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HomeMy WebLinkAbout2520 W 16th St - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Deatched garage 6 circuits panel Owner Holman Dan PO BOX 1322 PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 98362 143834 67 50 4/06/09 10/03/09 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 09 00;000294 618490 2520 W 16TH ST 06 30 00 4 4 0030 0000 ELECTRICAL ONLY RS9 RESDNTL SINGLE FAMILY 0 Contractor OWNER ELECTRICAL ALTER RESIDENTIAL Plan Check Fee Valuation Qty Unit Charge Per 5 00 2 0000 ECH EL -ECH ADDNT BRANCH CIRCUIT 1 00 57 '5000 ECH EL -R OUTBD /DTCH GAR IN /SEP Charged Paid Credited Permit Fee Total 67 50 67 50 00 Plan Check Total 00 00 00 Grand Total 67 50 67 50 00 DATE RESULTS 1 i 1 oi 3 /zz Signature of owner or Electrical Contractor N V Date 4/06/09 00 00 00 00 0 Extension 10 00 57 50 Due INSPECTOR. Date City of Port Angeles Permit Application Building DivisionlElectrical Inspections 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 Ph. (360) 417 -4735 Fax: (360) 417-4711 Date. 1 2 Single Family Dwelling Multi Family or Commercial* _fin Alteration Remodel Repair* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: we z I ((mil Building Square Footage: L_I C 1 Unit Charge 93.75 $113.75 $160.00 $205.00 $291.25 2.00 57.50 2.00 72.50 86.25 $116.25 $131.25 75.00 69.00 75.00 50 00 50.00 93.75 80.00 86.25 27.50 57.50 86.25 43.75 Signature of owner electrical contractor or electrical adrhinistrator Description of above r i��- ksue i--)P I 19c' <<vug I Owner Inform tion Contractor Information Name. l=4 -1 DC A Name: l")wt--'��Z Mailing Address: 7<c.>, P-,1/4• -ZZ Mailing Address: City 7, 4 State. Zip 99, 7_ City State. Zip: Phone: 1 49- LoS<Lf Fax: Phone: Fax: License Exp License Exp I Qty I Total (Qtv Multiplied by Unit Charge) Service /Feeder 200 Amp. Service /Feeder 201 -400 Amp. Service /Feeder 401 -600 Amp. Service /Feeder 601 1000 Amp. Service /Feeder over 1000 Amp /Pi Owner as defined by RCW 19.28.261 (1) Owner 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 installation or alteration in compliance with the electrical 'laws, N.E.C. RCW Chapter 19.28, WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code, and Utility Specifications. Date. 1 Z c�� RECEIVED APR 6 2009 LIGHT DEPT Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Temp. Service/ Feeder 200 Amp. Temp. Service /Feeder 201 -400 Amp. Temp. Service /Feeder 401 -600 Amp. Temp. Service /Feeder 601 1000 Amp. Portal to' Portal Hourly Sign /Outline Lighting Signal Circuit/ Limited Energy Commercial Signal Circuit/ Limited Energy 1 2 Family Dwelling Signal Circuit/ Limited Energy Multi Family Dwelling Manufactured Home Connection Renewable Electrical Energy 5KVA System or Less First 1300 Square Ft. Each Additional 500 Square Ft. or Portion of 5 Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Thermostat S/ I�f otaI C ash Check Credit Card :fPORT~ lO~~~ ~ "-~ ~ ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32] 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 08-00000790 Date 491790 2520 W 16TH ST 06-30-00-4-4-0030-0000- DAN HOLMAN RES DETACHED GARAGE 7/24/08 RS9 RESDNTL SINGLE FAMILY 14400 Application desc 480 SQ. FT. DETACHED ,WOOD-FRAMED, GARAGE Owner Contractor DAN HOLMAN 2520 W 16TH ST. PORT ANGELES WA 98362 (360) 457-6840 Structure Information 000 000 OWNER 480 SQ. FT. DETACHED GARAGE Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT -RESIDENTIAL 480 SQ. FT. DETACHED GARAGE 129395 277.75 Plan Check Fee 7/24/08 Valuation 1/20/09 111.10 14400 Qty Unit Charge Per Extension 95.75 182.00 BASE FEE 13.00 14.0000 THOU BL-2001-25K (14 PER K) Special Notes and Comments The Fire Department has reviewed the project application and has no comments Public Works Utility Engineering has no requirements for this plan review. Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 277.75 277.75 .00 .00 Plan Check Total 111.10 111.10 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 393.35 393.35 .00 .00 ~ ? ~L S~ " qp 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. ::Uzs-lact; ~W~ D4-~ Dale Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building DivisionlBuilding Permit (051l3/08).wpd BUILDING PERMIT INSPECTION RECORD o 09 ~ -5:) o CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4 J 7-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES. CALL 417-4886 FOR BACKFLOW PREVENTION 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 AND APPROVED PLANS AT THE JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: rnOVlD 5: \ah FOOTINGS 7 -z. g-o & P.B SHEAR WALLS I WALLS FOUNDATION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLOG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING I I FRAMING 9'-1:)-08- '3"LL JOISTS I GIRDERS SHEAR W ALL(HOLD DOWNS) I q -5 --(1 C;S :\1 -G WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL I FLOOR I CEILING I MECHANICAL HEAT PUMP I FURNACE I DUCTS GAS LINE WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING I SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT II'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.I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 4 J 7-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 L-f- 5-o~ -r [A- BUILDING N 0C ~ ~ " ~ ~. 