HomeMy WebLinkAbout240 Motor Ave - BuildingPREPARED 1/08/09 9 45 47 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 1/08/09
ADDRESS 240 MOTOR AVE SUBDIV
TENANT NBR CHRISTINE JACOBSON
CONTRACTOR ALL WEATHER HTG COOLING INC PHONE (360) 452 9813
OWNER CHRISTINE JACOBSON PHONE (360) 928 1156
PARCEL 06 30 09 5 2 1536 0000
APPL NUMBER 08 00000359 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 1/08/09
MECHANICAL FINAL TIME 12 00
January 2 2009 9 46 31 AM 1pangrle
CHRISTINE 928 1156 OR 461 6484
MECHANICAL FINAL ELECTRIC FURNACE
PLEASE INSPECT BETWEEN 12 00 NOON 1 00 PM SO THE TENANT
WILL BE HOME FOR LUNCH AND CAN CONTROL HER INDOOR DOG
COMMENTS AND NOTES
Application Number 08 00000366
Application pin number 611772
Property Address 240 MOTOR AVE
ASSESSOR PARCEL NUMBER 06 30 09 5 2 1536 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Owner Contractor
Jacobson Christine
240 MOTOR AVE
PORT ANGELES
WA 983622540
Qty Unit Charge Per
1 00 46 0000 ECH EL R OR RM 1 4 ALT CIRCUITS
Fee summary Charged Paid Credited Due
Date 3/24/08
ALL WEATHER HEATING COOLING
302 KEMP RD
PORT ANGELES WA 98362
(360) 9813
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 123471
Permit Fee 46 00 Plan Check Fee 00
Issue Date 3/24/08 Valuation 0
Expiration Date 9/20/08
Permit Fee Total 46 00 46 00 00 00
Plan Check Total 00 00 00 00
Grand Total 46 00 46 00 00 00
Extension
46 00
N
SPECTION
TYPE DATE
DITCH
SERVICE
ROUGH Il\
FINAL
COMMENTS:
4//6/og vetb
ELECTRICAL
RESULTS INSPECTOR
Application Number 08 00000362
Application pin number 366164
Property Address 240 MOTOR AVE
ASSESSOR PARCEL NUMBER 06 30 09 5 2 1536 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Owner Contractor
Jacobson Christine
240 MOTOR AVE
PORT ANGELES
(360) 928 1156
WA 983622540
Date 3/24/08
ALL WEATHER HEATING COOLING
302 KEMP RD
PORT ANGELES WA 98362
(360) 9813
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 123422
Permit Fee 35 00 Plan Check Fee 00
Issue Date 3/24/08 Valuation 0
Expiration Date 9/20/08
Qty Unit Charge Per Extension
1 00 35 0000 EC EL LOW VOLTAGE 35 00
Fee summary Charged Paid Credited Due
Permit Fee Total 35 00 35 00 00 00
Plan Check Total 00 00 00 00
Grand Total 35 00 35 00 00 00
r
SPECTION
TYPE DATE
DITCH
SERVICE
ROUGH IIN
FIJ
AL
COMMENTS:
ELECTRICAL
RESULTS IN SPECTOR
°Thla
-ThP
OP PORT, 0%.
VA
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
INSTALL ELECTRIC FURNACE
Owner
CHRISTINE JACOBSON
484 DODGER LANE
PORT ANGELES
(360) 928 1156
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
WA 98363
Qty Unit Charge Per
1 00
Fee summary
14 8000 ECH
Permit Fee Total 64 80
Plan Check Total 00
Grand Total 64 80
34A /'dM, r f4
/bat Print Name
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
MECHANICAL PERMIT
123398
64 80
3/20/08
9/16/08
Charged
T Forms /Building Division/Building Permit (l0 /01 /07).wpd
08 00000359
644859
240 MOTOR' AVE
06 30 09 5 2 1536 0000
CHRISTINE JACOBSON
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
2304
Contractor
BASE FEE
ME INSTALL 100- FAU
Signatur
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452 9813
64 80
00
64 80
Plan Check Fee
Valuation
Paid Credited
00
00
00
Date 3/20/08
Due
00
2304
Extension
50 00
14 80
00
00
00
4
0
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
ontrazt or uthorized Agent Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES G�
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE 1
INSPECTED AND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION UJ
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
FOUNDATION•
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
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
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
ELECTRICAL LIGHT DEPT 417 -4735
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
I PLANNING DEPT 417 -4750
BUILDING 417 -4815
T Forms /Building Division /Building Permit (10 /01 /07).wpd
YES NO
I I I
FINAL
PLANNING DEPT SEPARATE PERMIT N's I SEPA.
PARKING /LIGHTING ESA.
LANDSCAPING SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
1'W ENGINEERING
FIRE DEPT
PLANNING DEPT
BUILDING
DATE ACCEPTED BY.
