HomeMy WebLinkAbout1033 W 13th St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
VIRGINIA RICHARD MADRID
1033 W 13TH ST
PORT ANGELES
Other struct info
Permit
Additional desc
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per Extension
1 00 66 9000 ECH EL -R OR RM 0 200 ALT SRV FDR 66 90
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/15/2006 10 04 AM SROBERDS The proposal will result
in a 400 sq ft accessory pole building in the RS 7 No
land use issues noted
MAINTAIN CLEARANCES FROM SERVICE WIRES
05/02/2006 10 56 AM GMCLAIN
Electrical load calculations and elctrical permits are
required
Public Works Utility Engineering has no requirements for
this plan review
Other Fees STATE SURCHARGE
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
WA 98363
ELECTRICAL ALTER RESIDENTIAL
APS/ GARAGE FEEDER +CIRCUITS
81588
APS ELECTRIC
66 90
7/05/06 Valuation
1/01/07
Charged
66 90
00
4 50
71 40
COMMENTS /ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES. WA 98362
06 00000386
802162
1033 W 13TH ST
06 30 00 0 3 7058 0000
RICHARD MADRID
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
10080
Contractor
BUILDING BROKERS CONSTRUCTION
P 0 BOX 3831
SEQUIM WA 98382
(360) 683 6216
TOTAL LOT COVERAGE 18 57
NUMBER OF STORIES 1 00
EXISTING LOT COVERAGE 7000 00
LOT SIZE 7000 00
PROPOSED LOT COVERAGE 400 00
TOTAL LOT COVERAGE 1300 00
NUMBER OF UNITS 1 00
Plan Check Fee
Paid Credited Due
66 90
00
4 50
71 40
00
00
00
00
Date 7/05/06
4 50
00
00
00
00
00
0
ELECTRICAL PERMIT INSPECTION RECORD
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.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
GENERAL COMMENTS:
PW- I102.IS 1461
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
YES I NO
DITCH
ROUGH -IN COVER
SERVICE
FINAL 17-6-06 1 .r i)I
ELECTRICAL PERMIT INSPECTION RECORD
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.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
GENERAL COMMENTS:
PW- I102.IS 1461
PREPARED 7/03/06 9 48 32 INSPECTION TICKET PAGE 8
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 7/03/06
ADDRESS 1033 W 13TH ST SUBDIV
TENANT NBR RICHARD MADRID
CONTRACTOR CLEAR HORIZON PHONE
OWNER VIRGINIA S RICHARD MADRID PHONE
PARCEL 06 30 00 0 3 7058 0000
APPL NUMBER 06 00000566 FIREPLACE /INSERTS /FREESTANDING
PERMIT
TYP /SQ
ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
COMPLETED RESULT RESULTS /COMMENTS
MCF 01 6/14/06 JLL MECHANICAL CHIMNEY FLUE TIME 13 00
6/14/06 DA RICHARD 452 3569 CHIMNEY
06/13/2006 03 05 PM DYASUMUR
06/14/2006 02 01 PM JLIERLY
no answer at door or phone ill
ME1 01 6/22/06 JLL MECHANICAL ROUGH IN TIME 13 00
6/22/06 AP RICHARD THIS IS A INSPECTION FOR THE TILES FOR THE CHIMNEY
06/21/2006 08 24 AM DYASUMUR
06/22/2006 04 38 PM JLIERLY
cmu grout/j11
JLL MECHANICAL WOOD STOVE /PELLET TIME 13 00 ,JI 1
--A19 RICHARD 452 3569
07/03/2006 08 12 AM DYASUMUR
ME4 01 7/03/06
COMMENTS AND NOTES
PREPARED 6/22/06 11 03 25 INSPECTION TICKET PAGE 10
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 6/22/06
ADDRESS 1033 W 13TH ST SUBDIV
TENANT NBR RICHARD MADRID
CONTRACTOR BUILDING BROKERS CONSTRUCTION PHONE (360) 683 6216
OWNER VIRGINIA RICHARD MADRID PHONE
