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HomeMy WebLinkAbout529 W 8th St - Building 1 P ELECTRICAL PERMIT f CITY OF PORT ANGELES 360- 417 -4735 d O Application Number 11- 00000872 Date 8/15/11 Application pin number 511344 REPORT SALES TAX y ^1 Property Address 529 W 8TH ST our excise tax form I ASSESSOR PARCEL NUMBER: 06-30-00-0-2-3655-0000- 0i7 Application type description ELECTRICAL ONLY to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning COMMERCIAL NEIGHBORHOOD Application valuation 0 Application desc Demand heater are 6 coo OD Owner 4 2,19c Contractor MICHELE A D'HEMECOURT ALL WEATHER HTG COOLING INC 529 W 8TH ST 302 KEMP ST I PORT ANGELES WA 98362 PORT ANGELES WA 98362 V (919) 619 -5268 (360) 452-9813 462- 5 -07 6,40 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit pin number 191023 Permit Fee 73.50 Plan Check Fee .00 Issue Date 8/15/11 Valuation 0 Expiration Date 2/11/12 Qty Unit Charge Per Extension 1.00 73.5000 ECH EL- BRANCH CIRCUIT WO /FEEDER 73.50 Fee summary Charged Paid Credited Due Permit Fee Total 73.50 73.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 73.50 73.50 .00 .00 T Ta1Z R)L 6600 2() Z %(5 06 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN y A r I� y '.c!� fir41P 6 ____----1 FINAL 1 /2--- b COMMENTS: I PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING oF4Z% ELECTRICAL INSPECTION G WIRING REPORT I 417 -4735 COR 05 DATE PERMIT I NSPECTOR //-,n a��_--.�'/ OWNER` /CCONNNT/,RA)CSTOR )6 w 4 ADDRESS APPROVED NOT APPROVED 0 DITCH ROUGH IN /COVER SERVICE FINAL CORRECTIONS NEEDED: GPI/ Gt T i. -4 .-is{_ /l S fjnx f% r (-t L/ 5(1.4 0 4 4.7 G .5n -.AJ /,,r G rV kti/ rsk s /ix i t/ `56 ivec. ,,o- NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DO NOT REMOVE OLYMPIC PRINTERS, INC. (360) 452 -1381 q City of Port Angeles Permit Application 1 Ot ppc a �fr Building DlvisionlElectrical Inspections p 0 321 East Fifth Street P.O. Box 1150 3 Port Angeles Washington, 98362 AUG 1 2011 Ph: (360) 417.4735 Fax: (360) 417.4711 6 4ar:: °'7 __..1 Nis: Date: %.11FIl1 ELECTRICAL INSPECTIONS A„ 1 2 Single Family Dwelling Multi -Family or Commercial* Commercial Addition Alteration 1 Remodel Repair' Plan Review May Be Re.uired, Pie- se Co plete El-ctrical Plan Review Information Sheet Job Address: 1 i1e.. ,i_ 1 Building Square Footage: Urit.—•— Des ion al above 1 1. i �c �l h 'r_ 2S per ir Owner f•rLrtatlon ContracAVorm -tip C00,t Name: l: ak� �.7 .G Name: >t 1.. Mailln. •ddress: li L O. MailingAd''-ss: VP11 �a 1�� r� t ��I City: State: UJ Zip: 1 City: r Sta te:, p. Phon !ail r 'Fi 4r: ax: Phone: 1. ..4, Fax: ea License Exp. License Exp. 1 :1 1‘ �11I► Unit Charge Qty Total.(QtV Multiplied by Unit Charge) 93.75 Service /Feeder 200 Amp. $113.75 Service /Feeder 201 Amp. 5160.00 Service /Feeder401 -600 Amp. 5205.00 Service /Feeder 601 -1000 Amp. $291,25 Service /Feeder over 1000 Amp. 2.00 Branch Circuit W/ Service Feeder -5 57.50 Branch Circuit W/0 Service Feeder 2.00 Each Additional Branch Circuit 72.50 Temp. Service/ Feeder 200 Amp. 86.25 Temp. Service/Feeder 201400 Amp. 5116.25 Temp. Service /Feeder 401 -600 Amp. 5131.25 Temp. Service /Feeder 601 -1000 Amp. 75.00 Portal to Portal Hourly 5 69.00 Sign /Outline Lighting 75.00 Signal Circuit/ Limited Energy Commercial 50.00 Signal Circuit/ Limited Energy -1 2 Family Dwelling 5 50.00 Signal Circuit/ Limited Energy Multi- Family Dwelling 93,75 Manufactured Home Connection 5 80.00 Renewable Electrical Energy 5KVA System or Less 5 86,25 First 1300 Square FL 27.50 Each Additional 500 Square Ft. or Portion of 57.50 Eac utbuilding or Detached Garage 86.25 ach Swimming Pool or Hot Tub 43,75 Thermostat -_-7—.6 J Total 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, ront or lease. Atter reading the above statement. I hereby certify that 1 am the owner of the above named property or a licensed electrical contractor. I am making the electrical Installation or alteration in compliance with the electrical laws, N,E.C., I2CW. Chapter 1928, WAC. Chapter 226.46B, The City of Port Angeles Municipal Code, and Utility Specifications. Signature