FINAL I U �l 1 DATE :ILL, ACCEPTED BY.
DATE
ACCEPTED
YES I NO
Mar 20 08 10•52a
BUILDING PERMIT
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
Applicant or Agent 1,9 Q'v IVAtin5 e, ((i(" i i l'}
Owner Coins -r..l (t (0, e,rh
Owner's Address 9,ti r\o v .(A .e
Contractor /Engineer NI .,liPC Mtn f (c;r7tll1C
Contractor /Engineer's Address �f 7 Ez 1c -5A
License# _i_Lk'F_1_ nl
PROJECT ADDRESS 71 KAC #O
Parcel Number Lot
Project Type Brief Description.
Check all that apply
o New Construction
o Addition
o Remodel
o Repair
o Re -roof
o Demolition
o Sign
X ieat System
o Other
Floor Areas
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shea
Other
T:Forms,Building Division /Bldg Pernil Appl. -2006 Ccde.doc
o wall- mounted o projecting o freestanding o awning o other
Total sign area sq. ft, Maximum allowed sign area sq ft.
Heat pump o wood- burning stove o gas fireplace o pellet stove Erther
Existing (sq. ft.) Ph ased (g. ft.)
Total footprint of structures sq ft Lot size
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
p1
APPLICATION Print in ink
esidential Commercial a Multi- family
For City Use Only:
Date Received ?-b. 0 E
Permit# 09, 5q
Date Approved
Phone
Phone
Phone u c c E L 13
Expires OT-1 -6F)
Zoning
per sq ft.
of bedrooms
of full baths
of half baths
o Industrial
TOTAL VALUATION L,4
sq ft. Lot coverage
I have read and completed this application and know it to be true and correct. t am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required anO•to .btain permit- .nor to working on
projects Cn 601 ,1 -t -en ;I, 1 g
Date `."'fro Os Print
PREPARED 12/29/06 9 51 21 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 12/29/06
ADDRESS 240 MOTOR AVE SUBDIV
TENANT NBR CHRISTINE JACOBSON
CONTRACTOR INNOVATED FIRE SPRINKLERS PHONE (360) 452 7583
OWNER ROGERS EDITH H PHONE
PARCEL 06 30 09 5 2 1536 0000
APPL NUMBER 06 00001282 RES REMODEL
PERMIT BPR 01 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 12/29/06
JLL
BUILDING FINAL
12/28/2006 09 59 AM PBARTHOL
CHRISTINE JACOBSON
461 6484 CALL FIRST LIVES IN JOYCE
HOUSE LOCKED
COMMENTS AND NOTES
PREPARED 12/07/06 8 58 35 INSPECTION TICKET PAGE 8
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 12/07/06
ADDRESS 240 MOTOR AVE SUBDIV
TENANT NBA CHRISTINE JACOBSON
CONTRACTOR INNOVATED FIRE SPRINKLERS PHONE (360) 452 7583
OWNER ROGERS EDITH H PHONE
PARCEL 06 30 09 5 2 1536 0000
APPL NUMBER 06 00001282 RES REMODEL
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 12/07'06
PLUMBING ROUGH IN TIME 13 00
VINCE 461 9635
12/06/2006 02 01 PM PERMITS
COMMENTS AND NOTES
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
ROGERS EDITH H
240 MOTOR AVE
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
10 00 3 0500 HND
Qty Unit Charge Per
1 00 7 2500 ECH
Qty Unit Charge Per
2 00
1 00
Other Fees
7 0000 ECH
7 0000 ECH
Fee summary Charged
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
WA 983622540
91868
80 50
12/06/06
6/04/07
Per
Permit
Additional desc
Permit pin number 91702
Permit Fee 57 25
Issue Date 12/06/06
Expiration Date 6/04/07
Permit Fee Total 208 75
Plan Check Total 00
Other Fee Total 4 50
06 00001282
198156
240 MOTOR AVE
06 30 09 5 2 1536 0000
CHRISTINE JACOBSON
RES REMODEL
RS7 RESDNTL SINGLE FAMILY
1500
BUILDING PERMIT RESIDENTIAL
BASE FEE
BL -501 2K
MECHANICAL PERMIT
BASE FEE
ME VENT FAN
Signature of Contractor or AuthorizedAgent /Dat4
T- \Policies \1102_15 building permit inspection record05 wpd [1/4/2005]
208 75
00
4 50
Contractor
INNOVATED FIRE SPRINKLERS
81 NEW HAVEN LANE
PORT ANGELES
(360) 452 7583
Plan Check Fee
Valuation
(3 05 PER C)
Plan Check Fee
Valuation
oZo tzAkc
Paid Credited Due
00
00
00
Date 12/06/06
WA 98362
00
00
00
00
1500
Extension
50 00
30 50
00
0
Extension
50 00
7 25
Permit PLUMBING PERMIT
Additional desc
Permit pin number 91694
Permit Fee 71 00 Plan Check Fee 00
Issue Date 12/06/06 Valuation 0
Expiration Date 6/04/07
Extension
BASE FEE 50 00
PL- EA FIXTURE ON ONE TRAP 14 00
PL- EA REPAIR/ DRAIN VENT 7 00
STATE SURCHARGE 4 50
0i o
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
con ;truction.
