The URL can be used to link to this page

Home My WebLink About2103 W 16th St - Building CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 12- 00000250 Date 3/08/12 Application pin number 633000 Property Address ASSESSOR PARCEL NUMBER: 06-30-00-9-2-0160-0000- REPOR T SA LES TAX Application type description SIDING on your state excise tax form Subdivision Name to the City of Port Angeles Property Use Property Zoning RESIDENTIAL TRAILER PARK (Location Code 0502) Application valuation 1500 Application desc PARTIAL TEAR -OFF AND RE -SIDE Owner Contractor OSCAR RYCHLIK /KRISTINA NASON OWNER 2031 W 15TH ST PORT ANGELES WA 98363 n 1 8.21. 1� Permit BUILDING PERMIT NO PR FEE V Additional desc PARTIAL TEAR -OFF AND RE -SIDE Permit Fee 80.50 Plan Check Fee .00 Issue Date 3/08/12 Valuation 1500 Expiration Date 9/04/12 Qty Unit Charge Per Extension BASE FEE 50.00 10.00 3.0500 HND BL- 501 -2K (3.05 PER C) 30.50 Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 80.50 80.50 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 85.00 85.00 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work 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 presume to give authority to violate or cancel the •rovisions of any state or local law regulating construction or the performance of construction. of .A Date Print Name Signature .'Contractor or Authorized Agent Signature of Owner (if owner is builder) T:FormslBuilding Division /Building Permit BUILDING PERMIT INSPECTION RECORD O 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 IT IS UNLAWFUL_TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. 11 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 FINAL Date Accepted by 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 FINAL Date Accepted by MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting I4 PLANNING DEPT. Separate Permit #s SEPA: �J Parking Lighting ESA: Landscaping SHORELINE: 0 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 0 Building 417 -4815 C a' 2- T:Forms /Building Division /Building Permit N N H N W W S S a q 0 N r m a u a .0 w H H a zz cn x w a oo H Q Cr) as N 0 H h m o z co H O cn N H N Oi VI u u z H w w o z a a E N In z z W o o a- E H Z O N z N Z 0 aH H w ,JH z 0 0 0 7� So 01441441 0 b1H H O 1 Q a P] S E. cn 0 E H o z a E' 0 4I m HN 244) �I� H x a O E H W \P In H x 01 In Z a O u N H N H 1, O O 9 V P O o N W M Q M O H H '-I 0 O u 1 fn W H U) l0 N O W ra h r 4 N 0 0 H O a a N �E. a 03 oo a 0 a a o w 01 O E. .X W w a0 cn¢ az F 0 0 s r a H w u a a t m a 01 O 03 Q a pi N a a u S u 0 a Q a H CO PROJECT STATUS UPDATE Permit 2-' 2P20 N 092 I 1P Date: 919 311a I phoned the: Applicant at Property Owner Y-(6 Y N'a "o at S 492.5 Contractor at I (left a phone message, r discusse y: The permit (has expired, o will expire so. What is the status of this project? Please call and schedule a final inspection. i I l Or Submit a "permit extension request" letter. Or Let me know if the project is abandoned. Al •I T:Forms /Building Division/Project Status Update pf PONrq,1c. BUILDING PERMIT APPLICATION Print in ink -dam— CITY OF PORT ANGELES For City Use 0 y: .r Attn: Building Permit Technician Vie 321 E. Fifth St., Port Angeles, WA 9836662 Date Received 2.. NERSP (360) 417 -4815 fax (360) 417 -4711 Permit ate Approved Applicant ;^i /4_S v�2 Phon 3O ‘190 Property Owner ,5'cik L„&,c. ck. 5 al, era Phone Property Owner's Address 1 a Contractor r /arse—v-- Coy, ra..c Phone a 6o 1 !a y f' 7 Contractor's Address er. 021,ox, License Expires E -mail PROJECT ADDRESS r D u /P` -57 ?4 U7 Parcel Number 1 -L Lot Zoning Project Type Brief Description: Residential Multi family Commercial Industrial Check all that apply New Construction Addition Remodel )Repair J -J•( .c' Old warn) r-e-p1ct,C( l,€ J Demolition Re -roof House garage other tear off re -roof lay over one layer Heat System Heat pump wood- burning stove gas fireplace pellet stove other Other Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq. ft. 