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HomeMy WebLinkAbout1130 W 7th St - Building oeo .-10 ...... M 0 ...... M 0000 t9E-< 0<(0<( "'0 "'.,. M'" "'.-I 0'" , , t9 "1M Z ",eo H .,.'" 12 00 Ql U 0 00 .-I 0<( :E "'''' I-< ~ ,.. MM 01 00 ..:l 0<: ;.:: I>: o oil "- E-< 00 .. 0. H :> "'.... U Z ..:l H 0000 0 H H E-< 0 ZZ I>: 00 en gJ 00 ~~ E- 00 00 :<:00 ;.::;.:: U I>: E-< 8~ en "''''' :E 00 00 0 HI' ..:l ;.:: Z E-<,"> E-<.,. 00 E-< Z .. "I ,.. ~ 01>: 0 ..:l HO E-< en H .. 0\ H Z E-<E-< H E-< ,:::(O'I"'~ 0 en UU :E Z Z "'Z E-< 0000 I>: 00 HooOH en Z "''''' 00 Z~ ~ 0 I tz.. H 00 en en '" ON :E ZZ U 00 HNI.{)H E-< :E H H Z HU () .,.0<( ~ 0 H ..:l E-<...... U U '" ",en H"'~Hc.?Z enu '" HE-< ~ H~Zoo "":> 0<( I>:..:l -5~~H~ HI>: , U~ ..:len o..:l en en UI-< u1200 ..:l 00<( 0000 00 oil 00 000;':: Ht9 oU !-<Ol>: :E:E'">:E:EE-< ;'::Z OH H '" H 'g ~ ..:l "I ~O(J),., ~O~N ~~~ '" HUHo:r~ .... E-<O<( ..:l , :E en~~..:lN "I H , .-I "I ;.:: t9;.::0.,. t:. t E-t E-4j:l.. t N '" r-en;.:: 00 en ~ ,">00 00 ~ en , 0 -..:l Z- Zoo ~oooo <Xl eo 00 OH~H"'O E-<E-< 0 0t9 M:>::>:> I I enoo ...... ~~ ..-t~,.:(~I.DCO g~ii ~ r-t::S::O::S::oo 0 O:E ...... ......E-< 000 M MI>: I>: I>: I>:U 0 . (Ill>: ,00 ~ '" zo (Il 0 E-< .~ 00"- en -u .-I 1>:0 enE-<o<( ..:lZ !-< 0 0 0<( ~~~gj[L H en "',.. ~ ...... '" 00E-< o&1si~ii: '" '" I>:H ~E-<uo"'o<( ,.. 00 "'u '" E-< :E Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000250 Date 826500 1130 W 7TH ST 06-30-00-0-2-4232-0000- ELECTRICAL ONLY 2/28/08 RS7 RESDNTL SINGLE FAMILY o Owner Contractor Phillips Kevin 1130 W 7TH ST PORT ANGELES WA 983635602 APS ELECTRIC 546 BENSON RD. PORT ANGELES PORT ANGELES (360) 452-6753 WA 98363 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc -- Permit pin number 121764 Permit Fee 46.00 plan Check Fee .00 - Issue Date 2/28/08 Valuation 0 IN Expiration Date 8/26/08 Qty Unit Charge Per Extension 0 1. 00 46.0000 ECH EL-R OR RM 1-4 ALT CIRCUITS 46.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 46.00 46.00 .00 .00 Plan Check Total .00 .00 .00 .00 0 Grand Total 46.00 46.00 .00 .00 ~ ~ ,-- -- I I , , SPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE OUGH - IN v ~7 FINAL J- ~/? OMMENTS: CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000241 223628 1130 W 7TH ST 06-30-00-0-2-4232-0000- KEVIN &SHANNALEE MECHANICAL APPL. PERMIT Date 2/26/08 PHILLIPS RS7 RESDNTL SINGLE FAMILY 2885 Application desc INSTALL AN ELECTRIC FURNACE Owner Contractor KEVIN J PHILLIPS 30 BLUEBERRY PLACE SEQUIM WA 98382 (360) 683-6164 DAVE'S HTG & COOLING SRVC INC PO BOX 413 PORT ANGELES WA 98362 (360) 452-0939 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date MECHANICAL PERMIT INSTALL ELECTRIC FURNACE 121665 64.80 Plan Check Fee 2/26/08 Valuation 8/24/08 .00 2885 Qty Unit Charge Per Extension 50.00 14.80 BASE FEE 1.00 14.8000 ECH ME- INSTALL 100- FAU Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 64.80 64.80 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 64.80 64.80 .00 .00 ~ Os 'Z~ (] :s '0 EP Separate Perm its are required for electrical work, SEP A, 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 specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the R isions of any state or local law regulating construction