HomeMy WebLinkAbout919 W 12th St - BuildingPREPARED 10/01/07 9 59 52 INSPECTION TICKET PAGE 11
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/01/07
ADDRESS 919 W 12TH ST SUBDIV
TENANT NBR DIANE THANEM
CONTRACTOR PHONE
OWNER GLENNA D THANEM PHONE (360) 457 9756
PARCEL 06 30 00 0 3 5275 0000
APPL NUMBER 07 00001074 RE ROOF
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 10/01/07 Jy BLDG FINAL
09/28/2007 01 09 PM LPANGRLE
STAN 477 6100
BLDG FINAL RE ROOF
COMMENTS AND NOTES
OF PORT M,
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner Contractor
GLENNA D THANEM
919 W 12TH ST
PORT ANGELES
(360) 457 9756
WA 983637212
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF AND REROOF
Permit pin number 111161
Permit Fee 151 75 Plan Check Fee 00
Issue Date 9/18/07 Valuation 5300
Expiration Date 3/16/08
Qty Unit Charge Per Extension
BASE FEE 95 75
4 00 14 0000 THOU BL -2001 25K (14 PER K) 56 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 151 75 151 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 156 25 156 25 00 00
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 thority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Sigr t'ire of Contractor or Authorized Agent
T Policies \1102_15 building permit inspection record05.wpd [1/4/2005]
07 00001074
204412
919 W 12TH ST
06 30 00 0 3 5275 0000
DIANE THANEM
RE ROOF
RS7 RESDNTL SINGLE FAMILY
5300
OWNER
Date 9/18/07
-5\
Date Signature of Owner (if owner is builder) Date
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
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
INSPECTION TYPE
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -IN
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT 417 -4735
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653 I
I PLANNING DEPT 417 -4750 I
BUILDING PERMIT INSPECTION RECOED
I I
I BUILDING 417 -4815 iCr CA l 0 Il./ I
T \Polici \1102 15 building permit inspection record05 wpd 11 /4/2005]
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
DATE I ACCEPTED COMMENTS I
YES I NO
FINAL
FINAL
SEPA.
ESA.
SHORELINE:
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
I PLANNING DEPT
I BUILDING
DATE ACCEPTED BY.
DATE ACCEPTED BY.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
DATE YES NO COMMERCIAL DATE I ACCEPTED
I YES I NO
0
poRT
s
Residential projects: submit two sets of plans
Commercial projects- submit three sets of plans
Applicant or Agent Sew Pk I .as
nNE 114 RN
Owner
Fill out COMPLETELY and in INK. Your application, prescriptive energy
form, plans, specs, and a 8'A" x 11" site plan MUST BE COMPLETE to be
accepted for review (360) 417 -4815 FAX (360) 417 -4711
Owner's Address 1 9 LAA 2 T ST
Contractor/Engineer
Contractor/Engineer's Address
PROJECT ADDRESS 9 q 12 714 Sr
LEGAL DESCRIPTION Lot:
CLALLAM COUNTY PARCEL NUMBER.
/Residential
Multi family
Commercial
Repair
BUILDING PERMIT APPLICATION
Block:
TYPE OF WORK
New Constr eke-roof Stove
Addition Move Garage
Remodel Demolition Deck
Sign Other
BRIEF DESCRIPTION OF THE PROJECT:
Tl F X.1 T M El A ce niv4
ti4nz LL1e S t“wt..L£S
COMMERCIAL/RESIDENTIAL. Occupancy Group:
LT N A t t-- arm
Existing Structure(s) basement
1 floor
2 "d floor
3` floor
Accessory Structures
Existing Structure(s) TOTAL
LOT COVERAGE
Lot size Sq Ft.
Existing Structure(s) Sq. Ft. Footprint
Proposed Structure(s) Sq Ft. Footprint
TOTAL Structure(s) Sq. Ft. Footprint
Total Lot Coverage
Sq. Ft.
Sq. Ft.
Sq. Ft.
Sq. Ft.
Sq. Ft.
Sq. Ft.
I hereby certify that I have read and examined this application an
apply for this permit and understand that it is my responsibility t
such permits prior to work. 7
Date /F 7 Applicant
T• \FORMS \BUILDING DIVISION \BldgPermitAppl. -2006 CODE backup.wpd
State License
Phone.
