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Home My WebLink About213 E 10th St - BuildingApplication Number Pin number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Use Property Zoning Application valuation Other Fees CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 h 4 S 4 T \PLANNING \FORMS \1102.15 [11/14/2003] 04 00000015 217085 213 E 10TH ST 06 30 00 0 2 9060 0000 RES ADDITION RS7 RESDNTL SINGLE FAMILY 20000 Owner Contractor HULETT AARON OWNER 213 E 10TH ST PORT ANGELES WA 983627833 (360) 460 4179 Structure Information 126SF ADDNT REMODEL Construction Type TYPE V NON RATED Occupancy Type SINGLE FAM CONGREGATES Other struct info HARD SURFACE AREA Date 6/22/04 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc HP /FURNACE T STAT Sub Contractor DAVE S HEATING COOLING Permit Fee 46 70 Plan Check Fee 00 Issue Date 6/22/04 Valuation 0 Expiration Date 12/19/04 Qty Unit Charge Per Extension 1 00 46 7000 ECH EL R OR RM 1 4 ALT CIRCUITS 46 70 Special Notes and Comments Electrical load calculations and elctrical permits are required Any modifications to the City s electrical facilities will be at the customer s expense STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 46 70 46 70 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 51 20 51 20 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 UNDERFLOOR /SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR I 4 1 FOUNDATION. FOOTINGS WALLS FOUNDATION DRAINAGE /DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN PLUMBING rINSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP GAS LINE 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 PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I PLANNING DEPT 417 -4750 I I BUILDING 417 -4815 I T \PLANN[NG \FORMS \1102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES i NO 417 -4735 ELECTRICAL LIGHT DEPT Ex P ,e.st.0 SEPA. ESA. 1-8 -D4 SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE DATE YES NO COMMERCIAL DATE I ACCEPTED 1 YES I NO CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT 1 BUILDING I I I I I I I 1 I I Application Number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Use Property Zoning Application valuation Owner Contractor HULETT AARON OWNER 213 E 10TH ST PORT ANGELES WA 983627833 (360) 460 -4179 Structure Information 126SF ADDNT REMODEL Construction Type TYPE V NON RATED Occupancy Type SINGLE FAM CONGREGATES Other struct info HARD SURFACE AREA Permit ELECTRICAL NEW RESIDENTIAL Additional desc 200 A PANEL W/ CIRCUITS Permit Fee 76 30 Plan Check Fee 00 Issue Date 1/21/04 Valuation 0 Expiration Date 7/19/04 T• \PLANNING\FORMS \1102.15 [11/14/2003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 04 00000015 213 E 10TH ST 06 30 00 0 2 9060 -0000 RES ADDITION RS7 RESDNTL SINGLE FAMILY 20000 Date 1/23/04 Fee summary Charged Paid Credited Due Permit Fee Total 76 30 76 30 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 80 80 80 80 00 00 Qty Unit Charge Per Extension 1 00 76 3000 ECH EL -RM 0 200 1ST SRV FEEDER 76 30 Special Notes and Comments Electrical load calculations and elctrical permits are required Any modifications to the City s electrical facilities will be at the customer s expense Other Fees STATE SURCHARGE 4 50 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 1 v r V rtA 0 0 BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS I WALLS FOUNDATION DRAINAGE/DOWN SPOUTS I ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN I J C Z s Ly� 541 1 I PLUMBING r UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE I BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE PELLET CHIMNEY HOOD DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM I I ej�' pt a_, SP PLANNING DEPT SEPARATE PERMIT #'s SEPA. �T 243 Q 6 PARKING/LIGHTING 1 ESA. LANDSCAPING I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES 1 NO ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 I 1 1 I FIRE DEPT I PLANNING DEPT 417 -4750 I 1 1 1 PLANNING DEPT I 1 I BUILDING 417 -4815 1 1 1 1 BUILDING 1 1 T•\PLANNING\FORMS \1102.15 [11/14/2003] . Of 'OA::~~ l:~~ rea 'L ~ c-=- ~IC~ 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 Subdivision Name Property Use Property Zoning . . . Application valuation 04-00000015 Date 213 E 10TH ST 06-30-00-0-2-9060-0000- RES ADDITION 1/21/04 Owner Contractor EXPIRED ~/2-~0 RS7 RESDNTL SINGLE FAMILY 20000 HULETT, AARON 213 E 10TH ST PORT ANGELES (360) 460-4179 Structure Information Construction Type Occupancy Type . . . . . Other struct info . . . . OWNER WA 983627833 126SF ADDNT & REMODEL TYPE V NON-RATED SINGLE FAM & CONGREGATES HARD SURFACE AREA Permit BUILDING PERMIT -RESIDENTIAL Additional desc Permit Fee 344.75 Plan Check Fee 137.90 Issue Date 1/21/04 Valuation 20000 Expiration Date 7/19/04 Qty Unit Charge Per Extension BASE FEE 92.75 18.00 14.0000 THOU BL-2001-25K (14 PER K) 252.00 ~ - ~ 11l Permit Add.itional desc Permit Fee Issue Date E~iration Date MECHANICAL PERMIT 76.00 1/21/04 7/19/04 Plan Check Fee Valuation .00 o o ..}.. f -Qty Unit Charge Per Extension 47.00 29.00 BASE FEE 4.00 7.2500 ECH ME-VENT FAN Permit Additional desc Permit Fee Issue Date Expiration Date PLUMBING PERMIT 96.00 1/21/04 7/19/04 Plan Check Fee Valuation .00 o Qty Unit Charge Per Extension 47.00 49.00 BASE FEE 7.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP Special Notes and Comments Electrical load calculations and e1ctrical permits are required. Any modifications to the City'S electrical facilities will be at the customer's expense. Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due 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. ;4- /: /~ CiI/ZI/O'1 Date Signature of Owner (if owner is builder) Signature of Contractor or Authorized Agent T \PLANNINGIFORMSll1 02 15 [11114/2003] 0# f"OR--Vr, ,>"'O~~ 0Ra "-~ ~ "l.tii:.,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUll-DING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 04-00000015 Page Date 2 1/21/04 Permit Fee Total Plan Check Total Other Fee Total Grand Total 516.75 137.90 4.50 659.15 516.75 137.90 4.50 659.15 .00 .00 .00 .00 .00 .00 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, If construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Owner (if owner is builder) Date Signature of Contractor or Authorized Agent Date T \PLANNING\FORMS\1102.15 [11114/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. r INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I PLUMBING ~ I. p~ r - 3/~~r A-p '-T UNDER FLOOR 1 SLAB ROUGH-IN l~... o.v--oH f<V WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS . ~ D,l-)"'OrJ J L.). I CEILING r FRAMING JOISTS 1 GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING d.. ~ -() L..J LL DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING ~ -;Pi - I'JJJ I .,L 1., I / 1--' ,L ''I MECHANICAL ~ HEAT PUMP L ,,j GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engmeenng DIVISIOn) SEPARATE PERMIT #'s. WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTING ESA LANDSCAPING SHORELINE' FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R. W. 1 PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \PLANNING\FORMS\1102 15 [11/14/2003] Fill out COMPLETELY and in INK. Your application and site plan MUST COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 FOR OFFICIAL USE ONLY D'WR"~~q PermIt # - s: Date Approved '0 Date Issued BUILDING PERMIT - APPLICATION Applicant or Agent: Ao..yOVl \2... \-hA\.e:rt Owner: Aa 'Y D VI rz. . H LA l-t t~ Address: 2-.