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Home My WebLink About821 W 10th St - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Alarm System Owner SOHLBERG VERNON 821 W 10TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary Permit Fee Total Plan Check Total Grand Total INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 983635727 10 00000229 115460 821 W 10TH ST 06 30 00 0 2 9970 0000 ELECTRICAL ONLY RS7 RESDNTL SINGLE FAMILY 0 Contractor ELECTRICAL ALTER RESIDENTIAL 162008 63 90 3/08/10 9/04/10 Charged 63 90 00 63 90 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 Date 5/27/10 ADT SECURITY SERVICES INC 11824 NORTH CREEK PKWY BOTHELL WA 98011 (425) 489 3668 Qty Unit Charge Per 1 00 63 9000 ECH EL SINGLE CIR LIMITED RES Paid Credited Due 63 90 00 63 90 DATE Plan Check Fee Valuation 00 00 00 RESULTS /z? c o 7Q Extension 63 90 00 00 00 00 0 Signature of owner or Electrical Contractor X Date INSPECTOR. x CITY OF PORT Ads GELES PERMIT APPLICATION Building Division/Electrical Inspections ELECTRICAL 321 East Fifth Street 1' 0 Box 1150 Port Angeles Washington, 96 Ph (360) 417 -4735 Fa.1 (360) 417 -4711 Date: 3/5 /l a X 1 2 Singe Family Dwelling Multi Family or Commercial* Commercial Addition Alteration Remodel Repair' Plan Review May Be Re>tauired ?lease Complete Electrical Plan Review Information Sheet Job Address: Fs 21 10.1 t Q Building Square Footage of above tII rJOf, 5 l Description of o 21:tE•r- tn.r0.� Owner Information Name: rlv„�n Sehib ear"--■ Mallin Address: temC wsz s� City Stahl. \--1A—Zip: Phone: Fax: License Exp, Item Service/Feeder 200 Amp, Service /Feeder 201 400 Amp, Service /Feeder 401 -600 Amp ServicelFeeder 601-1000 Amp. Service /Feeder over 1000 Amp. Branch Circuit WI Service Feec.or Branch Circuit W10 Service Felder Each Additional Branch Circuit Temp. Service/ Feeder 200 Arr p. Temp, Service/Feeder 201-40C Amp. Temp. Service /Feeder 401 -60C Amp. Temp, Service/Feeder 601 -1000 Amp Portal to Portal Hourly Sign /Outline Lighting Signal Circuit/ Limited Energy First 1500 sf Commercial Note: $5,00 for each addilional 1500 sf Signal Circuit/ Limited Energy I 2 Family Dwelling Signal Circuit/ Limited Energy Multi- Family Dwelling Manufactured Home Connecting Renewable Electrical Energy 5KVA System or Less Thermostat NEW CONSTRUCTION ONLY* First 1300 Square Ft. Each Additional 500 Square Ft or Portion of Each Outbuilding or Detached garage Each Swimming Pool or Hot Tub Signature of ownerelectrocal contractor or electrical administrator Too Unit Chart* 119.90 145.50 204.60 262,20 372,50 2.60 73.50 2.60 92.70 110.30 148.70 167.90 95,90 88.20 95,90 63,90 63.90 119.90 102.30 56.00 110.30 35.20 73,50 110,30 Salad: RECEHO P9�R C 2009 Contractgr nformation Name: Mailing Address; 11 ZJ.} Clry: Jrt State: Phone: Fax: License /Exp._ki 'V ,P._ S Qf _t.'1 Total Total (abr Multiplied by Unit Charol Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contract:r if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor I am making the electrical installation or i7lteration in compliance with the electrical laws, N.E.C. RCW Chapter 19.28, WAC. Chapter 296-468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. tt 14.10 Cash Check 3SHM UOOMSi1n1 JAV 06650Z9C2Z red bS 9T OTOZ /2O /C0 0 0 1.1 .,.. CITY OF PORTANGEI:.ES DEPARTMENT OF CO~ DEVELOPMENT - BUll-DING DMSION 321 EAST:STH STREET, PORT ANGELES, WA 98362 ~,~ .' Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Property Zoning .". . Application valuation Owner SOHLBERG VERNON 821.W 10THST PORT ANGELES Date 5/16/03 03-00000149 821 W 10TH ST 0630000299700000 RES REMODEL 26947 Contractor WA 983635727 COZI HOMES 324 E9TH ST PORT ANGELES (360)452-9906 WA 98362 -- - -:.- - - -:~ -'- - -:"-"~ ----... -... ~,..."~,- - - - - - -... - - - - - - - - - - - - - - - -. - - - -, - ':"','... - - - - - - - - - - - - - - - -... - - - -- Permit . . . . Additional desc Permit Fee Issue Date Expiration Date BUIWmGP~IT -RESmmnIAL 434.95 5/16/03 11/12/03 Plan Check Fee Valuation 173.98 26947 . t:,. Qty Unit ChArge Per Extension 414.75 20.20 BASE FEE 2.00 10.1000 THOU BL-25,001-50K (10.19. PER K) --------------------------------------------~---------------_._-----_._~------ Permit . . . . Additional desc Permit Fee Issue Date Expiration J)at~ MECHANICAL P~IT 54.25 Plan Check Fee 5/16/03 Valuation 11/12/03 .00 o ,'-",'1" Qty Unit Charge Per Extension BASE FEE 47.00 .1.00 7.2500 ECH . ME-VENT FAN ,i" ' 7..2~ __...:..................... __-........................ __................................. _'_............ __............ "',"'''' _._ _._............... ~_...! ::0.;.,............. ~....;;,; ~ _.....l. _'~_ Permit . . . . Additional desc Permit Fee' .'. Issue Date Expiration Date PLUMBmG P~IT . \ 68.00 5/16/03 11/12/03 Plan Check Fee Valuation .00 o Qty Unit ChArge Per Extension 47.00 21.00 .. BASE FEE 3.00 7.0000 ECH PL- EA.FIXTURE ON O~ TRAP Other Fees Feespnunary Permit Fee Total Plan Check Total Other. Fee Total Grand Total STATE SURCHARGE 4.50 Charged Credited Due Paid 557.20 173.98 4.50 735.68 557.20 173.98 4.50 735.68 .00 .00 .00 .00 .00 ,00' .00, .00 Sep~r~tePermlts are~'quired for electric(il work, SEP A, Sh()Jeline.~~}\;utilities, private and public improlJerJ!eti~.:J:~I~PfiifflJl;t~~9tn+S null~ndvoi~ if work or construction authorized is notcommenced withln 180 days, if construction or work Is/~~~pentt~~orabandoned foraperiod of 180 days after the work as cOrnmenced,S>fif r!9ulre.~m~P!ctlons have notbeen requested wit~i~,? ~g'~~YSifl"()mthelast Inspection. I hereby certify that I have read and examined this application and know.,the same lobe truea~Cf~rr~c(;;'AlrproVisionsof laws. an~ ordin~ncesgoveming this type of work win be complied with -.yhether specified herein or not. The gratlting 'Of a pe'rinit 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 T:\PLANNING\FORMS\1102.15 (412002] BUILDING PERMrl~~rEC~ON RECORD . . i,..1' '..'.' r' ~ i:-;, t "~~'/:'. r ;.d,;,' _/:, ,,_'<-~f';~~#'.'>"'rt' CALL417~4815 FOR BUILDING INSPECTIONS.PLEASE.PROYIDE^ MINIMUM 24 HOuRNOTICE.. IT IS UNLAWFUL Tpp(itER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION; KEEP PERMIT <,::^RD AND APPROVED PLANS AT JOB SITE .,..,,'"'' INSPECTION TYPE DATE I ~CCEPTED iJ . COMMENTS ' ?