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HomeMy WebLinkAbout1130 W 12th St - Building jft ~~. ~/T ., CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDINGDMSION 321 EAST 5TH STREET, PORT AN.GELES, WA 98362 OWNERlAPPl:ICANT HOWARD PRIEST 1139 OL YMPUS AVE Port Angeles, W A 98362 360/457-8834 T: CONTRACTOR OWNER VARIOUS Port Angeles, WA 99360 206/000-0000 PROJECT INFO Project Value: $1,495.00 Project Type: GARAGE NEW Occupancy Type: RESIDENTIAL 0ccupancyGroup: Construction Type: Zoning Use: PERMIT NO: 13735 S: ISSUED: ' ,10/04/2002 "PROPERTY LOCATION 1130 12TH ST W Lot: B Block:,,' 3El~ D:~opg Legal Subdivision: VANGESEN SP Parce1J-:Jo: 063000036990000, , -, ''t-; ARCHITECT N/A' , 98360-0000 360/000-0000 SFD Units: SFDSQ FT: 1 1,800 Commercial: Industrial: Garage: "MFD Units: ' MFDSQ FT: o o \N o 'C': PROJECT NOTES CONSTRUCT 13' X 23' DETACHED GARAGE RECEIPT#9753 FEES ASSESSMENT BuildingPermit: Plan Check: State, Surcharge: House Moving: Manufactured Home: Sign: Plumbing: Mechanical: Radon: $54.00 $0.00 $4.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 rJl ~..; Misc Fee 1: Misc Fee 2: Misc Fee 3: $0.00 $0.00 $0.00 TOTAL FEE: AMOUNT PAID: BALANCE DUE: $58.50 $58.50 $0.00 SepalJlte PEtonlts are reqIJlrl3d for electrical work, SEPA; Shoreline, ESA, utilities, private and public improvements. This permit beco,mes null andvold~ work or construCtionalithorized is not commenced within 180 days, if construction or work Is suspended or abandoned for a period?f~ll40d~ys~fter the \\,ork as commenced, or If required Inspections hElve not ~e~n r~questedwimin180'~llysJt~rptl1~last Inspection. ,,' IhereDy'ceffifY'thatlhave read and examined this application and J<now the same to De true and eorrect..JSJI PrQvIsl,ohs, of laws and ordinances governing this type of work will' De complied with whether specified herein or not. The granting of a permit does not presume t9 give authority to violate or cancel the provisions of any state or local w regula' g co ruCtion or the perfOnn~nce of construction. Signature of Contractor or Authorized Agent Date 1'\ T:\PLANNING\FORMS\1102.1S [4/2002] t BUILDING PERMIT INSPECTION RECORD ~... -*'"t CALL 417-4815 FOR BUILDING 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 PERMITCARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE l~ ACCEPTED COMMENTS ' -," ~~\ I YES NO .' ,L FOUNDATION: ", . ~, FOOTINGS iA. _oA_ rb--- "'7-cr2_ UIt '. WALLS . '. ~, Ii" FOUNDA nON DRAINAGE ,,;' , " . " ELECTRICAL (LIGHT DEPT) SEPARATEPERMITT:~ ROUGH-IN I I PLUMBING UNDER FLOOR {SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW {WATER ."i AIR SEAL WALLS CEILING I I FRAMING JOISTS { GIRDERS i SHEAR WALL WALLS { ROOF { CEILING DRYWALL " ,. T-BAR INSULATION SLAB WALL { FLOOR { CEILING I I MECHANICAL . HEAT PUMP WOOD STOVE {PELLET {CHIMNEY HOOD { DUCTS PW UTILITIES { SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE {METER SEWER CONNECTION " SANITARY < STORM , PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKINGILIGHTING ESA: LANDSCAPING SHORELINE: " ., FINAL INS,P~ONS.