HomeMy WebLinkAbout1419 E 4th St - Building PREPARED 9/03/10 8 10 12 INSPECTION TICKET PAGE 6
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 9/03/10
ADDRESS 1419 E 4TH ST SUBDIV
TENANT NBR DERRICK JAMES HALSEY
CONTRACTOR PHONE
OWNER DERRICK JAMES HALSEY PHONE (360) 461 0474
PARCEL 06 30 00 5 6 0045 0000
APPL NUMBER 10 00000863 RE ROOF
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL99 01 9/03/10 JLL BLDG FINAL
September 2 2010 3 51 43 PM 1pangrle
DERRICK 461 0474
BUILDING FINAL RE ROOFED THE HOUSE
THE PERMIT IS ON THE FRONT DOOR
COMMENTS AND NOTES
:au,; CITY OF PORT ANGELES
��� DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT BUILDING DIVISION
3321 EAST 5TH STREET PORT ANGELES,WA 98362
Application Number 10 00000863 Date 8/16/10
Application pin number 218938
Property Address 1419 E 4TH ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER 06 30 00 5 6 0045 0000
Tenant nbr name DERRICK JAMES HALSEY on your state excise tax form
Application type description RE ROOF
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 4200
Application desc
TEAR OFF & RE ROOF THE HOUSE
Owner Contractor
DERRICK JAMES HALSEY OWNER
1419 E 4TH ST
PORT ANGELES WA 98362
(360) 461 0474
Structure Information 000 000 RE ROOF THE HOUSE
Permit BUILDING PERMIT NO PR FEE
Additional desc RE ROOF THE HOUSE
Permit pin number 171447
Permit Fee 137 75 Plan Check Fee 00
Issue Date 8/16/10 Valuation 4200
Expiration Date 2/12/11
Qty Unit Charge Per Extension
BASE FEE 95 75
3 00 14 0000 THOU BL-2001 25K (14 PER K) 42 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 137 75 137 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 142 25 142 25 00 00 \V�
1�
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 has 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 corye . All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The gr�r tf of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulati g construct ri the performance of
construction
`� lb-lo err,c s
r"
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
O
BUILDING PERMIT INSPECTION RECORD
— PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS—
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION-
Footings
OUNDATION•Footin s
Stemwall
Foundation Drainage/Downspouts
Piers
Post Holes(Pole Bldgs)
PLUMBING
Under Floor/Slab
Rough-In
Water Line Meter to Bldg)
Gas Line
Back Flow/Water FINAL Date Accepted b
AIR SEAL.
Walls _
Ceiling
FRAMING ^�
Joists/Girders/Under Floor
Shear Wall/Hold Downs
Walls/Roof/Ceiling
Drywall Interior Braced Panel Only)
T-Bar
INSULATION:
Slab
Wall/Floor/Ceiling
MECHANICAL.
Heat Pum /Furnace/FAU/Ducts
Rough-in
Gas Line
Wood Stove/Pellet/Chimney
Commercial Hood/Ducts FINAL Date Accepted b
MANUFACTURED HOMES
Footing/Slab
Blocking&Hold Downs
Skirting
PLANNING DEPT Separate Permit#s SEPA.
Parkin /Lighting ESA.
Landscaping I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
Inspection Type Date Accepted By
Electrical 417-4735 7
Construction R.W PW /Engineering 417-4831 eb
Fire 417-4653
Planning 417-4750
Building 417-4815 2-22- 10
V
T.Forms/Building Division/Building Permit
°Rr�.,. BUILDING PERMIT APPLICATION Print in ink
r
•�"�- CITY OF PORT ANGELES
� For City Use Only
_ Attn Building Permit Technician Date Received 16-10
321 E. Fifth St. Port Angeles WA 98362
(360) 417-4815 fax (360) 417-4711 Permit# �p� (��
Date Approved
Applicant cr Gw 46- Phone j b -0
Property Owner e Phone
Property Owner's Address
Contractor f11 a t4C,,15ey Phone
Contractor's Address
License # Expires E-mail
PROJECT ADDRESS
Parcel Number Lot Zoning
Project Type & Brief Description. ia�idential ❑ Multi-family ❑ Commercial o Industrial
Check all that apply
❑ New Construction
❑ Addition
❑ Remodel
❑ Repair
o Demolition
COe-roof p klouse ❑ garage o other wear off& re-roof ❑ lay over one layer
o Heat System ❑ Heat pump o wood-burning stove ❑ gas fireplace o pellet stove ❑ other _
o Other
Floor Areas Existing(sq. ft.) Proposed(sq. ft.)
