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HomeMy WebLinkAbout426 E Lauridsen Blvd - Building f) . -- ""c~ 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 03-00001211 Date 12/22/03 426 E LAURIDSEN BLVD 06-30-10-5-0-2100-0000- PLUMBING REPAIR COMMERCIAL OFFICE 1300 OWner Contractor DIVERSIFIED INDUSTRIES INe 430 E LAURIDSEN BLVD PORT ANGELES WA 983627952 OWNER Permit Additional desc Permit Fee Issue Date Expiration Date MECHANICAL PERMIT 54.25 Plan Check Fee 12/22/03 Valuation 6/20/04 .00 o ...t. N IS' Qty Unit Charge Per Extension 47.00 7.25 V-( BASE FEE 1.00 7.2500 RCH ME-VENT FAN Permit Additional desc Permit Fee Issue Date Expiration Date PLUMBING PERMIT WATER PIPE TO CLOTHES WASHER 54.00 Plan Check Fee 12/22/03 Valuation 6/20/04 .00 o I ~ ~. Qty Unit Charge Per Extension 47.00 7.00 \\.... \" ~ ~ > BASE FEE 1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE Fee swnmary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 108.25 108.25 .00 .00 Plan Check Total .00 ,00 .00 .00 Grand Total 108.25 108.25 .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. ~ /2. 22~o3 Si Date Signature of Owner (if owner is builder) Date T:\PLANNING\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 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 1 NO FOUNDATION: FOOTINGS WALLS FOUNDA nON DRAINAGE/DOWN SPOUTS ELECTRICAL (UGHT DEPT) SEP ARA IE PERMIT; # ROUGH-IN I I I PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO SLDG) GAS LINE BACK FLOW I WATER AIR SEAL WALLS I I T CEILING I I I FRAMING JOISTS I GIRDERS SHEAR W ALL/HOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERJOR BRACED PANEL ONLY) I-BAR INSULATION SLAB I I I WALL / FLOOR I CEILING I I T MECHANICAL . HEAT PUMP GAS LINE WOOD STOVE / PELLET I CHIMNEY HOOD / DUCTS 1==",,'^ I 2-Z~'OS " LL PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARA IE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO CO:\1MERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 I::, '2'5..05 I( L BUILDING T:\PLANNING\FORMS\1102.15 {l1l14/2003] FOR OFFICIAL USE ONLY, BUILDING PERMIT - APPLICATION Date Rec.; Fill out COMPLETELY and in INK. Your applicatiou aud site piau MUST BE COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 Permit#: Date Approved: Date Issued: Applicant or Agent: . -;~ (e,I'\.~ " lws Owner: })uel'Sl-4,;d 'i4~ll\CQ (l2x1A.cr Address: 4:36 r:;. /..4unc\:',-<.{I 'f:,l~c.\ City: -Pov't- ArchitectlEngineer: rJ I f-t- Phone: Phone: '-JS,) J17 89 LIs,..;) - cn8'7 Zip: Cf8 3(.2- 1-1-(\ ~ to <:, ( Phone: Contractor State License #: Exp: Phone: Address: City: PROJECT ADDRESS: Yd~ € LCi.l<. y-;c(Si.-i-> I:)., \\1 C~ Zip: ZONING: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Block: Subdivision: Credit Card Holder Name: Billing Address: Credit Card Type VISA TYPE OF WORK: D Residential D New Constr. D Re,roof D Multi.family D Addition D Move D Commercial ~emodel D Demolition D Repair D Sign BRIEF DESCRIPTION OF THE PROJECT: i,AJ i d mOl/Pi I1dI'7 K';'" /;1 if1"1 / COMMERCIALfRESIDENTIAL: Occupancy Group: City: MC # Exp. Date: SIZEN ALUATION: SF.@$ SF.@$ SF.@$ TOT1}L VALVATIO add..R, , c Oaor?1oc&k /SF. ~$ /SF. =$ /SF. =$ $ D Stove D Garage D Deck D Other ~ ("All fJ r /( Occupant Load: & Proposed Sq. Ft. 