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HomeMy WebLinkAbout2417 W 16th St - Building s... ~~. CITY OF PORT ANGEI:.ES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUilDING DIVISION 321EASTSlH STREET, PORT ANGELES, WA 98362 ~ Application llumber pin number . . . . Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use . . . . Property Zoning . . . Application valuation 04-00000867 Date .606015 "-. 2417 W 16TH ST 06-30-01-6~3~9020-0000- MECHANICAL PERMIT 9/29/04 RS9 RESDNTL SINGLE FAMILY 6685 Owner Contractor FIELD, CAM AND CARLA 2417 W 16TH ST PORT ANGELES WA 983631347 (36) 45-9690 DAVE I S HEATING & COOLING PO BOX 413 PORT ANGELES WA 98363 (360) 452-0939 _________________________________________________________________________4__ Permit . . . . Additionaldesc Permit Fee Issue Date Expiration Date MECHANICAL ~PERMIT FURNACE,HEATPUMP,DUCTS 61.70 plan Check Fee 9/29/04 Valuation 3/29/05 .00 .0 Qty Unit Charge Per Extension 47.00 14.70 BASE FEE 1.00 14.7000 ECH ME- INSTALL 100- FAU Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 61.70 61.70 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 61. 70 61.70 .00 .00 ~ ...t: - ....::r 11 < t r ~ ~ "':"t'< ..:s- . !j S~paratef>>$rrrilts are required forelectrlcal work, SEPA, ShoreUne, ESA, utiUties, private and pubUc ImprOv~ments. Thisperrl1lj,~~()mes null and void If work or construction authorized is not commenced within 180 days; If construction or work Is suspended ()r abandoned for aperioitot180 days after the work as commenced, or If required inspections have not been requested within 180 days frofiithe last inspectlon,_ .I.h~reby <;ertify that I have read and examined thisappUcation.and know the same to be true andconect. All provisions of laws andprdinances governing this type of wo.rk will be complied with whether specified herein or not. The granting of a permit goes not presume to give authority to vIOlate or cancel the provisions of any 'state or iocallaw regulating construCtion or the perfonnanceof construction. . / - ...... t9 ^ 1-( f.-.~ Signature of Contractor or Authorized Agent Signature of Owner (If owner Is builder) Date Date T:\PLANNING\FORMS\II02.IS 11111412003) t -'-~'.~',;.,;, ;,-,_,:0,,:_, _.;0- !'<lIi PERMIT INSPECTIONRECO~ CALL 417-4815 FOR BUlLDINGINSPECI1ONS. CALL 417-473SFOR ELECTRlCAr.INSPBCTIONS. - .' . ..- ". '. " . PLEASE 'PROVII>e'AMINIMUM 24}iOl"ffl.}Il()'fICE. ..ITIS UNLA WFUL TOp'OJlER,;JlI{~1/14r.~l!l.!,~QffqgAL~JIIORIg,!,EFqRE . ..... INSPECTE})ANIiACCEPTED.POSTPERMI'J.' IN AC()NSPICpOJJS\LOCAnON. ..r' ...../ " KEEPJIERfMrCARD AND APPROVED PLANS AT JOB SITB. ", ' INSPECTION TYPE DATE ACCEPTED = COMMENTS " ,. .' " . ' YES J: NO .'. ','. ':'.' FOUND^TlON: .' . FOOTINGS , WALls .> . FOuNDATION DRAlNAGEIDOWN SPOUTS , ; ELEC1lUCAL (UGHTDEP1) SEPARATE PERMIT: /I '. " , '.... ROUOH"IN " r I . PLUMBIN~ , : . . :, UNDER FL09RI SLAB ROUGH-IN .' . WA~~,(METER TO BLDG) dAs wm, ' .' " : i BACK FLow (WATER " , . . :'. AIR,SEAL .' , ,,". WALLs , " f J CEILING -e" I I I FR,utII'is; . , JOISTS I. GIRDERS sHEAR\VAiLlHOLD DOWNS , wALLs/ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T"BAR. ,', '., '. , i " ,.' INSULATION" .... SLAB .'. I WALL (FLOORl CEILING T , I 1 . M~' , , , . HEAT~ , . .' <GASUNE, " woop'Sii:WB (PiiLiEi I.CHIMNEY ; HOOn/,DUcTs , 'PW ~J:s''tSlTE WORK ,(Engineering Division) SEPARATE PERMIT /I's: , WA~tNBi{:~, " SEWER:~ON SANITARY ., STORM '. , - ,:.,,.. . PLANNINf:;DEn.', SEPARATE PBRMlT t#'1 , SEPA: , ,PARKINGlLIGIl'i'ING . "',' BSA: ~.7.'_""_""_"_",_""",,,,_,,,,,,,,,,,_;___,,,,;,,_,,: , " ,~~G;:,i#;'; " ". SHOR!!LINI!: .,{'iL"r: :;"',, .'" ,<,,' ;. F1!IIAL INSPECTIONS REQUIRED PRIOR TO ,OCCUPANCY/VSE\., , " '; , 'RESIDENTIAL - DATE YES NO COMMERCIAL .- ,DAn "'~~EPTED' 'v , . YES NO ,ELECTRIC#oAUGHT.DEPT. m.BcriU& -.-- : . 417-473S' " ". LIGHT'DEPT " , , <XlNSTRtJtnoNR.W./ PW/ CONSTRUC11ON,,'&'W. ENGINEERING , 417-4807 PW / ENGINBE1UNG FIRE ." , ,.,. 417-46S3 FIRE DEPT. .' ", , , ". , pLANNING DEPT. 417-47S0 PLANNING DEPT. , ":,' , , BUILDiNG ", 417-4815 I/7i. /- . ~ .)., BUILDING , ",' " T:\PLANNlNG\FORMS\1 U12.IS {I 111412003] ~. . 