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HomeMy WebLinkAbout1621 W 6th St - Building ELECTRICAL PERMIT AND INSPECTION RECORD CITY OF PORT ANGELES 360-417-4735 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 06-00000715 Date 137935 1621 W 6TH ST 06-30-00-0-1-2870-0000- ELECTRICAL ONLY 4/18/08 RS7 RESDNTL SINGLE FAMILY o Owner Contractor OLIVER, DON 1621 W 6TH STREET PORT ANGELES (360) 417-5366 ANGELES ELECTRIC 524 E. 1ST ST. PORT ANGELES (360) 452-9264 WA 98362 WA 98362 permi t . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL ANGELES/ HP-FURN. 81794 ANGELES ELECTRIC 48.10 4/18/08 10/15/08 Plan Check Fee Valuation .00 o Qty unit Charge Per 1.00 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48.10 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 48.10 48.10 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 48.10 48.10 .00 .00 .~ ~ ~ ~ ~ ~ \~ '^ :-\ SPECTION TYPE DATE: RESULTS: ELECTRICAL INSPECTOR: DITCH SERVICE OUGH - IN FINAL 1 ~ Oh {j/5;WJPj)~V€- f,tiemi"t t:-JCPII'....uJ / HomE- ,tUjtV~ <5A;j.s H7L. WIL.-L- ;VOl h/-.//51-1 ~ -- :Joi3 . , OMMENTS: CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000138 Date 653134 1621 W 6TH ST 06-30-00-0-1-2870-0000- WILLIAM DON OLIVER MECHANICAL APPL. PERMIT 2/01/08 RS7 RESDNTL SINGLE FAMILY 2000 Owner Contractor WILLIAM DON OLIVER/CINDY MCGEE 1621 W 6TH STREET PORT ANGELES WA 98363 (360) 417-5366 OWNER Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date MECHANICAL PERMIT INSTALL GAS FIREPLACE 120246 60.65 Plan Check Fee 2/01/08 Valuation 7/30/08 .00 2000 Qty Unit Charge Per Extension 50.00 10.65 BASE FEE 1.00 10.6500 ECH ME-GAS PIPE 1 TO 5 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 60.65 60.65 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 60.65 60.65 .00 .00 ~ 7 O~ V ~~ S'\ " <?P Separate Perm its are required for electrical work, SEP A, 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 correct. All p. visions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a r, it does not presume to give authority to violate or cancel the provisions of any state or local law regulating c struction or the mance of con,t,ud n. VI ai/if M Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building DivisionIBuilding Permit (10/0 I/07).wpd I BUILDING PERMIT INSPECTION RECORD o \F) I CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4 I 7-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVfDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE 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 I YES NO FOUNDATION: FOOTINGS SHEAR WALLS / WALLS FOVNDA TION 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 JOISTS / GIRDERS SHEAR W ALL/HOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP/FURNACE/DUCTS GAS LINE I-II,,-Ox- -'\U--- FINA0- 21Y-08' DATE WOOD STOVE / PELLET / CHIMNEY ZJLL ACCEPTED BY: COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: 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 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. 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'" o '" ,., I>ll>l ZZ 00 :X::X: Po Po <>: I>l :> H ..:I E-<O 00 Z :x: 0 E-<Q ;~ H ......:1 N..:I "'H ....~ E-< H :E <>: I>l I>l Po I>l C!