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Home My WebLink About2614 S Francis St - Building Of 90RT ~ A...J.,~('(C';. ~h!a~ "- oo:;::..JIf ~. ~7"""~ . CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUIlDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 . ;&;.1; l' ~ Ll _.~..h........ . . . . . V..;J-vvvvvo::r:> uat:e B/~o/03 Property Address . . . )b( 'f ~S FRANCIS ST ASSESSOR PARCEL NUMBER:. '06-30-10-4-3-0360-0000- Application description ELECTRICAL ONLY Subdivision Name Property Zoning . . . Application valuation 0 Owner Contractor HOUSING.AUTHORITY OF CLALLAM 2603 SFRANCIS ST PORT ANGELES WA 983626710 SIMPSON ELECTRIC 243036 W HWY 101 PORT ANGELES (360) 457-9270 WA 98363 'permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER COMMERCIAL . FIRE AND BURGLAR SYSTEM HI TECH ELECTRONICS 52.00 Plan Check Fee 8/26/03 Valuation 2/23/04 .00 o \j Qty 1. 00 1..00 Unit Charge 40.9000 .11.1000 Per EL-LOW VOLT SYS <=2500 SQFT EL-LOW VOLT SYS >2500.SQFT Extension 40.90 11.10 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 52.00 52.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 52.00 52.00 .00 .00 ~ f (j \A ~ ~\ 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 haye not been requested within 180 days from the la.st 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 perfomiance of construction. Date Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) T:IPLANNINGIFORMSlll 02.15 [4/2002] BUILDING PERMIT INSPECTION RECORD ~ CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL 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 YES 1 NO FOUNDATION: FOOTINGS WALLS FOUND A TlON DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE . BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS , , SHEAR WALL WALLS / ROOF / CEILING DRYW ALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: Ex-p I ~€.. D PARKING/LIGHTING ESA: P~l\ LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 4 I 7-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W./ PW/ CONSTRUCTION - R.W. ENGINEERJNG 4 I 7-4807 PW / ENGINEERJNG FIRE 4 I 7-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING Hi-Tech E I ec"t.... on i cs 360 452 8560 P 0':> __.i I \. . FORomC~USE.ONL~" r ELECTRICAL PERMIT APPLICATION I~: . .' .. i I........ .: l I' Dale """'-.I:. ,. ; I Dale .......J. The Electrical Permit Appltcation ml.lllt be filled out co..,.tv. I .' Plase type or reprint In ink. If you have anY(360Que)StI,on7 ~7'lP11~ call (360. 417-4?s fiT&,' " S: Fax number: .. - I . I !' ~\ I '~c..-l c'/ ~J.-rc,n(<-'-) PhW1e: ltf-sJ"{:n)~Fax: +S::L<'f;5~G I ' ~ vb! ~hone: 7. ,'. i City: I i ~Q I ~tionlAdd'ion I , 7 1 o MuhHamily .' 0 Commercial 0 Mobile Home j Sq. Ft. .' 17 / K >5 :3' /.; Rt#note i Meter o Detached garage o Hot Tub o Swim Pool oSeptJ-p,ump~oItage ClTelecom. 0: . .' (' ,'j' I i . art..1 I" '1 .! I i . I ., I .$ervlee Information i VOltage1! Phase: 0 1 0 3 Service 'Size: Feeder Size: I i I , I AMq 1..~,06O(B); For industrial, comme.rcial. to residential projects larger than a dup~x. a ~ -line dr~wing of the Electrical Servq ~ . , . ~ng size (sq. ft.), load calculations, and the type & of condl,lctors and/or raqeway IS required ~nd shall accompany the ': ' iicat Petrnit application. . I " , !. ~~:he~byt;ert#y that I have read and examined this application and know[that same to b~ true an~ correct, and r .' {L. u~ to apply for this permit. I understand it is not the City's legal ,yaspons/bility to'determine what permits :', f~:: ~d; it remains the applicants responsibility to determine what Jjrmits are reqired and to obtain sUc/)..' :" j , . I I i I I ,"~ I Date: .1 'Z-.-tcro S'T.: I . i I , lor flee. Contractor Agent: '~r.~ '" t;lIfd Holdei' Nsme: 1I~~S: I~~ E' . c.d Number: ~ ~ %' s~, 7 Check all that apply: o New ':' um~ of Circuits added or altered: ,I ,'. . ;1;<.. I. . ..