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BUILDING DIVISION
CITY OF PORT ANGELES
* *
Correction Notice
Job Located at -1..111 ~lLf)oR-A e.
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
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These corrections must be made and are not to be
covered until reinspection is made. When corrections
have been made, please call #17- 981<
for inspection. /J //
Date 1>-~71c~ ~--/~
/ / (nspector for Building Division
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CITY OF PORT ANGELES.
FIRE DEPARTMENT PERMIT
321 East 5th Street, Port Angeles, WA 98362
Application Number
Application pin number
Revision number . . . .
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000646 Date
662622
1
1411 AURORA CT
06-30-01-7-5-0080-0000-
RES NEW SFR
4/05/06
OLYMPIC LAND DEVELOPMENT INC.
259403 HWY 101
SEQUIM WA 98382
(360) 457-7222
Other struct info
WANT ACTION CONSTRUCTION
P. O. BOX 1425
SEQUIM
(360) 681-3992
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC.
~
~
, \
~
~
RS9 RESDNTL SINGLE FAMILY
177900
Owner
Contractor
WA 98382
23.00
1. 00
9024.00
2104.00
1.00
Permit FIRE SPRINKLER RESID
Additional desc
Permit pin number 73981
Permit Fee .00 Plan Check Fee .00
Issue Date 4/05/06 Valuation 0
Expiration Date 10/02/06
Special Notes and Comments ..
All homes in new subdivisions that are outs~de of the F~re
Department four-minute .response area shall be e~ipped with
residential fire sprinkler systems that comply w~th the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
08/10/2005 09:54 AM SROBERDS -- The proposal is a new
s.f. res w/attached garage for total lot coverage of 23%.
Improvements have been bonded and MUST BE PLACED P~IOR TO
OCCUPANCY of residential unit. No other land use ~ssues
are noted.
Electrical load calculations and elctrical permits are
required.
Electrical u/g connection fee of $222.00 required
07/26/2005 10:22 AM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
-------------------------
-------------------------
--------------------------
Other Fees
RES UNDERGRND SERVICE FEE
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
222.00
745.00
4.50
1025.00
~
~
Fee summary
Charged
Paid
Credited
Due
This pennit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
180 days from the last inspection. I hereby certify that I have read and examine:! this application and know the same to be
true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compied
with whether specified herein or not. The granting of this pennit does not presume to give authority to violate or cancel
the provisions of any state or local law regulating the work specified in the permit.
~c
q
b
Signature of Owner (if Owner is builder)
Date
I
-~
FIRE PERMIT INSPECTION RECORD
Call 360-417-4655 for fire 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
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough-in inspection
..
Alarm final
LP-GAS Completed by Contractor:
Underground piping inspection/pressure test Test #1
Above ground piping inspection/pressure test Piping pressure test pSI
Tank (container) inspection Time initiated
Test #2
Appliance inspection Piping pressure test psi
Time initiated
LP-gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final
Inspection Type
I Date Passed I
Comments
GENERAL COMMENTS:
2/15/00
CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East 5th Street, Port Angeles, W A 98362
Application Number . .
Application pin number
Revision number .
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
05-00000646
662622
1
Page
Date
2
4/05/06
.00
.00
1996.50
1996.50
.00
.00
1996.50
1996.50
'.00
.00
.00
.00
.00
.00
.00
.00
This penn it becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
180 days from the last inspection. I hereby certify that I have read and examimrl this application and know the same to be
true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the provisions of any state or local law regulating the work specified in the permit.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if Owner is builder)
Date
-<
FIRE PERMIT INSPECTION RECORD
Call 360-417-4655 for fire 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
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough-in inspection
Alarm final
LP-GAS Completed by Contractor:
Underground piping inspection/pressure test Test #1
Above ground piping inspection/pressure test Piping pressure test . pSI
Tank (container) inspection Time initiated
Test #2
Appliance inspection Piping pressure test psi
Time initiated
LP-gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final
Inspection Type
I Date Passed I
Comments
GENERAL COMMENTS:
2/15/00
PORT ANGELES FIRE DEPARTMENT
102 East Fifth Street, Port Angeles, Washington 98362
(360) 417-4650 FAX (360) 417-4659
Fire Sprinkler System Plan Review
Project Name: Private Residence Address: 1411 Aurora Court
Installer: Innovative Fire Sprinklers Installer Telephone: 452-7583
Type of System: Open 130 13RO 13DIZI
Date: 4.3.2006 P AFD Permit #: 06-18
We have checked this plan and find that it conforms to the requirements of the code.
Additional Comments:
All systems, including underground mains, shall be installed by a state licensed and certified
company. Systems shall be installed per the applicable NFP A Standard.
All electrical components shall be compatible with the fire alarm system.
All underground piping must be inspected and hydrostatically tested by the Port Angeles Fire
Department PRIOR to being covered. A witnessed flush of the underground piping is required.
A design sprinkler flow test and alarm test are required for all13D systems.
Before final acceptance of the system, an inspection will be conducted to ensure that the
installation complies with the applicable NFP A Standard. This 13D system will require a
measured flow test.
Contractor
Reviewed by: ^fC2Q~
Date: ~.~. 0,",
o
~
o
Building Department
Fire Department
BUILDING PERMIT - APPUCA TION
FOR OFFICIAL USE ONLY:
Date Rec.: ,G-:';"'2 8 ~o'-
Permit #: tJ ~-~4G,
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Date APProv~~
Date Issued:~
Applicant or Agent: ~ ~ '^-C- <2. V"'.. + 16 -e.. ++:J ~ v Phone: Lf S 2. -, S 83
Owner: Wa...\A.+ A-c... +:'(J~ Cc ~ s tv-. Phone:
Address: Pial lS Ox I 4 2..s City: 5 ~ ~ ~.) VV\.. Zip: 9 9,,38 <-
Architect/Engineer: Phone:
Contractor IIVA(dV #TE L) F /1<E. State License #:JAlA/tJv/9-[JL/l,fflf.. .3/eo/07Phone: Y 02 -7.s=8::s
J I / ~
Address: 81 Jl/..e....L.J /Tc....."J..e. ~ L.. ~ City: p~ vi 4-'-'-J~ Ie.J' Zip: '7 g.:J 62-
PROJECT ADDRESS: I Y II ,4 V\.. rC v-a.... C C \..A- .,. + ZONING:
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA MC #
TYPE OF WORK:
~esidential D New Constr. D Re-roof
D Multi-family D Addition D Move
D Commercial D Remodel D Demolition
D Repair D Sign
BRIEF DESCRIPTION OF THE PROJECT:
City:
Exp. Date:
D Stove
D Garage
D Deck
~ Other
-Lr~
SIZEN ALUATION:
SF.@$ /SF.=$
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION. $ 2 "206, Of/'
.sr-l"-}~ Ie I~F S ,?S -I-~ ~
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
ESAlWetland(s): DYes D No SEPA Checklist required? DYes D No Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
PLANNING USE ONLY:
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with 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 pernnt application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno 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 R105.3.2
of the International Building/Residential Code, 2003). No application can 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 am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are requifi ,not the City's, and that I must obtain such permits prior to work.
T:\RVESS\BLDG-forms-brochures\2004-Buildingpermit.wpd Applicant: ' Date: _~2/0 ~
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
Owner
05-00000646 Date 11/30/05
662622
1411 AURORA CT
T6-30-00-1-0-7800-0008-
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
177900
Contractor
OLYMPIC LAND DEVELOPMENT INC.
259403 HWY 101
SEQUIM WA 98382
(360) 457-7222
Other struct info
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
WANT ACTION CONSTRUCTION
P. O. BOX 1425
SEQUIM
(360) 681-3992
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC.
WA 98382
23.00
1. 00
9024.00
2104.00
1. 00
PUBLIC WORKS RES WATER SERV
3/4" DROP IN METER
56143
195.00 Plan Check Fee
11/30/05 Valuation
5/29/06
.00
177900
Qty Unit Charge Per
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BASE FEE
Extension
195.00
RIGHT OF WAY
56135
50.00
11/30/05
5/29/06
Plan Check Fee
Valuation
.00
177900
Qty Unit Charge Per
1.00 50.0000 ECH RIGHT OF WAY PERMIT
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
Extension
50.00
SANITARY SEWER HOOK UP
56127
110.00
11/30/05
5/29/06
Plan Check Fee
Valuation
.00
177900
Qty Unit Charge Per
1.00 110.0000 EA SAN SEWER HOOKUP
Extension
110.00
Special Notes and Comments
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
08/10/2005 09:54 AM SROBERDS -- The proposal is a new
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
construe '00. .
T:\Policies\1 102.15R [1/051
(1-~O-05
Date
Signature of Owner (if owner is builder)
Date
I
PERMIT INSPECTION RECORD
".
CALL 417-4807 FOR UTILITY 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
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANIT AR Y
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED I
YES NO
CONSTRUCTION R. W. I PW I CONSTRUCTION - R.W.
ENGINEERING 417-4807 . PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [1/05]
o~ 'Ofl~v,.G
...!O.~~....
Urca~
L~
~
~,,~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000646
Application pin number 662622
Page 2
Date 11/30/05
Special Notes and Comments
s.f. res w/attached garage for total lot coverage of 23%.
Improvements have been bonded and MUST BE PLACED PRIOR TO
OCCUPANCY of residential unit. No other land use issues
are noted.
Electrical load calculations and elctrical permits are
required.
Electrical u/g connection fee of $222.00 required
07/26/2005 10:22 AM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
745.00
4.50
1025.00
Fee summary Charged Paid Credited
----------------- ---------- ---------- ----------
Permit Fee Total 355.00 355.00 .00
Plan Check Total .00 .00 .00
Other Fee Total 1774.50 1774.50 .00
Grand Total 2129.50 2129.50 .00
Due
.00
.00
.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 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
constr . n.
I
/
I/-ffl -~
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102.15R [1/05]
PERMIT INSPECTION RECORD
,..
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
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:\Policies\1102.15R [1/05]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
property Use
Property Zoning . . .
Application valuation
05-00000646 Date 11/30/05
662622
1411 AURORA CT
T6-30-00-1-0-7800-0008-
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
177900
Owner
Contractor
OLYMPIC LAND DEVELOPMENT INC.
259403 HWY 101
SEQUIM WA 98382
(360) 457-7222
Other struct info
WANT ACTION CONSTRUCTION
P. O. BOX 1425
SEQUIM
(360) 681-3992
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC.
WA 98382
23.00
1. 00
9024.00
2104.00
1.00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
57455
1454.05
11/30/05
5/29/06
Plan Check Fee
Valuation
581.62
177900
Qty Unit Charge Per
Extension
1017.25
436.80
BASE FEE
78.00 5.6000 THOU BL-100,001-500K (5.60 PER K)
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
57489
36.40
11/30/05
5/29/06
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
1.00 36.4000 EC EL-LOW VOLTAGE
Extension
36.40
Permit MECHANICAL PERMIT
Additional desc
Permit pin number 57463
Permit Fee 83.45 Plan Check Fee
Issue Date 11/30/05 Valuation
Expiration Date 5/29/06
Qty Unit Charge Per
BASE FEE
1. 00 14.7000 ECH ME- INSTALL 100- FAU
3.00 7.2500 ECH ME-VENT FAN
.00
o
Extension
47.00
14.70
21. 75
F/nC/J eJ
06-01
-07
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
PLUMBING PERMIT
57471
146.00
Plan Check Fee . .
.00
~
\Y
C);>
- ~
\' _.
Db
& .~
~
\)
-\
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
constru 90n.
/
/ - 50 -oS-
Date
Signature of Owner (if owner is builder)
T:\Policies\1102_15 building pennit inspection record05.wpd [I/4/2005]
Date
"
BUILDING PERMIT INSPECTION RECORD
":-- ~..
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 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 DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS 1 ROOF 1 CEILING ,
DRYWALL(INTE~ORBRACEDPANELONL~
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL. INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECT~CAL - LIGHT DEPT. 417-4735 ELECT~CAL
LIGHT DEPT
CONSTRUCTION R. W.I PWI CONSTRUCTION - R.W.
ENGINEE~G 417-4807 PW 1 ENGINEE~G
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102_15 building permit inspection record05.wpd [114/2005]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . .
Application pin number
Issue Date
Expiration Date . .
Page 2
Date 11/30/05
Valuation
o
Qty Unit Charge Per
BASE FEE
10.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE
1.00 15.0000 ECH PL- EA. BLDG SEWER
1.00 7.0000 ECH PL- EA.WATER HEATER
Extension
47.00
70.00
7.00
15.00
7.00
Special Notes and Comments
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
08/10/2005 09:54 AM SROBERDS-- The proposal is a new
s.f. res w/attached garage for total lot coverage of 23%.
Improvements have been bonded and MUST BE PLACED PRIOR TO
OCCUPANCY of residential unit. No other land use issues
are noted.
Electrical load calculations and elctrical permits are
required.
Electrical u/g connection fee of $222.00 required
07/26/2005 10:22 AM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
745.00
4.50
1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 1719.90 1719.90 .00 .00
Plan Check Total 581. 62 581. 62 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 4076.02 4076.02 .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 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
constryction.
'/
/,
/1- eo ~05-
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
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 UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION: ::~. .:.~~ - Y).J/OC J~L
FOOTINGS l-Z---~ -c.~ :n--L
WALLS (2/,C"/()~ =.Fu- r
FOUNDA nON DRAINAGE / DOWN SPOUTS 112:/
PIERS /
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN 1?/3/0(; Jct.- t1 ()C\ I :ILL
WATER LINE (METER TO BLDG) "'VJv 1 V1.. -:rw o~ /6/ / 0-' ~
FINAL/ '-Ir/ l-6DATE
GAS LINE 'f-7 ACCEPTED BY:
BACK FLOW/WATER I
AIR SEAL
WALLS "3();; !o~ N
CEILING I
FRAMING oo-:-S~ - J(>>/~ Jlt-
JOISTS / GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS / ROOF / CEILING 1/ "H I tJ(, 7W
DRYWALL (INTERIOR BRACED PANEL ONLY) 4 ,.,/~[, ~~
T-BAR ,
INSULATION
SLAB I I ..
WALL I FLOOR / CEILING I~ I
MECHANICAL
HEAT PUMP/FURNACE/DUCTS
GAS LINE DATE #
WOOD STOVE / PELLET / CHIMNEY FINAL ~ ~r ACCEPTED BY:
.
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL.INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
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 C binI/i'll ~W- BUILDING
T:\Policies\1102 15 buildin rmitins ction record05. d 1/412005 ,
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BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: Le~ fLocuJs Phone: 3&01 <?oC;-- olfLfL/
Owner: D IVI-l p/c L.cu--uA Oeve.lC:>y::Jr'VteYl-f- Phone: q-s 7- 7 ;2..2<-'
Address: {'.o- &:,X' S&J5 City: ec...,lsho~ wA Zip: 9i5 :=s2.1L
Architect/Enpneer: L--JA A. CL Phone: 3&0/ roc; - D"!:/ 'I:S
(A.Jc-../l:r /~..f"<.111 /' IV 1 -/ I
Contractor LOYlsfrtAcflCY1 State License #: '112-f3..~ Exp: /t'.27 (O(p Phone:&if/- ~1~'2....
Address: P-O. ~y /12:5 City: S-ecru..,/YJ-f L.NA.. Zip: q!"3 8' "2..
PROJECT ADDRESS: I 'f II At<....rv,...~ L:f- ZONING: ~ S c=,
LEGAL DESCRIPTION: Lot: {/; 8' Block: Subdivision: 0/..../11-1(/1'- f{e.J'7~I-J
CLALLAM COUNTY PARCEL NUMBER:
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA MC #
TYPE OF WORK: SIZEN ALUATION:
lilt Residential ~NewConstr. 0 Re-roof 0 Stove I S2.(P SF.@$ Iff) /SF. =$ 1/52... (Pm .qo
o Multi-family 0 Addition 0 Move 0 Garage <;; 0 ~ SF. @ $ S c) /SF. = $-2~. .3C!O ' ~.)
o Commercial 0 Remodel _ 0 Demolition 0 Deck SF. @ $ /SF. = $
o Repair 0 Sign 0 Other , TOTAL V.(\.qJATION ,$-171: q "0-: CV
BRIEF DES~RlPTION OF THE PROJECT: Sir77/~ Ta-~ 1'1 If' ~S r cfl6-1 Cop I r{ _
Je..v4 OpVh~rrt- (') f- ,;:'2 hC)l'Y1.(' S
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: L Lot Size: 10'2. L{- Existing Sq. Ft. 0
Total lot coverage 230/0
City:
Exp. Date:
Occupant Load: Construction Type:
& Proposed Sq. Ft. ,,2 {o'/ = TOTAL Sq. Ft. 2 ( 0 '-f
%
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BUILDING 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 must 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 pennit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno 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 Rl 05.3.2
of the International BuildinglResidential Code, 2003). No application can 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 am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permits prior to work.
T:\RVESS\BLDG-fonns-brochures\2003-BuildingpermiLwpd Applicant: ~ ~ Date: 7/ZDID5
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Scale:
120'
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5e 11 i ~l V\: e. ( C;OLA. r t-
1" = 1 20'
240' 360'
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\Vashington State Energy Code
Plan Review Checklist
Ui1J'
~~:
HING
Appl1cant please Check. v,nite in N/A. or fill in value on boxes or lines.
Project Address:
ILift
Al.AforA
Lf
Compliance Approach:(check one) 0 Systems analysis
o Component perfonnance ~ Prescriptive path
REA TlNG SYSTEM
o Zone Heating
or
rY'Electric Furnace ~eat Pump
FOUNDATION PHASE
o Slab R-_ Exterior down to frostlineislab bonom; Interior 24" horizontal or vertical; or, If radiant under entire slab
o Below grade exterior wall insulation: R-_ (If interior -see Insulation Phase)
FRAMING PHASE
~ Standard 0 lntennediate 0 Advanced
j( Standard air seal: sole plate/sub floor; rim joist; window & door frames; wires, plumbing, ducts, light fixtures
~Source specific exhaust fans: bath & laundry(50 cfrn) kitchen(100 cfm)
a< Whole house exhaust fan _ cfm intemntlent system has manual & auto controls: Outdoor ail supply reg. for habitable rooms
or
o lntegrated forced -air system, fan _ cfm, outside air duct(\vith motor damper) allowing .35 and .5 ACH
INSULA nON PHASE
o R-R Wall insulation(above grade)
DR-2/- Wall insulation(below grade): Interior wall insulation
o R- 3i2 Floor insulation
o R-~ Ceiling insulation: Incllldulg attic hatch
o R-.3-0- Vaulted Ceiling ulS11lation
o Vapor retarders: Walls, Ceiling: 0 4 mil poly ~Penll rated paint Dkraft faced batts
o Vapor retarders: Floors: 04 mil poly ~kraft faced batts
~ Ground cover: 6 mil Black polyethylene, 12" lap at joints & extending to foundation wall
T:\ROGER\BLDG_FORMS-BROCHURES\Et\'ERGYPLANREVIEW
Over: Fill in back side also.
Prescriptive Approach - Simple Form
For the Washington State Energy Code (2003 Edition)
Climate Zone 1
Site Information
#-g-
Address: / t.{ I (
City:_forf
State: {.J A
Contact: U tLh f{ dc{ &.s
Phone: (f) ~, - 317'2_
Phone 2: 80 q - oLft/ 4-
(O~, - 3~?.-
Building Department Use Only
Lot:
Permit #:
A~rA et-
A Vile {(}::~
Zip: ~83~'L.
