HomeMy WebLinkAbout1125 W 8th St - BuildingCITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 08 00001505 Date 12/05/08
Application pin number 183250
Property Address 1125 W 8TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 2 4256 0000
Tenant nbr name ADAM J /NICHOLE JOHNSON
Application type description RE ROOF
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 2940
Application desc
TEAR OFF RE ROOF
Owner Contractor
ADAM J /NICHOLE JOHNSON TOPNOTCH ROOFING GUTTER
1125 W 8TH ST 1235 W 9TH
PORT ANGELES WA 98363 PORT ANGELES WA 98362
(360) 457 0066
Structure Information 000 000 TEAR OFF RE ROOF
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF RE ROOF
r Permit pin number 138727
Permit Fee 109 75 Plan Check Fee 00
Issue Date 12/05/08 Valuation 2940
Expiration Date 6/03/09
Qty Unit Charge Per Extension
BASE FEE 95 75
1 00 14 0000 THOU BL -2001 25K (14 PER K) 14 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 109 75 109 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 114 25 114 25 00 00
-c) l c,-a-i
Date Print Name Signature of Contractor or Authorized Agent
T:FormsBuilding DivisionBuilding Permit
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.
Signature of Owner (if Amer is builder)
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls
Ceiling
FRAMING
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting ESA.
Landscaping SHORELINE.
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
7-21:_o 9
T.Forms /Building Division /Building Permit G..�
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 -7 ,4c..
Property Owner ,Tr, ti N
Property Owner's Address ,97,49 e ,00, '2I ID kc
Contractor /Engineer ells j,, ,r, a R. obis)
Contractor /Engineer's Address )2..11 s' b
License #17 plot i 6 (14 y n4.Expires Y 4-„2
PROJECT ADDRESS i v t 'F
Parcel Number
Floor Areas Existing (sq. ft.) P (sq. ft.)
Basement
1 Floor
2 Floor
3` Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures 14 4 sq. ft. T 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
APPLICATION Print in ink
Project Type Brief Description. )(Residential Commercial Multi family
Check all that apply
New Construction
Addition
Remodel
Repair
Re -roof
Demolition
Heat System
Other
Heat pump wood- burning stove gas fireplace pellet stove other
For City Use Only
Date Received 12 -OB
Permit O- I-5
Date Approved
Phone E-) i-7-41 4 in
Phon 3 2
L JA `z 31
Phone t j --add
A—
ds E -mail
Lot Zoning
Industrial
0 -'0 ".Ett A .eg V A a.rvr 14---
per sq. ft.
TOTAL VALUATION 14e,
sq. ft. Lot coverage
of bedrooms
of full baths
of half baths
I have read and completed this application and know it 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, and to obtain permits prior to working on
projects.
Date A% '20 ir Print Name r` I 1.4 t Signature(s
OA
12/3/08
Company signature ,7
topnotchroofing@qwestoffice.net
TOPNORG994DA EXPIRATION DATE: 5/18/10
Date lZ
Bid prices are subject to reasonable increases due to any necessary alterations, additions, increases in material and /or
labor to complete work. Homeowner will be notified of any necessary changes, which may affect cost.
Property owners are responsible for obtaining any permits required for work and materials described herein. TOPNOTCH is happy to provide
permit, but will add the cost to the final bill.
Bid prices are applicable for 30 days* from date below, unless otherwise stated or agreed to. Please feel welcome to call if you
have questions concerning this estimate /bid If bid is accepted, please sign one copy and return it to TOPNOTCH ROOFING GUTTER,
at the address above Work is scheduled upon receipt of sinned bid. Verbal agreements will not guarantee scheduled work.
References are available!