PARCEL 06 30 00 0 3 7058 0000
APPL NUMBER 06 00000386 RES DETACHED GARAGE
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
9 f 1
BL6 01 5/18/06 JLL BUILDING POST /COLUMN FTG TIME 13 00
5/18/06 AP SEAN 683 6216 05/17/2006 03 56 PM DYASUMUR
05/18/2006 04 10 PM JLIERLY
BL99 01 6 22/06 L n BUILDING FINAL TIME 13 00
/f/ AMY 683 6216 06/21/2006 11 01 AM DYASUMUR
COMMENTS AND NOTES
PREPARED 6/22/06 11 03 25 INSPECTION TICKET PAGE 15
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 6/22/06
ADDRESS 1033 W 13TH ST SUBDIV
TENANT NBR RICHARD MADRID
CONTRACTOR CLEAR HORIZON PHONE
OWNER VIRGINIA S RICHARD MADRID PHONE
PARCEL 06 30 00 0 3 7058 0000
APPL NUMBER 06 00000566 FIREPLACE /INSERTS /FREESTANDING
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
MCF 01 6/14/06 JLL
6/14/06 DA
ME1 01 /22 06
MECHANICAL CHIMNEY FLUE TIME 13 00
RICHARD 452 3569 CHIMNEY
06/13/2006 03 05 PM DYASUMUR
06/14/2006 02 01 PM JLIERLY
no answer at door or phone ill
MECHANICAL ROUGH IN TIME 13 00
RICHARD THIS IS A INSPECTION FOR THE TILES FOR THE CHIMNEY
06/21/2006 08 24 AM DYASUMUR
COMMENTS AND NOTES
041
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PREPARED 6/14/06 10 44 18 INSPECTION TICKET PAGE 14
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 6/14/06
ADDRESS 1033 W 13TH ST SUBDIV
TENANT NBR RICHARD MADRID
CONTRACTOR CLEAR HORIZON PHONE
OWNER VIRGINIA S RICHARD MADRID PHONE
PARCEL 06 30 00 0 3 7058 0000
APPL NUMBER 06 00000566 FIREPLACE /INSERTS /FREESTANDING
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
MCF 01 6/
MECHANICAL CHIMNEY FLUE TIME 13 00
RICHARD 452 3569 CHIMNEY
06/13/2006 03 05 PM DYASUMUR
COMMENTS AND NOTES
W\-
Application Number 06 00000566 Date 6/06/06
Application pin number 741154
Property Address 1033 W 13TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 3 7058 0000
Tenant nbr name RICHARD MADRID
Application type description FIREPLACE /INSERTS /FREESTANDING
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 2499
Owner Contractor
VIRGINIA S RICHARD MADRID
1033 W 13TH ST
PORT ANGELES WA 98363
CLEAR HORIZON
PO BOX 38
PORT ANGELES WA
PORT ANGELES
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Permit MECHANICAL PERMIT
Additional desc
Permit pin number 79392
Permit Fee 50 00 Plan Check Fee 00
Issue Date Valuation 0
Expiration Date 12/03/06
Qty Unit Charge Per
1 00 50 0000 ECH ME WOOD BURNING APPL
Fee summary
Signature of Contractor or Authorized Agent
Charged Paid Credited
T•\Policies \1102_15 building permit inspection record05.wpd [1/4/2005]
WA 98362
Due
Permit Fee Total 50 00 50 00 00 00
Plan Check Total 00 00 00 00
Grand Total 50 00 50 00 00 00
Extension
50 00
P/N/A z_
Date Signature of Owner (if owner is builder)
`Io //ob
Date
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 i co truction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspe ions have no been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this applicati n and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with w ether specified erein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any s -te or local la regulating gpnstruction or the performance of
construction.
sDDr rDdVV111l,t111.vAl \L Al aa.v..a.
