0 f. Pl).
/
cOn o<tnf,-::::;8
PROJECT ADDRESS: 17~'f <> IYM -<'T
LEGAL DESCRIPTION: Lot ~ 13.:~/ or 7 Block: ~(!)'
I
CLALLAM COUNTY PARCEL NUMBER: V" :~ (')
Credit Card Holder Name:
Billing Address:
Credit CardType VISA MC #
TYPE OF WORK:
o ReSIdentIal 0 New Constr 0 Re-roof
o MultI-farmly 0 AddItIOn 0 Move
o COIDIDercral ~ Remodel 0 DemolItIOn
o Reparr 0 SIgn
BRIEF DESCRIPTION OF THE PROJECT:
City:
EJ..'}l. Date:
o Stove
o Garage
o Deck
o Oilier
t:\. [)l\ lAib
SIZEN ALUATION:
SF @ $ /SF. = $
SF @ $ /SF. = $
SF @ $ /SF. = $
TOTAL VALUATION $ I 5PD
0A TR ROOM -t 0 E)f. I' $.1- t (."> t\ v.Q.. ~;.... dl,
~~r~~
COMMERCIAL/RESIDENTIAL: Occupancy Group:
Occupant Load:
& Proposed Sq Ft.
ConstrucTIon Type:
No. of Stones:
Lot SIZe'
EXIStlng Sq Ft
Total lot coverage
= TOTAL Sq. Ft
%
APPRO V ALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
PLANNING USE ONLY:
ESAlWetland(s) 0 Yes 0 No SEPA Checlchst requrred? 0 Yes 0 No Other
BUILDING PERMIT APPLICATION SUBMITTAL: The Buildmg DivlSlon can provIde you WIth infonnatIOn on the applIcatIOn and
plan subrmttal reqmrements If you have questIOns
VALUATION OF CONSTRUCTION. In all cases, a valuation amount must be entered by the applIcant TIllS figure WIll be reVIewed
and may be reVIsed by the Bmldmg DIVlSlon to comply WIth current fee schedules Contact the Penmt Coordmator a1417 -4815 for aSSIstance.
PLAN CHECK FEE IF a plan check fee IS due It must be subrmtted at the tm1e the bmldmg penmt applIcatIOn and construction plans are
subrmtted. All other pemnt fees are due at the tnne of penmt Issuance
EXPIRATION OF PLAN REVIEW: If no penmt IS Issued wIthiI1180 days of the date of applIcatIOn, the application will expire. The
Bmldmg OffiCIal can extend the tm1e for actIOn by the applIcant up to 180 days upon wntten request by the applIcant (see SectIOn 1074 of
the Umform Bmldmg Code, cunent edItlOn). No applIcatIOn can be extended mOle than once.
I
I hereby cerlify that I have read and exammed 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 determme what permils are reqUJ d ,not the City's, an hat I must obtam such permils pn r to work
T \FORMS\APPS\BU11dmgpenmt wpd
Apphcant"
Date'
PREPARED 7/22/05-, --12: 08- -06
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
ADDRESS
CONTRACTOR
OWNER
PARCEL _ _
APPL NUMBER
1724 W 14TH ST
SUBDIV:
PHONE
PHONE -
LAUSCH JEREMY D
06-30-00-0-4-0628-0000-
04-00000419 RES REMODEL
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BAIR 01 9/02/04 JLL BUILDING AIR SEAL TIME 17 00
9/02/04 AP JEREMY 417-8811
BL3 01 9/02/04 JLL BUILDING FRAMING TIME 17-00
9/02/04 AP JEREMY 417-8811
BL99 01 12/30/04 JLL BUILDING FINAL
1/03/05 DA JEREMY 417-8811
MORNING INSPECTION SET FOR 10 A M
se1sm1C strap on w/h - electr1cal f1nal reqd before
bU1ld1ng f1nal can be completed/)ll
BL99 02 ~~ BUILDING FINAL
07/21/2005 03 58 PM JLIERLY
JEREMY 417-8811
1-
7/22/05
-------------------------------------- COMMENTS AND NOTES --------------------------------------
~
_ J'R_EfARED 7 /n/~5_L16_:_3 5_ _19
CITY OF PORT ANGELES
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
TN~PR("T' TOM----T-ICKET__
INSPECTOR JAMES L LIERLY
PAGE
DATE
1724 W 14TH ST
LAUSCH JEREMY D
06-30-00-0-4-0628-0000-
04-00000419 RES REMODEL
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
ME99 01 ,~~~/~ ~ MECHANICAL FINAL
~ . ~ 07/22/2005 04 34
----------------------------------- CONTINUED ONTO
SUBDIV
PHONE
PHONE
PM JLIERLY ----------------------------
2-
7/22/05
NEXT PAGE -----------------------------------
PRE:EARED ~L2 2 Lo 5_._16_.3 5_:_19
CITY OF PORT ANGELES
TNQpRrTTON_TICKET
INSPECTOR: JAMES L LIERLY
PAGE
DATE
3-
7/22/05
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
1724 W 14TH ST
SUBDIV:
PHONE
PHONE .
