HomeMy WebLinkAbout3419 Wabash St - Building CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
II_ MGM
321 EAST 5TH STREET, PORT ANGELES WA 98362
-ate
Application Number 12- 00000012 Date 1/09/12
Application pin number 504056 REPORT SALES TAX
Property Address 3419 WABASH ST
ASSESSOR PARCEL NUMBER: 06- 30- 14 -1 -3- 9010 -0000- on your state excise tax form
Application type description PUBLIC WORKS UTILITES
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning RS9 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
Install curtain drain RCP #11 -47
Owner Contractor
HUNT, GLADYS ENVIROCLEAN NORTHWEST
2240 EASTSIDE RD 1125 E 3RD STREET
UKIAH CA 95482 PORT ANGELES WA 98362
(707) 462 -2430 (360) 670 -4595
Permit RIGHT OF WAY
Additional desc INSTALL CURTAIN DRAIN RCP11 -47
Permit Fee 150.00 Plan Check Fee .00
Issue Date r 1/09/12 Valuation 0
Expiration Date 7/07/12
Qty Unit Charge Per Extension
1.00 150.0000 ECH PW RW CONST EXCAVTION OTHER 150.00
Special Notes and Comments
EROSION SEDIMENT CONTROL PER CITY STANDARDS OR APPROVED
ENGINEER DESIGN PRIOR TO START OF WORK.
Fee summary Charged Paid Credited Due
Permit Fee Total 150.00 150.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 150.00 150.00 .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 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.
C0 t t tti V
Signature ofontractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:Forms /Building Division /Public Works Permit
PERMIT INSPECTION RECORD
CALL 417 -4831 FOR UTILITY 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 I NO
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY vU
STORM
SITE DRAINAGE,
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB &'GUTTER
DRIVEWAY'APPROACH
BACK FLOW DEVICE
r r0
St
R TO OCGUPANCI l
PINAL INSPECTIONS,REQUIRED PRIG
RESIDENTIAL,.:• DATE YES NO COMMERCIAL DATE ACCEPTED
CONSTRUCTION R W ,G`PW/ CONSTRUCTION, R W
ENGINEERING;; 417 -4807 PW ENGINEERING
FIRE 417 -4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING: DEPT.
BUILDING 4I7 t BUILDING
815
4
T Fornis /Building•Drvision /Pubbc Works Permit 4
FROM KIRSCH ELECTRIC FAX NO. 3606830869 May. 20 2004 03:34PM P1 V,
2lJu4 /11A* Uri r.1 01 39 Ili i Dr Yid BLDG DEFT
,reAr 711
i� ELECTRICAL P APPLICA n :ON1
p� ma.:
DHCAVarew
t,..--1:- The Electrical Permit Application =at tie Riled out aemnietely.
CC Please type or reprint In ink: If you bailie any Rogations, please tail CM) 417.x735 DK 37
Fax number (3E1)417-4711
Owner or Elegy. Cdllkaotor Agent a P., t r S[-t,--- phono: le$ a.1` 1 Fax: L°g• 68b9
Property Owner. Dom. -C',t4 t 3 b
Phone: So�
Address: 30 (_�o• l\JG 61, R-1 'city:: €QCA 1M -5 7ip: q c�"F ,a-
Electrical Conbaotor. K 2 rt C C,t L Ueesl fAK I CI✓ lo3z5w y 4 Zee phone: 6 r";L
Address: R) 1 i 7 .City: zp qg 7
�CD
INSTAL .AT1DN WIRED BY: 0 OWNER kELECTRIcAt. CONTRACTOR
Credit Gerd Bolder Name: 4 Kt e cln ec rl�
Billing Address: Y ap)( f m u'EM zip qg JoD-
U.,te:
VISA: 11sC. P
PROJECT/WORMS: 3 1 w 4 i i t--4 'fit
TYPE OF WORK: Check 1111 that apply: ,kNew D Alteration/Addition 1'. I p S
O
,Residential Multi- farnily D Commercial D Mobile Home ISO
R.,± Ft. 1 ,f .(2 G{
D Remote Meter 0 Detached game D Ht t Tub D•SWIm Poe) D Septic Pump 0 Low Voltage O Telecom. D Sig
Number of Circuits added er altered:
DESCRIPTION OF THE ELECTRICAL PROJECT:
Eloctricai Heat gad msit turd or 8ub cif $ervlee information
D Baseboard' KW Voltage: loll v 7 d
q Fumece KW 0 Overhead Service Phase: 1 pl 3
Heat Pump TON LRA c Temp Service Service Si e: bwf
ID Fan -Wall KW `�Q'Underground Service Feeder Size•
1 hereby certify thet C have read and examined this application and know that same to be true and correct, and an
authorized to apply for this permit 1 understand It Is not the City's legal responsibility to determine what permits
are required•• it remains the applicants responsibility to rmir what permits are required and to obtain such.
Credit Card NoIder's Signature: Date: 0 51
5' /z-1 �6 'r" Owner or Elec. Cont. signature: Date:
A( RtF 790 d0 P7 0l ®z„...,
PERMIT FEE: 1 ,(0
/ELECTRICALPERMITAPPLICATION l f j 1=0 e c_r UT 't T:eSc j
y
40
6 4c!a
08/12/04 THU 13:08 FAX 360 683 3971 AIR FLO HEATING tj001 4
-i 1
:..'_,f 1T F.. PT 4I•A -EL E
A 1 1
1
o f ooar, i
a wf' F C!EV
0' vise 41 ELECTRICAL PERMIT APPLICATION Fermis Peil
i t Date Approved: r_
o The Electrical Permit Application must be filled out completely.
Please type or reprint in Ink. If you have any questions, please call (360) 417- t0 9 ,376
4735
Fax number: (360) 417 -4T11
REQUEST INSPECTION 0
Owner or Etec, Contractor Agent Contract Interiors Phone- 683 -8588 Fax:
Property Owner: Gladis Hunt
Phone:
3419 Wabash Street Port Angeles 98362
Address: City: Zip:
Electrical Contractor: Air Flo Heating License IRFLHC009C8 phone 683 -3901
Address: 221 W. Cedar City. Zip:
Zip 98382
INSTALLATION WIRED BY: 0 OWNER 16 ELECTRICAL CONTRACTOR
Credit Card Holder Name: Air Flo Heating
Billing Address 221 W. Cedar City: Sequi Zip:
98382
Credit Card Number: Exp. Date: VISA MCA
PROJECT ADDRESS 3419 Wabash Street PORT ANGELES
TYPE OF WORK: Check all that apply: I tANew 0 Alteration /Addition
Ilit Residential 0 Multi- family Commercial Mobile Home Sq. Ft
Remote Meter 0 Detached garage Hot Tub Swim Pool Septic Pump 91Low Voltage 0 Telecom. S
Number of Circuits added or altered:
DESCRIPTION OF THE ELECTRICAL PROJECT: Thermostat Wiring
EIectrieitHeat Load Additions PERMIT FEE: gl,P 40 Service Information
7 P
Baseboard KW -1 1. Voltage:
159 Furnace I n i KW Overhead Service Phase: 0 1 0 3
Heat Pump TON LRA 0 Temp Service Service Size:
D Fan -Wall KW 0 Underground Service Feeder Size:
1 hereby certify that 1 have read and examined this application and know that same to be true and correct, and l a
authorized to apply for this permit. understand it is not the City's legal responsibility to determine what permits
are re uir d, it remains the applicants responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature: t pv a_ Date: P D
Owner or Elec. Cont. Signature; Date:
C /ELECTRICALPERMITAPPLICATION
6*
e;Z-/D 9 3 &.Ic
pDRi
"w'' cF� FOR OFF1C1P1 USE ONLY
ELECTRICAL PERMIT APPLICATION Date /Rrc
Permit ti.
y Date Approved:
>r Date Issued:
The Electrical Permit Application must be filled out completely.
t Ks ANO,
Please type or reprint in ink. If you have any questions, please call (360) 417 -4735 0g s/ .3
(.6"412( Fax number: (360) 417 -4711
Owner or Elec. Contractor Agent: /�je.s(.,N Phone: 63 _t$/7 Fax: 45'3- Dia?