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'M III III A g "I MfI< fIl .CJ .... ~O gJ~~I>:t;'j ... 0 0 ... fIl 0..>< I>: E-<MCJ..:l ~ , 0 ME-< A&l~~~g: 0.. fI< I>:H >< ..:l "'CJ ~E-<CJOo..< III E-< III r -, BENT VERTICAL REINFORCEMENT TIED IN PLACE TO HORIZONTAL REINFORCEMENT 2003 INTERNA TJONAL BUILDING CODE CONCRETE FOUNDATION WALL & FOOTING DETAIL Q/. ~.(:- f GQVERNtJI WAr. THICKNESS 6" THIC OR WALLS UNDER 6' HIGH 8" THICK WALLS OVER 6' HIGH '/, ANCHOR SOL TS FOR 1. STORY @ 72" O. C. & 2 TORY @ 48" O. C. ,.,.~.. PLACE BOLTS WITHIN 12" OF EACH PLATE EN USE 3"X3"X1/4" SQ. WASHERS UNDER NUTS PRESSURE TREATED SILL PLATES ANCHOR 7"MIN. EMBEDMENT CRAWL SPACE HORIZONTAL REINFORCEMENT VERTICAL REINFORCEMENT BEND =12 X BAR DIA., #4 BAR = 5" BEND #4 @ 48" O. C. #4 @ 48" O. C. (1) #4 TOP BAR #4 @ 24" O. C. #4 @ 18" O. C. #4 @ 10" O. C. **6' TO 8' >8' ENGINEERS AL YSIS WITH STAMPED & SIG PLAN REQUIRED . VERTICAL REINFORCEMENT MUST BE BENT & TIED TOTING REINFORCEMENT. - REINFORCEMENT SHALL BE GRADE 50-HYDRAULIC BEN FOOTING WIDTH 12" 1-STORY 15" 2-STORY 23" 3-STORY #4 REINFORCEMENT 2-PIECES CONTINUOUS FOOTING THICKNESS 1-STORY 6" 2-STORY~" 3-STORY 81/2" MONOLITHIC CONCRETE'FOUNDATION DETAIL NO SCALE %" ANCHOR BOL TS(SAME AS ABOVE) PRESSURE TREATED SILL PLATES :------#4 REINFORCEMENT 1-PIECE CONTINUOUS FINISH GRADE MIN. FOOTING DEPTH BELOW GRADE INTO UNDISTURBED SOIL 12"1.STORY 1 B" 2.STORY Bl-1102_0BIRC.WPD I ,\ l {1Pt 0 I t. r- _\ zP o o 1\ " ?; 1-: _~0Y '- v-> sJ , ) \ l' \ Z (/-- a - 25 0 '-...-/ ~ \-, U / SD~O c>f> HD ~\\ ~KO co.( ~o{J QwJ~ ,t '7U _ &-" , \ ,\ ~\v'vVl '1 \\.1) ~ejl( \ ~D \\ o ,\.p-"r:5) \p v- . ~ ~ 0- t ~o\ t U \. Cb ()' tcce.- ()~~~ tJ:;oe l . to \ L \ ~p 7' ,f Z ~Ll I f.9 0/--. '1 x 0 uJTv-Jcu0 t-I~~~ L1,'< I Z- GPtl'2A,\c D::oIL ' r-l&iX6L i/v'P/.J l{ ~t().tlC() T (Z.J.<::l7 'S' t z-- l~~C. '^ , J I, z...../ D~~ ( lo I \ oceU1~ vlAotJJU'-TV\.J:"G f-ov. 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I' 10 t>r0l\~Z- ~[+5 J--.J I - I 0, C l \ \\0 l T -zLl -12: +, . l llO CITY 0 PORT ANGELES - ConstruC"~ion Plans The Issuan e of this permit based upon these plans, specifi- cations an other data shall not prevent the building official from ther after requiring the correction of errors in said plans, sp ifications and other data, or from preventing building 0 erations being carried on thereunder when in violation all codes and ordinances of this jurisdiction. . . . . 0-D0(pI Approval Ie 7 If f'1 OYBy ~)( ( - I I pt~l ~D/L~ .bu&j f:X.-~ J.-v h zlsp{ po E)<~~~~ ~vtS~\ r 'Z-D 1 , " L-l~ <7)~-n:~9 HCu2;S --- 1~ W \ ]J "t)L\ Z 520 U0t(ST -. ) 1;0 '2-~ ?l?c~\"~~~ED G~lc FILE l "I ""- b ~C:::~ U -l ~s- -( Applicant or Agent \)~ -0.o~ Property Owner C)~ HaC .Af\AP-N Property Owner's Address Z. c:s 2C) u..-t=;(:'),\ Contractor/Engineer "5~\e- Contractor/Engineer's Address License # I - BUILDING PERMIT APPLICA TION Print in ink CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St, Port Angeles, WA 98362 (360) 417-4815 fax (360) 417-4711 Pho Phone ( {9 IV'- Phone Expires ~ f2-"CS - <i Parcel Number PROJECT ADDRESS '2 Proiect Tvpe & Brief Description: leck all that apply New Construction o Addition o Remodel o Repair oRe-roof o Demolition o Heat System o Other Floor Areas Basement 1 st Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other Lot Zoning o Residential o Commercial o Multi-family o Industrial ~ c:..O" o Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other Existinq (sq. ft.) Proposed (Sq. ft.) @ $ per sq. ft. = $ rl~L.J 1 .~ '-j1JJ ~~ ~.Oo TOTAL VALVA TlON $ Total footprint of structures ~ sq. ft. + Lot size 37 I DB sq. ft. = Lot coverage .. ~ % ~ llo~ # of bedrooms # of full baths # of half baths Max. height of proposed structures _l L-\ Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? 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 obtain permits prior to working on projects. Date 1Iro{oL5 Print Name ~ ~~ Signature N6~ T:Forms/Building Division/Bldg Permit Appl.-2006 Code.doc 1/g/1)~ Jf3Y'() ~ ~vl {Jx;/G,J Y>/L e,.]t)l,,~f f;. .-.ej ~ I Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000284 Date 595708 2520 W 16TH ST 06-30-00-4-4-0030-0000- ELECTRICAL ONLY 3/11/08 RS9 RESDNTL SINGLE FAMILY o Owner Contractor Holman 2520 west 16 street PORT ANGELES WA 98362 KIRSCH ELECTRIC INC. P. O. BOX 3396 SEQUIM WA 98382 (360) 683-6819 Permit ELECTRICAL NEW RESIDENTIAL Additional desc Permit pin number 122242 Permit Fee 75.00 Plan Check Fee Issue Date 3/11/08 Valuation Expiration Date 9/07/08 .00 o N \J1 ~ Qty 1. 