Signature of Owner (if owner is builder)
Date
INSPECTION TYPE
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
I SHOWER PAN
MEDICAL GAS LINE
AIR SEAL
WALLS
CEILING
I FRAMING
I JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
ELECTRICAL LIGHT DEPT
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
I FIRE 417 -4653 I
I PLANNING DEPT 417 -4750 I
I BUILDING 417 -4815 I
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 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.
DATE ACCEPTED
YES NO
FINAL
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING /LIGHTING ESA.
LANDSCAPING I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT
I PLANNING DEPT
BUILDING
COMMENTS
DATE ACCEPTED BY.
FINAL DATE ACCEPTED BY.
1 I I I
l I I
I I I
Ii
P RT,k,
m N
mow
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Page 2
Application Number 06 00001282 Date 12/06/06
Application pin number 198156
Grand Total 213 25 213 25 00 00
Signature of Contractor or Authorized Agent
T• \Policies \1102_15 building permit inspection record05.wpd [1/4/2005]
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.
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.
INSPECTION TYPE
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
SHOWER PAN
MEDICAL GAS LINE
AIR SEAL
WALLS
CEILING
FRAMING
I JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING Sr. HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
BUILDING PERMIT INSPECTION RECORD
T1- 7 X 06 I U w
t7/ G
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
I FIRE 417 -4653
I PLANNING DEPT 417 -4750 I
DATE ACCEPTED
I YES I NO
I t
I I
I BUILDING 417 -4815 I641/d
T• \Policies11102_I5 building permit inspection record05 wpd [1/4/2005J
FINAL
SEPA.
ESA.
SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
417 -4735 ELECTRICAL
LIGHT DEPT
COMMENTS
FINAL DATE ACCEPTED BY,
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
1 PLANNING DEPT
BUILDING
DATE ACCEPTED BY..
12/04/2006 09 07
Date.
To
From
including cover sheet
1
La-07 oh
CARROLL REALTY
809 E FIRST
Port Angeles, WA 98362
Phone
AZ_Oked-
CARROLL REALTY
Total pages Reply requested Yes
360 457 -1111 (Office)
360 457 -1114 (Fax)
paeraliz @olypen corn
ziz2-
(,GrJe,: 5V-44
subject
r
—ffdL'e(4-er -244° Akpe
No
PAGE 01
12/04/2006 09 07 1
106, City /town taxes
107. County taxes
108. Assessments
109
110
111
112,
113
114
1 15.
116.
,.RTMENT OF HOUSING AND URBAN DEVELOPMENT B. TYPE OP
SETTLEMENT STATEMENT 1 LI FHA 2, I.._ FHMA
4. _I VA 5. Li CONV INS.
6. FILE NUMBER: 7 LOAN NUMBER
99209SB 301171173 -0 &0717953269
8. MORTGAGE INS. CASE NO,
C. NOTE, This form is furnished to give you a statement of actual settlement costs, Amounts paid to and by the settlement agent are shown, Items
marked "(p.o.e.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
D NAME ADDRESS
OF BORROWER.
E NAME ADDRESS
C)f 'SEL1,E1(.
I- NAME ADDRESS
OF LENDER.
0. PROPERTY LOCATION
Christine Jacobson
484 Dodger Lane, Port Angeles. WA 98363
Edith Rogers
240 Motor Ave, Port Angeles, WA 98362
Washington Mutual Home Finance Center
3060 139th Ave„ SE Ste 201, Bellevue, WA 98005
240 Motor Ave, Port Angeles, WA 98362
H. SETTLEMENT AGENT Clallam Title Company
PLACE OF SETTLEMENT 204 South Lincoln, P.O, Box 248, Port Angeles, WA
1, SETTLEMENT DATE. 11/16/2006 Final
J. Summary of Borrower's Transaction
100. Gross Amount Due From Borrower.
101 Contract sales price
102, Personal property
103 Settlement charges to borrower (line 1400)
104 Property Tax 2nd Half
105.
Adiustments For Items Paid By Seller In Advance:
to
to
120. Gross Amount Due From Borrower.
200. Amounts Paid ley Or In Bghatf Of Borrower;
201 Deposit or earnest money
1 202. Principal amount of new loan(s)
203 Existing loan(s) taken subject to
1 204 Amount Of 2nd loan
1 205 Initial Deposit To Escrow
206.
207
208
209,
Adjustments For Items Unpaid By Seller.