Property Owner: 33 Z 1 tt! Phone:
Address: 3J en0CiK/N 4 gi City: .feint ht, Zip: 9$34e Z,
Electrical Contractor: License Exp: Phone:
Address: City: Zip:
INSTALLATION WIRED BY: OWNER ELECTRICAL CONTRACTOR
Credit Card Holder Name:
Billing Address: City: Zip:
Credit Card Number: Exp. Date: VISA: MC:
PROJECT ADDRESS: 3'%/ 9 W /S.4t5 y ,f-r-:
TYPE OF WORK: Check all that apply: New Alteration /Addition
Residential Multi- family Commercial Mobile Home Sq. Ft
Remote Meter Detached garage Hot Tub Swim Pool Septic Pump Low Voltage Telecom. Sign
Number of Circuits added or altered:
DESCRIPTION OF THE ELECTRICAL PROJECT: fj�,yy7, cSy/ C.
Electrical Heat Load Additions and or Subtractions Service Information
Baseboard KW Voltage:
0 Fumace KW Overhead Service Phase: 1 3
0 Heat Pump TON LRA )(Temp Service Service Size:
Fan -Wall KW Underground Service Feeder Size:
I hereby certify that I have read and examined this application and know that same to be true and correct, and am
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 responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature: Date:
�j Owner or Elec. Cont. Signature: Date:
l- T. p f tA 1 Al -6 e t,.,,. otr rte'
J T 7 PERMIT FEE: o po
/ELECTRICAL IR�PPCATION
‘9,es..4t
,4 ELECTRICAL PERMIT SUBMITTAL REQUIREMENTS
INSPECTOR OFFICE HOURS 8 9am AND 1- 2pm
NO INSPECTIONS WILL BE MADE UNTIL PLANS HAVE BEEN
APPROVED AND A PERMIT HAS BEEN ISSUED!
4EN IS AN ELECTRICAL PERMIT REQUIRED?
BEFORE ANY ELECTRICAL ADDITIONS OR ALTERATIONS HAVE BEEN STARTED
WHO MAY APPLY FOR AN ELECTRICAL PERMIT?
1:) ELECTRICAL CONTRACTORS 'OR THEIR REPRESENTATIVES
2.) OWNER OF A BUILDING; UNLESS THE BUILDING IS NEW AND FOR RENT OR SALE
WHEN ARE PLANS REQUIRED?
1.) ALL NEW SINGLE AND MULTI- FAMILY RESIDENTIAL PROJECTS.
2.) ADDITIONS AND REMODELS WITH ANY NEW ELECTRICAL WIRING, REQUIRING MORE
THAN FOUR BRANCH CIRCUITS
3.) ALL COMMERCIAL AND INDUSTRIAL PROJECTS.
4.) PROPERTY OWNERS PERFORMING THEIR OWN WIRING
JAT IS REQUIRED FOR A COMPLETE ELECTRICAL PERMIT SUBMITTAL?
1.) AN APPLICATION FILLED OUT IN ITS ENTIRETY
2.) FEE PAYMENT IN FULL
3.) PLANS MUST CONTAIN THE FOLLOWING:
a.) WIRING PLAN (SHOWING THE LIGHCTING, RECEPTACLES, PANEL
DISCONNECT LOCATIONS, SERVICE LOCATION SIZE)
b.) PHASE(S), VOLTAGE, AMPERAGE
c.) LOAD CALCULATIONS PANEL SCHEDULES (COMMERCIAL, INDUSTRIAL
RESIDENTIAL REMODEL AND ADDITIONS)
(1) DETAILED RISER DIAGRAM (COMMERCIAL INDUSTRIAL) SHOWING
BREAKER, CONDUIT WIRE SIZE AND TYPE
WIIEN ARE PLANS REQUIRED TO BE PREPARED BY AN ELECTRICAL ENGINEER?
1.) EDUCATIONAL, INSTITUTIONAL, OR HEALTH CARE FACILITIES AND OTHER
BUILDINGS PER WAC 296 -46A -140
2.) COMPLEX INSTALLATIONS AND /OR LARGE FACILITIES, AS REQUIRED BY INSPECTOR
ITEM MUCH DOES AN ELECTRICAL PERMIT COST?
REFER TO THE ELECTRICAL PERMIT FEE SCHEDULE FOR APPROPRIATE FEES FOR YOUR
PROJECT. COSTS FOR PERMITS VARY DEPENDING ON THE SCOPE OF WORK.
QW LONG DOES IT TAKE TO GET AN ELECTRICAL PERMIT?
IF PLANS ARE REQUIRED, PERMIT ISSUANCE FOR MOST RESIDENTIAL PROJECTS WILL
NORMALLY TAKE LESS THAN THREE WORKING DAYS. COMMERCIAL PROJECTS MAY
TAKE LONGER DEPENDING ON THE COMPLEXITY OF THE PROPOSED INSTALLATION.
MIEN AND HOW ARE ELECTRICAL INSPECTION SCHEDULED?
1.) BEFORE COVER AND AGAIN WHEN ALL DEVICES AND EQUIPMENT ARE INSTALLED.
2.) INSPECTIONS ARE SCHEDULED BY CALLING 360 417 4735 BY 7:OOam
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
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
5/11/04
04-00000376 Date
.555080
3419 WABASH ST
06-30-14-1-3-9010-0000-
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
103029
Owner
Contractor
HUNT, GLADYS
2240 EASTSIDE RD
UKIAH
(707) 462-2430
Structure Information
Construction Type
Occupancy Type
Other struct info
CONTRACT INTERIOR ASSOC. INC.
33 MOCKINGBIRD LANE
SEQUIM
(360) 683-2569
NEW 1569 SF SFR W/ATTACHED 312SF GARAGE -----
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
CA 95482
WA 98382
10.90
V-N
2.00
1. 00
11322.00
1241.00
1241.00
1. 00
permi t . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
94.20 Plan Check Fee
5/11/04 Valuation
11/07/04
.00
o
Qty Unit Charge Per
BASE FEE
3.00 7.2500 ECH ME-VENT FAN
1. 00 10.6500 ECH ME-GAS PIPE 1 TO 5
1. 00 14.8000 ECH ME-INSTALL FLOOR FURNACE
Extension
47.00
21.75
10.65
14.80
Permit PLUMBING PERMIT
Additional desc
Permit Fee 132.00 Plan Check Fee .00
Issue Date 5/11/04 Valuation 0
Expiration Date 11/07/04
Qty Unit Charge Per Extension
BASE FEE 47.00
8.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 56.00
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00
1. 00 15.0000 ECH PL- EA. BLDG SEWER 15.00
1. 00 7.0000 ECH PL- EA.WATER HEATER 7.00
permi t BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit Fee 1039.65 Plan Check Fee 415.86
Issue Date 5/11/04 Valuation 103029
Expiration Date 11/07/04
Qty Unit Charge Per Extension
,
~
~~ .....t
-
~
~~ ~
~
l0-
r
Vi
~
ht-..lkL
~ {2-C::; (6\
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 'give authority to vi9~ate or. ancel the provisions of any state or local law regulating construction or the performance of
construct on. ' / / /
./ I
T:\PLANNING\FORMS\1102.15 [11114/2003]
Signature of Owner (if owner is builder)
Date
r---
to to to
t" t" :><
\0 H H
\0 :u
to to
t" t"
W \0
to
t"
."
t:J
to to
H t"
N ....
