HomeMy WebLinkAbout709 W 5th St - BuildingPREPARED 5/20/11 8 39 41 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/20/11
ADDRESS 709 W 5TH ST SUBDIV
TENANT NBR DAVOD E HOGLUND
CONTRACTOR AFFORDABLE SERVICES PHONE (360) 683 9619
OWNER DAVID E HOGLUND PHONE (360) 452 4434
PARCEL 06 30 00 0 0 9975 0000
APPL NUMBER 11 00000449 RE ROOF
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 5/20/11 BLDG FINAL
%1 May 20 2011 8 37 35 AM 1pangrle
JANE 683 9619
BUILDING FINAL RE ROOFED THE GARAGE
COMMENTS AND NOTES
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 11 00000449
Application pin number 228309
Property Address 709 W 5TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 9975 0000
Tenant nbr name DAVOD E HOGLUND
Application type description RE ROOF
Subdivision Name
Property Use
Property Zoning PUBLIC BUILDINGS PARKS
Application valuation 1975
Application desc
TEAR OFF RE ROOF THE GARAGE
Owner
DAVID E HOGLUND AFFORDABLE SERVICES
709 W 5TH ST 258663 HWY 101 WEST
PORT ANGELES WA 983632247 SEQUIM
(360) 452 4434 (360) 683 9619
Structure Information 000 000 RE ROOF THE GARAGE
Permit BUILDING PERMIT NO PR FEE
Additional desc RE ROOF THE GARAGE
Permit pin number 185504
Permit Fee 95 75
Issue Date 5/11/11
Expiration Date 11/07/11
Qty Unit Charge
15 00
Other Fees
Fee summary
3 0500
TForms/Building Division /Building Permit
Per
Permit Fee Total 95 75
Plan Check Total 00
Other Fee Total 4 50
Grand Total 100 25
Contractor
BASE FEE
HND BL -501 2K (3 05 PER C)
Charged
Date 5 /11 /11
WA 98382
Plan Check Fee 00
Valuation 1975
Extension
50 00
45 75
STATE SURCHARGE 4 50
Paid Credited Due
95 75
00
4 50
100 25
00
00
00
00
00
00
00
00
5 avu.k 51- 1A IJ IA oboe/
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
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 re ing construction or the performance of
construction
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
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
AIR SEAL.
Walls
Ceiling
FRAMING
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
T Forms /Building Division /Building Permit
FINAL Date Accepted by
FINAL Date Accepted by
Date Accepted By
BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
Applicant U C Phone 5(ot' Zei ifq
Property Owner f� it Phone %L (/C/3a
Property Owner's Address 61._. Portefnleffs J r z
Contractor I7/P Phone y,D/o04,giplce
Contractor's Address 2_50 &03 ti (i c ii/11-610.307 *-74/2e0 License arc 0/!"» Expires E -mail J
PROJECT ADDRESS `icyi (/U f
Parcel Number d Y)/5'YY.) C r S
P Type Brief Description: %Residential Multi family Commercial Industrial
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
House )(garage other Iktear off re -roof lay over one layer
Heat System Heat pump wood buming stove gas fireplace pellet stove other
Other
Floor Areas Existing (so. ft.) loosed (so. ft.)
Basement per sq. ft.
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage ok
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
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be installed? Construction type
I have read and completed this application and know it to be true and correct. 1 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 to working on pr 'ects.
Date "'"1/ Print Name SA` e khii `M Signature
T:Forms /Building Division/Bldg Permit.doc
For City Use Only
Date Received 11- l t
Permit# 11 -449
Date Approved
Lot 9 Zoning
TOTAL VALUATION 10 t
of bedrooms
of full baths
of half baths
Name at th
Address
City,
DEPOSIT
A ffordable Roofing's Representative:
Customer's Signature of Acceptance:
See attached Warranty Statement.
