HomeMy WebLinkAbout3804 Old Mill Rd - Building
01/25/2005
13: 58
3504523498
OLYMPIC ELECTRIC
PAGE
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DOwner W
ELECTRICAL WORK PERMIT APPLICATION
~tric:al Contrar:t(lT
[J Annual Permit 0 Alarm 0 CRrDinl 0 Commercial 6:sldentlal 0 Re.~dentIDI Maint. 0 Sign,; ~rmostat [J Telecom.
o Request Inspection
Job wired by
ni"ectrical Contractor a Owner
1n,,,II,,,on description ;?;;.
1Irc7/- ..&.mA d- r/7d~t":;
r
I_if t:-Ir~tJ
EI cctn.clll contractor name UCc:TlRC l1umbcr
~~~.-;. F=//4"'76 I'?/Ytl1P~2d:.'ifJ/
Pu,,! ,ec's "iling .dd.." 6;
Jf~Jt!? (P./.7J..J:0-.7 ~
c~ .f St.,. ZIP
~ ,?t1'....,-, 1I/r,7- ? .rItf f
Telephone number 'FAX number
~ U,l/;'?re -d/";/7JdS;f;;7/-
,/
-
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a Cash 0 Cheek #
I hereby certi.fy that r am the owner of the above: named property or a licensed ----L'"
ItrCrcdit Card Visa
electriclll C(lntractot (or the :finn's authorized agent) and 3m making the electrical
installation or altrraticm 'io compliance with tbe clectric..111aw. Cha'J.'ter ] 9.28 RCW. CaTd #
Mastercard
Discover
Signature of owner, eled.-ical cnntnctor or eleetrieal administrator
ExpiratiOtl Date
of card
WALLS
Insulation Only
CElLlNG
Tn!lulat;nn Only
THERMOSTAT
SERVICE
DMC
Appra.-:d Dy
Dale
Al"l"mvel1 Hy
Oftle
^rpmVl!d Ely
OM!'
^WO"lld fir
DITCH
FF.E>ER
Cover
Cover
Dnl!'
AwlclVedSy
nM~
A~Hy
Dill!'
^PI"l1lved By
/Jllle
"J'lf'"lVefl By
EIActrical Load Additions and or s.!!".!~ac.lJ.o.D.s.
o NO LOAD CHANGES
CJ Baseboard KW
~(imaoe J.2.Kw
8"Heat Pump J.. Ton _ LAR
CJ Fan-Wall _ KW
~oo.lte-'nlormatlon
CJ Overhead Service
[J Temp Service
[J Underground ServIce
Voltage
PhaseD' 03
Service Si%e: _
Feeder Size:
(
Tftsp~ction A~a~ Bui1dit:Jg or F..qIJlpment Jnspected Action Takcn ElcctriC.!LJ
D<ltc , lnE>pcctnr
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01/21/2005 15:59
0,lv1
3505830859
KIRSCH ELECTRIC INC
PAGE B1
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iE1eetrieal Contractor
C AlInuoll'.rrnlt C Alarm
(I
i:I Owner ~"",~:r"
ELECTRICAL WORKPERMJT APPLICATION
~equest Inspection
t'
Telephone numb
Job wired by ;t Electrical Contractor i:I Owner
1::1 elrical contrsclor Tlllmi::: I ...L...~ License nun,bcr
\ lSCVi V -eOn IC- . I. ~ ,
Purehaser', t'~.,,~~ ..s3~ Co
City 36QL-{ I tv) SWf1 q~3~:?
b number Io~ O~
o Carlliva' tJ Commercial ~Restdentla.1 Q Resldenthtl Maint. Q Signs D Thermostat D TeJeeom.
Installation description
w
PremllJes owner'!! name
~
Addr~'6 old V\ '\ ,\ gd
City ~ fOr s.
, hereby certify tbal J am the owner of the above named property or a licensed
electrical contractor (or the fum's aulhorized agcnt) and am milking tile electrical
installation Of alteration in compliance with the electrical law. Chapter 19.28 RCW.
i:I Cash Cl Check #
)( Credit Card VISa ~[.terc';;>
x
Expiration Date
of card :.
WALLS
In~lllntion Only
CEILING
Insularion Only
1'HI;;RMOSTAT
Cover
API"'OVed By
Dnle.
