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Home My WebLink About835 Church Ave - BuildingApplication Number 10 00001121 Application pin number 636757 Property Address 835 CHURCH AVE ASSESSOR PARCEL NUMBER 06 30 15 5 2 1380 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Ductless heat pump Owner u RICHARD SANDRA M GRANGER 835 CHURCH AVE PORT ANGELES (360) 565 1237 Qty Unit Charge Per 1 00 73 5000 ECH Fee summary Charged Permit Fee Total Plan Check Total Grand Total WA 98362 ELECTRICAL HEATPUMP Permit Additional desc Permit pin number 174680 Permit Fee 73 50 Issue Date 10. /05 /10 Expiration Date 4/03/11 Signature of owner or Electrical Contractor X 73 50 00 73 50 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 Contractor EXTRA MILE TECH ELECT LLC 418 N RACE ST PORT ANGELES WA 98362 (360) 457 0198 EL BRANCH CIRCUIT WO /FEEDER Paid Credited 73 50 00 73 50 Plan Check Fee Valuation INSPECTION TYPE DATE. DITCH SERVICE ROUGH IN FINAL COMMENTS PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION 1511 n ID /4 D 00 00 00 Date 10/05/10 �Z5l• S RESULTS 00 0 Extension 73 50 Due 00 00 00 REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR. Date: i PREPARED 10/05/10 9 02 42 INSPECTION TICKET PAGE 9 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/05/10 ADDRESS 835 CHURCH AVE SUBDIV TENANT NBR RICHARD SANDRA GRANGER CONTRACTOR DAVE S HTG COOLING SRVC INC PHONE (360) 452 0939 OWNER RICHARD SANDRA M GRANGER PHONE (360) 565 1237 PARCEL 06 30 15 5 2 1380 0000 APPL NUMBER 10 00001111 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME99 01 10/05/0 JL f I MECHANICAL FINAL TIME 01 00 October 5 2010 8 51 20 AM 1pangrle JEANNIE (DAVE S HTG) 452 0939 MECHANICAL FINAL HEAT PUMP AFTERNOON COMMENTS AND NOTES OCT -04 2010 11 45 AM E JANSSEN City of Port Angeles Permit Application Building DivlalonlElactrIcal Inspections 321 beat FIfth Street P,0. Box 1150 Port Angeles Wnehington, 06362 Ph: (3601417.4735 Fax: (360) 417.4711 Daln Unit Chnrgr 511990 5 1 .45,50 5 204.60 S 262.20 S 3T2.50 5 2 60 5 73 50 E 2 60 5 92.70 110.30 5 143 70 5 10 .90 5 95.911 5 88.20 05 90 63 90 5 0.3 90 5 113.90 S 102 30 110.30 5 3520 5 .3 50 5 110 30 5 50 00 V 1 2 :angle Family Dwelling Muth Family or Commercial' Commercial Addition Alteration Rernud( Ref air' Plan Review May Be Required, Please Compete Electrical Plan Review Information Sheet Job Address 5' L.�'� :SSG Building Square. Fooiago. Description of above owner ln(onnalion Name $.4 /CA K Mailing Address _l E: City t Slate: tn. );k 7-i: Phone. el Q, Lrcerlse ft 1 Exp oy I J net :k na IDa)a. 1 C� �y, i 6 i 360 452 2982 r J C 4 200 ELCCIPICAL .,f Total (Dv Mulliolied by Unit Chortle) Servta?lFeeder 200 Amp. Service/Feeder 201 -400 Amp Service/Feeder 401-600 Amp Service/Feeder 601 -1000 Amp. Service/Feeder over 1000 Amp. Branch Circuit Nil Service Feeder r�zL Branch Circuit W/O Service Feeder Each Addibonel Branch Circuit romp Service/ Feeder 200 Amp rump Service /Feeder 201 -400 Amp Temp Service/Feeder 401-600 Amp Temp ServicelFeeder 601-1000 Amp Portal to Portal Hourly r Sign /Olilllne Lighting Signal Circuit/ Limled Energy Commercial Additional -ll :C Signal Circuit) Limited Energy 1 2 Family Dwelling Signal Circuit/ Limited Energy MuslI -Fa niy Dwelling Manufactured Home Connection Renewable Electrical Energy 5KVA System nr t e° First 1 :300 Square Ft Each Addillnnel 500 Square Ft. or Portion of Each Outb, ilding or Detached Garage Each Swimming Pool nr Not Tub Therma5ta1 5 Total P 01 Cgqntractor Information Name. EXt/I4 M 7"e- e_•f E. (–r'd( 4 l Mailing Address: 1 F d N( .1R,1/ F .f City LA State' '.ir "t 4 Z Phone: Y5 S.7 Fax' 1 xense Exit E1C 714,9 1/:F 'T L .C2 7„t-c' II 1 N ht 2kit 01 ,p SIB Sf -.r"\ Owner es defined by RCW.19.21,2e1. (1) Owns r wiv occupy the structure for two year attar this electrical permit is finalrzen. 2 OA per required to hire an electrical contractor f above sold property is for sale, rent or lease. 