'j : ;{~~< PREPARED 10/06/04, 8:15:16 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 4 10/06/04 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 2417 W 16TH ST DAVE'S HEATING & COOLING FIELD, CAM AND CARLA 06-30-01-6-3-9020-0000- 04-00000867 MECHANICAL PERMIT SUBDIV: PHONE: (360) 452-0939 PHONE : (36) 45-9690 PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 MECHANICAL FINAL Call Cameron before you go at 460-6658 -------- COMMENTS AND NOTES -------------------------------------- FROM :Da~e's Heating & Cooling Srvc FAX NO. :13604520939 FOR OFFIClAL USE ONLY: Date Rec~ 7 -O~ Permit tI: ....Ab 7 Date Approved: Da~ Issued: 1t. co,,-t-~ ("OVl".e.OWII\~V- -/1:l Gt <;.c.JL,.$S CAR LA I $ Wo~ K PHoM:; ..5~S:";~5S / Cq....(Q'S """"rt::;. 45;).- ?b"tO Sbs-3;;)S5 , Applicant or Agent: Phone: Owner: C ~ Vh -e. v-o V' <::4-- Co. v- \ <^. F \' -e.J J Phone: Address: ;l t..( \ -, W. {left 5-/r-e.e- +- City: (0 rJ.. k ~ Le...s ArchitectlEngineer: . . Phone: - . . . . .:DAVes HCC?'1/ I:.c...... . /. Contractor..DOlV-elS +-\-eG\.j1~"'f Cool \ n.~ State LiCenSe #: t.xp: 5')05 ..::>en/I , ~c;...-. j) J Address: f o..lhx- ~/3 City: roY'../- .7t71.~lo.s PROJECf ADDRESS: ;; t-{ , -, w. /6 -th ,5'-f-re.-e.;f' ? '7 LEGAL DESCRIPTION: Lot:. Block:' CLALLAM COUNTY PARCEL NUMBER: 7 Zip: q~3b3 Subdivision: Phone: 'fs:1-o93CJ Zip: cn?:k:;~. ZONING: ? -? Credit Card Holder N.'P: ....Te~ ""~ P. o. "'........... .~q n - BilUDl Address: [../2.' ~OX ~t 3. City: 0 ## TYPE OF WORK: SIZEN ALUATION: I(' Residential 0 New Constr. 0 Re-rool 0 Stove SF. @ $ /SF. = $ Cl Multi-family CAdc.tition 0 Move 0 Garage . .' SF. @$ ISF. "" S o Commercial 0 Remodel 0 D~lition 0 Deck .... -SF. @$. . '. ISF. = $ o Repair 0 SigIl .0 Other . :TOTALV~LU~TION $ '==-( lo<f5Sesa BRIEF DESCRlPTlONOF T.JIE PllOJECT: I Y\ 5+01.\ \ ~+\ on oS(- ele.c:..+n c:.' +u.'t"'I'\<,\,c:.2- '*- h.e.~+ P'^-""f) ~\~~ ~ e.~(\'STh'7 dlA.c..-+ uJo-rk.j ~ \OI..U VO \-\-a...~ ~VY'.o"::.-\-a:k w,r-e.... COMMERCIALIRESIDENTIAL: Occupancy Group: - Occupant Load: . ... Construction Type: No. of Stories: _ Lot Size: Existing Sq. Ft. & Proposed Sq. Ft. = TOTAL Sq.Ft. Existing lot coverage _ % & Proposed lot coverage _%... Total lot coverage % APPROV ALS: PLAN: BLOG: DPWU:_ FIRE: OTHER:_ ~ fLf:A5[. 'PAX cOfVP::I RMA-rxotJ 'To -'70;;>.-6 "3Cf BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the applicatioD all plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In.O eases, a valuation amount must be entered by the applicant. This figure will be revicW'c and may be revised by the Builduig Division to comply with current fee schedules. Contact tbe Permit Coordinatorat 4 17 -48 I 5 for assistant PLAN CHECK FEE: IF a plan cbeck fee is due it must be submitted at the time the building pennit application and construction plans al submitted. All otbcrpcnnit fees arc due .tthe time ofpennit issuance. EXPlRAnON OF PLAN REVIEW: If no permit is issued within 180 day. oftbe date of application, the applleatioD will upire. TI Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 I the Uniform Building Code, eWTont edition). No application can be extended more than once. PLANNING USE ONLY: ESA/WetJand(s): eYes [J No SEPA Checklist required'? 0 Yes 0 No Other; / hereby certify that I have read and examined this application 8nd know. the same to b& tfUfJ and correct. I am authorized to apply for this permit 81 understand that it is my responsibility to determine what pennits are req Ire . not th CifY.'. 8 that sf obtain such permits prior to work. T:\FORMS\APf'S\BuildinlJlOlUlil.wpd Applicant: Date: '1/::)/ /lJt/ ~::'--- ! J . , crry<OFPORTANGEL,ES DEPARTMENT OF COMMUNITY DEVELOPMffi\rr .... BUILDING DIVISION 321 EAST5TJ{S1REET, PORT ANGELBS,WA9.8~62 Application Numb~r Pinilumber . . . . Property Address . ASSESSOR.. PARCEL Nm>mER: App+g:a~ion description subdivision Name Property Use Property Zoning . . . Application valuation 04-00000895 Date 10/04/04 .101560 2417 W 1.6TH ST 06-30-01'-6';3-9020-0000- ELECTRICAL ONLY RS9 RESDNTL SINGLE FAMILY o 48.10 10/04/04 4/03/05 . Plan Check Fee Valua.tion .00 e OWner Contractor FIEIp i CAM AND CARLA 2417'W.16-TH'. ST PoRT ANGELES WA 983631347 (36) 45-9690 .APS .ELECTRIC 546 BENSON RD. PORT ANGELES PORT.. ~GELES (360) 452-6753 WA 98363 -------------------------------------------------~-------------------------- Permit Ad.ditional desc PeZ'\llit Fee Issue Date II Expiration Date ELECTRICAL ALTER RESIDENTIAL -'"-,,,! Qty 1.00 Unit Charge Per 48.1000ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48..10 tU ~ --- ~. Fee s~ry 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 ," <S" j Q ~ ~., -. ~. ~ '. Signature of Contractor or Authorized Agent Date Signature ofOwfter (if owner is build~r) . :. Date Separate ~QlJ11its are required for electrical work. SEPA.Sholl'l!ln~. E$A. utilltieti'llrivate andpubli~JmP~~m~~~,;l1'1!