Phone
Subdivision.
0TD S N M71 It!‘
Proposed Structure(s) basement
1 floor
2' floor
3 rd floor
Accessory Structures
Proposed Structure(s) TOTAL
TOTAL of existing proposed structures
Maximum Height of Proposed Structure(s)
(Divide Total Structure(s) Sq. Ft. Footprint by Lot Size Sq Ft.)
1 477-4/o0
`t 1 q1S,,
Expires
Phone
ZONING
SIZE/VALUATION
.22O) SF
SF
SF
TOTAL VALUATION
/SF
/SF
/SF
Occupant Load. Construction Type:
Are you planning to install.a lawn sprinkler system?
FOR OFFICIAL USE ONLY
Date Rec. g I q �7
Permit 0 7 107y
Date Approved: C r t. o7
Date Issued:
Sq. Ft.
Sq. Ft.
Sq Ft.
Sq. Ft.
Sq. Ft.
Sq Ft.
Sq. Ft.
Ft.
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. The plan check fee must be paid at the time the building permit application is submitted. All other permit fees are
due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW An application for a permit for any proposed work shall be deemed to have been abandoned 180
days after the date of filing unless such application has been pursued in good faith or a permit has been issued, except that the building
official is authorized to grant one or more extensions of time for additional periods not exceeding 180 days (90 days for commercial
projects) each. The extension shall be requested in writing and justifiable cause demonstrated. (IRC/IBC 2006 105.3.2)
ow the same to be true and correct. I am authorized to
rminyhat permits are required, and that I must obtain
Q DEPARTMENT OF c9~~i;w~.ME.E....L....~..S._ BUILDING DIVISION
321 EAST 5TH STREET,PORT ANGELES, W A 98362
~~pplication Number 03-090'60'002 Da.tEi1/13/03 . '''.'
I: 'r;- __~ ..jl___~ ...... " ........... ..,..
ASSESSo.R PARCEL 'NUMBER: 06B()()OOjS~7S0()OO
Application description RES Fo.UNDATIo.N REPAIR
Property Zoning . ..., "
Application valuation .
Property owner . .
o.wner address . . . . .
Contractor
3000
THANEM GLENNA D
919 W 12'1'H.ST
Po.RT ANGELES
( ) .
REIHIT COMPMY
WA 983637212
------------~----~---------------------------------------------~-----------
Permit
Additionaldesc
Permit ~ee
Issue Date
Expira~ionDate.
BUILDING PERMIT - Nb PR FEE
106.75
1/13/03
7/12/03
plan Check Fee' .
Valuation
.00
3000
Qty Unit Charge Per
Extension
92.75
1.'1.00
BASE FE.E
1.00 14.0000 THo.U BL-2001-25K (14 PERK)
--------~--------------------------------------------------------_._----~----
o.ther Fees '.
STATE SURCHARGE
4:50
Permit Fee Tota,l
Plan Check Total
o.ther Fee Total
Grand Total
- ... - - ... - - - -
,
.00
.00
.00
00
,00
.00
.00
.00
"~.
--
-.Q
Fee summary
Charged
.Paid
Credited
Due
106.75
.00
.4.50
111.25
106.,75
.00
4.50
111.25
Separate Permits are required far electrical work, SePA/Shar~it~~:E~A. utlll~9'&,privateand public impr.Ov.~.o:l~['\~~thl$.P ". . . ...... '. '. ,.
null and ,void If~()rk arconstructio.n authorized Is no.t ~9"1men~~~~thln ~8q~,.YS; If constructian or.\V()r1(;I~~~~~~dJt ;>6~ori~~
far a periad af.1~O days after the wark as C()mmenced, ar ifrequJred Inspec:tlons rave no.t beenrequest~dWlthln 180 ~a, .;th~last
Inspectlcin. .1'Ilereby certify. that I. have read an~ ~xamiiied.thrS1ip.Pllq~~on~~~ kno.w the salTuno ~e trufand cq;'ffl~.~t[mP~~I,!>~~?f
laws and ardlnances gavernlng thiS type af wark WIll be complied, WlthWlie,ther specified herein ar not. The grantln~of ~'P~rmlttlo8t)'nat
presume to giveautharitY to. violate ar cancel the' pravisians af' any state. ar: lacallaw regulating C()nstrtiction91'.the~tfonn~nce' of
constructian. . ." "'>,;'.'S-
o/f)" k"ILC
.
