HomeMy WebLinkAbout228 Fogarty Ave - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION'
321 EAST 5TH STREET, PORT ANGELES, W A 98362
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Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00000201 Date
133014
228 FOGARTY AVE
06-30-09-5-2-2725-0000-
MARIAN MERTZ
MECHANICAL APPL. PERMIT
3/01/07 .
6
RS7 RESDNTL SINGLE FAMILY
7967
Owner
Contractor
MERTZ MARIAN
228 FOGARTY AVE
PORT ANGELES
WA 983622514
ALL WEATHER HTG & COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452-9813
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
BOILER INSTALLATION
96230
55.45 Plan Check Fee
3/01/07 Valuation
8/28/07
.00
o
Qty Unit Charge Per
1.00 55.4500 ECH ME-INSTALL BOILER 1.7-
Extension
55.45
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 55.45 55.45 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 55.45 55.45 .00 .00
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Separate Permits are required forelectricalwork, 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.. .
~~.~.
Signature of Contractor r-Authorlzed Agent
J!'8 I~""
Date
Date
Signature of Owner (if owner is builder)
I
T:IPoliciesIII02_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 4] 7 -4807 FOR PUBLl C WORKS UTILITIES .
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY '''VORK BEFORE
INSPECTEDANIJACCEPTEIJ. POST PERMIT IN A CONSPICUOUS LOCATlON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I ,
YES NO
FOUNDATION:
FOOTINGS I
SHEAR WALLS 1 WALLS I
FOUNDA TION DRAINAGE 1 DOWN SPOUTS I
PIERS I
POST HOLES (POLE BLDGS.)
PLUMBING
uNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL
WALLS ,
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLIHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYW ALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
ROUGH-IN
HEAT PUMP I FURNACE 1 DUCTS FINAL 8/z:zltY6 DATE ;fLL-
GAS LINE . ACCEPTED BY:
, ,
WOOD STOVE I PELLET I CHIMNEY
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKJRTING
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
P ARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE .YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LlGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION RW./PWI CONSTRUCTION - RW.
ENGINEERJNG 417-4807 PW 1 ENGINEERJNG
FIRE 4 17-4653 FIRE DEPT
PLANNING DEPT. 417-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
T:\Policies\II02 15 building pennit inspection record05.wpd [1/4/2005]
BUILDING PERMIT.. APPLICATION
POR OFFIClAL USE ONLY:
Dote:: Roc.:
Permit #: t'?7 -'1..P'J J
Date Approvc:d:
Dat61$~ucd:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for revl~w. It' you have any questions, caD
PERMITS (360) 417-4815 FAX(360)417~4711
Applicant or Agentp..\\ h)()c.~j\Pr ~,()CA~J'h(\lt'l~ ~()f)\;oI\r~.l,.o.C Phone: t ~o6)L\'Sa- q, \ .~
J .
Owner: f'l\O r \ Cl '^ Mp C'+:h . Phone: t ?,\t,r))q '51-- 'So '3 ~
Address:d;J ~ r=- o{).. Ct (.h^ A-... ,.e City; Po ,,+- AlA (I. ~ Lp ..... Zip: q ~ ~l.o;:;t
J ) \
ArchitectlEngineer:-.JJ I A Phone:
.Contractor~ \ \A )~C~ r Upo\l ~State License #:.P>.\...LIi ~G+\c..\5~~p: q II , 0 -=r Phone:L1'5a - <3 ~ 1"3
Address: ~O~ ~'^"~ ~~. . City:~'DC-\- A-v-..(l, cl-P ~ Zip: q~ ~\..D;:}
PROJECT ADDRESS: ,q~ JS rc:n..lc. r~ A\I~ '\ ZONING:
.) \
LEGAL DESCRIPTION: Lot: Block: Subdivision:
CLALLAM COUNTY P MCEL NUMBER.:
Credit Card Holder Name:
Billing Address: ~ City:
Credit Card Type VISA Me # Exp. Date:
tYPE OF WORK: SlZE/V ALUAl'ION:
Residential 0 New Constr. 0 Re-roof 0 Stove . SF. @ $ /SF. ;:>J $
Multi.family Cl Addition I:l Move I:l Garage SF. @ $ /SF. = $
o Commercial 0 Remodel I:J Demolition 0 Deck SF. @$ /SF. "" $
o R.epair .0 Sign 0 Other TOTAL VALUATION $~C\~~
BRIEF DESCRIPTION OF THE PROJECT: "1:-.,1':) i \..p (" TI..... ~~ (l \.\ r
COMMERClALIRESmENTlAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load; Const1llction Type:
& Proposed Sq. Ft. == TOTAL Sq. Ft.
