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HomeMy WebLinkAbout228 W 1st St St J - Building riVO"'""" $....~q..(<<,:;. ,.~ ~ ""<c;;p> CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Separate Permits are required foreleclncal 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 penod 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 applicalion 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 granling of a permit does not presume to 9,ve authority to violate or cancel the provIsions of any state or local law regulating construction or the performance of constructton .~J~~ Application Number Application p~n number Property Address ASSESSOR PARCEL NUMBER; Application type description Subdivision Name Property Use Property Zoning . . . Appl~cation valuation 05-00000512 Date 124736 228 W 1ST ST J 06-30-00-0-0-3360-0000- COMM REMODEL CENTRAL BUSINESS DIS~ICT 100000 Owner Contractor JOHN Z MILLER JR ET AL PO BOX 1142 PORT ANGELES WA 983620215 OWNER Construction Type . . Occupancy Type Structure rnformat~on 000 000 TYPE II NON-RATED HEALTH CARE Permit BUILDING PERMIT - COMMERCIAL Additional desc REMODEL INTERIOR Permit pin number 54080 Permit Fee 1017.25 Plan Check Fee Issue Date 7/n/05 valuation Expiration Date 1/07/06 Qty Unit Charge Per BASE FEE 50.00 7.0000 THOU BL-50,001-100K (7.00 PER K) Permit MECHANICAL PERMIT Addl.tional desc Permit pin number 54098 Permit Fee 61. 50 Plan Check Fee Issue Date 7/11/05 Valuation Expl.ration Date 1/07/06 Qty Unit Charge Fer BASE FEE 2.00 7.2500 ECH ME-VENT FAN Permit . . . . . Addl.t~onal desc . Perm1t pin number Permi t Fee Issue Date Expiration Date PLUMBING PERMIT 54106 152.00 7/11/05 1/07/06 Plan Check Fee Valuation Qty Unit Charge Per 15.00 BASE FEE PL- EA. FIXTURE ON ONE TRAP 7.0000 ECH special Notes and Comments The Fire Department will require more detailed plans for this project./06/29/200S 02:45 PM KDUBUC 06/28/2005 11:07 AM SROBERDS proposal is an interior remodel. No land use issues anticipated. , Signature of Contractor or Authorized Agent '1/'1/0 )- Date Signature of Owner (if owner IS builder) T \POhCICS\II02 _15 bulldmg pcnmt mspcCllon record05 v.pd [1/412005/ 7/n/05 661.21 100000 Extension 667.25 350.00 .00 o Extension 47.00 14.50 .00 o Extension 47.00 105.00 ~ I CS\ -- r ~ ~ <' <.... 8Y\~\~J ..-- ~ lO~05 /01 ~) , ~ q " BillLDING PERLWIT INSPECTION RECORD o 01 CALL 417-4815 FOR BUILDING INSPECTIONS CALL 417-4735 FOR ELECTRlCALlNSPECTIONS CALL 417-4807 FOR PUBLIC WORKS UTILITIES 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 LOCATJON KEEP PERMIT CARD AND APPROVED PLANS AT lOB SITE 0\ ~ ~ lNSPECTION TYPE DATE I ACCEPTED COMMENTS YES I NO FOUNDATION' FOOTINGS W 1\1..1..5 FOUNDA TIDN DRAINAGE I DOWN SPOUTS - PIERS POST HOLES (POLE BLDGS) PLUMBING UNDER FLOOR I SLAB ROUGH-IN n...Jf.~ -.]1.l. ?\uml:::>,\'\j WATER LINE (METER TO SLOG) Fn<\\ 16 -OS"--or 'J L.L- GAS LINE BACK FLOW/WATER AIR SEAL WALLS I I CEILfNG I I I liRAMING JOISTS I G1RDER$ SHEAR WAl.L/BOLD DOWNS WALLS I ROOF I CEILfNG B/r( ;,,'(" .fU. DR YW ALL (INTERIOR BRACED PANEL O~L Y) , T_BAR .. INSULA nON SLAB I W ALL I FLOOR I CElLING I I MECIIANICAL IlEAT PUMP I FURNACE I Duers (YI e c.hli.r\\ Cl<./ GAS LrN'E IYI...A. .."",I 0/'" In_"'" JLL WOOD STOVE I PELLET I CHIMNEY n'ne,,", 10- OS--oi "ILL COMMERCIAL HOOD J DUCTS MA.NUF';\.CI'lJHED HOMES fOOnNG / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNJNG DEPT SEPARATE PER.