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Home My WebLink About404 E Ahlvers Rd - Building CITY OF PORT ANGELES i DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00000320 Date 4/19/11 Application pin number 768960 Property Address 404.E AHLVERS RD ASSESSOR PARCEL NUMBER: 06- 30- 15 -3 -1 -9060 -0000- REPORT SALES TAX Tenant nbr, name JACK TERRI HARMON on your state excise tax form Application type description RES REMODEL Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 1800 Application desc REMOVE EXT. DOOR /REMODEL CLOSET /ADD WALL Owner Contractor JACK L /TERRI L HARMON HARMONY LAND INCORPORATED 404 E AHLVERS RD 133 MARIAN WINDS WAY PORT ANGELES WA 983623708 PORT ANGELES WA 98362 (360) 460 -1217 (360) 452 -9696 Structure Information 000 000 REMODEL CLOSET /ADD WALL /RMV EXT DOOR Permit BUILDING PERMIT RESIDENTIAL Additional desc REMODEL CLOSET ETC Permit pin number 183699 Permit Fee 89.65 Plan Check Fee 58.27 Issue Date 4/19/11 Valuation 1800 Expiration Date 10/16/11 Qty Unit Charge Per Extension BASE FEE 50.00 13.00 3.0500 HND BL- 501 -2K (3.05 PER C) 39.65 Other Fees STATE SURCHARGE 4.50 iw Fee summary Charged Paid Credited Due inck Permit Fee Total 89.65 89.65 .00 .00 Plan Check Total 58.27 58.27 .00 .00 Other Fee Total 4.50 4.50 .00 .00 p� I Grand Total 152.42 152.42 .00 .00 1 \J 61 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 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. 6 ,T-c (‘E p,,,, G'`- Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS 0 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 Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back How Water FINAL Date Accepted by AIR SEAL: Walls Ceiling C> 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 Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts FINAL Date Accepted by 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 Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 7Q Fire 417 -4653 Planning 417 -4750 A Building 417 -4815 G -1 11 �W T:Forms /Building Division /Building Permit U 101 0 0 VD C.4 r=1 'OP FC cc a 0 iO r O\ H 'O N a\ H NO N 0 .7..7. 0 00 0 i0 0a a 00 0 a rd 0 w p H LL E a 0 Z Z 0 m w m 0 00 4 E xw H s m a s 0 0 v z E 7 M H 0 1 oa N �d H o m .i EE E ma, 3 m as 0a .c w m m 0 2 01 01 X H H 0 00 4 N r m 0 W z H H -o i.4 U at am o 0 O H H E a H w w M E a [y 0] U' 41 w r1 i FC 0w a mm 0 Gw01 0Z00 w w a a w ro 0000 1 00 Cr177U 20.01001 O a a I w F So FCoa H 0 a U x 0 1 H a 0H a rnw a s 000)0 c7 Hw a M O o a o 0 0 w w H H w 000 r M EE .H H0 a U a U m w 0 7 r.0 0 0 0 00,1 O 0 a, o a 7 x o ti 0 .7 a H H 00 Vo 1 E 0 0 WO0 a a 0 1 aU 0 w a w a a z0 w w 1 Q W m U 0. 0 a 0 oE+4C az E 0 o W E QQ Z z z a a a m a U 1EU00.0 01 E a7 I BUILDING PERMIT APPLIC TION Print in ink f ir CITY OF PORT ANGELES tic.; 7 For City Use Only: Attn: Building Permit Technician Date Received 321 E. Fifth St., Port Angeles, WA 98362 (360) 417-4815 fax (360) 417 -4711 Permit Date Approved 4 /r It Applicant �f� Prt'sest if Y) 9S/ Property Owner ,Tote_. K g h o y P 'orre c/60 4,21) Property Owner's Address 9,a L/ G C(144-e.¢.d Contractor D/7 a n ,Q n L Phone 022- 95 1 vY Contractor's Address License Expires E -mail PROJECT ADDRESS do t/ E 4at� Parcel Number Lot Zoning Project Type Brief Description: )(Residential Multi- family Commercial Industrial Check all that apply New Construction IL a Q Addition )(Remodel )(Repair Demolition Re -roof House garage other o tear off re -roof o lay over one layer o Heat System Heat pump o wood- burning stove o gas fireplace pellet stove o other o Other IUD PL t MELIA cholle s Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq. ft. 1St Floor 2nd Floor 3 Floor Garage Carport Covered Porch Deck Shed Other do TOTAL VALUATION ieOo Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage Max. height of proposed structures ft. Occupancy group of bedrooms Will 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 apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to work' g on rojects. Date y Print Name S�t� P `cc s IJ Signature T:Forms /Building Division /Building permit application Clallam County Assessor Treasurer Property Details 67751 JACK L JR AND TERR... Page 1 of 2 r r Clallam County Assessor Treasurer Property Search Results 67751 JACK L JR AND TERRI L HARMON for Year 2011 2012 l Property_. r Account Property ID: 67751 Legal Description: TPA SP #79 -6 -9 LT 4 1.53A V7 P60 Geographic ID: 0630153190600000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 Open Space: N DFL N Historic Property: N Remodel Property: N Multi Family Redevelopment: N Township: Section: Range: 1 Location li Address: 404 E AHLVERS RD Mapsco: PORT ANGELES, WA 98362 Neighborhood: Cycle 4 Res (City) Map ID: 2 Neighborhood CD: 10953130 Owner Name: JACK L JR AND TERRI L HARMON Owner ID: 29138 Mailing Address: 404 E AHLVERS RD Ownership: 100.0000000000% PORT ANGELES, WA 98362 -3708 Exemptions: Taxes and Assessment Details Property Tax Information as of 04/12/2011 Amount Due if Paid on: NOTE: If you plan to submit payment on a future date, make sure you enter the date and click RECALCULATE to obtain the correct total amount due. First Second Half Half Base Base Year Statement ID Taxing Jurisdiction `Amt. Amt. !Penalty Interest' Base Paid Amount Due 2011 161257 ST SCH STATE SCHOOL $513.41 $513.40 $0.00 $0.00 $0.00 $1026.81 2011 161257 CC -GEN COUNTY CLALLAM $283.44 $283.40 $0.00 $0.00 $0.00 $566.84 2011 161257 SD #121 SCHOOL DISTRICT #121 $671.11 $671.10 $0.00 $0.00 $0.00 $1342.21 2011 161257 'CITY PORT ANG CITY OF PORT ANGELES $654.29 $654.29 $0.00 $0.00 $0.00 $1308.58 2011 161257 PORT PORT OF PORT ANGELES $39.89 $39.89 50.00 $0.00 50.00 $79.78 2011 161257 NTH OLY LIB NORTH OLYMPIC LIBRARY $118.86 $118.86 $0.00 $0.00 $0.00 $237.72 2011 161257 HOSP #2 HOSPITAL #2 $116.35 $116.34 $0.00 $0.00 $0.00 $232.69 2011 161257 WSMET PK DIST WILLIAM SHORE MET PARK DIST $35.37 $35.36 $0.00 $0.00 $0.00 $70.73 2011 161257 CITY_STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $0.00 $72.00 2011 161257 FIRE_PATROL FIRE PATROL $8.70 $8.70 $0.00 $0.00 $0.00 $17.40 2011 161257 WEED CONTROL WEED CONTROL $0.88 $0.88 $0.00 $0.00 $0.00 $1.76 2011 161257 FP Fee FIRE PATROL COUNTY FEE $0.25 50.25 $0.00 $0.00 $0.00 $0.50 2011 161257 TOTAL: $2478.55 $2478.47 $0.00 $0.00 $0.00 $4957.02 2010 49542 ST SCH STATE SCHOOL $508.26 $508.27 $0.00 $0.00 51016.53 50.00 2010 49542 CC -GEN COUNTY CLALLAM 5270.48 $270.49 $0.00 50.00 $540.97 $0.00 2010 49542 SD #121 SCHOOL DISTRICT #121 $658.34 $658.35 $0.00 $0.00 $1316.69 $0.00 2010 49542 CITY PORT ANG CITY OF PORT ANGELES $626.26 $626.24 $0.00 $0.00 $1252.50 $0.00 2010 49542 PORT PORT OF PORT ANGELES $38.02 $38.01 $0.00 50.00 $76.03 $0.00 2010 49542 NTH OLY LIB NORTH OLYMPIC LIBRARY $78.60 $78.59 $0.00 $0.00 $157.19 $0.00 2010 49542 HOSP #2 HOSPITAL #2 $110.96 $110.96 $0.00 $0.00 $221.92 $0.00 2010 49542 WSMET PK DIST WILLIAM SHORE MET PARK DIST $35.30 $35.31 $0.00 $0.00 $70.61 $0.00 2010 49542 CITY STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $72.00 $0.00 http: /websrv8. clallam. net propertyaccess /Property.aspx ?cid =0 &year =2011 &prop id =67751 4/12/2011 kel 0 1 0, 1: 10--ir ca -NV I i C.AoSP 5 4 CS I! _`dam .sac 4‘. t---------/T-7' i� 3 4 7 tI itavnoy a e GI oSt-7' ,.......,:j .,_...t„\...._______,. G.var, k Ls lo Ce701 f 1—k r�iLP��,,E.ce 4 CITY OF PORT ANN .LES Construction Flans The issuance of this permit based upon these plans, specifi- cations and other data shall not prevent the building official from thereafter requiring the correction of errors in said plans, specifications and other data, or from preventing building operations being carried on thereunder when in violation of all codes .nd rdinances of this jurisdiction. 1 1 Approval Date i gy ar 1 .ztt 4414-• L (4) r d t 1 .#0a7 '-'6(--- Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000026 Date 235790 404 E AHLVERS RD 06-30-15-3-1-9060-0000- ELECTRICAL ONLY 2/04/08 RS9 RESDNTL SINGLE FAMILY o Owner Contractor HARMON, JR JACK L/TERRI L 404 E AHLVERS RD PORT ANGELES WA 983623708 ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452-6424 WA 98362 permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL ELECTRIC SER. SERVICE 118695 91.00 1/14/08 7/13/08 Plan Check Fee Valuation .00 o Qty 1. 00 Unit Charge Per 91.0000 ECH EL-R OR RM 201-600 ALT SRV FDR Extension 91.00 ..J: CY r-S:. Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 91.00 91.00 .00 .00 plan Check Total .00 .00 .00 .00 Grand Total 91.00 91.00 .00 .00 ~ ::t:> :t r c:, ~ \J' tINSPECTION ELECTRlCAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE - . . .' .. ROUGH - IN '2jilt/6 11'P ~ FINAL COMMENTS: ~ ....:..:..--.:......... -~~ ~ ~ "" - .--:~- -.-----.-...-.:.:.. --- --""," ...,-== ~- -_ _ -. - ___ ==""'~- =- ~ ===,~::::o:: -~ = == - - -.. ~ Noo o ...... '" M ...... M MM OE-< ..;..; o.Q >< ..:I I>: M H ..:I E-< MOO :<:M ~~ E-<.., Z .. 01>: HO E-<E-< UU MM 0.0. 0000 ZZ H H M o o tJl '" 00 M -..:I ooM 00 ~~ M ......E-< MI>: o 0. 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"'''' "'''' "'''' M M M N M 0 0 0 0 '" M '" M '" ..:I ..:I ..:I ..:I III III <Il <Il "" 00 ............ 00 NN ............ "'''' o 00 ...... 0. >< E-< M o 00 '" ..:I o:l 00 M E-< o Z ~ 00 E-< Z M ~ o U Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000026 Date 235790 404 E AHLVERS RD 06-30-15-3-1-9060-0000- ELECTRICAL ONLY 1/14/08 RS9 RESDNTL SINGLE FAMILY o Owner Contractor HARMON, JR JACK L/TERRI L 404 E AHLVERS RD PORT ANGELES WA 983623708 ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452-6424 WA 98362 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit pin number 118695 Permit Fee 91.00 Plan Check Fee .00 .. Issue Date 1/14/08 Valuation 0 Expiration Date 7/12/08 Qty 1. 00 Unit Charge Per 91.0000 ECH EL-R OR RM 201-600 ALT SRV FDR Extension 91.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 91.00 91.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 91.00 91.00 .00 .00 ~ o ~ fl\ ~ ~ - < ~ ~ INSPECTION ELECTRlCAL TYPE DATE: RESULTS: INSPECTOR: DITCH Ilflillfcl ~ ~ SERVICE . ROUGH - IN t(l~ /o~ -fR. ~. FINAL COMMENTS: Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00000186 Date 742854 404 E AHLVERS RD 06-30-15-3-1-9060-0000- JACK/TERRI HARMON RES DETACHED GARAGE 1/09/08 RS9 RESDNTL SINGLE FAMILY 25000 Owner Contractor HARMON, JR JACK L/TERRI L 404 E AHLVERS RD PORT ANGELES WA 983623708 OWNER Other struct info . HARD SURFACE AREA NUMBER OF UNITS 1. 00 permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL EL. SVC. / GARAGE 112169 75.00 1/09/08 7/07/08 plan Check Fee Valuation .00 o Qty 1. 00 Unit Charge Per 75.0000 ECH EL-RM-0-200 1ST SRV FEEDER Extension 75.00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments . 03/05/2007 10:12 AM SROBERDS --The proposal will result in a large detached accessory structure in the RS-9 for total lot coverage of 10%. No land use issues are anticipated. Electrical load calculations and elctrical permits are required. Any modifications to the City's electrical facilities will be at the customer's expense. Public Works Utility Engineering has no requirements for this plan review. J:: o J: rn ~ -S Other Fees STATE SURCHARGE 4.50 -- ~ ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 75.00 75.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 79.50 79.50 .00 .00 INSPECTION ELECTRICAL TYPE DATE: RESUL TS: INSPECTOR: DITCH SERVICE .- "- 9!-21!61 -k? .~ ROUGH - IN J ~G Ics ~7' ~ FINAL COMMENTS: - - - - ___~__ . _~:z=-:::'""=="=""""'"=:!"':":' -0-== ~~_.__:._-=""",;;=""",",=~.=--__._.~ ==== ---~~-- .. ="'" = ==~ ~=-: ==="" ~= == \Or- o , \0 N , '" MM C1E-o <C<C 0..0 >< ..:l I>: M H ..:l E-o MCJJ :<:M ~;'i ......, Z .. 01>: HO E-o'" UU MM 0..0.. CJJCJJ ZZ H H o r< r- o r< r<CJJ M ...:l r-M oCl ~~ N 'E-o "'I>: o 0.. o M~ 1>:0 <C 0..>< ME-o I>:H o..U , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , .. :~ '0 :~ , en , MM ZZ 00 :>::>: 0..0.. 