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HomeMy WebLinkAbout116 N Laurel St - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Owner TURCO DARLENE RAE PO BOX 87 JOYCE 36) 417 2220 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge 1 00 7 0000 Fee summary Permit Fee Total Plan Check Total Grand Total CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98343 PLUMBING PERMIT BOILER BACKFLOW 89276 57 00 10/19/06 4/17/07 Per BASE FEE ECH PL -OTHER Charged Paid 57 00 00 57 00 T•\Policies \1102_15 building permit inspection record05 wpd [1/4/20051 06 00001152 713856 116 N LAUREL ST 06 30 00 0 0 1500 0000 TURCO RES PLUMBING REPAIR CENTRAL BUSINESS DISTRICT 500 Contractor lme91c ANGELES PLUMBING P 0 BOX 1151 PORT ANGELES (360) 452 8525 PREVENTER 57 00 00 57 00 Plan Check Fee Valuation BACKFLOW 2 Credited 00 00 00 Date 10/19/06 WA 98363 00 0 Extension 50 00 7 00 Due 00 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 goveming 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 thorized Agent Date Signature of Owner (if owner is builder) Date CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. CALL 417 -4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS 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) IT-BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL BUILDING PERMIT INSPECTION RECORD YES 1 NO FINAL FINAL SEPA. ESA. SHORELINE. DATE ACCEPTED BY. DATE ACCEPTED BY. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 -.1;W kNGINEBRING !4 a FIRE 417-4653 I 1 1 I FIRE DEPT I 3 1 1 PLANNING DEPT 417-4750 I 1 1 1 PLANNING DEPT I% l ni IrpJI I 1 Ia_ 1 BUILDING 417 -4815 I I I 1 BUILDING 1.1 t y 1 T \Policies \1 102_15 building permit inspection record05.wpd [1/4/2005] Applicant or Agent: 7 9t4S Owner /i/f® Address. �/�o /U� Lri/// City Architect/Engineer Contractor 7 /e /t 4 State License Address: AO/ AT/ City PROJECT ADDRESS L�`2_. LEGAL DESCRIPTION Lot: Block: CLALLAM COUNTY PARCEL NUMBER. TYPE OF WORK. Residential New Constr Multi- family Addition Commercial Remodel Repair Sign BRIEF DESCRIPTION OF THE PROJECT PLANNING USE ONLY T•\FORMS\BIdgPermitform.wpd Applicant: BUILDING PERMIT APPLICATION 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 PERMITS (360) 417 -4815 FAX(360)417 -4711 Re -roof Stove Move Garage Demolition Deck Other `1t .#1 u' A4 p( PA vertu iZ C COMMERCIAL/RESIDENTIAL. Occupancy Group. No of Stories: Lot Size: Existing Sq. Ft. Total lot coverage ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Buildmg Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE. IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. l 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 to work. Phone: 7v zS Phone: Subdivision. Phone: Exp SIZE/VALUATION SF /SF SF /SF SF /SF TOTAL VALUATION Zip ZONING Occupant Load. Construction Type: Proposed Sq. Ft. TOTAL Sq. Ft. Date: a /�//0 FOR OFFICIAL 0 �Y Date Rec../ Permit Date Approved: Date Issued: Zip 2 1 vi`',i Phone: 0 2 APPROVALS. PLAN BLDG DPWU FIRE. OTHER. CITY OF PORT ANGELES FIRE DEPARTMENT PERMIT 321 East 5th Street, Port Angeles, W A .98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type-desc~iption Subdivision Name Property Use , Property Zoning . . . Application valuation' 08-00000055 Date 870545 116 N LAUREL ST 06-30-00-0-0-1500-0900- FIRE ABANDON TANK INSPECTION 1/14/08 CENTRAL BUSINESS D~STRICT. o Owner Contractor TURCO DARLENE RAE PO BOX 87 JOYCE ( 36) 417-2220 WA 98343 3 KINGS ENVIRONMENTAL INC PO BOX 280 BATTLE GROUND WA 98604 (360) 666-5464 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date UNDERGROUND TANK COMM RMV TNK w/ WTR MN PRJ UN SDWLK -, , 119073 100.00 Plan Check ,Fee 1/14/08 Valuation 7/12/08 .00 o t,/ Qty Unit Charge Per , , ,- -,'. BASEFE'E Extension '100.60 Fee summary Charged ,',,-,," Paid " Credited, -,,;Due .