'X - Total lot coverage Construction Type: = TOTAL Sq.Ft. % No. of Stories: Lot Size: Existing Sq. Ft. Existing lot coverage 'X & Proposed lot coverage - 0 - 0- APPROVALS: PLANNING USE ONLY: PLAN: BLDG: DPWU: FIRE: ESNWetland(s): DYes D No SEPA Checklist required? DYes D No Other: OTHER: - BillLDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with infonnation 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 reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417,4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRA nON OF PLAN REVIEW: Ifno permit is issued within 180 days of the dole of application, the application will expire. The Building Oll;.:i"l can exlend the time for action by the applicant lip to 180 days upon wrillin request by Ihe applicant (see Section 107.4 of the Uniform Building Cork, current edition). No application can he extended more than onct:. f hereLy certify that I have read and oxamined this nppfication and know the same to be trUf! .!i1d correct. f am authorized to apply fOI hs pe,mit and understand thAt it is my responsibility to determine what !Jermits are required ,not thpEity' , and lid t must obtain such permits prior to wa!!; npORMSIAPPSIH"ildingp,nmt."i'cl APPliC~ Dalc, {2..-- 2-z... - 63 / PREPARED 12/23/03, 12:35:05 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 12/23/03 - - - - ~ - -- ------------- ----------------------- ----- ADDRESS 426 E LAURIDSEN BLVD SUBDIV: CONTRACTOR PHONE OWNER DIVERSIFIED INDUSTRIES INe PHONE PARCEL 06-30-10-5-0-2100-0000- APPL NUMBER: 03-00001211 PLUMBING REPAIR ----------------------------------------------------------------- ------ PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ---~-------~-- ------ - - - - - - - - ~ - - --_.- PL99 01 12/23/03 JLL PLUMBING FINAL TIME: 17:00 ~ water lines to new wash machine, remove sink ____ ___________ COMMENTS AND NOTES ---- m~viLs ~} y~ t>O~ o'rL . PREPARED 12/23/03, 12:35:05 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 12/23/03 ------------------ ------------- ADDRESS 426 E LAURIDSEN BLVD SUBDIV: CONTRACTOR PHONE OWNER DIVERSIFIED INDUSTRIES INC PHONE PARCEL 06-30-10-5-0-2100-0000- APPL NUMBER: 03-00001211 PLUMBING REPAIR ----------------------------------------------------------------- PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS 'U ------------------------------ ME5 01 12/23/03 JLLi7 MECHANICAL DUCTS H- Dryer duct & exhaust fan & duct Brent 808-0451 or 452-6470 --------- CONTINUED ONTO NEXT PAGE e-AK~ Y7- .P JS OIl(J iLlf:, lSo-!..4 We- [ s. DYG ~ L~ -=- ~""" 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 03-00001208 Date 12/23/03 426 E LAURIDSEN BLVD 06-30-10-5-0-2100-0000_ ELECTRICAL ONLY COMMERCIAL OFFICE o Owner Contractor ------------------------ DIVERSIFIED INDUSTRIES tNe 430 E LAURIDSEN BLVD PORT ANGELES WA 983627952 ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452-6424 WA 98362 ----------------------------------------------------- Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL 2 DRYER CIRCUITS ELECTRIC SERVICE 46.70 Plan Check Fee 12/23/03 valuation 6/21/04 .00 o ~ ~ Qty Unit Charge Per 1.00 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 46.70 Fee sununary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 46.70 46.70 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 46.70 46.70 ,00 .00 ('\ t ~ ~ ~ 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 J 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 6tat~ ar focal I.~w 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 [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 BEFOI,lE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. ~ INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGEJDO\VN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I I PLUMBING UNDER FLOOR / SLAB RQUGH.IN WATER LINE (METER TO BLOG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS I I CEILING I I FRAMING JOISTS I GIRDERS SHEAR W ALUHOLD DOWNS # WALLS / ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) I-BAR INSULATION SLAB I I I WALL I FLOOR / CEILING I I I MECHANICAL HEAT PUMP GAS LINE , WOOD STOVE j PELLET / CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT fI's: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIO!\'S REQUlRED PRIOR TO OCCUPA!\'CV/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL - LIGHT DEPT. 417-4735 I;. /...../_. ..kn ELECTRlCAL LIGHT DEPT CONSTRUCTION R.W.I PWI I I CO'!'