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1103 W 10th St - Building
Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Ductless heat pump Owner FRED E WESTFALL 1103 W 10TH ST PORT ANGELES (360) 452 8306 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary Charged Permit Fee Total Plan Check Total Grand Total 51b /D INSPECTION TYPE WA 983635627 183616 73 50 4/12/11 10/09/11 73 50 00 73 50 Signature of owner or Electrical Contractor X G \EXCHANGE \BUILDING ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 11 00000313 458481 1103 W 10TH ST 06 30 00 0 3 029 0000 ELECTRICAL ONLY Paid DATE. Contractor ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452 6424 ELECTRICAL ALTER RESIDENTIAL 73 50 00 73 50 Plan Check Fee Valuation Qty Unit Charge Per 1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER DITCH SERVICE ROUGH IN FINAL COMMENTS PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Credited 00 00 00 Date 4/12/11 RESULTS WA 98362 00 0 Extension 73 50 Due 00 00 00 5 19 bi 0,(11 to REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR. Date: APR -11 -2011 07 06A FROM ELECTRIC SERVICE 4526424 =CITY OF PORT ANGELES PERMIT APPLICATION Building" Division/Electrical Inspections 321 East Fifth Street —P.O. Box /Port Angeles washing ro r, 9836 RR 1 2 2011 Ph: (360) 417 -4735 Fax: (360) 417.4711 ELECTRICAL INSpEC ONS Single Family Dwelling. Multi Family or Commerc a Commercial Addition Alteration Remodel Repair= Plan Review May BA Requi�d, Ple Complete Electrical Plan Revie N nformaton Sheet Job Address: 1 I a t.V l u 1 Building Square Footage: k' D Il I Description of above 1` Date: Owner Information Name sad to 3 gal State: LJ a Tip; Fa hiding City: W d-s PhonD' License ii 1 Exp. Item ServIceJFeeder 200 Amp. SerylcelFeeder 201 400 Amp. Service/Feeder 401 Amp ServIceJFeeder 801 1000 Amp. .ServicelFeeder over 1000 Amp. Branch Circuit VIII Service Feeder Branch Ciircuit W/D Service Feeder Each Additional Brenta Circuit Temp. Service' Feeder 200 Amp. Temp. Service/Feeder 201 Amp. Temp. ServicelFeeder 401 Amp. Temp. Service/Feeder 601 1000 Amp Podai to Portal Hourly SfgnlOutane t.ighNng 8820 Signal Circuit/ Limited Energy l First 1500 et Commercial 95.90 Note: $5.03 for each additional 1500 cif' Signal Circuit/ t.imted Energy 1 2 Family Dwelling 63.90 Signal Circuit/ Limited Energy Multifamily [Wing 8 63.90 Manufactured Home Connection 119.90 Renewable Electrical Energy 5KVA System or Less S 102.30 Thermostat 66.00 NEW COM8TRUCTION QNLY; First 1300 Square Ft. $110.30 Etch Additional 500 Square Ft or Portion of 35.20 Each Outbuilding or Detached Garage 73.60 Each Swimming Pool or Hot Tub 110.30 Signature of caner electrl ontraetor or elects Cal administrator' TO 4174711 RECEIVED Contractor information Name: f c_ City: V State: Zip: 9 C2, Phone z- D Fax: License /Bo L S r 1 "3 z vv, P 1'1 Unit Charge gy Total (Qty Mullioned by Unit Charge) $119.90 6145.50 S 204.60 6 6 26220 372.60 3 2.60 3 73.50 J 7 c>� 1e 260 S 9270 110.30 148.70 6167.90 $95.90 .8 -s Total Owner as defined by RCW.19.28.261 (1) Owner will occupy the structure for 1 in years after this electrical permit is finalized. (2) Owner is required to Mu an electrical contractor If above sold property is for sale, rent or tease. f is !nit expires alter six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the ve named properly or a licensed electrical contractor. am making the electrical kistallafon or alteration In compliance with the electrical laws. N. RCW. Chapter 19.28, WAG. Chapter 296 -46B, The City of Port Angeles Munldpal Code, and Utility Specifications and PAMC 14,06. 