HomeMy WebLinkAbout403 S Lincoln St - Building CITY OF PORT ANGELES
icz�� DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00000371 Date 4/25/11
Application pin number 975405
Property Address 403 S LINCOLN ST
ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -1 -6920 -0000- REPORT SALES TAX
Tenant nbr, name LINCOLN ST. STATION on your state excise tax form
Application type description PLUMBING PERMIT
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning COMMUNITY SHOPPING DISTR
Application valuation .600
Application desc
REPLACE WATER LINE, METER TO BUILDING
EXPIRED
Owner Contractor
KEN W PRICE MORRISON EXCAVATING INC
5418 S OLD MILL RD P. O. BOX 3051
PORT ANGELES WA 983621972 PORT ANGELES WA 98362
(360) 460 -8310 (360) 452 -7179
Permit PLUMBING PERMIT
Additional desc REPLACE WATER LINE
Permit pin number 184440
Permit Fee 57.00 Plan Check Fee .00
Issue Date 4/25/11 Valuation 0
Expiration Date 10/22/11
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 7.0000 EA PL -WATER LINE 7.00
Fee summary Charged Paid Credited Due
Permit Fee Total 57.00 57.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 57.00 57.00 .00 .00 �J
c
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 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.
�"a /1 Di 4, le.,[ G' �C
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Vr
Building Inspections 417 -4815 Electrical Inspections 417 -4735
Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886
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 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 FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceilin9
Drywall (Interior Braced Panel Only) /1
T -Bar 1 C/
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Stocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417-4750 C
Building 417 -4815 E -3 f
x
T:Forms /Building Division /Building Permit
PROJECT STATUS UPDATE
Permit 31
Date: \O 1 L
460 -83 l0
I phoned the Applicant �,L at
Property Owne at
Contractor at
(left a phone message or discu
io ZZ-II
The perms as expired, will expire soon). hat is the status of this project?
Please call and schedule a final inspection.
Or
Submit a "permit extension request" letter.
Or
Let me know if the project is abandoned.
iO -11 NO\9 Catle n922.644oan J so -t—
ell Pe.-6t s Re.rtrici
T:Forns /Building Division/Project Status Update
?oltr4.,, BUILDING PERMIT APPLICATION Print in ink
41 CITY OF PORT ANGELES
For City Use Only:
Attn: Building Permit Technician Date Receiv d 4-2-6 321 E. Fifth St., Port Angeles, WA 98362
Permit# 1� =3'71
(360) 417-4815 fax (360) 417 -4711 Date Approved
f
Applicant KCN k✓ p„,.e Phone 3 6O -S3/
Property Owner P c- Phone
Property Owner's Address //S O`d /tt //Re
Contractor Mo2Rt s eoe Phone 360 60- o>
Contractor's Address p 0, eo h v 5/
License naggiE /0 o ,fin Expires (Mt- cf_ a E -mail
PROJECT ADDRESS O 3 50, eJ/ti L ihColh 5 S{��ihoh
Parcel Number Lot Zoning
Project Type Brief Description: Residential Multi family C ommercial Industrial
Check all that apply
New Construction IR e e p 1il c e I,v e .Se/ u /e. e5 '744om ,Y j /&J A4 -P/ P.K
Addition -/-o J
Remodel
xRepair
Demolition
Re -roof House garage .0 other tear off re -roof lay over one layer
Heat System Heat pump wood burning stove gas fireplace pellet stove other
Other
Floor Areas Existing (sq. ft.) 'Proposed (sq. ft.)
Basement per sq. ft.
1 Floor
2nd Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION k‘
Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage cyo
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 ft. Occupancy group of bedrooms
Will a lawn sprinkler system be installed? Occupant load of full baths
Will a fire sprinkler system be installed? Construction type of half baths
I have read and completed this application and know it 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, and to obtain permits prior t orking on projects.
Datee -5- /f Print Name ��A-^) vkai Signature 6% vim'```."
T:Forms /Building Division /Building permit application
Official Use Only
Asscm.# !'i 1
Received
0 '4/
Backflow Assembly Test Report
City of Port Angeles
Public Works and Utilities Department
j Water/Was t�ewater Collection Division
NAME OF PREMISES. 5 b A/ C
SERVICE ADDRESS "t' !f A/ C Z- f X to
LOCATION OF DEVICE. IA/ k' T C we* U Av84 T6 G eir of S /N,4-
ASSEMBLY 4 4 7/ S' 5
Manufacturer Model Size Serial No
IS THIS AN APPROVED ASSEMBLY" YES IYNO IS ASSEMBLY INSTALLED CORRECTLY" YES II 1 o
DATE OF INSTALLATION 17 2 0i UNKNOWN
RPDA
REDUCED PRESSURE PRINCIPLE ASSEMBLY RP DC 0 DCDA
DOUBLE CHECK VALVE ASSEMBLY PVB Air Gap
svB AVB
Initial
Test
Repairs
Details
COMMENTS
Initial
Test
Repairs
Final
Test
CHECK VALVE #I
Leaked
Held at 5, psi
Cleaned
Replaced
CHECK VALVE #2 I RELIEF VALVE
Leaked Did Not Open
Closed Tight
Opened at psi
Held at psi
Cleaned Cleaned
Replaced Replaced
f
Line Pressure UG psi
WHITE CUSTOMER COPY YELLOW PURVEYOR COPY PINK TESTER COPY
PVB /S V B
AIR INLET
Did Not Open
Opened at psi
CHECK VALVE
Leaked Held at psi
REPAIRS
Cleaned
Replaced 1�
3 psi Butler YES NO
Final Closed Tight AIR INLET Opened at psi
CHECK VALVE Held at psi S 41-
Test Held at/ C psi Held at psi Opened at psi BACK PRESSURE NO YES J
AIR GAP INSPECTION 0
REQUIRED MINIMUM SEPARATION• YES NO TYPE OF HAZARD 5P.19 A? 4 )i t")Ne t
Held Backpressure YES EV NO
#2 Shutoff Held YES I'NO
Relief Valve Exercised YES [V
I Date'Time Tester Signature Cert. Test Kit Passed Failed
4 6 J /c !L Ci .n'7- ff r a L S A J'• AI 6 J f`
`r lfi l i 6 L ckex r 6 4G /i'I!nw6s7 P'
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning COMMUNITY SHOPPING DISTR
Application valuation 0
Contractor
PRICE KEN W OWNER
5418 S OLD MILL RD
PORT ANGELES
Owner
WA 983621972
COMMENTS /ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES. WA 98362
07 00000321
057930
403 S LINCOLN ST 5
06 30 00 0 1 6920 0000
ELECTRICAL ONLY
Qty Unit Charge Per
1 00 35 0000 ECH EL COMM 1ST SIGN
Fee summary Charged Paid Credited Due
Date 4/04/07
Permit ELECTRICAL SIGN PERMITS
Additional desc TC NORTHWEST
Permit pin number 98327
Permit Fee 35 00 Plan Check Fee 00
Issue Date 4/04/07 Valuation 0
Expiration Date 10/01/07
Permit Fee Total 35 00 35 00 00 00
Plan Check Total 00 00 00 00
Grand Total 35 00 35 00 00 00
O 7 as 8 S,G /v rr 69
Extension
35 00
GENERAL COMMENTS:
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.