> U ..:I :E Po Po >< <( ~~..:I HO<( UoU ~~~ :>r-:;: HOOU ..:INI>l o , :E .... Z , 00 00,., Q , .... ~gg <( , 0 HOO ..:IMO ..:I , , H"'OO ~OO <>: 'I>l III E-< .~ 00 -U OOE-<;;j ..:I [:j~E-<gjtJ..:I Qffi13~~g: ~E-<uoPo<( <>: . III <>: ZO 00 E-< Z I>l Z~ 00 HU E-<...... Po 00 HE-< <>:..:1 U::> 0000 I>ll>l !-<Q<>: i Po E-< 5ei5 zoo HI>l ~Q: ~I>ll>l :EE-<E-< OOI>l ~~~ O':E 1>l0 <>:U ~ !-< i ll< L..> (;J t ~ <II .., .... " H ., P. '" '" :EM" PoLOU , nl 00 r- ..-i '" .... p. .....,. Q) o H ~ 0 l-l..... Z .. 0.... HN ...:Ir-IO\CO 0\ nl 0000001 <(or- t!)OI~ NNO ..:I ........ <( _ 0\ UN ., H......Ei:: ?;i .r:.~~ :;:U..-i :~~:~ ~ ~ 00 I>l E-< o Z Q ~ ~ 00 E-< Z I>l ~ o U (/\ ~ ~ ~ ::J ~~ 0' 00 ...... Po >< E-< .... o '" I>l :E 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 2- - I - 0 g Permit # 0 <6.-1 ~ 9- Date Approved Applicant or Agent w;i/;;j?j /Jon O/..;;U- Phone Property Owner W1ff: fJl/~i/?1i:i Zf:fhone Property Owner's Address / Z ~ >T; es . wI/- Contractor/Engineer Se {.f Ins.f{,1-/1 PKone Contractor/Engineer's Address /6 '21 tJ 6y'7 .>r License # Expires '1/1- 5"3ti;, 1;.;;t366 t/ / 7 - '73'-'6 PROJECT ADDRESS VAr ST t1 f?Jt Parcel Number Lot Zoning Proiect Tvpe & Brief Description: ~ Residential o Commercial o Multi-family o Industrial Check all that apply o New Construction o Addition o Remodel o Repair oRe-roof o Demolition o Sign o wall-mounted o projecting o freestanding Dawning o other Total sign area Sq. ft. Maximum allowed siqn area sq. ft. ~eat System o Heat pump 0 wood-burning stove -ygas fireplace 0 pellet stove 0 other o Other Floor Areas Existinq (sq. ft.) Proposed (Sq. ft.) " Basement @$ per sq. ft. = $ 151 Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUA TlON $ '2 c?oO Total footprint of structures sq. ft. Lot size sq. ft. = Lot coverage % Max. height of proposed structures ft. Occupancy group # of bedrooms Will a lawn sprinkler system be installed? Occupant load # of full baths Will a fire sprinkler system be installed? Construction type # of half baths I have read and completed this application and know it to be true and correct. I am authorized to ~p, for this permit and understand that it is my responsibility to determine what permits are required, and to 0 tain p . I prior to working on projects. . / / .. /) J ,~ Date /- '3/..... of Print Name WI/II tJUYJ /2Y7 (/U tiff Signature T:Forms/Building Division/Bldg Permit Appl.-2006 Code. doc \ <~: '.. it.' 7> . ..);'/,<:;TfYq13f9~lii~PE,LE~ DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EA,ST 'STHSTREET,/ PqRTANGELES, W A 983~~ :~',', I," /,,",";- '.... " 1.. : ,,'~', :',:,,'':;..,.,~-' '. Appli~tion ~r Property.Address. . ASSESsOR. PARCEL. NUMBER: Appliciationdescription SUbdivision'Name . . PJ:operty Zoning . . . Application valuation . 03-000009:31 Date 9/23/03 1621, W .6TH ST 06-30-00-0-1-2870-0000- RE-ROOF . 3180' owner Contractor ~,,,. ...-, ------------------------ 'PpmNTBL,; HENRY";-, 1621,W 6TH STREET ,PORT,JmGBLES NA 98362 ." ~,'~;':'>-,.,.. WESSEL'CONSTRUCTION PO 'Box 1514 POR~~S,WA PORT,)ANGBLES WA 98362 (360)457-8544 . - - - - - -........:-.................. -.................................... ~........ --,--;';;;;;';"~'~ ~...... '~.-_............. -'.;.;--"_...... -.......... PElrmit ." . Additionaldesc Permit Fee . . IssueDate . . Expiration Date BUILDING PERMIT - NO. PR FEE TEAR OFF, FELT, COMP . 