^fllll'Oved l!Iy
SER"lCE
?<I'~ Aen
e .\pproved By
Dille
Dnte
COver
AlIproved 6)'
DITCH
FEEDER
Dnl!:
^""l'Oved By
Dille
^~ellB)'
ElectrIcal load Additions and or subtractions
o NO !.OAD CHANGES
o eeseboe'" KW
[J Furnace KW
D Heal Pump _ Ton _ LAR
C Feo-Wall t(W
Dele
Afll"l'OvdR.V
DDte
^Pl'''llvolI' By
$ervlcA!nfDrmatlon
)( Overhead Service
l( Temp SBrvr~e
C Underground Service
VOltage
Phe.eD1C3
Service Site: _
~eed9r Size:
Jnspeetion
Date
Area. Building or Equipment Inspected
h t.-,
0.A-.
Electrical
ctOr
,
Tit.
6--r '1.l:~p ~ tJ IL. Fr.
1.:>4
Action Taken
"r@.r"
,AC-(1;)
#to 01/05"
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'~ORTANGELES
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WAS H I N G TON, U. S. A.
PUBLIC WORKS & UTILITIES DEPARTMENT
January 21, 2005
Fred Grinnell
C/o E.G. Enterprises, Inc.
1324 Jamestown Rd
Sequim, WA. 98382
Subject: 3808 Old Mill Road
Job# 9892
Dear Fred:
.
The estimated cost of labor and materials supplied by the City to provide
electrical service for your property is $ 527.89. This estimate was based on the
data you provided and is subject to review. This quote is good for 180 days.
.'
The City will be responsible for the following:
I.
,
1)
2)
3)
4)
Providing and installing the power pole.
Upgrading the transformer.
Providing and installing the service wire across the road.
Providing and installing the 120/240v meter.
The owner/contractor will be responsible for the following:
1)
2)
3)
4)
Providing, installing and future maintenance of the service riser on the
pole. (Ref: Underground Service-Secondary Riser CR 5 01)
Providing, installing and future maintenance of the underground
service wires in conduit from the power pole to the house and/or meter
base. (Ref: Trenching Specifications UM 001cS)
AIIRequired Permits. (Building, electrical, etc.)
Payment of $ 527.89.
321 EAST FIFTH STREET. P. O. BOX 1150. PORT ANGELES, WA 98362-0217
PHONE, 360-417-4805' FAX, 360-417-4542' TTY, 360-417-4645
E-MAIL, publicworks@cityofpa.us
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If the actual cost of construction exceeds the estimated amount, there will be no
. further billing. If the actual cost is less than the estimate, the difference will be
refunded to you.
Payment of the estimated amount will authorize the City to schedule the work. If
you have any questions or concems, feel free. to contact me.
Sincerely,
John G. Hebner
Electrical Engineering Specialist
ihebner@citvofoa.us
360.417.4706
Cc: James Harper I Electrical Engineering Manager
AI Oman, Electrlcallnspeclor
Roger Vess. Permit Tech
Attachments: 3
Ret. WF31216101
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El.ECT~WCAL ~~JSiPlECTy'Dj\JJ
WJ~J~G ~LEPORT
417-4735
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APPROVED
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NOT APPROVED
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CORRECTIONS NEEDED: . .~..J'''' 1-;_ .1"""::';-<'
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHiN 15 DAYS
- DO NOT REMOVE
OLYMPIC PRINTERS, INC. (360) 452-1381
v
02/21/2005 10:38
3606830869
KIRSCH ELECTRIC INC
PAGE 01
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I:l ~'I Contractor
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Wif
o Owner ~~.....;t''''
ELECTRICAL WORK PERMIT APPLICATION
~
~Re!lldCntlnl 0 Rl!_lOidcntlnl M,inl. 0 SI2DS D Tbcl"mostat 0 Telecom.
