HomeMy WebLinkAbout719 E 11th St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use . . . .
Property Zoning . . .
Application valuation
05-00000021 Date
.800834
719 E 11TH ST
06-30-00-0-3-3462-0000-
MECHANICAL PERMIT
1/07/05
RS7 RESDNTL SINGLE FAMILY
5925
Owner
Contractor
SCHAFFER, SCOTT
719 E 11TH ST
PORT ANGELES
( 36)
WA 98362
PENINSULA HEAT
502 W. 8TH ST.
PORT ANGELES
(360) 457-2775
WA 98362
Permit MECHANICAL PERMIT
Additional desc HEAT PUMP ONLY, STAT EXISTING
Permit Fee 61.70 Plan Check Fee .00
Issue Date 1/07/05 Valuation 0
Expiration Date 7/06/05
Qty Unit Charge Per Extension
BASE FEE 47.00
1. 00 14.7000 ECH ME- INSTALL 100- FAU 14.70
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 61.70 61.70 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 61.70 61.70 .00 .00
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Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAlNAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I I I
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYW ALL (INTERIOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I I
MECHANICAL
HEAT PUMP 1_ '7 L. -05 B//
GAS LINE
WOOD STOVE 1 PELLET 1 CIDMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 1-_ 2b- O~ IBK' BUILDING
T:\PLANNING\FORMS\1102.15 [11/1412003]
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec.: I . 7 ~ D ~;-
Permit #: D5 - 2.. I
Date Approved:
Date Issued:
Fill out COMPLETELY and in INK. Your application and site.plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
Applicant or Agent:~Je ArvJ~ Phone:
Owner: 5'c~f.t- s.h a.rk..r Phone:
Address: '7 / q E. /ltIL 51- City:/?; /r 4, fle?.s
Architect/Engineer: Phone:
ContractorYevu~m ~I Jl,~ 1-State License #:-.J1:;N fA) th~
Address: 502 W 'St:1:1- City:~jPlRs
PROJECT ADDRESS: 7 I q E (/ t:!2 57- .
467-~ 77S-
4/7-69 79
Zip: cp ~6 ;;z.
Phone:Lf f17-;).776-
Zip: q <?bb J
ZONING:
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Subdivision:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA MC #
TYPE OFWORK:f
o Rellidential 0 New Constr. 0 Re-roof 0
o Multi-family 0 Addition 0 Move
o . Con'm1ercial 0 Remodel 0 Demolition
o. ~air ,0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
City:
Exp. Date:
COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load:
No. of Stories: _ Lot Size: Existing Sq. Ft. & Proposed Sq. Ft.
Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage
Construction Type:
= TOTAL Sq.Ft.
%
I APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Pennit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the buildingpennit application and construction plans are
submitted. All other pennit fees are due at the time of pennit issuance.
EXPIRATION OF PLAN REVIEW: 1fno pennit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
correct. J am authorized to apply for this permit and
t Just 0 in such pennits prior to work.
T:\FORMS\APPS\Buildingpermit. wpd
Applicant
ate:
. j / b LtJS-
. ,.-
".(i....~.........
"IIIc'
~"i
~~..
CITY OF PORT .ANQ~LES.. .',
DEPARTMENT OF coMMUNITY DEVgL9PMENT'- BUILDINGDIVISION
321 EAST 5TH.STREET, PORTAN9ELES,\l{A ~8362
t';: .,.~:C"
Application NUmber
Property AddreSs
ASSESSOR PARCEL NUMBER:
Application description
'Subdivision Name
Property Zoning . . .
Application val~tion
Owner
03-00000592 Date 6/17/03
719 E 11TH ST
06-30-00-0-3-3462-0000:
RE-RooF
106.75
6/17/03
12/14/03
PlcmCheck Fee
Valuation
.00
2360
2360
Contractor
SCHAFFER, . SCOTT.
719 E 11TH ST
PORT ANGELES
(360)
WA 98362
ROOF ~EMENT
325 E WASHINGToN
SEQUIM
(360) 683-2272
WA 98382
_ _ _ _ ____ __,. _.~,_ __ _ _ _ _ _ _ _ '.;...... _ ;.,... _;.. _ _ _ _ _ _ .:,;. ...:,':.;, _..;.; _ _.-:-_ _ _ '. ...';.. _..: .......:. _ _ __ .',2:. ..:.....:.-_.~..~ __ _ _ _ __
Permit . . . .