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
I
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
FINAL DATE ACCEPTED BY.
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
1
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
n'
v
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
s
SLAB
WALL FLOOR CEILING
MECHANICAL
6//i) —7r
FINAL v DATE v ACCEPTED BY:
HEAT PUMP /FURNACE /DUCTS
LINE
WOOD STOVE PELLET CHIMNEY
kikVGAS
k j
V
'7 A
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
SEPA.
ESA.
SHORELINE:
PLANNING DEPT SEPARATE PERMIT #'s
PARKING/LIGHTING
LANDSCAPING
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 PW/
ENGINEERING 417-4807
CONSTRUCTION R.W
PW ENGINEERING
FIRE 417 -4653
FIRE DEPT.
PLANNING DEPT 417 -4750
BUILDING 417 -4815
V f Y'
41.-
BUILDING
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
nnD n\ mr DT A ATC A T T(1R CTT1
.......or .n., rprnr wn
BUILDING PERMIT APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST B
If hay questions, call
COMPLETE to be accepted for review ti yvii have an; q
PERMITS (360) 417 -4815 FAX(360)417 -471
FOR OFFICIAL USE 9NLY
5t,t /cc.
Date Rec.
Permit n
Date Approved. 1
Date Issued: �/L /7 4
Applicant or Agent: littemfre) Plat/
Owner
Address
wig
10-;10- c3.
Architect/Engineer
Contractor 0131
y r., State License Exp Phone.
w p q;(0--1 Address. 0� n w Y 0- City t .),I.�tl� Zi
,nn'' ZONING
PROJECT ADDRESS Q� yV
LEGAL DESCRIPTION Lot:
Block: Subdivision.
CLALLAM COUNTY PARCEL NUMBER. 62(49;220 0e2 TD C t2
City p61k Qcn4P
Phone IM
Phone. 'P
Zip 4k56�—
Phone.
ST7F/VALUATION
TYPE OF WORK. 0 SF /SF
I Residential New Constr Re -roof /SF
Multi- family X Addition Move Garage SF
Demolition Deck SF
0 Repair 0 Sign Other /SF
Commercial Remodel Age,.. yo TOTAL VALUATION 00
BRIEF DESCRIPTION OF THE PROJECT t 1,, G�,�
l ij4 c+ 1 �3� 4 ''l It l
Occupant Load. Constructron Type:
COMMERCIAL/RESIDENTIAL. Occupancy Group` p Ft.
i 67".
No of Stories: Lot Size:`6_ Existing Sq. Ft. 4; D� Proposed Sq Ft. Sq
Total lot coverage
PLANNING USE ONLY
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
APPROVALS
PLAN
BLDG
DPWU
FIRE
OTHER
VALUATION OF CONSTRUCTION In all
comply with current fee schedules. Contact the Permit Coordinator at 41 figure 815 be reviewed assistance.
and may be revised by the Building Division to p y
PLAN CHECK FEE. IF a plan check fee is d it of must submitted m at the time the builduig permit application and construction plans are
submitted. All other permit fees are due
EXPIRATION OF PLAN REVIEW If no permit is issued witl 180 days of the date of application, the application will expire. The
Buildmg 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 Building/Residential Code, 2003). 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. 1 am authorized to apply tof for
k is permit and
understand that it is my responsibility to determine what permits are required ,not the City's, and that 1 must obtain such permits prior
TAPoli \BL 1 102_13.wpd Applicant: Date:
4
Atc
4
4
WY OF PuR 5 ANGELES Colstruction Plans
IThellssuance of based upon these plans, spet.ifi-.