PLANNING USE ONLY:
APPRO V ALS:
PLAN:
BLDG:
DPWU:
FlRE:
OTHER:~
ESAlWetland(s): I:l Yes 0 No SEPA Cl1eck1istrequir~d? 0 Yes 0 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 CUIrent fe~ schedules. Contact the P~mrit Coordinator at 417-4815 for ass~tance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and consb;uction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no penuit is issl1lld 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 Rl 05.3.2
of tIle Intcmational BuildinglResidential Code, 2003), No application CaIl be exteuded more than once.
( hereby certify that I have read and examined this applicatIon and know the same to be true and COffeet. I am authorIzed to apply for this permit and
understand thai Jt Is my responsibi/J1y to determine what permIts are requlrBd ,not the City's, and that I must 0 fain such permIts prior to work.
T:\RVESS\BLDO-fomlSobrochurcsIJOO4-BuildinspclrmlLWpd Applicant: fA; J"Date: rO~Fe...\r) ri..C9lJ"'"
Z:13/Hl 39'ii'd
9NI1'ii'3H ~3Hl'ii'3M ll'ii'
LL1SZ:Stl139El
813:913 91313Z:/SZ:/S13
s
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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
04-00001141 Date
.101314
228 FOGARTY ST
06-30-09-5-2-2725-0000-
MECHANICAL APPL. PERMIT
12/08/04
FttJAUO
//~f /tJG
RS7 RESDNTL SINGLE FAMILY
3300
Owner
Contractor
MERTZ MARIAN
228 FOGARTY AVE
PORT ANGELES
WA 983622514
EVERWARM
257151 HWY101
PORT ANGELES
(360) 452-3366
WA 98362
----------------------------------------------------------------------------
permi t . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
57.65 Plan Check Fee
12/08/04 Valuation
6/07/05
.00
o
Qty Unit Charge Per
Extension
47.00
10.65
y
'P
~
BASE FEE
1.00 10.6500 ECH ME-GAS PIPE 1 TO 5
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 57.65 57.65 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 57.65 57.65 .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
construction.
CJ 1\( r::- I L-L...:<.
,
Signature of Contractor or Authorized Agent
Signature of Owner (if owner is builder)
Date
Date
T:\PLANNlNG\FORMS\] 102.]5 [1 ]/]4/2003]
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, INSULA TE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTI()N'TYPE DATE ACCEPTED COMMENTS
. I
YES NO
FOUNDATION: .
., ~
FOOTINGS
WALLS
FOUNDATION DRAlNAGElDOWN 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 I I
FRAMING
JOISTS / GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERlOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB I
WALL / FLOOR / CEILING I
MECHANICAL
HEAT PUMP
GAS LINE m. -{.} 74-1 I L
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:
P ARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W, / PW / CONSTRUCTION - R.W.
ENGINEERlNG 417-4807 PW / ENGINEERlNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 / -?'j-()) i> L BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003]
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FROM :EVERWARM HEARTH HOME
4-30-03; e: '~AM;CITY PORT ANGEL~S
(9" ~:u out CO;~~:::'~d :::~::ap::~::::~~o MUST BE
COMFLETE to be accepted for review. If you bave any q uesttons, call
(360) 417-4815
FAX NO. :13604523367
Dec. 07 2004 03:09PM Pi
; 3eO'H 747'1
"
1/
FOR OffICIAL USE ONLY,
DIlle R.cc.:4- ? -OJ/_
Perrnill/: (!)I.j - 111-/ I .
Oale Appruved:/~-r? -of
Dill<! CUlled; I ~+- -'- q -0 J../
Applicant or Agen~ \I~e L.U -A-fG.AI\
0,.".., :B '" ~ -- _M ~.( + '7-
Address: d ~ 8 +D err i-'I City:
ArchitecrJEngineer:
~'\) e~r2 uJ, *
Contractor ~V~<2LD'(':::U:2...^1 State License #: 0 ~ 'i< tv (.