210. City /town taxes to
211 County taxes to
212. Assessmentss to
F2.13
214
215
216
154.900.00
3,474.41
71.31
1.000.00
123 920.00
CARROLL REALTY
98362 (360) 457 2000
DISBURSEMENT DATE, 11/16/2006
I{. Summary of Seller's Transaction
400, Gross Amount Due To Seller
401. Contract sales price
402. Personal property
403.
404.
405.
Adiustments For Items Paid By Seller In Advance:
406, Cityhovm taxes
407 County taxes
408. Assessments
409.
410.
41)
412.
413
4,4,
415
416.
158,445 721 420. Gross Amount Due To Seller
1 500, Reductions In A aunt Duce To Selma:
501 Excess deposit (see instructions)
502, Settlement charges to seller (lint 1400)
503 Existing loan(s) taken subject to
15.335.00 504 Payoff 1st Mt$, Ln. City Of Port Angeles
18,190.72 505, Payoff 2nd Mtg. Ln, USDA
506, Payoff To Olympic Community Action Programs
507 Disbursements To Seller
508,
509
Adjustments For Items Unpaid By Seller
510. City/town taxes to
511 County taxes to
512. Assessments to
%513
5,4
515
516.
e
to
to
to
PAGE 02
OMl3 No. 2502 -0265
LOAN
3 iX; CONV UNMS.
154.900.00
154,900,0
13,893.5
25.073.(
7.755,1
9.255,
98.922,.
Street Lookup Page 1 of 1
Parcel Number 0630095215360000
Site Address 240 MOTOR AVE PA
Taxpayer
ROGERS EDITH H
Title Owner
ROGERS EDITH H
Description
FOGARTY DOLAN'S
LOTS 19 &20 BL 15
Quit I
240 MOTOR AVE
PORT ANGELES
240 MOTOR AVE
PORT ANGELES
ADDITION
WA 98362 2540
WA 98362 2540
Value Summary*
Note Listed values do not reflect adjustments made for exemption programs such as
Senior /Disabled or Current Use programs (except Commercial Forestland properties)
Land Value 35 360
Improvements Value 62,210
Total Assessed Value 97 570
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 1112 TWO BEDROOM
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 Verify all
zoning with the appropriate planning or building department.
Building Characteristics. (Click on Bldg. for more details
Bldg. Type Blda. Style Total S.F. BD
01 House 1 1/2 Story Finished 892 2
Tax History Sales History
Other parcels at this address.
Quit
BA
1
http. /apps.clallam.net/website /sites_ s.pgm ?address =240 &street =MOTOR AVE 11/30/2006
Architect/Engineer.
LEGAL DESCRIPTION Lot:
TYPE OF WORK.
Residential New Coast
Multi- family Addition
Commercial Remodel
BUILDING PERMIT APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COMPLETE to be accepted for review If you have any questions, call
PERMITS (360) 417 -4815 FAX(360)417 -4711
Applicant or Agent: V 1 ec_12, vt+ fir g Phone:
.!‘:"4"" tn 2 S 8 3
Owner C_ L` h 3 C c c k) St3'Vt_ Phone. _3 Z 8' S'(Jy6 /-6Yece
Address: /St/ .fir L. City Po. J' ltit' -2 ICJ` Zip 6 ig
Contractor MIA/0/./.9-,71) State License A4V02/ 04' 'd xp 2t Phone:YS2 Z,Ejj
Address: Qt C 1 L City P /J Zip Z �✓3g
PROJECT ADDRESS 2. Q f l C'1 Q ,e 4 U ZONING
CLALLAM COUNTY PARCEL NUMBER.
Re -roof Stove
Move Garage
Demolition Deck
Repair Sign Other
B
17 F DESCRIPTION OF THE PROJEC IF Vl S' if
(d t _1 10 cx. -l-.
J
COMMERCIAL/RESIDENTIAL. Occupancy Group.
No. of Stones: Lot Size: Existing Sq. Ft.
OA
Block: Subdivision.
Total lot coverage
PLANNING USE ONLY
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
Phone:
STZE ✓VALUATION
SF /SF
SF /SF
SF /SF
TOTAL VAL ATION
Lej-
Date: 2q /Q6
FOR OFF]
ate Rec.
ermit
ate Approved
ate Issued:
VLa j—/
SP
SoO. U
t a 10 aj-a
Occupant Load. Construction Type:
Proposed Sq. Ft. TOTAL Sq. Ft.
APPROVALS
PLAN
BLDG
DPWU
FIRE.
OTHER.
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 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
R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that 1 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 wo h.
T•WORMS\BIdgPermitform.wpd Applicant:
1-0 J
c:511x.
4
MJJ cr-rh
tre— toit_ (L._
I
FILE
CITY OF PORT ANGELES Construction Plans
The Issuance of this permit based upon these p!Jns, specifi-
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
plans, specifications and other data, or from preventing
building operations being carried on thereunder when in
violation of all codes and ordinances of this jurisdiction.