~. ." YES I NO '.' ,. FOUNDATION: '., , ..' FOOTINGS '.' WALLS '. . FOUNDATION DRAINAGE .' ELECTRICAL (LIGHT DEPT) SEfARATE PERMIT: # ". ,. }, '\', , ROUGH-IN I I . PLUMBING ';.f. ...... UNDER FLOOR I SLAB ROUGH.IN 7Ftt. 'fA? JL WATERLINE . , - GAS LINE ~-t ,. BACK FLOW I WATER . '. , , .' AIR SEAL .... WALLS CEILING I.' ". FRAMING F-:')./-o~ In&;p#".J:Gl~'. ~Jp I-C- JOISTS I GIRDERS ,"S~ll~ &"~pf'/~tBJicl ~ter- ttdf- SHEAR WALL .' j 1') 1,81-111 h:.tL./~,' . ., J, J- WALLS I ROOF I CEILING rL];: lit?' ..I.l. p,,,,~J- pI}- 1/.../1' ~ "5 J~J.." DRYWALL , I , . T-BAR INSULATION SLAB T WALL I FLOOR / CEILING I/;i,'!,. . .... . ". MECHANICAL' '. . HEAT PUMP '. .... . WOOD STOVE I PELLET / CmMNEY HOOD / DUCTS '. '.C :.c':' '.. .....'1.. '.. PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:. ;'- :'~ '.' . WATERLINE / METER SEWER: CONNECTION :,' SANITARY STORM . PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTING ESA: LANDSCAPING' . , . SHORELINE: . .... , '. ....;., FIN~ill/~t~CTlPNSR.lj:QtJJRED PRIOR TO OCcyrAN9YIVSE~:'; '.' ,.... . '. ~ _ ,!,_' ,,- H j.. 1>~b:'" I' AcC'EfuD':: , JU:S1D~IAL .;,. DATE. ' YES NO . ,. CO~~~f~.4L , ,;...., .;;-,) ", .... '''.., , ,-" ~..-. .., ...., .... f ":' . s ,'" ."-;~ '" ' . ;., ""YES'", ,NO ELECTRItAL.- LIG~T DEpJ,'- 417-4735 i ., -,.- ELECTIuCAL . " : '.;,;"., . '; ,LlGHT,DEP';J;"; ;,: , .: .... '. . .... C',;.' CONSTRUCTION R. W./ PW/ , . , CONSTRUCTION- R. w. '." ". "".'0,;;' ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 ". FIRE DEPT. . . - '. I PLANNING DEPT. - ~~~ ~)t'k.(L 417-4750 PtANNlNG DEPT. .' .. BUILDING 417-4815 JIW' ~JO.T Irl/ BUILDING -' " -. ,. ,_." ~.f""" -- ;_~ ,I , , .,...,.... ", ~ J ,.I., f,_,~ (,to.') f".... j. c.- ~ _# T:\PLANNING\FORMS\1102.15 [412002] CITY OF'PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . .. INSPECTION REPORT. . . . . . . . . . . REQUEST. /A/ A Date Time~Received by .:.-- j,,,- ~ersonl Location of Work to be inspected ~ -L-) Name of person requesting inspection .. I!:.~).-l Address of person requesting inspection Phone No..!1.&.() "-lX)SP Type of Inspection (circle appropriate one):. Permit No. III ~ Sewer Foundation Framing Chimney Plumbintgewer Excav. Other /D~ Inspected: Date Remarks: Time---PM- By ~ ct)L- RESTORATION REQUIRED . . . . .. YES \ NO ~v1 ~Di\.- \C~y ~ b,,= ~ }:: H - rltJ~' "1 b;t1 S~ ~ +h.-IL r SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved o Gravel o Asphalt OPCC o Other o Repaired by City D Repaired by Permittee D No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUeERINTfNDENT (DATE) CITY OF PORT ANGELES / DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST: Date c9G - orb -0 ~ Time -(.' 6- 6- Received by _<:::.~. ~ person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle a priate one~ Sewer Foundatio ChimneY~Final i ')-1 W L o.th- (.190.-1 t Phone No. t/ 6/ -o.')-Jf? Permit No. I J./. q Sewer Excav. Other INSPECTION NOTES: Time~ fL1- By SJT Inspected: Date Remarks: 'pf- RESTORATION REQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved o Gravel o Asphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE 'Fontinue 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 Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing o').J 1~2 r1 C.A ) I (:) rh - INSPECTION NOTE~ Inspected: . Date ?; \ \)/ \; Remarks: Time-GJ 11 !IV 1L- 'OV -/- 7~\-5~'l - . ..