'ormir oxo ves alter six months qJ last inspection, After reeding the above statement.1 hereby certify that I am the owner of the above named property or a licensed electrical contractor lam !naktng the electrical Installation or alteration in compliance with the electrical IeW N.E C. RCA,. Chapter 19.20, WAC. Chapter 296 -460, The City of Pod Angela, Mj m,1 Code, and Utility Specifications. O gnelure or owner electrical contractor ei elect( cal adminlntratgr L Can f7 Credit Card tt f Application Number 10 00001111 Application pin number 144895 Property Address 835 CHURCH AVE ASSESSOR PARCEL NUMBER 06 30 15 5 2 1380 0000 Tenant nbr name RICHARD SANDRA GRANGER Application type description MECHANICAL APPL PERMIT Subdivision Name Property Use Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 4070 Application desc INSTALL A DUCTLESS HEAT PUMP Owner RICHARD SANDRA M GRANGER 835 CHURCH AVE PORT ANGELES (360) 565 1237 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge 1 00 14 8000 EA Fee summary Charged Permit Fee Total 64 80 Plan Check Total 00 Grand Total 64 80 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. /elm) rw LD/ 4k i(.� .0 Date T Forms /Building Division /Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98362 Contractor MECHANICAL PERMIT INSTALL A DUCTLESS HEAT 174573 64 80 10 /01 /10 3/30/11 Per Date 10 /01 /10 DAVE S HTG COOLING SRVC INC PO BOX 413 PORT ANGELES WA 98362 (360) 452 0939 PUMP Plan Check Fee 00 Valuation 0 BASE FEE ME FURN /HP /FAU OR 5 TON Paid Credited Due 64 80 00 64 80 00 00 00 Print Name Signature of Contractor or Authorized Agent Extension 50 00 14 80 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS 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 I Accepted By 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 Flow Water AIR SEAL. Walls Ceiling 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 Fumace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping 1 SHORELINE. T:Forms /Building Division /Building Permit Inspection Type Electrical 417 -4735 Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 Comments FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE L� Date Accepted By Sep 30 10 03'01 p f Dave s Heating Cooling BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn:Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360 417 -4815 fax (360) 417 -4711 Applicant /)atom -5 /iaa. 7 n Phone Property Owner 6, c_ k ,4- Sc. A. 6 v-o. r Phone Property Owner's Address g 3 Gt, L.A. v-c-k v-e, Contractor 1 .D .ea U Kesi,fi n Phone Contractor's Address .,P 4 A0 x 1-{a ,s A'r..i License# DA KC Expires S /a4D 11 ma I PROJECT ADDRESS Parcel Number Eiect Type Brief Description: Check all that apply o New Construction o Addition o Remodel Repair o Demolition o Re -roof ,Heat System o Other Floor Areas Basement 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other o ,House o garage o other it feat pump n wood buming stove o gas fireplace o pellet stove o other Existing (sg. ft.) S('3 5 C Y- At Lot Zoning Residential o Multi family Commercial ppoosed (so. ft) Max. height of proposed structures ft. Occupancy group Will a Lawn sprinkler system be installed? Occupant load Will a fire sprinkler system be Iinstalled? Construction type I have read and completed this a and know it to be true and correct. I am authorized that it is my responsibility to determine what permits are required, and to obtain permits prior to Date e7,') 1/,0 Print Name_ ,.F D 4'444, O Signature r T:3=arms/Building Division/Bldg Perini ,doc 3604520939 p1 o tear off re -roof o lay over one layer per sq. ft. V For City Use Only Date Received q Permit #_PO t�l Date Approved ShS 3 w ,4 9 836 TOTAL VALUATION `'f", 010' 0' 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 1794 135 for exemptions) Site coverage of bedrooms of full baths of half baths o Industrial to apply for this permit and understand orking on projects. Clallam County Assessor Treasurer Property Details 67993 RICHARD AND SAND Page 1 of 7 Clallam County Assessor Treasurer Property Search Results 67993 RICHARD AND SANDRA M GRANGER for Year 2010 2011 Property Account Property ID Open Space: Historic Property N Multi Family Redevelopment: N Township Range. Location 67993 Taxes and Assessment De ails Property Tax Information us of 09/30/2010 Geographic ID 0630155213800000 Type Real Section. Legal Description. Agent Code Tax Area. 