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HomeMy WebLinkAbout1101 E 7th St - Building"OR T", CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 08 00000759 Date 6/27/08 Application pin number 935895 Property Address 1101 E 7TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 1055 0000 Application type description PUBLIC WORKS UTILITES Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Bore phone service under alley & 120 plow R/W Owner Contractor TOWNSEND BARBARA ANN EXCEL UTILITIES CONSTRUCTION PO BOX 535 54 MISTY LN PORT ANGELES WA 983620101 PORT ANGELES WA 98362 (360) 452 1110 Permit RIGHT OF WAY Additional desc 20 BORE/ALLEY 120 PLOW Permit pin number 128892 Permit Fee 00 Plan Check Fee '00 Issue Date 6/27/08 Valuation 0 Expiration Date 12/24/08 Fee summary Charged Paid Credited Due Permit Fee Total 00 00 00 00 Plan Check Total 00 00 00 00 Grand Total 00 00 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 Contractor or Authorized Agent T•\Po1icies\1102.15R [1/05] Date Signature of Owner (if owner is builder) Date F) 1 PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,. INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE I DATE I ACCEPTED COMMENTS YES I NO PW UTILITIES (Engineering Division) WATERLINE / METER I SEWER'CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK', CURB & GUTTER DRIVEWAY -APPROACH BACK-FLOW DEVICE y. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES, NO COMMERCIAL -- '--DATE-- ACCEPTED YES' NO. CONSTRUCTION R'.W / PW/' CONSTRUCTION R.W ENGINEERING 417-4807 PW / ENGINEERING FIRE' 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T•)Policies\t 102.15R [ 1/05] a °�;F� CITY OF PORT ANGELES �DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 07 00000809 Date 7/23/07 Application pin number 533344 Property Address 1101 E 7TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 1055 0000 Tenant nbr name TOM KAUFMANN Application type description RES REMODEL Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 40000 Owner Contractor THOMAS / TERESA KAUFMANN OWNER PO BOX 2553 PORT ANGELES WA 98362 (360) 457 8010 Permit BUILDING PERMIT RESIDENTIAL Additional desc INTERIOR REMODEL Permit pin number 106542 Permit Fee 569 25 Plan Check Fee 227 70 Issue Date 7/23/07 Valuation 40000 Expiration Date 1/19/08 Qty Unit Charge Per Extension BASE FEE 417 75 15 00 10 1000 THOU BL -25 001 50K (10 10 PER K) 151 50 Permit MECHANICAL PERMIT Additional desc Permit pin number 107284 Permit Fee 164 20 Plan Check Fee 00 Issue Date 7/23/07 Valuation 0 Expiration Date 1/19/08 Qty Unit Charge Per Extension BASE FEE 50 00 4 00 7 2500 ECH ME VENT FAN 29 00 8 00 10 6500 ECH ME OTHER APPL N/R 85 20 Permit PLUMBING PERMIT Additional desc Permit pin number 107276 Permit Fee 149 00 Plan Check Fee 00 Issue Date 7/23/07 Valuation 0 Expiration Date 1/19/08 Qty Unit Charge Per Extension BASE FEE 50 00 10 00 7 0000 ECH PL- EA FIXTURE ON ONE TRAP 70 00 1 00 7 0000 ECH PL- EA INSTALL WATER PIPE 7 00 1 00 15 0000 ECH PL- EA BLDG SEWER 15 00 1 00 7 0000 ECH PL- EA WATER HEATER 7 00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments 07/19/2007 05 26 PM SROBERDS The proposal will result 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 Ownev owner is builder) Date T \Policies\I 102_15 building pennit inspection record05 wpd [1/4/2005] BUILDING PERMIT INSPECTION RECORD CALL 41"i-481 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAN FUL TO COVER, INSULATE OR CONCEAL ANI N'OPJ BEFORE c I.A'SPECTED 4.1VD ACCEPTED POST PERMIT IN 4 CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT .JOB SITE. INSPECTION TYPE I DATE, ACCEI'TE NO I NO ES FOUNDATION: FOOTINGS SHEAR WALLS / WALLS FOUNDATION`' DRAINAGE/ DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDERFLOOR/SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS/ GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL/ FLOOR/ CEILING MECHANICAL ROUGH -IN HEAT PUMP/FURNACE/DUCTS GAS LINE WOOD STOVE/ PELLET/ CHIMNEY MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING 1 FINAL 1 1 1 FINAL DATE DATE PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING/LIGHTING I I ESA. I LANDSCAPING I SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL ELECTRICAL LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W /PW/ CONSTRUCTION R.W ENGINEERING 417-4807 PW /ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 _- BUILDING