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M ..:l ..:lo.. ...,<C 1i- ~ ..:l ..:l<C ""0 ..:l ..:lo.. ...,<C r-r- 00 " 00 N N " \0 \0 r-r- 00 " or< NN " "'''' r-r- 00 " or< N N " "'''' o CJJ , 0.. >< E-o r< o N o r< o r< o CJJ ~ ..:l P'l '" ..:l P'l M ..:l P'l M ..:l P'l CIl M ... o Z o ~ CJJ E-o Z M ~ o U CML ENGINEERING LAND SURVEYING EN (9 V Ie & ASSOCIATES 30 I East 6th Street, Suite I Port Angeles,Washington 98362 (360) 417-050 I Fax (360) 417-0514 INCORPORATED E-mail: zenovic@olympus.ner September 21,2007 Mr. Jim Lierly, Building Inspector City of Port Angeles Department of Community Development 321 East Fifth Street Port Angeles, W A 98362 SUBJECT: 48'x50' GARAGE, 404 EAST ALVERS ROAD, BPT: 07-00000186 Dear Mr. Lierly: Upon the request of the owner this office has provided a revised plan for the above mentioned structure. Essentially the back (south) wall of the structure is to match identically the front (north) wall of the structure. Due to the fact that the concrete foundation was already in place there was a need to epoxy additional anchors for holdowns and add additional "wedge anchors" in combination with standard anchor bolts. -+= C> ---e: This office has preformed "special inspection" on the epoxy anchors used for the holdowns and has verified the installation of "wedge anchors" for use as the required anchor bolts per shearwall schedule. \t\ No other items were inspected at this time. A> 5" --. ~ (V) Fllt ~ Scott Headrick, P.E. Fc: JN 06308 EXPIRES 2/15/1CVe I .-<r- o ...... o N ...... '" WW c.'JE-< .0:.0: 0..0 >< ..:l <>: W H ;': ..:l WW E-< 0 ZZ WUl f'5 00 :.:w :.::.: ~~ CIl 0..0.. E-<..., Z .. 0<>: HO E-<E-< UU WW 0..0.. 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'" O:H ~M03:";o. >< ..:I o.u f-<UOo...; 0. f-< <Xl ,- fJ c,.~ ~ ~,,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ~ ~ c. ~ Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property zoning . . . Application valuation 07-00000186 Date 742854 404 E AHLVERS RD 06-30-15-3-1-9060-0000- JACK/TERRI HARMON RES DETACHED GARAGE 3/12/07 ~ CS" RS9 RESDNTL SINGLE FAMILY 25000 Owner Contractor HARMON, JR JACK t/TERRI L 404 E AHLVERS RD PORT ANGELES WA 983623708 OWNER Other struct info . HARD SURFACE AREA NUMBER OF UNITS 1. 00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT -RESIDENTIAL 3000 SQ. FT. DETACHED GARAGE 95919 417.75 Plan Check Fee 3/12/07 Valuation 9/0S/07 167.10 , 25000 Qty Unit Charge Per Extension 95.75 322.00 BASE FEE 23.00 14.0000 THOU BL-2001-25K (14 PER K) Special Notes and Comments The Fire Department has reviewed the project application and has no comments 03/05/2007 10:12 AM SROBERDS --The proposal will result in a large detached accessory structure in the RS-9 for total lot coverage of 10%. No land use issues are anticipated. Electrical load calculations and elctrical permits are required. Any modifications to the City'S electrical facilities will be at the customer's expense. Public Works Utility Engineering has no requirements for this plan review. ~ ~ -I:.. Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 417.75 417.75 .00 .00 Plan Check Total 167.10 167.10 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 589.35 589.35 .00 .00 ~ / .I:?'ZL /~ Y 6, OJ3 ~ ~ ::> r Other Fees STATE SURCHARGE 4.50 ;::v 0- 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 sa'me 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 \.j€AlI~~fl1 Signature of Owner ( owner is builder) ~~I) Date T:\Policies\1 102_15 building pennit inspection record05.wpd [1/4/2005J ~ BUILDING PERMIT INSPECTION RECORD CALL417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTJONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER. INSULATE OR CONCEAL ANI' WORK BEFORE Q\ INSPECTED AND A CCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. ...J KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO FOUNDA TlON: M-~ptJ 5t-~ r~ &)7 JLL. FOOTINGS SHEAR WALLS I WALLS C1lzo 16"'7 '"J L-L- FOUNDA TJON DRAINAGE I DOWN SPOUTS , PIERS' POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-rN WATER LrNE (METER TO BLDG) GAS LrNE FrNAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING ~ /2-b/O, :rU-- JOISTS I GIRDERS SHEAR W ALLlHOLD DOWNS WALLS I ROOF I CElLING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL I FLOOR I CEILING I MECHANICAL ROUGH-IN HEAT PUMY I FURNACE I DUCTS GAS LINE FINAL DATE ACCEPTED BY: WOOD STOVE I PELLET I CffiMNEY MANUFACTURED HOMES f FOOTrNG I SLAB BLOCKING & HOLD DOWNS SKlRTJNG PLANNING DEPT. SEPARATE PERMlT#'s SEPA: P ARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W. ENGrNEERrNG 417-4807 PW I ENGINEERrNG FIRE 417-4653 FIRE DEPT. PLANNrNG DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 l....lh-t'}~ ~G\....- BUILDING . . " ~ "()' -t ~ ~, ~ \' ~ lI). T:IPoliciesl! 102 IS building permit mspeclJon Tecord05.wpd [1/412005] ~ . BUILDING PERMIT - APPLICATION FOR OFFIClAL USE ONLY: .~ Date Rec.: g../ ~? /07 P=n# ~~t~5 Date Approve. . 10 I Date Issued: Fill out COMPLETELY and ill INK. Your application and site plan MUST COlvIPLETE to be accepltu lor revievr. Ifyoli hBVc any que:;tiDns~ t:~n PERMITS (360) 417-4815 FAX(360)417-4711 Applicant or Agent:;!;Jf' /( L . /-rEfCR ~ L. f/ lJ.fC/1l()/II,:I1\. Phone: 3~D'-4&7 -7'7/'7 . / . Owner: i..S::; rnf) Phone: Address: If/Vi- F:. A-I--I L V Q! S :;t~ Architect/Engineer: 2 evcv j e.- City:?o~ t ms/~~ Zip: 1~3h d Phone: iff'l-ifx) / Con1nctor ."\ a F State License #: Exp: Phone: Address: I City: PROJECT ADDRESS: t-to4-- E, 41-# LV ER~ i2'D I?oRt4I1sy.4P~ (,J?a LEGAL DESCRIPTION: Lot:4 Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: (X)3cJ /531 CfOr.o()oooo Zip: ZONING: TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof 0 Stove o Multi-family 0 Addition 0 Move "!iL Garage o Commercial 0 Remodel 0 Demolition 0 Deck o Repair 0 Sign 0 Other BRIEF DESCRll'TION OF THE PROJECT: (I/II/PIP ,;( ~19&0 j1J D-e. +a.e-h ~~ G am 8 0 SIZE/VALUATION: SF. @$ /SF. = $ SF. @ $ /SF. = $ SF. @$ /SF.=$~ TOTAL VluDATION $_ rT:J.