,~,.t
::r.....
t.-
?
-+
.~
<1/).
:t
^>.,.....'''."......':.{",,'.. .,~.,
Signature af Contractarqr Authorized Agent
Date..
-r,
,~igp~tureof&"er (ifownel'.is builder)
";\' "
.~.;:(Q~te
i:\PLANNING\FaRMS\1102.1S [412002]
'''ti'
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'(~~'i>~:<~,-";;,:'~ -._, "~';:"'.-.:' ;:.:"
BuILDING PERMITINS.fECTION RECORD
,J'-"l;<,:'<
-:..- r ! ,j..:'~.,': _. " ,~"'-N,,:_:~"i
CALL 417-4815 FOR BUILDING INSPECTIO~,::r.EPLEASEPROVIDEA MINIMUM 24, IiOUR NO'fICp. ITIS UNLAWFPf TfJ@"",
INSULATE OR CONCEAL ANY woilK BEFO/lBINSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATIO"N;
,j'",;:,,' - - , .", ". - "_,~ - :-_.~ ,.' . . . .. '. '.' O',~",'~!,.- ',.-' ~.
INSPECTION TYPE DATE " ACCEPTED' CO~MENTS , ;.' '"
I .- ,
, , YES NO .' " 'C', ,";, ",s"
FOUNDATION: :'" t.
, ,
FOOTINGS 1~/4 -'Q~ IEII/- I I
" "
'WALLS ",; .-
FOuNDA nON DMlNAGE , .., , I', '. -,,' T'" , " "
ELECTRICAL (LIGHT DEPT) SEPARATE PERMITctl ' , ,
" "
ROUGH-IN i-" ","
PLUMBING ",
uNDER FLOOR I SLAB .
, "
ROUGH-IN ,
WATER LINE ,
GAS LINE ,
" , , :
BAck FLOW I W ATElt" 0
AIR SEAL .' "
, , ',' ,
, ,
WALLS "
, CEILING ; , ,t, " , I .,,,:
<<' '-, '"
, FRAMING , ", c
"
r JOISTS I GIRDERS ,
" , "','
I SHE~,WALL , ,
WALLS I ROOF I CEILING ,
, DRYWALL "
T-BAR ' ',J', ,
, INSULATION .
,
S~
, WALL I FLOOR I CEILING I " I .
, "" ,
, " , , .,;:.,
MECHANI<;AL , " ",
HEAT PUMP , " ';-"
WOOD STOVE I PELLET I CHIMNEY >
1l00Di DUers '" , " , i,'
,
PWUTILITlESI SITE WORK' (Ellgineerin'g Division) SEPARATE PERMIT #'s: , " ' ",
.'
WATERLINE I METER ' .. "
SEWER CONNB~ON ,
SANITARY " " ,
, "
STORM ,
PLANNINGDEPT; SEPARATE PERMIT /I's' SEPA:
PARKINGlLIGHTING ESA:
LANDSCAPING " S~ORELINE: ;< ,,', , '
, " .(,;iff'"'" ,n .,' ,.,,;;i.,mNAMINSP~01Y,~;1U:QU~P~QIl:m9C ~S,;'- ., ' " ....:,
H .:
" RESID.JNTIJ\L: ; .') DATE ,." YES , :;,'NO' ~'" ..:. ;.c ~ cOMMERCIAL ',:PATE ,,,,'?~f~, ,"
:'\!- ,
I'i' , ". > , ',' ',D", ,,"':~ . <" "fI .....'.{' : ,"Y':n",. .'H:f}i)':'" , ,'/ " ~"{l~~; ~ rJ~,.;~ ',Y'!'NO"",',
ELECTIUC~- LIGHT DEP'f. ., ' ",. .. ," ~: ~.',,:;, , y, ".' ,',..' a;~;': 'W .r~._i"~f,: t " Ii .' rp ilf
4i 7-473~, ELECTRICAL !.; '"
.' :'>- LIGHT DEPT ", , :':;;, ,
;'.'0" ",.~'h" ", 'i..' , , y. " ." cONsmiJCnoN~ R.W, '''-'' ""I ',' ','.'