-1 ~ B. \ Ol-:b <;Jo-. CIty: Phone: L3LPOj L/-tfJO-L{ /7t:t Phone: L3LPO) 4-f.t;o -1.//7Cj -roY'\-- A-v1~\C~ I U)c.t, Zip: q~3LPL- Phone: ArchitectJEngineer: Contractor State LIcense #: Exp: Phone: Address: PROJECT ADDRESS: ?-\? LEGAL DESCRIPTION: Lot: - , CLALLAM COUNTY PARCEL NUMBER: e. \? CIty: \cjb <;-\:.',l ~ov\- AYl1<J.e~ wa. tiJY3l.oz.. ZONING: Block: Zq 0 SubdivisIOn: Ow3 0000 2-~O /.DOODOD Zip: fJ/LI-I ,oJ .........1-'1. p- - j 4~s /? TYPE OF WORK: kReSIdentIal 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial ~Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: I Yl ~\A ll\.t( ~\tLe-Lh'b v10 l7~i(Vt COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No.ofStories.L Lot Size: {OOO ExistingSq.Ft. /(,3L &ProposedSq.Ft. 17...(4 =TOTALSq.Ft. 17<(8- Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage ~S, I % # o Stove o Garage o Deck o Other ('{\\)V~ IV\reV\ O\r SIZEN ALUATION: SF. @ $ /SF. = $ SF.@$ /SF.=$ SF.@$ /SF.=$ TOTAL VALUATION $ 2~ WbtllC/YfplfAL.e. IAJ\()tWW~. V(-tAlII'( YP-plv\VYlb.l APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUBMITTAL: The BUIldmg 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 applicant. This figure will be revleJed and may be revised by the Building DivisIOn to comply with current fee schedules. Contact the Permit Coordmator at 417-4815 for assista~ce. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the bUIlding permIt application and construction plans are submitted. All other permit fees are due at the time of permit Issuance. , EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The BuIlding Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 1074 of the Umform BUIlding Code, current editIon). No applIcatIon can be extended more than once. I I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that If is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permits prior to work Applicant. L /;:: ~ Date: 0 l ( )?-!6 c.J T \FORMS\APPS\BUlldmgpenmt wpd -PREPARED-8131-/ 0 5-;-1-3-:-1-7 : 29 CITY OF PORT ANGELES fNSPE&T~ON-TICKET INSPECTOR JAMES L LIERLY PAGE DATE 1 8/31/05 ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 213 E 10TH ST ------------------------------------------------------------------------------------------------ HULETT, AARON 06-30-00-0-2-9060-0000- 04-00000015 RES ADDITION SUBDIV_ PHONE PHONE _ (360) 460-4179 PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP TYP/SQ COMPLETED RESULT ------------------------------------------------------------------------------------------------ DESCRIPTION RESULTS/COMMENTS PL2 01 5/20/04 RV 5/20/04 AP ------------------------------------------------------------------------------------------------ PLSP 01 ~+f- PLUMBING_ROUGH-IN TIME 17 00 JOHN 460-6902 HOUSE WILL BE UNLOCKED AFTER TWELVE NOON SECURE FREEZER IN BACK YARD, REMOVE DOOR, LOCK, OR REMOVE COMPLETELY PLUMBING SHOWER PAN TIME 17 00 08/31/2005 08 00 AM PBARTHOL AARON 460-4179 ***** AM INSPECTION REQUEST ****** -------------------------------------- COMMENTS AND NOTES -------------------------------_______ ~EPARED 8/24/04, 12-27 'SI CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 1 8/24/04 ---------------------------------------------------------------------------~-------------------- ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 213 E 10TH ST SUBDIV PHONE PHONE (360) 460-4179 HULETT, AARON 06-30-00-0-2-9060-0000- 04-0000001S RES ADDITION PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 8/03/04 JLL BUILDING FRAMING ./03/0 AP Aaron HULETT 460-4179 BAIR 01 4 4 ~ BUILDING AIR SEAL TIME 17 00 aaron 460-4179 BLI 01 BUILDING INSULATION TIME 17 00 aaron 460-4179 ------------------------ ------------- COMMENTS AND NOTES -------------------------------------- PREPARED 