HomeMy WebLinkAbout808 Golf Course Rd - BuildingPREPARED 10/15/10 8 18 59 INSPECTION TICKET PAGE 7
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/15/10
ADDRESS 808 GOLF COURSE RD SUBDIV
TENANT NBR LAWRENCE NANCY LANG
CONTRACTOR PENINSULA HEAT INC PHONE (360) 681 3333
OWNER LAWRENCE AND NANCY LANG PHONE (360) 452 4348
PARCEL 06 30 14 5 7 0030 0000
APPL NUMBER 10 00000977 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 10/15/10
V�
MECHANICAL FINAL TIME 01 00
October 13 2010 3 39 17 PM 1pangrle
LARRY 452 4348
MECHANICAL FINAL HEAT PUMP
AFTERNOON
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
Ductless heat pump
Owner
LAWRENCE AND NANCY LANG
808 GOLF COURSE RD
PORT ANGELES
(360) 452 4348
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty
1 00
1 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
Unit Charge Per
73 5000 ECH
2 6000 ECH
WA 983624940
10 00001141
231353
808 GOLF COURSE RD
06 30 14 5 7 0030 0000
ELECTRICAL ONLY
Contractor
ELECTRICAL ALTER RESIDENTIAL
3
174946
76 10
10/07/10 Valuation
4/05/11
Plan Check Fee
EL BRANCH CIRCUIT WO /FEEDER
EL ECH ADDNT BRANCH CIRCUIT
Charged Paid Credited
76 10 76 10 00
'00 00 00
76 10 76 10 00
INSPECTION TYPE DATE.
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
OLYMPIC ELECTRIC CO INC
4230 TUMWATER
PORT ANGELES
(360) 457 5303
Date 10 /15 /10
RESULTS
4s?
WA 98363
00
0
Extension
73 50
2 60
Due
00
00
00
Date.
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
10 05/2010 15 21 FAX 360 452 3498
City of Port Angeles Permit Application
Building Division/Electrical Inspections
321 at Fifth Sweet P.O. Box 1150
Port Angeles Waehington, 90362
ph; (360) 417-4735 Fax; (380) 417.4711
Date: ,ii,/4 /O
yet 2 Single Family Dwelling
Multi- Family or Commercial'
Commercial Addition I Alteration Remodel Repair'
Owner information
Name;
Mailing Addre
City'
/:;./9/7 �itir/r
i/ r Stale: s, /.7 Zip: ric 7
Phone; Its 2 Fax:
License Exp.
Unit Chergg
119.90
146,50
204.90
262,20
372.60
5 2.60
73.50
2.60
5 92.70
110.30
3148.70
167.90
95.90
88.20
95.90
53.90
63.90
119.90
$102.30
110,30
3 35.20
73,50
5110.30
55,00
Check
)(��i� Date:
Olympic Electric Co PA CITY INSPECT a 001/001
Credit Card 0
Ju j�
6 2003
ELECTRICAL
INSPECTIONS
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
JOb Address: _2 Y
Building Square Footage:
Description of above 11-r ,-rs fr/, l/: //1i. 7 y
Total (Qtv MuIliolled by Unit Ctlarael
ServlcelFeeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401 -600 Amp,
Service/Feeder 601 -1000 Amp.
Service /Feeder over 1000 Amp.
Branch Circuit W/ Service feeder
Branch Circuit W/0 Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Tamp. Service /Feeder 201400 Amp.
Temp, Service /Feeder 401.600 Amp.
Temp, ServicelFeeder 601 -1000 Amp.
Pone) to Portal Hourly
Sign /Outline Lighting
Signal Clrcult/ Limited Energy Commercial, Addldonel 1600 $5.00
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi -Family Dwelling
Manufactured Home Connection
Renewable EIecM WI Energy 5KVA System or Less
First 1300 Square Ft.
Each Additional 500 Square FL•or Potion of
Each Outbuilding or Detached Garage
Eacn Swimming Pool or Hot Tub
Thermostat
Total
►�D
Name: r/ it I
Mailing Ad
City; Stele; i__/ Zip:
Phone: 475 Fax: Yj,Z J» y p
License Exp, �i1c 49ia. eRri,e
Signature of owner, electrical contractor or electrical administrator D Cash
Owner as defined by RCW.19.28.281 (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner b required lo hire en electrical contractor ff
above 'ski property to for Nam rent or lease. Permit expires offer six months or last Inspection.
