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Home My WebLink About726 Georgiana St - Building d'O't'~_ $fi~~ D8 ""'~,... CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION :\2\ EAST 5TH STREET. PORT ANGELES. WA 98:\62 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use property zoning . . . Application valuation 05-00000218 Date .078454 726 GEORGIANA ST 06-30-00-5-1-3920-0000- ELECTRICAL ONLY 4/01/05 RS7 RESDNTL SINGLE FAMILY o Owner Contractor ------------------------ -----~------------------ GARY AND APRIL HEILMAN 726 GEORGIANA ST PORT ANGELES WA 983623510 ( 36) 452-4278 OWNER ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL OWNER/ GARAGE 48.10 Plan Check Fee 4/01/05 Valuation 9/28/05 .00 o Qty 1. 00 Unit Charge Per 48.1000 ECH EL-R-OUTBD/DTCH GAR SEP Extension 48.10 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 48.10 48.10 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 48.10 48.10 .00 .00 COMMENTS! ACTION NEEDED ~ ~ "" " ' G0 ~ ..... X ~ ~ \ ....... ~ ~l ELECTRICAL PERMIT INSPEQ'.ION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 COMMENTS NO GENERAL COMMENTS: PW-II02.JS (4196) d ~ORT ~ t~~ rw. "-~ ~ "l.oii:.,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation 1/05/05 RS7 RESDNTL SINGLE FAMILY o f=\ I) Nft~ l/IO/{~ Owner Contractor ------------------------ ------------------------ GARY AND APRIL HEILMAN 726 GEORGIANA ST PORT ANGELES WA 983623510 ( 36) 452-4278 OWNER ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT INSPECTION ONLY 47.00 1/05/05 7/04/05 - NO PR FEE -FINAL GARAGE Plan Check Fee Valuation .00 o Qty Unit Charge Per BASE FEE Extension 47.00 ---------------------------------------------------------------------------- Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 47.00 47.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 51.50 51.50 .00 .00 -::::J "P \)'. -nr:--.. - -J \ Z (t --+- r~ \c" ~ C\2 ~ ..... ,'::" g ~ 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 10caVJew/:e ulati g construction or the performance of construction. f/ / ..... ? I . r--. / Srgnatur of Owner (if owner is builder) I 5- (;) ( Date Signature of Contractor or Authorized Agent Date T:\PLANNING\FORMS\1102.15 [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 I YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGElDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE I PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 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. 1 PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 I I {)()<' ..IL BUILDING T:\PLANNlNG\FORMS\1 102.15 [I 1/14/2003] BUILDING DIVISION CITY OF PORT ANGELES * * Correction Notice .~ Job Located at Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: These corrections must be made and are not to be covered until reinspection is made. When corrections have been made, please call for inspection. Date Inspector for Building Division DONOTREMOVETH~TAG tIl tIl >-3 '" ~~~8E; ()'" r-' r-' >< ~ H" '" '" '0 'O"ZZO >-301 '" '" '- r-'()t>:I>-3" ><'0 [J) >< 01""01 :>> 0 0 10 ... 