( ,. fL,. s#tIPTIoN OF THE.ELECTRICAL PROJECT: 0\ ~," ;\. ' d . l-Heat ns . ,. \,i} .BaIiieboafd ~"F~e L" ',H.t pump ;:' Fari-Wall' _KW _KW ._KW -KW o Overhead Service o Temp Service o Underground Service Credit Card. Holder's Signature; :.., ~ Owner or Else. Cont.. Signature: c~ 8!U/63 ~~o., , D ) I. f. 0, ~. S)~-:OV Zip: Zip: 9~3';L ',:' VISA: V AfC: f' Dato: . ~ pORT ~ ~O~" ~~ "-~ ~ 'l.oii:~. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362. Application N~er . . . . jJ Property Address . . .;l(P'/-t ASSESSOR PARCEL NUMBER:. Application description Subdivision Name Property Zoning . . . Application valuation 03-00000695 ~ S FRANCIS ST 06-30-10-4-3-0360-0000- ELECTRICAL ONLY Date 7/25/03 o Owner Contractor HOUSING AUTHORITY OF CLALLAM 2603 S FRANCIS ST PORT ANGELES . WA 983626710 SIMPSON ELECTRIC 243036 W HWY 101 PORT ANGELES (360) 457-9270 WA 98363 Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL.NEW COMMERICAL BOYS &GIRLS CLUB,600A.SER. &CI SIMPSON ELECTRIC 213.60 Plan Check Fee 7/25/03 Valuation 1/22/04 .00 o , . ~ ~ ""'- ~ ~ ~ ~ \\ ~ ~ Qty 1.00 2.00 Unit Charge Per 94.8000 ECH EL-COM 101-200 NEW SRV FEEDER 59.4000 ECH EL-COM 101-200 NEW ADD SRV FDR Extension 94.80 118.80 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 213.60 213.60 .00 .00 Plan Check. Total .00 .00 .00 .0,0 Grand Total 213.60 213.60 .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 local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent. Date Signature of Owner (if owner is builder) Date T:\PLANNlNG\FORMS\1102.15 [4/2002] BillLDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: , . ...,... ,~....~ FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL . (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE . BACK FLOW / WATER AIR SEAL WALLS .,,<, CEILING FRAMING' JOISTS / GIRDERS SHEAR WALL , WALLS / ~OOF / CEILING DRYWALL T-BAR INSULA TIdN SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s , t:)cfJ/~ SEPA: PARKING/LIGHTING ESA: 7-/5 --DB LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL 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. BUILDING 417-4815 BUILDING , T:\PLANNING\FORMS\11 02.15 [4/2002] f VeRT ""-\t, l.e~~~ ha ...~ ~ ~~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application description Subdivision Name Property Zoning . . . Application valuation 03-00001016 Date 10/23/03 2614 S FRANCIS ST 06-30-10-4-3-0360-0000- BOY'S & GIRLS CLUB COMM REMODEL 210000 Owner Contractor HOUSING AUTHORITY OF CLALLAM 2603 S FRANCIS ST PORT ANGELES WA 983626710 OWNER Structure Information Construction Type . . . . Occupancy Type . . . . . INTERIOR REMODEL TYPE V NON-RATED ASSEMBLY <300 W/O STAGE Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT - COMMERCIAL 1633.25 10/23/03 4/21/04 Plan Check Fee Valuation 1061. 61 210000 159.00 10/23/03 4/21/04 Plan Check Fee Valuation .00 o 'P ~ - J::.. " (j': " 0 "]\\) 1~ ~ ..... . n \Il ?J Vl 71 ~ Qty Unit Charge Per Extension 1017.25 616.00 BASE FEE 110.00 5.6000 THOU BL-100,001-500K (5.60 PER K) Permit MECHANICAL PERMIT Additional desc Permit Fee 112.65 Plan Check Fee .00 Issue Date 10/23/03 Valuation 0 Expiration Date 4/21/04 Qty Unit Charge Per Extension BASE FEE 47.00 2.00 14.7000 ECH ME- INSTALL 100- FAU 29.40 5.00 7.2500 ECH ME-VENT FAN 36.25 Permit Additional desc Permit Fee Issue Date Expiration Date PLUMBING PERMIT Qty Unit Charge Per Extension 47.00 98.00 14.00 BASE FEE 14.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 2.00 7.0000 ECH PL- EA.WATER HEATER Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1904.90 1904.90 .00 .00 Plan Check Total 1061. 61 1061. 61 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 2971. 01 2971. 01 .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 local law regulating construction or the performance of constructi /p12Jto3 Date Signature of Owner (if owner is builder) Date T \PLANNING\FORMS\1102 ]5 [4/2002] ~ VORT "'-'\t, $~O~~~ . ha ...