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Home My WebLink About530 Rose St - Building .t...„ 7 CITY OF PORT ANGELES DEPARTMENT OF COM MUNITY &ECONOMIC DEVELOPMENT BUILDING DIVISION 32 1 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 12- 00000416 Date 4/12/12 Application pin number 319008 Property Address 530 ROSE ST ASSESSOR PARCEL NUMBER: 06- 30- 15 -5 -4- 0400 -0000- REPORT SALES TAX Application type description RE -ROOF Subdivision Name on your state excise tax form Property Use to the City of. Port Angeles Property Zoning RS9 RESDNTL SINGLE FAMILY (Location Code 0502) 0 Application valuation 5240 Application desc TEAR OFF REROOF Owner Contractor MCCURDY CHERYL GARLAND CONST MAINTENANCE 5414 S DOSS RD 2512 E RYAN DRIVE PORT ANGELES WA 983628951 PORT ANGELES WA 98362 (360) 457 -5186 Permit BUILDING PERMIT NO PR FEE Additional desc TEAR OFF REROOF Permit Fee 151.75 Plan Check Fee .00 Issue Date 4/12/12 Valuation 5240 Expiration Date 10/09/12 Qty Unit Charge Per Extension BASE FEE 95.75 4.00 14.0000 THOU BL- 2001 -25K (14 PER K) 56.00 Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid 'Credited Due Permit Fee Total 151.75 151.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 156.25 156.25 .00 .00 ata1 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. I k. C. t A dq »t v i,i_ A 6L(14 b/ 1 Date Print Name Signature of Contractor or A Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MIN s 4 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 481 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 4174886 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 INSULATION: Slab Wall Floor Ceiling MECHANICAL: Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: Parking Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 (a' T•Fnrmc /Ruiiriinn rliuicinn /Rnilriinn Parmit \0 N H I H H I I w C7 H I aa1 q 0 N N C 0 O N V) 0 7 M a o w I q H 7 1 H W W w 0 M o O a0 DX X Hs o 0 E.7 m y q O a a H O v] ao F F F cn u u l z N H w w w H z a s o w Z 1 woo a H H f}.I H U R( O W H Z0 Lo U U fka HHW 7 aHF C ul o iz4 W o Z 0 0 q N 0 F 0 w w a ar 2 o D a 040 H O w 0 E. 00 H oft g 0 E •-1 011 ma0 O E 2 0 O' HO o cnOx cnn Z a U U W H 0 W 00 (0 [n Q H O a 0 0 Z 0 0 HQ (21 o O W H F H o a u (1)0 r.( 100007 00, 0 �F pc 00 00 a aaI x 0au o •a •w Z a 0 al W Q F w w MC) 4 C1).< aa w z H 0 aHQO3 W a CL U i a u o 4L R( 6L H P7 °Rr .I BUILDING PERMIT APPLICATION Print in ink b CITY OF PORT ANGELES For City Use Only: Attn: Building PermltTechnicia Date Received la• la- S._:7E111111111► 321 E. Fifth St., Port Angeles, WA 98362 Permit 1a— L- 1 to (360) 417 -4815 fax (360) 417 -4711 Date Approved 4- 1� la Applicant Lk_ C. t r\ -0(-Co._ Va.. (L9 !�-Q-/-, y Phone 5 7 5/ B Property Owner SJ (j /4 Ca r Phone y 7 3c) (j Property Owner's Address o 5-4- e. A- Ld 7 6 g Contractor C 6 r a y2_ {s o -c -ir`1 Phone y 5 7 5/ 8 C, Contractor's Address 51 a A ,Dr License C' Pc-' L C NLD DEx•ires o E -mail 13 PROJECT ADDRESS 5 3 0 6 5-.c_ 3 1 Parcel Number 0 (D 1 5 64-04-00 Lot Zoning Project Type Brief Description: Residential Multi-family o Commercial Industrial Check 'RECEIVED Addition Remodel APR 1 2 2012 Repair Demolition CITY OF PORT ANGELES e -roof 44/40 P4 4Nnfnor tear off re -roof lay over one layer Heat System Heat pump wood- burning stove gas fireplace pellet stove other Other Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq. ft. 1 Floor 2 Floor 3` Floor Garage Carport Covered Porch Deck i t i D10 2 p l iov 1,9(e Shed 1 -4• ld• 1- Other TOTAL VALUATION C321-4 Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage Max. height of