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"'0'" , >i n ' H , >-lOt:-< ",QtJ:l :<10 I HO~ H:>>C , "'''' 00 Z:<1H , CJ)CJ)iZi zo :>>o<t:-< , coO , t:-< 0 , t:-<:<1 0 ~H , >-lH'tI Z ","'Z , CJ)'O"" t:-< 0 OHQ , ___>-l 0< 0 :<1t:-< , OH'<l H 3: Q~::l , OOt>:l HZ 3: , 3:Zt>:I ZCJ) '" :>> Z , 3: CJ)'O Z :<1 :>> , OJ '0'" >-l :>> t:-< , Z OJn CJ) Q , , >-l n>-l OJ , Ul >-lH ~ 00 ","'>-l , :<1Z 0 :<1LTlH , Otv3: '-<>-l Z 3: , '" , ~8 0 ", .. , 'O'OCJ) >-l '0 tv 5563 "'~ OJ :<1"H , CJ)'" CJ) HOO" , ZZO >-l 0 .. , OJ"'H t:-< :<1 0 < "- 0 t:-< '0 H OJ '" :<1 :<1 3: w t:-< H '" 0< >-l 0 ", H en :<1 N n , :>> ", tv H " \0 00 \0 ", 0'0 :>>:>> >-lQ "'''' H --- 0 '" --- OH LTl'" ..... o<'OAT~ l~~ ,. "'=--- ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 J r-".il_..._l___ .._..b_~ Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation V~-vUVUU/~O uate B/Ob/O] 726 GEORGIANA ST 06-30-00-5-1-3920-0000- ELECTRICAL ONLY o Owner Contractor GARY AND APRIL HEILMAN 726 GEORGIANA ST PORT ANGELES WA 983623510 (360) 452-4278 ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452-6424 WA 98362 Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL 200SER+200AFEEDERTO HOUSE ELECTRIC SERVICE 99.00 Plan Check Fee 8/06/03 Valuation 2/03/04 .00 o Qty 1.00 1. 00 Unit Charge Per 76.3000 ECH EL-RM-0-200 1ST SRV FEEDER 22.7000 ECH EL-RM-0-200 ADD SRV FEEDER Extension 76.30 22.70 "J N ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 99.00 99.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 99.00 99.00 .00 .00 \\~ i~ ( ~ ~ ~ " 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'\PLANNING\FORMS\1102.15 [4/2002] " BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING 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 I YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT' # ROUGH-IN PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW I WATER AIR SEAL WALLS I CEILING I FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYW ALL T-BAR INSULATION SLAB , WALL / FLOOR / CEILING I I MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineenng 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 8/11 h3 AoO ELECTRICAL LIGHT DEPT -,- CONSTRUCTION R W./ PW/ CONSTRUCTION. R.W. ENGINEERING 417.4807 PW / ENGINEERING FIRE 417.4653 FIRE DEPT PLANNING DEPT. 417-4750 PLANNING DEPT ---- 417.4R15 BUILDING c/ ,Oftf ~ l~ ,. ~ -- ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 A_t"l:'....l.............~........ .I...'-U.lu..I~.L Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation U"-UUUUUI':JU 726 GEORGIANA ST 06-30-00-5-1-3920-0000- ELECTRICAL ONLY Date 8/20/03 o Owner Contractor GARY AND APRIL HEILMAN 726 GEORGIANA ST PORT ANGELES WA 983623510 ( 36) 452-4278 OWNER Permit Additional desc Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL ADD/ALTER 6 CIRCUITS. 57.10 Plan Check Fee 8/20/03 Valuation 2/17/04 .00 o Qty 1. 00 2.00 Unit Charge Per 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS 5.2000 ECH EL-R OR RM ALT ADDNT CIRCUITS Extension 46.70 10.40 ?J (J Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.10 57.10 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.10 57.10 .00 .00 ~ ~f ~ C1' 1\~ ~~ ~ 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 sp' cified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or 0 alia r ulating construction or the performance of construction. Date ~ 15-d.A.o Signature of Contractor or Authorized Agent Date T \PLANNING\FORMS\1102 15 [412002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING 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 ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineenng 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 ELECTRJCAL - LIGHT DEPT. 417-4735 /;~J -!oS /!c// ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W / PW/ / /' CONSTRUCTION - R W. ENGINEERJNG 417-4807 PW / ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15514 7 ' Port Angeles. WashJngton..m.....m__..__._..........~....m__mm......__oo.m. 19"_'00_' In accordance with the City Ordinance to regulate the installation, extension. or repah' 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 ooJ.