(SECTION 3 ode.)
Approval Date By
6te_
Mar 20 08 10:52a
p.2
,
,
CJ3 ---0 D Z,
~._-'~.
.,~.......
'.. ",f
-~
ELECTRICAL WORK PERMIT APPLICATIii>N
Electrical contractor name
~\\ \l~lil~i~,~.. HpCi'nCV!J<"'; C-:'-:i(Y'i
Purcll~scr's mailing address
~;7 rpilf11'J <St-,
71"
YO v1 h'1('f' 11" S"
T~le hone number"
, -0, I Z
License number
en..\. t'.)f;"f~!H'I 2:'-111-\1 i
Dale Expires
C]-\-(.ri
l:lstallalion descriplio':1
Q Commercial J( Residential
o New ::J Altered/Addition
Job wired hy
')( Electrical Contractor 0 Owner
S{:JIC ZIP
l ' 'f+ OI"'Z( l..
\/' In "'}..,
fA.X number
'-:i C)' _C-
Ul f - ":"7ITH
full.1 ~ iCI L\
- J
g~7'-f'\C~
(,\ ii//) (JC".
- ..I
In
Ijr~mises Owner's name -
\.. \'W\c,t\()f' j C\(d?~Olfl
Address of ins~ection
24(; A1Ctr'if f1\!f
~?Vt P(110)P it'S
PIlont- ,r~umbCT o.scht'dule inspection: --:2/" zJ Jt
c 1", vt;;IJ Ib
~lbllW.6
ru\2.N k.L
()-{ 8
01\'m.'r us defined fly RCW !9.28.261:(lj OW!1n wiT,' (.CClfPY (he s,'rUCWi'<, for (wu
years ufter litis e/!!cfricuJ permit is finalized. (2) Owner i.f req;Iired (u Jrire an f?lectrical
(;()l1JrrJUor if 1I0r-WI wu'd prop<?rty is for :iaJe. relll (J1'/r;osc.
After reading the above stiltemCfll, I hereby certify lh3t I am the owner of the abo\'c
n::Jnled properly Of a licensed electrical conlraclor. I <tm maKing the clectric.al ins:al.
Jation or alteration in compliance with the electrical laws, N.E,C., Re\\.'. Chapler
19.28, WAC. Chapler 296-468, The City or Pori Angdes Municipal Code, <md
vtility Specificalions.
Si n~ rtl '1f oW,.?er. ele I 'cal c ntr~clOr or electrical administrator
.. I , . I' J -Z '1,; 110..
. I.,: 'I' J,', Date: YiC-vU
Electrical Load Additions and or sub1ractions
o NO LOAD CHANGES
Q Baseboard KW
o Fumace KW Cl Overhead Service
o HeatP~mp _ TOI1_ LAR Q TempService
o Fan-Wan KW 0 Underground Service
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
o C.,h 0 Check"
R Credit Card
Card #
Visa
Mastercard
Di sower
---------------.
Expiration Date
of card
Service Information
Voltage
PhaseD 103
5eNice Size:_~
Feeder Size: __
,,- ROliGH-IN -, "'--'THERMOSTAT , SER\lCE ,
bh~tca ~ I bjtfdclf, ~ I
Afll\rond B)' '- 00'>: .'''I'l'fQ''ed(1). "- D~lc .l,ppro\'::J8y
f F~AL DITCH r FEEDER
~ :!2.,/
'- D~k Apl'l'rwcd By '- D~h: APfll'(WM By./
Irlspcction Area, Building or Equipment Inspected Action Taken Elc=clricaJ
Date Inspector
Mar 24 08 07:01 a
p1
/
013~63(o0
Q_..
.'
, .
,..''E::..........
'-'-J'
~~$'
........
.
ELECTRlCAL WORK PER'\lIT APPLICATION
Job wired by
Electrical Contractor 0 O"'ner
InSlallation description
o Commercial ~ResidcntiaJ
Electrical CO;LIT3ctor name
I~U:l\;nVV"";" nf(>,':'\"':~", ~
Purchaser's :":1:Jilin~ address .'
"7.(:,7 t.>,!, '"~ rr 0 "<it.
\~TY- I
,:; 1,'\ [Ai~/." ~-; i ~,
_~ I r W 1/ II It. i. \/
Tc,lcph.one_.nump;>~ _ '
..... (/-,,' _ \. ,'-/! 2...
License number
i r ~ I\!~-. ~ !n'FI t"f:t.'"""; 7.....;"(
J
DatE' Expires
,\ /)- ~ -t~~)
[J ~ew
o Altered/Addition
r Stale ZIP
~ elF,?../.7
I ". 'F I
fAX number
.t"'"::. ~ ~ ,,'~
,
J-1\" ,~
i :,\,
I
~ ('
L (-, ; "V.', r:
J. . . ,
'I (I.,...r\..
