HomeMy WebLinkAbout112 Orcas Ave - Building
PREPARED 5/09/08, 11 23 41
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR- JAMES LIERLY
PAGE
DATE
3
5/09/08
ADDRESS
TENANT, NBR
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
112 ORCAS AVE
MARCY SMITH
WIKER & WIKER CONSTRUCTION INC
MARCIA E SMITH
06-30-10-5-0-2024-0000-
07-00001144 RE-ROOF
SUBDIV
PHONE
PHONE
(360) 681-4800
(360) 457-0266
PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL99 01
5/09/08
BLDG FINAL
May 9, 2008 8 24 43 AM Ipangrle
MARCIA 457-0266 OR 457-9111
BLDG FINAL - RE-ROOF
THE PERMIT IS ON THE PORCH BY THE FRONT DOOR
-----------------~'"'E>" AND N"" ---- -----------------------------
;:;</4'<- ((P
~
'5~-
~ 'f'ORT ~
$"~O~~~
,.,...
1L s;;;....w
~
~IC~
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.
Tenant nbr, name
Appl~cat~on type descript~on
Subdivision Name
Property Use
Property Zoning .
Appl~cat~on valuat~on
07-00001144 Date 10/03/07
375816
112 OReAS AVE
06-30-10-5-0-2024-0000-
MARCY SMITH
RE-ROOF
RS7 RESDNTL SINGLE FAMILY
5250
Owner
Contractor
MARCIA E SMITH
112 ORCAS AVE
PORT ANGELES
(360) 457-0266
WA 983622552
WIKER CONSTRUCTION INC
RD.
WA
Structure Informat~on 000 000 TEAR
WIKER &
43 SENZ
SEQUIM,
SEQUIM
(360) 681-4800
OFF AND RE-ROOF
WA 98382
Perm~t BUILDING PERMIT - NO PR FEE
Add~tional desc TEAR OFF AND RE-ROOF
Perm~t p~n number 112417
Permit Fee 151. 75 Plan Check Fee .00
Issue Date 10/03/07 Valuat~on 5250
Exp~rat~on Date 3/31/08
Qty Unit Charge Per Extension
BASE FEE 95.75
4.00 14 0000 THOU BL-2001-25K (14 PER K) 56.00
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Perm~t Fee Total 151 75 151.75 00 00
Plan Check Total 00 00 .00 00
Other Fee Total 4.50 4.50 00 .00
Grand Total 156.25 156 25 .00 00
~l
?
o S: <f~
O~
'ocP
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 t give authonty to Violate or cancel the proviSions of any state or local law regulating construction or the performance of
constructi
~
(
Date
Signature of Owner (If owner IS bUilder)
Date
Signature of Contractor or Authorized Agen
T \Pohcles\1102_15 bUlldmg permIt mspectlOn record05 wpd [114/2005]
BUILDING PERMIT INSPECTION RECORD
3
,
CALL 417-48]5 FOR BUILDING INSPECTIONS CALL 417-4735 FOR ELECTRICAL IN SPECTJONS
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A Iv1INIMUM 24 HOUR NOTICE IT IS UNLA WFUL 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
...c
-C
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDA nON
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE/ DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS )
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
J01STS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (D\TTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CElLING I
MECHANICAL
ROUGH-IN I -
HEATPUMY/FURNACE/DUCTS I
GAS LINE FINAL DATE ACCEPTED BY
WOOD STOVE / PELLET / CHlMNEY
MANUFACTURED HOMES
FOOTING / SLAB
BLOCYJNG & HOLD DOWNS
SKJRTING
PLANNING VErT SEPARATE PERMIT#'s SEPA
PARKING/LIGHTING ESA
LANDSCAPING SHORELINE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/LSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTJONR W /PW/ CONSTRUCTION - R W
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FlRE 417-4653 FlRE DEPT
PLANNING DEPT 417-4750 PLANNING DEPT
BUILDING 417-4815 ~-t!-() 8' PB BUILDING
~
f'J
o
..,.
