HomeMy WebLinkAbout609 S Ennis St - BuildingPREPARED 9/15/08 8 47 19 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 9/15/08
ADDRESS 609 S ENNIS ST SUBDIV
TENANT NBR DICK JACOBS
CONTRACTOR ALL WEATHER HTG COOLING INC PHONE (360) 452 9813
OWNER C R /MARLYCE JACOBS PHONE (360) 457 7053
PARCEL 06 30 11 5 5 0770 0000
APPL NUMBER 07 00000592 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 9/15/08 L
MECHANICAL FINAL TIME 01 00
September 9 2008 9 33 02 AM 1pangrle
MRS JACOBS 457 7053
MECHANICAL FINAL FURNACE
AFTERNOON
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner Contractor
C /MARLYCE JACOBS
609 S ENNIS ST
PORT ANGELES
(360) 457 7053
WA 983620104
COMMENTS /ACTION NE :DED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES. WA 98362
07 00000592
388304
609 S ENNIS ST
06 30 11 5 5 0770 0000
DICK JACOBS
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
7606
Date 7/30/07
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA.98362
(360) 452 9813'
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc ALL WEATHER/ T STAT`
Permit pin number 103085
Sub Contractor ALL WEATHER HTG COOLING INC
Permit Fee 35 00 Plan Check Fee 00
Issue Date 7/30/0'7' 'Valuation 0
Expiration Date 1/26/08
Qty Unit Charge ;Per n. Extension
1 00 350000 ECH EL LVT FIRST THERMOSTAT 35 00
Fee summary Cha Paid Credited Due
Permit Fee Total 35 00 35 00 00 00
Plan Check Total 00 00 00 00
Grand Total 35 00 35 00 00 00
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
DITCH
ROUGH -IN COVER
SERV ICE
FINAL
GENERAL COMMENTS:
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED
YES I NO
COMMENTS
t kkiG i 6'.-6.66 //03
Pw -i IO2.ls 11
Application Number 07 00000592
Application pin number 388304
Property Address 609 S ENNIS ST
ASSESSOR PARCEL NUMBER 06 30 11 5 5 0770 0000
Tenant nbr name DICK JACOBS
Application type descri)tion MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
C R /MARLYCE JACOBS
609 S ENNIS ST
PORT ANGELES
(360) 457 7053
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
Fee summary
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
WA 983620104
MECHANICAL PERMIT
HEAT PUMP INSTALLATION
102699
64 70 Plan Check Fee 00
5/24/07 Valuation 0
11/20/07
Per
1 00 14 7000 ECH
Charged
Permit Fee Total 64
Plan Check Total
Grand Total
70
00
64 70
T \Policies \1102_15 building pennit inspection ilecord05 wpd [1/4/2005]
RS7 RESDNTL SINGLE FAMILY
7606
Paid
Contractor
BASE FEE
ME INSTALL 100-
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452 9813
64 70
00
64 70
FAU
Credited
00
00
00
Date 5/24/07
Extension
50 00
14 70
Due
00
00
00
Separate Permits are required fore ectrical 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 A6thertz Agent bate Signature of Owner (if owner is builder) Date
0
0
v J
5
5
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
ROUGH -IN
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT Ws
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
BUILDING PERMIT INSPECTION RECORD
CALL 417 -4815 FOR BUILDING INSPECTIONS CALL 417 -473 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 WORA BEFORE
INSPECTED 4ND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES
NO
FINAL
FINAL
SEPA.
ESA.
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW /ENGINEERING
FIRE 417 -4653 I I I I FIRE DEPT
PLANNING DEPT 417 -4750 I I I I PLANNING DEPT
I BUILDING 417 -4815 I9-115 2 I 751i-- I BUILDING
T: \Policies \l 102 15 building permit inspection record05 wpd 1/4/2005]
DATE ACCEPTED BY.
DATE ACCEPTED BY.
