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Home My WebLink About1113 W 16th St - Building f~ORT~ 'S L~ ~ 'lO;:",~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ,,::, -S , Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00000362 Date 693412 1113 W 16TH ST 06-30-00-0-4-3165-0000- GAYLORD WARREN RES DETACHED GARAGE 4/20/07 v\ €'- 'P RS7 RESDNTL SINGLE FAMILY 6500 Owner Contractor WARREN GAYLORD PAUL 1113 W 16TH ST PORT ANGELES WA 983637039 OWNER Permit BUILDING PERMIT -RESIDENTIAL Additional desc DETACHED GARAGE Permit pin number 99101 Permit Fee 165.75 Plan Check Fee 66.30 Issue Date 4/20/07 Valuation 6500 Expiration Date 10/17/07 Qty Unit Charge Per Extension BASE FEE 95.75 5.00 14.0000 THOU BL-2001-25K (14 PER K) 70.00 _. Special Notes and Comments The Fire Department has reviewed the project application and has no comments 04/13/2007 04:29 PM SROBERDS -- The proposal will result in the construction of a garage in the RS-7 zone for total lot coverage of 27%. No land use issues anticipated. Electrical load calculations and elctrical permits are required. MAINTAIN CLEARANCES FROM SERVICE WIRES - minimum of 3 feet from roof - see Electrical Engineering. 04/16/2007 04:20 PM GMCLAIN ---------------------------- Public Works Utility Engineering has no requirements for this plan review. - - f]i t -. Other Fees STATE SURCHARGE 4.50 ~ """'f- - -.J Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 165.75 165.75 .00 .00 Plan Check Total 66.30 66.30 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 236.55 236.55 .00 .00 /)3 fJ. :t i(l V ~> ~> (f\ -+- 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. L . ,'j / :l~V' Li ~ -' /.leli/, L&-- -, -), O-(}7 Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:IPoliciesll102_15 building pennit inspection record05.wpd [1/412005J " I BUILDING PERMIT INSPECTION RECORD CALL 417-48] 5 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTJONS. CALL 4] 7-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MIN1MUM 24 HOUR NOTJCE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANJ' WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 11'\ A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSI'ECTION TYPE OATE ACCEPTEO COMMENTS YES NO FOUN[)A TlON: (lion OfOLI V' GmJl.- fl &0 r JLL 5-8- P FOOTINGS SHEAR WALLS / WALLS FOUNDA TION DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.l PLUMBING UNDER FLOOR / SLAB ROUGH-lN WATER LINE (METER TO BLDG) GAS LlNE FlNAL DATE ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CElLING FRAMING lP/l 'i / 0+- 1"U. ~ JOISTS / GIRDERS SHEAR W ALUHOLD DOWNS WALLS / ROOF / CElLlNG DRYW ALL (INTERIOR BRACED PANEL ONI.. Y) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL ROUGH-IN HEATPUMY/FURNACE/DUCTS GAS LINE FINAL DATE ACCEPTED BY: WOOD STOVE / PELLET / CHlMNEY MANUFACTURED HOMES FOOTING / SLAB BLOCKlNG & HOLD DOWNS SKJRTING PLANNING DEPT. SEPARATE PERMlT#'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUI'ANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRICAL L1GHTDEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERlNG 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNlNG DEPT. BUlLDlNG 417-48] 5 '1/1'11r1 I TLL BUILDlNG T:IPoliciesl] 102 15 buildin' ennit ins eClion record05.wpd [1/412001] 7 g p p d'O.'