Basement @ $ per sq ft. = $
1 S1 Floor
2nd Floor
3`d Floor
Garage
Carport Xt�Q)s 0
Covered Porch Labor
Deck
Shed
Other
TOTAL VALUATION $ ZOC�
Total footprint of structures sq ft. T Lot size sq ft. = Lot coverage %
Site Coverage = the amount of imp;PAMC
u ce O a parcel including structures paved d �vewa sidewalks patios
and other impervious surfaces (s 1 9 135 for exemptions) coverageMax. height of proposed structuresft. Occupancy group # f bedrooms
Will a lawn sprinkler system be instOccupant load #o ull baths
Will a fire sprinkler system be instalConstruction type #of half baths
I have read and completed this application and know it to be true and correct. I am authorized to apply for this p rmi and understand
that it is my responsibility to determine what permits are required, and to obtain permits prior to rking on proje
Date " 6-
,�& Print Name �4,Cc% C k- 4g,I SCV Signature
T Forms/Building Division/Building permit application
Clallam County Assessor-& Treasurer-Property Details - 62022 DERRICK JAMES HA. Page 1 of 6
Clallam County Assessor & Treasurer
Property Search Results > 62022 DERRICK JAMES HALSEY for Year 2010 2011
Property
Account _
Property ID- 62022 Legal Description. CARTER'S,THOMAS W
SUBDIVISION LOT 14 BL
102
Geographic ID- 0630005600450000 Agent Code.
Type Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11
Open Space. N DFL N
Historic Property- N Remodel Property- N
Multi-Family Redevelopment: N
Township- Section.
Range.
Location _
Address: _ 1419 E FOURTH ST Mapsco
PORT ANGELES WA 98362 < �v
Neighborhood Cycle 5 Res Map ID- 2
Neighborhood CD- 10955130
Owner _
Name.m DERRICK JAMES HALSEY Owner ID- 194610
Mailing Address: 1403 SHIRLEY CT %Ownership. 100.0000000000%
PORT ANGELES WA 98363
Exemptions.
Taxes and Assessment Due - _ _-
Property Tax Information as of 08/16/2010
Amount Due if Paid on .