CONSTRUCTION R. W.I PWI
ENGINEERING , , 417-4807 PW I ENGINEERING
FIRE 417~S3 " ~.
, FIRE DEPT. \ " , .',
"--,,.' .",- , ., , y" '~;:~~~ "/ ::;y~ "" PLJ\I'lNtNo'D,EPt. ''', ;-;)' "" ,-
PI.A.NJIlR'IG DEPT. "',
, A~ , , , , .,"" ,
BUILDING ,
BUILDING .',. '"
,. / :/ .
KEEP PERMIT CARD AND APPROVED PLANS ATJOB SITE
I '
"
,- ~-.
~,
T:\PLANNING\FORMS\1I02.IS (412002) .
~~\cl...J-ls--C3.
BUILDING PERMIT _ APPLICATIOt?' ill,;).5
FOR OFFICIAL USE ONLY:
Date Rec.: /-ID - os..
Permit #: ~.
Date Approved:
Date Issued:
Applicant or Agent:
Dr.4?V e..
9/1
The Building Permit Application must beftlled out completely.
Please type or print in ink. Uyou have any questions, please call 417-4815
7Z- fd rlh re, :z;;,c-
, /
7hJ<hV~
o. (21Z City:
Phone:
~(7"'b/ /~
/
Owner:
Phone:
Address:
P/f-
Zip: 9/"362-
Architect/Engineer: Phone:
Contractor rL-12". ?4r C k~License #: r::?et/t7fc7Zf KFExp: o%s
/
Address: 2--)2-6 S;' ~",-e-L- City: P ~
PROJECT ADDRESS: t/ ~ W r Z 73:.-
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Billing Address:
Credit Card #:
Phone: "7/1'-6'7) r
Zip:
ZONING:
Subdivision:
Credit Card Holder Name:
City:
Exp. Date:
VISA
MC
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-roof 0 Wood-stove
o Multi-family 0 Addition 0 Move 0 Garage
o Commercial 0 B.emodel 0 Demolition 0 Deck
!l('"Repair 0 Sign 0
BRIEF DESCRIPTION OF THE PROJECT: r;Q ~4f7?c1~
SIZE/V ALUATION:
SF. @ $ /SF. =.$
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION $
~4-f;-
f
~~
COMMERCIAL/RESIDENTIAL: Occupancy Group:
Occupant Load:
Construction Type:
%
/sq. ft. = TOTAL LOT COVERAGE:
APPROVALS: PLAN
BLDG.
DPW
FIRE
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER
BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must beft/led out completely to be accepted/or
review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your
completed application, site plan (for additions) and building construction plans are to be submitted'to the Building Division.
No. of Stories: _ Lot Size:
Existing Lot Coverage:
PLANNING USE ONLY:
Notes:
% Lot Coverage:
/sq. ft. + Proposed Lot Coverage:
/sq. ft.
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: Your plan check fee is due 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, this 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, and I am authorized to apply for
this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's
responsibility to determine what permits are required and to obtain such.
~~~
Applic . .-
Date:
.?~(f-~3
/ /
T:\FORMS\APPS\Buildingpermit
I
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date I-/~-O~
Time
Received by
~ 1/. (phone, person)
Location of Work to be inspected q J cr oJ /2. 'I V[
Name of person requesting inspection . :J)~
Address of person requesting inspection Phone No. ~/7 -6 77'/
Type of Inspec . 'rcle appropriate one): Permit No. 1l.....
Sewe F undetio rami~g Chimney Plumbing Sewer Excav. Other
. T(4~ ~~\{
INSPEC 16N~O~ES; I L,. 'R.~~.r ",. /)
Inspected: Date ~ ~ Time By" r7\
Remarks:
&~
\. I
RESTORATION REQUIRED . . . . . . YES NO
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved DGravel o Asphalt OPCC
o Other
D Repaired by City
D Repaired by Permittee
D No Damage Found
Work Order #
D COMPLETE
D INCOMPLETE
(Continue on reverse side i' necessary)
.,STREET SUPERINTENDENT..,i.(DATE)
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Application Number 16- 00000255 pate 2/24/16
Application pin number . . , 650050
Property Address . . , , . , 919 W 12TH ST
ASSESSOR PARCEL NUMB7R; 06-30-00-0-3- 5275 -0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . , . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . , 0