- ~", Permit Fee Total Plan Check Total Grand Total 100.00 ,00 100.00 100.00 .00 1.00.0,0 . Q_O ,00 .00 , .~, _. ..00 . .00 ,00 ...~ ,"""':". -.I,{'-:-;-'" '..... ,~' .Do','......... >., ~:'. :.:'; :'~ ' ; : , ' . .,'.-. 'c., ~ . 'f.: :"'~,.;\< , ' .~' ,. . ~ '. _,' . L ~. ~ ,: ..' ",..;,' ." ''1 ,-,,-, {:' -""-.' -"~ ~". ,'I.< .r "". l,j;,:O: "~::. ;,,;;, " "''''. ."', !;' .~... ",. ...." ." .',., . ,.~" "'. .. ,""" ".. ~",. . , ~~.~~ .' ',' . ~ " :1,' i ~{ , '~?;:"--- . 0, ",: ,/7~/ . ,1(::' o y: ._ - '[~:: _p - '0 ,~ ~.' " OJ) ~(){) t, '.J' . i f This permit becomes null and void if work authorized is not commenced within ] 80 days, if work is suspended or abandoned for a period of 180 days afer the work has commenced; or if required inspections have not been requested with 180 days frop1the Jast inspection. I hereby certify that I have read and examine:! this application and know the same to be true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled with whether specified herein or not. ThegrElI1ting ofthis'permit doe~ not presume to give, authority to vioiat~ or cancel :t!ie p;'j~~'ens ,', tate or l~~,~~ law regulating the work specifi~~..i_~_t.~~pe;~!Iit. ' . ,,' ,...."',.,. ,:'.:$,igratu~.e of Owner (if Owner is buildei)..~. Date . . . ,. ,,~.. ~'.. -, .' '.'" '--..~.~, . ,. ,"" .~.-;.. () \A , Call 360-417-4655 for fire inspections. Please provide a minimum 24-hour ~otice. It is unlawful to cover, insulate ~ or conceal any work before inspected and accepted. Post permit in a conspicuous location. FIRE PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE Inspection Type Date Passed Comments FIRE SPRINKLER Underground piping hydrostatically tested Underground piping flushed Interior piping hydrostatically tested Interior piping inspection Dry system air tested at 40 psi (24 hours) Sprinkler final FIRE ALARM Rough-in inspection Alann final LP-GAS Completed by Contractor: Underground piping inspection/pressure test Test # 1 Above ground piping inspection/pressure test Piping pressure test pSI Time initiated Tank (container) inspection Test #2 Appliance inspection Piping pressure test pSI Time initiated LP-gas final UNDERGROUND STORAGE TANK (UST) ABANDONMENT Removal of flammable/combustible liquids Tank appropriately abandoned UST abandonment final .01- 0'2.-0'l k~t) PERMIT OTHER (specify) permit final - --- 6' z: )' t ~ ,...-- o + . 2/15/00 ~ ::5 7' 7Y ~ .c p GENERAL COMMENTS: -- '" CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 (360) 41k4815 fax (360~ 417A7t1 · \J t\ v';;:- r~ Ir-J. ~ Applicant or Agent '] k1lUj) eNVll'J-ur-Jr[;"-'/-WI l PropertyOwnerCI'+y <fJVC PC>'1-+ VJ-':.b!tr/wt> Property Owner's Address ?.a I E Pi J?1 Contractor/Engineer J V< lrv~ 5. Contractor/Engineer's Address pc:} tso>,,- 2-re> License # BUILDING PERMIT APPLICA TION Print in ink For City Use OnJy: Date Received 1-1'/-02> Permit # 8~ - ~c" Date Approved I~/.-I-e?e Phone 3 {,o bb {,. - ~ 'I b <} Phone Phone 36 d b66 .)'Y6,/ fj. ~ f t-UsYr.fLo./'rvd) t..