HomeMy WebLinkAbout132 W 4th St - Building
.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
PERMIT NO. q 7 ?b
7/i/P1
DATE
Site Address:
;;<l: READY FOR
f . INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Installed By:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
ELECTRIC HEAT
o BASEBOARD KW _
o FURNACE KW _
o HEAT PUMP KW_
o FAN/WALL KW _
o RESIDENTIAL
o COMMERCIAL
o NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
~ SERVICE UPGRADE/REPAIR
o TEMPORARY SERVICE
o RISER
2 OVERHEAD SERVICE
o UNDERGROUN.%EBl(ICE
VOLTAGE: /2& 2--'/(/
. ,
~1l1S D3f1\
SERVICE SIZE ~ AMPS
FEEDER SIZE AMPS
Details/Description:
(2~-i:5 L-
vVLt1-5f.
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
o Rough-in/cover O.K.
--1~ O.K. to connect service
o Final O.K.
Site Address:
I.J~ W,
Installer: New Meters
--
.
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the Building Permit. PHONE 457-0411, EXT. 224. "q.
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ ~ c:>L ()
~nspeclo' Perm;1 Fee
WHITE - File by address
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept., Bottom: City Hall
OLYMPIC PRINTERS INC.
582..
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
t /P!MIT NUMBER
.
TOTAL FEE
Jb~
[s,
Q. STORIES
LEGAL OCCUPANCY
Site Address
ELECTRICAL PERMIT ONLY
f711
IS RESPONSIBILITY OF APPLICANT
NO OCCUPANCY OA USE ESTABLISHED UNDER THIS PERMIT
Owner '7t
Owner's Address
PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Inst~'lation By ;&: (. (c f-tt, c. S; to It U Ice
Installers Address
Installers Phone
Day Phone
,
Application is hereby made for Permit to install Electrical Equipment as follows:
flU rk{( J/[t../. M -ftAib. 0 i~w
21-0 V,
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5"Zl
AM'"
.
I:"t. '-A-Ic 1/l...-
Wiring Method
.
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PEA. 10 100R FEE USE OF CIRCUIT CIRCUITS PER 10 ,00R FEE
~IR 30 CIR 30
LIGHT SIGN
LIGHT 50 VOLTS
OR LESS
CONVENIENCE MOTOR
CONVENIENCE MOTOR
APPLIANCE MOTOR
DISHWASHER FIRE ALARMS
DISPOSAL BURGLAR ALARM
RANGE MISC.
OVEN
WATER HEATER
LAUNDRY " '- -
DRYER '-10/ jut REINSTALLATION LIGHT FIXTURE #
FURNACE / ~ J SUB TOTAL FEE
GAS. OIL
FURNACE IP;- ENERGY FEE
ELECTRIC BASIC FEE
ELECTRIC HEAT /2-. '/Z< 0
TOTAL FEE
ELECTRIC HEAT " ,. SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT 'If-b v AMP PHASE
FEEDER 52 , /J ~ 1!f4[ : ~ SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE A.W.G.
I SUB. TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
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.
Date Application made ,19 By )(
/ CONTRACTOR OR OWNER (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, subject to compliance with the Ordinances of the ity of Port Angeles.
~T OF. I
. ~"~'m" "~ro t:!..,::." "" "'" . ",,!~:.:.::. :',m" "om~' ~'" ~'" "","~"" W~ mo" "m
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.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
WARNING
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
OLYMPIC PRINTERS, INC.
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
,
I I ,
0
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5i/tt/,Pi AIr FINAL O.K.
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CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N~
17851
/ - /61-.. F3
Port Angeles, Washlngtonm..m..m......._........m..mm.m...m....m...., 19..moo.
In accordance with the City Ordinance to regulate the Installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to d~ctrical work as listed below.