After reading the above etatement, I hereby certify that 1 am the owner or the above named property or a licensed electrical contractor. I am making the electrical Installation or
alteration In compliance with the electrical lewe, N.E.C. RCW. Chapter 18.28, WAC. Chapter 1.96-488, The City of Port Angeles Munlclpel Code, and Utility Speclllcallone.
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
INSTALL A MINI SPLIT HEAT PUMP
Owner
LAWRENCE AND NANCY LANG
808 GOLF COURSE RD
PORT ANGELES
(360) 452 4348
Permit MECHANICAL
Additional desc MINI SPLIT
Permit pin number 172890
Permit Fee 64 80
Issue Date 9/07/10
Expiration Date 3/06/11
Qty Unit Charge Per
1 00
Fee summary Charged
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
WA 983624940
PERMIT
HEAT PUMP
BASE FEE
14 8000 EA ME FURN /HP /FAU
Permit Fee Total 64 80
Plan Check Total 00
Grand Total 64 80
121//) ALA
10 00000977
601733
808 GOLF COURSE RD
06 30 14 5 7 0030 0000
LAWRENCE NANCY LANG
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
3436
Contractor
PENINSULA HEAT INC
782 KITCHEN DICK RD
SEQUIM WA 98382
(360) 681 3333
64 80
00
64 80
Plan Check Fee
Valuation
OR 5 TON
Paid Credited Due
00
00
00
Date 9/07/10
00
00
00
0 0
0
Extension
50 00
14 80
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
c (IAA
10-15 -10
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 compli with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or camel the provision o any state orlocal law regulating construction or the performance of
construction
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
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 1 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
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 1 Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
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
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
Inspection Type
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping 1 SHORELINE.
FINAL Date Accepted by
05
FINAL Date I I Accepted by �L
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
09/07/10 11 03 FAX 3606812086 Peninsula Heat a 02
Applicant (if G r 66 f-
Property Owner rrv,
Property O er's Address-)
Contractor P 1 hSi c,r'
Contractor's Address
License
PROJECT ADDRESS
Parcel Number
BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St, Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
Phone
Na n cu Phone
Phone
Expires
2g 6-0 i Covtir R�
E-mail
Lot
For City Use Only:
Date Received c i 1 O
Permit 10 qJJ
Date Approved
/3 Ye'
/Sr -33'3
Zoning
Protect Time Qrf f Descriroton: f R dentiel o Muhl family o Commercial D Industrial
Check all that appy
o New Construction
o Addition
o Remodel
o Repair
o Demolition
q Re-roof a House o garage o other o tear off re-roof o lay over one layer
g Meat System o Heat pump o wood burning stove o gas fireplace o pellet stove der
o.O ier PI/ n i 4a/17
1 I
Pluck= &x sllinq fsa. R) fposed
Basement per sq. ft
1 'r Floor
2 Floor
3i Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION S .5.43 6 c42
Total footprint of structures sq. ft. T Lot we sq. ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel. including structures, paved driveways. sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage
Max. height of proposed structures
Will a lawn sprinkler system be installed?
WII a fire sprinkler system be installed?
R Occupancy group
Occupant load
Construction type
I have need and cnmpleled this application and MOW it to be true and correct. l am authorir
Mat it is my responsibility to determine whet permits are requl and to obtain permits prior
Date$'? L Print Name C4 er3 Signature
T:Fvme1Bulding DMsteW tIy Permit.doc
of bedrooms
of full baths
of half baths
Clallam County Assessor Treasurer Property Details 67376 LAWRENCE AND NA Page 1 of 6
Clallam County Assessor Treasurer
Property Search Results 67376 LAWRENCE AND NANCY LANG for Year 2010 2011
Property
Account
Property ID 67376 Legal Description. UPLANDS THE LT4
Geographic ID 0630145700300000 Agent Code
Type Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11
Open Space N DFL N
Historic Property N Remodel Property N
Multi Family Redevelopment: N
Township Section.