-Kl 1860'1 Exp I res PROJECT ADDRESS lh t'J lC4v (; L ~+- 6 /~ l/ fA- Parcel Number Lot Zoning Proiect Tvpe & Brief Description: o Residential {j.9ommercial o Multi-family o Industrial Check all that apply o New Construction o Addition o Remodel o Repair oRe-roof o Demoli.tion o Sign o wall-mounted o projecting o freestanding Dawning o other Total siqn area SQ. ft. Maximum allowed sign area SQ. ft. o Heat System o Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other o Other Floor Areas Existinq (Sq. ft.) Proposed (Sq. ft.) Basement @$ per sq. ft. = $ 15t Floor 2ndFr~'or 3rd Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION $ Total footprint of structures Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? sq. ft. Lot size sq. ft. = Lot coverage # of bedrooms # of full baths # of half baths % ft. Occupancy group Occupant load Construction type I have read and completed this application and know it 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, and to obtai ermits prior to working on projects. \ ~~ Date 17L t-J/t?k Print Name (U 14..; 6 jC>"l-i4:'-I frc.)/# Signature I T:Forms/Building Division/Bldg Permit Appl.-2006 Code.doc ~:,:.. " PORT ANGELES FIRE DEPARTMENT Permit Attachment = c-:. o--'J , = en , "'-.:l = = ---:J , >-xj ~ Abandonment or Removal of Commercial Underground Tanks pate, Initial , II ~y t?~1-. 1. l~ DD~ 2. Y] L-/ Of) 1- 1. lb~'J-. 2. tL1 001-- 3. . \/~ OIJ -}. 4. FP - 25 (Revised 2/22/00) = ''0 = ~ect~oI1 J :,JJlforJP:3t!o~ 1~~q~.ir~d "=' ~ Applicant is required to furnish the following information before a permi~ may be processed.. t:::l M '\:1 >-3 o >-r) n o :s: s:: Size and number of tanks to be removed. S 6. () Fill out tank closure work ~l1eet (attached). ~. t:::l t::1 -- 3. Submit diagram of tank. location. Section II ;. Requirements and Limitations .\ >-xj ;:=, >< Issuance of permit subject to compliance with recognized standards, listed requirements and approval by a field inspection from the Port Angeles Fire Department. z = LD => = ..p.. Provide one fjre extinguisher with a minimum rating of 40-B-C. ---:J ~ ---:J There shall be no welding or other sources of ignition in the area while abandoning operations are in progress. Welding or cutting on tank requires a permit from the Port Angeles Fire Department. Removal of all flannnable or combustible liquid from the tank and all connecting lines shall be pumped out. Use a hand pump or other meaIl.'i to remove remaining flammable liquid as far as practical. Liquid shall be placed in a tank truck or suitable containers for removal. "=' = = "'-.:l Disconnect the suction, inlet, gauge, and vent lines. Cap or plug open ends of lines which are being removed. and those wmch are not to be used any further. Page 1 of 2 Date Initial JjJL OVJ ~ y. 1 ~ o.,~ 1lLo~-1-- l[ir O()-i- Y/D ()'/ f 9. l!l) Pv {- 10. -- ---P!~ 11. 5. When capping or plugging all tank openings, use screwed plugs and leave 1/8 inch vent h~le in one plug to allow for temperature expansion. = c-:> >-3 ""'- = Ln ""'- r--...:> = = ----:] ""'- '=:l = 6. Tanks should be conditioned and flammable vapors removed by adding dry ice in the amount of 1.5 pounds per 100 gallons of tank capacity. , The dry ice should be crushed and distributed evenly over the greatest possible area to secure rapid evaporation. NOTE: Removal of ignition sources from the vicinity of the tank or container before venting operations are started shall be considered including all ,electrical e{}lJipment -jn the vicirli!y. >--cl ~ = r--...:> = 7. This process does not ensure a gas free tank and the tank shall not be welded upon unless certified by a qualified engineer after a test. .. '. t::::l tr:l '-0 >-3 o '"r:J n o ~ 8. If the tank must be stored on site, the tank shall be placed in a secure location and blocked to prevent movement. The tank would also be required to be inerted a second time before ~eing allowed to Qe, transported. t::::l ".- tr:l -< Refill hole with suitable material (earth, sand, etc.) Tank. is to b~ inspected by a Fire Department inspector prior to b~.!ng transported. "rj :=- >< z = If the tank is to be abandon in place, remove all flammable and combustible liquids, fill the tailk completely with an inert solid material. Cap remaining underground piping. LJ...) -.en .