Dl'1'C;H
ROUGH COVER
SERV ICE
FINAL
ELECTRICAL PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED
YES I NO
COMMENTS
epic 5/909
PW- 1102.15 (4,96]
Job wired by
Electrical Contractor Owner
Electrical contractor name License number
NOR#ALU t TNC
'Pr mi s ner' rite
d ress f inspectio
pity e-P0 c
Phone number to schedule inspection
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.
After reading the above statement, I hereby certify that I am the owner of the above
Inspection
Date
Appr ed By
Date
FINAL
/Date
Approve/1'1
Date
Date
Date Expires
DITCH
Area, Building or Equipment Inspected
ELECTRICAL WORK PERMIT APPLICATIOj
\(Installation description
X Commercial Residential
New Altered/Addition
Purchaser's mailing addre
N J e-9 v h-� (Rv-e .EL) s� `t Z vv-c-w
City S State ZIP
S e e i v t i..-. L A J A 4 2 3 8 2 C L A cj r r e 1 Iie•r S y s
Tele hone number FAX number
3.-63- -loess 36o 6133 -66 S S o kJ FA RIPC.Jet./
('flJ CAN- Sou 3o
O ti t O P) NO2, -IA S O i
b <td
Cash Check
named property or a licensed electrical contractor I am making the electrical instal- Credit Card Visa Mastercard Discover
lation or alteration in compliance with the electrical laws, N E.C. RCW Chapter
19.28 WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code, and Card
Utility Specifications.
/Signature of owner el ctrical contractor or electrical administrator Expiration Date D
X Date: 3/z .,Of card Inspection fee
Electrical Load Additions and or subtractions
NO LOAD CHANGES
Baseboard KW Voltage
Furnace KW Overhead Service Phase 1 3
Heat Pump Ton LAR Temp Service Service Size:
Fan -Wall KW Underground Service Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7 00 AM 360- 417 -4735
ROUGH-EN THERMOSTAT SERVICE
Appr ed By
Appr ed By
Date
I-
Date
FEEDER
Action Taken
Service Information
Approved By
Approved By
Electrical
Inspector
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
PRICE KEN W
5418 S OLD MILL RD
PORT ANGELES
Permit SIGN
Additional desc
Permit pin number 98038
Permit Fee 47 00
Issue Date 3/29/07
Expiration Date 9/25/07
Qty Unit Charge Per
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
47 00
00
47 00
T Policies \1102_15 building permit inspection record05 wpd [1/4/2005]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
07 00000308
309976
403 S LINCOLN ST
06 30 00 0 1 6920 0000
B &W SUBWAY INC
SIGNS
COMMUNITY SHOPPING DISTR
2400
Contractor
T C NORTHWEST INC
518 N SEQUIM AVE
WA 983621972 SEQUIM
(360) 683 6655
1 00 47 0000 PER S SIGN LES THAN 25 SF
Date 3/29/07
WA 98382
Plan Check Fee 00
Valuation 0
Extension
47 00
Paid Credited Due
47 00 00 00
00 00 00
47 00 00 00
Foq
036 z I� U
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
3 /z4 /o
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
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 LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
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 -IN
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
INSPECTION TYPE DATE
BUILDING PERMIT INSPECTION RECORD
\'ES
ACCEPTED COMMENTS
NO
I FINAL
FINAL
SEPA.
ESA.
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
DATE YES NO COMMERCIAL DATE I ACCEPTED
I YES I NO
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW ENGINEERING
FIRE. 417 -4653 I I I I FIRE DEPT
1 PLANNING DEPT 417 -4750 1 I I I PLANNING DEPT
I BUILDING 417 -4815 I I I I BUILDING
T \Policies \1 102 15 building permit inspection record05.wpd [1/4 /2005]
DATE ACCEPTED BY.
DATE ACCEPTED BY.
..1 II1 A
•v .J
Fill out COM PLETF.1 and in lhK. S our application and site plan MUST B
COMPLETE to be accepted for review If you have any questions, all
PERMITS (360) 417 -4N15 FAX(360)417.4711
Applicant or Art: 7o re) R w .1 l
Owner 4 Ui S tL t3 -T __I N G'
Address: RQ d 5 '7 City
Architect'Enginecr'
f
Contracttrr' �_S State License #1:CJJOi't' 1Grp 4
Address: 6 r/ c5 tfr,v) City prr >i r i w e-k.-
PROJECT ADDRESS, 403 SS C lake' ii 6'"
LEGAL DESCRIPTION Lot. Nlack:
CLALLAM COUNTY PARCE,L NUMBER
TYPE OF WORK.
Residential New Cunstr U Re -roof Stove
Multi- iirtnily 0 Addition 0 Mnvc 0 Garage
Commercial Remodel 0 Demolition Deck
Repair Sign 0 Other
BRIEF DESCRIPTION OF THE PKOJE('T
,e Per9 ?E E7 1`Tin c Sri, S'
No. of Stories: Lot Size:
Total lot coverage
PLANNING USE ONLY
TO d
BUILDING PERMIT APPLICATION
£SA/Wetland(s): Yes No SETA Checklist required'? Yea No Other
TVORMS1131dgPennitfurm.wpd Applicant:
Existing Sq 1.1.
061-9 £89 09€
Phone:
Phone:
Phone:
Subdivision:
O Ar Mai S S"Uc.)TH
St 61.e (s?Zr,s S -Aver/
COMMERCIALIRESIDE:NTIAL. Occupancy Group- I .had:
Proposed Sq. Ft.
VON orrtcjA t NNE
rate R.
perm,t 1. /r7
ate Approved.
at Issued:
3 0- (o33
3(0
Zip _5 S 507
Phone: &N J3 66,55
ZONING _CS L7
Zip:
SIZE/t ALLATION
SF (a 'SF
SF (�d /SF
SI' (a: S /Sr S
TOTAL VALL ATION a, N 62-e)
si a ae" /36//4./Ain.c,
Construction Type.
TOTAT Sq. Pt.
Date: 3/
Z6 /ta7
APPRO
PLAN
BLDG,
DPW U'
FIRE.
OTHER:
VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant.. t t
This figure will be reviewed and may be revised by the Building Division to comply with ctm'ent fee schedules. Contact the Permit
Coordinator at 417.4815 for assistance.
PLAN CHECK FEE. IF a plan check fee is due it must he submitted at the time the building permit application and constr plans are
submitted. All other permit fees arc 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 acttnn 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 eau 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 em authorized to
apply for this permit and understand that It is my responsibility to determine whet permits are required ,not the City's, and that I
must obtain such permits prior to work.
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This certificate lS issue
certifYmg that at the t
regulatmg buildmg c,
Business name ~' ,
Business address:
Property owner,
Property owner's
Automatic fire spri
Use & occupancy c
Building permit num
Type of construction.
Occupant load:
Post on the premises in a conspicuous place. This
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CERTIFICA TE OF OCCUPANCY APPLICA TION Permlt# 08- '6y ~
"
.
CITY OF PORT ANGELES FEES
Attn BUilding Permit Technician Ji150' Certificate / Inspection
321 E. Fifth St., Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711 $ .00 Parking Business Improvement Area (PBIA)
fee charged for downtown locations
Print In Ink
BUSINESS NAME
BUSINESS ADDRESS
Business owner's name ~ C\Yl
Business owner's home address
PLEASE NOTE: ~ f ~ ~ \
A Business License IS also required for the followmg busmesses' TaxI, Peddlers, Second-hand dealer, Pawnbroker, Dance, Hotel-
Motel, Fireworks, Ambulance, Tattoo shop. Contact the City Clerk at 417-4634 for additional information
ACTION. . - ..;:..,
New bUSiness
Transfer of bUSiness
location from a
PBIA location
Transfer of bUSiness
location from a
non-PBIA location
Change of ownership V
Remodel
Temporary bUSiness
Change of use
.