000
.... .... ....
o 0
.... ....
o 0
.... ....
o
....
toooooooooooo~~mm~~~~
............................................................................................................................................
NNNNNNWOOOONNI--'l-'
~.~~~~~~~~~~~~~~~
000000000000000
_, ,t:.,t:.,t:.tf::>. tf::>...",~..", .Po..",..",..",tf::>..Po
1i~:><~:><~:><~:><~:><~:><:u:><:u
l"dt"ll"dt-1't:1t"1 l"dt"l "Ot-1't:1<:'t:I<:
t"I t"I t"I t"I t-1
n
o
3:
3:
01
"I
>-l
Ul
n?;:olJ:l?;:IJ:l?;:IJ:l?;:tIl.PolJ:l?;:tIlC.j1J:l
:><01~c:",c:",c:",c:mC:01C:OC:
t"lZ..........H~H~H:JHOHZH~H
t;1 Wt"l t-1 t;1 t;11t"1 t"I:Jt"I
""'0 t:1..",O~O\OO 0 0
I'1j ..........H HO'\HO'\HOOH I H~H
H..",NZIZl-'Zl-'Z.PoZ ZO'\Z
:;d0'\0G) G) I G) I G).PoG) G)l-'Q
(J)l-'O 0 0 ~
I-3IUlI'1j HO'\~O\I'1j(JlCl)O'\I'1jWI'1j
o HM:>.ZI--'HI--':;drt:I:I--'ONO
~l-'~~~N:;dN~~f;;~~~~
WOt"llt-1 (J) Hro:;dO'\O 0
\0:>< 01 "I :>:....:>< :><
N 001-3 ~ Q~):>INI-3 1-3
N M:>.H t"I rot"l H H
M:>.O :Jt"I 0 0
"I 0 "I "I
'-
.. t:J:>:
m :u:><
.... :>< t"
H t"
"I
:><
Gl
01
~
t:J
"I
o
>-l
01
Ul
!\:
>-l
H
3:
01
Ul
:u
o
to
01
:u
t:J
Ul
..
00
m
m
....
~
o
o
:T
'"
'i
3
P>
"'
>-l 'd
~ ~
Ul H
10 ..,
to
8
t"
t:J
Z
Gl
."
o
~
t:J
:><
>-l
H
o
"I
."
o
o
>-l
H
"I
Gl
to
'd
n:u~
001
3:10
'Oc:o
t"010
O1Ul
>-l>-lto
fH1S
e;
H
:u z:
O1HGl
UlZ
C:Ul'd
Sil"d~
H
..,
:ut:J,
0101
8~~
t":uC/l
>-lHH
Ul'Ot:J
;;-~~
00:::1
3:ZH
[;j ~
"I
>-l
Ul
i;;:g~8E;
'O:uzzt:J
t-1ntI:ll-3:;d
z~:;dS;~
c: nUl
3: . >-l
to 0
01. :u.
:u
oo:I:nw
~~~g~
ow 1-3 1-3 \0
00" :;d
o :><:>:
Ol--'Qn~
OM:>.t"ll-3tIl
w I ~ ~
...J 1--'0 H(J)
0'\ I K; Z ::r:
WUl>-l
:u O1(/)
tI:I\O :;d1-3
UlO H
.... 0
210 :u
01'
:>:0 :><
o Ul
UlO Ul
"'0 0
:u n
n'O
H:U
>-lO1
><'0
:><
o:u
.,,01
t:J
'0
o
:UVl
>-l'-
~~
Glo
O1Vl
t"-
01
Ul....
W
....
00
N
\0
Z
n
H H
2121
UlUl
'0'0
0101
nn
>-l>-l
OH
:UO
.. "I
~>-l
!\:8
O1~
(/)01
>-l
t"
t"
H
01
:u
t"
><
'O'OUl
66~
zzt:J
O101H
<:
~W
om
~o
..m
m 00
NW
, ,
N N
..Vl
wm
0\0
t:J'O
:><:><
>-lGl
0101
Vl
'-
N
Vl
'-
o
VlW
tJj tJj tJj tJj tJj tJj tJj 0-] '0 , ;;;~~8E; n'U
,.. i': ,.. ,.. ,.. H ,.. >< ~ , H'"
H W '" "' " H '0 , 'U"'ZZO 0-]",
'" 0 '- , ,..n",o-]", ><'0
Ul >-< , l:l:I~::utt1 :>>
0 0 0 0 0 0 0 0 >-l , Z'" :>>Ul 0'"
H H H H H H H " , ~. nUl "''''
, 0-] 0
tJj , tJj 0 '0
'0 , "'. "'. 0
n"'~ '" "'oo
Q)Q)Q)OOCD-J-JO"IO'\U1LnUlV1 0'" 0-]'-
................................................................................................................................ 3:0 "
l\Jl\Jl\JNNOOOONtvl--'l--' 'UC::O oo::r:nw ~:::
-J>f:>,j'::..t:>.t>Nl\JQ:lCOUlU1l..Ol"O "''''0 ~~g~e
~................................................................................................................................ "'Ul G"lo
boooooooooooo o-]o-]tJj QW.....:]>-j\.O "'''''
~.t:>K::>,j'::.,j'::..t:>oI=>o,t>.,.t>..t:>,t>of::>~ "''''e:: 00- '" ,..-
00>-< 0 , :>>::E '"
b o 1-'G1 n:D' UlH
:~ , o,t>.t"">-3tr1 W
>-< ~~E;H~
'~>" ,","," ,. ," '" iZi 0
I .. t""'l::::lt"""'Ot""'l::::lt""'l::::lt""'l::::l<:"'0<: "'HGJ '" ><Z:>: ""
I L'L't""L' UlZ wUlo-]
C::Ul'O '" "'Ul H
, ~'l::::l~ "'''' "'0-] -.J
, Ulo H
, H 0
>-< ZO '"
>-l '" ,
::Eo :>>
~to~tJj~b:l,.t>.tJ:I7:tJjCjtJj tJj "'0 , 0 Ul
roc::roc::roc:::mc:::tI:lC::OC: 8 "'''' UlO Ul
;::1 H;::1H::lHOH'2;H:TH UlUl~ ",0 0
,.. ,.. ,.. ,.. ,..::> ,.. ,.. c::n", '" n
t::l~t::l,.,.t:lI..Ot::l 0 0 0 "''''CIl
HO'\HO'\H(PH , H""H Z o-]H>-<
, ZI-'ZI--'z,.,.z Z"'Z Ul'Utl H
n G"l , G"l , G"l""G"l G"lHG"l G"l '-o-]~ Z
0 0 0 "" nH n H
3: HO'I):>IO'll"IjUl(nmt-rjW'"Ij "' 00 HZ
3: ,+::>.ZI--'H!--'idr1:r::!--'ONO 0 3:Z>-< ZUl
'" ~~l\JidN~~~~@~@ !@ 3: ~ Ul'U
Z '" '0'"
0-] , ,.. Ul Hro:;dmt:1 0 t:l Z ",n
Ul "':>> '" Z ::EH:>> :>> :>> 0-] no-]
"'0-] :>> GJI-1~N..., 0-] 0-] Ul o-]H
~ ""H ,.. !D ,.. H H 0 00
""0 ::> ,.. 0 0 "'z
0 Z 0 Z Z Z
'- '-<0-]
Z 0-] "" 0 ::E "' ~8
0 H '" '" :>> 0 'U'UUl
0-] 3: H :>> ,.. 0 g;g;~ "'~
'" '" , z ,.. 0-] Ul'"
Ul "" Z zzo 0-]
oo :>> "''''H , ,..
H '" G"l G"l <:
-.J '" '" ,..
0 H
:or '"
0 !D -.JW '"
" 0'" ,..