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 DFL N Remodel Property N LOTS 29 30 BL 13 CHAMBERS ADDITION SURV V32 P99 Address: 835 CHURCH AVE Mapsco PORT ANGELES WA 98362 Neighborhood: Cycle 4 Res Map ID 2 Neighborhood CD 10952130 Owner Name. RICHARD AND SANDRA M GRANGER Owner ID 27445 Mailing Address: 835 CHURCH AVE Ownership 100 0000000000% PORT ANGELES WA 98362 Year I Statement ID !Taxing Jurisdiction 2010 49736 ST SCH STATE SCHOOL 2010 49736 CC -GEN COUNTY 2010 49736 PORT I PORT_ 2010 49736 PORT ANG PORT ANGELES [201 49736 SD #121 SCHOOL DISTRICT #121 2010 49736 NTH O LIB NORTH OLYMPIC LIBRARY 2010 49736 HOSP #2 HOSPITAL #2 E2010 49736_ PK DIST WILLIAM SHORE MET PARK DIST 12010 49736 CITY STORMWATER CITY STORMWATER 2010 49736 FIRE_PATROL FIRE PATROL 2010 49736 WEEDCONTROL WEED CONTROL 2010 49736 FP Fee FIRE PATROL COUNTY FEE 2010 149736 TOTAL. r 2009 679932008 ST SCH STATE SCHOOL 2009 679932008 CC -GEN COUNTY Exemptions. Amount Due if Paid on ra. NOTE If you plan to submit payment on a future date make sure you enter the click RECALCULATE to obtain the correct total amount due First i Second Half Half Base IBase Amt. _Amt. Penalty I Interest Base Paid $246 49 $246 49 $0 00 $0 00 $246 49 $131 18 $131 16 $0 00 $0 00 $131 18 $18 44 $18 43 $0 00 $0 00 $18.44 $303 72 $303 70 $0 00 $0 00 $303 72 $319.27 $319.28 $0 00 $0 00 $319.27 $38 12 $38 11 $0 00 $0 00 $38 12 $53 81 $53.81 80 00 $0 00 $53 81 $17 12 $17 12 $0 00 $0 00 $17 12 $36 00 $36 00 $0 00 $0 00 $36 00 $8.70 $8 70 $0 00 $0 00 $8 70 $0 82 $0 81 $0 00 $0 00 $0 82 $0.25 $0.25 $0 00 $0 00 $0.25 $1173.92 $1173.86 $0.00 $0.00 $1173.92 $257 38 $257 38 $0 00 $0 00 $514 76 $130.26 $130.26 $0 00 $0 00 $260 52 http. /vpn.clallam. net. 808 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =67 9/30/2010 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION %~ 321 EAST 5TH STREET, PORt ANGELES, WA 98362 BUILDING PERMIT ISSUED: 10/31/2002 PERMIT NO: 13831 OWNER/APPLICANT PROPERTY LOCATION 835 CHURCH AVE RICK & SANDY GRANGER 119 PENN ST APT 21 Lot: 29 - 30 Port Angeles, WA 98362 Block: 13 [] Long Legal 360/565-1237 Subdivision: BEN CHAMBERS ADDN T: S: Parcel No: 063015521300000 CONTRACTOR ARCHITECT ALL WEATHER HEATING & COOLING N/A 302 KEMP STREET PORT ANGELES, WA 00009-8362 , 98360-0000 360/452-9813 360/000-0000 PROJECT INFO Project Value: $3,181.00 SFD Units: 0 Commercial: 0 Project Type: PROPANE STOVE SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: RS9 PROJECT NOTES INSTALL PROPANE STOVE LINES & TANK RECEIPT#9882 FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $35.00 Plumbing: $35.00 AMOUNT PAID: $35.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, pdvate 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 pedod 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 A~'horized Agent [~ate Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\I 102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DP. AINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERNiIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE !/.-& /'5 v' FROM : ALL I,JEATHER HEATING S COOLING FAX NO, : 350 452 5177 Oct. 31 2882 02.'46PM P1 FOR O~IC~ U~ ONLY: BUILDING PEBIT- APPLICATION ', PI~ ~ o~ p~t ~u ~K ~f you ~ve thy qu~o~ pk~ c~ 417~1S .... B~' ~ON: ~[ _ Bloc~ ..... $u~vbiou: ~ ~ P~ ~: ~ Cr~jt Ca~ HoI~ N~: ~ ~: Ct~: , ,, ~ C~ ~: Exp. D~: ~ MC .... ~ ~ ~ N~. u ~f ~ W~e ~.~$~5~.-$ , ,, ~0~: ~y ~oup: Occ~tLo~; __ C~~e: ~ No.,~ ~ ~: ,,, , % ~t Cov~g~: % .. ~ ~: I~. h. + ~d Lot Cov~e: ~/sq, fi, = T~AL LOT ~V~GB: P~ ~ O~Y: ~ROV~ .... ~PW , E~(~): ~ Y~ = No S~A ~t r~ = Y~ u No O~: . _ Oz'~R r~l~ ~ ~l~ ~vbi~ ~ ~vi~ you ~ ~ ~ mfo~adon ~ ~ a~ii~ ~ p~ ~b~ ~. Y~ c~l~ ~ fi~ p~ (f~ a~om) ~d bu~g ~c~ p~s ~ to be su~ ~ ~ B~ Di~on. ·: VALUATION Og CONS'[P. UCTION:. In an ~ a valuation amount must he ent~wed by the applicant. This ~ will bo mviewud ofpevmi! for ~fion by ~e ~pllc~t up to 1~0 dnp u~n ~ ~qucst by ~e a~lic~t (~ Section 107.4 of e~fion). No ~pl~fi~ can ~ ~t~d mo~ ~ once. thb pe~lt. I u~m~ tt ~ ~t the 0~ legal r~ibili~ to d~e~ine what pe~t~ are r~ui~d; .tt ~mal~ the ~pl~cant~ r~lbtl~ to d~t~ing w~t ~t~ a~ r~qui~d and to obtain such. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date [ ~ ~ - 0"2 Time Received by ~ ~// (phone, person) Location of Work to be inspected (~ 5'- ~.~ h U~'~, ~, A V"-~ Name of person requesting inspection Address of person requesting inspection Phone No. Permit No. Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney/~umbing'" ~Final Sewer Excav. Other INSPECTION NOTES: ~,~ /' '~ ? Inspected Date ! / _ ~L, *~ ~. ~n~'~ ....... By Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved I-~Gravel I~Asphalt []PCC [~]Other [] Repaired by City Work Order # [] Repaired by Permittee L-~ COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES D EP ARTMENT OF C O MMUNITY DE V EL CEMENT - B UILD1NG DIV IS ION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ~..~,,v~ r,-r~w~l ISSUED: 6/04/2002 ~I:I-<MIT NO: 13434 OWNER/ApplICANT PROPERTY lOCATION 835 CHURCH AVE RICK & SANDY GRANGER 119 PENN ST APT 21 Lot: 29 - 30 Port Angeles, WA 98362 Block: 13 [] Long Legal 360/565-1237 Subdivision: BEN CHAMBERSADDN T: S: Parcel No: 063015521300000 CONTRACTOR ARCHITECT ADMICH CONSTRUCTION N/A 810 CHURCH Port Angeles, WA 98360 , 98360-0000 360/417-3409 360/000-0000 PROJECT INFO Project Value: $130,000.00 SFD Units: 1 Commercial: 0 Project Type: SFR NEW SFD SQ FT: 1,643 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 504 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: RS9 PROJECT NOTES CONSTRUCT NEW SFR 1611 SQ. FT. WITH 525.5 SQ. FT. ATTACHED GARAGE AND 209 SQ. FT. OF COVERED PORCHES RECEIPT#9181 PLANS B-8 FEES ASSESSMENT Building Permit: $1,161.75 Misc Fee 1: $0.00 Plan Check: $464.70 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $1,781.45 Plumbing: $98.00 AMOUNT PAID: $1,781.45 Mechanical: $52.50 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes I 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. Ail 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 ':~PLANNING\FORMS\I 102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT1S UNL4 WFUL TO COVER, INSULATE OR CONCE/tL ,4NY 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 FOENDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # PLUMBING UNDER FLOOR / SLAB WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS/ROOF/CEILING DRYWALL T-BAR INSULATION SLAB WALL/FLOOR/CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD/ DUCTS PW UTILITIES [ SITE WORK (Englnecting Division) SEPAR~,TE PERJvIIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM 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 DEFT, PLANNING DEPT. 417-4750 PLANNING DEPT, BUILDING 417-4815 '0 ~'~B~-- ~-~--/'2/ BUILDING T:\PLANNING\FORMS\1102.15 [4/2002] ~.'~e°Rr' Date Rec.: eo~< for OmC~L VS~ ONLY: ~ ~ BUILDING PERMIT- APPLICATION e~,~: Date Approved: Date Issued: The Building Permit Application must be filled out completely. Please type or print in ink. If you have any questions, please call 417-4815 Applic~t or Agent: ~~ ~¢q~~ Phone: ~ ~ Owner: ~lC~ ~ ~O ~.~md~ Phone: ,~- Address: lt~ ~5~~ City: ~C~ ~S I~. Zip: q~ ~chitect~ngineer: Phone: Contractor ~'~ck ~~nLicense~:~Exp: ~ao/~ Phone: ~7~d Address: ~[O ~ :~- City: ~ ~[~S t~. Zip:~ PRO'CT ~D~SS: ~5 ~ ~ ~C ~ A ~ ~ ~ _ ~NING: ~ L~a~ o~SCmPttO~: Uot: 2 ~ t ~ ~ock: t3 Subdivision~ ~ ~~ CL~L~ COUNTY P~CEL ~MBER:~redit Card Holder Name: Billing Address: City: Credit Card g: Exp. Date: ~SA MC T~E OF WO~: SIZE~UATION: Residential ~ New Com~. ~ Re-roof o Wood-stov41~ SF. ~ $ /SE. =~. ~ Multi-fa~ly ~ AddiSon ~ Move ~ Garage ~a~~ ~, ~ SF. ~ $ /SF. = $. ~ Co~ercial D Remodel ~ Demolition ~ Deck ?