50 re it 19 Electrical Perms Applications. ash Clack CreditCerdl o11tNl2o1a Date Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc INSTALL A HEAT PUMP Owner FRED E WESTFALL 1103 W 10TH ST PORT ANGELES (360) 452 8306 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Permit MECHANICAL PERMIT Additional desc INSTALL A HEAT PUMP Permit pin number 183483 Permit Fee 64 80 Issue Date 4/11/11 Expiration Date 10/08/11 Qty Unit Charge 1 00 Fee summary 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 sp cified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or 1 I law regulating construction or the performance of construction. A Print Name 14 8000 EA T: Forms /Building_Division /Building Permit WA 983635627 Per Charged r r 11 00000305 921245 1103 W 10TH ST 06 30 00 0 3 0295 0000 FRED WESTFALL MECHANICAL APPL PERMIT RS7 RESDNTL SINGLE FAMILY 4498 Contractor ALPHA BUILDER CORPORATION 105 1/2 E 1ST ST PORT ANGELES (360) 452 3154 BASE FEE ME FURN /HP /FAU OR 5 TON Paid Credited 64 80 00 64 80 Date 4/11/11 WA 98362 Plan Check Fee 00 Valuation 00 00 00 Extension 50 00 14 80 Due 00 00 00 0 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) 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 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 Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting T:Forms /Building Division /Building Permit 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 Inspection Type Date Accepted By /Lc-/< Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 FINAL Date FINAL b ate PLANNING DEPT Separate Permit #s SEPA. Parking Lighting 1 ESA. Landscaping 1 SHORELINE. Comments FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Acceoted by Acceoted by Date Accepted By Applicant Property Owner Property Owner's Contractor A Contractor's Address License PROJECT ADDRESS Parcel Number Address Proiect Tyne Brief Description. Check all that apply New Construction Addition Remodel Repair Demolition Re -roof Heat System Other Floor Areas Existing (sq. ft.) Lgposed (sq. ft.) Basement per sq ft. 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other d� TOTAL VALUATION Lj y_ b'� r m ,K 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 17 94 135 for exemptions) Site coverage Max. height of proposed structures ft. Occupancy group Will a lawn sprinkler system be installed? Occupant load Will fire sprinkler system be installed? Construction type I have read and completed this application and know it to be true and correct. l am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Date 4 Print Name C. Signature 1344 T Forms /Building Division /Building permit application BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn Building Permit Technician Gel 321 E. Fifth St. Port Angeles WA 98362 �5 (360) 417 -4815 fax (360) 417 -4711 p 1t, I(2 r Expires C w PD ,Residential House garage other tear off re -roof lay over one layer XHeat pump wood burning stove gas fireplace pellet stove other Multi- family Phone Phone Phone Lot Ft— /1Pl7 For City Use Only Date Received Permit# !1 '90S Date Approved s2 —R:3c `f52 e4fileic- J Pte. Zoning Commercial Industrial of bedrooms of full baths of half baths Clallam County Assessor Treasurer Property Details 58965 FRED E WESTFALL f Page 1 of 2 Clallam County Assessor Treasurer Property Search Results 58965 FRED E WESTFALL for Year 2011 2012 Property Account Property ID 58965 Legal Description. S2 LT 18 EXC W 2' OF S50' S2 LTS 19 &20 BL 302 MAP 1 -5 Geographic ID 0630000302950000 Agent Code Type Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 Open Space N DFL N Historic Property N Remodel Property N Multi Family Redevelopment: N Township Section: Range. Location Address: 1103 W TENTH ST Mapsco PORT ANGELES WA Neighborhood: Cycle 5 Res Map ID 3 Neighborhood CD 10955130 Owner Name FRED E WESTFALL Owner ID• 59247 Mailing Address: 1103 W 10TH ST Ownership 100.0000000000% PORT ANGELES WA 98363 -5627 