First Half Second Half
Year Statement ID Taxing Jurisdiction Base Due Base Due Penalty Interest Base
2010 447_01_ ST SCH STATE SCHOOL $15619 $15619 $000 $000 $1:
2010 44701 CC-GEN COUNTY $8311 $83.13 $000 $000 $E
12010 44701 PORT PORT $11 68 $11 68 $000 $000 $1
2010 44701 PORT ANG_ PORT ANGELES $192.4_5 $192.45 $000 $000 $1 E
2010 44701 _ SD#121 SCHOOL DISTRICT#121 $202.30 $202.32 $000 $0.00 $2C
2010 44701 NTH_OLY LIB NORTH OLYMPIC LIBRARY $2415 $2415 $000 $000 $2
2010 44701 HOSP#2 HOSPITAL#2_ $34 10 $3410 $000 $000 $:
2010 44701 WSMET PK DIST WILLIAM SHORE MET PARK DIST $1085 $1085 $000 $000 $1
2010 44701 CITY_STORMWATER CITY STORMWATER $3600 $3600 $000 $000 $�
2010 44701 WEED CONTROL WEED CONTROL $082 $081 $000 $000 9
2010 44701 TOTAL. w $751.65 $751.68 $0.00 $0.00 $7'
2009 620222008 ST S_CH STATE SCHOOL $178.38 $178.38 $0 00 $000 $3E
2009 620222008 CC-GEN COUNTY _ $90.28_ $90.27 $0.00 $000 $1E
2009 620222008 PORT PORT $12.79 $12.78 $000 $000 $2
2009 62_0222008 PO_RT_ANG_ PORT ANGELES $19802 $19800 $0_00_ $0.00 $35
2009 620222008 - SD#121 SCHOOL DISTRICT#121 $220.58 _ $22061 $000 _$000 $44
2009 620222008 NTH OLY LIB NORTH OLYMPIC LIBRARY $26.23 $26.23 $000 $000 $E
http.//vpn.clallam.net:8084/propertyaccess/Property.aspx?cid=0&year=2010&prop id=62 8/16/2010
�,pORTq"QF ELECTRICAL INSPECTION
u SAN
-W WIRING REPORT
FRIKS&��F 417-4735
DATE PERMIT# INSPECTOR
z a -a�t
OWNEAlCONTRACTOR
S�+-
ADDRESS y
APPROVED NOT APPROVED
❑ DITCH ❑
❑ ROUGH IN/COVER A
❑ SERVICE ❑
❑ FINAL ❑
CORRECTIONS NEEDED:
(-jFC_! 'iia-a t bis GPtzp,/_ FZ�c� "fFCc_�S
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Alf-c- Zz,5-0 lot-(
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
srr�- �ti- X04,%- c���e-C to les AK
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
.s
Application Number 09 00000913 Date 9/08/09
Application pin number 071454
Property Address 1419 E 4TH ST
ASSESSOR PARCEL NUMBER 06 30 00 5 6 0045 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
200 amp service
Owner Contractor
Halsey Derrick OWNER
1419 E 4TH ST
PORT ANGELES WA 983624707
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 153007
Permit Fee 93 75 Plan Check Fee 00
Issue Date 9/08/09 Valuation 0
Expiration Date 3/07/10
Qty Unit Charge Per Extension
1 00 93 7500 ECH EL 0 200 SRV FEEDER 93 75
Fee summary Charged Paid Credited Due
Permit Fee Total 93 75 93 75 00 00
Plan Check Total 00 00 00 00
Grand Total 93 75 93 75 00 00 41
INSPECTION TYPE DATE RESULTS INSPEC OR.
DITCHG *i? -1th) \a
SERVICE 109 114P
ROUGH IN a�
FINAL
COMMENTS \
Signature of owner or Electrical Contractor X Date
RECEIVED
City of Port Angeles Permit Application /I
Building Division/Electrical Inspections SEP 4 2009
321 East Fifth Street—P.O.Box 1150
Port Angeles Washington,98362 ELECTRICAL
Ph:(360)417-1735 Fax:(360)4174711 INSPECTIONS ��—
Date: q 10
�:l &2 Single Family Dwelling
Multi-Family or Commercial*
_Commercial Addition/Alteration/Remodel I Repair*
Plan Review May Be Reuired,Please Complete Electrical Plan Review Information Sheet
Job Address: 1'� (� t� 9
Building Square Footage:
Description of above goo kOtLf— ckl AQ to
Owner Information Contractor Information
Name: 1DW_F_ _(CK HFkL5-tS�7) Name.
Mailing Address: /N 1'7 W_ Mailing Address.
City. State: WA Zip. �;6 City. State: Zip:
Phone- Fax: Phone:
License#/Exp. License#/Exp.
Unit Charge Qtv Total(Qty Multiplied by Unit Charge)
$ 93.75 �_ $ !73_- Service/Feeder 200 Amp.
$113.75 $ Service/Feeder 201-400 Amp.
$160.00 $ Service/Feeder 401-600 Amp.
