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Home My WebLink About4509 Old Mill Rd - BuildingApplication 4% Application Number Pin number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Use Property Zoning Application valuation Owner GRAY RANDY /JENNIFER 31 NELLO PLACE SEQUIM (360) 683 2318 Permit Additional desc Permit Fee Issue Date Expiration Date T•\PLANNING\F'ORMS \1102.15 [11/14/2003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98382 04 00000984 948728 4509 S OLD MILL RD 06 30 22 2 1 9000 0000 PLUMBING REPAIR PLUMBING PERMIT RS9 RESDNTL SINGLE FAMILY 3000 Contractor 54 00 Plan Check Fee 00 10/27/04 Valuation 0 4/26/05 Qty Unit Charge Per BASE FEE 1 00 7 0000 ECH PL- EA LAWN BACKFLOW Fee summary Charged Paid Credited OSTERBERG LANDSCAPING 706 S H ST PORT ANGELES WA 98362 (360) 452 9511 Date 10/27/04 Due Permit Fee Total 54 00 54 00 00 00 Plan Check Total 00 00 00 00 Grand Total 54 00 54 00 00 00 Extension 47 00 7 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 constru do (6_7zz Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date 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 9ND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS FOUNDATION: FOOTINGS I I WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN PLUMBING 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 HEAT PUMP GAS LINE WOOD STOVE PELLET CHIMNEY HOOD DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 PLANNING DEPT 417 -4750 I BUILDING 417 -4815 I T•\PLANNING\FORMS 1102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD YES NO SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT I BUILDING 1 1 1 1 1 1 I 1 1 05/01/2004 11:52 13504521589 SHAMP ELEC PAGE 01 , 1/ (;'1 ELECTRICAL PERMIT APPLICATION POR. DFflCIAL USE OM.. Y D,.aIll...., PennitP: Ddt Approved; Due b\led" /. ~ The Electrical Permit Application mUl!;t bQ filled out C;Ql1:Jpl~~.~IY. Please type or reprint In ink, If you have anyque.llons,plcase call (360) 417-4735 Fax number: (360) 417-4711 . OWner or E1.e, Contractor Agent: /JllftmP F1 Ji'!TR KALe ONTefrcll Nr.. /0 C. pnono: Property Owner: . ~ A-\.j Addreso: '-I'SIY'l S'. ,) IJ f{\', \\ electrical Con~eclo" Sl-lmnP t\m'i'f lCA'L-(',[\ \.Y1iUk-ml & Lf[/2.-lh8~ Address: 'PO ~ oB 3 City. J)uY-T ~"I4<' U-A. . uHA'h)PEC02')D3 1I..\~ I ;r."MR /I: Exp:~' 04 City: .JlV'tr A-~ (,~ PS UJ{\ , Fax: ,3,;;>m-c- Phone: "1100 - S'lb t> ziP~&?fo1.. Phone: 4S? -II~ Z;p:~'l.. INSTALLATION WIRED BY: 0 OWNER XELECTRICAL CONTRACTOR Credit Card Holder Name: Mf\1(K W' SIJ.I"lrf)f 8/11lng ArldrMs: ClIO IN, ii)"11-1 :5h'fd . city: ,T>OCT f\\..\1$GLBS iN4, Credif Card Number. \ Exp. Date: ~ PROJECTADCRESS: L\SlR ~. bW M'd\ R.;:'~d. TYPE OF WORK: Check all that apply: ~ew 0 Alteration/Addition Zip: <:;j83rc 3 VlSA:X MC: ~Residential 0 Multi-family o Remote Meter 0 Detached garage o (;ommerclal [) Mobile Home ;J...753 ,2/;?37 'll.300-s~/G Sq. Ft o Hot Tub 0 Swim Pool 0 Seotic Pump o Low Voltage 0 Telecom. nSigl Number of Circuits added or a~ered: DESCRIPTION OF THE ELECTRICAL PROJECT: GG~€ 03 - 11-15) 41, ,70 1- ~\L;)75"3 ~Cl fT. , v.....2.:ere 5' ~~ . . T ~DTL /11f'.-'Tf-../.