.
Call for Certificate of Occupancy inspections before opening business:
Building Department Inspection 417-4815 & Fire Department InspectIOn 417-4653
Please proVide a minimum 24-hour notice for inspectIOns
NO/ YES/ IF YES, CONTACT
v Electrical Dept at 417-4735
V BUlldln Dlvat417-4815
V
v
V
v
v""
\,/""
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V""
\,../
Public Works at 417-4807
\,../
v
\,.-/
Please sign up for utility services
at the cashier counter.
I hereby apply for a Certificate of Occupancy. I acknowledge that I have read thiS application and state that the informatIOn I have
supplied IS correct to the best of my knowledge \ J7 IJ -L d-Q
Date (- \ ~ - D ~ Print Name T2 e..b...Q..cc... 0\-\ Vljf)~ ml~nature l L/ ~'U I
-to IL D-Z.lAY\ D'I IZ-\L.')
Rejected
Initials & date
Building
Type of construction
Comments / Conditions
Occupant Load
Fire
I-~~IA
~nnlng
I
I City Clerk
Automatic fire sprinkler system reqUired
Pubk Works
T Formsli3'Jlldlng DlVtSl011lCt-I t '1r-2fe r,f Occupancy ApplicatIon
no
yes
e..
Street Lookup
Parcel Number 0630000169200000
Site Address' 403 S LINCOLN ST PA
l Quit I
Taxpayer:
PRICE KEN W
5418 S OLD MILL RD
PORT ANGELES, WA 98362-1972
5418 S OLD MILL RD
PORT ANGELES, WA 98362-1972
Title Owner:
PRICE KEN W
Description:
L TS 8&9 BL 169
Value Summary:
Note: Listed values do not reflect adjustments made for exemption programs such as
SenlorlDlsabled or Current Use programs (except Commercial Forestland properties).
Land Value 224,000
Improvements Value. 402,800
Total Assessed Value: 626,800
Property Characteristics:
Note: Use Code IS for Assessor's purposes only Contact the appropnate planning or
bUilding departments for Zoning and allowable usage of property.
Use Code' 5900 OTHER RETAIL
Land Size (acreage) .00
Note Acreage IS not listed for all properties In the
Assessor's records More information about land size
Tax Status Taxable
Tax Code Area': 0010
Note' Zoning and zOning codes change constantly Venfy all
zoning with the appropnate planning or bUilding department
Building Characteristics: (Click on Bldg # for more details)
JL Bldg. Type Bldg. Style Total S.F. BD BA
01 One Story 4900
Tax History
Sales History
Other parcels at this address:
I Quit I
http://apps.clallam.net/website/ sitis _ s. pgm ?address=403 &street= UN CO LN ST
Page 1 of 1
&... 7/16/2008
216
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Page 1 of2
Subway549
From:
To:
Sent:
Subject:
"Dean Dirks" <dean@deandlrks com>
<RACSJTD@aol com>
Tuesday, July 15, 20083 08 PM
PA permission
City Of Port Angeles,
I am giVing Becky Tunstal permission to get a permit from the bUilding department and set up utilities services for
the Subway In Port Angeles
I spoke to Mrs Pangre on the phone today, who authorized this e-mail of permission The city needs to make
these changes effective our first day of business on the 23rd
Please send the bills to
Dirks LLC
PO Box 316,
Wauna, WA 98395
(253) 858-1553
Port Angeles Account #
83183-156390
Federal Tax Id number
tax Id
20-5332136
Dean Dirks
Dirks LLC
5214 Tlmberlane NW
Gig Harbor, Wa. 98335
Cell 253-225-9951
Fax 253-276-0182
www.deandirks.com
7/16/2008
CERTI FICA1'E.o~OF~"6CCU P ANCY
-'~' '\~~
-.~ .~
. /\)' City of Port Angeles t.,....~.._
~/frJ;1 Building Division "~\',:
,~ ~
This C.#~;jiⅈlitt ISs.ued f.~rsuant to the requirements of Sectio;:"J, 09 of the
Uniforrf Building Code ce~tifJlr'!!i:fl!fJU!!. the tlm(f.,Of~.~f,e this sl1i}fcture was
In cfmpiiance with the variaMs''fjrdi~~''!!.f.i~~ .q,!r~ti#f#ilJK alii/ding
,r. construction,<J1' use. ~~'fiitrhJltig: ~.
t' ',," .' . ~E\
.. \
UseClassificationESpres~b/specialtY Coffee Building Permit No. '.'
~'f
M ~; Type of Construcnon VN Use Zone
,~
~.
OwnerofBusmesslResidenceL~da M. Berglund Mdresil24 E. Angeles,
'"
Bwlding Address 4
2 2
~-----
.... '.
ROUTING SLIP
Certificate of Occupancy
$47.00 Certificate/Inspection Fee
DATE J)f C- ~ ( 200u
?oY'f.Avl~6les I Wll\ q~~G?2-
Phone: busmess if/l ~ 5 40 ~ome Lt'57 -oqq~
Brief description of proposed business:
legal Description:? lot
,
Current Use of Property:
Zoning Classification of Property:
8"t~
O~~,.C ~
Block
WILL THERE BE ANY OF THE FOLLOWING?
Construction changes
Electrical changes
Mechanical (heating, cooling, stoves)
Plumbing changes .
New or relocated signs
New septic tanks
New sewer service
Admission charged to patrons
Is this a home occupation?
Excavation of filling of lots
Work done In City nght-of-way
Is there suffiCient off-street parking?
New dnveway openings .
A grading plan for site drainage
(parking lots, downspouts, etc) ..
Are the eXisting streets paved?
Are there eXisting Sidewalks?
Is there curb and gutter?
Other
~ NO
--
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I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the
mformatlon I have supplied is correct to the best of my
\ knowledge.
REJECTED
Building Section
Public Works Department
Planning Department
Fire Department
1~12-ot - ~~
/-25- O/--kiJ{;
\8v '-/2 -OJ
City Clerk
P.B.I.A.
New Business ............................ (t><.)
Transfer of Business location. . . . . . . . . . . . . . .. ( )
Change of Ownership . . . . . . . . . . . . . . . . . 0 . . .. ( )
New Building ...... 0 . . . . . . . . . . . . . . . . . . . . .. ( )
Remodel. . . . 0 . . . . . . . . . 0 . 0 . . . . . . . . . . . . . . . 0 ( )
Temporary Business ...... . . . . . . . . . . . . . . . .. ( )
Change of Use . . . . . . . . . . . . . . . . . . . . . . 0 . . . .. (oX- )
e..