~,.= ..- ..... I-----"- -..::J ..p.. ----:] Additional comments and/or requirements I have read and unde and the requirements of this application. Applicant's Sig~ >--cl = = LJ...) Date: !! I 1./ (J Y FP - 25 (Revised 2m/DO) To be completed by City of Port Angeles: Permit # Page 2 of 2 ~ " . . .,:::.... TANK CLOSURE WORKSHEET Tank Owner Address ~~+y' ~ p ()~ ~ Ill.? IV (JAv)-1.-J+L Regulating Agen cy(ies) Department of Ecology 1-800-826-7716 , Port Angeles Fire Department 360-417-4653 P. A. Public Works Dept. 360-417-4803 Contr~_ctQr Q.!lm~(s) ytN[)} '4-5 Phone No "3 I- () II 907- LJFJ D Notified Permit Issued [ J [ J [ ] ( ] [ ] [ ] ~t)b ,., 3 kLr~ . . l/t\tv k f\ uf to>J..,- L . . (excavation, de-gassing, sludge . 'sposal, tank dIsposal, cleanup, transport, other - descnbe) -d. l c. Tank closure start date I- v. Tank c10sure completion date 1) l k TANK CLOSURE INlTIALPROCEDURES: F?1J.ow safety measures [J Obtain recommended safety equipment [ ~ Avoid contact With product [Y Bond or ground equipment [ IY' Drain product from piping ['1 Disconnect, then cap or remove piping [.,- Remove product and residuals from tank [ tf: - ExCavate to tank top [r Remove drop tube, fin pipe, gauge pipe, vapor recovery tank connections, submersible pumps and other tank fixtures [~ Temporarily plug all other tank openings except the vent line Purge tank of flammable- vapors ABANDONMENTIN~LACE . (see below if tank is removed) ~~~ut holes in tank top if necessary ] Clean and inspect tank . ] Fill tank as full as possible with inert mixture until filling overflows tank opening [ ] Plug or cap all openings [ J Disconnect and cap or remove vent line [ ] Diagram of tank location Site specific requirements: [ J [J [ ] OATH: I certify that the information concerning the removal or abandonment oftank(s) is true to the best of my belief and knowl;d~ r-.. 0 ~'I>nHo r<IL\I\<"'kLJ ~W~ /II'I/o~ I Name Date = c-> >---3 ---------- = LJl ---------- t'0 = = ----J ---------- '"=:J = = t'0 CD >----cJ ~ t::::1 tr:l >--c:l --:3 C> >--r:l n C> :::: --S. t::::1 ':2 ----. '"=:J ~ .>< Z <:> LU CD = .1'>- ----J >-I'>- ----J >----cJ = = >-I'>- . . . CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO. ~5~ f?1 DATE o/.?~/ 7/ ELECTRICAL PERMIT SitelAddress: o READY FOR INSPECTION WILL CALL FOR INSPECTION Phone: ;;:;07 I nstalled By: I License Number: Phone: Sq. Ft. o New Construction o Remodel o Service update/alter/repair o Overhead o Underground Voltage 010 03.0' Service size o Temporary Residential Heat KW Baseboard 0 Furnace/Boiler Heatpump 0 Other Commercialllndustrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) Det~iISlDescriPtion: I I ~ == I I I I I w.s.1 No. Service Size Cap$city: 0 O.K. 0 Not O.K. Comments o qitch inspection O.K. o R'ough-in/cover O.K. o ~.K. to connect service ~Inal O.K. Site IAddress: I ~Add/alter circuits /0 Auxiliary power (list below) o Special equipment (list below) /J1r?1 ~ t7ne /./~-"~ ~ . a /I,,~~ tJnL. ~L.A/.uL./- Amps 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 New Meters - Notify the Dep men 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 t~e Inspector~in Writing on the Wiring Report or the Building Permit. PHON$7'0411, EXT. 158 or EXT. 224. ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT . A /"1 . ~.OV Ins ctor Amount paid WHI IE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMP C PRINTERS, INC. 1U:4U FAX Jij04574698 STRAITS ELECTRIC 14101 ELECTRICAL PERMIT APPLICATION FOR OFPlCIAL USE O:"l Y o.16IRa-: """,.. O'ltApprU-.l: [blrbN.at>l, The EleclIIcaI Permit AppllcallM musllllo ftl'-<l out como_v. PIeaN tvPO or reprlnlln Ink. If you ""ve any qu.sllon.. pleaN call (360. 