3 -.JO ><
'"
:0
""'"
"'oo
" W
, ,
""
""lJ1
W'"
0",
0'0
:>>:>>
o-]G"l
"''''
oo
'-
"
-.J
'-
o
""""
UJ UJ UJ UJ UJ UJ >-3 '0 ;:;~~8E; n",
::: Ie' Ie' Ie' H Ie' >< ~ H:U
w '" "' N H '" ",:UZZO >-3'"
:u 0 '- L'Otl1I-3::d ><'"
w H tl1::t1:;dtIj ;p
0 0 0 0 0 0 0 >-3 ZIe' ;PW O:U
H H H H H H !ji. nW "''''
>-3 0
tJ:l UJ 0 '"
'0 "'. :U. 0
n:u:.; :u :u'"
.~~.m.. 0'" >-3'-
................................................................................... 3:0 N
rvQOOOl\JWI-'I-' 'dC::O o O:r:: Ol,.../ ~.::
ol:::>NNOOCDUlUll.01.O t""'O -;~~~;::
~............................................................................... ",W QO
00000000 >-3>-3tJ:l Qwl--3'""'3l.O "'.,
of::>,t::.of:..~ol:>~,t:.,t::.,l:>. "''''c:: 00- '" t"-
OOH 0 , ;p:>; '"
E; o I-'G) ();t>o WH
O,t::.t"il-:3tD N
:~>c>c>"'" H ~~E;H5; N
'" iZi
I L' L''1:lL'I''{jL''1:I<:'"O<: , "'HQ en ><Z:r: -.J
I' l' t""" L' L' wZ wW>-3
C::W'd :u "'w '"
~'1:l~ "'''' "'>-3 H
WO H
H 0
, H Zo '"
>-3 '"
:>;0 ;p
"UJ"UJ.,UJ"UJ'-<UJ UJ "'0 , 0 W
roc::roc::enC::",C::OC:: 8 "'''' wo W
::JH::JHOHZH::JH WW:.; "'0 0
Ie' t" t" t"::J t" t" c::n", '" n
n ot>t:J,t>.tj\.O\::1 0 0 0 t""'CIl
0 O'\HO'lHOJH , H.,H H >-3HH
Z I-'ZI-'z,t:.z ZenZ Z W"'t1 ~
>-3 , Q , Q.,G) G)HG) Q '->-3~
~ 0 0 ., , nH n H
O'I:X:>O'l'"I:IOOCf)O'I'"IjWl-tj '" 00 HZ
c:: I-'HI-'::tIrt:r::.......OtvO 0 3:ZH Zm
OJ t0~t0~~S;~~~~ ~ 3: ~ w'"
0 '" "''''
W Hro::::dmt::! 0 0 Z "'n
0 '" Z ~I-'~ ;p ;p >-3 n>-3
Z ;p G1ti);<tvl-:3 >-3 H W >-3H
>-3 t" ro t" H H H 00
0 ::J t" 0 0 0 :UZ
0 Z Z Z
Z '- '-<>-3
'" >-3 ., 0 :>; "J ~n
>: 3: en '" ;p 0 "''''W
>-3 H ;p t" 0 g;g;5i "'"
'" ,;" ~ t" H w'"
'" ~ ZZO H
;p '" ;p "''''H t"
Q H en G) Q <:
'" -.J '" '" Ie'
H
0 :T '"
0 ro -.J W , :u
'i oen t"
3 -.J 0 ><
'"
::J
.,en
en",
NW
, ,
N N
.,,,,
wen
0",
0'"
;p;p
HG)
"''''
'"
'-
N
.,
'-
0
.,w
'0 o-J '0 ;J>'Oon;J> n'O
I:" , >< ~ 'O;J>:<:OO H:U
tv '0 'O:UZZO o-J",
'- L'ntI:lt-l:::d ><'U
[J) H tJ1::U::UtI1 ;J>
a '10 o-J ZI:" ;J>[J) O:u
H !ji. n[J) '""'
o-J 0
'0 OJ 0 'U
t' OJ. :U. 0
n:u :u :uoo
J 0", o-J'-
'- 3:10 tv
tv 'OC::o oo::r:nw ~.::
, .. 1:"",0 o;~~ge
, '- ",[J) I;) a
, , o-Jo-J'd Qwt-3t-31...D ","
.. , "'"'t' a a- :u 1:"'
, ~ ' oOi a , ;J>:<: "'
~: QI-'Qn)::! [J)H
o~t<<t-3!Jj tv
.-W , H ~~~H~
, :u 21 tv
, ",HGJ '" , ><Z:I: "
UlZ WUlo-J
, C::Ul'd :u , ",Ul en
~~~ OJ", :uo-J H
[J)a H
H 0
H Za '"
, o-J "' ,
:<:a ;J>
",'U , :U0 a Ul
ro I:" ",OJ Ula Ul
:J !ji UlUl ,"a 0
c::n :u , n
"OJ 1:"'"
'" H o-JH
HZ Ul'U H
n ~ I;) '-o-J Z
0 nH n H
3: "'''' 00 HZ
3: HO 3:Z ZUl
"' tvC:: 3: Ul'U
Z I;) "' '0"'
o-J :I: Z ",n
[J) o-J no-J
Z Ul o-JH
~ , 00
"'Z
0
c,o-J
Z o-J ~~
0 H 'O'OUl
o-J 3: :I::I:C:: OJ",
"' "' OOOJ Ul",
Ul ZZO o-J
",",H I:"
H <
" I:"
H
a "'
a " W :u
a", I:"
"a ><
"'"
'" 00
tvw
, ,
tv tv
..en
W'"
a",
0'0
;J>;J>
o-JI;)
",OJ
00
'-
tv
..
'-
a
....
tlJ tlJ tlJ tlJ >-3 'tI ~'tI0()~ ()'tI
t' t' H t' ><: ~ 'tI~::80tJ Hi<l
'" '" '" H '0 'Oi<lZZtJ >-301
tJ '- L'()tz:!I-3::.u ><:'0
Ul H 01i<li<l01 ~
0 0 0 0 0 >-3 Zt' ~Ul Oi<l
, H H H H ~. ()Ul "'01
, >-3 tJ
from~ Il:l Il:l 0 '0
'tI 01, i<l. 0
()i<ll<' i<l i<l-.J
001 >-3'-
I ....................................................................... 3:0 0
I oootvNt-'l-' 'OC::O oo:I:()loJ ~~
I NOOCOV1V1\D1.D t'01o -;~~~~
I .......................................................................... O1Ul Qo
I 0000000 >-3>-31l:l OW>-3I-3\D 01'"
I ,f::>,,f::>,ot:>,s::.,s::.ot:>ot:> 0101C:: 00- i<l t'-
, tJtJH o I >- ~ 01
e; Ot-'Q()~ UlH
Ool:>L'l--3tI1 '"
~Y>Y>m H w, ~ ;J>
i<l 2i -..J1-'t::lHCf} '"
I L''1:It"l'1:l <: '1:1< O1Hc;l '" , ><:Z~ 0
I .. t-t L' rnZ wUl>-3
, C::Ul'tl i<l' O1Ul w
~~~ 01'" i<l>-3 en
Ulo H
, H 0
, H Zo i<l
>-3 01'
::80 ~
,s::.tIl~toCjttl tlJ , i<ltJ I 0 Ul
"'C::01C::OC:: 8 0101 UlO Ul
OHZH::TH UlUlI<' ",0 0
t' t'::>t' t' C::()t'l i<l ()
"'tJ tJ tJ tJ t'i<lCll
oo H , H"'H Z >-3HH
"'Z Z"'Z Ul'OO Z
() "'Q QHQ Q '->-3~
0 '" , ()H () H
3: Ulrn'" w", '" 00 HZ
3: rt::r::t-''ljNQ 0 3:ZH ZUl
01 rotIjlON~ ~ 3: ~ Ul'O
Z ~~~~ot:1 01 '001
>-3 tJ Z 01()
Ul ::8HO ~ ~ >-3 ()>-3
" ~"'~ >-3 >-3 Ul >-3H
~ ro t' >-3 H H 00
::> t' H 0 0 i<lZ
tJ 0 0 Z Z
'- Z '-<>-3
Z '" ::8 '" ~H
0 '" tJ ;J> 0 'O'OUl 3:()
>-3 H i<l t' 0 88fiJ 01~
01 , ~ t' >-3 UlO1
Ul '" H H zztJ >-3
oo Z Z O101H t'
'" ~ Q <:
'" Cl t'
01 H
;:r 01
ro -.Jw i<l
" 0'" t'
;3 -.J 0 ><:
"'
::>
"''''
"'oo
'" w
,
"''''
"'en
wm
0'"
tJ'O
;J>~
>-3Q
0101
-.J
'-
0
'"
'-
0
"''''
to to to >-3 '0 1 :;;:;;~8E; n'O
" H " >< ~ 1 H",
"1 N H '0 1 'o",ZZO >-3'"
0 '-- 1 L'()tI:lt-3:=tJ ><'0
(J) .... 1 "'"'"'''' ;p
0 0 0 10 >i 1 Z" ;P{J) 0"'
H H H .. 1 ~. n{J) "1'"
1 >-3 0
tD 1 to 0 '0
'0 ",. ",. 0
n"'l<l "' ",'"
0'" >-3'--
3:10 0
'OC:O oo:;I:nw ~~
""'0 ~~~~e
"'{J) QO
>-3>-3tD owt-3t-4'-D "'...