Subdivision TPA
THE FOllOWING Will BE REQUIRED:
PERMITS
1) BUilding
2) Plumbing
3) Electncal
4) Mechanical
5) Sewer
6) Sidewalk Installation
7) Dnveway Installation
8) Curb Installation
9) Sidewalk obstruction
10) Water meter Installation
11) Fire
12) Occupancy
13) Sign
14) Shoreline
15) Home occupation
16) Conditional use
17) Other
BUSINESS LICENSE
1) TaxI
2) Peddlers
3) 2nd Hand Dealer
4) Pawn Broker
5) Dance
6) Hotel - Motel
7) Fireworks
8) Ambulance
9) Tattoo shop
10) Other
Date: ~ C . (p ( ,;)000
Signed ~ '1th- ~
Comments / Conditions
ti
'l4ir~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:m EAST 5TH STREET. PORT ANGELES. WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
App11cation type descr1ption
Subdiv1s1on Name
Property Use
Property Zon1ng
Application valuation
05-00000903 Date
505854
403 S LINCOLN ST.4&5
06-30-00-0-1-6920-0000-
ELECTRICAL ONLY
9/26/05
COMMUNITY SHOPPING DISTR
o
Owner
Contractor
PRICE KEN W
5418 S OLD MILL RD
PORT ANGELES WA 983621972
ANGELES ELECTRIC
524 E. 1ST ST.
PORT ANGELES
(360) 452-9264
WA 98362
Permit
Additional desc
Permit p1n number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER COMMERCIAL
ANGELES EL/ 1-5 CIR
60772
ANGELES ELECTRIC
61.30 Plan Check Fee
9/26/05 valuation
3/25/06
00
o
~
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\A
Qty Unit Charge Per
1 00 61 3000 ECH EL-COMM ALT <5 CIRCUITS
Extension
61 30
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 61 30 61 30 00 00 ~
plan Check Total 00 .00 .00 .00
Grand Total 61 30 61 30 00 00
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COMMENTS/ ACTION NEEDED
ELECfRICAL PERMIT INSPECfION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
I JI' I'( :H
RClllnl-l_IN I COVER
~.hK V ICE
~-'3....(!)'5'" I.MU
GENERAL COMMENTS:
PW.II02.J$(4I96J
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.
Post on the premises in a conspicuous place. This
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CERTIFICA TE OF OCCUPANCY APPLICA TION Permit # O<B -\.'l.q
CITY OF PORT ANGELES
Attn' BUlldmg PermIt TechnICIan
321 E Fifth St., Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
"
Print In Ink
BUSiness owner's name
BUSiness owner's home address
FEES
~o 00 - Certificate I InspectIOn
$1O~ Parking BUSiness Improvement Area (PBIA)
fee charged for downtown locations
1-10 U;..J -e.-
IT 5, E
IJ-e I G
4o~
oS~ Go
...s L f VI f.-"0 I
li:oJ{JM
51..(V/
Phone #
{.,vA
PLEASE NOTE:
A Business License IS also reqUIred for the following bUSinesses Taxi, Peddlers, Second-hand dealer, Pawn broker, Dance, Hotel-
Motel, Fireworks, Ambulance, Tattoo shop Contact the City Clerk at 417-4634 for additional information
ACTION ./
New busmess
Transfer of bus mess
location from a
PBIA location
Transfer of busmess
location from a
non-PBIA location I
Change of ownership ./
Remodel
Temporary busmess
Change of use
Will THERE BE ANY OF THE FOllOWING? NO// YES/ IF YES, CONTACT
Electncal chanCles ~ Electncal Dept at 417-4735
New or relocated slans ./ BuJldma DIvIsion at 417-4815
Construction changes .// "
Mechanical chanCles (heating, coolma, stoves) /' ./ "
Plumbing chanCles ,../ "
Fire spnnkler system chanaes v / "
Fire alarm system changes // "
Is this a home occupation? ,/ PlannmCl DIvIsion at 417-4750
Second-hand dealer or pawn broker? ............./ CltV Clerk at 417-4634
New or relocated sewer or water service /' Public Works at 417-4807
Excavation or filling of lots ---- "
Work done In the City nght-of-way // "
New dnvewav open lOgs .....- "
Gradmg site drainage (parkmg lots, downspouts, etc) "" "
Landscape Irrigation system (backflow deVices) /'" Water Dept at 417-4886
Off-street parkmCl .../'./
EXlstmg streets paved /~
EXisting sidewalks .../
Curb and gutter .../
Call for Certificate of Occupancv inspections before opening business:
BUlldmg Department InspectIOn 417-4815 & FIre Department InspectIOn 417-4653
Please prOVIde a mmlmum 24-hour notIce for mspectlons
Please sign up for utility
services at the cashier counter,
I hereby apply for a CertIficate of Occupancy, I acknowledge that I have read thIS appilcation and state that t e mformatlOn I have
supplied i correct to the best of my knowledge
Date?- ) ~ Print Name ~ e: Me;- ~vvJ Signature
BUilding
Fire
PBIA
Plannmg
City Clerk
Public Works
Rejected
Imllals & date
Comments I CondItions
Type of construction
Occupant Load
AutomatIC fire sprmkler system reqUired
no
yes
T FormslBUlldlng DlvlslonlCertlficate of Occupancy Application
Parcel Lookup
.
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"
Parcel Number 0630000169200000
Site Address' 403 S LINCOLN ST PA
r ee'",'y?:~' F: 'T ~.,," I
,:Quif! 'Back
Taxpayer:
PRICE KEN W
5418 S OLD MILL RD
PORT ANGELES, WA 98362-1972
5418 S OLD MILL RD
PORT ANGELES, WA 98362-1972
Title Owner:
PRICE KEN W
Description:
L TS 8&9 BL 169
Value Summary:
Note: listed values do not reflect adjustments made for exemption programs such as
Senior/Disabled or Current Use programs (except Commercial Forestland propertJes)
Land Value 224,000
Improvements Value' 402,800
Total Assessed Value, 626,800
Property Characteristics:
Note: Use Code IS for Assessor's purposes only Contact the appropriate planning or
bUilding departments for ZOning and allowable usage of property
Use Code: 5900 OTHER RETAIL
Land Size (acreage). .00
Note Acreage IS not listed for all properties In the
Assessor's records More mformation about land size
Tax Status: Taxable
Tax Code Area 0010
Note Zoning and zoning codes change constantly Verify all
zoning with the appropriate planning or bUilding department
Building Characteristics: (Click 011 Bldg # for more details)
-.fL Bldg. TYM_ Bldg. Style TotaIS.F. BD BA
01 One Story 4900
Tax History
Sales History
~~
111,631.25811
http://apps.clallam.net/website/sitis ~. pgm ?parcel=063 0000 169200000
Page 1 of 1
f\\e
2/13/2008
:'(pORT ""'"
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CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application description
Subdivision Name
Property Zoning . . .
Application valuation
03-00001014 Date 10/24/03
403 S LINCOLN ST
06-30-00-0-1-6920-0000-
LINCOLN STREET STATION
SIGNS
2000
Owner
Contractor
PRICE KEN W
5418 S OLD MILL RD
PORT ANGELES WA 983621972
J & J CONSTRUCTION
233 ALICE RD.
PORT ANGELES
PORT ANGELES WA 98363
(360) 457-1809
Permit . . . .
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL SIGN PERMITS
1 SIGN CIRCUIT
STRAITS ELECTRIC
35.30 Plan Check Fee
10/24/03 Valuation
4/22/04
.00
2000
~
~
tA
Qty Unit Charge Per
1.00 35.3000 ECH EL-COMM-1ST SIGN
Extension
35.30
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35.30 35.30 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 35.30 35.30 .00 .00
(A
"
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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 Contractor or AuthOrized Agent
Date
Signature of Owner (If owner is builder)
Date
T \PLANNINGlFORMS\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,
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 NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEP ARA TE PERMIT #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
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
ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL iJ//t,j,:. /-c{;)
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 \PLANNING\FORMS\1102 15 [4/2002]
~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32\ EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application description
Subdivision Name
Property Zoning . . .