~U1RED PR~OR TO OCCUP~CYIl!~E " ; ~ "'. RESIDENTIAL DATE ", YES NO COMMERCIAL DATE ACCEPTED:. , :i ., I, " YEs " NO ELECTRICAL - LIGHT DEPT. 4j7~735 'y . ' ' . , ELECTRICAL LIGHT DEPT CONSTRUCTlONR. W.{ PW{ /> CONSTRUCTION - R. W. ENGINEERING ' 417-48~7 PW {ENGINEERING FIRE ..,..- 417-4~53 , FIRE DEPT. .".- , \ PLANNING DEPT. " j " ~,,;"'d 417-4750 'Il""r~ PLANNING DEPT, BUILDING 417-4815 (; :':;)..I-O~ Jj-L. BUILDING T:\PLANNING\FORMS\1102.15 [412002] -, BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY: Date Rec.: t:t -I 8 . O'Z:- Permit#: J ~7"z'C:- 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 Applicant or Agent: . # Waf' d ~ /e...d Phone: . .& ().fn.L- Address: //31 tf'J{y"'l!JS' Ave.' City: R>rt-Al!Jde~ tuA-. Architect/Engineer: L/tIJ/UJ"t :at/iJ" Owner: . ~ ~ -~z ~'1 ~e.- Phone:~7-~63~ ~Dr~ Zip: ~B362- Phone: Contractor Licen'se #: r". Exp: Phone: '., ". c Address: City: Zip: PROJECT ADDRESS: /1.30 /d /z1lz i5't; '__ WNING: Rs 7 LEGAL DESCRIPTION: Lot::.B Block: ..3'-&J 'Subdivision: VClnGese,., ~,.t; Pla..f:, CLALLAM COUNTY PARCEL NUMBER: 0 "3CJ()(J.~03' 'I '0 Credit Card Holder Name: Billing Address: 1<0. ../3oX 8tfif'; '. .... i '. '-City:, p()l'-t Aflqe/es.. idA. 9B3b'2- '. v Credit Card #:.' , . - . Exp. Date: VISA '\,. -,' MC !/ TYPE OF WORK: o Residential 0 New Constr: o Multi-family 0 Addition o Commercial 0 Remodel o Repair OIRe-roof- ow ood:::stove o Move ,XGarage o Demolition > 0 Deck o Sign 0, SIZEN ALUATION: _ "'aq4- SF. @$ So fIB ISF. =.$_ / Lf 1 S-=_ SF. @ $ ISF. = $ SF.@$ ISF.=$ TOTAL VALUATION $_ /if9S=::- f~/J.stru.t...-I/4JJ1. 0..f. ".A: Ja:~a-.Je..- ~;. C!.Ar ..." .. ;... ,....~... % .....hC..'..." ,;).19 7'/sq.ft.'=,TOTALLOTCOVERAGE:_ ~or9-- 'sq.~. ..t" . :rAPPROVALS: PLAN' ;. '; BLDG. DPW FIRE ESA/W etland(s): 0 Yes 0 No SEP A Checklist required? 0 Yes ,0 No Other: . OTHER BUILDING PERMIT APPLIC~TION SUBMITTAL: Your application and site plan}nust lkfilled out completely to be acceptedfor review. The Building Division can provide you with more detailed informatidn on the applicati()n and plan submittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. BRIEF DESCRIPTION OKTHE PROJECT: and S~D"A.Je..! 1 ' COMMERCIAL/RESID~N'TIAL: Occupancy.Group:. , : , ,1 No., of Stories: . I. '.' Lot;Size: SOXJlfO :".% LotC'overage:. Existing Lot Coverage: /800; Isq. ft. + Proposed Lot Coverage: _ PLANNING USE ONLY: ' :. Notes: Occupant ~9ad: Construction Type: j" ., / VALUATION OF CONSTRUCTION:. In all cases, a va'uation 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;,C'ontact the Pertnit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuanc:e. EXPIRATION OF PLAN RE~W: Ifno permit is issued within l~Q days of the date of application, this application will expire. The Building Official can extend the tUne for action ,by the applicant up to 1'80 days upon written request by the applicant (see Section 107.4 'of the Uniform Building Code, curre~t edition). No appiicatlon