~ ~O~ SF. ~ $ /SF. = g. ~ Repair ~ Si~ ~ TOTAL VALUATION COMMERCI~SIDENTI~: Occupancy Group: Occupant Load: __ Cons~cton T~e:. No. of Stories: ~ ~t S~e: ~ % Lot Coverage:~ f % Existing Lot Coverage: /sq. ff. + Proposed Lot Coverage: 2 s~5, b /sq. ~. = TOTAL LOT COVE~GE: PLANING USE ONLY: ~PROV~S: PL~ Notes: BLDG. DPW F~ ES~etland(s): D Yes ~ No SEPA Chec~ist required? D Yes ~ No O~er: OTHER BUILDING PE~IT APPLICATION S~MITT~: Your application and site plan must be filled out completely to be aecepted fot r~iew. ~e Building Division can provide you M~ more detailed ~o~tion on ~e application and plan sub~al requirements. Yom completed applicaffon, site plan (for additions) and building cons~ction plans are to be sub~ffed to the Building Division. V~UATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. ~s fig~c ~11 be reviewed and ~y be revised by ~e Building Division to comply wi~ c~ent fee schedules. Contact the Pe~t Coordinator at 417 -4815 for assistance. PL~ CHECK FEE: Yo~ pl~ check fee is due at ~e time ~e building pe~t application and cons~cfion plans ~e sub~aed. All other pe~t fees are due at ~e t~e ofpe~t iss~nce. E~I~TION OF PL~ ~V~W: If no pe~t is issued ~thin 180 days of the date of application, ~is application will expire. The Bulldog Official c~ extend ~e time for action by ~e applicant up to 180 days upon ~i~en request by ~e applicant (see Section 107.4 of · e U~fo~ Building Code, cu~ent edition). No application can be extended more ~an once. [ hereby cert~ that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for this pe~it~ I understand it is not the Ci~'s legal responsibili~ to determine what permits are required; it remains the applicant'~ responsibi[i~ to determine what permits are required and to obtain such. T:~O~S~PPS~uildin~emit FIL£O FOR A'ECO~D A'F THE 2002HAY 13 AM 9:26 2002 1084915 ZON~G LOT CO~NANT I/WE the undersigned owner(s) of the following described property: (Inserl legal description here) do hereby covenant that said property shall be designated as one zoning lot as defined in Section 17108.032 "Z" of the Port Angeles Municipal Code. This covenant cxeates one inseparable building lot be removed through compliance with Chapter 58.17 RCW (subdivision regulations) and/or the City of Port Angeles short subdivision regulations (Ordinance No. 2222, as mended). This covenant shall be binding on the owner(s), heir(s), assign(s), and successer(s) in interest and shall be filed with the County Auditor's Office. This covenant is for the mutual benefit of said owner(s), heir(s), assign(s), and successor(s) in interest and is for the further purpose of compliance with state and local land use and building regulations. This covenant may be enforced by injunction or other lawful procedure and covenant by the recovery of any damages resulting from non compliance. DATED this ¢ day of//~%~,r . (Ox~vner) (Owner) (Owner) (Owner) STATE OF WASHINGTON ) COUNTY OF CLALLAM ) ss ~[~ U(,,~ I(1 Id .Notary .Public in and for the State ofWashinl~o~,do_he_r~.~y c~rtify t~t 9n~ this[~_.4~d, ay of,~.~. . . ., 20.~_z.p[rsonally appeared before me to rp~,known to be the individuaKs) desribed in/~xc[whd,executed the with/n insmmaent and acknowledged that ~ sign*d and sealed the same as .-F,h_~l/F free and voluntary act and deed for the purposes herein mentioned, ' - - x"k'"ttl'ltllltto d/~x day of ~r~d~ x ~,~, , .~ .*~, ............ ~ . . ~ O, ' .............. . ~ NOTARY PUBLIC in and for Ibc State of ,'+///v ±'4 9\x ' Washington residing at Port Angeles. //////,,ll,llllt\' ~/5 0~_../ ^UmTO 'S C ,TraCATE Filed for record at the requcst of ~);td~t/O/ ~v'dD'/ff'¢~'-' this /._.3 dayof CLALLAM COUNTY AUglTOR ;r~m: Ken Dubuc TO: Roger Vess Date: 5/21~]2 1:22pm Subject:. Building Application reviews Roger, The Fire Department has reviewed the following building applications: 1) 312 sf addition and remodel at 3604 Canyon Edge Drive. NO comments. 2} 750 sf attached garage to be located at 2214 West 10th Street. No comments. 3) 1643 sf SFR to be located at 810 Church Ave. This home lies outside Of the PAFD 4 minute response area· The home must be equipped With a residential sprinkler system that complies with NFPA 13D, or all Of the dwelling smoke detectors must be connected to an outside alarm bell that Is painted red and labeled "fire alarm." Also, the standard addressing comments apply, · Thanks, Ken pORTANGELES WASHINGTON, U.S.A. DEPARTMENT OF COMMUNITY DEVELOPMENT DATE: June 4, 2002 TO: Roger Vess, Permit Coordinator FROM: Sue Roberds, Assistant Pla~,~ RE: Building Permit Applications - Week of May 21, 2003 1. Property Owner: Williams Address: 3604 Canyon Edge Dr. The site is located in the RS-9, Residential Single Family zone. Setbacks and lot coverage for the addition are appropriate for the RS-9 zone. Lot coverage is 16%. Planning has no further comments. 