Application dese
sump pump
owner Contractor
THANEM GLENNA P BOB'S ELECTRIC INC
919 W 12TH ST 2293 DEER PARK RD.
PORT ANGELES WA 983637212 PORT ANGELES WA 98362
(360) 457- -6867
_
--------------------------------------------------------- - 9``i3 - - - - --
Permit , , . , . , ELECTRICAL ALTER RESIDENTIAL
Additional desc . . 1-4 CIR
Permit Fee , , , , 75.00 Plan Check Fee 00
Issue ]late 2/24/15 Valuation 0
Expiraticn Date 8/22/16
Qty Unit Charge Per Extension
-3A,SE FEE 73,00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 ,00 .00
Grand Total 75.00 75,00 .00 .00
LIS
' 1
, vl
REPORT SALES TAX
on your excise tax Form
to the City of Port Angeles
(Location Code 0502)
INSPECTIONTYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:
zv
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date.-
GAEXCHANGMBUILDING
FEB -23 -2016 08:44 FROM:BOBS ELECTRIC 3604529943
CITY OF PORT ANGELES PERMIT APPLICATION
Btliitling Divisiop /Elaectrical Inspections
321 East Fit"th Street — P.O. Box 1150 / Port Angeiea Washington, 98362
Ph: (360) 417-4735 Fax.. (3610) 417-4711
Date:
" Plan Review May Be
,fob Address:
8trldfng Square Foolln% _
osacriptlan of 8bavq
tlwn®r Info tian
Hamv, ,
tlleilifig Ad 5
Phone,_ _ r _Fax;
Lkenso 41 exp.
!tom
Servlco/Feeder,200 Amp.
SONIcefFeeder 201 100 Amp.
ServicefFeeder 40MOD Amp
ServicefFeeder 801 -1000 Amp.
8etvicadFee4orover 1000 Amp.
Branch Qq;uit WF $srvice Feeder
Branch Circuit WO Servlcs Feeder
ai Branch Circuit
Branch Clrculta I-4
emp.. a rteder 200 Amp,
Tsmp, Servi€xalFeeder 201400 Amp,
Temp. ServlcgfFeeder401-600 Amp.
Temp. SvrvicelFaedar601.1000Amp .
Paul to Portal mouriy
Signal Mcuili Limited Energy -18,2 1 =Vmlly Dwelling
Manufactured tfome Connectlun
Ronewoble Elaci loci Energy. 51{VA 5yatem or Leas
Thermostat
Nato; $5,01) for-each additional T «Stal
M ,pllsr CTrc�u ohl„
First 100 Square Ft,
Each Additfnnal 500 Square Ft, of Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or HQt Tub
„- 9 & 2 Single Family getting
TO: 4174711
Y H�s r vt;:,
R I"
FEB 2 3 x01h
Plan RevieW Information Sheet
161 .f111R1CIAL
P.1 /1
0� JIM
r�
ciry;, �,Statelip:
121 Mo. Fax; _ --
License 01 Pxp._
N
Unit are
Total ME ftftlled by Unit Cho
- $
3 %S.Oit
�,
t33.ai1
41r�'
F
v'7��.
�
S 188.00
S�
S 84x00
� S
$ 102.00
$ 56.00
S 40,40
$ 740
S
Owner as deflned by RM19.28.26t, (1) Owner will Occupy the structsare for two years after this electrical permit is finalized, (2) Owner is required
to hire an electrical eantractor'if above said property is for sate, rent or tease. Permit expires after Six rnanths of last inspection.
After readirlg the above statemertt. I hereby Certify that i am the aWrter of the above named properly or a licensed elactrlcel contractor. ism making
the 6180trical Wtallation or alteration in compliance with the electrical laws, NZC„ RCW. Chapter 19.26, WAC. Chapter 296-488, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14. 45.450 regarding Electrical Peinilt Agpfcatfonv,.
8lOnSlture Of mmer, electrical contractor or elactrical administrator, 0 Caen Q chock
,Stvcreettcarerr �. / ..i e97
ersd� OffU1724yg� ,r ] J