~ ~ ~,,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 03-00001016 Page 2 Date 10/23/03 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized IS not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined thiS application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T \PLANNING\FORMS\1102 15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS PLEASE PROVIDE 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 YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN PLUMBING UNDER FLOOR I SLAB 4J - Jf>-d3 .1 L L ROUGH-IN /O...23-0Z WATER LINE GAS LINE BACK FLOW I WATER AIR SEAL WALLS J()-7:z.-o"? lILL CEILING FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I ROOF I CEILING /O-Z4t;~ JLL DRYWALL T-BAR INSULATION SLAB WALL I FLOOR I CEILING !)--2?-D3 I J lL MECHANICAL I iY1ech a n ,co-I +I~' ;')-1-7- 01 J,~\ HEAT PUMP WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engmeenng DIVISIOn) SEPARATE PERMIT #'s WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA P ARKING/LlGHTlNG 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. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT. 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING n -A:i\-Of J..j.L.. T \PLANNING\FORMS\I 102 15 [412002] PREPARED 2/25/05, 12 27.02 CITY OF PORT ANGELES ADDRESS TENANT, NBR CONTRACTOR OWNER PARCEL . APPL NUMBER 2614 S FRANCIS ST BOY'S & GIRLS CLUB INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 1 2/25/05 SUBDIV HOUSING AUTHORITY OF CLALLAM 06-30-10-4-3-0360-0000- 03-00001016 COMM REMODEL PHONE PHONE PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BAIR 01 10/23/03 JLL 10/23/03 AP BLWS 01 10/23/03 JLL 10/23/03 AP BL3 01 10/23/03 JLL 10/23/03 AP BL99 01 4/27/04 JLL 4/27/04 DA BL99 02 ~~~ BUILDING AIR SEAL BUILDING INSULATION WALL/FLOOR BUILDING FRAMING TIME 17 00 Boy's and Glrl's club for Steve Zenovlc. Startlng to hang sheet rock also lnsulatlon/alr seal/plumblng rough/ ok checkfor under slab lnspectlon under other permlt # was done under wrong permlt/]lm BUILDING FINAL TIME 17 00 steve zenov1.ch address number 6" mln and verlfy locatlon on grab barslJII BUILDING FINAL Jlm Hall 417-2831 boys & glrls club, take correctlon notlce from Frl bln slot -------------------------------------- COMMENTS AND NOTES ----------------------------__________ PREPARED 4/27/04, 12.35.23 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 1 4/27/04 ------------------------------------------------------------------------------------------------ ADDRESS TENANT, NBR CONTRACTOR !OWNER PARCEL APPL NUMBER 2614 S FRANCIS ST BOY'S & GIRLS CLUB SUBDIV HOUSING AUTHORITY OF CLALLAM 06-30-10-4-3-0360-0000- 03-00001016 COMM REMODEL PHONE PHONE -~---------------------~---------------~---------------------------------~---------------------- PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BAIR 01 10/23/03 10/23/03 10/23/03 10/23/03 10/23/03 10/23/03 JLL AP JLL AP JLL AP BUILDING INSULATION WALL/FLOOR BUILDING AIR SEAL BLWS 01 BL3 01 BUILDING FRAMING TIME 17 00 Boy's and Glr1's club for Steve Zenovlc Startlng to hang sheet rock also lnsulatlon/alr seal/plumblng rough/ ok checkfor under slab lnspectlon under other permlt # was done under wrong permlt/]lm B""."'...'\\(;:-)\~~.~...:~:~:::;::::~O.,:'::"':A:: ...................____._..._____.. 7~ ~~4 PREPARED 4/27/04, 12 35 23 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 3 4/27/04 ------------------------------------------------------------------------------------------------ ADDRESS TENANT, NBR CONTRACTOR OWNER PARCEL APPL NUMBER 2614 S FRANCIS ST BOY'S & GIRLS CLUB HOUSING AUTHORITY OF CLALLAM 06-30-10-4-3-0360-0000- 03-00001016 COMM REMODEL SUBDIV PHONE PHONE --------------------------------------------------------------~--------------------------------- PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS 10/23/03 JLL 10/23/03 AP 10/23/03 JLL 10/23/03 AP '""_O'___'\~---'""""N:,:::::, .::":0'::-"___________________________________ eJc6J~, PL1 01 PL2 01 v~&(.b\e .e Vc....