Loading...
HomeMy WebLinkAbout1715 W 10th St - Building CITY OF PORT ANGELES DEP ARTMENT 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 04-00000531 Date .655310 1715 W 10TH ST 06-30-00-0-3-0895-0000- RES MANUFACTURED HOME 8/09/04 RS7 RESDNTL SINGLE FAMILY 62000 Owner Contractor WA 98362 M & C CONSTRUCTION 653 N. 7TH AVE SEQUIM (360) 683-4571 NEW MANUFACTURED HOME 1475SF TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS INC MANGIAMELI, JOSEPH/TERESA P. O. BOX 2832 PORT ANGELES (360) 417-8056 Structure Information Construction Type Occupancy Type Other struct info WA 98382 21. 00 1. 00 7000.00 1475.00 1475.00 1. 00 Permit Additional desc Permit Fee Issue Date Expiration Date BL MANUFACTURED HOME HOMEBUILDERS NORTHWEST#48724 230.00 Plan Check Fee 8/09/04 valuation 2/06/05 .00 62000 -::I - ~ \l ...... t "- <. ~ \' ,.... c ~ V'J '='-1 BASE FEE Extension 230.00 Qty Unit Charge Per Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. Manufactured home must be pit set so that no more than 12" of skirting is visable above grade. A residential fire sprinkler system shall be installed per NFPA 13D will be required. 2nd option is to install an out side alarm bell that is eletronicly connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as IlFire alarmll The site is zoned RS-7. Setbacks and lot coverage are good. Noland use issues are noted. Electrical load calculations and elctrical permits are required. Sidewalk to City standards required for school walking route. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 745.00 4.50 1025.00 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 {~ ~ 'tZ~~ /'8VA& . 1'11(44$// ,Y:' t!>1- Sfgnature of Own"er (if owner i uilder) , D~te T:IPLANNINGlFORMSll 102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTR]CAL 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 WALLS FOUND A TION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR W ALLIHOLD DOWNS WALLS 1 ROOF 1 CEILING DR YW ALL (INTERJOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLA)\''NING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNINGIFORMSl11 02.] 5 [11/14/2003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000531 pin number . . .655310 Page Date 2 8/09/04 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 230.00 230.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 2004.50 2004.50 .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 [11/1412003] 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: f)f OJ< q 'Tle~'" P,f rJ/~1 ji-\... FOOTINGS ~ f. h ~ 11- ON \ L WALLS -, FOUND A nON DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF 1 CEILING DR YW ALL (INTERJOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING MECHANICAL HEA T PUMP GAS LINE WOOD STOVE / PELLET / CHIMNEY HOOD 1 DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI jl).. -~H<-o; CONSTRUCTION - R.W. ENGINEERING 417-4807 --1'1:: PW 1 ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 ) 11-1/,-O;-..J I, 1-. BUILDING T:\PLANNING\FORMSII 102.15 [11/14/2003] (",~f'ORT ~G' ~....;.~~ u~~ "-~ ~ "to\~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 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 04-00000531 Date .655310 1715 W 10TH ST 06-30-00-0-3-0895-0000- RES MANUFACTURED HOME 9/07/04 RS7 RESDNTL SINGLE FAMILY 62000 Owner Contractor 21.00 1. 00 7000.00 1475.00 1475.00 1. 