~ J~~~ D! "'"~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION :12I EAST 5TH STREET. PORT ANGELES. WA 911362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name . Property Use Property Zoning . . . Application valuation 07-00000362 Date 693412 1113 W 16TH ST 06-30-00-0-4-3165-0000- GAYLORD WARREN RES DETACHED GARAGE 7/30/07 RS7 RESDNTL SINGLE FAMILY 6500 Owner Contractor WARREN GAYLORD PAUL 1113 W 16TH ST PORT ANGELES WA 983637039 OWNER Structure Information 000 000 432 SQ. FT. GARAGE Other struct info . . . . . HARD SURFACE AREA permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date ELECTRIC~L NEW RESIDENTIAL OWNER/ 100A SVC GARAGE 107003 75.00 Plan C~eck Fee 7/30/07 Valuation 1/26/08 .00 o '" "- ~'- ~\.x\ ~t G" ~ \~ Qty 1. 00 Unit Charge Per 75.0000 ECH EL-RM-0-200 1ST SRV FEEDER Extension 75.00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments 04/13/2007 04:29 PM SROBERDS -- The proposal will result in the construction of a garage in the RS-7 zone for total lot coverage of 27%. No land use issues anticipated. Electrical load calculations and elctrical permits are required. MAINTAIN CLEARANCES FROM SERVICE WIRES - minimum of 3 feet from roof - see Electrical Engineering. 04/16/2007 04:20 PM GMCLAIN ---------------------------- Public Works Utility Engineering has no requirements for this plan revi~w. Other Fees STATE SURCHARGE 4.50 ~ ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 75.00 75.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 79.50 79.50 .00 .00 COMMENTS/ACTION NEEDED ELECfRlCAL PERMIT INSPECfION .RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE COMMENTS NO GENERAL COMMENTS: PW-lI02.l' (4'96) ",r- 0 ..... r- .... ..... '" ~~ ~E-o Ul .0:.0: H o.Q :>: ~ Z H g; 3 :>: 0. 0 0 E-o >< ~ ~ ~ ~ .0: ..:l ..:l ..:l U ><>< ..:l P: P: ..:l P: j ..:l..:l P: ~ ~ ~ P: ~ P:P: ~ :>: H :> ~ ~ ~ 0. ~~ ~ 0 ..:l H ~~ H H H U E-o Q ZZ 0. ..:l 0. Z ..:l..:l 0. Ul ~Ul gJ 00 ..:l '> ..:l H '>'>o..:l ~ ~ ~~ :>::>: 0 {IJ E-< ~~ {IJ 0.0. Q .0: 0 :E gj~ :E ~ ~:>:....:>: ~ z E-o'> 0. 0. 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Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: _$J /~ / $;'_ ~J~ IT ,(-jI?!JAt ~.a:-?'I ,dJ -: ~ /Ab-n? ./If'Cl,A/b 5rL~~ ~ ,..--, //f...LJ.", . p/ 'I-~ /L-f'vc' -;~ /1 ,,/ {,P'}-L.-c-. ;: &/l/c:/r-/ / Ik~c::'c- - - C {""-/ r~/!-rn//Ur; ,c/1-7J (;; ~ , 5 ~ 6;t/ ~ tJ {);eX' .. ~ ~; These corrections must be made and are not to be covered until reinspection is made. Whe,n /corrections have been made, please call 4/7 - '7' b'; c:- , for inspection.. ~ p Date U;J 3/0 7 if r/\ , / Inspector for BuildinQr5lVision DO NOT REMOVE THIS TAG or- ....0 ..... lXl o ..... III WW ~f-< <(<( 0.0 :>< ..:l 0: W H ..:l f-< WCJl :':W ~~ f-<OJ Z .. 