~
VI
~
~
)
J
~
L
T IPo!JCleslll02 15 bUlldmg penmt JJJSpectlOll recOld05 wpd [1/4/2005]
BUILDING PERMIT APPLICA TION Print in ink
CITY OF PORT ANGELES
Attn. BUilding Permit Technician
321 E Fifth St , Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
For City Use Only'
Date Received It!)- o'S-ol
Permit # c)l~ (ILfLf
Date Approved
6ve~
lJXev-
Phone
Phone
Phone
7V'6Z
Expires Jtl111 I~r"
Parcel Number
PROJECT ADDRESS
Zoning
Proiect Tvpe & Brief Description:
Check all that apply k
o New Construction ~~y 071
o Addition
o Remodel
o Repair
)1' Re-roof
o Demolition
o Sign
o Heat System
o Other
Lot
o Multi-family
o Industrial
o wall-mounted 0 projecting 0 freestanding 0 awning
Total si n area s . ft Maximum allowed Sl n area s . ft.
o Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other
o other
Floor Areas Existing (Sq, ft.) Proposed (Sq, ft.)
Basement @$ per sq. ft. = $
1 sl Floor
2nd Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION $ ~52!J) 170
Total footprint of structures
Max height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
sq ft
ft
Lot size
sq. ft = Lot coverage
# of bedrooms
# of full baths
# of half baths
%
Occupancy group
Occupant load
Construction type
I have read and completed this application and know If to be true and correct I am authorized to apply for this permit and
understand that it IS my responsibility to determliJ'ne what permits are required, and t obtain{A.rJts prior to workmg on
proJe~ts. C:' L
Date I Print Name l)~ I !\€Y' Signature
T Forms/Bu Idlng Dlvlslon/Bldg Permit Appl -2006 Code.doc
iR(),O:F:I:N:G:' :S:PiEOIAL'IST
., ", ';, ",' _', "" ',' ", ' ' ,> ~ 'L, \_ ,,-', , ,
Wiker & Wiker Construction, Inc.
43 Senz Road
Sequim, WA 98382
Phone: (360) 681-4800
Contractor #: WIKERWC981lM
Sven Wiker, Owner
Bid Proposal
g 0
Date:
Location:
Owner;
Bill To:
July 23, 2007
112 Orcas Ave Port Angeles
Marcy Smith
Marcy Smith 457-0266
Description Amount
Main House:
Tear off existing 3-tab shingles (one layer)
Apply 15lb underlayment
Use Ice & Watershield around pipes, hoods,~ and valley
Replace old pipe flashing and hoods (exclude p6'N0f pole flashWgl 'et~K {,'(\..~ ~q\\ ~ ~~\~
Apply 30 Year Laminated Shingles=-Elk, Pabco, lvIal~ " J
Six nails to each shingle (helps prevent wind damage) .~~S
Dispose of tear off to transfer station
Clean Up
$4885.00
Apply Ridge Vent $260.00
Tear off 2nd layer of old shingles - labor & landfill $840.00
-----------
(Subject to WASt. Sales Tax) Sub-Total $5985.00
Skylight: 2x4 curb, metal flashing - Add $350.00 to Sub-Total
(does not include skylight window or any interior finish work)
WIKER & WIKER CONSTRUCTION 5 YEAR WATERTIGHT WARRANTY
30 YEAR MANUFACTURER'S WARRANTY
-
Accepted By; Date:
-
o,'°" CITY OF PORT ANGELES
a'.~.~ PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. I~.)RT AN(iELES. WA 98362
ELECTRICAL PERMIT ISSUED: 7/31/2001 PERMIT NO 7353
OWNER/APPLICANT PROPERTY LOCATION
HAZEL HOPKINS 112 ORCAS E
112 ORCAS Lot: 8
Port Angeles, WA 98362 Block: 20 [] Long Legal
360/000-0000 Subdivision: PSCC 2ND ADD
T: S: Parcel No:
CONTRACTOR ARCHITECT
OLYMPIC ELECTRIC N/A
1805 TUMWATER
PORT ANGELES, WA 98362 , 98360-0000
360/457-5303 360/000-0000
PROJECT INFO
Project Type: RES. MISC. Project Value: $0.00
Occupancy Type: Construction Type: HEAT PUMP
Occupancy Group: Zoning Use: RS7
Electrical Heat:
[] Baseboard 0 KW [] Riser [] Underground Service
[] Furnace 0 KW [] Overhead Service Voltage: 120,240
[] Heat Pump 0 KW [] TempService Phase: [] 1 []
[] Fan Wall 0 KW Service Size: 0
Feeder Size: 0
PROJECT NOTES
FEES ASSESSMENT Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $45.50
