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Home My WebLink About1009 Golf Course Rd - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner OLYMPIC VIEW PARTNERS LLC 113 SOUTH VALLEY STREET PORT ANGELES WA 98362 (360) 417 1110 Other struct info Permit Additional desc Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date Other Fees COMMENTS /ACTION NEEDED CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321 EAST 5TH STREET PORT ANGELES. WA 98362 06 00000880 427040 1009 GOLF COURSE RD 06 30 13 5 7 0170 0000 RES MANUFACTURED HOME RESIDENTIAL HIGH. DENSITY 78545 Contractor OWNER TOTAL LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE ELECTRICAL NEW RESIDENTIAL SHAMP/ MOBILE FEEDER 90423 SHAMP ELECTRICAL CONTRACTING 78 70 Plan Check Fee 11/13/06 Valuation 5/12/07 STATE SURCHARGE Date 11/13/06 29 70 1 00 5241 00 1556 00 1557 00 Qty Unit Charge Per Extension 1 00 78 7000 ECH EL -MANF HOME SERVICE FEEDER 78 70 Special Notes and Comments Address numbers shall be plainly visible from the street Address numbers shall be a minimum of six inches high and be of contrasting color from the background All homes in new subdivisions that are outside of the Fire Department four minute response area shall be equipped with residential fire sprinkler systems that comply with the International Fire Code (IFC) .and National..Fire .Protection Association (NFPA) 08/18/2006 12 05 PM SROBERDS The proposal will result in placement of a mfg home in a PRD in the RMD zone for total lot coverage of 30% 5 interior setbacks are good Electrical load calculations and elctrical permits are required Ditches 12 culverts will be installed to City Stanards See Public Works Engineering for Standards Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch 24 hour advance notice is required Construct driveway and Sidewalks. toy 'CifyFStandards,..w,.__.,..._ No concrete with exposed aggregate allowed in the City road right of way An inspection by Public Works Engineering is' required prior to prouring concrete SEWER SYSTEM DELV CHARGE 870 00 Vt. iI�"� 'u Ca'ty 'SC'na cC 4 50 1 4i inches h. h i 00 0 (ALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO DITCI1 ROUGH -IN COVEk SERVICE FINAL GENERAL COMMENTS: ELECTRICAL PERMIT INSPECTION RECORD 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 PW- 102.151 Application Number Application pin number Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total COMMENTS /ACTION NEEDED CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 06 00000880 427040 PW WATER SYSTEM USE FEE 1200 00 Charged Paid Credited Due 78 70 78 70 00 00 00 00 00 00 2074 50 2074 50 00 00 2153 20 2153 20 00 00 o6 Page 2 Date 11/13/06 00 t, u CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. INSPECTION TYPE DITCH ROUGH -IN COVEk SERVICE FINAL GENERAL COMMENTS: ELECTRICAL PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE DATE ACCEPTED YES I NO 1 1 I 1 1 1 1 COMMENTS pw- 1102.15 14961 11/01/2006 12 15 FAX Job wired by E ctrical contractor name License nuelber aate Ex•ires P haser's sill dd s I i• 1L State ZIP 0 A Telephone nu f /t Addr�gs of inspar e.cLt`ns v n Cit Phone number to schedule inspectldh Owner as defined by RCW /9?8?61 (1) will occupy the si are for two years after this electrical permit rs finalized. (2) Owner is required to hire an electrical contractor if above said property is ,for sale, rent or lease. After reading the above statement, 1 hereby certify that 1 am the owner of the above named property or a licensed electrical contractor. 