Range.
Location
Address:
Neighborhood
Neighborhood CD
Owner
Name
Mailing Address:
Taxes and Assessment Due
Property Tax Information as of 09/07/2010
Amount Due if Paid on. M.
808 S GOLF COURSE RD Mapsco
PORT ANGELES WA
Cycle 5 Res Map ID:
10955130
LAWRENCE AND NANCY LANG
808 GOLF COURSE RD
PORT ANGELES WA 98362 -4940
Exemptions.
Year Statement ID Taxing Jurisdiction
2010 49230 ST SCH STATE SCHOOL
2010 49230 CC -GEN COUNTY
2010 49230 PORT PORT
2010 49230 PORT ANG PORT ANGELES
2010 49230 SD #121 SCHOOL DISTRICT #121
2010 49230 NTH OLY LIB NORTH OLYMPIC LIBRARY
2010 49230 HOSP #2 HOSPITAL #2
2010 49230 WSMET PK DIST WILLIAM SHORE MET PARK DIST
2010 49230 CITY_STORMWATER CITY STORMWATER
2010 49230 WEED_CONTROL WEED CONTROL
2010 49230 TOTAL.
2009 673762008 ST SCH STATE SCHOOL
2009 673762008 CC -GEN COUNTY
2009 673762008 PORT PORT
2009 673762008 PORT ANG PORT ANGELES
2009 673762008 SD #121 SCHOOL DISTRICT #121
2009 673762008 NTH OLY LIB NORTH OLYMPIC LIBRARY
2009 673762008 HOSP #2 HOSPITAL #2
2009 673762008 CITY_STORMWATER CITY STORMWATER
2
Owner ID: 36044
Ownership 100 0000000000%
First Half Second Half
Base Due Base Due Penalty Interest Base
$268.71 $268.71 $0 00 $0 00 $2€
$143 00 $142 99 $0 00 $0 00 $14
$20 10 $20 10 $0 00 $0 00
$331 10 $331 07 $0 00 $0 00 $3Z
$348 05 $348 05 $0 00 $0 00 $34
$41 55 $41 55 $0 00 $0 00 $4
$58 66 $58 66 $0 00 $0 00 $E
$18 66 $18 67 $0 00 $0 00 $1
$36 00 $36 00 $0 00 $0 00
$0 82 $0 81 $0 00 $0 00
$1266.65 $1266.61 $0.00 $0.00 $12E
$306 98 $306 98 $0 00 $0 00 $61
$155 36 $155 37 $0 00 $0 00 $31
$22.01 $22.00 $0 00 $0 00 $4
$340 76 $340 77 $0 00 $0 00 $6E
$379 62 $379 63 $0 00 $0 00 $7E
$45 14 $45 14 $0 00 $0 00 $E
$63 71 $63 72 $0 00 $0 00 $12
$36 00 $36 00 $0 00 $0 00 $7
http. /vpn.clallam. net. 8084 propertyaccess /Property.aspx ?cid =0 &year 2010 &prop_id =67376 9/7/2010
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:12I EAST 5TH STREET. PORT ANGELES. WA 911:\62
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000090 Date
354140
808 GOLF COURSE RD
06-30-14-5-7-0030-0000-
RES ADDITION
5/23/05
.,
RS7 RESDNTL SINGLE FAMILY
40302
Owner
Contractor
LANG LAWRENCE A/O J
808 GOLF COURSE RD
PORT ANGELES
.DOUBLE S CONST.
PO BOX 1386
WA 983624940 PORT ANGELES
(360) 452-0824
000 000 261 SF ROOM ADDNT & 189
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL-% LOT COVERAGE
CONSTRUCTION TYPE
HARD SURFACE AREA
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
Structure Information
Construction Type
Occupancy Type
Other struct info
Pe rmi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
S&J ELECTRIC/ ALTER 5 CIR.