~. . null anc:lvoidif work or construction authorized Is not commenc~d\yithin '180 days,if construction or. Yfo~ls 'suspgrid." .. ,- for a period of. 180 days after the work as commenced, or if requlred'lnspectlons ~ve not b6en r9ques~ ~:I~O"cIa; InsPllc:tlc>>n;;lh~reby~ertify that I have read and examined thi~appUCationandkQp\y the same to be trueilQ,d,<<?priect..Pj{ .' lawS'and oroinances govemingthls type of work will be compUedwith whether'5p~ed herein ornol TheiJranting otap .' .... ....... es"not presume to give authority to violate or cancel the provisions of . any 'state or loalllaw regulating constrUCtion. or tI1~perf()[I11ancEt of construction. .... . ." T:\PLANNlNG\FQRMS\II02.1S [1111412003] f'-- . ., ".,':'~!'!<t ~,"<<'ic ,'f; .. ",/,-;",::.:.";,,'., ,;::.'.{r'~':,"';;' BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 fJ:QUR NOTICE. IT IS UNLAWFUL TO tOVER,JNSUUTEOR coNcfEALAlVYWORK BEFORE INSPECTED AND ACCEPTED. . POST PERMIT IN A CONSPICUOUS LOCATION. . KEEP PERMIT CARD'AND APPROVED PLANS AT JOB SITE .- INSPECTION TYPE .' DATE I . ACCEPTED . COr.IMENTS I YES I NO . . . FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGEIDOwN spoUTS .' ELECTRICAL (l.1(jHT DEPT) SE?ARA~PERMIT:# .11. (~he _..LI~B/J ROUGH-IN ..... IJ'D-L'1'I.LI~1f I . .' PLUMBING '. , .UNDERFLOOR/ SLAB RQUGH-IN WATER LINE (METER TO BLOO) . . GAS LINE BACK FLOW / WATER AIR SEAL . '. WALLS I I CEILING .'. I I I FRAMING . >.' I JOISTS / GIRDERS SHEAR W ALUHOLDDOWNS I. ..... WALLS/ROOF/CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR '. ..' .; INSULATION .. SLAB .' I . WALL/FLOOR/CEILING '. I.... I I '. MECIJ,4.NICAL . .' . .- . , ',.L.'. i,; MEAT J't!MP I. ." GAS LINE . .."iX':. '. " ? .\,.. ..,........ WOOD STOVE / PELLET / CHIMNEY ....:.. HOOD / DUqrs . PW UTILll'JESI'SITE WORK (Engineering Division) SEPARATE PERMlTt#'s: .... WATERLINE/ METER SEWER CONNECTION I, SANITARY STORM PLANNING DEPT. SEPARATEPERMIT#'s SEPA: PARKINGILIGHTlNG' ESA: .. . LANDSCAPINC"....>;.. "',...,.' .." ".' ...... ., SHO~ ~ ~ ' , :- .~ .. . ..<;'-'-, c....>.;,'; .". . ;"(~AL'INSPECTIONS REQUIRED PRIOR TO OCCUPANcrfUSEi. .... , ..<..... . RESIDE,NTIAL --c DATE . YES NO .' COMMERCIAL DATE' '. .' I\CCEl"n:D, .. .... I.,' , YES-'" NO ," 7( I( . '" ... ELECTRICAL - UGH:f DEPT. 4174735 'b~f, "04' ELECTRICAL UGHTDEPT CONSTRUCTION R. W./ PW/ . . CONsTRUCTION - R. W. ENGINEERING 4174807 PW / ENGINEERING '.' FIRE >417.4653 FIRE DEPT. '. . PLANNING DEPT. 4174750 PLANNING DEPT. Bun.DING ..... 4174815 inJILDING .' .' T:\P~II02.15{11/1~) CIty of Port Angeles c)w _ <:00 T - '2./ 'ie Public 'Vorks Departnlent "Tater Distribution Repair Report 3S:B 'Work Order No: ~ L31 I Crew 7/Y DATE REPORTED' ~-1}-62- CONDITION EMERGENCY 0 ROUTINE 0 CITIZEN COMPLAINT ~ ~EAKAGE SURVEY 0 OTHER 0 ---,; -6J- TIME. S fA.M. DP.M. ADDRESS 9- Y I 7 (.,1/ Iff{ DATE OF REPAIR.. REPAIR. LOCATION TYPE OF MAIN SIZE. DEPTII OF MAIN CLOSEST VALVE DEPTII. COMPONENT REPAIRED. MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAKj 0", .. _ J _ 5 A e- 6J5/lI j? E- HOLE 0 CLAMP 0 OTHER R-eNetAJ.ed Ix/o..Gl'\.. It! ( SERVICE TAP 0 CORP STOP 0 PIPEw!CURB STOP 0 FITTING 0 Vf j:? E METER SETTER 0 METER 0 LINE VALVE. FLANGE NUTS/BOLTS 0 STEM 0 BONNET 0 HYDRANT BRANCH 0 VALVE 0 BARREL 0 OTHER. COMPONENTS OF REPAIR. CLAMPD DRESSERD OTHER SITE CONDITION GRAVEL 0 ASPHALT 0 SIDEWALK 0 CURB 0 TOP SOIL AREA 0 SOIL TYPE CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT DRIVEWAY CUT _FT MAIN CONDITION INTERNAL LINING TIJBERCULA TION-MINOR 0 SEVERE 0 EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0 CHLORINE RESIDUAL SAMPLE ~P.P.M. WATER OFF FROM gA- M.TO 91fM. ())J ...e /loose 6-/;1+ 6 r j erc){[ ~ FROM M.TO M. APPARENT CAUSE OF LEAK. 13 v; If/-e: '!If r E ~p J;L 106 k-c'd 1-v>K--R- 50 CJJc -e t- If-c, c; .