2. Property Owner: Ho ffman Address: 2214 West 10~ Street The site is zoned RS-9. The proposed garage addifton meets setback and lot coverage standards of the RS-9 zone. Lot coverage is 1%. Planning has no further comments. 3. Property Owner: Adamich Address: )b145'Church Avenue The site is zoned RS-9. The proposed residential construction will result in lot coverage of 23% for a 2112 square foot structure. Setbacks and lot coverage are appropriate for the RS-9 zone. Planning has no further comments. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date _~- ~//- ~)~'- Time Received by ~'~ (phone, person) Location of Work to he inspected ~ ~_~-- ~_~ ~t ~Lv~C.~ ~. /~ Name of person requesting inspection ~l[~' Address of person requesting inspection Phone No. Type of Inspection {circle appropriate one): Permit No. ./~'~ Sewer~'~/~n~~./~ ~.j.~ Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION~/~'~NOTES.~_ ~ ~ Inspected: Date ~' -~ ~ _Time By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [--IGravel [-]Asphalt I~PCC [~Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~::>-- I (.~ (~'-~ Time Received by ~ ~// (phone, person) Location of Work to be inspected ~" ~ ~t~ ~.% Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer F~/~d~a~/on~Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES:i , / i' Inspected: Date ~ Time By / Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel []Asphalt []PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE []No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~ ~ c:~ .~.(~.~ Time Received by ~ (phone, person) Location of Work to be inspected ~ ~'~'~'~'~'~'~'~'~'~- C J~, ~.~-C~ ~ Name of person requesting inspection Address of person requesting inspection Phone No. ~ Type of Inspection (circle appropriate one):~~ ~'~ Permit No. Sewer Foundation Framing Chimney ('Plumbing ~Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date ?'~ /' '"~" Time. By Remarks: RESTORATION REQUIRED ...... YES. NO cau SURFACE RESTORATION: SURFACE TYPE: [] Unimproved ~lGravel ~-]Asphalt F~PCC [~Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT .... ....~-~. REQU~__T: Date /J ~- 2 ~7- ~ ~7~ Time Received by ~" ~ (phone, person) Location of Work to be inspected ~ ~ ~~- ~''? t~2/ Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation~Chimney Plumbing Final Sewer Excav. Other~----~~'~-~/~ INSPECTION NOTES: ~, Inspected: Date ~ ~/ ~ ~' (-~ Time By Remarks: ,, /'.- RESTORATION REQUIRED ...... YES_ NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel []Asphalt []PCC []Other ~-1 Repaired by City Work Order # r-j Repaired by Permittee [] COMPLETE I--} No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date /~ '~ ~--~- ~/~ "?'--- Time Received by (phone, person) Location of Work to be inspected ~(~ ~ ~'~- Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing~ewer Excav. Other Inspected: Date,.' Time By Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved E~Gravel []Asphalt []PCC []Other [] Repaired by City Work Order # ~-] Repaired by Permittee [~ COMPLETE El No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION ~21 EAST 5T t STREET. PORT ANGELES. WA 98362 ELECTRICAL PERMIT /u /zuuz OWNER/APPLICANT PROPERTY LOCATION RICK & SANDY GRANGER 835 CHURCH AVE 119 PENN ST APT 21 Lot: 29 - 30 Port Angeles, WA 98362 Block: 13 [] Long Legal 360/565-1237 Subdivision: BEN CHAMBERS ADDN T: S: Parcel No: 063015521300000 CONTRACTOR ARCHITECT HALVORSEN ELECTRIC N/A 1426 W. 11TH PORT ANGELES, WA 98363-0000 , 98360-0000 360/457-7803 360/000~0000 PROJECT INFO Project Type: TEMPORARY SVC. Project Value: $0.00 Occupancy Type: RESIDENTIAL Construction Type: Occupancy Group: Zoning Use: RS9 Electrical Heat: [] Baseboard 0 KW [] Riser [] Underground Service [] Furnace 0 KW [] Overhead Service Voltage: 0 [] Heat Pump 0 KW [] TempService Phase: [] 1 [] Fan Wall 0 KW Service Size: Feeder Size: 0 PROJECT NOTES TEMP SERVICE RECEIPT#9130 FEES ASSESSMENT Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $0,00 Temp Service: $39.80 Misc Fee: $0,00 TOTAL FEE: $39.80 AMOUNT PAID: $39.80 BALANCE DUE $0.00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417.