ESTIMATE AND BID PROPOSAL CONTRACT
TO Adam Johnson, P 0 Box 1521 Forks WA 98331 374 2590
FOR: Re -roof 1125 W 8th St Port Angeles, WA 98363 Kami Reader 457 8581 or. 565 1353
Much of this composition roof is cracked and very brittle The roof is leaking In several areas
9 up' and disposal. j (p ad sec;
Tear off-existing 3 tab roofing Clean u included lease abe ndvl
First lof the ,year, the City. of PA IS raising the price xat th landfill :which will Increase
Fees for any contract work done Iry ;2009) Roof ,with sq 30' year laminated, arch
composition over 30# felt Install Elk starter course, 58' of ridge cap, 6 AF50. vents *441N valley
90' Drip edge metal, remove old chimney plug hole, roof over, 1 -4" neo 1 -1'. '5" 'neo ;neo,
f
Flat roof can be cleaned and torch down application will be applied over the existing�ffat�;roo; ,mate. rial
Estimated cost of tear off, Hauling and landfill disposal, re -roof using the, materials specified 'herein,
labor to complete work as described, and sales tax
Pius City of Port Angeles Building permit required
Tenant Kambra Reader will supply materials as stated on attached order, using her employee
Discount
Topnotch will provide the labor
$2940 00
246.96 rN(
$3186 96
$5050 23 Total plus building permit
Authorized party to accept bid
Material estimate
$1718 88
144.39
$1863 27
Date
MATERIAL WARRANTY BY MANUFACTURER, W RK ANSHIP GUARANTEED BY LICENSED, BONDED, INSURED CONTRACTOR
Workmanship warranty does not cover alterations, lack of maintenance, or improper maintenance, etc.
PAYMENT TERMS: ONE HALF TO START WORK. BALANCE DUE IN FULL WHEN WORK IS COMPLETED ALTERNATIVE PAYMENT ARRANGEMENTS
MUST BE DISCUSSED AND AGREED TO PRIOR TO THE START OF THE ]OB
fPOA'T~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Appl~cat~on Number
Appl~cat~on pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zon~ng . . .
Appl~cat~on valuation
06-00000224 Date
204416
1125 W 8TH ST
06-30-00-0-2-4256-0000-
JOHNSON RESIDENCE
MECHANICAL PERMIT
3/08/06
Lasered
CEO
RS7 RESDNTL SINGLE FAMILY
5035
Owner
Contractor
JOHNSON ADAM / NICHOLE
1125 W. 8TH STREET
PORT ANGELES WA 98363
DAVE'S HEATING & COOLING
PO BOX 413
PORT ANGELES WA 98363
(360) 452-0939
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 72322
Permit Fee 36.40 Plan Check Fee
Issue Date 3/08/06 Valuation
Expiration Date 9/04/06
.00
o
Qty Unit Charge Per
1.00 36.4000 ECH EL-LVT-FIRST THERMOSTAT
Extens~on
36.40
pemit MECHANICAL PERMIT
Additional desc
Permit p~n number 72314
Permit Fee 64.70 Plan Check Fee .00
Issue Date 3/08/06 Valuation 0
Expirat~on Date 9/04/06
Qty Unit Charge Per Extension
BASE FEE 50.00
1. 00 14.7000 ECH ME- INSTALL 100- FAU 14.70
Fee summary Charged Pa~d Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 101.10 101.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 101.10 101.10 .00 .00
;t,
0;;> ~
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K:'
Separate Permits are required for electrical work, SEP A, 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 ordina[ns governing this type of ,vIork will be complied with whether specified herein or not. The granting of a permit does not
pres ~ to give uthority to violate or cancel the provisions of any state or local law regulating construction or the performance of
co truction. /
,. I . ~ /cJ6
Signature of Owner (if owner is builder)
Date
T.\Pohcles\1102_15 bulldmgpemllt inspectIOn record05.wpd [1/412005]
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.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I 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 I I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I I
MECHANICAL ~.. 7[ll,{{j(p <[~
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
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
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T:\Poltcles\1102_15 bwldmg peroni mspechon record05 wpd [114/2005]
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL OrvlSION
~21 EAST STH STREET. PORT ANGELES. WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr, name
Application type description
Subdivis~on Name
Property Use
Property Zoning
Appl~cation valuation
06-00000224 Date
204416
1125 W 8TH ST
06-30-00-0-2-4256-0000-
JOHNSON RESIDENCE
MECHANICAL PERMIT
3/10106
RS7 RESDNTL SINGLE FAMILY
5035
Owner
Contractor
JOHNSON ADAM 1 NICHOLE
1125 W. 8TH STREET
PORT ANGELES WA 98363
DAVE'S HEATING & COOLING
PO BOX 413
PORT ANGELES WA 98363
(360) 452-0939
Permit
Additional desc
Permit p~n number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
EXTRAI FURNACE AND HP
72546
EXTRA MILE
48.10
3/10106
9106/06
TECH & ELECT , LLC
Plan Check Fee
Valuation
.00
o
'-...