00 Unit Charge Per 75.0000 ECH EL-RM-0-200 1ST SRV FEEDER Extension 75.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 75.00 75.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 75.00 75.00 .00 .00 s - Cf' ~I SPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: .&. DITCH .3 108 SERVICE .~ OUGH - IN FINAL ~r7IOB ~ OMMENTS: CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32 I EAST 5TH STREET, PORT ANGELES, W A 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 08-00000067 Date 474235 2520 W 16TH ST 06-30-00-4-4-0030-0000- DAN HOLMAN RES MANUFACTURED HOME 2/04/08 RS9 RESDNTL SINGLE FAMILY 52500 Owner Contractor DAN J HOLMAN PO BOX 1322 PORT ANGELES (360) 457-6840 Structure Information Other struct info . . 000 BUY RITE HOMES 259403 HWY 101 SEQUIM (360) 681-0777 000 1047 SF MANUF. HOME & TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98382 WA 98362 32 SF DECK 11.80 .01 9075.00 1079.00 1079.00 1.00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BL MANUFACTURED HOME 1079 SF MANUF. HOME 119214 230.00 Plan Check Fee 2/04/08 Valuation 8/02/08 .00 52500 Qty Unit Charge Per BASE FEE Extension 230.00 permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date PLUMBING PERMIT WATER LINE 119222 57.00 2/04/08 8/02/08 Plan Check Fee Valuation .00 o Qty Unit Charge Per Extension 50.00 7.00 ~ 7,?~. OS'~ " O~, "- OcP- BASE FEE 1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE Special Notes and Comments . Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. A residential fire sprinkler system, installed per NFPA 13D, will be required. 2nd option is to install an outside alarm bell that is inter-connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" January 29, 2008 5:08:51 PM sroberds. The proposal will result in the placement of a mfg home in the RS-9 zone for total lot coverage of 12%. No land use 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. Date o Y"I f1'l e.. Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building DivisionIBuilding Permit (10/01107). wpd 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 BEFOR/;'. 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 FOUNDA TION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLDGS,) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALL/HOLD DOWNS WALLS I ROOF I CEILING DR YW ALL (INTERIOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB W ALL I FLOOR / CEILING I I MECHANICAL HEAT PUMP I FURNACE I DUCTS GAS LINE WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: PARKING/LlGHTING 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, I PW/ CONSTRUCTION - R,W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT, BUILDING 417-4815 BUILDING T:Forms/Building Division/Building Permit (10101/07), wpd CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32\ EAST 5TH STREET, PORT ANGELES, W A 98362 . Application Number . . . . . 08-00000067 Application pin number 474235 Page Date 2 2/04/08 Special Notes and Comments issues anticipated. Electrical permit required, Customer Electrical Connection Fee is $713.00 January 17, 2008 4:27:12 PM GMCLAIN. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to pouring concrete. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 1125.00 4.50 1265.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 287.00 287.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 2394.50 2394.50 .00 .00 Grand Total 2681. 50 2681.50 .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 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. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/BlIilding DivisionlBlIilding Permit (10/01/07).wpd BUILDING PERMIT INSPECTION RECORD . , CALL 4 17-4815 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 FINALO? -o5-Ci2rE :n...L- ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALLIHOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEAT PUMP/FURNACE/DUCTS GAS LINE WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES \l'1 0 Yl 0 slo...b t Re.h o..Y 02-07-08 PB FOOTING / SLAB Fbvi'\dAt1 on w a..'\€.r- S~~ 03 -1'3 -0 g. BLOCKING & HOLD DOWNS I (J?_-7~1- f)~ .~U- SKIRTING 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 oS -DS-D9. ;Xt,..L- BUILDING o 00 , 6' --J N \.n N C) z=. ~ ~ fB "7"J (0 \f) T:Forms/Building Division/Building Permit (10/01/07).wpd 3 ~ ~ ... :s: o 3 ~\ . ,ORT ""- 'lO~",:~ ha 1!. -- , ~Vdo'" CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 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 Owner DAN J HOLMAN PO BOX 1322 PORT ANGELES (360) 457-6840 Structure Information Other struct info . . Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date 2/04/08 08-00000067 Date 474235 2520 W 16TH ST 06-30-00-4-4-0030-0000- DAN HOLMAN RES MANUFACTURED HOME RS9 RESDNTL SINGLE FAMILY 52500 Contractor BUY RITE HOMES 259403 HWY 101 WA 98362 SEQUIM (360) 681-0777 000 000 1047 SF MANUF. HOME & TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98382 32 SF DECK 11.80 .01 9075.00 1079.00 1079.00 1. 