Address ooooL2...;J,oo__~---2'1--.~m--mm.moo.oom---m-m--mhh--. Occupancy__oo__~1.R''"''a___~__m.______hhhm.oo
Owner r:';;!:;,.<!.~.m__~~m.m.m__oo____oommm Tenant___m__m.mmm_.m__.m_hmh.h.____oo__._________mm____
Wiring ~ontracto~ .Jif".~~.~""-----tlf~~~dr.--. By_____oommm.moommmmm____m._______mm__oom__.oo
Light Outlets___...n_m.m_n..._................... Service, volts ......n.mmn..._n....._.......... Type ot Wiring:
Receptacle Outlets_m.__t..Q............... No. wires .....................mm.._..._...._ Armored Cable ..._._..m..m..d_._h____.
Dryer, KW __nnnU...h.....Uh..n.___.__n_____
Range, KW m_m_hnm_hn_
Water Heater;
SIze wIres...n........n...nnnn.n_..n._..
Main fuse 00___000000._.._.......................
Enclosure ................mm_.mm.__
Heat~:~:::::_-_p~:;;;:l;;;y
Type of wirIng;
Entrance Cable _mm..mmmn.
Motors: size, volts and phase:
Rigid Conduit
, --."'"
JZ2f:.JZ~::::::::::::::::::::::::::::
Metallic Tubing nm__...........__.......
Current transformers:
No. & Size...................nn____.n
Ser. NO.....n..n......n_nn............_.........
Ser. No. n.._..n_____.................nn...nn...
Ser. NO........_._..__...............n..nn..._n...
Non.Metallic ..........................._.....
Knob & Tubennmmm.m_m.nnmm..
Rigid Conduit n_nn.mnmnn.___mnn
Metallic Tubing _mnm__m_mmm.__
Raceway .....................n...............n~
Circuits, Light.m...____mn.m___.m___.__._.h_
Utility ..m_nnmmmnnnnnnnnnnmm
Ifeat .._..____._........................._..........
Range ._..___.___________________._____________n__
Water Heater ..m____mm..mm..m.._
Motor .............00..............................
Dryer _________.________........___.___.......__......_
Furnace .........u.......u......~....n._n.._m___
Total Loadnn_..n...._n............. Ser. No. ................._00__0000...__.__.._....... Total .............n_....hn.........n..n
Remarks: n_n___n_u_t1!u_tf!._~f.;::Z~:.-::t?::.._':::n______.__nn_.n..nnnu___n____u__._._n_nnnnn_nn.___dh...__n_nnnnuuunnnuu
_.____.________n__________...___unnn________._.___n_._______.._____________________._u_.__n_________________._____n_____n_____._____..______________.________._.._____
Permit Fee
Treas. Receipt
...UU.h___________nn.uu_un...nhhnn_~n_n_u_nuU_nn_nn_.__nn_n_____UU______n___nnn_u_n..___.....nh__nn.'UU_n_n__n_nnu.unn.n_un
$_m__....m____..oo....m.m__m.
No.............._____________.
By .::.:'~~~::.ll.!:.(..A.1.~?~..~".~
I .
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N~ 1 785 1
Address.___._..___.____..._...._..............._._...___..____.....___.._..._.............._n.___._...........................____._.___.....Date..._.........._____.___..____.._......_......_.....__._
Owner ........__nnnnnn__.._._._......_........._..u.........._.._.....nnun..............._nn__..n..n_n.__...n...n Tenant......n_nn_nn_...........__....n._n_._._............nn.__..
Wiring Contractor ........................._______..._..............._._...____..___..________.._..__..._._........._._________..__._.___.. By .___................____.__...._._................._.._...__..
NOTICE-Current must not be turned on until Certiflcate of Inspection has been issued. If work is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
1M Olympic Printers. Inc.
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
'""t'.t'-'-..................vu UUJlUJO::.L
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
property Zoning . . .