AFFORDABLE ROOFING
258663 Hwy 101 West
Sequim, WA
(360) 683 -9619
qr 5 r)
Phone #1 3(,L
Phone #2
State WV r Zip Code
.,Tarp house perimeter to protect landscaping
Remove old roofing and haul to Landfill
OSB
9
Install Plywood
Install Roofing Felt
Install 'Pipe Flashing
Install Exhaust Vents
Install Ridge Vents
Install Attic Vents
Install Sun Tube
Install Skylights
Install
Install
Install
Install
Secure Locate Septic Drain Field Loci "on
Price Includes Building Permit k C
Customer to Secure Building PenT t
•t
Description
With Soot Guard Aig: BIocI S ystem.
w e Mi✓ `S Pik I Yv )0/A A;
y i l
Payment m full upon completion of project,
unless other arrangements accepted
We propose hereby to furnish material and labor,
complete in accordance with the above specifications.
All material is guaranteed to be as specified. Any alteration or deviation from the above
specifications involving extra costs will be exeuted only apon written orders and will
become an extra charge over and above the estimate. We are not liable for preexisting
defects caused by others. All agreements contingent upon strikes, accidents or delays
beyond our coniroL Owner to carry fire, tornado and other necessary insurance.
A cceptance of Proposal the above prices, specifications and conditions
are satisfactory and are baby accepted. You are authorized to do the
work as specified._ Pa Y cnt will be made as outlined above.
(360) 385 -2724
Install
Install
Install
Install
Cut In
Install
Install
1 Pr
(360) 452 -0840
PROPOSAL
Drip Edge Metal
Metal W- Valleys
Roof to Wall Flashing
Roof to Wall Step Flashing
Chimney Counter Flashing
Chimney Step Flashing
Skylight Flashing
i
SUBTOTAL. ti
SALES TAX (p C
TOTAL. 4
Note: this proposal may be withdrawn by us if
not accepted within 30 days
Brand ..3 C ear R C
Color J6tX Workmanship
10 Year Warranty
Lifetime Warranty
Clallam County Assessor Treasurer Property Details 56443 DAVID E HOGLUND f Page 1 of 2
Clallam County Assessor Treasurer
Property Search Results 56443 DAVID E HOGLUND for Year 2011 2012
Property
Account
Property ID 56443 Legal Description. LOT18 BL 99
Geographic ID 0630000099750000 Agent Code
Type: Real
Tax Area. 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11
Open Space: N DFL N
Historic Property' N Remodel Property N
Multi- Family Redevelopment: N
Township Section:
Range.
Location
Address: 709 W FIFTH ST Mapsco
PORT ANGELES WA
Neighborhood: Cycle 5 Res Map ID 3
Neighborhood CD 10955130
Owner
Name: DAVID E HOGLUND Owner ID 30872
Mailing Address: 709 W 5TH ST Ownership 100 0000000000%
PORT ANGELES WA 98363 -2247
Exemptions.
Taxes and Assessment Details
Property Tax Information as of 05/11/2011
Amount Due if Paid on 7.