""'-
~~
~ V\.
~ t
,
Qty Unit Charge Per
1 00 48 1000 ECH EL-R OR RM 1-4 ALT CIRCUITS
Extension
48.10
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 48.10 48 10 .00 00
Plan Check Total .00 .00 .00 00
Grand Total 48 10 48 10 .00 00
\ 'it
\
COMMENTS/ACTION NEEDED
ELECfRICAL PERMIT INSPECfION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr IS UNLA WFUL TO COVER,
INSULATE 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 I NO
IlITCH
II II II -rH_IN I COVER
......K v II ....
"TN AT 13-IO".n~ hJJI
GENERAL COMMENTS:
PW.II02.1~ (4'96)
PREPARED 3/13/06, 13 53,43
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
8
3/13/06
ADDRESS
TENANT, NBR,
CONTRACTOR
OWNER
PARCEL . .
APPL NUMBER
1125 W 8TH ST
JOHNSON RESIDENCE
DAVE'S HEATING & COOLING
JOHNSON ADAM / NICHOLE
06-30-00-0-2-4256-0000-
06-00000224 MECHANICAL PERMIT
SUBDIV'
PHONE
PHONE
(360) 452-0939
PERMIT, ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
ME1 01~/13/ 6 JLL MECHANICAL ROUGH-IN TIME. 13 00
~ ~~ ~ ~i~~O~~~~~ @1~~~=30~ T~Y~;~~H;~~~~-~~~-~~~~~-~~~~-~;;~
-------- ---- ------------------------ COMMENTS AND NOTES --------------------------------------
f
Mar 07 06 09'57a
DAVE'S HEATING & COOLING
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for re,,'iew. UyaD have any questions, call
PERMITS (360) 417-4815 FAX(360)417-471l
Applicant or Agent: .j) C-l. v-e..- t s -K -€.~ -t..' V'\. 't"
Phone:
4-f5;;)-OQ3 ery
~ 17 -5L.( d.. ()
ZIp: q?3~"2>
Owner: A d &l. VY\. <f- IV I 'c... h 0 I-e... SO h V\. s 0 \"'\ Phone:
Address: / I :2 5 CUe 5-1 S?-tk S-iret:tCity: /bv..f- An ~
ArchitectlEngineer: '. Phone:
'D4-Vc=.~rlcf791 kG . /
Contractor Dt?II~,).s l1-e.a.A-r'Y\{j StateLicense #:.DAoe:;;.sKC?, Exp: 5/0'7
1~c.... .
Address: p.o. "tox: 7/13 City: ~V+~jQ,l9..s
PROJECT ADDRESS: 11;;Z5 CJe5-t ~-!:6. 5+re-e-r-
LEGAL DESCRlPTION: Lot: Block: SubdIvisIOn:
CLALLA1V1 COUNTY PARCEL NUMBER:
Phone: ~5~.o'13'1
Z q J2-6~
Ip.