proposed structures ft. Occupancy group of bedrooms Will a lawn sprinkler system be Installed? Occupant load of full baths Will a fire sprinkler system be installed? Construction type of half baths 1 have read and completed this application and know it to be true and correct. t am authorized to apply for this permit and understand that it is my responsibility to determine what permits are re ired, and to obtain permits pri r to working oa pr facts. Date L Print Name "C l �G�a V�uc� vy��t Gt Signature /i 4 T:Forms /Building Division /Building permit application GARLAND ROOFING 251'2 East Ryan Drive Port Angeles, WA 98362 360- 457 -5186 rill Lic. Bonded -Lic.# GARLACMQ44 7 h e r i to p Proposal Submitted To:,S eh rill McCurdy Address: 530 Rose St., Port Angeles t G� Phone Number: 360 -417 -N C7( y�r Job Location: Same 3t- H 4___ Date: 3-27-12 tcriv9/1 ��v. _a_ We hereby submit specifications and estimates for: Tear off old shingles one layer and re -roof. Remove and haul -off all roof debris. Install ridge, ASTM 151b felt, starter shingle, and a Owens Corning 30 year laminated shingle with algae resistance. Color. home owners choice. Replace all pipe flashing, vent cans. The purchase of a city re -roof permit if needed would be an add cost. We propose hereby to furnish material and labor complete in accordance with the above specifications for the sum of: $5640.00 plus tax Spring Special $400.00 (expires 6- 21 -11) Total $5240.00 plus tax With the payments to be made as follows: 50% deposit and balance paid upon completion. Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. Respectfully Submitted G Note this proposal may be withdrawn by us i not acc ied within 30 days. Acceptance of Proposal The above prices, specifications and conditions are satisfactory and hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Date of acceptance A c J Signature (A' G j epo5A jo 400'6 4, q W' c. d 4ft w 6 0 L t f --v-. —4,_ it J J 4 ri'' Eun►ce}S� 4. r i o a h r ,X a y t,. r- t S x t LL W d+ +Ti a <f I t,y�,r s r c cr il.:_ i d t. o i r l ,gin 4 p J T. '�w.e.+ f V ,S i 'Y t• Y-`` a 3 .4Z,,- -a„.,, t fi f s x rt '4:-''''''' r*.... p ^Y r r. v u- a .1 7 IQ I a t� b nom ,y.. f l! 1.� �.�.YS •L VJ rr 4 y e t _i. 4 0.. j 1 rs{{�� p �w. :e 'v t 4 1 c V �T 'PP ttt t it ,_t C01 P' q P. c, t 'PPP �y=v.�, by f a J- y�.. -t om r e t c J, e O•' y jam a w t: 'D Contractors or Tradespeople Printer Friendly Page Page 1 of 2 General /Specialty Contractor A business registered as a construction contractor with L &I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name GARLAND CONST a MAINTENANCE UBI No. 600566135 Phone 3604575186 Status Active Address 2512 E Ryan Drive License No. GARLACM044ND Suite /Apt. License Type Construction Contractor City Port Angeles Effective Date 8/4/1996 State WA Expiration Date 9/17/2013 Zip 98362 Suspend Date County Clallam Specialty 1 General Business Type Individual Specialty 2 Unused Parent Company Other Associated Licenses Specialty Specialty Effective Expiration License Name Type 1 2 Date Date Status VAUGHG*082N6 VAUGHAN, Construction General Unused 8/26/1992 8/4/1996 Archived GARLAND Contractor Business Owner Information Name Role Effective Date Expiration Date VAUGHAN, GARLAND Owner 08/04/1996 Bond Information Bond Bond Account Effective Expiration Cancel Impaired Bond Received Bond Company Number Date Date Date Date Amount Date Name 5 CBIC SF4691 03/11/2004 Until $12,000.0003/26 /2004 Cancelled Assignment of Savings Information No records found for the previous 6 year period Insurance Information Company Policy Effective