Notes:
Fax:
Un Imlte G azmg Or hon Only
Glazing Glazing U-Factor Door9 Wall Wall Wall SIab4
Option Area10 U- Ceiling2 Vaulted Above Int4 Ext4 Floors On
% of Floor V ertj cal Overhead J I factor Ceiling3 Grade Below Below Grade
Grade Grade
III Unlimited
Group R-3 DAD 0.58 0.20 R-38 R-30 R-21 R-21 R-I0 R-30 R-IO
Occupancy
Only
Table 6-1
PRESCRIPTIVE REQUIREMENTS 0,1 FOR GROUP R OCCUP ANCY
CLIMATE ZONE 1
r . d I . I )
See the code text for footnote references
This project complies with the following:
./ The project is a single family residence or duplex.
./ The project is wood frame OR all of the insulation is interior or exterior of the framing.
./' All building components meet the requirements listed in Table 6-1, Option III.
./ The project will meet all other provisions of the WSEC and VIAQ.
The project will take advantage of the following exceptions to the prescriptive option:
o 602.6 Exception 1. One door, that is 24 ft.2 or less, that does not meet the standards is allowed.
Location of the door taking this exception
o 602.6 Exception 2. Doors with a U-factor of OAO allowed without calculations, Option III only.
Location of the door(s) taking this exception
Copyright 2002, WSUCEEP02-056
Copied by permission from the Washington State University Extension Energy Program
Prescriptive - Simple Form - Climate Zone 1
7/26/2004
,~
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
121 EAST 5TH STREET. PORT ANGELES. WA 98362
"\
l. !
Appl~cation Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER.
Applicat~on type description
Subdiv~sion Name
Property Use
Property zoning
Application valuation
05-00000646 Date
662622
1411 AURORA CT
06-30-01-7-5-0080-0000-
RES NEW SFR
2/07/06
RS9 RESDNTL SINGLE FAMILY
177900
Owner
Contr-actor
OLYMPIC LAND DEVELOPMENT INC
259403 HWY 101
SEQUIM WA 98382
(360) 457-7222
Other struct info
WANT ACTION CONSTRUCTION
P. O. BOX 1425
SEQUIM
(360) 681-3992
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC
WA 98382
23 00
1 00
9024 00
2104 00
1 00
Q
Permit
Add~t~onal desc
Perm~t p~n number
Sub Contractor
Permi t Fee
Issue Date
Exp~rat~on Date
ELECTRICAL NEW RESIDENTIAL
JARMUTH/ 2032 SQ FT SFR
70524
JARMUTH ELECTRIC
119.80 Plan Check Fee
2/07/06 Valuation
8/06/06
00
o
'-
~
~
Qty
1 00
2.00
Unit Charge Per
73 0000 ECH
23 4000 5C
EL-R-SQFT FIRST 1300
EL-R-SQFT ADDITIONAL 500
Extension
73 00
46 80
t
~
t
Special Notes and Comments
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equ~pped with
residential fire spr~nkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
08/10/2005 09'54 AM SROBERDS -- The proposal is a new
s.f. res w/attached garage for total lot coverage of 23%.
Improvements have been bonded and MUST BE PLACED PRIOR TO
OCCUPANCY of residential unit No other land use issues
are noted
Electrical load calculations and elctrical permits are
requ~red
Electrical u/g connection fee of $222.00 required
07/26/2005 10 22 AM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Publ~c Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of ~ay. An inspection by Public Works
Eng~neer~ng is required prior to prouring concrete
()
'\
,
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
745 00
4.50
1025 00
COMMENTS! ACTION NEEDED
'~
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:m EAST 5TH STREET. PORT ANGELES. WA 98362
..
Application Number
Appl~cation pin number
05-00000646
662622
Page 2
Date 2/07/06
~ ----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Perm~t Fee Total 119 80 119 80 00 00
Plan Check Total 00 00 .00 00
Other Fee Total 1774 50 1774 50 00 00
Grand Total 1894 30 1894.30 .00 00
COMMENTS! ACTION NEEDED
If
ELECfRICAL PERMIT INSPECTION RECORD
~
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER.
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
UITCH
IH11IBI-I.lN I CUVbK 3-/3-c6 Jr:.tQ
''''W'\./II'''' ~-IPJ- cG 7T..D
1...~-"c. .Jr.!) I
J
GENERAL COMMENTS:
PW-II02 1'104/96]
.'
~
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~
'tiii.<?
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
OS---&4-y
Application Number
Application pin number
property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
property Zoning . . .
Application valuation
05-00000646 Date
662622
1411 AURORA CT
T6-30-0Q-I-Q-7BOQ-0008-
RES NEW SFR
ll/30/05
14 J( {kuuw0 tb
RS7 RESDNTL SINGLE FAMILY
177900
OLYMPIC LAND DEVELOPMENT INC.
259403 HWY 101
SEQUIM WA 98382
(360) 457-7222
Other struct info
WANT ACTION CONSTRUCTION
P. O. BOX 1425
SEQUIM
(360) 681-3992
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC.
O~~DM'
Owner
Contractor
WA 98382
23.00
1. 00
9024.00
2104.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Pennit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
3/4" DROP IN METER
56143
195.00 Plan Check Fee
11/30/05 valuation
5/29/06
.00
177900
f!r~,/D1
~/
_________~:~___~~~:_:~:~~:__::~__~~:~_~~~________________________~;~;i~~
Permit .. . .. RIGHT OF WAY
Additional desc .
Permit pin number
Permi t Fee
ISsue Date
Expiration Date
56135
50.00
11/30/05
5/29/06
Plan Check Fee
Valuation
.00
177900
Qty Unit Charge Per CnSi~
1.00 50.0000 ECH RIGHT OF WAY PERMIT 50.00
------------------------------------------------------------------ --------
Permit . . . .. SANITARY SEWER HOOK UP
Additional desc .
Permit pin number
Permi t Fee
Issue Date
Expiration Date .
56127
110.00
11/30/05
5/29/06
Plan Check Fee
valuation
.00
177900
--------=~~~---~~~~=~~~~~~-~:~-_:~_:~~~~-~~~~~----------------~
Special Notes and Comments
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
08/10/2005 09:54 AM SROBERDS -- The proposal is a new
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:\Policies\1102.15R [1/05]
..
..:..
ci:~ORT~
l~':~
rSi
, =-~
""""""
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000646
Application pin number 662622
Page 2
Date 11/30/05
Special Notes and Comments
s.f. res w/accached garage for total lot coverage of 23%.
Improvements have been bonded and MUST BE PLACED PRIOR TO
OCCUPANCY of residential unit. No other land use issues
are noted.
Electrical load calculations and elctrical permits are
required.
Electrical u/g connection fee of $222.00 required
07/26/2005 10:22 AM GMCLAIN ---~------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
Fee summary Charged Paid Credited ue
----------------- ---------- ---------- ---------- --------
Permit Fee Total 355.00 355.00 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 2129.50 2129.50 .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 orwork 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:\Policies\1101.15R [l/05J
. . . . .
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . .
REQUEST:
Date b - f - 0, Time Received by RV (phone. person)
Location of Work to be inspected / L( / / A u v--c v- G... c.. +-
Name of person requesting inspection ..5i..<..&<:::U~ ~
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. OS - (.. tit;
Sewer Foundation Framing Chimney Plumbing ~ Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date &, -1- 0""
Remarks:
Time
By
Rv
.s:ew <2-.,.- 2... /+ 0 b
J:>,.''''-<ii!-wo.-v (') k
lJo<-v,tspoufs -fc, C),.c.,'u4'Jej),'fch Dk
RESTORATION REQUIRED. . . . .. YES
NO X
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Re'paired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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APPLICATION FOR WATER
City Water Division
':"
Port Angeles, Washington
,20_
I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises: WA'-:>l AcrlD,," e..()I\'i>TWC.tlO--..)
I ~ "151 --:,ct92
Name of ApplicantJ- 1=14 H OA 0 S
Address: J1JLA-u eOeA
.../ g:: O(iTl'\el~
Renewal 0 New Service l!IBlk. Lot Add IIC~(}'I4TS
Size of serviceh:Y~ Meter zer ~S-6'~08~
Service Left On 0 Service Left Oft 13"'"""" Signed . 8 ?1J / Pz
.:/I /();25.~ 1;''5 M
Installed by
RemarkSPe~)fl;J -ti 05-(.,'10
Pit,eca'li
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .'
REQUEST: z/,Io
Date y
Time
Received by
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
~~Inspection (circle appropriate one):
ewer Foundation Framing Chimney Plumbing
Final
Phone No.
Permit No.
Sewer Excav. Other
INSPECTION NOTES:; /
Inspected: Date "Z/ // IJ ~ Time rv~ By Q V
Remarks: c."""n"c\".'~. "'-'...& lAA,.o-&e.. CJ..~ -<2.)(ls'''''':j b'" /a 0;2,,-&..1 "t+ :P,-ope,l"
u /I p " ' I I I II t' I
, V <'. e-e,. 0.. <1.0 ec:.T. IA. 10 ...'" '-OM So....-tlA.w c::
Co.t\~r: 5' I of '111 PV( +0 ~/() C>~ -"'OlAi"'- s:dQ. '~'f Hcu-s.<e..- '
(phone. person)
sc??~~
ttJS-//~V
I,'v.~. ,
,
N~
RESTORATION REQUiRED...... YES
I"~:' <!GO fl.,{o fll-
,1.'1' - t.{so
<JI'je. '1. '
~cJ
NO '\(.
- y""vc.
/.
;{Il <}
\L\
'I>
"'",,11-\
r/L
Iq'O'
,UA'\,. G.. c..,-
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
02/02/2005 08:34
... I
.:/
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L(1
350-581-7272
--
JARMUTH ELECTRIC
PAGE 03
ri'leetlicl. COIIerl.tor
o Alula" P.nalt 0 Alarm
o OwIler .
C CllI'atval 0 Commorclal ~'ld..lIal 0 lIMId._1 MoI.t. 0 SIps 0 TWm_t 0...-...
ELECTRICAL WORK-PERMIT APPLICATION
r-
Job wIrd by
~o.trttll Contnotor 0 Ownor
lueu.llllioa detcriptlon ,
~ 54/"1 'F/!:/d-H&-t'
/5'H
S'O,"
~C> J 2..
r/J F..
CI Cosh CI Chc.k#
] hereby certify that I am. rhe owner of the Ibove named property or a licensed. --../
ol..lrita' eon_... (or the finn', authorized agmt) and am making <he elec1rieol l/ICreditCard Visa Muatereard Discover
iDalBlllllion or aI_don in eornplianee with <he eleelrica1law, Chapter 19.28 RCW. Card #, ~ b..!"-=. _-_ _ _ _-_ _ __
.
...:{
SIIDa..re of oW'D.e~. II ectrieal cODtrador Or eleetrlul admlallt,...r
Expiratioo DIIll
of card
CElUNG
[nluladon Only.
llIERMOSTAT
t>
x
Dale AJItlrovedBy
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. DIMe AfCmlved By
~ he(. CD"'~
~I' ApPfOII Y
~ ........ By
. -Cover ~
.... ~)'
.
,
mar
PJUWI!:Il
.'
Oltt Appn:oqd By
- .
m.clrl..llD8d AddltlDnl Ind Dr lubtractlonl
LJ NO LOAD CHA"'GES
OjlaMboard KW
"FulNlOll ~ KW
liJ1l"e' Pump ~ Ton _ LAR
o FIn-Wail KW
C Ova"'ood SoNI..
lJ Tomp Sarvtoo
Iil"Gnda<ground SorvlCl
ServIce __1011
V'*QO ~/~~
PIIuo lJ 3
SoMoo SIze: ~#J
F_rlllza:~.:a
Inlpection
Date
Area, BuildiJl& or Equipmentlnspeeted
Action Taken
Electrical
In.peetol'
1../7 Db
(PflNJ...{cc..7/00
R;;(;;
...It "0
'fJ' 2'22-
AfJO-
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