-Sj '(')6--;r- <;11f7/k:>r COMMERCLALfRESIDENTL<\L: Occupancy Group: ~ - J No.ofStories:_ Lot Size: ~1-c:rl90 ExistingSq.Ft. ';,'(00 Total lot coverage r. 15" % Occupant Load: Construction Type: 11- H & Proposed Sq. Ft. '3t9lPO = TOTAL Sq. Ft. (0 ~t; 0 ESAfW etland(s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other: APPRO V ALS: PLAN: BLDG: DPWU: FillE : OTHER: PLANNING USE ONLY: VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This iigure \"ill be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE: IF a plan check fee .is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the tinle of permit issuance. EXPIRATION OF PLAN REVillW: If no permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R1 05 .3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that I have read and examine this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determ e wha erm~re required ,not the City's, and that I mu~t obtain such permits prior to work. T:\Policies\BL-1102_13.wpd Applicant: ~t'^'-----nate: ~ 3 t:c....~ 67 . t j ] o o o 3~<+ i ! I . I 0"1 I . I lOmm..l o -r\ I \ j \ l \ 1-- \ ocfj 31~fi r I 1--' I 1 i j , , L 1\, 11\...\ II ~/[ 1 i i I i I I i J, [' \ "..-,.~ I . . \1: f ) I( j, ! i j i 1/ I~- ,~ ~of/J r-e-d / ~)j~ D I q~ 'J! I . [ 7D r. 1 I nt- '" ..~ , ;.13~ ~o (,0 ..lO o~,( ~ t. ~ tp('~ I Jl; : re' ')l)'~(i ~ \ ,...1 ~ -$ I \ ...... t \ IV] , '. ( " ti1 \ '- \ .. -.J ~\ \ -::. . . !JOY t::. :::J \.. Dr \ r/{ ...... - - -. --....~ I ! .d~ ~,\ 1 ~\ <'I ~ ! - I~ !~ -1-7 I I I q g, If") 'JO --J I I I ! City of Port Angeles Applicant Project Review Sheet . o/~%~ ifo '+ (;; - /H-.It...,) as 12. b I f). II I u.b . Zoning: _ Applicant~1a(:;k L ./-r~( L ./-II4tuJ1()N ;it Owner: ~ ~ I Property Address: Proposed Use: Is the proposed use listed as a" permitted use" or an " accessory use" in th Is this the only use (business, residence, etc.) On this site? Has there ever been a subdivison, shortplat, or PRD approved for this site, or has one been submitted and is pending approval? Does the proposed use require a new business license? Does the project extend into any required setbacks or cross any lot lines (interior or exterior)? Does the project exceed the permitted height allowance or cause the property to exceed the allowed lot coverage in this zone? Does the project require any additional parking or special design/landscape improvements in this zone? Does the project eliminate any existing parking spaces? Is the project located within 200 feet of the shoreline? Are there any environmentally sensitive areas on or within 200 feet of the property, including: . Wetlands or areas of standing water (year round or seasonal); . Streams (year round or seasonal); · Areas with a slope of 40% or greater; or . Areas that have evidence of past ground movement or erosion? Have all the required submittals been provided by the applicant? DSite Plan. 0 Construction Drawings 0 ParkinglDrainage Plan DCivil Drawings 0 Energy Calculations 0 Supporting Engineers Calculations DLandscape/Lighting Plans 0 Others. ((Planning Department review is required, the processing time may be extended. If it is determined a separate Planning Department permit(s) is needed, the Planning Department must be approved prior to the issuance of any other pennit. 0 Yes: Ok ~o:. requires PD r VIew 0 Yes: Ok ~ No:. requires PD reVIew 0 Yes: requires PD ~O:Ok review ~ No: Ok 0 Yes: requires CC review 0 Yes: requires PD ~O:Ok review 0 Yes: requires PD ~NO: Ok review 0 Yes: requires PD ~O:Ok review 0 Yes: requires PD RNO: Ok review 0 Yes: requires PD ~NO: Ok review o Yes: Ok o No: Mark required item The information provided above is true to the best of my knowledge, I understand that in the event that any of this information is detennined by the City to be incorrect, this project will be stopped until such time the City determines the correct information is pI' vided a d any su sequently required review and approvals are completed and granted. .d ~ r::- 6-t~ 07 Date ~' I 1 G41.A4-i rc/l N~<AJ \h.{"-.J A l... v' ~ /Z-s 446 ?e/U? ~1:L<:S; I LA -1,z"z4 '- G'1..G/c'/v ~~" /' 10, " +0 16 A~/ (.~ LtJA<:>~', j 00 uA~H I ~. ._- -- ~ - -- ------ Lv ~ !..DA..~I AJ~ f+ -, 2? PSf A -. 3. <d>PI:/ fii ": /1...(. (, /7:. -- - 3. Z. I -:;0'10 --[~ .. ~o '1 c.) C1 -. . l{ (10,) -:: &. '1 0/2- . I (liB ') ~ t-(, S L/\Y.- CD t (J;) \,0 r;. '/ (j) .L-1 \ II . ~ tnJ I~-- .22(1. 2\)( ~.Y ') ( B') rl ~~I.1-I) (~~~ J(e) . ,~ \d -t l<f.b(I.?I)( k-&.'fL"2)Y'cJ\ 3.Z(I.Zl)(btJ- 6.4(')~e,~ ~'") 9'bSO f:,"b I \ {j '-( o6.s.<IluA""1:.o-U' 1..v.~ t.->J LL CoVk,.....J C~~ Fzrt-U- L----- @) '- ~~~/LtB 1b.b -:. B L~tL CD ~;; -.. s'if -. $b 9~S Cfgb ~vJ~ ~ ~ ~?~ 1%;0 Mo ,-t>t>W""/ & _ '2(]?~4.;g-' ~..,. - . 10 d } ~;' ,... ~ 06' ^""'''~ d e '-/(2 l)(oJ< ~-/7-"', 110"':' s,~s 7 BC6Ll> . ".Id\"1. _...~ 'b:' 7s:, <;,1.'\ ~ _ IJ ,€........ ....,'~I ~?$ }6p' ( L.(....~ 1- '2.J I . 01'~ -:. 16 ~olt. ~-~ I ~~(?J\ -_ t q~'pv- _ , ~ -:: 7~_~ ~ t~ /lHO.(')1'1 r-el ~ . -^ ..<....1. ,'. -f .;> . tI'- - TJ:i' (/oJ'T~.'" .;) ""0 - ~L" l,y;r ',-'" -"~ ~L 'Y <". 5' U":::IZ.- t4(+~tj} II.( ,;.J I ,'" (J T'V~. qtJo ,_ Lj _ 8. \)''' . ~ f2.u~ w{ -;},~" /~-~ ~. X -!::l /z.t3.LT,> A< s.~ 71.!~0.b). __ q~55 - I ff'I/._' t/ 1/& .:~ ., J#1 !Jl~ rt -"'~("S ~ ~ ~. w- I b~ }Y'! \ Q"1 Ie..( ( "6 o~ lea t\ elf- rVv --- " I f\.....)u.d 0'L 'lJ/L ::. , ,'\ F!(E 08SS /f-:- ~~. -- 98S5 b/0, Vv '"< ~ 1 ~ I -=- J:-/:::t9 J'~ -:Wi5 j 10 'o-1'~ 6116(11) (I oj ~ IS 7680 (&AA -:: I !o06l"l. -::.. ~ ~20 - ~ /?J;-'o .., /~/6Bo- ;2H520 I, ..-, 'I 16' ...- r- .-/1 - -t;, D-\. 2/ . LY\J~ 2.. G.N4 A I~ p-- :2:2(I'~I'{ ( Ii) (e.~) -:.- ~" CV'? '3~ ~I' fl,~ .3<;:'lcQ!/l-f1 :.,. Pi -Iv IJ/2, - 710(/~b,,>::- ~z, ~ -B-S3C ~lt:, /'1 --;.;2 I~ '7 8BC ~ "'''-~.cJu''. -t- IL{, C:, (t, Z/~ I ~ ~)~"'f(L \ \(/?-) . \ - (~/' - - - -. - "- ~ I~ I --' .,-- 7/~u ~< ~~ d e 3ft'll 4-u- ~A' (~I 3~ II L -'U~ A '.L f .A f . I tJ.,7, 'J.~ ,I'eo ., J , I sf :. A -f j:/L +;( -, ~ s-o Q331' /81 17Jv-J -- ~D -- Me. f (.L- ~5o t-2.-;;; 1'=1 '1 ~I '63 Co Q"1~ --- J1(~)(/b); ~;n ()( :.. /D~(Jb\ I- Z-4 (10):- "toupe 12-'{ 1?Sb flW'."'- I.( cl ~ ( 1'T J --~, r~ '3 ~ ("3J~ 56~ M H~~ ~Sj'2._7L(200_ ~ I~ ..!-r t'2; 5"' .----------.. - Ux. Yz <. d ..4.~ - ~ Ljp/ 0, C b .' ( ( 7/1{" /VAl <--10 eO. ~ 6//2- 1& I. 