~ II. . I () UA $ ~7 rr30 Electrical Heat Load Additions and or Subtractions Service Information o Baseboard o Furnace o Heat Pump o Fan-Wall _KW KW TON -KW LRA o Overhead Service 0" emp Service o Underground Service VOltage: Phase: 0 1 0 3 Service Size: Feeder Size: I hereby certify that I have read and examined thIs applicatIon and know that same to be true and correct, 'and I a~ authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are require~' it remains th.. applicants responsibility to determine what permits are required and to obtain suoh. . r,J}f 04- ""'" Co" H."._..,.~~., _~ ~ Do" ~ \, \D~ . A ( Owner or Elee.Cont. Signature:, 'it...--it.- _ Date: 10 \ U O~ !2t- F o;1'~ vuP I b~W!O ( , . No ~+t,C-+ -oL..{s 's PERMITFEE: $~ C:IELECTRI . S . t /3.8 r LJri/l /1:, /^,/ 'PfMT T6 tJTI(.,lf!( r:c. b - 't' ' /7V(/ fR/;/ 1/7 -rA.'f-J~"" "J7 60. . , \ ~b/~l/~~~q ll:~~ 1~btlq8Llbtl':l ~HAMt-' t..Lt.G I""'Al:lt.. t::Jl , ,.. /) "1' r ,,/ (0 The E:~::::~~~i:t:~::~JC~02 y Please type or reprInt in ink. If you have any quesllons,plcase call (360) 417-4735 Fax number: (360) 417-4711 POR. ~FF1Cf.4.L USE OM. Y D~..alll._ PCl"IT'itP; Ode ApprovC\l: DUi:"blled: .. . OwnerorElec. ContmctorAgOnt:SI!ltmP FlECrRICALCONTVtcllNl. ItJC. >,nono: Lf5'L-lh8~ ProPerty Owner: . <S-a. N Addreso: lIsaq 5'. r')\J Nf, \\ ('ectrioal ConlTocto", ~p Umil' lCA'L-c{) \.\~l1~l /, Cily.j)DYT An~,<1, , LJ1\ . H-I~. i ;o..~~{{ PECOZ,B3EXP:I_13_04 City: ,jlU'tl AN. (,<'1 ~ W.(\. Fax: 3,;;>m-c- Phone: "1100 ~ 51.10 tl ZiP--9&?fo'l.. Phono: 4S? -II~ Zip:~1L Address:_l'o ?l'))( 38 3 INSTA~LATION WIRED BY: 0 OWNER XE~ECTRICAL CONTRACTOR Credit Card Holder Name: Mf\,:(K W. Slh'lrflf a/lllngArldrtuls: qln IN. fait! JtYfd city: tB'i.TA':'~ W"'. Credit Card Number: \ Exp, Date: ~ PROJECT ADDRESS: 1.\501 ;:), 1J~ M:l\\ R,,~J. . TYPE OF WO&K: Check ~ that apply: ~ew 0 Alteration/Addition Zip: ~83",:;' VISA:jL Me: ~Residential 0 Multi-family o Remote Meter 0 Detached garage o (,;ommerclal 0 Mobile Home Sq. Ft ;;"'753 .26737 . 1.joo S~/G o Hot Tub 0 Swim Pool 0 Septic Pump o Low Voltage 0 Telecom. nSigl I, Number of Circuits added or a~ered: DESCRIPTION OF THE ELECTRICAL PROJECT: ~:375"3 ::::.~ fT. . SJ....9..W 5} ~~ . Electrical Heat Load Additions and or Subtractions uj., Service InformatIon o Baseboard _ KW VOltage: CJ Fumace KW 0 Overhead Service Phase: 0 1 0 3 o Heat Pump _ TON LRA 01 emp Service Service Size: CJ Fan-Wall KW CJ Underground Service Feeder Size: ~ Af- n{V NttV/)5 70 Ct; F~Ed)-; I hereby certify that I have read and examined ttlls application and know that same to be true and correct, and I arr, auttlorized to apply for this permit I understand it is not the City's legal responsibility to determine what permits are re;~;n:~/~ remains the applicants responsibility to determine Wha&t permits are required and to obtain such, . .~,) -, Credit Card Holder's Signature: ~ . Data: \Q\I \Dl.\ . A ( - OwnerorElec.Cont.Signature:, t:.:""'--/- Date:..kh \04 Be I:: c;7~C; (;UP! 109w/0 I . . Nd e".,-F( ,'d - Oc As I s PERMIT FEE: $~ C:iELECTRICAlPERMITAPPLlCATlON t Q . Nttrr 7~ VT1.t. !-1-~/ 121 (h -- 't' /38 If 0 -or-I, - r.. I ~~ ......J(~......i I hCO t~lo~ , - ., '... tElIEC1rfRl~<CAIL !fi\!lS~EC1r~ON W~IFUN<G IRHE~OIRl1r 417-4735 PERMIT' 03- i 2-1 APPROVED NOT APPROVED o ................... DITCH ................... 