00 DRIVEWAY INSTALLATION 119669 170.00 2/04/08 8/02/08 Plan Check Fee Valuation .00 o Qty Unit Charge Per Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BASE FEE Extension i70.00 PUBLIC WORKS RES WATER SERV 1"X5/8" DROP IN METER 1196 77 200.00 Plan Check Fee 2/04/08 Valuation 8/02/08 .00 52500 Qty Unit Charge Per Permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BASE FEE Extension 200.00 RIGHT OF WAY 119685 50.00 2/04/08 8/02/08 Plan Check Fee Valuation .00' 52500 Qty Unit Charge Per 1.00 50.0000 ECH RIGHT OF WAY PERMIT' Permit . . . . . Additional desc . Permit pin number Permit Fee Extension 50.00 SANITARY SEWER HOOK UP 119693 120.00 plan Check Fee . . .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. 6</\ ~"le Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) . Date T:\Policies\1102.15R [1105] PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY 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 PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15R (1/05] I I I rI ,ORT ~G d~~ ,. ~ . ~WfitP CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number Application pin number Issue Date Expiration Date 08-00000067 474235 2/04/08 Valuation 8/02/08 Page Date 2 2/04/08 52500 Qty Unit Charge Per 1.00 120.0000 EA SAN SEWER HOOKUP Extension 120.00 Special Notes and Comments Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. A residential fire sprinkler system, installed per NFPA 13D, will be required. 2nd option is to install an outside alarm bell that is inter-connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" January 29, 2008 5:08:51 PM The proposal will result in the RS-9 zone for total lot issues anticipated. Electrical permit required, Customer Electrical Connection Fee is $713.00 January 17, 2008 4:27:12 PM GMCLAIN. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to pouring concrete. sroberds. the placement of a mfg home in coverage of 12%. No land use Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 1125.00 4.50 1265.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 540.00 540.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 2394.50 2394.50 .00 .00 Grand Total 2934.50 2934.50 .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 Signature of Owner (if owner is builder) . Date T:\Policies\1102.15R [1/05] PERMIT INSPECTION RECORD ~ CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRlVEW A Y APPROACH BACK-FLOW DEVICE I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Po1icies\1102.15R [1/05] I I CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 WA 980650798 rontract r ------ ----------------- OWN 2/04/08 rA':>':' \[ C r?' 0'/ .v5 ~ b- 0" 0 0(f, Y::t' U v' i,~" ...Y '- ..(' O~ Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000067 Date 474235 2520 W 16TH ST 06-30-00-4-4-0030-0000- DAN HOLMAN RES MANUFACTURED HOME RS9 RESDNTL SINGLE FAMILY 52500 Owner PARTNERSHIP Structure Information 000 000 1047 SF MANUF. HOME & Other struct info . . TOTAL % EXISTING LOT SIZE PROPOSED LOT COVE TOTAL LOT COVERAG NUMBER OF UNITS DECK 11.80 .01 9075.00 1079.00 1079.00 1. 00 BL MANUFACTURED HOME 1079 SF MANUF. HOME 119214 230.00 / Plan Check Fee 2/04/08 valuation 8/02/08 Qty Unit Charge Per Extension BA~ FEE 230.00 ----------------------------------~---------------------------------------- Permit . . . . . . PLUMBIN9 PERMIT Additional desc . . WATER tINE / Permit pin number 1192k2 Permit Fee 57.00 Issue Date 2/04/08 Expiration Date 8/02/08 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date .00 52500 Plan Check Fee Valuation .00 o '1. 00 ECH BASE FEE PL- EA. INSTALL WATER PIPE Extension 50.00 7.00 Qty Unit Per 7 / -----;~~~~~~-~~~~~-~~-~~~~~~~~--------------------------------------------- Address numqers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. A residential fire sprinkler system, installed per NFPA 13D, wiil be required. 2nd 0 ion is to install an outside alarm bell that is inte -connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" J nuary 29, 2008 5:08:51 PM sroberds. he proposal will result in the placement of a mfg home in the RS-9 zone for total lot coverage of 12%. No land use 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 w'th whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions 0/ Y state onoca"aw7eg lating construction or the performance of construction. 1k/1 /1 - , // . / /I . J / I /~ I:dl / . i / r / ~ If rint Name thorized 't Signature of Owner (if owner is builder) T:Forms/Building DivisionlBuilding Permit (10/01/07).wpd BUILDING PERMIT INSPECTION RECORD , CALL 4 17-48 I 5 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. t J 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 YES NO FOUNDATION: FOOTINGS SHEAR WALLS / WALLS FOUNDATION DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLOGS.) PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALLfHOLO DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP / FURNACE / DUCTS GAS LINE WOOD STOVE / PELLET / CHIMNEY FINAL 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 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 4 J 7-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:Forms/Bui1ding DivisionlBuilding Permit (1010 1I07).wpd I I . ,. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDfNG DIVISION 32 I EAST 5TH STREET, PORT ANGELES, W A 98362 . . Application Number . . . . . 08-00000067 Application pin number 474235 Page Date 2 2/04/08 Special Notes and Comments issues anticipated. Electrical permit required, Customer Electrical Connection Fee is $713.00 January 17, 2008 4:27:12 PM GMCLAIN. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to pouring concrete. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 1125.00 4.50 1265.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 287.00 287.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 2394.50 2394.50 .00 .00 Grand Total 2681.50 2681.50 .00 .00 Separate Perm its are required for electrical work, SEP A, 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 loeallaw regulating construction or the performance of construction. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building Division/Building Permit (10/01/07).wpd BUILDING PERMIT INSPECTION RECORD INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS SHEAR WALLS / WALLS FOUNDA TION DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR W ALL/HOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP / FURNACE / DUCTS GAS LINE WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING I'LANNING 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. 4 I 7-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R. W. / PW/ CONSTRUCTION - R. W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 4 I 7-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING 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 I'O INSPECTED AND ACCEPTED, POST PERMIT IN A CONSPICUOUS LOCATION. r;j:). KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. \ ()' -J f'J 01 t] z ~ * ~ 70 ~ '- ~ Sn , :::t:" o ~ <" T: Forms/Building Division/Building Permit (1010 1107). wpd IU c!'ORr~ f>'~~<;' U,.~ ~-- ~C~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Owner PARTNERSHIP Yontra tor ----- -------- OWN 2/04/08 ~~ -~ ~ ~" ~ ~ i.;{" ~ ~ (}J'f' \( ,.( ~ ~ ("Q, Q o ~'\ , -~...r" ~' if <{" o-Y Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation WA 980650798 08-00000067 Date 474235 > 2520 W 16TH ST 06-30-00-4-4-0030-0000- DAN HOLMAN RES MANUFACTURED HOME RS9 RESDNTL SINGLE FAMILY 52500 Struc re Information 000 Other'struct info. . 000 1047 SF MANUF. HOME & TOTAL % EXISTING LOT SIZE PROPOSED TOTAL LO NUMBER F 32 SF DECK 11.80 .01 9075.00 1079.00 1079.00 1. 00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date DRIVEWAY Plan Check Fee Valuation .00 o Qty Unit Charge BASE FEE Extension 170.00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Qty UBLIC WORKS RES WATER SERV 1"X5/8" DROP IN METER 119677 200.00 Plan Check Fee 2/04/08 Valuation 8/02/08 .00 52500 Per BASE FEE Extension 200.00 Permit Additiona Permit p' Permit F e Issue D te Expira ion Date RIGHT OF WAY 119685 50.00 2/04/08 8/02/08 Plan Check Fee Valuation .00 52500 Unit Charge Per 50.0000 ECH RIGHT OF WAY PERMIT' Extension 50.00 SANITARY SEWER HOOK UP desc . number 119693 120.00 plan Check Fee . . .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 ~Rresume give autho' to violate or cancel the provisions of any state or local law regulating construction or the performance of :oostr con. ,- L -~ --.. Date Signature of Owner (if owner is builder) , Date T:\Policies\1102.15R (1105] PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY 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 PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRlVEW A Y APPROACH BACK-FLOW DEVICE I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15R [lIDS] Of ,ORT ~ ~.~":~ ~~ . if~ ~ -- ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Issue Date Expiration Date 08-00000067 474235 2/04/08 valuation 8/02/08 Page Date 2 2/04/08 52500 Qty Unit Charge Per '1.00 120.0000 EA SAN SEWER HOOKUP Extension 120.00 Special Notes and Comments Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. A residential fire sprinkler system, installed per NFPA 13D, will be required. 2nd option is to install an outside alarm bell that is inter-connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm.' January 29, 2008 5:08:51 PM The proposal will result in the RS-9 zone for total lot issues anticipated. Electrical permit required, Customer Electrical Connection Fee is $713.00 January 17, 2008 4:27:12 PM GMCLAIN. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to pouring concrete. sroberds. the placement of a mfg home in coverage of 12%. No land use Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 1125.00 4.50 1265.