8/03/04, 12:27:15 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 3 8/03/04 ------------------------------------------------------------------------------------------------ ADDRESS CONTRACTOR OWNER PARCEL . APPL NUMBER 213 E 10TH ST SUBDIV: PHONE PHONE (360) 460-4179 HULETT, AARON 06-30-00-0-2-9060-0000- 04-00000015 RES ADDITION PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ~_~_;_-_-_~_~_-_-_-_-_~-o----r-~-----~-,-~-~-~-~-----_-_-__--_~_~_~_-~_-~_-I_-:~~~~~~~~---:::~::~:------------------------------------- COMMENTS AND NOTES ----------------------------------____ PREPARED 6/28/04, 13 07,57 CITY OF PORT ANGELES ____ ;~3 E 10TH ST HULETT, AA~O~9060_0000_ 06-30-00-052RES ADDITION 04-0000001______________ --------- PERMIT ME 00 MECHANICAL DESCRIPTION PERMIT: REQUESTED INS~T RESULTS/COMME~_______ COMPLETED RESU _________ __~--- TYP/SQ__ MECHANIC FINAL t only ------ ~/28/04 'LL J~aI1<:!1e 452-0939 ____ ME99 01 ------------- COMMENTS AND NOTES - n m (0..J6 0..:> ~ r!-e/..J.JIL.'KJt>/L DF ALDy J:-~~f- ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER INSPECTION TICKET LIERLY INSPECTOR_~~~:_~_ SUBDIV PHONE PHONE (-360) 460-4179 ~~ PAGE DATE 3 6/28/04 --~u 6h-/y xJo }WAd\..f;( ~d PREPARED 5/20/04, 130S,57 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 213 E 10TH ST INSPECTION TICKET- INSPECTOR ROGER VESS HULETT, AARON 06-30-00-0-2-9060-0000- 04-00000015 RES ADDITION SUBDIV. PHONE PHONE (360) 460-4179 PERMIT, PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL2 01 5/20/04 AT> 7 RV ) R' V PLUMBING ROUGH-IN TIME. 17 00 JOHN 460-6902 HOUSE WILL BE UNLOCKED AFTER TWELVE NOON PAGE DATE 4 5/20/04 -------------------------------------- COMMENTS AND NOTES -------------------------------------- ---t- C)~.} -I- S L-r -r ~j oS - --,- \/J -S ""'7- r ,..... 1<\1 M \--.... <> 'I- ...... - c c-- I , I I \-- I } "( tt [.01 0 \'p.J.,d f').)."')(IO') I ~ ----___1___--.,(, ~ .:; --t"" ~-r <::;... I ! I 1 , I , I j , I I l' r , ~ ~ I a 3 4 ~ ) ""'l i '") i ~7.. i , ~ II I _ I :v J--~ I j ) ? <J r '" -- <J {VI , tll II ~ j)\;J\. f'I) -, t.) II .)~'- ~ ~ ~~- ~~:-, ~ <;'I' '" - -- ::: \) ::r M I I I I I I i 1'/ I f t ~ .3 ~ & '?' t J S L 'bL./~~ - ~?~ Ci t'),nf'o;) ~(> C;;.....ti$,.Jt(~ , '-\ > t--; ",' + I .~ 1!,\ ! . I I I I I I i 1. -J- ::'9 -::.t"' "- <0 T I I ~ II; :. o 'IS ?t ~.:L.9 C;:_t (: : J~_r '~"hi )/.1 S ~ N V= ~ " () '0 ~ r- -- .. ..... ---~-I .:-,:. <.....;.- ~~ .t \. 0 \,j' ~ '5\'" - o c:() - JI i < j <;) . 1- ::r- -'t, I _._.~-- ----- _.- --------~ '" , -= :::J l -----------~-- I.. 377f/ AiLE Y I 'Z--,:: -t , c , . ..co c> _.. __.c..______ if wil'::. b' -" o '\ ,. i f L~:~ 1- '0:;. :0 N --r.---J " I ! I I -.t::.. ={\ N 1 '),/< 'PL {~r 213 f -rc~.Jl1 ~ o i" - I' - L o ~t >w I ~ \.J' ~ ~ , I I I I I I i --t> ------l 0'" I I ~ "'t:. I t;l 1 \- I i ! I , I I I I i , ~-4 -(... t \- , , I e;r.1'!f--> \~/."uc;:,( D(<:.\; - -Y<:lI'7'i,'7s,.(r-, ;!:I 6"- > W ..l::: C1 O\f_~ --t2l\:. 'I ~ C , tJ) ~ ~ 11\ \AI D \J .J ~.\-, r:- ~ I:: ~ 1 C.OJ'-"'<.1 ?,,,~I.., 10'2 H L ...... :,W ~ ..J to --:l o ~ sc>' {0,L YI 5irce t- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 05-00000670 Date 136010 213 E 10TH ST 06-30-00-0-2-9060-0000- MECHANICAL APPL. PERMIT 7/26/05 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation RS7 RESDNTL SINGLE FAMILY 1235 Owner Contractor HULETT, AARON ,213 E 10TH ST PORT ANGELES ( 36) 460-4179 SUBURBAN PROPANE 25 SETON RD PORT TOWNSEND (800) 647-5485 WA 983627833 WA 98368 Permit MECHANICAL PERMIT Additional desc TANK SET, 2 OUTLETS Perm1t pin number 55921 Permit Fee 68.30 Plan Check Fee .00 Issue Date 7/26/05 Valuation 0 Expiration Date 1/22/06 Qty Unit Charge Per Extension BASE FEE 47.00 2.00 10.6500 ECH ME-GAS PIPE 1 TO 5 21. 