HomeMy WebLinkAbout722 Milwaukee Dr - BuildingPREPARED 9/10/08 12 42 34 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 9/10/08
ADDRESS 722 MILWAUKEE DR SUBDIV
TENANT NBR FRED WIRTH
CONTRACTOR ALL WEATHER HTG COOLING INC PHONE (360) 452 9813
OWNER WIRTH FRED PHONE 45) 3718
PARCEL 06 30 01 7 1 9010 0000
APPL NUMBER 07 00000490 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 9/10/08 MECHANICAL FINAL TIME 01 00
bi 44 September 2 2008 9 36 51 AM 1pangrle
FRED 452 3718
MECHANICAL FINAL HEAT PUMP
AFTERNOON
COMMENTS AND NOTES
Application Number 07 00000490 Date 5/16/07
Application pin number 525480
Property Address 722 MILWAUKEE DR
ASSESSOR PARCEL NUMBER 06 30 01 7 1 9010 0000
Tenant nbr name FRED WIRTH
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning RS9 RESDNTL SINGLE FAMILY
Application valuation 13578
Owner Contractor
WIRTH FRED
722 MILWAUKEE DR
PORT ANGELES
45) 3718
WA 983631421
Permit MECHANICAL PERMIT
Additional desc HEAT PUMP INSTALL
Permit pin number 101105
Permit Fee 64 70 Plan Check Fee 00
Issue Date 5/16/07 Valuation 13578
Expiration Date 11/12/07 t
Qty Unit Charge Per Extension 5
BASE FEE 50 00 „1
1 00 14 7000 ECH ME INSTALL 100- FAU 14 70 1
Fee summary Charged Paid Credited Due 1
Permit Fee Total 64 70 64 70 00 00
Plan Check Total 00 00 00 00
Grand Total 64 70 64 70 00 00 3
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 c
inspection I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of 7
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 kAilthorized Agent
T \Policies \1102_15 building permit inspection record05 wpd [1/4/20051
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452 9813
5/
Date Signature of Owner (if owner is builder) Date
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.I
PLUMBING
UNDERFLOOR /SLAB
ROUGH -1N
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALL.,
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -1N
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE i PELLET CHIMNEY
ELECTRICAL LIGHT DEPT
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653 I
I PLANNING DEPT 417 -4750 1
IL
1
I BUILDING 417 -4515 14__
T \Policies \1102 15 building permit inspection recordO5 wpd (1/4/2005)
BUILDING PERMIT INSPECTION RECORD
O CALL 417-4S 15 FOR BUILDING INSPECTIONS CALL 417 -4735 FOR ELECTRICAL INSPECTIONS
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES i
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER INSULATE OR CONCEAL 4.NI' WORK BEFORE
INSPECTED AND 4CCEPTED POST PERMIT IN 4 CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. Q
INSPECTION TYPE DATE I ACCEPTED I COMMENTS I
1 YES
NO
FINAL
MANUFACTURED HOMES
FOOTING 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
417 -4735 ELECTRICAL
LIGHT DEPT
FINAL 9 16 "08 DATE
CONSTRUCTION R.W
PW /ENGINEERING
I FIRE DEPT
PLANNING DEPT
BUILDING
DATE ACCEPTED
ACCEPTED BY.
3
DATE 1 ACCEPTED
1 YES 1 NO
3
I I I
1 I 1
Application Number 07 00000508
Application pin number 152308
Property Address 722 MILWAUKEE DR
ASSESSOR PARCEL NUMBER 06 30 01 7 1 9010 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS9 RESDNTL SINGLE FAMILY
Application valuation 0
Owner
WIRTH FRED
722 MILWAUKEE DR
PORT ANGELES
45) 3718
Permit
Additional desc
Permit pin number,
Sub Contractor,
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
COMMENTS /ACTION NEEDED
35 00 35 00
00 00
35 00 35 00
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321.EAST 5TH STREET PORT ANGELES, WA 98362
Contractor
Qty Unit Charge Per
1 .00 35 0000 ECH EL LVT FIRST THERMOSTAT
Charged Paid Credited
op
00
00
EXPIRED
Date 5/15/07
ALL WEATHER HTG COOLING INC
302 KEMP ST
WA 983631421 PORT ANGELES WA 98362
(360) 452 9813
t.