or the performance of construction. () Signature of Owner (if owner is builder) T: Forms/Building DivisionlBuilding Permit (I % 1/O7). wpd BUILDING PERMIT INSPECTION RECORD CALL 4 17-48 15 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 UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. o ~ \ ~ INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS -. SHEAR WALLS / WALLS FOVNDA TION DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALL/I-lOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP / FURNACE / DUCTS GAS LINE WOOD STOVE / PELLET / CHIMNEY 3 -3 -Og DATE :JLG ACCEPTED BY: FINAL COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO 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 BUlLDlNG - ~ o ~ ~ $- C:t ~ ~ :5 P' fb T: forms/Building Division/Building Permit (I % 1/07). wpd ~ Feb 26 08 11 :19a Dave's Heating & Cooling 360-452-0939 p.1 BUILDING PERMIT - APPLICA TtON Fill out COMPLETELY and in INK. Your application, prescriptive energy form, plans, specs, and a 8 ~" x 11" site plan MUST BE COMPLETE to be accepted 'for review. (360) 417-4815 FAX (360) 417-4711 FOR OFFlClAL USE 0"'1. Y: DaleRec.: 1. -2~-o8 Permit N: Ci R' - z. ~ l Date Approved; Dale Issued: Residential projects: submit two sets ofplans Commercial projects: submit three sets of plans APplicantorAgent~av-e....ls H~a..+1 Y'% .'. Phone ~S;;J.-O&f3Cf Owner k e V I n 4- 5 h 0. n Y\ 0... l-e..e. P h ~ \ l , f' S Phone 6 &' 3 - '- ( (., '+ Owner's Address 3 () .8i ~b..e.("'~ P1 tJ.u.-, Se.1/.-t...t" vn I LU A. 4<6' 3 ~.;I . .h I U , _' . :DAVeS' H c"14 t k c.... / ContractorlEngmcer-vt:-\ v.e. S n ett..1I no. ~ State Llcense 1f Expires :5 I oC:; ContractorlEngineer's Address f O. &ox <{I 3 .' Po 'f..t Art~ Phone ' PROJECT ADDRESS:. i 130 We-sf i--/:A Sfree{ ZONING: LEGAL DESCRIPTION: Lot: Block: Subdivision: CLALLAM COUN1Y PARCEL NUMBER: TVPE'OFWORK I!f'Residential CJ New Constr. 0 Re-roof 0 Stove CJ Multi-family CJ Addition CJ Move CJ Garage CJ Commercial CJ Remodel C Demolition CJ Deck CJ Repair CJ Sign CJ Other BRIEF DESCRIPTION OF THE PROJECI': i n 5 -tAll 0... .r, D 1'\ 0 f -e ~ e c.. -n-l c- -h,... v- ~ o..c..A2...J SIZEIV ALVA TION SF. @ S ISF. = $ SF.@$ ISF.=$ SF.@$ /SF. = $ TOTAL VALUATION $ c::! '?l ?:5 ~~ 1 COMMERClALfRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: Existing Structure(s).basemem Sq. Ft & Proposed Structure(s) basement Sq. Ft. 1- floor Sq. Ft & I II floor Sq. Ft 204 floor Sq. Ft & 21ld floor Sq. Ft 3" floor Sq. Ft. & 3'd floor Sq. Ft Accessory StnJctJJres Sq. Ft & Accessory Structures Sq. Ft Existing Structure{s) TOTAL Sq. Ft. & PrOposed Structure(s) TOTAL Sq..Ft. TOTAL of existing & proposed structures Sq. Ft. Maximum Height of Proposed Structure(s) Ft. LOT COVERAGE Lot size Sq. Ft. Existing Structure(s) Sq.Ft. Footprint Proposed Structure(s) Sq. Ft. Footprint TOTAL Structun:(s) Sq. Ft Footprint Total Lot Coverage % Arc youpl~ing to installa lawn sprinkler system? (Divide Total StructlD"e(s) Sq. Ft. Footprint by Lot Size Sq. Ft.) V ALUA TION OF CONSTRUcnON: Io aD 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 ClDTent fee schedules. Contact the Permit Coordinator at 4 I 7-4815 for assistance. PLAN CHECK FEE: The plan check fee must be paid at the