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HomeMy WebLinkAbout1032 E 4th St - Buildingof poRr .w Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation RAMSEY MARK /JENNIFER 1032 E 4TH ST PORT ANGELES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 983624111 07 00000845 129520 1032 E 4TH ST 06 30 00 0 1 7700 0000 JENNIFER RAMSEY RE ROOF RS7 RESDNTL SINGLE FAMILY 1500 Owner Contractor OWNER Fee summary Charged Paid Credited Due Date 7/17/07 Permit BUILDING PERMIT NO PR FEE Additional desc TEAR OFF AND RE ROOF Permit pin number 107367 Permit Fee 80 50 Plan Check Fee 00 Issue Date 7/17/07 Valuation 1500 Expiration Date 1/13/08 Qty Unit Charge Per Extension BASE FEE 50 00 10 00 3 0500 HND BL -501 2K (3 05 PER C) 30 50 Other Fees STATE SURCHARGE 4 50 Permit Fee Total 80 50 80 50 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 85 00 85 00 00 00 Signature of Contractor or Authorized Agent Date T \Policies \1102_15 building permit inspection record05 wpd [1/4/20051 D finer (if o n-r is builder) 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 days if construction or work is suspended or abandoned fora 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 loc .w regulating construction or the performance of construction 1 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, IA'SULATE OR CONCEAL 4NI' WORK BEFORE INSPECTED 4ND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE I ACCEPTED I COMMENTS FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) 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 I DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL ROUGH -IN HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY I MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s ELECTRICAL LIGHT DEPT BUILDING PERMIT INSPECTION RECORD YES 1 NO 1 FIRE 417 -4653 I 1 1 I PLANNING DEPT 417 -4750 I 1 n I A I 1 BUILDING 417 -4815 I) O O O 1 xP( WA T• \Policies \1102 15 building permit inspection record05 wpd [1/4/2005] FINAL DATE ACCEPTED BY. FINAL SEPA. PARKING /LIGHTING ESA. LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE RESIDENTIAL DATE YES NO COMMERCIAL 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW /ENGINEERING FIRE DEPT PLANNING DEPT BUILDING DATE ACCEPTED BY. DATE ACCEPTED YES I NO I I I I I I I I I I T.RGAL DESCRIPTION Lot: Fill out COMPLETELY and h INK Your application and site plan MUST BE COMPLETE to be accepted for review If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4711 Applicant c r Agent: Owner N. L'X)Y11 RraIYl4 P A Address: Architect/Engineer Contractor Address: State License 4 City' PROJECT ADDRESS 1 032_ E, y S4- CLALLAM COUNTY PARCEL NUMBER. TYPE OF WORK. Residential New Constr P� Re -roof Stove Multi family Addition 0 Move 0 Garage Commercial Remodel Demolition Deck Repair Sign Other BRIEF DESCRIPTION OF THE PROJECT Block: COMMERCIAL/RESIDENTIAL. Occupancy Group No of Stones: Lot Size: Existmg Sq. Ft. Total lot coverage PLANNING USE ONLY T•\FORMS\B1dgPermitform.wpd Applicant: c BUILDING PERMIT APPLICATION City 42 ST7.F/VALUATION SF /SF SF /SF SF /SF TOTAL VALUATION 1.5D/9, t .1 cP IV r1 VOILvs it_ I i Occupant Load. Construction Type: Proposed Sq Ft. TOTAL Sq Ft. ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other Phone. Phone. Subdivision. Phone: Exp Zip Phone: Zip ZONING Date: 7 FOR OFFICIAL USE ONLY Date Rec. 0'?- r -07 Permit 4 07- Date Approved: 07 Date Issued: 11 APPROVALS PLAN BLDG DPWU FIRE. 