-~? PLUMBING UNDER SLAB PLUMBING ROUGH-IN \-0 W/J. TIME 17.00 TIME. 17 00 PREPARED 4/27/04, 12.35 23 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 2 4/27/04 ADDRESS TENANT, NBR CONTRACTOR OWNER PARCEL . . APPL NUMBER. 2614 S FRANCIS ST BOY'S & GIRLS CLUB SUBDIV HOUSING AUTHORITY OF CLALLAM 06-30-10-4-3-0360-0000- 03-00001016 COMM REMODEL PHONE PHONE PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 4/.27/04 ,J J~ n It\ -an \~"'\.~ ----------------------------------- CONTINUED ONTO NEXT PAGE -------------------________________ MECHANICAL FINAL TIME 17 00 PREPARED 10/23/03, 12 28 34 CITY OF PORT ANGELES ADDRESS TENANT, NBR CONTRACTOR OWNER PARCEL APPL NUMBER INSPECTION TICKET INSPECTOR JAMES L LIERLY 2614 S FRANCIS ST BOY'S & GIRLS CLUB SUBDIV HOUSING AUTHORITY OF CLALLAM 06-30-10-4-3-0360-0000- 03-00001016 COMM REMODEL PHONE PHONE PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 10/23/03 PAGE DATE 8 10/23/03 ~L BUILDING FRAMING TIME 17 00 Boy's and Glrl's club for Steve ZenOV1C Startlng to hang sheet rock ------------------------- ----------- COMMENTS AND NOTES ------------------------------________ ~<;,u I )(fY~c>0 ~fl- ~ 1 P((}>11lJIU~ PI u~ b;<<j- ]tJ-d3- o~ ~ 'b - ;;\.3 - 6~ '!;;>(-a-& /CltQutL oMtUt ( ( 0yL.wl d- ~ u;Jf)t/L rLoJ~ WlSD 1200 <:yt, 10 ;;}'3 -6~ C.- 4.-ev k ( Pv12- fi,LK;G . CITY OF ~ORTANGELES d1f!!A... .. ~ WAS H I N G TON, U. S. A. PLANNING DEPARTMENT . ~' .,' ., p ~c>, ~+.... i~ ^ - \ ....;.j..-' ~:.~ . p September 13,2001 Mr. Steve Zenovic 519 South Peabody Street #4 Port Angeles, W A 98362 RE: Conditional Use Permit - CUP 01-06 BOYS AND GIRLS CLUB - 2603 South Francis Street Dear Steve: As you know, following a public hearing conducted on September 12, 2001, the City's Planning Commission approved the 'conditional use permit referenced above with the following conditions: Conditions: 1. '. The 4 off-street parking spaces shown on the site plan submitted for CUP 01-07 located at 2602/04 South Francis Street shall be made available when needed for the expanded ,'boys and girls club use. 2. The CUP is approved predicated on the 8 off-street parking spaces identified as proposed for spring of 2002 on the SIte plan submitted for CUP 01-07 being constructed as proposed. The decision of the Commission is final unless appealed within 14 days to the City Council. If you have any questions, please don't hesitate to contact this office. Sincerely, Sue Roberds Planning Specialist cc: Building Division 321 EAST FIFTH STREET · POBOX 1150 · PORT ANGELES, WA 98362-0217 PHON E 360-417-4750. FAX 360-417-4609 · TTY 360-417-4645 E-MAIL PLANNING@CI PORT-ANGELES WA US \f\ 11 .~ c ("\ - \f\ .. MEMO DEPARTMENT OF COMMUNITY DEVELOPMENT Brad Collins, Planning Director 417-4751 Sue Roberds, Plannmg Specialist 417-4750 Debra Barnes, Associate Planner 417-4752 Lou Haehnlen Building Official 417-4816 Roger Vess Permit Technician pORTANGELES WAS H I N G TON, U. S. A. August 23,2001 To: Sue Roberds, Planning Specialist L!J / Lou Haehnlen, Building Qfficiat1f>O' From: Subject: CUP 01-05 Boys and Girl Club- 2620 S. Francis Street The Building Division has reviewed the application and has the following comments, 1) Plans to be submitted for interior remodel work. 2) Building to meet ADA requirements. 3) Building to meet the 1997 Uniform Building Code requirements. 1\ ~ ~ ~) APPLlCANTIOWNER INFORMATION: File # (7i/pCI -().~- Recpt# J;'fl <l~(, - i//j( Applicant: ~'t' ~ '1 6., \'2..C ~ c.~..,,-~ ot= T I>H8" 0 1..'l1oV\,P l L Pt::~ It.:) &\,,)'- r\ Address: P.o, ~D" 4l~".' ~~UPMI W,4 'd3~c:02- Daytime phone #: ~~ - 8e>'iS. * Applicant's representative (if other than applicant): <Srl.,iK. ~O\ll t... .I ~o" Ll..