120.75 Plan Check Fee 9/23/03 Valuation . . 3/22/04 .00 3180 Qty Unit Charge Per Extension 92.75 28.00 BASE FEE 2.00 14.0000 THOU BL-2001-25K (14 PER K) . - -. ---------------------------------------------~------------------------------ "<",:""',',,,^,, STATE.~UR<;HARGE . "~:r::;r !-_;,. ,...",.~;...; 4.50 Fee summary Charged Paid er:AAiteq J)ue ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 120.75 120.75 .00' .00 Plan Check Total .0.0 .00 .,00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 125.25 125.25 .00 .00 "'; " ",.- "'~" ::",~'.' -~. '".' , ':"""':'_;' , . .". '-'-",.,; ,:\.~':-v',--.--~,-- , _;-:;,'i,,-~,,-,..--.-..,"..,~\~';',":f>,:;,'t~<;.:'.,:-"'.:.;.-.;':;.:..',~r',,,l:,.,,-':',.,'; Sep,!l'ate ~e~l~ are ~gulred forelecbical work, SEP/Jc, A.utilltlesn:~r1vate and pul:llicJmpr(:)Vemen~.;Tms;p~rmltJ:J~~n.1es ~~"an1ivC)ld.jf wgrk or construction authorized Is not .,. .... .. ,., ... " n180dayij.IfConst<ucllonorwon<'l~jiHSRAAijJa;Q'R.~~an.at)ijed f9rl:\'R~ri~~:9cf"!;18()\days~fter the, work .as commenl::e~i <>'li~,~u~re:~~n,~p.~tlons have nol!>een!"EJquested.within ~~,~;~Rys,'m>~~~~"a,~t Il)spectl~n;,..:I.hereby"certlfy that I have.. read:,ahd'examIAedi.thls:spphcation 'and ,know,thesameto~be.true..ahd<oorr@~~lkpro~I~J(;)n~.()f lar-'~~~dprpJ"ancesgQvemlng this type of workwill:be complle(i\\<ith whetJ)er specified herein ()r;not The granting t)f;8p~fiTfitdoeslno.t p'resQme)o'glve,authority to 'violate or cancel. the provislonsotany state or local law regulating. constructioll or..the,' pefformance of construction,' - " Signature ~r?Ymer (if owner.isbullder) .! ' '. . ' ' BUIL~G,PERMIT INSP~~:~I.~~RECOJIDfPv~~r 31 CALL 417-4815 FOR BUILDING INSPECfIONS:LpLEASE'PROVIDE A MINIMUM 24 HOURNOTICE. ITIS UNLAWFUL TO ~OJ(ER. INSULATE OR CONCEAl. ANY JYORK BeF()RE.JIVSPECTED AND 1CCEP,!:ED~P()~ p~.IN~CONS~~~QUSLOCAlION.' KEEP PERMIT CARD AND APPROVED PLANS,^T JOB SITE . INSPECTION TYPE DATE ACCEPTED COMMENTS .s. .' I I . - YES NO '0 FOUNDA TIONI FOOTINGS ..' "i , WALLS , FOUNDA nON DRAINAGE 0 ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # . . ~ ROUGH.IN . , - PLUMBING ' ~. ' - UNDER FLOOR' SLAB ROUGH.IN WATER LINE . . ." , , .]. GAS LINE . BACK FLOW' WATER '. . AIR SEAL WALLS ",j .... .,. CEILING '. I ,> " FRAMING " '-:'f:',(}'~' +.,~, JOISTS' GIRDERS .... SHEAR WALl. i . .. WALLS / ROOF / CEILING ' :, DRYWALL . ToBAR '. '. '. .' INSULATION 0 SLAB c. . WALL' FLOOR 'CEILING I I I - MECHANICAL . - . HEAT PUMP .... WOOD STOVB/ PELLET / CHIMNEY HOOD' DUCTS PW UTILITIES' SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER '.' . . .;, SEWER CONNECTION '.'" . ...... , SANITARY . STORM c- . " PLANNING DEPT. SEPARATE PERMIT #/'s SEPA: ,Co' ' PARKINGlLIGHTING .' '.." . ESAl LANDSCAPING SHORELINE: " ~'.. '0 . .'. FINAL INSPECT,IOJl!S.Rf,QUlR,Ep ~JOR TO ()CCU~ANcyIUSE' ~., ',' ,', :: , . "., f RESIDENTIAL "~Ct r .,', ,t" . "DATE ;. (YEs ; NO . COMMERCIAL ,. :,' nATE' ACCErt'tb=' . ; .,., f.:f) \. ,"., NO' ns " -ELECTRICAL - LIGHT DEPT. 417-4735 '., ELECTRlCAlf. ~;1 "->'J ,'. , ' J LIGHT DEPT .... h. ,."" " CONSTRUCTI8NR. W./ PW, CONSTRUCTION 0 R.W. ENGINEERIN 417-4807 PW / ENGINEERING '0 , FIRS'DE~') '1 ':' ."t. ,. 