of owner, electrical contractor or electrical administrator Cash Check X Date: 0 Credit Card 0 £O/£0 3gelci SNI1v3H c13H1v3M 11U LLISZSt'09ET 8080 'HOZ /ST /80 CITY OF PORT ANGELES rittlit DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION "91.011 321 EAS 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00000839 Date 8/05/11 Application pin number 688085 Property Address 529 W 8TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-2- 3655 -0000- Tenant nbr, name MICHELE D' HEMECOURT On your state excise fax form Application type description MECHANICAL APPL. PERMIT to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning COMMERCIAL NEIGHBORHOOD Application valuation 1807 Application desc STEFFES HEATER Owner Contractor MICHELE A D'HEMECOURT ALL WEATHER HTG COOLING INC 529 W 8TH ST 302 KEMP ST PORT ANGELES WA 98362 PORT ANGELES WA 98362 (919) 619 -5268 (360) 452 -9813 Permit MECHANICAL PERMIT Additional desc STEFFES HEATER Permit pin number 190603 Permit Fee 64.80 Plan Check Fee .00 Issue Date 8/05/11 Valuation 0 Expiration Date 2/01/12 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 14.8000 EA ME- HEATER(SUSP /WALL /FLOOR -MTD) 14.80 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 fl 1461/1 3 ltal1v 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 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. 3 /I7111 I/104m (.t<.}&Dc n 0 /Ael--- Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS _S) Building Inspections 417 -4815 Electrical Inspections 417 -4735 Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886 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 Date Accepted By Comments 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 FINAL Date Accepted by AIR SEAL: Walls �7 Ceiling FRAMING: �1 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 FINAL Date?)' 1 q y w I' I (/Accepted b MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: Parking Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 3 r Cr,rmc /Ruilriinn nivisinn /Ruildina Permit 0 N H r H I t'1 I 01 0 0 F a aQI 0 00 H 0 CO N 0\ 0 N 01 0 0 01 N 1D O r U W .0 H 1 y .-7 i 0 W W F I 0 00 0 t0 x w 0 0 a m 0 EW X 1 a s 0 O z N 0 o o o H N a 0 c FF H F a (1) U U 0 Z Z 0 0 F w w x w H H D z as r w (0 worn w cnm r a zX 0 1 z z r u 0 0 a H H I 2 H U o 2 7 0 H r- F U 0 0 U a a n H H 0 7 a H F z U z a as a H u a x U 0 0 0 0 01 N U 0 00400 E 0 a X E w F o H H 0 0 0 0 0 R oEa 01 a 0 0 0 U R r 01 (0x00 1 m H L O 0 o 0 H (0 0 0 1 0 0 [1) 00 <0100 a awawoo fgww 0 0 W x x 0 o E F F H 000H01 0 01 0 01 m to Z 10(0 0 H 004. H a F.. W 0 0 M x (0 a 00 a z0 a F 0 0 of E+ U z F 0 o a H 0 0 0 3 a x 0 al 0 r w aU FCE-U0 0 r.( 0> F ((_3141] PROJECT STATUS UPDATE Sfinl Permit 1 �1p (C3 X2 W gq f 3- M (2 Date: 3 l 4-' 12- I phoned the: Applicant at Property Owner at Contractor t t,U2ctt'h at ti52 3 1 (left a phone message, or discussed): The permit (has expired, or will expire soon). What is the status of this project? Please call and schedule a final inspection. Or Submit a "permit extension request" letter. Or Let me know if the project is abandoned. ik Vt o6 I I -PO I i'lp o Y 5.6 KSeAnN trEFe_o ons Shco t .vim Vpe vJtQ,I,etill ICAP I WI/11 1S 1D SO UP al l rea f iN -k'ln, Q J viers C-1‘r.e./ G ood 3. red 1", 2 V T:Forms /Building Division/Project Status Update F °47-14 BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES For City Use Only: ef ilv Attn: Building Permit Technician Date Rece i yyed 5 321 E. Fifth St., Port Angeles, WA 98362 Permit l� (360) 417 -4815 fax (360) 417 4711 Date Approved Applicant 4,\ k M 3 Phone 0i !�s'�' ai Property Owner Ck iC Phone rItaiCf 'rk; Property Owner's Address aWytrl ±o Co.ntractor ,t A Phone III l r am Contractor's Address :►ti =a tY License _.��_11 E -mail 1,M PROJECT ADDRESS 5aC1 1,+3e9 4th c Parcel Number Lot Zoning Project Type Brief Description2esldentlal o Multi family o Commercial o Industrial Check all That apply New Construction 1 4M O Q f� o Addition o Remodel o Repair Demolition o Re -roof o House o garage o other o tear off re -roof o lay over one layer o Heat System b Heat pump o wood- burning stove o gas fireplace o pellet stove ,other Other fi Floor Areas Existing (sq. ft.) Proposed (sq. ff.l Basement per sq. ft. 1' Floor 2' Floor 3 Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION \711.71 \la Total footprint of structures sq. ft. 