Application valuation
03-00001014 Date 10/15/03
403 S LINCOLN ST
06-30-00-0-1-6920-0000-
LINCOLN STREET STATION
SIGNS
2000
Owner
Contractor
PRICE KEN W
5418 S OLD MILL RD
PORT ANGELES WA 983621972
J & J CONSTRUCTION
233 ALICE RD.
PORT ANGELES
PORT ANGELES WA 98363
(360) 457-1809
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
SIGN
48 SF FREE
115.00
10/15/03
4/13/04
STANDING SIGN
plan Check
Valuation
Fee
.00
o
Qty Unit Charge Per
1.00 115.0000 PER S- SIGN FREE OR PROJ 25+
Extension
115.00
~
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 115.00 115.00 .00 .00
plan Check Total .00 .00 .00 .00
Grand Total 115.00 115.00 .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, jf construction or work is suspended or abandoned
for a period 01.180 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. AU 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 v'olate or cancel the provisions of any state or local law regulating construction or the performance of
construction. -
_\, "
j/L--.
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\II02.15 (412002)
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BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY,
Date Rec.' I 0-15-0 -~
Permit #, 10
Date Approved: Ib
Date Issued:
Fill out COMPLETELY and iu INK. Your application and site plan MUSTt#r
COMPLETE to be accepted for review. If you have any questions, call, )
(360) 417-4815 V
Applicant or Agent: -. ~ cl. ~\ (Oe--,v" + Phone: 510 () -. L.J )/ ~ / P> () 9'
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Owner: kc..-,./ Y(2..It<' r Phone: y f7~
Address: <.; (') ~ '5' , 1, I^--@O llt; CIty: \ :'-. f) /14"7' p~ Zip: ;? & 'S 6 ::1-.
ArchitectlEngireer: ...L (f~ R r f 4- ~~ / ./ h" Phone: ....y ~":.2 ~ / It,
Contractor , \ c:i j . c::: St1te License #: '. Exp: Phone:
Address:c~ "3_~ #//("6 (j2 r/ City: r?1J /2../ ~p/~ Zip:
PROJECT ADDRESS: -1/ c?~~ ~,<? ..1//1/ f'{)./-/(./
LEGAL DESCRIPTION: Lot: Block:
ZONING:
?P?63
C,c; ()
Subdivision:
CLALLAM COUNTY PARCEL NUMBER:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA MC #
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Conunercial 0 Remodel 0 Demolition
o Repair ~Sign
BRIEF DESCRIPTION OF TH!t"PROJECT:
City:
Exp. Date:
o Stove
o Garage
o Deck
o Other
SIZEN ALUATlON:
SF, @ $ /SF, ~ $
SF, @ $ /SF, ~ $
SF, @ $ /SF, ~ $
TOTAL VALUATION $ 2C::::x:'J <:>D
COMMERCIAL/RESIDENTlAL: Occupancy Group: Occupant Load:
No. of Stories: Lot Size: Existing Sq, Ft. & Proposed Sq, Ft.
Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage
Construction Type:
= TOTAL Sq.Ft.
%
~~~~ ~~~~~f ~t;):::~~ :'-]J::,~j:;, J :,V If ~ ~,
ESA/Wetland(s): 0 Yes I2l'No SEPA Checklist required? 0 Yes ~o Other:
(' ~<-, ()
APPR~~:
PLAN:'/?
BLDG:
DPWU:
FIRE:
OTHER:_
BmLDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount mnst 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 107.4 of
the Uniform Building Code, current edition), No application can be extended more than once,
I hereby cerlify that I have read and examined this application and know the same to be true and COlTect. t am authorized to apply for this permit and
understand that Ii is my responsibility to determine what permits are required ,not the City's, and hat I ust obtain such permlis prior to worn,
T:\FORMS\APPS\Buildingpermit.wpd
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
12\ EAST 5TH STREET. PORT ANGELES. WA 98362
06-00001021 Date
935250
403 S LINCOLN ST 2
06-30-00-0-1-6920-0000-
ELECTRICAL ONLY
9/27/06
Application Number
Application pin number
Property Address .
ASSESSOR PARCEL NUMBER
Application type description
Subdivislon Name
Property Use
Property Zoning .
Application valuatlon
UNKNOWN
o
Owner
Contractor
PRICE KEN W
5418 S OLD MILL RD
PORT ANGELES WA 983621972
HALVORSEN ELECTRIC
1426 W 11TH ST
PORT ANGELES WA 98363
(360) 457-7803
Permit
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER COMMERCIAL
HALVORSEN/ ALTER FRONT COUNTER
87122
HALVORSEN ELECTRIC
61 30 Plan Check Fee
9/27/06 Valuation
3/26/07
.00
o
Qty unit Charge Per
1 00 61 3000 ECH EL-COMM ALT <5 CIRCUITS
Extension
61 30
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permlt Fee Total 61.30 61. 30 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 61.30 61. 30 .00 .00
COMMENTS/ACTION NEEDED
~
\t3
~
rt
"1 )'-
~ ~
~
~ t
CJ\
~
ELECfRICAL PERMIT INSPECfION RECORD
I
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 ACCEPTED COMMENTS
I YES NO
IJI I:H
Il IUU.~-lli'll COVER
~"".H: VI(..... I
I
.........~ q:./~-"1, .A...A, ) I
GENERAL COMMENTS:
PW.II02.I'I4'96]
d'~'~
.~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
.'21 EAST STIl STREET. PORT ANGELES. WA 9Rl62
ELECTRICAL PERMIT
Issued: 4/20/99
Permit No:
6613
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
KEN PRICE 403 LINCOLN S
403 SO. LINCOLN Lot: 8&9
Port Angeles, WA 98362 Block: 169 Long Legal:
360/452-2221 Sub: TPA
T: S: #3 Pare No: 063000016920a
CONTRACTOR-----------------------------DESIGNER---------------------------------
PENINSULA SIGN SERVICE
PO BOX 791
CARLSBORG, WA 98324
360/683-4294
,
000/000-0000
PROJECT INFO--------------------------------------------------------------------
prj Type: COML. MISC. prj Value: $0.00
Occ Type: Cnstr Type: SIGN
Occ Grp: Occ Load: Land Use: CSD
Electrical Heat
Baseboard KW:
Furnace KW:
Heat Pump KW:
Fan/Wall KW:
Service Type
o Riser
o Overhead Service
o Underground Service
o Temp Service
Voltage:
Diameter:
Service Size:
Feeder Size:
-1
o
-3
o AMPS
o AMPS
PROJECT NOTES-----------------------------------------------____________________
ONE SIGN AND FEEDER
PROJECT FEES ASSESSMENT--------------------------------------___________________
Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
Mise SIGN $32.25
TOTAL FEE:
Amount Paid:
$32.25
$32.25
---------------------------------
---------------------------------
--------------------------
TOTAL FEE:
$32.25
Balance Due:
$0.00
COMMENTS/ACTION NEEDED
ELECfRICAL PERMIT INSPECfION RECORD
CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEIlL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPR DATE ACCItPTEll COMMENTS
YES I NO
]gE -IN /I.;UVI:.K
~ V 11.;10
I L//Z-;/dIJ I I
GENERAL COMMENTS:
PW-II02.IS(4I96]
.~.~
J~
\M
CITY OF PORT ANGELES
PUBLIC WORKS . ELECTRICAL DIVISION
]21 EAST 5TH STREET. PORT ANGELES. WA 98]62
ELECTRICAL PERMIT
Issued: 11/02/98
Permit No:
6463
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
KEN PRICE
403 SO. LINCOLN
Port Angeles, WA 98362
360/452-2221'
'T: FIRST FEDERAL
S:
403
Lot:
Block:
Sub:
Parc No:
LINCOLN S
8&9
169 Long Legal:
TPA
CONTRACTOR-----------------------------DESIGNER---------------------------------
COLEMAN ELECTRIC