Additional desc
Permit Fee
Issue Date
Expiration.Date
BUILDING PERMIT - NO PRFEE.,
Qty . Unit Charge Per
Extension
92.75
14.00
BASE FEE
1.00 14.0000 THOU BL-2001-25K (14 PERK)
----------~---------~-------~------------------~~~~--~-~-~-----.;..--,------,----
Other Fees . . . .. STATE SURCHARGE 4.50
:~~-~::_----- Charged Paid Credited, Due
---------- ---------- ---------- ---------'.
pe~t Fee Total 106.75 106.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 111.25 111.25 .00 .00
.. , ,.. - .. .. - ~'.},., ,:.,,:,-, ........' '_ .. -' -:c..:.,:.,.:.'. .. : ,:'>: .... ,:',.. .,.,,".... , ,":'.'_, ",,- "..' "-.. .,';:- '.:. .: <<""" -,": - '," .
Separa~ePe"!1lts arE! required for electricarwork, SEP A, Sho~~line, gSe,',lJ1iUties; private and public improvements. . This p~.-rnlt bec:~ro~~ .
null and void jf work or construction authorized is not .commenced within 180 days, if construction orwork Issu~~~~~!dor.a~~ndo,ned
for a period of 180 days afterthe work as commenced, orifrequlredlnspections have not been requested 'Nithi11~bdays fr"om thela.st
insp~ctlon, I hereby certify that I have read andexa.mined thls application and know the same to be trueCln~,cQrr~ct,~U pJ:Qvi~lqn~;g~
laws and ordinances goveming this type of work will be complied with whether specified herein or not. The grantingofa ilermitdoEl.s,,!Qt
presume to give authority to violate or cancel. the provisions. of any state or 10ca.I.law regulating construction or the performariceof
construction. . '. , .
~/loJflh tv [~ (P-17~o.5."
Signature of Contractor or Authorized Agent
T:\PLANNING\FORMS\1102.15 [412002]
CALL 417-4815 FORBUILDING.INSP. ECTIONs.'.ptEASE PROVIDE A NnNI~fUM 24 HOUR NOTICE: riis 'UNLA WEUL, tOqlJjpiJ.. '
.. .." .. ," .. .....,;... .. '-...~...~'. :,;, .'_ ',""" ,-'c. ..0' ;\';:>t,':c,..- ",.
INSULATEcOR C:ONCEAL AJ!X WORKll~!l!.!!ft INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOVS!-~ATJON.
,,",... '."0_-.' - ,'0.. ',-
BUILDING PERMITINSPEGTION RECORD
" ,"l'. ; "~~
,........,.:-.,-:".....?
KEEP PERMITCARDANDAPPROVED PLAl'l&;ATJOB SITE'
t-:/j
: . 1 T .: " .,' .........
INSPEctION TYPE .DATE ACCEPTED ;,: COMMENTS' ,,\. ~
.. 'y.
YES NO
FOUNDATION:
FOOTINGS . ,
WALLS , .
FOUNDATION DRAINAGE .
.
ELECTRiCAL ...... (LIGHT DEPT) .. " ::j..' .
SEPARATE PERMIT: # ,"
ROUGH-IN . I ' .'. '. .,.
. --
PLUMBING
UNDER FLOOR I SLAB t',.,
ROUGH~IN -c.'
..' "
WATERLINE ,
GAS LINE . ',i'" , .... .;!'.
BACK FLOW I WATER .'. ~;" , .
., .. (.. V<., 'pr ,.
AIR SEAL ....
WALLS .... I
,
CEILING . .' I . . : ..... .J
,
FRAMING ....
.
JOISTS I GIRDERS .
'., .
SHEAR WALL '.
.. 1...-
.' . , "
WALLS I ROOF I CEILING " :
DRYWALL
T-BAR .
.. . .
INSULATION .
. SLAB
WALL 1 FLOOR I CEILING I I I . ,
" -,:.
MECHANICAL
HEAT PUMP .
WOOD STOVE I PELLET rcmMNEY
HOODI DUCTS .'
, .