NOTE If you plan to submit payment on a future date make sure you enter the date and
click RECALCULATE to obtain the correct total amount due
First Second
Half Half
Base Base
Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest Base Paid I Amount Due
2011 151186 ST SCH STATE SCHOOL $159.20 $159.20 $0.00 $0.00 $318.40 $0 00
2011 151186 CC -GEN COUNTY CLALLAM $87.90 $87.88 $0 00 $0 00 $175 78 $0 00
2011 151186 SD #121 SCHOOL DISTRICT #121 $208.11 $208 10 $0 00 $0.00 $416.21 $0.00
2011 151186 CITY PORT ANG CITY OF PORT ANGELES $202.89 $202.88 $0 00 $0.00 $405 77 $0.00
2011 151186 PORT PORT OF PORT ANGELES $12.37 $12.37 $0.00 $0.00 $24 74 $0.00
2011 151186 NTH OLY LIB NORTH OLYMPIC LIBRARY $36.86 $36.86 $0.00 $0 00 $73 72 $0.00
2011 151186 HOSP #2 HOSPITAL #2 $36.08 $36.07 $0.00 $0 00 $72.15 $0.00
2011 151186 WSMET PK DIST WILLIAM SHORE MET PARK DIST $10.97 $10.96 $0.00 $0.00 $21 93 $0 00
2011 151186 CITY_STORMWATER CITY STORMWATER $36.00 $36.00 $0 00 $0 00 $72.00 $0.00
2011 151186 WEED_CONTROL WEED CONTROL $0.82 $0.81 $0 00 $0 00 $1.63 $0.00
2011 151186 TOTAL. $791.20 $791 13 $0.00 $0.00 $1582.33 $0.00
12010 39484 ST SCH STATE SCHOOL $157 60 $157 61 $0.00 $0.00 $315.21 $0 00
2010 39484 CC -GEN COUNTY CLALLAM $83.88 $83.88 $0.00 $0 00 $167 76 $0 00
2010 39484 SD #121 SCHOOL DISTRICT #121 $204 14 $204 14 $0.00 $0 00 $408.28 $0 00
2010 39484 CITY PORT ANG CITY OF PORT ANGELES $194.20 $194 18 $0 00 $0.00 $388.38 $0.00
2010 39484 PORT PORT OF PORT ANGELES $11 79 $11 79 $0 00 $0 00 $23.58 $0.00
2010 39484 NTH OLY LIB NORTH OLYMPIC LIBRARY $24.37 $24.37 $0 00 $0 00 $48 74 $0 00
2010 39484 HOSP #2 HOSPITAL #2 $34 40 $34 41 $0.00 $0 00 $68.81 $0.00
2010 39484 WSMET PK DIST WILLIAM SHORE MET PARK DIST $10.95 $10 95 $0 00 $0 00 $21.90 $0.00
2010 39484 CITY_STORMWATER CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $72.00 $0.00 i
2010 39484 WEED_CONTROL WEED CONTROL $0.82 $0.81 $0 00 $0 00 $1.63 $0.00
2010 39484 TOTAL. $758.15 $758.14 $0.00 $0.00 $1516.29 $0.00
http. /websrv8 clallam.net/propertyaccess /Property aspx ?cid =0 &year= 2011 &prop_id =56443 5/11/2011
f- ~ORT ~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
pin number
property Address
ASSESSOR PARCEL NUMBER:
Application descriptlon
Subdivislon Name
Property Use
Property Zoning . . .
Application valuation
9/15/04
04-00000821 Date
.057242
709 W 5TH ST
06-30-00-0-0-9975-0000-
MECHANICAL APPL. PERMIT
PUBLIC BUILDINGS & PARKS
3082
Owner
Contractor
HOGLUND DAVID E
709 W 5TH ST
PORT ANGELES
ALL WEATHER, HEATING & COOLING
302KEMP ST.
PORT ANGELES, WA
PORT ANGELES WA 98362
(360) 452-9813
WA 983632247
Permit MECHANICAL PERMIT
Additlonal desc PROPANE INSERT, LINES, TANK
Permlt Fee 57.65 plan Check Fee .00
Issue Date 9/15/04 Valuation 0
Explration Date 3/15/05
Qty Unit Charge Per Extension
BASE FEE 47.00
1. 00 10.6500 ECH ME-GAS PIPE 1 TO 5 10.65
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permlt Fee Total 57.65 57.65 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 57.65 57.65 .00 .00
ptIV/rl!5-0
C;/Z4A74
~
~
~
~
iIt
1
<<t)
"':j
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.
q
Date
Signature of Owner (if owner is builder)
T:\PLANNING\FORMS\1102.15 [11/14/2003]
Date
BillLDING 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, 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 DRAINAGEfDOWNSPOUTS
ELECTRICAL (LIGHT DEPl) SEPARATE PERMIT #
ROUGH-IN
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP
GAS LINE q, I 'J-I} Ii I...J j.. 1"
WOOD STOVE 1 PELLET 1 CHIMNEY I
HOOD f DUCTS
PW UTILITIES f SITE WORK (Engmeenng DlVlslOn) SEPARATE PERMIT #'s'
WATERLINE f METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGfLlGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R W. f PWI CONSTRUCTION - R W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT 417-4750 PLANNING DEPT.