T \Policies\1102 15 building permit inspection record05 wpd (1/4/2005] ACCEPTED BY. ACCEPTED BY. DATE I ACCEPTED YES I NO CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Page 2 Application Number 07 00000809 Date 7/23/07 Application pin number 533344 Special Notes and Comments in extensive remodel of a sfr in the RS 7 zone The e/w facing lot setbacks were compromised when the lot was turned e/w from n/s The property owner wishes to identify the front setback as from Chambers which is permissible given the lot configuration BUT once so determined it will remain The proposal will not result in enlargement of the existing footprint No land use issues are anticipated at this time MAINTAIN CLEARANCES FROM SERVICE WIRES Electrical load calculations and elctrical permits are required Any modifications to the City s electrical facilities will be at the customer s expense Public Works Utility Engineering has no requirements for this plan review Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 882 45 882 45 00 00 Plan Check Total 227 70 227 70 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 1114 65 1114 65 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 Contractor or Authorized Agent T \Policies\l 102_15 building permit inspection record05 wpd [1/4/2005] Date Signature of Owner (if owner is builder) Date BUILDING PERMIT INSPECTION RECORD Q CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE 4, 1dIINIJMUM 24 HOUR NOTICE. ITIS UNLAN FUL TO COVER, INSULATE OR CONCEAL ANI' WORK LErORE ss � INSPECTED 4ND ACCEPTED POST PERMIT INA CONSPICUOUS LOCATION 4i KEEP PERMIT CARD AND APPROVED PLANS AT .JOB SITE. INSPECTION TYPEI DATE I ACCEPTED I COMMENTS YES I NO FOUNDATION: FOOTINGS SHEAR WALLS/ WALLS FOUNDATION DRAINAGE/ DOWN SPOUTS i PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDERFLOOR/SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL ROUGH -IN HEAT PUMP/FURNACE/DUCTS FINAL DATE GAS LINE I I I FINAL DATE WOOD STOVE/PELLET/CHIMNEY � I MANUFACTURED HOMES I l FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #Ys J SEPA. PARKING/LIGHTING I ESA. LANDSCAPING �- __- I I SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL I DATE I YES I NO I COMMERCIAL ELECTRICAL LIGHT DEPT 417-4735 I I I LIGHT DEPT R.W / PW/ W ENGINEERINGCONSTRUCTION 417-4807 I I l WI% ENGINEERING RING FIRE 417-4653 I FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 I BUILDING T-\Policies\l 102 15 building permit inspection record05 wpd [1/4/2005] ACCEPTED BY. ACCEPTED BY. DATE I ACCEPTED YES I NO A0 S ',#,6rp,r� hest 't,,Zs[bs'5 &� �, �ooy 4t 5 �K (0 CAI) 101 ao'\wz Y -o- AANX tl^ C7 FOR OFFICLA-L USE ONLY 'BUILDING PERMIT - APPLICATION Date Rec -7 I Pennit ?-7 ' 'r Fill out COMPLETED' and in INK. Your application and site plan MUST BE =t"M COMPLETE to be accepted for review -If you have any questions, call ate Approve - PERMITS (360) 417-4815 FAX(360)417-4711 - Issued:. I =:7_1 IV6-7 Applicant or Agent: �n PA in., m 0 Owner- —7-0 NA \/,-,aJ AAn KI K-1 Address.�\nj V Architect/Engineer- Contractor 4z\v Address: �. (-) VV -A PROJECT ADDRESS k k C) k Phone: Phone. r) 10 City , y(na-T At'a'eke-' ZIP q?1 Phone: State License 4 - city. (,.t Zes LEGAL DESCRIPTION Lot. --'-,-I - VO- t( Block: (') CLALLAM COUNTY PARCEL NUMBER. f) Exp Phone: ZIP Subdivision. ZONING r--, W. owner 'Per Sve of home faces c.kamr ers st 'A I'D ONek-0— 15 TYPE OF WORK. SIZENALUATION 0 Residential 11 New Constr D Re -roof 0 Stove SF @$ /SF c Multi -family 0 Addition 0 Move 0 Garage SF @$ / F 11 Commercial 9 Remodel 11 Demolition 11 Deck SF /SF - 0 Repair 13 Sip o Other TOTAL VALUATION $ BRIEF DESCRIPTION OF THE PROJECT taOc~ W-, -re-,, �b (-t tx < It A 9 n Le.PIAI" LNY%A V-, )AA �Q uCA N tj<NA CA -V i 0,11,flmeet COMMERCIAL/RESIDENTIAL. Occupancy Group Occupant Load. Construction Type: No of Stones: � Lot Size: -7,000 Existing Sq Ft. f_�4�4(�6 &Proposed Sq Ft. =TOTAL Sq Ft. Total lot coverage I % Movinq, �OcaJioh a+ electricj+y aacr. ejjj+0 j+,,e Qz,�lek\ simc+vm—re,4omj ermvp, (y-,jekA1or of- +)e_kami hone.. PLANNING USE ONLY APPROVALS PLAN BLDG DPWU :5- ESAIWetland(s) 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other- FIRE. - OTHER. VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. 00 PLAN CHECK FEE IF a plan check fer, 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 If no permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section RI 05.