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Home My WebLink About1311 W 5th St - Building "s "".......,. CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION :121 EAST 5TH STREET. PORT ANGELES. WA 98:162 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00000048 Date .061936 1311 W 5TH ST 06-30-00-0-1-1985-0000- ELECTRICAL ONLY 1/21/05 RS7 RESDNTL SINGLE FAMILY o Owner Contractor MCCLAIN GEOFF G 1311 W 5TH ST PORT ANGELES WA 983631806 BOB'S ELECTRIC INC 2293 DEER PARK RD. PORT ANGELES (360) 457-6887 WA 98362 ---------------------------------------------------------------------------- Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL 200A SERVICE CH~GE BOB'S ELECTRIC INC 78.70 Plan Check Fee 1/21/05 Valuation 7/20/05 .00 o Qty Unit Charge Per 1.00 78.7000 ECH EL-RM-0-200 1ST SRV FEEDER Extension 78.70 .......... \JJ '- .......... Fee summary Charged Paid Credited Due Permit Fee Total Plan Check Total Grand Total 78.70 .00 78.70 78.70 .00 78.70 .00 .00 .00 .00 .00 .00 ~ '--' l;\ l~ V\ "'l COMMENTS/ACTION NEEDED ~ ELECTRICAL PERMIT INSPE~JON RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED . COMMENTS YES NO nlTf'H lUll TnJ.l_IN / COVER SERVICE J<ThT A T I, ).. { - t' -:.- I /fC(.C' GENERAL COMMENTS: PW-II02.I$ 141961 - . ~ ~~~~ ~,~'9.~., "'~,<~\ '" 'h ~,,~~~~,~:.~....'c~~~~-;__~~~..._ r__"~>,:,,__~ '.Ce;_"\;'~-- ,..,,-",, :.'....,...-,',,...,-'~<;'-' '<"". ~~':c_"",:.",,,,,,,,,_~,~~~.~'{,,~~~.,"... u_'-:"~~~~~_W"...,.-''t~;b-''-" ''''-''',"'''';'f''J'..~". .'-"W~-;'""-:":" "':""J';:A~~~1';";r. "'"'-""'V~,'f STA~EMENT Robert an! Jenny Haines 15708 oth Ave. W. i/4-44- . Edmonds, Wa. 98026-4611 To: City of Port Angeles 321 E. 5th 51. Port Angeles, Wa. 98362-0217 DA TE:07 /15/2005 DATE: CHARGES AND CREDITS BALANCE 07/1S/200S Cost Sharing for paving at 1311 E. sth St, Port Angeles 2084.78 101- .,1.:!..:l - $Lf2 -~ 12..::> ;j.. t- '/lqjO)" Thank Yau! . tA.: _~, ~ORTANGELES --.-.'..:'...~~, 'C r;ry",op, , _ r_" ~- - .,.; ... ~~,., _~', ____ori,._ ...---_" .. ::_g:'\~"t": ::: ")' ;:;~ ~- .......,. ~:;-:..:. -.. ~,~~-.: ---..'"- ~:... -- 4-( ~~~t? ,,' )~~ ~ ~~" WAS H I N G TON, U, S. A. PUBLIC WORKS & UTILITIES DEPARTMENT November 2, 2004 Mr. Bob Haines 15708 60th Avenue W Edmonds, WA 98026 ' RE: Cost sharing for paving at 1311 East Fifth Street Dear Bob, The recent installation of curb, gutter and sidewalk at the above address is completed. These improvements were placed at an elevation consistent with a roadway constructed to City Standards having a 2% cross slope from centerline. Fifth Street adjacent to the subject property currently has a cross slope in excess of 8%. This has created a situation in which the paving necessary to match the existing road to the new improvements is' overly burdensome for you to bear the entire cost. Therefore, I am willing to agree to purchase the asphalt paving material required to reshape the road section adjacent to your property. The estimated value of this commitment is for approximately 50 tons of asphalt concrete pavement at $38.50 per ton for a total of $2084.78 including tax., Your share of the cost shall include all other labor, equipment, and materials necessary to perform the work_ ' Sincerely, J\~ l.-..