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 540.00 540.00 .00 .00 plan Check Total .00 .00 .00 .00 Other Fee Total 2394.50 2394.50 .00 .00 Grand Total 2934.50 2934.50 .00 .00 Separate Permits are required for electrical work, SEP A, Shoreline, ESA, utilities, private arid 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. Date Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder)': T:\Policies\1102.15R [1105] PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL 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 YES NO PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W.I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING ~\Pol'ci~\II02.lSR Ilro'J ....'" o ..... ll1 o ..... ll1 f>lf>l elE-o <(<( "'Q ....0 ....'" ....'" 0'" , , ~.... 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Main disconnect size: ~ 20/240 1 ph 0120/208 3ph 0120/240 3ph 0480 3W 3ph OOther: Standard residential loads (Lighting, refrigerator, dishwasher, washer) g AlC L FLA) r& Range/Oven 0 Hot Tub l81 Clothes Dryer ~ Heating 0 Pumps <-Hp) ~ Water Heater 0 Elevator <-Hp) 0 Other Check all that apply: Supporting Please provide a copy of the following: *Detailed plot plan (.dwg or .dxf format mandatory for subdivisions). *Electrical one-line drawing showing the service entrance panel and location. *Connected load data. *Size and locked rotor am Date: MAIL OR DELIVER COMPLETED FORM TO: 321 E 5TH STREET; PORT ANGELES, WA 98362 FAX TO: 360-417-4709 EMAIL: gmclain@cityofpa.us (west half of city) Information form rlarson@cityofpa.us (east half of city) WS -1 STATEOFWASHINGTON. , Department of Labor and Industries ~ewlT1D;al!!J.tlo\1L""'- . ~-.r. # .. ....oIll:~ Certified Manufactured Home Installer James H Haesel ~ Wains 0250 Expires 07/31/2010 Manager, FUCIOf} A<semblcd Structures J I Ln .. cr- t ~ of- ~t "<;j-Ln I .. a I ..c I r-------~-- ~L ------------...., I I I I I T I , : '2'2 I - ~ 1-1- ~ .:e ~II: (E a- : ~ rcJ I- c: I ~ ~ t~ I I , , '_L... ~ 1- - 1-1- ~ K 17 _F; Ft-- '7 a 101 af L r -;t. ~~ lL+-- 3 1\ ~ L ~ -- ~J N .1- 1\ I m \C~:2 I ~~.) : J>.~ V ~ I _ ~ I I I I ~ I I lQ I I i: I I N I I I I I I I I I N..r~~H ~ I : ~~~ ~. I : ~I 0 ~~ ~ : I I L-__________ AQiX9V _____________-1 "Ohll I "Ohll "G-,fC: t o ~~ J t CO I in -1 U) .c ~ ~ N .S 4-l Iu..N ~ cr-E Qti10 _ 0 ~ L "":':()\J ~-~ () N 1: :J 62iYO 911~io, y, 'S,.-^'"t>....t...o t-Ao6\1...~ ~u. rUUNs::.~~^, Folt- Kkfl..~1"l'. oJ - c.~....,-~....""" \, ~~ f r {..JC..~~ CovN -nt> \ ON.....'Y PLA",S ()'>~6 /,-..J LJH/61 /' ""7'^6(,),-,.,,) '5'(.1"-<- D~1~~ 9' 30/Ci'1 (.g-I..qootA') r.!>~ """"",-;,-,.(.(,,) \)r!.\~ N A~1>\)",^f''''W~ 'r\hN~ ~{.. :r. SNO..-.J - 2.!J,,",>, '10 ~~~ (Of.... ~ \ =- 3Qf\'~ e' w""",- 'il1-z. MMe.""". r.TUI 1DOOr:.( so.~\ Zp' ~'- WI DC '2. '(. OII~ rj "'.'J,", 2-~' M "1' j> 1I-...lL rI ,.. "10" 5"T}t....p ^N:.-t~c. G.:J"",, \' t'VJ~ v << .,..,~- 1:>1.. ~ 10/' lot lo)/L/C,r'Vd,N'1'- "'" J'-"" ..I, (!>,........""~ ~"'-n~ (;,j.OU/JO A}J<-~~ SP. 10' T. 1.(12..'0 .M. ~ ~* l-...,J:.'..$. T' ~'7.Stl. e S'c. · 31",1"~ 3'-""1 L"; 1.~1' '1'to.S'~/'5(,) or' '/0' ~ He ~/*'/ (9 .) "'t 'i ~ ~v'~'~'L ,',,--fl, ~ V fltlb A\ T'"; O. "l ( "%.0 ......,;x I. ri'i "\oJ'" L. 'l. '1- 'A 5 ^""r~ 1,)."\ .- I "fe" foe.. 1"'1.....'" 1-'" $ c.QN'TI....,Vt;IU~ MA-I 'P,...IL (A"h<..''T'''J' ,:l,U,. <2 12.' u.c_ p. ., LtX) it; A-u" ... .", z,ox..> IQUe. "'T. z.. \t ~ ~ \1 1. I .- - - . " I I f 51 I I I ~o I '..... , L.. . .. .- .. __I z.~ ~-N-'<":>L-C 1',('"<4 1..uJ'rl.> 8ASs:.O c.lf" PI ~ rt- UlM:>.A1Z (, ^ A ,. S(PO,,, ~: $. ~8 q z. ~ tooops(. lflflfl it< "'\..-- 4000 ~ PfEIL (..o~ v-.I tZb;,., L 13/tS~ ;'ft.E,A. I 110.00' 82.?O' i I c~hl ~r:wr:r? II .00' 27' rr:ar ~et l1acl- hou~r: North ~ 77.00' fiLE 8' sulr: set l1acl 1-- -------------1 I I I I I I 1 t I sr:wr:r I 8' IW I~ pump ~r:t I I l1acl I 1 I I I Propo5ed I home I 24x44 I I meter I I ~~ L ~- -t- - - - - "'- - - - -i - - ~~ : :j:;;.J~tDUS 11~ ~O.OO' 112'60' I I :'-"' I I 'koD ~ ff' : : :..., = ~~kl2;- !(loo ~J powr:r and w 1'" (\C> V I 0 (; iMch approx7 ' ~ r+~""1 S ~ U - 4bre- - ~-6lO- - -d-v (be ~s(. dt-/LE Go JWL. i'IP' OF PORT ANGELES .- COlistmctio:1 P!ll!lS ~e I~suance of this permit based upon these pl,ans. sp,;d:i. c;tions and other data shall not prevent the bUildmg .ofd~,a~ from thereafter requiring the correctIOn of errors In salG pl,,~s, specifications and othe~ data, or from preventlr:g building operations being earned on thereu~d:r ~hen m violation of ail codes and o:dinances of tl:IS I=on~ 1""1011 '''IoI;-~ ",..., f7r- I\pproval Date '2:. By I p..~' Wt:>f2-I-::::: SO~&c:..--r ~ ~, i?l.