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HomeMy WebLinkAbout1131 Caroline St - BuildingApplication Number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Zoning Application valuation Owner THANHEISER HORST F 1131 CAROLINE ST PORT ANGELES Qty Unit Charge WA 9 Structure Information Construction Type Occupancy Type Other struct info Permit Additional desc Permit Fee Issue Date Expiration Date Per 1 00 46 7000 ECH EL -R Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total T• \PLANNING \FORMS \1102.15 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Charged 46 70 00 4 50 51 20 03 00000719 1131 CAROLINE ST 06 30 00 5 3 0580 0000 RES ADDITION 6500 Contractor ELECTRICAL ALTER RESIDENTIAL 46 70 Plan Check Fee 9/02/03 Valuation 3/01/04 OR RM 1 4 ALT CIRCUITS 46 70 00 4 50 51 20 00 00 00 00 Date 9/02/03 DOUBLE S CONST PO BOX 1386 83624203 PORT ANGELES WA 98363 (360) 452 0824 RELOCATE FRONT DOOR 360 5 SF ADDNT /DECK TYPE V NON RATED SINGLE FAM CONGREGATES NUMBER OF UNITS 1 00 STATE SURCHARGE 4 50 Paid Credited Due 00 00 00 00 00 0 Extension 46 70 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 z CALL 417 -4815 FOR BUILDING 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 NO FOUNDATION: FOOTINGS I I I WALLS I I I FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN I I I PLUMBING UNDERFLOOR /SLAB I I I ROUGH -IN I I WATER LINE I I I GAS LINE I I I BACK FLOW WATER I I I AIR SEAL WALLS I I I CEILING I I I FRAMING JOISTS GIRDERS I I SHEAR WALL I I WALLS ROOF CEILING I I DRYWALL I I T -BAR I I I INSULATION SLAB I I I WALL FLOOR CEILING I I I MECHANICAL HEAT PUMP I I I WOOD STOVE PELLET CHIMNEY I I HOOD DUCTS I I I PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 I FIRE 417 -4653 I I PLANNING DEPT 417 -4750 I I BUILDING 417 -4815 I BUILDING PERMIT INSPECTION RECORD I I I I I I I I I I I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE DATE YES NO COMMERCIAL 417 -4735 SEPA. ESA. SHORELINE. ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT PLANNING DEPT I BUILDING DATE ACCEPTED YES I NO I I I I I I I I I CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT .. BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 03-00000719 Date 7/28/03 1131 CAROLINE ST 06-30-00-5-3-0580-0000- RES ADDITION 6500 Owner Contractor THANHEISER HORST F DOUBLE S CONST. 1131 CAROLINE ST PO BOX 1386 PORT ANGELES WA 983624203 PORT ANGELES WA 98363 (360) 452-0824 Structure Information RELOCATE FRONT DOOR, 360.5 SF ADDNT/DECK----- Construction Type TYPE V NON-RATED Occupancy Type . . . .. SINGLE FAM & CONGREGATES Other struct info. . .. NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT NEW 300SF DECK, 162.75 7/28/03 1/25/04 -RESIDENTIAL 60.5SF FOYER Plan Check Valuation Fee 65.10 6500 Qty Unit Charge Per Extension 92.75 70.00 - - BASE FEE 5.00 14.0000 THOU BL-2001-25K (14 PER K) VJ ---------------------------------------------------------------------------- Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 162.75 162.75 .00 .00 Plan Check Total 65.10 65.10 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 232.35 232.35 .00 .00 ~ <S - ;s ~ ~ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, pnvate and public improvements This permit becomes null and void if work or construction authonzed 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 authonty to Violate or cancel the provisions of any state or local law regulating construction or the performance of construction 1~~ Signature of Contractor or Authorized Agent 7.......L"8-03 Date Signature of Owner (If owner is builder) Date T IPLANNINGIFORMSIII02 15 [4/2002J 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 "") -~q...o, J.'- WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS O_Ad .., I l. CEILING r , I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING I cf-'J...C/-Io.? J.t.. DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING q-I'H-OA J,t... MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engmeenng DIVIsIOn) SEPARATE PERMIT #'s' WATERLINE / METER SEWER CONNECTION SAN IT AR Y 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 ELECTRICAL - LIGHT DEPT 417-4735 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 J h- "fb....Q~ .1. J." BUILDING T \PLANNING\FORMS\1102 15 [4/2002] PREPARED 10/30/03, 12 11 43 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 5 10/30/03 ------------------------------------------------------------------------------------------------ ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 1131 CAROLINE ST DOUBLE S CONST THANHEISER HORST F 06-30-00-5-3-0580-0000- 03-00000719 RES ADDITION SUBDIV PHONE PHONE (360) 452-0824 -----------------------------------------------~------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BL1 01 7/29/03 JLL BUILDING FOUNDATION FOOTING 7/29/03 AP BL3 01 8/29/03 JLL BUILDING FRAMING 8/29/03 AP BAIR 01 9/04/03 JLL BUILDING AIR SEAL 9/04/03 AP BLI 01 9/04/03 JLL BUILDING INSULATION 9/04/03 ~ BL99 01 10/30/03 BUILDING FINAL -------------------- --- ----------- COMMENTS AND NOTES -------------------___________________ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ~c:;>f . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST: Date .,., - ;t-1- 0.3 Time :3 ; c) Z--- Received by B rlo...JI1 S' m, th 1/':3 J CO-VLJ (ll.4 ~ erson) (5"T Phone No. tf 6 0 <7463 Permit No. '7 I ? Sewer Excav. Other raming Chimney Plumbing Final Time ~~RBY~ lifJ RESTORATION REQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved~ OGravel 0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) ~TRFFT ~I JPFRINTFNnFNT InATFl CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST~ Date f S- D~ Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspec . ircle appropriate one): Permit No. oundation raming Chimney Plumbing Final Sewer Excav. Other 11'6/ Received bY-JL - (:tPh~personl [~I';le- Phone No. L{(pi)- it t./ (P3 Time--fM /""' INSPECTION NOT~~ Inspected: Date ~ - ().3 Remarks: Time-f /L1 By yz. RESTORATION REQUIRED . . . . .. YES NO T JO-t..M-t {{/ltJSG-IG Ii DM-e SURFACE RESTORATION: SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC D Other D Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) PREPARED 9/04/03, 13 56 12 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 1 9/04/03 ------------------------------------------------------------------------------------------------ ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 1131 CAROLINE ST DOUBLE S CONST THANHEISER HORST F 06-30-00-5-3-0580-0000- 03-00000719 RES ADDITION SUBDIV PHONE PHONE (360) 452-0824 ------------------------------------------------------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BL1 01 7/29/03 1 BL3 01 8/29/03 BAIR 01 9/04/03 BLI 01 9/04/03 ~Jf BUILDING FOUNDATION FOOTING BUILDING FRAMING BUILDING AIR SEAL BUILDING INSULATION COMMENTS AND NOTES ---------------------------------_____ ~;+e BUILDING PERMIT - APPLICATION . FOR OFFlklL U';~NL Y Date Rec (P I~ PermIt # 7 , Cf Date Approved Date Issued Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 Applicant or Agent: Owner: \-\-oR -;.,... ~ Address: \ \ ~ \ ""\)u\J~~~~TQ.Ua "~N Phone: WA,\ t("A-~Y Ih~ \\.f;l~&/Z.. Phone: Q~~~Ne City: 'Po a.'