BUILDING 417-4815 q - {).rJ -OJ-! JLL- BUILDING
T \PLANNINGIFORMS\1I02.15 (11114/2003]
PREPARED 9/24/04, 13 12 26
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
6
9/24/04
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
709 W 5TH ST
ALL WEATHER, HEATING & COOLING
HOGLUND DAVID E
06-30-00-0-0-9975-0000-
04-00000821 MECHANICAL APPL PERMIT
SUBDIV
PHONE (360) 452-9813
PHONE .
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
ME6
01
9/17/04
9/17/04
9/23/04
9/23/04
JLL
AP
MECHANICAL GAS LINE
DARREN 452-9813
GAS LINE PRESSURIZED SINCE YESTERDAY
MECHANICAL FINAL
AMY 452-9813
tank lS In place but lnterlor appllance not connected flnlsh
connectlng and recall /Jll
MECHANICAL FINAL
ME99 01
JLL
DA
""-"'--~~---------
COMMENTS AND NOTES --------------------------------------
PREPARED 9/23/04, 12:51 56
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
709 W 5TH ST
ALL WEATHER, HEATING & COOLING
HOGLUND DAVID E
06-30-00-0-0-9975-0000-
04-00000821 MECHANICAL APPL PERMIT
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
ME6
9/17/04
9/17/04
JLL
AP
01
MECHANICAL GAS LINE
DARREN 452-9813
GAS LINE PRESSURIZED
M"'_"__~:t:>f)_____~~'::::::::;AN'
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1J~e
~ O{, \ n
",." \ -, If.(/rt' V I
~ , r-'
I L
J ~.tJ Yl,
f)\fL"
SUBDIV
PHONE (360) 452-9813
PHONE .
SINCE YESTERDAY
PAGE
DATE
7
9/23/04
NOTES --------------------------------------
\ .....(J,J
\?(i~
~
PREPARED 9/17/04, 13 59 01
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
3
9/17/04
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
709 W 5TH ST
ALL WEATHER, HEATING & COOLING
HOGLUND DAVID E
06-30-00-0-0-9975-0000-
04-00000821 MECHANICAL APPL PERMIT
SUBDIV
PHONE
PHONE
(360) 452-9813
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
~;--;;--~-~---~~;:~::':'::!u!!:!v-"NC'-"""'A'---------------- -- - ------
-------------------------------------- COMMENTS AND NOTES --------------------------------------
Sep.
15 2004 08:54AM P2 //
CIa. RIe.: C( - 15" - d..,.
Pamit': 0'-[... A7_1
Date Approved:
n.leI\lod:
BUILDING PERMIT. APPLICATION
City; 1>9( \ MO \es
\J~
Phone:
Phone: ~ (,,0 -c.(<,."2. ... '1'8' I ~
,
Zip: ~ fA:;)...
ZONING; ..
~
Me
TR.OFWOJUC:
Q 1....."1Il1 a New CoDs1r.
Q WQlti.fuDily I:J Ac1diticm
Q Cot..~ c P~l
Q Repair
Q R.e-root
o~
Q DeblOliuOD
Q Sign
SIZEIV .ALUADON:
o Woods1ovc SF.@S ISF''''$
Q Garage SF..@$ /SF.-$
o Deck SF.;@'S- - /SF. m$
c TOTAL VALUATION S~) t::'J n-:l..
'I""~(i \\ ~'(()r(\1\q, '1^<;PV~. ~ Q., p.v ~ +flV\ I(:
'Z.'L
qgr.~ON OrTBB PllO.mCl':
.'