-. ~~ -6a-;:;;V ~ K~worthY, City Engineer cc: File C:\Projects\1313 E Fifth St Paving.wpd 321 EAST FIFTH STREET" p, O. BOX 1150" PORT ANGELES, WA 98362-0217 PHONE, 360-417-4805 " FAX, 360-417-<!I542," TTY, 360-417-4645 O ~~~ow'rc':~~I\ ,- _;1/ ! i ,.... JUt 1 9 2005 :~ July 15, 2005 Gary W. Kenworthy, City Engineer Dear Gary; The required paving at 1311 E. 5th St., Port Angeles, was completed and accepted by the City inspector on Thursday, July 14, 2005. I am enclosing a statement for the portion of the job that you said would be taken care of by the City of Port Angeles as well as a copy of your letter dated Nov. 2, 2004. I am also enclosing the contract for the job as you required it to be done and a copy of the estimate from another contractor who looked at the job before talking to Eric and knowing the scope of your requirements. If you need anything else, please contact me at (206) 226-3848. Thank you, / / -g~ #.4 . Bob Haines ., \p~A7 .' . ASPHALT PAVlNG_ ~ri- land8capJn,V Con.trucUon excavation ~ w e12Tc::... -" P.O. Box 2849 Port Angeles, WA 98362 360-452~9088 Residential' Commercial. Licensed. Bonded' Insured rol'lTl\. kr.C.1I 'A,,!i'PC(}MOL BILL TO. #6 ADDRESS: /.> .? t:!J d' 6 $ ~-" CITY, STATE, ZIP: E/_o.............s PHONE. Qve. tv...~ T 9902.6 DATE'6 _ l? -0 5 START DATE: Jol, - .22'- - 73'-/3 E: f,;<.. w~ o DAY WORK o CONTRACT o EXTRA ADD-ON "'-/7 - Y.$e? ~ ~.;t5 - 7V J - ;>3yl? LOCATION: / /1 5"~ CUSTOMER ORDER NO. ORDER TAKEN BY: MECHANIC: HELPER: DESCRIPTION OF WORK o no 4< T ,. cr~<!" ... Tev ee" S r~ 57'....eT d_ c t: v 77;. v~, /0 /. c-]:L ,.,. .,.7 ~r. ... "OJ( 6S A/ t" o.v ",T,.,; q / 2" or ,h,;.Jl hc,/r -1-... X "'0 /. 7 .fJ.:2 - I '/7.90 TOTAL MATERIALS. TOTAL LABOR: DATE (:OM..Lnm:" WORK ORDEReD BY: ~AL_ 1.9.2 9.<f CJ o NO ONE HOME o TOTAL AMOUNT DUE o BILLING TO BE MAILED \'"&A7 ASPHALT PAVING. . . --- Landse8P,nW'COftStnKtlon Excavat'oq .... --------=::::: - IJPrrAZ- 7f} L-K.DJ {q, TO &J2-~c P.O. Box 2849 Por~ Angeles, WA 98362 360-452-9088 Residential' Commercial. Licensed' Bonded' Insured CONn. ar;o.. 'AASPt'C04'lOL Bill TO: lloiJ #0:""("'5.' DAT":, -/5-05 ADDRESS: /J' 70$ 6 g ~4 START DATE: ~V'" L</ CITY. STATE, ZIP: E ~ 01. @DAY WORK ,h7c>" .J o CONTRACT PHONE: o EXTRA ADD-ON .lOB NAME: . LOCATION'; f II .E .5 T'~ I PHONE: CUSTOMER ORDER NO. ORDER TAKEN BY' MECHANIC: HELPER: DESCRIPnON Of' WORK 5'.,<4/ C 0/ r _/~A"" e'''''' .,~" /~-"e - /1/1' /pv~ J q',,~ y /-'n e AfJp./e ..- ~ u 77..-,- ("", ~T.t",- /,1''''''' To of S- T'" 5;;- tPhc-K- ~ /-J-e - - '" _ V" 0-.... of cf(oqd .- ~_Ar<?x .2 A~ $ ror k "P S 760 ."~- -f rq~ L1... 7 ~ DQ.. - -- . it " & . 2.31? ~ t \ TOTAL MATEIWWI: TOfAL LABOIb TAX: DATE COMPLETED: \WORK ORGEAED BY: TO"rAL AtraOUNT:. $ .. o NO ONE HOME o TOTAL AMOUNT DUE o BIL-LlNG TO BE MAILED . , , , , " APPLICATION FOR WATER City Water Department Port A~geles, Wosh. 2 - I () 2C6 L( ;:w i . I hereby apply for water to be furnished in accordance with rates and rules, of tbe City for the following premises: rnflll..'....~ e;yj(lt'"t!i!iS ~)..J. . /57t:8,tJ:;O!ZJ Aoe. W Nome of Applicont Ain~c. ~~1'><; Wfi q:?/)?fe, Address /?/ / E 5~ ('LOt" zU-S ~1J) Renewol 0 New Servi~e!;:d--, Blk~ LotL Add 6e'.FrhIf/VI!''J I )( -ff ,y Meter Number ' o Service Left Off..f:]- Signe~ ;;?t-.....i--4 fj (;40- + <j /oZS- rer'>>'llT$L 01.