The URL can be used to link to this page

Home My WebLink About115 Apple Ln - BuildingPREPARED 10/23/06 8 25 35 INSPECTION TICKET PAGE 16 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 10/23/06 ADDRESS 115 APPLE LN SUBDIV TENANT NBR SMITH RES CONTRACTOR ACE MICHAELS INC PHONE (360) 417 9579 OWNER SMITH GREGG /RONDI PHONE PARCEL 06 30 15 2 2 9100 0000 APPL NUMBER 06 00000936 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 9/26/06 JLL BUILDING FOUNDATION FOOTING TIME 13 00 9/26/06 AP kelly 808 4827 09/26/2006 08 07 AM DYASUMUR 09/26/2006 03 48 PM JLIERLY BL2 01 9/27/06 JLL BUILDING FOUNDATION WALL TIME 13 00 9/27/06 AP kelly 808 4827 09/27/2006 07 56 AM DYASUMUR 09/27/2006 03 13 PM JLIERLY BL9 01 10/16/06 JLL BUILDING SHEARWALL TIME 13 00 10/16/06 AP MIKE 460 6172 10/13/2006 09 13 AM DYASUMUR 10/16/2006 03 25 PM JLIERLY BAIR 01 10/23/06 OF BUILDING AIR SEAL TIME 13 00 10/23/2006 08 19 AM DYASUMUR BL3 01 10/23/06 Lik BUILDING FRAMING TIME 13 00 MIKE 460 6172 10/23/2006 08 19 AM DYASUMUR COMMENTS AND NOTES PREPARED 10/16/06 9 44 41 INSPECTION TICKET PAGE 9 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 10/16/06 ADDRESS 115 APPLE LN SUBDIV TENANT NBR SMITH RES CONTRACTOR ACE MICHAELS INC PHONE (360) 417 9579 OWNER SMITH GREGG /RONDI PHONE PARCEL 06 30 15 2 2 9100 0000 APPL NUMBER 06 00000936 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 9/26/06 JLL BUILDING FOUNDATION FOOTING TIME 13 00 9/26/06 AP kelly 808 4827 09/26/2006 08 07 AM DYASUMUR 09/26/2006 03 48 PM JLIERLY BL2 01 9/27/06 JLL BUILDING FOUNDATION WALL TIME 13 00 9/27/06 AP kelly 808 4827 09/27/2006 07 56 AM DYASUMUR 09/27/2006 03 13 PM JLIERLY BL9 01 10/16/06 BUILDING SHEARWALL TIME 13 00 MIKE 460 6172 10/13/2006 09 13 AM DYASUMUR PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS PL2 01 10/16/06 11114 1;-- PLUMBING ROUGH IN MARK 808 0174 10/13/2006 01 38 PM PERMITS COMMENTS AND NOTES PREPARED 9/27/06 10 54 07 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 9/27/06 ADDRESS 115 APPLE LN SUBDIV TENANT NBR SMITH RES CONTRACTOR ACE MICHAELS INC PHONE (360) 417 9579 OWNER SMITH GREGG /RONDI PHONE PARCEL 06 30 15 2 2 9100 0000 APPL NUMBER 06 00000936 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 9/26/06 JLL 9/26/06 AP BL2 01 9/27/06 JLL BUILDING FOUNDATION WALL TIME 13 00 kelly 808 4827 09/27/2006 07 56 AM DYASUMUR BUILDING FOUNDATION FOOTING TIME 13 00 kelly 808 4827 09/26/2006 08 07 AM DYASUMUR 09/26/2006 03 48 PM JLIERLY COMMENTS AND NOTES PREPARED 9/26/06 10 08 49 INSPECTION TICKET PAGE 11 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 9/26/06 ADDRESS 115 APPLE LN SUBDIV TENANT NBR SMITH RES CONTRACTOR ACE MICHAELS INC PHONE (360) 417 9579 OWNER SMITH GREGG /RONDI PHONE PARCEL 06 30 15 2 2 9100 0000 APPL NUMBER 06 00000936 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 9/26/06 JLL BUILDING FOUNDATION FOOTING TIME 13 00 kelly 808 4827 09/26/2006 08 07 AM DYASUMUR COMMENTS AND NOTES SMITH GREGG /RONDI 115 APPLE LN PORT ANGELES Other struct info Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date T• \Policies \1102_15 building permit inspection record05 wpd [1/4/2005] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 06 00000936 Application pin number 773408 Property Address 115 APPLE LN ASSESSOR PARCEL NUMBER 06 30 15 2 2 9100 0000 Tenant nbr name SMITH RES Application type description RES ADDITION Subdivision Name Property Use Property Zoning UNKNOWN Application valuation 20000 Owner Contractor ACE MICHAELS INC 431 VASHON AVE WA 983626903 PORT