- ! ,k'Dc';. ) I nc... Address: Sl4 ~. P-r"'c.. bod '" ~~. '-Lei I P A- ~t"l~ ~ 2.. Daytime phone #: A..t '7 -C) SO I Property owner (if other than applicant): C L. L lA 1M. CD.JIoIl-ly ~,)S I \00\.'; ~ovf1.y Address: ~?, S, -=h:-KlA Ll~ <;~,. l>.A . Daytime phone #: 4-52-1 ~ ~ I , PROPERTY INFORMATION: Street address: 2<,2..0 S, ~4""LI (. c;.+-') t>c...A ~,~_L-e..s L'2i..lO -~U>) Legal description: Zoning: 12s- 7 Comprehensive Plan designation: f2..es.~"i, \ Property dimensions: Property area (total square feet): Physical characteristics (Le., flat, sloped, vacant, developed, etc.): F\~+- -+c '!".Ll~+1"( ~~~d ((. S~o)) ~~~ ~fk.. t.". JJ~l~A ~ '\\~ \\4 -c.~~'I ~D~L~ PROPOSED USE INFORMATION: Please describe the proposed use: AJul.H.,&"""" '^'i r1.... ~ k~~!>. ~ l-b ~ "~A.4.).lJV I lAc. I ~ u.xv ~ tuc~ (~~I e^"fl'"lW\.l~s\:..\U",) ~f6-kv~lc.;LI~,~.). &.~S.11o~1'~ t.wk r9vov:rl..Lt "E>...Ip~"I~ ~-:h\J\+1"'1l!.s. ~V' i.ou~ fi.'(.J.. c...-I~, ~- 4- ~ 'i-I Number of employees: ~ t,!.. LLub - (0 Hours of operation: 9..kl.:. c V.ID '2..-1 Number of on-site parking spaces: 21.- Number of off-site parking spaces: Building area (total square feet of floor area for the proposed activity): c." 4..co ~t= +t _ SIGNATURES: Applicant: I certify that all of the above statements are true and complete to the best of my knowledge and acknowledge that wilful misrepresentation of infamation will terminate this permit application. I have read this application in its entirety and understand my that submittal will be reviewed for completeness and, if found to be complete, will be scheduled for the next available Planning Commission meeting. Applicant's Signature -4Jm J - ~ f't, ~I.,..j.~ tl"h Date 'is'/t.j./ / -j ;'V ~ Owner's Signature (if other than applicant~: 4t1v jlj 1/;..it}) _ Date Z) /ID /0\ .- J-vl~n~~C{,tfiJL t)r<<~ijor .' " " 0' 0 )0". - ~..' rt') (Q li -,' ,- "- , j I '0 '. , ~g '", ff~ j2 ... ~ ~. r.~5~.~ " '" w ~, ~~ ,... . -=:... \:; ~..~ ..J ~~~~I ~ ot en a. ~ ,g 'lh~ 0 ., Q c :2 "'t~ 0 N V ~ ;;:.,lQh: , - <5 3: .2 (/) CI,) 0 L~ '" .- c Cl 0 :::I", !!! ~, <..l ~ c: "'t .. ;t' CD 0 Q) ~ 0 "Of" ~ . (/) 0:: ... ... ,~ " , ~... ~ I ... .11. ~ .':>}= ....S-.- I ;fiiii'i~ ::: 0 !;f roUl/ N ~- I,ItJ'WJ ,-" ;! ,,;. o o .:.) , \2; ','-\ '0,- -"'."<'1 , ~ ,~--;;.' 5":: i :"-~ -',:"::/1 , ,,,,,1 " '~- , .. ;,,~ :'}:',4~1 ~ ',! '::~Z~ 1" ''''1 " ];. ':"'j"1 -'% : '" ,"; '~ "_:~ - ;'.;:5J . ,,:, ::~j .:~.~ti "'-JJ ,:::'''\ <-~i ';'j '<j 'j " '. co ~ .1 " - o~ ~:i! ur f- 1ft \ tJ : ,~ ~:o I' ~ 'R'..{ >" ~-~ i !I ~ ; IS: ::. ~- ~ ".l i * i " . ~; >.. i~ .! '. ~ ~ 0 ~. ~ ~ -" N ~:: 0 -lO' ,'-." ~L ) ~ ~j 0 ~ ') . ~: ~ ~ "- ~ --> " ~ ~~\' , < \ ~ . % '" mr 1_; '~~ ~ ... i o ~ . ". ~;; 'It ~: "- ~ o ~ !d ~/~ ~I --.. iJ o c r- :WI A'OlS<;lN~,JJ ^Il )flll' 1/Y.1"}I,f'}J 'Sli~ti' :UIJIJlfl' v hIli II,I'TJ.~IIJ 1 ~: aN'I( 'n1aH0'11~ 1ltV ,Plll.!. ~ 62NJI'1 .,,zHMtJob,J On.V :J~l(.ll:l,'" .l.7S;f,>/(;' ,4ff'l,I'. {1J a,il'i::J..z,.1 >~ J". CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS /" . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date (94' 10 /0"3 Time II' {,S-- Received by ~~ (PhOne~p~ II I I' . Location of Work to be inspected !.3f:, s ~ Name of person requesting inspection y} G: lOt Address of person requesting inspection one No. 1/ IPO-Cdo3.!J. Type of Inspection (circle appropriate one): Permit No.13~S- ~ tel~ Sewer Foundation Framing Chimney Plumbin Final Sewer EXC~V. Other \ - ~\J ~o(\.. b ~,?- $; 1(1 ~ INSPECTION NOTE~:\ '" (r. ' Inspected: Date ~y Time----Rlvt By J"[...; Remarks: ~ RESTORATION REQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC D Other D Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) ~TRFFT ~I JPFRINTFNnFNT (DATE) /-.p':x \V \ BUILDING DIVISION r \~\<." CITY OF PORT ANGELES * * Correction Notice Job Located at ;2(0 d- b Sov Llt - ~~ Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: ~ ~ is ~ (;;.j:;;:~ I ~'vt-1 ~J-i2~.t\..Lb ~ ~l)b~-sS 0)...1 i;u\ tJ ; u~ lo 11 M j~ ~~ ~ rd-c...c.....