ELECTRICAL NEW RESIDENTIAL
ALL WEATHER/ T, 'STAT
1014.10
ALL WEATHER HTG COOLING INC
`35 Plan Check Fee
5/15/07 Valuation
11/11/07
00
0
Extension
35 :00
Due
00
00
00
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
DITCH
ROUGH IN COVER
SERVICE
FINAL
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES 1 NO
i t jcp I rf2- -Q
PW- 1102.15 14196]
05/04/2007 00 56 13604525177
Applicant or Agent: 1 r liQCL (C.t,t( Phone: -Ce�i
Owner U `V Phone: LtS 2
Zip. 9S No
Address: A 2Z N\ 1 l Q GSitr
Architect/Engineer AI 1 k"a
•Contractor 1 WaShsjr State License Qi1P la +t 1 xp. --1 C-
Address: ?)CD j c p Cit �l Q /1
PROJECT ADDRESS:17ZZ- I('V\ t `�A)Ce JJ 0� ZONING.
LEGAL DESCRIPTION Lot: Block:
CLALLAM COUNTY PARCEL NUMBER.
Credit Card Holder Name.
Billing Address:
Credit Card Type VISA MC
TYPE OF WORK.
91 Residential 0 New Constr. Rc -roof
Multi- family Addition Move
Commercial 0 Rernodel Demolition
Repair Cl Sign
BRDiT DESCRIPTION OF THE PROJECT
CO1VII1ERCIA.L/RESIDENTIAL. Occupancy Group
No. of Stones: Lot Size:
Total lot coverage
PLANNING USE ONLY
BUILDING PERMIT APPLICATION
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
PERMITS (360) 417 -4815 FAX(360)417 -4711
Existing Sq. Ft.
City
BSA/Wetland(s): 0 Yes No SEPA Checklist required? Yes 0 No Other
ALL WEATHER HEATING
Subdivision.
SIZE/VALUATION
o Stove SF /SP
O Garage SF /SF
O Deck SF /SP
O Other
4fPD1f ,Lt,/np /nV172 OA.
Phone: 1 -15 Z 9 X1,3
Zip: 5 6
Exp. Date:
TOTAL VALUATION I 3 OW; t l
Occupant Load: Construction Type:
Proposed Sq. Ft. TOTAL Sq. Pt.
PAGE 02/02
FOR OFFICIAL USE ONLY
Date ltcc. 0 5.— O
�7
Permit 0 7 1 4 1 4,0
Date Approved: 0 0 1 4 0 r
Date Issued: a 5 ,-04{ -0- 7
APPROVALS:
PLAN
BLDG:
DPWU
ME.
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 ice is duc 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 R105.3,2
of the International Building/Residential Code, 2003) No application can be extended more than once.
1
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 detennine what permlts are required ,not the City's, end that I must obtain such permits pprio to work.
Date: /j/ 1
TIRVESS\BLDG- forma- brochums \2004- Auildingpermit.wpd Applicant
05/04/2007 00:56
13604525177
ALL WEATHER HEATING
PAGE 01/02
~,
~
W
ELECTRICAL WORK PERMIT APPLICATION
.
