HomeMy WebLinkAbout633 Georgiana St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EASTSTH STREET, PORT ANGELES, WA 98362
Application Number
property Address
ASSESSOR PARCEL NUMBER:
Application description
Property Zoning . . .
Application valuation
Property owner
Owner address . . . .
03 -.00000008 Date
633 GEORGIANA ST
0630005135700000
RES ACCESSORY BUILDING
1/18/03
Contractor . . . . . . .
Structure Information
Construction Type
Occupancy Type . . . . .
Other struct info . . . .
4466
BRIDENBAUGH GLENNDIA W
334 W ANDERSON RD I,
SEQUIM WA 983828046
( )
COZI HOMES
CAR PORT
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
NUMBER OF UNITS 1.00
Permit
Additional desc
Permi t Fee
Issue Date
BUILDING PERMIT -RESIDENTIAL
111. 25
1/02/03
Plan Check Fee
Valuation
.00
4466
Qty Unit Charge Per
BASE FEE
Extension
111. 25
Other Fees
STATE SURCHARGE
4.50
Fee sunwary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ~---------
Permit Fee Total 111. 25 111. 25 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 115.75 115.75 .00 .00
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Separate Permits are required for electrical work, SEPA, Shoreiine, 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. I hereby certify Ihat 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 vioiate 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\II02.J5 [412002]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
#~
BUILDING PERMIT
13917
PERMIT NO:
S:
ISSUED: 1/02/2003
PROPERTY LOCATION
633 GEORGIANA E
Lot: 15
Block: 35 0 Long Legal
Subdivision:' NR SMITH
Parcel No: 0630005135700
OWNER/APPLICANT
GLENDIA BRIDENBaUGH
633 GEORGIANA
Port Angeles, WA 98362
360/000-0000
T:
CONTRACTOR
COZI HOMES
324 E. 9TH STREET
Port Angeles, W A 98362
206/452-9906
PROJECT INFO
Project Value: $4,466.00
Project Type: CARPORT
Occupancy Type: RESIDENTIAL
Occupancy Group:
Construction Type:
Zoning Use: RS7
ARCHITECT
N/A
, 98360-0000
360/000-0000
SFD Units:
SFD sa FT:
o
o
Commercilill:
Industrial:
Garage:
o
o
o
MFD Units:
MFD sa FT:
o
o
PROJECT NOTES
receipt#10013
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$111.25
$0.00
$4.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Mise Fee 1:
Mise Fee 2:
Mise Fee 3:
$0.00
$0.00
$0.00
TOTAL FEE:
AMOUNT PAID:
BALANCE DUE:
$115.75
$115.75
$0.00
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. "'. /}
.~ "c U; )-;;2- "3
Signature of Contractor orized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORMS\1102.15 [4/20021
. . . . . . .
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT . . . . . .
. . . .
REQUEST: '
Date C Tf- /; y /(' -:>-,
'! /
Time " (;. ,"--f> Received by .st c-'-- (phone, ~0~0
~/
location of Work to be inspected (/;:7 .) (',',.. '>) ,j ,', " t'
Name of person requesting inspection K,., '7
Address of person requesting inspection Phone No.f'/'(! C(, '.) {,
Type of Inspection (circle appropriate one): ~ Permit No. cc ~.
Sewer Foundation Framing Chimney Plumbi~e/" Sewer Excav. Other
( ("", j~ \ l~ ,- t
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
By
RESTORATION REQUiRED...... YES NO
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT - APPLICATION
FOR OFFICIAL U:>E Qt-IL Y
Dale Rec.. I'Z. - ,B -(;> z..
Permit #,~ '"7
Date Approved:
Date Issued;
The Building Permit Application must he filled out completely.
Please type or print in ink. If you have any questions, please call 417-4815
Applicant or Agent: f{eIJ Z:.:1 Lci .
OW"~ _.iie<>~~a- 'R ~ "d':AJ~"t
Address: , ""i ~ ~f!:j-~
Architect/Engineer: c;,~ L ~ -j '/1 ;If-/Ce-r ..