'cations and other data hall notipreventirelbuilding official
from thereafter rectuiring-the eormIctio of e9orslin said
plans, -specification's_ and othe_data„or om preventing
1 1 i
bui ding operations btng and1 i d on hereunder when in
Arlo ation of all codes iancil ordinanceil of this jurisdiciion.
niform Buil Code 1 2 ivc)3
Approval Oath BY
111
SV i •600-1/_. ?-c "r2t) alt"
-1.J7rs-1- I 1 l
1
t
t
l
PREPARED 5/18/06 10 26 26 INSPECTION TICKET PAGE 13
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 5/18/06
ADDRESS 1033 W 13TH ST SUBDIV
TENANT NBR RICHARD MADRID
CONTRACTOR BUILDING BROKERS CONSTRUCTION PHONE (360) 683 6216
OWNER VIRGINIA RICHARD MADRID PHONE
PARCEL 06 30 00 0 3 7058 0000
APPL NUMBER 06 00000386 RES DETACHED GARAGE
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL6 01 18/06 LLD SEINDI 6216 /05 FTG 13 00
SEAN 683 83 6216'05/17/17/ 2006 06 03 3 5 56 PM DYASUMUR
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
VIRGINIA RICHARD MADRID
1033 W 13TH ST
PORT ANGELES
Other struct info
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
WA 98363
75457
221 75
11/13/06
Charged
221 75
88 70
4 50
314 95
T• \Policies \1102 15 building permit inspection record05.wpd [1/4/20051
06 00000386
802162
1033 W 13TH ST
06 30 00 0 3 7058 0000
RICHARD MADRID
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
10080
Contractor
BUILDING BROKERS CONSTRUCTION
P 0 BOX 3831
SEQUIM WA 98382
(360) 683 6216
TOTAL LOT COVERAGE 18 57
NUMBER OF STORIES 1 00
EXISTING LOT COVERAGE 7000 00
LOT SIZE 7000 00
PROPOSED LOT COVERAGE 400 00
TOTAL LOT COVERAGE 1300 00
NUMBER OF UNITS 1 00
BUILDING PERMIT RESIDENTIAL
Plan Check Fee
Valuation
Qty Unit Charge Per
BASE FEE
9 00 14 0000 THOU BL -2001 25K (14 PER K)
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/15/2006 10 04 AM SROBERDS The proposal will result
in a 400 sq ft accessory pole building in the RS 7 No
land use issues noted
MAINTAIN CLEARANCES FROM SERVICE WIRES
05/02/2006 10 56 AM GMCLAIN
Electrical load calculations and elctrical permits are
required
Public Works Utility Engineering has no requirements for
this plan review
STATE SURCHARGE 4 50
Paid Credited Due
221 75
88 70
4 50
314 95
rg_
00
00
00
00
Date 5/17/06
00
00
00
00
88 70
10080
Extension
95 75
126 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 an rdinances goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not
pres a to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
con truction.
Lure of Contractor/or Authorized Agent Date Signature of Owner (if owner is builder) Date
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
P/Q
y
V 2 A
PLUMBING
FINAL DATE ACCEPTED BY.
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
FINAL DATE ACCEPTED BY.
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
SEPA.
ESA.
SHORELINE:
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
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 PW/
ENGINEERING 417 -4807
CONSTRUCTION R.W
PW ENGINEERING
FIRE 417 -4653
FIRE DEPT
PLANNING DEPT 417 -4750
PLANNING DEPT
BUILDING 417 -4815
L`
BUILDING
T \Policies \I 102_15 building permit inspection record05 wpd [1/4/2005]
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.
T
k
4
PLANNING USE ONLY
APPROVALS.
PLAN
BLDG
DPWU
FIRE.
ESA/Wetland(s) Yes No
SEPA Checklist required? Yes No Other
OTHER.
