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HomeMy WebLinkAbout1233 Georgiana St - Building r' CITY OF PORT ANGELES are;. !s 1 DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION vi vz 321 EAST 5TH STREET, PORT ANGELES, WA 98362 9r,ts Application Number 11- 00000552 Date 6/02/11 Application pin number 333272 Property Address 1233 GEORGIANA ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 00 -5 -3- 1085 -0000 Qn our state excise tax form w w Application type description RE -ROOF y i Subdivision Name to the City of Port Angeles Property Use .4 4 Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 1834 Application desc C O TEAR OFF /INSTALL COMP GARAGE ONLY Owner Contractor 7f� y ,pr; MAYBERG JOHN P OWNER 0, 1233 GEORGIANA ST 1.0.7,; PORT ANGELES WA 983624213 Permit BUILDING PERMIT NO PR FEE Additional desc TEAR OFF /INSTALL COMP Permit pin number 186957 Permit Fee 92.70 Plan Check Fee .00 Issue Date 6/02/11 Valuation 1834 Expiration Date 11/29/11 Qty Unit Charge Per Extension BASE FEE 50.00 14.00 3.0500 HND BL- 501 -2K (3.05 PER C) 42.70 Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 92.70 92.70 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 97.20 97.20 .00 .00 $tS• (7 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 has 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 s•-cified herein or not. The granting of a permit does R aanot presume to give authority to violate or cancel the provisions of any state ocal I. regulati co tr ct' n or the performance of construction. ei V 'r b 1 v1 D V6'i�J 11) J Z� I Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit B O t7.,& N UILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECT IONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water FINAL Date Accepted by AIR SEAL: Walls Ceiling FRAMING: Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling y Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab Wall Floor Ceiling MECHANICAL: Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: Parking Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 Q 1 Fire 417 -4653 V\ Planning 417 -4750 Building 417 -4815 15 I �w T:Forms /Building Division /Building Permit N N H H O N C7 F 0. Q N b 0 0 N N O N rct JJ .Ci a U a C 0 w ro H J F Q V' m ul x w p°o v r- H H cnaa 3N Z Fh HOU7 o w 0 O a a H O u] U U z N N ro w 0 o w U) U) O Z O N Q) H H O O N S 0 1 U) a H E• w as 000 o Z 0 0 d m o I qa w X o H o w O H F to o H co a 04-143 a ,„„411P z a amo a x N H W a a O LO M H a h O o o 5 V) W 0 o o 41 0 r4 0 woo 0 W w N N W rn 0.l rn O W F E+ aE \F a wo Ma a 0 O a w z o w F a o cn z H a o ar g0Fwua H m W U 4U00a a ry Ems+ aW PROJECT STATUS UPDATE Permit Date: 1,2- 19 !7 1 phoned the: Applicant at Property Owner Peke, V r at t-f'S X1'41 Contractor at I (left a phone message, or discussed): The permit (has expired, or will expire soon). What is the status of this project? Please call and schedule a final inspection. Or Submit a "permit extension request" letter. Or Let me know if the project is abandoned. Lim -r& e;x p t reel. ei r i f T :Fonns /Building Division/Project Status Update 'C' "t A1r. BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES For City Use Only Attn: Building Permit Technician Date Received 321 E. Fifth St., Port Angeles, WA 98362 r (360) 417 -4815 fax (360) 417 -4711 Permit Date Approved fo- Z- 1/ Applicant Pe MA Phone 4 57 7 98o Property Owner sA Phone Property Owner's Address /Z 3 3 aenft.. r r A Contractor Phone Contractor's Address License .Expires _._._____E- mail PROJECT ADDRESS 7 3 61-.QP1 Parcel Number Lot Zoning Project Type Brief Description: Residential Multi family Commercial Industrial Check all that apply New Construction Addition Remodel Repair Demolition `KRe -roof House garage other Xtear off re -roof lay over one layer Heat System Heat pump wood- burning stove gas fireplace pellet stove other Other Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq. ft. 1 Floor 2nd Floor 3 Floor Garage d 3 6 Carport Covered Porch Deck Shed Other TOTAL VALUATION Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage Max. height of proposed structures ft. Occupancy group of bedrooms