PO BOX 1326
PORT ANGELES, WA 98362
360/452-7194
,
000/000-0000
PROJECT INFO--------------------------------------------------------------------
prj Type: COML.REMODEL prj Value: $0.00
Occ Type: Cnstr Type:
Occ Grp: Occ Load: Land Use: CSD
Electrical Heat
Baseboard KW:
Fu::-nace KW:
He'it Pump KW:
Fan/Wall KW:
Service Type
o Riser
o X Overhead Service
o Underground Service
o Temp Service
Voltage:
Diameter:
Service Size:
Feeder Size:
-1
o
-3
o AMPS
o AMPS
PROJECT ~OTES-------------------------------------------------------------------
REWIRE OLD SMITH BARNEY OFFICES INTO OFFICES FOR FIRST FEDERAL
PROJECT FEES ASSESSMENT-----------------~---------------------------------------
service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $54.00
Temp Service: $0.00
$0.00
Misc
TOTAL FEE:
Amount Paid:
$54.00
$54.00
============~====================
TOTAL FEE:
$54.00
Balance Due:
$0.00
C0t\1MENTS/ACTlON NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE rr IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE . ACCEPTIW COMMENrS
YIIS I NO
-IN I If/lc,It?t' rJ>'
]ID<.. V IL "-
. I I I . ,
GENERAL COMMENTS:
PW-IID2.UI06J
.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
PERMIT NO. 71 cf .2 '1
DATE /0./.2(, ;1 r
Installed By:
~ t:-,'
~
lV
, 0 READY FOR
r 1/'5 INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Site Address:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
ELECTRIC HEAT
o BASEBOARD KW _
o FURNACE KW
o HEAT PUMP KW
o FAN/WALL KW _
o RESIDENTIAL
o COMMERCIAL
o NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o TEMPORARY SERVICE
o RISER
o OVERHEAD SERVICE
o UNDERGROUN~E~~E
VOLTAGE: /;uJ 02~
0116 1f316'
SERVICE SIZE ~
FEEDER SIZE
AMPS
AMPS
Details/Description:
CJ
.s-o
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
A,lr"'1j(ROugh-in/cover O.K.
, ~O.K. to connect service _~ k~
~'"tJ. Final O.K.
fk~,-;~~ &~)
Site Address:
CL.;;6 ;:j- 'I
Installer:
.
Notify 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 Building Permit. PHONE 457-0411, EXT. 224. ":#
~~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ !fiS 7 {}
Electrical Inspector
Permit Fee
WHITE - File by address
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Metsr Dept., Bottom: City Hall
OLYMPIC PRINTERS INC.
I-~
.
Site Address:
0.3
0-4
Installed By:
Owner/Business:
Owner/Business Address:
I
o RESIDENTIAL
~. COMMERCIAL
o . BASEBOARD KW _
o FURNACE KW _
o FAN/WALL KW _
o HEAT PUMP KW_
o SIGN
Details/Description:
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
PERMIT NO. :s 7 C" /
8/Z.1/7C-
. .
DATE
ELECTRICAL PERMIT
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Phone:
Sq. Ft.
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
:;g. SERVICE UPGRADE/REPAIR
o SPECIAL EQUIPMENT
(LIST BELOW)
~ OVERHEAD SERVICE
o UNDERGROUNIi> SE.RllICE
VOLTAGE: /2-0/ 2. ~
o SINGLE PHASE
~ THREE PHA99'
SERVICE SIZE reJ-O AMPS
!(&wlOV[ C T
c//R-c-cI- rl1 c& ~
.
/11 E~/lvq
I
IN.s 4//
3
~
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.
o Rough-in/cover O.K.
~o.K. to connect service
o Final O.K.
Site Address:
'I () ::s
~.
L;~
Permit/Receipt No.
'J- 7& I
Installer: 0fr...
L
New Meters
~
.
Notify 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 Building Permit. PHONE 457-0411, EXT. 224.
1&wJ
Electrical Inspector
WHI!E - File by address
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
$
.s-o ~
Permit Fee
YELLOW - file by number
GREEN - Top: Meter Dept., Bottom: City Hall
OLYMPIC PRINTERS INC
PINK - Top: Eng, Bottom, Customer
.
.
.
Installed By:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
.
,
I.
Site IAddress:
,
ELECTRICAL PERMIT
PERMIT NO. t'lhO 3
DATE 1/>;/'1 J
EADY FOR
INSPECTION
License Number:
, WILL CALL FOR
INSPECTION
Phone:
Owner/Business:
Phone:
OWl"!erfBusiness Address:
Sq. Ft.
o Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/Industrial load 0 Add/alter circuits
Total Connected load 0 Auxiliary power
(attach breakdown) (list below)
Total Motor load 0 Special equipment
(attach breakdown) . () , (list below)
DetailslDescription: ~ i( S ( K*IUJ:
~JOj' /
~;:;~~
o New Construction
o Remodel
o Service update/alter/repair
o Overhead
o Underground
Voltage
o 10 030
Service size
o Temporary
Amps
.
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough-in/cover O.K.
o O.K. to connect service
~ Final O.K.
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for instailation
o Fire Department notified of inspection
o Plan Review approved/pending
Installer:
~
Permit/Receipt No.
Site Address:
:;::2 (gO
r'
New Meters
.
( AJ.5
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 the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457-0411, EXT. 158 or EXT. 224.
I 5 I j 0 NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ;/.); tJ V
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYMPIC PRINTERS. INC.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N~
18072
Port Angeles, wash1ngton......._2/..;;lL.?l..i.........m..... 19__000000
1//
i In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles. per-
mission is hereby granted to d6 electrical work as listed below.
~ddress .....<;:.;iy::2:~---I-~.-J.~~~ooo.~..:~-);.c;.~.({L----. occupancy.C.Q~.~__~cs:j.J./__.____.__
Owner _____.___J:::L~L___...______oo.____jLoooo.___5___..,oo___,. ~enanLm__..oo~.m.."moo..\~______ooooo_____.oo___ooo.._____oo...
Wiring Contractor .__A::t:!.~.~l~;'J___oo.EL.!':!:~.L... BY...___.,e::d:..",oo1J.~~...________.__.oo..__
Light Outlets..............................._.._.....
Receptacle Outlets...............................
Service, volts .......................................
No. wires .......................................
Dryer, KW........n...n........................_..
Size wires..................................._..
Range, KW m.mhmh.mmm._._n
Water Heater:
Main fuse .......................................
Enclosure .................................
KW.m.......m..m...m
Type of wiring:
Entrance Cable .............................
Heat: KW...................................................
Motors: size, volts and phase:
Rigid Conduit .........................
Metallic Tubing .....................
Current transformers:
No. & Size..............................
Ser. No..............................................
Ser. No..............................................
Ser. No...............................................
Total Load.............................
Sec. No. ................._..........................
Remarks: oo___...______mmoo....____.___...__ooo.__.___oo.moo......m...___.___..oo.___.___oooo....._____m___oo__'OO______'___OO"oo______.moo.oooo..."___
Total.......................................