(- 7"4/ Size of Service Service Left On Instolled by Remarks: N , ~ ~ '^ " 13// e S-n, "r- Q9~. J.. b~1/C ~305' .' E W / :;fl. ~'cI :... "" - e:;<> r- C I' t '" ~ s: . \ s ~ORTANGELES WAS H I N G TON, U. S. A. f~-#- 04-4 PUBLIC WORKS & UTILITIES DEPARTMENT November 2, 2004 Mr. Bob Haines 15708 60th Avenue W ~dmonds, WA 98026 RE: Cost sharing for paving at 1311 East Fifth Street Dear Bob, The recent installation of curb, gutter and sidewalk at the above address is completed. These improvements were placed at an elevation consistent with a roadway constructed to City Standards having a 2% cross slope from centerline. Fifth Street adjacent to the subject property currently has a cross slope in excess of 8%. This has created a situation in which the paving necessary to match the existing road to the new impr6vements is' overly burdensome for you to bear the entire cost. Therefore, I am willing to agree to purchase the asphalt paving material required to reshape the road section adjacentto your property. The estimated value of this commitment is for approximately 50 tons of asphalt concrete pavement at $38.50 per ton for a total of $2084.78 including tax.. Your share of the cost shall include all other labor, equipment, and materials necessary to perform the work. Sincerely, ~' ~- """"",,,-. ~ Gary W. Ke worthy, City Engineer cc: File C:\Projects\ 1313 E Fifth 51 Paving. wpd 321 EAST FIFTH STREET' P. O. BOX 1150' PORT ANGELES. WA 98362-0217 PHONE: 360-417-4805' FAX: 360-417-,4542.' TTY: 360-417-4645 E-MAIL: publicworks@cityofpa.us ,. . . ~ , j . = !lI M 1 ffi 'fi/~:<i- 1 $ ;:S-50- 0/1&4 q/ll'J'-O~) ,______---~Zou,"c, 6J ~\:',:, <p1' ="'c ,..1 ~f,io"'t"m.'o~!!oe!! ~"II qA. -_.~ ':t1J/l -!lEe- 1:~t'S~07bt'bl: :It'b~..,ot':I~Bt'II' qoO~ &lz'i; )01-- 98_762/1251 , . DAfE --~ '.- . 592 Carlsb0rg Rd~ Sequim, W.~82 360 683 5273 360 379 9973 360 681 4437 FAX J, L'01.o ,- .,.! cl '-<> . MARISTAR ASPHALT PA VING, LTD Maristar Asphalt Paving, LTD. 592 Carlsborg Road Sequim, W A. 98382 PROPOSAUACCEPTANCE; y ~ CONTRACT (0-01-0,0\ CUSTOMER! ACCEPTOR (5): Name: +i i n fUJ Address: Telephone: Contractors Reg. MARJ~77QD Job No. o...{ Lf;). (- 'IlfJ - Dilll\" W"r" On.h:r H 3~ r CONTRACTOR: "', IMPORTANT NOTICE By signing this contract you are acknowledging that your opportunity to consult with legal counsel before- proml)lng to dblJc ~: '.:--:~' conlracl and each one of the provisions has been satisfied. You are accepting the specifications, price eSllmate, prU\JSIOnS, and tU~-..:.::.. payment of the debt created by this contract. Changing the spe<;ifications may mean that the debt and payment due may be adjusted b\ !DC COnlraclor and riled to or subtracted from the tola! paYll1ent due, By signing this contract you are certifying that you have the kga! ''"1''''-''[\ to enter into this CQntract and bind yourself and your agent, attorney, representative, heir, and successor to abide by the COnLJa:.:l. specifications. price estimate arx:I provisions. You are ordering that your deb! be excluded and exempted from bankruplcy prQ[ec[lon The customer has read, understands and acknowledges the above notice by signing initials here X SPECIFICA TIONS: The customer has solicited the contractor to furnish all materials and labor necessary,,, plan, transport, construct and lace the imyrovements de cribed In these specifications and daily ,,:or~ orders or, property located at ,:Tl:l '::::,'\Y12.R..;t ('ftVl ,In the State ot V, ashlngton Maristar indu,strial specifications: [annex attachments as necessary] COld ~ ~({N u~~ I~O' c~ ~-r~1vf ir~rJ.. ' r ~o.muc,.