, "''''c:: 00- "' ,,-
, 00.... o I P ~ '"
, e; ~~g3~6; (J)H
'if N
.... ~~E;H5;
I ;J:-:;o;t:>t::d "' = W
I t"l'"d<:tO<: "'HG') "', ><Z;I: -.J
, " (J)Z W{J)>-3
, C:{J)'O "' , "'{J) ...
, ~'"d~ "'\0 "'>-3 '"
, {J)O H
, H 0
, .... Zo "'
1 >i '" ,
, :0;0 ;p
, :>:to"-<tJ:l to ",01 0 (J)
, ",c:Oc: c: "'''' {J)O (J)
1 ZH::YH H gj~~ "10 0
, ";l" " "' , n
, 0 0 0 "",CIl
1 , H"'H H >-3HH
Z"'Z Z (J)'OO H
n QHQ Q '-->-3~ Z
0 ... , nH n H
3: '" W"1 "1 00 HZ
3: l--'''IjtvO 0 3:Z.... Z{J)
'" IOtv~ ~ 3: ~ (J)'O
Z '" 'Ol'l
>-3 ~~OO 0 Z l'ln
(J) HO ;p ;p >-3 n>-3
N;P >-3 >-3 (J) >-3H
~ >-3 H H 00
H 0 0 ",Z
0 0 Z Z
Z "-<>-3
Z :0; "1 ~~
0 0 ;p 0 'O'O{J)
>-3 "' " 0 i5i56i l'l:>:
'" ;p " >-3 {J)'"
(J) Z H ZZO >-3
Z "''''H "
;p Q <
Q "
'" H
'"
-.JW "'
0'" "
-.J 0 ><
...'"
"''''
NW
, ,
NN
"'1J1
W'"
0\0
0'0
;p;p
>-3Q
l'll'l
'"
'--
0
'"
'--
0
...1J1
to to' >-3 'd ::;~~8Ei 0'"
H t" >< ~ H:O
, '" H '" "':OZZO >-3'"
, '- t"O"'>-3:O ><'"
, (J) H "':0:0'" :>>
, 0 0 <0 .... Zt" :>>(J) 0:0
, H H ~. O(J) "''''
, >-3 0
, to to 0 '"
~m 'd ",. :0' 0
O:OiQ :0 :0 en
0'" >-3'-
'-'-'- 3:<0 '"
I tvl--'f-1 ~~g oo:I:nw ~~
en",", -;~~~e
I ................................ "'(J) G"lo
I 000 >-3 >-3 to QW 1-3 1-3\.Cl "'",
I ~~.p. "''''C:: 00- :0 t"-
, OOH o I ~:e: '"
, S OI--'G1()~ (J)H
, O~t"'t-3tJ:l '"
i">> H ~~~H~ '"
:0 I;!:
I <:I'd<: "'HG1 "" ><Z;r: , '"
, (J)Z "'W>-3
, C::W'd :0' "'(J) en
, ~~~ "'"' :0>-3 ",
, WO H
, H 0
, H Zo :0
, .... "',
, :>;0 :>>
, '-<to to :00 , 0 (J)
, o c:: c:: "'''' WO (J)
, ;:rH H gJ~t:l ",0 0
, "' t" t"' :0' 0
0 0 t":OW
, "'H H >-3HH
"'Z Z (J)'dO Z
0 HG"l G"l '->-3~
0 , OH 0 H
3: "'"' "' 00 HZ
3: "'0 0 3:ZH zw
'" ~~ ~ 3: ~ w'"
Z '" "''''
>-3 0 0 Z "'0
(J) :>> :>> >-3 0>-3
>-3 >-3 (J) >-3H
~ H H 00
0 0 :OZ
0 Z Z
:0>-3
Z :>; "' OH
0 :>> 0 "''''(J) G"lO
>-3 t" 0 gJgJg "'''''
'" t" >-3 :0'"
(J) Z ZZO >-3
"''''H <:
G"l <: '"
W
(J)
....'"
0'"
....0
",'"
'" 00
'" '"
, ,
"''''
",en
"''''
0",
0'"
:>>:>>
>-3G"l
"''''
en
'-
'"
en
'-
0
",'"
()
o
3:
3:
t'1
Z
>-l
[fJ
~
tJ
Z
o
>-l
t'1
[fJ
lJ:l
t"
....
>-l
0<
'0
'-
[fJ
o
"',
~:
H'
~:
,
O:l'
"',
()"'i<l
0t'1
3:0
'OC:O
t"t'10
t'1[fJ
o-)o-)O:l
lHJS
r;
H
'" ill
t'1HCJ
[fJZ
C:[fJ'O
~td;
H
0-)
o
....
~
~~
to
8
t"
tJ
Z
Cl
"1
o
~
tJ
:J>
0-)
H
o
Z
"1
o
o
0-)
Z
Cl
"'tJ,
t'1t'1
i3~~
t""'CIl
o-)HH
[fJ'Otl
'-o-)~
()H
00
3:ZH
[lj ~
Z
0-)
[fJ
:;;:g~8Ei
'O",zZtJ
r-<()tIjl1~
t'1"''''t'1
Zt" :J>[fJ
c: ()[fJ
3:. 0-)
to 0
t'1. ",.
'"
oo::r:nw
~~~ge
OWI1I--3\.O
00" ::u
o I ". ~
O.....G)())::>' I
o,/:>.t"l""'3lJ:l
~~[jHl;
cnl~Z::r:
W[fJo-)
:;d I tJj u)
tr:1\J) ::0..,
[fJ0 H
.... 0
Zo '"
t'1'
:>;0 :J>
o [fJ
[fJ0 [fJ
"10 0
"', ()
()'O
H'"
0-)t'1
0<'0
:J>
0'"
"1t'1
tJ
'0
o
"'111
0-)'-
~~
Clo
t'1""
t"-
t'1
[fJ....
""
W
""
tv
111
H
Z
()
H
HZ
Z[fJ
[fJ'O
'Ot'1
t'1()
()o-)
o-)H
00
"'Z
"'0-)
OH
Cl()
t'1~
"'t'1
0-)
<:
t'1
[fJ
[fJ
'O'O[fJ
55~
ZZtJ
t'1t'1H
<:
-.J W
0'"
-.JO
""'"
"'CO
tvw
, ,
tv tv
,,"111
CO '"
0\0
tJ'O
:J>:J>
o-)Cl
t'1t'1
111
'-
....