Application valuation
U~-U0000799 Date
132 W 4TH ST
06-30-00-0-0-8825-0000-
MECHANICAL PERMIT
8/18/03
6375
Owner
Contractor
HURD LARRY W
132 W 4TH ST
PORT ANGELES
WA 983622806
PENINSULA HEAT
502 W. 8TH ST.
PORT ANGELES
(360) 457-2775
WA 98362
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
35.30
8/18/03
2/15/04
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
1.00 35.3000 Ee EL-LOW VOLTAGE
Extension
35.30
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
HEAT PUMP
61.70 Plan Check Fee
B/18/03 Valuation
2/15/04
.00
o
~
Qty Unit Charge Per
Extension
47.00
14.70
oj
'P
BASE FEE
1.00 14.7000 ECH ME- INSTALL 100- FAU
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ----------
Permit Fee Total 97.00 97.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 97.00 97.00 .00 .00
~
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:;t.
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.
OAJ F/[c-
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNJNG\FORMS\ 11 02.15 [412002]
BillLDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: 'II
ROUGH.JN I I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS I I
CEILING I I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
I-BAR
INSULATION
SLAB I I I
WALL / FLOOR I CEILING I I I
MECHANICAL
HEAT PUMP
WOOD STOVE I PELLET / CHIMNEY
HOOD I DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #',:
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARA IE PERMIT N's SEPA:
PARKINGfLlGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRJOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL. LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R,W./ PW/ CONSTRUCTION ~ R. w.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417.4653 FIRE DEPT.
PLA'\'.TNING DEPT. 417-4750 PLANNING DEPT.
BU1LDING 417-4815 Q";"~2~ I.L BUILDING
o!"'IRJ~
(i
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY,
Da'" Rec., 'd. -/5-03
Penni,", 7QCj-
Date Approved:
I";
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Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
Date Issued:
ApplicantorAgent: t!.1ar/ofk k?/erSP>-1 Phone:
Owner: L1. r r.1J HI/I 10"1 Phone:
Address: J '3 a,' hi 4-.) }, City: a rr- A:J P // 5
ArchitectJEngineer: Phone:
Contractoryen 'O'\.SlIJ tl W IiL State License ~IJ JJlJhH (IU~
Address: 503-.. fA) 8& City: fbrhcfnaN5
PROJECT ADDRESS: /77""?l, ttl. ':T-i.!!. v
-
~"5 7- ,;177<;-
4/7-03h.:J.
Zip: q?<3~:A
Phone: 'f.57-;;J77.s-
Zip: q 2f3h:2.
ZONING:
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Subdivision:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA Me
'TYPj: OF WORK:
~esidential 0 New Constr. 0 Re-roof 0 Stove
o Multi-family 0 Addition 0 Move 0 Garage
o Commercial 0 Remodel 0 Demolition 0 Deck
o Repair 0 Sign ~er
BRIEf DESCRIPTION OF THE PROJECT: "J"' WI d?
1~/nn4 I
COMMERdAL/RESIDENTIAL: Occupancy Group: Occupant Load:
No. of Stories: Lot Size: Existing Sq. Ft. & Proposed Sq. Ft.
Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage
City:
#
Exp, Date: ______
SIZENALUATION:
SF. @ $ ISF. ~ $
SF. @ $ ISF. ~ $
SF. @ $ ISF. = $
TOTA~ YALU;\TION . ,$ 'trJ G~
m-s-b7~/r1/} / //i/A/ j-_Cf-_
I
Construction Type:
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on Ihe applicallu:l edld
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be re\",,,
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at417 -4815 for assislallce.
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 pennit issuance.
EXPIRATION OF PLAN REVIEW: Ifno pennit is issued within 180 days of the date of application, the application will expire. The
BuildingOfficial can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Seclion 107.4 of
the Uuiform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true an
understand that it is my responsibility to determine what permits are requi the City' a th
correct I am authorized to apply for this permit an,.
I must obtain such perm:;6rior to work.
Date: 7, ',;( r ;A
/ "
T:\FORMSIAPPSlBuildingpermil. wpd
Applicant:
'i"7
. . . . .
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . INSPECTION REPORT. . . . . .
fl.