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION Total footprint of structures /5 J la sq. ft, T Lot size sq. ft. of coverage Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage Max. height of proposed structures ft. Occupancy group of bedrooms Will a lawn sprinkler system be Installed? Occupant load of full baths Will a fire sprinkler system be installed? Construction type of half baths I have read and completed this application and know it 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, and to obtain permits prior to working on projects. Date•3 Print Name ri Sft na I Sd Signature T:Forms /Building Division /Building permit application Clallam County Assessor Treasurer Property Details 62688 OSCAR RYCHLIK JR Page 1 of 4 Clallam County Assessor Treasurer Property Search Results 62688 OSCAR RYCHLIK JR AND KRISTINA M NASON for Year 2011 2012 Property Account Properly ID: 62688 Legal Description: GRANDVIEW HEIGHTS SUBDIVISION LOT 16 NEW MH 01- 02NC 1995 FLTWD 46/27 riORFL48AB19649BS Geographic ID: 0630009201600000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 Open Space: N DEL Historic Properly: N Remodel Properly: N Multi-Family Redevelopment: N Township: Section: Range: Location Address: 2103 W SIXTEENTH ST Mapsco: PORT ANGELES, WA Neighborhood: PA Sublets MH Map ID: 3 Neighborhood CD: 5202000 Owner Name: OSCAR RYCHLIK JR AND KRISTINA M NASON Owner ID: 49971 Mailing Address: 2103 W 16TH ST Ownership: 100.0000000000% PORT ANGELES, WA 98362 Exemptions: Taxes and Assessment Details Property Tax Information as 0803/07/2012 Amount Due if Paid on: NOTE: If you plan to submit payment on a future date, make sure you enter the date and click RECALCULATE to obtain the correct total amount due. Click on "Statement Details" to expand or collapse a tax statement. First Half Second Half Year Statement ID Base Amt. Base Amt. Penalty Interest Base Paid Amount Due Statement Details 2012 44805 $540.89 $540.84 $0.00 90.00 $0.00 $1081.73 Statement Details 2011 157005 $564.99 $564.95 80.00 $0.00 $1129.94 $0.00 Values Improvement Homesite Value: $0 Improvement Non-Homesite Value: 854,360 Land Homesite Value: $0 Land Non-Homesite Value' 836,000 Curr Use (HS): $0 $0 1+) Curr Use (NHS): 80 $0 1=) Market Value: $90,360 Productivity Loss: 90 Subtotal: 990,360 Senior Appraised Value: $0 Non-Senior Appraised Value: $90,360 Total Appraised Value: 590,360 Senior Exemption Loss: $0 Exemption Loss: $0 Taxable Value: $90,360 Taxing Jurisdiction Owner OSCAR RYCHLIK JR AND KRISTINA M NASON Ownership: 100.0000000000% Total Value: $90,360 Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Levy Code Description Levy Rate Appraised Value Taxable Value Estimated Tax STATE SCH STATE 2.3523324994 $90,360 $90,360 $212.56 SCHOOL CC GENERAL CLALLAM 1.2567736569 $90,360 890,360 $113.56 COUNTY GENERAL DEVDISIBLT DEVELOPMENT 0.0250000006 $90,360 890,360 $2.26 DISABILITIES COUNTY LND ASSMT LAND 0.0012000000 990,360 $90,360 90.11 ASSESSMENT COUNTY TAX REFUND TAX REFUND 0.0000000000 890,360 $90,360 $0.00 FUND COUNTY http://websrv8.clallam.net/propertyaccess/Property.aspx?cid=0&year=2011&prop_id=62688 3/7/2012 Clallam County Assessor Treasurer Property Details 62688 OSCAR RYCHLIK JR Page 2 of 4 VET RELIEF VETERAN'S 0.0112499996 690,360 $90,360 $1.02 1 RELIEF