\0
'-
o
,,"CO
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST fJJ
COMPLETE to be accepted for review. If you have any questions, call .
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: CeJiVi~.4C r IAJ~7(It:1.e.. .4$tX:.. lAIc. Phone: 3t.CJ-c..:''S'3--;%.501
Owner: GI.Q./)r~ J-Iup"( Phone: 1t1/} - '1&2 - ;;l'f:30
Address: -z.~ Yo ?a,Ct'<;,;:c:k..- Rd City:~ ~ a.. ~ c..A Zip: q <;; q a "2-
Architect/Engineer: &/)&:>(7,11/ &llcIm}~ f)esl6-M /~ c::- Phone:L3&o) t,<;?3 - 8~S8
ContractorGAJ'nfkT /J1)ll!'it'lne ~ /~tate License #: C,tJ11b?. 358' Exp: t.../Zr,;/os- Phone:~t.g3-~,S?,;,7
Address: 33 /I)~/AJ6-~M'LJ J.A1tJE City: (;7j)t.7Id] ( tJ/). (/'_~ip: 983S-Z-
"' "-\\
PROJECT ADDRESS: <;Lf 1....1 ~{)>4 L, ~ .; .1 c.ohrT~\ '"' ZONING: [("
LEGAL DESCRIPTION: Lot: is
Block:
Subdivision:
CLALLAM COUNTY PARCEL NUMBER: ~c. 301~ - /39'010
Credit Card Holder Name:
Billing Address: City:
Credit CardType VISA MC # Exp. Date:
Tx,PE OF WORK: SIZEN ALUATION: ~ d
j;("Residential 0 New Constr. 0 Re-roof 0 Stove I~ 15l:.Q SF. @ $ bo <l /SF. = $ q4 '40 c ~
o Multi-family 0 Addition 0 Move j6-Garage~.3 i"Z- SF. @ $ 21/ s@ /SF. = $ ~~~ 0
o Commercial 0 Remodel 0 Demolition ~ Deck -be:;.}. -, 52.. SF. @ $ , 4 I 6Cl /SF. = $
o Repair 0 Sign 0 <;Jther. TOTAL VALUATION $ I h'5-0'7.. q oU
BRIEF DESCRIPTION OF THE PROJECT: :; 5m~; ~/~Jc- rAn?!/! ;f.(='SiV~
COMMERCIAL/RESIDENTIAL: Occupancy Group: S,1I..ldlr.... C~ccupant Load: Constmction Type:
" fl/rr If pl"pr
No. of Stories: 2- Lot Size: /1/1>22._ Existing Sq. Ft. IU & Proposed Sq. Ft. 12 <.J I = TOTAL Sq. Ft...L?:.!L/
Total lot coverage_I O~
AFPROV ALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Pennit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tin1e the building permit application and construction plans are
submitted. All other pemlit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no pemlit 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 wTitten request by the applicant (see Section 107.4 of
the Uniform Building Code, cunent edition), No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required ,n' th y's, and that I must obtain such permits prior to work,
T:\FORMS\APPS\BuiJdingpermit.wpd Applicant: Date: s-.~ /0 'I
I
I i
'. i..i.1 .-it-i-h----r-
,:1 . I j !
!, I I
'III. I . __
:i I'; I
!I, I
II1I I
i,/ !
!
I'
il
:1
Ii
. i
~I
f:,
-1
I
i
I ! I
r-
i
,I i
it :
+
J,l
i I :
Ii,
, I! I .[
.1 I
t
I
. ~.
i
i
itt
.j
I -:
, I
! 'j
t. It\
J ,I
. --:......:
. I
I ! I !
I -I
(-
t
. I.n
,q
.~JBZ.I.
I
_ [~;?C"T
i
,,"-,.- .........
r --
--I
'11'
~ \ .
4-
"';"""'-i
II-/<p~.
~~ r.271
I
I
,
I
I
/.
~
,
J
+-,--+
I ; I
, I
i I ~ i,,:
i~I'~ ~
i ~ll~
I I ,..,
j'-l
I
I
I
I'
I
I,
t~
I
. ,
lu,,1
,""> I
e;-,
~\ i
1".,-""'"
-j
. 'I
I
W4-f.4SH
.57:PPRT
"
--
~
~
~
~
I
I
3
~
11-- O~ 3 <7 D/O
SHORT PLAT NO. SP 88/01/2
SECTION 14
1/
~1
I
;1 ~
~I ~
I ~ ~
(() ,~
!VI ~
:: ~
~ ~
~I' ~
I ~
.I bl
~
~ f
~ \
3
~
~8;
.b ~
TOWNSHIP 30 NORTH RANGE
CLALLAM COUNTY, WASHINGTON
THIS IS TO CERTIFT THAT ON THIS I~ OAT OF
..:rIA l.'l , III 8a , IEFORtItt";IHE UNDEUI;IED, A NOTAIT
PUBLI~ IN AND FOR THE-sTXTE OF WASHIN;TON, DULT COMMISSIONED
AND SWORN, PERSONALLT AppEARED ;EORGE M. CASADT TO ME KNOWN TO
IE THE INOITIDUAL WHO EXECUTED THE FORE;OING INSTRUMENT ANO.
ACKNOWLEO;ED TO ME THAT HE SIGNED AND SEALEO THE SAME AS HIS
FREE ANO YOLUNTARY ACT AND DEED FOR THE USES AND pURpOSES
HEREIN MENT~IONE~~ .
WITNESS MY H D~~:~~f~L~EAL THE DAY AND YEAR FIRST AIOYE
If _ _!if' 10,0 WRITTEN. ~~' " \) \
~ - ~. ,. ,-:. r f).. U
SCALE. IN "Ee.T V. _ ~O't~.tf.'L'\c Yll~ FOR THE STATE
(' r.. " OF WASH IN;TON
',. I. ._' RESIDIN; AT PORT A.":'FLE<:
.b.......~1" "
'I .
. .
T REA SUR E R 's C E. R T I F I CAT E
I #Lc"AL .d /1/....- TREASURER OF CLALlAM COUNTY, WASHINGTON,
HER[~~T~~ar~osrr-ro COYER ANTICIpATED TAXES ON THE AIOYE
PROPERTY TO AND INCLUDING THE YEAR 19~, HAS IEEN MAD TO MY OFFICE.
L.~J:,AnIH," ~
\e(ALLAH CO UN r-TREASURER :i!'I;/n(
GCCT/OJ./ Svao'V/.s/.""" ,.1 1110$.0 01<.1 M_"'UNl&4/r.
SET' av TN. C.Ova..lTY .N.'AI.~IC AND SHowA) 0-.)
lW\"po 0' TI>4I. .s;"c.T/Cl~ O"T&Q "'1",y ,"',t.
6.980?
~D
!77- ~~~
~.e-~ ---
I~Cb'
'::f?l; .4
3<f /5'~r.
N trQ.
~~, "4'- W
30
0.
0\
~ t
~
~
roI
; ~
~
t'J
31/1
~~~q. !!..\~~
~ I"
~ ~
fi/
~
. $9'46'~
~~.~Z
::~::;.s":!::: c.",~,.
\ 342-1 ....,.....
z.:OT C ~
11'2.2 . ~
\ q.....7: ~
/3tO. ~
iN8r 25' /1. W
$.,'n'sz'w M.oooll
- \:~~'''fI/' h~~
~~'i'lbN ;.r.
""
Ct)
!!!!f!!!!!!!!!