clUi 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, and I am authorized to apply for this permit. I understand it is not the City's legal respo~sibllity to determine what permits are required; it remains the applicant's responsibility to determine what p:rmits are required and ~o Obtain~suc ~ (). , ApplIcant: _ _~4.,i~/ Date: 9 - / 8- -~A . T:\FORMS\APPS\Buildingpermit . \ ,/ * , DEPARTMENT OF PUBLIC WORKS, BUILDING ,DIVISION II I'f? " 4.s-2 - 62- 99 H"Me APPLICANT:" f-/~IJ)tJ I'J rrlJPs-C- PHONE: 'I5?'''' 88.3lJ WOJoK. PRO~ECT/DEVELOPMENl: A[>DRESS: "1)30 IA), / ~7A. 5"6-. ' .' , See Page 4 for instructions on completing the site plan. For. more information, caI/417-4815. ... J J .....; ;.' # r L ,L. ::: f" II ",. r' ., ZZ" ~ ~ p ~'. ; - , '.\ " . "r \ ""', I' '" I), :Y, ~ '3l ,I .J - " " . J3 'J'l ~r '7 ~4 ( ., 7ft: ) ", IY , 13 " ,n/ " , AI 17 : . J ~ , " j " . \) \f ~ . ~ I .~ ~-; . .... " , I ~ .- ~ t;/ .... ~ V . '" II "V --;;- J, ~ "'/!. -I -- ~ 2j I e/ -? , -..:::: ,.. " ,~ J~ . ~g . , I " I~ /2-til S~. -- ~~~< ~.~ .....~>.::~~.~.. \ . ~~.........."....-...<~'::::~~ _____~_ -rr'7:: -.. -~k/ C."pJf:..1f! -.'~ ....... ..,.,,~ .....~. '1' ...........'.-.................. CITY OF PORT ANGELES - Construction Plana The Issuance of this permit based upon these plans, specifl. cations and other data shall not prevent the building official from thereafter requiring the correction of errors in said plans, specifications and other data, or from preventing building operations being carried on thereunder when in violation of all codes and ordinances of this jurlsdicti.on. (SECTION 303(c) . Uniform Building Code.) r> I /" Approval Date / crY -D~y ~ .' . ..h~. .. "'~~... _.... ~.. ..,......... _~. _ ......._r_. . . __'_. . Z>< \.( Wj}LL 1(,'/ O.0~ , t ~---- Yc II 1"1 -1/ .. S/DIAk-:> / ( j"=-t...-VwOOD\ 1 !I 1UILfLG~J) 6D&G tl i R~{(. 6fl{O 7~Tf(;.(2N Z--I.{.I D.G. L\ --- " #. SU+/~ \ . tI/I-_. ."'...,~.. . ! /~<---. l .p; f ;(("tYll< e?%/.."l........../~- ./A' ~ i . I ji e#-- I ___....__.__1 ,...,r,..".,_.... It,1 T&rJ{,,!5 L('rJ. c.. pr i e ~t: - Ga.Y'o..3 ~ - /I 3(,) W. 12".b 5-1; . CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST:. _~. Date 10 - 7 - tJ "2- Time Received by ~ (phone, person) Location of Work to be inspected 1/50 Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer Foundati Framing Chimney Plumbing ?cJ I Z ?;t Phone No. Permit No.I'l".3~ Final Sewer Excav. Other I I .~I , Inspected: Date Remarks: ~ Time By ClJ. ~ RESTORA TIONREQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC o Other D Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE D INCOMPLETE (Co!,~inue on "-~Vf.'rsf.'sideif necessary) .STREETis.ueERINTENDENT ..\...i'i!