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. 1 hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required not the City's, and that I must obtain such permits prior to work. TAF0RMS\B1dgPenmitforTn.wpd Applicant. Date: 7-q-07 V/ Prescriptive Approacb-Simple Form For the Washington State Energy Code ( 2003 Edition Climate Zone I Site Information Building Department Use Only Lot: Permit# %09 Address: i n i -7" Notes. City. State. Zip. Contact: Phone. Phone 2. FAX. Table 6-1 PRESCRIPTIVE REQUIREMENTS FOR GROUP R OCCUPANCY CLIMATE ZONE I Unlimited Glazing Option Only) Option Glazing Glazing U -Factor Door Wall Wall Wall Slab Area % U- Vaulted Above Interior Exterior on of Floor Vertical Overhead Factor Ceiling Ceiling Grade Below Below Floor Grade Grade Grade Unlimited' Ill Group R 3 040 0.58 0.20 R 38 R 30 R21 R 21 R 10 R 30 R 10 Occupancy Only This Project complies with the following: V The Project is a single fan -lily residence or duplex. V The Project is wood frame OR all of the insulation is interior or exterior of the framing. VAH building components meet the requirements listed in Table 6-1 Option III. t/ The Project will meet all other provisions of the WSEC and VIAQ The Project will take advantage of the following exceptions to the prescriptive option P 602.6 Exception I One door, that is 24ft. Or less, that does not meet the standards allowed. Location of the door taking this exception 0 602.6 Exception 2. Doors with a U -Factor of 0 40 allowed without calculations, Option III only Location of the Door (s) taking exception Type of Heat Source: �Ocil � kAo-c-ir-9—N,; EXHIBIT A I 1 1 ,1 1 V '� CITY OF -PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321'EAST 5TH STREET .PORT ANGELES, WA 98362 Application Number 07 00000791 Date 7/09/07 Application pin number 560014 Property Address 1101 E 7TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 1055 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Owner Contractor TOWNSEND BARBARA ANN OWNER PO BOX 535 PORT ANGELES WA 983620101 Permit ELECTRICAL NEW RESIDENTIAL Additional desc OWNER/ 2042.SQ.FT SF.R< Permit pin number 106534 Permit Fee 135;00 Plan Check -Fee 00' Issue Date 7/0,9/0.7' Valuation 0 Expiration Date 1/6'5/0"8 Qty Unit Charge Per Extension 1 00 69 0000 ECH EL R SQFT FIRST 1300 69 00 3 00 22 0000 5C EL R SQFT ADDITIONAL 500 6,6 .0.0. Fee summary Charged Paid Credited Due Permit Fee Total 135 00 135 00 00 00 Plan Check Total 00 00 0'6 00 Grand Total 135 00 135 00 00 00 0 COMMENTS/ACTION NEEDED I =- ELECTRICAL PERMIT INSPECTION RECORD CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE ITIS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE i INSPECTION TYPEDATE , ACCEPTED COMMENTS IYES I NO DITCH/2c{/OgJ ROUGH -IN / COVER ' , SERVICE h/Z/XPi - FINAL I I I 1 MST? `71 .1 /4)7 , GENERAL COMMENTS: Pw-1102.1514"961 / Job wired by ❑ Electrical Contractor Owner ELECTRICAL WORK PERMITAPPLICATION '\/"Installation description ❑ Commercial Residential U Electrical contractor ame License number Date Expires El New ' ❑Altered/Addition 0 M 1/ aO�n�u Purchaser's mailing address AMD sem, tty State ZIP �] A - 4 t )�)�.1� Ir I CJv QL7.S�.� � N ( t Telephone number(` FAX number M �� I �] Q� Pr_em-i-sees owners na e 1 SAA_ Address of in ection r t© t `Z��d�� Cup, Phone number to schedule inspection ` 11 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 contractor if above said property is for sale, rent or lease. ❑ Cash ❑ Check # 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 instal- El Credit Card Visa Mastercard Discover lation or alteration in compliance with the electrical laws, N.E.C. RCW Chapter 19.28, WAC Chapter 296-46B The City of Port Angeles Municipal Code, and Card # — — — — — — — — — — — — — — — — Utility Specifications. /Signature�f owner lectrical contractor or electrical administrator Expiration Date / Inspection fee � ( X Dateofcard $ Electrical Load Add' i s and or subtractions Service Information El NO LOAD CHANG Z/o ❑ Baseboard _ KWVoltage LlFurnace _ KW Overhead Service Phase ❑ 1 ❑ 3� ❑ Heat Pump _ Ton LAR ❑ Temp Service Service Size: ❑ Fan -Wall _ KW ❑ Underground Service Feeder Size. SAME DAY INSPECTION, CALL BEFORE 7 00 AM 360-417-4735 ROUGH-INTHERMOSTAT SERVICE Date Appr ed By Date Appr ed By Date Approved By FINAL DTI CH FEEDER Date Appr ed By O:a, Appr ed By \ Date Appr ed By Inspection Area, Building or Equipment Inspected Date Action Taken Electrical Inspector 7-13 a7 RECEIVE® JUN N 8 20 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . Pin number . . . . . . .2678 Property Address . . . . . . ASSESSOR PARCEL NUMBER: Application description . . . Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . Application valuation . . . . 03-00001138 Date 4/08/04 1101 E 7TH ST 06 -30 -00 -0 -2 -1055 -0000 - RES REMODEL RS7 RESDNTL SINGLE FAMILY 2500 Owner Contractor TOWNSEND BARBARA ANN OWNER PO BOX 535 PORT ANGELES WA 983620101 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL NEW RESIDENTIAL Additional desc 200A PNL/ RE -WIRE Sub Contractor D R LINDSLEY ELECTRIC Permit Fee . . . . 76.30 Plan Check Fee .00 Issue Date . . . . 4/08/04 Valuation . . . . 0 Expiration Date . . 10/05/04 Qty Unit Charge Per Extension 1.00 76.3000 ECH EL -RM -0-200 1ST SRV FEEDER 76.30 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 76.30 76.30 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 80.80 80.80 .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 Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1102.15 [11/14/20031 BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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 I ACCEPTED COMMENTS I I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH -IN PLUMBING UNDER FLOOR / SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE/PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY y P STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: ax PARKING/LIGHTING ESA: t4 o q . os LANDSCAPING I l SHORELINE: RESIDENTIAL ELECTRICAL - LIGHT DEPT CONSTRUCTION R.W. / PW/ ENGINEERING FIRE PLANNING DEPT. BUILDING TAPLANNING\FORMSA 102.15 [11/14/20031 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION - R.W. 417-4807 PW / ENGINEERING 417-4653 FIRE DEPT. 417-4750 PLANNING DEPT. 417-4815 BUILDING DATE ACCEPTED YES NO P WORD = Bil(3N aa M C- PSWIT:�� � � PERMIT NO: 12230' ISSUED ' �9/251��A' � ` 131111" EF APPLfOANT : _', PR4iRrf"LOCATION [BARBARA TOWNSEND A, T.E 1.101 E. 7TH ST Lot _ S_ 1,12 OFA, & 9 Port Angeles:, WA 98352 :. B" - .210 [ L.ong LOW 360/434-W78 ubd fon: TPA a, ' .: W , P; No: PONTW, TOR AReI4I*EC-T. = _ OWNER .:. fZ' VARIOUS fort Angeles , WA 990 , `110 ,,; . �.... r_ /OOo-GOOD :. (IO PROJECTINFO Project Value: $S,OOO.Ot1 � _ SFD Unjts: �_. 0 " Oomr�t Project Type SFR ADD/REM 0tL , [ `'S f* 1: 0 Irt� Maf Occupancy Type, RESIDENTIAL Gore Occupancy Group: MFD Un:.,. 0 .... 0 Construction Type: aMFD SO f`T �! _e Zoning Use: RS7 j PROJECT NOTES„ Ab"EW FOUNDATIONM2EPAfRWGiO'0D''ROT/ADCC DORMS rm TM "v :FEFS i4ES3fikFENIT Building Permit: $111.25 M sc Fee 1 $0.,00 Plan Cheek: . r $44.60 I�F StateSurd+ : $4.50 Mlic Fee 3 $0.00 q; Douse Moving: $0.00 Manufactured Hoare: $4.00 _ Sign: $0.00 TOTAL SEE: $160.25 Plumbing: $0.00 AMOUNT PAfD.. $`I6�i.25 Mechanical: $0.00 ECf~ DUE: $0.00 Radon: $0.00 I RW SANITARY W TE1t STORM'' S 0"'In is are recj�red dor etocM�l vM�k, Improvemuft This .�.... Or aadfS not commenr�d��18t� �� � fo iwii ft oK or N required ins , atter tl�appWca6onandlvttree#e” r� -, m._ ,: ,> J �is�s of firs shtl o 0two* v sPe cdidid t�ereur� � ����`noE ptewNrrsfo�re aa�ihoritti°ie'violat�e ;:... r dei th+e etete toca law reguiat% 1 or the oe of oor.�udio t_ of L r. or Authcarraed.&ent . tate „ r ;r osihre of Owner cif owner is . PORr:�ib ,''p BUILDING PERMIT APPLICATION p The Building Permit - Preapplication must be filled out completely. Please type or print in ink. If you have any questions, please call 4174815 Applicant and/or Agent: -�3/�-�- lvwivSF�� Owner: 705-1-vivSZ-=N4� Address: ✓/4/5 7'`ti . City: 1? Architect/Engineer: O WNE-R, Contractor it I'v &j&? License #: Address: City: PROJECT ADDRESS: LEGAL DESCRIPTION: Lot: 2 I0, 1 ! Block: 2. I CLALLAM COUNTY PARCEL NUMBER: Exp: FOR OFFICIAL USE ONLY: Date Ree.:` —7,,jP —OG Permit#- i �Z�n Date Approved - Date Issued: Phone: 0 5135- &S7e) Phone: Zip: %'Q (o Z -- Phone: Phone: Zip: ZONING IZS Subdivision: —T—p r/ -t- TYPE OF WORK:. SIZE/VALUATION: ,0 Residential o New Constr. 