THAT PORTION OF THE SOUTHWEST QUARTER OF THE NORTHEAST QUARTER
OF SECTION 14, TOWNSHip 3D NORTH, RANGE 6 WEST, W. M., CLALLAM
COUNTY, WASHINGTON, DESCRIIED AS FOLLOWS:
lEG INNING AT A POINT 60 FEET EAST AND 30 FEET NORTH OF THE
CENTER OF SAIO SECTIO. 14.
THENCE NORTH 04' 33' 52' EAST, PARALLEL WITH THE WEST LINE OF
SAID SOUTHWEST QUARTER OF THE NORTHEAST QUARTER AND 60 FEET
DISTANT THEREFROM TO ~N INTERSECTION WITH THE SOUTHERLY LINE OF
THE RI'HT OF WAY CONYEYED TO CLALLAM COUNTY IY DEEO DATED
FEIRUARY 21, 1964 AND RECORDED IN VOLUME 272 OF DEEDS, PA;E
6S6, UNDER AUDITOR'S FILE NUMBER 346305;
THENCE SOUTH 77. II' 4S. EAST, ALONG THE SOUTHERLY LINE OF SAID
RIGHT OF WAY, A DISTA.CE OF 131 FEET;
THENCE SOUTH PARALLEL WITH THE WEST LINE OF SAID SOUTHWEST
QUARTER OF THE NORTHEAST QUARTER TO A POINT 30 FEET NORTH OF
THE SOUTH LINE THEREOF;
~:~[IlCE WEST PAULLEL HTH AND .0 FEET NORTH OF THE SAID SOUTH
LINE OF THE SOUTHWEST QUARTER OF THE NORTHEAST QUARTER TO THE
POINT OF IE;INNING.
DeSIGNED I',
DRAWN I'. ~J(~L.Ue /of. ""ELTON
PLAT CHECK I',
FINAL CHECK I'
r--,
SUR Y E Y 0 R ' S
C E R T I F I CAT E
~ .m'RT I1Lf~
REGISTERED LAND SURVEYOR
LICENSE NUMBER 22344
DATE: B AIJ&VST
, 19.m...
}HA~O~A~~ kEG~~~::~D :~ :O~I~~E~~~~~y~~R:~T~:~E~tA~=COF ~~~~'~G~g:~I~~D
DECLARE THAT THIS LANI DIYISION IS BASED ON AN ACTUAL SURVEY OF THE LAND
DESCRISEO HEREIN, CONIUCTED BY ME OR UNDER MY SUPERYISION; THAT THE
DISTANCES, COURSES ANI ANGLES ARE SHOWN THEREON CORRECTLY; AND, THAT
MONUMENTS OTHER THAN THOSE HONUHENTS APpROVED FOR SETTING AT A LATER DATE
HAYE IEEN SET AND LOT CORNERS STAKED ON THE GROUND AS DEpICTED ON THE
SHORT PLAT. ,-.lIESA"r
':> '1''' ',,(;
i!~f
:i 4 1.~'W
,,~;~), '>
A.<(v.'~ ~
1-~ f: f:r;\ :r,.'
~:rSI."'\ \~
~
r-
C
~
rn
o E C L A RAT ION
'KNOW ALL MEN SY THESE PRESENTS THAT I, THE UNDERSIGNED, OWNER OF THE LAND
HEREIT PLATTED, HEREII DECLARE THIS PLAT. THE PLATTOR HEREIT ACCEpTS ALL
RESPONSIIILITY FOR ALL CLAIMS AND DAMAGES WHICH MAY IE OCCASIONED TO ANY
OTHER LAND OR PERSONS IY THE ACTIONS OF SAID PLATTOR AUTHORIZED IY THE
COUNTY IN RELATION TO THIS PLAT, I HEREBT CONSENT TO THIS PLAT.
OWNER: .." ~fi~~~~~~,.. ~~-=1::t.~;~<<,.. O:6&~':\::"~u
l. ~ ~.. n 'JHt """,,,,,,,,,~",t It.t.U~DI"''''. 0_ """ ~lU'1t:r ~.T "..,; Ht.U.'"
. 1 ..,u..t) n PlollJllrt." n, 'to OIC iC'\JSt' ""U"UT "' 1l\( c......~ I\'....'...D
,L .. '. (' ~",----.- ,...'" ~I"'r 1\Pf'_,"~l.. s~~' . ~-=-~ A.-..."o'l
HOKWC It. ASAOT 6Il\ ~ .
. uI ..... -. '"
CASADY
SHORT PLAT
NO,
6
WEST, WM,
THIS PLAT IS lASED ON A SURYEY ON THE WASHINGTON COORDINATE SYSTEM ;RID.
NORTH ZONE. ALL IEARINGS ARE RELATIYE TO SAID GRID. ALL DIST~NCES ARE
REDUCED TO SAIO GRID.
LLu.....!!--~
DENOTES 5/0' REBAR NITH PLASTIC SURVEY CAP STAMPED .nTI-NESARY 22344. AND
3. X 3" WHITE CUARD POST.
~ AC~NOw""'''t>""eM..>JT
~
<JI
............. -- W~l-lIN6'Tt:N )
COUNTY oF- I< ,'n)!j ) ~
III 7'-'/. /11 -noC....eTIFY TlJAT"'" 'n..Wi> /~..Y '*' ~gt- 1"1 %J'
~ .. N\e '" ~O"'i!:'O''''''''EO, A NorAlZ.y P'-'lIL.Ic., f.~J~u..y APP&A~O ·
.f>IoJt> :TOMe 1<>10",.. To ~15 TH.
? tJ....""'- a....l~ , e.es~VfLY,_F
~ COe.-""'loN W'-'I~ Jiixe' ~ ~;-~<<..,""" '/'4=0.uo\,"NT ANI> ...::r~
(l 1J-.I1;i......,,, '''''T14-IMENT.,., e.r; ~ f"El;; AI-C V~UI""'''''~ Acr AND ~o cp ~'o
\J ~~~: ~~~ ~~~~~E.\<~~~=~~'~5~~~~~
T1-le SEAL... AF-FI)ff'iD IS 'TI-lE C::~~ eEAL OF- 'SAID e: rrJoI-J.
~ Pl~:~ "":Z= A-Il> "'!"f'ICIAj.. eEiOlL l-JER 1<:> FF/><1iO _ A ~ Y
~
~
~
,,>>
D
:>
"
A C K NOW LED ; E MEN T
STATE OF WASHINGTON
COUNTY OF CLALLAM
SS
A P PRO Y A I"
PLANNING DEpARTMENT
EXAMINED AND APpROYED THIS ~ DAY OF <:>c:r~
&'1 r'2.... q~
o trfCTii R
DEpARTMENT OF PUILIC WORKS
...
EXA~IN A . P OYED THIS JeL OAT OF
ST
. --
LIGHT OEPARTHENT
, uaa....
Oc.:n:,es:a..
,1986
EXAMINED AND APpROYED THIS ~ DAY OF
aT ~fJ Lk
t:X.-f"oa~
, u~.
FIRE DEpARTMENT
IT
THIS ~~ DAY OF
, ItA.
Uc j~ 66,-
~ I L I N G
E COR D.
FILED FOR RECORD AT THE REQUEST OF VJI.JJ S...~~7.A~ ,,;;,
tHIS .54rOAT OF -~..Itf,) , 19...11: A.D, AT .3.~
HINUTES PAST ~_ O'CLOCK ~.H. AND RECORDED IN VOLUME ~ OF pLATS,
PAGE ~ RECORDS OF CLALLAM COUNTT, WASHINGTON,
CaCt(1~tT~~,1)V K Tim14~~'/~:,~,& ~ c<J
2
~
NTI
NORTHWESTERN TERRITORIES. INe.
_._--
--'-*-r
'" Dftl...............LB. __._.....