Contractor ('0 n fI.~,fY1.-<" C.., License #: ~ ''Fi Ie Exp:
- . ^-
Address: 'J,.7 l( F CJ7 City: I A
PROJECT ADD~SS: (. "3.2:. ~PO ~ laAJ~
LEGAL DESCRIPTION: Lot: Block: Subdivision:
CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name:
Billing Address: City:
Credit Card #: Exp. Date:
Phone:
If 5;;L~ 9?~)~
{, &3 93-77
Zip: "1$ '3 f, 'L
45:J--C)CJr,L
Phone: <'(.5.') t.79-rC-,
Phone:
Phone:
SeD. ( ;
)yt
Zip:
ZONING:
VISA
MC
TYPE OF WORK:
o Residential 0 New Constr. 0
o Multi-family ')i<( Addition 0
o Commercial 0 Remodel 0
o Repair 0
Re-roof
Move
Demolition
Sign
o Wood-stove SI~:s<ALUS~T~;: /SF. ~~~~tf~(;.. .L9(]
o Garage SF. @ $ /SF. ~ $
o Deck SF. @$ /SF. = $' tll. :z!
o ( 1lf5'1< A- TOTAL V ALUA TION $ . y. ~o
B ~j U C i/rF poM- u tV ~ !/,r el 0 p ,46.f{t#
-Ii). if/3
*(/"
%-
/sq. ft. ~ TOTAL LOT COVERAGE:
APPROVALS: PLAN
BLDG.
DPW
FIRE
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER
BillLDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must hefil/ed out completely to be accepted for
review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your
completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division.
BRIEF DESCRIPTION OF THE PROJECT:
r;: '>' ,-erf"!::1 g I ),:Z!
COMMERCIALIRESIDENTIAL. Occupancy Group:
No. of Stories: I Lot Size: % Lot Coverage:
Existing Lot Co~: /sq. ft. + Proposed Lot Coverage:
PLANNING USE ONLY:
Notes:
Occupant Load:
Construction Type:
/sq. ft.
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: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other
pennit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: lfno permit is issued within 180 days of the date of application, this application will expire. 111e
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 edition). No application 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, and I am authorized to apply for
this permit. I understand it is not the City's legal responsibility to determine what pennits are required,. it remains the applicant's
responsibility to determine what permits ar~"required and to obtain su:~. ~
Applicant: 'll.-.:.orr
't: ""3/-.../...../Date:
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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
Property Zoning . . .
Application valuation
03-00000157
633 GEORGIANA ST
0630005135700000
ELECTRICAL ONLY
Date 3/16/03
o
Owner
Contractor
BRIDENBAUGH GLENNDIA W
334 W ANDERSON RD
SEQUIM WA 983828046
ELECTRIC SERVICE
82 DRAPER RD
PORT ANGELES
(360) 452-6424
WA 98362
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
ELECTRIC SERVICE
46.70 Plan Check Fee
3/16/03 Valuation
9/12/03
.00
o
Qty Unit Charge Per
1.00 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS
Extension
46.70
S\
6J
0J
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 46.70 46.70 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 46.70 46.70 .00 .00
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Separate Permits are rbquired for electncal work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work o~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 Jertify that I have read and examined thiS application and know the same to be true and correct. All provisions of
laws and ordinances g9verning 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. I
I
I
I
Signature of Contractor or Authorized Agent
I
T IPLANNINGIFORMSll102 15 [4/2002]
Date
Signature of Owner (If owner is builder)
Date
BillLDING PERMIT INSPECTION RECORD
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
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
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I
MECHANICAL
HEA T PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engmeenng DIvIsion) SEPARATE PERMIT #'5.
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARA TE PERMIT #'5 SEPA
PARKING/LIGHTING ESA
LANDSCAPING SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT 417-4735 ~ht1/,;~ k-n ELECTRlCAL
LIGHT DEPT
CONSTRUCTION R W / PW/ ;' P'
CONSTRUCTION - R W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT
PLAl\'NING DEPT 4 I 7-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
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
t~UILIJIIV{~ I"'~'I~M~- ISSUED: 10/10/2002 PERMIT NO: 13766
OWNER/APPLICANT PROPERTY LOCATION
633 GEORGIANA E
GLENDIA BRIDENBOUGH
633 GEORGIANA Lot: 15
Port Angeles, WA 98362 Block: 35 [] Long Legal
360/000-0000 Subdivision: NR SMITH
T: S: Parcel No: 0630005135700
CONTRACTOR ARCHITECT
PELLET HEAT CO. N/A
230 "C" E. 1ST STREET
Port Angeles, WA 98362 , 98360-0000
360/457-1649 360/000-0000
PROJECT INFO
Project Value: $1,800.00 SFD Units: 0 Commercial: 0
Project Type: PROPANE STOVE SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use: RS7
PROJECT NOTES
INSTALL FREE STANDING PROPANE STOVE
RECEIPT#9803
FEES ASSESSMENT
Building Permit: $0.00 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $0.00 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $35.00
Plumbing: $35.00 AMOUNT PAID: $35.00
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and punic 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 knowthe 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.
o,,,V /-/&
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PL ANN~'Gt FO Pdvl S\ 1102A5 [4/:[002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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
ELECTRICAL (LIGHT DEPT) SEPARATE PEKMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
OAS LINE 1i-6,- OZ
BACK FLOW / WATER
AIR SEAL
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / 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
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 II- i'j]'Oz ~.~"ffff'~ BUILDING
T:\PLANNING\FORMS\1102.15 [4/2002]
FRO~: SPA SHOP-P~LLET HEAT CO FAX NO. : 3684520503 Oct. 09 2002 07:50AM P~
BUILDING PERMIT - APPLICATION
~#: /
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LEGAL'D~ON: ~ / %~ _ a~ ~ ~ ~ ~ ~. ~,'+&
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fees ~ ~e ~ ~c ~o ofp~t ~.