1 am making the electrical instal- lation or alteration in compliance with the electrical laws, N.E.C. RCW Chapter 19,26, WAC. Chapter 296 -468, The City of Port Angeles Municipal Code, and Utility Specifications. Signa urc or owner, electrical contractor or electrical administrator N X eF owner's name wv■\ riiaLI,.0 Electrlcal:oad and or subtractions NO LOAD CHANGES Baseboard KW Furnace KW inspection Date -o(� 41) ri i/ Electrical Contractor Owner W FAX number s Heat Pump Ton LAR 7 Fan -Wail KW Overhead Service Temp Service "Under Service ?MME DAY IINS>'F CALL BEFORE 7.00 AM 360 -417 -4735 ROUGH .4N r THERMOSTAT Date ,T Appr ea ay FINAL Date/ Approved By J Date: II 0 oats DITCH j x ,y� D A icy Area, Building or Equipment Inspected ELECTRICAL WORK PERMIT APPLICATION 1 iinstallation description O Commercial D Cash Check redit Card Card Expiration Date of card Appr ved By j 713, ao J (ov «ice /-13-1 D4esidential Altered/Addition Visa Mastercard Discover Service Intimation Voltage a Phase O 1 3 SorvICe Size: Feeder Size: SERVICE Action Taken 4 7 8a '70 J Approved By l kuI)lR ApDNved By J a 002/002 Electrical Inspector cs\ Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00001517 Date 12/21/07 174940 1009 GOLF COURSE RD 06-30-13-5-7-0170-0000- ELECTRICAL ONLY RESIDENTIAL HIGH DENSITY o Owner Contractor OLYMPIC VIEW PARTNERS LLC 113 SOUTH VALLEY STREET PORT ANGELES WA 98362 (360) 417-1110 ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452-6424 WA 98362 Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL 118026 ELECTRIC SERVICE 40.00 12/21/07 6/18/08 Plan Check Fee Valuation .00 o Qty 1. 00 Unit Charge Per 40.0000 EL-LOW VOLT SYS <=2500 SQFT Extension 40.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 40.00 40.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 40.00 40.00 .00 .00 .--- <::) o ~ GJ o ...-- -t\ ~ c "1 V"' CD ~ [INSPECTION ELECTRlCAL TYPE DA TE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH - IN '2.!~1 I tl-.. .p.."" . ~ FINAL COMMENTS: U2.1/29/2007) Linda Pangrle - Fire Sprinklers Page1! From: To: Date: Subject: Linda Pangrle Ken Dubuc 11/29/2007 11:33 AM Fire Sprinklers Hi Ken, F.Y.I. Today I called Kathy Roush 457-0655 (who is the contact for the two homes listed below that we discussed yesterday). Olympic View Partners, LLC 417-1110 is listed as the owner of the homes. )' #06-880 1009 Golf Course Rd #06-881 1912 Village Circle I asked her if the homes have sprinkler systems in them, and she said yes. I asked her to call you and request fire sprinkler final inspections when they are ready. Linda Pangrle, Permit Tech City of Port Angeles 360-417-4815 ELECTRICAL PERMIT AND INSPECTION RECORD CITY OF PORT ANGELES 360-417-4735 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 06-00000880 Date 10/29/07 427040 1009 GOLF COURSE RD 06-30-13-5-7-0170-0000- RES MANUFACTURED HOME RESIDENTIAL HIGH DENSITY 78545 Owner Contractor OLYMPIC VIEW PARTNERS LLC 113 SOUTH VALLEY STREET PORT ANGELES WA 98362 (360) 417-1110 Other struct info OWNER TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE 29.70 1. 00 5241.00 1556.00 1557.00 Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date RESIDENTIAL ELECTRICAL NEW BOB'S/ GARAGE 110098 BOB'S ELECTRIC 46.00 10/29/07 4/26/08 INC plan Check Fee Valuation .00 o Qty 1. 00 Unit Charge Per 46.0000 ECH EL-R-OUTBD/DTCH GAR SEP Extension 46.00 Special Notes and Comments Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. All homes in new subdivisions that are outside of the Fire Department four-minute response area shall be equipped with residential fire sprinkler systems that comply with the International Fire Code (IFC) and National Fire Protection Association (NFPA). 08/18/2006 12:05 PM SROBERDS -- The proposal will result in placement of a mfg home in a PRD in the RMD zone for total lot coverage of 30%. 5' interior setbacks are good. Electrical load calculations and elctrical permits are required. Ditches & 12" culverts will be installed to City Stanards. See Public Works Engineering for Standards. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway and Sidewalks to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to prouring concrete. Other Fees RES UNDERGRND SERVICE FEE SEWER SYSTEM DELV CHARGE 713.00 870.00 ~ - . '" ~ C> "'0 ~ {' "" p ~ 8: -/1 INSPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH - IN FINAL COMMENTS: ELECTRICAL PERMIT AND INSPECTION RECORD CITY OF PORT ANGELES 360-417-4735 .. , Application Number . . . . . 06-00000880 Application pin number 427040 Page 2 Date 10/29/07 Other Fees STATE SURCHARGE PW WATER SYSTEM USE FEE 4.50 1200.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 46.00 46.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 2787.50 2787.50 .00- .00 Grand Total 2833.50 2833.50 .00 .00 , . 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L -=-- ~ ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 06-00000880 Date 427040 1009 GOLF COURSE RD 06-30-13-5-7-0170-0000- RES MANUFACTURED HOME 8/22/06 RESIDENTIAL HIGH DENSITY 78545 Owner Contractor OLYMPIC VIEW PARTNERS LLC 113 SOUTH VALLEY STREET PORT ANGELES WA 98362 (360) 417-1110 Other struct info OWNER TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE 29.70 1. 00 5241.00 1556.00 1557.00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BL MANUFACTURED HOME MANUFACTURED HOME 84608 230.00 Plan Check Fee 8/22/06 Valuation 2/18/07 .00 78545 Qty Unit Charge Per BASE FEE Extension 230.00 Permit BUILDING PERMIT -RESIDENTIAL Additional desc Permit pin number 85290 Permit Fee 207.75 Plan Check Fee 83.10 Issue Date 8/22/06 Valuation 9407 Expiration Date 2/18/07 Qty Unit Charge Per Extension BASE FEE 95.75 8.00 14.0000 THOU BL-2001-25K (14 PER K) 112.00 Special Notes and Comments Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. All homes in new subdivisions that are outside of the Fire Department four-minute response area shall be equipped with residential fire sprinkler systems that comply with the International Fire Code (IFC) and National Fire Protection Association (NFPA). 08/18/2006 12:05 PM SROBERDS -- The proposal will result in placement of a mfg home in a PRD in the RMD zone for total lot coverage of 30%. 5' interior setbacks are good. Electrical load calculations and elctrical permits are required. Ditches & 12" culverts will be installed to City Stanards. See Public Works Engineering for Standards. ~, ?f: O.j .~ ~ ~ '?P 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-certifythat--l have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not presume t give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of constru '" Date Signature of Owner (if owner is builder) Date T:\Policies\1102_15 building pennit inspection record05.wpd [1/4/2005J ____---4 BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL 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 FOUNDATION: FOOTINGS SHEAR WALLS I WALLS FOUNDATION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLOGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLOG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS I GIRDERS SHEAR W ALLlHOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL I FLOOR I CEILING MECHANICAL HEAT PUMP I FURNACE I DUCTS GAS LINE WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING I SLAB BLOCKING & HOLD DOWNS SKIRTING - PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKJNG/LIGHTlNG ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R. W. I PW I CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:IPoliciesl] 102_15 building permit inspection record05.wpd [1/412005] . o<'ORT~ fir ,. L~ ~ "\ftC~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 06-00000880 Application pin number 427040 Page 2 Date 8/22/06 Special Notes and Comments Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway and Sidewalks to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to prouring concrete. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 870.00 4.50 1200.00 Fee summary' Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 437.75 437.75 .00 .00 Plan Check Total 83.10 83.10 .00 .00 Other Fee Total 2074.50 2074.50 .00 .00 Grand Total 2595.35 2595.35 .00 .00 .' .. ..- .. ..... '" '0'" . ~ .~:~ .; 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. '-hereby-certify that I have read-and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\Policies\II02_15 building permit inspection record05.wpd [1/:'/2005] BUILDING PERMIT INSPECTION RECORD - CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL 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 I NO FOUNDATION: (0/14/ OT :xL\.- FOOTINGS Co/db fOT .:JLL ~M 'W-P< \...L SHEAR WALLS I WALLS ~ FOUNDATION DRAINAGE I DOWN SPOUTS l7'/~ /()b \lh- PIERS I , POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING '81 :2.1 lor :ILL- JOISTS I GIRDERS I ~ SHEAR W ALI{HOLD DOWNj) :r / CJ2/ 61- -JLL WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL I FLOOR I CEILING MECHANICAL HEAT PUMP I FURNACE I DUCTS GAS LINE WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING I SLAB , , BLOCKING & HOLD DOWNS J11/);/~ vw SKIRTING . - PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 4 I 7-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 '^ PW I ENGINEERING FIRE 417-4653 f\ FIRE DEPT. PLANNING DEPT. 417-4750 ( A \ PLANNING DEPT. BUILDING 417-4815 lJ . Ll( ')~ 1\ BUILDING T:\Policies\J 102_15 building permit inspection record05.wpd [11"4/20 5] "- \I \, ~ ! ~ ~ ~~ ~~ ~.~ ~~ ~~ ~~ ~~ ~~ ~ " . c1'MT~ S 11:..-- ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation Owner OLYMPIC VIEW PARTNERS oLLC 113 SOUTH VALLEY STREET PORT ANGELES WA 98362 (360) 417-1110 Other struct info Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date 8/22/06 06-00000880 Date 427040 1009 GOLF COURSE RD 06-30-13-5-7-0170-0000- RES MANUFACTURED HOME RESIDENTIAL HIGH DENSITY 78545 Contractor OWNER TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE 29.70 1. 00 5241. 00 1556.00 1557.00 PUBLIC WORKS RES WATER SERV RIGHT OF WAY 85134 50.00 8/22/06 2/18/07 Plan Check Fee Valuation .00 78545 85126 750.00 8/22/06 2/18/07 Qty Unit Charge Per 1.00 750.0000 EA PW W/M 1" SERV 3/4" METER Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date Extension 750.00 Plan Check Fee Valuation .00 78545 Qty Unit Charge Per 1.00 50.0000 ECH RIGHT OF WAY PERMIT Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date Extension 50.00 SANITARY SEWER HOOK UP 85142 110.00 8/22/06 2/18/07 Plan Check Fee Valuation .00 78545 Qty Unit Charge Per 1.00 110.0000 EA SAN SEWER HOOKUP Extension 110.00 Special Notes and Comments Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. All homes in new subdivisions that are outside of the Fire Department four-minute response area shall be equipped with residential fire sprinkler systems that comply with the 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 constructioon or the performance of constructi . ^ ~ Pa;;'D( . gnature of Contractor or Authorized Agent T:\Policies\J J02.JSR [1/05] Date Signature of Owner (if owner is builder) 0 Date PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOc." TION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO PW UTILITIES (Engineering Division) WATERLINE / METER I SEWER CONNECTION I SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRlVEW A Y APPROACH BACK-FLOW DEVICE I I . . FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING - T:\Policies\1102.15R [1/05] _ ~,""r~ S ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . .. 06-00000880 Application pin number 427040 Page Date 2 8/22/06 Special Notes and Comments International Fire Code (IFC) and National Fire Protection Association (NFPA). . 