\) ~ t"l\..W\Ile '. . ... .. . ~ J-u .. ... RESTORATION REQUIRED . . . . .. YES NO 0. 6/, 's cv..~ ) Y1 I 00 ___ JOU We..... + ~. . a+ fi4Wl ~re.. .f-'{oorid r loa!:- J.c,'-O y1] SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 pcc D Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERll\IltENPJ;.I\IT ([)A l;E) IJ~ b?5 / C\'fs\- 4 '34. coc.> B~NG~MIi- - A~PLlcfl~I~~ 4. ~-o f' 't e- .:J 'i.,d- FOR OFFICIAL USE ONLY: Date Rec.: Permit #: Date Approved: :z.",- Date Issued: The Building Permit Application must be filled out completely. Please type or print in ink. If you have any questions, please call 417-48 15 ~6 OCJ ~ ~ Applicant or Agent: ~c:rz;::r: {fr:IY>1..e.s . Phone!: 4$;>- 97010 Owner: [J.~-,u ~ 0 j I b~ Phtne: LiS;;> 76.3 I 6"kJ I Address: t6;;)/ W It:> City: f A i Zip: ?CZ3 ~ ~ Architect/Engineer: ~- (J~- -J Contractor CrJZ-:r- License #: Address: "S~ If F crtZ City: PROJECT ADDRESS: Q....) I c...v to LEGAL DESCRIPTION: Lot: . 0f\J h Block: CLALLAM COUNTY PARCEL NUMBER: Billing Address: Credit Card #: ~Phone: Exfl/~ Phone: I I I I I ZONING: SUbdivision:~ Credit Card Holder Name: I City: i Exp. Date: (5IJ f-/l Zip: VISA MC TYPE OF WORK: t:f!( Residential 0 New Constr. o Multi-family ~. Adqition o Commercial 0 Remodel o Repair ORe-roof o Move o Demolition o Sign IZEN ALUATION: 45D SF. @$ /SF. =.$ ~b)q4 7.<90 SF. @ $ /SF. = $ SF.@$ I /SF.=$~' TOTAL VALU1TION $ gqJ I ~~ p()'toJ/~ I I Occupant Load: tJ-It % i /sq. ft. = TOT A~ LOT COVERAGE: APPRqV ALS: PLAN I BLDG. ! DPW i FIRE ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: I OTHER BUILDING PERMIT APPLICATION SUBMIl'T AL: Your application and site plan must bt filled out completely to be accepted for review. The Building Division can provide you with more detailed information on the applicatiop. and plan submittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitteq to the Building Division. I VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by ~e applicant. This figure will be reviewed and may be revised by the Building Divisionto comply with current fee schedules. Contact the Pe~t Coordinator at 417 -4815 for assistance. i 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 issuance. I EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date ofappli~ation, this application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written requbst by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I . I hereby certify that I have read and examined this application and know the same to be true and horrect, and I am authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits re required; it remains the applicant's responsibility to determine what permits are required and to obtain su h. COMMERCIAL/RESIDENTIAL: Occupancy Gro\lp.;- No. of Stories: ~ Lot Size: S}C l~D % Lot Coverage: Existing Lot Coverage: /sq. ft. + Proposed Lot Coverage: PLANNING USE ONLY: Notes: i ; Construction Type: BRIEF DESC~OF THE PROJECT: -s;;-t-, ~ r--i r. ~ /sq. ft. Applicant: Date: ;l ~/1-(J3 T:\FORMS\APPS\Buildingpermit " i ....