$205.00 $ ServicelFeeder 601 1000 Amp.
$291.25 $ Service/Feeder over 1000 Amp.
$ 2.00 $ Branch Circuit W/Service Feeder
$ 57.50 $ Branch Circuit W/O Service Feeder
$ 2.00 $ Each Additional Branch Circuit
$ 72.50 $ Temp.Service/Feeder 200 Amp.
$ 86.25 $ Temp.Service/Feeder 201-400 Amp.
$116.25 $ Temp.Service/Feeder 401-600 Amp.
$131.25 $ Temp.Service/Feeder 601 1000 Amp.
$ 75.00 $ Portal to Portal Hourly
$ 69.00 $ Sign/Outline Lighting
$ 75.00 $ Signal Circuit/Limited Energy Commercial
$ 50.00 $ Signal Circuit/Limited Energy 1 &2 Family Dwelling
$ 50.00 $ Signal Circuit/Limited Energy Multi-Family Dwelling
$ 93.75 $ Manufactured Home Connection
$ 80.00 $ Renewable Electrical Energy 5KVA System or Less
$ 86.25 $ First 1300 Square Ft.
$ 27.50 $ Each Additional 500 Square Ft.or Portion of
$ 57.50 $ Each Outbuilding or Detached Garage
$ 86.25 $ Each Swimming Pool or Hot Tub
$ 43.75 $thermostat
$ �3?�Total
Owner as defined by RC W.19.28.261 (1)Owner will occupy the structure for two years after this electrical permit is 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,I hereby certify that I am the owner of the above named property or a licensed electrical contractor I am making the electrical
installation or alteration in compliance with the electrical laws,N.E.C. RCW.Chapter 19.28,WAC.Chapter 296.46B,The City of Port Angeles Municipal Code,and
Utility Specifications.
Sign atur of owner electric I c tractor or electrical administrator ❑ Cash
Check Z'
X Date: / -7 -a ❑ Credit Card#
ELECTRICAL PERMIT 1
OITY OF PORT ANGELES
360-4174735
Appli0Agi* saber . . . . . 61282-050 4307 Date 3/15/18
Property`Actds;s8_.mbar 14194E '.
�,
. 4TH ST O" RT STATE SALES TAX
ASSESSOR PARCEL-NUMM: 06-30-00-5-6-0045-0000-
Application type +ti"cript:ion ELECTRICAL ONLY on your excise tax form
Subdivision Name to the City Of Port Angeles
PropertyUse .
Property Zoning . RS7 RESDNTL SINGLE FAMILY (Lo+cn Lode 0502)
Application valuation . 0
"
Application desc
-^----Rebuild-exsiting service and new garage j
Owner Contractor
--------------------- ------------------------
-SHELBY LYNN NAPIONTEK ANGELES 4ECTRIC
PO SOX 1-25 524 S. IST ST.
PORT ANGELESWA 98362 PORT ANGELES WA 98362
(366) 4524264 ,
---- ----- ---.-- --------------------=---------
Permit ELECTRICAL• ALTER RESIDENTIAL
f Additional desc
Permit Fee 120.00 Plan Check Fee .00.
Issue Date . :` . 3/15/18 Vai4 t:4on . . . 0
Expiration Date 9/11/18
Qty Unit Charge Per Extension
1.00 120.0000 ECH EL-0-200 SRV FEEDER 124.00 '3
----------------------
----------------------- ---- --------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- --------- ----------
Permit Fee Total 120.00 120.00 00. 00 ¢
Plan Check Total .00' ,.00 .00"' .00
Grand Total 120.00 126.00 .00 .00 -
w.
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k
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
03/07/2018 14:09 FAX 360 452 9265 Angeles Electric Q0001/0001
Orte\
y
CITY OF PORT ANGELES PERMIT APPLICATION ^l
Building Division/Electrical Inspection= �J
321 East.Fifth Street—P.O.Box 1150/Port Angeles Washington,98362
Ph:(360)417-4-034 Fax:(360)417-4711
Date: a ,_+�1 b 2 Single Family Dwalpnp
Plan Review May Be Required,Please Com Electrical !