COUNTY CAPT IMP CAPITAL 0.1807291674 690,360 $90,360 $16.33 IMPROVEMENT PORT DISTRICT LIB LIBRARY 0.5000000000 $90,360 690,360 $45.18 i COUNTY LIB BD PORT 0.1842692429 990,360 $90,360 616.65 ANGELES CITY LIBRARY BOND PRT ANG PORT 2.5752211723 990,360 $90,360 5232.70 ANGELES CITY GENERAL REFUND BD PORT 0.0772077833 $90,360 $90,360 $6.98 ANGELES CITY REFUNDING BOND SD 121 BD SD 121 BOND 0.4211676018 690,360 $90,360 $38.06 SO 121 GEN SD 121 M 8 0 2.8788787613 690,360 $90,360 $260.14 HOSP 2 GEN HOSPITAL DIST 0.5323634246 $90,360 $90,360 $48.10 82 GENERAL WSMETPARK WILLIAM 0.1599036024 $90,360 $90,360 $14.45 SHORE MEMORIAL POOL MET PK DIST Total Tax Rate: 11.1562969125 Taxes wlCurrent Exemptions: $1,008.10 Taxes wlo Exemptions: 91,008.10 Improvement Building Improvement 81: MOBILE State Code: 11 1188.0 soft Value: 554,360 Exterior Wall: 1 11 -11 Foundation: 1 Concrete Block Heating /Cooling: 1 Forced Air Electric Kitchen Quality: 2 Average Roof Covering: 4 Composition Type Description Class CD Sub Class CD Year Built Area CP -PATIO CARPORT PATIO 08 01 1995 220.0 DET GAR DETACHED GARAGE 08 03 1995 576.0 MH2 MH MULTI -WIDE 08 03+ 1995 1168.0 PORCH -4 PORCH ENCLOSED 08 03 1995 60.0 PORCH.4 PORCH ENCLOSED 08 02 1995 80.0 Sketch No sketches available for this property. Property Image ry mot `7'Yr 2 y -4 tt i !i;''''' 'i 1 i:::: Ti::t r ...2:11,.. 1 1 7 1 ti http: /websrv8.clallam. net propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =62688 3/7/2012 Clallam County Asse Treas urer Property D etails 62688 OSCAR RYCHLIK JR Page 3 of 4 1. G n 4 b AYH• vµ¢a. n I 4 d 'p 4 H �j y XT h�._ t mY d ati P 3 D f a A s A r s n �p ki. A#4:::14i:31C4''':!--4.''' :14 :WI! i 4 4 A '4'64,:::7,71,,,, R" y ti'-/-:.,- rf x '°''3 f '.y 1 'mac u "m� 44 ft DWMH 1188 sf 27 ft 27 ft efp 60sf 6' 10' http: /websrv8.clallam. net/ propertyaccess /Property.aspx ?cid &year 2011 &pro =62688 3/7/2012 Clallam County Assessor Treasurer Property Details 62688 OSCAR RYCHLIK JR Page 4 of 4 Land Type Description Acres Sgft Eff Front Eff Depth Market Value Prod. Value 1 1150 1150 0.0000 0.00 0.00 0.00 $36,000 $0 Roll Value History Year Improvements Land Market Current Use Total Appraised t Taxable Value ,2012 N/A N/A N/A N/A N/A 2011 $54,360 $36,000 $0 090,360 990,360 2010 562,723 540,500 $0 $103,223 $103,223 2009 $83,630 $40,500 $0 9124,130 $124,130 2008 $83,630 $45,000 $0 9128,630 $128,630 '2007 $83,630 $45,000 $0 $128,630 $128,630 2006 $86,105 $38,895 $0 $125,000 $125,000 2005 $68,885 $28,600 $0 $97,485 $97,485 2004 949,205 $22,000 $0 $71,205 $71,205' 2003 $49,205 $22,000 50 $71,205 $71,205' 2002 $49,205 $22,000 90 $71,205 571,205 ,2001 $0 $22,000 $0 $22,000 922,000' X2000 $51,690 $18,000 $0 969690 $69,690, i 1999 $51,690 $18,000 $0 $69,690 $69,690: 11998 $51,690 $18,000 $0 969,690 $69,690: Deed and Sales History :Excise Deed 1 Deed Date Type `Description Grantor Grantee Volume Pagel Sale Pnce Number Number 1 QUIT CLAIM QUIT CLAIM DEED OSCAR L RYCHLIK,JR OSCAR RYCHLIK,JR /KRISTINA NASO 0 $0.00 200464959 20041128418' I 2 WARRANTY D WARRANTY DEED STARR A RACKEY OSCAR L RYCHLIK JR 0 $40,000.00 200153010 20011067933 43 SAD SAD JULIE LEIGH WASHINGTON PRIVATE MORTGAGE IN 995 571 $30 000.00 199100000 683163 4 REAL ESTAT REAL ESTATE CONTRACT J. LEIGH AKA BETTY LOTERO STARR A RACKEY 926 146 930,000.00 199110782 654536 5 WARRANTY F WARRANTY FULFILLMENT DEED WASHINGTON PRIVATE MORT STARR A RACKEY 1076 707 $30,000.00 199410782 715317 ,6 WARRANTY D WARRANTY DEED CLIFFORD /JOYCE M WHITNEY BETTY LOTERO 897 639 930,000.00 199007134 641949 7 CLIFFORD /JOYCE WHITNEY BETTY LOTERO 0 $0.00 199007135 0 8 WARRANTY D WARRANTY DEED JOHN