-'
a Annual Permit 0 Alarm 0 Carni'V'2l 0 Commercial
Inslt1l1atioll de!lcription
Job ..ired by
Electrical Contractor i:I Owner
(~-3~v-J ~ I~ ~ ~
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(:P'l\0H J-jDl0~)
City
9VLD
Q Cash 0 Check #
I hereby certify that I am the owner of the above named propeny or a licensed [J ~
eleetrical contractor (or the finn's authorized agent) and am malcing the electrical Credit Car sa M
installation or alterlltion in compliance with the clectrical1llw, ChDpter 19.28 RCW. Card # _ _ _ _ _ _ _
III administrator
Expiration Dale
of card
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D.u~ ^f1provd Rr
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WALlS
InsullUiol'l Only
CEILING
Insulation Only
TIlERMOSTAT
\. DftlC Approved e~
/' DITCH
zJ f-1-!o., /feD
.. 011(11 Ajll1<"t'W'l'1 By
Dlle
1-lf-,o S Cover
[l.,t
OftlC ~
'-4-6S0V.~
f UIle i\ppl'O\'ItllBy
Electrical Loed Additions and or subtrectlons
D NO LOAD CHANGES
D Baseboard KW
o Furnace KW
CJ Heat Pump Ton LAR
o Fan-Wall _ KW
Service InfQllI1l1Ilm
o OVerhead Service
o Temp Service
CJ Underground Service
VOltage
Phase GJ , 0 3
Service Size: _
Feeder Size:
'~
~p
Inspection Are~. Building or Equipmenl inspected Elcccriclll
Date I Action Taken Inspector
2./ '& 31n 'i'" of<=- -!Jf7 (~ G"'.vC.<-f ~<-e fI..o"f(; ~
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CONNECTION FEE PAYMENT 0'1 - /OhB
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(c~fY~
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Customer: E.G Enterprises, Inc - Fred Grinnell
Contractor: Kirsch Electr. (Fee paid for by Fred Grinnell)
Project Addre~i11 R~
Connection fee due: $ 713.00 Date Paid: 2/11/05
CASHIER:
1. Please post check to:
Capital Contributions / Construction Contributions
LT 401-7180-343.30-24
In "additional comments";
WF 31216/01 or 31496/01
WS 9892 or 9703
2. Send a receipt of payment upstairs to:
John G. Hebner
Public Works & Utilities Dept
417-4706
GRINNELL CONSTRUCTION INC
(360) 452-11370
756 ORAPER RO
PORr ANGELES, WA 98362
FRONTIER BANK
. 901 W WASHINGTON
. SEQUIM, WA 98382
98-762/1251
4003
~/oq/Cif
$ 7/3 ~
PAY TO THE
ORDER OF
1Zd-
JiilSe<.oJrityfealures
W~Onbed<-
MEMOJd,6,# 9703 tv ~ <3/'19(/01 \._~~ 4- M'
11'001,00 :JIl' I: ~ 2 5 ~O 7(; 2(;1: 7 ~ 7 7"'00 ~:J 2 :JIl'
Paymenllnqulry
Operator 10:
Post da~:
Tender:
Check number;
SEOGINGT
2/11105
CHECK
D~.:
2111105 Number:
22 Receipt number:
15476
4003
713.00 LT
2/11/05 13:58:21 ~
GPINNEL CQHSTPUCTIOH
,
Total payment
Total tender:
71300
71300
d'04Il'~_
.sti~~
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98~62
Application Nunilier
pin nunilier
Property Address
ASSESSOR PARCEl, NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000068 Date
.891204
3804 OLD MILL RD
06-30-15-3-2-9060-0000-
MECHANICAL PERMIT
1/31/05
RS9 RESDNTL SINGLE FAMILY
10800
Owner
Contractor
LESLIE JUDITH SPOTKOV
3804 OLD MILL RD
PORT ANGELES WA 983623734
PENINSULA HEAT
502 W. 8TH ST.
PORT ANGELES
(360) 457-2775
WA 98362
---------~------------------------------------------------------------------
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
1-4 CIR+ LV STAT
OLYMPIC ELECTRIC
84.50 Plan Check Fee
1/31/05 Valuation
7/30/05
.00
o
Qty
1. 00
1. 00
Unit Charge Per
48.1000 ECH
36.4000 ECH
EL-R OR RM 1-4 ALT CIRCUITS
EL-LVT-FIRST THERMOSTA!
Extension
48.10
36.40
0J
(',()
o
r'
'"'"
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 84.50 84.50 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 84.50 84.50 .00 .00
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COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPEc:",ION 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
GENERAL COMMENTS:
PW-II02.l~ (4196]