Job wired by
, Electrical Contractor CJ Owner
Inslalllltinn dC!'lcripTiQI1
r:J Cnmmcrclnl .~ Res1dential
Electrical contr.lctor name
el\W~r l-lPa:lr"'1i:flYJ1on'J \AlllIJl:ol-I(\..3Q_~[) 'f-1-0+
Purchaser's llJOtilins: oddrcss
:30 '2 K.ef'r\P ~
Cilv
~ ~.R1U)
Telephone number
51
FI'e-mlscs owner's- nil me
Etl..c\ \,u I ~
^dtlress or inspection _ a _ , ~
!}'l.-7- "^" \~P41
c:~
\-'CA* ~y I ,-"
Phone number to "c:hcd~1J In'lflcctlon: 15"7- '3, J g-
Owner ".I' dcIlflarJ h)! RCW19.28.26/:(I) Owner will "cr.up.1' tll" .(frl,C/lu'f'/or two
yean: ajtf1/' tI.t~' electrical prml'fit i.~ .1iflalizr!d. (2) Owner Is required In hire! 1711 eleclrlCQI
c;rmtracrnr if I2bO\lC ~'lIirJ propart)' ir Im' .~all? ren, Of" Ico..tr:.
After reading the ah(lvc !ilt."ltc:mcnt, , hereby certify that I nm the owner of the ahovc
n3n\c(1I~I'Opcrty Or a liccm.cd clcctl'iClll conlr<lctor. I om making the: dcctrical instal-
lation or !Ih.cr:'lliOt\ ill complhmcc with the elecrrical l<lwS. N.E.C.. RCW. Ch;lptcr
19.28, WAC. Cl1;,ll'tcr 296.468. Thc Cily (lr Porl ^n(!~le:; Municipal C(l(lc. <lnd
Ulility Specific3Iinn~.
~Hl!"fHIln.: or nwncr, C!1f!C1rICnl
. 'lh
Liccn~c numher
1)"IC Expiros
ON.,.
o AIl.red! Addillnll
u.~
PAx numher
~ -\ sk\-
g,.. ..
CJ Cash CJ Check II
~ Credit Card
Card #
Visa
Mastercard
Discover
-_._---------------
Expiration Date
of card
ServlceJI1I.ormatlon
o Overhead Service
Q Temp Service
o Underground Service
Vottage
Pha.. a , 0 3
Service Slze~
Feeder Size:
SAME DAY INSPECTION CALL BEFORE 7:00 AM 360-417-4735
,
" ROUGH-IN " TIlERMOSTAT SER"lCE
Il"l", ^wmvc<ll-l.\l "- I)nl~ "l'~rvull Dr "- DntC! ^t1'TlIvgdJJy
FJNAL '\ " DrrCH '\ '\
I FEEDER
I)nl~ ^I'rmwe... Ry '-. Dllla ....llfll'O"<:!d 0)' DlIlt ^lIl'l'llveol liy
InRfle:cri(l'l ArC>1. Building Or Equjpmenl Inspectcd Electrical
Dote Action Taken ,IMpcctor
-
/
ff--PIM-D 8/i /08
/ I /
~re.,
,""'. II' 1....11&
MAY 1 0 2D( 7
LIGHT OEPT
Dee DB 04 11:34a
\.
~s'" "ile '"
~.'"
Bobb~ O. Coleman 360-452-7594
CITY U~ YA ~Ll1v Vet'! '^A ;., 5bU q I: q II i v,~
p. I
.'.
FOIl o~FJCv..!.. ~S6 oN'~"
QcIVRH"
,.........
0-"""...-'
o.~ Wood'
ELECTRICAL PERMIT APPLICATION
The E1achical Permil Application must be fiJlHI out comnletelY,
Pluse type or Jepnntln Ink: If )'bU hDe IInV qUl!!stlans, pINs", call (36Dj 411-4135
fu number: PliO) 0417-4111
~
O"""DTEIe<:CDn".~?nt (~
P'OO.rt, Ownec. ~ ,.J '..IJ._iL.
"'ddress: 17.&r69-- 'A:~ lJU'1IJ!:;'U CUy:
.J / -p. #-
ElGdrtcaICon1raC\or: i'A ~"A f- p~~.r;;:.~_
AddrQS&: CRy.
Ph_::; ~ 7/7.v
Fax: .a. 7 )7 'I-
Pt\onr:'
f2 /-- jJ"/.j /.