'jd( ".J (..'. ,( ~~-< ~ tA()dJ~ Bu:/ , --- ---.....--- .. --.- ~ -.-- A.,l'" ,"-' _._~ .0 (471: ( ~~ ., 'PI.::. b i ~1 ~f.!lljJ!B; ), 8bb 4l 5'0 ,i~ ~ -g:~~ ~D~~~ ~f~$ I I ? rtJ4 h ~ u~ , l r ,~1' I ~ ,. ":J sl' ~ ~U -( 'Z? ~ ~ 93:Y'1 2 ~ B V....~. ~ -_ ~ p(,L S>"17 .,' :::> .." 7 116 -f /\J.A,,- ~ ~ l<- iY~ c:..L~ ( G~ Ls-nt~e ?~ ;4/1 ~ 6D~(\.6\ ..~~ - ~ ~",i:S"'} '2)..{ ;:) S"/l~.~,- I 1+~41-C'l.. ~'1rt.~ CA"V~(.~ Bn"l. !-,/tn."" - I / W,,: L(ol?>) -:... f7-oPe. jlLA-- IV)O(OJ'1.t1" -;. 'Z~q2.~ - t? _ 2 '-IS 06\ (12.S~:; 49(:po (flAIl" I.' ~ ;2S(IC>\ =- t.1\O pvc i0L -:.. IDL'6) '2 ~J\,-\ -. J-~ '> -=- '3_2.~:\ \. _ _/-'u q boo - ~ 7 ,.1._ . ";..( ) Y (?S II~ _ -'~r'-"'_ - (,4 '-;. 'c 3 Lh Sku ". 'J -_ Z9,^" 6~~ '2 ~-f~ - 900 5 v-I~ ~ W-;. '-Ib6f;) ........'olfo p('& fV1 -;. / ~ 'f ul ~ ) ~ '2.-' - _ "3>9 0.;:),:;:) ::g ~"'-"<.l -:.. -; 'i" l)~ q ..,,(1,'~1 ") -= 3 -:; I '" Cd.~( k. fOv-f.- ( 10'1... .5w '2. IV\ :. /5jQc;)( ~) C 1. ~) -. / ') t3l.fJ~ '''' >f A ~ .-, / r-'8<e {$'!' ~ ,/, ()'" ,. q (1<,)0....)( 1~, 6 '1'\(1 " ) ji;'-~ ~ . ' @ ,,' 'Iii! ~$ CITY OPPORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION 321 EAST 5TH STREET,>PORT ANGELES,WA 98362 Application Number Application pin number PropertYc~ddress ASSESSOa.PARCEL NUMBER: Application type-description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00000571 Date . 218401 404 E AHLVERSRD 06-30-15-3-1-9060-0000- RE-ROOF 7/07/05 RS9 RESDNTL'SINGLE FAMILY 7727 Owner Contractor HARMON,'- JR JACK L/TERRIL 404 E AHLVERS RD PO~T ANG~S WA 983623708 AFFORDABLE SERVIcEs 258663 HI - WAY 101_ SEQUIM WA 98382 (360)' 683-9619 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date . Expiration Date . BUILDING PERMIT - NO PR FEE TEAR-OFF, FELT, COMP 53942 176.75 Plan Check Fee 7/07/05 Valuation 1/03/06 ~. '0- ~ ---------------------------------------------------~------------------------ .00 7727 \U Qty Unit Charge Per Extension 92.75 84.00 Other Fees STATE SURCHARGE 4.50 )> -S- .....- ~ ~ BASE- FEE 6.00 14.0000 THOU BL-?001-25K (14 PERK) ,...-,,-.;.; - _ - _ _ - - - - - - - - - - _ _ _ - - _.;;. - - - _ _ _ _ _ _ _ _ _ _'j_ ___ __ _ _ _'_ _ _',_ =- _ _,_ _ _ _.;;. _ _':,;.:;. ~':.o _-_:_ _ _ _ _ _ _..: __ ---~------------------------------------------~----------------------------- Fee summary Charged Paid . Credi ted Due ----------------- ---------- ---------- ' ---------- ---------- Permit Fee Total 176.75 176.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 181.~5 181.25 .00 .00 .~ Separate P~rmitsare required for electrical work, SEPA, Shoreline, ESA!. utilities, private and public improvements. Thisperll1lt becomes null and void if work or construction authorized is riot commenced within 180 days, if construction orwork is suspended orabandom!d for a period of 180 days after the work as commenced, or if requlredlnspe~tlons hayenotbeen requested within 180, days from the last inspection. thereby certify that I have read and examined this application and knowthe 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 ofa permitdoes not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. --. r (9/( 1-- / )-/:::.. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\Policies\II02_1S building permit inspection recordOS.wpd [1I41200Si . . Bun.DING PERMIT INSPECTION RECORD . . .', CALL 417-4815 FORBUILDINO INSPECTIONS. CALL417-4735FOR ELECTRICAL INSPECTIONS; . . CALL417-4807FORPUBLlC.W()RKSUTlLI1'IES . ..' ...... PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE.'IT1SUNEAWFllbTOCOVERi~INSULATEORCONCEALANY WORK BEFORE INSPECTEDANDACCEPtED..POST PERMIT INA CONSPICUOUS LOCATION. KEEPPEliMttCARDANDAPPROVED PLANSAT'JOBSITE. Il'lSPECTlON TYPE DATE I ACCErtED . COMMENTS . .. I YES NO '. .... . FOUNDATION: .''':. .' FOOTINGS - WALLS I FOUNDATION' DRAINAGE / DOWN.SPOUTS " . PIERS ;. ..' POST HOLES (POLE BLDGS.) '. .. " ..... PLUMBING ..... .. .... .. UNDER FLOOR/ SLAB .. ROUGH-IN . - WATER LINE (METER TO BLDG) GAS LINE BACKFLOW/WATBR ...... .' . ..... . . AIR SEAL . WALLS I. . CEILING' .. " I . . ........,.,... '; FRAMING '. . JOISTS I GIRDERS SHEAR WALl1HOLD OOWNS c. WALLS / ROOF I CEILING ... .. DRYWALL (INTERIOR BRACED PANEL ONLY) :.' . T-BAR . ,. INSULATION .. ,,' '. SLAB .. WALL/FLOOR/CEILING ..' I . MECHANICAL . HEAT PUMP 1 FURNACE 1 DUCTS GAS L1NE . WOOD STOVE /l'ELLIIT / CfIlMNEY COMMERCIAL aOOD I DUCTS . MANUFACTURED HOMES . '. FOOTING / SLAB . BLOCKING & HOLD DOWNS .; - SKIRTING '.' PLANNING DEPT. SEPARATE PERMIT #'s . SEPA: P ARKINGILIGHTING ESA: LANDSCAPING .. :.. y .. .. .;:, SHORELINE: . .' ., .. 'FINAI!IN$PECTIONSREQUlRED PRIOR TO OCCUPANCYIUSE . .. ./....; RESIDENTIAL ," DATE' YES NO .." .COMMERCIAL DATE ACcEPTED ., . .. Ii.. . YES NO" ELECTRICAL- LIGHT DEFT. 4174735 .. ". ELECTRICAL . '. LIGHT DEPT "" CONSTRUCnONR.W.1 PWI CONSTRUCTION - R. W. ,- , ENGINEERING 417-4807 PW I ENGINEERING , '. 417-4653 , .. , ~ " " . ." FIRE FIRE DEPT. 417-4750 . .PLANNING pErT. . .. < .... PLANNING DEPT. BUILDING' , 417-4815 1r:.tR"tJ<( ~}J.. _ BUILDING .'. .' .' .... T:\PohCles\U02_IS butldmgpemllt mspectlon recordOS.wpd [1/412oo5J PREPARED 7/19/05, 12:33:17 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL , , APPL NUMBER: 404 E AHLVERS RD AFFORDABLE SERVICES HARMON, JR JACK L/TERRI L 06-30-15-3-1-9060-0000- 05-00000571 RE-ROOF INSPECTION TICKET INSPECTOR: JAMES L LIERLY PAGE DATE 5 7/19/05 SUBDIV: PHONE PHONE : (360) 683-9619 PERMIT: BNOP 00 BffiLDING PERMIT - NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ~:::_::__~_~___::~~:~~:::::::~4~ ~OT::A:~~_~~~~~~~~~~~~~~~~~~~~~~~~~~~_____ rJI'ORr~ t~~~. L~ ~ '<i<iO'" CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Property Zoning . . . Application valuation Property owner OWner address 03-00000076 Date 1/29/03 404 E AHLVERS RD 0630153190600000 FIREPLACE/ INSERTS/FREESTANDING Contractor 4900 HARMON. JR JACK L/TERRI L 404 E AHLVERS RD PORT ANGELES WA 983623708 ( ) EVERWARM Permit Additional desc Permit Fee Issue Date Expiration Date MECHANICAL PERMIT 100.00 plan Cbeck Fee 1/29/03 Valuation 7/28/03 ,00 o Qty Unit Charge Per 2.00 50.0000 ECH ME-WOOD STOVE Extension 100.00 ::r Fee summary Charged Paid Credited Due " Permit Fee Total plan Check Total Grand Total 100.00 ,00 100.00 100.00 ,00 100.00 ,00 ,00 ,00 ,00 ,DO ,DO ~ ---!. 