17 Reroof o Woodstove SF. @ $ /SF. = $ 5aQ 5 —' o Multi -family IX Addition o Move a Garage SF. @ $ /SF. = $ o Commercial p Remodel of Demolition ff Deck SF. @ $ /SF. = $ 9 Repair 0 Sign o TOTAL VALUATION $ BRIEF DESCRIPTION OF THE PROJECT: GOiVSra_ir_ i G'UY�CO r -E 1v v�,� Ti 0 1 f? R�gC..Er Jin DOlr )K'8f;A DAorz—1ZjQQD'Tw0 .f f277F,c'oyiSr1ucr Pkf'*46" J2W*! COMMERCIAL/RESIDENTIAL: Occupancy Group: 3 -7 Occupant Load: I Construction Type: No. of Stories: Lot Size: !)n n % Lot Coverage: Existing Lot Coverage: /sq. ft. + Proposed Lot Coverage: /sq. ft = TOTAL LOT COVERAGE: /sq.ft PLANNING USE ONLY: APPROVALS: PLAN Permits Required: Notes: BLDG Max. Height: Setbacks: Zoning: DPW Site Plan and Use Approved by: Date: FIRE ESA/Wetland(s): o Yes o No SEPA Checklist required? o Yes a No Other: OTHER BUILDING APPLICATION SUBMITTAL: Your application and site plan must be oiled out completely to be accepted for review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. BUILDING PERMIT APPLICATION SUBMITTAL: Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Div. to comply with current fee schedules. Contact the Permit 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 issuance. EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this application will expire by limitations. The Building Official can extend the time for action by the applicant up to 180 days, on written request by the applicant (see Section 107.4 of the Uniform Building Code, current 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 twe and for this permit. I understand it is not the City's legal responsibility to determine what rmits cy responsibility to determine what permits are required and to obtain such. V am authorized to apply it remains the applicant's O Applic Date: P W-1102 13 [rev.2/99] I t ■EN& �m it��t4 3!� -- -- vp!:�,m � -�- Craig R. Owen, P.E. Consulting Structural Engineer 220 E. First Street Port Angeles, WA 98362 September 18, 2000 Barb Townsend 1101 E. 7th Street Port Angeles, WA 98362 Dear Ms. Townsend; Phone: (360) 452-8574 Fax: (360) 457-8020 RE: Exterior Foundation Review for a Second Story Addition to the New Portion of Townsend Residence I have reviewed the specified foundation for support of the intended framing for the second story addition proposed by Bill Townsend and found it to be adequate, based on provisions of the 1997 Uniform Building Code (UBC). If the existing 14" tall 6" thick foundation wall with 12" wide footing meets the minimum reinforcement requirements of Chapter 26 and soil capacity of Class 3 or 4 materials of Table 29-B, UBC, of the 1969, 1972 or more recent UBC (with different chapter numbering for the most -recent editions) for concrete construction, then the proposed second story 14, X 24, addition will not cause a violation of the UBC. The gravity load situation will actually be improved as the current floor and roof load are supported primarily by 14, long walls with a design load of (25 + 15)(12 + 2) = 560 lbs. per foot for the roof and (40 + 10)(6) = 300 lbs. per foot for the floor with (8)(9) = 72 lbs. per foot allowed for the framed wall, totalling 932 lbs. per foot applied to the foundation wall. The 24, long wall currently just carries wall load and a few feet of contributory roof load from the roof overhang effects. The proposal is to remove the existing roof from bearing on the 14' long foundation wall and support it and the new shorter span. roof on the 24, long foundation wall, of (7)(40+10) for the new second floor + (7+2)(25+15) for the nel# roof, and (18)(8) for the total taller wall framing, equalling 854 lbs. per foot, which is less than the existing 14, long walls now carry. This load when combined with the weight of the foundation wall and footing of (75)(1.17) + 125(1) = 213 lbs. per foot for a total of 1067 lbs. per foot, which at 11 width is also 1067 psf which is less than 1500 psf of current Table 181-A of the 1997 UBC for Class 4 materials. Class 3 materials have been described for this site which would have 2000 psf basic capacity. The 6" wide reinforced concrete wall and footing would have more capacity and certainly more ductility to transfer the effects of lateral forces than an 8" non -reinforced concrete wall and footing that may have otherwise been accepted for a two-story Report to Barb Townsend September 18, 2000 Page two of two residential foundation. Although the 6" wall is lighter, the change of roof framing orientation puts considerably less potential wind uplift load per foot on the foundation and less total net uplift with the added weight of the second floor. Therefore, by the provisions of the 1997 UBC, I find the existing foundation