( 9r.RCA..- Gl ,,-, .:) JJ. ;!...J...vIJ <V -firu gVtAcA..J...- ~~~{(i: ,~ ~~~J_ ~,:::::~~' r;T'~;,"i ] Ii.;. 'JO /JUIh I $\o'u(),UU specifi~ations: annex,attachments as n,ecessar Ct.1l u.. ( . r u-u.... (~ t :.1.,/(,\ U ft;r;rn (Jf- ;PH- Q (/,- t'iiv; (~ N '".... ....U.:.~Vlll<;;1 <1O'I=-'l WlliJ <ill Ul lne Spoeclllcauons llncluomg aIUlex attac e~J a ve and aUlhonzes (work) piannlng. lrilnspvn:it!0;. :onstruclion an.::i placement of the improvements to commence on Cw . The customer JSSU<T!es -esponsibility for and guarantees thai all project site permits, designs, markings, agging, staking will be completed anJ In plc:~'c- x!''.!:;,, viaristaf transp:>rts eqwpmenl, material and labor to the work project site. The customer authorizes a "show up" (ee {O be charg~ 2..:1...:.: ..l..l..L:": o the deht and payment due in the event that the site is not pre~ for Maristaf work al the ti me of Marislars \\ orkers am \ e It !f:f ',\ ':"::' )rOjecl site. X,Y rhe customer approves the aoove specificaIlOns, diily work orders and attachments by signing initials here _ ?RICE ESTIMATE: [daily work orders are annexed] The Cus[Qmer promises to make the full and final payment, in the form of a fully negouabJe Instrument, to the COntf3.ClOr (or malenaJs furnished, labor costs, fees, show up fees and part I payment incurred 10 SIaI1 and complete the \\OrK, Part I payment: NOT REFUNDABLE (irreversible business a.drnlnistration, transport, equipment, materials and/or lab'or costs) DUE AT COMMENCEMENT OF PROJECT ~ " ,..." Go Amount of down payment to secure commencement of project 'Jv $ _n~_~9.,_Q() $ __n~5_~~~-6 Estimated SHOW UP FEE Includes; travel, transportation, equipment, materials, & labor or & when charged each inCident) ($ __n~ Adjustments: Deductions or Additions to debt and/or payments due causea by changes in specifIcations, and/or requirements of engineers or inspectors~. ~ 0; 0 , (S$ nnnC\-I-e;--C;-(t Estimated amount of Washington Stale Sales Tax () ______n_~_~~L~_ Estimated full and final payment (plus or minus 10%1 --E\ Y\,l...\ ~-1l1. $ d- q '+-~ . (1 b' , -': ~r c\LU.. vyC'V\ \: (.V\.\ P \L t1 ViL.. ie contractor a'1d Customer (acceptOr) certify.that each has read, understands and acknowledges the nOlle-e, sr'ecil\cal1ons, pnce eSUf"T1J.'.::- _~~..:. I pro\'Jsions on page one (IJ and page IWO (2), Nel30 days from invoice applies 10 [ull payment. ' ~)[~~Stfl~ ~OriZed Agent ~r =-t?~t;Aaoi/' ~ ...:!.ile IMPORTANT! THIS CONTRACT CONTINUES ON PAGE 2 592 C:!flsb("~~Rd.. Sequim, W...r%382 360 683 5273 360 379 9973 3606814437 FAX o '1'- q~ j'VIARISr:DAR ASPHALT PA VlNG, LrrD , / 2 C:l(P. ,,2 J. \,.1- Maris12r Asphalt Paving, LTD. S92 Carlsborg Road Sequim, W A. 98382 PROPOSAUACCEPT ANCe..- CONTRACT 0-01-6.0\ CUSTOMER! ACCEPTOR(S): Name +I i n UJ Address: Telephone: ContrdC10rS Reg. MARlS 77QD Job No 0..., t.(J. s,'il/ f - [);1I1 \" \V\ ld: Order n VLlY CONTRACTOR: IMPORTANT NOTICE By sit'oing this conu-act you are acknowledging that your opportunity to consul! with legal counsel c..:(ore promisIng [0 ".:OI.Jt ~> .... cOnlfacl and each one of the provisions has been sausfied. You are accepting the speciCicalions, pnce eSllmale, pro\ !S!iJ.r1S, Q..r!G t..:~'~:..