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HomeMy WebLinkAbout120 S Laurel St - Building ti ij ~ ,.. L~ ---- ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 06-00000043 Date 084715 120 S LAUREL ST 06-30-00-0-0-3280-0000- DORIS MCREVEY RES REMODEL 4/21/06 COMMERCIAL OFFICE 4200 Owner Contractor FLOYD B/DORIS E MCREVEY TTE 120 S LAUREL ST APT 75 PORT ANGELES WA 983622601 HENDRICKS CONSTRUCTION INC 327 E 10 TH ST PORT ANGELES WA 98362 (360) 452-1641 ~ 4/0t/OV permi t MECHANICAL PERMIT Additional desc REPLACE 5 EXHAUST FANS permi t pin number 75101 Permit Fee 86.25 Plan Check Fee Issue Date Valuation Expiration Date 10/18/06 .00 o Qty Unit Charge Per 5.00 BASE FEE 7.2500 ECH ME-VENT FAN Extension 50.00 36.25 ).} \) Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 86.25 86.25 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 90.75 90.75 .00 .00 ~ () r ~ C ;v ~\ \' V) ":i 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 (t/(7~ 0/ /f/h Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:IPoliciesllI02_15 building permit inspection record05.wpd [1/4/2005] ;, BUILDING PERMIT INSPECTION RECORD 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 YES NO 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 FINAL DATE ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS / GIRDERS SHEAR WALUHOLDDOWNS WALLS / ROOF / CEILING DRYWALL (INTERlOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING I I MECHANICAL HEAT PUMP/FURNACE/DUCTS GAS LINE FINAL 41ulob 10 WOOD STOVE / PELLET / CHIMNEY DATE ACCEPTED BY: . COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRlCAL LIGHT DEPT CONSTRUCTION R.W./ PW/ CONSTRUCTION - R.W. ENGINEERlNG 417-4807 PW / ENGINEERlNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 J , / ...... PLANNING DEPT. BUILDING 417-4815 'b/wl () 1/7 vlA/ BUILDING . . n nnit ins tion record05.w 1 r4/2005 T.\PollcleslI102_l5 bUlldl g pe pee pd[ ~ pORT ~ 8.J..O~~~ ha 1t::.-- ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 06-00000043 Date 084715 120 S LAUREL ST 06-30-00-0-0-3280-0000- DORIS MCREVEY RES REMODEL 2/27/06 COMMERCIAL OFFICE 4200 Owner Contractor FLOYD B/DORIS E MCREVEY TTE 120 S LAUREL ST APT 75 PORT ANGELES WA 983622601 HENDRICKS CONSTRUCTION INC 327 E 10 TH ST PORT ANGELES WA 98362 (360) 452-1641 Permit BUILDING PERMIT -RESIDENTIAL Additional desc Permit pin number 69385 Permit Fee 137.75 Plan Check Fee 55.10 Issue Date 2/27/06 Valuation 4200 Expiration Date 8/26/06 Qty Unit Charge Per Extension BASE FEE 95.75 3.00 14.0000 THOU BL-2001-25K (14 PER K) 42.00 - )0 \J Other Fees STATE SURCHARGE 4.50 ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 137.75 137.75 .00 .00 Plan Check Total 55.10 55.10 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Tota.l 197.35 197.35 .00 .00 1- ~ C ~ ~ J- . 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 orwork 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' 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 0 local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date T:\Policies\1102_15 building permit inspection record05.wpd [114/2005] . , BIDLDING PERMIT INSPECTION RECORD 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 UNLA WFUL TO COVER, INSULA TE 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 FOUNDATION DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) . . PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW 1 WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS 1 GIRDERS SHEAR W ALLIHOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I I MECHANICAL HEAT PUMP 1 FURNACE 1 DUCTS GAS LINE FINAL 4/ 14/ ~ DATE ('Jtu WOOD STOVE 1 PELLET 1 CHIMNEY ACCEPTED BY: . COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL.INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R. W. 1 PWI CONSTRUCTION - R. W. ENGINEERlNG 417-4807 PW 1 ENGINEERlNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 , / / - PLANNING DEPT. 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Z ~ ~ ,-<.., Z ~~ 0 '0'0 Ul .., ~~ 6J OJ~ OJ '0 '0 00 [J)OJ [J) to to ZZ tJ .., :>- :>- OJ OJ < t" :d :d .., .., t" ~ ~ H 0 0 OJ t" t" w :d '" t" 0 >< "" 1Jl N , H '" "" H tJ'O :>-:>- ..,G) OJ OJ "" -..... N H -..... 