UrenslC"#I: Exp:
ZiD <1,fSc, ?
Phone:
Zip:
INSTALLATION WIRED BY'
DOWNER
~LECTR.ICAl CONTRACTOR
c,...m Card Holder Name:
Cndil Cant Number.
Zip:
V1SA:_ Me:
City:
Exp. Dale:
Billing AddreSs:
PROJEC"T ADDRESS:
782 a/;;"IAJke:'?
Check alllhat apply: 0 New 0 A1teratiorllAddiUon
lVPE OF WORK:
o Commercial 0 Mobile Home
$q.Ft
y(Residentlal D. Multi-family
o Remo1e Meter D Detached gamge 0 Hot Tub 0 Swim Pool 0 Septic Pump
o Low Voltage 0 Telecom. 0 Sign
NUmber of CircUits added Dr altered: .
/-Jef!J ,,';iff//;-
diaL.! <' ,j.
DESGRlPTION Of THE ELECTRICAl. PROJECT:. .
Electric.1 Heat t..oad Additions and or Sub\nlctlons
Service 'n'onnatlon
o Baset)oard
DFumaD!
o Heat Pump
o Fan~afl
_KW
KW
TON LRA
_KW-
o Overhoad Sen<ice
o Temp Service
(J Underground Service
Voltage:
Phase: 0 1 0 3
Service Size:
Feeder Size:
, hereby certify that I have read and examined this application and know /Il..t same to be true anel correct and I am
authorized to apply for this permit. I understand il is not the Cily's leg81 responsibility to determine what permits
3re required; it fsmains the applicants responsibility to de~;;;~ermits are required and to obtain such.
credit Card Holder's Sign.lure: j? ~ (f;;!4 d Date' L:;J..-~ -M-
Owner or EIIC. Cont Signature: Date:
PERMIT FEE: $/1[3,10
::JELEC"ffiJCALPERMrrAP'PUCATION
J~
'\oil r..?
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
."\2\ EAST 5TH STREET. PORT ANGELES. WA 9R~62
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00001111 Date
.930461
722 MILWAUKEE DR
06-30-01-7-1-9010-0000-
RES REMODEL
2/01/05
RS9 RESDNTL SINGLE FAMILY
3592
Owner
Contractor
WIRTH, FRED
722 MILWAUKEE DR
PORT ANGELES
(452) 3718
OWNER
WA 983631421
SEBRING
FL
----------------------------------------------------------------------------
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER
ADD ONE CIRCUIT-
COLEMAN ELECTRIC
48.10
12/09/04
7/31/05
RESIDENTIAL
Plan Check Fee
Valuation
.00
o
Qty
1. 00
Unit Charge Per
48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS
Extension
48.10
\:;
i"
----------------------------------------------------------------------------
Special Notes and Comments
Building Division has no requirements.
The Fire Department has reviewed the project application and
has no comments
Proposal will result in a deck flush with the north side of
the residence which has been field verified by PW as being
65' from top of bank. No land use issues are noted.
Electrical load calculations and elctrical permits are
required.
Public works utility engineering has no requirements for
this plan review.
j
Other Fees
STATE SURCHARGE
4.50
""-
l'
t'
t
),.
~
~
~
---------------~------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 48.10 48.10 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 52.60 52.60 .00 .00
~
~
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPEq'.I0N 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
COMMENTS
NO
.e. i::..
GENERAL COMMENTS:
PW-II02.l~ [4196]
c1 VORT ~
$~~
,..
.... --
~C~
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
04-00001111 Date
.930461
722 MILWAUKEE DR
06-30-01-7-1-9010-0000-
RES REMODEL
12/06/04
RS9 RESDNTL SINGLE FAMILY
3592
Owner
Contractor
WIRTH, FRED
722 MILWAUKEE DR
PORT ANGELES
(452) 3718
OWNER
WA 983631421
SEBRING
FL
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit Fee 120.75 Plan Check Fee 48.30
Issue Date 12/06/04 Valuation 3592
Expiration Date 6/05/05
Qty Unit Charge Per Extension
BASE FEE 92.75
2.00 14.0000 THOU BL-2001-25K (14 PER K) 28.00
Special Notes and Comments
Building Division has no requirements.