00 3\CJ ~ -f::::. ~ .... ~ {~\f',. ~ VI ~~ MANGIAMELI, JOSEPH/TERESA P. O. BOX 2832 PORT ANGELES (360) 417-8056 Structure Information Construction Type Occupancy Type Other struct info WA 98362 M & C CONSTRUCTION 653 N. 7TH AVE SEQUIM (360) 683-4571 NEW MANUFACTURED HOME 1475SF TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS INC WA 98382 Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL SERVICE/FEEDER QUALITY ELECTRIC 78.70 Plan Check Fee 9/07/04 Valuation 3/07/05 .00 o "'- ~ .............. ---.J \ --- ....... ~ \ 0 c-. G -.c-~ --......... <0 P ~ ~ Qty 1. 00 Unit Charge Per 78.7000 ECH EL-MANF HOME SERVICE & FEEDER Extension 78.70 Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. Manufactured home must be pit set so that no more than 12" of skirting is visable above grade. A residential fire sprinkler system shall be installed per NFPA 13D will be required. 2nd option is to install an out side alarm bell that is eletronicly connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" The site is zoned RS-7. Setbacks and lot coverage are good. Noland use issues are noted. Electrical load calculations and elctrical permits are required. Sidewalk to City standards required for school walking route. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE 745.00 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 T:IPLANNINGIFORMS\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 LOCA nON. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDA TION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) . GAS LINE BACK FLOW 1 WATER AIR SEAL I WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHJMNEY HOOD 1 DUCTS PW UTILITIES / SITE WORK (Engineering 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 ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL 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:\PLANNINGIFORMS\1102.15 [11/14/20031 '0~ ~ORT ~G '8"'~~~ , rea "-~ ---- "4i;:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000531 pin number . . .655310 Page Date 2 9/07/04 Other Fees PW WATER SYSTEM USE FEE 1025.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 78.70 78.70 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 1853.20 1853.20 .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 orwork 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:IPLANNINGIFORMSII 102.15 [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, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTrNGS WALLS FOUNDA TION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # /J t1-1h $&~. r Y- h/ j)(}A./' ROUGH-IN 1'1 -Jlf-'cd JrK PLUMBING r ( UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL I WALLS CEILING I I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERJOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKING/LlGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 P-I-OC{ [/( '::' ELECTRJCAL 9-bJY- e/C( LIGHT DEPT CONSTRUCTrON R.W. 1 PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 4 I 7-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNINGIFORMSlI102. 15 [11/14/2003] , tJ:j tJ:j tJ:j >-3 '" I :J>'Uon:J> n'U , t' t' t' >< ~ I 'U:J>:>:oa H'" , '" tJ:j "' 'U I 'U",zza >-3'" , '" >-3 (f) '- I t-t()tI:lI-:J::U ><'U , (f) H I toJ"''''''' :J> , 0 0 0 0 >-3 I Zt' :J>{f) 0'" , f-' f-' f-' .. I !ii. n{f) "'''' , I >-3 a tll I tJ:j 0 'U 'f n"'~ "'. "'. Of-' , f-' '" "'''' I tv 1.0 \.0 00 CD 0'" >-3'- I ,.......................................... 