Temp Service: $0.00
' Misc Fee: $0.00
TOTAL FEE: $45.50
AMOUNT PAID: $45.50
BALANCE DUE $0,00
(/OMMt:N'I S/ACTION NEEDED
ELECTRICAL PERMIT INSPECI'ION RECORD
CALL 417..4735 FOR ELECTRICAL INSPECTIONS PLF~SE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLAWFUL TO CO VER,
INSULATE OR CONCEA£ ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE { DATE ] YEsACCEPTI~DI NO COMMI~FFS
DITCH
ROUGH-IN / COVER
SERVICE
FINAL I ?/3?lot [ a~O' ]
.¢~.. .... CITY OF PORT ANGELES
~(~i' - DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
~ 321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT ISSUED: 8~27~2002 PERMIT NO: 13653
OWNER/APPLICANT PROPERTY LOCATION
112 ORCAS E
MARCIA SMITH
112 ORCAS Lot: 8
Port Angeles, WA 98362 Block: 20 [] Long Legal
360/000-0000 Subdivision: PSCC 2ND ADD
T: S: Parcel No: 063010502024000
CONTRACTOR ARCHITECT
KOCHANEK CONSTRUCTION N/A
4339 S. MT ANGELES RD
Port Angeles, WA 98362 , 98360-0000
360/452-3130 360/000-0000
PROJECT INFO
Project Value: $2,500.00 SFD Units: 0 Commercial: 0
Project Type: PORCH-NEW SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use: RS7
PROJECT NOTES
CONSTRUCT NEW FRONT PORCH 6 X16'6"
RECEIPT#9601
FEES ASSESSMENT
Building Permit: $83.25 Misc Fee 1: $0.00
Plan Check: $33.30 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $121.05
Plumbing: $0.00 AMOUNT PAID: $121.05
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
Separate Permits am 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 mad 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
construct~. ,,// /~ / /
Signate~rre of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORMS\1102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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 I DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CRILING
FRAMING
IOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEy
HOOD/ DUCTS
PW UTILITIES / SITE WORK (Englneering Division) SEPARATE PERMIT #'s:
WATEP~LIN E / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHOKELINE:
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/ CONSTRUCTION - R.W.
ENGINEERING 417 4807 PW / ENGINEERING
FIRE 4[7-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-48l$ _~. i/]~'. ~,~..- ~_l,~ BUILDING
T:\PLANNING\FORMS\1102.15 [4/2002]
~ ~oar~ FOR OFFICIAL USE ONLY:
d'°~ Date Re<.:
.e~,$~, BUILDING PERMIT - APPLICATION
Date Approved:
Dat~ ~sued:
The Building Permit Application must be filled out completely.
Please type or print in ink. If you have any questions, please call 417-4815
Applicant or Agent: ffocLa~ ~ ~. Phone: ~O ~5 7- fOZ~
0~er: ~a~C 1'~ 5~ , ~ ~ Phone:
Ad.ess: 112 ff ~*~5 ~Oe City: ~Or4 ~9C /e5 Zip:
Mchitec~ngineer: Phone:
Contractor /~ocLa~ /c ~o~ ~. License~: Exp:Rd ~} Phone: ~57-
Ad&ess: t/~3V 5 ~ g-ge[.c~a City: ~ ~ge/ec Zip: ~5~
PROJECT~D~SS: 112 ~ O~Ca n ~c ~NG:
LEGAL DESC~PTION: Lot: ~ Block: ~ Subdivision: ~ 5E( ~ Z ~d d
CL~L~ CO~TY P~CEL N~BER: Credit Card Holder Name:
Billing Addre~: Ci~:
Credit Card g: Exp. Date: , ~SA MC
TYPE OF WORK: SIZE/VALUATION:
13 Residential [] New Comer. [] Re-roof [] Wood-stove SF. ~ $ /SF. =.$.
[] Multi-family [] Addition [] Move [] Garage SF. ~ $ /SF. = $
El Commercial [] Remodel El Demolition yl Deck SF. ~ $ /SF.-$
El Repair [] Sign [] TOTAL VALUATION $
BRIEFDESCRIPTIONOFTHEPROJECT: AJd,~4 bt lO'O" Cowered ~)ece
COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type:
No. of Stories: [ Lot Size: % Lot Coverage: %
Existing Lot Coverage: /sq. ft. + Proposed Lot Coverage: /sq. fi. = TOTAL LOT COVERAGE: /sq. fi.
PLANNING USE ONLY: APPROVALS: PLAN
Notes: BLDG.
