HomeMy WebLinkAbout105 W 6th St - BuildingINSPECTION TYPE
DATE.
RESULTS
INSPECTOR.
DITCH
SERVICE
ROUGH IN
Z
0 I)
h.A
FINAL
l ti
W
COMMENTS
VS LAni k AYR-. 6 NrgoL1- 1-1
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
3 circuits lights recept
Owner Contractor
FIRST BAPTIST CHURCH
105 W 6TH ST
PORT ANGELES
(360) 457 313
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit pin number 180836
Permit Fee 78 70 Plan Check Fee
Issue Date 1/27/11 Valuation
Expiration Date 7/26/11
Qty
1 00
2 00
Unit Charge
73 5000
2 6000
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
1 12 k 4k1
b
WA 983626034
Per
ECH EL BRANCH CIRCUIT WO /FEEDER
ECH EL ECH ADDNT BRANCH CIRCUIT
78 70
00
78 70
11 00000086
459632
105 W 6TH ST
06 30 00 0 0 9157 0000
ELECTRICAL ONLY
RESIDENTIAL HIGH DENSIT'
0
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457 9270
Paid Credited
78 70
00
78 70
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
00
00
00
Date 1/27/11
WA 98363
Due
00
00
00
00
0
Extension
73- 50
5 20
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Signature of owner or Electrical Contractor X Date:
G \EXCHANGE \BUILDING
0
00
'67
U`
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 Fast Fifth Street P O. Box 1150 Port Angeles Washington, 98362
Ph. (360) 417 -4735 Fax: (360) 417 -4711
Date: J 9 /J
1 2 Single Family Dwelling
Plan Review May Be Re uired Plea e Electrical Plan Review Information Sheet
Job Address:
Building Square Footage:
Description o,:bove
Owner In! rmItio A
Name: 4
Mailing Ad ss:
City r /4 State:104 Zip:
Phone
License Exp.
Item Unit Charge
Service /Feeder 200 Amp, 119.90
Service/Feeder 201-400 Amp. 145.50
Service /Feeder 401 -600 Amp 204.60
Servlce/Feeder 601 -1000 Amp. 262.20
Service/Feeder over 1000 Amp. 372.50
Branch Circuit W/ Service Feeder 2.60
Branch Circuit W/O Service Feeder 73,50
Each Additional Branch Circuit 2.60
Temp. Service/ Feeder 200 Amp, 92.70
Temp, Service/Feeder 201.400 Amp. 110.30
Temp. Service/Feeder 401-600 Amp. 148.70
Temp. Service/Feeder 601.1000 Amp 167.90
Portal to Portal Hourly 95.90
Sign /Outline Lighting 88.20
Signal Circuit/ Limited Energy First 1500 sf Commercial 95.90
Note: $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy 1 2 Family Dwelling 63.90
Signal Circuit/ Limited Energy Multi-Family Dwelling 63.90
Manufactured Home Connection 119,90
Renewable Electrical Energy 5KVA System or Less 102.30
Thermostat 56.00
NEW CONSTRUCTION ONLY:
First 1300 Square Ft. 110,30
Each Additional 500 Square Ft or Portion of 35.20
Each Outbuilding or Detached Garage 73.50
Each Swimming Pool or Hot Tub 110.30
in
lig Credit Card
Dated: 1
RECEIVED
JAN 262011
ELECTRICAL
INSPECTIONS
010112010
Multi-Family or Commercial" X Commercial Addition Alteratior Remodel Repair"
Contractor Inf I t 9 I g
Name: 5 Z,LC'o
Mailing Ads
A
Name
City; State: ZII
Phone: Fax: O Fax: L.
License Up, 5'T)r S E-L. 'Y 75 K.
Total (Qtv Mul )plied by Unit Charge)
7 j, ro
Owner as defined by RCW_19.28.261 (1) Owner will occupy the structure for two years after this electrical permit is finalized. 42) Owner is required
to hire an electrical contractor If above said property is for sale, rent or lease. Permit expires after six months of last inspectiol
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical ct ntractor I am making
the electrical Installation or alteration In compliance with the electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296. The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Sign of owner, electrical c 'tj actor or electrical administrator' CI cash Check
PREPARED 1/20/11 9 00 58 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 1/20/11
ADDRESS 105 W 6TH ST SUBDIV
TENANT NBR FIRST BAPTIST CHURCH
CONTRACTOR AIR FLO HEATING CO INC PHONE (360) 683 3901
OWNER FIRST BAPTIST CHURCH PHONE (360) 457 3313
PARCEL 06 30 00 0 0 9157 0000
APPL NUMBER 10 00000792 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 1/19/11 JLL MECHANICAL FINAL TIME 01 00
1/19/11 CA January 13 2011 11 39 38 AM 1pangrle
SHELLY 457 3313
MECHANICAL FINAL INSTALLED TWO HEAT PUMPS TO REPLACE OIL
HEATING
PLEASE INSPECT WHEN THE OFFICE IS OPEN BETWEEN 9 30 AM
2 30 PM
PER SUE ROBERDS CALL AL AT 457 4269 WHEN YOU ARE HEADING
OVER TO THE CHURCH SO AL CAN MEET YOU THERE
January 19 2011 4 51 29 PM jlierly
owner wanted to wait till all balancing of system was
complete /j11
ME99 02 1/20/11 JLL JanuarICA0 FINAL
January 20 2011 8 51 34 AM 1pangrle
SANDY (FROM AIR FLO HEATING 683 3901 EXT 2)
MECHANICAL FINAL INSTALLED TWO HEAT PUMPS TO REPLACE OIL
HEATING
COMMENTS AND NOTES
PREPARED 1/19/11 8 40 41
CITY OF PORT ANGELES
ADDRESS 105 W 6TH ST SUBDIV
TENANT NBR FIRST BAPTIST CHURCH
CONTRACTOR AIR FLO HEATING CO INC PHONE (360) 683 3901
OWNER FIRST BAPTIST CHURCH PHONE (360) 457 3313
PARCEL 06 30 00 0 0 9157 0000
APPL NUMBER 10 00000792 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01
1/19/11
2+�
INSPECTION TICKET
INSPECTOR JAMES LIERLY
MECHANICAL FINAL TIME 01 00
January 13 2011 11 39 38 AM 1pangrle
SHELLY 457 3313
MECHANICAL FINAL INSTALLED TWO HEAT PUMPS TO REPLACE OIL
HEATING
PLEASE INSPECT WHEN THE OFFICE IS OPEN BETWEEN 9 30 AM
2 30 PM
PER SUE ROBERDS CALL AL AT 457 4269 WHEN YOU ARE HEADING
OVER TO THE CHURCH SO AL CAN MEET YOU THERE
COMMENTS AND NOTES
t 1'
ca-i It 1
ealoittc,
kJ a
PAGE 4
DATE 1/19/11
40'
0 2
\r'
Permit 16 -7 111
Date 1 -13
PROJECT STATUS UPDATE
I phoned the Applicant at
Property Owner at
I (left a phone message o
The permit .(has expired •r will expire soon). What is the status of this project?