\" AN(::)~\~~ WPt 4\1-CS'l.OS 4'5).- t5~i7 Zip: G ~ 3ec,~ Architect/Engineer: Contractor U Co l?>\e ~ ~~'ST. Address: "Po t?,O~ \~~b PROJECT ADDRESS: l t '?> l l)lIu$l'1>C. ObbNA State LIcense #: Exp: CIty: ?o(2:\ ,A~,"~ \~ Q A ILoL""H~ Phone: cg-- \ - C.q Phone: 4 \'-'5;\ oS ~A. Zip: ~~~\o~ ZONING: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Block: Subdivision: Credit Card Holder Name: Billing Address: City: Credit CardType VISA MC # Exp. Date: TYPY: OF WORK: SIZEN ALUATION: c) ~esidential 0 New Constr. 0 Re-roof 0 Stove ~O,S- SF. @$ /SF. = $ "see~ o Multi-family ~ddltton 0 Move 0 Garage goo SF. @$ /SF. = $ :s sac 00 o 'Commercial 0 Remodel 0 Demolition ,Ii t>eck. .' SF. @ $ /SF. = $ :' , - 0 Repair 0 Sign 0 .other T.oTAL VALUATI.oN $ \ ; ~S'oo'IJO ~RiEF:PitSCRIPTION OF THE PROJE~T: ''Re'\.~~ F.A.D.J\ OOC)~ J b, lei A-..J ~ ~b I~A> 0,", 'F"'o'r6-P-1- ~'1Icl "':36o~._~~0~ u.h.d ?~+to'-- ])00(-" -' ,.. ' -- .... ' ~ , ,- . - ... COMMERCIAL/RESIDENTIAL: .occupancy Group: .occupant Load: Construction Type: No. of Stories: _ Lot Size: /~ Existing Sq. Ft. 824/ & Proposed Sq. Ft. ~Sfd:JI~ = T.oTAL Sq.F{69~ S::. Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage 'Zc.; , I % APPROVALS PLAN: BLDG: DPWU. FIRE: OTHER:_ PLANNING USE ONLY: ESNWetland(s): 0 Yes 0 No SEPA Checklist requITed? 0 Yes 0 No Other: BillLDING PERMIT APPLICATION SUBMITTAL: The Building DiVIsion can provide you with informatton on the apphcation and plan subrmttal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. TIns 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: Ifno permIt is issued Within 180 days of the date ofapphcation, 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 107.4 of the Uniform BuIlding Code, current editton). No apphcation 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 ity's, and that I must obtain such permits prior to work. T \FORMS\APPS\BUlldmgpermlt wpd Applicant: Date: B- \ - 04 ,..) 'L h V' c t. t. CP v V --I V f1\ f" ,,- ~ - o o f;l 1..""1 '" "', :;:; 1:) v ll.'~ .~- -"o't... I I I -\ \.fJ C :... I r;~ I y ) ! - I ,.., m -I.. \...ll I 0 - \1 j I -- ~"'l I r r l- >1 .~ ~-. ..--~,." __c_ -- c__- .H._~ --- ---J ,,-.. 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I/' , I l' ;-" ----I--~- I"; "";., ;,' , "' I., ': , J 1,1;1>}' ,,- I I _1____ , I ..I - -. I I , -~ --r , , ell " _ __ --.i. - _: I~- I r ~. ~ I . '..J,. " - _:_--~++~~ : ; "" _1 ---T- I ,...... \ - _: ---J----Lb .. .. L. +--t+ --- - ----: - ~--l-T . ; I. I ...'. '., ; iSJ'c ~---~" I ' ' I' - -- ! i ' --- - r--i I 1,,1 :~+I ----- , I I I I. . 1 :__J..._~ Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT . ELECTRICAL PERMIT DATE Site Address: ~EADY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: Sq. Ft. o Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction o Remodel o Service update/alterlrepair o Overhead o Underground Voltage 010 03.0 Service size o Temporary o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) Amps Detai IslDescription: MrJ 6 ecJ . W.S. No. Service Capacity: 0 O.K. 0 Not O.K. o Ditch inspection O.K. ~ough'in/cover O.K. .K. to connect service c-fr- Final O.K. Size Comments Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Site Address: Permit/Receipt No. 026 (}b New Meters - '0 . Notify the Department of City light by Street Address and Permit Number when ready for Inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Buiiding Permit. PHONE 457.0411, EXT. 158 or EXT. 224. ~ f1:j/V/ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT .;;;;( 0 ~ Inspector Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMPIC PFlINTEFlS. INC. CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N'! 