0 "'..., Fill oui COMPLETELY and in LNK. Your application and site plan MUST B CQlvIPLETE 10 be ~ct:epLeu fOf Yf:Vie\1~. Ifyuti have any guc:;tion:;~ ~~11 PERMITS (360) 417-4815 Fl0~.(360)417-4711 I J I ... ~1\ ~oln"1.\:'~1 "~"""","',,,'? w._ .".=.... ..'.'.'~:'._ -J i~~' ~\) I~;::;,;-= .iWi. \ r, ,7~?r''T \, ! "'~'/ BUILDING PERMIT - APPLICATION Phone: ~O~ - ?~~- 8"7~'I S,'t' 0- Lf6? - D() If ~ &~O - V~?- OO't<i? Zip: Of <? ~ t. :> - Applican1 or Agent:. L f1 U~EP CE K~ \ l i JJ(::I~ e.. Owner: Ooru CS; t'\ c.1\cv e-~ Address: \;Q 0 <3. L AlAt<.G"1 it 7~City:_ff}.Q.:\- Phone: Archltect/Engineer: Conh-actor ~oJ Address: PROJECT ADDRESS:.-l1 0 LEGAL DESCRIPTION: Lot: CLALLAM COl]1\.TTY P_ARCEL NUMJ3ER: AN~I G,") Phone: Exp: Phone:~' ((;41 Zip: ZONING: 'S. City: LAlAv<.G \ ~. Block: Subdivision: TYPE OF WORK: o Residential 0 New Consu. 0 Re-Ioof )r Multi-family 0 Addition 0 Move o Commercial )4 Remodel 0 Demolition .,. Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: .~~L ~ ~ ~r' o Stove o Garage o Deck o Other (('1~O l\i ^^~ SIZE/V.i\.L UA TION: SF. @ $ /SF. = $ SF.@$ /SF.=$ SF. @ $ /SF. = $ TOTAL V.ALUATION,~ $.4,1.00- \);.1-W~ t ~ ~ , ~ COMMERCLi\.LfRESIDENTIAL: Occupancy Group: No. of Stories: ~ Lot Size: Existing Sq. Ft. Total lot coverage % Occupant Load: Construction Type: looo & Proposed Sq. Ft. - 0 - = TOTAL Sq. Ft. & 00 (") ESAf'iN etland( s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other: APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: 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: 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 pemnt fees are due at the time of pemnt issuance. , EXPIR.4..TION OF PLAN REVIEW: If no pemnt is issued within 180 days of the date of application, the application will expire. The Building Official can extend the tin1e for action by the applicant up to 180 days upon written request by the applicant (see Section Rl 05 .3.2 of the Intemational 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. I 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. o WfJ~'< ~ -C i f) T:\Policies\BL-ll02_13.wpd l>.ppHG8.'B.t: ~J<M)4) h f7j?c J/~", Date: r I) ~ e t:' '8{ &, . <1)(1 &, . . N Area Map This map is not intended to be used as a legal description. .<, ,,*,' This map/drawing is produced by the City of Port Angelesfor its own use and purposes. ;t::.,'c';.=;:: Any other useo/this map/drawing shall not be the responsibility ~fthe CiW "~.- Feel A"-" ::~~~-~"'_~\"~~/~ """'.. f - -">l'i6.'~~.iP\~' s' ~........\ ~'S~l ,.....,:;::.. "--"~~":""'l' C~<'-'~'~' _ _ BUILDING PERMIT - APPLICATION FOR OFI'IClAL U E ONLY: Date Rec.: 2J,"CJ b Pennil# O(P- t743 Date APprovect:+t:;!f6 Date Issued: . U ~ Fill ont 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 Applicant or Agent: 11(' /LIef r / (/7 s (' c') tv.:5! Owner: ~l';:> tl1(!ft'UC,/ 1 Address: 1;;( C: r ,5' c '-""( 1'> AI<) l(J" /{ I City: ^- ht tIE r-,1.0'!U(>F/ Ct)t'>JY1'/jc?r- .'""\.1 c i ec. ngineer: u Contractor Hl."NJ I' /Cf3" (0/lJ S ( Address: 1t.(3;;2. W (l>f Lf"'~ PROJECT ADDRESS: (;<0 !) Cq r"- J,,-,c Phone: 1(0 I -;( b 'f r Phone: qS~ ~ /t: h(l AtV~ 7'"(r-SI Zip: 9'8'3 be. Phone: jJcJo."{ State License #: City: r. Of't r::.}/I./.;7 1'( r-5 ~~ C4/'~ ( Exp: 0 7 Phone: ?/s;:;./6 &/1 Zip: 18J(,s ZONING: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Block: Subdivision: TYPE OF WORK: o Residential D New Constr. 0 Re-roof D Stove ){Multi-family D Addition 0 MoveD Garage o Commercial ;(Remodel D Demolition D Deck ( Repair D Sign D Other 111 e ~tr r'V"'1-1'J 1 BRIEF DESCRIPTION OF THE PROJECT: ;r:: (V S 74 If ICe u-rc-(' c 5: c Ii P/f (1/\5 T'V "5. ?--,e; I ( "']"a /{/-(.. vv F/l1V S COMMERCIAL/RESIDENTIAL: Occupancy Group: No. of Stories:.3 Lot Size: Existing Sq. Ft. Total lot coverage % SIZEN ALUATlON: SF. @$ /SF. = $ SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ .N'c'V g114 /'CJc5k-r r/jll/~, /l---c ~ (;)15Cc-'/V/,,_NC( Fir"" X V- ~oo~ c.r/' r Occupant Load: & Proposed Sq. Ft. Construction Type: vt...IoO'c' ;<:,;<;(/.Jo/. , I/-L'/o<< = TOTAL Sq. Ft. APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: ESA/Wetland(s): DYes 0 No SEPA Checklist required? 