Expiration Cancel Impaired Received Insurance Name Number Date Date Date Date Amount Date 18 Atlantic Cas L125001667- 04/10/2012 04/10/2013 $300,000.0004/10 /2012 Ins Co 0 17 Atlantic Cas L1250010172 03/18/2011 03/18/2012 $300,000.00 /2011 Ins Co 16 ATLANTIC L1250010171 03/18/2009 03/18/2011 $300,000.0003/17 /2010 https: fortress .wa.gov /lni /bbip /Print.aspx 4/12/2012 Contractors or Tradespeople Printer Friendly Page Page 2 of 2 CAS INS CO CATLIN 15 SPECIALTY 4600100161 02/16/2008 02/16 /2009 $300,000.0002/07 /2008 INS CO WELLINGTON 14 SPECIALTY 4600100076 02/16/200702/16 /2008 $300,000.0002/22 /2007 INSURANCE 13 CBIC INSSF4691 03/11/2006 03/11/2007 03/14/2007 $1,500,000.0006/O1/2006 Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period https: fortress .wa.gov /lni/bbip /Print.aspx 4/12/2012 CHERYL MCCURDY 530 ROSE ST PORT ANGELES (360) 417 3060 T.Forms /Building Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 08 00001236 Date 9/26/08 Application pin number 282712 Property Address 530 ROSE ST ASSESSOR PARCEL NUMBER 06 30 15 5 4 0400 0000 Tenant nbr name CHERYL MCCURDY Application type description MECHANICAL APPL PERMIT Subdivision Name Property Use Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 900 Application desc INSTALL FREESTANDING GAS HEATING STOVE Owner Contractor WA 98362 EVERWARM INC 257151 HWY101 PORT ANGELES (360) 452 3366 Fee summary Charged Paid Credited WA 98362 Permit MECHANICAL PERMIT Additional desc INSTALL GAS HEATING STOVE Permit pin number 135434 Permit Fee 121 30 Plan Check Fee 00 Issue Date 9/26/08 Valuation 0 Expiration Date 3/25/09 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 10 6500 ECH ME OTHER APPL N/R 10 65 1 00 10 6500 ECH ME GAS PIPE 1 TO 5 10 65 1 00 50 0000 HR ME INSPECTION OTHER 50 00 Due Permit Fee Total 121 30 121 30 00 00 Plan Check Total 00 00 00 00 Grand Total 121 30 121 30 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 9d/087 4'° /44/ '��O'04 Date Print Nanie -.>5ignature of ontractor or Authorized Agent Signature of Owner (if owner is builder) Inspection Type 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 AIR SEAL. Walls Ceiling FRAMING Joists Girders Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace Ducts Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s Parking Lighting Landscaping RESIDENTIAL Electrical 417 -4735 Construction R.W PW Engineering 417 -4807 Fire Planning Building 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 4807 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. 417 -4653 I 417 -4750 I 417 -4815 I Date Accepted By iD IH OR ��l SEPA. ESA. SHORELINE. Construction R:W PW Engineering I Fire I Planning I Building Comments FINAL Date: Accepted by FINAL Date. `0-'(7 U by L FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE DATE Accepted By Commercial Date Accepted By I Electrical I I PREPARED 10/17/08 9 00 07 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/17/08 ADDRESS 530 ROSE ST SUBDIV TENANT NBR CHERYL MCCURDY CONTRACTOR EVERWARM INC PHONE (360) 452 3366 OWNER CHERYL MCCURDY PHONE (360) 417 3060 PARCEL 06 30 15 5 4 0400 0000 APPL NUMBER 08 00001236 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 01 10/10/08 PB MECHANICAL GAS LINE TIME 01 00 10/10/08 DA October 10 2008 8 31 04 AM 1pangrle CHERYL 417 3060 GAS LINE AFTERNOON October 10 2008 3 58 44 PM pbarthol install gauge pressurize recall inspeciton ME6 02 10/14/08 JLL MECHANICAL GAS LINE 10/14/08 DA October 13 2008 4 48 05 PM 1pangrle CHERYL 417 3060 GAS LINE October 14 2008 4 14 03 PM jlierly Provide 30lbs 24hrs check for leaks and recall/j11 ME6 03 10/16/08 JLL MECHANICAL GAS LINE 10/16/08 AP October 16 2008 8 31 44 AM 1pangrle TERRY 301 2362 GAS LINE October 16 2008 4 26 01 PM jlierly ME99 01 10/17/08 MECHANICAL FINAL TIME 01 00 October 17 2008 8 34 23 AM 1pangrle SHERYL 417 3060 MECHANICAL FINAL GAS HEATING STOVE REQUESTED A 2 30 PM INSPECTION COMMENTS AND NOTES PREPARED 10/16/08 9 22 50 INSPECTION TICKET PAGE 10 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/16/08 ADDRESS 530 ROSE ST SUBDIV TENANT NBR CHERYL MCCURDY CONTRACTOR EVERWARM INC PHONE (360) 452 3366 OWNER CHERYL MCCURDY PHONE (360) 417 3060 PARCEL 06 30 15 5 4 0400 0000 APPL NUMBER 08 00001236 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 01 10/10/08 PB MECHANICAL GAS LINE TIME 01 00 10/10/08 DA October 10 2008 8 31 04 AM 1pangrle CHERYL 417 3060 GAS LINE AFTERNOON October 10 2008 3 58 44 PM pbarthol install gauge pressurize recall inspeciton ME6 02 10/14/08 JLL MECHANICAL GAS LINE 10/14/08 DA October 13 2008 4 48 05 PM 1pangrle CHERYL 417 3060 GAS LINE October 14 2008 4 14 03 PM jlierly Provide 301bs 24hrs check for leaks and recall/j11 ME6 03 10/16/08 !L MECHANICAL GAS LINE t October 16 2008 8 31 44 AM 1pangrle TERRY 301 2362 GAS LINE COMMENTS AND NOTES Job Located at BUILDING DIVISION fi CITY OF PORT ANGELES Correction Notice ST__go T2D5J Inspection of your work revealed that the following is not in accordance with the codes governing the work this jurisdiction t t c. C 1 6 -,Ll 1.7 These corrections must be made and are nof" to be covered until reinspection is made. When corrections have been made, please call <-=J i 5 2/ 77 for inspection Date /0 .F- f f i lnspfctor for Building division DO NOT REMOVE THIS TAG PREPARED 10/14/08 9 04 45 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/14/08 ADDRESS 530 ROSE ST SUBDIV TENANT NBR CHERYL MCCURDY CONTRACTOR EVERWARM INC PHONE (360) 452 3366 OWNER CHERYL MCCURDY PHONE (360) 417 3060 PARCEL 06 30 15 5 4 0400 0000 APPL NUMBER 08 00001236 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 01 10/10/08 PB MECHANICAL GAS LINE TIME 01 00 10/10/08 DA October 10 2008 8 31 04 AM 1pangrle CHERYL 417 3060 GAS LINE AFTERNOON October 10 2008 3 58 44 PM pbarthol install gauge pressurize recall inspeciton ME6 02 10/14/08 JLL MECHANICAL GAS LINE October 13 2008 4 48 05 PM 1pangrle CHERYL 417 3060 GAS LINE COMMENTS AND NOTES aL( LEA iress PREPARED 10/10/08 9 52 02 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/10/08 ADDRESS 530 ROSE ST SUBDIV TENANT NBA CHERYL MCCURDY CONTRACTOR EVERWARM INC PHONE (360) 452 3366 OWNER CHERYL MCCURDY PHONE (360) 417 3060 PARCEL 06 30 15 5 4 0400 0000 APPL NUMBER 08 00001236 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME6 01 7/10 JLL MECHANICAL GAS LINE TIME 01 00 October 10 2008 8 31 04 AM 1pangrle CHERYL 417 3060 GAS LINE AFTERNOON COMMENTS AND NOTES )1 Clow te-r" 4iii.f�- ht/574V-4- 6m,c14.- 4"`-el CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant or Agent Cketeil Property Owner ChPry/ Property Owner's Address 5'.3a4,-f, Contractor /Engineer LC, l/d'r)27 Contractor /Engineer's Address License PROJECT ADDRESS 3 /of,- 51 ;t r ?e 7t /2°s, Parcel Number Proiect Tvoe Brief Desc Check all that apply New Construction Addition Remodel Repair Re -roof Demolition Heat System Other Floor Areas Basement 1st Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other notion. Total footprint of structures /05 Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? BUILDING PERMIT APPLICATION Print in ink /1c (lad Sal` Y27eVes Expires ❑Residential Commercial re .P/1u /2g .