The URL can be used to link to this page

Home My WebLink About202 E Lauridsen Blvd - Building 'Ii,' ~,v' .-~ /O~"<", ,o~. L -=-- :::; CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT, BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application description Subdivision Name Property Use Property zoning . . . Application valuation 04-00000218 Date .720308 202 E LAURIDSEN BLVD # 21 06-30-10-5-0-2320-0000- APT #8, 9, 21, 22, COMM REMODEL 3/17/04 COMMERCIAL ARTERIAL 55151 Owner Contractor VINCENT, TTE DARREL ALLIANCE RESTORATION INC. 711 E FRONT ST 8583 154TH AVE NE PORT ANGELES WA 983623610 REDMOND WA 98052 (425) 882-7930 Structure Information REPAIR FIRE DAMAGE Construction Type TYPE V NON-RATED Occupancy Type . . . .. SINGLE FAM & CONGREGATES Other struct info. . .. NUMBER OF UNITS 4.00 Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT - COMMERCIAL REPAIR FIRE DAMAGE #8,9,21,22 709.25 Plan Check Fee 3/17/04 Valuation 9/13/04 .00 55151 f\l o (V Qty Unit Charge Per Extension 667.25 42.00 ITI BASE FEE 6.00 7.0000 THOU BL-50,001-100K (7.00 PER K) rr ~ r ~ Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 709.25 709.25 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 713.75 713.75 ,00 ,00 c, Q. ~ f iJ:. -<i A Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null aha void ifworko{ 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 ifrequired inspections have not been requested within 180 days from the last inspection. I hereby certify that J 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. i~ ntfL 05 Date Signature of Owner (if owner is builder) Date r or Authorized Agent T:\PLANNING\FORMS\1102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD . '~':. CALL 417,4815 FOR BUILDING INSPECTIONS. CALL 417,4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRATNAGEIDOWN SPOUTS ELECTRJCAL (LIGHT DEPT) $EPARA IE PERMIT: # ROUGH IN I I I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO SLDG) GAS LINE BACK FLOW I WATER AIR SEAL WALLS I N-/5-Dlfl.l.L I CEILING I I I FRAMING JOISTS I GIRDERS SHEAR W ALUHOLD DOWNS WALLS! ROOF I CEILING ~,1t. '04 T/, DRYWALL (INTERIOR BRACED PANEL ONLY) I-BAR INSULATION SLAB I T I WALL I FLOOR I CEILING li-I-Ul.fftI I I,/..., I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE! PELLET / CHI.M:NEY - 1-0--1 QV HOOD / DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'5: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R_W. I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 4]7-4815 -::::" ''S -<-,..j J./." BUILDING T:\PLANNfNG\FORMS\ I ] 02.15 [11/14/2003] PREPARED 6/03/04, 13:25:01 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 6/03/04 - - - - - ~ - - - - - - - - - - - - - - -- - - - - - ~ - - - - - -- .., ADDRESS 202 E LAURIDSEN BLVD # 21 SUBDIV: TENANT, NBR: APT #8, 9, 21, 22, CONTRACTOR ALLIANCE RESTORATION INC. PHONE (425) 882-7930 OWNER VINCENT, TTE DARREL PHONE PARCEL 06-30-10-5-0-2320-0000- APPL NUMBER: 04-00000218 COMM REMODEL -------------~------------------------------------------------------------- ,.. PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------- --------------- ------------~---------------------------- ---- BL3 01 3/26/04 JLL BUILDING FRAMING 3/26/04 AP ED 425 766-3904 JIM, THIS INSPECTION IS TO HAVE YOU LOOK AT ALL THE EXPOSED FRAMING, VERIFY THAT IF ANY STRUCTUAL FRAMING WAS DAMAGED IT HAS BEEN REPLACE OR REPAIRED BEFORE WORK CONTINUES. NEXT INSPECTION AFTER WIRING IS INSPECTED WILL BE THE AIR SEAL, THEN INSULATION, AND SO ON. frame appears to be in good shape on interior repairs to be made on exterior ok to finish work on interior/jll BAIR 01 4/15/04 JLL BUILDING AIR SEAL 4/16/04 AP ed 425-231-0480 make this inspection last per contractor/jll BLWS 01 4/20/04 JLL BUILDING INSULATION WALL/FLOOR 