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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
04-00000440 Date
.314600
609 E 11TH ST
06-30-00-0-3-3360-0000-
MECHANICAL APPL. PERMIT
5/24/04
RS7 RESDNTL SINGLE FAMILY
1000
Owner
Contractor
GOIN DORI
609 E 11TH ST
PORT ANGELES
WA 983627937
B&B ENTERPRISES
520 ROSE ST.
PORT ANGELES, WA
PORT ANGELES
(360) 417-0436
WA 98362
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Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
WOOD STOVE INSERT
50.00 Plan Check Fee
5/24/04 Valuation
11/20/04
.00
o
Qty Unit charge Per
1.00 50.0000 ECH ME-WOOD BURNING APPL.
Extension
50.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50.00 50.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 50.00 50.00 .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
constn/lion/) 4-. ..
~.{,"'- / 0
Signature of Contractor or Authori Signature of Owner (if owner is builder) Date
T:\PLANNINGIFORMS\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 UNLA WFUL 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
\ I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TION DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS ,
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I I I
MECHANICAL
HEA T PUMP
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 11i_ ~ -{J ,)../ -J ,t., I BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003]
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FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
3C)8
PERMIT NUMBER
.
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TOTAL FEE
, .' . CONT. Lie. NO. TIMETO COMPLETE NO. STORIES LEGAL OCCUPANCY
15~
ELECTRICAL PERMIT ONLY . NO QCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
/"R1 01,- ~S' T'~ II' a
Site f'ddress '-" V;;...L ~ '/
\. ., 1 CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT ' . PEAMITS WITH WRONG ADDR9~ES ARE CA~CElLEp ..
owne;-G'e-;,(I,_ ~,-f,/..'f'V\' e.r Ins.tallationBy" . . H-nu.<2-It"-R ~I e~
Owner'sAddress _: r.,oq' '~~~. IIf}-, Ins~allersAddress' ,<; rlY4' ~ /g,-
Day Phone 4s;t-"~3~ -"~~"r::LI,lt) Installers Phone' ~,<;;:J...-'7.J..i';'t
Appljcation is hereby made for Permifto Iflstall Ele'ctrical Equjpment as follows:.
....'Set',) \~J> _ ' 'M. ef \ t Ic-mrt--v
"
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Wiring Method
.-
-, NUMBER "AMP 240V AMP 24QV
USE OF CIRCUIT PER 120V 100R FEE USE OF CIRCUIT NUMBER PER 120V 10QR FEE
CIRCUITS \ CIA 10 ,30 CIRCUITS CIR 10 30
LIGHT SIGN
LIGHT 50 VOLTS
OR LESS
CONVENIENCe" - MOTOR
CONVENIENCE - --- MOTOR
APP.L1ANCE. , - MOTOR
DISHWASHER FIRE ALARMS
DISPOSAL BURGLAR ALARM
RANGE MISC.
-
OVEN
WATER HEATER
LAUNDRY
DRYER - REINSTALLATION LIGHT FIXTURE #
FURNACE - -- - SUB TOTAL FEE
GAS. OIL
FURNACE ENERGY FEE
ELECTRIC BASIC FEE
ELECTRIC HEAT - 3D,~
TOTAL FEE
ElECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT Qrx) AMP /tZf PHASE
FEEDER SIZE OF SERVICE ENTRANce' CONQUCTORS
- - )/'/& /11-
SERVICE AW.G.
T SUB-TOTAL SIZE OF GROUND::tf), ~ SIZE ~F ENTRANCE SWITCH ~
I certify that the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code.
DateApplicationmade f.q/~~/@S. ,19 BY~~~~~~RIZEDAGENl)
Permisslonis.h~reby given to do the above described ,work, according to the conditions hereon and according to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles.
DIRECTOR OF CITY LIGHT
. .
B;f-'Pft.1
PLANS APPROVED
Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in
Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158.
,
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.
Date Permit Issued
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
n., "Ugjl"'. gl;lINTI=R~.lN~.
, - .....,.
REPORT OF INSPECTOR
DATEOFVISIT MADE BY REMARKS
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. O.K. FOR COVERING
1'-30-~) /!l /' J O.K. TO CONNECT SE~VICE
FINAL O.K. .
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1009
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E L E C T R I C A L
PER M I T
ADDENDUM
-
RELEASE OF ELECTRICAL PERMIT TO'OTHERS
PERMIT- NO. 3 '/17
I .~ "),,1'3:...~.-JU\ I , reques t release of and inspect ion
'.-Permit 'fr;;~r
on the above electrical permit. I assume liability and responsibility
on ~ork done to date and additional work required to pass inspection
for release. I assume no other liability and responsibility on this
, .
elecJ:,rical permit.
Passed inspect iOE .for release:
~'''' ,
Signed: ~"'-
Date: -- {/~I BS
;JftP/~2~~
Electrical Inspector
Date: <7 - . I - c;{ r
ASSUMPTION OF ELECTRICAL PERMIT BY OTHERS
.
I,
;~~
. request cont in.ua.nce of the above
Permit:re<;aJest~
, ~. '. t,.
ele'ctric~l permit i.
; .1- -. ,:., ....
;fo'r"worJ:t tope done 'on
this'd'ate f~F:ward.
K:lam~. I assume respons1lbility and liability
this continuance of the electrical permit from
Acc~Pted} 4/rrc(f ~~y-
, . ,J'" . Elect-r.J,ca-l Inspector'
. ' . . 'Vr-
. .oa~e :1" I' ~ 0 .
Date:
Signe,d:
,".
.
Port Ang~les City Lig~t assumes no responsibilitY or liability for
this elect~ical permit transfer.