ANGELES (360) 417 9579 TOTAL LOT COVERAGE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS MECHANICAL PERMIT Special Notes and Comments The Fire Department has reviewed the project application and Date 9/06/06 WA 98362 15 80 1 00 3401 00 23650 00 3739 00 1 00 Permit BUILDING PERMIT RESIDENTIAL Additional desc Permit pin number 85555 Permit Fee 347 75 Plan Check Fee 139 10 Issue Date 9/06/06 Valuation 20000 Expiration Date 3/05/0T Qty Unit Charge Per Extension BASE FEE 95 75 18 00 14 0000 THOU BL -2001 25K (14 PER K) 252 00 86322 57 25 Plan Check Fee 00 9/06/06 Valuation 0 3/05/07 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 7 2500 ECH ME VENT FAN 7 25 Permit PLUMBING PERMIT Additional desc Permit pin number 86330 Permit Fee 64 00 Plan Check Fee 00 Issue Date 9/06/06 Valuation 0 Expiration Date 3/05/07 Qty Unit Charge Per Extension BASE FEE 50 00 2 00 7 0000 ECH PL EA FIXTURE ON ONE TRAP 14 00 Separate Permits are required forelectrical 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 fora period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. l- hereby certify -that-1 #lave -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 corstruction. Si6nature of Contractor or Authorized Agent l Date Signature of Owner (if owner is builder) Date 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 I NO FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP /FURNACE /DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 PLANNING DEPT 417 -4750 BUILDING 417 -4815 I T \Policies \l IO2_I5 building permit inspection record05.wpd [1/4/2005] I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO 417 -4735 ELECTRICAL LIGHT DEPT FINAL FINAL SEPA. ESA. SHORELINE. CONSTRUCTION KW PW ENGINEERING I FIRE DEPT I PLANNING DEPT I BUILDING DATE ACCEPTED BY. DATE ACCEPTED BY. Application Number Application pin number Special Notes and Comments has no comments 08/31/2006 12 49 PM SROBERDS The proposal will result in a kitchen addition in the RS 7 zone with lot coverage of 16% No land use issues are noted •a ti Electrical load calculations and elctrical permits are required Public Works Utility Engineering has no requirements for this plan review Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total 06 00000936 773408 Charged Paid Credited T•\Policies \1102_!5 building permit inspection record05.wpd [1/4/2005] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Page 2 Date 9/06/06 STATE SURCHARGE 4 50 469 00 469 00 Q0 1, c 00; 139 10 139 10 00 00 4 50 4 50 00 00 612 60 612 60 00 00 Due n 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. 1- hereby certify- t-hat-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 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 FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALLS JOLD DOWAIS.. WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT BUILDING PERMIT INSPECTION RECORD DATE ACCEPTED YES I NO I I I I I I I I I FINAL FINAL I I I I I I I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE SEPA. ESA. SHORELINE. DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO 417 -4735 ELECTRICAL LIGHT DEPT COMMENTS DATE ACCEPTED BY. DATE ACCEPTED BY. CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 I I FIRE DEPT I PLANNING DEPT 417 -4750 h I I I PLANNING DEPT I I I C BUILDING 417 -4815 10 Zb —"71) 1 I EX®] reef I BUILDING I I I T \Policies \I 102 15 building permit inspection record05.wpd [1/4/2005] TYPE OF WORK. ,rResidential New Constr Multi family 2Addrtion Commercial Remodel Repair Sign BRIEF DESCRIPTION OF THE PROJECT PLANNING USE ONLY Re -roof Stove Move Garage Demolition Deck Other AAA t 6r. ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other BUILDING PERMIT APPLICATION Fill out COMPLETELY and in INK. Your application and site plan MUST B COMPLETE to be accepted for review If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4711 Applicant or Agent. Ari e_ c.1 C Phone Owner 5 t `SAM Phone Address: P F._i'.L City ih'Y'C Architect/Engineer Phone: Contractor tt Ce 14 c_ if S Try' State License A C Z tilS ON. 974P? l Address: R 7 4 U -I- C "`"'c City k PROJECT ADDRESS /5 l e LA N LEGAL DESCRIPTION Lot: 3 Block. Subdivision. CLALLAM COUNTY PARCEL NUMBER. 06 O t f✓" Z Z q (c2O 4 -'*-4 5� --6669 Zip Zip ZONING STZ.F/VALUATION SF /SF SF /SF SF /SF TOTAL VALUATION x a c2, p C7 c3 f 7 FOR OFF1 /P Date Rec.� 10` p Permit f/ Date. Approve. a Date Issued:`? Phone: C,) fr COMMERCIAL/RESIDENTIAL. Occupancy Group Occupant Load. Construction Type. No. of Stones: 0- Lot S e:e 3(o CO Existing Sq. Ft. 31/0 I Proposed Sq Ft. 33 g TOTAL Sq Ft. 3 "39 Total lot coverage APPROVALS PLAN BLDG DPWU FIRE. 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 due 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 they 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 1 must obtain such? permits prior to work' II Q T•1FORMS\B1dgPenznitfgrm.wpd Applicant: I JZ) Date: v/ V CO J 60 Feet Vertical Datum NA! D 88 Ni va! Datu ft NAD 83/91 Paject Si4c Apple Ln 10 A Area Map Park Ave 1k-4• Th ap is not intended to be used as a legal de iptim Th map /di ig produced bi th Ciro of Port Angele fo its of n use and p+ rpos Anr other se of this map /di mg shall not be th spo ibilitr of the Cur' -1( k etAir ---51>Ngc3 I C ow. Nt 9 he . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT Site Address: PERMIT NO. 3~Y? DATE //-319-<72.... o READY FOR INSPECTION License Number: Installed By: Owner/Business: Owner/Business Address: ~ RESIDENTIAL o COMMERCIAL o BASEBOARD KW -;--n- o FURNACE KW ~ o FAN/WALL KW o HEAT PUMP KW ~ o SIGN o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION o REMODEL o ADD/ALTER CIRCUITS ~ SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) Details/Description: ,JKJ WILL CALL FOR INSPECTION Phone: Phone; Sq. Ft. PJ IS C,( o OVERHEAD SERVICE ~ UNDERGROU RVICE VOLTAGE: 20 I3-SINGLE PHA E o THREE PHASE SERVICE SIZE at90 AMPS . ~>>/ ~~1 ~/I W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. ~ tp O.K. to connect service ~ 13 Final O.K. Site Address: Installer: ~L. ~ Permit/Receipt No. 381t' New Meters -- Notify Port Ange s 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 eitherthe Wiring Report or on the BU~'lding Pe it. PHONE 457-0411, EXT. 224. trO NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT LID - I r7JM- $ {J Electrifallnspector Permit Fee . WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer OLYMPIC PRINTERS INC. GREEN - Top: Meter Dept., Bottom: City Hall CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N~ 17688 / - / 1" f;) Port Angeles. Washlngton.___oo___.___..___............___..______..______....___h.oo.. 19'h.n.. . In accordance with the City Ordinance to regulate the tnstallatlon. 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 .___/!___~oo___(X~{'.-/::.<(__~~,:.:;..~s:::o.________....__ Occupancy__,d,L~,......__n___.....___..___...h I I . Owner ...___m______....___________oo____________.~...h...h__________n... Tenant.oo....._____.oo..........___.m________...._____.....n___n.....______ Wiring Contractor ___.~...~'J-:::!.