00: HO f-<f-< UU WW 0.0. CJlCJl ZZ H H N III o .... 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'" 0; ~ e"." ~ I .~ 'p.'''' 0; e ~ ~ w" ~ ~ <>' p __.... ., ..-: ') , _ 1 I _.". ifl.<')o_~o ~ ~%,~<::-o..-'" B) (: :0- -;:, .~. ~ '& 'B ,.... 1 o ~o:'\?,~ ~ ~"~ I,.) ~~';:.-c>~,<;.' ~ \ -a ~ '3 o;'~ '% ' ~ I .r. ~ 0 '" ~ '3 rt!' ~ ~ ~:, '" '" J:.. 0 -0 ~ '0. ' I ~p~"--o"'&<;' ~ ~~~ (;.'1i'> . ~ ';:, if>.o;::. "" P <(;, ~ ~ ~ .'%,- ~ ". ""b '. I 6. .t{j.~ ce.~~~ ~~'d"~~~'~ \:l'.__.J::'O:>~o; c:: I o 0 "0 .s::, .t; c>"O 0. 'B.,,~~':o':'~ u-~~..,,,,,,,,~,.. I o ~ if! ~ .. '-6 ""co \ ~c.o!":.~~"'O\": ..". ....... 0 v c::: ~.- \;, ~'.::,i, ~ --p. P ? 0""'''' .'- - i :t' .Q ~ ~. D ): G ,--- ClG>Q(] QJ 0'J' 3OJtJc.:; -1J-l9/~ ~?I j U I :::> t{ ~ lr: ~ ~ UJ ~3 l-- ~ -'. L .. . /6 -l-.!J- s1-rL rlt,-r <- !J-e; ~ r c.url.b~ L{O J I 0t - -...:; j-Iou5 E. ~ ~ ~ 1 ~~ 110"- IS' J'/ G~RftGE. 3 I sET BfJc.../<. ftLLIl( JI) 'sliT ellek Si tE PLffA/ L BUILDING PERMIT - APPLICATION (l i FiU out COMPLETELY and in INK, Your application and site plan MUST BE COMPLETE to be accepted for review, If you have any questions, can \. PERMITS (360) 417-4815 FAX(360)417-4711 FOR OFFIClA.7.US~ONLY: DateRec.:1, r, o? pennit#:~ Date APpr~Ved:~'" Date Issued: Applicant or Agent: ~J9. yLo f..f) . W /l- R R ~ AI Owner: {;i9yLoH...D (lJ f}..RRE.tv Address: { ( I 3 W I fa +-.!J. City: Po e.. + Ihu!J ~ LIZ.. S Phone: Phone: 3GO - LI.s~ - Q08:t. Phone: 3~() - 4s:2 - q 0 8.::l Zip: q8363 ArchitectlEngineer: Contractor Address: PROJECT ADDRESS: / '13 W LEGAL DESCRIPTION: Lot: /7 CLALLAM COUNTY PARCEL NUMBER: State License #: Exp: Phone: City: I ~ i.l1 POtl-t f+PJ c1 ,-S Block: 43 I Subdivision: Zip: ZONING: SIZENALUATION: SF.@$ ISF.=$ SF.@$ ISF.=$ SF. @ $ ISF. = $ TOTAL VALUATION $ ~SOO tJ5!. 18 i X 2. L/ \ (;/r R. fJc. e "'I'?Jl ~~ ft- ~ ItIU /) 5 ( 0 I \ hi /J-AJ boo Il.. TYPE OF WORK: o Residential ~ New Constr. 0 Re-roof 0 Stove o Multi-family 0 Addition 0 MoveJ( Garage o Commercial 0 Remodel 0 Demolition 0 Deck o Repair 0 Sign 0 Other BRIEF DESCRIPTION OF THE PROJECT: t.u / q , ~ ') 'l 0 V fJLIf/t:R D Doo It . COMMERCIALlRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: I Lot Size: $'0 ')C 140 Existing Sq. Ft. '['1 t.J 2 & Proposed Sq. Ft.~3 J.. = TOTAL Sq. Fd ~ 80 Total lot coverage ~., % APPROVALS: PLAN: BLDG: DPWU:_ FIRE: OTHER:_ PLANNING USE ONLY: ESNWetIand(s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No 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. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are d,ue 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 R105.3.2 of the International Building/Residential 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 permits are required ,not the City's, and that I must obtain such permits prior to work. dt /7 f/) / U _ C; ...... 