~ 1.0+5 of ~/)J /fo/-e 5 r1_T~_ l~ ~ ~ -- "t&;~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 03-00000877 Date 9/22/03 2417 W 16TH ST 06-30-01-6-3-9020-0000- ELECTRICAL ONLY o Owner Contractor FIELD, CAM AND CARLA 2417 W 16TH ST PORT ANGELES WA 983631347 (360) 45-9690 OWNER Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL 200 AMP + HOT TUB APS ELECTRIC 64.90 Plan Check Fee 9/22/03 Valuation 3/21/04 .00 o Qty Unit Charge Per 1.00 64.9000 ECH EL-R OR RM 0-200 ALT SRV FOR Extension 64.90 ~ ~ .......... '-.J Permit Additional desc Permit Fee Issue Date Expiration Date EL-HOT TUB 29.-6-0 9/22/03 3/21/04 Plan Check Fee Valuation .00 o t't ~, ~ ~ ,~ ~ L1 r, Qty Unit Charge Per 1.00 29.6000 ECH EL-R-HOT TUB W/SRV Extension 29.60 Fee sununary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 94.50 94.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 94.50 94.50 .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.J5 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 WALLS FOUNDATION DRAINAGE - ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I PLUMBING - UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL WALLS 1 ROOF 1 CEILING DRYWALL T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING MECHANICAL - . HEAT PUMP WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engmeenng DIvISIon) SEPARATE PERMIT #'8: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'8 SEPA. PARKINGILIGHTING ESA: LANDSCAPING SHORELINE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ';1.;/0:5 ~ ELECTRICAL LIGHT DEPT I' r 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.\PLANNING\FORMS\1102.15 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 03-00000877 Date 9/22/03 2417 W 16TH ST 06-30-01-6-3-9020-0000- ELECTRICAL ONLY o Owner Contractor FIELD, CAM AND CARLA 2417 W 16TH ST PORT ANGELES WA 983631347 (360) 45-9690 OWNER Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL 200 AMP + HOT TUB APS ELECTRIC 64.90 Plan Check Fee 9/22/03 valuation 3/21/04 .00 o Qty Unit Charge Per 1.00 64.9000 ECH EL-R OR RM 0-200 ALT SRV FOR Extension 64.90 ~ '" .......... '-J Permit Additional desc Permit Fee Issue Date Expiration Date EL-HOT TUB 29.'6-0 9/22/03 3/21/04 Plan Check Fee Valuation .00 o ~~ ~, ~ ~ ,~ ~ l,1 r '\ Qty Unit Charge Per 1.00 29.6000 ECH EL-R-HOT TUB W/SRV Extension 29.60 Fee swmnary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 94.50 94.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 94.50 94.50 .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 oU80 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 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE - ELECTRICAL (LIGHT DEP1) SEPARATE PERMIT: # ROUGH-IN PLUMBING - UNDER FLOOR I SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW I WATER AIR SEAL WALLS CEILING I FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYWALL T-BAR INSULATION SLAB W ALL I FLOOR I CEILING I MECHANICAL - - HEAT PUMP WOOD STOVE I PELLET I CHIMNEY IIOOD I DUCTS PW UTILITIES I SITE WORK (Engmeenng D1V1slOn) SEPARATE PERMIT #'s. WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA PARKINGILIGHTING ESA- LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL - LIGHT DEPT. 417-4735 'JIZ.t,h3 /IUJ ELECTRlCAL LIGHT DEPT CONSTRUCTION R.W I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T.\PLANNING\FORMS\1102.15 [412002] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 03-00000877 Date 9/22/03 2417 W 16TH ST 06-30-01-6-3-9020-0000- ELECTRICAL ONLY o Owner Contractor FIELD, CAM AND CARLA 2417 W 16TH ST PORT ANGELES WA 983631347 (360) 45-9690 OWNER Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL 200 AMP + HOT TUB APS ELECTRIC 64.90 Plan Check Fee 9/22/03 valuation 3/21/04 .00 o Qty Unit Charge Per 1.00 64.9000 ECH EL-R OR RM 0-200 ALT SRV FDR Extension 64.90 ~ ~ ......... '-J Permit Additional desc Permit Fee Issue Date Expiration Date EL-HOT TUB _29."6-0 9/22/03 3/21/04 Plan Check Fee Valuation .00 o t't ~, ~ ~ ,~ ~ 1Il r, Qty Unit Charge Per 1.00 29.6000 ECH EL-R-HOT TUB W/SRV Extension 29.60 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 94.50 94.