49460
S & J ELECTRIC
64.00
5/23/05
11/19/05
Plan Check Fee
Valuation
.00
o
G'\
o
r
1\
Qty
1. 00
3.00
Unit Charge Per
48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS
5.3000 ECH EL-R OR RM ALT ADDNT CIRCUITS
Extension
48.10
15.90
o
o
~
<A
r"
Special Notes and Comments
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
The proposal will result in a 240 sq. ft. room addition with
a 188 sq. ft. covered deck for total lot coverage of 2436
sq. ft. or 18%. Setbacks are good. No land use issues are
noted.
> Public works electrical engineering has no requirements
for this plan review.
> Service Connection Fee DOES NOT Apply.
~y modifications to the electrical facilities will
be at the customer's expense.
Other Fees
STATE SURCHARGE
4.50
~
Fee summary Charged Paid Credited Due
Permit Fee Total 64.00 64.00 .00 .00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPEg.lON RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE I ACCEPTED COMMENTS
I YES I NO
UITCH
IHlIICyH_IN / CUVbK
SERVICE
FINAL I I I
.
:
...
GENERAL COMMENTS:
PW.II02.1'14I961
'S
"'r .....-,...
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 911:\62
.
Application Number
Application pin number
Plan Check Total
Other Fee Total
Grand Total
.00
4.50
68.50
COMMENTS/ACTION NEEDED
05-00000090
354140
Page
Date
2
5/23/05
.00
4.50
68.50
.00
.00
.00
.00
.00
.00
ELECTRICAL PERMIT INSPEQ'JON RECORD
I
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COliER.
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPEcnON TYPE
DATE
COMMENTS
NO
Exp,uD
5' ~ lS ~ 0 6
GENERAL COMMENTS:
PW-II02.I' [4'961
.... cr rOR" ~
....~~
~rGii~
~--
~~
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:
Application type description
Subdivision Name
Property Use . . . .
Property Zoning . . .
Application valuation
Owner
LANG LAWRENCE A/O J
808 GOLF COURSE RD
PORT ANGELES
Structure Information
Construction Type
Occupancy Type
Other struct info
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty
05-00000090 Date
354140
808 GOLF COURSE RD
06-30-14-5-7-0030-0000-
RES ADDITION
4/20/05
P~1 Ekft~
ll/-z--t:f IOJ
RS7 RESDNTL SINGLE FAMILY
40302
Contractor
DOUBLE S CONST.
PO BOX 1386
WA 983624940 PORT ANGELES
(360) 452-0824
000 000 261 SF ROOM ADDNT & 189
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
HARD SURFACE AREA
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
WA 98363
SF DECK
18.90
V-N
1. 00
2000.00
12941.00
450.00
2450.00
1. 00
..."
\:X
c:;:)
~
BUILDING PERMIT -RESIDENTIAL
261 SF ADDNT/188 SF DECK
46664
576.35 Plan Check Fee
4/20/05 Valuation
10/17/05
230.54
40302
Unit Charge Per
Extension
414.75
161.60
~
<::,
-
'-0
o
c
....
\/"
it
BASE FEE
10.1000 THOU BL-25,001-50K (10.10 PER K)
16.00
--------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
MECHANICAL PERMIT
REPLACE FIREPLACE
47597
.00 Plan Check Fee
4/20/05 Valuation
10/17/05
.00
o
Special Notes and Comments
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
The proposal will result in a 240 sq. ft. room addition with
a 188 sq. ft. covered deck for total lot coverage of 2436
sq. ft. or 18%. Setbacks are good. No land use issues are
noted.
> Public works electrical engineering has no requirements
for this plan review.
> Service Connection Fee DOES NOT Apply.
Any modifications to the electrical facilities will
be at the customer's expense.
~
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
presu~Ye authority to viola e or cancel the provisions of any state or local law regulating construction or the performance of
constr tion. , ~ .
- --'
-j--. c------_ Iv\, ~c-""'--- '--,
Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) Date
T:\Policiesll 102.15 building pennit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
- .
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 LOC~ TION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION: ,
FOOTINGS
WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS '7/' /C.(j ;1U--
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL *.w::.
WALLS 11h.cj lot) ,Jw
CEILING I I
FRAMING
JOISTS / GIRDERS '0/~"0j,)7 .:::JcVC.
SHEAR W ALL/HOLD DOWNS I;?