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date ~) -- [ -- (~ Time Received by /~ ~/~ (phone, person)
Location of Work ,o be inspected (~_,~ (~--~c:::~ ~ ,'
Name of person requesting inspection ' ~' ~ ~ ~
Address of person requesting inspection Phone No. ~-
Type of Inspection (circle appropriate one): Permit No. /
Sewer Foundation Framing Chimney Plumbing ~ewerExcav. Other
/~
~s~c~o~ ~o~[~:~
Inspected: Date /~- ~- ~ Time By
Remarks: ,,~
RESTORATION REQUIRED ...... YES NO.
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel [~Asphalt ~--~PCC [~Other
[] Repaired by City Work Order #
[-I Repaired by Permittee [] COMPLETE
[--} No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
.
.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO.
{/:;k?
ELECTRICAL PERMIT
DATE
Site Address:
o READY FOR
INSPECTION
License Number:
,6"WILL CALL FOR
INSPECTION
Phone:
Installed By:
.
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/alter/repair
o Overhead
o Underground
Voltage
~10 O~
Service size
o Temporary
Amps
o Add/alter circuits
o Auxiliary power
(list below)
b(Special equipment
1II\,ist below)
DetallslDescription:
,.
r;ul ~K' /Jmc:./ E
. /
rY/;'iJ /101 ;,:/)
d/ ~t2-
,
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough-in/cover O.K.
o O.K. to connect service
~O.K.
Site Adte3' '3
Installer:
LEG
Date
Hold for: 0 Easement 0 Letter
Size
Comments
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
permitlRi17ff
New Meters
cJ
~
let -.Ute.-
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 Building Permit. PHONE 457.0411, EXT.158 or EXT. 224.
I ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT c2/ a::!:!
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYM"IC PRINTERS. INC.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N?
16787
. ~~ ~~
~ ~ ?y ./ .
Port Angeles. Washlngton........__.........".:......__._......_..._...__._.___........ 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 dO electrical work as listed below.
Address ._(~__~_d..__::'~-e:.l.::~~~~~.;,,,_____________________..______ Occupancy._-/-__C_".2_____...______.____.__________
Owner a" (J...J:L f!:'8>.Yf:.g.----,,__"____E'_____ TenanL____.____.____..____.__.___..___.___.....__________....______________..
Wiring ~o~~:{~~~.:::(!.;~#.c:.~;:&~~:,,::tf__________.______ By.______...___________________________.___________.....___..___________
Light OUtl.ts..._.......................:'._~_...'" S.rvlc.. volts /tf!:._'?~'5?!!:t?.... Type of Wiring:
3'
No. wires .......................................
Slz. wlres~~4.;d:.-..
Main fuse ....~.......:....:!...h........
S
Enclosure .......................................
Receptacle Outlets...............................
Dryer, KW....................__....................
Rallg,~, KW...............h.............
Water Heater:
KW..._m_.......m....mm_m........ _
Type of wiring:
Entrance Cable ...............h............
Heat: KW...........................................
Motors: size. volts and phase:
Rigid Conduit .....................
Metallic TUbing ..................
Current transformers:
No. & Size.......................................
Ser. No..............................................,
Ser. No..............................................
Ser. No...............................................
Armored Cable ..............................
Non-Metalllc ................................_
Knob & Tube____............................'"
RIgid ConduIt ................___..___.......
Metallic Tubing ...........................
Raceway ..............................._._..._
CIrcuits, Llght..........n......................._..
UtilIty ___.._______..._...___......................
J.Jeat ......................._.............._.._
Range .............................................
Water Heater ...............................
Motor ..._........................................
Dryer ....................._.......................__
Furnace .........................,~...................
Total Load............................. Ser. No. ............................................. Total ....n.................................