0 7 T:\FORMS\BldgPennitAppl..wpd Applicant;. /~~ !L..b--- Date: .../- -{ / i/ ___J :'C'PORT~ ~...O~~"" &ha" "-~ ~ ~C~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 04-00000855 Date .877440 1113 W 16TH ST 06-30-00-0-4-3165-0000- RE-ROOF 9/24/04 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation RS7 RESDNTL SINGLE FAMILY 1500 EXPIRED ~?4 /t7r7 Owner Contractor WARREN GAYLORD PAUL 1113 W 16TH ST PORT ANGELES WA 983637039 OWNER Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT - NO PR FEE TEAR OFF,FELT, COMP 77.50 Plan Check Fee 9/24/04 Valuation 3/24/05 .00 1500 Qty Unit Charge Per Extension 47.00 30.50 BASE FEE 10.00 3.0500 HND BL-501-2K (3.05 PER C) Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Cred~ted Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 77.50 77.50 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 82.00 82.00 .00 .00 --- "- -.... 0\ c '"'- ~ ~ !} 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 ;ZL{ S ~ T.\PLANNINGIFORMS\1102.15 [11/1412003] r/ y /),j g i FEE RECEIPT NUMBER CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A fJ~~rl . TOTAL FEE 1&, ~ ,"OD~I../I1 i CONT.lIe. NO. ;1.IJOV gy K.' - ME TO COMPLETE LEGAL OCCUPANCY NO. STORIES ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT /' , '? ~ " . fi. Site Address / I:.') .c.'S1 IC, '-'" /1 CORRECT A DRESS IS RESPONSIBIliTY OF APPLICANT PERMITS WITH WR~NG ADDRESS~SAARE CANCE~LED '.! 1'. Owner c2/JvLotLl) P,WA-I]f?E/l/' InstallationByX RlOOVllt1!. Mobil (-!olliE. 1k1l./I',/~tE. owner'sAddret.. 11/ J W Et-; f- / J 'f-!J InstallersAddressl( /3S /-I-"..:;/::. iii'S Rb Day Phone '-/.<),;}- 9015:). "l<.lf....,')-/4//..3 InstallersPhoh~'/.> ~~k.l;:."'~LI.s) (.U)., '71/8"'8"//( Application is hereby made for Permit to install Electrical Equipment as foliows: ~ , N I.'i h. /-I co k " (..I D _:f'O/l. /J1o[)u..L/F~r If o Hll-': ti.lJ/t.'t By kF:/<.IfWoo{) HOJI--IES, WiriQQ Method _R (\ Me.)( .; AMP 24QV NUMBER AMP 120V . . 24QV USE OF CIRCUIT NUMBER PEA .12DV 100R FEE uSe OF CIRCUIT PEA l00R F.EE CIRCUITS 10 CIRCUITS 10 CIA 30 CIA .' 30 LIGHT iJ 15' V SIGN I LIGHT - I 50 VOLTS OR lESS CONVENIENC'1'~ F. I, '20 V MOTOR CONVENIENCE MOTOR APPLIANCE rPfl[fP I 7D t.../ MOTOR DISHWASHER IS" V FIRE ALARMS DISPOSAL BUAGLAA ALAAM ~ CDOf'mo I 40 ~ IVf61 MISC. OVEN 'W ./& WATER HEATER --:2..<; /lR LAUNDAY W~ '70 t/ f. DRYER I '7,0 liS) REINSTALLATION liGHT FIXTURE # FURNACE /' ~ . "- . SUB TOTAL FEE GAS. OIL ~ - FURNACE (( Zo KiJ ) /& ENERGY FEE ELECTRIC BASIC FEE ELECTRIC HEAT / . TOTAL FEE ELECTRIC HEAT \ ./ SIZE OF SERVICE SWITCH OR CIR UI;.bEAKER A.C. UNIT '7..=.fl AMP PHASE FEEDER I 2"l9 SIZE OF SERVICE ENTRANCE CONDUC'rORS . 3/p l.tOI t J In JJFil. SERVICE ,AW.G. I SUB- TOTAL ...:10/ f- SIZE OF{;AOUND SIZE bF E~~ANCE SWITCH I certify that the work to _be performed under this permit will be d~:me by the insta~ler and l:':onfoJmance with thAlN.~.C. ,~c.trlcal Code. Date Appiication made dr/T ;;).4ti- ,19 BL.