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 Coordmator 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 issnrnce. 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 l have read and examined this application and know the same to be true and correct. 1 am authorized to apply for this permit and understand that its my responsibility to determine what permits are required not the City's, and that 1 must obtain such permits prior to work. Application Number 07 00000844 Application pin number 976704 Property Address 1032 E 4TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 7700 0000 Tenant nbr name JENNIFER RAMSEY Application type description SIDING Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 1500 RAMSEY MARK /JENNIFER 1032 E 4TH ST PORT ANGELES CITY OF PORT ANGELES 0 DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 'J 321 EAST 5TH STREET PORT ANGELES, WA 98362 Owner Contractor WA 983624111 T \Policies \1102_15 building permit inspection record05 wpd [1/4/2005] OWNER Date 7/17/07 Permit BUILDING PERMIT NO PR FEE Additional desc SIDING Permit pin number 107359 Permit Fee 80 50 Plan Check Fee 00 Issue Date 7/17/07 Valuation 1500 Expiration Date 1/13/08 Qty Unit Charge Per Extension BASE FEE 50 00 10 00 3 0500 HND BL -501 2K (3 05 PER C) 30 50 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 80 50 80 50 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 85 00 85 00 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 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 loca:- -w regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature 1 AP wn (if `finer is builder) Date N n BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417 -473' 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 4ND ACCEPTED POST PERMIT IN 4 CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) 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 W ALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL ROUGH -IN HEAT PUMP /FURNACE /DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 I FIRE 417 -4653 PLANNING DEPT 417 -4750 1 BUILDING 417 -4815 DATE YES NO FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE DATE YES NO COMMERCIAL DATE I ACCEPTED 1 YES I NO 417 -4735 ELECTRICAL LIGHT DEPT I I I 1 1 in_70-ng i 1xfl t1 T \Policies \1102 15 building permit inspection record05.wpd [1/4/2005] ACCEPTED COMMENTS FINAL FINAL SEPA. ESA. SHORELINE: CONSTRUCTION R.W PW ENGINEERING FIRE DEPT PLANNING DEPT BUILDING DATE ACCEPTED BY. DATE ACCEPTED BY. BUILDING PERMIT APPLICATION out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4711 Applicant cr Agent: r Phone: Owner �L'Yl h 1 .TY1 P,i A Phone: f 299 Address: U City Zip Architect/Engineer Phone: Contractor State License Exp Phone: Address: City Zip PROJECT ADDRESS 103L E, yam Si- ZONING LEGAL DESCRIPTION Lot: Block. Subdivision. CLALLAM COUNTY PARCEL NUMBER. TYPE OF WORK. STZE/VALUATION Residential New Constr Re -roof Stove SF /SF Multi- family Addition Move Garage SF /SF O Commercial Remodel Demohtion Deck SF /SF Repair Sign Other S f'n TOTAL VALUATION /5 2t), DO BRIEF DESCRIPTION OF THE PROJECT J lea,✓— o 4Px.,•K+,' g 1ainc cxf,f ✓oplu Cf J/ h) f J Nn 1 00.ln+, ties COMMERCIAL/RESIDENTIAL. Occupancy Group Occupant Load. Construction Type No. of Stories: Lot Size: Existing Sq Ft. Proposed Sq Ft. TOTAL Sq Ft. Total lot coverage PLANNING USE ONLY ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other FOR OFFICIAL USE ONLY Date Rec. O7 p 1 1 -07 Permit D4 Date Approved: 07 1 7 -6 Date Issued: I APPROVALS PLAN BLDG DPWU FIRE. 