-,-c (Engineering Division)
PW UTILITIES I SITE WORK . SEPARATE PERMIT #'5: .
WATERLINE I METER "
SEWER CONNECTION .
.. '.
SANITARY '." ..
STORM ,. "
PLANNING DEPT, SEPARATE PERMIT #'5 " SEPA:
PARKINGILIGHTING . ESA:
LANDSCAPING SHORELINE;
;-., '. ,', ...... ,.' FINAL INSPE<;,I'}().NS R~UIRED PRlgR TQ,OCCU"~N9'm~E ..... .' ,', "~:. '. ....
.
RES~DOOIAL . .i '..' "','('-;'DATE" . YES . NOr COMMER9~L DATE ":Aq:;EP,J.ED'
" : ,. i 'i. , :.. :YES '.. ,.' .NQ
,,' .
. , . ELEdTRICAL ,.
ELECTRICAL" LIGHT DEPT.' 417-4735 .
LIGHT.DEPT '. . .;
CONSTRUCTIONR.W, I PWI CONSTRUCTION - R. W.
ENGINEERING . . 417-4807 PW I ENGINEERING
.
FIRE 417-4653 FIRE DEPT.
,
PLANNING DEPT. . 417-4750 PLANNING J;?EP'T. I. ......
BUILDING ;., .... .' '. ,417-4815 1~-30-o':Z 'to L }.... BUILDING
.,.:,-.-.......-,.. .,'--
'. -
_.1..-'':
T:\PLANNINQ\FORMS\1102.15 [412002]
BUILDING PERMIT - APPLICATION
FOR OFFICI~ ~SE ONLY:
Date Rec.: b ,)- 63>
Pennit #: 5" 9 2-
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
Date Approved:
Date Issued:
Applicant or Agent_R CJ6f f11 aN IlbE Me A.u Phone: r~(/() & g3 2 Z 72-
Owner: ~ ..5e.o -1+ Se- M F Fe Y' Phone:
Address: I / c; e. / I rf/ S r City: (t,tl2.. /- #II 1.e1c? t<.J J1: Zip: t?f? ~ ft1 2
f7
Architect/Engineer: Phone:
Contractor ~ #t M ~h?I:-",r State License #{l!dlll ~~A..Exp: /()-fS- os- Phone:3bo 6-$'32272-
Address:.'l25' f'4s-f Wnk~"k., ,-r #fN City"dZ'UM vO# Zip: f F" j>;$--Z
PROJECT ADDRESS: 7 (f e. Ifrff '5T It ;/kttj.ek;: uJ# ~.I~~ONING:
~
LEGAL DESCRIPTION: Lot
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA MC #
TYPE OF WORK:
o Residential 0 New Constr. r;f.. Re-roof
o Multi-family 0 Addition. 0 Move
o Commercial 0 Remodel 0" Demolition
o Repair o Sign
BRIEF DESCRIPTION OF Till: PI~9JECT:
City:
Exp. Date:
o Stove
o Garage
o Deck
o . Other
-/""t""'"Cc.r
SIZEN ALUATION:
SF. @ $ /SF. = $
SF.@$" /SF. = $
SF.@$ /SF. = $
(J-f?: '"'F~Ol~ V~lJ~~~ $ 2.sbd od
) '/ I
COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load:
No. of Stories: Lot Size: Existing Sq. Ft. & Proposed Sq. Ft.
Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage
Construction Type:
= TOTAL Sq.Ft.
%
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESNWetJand(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permits prior to work.
T:\FORMS\APPS\Buildingpennit.wpd Applicant: Ii' ~ t</ ~ Date: b - /7 -- tl3
CITY OF PORT ANGELES
DEPARTMENT,OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date ~ - .30 -03
~
Time
Received by
RV
(phone, person)
Location of Work to be inspected 7 19 e- // fL r,
Name'of, person requesting inspection ~c(' ~~e~t-
Address of person requesting inspection Phone No. 96 <::I ~ 2'272
Type of Inspection (circle appropriate one): Permit No. (.t:;Cf ~
Sewer Foundation. Framing Chimney Plumbing ~ewer Excav. Other
INSPECTION NOTES:~
Inspected: Date ---\f.,~\,.o3
Remarks:
Time~B~
RESTORATION REQ
NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
D Repaired by Permittee
D No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT,;,
(DATE)
IIJII"""
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N~
17752
/- / r~
Port Angeles, Washlngton..mm..n..mm......n.n..........nnnnm...mm., 19.0000.00
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to do eleotrical work as listed below.