Please call and schedule a final inspection
Or
Submit a "permit extension request" letter
Or
Let me know if the project is abandoned
3 1 1.a-Ya_ 3-kW Q c QQ VAivvv
BNQJYY) ,Azi,d&EL..,__GL.Ln___eLr2actaktha
(:13 -1 sQ!v egidaclet 4 50 1,9, Mai& aevi,e9,
.d 1
1.
loot CO
T Forms /Building Division/Project Status Update
Fm-el
L15^1- 3313 1 a f
y, 1 1 tc1- l I v a114,0 fii.
C E RTI F t O°
�C4T`E OF ��C-tU PA N CY
City of_ Port Angeles--':BtO d'irng�, ®iuision
Z
This certificate is issuedfpursuant to the requirements' of Section 171 otthe 2009 International Building
Code certifying that at�;the =timeaofissuance this structure was i ncompliance with the various ordinances
of the City regulating building .ruction orµuse for the folloiving-
Business name
Business address:'
Property owner
Property owner sa
Automatic fire c sprin
Use occupancy
Occupant load.
J
Building permit numbe
Type of construction.
Post on the premises in a conspicuous place
TheAChildren=s Montesson!School'(N,o n�Proft: °Organization)
:105:yW 6th St': lLL
First Baptisf.AChurc
dress 105 W 6th =:St:, WAi9.8:3624
kler .system. Per =GBC R=4
assifcation. Educatiortaf
Per 20:0 :931=B1C: Table;t1>
11/04/10
er Date
his,certificate,shail not be removed except by the Building Official.
miu (k4-o
1
PREPARED 10/21/10 9 48 37 INSPECTION TICKET PAGE 6
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/21/10
ADDRESS 105 W 6TH ST SUBDIV
TENANT NBR THE CHILDREN S MONTESSORI
CONTRACTOR PHONE
OWNER FIRST BAPTIST CHURCH PHONE (360) 457 3313
PARCEL 06 30 00 0 0 9157 0000
APPL NUMBER 10 00001219 CO CHANGE OF OCCP /USE
PERMIT CO 00 CHANGE OF OCCUP /USE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
C099 01 10/21/10 J BLDG BLDG C/0 FINAL TIME 09 00
L/ OVERRIDE TAKEN BY LPANGRLE DATE 10/20/10 TIME 16 47 40
October 20 2010 4 46 04 PM 1pangrle
PAULA BECKER 417 1945
C OF 0 FINAL THE CHILDREN S MONTESSORI SCHOOL
ROOM 11 INSIDE THE CHURCH
SHE REQUESTED A MORNING INSPECTION AFTER 9 00 AM
COMMENTS AND NOTES
INSPECTION TYPE
DATE.
RESULTS
INSPECTOR.
DITCH
SERVICE
ROUGH IN
02 1 2 lr t
c
FINAL
a I zt Jl D
d
COMMENTS
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning RESIDENTIAL HIGH DENSITY
Application valuation 0
Application desc
Add 15 ton heat pump
Owner
FIRST BAPTIST CHURCH
105 W 6TH ST
PORT ANGELES
(360) 457 3313
Qty Unit Charge Per
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
WA 983626034
Permit
Additional desc
Permit pin number 170316
Permit Fee 112 00
Issue Date 7/29/10
Expiration Date 1/25/11
112 00
00
112 00
10 00000794
061250
105 W 6TH ST
06 30 00 0 0 9157 0000
ELECTRICAL ONLY
Contractor
2 00 56 0000 ECH EL LVT THERMOSTAT
Paid
112 00
00
112 00
AIR FLO HEATING
221 W CEDAR
SEQUIM
(360) 683 3901
ELECTRICAL ALTER COMMERCIAL
Plan Check Fee
Valuation
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
Credited
00
00
00
Date 7/29/10
CO INC
WA 98382
b$ 3r7
Due
00
00
00
00
0
Extension
112 00
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Date:
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 10 00000792
Application pin number 182976
Property Address 105 W 6TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 9157 0000
Tenant nbr name FIRST BAPTIST CHURCH
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning RESIDENTIAL HIGH DENSITY
Application valuation 52496
Application desc
INSTALL TWO HEAT PUMPS TO REPLACE OIL HEATING
Owner Contractor
FIRST BAPTIST CHURCH
105 W 6TH ST
PORT ANGELES
(360) 457 3313
Fee summary
14 8000 EA
18 2000 EA
T:Forms /Building Division /Building Permit'
WA 983626034
AIR FLO HEATING CO INC
221 W CEDAR
SEQUIM
(360) 683 3901
Qty Unit Charge Per
BASE FEE
1 00 ME FURN /HP /FAU OR 5 TON
1 00 ME FURN /HP /FAU 5 TON
Charged Paid Credited
Permit Fee Total 83 00 83 00
Plan Check Total 00 00
Grand Total 83 00 83 00
00
00
00
Date 7/28/10
WA 98382
Permit MECHANICAL PERMIT
Additional desc INSTALL TWO HEAT PUMPS
Permit pin number 170290
Permit Fee 83 00 Plan Check Fee 00
Issue Date 7/28/10 Valuation 0
Expiration Date 1/24/11
Extension
50 00
14 80
18 20
Due
00
00
00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
0 0 CA
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
SAho G /1.L+J grnr -c
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Inspection Type
Date
Accepted By
Parking Lighting
Comments
FOUNDATION
Accepted By
Electrical
Footings
417 -4735
Stemwall
Construction
R.W
Foundation Drainage Downspouts
417 -4831
Piers
Fire
417 -4653
Post Holes (Pole Bldgs.)