Job Address: Y plate Plan Review rtfortttatieort Sheet
BuUM Square Footage:,
Descxi M of aWVs - _ - a.•- - - — _
Owner Informatio IL AvCort or his tion •
Nemo: Nirrrrk
bMaoiro Stebc qqr: ar: 21p:
Ptrone Far arc
l.icarcae 4/Exp LlcerMe !
Item Unk Charge
Servica Feeder 200 Amp. $MAO 9V S4ZV FY
ServicelFeeder201-400Amp. $14800 L
ServicelFeeder 401.600 Amp $20600
ServicelFeeder 601-1000 Amp. $26200
Servicefeedet over 1000 Amp. =37300 !
Branch Circuit W/Service Feeder $ LA0 !
Branch Circuit NO Service Feeder $ 63:00 ti
Each Additional Branch Circuit $ 600 t�
Branch Circub 14 $16.00 s
Terrp.SavicalFeeder200Amp. $ g3A0 s
Temp.Servi=FnW 2014W Amp. =11000 $
Temp.Servica Feeder 401.600 Amp. =149.00 S
Temp.ServicelFeWw 601-1000 Amp. =16800 ;
paw to Portal Hourly = 8600 =
Signai Circuitf Umbd•Eneryy-1 S 2 Family Dwelling $ d4A0
Manufactured Home Connection =120.00 =
Renewable Sech d Energy-5KVA System or Less $10200 i
Thermostat $ 6800
Note:$5.00 for each additional T-Stat
CONSIRUQNLY:
First 1300-Square Ft 12000 !
Each Additional 500 Square Ft or Portion of $ 40.00
Each Outbuilding or Detached(WW* $ 74.00 t
Each SwimMng Pod or Hot Tub $110.00
: Toted
Owner as defined by RCW.19.2&261:(1)Owner vdA ompy the structure for Iwo Yom after dit ONabW permit Is*Wind.(2)Owner Is MOW
to hire an electrical conbutor N above said property Is for talo,rentor lam 130mit.s Ira after sbt months of last Inspection.
After reading the above statement,I hereby certify that I am the owner of the above named properly or a kwmd eleelr W oorttratr W-I am MOW
the slectricai installation or alteration in compliance wfth the electrical laws,N.LC..ROW.Chapter 19.2x,WAC.ChwW 296.468,The Glc of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 repar ft EkctrkW ParmitAppliagons.
Signature of owner,elecbiat contractor or electrical adminlstrator. 0 e n 0 mutt
&W GY
'� olrslaou
i
I
i
1
NJV
ELEMUCALPERMIT
CITY OF PORT ANGELES
36040-4735 W
ApplicationNud�bet; 18-0000153i Date 10/01/18
Application pin ilumtser424730 REPORT STATE SALES TAX
Property Address . . . . 1419 E 4TH ST on your excise taxformASSESSOR PARCEL NUMBER: 06-30-00-5-'6-0045-0000-
Application a descr tion ELECTRICAL ONLY _.