08/18/2006 12:05 PM. SROBERDS -- The proposal will result in placement of a mfg home in a PRO in the RMD zone for total lot coverage of 30%.5' interior setbacks are good. Electrical load calculations and elctrical permits are required. Ditches & 12" culverts will be installed to City Stanards. See Public Works Engineering for Standards. Sanitary sewer connection inspection is required by.. Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway and Sidewalks to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to prouring concrete. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 870.00 4.50 1200.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 910.00 910.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 2074.50 2074.50 .00 .00 Grand Total 2984.50 2984.50 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work Is suspended or abandoned for a period of 180 days after the work as commenced, or if required Inspections have not been requested within 180 days from the last Inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder). . Date T:\Policies\1102.ISR [I/OS] PERMIT INSPECTION RECORD CALL 417-4807 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 I INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE I I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R W.I PWI CONSTRUCTION - RW. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING - T:\Policies\1 102.15R [1/05] 00'" ....0 ...... .... '" .. .... ...... 00 00 0 1fI .... tiIti1 OE-< tiI 0<:0<: :E: "-0 H E-< '" 0 0 0...... .... Olfl .... -- .... .... M...... , ....00 r- 0 .... .. tiI .. :E:ti1 HE-< >< 0 E-<O<: ..:l '" 0 l>: M ~ tiI H ~ ..:l ~~ :> rn ..:l HtiItiI >': E-< OZZ rn tilrn glOO orn 0 tiI :4ti1 == ZO<: E-< ~~ rn"-"- 0>< 0 :E:O :E: Z E-<I-J "- Z>< ~ Z .. O~ 01>: f::z 00 HO rn 0 E-<E-< E-< 0<: tiI -- rn uu tiI &i ~:4 M E-< tiIti1 :E: 0<: 0 &i "-"- 0 z~ E-<1fI rnrn = 0 '" ~ ZZ 00 ~WCD\D H H 0 HU 000 0 tiI E-<...... t!) H 10 U g; "-rn ZO:::f'N U HE-< H~r--......... ..:l E-< ~~S Ot1l~1.f'l ..:loU ..:l:> .... 00<: rnrn HO::E:........ rnor>. Otiltil ~ HOO l>:0~ III 0 I>: III. ~o 0 tilo I>: Z. I~~ E-<o tiI ~~rn ~ rn r- g; "-otil N '1>: 0 3:r- I~~ 0 U tiI'0 .... HlfIOO r>. :> . 00 '" ..:l MO rn 8 u....O tiI H . 0 ..:dHl ~1 -..:l "-00 "'ti1 '" :E:MO 1llE-<E-< 00 0 ><. . rntil ;;,~ 0 ..:l"'''' ggJo; .... 000 .... CJI:E: ......E-< .. .. .. .. .. til0 001>: I>: 31>:u 0 -I>: -ti1 "- 0 ~ III 0 E-< - - ~ tilr>. rnu .... ~o gj~l>:&J !-< CJI 0 H rn "->< l>:!-<tiIU..:l ~ ...... tilE-< 013~~ll: "- :E: I>:H >< ..:l "-U ~uo"-o<: "- !-< ~ Leiter 0 1\ R ~e. PeV'I'Y\\-t-- ex--\er\d.eet 'th ,:,u~h l' I03(~ Mew ~~e.. P\oX\S were 5LJbMlt~ oh 0 FO;:F~' S y. BUILDING PERMIT - APPLICATION DateRec.:fPJ/c8~ . ~th Fill out COMPLETELY and in INK. Your application and site pIal) MUST BE COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 S" ~ 0 to 55' -fV r CD ntro-cto r- s-htm J//~ ~/Lhf~.J; LLr Ro us h Owner: CLALLAM COUNTY PARCEL NUMBER: TYPE OF WORK: SIZENALUATION: --,e- -- ~esidential KNew Constr. 0 Re-roof 0 Stove~ SF. @$ /SF. = $ /(J / J9'j o Multi-family 0 Addition 0 MoveJl' Garage --44D- SF. @ $ /SF. = $ o Commercial 0 Remodel 0 Demolition 0 Deck SF. @ $ /SF. = $ o Repair 0 Sign 0 Other TOTAL VALUATION $ BRIEF DESCRIPTION OF THE PROJECT: /1/7/!J,.vV'h4t' ~~~?r (? ~/f.07A.vT ~M Co r;-:tr I) of PrJltJlVJ"vtA V/UAttf ~~- COMMERClAL/RESIDENTIAL: Occupancy Group: No. of Stories: -L Lot Size: .s-,. Ji I Existing Sq. Ft. Total lot coverage ~ q, 7 % Occupant Load: Construction Type:/Z"7Ap vI;4 0~j o & Proposed Sq. Ft. I ~-5 '7 = TOTAL Sq. Ft. I s-.s 7 APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: ESAIW etland( s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other: 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 Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R105.3.2 of the International BuildinglResidential Code, 2003). No application can be extended more than once. I hereby certify that f have read and examined this application and know the same to be true and correct. f am authorized to apply for this permit and understand that it.is my Ii spon~ifity to determine what permits are required ,not the City's, and that I must obtain such permits prior to work. '- cr- /-V 6 Date: T:\FORMS\BldgPerrnitform.wpd Applic eninj!