3:0 f-' I 1-'001-'1-' 'UC::O OO~3:"'" ~~ I ffi CX>0l 1-'1-' t''''O ",'" -.l I ..................................................... "'{f) I I I?'I-' G'Jo I 00000 >-3>-3tll oWG'J Ul "'", I ~,f:>,.f::>.Il:>o,p.. "'''''" COHn t'. ~~ aa g~~n~ '" ~Hi (f)f-' 00 tI:l 01-' '" Ul t'Zo *">">" WOH(J)t-3 Ul t"l"Ot""I-dt-t f-' , - >-3;1: -.l t' t' t' ~~~ w '" '" , "-<C::{f) 0 t''U tIj 00 nl-:3 -.l >-3 C/)CD{J)!--:l "''''H ~ 3:Ul"OO ~';l:Z , 0'- ,,-<tJ:j"-<tJ:j"-<tJ:j , ",a= COI-:3H He H C:::)-'. c:: "''''0 ~otrlZ :S:H3:H3H , ~~~ ~O::U() t' t' t' , n , '" aa a a , t'''' >-3 (f) :J>H Z Z >-3H ~ :J> <Z , , (f)'U n HG'J G'J G'J , '->-3 '" 0 (f) , nH a H :;: "' tJ:j "' , 00 HZ 3: H,p..t"cnO , 3:Z ;I: Z{f) '" , 2:;0"1000 , 3: 0 (f)'U Z )>'1-'()CDt-3 , '" :;: 'U'" >-3 t' , ?: , , Z '" toJn (f) CD f-' w'- >-3 n>-3 0 ~~~~ (f) >-3H ~ CD , 00 .:, 1.Ot:t1--')>' , "'Z a tJ:j w >-3 "-<>-3 Z w H , ~;:; 0 0 toJ , 'U'U{f) >-3 a >-3 , 55g "'?: '" 0 H , {f)'" (f) :>: :;: , zza >-3 Z '" , "''''H t' (f) .. , < , t' f-' I H -.l , '" .. , w w '" 0 "'''' t' 0 00 >< , , ",'" , f-'CD , -.l W , , , CD'" , OUl , Ul-.l I "'f-' , , , , , , a'U , :J>:J> , >-3G'J , "'''' , , f-' , '" , '- , f-' , '" , '- , 0 , ",'" OJ OJ >-3 ":l I ::;:;;iJ8/'j n'O 0-< 0-< ><: ~ I H" OJ "1 '0 I '0 ",ZZt:l >-3t>1 >-3 U) '- I t"'ntIjl-i~ ><:'0 U) H I tI:I::o::otI:I :J> 0 0 0 >-3 I Zo-< :J>U) 0", H H .. I ~. nU) "1t>1 I >-3 t:l III I OJ 0 'tl n"li: I t>1. ". 0 " ,,'" 0t>1 >-3'- 3:0 0 'tlCO OO~3:1--' ~~ 0-<t>10 "'''' -.J t>1U) I I ~I--' G'lo >-3 >-3 III OWG'l Ul t>1"' t>1t>1t" OOHn 0-<- t:ltJ ~~~() :>: t>1 , ~Hi UlH , OOtI:lOI--' W ll"PO Ul , o-<Zo , WOH(J)1-3 H I t"''1:It'" H , - >-3:>: Ul , 0-< 0-< gJ~i W " ", ,,-<CU) H O-<'tl tIjoonl-3 "' , >-3 (J)OJ(J')1-3 , "'t>1H ~V1'l:lO ':>:z 0'- ~tDytIl "t:l= C::OI-iH H c::: 1-" c: t>1t>10 "tjotI:lZ 3::H3H gJi!i~ ):>O::tln 0-< 0-< n , t>1 t:l tJ 0-<" >-3 U) Z H >-3H ~ :J> , Z U)'O n G'l G'l '->-3 t>1 0 nH tJ H 3: OJ "1 00 HZ 3: ,l:>ot"1OJO 3:Z :>: ZUl t>1 0"\000 3: 0 U)'tl Z I-'()rol-i t>1 3: 'tlt>1 >-3 , "'" Z t>1 t>1n Ul H w'- >-3 n>-3 ~~~~ Ul >-3H ~ 00 1.Dt:11-';:t::' , ",Z t:l OJ , >-3 "-<>-3 Z H , ~8 0 t>1 , 'tl'OU) >-3 tJ >-3 , 55~ t>1"" t>1 0 H , U)t>1 U) :>: 3: , ZZt:l >-3 Z t>1 , t>1t>1H 0-< U) , <: , 0-< H H -.J , t>1 .. , W W "' 0 "'''' 0-< 0 00 ><: , , "'''' , HOO -.JW , , , 00"' OUl , Ul-.J "'H t:l'O :J>:J> >-3G'l t>1t>1 '" '- 0 00 '- 0 ",Ul to >-3 '" ~~~8E; n'd t" ~ ~ H:O 'oj '0 'd:OZZtJ >-3t'l [/) '- t"'ntz:l.....,::u ~'d [/) H tI1::U~tzj ;t> 0 0 >-3 Zt" ;t>[/) 0:0 H ~. n[/) 'ojt'l >-3 tJ tll to 0 '0 n:o~ t'l. :0. 0 :0 :0 CD Ot'l >-3'- 3:0 H 'dC::O OO~3:""" ~~ t"t'lo "'''' -J t'l[/) I I I?'I--' (;)0 >-3>-3tll OW(;) Vl t'l'" t'lt'lt" COHn t"- tJtJ ~~~n:E t'l , GiHi [/)H oott101--' tv {" Vl , t"ZO WOHU)I-j '" , t" H , - >-3;J: W , t" i9~i W :0 :::t!ICjcrn Vl , t"'d t'Ij 00 n!-:3 0 , >-3 (J)();)(J)I-:] , "'t'lH 3: Ln"tl 0 ~';J:Z 0'- C4to :otJ= COI-:lH ~. c:: t'lt'lQ l-IjottlZ 3 H i9~lll ~O::O() t" n , t'l tJ t":o >-3 [/) H >-3H ~ ;t> , Z [/)'0 n (;) '->-3 t'l 0 nH tJ H 3: 'oj 00 HZ 3: CDO 3:Z ;J: Z[/) t'l 00 3: 0 [/)'0 Z 00>-3 t'l 3: 'dt'l >-3 , Z t'l t'ln [/) w'- >-3 n>-3 tv[/) [/) >-3H ~ CDt" 00 H;t> :OZ tJ tIl C4>-3 Z ~8 0 'd'd[/) >-3 >-3 g;g;liJ t'l~ t'l H [/)t'l [/) 3: ZZtJ >-3 t'l t'lt'lH t" <: t" H : H -J t'l .. , w W :0 0 , "'''' t" 0 , 00 ~ , , , "'''' HCD , -JW , CD'" OVl Vl-J "'H tJ'd ;t>;t> >-3(;) t'lt'l CD '- H H '- 0 "'-J Fill out COMPLETELY and in INK. Your application and site plan MUST B COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 FOR OFFlCL-\L USE ONLY: Dale Rec.: 6-/0 --04.0/ perJllit#:~ f Date APproved:~J Dale Issued' BUILDING PERMIT - APPLICATION Applicant or Agent: Owner: ,loe Address: /11-1 C Colt/s7:eocZTcN-T,A-C Phone: G8,j'-4S?