Willa lawn sprinkler system be installed? Occupant load of full baths Will a fire sprinkler system be installed? Construction type of half baths I have read and completed this application and know it to be true and correct. t am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Date -2 /1 Print Name d /1lgyber5 Sig nature T:Forms /Building Division /Building permit application HARTNAGEL BUILDING SUPPLY INC. PAGE NO 1 3111 HIGHWAY 101 EAST PORT ANGELES, WA 98362 TOLL FREE 1- 888 -452 -6252 PHONE: (360) 452 -8933 AN EMPLOYEE OWNED AND OPERATED LUMBER TRADERS STORE CUST NO JOB NO PURCHASEtORDER ;.REFERENCE TERMS CLERK DATE /TIME 210309 000 NET ;IOTH 56 6/2/11 1033 TERMINAL: 560 SOLD TO SHIP TO EXP DATE• 6/9/11 WINDERMEREPR MNGMT 703 E FRONTaST SALESPERSON: 56 STEVE HOSKINS FORT ANGELES WA 98362. TAX: H1 HARTNAGELS- CHARGE RET ESTIMATE: 430906 LINE �SHIFPED ORDERED; UM r!. ;SKU, DESCRIPTION, SUGG UNITS PRICE/ PER'EXTENSION 1 48 EA H3OMB MAL HIGHLAND 30 MID.BLACK[4]Y 48 17.55 /EA 842.40 2 3 RL FELT15 4 SQ 15# FELT (49) 3 25.17 /RL 75.51 TAXABLE 917. NON- TAXABLE 0 .00 (THOMAS DUCE) SUBTOTAL 917.91 TAX AMOUNT 77.10 TOTAL 995.01 TOT WT: 3072.00 X Received By ~ VORT ~ l'O~~~ r-Gii 'IL~ ~ ~lC~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property zoning . . . Application valuation 04-00000962 Date .253814 1233 GEORGIANA ST 06-30-00-5-3-1085-0000- RE-ROOF 10/18/04 Owner Contractor Ar-J A: CLY~ l vz/c;~ RS7 RESDNTL SINGLE FAMILY 4900 ------------------------ MAYBERG JOHN P 1233 GEORGIANA ST PORT ANGELES WA 983624213 MICHAEL D. HALLER 63 SO. ALDER LN PORT ANGELES (360) 452-6677 WA 98362 Other Fees STATE SURCHARGE 4.50 " :z r f0 W lfJ ~ (D () ""I CY -'/ 9 ~ P ---------------------------------------------------------------------------- permi t . . . . Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT TEAR OFF, FELT, 134.75 10/18/04 4/17/05 - NO PR FEE COMP Plan Check Valuation Fee .00 4900 BASE FEE 3.00 14.0000 THOU BL-2001-25K (14 PER K) Qty Unit Charge Per Extension 92.75 42.00 ---------------------------------------------------------------------------- Fee swmnary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 134.75 134.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 139.25 139.25 .00 .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 ~ (,I /j/l Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1102.15 [11/14/2003] BUILDING 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 I YES NO FOUNDATION: FOOTINGS WALLS FOUNDA TION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DR YW ALL (INTERJOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGfLIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 'f. ).... 11...- i t . BUILDING T:\PLANNING\FORMS\I 102.15 [11/14/2003] tJ:l >-l 'tl ~:;:~8EJ ()'rJ r< ><: ~ H:<' '" 'rJ 'tl:UZZO >-lOJ '" ---- t"l()tI:lt-3::U ><:'rJ m H OJ:U:UOJ :J> 0 0 ..; Zr< :J>m o:u >-' ~. ()m "'OJ >-l 0 ~ tJ:l 0 'rJ :Ii OJ. :u. 0>-' ():uo :u :U>-' , >-' OOJ'tl >-l____ , 3:0 0 , 0 'tlc:o oo~3:1-' ~~ , N r<OJO ,t>.m:X:-H~ , ---- OJm ' , ><:()W G'lo >-l>-lll:l owtIl;I:W OJ"" , "" OJOJC::: ootI:l~ r< . , OOH 0' :UOJGl OJ , ~ ooQt""itI:l m>-, , 00 0 W .~ H "" c..0:U :u = m Ln 0 . G'l N OJHI;l N , ::r: H W , r< mZ ::u~z~~ , c:m'tl 0 , ~~~ tr:1l-'tUL'):>I '" 0 r< , :UCD OJm H OUl :U>-l , ..; 0' , "'0 , 3:tJ:l :UO' 0 , ro. c: OJ OJ 0 , 7;'H mm= 0 , " r< c:()0 , , 0 r<:U , ,,"H >-lH'tl UlZ m'rJi<l n NG'l ____>-l 0 , nH"l H 3: "'''' OOt>:l HZ 3: "'H ~Zt>:I zm OJ ""'Z m'rJ Z ....,:J> OJ "OJ >-l r< Z OJ() m >-l ()>-l m >-lH ~ 00 :uZ 0 c..>-l Z !i:8 0 'rJ'rJm >-l 55~ OJ~ OJ mOJ m ZZO >-l OJOJH r< < r< H OJ W :u '" r< 0 ><: "" Ul N , '" '" ...., ...., 0'rJ :J>:J> >-lGl OJ OJ >-' >-' ---- 0 N ---- 0 ""CD ELECTRICAL PERMIT r-;L . /,;2. Port Angeles, Washlngtonmm._.m...u......:...m.:u..........uum...m.m, 19.oo~___. . CITY OF PORT ANGELES LIGHT DEPARTMENT N~ 17775 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 eiectrical work as listed below. Address ..oo/.~oo.Joo3.ooooC..ood~'~.:!rr:'~'":.oo~oo...n___.. Occupancyoomoo~?:::.~.,......mmoom.. ~:::~::~;::{1.~'t~~:~:::.m~~:~~~~~:::::::::::::......