4--
REQUEST:
Date ~ - 2 t ~ e-::s
Time
Received by
,0v
(phone. person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
(37..
YP J") " ., <;.u ta:_
w
q-IA
~'T
Phone No. /f.?fiq Z TIS-
Permit No.
Sewer Foundation Framing Chimney
Plumbing Final Sewer Excav. Other
H-eQt
YI..(-i'~'\P
Time~lt"V<
INSPECTION NOTEJf..,..., r .~
Inspected: Date ~ ~
Remarks: .
By
5C
~
RESTORATION REQUiRED......... YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
[] Repaired by Permittee
D No Damage Found
Work Order #
D COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
w
... --
~~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
-rrl_--~~_.. ~._._....
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Zoning . . .
Application valuation
V~-UUUUU1~~ Date 8/20/03
132 W 4TH ST
06-30-00-0-0-8825-0000-
ELECTRICAL ONLY
o
Owner
Contractor
HURD LARRY W
132 W 4TH ST
PORT 'ANGELES
WA 983622806
OLYMPIC ELECTRIC
4230 TUMWATER
PORT ANGELES
(360) 457-5303
WA 98363
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
HEAT PUMP/FURNACE
OLYMPIC ELECTRIC
46.70 Plan Check Fee
8/20/03 Valuation
2/17/04
.00
o
Qty Unit Charge Per
1.00 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS
Extension
46.70
'-
(N
~
~\ t
~ *
t V1
"'\
Fee swnmary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 46.70 46.70 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 46.70 46.70 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work Is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authori2ed Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\II02.15 [412002]
BUILDING PERMIT INSPECTION RECORD
CALL 417 -4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITlS 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
FOUNDA TIQN DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT:"
ROUGH.IN I I 1
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW /WATER
AIR SEAL
WALLS I I I
CEILING I I I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T -BAll
INSULATION
SLAB I I
WALL I FLOOR I CEILING I I
MECHANICAL
HEAT PUMP
WOOD STOVE I PELLET / CHIMNEY
HOOD I DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT N's:
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT If's SEPk
PARKING/l..IGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL. LlGHT DEPT. 417-4735 8111/ C>'1 I1W ELECTRlCAL
LIGHT DEPT
CONSTRUCTION R.W./ PW/ --, . CONSTRUCTION. R.W.
ENGINEERING 417.4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
...l'J:I.&..&....a....&.vu ~'IIWIWt:::L
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
property Zoning . . .
Application valuation
Uj-U0000799 Date
132 W 4TH ST
06-30-00-0-0-8825-0000-
MECHANICAL PERMIT
8/18/03
6375
OWner
Contractor
HURD LARRY W
132 W 4TH ST
PORT ANGELES
WA 983622806
PENINSULA HEAT
502 W. 8TH ST.
PORT ANGELES
(360) 457-2775
WA 98362
Permit
Additional desc
Permit .Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
35.30
8/18/03
2/15/04
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
1.00 35.3000 Be EL-LQW VOLTAGE
Extension
35.30
.......
~
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
HEAT PUMP
61. 70 plan Check Fee
a/18/03 valuation
2/15/04
.00
o
~
~
D
t
Qty Unit Charge Per
Extension
47.00
14.70
~
BASE FEE
1.00 14.7000 EeR ME- INSTALL 100- FAU
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 97.00 97.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 97.00 97.00 .00 .00
~
,
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or nol. 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 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPn SEPARATE PERMIT: II
ROUGH-IN I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS I I I
CEILING I I I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
I-BAR
INSULATION
SLAB I I I
WALL I FLOOR I CEILING I I T
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET I CHIMNEY
HOOD I DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
W A TERLlNE I METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SErARA TE PERMIT #'s SErA:
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 I./_l_ Act') ELECTRICAL
IrJI LIGHT DEPT
CONSTRUCTION R.W. / PW/ II , CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 4\7.4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 4\7-4815 BUILDING
';'-'<:1-03: fl,~15t3;:'IV,:<::IT( p"nT Aj'Ic:lEL.E~,
; :.FjO~ 1 ,.iT 1 I
u
fi
~ ~ ELECTRICAL PERMIT APPLICATION
TIll' E faeft1O!1I PSliTlIl Applicafion tnU$t tile fnll.d oul com D'flltlllv.