30 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 68.30 68.30 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 68.30 68.30 .00 .00 EXPiRED l/1;I!O~ ~ - ~ \\\ -- \::J \~ if- 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 compiled With whether specified herein or not The granting of a permit does not presume give authority to vlol@te- r cancel the provIsions of any state or local law regulating construction or the performance of r tI 7~a,-@ Date Signature of Owner (If owner IS bUilder) T \Pollues\1I02_15 buIldmg penmt mspectlOn record05 wpd [1/4/20051 Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS CALL 417-4735 FOR ELECTRICAL INSPECTIONS CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLAWFUL TO COVER, INSULATE 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 FOUNDA nON FOOTINGS WALLS FOUNDATION \pRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLDGS ) PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP/FURNACE/DUCTS GAS LINE <i1<(IOj~ Ju.- WOOD STOVE / PELLET / CHIMNEY COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s SEPA PARKING/LIGHTING ESA LANDSCAPING SHORELINE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R W / PW/ CONSTRUCTION - R W ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 4 I 7-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \Pollcles\ll 02_15 bUlldmg pennll mspectlon record05 wpd [1/4/2005] Suburban Propane PROPOSAL PHONE NO ..~ ,.,-, ",- ""-", /" d" ",,\-::" - r. " ......".., ..:.> C ,..,;) -"'> C? ( t./ PHONE NO L/lo- '-117 or DATE _ (-~. I'-n's- I "-'-- ,- JOB PHONE STREET JOB LOCATION CITY & STATE ..' .'~'m..:~.....I.~2:~;~f":~~.'....::..:.:.:m m. ...........m ....~.~~:. .. r~ . ...~.-- ...--.. .............__.mm.m__.__.__m.__...... --. m. -- .__.____m... ..... .........--. ....--.CiSJo/Z....fV--P----.. .----...--.....~--,;;;.:.j.:;=-.~.---..... .... ".01\::::. .{d \f~:J.'b2. ~~1h:::b> ............ '. r3<,,~ c~..5t~?.... .... "1.... t;::>.m...... ..... ... ....... . __ .... __'Om m__ _..__.!______m __.__.... __..__.._.. __/~tj:.~.~?e~. __.~____/~~:t6:~.~.ALs. _____. __..____.____ __ ___. __ ____.. __ . .:.____.m __.. m.__m m m.___.J. I __'.~.~~.~' --.~~~..-~]?d.;~--~~t~..tEc~.~.~~~~~..~~--.~-.~~~-..~.~. .~~~.~~~~~~~.~~~.~~~~..--.~~~~.~~~~~~~.~~~.~~~.~-.~~~~~~~.~~~.~~~.~-.~.~~-.-~..~~.~~.--.~~~.~~~.~~~~~--~~....~.~~~~~.~~Bs~=.~.~~~~~~~~~~~. ...,__.__.__.. '" u..____ .,:i. . 6.r.:/t-.hll ..e~.w.>t:.r:~ .~--.t--B$-~.fj1ftf~. __...............__:..._____.__ ~.~..~~.._--..~_.._. .~~_.__.... ~~__'~ 'O~__~~__..~..~.--..~~.~~.~~. ____~~~~.__ ~~--.~~.___..~.~~_~~I~.j5;;;~.~.~ -~~~__.__~--.~~~~..~..~~~..~~~~~.~ ~~.__~~._~__~. .~~~.~~... .__-... . _~.~ Buyer acknowledges that Seller's pricing and service schedule contains confidential and proprietary bUSiness Information, and Buyer agrees not to reveal, divulge, or disseminate said pricing ad service schedule or propane purchasing information to any person or enterprise other than Buyer's staff without obtaining prior written consent of Seller. The price of propane is subject to escalation/de-escalation plus applicable taxes. Any alteration or de\{!ation from above speCifications Involving extra costs Will be executed only upon written orders, and will become an extra charge over and a60ve the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary Insurance. Acceptance of this proposal is contingent upon Purchaser signing a Suburban Propane Gas Sales & Service Agreement. We propose to furnish toe above stated specifications, for the sum of: AUTHORIZED SIGNATUR~ ,'" '>-, j/. ("..\~~ II) <__.-1 ~) ._ ;// ~. ACCEPTANCE OF PROPOSAL The above prf~es, speclflcat ons and conditions are hereby accepted. You are authorized to do the work as specified, payment to be made as outlined above. .,..