~ c:.. k L...::H~-k,2. W~k,2- ~v'L. r"-L 'S~ ~ 1l~"J2y ~~~A ~ Lee ~~IOI..J.-~ f.A:J I 4- ~ G- I2..t-so 1 ~ k O~\. ~ These corrections must be made and are not to be covered until reinspection is made. When corrections have been made, please call ~ II - L{ ~ / C-- :~t~ns~r:~'16<f ~ t!J..n Inspector for BUilding Division---- DO NOT REMOVE THIS TAG I I I I ,-x-----x___, I / : r /: I / ,/-- I ,~ ,,'j 1/ " T I n66 A I I PLA Y AREA I ~/--~~~ r ~ ...____2 Tfj----_ I // -----_______ Y ~ I~J<. (x~E~"" "--P;;;';;;~-;;~D ~ '\ \. _ _ ~ ENTR~_ AR~~~_----l >_____ ~ruITrmTll~~ I ! EXISTING PARKING AREA (22 SPACES) j /,,) 14 -'-, I '\~ I ,I \, EXISTING eoy 5 AND G!RL'S CLUB fACILITY, TO BE CONVERTED TO ADUL T LEARNING CENTER AND BOY S AND GIRL S CLUB STUDY / COMPUTER FACILITY (2000 SF:t) -..'" 10 A ~ SITE PLAN: x 1 " --..............~ -..................- L--.. <<, J '--------. i l I' /J/ 0/-1) -'-- " -----,1 '; ~i" ; ':'-'=-~,. -~-:- - - - - - - --,- - - - - - ~-- :'-':::; --~~,,:: ~'.:- - - - - - - - - - - - - -,~"A -, r r ~-)-, -', I PROPOSED NEw PARKING ~ --, ------...._____/" II I :2 1 '\. ~~, : AREA (B SPACES) "-, _ I N f'::7 /'-.\ r~ I /----, --,-, '- i ' 0 I fI ""/ r' 'j-- l j '/-- "''/'''I\~'---~~'~--~~~-~~'-'~'~-:~~::~:'-:---~~\- i{1 // I i I "-- --,/' - ---~, ___ -" I ...'_ \ \""_' L_ -- - ---- ---___J -___'___, J- _'~ \__ " ~ ~t \ ~ \ i --.......----- ,.f:) I / -~..." 0260 ~, ~, ~- PROPOSED BOY'S AND GIRL'S CLUB MAIN fAOUTY (4400 SH) 2690 X EXISnNG RESlDENnAL rOURPLEX ~ -/11~- ;- ) "/ / -',/ -J- -:; I I J J__ No ReVISion/Issue Dole mu CON011lONAl uS( P(~" feR "'1 ANenes '...aUN - 801"'5 AND ORlS Q.ue or lH[ Cl.'I\IPIC P{MHSUlA PRELIMINARY SITE PLAN clInn DRAWING ."'IDT/OI401J/0135P-IOwe BOY'S AND GIRL'S CLUB or THE OL Yl,CPIC PENINSULA ..,. NO SH(n PO BOX 4167 01073 SEOUIM, WA 98382 0.1t 1 Z [NOV 1\ & ,., 5 ...."'" 51 Sit . AUGUS T 2001 ~ PO'tl AHC{l.[S w... 18J6:l ASSOCI ATES ""'H' lJOOI "'-0",,' "'Ol' IHCORPORA'lQ FAX (lIO) .11-0~'4 I" - 3D <T I , II _ J I I I J I _ ,/ ! :' " j I / 11/ j/ 30' ----- ---~-- - ---- - ---- -40- ------ -------- ...:.::~ -- ::::-_~----- - -:--- , - - -- - ---,,'- '" '" ru "- m ~ 0> => "" L <c 12 ~2 0__ NORTH ELEVATION EAST ELEV A TI ON (WEST ELEVATION SIMILAR) 12 :::=-12 ------~------- --- - ~~ --- -- - ----- ----- SOUTH ELEVATION No RevIsIon/Issue D. DIU DuPlEx A[UOO(l - W' AHC(US r AQlITY fRAHOS Sf POA' A..C(l.[S WI., ELEV ATIONS Clt:Hl DRA\\ING "'/Df!OIOOI/Bac [U:VDWC BOYS ANO GIRLS CLUB or THE OLYMPIC PENINSULA JOB NO $HEET PO BOX 4167 01001 SEOUl/,(. WA 98382 1 OAIt Z ENOVIC & $It 5 P0800Y Sf. Srt . /'(A Y 2001 ASSOCI A rES PORI ANC:UES .A MJel PHOH[ (.160) 417-0~0I stAll INCQAPORATEO r.... (360) 4'7-0$'. 1/8" . 1'-0" CT 3 6030 CLASSROOM BAll-< BAll-< C> C> ru Orrtc( ru '" ru 6030 ::; ,,~ J J N. Revls.onllstu. Dote mu DuPU;X RtYOD(l - W' AHC(W 'AOllTY ntAHOS ST. POAT ANCI[US ."- FLOOR PLAN CU{NT DRAWING 'MNlDr/oloo'~ Q.Ut1 owc BOYS AND GIRLS CLUB or THE Ol YJ,tPIC PENINSULA ... NO SHE" POBOX 4167 01001 SEOUIIA, WA 983B2 .A" 2 Z ENOVIC & 51t 5 P(ASOOy ST SI[ 4 IAAY 200\ PORT ANCiUlS WA II)U ASSOCI A TES PttOH[ (360) 40-0501 stAlL WCCRPORA TEO "AX (J601 417-05'4 1/8" . 1'-0" " 3 s: a. => <( L u.. 6030 CLASSROOM ., '" ~ '" '" :!; SlUDY /COMPUTER ROOM ~ 35'-3" CLASSROOM 6030 6030 is N o ~ NORTH ELEVATION 12 WEST ELEV A TION C> ~ ~ '" => ""' , u_ No ReVfston/lssue Dote nT\.[ rQURPl.(It Jf(1ol00tL ~ LIt ANenES rAOUTY SOUTH FlU.HOS 51 PORT ~G(L(S WA ELEV A TIONS CLIENT DRAWING ","/DT/OlOOlj'86:C ElIVl owe BOYS &< GIRLS CLUB or THE Ol Yl.4PIC PENINSULA JOIl NO SHCET POBOX .'67 01001 SEOUllA, WA 96362 0.1t 1 Z ENOVIC /3. ,,,. ""'.00' Sf .It . MAY 2001 ASSOCI A ITS "OAT "'",,'" .. '0"" .. :, PHON( (.360) 417-0~OI SOU INCQRPQRAT[O rAll ()60l .17-0~U 1/6- . 1'-0- a 3 --- ------- ----- --- ...~-~ .-~-~~---~~- ~ - - ---------- o o ru o '" '{] 0> ~ L '-'- --------- ----- - -- - -- - ----- ----- - SOU TH ELEVATION 12 12 ----------- - ~ -- --- - ----- j ------- ~- - - ---- -- ) :~ ~ --- - -=-=--=--: - EAST ELEV A TI ON N. Revlslon/lssue Dole ntu rOJRPL[I R(UClO(L - "" ANClLE$ rAOLIT'Y SOUJH rRANO'S ~1 POR1 ANC(LE$ WA ELEV ATIONS ClIEN1 ORA WING WlN/tIT/01OOt/llac [l(VIOwe BOYS ole GIRLS CLUB or THE OLYMPIC PENINSULA JOO N. SHE" po BOX 4167 01001 SEOUIM, WA 98J82 ..It 1 Z ENOVIC 8- 51' S P(A900,. $1 Sit . MAY 2001 ASSOCIAT[S PORT AHC(US WI. '8.)61 PHONE (J60) 417-0501 SOU INCORPORA1(O rA)l (360) 417-051" 1/8- . 1'-0' IY J 6030 h\ =v:l" I ~ COPYI SUPPLIES -....... \ OFFICE o '" ~ /2668 \~068 '-- /'" , g 6030 = 6030 6030 6030 OfnCE :g ~ - - - - 51/B 7", 224F-W GlB-- ART SUPPLY 1 STORACE AR T ROOM 2668 ~ ~ I I OUIET ROO" S GA"ES I I s 0 I I 0 '" '" 0 6 X 12 0 r 12 ---'l ~ 6 X 12 or '2 (ABOIlE) I I (ABOIlE) S I I 0 I I .. ~ g I I OUTSIDE COIlEREO c====dc=.=.=.=. PLA Y AREA '/2 WALL GLASS S S 0 0 '" ., . GA"ES 1I:l S II; S ~ II :; DINING AREA g .. )( 12 0 r '2 (ABOIlE) . ~ .. x 12 0 r 12 (ABOIlE) C> C> '" RECEPTlON/ EOUIPMENT .. )( 10 0 F (ABOIlE) ....7- '2 '" 6030 en '" ., L LL KITCHEN \J GLASS g l'; _ _ _ _ ~'~ ~'.~_?~_~ ~8__ '2 TEEN ROO" '" g 6030 6030 6030 -=------=--- ---- No Rellls1on/lnue Dole nf\.( '0URPl.[1l A[WOO[l - Ul oUfC(L(S rAQurv SOUfl1 'RAHCts Sf PORt AHG(l('5 WA fLOOR PLAN ClI(Nl DR A WING W1NIOT/01OOIj'B.a<; o.U82 aM; BOYS &. GIRLS CLUB or THE Ol YlAPfC PENINSULA ..<lB NO SHUT PO BOX 4167 01001 SEOUIM, WA 98J82 2 OAll Z ENOVIC & !ll' 5 P{A8QOv Sf Sft . AUGUST 2001 ASSOCI AT[S PORT M1Gtl[S WA '8)6' PHOH[ (380) 411-0~1 se", INCORPORATED r.... (.160) H1_0~14 1/8" . 1'-0' CT J BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY Date Rec /d"'I'-.-O:S PermIt #, 10 I ~ Date Approved, Date Issued Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 Applicant or Agent: lc.~I~ \ (.,., tu...~ Cl.""" oF' TIt'r'Ot""",,,,l... Pt:t>.:)'t.:IS\ll..A Phone: (P8~ -8cC11s Owner: ~LlC:.''^1 Jh,-I-kO"'I~ o~c..I~L1a.......l.'C). Phone: 4-5L-L~bl Address: 2(PD~ <3. .. =1="'_ "'C,{,. Sf... City: a,.....+- ~~l_~ \ U; A Zip: ct5~c,2 Architect/Engmeer: 1:-elAo'tI'-l ~t;Ot:..... I lAC. . Phone: Ao.t"-~-ol Contractor ()~vVV' State LIcense #: Exp: Phone: Address: CIty: PROJECT ADDRESS: "2~ I 4- s . ~'^c I So s.-r...-e-L:t ZIp: ZONING: ~V\o\ i) LEGAL DESCRIPTION: Lot: Block: SubdiviSIOn: CLALLAM COUNTY PARCEL NUMBER: c!:l(,p-l.O -lo- 4.:~o:3cd) Credit Card Holder Name: . Billing Address: Credit CardType VISA l\1C # TYPE OF WORK: '" SIZENALUATION: o ResidentIal.- 0 NewConstr. 0 Re-roof 0 Stove 42.00 SF.@$ 50 /SF.=$ '2..101000 o Multi-famIly 0 AddItion 0 Move 0 Garage' SF. @ $ /SF = $ o CommercIal f!("Remodel 0 DemolItion 0 Deck . " SF. @ $ /SF. = $ '0 RepaIr 0 SIgn 0 Other TOTAL VALUATION $ 2.IO,WO BRIEF ))ES(;.RIP~ION, q! ~~E ~~OJECT: \ '" k...-,I'\;"" ~INI. 6~ "..tc."'t"DV\~' do > qp4~~"d.~ 1101\ ~ V\eu.1 Bo'{llo i G.\.A's c...\ J" ~c.' di.~ COMMERCIAL/RESIDENTIAL: Occupancy Group: A- 3 '. Occupant Doad:, "l ~o Construction Type:' \/: No No. of Stories: L Lot Size: "-lJtl. EXIstmg Sq. Ft. & Proposed Sq. Ft EXIstmg lot coverage _ % & Proposed lot coverage _% = Total lot coverage City: Exp. Date: APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: ESNWetland(s)' 0 Yes 0 No SEPA ChecklIst required? 