0 Yes D 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 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 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 RI 05.3.2 oftlle 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. I 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 pri~r to wor~/! -,/ ~ T:\FORMS\BldgPermitform.wpd Appl1cant: 10z. ~/'t Date: 7/ f? I /0 i f ,"ORT ~ t.J.O~~~ na ~ -- "IOl"7"""~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property zoning . . . Application valuation 05-00001223 Date 12/12/05 576588 120 S LAUREL ST 06-30-00-0-0-3280-0000- PLUMBING REPAIR COMMERCIAL OFFICE 55000 Owner Contractor R vtttk4 4lu!tJ~ \JUJ FLOYD B/DORIS E MCREVEY TTE 120 S LAUREL ST APT 75 PORT ANGELES WA 983622601 ANGELES PLUMBING P. O. BOX 1151 PORT ANGELES (360) 452-8525 WA 98363 Permit . . . , . Additional desc . Permit pin numper Permit Fee Issue Date Expiration Date PLUMBING PERMIT 67082 . 183 .oe 12/12/05 6/10/06 Plan Check Fee Valuation .00 o Qty Unit Charge Per Extension 50.00 126.00 7.00 BASE FEE 18.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 183.00 183,00 ,00 .00 Plan Check Total .00 ,00 .00 .00 Grand Total 183.00 183.00 .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 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 c. T:\Policies\11 02_15 building permit inspection record05. wpd [1/4/2005] 1) tj) c , .../ r \j~ rl Date BUILDING PERMIT INSPECTION RECORD 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 UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. ~ , -... W N OJ INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE 1 DOWN SPOUTS PIERS . . POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR 1 SLAB Vl'l\t -11-7::; .~ I 0 '?/z-1f ROUGH-IN \/~ /tJL.. WATER LINE (METER TO BLDG) I GAS LINE FINAL~/~ jtJ t? DATE \!W ACCEPTED BY: ~ BACK FLOW 1 WATER -( ... AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR W ALLIHOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL (INTERlOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I I MECHANICAL HEAT PUMP 1 FURNACE 1 DUCTS GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W. 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Z ,-<.., ~~ 01;>: UlO1 .., I:"' I:"' H 01 :<1 t"' 0-< LV '" o ><> '" '" , ro '" '" '" tJ'O :>0:>0 ..,eJ 0101 ... ...... f-" -.l ...... o "'-.l BUILDING DIVISION CITY OF PORT ANGELES * * Correction Notice Job Located at ~ l.to <; L..~ I Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: 4( ; ~ F.e....1 S ytt-Na-ir + ~ ~[l nkl8\H.1- +- rx~~ '<x- ~ r <...) . A. LJ. 12e-12 rJl ru;- ~~ ~tJ'lV4-0 l\~ ('~,~ These corrections must be made and are not to be covered until reinspection is made. When corrections have been made, please call tA {7 - ~ for inspection. t.f f-/ d Date 1/17/0 , r Inspector for Building Division DO NOT REMOVE THIS TAG . I ;]1 Sit~ Address: II tn'Stalled By: ~, /:J-O 6/. Owner/Business: Owner/Business Address: , I ELECTRIC HEAT D BASEBOARD KW _ D FURNACE KW _ D,'HEATPUMP KW_ D I 'FAN/WALL KW_ ,I Det~ilslDescription: ~ . g, I . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT ~. PERMIT NO. $/9 t ,g I/?'s'- DATE D READY FOR INSPECTION License Number: D WILL CALL FOR INSPECTION Phone: , /he- ~ 'tzlC'RESIDENTIAL D COMMERCIAL D NEW CONSTRUCTION 'l8i REMODEL D ADD/ALTER CIRCUITS ;iJ SERVICE UPGRADE/REPAIR D TEMPORARY SERVICE -3.-$ ( /t9D ~ ~ Phone: Sq. Ft. D . RISER ,;!1: OVERHEAD SERVICE D UNDERGROUN9'SERVICE VOLTAGE: /2(JP~O D 1!11 V3~ SERVICE SIZE /CflD AMPS FEEDER SIZE AMPS ~ /tfl.W' W.S. No. SERVICE SIZE CAPACITY: D O.K. D NOT O.K. ACTION REQUIRED: D CHANGE TRANSFORMER D INSTALL SERVICE POLE DATE ENGR. D OVERHEAD SERVICE APPROVED D CHANGE SERVICE WIRE D OTHER D Ditch Inspection O.K. ~~ough-in/cover O.K. JA'i'-~ ,O.K. to connect service IV' ,'1 ,vJ Jt2 Fiinal O.K. jlf' !Site Address: New Meters - Noiify Port Ang s Cit Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. tIJ ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ i $0 , Electrical Inspector Permit Fee . WHITE - File by address OLYMPIC PRINTERS INC PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept" Bottom: City Hall ---