to be adequate for the proposed second story addition. This is based only on an engineering analysis of the given information stated herein, without inspection, testing of soils, or concrete or verification of minimum reinforcement requirements of the UBC being previously met. Respectfully submitted, Craig R. Owen, P.E. 1 17175 �h1AL�� FXPMS 9/21/ Vj cro:cs cc: Bill Townsend City of Port Angeles Building Department 1111- 1-1 l Craig R. Owen, P.E. Consulting Structural Engineer 220 E. First Street Port Angeles, WA 98362 September '18, 2000 Barb Townsend 1101 E. 7th Street Port Angeles, WA 98362 Phone: (360) 452-8574 Fax: (360) 457-8020 STATEMENT File No. 00263: Exterior Foundation Review for second story addition to the new portion of Townsend Residence, Bill Townsend, Builder Description Dates Hours Amount Principal Sept. 14, & 16 2.0 $ 176.00 Engineering Clerical/ Secretarial Sept. 16, & 18 .75 18.00 TOTAL AMOUNT $ 194.00 Thank You. CLALLAM COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT DU1LIANU Ll V1J1UNIE IKM_ LVJAK6 AJU ENVIRONMENTAL HEALTH DIVISION PLANNINGDIVISIONMATERQUALrrY Certified Letter # 2466 141 870 October 11, 1999 Barbara Ann Townsend P.O. Box 535 Port Angeles, WA 98362 RE: Property located at: 1101 E. 7t' Street, Port Angeles, WA Parcel # 063000021055 Dear Mrs. Townsend: CLALLAM COUNTY COURTHOUSE 223 E. FOURTH ST., P.O. Box 863 PORTANGELES, WA 98362-0149 (360) 417-2000, FAX (360) 417-2443 On July 1, 1997, the Clallam County Sheriff's Department confiscated an illegal methamphetamine drug lab while executing a warrant at the above referenced address. On September 9, 1997, the Clallam County Environmental Health Division issued an order prohibiting use of the property according to WAC 246-205-506. On or about June 10, 1999, a certified clean up contractor, All Out Industrial and Environmental Services, Inc. performed cleanup procedures of the premises as outlined in their assessment and clean up plan. On September 30, 1999, we received the post clean up sampling results and the contractor's statement of assurance that the property has been decontaminated and fit for use. As provided in WAC 246-205-580, to the best of our knowledge, based on the information submitted by All Out Environmental and their findings that the home is fit for use, we rescind the Order Prohibiting Use at the above referenced property. If you have any questions, please do not hesitate to call me at (360) 417-2415. Sincerely, Andy Brastad, R.S. Environmental Health Specialist c: Clallam County Auditor's Office Clallam County Building Division City of Port Angeles Building Department Clallam County Prosecuting Attorney Lew Kittle, Washington State Department of Health Clallam County Sheriffs Office Clallam County Board of Health Dr. Tom Locke, Clallam County Health Officer Tania Busch -Weak, Director, Environmental Health Division All Out Industrial and Environmental Services, Inc CITY OF PORTANGELES DEPARTMENT OF PUBLIC WORKS INSPECTION REPORT . . . . . . . . . . . . ■ . . . . . . . . REQUEST: % Date Time Location of Work to be inspected Q Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Sewe Foundation Framing Chimney �f�-�'S INSP TION NOTES: Inspected: Date ' Remarks: Received by (phon , person) 7' ��- Phone No. Permit No. lot-, -:3 7 Plumbing Final Sewer Excay. Other Time �� By4-e7c (!� t lz�e RESTORATION REQUIRED ...... YES SURFACE RESTORATION: SURFACE TYPE: ❑ Unimproved []Gravel ❑ Asphalt ❑ PCC ❑ Repaired by City ❑ Repaired by Permittee ❑ No Damage Found (Continue on reverse side if necessary) NO Work Order # ❑ COMPLETE ❑ INCOMPLETE ❑ Other STREET SUPERINTENDENT (DATE) f CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date Time Received by (phone, person) Location of Work to be inspected J. //a/ Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): 67- —7 - Sewer Foundation Framing Chimney Plumbing Final INSPECTION NOTES: / 7/' 5 - Inspected: Date "` Time Remarks: -0-� e r'0000, JV RESTORATION REQUIRED ...... YES Phone No. Permit No. Z Z 3<5 Sewer Excay. Other By �e SURFACE RESTORATION: SURFACE TYPE: ❑ Unimproved ❑ Gravel ❑ Asphalt ❑ PCC ❑ Repaired by City ❑ Repaired by Permittee ❑ No Damage Found (Continue on reverse side if necessary) NO Work Order # ❑ COMPLETE ❑ INCOMPLETE ❑ Other STREET SUPERINTENDENT (DATE) 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 flays 