E DUEDE CLIFFORD E WHITNEY 857 631 $22,500.00 198901143 623861 9 JOHN E DUEDE CLIFFORD E WHITNEY 0 $0.00 198901145 0 10 WARRANTY D WARRANTY DEED CATHERINE NAPIONTEK JOHN E /BEVERLY A DUEDE 803 222 514,000.00 198803678 600852 Payout Agreement No payout information available.. Website version: 9.0.32.2200 Database last updated on 3/7/2012 3:54 AM 2012 True Automation, Inc. All Rights Reserved. Pnvacy Notice http: /websrv8.clallam. net/ propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =62688 3/7/2012 ~ .... CITY OF PORT ANGELES °~ PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 3/22/2001 PERMIT NO: 12556 OWNER/APPLICANT PROPERTY LOCATION 2103 16TH ST W STARR RACKEY 2103 W. 16TH STREET Lot; 16 Port Angeles, WA 98363 Block: [] Long Legal 206/452-5399 Subdivision: GRANDVIEW HEIGHTS T: S: Parcel No: CONTRACTOR ARCHITECT VALLEY PROPERTIES N/A 164 HEUHSLEIN RD Port Angeles, WA 98362 , 98360-0000 360/457-5518 360/000-0000 PROJECT INFO Project Value: $43,000.00 SFD Units: 0 Commercial: 0 Project Type: MANUF. HOME SFD SQ FT: 0 Industrial: 0 Occupancy Type: Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: RTP PROJECT NOTES REPLACE 3 BEDROOM FIRE DAMAGED MH WITH NEW 3 BEDROOM MH .~' FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $230.00 Sign: $0.00 TOTAL FEE: $230.00 Plumbing: $0.00 AMOUNT PAID: $0.00 Mechanical: $0.00 BALANCE DUE: $230.00 Radon: $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 certi~ 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 ~ction. [Si'~nature of Contractor or Authorized Agent Date -- Signature of Owner (if owner is builder) Date 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 I. FORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 1N A CONSPICUOUS LOCATION. INSPECTION ~t'P E DATE ACCEPTED COMMENTS YES I NO FOUNDATION: BUILDING 417-4815 ~'~' l/t-/S-O~ ~:~ BU, LD[NG ~ Building/Utility/Electric/Fire Permit Application r~t~ ~':~~:~ Please fill m~t compleidy. T~pe or print in ink_ If ~ou have qu~ns PmApld Coml~ %-~--~ plca~ call {360) 417-4815 or Fax: (360) 417~,711 Leu~of¢om~mm~_ A~Ire~: ~./O ~ L~, /&-/-/~ city:. ~flp zip:9,~,~ Architect/Eag~/eer/Desi~mf: , ,. Phon~ ~ ~ r~ ~ ~ ~ - 3 o -~ ~ 1~o c~ c~ H~ N~ B~ ~: Ci~: ~ ~p: C~t C~ ~ ,K~ Date:~A MC_, ~ EI~ ~ ~-g~ ~ S~ = UST T~V~UA~ ES~(~): ~ Y~ a N~ ~Pt ~i~t ~? ~ Y~ ~ N~ ~: OI'~ · pply for ~it ! ~ ~ ~ ~ ~e ~W's I~ r~ a~ica~'sm~biH~ to ~i~ ~ ~1~ are ~q~d and to . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT PERMIT NO. 1- r b / DATE I - Z(; - '(57 Site Address: 'ZIO Installed By: o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: 56L-F Owner/Business: Z- Phone: "Z. -Sf5 Sq. Ft. Owner/Business Address: \ ELECTRIC HEAT o BASEBOARD KW _ o FURNACE KW o HEAT PUMP KW_ o FAN/WALL KW o RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION o REMODEL o ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE o RISER ~OVERHEAD SERVICE )i1 UNDERGROU?D SERVICE VOLTAGE: /r?79 2..-{D I/'lq\ D3S!\ SERVICE SIZE ,..;J.W FEEDER SIZE AMPS AMPS l!{JH'~( /IGW l0.4-iJ{)F~(U~ FOr 1M / , . Jh.14-f~ ' [ DetailslDescription: . W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. ~ O.K. to connect service Ar~Final O.K. Site Address: 'Z1t1?:> ItA Permit/Receipt No. Installer: e. 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. JYI / ~M Electric~1 tspeClort WHITE - File by address NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ f-t; ~ Permit Fee PINK - Top: Eng, Bottom, Customer GREEN - Top: MeIer Dept.. Boltom: City Hall / OLYMPIC PRINTERS INC C1TY OF PORT ANGELES LIGHT DEPARTMENT N~ 18352 ELECTRICAL PERMIT port Angeles, washlngton........(L....:::____J.CL......