WALLS / ROOF / CEILING i /)/1 !V'tJ {2Vtfi,:;
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING ' '" i j /0':7 Ju.
MECHANICAL
HEAT PUMP/FURNACE/DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING 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. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\II02.I5 building pennit inspection record05.wpd [1/4/2005]
-I. 0" rORl ~~
.t~~
na
~ --
~';;iF'
CITY OF PORT ANGELES
'DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
----------------------------------------------------------------------------
Application Number . . . . . 05-00000090
Application pin number 354140
Page 2
Date 4/20/05
Other Fees
STATE SURCHARGE
4.50
----------------------------------------- ----------------------------------
Fee summary charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 576.35 576.35 .00 .00
Plan Check Total 230.54 230.54 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 811.39 811.39 .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 authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Date
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T:\PoliciesllI02.15 building pennit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 4 I 7-48 I 5 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.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS 4'- 2./ -05 Ji-L
WALLS 4 .' ;l t..,tJ:;- JLt...
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
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 ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
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. 1 PWI CONSTRUCTION. R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:IPoliciesll102_15 building pennit inspection record05.wpd [1/4/2005]
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FOR OFF!CLA.L USE ONLY:
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: (~UJ rot. '" c:... ~ ~. Lo...lI'\ J Phone:
Owner: ~~ Phone:
Address: 20 ~ b,tI>({- (~u....vs ~ RJ City: po or./-ArA..f e..lI<.~
Architect/Engineer: ItA.. {'(" ~ Co.. .Q.. I G "'t.l^ k-y Phone:
Contractor ~ I tJe.- > ~ c<s:t-State License #: Exp:
1-SL-~3VJ{
Zip: 9rf3~""\..-
<(C7-7~~{)
Phone:
Address: City:
PROJECT ADDRESS: 8' ~ s< c; tI (F Co u.. \f3 ~ 1? d
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Zip:
ZONING:
Subdivision:
Credit Card Holder Name: L '" UJ C~ C-.Q.... A... L
nmingAddr"" go)< <;. (~ C. V-.rs", R<! - Ci!::;;::I-+- ""-<><'7 ....,;".i: , w t..
Credit Card Type VISA ---- MC #_ . , - _ Exp. Date: _
TYPE OF WORK: SIZEN ALUATION: (
~sidential D New Constr. D Re-roof D Stove Md4 2.. ~ I SF. @ $ /SF. = $ 'To -;}oZ Go C
D Multi-family IOYAddition D Move D Garage"PeJ:K. j S ~ SF. @ $ /SF. = $
D Commercial !;YRemodel D Demolition iit15eck SF. @ $ /SF. = $
D Repair D Sign D O~r 2~:~ VA:U~~~Or~ /, D ~ :0 :SD~ ~
BRIEF DESCRIPTION OF THE PROJECT: ~ Z. 0 S D' of+: :L'" ~ = """~!:!::: -H _
C-. '" C-Jr~ k / c>... fA 0....., . \JJ: f---'r.-. C <0 0 F d.o. ~ k., .-t, J J F,' Ie: p/~ l' e.
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COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: -1- Lot Size: f2.'j111 Existing Sq. Ft: ZDcx.:>
Total lot coverage I 2, , q %
Occupant Load: Construction Type:
& Proposed Sq. Ft._ 45'0 . ~ = TOTAL Sq. Ft. 2i(S.O
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetland(s): DYes D No SEPA Checklist required? DYes D No Other:
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: If no 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 RI05.3.2
of the International Building/Residential Code, 2003). 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 requ' not the City's, and th~ust obtain such permits prior to work.
T:\RVESS\BLDG-forms-brochures\2004-Buildingpermit.wpd Applicant: ~ ~::... Date: 2-/7 / 0 ~
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60
Area Map
This map is not intended to be used as a legal description. "r'
This map/drawing is produced by the City of Port Angelesfor its own use and purposes. :'~
An,v other use f:?fthis map/drawing shall not be the responsibility of the Cj(~'. ;~.