1\ '" 0:+: '\ (' '\ I r 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. / c;' /,( C ! (- r:.;; Signature of Contraclor or Authorized Agent Signature of Owner (if owner is builder) Date Date T:\PLANNING\FORMS\1102.1S [4/2002] JArj 23 "03 03; 50PMm~~1't Yeady '* ~ WI[ ( e-q Ii P,l- i~'J-=:; S:03.M;CI,y ~O~T 4NOR~kS s ~:;ilI :3.,0.17.'11 . i / .:. Archi~cl.l'&gincer; - <B === . ~UCIi:W' ContractQr IJI..llA... . '-" ,............. LicclI!le #:~g\{NL Ad~ss:2..~7/S1 ~\{~City: f'Ja PROJECT JU)l)lUsS:~ € ,~"'" \~ ZONING: I..EGAl. D.lSCRlPnON: Lot Block; SlIbcUvilJoa: cw......., "'''''''' PAJICIL _0< ,-, "'''~J' ""'....w ,_" (__ , BlWlli Add,..: :2 fi::] po oC) "'~" em'" 11., ~ " .....'" _ D!EOF WOlUl:: 5IZlUVALtlATlON: ~~cljdeatfaJ Q New Co.all7, 0 R.roar Q WOOdatavo .51', @ ~ ISF, . $ o MuJti.t'amiiy 0 AddidO(J Q Movo Q Oarago SF. @ $ /SF, _ S Q COlllll1.reiiJ Q Reu1odol Q Demolilioa 0 Dock SP. @ ~ /SP, . ~ o Repair 0 Sip 0 TQTAL VALUATI oS BRIEF DESCRIPnON F TRI PIlOJlcr: . , ,T1w BuDd/", P""'il -I''''-appflcalfoll mill, 6'/III~ 011I COmpletely. Pl....typ. or prill! III IaJc. UyoU bav. .lIy quellio"" pie... cab ~17004815 APPlic8lltandlorAgcut:_ f"v6el.IAr<::>-t l::L<+ H Pbouc:if-'i2- 3?6b 0",,,,, \" ",I( ~rh-. "'''''' Ph_, ~ /.Z , 7 Add,,,,, LJ 0 '-/ E. A>,l.....~ Cilyd3;l. Zi,,_q \\3 g 2 BUILDING PERMIT. APPLICATION flOlI omcw..1SE ONL v; Dolo Roo,:1- :-i - <J '5 I'onaJa .~ ~ '" 0.. Approvcd~ - 2't.::...c..2 D<lI "'oed: _ Phone: _ Exp: ~ I ~~ J 0: PhoQe;~ 52 . ~ 5&(,., Zip: q 830 ~ ~. Me O'D - COMMERClA.LiREsmlNTIAI.: OeC\lP&lIC:Y Group: OeeUPIlll Load: _ COUIlnleti0ll1)ope: II 0 of Srort.., _ Lor Size: ~ 1.01 COVel'i&e; ~ """'. ,-" "".,,, ''''' ft · -... Loo """". "" ft . TOTALi!oT "'VIRA., J.." PLANmNc lISE ONLY: APPROVALS: PLAN Nor..: BLDG. DPW mu OSAlWetl&Zlcf(I): 0 YC,J 0 No SBPA ChocIcJlsl roqlllrod7 0 Y.. 0 No Other. 0TRIa.. llJILDING APPIJCAnON stIBMIn.\L: Y"'"qpl/C#l/oll fUUi.il#p/im mIlII6_/IIIlt/olllCOmp~lJ to ~ lIIC1:rpl.d/o"nlcw, The IUilding Divulon ea.o proYide)'01l Wilb morc delelJcd lntonn.llon OIIlbo appUelllOlllDd plIO lubll1itt&l nqllinulllDlI. IlI11.DING 'ERMrr APPIJCAnON SllBMrrrAL: Your eompJered appl1eatioll, .ite pllll (Cor additioll.!) IIId building COllStrUction lalU aro co buubmilled to lbe 811l1dio& OIYillcm, ~ . - 'AL"AnONOF """""'eno" ...-'...--_........,.._ ""_ ....""'Wod~d .Y be revised by Illa 8Uildillg Div. to eomply wilb e\I1reI:l! r.u.hodulce. COQlIl:t tbe PCl'lIIit Coordlaaror at 417-4IJS (Dr Uliotanc., CAN CHl<C"'", y~....................... "''''_ _"''''''''' ,,,", ~ _,"" AM. llllic fee. ar.d1l1 u the dIlIe ofJlenlllllUu&lloe, ""'^ nQ' OF PLAN """",W, lf~ -" ""'~ wi.. ,,,..,, "''''.'''_.. .pp....... w., "."., ,,",= no ""..... om,,,, .. ..... .. .., Ow - ., ., ~.... ~ "'" ...~. ~ -. ""wi"', "'"'m, (." ction 107,4 of lb. lJlllfollll BulIdUig Code, Dllrnllt edition), No appJl.atloll elll be extcaded mon !ban one.. ""~M" '....""'.."_""".._......._........_ ..,_ _..,,,,,. '''~", '_'0' - ... Coy" ,'.. """''''' " ....... ... _~ _ ~,.,_ "< 'J'PIi,~', ,..,,".,........... -.. -......., "". _. -C/f - - <2-. ~ '/.13/ . ..... "'01.131"'''011 , .. , FROM : 'AFFORDABLE SERV ICES FAX NO. :3605829029 Jul. 07 2005 i2:50PM Pi s ,,:;'.,.:,>;}~?_?~t~,~-~:'-~F~r.~~w,.,'::~:_.' ",. BUILDING PERMIT . APPLICATION FOR. CFFlC'.6.1~tJSB OWLY, DalaRec,: '7-o~~ Ponnit*: !)atoApproved: ' 0.. blued: ' FW Ollt COMPLJ:TJ;L Y and In INIC. YOllr applicaUo.D met lite plaD MUST BE COMPLETE to be accepted for review. It you hive Ill' qi1elldoDt, caD (360) 417-4815 Applicant or Agent:~:>L( ~(I) J(O'S . PhODC:?J/i;(J (.,f!;3 -q ~/O Own...: ~ac.k ~!"()~rv[ diPhone: 3(eQ 4.<i1 II I q Addrces:~ ~ It h \ ve KS City: ':P-t- ~.() s l.JJ/J:z;p:806UZ, Archi1cctlEngincer; ',.' Phone: , I+:-.Fc;. fL*~SO~ Contractor.:x-A"-l G. Ke..4-{j'tu t~ StatcLicensc#: {) :~: . V(')5 Address: Z.:S~.-.z,I-IW't'()1 W, City: 5~'" /M JA) A- PROJEct ADDRESS:~ (JU E. A h \ ve. is L~GAL DESCRIPTION: Lot: Block: Subdi\'ision:' ,CLAu.AM COUNTY PARCEL NUMBER: .phODC:~3~/f1 Zip:qf);~/_-1~ ZO!IIJNG: .. Credit Card Halder NAJDe:~~~' ~ 1 4 VIA ' BIlliDIAddrllSl Z:5~(p{;,~ i-tlIlJ\ {I DI Cu , cteYL1:l~/..LJI1A w4q.r1J5<?'J/-7i...J?~ CreditCanlryp.VIS4~MC_N 01'\ t=., te.. ' Exp.Dale: , TYfEOFWOJUC: ': SIZI/VALU4T10N: ' , , t o Residential 0 New CODStr. 19"'b.roof 0 Stove., sp. @ S ISP. ... $ o MI11ti..6iml.ty C Addition C Move C Garage SF. @ S /SP." S CI Coome:rcial C Rm10deI 0 DwDolltion O'Deck, SF. @S ISF..=$ , , 0 ~ C Sign (] Other TOTAL VALUATION, $' ."z...,.~ BIU:EP DESCRIPTION' OF THE PROJECT: f.f1/J. rn ii!j 0. / t-,t I" fJ7','tp, ' , COMMItRCIA.LIBI:SENnAL: OCcupancy Group: ' OCCUPlDt Load: No. of Stories: _ Lot Size: BxiltiDg Sq. Pt & Proposed Sq, Ft. Existing lot cOvCllap _ % Ii: Pr~ lot covallgo _% · To1Bl Jot coverage ~on Type: , - TOTAL Sq.Pt. % APPROVALS: PLANs BLDG: DPWv:_ J'I:U: OTllEaI_ PLANNING USE ONLY, ESA/Wotland(a): C Yea C No SErA Cbecldistrequimt? eYes C No Otbai Bun.DING PERMIT APPLICAnON SUBMn'TAL; The Builliin& Division can provide you wiat iDfDI1llltiOIl on tho epplicaUOl! and plan submiuaJ requircmems if you bavc qw:stioDS. ' , VALUATION OF CONSTRUCTION: In aD cua, a valuadon IJDOUAt IIWIt beentend. by the applicmt. lb:is figlae will be reviewed and maybe revised by1be &ildiDsDiviBwu to comply with cunent fee schedules. CoIltactthe Permit CoordiDacor tt417 -481 S for assistance. PLAN CHECK FEE: IP a piau clJa:k fee is due it DlWt be .ubmla:M at tlIc time tho builcliDg permit applicatian aud COD!b'u~an plans ~ 8Ubmittcd. AD other pezmit fees are due at the time ofpcrmit ~c. EXl"IRATlON OPPL\N BEVIEW, If DO pennie is iuuecl wUhin 180 day. of the dato ofapplicanon. tbt .plkatlau win aplre. The BWldiDg 0Bicia1 call eldud tho time for .enOl!. by the tpp&ant up to 180 cfa.ya upoIl Written ~ by me applicant (600 SectiOI1 107.4 of the UcitolDl Building Code, currmt edJtioZl). No application can be axtnded moro than 0DJ;e. I heraby Cliftlfy that I flaw ttatlllld examtl8d this app/lcatfof/ Bfld MOW the same to be true .nd ccvrect. I am atihortlsd tD .ppiy for tIiJs permK and lIIderstand ttmf i if my INpOtlSJbllify 10 detBtmine what permlti are Teqursd ,not fJI. Ciy", and thli I must obtBiI auell pe",.,g prior 10 IrOI1c. T:\J'01QofSWP5'>>ulldlllepemdtwpd 'Applicant '}/lrt?:lt..L-- _ Date: """-7-or' Affordable Servi,ces 258663 HWY 101 West. Sequim. WA. -Since 197~ (360) 683.9619 (360) 385.2724' (360) 452.0840 BID .PROPOSAL ' ~ "; " " Name :l ~;\:\f1V ~,.s:\ , PhoneNI Address e~ E.. 