\.1lT #'s SEPA PARKING/LIGI1TING ESA LANDSCAPING SHORELINE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RES]DENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO E1.ECTRICAL. UGHT DEI'T 417-<1735 ELECTRICAL LIGHT DErT CONSTRUCTlUN R W /I'w/ CONSTRUCTION - R W ENGINEERING 417-4807 I'W I ENGINEERING fIRE <117-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DErT BUII.DING 417.48]5 BUILDING IIl-05'Ol :rL-G T \l'ohclcs\1I02_15 bluldlngperrrllllnspectlOn recordOS I.Vpd [1/4n005) "' o ~ ~ o ~ o " 00 ~" "'''' .0 ~ ~ ~ o H ~ " om "0 U~ H'" "~ Z O~ HO "" UU 00 .. mm ~~ . o N " o "'" o ,~ ,0 o~ ;;;~ o ~" o~ "0 . o o~ ~O .~ 0" ~H .U > Q @ m 00 ZZ 00 ~~ .~ ~ " U ~ " ~ '" o ~ ~ ~ ~~ o " '" "2 .0 U m N'" N. ~ '0 ~oo "'00 o~ "00 o , ~ o ~w~ ~~~ ~o ~ U 00 ~'N ~OH H'~ ~oo 00 "0 00 z~o ~ , , OW~ ~oo ~ ~ .roo: .(iJ zo m Ul ,ti . 5 UlE-<~ ,...lZ ~~E-<&itl..:1 OZZZt:l::P< ~~8~ri:~ m " z o ~z2 "00 ~u ~~ "" ~~ 8~~ 00 'o~ " L~ .m~ zm OHO . ~ " 9 S~S} me" mo grgo; ,,~ 00 ,,~u . m " i . W N , . N ~ . o ~ ~ .~ .~ HO "" '" co .. o.H H~ ~ ~m H ~ O~ ~~ "~ ~o "'H m~ ~~o ow ..,.-,0: ~~6~t3 .'" Nco~..;,:3 oo"':E: ~ \0 .. 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E-< t-Cj o .'" \D~ ..;,:~ " ~ ~ ...... li'l<I;r-- CI} \D'<I'::lZO ,:(Ul.-lOOHOM 0Uo I-ot<.NN " , ...:lCt.""In'rl...J _0"1 <:( fI. 0 0 C.:e: <:" Z UOO)o U r- 0 H N'''''\.<li'lO ~~ ~~~.8"',...l@ a E-< (iJ.-I m:I: 0:':: <:( (iJ wffi:t-;;;~~t~~t :SOOoO::E:o;r:r<..:e: o o , H om ~'" H~ " ~ '" U OH zO H~ ~~ ~ ~. ~'" ~ mm 00 ~~ NN "" ~~ rnrn , o ~ m o ~ o " " o " o rn rn ~ ~ w ~ ~ '" " z ~ , z, 00 HU "~ ~'" "" ~~ U~ mm ~o o~ ~ " ~~~ zm OHO . ~ to ~~o ."" mo g[go; ,,~ ~o ~u " . " i . o o ~ o ~ " ~ '" m . ~ m '" ~ ~ ~ ~ ~ ~ m m o . W N , . , N , . , " o , " ~ o ~ o " " ~ .~ .~ HO "" '" co .z ~ o.H ~o""~ 00 ~ H.. ::E: ..J......n.[J) ~O H ~ o ~ " o o , o " " ulflP: ~ f:a ~~r=:t3 H.'" ZZM""",...l ll1f-o..;,:3 1-1 H N \0 Q'" ... :E ~x';;65: ""...J~ -.... 1::100'0"'0.0;:0"'.0;: ::lP 0\:;;'''' ZNNZ 00 0 .,. H lJlH O::O::lI'l<O(iJ.,. LllD.. _O\u. o > 0... Z (jc;lo .-:t:E-<Ol'l ["-00 ZZN OUlNZl-oltlZO HH...... .................QJ.......Z IIlrtl...... .,. ......lIl'O 1IlP:: 55':::~: j':::5~~~d~ ..:l,...l co <l;" o<l; lXl.::l U ~..:l r... l1"l..OO" UOCl.O:r:o.<:( mm 00 ~~ H" "H ~~ mm " '" ~ ~ ~ " ~ ". ~'" " o N ~ ~ w , o ~ m o ~ o H H o rn rn " ~ m o " o z o ~ m " ffi ~ ~ o U . City of Port Angeles Community Developement (Building Division) 321 E 5th St Port Angeles, Washington 98362 360-417-4815/ Fax 417-4711 Plan analysis based on the 2003 International Building Code Project Number: 05-512 Project Name: DENTAL CLINIC Address: 228 W 1st STREET Date: June 29, 2005 Occupancy: B Construction: V-B Contractor: TBA Architect: HANK GIBSON Engineer: Report By: JIM LIERLY NOTE: The code items listed in this report are not intended to be a complete listing of all possible code requirements in the 2003 IBC. It is a guide to selected sections of the code. Report created using plan Analyst software by IHS Global 800-854-7179 # SHEET IDENTIFICATION CORRECTION REQUIRED ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- 1 Toilet rooms are required to have a smooth, hard nonabsorbent surface that extends at least 6 inches onto walls. -- Sec. 1210.1 2 Walls within 2 feet of urinals and water closets are required to be covered with a smooth, hard nonabsorbent surface to a height