ZONING:
Credit Card Holder Name:
Billing Address: City:
Credit Card Type VISA MC # Exp. Date:
T\'YE OF WORK: SlZENALUATION:
~Residentia1 0 New Constr. 0 Re-roof 0 Stove SF. @ $ ISF. = $
o Multi-family 0 AdditIon 0 Move 0 Garage SF. @ $ ISF. = $
o Commercial 0 Remodel 0 Demob.tion 0 Deck SF. @ $ ISF. = $
o Repair 0 Sign 0 Other TOTAL VALUATION $..5, 03S5U
BRIEF DESCRIPTION OF THE PROJECT: -::r I'i. s+=...Ua..:::h '0",- DR- -e..k~l c.., fu cr~o.. <=-~ ~V\ A,
~ pv..--. f -to l""ef> 10. <:..S2.... 0 (' \ .fu lI"'V'Q.. C5L,. ,A/'J .D I 0 <.LJ (/0 I Tel. ~~ +-5+0-* c..u r .....~
COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type:
No. of Stories: _ Lot Size: Existing Sq. Ft. & Proposed Sq. Ft. = TOTAL Sq. Ft.
Total lot coverage %
APPROVALS:
PLA...1\J :
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESA.lWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other.
VALVA TION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revlSed by the Building Division to comply with current fee schedules Contact the Permit CoordmatoI at 417 -4815 for aSSistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tIme the bUlldmg pemnt application and constructlon plans are
submitted. All other penmt fees are due at the time of permit issuance.
EXPlRt\.TION OF PLAN REVIEW: Ifno permit is Issued within 180 days oftbe date of application, the application will expire. The
Building OffiCial can extend the 11me for action by the apphcant up to 180 days upon written request by the applicant (see Section RI05.3.2
of the International Bu1.ldinglResidential Code, 2003). No appb.cation can be extended more than once.
I hereby certify that I have read and exammed this appfication and know the same to be true and correct. , am a4ihorized to apply for this permit and
understand that if IS my responsibility to determine what permits are reqUIred ,not the Cify's, and that J must obtain such permits pnor to work.
T.IRVESSIBLDG-f_.b",dwre,\2004-Bm~""'~"wpd Appli,"": ~ D,"': 2/( /Ok,
010 A-
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A~
PERMIT NUMBER
FEE RECEIPT NUMBER
.
~6. "". , {/?C,)J.j.n, / ( !loMe
TOTAL FEE ~
CONT. Lie. NO. TIMETO COMPLETE NO. STORIES LEGAL OCCUPANCY
Owner
Owner's Address
Day Phone
Application is he
Installation By
Installers Address
...... Installers Phone
by made for Permit to install Electrical Equipment as
. . r-
.~~ -'1[.' ,~,
-~p
I
'.
W.,iring Method
.\;.
'~;YJ
1',"
USE OF CIRCUIT
NUMBER
CIRCUITS
AMP
PER
'CIA
/" 120V
10
. 240V
100R
3'0
FEE.
,
.' , AMP :" ~M'O": " ,
'USE OF CIRCUIT NUMBER PER 120V 100R FEE
. CIRCUFfS CIR \!Zl '.::a0
..
SIGN ,
50 VOLTS
OR LESS
MOTOR
MOTOR ...~
MOTOI' [: '....', ,>' ,1 ,.' :~~ f~;i ","""
.. , ,< , ,
FIRE ALARMS
BURGLAR ALARM
LIGHT
LIGHT
CONVENIENCE
CONVENIENCE
APPLIANCE
DISHWASHER
DISPOSAL
.
. RANGE
OVEN
WATER HEATER
LAUNDRY
..
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.
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MISC.
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:' ; ~:~ ,,'f 'i !t1~':':' -~ ~!j i ';
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DRYER
FURNACE
GAS - 01l
FURNACE
ELECTRIC
ELECTRIC HEAT
(,[,:"" '.'.'77 r"p
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11';H":'if 0 AEINStIiLCAflbN,L10AT:f)x1v~E.ji..;,::- "';'"", './<, ; .
A.C. UNIT
FEEDER
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TOTAL FEE " '.,'.',,,, ;.( ..-,.,....0'-y.,'o-o
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SIZE OF SERVICE SWITCft OR CIRCUIT BREAKER
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ELECTRIC HEAT
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T SUB,TOTAL
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AMP
SIZE OF SERVICE ENTRANCE CONDUCTORS
PHASE
SIZEOF.;MP\lJo ,
"", PeW.O;
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I certify that the work to be performed under this permit will be done ~y th~.:i~stall~r an~~.in,conf<?rm~!lce ~it.h th~..'~-:~ft~~lectrical Code.
Q-'; 'f;r" ".........,..~-',,:'.::.-;'- "',,
Date Application made L I 7 ,19' , By
," ,n .).~ 'i _;':~'- CO~,;~~C~OPl'q~:'~~N.ER}?~.A:~SH,6~,~~~ ~~;~T}
Permission is hereby given to do the above described work, according ~o tt:fEfconditions hereo'n 'and'ac;tfdrpin~dd 'h~ea:~prOVed'plans and
specifications pertaining thereto, subject to compliance with the Ordinances'of the City'of Port Angel'es. . .," . .11 , ,.,_1.. q
',', ",~'!:l' Eel }J~~,_ IT'.H,G~i~
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Date Permit Issued .' ~lANSAfi OVED ,'"I;', .> '~_'- .,.,;~:",""
q - 17"- r S Notify Department of City Light by Stre~t Address and Permit Number whe~ ready fo; inspection. Work must not
/ be covered or current turned on before inspection and O.K. for covering or service has been given b~ Inspector in
I Writing on Perm I! Placar~: ~A: ..Permit~..fh?n€!: 4.5?-O~.11 .E~t 158., ,~. ; t j J It./11r >', \
WARNING - ;' PERMIf PLACAR1J'MUST BE" KEPT pOSTED 6~':fH~;rl"IK'- SEE~ OV~R _ ': ilr~'~;>:, ;i'"<> ;?;
WHITE. Original CANARY. Duplicate PINK. Trfpllcaie' . . W;:;ITE CAAO' .ilns~~ctor'S Repo;t ;; f
OLYMPIC PRINTERS. INC.
.~~~ :. ~, i-j t ~;.; '.:,
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1,._ , .' ". _ _, J
DATE OF VISIT
MADE BY
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REPORT OF INSPECTOR
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REMARKS
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O.K. FOR COVERING '.
O.K. TO ~~N,NECT SERVICE
FINAL O.K. }
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MAR-09-2006 10:00 AM
E.JANSSEN
360 452 2982
P. 01 I
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.. EI~ctrlcal Contractor
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o Owner ~'t'~o.o:?
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ELECTRICAL WORK PERMIT APPLICATION
o Request Inspection
o Annuli Permit CJ AllIrm CJ CurniV81J 0 Commercial . Re!lldcltlJal a RCfl;ldcntlal Molnl. I;J Slgnl CJ Thermoltllt 0 Telecom.
JUb ",ired by
)lI Electrtc,,1 Contructor CJ Owner
Instilllurlon description
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Licen5e numher
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Purc lIer'lS mailinll 81ldrels
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Tl!ll.'l)honc nUmhl.'f FAX number
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I hereby certify thlll l:!Im the ownl'r or the above III.llm:d prnpct'ry or <.I Ijccm~'d
c1eClr~cnl contraclor (lIr thc firrn's authorizcd agenr) .mcl am. makinf. th\' (:leclrh::al
inslllol!Hlion or alteration in cOl'l1plit\lIce with the ckclric.:lllaw. Chaprer 19.28 RCW.
U Credit r;urd
Visa
Mastercard
Discover
C~ff________________
owner, etoctrlcal enUfraNl)r or electrical :lIllt1inistrator
Expiration Date
of card
x
WALLS
Insul/Jlion Only
n:II.JNG
lm\ll~lin1' Only
Tllr;:\{MOSTAT
D~l~ ^F\I'I"\HII l\y
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, SERVICE
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FUDER
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~81 Load Addlllone_and or sublracllon.~
D NO:LOAD CHANGES
a Be.,board KW
D Fur~ac. l~lJN
IJ HeM Pump ~on __.. LAR
D Fan,Wall KW
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Service Information
r.:J Overhead Smvlce
Cl Temp Service
CJ Underground Service
VOllage
Ph... D 1 D 3
Service SIze: _
Feeder Slze:
1!1IlJlCClion
. Dote
Arc:a, B\!ildinp, or Equipmenllnspccled
AClinn Token
F.leclriclll
InspectOr
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