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 of bedrooms Will a lawn sprinkler system be installed? Occupant load of full baths Will afire sprinkler system be installed? Construction type of half baths I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that It is my responsibility to determine what permits area requireQ, and to obtain permits prior to o g on protects. Print Name �I ��1�� C�� Signature 'r:Formsieullding Division /Bldg Permil.doc i;0 /i;9 39 d 9NI1v3H 2l3HlV3M 11V LLTSESb99ET 3T:60 TT9Z /S0/80 Clallam County Assessor Treasurer Property Details 58089 MICHELE A D'HEME... Page 1 of 4 Clallam County Assessor Treasurer Property Search Results 58089 MICHELE A D'HEMECOURT for Year 2011 2012 Property Account Property ID: 58089 Legal Description: LOT 13 BLK 236 Geographic ID: 0630000236550000 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: 529 W EIGHTH ST Mapsco: PORT ANGELES, WA 98362 Neighborhood: Cycle 5 Comm Map ID: 2 Neighborhood CD: 20953140 Owner Name: MICHELE A D'HEMECOURT Owner ID: 208958 Mailing Address: 529 W 8TH ST Ownership: 100.0000000000% PORT ANGELES, WA 98362 Exemptions: Taxes and Assessment Details Property Tax Information as of 08/05/2011 Amount Due if Paid on My 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. Click on "Statement Details" to expand or collapse a tax statement. First Half Second Half Year i Statement ID Base Amt. Base Amt. Penalty k Interest Base Paid Amount Due l' Statement Details 1 2011 152770 878122 5781.17 80.00 $0.00 $781.22 8781.17 Statement Details V 2010 41061 $771.29 5771.27 $0.00 $0.00 6154256 50.00 i Values Improvement Homesite Value. N/A i Improvement Non Homesite Value: N/A Land Homesite Value: N/A Land Non Homesite Value: N/A Ag Timber Use Value Curr Use (HS): N/A N/A _\,\c\C 1) s.........) Curr Use (NHS): N/A N/A r Market Value: N/A Productivity Loss: N/A Subtotal: N/A CO Senior Appraised Value: N/A Non Senior Appraised Value: NIA Total Appraised Value: N/A Senior Exemption Loss: N/A Exemption Loss: N/A Taxable Value: N/A Taxing Jurisdiction Owner MICHELE A D'HEMECOURT Ownership: 100.0000000000% Total Value: N/A Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Levy Code Description Levy Rate; Appraised Value Taxable Value; Estimated Tax STATE SCH STATE SCHOOL N/A N/A N/A N/A ;CC GENERAL CLALLAM COUNTY N/A N/A N/A N/A GENERAL DEVDISIBLT DEVELOPMENT N/A N/A N/A N/A DISABILITIES COUNTY ;LNDASSMT LAND N/A N/A N/A N/A ASSESSMENT COUNTY 1 TAX REFUND TAX REFUND N/A N/A N/A N/A i FUND COUNTY I VET RELIEF VETERAN'S N/A N/A N/A N/A RELIEF COUNTY CAPT IMP CAPITAL N/A N/A N/A N/A IMPROVEMENT PORT DISTRICT i LIB LIBRARY COUNTY N/A N/A N/A N/A LIB BD PORT ANGELES N/A N/A N/A N/A http: /websrv8.clallam. net propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =58089 8/5/2011 &' \fI! CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION nl EAST 5TH STREET. PORT ANGELES. WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 06-00001084 Date 10/18/06 418600 529 W 8TH ST 06-30-00-0-2-3655-0000- ELECTRICAL ONLY COMMERCIAL NEIGHBORHOOD o Owner Contractor SMITH, STEVE & JENNIFER 529 W 8TH ST PORT ANGELES WA 983625835 S & J ELECTRIC PO BOX 2233 PORT ANGELES (360) 461-9380 WA 98362 Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL S & J / 1-4 CIRCUITS 88229 S & J ELECTRIC 48.10 Plan Check Fee 10/18/06 Valuation 4/16/07 .00 o Qty Unit Charge Per 1.00 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48.10 \J\ ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 48.10 48.10 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 48.10 48.10 .00 .00 ~ ~ t1 ~ !!:" COMMENTS/ACTION NEEDED ELECfRlCAL PERMIT INSPECfION .RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE I INSPECTION TYPE DATE ACCEPTED COMMENTS . I YES I NO DITCH ROT JGH_IN I CUYbK J{)- 18ro' .he ) '...KVU.... - FIN AT I t'l..-U>-oc...1 .~ GENERAL COMMENTS: PW-II02.1' (41961 of ,ORT ~ S ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 06-00001056 Date 787712 529 W 8TH ST 06-30-00-0-2-3655-0000- PLUMBING REPAIR 9/26/06 Applicatlon Number Applicatlon pin number Property Address ASSESSOR PARCEL NUMBER: Appllcation type description Subdlvlsion Name Property Use Property Zonlng . Applicatlon valuation COMMERCIAL NEIGHBORHOOD 6000 Owner Contractor STEVE / JENNIFER SMITH 529 W 8TH ST PORT ANGELES WA 983625835 (452) 6133 DOUBLE S CONST. PO BOX 1386 PORT ANGELES (360) 452-0824 WA 98363 Permlt PLUMBING PERMIT Additional desc PLUMBING REPAIR Permlt pin number 87742 Permit Fee 106.00 Plan Check Fee .00 Issue Date 9/26/06 Valuation 0 Expiration Date 3/25/07 Qty Unit Charge Per Extenslon BASE FEE 50.00 6.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 42.00 1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00 1. 00 7.0000 ECH PL- EA. REPAIR/ 'DRAIN / VENT 7.00 Fee summary Charged Pald Credlted Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 106.00 106.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 106.00 106.00 .00 .00 lasered CEf) f;'n I ~'ed (2---2 I~06 ~ \ r--- C) ~ ~~ ~~ --I~ J=t ~ .. 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 -l 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 construc~o~. ~~~ C\-24-0b Signature of Contractor or Authorized Agent Date Date Signature of Owner (if owner is builder) T \Pohcles\1102_15 bUIlding perrmt 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 YES NO FOUNDATION: FOOTINGS \ SHEAR WALLS 1 WALLS FOUNDA nON DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS ) PLUMBING UNDER FLOOR 1 SLAB I ROUGH-IN lD/1 t;.i?//Z ~ WATER LINE (METER TO BLDG) , GAS LINE FINAL ~'J-/f)-I!o"DATE ...11-1- ACCEPTED BY: BACK FLOW 1 WATER I AIR SEAL WALLS CEILING 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 I I MECHANICAL HEAT PUMP 1 FURNACE 1 DUCTS - GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY: G COMMERCIAL HOOD I DUCTS ~ MANUFACTURED HOMES FOOTING 1 SLAB J BLOCKING & HOLD DOWNS '- SKIRTING - PLANNING DEPT SEPARATE PERMIT #'8 SEPA. l P ARKlNG/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 ~ ~ "0 3l~ ~ {T~ ~~ ~ T IPohcleslll02 15 bUlldmg permIt inspectIOn record05 wpd [1/4/2005] PREPARED 12/21/06, 10 18 14 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . APPL NUMBER INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 6 12/21/06 529 W 8TH ST DOUBLE S CONST STEVE / JENNIFER SMITH 06-30-00-0-2-3655-0000- 06-00001056 PLUMBING REPAIR PL2 01 10/19/06 JLL 10/19/06 AP PL99 01 12/21/06 ~ 'i SUBDIV, PHONE PHONE (360) 452-0824 (452) 6133 PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP TYP/SQ COMPLETED RESULT DESCRIPTION RESULTS/COMMENTS PLUMBING ROUGH-IN steve 461-9380 10/18/2006 08 55 AM PERMITS ---------------------------- 10/19/2006 04 16 PM JLIERLY ---------------------------- PLUMBING FINAL 12/21/2006 08.09 AM PBARTHOL --------------------------- steve 460-9423 ****************CALL 1ST TO BE LET IN************************ -------------------------------------- COMMENTS AND NOTES -------------------------------------- PREPARED 10/19/06, 10 41 40 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR: JAMES L LIERLY PAGE DATE 15 10/19/06 ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER: 529 W 8TH ST DOUBLE S CONST STEVE / JENNIFER SMITH 06-30-00-0-2-3655-0000- 06-00001056 PLUMBING REPAIR SUBDIV: PHONE PHONE (360) 452-0824 (452) 6133 PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP TYP/SQ COMPLETED RESULT DESCRIPTION RESULTS/COMMENTS PL2 10/19/06 ~L PLUMBING ROUGH-IN \ ' steve 461-9380 10/18/2006 08 55 AM PERMITS ---------------------------- -------------------------- ---------- COMMENTS AND NOTES -------------------------------------- 01 ,,~'4 ~<:-.. :"Jjll\~;~~~,~'" v -' '4q:/,~r 'I%,W.<,,\!' ~--0. ~-~) '~~ BUILDING PERMIT - APPLICATION Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 F.AX(360)417-4711 Applicant or Agent: Ovvner: S~\lg.N l ~::Ie~~~ Address: '5 'l.. <1 0 ~ ~ Phone: <) u-ut\ Phone: 4- S ~ - <.n \ 33> CIty: ~oQ:l ~~c;.~\~.s. ~~ Zip: ~ B~Co':t Phone: Archltect/Engrneer: Contractor 1) /"';ue\ E: S C, I\.c;\::t:' ~c.... State License #. 1) O()~ ~c.. <<\l..lo G> G. Address: 7(.:> e,~ \~ aCe:. CIty: ? OJL"t" ~,v~ ~ \..B PROJECT ADDRESS: c:; J.\-M..E- ~s ~ ~~ LEGAL DESCRIPTION: Lot: Block: ~. Exp: It..13oJ'01Phone: 4\ l-S:to'5" . Zip: .q t&~ \0 ~ ZONING: SubdivISIOn: CLALLAM COUNTY PiiliCEL NUMBER: r::jp'??~~ 'SCpS-SObC>O TYPE OF WORK: SIZEN ALUATION: llYResIdentml 0 New Constr. 0 Re-roof 0 Stove SF @ $ /SF = $ o Mulu-fanuly 0 AddIuon 0 MoveD Garage SF @ $ /SF. = $ o CommercIal ~Remodel 0 DemolitIOn 0 Deck SF @ $ /SF. = $ o Reparr 0 SIgn 0 Other TOTAL VALUATION $ ~ eOb,C5V BRIEF DESCRIPTION OF THE PRO.rnCT. (( ~M..~~E L ~~~LcsoW\.s t+~~Ojt;/2.. O~ 1?~~ No of Stories: Lot SIZe' Total lot coverage Construcflon Type: = TOT},L Sq. Ft COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: & Proposed Sq Ft EXIsting Sq Ft. % ESA/Wetland(s)' 0 Yes 0 No SEPA Checkl1strequrred? 0 Yes 0 No Other: APPROVALS: PLAN: BLDG: DPWU: FIRE: OTBER:_ PLANNING USE ONLY: VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. Tills figure will be revIewed and may be reVIsed by the BUlldmg D1VlSlon to comply WIth current fee schedules. Contact the Permit Coordmator at 417-4815 for asSIstance. PLAN CHECK FEE: IF a plan check fee IS due It must be subIDltted at the t11lle the building pernut applicaflon and construction plans are subIDltted. All other permit fees are due at the t11lle of permIt Issuance. EXPIRATION OF PLAN REVIEW: If no permit is Issued wIthm 180 days of the date of applIcatIOn, the application will expire. The Bmlding Official can extend the t11lle for actIOn by the applIcant up to 180 days upon wntten request by the applIcant (see SectIon R105.3.2 of the InternatIOnal BUlldmg/Residential Code, 2003). No applIcatIOn can be extended more than once. I hereby cerlify that I have read and examined this application and know the same to be true and correct. J am authorized to apply for this permit and understand that it IS my responsibility to dete/mine what permits are required ,not the City's, and that I must obtain such permfts prior tOio'h 0 ( \ ______ .\. T.\FORMS\BldgPer=tform.wpd Applicant: ~ Date: 3 - lk~ ". ,OAT ~ l~ r. L -=.. .....- ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Appl~cat~on Number Appl~cat~on pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Appl~cat~on type description Subd~v~sion Name Property Use Property Zon~ng . . . Appl~cation valuation 06-00001055 Date 908930 529 W 8TH ST 06-30-00-0-2-3655-0000- SMITH RES. FIREPLACE/INSERTS/FREESTANDING 9/26/06 COMMERCIAL NEIGHBORHOOD 1200 rrN~ /O/,Q/00 ~ , Owner Contractor ~ \J ~) STEVE / JENNIFER SMITH 529 W 8TH ST PORT ANGELES WA 983625835 B&B ENTERPRISES 520 ROSE ST. PORT ANGELES, WA PORT ANGELES (360) 417-0436 WA 98362 Permit . . . . . Additional desc . Perm~t p~n number Permit Fee Issue Date Expiration Date MECHANICAL PERMIT 87726 50.00 Plan Check Fee 9/26/06 Valuation 3/25/07 .00 o Qty Un~t Charge Per 1.00 50.0000 ECH ME-WOOD BURNING APPL. Extension 50.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Perm~t Fee Total 50.00 50 00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 50.00 50.00 .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-l nave read and examined this application and know the same to be true and correct. All provisions of t-f\ 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 \' CO~~ '1/2~~ Signature of Contractor or Authorized Agent Date " Signature of Owner (if owner is builder) Date T \Pohcles\ 1102_15 buildmg penmt mspectlon 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 YES NO FOUNDATION: FOOTINGS SHEAR WALLS 1 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 FINAL DATE ACCEPTED BY: " BACK FLOW 1 WATER AIR SEAL WALLS I CEILING I FRAMING JOISTS 1 GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL(INTE~ORBRACEDPANELONL~ T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP 1 FURNACE 1 DUCTS GAS LINE (f)/~ /Ob DATE Vw WOOD STOVE 1 PELLET 1 CHIMNEY FINAL ACCEPTED BY' COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKIRTING - PLANNING DEPT SEPARATE PERMIT #'5 SEPA. P ARKlNG/LlGHTING ESA. LANDSCAPING SHORELINE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECT~CAL - LIGHT DEPT 417-4735 ELEC~CAL 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 ~I ,~/' ,~ PLANNING DEPT ~V llA II. IVVC BUILDING BUILDING 417-4815 I V lV\V T IPohcleslll02_15 bUlldmg penml inspeclJon record05 wpd [1/4/2005] PREPARED 10/19/06, 10 41:40 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR: JAMES L LIERLY PAGE DATE 14 10/19/06 ADDRESS TENANT, NBR CONTRACTOR OWNER PARCEL . APPL NUMBER 529 W 8TH ST SUBDIV' SMITH RES B&B ENTERPRISES PHONE (360) 417-0436 STEVE / JENNIFER SMITH PHONE 06-30-00-0-2-3655-0000- 06-00001055 FIREPLACE/INSERTS/FREESTANDING PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 10/19/06 ~ MECHANICAL FINAL (( steve 461-9380 10/18/2006 08 57 AM PERMITS ---------------------------- -------------------------- ----------- COMMENTS AND NOTES -------------------------------------- J _ t."" ,m_ rl'\;~.".1 cXr'''41;1If~R'' (?J I. ~~ .~~ /~~~ I, ~_ :IJ \,-- -..-." ,',) ~~.- , -,~~r BUILDING PERMIT - APPLICATION Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for reVIew, If you have any questions, call PERMITS (360) 417-4815 FA..X(360)417-4711 ApplIcant OJ Agent C" t-.O ., Ben T Phone' 4 J 7 -0 I..( 3 f:, Owner S Tev e.. S vn I' T tJ Phone' Address Si:J'~ ~ $~~ Vv if-City, p" I'J Tt 1/1t5 -eL~_5. ZIp: Of 8""' 3b L. ArchItecl/Engmeef' Phone Contractor 13 l7- HEn j-e I PI' j 5e ( State LIcense # B B E 117 *t-O 4 3r!:.ff Address' C;}-O f{ D S e.. ~ J rtfItyd 0 I I A-~ eL"e f' PROJECT ADDRESS: ~ w, 't/ -- ' JllzlOflhone: (,1/7-0 <f3t . Zip: q g- 36 :L ZONING: LEGAL DESCRlPTION. Lot CLALLAM COUNTY PARCEL NUMBER: Block SubdivIsIOn f>>, '?;;O-I~rG.-tf..... 04/u TYPE OF WORK: o ResIdentlal 0 New Constr. o MultJ- family 0 Addmon o CommercIal 0 Remodel o Reparr 0 Sign BRIEF DESC TION 0 EXlstmg Sq Ft ConstructlOn Type' = TOTAL Sq. Ft COMMERCHL/RESIDEt>.TTIAL: Occupancy Group Occupant Load: & Proposed Sq. Ft No of Stones: Lot Size. Total lot coverage % ESA/Wetland(s) 0 Yes 0 No SEPA Checkhstrequrred? 0 Yes 0 No Other A.PPROV ALS: PLAN: BLDG: DP'WU: FIRE: OTHER:_ PLANNING USE ONLY: VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the apphcant. Tills figure will be revIewed and may be revIsed by the Buildmg DlVislOn to comply with current fee schedules. Contact the PeIIlllt Coordmator at 417-4815 for assIstance. PLAN CHECK FEE: IT a plan check fee IS due It must be subillltted at the tune the building permit apphcatIOn and constructlOn plans are subll11tted. All oilier pemt fees are due at the time of permit Issuance. EXPffiATION OF PLA.N RKVIEW: Ifno peIIlllt is Issued witlun 180 days of the date ofapphcation, the application will expire. The Bm1dmg OffiCIal can extend the tnne for actlOn by the applIcant up to 180 days upon vmtten request by the apphcant (see Section R105.3.2 of the International Buildmg/ResldentJal Code, 2003). No applIcation can be extended more than once. . I hereby cerrity 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 tha~it is y responsibility to determine what permits are required ,not the City's, and that I musl oblain such permfts prior 10 w~ - 0 /J j , J 1'\FORMS\BldgP=""mn"""Applic,""~ ~ Date: ~.;;- /O,h . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 PERMIT NO. -7" 7/3 7'$/9'1 DATE ELECTRICAL PERMIT Site Address: 5;{. '-tJ e I?t D READY FOR INSPECTION License Number: WILL CALL FOR INSPECTION Phone: Installed By: Owner/Business: Phone: Owner/Business Address: Sq. Ft. DetailslDescription: ~ RESIDENTIAL D COMMERCIAL D NEW CONSTRUCTION D REMODEL D ADD/ALTER CIRCUITS D SERVICE UPGRADE/REPAIR D TEMPORARY SERVICE ~t?A".//L :i tf'/L/rr---' D RISER D OVERHEAD SERVICE )8(' UNDERGROUND SERVICE VOLTAGE: D1lD D3lD SERVICE SIZE FEEDER SIZE ,l){) ELECTRIC HEAT D BASEBOARD KW _ D FURNACE KW _ D HEAT PUMP KW_ D FAN/WALL KW _ AMPS AMPS . W.S. No. SERVICE SIZE CAPACITY: D O.K. D NOT O.K. ACTION REQUIRED: D CHANGE TRANSFORMER D INSTALL SERVICE POLE DATE ENGR. D OVERHEAD SERVICE APPROVED D CHANGE SERVICE WIRE D OTHER ""tlDitCh Inspection O.K. -'\M-~ Rough-in/cover O.K. IV 0 O.K. to connect service ~ 'fl Final O.K. Site Address: ,,-1)~9 yJ rf /.f &-eu Permit/Receipt No. 4713 . Installer: /IJ <-----\,;;tl.:/!Iu-, Notify Port Angeles City Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered before inspection and 0 K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Per it. HONE 457-0411, EXT. 224. 5 C-1 New Meters 7,ed'S" /9<1 NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ 4000 Permit Fee WHITE - File by address PINK - Top: Eng, Bottom, Customer GREEN - Top: Meier Dept., Bottom: City Hall ~- .. 1 _ OLYMPIC PRINTERS INC. CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT NI! 17026 Port Angeles, washington___....____nn___n.._n___.....___.______.___...__._.__., 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 .-..s.---~---~---.r',tlj------f..:J;t,.,--...:..----------------------.-- Occupancy___.____.._~---.-.--.------------- ~::~~.~~~~~~~.~.:::~A~---~~::~~~~:::::::::::::.:...~~:::::::::=::::::::::::::::::=::::::::::::::::::: Light Outlets....................______.___....._..... Receptacle Outlets.........______________..._..n Dryer, KW n....._..............__....____._..______ Range, KW __________mm._n_n_. Water Heater: KW.................. ..................... ...... Hea', KW.....Lt.J..",........l~..B....... Motors: size, volts and phase: Total Load____.________................ Service, volts ...!.:!...<..I..,_.k..':1....Q... No. wires .....000000'3.........._........0000_ Size wires.....~-/a..............-.. -"l q-a ..4- Main fuse ..~............................ Enclosure ...___..00........_........___...00.... Type of wiring: Entrance Cable _______m....m___._ Rigid Conduit ..................... Metallic TUbing m.___........._ Current transformers: No. & Size............nnn__................... Ser. No............................................... Ser. No. 00......____0000..00.00............0000...... Ser. No. ..0000..........................._.....00.00. Ser. No. .n._.nn_nnn_nnn_..n.._...._.._._. Type 01 Wiring: Armored Cable ................m......_.n. Non-Metallic ................___________....._ Knob & Tub.................................. RIgid Conduit ............................... MetaIllc Tubing ..............._......__... Raceway _......................_.....___._ Circuits, Llght.........................___._.____.... UtlIlty............................................. Heat .._n___.._............................_..__ Range ....._____________.____.___..__d............ Water Heater .....00.....00_................ Motor .00.................................._...._.. Dryer ..........._._nnn.........._...___nn.....__ Furnace ___._________............._._._.__.__........ Remarks: _________~_________________________________.._____.______.._....___.._________________..______..___._m___________._____ Total....................................... Permit Fee Treas_ Receipt 4J " /J By..........~___~.~~._...... $:____________.....___..____...______.. 'Noh______________n_.._....... NOTICE-Current must not' be turned on until Certificate of Inspection has been issued. If work fs to be con. cealed due notice must be given the Inspector so that 'Work may be inspected before concealment. i , NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 17026 Address....._................_...._.__..................................._._........__..................___....................................Date..._......_.._.._.._.......~.._...._._..._._....._._ Owner........____.__...................._.........._......____..._..___.__......._........_.............................________Tenant.....____.______...................................____......___.__. WiringContractor....._...._...__.___.__............____..._.............._...._.........................._..___........_.._._.........~,_:~.............................___._._..._......... NOTICE-Current must not be turned on until C~rtfficate ot Inspection has been issued. It work ts/to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. / 1M );-' Olympic Printers. Inc. I ! CONDEMNATION TAG , I i (' By Order of the Fire Chief (UFC Sec. 2.204) Do not use LUO 0'::.- :3fD'/C 1 ----... / tJ:5?e I Located at 5)9 I 2.(11"'S/ uJ until such repairs or alterations are made. I i it I: Ii it II ,I I, If ,i JI. il If t It is unlawful to remove this tag until inspected and approved by the agency noted below (UFC Sec. 2:104). ~~ Angeles Fire Department ~rt Angeles Building Department o Port Angeles City Light o Other (}D-~ p/ \,r ~...9-</../ __ J A, rV Issued by: i'-C) ~ I"JI ~. /~ I l F/-" ~- Date of posting: \~ I U I !:... v ) c?J 16 <, Time: Failure to comply with this order will result in a legal action (UFC Sec. 2.101). r ~ ~ORT 4-\, 4. O~Q~ " < c:; ~ .,.....~ L. - w --- "> ~ .:>.." ~~ ~~ DEPA~"{" White - PAFD Yellow - Agency Manila - Posting 7-87 ___~___ _______~_l .. Incident Report 2005-0002532-000 Port Angeles Fire Department Narratives Narrative Name Narrative Type Author Narrative Text Narrative Name Narrative Type Narrative Date Author Author Rank Author Assignment Narrative Text CAD Narrative CAD Narrative Incident ORI# = 05M03 Incident # = 200500002532 CHIMNEY ON FIRE, FLAMES COMING OUT OF PIPE EN2 ON SCENE OF A 2 STORY WOODEN STRUCTURE NOTHING SHOWING 20:42:53 INVESTIGATING 20:4 New Narrative Incident 22:50:08 Tuesday, October 18,2005 033 - Patterson, Jake D FFPM 1 The home owner @ 529 Wes8h St. heard smoke dector and went out to check chimney saw flames called 911 threw in some water and closed down stove. E-2 arrived to find a 2 story wood frame structor nothing showing. Inspection of chimney shows sparks from top no fire We inspected the attic found no fue we started to cool the stove/ chimney from the fire box and noted pipe red hot/glowing and found (3) cleanouts had blackened the wallboard/paint. we removed the cleanout covers and applied water down the pipe. we checked the areas with the thermal imager and after more water and time to cool the wall/chimney was still warm to touch but not hot. we found small holes in the pipe inside the chimney The home owner Steve Smith 452-6133 has Farmers Insurance was told not to use the stove til the pipe is repaired/replaced. posted condemnation notice copy to home owner. err J\) -C t ~ ~ :r- U} :-\ End of Report Page: 1 Printed. 10/18/2005 23~ ELECTRICAL WORK PERMIT APPLICAWON Job wired by i.lIl Electrical Contractor 0 Owner Installation description [J Commercial ~ Residential Elc'ctrica! contractor name . ,) & T' [;/..!( If,', ;tJ.y ,........ IPurc~r's mailing address &.' x 22?\ Ci~ 'Eft ~Lli TelcRhone nu her L'/ c.... r.' .- t.I License number Date Expires QNew .. Altered/Addition ?v4/ State ZIP 9f] t,d.-. f../I" C<. rh.>J) ",,1.. 1u..6c:. 1- (w-.R 'lore. ...//.5 .' Premises owner's name Sf-ev<!. t'''''~ 'j"'r'l",,..r-<, ,Address of inspection Q~I W 5;tl. CitY/Jrf' A., l'" . ',--;;)(' IJ Phone number to schedule inspection: . , .\.",,'/..... jj:~1- it/ '-'7 J8D Owner us defined by RCWJ9.28.26/:(l) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if G'bove said property is for sale, rent or lease. 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- lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapler 296~46B. The City of Port Angeles Municipal Code, and Utility Specifications. o Cash 0 Check # o Credit Card Card # Visa Mastercard Discover electrical contractor or electrical administrator x -.~.- Date: '()- 2-D(> Expiration Date of card Electrical Load Additions and or subtractions o NO LOAD CHANGES o Baseboard KW o Furnace KW o Heat Pump Ton LAR Q Fan-Wali KW Service Information o Overhead Service o Temp Service o Underground Service Voltage ;2 'it Phasef!l1 Q ~ Service Size: ;:,,; /4- Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417.4735 ;?fa ,/ ROUGH.IN /' THERMOSTAT SERVICE IO-(~-D&, JuG Date \. Date Approved By Date Approved l:Jy "- Approved By ,/ " FlNAL DITaI FEEDER f2.-?o-Ob kG:) \.~ Date Approved By ./ Date Approved By Date Approved By I nspeclion Area, Building or Equipment Inspected Action Taken Electrical Date Inspector ~) -_/ /.,j -, ----