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 94.50 94.50 .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 or180 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 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. 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 INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE - ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING - UNDER FLOOR I SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW I WATER AIR SEAL WALLS CEILING I FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYWALL T-I3AR INSULATION SLAB WALL I FLOOR I CEILING I MECHANICAL - . HEAT PUMP WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engmeering DIvisIOn) SEPARATE PERMIT #'s. WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA PARKINGILIGHTING ESA- LANDSCAPING SHORELINE' FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYtuSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 7/1." /r; :5 ~ ELECTRICAL LIGHT DEPT CONSTRUCTION R.W I PWI , CONSTRUCTION - R. W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT I3UILDlNG 417-4815 BUILDING T.\PLANNING\FORMS\1102.15 [412002] ~ . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 PERMIT NO. .s- / s- f DATE Co tG>~r ELECTRICAL PERMIT Installed By: o READY FOR INSPECTION license Number: o WILL CALL FOR INSPECTION Phone: Site Address: Owner/Business: Phone: Owner/Business Address: Sq. Ft. ELECTRIC HEAT o BASEBOARD KW _ o FURNACE KW o HEAT PUMP KW o FAN/WALL KW _ o RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION o REMODEL 'l5iC ADD/ALTER CIRCUITS tJ SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE o RISER o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: o q\ D3rD SERVICE SIZE FEEDER SIZE AMPS AMPS DetailslDescription: G- FC A- c~ A. ;lLt/-u / , . W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ~Final O.K. Site Address: New Meters - Installer: . Notify Port Angeles Ci Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and 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. # ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ f/" e:::2.r Electricallns6ector Permit Fee WHITE - File by address PINK - Top: Eng, Bottom, Customer GREEN - Top: Meier Dept., Bottom: City Hall OLYMPIC PRINTERS INC. CITY OF POI!lT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT , N~ 17818 7 - .:; /' Ie) Port Angeles, Washlngton__mm...:m..m....__....m.__..__..____._.._.m___..... 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 d6 electrical work as listed below. . <9 Y/? i-rI.g!/t5;jf; /l-~ Address mm_.m.__m.m.__.__.____._.___.___m--..__.__.__._____.__m.______.mm____. Occupancy.____m..__.___...m.mm._.._.m.__m____ ow~er --~~l~--m.~~bc::m TenanL.m.m.m.m..._m___.m_.__m________mm.__mm.mm... Wirmg Contractor .____.__m__....___....mm.___________m__m_m__..__m._. By__...m.m..m__.mmmmm....mmmm.mmm.__..m. $ V Light Outlets___.....__......._...................... Receptacle Outlets...~........_.......... ServIce, yolts ....................................... No. wIres ....................................... Dryer, KW........n...........__................... SIze wires..................................._.. Range, KW m.hm...m.m..... Wa.ter Heater: Main fuse ....................................... Enclosure .........__............................ KW.m................................... Type of wIring: Entrance Cable .....mm.mm..... Heat: KW............................................ Motors: size, yolts and phase: Rigid Conduit ............................... Metallic Tubing .m....................... Current transformers: No. & Size....................................... Ser. No........._..................................... Ser. No. ............................................. SeT. No. ............................................. Type of Wiring: Armored Cable .............................. Non-Metallic ................._.............._ Knob & Tube........._....................... Rigid Conduit ............................