{ By t:::?Y1. J:rt Ill/If{ "1 CONTRACTOR QR QWN (AAU~~GENT) . Permission Is hereby given to do the above described work, according to the conditions hereon and accord I JJo the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. l ~' v WARNING . . By . 1td:;;0/?1:~~ ~ PLA{;:f:ROVED 7 ~ Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in Writing on Permit Placard. A. - Permits Phone: 457.0411 Ext. 158. PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER - . Date Permit Issued WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report OLYMPIC PRINTERS, INC. _ .f" ; ~..' ~ " \' '"T.. ..,~ j ..:~----=- REPORT OF'INSPECTOR DATE OF VISIT MADE BY \. ,\, ~-r..." \...,11 . - .. .....L'.\~. ,., ~',,,,\.-\ REMARKS ~ \~... . -;...'\ ~ \ ' . - \.....;. ......_~,\ (",~ ",/""1:\' LI,,\ 'k ~', J i\\ >, " ~\ ; ~ .,,;,\ .\' '"I'" ~ \, \\ '0, c- " .. " .. .\ I ; , , -,' - \,,1' f" " . '\ , . h '0 .., ,'") \ , , .\ , J , ,. ''''. \:\ I , j(".-' - 1'-' I ...\, ,(', . . I It/_l SC7 ' 7lil7r\....-" 'P~;2fJ ~S- ''115i " \ -~, .~ 'I :~ . I O.K. FOR COVERING O.K. TO CONNECT SERVICE FINALO.K. '/ .' r)\ .1\ ,~.l. "\::.:'\'V,} .1', \.. ., .., \, ~ \~', t....'..;.... . , '\ >," \ .'\ \.\ \:~.-'-; \ .!!..' ,r:;'t.. l\, " ~_, .-,' .......-'J ~ 1 .......' \) '" '\:." ~ "~.I.. \( .l\!~ " i ~ '_,\ Y I " ~ :" . ' \: \ \ . (I ~".~ V \\ " ) -' ,;: \' " \ - \. " " ,....l.\.,~ t., \ ~ ('\ 'II', -- .'"y_ \. 14' , ~\ ;)1 . " . , , . Z Cl 11:. <I: :E ~ " J: I- Z W .. . l- e z e .. Q .. . ~- , ' , . ^ ELECTRICAL WORK PERMIT APPLICATIqN Job wired by o Electrical Contractor )l!l: Owner Installation description o Commercial 0 Residential Electrical contractor name License number Date Expires ]lNew o Altered/Addition Purchaser's mailing address City Slate ZIP J.... '-I 1. I S' GI+rl4j f Jo It. LI'j'L1- 5 ~D L.J;f(..~ Dol u/:s Telephone number FAX number Premises owner's name AdS:~ :ii~~''::.?_ ~. ..~~ ~, P- It ~(I) -.lJ I ~ .G.:l I b 6-<51:. CHY0 t- ---.:..ro It. ,~g d ~ S Phone number to schedg inS cellOn: '15).- 0 w. 1..{~'7-0700 OWI/er (IS defined by RCW/9.28.16/:(J) Owner will OCC/lpy the structure for Iwo years after this electrical permit is finalized. (2) Owner is required to hire an electrical cun/rae/or !f ahove said properly is for sale, rent or lease. Arter reading the above statement, [ 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. Chaptcr 19.28, WAC. Chapter 296.468, The City of Pori Angeles Municipal Code, and Utility Specilications. o Cash 0 Check # o Credit Card Card # Visa Mastercard Discover x Date: 7-/0-07 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 o Fan-Wall KW o Overhead Service o Temp Service o Underground Service Voltage Phase 0 1 0 3 Service Size: Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-h'l THERMOSTAT SERVICE Dale Approveu By Dale Approveu By Dale Approved By DITCH FEEDER Dale Approved Hy Date Approved By I nspeelion Date Area, Building or Equipment Inspected Action Taken Electrical Inspector 2 "