Applicant or Agent: DO t t^ DI C
phone( 3G'O> b �G
Owner (1(1 "A 01210 R\ CWAQ_O Phone: 1,(c4:
Address. ()ZS r CAR QC 1 P"r N uoil' Zip 6a
Architect/Engineer ETS
Phone: (10 cf: '4q t 3cio
Contractor/0 I WE t.3 2:2 2 5 State License 1 0 i L D Cd 1( lxp Ol 1 I Phone: C g
Address: t ®2 L11E5 I O Q l..ol City .SC :a/ l M 1iki Zip
PROJECT ADDRESS 1 \r?) 4 S� P+' ZONING
LEGAL DESCRIPTION Lot: Block: 0 Subdivision.
CLALLAM COUNTY PARCEL NUMBER. O 63 OD003 O5
PE OF WORK.
Residential New Constr Re -roof Stove
Multi family 0 Addition Move Garage
Commercial Remodel Dem lition Deck
Repair Sign Other
BRIEF DESCRIPTION OF THE PROJECT
T•\FORMS\BIdgPermitform.wpd Applicant:
BUILDING PERMIT APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COMPLETE to be accepted for review If you have any questions, call
PERMITS (360) 417 -4815 FAX(360)417 -4711
FOR OFFIC[A USE )ONLY
ate Rec.
Permit #•0
to Approved:
ate Issued:
1i
1 SIZE/VALUATION
`cOO SF 2.3 O /SF 1 O
SF /SF
SF /SF
TOTAL VALUATION I 0 W)
COMMERCIAL/RESIDENTIAL. Occupancy Group Occupant Load. Construction Type:'Po.c i P M C
No of Stories. 1 Lot,Size. 000 Existing Sq Ft. 90(') Proposed Sq. Ft. goo TOTAL Sq. Ft. 00
Total lot coverage 1 F, IS+
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 If no 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 Building/Residential Code, 2003). 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 i is my responsibility to determine what permits are required not the City's, and that 1
must obtain such permits prior to work.
Date: I c/ Old
c?aOUW C am+
D\ 163u-
0
3
1
Installation aescnpu n
Commercial 4 Residential
li1J New IX/Altered/Addition
J (.O'AAR)
4E4.0 (44A1) -QOQ
t44-6-4e,
L 4 j1SelkA
4 122.4bA
O Cash D Check en-
0 Credit Card Visa Mastercard Discover
Card
A 0
Expiration Date
nspeclian fee
of card c 1_n .pa_
Job wired by Electrical Contractor 0 Owner
lectrical contractor name License number Date Expires
PS el e f cal (a it r. 41i S6 Lett f'
Purchaser's manioc address
6 'lb e n aa'n a4)
41/4 g �l�?3 grate Z A c tri 63
Telephone number FAX number
7;4,0 t5 a 6'7 63 r et. rno.
t Premi e s wnery me
R C U I I A I q yvr� f d
Address ioa
O of inspect i63. 13 zA'
CIty
4
Phone number to schedule Inspection: 1 5a
Inspection
Date
Owner as defined by RCW.19.23.261:/IJ Owner will occupy the structure far two
years Wier this electrical permit is finalized. (2) Owner is required to hire an electrical
contractor ifahove 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. I am making the electrical instal-
lation or alteration in compliance with the electrical laws. N.E.C., RCW. Chapter
19.28, WAG. Chapter 296.463, The City of Pon Angeles Municipal Code, and
Utility Specifications.
Sian re owner, p ale rival contact or electrical administrator
2 eZDate: Co )4'2
Electrical Load Addltjaq an d ftlptractIons
NO LOAD CHANGES
Baseboard KW
O Furnace _KW N JEl f Overhead Service
Heat Pump Ton LAR Temp Service
Fan -Wall KW 0 Underground Service
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360 417 4735
Area, Building or Equipment Inspected
ELECTRICAL WORK PERMIT APPLICATION
Action Taken
Service Infformafign
Voltage Xic^44 0
Phase 41 O 3
Service Size: Z..<=tO
Feeder Size'
Electiical
Inspector
£SL9 ESb _09£ ON Xed JOIDddlNOJ lbJIa1DB13 S d U Wald