IIOIl00000CIALUs.i0N'L'V
-,
~.~
llB~Af'IMI~
p.......ai:
P l&l!I.8 t)'tte or N!lprfnf In Ink. tfyotJ MWI !Iny qU1!UlltJon8, pl.... cell (3eD) .17....7lS
F.. number,' 4.)(50) .17....711
~~
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OWnarorElec.ConlT.,krAQ"'~ 01 ymp i c El ec tr ic Co" I nc ,
P",portyOwn..-: L{,,/y flv/i
Add.....: 1/3 Z. W ~ ,..., Cft;:
F~o"": 457-5303
fa.: 452-34;16
Fhon.: '1/ 7 ~()? (.2
ZllT:
EIeCl/k:8I(;;""""",,, ,Olympic Electric Co., Inc. L1eM'.#: QY!'+tC2S;QlEKp. 3131/03 F_.: 457-5303
A<'dr-= ,4230 Jumwater CIty: Port Angeles ZIp: 98363
IN5TI'.LLATrON WIRED: BT:
DOWNER
~ J;:LECTRICAL CONTRACTOR
Cntdlt CarrlHo/der Name: Charles T. Burkhardt, Olympic Electric Co., Inc.
SIHlng Addmu; I Same
Cretm CIIrrl Num*
city:
Exp. Da"':
ZJp:
\l7SA: X Me:
PROJECT ADDRESS:
/32- W r;rp
TYPE OF WORK: Check all that apply: 0 New ~ter"UoolAddillon
?ReslCl9I1tia1 0 ~ult1-family 0 Commercial u Mobile Home Sq. Ft.
o Remote Meter 0 De1ached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
2-
,
Number of Circuits added or altered:
I!rt/r IN",!, h/,,~(?
I I
[J Low Voltaga 0 Teltw:Om. 0 SIg
(/Mr.SI1'. lIe..0
DESCRJPTION OF Tl--IE ELECTRICAL PROJECT:
EIK'lrIc:IIJ ' "Do;! Addition. 8nd or .ubtractJOI'II
-trl.-r?fJ
~
S41rvlce Infonmltion
o B""eboartl
~umace
ja"Hcat Pump
o Fan-Wall
KW
Ii. _KW
---.:... TUN
. KW
LAR
o OvertIaed Service
(J Temp S8Nice
o Underground Service
Voi1age:
Ptlase: 0 1 O:'l
Service S12e:
Feeder Size:
PAMC 14.05.060(8): For Indusll1al, commercilli, & resl~nli8J projects larger than a dupleK, a one -11M !Il'1'1Wlng of tl'lll E_es1 Sefvic& &
FHdenl, building size ,("'1, ft.), load calcul81l0l'\9, and lha typa & 01 conductors and/or raceway Is rnqulred end shell a<:compony the
Eleclrtcal Permit appll~atlon.
I heret)y certify t~t I have read ena examined rtrls appl/caUon and know thai same fo be true aOO corract and I al
aulhorized to apply fbr this permit I understand it Is not th& City's legal responsibility to determine what permits
aru required,- it remains the applicants responsibility /0 de/ermine what permits ara mqulred and to obtaIn such.
AI - 8f 16/0.3 -'-
No ~f-{( ,...,.1. OodltCord Holda~.Slllnalunl: D.rla; 8/1'3/0.3
Ot--- A-7 " <, I '
~ Ow"er or Elee. Cent Sagnlltura: bill":
P'W-9019J7![l3 ~ 'It.. 70
~ CtJ- t1.~,~,"
R6tr.7.<:tOl:H' YVol'
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