417-4735 Fax number: (360) 417-4711 OwnEr or Elec. ~ 1tllctorAgent Straits Electric I' 0 /..cU1dJvl ~ I REQUESTINSPEcnON 0 452-9104 F~:457 469B Mvza 1- 'Purl- A1t~ ~ UeonsO#: STRAI~OU,DS 9/03 CIly: Port Angles, WA ~ ELECTRICAL CONTRACTOR Electric Phone; Property Owne Address: elly: Zip: Phone: 452-9104 Zip 98362 Electri",,1 Con Add",..: P. r. Straits Electric I , Box 2914 I IRED !lV: 0 OWNER , I ~e,Na~' Straits I . 's: P.O. "ox 2914 I I moo" Exp. Otlte: I i ss, /14 /tlLP N. kaL.t..rf) S/1-a.1- I I City: Port Angeles, WA ZIp: 98362 VISA:~MC:_ Credit Card Blfflng Add Credit Card Check all that apply: o New k.uftu Pi Anaration/Addition Wa- o Remote j I 0 Muili-family , I " r 0 Detached garage 0 Hot Tub 0 Swim Pool I u s added or altered: i F THE ELECTRICAL PROJECT: o Commercial o Mobile Home Sq.Fl o Septic Pump o Low Voltage 0 Telecom. 0 Sign Numbe, of Ci 3 - &()7t 7~ 30 CU:/uLrl fwiers DESCRIPTIO e/? K"5 ::0 ,;2,:J. :J..Cl c , I I Electrical H a Load Additions ~J...;(c;o ServIce Information , I !_KW I_KW I-KW ,_KW I , I PAMC 14.05, 8): For industria', commercial, & ",.identiaJ projects larger than a duple" a one - line drawing of the Electrical Service & Feeders, build n slls (sq. IL). load calculs~OnS, and ll1e type & of conductors andlor I'lIceway is required and .hall accompany the Electrical Pe it, pplicalion. I I i that I have read and examined this application and know that same to be true and co"ect, and I.am , ply for this permit. I understand it Is not the's gal responsibility to determine what permits remains the applicants responsibility to ine at rmits are required and to obtain such. o Baseboard o Furnace o Heat Pump o Fan-Wall o Overhead Service o Temp Service o Underground Service Voltage: Phase: 0 1 Service Size: F oeder Size: 03 Credit Carel Holder's Signature: Owner or Elec. ConL Signature: Christie Tucker Oaw: Date: PW-9019 ELECTRICAL WORK PERMIT APPLICATION 0\ ~77Z~;~ctorz~ Purchaser's mailing address 'P. () . 30><" 9# City ~: n1:t~U~ 4~/-"1.n1 Installation description ,)iiP Commercial 0 Residential Job wired by o Electrical Contractor 0 Owner o New )sJJ.ltered/Addition Premises owner's name cf)u# ~ State ZIP R ,/2 ?J.-&- rl'7 (11'2- FAX number -VS-Z- 7 s-yr f?uctr lJ'l $-1" At.<.. + F//J7l/6 . MIn..) tH7rd/ wi L/<IJ-ft , / YI'Z<IVIO If 15L1f<:-r R:n- Address of inspection. //~ # f1,~:I- City L,/"vctJ L/V'" ~L~$ .$'7'bA-N\ -J-I~us Z2t>1J ~ aelt><f' bbD; If 6.~II-7S - PI/rN llS-u ~S17.(jt-- ""hJ (~F Wlt..L & /fCflnt.d) -Ie Cn<tlJr7l.J ~1t1L~ ll5J & O"1'WjS.'l-~ fWV' Pbone {lfYLcr to SC~ inspection: Owner as deft 'd hy HeW /9.28.261:(1) , wner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical instal- lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-468, The City of Port Angeles Municipal Code, and Utility Specifications. o Cash 0 Check # o Credit Card Card # Visa Mastercard Discover x Date: Expiration Date of card Inspection fec $ Electrical L d Additions and or subtractions D NO LOAD CHANGES o Baseboard KW o Furnace KW o Heat Pump Ton LAR D Fan-Wall KW ~- Service Information o Overhead Service o Temp Service o Underground Service Voltage PhaseD 1 D3 Service Size: Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN /' THERMOSTAT SERVICE "- Date Approvcd By Date Approved By /' DITCH FEEDER "- Dale Approved By Dale Appro\'cd By Inspection Area, Building or Equipment Inspected Action Takcn Electrical Datc Inspector . 4d2 9 h 7~/'" .; , , , Dale Approved By FINAL ,kiJ at Approved By