0 Yes 0 No Other: BillLDING PERMIT APPLICATION SUBMITTAL: The BUlldmg DIvision can proVIde you with information on the applicatIOn and plan submittal requIrements If you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the apphcant. ThIS figure will be reviewed and may be reVIsed by the Buildmg 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 bUlldmg permIt application and constructIOn plans are submitted. All other permIt fees are due at the time of permIt Issuance. EXPIRATION OF PLAN REVIEW: If no permIt IS issued within 180 days of the date ofapphcatIon, 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 107.4 of the Uruform BUIlding Code, current edItion). No applIcation can be extended more than once. I hereby certify that I have read and exammed 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 determine what permits are required ,n t the CIty'S, and that I must obtam such permits prior to work T \FORMS\APPS\BUlldmgpermlt wpd Apphcant: Date: IO! '1cJ3 , 07(20(2003 03.:33 4579270 SIHPSON ELECTRIC PAGE 01 , j., '.~i Ii '- : {'/;'O) ELECTRICAL PERMIT APPLICATION in. tlloO\rlOllI Pormll ApplloAUon mUll) Il!l mind oul pqll'"I~. 1'1e".IVI'" or ,,,,,,,Inlln Ink. ~ you lI.w",y que.tlen., pI........1I (3ao. 41'1-41$~ fox numIM" (3gO) 411-4711 Owner or IlI.o, Conlrootor Ag.nt:s.~.t J'L IA. . Fie .:.j~ r L Phon.: _Lf..1i.,2.::!111~~.,,: ,.."..,~_l:!:~'i-;.. ". propenyO\lJ1lor:_Gi'\jS" ...Q:,.-~L_. I,.. ;Loot) ""b (If Th 1.~:t;e~tftl~~,~I!';,,___~... A~a",..: P.C'J,:($ ~)<,tib. ') .$c~" ~ Oily: Ptl.rT j~~ C ._._,....._._._Zip_ '1, 3'1(;, l..._,., ~IOOlflo.IOon'fIl1llOr: ,.~.. W").t~.l'2.:I::::o",~Y Go::. Jr ,'c t1aon..41:~~..ss:.5"!"_,_.QS_.._""J'M<1.:.2:$-2JL2a0? Mdree.: 'L'1,~ ')):? (. ~oo/O I W o/lY:-ft1:. '17"J Y.1/ ,__,__,_.,..,_.....,...ZIP,!1"iJ '-':1 . INSTAL-I.A nON WIRl!.q BV: 0 OWNeR .1il ELEOTRICAL. CONTRACTOR t flO\\ ;';;~I^L \)8JI O~L Y 1 (;Illl~IIt~,..: ,-'. U f'",T1lU~; ..__..____ I~~lil AlPflf"~: .___--:-_._.. I:l,w 1~~I!I1J'''__J_ jfit1F~9~- Crtlellt Ctlrd Holdsr Nsm.: SlIIlng Addreee: , , "--- .-.---....,,-....--..-.....---.-. '''-.'-- _ CltYI_ __..,__..._....._,_.......... lilt: __.._,_..... .----_....,,_,,_..._,._.. YISA:___MC:_...".. CtrIdll ClIrd Number: , , ~" Ell"" O'*'SI ;(PNiJ--"3"h.iLT-- ... ~' ,- ..-'..__ S I _r~.5 '''~ Check fi1J that l!lpply:~New PROJeCT AOOAess: ' sT. -~...,_.,~.,........"..,~-'""..~ ,..,_... -,.....~ TYPE Q" WORk: o Alteration/Addition o Resldental 0 Multi-family j{ CommerCllal 0 Mobile Home ,Sq. fl._..."__.,,...._....,.. I .>i o RQmotm Marer 0 Detflchllld gEiraglll 0 Hot Tub 0 Swim Pool 0 Septic Pump 0 I,IJW '1011'!91.1 0 TlJIieool7l, 0 Sll'.ln I Number of Clroulte Oddmd or alterllr!: __~_"_ Ol!SCFllPTrON OF rr-ilii IilllCT'RIGA!, f'AOJI!CT: _..w. It( e.. !Q . "r ~ IV\- "[ /1", Q ,(]."h~ (> s;;t-::.wdc e- (,A.- ("~, :~---v.~_1I.... ".~"X""-'~'--r-r.J.. _ ..........,---. -------,'....'.....-..,..""'...........,..-.,.-.,------....... ..._-..... ----..--..,...,.......-..-" i/ G 'TF'X IDl'41rlCII Heel LoBd AddlllQnlll '2... FJ,>r hU~ HG,,--r~v..."'^-fS o Ssaeboard /'<'- KW I C' k r-/ o PurnSCQ ~_ KW __ CI O'ltil'''..d Servloe o Helll Pump :; :,~W 'f I tf h. 0 Temp Service CI Pon.W,,1I - KW 0 UnderQround Service jjmlYJf.lfll1:m@J~9:1.1 \lrJi18Q~' 219/t.Y:L_ 1'''90&; [J 1 ]::1 ~ S."'lc.lil ~ll,.: _(,.J?~..i! ' 1'~lcI6J" ;)IZG:.~,"",._,,_. PAMC 14,,06.080(6): For InduBtrl'11. .Ol1lme~llll, & rIle/danl'al projeOl$larger filen a duplex, . Qn0 -line dr~wlng ill fl'll! f:lectrl.ol Sllrvl(,* & Fasclsl'll, building IIlze (sq, It.), load C.loul~1IoIl9, una tllD Iype 8. of cond~lclol'll end/or raoawav I. r9ql~lred 41110 &helll.er.(lmpeny the o;lootrloal P&rmll..pplla~llon. . : I herlby oertlfy If/a. 'I J have '"ael Gnd examined Ihls appUc8tion ana knOW;tfrs.i S~jme to be frum l!nd correa~ and I Ill/! authorlzecl 10 apply ,for IhlEi parmlt. I /)nelfJrsfSnrJ It Is northa City's Isgal f$llponslbll/fy /0 d/lt~l(mllll;1 whal permlta a~ r9q0l.1IMd; It remB/ns the 'Wl/icanls I'9spon9Jblllly to determine wh1)l1 piJ/mlltJ Eire req(lif/!l1 and to obtaIn such. 7/'/...1 0'; l :,' 1M ~ ?JI:- A7 h - tt--,c J'el " ... Cmd8t Clltlll1Qlclllr'. Slgn.turfl:_~ ~_I..._..,__ KJIIIQ:._ _._.. OWI1.." o. i~130. com. SI\l...at!.lI'\l:-..________..___,__~~11l!!t: 7 - (1:..___0J : f.-',tp)~ $ql/,~o. ~"2.13'(1?O ~ j1 fJ-;l: 7-/5'~ot3 'J-~. 'foX 2. tflle.so c.. I 7-2.1 -0) , , PW.Q01Q