Address .m'21.Y.m.m?~g;:!mm.m./.'.oo.m.....nm....moooo Occupancyoo___oo.oon.m.m..mmoo..n.mm...oooo
O~~er .---.~~.y.~.:.<:~.~~?JPp2("._Wnt.m----....oo..---oo-..mm..-..m...--.m000000000......0000000000
WIrIng Contractor __..._~.mooR.?hf!~m.oooooo........t;.........Z"... Byoooo.mm.m.mmm.m.......m.moomm...oo....__m.oooo
'j .
Light Outlets...___u.uu___mumu..m_u_..:.., . C.Bervlee, volts u/",#:::;::"u.
Receptacle Outlets..................__n....__m No. wires ..:h~:"t:[<E?:.--n...._.m_
,. /'
Size wires.:................................._..
Dryer, KW.....__..........h...._h..._____n._..-:'.
Range, KW ____....__nhmm
Water Heater:
Main fuse ._.._mhmmm.___.....__n.......
Enclosure ._.om___no._n...____._.._____
KW......__.__.____n_____n___.___n."l......____.
j-P IX
Heat: KW...../.::.?.tiu~..,{;.!:-:~ .,
Motors: siz.e J...o)JJ an~Jh~
m.u--.J!iz"J..;::..~"'m.7~a,
Type of wIring:
Entrance Cable ......__nnon......
Rigid ConduU ..__nnnnmm____.........
MetalUc TUbing m.m
Current transformers:
No. & Size...m..mm.mm.mm.
Ser. No...............................................
Ser. No........................................__.....
Ser. No...............................................
Total Loadm.........m.m....m...
Ser. No. ...............................__....n......
Type of Wiring:
Armored Cable .........................m..
Non.Metallic ......h......................h.
Knoh & Tuheuu...mn..m__.__....un_
RIgid Conduit m...mn....._______...___
MetalUc Tubing h..............mnm...
Raceway ..............................._......_
Circuits, Light..n.......m.........................
UtllJty h....,un.,m..___...hm..__..___.u___
Heat ...........__.........................._.._..
Range h..,h.h.muunmh........__h...__.
Water Heater ...m.........................
Motor ..._............h.....................__...
Dryer........................__........................
Furnace .........................'_...nn.......n...
Total.......................................
Remarks: oom______'~d.t::<.~Jm..__oo___uoou.....n___....nu..___moouoo.oo.___moo___..mu.__.........___..___.um.......oom.m..___
/'
...........-..-..........--...--...-.-.......-.-.-..---.....-.---..---.-..................-.._....._._._..._...._.....u._...uu_........u......uu.u...u.........un..u
.;~~;~.;::mmmoomoo.u___m.m;~:~~.oo~:::;~~.m.___u......___..___.m.mu~~~~ml.n.....Z.....---..u
$___..___.........m.m.m.mum. No....___.____....___.......... By r!f:..ri(uLm[;;:!..moo!:.f...:?:::.ctf21L'U__.__
NOTICE-Current must not; be turned on until Certificate of InspeCtion has been issued. It 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
ELECTRICAL PERMIT
N~ 1 7752
Address........................................................................................................................................Date..._.........._.._.._.........................._.........
Owner ..................................._......____......_......_.....................h..................................._.... Tenant....................................__.........n...................
Wiring Contractor........................................ ..................................................................................BY.....................n.......................................
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con.
_ -,_. cealed due notice must be given the Inspector so that work may be inspected before concealment.
\.
"
1M Olympic Printers, Inc.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
N~
17696
ELECTRICAL PERMIT
~ -/6 f"07
Port Angeles. Washlngtonmm._ummm_.._..........._.......uu....___._..u. 19m.....'
In accordance with the City Ordinance to regulate the Installation. extension. or repair of elec-
trical equipment In. on. or about any building or other structure In the City of Port Angeles. per-
mission Is hereby granted to do electrical work as listed below.
Address .m__'Z!.f.m...fi..d...~u.u...um..mummm..__________. Occupancyu,..-C.l.:?_~.m...u____uu...mu..
