HomeMy WebLinkAbout320 E 11th St - Building "54;,, CITY OF PORT ANGELES
1 DEPARTMENT OF COMMUNITY R. ECONOMIC DEVELOPMENT BUILDING DIVISION
tr 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00001410 Date 12/19/11
Application pin number 342970
Property Address 320 E 11TH ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-3- 4120 -0000-
Application type description MECHANICAL APPL. PERMIT on your state excise tax form
Subdivision Us e i Name
Pro to the City of Port Angeles
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation 0
Application desc
heat pump HVAC
Owner Contractor
ALL WEATHER HTG COOLING INC
320 E 11TH ST 302 KEMP ST
PORT ANGELES WA 983627932 PORT ANGELES WA 98362
(360) 452 -9813
Permit MECHANICAL PERMIT
Additional desc HVAC HEAT PUMP
Permit Fee 64.80 Plan Check Fee .00
Issue Date 12/19/11 Valuation 0
Expiration Date 6/16/12 ra 9) C 1
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 14.8000 EA ME- FURN /HP /FAU OR 5 TON 14.80
Fee summary Charged Paid Credited Due
Permit Fee Total 64.80 64.80 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 64.80 64.80 .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.
/46/g C. 'ea. j
Date Print Name Signature VContractor or Authi /Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE. PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 4174735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line'
Wood Stove Pellet Chimney I
Commercial Hood Ducts FINAL Date (.01g4 1 1'epted by ja--
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting 1
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 C)
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
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CITY of k ORT A NGELES
W A S H I N G T O N U. S. A
TI
COMMUNITY ECONOMIC DEVELOPMENT
June 18, 2012
Tyson Kristine Henry
320 E 11 t Street
Port Angeles, WA 98362
RE: Expired Building Permit #11-1410
Dear Mr. and Mrs. Henry:
I am writing this letter to inform you of the status of the above permit. The permit expired on June
16, 2012. If the work has been finished, please call to have the work inspected. If we haven't
performed the inspection by July 6, 2012, we will close the permit entirely. After that time, you
may request an inspection and pay a one -time inspection fee. If you have any questions', do not
hesitate to contact us.
Sincerely,
Nak,u_ gti
Heather Catuzo
Building Permit Technician
321 E 5 Street
Port Angeles, WA 98362
hcatuzo@cityofpa.us
360 417 -4817
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PROJECT STATUS UPDATE
1' WO
E l
Permit
Date: 1p\I Va
1 phoned the: Applicant AU \N? kft at 45'). 9gI3
Property Owner at
Contractor at
I (left a phone message, or discussed):
The permit (has expired, o ill expire soo What is the status of this project?
Please call and schedule a final inspection.
Or
Submit a "permit extension requesfTetter.
Or
Let me know if the project is abandoned.
T:Forms /Building Division/Project Status Update
BUILDING PLUMBING /MECHANICAL PERMIT APPLICATION SHORT FORM
(To be used for projects that do not require plan review.)
Date Received [2_4i42 1,,l
Permit i,L —14 0
City of Port Angeles Please print In Ink, Date Approved t- --t.
Attn: Building Permit Technician Approved by -::3
321 E. 6 St, Port Angeles, WA 98362
360 -417 -4815 fax: 360 417 -4711 Credit card payments are accepted Mon -Fri 8 -5 pm (no American Express)
Hours: Mon through Fri 8 5 pm Cash checks are accepted Mon -Thurs 8:30.4 pm Fri 8:30 -12:30 pm
MactilEW 1-11,6-19 Ceotiiri P AZ t-F)291W.')
IL
Property5n mailin -MKT;
J '"em for+ ioft 9(3 2
Contractors business narne:All Weather Heating Cooling P hone: (360) 452 -9813
(or property owners name if he /she Is doing /overseeing the work)
Contractor's mailing address: 302 Kemp Street
Contractor's L &I license number ?.LLWEHC150KU Expiration date:
5/01/12
Project Address; 0 tea 11-'1)
Project Typ Residential o Commercial o Industrial aMulti- family
Project Business Name
(for commercial, industrial, or multi- family protects)
The following permits are usually issued over the counter Immediately, without the need for plan review,
Complete only the portions of this permit that are relevant to your project,
Re -roof: house o garage other
c tear off re -roof u lay over one layer
(1) Licensed contractor: Submit a copy of your re-roof bid,
Project Valuation (labor materials, not including sales tax)
Ro- side:. C house c garage c other
Project Valuation y (labor materials, not including sales tax)
Repair (explain the project)
Project Valuation
*Homeowner: If you will be doing overseeing the work, then the project valuation will be determined by doubling the
cost of materials, to reflect the value the repair adds to your property,
Cost of materials x 2 Project Valuation
T :Forme /Building Division /Building/ Plumbing /Mechanical PerniitApplication -Short Form (Revised 2011)
Page 1 of 2
60/b9 39'71d 9NI1'•✓3H c13H1v3M 11V LLIGZSb99£T 6£ :91 TT9Z /ST /ZI
Swimming Pool or Spa (z 24" deep): For prefabricated swimming pool or spa projects that
dq,iot regyim Dien review.'
Obtain the City of PA handout entitled "Pools a Spas" follow the requirements.
Project Valuation
Demolition: A demolition permit Is needed when an entire building gets demolished,
What Will be demolished? ,o house o garage cr other
Note: some demolition permit applications need to be reviewed by verious City departments, and may take
approximately two weeks to obtain.
Agree to ensure that all utilities are /will be properly turned off (and capped off If needed)
prior to demolition,
Obtain (from the City of PA) an aerial view map of the parcel and put an "x" over the structure(s) to
be demolished. Submit the map with this application.
Obtain (front the City of PA) a copy of the Olympic Region Clean Air Agency (ORCAA)
Demolition Permit Application.
Contact ORCAA at 360- 417 -1466 to discuss whether or not an ORCAA Demolition Permit will also
be needed.
d yes o no Will the debris be going to the Regional Transfer Station in Port Angeles?
o yes No If yes, will a licensed contractor be taking it there?
If yes, obtain (from the City of PA) a copy of the Waste Disposal Application.
Complete and submit the waste disposal application to the Building Permit Technician, now
(or later If asbestos testing Is needed),
Plumbing Permit: (explain the project)
Project Valuation
IVlechanical Permit: 'explain the nroiect)
Installation of Heat Pump 1
Project Valuation
I have read and completed this application and know it to be true and correct, I am authorized to apply for this permit
and understand that It is my responsibility t• ternine what permits are required, and to obtain penults prior to
working on profec s �1,�
Date. i I i !6i Signature 40 V�
Print Name n\ Sm 1.
Page 2 of 2
60/S0 39vd 9NIlv3H a3HJVBM 11V LLTSZSb0SEI 66:9T TTO-6/ST /-6T
ELECTRICAL PERMIT 1'
CITY OF PORT ANGELES
360- 417 -4735 Ct
Application Number 11'00001407 Date 12/16/11
Application pin number 710926 REPORT SALES TAX
Property Address 320 E 11TH ST
ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -3- 4120 -0000- on your excise tax form
Application type description ELECTRICAL ONLY to the City Of Port Angeles
Subdivision Name
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
T -stat no load change
Owner Contractor
HENDRY CHRISTOPHER J ALL WEATHER HTG COOLING INC
320 E 11TH ST 302 KEMP ST
PORT ANGELES WA 983627932 PORT ANGELES WA 98362
(360) .452 -9813
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit Fee 56.00 Plan Check Fee .00
Issue Date 12/16/11 Valuation 0
Expiration Date 6/13/12 v
Qty Unit Charge Per Extension O
1.00 56.0000 ECH EL -LVT- THERMOSTAT 56.00
Special Notes and Comments
December 16, 2011 9:12:56 AM tamiot.
Transformer loading looks fine.
Fee summary Charged Paid Credited Due
Permit Fee Total 56.00 56.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 56.00 56.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH IN p� 4
FINAL 2
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X 1- Date:
G: \EXCHANGE' \BUILDING
oF pOR74 �'F EJECTRIC,4 L INSPECTION
11-1Ai i a EPORT
417 -4735
ck"oRKS yS�
DATE: 4 INSPECTOR
OWE ZZ /G -11107 �17
CONTRACTOR
ADDRESS
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
CORRECTIONS NEEDED: glrLQ LA ®'hZ
L>5 1F-- t ri Czb -A.r GDS,
NOTIFY INSPECTO,', WHEN CORRECTIONS
RE COMPLETE WITHIN 15 DAYS
Di NOT F E OVE
d Y
J
L11, gE CITY OF PORT ANGELES PERMIT APPLICATION DEC 1 6 201 i r <--E, Building Division /Electrical Inspections
„,,,:s;,: Q
321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362-
CEC 1 RICAL
Ph: (360) 417-4735 Fax: (360) 417 -4711 INSPECTIONS
Da e: 12 IL-t) I
1 2 Single Family Dwelling Multi Family or Commercial* Commercial Addition Alteration Remodel Repair'
Plan Rev] B- 'e• Ir P ase Co pie Electrical Plan 'ev'ew Ir orma �e
Job Address: 7.46 a. G ise.t Pr r
Building Square Footage: ie
Description of above
Owne for r at on Cont ctor n o ation
Name: S ic l :AI Name i t 1 L.: E
MaiiingAddress: raZCiiatf” 'NI Mailing A. dress: 4V_ 7:4. KUL!
City State: Zip: t:"rr►.r City: Slate: ZI.: °RH&
Phone: eiii• ti i Fax: Phone ,1J:1 Fax 'rirf.
License Exp, License #I Ex. V111,11f r lt2.'12:9 '1U1 IZ
km Unit Charge 2yt Total (Qtv Multiplied by Unit Charge]
ServicelFeeder 200 Amp. $119.90
Service /Feeder 201 -400 Amp. 145.50
ServicelFeeder 401.600 Amp 204.60
ServicelFeeder 601 -1000 Amp. 262.20
Service/Feeder over 1000 Amp. 372.50
Branch Circuit W/ Service Feeder 2.60
Branch Circuit W/0 Service Feeder 73.50
Each Additional Branch Circuit 2.60
Temp. Service/ Feeder 200 Amp. 92.70
Temp. ServicelFeeder 201 -400 Amp. 110.30
Temp. Service /Feeder 401.600 Amp. 148.70
Temp. ServicelFeeder 601.1000 Amp 167.90
Portal to Portal Hourly 95.90
Sign /Outline Lighting 88.20
Signal Circuit/ Limited Energy I 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 Clrcult/ Limited Energy Multi Family Dwelling 63.90
Manufactured Home Connection 119,90
Renewable Electrical Energy 5KVA System or Less 102.30
Thermostat 56.00 —1
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 Mot Tub 110.30
g 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, The 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: cash Check
1 Credit Card ft
J Oated: III I 01/0112010
60;E0 39Vd 9NIIC3H d3H1V3M 1 LLTSZSb99ET 6E:91 TT9G /ST /GT
Application Number 08 00001438
Application pin number 645656
Property Address 320 E 11TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 3 4120 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
200 amp service change
Owner Contractor
HENDRY CHRISTOPHER J
320 E 11TH ST
PORT ANGELES
WA 983627932
ANGELES ELECTRIC
524 E 1ST ST
PORT ANGELES
(360) 452 9264
Date 11/14/08
WA 98362
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 137844
Permit Fee 64 00 Plan Check Fee 00
Issue Date 11/14/08 Valuation 0
Expiration Date 5/13/09
Qty Unit Charge Per Extension
1 00 64 0000 ECH EL R OR RM 0 200 ALT SRV FDR 64 00
Fee summary Charged Paid Credited Due
Permit Fee Total 64 00 64 00 00 00
Plan Check Total 00 00 00 00
Grand Total 64 00 64 00 00 00
[NSPECTIO1\
TYPE
DITCH
SERVICE
ROUGH III
AL
COMMI
TS:
EL F C TRI CAL
DATA; RESULTS INSPECTOR
11,1q.0.0
'(I
"'l..;"
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:l2\ EAST 5TH STREET. PORT ANGELES. W A 98]62
Appllcatlon Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05 00000492 Date
451068
320 E 11TH ST
06-30-00-0-3-4120-0000-
ELECTRICAL ONLY
6/20105
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
HENDRY CHRISTOPHER J
320 E 11 TH ST
PORT ANGELES WA 983627932
SIMPSON ELECTRIC
.243036 W HWY 101
PORT ANGELES
(360) 457-9270
WA 98363
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin nurr~er
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
SIMPSONI ALTER SVC.
52274
SIMPSON ELECTRIC
66.90 Plan Check Fee
6/20105 Valuation
12/17/05
.00
o
Qty
1. 00
Unit Charge Per
66.9000 ECH EL-R OR RM 0-200 ALT SRV FDR
Extension
66.90
VJ
).;
C)
----------------------------------------------------------------------------
Fee summary Charged Paid Crediled Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 66.90 66.90 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 66.90 66.90 .00 .00
IV-
~
V1
'"'
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECT.ION RECORD
CALL 417~735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER.
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
DATE
COMMENTS
NO
GENERAL COMMENTS:
PW-II02.1) (4196)
CITY OF PORT ANGELES
DEPARTMENT OFCO~Df::vELOPlvffiNT -BUILDINGDNIS10N
. 321 EASt 5TH STRE13T, PORT ANGELES, WA98362 .
&<
BU1UJING PERMIT
'.,","
PERMIT NO:
ISSOED5;10/15/2002
PROP~~;rvL6cATION
'326 11TH ST E
',',..' ,no, "
Lot: 5
Block: 341
. Subdivision:. TPA
Parcel No: 063000034120000
13781
-,:, '- "-',;,
OWNER/APPLICANT
. CHRIS HENDRY
320 E 11TH STREET
Port Angeles, W A 98362
360/000-0000
T:
D Long L~gal.
S:
ARCHIteCT
> .".-:'c"':..... __, .",,~ '. h
CN/A
, 9a~60-o000
360/000-0600
CONTRACTOR
DAVES HEATING & COOLING SERVICE I
991 FRESHWATER PARK,RD. .
PORT ANGELES, W A 98362-0000
360/928-0245
PROJECT INFO
Project Value: $5,000.00
Project Type: HEAT PUMP ADD
Occupancy Type: RESIDENTIAL
Occl1psl'lcy Group:
Construction Type:
Zoning Use:
:. ';:~~I
SFDUnits:
SFDSa FT:
o
o
Commereial:~- 0
o
o
Industrial:
Garage:
MFU Uhits:
MFD sa FT:
o
o
PROJECT NOTES
ADD HEAT PUMP & LOW VOL TAGETHERMOSTAT
RECEIPT#9816
FEES ASSESSMENT
Building Permit
Plan CheCk:
StateSureharge:. .
House Moving:
Manufactured Home:
Sign:
'Plumbing:
Mechanical:
Radon:
Mise Fee 1: THERMOSTAT
Mise Fee 2:
Misc Fee 3:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$34.15
$0.00
$35.30
$0.00
$0.00'
$69.45
$69.45
$0.00
TOTAL FEE:
AMPUNT PAIQ:
BALANCE DUE:
Separate Permits are required for electrical work, SEPA, Sho~lIri~i;'ES~i utilith3s'IJrlvate and public Improvements.~1ll'
null and )':oJd if work or construction authorized is notcomme.~~ed \Vithin 18p days, .if consb}lction orw.ork Jssti ....
fot.ap,eJjCl(t9f'80d~Y!.~ftetthe wqrk ~~C()mmElllced~()r if r4!~9~~e~JI'!!~!5!I()Il~.h~ve not ~~en requestedwith!n;!!,O;
Inspection.. I hereby certify that I have read and examined thls'appllcationandknow the same to be true andcdffe~ .' ,.
laws and ordinances goveming this type of work will. be complied with whether specified herein or not The .grantingofa ~ it does nO.t
presume to give authority to violate or cancel the provisions of any state or local law regulating construction 0'1" me - p~ifoliilance of
rtJJ~ aUL? /Q/ir;Iz. . ..
Signature ,of Contractor or Authorized Agent Date SIgnature of Owner (if owner is bullder)-
T:\PLANNING\FORMS\II02.1 S [412002]
.' <""~4" ",~,:,:"-"',~1 c'"
.;-t:.::r~:;:~-;~:!~
. ,-" .... -""."..~
. .. .
BUlLDIN,(lPERMIT.INSP~CTJON RECORD:.';;f~t,
f'/ _ ' '~l\~~":, ,"-'~>/l'f':;' '~--~.~(:; ,; ,/:_<r ,:.._.:.--'+'~ _I_,~: ,', .__;!~.-.',,~ti'~~rt~::~'-..'
CALL 417-4815 FOR BUILDING IN~PECTIONS,.t;P.!tgAS~;PRpVIDE, AMINI~:QM~4'JIOUR NO'flCE. 'iT IS UNLAWEpL''fO:~Q.VlJ.!J,'
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A ~ONSPICUOUS,U)O\.TIpIl{::
. . ,
~-.
KEEP PERMI,~J\RQ,AND APfROVEO PLANS AT JOB SITE
"-;:;:'~.","
;'C'}':~.~~i~fs,
,..>
.
INSPECTION TYPE
bATE; "11 ACCEPTED
c r. h'i I'"", YES NO ".
,.",
:
COMMENTs' .:~',:
i..,
, ,
FOUNDATION:
~
,
FOOTINGS ".'J. ....
WALLS '_
FOUNDATION DRAINAGE " : '('i ,,' "'F'
ELE~ICAL _., (LIOHTJ:)J;Pl) sE1>MA:rnrERMlT: #
ROUGH-IN .'1 ,'.
PLUMBING . ...,'.
I
:".. '.
t_ '.'
.
c
, - ~
: ,1,1 .
I ,~
,':J ., ^. ,~;
"
.
" ,"
.:(;.
:~):~
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
,:, :i,':H,i,
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PW UTILITIES.' SITE WORK '~(Eni;(A~ng Division) SEPARATE PERMIT #'5:
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".d,':FIN~~ 111~!.Eg'ION~ REQUIREI)'P!UO~T<!l?(:91~crPSE .. ,""",;,': "iP' ,+,' I.
,'. DATE YES..' , ~O~,;) ,k,fOM.ME:R(:~ DATE ..,I:,'A~~i!)f' '1\
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417-4653 FIRE DEPT. ! '. " ' ,'.
LANDSCAPING
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CONSTRUCTIONR.W. Nw/
ENGINEERING
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BUILDING
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T:\PLANNING\FORMS\1102.15 (412002)
-
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
-
N?
15461
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Port Angeles, Washlngton........u.............~......m............m............ 1900......
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 ~orlectrical work as listed below.
J;i0 C'lltx
~::::s..::::::(2~;;;::::;:;;~:::::~;:::::::..u~~~~~:::.u~~~~:~.n.c.~::::::::::::::::::::::::::::::::::::::::::::::::
.. ~/e ~;1c Y-'-"",.~k)/
WITlllg Contractor u...oo..moooo~..oouoo.uu...u.............u...uu.....u Byuuoo.mu........mm.....oom................u...moo.u.....
1'/ '.
.. A 'O.;lf -
Light Outletsm.unm___..__..............._______.. Service, volts _.__n'?::...___./........:...~...__ Type of Wiring:
7 '
No. Wl~es ...--1,......iJ..&J5"m-
SIze Wlres..~'trA"''''''''''
Main fuse ....uS.................---------oo
Enclosure ____mm_nm...mm___________._.
Receptacle Outlets__m____................._nn
Dryer, KWI...._n__......_n_____n____n___________
Range, KW umn__m______mn__m_n
Water Heater:
Type of wiring:
Entrance Cable mmnnm__nm.___nm
KW,u'd;;J;S7rDffur.
Heat: It \V .....nnn_n.___nn________..______.....________
Rigid Conduit unmn_____________.____.._.
Motors: size, volts and phase:
Metall1c Tubing ..h__...U________...__.h
Current transformers:
No. & Size___.___.__..______......__..______..__.
Ser. N 0..._..0..__......__...__...___0........_.......
Ser. No.-..__..__.._____.._._.._.____......._._.......
Ser. NO.__________h....___..___._h_________________
Total Load__..._..___..................
Ser. NO...____.....h....___h.__...._____________.__
Remarks: ..~~~..........................m........m............................._............mm................m.............
Armored Cable _.___.____.._________.___..._.
Non-Metallic ..._......______________..__..._.
Knob & Tube_no...._____........____.....___
Rigid Conduit ..__..m..___._....._______h.
Metallic Tubing ._____0..............._____
Race,vay .........______...________...............
Circuits, Light.....___.._...__..........___.....__...
Utility .___........__..._______________.___.....__._
Heat
Range .....h_....h......._..________n______n.._
\Vater Heater __________m...__..h_.h.....
Motor ________....___.._..._...__..........._____._
Dryer.._____________._...__..__....._.........n._.....
Furnace _____h__"'___""'__'''__m__.
Total ___________________________............
.i~.~.~~..~~~.....~..~~......~.~..~......~..........i~~.~.~:~..~.~.~.~~i.~.~..~...~..................:~.9t..::l!~:l~];2::...::
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con.
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
d ;) I 5/t0-. L 1___-aA:.
r~~~CTRICAL PERMIT
N?
15461
3;/0 c~ / /J:!
::~I~~:l:r:f;:~~;~~~:::::~~::.::::::::::::::=:.::::::::::::::::::::::::::::::..::::..:::::::::::::..::::::::::::::::.:::::::::::::=::::::::::::::::=
InspectioJ?completed____.....__.........._____________.......--...--.-.-........--.....--....--_.........._____________..___.__...__...__..__________.........__.__________...._..__......._......_
Total Load _.......___.___.___________.___.._______..__.............__..__...__.__._.___
1M 3-72 Olympic Printers, Inc.
05/12/2005 23:12
4579270
SIMPSON ELECTRIC
PAGE 01
t-J;3)tJS (i
)d Electrlc,,1 Contractor 0 Owner '-...""
CJ Aomu_' 'Permit l:I Alarm 0 Camhl"l Cl Cnmmercial
ELECTRICAL WORK PERMIT APPLICATION
o Request Inspection
.
o Residential Malnt. Q Sign!; 0 Therrnf)!.tat CJ Telecnm. \
Job ",ired b)'
'91 Electrical Contractor IJ Owner
<" Licen!lc number
~ -J/ .& }_~
IMlnlJalil,)!'l description
f? ~ ?/All'll t:P- "f-'
.../Uu M ~~ r:r, tJ R,A.-./
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K.JiJ
P:1~ m;;$r:"i~ /01 W
C;)'?;/Zf 1J~,.g'1e) Sujt- 9i;363
Telephone 5mb'" . J 7 () FAX~q:/:;...
Prem~. 0"."" name I~/o~ /r 1.f5d--fo"'li3
( '!j. IZ/ S IvnC{ ,rt-1
Addre" of inl'ilpeetion ...J-.L ~
E. / /V7 <;J+
J.
City
I hereby certify that J am the owner of the above named property or a licensed
electrical contractor (or the firm's allthori7:cd a.gent) and am making the c1cctriclIl
installatiof'i or alteration in complhmcc with the c1cctricll.llaw. Chapter 19.28 RCW.
IJ Cash 0 Check #
Credit Card Q
Card #
Mastercard
Discover
. .
---_.------------
ctrlcal administralor
E"piration Date
of card
x
WALLS
In!lulation Only
CEILING
Tnsulation Only
THERMOSTAT
SERVICE
DM'
ANlMved ay
DBI~
^M'rov.::d 8y
Oll'e
^~~,.wel\ By
Dftle
ApPll:'''",ll:1y
DITCH
FEEDER
Cover
Cover
Ollie
^PC'/ftYert By
D~'f
^~vt\1Ry
Dille
APJIftlvox! By
DM'
A""l'fIvcd 9y
I=lectrlcal Load Additions and or subtrac.tl.om;
o NO LOAD CHANGES
o Baseboard KW
CJ ~ume~ KW
o Heat Pump Ton LAA
o Fan-Well KW
lil.!l.Qflce Informallon,
o Overhead Service
Cl Temp Service
a UndBrground Service
Vol1aga
Phase 0 103
Service Size:
Feeder Size;
JnSI'CClion
Dalt
Area. Building or Equipment Inspected
^ctiof'l Taken
Eleetric!ll
'nspoctor
(}..1M..
Ir:f
11/12/2008 10:53 FAX 360 452 9265
fRi IE ~~I.~~>>iC
~ 0001/000.1
~
W,
NOV 1 3 2008
ELECTRICAL WORK PERMIT APPUCATION
LIGHT DEPT.
Job wired by
o Electrical Contractor 0 Owner
Installation description
[J Commercial 6esidcDtial
~eredlAddition
o
Telephone number
License number Date Expires
..a t'}~ c.-l~ 1J8-+~ (J..".h"4 '" J ""'dr''';
PurchasCCJ mailmg address ~
~'16r
State ZIP
IAJ tn'J... '1 <6:3 C;)...
FAX number
%'J.--
Premises owner's Dame
C.ntd D<V<!.-J1 ~ 'dwk Qt-
ih+- lith
DNew
Electrical contractor Dame
(,11~ n,,<f- alJ
? t 1\ SCl'h p'M...J
r:;:< .::v'f' fh'r- tS. tr 0..:;+
.Jo tiv-;r{-v- lie", fv-
-t:
~
c~a.. '-I
citt?4
Address of inspettioD
3 a..o
CHy QA_
Phone Domber to schedule inspection:
/Vii
Owner as defined by RCW.J9.28.26l:(J) Owner will occupy the structure for two
years after this electrical permit is finolized (2) Owner is required to hire an electrical
contractor if above said property is for sale. rent or lease.
After reading the above statement, I hereby certify that I am the owner of the above
named property or a licensed electrical contractor. I am making the electrical instal-
lation or alteration in compliance with the electrical laws. N.E.C.. RCW. Chapter
19.28, WAC. Chapter 296-468, The City of Port Angeles Municipal Code, aod
Utility Specifications.
SiKoaturc r, !electrical contractor or electrical adminutrator
o Cash 0 Check #
~dit Card VIsa
Mastercard
Discover
Card #
x
Date: II I
0'1
Expiration Date
of card
tnspecti~IJ f~
$ 67-..-
Servlcl!! Information
D NO LOAD CHANGES
D Baseboard KW
Cl Furnace KW
D Heal Pump Ton
D Fan-Wall KW
LAA
~verhead Service
[J Temp Se/Vice
(J Underground Service
Voltage j;u I :1.~()
Phase rL 1 D :l
Service Size: ~ /J-If.er.cJ
Feeder Size: .
SAME DAY INSPECTION, CALL BEFORE 7'00 AM 360-417-4735
ROUGH-IN lHERMosr,cr SERVICE
J//,'i/D8 ~
o.~ _By o.~ Appro~By 0"" App,cMld By
FINAL DIICH FEFDER
n!J'!irs ~~By Date Approved By ../ o~, AppI'oved By
'- 0
Inspection Area, Building or Equipmeotlospected Action Taken Electrical
Date Inspector
//-/3 -0'3 7>1>. Jo& HftS AtJ!r;AA'r /!ZPJ DONF./ /!ft.Jc->Jfii) ~lhU
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