0 o .............. ROUGH IN ICOVER .............. 0 o .................. SERVICE .................. 0 o .................... FINAL. . . . . . . . . . . . . . . . . . . . ~ ~~ M~-:-: "}5a-.Liv It!z:,: ;"~J<' 'S tJ~J c:L~;di:v' ~A_V - NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452.1381 ELECTRICAL PERMIT APPLICATION FOR OFFlCL".L USE ONLY Dale/ltec Pennit#: Dale Approved Date Issued , ! . The Electrical Permit Application rnust be filled out completely, Please type or reprint in ink. If you have any questions, please call (360) 417-4735 03 - /;2 / r Fax number: (360) 417-4711 Owner or Elec. Contractor Agent: ~Af15 ( If ~) Property Owner ~Mb ~ ~ If~ Address: "/ r,cq' C'" dt.. 'r, b>III./[ R. b . Electrical Contractor j Iff ~ tR"o .fl (h/..7!1, C Address: qJ,(!9, irox (00 ':A~[?~ Phon.@' Cj'z:!- 5 t;C. / Fax '[-;;61 - :::? /1> -:; City: (fA. Phone: License #: Zip r!~J/~7 i5''l If Ii EXP@tj Y ;?iY@.5 Phone '~.y~ l-d A0 If ' Zip 1.7f 3/1 '5 Cily: J1; YU'i . . INSTAllATION WIRED BY: 0 OWNER Credit Card Holder Name: r: / T I ~ECTRICAl CONTRACTOR \ bf<.IIJPM Ij fLhl'<L. Billing Address: p. (), ~c9 X. Credit Card Number: (., Exp. Date: J "'Yc: IL_, /.(f/J-t;!f ' P ~, /{/',ASI/ qa "I '" Zip: '1]/...:J r VISA:_ MC: L PROJECT ADDRESS: 4 ,~ 0 '1 L:..l ol.b IJIII,I.-. Rh TYPE OF WORK: ~idential Check 2!1 that apply: o New o Alteration/Addition o Multi-family o Remote Meter o Detached garage o Commercial 0 Mobile Home Sq. Ft o Hot Tub 0 Swim Pool ~PtiC Pump o Low Voltage 0 Telecom. DSign Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT: I{ f"--i() 1(&/11 If _ olf./2/l e.. ;Od '" P t9/f/L / Electrical Heat Load Additions and Or Subtractions Service Information -" o Baseboard o Furnace o Heat Pump o Fan-Wall _KW KW TON_LRA KW o Overhead Service o Temp Service o Underground Service Voltage: Phase: 0 1 0 3 Service Size: Feeder Size: I hereby certify that I have read and examined this application and know that same to be true and co(rect, and I 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. Bf}/OtY Credit Card Holder's Signature: Date: f!J(.,/ Owner or Elec. Cant. Signatureu~ ~If), (l t Date: M)CP {~, '},t'Joj o1r '* -J-L PERMIT FEE: $ 'I ;;% C:/ElECTRICALPERMIT APPLICATION /eo Bitt/or 03/17/2004 15:03 13504521589 SHAMP ELEC PAGE 01 ..... " ELECTRICAL PERMIT APPLICATION FOil. (lFFlrJ.....l,fJSEONty OI,lclRl'C: .. ____'__.._.. ___ [',""it'" ._n'_"_.______. O~tC^FPfoved:_.. Du~k'lIc~ ""._. "'_ The Elcctric:lIl Par-mit Applic:ltion rnus:t bo "!lad aut eomDIDflClly. Please. type or reprint In ink. 'fyou hav@any ClUl::!stlonsj pleas~ call (360) 4174735 Fax number: (360) 411-411 1 07"-220 Owner or Elcc, Contractor Agen!; SflitmP ELi1",'R/C!tLC UiJ ft/fC)J /lib /1..1 C. Phone; ~["2.-1 ~ Sq Fax: Property Ownor' -E1A~ - .I l I ~ Phone LfS'~~' 'M', rJ S. 01(..1 IV I I . S 0 ress J..oLl..;--WJ.l...I....k.~Ee't.. ~~ City ~O'l2-r t\:...Ihel.-b'S, uJ.4. , . _ LiHFl IY)P EC023l>; /VI.'j, :"", Con'mo'o' ~p ",l-r-<"l1lC.41~LJ..I1~. Lioeo'.~: exp: I ''23 C'I Address:~t;G)( .";83 City; .p~T A\'':, b'G'1..f'S lAi-l\ . 3,:;>m.e- Zip; ~e~2._ 1'''000' 45'1. I ~,g'J Zip' Cj63~Q.. INSTALLATION WIRED BY, DOWNER ~LECTRICAL CONTRACTOR Credit Card Holder Name: NA IZ K 'IN. JIWrri')f Billing Address: Cj 10 V-J I;) "i'tIJtY(.d Credit Card Number; 45'0'1 S. OI.