~735 FOR ELECTKICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA ~'VFUL TO CO VER, INSULATE OR CONCEAL AN]' WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PI~MxlS AT JOB SITE DITCH ROUGH-IN / coVER SERVICE FINAL [ "t /'z Z./o ~.l ,~k--9 I GENERAL COMMENTS: CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 EAST 5TIt STREET, PORT ANGELES. WA 98362 ELECTRICAL PERMIT ISSUED: 8/21/2002 PERMIT NO 7785 OWNER/APPLICANT PROPERTY LOCATION RICK & SANDY GRANGER 835 CHURCH AVE 119 PENN ST APT 21 Lot: 29 - 30 Pod Angeles, WA 98362 Block: 13 Long Legal 360/565-1237 Subdivision: BEN CHAMBERS ADDN T: S: Parcel No: 063015521300000 CONTRACTOR ARCHITECT HALVORSEN ELECTRIC N/A 1426 W. 11TH PORT ANGELES, WA 98363-0000 , 98360-0000 360/457-7803 360/000-0000 PROJECT INFO Project Type: RESNEW Project Value: $0.00 Occupancy Type: Construction Type: Occupancy Group: Zoning Use: RS9 ~ Electrical Heat: ~ I Baseboard 0 KW ~ Riser ii Underground Service ~j~ ! Furnace 0 KW ' Overhead Service Voltage: 240,120 Heat Pump 0 KW Temp Service Phase: i 1 ' 3 ['~ Fan Wall 14 KW Service Size: 200 Feeder Size: 0 PROJECT NOTES NEW RESIDENCE 2136 SQ. FT. RECEIPT # 9548 FEES ASSESSMENT Service: $116.20 Additional Feeders: $0.00 Circuit Wiring: $0.00 Temp Service: $0.00 Misc Fee: $0.00 TOTAL FEE: $116.20 AMOUNT PAID: $116.20 BALANCE DUE $0.00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL I~SPECTIONS. PLEASE PROVIDE A M]NIMU'M 24 HOUR NOTICE. IT IS UNLAWFUL TO CO.R, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE DITCH ROUGH-IN/COVER SERVICE / GENERAL COMMENTS: pwq 1o2.13 [4t96] o '~" CITY OF PORT ANGELES ~'~ PUBLIC WORKS - ELECTRICAL DIVISION 321 F, AST 5TH STREET. PORT ANGELES. WA 98362 ELECTRICAL PERMIT ISSUED: 8/20/2002 PERMIT NO 7784 OWNER/APPLICANT PROPERTY LOCATION RICK & SANDY GRANGER 835 CHURCH AVE 119 PENN ST APT 21 Lot: 29 - 30 Port Angeles, WA 98362 Block: 13 [] Long Legal 360/565-1237 Subdivision: BEN CHAMBERS ADDN T: S: Parcel No: 063015521300000 CONTRACTOR ARCHITECT HI - TECH ELECTRONICS N/A 2640 HWY 101 EAST PORT ANGELES, WA 00009-8362 , 98360-0000 360/452-2727 360/000-0000 PROJECT INFO Project Type: RES. MISC. Project Value: $0.00 Occupancy Type: RESIDENTIAL Construction Type: Occupancy Group: Zoning Use: RS9 Electrical Heat: [] Baseboard 0 KW [] Riser [] Underground Service [] Furnace 0 KW [] Overhead Service Voltage: 0 [] Heat Pump 0 KW [] TempService Phase: [] 1 [] 3 [] Fan Wail 0 KW Service Size: 0 Feeder Size: 0 PROJECT NOTES LOW VOLTAGE WIREING FOR SPEAKERS, SATILITE RECEIPT#9573 FEES ASSESSMENT Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $0.00 Temp Service: $0.00 Misc Fee: LOW VOLTAGE $40.90 TOTAL FEE: $40.90 AMOUNT PAID: $40.90 BALANCE DUE $0.00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA W'FUL TO COPER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE DITCH ROUGH-IN / coVER SERVICE GENERAL COMMENTS: PW-1102.15 [4D6] ELECTRICAL PERMIT APPLICATION FOR OFFICIAL USE ONt y DillelRill:: Po::nnilt#: Dale Approved: The Electrical Permit Application must be filled out comDletelv. Please type or reprint in Ink. If you have any questions, please call (360) 411. 4735 Fax number: (360) 417-4711 7765' REQUEST INSPECTION ~ Owner or Elec. Contractor Agent: Property Owner R/c.HfTRD GRANGEr? Address: ;>,:? 5' CNUPrj.f .'>7 ElectricalContraclor 1!/fL.v'rJRSI;N, CLj;Cil?/~ Address: I " P I. IN fJ I',j Phone" Fax: Phone: City: p,jRf /l/vt;J:dS /fftLVr; E.TlJ 4"1 cL License #: Exp: 2/;3)o~ Zip: .9A'3~?- Phone: 4/?'J -1),U,p J Zip: ,9g:!>lf,"3 City: PbRT AAlt:F-/~5 INSTALLATION WIRED BY: 0 OWNER J\ElECTRICAl CONTRACTOR Credit Card Holder Name' 1/,4/1//)/7,1'"#.'