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 We of work will be complied with whether specified herein or not. The granting of a permit sloes not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. :tau l A�o% Signature of Contractor or Authorized Agent .Bate Signathire- of,Owwner (if owner Is builder) Date CITY OF PORT ANGELES PUBLIC WORKS -BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 48362 BUILDING PERMIT ISSUED: 11/06/2001 PERMIT NO: 13074 OWNER/APPLICANT PROPERTY LOCATION BARBARA TOWNSEND 1101 7TH ST E 1101 E. 7TH ST Lot: S 112 OF 8 S 9 Port Angeles, VITA 98362 Block: 210 Long Legal 360/434-6578 Subdivision: TPA T: S: Parcel No: CONTRACTOR ARCHITECT i OWNER N/A VARIOUS Port Angeles, WA 09350 98340-0000 206/000-0000 360/000-0000 I PROJECT INFO Project Value: $2,500.00 SFD Units: 0 Commercial: 0 Project Type: SFR ADD/REMODEL SFD SO FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 ---�, Construction Type: MFD SO FT: 0 Zoning Use: RS7 q PROJECT NOTES PERMIT RENEWAL FOR BP # 12230 1+ RECEIPT # 8226 FEES ASSESSMENT Building Permit: $83.25 Misc Fee 1., $0.00 Flan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0,00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $87.75 Plumbing: $0.00 AMOUNT PAID: $87.75 Mechanical: $0.00 Radon: $0:00 BALANCE DUE: $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 orwork is suspended or abandoned for a period of 180 flays 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 We of work will be complied with whether specified herein or not. The granting of a permit sloes not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. :tau l A�o% Signature of Contractor or Authorized Agent .Bate Signathire- of,Owwner (if owner Is builder) Date PO )"17� �GEILES f, WASH I N GTO N, U.S.A. PUBLIC WORKS & UTILITIES DEPARTMENT April 13, 2004 Barbra Townsend PO BOX 635 Port Angeles, WA. 98362 Subject: 1101 East 7th Street Job# 9773 Dear Barbra: The estimated cost of labor and materials supplied by the City to provide electrical service for your property is $ 264.63. This estimate was based on the data you provided and is subject to review. This quote is good for 180 days. The City will be responsible for the following: 1) Providing and installing the O/H service wire to the meter base. 2) Providing and installing the 120/240v meter. The owner/contractor will be responsible for the following: 1) An easement across 516 S Chamber St 2) Payment of $ 264.63. If the actual cost of construction exceeds the estimated amount, there will be no further billing. If the actual cost is less than the estimate, the difference will be refunded to you. Payment of the estimated amount will authorize the City to schedule the work. If you have any questions or concerns, feel free to contact me at 360-417-4706. Jo n G. Hebner Electrical Engineering Specialist Cc James Harper, Electrical Engineering Manager Al Oman, Electrical Inspector Roger Vess, Permit Tech - Attachments.3 Ref. WF 17767/01 r 321 EAST FIFTH STREET • P O BOX 1 150 • PORT ANGELES, WA 98362-0217 - i PHONE 360-,417-4805 0 FAX 360-417-4542 0 TTY 360-417-4645 E-MAIL PUBWORKS@CI PORT -ANGELES WA US k S CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N° 16491 Port Angeles, Washington ------------- ----------------------------------------- 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 work as listed below. Address------------------------------------------------------- --------_---------------- Occupancy------------------------------------------- Owner ----------------------------------- r Owner ..... ---'------- - - = -= Wiring Contractor --*---------------------------------------------- Light Outlets .................... ...........---- -- . Service, volts Receptacle Outlets ............................... No. wires Dryer, KW ................... ........... .----------- Size wire'. Range, KW ------------ ---------------------- Main fuse Water Heater: Enclosure KW ----------------------------------- -__-_ Type of wiring: Heat: KW. ---- _:....................... t`. Entrance Cable ..... Motors: size, volts and phase: Rigid Conduit ...... ______________ Metallic Tubing ... __......................._.._....,......._......