LAUSCH JEREMY D
06-30-00-0-4-0628-0000-
04-00000419 RES REMODEL
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP
TYP/SQ COMPLETED RESULT
DESCRIPTION
RESULTS/COMMENTS
PL2 01 5/21/04 RV PLUMBING ROUGH-IN TIME. 17 00
5/21/04 AP JEREMY 417-8811
PL99 01 ~ ~ ~~~~~~~0~IN~~.35TI~~ ;ZI~~LY ____________________________
-------------------------------------- COMMENTS AND NOTES --------------------------------------
PREPARED 12/30/0A, 1.2 __38_ 56
CITY OF PORT ANGELES
INSPECTIO~ TICKET
INSPECTOR JAMES L LIERLY
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
1724 W 14TH ST
LAUSCH JEREMY D
06-30-00-0-4-0628-0000-
04-00000419 RES REMODEL
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
SUBDIV
PHONE
PHONE
BAIR 01 9/02/04 JLL BUILDING AIR SEAL TIME 17 00
9/02/04 AP JEREMY 417-8811
BL3 01 9/02/04 JLL BUILDING FRAMING TIME 17 00
9/02/04 AP JEREMY 417-8811
BL99 01 ~ ~ BUILDING FINAL
JEREMY 417-8811
MORNING INSPECTION SET FOR 10 A M
PAGE
DATE
1
12/30/04
-------------------------------------- COMMENTS AND NOTES --------------------------------------
· · LJ...n .At:)
Sa;l~ fo1 , (.., Vr f"""1\ .....
~u. ~ /~
I..
~
J
Glee.
}:~~)
~
PREPARED _9/02/04, 1-3-,-3-7 49- -- ----INSPECT-ION,ICKET--
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY
PAGE
DATE
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
1724 W 14TH ST
SUBDIV
PHONE
PHONE
LAUSCH JEREMY D
06-30-00-0-4-0628-0000-
04-00000419 RES REMODEL
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BAIR 01 ~ BUILDING AIR SEAL TIME 17 00
JEREMY 417-8811
BL3 01 JL BUILDING FRAMING TIME 17 00
~Q JEREMY 417-8811
3
9/02/04
-------------------------------------- COMMENTS AND NOTES --------------------------------------
PREPARED 5/21704, --i-3 25 54
CITY OF PORT ANGELES
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER,
1724 W 14TH ST
LAUSCH JEREMY D
06-30-00-0-4-0628-0000-
04-00000419 RES REMODEL
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP
TYP/SQ COMPLETED RESULT
PL2 01 5/21/04
~
RV J
12'v
INSPECTION TICKET
INSPECTOR ROGER VESS
SUBDIV
PHONE
PHONE
DESCRIPTION
RESULTS/COMMENTS
PLUMBING ROUGH-IN
JEREMY 417-8811
TIME 17,00
-------------------------------------- COMMENTS AND NOTES
6K.
+0
e.ov.tC..v-
PAGE
DATE
6
5/21/04
CITY OF PORT ANGELES
tIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 15668
Port Angeles. washlngton__m.r2m.::::....LL..__..__..mm____...m...... 1~"
In aocordance with the City Ordinance to regulate the installation. extension. or repair of elec-
trical equipment in. on, or about any building or other structure in the City of Port Angeles. per-
mission is hereby granted to do electrical work as listed below.
Address ...l2.2__.(l....~n.!..f.ti.m.m_______.__n__n........__. Occupancy.n.m~.....__m--m.....
Owner .__....:t:;;, f?..__.::-:.b-'.'-,,~.""_.mm.m.......__. TenfLliL.....__...mmm_..mm.._.mm....mmmmm........__m
Wiring C:Utractor m.a__Z.:__Lf2L:l....-!dt:?:;".m.r:.~~'_5.';j. By......__..mmm__mmmmm..m.n__n______mmm.__..__
Ll"ht Oullet..........______!.f..__:...__...... Service. volts --/c?.r--!...Y..9.------ Type of Wiring:
Receptacle Outlets .J C/ No wire. 3 Armored Cable .---.---....................-
__.....d2..X__..____..... . . --.....................-.77------
D1)er, KW....__.'___.m__.n.___.:.____________. Size wlres..~t...d....-..
Rurge, Kw...../d...nn.......... Main fuse ......~../l...........