time the building permit application is submined. All other permit fees are due al the time of permit issuance. EXPIRATION OF PLAN REVIEW: AD application for a permit for any proposed work sball be deemed to have been abandoned 180 days after the date offiling unless. such application has been pursued in good faith or a permit has been issued; except that the building official is authorized to grant one or more extensions of time for additional periods not exceeding 1 SO days (90 days for commercial projects) each. The extension shall be requested in writing and justifiable cause demonstrated. (IRClIBC 2006 105.3.2) . I hereby certify that I have read and examined this applic;ation and know the same to be true and correc:t. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required. and that J must obtain such permffs IJrior to work. it' Date ;2/ ~€:.(o 'l . ApPlicant~ .'~~ T:\FORMS'BUILDING DIVISION\BldgPermitAppl.-2006 CODE - backup.Vipd \D\D o '-. \D '"' '-. N "'''' (9E-< <1;<1; 0.0 r- '" r- III , III 0) .., >< ..:I ~ '" H ..:I ..:I E-< ",CO :.:'" 8~ E-<o-, Z .. O~ HO E-<E-< UU "'''' 0.0. COCO ZZ H H o \D .., :> H o ~ 'CO "'''' ZZ 00 :I::I: 0.0. N N '" .,. , 0..:1 0<1; oU Z~ Ml-JM;:r: (J)~Z~~ E-+ 0.. 0.. H I ~ (t}HO:>N H ~ M I lI'l :I:Ho..~OO E-l H l.-f r--::r:WOOOO o..ZAlOO ~ H H 10 Z::r:HOO OH(J)Hl""'lO ~~?5~~~ .-t~cno..OO N ,",CO '" -..:I \D'" 0(9 ~~ '"' '-.E-< N~ o 0. o "'''' ~O <1; 0.>< "'E-< ~H o.U ~ . a:l ~ ZO E-< . ~ CO -U COE-<<1; ..:I ~~~&1tJ..:I oi:18i~g; ~E-<uoo.<1; E-< ~ ~ '" 0. CIJ E-< i:1 ;,: z;,: 00 HU E-<'-. 0. CO HE-< ~..:I U::> COCO "'''' E-<O~ ~ 0. E-< 0...:1 BCO::> Zco H'" ~O: ~"'''' XE-<E-< CO'" 0",..:1 0::>0. 0;': "'0 ~U ~ ~ .", <Il E-< ~ 0. '" E-<:I: <1;E-< '" :1:'" E-< ><'" ..:1..:1 Zo. 0:>: o "'u :I: E-<..:I ..:I COH H:<: COE-< H<1; :I:'" E-<:I: -'" ><Z o UH o Z:I: ';;!3~~ '"'13&1co ..CO;': "'<1;"'0 :>:>< CO ~o~'" :> ~~~ '" Z co>< HrlHH ....:JO::I:H co.;;E-<~ ,.::(or--~ (9 '" r-co H\Dll'lH ,::( 0 , ::r: UOl/'lf-4 HNCO E-+ ~~M~~ a~~g53 "'N<1;O~ ::E oC! 000.. ~~ fi: o CO '-. 0. >< E-< '"' o \D '" :>: CO '" E-< o Z o ~ CO E-< Z '" ;,: :>: o U Jan 23 06 07:48a If " , 1'625.052-(HlO (l'f'm Levi 1-360-385-5875 __~L,' ~....-i~~ ., --..:..: .!;:,._ .:;;[ DEPARTIvlENT OF LABOR AND INDUSTRIES REGISTERED AS PROVIDED BY LAW AS CONST CONT GENERAL " .... , '::' ~~~[:-:' , .,~~t,:,:t!:t ,:,!.::::. ,":;,:; , REGI ST;~ '#:. ;;,t,~.XlP:A\::!~:DA'I'2 ceo 1 SUNSHP* 0 7 7Q~\~i%0;;1l~o 06 EFFECTIVE DATE....l1117!1993 SUNSHINE PROPANE 10853 RHODY DR PORT HADLOCK WA 98339 -=. A:.i.~~-~M~-A~.:-.. __" - frTf" ;U J),w ID """""'!Ii':- ~! p. 1 :Ii ". L ot pORT ~(" .....~~~~ G~~ 1\..-- ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property zoning . . . Application valuation 06-00000105 Date 544500 1130 W 7TH ST 06-30-00-0-2-4232-0000- KEVIN PHILLIPS MECHANICAL PERMIT 2/01/06 RS7 RESDNTL SINGLE FAMILY 482 Owner Contractor PHILLIPS KEVIN J 30 BLUEBERRY PL SEQUIM WA 98382 SUNSHINE PROPANE 10853 RHODY DR. PORT HADLOCK (360) 385-5797 WA 98339 70375 50.00 Plan Check Fee 2/01/06 Valuation 7/31/06 .00 o f~ -:D ~ ~ -1 ~ \~ ~L f Permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date MECHANICAL PERMIT Qty Unit Charge Per 1.00 50.0000 ECH ME-WOOD BURNING APPL. Extension 50.