- -. i :\ ~., DE. SC R./ P710rJ "., " , ,bf,\RAG~ :E x, S -rllJ l7. JJOU ~ E.. TaTA L LOT 15 BLp c 1<2. q ,q ; V6RttJ t' ;1'ARV S6HLBERG 82/ W, S9. F r: 2'Y(, 528 /232 20it, , ',LJI?EA o~,Lo-r (t'1-841 -0 AJctJV: e R {; D 70% GRouvP F L 00 R. '. , Ex 1 S-r J '/J '(f, 4'100 ..,I I d, T tIrv. OF PO~T ANGELES _ Construction Plans 'The Issuance 0 this rmit based upon these plans, specifi- cations andoth r da'shall not prevent the building official from thereafte~ req,ybfJIg the correction of errors in said pIa ns, specificcltionRnd, other data, or from preventing building operations jng carried on thereunder when In ordinances~ ofju ljiECTION 303, ,). Un, ding Code.)' , < " 1, t)~ B ,,' Approval,Date ; y, , ALLE..Y , , Zz.x 2+ , " Ji' bC?,' ARp\GE. ' ,1\, - J" i I ' , 'I 18"0 II SHEO i " I I ,I , - ~ " ,,' .. 'i ,I ~ I I."" -ro' .f ~ .,-- I . ., i/lenJ ~II L ~1'" ",""-f\ J '" I )~~ I tif I Jj Tlf./ I '~I \ \"\ \ . rf 'I. to \) 1\" fl') I 1\ )( 0 ~.,- I .-h~' .., f , 0 I 1--- u. *~ 1 . / "'" ,-. ~c ~ "-..~ J v 7 -. . o . \ V , (' 0( A.. de ..-(" . JRct~~1\ -- r lit:].... ()~~f~ OA \< ~kT ,.* / ~, In,'~ ., ~ "'4~ ~ ~ /C.L- - v :- 'I rH J;wlf': 1"";1.lI~ / ~a~.,~~ _I. 1 ~. / "..,.. ~... .tr a... tA. . t.I\ .... !4= .Y-- · ~ t=~i< t. 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'), ". . f . .. i.. -. i ';,.:' i\ . . . \'\ -:; . / ,- '00;" ,"' ...,.". ......... . : D:s.s~({'1 P.7Io'tJ . , . : ': . . .~J?RQP.o s &0 . . .; . !'.8. .rfJ' RoiJ;hV\' ...,:; 'TA~4i+i~',i, :7" ~ - ./: .: I ":, .J;'~R~iGe'; ,. : . li~' I. j' ~ . '. . " .. .. ~. . j' . .' . : . . ; . I . .: J. " 2tJ~ ':STd~Y A 00 .~:~ t 0 ~ 20'~ . Z. 4/ : r.u I ';....): ;O;L-.YL..K..... I . . . . I . . ~ , Vil?l\J f' ,frt~R..Y 56 HLBERG . '82 I: W, I () -r H , ,,' -I :ALLE.Y f, @ . . " If' S9. F:T: :2576 " J '2~x 2+ ;, .'~. \ :' . .. ::~'. GM~G~'. . . .i^. . .... .... . .' . , .. 5Z8, '. . ", 8xJQ. ..: "~ , ,,' . (?I061:. , . , ,,' . .' -- .... () N -" .. Itf 4. 2~ . o .. . . ZD)(~ I:, . ~. .' ~ ~ ~ ~ /1) :!J c; r: r~x AS NE t:/:) cO . ,b :." r +-t. Ii' fl2 Ot ~., -_.f.- ...... I ! .-.......1'-- . _.--~-- - ._- c_ --t __ . I ! l' ...~ JI.t, tr~.. -- D ! 1-+ -+-:8 2.,' :'L~ ~= =t '+ '-+--J+-' -i--'-}!' ( -- VVI t'-t~-f-- tl'1 -----;---- -+- --~ -~!L l:r e1); 1'---1-. 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'S~< ~... ~4~~t."'Z _:ro:!H '1\ j. 1I~ \ ,,-:J..o:.l? - - = ~i ~ ~ ~ ~ % \J ~~ \\- 'p;-" -"..-.---....-=-.>.;.;.. ;,""_tJP. ~, .. v~L,.. 'Ne.\.V ~ , f#f ; ql_li~u ~f. . \ II 71-1~ ~ ~.e:c, -( lO N , II Y4 II -:::.11_ 0 t~ CITY OF PORT ANGELES DEP~TMENT OF COMM~ITY DEVELOPMENT BUILD~G DWISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number ..... 0300000035 Date 1/30/03 Property Address ...... 821 W 10TH ST ASSESSOR PARCEL NUMBER: 0630000299700000 Application description . . . ELECTRICAL ONLY Property Zoning ....... Application valuation .... 0 Property owner ....... SOHLBERG VEP~NON Owner address ........ 821 W 10TH ST PORT ANGELES WA 983635727 () Contractor ......... SFL~MP ELECTRICAL CONTRACTING Permit ...... ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee .... 35.20 Plan Check Fee . . .00 Issue Date .... 1/30/03 Valuation .... 0 Expiration Date . . 