Loading...
HomeMy WebLinkAbout1209 B St - Building 0%"" CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION NOW 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00000083 Date 3/17/11 Application pin number 065790 Property Address 1209 B ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-3- 7240 -0000- Tenant nbr, name USA ACTING RURAL HOUSING on your state excise tax form Application type description MECHANICAL APPL. PERMIT to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 550 Application desc INSTALL A PELLET STOVE Owner Contractor USA ACTING RURAL HOUSING SRVS PELLET HEAT CO. 1601 E FRONT ST, BLDG A STE B 230 EAST 1ST SUITE C PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 457 -4406 Permit MECHANICAL PERMIT Additional desc INSTALL A PELLET STOVE Permit pin number 180794 Permit Fee 60.65 Plan Check Fee .00 Issue Date 3/17/11 Valuation 0 Expiration Date 9/13/11 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 10.6500 EA ME- STOVE /FIREPLACE /MISC. APP. 10.65 Fee summary Charged Paid Credited Due Permit Fee Total 60.65 60.65 .00 .00 Plan Check Total .00 .00 .00 .00 j4N Grand Total 60.65 60.65 .00 .00 C\ V 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 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. 14/‘)(01(Lb NZ. Date Print Name Signature of C tractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS 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 Drywall (Interior Braced Panel Only) T -Bar C INSULATION: Slab Wall Floor Ceiling MECHANICAL: Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney 1 �Z Commercial Hood Ducts FINAL Date 1 Accepted by 3 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 7 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T:Forms /Building Division /Building Permit H H HI N WWI aQ F H X a 0 a i Cr 0 0 1 H vx 0 F r to C .4 roz 0. o H w a 1 0 O a o X H O H H XU) ,a 0 00 i o N H H 1 0 00 F, 0 0 1 0 W V1 0 x x O O 1 W W U W 1 O 1 X 0 0 E. u 1 n 1244, 1 H n W H 1 1 H a W z NI 1 H m a a 0 z Ht.) I 0 a H H O H N 4 oH.1 NH 1 H F 1 .4N 0 4 1 c 4 1 0 0 1 H -00 Z 040, 1 W O 1 w a m W W H H i 0 a H 0 U I a $-1 I a z 0 X H. 1 U v r U 0 u 0 a am 1 H r- H 0 a H: c H 0 O I U aOU EE 0 0 0 0 U F 0 a' X M x X 0 O o H H 0 x Pi4 0 N at. H a a zmla N 0.40om H H a F 2 W z 0 OJ 1 fn H x H 0 0 I F E- 0 W I M U H U 1 o y 0(0 I H W 1 0 1 1 P1 0 T F H i 0 H U' 0 ..4 .7 Q I U7 W 1\ --...Z I N V7 W U1 lO H 0 414 I H H H 0 a 0 0 H 004, I N N I OX I\ WO ICII a zo m C1 I E. 414, 1 0 U H a O 1 cn z H RC .a z FF d o wH 0zzza a E IX a i m aH 1 000 I W r W aU 1 1¢ HU0a 4 a E 1 Z 01/24/2011 14:30 13604520503 SPA SHOP PELLET HEAT PAGE 01 o, r_K, BUILDING PERMIT APPLICATION Print in ink r ::11,1011,;(f CITY OF PORT ANGELES For City Use Only sr Attn: Building Permit Technician Date Received U 1 -Z6 --t I 1.... ui 321 E. Fifth St., Port"Angeles, WA 98362 Permit )1 -83 —m roved 1111 111r (360) 417 -4815 fax (360) 417-4711 Date App Applicant or Agent M Pfv vi t as.; r a", Phone 3tyL 9,1P yy4,; Owner N Phone ;G. E 9/p Owner's Address $z0 Li i Lit. s I `I y;oN>01 °✓rt g ryl ik 7g.Rrc=• t. P //ei' /r t Ca Phone .3 ys, -`/Y%. Contractor /En ineer Contractor /Engineer's Address Z T "gs 4 iva P �"N e 0 U rhv Expires ti -,7 License PROJECT ADDRESS e. 5 4. r• t Parcel Number 06 14 s_ 3 2 000 L ot v Zo nin C s Project Type Brief Description: Residential o Commercla/ o Multi- family o Industrial Check all that apply o New Construction o Addition u Remodel wa 4..