___ Metallic Tubing ........................... Raceway ..............................._._..._ CIrcuits, Light....................................... UtlIily............................................. Heat ......................................._.._.. Range ......................_...................... Water Heater .......h...................... Motor ............................................. Dryer .................._.._.__....................__ Furnace . ........................,~................... Remarl:~I.:__:~~...~;,!,:~~~::.L1~_.____S~~Z~=.l:...~:=_;.~~~-d__.mm.~~~::__~::~...~.:.-.....:..:.....:~....:. nn__.____..____n________n__.______.~.~.__~nn_______n____uun~n__~...~___.__nnn___.____~~___.____nn________~....n__nn__.__._u._h._u____n_u__uh_~_.n.... Permit Fee ___n..~~.__.__nu____.___..u__..~___n~___n__.uh_.__.__h______~_._____n________~h_~____uu__..__.__.h._nn__.__nnn____u___..._______.____.uun.....~__.u..~__ $:m__.____m.m........m.mm.. Treas. Receipt NO..____...__......m_.__.... j/Y~ By __.m.____.m...mm..__mmmm__________m.m__m__..__._ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It 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 N~ 1 78 1 8 Address................_...__.............................d.............................................._....................................Date..._......____.._.._.........._......_......_......._ Owner ................_.................._.........._......_......_.._.............._........................................... Tenant..................__................................................ Wiring Contractor........................................ ................_....;~............................._...............;,.~........._.By.............................................................. NOTICE-Current must not be turned on untn Cert1flcate of Inspection has been issued. If work Is to be con- cealed due noUce must be given the Inspector so that work may be Inspected before concealment. l 1M Olympic Printers, Inc. . CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 16454 / ~ -.;L. /c Port Angeles, Washlngtonumu_.ummu________..u.__.m.mmm_......m.. 1900.00.__ 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 d6 electrical work as listed below. Address u.,2u?:f.12m~/._f.m~._~____.umuu__.u__.m.m Occupancy.um~:ummu.........mu. ~. ':)i!- ';i/~;J! ~::: ~.~:~:~~~"';:=ct~&:~~d;:~~~;:::::::::::::...:::.~::::::::::=::::::::::::::::=::::::::::::::::::::: Light outlet..__./.__E::....=__....._.~.... Service, volts .1..?:.C>./~:'f..c!____.__ Type or Wiring: . , Receptacle Outlets.....d::9............ No. wires u...;?.....__.....___m__..____... Armored Cable .___m__...................., . (,; '#0 of!. Dryer KW Size wlres..................................._.. R.ng~, KW........2...~:....:..::.............:.--------- Main luse ......'tz.l2__q.A..__....... $ Enclosure ...._m___...___..___.__________n__._ Water Heater: ./ lj S Heat~:~:::::;:::.fF~.:::...... Motors: size. volts and phase: /dh,' :::::~:~::::tI;.t;;:::::::.::::::::::::::: I Type of wiring: Entrance Cable _____mm....mn'........ Rigid Conduit .hnmh___n...........,.... Metallic Tubing ..__.....'.......n___...._ Current transformers: No. & Size....................................... Ser. No............................................... Ser. No.............................................. Ser. No............................................... Non.Metallic ................................. Knob & Tube................................_ RIgid Conduit ..__........................... Metalllc Tubing ........................... Raceway ...._.................._..........._._ ~ Circuits. Light..c;..........mm................. Utility ................__..___...__...........______ C ::::--~:=;:.:~..::::.:..:.:.:...::::: ::.:::.....~~~..~..~~~~~~~~~~~~..~~~~~~~~~~~~~~..~~= Furnace .........................'_................... ;;y Total Load............................. Ser. No. ................._.......................... Total....................................... Remarks: ......n..._~_-:...-f.~_-!.::':':.n.C_....-:::..~:r.?:.."~!~.r_..._n.._n_.._..n_..nn..n_nn..nn.Uhn...___..u......u_n.._n.......n.n.... Permit Fee .300 $mu___!....m.mmm___..______. Treas. Receipt NO..m...mmmm__.