~(DA[E) CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 EAST 5TH STREET. PORT ANGELES, WA 98362 ELECTRICAL PERMIT ISSUED: 10/04/2002 PERMIT NO 7847 OWNER/APPLICANT PROPERTY LOCATION HOWARD PRIEST 1130 12TH ST W 1139 OLYMPUS AVE Lot: B Block: 369 ~ Long Legal Port Angeles, WA 98362 360/457-8834 Subdivision: VANGESEN SP T: S: Parcel No: 063000036990000 CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 l 360/000-0000 PROJECT INFO Project Type: RES, MISC. Project Value: $0.00 ~- Occupancy Type: Construction Type: SERVICE INSTALL Occupancy Group: Zoning Use: Electrical Heat: '/ Baseboard 0 KW I ! Riser ~ Underground Service I Furnace 0 KW I Overhead Service Voltage: 240,120 [ Heat Pump 0 KW Temp Service Phase: Fan Wall 0 KW Service Size: 200 Feeder Size: 200 PROJECT NOTES MANUFACTURED HOME AND GARAGE. 200 AMP METER ON GARAGE FEEDING 100 AMP PANEL AT GARAGE AND 200 AMP AT HOME. RECEIPT # 9737 TEES AssESSMENT Service: $76.30 .~. Additional Feeders: $0.00 Circuit Wiring: $0.00 Temp Service: $0.00 Misc Fee: FEEDER $46.70 TOTAL FEE: $123.00 AMOUNT PAID: $123.00 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 UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERM/T CARD AND APPROVED PLANS AT JOB SITE DITCH ROUGH-IN / COVER ' ., . - SERVICE ? · ~ ~ .. Fn'4,~ I'" /'i- ~ I/, ,' I GENERAL COMMENTS: .... CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 8/15/2002 PERMIT NO: 13583 OWNER/APPLICANT PROPERTY LOCATION 1130 12TH STW HOWARD PRIEST Lot: B 1139 OLYMPUS AVE Port Angeles, WA 98362 Block: 369 [] Long Legal 360/457-8834 Subdivision: VANGESEN SP T: S: Parcel No: 063000036990000 CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 360/000-0000 PROJECT INFO Project Value: $40,000.00 SFD Units: 0 Commercial: 0 Project Type: MANUF. HOME SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 k,/ Construction Type: MFD SQ FT: 0 Zoning Use: PROJECT NOTES INSTALL 65' X 28' MANUFACTURED HOME RECEIPT#9561 FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $230.00 Sign: $0.00 TOTAL FEE: $234.50 Plumbing: $0.00 AMOUNT PAID: $234.50 Mechanical: $0.00 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 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 construction.presume to give authority to violate or cancel the provisions of any state~ or~,~,~,/,~.Z~,~oca~w regulatil/~nstruction,,,, .. or ~'~/',,~'-~ O~.-the performance of Signature of Contractor or Authorized Agent Date Sigr~ure of Owne~ (if ~vn~r is builder) Date T:\PLANN ING\FORM S\ I 102. ] 5 [412002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. 1TIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP INSPECTION TYPE DATE I ACCEPTED COMMENTS YES I NO WALLS ELECTRICAL (LIGHT DEPT) SEPA~TE PE~iT: ~ ~DER FLOOR / SLAB RACK FLOW / WATER WALLS CEILING JOISTS / GI~ERS SHEAR WALL WALLS / ROOF / CEIL~G DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEIL~G MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHI~EY HOOD/ DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT g's: WATE~INE / METER SEWER CONNECTION SANITARY PLANNING DEPT. SEPA~TE PE~IIT ~'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHO~LINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECT~CAL - LIGHT DEPT. 417-4735 ELECT~CAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. FI~ 417-4653 FIRE DEPT. PLA~ING DEPT. 417~4750 PLANNING DEPT. FOR OFFICIAL USE ONLY: BUILDING PERMIT- APPLICATION .