__~__~_oo_____m.:m:mm:.:____.___m.Coo_.:_______________________oo Occupancym.m::__:____."._~m_m.m.____oo__m.__ Owner _____mm__m.m_______mmm__m.mm_____.oo_m__mmm. Tenant.m___.___mm_______.__m___________m__.m__.m__oo_mmm... Wiring Contractor ____oo_____m.oo.m.mmh________oo_mm________________m By_________oo_m.moom__mmmm_____m.m__.m______m_____ light Outlets_......._.......__...___......._m_..... Service, volts ....................................... I eceptacle Outlets.....__m___....n............ No. wires ........_.......__.......___....______. L cyer, KW......n.___n.._n.__n.nn.......n.... Size wlres........__..m__n_.mmm...._.. Range, KWm.hmmm__mmu__n Main fuse ....h................................. 'vater Heater: Enclosure ....__...m:.___.._____mm..m__.. KW.oo__m.............____...____.....__..__.. Heat: KW...h__:~..L!....m.u..":.__:.n__~.__.. Type of wiring: Entrance Cable ._____..h.___h....__....... Motors: size, volts and phase: Rigid Conduit .h.h..h..........h......... Metallic TUbing ____m___..m.. Current transformers: No. & Sizem....hmm....mm.... Ser. No..............__....________..__.___.______.... Sec. NO.......__________........____hn..______.__.. Sec. No..........________....__..____.........__.__... Total Load...........__................ Ser. No. .h__........................................ F,emarks: _____oo_________oo_______________._,____________________________C:__.oo__m.mm_mmmmm.m__m______m______...m.mm__m.m.m_______ Total....................................... Permit Fee Treas, Receipt No.._.____.______.............. By __________m__._____hm.m____mm__hmmmmm__m______ ~-----....---.------.---m-.m--m.. Type 01 Wiring: Armored Cable ..__m...mm............., Non-Metallic ................._.............._ Knoh & Tube............_............___...... Rigid Conduit ....__.........._m_.________. Metallic Tubing __...........m__.._..____ Raceway ..............................._._..._ Circuits, Light....__..hn........................... Utility......______..........................__..... Heat .._...................................._...... Range ......................._..................... Water Heater .....__..__.................... Motor ..._........._...._.......................... Dryer _...................__.........................._ Furnace .........................._......_..m.....' NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be COD- c:Jaled 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 N? 15514 Address.............__...._.............._................................_....__...........n.............__.................................Date..._......_.._.._.._..n......_......_......_......... Owner...............................__.._.__......._......_......_.._...........................................................Tenant._.....................___...__..._.......__......_..........._..... Wiring Contractorh...__..h__...........nn.__..........n...........__u._.n__.......h....____....h__.___........____....__.__..____ By..u.....................u_.................__.....__..____.. NOTICE-Current must not. be turned on until Certificate of Inspection has been issued. It 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. Rug 14 03 08:09a Port Angeles 13604570460 p.l FOR OFFICIAL USE ONLY lblclReo::' f'f'nDiIlt:. D;)j..~"cd; De.t"ml.lcd: The Electrical Permit Application must be filled Qut com Dletelv. P lease type or reprint in ink. If you have any questions, please call (360)417-473~'" ~ G 0 Fax number: (36G) 417-4711 r ,-, OWnerorElec. ConbaclorAgenl; C7ACZ- '-I Cj..-Hvl?IL i~( ) 1-'NIp., J Phone L(S2> CfJl'i<, Fax: 4S7o'iG,O Property OWner: S PI fY'--c Phone: '1Sdt/d-. ;(<; Address; /;JJ< 0 (' ?C::O e. G I A J\J A City J=:> ,4 Zip; 7'<s 3::;,z- ti ~.\f> ELECTRICAL PERMIT APPLICATION Electrical Contractor: License #: Exp; Phone: Address: City; INSTALLATION WIRED BY: ";faWNER 0 ELECTRICAL CONTRACTOR Credit Card Holder Name: I~ I?R I L [-I f I L vv\ f-\ 0 Billing Address: / I 0 ~ 0 (( G { A N 11 City: ~ A Credit Card Number: ") ?A Zip: g~( VISA: Me PRO~ECT ADDRESS: 'J;) ( r7 bED (? G / A A.J A TYPE OF WORK: Check all that apply: ~New .~teration/Addition )4ReSidential o Multi-family . 0 Commercial" .0 MobileHome Sq. Ft. o Remote Meier . 'II Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump'. Number of Circuits aict\'ecf or altered: . o Low Voltage 0 Telecom. o !--AAJ (\'\ Ii Co.") f( E (~f-\'fr:"'? no...):::' yC(~A 5 c..':: 4S'l-04 G e u- G;rLL f{\!,;; 4, Wo~ Co 9 ---rl~ A "_-He :s Service Information ~aSebOard Aj ~umace o Heal Pump o Fan-Wall Electrical Load Additions and or subtractions Ci'i, Gf)~AG~ ~ KW TON KW 03 LAR o Overhead Service o Temp Service o Underground Service Voltage; Phase; 0 1 Service Size: Feeder Size: PAMC 14.05.060(8); For industriai, commercial, & residential projects larger than a duplex. a one -line drawing afthe Electrical Service Feeders, building size (sq. ft.), load calculations, and the ty pe & of conductors andlor raceway is required and shall accom pany the Electrical Permit application. I hereby certify that I have read and examined this application and know that same to be true and correct, and I , authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants responsibi. to determine what permits are required and to obtain such \ ~ . Credit Card Holders Signature Date: 8 -I () -03 Date: M -10 '0 S PERMIT FEE: $~ Ow /0' ~ :. OAT ~ '/'1. 5 WNE CONTRACTOR tJt-U/../M ADDRESS 2;;.6 bttJ,c;b-I/hv.;v.A sr, APPROVED ~ P w ~ f.-.k:,..... No?A~bvED D ................... DITCH ................... D D .............. ROUGH IN/COVER. ... .. .. . . . .. . :N: D .................. SERVICE .................. D D .......... (J) . . . . . FINAL. . . . . . . . . . . . . . . . . . .. D CORRECTIONS NEEDED: h~u/-:,10 807?-f /~.,- ~ ("'.fl../) (.~L ,P/.......e. s . @ 0.e-t!1U,v.iJ /tI.<- ,;nU7H ,BDXC< (J) eK/M>.6r r/i'J{ ~/,)v..,~ ElIECTR!CAl ~INlSI?IECTiOINl WilRliNG IRHElPJOIRnr 417-4735 05-1.;2.. IN~p PERMIT. (//V r/~ /.N BA7H ~ @ ~"/) .:i-.y" V f'L/ffJEs ~ &,n""A/) Kxf1:3.NSn>/V IC/N6S C!../~.rr'. @'") rlt.uiJe A7 /'/f'N.€.-L. @ ,I/o fx.,f'!IO '<#'LJ L/,t;H'''- F,uLA< h^-- T~-"", ~rS. (P/""~ hM~-,",) , -' ;44A.9~- /Mv. /71'- /tJiNA/ c!o4L),"-,..n:. (/kr P6t!~/T.S ON 5,.~J C4Y~ &,/,::>"v?' /';lepr: t"7/V /?7/lA/~7 /V/C ,d{.Ot/)hV~ ~~..-?,'r , NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 .I tt;' (jI o Electrical Contractor D Annual Permit Job wired by Id o Electrical Contractor IT Owner Electrical contractor name License number Purchaser's mailing address (!.-x':"J:'f2r'--; IA >J A - State ZIP Cl~ 0)- FAX number <..{ --JoY G> . j;:;Hn City -ph Telephone number " '57 '1 Premises owner's n~"le P\ ~l?- \ L t:1<S I L iY'f"- tV Address of inspectiqn ., ~l </ ~C;Oe.(011\ A..J po., City 9A I hereby certify that I am the owner of the above named property or a licensed electrical contractor (or the firm's authorized agent) and am making the electrical installation or alteration in compliance with the elcctricallaw, Chapter 19.28 RCW. /\ ;gnature of t' ele "al cont"ctor or elect"cal administrator WA LS Insulation Only CEILING Insulation Only Dale Approved By Cover Date Approved By Date Approved By Cover Dale Approved By Electrical Load Additions and or subtractions CJ NO LOAD CHANGES Cl ~Baseboard KW CI Furnace KW Cl Heat Pump Ton LAR CJ Fan-Wall KW , . ELECTRICAL WORK PERMIT APPLICATION o Residential Maint. 