_............__.., 19E(;"' , ~ / In accordance 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 bellw. _j;.. Address ooooa.J..Q.3___w.~_d.J0dboooo _.~.~~ll{ Jqccupancyl?~~-=.2??~-t:::..~ffI: "-€V ~ O~ .___~,oo___QCJ-PJ.Qn:l!'" ". ;;l~.___oo 1'enanL__c.___..Qc,.-JQJQ.nj_\:.~._.______oo.___....... Wirlng~ ___00_.__ .' n' __~By..::Rcuj...---__,,)LLn~oo--.---oo.------...oo Light Outlets..........____.__.......________.._.._.. Service, volls __L"1r!j;_Y:.o..__. Type 01 Wiring: Receptacle Outlets..hm_......._..._.m....... No. wires ..J:._'?!:.~.....~.:(()._.._mm Armored Cable ...m..md............____. Dryer, KW .._u...___~...____________.n__..._. Size wiresh.!...._.~___.d:.h......._.. Non-Metallic h_.h............___d_h__..... ,V Cl.. od _ Knob & Tube..__...........m.d__........... Honge, KW ______________________ Main luse ____.- _h.______~...-- ____..______._. -1 /) tJ Rigid Conduit __________h...__.._______._... Water Heater: Enclosure .:;;X..(Lm ,..'h"" _.m.n ~ t--- Metallic TUbing ___.h.......m___n...... KW......._. .u.n_n_n.nnunn Type of wiring: Raceway ........___m................._......_ Heat: Kw......!...ll.m......n..h...........h Entrance Cable ......nm......m......... Circuits, Lighth...............mm_............... Motors: size, volts and phase: I ") Rigid Conduit ..n...._.m.......m........ '~~Ubing __._____~____. Util!lY .h.__h__..........________h______..._____. Heat ___,..___._............................_...... Ser. NO.n.....n..............,..................._.. Range .......n.........n............n_....._.... Water Heater mm...........mm........ Motor .,.......................................n... Current transformers: No. & Sizem.mh...hn............... Ser. No................_.............................. Dryer .................................._............._ Furnace ............_.._.........._................... Ser. No............................................... ~~::~~:~:~:::":~~~::~~~u~u~~:=:_~~i?:~~~'.O......~~~--:?~::::::::::::::::::::::::-:.:~::.~:.~:.~:~::.~::~..~::~.~ .:ii~----_oo..~~~..~...--~-------..-::~.~-.~.~~~b~~~..._-----.-------.---:~.~2~d2~ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work IS"" be con. cealed due notice must be given the Inspector so that work may be jnapected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION /:J~ JP~ ELECTRICAL PERMIT M_. r2JQl~H;:;/Jf-~-- __'L:,~<f- ::::: ~~=;~~~~::::3:~L~_____:~,.u~:::::::::::.:::-::._:..:.___.~:~a_~t'~5~kf...(!"::::~:~ ~ - , N~ 18352 NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. 1M Olympic Printers, Inc. , \ '~- '... ~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . , . . . INSPECTION REPORT. . . . . . REQUEST: Date A - 6- - os Time /O.'CD d/YI Received by 1(-7 (phone,~'!D Location of Work to be inspected ..?/ 0:3 fA/' / is rL Name of person requesting inspection (~/C:i.fe,r /},;/ Address of person requesting inspection 170e .) ft. () "r Phone No. '-//7A/f)'I'7 Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. ~ c,/?c/e.r Inspected: Date Remarks: INSPECTION NOTES: 6-6'-0'6 Time /J,;UV tl ffl f By 7 ( 7 ,J \, (';I rIlrC'~l ,b/'e<~ k . CH'l'j", h.",1~. btr'<,k (etJCi-tleJ.- ,-,,,e!f- ['"..,11 I I Ca./5ed /'1/ 71'...... ///7;/5 RESTORATION REQUiRED...... YES NO )( ft ;)"CI ~J7" '<7 ~ ~ I\J '0.) Jill- .,.. ') , '-,> Ilo (j r.. " SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel o Repaired by City o Repaired by Permittee o No Damage Found o Asphalt 0 PCC }Q Other Tty - So,' / Work Order # '? 0.3 Lf,) - 175 7 ~. COMPLETE o INCOMPLETE (Continue on reverse side if necessary) ___~_ __ _____ ___ _ _ __ST.RF.:F_T_~I,IPI=J:lINT~Nns:l\.IT. Ir.\A:r:Cl___