Remarks: ________._-:'!.~{'[""'.1._~,,_____!2::~~~__._______..._________________________________________.____.________________.._.........__.."..__
. /
.nnnnuu.d...__.nnnnun__.nnnn..nnn...nnnununununnnuu..UHn_hnn..n..n.n.uu.n._..nunu....n...h.n.nnnuu.~._n.~~.n.u_.
d
-----------.--------m------m--------------mm---------h_____mm__.m________h._____..__m__..m__;~7...__mmp-,__.___mm____.__,_mmmmm;;r
Permit Fee Treas. Receipt , //:~ ~~.... t /
$:___....._m____________.___.._m.. No..____....__.....___________ ByLJ1d;,!."'_:__l:../(...r.?_!.....,_..-:'}(,:.-?__!:.:-;.'-'::~"-'_,,..
NOTICE-Current must not be turned on until Certificate ot In~Ction has been issued. It work Is to be con.
cealed due notice must be given the Inspector so that ~ork may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
16787
(
Address..................._......t...........................................................................................................Date..._......_.._.._.._.........._......_......_......._
Owner ....................h............._......_.._......_......_h_........................................................... Tenant........................................................_..........
',." Wiring Contractor..................................._......................_............................................................. By..............................................................
\ NOTIC~urrent must not be turned on until Certificate ot Inspection has been issued. It work.. ~s to be con.
O',ealed due notice must be given the Inspector so that work may be inspected before concealment. .
\
1M Olympic Printers, Inc.
FROM
Electric~S
')
FAX NO. : 4525424
Feb. 19 2003
04: 34PM Pi r
FORO'f!t~. ">!'91't"'~
D_lr./lht: ~.cu-<.J
.._.,~
I'mnI1"', _~
D;:rtc."t1pr""~, ~_~-_,._
D"'l~ luum: _no __._.._
ELECTRICAL PERMIT APPLICATiON
The Electrical PeffTli't Ap~lication must b. flUHt C!Jt c:omDletelv.
Plell$e~ or r.prtnlln In~. If you hoWl eny qu..~on., piau. cell (360) 417-4735
F... numller: (3GlI) 4H-4711
REQUEST INSPECTION ~
Ow-narorElec.ContractorAgent:~O'?f?l~ ~"'IU J..LL,-- Pnone: ~-s-2.-0\i')"" Fax; ~ C"'l..-I.,,,,,,,
/ Property Owr..c \3 Y ",.i rk C)ce.~~ Phona:
Add",s': ~ 13_ G-0C "'~r~~\ff Cir.: _ PtT<i" A'~'-\-Iri~ (;}.ill Zip: 9Q3C;2
I=:-' c-, . ~. d'<"
Electrlc&lContraclor. \?\l<'-~\<- ~I ~_ Li",,",,'f:~ITI' Exp: 0/("/'"'1. Phon.:4S'2..--{,v.
Address: <8"L.. ~ V~ re.& City: ~~""" ~ I L-V-- ( Zip: <t1"~(..,-
INSTALLATION WIRfO BY: 0 OWNER ~l CONTRACTOR
Credit Card Holdsr Nllme:
~~
(y--/' . City:
BllIi"g Address:
Credit Card Number:
Exp. Date:
Zip:
VISA:_MC
PROJECT ADDRESS:
t'33
t,eD~(AN(J:
j
TYPE OF WORK'
Check Il.II that apply: 0 New
o Alteration/Addition
1t(:Resldental 0 M ultl.family
o Commercial 0 Mobile Home
Sq. Ft
Remota Meter 0 Detached garage 0 Hot Tub 0 Swim Pool C Septic Pump
Number of Circuit. add.d or altered:
o Low Voltage 0 Telecom. O.
DESCRIPTION OF THE ELECTRICAL PROJECT:
ra.Il port-- I; U ~lr
Electrical Heat Load Additions
PERMIT FEr: 1/ h . 7 D
Service Information
!:J Baseboard
Cl Fumece
c:; Heat Pump
o Fan-Well
KW
KW
-TON
_KW
LRA
o Overhead service
o Temp Service
o Underground Serv.c..
Vo~age:
Phase: Cl 1 0 3
Service Size:
Feeder Size:
PAMC 14.05.060(8): For Industrial, commercial. & residential projects larger then a duplex, a one -line drawing of the Electrical Service
Feeders, building SIZe (sq. ft.), load calculations. and the type & of conductors andfor raceway Is required and shaJi accompany the Electl
Permil application,
I hereby certify that I have read and examined thIs application and know that same to be true and correct, and /
authorized to apply for this permit. I understand it /" not the City's legal responsibility to determine what permits
required; it remains the applicants responsibility to determine whet permits ere required and to obtain such.
Credit Card Holder's Signature:
Owner or Elee. Cont. Signature:
C:/ELECTRICALPERM IT APPLICATION
t2eL cO~ 2~t-o- 03
~~
Date:
?jl'~(~~
'1-/(~{y
Date: