HomeMy WebLinkAbout221 1/2 W 6th St - BuildingPREPARED 4/16/09 8 48 48 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/16/09
ADDRESS 221 1/2 W 6TH ST SUBDIV
TENANT NBR RAYMOND C MARTELL JR
CONTRACTOR DAVID SUE RENOVATION LLC PHONE (360) 452 9848
OWNER RAYMOND C MARTELL JR PHONE (360) 457 0147
PARCEL 06 30 00 0 0 9255 0000
APPL NUMBER 09 00000219 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 4/16/09
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME1 01 3/27/09 PB
3/27/09 AP
ME99 01 4/16/09
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BLDG FINAL
April 16 2009 8 44 43 AM 1pangrle
SCOTT 775 8144
BUILDING FINAL
MECHANICAL ROUGH IN
March 26 2009 2 13 57 PM 1pangrle
SCOTT 775 8144
MECHANICAL ROUGH IN
SCOTT REQUESTED THAT YOU INSPECT AS EARLY AS POSSIBLE
March 27 2009 2 54 42 PM pbarthol
MECHANICAL FINAL
April 16 2009 8 43 38 AM 1pangrle
SCOTT 775 8144
MECHANICAL FINAL
PL2 01 3/27/09 PB PLUMBING ROUGH IN
3/27/09 AP March 26 2009 2 15 07 PM 1pangrle
SCOTT 775 8144
PLUMBING ROUGH IN
SCOTT REQUESTED THAT YOU INSPECT AS EARLY AS POSSIBLE
March 27 2009 2 54 42 PM pbarthol
PL99 01 4/16/09 ,J PLUMBING FINAL
April 16 2009 8 44 21 AM 1pangrle
SCOTT 775 8144
PLUMBING FINAL
COMMENTS AND NOTES
PREPARED 3/27/09 8 46 54 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR PAT BARTHOLICK DATE 3/27/09
ADDRESS 221 1/2 W 6TH ST
TENANT NBR RAYMOND C MARTELL JR
CONTRACTOR DAVID SUE RENOVATION LLC
OWNER RAYMOND C MARTELL JR
PARCEL 06 30 00 0 0 9255 0000
APPL NUMBER 09 00000219 RES REMODEL
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME1 01 3/27/09
PB
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 3/27/09
PB
SUBDIV
MECHANICAL ROUGH IN
March 26 2009 2 13 57 PM 1pangrle
SCOTT 775 8144
MECHANICAL ROUGH IN
SCOTT REQUESTED THAT YOU INSPECT AS EARLY AS POSSIBLE
PLUMBING ROUGH IN
March 26 2009 2 15 07 PM 1pangrle
SCOTT 775 8144
PLUMBING ROUGH IN
SCOTT REQUESTED THAT YOU INSPECT AS EARLY AS POSSIBLE
COMMENTS AND NOTES
PHONE (360) 452 9848
PHONE (360) 457 0147
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Bathroom remodel
Owner
MARTELL JR RAYMOND C
221 W 6TH ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983626008
ELECTRICAL ALTER
143008
59 50
3/17/09
9/13/09
59 50
00
59 50
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
09 00000237
863681
221 1/2 W 6TH ST
06 30 00 0 0 9255 0000
ELECTRICAL ONLY
RESIDENTIAL HIGH DENSITY
0
Contractor
APS ELECTRIC
546 BENSON RD
PORT ANGELES
PORT ANGELES
(360) 452 6753
RESIDENTIAL
Qty Unit Charge Per
1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
1 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT
Paid Credited
59 50
00
59 50
DATE.
Plan Check Fee
Valuation
00
00
00
1
L017 Lei 9Q
Date 3/17/09
WA 98363
00
0
Extension
57 50
2 00
Due
00
00
00
RESULTS
Signature of owner or Electrical Contractor X Date
INSPECTOR.
FROM A.P S. ELECTRICAL CONTRACTOR
City of Port Angeles Permit Application
Building DivisionlElectrieal Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 417-4735 Fe.t: (360) 417.4711
Date: /b R.0 0 9
2 Single Family Dwelling
Mul6- Family or Commercial'
Commercial Addition Alteration Remodel Repair*
Owner Information
Name: f'a.a re$1 wire -e,d
Mailing Address: 2. 1 LL)
City f 4, State: W ?1p:
Phone: NG 7 —el 1 1 -17 Fax Ai
License Exp �4.
Unit Charge
93.75
5113.75
5160.00
5205.00
$291,25
2.00
57.50
2.00
72.50
86.25
511625
5131.25
75.00
69.00
75.00
50.00
50.00
93.75
80.00
86.25
27.50
57.50
86.25
43.75
Signature of owner, electrical contractor or electrical administrator
x c �na,ri: °16009
FRATUDIP
MAR 1 6 2009
UGHT DEPT
Plan Review May Be Requiret Please Complete ElecbicalI'� Review Information Sheet
Job Address: e 2 r l 7 i4j fp f P
Building Square Footage: 1 0 oa
Description of above Jil l t ✓n.& N tAall
Q3'ib"a
Contractor Information
Name: R P 5
Mailing Address:
City_
Phone`
License Exp.
Mar 16 2009 1 51AM P1
mc. -f'! i C J
State: Zip
Fax
/9
Total (t r MufGo9ed bv_Unit Cha ff
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp_
ServiedFeeder 401.600 Amp.
19 Service/Feeder 601 1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
57 5a Branch Circuit W/O Service Feeder
.7 a Each Additional Branch Circuit
Temp. Service/ Feeder200 Amp.
Temp. Service/Feeder 201 -400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601 -1000 Amp.
Portal to Portal Hourly
SO/Outline Lighting
Signal CfcuM Limited Energy Commercial
Signal Circuit/ Limited Energy 1 2 Family Dwelling
5 Signal C Limited Energy Mufti- Famiy Dwelling
Manufactured Home Connection
5 Renewable Electrical Energy 5KVA System or Less
Fast 1300 Square Ft
Eacb Additional 500 Square Ft or Portion of
5 Each Outbuilding cc Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
59.5 Total
Owner as defined byRCW.1928161: (1) Owner wiN occupy the structure for two years after this egedlleal permR is Sinekzed fA Owner is respired to ma, an
e l e c t r i c a l c o n t r a c t o r if above said property isforsafq rent or lease:
0
w
-J
After reading the above statement, hereby =Iffy that I am the owner of the above named property or a licensed electrical eontractor.1 am making the electrical
installation or alteration in compliance wllh the electrical laws, N.EC. RCW. Chapter 19.211. WAC, Chapter 296418, The City of PortAngeles Municipal Code, and
Utility Specifications.
Cash
El Check
E4 Credit Card 6 5 5 000 6 614 Lj
Dto 1`Jr,
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
REMODEL BATHROOM
Owner
RAYMOND C MARTELL JR
221 W 6TH ST
PORT ANGELES
(360) 457 0147
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
3.5-09
Date
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
BUILDING
BATHROOM
142687
151 75
3/11/09
9/07/09
Qty Unit Charge Per
BASE FEE
4 00 14 0000 THOU BL -2001 25K (14 PER K)
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
1 00
1 00
7 2500 EA
14 8000 EA
1 00 7 0000 EA
T:Forms/Building Division/Building Permit
WA 983626008
MECHANICAL PERMIT
142794
72 05
3/11/09
9/07/09
Per
Qty Unit Charge Per
Print INaa
09 00000219 Date 3/11/09
919066
221 1/2 W 6TH ST
06 30 00 0 0 9255 0000
RAYMOND C MARTELL JR
RES REMODEL
RESIDENTIAL HIGH DENSITY
5500
Contractor
BASE FEE
PL- PLUMBING TRAP
DAVID SUE RENOVATION
201 DOGWOOD PLACE
PORT ANGELES
(360) 452 9848
PERMIT RESIDENTIAL
REMODEL
Plan Check Fee
Valuation
BASE FEE
ME VENT FAN (SINGLE DUCT)
ME HEATER(SUSP /WALL /FLOOR MTD)
LLC
WA 98362
98 64
5500
Extension
95 75
56 00
Plan Check Fee 00
Valuation 0
Permit PLUMBING PERMIT
Additional desc
Permit pin number 142802
Permit Fee 79 00 Plan Check Fee 00
Issue Date 3/11/09 Valuation 0
Expiration Date 9/07/09
Extension
50 00
7 25
14 80
Extension
50 00
7 00
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 constr
17;7
Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Inspection Type
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 Fumace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
T.Forms /Building Division /Building Permit
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
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting 1 ESA.
Landscaping 1 SHORELINE.
Comments
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
Application Number
Application pin number
T:FormsBuilding DivisionBuilding Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
09 00000219
919066
Page 2
Date 3/11/09
Qty Unit Charge Per Extension
1 00 7 0000 EA PL -WATER LINE 7 00
1 00 15 0000 EA PL -SEWER LINE 15 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 302 80 302 80 00 00
Plan Check Total 98 64 98 64 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 405 94 405 94 00 00
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.
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
T:Forms /Building Division /Building Permit
01
Inspection 1 r't5
Inspection Type
rR
1
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting 1 ESA.
Landscaping 1 SHORELINE.
FINAL Date /6 Accepted by 3
FINAL Date 1 "I 6` a 1 Accepted by TO
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
0
--0
j\
g
G
0
Applicant b,(h S
Property Owne,r r,p cac_
Property Owner's Address
Contractor _c
Contractor's Address 2_, N
License
PROJECT ADDRESS
Parcel Number
Proiect Tvne Brief Des
Check all that apply
New Construction
Addition
Remodel
repair
Demolition
Re -roof
Heat System
Other
Floor Areas
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
u�9 Tia2mv�
crintion.
Total footprint of structures
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
re -04 1-007
GTA
r'�vct�
Expires 2
/3 -/0
2-2_ P2_ G� ?o r: g...lagzs, S i.
Lot Zoning
Residential Multi family
,2 gt_ 5 t42-e 19 t. 1 E re_�
t7 r der T�.I i( f l P_uo/ A X 4
�c►� 1 17,,s714-// .tea/ ,1 /1-kokacr
aF��
House garage other tear off re -roof lay over one layer
Heat pump wood burning stove gas fireplace pellet stove other
Existing (sq. ft.) Proposed (sq. ft.)
sq ft. Lot size 1 K
Site Coverage the amount of impervious surface on a parcel including structures
and other impervious surfaces (see PAMC 17 94 135 for exemptions)
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. I am authori
that it is my responsibility to determine what permits are required, and to obtain permits
DateJ 9 41 '2 x Print Name „,„v e .SSE XSignar,
T Forms /Bu Id ng Division /Bldg Permit.doc
C For City Use Onl
Date Received 3-- o Q'
Permit
i d/ Date Approved
Phq�e\ y 9p/c
Phone y s j a y 7
1 /4://G& csS ee.t4e, giN L
Phone <2 gy T2
E -mail ,ecs egi
cow
Commercial
TOTAL VALUATION
sq ft. Lot coverage
paved driveways sidewalks patios
Site coverage
per sq ft.
of bedrooms
of full baths
of half baths
apply for this permit and unuerstand
ing on project
Industrial
1
L.*
0
1
60- 6 0- 1472
key c
10057.01 re-hbfi
CIVe OF PORT ANGELES Constritction Pis is I
The Issuance of this (permit based upon these pans, spelifi-
cations and other data shall no prevent the, building off ial 1
frem thereafter requiring the correction of errors in -aid
Me specifications and other data, or from 'preverting
building operations being carried on thereunder whi 1 in
r
violation of all codes and ordinances of this jurisdi lion. I
;3i4 3ti,3i c3 ,....1. 0 4_ c____
Approval Date 0
i
I
Ns,
Loceie_
4-e3. 4-1G-74/
i 0 71, I
I T
4,r
1
84 ,6 754 43c77r;-.07/14i.6.1%
D77 ti/Petzwfi trorro
VPF 1 ry
FILE
1
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
l21 EAST 5TH STREET. PORT ANGELES. WA 9R~62
Applicat~on Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type descr~ption
Subd~vision Name
Property Use
Property Zoning .
Applicat~on valuation
05-00001181 Date 11/29/05
847736
221 1/2 W 6TH ST
06-30-00-0-0-9255-0000-
ELECTRICAL ONLY
RESIDENTIAL HIGH DENSITY
o
Owner
Contractor
MARTELL JR RAYMOND C
221 W 6TH ST
PORT ANGELES WA 983626008
APS ELECTRIC
546 BENSON RD
PORT ANGELES
PORT ANGELES
(360) 452-6753
WA 98363
Permit
Additional desc
Permit pin number
Sub Contractor
Perm~t Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
APS/ ALTER SVC.