17082 Port Angeles. washlngton__m//...ILmmm.......m........m.m.. 19~~t." In accordance with the City Ordinance to regulate the installation, extension. or repair of elec- trical equipment in. on, or about any building or other structure in the City of Port Angeles, per- mission is hereby granted to do ~ectrical work as listed below. Address /13 (."..~~______.~.__mmm__mm Occupancym...-:!.__<<-."Q,!.m_______.m__________ Owner --:=9.l:~~~~~m..~;i5~ /l'ep,~nt..--m-m--m--m--.ooo~.--~=.:m..--m.--------mm--m...-- Wiring Contractor .&~::e~~~____.~~~. By...ooo__________m_____m__mm__mm.__m____________________ :;0 GI Light Outlets...........:.......___........._.._..... ~CJ Receptacle Outletsm....d...................... Drver. KW.n.....h.r:!h............_........._ Ra~ge, KW___..j)______m__m..m Service, volts ....................................... No. wires ....................................... Size wlres..................................._.. Main fuse ....................................... Water Heater: ,- Y/, KW.__....__..___..m..mm....___...... Hea', KW../.:.~...8.../j........ Enclosure ........................ Type at Wiring: Entrance Cable .d.......................... Motors: size, volts and phase: Rigid Conduit .......n....... Meta1l1c Tubing ......... Current transformers: No. & Size....................................... Ser. NO....................d.........n............. Ser. No.............................................. Type of Wiring: Armored Cable .............................. Non-Metalllc ................................_ Knob & Tube..............................._ RIgid Conduit ................_____.......... Metallic Tubing ...................._m... Clrc:l::~ ::;h.~::~~:~~~::::~~~~:::::~~::~:~~~:= Utility.......4;................................. I-Jeat .....L~........................._...... ~ Range ............................................. Water Heater .;2........................ Motor ..._........................................ ~- Dryer ......................n........................_ Furnace .........................._................... Ser. No............................................... ( Total I..oad............................. Ser. NO.................._.n........_n............ Total ..~................................ Remarks: m.m.__.:__~:l.e.el:..~.r.::.__mC~~..t.__mm.__mmmmm.m__mm.m__m__m.:____mm.m.__000000000__000 --.--.--.-----.000--000----------.-------000..000000----000000------.------.000---_____________000__.____.__/,-------000000-1./1;.-----------.-----.....000000----..000-- Permi; Fee . Treas. Receipt 0/ y ;V; . A ~ $______:?..!..2.JL.____.____h.__ NO.__m.mm__m__m._.__ By /l.:__.L__m._.._..mn~(b.~m_"__mm'~.~ NOTICE-Current'must not be turned on until Certificate of Inspection has been issued. It work Is to be eOD- cealed due noUce must be given the Inspector so that work may be inspected before concealment. " NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION 17082 , \ \ Address...................................................................................__...................................................Date..._......_.._:._.._.........._._...._......_.\..__... I. Owner ..........h.........._............_.........._.................._........................................................... Tenant...h..n..............................................n__..~:..... -~.-..........--" , / ELECTRICAL PERMIT .. , N'? \ \ , WiringContractor......__....._....n...............______................._................................................._._....._...By...................__...................................~..... " NOTIC~urrent must not be turned on until Certificate of Inspection has been issued. It work Is to be COD- cealed due notice must be given the Inspector so that work may be inspected before concealment. 1M Olympic Pritters, Inc. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . REQUEST: Date b - 2-8 -Db Time '? /I h'l Received by {)~k""~" E (phone, person) Location of Work to be inspected / I 5 t C:a-ro I,-"'~ Name of person requesting inspection f)evLY1;') r. Address of person requesting inspection C.:rrtJ ~~r~ I Type of Inspection (circle appropriate one): Sewe'r Foundation Framing Chimney Plumbing Final l7'f-t3 Phone No. :.!fI-'/J'<t9 Permit No. .---... - Sewer Excav. Othe(~~~) INSPECTION NOTES: Inspected: Date t; -z8 -D0 Remarks:: ~e.,t'AI'rlZ-tJ (ea..kl~ I VIA-€-1- e. r-- Time /z-- ":p1lA... By O-e.,."<,s E..- $erJt~""- (,,:,,,~ b-<-+t.Je.e.v... /tt.-\4/ ~ cJ~,^-J RESTORATION REQUIRED. . . . .. YES NO ~ , m f0 () /<-- 50' ~ ,~ ~7 I' L"L " J. <-, Vi l ~ .,. 'Ou-fJ (V) 'I/) ~ ~ ;j ~ <S (~ .--.t: \) , SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved o Gravel o Repaired by City [] Repaired by Permittee o No Damage Found o Asphalt 0 PCC 0 Other Work Order # $03.4 C, - f I 3 o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) ~TRI=I=T ~IIPJ:aII\lTl=l\lnI=I\IT lnATJ:\ ELECTRICAL PERMIT APPLICATION FOR QFACIAL USE O:o.:L Y ~lelKco:; PamiI .: Daile Appnl\I'ClJ: OareluucoJ: ~ The ElectricaJ Permit Application must be filled out comDletetv. Please type or reprint in ink. "you have any questions, please call (360. 417-4735 Fax number: (360) 417-471t JITlL 7/'1 Owner or Elee, Contractor Agent: ,4 t'i/7:31 'I/fA /J HE 1:5'E/.2 Property Owner: ;-/0 JL", r r/fA)./ liE/,SF'€' Address: II:?; CAIZOi.-;I.JL3 Phone: If.., -2 - .5 q 7 7 Fax: Phone: qt:;2" S'1 7 7 Electrical Contractor: City: PoRT /t/i./r7F:I-E< license #: Exp: Zip: q.?;::)(;-Z Phone: INSTALLATION WIRED BY: fi?6WNER City: o ELECTRICAL CONTRACTOR Zip: Address: Credit Card Holder Name: Exp. Date: Zip: VISA: Billing Address: City: Credit Card Number: MC:~ PROJECT ADDRESS: / /3/ (!;'1runJ Aif. TYPE OF WORK: Check all that apply: 0 New wAlterationlAddition J~I1=lesidental 0 Multi-family o Commercial 0 Mobile Home " Sq, Fl. o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic P.ump 0 low Voltage 0 Telecom. 0 Sigr Number of Circuits added or alleroo:'/-'-/ C.tL. DESCRIPTION OF THE ELECTRICAL PROJECT: I .(;;U T. t'. r T 'lit/c) /,-/(;411 ;~ .._, Electrical Heat Load Additions Service Intormation o Baseboard o Furnace o Heat Pump o Fan-Wall _K:W _K:W _K:W _K:W o Overhead Service o Temp Service o Underground Service Voltage: Phase: 0'1 0 3 Service Size: 1..#v Feeder Size: PAMC 14.05.060(B): For industrial, commercial, & residential projects larger than a duplex. a one -line drawing of the Electrical Service & Feeders, building size (sq. ft.), load calculations, and the type & of conductors and/or raceway is required and shall accompany the Electrical Permit application. 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 are required; it remains the applicants responsibility to determine what permits are required and to obtain such. Credit Card Holder's Signature: Owner or Elec. Cont. Signature: 4N'(J I Te.-<?, .-<:.<<- Date: Date: (; -- 2"1-Q3 PW-9019 d!t e O~ jrP "361 - (1)3 ,5-..2/- oJ h Hrfrt- ./ ~& 70 /