~~~::::::::=::::::::::::::::::=::::::::::::::::::: v Light Outlets:.............................._.._..... Receptacle Outletsumn......___........____... Service, volts .'................._.......__.__...... No. wires ...nn_nn'n........................ Dr)'er, KW....nn....______.,.._____.,.__.______... Size wlresn........nn_..._................_.. Rnilge, KW ___'_n..'.....____________________ Water Heater: Main fUBe ._..___...__.._.......__..........__... Enclosure .........___...._____n.m.._._....... KW...........nnoo...nn...nnn... Type of wiring: Entrance Cable ..................___m..... Heo,t: KW.........._u.................h........... Mptors: sIze, volts and phase: Rigid Conduit ............................... MetallIc TubIng hm...................... Current transtormers: No. & Size......h..................... Ser. No............................................... Ser. NO....h............................h.......... Ser. NO..........................h...............h. Type at Wiring: Armored Cable .............................. Non.Metallic ................................. Knob & Tube........n.........._..........._ RIgid Conduit ............................... Metallic TubIng ........................... Raceway ......................._.....__..._ Circuits, Light....................................... Utlllty ............................................. Heat .......................................___.. Range ............................................. Water Heater ....h...............h.....h. Motor ..._........n.....h..h................... Dryer .............._................................._ Furnace .....h..................'_................... Total J...oad............................. Ser. No.................._.......................... Total....................................... Remarks: ...r::r:1"I!-P.~m~oo..~.2::..~...~.~...,.oo.oo-:~~.d~.;;b;~':"...mmmmmoo.___.. m'..___mmmm__oo__mm.m___moo...m___m.m___.m.mmml=..........moo___.moomoo__.____oooo___oooo__..mmm_______.moom..__.....__.m. .:~.=.~~oo~:~.oo.~~~...oo.oo____.~.~~m.mn.::~.~.~:__:~.~~~.~.~~~..~~~~.-----..oomOO--OO:;';lP1li~~:Z;~==-- NOTICE-Current must not be turned on until Certificate at Inspection has been issued. If work is to be con. cealed due noUce must be given the Inspector so that work may be Inspected betore concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N~ 1 77 7 5 A<ldress........................................................................n..............................................................Date..._.......:.._.._.._.........._......_......_......... O'wner .........h........................_......_.._......_......_.._..............n..........................__............... Tenant.""'h''''''''__' .\ Wiring Contractor.......................................................................................................................... By................................................................ l, NOTICE-Current must not be turned on until Certit1cate ot Inspection has been issued. It work is to be con. cealed due notice must be given the Inspector so that work may be inspected betore concealment. \ '. 1M Olympic Printers, Inc. CITY OF PORT ANGELES LIGHT DEPARTMENT N~ 1776 1 ELECTRICAL PERMIT . ;; - / ..;- T:::z Port Angeles, Washlngton__m,m.m..mm.....--.:::mmm--mm__.._m_m., 19!.ooom In allCordance 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 /:c/;:;.5.3ooo.--r..T-'~~~'~~.---------ooo Occupancy_ooo~oooooo__o.____.__.___________ ~:~=: &:~:~~::::::t~~%;.~~~~oo--~~:~~~;~:::::::::::::......~~~::::::::=::::::::::::::::::::::::::::~::::::::: Light Outlets..............................._.._..... Receptacle Outlets.m____m_m_..__n_.nn... Dr~'er, KW.....___n........n......h.__._______._. Range, KW n..___.h__h.____________.___n___..._.. Water Heater: KW.__m_o.o.mnnmoonnnoon. 0000 .nmn. He~ll: KW................._n...................n..n Motors: size, volts and phase: Service, volts n...._._......_...........nm....... No. wires ....h..h..._._____................... Size wires........._.......n__nn..n....._.. Main fuse _..._.___n.................__n.nnn Enclosure ._.._00___.................0000_0000... Type of wiring: Entrance Cable __.mm__.m..._.......... Rigid Conduit 000000..