~.:: pavment of the debt created by thlS contract Changtng the spectftC3llons may mean that the debt ana payment due mal be adJusteu b\ 'ne l2ontrdC10r and ockiedto or subtracted from the lolaJ payrn.e~t due. By signing this contract you are certifYing thdt you hdve [he leg::.! l::"~~"::.> to enter into this contract and bind yourself and your agent, attorney, represenk'1tlve, heir, and successor lO abide 6y the conl:,:.C~, specirications, price estimate and provisions. You are ordering that your debt be excluded arid e,xempted from bankruptcy protel..'t!(}r: The customer has read, understands and acknowledges the above notice by signing initials here X SPECIFlCA TIONS: The customer has solicited the contractor to fumlsh all materials and labor fleeeSSa'\ 'j plan, transport, construct and lace the imyrovements de cribed ).0 these specifications afld dally ':ork ?rders C'I' property located at .:to '::::,','1' ~ I .ftYl, . tn the State 0; \V2S!1'cgtO!' Maristar industrial specifications: [annex attachments as necessar)] COlcZ 0 ~urv. u~~~ /~()' c.~ ~.{~1v( -ir;).,r~ '~{ ~UrYlL<("'(:"( OY.R!A. -, u C J .u :J....;...v<1 OJ {-7 ru (,VI-< '^-'--' ~""-": " ~ ~';;"_ ,,;, :~~~A r;'r~;~1 ustQrne specifi<;ations: () v...T1 I u tvyJ /Jum Ih 5 OvU.Uu ! C '-0fc/f'J~ {t - II The CUSlomer agrees with all of the specifications [including annex attac ve and authonzes (\....ork) planning, t,jI1S?)L"'..:i\!0'; \.:onstruclion ar.d placement of the improvements to commence on Cw The ('USlOmn :'-S~,F:ll'S rcsPJnsibiliry for and guarantees that all project site pernlits, designs, markings, agging, staking will be completed :.TiC 1~ ?I;:.~'I.' =-('l',.I~' .\13Jlstar lrJJlsp::>rt.s equipment, material and laoor \0 the work project site. The customer authorizes (l "show up" (e~ \0 c-c ('~g,;,:..: :-:.;""1.-= .1...L.X::": lO lhe debl and payment due in the event that the site is not pre~ for Maristar work at the time oi tvianSlar5 \\Oi":':'ers- S--;l\t ::'l :,:'"':~ ." ,)~" proJeCl 51 te The I.;u$lomer 3.pproves the aoove specifications, ciJjly work orders and attachments by signing initials here X PRICE ESTIMATE: [daily work orders are annexed] The CUSlOmer promises to make the full and final payment, in the fom of a fully negouable Instrument, to the (oecroe-'.ae '0: m,,,erials furnished. labo, costs, fees, show up fees and pan I payment incurred 10 star! and complete the \\OrK Pan 1 payment: NOT REFUNDABLE (IneYecslble busin.es.s administration, transport, equipment, materials and/or labor costS) DUE AT COMMENCEMENT OF PROJECT i' Amount of don'n'pa'jment to -secure commencement of project sD UJ '5DCoO(jO s ~~~~~5~~~~~? s Estimated SHO\V UP FEE Includes: travel, transportation, equipment, materials, & labor (if & when charged each incident) (S m mLEl !:o_ '_ QQ _ Adj ust men ts: Deductions or AddItions to debt and/or payments due caused by changes In specifications, and/or requiremenlS of engineers m tnspectoe:,. 2.. 0/ 0 I~S nnncFc\-.-C/,-\T Estiml:lted amount of \\'ashington State Sales Tax a.J i\1: _________~_____~_ Estimated full and finnl paYment (plus or minus 10%1 --0 y\,C-.\ \'1). S d- '1 '+~ , (1 3" , . -<; -\<!