~ pvt)~t 82.70' l. 2,' 'root "" ... We5t 16th 5treet Holman, Van ~ot? 16th Street ~aqle5 ~a~r P A Par eel #06?0004400?OOOOO I I- I /5cale 111""20' _1~5 ofll/'}()/()1 I a5 of 1/:;'108 Applicant or Agent Property OWner Property Owner's Address Contractor/Engineer _ / Contractor/Engineer's Add ess License # lJtJ V If I /I $-tJRt.)tJl3 I . ., " ~ - BUILDING PERMIT APPLICA TION Print in ink CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 (360) 417-4815 fax (360) 417-4711 For City Use Only: Date Received 1- 15"'-O~ Permit # Of( :ft.; Date Approved yo f! one /P8/-a 7 77 Phone 1f51-108 WJ 3&. I?- Phone MI-0777 z., Expires 5" J tJ8 , PROJECT ADDRESS Parcel Number 0 It> Proiect Tvoe & Brief DescriDt/on: Check aU that apply ){ New Construction o Addition o Remodel o Repair oRe-roof o Demolition o Sign o Heat System Other o Multi-family o Industrial o wall-mounted 0 projecting 0 freestanding 0 awning Total si n area s . ft. Maximum allowed si n area . ft. o Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other o other Floor Areas Exist/na (sa. ft.) Prooosed (sa. ft.) J=~~~ tld Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other @$ per sq. ft. = $ .', ~ /61-'7 ---;> ~==r !J~ - /7 () 0 ~ TOTAL VALUATION $ -!:uJ... SOJ), t "" tJ tJ 75 sq. ft. = Lot coverage JL. fJ - % c:!:Jv Total footprint of structures /0 7q Max. height of proposed structures / (p , Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? sq. ft. + Lot size ft. L1L '7tc Occupancy group Occupant load Construction type L Z, ---/U # of bedrooms # of full baths # of half baths I have read and completed this application and know it to be true and correct. I am autho zed to app' understand that it is my responsibility to determine what permits are required, a d to tain pe projects. / ~ J?;~d' ~ j., ,". Date "I.&). 08 Print Name J ~t3nJU'j Sign'ture Website Version I Dec. 2007 </P[}RT""" t~~~ f"'Ei1ii . L -- · ~o::;W:;P CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 {) s-& 7 2/04/08 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning Application valuation 08-00000067 Date 474235 . 2520 W 16TH ST 06-30-00-4-4-0030-0000- DAN HOLMAN RES MANUFACTURED HOME PI RS9 RESDNTL SINGLE FAMILY 52500 Owner Contractor DAN J HOLMAN PO BOX 1322 PORT ANGELES (360) 457-6840 Structure Information Othel~ struct info BUY RITE HOMES 259403 HWY 101 WA 98362 SEQUIM (360) 681-0777 000 000 1047 SF MANUF. HOME & TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98382 32 SF DECK 11.80 .01 9075.00 1079.00 1079.00 1. 00 Permit Additional desc Permit pin number Permit Fee Issue Date Expil:ation Date DRIVEWAY INSTALLATION 119669 170.00 2/04/08 8/02/08 plan Check Fee Valuation .00 o Qty Unit Charge Per ~EX . <On ~- ~. BASE FEE C 1~0.00..-..J -------------------------------------------------------~-~------- ---- Permit PUBLIC WORKS RES WATER SERV Additional desc. 1"X5/8" DROP IN METER Permit pin number 119677 Permit Fee 200.00 Plan Check Fee .00 Issue Date 2/04/08 Valuation 52500 Expiration Date 8/02/08 _______Qty___Unlt_Charge__per__~~:E_:E:__________ __________~~~l~ Permi t RIGHT OF WAY "Additional desc Permit pin number Permit Fee Issue Date Expiration Date 119685 50.00 2/04/08 8/02/08 plan Check Fee Valuation .00 . 52500 Qty Unit Charge Per -EXfP~~~~~ ~ ___ ___ __ ~ ~ ~~__ __ ~_~ =~~ ~~~~_~~~ ___ ~~~~= _~~ _~~=_~~~~!_ _ __._ ___ __ C 50. 00 ~ Permi. t SANITARY SEWER HOOK UP Additional desc Permi.t pin number 119693 Permit Fee 120.00 Plan Check Fee . .00 1-101 (7ICt/YL dS-ZO W /& ttL r:; 'oJ r I JIlrD8 '5--/'3 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 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 Date Signature of Owner (if owner is builder)' T:\Policies\1102.15R [1/05] ~,ORr~ lO~":~ r..,S:i ..... -- ~;;;;> CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DNISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 .. Application Number Application pin number Issue Date Expi~"ation Date 08-00000067 474235 2/04/08 valuation 8/02/08 Page Date 2 2/04/08 52500 -----~;~~I~f-~~~~~~~~i~~!~~~~~~--s~-~~~~~-~~~~~p--------------~~~~ Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. A residential fire sprinkler system, installed per NFPA 13D, will be required. 2nd option is to install an outside alarm bell that is inter-connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" January 29, 2008 5:08:51 PM The proposal will result in the RS-9 zone for total lot issues anticipated. Electrical permit required, Customer Electrical Connection Fee is $713.00 January 17, 20084:27:12 PM GMCLAIN. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to pouring concrete. sroberds. the placement of coverage of 12%-. a mfg home in No land use Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 1125.00 1265.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 540 .00 540 .00 .00 .00 plan Check Total .00 .00 .00 .00 Other Fee Total 2394 .50 2394 .50 .00 .00 Grand Total 2934 .50 2934. 50 .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 Signature of Owner (if owner is builder) Date T:\Policies\ 11 02.15R [lIDS] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . INSPECTION REPORT. . . . . . . REQUEST: Date 7.