0 .' FIRE , 417-4653 I " 'l .' r....,..n........r& . " ,-1',' PLANNING DEPT. ,..' ., 417-4750 , PLANNING DEPT. , ; .-I.,. "" n ~ k'V BUILDING.. . ; BUILDING 417-4815 '('J.~ . ~ - ,. ..-- -,- T:\PLANNING\FORM$\1102.15 14~,OO21 CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N~ 17933 Port Angeles, washlngton___..___..___.i,2..____.___._..___..______.....___..___, 19.d'] 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 ele~trlcal work as listed below. Address .ul?.~J------.~u_u~-!:..~___....mi~t.i&,u,..__.. Occupancy.h_____mu___...___...mu.____.._.____m__ Owner ..ml:Lf!,f.:..QL?!.___.___ul.l.~__t_J______.uhhh___mu TenanL__u.______.u...._..m._____.________m___..uu....___.___.______ Wiring Contractor -________.OLL!..Il.!..4.__..m________uhu____.___.___ By-..u........_____u.__.u___u___u._u..__h____.umu__.u___... Light Outlet8---._n___..___n___.___n__m_n____.. Receptacle Outlets......__.__.................... Dryer, KW.n.....__............__.__............... Range, KW..............__u__....._............ Water Heater: HeatK:~:::::.>02~~..::::.&.g~ Motors: size, volts and phase: .............................................--.-.......... -.......--..............................................- Service, volts ............____....................... No. wires .............___............__......... Size wIres............____.__................_.. Main fuse .....__...........__..____....... Enclosure ..............__m________...... Type of wIring: Entrance Cable ..............._____. Rigid ConduIt ....mm........_.. Metallic Tubing mm____.hm. Current transformers: No. & Size...........__................. Ser. No.........................__.............__..... Ser. No. ____................____................__... Ser. No.........______...........................__.. Type of Wiring: Armored Cable ..__n........................ Non-Metallic .................__............._ Knob & Tubem.__m__..............m...._ Rigid Conduit '___.______.___.__n.m'___'n Metallic Tubing _mnnn__________.n____ Raceway ...............................__..._ Circuits, Light..........__.._m...........m....... Utility __nn___.______.____m___.n___n______nn Heat ..............._......................._.._.. Range ........__................__.__._............ Water Heater ............................... Motor ............................................. Dryer .......__.________............______.............. Furnace .........................'...........n....... Remark:~ta:u~.~~d1k::;;::___u/f));;.t~~=.:::~.::.:::.:__-_._:~.::..:..___u___.___..___uu~:~::u::::..:..::::.:::..:.:.::::.::..:.':: ..--nnn._nnnn__..nnnn_____nnnn._nn._n.nnn.__.___nn.n__.__...n-nn.....nn..n...nnn_...n_n_n......_n_..nnn.n.nnnn__hnnn__....nn_ ....-.-..h--.n.__n__hn____n...n.n___n._.__nn.__..nnh.~.____n...____h-..--.....------....~.._...__________n__n.n______.nn___h..nnh_..__...h...~.__n___ Permit Fee ---- $.m___.._____.___.u.______u...___.. Treas. Receipt No.u......u___u........_u. By ..m---h--~u___.___.....UUUh___U___U___uuu NOTICE-Current must not be turned on until Certificate of Inspection has been Issued. If work is to be con. cealed due noUce must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION N~ 1 7 9 3 3 ELECTRICAL PERMIT A~~. jj,;zLYL,It--------_ &w--7li,l{L_ Owner .hh..nhhlfc'-~.