____ BYu.Jltm~ft~. NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con- cealed due noUce must be given the Inspector so that work may be inspected betore concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT ../". ~ N? 16454 Address........................................................................................................................................Date..._......_.._.._.._.........._......_...____._....... Owner ..................................._......_.._......_......_.._.............._........................................... Tenant...........:................._...................................... WiringContractor............~..........._......_......................_..........................................._.................By.............................................................. NOTICE-Current must not be turned on until Certificate at Inspection has been issued. It work 18 to be con. cealed due notice must be given the Inspector so that work may be inspected betore concealment. . ....,..-_,_ .n..,_...... T...... .. FROM A.P.S. ELECTRICAL CONTRACTOR FAX NO. 360 452 6753 Sep. 302004 i0:iiAM Pi ~-S ~J,.- ...~~... r...~oI' fi!i~1.~ ~~ oo.=',;.:..cr .... ~-~ :#' ~...~.,\~ / I}r l'\ A . L' /' wnerorElec.Contr.lClorAgent. Yl.ddJ .:JlC\.(:-<:. Phone: 17S;1.-b7S3 Fax: LfSd-/--,75~ ropeny Owner: ka yY) _ ~ t-Q; A. r \ e-I J Phone: If 5d- - 9'q 0 ;dress: ~.l-f f -Z [,J. J ~ ~ C~L-c., P.A, . <' lil~"-" Zip: q<g<..f,-::S eClr;caICon""ctor:A.P.;,-, .file;r;rr--, ral (',n"f,a'-!---,,\' Licensej,<APSeL.C.1:q~: 4'15-0' Phone: L)5::<-b75~ Jdress: 6410 &nc,;:,n K(')(~ d City: R"T A fl'] e-I e " Zip: q',? sf:,. '5 ELECTRICAL PERMIT APPLICATION FD!\ ('!-"HC!.\! _ '.lSF ().~t~.~' It,,,ttl~o;: ....___.._u J'o:J"li!lI _.____._ r"'t~^p"mv"'" ..___.... I),'leh;ucu"__.. .____ The Electrical Permit Applicalion must be filled out cOTncletelv. Please type or reprint in ink. II you have any questions, please call (360) 417-4735 Fax number. (360) 417-4711 llling Address: 011 A p, '5. ~~ )e- f- ; !f~ -. W- J/otZ? ~LECTRICAL. CON~RACTOR I 6 e-t' () I 6..-a ( Co j\- T V"IJ-_C':.,f_-,,'r :STAl..LATION WIRED BY: DOWNER redit Card Holder Name: redit Card Numb~r. .. O.n f?ity: EXp. Date: Zip: a --t: . . - ~': '. ' "-. vtSA:_ Me: ~OJECT ADDRE~S; (PE OF WORK: ;;24 I, ~t ....._.-.-.~-LA._.,..~....._~_...._... C>() Check i!!! that apply: 0 New Jli\AlterationfAddition ...s;; (Residential 0 Multi-family o Commercial o Mobile Home Sq. Ft (J Remote Meter 0 Detached garage .mher of Circuits added or altered: ;;l ,SCRIPTION OF mE. ELECTRICAL- PROJECT: o Hot Tub 0 Swim Pool o Septic Pump o Low Voltage 0 Telecom. 0 Sign Wor-,k ...:;~ (' _; r- c. lA\t f'~1 h e ti.--t ..-f).lA rnp ~. Wtc<.J r 7Z6?1()<.Je'D ...~._~-_._. .~._._- e<:trical Heat Load Additions and or Subtractions Service Information 3aseboard =umace -leal Pump =an--Wall _KW I1:L KW 3- TON_LRA _KW o Overhead Service o Temp Service cR.Underground Service Voltage: Phase: ~1 0 3 Service Size: ~oC'\ A Feeder Size: ;\J i ~\: / jJD~Lt\D . l lereby certify that f have read and examined this application and know that same to be true and correct, and I am 1horized to apply for this permit I understand it is not the City's legal responsibility to determine what permits 9 required; jf remains the applicants responsibility to dete ine what permits are required and to obtain such. Credit Card Holder's Signature: .- I e e. Owner or Elec. Cont. Signature: Date: 0" S:::X:h:J'f Date:q' -30 ',;;)Q\fI .:lECiRICALPERMIT APPlICA nON PERMIT FEE: $ 42?, 10 ELECTRICAL WORK PERMIT APPLlCATIQN Job wired by ~Iectrical Contractor 0 Owner Installation description o Commercial )a=Residential Electrical contractor name 7/f'aA'/./cr:r ~F Purch~r's mailing address /'. tJ. 99/ City ') I ~/4 Telephone number S-hS"'-/2-/Z- Date Expir9 T?/tJM?,e~!j?Sf(ff tJ sY License number DNew ~lteredlAddition Slate ZIP tV',#- c;? 30 '2-- FAX number - 7S-l1? 77Iz;7tatR0 wcJ!.= &c-rf- Premises owner's name ~ffJU?1cf~ aM Address of inspection Z Vl7 ~. City P'# h~Lfl /t,.