/ /11.4 IV".L~ ,vi ~ L.- Z- Phone 6' ~{ ,") <1"1 <r r 17- ~OS(-- City: Z p: 0 P LEGAL DESCRIPTION: Lot: Architect/Engineer: Phone: Contractor/!1-1C CoA.6 ?;eU--7Ji:A..;' State License #l1cCaIV/~ - ~f /0/0 S- . f Address: 0\53 /\/ '/ ~ City: S.E6; v~'rl/1 ("vA PROJECT ADDRESS: ,., IS- W i () 1- ~ / ") Block: '- ~ 0 8 . . O~30oo0<..s087~-OOO C) Phone: 0'83 .4S7 I Zip: 9'A..38Z- ZONING: Subdivision: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: Billing Address: Credit CardType VISA TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Cor=1ercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: City: MC # 4Jo,~fhUJesf J? MA^"C/FAe-:r~ COMMERCI SIDENTIAL: Occupancy Group: .J?~S Occupant Load: Construction Type: J.Ic.,..,., L No. of Stories: -L Lot Size: O<X:) Existing S~J<t. _.d _ & Proposed Sq. Ft.J;'I''l~ = TOTAL Sq. Ft /11-76 Total lot coveragL '.f-l: Q ~ APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER: Exp. Date: SIZENALUATION: 00 L'100 SF.@$4? -/SF.=$ 02/ C/CO I SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ C.2. 000 c(l ~ G>C PLANNING USE ONLY: ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division cau provide you with information on the application and plan submittal requirements if you have questions. V ALVA TION 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 complywith current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLA.1\! 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: Ifno pelmit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the tinle for action 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 u,deest"d that it is my reSPO'SibilitY: d.."eemi" whal p,rmits are required .,ot ~ aM that I must oblai, such peemilSZ ;_ w0'k TIFQRMSIAPPS,""ildi"gpocmi'",," . '~.E APPh"n~. n"e, c; k<f tv (;J <---~-'> f i -5 ~6T -It IY / II;: 10 I ~'7 / .... ~ \:)! - , ~-I 't1 ! ! I i I I I I I I I I I i ('-v ~ -S ~ I . /\ ~I ..... l ; l-J! 1 , )_o~-. .' /;' j! ( .,' /f . -=.c.2'-i-7~~ _~G - 8 ~r~'. I r I I i \: \'1 -', -~ -.. -"""'--..... ~4> ~3l~ ; .I .' CITY OF PORT ANGElES - Construction Plans The Issuance of this permit based upon these plans, specifi caticns and other data shall not prevent the building ollicla fwm thereafter requiring the correction of errors in sai pti'nS, specifications and other data, or from prcventi;; h!<~I'-{ir,p r,;::;..:?ti::;;~ G~~ing c8fric:t on thereunder W~i:}t; 1 ~ :;f ...:! ,",-,,"'Gr: ~,,-...; n~_01~:;ncP? of thi:3 llnis~~!,~'t!:;r; ~[6Ibi :,~ r'../. ' I ,-~ <.. ! \ ~~;4C' . f' I "- () ~I " ~ "I <{ ~I I S]/Jf~ 1\1 Ie:' i L_______ ."'._'~.._.~._.__.'"--,_.....,~---,-'",._..--" (0 ;." <:-7", ""'.+:, -~- '-""" l_~_-C_.,~__ * , ij j I 1 j I ) I I I I (; " <I' I I I I ~ ,,-I;;, --- , \' ,. ,,~' .~ \ ',," ,.,'~ \ " ~ \; " "- \) \) I ~ If' , v l- DVl--\~\-\~J V~\ \-~ l41 ~ ~:2- ~o~ 12-~u.J \ Sf~ I I ~ Qc-c;..s ~ I i Ii ~t\L~J-V~ I I j~ hrLG ~ell ~ r 00. b)( ~2i oiL I T1 Q(J +--c i l~kG ~kk kl1::'~~l7 ! i~ noJ--, I I r I 1 I. ~ ! P \ ~s. ~ (VI1&iLK-... I~/L ~tJN~ ~p. 'St~-vL W$Je- L'0G cl~oVJ- ~GD k I :te W L JA., i A-I /'-\ \. (' -:.::> - D c.+- .11 B.0~ \ 0; 0.~ ~ tR ~~0 S:r~Jr- ! ~;u ~ b~clJ ~ \6e :L'uSf. , ;.:"Y.'~ "".:~. I ,'. (; '?: ~'g"~.' ~~,~;'o-:~>',." r~ ~:, I ....;:.:~ .,' '. ;:/,,;.;/OfT.,ci,,, ~ H. 1>,. ".. ", ". ,'.. J "" .."1"1 /U : lJ) II to. "~"!'