The Fire Department has reviewed the project application and
has no comments
Proposal will result in a deck flush with the north side of
the residence which has been field verified by PW as being
65' from top of bank. No land use issues are noted.
Electrical load calculations and elctrical permits are
required.
Public works utility engineering has no requirements for
this plan review.
-...::J
'}>
'P
~
--
Other Fees
STATE SURCHARGE
4.50
~
~
t
~
t.
rb
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 120.75 120.75 .00 .00
Plan Check Total 48.30 48.30 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 173.55 173.55 .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.
1.2 04-
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
I YES NO
FOUNDATION:
FOOTINGS J~l-} ~ -o.-.J J.L
WALLS
FOUNDATION DRAlNAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I I I
PLUMBING
UNDER FLOOR / 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 I
MECHANICAL
HEAT 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:
PARKlNG/LIGHTlNG 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. / PW/ CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 / -z'd ~{)~'- r....J LL BUILDING
T:\PLANNlNG\FORMS\1102.15 [11/14/2003]
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BUILDING PERMIT. APPLICATION
FOTZ OFF]CLAL L~SE Ol~L ,\7: I
I
Do"R" il-~lbJ
Pem1il# (t}1-11' /
'LJ81" I. ,)""o~""';'. '1
'- . ~I yJ u,..........:.
Dale Issued:
Fill oui CO.MPLETELY and in INK. Your llpplication and sitt plan MUST ~E
COl\11'LETE to be accepted for review. If you have allY questiolls, call \
l)Er-.MITS (360) 417-4815 FAX(360)417-4711
Phone: -1.5 2.... .31 \ 8
Phone: A.. 52. 51 \ 9
t\6..i9~Jes Zip: Cj83~3
Phone: -4~2 (j 2 Ci 7
Phone:A5 2- 3"7 ( e
Zip: ge~63
ZONING: ~ - C;
Applicant or Agent Fv-e-r9.., J, \jJ- lrt k,
O\vner: f roe <"- -J'. \).. 9 I ~
I '2) l
Address: 7-;"2.. M, \/I-JI.)..A)K~e. t>h~Y: \t..t~
Architect/Engineer: IP t-r Sc ~ u ~ f.t~
Contractor fr~o....:r \}...) \~ State License #: Exp:
Address: 722- MI\~D\O\t.o'" ~""vP City: ~(p~.lj\Lo~IB5'
PROJECT ADDRESS: 722. M\ ~\J."j"1<< ~ 1)'N. 'J~
LEGAL DESCRIPTION: Lot: Block:
CLALLAMCOUNTYPARCELNUMBER: (?~ ~CC>/ 7110/0
Subdivision:
Credit Card Holder Name: f v-e& ~,. w \ t-::~
Billing Address: 7'2...2. M \, 11.~1l'\~ 0.... tl t'-\ V ~
Credit Card Type VISA _MC #_
T'lPE OF WORK:
J8 Residential 0 New Constr. 0 Re-roof 0 Stove
o Multi-family Ii! Addition 0 Move 0 Garage
o Commercial 0 Remodel 0 Demolition ~ Deck
o Repair 0 Sign 0 Other
BRIEF DESCRIPTION OF THE PROJECT: .A1)D ITlDt-J ~F
It-Jc..u~An:: ~ $)~rP-l>~ .f2corvt
City:
~dl t=\- /+v.a c \~ -.;:;
Exp, Date: _
SIZEN AiUATrON:
I H J..f SF. @$ /SF. = $
SF. @$ ISF. =$
SF. @ $ ISF. = $
TOTAL VALUATION $"3 67'9- ~
p.lfA J2. tJF"c.J:::." ~ T f\ I rz.-s
A~{) VE 'EJGISiJ 1\f6 r.;./VLAbG
COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load:
No. of Stories: Lot Size: c.{;(;t,h ') Existing Sq. Ft. -1' 8'J..f ~ & Proposed Sq. Ft.