-. NOTE: This proposal may be Withdrawn If not accepted In ~ days. CUSTOMER SIGNATURE CUSTOMER SIGNATURE DATE OF ACCEPTANCE Item No 1518549 SAL 5104.1197 DISTRIBUTION: WHITE. Customer YELLOW - Customer Service Center PINK - File PREPARED 8/04/05, 12 31 49 CITY OF PORT ANGELES INSPECTioN TICKET INSPECTOR JAMES L LIERLY ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 213 E 10TH ST SUBURBAN PROPANE HULETT, AARON 06-30-00-0-2-9060-0000- 05-00000670 MECHANICAL APPL SUBDIV PHONE PHONE (800) 647-5485 ( 36) 460-4179 PERMIT PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME6 W-~ MECHANICAL GAS LINE LP GAS LINE 08/04/2005 08 38 AM AARON 460-4179 PBARTHOL 01 PAGE DATE 5 8/04/05 -------------------------------------- COMMENTS AND NOTES -------------------------------------- ~ pORT ~ ",U-~"<., -~.:J~\Il if 'E!II !:..-- ~.,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32\ EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation 04-00001060 Date .134120 213 E 10TH ST 06-30-00-0-2-9060-0000- MECHANICAL PERMIT 11/15/04 RS7 RESDNTL SINGLE FAMILY 5845 Owner Contractor HULETT, AARON 213 E 10TH ST PORT ANGELES ( 36) 460-4179 WA 983627833 DAVE'S HEATING & COOLING PO BOX 413 PORT ANGELES WA 98363 (360) 452-0939 Permit MECHANICAL PERMIT Additional desc HEAT PUMP DUCT FURNACE Permit Fee 61.70 Plan Check Fee .00 Issue Date 11/15/04 Valuation 0 Expiration Date 5/15/05 Qty Unit Charge Per Extension BASE FEE 47.00 1. 00 14.7000 ECH ME- INSTALL 100- FAU 14.70 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 61.70 61.70 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 61.70 61.70 .00 .00 '9 (JJ );-\ ......... \:) -,... .:::> ~ , r2 1\1 r:: , t.- ~ Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMSIl102.15 [11114/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALLlHOLD DOWNS WALLS / ROOF / CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CHIMNEY I HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: ~ WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTlNG ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R. W./ PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 1(- 2- ~4 Ek BUILDING T:\PLANNING\FORMS\ 1102.15 [11/1412003] 3: o-j '" ~;;~8E; ()'O '" >< ~ H" N '" "':OZZO o-j", ...... L'OtIjt-3::t1 ><'0 Ul H "''':0''' )> 0 10 ... Zt:-< )>Ul 0:0 H !ii. ()Ul "'''' o-j 0 ~ tv 0 '" "'. :0. OH ():o :0 :OH 0'" o-j...... 3:10 H "'C::O OO::X:Otv S;~ t:-<"'O .&::>.O"Ic:::J:::f...... "'Ul , ILl<:w Glo ;;J;a owMM "'... 00 t-3 - tI:l t:-<- OO~ OI!-3CfJ '" 00- UlH HO :>:0 w ~ :0 H ~~~~~ 0 r:J "'H~ OI::cJt-3 -.] UlZ tuOH{f.) C::Ul :3;:IZZI-j 0 t:-<'" "'''' Gl N >-0 '" ()O 0 ~ :>:""' .. ? s;<;> () H HO 0 3: :00... ()O 0 '" "'''' )>0 t:-< () UlUl t:-<o Z :>: C::() S; t:-<:o '" Gl ~ o-jH '" H Ul'" :0 () () ......o-j 3: 0 ;po ()H H H 3: t:-< 00 o-j HZ 3: 3:Z ZUl ~ '" :>: 3: Ul'd Z 0 '" 'd'" o-j 0 Z "'() Ul 0 o-j ()o-j Ul >-OH S; ...... 00 :OZ 0 0 c:: ,-<o-j Z () )>H 0 o-j "''dUl 3:() o-j 55@ "'?': '" Ul'" Ul ZZO o-j "''''H t:-< < t:-< H '" t- w :0 W""' t:-< ,,",0 >< ...... ""' Ul ON , , "'0 H'" -.]W ~ "'''' (" 0'" :A )>)> >-oGl "'''' \!' H H ...... H '" ...... ~ 0 ...'" FROM :Dave's Heating & Cooling Srvc FAX NO. :13604520939 Nov. 12 2004 04:33PM Pi 1=4$#- 1-1 J"" - l.J -, J I '~<<f BUILDING PERMIT.. APPLICATION roR ""]I~ttJ Date Rec.: fit- Pc:nnillf: . I Dale Apptoved: o.~ ".ued: Fill out COMPLETELV .ad in INK. Your .ppUcation .nel site plan MUST BE COMPLETE to be accepted for review, If you have any questions, ealJ (360) 417-4815 Applicant or Agent: Phone; Owner: Aa..v-oY"\ Hu..t.e-+t- Phone: ~-;K j) Address; ,;;( (:3 b C<. oS 1'" ( O-tf, 6f- City: j.S~ t"::.J-.A'1~ _~~ ArcbitectlEngineer: ., - Phone: . _Jr.(' .'bA(J,esf{c..:"''''/I<<.- .j Contractor ])a.