~rm.#: l_~ Da~ Approved: - The Building Pe~it Application must be filled out completely. Please type or print in inL If you have any questions, please call 4174815 Applic~t or Agent: ~d ~Z~ Phone: Owner: ,~ Phone: Address: //~? ~flas ~. City: ~~ Zip: ~chitecffEngineer: ~- Phone: Con.actor N~~ ~ ~License ~: Exp:' Phone: ~' ~8~ Ad&ess: City: Zip: eao~cx~ss: //30 ~ /~ ~dt~e.~ ~NINg: LEG~ DESC~PTION: Lot: Le~ ~ Block: ~& 9 Subdivision: V~ ~en ~[~ CL~L~ COUNTY P~CEL N~ER: o~- o Credit Card Holder Name: BilHng Address: O ~~ ' Credit Card ~: Exp. Date: ~SA MC T~E OF WO~ SI~UATION: ~ Residential ~ New Cons~. = Re-roof ~ Wood-stove SF, ~ $ /SF. =$ ~ M~ti-f~ly ~ Ad~tion D Move ~ G~age SF. ~ $ /SF. = $. ~ Co~ercial ~ Remodel ~ Demolition ~ Deck SF. ~$ /SF.=$ . D Repak ~ Sign ~ TOTAL VALUATION 7 CO~[RCI~8~[~TI~: Occup~cy Group: 0~cupant ~ld: Cons~cfion T~e:~ No. of Stories: / ~t S~e: 7~O ~ % Lot Coverage: ~ % Existing Lot Coverage: ~ /sq. ~, + Proposed Lot Coverage: ~/sq. ~. = TOTAL LOT COVE~GE: PL~I~G USE O~LY: ~PROV~S: PL~ ~otes: BLDG. DPW ES~etl~d(s): O Yes o No SE~A ~ecklist tequ~ed~ Q Yes Q No Other: OTteR B~LD~G PE~IT APPLICATION S~MITT~: Your application and site plan must be filled out completely to be accepted for review. ~e Bdld~g Division c~ provide you ~th more derailed ~omtion on ~e application ~d pl~ sub~l req~ments. Your completed application, site plan (for additions) ~d build~g core,etlon plus ~e to be subdued to ~c Building Division. V~UATION OF CONSTRUCTION: In all eases, a valuation amount must be entered by ~e applicant. ~s fig~e MIl be reviewed and my be revised by ~e Build~g Division to comply ~ffi c~ent fee schedules. Contact the Pe~t Coord~tor at 4174815 for assis~ce. PL~ C~CK FEE: Yo~ plan check fee is due at ~e t~e ~e build~g pe~t applicahon and cons~ction plans ~e sub~aed. All offier pe~t fees ~e due at ~e time ofpe~t issuance. E~TION OF PL~ ~EW: If no pe~t is issued ~th~ 180 days of~e date of applicatio~ ~is application will expire. ~e Bufl~g Official c~ extend ~c t~e for action by ~e applicam up to 180 days upon ~i~en request by ~e applic~t (see Sec~on 107.4 of · e Uffifo~ Building Code, c~ent edition). No applica~on c~ be extended more ~an once. I hereby ce~ that I have read and ~amined this application and know the same to be t~e and co~ect, and I am author~ed to apply for this permit. 1 understand it is not the Ci~'s legal responsibili~ to determine what permits are required; it remains the applicant's responsibili~todete~i~ewhatpermitsarerequiredandtoobtains~ ~ ~. Applic~t: ~~ Date: T:~0~S~PS~Buildin~e~it / - - ~ ' ~ ~;%~[[~,} SITE PLAN DE.~rM~.~ oF .uB.c wo. Ks, .U,LD~.G =~WS,O. APPLICANT: ,~2 ~,'~ PHONE: PROJECT/DEVELOPMENTADDRESS: //~ ~ /~ ~ ~. See Page 4 for inst~ctions on completing the carl 417-4815. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~-- ~'~ -- ~)'-~ Time Received by (phone, person) Location of Work to be inspected I J~-~--~ ~ Name of person requesting inspection Address of person requesting inspection Phone No. /'~::> / Permit No. Type oldie appropriate one): Sew~ ~d~,~a~ing Chimney,~, ~Plumbing Final Sewer Excav. Other ~NS~,~ON NO?S*-./ ~+?~ ..... Inspected: Date~_--'~ ~ -~,,~ c, 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 El 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): Permit No..,/~'-~.~_'-~ ~'~ Sewer~"~-nd~Fra~ming 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 I--J Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE []No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) '13 ~"'" "'ALoMA~- ELECTRICAL PERMIT APPLICATION FOR. OFfIC1AL USE ONt y DltclRcc:: Pc:rmil": ,,_ [)atJ:Apptovcd: Dolle lKUCd: The Electrical Permll Application must be filled out comDletelv. Please type or reprint In Ink. If you have any questions, please can (360) 417-4135 Fax number: (360) 417-4711 # 7IJYl Phone: REQUEST INSPECTION 0 Ljs7-883'1 Fax: tJ5"1- f3R.-:<;.t:; Phone: Address: 'po f-50l( 8f1.'f Cltv: Zip: J?1?302- Electrical Contractor: License #: Exp; Phone: Address: City: o ELECTRICAL CONTRACTOR Zip: INSTALLATION WIRED BY: )(,OWNER Credit Card Holder Name: BlI/ingAddress: ;:;0 ,Box tl/4 _.~~._.___City=--_!!.pt;- IlnJPk'\ Zip: 7'f?3b'Z.- Credit Card Number: ._____=_,.~c::---..._.______.. Exp. Date: '--~, VISA: MC:_ .------.- --. ......~ __.'_~.r.""~- ~ PROJECTADDR~~S: ;/30 /;{)ui; /:<..J!1 S-bf'ee-b I _", \ . _._.__...-.,-----~........ TYPE OF WORK<-----.---Check.1!1I.lfjaCapp1i-.....)l<New 0 Alteration/Addition /I",me. -/Soo ~Residental 0 Multi-family 0 Commercial ~ Mobile Home Sq. Ft G-a.Y>::J-P - ..300 Remote Mater }(Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump 0 Low Voltage 0 Telecom. 0 Sign Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT: jrJ dtnM.j1oll~_-6A. fl, j ,/;t))J;N'.. set!: ~ (# n d n<P./ d ~~~.jJ/ -t:fJ~~0 st;:~'~pCio/ ~;'om to/~ -1.0 J1areIJ@ -Co ,b",~tO- - .!J?~~h Electrical Heat Load Additions PERMIT FEE:~ ~e Information /;).3 qs; ~ 7737 o Baseboard )!(Furnace o Heat Pump o Fan-Wall ~ KW -TON -~ LRA ~"a.J._w4 S_.~Q o Temp Service )(Underground Service VOltage: :7'10/iZ-O Phase: 1<[1 I(J 3 Service Size: .;;..t.rO Feeder Size: PAMC 14.05.060(8): For industrial, commercial, & residential projects larger than a duplex, a one -line drawing of the Electrical Service & Feeders, building size (sq. It.), load calculations. and the type & of conductors and/or raceway is required and shall accompany the Electrical Permit application. 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 ara required; it remains the applicants responsib,1ity to delermine what permits are required and to obtain such. Credit Card Holder's Signature: ~ #/,6 I 6~.e.. ..f?6,30 ;5ft;e1/tc-e r~/L;6. 70 Date: Owner or Elec. Cont. Signature: C:/ELECTRICALPERMIT APPLICATION ?U e ~ /~/ /Oz... o r:- / ~t~~ DateJO-/- "2-. /D (L-/O 'Z- . . ~ --- ./ qr ~.9--Ji.4:it / / ~ I I I I I , ! i I \ \ \ 3d' -{;t> bj e.f flF I , : I I I I i I I I , I -=-- -------, ,