___hli?:J..~.hm.n______hh__h___h...hnn.h___hm...h TenanLh..nnmm~'hmmn '__mmnhh..mh___hm'n. Wiring Contractor.........____...C!2!_A.~.........__..__..............__._..........._.........__............_._u.. By......n..... . .. ..__.........__............__....u... '..- NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work Is to be con. cealed due noUce must be given the Inspector so that work may be inspected before concealment. 1M Olympic Printers, Inc. ,.......:. 6-27-206 8,44AM FROM ANGELES ELECTRIC INC 360452.9265 p:r . Job wired by 5- . ~ -=-;":1 ..,"oiliiii....~ ELECTRICAL WORK PERMIT APPLICATION. IJ Owner Install81iOD dcscriptiun ~ Q Commercial lir'lfesideDtial Electrical.contractor name licC'Ost; number Date Expires ClN<w Cl Altered! Addition Purchast.'t"s mailing address City State ZIP ~ii:J~ " I .. J Telephone number fAX number premo ises o~~'s name k614/ Ohr#F~ Add"" .r ;nsp./tG..2/ It/. ;'; -dS/ City ;;:4~ PhOb/? nun_bet to schedule Inspection: 77' _ ~ OWI'l(!" tiS dt!jifted by RCw'/9.2!)'.lM:(I) Owner wiJl occupy the .\.trlJ.cturejor two y{'urs afl"r this ~1t!CI,.icul pr:r".U is finuli.:c:d. (1) OMlntr is n;qllired 10 hire an. elt..>c(,.i<;al CQnfructOr if l1bove said property Is for sale. ren.t or lease, Afll'T rCOlding. the u.bovc Slalemenl. I hereby certify (ha! r am the owner of the above I'I;'Imc:d p1'Opcny or 1lI licensed electrical contractnr. I sm makins the electrical IMtal. lation or altCTallOn in compliance with the electrical laws, N.E.C.. RCW. Chapler 19.21\; WAC.. Ch:l.pu:r 2%-46B, The City of Pon Angele~ Municipal Code. and Utility Specifications. Sil:naturc Df IJ Cash IJ Check # ~ard Visa Mastercard Discover C~#___~_QY~~~F____ x Date: ~ Expirat.ion Date of card /'lJ ~ Eleetrleal L ad A diti Cl NO LOAD CHANGES D Baseboard _ K,W Cl FurnaoQ KW f.J Hea't Pump _ Ton _ LAR Cl Fan-Wall KW ~ SeMe. CJ Tamp Service CJ Und~rground Service Serviee Information VOI"ge~~~ Phase Cl 3 Service Size: ~ Feeder Size: _~ " SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN THERMOSTAT ,~ , , SERVICE Lhl~ Approved ~y [l;!,te ^I'Jl'IOW<l ~~ O:r.te AppI'Ovell 0) FINAL DerCH FEEDER Umte A{lpHwea. ~y lJ:lle AN"f"Ov~d Hy D3Le ApJlroved n~' ln$pection Dl'ltc Area, Building or Equipment Inspected Action Taken Electrical Inspector i:J " , '- DATE ELECTRICAL INSPECTION WIRING REPORT 417-4735 7- OWN;;;;;;'~ ADDRESS c.. ~ APPROVED NOT APPROVED o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 DITCH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 Do 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ROUGH IN/COVER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Do 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SERVICE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Do 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FINAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 oJ2lC CORRECTIONS NEEDED: CD B~~ I9N ffi.en-'d- '::t?519.F P"'"'!h . fZJ- -?-L / 0 - il.;)-HJt.e - . /&. -lGtn-..re... ~/ -' 7b PU~~ J:iJ T7~;k/E4ll Az.L- c,o,u~P~.3 -@~GI>r C~ <J -y:> r~foYJ "P> .JCj.~A.J of ~t. @ L/~Hr ~ ~p"~r"c...L€.. /l.Lo"'J~ e r~,y.e. NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381