(Ie~ H.e~+rf\.~ (n.~tate License#: Exp: 005 56r"Vt Cte-t c. ~ . Address: f. o. BDX Q/2. City: I ~yk h~.GL:s PROJEer ADDRESS: ~ (3 ~a s+ (D-8 .5tr~-+- 400- '-(lrCj Zip: q33'~ Phone: ..y- 5.;L. 0"1 a 9' Zip: 9~3b~ ZONING: LBGAL DESCRIPTION: Lot: .Block: CLALLAM COUNfY PARCEL NUMBER: Subdivision: Credit Card BDlder. N_ o-<..~ ~~ / 6(,{~~~](2 tJ...ve',. fk".+r~ "" Coo (~~ BlIU. Addr".: .f:5J. ~ov c..f13 . ___ _ City: rOr'+ ~::...! (..c),A- __r;";:: '/ TyPE OF WORK: SIZEN Al"UATION; rd'Residential C NcwCon$tr. 0 R.e-roof 0 Stove . Sf. @ S. ISF." S [:J Multi.family 0 Addition 0 Move 0 Garage SF. @S /SF. I: S t:I Commercial lit'llcmoc:lcl 0 Demolition Cl Deck . ~ SF. @ $ /SF. == $ t:I Repair .0 S~P: ~ Other TOTAL VALU.\TJON S SfV.5 ~ BRD;F DESClUPTION 0'" 'fHE PllOJECT: I n j + ^ ( l ~ -1, '()" o~ ..e..t -4 c:.+n' c::... ~ ....I^- Ct.. c.....R...... tith. J. ~~ fLAl'Y'\f W l~ d.u c..+ v.~o '( k COMMERClALIRESIDENTIAL: Occupancy Group: Occupant Load; No. of Stories: _ Lot Size: E7tisUng Sq. Ft. &. Proposed Sq, Ft. Existing lot coverage _ % & Proposed lot coverage _% =- Tota] lot coverage (''()lUittuction. Type: Al'PROV ALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: .- BSA/Wetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes [:J No Other: BUILDING PERMIT APPUCATION SlTBMln'AI.: The Building Division can provide you with infonnation OD the application and plan subm!ttaJ requiremeDts if you have questiuns. VALUATION OF' CONSTRUCTION: In.U callell, a valuation lImount must be entered by the applicant This figure wil1 be MVicwcd and tbaybe revised by the Building Division to comply with cum:nt fee schedules. Contact the Permit Coordinatorat 417 -4815 tor assistance.. PLAN CHECK FEE: IF a pllll1 check. fee is due it must be submitted at the time the building permit application and construction plans are submiued. AU other penmt fees are due at the time of permit issuance. EXPDlAnON OF PLAN REVIEW: Ifno pennit is issued within 1110 da)'$ of the date of application, the applia:ation wUl e1pice. The Building Official oan extend the time for action by the appbcant up to 180 days upon written request by the applioant (see Section 107.4 of the Unif'onnBuilcling Code, cunent edition), No application can be elttcnded more than once. / helBby C6ftJfy that I have reed 81Id examined this application and know the seme to bfl true and correct, I 11m ~uthorized to apply for this perm" and undetSt8nd th8t it Is my responribi/ity to det,,""In. what permits 81'8 required ,not the City's, end thllt { must obt,ln such permits prior to worlc. Applio... ~-! ~ ---.ll.\ \ a-( elf T:\FORMS\APPS'Buildinapennit.wpd iJV le,' ELECTRICAL PERMIT APPLICATION FOR OFF1CIAL USE ONLY Da1c/Ra:: . hrmiI .: Dale Appnlvcd: O~e bsual: The Electrical Permit Appltcation must be filled out comoletelv. tl1 ~ /~ Please type or reprint In Ink. II you have any questions, please call (360. 417-4735 Fax number: (360) 417-4711 City: j:>.)1' t AY1~I'\e<; License #I: Phone:l3(QO) 'iliO -4 n"l Fax: Phone:(~I.PO) LkPo -<..(/7"1 Zip: q'63~ Z Owner 0( Elec. Contractor Agent: Au YO VI ~+--+- Property Owner: MyOYl [l. \.ht\.cH- Address: "2...1'7 E. jOw. S-t U)et Electrical Contractor: Exp: Phone: Address: City: Zip: INSTALLATION WIRED BY: )ioWNER 0 ELECTRICAL CONTRACTOR Credit Card Holder Name: d. ~.... V( die ;1 Billing Address: 5&() f1" "5;~.""'Id"" pJ City: P- rJ ;:;"~,,jA..l; MC:_ PROJECT ADDRESS: 2-13 e. \O-l:b <;-\;. ?Dv'{- Av1~/\e~. \A)ll. q~3(,z.. TYPE OF WORK: Check all that apply: 0 New 0 AlterationlAddi1ion ~ Residental 0 Multi-family - 0 Commercial 0 Mobile Home . Sq. Ft. . 10 '3 2:.. o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 ~pticP.u.mp 0 Low Voltage 0 Telecom. 