Taxes and Assessment Details Property Tax Information as of 04/11/2011 Amount Due if Paid on Exemptions: NOTE. If you plan to submit payment on a future date make sure you enter the date and click RECALCULATE to obtain the correct total amount due First Second Half Half Base Base Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest Base Paid Amount Due 2011 153591 ST SCH STATE SCHOOL $219.31 $219.30 $0 00 $0.00 $0 00 $438.61 2011 153591 CC -GEN COUNTY CLALLAM $121.06 $121.06 $0.00 $0 00 $0 00 $242.12 2011 153591 SD #121 SCHOOL DISTRICT #121 $286.67 $286.67 $0 00 $0.00 $0.00 $573.34 2011 153591 CITY PORT ANG CITY OF PORT ANGELES $279 49 $279 48 $0 00 $0.00 $0 00 $558 97 2011 153591 PORT PORT OF PORT ANGELES $17.04 $17 04 $0 00 $0.00 $0 00 $34 08 2011 153591 NTH OLY LIB NORTH OLYMPIC LIBRARY $50`.78 $50 77 $0.00 $0 00 $0 00 $101.55 2011 153591 HOSP #2 HOSPITAL #2 $49 70 $49 70 $0.00 $0 00 $0 00 $99 40 2011 153591 WSMET PK DIST WILLIAM SHORE MET PARK DIST $15 11 $15 10 $0.00 $0 00 $0 00 $30.21 2011 153591 CITY_STORMWATER CITY STORMWATER $36'00 $36 00 $0 00 $0.00 $0.00 $72.00 2011 153591 WEED_CONTROL WEED CONTROL $0.82 $0.81 $0 00 $0.00 $0.00 $1.63 2011 153591 TOTAL. $1075:98 $1075.93 $0.00 $0.00 $0.00 $2151.91 2010 41877 ST SCH STATE SCHOOL $217 11 $217 11 $0 00 $0 00 $434.22 $0 00 2010 41877 CC -GEN COUNTY CLALLAM $115.54 $115.53 $0 00 $0 00 $231 07 $0 00 2010 41877 SD #121 SCHOOL DISTRICT #121 $281.22 $281.21 $0 00 $0 00 $562.43 $0 00 2010 41877 CITY PORT ANG CITY OF PORT ANGELES $267.50 $267.52 $0 00 $0 00 $535.02 $0.00 2010 41877 PORT PORT OF PORT ANGELES $16.24 $16.24 $0 00 $0.00 $32.48 $0 00 2010 41877 NTH OLY LIB NORTH OLYMPIC LIBRARY $33.58 $33.57 $0.00 $0.00 $67 15 $0.00 2010 41877 HOSP #2 HOSPITAL #2 $4740 $47.39 $0 00 $0.00 $94 79 $0 00 2010 41877 WSMET PK DIST WILLIAM SHORE MET PARK DIST $15.08 $15 08 $0 00 $0.00 $30.16 $0.00 2010 41877 CITY_STORMWATER CITY STORMWATER $3600 $36 00 $0 00 $0.00 $72.00 $0 00 2010 41877 WEED_CONTROL WEED CONTROL $0.82 $0.81 $0 00 $0.00 $1.63 $0.00 2010 41877 TOTAL. $1030:49 $1030.46 $0.00 $0.00 $2060.95 $0.00 http. /websrv8 clallam. net propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =58965 4/11/2011 NOTE TO PLAN suBmrrrER. permit issuance. 0 Concept Review 1:1 Preliminary Review CI Final Review COMMENT NO PROJECT NAME. PW 1104.04 (121931 PLAN REVIEW COMMENTS SENT FOR DEPARTMENT REVIEW ON Z REVIEWING DEPARTMENT Dillhulding 1 PW Engineering 1 Wastewater 1 Water 1 Street 1 Solid Waste 1 Light 1 1 Fire u03 W 104, DEPARTMENT COMMENTS RETURNED COMMENTS TO SUBMITTER. DRAWING OR SPEC REF All plan comments require written response and/or correction for permit issuance. Return response with plan resubmittal. Approval of ALL reviewing departments required prior to 1:1 Revision Not approved. Comments returned to submitter for response and or correction. o 4 other 0 Reviewed by C74 7 1‘f o REVIEWING DEPARTMENT FINAL APPROVAL. by Date COMMENTS l‘lis.LI Isit 4 Lt ilt cauwc,--rizvItsgli,..4. t ty-o.L>ttl.m. .7 c 7eNk kNA___LS,A.cke,,e 1 IlL6049tA c=6t -Q-iii?_. 1A.,.‘e lt Q. Ake 1 k ise l L1 Axel= -4 se=1".-tp.. AL.A.1-.00. I kokktek LtikAAI e.Att 4 e_Ca Lk- 1 i l.o..mAt, 1.--via `Mk.le.. V-e‘w_ kl .b 'bello i Ni ‘)■tow. 0 .-v. kr...t zr.... 742 .../..9t.0 QtEobOme.-irLoM 1k. ski..Q. \IA. v_smi..e.v2S 4;G2 I L k\e/i._ ktb \Cmiy6 CC) 64,16LEC-.110 14 1)6A" leits 1 kew woe. at.:( mictkciA-exLe? LOCATION Lity IA L 0 4- L4' SHEET OF SUBMITTER RESPONSE DATE. VOItIMENZ *SPEC R. farena BACK CHECK BY/DATE. STATUS CODES. A COMMENT ACCEPTED C CORRECTION MADE N NO RESPONSE REQ'D pERmrr ''"Z•zic? T A U CITY OF POR'I ANGELEb PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT Issued: 10/16/97 Permit No: 10072 Conditions: OWNER/APPLICANT ........................ PROPERTY LOCATION ........................ FLORA WESTFALL 1103 10TH ST W 1103 W 10TH Lot: SEE PERMIT Port Angeles, WA 98362 Block: 302 Long Legal: 360/452-$00G Sub: TPA T: ~0~ S: Parc No: CONTRACTO~ ............................. DESIGNER ................................. OWNER VARIOUS Port Angeles, WA 99360 , 206/000-0000 000/000-0000 PROJECT INFO .................................................................... Prj Value: $25,000.00 SFD UNITS: 0 MFD UNITS: 0 Prj Type: SFR INT/REMOD SFD SQ FT: 0 MFD SQ FT: 0 Occ Type: Occ Group: Occ Load: COMMERCIAL: 0 Cnstr Type: INDUSTRIAL: 0 GARAGE: 0 Land Use: RS7 PROJECT NOTES ................................................................... PROJECT FEES ASSESSMENT ......................................................... BUILDING PERMIT $349.75 .............. $0.00 ..... ~ ........ $0.00 PI~kN CHECK $0.00 .............. .$0.00 ......... RADON $0.00 STATE SURCHARGE $4.50 .............. $0.00 $0.00 HOUSE MOVING $0.00 .............. $0.00 $0.00 MANUFAC HOME $0.00 .............. $0.00 $0.00~ SIGN $0.00 .............. $0.00 PLUMBING $76.00 .............. $0.00 TOTAL FEE: $430.25 MECHANICAL $0.00 .............. $0.00 AMT PAID: $430.25 ............... $0.00 .............. $0.00 ....................... ............... $0.00 .............. $0.00 BAL DUE: $0.00 R/W SANITARY WATER DWY STORM DRA OTHER Separate Permits are required for electrical work, 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 bu~ld, jer) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS PLEASE PROVIDE A MINIMUM 2~. HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN n CONSPICU(~JS LOC~ATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE / ~)(~) 7'3 FOUNDATION: FOOTINGS FOUNDATION DRAINAGE I~CTRICAL (LIGHT DEPT) WALL / rLO0~ SANITARY CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS .... INSPECTION REPORT Date ~D]! '-~ I , ime [~ ~ Received b (phone.~~ Location of Work to be inspected //__1~.~ L/~ .~)~ ~,~____~ Name of person requesting inspection Address of person requesting inspection ~'l~hone No.~--~5-~-~ Type of Inspection (circle appropriate one): __ J~ermit No. Sewer Foundation Framing Chimney Plumbing Final/~werExcav."~Other INSPECTION NOTES: Inspected: Date ~ ~ ~..:~ ~ Time .' ~-' By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel I-]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 '~~ -~--) (~ ~:~ Time ///' ~-~' ~-~ Received by C-' ~ (phone, person) Location of Work to be inspected//~7'~ ~-? /~'~ ~ Name of person requesting inspection Address of person requesting inspection Phone No, Type of Inspection (circle~app~p, riate one): Permit No. ~/~ ~ ~ 2- Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other -d~,~' ~ t ~,~2/.~ ~ INSPECTION NOTES: Inspected: Date -~ -~ ~ Time. ~-~ ~ By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel r~Asphalt r~PCC []Other [] Repaired by City Work Order # [] 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 . .. Date~7~ / Time .Received b phone, person) Location of Work to be inspected //O ~-~ ~_~ /~ Name of person requesting inspection Address of person requesting inspection Phone No. Type of _ inspection (circle appropriate one)~ Permit No. Sewer Foundation Framing Chimney__Final Sewer Excav. Other INSPECTION NOTES: inspected: Date '~- / 7- ~F Time. ~ ~ By ~ Remarks: .