___00.00........00.0000 MetalUc TUbing ....m Current transformers: No. & Size......nmm___.__.....n.....h. Ser. NO............__...............n_....n......... Ser. NO.nn_._.____n................_n.nn....... Ser. No. .n_n.nnn___............h..n_____...... Type at Wiring: Armored Cable ..._.m_..................._ Non-Metallic ......................__.__.._.__ Knob & Tubeh.......n........_______......_ RIgid Conduit .00_______0000_________00______ Metallic Tubing .mm__._m_m___._.... Raceway __....................._......__..._ Circuits, Llght.....n..._.....m___..._............. Dlillly _00.._____00..._.____________....__....____. I-Ieat ..______._..._.__......................_...... Range ....._......................__nh.._.._..... Water Heater ............................h_ Motor ._......._......_........_.....0000........... Dryer nnnn_nn___._....................nn..n__ Furnace .........................,~._................. Total Load.....n.nn___.............. Ser. NO.nn_.__........._..._......_.._...._....._. Total ...........................000000_..... Remarks: ./.-1.,:J!."tJ!.:lZooo.moo~___ooo~:_:.~ooot~~.!.oooooo==-:-.oooooo.oooooooo...ooooooooo.oooooo.__..' ooo'ooooo.----oo--ooooooo...__.__ooooooooo.ooooo..ooo.ooo.ooooo___...ooo__.__ooo--;;;JJ;;,_oo~.;--ooo.ooi;:;-;::)-,..::;-.;y.";;;J...;ooo.o.oooooo.ooo..--oooooooooooo--.___ ---...o.------ooooooooo.--------ooo.m.o..---___ooo..moo______ooo.o.___._______.....--m..O--.00000...----000__000..__.___000__000...00___.000_______00000000....___..00000 :~.:.~~..~::oooooo.ooom..ooo. ::~.~.~:oo:~.~.~~.~.~ooom.. By JI..~g~::4~~.~/. NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con- 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 ELECTRICAL PERMIT N~ 1 77 6 1 Address.._____.___.......__.._.._____................._____.__.....,.......................__..._.............................................Date..._....._____.._.._..........____..._......_....___.. Owner .n......n.......__n___n._.__.n_......_.._..._n_.nn.__._...n..nn-.._.__..........n._n........h.....n....... Tenant.......n...n.......n_nn_.....n..........n___...............n Wiring Contractor....................................... ......__.__.............................___.__.__._.........______..........__..___By..___..___.........._.________._......________.............___ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work Is to be con- cealed due noUce must be given the Inspector so that work may be inspected before concealment. 1M Olympic Printers, Inc. v CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N'! 16972 5-/~ ?'7 Port Angeles, Washlngtoll._________u________<___._______._u______._____________'" 19_____u_ In aooordance 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 ~electrlCaI work as listed below. Address u,.(~_~oo__~__u_.oo_______~~------u---. Occupancy__~_<t___:::__________oo___________ ~::~~-~~~~~;.;;;;.;~::~;~_:-_::::::::-_:-~~~-~~:::::::::=::::::::::::::::==::::::::::::::::::: Light Outlets..._..__......................_..__.n. Service, volts ../~f/..~-... Type of Wiring: Receptacle Outlets........___........_____.....__ No. wires .___.....__..........._____............ Armored Cable .................---........- Dryer, KW..nu....._.___......_n........__n...__ Size wlres...................................__. Range, KW n__n...._____________.... Main fuse ..n......______......__............... Water Heater: Enclosure ........._...._m_...___..____........ KWmj2mhu__;Lmu_nnnn_nn :::~:~~;::::r~:~=-- Type of wiring: Entrance Cable ...__n....______m......... Rigid Conduit ........___.___.....m........ MetalUc Tubing .u...m. Current transformers: No. & Size....................................... Ser. No......................__....................... Ser. No............__................................ Ser. No............................................... Total Load......m..........._........ Ser. No. .............-.-...............-............. .... Non-Metallic ..__......._____......__..._..... Knob & Tuben_......_......____n_____...o__ RIgid C,mdult _...____......_u...______...