DATE I ACCEPTED
YES I NO
I I I I
I I I I
I i I I
05/23/2007 00 56 1
BUILDING PERMIT APPLICATION
Fill out CCMPLETEL 1. and in INK. Your application and site plan MUST
call
PrRl T BE
COMPLETE to VI Ts (360) 417 -4815 FAX(3t;0141. 4711
vaxs
WYCy Vtl 1 4(1)01110o, Pi one 3.1.PO 1 5 2- I 91 I
Applicant or Agent:,
Owner_DI 04 .\CLCat Phone: 3(40 -1-4 5 7 7 05
Adaress.S.gA 4 City Po Irk Pwtc e S
Phone:
prcbitect/P.n
Contractor
it Watt License P41(A) eRLEO'L V Exp q M M 0 7 Phone: 1- 152â c iW
Address: 742. IL(yY' e- City Amyl Zips Z-
PROJECT ADDRESS.,,,SI 0 0\ S. E y, Y\% S ZONING
LEGAL DESCRIPTION Lc t: Block Subdivision.
CLAILAM COUNTY PAR NUMBER.
TXPE OF WOT.7X.
Residential D New Constr. Re -roof Stove
0 Multi family Addition Move Garage
D Commercial Remodel Demolition 0 Deck
0 Repair Sign o Other
BRIEF DESCRIPTION 01? DIE PROJECT
CONVIKERCIAL/RESrDENTJ 4.L. Occupancy Group:
No. of Stories: Lot Size:
Total lot coverage 0
PLANNING USE ONLY
Tâ˘\FORMS\Bldp3crmitfonn.v+pd Applir
3604525177 ALL WEATHER HEATING
G
Existing Sq. Pt.
POP P l nci\TA
ESA/Wetland(s) Yes 01 No SEPA Checklist required? 0 Yes No Other.
SIZG/VALUATION
SF /SF
SF /SF
SF /SF
TOTAL VALUATION
Occupant Load. Construction Type:
.X: Proposed Sq Ft. TOTAL Sq Pt.
VALUATION OF CONSTRUCTION Li all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and ay be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417 -4815 for assistance.
PLAN CI ECCK FEE. IF a plan check fee is due it must be submitted. at the time the building permit application and constru.ction plans are
submitted. All other permit fees .re due at the time of permit issuance.
F 'IRATION OF FLAN Vii' um) permit is issued within 180 days of the date of application, the application will empi Th
Building Official can extend the time for action. by the applicant up to 180 clays upon written request by the applicant (sec Section
R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that I have rea and examined this application and know the same to he true and correct. 1 am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits prior i° work,
Date:
Zip
icenCP oa
PAGE 01/02
FOR OFFICIAL. USE ONLY
Date Rec. 5 â23-4)7
Permit 1; 07â 59
Date 4pproved: (c .2 3 -CI
Date 1ssucci ()5-- 2..4 0?
APPROVALS
PLAN
BLDG.
DPWU
FIRE.
OTHER.
,~..,
"r,.;!
~
."
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNlTYDEVELOPMENT - BUILDINGDMSION
321 EAST 51H STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address '
ASSBSSOR PARCBL NUMBER:
Application type description
subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00001091 Date 11/07/05
795785
609 S ENNIS ST
06-30-11-5-5-0770-0000-
RB-RooF
~f1.~
4/~7/~
CJ'
RS7 RBSDNTL SINGLB FAMILY
5805
OWner
Contractor
GARNBRO RONALD A
PO BOX 562
PORT ANGBLES
WA 983620104
LARRY I S ROOFING
352 AVIS ST.
PORT ANGBLES
PORT ANGBLES
(360) 452-2215
WA 98362
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
BUILDING PERMIT - NO PR FEB
64774
148.75
11/07/05
5/06/06
Plan Check Fee
Valuation
.00
5805
Qty Unit Charge Per
Extension
92.75
56.00
BASE FEE
4.00 14.0000 THOU BL-2001-25K (14 PER K)
-----~-------------------------------------~----------~---------------~-----
Other Fees
STATE SURCHARGE
4.50
Fee SUImllary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 148.75 148.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 153.25 153.25 .00 .00
~
Separate Pennltsare required for electrical work, SEPA, Shorelil18"ESA, utilities, private and public Improvements. This permit becomes
null and void if work or construction authorized is not commencEia within 180 days, if construction or work Is suspended or'abandoned
for a,period of 180 days after the work as commencea, or if required Inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examinea this application and know the same to be true and ,correct. All provisions of
laws and ordinances gov Ing this type of work will be compliea with whether specified herein or not The granting of a permit does not
. presume to, gi authori violate or cancel the provisions of any state or local law regulating construction or the performance of
construction. . .
l{- 7-a:;
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is bullaeI')
Date
T:\Policies\ll02_IS building pcnnit inspection rec:QI'dOS.wpd [11412005]
,
BUllJ)~G PERMIT INSP~CI'lON RECORD
C~L 417-4815 FOR BUILDING IN.SPECTIONS. CALL 417-4735 FOR,ELEcrRICAL INSPECTIONS.
'.- -C~l:;417~()7 FOR PUBLICWORKS UTILITIES ",
PLEASEPROVIPEA MINIMuM 24 HOUR N(J:rIC~.lT1S UNLAWFUL TO COVER,llVSULiT~ OR CONCEAL ANY WORK BEFORE
INSPECTED4NDAc;qi1>>TEJi POST p~ IN A CONsJ:'i~ous LOCATION. .
KEEPPERMrrCARIlAND APPROVED PLANSA1:l]ORSITE. .
WALLS
FOuNoAoTION .'. DRAINAGE / DOWN SPOUTS'.
-
PIERS . ..,
pOST-HOLES (poLE BLOGS.)
PLUMBING: ...... -c'
, )_JNf)~R.F~RISLAB"
IU>OOH-IN .
~WATER ~(METERTO BLOG)
GAS LINE
BACKFLOW/WATER
.. ,
FRAMIlllC:; ." ....
JOISTsr,GlRDa8
..... "',~.';N'
SHEARWAili!HOLI>I'>OWNS
.... WALLS I mFl CEIL.ING
DRywALL (ilfimuoRB~CJ:!D PANEL ONLY)
T-BAR. " ~tcb. ...
"'i':;'.',;::;".,.
FooTINGl SLAB.
BLOCKING & HOLD DOWNS
SKIRTING,
'. .'
PLANNIN~J)EPT.SEPARATE PERMIT /#'s
PARK:.IN~(;~~
iLANDSCAl'ING'. . .' ." .
;:, "'..
REsIDE~
INS~ECTlON.mE'"
..< ".'.'"
\.'
FOU~ATlQl'W
FOonN(JS ....
~.S~.
WALLS,"
CEILING'
.
INSULATION
SLAB
W ~.~.fLQOR/ CEn.rnG
MEcuAPi~ ..
HEAT~/FURNACE I DUCTS
GAS LINE '-::;"
WOOD STOvE I PELLET / CHIMNEY
COM!'vfERClALHOODI.DUCTS -c.'
MANUFAC1lIRJl:DH()MEs .'
.
.
ELECTRICAL - LIGHT DEPT.
. .... .
CONSTROcTION R. W. / PW/
BNGThIEERING
FIRE.....
:r.,.. 1> -':1,;:,<1 DATE
" I '.
'-,.. "".'
..\ . ."
COMMENTS
ACCEPTED
,
.'.1 YES NO
,
-c-
'.
.
'.
....,
.
..... ,
-.'
1 " """.'
."
.
/:... .,
,>
. ,~
"
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""',o.". '.-
.. ".
-'<
1
,
.
.
'.
I
..' 1
1
.
.
.'
;,
.".
.....
SEPA:
.' .
'~'" '^:.;i ..,. .' ESA:
,,~;}.. '.' ,..'''' I~. S1W~:'~;..
FIN~~S~~{)NSREQ~ PRlORT,? ~~~~'M~ ",.. .'."
"''',DATE,'Tm NO>;.)COir!MERCIAI:.
;. .
DATE
, ."
. ACp:P.TED..
,
417-4735
'. ..,
417-4807
417-4653 .,
417-4750 .'..; .' ".
417-4815 '..
,
.'. YES 'NO
, i;. (T
. .
<'
.'.
<
,.."V
ELECTRICAL
LlOHTDEPT,
," CONSTRUc:TICni,-,.R.w.
PW/~G~ _
FIRE DEPT. '.- ", 7
PLANNING DEPT,
BUILDING
I,
.
P~GP,wr.
BUILDn.tCi!" , . ..<.
,'T;\Pdl~~~p,em'!!HJ~OD reco~~WJM!Jl/~~,:.."
..
,~j~
--
Et:ECTRl"CJQ"l,NSP EeTIO N
, '""W:IRI,NG ~EPORT
, 457-0411 Ext. 158
LTOR
6..-' n V1 " S
APPROVED NOT APPROVED
o ................... DITCH ................... 0
o .............. ROUGH IN/COVER.. ." ... .. .... 0
o .................. SERVICE .................. 0
o .................... FINAL.................... ~
CORRE~S NEEDED: '.
~w;M ~/Z.. o"",h;k.. c::.0
o '" -fi, .1 0 ~ j:: e -fc...
~) ;r; M e-'~ / "Jp f
.e-.A .s
.5-'" "'"I "" M
, ~
~p~e~ (U^~ I~~.s~)
/C> 'd _e-Jc: / ;J...,t ;;,""'; n...M
Uvt~ ~<-<-..s~/
4-) ,;;//",1<- ,<i!> A ,61' ~~
re.--A s ~ eL-l'l:Jj -4'_ ..t?~ C". ~r.f f'
.<)') Ga.. n<-j ,,_ ~ c-eyJ'/: L.d05e.....
,Jo;C:
C.r~e_____
f?O J< d- r ,,)p..."-<... ~
.
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (206)452.1381
..
Site IAddress:
Installed By:
C;o
~?
Ow ef/Business:
I
Owner/Business Address:
I
~ Residential
Heat KW 10
Baseboard 0 Furnace/Boiler
Heatpump 0 Other
Commercial/Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
;1'V'
,u
'" \"'~J)
\ 'AJJJ .:;Det
.). , 0
"/ _J
ilslDescription:
4/'
.
"
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO.
~J;:Jt
ELECTRICAL PERMIT
DATE
C' '
CA'
~C' ,-lC-
Phone:
,READY FOR
INSPECTION
D WILL CALL FOR
INSPECTION
Phone:
Sq, Ft.
o New Construction
o Remodel
o Service update/alter/repair
o Overhead
~ Underground~ f/f)
'~Itage /.;)0. 0<-
t:1003.0
Service size c;::?oto Amps
o Temporary
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
h't:7{) I/-olUX.
V
\L-
~/o
'c} '\ f) /
. 0 0
\ d /1. ,S, No, Service Size
/0 CaP'ilclty: 0 O,K, 0 Not OK Comments
:}- 0 oIitch inspection O,K, . . J So
'1JV-~ RpUgh.in/cover O.K. - ~, . ,'Ji~
])ir Cj.K. to connect service Kl~UJ'
~ Final OK
I
Site !Address:
I t & So . 41/11:5-
..
Date
Hoid 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
Permit/Receipt No.
0:08 J
New Meters
CO
Notify the Departm t of City Light by Street Address and Permit Number when ready for inspection. Work
I
must not be covered or electrically energized before inspection and O,K, for covering or service has been given
by tle Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457-0411, EXT. 158 or EXT. 224.
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ..::;;>t) ~
Inspector - Amount paid
WHI E - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom City Hall
OLYMP~C PRINTERS. INC ~
.
--. ---
Site Address:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
.
ELECTRICAL PERMIT
PERMIT NO. /'1,1 7
J,;;z/d7,48
DATE
~.
o READY FOR 0 WILL CALL FOR
INSPECTION INSPECTION
License Number: Phone:
Installed By:
GJ
Ow erJBusiness:
Phone:
Ow erfBusiness Address:
Sq. Ft.