~1 /7) . RESTORATION REQUIRED ...... YES. NO_ SURFACE RESTORATION: SURFACE TYPE: [] Unimproved r~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 ........... ~, Received by ~'d2~' (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 Foundation Framing Chimne~ Final Sewer Excav. Other 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 r-I No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REOUEST: ~ ~ ~ ~o Date ~:~" ~-~ - ~ Time f~ 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 (c~priate one): Permit No. Sewer Foundation(~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 [] 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 ~-' ' { ~ Time / Received by -' (phone, person) Location of ~o~k to ~e inspected , - - ...... ~am~ of ~raon re~u~atin~ ina~tion 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 SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel r-]Asphalt I--IPCC []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 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 Foundation Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date 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 ~--{J-~/©c-~ Time ~ ~ Received by ~/ (phone, person) Location of Work to be inspected / ( C ~ (~ i (-?/~ ~-~'(" Name of person requesting inspection ~/~/,ir'~'~ ~--~/~S~ Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. /c~c:~ Sewer Foundation Framing Chimney Plumbing Final Sewer Excav.,O~'i?~,-~?~-,-~. INSPECTION NOTES: Inspected:Date ~-~/'7'- ~ /(~'~/-J Time. ~ ]"'~ By Remarks: RESTORATION REQUIRED ...... YES. NO ~ SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel [~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 ........... REQU~ST: ~, ~ Date i, Time / Received by (phone, person) Location of Work to be inspected //~ ~ //**/'~'~}~ ,/I/' 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: ~. ~,*r~* ~ Inspected: Date * ~' Time ~ By Remarks: RESTORATION REOUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved ~Gravel []Asphalt []PCC []Other []Repaired by City Work Order # __ r-IRepaired by Permittee [] COMPLETE E] 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 II ~ ~ I O~L ['~ 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 ~SewerExcav. Other INSPECTION NOTES; Inspected: Date ~~.~ .Time ~I~V~ By ~L~ Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [-~Gravel [~]Asphalt I-]PCC I-'~Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) (]CT 1 5 1997 October 15, 1997 £ Ms. ~. ChiIdress City of Port Angeles Building Permit Department Port Angeles, WA 9836~. Re: Permit #8512 Dear Ms. Childress: This is a formal request to extend the above referenced Building Permit. We started construction on our residence at 1103 W. 10th during 1996 but ran out of mozzey and were unable to coz~tinue to completion. We have now sold some property in Grays Harbor County and wish to continue construction per submitted plans. I understand there will be a fee for this extention. Thank you for your consideration in this matter. Sincerely, Flora Westfall 1103 W. 10th Port Angeles, WA 98363 Phone: home 452-6306 office 417-3448 M"'.f;'~IM'lI'~~llMN,.S,~J'''1':,j,'-----c.''',"iir<i~-IioiW''"~i;;i;.;.;.,:i.;,;'f:f'ji~' ,~"t~-~~~:j,;';:'~;'iY~;'",l.ll,~~t:It~~~~<~,A'i.1~~!~;-tls.~._~,~.~- 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 04-00000272 Date .924592 1103 W 10TH ST 06-30-00-0-3-0295-0000- RE-ROOF 4/05/04 RS7 RESDNTL SINGLE FAMILY 1685 Owner Contractor WESTFALL FRED E 1103 W 10TH ST PORT ANGELES WA 983635627 AFFORDABLE SERVICES 258663 HI - WAY 101 SEQUIM WA 98382 (360) 452-5264 permi t . . . . Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT - NO PR FEE TEAR OFF/COMP/FELT 83.60 Plan Check Fee 4/05/04 Valuation 10/02/04 .00 1685 Qty Unit Charge Per Extension 47.00 36.60 - - BASE FEE 12.00 3.0500 HND BL-501-2K (3.05 PER C) Other Fees STATE SURCHARGE 4.50 \:\ ~G.i ~ ~t: ~- ~ () ~:;t -t\(/) S~ f Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- permi t Fee Total 83.60 83.60 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 88.10 88.10 .00 .00 Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:IPLANNINGIFORMSIJ 102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH. IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW I WATER AIR SEAL WALLS CEILING I FRAMING JOISTS I GIRDERS SHEAR W ALL/HOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB W ALL I FLOOR I CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: PARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 11)'... ,r')!f{>o'i J,).... BUILDING T:IPLANNINGIFORMSII102.15 [11/14/2003] '" >-l '" ~~~8E; ()'" t-< >< ; H:O '" '" "':OZZO >-lOJ '" '- L'()MI-3::d ><'" Ul H tIj:=tl:=tltIj :t- o 10 >-l Zt-< :t-Ul 0:0 f-' ~. ()Ul "'OJ >-l 0 ~ '" 0 '" Jj OJ. :0. 