-l> I\\\t.t.. ?-O. PROJECT ADDRESS: LOt I. , M \ LL C~ Check all that apply: \.ffNew City: ,p [5'(.T A hl (,G~ Exp. Date: - i,04 Zip: G)8?':~ VISA:.lL MC; TYPE OF WORK: - l::6\i'\"n~~ I'u g. OL P tr\ \ LL f.l). o A1terationlAddition \dResidential 0 Multi-family o Commercial 0 Mobile Home Sq. Ft o Remote Meter C1 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump o Low Voltage n Telecnrn, n ~ Number of Circuits added or altered: DESCRIPTION OF THE EL.ECTRICAL. PROJECT: S ~ -f J tm.p . Electrical Heat Load Additions and or Subtractions Service Information o Baseboard (J Furnace CJ Heat Pump U Fan.Wall _KW KW IUN KW LKA o Overhead Service [J I emp Service n Underground Service Vo/laoe: Phase: 01-(:i-3- Service I:>ile: Feeder Size: . :Y;'h1 //A.Mt. ff, I nereby certify that I have reaa and examined this ap;Jj;;ation and know that same to be true and correct. and I a authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; if remains the appli():;lnts r"8(lnn.~ihi1ity tn rl"t"rminR what (l",rmifs "If" re'1//ir"danrl to nbtl'lin such, it,;'<!- . Cro'"C."'H.".......'..."M' ~ ~ Do'" B-I'71H ~ ,4--&- Ow..",S~. C"'LS.,o,,"ro, -"<-4- . z.r D""av/2-iij ~ \ ~ '/7&3 HrL Wr-' /'&CJ/-s;01' '7. E:$~ '\",cTR.lA~PERMITAPPLlCATION D, < . ) fUr.. C ' /' f'-L:.~.D . <7f..., -r~/P {l1. tJW '170P (Jr'2A/:..."..- ~ic <. t\L- _ ) CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 03 00001214 Date 6/17/04 Pin number 055170 Property Address 4509 S OLD MILL RD ASSESSOR PARCEL NUMBER 06 30 22 2 1 9000 0000 Application description RES NEW SFR Subdivision Name Property Use Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 135939 Owner Contractor GRAY RANDY /JENNIFER ANDERSON HOMES LLC 31 NELLO PLACE 618 SOUTH PEABODY SEQUIM WA 98382 PORT ANGELES WA 98362 (360) 683 2318 (360) 452 4641 Structure Information NEW 2089SF SFR W /ATTACHED 736SF GARAGE Construction Type TYPE V NON RATED Occupancy Type SINGLE FAM CONGREGATES Other struct info TOTAL LOT COVERAGE 18 50 CONSTRUCTION TYPE V N NUMBER OF STORIES 1 00 EXISTING LOT COVERAGE 1 00 LOT SIZE 17460 00 PROPOSED LOT COVERAGE 3233 00 TOTAL LOT COVERAGE 3233 00 NUMBER OF UNITS 10 00 Permit ELECTRICAL NEW RESIDENTIAL Additional desc LV SECURITY AUDIO TV SYSTEM Sub Contractor HI TECH ELECTRONICS Permit Fee 40 90 Plan Check Fee Issue Date 6/17/04 Valuation Expiration Date 12/14/04 Qty Unit Charge Per 1 00 40 9000 EL LOW VOLT SYS =2500 SQFT Special Notes and Comments Down spouts from roof gutters shall be piped to drywells or may be piped to curbs that flow to strom drains No pressurized or pumping to curbs are allowed Address numbers shall be plainly visible from the street Address numbers shall be a minimum of six inches high and be in contrast in color of there background Electrical load calculations and elctrical permits are required 4 wide gravel walking surface per City stanards required for school route Other Fees STATE SURCHARGE PW WATER SYSTEM USE FEE Fee summary T \PLANDTNG\FORMS \1102.15 [11/14/2003] Charged Paid Credited 4 50 1025 00 Due Permit Fee Total 40 90 40 90 00 00 Plan Check Total 00 00 00 00 Other Fee Total 1029 50 1029 50 00 00 Grand