HomeMy WebLinkAbout1028 Caroline St - Building
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CITY OF PORT At"\!GELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Appi1cat1on Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Zoning . . .
Application valuation
03-00000750 Date 8/29/03
1028 CAROLINE ST
06-30-00-8-1-0210-0000-
ELECTRICAL ONLY
o
Owner
Contractor
OLYMPIC MEMORIAL HOSPITAL
939 ~OLINE ST
PORT ANGELES WA 983623909
TWETER ELECTRIC
423 BLACKHAWK LOOP
PORT ANGELES WA 98362
(360) 417-1151
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW COMMERICAL
OMC PARKING LOT
TWEETER ELECTRIC
76.30
8/29/03
2/26/04
INC.
Plan Check Fee
Valuation
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Qty Unit Charge Per
1.00 76.3000 ECH EL-COM 0-100 NEW SRV FEEDER
Extension
76.30
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 76.30 76.30 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 76.30 76.30 .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.
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T \PLANNING\FORMS\1102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL 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
I INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL {LIGHT DEPD SEP ARA TE PERMIT: #
ROUGH-IN
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL ,
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I I
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engmeenng DIvision) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA-
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL 9hlo3 M
LIGHT DEPT
CONSTRUCTION R W./ PW/ CONSTRUCTION - R W. I I
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
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ELECTRICAL PERMIT APPLICATION
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The Electrical Permit ApplicaUon must be filled out comDletelv. Ifrf:..
P lease type or reprint in Ink. If you have any questions. please call (360) 4174735
Fax number: (360)417-4711
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Owner or Elee. Contractor Agent:
lu_Ji2-77f't1-lU/-a: / N C Phone 07 1/5t
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Fax:
Property Owner. OM H
Address: it! 0+t2..0)..r AI 17
Electrical Contractor: --;('). r?77t-fi-
Phone:
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Zip:
License #:
Exp:
Phone:
Address:
INSTALLATION WIREO BY:
DOWNER
City:
1f ELECTRICAL CONTRACTOR
Zip:
Credit Card Holder Name:
Billing Address:
Credit Card Number:
City:
Zip:
VISA:
Exp. Date:
M
PRo.IECT ADDRESS:
/0;2..8
~L-/ P-Nt.
TYPE OF WORK:
Check all that apply: 0 New
o Alteration/Addition
o Residential o Multi-family
)sl Commercial 0 Mobile Home
Sq.Ft.
:,
~ Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump' 0 Low Voltage 0 Telecom. 0
Number of Circuits added or allered: ,.
DESCRIPTION OF THE ELECTHIC,I>.L PHQJECT:_IOo-A- . :-SVil-VICll / hz-lll.. j{lff . /?;LI? 5
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Electrical Load Additions and or subtractions
Service Information
o Baseboard
o Fumace
o Heat Pump
o Fan-Wall
KW
KW
TON
KW
lAR
al Overhead Service
o Temp Service
o Underground Service
Voltage: rJrra,?- Z<D
Phase: 'i2fl 0 3
Service Size: /00,<j--
Feeder Size:
PAMC 14.05.060(B): For industrial, commercial, & residential projects larger than a duplex, a one - line drawing of the Electrical Servicl
Feeders, building size (sq. fl.). load calculations, and the ty pe & of conductors and/or raceway is required and shall accompany the
Electrical Permit application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and I
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such.
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r' _ (W ~.n;j vJ IfLtC'T U1IL.t77/Z-'5 - DI:=--4s. /5, - 0'* "TV BIt. o+f'
~( Ojfo'O <. ) Jotpard Holder's Signature: Date: 'S <-J 7{0 P (' -C'f~
t-ln:.J:.. 7<;~?f( ownerorElec.cont.SignaW~") Da} 7\/~:' ~~
PW-9019n103 A ~ ~d'f7~ ,30 R-r .
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