Planning
PLUMBING
FINAL Date
Accepted by
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
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.
FINAL Date 0
1 1
Accepted by
r
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
SEPA.
ESA.
SHORELINE.
Parking Lighting
Inspection Type
Date
Accepted By
Electrical
417 -4735
Construction
R.W
PW Engineering
417 -4831
Fire
417 -4653
Planning
417 -4750
Building
417 -4815
PLANNING DEPT
Separate Permit #s
SEPA.
ESA.
SHORELINE.
Parking Lighting
Landscaping
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.
T /Building Division /Building Permit
Applicant or Agent 4\1 td K AN\ N 1
Owner Ft R5f cwit kk
Owner's Address 16 S W b d' 1l2EET
Contractor /Engineer 1\1 FL-0 H o4'S't N 4-
Contractor /Engineer's Address a►){
License# Jk g. ft-14 Cobeiel
PROJECT ADDRESS
Proiect Type 8 Brief Description.
Check all that apply
New Construction
a Residential X Commercial
o Multi- family Industrial
Addition
CEP 1 0 k 0 I J 6- 01 L k P 1 N b- 11J rvlt
E ()OAP 5NSTc_f4AS
o Pt^FIo( wdk 4.2.,11
Remodel
Repair 10 -r h
Re -roof
Demolition
Sign
5 -4-o n C h uv-cAn o of errn ►t'+v
0- bahrkovr a.vk on v►K if he -0-et
o projecting eestanding o awning o other
sq. ft. Maximum allowed sign area sq ft.
o wall- mounted
Total sign area
)(Heat pump wood burning stove o gas fireplace o pellet stove o other
Heat System
Other
Floor Areas
Parcel Number
Basement
1 Floor
2nd Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures sq ft. Lot size
Max height of proposed structures ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant Toad
Will a fire sprinkler system be installed? Construction type
r
have read and completed this application and know it to be true and correct. l am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required, and obtain permits prior to working on
project I
Date g 0 Print Name CAA -EGN N�G"(L
tF--S Signature
T:Forms /Building Division /Bldg Permit Appl. -2006 Code.doc
i d 1L66 689 096
BUILDING PERMIT APPLICATION 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
Existing (sq. ft.) Proposed (sq. ft.)
105 *J 6, $tt
3 a
Phone 34,o- L4S'1- 3313
Phone
For City Use Only
Date Received 1- 2'3
Permit to
Date Approved
Phone 360-443 39 01
SE6m M kkOr clic 5T
Expires
Lot
Zoning
per sq. ft.
TOTAL VALUATION `T l (Q 0"D
r
sq ft. Lot coverage
of bedrooms
of full baths
of half baths
01d mId Wd02 6 0102 82 Inc'
City of Port Angeles Permit Application
Building Division/Electrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98382
Ph: (360) 4174735 Fax: (380) 417 4711
Date: it 1 o
1 2 Single Family Dwelling
Multi- Family or Commercial'
iI Commercial Addition /Alteration Remodel 1 Repair'
Plan Review May Be Required, Please Complete Elgstrical Ian Review Information Sheet
Job Address: 165 W it s& 5
Building Square Footage:
Description of above eLel.AG 0 rn Ott fisvc W lZ rlt 'CWo K£t#CT POMP 5Y4'f.M 5
Owner Information
Name: FIRST 31tPTA5r C HIV RCM
Mailing Address: 10 5 W t6 S
City Poor kNipc.LE S State: W k Z p: 4 183 en z.
Phone: 360 45, 33p
License I Exp.
Unit Change
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
8625
27.50
57.50
86.2
$4
2
.it
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for Iwo years after this electrical permit Is finalized. (2) Owner is required to him 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 296468, The City of Port Angeles Municipal Code, and
Utility Specifications.
d
tune owner electrical contractor or electrical administrator
ow:'04I it)
RECEMO
JUL 2 2009
ELECTRICAL
INSPECTIONS
Total fQty Multiplied by Unit Charnel
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service /Feeder 401 -600 Amp.
Service /Feeder 601 -1000 Amp.
Service /Feeder over 1000 Amp.
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
Each Outbuilding or Detached Garage
Swimming Pool or Hot Tub.
J
III Thermostat
0 Total
/12
Cont lion
Name: l� 01 1N G'
Mailing Address: 7. e,e.D kW
City SE v State W k Zip: t 175 SSC
Phone: 3t. b— 11:1451
License /Exp. At Q f L- �-1 t^ o b qc(
I LGE E89 09E 01.d ?MIA IA Wd02 E 0 T 02 82 I mC
WILL THERE BE ANY OF THE FOLLOWING?