'A~ Phone #2 City eft' ~~ ,State VJPr~" Zip Code ... ..... .... ......-- --------............. ....................------.......... .................-----.-.....---------.----....---.....-..-.............-.----........---...... ..... ... 'j.5?- 77/9 q't~'i 4,~ 9:f!:. Tarp house perimeter to protect landscaping ~ Remove old roofing haul to landfill Install ~_ Plywood ~o B , Install, Roof Felf Install Install _ Pipe,Flashing Install Install, _ Ex!1aust,Vents rtit Install t'7.:o Install _ Ridge Vents ~ Install ..x.::t:J. Install _ Attic Vents 7"7:fj Out In Install Sun Tube ~ Install Install '= Skylights _ Install Install Install Install Install _ Secure / Locate Septic - Drain Field Location ----.:.. Price Includes BuHding Permit -.-.:.. Customer to Secure Building Permit Comments ' _ Drip Edge Metal _ Metal W - Valleys _ Roof to Wall Flashing _ Roof to Wall Step Flashing _ Chimney Counter"Flashing _ Chimney Step Flashing _ Skylight Flashing " j F\- "','^' ~~c\. Sl, ;~; . . ;J'~3a ~. r~.n~'\ \ go '-(t" ',~ 5Uj?~+ ,N R1ln AQ-. 'rt\ 6 ~ "'"'" Bid prices are subject to reasonable Increue. due to anv necessa~y alteration., additions, Increnes In material and/or labor to c~~I~te w~rk. Homeow~~,r will be notified of any necessary Changes" which may affect cost.' : Braad~ Ye8~ Color CW(OlDers 1Jlltial~ Atrordable Services lJlitia\:i #- I 0 Year Installation Warranly Affordable ServicelI' Representative ~~- ':/ " Date IO-J5-0V Customer's Signature of Acceptance ' Date ~d WdGS:G~ S00G L0 'lnf 6G06G8S09~: 'ON X~~ S3JI~~3S 3l8~a~o~~~: WO~~ .~ "4Iir*'" CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION '21 EAST 5TH STREET, PORT ANGELES, WA 98,'62 ELECTRICAL PERMIT PERMIT NO 7422 ISSUED: 10/08/2001 OWNER/APPLICANT jack harm on 404ahlvers Port Angeles, WA 98360 360/000-0000 T: S: ARCHITECT N/A CONTRACTOR COLEMAN ELECTRIC PO BOX 1326 PORT ANGELES, WA 98362 360/452-7594 PROPERTY LOCATION 404 AHLVERS RD, E Lot: Block: D Long Legal Subdivision: Parcel No: , 98360-0000 360/000-0000 ..r: CI ..t Project Value: $0,00 Construction Type: ADD HEAT Zoning Use: PROJECT INFO Project Type: Occupancy Type: Occupancy Group: Electrical Heat: D Baseboard k><J Furnace k><J Heat Pump D Fan Wall RES, MISC, Underground Service Voltage: 120,240 Phase: k><J 1 D 3 Service Size: 200 Feeder Size: 0 IT' >, <./' .-t o KW 10 KW 8 KW o KW D Riser D D Overhead Service D Temp Service , .) .:5' ',< " ..., U' PROJECT NOTES 10 kw furnace, 3 ton heat pump, Took out 25 kw furnace, I\. ..s.. FEES ASSESSMENT Service: Additional Feeders: Circuit Wiring: Temp Service: Mise Fee: TOTAL FEE: AMOUNT PAID: BALANCE DUE COMMENTS/ACTION NEEDED $0,00 $0,00 $45,50 $0,00 $0,00 $45,50 $45,50 $0,00 ELECfRlCAL PERMIT INSPECfION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS, PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE, IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE 71yY INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES I NO ~ ,-lN/cUV~K ~VICh I /t'/i'/() I I J J.j.... I GENERAL COMMENTS: PW-I 102.1S 14'96] CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15507 7 - -"2- Y Port Angeles, Washlngton___...___.___.______..;._....___________.._____._.__..___.___, 19_:___._: In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, 01)., 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. =~ ~~~~~~~~=:.~:=~=~~:j:~~,~=";;-==~=::~=:=::==- Light OutletB....__..............__.......________._. Servi~e. volts ./:l..~..../...~:...:.............. , No. wires .....!................................. --// . . Size wiresmm;.,mm..n/-.:.:n___:..._'nf.. / '... Main fuse .m._::i:h~f...1..n!..m.nmm... . --- , , Enclosure ........::........!:...?............... Receptacle Outlets.........._..............._____ Dryer, KW nn_u..___.___..............n__....n.. Range, KW m.m__..m___.mm.. Water Heater: KW..________________________________. . ~, r-,_ () /- Jl ,.. Heat: KW.....~...........................".......__n Type of wiring: Entrance Cable ............................. Motors: size. volts and phase: / /" '" J~ :;.:::::::t.:::.~~~~:;;.:~~:~~::::::::::::::::::::::~~~ Rigid Conduit ......h....h.h.. Metallic Tubing ..nmm Current transformers: No. & Size.........~n.._mm_......n Ser. N 0.__......__......___..00....00...00.00__...... Ser. NOp...__h...n.......n_nn.n._...____.__... Ser. NO.,.hn.........n__..._..n................... Total Loadm.m______................ Ser. NO.n__..nn.n.__..........nn............... Remarks : hd.:_~'_~.."~_n_;...n_!.~"::"_:u_t::._~....:'-_-~n_~_~__d___::!.____~n_..nonnonn...___unn.nun.____..u_.n__hnn...U._UU_.....nnnn_.__....._ . r Total ....q;:~.....~........................ Type of Wiring: Armored Cable ..00...."..................... Non-Metallic ..........._.....______.....__.._ Knoh & Tube...____...____...__.............. RIgid Condult __............_.___.________... Metallic Tubing ..............m___.___... Raceway ................................__...._ . </ circ~:~.i t~i:~:~~~~~~~~~:~~~~:~::::::::~:::::::: .(' Heat .......:::............................._...... <;C. Range ..............__.__..........._.............. V Water Heater ....__......................... Motor ...................0000.__00.00.00..00....... Dryer _u ....n..'.:~......n.......... ........00......_ Furnace nn___...........n......~nnn_n...__h.. . J Permit Fee Treas. Receipt ,I .' Ii:, I . .?) , r. I ~ I . I. ., / $___._..__.;.:......"