of 4 feet. -- Sec. 1210.2 3 At least 50 percent but not less than one entrance shall comply with accessibility requirements. -- Sec. 1105.1 4 The top of accessible water closet seats shall be 17 in to 19 in above the floor. -- ICC/ANSI Al17.1 Sec. 604.4 5 Accessible urinals must be a stall type or a wall hung type with the rim at 17 inches high maximum. ICC/ANSI Al17.1 Sec. 605.2 6 Note: Manually operated edge or surface-mounted flush bolts are prohibited. -- Sec. 1008.1.8.4 , . Code review for: Project Id.: DENTAL Address: 228 W 1st 7 8 9 10 11 12 Page # 2 CLINIC STREET The doors from this area are required to swing in the direction of exit travel. -- Sec. 1008.1.2 Provide a landing on both sides of door. Note: The step & size requirements. -- Sec. 1008.1.4 All glazing in hazardous locations is required to be of safety glazing material. -- Sec. 2406.1 & 2406.3 The number of water closets/unirals is inadequate for male occupants in this area. Provide at least __ water closets/unirals. -- 2003 IEC chapter 29 table 2902.1(Washington Amendment 413.0) The number of water closets is inadequate for female occupants in this area. Provide at least water closets. -- 2003 IEC chapter 29 table 2902.1 (Washington Amendment 413.0) The number of lavatories is inadequate in this area. Provide at least lavatories. -- IEC chapter 29 table 2902.1 (see-Wash. Amend. 413.0 2003 UPC) .....r.JPORr~ G~~ f"'E!!ii ~~ ~ '4;;;~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number pin number \ property Address . . . ASSESSOR PARCEL NUMBER: Tenant nbr,1 name Application description Subdivision Name Property Use property zoning Application valuation 04-00000350 Date 5/19/04 .006200 228 W 1ST ST J 06-30-00-0-0-3360-0000- OLYMPIC COMMUNITY ACTION COMM REMODEL CENTRAL BUSINESS DISTRICT 15000 Owner Contractor WA 983620215 RENOVATE INC. P. O. BOX 1075 PORT ANGELES (360) 457-7465 INTERIOR TENTANT IMPROVEMENTS TYPE V NON-RATED BUSINESS:OFF/PRO/MED/REST WA 98362 JOHN Z MILLER PO BOX 1142 PORT ANGELES JR ET AL Structure Information construction Type . Occupancy Type Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER COMMERCIAL TELEPHONE/DATA ADD/ALTER ANGELES COMMUNICATIONS INC. 63.10 plan Check Fee 5/19/04 Valuation 11/15/04 \,., N \;.)\) .00 o ~ EL-LOW VOLT SYS <:2500 SQFT EL-LOW VOLT SYS >2500 SQFT Extension 40.90 22.20 Qty 1. 00 2.00 Unit Charge 40.9000 11.1000 Per Other Fees STATE SURCHARGE 4.50 ....... \\1\ "' Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 63.10 63.10 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 67.60 67.60 .00 .00 iii "'\ ?' ~ ~ L\ 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\FORlvlS\] 102.15 P ]/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4 J 7-4735 FOR ELECTRICAL INSPECTIONS. 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 I ACCEPTED COMMENTS I YES I NO FOUNDATION; FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARA IE PERMIT; # ROUGH.IN I I I PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BlDG) GAS LINE BACK FLOW I WATER AIR SEAL WALLS I I T CEILING I I I FRAMING JOISTS I GIRDERS SHEAR WALL/HOLD DOWNS WALLS I ROOF I CElUNG DRYWALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB I I T WALL I FLOOR I CEILING I I I MECHANICAl.. I-lEA T PUMP GAS LINE WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL. LIGHT DEPT. 417-4735 Iq-13-0'; ,t,(] ELECTRICAL LIGHT DEPT CONSTRUCTION RW./ PWI CONSTRUCTION. R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FOIUvlS\1102.15 [11/14/2003] r/I'OAT"", l~ rUi .... -- ""<;;;<P CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER; Tenant nbr, name Application description Subdivision Name Property Use Property Zoning . Application valuation Owner JOHN Z MILLER PO BOX 1142 PORT ANGELES 04-00000350 Date 5/18/04 .006200 228 W 1ST ST J 06-30-00-0-0-3360-0000- OLYMPIC COMMUNITY ACTION COMM REMODEL CENTRAL BUSINESS DISTRICT 15000 Contractor JR ET AL RENOVATE INC. P. O. BOX 1075 PORT ANGELES (360) 457-7465 INTERIOR TENTANT IMPROVEMENTS TYPE V NON-RATED BUSINESS;OFF/PRO/MED/REST N ~ ~ WA 983620215 WA 98362 Structure Information Construction Type Occupancy Type Permit Additional desc sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER COMMERCIAL ADD / ALTER 5 CIRCUITS SIMPSON ELECTRIC 59.40 Plan Check Fee 5/18/04 valuation 11/14/04 .00 o l Qty Unit Charge Per 1.00 59.4000 ECH EL-COMM ALT->600 VOLTS Other Fee's Fee sununary Permit Fee Total Plan Check Total Other Fee Total Grand Total Extension 59.40 ...... \VI ~ STATE SURCHARGE 4.50 Charged Paid Credited Due ---------- ---------- ---------- 59 .40 .00 .00 .00 .00 .00 4 .50 .00 .00 63 .90 .00 .00 ~ 59.40 .00 4.50 63.90 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction orwork is suspended or abandoned for a period of 180 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. Date Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\! 102.15 [11/1412003] BillLDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. 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 I NO FOUNDATION: FOOTINGS WALLS FOVNDA TION DRAINAGE/DOWN SPOUTS . ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I nUMBING UNDER FLOOR I SLAB ROUGH-IN WATER UNE (METER TO SLOG) GAS LINE BACK FLOW I WATER , AIR SEAL W ALL$ I I CEILING I I fRAMING 101STS' GIRDERS SHEAR W ALL/UOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB I I WALL I FLOOR J CEILING I I MECHANICAL ilEA T PUMP GAS LINE WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES { SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE I METER SEWER CONNECTION SAN!T ARY STORM PLANNING DEPT. SEPARA IE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE RESIDENTIAL DATE YES NO COl\lMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417.4735 9.//3~M Jr./) ELECTRICAL LIGHT DEPT CONSTRUCTION R.W./ PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417.4815 BUILDING T:\PLANNING\FORMS\11 02.15 [11/1412003] ~ ~ -.. Job wired by ~Eleetrieal Cunlcoetor 0 Owner Elc:ctrical contractor name .,' <::License l!}unbtr 3 DElle expires S,'mpseJ"\ r:f<"''''<'- ..Jpn/,Jet."'1--"'-f' Purchll!lcr's mailinE IIddrcss . I .;;..i3&;)'" p.w '1 /()( /.;V C;'y P~r /4t.5f Ie:; ~~!t-- q r~31.z3 Telephooe l\umbcr 'f5?~::L-7 Q Premise!; uwner's u1m...l 01 '''''f ; c. QIrr.trJ Addl'.'a:r'fClIW. J.,j.-+ St-. ~ ",'/<6 :r City POrLf- I1tUfe J~, (,1)Jt- Phol1e dumber tu schedule inliPl'ctlou: S? -?'t(PJ' OWller a:i J(ifl/ll!d by H.CH'..19.18.26/:(J) Owfl('r wllJ occu.py the sJrllcture lor twa )leurs after thi~ r;/(;(.'lrlctil pti!flflil j,)" Jinull:l.!d. (1) Ownt:r ~. rl!qujred to hire (Jr. ~lectrjcal contractur if ubove said properly is ,tal' sale. r('nl or least!. After reUllin~ the above :iWlcmeul, I hereby certiry that I am Ute uWlllI:r of the abuvc named prop~l1)' or 11 licensed clcctncw. conlrJctor. I am m<lking the electrical instal- lation or altcrution in' compliance with the electrical laws, N.B.