66043
APS ELECTRIC
66 90 Plan Check Fee
11/29/05 valuation
5/28/06
00
o
~
-
Qty
1 00
unit Charge Per
66 9000 ECH EL-R OR RM 0-200 ALT SRV FDR
Extension
66 90
~-
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 66 90 66 90 00 00
Plan Check Total 00 00 00 00
Grand Total 66 90 66.90 00 00
E
~
\~
~
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECfION 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 TYPIt
DATE
COMMENTS
NO
GENERAL COMMENTS:
PW.ll02" (4'96)
;",-"
.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
PERMIT NO. 1.;2 ;7ji
~/i& J?7
r ,
DATE
Site Address:
;;l;;J
o READY FOR .~ILL CALL FOR
INSPECTION INSPECTION
License Number:
Phone:
Phone:
Owner/Business Address:
Sq. Ft.
o Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
o New Construction
o Remodel
,Jii(Service update/alter/repair
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
.0 Overhead
o Underground
Voltage
o 1.0 03.0
Service size
o Temporary
Amps
,
DetailslDescrlption:
N~ttI~
/JJ~ ~L
.
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough-in/cover O.K.
)Ii O.K. to connect service
o Final O.K.
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
.
Site Address: Jj.
.;>.~ 12 (,U,
Installer: L
W\C; C,lJNfl7oJ
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 n the Wiring Report or the Building Permit. PHONE 457-0411, EXT.158 or EXT. 224.
.---. ~ n . NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT 'fJ I;'; !!!!?
nspe Amount paid
WHITE - file by addr 5 YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
New Meters
o
OLYMPIC PRINTERS, INC.
.-
.-
~=~
'\+ ~".
.......
..
ELECTRICAL WORK PERMIT APPLICATION
i
Job wired by
CI Qwner
InstaUalion dC5cripliO,n
CJ Commercial )( Residential
Date Expires
ON""
CI AlteTedJAdditjoD
r-
e..-n 1\
City ..\.. ~I State ZIPJ ^
0"\ L' 4\lIa (J..te~ L- ,...
Telephone numbi.15d-."""J b I5-.iAX nurnS( m <L.
PrePiisu .OWDe{'s Dame - t
lA r-o I m. a. r- e..
Address of InspeclioD I -t t
~;ll - I/~ LA) ~-
CIIY~A
~ffl/lP~ 5b~J.
g%Sb"5 Y\.Qt.c,tt ,;lOC A ~
Phone
r to se e
r
sp don:
Own!!'r G.S' defined by RCW./9.2 16/:(') Ow"er will occupy the str'lJ.ctwefor twQ
Xean after this tleclric:ul permit is fmaUzed. (2) o,..71CT is required to hire un eledn"cxtl
cono'actor if above said property is for sale. relit or reuse.
AIler readin!; the above statement, I hCTchy certify that 1 am the owner of the above
named property or a licensed eleclrical contractor. I 3Jl\ making the elcctrical instal-
lation or al1cration in' compliance with tbe eleclrical laws, N.E.C., RCW. Chapter
19.28, WAC. Cl1apt~r 296-46B. The Cily of Port Angeles Municipal Code, and
Utilily Specifications.
cr, elecrr.
o Cash 0 Check #
a Credit Card Visa
Card #
~
,-
,~
6'Y\.~
Mastercard
Discover
x
ate: / / -:n 05
Expiration Date
of card
EJ clrical Load Addlll nand r u
- . NO LOAD CHANGES
o aseboard 'tQN
a Furnace ~
CJ Heat Pump Ton LAR
o Fan.Wall t<:oN
Ll!!
Q Overhead Service
o Temp Service
o Unde:rground Service
Voltage
Phase 0 1 IJ 3
Sel'Vlce Size:_
Feeder Size:
SAME DAY INSPECTiON. CALL BEFORE 7:00 AM 360-417-4735
/ ROUGH-IN '\ THERMOSTAT '\ SERVICE
//~;J.<? --'5 4-0
., D~l~ '\I'E'ravcd Ry D:lte AJ'lprovedlo!)I ll.ale Ar..tt\"~P.)I
,,- FINAl, mrrn FEEDER
~I_- - ~~
," Dille )')t\lC Apprg~\;d Dy O;ate Approved By;/
Inspection Area, Builwng or Equipment Inspected Action Taken Electdcal
Date Inspector
~ //, ~ /. .-u /J/,~H/lC - ,
-
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--_._.~
...._~ -~
/tfX/ II/?;:: }ns'
/ ,
ld Wd6~:Gl 500G 5G '~oN
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'ON Xl:jcJ
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