~':.;_.",' ;',. >,;.:'.>.~.'~' ""..,..,'" r:; I). 1 ~<. ...,.,"...'''..!....'''.'......:c..tJ () :!~ (; ::.-:~" Y;~~i., ., :}'l' :: . ".' !] . (' . . ,. llJ.- " "~. >. .. ~ 19 ", ',. ~ .......:,..~.... tI~ .... :'.:. f)' . . .' ." . . fJ~~ .. ye.6f..'f.:. -'1' PJ I <;> .;~ (!~ ;;..... I (0 'D U /) ~. ,a L E~3~r ,. . t:.:.:1b~ :i, I).' , ~ 1<') w;' #fpJ ~ . r~: l#./W1&... __ ~~ W~tv \ fl . :'..\, ~ 4- . =-/1'...... J l ("-:.....-~ .'.'t~.~t.:(;;;:..cd;'-'.u;' Pi'2n~{. " ",' ..., -.- .......- "--J' --.t:;~r' '.::~~-- . - t SJIFd ,; ( ". -1t 5rljj;~ T T' ... II I .'f,; ::.: ...,' '\,' I . ".~ I ,~. II I : ':.; ~~'I ;.~ ,.'~.' .. I :;1 I j '> IA (1 --1 e. :1- . 1 1 I I I ; :~:,', I.., -II I ~.~ J ..' ~ .1 :') o 17 t.. '/? ~ .! ~ in the footing and centered beneath the pier locations (See Figure 303.7); (9) A minimum of 4 inch (10 cm) nominally thick con- tinuous footings, not less than 48 inches (121 cm) wide, reinforced with approved fibers or with 10 gauge 6 inch ( IS cm) by 6 inch (IS cm) wire fabric centered vertically within the continuous footing and no closer than 1 inch (3 cm) from the edge of the continuous footing. (See Fig- ure 303.8); (10) A minimum 4 inch (10 cm) nominally thick slab not less in area than the manufactured dwelling and cabana, reinforced with approved fibers or with 10 gauge 6 inch ( IS em) by 6 inch (15 cm) wire fabric centered vertically within the slab and no closer than I inch (3 em) from the edge of the slab. (See Figures 303.9 and 303.10); ( II) Tested and listed prefabricated footings; (12) Footings designed by an Oregon licensed professional engineer or architect and approved by the Division; or (13) Other equivalent materials approved for the intended use by the authority having jurisdiction. (b) Piers. Piers shall be placed on footings and shall not exceed the size of the footing. Piers shall be: (I) 8 inch (20 em) by 8 inch (20 cm) by 16 inch (41 em) concrete blocks (See Figure 303.11); ~JlJulJ .IJII' :91 - MINIMUIriI 256 SOUARE INCH Pl YWQOO FOOTING PRESSURE TREATED ON AU SIX SIDES illliL flEW TREATMENT Of CUT EDCES IS NOT ACCEPTABLE Figure ,303.5 Single Layer Plywood Footing 16 TYPICAL. PIER BLOCK r piulJ /i~1I' ~ ~INI~U~ 256 SQUARE INCH DOUBlE Pl 'lWooD fOOTlNC PRESSURE TREATED ON AU. SIX SIDES .!IllIE; flEW TREATMENT Of CUT EDCES IS NOT ACCEPTABLE Figure 303.6 Double Layer Plywood Footing 18" t.lINIMUt.I 10" .~ t (2) CONTiNUOUS H 4 REBAR CONTINUOUS POURED-iN-PLACE CONCRETE fOOTING W/MINI~UM 2500 PSi IN 28 DAYS. Figure 303.7 Continuous Concrete Footing . A /. ~ . "'~-,-_._---- "......."kC XC.~ ~~~ ::~'"""'---~_~__. . ____ . I " . MINIMUM NOMINAL 4" CONTINUOUS CONCRETE FOOTING 2500 PSI IN 28 DAYS REINFORCED PER SECTION 303 OF THE STANDARD . .. .. .. .. .. .. . . . . . . II . . J , , . . . .. L 48" MINIMUM liQIE; SEE TABLE 304 FOR REQUIRgl PIER SPACING Figure 303.8 Continuous Concrete Footing Isometric , ~ "X, "X,..... ...)<....... ',~~~ ',~~~ 'x~~ 'x' ~~ ~'><:, ;X"~,,, ~' ", ~~ , ',---</ I ").<~ ><': '...x;. ,::<., ", ~ "'''~~' ", ~~~ "x~~ ",,,,~~ ',--",,::' ',--",,::~ ~~', ~;'"<''' ~~~ ", ,~' ", /~ "- ~~' "- ~,~ ' '......-<: ':;';":-, ,'><, ;>...." ~,.)o-::._ ,~"',_ ~ ", ~~~ ", ~~ '--...~~~ ',>" ">~~ ~~"" ~~'''''' ,~~ ", ~,~ "" ~~~ -', ;:::<:, ~.>'-:.- ~><, ~~"<" ................"". ....,,..,,,-" ......"v"... ".... ............... .;"".,,, '............ ".,;.", ........... '" ~ ,,' ............. "",;""...., ~....., ........ ..." .... '...., ", 1 0 GAU G E 6" X 6" WIRE FABRIC CENTERED VERT/CALLY IN SLAB OR REINFORCED WITH APPROVED 8BER PER SECT/ON 303 OF THE STANDARD 4" NOMINAL POURED-IN-PLACE CONCRETE SLAB FOOTING 2500 PSI IN 28 DAYS Figure 303.9 Poured-In-Place Concrete Slab 17 ~ Figure 303.10 Poured-In-Place Concrete Slab Isometric ~ (2) Tested and listed prefabricated piers (See figure 303.12); (3) Designed by an Oregon licensed professional engi- neer or architect and approved by the Division; or (4) Of other equi valent materials approved for the intended use by the authority having jurisdiction. Exception: Concrete pier blocks may have wood placed between each block to absorb shock if the wood is equal in area to the block and is one of the approved materials identified in Section 303(c)(2), (3) and (4) of this standard. (c) Pier Caps. Each concrete pier shall be capped with a pier cap equal in area to the pier blocking (i.e., 8 inches (20 em) x 16 inches (41 cm) or 16 inches (41 cm) x 16 Inches (41 cm)). Pier caps shall be (See Figure 303.13): ( I) A 4 inch (10 cm) nominally thick solid concrete block; (2) A I inch (2.5 em) nominally thick group 2 or 3 paral- lei laminated veneer wood plate; (3) One 1-1/4 inch (3.18 em) piece or two 3/4 inch (19 mm) pieces of plywood; (4) One 2 inch (5 em) nominally thick Number 2 or better grade board lumber; (5) One 2 inch (5 em) nominally thick wood polymer com- posite; 18 \ 4- NOMINAl POURED-iN-PLACE CONCRETE SLAB FOOTiNG 2500 PSI IN 28 DAYS (6) Tested and listed prefabricated pier caps; (7) Designed by an Oregon licensed professional engi- neer or architect and approved by the Division; or (8) Of other equivalent materials approved for the intended use by the authority having jurisdiction. Exception: Wood and wood product materials specified in Subsections (2), (3) and (4) of this section shall be pressure treated on all six sides when placed in an area subject to excess moisture (i.e. outside the underfloor enclosure or below open deck areas). (d) Pier Shims. Where shim material is used between the top of the pier cap and the bottom of the main frame, the shimming material shall not exceed 9 vertical inches (23 em). Pier shims shall not be used with prefabricated piers unless the shims are included in and installed according to the pier's listing. Pier shims, when used, shall be one or more of the following (See Figure 303.13): (I) 2 inch (5 em) nominally thick solid concrete block equal in area to the pier cap; (2) I inch (2.5 em) nominally thick group 2 or 3 parallel laminated veneer wood plate equal in area to the pier cap; (3) 3/4 inch (19 mm) or greater plywood equal in area 10 the pier cap; .. .. .. . .. .. .. .. .. .. .. ... -' -' - .. :-....~ ~ :.: _ ....:;...;:.:t:y.- TIE DOWN ENGINEERING Engineered Tie Down System Manufactured home tie down calculations and schedules for single/double/triple wides Dltl\ign Lo.ads <;1.r IJ'ld So;l B~'UlE: ~ TIe Down Stnpo I s c i.\;rwc lone 15 psp 10C() PSF 3150 t \Vorona !..olIO 4 ! Tu: JO',I,T, ~tJl.Ps moot. fMoral ~dticuion3 QQ-S.781H fo(T~ 1, . ClIl.I..\ 'S. Grndt I slupplIlg and ~ allew 1.))4" x .oJS. nnc plated. , E.1rt:h ^I.lgm 2962 ~ (1'ewxl ro 4750 * rrummum) C:-cu Dr1Y~S I 717 ~ (Wlc\Jlaled) I ConcreO"- SlAb Anchors 1390 14 (Cllrular.ed) 1.\.0(4 Ma..Ntw./'fl !C!il p res" rt i.s !COO P SF .",~ a /Q(/..J I'fport General Notes , Tile cham shown te1":'JI lI1"t for the requu-t-d nwnber of l1e doWlU ' on the 1 \de s of the Manu facl'llrecl Horne. "j ':'"le dowus ilI~ requIred It each C~l~ bea.-n. euh end of each (T";ln~ble ~tlOn 01 the Ma.cufaclUrtd HOeM and C~ be lUly o( me type! Ihown hcn:tn i I I '\ CombiIunons of the different cypu of oe do~'f\6 CMl be used I i" in the CYeIlI A:l:1 O4!'tl1au ~ canoOl be. l.1l.Uill.ed. due to Ul obl;tnl;. I i tJo~ UR of CrolS dl'lVt l.D..;;hors i. pe~ttod, pcovidtd 2 cros.~ driYe I a.nchon an i.ru~ for !tch t~ AUi<< that cannot be l.n$t&llod. ( ror aJl Ute down lnsulhllor1!;, the MAn\lf~ Home cW5is r.1CmbcTs lIe shown 1.0 "XO ~ fOf illwtntion purpo~s only. Q,a.sllS bemDl ~ 4.150 be "C Ul~ptId 01 JtFC~. I I 6 End ti e 00wn' C2f\ b<-. lC>ca led 'IV'Ith m 1 80 of ~ ther ~l d.& 0 f ell &.l Sl& I 6am WI &$ &oown One e'1d 111I down 'eQUlrad \b~ Chassis Beam ~j eacn 'I' MClm end 1~:'7 i The cU:OS, types, lengths, etc. of nuteri.l& s..bown herein ue rr..l."ll';"J6 LugCl, lor.~cr. he.llY~r rn.uena!s supplied by TIC D<Jwrl E.n.gJ.oOtlT\Dg ma) be ~ a.: th( WDC spacmx anc kx3tio m I he wn. Alternate eevlccs may bc SUb$linmd with eflii.'lecn approvah. ":!.~~.-~.~...........".._... _____4 , .~---, I i , ---- j " I ENGJNEERED f1t.DOWi~ 3Y Sill! I I MPRCYED ~Cl' TO ~owcn~ ,C'TC "'",,' d"n "" ."',,"" ,. ~ '''~ '". "" j j ~e't=...~!n Itq~l~el."1tn~1 c~ ....,:.l.:1c $U~ '~, .1 ~ec~ ~~~~! ~ l ~Olru;I:C~'-"d(,QC''''.'~''''~ '.co. '-. 1\ _I ~~~~i or C'Cco A.:,I? S.~~___?' b~.ueQJ o,:..Q:72 'L' ! I l*'JdiO _ O.'tdC~fS, I i '-1_-=-=. \ I au '''' ""'.' "",.. C Z -1.. 2 -{. '0_ - i! r ____. __._-~_ .~ fhl" t,J, 40Y-1" lty6t~"l'\ rr.,,~t-<> '.oe r"'"....J..'c....,c-..t;-' I i~r 1:336! sLb5U"JV<1 (.I) ____ 't CE DOWN ENGINEERING ' 5901 Whca:on OrlVI1 : Auantl, G"orgl$. 303.31: EJ' 404 ~.(l()()O ' Fax 404'349-C40' 'I , _~~___ - __ ~_ __"' I ._.:::.:--~;;;;;_ ~__. __.' I St~te Approval .,;~-02 04:02 PM ;1i-;';'L0J:(fRII II~O) TJT INC SALEM lIt DOl~ EH~IHELR\~C ~O3' 393 613-4 \H\l~~~ ~~~ ~~~\ P.06 ~ , U~I Patio Slab Anchor Concrete Anchor This ar,chor Is deslQnod 10 be Inserted through a '314. hO\G dri/leo or lormco Into nn existing concrete alab. The MlJ2 15 designed to be In,1allotllmo ~ conCfllla slat a\ the time Ih~ OOl'lcr6lo 113 D&lno poured. ~..~..~~ I , ' I !^ . Conc:rBte m~t be A 2500 PSI minimum ~l:1lJ wtt/:14. minimum thlekness and 8/a )( 10/10 wire mesh or flblH m.ilih Inml1~~. . Concrele slab mUBt allow 472~ lbs of vllrllcal teMlon on Inanor without nttfng. This U!\JrM' thllt the oonorete \..elohs 15010' per cu. n. . MInimum distance from the anchor shaft te one o~ge or Un slab 19 4 In, from ana edge nnd 2 rt. from any other ode", . concrete must bo ; 2500 PSI minImum slab with 4' minimum thickness and 515 x '0110 wlrQ mesh or fIber mest1 InstaHed. . Concn'ta slab mus' allow 47t5u cl vertloal tension on anchor without liftIng. Thls a~umes thilt the conc.rete weIghs ,~O Ib; pn CU, ft, . Mlnrmum dl5tilnc~ (rom the Mchor ~hth to one edt)e of the ,lab II 4 11'1. from one odae Dnd 2 H, from any Dther DdQC. . If Initllled In n 4. slab at mlrl:miJr:, dlSUnceli from IdO~. an iddltlon~1 ~yer of ~/5 or 10r10 m!Sh rs recommended. . Slob mu5t be e In. minImum IhlckMS8 allociltfol1 und~r any oMhor to Illlow Sin. embedmant ot anchor 'J' ro( Concrete Slab Anchor ~ c::::>> ~ ~ I Tllla anchor Is d an IIX\6\lng conl;ralCl LIe-b. . Af1er reviewing rOilrlCllOn5 [lSIOa to II\ll rl~nf. crUI a 6/8 In x 3 In. holt In the cllb whOl'1 lhO llf1chor h~d III to ba 100J1ed. . Concflle must ~ . 2500 PSI minimum s~b ....lln 4' mlnlmlKTllhlcl<nua and 6/e x 1M 0 wirtl m<u11 or ~cr 1'N&n 1II1wnaa. . I"lac, Nol GXp,lnJlon IIloovo over bolllnd pklCD Inlo the drUlca hQIe. . Oonorolo $lab musl allow 4725 Ibs 01 110 rtl c:ll tOM;O~ on anchor wllhout liliifl\). Thl, pnvrrin !h<1t !IiO conCrCID YtlllChs 1 ~O Ib~ per cu. It. . Pt.:Jco Iha washar onto the ClXpi1t1slan boll . thaad nut onl9 eXPllnl,llon belt llnd tlgllltln Uf1\i1 m;LXlmum 8xpanclon 01 atnllxlll1ulon II"VI 1tJ, blan ~ohleved, . Mlnlmum dl5tanGe Irom the ancJ1'Jr 5hafllO 0(\00000 ollhll 't~b l~ 4 In. from one '(1Q' anc , tl, Ire m any othor edgo. . It In./allid In , ~. 5'_0 ~l mInImum dl,\JJ;CCS rrem IId~S, on odd\tlonJl \Iy.r of e/6 or 10/10 vwlrt mel/'. or tlbor mash I' raCDmmend~d, . AemoviI nul and wuhor end plato onchor hood c...or oxpo~ad boll. . Placi W1I~QI _no nut onto bon 10 :lttnch anther he~d, Ilahl~n nut. 01/25/02 16:25 TX/RX NO.2045 P.006 . e4;07 PM TJT INC SA~EM / ~!\f!\1 \1:1\ !It um EmmmG I / . L-rll. c\' ~3-~1 I I ir @' t .t ' ~ ; ; '~ ~ Ul <. ~e:3 :393 6134 \in}~U~ '1H U~U\ p.22 ~ ' ~ l ~ en .~. a ~. , C) Ii cv! ~ ~ .. t:. a-. ~ ~ "g>i ~ ~ lI: iDW d ..J t; ~ ~ ~] .i i~ ~1 ~ li . :;t;~~ ~~ 21' ~. 4f' "~)(~.,,I l'J o ~ M ",r, OJ I ~ ' 81 I ~ .- I ""I C\j i~ ~~ > ~~ i Q)! I.) ;: ~ ;t; ~ ~ ~ Il.~': rJ I, lll:: ... ~ e @> i ISi 1;: J ~ ~ S It ... i I ! ~ ~:J . x C'U <3 .- . 01/25/02 16:25 TX/RX NO.2045 P.022 . FROM KIRSCH ELECTRIC '.""" on"~, ".'~ ..../,', VI ~'.' ~,. iUG4i!lAR;uSifRl OU~ I~ FRX NO. : 3505830859 Rug. 31 2004 03:25PM P3 ClT'{ OF p~ BL{X; OEPI fH H~. 360 HI q i \ :. uU:/GG; /. i Ii ELE'CTRICAL PERMIT AF'F'LlCATION fO~ omc:w... UsE QN\..Y Cc........-; 'llIIIIIl .~ DRt.Jo.pp.ncd: Qtyt".,1l4 The E1lidJ.1CAl PwmltAppllt:al:ion mU5It t]fl ftllll:d out comblateN. PlaBM iype or reprlnt In Ink: If yOu 1\..... ~y qlJutioru, plo.ua call (360J 4174735 Fu number: (3SO) ...17-4111 . (/ij -53/ OlNnllf or elcc:. CO"iRlQtor AgDnt! Q, \ 0. \'\~'-J .' J E\f(':f" . PhOl\9; Fax~ Froporty Ownsr. Add,....: Phone: CHv: . a.cl1l..1 Con""~"" . ... Uoena. #; E)(jl: ZIp: f'hcroe: lip' Addras: Oily; .INSTALlATIONWIRWSV: OOWNai ~RIC...q:OI>(T~Ofl . . CudItCBnJHorderN.m.:'\o.<;~~\t, .,~ . KiJ-~c..~ BIlling Address: City; CIWJ/t Card Numb,." Zip: VI.sA:_ Me: PROJECT ADDRellII: ~/)S- v.J. Check lII1lhet apply: /'iNew Exp,Date: lo..+.h. o A1teraUonlAddi1lon:: . .lYPE OF WORK, CJ Reelden~aI 0 MuI1l-f.amny D Commercial 1\. Mobile Home.. . Sq. Ft. C Rcmotoo MBler C Detaohell glll1llle . C Hot Tub trswlm P""I 0 SeptlC Pump. 0 I.owVoi!age' CJ Telecom. D Slg Numb., of Cln:uilo BIIded or ellBrtod: . DESClUPTIONOFTHEEL.ECTfIICM..'ROJE~:~O() A-(,V\f.s::;erVt~~' -k'mob;lf J-Iou..{ EI""bi!:ll1 HMt Load Additions and 01' Subtl'llctlon8 . 'Servlce Information o Baseboanj. 'W~p c:JFan...Wall _KW .J..J:)KW . .:....- TON_ LRA _KW o OVem.ad Servtce c Tomp Salvi.. . . '0' Undsrground Sarvlc:e VOllago: Pha..: Cl' 0 3 .. Servlc. Sli.: Feeder S!ZB: , hereby Cflrtify that I have read and eXfJmlned this application and know that same to be true end cOrroot and I em aufhotizad to apply forthls parmit. I understand It Is not the CIty's legal responsibility to determine what permits ~ra f8qu~d: it mmainil tha applioMts responsibility to determina What parmits are r9!{lJfred and to obteln such. . C~llCardH'ld8r'8;!Jg~e.tllredroAfl j K,l~D";": cr--:)/-O~ Owner or EI.1:. Cant. SllInllbsre. .. Date: :;lEl.eCTRJ~ERM/TAPPLICATlON or:- -KF"vYlf:-... D(k.1(2./j/Je LuS 9.,?ytJ /lcJJ L'e!JNf! Lf;i"(0 , PERMIT FEE: $ 7 P> , 70 c1/3/~7F /!t!tfJ q/,Iott