4/21/04 AP Kevin at 818-1947 requests a Insulation Inspection at #21 in the P.M. BLCH 01 5/11/04 RV BUILDING STOVE CHIMNEY 5/11/04 AP ED 425-231-0480 BL99 01 ~ JLL BUILDING FINAL ~F ED 206-818-1947 BUILDING IS LOCKED, THE KEY IS IN A LOCK BOX AT THE DOOR THE CODE TO OPEN THE LOCK BOX IS "ARC" INSPECT APARTMENTS #8; #9; #21; '" COMMENTS AND NOTES PREPARED 5/11/04, 13:19:03 NSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR ROGER VESS DATE 5/11/04 --------------------------- --------------- ADDRESS 202 E LAURIDSEN BLVD #- 21 SUBDIV: TENANT, NBR: APT #8, 9, 21, 22, CONTRACTOR ALLIANCE RESTORATION INC. PHONE (425) 882-7930 OWNER VINCENT, TTE DARREL PHONE PARCEL 06-30-10-5-0-2320-0000- APPL NUMBER: 04-00000218 COMM REMODEL -------------------------------------- ---------------------------------- PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS -------------- ------------------------------------------ .., BL3 01 3/26/04 JLL BUILDING FRAMING 3/26/04 AP ED 425 766-3904 JIM, THIS INSPECTION IS TO HAVE YOU LOOK AT ALL THE EXPOSED FRAMING, VERIFY THAT IF ANY STRUCTUAL FRAMING WAS DAMAGED IT HAS BEEN REPLACE OR REPAIRED BEFORE WORK CONTINUES. NEXT INSPECTION AFTER WIRING IS INSPECTED WILL BE THE AIR SEAL, THEN INSULATION, AND SO ON. frame appears to be in good shape on interior repairs to be made on exterior ok to finish work on interior/jll BAIR 01 4/15/04 JLL BUILDING AIR SEAL 4/16/04 AP ed 425-231-0480 make this inspection last per contractor/jll BLWS 01 4/20/04 JLL BUILDING INSULATION WALL/FLOOR 4/21/04 AP Kevin at 818-1947 requests a Insulation Inspection at #21 in the P.M. BLCH 01 5/11/04 RV BUILDING STOVE CHIMNEY A-P l:?v" ED 425 231-0480 -------. COMMENTS AND NOTES ,/ 2004!MAR/16/TUE 08:43 AM CITY OF PA BLDG DEPT FAX No. 360 417 4711 P. DOl/DOl {J BUILDING PERMIT ~ APPLICATION FOR OfFlCIA.L USE ONLY, 0... Roc, :3 - i'7 -t:'1 P...... <<, lId - 9-1 c: . Dalo Approved' ') -II} -()rl D""'IsSUed:"\-/7 -ei( . FlU oat COMPLETELY aod in INK. Your application and site plan MUST BE COMPLETE to be accepted for x-m..... If yuu ban any question., call (360) 417-4815 i 'j ApplicBIllorAgent: ^\lICINt!: ~lJ(\.A".J S(""Vll el Owner. Dqll,t,l.l \.I+IV((<'/1 Address: IJi.i:: 'Ft..)"vj- City:_f'o,>t-l' 11- ,.Lr.-J I I ArchitectfEngineer: tJ A Phone: ContractDr AIIJ~ -.;( E. ~'J~ c?l'l....l, ,J SfateLicense #:/11/ I MS': nLt' Exp: J" ",to ::>'1 Phone; 'f IT- .JilZ - 7"" co Address: g)",~ ,fj-'1 A/I~ J.JL t3/~,L City. /lr c!MJ~.!. , t.vlJ. Zip: '7<?D \'z.. PROJECT ADDRESS: LD Z. E. Ll1lA~ dJH." ~"J J r,.J A"ykZONlNG: LEGAL DBSCRIPTION: Lot Block: Subdivision: CLAIl.AM COUNTY PARCEL NUMBER: Phone: .Phone: 4zr - <8'2 l..- -r1]O 3b~r tiT 7 - 0 '/5" Zip: Q53(, L Cx-edit Card Holder !'lame: c , SIZE/VALUATION: tJ Stove SF. @ $ ISF. = $ o Oara,ge SF,@$ ISF.=$ o Deck SF. @$ /SF. =$ o 01her TOTAL VALUATION $' PI k_ c.ft'{ i1AUY_ f2r:- fO<lJ!2- . . I Co,N~J'" j/ $ 55, 15-/ ~ / Occupant Load: & PtDposed Sq. FI. 0/, = Total lot covexage ConstnJction Type: = TOTAL Sq.Ft. % o c - - . APPROVALS: PLANNING USE ONLY: .. l'LAN: BLDG: Dl'WU: ESAlWetlaod(s): J:i Ye, 0 No SEPA Cho:cld uiremeDts if you bave questions. VALUATION OF CONSTRUCTION: In an eases, a valuation amount must be entered by Ibe appliCllDt. This figure will be reviewed and may be rcvised bylbe Building Div.isio.n tu comply wi1I1 cwrem fee &cheduIes. Cootoctthe Pemrlt Coordinator at4 174815 fur ...iotance. PLAN CHECK FEE: IF a plan check fee i. due it nmst be submitted at the lime the building permit application and construction plans are S\lbmitled. AD other permit fe.. are doe.at1bc'time ofpermitissuance: EXPIRATION OF PLAN'REVIEW: !fno peIlXlit is issued within 180 days of the date of application, the application will expire. The Building Official can _dthelimefor action by the apphcantup to 180 days upon wril1Enrequest by the applieant (see Sectiool07,4 of tht UDifonn Building Code, cwrent edition). No application can be e>cteaded IllDre than Dace. I hereby certify that J have read end examined this application and know /he seme to be true end correct. I am euthorlled to apply for this permit end understand that ff is my IBSponslbillty to determine what permits BIB IBqujlBd ,not tho Cffy's, and thet t must obtain such permits;;;,' to wort!. T:IPOllMSIAPPSIllundinllJ>'n!htwp<l. . Applicant: ~ (j'tj/J"l)- Dalr:: 0;3 17~LI ~ ~ ~, ? o i"" w ~ -r- r V- ~ ~~ n o ~ o Z " ~ UlZOO'IJc..,trltll trltrJO;;:~"""dC::: ~~~~~~",8 - H Gl H tv \j ......ZtrlZo-lU'lH ;jtJ5itJ9;':;-.J~ t>J'O{J)H (1)0\ Z t>:I. "'l <: <1\ '>'l rl t>l""':>:l Z~ ~~~~~ (/]0 (J)'IJ'1;IOH C:::Z ><t'l...Z L' tIl () GJ )>:r> trl""'lo-i >-'l"'J t<l:I:H ......rJ '2:>00 Otrl ""1'2: Z. . OHH ~ 'I:l"'lUl ~ ~H C tl f;~;j Z O~ ~Q ~ o Om>' H :>;:lo-,l<: OUl ::dOO Z .C Z ~~c; Ul ):tCe:: " H~ trl :>::It"'t''' n 0 0 >-cl tl"'lO o .~ tj g;~>, ~ 'ljH>-1 H OZ L' ::dGJ>' C 0 C 'C " .~ trI OUl>') . " " " 0 " o 0 X " o ~ o o ~ o Z o " o ~ ~ ~ " C w " ~ " , ~ o o H " . n.n 00 .0 'CO COO O~ """ OOd OOH S H . Z OH~ ~Z d~' ~'I:l~ H ~ .0' 00 ill ill 8 fiq! "H ill" '" nHn OOH ~z~ o Z ~ ill i H ~ ~~i]8~tj 'd;:dZZZtl t"'[:J~;;5~~ ~t"' Po-1Ul n. ~ . . " " OZ t'J, ::<ltll. . . DO <>o::r>rv ,1:>0'\ Ht"''"dO ZL''''llV own...... g<;>~s::~trl 01-' >-j n- t" 00- [I] >' ~~>-3:U~~ 001 >-j[l] H OtrlUlND n I 0-11-' IJ) o tv 0 0- I:Tl 3:w;:r.::d Z 3:N;:d>''''' O:>::lo-itvtll ;:d I:>l H- t'" l'JOt"'O <: ::':0 z tl 00 00 o C n" H. "0 '" ~ O. "0 o " o .w ~, ~~ QO O' C' o ~H ~ ill , ~ w ~ n ~ ~ H "" "" 00 ZZ 00 H HZ Zill ill" "0 on n" ~H 00 .Z y~ ~n 0" ill 0 " ill ~ o ~ C S o . C , . ~ ill 00 00 ~ , w w o 0" ~~ "Q 00 w , ~ 00 , o ow w w w " i ~~~8t;iE; n~ ~ ~ C '" ~~ . ::'. '1j ~zo "w w ~ t-~~~~~ "'~ W ~ ~ 0 0 0 0 " ZL' >-1Ul O~ ~ ~ ~ ~ n- U) ~w . " 0 ~ 00 OZ ~ ~ ~. ~ oo. 0 n~n ~ " ~. ir ww OW '" '" " .0 N . \.f.:l.......... NN ~5ig OO<;l>:l>~ ~~ o~~ ~~ o/>o0'\>-It"' '00 ,,' " ~W Zt"....;1V QO 000 00 ""00 own...... w. ... .. ~"O :5'7'~~:t>J ~, OOH ~ S :5 6~ [J' ~ w~ N H ~ ~ >-1 :>:l''''~ ~ Tr~ ~~ ;;;H~ ~~~ ~~ 00 ,,~ ~ N ~ ~ wZ Ot'lIJ.lIVtl cw. n , ,,~w w ~'d~ o tv tl o. ~ ~ 3:W:J:':t:I Z 3:tv)d>N ~ O:>::l'"'ltvtI! " " ~ ~, ~ t<jot"'o ~ n-:;<:lJlrllIJl3 H,(JlZntl"lc...ttltd "0 , '0 Z 0 ::tfllC::~C::Pltit'lt':lO~::aHt:Jc:: ~w 00 ro~_~oI:>~rt~~~~ ~:"=",,~ ~i!S8 00 ~ # W' '0 P t:J t..l t:l Ill' H Q H tv tl ~"I ~ n N 3:Il>Z~zgPl...,z~gj~Si<J1z "H ~ W" n 1'1" Q tv Gl '1j::I: Ul tt] . H....J Q '" 0 w ro'O t>:I 'tl Ul H ill'" nHn H . OOH.....>:<roZM..,< "'''l OOH HZ . .....Z' .....,-tlll OJ t>:IHI:a ~z~ Zw ~ ~i3~:a~~zj ~t:5i0~ W" Z w "~ " ..... t'" OJ IJ.I,.' (/] 0 Ul "Il '1:1 0..... Z ~n w :f~o~g8"fiZ ttl><:~""~ " n" w "H ~ --.lH3t'" o t1 ~ ~ "HH 00 00 ~X~ "Z 0 "Z" ,... m H >-l Z~O Z 0 0 o~ "Z ~" .o. n-.... Z:a " ~n 0 O~rt o 0 ' ~~H ~" W " O~~ . ""W XX ~ ~~ ~ U'lt"'l-" ~~ ~ ~ ~ 00 ww m rt,oo ~~6 zz 0 " . " POClH ~~ H ~ ~e e. 0- Z ~'" < o 00 . WQ om~ ~ 0. ~mo ~ H "" ~ H ~,,~ 0 0 :< flJ 0 Ul ~w . ~ . n 0" Z ~C N ~ 0 rt " 0 ~ wn'" ~ '" ~ e " ""0 0 0 0 W ~CC rt 0 o 0 " H~ 00 e. 0 ~ ~~~ 00 0 ~ e n ~ 0 N , . e 0 " 0"0 m o rt ~ ~~: , H rt rtro 0 ~ , ro " w m " " e ~ "H" 0 " ro e 0 OZ ro " o " C ~Q~ n " c w C rt n '" .~ e 0 w ro 00 .~ 0 , ~" ~ OW" , rt ~O ~ X O~ " e " , W ~~ . 0 " X "Q rt n . ~ " WW rt " # 0 rt ~ " N " 0 0 ~ , rr ~ w . ~ e ~ 0 0 , 0 ~ N 0 , 0 '00 ~ n o , . o z " ~ ~ o z o " o ~ o ~ " a e ^ , e ~ , a ^ III to:3 H>~ ~ n~ 'lj c., trl to o.CPJI1 ~O~::>:l"""OC::: .,.~&'~ t-'~~~~-~ol>~ NO ro- HQH NO ~zg PJ .-d2~atl~~Lr1Z tv Gl 'O::I: Ul trl - H...] Gl <.oJ Ill't:l trI 'U Cfl H lIlO'\ f-' P ~ ro Z t<J. o-J <.: '" "'l Hrtlli (1 t':]Hlid ~id~gZ;j ~~~~~ 00 tIJ,..." (fJ 0 U'J "Ij '0 0 H otrlOrtCZ ><:trJ.,.Z )> ti 0 l' III n Gl 3t"' v>o M...,...., (lJ OO'o-J'lj t"l::I:H '" ;>;"I]lH>-'i ZVO I'D Ot'l ...,Z rt f-'" Z id :u o ::J' tIl H H :E 'U"JUl ~~ s::;; t""' ::J 0 tJ...... ~ ~ ~ r'- 0. Z (Il >< (II UlG) ::I: ::rUlO QUlV ::r H :>:1>-')<: ~ PI 0 (JJ :>:I trl 0'0 Z :>:I c:: ti III H t'l n >< ;>;" Z '1:1....,0 o (f.l vc::c:: O:J 'U H V ::J trl :<:It"'t"' I-' n t'l 0 f-'::J ., tJ >,j 0 ~~ tl ~~: ti,." :;;: 'I] H >-l ,." 0 H 0 Z 0'1 t""' :<:IQ)> ti l:'" trl t"' .......'1 ::E:t"' LJ.1]l tll :::;:::)> """'0 trl 0 Ul >-l I-'PJ ,,::I: f-'- +-:! ::0:: trl " ~ moo , ~ ;g " ~ o o o " m e , m '0 ro n o e. o , ~ w m o '0 ro " n o , o " w n o o " ::;: ~ ~ o o ~ ro o ~ w " . ~ ! ~ " o " a ~ ww " ~~ ~~ " 00 ^ ^ " . noon 00 '0 .~O "00 o~ """ tal S ~ " " . o"~ ~z ~~~ " " "0, 00 i3i!-i8 ~~I ~. ," n"n 00" ~z~ ~ " ~ ~~ '0" ~ ~~~8t;i~ 'U~ZZZt:l l""'ggJ+-3~Gl zt-< ~"'(J) c: n- Ul .. " o oz t<J. :utD- . . oo<:vvtv ""(T\Ht"'UO I I Z t""' >-3 ty OWnH ~'i'~S;~Pl Of-' >-In- t"' 00- trl ;t> ~~o-J:>:I~~ oo.....,t<l ..... Ot>:lUlNd n' >-'l f-' en o tv tl 0- trl ~~~~NZ 0:>:1 o-J N!Jj " , t'l H_ t""' [IlOt""'O <: 3;:0 Z 0 00 00 0' " n. ". "0 ~. ~ o. ~o o . o .. "' S;~ ~o o^ ~, o ~~ w a a w ~ ~ n ~ ~ ~ '0' ~" 00 zz 00 " "z z~ ~'O '00 on n" "" 00 .z ~" ~~ ox ~o " " " o " " ~ ~ ~ o ~ ^ ~ ~ 00 00 ~ , w W a 0'0 ~~ "Q 00 ^ , ~ ~ , a ^~ I'~ORr~ -'.O~~ tr1iiiit L~ ~ "tij(IC~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT ,BUILDING DIVISION 32] EAST 5TH STREET. PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use property Zoning . . . Application valuation 04-00000204 Date .255436 202 E LAURIDSEN BLVD # 21 06-30-10-5-0-2320-0000- ELECTRICAL ONLY 3/15/04 COMMERCIAL ARTERIAL o Owner Contractor . J K T DEVELOPMENT, 1033 OLD BLYN HWY SEQUIM INC Q ~- ---------------------------------------------------------------------------- ~ Permit ELECTRICAL NEW RESIDENTIAL __~ _~ Additional desc . . FIRE DAMAGE/ 100A PNL+REWIRE ~~ ~ Sub Contractor . . SIMPSON ELECTRIC I Permit Fee . . . . 76.30 Plan Check Fee Issue Date . . .. 3/15/04 Valuation Expiration Date .. 9/11/04 ~ Qty Unit Charge Per ~. 1.00 76.3000 ECH EL-RM-0-200 1ST SRV FEEDER ~Fee summary Charged Paid Credited WA 983827670 SIMPSON ELECTRIC 243036 W HWY 101 PORT ANGELES (360) 457-9270 WA 98363 ,00 o Extension 76.30 Due Permit Fee Total Plan_Check Total Grand Total 76.30 ,00 76.30 76.30 .00 76.30 ,00 ,00 ,00 .00 ,00 .00 ~ "-l '" N ~ 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 periodof 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:\PLANNING\FORMS\1102.15 [I 1/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 4] 7,48] 5 FOR BU]LDlNG ]NSPECT]ONS. CALL 4] 7,4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNOA TION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEP ARA TE PERMIT: 14 ROUGH-IN I I I PLUMBING UNDER FLOOR! SLAB ROUGH-IN WATER LINE (METER TO BLOG) GAS LINE , BACK FLOW I WATER J1 AIR SEAL ~.. .., WALLS I I ... ~ CEILING I I fL FRAMING , JOISTS I GIRDERS SHEAR W ALUHOLD DOWNS '.: WALLS! ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) ~~~ I-BAR k INSULATION - SLAB I I WALL / FLOOR I CEILING I I .. MECHANICAL .. J HEAT PUMP ., GAS LINE I.' WOOD STOVE / PELLET I CHIMNEY .~ HOOD ( DUCTS ~ PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE J METER SEWER CONNECTION SAN!T ARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LiGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 11ft lor ;1-eD ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.! PW! 1/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW ! ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING . J ......, ,. .;r~' :,. ,I ') J' .' "" , ,-. :~ ..... ~~ ~ 't'lf. ~ . J:.. ,- \" J'j ,..... , ,,~.1 ~." . T:\PLANNING\FORMS\II02.15 [11/1412003] oS CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name property Use Property Zoning . . . Application valuation 04-00000204 Date .255436 202 E LAURIDSEN BLVD # 21 06-30-10-5-0-2320-0000- ELECTRICAL ONLY 4/06/04 COMMERCIAL ARTERIAL o Owner Contractor J K T DEVELOPMENT, INC 1033 OLD BLYN HWY SEQUIM WA 983827670 SIMPSON ELECTRIC 243036 W HWY 101 PORT ANGELES (360) 457-9270 WA 98363 Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL BRANCH CIRCUITS EXTRA MILE TECH & ELECT., LLC 76.30 Plan Check Fee 4/06/04 Valuation 10/03/04 .00 o '\J <:) ~~ ~~ ~ t::\ ).~ ~ Z l' ----------------------------------------------- Qty Unit Charge Per 1.00 76.3000 ECH EL-RM-0-200 1ST SRV FEEDER Extension 76.30 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 76.30 76.30 .00 ,00 Plan Check Total .00 .00 ,00 .00 Grand Total 76.30 76.30 .00 .00 ~ ~ \) Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and pubiic 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 10 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 Ihe 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:\PLANNING\FORMS\1102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 417,4815 FOR BUILDING INSPECTIONS. CALL 417,4735 FOR ELECTRICAL 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 I ACCEPTED COMMENTS I YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEP ARA IE PERMIT: # ROUGH-IN I l I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW I WATER AIR SEAL WALLS 1 I CEILING I I FRAMING JOISTS I GIRDERS SHEAR W ALLfHOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERJOR BRACED PANEL ONLY) I-BAR INSULA IION SLAB I I I WALL / FLOOR I CEILING I I I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'s; WATERLINE I METER SEWER CONNECTION SANITARY f7NfIZ 51;:1'1 STORM PLANNING DEPT. SEPARATE PERMIT #', SEPA: ,,""'-' PARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417.4735 "J r/n ~ ELECTRICAL 5iM 0'1 LIGHT DEPT CONSTRUCTION R.W./ PWI , CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417.4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\1102.15 [11/1412003] r 4;:;;'," CITY OF PORT ANGELES. DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A q !t NUMBER . TOIrAL FEE J/,9R CO NT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL QCCUPIl.NCY Site Add~ess L PERMITS ,^:ITH ':"'RO~G AD~.RESSES ARE CANC~lED : Owner Installation By ,[6: c.. -(t....c.. cl Uti I c L Owner's ~.ddress Installers Address DayPhof)e Installers Phone ApplicaHbn is hereby made for Permit to install Electrical Equipment as follows: ~~; O:~4..f~:~~~) M~ ELECTRICAL PERMIT ONLY 1\l fll.lT ~,t-lao.- U'!" ->>7 Wirin.g Met~od .' NUMBER AMP 120V 240V USE OF CIRCUIT" - NUMBER AMP 120V 240V USE bF CIACUIT CIRCUITS . PEA' 10/ 10~AJ FEE CIRCUITS PEA 10 100R FEE CIA 30 ~SF , CIA 30 LIGHT I '~ I (M ~r.., LIGHT . ;"g-OVOLTS OR LESS , CONVE,NIENCE , ~ A~AA -.:.... .. ,eI , '-rJ .....0 , CONVEJ:JIENCE 1: (fI, b/~ I~' ~ ~ /l 1,,.,,..// MOTOR . t7<-0. ... APPLIANcE MOTOR . DI~HW*,SHER FIRE ALARM~ . DISPO~AL BURGLAR ALARM RANGE:; MISC. OVEN .. WATEfl. HEATER LAUNDRY .. 1 DRYER .. . . REINSTALLATION tiGHT FIXTURE # FURNA E .. SUB TOTAL FEE GAS-( IL FURNA E ENERGY FEE ELECT IC .0.- _ .. BASIC FEE ~LECTRIC H.EA T TOTAL FEE. . ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.C. UNiT AMP PHASE: FEEDEll , SIZE OF SERVICE ENTRANCE CONDUCTORS SERVIC~ " . . A.W.G. '1 SUB:TOTAL . . , SIZE OF GROUND SIZE OF ENTRANCE SWITCH ! certify ~ha.t the work to be. performed wider this permit will be done bY. the installer and in conformance with the N.E.C. Electricai Code. . Date Ap~lication made . 19 By - , I;' .' .. .. CONTRACTOR OR OWNER (OR AUTHORIZED AGENT) Pe;'rpiSSion,iS hereby give}] t9 do the ~bove des~ribec;J work, ac.cording to the conditiops hereon and ccording to the approved plans and specific~tions pertaining thereto, subject to compliance with the Ordinances f the City of Port Ales. . " '--/10,,-: 1,;' ,', .,!f By . ECT O~ 'i'T~ LIGHT.... ',' . 1,. Date Permit Issued "VJ";7 ("I PLA A eVED > I i Notify Department of City Llght~by Street Address and Permit Nu~be~ when ready for inspection. Work must not be covered or current turned on b~fore Inspect[onand.o.K. Io! covering or s~rvice has Qeen given by Inspector in i Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158. W~~NING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ WHITE - Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report ^, ",..n,,, ,o\n'.'T"nC" ,.," REPORT OF INSPECTOR , DATE OF VISIT MADE BY REMARKS \ .' , .. .' , . -. " , . . it;', , . ,'. .. .' , . ,. . ", /'" , . . .. i : '. \ , " ., \ ' ' , '-, . .' " J - ./ /I O.K. FOR COVERINGIV' \ :27, fH1 IJ U-' ' , / Nf<;,P IAJJ Ih,-r/o..J. c)~ c (fA. \> O.K. TO CONNECT SERVICE 11>" (.f. '~^ .. , , "/}/ r ....<2..-' ?.r' ,.... / '/ FINAL O.K. -~ , v . z Cl a: <I: :E !!! ::t: I- Z w . l- e z e Q r.e . APR-02-2004 09:38 AM 8 c;'b b' i ;: E.JANSSEN 360 452 2982 P.01 ~,., 'I , i' ELECTRICAL PERMIT APPLICATION F{). 01PICJA.\. USE ONLY D.t....<< ____....__ ~" -'----- D.- "DptO~. ___",-- OtIc Inwd __.______ Tne SfeCrrJCill Permit Appllcalion must b. flllld out t'oma....tv. PI.8". t)fP' 0' I'.P'lnt in ink, r, you h.V8 .ny qU"Uon&, pl..1S1 caU (380) 41'-472' FIX numbor: (310) 417-4711 Own,*, Of Elec. CantrlctoI Agent c3e.c# P"'ll"", Ownor: L ) I n~J..... m~AJI A~a,"'; SMc-&c.J ?(lopd<..~y City: Phone; <(S7-r~;;J Fax: mo..v,tT'~ _Phone: 'f)?- 8S'"'bS- Eiec:1tlc1l1 Conl/aclor: e J( J.... OJ. /III, (, 1<(. It. oS El~ 11<.,(< I Llcons..; Ad~r... : i ~ INSTA/-LATiON WIRED BY: C"di~ C.nI Holder Name: a""n~ AfhI,...: , Cntdit;Canl Numb",.: , . " Zip: Exp: Phon.: DOWNER Clly: ..teLeCTRICAL CONTRACTOR ZIp: C;l 0 :;. 5' C/ty~ Exp. D,'e: t..I&u<..cDsl.-N {j/...VD, 2. D (......~~S ';;0'), luve"!",, sf. D Alteration/Addlllon #- .;;l( _ Zip: vrSA:_ Me: - Pllo.lllch ADDIlIIIII: I~C.'/~ " " TYPE pF WQRK: 'Rea'~entjel o Mulli-tell1l1y Cneck .III! lhel apply: o Cornrnerciel o MObile Horne I':?oo Sq, Fl o Ranldl'. Meier 0 Oetached garage 0 Hot Tut> 0 Swim Pool 0 Seplic Pump Nurnb.,'ol Clrcull$ added or altered:_ , OEIC~IPTION 01' THe ELECTRICAL PROJECT; I: I, ElectrlclIl Heal L.a.d Additions and or Sublractlons . /Vo ~.A'2::/ o e.'8t\9ara _ KW o Fumalce _ KW o Heet "~mp _ TON_ LRA o Fan-Wall _KW I I hereb$2eft"y that' have read and examined tllis application and know thai same to be true and correct, and I am authorl to apply for this permit, I understand it is not the City's legal responsibility to determine whet permits are re Ired; it remains the applicants rssponsibi/ity to determine what permits are reqUired and to obtain Such. :i " /' fl : ! Credit Card Holder'. Slgnalure: z:/~~ (:).A::J~.. I ~ ( c" -;0 q.... Owner ar Elec, CDnt. Signature: C:;;/~O .--r:f!~ ~! - r/, ~((:ct w ( C(..t:c.,,... 011(;1 ~ERMIT FEE: $ 01:::.. a9/c; 1<;' - ~ rc ..J,.,l. l../al<..1 1/91..1' C IElECTIIICALI'ERM,TAPPlICATION ;td() ~~I Cl LOIN Vo/lage 0 Telecom. 0 Sign F",l,,,.u;,o J(... c..J' n.., v-r~................J o J....I 1 #?..I. ~ '1 P 21 c~6'~ Service Infarm.t'on ~7I- D Overhead Service o Tll",p Service ::J Underground Service ~ Vollage: Pha..: 0 1 0 3 SeNlc. Size: Feeder SIze: Date; C y- 2 -Oc( - D.te: dr'-c:'Z. -& 'I ~ rP \~ll'r'~UIi',~~IIC_lI' 111"~I~llJllJl~" , I!I..!ClTFtIOAl peRMIT APPI..ICATION P(I~ n~~I!.'1A I, U81 1 L~I., V ~m"'''1.~: "....".... "....',....."""""""',,,. PlIlmnlJl "'''',''''''.... """'''r'''''''....'''"'n~ l'nUl""'I~wnul"...... , "I,..lV"MI>IT"...."It"". Clilf~.IMlllld'.,._,,,. ...".."""............_ 'rhm al~glrlaml "'Brmlll\ppllnNtlanlll~_~ Pr~~(jfI1\fIllIt III mll'/JIt III Illk. .1 Y'M ftRVuny qll'~II~n'l PIII~m ~$If (3QD. ~1'r"4r~lrn p:,~ nMmlillrl (Mil) 411-4711 (lwnetof iil~n, QAnlr~Glf!r flMmn~,-5.il:XJl).~t!;;;b.,._Ek~,CLs.-._ phonm, .:l.;i..~:J{J: ,.,...~~_~..,. ~ D -,..T; '"11~llm' '7-04<L ~1O~UlirkaQwnQr: I~l ~ntb~, ,""'~fI!I\lf\""_""'Im_"''''M' '",/I"",,,, "f'_~ "~~.M\:IIII't!~ ~" ..... /ff 1\", ...."",,~""''"',.............._.............-..'''''_'''..,''''''''''''."m'''''.'''''T7Il''''~ Alltll'PMI.. .". ,7' (~_..~~,.~i___QIIyI~e~"""~i? A!,/,"-::;;.".._,..,.""."",.,.~~IPI,.<Z~.3'"(,,,k,,..'m. ~ Li, I~' Lt' II ", ilIup' "Mn~' 111Kt:ltrlo'" Qli'nt..~tQr: . . .t.J C ~ ~ - ~ ( r L rJ,lomnlA8 "", <I",_"""~""",,,,""""",~(I\, ' .."",......""."...,......,../1"..., . """~"" "I rm.,~''''"U!lI\liInI. ""'r.-"j..,,,. '"' "....."'_.._~ ~ f J. J 0(/36 Mrlr~a.' "li..{::ln-:lf_ 11,~. I PII": [Jo.e:: ;;!,l;;.L~5.:..~~__.".l,t..{-'q,,,~.......l,ll"...;,:.Q"_,~...,. ' ''''''"'''~~~''''''''''''''''~ . ~Mf'I!I ~l'/I'ilf!lJ";~~1""""",", T INIl'l'A~~1\ TtI'.lN WlI'Imi:lll\v: 1:1 CIWN!lfIl ;111i~mo1'RIQI\~ OONTIIAl:m':lR ,..."...,..."....."J.""~,~,.,.,."...,,_"'II~ Oy'- ,,;Jay _flit Dard Holt/" Namel _M ---...-........"""\_""'".,.-""..,..""""-".,,1"I'..."""""..,',.,..,~.".,,.~""'''''''\1''''"'''''''''" ", ...,.~""."",""""""."",,," """'~"---"""~~"'"''"'"''''''''''''''"~='~''' ,., "... ....,.."","''",.,.;...,..... " ' '"11'" ArJdMaJt __ Q'tu: _..........".""',..."'''''''....''''~.....''''.,..'''...~^"'''''''''''''~'',.,,~.. .;M1J)~~1 ..,,""',"'"'" ... ""_'"","~...". /I~. ' fI' ~,..,I\I'lI'~Iftll"M"".."'.""'IIt~"'.lm__"..''''~ f/; p. """^..........._"'__,~'..... . " QmIlIf "AIWI ..........." .....~ 11....'1___... ......._.__...._."..,..,..."""... ~iI$AI.._. ,,' .IIIICI_...~. ..,., '''IwAw'M/lII"1I', '''''''''-.fl'I'I1m:m'm''''l\\'''''''''''''''~"'''n.''.....''lrff'tfl1'_~_'''' ~""''''' ""M~~ M..._ '".,......,'..".'"'~,~.... , . , !i- ~b5w ' PA0411Cl1' AtlllI'lIl11l9,-?:-f N.~::!~l:.~-..:S~~N!!!:4.:.,...AP2:...~~~.....ltt:zj!.?L" .'_"""m.. lY~ OI1~Qk.mJ.lIMlml~pll1: 2.'fNlloW CrAnlllrllllllln/A<<(I/tllln D I'tlllmldlllnllll y.r MY/ll-fllmlly CJ Ollmmerl.lllll r.:i MIlI:\II$ Hamill Iill,j, Fl_"...._."""..,,,.,,..,,.,,. f,J fI,mllltll MI\IMr 0 OllllllohmCl G^U'tlglll CJ Hill flAb CJ Swim 1~IlQf ~:I $~pllo II'IAmp C'J1.lJw '1(;\II~jl1l11 r.J 'l"m'I1lIlQl'l. I~~I {$lfJ"1 N~mb~r 01 (.)1/'llI,llt$ mdQ~(,f III 1Illolocl: ......_..__..,,_... nIlIllQ!lIIP'fIQN 011 TItIlIllI,IBe"IIII:1A6. r,IPIt:"'fIl(lTI..,_1k:"~~,,.. .. bU.!AUL.".Q..--..jl~mwrzL._...~.",.., ".,.._.".... """"""'-......,..._~_~'Ifll~,"'l1f~,~.""'""..""~"J ,,",,,,,,''''-''II/IIII''''~'''''''''<l'lm',I''n'II'!~lMIlII~'''-'lIl~_'''~'~'''''''''''Il'"-''_''M''''_'''''',,,,,,,,,,,,,,"'~~.","'"'''^'~'''''''~'~'''''"""''''''"' ." """....,.........",. """'~~. ".......""'...........-..-.---. ~ --.--.-.-"'...... - "",,.,""""""''",~.,'"....,,,~,...,,.,,,..",,."..,."'"'''''''n.'"'''"'''''''l',..~.....,, "" "'''''''''l?ImnlT''M .......,"-'"".,...,.."...."'-'....m'"''''''''',....''..,....,......"",..._."....ot,''''' ,,,'",,,,,.. .,.".m",,"'"''""''''' lI.rtAlt,.l:1~II.lB.ll11 tvr/' \J, tjjlff"l!jllflU(lWIJ!.~fill!!IlI.1 Q li\a~,l)l,lml(! CI ~~rnIlUIl 1::1 Helll PMmp r.:JfI~n'WIl\II ",.._IQAt ...".,~.....t(W -I'(W -...I<W r.:IOv@r1II,lQ!:l @\IlRlIO@ [;;J T@mp IilmR/lrle eJ ilnrJarlll'llMflrJ amMoe . ~4ov IIOIW.. Q@. ~~"."""''''..'''"'. r"f'l~~Il: C<t 1 1:1 lil 1I/11M<<9~ (fM~,;" ,.1go.:&, I"/II~CII~I' l1'~~:....:~L~""fIL-. ~:Q~;'4bll/fj,~~O(1I): i"or Inl:II,lmtllfill. ~ICmlmI\lI'lMm~ ilMl,llrJml1llml pM}Il~tm Imlgelll1M I.l ii1!lpl@X, Iil ~/1" . /1/1@(,jl'/IIWlnfjl,lt ll't* f'l@g~rIWill illll'" 1I~1~ &, "IA.trl~' '" MI ",lIg al~. (Ilq. ~.), lulilti fJllIlOMlfilllQlla, /lnd tIllll tV~01l 01 Ql.lnOOiOlol!r@Mdlllf Ill1Q@mllllvle r~qMlrul() I""N ~hml/ ~OOlil\'l~1I11ny Ihl IN~. om dollmll M/!PlI!lOllml\, I "''''''JlflSrtlfjl "lilt I MV(/I f'f/(MJ ana _mlnfJt1 tllf$lPPU(,J8tfP1l mn{/ knew film! /fJ.Qm(!) Ii:) tli!l flim timl! Ol;llmo~ f!, 111;. 'i Imfi'l :~tI:/~~ tQ lWIiy for IhM p~rrnh. IlJl'lri$fl!JttJnd It I' not tM OW's '1JfI" r~lipcmsltJlllfJ! (0 11elllJI"ffllllIfJ wlltIJt pmnt~' l'/I.l IYIa; It mtrMllnP! ti1i$ (iJ'lPI/Qlfintlil /WIRPOf/BI"'IIh)l m ~term'n(l wh~t ,f.M9rml/1i9 811~ IWlql,lif'$rl nmd '.;I (,)/,/tIfIln I/I~ ~II. 711<4 _...._-"'~~-_.._- W (~v'm,,~' (W ~!Il~. .a"r1~. 61"1l1ll~lfMI ~ ;.._~ ,,~.,.,,;;: / / / 1:J L? . . .Q01Q Iff - (Va ~~I~'~~ .. '1J .~t-:'f.....fJ1H,'..":;:.'a..'[.__:;:.-;t ':,{,::--rfy /lr!O 3ft, / 0<( ~jL 1 CITY OF PORT ANGELES PERMIT APPLICATION Building Division /Electrical Inspections - 321 East Fifth Street -- P.O. Box 1150 / Port Angeles Washington, 95362 Ph: (360) 417 -4735 Fax: (360) 417 -4711 AUG .4 Date; - 6i w.. s * Plan Review May Be Required, P Job Address: A'K°- ---r Building Square Footage: Description _U. ove — Complete Electrical Plan Review Information Sheet Owner Information Zi /U010/4) . S:`60A)?e- Ar Name: ' Mailing Address: City: D A state Zip: C/ ty K41 Phone, , Fax, License # / Exo. Item Servico /Feedor 200 Amp. Service /Feeder 201 -400 Amp. Service /Feeder 401 -600 Amp Service /Feeder 601 -1000 Amp. Service/Feeder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W10 Service Feeder Each Additional Branch Circult Branch Circuits 1-4 Temp. Service/ Feeder 200 Amp. Temp. Service/Feeder 201.400 Amp. Temp. Service/Feeder 401 -600 Amp. Temp. ServicelFeeder 601 -1000 Amp Portal to Portal dourly Signal Cfrcuitl Limited Energy -1 & 2 Family Dwelling Manufactured Home Connection Renewable Electrical Energy - 6KVA System or Less Thermostat Note: $5.00 for each additional T -Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. Each Additional 500 Square Ft, or Portion of Each Outbulldfng or Detached Garage Each Swimming Pool or Hot Tub Unit Charge $120.0 Iv000 $ 205.00 $ 262.00 $ 373,00 $ 5,00 $ 63.00 $ 5.00 $ 75.00 $ 93,00 $110.00 $149.00 $ 168,00 $ 96,00 $ 64,00 $120.00 $102.00 $ 56.00 $120.00 $ 40.00 $ 74,00 $ 110.00 $ $ $ $ $ $ A> Total Owner as defined by RCW.19,28.261; (1) owner will occupy the structure for two years after this electrical permit is finalized, (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or a €teration in compliance with the electrical laws, N.E,C., RCW, Chapter 19.28, WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14,05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: ❑ cash ❑ check LZ Credit Card # X Dated: (} J � 40112012 1 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 -417 -4735 Application Number . . . . . 13- 00000897 bate 6/09/13 Application pin number . . . 240792 Property Address , . , . . .. 202 E LAURID.SEN BLVD ASSESSOR PARCEL NUMBER: 06-30-10-5-0- 2320 -0000- Application type description ELECTRICAL ONLY Subdivision Name , . . . . . Property Use Property Zoning . . , . . . , COMMERCIAL OFFICE Application 'valuation . . . . 0 Application desc 400 amp meter replacement. Owner Contractor VINCENT, TTE DARREL BOTERO & SON ELL CTRICAL 711 E FRONT ST 940 TAMARACK WAY PORT ANGELES WA 983623610 PORT ANGELES WA 9.8362 (360) 452 -4766, Permit , , . . . , ELECTRICAL ALTER COMMERCIAL Additional desc . , Permit Fee . . , . 160.00 Plan. Check Fee .00 Issue Date . . . 8/09/13 Valuation . . . 0 Expiration Date . 2/05/14 Qty Unit Charge Per Extension 1.00 160.0000 ECH EL -COM 201 -400 SRV FEEDER 160.00 Fee summary Charged Paid Credited Due Permit .Fee Total 160.00 160.00 .00 .00 Flan Check Total .00 00 .00 .e0 Grand Total 160.00 160.00 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contra_ ctor X. GAIEXCHANGE\BUILDING Date: ..0 N C) N FMI