-t1I- Phone number yj!Z~~~1~n: OWlIer as defined by RCWJ9.28.261:(/) Owner will occupy the strue/ure for two years after this electrical permit is finalized. (2) Owner is required 10 hire an electrical contractor if ahove said property is for m/e, renl 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. Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specification. Signature 0 contractor or electrical administrator o Cash 0 Check # o Credit Card Card # Visa Mastercard Discover DateS: V- <:) h Expiration Date of card Inspe..cY1n fee $ ~JY.~ Service Information EI rica I oad 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 Q 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-IN THERMOSTAT /' SERVICE "- Date Approved By Dale Appro"ed By "- Date Approveo.lll)' /' /' FINAL DITCH FEEDER Dale ,\pprovedBy/, Dale Appro\edBy.-/ Dale Approved By Inspection Area, Building or Equipment Inspected Action Taken Electrical Date Inspector - --nt& ~ ." II(Fh -- . 4hO s/, ,,~(; , " ,. "..~ s~ CITY OF PORT ANGELES PUBLIC WORKS . ELECTRICAL DIVISION .12\ 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 06-00000455 . Date 5 B3 3 6 5 2417 W 16TH ST 06-30-01-6-3-9020-0000- ELECTRICAL ONLY 5/12/06 RS9 RESDNTL SINGLE FAMILY o Owner Contractor FIELD, CAM AND CARLA 2417 W 16TH ST PORT ANGELES WA 983631347 (36) 45-9690 THORNES REFRIGERATION PO BOX 991 PORT ANGELES WA 98362 (360) 461-0158 Permit Additional desc Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL THORNESI T-STAT WTR. HT 76927 THORNES REFRIGERATION 48.10 Plan Check Fee 5/11/06 Valuation 11/07/06 .00 o Qty 1. 00 Unit Charge Per 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48.10 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permi t Fee Total 48.10 48.10 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 48.10 48.10 .00 .00 COMMENTS/ACTION NEEDED FROM: R.P.S. ELECTRICRL CONTRRCTOR FRX NO. 360 452 .~ 753 , Sep. 08 2003 07:50RM Pi . (2,'Y .. Please ~ype or reprint in Ink_ If yoo ....ave any questions, pllitase call (360) 417-4735 ~ # f3~77 Fax numbor: (360) 41'7-4711 'v REQUEST INSPECTION )<'\ ont"'clorAgenl A r~ SltiJ..k Phone: lft);;l. -&753 Fax: SlllY1. e... Pwpge,OWnar La.m "Y L-ct,LtL ~;~IJ Phone: 45-;) Ab90-j, AOdms, ';).1f17 lJ, It,tP r r I,--t- A~~~e<"{-:L'1~'::fN Zip: 'tlJi,3 I.f c- Eleclc;calConlractoro r..P.:,. EI,,-cfl'/tIJ( L.J Nl( ([(:fnc~lcense#: Exp: !/-/Cj-o'{ Phon.: 5;;)-&7~. Address 5 '16 Be,n ",Jfl ((e,a./J Cj~: ~"..'f- r1 h5 fIe 'S Zip: 93' -5&3 INST AlLA TlON WIRED BY: 'J OWNER ~lECTRICAL CONTRACTOR. . Credit Card Holder Name: A - p. ~ 6/ e e-+;- i ca.1 c: G n -I-- to. L..-1 0 \- BillingAddress:61b &n.SJA Rca& city:Jn ,+ 4.Df1f.f.es ELECTRICAL PERMIT APPLICATION fOR OFFICIAL Uflt:Ot-'LY l4l..rR""" .... _____. rmnil f: _ D5tosAppm~cI!: ""'_'_'. D:o.tclil&un:l:__..._ Tile Elel.:lric::aJ Permit Application must be filled out comoletelv. ./'. Zip:. 9%363 VISA:_MC:"j ..rR_OJ~C!AOoRESS~ ;;2l-j 17 '/~ 0. lra- p. A. TYPE OF WORK, Check.1!!! that apply: [] New ,){ Alteration/Addition XResidental [] Multi-family o Commercial 0 Mobile Home Sq. Ft Remote Meter 0 Detached garage )(not Tub (] Swim Pool Number of Circuits added or allereo: d DESC~OF THE ELECTRlC:L- PROJECT:_}j&+ M --f ~~. U Septic Pump o Low Voltage 0 Telecom. 0 S;~ ~~~ ~.~ / Electrical Heat Load Additions PERMIT FEE: 91,5'0 Service Information _-.~ Baseboard ')lfurnace , i Heal Pump .~~ Fan-Wall KW ~OKW =TON KW LRA 'Jl! Overhead Service ,. OT emp Service cfUnderground Service Voltage: ;;1.40 Phase: .!"l.1 0 3 Service Size;~ Feeder Size:~ PAMC 14.05.060(6): For industrial. CC(~lmerC:ar. & residenlial projects larger than a duplex. a one -line drawing of the Electrical SeNlee & Feeders. building size (sq. ft.), load calculations. shall accompany the Electrica Pefmil application ~C-~ I hereby certify that I have read and examined this application and know that same to be true and correct, and I an authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits ar required; it remains the appiicants responsibility to determine what permits are required and to obtain such. Y..rt'f.(L o.t:. !66 Awtl~ t:1F- cELefi(t€'N@~ ~ '1t+ 8V(!.. --f-D tb-r TuB J~ Credit Card Holder's Signature; R- ~. Date:q~S-~3 Owner or Elee. Cant. Signature: ~ Date: l( -5'~oG3 CIELECTRICALPERMIT APPLICATION <1/,1, tjtJ -+ .$ r:J<!,to Q/qJ03 .:: f1L/,5D