Address: -:< ~~7 J Sf ~'1 1 tJ.' City:-.-fJ OJ
PROJECT ADDRESS: :;;).:; 9 y;:: l'> ~ "-f) t
LEGAL DESCRIPTION: Lot: Bock:
CLALLAM COUNTY PARCEL NUMBER: "0 ~ 3 C) C)
PO-.
Phone: AI:")- ~ . ~ ~ 6. <.r..
Phone: .i/6---',,_ 5" o~ 7
Zip: 9 ~ ~ lo"L
.Phone: ,.--....,
Exp;..:Ljll 'b 5 Phone: '3\~ t- (,._
Zip: q ~ ~ ~ -L
ZONING:
Subdi vision;
9 S 2. 2. ., a~ (;:> C a ~
~:; ~~~~er Name: I EO )..~ ~I[. A ~ t KJ:'i:::
Credit CardType VISA MC ~ # _ ~
TYPE OF WORK: SIZEIV ALtJATION:
~8identiaJ 0 New ConstI'. 0 Re.roof 0 Stove SF. @ S /SF. .. $
o Multi-family r:J Addition C Move [J Oarage SF. @ $ ISF, .. $ .
o Commercial 0 Remodel 0 Demolition CJ Deck SF. @ $ ISF. '" $ ~
U Repair . D Sian D Other. ' ro;rAL VALU~TIO~,,~. ""'"
BRIEFDESCRJPnONOPTHEPROJECT, ~ ~.*~~' QAA-'~
C>..~ r"ill~ J c~... ~f'-' ~_ -_
COMMERcr SIDEN'IW-: Occupancy Gra . Occupant La ; Construction Type: -
No, oCStorics: _ Lot Size: Bxisting Sq, Ft. & Proposed Sq. Ft. "" TOTAL Sq.Ft..
Existing lot coverage ___ % & Proposed lot coverage _% .., Total lot covero.ge ~
~ ~,,-O <
E%p. Date:
APPRO V ALS;
PLAN:
BLDG:
DIJWU:
--
FIRE:_____
OTHER:_
PLANNING USE ONLY:
ESA/Wetla.nd{s): 0 Yes D No SEPA Chec;1dist required? CJ Yes LJ No Other:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division CAD provide you with information on the Ilpplication and
plan 5ubmittaJ requirements if you have questions.
VALVA TJON OF CONSTRUCTION: In aU ealU, a valuatfon amount must be entered by the applicant. This figure will be reviewed-
and may be revi5ed by the Building Division to comply with current fee schedules. Contact the Pemi.it Coordinator at417 -4 8 15 lor assistance.
PLAN CHECK FEE: .IF a. plan check fee is due it must be submitted at the time the building permit application aud construction pl!Uls are
submitted. All other permit fecs are due at the time of pemrit illsunnce, , '
EXPIRATION OF PLAN REVIEW: If no pcnnit is issued within 180 days ofth~ date' of application, the application will expIre. The:
Building.Qfficialca.n..cXtc.iid. thc.time-for.action..b~_tbc_applicant. up. to 1-80.d~y.-upen'writtenreqtlcst-by' the-applicant (see SectiOIl '1 cnA of
the Uniform BuUding Code, current edition). No application ClUl be cxtendc:d more than once. 'If
I hereby certify that I have reed and examined thIs appJlcsfion end know the same to be truB and correct. I am authorized to apply for this pormit Dnd
understand that h Is my responsibIlity to determine what pennlts are requIred ,not the Clty's, end that I must obtain stJch permfts prfor to work.
T''''''RMS,^pPS''''''''fnIP='c"", ~~~~Dat" 1'"Z. ,." - b 'j
g
w
@
fL/~D1
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
\21 EAST 5TH STREH. PORT ANGELES. WA 98362
Application Number
Appllcation pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
07-00000197 Date
179807
228 FOGARTY AVE
06-30-09-5-2-2725-0000-
ELECTRICAL ONLY
3/02/07
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
MERTZ MARIAN
228 FOGARTY AVE
PORT ANGELES
WA 983622514
ALL WEATHER HTG & COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452-9813
Permit
Additional desc
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date .