7/29/03 Qty Unit Charge Per Extension 1.00 35.2000 ECH EL-R OR RM REPAIR METER/MAST 35.20 Fee summary Charged Paid Credited Due Permit Fee Total 35.20 35.20 .00 .00 Plan Check Total .00 .0O .00 .00 Grand Total 35.20 35.20 .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 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 las inspection, I hereby certify that I have read and examined this application and know the same to be true and correct. All previsions o 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:~PLANNING~FORMS\1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 41%4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 1N A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DILA. INAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING ELECTRICAL - LIGHT DEPT. 417-4735j/~.~O/LD.~t4a~ LIGHT ELECTRiCAL DEITY ELECTRICAL PERMIT APPLICATION ~OR OF~ICI.\L l'~t. U:\L 1 D~liIil-tL: ___,,~~.- rermJ":~-- [:~[~ A,,:m,~d: _ ''" ' D"lcJ~~u~d .,___~""~ Owner or Elec. Contractor Agent: property ownsr:~ ~ The Electrical Permit ApplIcation must be tilled out comoletelv. please type or reprint in ink_ If you nave any qU~:iltlon~l please (1311 (360. 417..47~r; 08 - :3 5 Fa. numl><!" (360) 417.471 1 :~ REQUEST INSPECTION r ~. phone; LfS-z-~ 1.4 e. , Fax: tfSZ-{J:. g<t AddriCl';;:;l:: ~ U ""'" cz.e~ Electrical Contractor: ~H..Jw-\<? \.. I 11, ...,,, -. Address: ....~, \-""'-;":: ~ . .~ City; ~A.~~e2".Yl_-;!~'.3 c.,,~ n<<.:r1""G- I <lC Liesnse #: City: PO,""" ''\-N61t('6 = OWN~A \1, ELECTRICAL CONTRACTOR INSTALLATION WIRED BY: .. f\ Credit Card Holder Name; S 11. '" U-t,! S N'rJ-.,.f' B;1II119Address: '9"10 ~.:. /<;)""3.. ,;;..- City: Pc.rz.-.:- A....bO"'~ \ O'.l\ tJ..1. Sl :; ...~p f-1..EcrlJ.tc.A<C "5 c \A- 1,..8 li'C(.- \ ~ ij <f.-T Phone: \N. Porzx A.J.!.6,r;,. L.es Exp; ~3 ~ Zip ~2,3~3" pnoou, l/S't-I bil9 Zl~: "l'iJ~~ 1.J4 Zip: q S3-'3 V/SA:.L MC:_ PROJECT ADDRESS: lQ '--\ '=: Residen\al :J Multi-family G Corrlrrll:lrcie.l ~Iteration/ Addition o Mobilo Home Sq. Ft. TYPE OF WORK: Check all that apply: CJ New C:J Remote M",t", [j Detached garage :J Hot Tub C Swim Pool :J Septic Pump 0 Low Voltage :J Telecom. ':J S Number :If Circuits added or altered: DESCRIPTION OF THE ELECTRICAl PROJECT:_~ ~ M'2.-~ 1P PIW0--- ('"fZ,'-f'Pc\lZ. cl'- ",,,,-TV- c.W~"'O <$ l-e>Af) c.e. ,,^-fl$r) fI 35 ~ ~(j)'i. Wl,L.~S ~J<J\ ft;t. '$:> s .~ , EOlectrical Heal Load Additions ~ ~'f/rTN., Service Information Voltage: .!~.__ Phase: ili, c 3 Service S-i~e: ~ Feede' SjZE,,_7~,~ rJ Baseboard o Furnace !.J H.al Pump LJ Fan-Wall _KW KW _KW _KW ~verhead Service E. Temp Service U Underground Sarvies PAMe 14.05.060(8): For indu~trio.l, cornmGl'cial, & r~~ldentia! projects l~rg13r ~h.?ln Pl, d1Ipl€Y, g size (sq. ft.). 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 i authorized 10 appiy for Ihis permit. I undeJT5tand it i~ not ths City's logal responsibility to determine what permits are required; it remains the applicants responsibility to determine what permits are required and to obtain such. pD f(Lf}) l\l,dD Credit Card Holder's Signature; ~_h.2--- 5h v~__ .p---,,- .' -'L-" Date:~~, 1 . Date: ~ Owner or Elee. Cont. Signature: $W-9cD~ j-/?"cJ