0 ():oO :0 :OUl OOJ'" >-l'- 3:10 '" "'~O OO~;t>t1-' ~~ t-<OJO of::>. 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Dat, Apprv\lld: 0... r..ri, rUI Ollt COMPLrl'ltLY and la INK. Your appllCIUOD Ind lItte plu MUST U COMPLETE to be accept.d fltr review, U you !lave uy qU.tioDI, caD (360) 41'--4815 Applicant or Agent:~(Cd.1~ ~f J} 1 to S l'nooc: -~O h~s -q I"'r-,IQ Owner; f:v-e.l1 ~. ~V~S+-t=C1 U- Phone: CiS 2 9J~ _ Addreu: J J D ~ L~J' I) fv'... ,<fy ~ f/ :to . City: RJY".J. ftr1,.. (I Jf, ZiP:ol.~q~;~ ~. ArchitcctlP.ngi.ncer: _ Phone:_ . A-FC^fl.~~~~. . . Contractor..:!c.A.'-i b. KeA..(...h..u ~l.\. State License 'If. (.f. :l!,q;:_ t..1CE5 .rhonc:3uD{&~t~/,t Ackl.ress:1sP><t:.(/-l,I-IW'iII)/ W~ . City: 5:3"/M LA/I+- _ Zip:qPJ~'--l~ PROJECf ADDRESS; /1 {) 2, vt/ I ()'tl\~fy- of' €~ _ ZONING: LEGAL DBSCR.IPTlON: Lot: Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: ____ CnllItl Cwd Kallla, N":8~~' ~ 1t!31 ( t'1t\ BIIIiA& Ad...... 'Z '&~fll'# ~ ~ I rd. l'D; flU = City: ~~ III IU Wfr C/ 0 $ '0 :;) -7U ~ ~ : Credit CII'd1'J'pe VISA V- MC _ 1# (5r\ P 1 I e- : .... TYPE or WO:RK: SIZI/V ALVA nON I o Re.identiaJ 0 NtwCODItr. ~roof C Stove. S1'.@S ISP.-S c:J MlIlti.fimiIy C Addition CI Move C Gange SF, @ S /SP. . S c CoaaIln:W C R.aod.el 0 Demolitiol1 Cl Deck SF. @ S ISP.,- $ . C R.epair CI Sip ~ Other TOTAL VALUATION $ It l:;l)laJ . BlUEPDESCRIP'l10NOPTBEPROJECT: 7~L';(I'I)-lCie J H-'/t-.f 6.-7fhO _;.. ... I" COMMl.R.ClALl&&SIDENTIALl Occ:upallcy Group: OCeupIDI Load: ___ CaDatNttto.n Type: No. of Storin: _ LDt Size: &I111Dg Sq. Pt. & Propoeocl Sq. Ft. - TOTAL Sq.Pt. Existing lot cOY", _ % &; Propelled lot CQvon&; _ % · Tota.llot coverlle % APPIlOV AL8: PUNa BLI~G: DPWU:_ lPIRZ: OTIIU.:_ PLANNING USE ONL YI I I i ESAlWcllalld(a): C Yet 0 No SErA Cbccklilt requtred7 0 Yea C No Other. BUILDING llRMIT APPLICA nON StJBMrrT AI.: ThcBuildin& Division Cltl provide you with iDformatlon OD the applicatiOl1IZld planlU.l:lmital requ.\rrlDmllif you hive quaUons. V ALUAnON or CONSTIlOCTION: 1D aU c..lIlI. a valllldon IIIIIGWlt IIWIt be entered by dse appliClllt. ThiI f1pre will be revic~ and maybe n:vbed by me B1Ii1dlDi DiViliDn to comply with CUD eat foc Ichcdule.. CoalaCtdlc Permit CooE1tiDalor &t417-481 5 for ...iltance. PLAN CDCK FEE: IP a plan du:c:k fee 11 due it mwt bo aubmiaecl at tbe time 1bo bull4iq permit appliOltioD ud oautructiau pla.Qs IrC IUbmittIcl AD ok permit r.. .,. d\w It the time ofpcmlit iaNaDcc. EXPIRAnON 01' ....AN UVJEWI If DO permit l. IMued withia ! 80 daY' of the dale of applioatioa. the applled_ wiD uphe. The BuildiftaOfticia1 ou.1dIDll tile time fol' aetioD by tho applicant up to 180 cLaYl upoD. writt.uoqualby tile appl1ca1at(aeo Section 107,4 of me UmlODll BuUdiDa Code, CU%fCt ecUtioD.). No appbcatioD can be extmded more tll&D ODCe. I h"'''y */Iy thtt 1 trN INd IIId ,xBnliltd "'It .pplleat;o" end know the .!lomll to b. he .rtd COfTtGt. 