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!.......'f
7"-1 C J
C\y\X
-
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p'..,.el1!ises owner's name-, ". ,
\ \"^'~"-"'~ 'f i(r"ri-1
... ' \ > i....... \ I 1 ; or , l ' ;" i ~
Addres" or in~pe~'ion
1.'-1 (' I, iUi'\..- ,n,1 :.'
~~' .
. I \. ,""'~ ,Yt(\ (7" .~. J':',-
, -, - I , L ..- \ " -
~ . .: ) ~ .....
PhOne.,l!.I!mber '.o,st;.hedulc insptction:
r;. / '.-'~ V'-'.-/
OmU'T a_~ defined b.t: RCW/918.26l:(J) OWlfl!'r will occupy the strl.lL'llilvfor two
Yf!Q".~ afit!,. lhi~' eh:ctric:Cl,' "t:.nml1~' finalized. (2) Owner ,:., requin!ll to hi,'c an e/rxtr{cal
cor.lraCWr tf a,>,ol't' ....aid properly Lll f!)T Sllfe. rent or teo.1lc.
Aft:;r reading lbe ..bove stalement, J hereby certi.fY lhnt t am the owner of the above
named properL\' or a licensed electrical contractor, I am making the electrical instal-
l:alion or illter~tion in compliance wiln the e1ecuical laws, N.E.C., Re\\'. Chapter
19.2B. WAC. Chapter 296-468, The CilY of Port Angtdcs Municipal Code and
Utility Specifications.
Si~~t,uTe of o"'-,ner. de.t.tl'1a.l ~ontl":l,ctor <)l' eledrl<:al administrator
X . I /1 I yl ;; r<( i IT e'F,. Date: :: -1 l-C';:'
EleC(rical Load Addition.and or subtractions
o NO LOAD CHANGES
o Baseboard KW
o Furrmce KW
o Heat Pump Ton
Q Fan-Wall KW
SA-ME DAY INSPECTION
o Cash
o Check #
~CreditCard
Card #
Visa
Mastercard
Discover
----------------
Ex.plratlon Date
of card
LAR
Q
CI
CI
CALL BEFORE 7-00 AM 360-417-4735
Overhead Service
Temp Service
Underground Service
Voltage
PhaseD 103
Service Size: _
Feeder Size:
.
ROUGH-IN THERMOSTAT '"' SERVICE "
h k!'J?> -nP \.. f)~lc A~p1":l~cd 8)'
Aopmyw By D:Jl~ Af'PtOvctl By
FINAL ( DITCH " / FEEDER
If f~lre ~ ) I
-Approntl By ~ Dale ,'l.I'PIO~Ctl B" ()~lC ApPIIo'.'itd, '0)' ..J
Inspc:;tion Area, Building or Equipment lnspeclc:d ,\clion Taken Electrical
Dale Inspecior
I
1
(jR- 03b L I -
I
::"to" i
ELECTRICAL WORK PERMIT APPLICATIO~,
~equest Inspection l
~
a
~i~trieaJ Contractor 0 Owner ~~_~I
o Annual Pennit CJ Alarm - 0 Carnival 0 Commercial 0 R.esidendal a Residential MaiDt. 0 Signs D Thermostat a '1'elecom.
Job wired by )(EleCtriCal Contractor 0 Owner
Electrical contracto;'1'm.J= . ,.' f)... License T'lllmber
Cf3J,.~~M~.L 6oA'
rurcbasec'~2~'5 ~ /J~
C;::Ad- Stat~ CL/
fAX number
lnst..tllation description.
,,9'.M~ ,4 .,dF.r-
7~i! ,-,,-, "~" Jh-L_ l
f=i-l::~
City
~1 ;{;i/
I hereby certify that I am the owner of the above named property or a licensed
electrical contractor (or the finn's authorized agent) and am making the electrical
installation or alteration in compliance with the electrical law, Chapter 19.28 RCW,
o Cash Q Check #
o Credit Card @:) Mastercard
Card #
Discover
x
WALLS
JnsuJ;)tion Only
CEILING
Insulalion Ol\ly
THERMOSTAT
SERVICE
n~le
Approved By
D"'t~
Afo}II'(lVe<l By
D~tc APPN"ct1 Bv
/* In 6V<' Ad)
Dll.te~ A(lJlHwCtl 8y
IZZ~/'tver A~
~ 1o.PProvcdDy
DITCH
FErnER
D"le Approvod By
Dille AJlpmvO(J By
Eleetricalload Additions and or subtractions
o NO LOAD CHANGES
o Baseboard _ KW
Cl Furnace _ KW
Cl Heat Pump _ Ton LAA
o Fan-Wall _ KW
/
Service Information
. ~
Inspection Area, Building or Equipment Inspected Electrical
Date Action Taken
Inspector
17_ z..../^ ,- t=l.kkl- AP . J _
J J I
,
.
Cl Overhead Service
{J Temp Service...
Q Und9r9round':~ervlce
Voltage
Phase Cl 1 0 3
Service Size:
Feeder Size:
~ j:z./.:;,/{;c.
td W~tG:0~00~t~ '~da
[1766 GSl7 09Z t
'ON X~j
~)..lPd13 S,ElOEl
WOClj
FROM: BOB'S Electric
-Le.H l..li~N""--
DAN :Zo&, 37'73>G3(
BOB'S ELECTRIC INC.
2293 DEER PARK RD.
PORT AN~ELES, WA., 98362
FAX NO. : 1 360 452 9943
Mar. 17 2008 11: 47PM Pl'
,~)::e~
77f~t'
**~************
*
*
ok
1 N V 0 ICE
*
*
*
***************
Invoice Number:
(InVOice Date:
Page:
002185
01/12/00
1
Sold CHRISTIN~ JACOBSEN
To: 484 DODGER LANE
PORT ANGELES, WA., 98363
Ship CHRISTINA JACOBSEN
To: 240 MOTOR AVE
PORT ANGELES, WA.,
Ship Via. : P.O. Number. . :
01/10/07
02/11/07 Job/Order No.:
Salesperson. . :
Item I.D./Desc. Ordered Shipped unit Price Net TX
LBRBOB 2.00 2.00 HR 55.000 110.00 T
JOURNEYMAN
LEV8599 2.00 2.00 EACH 9.813 19.63 T
15A GFI OUTLET
LEVS8001 2.00 2.00 EACH 0.325 0.65 T
1 WHT SW PLATE
PRMPERMIT 1. 00 1. 00 EACH 48.100 48.10 T
CITY ELECT PERMIT
Subtotal:
Tax.. .. . :
Payments:
Total. . . :
178.38
14.98
0.00
193.36
s~
~
CITY OF,PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:m EAST 5TH STREET. PORT ANGELES. WA 98~62
Appl~cat~on Number
Application pin number
Property Address _
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
06-00001282 Date 12/28/06
198156
240 MOTOR AVE
06-30-09-5-2-1536-0000-
CHRISTINE JACOBSON
RES REMODEL
._~" -:::, .
RS7 RESDNTL SINGLE FAMILY
2500
Owner
Contractor
WA 983622540
INNOVATED FIRE, S?"j'i-}l!Kf;,~Rf..
81 NEW HAVEN LANE
PORT ANGELES
(360) 452-7583
.0 ,. ,. \.
'..... -..., .
ROGERS EDITH H
240 MOTOR AVE
PORT ANGELES
WA 98362
Permit
Additional desc .
Perm~t pin number
Sub Contractor
Permit Fee
Issue Date
Exp~ration Date
ELECTRICAL ALTER RESIDENTIA~, .
BOB'S / REMODEL ,,- ":"
92478
BOB'S ELECTRIC INC
48 10 Plan Check Fee
12/28/06 Valuation
6/26/07
.00
o
tv
J:..
o
Qty Un~t Charge Per
1 00 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS
Extension
48 10
Other Fees
STATE SURCHARGE
4.50
------------------------------------------_:~~-----~--------=~~-------------
Fee summary
Charged
". 'Paid ~ ....~- CreaHed--- - - Due
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
48.10
.00
4 50
52 60
48 10 .00 .00
00 .00 .00
4.50 .00 00
52.60 .00 00
,
o
~
l'
.1:"'.1",_~
. -. j 'lt10\tA'l'eID...l"I.~_Sf<'in ~jKI,k,,-;
""l"ii' '11)' }"
~
~,
~
I . .~,. _
, _.P. r"
_ ~_...4.-.....,jt~~"IIH'-~~~M ~
COMMENTS/ACTION NEEDED
~. bB . '.q'~ ": .
. \ ,t:; '". "
_ ....~~ t __ '''''___T_
o ,.f ' : .
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
I INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
I KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCItPTII'.D COMMENTS
I I YES I NO
I
IJIII :H I
III II I( TH-lllll COy ~K
- - --- \
~hKVIL;h I
1
1<'ThT ^ T I 1J....~fJ -t:kJ M.&l I
I
I
1
I
I
I .~ I
.... ,GENERAL COMMENTS:
.~ I
f
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-,
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,.4.....