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ELECTRICAL WORK PERMIT APPLICATION
i
~ Electrical Contractor 0 Owner
o Annual Permit 0 Alarm 0 Carnival 0 Commercial M Residential 0 Residential Maint. CJ Signs 0 Thermostat 0 Telecom.
Job wired by
I!!l' Electrical Contractor 0 Owner
License number
Electrical contractor name
") 11:r Fl-ed/.c Nw
Purchaser's mailing address
Po /30 2
City
Port tP-yl..S
Telephone number
Premises owner's name
[<il'! y <;~i. AJ.....~~
Address of inspection
1053 GoLF CC'JS~
C~d
,"he
I hereby certify that I am the owner of the above named property or a licensed
electrical contractor (or the finn's authorized agent) and am making the electrical
installation or alteration in compliance with the electrical law, Chapler 19.28 RCW.
L1...It"L
FAX number
Lr.'J
(?J..
x
Signature of owner, electrical contractor or electrical administrator
WALLS
Insulation Only
Dale Approved By
Cover
Date Approved By
/ CEILING
Insulation Only
Date Approved By
Cover
Date Approved By
Electrical Load Additions and or subtractions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton LAA
o Fan-Wall KW
Inspection
Date
~ 5)'l~~
Installation description
-At f-w1. .57" C ,'I' c......'tS
7
o Cash 0 Check #
o CrcditCard
Card # ,
Visa
Expiration Date
of card
THERMOSTAT
Date Approved By
DITCH
Dale Approved By
CJ Overhead Service
o Temp Service
CJ Underground Service
Area, Building or Equipment Inspected
{ IUL.D
Mastercard
Discover
, tTD
Inspection fee
$
/' SERVICE
"- Dale Approved By
/' FEEDER "
Dale Approved By
Service Information
Voltage
PhaseD 103
Service Size:
Feeder Size:
Action Taken
Electrical
Inspector
Application Number . . . . . 23-00000015 Date 1/06/23
Application pin number . . . 019510
Property Address . . . . . . 808 GOLF COURSE RD
ASSESSOR PARCEL NUMBER: 06-30-14-5-7-0030-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Heat pump
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
LAURA BULLEN BLACK DIAMOND ELECTRICAL CONTR
808 GOLF COURSE RD 502 BLACK DIAMOND RD
PORT ANGELES WA 983624940 PORT ANGELES WA 98363
(360) 477-9447 (360) 565-1035
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee . . .00
Issue Date . . . . 1/06/23 Valuation . . . . 0
Expiration Date . . 7/05/23
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
----------------------------------------------------------------------------
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
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Pub! ic \Yorks and ULili ties Department
32 l E. 5th Street. Port ;\ngeles. WJ\ 98362
300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us
Project Address:--------------------------------------
Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _
OWNER JNFORMATtON
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRfCAL CONTRACTOR fNFORMATION
Name: ___________________________ License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 $
Service/Feeder 201-400 Amp. $146.00 $
Service/Feeder 401-600 Amp. $205.00 $
Service/Feeder 601-1000 Amp. $262.00 $
Service/Feeder over 1000 Amp. $373.00 $
Branch Circuit W/ Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 $
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder 401-600 Amp. $149.00 $
Temp. Service/Feeder 601-1000 Amp. $168.00 $
Portal to Portal Hourly $96.00 $
Signal CircuiULimited Energy - 1 &2 DU. $64.00 $
Manufactured Home Connection $120.00 $
Ren ewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat (Note: $5 for each additional) $56.00 $
First 1300 Sql;Jare Feet $120.00 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding / Detached Garage $74.00 $
Each Swimming Pool/ Hot Tub $110.00 $
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-
468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
'"'CJ CD
PREPARED 1/05/23,14:04:27 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
---------------------------------------------------------------------------
APPLICATION NUMBER:23-00000015 808 GOLF COURSE RD
FEE DESCRIPTION AMOUNT DUE
---------------------------------------------------------------------------
ELECTRICAL ALTER RESIDENTIAL 63.00
TOTAL DUE 63.00
Please present reciept to the cashier with full payment
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
11/21/2023 23-15
TAP
OWNER
CONTRACTOR
Black diamond Electric
PROJECT ADDRESS
808 Golf Course Rd