~___~.?_________ By....oo......______________.___oo.___h.oo___.h__...____....h___.__oo /.J ,,/.6 ,VC? Light Outlets......mn..._m...._m....._.._..... Service, volts ......................._.._............ Type of Wiring: Receptacle Outlets__n_m..____n_m.....m... No. wires .......;:;......mm........11..... Armored Cable ..............._n.........._ Y//tJrbV Size wires.................__._nnn._......_.. Main fuse .d.t-:.Q___.'1.::.....m. Dryer, KW n........__.___.._..___....____....__.... Range, KW n____n_.._.__...__....n__...n______._. Water Heater: S Enclosure m.....m___.._____m KW..____________.________..n_________ Type of wiring; Entrance Cable _____mm_____............. Heat: KW.......nn.....................n_n.......__..... Motors: size, volts and phase: Rigid Conduit .....m__........._________... Meta1l1c Tubing .....m.....n________.._. Current transformers; No. & Sizen__n......n...........n......__n.. Ser. NO.__.........n.................._nn...._._._. Ser. NO._.n..nnn__................._.....n.__... Ser. NO.........__.....____.._...n__............_.n. Non.Metalllc ......m___.....______mm..__ Knob & Tuben............._........__._....~ RIgid Conduit 'mmm..mmmmm.m Metallic Tubing .mm.._.m__..m___... Raceway ___._______.__...._...._......__n._ Circuits, Llght.....................___......n._.... Utility ....___..______...m..m.........mm.... Heat .....__......................___...._.._....... Range ......................_......___....n__.n.. Water Heater ........._..._.____........_... Motor ..._........._.....nn.._.nnn...___..... Dryer .......n_........n..._..n...._____n._......._ Furnace ..........__......_...._.'_........._......... Remark:~t.:__::.!.~:..,~~::____:____,~m4:;.::~.__:%:.__:..__:t2:~.___;~:::~~:~__::..::~:::~:.~::~__: - .. i / n n.n.nh_____nnnn_nnhnhhnn_nnuu.h_.__nnn_un_hn..n.nnnnn_unn-..__.nnnnn__..._Unn_nnn_.u...nnnn_n__..h__nnnnnnu.u.n .---.mh_________..___mn...._______________..___.________....n.m___oooooooo______hnn________.____...__.---.-----.....-----llm----------.........----------oo-----. P~rmit Fee Treas. Receipt L/f)ff)l';;j 1~-4 $_____._____....._____......_____.___.. NO.___.....m....m.......... By oooo__'___mm.mm.rI!:f:!.!!.oom___moo:mh.J!,:l..,<' , NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If 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~ 17688 <~,. ,'....... . .~...- .~. Address........_.._.__........................_.........................._.......____.................._._____._................._..._._.......Date..._....______.._.._..........____..._._...._......... Owner nn..............nn.............__....._.._......__.__.._.._n_.................n_n__............._..nn.....n..... Tenantn..._............__nn_.n.............._..nnn.n_...........__ ''',,: WtringContractor...:........_.__......................................._..._....................._........__...______.............___h_.By..__.__.............___...._._____.............._...__.____... \ NOTICE-Current must not be turned on until Certificate of Inspection has been Issued. If work Is to be con- cealed due notice mUst be given the Inspector so that work may be Inspected before concealment. . I , 1M Olympic Printers, Inc. ELECTRICAL WORKPERl\nT APPLICATION . . ~ReQuest Inspection ?,Electrical Contractor 0 Owner o Annual Permit 0 Alarm 0 Carniv:.1 0 Commercial 1 herebr certify that I am the owner of the above namc:d property or a liccn~cd electrical contractor (or the finn's authorized agent) and am making :he electric a inslal1ation or alteration in compliance \\'ith the eleclricallaw, Chapter 19.28 RC Electrical Load Additions and or subtractions o NO LOAD CHANGES o Baseboard KW o Fumace KW o Heal Pump _ Ton _ LAR a Fan-Wall KW Job ..ired by Electrical con1ractor name . ~e..\)\ 5!ec:ln'C/ Purch:lser',; mailinG addr~~5 r"? Pc cJ. G..:,)C <5 City por< A~ie5 Telephone number '-(t;,- O~ (, p...~;n.r"~~ ! ,t., Address: of i'5tdiOJ ' (t'-7 p? fe- Cit.,. J'I' . / I rr~ x WALLS r. Insulation Only 1 Due ^f)pfOVC:ct B)' .t /o,/; /" c;v" A..o / Oil:} App..wcd B}" o Residential I'tlaint. 0 Signs 0 Thermostat Q Telecom. lectrical Contractor a Owner Installation descripticn License Ollmber ~eJ \ f3f3.XC(51C-:Z r J' too % ~oI.'T;i) ," . State ZIP w"- q~J' 2- FAX number L-(f7- [707 Ie:;. VI e- o Cash 0 Check # redil Card ~ Card # tractor or c1ccirical administrator 00 Mastercard Discover ---------------- CEIUNG Insulalion Only TIlERMOSTAT SERVICE lhle Approvcdl3y Dalc Apf'I'O\.aj 8y Dale AI'~lIovcd BI' /~h ~~vc, Ad:) '" D~le;' ,\pp"..-c018y DITCH FEEDER D~IC "pPrD\'~J B~. O.lC ....Pp:'"o,.dBy Service Intonnatlon o Overhead Service o Temp Service Q Underground Sel'\lice Voltage Phase 0 1 0 3 Serv:ce Size: Feec:er Size: Inspccti.on , EleclricaJ Date Area, Building or Equipment [nspected Action Taken Inspector -f?~/)"" 17~./YL. /hO .hI} I I ...'~- ~ . Z:: /ICt9 /~;lO/~ ~d SH ~-S9S (09E) ,~ don ~ 90 6~ PO AaZWI)i par FROM FAX NO. : 4526424 Oct. 16 2002 12:56PM P2 ELECTRICAL PERMIT APPLICATION FOR OFFICIAL '10 UNLY 0...."... ~F.. ~:~;pr~"-;}t) 2'i ' Oll1Ctm..:d: _"__ -;.1&/ The E.!sctrioal PermH Appiication must be fWe~ out oomDlut..tv, ~~v 1'1_.... type 0' ,"print In Inl<. If you have ~ny qu08\lana, pl..... call (38()) 417~7a5 F.... numb." (380) 417~711 Owner or E1ee, c"nlractor Agent: . f (.p.-<.. rn- '<- ~ Ptoperly Ownec GN. 9"Y1".'+t... Add,...e: \ I 5"" 1+.pp l-e LV\. City: Electric.1 Co~nt'ac1ar:'J21I2<.~ ~.-f2-- Add,...: 8'2- b~ VJ&, U Pilon.: REQUEST INSPECTION C ~ \'.-(,<.;2.<1 F...: c,c.-- Phon.: ZI: <7T3bQ., INSTAI.LATION WIRED BY; o OWNER LIC8Il$. #:Fli.Rt:;.exp. : C~'?~-'_ o ELECTRICAL CONTRACTOR 0/1<(03 Phone: C;I't..-t.</'v Zip; Credit Card Holder Name: Billing Addren; Credit OIrd Number: Q1^ f}Qey; Exp. Date: Zip: VISA: Me PROJECT ADDRESS: /1 s A ,PPLE LAV, . ~ORK' Check ill that apply: C New ~ental 0 MultI-family 0 Commercial ~AdditiOn o Mobile Home Sq. Ft Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump o Low Voltage 0 Telecom. 0 Number of Circuits added 0' altered: OESCRIPTION OF THE ELECTRICAL PROJEcT: ..;,', '< --..:> () aV"iu~' .'. Electrical Heat load Additions PERMIT FEE: Service Information o Baseboard o Furnace o Haat Pump o Fen-Wall KW KW -TON =t<W LRA o OVerhead Service o Temp Service o UndergtDund Service Voltase: PhaGe; 0' ::J 3 Service Size: Feeder Size: PAMC 14.05,060(8): For industrial, commercial. & ,esldential projects large, than a duplex, a on. - line drawing of the Electrical Service Feeders. building size (sq. ft.), load calculations, and the ty"" & of conductoro enOlar raceway I. ""lU;red and shall aec:ompsny the Elect. Permit application. I hereby certify that I have read and examined this application and know that same to be true and correct, and I authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits required; Fr remains the applicants responsibility to determine what permits are required and to obtain such. )J - f)~ ~ IS -' ~tl- tel&.-' . . Credit C~rd Holder'. Signature; Date: ~ Owner or Else, Cont. Signature: Date: (I}/,t/oc C:IELECTRIC~MITAPPLICATION . ~ C ~ /r/0z-