-IC)-d'?> Time Received by RV (phone. person) Location of Work to be inspected '2. 52.0 W / b iVt Name of person requesting inspection CG-r \ 8o",-,,,^, Address of person requesting inspection ~~ Inspection (circle appropriate one): ~ Foundation Framing Chimney Plumbing Final Sewer Excav. Other ]):<tw,o....d tc""s t Phone No. 'i 77 -'70 A Permit No. 02> - b 7 INSPECTION NOTES: Inspected: Date .2 - 11- 08 . Remarks: Ne-uJ tOo"" -{f!) e.,(~d~J I ~ ",," /-10 lJ-.:<' e.. Time p,'1 PVc:::.. JUa..:.A i J By "III rve kV .~ ro.v:ty .se.IJ..j~r RESTORATION REQUIRED . . . . .. YES NO ^ leaH.. ST...e~:t N PIL ?JL t I?" \4--' l -+i .~ ll"c~ "'~ r '{'I v..Jv~ ..--IJ"-W Pl/~ 571 , I ~c...f I ~ ~" p,<,c.. /vA,o..V\, M/H- "- ",P, II / .... T. 0 s'( ~ s,f;' r , SURFACE RESTOR ATrON: SURFACE TYPE: 0 Unimproved DGravel o Asphalt OPCC o Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . INSPECTION REPORT. . . . . . . . . . REQUEST: Date .if- /7 - D6 Time Received by ~v (phone. person) Location of Work to be inspected "2.SZ.0 l.v /6-+ it Name of person requesting inspection (1.nc~~J C., I-O~ { Address of person requesting inspection Type of Inspection (circle appropriate one): Phone No. Sewer Foundation Framing Chimney Plumbing Final Permit No. 08-67 ( Sewer Excav. Other .j)",ve. lAJO.y INSPECTION NOTES: Inspected: Date ~-/7- OB Remarks: Time By kV ()k tu Po~cr RESTORATION REQUIRED . . . . .. YES NO x.. SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC 0 Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessarv) C'Tn~~"T COllnt:nl'UTr-'UI"'Ior-IU"I" Ir"'\."....t:\ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . INSPECTION REPORT. .... REQUEST: Date J.-/ - 2. ,,- 0 6 Time Received by ~v (phone, person) Location of Work to be inspected 2520 11\1 I bi-L, ') . , ., "?> /") .L Name of person requesting inspection 6"I'CJ.~ ~"..y t"\.1.~'€- .. Address of person requesting inspection Phone No.~8./- 0(,7 Type of Inspection (circle appropriate one): Permit No. 09 - '" 7 Sewer Foundation Framing Chimney Plumbing E)ewer Excav. Other INSPECTION NOTES: Inspected: Date .;- - 13-08 Time Remarks: C;-eLAJer 2.- (Cf-6~ C.....b ;,. e,(,\.-lk.~ '-1-7-0'0 J)"'~v'\Lv..:o.v '1-17-08 , By 7<1/ F/~I !Jt: RESTORATION REQUiRED...... YES NO X. Wa:h'I! ,"N~;l""" &ox +-q L..<:>uJ -.-~ tP K 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) APPLICATION FOR WATER City Water Division, Port Angeles, WA Issued date ,~ -4 - D 55 InstaIled by & date l (6 'Z -1 -Ofpenmt # (/ R ~ 7 I hereby apply for water to be furnished In accordance with rates Jnd rules of the City for the followmg premises: ApplICant ";ame & Phone V41./ Jk;C:/;Y'/?-h 467-C:;:feJ () SiteAddress Z?2/) j{)/j;;;tZJ MaiIingAddress PO 5t~i /-3Ze/_ Blk ~ /f- ;3 Add C ~if~ /iJ~P parcel'# vh?;,I/ZV44cL8(,; Svc: ON / t!! /#ter #'s C F ..;.lc4U.f5G.w/o#: <)0 ~(j '6 -:5 all Svc: Size )~o 1, . ~s: Jil/1' .;/;7~\-tl: Restoration Required: ,~, , / ' ,. ~ /, / . . /l f Signature: :.i / I]Z.f-L~ L-- 1 Remarks:// ~ '- / ~ e-j,;7';h2:) ):t'i};.df:"'h2.-0 MAR-6-2008 09:20A FROM:KIRSCH ELECTRIC 3606830869 TO:4l747ll P.l ~f; " ELECTRICAL WORK PERMIT APPLICATION Job wired by Cl Owner InUlllltion c1cKnplioD IJ Commercial ~"ld..t1.1 IJ Ne.. IJ AII.redlAddldoo E~lri~'1 conn.CHH n.me i r"',C' \""\ f" IF>C\-.ri (' p\)huc:r'I~'~" , () X ~?f1l P City ~I Jim Tclepho c number 3 l.lccnae number DaLe !!Apirc. lI-" rSC't"iDMll,) -4\Y~lo3 Stale ZIP I.LA Qe.3ci4 FAX number \{\()h\f\_ ~ fuj'(. -11Y Ow",r QJ d~fl"ed by RCIt'.J9.14.J6/:(1) Owntr will O'CUP)' 1M Jlruc.urt jur fwO J'atln after Wi ,Jecrricaf pcrmlllJ jlnQ'tud. OJ Owl/V U "QulrtJ 10 hI" an el<<lrlco/ CD/lUDe/or 1/ Qbo", said pnJperry lJ jor JQJ" nnl D1' letu" Af\n rndina the abon Ita\cmcnL, I hmb1 ~crtj()' thaI I 1m the gwncr or the above named property or I IicmM<l elClctrical contnl.clOr, I 1m maiinj the eleclrical inll1ll. I. lion or .Iltrllion in compUance with the clcclriul Jawl, N.E,C., RCW. Chlpter i9.28, WAC. Chaptet 296.468, The City Dr Pori AnlJelc, Municipal Code, "nd Utiliry Specificlrioal. SllOIfure of owur, eleclrlcal coolrlelar or e1eclrlcal admlDlllralor o Cosh 0 Check N o Credit Cird V"", B' ~aslcreard DiscovCf CirdN _LX:L-__~-____-____ x Date: Expiration Date of cird Clpcction lee S IJ NO LOAD CHANGES o Ba.aboard _ i<:W o Furnace i<:W o HeBI Pump _ Ton _ LAR IJ FM-Wall KW 'ibO '1?-<7D Service InformBtlon Q Qyerhead Service IJ Tomp Service o Underground Service VoIIag. Pha... IJ 1 IJ 3 Service SIze:_ FMCler Size: SAME: DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 t' ROUGH-IN TIlERMOSfAT '-. d.'" App.....'el Dy Dill. ",.,......-'0)' SERVICE 3(r7/of; 'Ui> '\... D~I ~8J t' FEEDER FINAL 3/~7/rP. 0'.1 ~ ADP"lvIll1B)' t' ~/IIIDP, Ca'l DITCH "Th9 APII"lWcd By D." ~a,./ lnlpectio" OUt Area, Building or Equipmenllrnpecled ACllon "'keo Electrical ,lp,pector .", ..3 -10-08 1',\o,~GL (1/j,lI)a_-r"/I1,-, k~ 4f 717;, 01::- >>~tI v ,