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The Cil)' M Pore Anodes Municipal Code, i.I11d Ulility Specifications. of owner, ctec.rlc:al 'rl...J4 ntnu:tor or electriclIl adm.inis.rator Date: 8/1l3 /DI-> Electrical Load Additions and or .!';ubtractions o NO LOAD CHANGES CJ Baseboard KW o Furnace _ KW o Heat Pump _ Ton _ LAR o FaIl.Wall _I<Y>I ELECTRICAL WORKPERMlT APPLICATION Inst;tll;uion dCl~L:;rip(j\)1l ~ Commerci..l CJ Residential DNew o Altered/Addition A dd. a..~ cJ Ie.i- In C'.er, J....".~<:::~ ~-....,., ~ +he... ~ 1/ ni':: 1%::,- Dro I 'p -I_'nO 7 , './ aJ" (' frWL..J--L '0 o Cash 0 Check # o Credit Card (~ Mast~reard Discover C~#___~~__~____ . Expiration Date I ufcard Cj /30//0 Inspection fee $ t..1. <iid.... Service Information a Overhead Service CJ Temp Service o Underground Service Voltage Phase 0 103 ServIce Size: _ Feeder Size: SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN THERMOSTAT SERVICE 0111<; AIIJ'IVV",j By DlIl~ Ap'lluv~d ~y DlIl" AppIVYlIlI By 9i~Iot.FJNAL DITCH HeIDER ./0,1. ~ -. D~I<; ApllW~~ I:ly Ollie ~P!'~td-~ - Inspection -" .. ----. Elcetricul Date Area, Buildin.g or Equipment Inspt':Cted (/ Action Taken Inspector '. " ". . ~f) #/ .., ,!p h / 1 10 39\1d ~Iol~3l3.NOSdWIS 0LG5LSP !. 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OlllllQ, II , D.WI W;.~ .... -~-/.$-O'7 ...~tar.;;:;~".lIIlll:llh /1uJ ~~r \5/ /70 67/28/2665 67:27 3664523498 OLYMPIC ELECTRIC PAGE 61" G/ 1'1 f./ ~ \~ o Ol-fner ~"tiii;;_~ ELECTRICAL WORK PERMIT APPLICATION o Request Inspection IllI Electrical Contractor D AnDual Permit o Alarm o Carnival )i( Commrrc:tol tJ Re~idential Cl Rc!;ldential Maint. o Si~n. o Thermo.tat o Telecom. r Installation dC!lcnption .fob wired by )(Eleetrieal Contractor DOwner 2.- 7LlIJ A RMf-'/S -I Elcc:trical contr.'lctor name License numbCT OLYMPIC ELECTRIC CO.. INC. OLYMPEC285Dl a ~f"o(;f al-d /All n Ilj fi.,.- Purchaser's m:\i1ing oddrC$S 4230 TUMWATER ~Gdei City Stone ZlP PORT ANGELES, WA 98363 Tl::lcphone number FAX number (360) 457-5303 452-3498 Premises owner's nllmt Nfl Iff. (~ Port An1e/~ to",~ Or<<./ A.ddreu of Ins:pceUon ~U tAl F1l~-r City PnW- L. _J~$ ,; o Cash o Check # I hereby certify that I am the owner (If the above l1am,ed property or a liCCtlscd IJ Credit Card Visa Mastercard Discover electrical contractor (or the flnn:s authorized oi'gcnt) and am making the electrical in!:talJation or alteration in compliance with the dcetr1c:1t law, Chapter 19.28 RCW. Card # - - - ---------------- Signll.lure of Gwner, el~l:tric:.l c:ontrlctor nr elc:ctrtc1l1 adminisrrntor. E.xpiration Dale X ~ ;11, 11.- Ai of card ($'?~1 ~e~ '- o li\ ( (S"' ~ G o,~ A~"y THERMOSTAT '- Date AP1lP'O~~rl By DUCH '- Dnlt IWDl'(lvl'(! My I' SERVICE "- O.l~ Approvlld By FEEDER nUe Apprtlved By WALLS Insul<ltion Only O.to "l'f\mved By CoveT 1).le Appro"''''' tly CE1LING Insulation Only D~IC "'!'Pmvt:rlBy Cover Electrical Load AdditIons and or slllltractlons. IJ NO LOAD CHANGES Q aaseboard KW CI Furnace _ 1<JN CI Heat Pump Ton LAR C ~an.Wall _ KW LJ4 ~rvlc~ Inlonnatllm D Overhead Ser'\lice Q Temp Service CJ Underground Service Voltage Phase IJ , IJ 3 Service Size: _ Feeder Size: Area. Building or E:quipment Inspected Action Taken ~leclriC:Jl 'nspeclor ItpI>LI~ 6~/~c. L",:" ~CJ -,2.0-07 I"l t-I A-1--