0 S Number of Circuits added or altered: h ',- J ,:. \' , DESCRIPTION OF THE ELECTRICAL PROJECT: ,"-. '~. -.. -4/~ "- ~~f2e Service Information Electrical Heat Load Additions o Overhead Service o Temp Service o Underground Service Voltage: Phase: 0 1 0 3 SeNice Size: Feeder Size: o Baseboard l&l.-Fumace 00 Heat Pump d Fan-Wall _IW'I .Lfl1W'l _IW'I ,)..~ 'rl))./ _IW'I PAMC 14.05.060(B): For Industrial, commercial, & residential projects larger than a duplex. a one -line drawing 01 the Electrical SeNice Feeders, building size (sq. II.), load calculations, and the type & of conductors andlor raceway is required and shall accompany the Electrical Permit application. I herebycertily that I have read and examined this application and know that same to be true and correct, and I . authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants responsibility to determine what permits are required and to obtain such. Credit Card Holder's Signature: d/2~ ~?/~ Date: 01 1Iz..1o<t Date: (JIll/at( Owner or Elec. Cont.. Signature: PW-9019 ;fr!IJlu/ FROM :Dave's Heating & Cooling 5rvc FRX NO. :13604520939 ; ~. ~. ; :\1,.~ '~,.I,'I" l:~ I-',~ 1"-1); JU j :,; ~ ;i'':. _.:. .:.,..." '''. ",} l Jun. 17 2004 08:29RM Pi '" ," 1 $, I ~~O D: " ! q , I ! EL.ECTRICAl PERMIT APPLICATION PDt. OJJI;o,J. un ONlV p.\..1\o.., __ Prnllll": ...._...___..___-_. D""^p,Jlr~ftlt.____ P"t.w~r.i The Elg~jc~i P9f",ii ApPllcatton mua:1 ~. flll.d out eOl't\DIG"'\I~ "lD". type D~ ...print lfllnk. ItY"O''' hllV4laf1i' "'''.iI1liHlIi, plitue uall (380) 4114135 Fax. number: (JaO) <411--4711 . \ 5e,V:(/OI~<'-' o..n.rorElo<.C?"_......nl))o-Ve.'.5 \{-ecc11,,+.-,,\-- C""', '''"6, _ Phon.: "f5d.0'1'3'!.Fu: "{5;:l.0"13'1 PTllPony 0\Ml0r; . A 0.. '(' 0 V"\ '*' K ~,::I-_' e.. _...H.~ \ ,e..++ . Phon.: t~~-_'-I:i ;;'.;1'"'7 ...."""_3~9....E~._i5~,'~~-E_fl.?J:d~~.c;"'_j6~~~,,'tsJ~~q_"\\ I<c.. ~Ip "78'.3(..:>-- li1oob1C1ICcn_j)"'-V-e.'5 ,.,e<t-k~ oI--Co",ll"~ 5e....-VIO'--dllOl'...Ii:"7TV6Sn EllIl: 5'/05 Phon.: -'/5.;;-6'13' p. ' ~ ~^l~&H~qq\ac' McRa: .0.: 601< 113 City: Or.f .I"'tY1~ ZIp: '7'i\.3~ lN5TAl.I.ATI~ VIlREC SY, c OWNER llf'EL.ECTRICAL CONTRACrOR . . -.. ..'.' , ,..".. -. CreditCatd~""Name:5e-a'.:',,~() rEe.,,~~.:Pa.\fC-'S \-\e",-+t,,-~,- Coc>\l~ mOJ"flAtI~~P'6. 60>( Lf/3 CI/y: 16r-f- An~~ _ Zip: "7'8'3(.';;;.. lie; 5-fy--e<-+, 10'---+ A-h~~s,.Gv:4 9g3~ ,-,':" PROJecT O\DP~SS: ;) (:3 Gas-+- /D--f:h -' r'1N_ o A1i...,..UonIAddKion . TYPI! 0' WORK: Oheck.itll tho! ""ply: m'RlI8ldlll1t1a1 ' 0 Uulti.famlly 0 Commercial 0 Mobile Home , o Remote Ll8~r 0 Ol!U\d'led gBrllOe LiHol Tub 0 Swim Pool 0 Ssptle Pump' SQ.Ft NumDw of Ci'C.b ad,*, or .....od: .. ~LoW VoitBgs 0 T eiec:om. 0 S:gl .:fl-.en.....o$+o...:-\- ......,;...--<:... D"SCIlIPTION~FTHl5EU!C'TRlCAL.PROJSCT; o.J:J,,,,-'3' l<'\JLuJ' ~"'",,,,-\-<>-..k (.A.J,.-tf-....- I ~S-t oJJ... o...:k\ 6" 6-\- :e...l,~ ~~ "'" ~~VW"" <:.t.L. <i.- hs....,=,--* P Gt"Yl f --------~~-_._-~_..- --- --'-'--"'---------'----'---"-.-.. Electrlc.1 Me. I.tlad Addltlo"s and t" subtractions, SeMCti Inforrrlatiu ~"'bQ8rd umace oBI Pump OF_oil _.KW ~'WN..h!..... LRA _KW CI OvomNd Servloe o "amp S.",'ee ::l Undlitllround Service VohliQe: ~ _~.:_._ PI1ass: 01 eby certify /hat I have read aM 8xaminfJd this .application .a~d know that same to be trV9 ilnd COrrElct, and J am ,ulhoriZBd 10 apply for this permll. I understand II IS not the Cif'l" legal responsibility /0 determine what psrmlls ..Jlr.e.req.uired:.It.J8I1lIJinS-the-applicants.r.8spOJlsibllity..io-d8fBrmine.wh f1'JImlts.al'fW.equlred tilntJ-/()-<)blaJil.-s/JQ//~.- . Credit Cerd Holder's Signatll": ,~ Da": (.,,1 f &/0 '-f J.. O'.I,i.i~ Date:. t,/Ibld/{ PERMIT FEE: $ tfla-J.E. Owner or Elec. Cont. SlgnstUl'll. . ::IELECTR1CAL~~"'lrAf'f'UC~T'ON 4~ ~' Af-O (p 1. Dd......... 5 .. ~ t- 'P \ ~. t- fIcO &~o~(