Residential
Heat KW
Baseboard D Furnace/Boiler
Heatpump D Other
Commercialllndustrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
D New Construction
D Remodel
D Service update/alter/repair
D Overhead
D Underground
Voltage
D 1121 D 3.0'
Service size
A Temporary
Amps
D Add/alter circuits
D Auxiliary power
(list below)
D Special equipment
(list below)
.
Dl"""""""'OO
_I
I
./'
~/W1~
~
.
W.S. No. Service Size
Capacity: D O.K. D Not O.K. Comments
I
D Ditch inspection O.K.
D Rbugh-in/cover O.K.
"'1d_~~ g.K. to connect service
UV/?B Final O.K.
I
Site Idt~
Inst '1Ier: ct.J
,
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
mus\ not be covered or electrically energized before inspection and O.K. for covering or service has been given
by t Ie Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224.
/ { f!i!-
Date
Hold for: D Easement D Letter
D Signed up for service/meter
D Meter Department notified for installation
D Fire Department notified of inspection
D Plan Review approved/pending
,.S
&,;'s
duA;;
New Meters
>lR ccV
I
l~
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Inspector
WHITf - file by address YELLOW - file by number
OLYMP~C PRINTERS, INC.
Amount paid
PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OS/23/2007 00:56
13604525177
ALL WEATHER HEATING
PAGE 02/02
S'~
,
. .
\'~~....~
ELECTRICAL WORK PERMIT APPLICATION
Job wired by ~Electricol Contractor 0 Owner
Electrical conlrnCfor nome LiccnRc n\lm\lcr Dille Elt'pires
/illJAK'lltr\(V npc.nntlj e (()l1Ii m AIIWt"c..I't)~'1 "III/Ill
Purcha.ser's moiling nddres!! .~
?J.,O 1... \(.e m I? "Y\-.
P6vt M~!le\
Telephone numb t
t-/0 - q \
rrcml~E!I owncr~~ name
~.Otl<;
Addrc?lof iupection ~
(00"'\ 'S '. t::VW, IS
~Vt MO)e.leS
JnRt3.llation dC!'lcTi'PtiO~'D
(J Commercial r,eSidontlal
tJ New tJ ^Ilered/^ddltton
LV -+-.c::.to..-t I.A.JW\nq--
.
Owner as dcfin.ed h.l' RCIr.19,J8.26J;( I) Owner will ocr.IJI'Y Jhe .\'JruCWre Inr 1""'0
YC(1r.~ ~fkr thls electrical pe1'mil is fin(lli:ed. (2) OWlleJ' f.~ reQw'red in Illre all dcctrlctll
cmlfracior if allow! !;aid prcJpl!rly I.'r fm- stile. rent nr lc(ISC~,
After reading; the .,\1ovc l>tatcment. 1 hereby certify that I am the owneT of the 41bove
named properry OT R licensed electrical contmctnT. 1 nm Tnrlkil1l; thc electric", insral-
1"t.i1;l" ()r alteriltion in compliance Wilh the clectric:!l hW!I, N.E.C" RCW. Chapter
19.28. W^C. Chapter 296-46B, The City (If Port Angeles Municipal COcle, and
Utility Specifications.
~l~n.turc .r oWII~r!liJAtr'
X Iff. Date:
o Cash 0 Check #
')i:l Credit Card
Card #
Vi""
Mastercard
Discover
Expiration Dale
of card
,S_eJvice Inlormatlon
o Ovemead Service
tJ Temp Service
a Underground Service
Vohage
Phase tJ 1 tJ 3
Service Size: _
Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH,IN THERMOSTAT SERVICE '\
DllIe Ap"rg....~~ By DlI(~ /lrpMv~d fly I)Al~ Atllll'(.lve(1 ~)'
FlNAL DrrCH FEEDER '\
'- Ol\l~ ^rprovedD)'/ 1lAle ^ppro~e<l By Oule Arrrt....cd Dy
Inspectioll Area, Building or Equipment Inspected A ctinn Taken Electrical
DQle Tnflpcctor
~f<- 0 I rut.(J /3-/ - Df!;
PIl 11""1" I!!! I ,~ A
nlboV-' lit --
MAY 2 4 2007
LIGHT [ EPT.