O~~er ......A:!:~~~~~1',8lI~~t...--....-..-u--....-...um---m--um.-mm-m...m.....m.u
Wmng Contractor .._uummu..."..umumuumu..muumuuu.um. By...umm.__.m.umm...m.m..mm_um_uum.m.......
Light Outlet........................................... Service, volts /...:>.."-c..:.::..!...~......... Type of Wiring:
Receptacle Outlets......._....................... No. wires ...:J._._.~...................~n.__ Armored Cable ..._..__...m...__._...._m.
y/ t:J o-f/
Size wlres......7dtJ..;t.......
Main fuse .....!...............n_:...._ .
rS
Enclosure __..............__.......00...._.......
Dryer, KW.....___.............................._n_
Non-Metallic ............___............_...._
Range, KW..nn..nnu..u______.
Knob & Tube................................_
Water Heater:
RIgid Conduit ....u.........................
Metallic Tubing _.._......._m.......n...
KW....................__......u.u..
Type of wIring:
Entrance Cable ....noon
Raceway ___..______.__..__............._....._
Circuits, Light....................._.................
Utility.............................................
Heat; KW............._n....._.......n_._n............n.
Motors: size, volts and Ph~
~~4:r;<<~.y:!.......,4....~.
../:I. U ~!....~ --:t../t,....../:5..r~..
.-/ .~ ._, . .r..o.r:Y.7
Rigid Conduit .....mnm___
Metallic Tubing ..n_.._m......
Current transformers:
No. & Size.............._....nn....._
Heat _..............................................
Ser. NO........._..nn...............................
Range ........._......................00._.........
Water Heater ............mn..............
Motor ..._........n..........._..................
Ser. No. ......_n_n.._..............................
Dryer nn..n.nn_n..____n..___.n...___..__........
Furnace ...00.._._..00._.........'_...................
Ser. NO._.nn.............nn_n....n__...........
Total Load............................. Sec. NO......-...............................l.~. r-/ &~I ......-................................
Remarks: ..-m.--uu1-.L(:'.-:(.~.._!:::.___.____uu;?m!'?:':."=u._..yu..umd?::':'!:.:.u....u:;_:~~;.!umm....uummu.....
..........____..nn...n_n_..h.....nnn.............n.....n..n.n..nnnnunnu.....nn....n.u..u.h...U_~h.uu___uu......nu______u__U__U.dU.n..n
.:i.=.~~u~::~..-.__.~~..~~~.~~__.n--mn::~.~.~:~~:~.~:~.~.~~-...~~~~~unmmnn--n:;.:__;l2::~~;Z~;Z:;:__:__:.::::::
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con.
cealed due notice must be given the Inspector so that work may be inspected betore concealment.
"
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
N~ 1 7 6 9 6
ELECTRICAL PERMIT
Address...___.._________.._....................._...__......__............................._.___._._........................._................Date..........__.._.._......................_......_h_......
Owner ........nn_....n_n.............................u.._._...._.._.n.............................._.................00_..... Tenant....._.........................._..............nn..n__n_........
"\
_\
Wiring Contractor .-......----..............._.__........................_..._..........._____....._........___..._._.__................... By._...............______.___..............._________.__........
NOTICE-current must not be turned on until Certificate of Inspection has been issued. It work is to be con.
cealed due notice must be given the Inspector so that work may be inspected before concealment. .
\
1M Olympic Printers, Inc.
Application Number . . . . . 23-00001181 Date 11/06/23
Application pin number . . . 623631
Property Address . . . . . . 719 E 11TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-3-3462-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
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Application desc
Car Charger
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Owner Contractor
------------------------ ------------------------
SCHAFFER, SCOTT M FREDERICKSON ELECTRIC INC. PO
719 E 11TH ST PO BOX 2108
PORT ANGELES WA 98362 PORT TOWNSEND WA 983680269
(360) 385-1395
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee . . .00
Issue Date . . . . 11/06/23 Valuation . . . . 0
Expiration Date . . 5/04/24
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 63.00 63.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 63.00 .00 .00
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
11/20/2023 23-1181
TAP
OWNER
CONTRACTOR
Frederickson Electric
PROJECT ADDRESS
719 E 11th St