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 50.00 50.00 .00 .00 plan Check Total .00 .00 .00 .00 Grand Total 50.00 50.00 .00 .00 ~ o ~, Cf2 ~ ~Cr ~ ~ Separate Permits are req u"i red 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 atterthe 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. 2--.05 Date Signature of Owner (if owner is builder) Date T;\Policies\1102_15 building pennit inspection record05.wpd [1/4/2005] \ BUILDING PERMIT INSPECTION RECORD CALL 417-4815 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 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 I NO FOUNDATION: FOOTINGS . WALLS FOUNDATION DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS 1 GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP 1 FURNACE 1 DUCTS . GAS LINE "'7lf# /O~ -JVV WOOD STOVE 1 PELLET 1 CHIMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKJRTING PLANNING DEPT. SEP ARA TE PERMIT #'s SEPA: P ARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCy/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\II02_15 building permit inspection record05.wpd [1/4/2005] Fill out COMPLETELY and in L1\"'K. Your application and site plan :MUST BE C0I\iPLETE tv bt ac!.:epleu lor rr.vic\1~. If yr,u h~vc anT qiJt:;tion:;~ :~11 PERMITS (360) 417-4815 FAX(360)417-4711 FOR OFF1CY7 U~E ONLY: Datt Rec.Z. { / () C, Permit tic a - LOG Dale Approved: Z. ( tJ(, Dale l;;;;ued ? I ( ( ~ to ~~ ~;cr~~) ..:tr:,~~ ::" -:::-.;...",.-~- .'.... ~. - ~ --~..._...__.._, '. -T"-* I ",~i BUILDING PERMIT - APPLICATION Applican1 or Agent: 5vIJ:'51 flZ€ - ?( a ,PC( /Ie.. ~ Owner: Kev;1l P A; /1 /p 5 Address: 39 blve...-beYry pi City: Sef(,V1rv? Phone: 360- $85---s-r-Cf~ Phone: JIG -6$') -{ Ib r Zip: Architect/Engineer: Contractor Phone: State License #: Exp: Phone: Address: City: Zip: ZONING: PROJECT .4.DDRESS: 1/30 \,.I, ~f-h LEGAL DESCRIPTION: Lot ~ Block: CLALLAM C01J1\1TY PARCEL NUMBER: Subdivision: TI;PE OF WORK: ~ Residential 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial D' Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: 5~~ /SF. = $ /SF. = $ COMJ\1ERCL.i;L/RESIDENTL.i;L: Occupancy Group: Occupant Load:' Construction Type: No. of Stories: Lot Size: Total lot coverage Existing Sq. Ft. & Proposed Sq. Ft. = TOTAL Sq. Ft. % ESAlVVetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: APPROVALS: PLAN: BLDG: DP"WU: FIRE : OTHER:_ PLANNING USE ONLY: VALUATION OF CONSTRUCTION: In an 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 currentfee schedules: Contactthe Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE: JF a plan check fee .is due it must be suD'mitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the tin1e of permit issuance. EXPIRA.TION OF PLAN RKV1EW: Ifno 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 R1 05.3.2 of the International BuildinglResidential Code, 2003). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what pe~' r required ,not the City's, and that I must obtain such permits prior to work. T:\Policies\BL-1102_13.wpd Applicant: Date: ~ - I - 06" .. . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT Site Address: PERMIT NO. :J ~~ t./ DATE 0//2/9" l... o READY FOR INSPECTION license Number: o WILL CALL FOR INSPECTION Phone: Installed By: Owner/Business: Owner/Business Address: ~IDENTIAL o COMMERCIAL o BASEBOARD KW _ o FURNACE KW _ o FAN/WALL KW _ o HEAT PUMP KW_ o SIGN o TJ;MPORARY SERVICE ~ERMANENT SERVICE ' o NEW CONSTRUCTION o REMODEL o ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) Detai Is/ Descri ption: Phone: Sq. Ft. ~HEAD SERVICE o UNDERGROUNIO S~B.vICE VOLTAGE: L2tJa'tP a-sTNGLE PHASE o THREE PHASE _ _ SERVICE SIZE.;L&(J AMPS #uu /hw..?/J . (77?-S &/' . . W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. ~)SI. Rough-in/cover O.K. /jtY"l )0 O.K. to connect service -1t:~ Final O.K. Site Address: //30 ft.. W. p~ Notify Port Angele ity Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered before inspection nd 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. ~ Electrical Inspector Installer: . NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ WHITE - File by address PINK - Top: Eng, Bottom, Customer YELLOW - file by number OLYMPIC PRINTERS INC Permit/Receipt No. 3Sbt/ ~o &!! Permit Fee GREEN - Top: Meter Dept., Bottom: City Hall oe-D2~D ti- ~.~~ ~.. ~.. ....... Job wired by IC!(Eleclrical Contractor 0 Owner EfctT'icalf'iontractor name /'. 1- ~iccnsc nrber rt ~te Ex~ ~..~ r . <;, e;;.1 e..U I'- 1 f...cIY..-~ Purch":S;r; mailing: a rcss b ~ '"t . ~6o-Y\.. ICO-. ~ Citypzs ~ t -A ~c ZIP -f\. Of~"363 Tclcpb% t$c~ LfS~ -, 5j nU"'Oct ~ f\-e...., Pr,\~i,s ow~r" nameC'\. L '\.1 1 ~-e.NI"- iT)1 1fS Addtn'1iC.CtlO.W [-tb- CI.y -?, -4~ ~JW ~p.N.lCI ':Zl;~~ Phone Dum er t u:bednle llupedJsln:" ' . '}..,"3'7 OMlner as defim'd by RCW./9.28.26J:(l) OWlIer will occupy the srru(.ture.!ct' two }'('.(I~' lifI€1' llli~ electriclIl permit i.t finalized. ~) OWMI' L..o; requjred 10 hj/'(> all eJectriC{,/ contractor if above $aid properry is for sale. rent or lease. After rc~~ing the abOve statement, J hereby ccnit)r that I ,un the owner of the above nameLl property or 3 licensed electrical contractur. I 3m making the tkCII'iC31 instal- lation or .tllcl-ation in compliance with the eleclric.,l Jaw$, N.c.C_, RCW. Chapler 19.28. WAC. Chapler 296.46B. The Cil)' of Port Angc:les Municipal Cod~. ano Utility Spcclfi\:'alions. Si~na of wneT, elect. a'felD)R1fr o.r;te.c cltrlC:31 3dmil1jstrator~ X ~ate: .;! ';;;J;,-<J Electrical Load Addjtio and or subtractions o NO LOAD CHANGES o Baseboard KW Q Fumace KW [J Heat pump Ton LAR o Fan-Wall IWI ELECTRICAL WORK PERMIT APPLICATION \ Installation dCSCriptiO~. D Commercial ~ResldeDtial CI New [)i(AltendlAdditioD -11PA-<.) fhQ.M) .~ eM...f'1 61...- !.uil- ~ o Casb 0 Check # o Credit Card VlSa Card # 6YL--/;4 Mastercard Discover - - ---------------- Expiration Date of card Service Information ~ Overhead Service U Tamp Service o Underground Service VoKago ~ 4 C> Pha... ~, 0 3 4 Service Sl~e: ~~ Feeder Size: ~ SAl'\1E DAY INSPECTION CALL BEFORE 7:00 AM 360-417-4735 - ROUGH-IN THERMOS-fAT SERVICE '2 J?fIO'?;, -W "- 0:1.1& -"JI(lTQV~'(l By OllIe ....lIpri)Ved By D:l.lt ~('IPTQval8y /' /' FEEDER FINAL DITCH ~ ~ 'C Quo ."Pr~Vl;llE't O:t.IC ^pPIV~cd By Ilupcclion Area, Building (IT Equipment Inspccled Action Taken Electrical Dale lnspcctor .- -- - ------.- -----.- -- - ---,- .-- --,-- ---"-- ld W~L0:80 800c Lc "qaj ESL9 CSt> 09E "ON X~j ~OlJ~~lNOJ l~JI~lJ3l3 "S"d"~ WO~j