>lSTRUCTlQN - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417~4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING '. , ..t .. " . ',' T;\PLANNING\FORMS\1102.15 [11/14/2003] ti ~ - ,.,.~ ,. L -=- ~ "'i.;;;id' CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation 04-00000643 Date .986145 426 E LAURIDSEN BLVD 06-30-10-5-0-2100-0000- MECHANICAL APPL. PERMIT 7/21/04 COMMERCIAL OFFICE 150 Owner Contractor DIVERSIFIED INDUSTRIES INC 430 E LAURIDSEN BLVD PORT ANGELES WA 983627952 FIX-A-FLAME LLC 461 SOUTH SOLMAR DR SEQUIM WA 98382 (360) 683-1787 -------~-------------------------------------------------------------------- Permit Additional desc pe rmi t Fee Issue Date Expiration Date MECHANICAL PERMIT GAS LINE, TANK, DRYER 57.65 Plan Check Fee 7/21/04 Valuation 1/18/05 .00 o Qty Unit Charge Per Extension 47.00 10.65 ~ ~ BASE FEE 1.00 10.6500 ECH ME-GAS PIPE 1 TO 5 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.65 57.65 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.65 57.65 .00 .00 ':\1 "I1t ~ 1 ~ - ~e;- l- , 1 ->.. \:l:1 -- c It.. 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 atter 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 vioiate or cancei the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date --J-- ~ tJ /7 ~ 7-,;2/-01 Date Signature of Owner (if owner is builder) T:\PLANNING\FORMS\1102.] 5 [] 1/1412003] 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 FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DErD SEPARA IE PERMIT: # ROUGH-IN I I PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO SLDG) GAS LINE BACK FLOW I WATER AI~ SEAL WALLS I I CEILING I FRAMING JOISTS I GIRDERS SHEAR W ALUHOLD DOWNS WALLS / ROOF / CEILING DRYWALL (INTERIOR BRACED PANEL QNL Y) I-BAR INSULATION SLAB I I I WALL I FLOOR I CEILING I T I MECHANICAL HEAT PUMP GAS LINE i-[/} 1-()1-1 AL, WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'5: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEP ARA IE PERMIT #'s SEPA; PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.I PWI CONSTRUCTION. R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 <;l.iLoi-1 TIT BUILDING T:\PLANNING\FORMS\1102.15 [11114/20031 ~ ~ ~ ~ i :1>"ClonEi n~ ~ ~ ~ >< :g~~@tj ~~ ~ ~ m ~ ~~ ~ ~ , t'nt>l>-i::a ><~ 00 ~ E'3::a~~ o~ 0 0 0 " ~ ~. . ~ U) ~ ~ ~ "~ 0 ~ w 0 ~ t ~. ~. 0 n~ ~ ~oo -.J-.J-.J-.l OM ~, "........, ~" 0 t<.lroJt<.lN ~[ijg oatl"''''' ~<:. tvNf-'1-' """'HHIV ..............,....... 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"~ " ~ Z ~ ~n ~ " n" " ~ " "H ~ ~ 00 .Z 0 ~ Z "" 0 ~~~ ~8 " 55fii ~" ~ ~~ ~ ZZO " ~~H " < " H W ~ . m " ~ "' m ro w H , ro , 0" >> "0 ~~ , , N H , 0 .~ \\ \'URr 't~'f:' O\~ :',~:i:;~~E(t'j ~"1f L_ ~,_~- ~ BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY; Date Rec7-Z/-0<.( Pecmit# ai{ -6'/3 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 PERMITS (360) 417-4815 FAX(360)417-4711 Date Approved: Date Issued' Applican.t or Agent: Owner: '{ S. i' Address:-Y,~O E. City:--1'hd C. Phone: Phone u'Q._ - <1-' B'l V'I~I('.s W A Zip: Qg::)0l-.. Architect/Engineer: Contractor AI p ~ I ( ) Co <, ,,_1 VV\c1 <II State License #:f 1 ,').' ~.,. , Address:J!.laJ S, $'O{ Hit( JJr:\tJV PROJECT ADDRESS: LEGAL DESCRIPTION: Lot: Phone: 'fExp:o~/O~{Oh Phone: I. _ /p' c <'. (i'" ',.. Z,'p'. ':""J ' '~~UI'" ZONING: Ml?, 1737 1A~S7- Block: Snbdivision: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: Billing Address: Credit CardType VISA MC # TYPE OF WORK: A Residential 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move D Commercial 0 Remodel D Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: City: Exp, Date: o Stove o Garage o Deck 'i1l;' Other j,^ v~ I((). tl ;,,"- SIZEN ALUATION: SF. @ $ /SF. ~ $ SF. @ $ /SF. ~ $ SF. @ $ /SF. ~ $ TOTAL VALUATION $ / sf) (~,f ,-p~ j i v'\~ -ilt, r rl r""jP 'r" 00 =--- COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: & Proposed Sq. FI. Constmction Type: No. of Stories: Lot Size: Existing Sq. Ft. Total lot coverage ~ TOTAL Sq. Ft. APPROVALS: PLANNING USE ONLY: PLAN: BLDG: DPWU: SEPAChecklistrequired? 