- n t r; A X c Repair L✓ Ar tS____J 1 T" n Re -roof o Demolition Sign o wall- mounted o projecting Ofreestanding o awning (7) other Total si.n area s• ft. Maximum allowed si.n area s.. ft, o Heat System o Heat pump wood- burning stove o gas fireplace xpellet stove o other o Other Floor Areas Existing (sq. ft,) Proposed (Sq. ft.) Basement per sq. ft. 1'' Floor 2 Floor 3` Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION 5 5-u o Total footprint of structures q s ft. Lot size ,sq ft. Lot coverage A. Max, height of proposed structures ft. Occupancy group of bedrooms Will a 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, I am authorized to_ apply for this permit ar understand that it is my responsibility to determine what permits are required, and to obtain permits pr to working c projects. Signature i f Date f72 y• -i Print Name f i Ile; T:Forms /Building Division /Bldg Permit AppI. -2006 Code,doc Clallam County Assessor Treasurer Property Details 59881 USA ACTING RURAL... Page 1 of 4 Clallarn County Assessor Treasurer Property Search Results 59881 USA ACTING RURAL HOUSING SERVICES for Year 2011 2012 Property Account Property ID: 59881 Legal Description: S70' LOTS 9 10 BL 372 Geographic ID: 0630000372400000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 Open Space: N DFL N Historic Property: N Remodel Property: N Multi Family Redevelopment: N Township: Section: Range: Location Address: 1209 S B ST Mapsco: 1 PORT ANGELES, WA 98363 1 Neighborhood: Cycle 5 Res Map ID: 2 Neighborhood CD: 10955130 1 I, Owner f Name: USA- ACTING RURAL HOUSING SERVICES Owner ID: 205568 Mailing Address: 1601 E FRONT ST BLDG A STE B Ownership: 100.0000000000% PORT ANGELES, WA 98362 Exemptions: Taxes and Assessment Details Property Tax Information as of 01/25/2011 v ,\"..y..12., Amount Due if Paid on: "l. NOTE: 0 you plan to submit payment on a future date, make sure you enter the date and click RECALCULATE to obtain the correct total amount due. First Second il k /b Half Half Base Base Year, Statement ID Taxing Jurisdiction Amt. Amt. Penalty. Interest Base Paid: Amount Due 2010 42765 ST SCH STATE SCHOOL $165.38 5165.37 $0.00 $0.00 $330.75 $0.00' 2010 42765 CC -GEN COUNTY CLALLAM $88.02 $88.00 50.00 50.00 $176.02 $0.00; 2010 42765 SD #121 SCHOOL DISTRICT #121 $214.20 $214.22 $0.00 $0.00 $428.42 $0.00 1 2010 42765 CITY PORT ANG CITY OF PORT ANGELES $203.77 $203.76 $0.00 $0.00 $407.53 80.001 2010 42765 PORT PORT OF PORT ANGELES $12.37 $12.37 $0.00 $0.00 $24.74 $0.00: 2010 42765 NTH OLY LIB NORTH OLYMPIC LIBRARY $25.58 $25.57 $0.00 $0.00 $51.15 $0.00' 2010 42765 HOSP #2 HOSPITAL #2 $36.10 $36.11 $0.00 $0.00 $72.21 $0.00 2010 42765 WSMET PK DIST WILLIAM SHORE MET PARK DIST $11.49 $11.49 $0.00 $0.00 $22.98 $0.00 2010 42765 CITY STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 50.00 $72.00 $0.00, 2010 42765 WEED CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0.00 $1.63 $0.00' 2010 42765 TOTAL: $793.73 $793.70 80.00 $0.00 $1587.43 50.00 2009 598812008 ST SCH STATE SCHOOL $189.10 5189.10 $0.00 $0.00 $378.20 $0.00 2009 598812008 CC -GEN COUNTY CLALLAM $95.70 $95.70 $0.00 $0.00 $191.40 $0.00' 2009 598812008 SD #121 SCHOOL DISTRICT #121 $233.85 $233.86 $0.00 $0.00 $467.71 $0.00 2009 598812008 CITY PORT ANG CITY OF PORT ANGELES $209.91 $209.91 $0.00 $0.00 $419.82 $0.00 2009 598812008 PORT PORT OF PORT ANGELES $13.56 $13.55 $0.00 $0.00 $27.11 $0.00 2009 598812008 NTH OLY LIB NORTH OLYMPIC LIBRARY $27.81 $27.80 $0.00 $0.00 $55.61 $0.00 .2009 598812008 HOSP #2 HOSPITAL #2 $39.25 $39.25 $0.00 $0.00 $78.50 50.001 ,2009 598812008 CITY_STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $72.00 $0.00 2009 598812008 WEED CONTROL WEED CONTROL $0.81 50.82 $0.00 $0.00 $1.63 $0.00 2009 598812008 TOTAL: $845.99 $845.99 $0.00 50.00 81691.98 50.00; Values Improvement Homesite Value: N/A Improvement Non Homesite Value N/A Land Homesite Value: N/A Land Non Homesite Value: N/A Ag Timber Use Value Curr Use (HS): N/A N/A Curr Use (NHS): N/A N/A Market Value: N/A Productivity Loss: N/A Subtotal: N/A Senior Appraised Value: N/A Non Senior Appraised Value: N/A Total Appraised Value: N/A Senior Exemption Loss: N/A Exemption Loss: N/A Taxable Value: N/A http: /websrv8.clallam. net /property access/Property .aspx ?cid =0 &year =2011 &prop_id =59881 1/25/2011 f90Rr~ $.A,O~~~ ". ~ -- 'l;;i,,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 o -J I ~ <5' ~ 07-00000869 Date 675784 1209 B ST 06-30-00-0-3-7240-0000- LEROY HAMPTON RE-ROOF 7/24/07 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation RS7 RESDNTL SINGLE FAMILY 4973 Owner Contractor SARAH & LEROY HAMPTON PO BOX 994 PORT ANGELES WA 98362 COZI HOMES CONSTRUCTION INC 324 E 9TH ST PORT ANGELES WA 98362 (360) 452-9906 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date . BUILDING PERMIT - NO PR FEE TEAR OFF AND RE-ROOF 107706 137.75 Plan Check Fee 7/24/07 Valuation 1/20/08 .00 4973 Qty Unit Charge Per Extension 95.75 42.00 BASE FEE 3.00 14.0000 THOU BL-2001-25K (14 PER K) Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 137.75 137.75 .00 .00 plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 142.25 142.25 .00 .00 ~ /"? <{p ?~ -~ ~ -0- ~ N o ~ ~ o ~ 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. 1---..? l_ c7 Date Signature of Owner (if owner is builder) ....---7 'L- C .gnature of Cont~ Au T:\Policies\1102_15 building pennil inspection record05.wpd [1/4/2005] 7\J (t ( ~ Date ~ BUILDING PERMIT INSPECTION RECORD CALL 417-48]5 FOR BU]LDING INSPECT]ONS. CALL 4] 7-4735 FOR ELECTRICAL INSPECTIONS. CALL 4] 7-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT 15 UNLA WFUL TO COVER, INSULATE OR CONCEAL ANJ' WOKK BEFORE J.l1/SPECTED A.ND ACCEPTED. POST PERMIT IJ'\ A CONSPICUOUS LOCA TJON. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTIO!" TYPE DATE ACCEPTED COMMENTS YES NO FOUNDA TlON: FOOTINGS SHEAR WALLS / WALLS FOUNDA T10N DRAINAGE / DOWN SPOUTS PIERS I POST HOLES (POLE BLOGS.) PLUMIlING UNDER FLOOR / SLAB ROUGH.IN WATER LINE (METER TO BLOG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR W ALUHOLD DOWNS WALLS / ROOF / CEILING DRYWALL (fNTERlOR BRACED PANEL ONLY) T-BAR INSULA nON - SLAB WALL / FLOOR / CEILING MECHANICAL ROUGH-IN HEAT PUMY lFURNACE/DUCTS GAS LINE FINAL DATE ACCEPTED BY: WOOD STOVE / PELLET / CillMNEY MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKJRTING 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 LlGHTDEPT CONSTRUCTION R W./ PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 4]7.4750 PLANNING DEPT. BUlLDING 417-4815 08101 J01 f'B BUILDING . . T:IPo]iciesl] lO2 ] 5 bUl]dmg perInI! mspeCllon record05.wpd [] /412005] ....r-- 0 ...... r-- 0 ...... '" r>1r>1 elE-< <(<( P,Q '" 0 '" '" , N lfl <I' 0 '" >< M r>1 o-l o-l I>: I>: r>1 el H f': ~ o-l r>1r>1 E-< Q ZZ P, r>1C1l ~ 00 o-l r>1 ~r>1 :I::I: E-< 8:1i CIl p,p, 0 :Ii Z E-<'":> r.. 0 Q Z .. 0 ~ 01>: lfl I>: HO CIl lfl , E-<E-< E-< r>1 CIl UU Z 0 I>: E-< r>1r>1 r>1 .... Z p,p, :;: "', r>1 CIlCll rolZ:;: M :;: ~~ ~OO ...:IC'"-o.....:l :;: HU ~OO..:t: 0 U E-<...... Z 0 I Z U i i"j I>:P,CIl HNOH P,HE-< ~""""'\D~ I>:o-l "'<I' Z , OU~ elo el 0 0 ZCIlCll Q......ZQ HZO r>1r>1 HCX)~H E-<Oo IQI>: ~O~~ tJE-tof1.. ~ Pt I 0 !-t ~ ~:Ii~~ H (f cn::I:NI fflp,~ /~ r-- Z r--r>1 M Z 0 >< , I>: i:lICIl~ QUaM ZCIl .... E-< I>: '''' tlIHr>1 M p,.c/)f;zlo\"o Z I>: , t;~~H~~ H , 0 ~ , ....CIl ::r:o~oo , r>1 CQ :I: '0 HQQ ~~ , -o-l )i ~oo ~r>1r>1 , r--r>1 O'\OH MO CQE-<E-< , oel OO:::N l 1 CIlr>1 , ~~ NOOO,:(lDf:"- Or>1o-l , M.....:lUCJlOO O~p' , 0 0:;: , ......E-< i:lIr>10 , "'I>: I>: I>: OI>:U , 0 . CQ I>: .r>1 ~ , P, ZO III , Q E-< .~ , r>1r.. CIl -U .... , 1>:0 gjE-<~I>:~Z !-t 0 0 , <( 1>:~E-<r>1Uo-l H CIl I P,>< ffl ...... '" , r>1E-< Qi;1s~~g: P, '" , I>:H >< o-l , P,U ~E-<UOp'<( i:lI E-< III , / ;r~ BUILDING PERMIT - APPLICATION L/to .,-- o~ 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 FOR OFFICIAL USE ONLY: Date Rec.: r- 24 -01 Permit #: ()( - '8ro~ Date Approved: 7, Z..L-/ -0 7 Date Issued: 7 - 2..~..::O.. 7 Applicant or Agent: f{..elU Z"<'!:j,k-If Owner: ~ \D':). t-f rl rY\ P .J-o,J Address: I';) () ct ~l) E. 5+, ~~ [O~ f(cJYYkS Phone: L{ T5;;)..- 970h Contractor (' D 7.::+- Phone: City: r (j ~ ~!~c. Phone: State License #: ~ F~ J~P, Zip: 7' ~ ~ b2-- }J74- ArchitectlEngineer: PROJECT ADDRESS: J~ DC; City: SC;, B c:+, Phone: Zip: ZONING: RS-"l Address: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Block: Subdivision: SIZEN ALUATION: SF. @$ /SF. = $ A./ Jcr f]..3 , oG:, SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ O-FF ,/ R< rooF TYPE OF WORK: o Residential 0 New Constr. ~-roof 0 Stove o Multi-family D Addition D MoveD Garage o Commercial D Remodel D Demolition D Deck o Repair D Sign D Other BRIEF DESCRIPTION OF THE PROJECT: T.erfl r COMMERClAL/RESIDENTIAL: Occupancy Group: No. of Stories: Lot Size: Existing Sq. Ft. Total lot coverage % Occupant Load: & Proposed Sq. Ft. Construction Type: = TOTAL Sq. Ft. ESA/Wetland(s): 0 Yes 0 No SEP A Checklist required? 0 Yes D No Other: APPROVALS: PLAN: BLDG: DP'WU: 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 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 Rl05.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that 1 have read and examined this application and know the same to be true and correct. 1 am authorized to apply for this permit and understand that i(is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permfts prior to work~ , _ '. () T:\FORMS\BldgPennitform.wpd Applicant: ~ -L ~~ ) Date: '7 ~ ;)..l( - 0 7 CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15177 j- \'" . > Y. Port Angeles, Washlngton..mmm..............m......m.m.m...m........m. 19...m~. 