1 Ml ~d Ie Ipptf fortliJa P'rmR end IIIdfflfllld /hit Ii, ml1111PGMlb11ity 10 de18rmlne wtI8r porm/t, .... ftqUied ,nor lh. c.ty'., 'nd th., mtIIt ob.., ..ur;h ".",. prior /0 work. T:l1OlUI(SWPoWNlldmprmllwpd ApplicllDt 9/1yetft.L- Da1l:l: 3 - 3/-otj" '~'~ fid $ ~r...'" CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION ]21 EAST 5TH STREET. PORT ANGELES. WA 98](,2 ELECTRICAL PERMIT Issued: 8/18/98 Permit No: 6405 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ FLORA WESTFALL 1103 10TH ST W 1103 W 10TH Lot: SEE PERMIT Port Angeles, WA 98362 Block: 302 Long Legal: 360/452-8306 Sub: TPA T: . S: Pare No: CONTRACTOR-----_-----------------------DESIGNER--------------------------------- JARMUTH .ELECTRIC P.O. BOX 635 SEQUIM, WA 98382 360/683-4104 , 000/000-0000 PROJECT INFO-------------------------------------------------------------------- prj Type: RES.REMODEL Prj Value: $0.00 Occ Type: Cnstr Type: ADD CIRCUITS Occ Grp: Occ Load: Land Use: RS7 Electrical Heat Service Type Baseboard KW: 0 Riser Voltage: 120,240 Furnace KW: 0 X Overhead Service Diameter: X-I -3 Heat Pump KW: 0 Underground Service Service Size: 200 AMPS X Fan/Wall KW: 8 Temp Service Feeder Size: 0 AMPS PROJECT NOTES------------------------------------------------------------------- WIRE REMODEL, ADD 8KW FAN HEAT PROJECT FEES ASSESSMENT-------------------------------------------------_------- service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $42.50 Temp Service: $0.00 $0.00 Mise TOTAL FEE: Amount Paid: $42.50 $42.50 --------------------------------- ------------~-------------------- TOTAL FEE: $42.50 Balance Due: $0.00 COMMENTS/ACTION NEEDED ELECfRlCAL PERMIT INSPECfION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. "IS UNLA WFUL TO COVEll, INSULATE OR CONCEAL ANY WORK BEFORE" IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATI< I ACCII:PTED InslNO COMMENTS KIIII{jH-IN7CUVER CE F q/'?/ff 9/"7ar r FINA.l I \ I GENERAL COMMENTS: PW.II02.1'I4I96J ,_. . 8ite Address: Installed By: Owner/Business: Owner/Business Address: ELECTRIC HEAT o BASEBOARD KW _ o FURNACE KW _ o HEAT PUMP KW_ o FAN/WALL KW _ Details/Description: . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 PERMIT NO. 7/ ~ cf6&~y DATE ELECTRICAL PERMIT o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Phone: Sq. Ft. o RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION ~ REMODEL o ADD/ALTER CIRCUITS ;&. SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE o RISER ~ OVERHEAD SERVICE o UNDERGRO~ SERVICE VOLTAGE: /~ zyfO ~116 0316 SERVICE SIZE.?'&O FEEDER SIZE AMPS AMPS W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. o O.K. to connect service o Final O.K. Site Address: Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. A' ~ NO OCCUPANCY OA USE ESTABLISHED UNDER THIS PERMIT t?" /*7!'l /flU11 $ 0 (.../ Electrical Inspector Permit Fee //03 Installer: . WHITE - File by address OLYMPIC PRINTERS INC h, /O~ ~ Permit/Receipt No. ~7~ New Meters ~ PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall Site Address: CITY OF PORT ANGELES LIGHT DEPARTMENT .1 ELECTRICAL PERMIT PERMIT NO o?l;~ DATE /02/ qt P Installed By: o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Owner/Business: Phone: OwnerfBusiness Address: Sq. Ft. ~Residential I Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction ~Remodel o Service update/alter/repair \7( Add/alter circuits I'd Auxiliary power (list below) o Special equipment (list below) o Overhead o Underground Voltage o 1.0 03.0 Service size o Temporary Amps Detai Is/Description: AcI,.! . /IJIJ{) WAil- L?R.{';:, b~ . W.S. No. Service Size Capacity: 0 O.K. 0 Not O.K. Comments o Ditch inspection O.K. 1JJv1!l! Rough-in/cover O.K. o O.K. to connect service o Final O.K. Date Hoid for: 0 Easement 0 Letter o Signed up for servicelmeter o Meter Department notified for instaliation o Fire Department notified of inspection o Plan Review approved/pendi ng Installer: Permit/Receipt No. Site Address: New Mete2? . Notify the Department of City Light by Street Address and Permit Number when ready for in pect'on. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 45711. EXT. 158 or EXT. 224. ~ I . NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT () #. (_lh.. ;::;;) - Inspector Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMPIC PRINTERS. INC. CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N~ 17965 -'if ~/ .- ~ 7 - /,V' ./ .' Port Angeles. Washlngton.......______......._..........~___........___.........______. 19..{~___ ..) 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 City of Port Angeles. per- mission is hereby granted to dO electrical w;ork as llsted below. //0 3 _ur/ t! C/ /L/?-<:2 ~:;Es~i~~i~~:~::::~;ti!iiii~:.:.:~:::~~;~:;~~~~~.~~~:::::::=::::::::::::::::'::::.'::::..:::::::::: .:1 . /.1 0/ ') :nJ Light ets.......k......h...h..__...._.._..... Service, volts .0...._...........:.;.................. . 5' R eptacle Outletsl.e:l.__........ 0._....... No. wires ._._._........h.m....h__.:<:::...... D'ye,. KW ___UhuC..uu.m.uuhm____. ... Size wlres.....?i::?ntf!.~..._n Range, KWuh/.-2..nmmh__.;m__ Main fuse .i:?~~.&nnn..... Water Heater: ,___ . Enclosure h...hm___....._........._...... Kw,......~.::'~m..hm.....uhnu...h_ Type of wiring: .~ D'jn b Heat: KW...._2........t.;Z~T..........._._.h...m... Entrance Ca Ie ..m.__......h............. Remark:~la:u:~:.~~!;~..:,:::..:~;~.~~?;;:__.~.~::.:;::~~.;~~...;.~:y....~~=:.;:~~.~~:;..!;q~:::. ::::::::::::r~:~~~:~:~:=::=:::::=::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::---:::::___-----u:~---....---...------.....---..--- .By .9~/l;~~:~::=;::2:::~:::~t-- . NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con- cealed due notice must be given the Inspector so that work may be Inspected betore concealment. Motors: size, volts and phase: fi-.(lA-"'~h""~~'..nu:;.n.=__..........___......._____.... \ ~I. / '~~:.:::::::::::.::::::::::':::2'~:: Rigid Conduit .......mm.... MetalUc Tubing _mhmm.............._ Current transtormers: No. & Size.......h_.................._.......... Ser. No...................._........._............_... Ser. No................_............................. ......._......0.._.._.........._........0._.............._ Ser. N 0....__.........0._..._......0............_.._.. Permit Fee, () 3.."o~-' . )- $,.........:........................... Treas, Receipt No............................. Type ot Wiring: Armored Cable ........h....m.........h.. Non-Metallic .__.n............._............_ Knob &: Tube__.........._..................._ Rigid Conduit .....................__........ Metallic Tubing .h_...__mm............ Raceway _._............_._._......_......._..._ Circuits, LIght................m.........._......... Utlllly........__................................... Heat ._...............__...................._....._ Range ._..._.............._........___..__._.._.... Water Heater _...h_h..._.__............h. Motor Dryer_ Furnace .........................'_.......n.........' '- . ( NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N~ 1796'5 / Address........____.._...._...._............._.........................__..___..........__............_............--.---....-..-.............Date..._.___..__._..____.........__......_...._._........_ Owner .......0..._....0.........._.......__....._.._......_0._...__.__............._....._._..........._n_..................... TenanL....._..h_h_.._......h..___.._......._............._.__.h..._.. Wiring Contractor....____....__...______.nn......._._..................._......._.0......._...........0.._._..........___............._. By 0....................__._................_........0.__.__.._.. NOTICE-Current must not be turned on unt11 Certlflcate at Inspection has been issued. If work ~:8 to be COD- cealed due notice must be given the Inspector so that work may be inspected before concealment. \ 1M Olympic Printers, Inc. ~ ..