~ -
Total lot coverage I..::J %
Construction Type:
i Iff( = TOTAL Sq. Ft. 3 9'67
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
PLANNING USE ONLY:
ESA/Wetland(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 tIle 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 cunent fee schedules. Contact the Pernnt Coordinator at 417 -4815 for assistance.
PL.<\N CHECK FEE: IF a plan chec1c 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 tinle of pernnt issuance.
EXPIRATION OF PLAN RE'\7J:EW: rfno 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 v,'litten request by the applicant (see Section Rl 05.3.2
ofthe International BuildinglResidential 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 required ,not the City's, and that I must obtain such permits prior to work.
T:\R VESS\BLDG-forms-broc1mres\2003- BuiJdingpermit.wpd
Applicant: 7/7.oct 8 - t)J.{~~
Date: 01'7/04
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CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
Site Address:
PERMIT NO. .;aSS- /
.;;1 L> 7/9Z-
.
DATE
~ READY FOR
INSPECTION
License Number:
Installed By:
Owner/Business:
,
Owner/Business Address:
~ RESIDENTIAL
El COMMERCIAL
o BASEBOARD KW _
o FURNACE KW ~
o FAN/WALL KW ----r:-
o HEAT PUMP KW---J.fL-
[] SIGN
o TEMPORARY SERVICE
o PERMANENT SERVICE
-g NEW CONSTRUCTION
b REMODEL
o ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o SPECIAL EQUIPMENT
(LIST BELOW)
Details/Description:
o WILL CALL FOR
INSPECTION
Phone:
Phone.:
Sq. Ft.
o OVERHEAD SERVICE
~~~g~:R~~!~VICE
(R SINGLE PHA E
tJ THREE PHAS.':;:
SERVICE SIZE ~D AMPS
#Wr ~ _
.:Jao ~
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
~.ROUgh-in/cover O.K.
~ O.K. to connect service
o Final O.K.
f)lotify Port Angeles City Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the Builffing Permit. PHONE 457-0411, EXT. 224.
~{)tYt/t NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
. $
Electricallnspeclor
,: Site Address: /
, 7?-;L M//w
:,lnstaller:SJ
'<-
.
WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom. Customer
OLYMPIC PRINTERS INC.
\.
permitl2?C~s /
New Meters
s-s- f-tJ
Permit Fee
GREEN - Top: Meter Dept., Bottom: City Hall
Site Address:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO.
3f/S/
Ihhz
I .
.
ELECTRICAL PERMIT
DATE
Ir;lstalled By:
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
'D Residential
Heat KW
D Baseboard D Furnace/Boiler
D Heatpump D Other
D Commerciallindustrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
D New Construction
D Remodel
D Service update/alter/repair
o Overhead
lldUnderground/, r;:-,
Voltage /z-pI.:2-y,-"
~ 10 D 3.0
~.rvice size /(JJf/ Amps
~ Temporary
D Add/alter circuits
D Auxiliary power
(list below)
D Special equipment
(list below)
Detai Is/Description:
.
W.S. No. Service Size
Capacity: D O.K. D Not O.K. Comments
D Ditch inspection O.K.
D Rough.in/cover O.K.
~ O.K. to connect service
D Final O.K.
Date
Hold for: D Easement D Letter
D Signed up for service/meter
D Meter Department notified for installation
D Fire Department notified of inspection
D Plan Review approved/pending
In~taller: ..5
Permit/Receipt No.
~ tis-- /
New Meters Date:
.
I
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by,th~Wrlting on the Wiring Report or the Building Permit. PHONE 457.0411, EXT.158 or EXT. 224.
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT t:5:l. 0 ~
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
l:-
OLY"'PIC PRINTERS. INC.