ELECTRICAL ALTER RESIDENTIAL
ALL WEATHER/ T-STAT
96198
ALL WEATHER
35 00
3/02/07
8/29/07
HTG & COOLING INC
Plan Check Fee
Valuation
00
o
Qty Unit Charge Per
1 00 35 0000 ECH EL-LVT-FIRST THERMOSTAT
Extension
35 00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permlt Fee Total 35.00 35.00 00 .00
Plan Check Total 00 00 00 00
Grand Total 35 00 35 00 00 00
COMMENTS/ACTION NEEDED
\J
-....,J
,
'-
-4)
-.......J
~
'l'l
~
d'
i"
J
t
'/
ELECTRICAL PERMIT INSPECTION RECORD
CALL 4] 7-4735 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 IS (4196)
'~
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
32\ EAST 5TH STREET. PORT ANGELES. WA 98362
Applicat~on Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER'
Application type description
Subd~v~s~on Name
Property Use
Property Zoning
Application valuation
07-00000197 Date
179807
228 FOGARTY AVE
06-30-09-5-2-2725-0000-
ELECTRICAL ONLY
3/13/07
~
~
,
"-
~
-....J
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
MERTZ MARIAN
228 FOGARTY AVE
PORT ANGELES
WA 983622514
ALL WEATHER HTG & COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452-9813
Permit
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Exp~ration Date
ELECTRICAL ALTER RESIDENTIAL
SIMPSONI 200A PANEL+BOILER
96875
SIMPSON ELECTRIC
64.00 Plan Check Fee. .
3/13/07 Valuation
9/09/07
00
o
Qty Unit Charge Per
1 00 64 0000 ECH EL-R OR RM 0-200 ALT SRV FDR
Extension
64 00
~
~
~
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 64.00 64 00 .00 .00
Plan Check Total .00 .00 .00 00
Grand Total 64 00 64 00 00 00
"1\
'\)
J
~
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION 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-lI02 IS (4196)
03/05/2007 19:08
4579270
SIMPSON ELECTRIC
PAGE 01
~
~i
""'....
ELECTRICAL WORK PERMIT APPLICATION'
Joh wired by )I Electrical Contractor 0 Owner
~7' cO;''J~e I?(-<.t;-Irr'l~rfft f SE;cf:J73
pu~~:to 3dZ;' 1M!/.. /0/ kJ
CiIY/1;14- /lntt-t' le/ta"/i/ If 9'?3 63
Telephone number FAX number
S-7-&J :2..70 -
'nstflll:'Ilion description
IJ Comn,cr6a. ~ R.esidential
I cw Altered! Addition
~c .
I.A.jO -oJ erth i! <e...-
'f- t~ ~ liDt'/ev
PrcmiU::f; owner'" n;lmt ~rn ""--
mtil'""~ "/~rZ-
Addreu I)f Inspection .r::::: J:o ~~
.:;L2'a'" ,09"'7 '-7-
City I~Kf ./l-tLf--C/-ej
Phone numhCl" t2.f-~1lle..:.:spec:~n;
Owner a.~ df'f1Il~d l~l' RCW,/9.28.26/:(I) Owner wW nr..:lII'Y (hI). .~/rll(~lltft> for two
)'r!Q".~ "fier lhi,t dc.c/rical pel'mit i.~ jinalf:.r:d. (7.) O'M'IlCI' is required ,~ hire an electrical.
CrJ1l1rO~'n,. ?f ah(lVl.' .~(liJ pnJpcrfy is f('),. .~(1lr.. "Nil nr l(!(1se.
After rc.:loing the above statement, I hcrehy certify TII<lt I am the owner of the nbove
named property or " licensed electrical contractor. , :lorn m~killg 1he clCCtriCill \nsl'ill-
Itltion Or alteration in complial'lce .....ith the clcctricallllw5. N.F..C.. RCW. Cl,;lplcr
19.28. WAC. Ch~ptl;:r 296.46D, The City of Port Angcles Municil'\'Il Code. l:lnd
Utility SpecifjclI.tjcm.~.
Si~natur 0 owner, ",leetricAI co r dor (lr t!lec:rrlc:'l1 ndmll'llslrJltor
o C..h
o Check #
o Credit Card Visa Mastercard Discover
Card# __~~___-____
1
Eleclrlcj\B.!:>,,~ A~~ltions an!!.9ll_
(J NO LOAD CHANGeS /
CJ Baseboard KW /' ~
D Furnace KV\f
o Heat Pump Ton
(J Fan-Wall !<:oN
ate:,J-7-0 7
Expirntion Date
of card
In~rcctil)nF fj.C: C1'O
$ t.?y. --
Service Information
ac.llom!