DPW
ESA/Wetland(s): El Yes El No SEPA Checklist required? El Yes [] No Other: OTHER
BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be filled out completely to be ctccepted for
review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your
completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division.
VALUATION OF CONSTRUCTION: In all eases, 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: Your plan check fee is due 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, this 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 107.4 of
the Uniform Building Code, current 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, and I am 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 applicant's
responsibility to determine what permits are required and to obtai~uc7
Applicant:'"~,4"'&4~' $t,-x /~ Date: t~ta ~ ~ 7t ~) -%
T:WORM SXAP PS~Buildingpermit
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
....
Date ~ ~'.- Time Received b phone, person)
Location of Work to be inspected 1~
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing i~al~.~ewer Excav. Other
INSPECTION NOTES: ~
Inspected: Date Time By
Remarks:.
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel [~Asphalt [~]PCC []Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 15893
// I " ~
/ - /',
Port Angeles, WashlngtolL_mm_________m_______mm_____________m____m___m, 19___m__
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to dO electrical work as listed below_
~::::sh::::!:l~:~~:~:~;:it:~~:~~~--~~~~~~:::___~~~:~~_~~~:::::::=:::::::::::::::::::::::::::::::::::::::
Wiring Co~tractor ooo((?'_f:~_",_J:_:t?.,-:,,_:r-C.~h_h____m By_oo_h_____________m__mm_mh_mmoohh__n___h____m__oo
~ U /.::J.(1/:1f{)
Light Outlets.........,..______.______.__.____.._..... Service, volts ................___..............__.._. Type of Wiring:
-?
Receptacle OuUets....___G.___.2._.....m.. No. wires ....::?---.............V.--..--- Armored Cable .........------...-...------..
Dryer KW...umh_tL..n..nn...._......_______ Size wires___.y~!.?~.:......__._.. Non.Metallic .......m______.______.._______.
- /:- _ ,r
Range, KW h--.7-!'-;:;!--.--..-------- Main fuse .._:.~/1.!.d....q....m...
Water Heater: ____ Enclosure __.5........................___......
Heat~:~:_::::::A~:;;_::~~:;.;;__q, TYp~::r:::~~ble ________ mm____mm_
r
Motors: size, volts and phase:
Knob & Tube_________oo____________._________
Rigid COOldult _h__h_hhh__h.h_______oo_
Metallic Tubing .........._.............-..
Rigid Conduit .m___________h___m________
Raceway ._....................._.........__.._
"3
Clrc~:~:t~~::t:-__-:__:__.::__:____:.:~::::::
;2
Range .__.______.___.________..____...___._____.._.
:2
Water Heater ____._.:....._...._............
MetalUc Tubing ___m
Current transformers:
No. & Size............._........_..__...
Ser. N 0..._....._.....___..___......._.........._____
Ser. No...........................__.........._...._.
Motor .............................._..............
0-
Dryer_____.._..__.__............................__.____
Furnace .............._..._..~_......_...........
Ser. No.....___..........._................_..........
/.)
Total .___.__________._.__....._.............
Total Load.........______.___..........
Sec. No. ..n_n..n_....._..__nn...__n_.._.......
Remarks: hd.hn.....u.~--hc::nt:.n.-!::-h--C.~..;.~'!.~u:-__-n-..-u----...nh--.n.nnnunuuu_._..nn..nunu#__UPhhnnnnn_____n
Permit Fee
;;J, '5 </
$___"_______oom...____._m____ooo___
Treas. Receipt
No......._______________...____
. ~7/j~)I' / p
B ~lr "/~ ffr/r..tl (.:1_~ u..! :::__~ _
y _.........n_____;n...n_.n_._#..__..__..n._.__.~.__n..'"'__.~~..
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con.
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
15893
Address___.._..........._.__._.._..............._...___.................___.___.............._..._.........................._._.__..........___Date..._._.__._____.._.._........_._._...._.......__....._..
Owner ..nnn..........nn__n______...__........._...._._.._...__.___......_n__...___...._...__..n_n.__._n..........nn__ Tenant....nn__..........n___n_nnn__._........___...n_.__.......n
WiringContractor___.___._............___............____._..._......_.....................__...__.__..._...__.___._____.___........__.____By._..._____..._........................................_..___._
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con.
cealed due notice must be given the Inspector so that work may be inspected before concealment.
1M Olymoic Printers. Inc.