> Fl.!; r;~/ C Billing Address' /42/. /,II {Iii City: ' P/);?T /TA/;';/iLES Credit Card Number- :> Zip: ~3G3 VISA:..-..lL... MC,-- PROJECT ADDRESS' 835' 'CffU.Rc)J ~/ TYPE OF WORK: Check all that apply: )5-New o Alteration/Addition ~ Residential 0 Multi-family o Commercial 0 Mobile Home Sq. Ft ;)/3h So. ~I Remote Meter 0 Detached garage 0 Hot Tub, 0 Swim Pool 0 Septic Pump . 0 Low Voltage 0 Telecom. 0 Sign Number of Circuits added or altered: /1 r. 20 DESCRIPTION OF THE ELECTRICAL PROJECT: IV 1=)1; ;;i{i:.5'1 0 EM:3f3 Electrical Heat Load Additions PERMIT FEE: / It; rd-O , ~t.c-f.i r'/ /I 7'~-sl8 Service Information o Baseboard o Fumace o Heal Pump o Fan-Wall _KW _KW _TON /3J.1!5. KW ~ lRA o Overhead Service o Temp Service li Underground Service VOltage:ft..2~/Z1O Phase: 1 0 3 Service Size: 1:> () () I)- Feeder Size: I hereby certify that I have read and examined this application and know that same to be true and correct, and I am authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits a:i required; it remains the applicants responsibility to determine what permits are required and to obtain such. s(v'('AL-- of.:-. Ac; JS _ k..C'...\)), IL'H99 ~ ~ c,..." C", Hold", SO",",, ~ .:; ~ DO<. ,w;W/o7. . /.10 'x., Date: ~/""1~1o ?, Owner or Elec. Cant. Signature,: C:lELECTRI9M;PERMITAPPLI~~'ON ~ ~ cY~ tJ/Uf~Z . - ____ ____ _ _ _ _____Uh!2L/ft..L-ILIJTlbN _RJcJlfJeD Sl<IlNCER_ _ 8'35 C.J-Iui<C,/-I _ .. .. poRT /lNb.EtES)-v//r- _ _ .flJ;)vER))L.jj)/tD _ ____ _ ~ __ __ _ __ __ u _ /9JJJ;L _ sq f:rcfP_.J VII_ __ h __n _ .5'1;:0 __ .. -- --2 --Zu/i_ /JPPII/MJc.e ().In.J;[_Ci~('k/r$__ ___ __@j5a> YA-_~IT- _ __3/lt>{) _ --.--- __J.../1WNDl?cI1_C)R.~l.r_ _- _______ _ _ _____ ;s't?i> _____ ______ - - - _OV-EIV_____ _ --_ _ __ __ ____ 90i!JO__ ) - _h __ -__w!trPRJ:tiiflI,PP_____ .. __'4!:[~U _ __n _ _ _ _ _DR'lP-TL _____ __ _ ___ __$()(){) m__ _ __ -M IfR~W~_vE _ _ u _ _ __ _ _ j O?)()_ i)}s.e~;JIU- _____ hOO__ ___ _ _u_ _ ~~ - __ h__ __ _ __ _ _ _ _ 29,IP'aC? _h A Rs r-..I.~ J(VllliLI~~% _ _ _ _ _ _ u-' PI r) I) I) _REMItIN/)/IJ::Lt.c ClJ.NGiWL-t.-tJ/)P!S __u _ _ _ 78- b_ __ _ _ ___LtO%.l~fe2DV/JX__Q~L ____ __ __ __ .. -- --{3!.EC Wfl-LL E/N)//:-iI2S _/3/1SQ. _ _.. __ __ _ _ u _ _ _ _2-4_,5'3t __ ___ _ u u._ _ __ - ---- - -. ---.- - -- - - __Z!t;_$l4 _,'__Z4:a =- If) 2 ,.23- _/ti<1;)j ___trlV1t""'MD_ _ _ _ FOR OFFlCI~SEf1,L Y 7 DalelRec: ..... '7 ~ Pcnnil#: 7. Date Approved: ELECTRICAL PERMIT APPLICATION The Electrical Permit Application must be filled out comoletelv. Please type or reprint in ink. If you have any questions, please call (360) 417- 4735 Fax number: (360) 4174711 Owner or Elec. Contractor Agent Phone" REQUEST INSPECTION p( Fax /IF';:?. -364? Property Owner: i(/C-/-!/J!?I) r::'jYI1NIo~el2 ;if.!1? cK /h/~ Phone: Address: City: PA , License tf/IiIIA)eI041f ceofp: Zip: 9 !?:::J tP ? 2.:/1:3 /tJ/1 Phone:,q5?-= 7B'?1:3 Zip: 9 (J) ":; 6 .?;> Electrical Contractor: Address: /,4 f!/. r i-I/9 1-1/ tJ If.':; Ie;: AI,- iN' II)/, i7LEc:n7I, City: PO!?r ,,f--Jl/r;/7-il;<S INSTALLATION WIRED BY: 0 OWNER J21(ElECTRICAl CONTRACTOR Credit Card Holder Name: lI;rw~ /?5/=31U S f!7j I;;;:, '//ZI C. Billing Address' /42& l-t/ //I"i City: P/J;;~r hll/f';I:;://T:; Zip: '--7ft,?!? 3 VISA- ~ MC,-- PROJECT ADDRESS' tJ 3E G-flu...ft'-e/-f TYPE OF WORK: Check all that apply: 0 New o AlterationlAddition o Residential 0 Multi-family o Commercial 0 Mobile Home Sq. Ft Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump o Low Voltage 0 Telecom. 0 Sign Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT: (liMP C;FRvIO;;: Electrical Heat Load Additions PERMITFEE:~ I' 3'1- Bo Service Information o Baseboard o Furnace o Heat Pump o Fan-Wall _KW KW _ TON_LRA -KW o Overhead Service "~Temp Service o Underground Service Voltage: Phase: 0 1 0 3 Service Size: Feeder Size: I hereby certify that I have read and examined this application and know that same to be true and correct, and I am 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: p/jr:;t~ ~ Owner or Elec. Cant. Signature: C :/ELECTRICALP ERM IT APPLICATION Date: lif/7/7 7_ Date: