HomeMy WebLinkAbout604 W 8th St - Building Electical Permit
604 W 8`" St
11 - 715
ELECTRICAL PERMIT 1
CITY OF PORT ANGELES 1
360-417-4735 -(
Application Number . . . . . 11-00000715 Date 7/14/11
Application pin number . . . 650025 REPORT SALES TAX
Property Address . . . . . . 604 W 8TH ST our excise tax form
ASSESSOR PARCEL NUMBER: 06-30-00-0-2-6200-0000- Or! y
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name . . . . . .
Property Use (Location Code 0502)
Property Zoning . . . . . . COMMERCIAL NEIGHBORHOOD
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
600 amp service 6 circuits remodel
----------------------------------------------------------------------------
Owner Contractor
MICHAEL L/CARRIE M MILLET BOTERO & SON ELECTRICAL
593 N FIFTH AVE 940 TAMARACK WAY
SEQUIM WA 98382 PORT ANGELES WA 98362
(360) 452-4766
- --------------------- ---------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit pin number . 189043
Permit Fee . . . . 579.90 Plan Check Fee .00
Issue Date . . . . 7/14/11 Valuation . . . . 0
Expiration Date . . 1/10/12
Qty Unit Charge Per Extension
6.00 2.6000 ECH EL-BRANCH CIRCUIT W/FEEDER 15.60
3.00 119.9000 ECH EL-0-200 SRV FEEDER 359.70
1.00 204.6000 ECH EL-401-600 SRV FEEDER204.60
-
Fee summary Charged Paid Credited Due
Permit Fee Total 579.90 579.90 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 579.90 579.90 .00 .00
� v
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE 1
ROUGH-IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:AEXCI-IANGE\BUILDING
RECEIVED
CITY OF PORT ANGELES PERMIT APPLICATIOl\TUL 13 21911
Building Division/Electrical Inspections
321 East Fifth Street—P.Q.Box 1150 /Port Angeles Washington- 98362 ELECTRICAL—
Ph: (360) 417-4735 Fax: (360)417-4711 INSPECTIONS
Da . -`J. ' p IJ
1 &2 Single Family Dwelling —Multi-Family or Commercial* _Commercial Addition /Alteration/Remodel/Repair*
*Plan Review May.Be Required, Please CoIRIete Electrical Plan Review Information Sheet
Job Address: &a� " ) I�
Building Square Footage:
Description of above
Owner Information / Contracto :)e--Tnftion
Name: �� ( n�w.S Name:
: Mailing res :Mailing AcdressuSt�at�e—: :12ZLip'
City: State: Zip: City: �
Z.
Phone: Fax: Phone:E//> i Fax: 4-'!5
License#I Exp. License#I Exp. a �� �-�z s f,
Item Unit-Charge y Total(Qty Multiplied by Unit Charge)
Service/Feeder 200 Amp. $119.90 _ $ -SSS •ZD
Service/Feeder 201-400 Amp. $145.50 $
Service/Feeder 401-600 Amp $204.60 $
Service/Feeder 601-1000 Amp. $262.20 $
Service/Feeder over 10DO 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 $
$ S �Total
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. Permit expires after six months of last inspection.
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,jThe City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owner,electrical contractor,or electrical administrator: VCra.sdit
h ❑ 'check
Card#
x Dated: 011 12010
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 11-00000348 Date 5/02/11
Application pin number . . . 507224
Property Address . . . . . . 604 W 8TH ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-2-6200-0000- F
Tenant nbr, name . . . . MICHAEL/CARRIE MILLET on your state excise fax form
Application type description COMM REMODEL
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . . . . (Location Code 0502)
Property Zoning . . . . . . . COMMERCIAL NEIGHBORHOOD
Application valuation . . . . 20000
----------------------------------------------------------------------------
Application desc
- --ADD A BATHROOM, PATIO, REPLACE EXT STAIRS, ETC
- -- ---------------------------------------------------------------------- EXPIRED
Owner Contractor
------------------------ ------------------------
MICHAEL L/CARRIE M MILLET ANGELES CONSTRUCTION
593 N FIFTH AVE 2535 JAKES RD.
SEQUIM WA 98382 PORT ANGELES WA 98363
(360) 808-2560 (360) 460-6508
-- Structure Information 000 000 ADD BATHROOM, REPLACE EXT STAIRS ETC ---
Construction Type . . . . . TYPE V NON-RATED
Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT - COMMERCIAL
Additional desc . . TEAR OFF & RE-ROOF THE HOUSE
Permit pin number . 184044 .
Permit Fee . . . . 347.75 Plan Check Fee 226.04
Issue Date . . . . 5/02/11 Valuation . . . . 20000
Expiration Date . . 10/29/11
Qty Unit Charge Per Extension
BASE FEE 95.75
18.00 14.0000 THOU BL-2001-25K (14 PER K) 252.00
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Permit . . . . . . MECHANICAL PERMIT
Additional desc . .
Permit pin number . 184051
Permit Fee . . . . 72.05 Plan Check Fee .00
Issue Date . . . . 5/02/11 Valuation . . . . 0
Expiration Date . . 10/29/11
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 7.2500 EA ME-VENT FAN (SINGLE DUCT) 7.25
1.00 14.8000 EA ME-HEATER(SUSP/WALL/FLOOR-MTD) 14.80
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit pin number . 184069F� (�, a—
Permit Fee . . . . 93.00 Plan Check Fee .00
Issue Date . . . . 5/02/11 Valuation . . . . 0
Expiration Date . . 10/29/11
Qty Unit Charge Per Extension
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.
J
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
ok
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 INCONSPICUOUS 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 Pum /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:
Parkin /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
T:Forms/Building Division/Building Permit
CITY OF PORT ANGELES
} DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
0
Page 2
Application Number . . . . . 11-00000348 Date 5/02/11
Application pin number . . . 507224 REPORT SALES TAX
Qty Unit Charge Per Extension on your state excise tax form
BASE FEE 50.00 to the Cit of Port Angeles
3.00 7.0000 EA PL-PLUMBING TRAP 21.00 y y
1.00 7.0000 EA PL-WATER LINE 7.00 (Location Code 0502)
1.00 15.0000 EA PL-SEWER LINE 15.00
----------------------------------------------------------------------------
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
April 22, 2011 3:01:06 PM Brian 417-4708. Electrical
service entrance is low and will be affected negatively by
proposed improvements. Service will need to be raised or JJ
altered and electrical permits to precede any action.
The new proposed parking lot will not be allowed to drain to
the alley. Stormwater run off from parking lot must be
drained to an approved location on site.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE SURCHARGE 4.50
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 512.80 512.80 .00 .00
Plan Check Total 226.04 226.04 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 743.34 743.34 .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/Building Division/Building Permit
9
BUILDING PERMIT INSPECTION RECORD
i
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 INCONSPICUOUS 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 �L
Water Line(Meter to Bldg)
Gas Line
Back Flow/Water FINAL Date Accepted b
AIR SEAL:
Walls C�
Ceiling
FRAMING: S41eaH•�ny �(,(� 'Z Zq-ll
Joists/Girders/Under Floor J
Shear Wall/Hold Downs
Walls/Roof/Ceiling
Drywall(Interior Braced Panel Only)
T-Bar
INSULATION:
Slab
Wall/Floor/Ceiling
MECHANICAL:
Heat Pum /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:
Parkin /Lighting ESA: f
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE �X
Inspection Type Date Accepted By
Electrical 417-4735
Construction- R.W. PW /Engineering 417-4831
Fire 417-4653 n
O
] lannin 417-4750 S
Building 417-4815 IYEAI J
T:Forms/Building Division/Building Permit EXPIRED
CITY OF ORTNGELES
`-
WASH I N G T O N, U. S. A
7�
COMMUNITY & ECONOMIC DEVELOPMENT
April 24, 2012
Michael & Carrie Millet
593 N 51h Avenue
Sequim, WA 98382
RE: Building Permit#11-348
Address: 604 W 8`h Street
Dear Mr. and Mrs. Millet:
This letter is to notify you of the status of the above permit. The permit expired on October 29,
2011. You are welcome to reapply for a permit if you wish to do work in the future, understanding
there will be full permit fees. If you have any questions, please let us know.
Sincerely,
Heather Catuzo
Building Permit Technician
321 E 5`h Street
Port Angeles, WA 98362
hcatuzoa,cityofpa.us
360-417-4817
PROJECT STATUS UPDATE
Permit# � �'�LK �d q w v 55
Date: --j - 19-
I phoned the: Applicant rnl, eft (-ame-z"i i Imo" at M-2-5&8
Property Owner at
Contractor at
(left a phone message, or discussed):
The permit (has expired, or 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.
T:Forms/Building Division/Project Status Update
PREPARED 7/29/11, 14:07:38 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 7/29/11
------------------------------------------------------------------------------------------------
ADDRESS . : 604 W 8TH ST SUBDIV:
TENANT, NBR: MICHAEL/CARRIE MILLET
CONTRACTOR ANGELES CONSTRUCTION PHONE (360) 460-6508
OWNER MICHAEL L/CARRIE M MILLET PHONE (360) 808-2560
PARCEL 06-30-00-0-2-6200-0000-
APPL NUMBER: 11-00000348 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
--------------------------------- -—
PL2 01 7/29/11 L PLUMBING ROUGH-IN TIME: 01:00
July 29, 2011 2:06:27 PM 1pangrle.
DALE 460-6508
ROUGH-IN PLUMBING
AFTERNOON
--------------------- ---------- COMMENTS AND NOTES --------------------------------------
PREPARED 7/29/11, 8:37:31 INSPECTION TICKET PAGE 8
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 7/29/11
------------------------------------------------------------------------------------------------
ADDRESS : 604 W 8TH ST SUBDIV:
TENANT, NBR: MICHAEL/CARRIE MILLET
CONTRACTOR ANGELES CONSTRUCTION PHONE (360) 460-6508
OWNER MICHAEL L/CARRIE M MILLET PHONE (360) 808-2560
PARCEL 06-30-00-0-2-6200-0000-
APPL NUMBER: 11-00000348 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCTAT•
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-------- -------------------------------—-
BLFO 01 5/19/11 JLL BLDG FOUNDATION TIME: 09:00
5/19/11 AP May 18, 2011 4:58:11 PM 1pangrle.
CARRIE 457-3027
FOUNDATION
MORNING
May 19, 2011 4:48:20 PM jlierly-
BLSH 01 7/29/11 BUILDING SHEATHING TIME: 01:00
0 July 29, 2011 8:36:30 AM 1pangrle.
TI-V DALE 460-6508
SHEATHING
AFTERNOON
-------------------------------------- COMMENTS AND NOTES ------- -----------------------------
�v
PREPARED 5/19/11, 8:17:59 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/19/11
--------------- ----
ADDRESS . : 604 W 8TH ST SUBDIV:
TENANT, NBR: MICHAEL/CARRIE MILLET
CONTRACTOR ANGELES CONSTRUCTION PHONE (360) 460-6508
OWNER MICHAEL L/CARRIE M MILLET PHONE (360) 808-2560
PARCEL 06-30-00-0-2-6200-0000-
APPL NUMBER: 11-00000348 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCTAT•
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-------------- ------------- -------------- ----------------
BLFO 01 5/19/11 JLL l BLDG FOUNDATION TIME: 09:00
May 18, 2011 4:58:11 PM 1pangrle.
CARRIE 457-3027
FOUNDATION
MORNING
-------------------------------------- COMMENTS AND NOTES ------
BUILDING PERMIT APPLICATION Print in ink
' - CITY OF PORT ANGELES
Attn: For City Use Only:Building Permit Technician jPn,
e Received �{--lq-l�
321 E. Fifth St., Port Angeles, WA 98362mit# $
(360)417-4815 fax (360) 417-4711 e Approved
-d
5-
Applicant
N
A licant `
Property Owner _ f
Property Owner's Address /t 5if
Contractor , oa/e, Gose/Icti�r� /=�nry�1 c"U.r�s�w jy Phone
Contractor's Address 2 5-3 5 W, k d Por* l,v 5.e/e5 Lure/
License # 6`001 aur fl'G C9o3op Expires 9j7/,.,
PROJECT ADDRESS (o04 51
Parcel Number Lot Zoning
Project Type & Brief Description: ❑ Residential ❑ Multi-familyCommercial ❑ Industrial
Check all that apply
❑ New Construction go sib S
AAddition �p -No�c� r +'k��IA1cAC' o
Remodel A .1 c1 i; au,,o 8,t Alr e q,�o 16 0,041216
epair
V-Demolition 2 e�n.vvt zpld s tr c,rla Y.1
X,Be-roof ❑ House ❑ garage ❑ other lVe,,., , m.l r ii tear off& re-roof ❑ lay over one layer
❑ Heat System ❑ Heat pump ❑ wood-burning stove ❑ gas fireplace .❑ pellet stove ❑ otherg-;W 4-1,
❑ Other
Floor Areas Existinq(sq. ft.) Proposed(sq. ft.)
Basement @ $ per sq. ft. _ $
1" Floor
2nd Floor
3rd Floor -
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION $ s000
Total footprint of structures a J sq. ft. T Lot size sq. ft. = Lot coverageg %
Site Coverage = the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces.,(see PAMC 17.94.1.35 for exemptions) • dam, r Site coverage .I0
,N ,.. .,v
Max. height of proposed structuresft. Occupancy.group #of bedrooms
Will a lawn sprinkler system be installed? VIV Occupant load #of full baths
Will a fire sprinkler system be installed? 410 Construction type #of half baths
/have read and completed this application and know it to be true and correct. tam authorized to apply for this permit and understand
that it is my responsibility to determine what permits are required,
i
ejquired, and to obtain pernflits prior to working-on pro.ects.
Date -20// Print Name (111j �/`�e, 1 h`1 � I I e,4- Signature
T:Forms/Building Division/Building permit application
J� ,
NOTES
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Clallam County Assessor& Treasurer - Property Details - 58370 MICHAEL L/CARRIE ... Page 1 of 2
Clallam County Assessor& Treasurer
Property Search Results > 58370 MICHAEL L/CARRIE M MILLET for Year 2011 -2012
............ _.._ _ ..w_-----
Account -..Account
Property ID: 58370 Legal Description. LOTS 1&2 BL 262
Geographic ID: 0630000262000000 Agent Code:
Type: Real
Tax Area: 0010-PA 121 PORT ST CNTY H2 L WMP Land Use Code 16
Open Space: N DFL N
Historic Property: N Remodel Property: N
Multi-Family Redevelopment: N
Township: Section:
Range:
Location
.......__. . ........-
Address: 604 W EIGHTH ST MaPsco.
PORT ANGELES,WA
Neighborhood: Cycle 5 Comm Map ID: 2
Neighborhood CD: 20953140
Owner
Name: MICHAEL L/CARRIE M MILLET Owner ID: 41327
Mailing Address: 593 N FIFTH AVE %Ownership: 100.0000000000%
SEQUIM,WA 98382
Exemptions:
Taxes and Assessment Details
Property Tax Information as of 04/19/2011
Amount Due if Paid on: € _ NOTE: If you plan to submit payment on a future date, make sure you enter the date and
click RECALCULATE to obtain the correct total amount due.
_.._... .
m First Second i
Half Half
Base Base
Year Statement ID'Taxing Jurisdiction Amt. Amt. Penalty,Interest;Base Paid Amount Due
2011 153028 ST SCH-STATE SCHOOL $323.70 $323.70 $0.00 $0.00 $0.00 $647.40'
- .... .._ . _ ..
2011 153028 CC GEN COUNTY CLALLAM $178.70 $178.68 $0.00 $0.00 $0.00 $357.38
2011 153028
�....
8 SD#121 SCHOOL DISTRICT#121 $423.13 $423.13 $0.00 $0.00 $0.00 $846.26
2011 153028 CITY PORT ANG-CITY OF PORT ANGELES $412.54 $412.53 $0.00 $0.00 $0.00 $825.07
12011 153028 PORT-PORT OF PORT ANGELES $25.15 $25.15 $0.00 $0.00 $0.00 $50.301
2011 153028 NTH OLY LIB-NORTH OLYMPIC LIBRARY $74.94 $74.94 $0.00 $0.00 $0.00 $149'88!
..
2011 153028 HOSP#2 HOSPITAL#2 $73.36 $73.35 $0.00 $0.00 $0.00 $146.71
12011 153028 WSMET PK DIST-WILLIAM SHORE MET PARK DIST $22.30 $22.29 $0.00 $0.00 $0.00 $44.591
._.... ......... _..
12011 153028 CITY-STORMWATER-CITY STORMWATER $51.32 $51.31 $0.00 $0.00 $0.00 $102.631
_.__. _ _
2011 153028 WEED CONTROL-WEED CONTROL $0.82 $0.81 $0.00 $0.00 $0.00 $1.63
2011 -153028 TOTAL: $1585.96 $1585.89 $0.00 $0.00 $0.00 $3171.85
2010 41319 ST SCH-STATE SCHOOL $330.95 $330.95 $0.00 $0.00 $661.90 $0.001
2010 41319 CC-GEN-COUNTY CLALLAM $176.11 $176.13 $0.00 $0.00 $352.24 $0.001
2010 41319 SD#121 -SCHOOL DISTRICT#121 $428.66 $428.67 $0.00 $0.00 $857.33 $0.00
2010 41319 CITY PORT ANG CITY OF PORT ANGELES $407.78 $407.77 $0.00 $0.00 $815.55 $0.00+
i2010 41319 PORT PORT OF PORT ANGELES $24.76 $24.75 $0.00 $0.00 $49.51 $0.00
2010 41319 NTH OLY LIB-NORTH OLYMPIC LIBRARY $51.18 $51.17 $0.00 $0.00 $102.35 $0.00
......- - -
€2010 41319 HOSP#2-HOSPITAL#2 $72.25 $72.25 $0.00 $0.00 $144.50 $0.00!
i2010 41319 WSMET PK DIST-WILLIAM SHORE MET PARK DIST $22.99 $22.99 $0.00 $0.00 $45.98 $0.00
2010 41319 CITY_STORMWATER-CITY STORMWATER $51.32 $51.31 $0.00 $0.00 $102.63 $0.00
2010 41319 WEED CONTROL-WEED CONTROL $0.82 $0.81 $0.00 $0.00 $1.63 $0.00
2010 41319 TOTAL: $1566.82 $1566.80 $0.00 $0.00 $3133.62 $0.00
_.
Values -
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ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 09 00000801 Date 8/11/09
Application pin number 637654
Property Address 604 W 8TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 2 6200 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning COMMERCIAL NEIGHBORHOOD
Application valuation 0
Application desc
Bathroom remodel
Owner Contractor
MICHAEL L/CARRIE M MILLET JEFF NELSON ELECTRIC
593 N FIFTH AVE 7062 OLD OLYMPIC HWY
SEQUIM WA 98382 PORT ANGELES WA 98362
(369) 460 4291
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc DOUBLE FEE WORK WITHOUT PERMIT
Permit pin number 151423
Permit Fee 115 00 Plan Check Fee 00
Issue Date 8/11/09 Valuation 0
Expiration Date 2/07/10
Qty Unit Charge Per Extension
2 00 57 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 115 00
Fee summary Charged Paid Credited Due
Permit Fee Total 115 00 115 00 00 00 /1
Plan Check Total 00 00 00 00
Grand Total 115 00 115 00 00 00
V
#4 K-rL a 2 6&t-tr2A c-V a fZ D
P40T 60"- f3P�LK
INSPECTION TYPE DATE. RESULTS INSPECTOR.
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS it lit) Q?1
Signature of owner or Electrical Contractor X Date
08/09/2009- 20 07 3605821583 RECEIVED- CAFE PAGE -4'02— I
AUG 10 1009
�y;Poor a�
CM of Po Angeles Permit APP11016on ELECTRICAL C1v/�'fs
B1lWW41F=:
I INSPECTIONS
321 t-PA.Box 1150
Portrr�on,983ti2
Ph:( (960)4174711
Date:
18,z ingle Family Dwelling
—MUlli-F ily or Commercial"
Comm ' I Addition/Alteration/Remodel I Repair'
Plan Rev May Be Required lease Complete lectrital Pl�Revfiiew Information Sheet
Job Addre
Building Sc uare Footage:
Descriptior above ~'
Owner Ink ion Contractor lnforma
me: Name:
Nae c 6/► �'lp G
Na e; Ad Z Mailing Address: 32
City State:lzLY-7jP: 1773Y2— City S� v,.*, State: FI �'z
Zip: rB
Phone: Fax: Phone: � � Fax �
License# Exp. License#r/UP. 9a'�/
nh C d Total Mei ed by Unit rM)
$ 93.75 S ServkalFeeder 200 Amp.
$113.75 f Servioe/Feeder 201400 Amp.
$160.00 f SwAcWFeeder 401.600 Amp.
$205.00 f Servicf•/Feeder 601.1000 Amp.
$291.25 5 Se Mce/Feeder over 1000 Amp.
$ 2.00 $ Branch Clrtut WI Service Feeder
A 57.50 ..L— f s o _Branch Cirarlt W/0 Service Feeder
$ 200 $ Each Add110 W Branch Circuit
S 72.50 $ Temp.Service/Feeder 200 Amp.
f 86.25 $ Temp.Servke/Feeder 201400 Amp.
$116.25 $ Temp.Servhx;/Feeder 401-600 Amp.
$131.25 $ Temp.Ser icelFeeder 601-1000 Amp.
$ 75.00 ! $ Portal to Portal Hourly
169.00 f Sigomine Lighting
$ 75.00 i Signal CircuW Limited Energy Commercial
$ 50.00 f Signal CrrcuPJ LYttlted Energy 1&2 Famtj Dwelling
150.00 $ Signal CWctW Lsdted Energy MW&Family Dwellln9
n
$ 93.75 $ Marwfactured Nome Corutettio
$ 80.00 f Renewable Elecmcal Energy 5KVA System a Less
$ 86.25 f First 1300 Square Ft
$ 27.50 E Each Additional 500 Square Ft ex Portion of
$ 57.50 $ Each oulblAding or Detached Garage
S 86.25 S Each Swimming Pool or Hot Tub
$ 43.75 $ Thermostat
$ told
A►rteras byRCNC1928.Mj.(.)Owren WD=Vydesl UChnforIMY#rsoAe,renlselbC&*WjPermRisl�iMNsed WOrr�erfsregiuisdmnlnesr►
olecaic:l nabd, 5"FoloorvisfarsMl nworkma.
After mW so the above tlabmaet.I h9mbY ardFy the 1 am the owner o1 the above ntmd property or a Ibsrrsed aboblcal arrb>tctor.l oat araldrlg fM aMcoilcal
Iftstallsib I ar aMsrMion In oompitance alth do electrical lows.N.E.C,,RCW.Chapter 19.28,WAC.Chapter 2M W,The City o1 Port AnOM Munklpal Coda,and
UdMy 8"Wkstlons.
Mondure owmer,dectrkat contractor of eleaul el dmMMlrelor ❑ cub
0 Chock
�� o �-ctaatC.rd.
All
P 'T ,. NGELA
FORt E
W A S H I N <G T 0 N, U S A
FAX TRANSMITTAL
Department of Public Works/Utilities
321 East Fifth Street, Port Angeles Washington
Phone (360) 417-4735 FAX. .(3 6 0) 417-4711
TO FROM
COMPANY IcTrzl LP
�QRTAIVGELES
WASHINGTON, U S.A.
FAX#- 6 gL4 75q Public Works&Utilities Department
NUMBER OF PAGES INCLUDING
COVER. Trent Peppard
Senior Electrical Inspector/Traffic Signal Technician
Phone: 360-417-4735
Email tpeppard@cityofpa.us
Website: www.cityotpa.us Fax: 360-417-4711
321 East Fifth Street P O.Box 1150 Port Angeles,WA 98362-0217
I)AY
60 S U LLt>lrl 1, D4-� F A VT M K-k T
LJILL
L'oc'M in.;-1 IT -f-0 mv To 170.Tw-iZ)A 14w-r—P
17
CrI'Y OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION
v 321 EAST 57H STREET, PORT ANGELES;-WA 98362
'4Rcvrd�
Application. Number 03_00001119 Date_ 11/21/03
Property Address . . 604 W 8TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-2-62000000
Application description MECHANICAL ADPL . PERMIT
Subdivision Name . . .
11 Property Zoning . . . . . . . COMMERCIAL NEIGHBORHOOD
-Application valuation 500
Owner Contractor
------------------------ - -
MICHAEL L/CARRIB M MILLET BILL KEITH CONST.
593 N FIFTH AVE 150 CLIFF ROBINSON IN
BEQUIIM WA 98382 SEQUIM WA-98382 rl
(360) 68378337
Permit • MECHANICAL PERMIT
Additionaldose PROPANE COOK STOVE
Permit Fee 57.65 Plan Check Fee . .00
Issue Date 11/21/03 Valuation . 0 "!
Expiration Date . 5/20/04
Qty unit Charge Per Extension
BASE FEE 47.00
1.00 10.6500 ECH ME-GAS PIPE 1 TO 5 10.65
Fee summary Charged Paid Credited Due
----- - --------- ---------- - --- ------ -----
Permit Fee Total 57.65 57.65 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 57.65 57.65 .00 .00
Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements.Th1s perm t becomes
null andvoid'If work or construction authorized is not commenced within 180 days,if construction or work s suspehded or abandoned
for a period of 180 days after the work as commenced;or if required inspections have not been requested within 181)flays from'the last
inspection, I hereby certify that I have read and examined,this application and know the same to be true and correct. alt provisions;of
laws and ordinances governing this type of work will,bercomplied'with whether specified herein or not. The granting of a permif does,not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the perforrrlance of
construction:
l
�VtUrj;_OfrContlractor or Authorized Agent Date Signature of Owner(if owner is builder) Date
TAPLAWNWORMS'11102.15 i11/1412003]
ti
� a
i
BUILDING PERMT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS.CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVE$INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED,` COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT:#
ROUGH-IN
PLUMBING
UNDERFLOOR/SLAB
ROUGH-IN
M- WATER LINE(METER TO BLDG)
GAS LINE
BACK FLOW/WATER
AIR SEAL
_ WALLS
CEILING
FRAMING
JOISTS/ GIRDERS
SHEAR WALLIHOLD DOWNS
WALLS/ROOF/CEILING
DRYWALL(INTERIOR BRACED PANEL ONLY)
T BAR
INSULATION
SLAB
WALL/FLOOR/CEILING
MECHANICAL
HEAT PUMP - `^
GAS LINE a L 1.. �N l^i714.►aC t1N'�'
WOOD STOVE/PELLET J 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 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.
BUII bING 4174815 BUILDING
T:IPLANNINGWORMS11102.15111/14/20031
PREPARED 11/24/03, 12:49:27 INSPECTION TICKET PAGE 8
CITY OF PORT ANGELES INSPECTOR ROGER VESS DATE 11/24/03
----------------------------------------------------------------------------`-
ADDRESS . : 604 W STH ST SUBDIV:
CONTRACTOR :BILL KEITH CONST. PHONE (360) 683-8337
OWNER MICHAEL L/CARRIE M MILLET PHONE
PARCEL : 06-30-00-0-2-6200-0000-
APPL NUMBER: 03-00001119 MECHANICAL APPL. PERMIT
-----------------------------------------------------------------------------
PERMIT:. ME -00 MECHANICAL PERMIT
REQUESTED INSP: .DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------- - --------------------------
ME6 01 11/24/03 V MECHANICAL GAS LINE -
propane line
Doc 808-5644 tues 25th
-------------------------------------- COMMENTS AND NOTES
PREPARED 11/26/03, 12:51:23. INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR ROGER VESS DATE 11/26/03
--------------------------------— ------------------------------
ADDRESS 604 W 8TH ST SUBDIV:
CONTRACTOR BILL KEITH CONST. PHONE (360) 683-8337
OWNER MICHAEL L/CARRIE M MILLET PHONE
PARCEL 06-30-00-0-2-6200-0000-
APPLNUMBER: 03-00001119 MECHANICAL APPL. PERMIT
------------------------------------------------------------------------------------------------
.PERMIT: HE 00MECHANICALPERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------ -----------
ME6 01 11/26/03 RV / MECHANICAL GAS LINE
propane line
Doc 808-5644 wed 26th
-------------------------------------- COMMENTS AND NOTES
---------------------------
�d S/ ►�C.�Grc� �-o a v� �7C�-� n
PREPARED 12/08/03,- 12:49:06 INSPECTION TICKET PAGE 8
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 12/08/03
--- - `----- - ------- ------ ------.--
ADDRESS . : 604 W 8TH ST SUBDIV: -
CONTRACTOR BILL KEITH CONST. PHONE X360) 683-8337
OWNER MICHAEL L/CARRIE M MILLET PHONE
PARCEL .. 06.-30-00-0-2-6200-0000
APPL.NUMBER: 03-00001119 .MECHANICAL APPL. PERMIT
---- --- - - - ------ --- -----. -
PERMIT: ME 00 MECHANICAL PERMIT`
REQUESTED INSP 'DESCRIPTION - -
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS - - - -
-------------------------------------------------------------------------- ---------------
ME6 01 11/26/03 RV MECHANICAL GAS LINE
11/26/03 AP propane line
Doc 808-5644 wed 26th
ME99 01 12/08/03 JL MECHANICAL FINAL
Call before you go
808-5644
-------------------------- -----------:COMMENTS AND NOTES --------------------------------------
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION
t� 321 EAST 5TH STREET, PORT ANGELES,WA 98362
WN
Application Number . . . . . 04-00001168 Date 12/15/04
Pin number . . . .2. .
Property Address 604 W 8TH ST l//./✓//� (//t///
ASSESSOR PARCEL NUMBER: 06-30-00-0-2-6200-0000-
Application description . . . PLUMBING REPAIR
Subdivision Name . . . . . .
Property Use . . . . . . ^
Property Zoning COMMERCIAL NEIGHBORHOOD
Application valuation . . . . 3000
Owner Contractor
________________________ ____________________-___
MICHAEL L/CARRIE M MILLET SANFORD IRRIGATION
593 N FIFTH AVE PO BOX 2246
SEQUIM WA 98382 SEQUIM WA 98382
(360) 683-9807
_____________________ _-___ __-___________
Permit . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 54.00 Plan Check Fee .00
Issue Date . . . . 12/15/04 Valuation . . . . 0
Expiration Date 6/14/05 ..
Qty Unit Charge Per Extension
BASE FEE 47.00
1.00 7.0000 ECH PL- EA LAWN BACKFLOW 7.00
Fee summary Charged Paid Credited Due �\
Permit Fee Total 54.00 54.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 54.00 54.00 .00 .00
Co
v
Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned
for a period of 180 days after the work 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
const on. /
e ` Yr
Signature of Contractor or Authorized Agent Date Signature of Owner(if owner is builder) Date
T:\PLANNING\FORMS\1102.15[11/14/2003)
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION
v 321 EAST 5TH STREET, PORT ANGELES,WA 98362
Application Number . . . . . 04-00001168 Date 12/15/04
Pin number . . . . . . .249088
Property Address . . . . . . 604 W 8TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-2-6200-0000-
Application description . . . PLUMBING REPAIR
Subdivision Name . . . . . .
Property Use • • • • ' ' ' G381dX3
Property Zoning COMMERCIAL NEIGHBORHOOD
Application valuation . . . . 3000
Owner Contractor
-- ------------------
MICHAEL L/CARRIE M MILLET SANFORD IRRIGATION
593 N FIFTH AVE PO BOX 2246
SEQUIM WA 98382 SEQUIM WA 98382 �/t Z/t�
(360) 683-9807
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 54.00 Plan Check Fee .00
Issue Date . . . . 12/15/04 valuation . . . . 0
Expiration Date . . 6/14/05
Qty Unit Charge Per Extension
BASE FEE 47.00
1.00 7.0000 ECH PL- EA LAWN BACKFLOW 7.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 54.00 54.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 54.00 54.00 .00 .00
Dl
vt
fl
Separate Permits are required forelectrical 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
const 'on. /
Signature of Contractor or Authorized Agent Date Signature of Owner(if owner is builder) Date
T:\PLANNING\FORMS\1102.15[11/14/2003]
OF PORT'14c
�•�,mm CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362 /
c rt (206) 457-0411 PERMIT NO. 7�(�
ELECTRICAL PERMIT DATE—
Site Address: Y4, ❑ READY FOR WILL CALL FOR
O INSPECTION INSPECTION
Installed By: / r'. f License Number. Phone:
Owner/Business: Phone:
Owner/Business Address: Sq. Ft.
❑ RESIDENTIAL ❑ TEMPORARY SERVICE 1!07 ERVICE
❑ COMMERCIAL ❑ PERMANENT SERVICE ND SERVICE
❑ BASEBOARD KW ❑ NEW CONSTRUCTION
❑ FURNACE KW ❑ REMODEL E❑ FAN/WALL KW ❑ ADD/ALTER CIRCUIT❑ HEAT PUMP KW ❑ SERVICE UPGRAD EPAIRAMPS
❑ SIGN SPECIAL EQUIP EN
(LIST BELOW)
Detai Is/Description:
s J
W.S. No. SEVICE S E DATE ENGR.
CAPACITY:
El OX NOT O.K.
ACTION REQUIRED: 71CHANGE RANSFORMER ❑ CHANGE SERVICE WIRE
❑ INSTALL SERVICE POLE [] OTHER
❑ Ditch Inspection O.K.
❑ Rough-in/cover O.K.
❑ O.K. to connect service
❑ Final O.K.
Site Address: Permit/Receipt No
� 7 �
Installer: New Meters Date:
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. /// B�
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ��
Electrical Inspector Permit Fee
WHITE—File by address YELLOW—file by number PINK—Top:Eng,Bottom,Customer GREEN—Top:Meter Dept.,Bottom:City Hall
OLYMPIC PRINTERS INC.
of Poar 4Nc
CITY OF PORT ANGELES i (1 LIGHT DEPARTMENT PERMITNO. �C>//
c,T ELECTRICAL PERMIT DATE410
��/ 9�
Site Address: ❑ READY FOR ?,IWILL CALL FOR
INSPECTION INSPECTION
Installed By: License Number: Phone:
Owner/Business: Phone:
Owner/Business Address: Sq. Ft.
Y Residential ❑ New Construction 'l <Overhead
Heat KW ❑ Remodel ❑ Undergroy�d L��
El Baseboard ❑ Furnace/Boiler .Service updatelalter/repair Voltage CG��
❑ Heatpump ❑ Other Y� �10 EJ 30
LlCommercial/Industrial load ryrAdd/alter circuits Service size --2d�-70 Amps
Total Connected load ❑ Auxiliary power ❑ Temporary
(attach breakdown) (list below)
Total Motor load ❑ Special equipment
(attach breakdown) (list below)
Details/Description:
W.S. No. Service Size-Date-Hold for: ❑ Easement ❑ Letter
Capacity: ❑ O.K. ❑ Not O.K. Comments
❑ Ditch inspection O.K. ❑ Signed up for service/meter
❑ Rough-in/cover O.K. ❑ Meter Department notified for installation
❑ O.K. to connect service ❑ Fire Department notified of inspection
Final O.K. ❑ Plan Review approved/pending
Site Address: ('1_0 C� o.
Permit/Receipt N
�,
Installer: New Meters Date:
Notify the Department of City Lht b reet Address and Permit Number when ready for inspection. Work
must not be covered or electrica ly an gized before inspection and O.K. for covering or service has been given
by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT.224.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT / O
Inspector A ount paid
WHITE—file by address YELLOW—file by number PINK—Top:Eng,Bottom:Customer GREEN—Top:Inspector,Bottom:City Hall
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date Time Received by (phone, person)
Location of Work to be inspected Cool-I .1 CQ«I w. �h
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excay. O� �moi-{- --
INSPECTION NOTES:
`Inspected: Date 10 25_-0_1 Time °C10 �"I By —7 t a-
1,lerparks:ffixAy-d (-IXAAeC : ' ✓ rf41 dh (10r+1't
DM CL/-) DM � � 8� 5� tomo y Cl0.Cka ayi� PrP=c�"
RESTORATION REQUIRED . . . . . . YES NO__ �J
13 s
"r �y
(noU W. +" L
SURFACE RESTORATION:
SURFACE TYPE: ❑ Unimproved ❑Gravel ❑Asphalt ❑PCC ❑Other
❑Repaired by City Work Order # M/—/— Do g
❑Repaired by Permittee ❑ COMPLETE
❑No Damage Found ❑ INCOMPLETE
(Continue on reverse side if necessary) CTRFFT R1 IPFRINTFIur1F1UT MATOV