CO~~ENTIAL: Occupmcy Group: Occupant Load:
NQ. of Stat'i0l: _ Lot Sizo: % .l.()t Coverage:
Exiatiq Lot Ccmnac: 'sq. ft. + Proposed Lot Coverage:
PUNNJNG USE ONLY:
No_
COnstruct10D Type:
%.
Isq. ft. ~ TOTAL LOT COVERAGE:
APPROVALS: PLAN
BLDG.
DPW
J'Ul2
O'l'BER
/eq.ft
ESAlWcdaDd(.): Q Va a No SEPA Checklist required? 0 Yes C No
Other:
,
'. I, -BIJIIJQNG JatMIT'A>>PUCAftON,StlBMlTTAL: Y.", tlpplJctl/ltla ..Illite pkut _JUt kJlllMl OlllU"""'" N ~f.r
Ut1Iew. The '8uitdina DivwoD call pzovide you with more cIctailcd iDformation on the applicatiDD aDd plan submittal requirements. Your
completed applicatioa. lite pIan (for additions) IDd buildiDg CODStJuction plans are to be submitted to the Building Division.
V ALl1A.'DON,OI' CONSTR.UcnO~~ 'ID aD cua, . wluatiDD amount mlllt be entered by the applicant. 1bia figure will be revifted
aDd may be revised by the Buildiq Division to comply with c:unent fee schedules. Contact the Permit CoordiDator at 417-4815 for assistazu:e.
PLAN (!UClUJEE: Your plm cbec:k fee is due at the time the building pennit application and construction plana are aubmitted. AU other
pem1it fea are due II the time of pcnnit issuance.
EXl'IRADON OF PLAN REVIEW: If DO permit is issued within 180 days of the eta.., of application. this ,appUaUo.. will ezplre. The
BuiJdiAg OffICial caD extend the time lor actiO.ll by the applicant up to 180 daY' upon wrincn request by tha applicllDt (see SeetiOD 107.4 of
the UDifoun Buildmg Code. CUlTCIlt edition). No application can be extended more than once.
. 1 h~ cerrth tIIlU llulYc read GIld Q41ItPted ,his applicatio1l aM mow the same 10 be InIe and correct, and I am lIfIthonza 10 apply for
thh pennlL J UMerstllM It is not the City's legal re.lporuibiliey, to determine what permits are required; II 'smatru tlte appltCllnt'l
re.fpolJSlbllltylO determine what permits are nquired and to obtain such.
ApplicaDt o.u \ 1 \ - ~ Dalo:~'
, T:\P.OJU4SWPS\8l1ilcSiAaPermlt ~
. '~'.' '. ., :.....,. ..f .
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.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
Site Address:
ELECTRICAL PERMIT
Sa
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
7tJ ,
~
Installed By:
Owner/Business:
Owner/Business Address:
~SIDENTIAL
o COMMERCIAL
o BASEBOARD KW ----cr-
B-FORNACE KW ~
o ..fAN/WALL KW _
~HEAT PUMP KW-3-
o SIGN
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
o REMODEL
~ ADD/ALTER CIRCUITS
tJ SERVICE UPGRADE/REPAIR
o SPECIAL EQUIPMENT
(LIST BELOW)
Details/Description:
PERMIT NO. rOb z..
01-?/f'~
DATE
Phone:
Sq. Ft.
o OVERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
o SINGLE PHASE
o THREE PHASE
SERVICE SIZE AMPS
.
R 'ih~ /i-fl ~cJ~
J~ ~! 1I-fJ.
(
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 O.K. to connect service
1/.!J^.1 Final O.K.
Site Addre? & uJ r .s ..;..e..
Installer:
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 eiectrical inspector in writing on either the Wiring Report
or on the Building Permit. PHONE 457-0411, EXT. 224.
--r(~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $
~
ElectricallnspeClor
WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom, Customer
OLYMPIC PRINTERS INC.
t90
~D-
Permit Fee
GREEN - Top: Meter Dept., Bottom: City Hall