..'..'..1.....----------.-. N B . '. . _ 00.___________________________ Y --.,------------------______________:______:_____,_~_~____.::..______.. NOTICE-Cnrrent 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 .~ / ......,~ () AU I. . J j ~,.."., I ! ELECTRICAL PERMIT N? 15507 Address.............i~...:..~....!.C.............................._..~......~........................__h__........._.:...................Date..._......_.._......_.........._.__..._......___....... owner...........~~;~.:.~~.;::_.:.........._..:.~{:.:...;.....__....l_.._..................................._._........._......__....Tenant.._...._......................_.........._........_....._.......... WjringCont;:ctor.........~).:L.!..;._~__.....::...........:.~.!.:._.....:~=..~.~............~.._.._....~_::.:.:.........:......BY......................................__...._._d......_...... ../ 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. 1M Olympic Printers, Inc. """';:;" :If'" -1<i"Mri<"CM"""" D ~'" F::,"'" G:f:;;"~ .s~n/\C~:J~~'<' tLR"~~'[~ d~,s"~~~"JJnr:~L \fee. {Lt'tJ<220fYJ , .' {) f\ ~"" ZIP . :;,1 I.::'J::t~ .t r-rX:lj-t- Lt ,"'W A q b',3 j" ,~onc llurnhef ( 1...\:\ llUlllh1..'r ;,'"" J"" :~.~ Q~_~~~Ltn~ ti" ,,' 'n'~on Jt I I ".. __~ 0'-/ _.. E .. V,,-€ ,'5' 2J\-.._._.. tn"I.JII:lLioll J\'.;cnp;ic,n ~ Cllmmt,,.dIlJ }tRe,yidntJbJ :::J ~ew . .~ ~~~r('d/'\ddition . vr '" . . --cDZ0 ~.'''.... ..~. "' ..... \, .... "'-. \. .~ "'~...;,"... ELECTRICAL WORK l'FIt:\lITAI'I'UC 1 !: ~ ~ O.Q_'?-.!'VV P .---.- c'( {.f.{ rf_cL.~, (l[ ~t. nllmblY/" y.'h~l..~I,:-JJ1~~"n= -=::1~ . ,,-L7 &1..1 ,1,};'lell hI la'W /4).28.26J"(!) O"tr/" "Il, ,)(('llf'l lh~- ,lnK!I",' :"1 fl.-I! 11..'1 IM9 ,-{,-t Ideul p<-rJllif I~ jimJli:",j (.:) ()Il "_T H ,..'quO'i.',' JI! h,r(J flll c>/t'/ "'Il'a{ /'01 ij ,J/lrll'jf .\tlid 1'1 uJIl'rl> ~ jill' 1111,', 1'1'11' or lnl.\e ~'re'hling 1111.' ..Illt'>" ~\\*'Illcnl, I hereby ...crlil) (11,lt I "Ill lhe \}...ncr of the <lbu~e pn'pnly OJ H lic..'n~('d dCdriCll.1 t,Ullmll:tm r ;1011 1ll,,I,ill.l\ the clcl.\f1cJI il1b"lal- 'or <lltt'fatioll ill C'ol11pli;lncc wiLh the ckdrl\'..1 l:lW;, \, Ie, /{( W, Chdl.lter ; WAr.. ('I1:;pl~r 296-460, The City "If Pon An~,ck~ MUllIt'lpal ('tHh', ;11111 , Spc-...jr."'lIti.-.ll!', ~ \ , q~ l~ TjO' o ('ash !.J CIo,'ck# r frf0 U.i>LOV;:: Q Credll Card VlS4l ('unfit D-h. E~pll,ltlon Date of card __ LAR ~ Overh~ad S~r'oli~e :..J Temp Service :..J Uml111yround Serv)c& Vollage ~t!..j2 ~I. Pha:;;"~ 1 0 3 ~:; S.,vloe Si'.: :::k-:U" Iti Feeder Si7e. ' .\ .J;~,-WI"'SI)E("!JQN, C-\!"'1_!!EFQ~F,.7:0!l AM J60'~.1}~.11~ , ---,- ( ~t.J{Vl('1:: 'I l. J/~;r.f2 'W'o,-) (:_!,,:~~_~tFm:~I,~.~,J C . R()(;(;U-I:>I I /" TlII-JtMOS'liH \ , . .J l)"k - ,;(i,;-r;;,d!I'-'/ \ PM' '. '\J'llL'u,'~'\ rh __/ e- .. .~, .'~- .---\ I 15j~IN"L i ( OITCII I I -,~"'i'~, .~,,) I - 'nl:f~'~-13~'~) :0. , "- n.lle "'I~"it~pl'fljj)n 1:":., ~ 11 lire ~~{fr .~ '~ /-/.I-,~ 1'; ,1~: t- "-("l'J.. Hllildmg or hltllpOli.:n/l"".pt'('k'd ~\"lIiHl r...hm ........;-..:#"~..~,'.. 'j- L;;j~/.~;,"J.A ",-Ii:;;',,' J.A'L.~:i - ~'.1'J,'~/C:- /;:r;(r d"e: r-~~o. , ,.. ..'~ ,.,. ";;"/ ,<.,"'." v~,.,''T...... r#/I'/," " t:f/J(~' ~\'(;;r:fJl~:tF /-t; .Mj{J;/d!-fC~;:":'lfg/j. /t;!/ .,.. ~A;~( 1;';,.4.~'Z".l. J .. _ ___,n -.!.<S./iK"l ,~.;r /'.1 t....JI/;!/~.I6- ~.:"~'c'::'~-';r (J'''''ll-''~'''.n'''{J') .'^ ''''--:T-'',,, /i#)'~;(/~ tl.l#F a'.h.!f,'/~ :1 02: t'P'PL2: EZt>S.L2:L/Z.LSZ2!;2: Wd 22:'P0 80-80-N~r ~ ~-' 4;.'''....:..,;~ -L~ ,- 'i ~ ,. -.. ELECTRICAL WORK PERMIT APPLICATION ~. Job wired by Q Owner InSlalla~ion lIescriptio~ . ______ CI Commercial ~sidential Elcrt co.ntraClor name ()n~l... I Purchaser's mailIMlf{ddr.ess I 9fL 1) I -J.,icensc number Dale: Expires V' Vl~ v...C~S \ 1~2 vetJ ONe'" - o Altered/Addition \060 Sl,c+- .. 'l. Slole ZIP W..... 'J'h t. L ~ Telcp~on: number '-t'\ L -~ V 1"-' PremiscsLowner's Rame I ~ c-c-\.'- ! Address of 'nspect'oJJlI.' /7 /pl A'I<' ' U /LV'T Clly ? A- ! Phone number to schedule inspection: I OWller as defined by RCW'/9.28.26/:(J) OWller will occupy tfll! structllrefor two years ofler this decrricaJ pe,!mit is jiM/iled. (2) Owner IS required tu 'lirt! an electrical contractor if obolll! said properly is for sale. rent or lease. After reading the above Slal'emcnt, I hereby cerlify Ihall am the owner of lhe above named propel1y or a licensed electrical contractor. I am ffilikillg the electrical instal- lation or alter31ion in compliance with lhe electrical laws, N.E.C., RCW. Chapler 19.28, WAC. Chapter 2961-468, The City of Port Angeles Municipal Code, and Utility Specifications. Signat FAX nllmber ~ lJ Cash lJ Check # x ontractor or electrical ud Date: ~ ~ar~r:ditCard _~_~ - ~~:over__ Expiration Date of card I Electrical Load Additions Bnd or subtrBctlons D NO LOAD CHANGES I a Baseboard KW ' CJ Furnace KW CI Heat Pump _ Ton _ LAR a Fan-Wall KW CJ Overhead Service C1 Temp Service o Underground Selvice Service Information voltage I~ I. .. b Phese1Ol"'1a 3 Service Size: ':.:~. Feeder Size: '- SAME DAY INSPECTION. CALL BEFORE 7'00 AM 360-417-4735 1~~~O~G~ 'ffiERMOSTAT I SERVICE . DB ' Appw~j;d By DBle Aptlrovcil By -TiJ;lu: Approvc;d Dy 1.1~~!bBFrN~ DITCH FEEDER p ......... Dille Approved 8y DBle Appro~ed By./ \..' I)BIC Approved ey Inspection , Electrical Area. Building or Equipment Inspected Date Action Taken Inspector . , I ! , lRfiEC~ u ' '~IUJ C.D 1 !l ?rhni . ,}tl!3HTDEI T. " .- d HLbLH',Ol b2b92Sb 3JI~d3S JldlJ3l3:WOd~ ~'[:L0 b002-[,-d3S ELECTRICAL INSPECTION WIRING REPORT 417-4735 ADDRESS 'j~ i2-C ICn=..- At1LV EQ.c:::... APPROVED NOT APPROVED o ...."............... DITCH. . . . . . . . . . . . . . . . . . . . 0 D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0 D. . . . . . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . . 0 D. . . . .. . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . . . '\ CORRECTIONS N,EEDED: .. g,~1U'I1<( IE. R- \Z. E""r"\l.-.\ N ~ R.. SW,,,",u-t 0:> I.i IZR.. ?J'-.."1e. rOiLI3AC.1< r=ErLJ> , " l . NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC.'(360) 452-1381