0 Yes 0 No Other: FIRE: ESAlWetland(s): 0 Yes 0 No OTHER: - % BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with infOlmation 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 reviewed and may be revised by the Building Division to comply with cunent fee schedules. Contactthe Pennit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tin,e the building pennit application aud construction plans are submitted. All other pemnt 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 achou by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of the Uniform Building Code, cunent edition). No application can be extended more than once. 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 it is my responsibility to determine what permits are requic ,not the Ci 's, and that I must obtain such permits prior to work. nFORMSIAPPSIB,ildingp"mit.wpd Applican: Date: ~( 7ffJ ( 0 V -1.... " ~ ......\.,1- j J ( '1 rt -4- (, -t- "= '< 'U .' r " " - C' n v, -'1 , J ,.'1 d -1 'D '* '::t ''J ,-) - 1 ~, If " r .J CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N9 15151 7-:/6 ;;-v Port Angeles, Washlngton_____nn_________n__m_n_m___n_____m__n_n__nmn_, 19nmn_ In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in,. on, or about any building or other structure in the ~~~o;~eles, }5z;, __ mission is he}'eby granted to do electricf, work as listed below. r;: -...._ ~f!.. Address __n '._~_;~__L_:::'~iJ.n~.-:-.nn::~::m:n;--n.-f.~-~n~nt..~ gccupancy -/'-"-,.<L.tt)",km<u:.''':'<n'--,, ow~er --..n.-!;c-',':!:~."':?i1t!n.1!t_::vnQ- ~enanL-.-,.------nm-nnn..--.-nn----m...m.m.--nnm.mnn.-- Wirmg Contractor .----.--nnc(f----.nnmm--n-..--mmn?n-;-::---~ .,B~,~-----.--..-'n----'-.n---n--.-m'nn-----'n--------n-m.--.' Light Outlets...___...______....................__.... Service, volts ....(........(..d..........___.... I Type of Wiring: RtlCeptacle Outlets....___...m.................. No wires Armored Cable ---........................... ") ~ Sfz'e w' Ires.,.,',',.,',{..v,',:,.,.,i,.,..{.....',:,',.,i,~,',',-,-,(-,'.,',',', Non.Metalllc .......___......m.............. ~ Dr)ler, KWI....uu__..n......h......h............ '7-"- L /p) Knob & 'rube..............___................ 1 Range, KW m_m.....m...mm _..m..m_.__.. Main fuse ..m.._..._.....___................... .d "Tater Hea~:~ Enclosure ..............__............___..___.n (I KW.mmG,-""(_.___..m._.....mmmmm. Type of wiring: (i 7/ S' 8 B Entrance Cable -------------------..,------- Hea!: RW.__....n_________________________________________, Rigid Conduit __..............._...___....... Motors: size, volts and phase: Metallic TUbing _...__..................... Current transformers: No. & Size......__...._............__....__...__. Ser. No.............................___......_....... Ser. No............................................... Ser. No. .._...__.......___._.........__......__..... Total Load.._................._......_ Ser. No. ....._..........................____......... Rigid Conduit ..m....................__.... Metallic Tubing .................__........ Race,vay .__..__.__...__........................._. Circuits. LighLfl?..Qm...............__....... Utilitv .B..~..._.......n.................... Heat' 'jL r Range --::::::/1..:::::::::::::::::::::: I. Water Heater .........:...__....__.......... hfotor _..___.........__........................... Dryer......._.......................................... Furnace ........_...