__ MetalUc Tubing .......---.....--.......... Raceway ....._.........__......_......_.__._ Circuits, Light.__.....................___......._.... Utlllty u___n...nn_____...uu_nuu___o...n___ Heat --........--................--.........--.... Range .....___........__......._........_.......... Water Heater .........._...m........_m.. Motor ......._.........___....._______......_...... Dryer ...___.n_..._____........__........._.......___ Furnace _.__........._............_._...._.._._.._.. Total ____._........_____......___........_._ Remarks: n_________.~------n-----.---------.n------n--n-noo.-n-------.n---------.n---____n________._____..__.___n , h.._.._n.n.._.._u.unnnuunn____..._u.nn___.nn.nn_..nunn...nn......unn.n.ndun.........__n_....nun.n_....nn.....u_nn_nn..un.....---- :~~~;~-;~~-------oo-__-nn------___---;~~~~:-~~~~;~~-----------____--------oo---n---?5/--~~---lQ-..oo $~_______..___________.._____________ NO.____oo_________.n.__n__.. By ;;Y.!'.____t;JLdn?:S;:;_______.oon______n~!'.~:.1..- 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 Nt? 16972 Address..._._.....__...____...._....___...........____..__.............___.............__..._......................___.._.............__._.__.Date..__......____..__._..........-....---......----...-.. Owner......_.................____......._.____._.._......_.._..._.._........__...._......._....._......_.._.___............_.__Tenant._.__n_.____........_.__....__.......______.........._._n......__. "iA'tring Contractor..........................................._-.............-............................_n....._......................._ By......................................n....__..........._n.. 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. \ 1M i , Olympic Printers, Inc. \ ., 1/ Z~ FEE RE':;EIPT NUMBER CITY OF PORT ANGELES 'DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A 618 PERMIT NUMBER . - Fu - TOTAL FEE Jb OP - ----- - CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT /2'3 3c; 'io~ 1/4-AI A - CORRECT ADDRESS IS R SPQNSIBILlTY OF APPLICANT !Iv l. - PERMITS WITH WRONG AODRZSEp ARE.CANCELlE~ _ ~ Installation By go r E{rc. 1!<AC-. Installers Address Site Ad.dress Owner Owner's Address -ptl Day Phone Installers Phone Appligatjon is hereby ma.de for Permit to install Electrical Eq~ipment as foll<?~s: tiN New ute. J4 '/ I hr-J be l s 4~ f VI MiAJt Wiring Method . NUMBER AMP 240V NUMBER AMP 120V 24QV USE OF CIRCUIT PER 120V 100R FEE 'USE OF CIRCUIT PER 100R FEE CIRCUITS CIR 10 30 CIRCUITS CIR 10 30 LIGHT SIGN LIGHT _. 50 VOLTS OR LESS CONVENIENCE -- MOTOR CONVENIENCE MOTOR APPLIANCE I MOTOR DISHWASHER FlflE f'LARMS DISPOSAL , . BURGLAR ALARM RANGE 0 I, MISC. OVEN i/r: y WATER HEATER h' LAUNDRY -- -. - V . DRYER REINSTALLATION LIGHT FIXTURE # FURNACE SUB TqT.AL FEE GAS -'OIL FURNACE ENERGY FEE ELECTRIC BASIC FEE ELECTRIC HEAT n .. - - TOTAL-FEE ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER .- A.C. UNIT AMP PHASE FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS -- SERVICE AW.G. .. I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH . I certify that the work to be pedormed under this permit will be'done by the installer and in conformance with the N.E.C. Electrical Code. Date Application made - 1 (II! '1 ~ . - .19 By . . {I - - ~ONTRACTOR OR OWNER (OR AUTHORIZED AGENT} Permission is hereby given to do t~e ~bove described work, ac~ording to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinance f the City of Port Angeles. . I. f: - . 0 RE T O~ CITY LIGHT Date Permit Issued 1 (~ 1? ~C.NS APP VEO . Notify oep rtment of City light by Street Address and Permit Number when ready for Inspection. Work must not be covered or current tl!rned on beforeinspec!lon and O.K. for covering or service has been given by Inspector in Writing on Permit Placard. A. - Permits Phone: 457-0411 Ext. 158. PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ WARNING WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report OLYMPIC PRINTERS, INC. - - ---- REPORT OF INSPECTOR DATE OF VISIT MADE BY REMARKS . ~ I\~ 1-' O.K. FOR COVERING v O~TOCn"'''' I:ft:RVICE r~".I\. . z o II: 04: ::E ~ :r:: I- Z W I- [e I- o Z o C .