LAR
o Overhead Servir:e
CJ Temp Serv;CB
CJ UndergrolJnd Service
Voltage
Phaso (J 1 IJ 3
Service Size: __
Feeder Size:
SAME DAY rNS.PECTION, CALL RKFORE 7:00 AM 360-417-4735
ROUGR:-lN
mERMOSfAT
SERVICE
r)nl~
^rrrnved My
Ontc ^flflf!lven Hy
1
DrrCH I
nM(': Approvcd I:ly
FlNAL
~Io~\.~
n,~\, "'Ilrm,'etl Ry
FEEDER
D!Je ^1'IlM""d fly
DJIC Apprnvell fly
l1lspcction
DMe
Area. .Buildinp; or Eql.l'iJ"lM1t:nt Inspected
Action T3.ke:n
Blcctrical
lnspector
.'
~
~',.
Job ..ired by o Elect,.;eal COil tractor Jl16tall;)lion description
o Owoer o Commercial ~esid"Dtial
EleCll'ical contractor nOlmlO: Lic<;lns.:: UWUb\ol' Dutc Expil'e$
All h'~oMn" r.\\p'~d~(""')\ -,,,,~ AlllllwUC. \<;,~"al ONe.. o Alte.-ed/Additiou
q(.,,,,...
Purch3,Ser's mailing addrc: .
-;2,,") rl. Y-P~~~ LV -\- - 'S\-~-;;:
City Stat.:l ZIP
?O.+ ,\R"-. L0A- CI.'i!-:'lo'::i- .
Tel~pht)nc numbo FAX .r~be;J
l.\.S;;) -~.,; \ ?, L\ -'6\ 1-1-
Premises owner's name
f\J\rl r"t 0... .^ Il\J\.p ( \- e
Addn:ss of inspection
~a<(., mrA Q f'\-u ^-.J-e..
c~ .,,) .)
'U r\- AI.-vr~-e'"
Phone numbet tu selic ule IIIspectloll: l.b+-"5a~i-
Owner us d~jined by RCW.J9.28.2o'J:(l) OWller wUl occupy Jhl! :JtruCIWi;!jor two
year.... after this deetrica] permit is j;,uJl/zed, (2) OWIU!r U required to hir(: u" e/edl'icaJ
(,.'()tllraclor If ablJ\l1! saM prQPe.rty fs jar s(Jf~. relit ur lease. D Cash o Check #
AL"ler reading tile abovt sll1t~meot, I hcrl:by cerrify that I am the owner of the abuv~ ol Crodit Card
named l)rOpct'ty or 11 Iicem:led olecuical contractor. I urn mukins the elecujcal in~lul- Visa Mastercard Discover
lation or alteration in compliance with the e1cctric<l1 la.ws. N.E.C., RCW. ChU.ptcT
19:Z8, WAC. Chapter 296.468. Tho City of POI'l Angeles Municipal Cod~. aud Card # - -
Utilit)' Spccificalion~. ----------------
~gn(W ::::.t;;;~~;:r; .I~'~i:;: 'j];~/~l Expiration Date e $n~~~~ .fCoo
~f card
Electri ... ,~ Additions aiiif ars Service Information
&0.
. ,
~...;:~;
ELECTRICAL WORK PERMIT APPUCATION
o NO LOAD CHANGES
o Baseboard _ KW
o Furnace 'rWoJ
o Heat Pump _ Ton _ LAA
[J Fan-Wall KW
o Overhead Service
a Temp Service
o Underground Service
Voltage
PhasoO 1 03
Service SI~e: _
Feeder Size:
SAME DAY INSPEC'flON. CALL BEFORE 7:00 AM 360-417-4735
ROUGH.IN ,,- THERMOSTAT
"- I)\ill,; AI'~~l>v,,~ Or 1)1l~~ "'I'II'U~~~ lir
FiNAL ,,- DITCH
~/r~/n7 ~ "- Do" APll'"Ov~d I~y
"'" 'Da~
SERVICE
DUll;
Appron..\Illr
li'll'll'nm
Ulll~
AJlp,'Ov~d l~y
Inl>pc:ction
Dali;:
Area, Building or Equipment lnspectt:d
Actioll Tak~l\
E1cctrical
lnspt:dor
Re.c.EIIVED
~tt:l;:; 0 ~UU{
In.:m. .._~..