/4(40-,-)
x- pORT ~
o 1-Q
~ ~
U- ~~<;
it (fl
--
It-~O~
SHING'\
Washington State Energy Code
Plan Review Checklist
Applicant please Check, write in N/ A. or fill in value on boxes or lines.
Proj ect Address:
Compliance Approach:(check one) D Systems analysis
D Component performance
D Prescriptive path
HEATING SYSTEM
D Zone Heating
~ectric Furnace
DHeat Pump
FOUNDA TJON PHASE
D Slab R-_ Exterior down to frostline/slab bottom; Interior 24" horizontal or vertical; or, If radiant under entire slab
D Below grade exterior wall insulation: R-_ (If interior -see Insulation Phase)
FRAMING PHASE
B'Standard D Intermediate D Advanced
(!l'Standard air seal: sole plate/sub floor; rim joist; window & door frames; wires, plumbing, ducts, light fixtures
I\lf Source specific exhaust fans: bath & laundry( 50 cfm) kitchen(100 cfm)
D Whole house exhaust fan _ cfin intermittent system has manual & auto controls: Outdoor air supply reg. for habitable rooms
or
fzf Integrated forced -air system, fan 1ft Dcfrn, outside air duct(with motor damper) allowing .35 and .5 ACH
INSULA TION PHASE
E:J R-2..,L Wall insulation(above grade)
D R-I_I;. Wall insulation(below grade): Interior wall insulation
o R-:: c' Floor insulation
B R-3S Ceiling insulation: Including attic hatch
D R-t),/:' Vaulted Ceiling insulation
B Vapor retarders: Walls, Ceiling: D 4 mil poly 0Perm rated paint Dkraft faced batts
G Vapor retarders: Floors: D 4 mil poly G!J'1aaft faced batts
[U Ground cover: 6 mil Black polyethylene, 12" lap at joints & extending to foundation wall
Over: Fill in back side also.
WINDOW GLAZING
Please fill out window information, inclued skylights, glass doors, and all other glazing on this form. Use rough opening area for calculations.
SIZE QUANTITY AREA U-VALUE & MANUFACTURER
3030 / 9 fR /J'l! /.c: ~.R.o
~~ tfP 9 ?~ ~ h1tJ~~n
:5 t!J L./ tV .:;. ;;('-/ ID h1,I6-.h'r1
3"1" 1 '1,.5' IV ,1)11 /t5-~O
3(;130 / q ftJ /}'}jL_ A
,
h r ~L IV S'~/d-e!!S / /8~ /)1/1 &-~.()
j::" oR f='7t.l::JI /h.,;. J 12 i/ 1'7 /111 J~~.j)
Total glazing area:
Total conditioned floor area:
Percentage of glazing:
It? / 14 p.r
~
DOORS
List doors by type(solid core, insulated, Etc.)quantity, U-value, and Manufacture.
SIZE
QUANTITY
AREA
U-VALUE & MANUFACTURER
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
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
04-00000376 Date
.555080
3419 WABASH ST
06-30-14-1-3-9010-0000-
RES NEW SFR
8/13/04
RS9 RESDNTL SINGLE FAMILY
103029
Owner
Contractor
HUNT, GLADYS
2240 EASTSIDE RD
UKIAH
(707) 462-2430
Structure Information
Construction Type
Occupancy Type
Other struct info
CA 95482
CONTRACT INTERIOR ASSOC. INC.
33 MOCKINGBIRD LANE
SEQUIM
(360) 683-2569
NEW 1569 SF SFR W/ATTACHED 312SF GARAGE -----
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
WA 98382
10.90
V-N
2.00
1. 00
11322.00
1241. 00
1241.00
1. 00
\.Ai
'-t:.
"""
~
----------------------------------------------------------------------------
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
T-STAT/ AIR-FLO HEATING
AIRFLOW HEATING
36.40 Plan Check Fee
8/13/04 Valuation
2/10/05
.00
o
(
~
~
~
'-
I(
Qty
1. 00
Unit Charge Per
36.4000 ECH EL-LVT-FIRST THERMOSTAT
Extension
36.40
----------------------------------------------------------------------------
Special Notes and Comments
proposal is to construct a 2-story SF residence in the RS-9
for a total lot coverage of 10.9%. N land use issues are
noted.
Electrical load calculations and elctrical permits are
required.
V1
:'/
----------------------------------------------------------------------------
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
745.00
4.50
1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 36.40 36.40 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 1810.90 1810.90 .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 Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\PLA]\''NING\FORMS\1102.15 [11/14/2003]
BillLDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4] 7-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND A CCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ,
ROUGH-IN I !!Jj 6 / &<<'/ I ,h JY
PLUMBING '7 /
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERJORBRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I I I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'5:
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 ~1v5/o/' if/) ELECTRJCAL
LIGHT DEPT
, CONSTRUCTION - R.W.
CONSTRUCTION R.W. 1 PWI
ENGINEERJNG 417 -4807 PW 1 ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003J
~ ~ORT ~
,~O~~<,<,
(;~~
"- -=...
~
"l.tO:,,~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application\Number
pin number i. . . .
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
04-00000431 Date
.873072
3419 WABASH ST
06-30-14-1-3-9010-0000-
EJ.,ECTRICAL ONLY
5/24/04
RS9 RESDNTL SINGLE FAMILY
o
Owner
Contractor
HUNT, GLADYS
2240 EASTSIDE RD
UKIAH
(707) 462-2430
CA 95482
KIRSCH ELECTRIC INC.
P. O. BOX 3396
SEQUIM WA 98382
(360) 683-6819
----------------------------------------------------------------------------
KIRSCH ELECTRIC
40.90
5/24/04
11/20/04
INC.
Plan Check Fee
Valuation
.00
o
\JJ
~~
~'{)
'\
~
~~
~~
~
~
~\
~
~
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL TEMPORARY SERVICE
Qty Unit Charge Per
1.00 40.9000 ECH EL-TEMP SRV - 0-60 SRV FDR
Extension
40.90
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40.90 40.90 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 40.90 40.90 .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 orwork 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 Owner (if owner is builder)
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 LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGEIDOWN 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 I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DR YW ALL (INTERJOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKINGILIGHTING 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,.<t/oy #ec ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W./ PWI CONSTRUCTION - R.W.
ENGrNEERJNG 417-4807 PW 1 ENGrNEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\I 102.15 [11114/2003]
'ti
""r......;
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 9R~62
CONTRACT INTERIOR ASSOC. INC.
33 MOCKINGBIRD LANE
SEQUIM
(360) 683-2569
000 NEW 1569 SF SFR W/ATTACHED 312SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL -% LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000376 Date
555080
3419 WABASH ST
06-30-14-1-3-9010-0000-
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
103029
Owner
Contractor
HUNT, GLADYS
2240 EASTSIDE RD
UKIAH
(707) 462-2430
Structure Information
Construction Type
Occupancy Type
Other struct info
CA 95482
000
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
1881 SQ. FT. SFR
27359
KIRSCH ELECTRIC INC.
KIRSCH ELECTRIC INC.
116.20 Plan Check Fee
5/21/04 Valuation
11/21/05
Qty
1. 00
2.00
Unit Charge Per
70.8000 ECH
22.7000 5C
EL-R-SQFT FIRST 1300
EL-R-SQFT ADDITIONAL 500
Special Notes and Comments
Proposal is to construct a 2-story SF residence in the RS-9
for a total lot coverage of 10.9%. N land use issues are
noted.
Electrical load calculations and elctrical permits are
required.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
5/25/05
WA 98382
10.90
V-N
2.00
1. 00
11322.00
1241.00
1241.00
1. 00
~
~.
-
~
.00
o
~
r
&
~.
Extension
70.80
45.40
{J
>1
745.00
4.50
1025.00
Fee!" summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 116.20 116.20 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 1890.70 1890.70 .00 .00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECT.JON 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.II02.1S (4196]