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 ..I;..'.9....f..~..0.-'--...............m........................... Occupancy..."'-,!?,.?'.......................m......... Owner .~~".,...[~.J:~"'''-,>l~&":./2................... Tenant.......................m....m.......m....m........................ Wiring Contractor m..."'''..<.'.=,."A'.c:":''"'=..............m............... By..........................................................m......... Light Outlets............................h............ Receptacle Outletsm..m..................m.. Dryer, KWj............n...................n....... Range, KW....___.___.... Water Heater: KW........m....nh...n_..................n Ilea" RW...(?..9!.....ltJ.Y.M1"(".(,.... Motors: size, volts and phase: Total Load.umuum......_......_ Service, volts ./..2:h(;./.?/..~nh -II / ~ No. wires uuu...................__....:'u..... Sfze wires....:t./.t?..9..L....... " A- Main fuse ...J..9.(,!....L.......hn.h. .s Enclosure ...mm.m___....m................ Type of wIring: Entrance Cable ............................. Rigid Conduit .m..mm...______.......... l\letal1lc TUbing .....m....m...mm... Current transformers: No. & Size..m.........m...................... Ser. No.............................................. Ser. No............................................... Ser. No............................................... Ser. No.,..........................................__ Type of Wiring: Armored Cable ....m..m....mm....___ Non.Metallic ......m.......m.m....mm Knob & Tube...........m.................... Rigid Conduit ....m..........___........... Metallic Tubing .................___....... Race,vay ......................................... Circuits. LighL......m.........mm..mmm.. Utility............................................. Heat Range ............................................. Water Heater m....m..................... Motor ............................................. Dryer.....................................__........... Furnace .........................._........u..... Total....................................... Remarks: .......~Lf?",..,..=:......ag~."',"~~;~",g,-:::..m.9:../.?.Ad.."I;~":!..,,"-...fr.fl~e_........................ . .. - F .~::;~.;::...m............m........;~:::...;:~:;~~nmnm.......n............=n:ll:1/""1l.;...j......::l:............. $...........................n...n.... No............................. By,..!....:.....-......., ....J/!.......~,{dn ........"~..,_"'... NOTICE-Cnrrent 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 9 ""J // f' r;; /(/-t..c'-(~f~ d 0"" If I.u-' ""~I./~"'- ELECTRICAL PERMIT N? 15177 :::~l~~~:::;~::~::~;~~~:~~:;;e::.:::::::::.:::::~.::.:::::::::::::::::::::':::::::::::'.::::::::::::::::::::::::::::::::::::.:::::~:::=:::::::::::::::::::: 6............L,.~~______ Inspectioncompleted..._.._.._.........._._.........._................................................................................................__..._.................._.........._......... r _Total Load .........................................h.U....Uh.....U...hh...................._ ..............h..U...............uuu...uu..................U..Uh.............u_._uuu._......_ I 1M 3.72 Olympic Printers, Inc. \.