~e~_1Attafje . 'fI'! I ..) ./'<.J I I /' ....,. ,.., ~;() :.'/ ( Of.t 1':1(' (/ornlnu/7./l'j AMENiTIES - LANDSCAPING - PLOT PLAN -.----.-.------.., ---.,---.-. .-~_.._.-_.~..,.- -..--.----...- --------p--.-----.--., AMENITIES PROVIDED TO PENINSULA VILLAGE HOMEOWNERS iv'J (C&Rs to insure a pleasant environment 1?1 Peninsula Village Community is located directly across street from the Peninsula Golf Club I;;] Membership and your first year's dues are paid at Peninsula Golf Club (subject to Club's approval) L~1 All homes feature a fire sprinkler system I!.J Boat & RV storage area available [{1 Walking trail around the neighborhood and surrounding areas FRONT YARD LANDSCAPING AND MAINTENANCE I{] Your Home Owners' Association provides maintenance for all common areas 1v1 Professional maintenance for your yard at a substantially reduced cost kl Low Home Owners' Association fees estimated to be $30 per month iv'1 Your home's front yard and all common areas will be professionally landscaped with sod, perennial plants. bushes. and trees PENINSULA VILLAGE COMMUNITY PLOT PLAN ~ LINDBERG ROAD 16 Q o II< 15 7 6 J - ----- --. ___ 27 28 29 .--.-- 30 rV0,t. / "- - '- -- '. 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A.... ~.A." ....0.... ~-.~...... ~--~...... .A.A.... - L:J.. ... ..0. 6 ... .4 '6. p <I. '6. p l> 221.<i' S~Cu~ON 18=/8 1Y1P~CAL ~ !BorI'H VIERS~OINS ~ r't4' .... ~.- ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DNISION 321 EAST 5TIISTREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . Application valuation 06-00000880 427040 1009 GOLF COURSE RD 06-30-13-5-7~0170-0000- RES MANUFACTURED HOME Date 8/22/06 o@~2g0 /ODQ 6~ &~b uPo Y/@A) ~ RESIDENTIAL HIGH DENSITY 78545 Owner Contractor OLYMPIC VIEW PARTNERS "LLC 113 SOUTH VALLEy STREET. PORT ANGELES WA 98362 (360) 417-1110 Other struct info OWNER TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE 29.70 1. 00 5241.00 1556.00 1557.00 Permit . . . . . Additional desc . Permit pin number Permi.t Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 85126 750.00 8/22/06 2/18/07 plan Check Fee valuation .00 78545 Qty Unit charge Per 1.00 750.0000 EA PW V!/M 1" SERV 3/4" METER Extension 750.00 Permit . . . . . Additional desc Permit pin number permi t Fee Issue Date Expiration Date RIGHT OF WAY 85134 50.00 8/22/06 2/18/07. plan Check Fee Valuation .00 78545 "~"/I ~/o8 1/. \ /1/0" -; Qty Unit Charge Per Ext~ns 1.00 50.0000 ECH RIGHT OF WAY PERMIT .00 -------------------------------------------------------------------- -- Permit SANITARY SEWER HOOK UP Additional desc Permit pin number Permit Fee Issue Date Expiration Date 85142 110.00 8/22/06 2/18/07 Plan Check Fee Valuation .00 78545 Qty Unit Charge Per E~~ 1.00 110 0000 EA SAN SEWER HOOKUP ~ -------------------------------------------------------------------- -- Special Notes and Comments Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. All homes in new subdivisions that are outside of the Fire Department four-minute response area shall be equipped with residential fire sprinkler systems that comply with the 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 constructio"n or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder)" Date T:\Policies\1102.15R (1105) CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DNISION 321 EAST 5TIISTREET, PORT ANGELES, WA 98362 Application Number . . . . . 