•OPN /I°) rt6vr ri,a/x oen2 4 +7117114 R€-1" Heat pump wood- burning stove gas fireplace pellet stove other Existing (sq. ft) proposed (sq. ft.) /1, ,5z/ sq. ft. Lot size ft. Occupancy group Occupant load Construction type E -mail Lot TOTAL VALUATION For City Use Only Date Received 26 0`6 Permit O —123b Date Approved Phone 3b o y/7 o6 Phone ee, lP 710 Phone Zoning Rs —c t Multi family Industrial per sq. ft. sq. ft. Lot coverage of bedrooms of full baths of half baths 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 9 Print Namea Signature ii/rd/ N? Port Angeles, washlngtonm9.:::_.l._7..___:::......Y.:..Q..mn.... 19.:2:'n - CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT 17365 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 ._fm3.__O'n.m~n---.s...d.m---n-----n---. Occupancy____n___~----_mmmnn ~::~~.~~~,8:~:f~::~::nn~~:~~~;:::::::::::::..:.::.~::::::::::~::::~::::::::::~=::::::::::::::::::: Light Outlets_.__mL.Om____.nnn____m. Service, volts _L?:n_c>__:._~__':i__Jdm Type of Wiring: Receptacle Outlets.n~.:6_..._---........ No. wires .....__.::~..........._............. Armored Cable ..............__h.........._ / SI I ~I..J. -.A A. L Non-Meta.lUc ........._....n.__.......__..... Dryer, KW..nnn.nhbmnmmnn______n__ ze w rB"---nm_hn""___ . _:__:mn___ ~-' _ .LJu_ Knob & Tube.....h.__......................_ Range, KW h_nnnL7..-.,'n___n___nn Main fuse .mn' ."_hLLnhT.::m RIgid Condult mnmmmm__mnnhm Water Heater: Enclosure _____................____ - KWmmhhh_'l-L~-----h-h----------. Hea', KW_nm/.JJn'm~n____mnm___h______ Type of wiring: Entrance Cable h..h.__..__..___..... Motors: size. volts and phase: _mmn.E2__~mmm__nmn___ .h__h__h/,)"'h__WhLh__hmhn.mm RIgid Conduit __nmmmnm______h___n Meta111c Tubing m___.....__u Current transformers: No. & Size.............................. Ser. NO.__................_....................n._.. Ser. No. ...00.....................00..........0000... Ser. N 0.....__.....................00.......00._...... Total Load.nn....n.................. Ser. No. ............00..._00....................._. Remarks: _______~W--m.--.-~~.'..m.m.-----n--n...--mnmmm------..--m--.........--..--..--m.--------.. Total ________'/h__1--____m_n________ By....?CL~m--~~... NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- cea.led due noUce must be given the Inspector so that work may be inspectiid before concealment. ''l. NOTO'" THE :NSPECTOR BY PERMOT NUMBER WHEN "AOY FOR 'NSPECT'ON ) :::::Sh:::::::::::':::::::~::::::::::::~::::::~::~::::::~::::::~::~--:::::::::::~:::::::::::::::::::::::::::::::::::::::::::--~~~~Ct~:::~::::::~::~::~::~:::::::::=::::::~::::::~:::::::~ , WiringContractor................__..............._._......................_.............................................................By...~................._............................._........_. Permit Fee .., 6'--'e $.~.L.........__.....:___________ Treas. Receipt NO.n.......................... ELECTRICAL PERMIT Metallic Tubing ............_..._......_.. Raceway ......................._......_._..._ Circuits, Llght...........3........._........_n Utlllty ________m___m_~-_n__mmmmm_ Hea, .______...m...__t.._____.n.______._mm Range nm____________~_n__n____hm_n__ Water Heater .....;l~........m.... Motor ..._........................................ DTyeT.....................~..........._- Furnace .n..._...n..............~......_.._....._ N? 17365 NOTIC~urrent must not be turned on until Certificate of....lnspection has been Issued. If work is to be con- cealed due notice must be given the Inspector so that wOEk ~y be inspected befc:>>re concealment. .---' _A / 1M Olympic Printers, Inc.