PW-I 102.1' 14'961
Q'
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
ELECTRICAL PERMIT
Issued: 6/17/97
Permit No:
5954
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
EDITH ROGERS 240 MOTOR AVE
240 MOTOR AVE Lot: 19,20
Port Angeles, WA 98362 Block: 15 Long Legal:
360/452-2163 Sub: FOGARTY & DOLAN
'1': S: Parc No:
CONTRACTOR-----------------------------DESIGNER---------------------------------
ELECTRIC SERVICE
924 DRAPER RD.
PORT ANGELES, WA 98362
360/452-6424
,
000/000-0000
PROJECT INFO---------~----------------------------------------------------------
prj Type: RES. MISC. prj Value: $0.00
Occ Type: Cnstr Type: ADD HEAT
Occ Grp: Occ Load: Land Use: RS7
Electrical Heat Service Type
Baseboard KW: 0 Riser Voltage: 120,240
X Furnace. KW: 15 X Overhead Service Diameter: X-I -3
Heat Pump KW: 0 Underground Service Service Size: 200 AMPS
Fan/Wall KW: 0 Temp Service Feeder Size: 0 AMPS
PROJECT NOTES-------------------------------------------------------------------
REMOVE OIL FURNACE, INSTALL 15KW ELECTRIC FURNACE
ADD CIRCUITS PER PA HOUSING REHAB (SMOKE DETECTORS, GFCI'S)
PROJECT FEES ASSESSMENT---------------------------------------------------------
Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $40.00
Temp Service: $0.00
$0.00
Misc
TOTAL FEE:
Amount Paid:
$40.00
$40.00
---------------------------------
---------,------------------------
TOTAL FEE:
$40.00
Balance Due:
$0.00
COMMENTS/ACTION NEEDED
ELECTRICAL 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 lS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE I ACCEPTED COMMENTS
'I YES I NO
uITcH / /
ROUGH-IN I CUV t:.K ~/17Iq7 7t~
ShR ViCE
/ J
I -XU!e}'.") I ~ I
GENERAL COMMENTS,
PW-I 102.lj 14/96]
L~E~TIBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT.
A
5+10
PERMIT NUMBER
.
30 670 ;} /.;", /';'C.' / J.-t.....-"'/~ ~9
. TOTAL FEE ..--. /[.:2..CL -
CONT. LIe. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
me> 10/<.. fJ u~
Eel ADDRESS IS RESPONSIBiliTY OF APPLICANT
PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Installation By f'I\c (~ IV IV.o-I ,IV i S
Installers Address 7 ~. 2r IU s-T~
Installers Phone '-1..;,- '7 \.')-I-;,~ 9
t J..r r,1i(
"
Owner "l
Owner's Address .::2 Lt C 0 -< . /J u e
4.'\ .J c::J' b .~
Day Phone
Application is hereby made for Permit to install Electrical Equipment as follows:
s,r.q,J,'l..'c C~" .......c,p. K ;t<: J...",,-+
(,
L i.J v.- ~"';,"""
I
Wiring Method
c /~<:" 0./7s:
/f' X.
.
NUMBEA AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PER 10 100R FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE
CIA 30 CIR 30
LIGHT SIGN
..-. .. 50 VOLTS -
LIGHT OR LESS
CONVENIENCE ... - :-c- MOTOR -
CONVENIENCE - MOTOR -.
APPLIANCE MOTOR
DISHWASHER - FIRE AL:~RMS -
DISPOSAL BURGLAR ALARM
...
RANGE MISC.
OVEN
WATER HEATER
-
LAUNDRY.
DRYER . - REINSTALLATION LIGHT FIXTURE #
FURNACE SUB l.:OTAL FEE
GAS - Oil
FURNACE ENERGY FEE
ELECTRIC BASIC FEE
ELECTRIC HEAT -
-TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT ,...000 AMP / PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE 5D<;!.:!L ij/o .y~ //0 A,W.G.
. 1 SUB-TOTAL SIZE OF GROU~D 7" ..c}I' SIZE OF ENTRANCE SWITCH ::Lee
I certify that the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code.
DateA~'Plication made -,;:J/j,] ,;;1('.) / ~ ,19 S"S- By
,
NER (OR AUTHORIZED AGENT)
Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and
specificationS pertaining thereto, subiect to compliance WIth the Ordinances of the City of Port Angeles.
f - _ JCTOR 0 CI Y
Date Permit Issued
I
.,
.
- - , .
Notify Department of City light by Street Address and Permit Number when ready for inspection, Work must not
be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in
Writing on Permit Placard. A.. Permits Phone: 457.0411 Ext. 158.
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
WHITE. Original
CANARY - Duplicate PINK. Triplicate
C ~Pl\' ,~ 0 Ie
WHITE CARD. Inspector's Report
'3 - n ~ Sf,.
OLYMPIC PRINTERS, INC.
.,---.~. ."" -.....
,-I
~~
REPORT'OF"INSPECTOR
, .
OATEOFVISIT MADE BY REMARKS
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r " O.K. FOR COVERINQ
-<.i/ 'j, r~ -1J17~ O.K. TO CONNECT SERVICE
7///1.,' ?{. ..
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