S
Enclosure ......m___..m___m....m....u._o
Wz.ter Heater:
/
KW__________~..{----.--.----
Hea', KW.....__p..f....1i.1L..............
Type of wirIng:
Entrance Cable ........mm..u...mu...
Motors: size, volts and phase:
/&v:::................................__....
Rigid Conduit m....uu.mm...
Metallic Tubing ..................
Current transformers:
No. & Size...........___..................
Ser. No..............................................
Ser. No..............................................
Ser. No..............................................
Non.Metalllc ................_..............
Knob & Tube................................_
RIgid Conduit ..............____.............
Metalllc Tubing ............__.............
K:.
Raceway ..............................._......_
CIrcuits, Light....;!:.............................
Utility ........__5-.::..__...............__...__...
Heat ......~..........__..____..........._......
~
Range .............................................
.;2
Water Heater ....n:........................
Motor .............................................
..;)
Dryer.......0........__.........................._
Furnace ..........................w......_..... ......
do
Total Load............................. Sec. No. ..n....u......._...................u...u Total.......................................
Renlarks: __ny4J~..~.;..::..1:~u.--C..t'.J).!..~-.n-nn__......h...........nd..n......n____U__n..__u_.__nuhu.._.u.._O.h_.o.___n__un__
Pennit Fee
$m~~...~...Q__...m__.___m
Treas. Receipt
No...............__........__..
By n;tl.t..j~lL&.~q,~g,.(..-
NOTICE-Current must not be turned on until Certificate of Inspection has been Issued. If work Is to be con.
cealed due noUce must be gIven the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
-?~
ELECTRICAL PERMIT
::';=~e:~~~~:::~-~~=:=~:=:
NOTICE-Current must not. be turned on until Certlf1cate of Inspection has been issued. If work is to be conw
cealed due notice must be given ~e Inspector so that work may be inspected before concealment.
II f /t-u /3 13
c;..,.,...J''t..-'
'\.
1M
Olympic Printers, Inc.
N?
15668
.
ELECTRICAL PERMIT APPLICATION
FOR OFFlClAL USE ONL ':'
UaldKn- .__._~__.___._.__"~___
PClrrJi! ~ ________._____._____
Da\~AIJ~"o"cJ ______~__
Dalr 1.\~u",.J .__.______~__
The Electrical Permit Application must be filled out completely.
OL/-J7'/
Please type or reprint in ink. If you have any questions, please call (360) 4174735
Fax number: (360) 4174711
Property Owner:
3c.:11..Ei?7I/
I.'
I 7:;; ({ fA) I'-f 7iI
~~REm V J....fJvfC I-!
/ ;
1). .zAu.t;c-ff
Phone: 3;.0"11, !ill" Fax
Phone:3~O.'-{ ("7.f/ 8//
Owner or Elec. Contractor Agent
Address:
ST
City:
,':J"i/T ANI.r-L~.5
~..Jl\r
Zip q.. 'l-:o.t.. ~
Electrical Contractor:
License #:
Exp:
Phone:
Address:
;
City:
Zip:
INSTALLATION WIRED BY:
)(OWNER
o ELECTRICAL CONTRACTOR
Credit Card Holder Name:
Billing Address:
City:
Zip:
Credit Card Number:
.
Exp. Date:
VISA: MC:
PROJECT ADDRESS:
/7.:2, t.f i/J
I t/'!!
.sf
TYPE OF WORK:
Check gI! that apply: 0 New
o Alteration/Addition
t><JResidential 0 Multi-family
/ ,
o Commerciai 0 Mobile Home
Sq. Ft
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool
Number of Circuits added or altered: ..!j
o Septic Pump 0 Low Voltage 0 Telecom. 0 Sign
j
DESCRIPTION OF THE ELECTRICAL PROJECT:
\
/;.)f e c..
(!,AIH ROoY'1
1,'Td ANO CPooND
F~vJ.r
Pll)(~
Axl}
I?^,~-
PJ...I.IG
Forl
A<e-c.:;z r:-R
IAi /?'lvO ROOm
rHo 7Um \
FfJN <;
Electrical Heat load Additions and or Subtractions
Service Information
~ Baseboard
:J Furnace
~ Heat Pump
)!.1.Fan-Wall
_KW,
KW
TON
KW
LRA
o Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 0 1 0 3
Service Size:
Feeder Size:
I hereby certify that I have read and examined this application and know that same to be true and correct, and / am
'Iuthorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
'Ire required; it remains the applicants responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature:~ V-
Owo., 0' ,,~. CO",. Si'"""ro'-l~ ),~~
PERMIT FEE: $
Date: .,
Date:~
It, 70
;:IE LE eTR I CALPERMIT APPLI CATION