06-00000880 Application pin number 427040 Page Date 2 8/22/06 Special Notes and Comments International Fire Code (IFC) and National Fire Protection Association (NFPA). Oa/18/2006 12:05 PM" SROBERDS~- The proposal will result in placement of a mfg home in a PRO in the RMD zone for total lot coverage of 30%. 5' interior setbacks are good. Electrical load calculations and elctrical permits are required. . Ditches & 12" culverts will be installed to City Stanards. See Public Works Engineering for Standards. Sanitary sewer connection inspection is required by Public works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway and Sidewalks to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to prouring concrete. ---------------------------------------------------------------G- ~- Other Fees . . . . . . . .. SEWER SYSTEM DELV CHARGE _;0 no ____________________________________~~~~;=;~:~~;~_~:~_~~~_~ 12~__ Fee surrunary Charged Paid Credi ted . Due Permit Fee Total Plan Check Total Other Fee Total Grand Total 910.00 .00 2074.50 2984.50 910.00 .00 2074.50 2984.50 .00 .00 .00 .00 .00 .00 .00 .00 Separate Pel'mils 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 goveming 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 constructio"n or the performance of construction. . Signature of Contractor or Authorized Agent Date Date Signature of Owner (if owner is builder) T:\Policies\l102.ISR {I/OS] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 1'2. - 7 - 0 b Time Received by g V (phone. person) Location of Work to be inspected I eO g Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing Final C ?"'>l ~ C' C'.>U v-s. e. 'Rd Phone No. Permit No. 66 -88 Q Sewer Excav. Other':PDl.9J^ ${>Ou--t C.0/4I1€.c.i-t<=:>Yl 'f- 0 S~O r-,,^ INSPECTION NOTES: Inspected: Date /2 - 7 -Db Remarks: Time By k?V .DjC RESTORATION REQUiRED...... YES NO X- I I I I I I S!JRFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date I ( - q - (:) G Time 7At-vI.. Received by iJelA-vt,S E (phone, person) Location of Work to be inspected / D OC; ~. Go (.(! Gv' 'S e Name of person requesting inspection U.-z.-'/,5; E. Address of person requesting inspection ur,?1 7~r2 Type of Inspection (circle appropriate one): I ~ Sewer Foundation Framing Chimney Plumbing Final 17<6-1]. Phone No. tin -'/S'<I'7 Permit No.a -:. B Sewer Excav. ther uJ",-+e-r INSPECTION NOTES: Inspected: Date I ( -1 -- 0 C, Time (z f//VL Remarks: --;;"',eJ,..;}ed f?" L..-.r. - (? 0kvtA ed- lVld€ r / f.e... + ~ --t pi '''"'0 ~e r+V . f I I By tJe M V[ 'S ;L'_ r" I.E. -r-()b,~-+o RESTORATION REQUIRED. . . . .. YES X NO ~ r ~ . - LltALi b.e"j ~ ~ ~- :x . \, (' " - \-i \) ] IN ~ , 0'- ~ ~' '\J .. \) ~5t.,' , B ((P'- I '- zl.t-' Ouf SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel ;CB Repaired by City v['] Repaired by Permittee o No Damage Found 4')(-5-' ro Asphalt 0 pec 0 Other Work Order # .31.(1 b 3,. / <fti COMPLETE o INCOMPLETE /fP 5fYtoE';f /1-/ 7-0~ /"p (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . REQUEST: Date I ~ ~ 1- 0 fo Time Received by Rv (phone. person) Location of Work to be inspected J DOC{ , Name of person requesting inspection :\, VIA Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing C..,..., \ ~C"'IA .rs<:... ~ . Phone No. Permit No. Final Eer9 Other Ob - &l~a INSPECTION NOTES: Inspected: Date JI -5- 0(" Remarks: Ne.w (t""","'ec3~~Yl fc., N<2.lJJ I-j/' PVC {'rowt. Ex,'s.-{-.''5 Time By R II \O:.)<'I$.t("":5 ~/I ii>Vc. '/9,..1e.-o..l c;." ?Ve... larerc../ --/0 hC,(>-S.{ I f,. d",-<j.- . ~7/6"PYCE' . ~f. c. "/d -'(,5f,'5" IOo~ ,\ ~ Coli; coLo.,~-e - Golfc.owse =Rd 'i' ~ t:><.> '.., ?-J-.. "," f>v<- I - fL.. '7 I I I I I I I i I SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE ICnntinue.on.re.v,er.se side if necessary) STREET SUPERINTENDENT (DATE I - '.; , ": ,:iIf:\' -~1"t ".,~ .,;~'"4-',~ ,,' -... ~, ',l' '..,c - ~ , \'- ,,-4',{.:::::, ,~":""":~~~,~ t~,~,.. );l'i.