-.r c\lU. v{) C"^- \: (/V.. P U-'t1 vY\...~ The COnU7..ClOr 3....'ld cUSlOmer (acceptOr) certify.that e-3ch has read, understands and acknowledges the nou ('(;' , S~('lJ-lc3t!OnS, Jr:::e eSt!:1~:':~;:- ,,-,~~ :.:.I! prc\-!slons on pJ.ge one (I) and page two (2). Net 30 days from ['nvoice applies to full payment x-----7 --v (0 f- s,~~{~~-Po~'i:on7ed Agenl LQ\J~\ dale: Signal 're of Customer (. 1 / J ~ ~~ ccepwrJ: -' 1,\IPORTA,'iT! THIS CONTRACT CONTINUES ON PACE, ~ ~' r/Q'- ,R, )T:'P;./ N, 'G~E:L; EI'S'i / ~' I, ;' I 1! ; r; , , , , , WAS H I N G TON, U. S. A. PUBLIC WORKS & UTILITIES DEPARTMENT February 15, 2005 - ~ -- Geoff G. McClain 1311 West 5th Street Port Angeles, W A 98362 ~ ~ \9 RE: Obstruction within City Right of Way Dear Mr. McClain: The Public Works & Utilities field inspector has observed a stack of wood being stored within the City's right of way adjacent to your residence at 1311 West 5th Street. Per P AMC 11.12.060 Obstruction of Sidewalks and Planting Strips Prohibited; It is Unlawful to erect, maintain or allow to remain on any sidewalk or planting strip of the City any temporary or permanent structure or thing which in any way obstructs, hinders, jeopardizes, injures or delays the use ofthe sidewalk or planting strip for pedestrian traffic. It has been determined by Public Works that the wood pile does in fact is a prohibited use of the planting strip ~d the wood must be removed within 48 hours of receipt of this letter. If you have questions, feel free to contact me at 417-4807. Sincerely, JIUAu~ ~ Trenia Funston, Engineering Permit Specialist. File OeD. Bwldmg Address file 321 EAST FIFTH STREET · P. 0 BOX 1150 · PORT ANGELES, WA 98362-0217 PHONE. 360-417-4805 · FAX 360-417-4542. TTY' 360-417-4645 E-MAIL. publlcworks@cltyofpa us o Electrical Contractor Cl Annual Permit 0 AlarDl ;J- ~ ELECTRICAL WORK PERMIT APPLICATION / / >>'i -'I \;, ReQuestInspection . o Owner ~:s' r. o Carnival Cl Commercial ~Sidential 0 Residential Maiht. 0 Signs a Thermostat a Telecom. Job wired by DOwner /:.,L_-r ~, P I'hu €-t- OIVt-)- 'iffU'L. ~"U"..<" ~. ~ 0JoJ Si~D3ture of owner, electrical contractor or clec:t."ic:al 3dtnfnistr.:uor o Cash 0 Check # ~redit Card ~ Mastercard Discover Card# --(PlL--rf-M-)------- Expiration Date of card Inspection fee ,..-.rO $ 7'1 ~ I hereby certify that I :un ~e owner of the above named property OT a licensed electrical contractor (or the firm's authori;-.ed agent) and am making the electrical installation or alteration in compliance with the electrical law, Chapter 19.28 RCW. WALLS Insulation Ollly OllIe A(lJlf'l)w.;(\ f.Iy Covel'" D.:lte A,PllfOvC(! By CEILING Insulation Only D~IO Approvell.l::)' Cover DMc ^ppraved By / THERMOSTAT " OllIe ^~~roved ~y / DITQH / " Dale' Approved By / SERVICE 1- $/-/)5 .~ " D'Ilo; Appl1l~~Y ".- FEl!Dm '- Dl\tll ApptO\'ed By Electrieal Load Additions and or subtractions o NO LOAD CHANGES o Baseboard KW a Furnace Kw [J Heat Pump _ Ton _ LAR o Fan-Wall K!N Service Information o Overhead Service CJ Temp Service [J Underground Service Voltage PhaseD 1 03 Service Size: _ FeQder Size: lnspcction Area, Building or Equipment Inspecred Action Taken Electrical Oate 1I1SpeC1Or A~ WI:J~0:0~/S00C 6. 'ue[ /fU/ / /1'1 IPS Zt?66 CSt? 09Z ~ 'ON XI:J.oJ ::l!.1+:JCil13 5,808 WO<:l.oJ