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 Coordmator 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. EXP RATION OF PLAN REVIEW If no permit is issued within 180 days of the date of apphcation, 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. hereby certify that 1 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 its my responsibility to determine what permits are required not the City's, and that I must obtain such permits prior to work. T•\FORMS\BIdgPermitform.wpd Applicant: Date: , Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000276 Date 557600 1032 E 4TH ST 06-30-00-0-1-7700-0000- ELECTRICAL ONLY 3/05/08 RS7 RESDNTL SINGLE FAMILY o Owner Contractor RAMSEY MARK/JENNIFER 1032 E 4TH ST PORT ANGELES WA 983624111 APS ELECTRIC 546 BENSON RD. PORT ANGELES PORT ANGELES (360) 452-6753 WA 98363 Permit . . . . . Additional desc' . Permit pin number Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL APS ELEC/ REPLACE PANEL 122077 64.00 3/05/08 9/01/08 Plan Check Fee Valuation .00 o "'-- \J WI N Qty 1. 00 Unit Charge Per 64.0000 ECH EL-R OR RM 0-200 ALT SRV FOR Extension 64.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 64.00 64.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 64.00 64.00 .00 .00 ~ ~ \j\ 1 r; SPECTION TYPE DATE: RESULTS: DITCH SERVICE OUGH - IN FINAL OMMENTS: .3 7, DB ~ ELECTRICAL INSPECTOR: ~ S~<"V12:l.~'( ~h~S iJG, rr-U-Dk>ti:17 N~c- o/Kl<:. ~ III~T Ra-~AB- LiZ..... I, g)<f:~ {I CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number Property Address . ASSESSOR PARCEL NUMBER: Application description Property Zoning . . . . Application valuation , 03-00000195 1032 E 4TH ST 0630000177000000 RE-ROOF Date 2/27/03 1500 , Owner Contractor ------------------------ RAMSEY MARK/JENNIFER 10~2 E 4TH .ST PORT ANGELES WA 983624111 OWNER ----------~-------------~-------------------------~--~~--------- Permit . . . . BUILDING PERMIT - NOPR FEE ------------ Additional desc Permit Fee Issu.eDate Expiration Date 77.50 2/27/03 8/26/03 , Plan Check Fee Valuation .,00 1500 Qty Unit Charge Per nxtension SASE 'FEE 47.00 - - - - - ~~~~~ ~;~~~ - - -- -= ~ ~=~~ - ~ - - - ~~= ~;~~~ -SOR-~~~~-GE:~~-:~ - - - - - - - - -:.- - - - =~ ~ =~- . . . . . . ~ 4.50 ------ . Fee summary Charged . Paid Credited Due ------------.---- --........----... ---------- --...------- ---------'- Permit Fee 'rotal 77.50 77.50 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee 'rotal 4.50' 4.50 .00 .00 Grand Total 82.00 82.00 .00 .00 \2y ,(;J.'. <p. \\') , ..:t: ::-f. :s..' . (YS :i Signature of Contractor or Authorized Agent 'Date i1der) <Z- ... ?.-7 - c;J. Date Separate Permits are required for electrical work, SEPA, Shoreline, ESA;utilitjes, private and public improvements. This permit becomes null and void if work or construction authorized is riot commenced within 180 days, if construction or work Is suspended or abandoned for a period of180 days after the work as commenced,orif req~lred 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 ordil;lances governing this type of work will be complied with whether specified herein or not. The granting of apermitdoes 110t presume to give authority to violate or cancel the provisions' of any state or local law regulating construction or the performance of .construction. T:\PLANNlNG\FORMS\1102.1S [412oo2J BUILDING PERMIT INSPECTION RECORD CALL417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HpUR 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 'I I lNSPEcrION TYPE DATE I ACCEPTED COMMUITS YES NO , , FOUNDATION: FOOTINGS , WALLS " FOUNDATION DRAINAGE . ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH.IN ., . I I PLUMBING UNDER FLooR/ SLAB ROUGH~IN WATER LINE GAS LINE ", BACK FLOW 'WATER AIR SEAL ;cc " WALLS '. CEILING . , FRAMING' . JOISTS' GIRDllRS SHEAR WALL '. WALLS / ROOF' CEILING DRYWALL T,BAR INSULATION SLAll WALL / FLOOR / CEILING I . MECHANICAL HEAT Pt,lMP . '. WOOD STOVE: I PELLET / CHIMNEY HOOD / Duers pw UTILITIES! SITE WORK (Engineering Division) SEPARATE PERMIT #'5: .' W A TERLINEI METER. SEWER CONNECTION '. . SANITARY '" STORM , PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: PARKlNGILIGHTING . ESA: LANDSCAPING SHORELINE: , FINAL INSpEcrlONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTJAL DATE YES NO COMMERCIAL I DATE, ACCEPTED ! YES NO ELECTRICAl.. LIGHT DEPT.. 4174735 . i '. ELECTRICAL , LIGHT DEPT CONSTRUCTION R. W. I PWI CONS~CTION .8'- w.: ENGINEERING '. 4174807 PW / EN lNEERlN '. FIRE 4174653 I FIRE DEPT. ! PLANNING DEPT. 4174750 f-"I.DJY"~ PLANNING DEPT_ , BUILDING 4174815 01.'111 . . .1- L BUILDING '''''I'll ni-~ , T:\PLANNlNG\fORMS\110:!.15 [4J200~] , ''0t::::7--- - CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Nl! 17208 Port Angeles, washlngton......._.....L__:;:.:um.m.....................u. 19..r.fj:J 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 d6 electrlca] work as listed below. ? AddreSj u../6l!?._l:J~,..u. .~.:?(.;t.--m-"1Z<muu.um.m Occupancyu_..,.-:td.di2..~.mm.n__uumuu___ o~~erJ~~-~u(.m.um:f;i~i:::~:~:::;: - ,:.;nant....m.m.mmm_..__________.m______uuuu.m.mu__.m__u Wmng Contractor _.m.._ .._!.?:.__m~~mmm_u__________u_.___u_m By__mm.mmummu__mumumum___uummm.m___u Light OUtletB_________!..'.__~=__~_________~ ServIce, volts _d~/..-#.::-y.-r;- Type 01 Wiring: Receptacle outlets....E.p.............. No. wires ...n_?.....h_.....___.h_.__....~ Armored Cable .............................. Y/';? &' ;?/ Dryer KW C, Size wires..........__......_.............._.. ~:~:'r K:.~~~~-.-Z?j~-;-------------------- ::~:o:::: :::~~~~=:_:-::: 9:;:S KW.n__hn_______n"nhn_____nn____ Heat' KW_____hL3._mll/l.______ Type of wIring: Entrance Cable ..___.____...m___..___...__ Motors: size, volts and phase: Rigid Conduit .h..............__..n........ MetalUc Tubing ..___m..m............__ Current transformers: No. & Size.........n..........__n.............. SeT. NO........._n.................______............ Ser. No........._______.__......____..........____... Ser. No...__......................................... Non.Metslllc ________________________._____h_ Knob & Tub"---_________________.___________. Rigid Conduit ___________________.__________ Metallic TUbing .m...._m............... Raceway _......................_....._._..._ <:: Circuits, Llght................................_.... UtlIity ____K____________________________.____ Heat ......~.~..........................-...... ~ Range ........~....._........................ ;:) Water Heater ......d....................... Motor ............................................. Dryer........;;;?..........__......................_ Furnace .........................._......_........... "lY Total Load______.____.................. Ser. No...__._..........._.......................__. Tota) ........:::':...!:........................ --. ~' Remarks: ____.__n__.___m(::.:e'J::!:""..d__~~.~r!.i2_n_h__.~c-U.'~.~_.