_._.... Current transformers: No. & Size............... _........._............................................... Ser. No ..................... ............................... _.... I..................... Ser. No ..................... TotalLoad....... .. Ser. No .............................................. Remarks- -------------------------------------- = ' ` - ------------------------------- ------------- --------------------------------------------------------------------- ----------------- ............. -------------------------------------------------------------------------------------------------------------------------. Permit Fee Treas. Receipt Type of Wiring: Armored Cable. Non -Metallic ..... Knob & Tube..... Rigid Conduit ... Metallic Tubing Raceway ------------- Circuits, Light........... Utility ----------- Heat --------------_-. Range ----------------- Water Heater .., Motor ................. Furnace Total $ -------------------------------- No ------------------- --------- By ---------------------------------------------------- ' --------- NOTICE—Current must not be turned on until Certificate of Inspection has been Issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT Address Owner N° 16491 Date. ................................................... - Wiring Contractor.......................................................................................................................... Ry............................................................. - NOTICE—Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. TM CA—ir P.inf . r.,r s 04/06/2004 07:41 3608951410 D R LINDSLEY ELECTRI PAGE 02 � r tj Ocw- 10 t C c- o13 2004/MAR/01/M0N 01.47 PM CITY OF PA BLDG DEPT PAX No. HO 417 4711 P.005 i 47V. imab?aarsaeaoMy ELECTRICAL PERMIT APPLiCR7iON � TON LRA j The Eleetrleal PwrnttAppicaeon1Mi tat be filled out oom etet rw.tps,a,.a Pima typo or reprint in ink. it you have any queeltana, please call (M) 417�02s 03 � V qi. Fox number taoea 417.4711 I LWAOtorElec. Con atorAgeni:..I �le4 s�s! Pham:3�LC}a7S �`YaSF�ax�u'Ja7St��9c��� rropeaya" ec L-eAl Ti`)fowz ,<t�"•.¢! 0 Pharte z/40-4110 Antes i! rr7, PC-)t,-r�?,5+— Cla;.kdne2T Ak1Qf-1=S zip: 9S�3C i E.,;4fwlCoabaoior.�,M1, (..tNn3trP? FfPr.�`K,rG -++uL. UocF»Fa{teDgC3N `r1a�/b ? Phane;, e0�+a7�pSy-S.Jln ` "''�#��EXq Address: f•d t /V/:--OUC-e-. /^fix-/ Z, CRY- 41.P_;t 41 n- j rNs rALtATiON WIRED BY: 'a OWNER UELECTRtrAL coNTRACTOR CreditGard/tordorNama•rl 1N 12 4Yj 614'051e'l Bdiing'Addrass: %6/tel C�Uee F / rQ,crr / .� C%[y zip. / Cnedit Card Alumber.• EV. Date; 0111 q v7sA MC PROJECTADDRms8 1 1 n %: -j -_TPE of WORK: Check all that apply. New I:f,AiterallonZAddition • •' ' I'IO Reskiontisi ❑ MuN-foomtly o Con4merG181 © Mobile Nome , Sq: Ft c . o. Remote Mater C7 Detachetl garage O Hot tub b Salim Pooi O Septic Pump C Low V*ft e O Telecorn, ❑ Sign Number of t'ilr mIM added orattered: ' 1 DESCRIPTION DF THE ELECTRICAL PROJECT, M&f o f €tectrtcat Heat LaaB Aeo lUons and or Sublimatigns . r'i ib0 ATnP ¢�PiZU�C-q� �!- (nt)n�a i� ice+�CriiS CHIC L75'4M/S Ae Overhead service in Temp Service o Underground SeMea Service Infermatieq Voil29e: • C2411) Phase:®1 a 3 SenAce Sias: Gd 44 1 Feedors¢d' D I hereby ced#y that I have read and examined this application and know that some to be true and correct, and I am authorf=d to apply for Dais Nrrrrn4. I understand it is not the CV8 regal responsibtW ID determine What permits are required, it remains the applkanfs respons1bA4Y f0 determine what per are mqufred and to nbtafn ch. Credit Card Holder's Slgnatuma. 4,x,,L_. ' C pate: owner or Elm Cont. Signature: '�t:r alYlt 1 i=GE, � � Oro, -50 C:IEl£CTRICALPERMtTAPi'rIiCATiOht I �- (- `� '77'73 wF 177(,7 f r' t*y 0,r, •}- . +11 . E1 F -e- - to /i /A� q1b /01-/ KW i0Sweboard "Fumaoe KW 41 Heat Pump � TON LRA O FawWali ^KIN r'i ib0 ATnP ¢�PiZU�C-q� �!- (nt)n�a i� ice+�CriiS CHIC L75'4M/S Ae Overhead service in Temp Service o Underground SeMea Service Infermatieq Voil29e: • C2411) Phase:®1 a 3 SenAce Sias: Gd 44 1 Feedors¢d' D I hereby ced#y that I have read and examined this application and know that some to be true and correct, and I am authorf=d to apply for Dais Nrrrrn4. I understand it is not the CV8 regal responsibtW ID determine What permits are required, it remains the applkanfs respons1bA4Y f0 determine what per are mqufred and to nbtafn ch. Credit Card Holder's Slgnatuma. 4,x,,L_. ' C pate: owner or Elm Cont. Signature: '�t:r alYlt 1 i=GE, � � Oro, -50 C:IEl£CTRICALPERMtTAPi'rIiCATiOht I �- (- `� '77'73 wF 177(,7 f r' t*y 0,r, •}- . +11 . E1 F -e- - to /i /A� q1b /01-/