\JJ,lt\~ ~~"'" !ir'_-"--L~fl.r""';~:~' CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . REQUEST: Date 3 -1.6-08 Time Received by k?V J;}J (phone. person) Location of Work to be inspected / DO q ~f.f (' ^u...J'S~f Name of person requesting inspection ~-I-iy i<."'",,-.;..k Address of person requesting inspection Phone No. '7' S7 - 06 ss- Type of Inspection (circle appropriate one): Permit No. 66 - B8::) Sewer Foundation Framing Chimney Plumbin~ewer Excav. Other INSPECTION NOTES: .5 - 20-0'2> Time 1'2-7-0<':' By KV Inspected: Date Remarks: Paw" ey>Ou:ls fo sTonvr. . S..Q...ue.,- / / - 3- 0 <6 2>.,.1ve....uo.y 3-Z0-08 -. f-tJ'I a { oK RESTORATION REQUiRED...... YES NO X / SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) e>(-/5'1 <1..""T~ ~~"~'.. ...~_.. -- ~ =.r.. ,:=-;~ ....."" ELECTRICAL WORK PERMIT APPLICATION Job wired by ,Electrical Contractor 0 Owner Installation description o Commercial ~ Residential ---Ekdnt /' Purchaser's mailing ad g2. DNew o Altered/Addition City spri IARI.cr WI :S 'ts tern.- I y y I'tlf'e., , Lt-t V ,,' 1 q ~ <r./ G-o 1 f' CoVrS& r.4 \ , c--) r c--v ')+ Phone number to schedule ins 7-bc.:.S' 61' l&d'h i[ ~ -J Owner as defined by RCWJ9.28.26I:(I) Owner will ace py the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical con/roc/or if above said properly is for sale. relit or lease. A fteT reading the above statement, I hereby certify that r am the owner of the above named property or a licensed electrical contractor. I am making the electrical instal- lation or alteration in compliance with the electricallaws,N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specifications. Signature 0 owner, elec}f~cal ontractor or electricaJ admin:strator X ;0 Date: /2:2 0 Electrical Load Additions and or subtractions o NO LOAD CHANGES o Baseboard KW o Furnace KW o Heat Pump Ton LAR o Fan-Wall KW o Cash 0 Checr o Cret'Cfld ~ ~stercard Card # Discover Expiration Date of card Service Information o Overhead Service o Temp SelVice o Underground SelVice Voltage PhaseD 1 03 Service Size: Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN TIlERMOSTAT SERVICE " Dale Approved By "- Date Approved By Dale Approved By ,.- / FINAL D1TGJ FEEDER ",}-tit <:f/ ~ ~ "- Date Approved By Dale Approved By "- Date Approved By/ Inspection Area, Building or Equipment Inspected Action Taken Electrical Date Inspector CI Elcctrical Contractor ~ ~ Cl Owner ~..... ELECTRICAL WORK PERMIT APPLICATION ~eQuest Inspection o Annual Permit 0 Alarm 0 Carnival Q Commercial 0 Residential CI Residential Maint. Cl Signs 0 Thermostat CJ Telecom. Job wired by ~Iectrical Contractor I:l Owner /J Licens~ ~uptber Q?~;>"'7"'7 Installstion descriprion ~~~~ ./ State Zlt:;f~ 2.- fW3 Clry. CI Cash I:l Chcck /I I hereby certify that 1 am the owner of the above named property Or a licensed electrical contrxctor (or the finn's authorized agent) and tun making the electrical installation or alteration in complianct:: with the electrical law, Chapter 19.28 RCW. o Credit Card Visa Mastercard Discover ot owner, electrieal c:ontractnr or el ical administrator Cal'd # ! ~ (/..~ Expiration Da! of card.' WAlLS CEILING THERMOSTAT SER\'lCE [ns.uJat;oll Only Insulation On ly Dllte !\ppruvooDy 0., .~pravedll)' DlIlll Appfl:l\/ecI8y DAle APPfv"ed By DITCH FErnER Cover COver """ ^ppt'Ovtcl8y Ol\.lC ."-IIProvC<l Dy DlIl~ ^Jlp'ovOl1 By n", Approvcdlh Electrical Load Additiol1S ,;)nd or subtractions o NO lOAD CHANGES o Baseboard t(W o Furnace _ KW Q Heat Pump _ Ton _ LAR o Fan-Wall _ KW ~ Information Q Overhead Service o Temp Service Q UndElfgrovnd Service Voltage Phase 1:]1 Cl 3 service Size: _ Feedsr Size: Inspection Dale Area. Building or Equipmt;:nt Inspected Action Taken Electrical Inspector -"<. '/ N 4l..-- AUG 1 7 007 UMDEPT. ,d Wd6c:,0 L00c 9, '6n~ [1766 CS17 09:0: , 'ON X~.:J :^ OI-,pa13 S.I:lOI:l WOCl.:J ."