Type of Wiring:
Armored Cable ..............................
Non-Metallic ................................_
Knob & Tube..................................
RIgid Conduit ...............................
Metallic Tubing ...........................
Raceway ........................................_
Circuits, Light.......................................
Utility.............................................
IIeat ......................................._......
Range .............................................
Water Heater ...............................
Motor .............................................
Dryer................................................_
Furnace .........................'_...................
...-----...----..-.------....-.-------------._._..______._._..._______........._..._.nn...._.._____....h_..________._.....________h_.____________..____.___._..._.__._._____
._.....__.......UU.Unu_..._.......nnn........__h_h_....U.....nn....uu....h__nn__.........__.n......hhUn._._.......n.__.........n.............__u......
Permit Fee
$:.00...00______...__.________.....___.
Treas. Receipt
No......__..___.oooo...........
By --------.......------......__________._________...m.______....______.
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work Is to be con.
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N~ 1 80 7 2
Address ......Yt!.;;?,.....m.;?.L~.=~\..~.:!..:y.~:..I..r.l.m.m......................mm..m........... Date...h.6!.3./E.r........._......_m......
owner..5E~2.'i?T.~...._1'(J..:n.r.5nL\2.t.!..m.......m..m.......m......m..n.n.Tenant.mm....mf.......~..m'..................mn.....m
...., -,. -"-, 4.. \'."
Wiring Contractor......hn!.':\.(Ltd..'?.,)........:t::.....~~.""L:,""f.',......m.m..........."",'m""m.m BY.m,&m.::::..,...,.2}.,""""'.~'"'1(.LLn
o ' . V
NOTIC~urrent must not be turned on until Certificate ot Inspection has been issued. If work fs to be con.
cea.led due notice must be given the Inspector so that work may be inspected before concealment.
1M Olympic Printers, Inc.
9t Electrical Contractor
o Annual Permit 0 Alarm
~
..'1l1iiiiIl
"-.~..
~t- ~....Ir
o Owner ~...o
o Carnival ~ Commercial 0 Residential 0 Residential Maint. 0 Signs 0 Thermostat 0 Telecom.
ELECTRICAL WORK PERMIT APPLICATION'
astRequest Inspection
!<
Job wired by 0 Electrical Contractor ~ Owner
Electrical contractor name License number
Installation description
RFLDcJl.rGD '!?JA7L.1U IL/CIIT sit/
/ilJL.J/tN?5f3AJs ii/EaRle
Purchaser's mailing address
244Z J.7/1JCF' 1?0
City
PORT A-JIIbm~
Telephone number
State ZIP
.9i? 863
FAX number
4
Premises owner's name
LiM.N C;TIrR p~'Jj)ay ttJ/t)./S'
Address of inspection
.'J Ii '3 .<;0 1.lk'CiJl./f/ .<)t.../r7l... 'Z-
City
PORT /f tJ c. r; t./~<6
I hereby cerrify that I am the owner of the above named property or a Jicensed
electrical contractor (or the firm's authorized agent) and am making the electrical
installation or alteration in compliance with the electrical law, Chapter 19.28 RCW.
o Cash 0 Check #
)iJ Credit Card (jjiP Mastercard
Discover
Card# __JL!,!J.Ike..._-____-____
Signature of owner, electrical contractor or electrical administrator
X~
Expiration Date /
of card
{;/; '3iJ
/ WALLS "'
Insulation Only
Dale Approved By
Cover
Dale Approved By
/ CEILING
Insulation Only
Dale Approved By
Cover
Dale Approved By
THERMOSTAT
Dale Approved By
DITCH
Dale Approved By
SERVICE "'
Dale Approved By ./
/ FEEDER
"- Dale Approved By
Electrical Load Additions and or subtractions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton LAR
o Fan-Waif KW
Service Information
o Overhead Service
o Temp Service
o Underground Service
Voltage
PhaseD1D3
Service Size:
Feeder Size:
Inspection
Date
Area, Building or Equipment Inspected
Action Taken
Electrical
Inspector
~,N~
S~
'"
.
'-'W'i
\. 'J'"'
-,..
ELECTRICAL WORK PERMIT APPLICATION
.
Electrical contc3ctor name
License number Date Expires
~v.Mt'.S
Illstal~ dc~crjprion
lit""Eommercial CJ Rcsidcarial
o New ~d/AdditiOn
(iJ~ ~ 1&La
J
J"b wired by
lectrical Con tractor 0 Owncr
Purchaser's m.tiling addrl:ss
City ANGELES ElECml~, !Nt:.
524 EAST FIRST
Telephone "umber PORT ANGELES\'MIA>~62
-~--i". -
Premi~e~ owoer'!l namt:
~':,JI~!Z-. s;:- {;t'3
City (fttt
Ph<,ne. number to srbedulc inllpcl:tiou:
s
C<<AL
blk/-rt&
sr)
~
#5'
Owner CIS d(fim:J by RCW /9.2,'j,2t51:(J) Owner will occupy the srruaure for two
years after this el€GTricCll permit is finaJi;;(..'cl, (2) Owltf:,. is I'(!qtlil'ed tn IIi,.!!: an dectrical'
,oof/traciQr if'aboVt~ nila property i~.ti),. ,falt:." reAl or least!.
After ~ading the "bove S"latel1lent. I hereby certify that I 3m the owner of the above
named property or ::t 1icen~cd electrical contractor_ I am making the electrical U1S1;l.i-
ladem or altcration in compliance with (he electrical laws. N.E,(:., ReW. Chapter
19.2$. WAC. Chapter 296-468. Tllc City of Port Angeles Municipal Code. and
Utility Specifications.
Si2naruc'c or. wner, electrical contnctor or c1cctric31 :tdminisr ator
CI Cash 0 Check 1/
o Credit Card Visa Mastercard Discover
Card# ____-_-LJAL-Jql.l:::.----__
x
Date:
Expiralion Date
of card
.El.\1.s;1r.~al Load Additions and or subtractions
Q NO LOAD. CHANGES
a Baseboard KW
CJ Furnace KW
(J Heat ~ump Ton LAR
o Fan-Wall KW
CJ Overhead SSl'\fice
::J. Temp Service
a Underground Service
-7
Voltage ~
Phase Q 1 Q 3
Service Size: _
Feeder Size: __
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
h--ROUGH-IN THERMOSTAT SERVICE
Dll1t; Aflflr<'lvea Ky D~t" --APII1'(JVQ(1 Hy O;llo; ^I'J'Mv<:d ~)'
.r r
FINAL DITCH FEEDER
9-;;..3-1:>S' A0 '- D;llo; "'~'f'TI'IVcd ~y
OllIe ^l.lp",.o1 t!y Ol!.!" AIlPr<.>vCl.IBy/
lnspcl;lion Area, Building or Equipment Inspected Action Takeo Electrical
Date In!lpcctor
.. ..
.-
~...~~~ ....'._M
/?CO 9h./ ~,--' .
/ -.
/ / I
(;-d
59(;6 (;5V.09E JNI JI~lJ313 S313~N~ ~o~~
~~E0'0L 50(;-RL-R
" , ~Jectrjc.l cOlliraetor /lnslll11ation descri{ltiOI1
Job wired by D o.wner !iil""Commen:i.1 O' R.sld.nll~l
----< ~w .