NO
YES/
IF YES CONTACT
Electrical changes
1/
2 1
Electrical Dept. at 417 -4735
New or relocated signs we d% SCvf fed per r i s
Opening date 7hh bolo
Fire
Building Div at 417 -4815
Construction changes
r/
yes
PBIA
Mechanical changes (ventilation, heating, cooling, etc.)
1
9 66) S
c a C.LJ0.1.2
Plumbing changes
1
City Clerk
Fire sprinkler system changes
96 -,E,
7 e z- -,��Q,
Fire alarm system changes
v
a. A T J i
anc-r ,,iJL-4n,, T i Win -L Llf
New or relocated sewer or water service
t/
Public Works at 417 -4807
Excavation or filling of lots
c
Work done in the City right -of -way
New driveway openings
i
Grading site drainage (parking lots, downspouts, etc.)
Landscape irrigation system (backflow devices)
Water Dept. at 41' -4886
Is this a home occupation?
i/
Planning Div at 417 -4750
Is this a second-hand dealer or pawnbroker business?
ity Clerk at 417 -4634
Is there off- street parking for this business?
How
many spaces? S 0
Is the street in front of this business paved?
i/"'
.S ox'es4 W ■+t-,
is there a sidewalk in front of this business?
+h e c uv -r_I^
Is there a curb gutter in front of this business?
Department
Approv d
I itial a e
Rejected
Initials date
Comments Conditions
BUSINESS ADDRE S 10 s L 6 5 J �or'
Building
2 1
I
9'0 9 Po,.*- 19 /i.s ui 9 c FChone #36
Type of construction Occupant Load
Opening date 7hh bolo
Fire
1e1 110 Wpb
Washington State Tax I D
Automatic fire sprinkler system required no
yes
PBIA
9 66) S
c a C.LJ0.1.2
Planning
City Clerk
t' o
96 -,E,
7 e z- -,��Q,
Public Works
a il
10-21-to
a. A T J i
anc-r ,,iJL-4n,, T i Win -L Llf
.4 -��`�C
BUSINESS
A, >^e.ri, S 114044 e 55 >e/ JG 0 v
NAME h e_ Gil
BUSINESS ADDRE S 10 s L 6 5 J �or'
Zon in g H D
Business mailing address P (Sdx
I
9'0 9 Po,.*- 19 /i.s ui 9 c FChone #36
9/7 9 'S
Opening date 7hh bolo
Days hours of operation c,/cy s ct k p-
Mon— Fri
Washington State Tax I D
If known list the name of the previous
business at this location
Change of ownership
Brief description of proposed business
Orjoilt.. nn Q 1j �J s )ioa 1
Q�
ACTION
New business
Transfer of business
location from a
PBIA location
Transfer of business
location from a
non -PBIA location
t/
Change of ownership
Remodel
Temporary business
Change of use
CERTIFICATE OF OCCUPANCY APPLICATION
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
Print in ink
Phone #20 9/ �9ys—
Business owner's name yln> if rr' 0 LOP)1 P
Business owner's home addres
4 siA SSL— r z/
PLEASE NOTE. C 5$2- 4 91
A Business License is also required for the following businesses Taxi, Peddlers Second -hand dealer Pawnbroker Dance Hotel
Motel Fireworks Ambulance Tattoo shop Contact the City Clerk at 417 -4634 for additional information.
T:Forms /Building Division /Certificate of Occupancy Application
Permit
$1100 00
FEES
Certificate Inspection
Parking Business Improvement Area (PBIA)
fee charged for downtown locations
Peru It 11
ye. kci
Call for Certificate of Occupancy inspections before opening business.
Building Department Inspection 417 -4815 Fire Department Inspection 417 -4653
Please provide a minimum 24 -hour notice for inspections
I hereby apply for a Certificate of Occupancy l acknowledge that I have read this a nd state that the information I have
supplied is correct to the best of nowledge
Date6 Print Name p AA 13 per' keS Signature
For Cityuseonly on hold un4 1JO. t' t 614.'6i on IQ 2 -I o1k.1
Please sign up for utility services
at the cashier counter
Clallam County Assessor Treasurer Property Details 56331 FIRST BAPTIST CHU Page 1 of 4
Claltam County Assessor Treasurer
Property Search Results 56331 FIRST BAPTIST CHURCH for Year 2010 2011
Property
Account
Property ID
Geographic ID
Type'
Tax Area:
Open Space
Historic Property' N
Multi Family Redevelopment: N
Township
Range
Location
Address. W SIXTH ST
PORT ANGELES WA
Neighborhood: Exempt Ref Region 5
Neighborhood CD 50985200
Owner
Name.
N
Taxes and Assessment Details
56331
0630000091600000
Real
0010 PA 121 PORT ST CNTY H2 L Land Use Code 69
FIRST BAPTIST CHURCH
Mailing Address. 105 W 6TH ST
PORT ANGELES WA 98362 -6034
Property Tax Information as of 10/20/2010
Legal Description:
Agent Code.
DFL
Remodel Pr
Section
Mapsco
Map ID
Owner ID
Ownershil
Exemptions.
LTS 17 20 BL91
cpA C1 e\sk- NO2--t\ncQn
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Cer-e)''►r5 Rat)
GP ._t_.
Amount Due if Paid on. E. NOTE If you plan to submit payment on a future date make sure you enter the
click RECALCULATE to obtain the correct total amount due
First Second
Half Half AVl-`
Base Base
Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest, Base Paid t
2010 39378 ST SCH STATE SCHOOL $0 00 $0 00 $0 00 $0 00 $0 00
2010 39378 CC-GEN COUNTY $0 0 $0 00 $0 00 $0 00 $0 00
2010 39378 PORT PORT $0 00 $0 00 $0 00 $0 00 $0 00
2010 39378 PORT ANG PORT ANGELES $0 00 $0 00 $0 00 $0 00 $0 00 0
2010 39378 SD #121 SCHOOL DISTRICT #121 $0 00 $0 00 $0 00 $0 00 $0 00 k
2010 39378 NTH OLY LIB NORTH OLYMPIC LIBRARY $0 00 $0 00 $0 00 $0 00 $0 00 ('Cl 2010 39378 HOSP #2 HOSPITAL #2 $0 00 $0 00 $0 00 $0 00 $0 00 JJ
2010 39378 WSMET PK DIST WILLIAM SHORE MET PARK DIST $0 00 $0 00 $0 00 $0 00 $0 00
i 2010 39378 CITY_STORMWATER CITY STORMWATER $157 38 $157 38 $0 00 $0 00 $314 76
2010 39378 WEED CONTROL WEED CONTROL $0 82 $0 81 $0 $0 00 $1 63
2010 39378 TOTAL. m $158._20 $158.19 $0.00 $0.00 $316.39
1 2009 563312008 ST SCH STATE SCHOOL $0 00 $0 00 $0 00 $0 00 $0 00
2009 563312008 CC-GEN COUNTY $0 00 $0 00 $0 00 $0 00 $0 00
2009 563312008 PORT PORT $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00
TM V
$0 00 $0 00 $0 00 $0 00 $0 00
2009 563312008 PORT ANG PORT ANGELES
2009 563312008 SD #121 SCHOOL DISTRICT #121
12009 563312008 NTH OLY LIB NORTH OLYMPIC LIBRARY
http. /vpn.clallam. net :8084 /propertyaccess /Property aspx ?cid =0 &year= 2010 &prop td =5 10/20/2010
'1
INSPECTION TYPE
DATE
RESULTS
INSPECTOR.
DITCH
SERVICE
127)10
ROUGH/IN
1
FINAL
1 zi7S i
4c
COMMENTS
Application Number 10 00000449 Date 5/07/10
Application pin number 558709
Property Address 105 W 6TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 9157 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RESIDENTIAL HIGH DENSITY
Application valuation 0
Application desc
225 amp feeder 12 circuits
Owner Contractor
FIRST BAPTIST CHURCH
105 W 6TH ST
PORT ANGELES
WA 983626034
Special Notes and Comments
May 7 2010 10 41 31 AM Brian 417 4708 OK
Permit Fee Total
Plan Check Total
Grand Total
176 70
00
176 70
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
176 70
00
176 70
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457 9270
WA 98363
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit pin number 164921
Permit Fee 176 70 Plan Check Fee 00
Issue Date 5/07/10 Valuation 0
Expiration Date 11/03/10
Qty Unit Charge Per Extension
12 00 2 6000 ECH EL BRANCH CIRCUIT W /FEEDER 31 20
1 00 145 5000 ECH EL 201 400 SRV FEEDER 145 50
Fee summary Charged Paid Credited Due
00
00
00
00
00
00
Date
ff
CITY OF PORT ANGELES PERMIT APPLICATION j
Building Division/Electrical Inspections
321 East Fifth Street P.O. Box 1 Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417 -4711
ELECtCAI.
Date:. 5161./T> INSPEI>oTc ONS
1 2 Single Family Dwelling Multi Family or Commercial* X._ Commercial Addition 1 Alteratior r Remodel Repair*
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 1 Q 511.(1_40-,C11-'
Building Square Footage:
Description of above
Owner 1
Name:
Melling Add
City:
Phone,'— ?3 j3 Fax:
License fk Exp.
Item
Service /Feeder 200 Amp.
Service/Feeder 201.400 Amp.
Service/Feeder 401 -600 Amp
SeMce/Feeder 601 -1000 Amp.
Service/Feeder over 1000 Amp.
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 401.800 Amp.
Temp. Service/Feeder 601.1000 Amp
Portal to Portal Hourly
Sign/Outline Lighting
Unit Charge
119,80
145.50
204.60
262.20
372.50
2.60
73.50
2.60
92.70
110.30
148.70
167.90
95.90
Signal Circuit/ Limited Energy I First 1500 sf Commercial 95.90
Note: $5.00 for each additional 1500 sf
Signal Clrcuft/ Limited Energy 1 It 2 Family Dwelling 63,90
Signal Circuit/ Limited Energy Multi Family Dwelling 63.90
Manufactured Home Connection 119.90
Renewable Electrical Energy 5KVA System or Less 102.30
Thermo:est 56.00
NgW CONSTR ON ONI t,
First 1300 Square Ft. 110.30
Each Additional 500 Square FI. or Portion of 35.20
Each Outbuilding or Detached Garage 73.60
Each Swimming Pool or tiol Tub 110.30
Sign re f owner, electri I c ry ctor or electrical administrator
mast .-51140
Contractor In!ntmali t LL e_
-D o.
Stag: t LIP
Fax:
Name:
Melling Add
City
Phone:,
License Exp, ,S eite S L c
—1.—
ID Cash Check
m e s a sacsota
01/01/201n
Total IQty Muni U Gharrle)
$..1 ,So
I'-
t Total
Owner as defined by RCW 19,28.261: (1 Owner will occupy the structure for two years after this electrical permit is finalized, Owner Is required
to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last Inspectlor
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical co •r actor I am making
the electrical installation or alteration In compliance with the electrical taws, N.E,C,, RCW Chapter 19.28, WAG, Chapter 298- 3, The City of Port
Angeles unldpal Code. and Utility pecificalions and PAMC 14.05.050 regarding Electrical Permit Applicfu1ions.
d
Application Number 03- 00000641
Property Address 105 W 6TH ST BLDG
ASSESSOR PARCEL NUMBER: 06-30-00-0-0- 9160 -0000-
Application description RE -ROOF
Subdivision Name
Property Zoning
Application valuation 17930
Owner
FIRST BAPTIST CHURCH
105 W 6TH ST
PORT ANGELES
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
Other Fees
Fee summary
Pern{it Fee Total
Plaq Check Total
Other Fee Total
Grand Total
T: \PLANNING \FORMS\ 1102.15 [4/2002]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
WA 983626034.
BUILDING PERMIT
TEAR OFF, SHEET,
316.75
7/07/03
1/04/04
Per
Charged Paid
316.75 316.75
.00 .00
4.50 4.50
321.25 321.25
Contractor
BASE FEE
16.00 14.0000 THOU BL- 2001 -25K (14 PER K)
Date 7/07/03
EMERALD ROOFING
114 MT PLEASENT CREST
PORT. ANGELES WA 98362
_(360) 452 -8173
NO PR FEE
FELT, COMP
Plan Check Fee .00
Valuation 17930
STATE SURCHARGE
Credited
.00
.00
.00
.00
Due
Extension
92.75
224.00'
4.50
.00
.00
.00
.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
fora 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 authori to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
--Z 7-7-03
ature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT:
ROUGH -IN
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL
WALLS ROOF CEILING
DRYWALL
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE PELLET CHIMNEY
HOOD /DUCTS
PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT.. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING
ESA:
LANDSCAPING
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCV/IISE
RESIDENTIAL
DATE
YES
NO COMMERCIAL
DATE
ACCEPTED
;YES
NO
ELECTRICAL LIGHT DEPT. 417-4735
LIGHT DEPT
CONSTRUCTION R.W. PW/
ENGINEERING 417 -4807
CONSTRUC"I'ION R.W.
PW ENGINEERING
FIRE 417 -4653
FIRE DEPT.
PLANNING DEPT. .417.4750
PLANNING DEPT.
BUILDING 417 -4815
f a. j
t L
BUILDING
BUILDING PERMIT INSPECTION RECORD 0 3- 6 14
CALL 417 -4815 FOR BUILDING 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
T:\PLANNING\FORMS\1102.15 (4/2002)
REQUEST:
Date (D)
Inspected: Date
Remarks:
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
INSPECTION REPORT
Location of Work to be inspected
Time s Received by ,C
INSPECTION NOTES:
7/
Repaired by City
Repaired by Permittee
No Damage Found
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No 6 4
Sewer Foundation Framing Chimney Plumbing' Final Sewer Excay. Other
e -(oo C
(Continue on reverse side if necessary)
r' ng_ Lk) 6
Time
BY j
RESTORATION REQUIRED YES NO
SURFACE RESTORATION:
SURFACE TYPE: Unimproved Gravel Asphalt PCC Other
Work Order
COMPLETE
INCOMPLETE
(phone, person)
STREET SUPERINTENDENT (DATE)
Site Address:
�S
(...4
READY FOR WILL CALL FOR
INSPECTION INSPECTION
Installed By:
n Li s
t
License Number:
Phone:
Owner /Business:
L
1
Phone:
Owner /Business Address:
Sq. Ft.
ELECTRIC HEAT
BASEBOARD KW
FURNACE KW
HEAT PUMP KW
FAN /WALL KW
Details/Description
WS No SERVICE SIZE DATE ENGR
CAPACITY:
O.K. NOT O.K. OVERHEAD SERVICE APPROVED
ACTION REQUIRED: CHANGE TRANSFORMER CHANGE SERVICE WIRE
INSTALL SERVICE POLE OTHER
Ditch Inspection O K
Rough -in /cover O K
A O.K. to connect service
i a Final 0 K
Site Address:
1oC Gc/ (gPi
Installer:
LL S
Permit /Receipt No.
New Meters
Date? /6
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the Building Permit. PHONE 457 -0411, EXT. 224.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
WHITE File by address
OLYMPIC PRINTERS INC.
actrEl ical Inspector
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457 -0411
ELECTRICAL PERMIT
RESIDENTIAL
COMMERCIAL
NEW CONSTRUCTION
REMODEL
ADD /ALTER CIRCUITS
SERVICE UPGRADE /REPAIR
TEMPORARY SERVICE
bu /Yet el.,2,t+3-Q F,
PERMIT NO. GOO
q
DATE T/// y
RISER
OVERHEAD SERVICE
UNDERGROUND SERVICE
VOLTAGE
1 O 3
SERVICE SIZE AMPS
FEEDER SIZE AMPS
Permit Fee
PINK Top: Eng, Bottom. Customer GREEN Top: Meter Dept., Bottom: City Hall
Site Address:
w
READY FOR WILL CALL FOR
INSPECTION INSPECTION
Installed By:
a S 5
n
I /L,CXIYJ
License Number:
Phone:
Owner /Business:
72,479
Sf n
/I
Phone:
Owner /Business Address:
New Meters
Sq. Ft.
Site Address:
DS
CO.
n
I /L,CXIYJ
Permit /Receipt No.
i/a
Installer
jao
‘5
t1
-c
New Meters
Date:
7/4
s
RESIDENTIAL
COMMERCIAL
BASEBOARD KW
FURNACE KW
FAN /WALL KW
HEAT PUMP KW
SIGN
SPECIAL EQUIPMENT
(LIST BELOW)
Details /Description AiPGlf ek904
W.S. No. SERVICE SIZE DATE ENGR
CAPACITY:
O.K. NOT O.K.
ACTION REQUIRED: CHANGE TRANSFORMER CHANGE SERVICE WIRE
INSTALL SERVICE POLE OTHER
Ditch Inspection O K
Rough -in /cover 0 K
O.K. to connect service
Final O K
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the Building Permit. PHONE 457 -0411, EXT. 224.
Electrical Ihspector
WHITE File by address YELLOW file by number
OLYMPIC PRINTERS INC.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457 -0411
ELECTRICAL PERMIT
TEMPORARY SERVICE
PERMANENT SERVICE
NEW CONSTRUCTION
REMODEL
ADD /ALTER CIRCUITS
SERVICE UPGRADE /REPAIR
Al) t
PERMIT NO. 14,2,7/
DATE 7 6 /7 i 7
OVERHEAD SERVICE
UNDERGROUND SERVICE
VOLTAGE
SINGLE PHASE
THREE PHASE
SERVICE SIZE AMPS
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Permit Fee
PINK Top: Eng, Bottom, Customer GREEN Top: Meter Dept., Bottom: City Hall
Site Address: l ,/v
G wf
n
G /���n
1 O C
c READY FOR
INSPECTION
License Number:
XW ILL CALL FOR
INSPECTION
Phone:
Installed By: n I
l}xi� L ,S
d i
Owner/Business: k
%V- j
Phone:
Owner /Business Address:
Sq. Ft.
f PORT \44 ,,L�.
U4/PW•SellN
IL- CM
d
Residential
Heat KW
Baseboard Furnace /Boiler
Heatpump Other
Commercial /Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
W.S. No. Service
Capacity: O.K. Not O.K.
Ditch inspection O.K.
`gi Rough -in /cover O.K.
4 3 O.K. to connect service
Final O.K.
Site Address:
64 F Lemli
Installer: A
OLYMPIC PRINTERS.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
New Meters
PERMIT NO a4710
DATE SVIQ
New Construction Overhead
Remodel Underground
Service update /alter /repair Voltage
10 3
Add /alter circuits Service size Amps
Auxiliary power Temporary
(list below)
pecial equipment
(list below)
Details /Description:
W/Lt Q c -rj d
Size Date Hold for: Easement Letter
Comments
Signed up for service /meter
Meter Department notified for installation
Fire Department notified of inspection
Plan Review approved /pending
Permit /Receipt No.
c
Date:
Notify the Department of City Light by Street Address and Permi Number when ready for inspection. Wo k
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspector in Vj sting on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
nspectbr Amount paid
WHITE file by address YELLOW file by number PINK Top: Eng, Bottom: Customer GREEN Top: Inspector, Bottom: City Hall
ELECTRICAL PERMIT
CITY OF TORT ANGELES
360 -417 -4735
Application Number , . , . . 15- 00001424 Date 11/05/15
Application pin number 792208
Property Address , , . 105 W 6TH ST
ASSESSOR PARCEh NUMBER: 06-30-00-0-0- 9157- -0000-
Ap.plication type description ELECTRICAL ONLY
Subdivision Name
Property Use . . . . ,
Property Zoning . . , . . , , RESIDENTIAL HIGH DENSITY
Application valuation , . , , 0
Application desc - - - - --
Replace baseboard heat with in wall units
Owner Contractor
FIRST BAPTIST CHURCH SIMPSON ELECTRIC
105 W 6TH ST 243036 W HWY 101
PORT ANGEIES WA 983626034 PORT ANGELES WA 98363
(360) 957 -3313 (.360) 457 -9270
Permit ELECTRICAL ALTER CQMMERCIAL
Additional desc 1 -4 CIRCUITS
Permit. Fee 96.00 Plan Check Fee 00
Issue Rate 11/05/15 valuation , , D
Expiration Date 5/03/16
Qty Unit Charge Per Extension
BASE FEE 86,90
2,00 5.0000 BCH EL -ECH ADIDNT BRANCH CIRCUIT 10.00
Fee summary Charged Paid 'Credited Due
Permit Fee Total 96.00 96,00 .00 ,00
Plan Check Total .00 00 00 .00
Crand Total 95,00 96.00 00 .00
REPORT SALES T
on your excise x form
to the City p ort Angeles
(Loco j n Code 0502)
PERMIT WILL EXPIRE SIX (6) MONTHS FRONT LAST INSPECTION
Signature of owner or Electrical Contra_ ctor X Data
G:IEXCHANGEIB UILDiNG
1
CITY OF FORT ANGELES .PERMIT APPL.T.CATION
I3uil�i>n Divfsion/Elech ical Ipspections
321 East."th Street .- JP,O.1iox 1150/Port Angele.9 Washington, 98362
Ph: (360) 417 -4735 Vnx: (360) 417 -4711
Sate: //-
* Plan Review May Bc
Job Addreas. __,_ --'Q,
8uifding Square Footag •
Rescdpllon of above
X Multi - Family or Comte rcpal*
Electrical Plan Review information Sheet
Owner` formatio ` r
Name: CSC
Mailing d ss:
Phone: State; �/f ZIP:
FaM;
License # I Exp.-
,c�'"� ^+
Ite�r
Service /Feeder 200 Amp,
Servlce/Peeder 201.100 Amp.
SenricWFeeder 401.600 Amp
SenricelFeedor 601 -1000 Amp,
ServlcelFeeder over 1000 Amp,
Branch Circuit WI Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Cirrult
Branch Circuits 1-4
Temp, Service! Feeder 200 Amp,
Temp. SenricWFeeder201 -400 Amp,
Temmp. Ser%ice/Feeder401 -600 Amp.
Temp, Senrice/Fooder 6011000 Amp .
Portal to Portal hourly
Sign /Outlfne Lighting
Signal Circuit! Limited Energy– Multi,Famify
519ml Clmuitl Limited Energy I First 1500 sf – Commercial
Note: $5.00 for sach addfifonat 1500 sf
genewabfe Electrical Energy - SKVA System or Less
Thermostat
Note: $5.00 for each additional T -Stal
11n_lt Gh w
$ 132.00
$ 160,00
$ 225,00
$ 268.00
$ 410,00
$ 5.00
$ 74.00
$ 5.00
$ 86,00
$ 102,00
$ 121,00
$164,00
$185,00
$ 96,00
$ 60,00
$ 64.40
$ 96.00
$113.00
$ 56.00
l I f f
'�k l
I,�l)N .
Contractor information
N9me: �f/f ^ ! a e L
Mailing d s' U ,�,,�,� p
C11y:, State,i.F% lip: Nia, Phone. 7.6 Fax: .
Llr-anse
00 P
To Mu -led b Unit Chafe
$—
Owner as defined by RCVV,19.28,261: (1) Owner will occupy the structure for two years after this electrical $ atal
to hlra an electrical contractor' if above said property is for sale, rent or lease. permit expires after six months o fast inspection, finalized. t ►wrier is required
After reading the Strove statement, I hereby certify that I am the owner of the above named property or a licensed elerctrlcal contra :;tor. I am making
the electrical lnstallalian or alteration incompliance with the eiac#rical laws, N.E,C„ RCW, Chapter 19 „28, WAC. Chapter 296 -4613, The City of Pork
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Sig re of owner electrk —
ica
con ctor or elactdcal administrator: d Cash f� Chetk
` Credit CAN 0 � . �f��,Q✓
0110112012
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360417-4735
Application Number . . . . . 17-00001638 Date 11/07/17
Application pin number . . . 557520
Property Address . . . . . . 105 W 6TH ST
ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -0 -9157 -0000 -
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . .
Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY
Application valuation . . . . 0.
----------------------------------------------------------------------------
Application desc
Wall heater replacement
----------------------------------------------------------------------------
Owner
Contractor
------------------------
FIRST BAPTIST CHURCH
------------------------
SIMPSON 'ELECTRIC
105 W 6TH ST
243036 W HWY 101
PORT ANGELES
WA 983626034
PORT ANGELES
WA 98363
(360) 457-3313
(360) 457-9270
----------------------------------------------------------------------------
Permit . . . . . .
ELECTRICAL ALTER COMMERCIAL
Additional desc
1-4 CIRCUITS
Permit Fee . . . .
146.00
Plan Check Fee
.00
Issue Date . . . .
11/07/17
Valuation
0
Expiration Date . .
5/06/18
Qty Unit Charge
Per
Extension
BASE
FEE
86.00
12.00 5.0000
BCH EL-ECH ADDNT BRANCH CIRCUIT
60.00
Fee summary Charged
----------------------------
Paid Credited
----------
Due
Permit Fee Total
----------
146.00
----------
146.00 .00
.00
Plan Check Total
.00
.00 .00
.00
Grand Total
146.00
146.00 .00
00
INSPECTION TYPE
DITCH
DATE: RESULTS:
SERVICE
ROUGH -IN Z zfZf17 4V
FINAL 11
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical. Contractor X
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Locaifon Code 0502)
INSPECTOR:
Date:
CITY OF PORT ANGELES PERmrr APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street — P.O Boa 1150 / Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711
Date: 11-6-17
,— Multi -Family or Co nmerciar
Plan Review May B'�, Rem plete Eie bxW Flan Review inition shw
Job Address: LJIr=r c sf�f t S` tilt r
Building Square Footage:
Desarptionofabove ���r� a-� i6&!Se46 L)rt(( I4,-aICL4 C,Ij<c ke co,. S
ru 0a-cj d f-4' cV i Y 0, i
Owner information Contractor ktlennallon
Name:
Address l res v t;,-tyj MaimAddress: U a �/U f t 1-1
I state: I LM_ zip: b;L-city state: its~ zip: CJ
0 Fax Phone: - Z)Fex%� b0) 4157- r1�7 0
License #k 1 Exp. l Lbmise 4/ Exp. S Cp
!tent Unit Chame QtV TObd fQty MUNDRed by Unit Charael
ServicelFeeder 2!10 Amp. $132.00 S
ServicelFeeder 201-400 Amp. $160.00 $
Service/Feeder 401-500 Amp $ 225.00 $
ServicelFeeder 601-1000 Amp. $ 288.00 $
Service/Feeder over 1000 Amp. $ 410.00 $
Branch Circuit W/ Service Feder $ 5.00 $
Branch Circe W/O Service Feeder $ 74.00 8
Each Additional Branch Circuit $ 5.00 i 2, $
Branch Ckults 1.4 $ 86.00 -'-( $__
Temp. Service/ Feeder 200 Amp. $102.00 3
Terre. ServicalFeeder 201-400 Amp. $121.00 $
Term. Service/Feeder 401-600 Amp. $164.00 $
Term. Service/Feeder 601-1000 Amp . $185.00 $
Portal to Portal Hourly $ 96.00 $
SigntOutlina Lighting $ 88.00 $
Signal CtraW Laded Energy - Multi -Family $ 64.00 $
Signed Circutil Umited Energy /First 1500 sf — Commardal $ 96.00 $
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy - 5KVA System or Less $113.00 $
Thermostat $ 56.00 $
Note: $5.00 for each additional T-Stat
$�otal
Owner as defined by RCW.19.28.261: (1) Owner wall occupy the structure for two years after this electrical permit is finalized. (2) Owner is required
to hire an el dnCal contractor I above said property is for sale, rent or lease. Permit expm atter six months of last inspection.
After reading the above statement, l hereby certify that I am the owner of the above named property or a licensed electrical contractor. l am malting
the electrical installation or alteration in c ornpliance with the electrical Paws, N.E.C., RCW. Chapter 1928, WAC. Chapter 296468, The City of Port
Angeles WH is o Code, and Utility Speaficatians and PANIC 14.05.050 regarding Bechcal Patau! Applmat ons.
Signature of owner, electrirai L.; or electrical adminMalor: ❑ cash A Chad
creacilrds
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