0 Signs 0 Thermostat 0 Telecom. Installation description IA ) le.~ ('___,AeA0G U.v i ,V "SuL-l\-n::D {9 Cl~.-s CJ L\Gt+O ~ e.. ~D \-\('<\~~ 00T usT5> I \-b1t,vA .~ <2 x>A-m?s d ~ W~ R~~s~ \ J ~..Jb(; 1.:-.. ~^""''\'J Or~_:t- Ail", eel Se... Su-e- B c:a:::> WI' \\ ~A ,~ ?IAA";~ ;(~ ~NS0lh<0:> ~T\o',J I o Cash 0 Check # o Credit Card Visa Card # . Mastercard Discover Expiration Date of card Inspection fee $ 18 /0 THERMOSTAT Dale Approved By / DITCH Dale Approved By ,.- SERVICE Date Approved By FEEDER "- Dale Approved By Service Information o Overhead Service o Temp Service o Underground Service Voltage Phase CJ 1 CJ 3 Service Size: Feeder Size: Inspection Date Area, Building or Equipment Inspected Action Taken Electrical Inspector ,e:/N~ /1t!() I ' I :N2,.'}jrJ;S- f~~ M r1Jd 4<...0 Owner or Elec. conlractorAgent:Ebtn(~ S-Z'(VI'W ,1 nc/ Phone: "7,)2.Ui'J.Lf Property Owner: G or.' I::lz " b" Q. Y1 ' Address: 73..' jt\.rtJ'o~^-:z ~ City: Mf't. ~'-~~~~~ ElectncalConlractor. Eb.rfVlr S-"-(\J":'~" Ihc/ . lIcense#:SA'3:0r>1 Exp: Address: l{:L. n .OI'{'OV-- lJu I~ ~Clty: !=bet V'1v.{ 1<::,,- INSTALLATION WIREO BY: 0 OWNER )<E'LECTRICAL CONTRACTOR Credit Card Holder Name: Ro ~...t (5', Rvvd -..,......, <;03 RiY,Ju f'~ cny, f3,~Z'ry, <'> Credit Card Number: Date: <; fi~~'~;~." ....;". -:;'....."'l\.\f! iJ .'~1fI ~~;:;t PRO.IECT ADDRESS: TYPE OF WORK: G1A FOR OFFICIAL USE ONi y Dal:clRcc: I'cnnittl; Dale Appuved:__ Dafcbsual: , ELECTRICAL PERMIT APPLICATION The Electrical Permit Application must be filled out comDletelv. P lease type or reprint in ink. If you have any questions, please call (360) 417-4735 Fax number: (360) 417-4711 H1Il:.-'1F 155 Fax: '152-G,4'-:J.f, '/5l - 42.. 78 Zip: '1[<' :::{'o") Phone:75') - &''1" Zip: / g::s Go:L. Phone: Zip: /,q3 Co'J... VISA: G!; Tf J-~ ~WrL&,tPn->NA Check all that apply: 0 New o Alteration/Addition c1Residential 0 Multi-family '0 CommerCial 0 MoblleHome " Sq. Fl. '. o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool O.Septic Pump '.' '.0 low Voltage 0 Telecom. 0 , .~ Number of Circuits added or altered: (:~ ~U.e.re.d' ~ A :~.'()e.IL Tb fflru-s It- . B~ 1/<;./1 ~'J 5 ~.rO""U'77t./LJ j '{(" ,"30 Electrical load Additions and or subtractions 7--?- ,10 DESCRIPTION OF THE ELECTRICAL PROJECT: f)dJf) CXV'-'l.. F' o Baseboard o Furnace o Heat Pump o Fan-Wall .s.e,u'U l;\J \ /2Z.. Service Information KW KW TON KW VOltage:!:1 U /2.'-1 ;) Phase: 0 1 0 3 Service Size: -:> 0 i') !4 Feeder Size: .L.(J 0 4 LAR "0' Overhead Service IOTemp Service o Underground Service PAMC 14.05.060(B): For industrial, com mercial, & residential projects larger than a duplex, a one - line drawing of the Electrical Service Feeders, building size (sq. fl.), load calculations, and the ly pe & of conductors and/or raceway is required and shall accom pany the Electrical Permit application. I hereby certify that I have read and examined this application and know that same to be true and correct, and I authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits s/fJl~wt ;~1/~~+ ~ppJ~ l~~ny to d''F~;%JE;~,:;cq"- ood to obt';n s~h. Credit Card Holder's Signature: g;lJ b 'I Date: ~ Owner or Elec. Cont. Signature: (;i? ~f Jr (K~Date: 2',/1& / Q 3 PERMIT FEE: $~ 9r1- cro PW.g01gm03 (').L c. ~ ~ // / ~ "0>