<:0/<:0 39\1d
9Nll\13H ~3Hl\13M ll\l
LLIS<:SP09EI
80-90 900<:/S<:/S0
Application Number . . . . ,
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivieion Name
Property Use
Property Zoning . . . , , . .
Application valuation , , . .
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
15- 00001189 Date 9/22/15
134794
2.28 FOGARTY AVE
06-30-09-5-2- 2725 -0000-
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
Owner
Contractor
MERTZ MARIAN
ANGELES ELECTRIC
228 FOGARTY AVE
524 E, IST ST,
PORT ANGELES
WA 983622514
PORT ANGELES
WA 98362
(360) 452 -9264
Permit . . . . ,
. ELECTRICAL ALTER RESIDENTIAL
Additional deac
REPLACE FRAYED SVC WIRE
Permit Fee
120.00
Plan Check Fee
00
Issue Date . . .
. 9/22/15
Valuation
0
Expiration Date .
. 3/20/16
Qty Unit Charge
Per
Extension
1,00 120.0000
SCH EL -0 -200 SRV FEEDER
120,00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
120.)0
126.40 .00
.00
Plan Check Total
,00
.00 .00
.0r0
Grand Total
120,00
120.00 ,00
.00
REPORT SALES TAX `is
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
PERMIT WILL EXPRZE SIX (G) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor
C:TXCHANGEIBUILDING
Date:
09/21/2015 09:02 FAX 360 452 9265 Angeles Electric
r.l
r.
CITY OF PORT ANGELES PERMIT APPLCATION
Building .Divisioin /ElectricalInspections !;
321 East Fifth Street — P.O. Box 11501 Port An ''etas Washington, 98362
Ph: (360) 4174735 Fax: (360) 4174711
Date: ___.1 2 Single Family Dwelling
" Plan Review May Be Required, Please Complete Eleo'ocal Plan Review Information Sheet
Job Address:
Building Square Footage:.
Description of above
SEE 2 �
im0001/0001
gzk POI
Owner inforsnatl A—L
Mailing Ad ress:
City State: Zip:
Phone: Fax;
License # 1 Exp,
item
Unit C e Total t Iti lie b
fir/" �� Y �1�(�,Chanr.el
Service/Feede<200Amp.
$12�'g—
ServioelFeeder 201-400 Amp.
$146.0
$
Service Feeder 401 -600 Amp
$ 205.Op
$
ServicelFeeder 601 -1000 Amp.
$ 262,0{)
$
Service/Feeder over 1000 Amp.
$ 373.0
$
Branch Circuit W/ Service Feeder
$ 5.OQ.
$
Branch Circuit WIO Service Feeder
$ 63.06.
$
Each Additional Branch Circuit
$ 5.06;
$
Branch Circuits 1-4
$ 75.00;
$
Temp. Service/ Feeder 200 Amp.
$ 93.06
$
Temp. ServioelFeeder201.400 Amp.
$110,06;
$
Temp. ServicelFeeder401.600 Amp.
$ in'04"
$
Temp. Service/Feeder 601 -1000 Amp,
$166.0 ;
$
Portal to Portal Hourly
$ 96.0:
$
Signal Circuit/ Limited Energy -1 & 2 Family Dwelling
$ 64.06`
$
Manufactured Home Connection
$120,00;
Renewable Electrical Energy - 5K1/A System or Less
$10206;
$
Thermostat
$ 56.00.
$
Note: $5,00 for each additional T-Stat
NEW CONSTRICTION ONLY:
First 1300 Square FL
$120.00pp
$
Each Additional 500 Square FL or Portion of
$ 40.00i
$
Each Outbuilding or Detached Garage
$ 74.00'
$
Each Swimming Pool or Hot Tub
$ i lao!
$
Total
Owner Owner as defined by RCW.19.28.261: (1) Owner will occupy tl�e 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 tt% owner of the above named properly or a licensed
electrical contractor. I am making
the electrical installation or alteration in compliance
with the el ctrical laws, N.E.C., RCW. Chapter 19.28, WAG. Chapter 296.466, The City of Port
Angeles Municipal Code, and Utility Specifications
and PAMC04.05.050 regarding Electrical Permit Applications.
Signature of owner, electrical contractor or electrical adm nistrator: ❑ CIA Q check
r�ln cud t
000/ Cl-
x_,.,_
Dated: ?' 2f /S".`_
01rrn12012