______.__m____mm__mm.m.mu__.___.u . /. -;~.=i~~:~~-u.-u-u__~-u.-u.-umu::~_~.~:__~~.~:~.~.~~...~~~~~mm-.m.mm::-_>$Z:li1:;.;~::~~ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If 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 ~I' \"':.'-' ELECTRICAL PERMIT N? 17208 Address.............................._....._......._........................................._.........................___.....................Date..._......_.._.._.._.........._......_......_......... Owner..................................._..._.__.._......_......_.._...........................................................Tenant.................................................................... '.-~lring Contractor ........................_........_._......_............................................................................. By............................................................... ), NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con. cealed due notice must be' given the Inspector so that work may be inspected betore concealment. .' 1M Olymple P,J~". Ino_ 0- -31 ~'_. .~ .- ..~'i ~ .' -... ,f .::! _ 1':, . . El(E~TRICAL WORK PERMIT APPLICATION ~ ,tl.- J-l-db I " .lob wired by iilElcctrical Contractor 0 Owner InstaJJation description a CommeTcfal l\( Residential Ele~lricul contractor name ~ It<=ense fl,"n.ber If, D<lte upires A. P. ~ ' 61 ('./ 1"/ C(1,{ !..d:lY\.-t"v-. P",ch~'~F~;ng a~ 060 (\ RJ.. City ~ ~ ^ ~ Slat< ZIP - t3 -1' 'ttI-1It) -eS Telephone number L""'t t.: "'2 PAX numbel'" -"61<>0 - 'loa -€I · 'iLl ~ z.e~ o New )(AIU~redlAdditiOd \AlA. q'i~b3 S~fII.~ R~ ~ ~(M\L.Q ('J~AUb ~ pr~wne~ Addre~'l of inspection _.l.- O~;;). &CJ/.Vf' City P-P., din~: ctho -/Cj 5"1 Ow,,(!r~' defined by RC",:J9,28.~6J:(]) Ownel' will OCCtI.Y III! Slr'llt:rurofor two yf....'rs afler (his dectricu/ per-mil is finalized. (1) OvmeT j$ rlt([UireJ to hin- (m r.lectrical COll17'acror if above. said prOpf!rry is for sale, rent or lease.. After reading the above statement. I hereby certify that I am the oWl\er of the above named property or a licensed tleccrieal eontraclor. I am making. the electrical insTlI.1. Imioo or alteration in CQmplianct; witll the elcerrieallaws. N.E.C,. RCW, Chaptcr 19,28. WAC. Chapter 296~46B, The City of 1'0" Al1gclc$ Municipal Code. and Utility Specifications. Sigaatllre uf UWDcr. o Cash 0 Check # o CrcrlilCard Visa Card # (fYt~ Mastercard Discover CC~J ~ el;t~~;: 33\i:~r:~ Expiration Date of card EI ri L . r subtractions liil. NO LOAD CHANGES Q Baseboard KW CJ Furnace KW o Hem Pump _ Ton _ LAR o i=an-Wall KW ~ Dverllead Sarvice o Temp Service o Underground Service Vollage ;zJ.lO Phasaili:ll Q 3 Service Size,>z.~j: Feeder Size: . SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 0:11= ....~llro"CIJ By D~l<: AJl/,T(Wcd Hy SERVICE 317(~ ~y FEEDER I)..re App.....,cll By../ ,- ROUGH.IN THERMOSTAT ~FlN~~m~,"' DITCH 031e AI'f'Mveol My Inspection Dale .o\rca, Building or f:quipTlll,.'"Ilt Inspected Action Taken Electrical Inspcctor s-S-oS Ccv/irt OI'f3.J/.Jb-.WSl"'.2s 1.J,,,fJOw wl7W NO,J-cA>J'.u~ ~tT)' /9lte.s ~ />>'114" hi' JtlJIf<<8SAiJiE. OiJ.i~wtSt: 5€:12v,a; E'lviWWCE l.JIl.-L Ant. ]Q &: CrlIW6f,.-tJ 7l> />taT NFL- i {olE?c. C!€"A.t.wCf3. AP /5 Td W~6~:60 800G ~0 '~ew .l-o.t-OB ESL9 GS~ 09E 'ON ><~.:I ~OlJ~~lNOJ l~JI~lJ3l3 'S'd'~ : WO~.:I ~ , ...., '-,- , ~ ~'~, ~ , , ~ , ? :; , ~ ~ "" , ~ , ~ <lIA , / IS'. 1\ " ~, I /' /< ~/ , '.0 +Jj" / I / ". fj t? ':S:> 0 rf C5 I / I / // I / ~ , ~ , ~ I " / / I / I /