Total 1070 40 1070 40 00 00 0 0 0 Extension 40 90 Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work as commenced or if required inspections have not been requested within 180 days from the last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date 0 U 0 r 70 CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN PLUMBING UNDERFLOOR /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 I INSULATION SLAB BUILDING PERMIT INSPECTION RECORD YES 1 NO WALL FLOOR CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE PELLET CHIMNEY HOOD DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING /LIGHTING ESA. LANDSCAPING I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE RESIDENTIAL DATE YES NO COMMERCIAL DATE I ACCEPTED 1 YES I NO ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING I FIRE 417 -4653 I I PLANNING DEPT 417 -4750 I I BUILDING 417 -4815 I T: \PLANNING FORMS \1102.15 [11/14/2003] I FIRE DEPT I PLANNING DEPT I BUILDING T• \PLANNING \FORMS \1102.15 [11/14/2003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 03 00001214 Pin number 055170 Page 2 Date 6/17/04 Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work as commenced or if required inspections have not been requested within 180 days from the last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE /DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN PLUMBING UNDERFLOOR /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 HEAT PUMP GAS LINE WOOD STOVE PELLET CHIMNEY HOOD DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT 417 -4735 FIRE 417 -4653 I PLANNING DEPT 417 -4750 1 BUILDING 417 -4815 T \PLANNING FORMS \1102.15 11/14/2003] FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE DATE YES NO COMMERCIAL DATE I ACCEPTED 1 YES I NO 8 -13 -0q Ac D YES i NO SEPA. ESA. SHORELINE. ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING FIRE DEPT PLANNING DEPT BUILDING COMMENTS C �poar 4 n St" UMW A0% Address:? QZ /IA t (-1- Electrical Contractor 7 Address' a3 6 P1-6w-°7 Electrical Heat Load Additions and or Subtractions C. /ELECTRICALPERMITAPPLICATION ELECTRICAL PERMIT APPLICATION The Electrical Permit Application must be filled out completely. Please type or reprint in ink. If you have any questions, please call (360) 417 -4735 Fax number (360) 417 -4711 Owner or Elec. Contractor Agent: 14I 7 fLa e...'i Property Owner iamb y 4 Phone. City 1 my V AS Zip 7U 3 6z License Exp: Phone. ST City AI-T Zip Ca,Z INSTALLATION WIRED BY OWNER ELECTRICAL CONTRACTOR Credit Card Holder Name Billing Address. City Zip. Credit Card Number Exp. Date. VISA. MC PROJECT ADDRESS: C)C_ MILL TYPE OF WORK. Check all that apply New Alteration /Addition I KResidential Multi- family Commercial Mobile Home Sq Ft Z q a® 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 Owner or Elec. Cont. Signature Al"— 5 `1 5 T 'l o B(57 kzeoise FOR OFFICIAL i tUSF ONLY Date/Re Permit Datc Appr ed Date Issued: a$ 2- 2727 Phone. Fax: Fax: q52--$S-a- Service Information Baseboard KW Voltage: Furnace KW Overhead Service Phase 1 3 Heat Pump TON LRA Temp Service Service Size. Fan -Wall KW 0 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 60/1 64- Credit Card Holder's Signature Date PERMIT FEE Date <p /9 /Q4/ ,90