___..........._.................. lie) Total ................................__..... R k. ..J /...-v<.-U-:..-,...;., ~,;,:.!?t A L-~2'," / -: (; -' II 1-3iXf;:f emar s. n_..._.nnn.n_u.._..n...un....__n._...u...Uhuh.._u.n......nunhn__nn_nnn..._Un...Uh.h__nnd_nnnnnn____nn__.___n_n_ hn__h~h__--_h---______m___nh...n_nmmnm~~___~m~_:__~:~.:!__/3.m.__h~::~~~::_~.:~._.U..:d~.:n.:~'__~_'?____.._-!_______m__nuh.h__hhhuhunn J ~~.~~~~.?nmmnmm ~~~.~.~:n~~.~.~~.~~_._n... By .In:~/j{;.::n!~L:.~~~',''u'___.___n.n._ N'OTICE-Current must not be turned on until Certificate of Inspection has been issued. If work Is to be con. cealed due notice must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 15151 Date called for inspection......__.............._........................................_.................................._........................._............................_..................... PreUmiDarylnspectiondates.........................................................._.._................................................................._...................._..................._ Inspecdoncompleted..._......_.........._........_.........._n..................._....._.............................................._........._....................._.........._..................... Total Load ..........................................__............................................_. 1M 3-72 Olympic Printers, Inc. Q W 0'k, , FAX NO. : 4526424 Dec. 18 2003 04:55PM Pi FROM: Electric7S ELECTRICAL PERMIT APPUCA TION - . The E loctr1caI Permit Appllcailcn muot lie Riled oul com .."'talv. P leas. type .., reprlnlln Ink, If you hava any quHtlon., p"'''. nil (380) 417-4731 Faa n....lllr: (310)41704711 FOR ()FPln.u tlSij D. O.todRm: __ "c.1Zll1 It: _.__._ D~f1 Appro"'I:d: __ DAte b".,cd: ___. -- Property OW.er. Phone: S'.R.yvi to J -:6-. P.o..: 4:f2-(PL.j~'-tF"": Address: 4J...{,., '1_ L6'" .,9- /!'tv.&._ CIty. 6.......,.. ~ _ EleclricalCaotraclar: E(u::..-h...u> kV;'C,.l.-,1:hL LiCllllSO#:si:7~:f["'1 E"ll: Adaros.: K-7:l- Or--~,_ Vc< I~;r ire:! _ClIy:fnr1 Ab'l~''-'U.~ INSTALLATION WIRED BY: 0 OWNER 0 ELeCTRICAl. CONTIUCTOR Credit Cal'fl Holder Nllme: <'J /; 'i Ic., , "I5'J.-k"11.< f~?-- 9?8 ( ZIp: <1.r?l., Pl1ane:'bl-~ Zip: 9 gu Blllln, AddnJss: Credit Cal'fl Number: On ~ City: ~ &po DIIfB: Zip: VISA: PROJeCT AOtIReSll: I/Zb L L/fwu tJ,JeN A.:.v-O, o A1teralionlAddiUon TYPE OF WORK: Check il! that apply. 0 New o Residential .familY - [J Commercial (J MobJ/IIHome Sq.FI. o Remote M..ter 0 O..lached garage Number of Circuits adclod or illter&d: DESCRIPTIOl\l OF ~E aECTA,lCAL PROJECT: o Hot Tubcl SwlmPooI 0 S..ptic Pump" -0 low Voltage 0 Telecom. '2.- t).,.'y- ~ c-"Sf.--u! 'r ServIce Inform_tlcn Electrical LDad Additions and or SUbtraCtIllns o Baseboard Cl FUmeGa o Heat Pump Ll Fan-Wall KW KW TON -KW LAR ~ Overl'.eed Service o Temp Service o Undelground Service Voltage; Pl1esa: 0 1 0 3 Service Size: Feeder Size: . PAMC 14.05.050(B): For Industrial, commerclal, & residanUIlI projects larger tllan a duple", a one. lin.. drawing of the Elsctrical SeNI FeedSlll, bu~dlng size (sq. ft.), load calculations, and lI1e ty pe & of conductors and/or laClOWay is required and shall ea:om pany!he Electrical ?ermn application. I hereby certify that I have read and examined this application and know that same to be true and correct; and authorizad /0 apply for this permit, I understand It is not the City's legal responsibility to determine what per mil are reqrlred: it remains the applicats rel$ponsibility to dete, rmine what permIts are required and to obtain Such IZ-(v~ OJ S.r-O.,J,JJ:.;D ,U/r, - -O~) A:<7?~ ~t --J...L_ Ad &J Cr.dil Card Holde". Slgnalure: ().,.~'-1.1f' ):fi?~ Dst.: /lel ({;/O$ , Qwnar or S;lao, !;<;Hlt, s,soatur.:_{iJd~' ~~ POI" ~ PW~OO1gI7J03 ;..1#~c~ It" 11-0J, PERMIT FEE: $ 16-70