Bltcmce.! CCtltra~tor pame Licensl; number pate E:xpirei o Altered/Addition
Al.A.e(\,\~A.l' \) ":!:teL J>,.lAexY\SSOii?,)PW /0...'.... (
~-
p.J.fchasCT'S mail g s:::ldre's I
PD e,D)( Cj 9- .4LA~ -Sr€.t"'\ --.-
Ci~lAf'I\yP vJA- Stale ZIP .
9~i~71 (VI 011 0 t-4 Sf,- N.<.,,~.r~
---..
. I2~t1;~";e73/~ .. .. fAX number
"zs~. 81'9', ,z1~ . "
--.,
Pn~I11"~U ownu's Dame f34vJ
SVf::,WA-y .:xt-1<.. . -
--'-
AoJdren of Inspe.dioD L'I'\c..oln -S+. # 5:--
L..JO '3. ~vt-h
.~
Clt1ft> A....q'e~
R-r --
Pilon!! number to Il:b.edu\f: lulpE-crf.o-D:
Z-?~. '19'1, '1!>I~
O.\?Tt.r as dr:fin.-ed by RCW19.28.261:(J) Owner will occliPY the structl1uJor twc>
)'w/'S oft>>' this I!!I~cfricaf ~1"mit iJ finaliuJ. (2) OYJJt~r is raquired to hire cPZ electrical
CC'.'1t1'acfor if abc\ll said pr(Jp~rty is fo.,. sale, rent OJ' l~a.re. o Cash o Cbuk #
AIler t~ad;"g the abo\'';\ St3lo:ment, I hexcby ct-.rtify that I am the owner of tDl1: above ~",ditCard ~
n:uucd propert)' or a 1i~{lsed tlectric.al contractOr. r am maJci.1t tbe electrkal instal. Maste,oard Disco~;r
l~tion at alteration ill compliilnce. with tllC etectrical1aws, N.E,C.. R,CW. Chapler CordI!
19.28. W."..C. Chapter 296-46'8, The City of Port Anscle6 Municipill (odEl, 'r.d
U.-ijity Specifi~titJn~. ChriS H-rl/Z..A
V"Slg11actrl"e or owuer,. eJectrlc:sl cDDtnl.etor or electrlc.:al admin.istr<lror Expiration
''i'
S
" . ..' .,,' .' , . P.131
ELEcnuCAL WORKPERMlT APPLICATI(:;
~
t .
Electrical Load AdditIons and or sublraetlollll
o NO LOAD CHANGES
o ea,.board ~N
o Furnace KW
o Heat pump _ Ion _LAR
o Fan.Wall KW
SAl\-lli DAY INSPECTION CALL BEFORE 7'00 AM 360-417-473S
Service InforlJ1ation
o Overhead SerJie~
o Tr'mp SaNIC.
o Underground Service
Voltage _____
Ph as. 0 1 0 3
Servic.c Size; _
Feeder Size:
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Il1speetion A".. Building oc Equipment Inspected Actiol1 Taken f.k..lfic.3:
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10/21/2003 10:50 FAX 36045i4698
STRAITS ELECTRIC
I4i 01 .,
b/~
ELECTRICAL PERMIT APPLICATION
. ------,....------...--...
FOil. OFf1ClAL USE OfllL'f
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The ElecuicaJ Permit Application must be filled out completely,
PleASe \)Ipe or reprint In Ink. If you ha... any questions, please coli (360.
F"" number. (J60) 417-4711
awn.ror.Eloe. CcnlnldorAgent Straits Electric Phon.'
PrnpertyOwner. ~Y1LOI VI 8-tcl ~
Address: 4f'V\ ~ Un~ City; fA-
PhOne:
Credit Card Holder Name:
Straits
city:
~ ELECTRICAL CONTRACTOR
Electric
u~.:STRAIE*O~DS
Port Angles, WI\.
9/03
tip: '1~~2..
P/1on.' 452-91 04
Zip: 98362
Electrical Cont.r;;ictcr.
Straits Electric
Addrnss: P.O. Box 2914
INSTAllATION WIRED BY:
DOWNER
Billing Address' P. 0 _ "ox 291 4
Exp. Date: ~
WA
Zip: 9 8 3 62
VISA:~MC,-
~l~t~
PROJECT ADDRESS' L
ftJ3 ...5 LlAf'!BLN~ sr,
TYPE OF WORK:
Check all that apply: Lj/'New
o Alteration/Addition
o Residental 0 Muttl-famlly
~ Commercial 0 Mobile Home Sq. Ft.
o Septic Pump
o Low Voltage 0 Telecom. 0 Sign
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool
Number of Circuits added or altere<l: ~
DESCRIPTION OF THE ELECTRICAL PROJECT;
~8t1
c jy-r LLl1-
Eleclrical Heal load Additions
4/oQ.
Service Infonnalion
o Baseboard
o Fu maCt!
o Heat Pump
o Fan-Wall ,/
_IWI
IWI
_IWI
_IWI
o OVemead SelVice
o Temp Service
o Underground SelVice
Voltage:
Phase: D 1
Service Size:
Feeder Size:
D 3
PAMC 14.05.060(8): For industrial. commercial. & residential projects larger than a duplex. a one - line drawing of the Electrical Service &
Feeders. building size (sq. ft.). load calculations. and the type & of conductors and/or raceway is required and shall 8<COmpany the
Electrical Pennlt application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and I am
authorized to apply for this permit. I understand it is not the City's legal responsibilily to determine what permits
are required; it remains the applicants responsibilily to dete . e what permits are required and to obtain such.
er/Christie Tucker
~
. slgnat~,
PW.9019 It( - Nb CdY\+td- vJ/ ~ .Co.-'
/)/l . c.(ut-rh"'C-c, ,frf1)ot>'\.. "S>T ~r
~C~ /~Jh'r
Dale:
Date:IO~2-l--o.3
U/., ,
~(Il.L &'0-
'lLf".cf..L...... ~ 35,30
Application Number . . . . . 23-00001324 Date 12/21/23
Application pin number . . . 765020
Property Address . . . . . . 403 S LINCOLN ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-6920-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Wall signs
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
KENNETH W PRICE PLUMB SIGNS INC
5418 S OLD MILL RD 909 S 28TH ST
PORT ANGELES WA 983621972 TACOMA WA 98409
(253) 215-0084 (253) 215-0084
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 176.00 Plan Check Fee . . .00
Issue Date . . . . 12/21/23 Valuation . . . . 0
Expiration Date . . 6/18/24
Qty Unit Charge Per Extension
2.00 88.0000 ECH EL-COMM-SIGN 176.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 176.00 176.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 176.00 176.00 .00 .00
MULTI-FA MILY/ COMMERCIAL
ELE CTRICAL PERMIT APPL ICATION
Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:--------------------------------------
Project Description:--------------------------------------□Multi-Family Residential D Commercial I Industrial/ Public Building Square footage: __________ _
OWNER INFORMATION
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRICAL CONTRACTOR INFORMATION
Name: License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
llim!
Service/Feeder 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/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Sign / Outline Lighting
Signal Circuit/Limited Energy -Multi-Family
Signal Circuit/Limited Energy/First 1500 sf -Commercial
(Note: $5.00 for each additional 1500 sf)
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Unit Charge Quantity
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
$113.00
$56.00
Total (Quantity x Unit Charge)
$ ____ _ $ ____ _$ ____ _$ ____ _
$ ____ _
$ ____ _ $ ____ _
$ ____ _ $ ____ _$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _ $ ____ _
$ ____ _
$ ____ _
$ _____ 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-
46B, 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]
lJ CD