PP YP P _..:.. �t�i"e of PQt�t A�r�l�
Subdivision Name
Property Use (Location Code 0502)
Property Zoning . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Security system \
------------------------------------------------------------ I
� 1
Owner Contractor
------------------------ ------------------------
SHELBY LYNN NAPIONTEK PROTECT YOUR HOME
PO BOX 125 3150 PRIORITY WAY SOUTH DRIVE
PORT ANGELES WA 98362 #200
INDINAPOLIS' IN 46240
(317) 810-4720
-----------------------------------------------------------------------------
Permit . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee 64.00 Plan Check Fee .00
Issue Date . . . 10/01/18 valuation . . . 0
Expiration bate 3/30/19
Qty Unit Charge Per Extension
1`.00 64.0000 ECH EL-SINGLE CIR LIMITED RES 64.00
Fee :summary ` Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 64.00 64.00 .00 00 j
Plan Check Total .00 .00 .00 .00
Grand 'Total 64.00 64.00 .00 .00
INSPECTION TYPE DATE: - RESULTS: INSPECTOR: JJ
DITCH I
SERVICE
ROUGH-IN
FINALAP
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
g`
Ad*
CITY OF PORT ANGELES PERMIT APPLICATION wlll "
Building Division/Electrical Inspections
321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362
Ph:(360)417-0735 Fax:(360)417-4711
Date 09/28/18 X 1&2 Single Family Dwelling
-Pian ft%*_w May Be Flegwed,Please Oorrplete Bec tnW Plan Flevtew Want bw Sheet
JobAdim 1419 E 4th St
EkAdrg940eFoA[t 1242 sq.ft.
D , 4" d abbe Installation of a low vottaae home security system
Owner Irtfoarieklon Contractor Infomtabon
NEM Cody Kotzerke Nerm Protect Your Roma
M tngAd"m 1419 E 4th St ?MkgAdy= 3750 Priority Way S Dr
ary, PortA%eles CUM WA 2pc 98362 CRY. Indiammob Site IN Zpr 46240
R1are 3604607451 Fmc n/a fhOM8865023559 Fes[ 3+75642547
LjowwM/Ejp n1a Lk)ErWM/E,p. PROTEYH934RS
ftet1 Unit mase Total cCYv KNOW by tktit Qwwi
Se A0WFeeder20DArrp. $12x00 $
SW*WFeeder 201400 M13L $146.00 $
SWVWFeeder401.6MArtp $2000 s
SmmA0WFeeder6W-1000Arrp. $2fiMOD $
SenkefFeeder over 100DArrp. $TWO s
wand,arait W Sevioe Feeder $ 600 $
„ _"63:6D
Each PdiianelBra;d arait $ &OD s
Do d i araits 1-4 $ 75.00 $
Tarp.Sermcaf Feeder200Mp $ MOD $
Terrp.SwAoefFeeder201.400Arrp $110.OD $
Twp.SwJam`Feeda 401-800 Arrp. $148.00 $
TarpSer%4mFeeda601-1000Anp. $168.00 $
Pbrtd to Pbrtel Hm* $ 96.00 $
Sk"arait/United EheV-1&2 Farcy DAdling $ 64.00 + $ se4.00
ivhr>t0adured Hare Cbrrrecdon $12000 $
ReremedeEkbiralEvmW-5WASyaemorLase $10200 $
Thermostat $ 56.00 $
t4Ye$&ODfor each adchawl T-ft
PEWCONSTR.I TOYCPLY:
Fwt 1300 Square R $1m00 $
Each AdAcnel 500 Square FL or PbrUen d $ 40.00 $
Each C LtWkkV or Dled Gerage $ 74.00 $
Each Sdrraring Pod or Hot Ttb $110.00 $
$ 584.00 Total
Ower as defined by FlLW.192&M:(1)Owner vA ooapy the dr a afor%a yeers efter hs electrical pwMt is finWized(2)Olener is retgtired
to hre an dechical contractor I above said property is far sole,rend or lease.Permit moms after six ffmft d last hmpecUm
After reeding the above sWe n aY l hweby ce*that l am the owner d the above named properly or a downs decitcel=63cbor.I am ffmm
tts dedriral installation or al on in corrpiianoe vvilh fhe decWcai laws,MEC.,FlLW.C hepter 19.28,WAC.almpter 296488,The CSy d Pbd
Angeles AMlcipei Code,and Lift 4*McOm and PAWN 14 05.050 regarding BeftEd Plamft A MIcellom
Signatureof owner,alWiicd contractor or electricel adrriNstrator: ❑ cash 51 Omsk
IR Creat cord rr
X 9X1494-11 octet 09/28/18 01/01012