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Home My WebLink About1808 W 5th St - BuildingPREPARED 9/29/06 8 17 48 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 9/29/06 ADDRESS 1808 W 5TH ST SUBDIV TENANT NBR KERSEY CLAUSEN CONTRACTOR PHONE OWNER CLAUSEN KERSEY C/ K D PHONE PARCEL 06 30 00 0 1 4305 0000 APPL NUMBER 03 00000734 RES ACCESSORY BUILDING PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL3 01 6/06/05 JLL BUILDING FRAMING TIME 17 00 6/07/05 AP 06/01/2005 12 04 PM RVESS KERS 452 3223 First or as soon as possible as he is leaving town 06/07/2005 08 59 AM JLIERLY BAIR 01 7/05/05 JLL BUILDING AIR SEAL 7/05/05 AP 07/05/2005 04 53 PM JLIERLY BLI 01 7/05/05 JLL BUILDING INSULATION 7/05/05 AP 07/05/2005 04 54 PM JLIERLY BL99 01 9/06/06 JLL BUILDING FINAL TIME 13 00 9/06/06 DA KERS 452 3223 09/06/2006 08 04 AM DYASUMUR 09/06/2006 04 26 PM JLIERLY no answer at door called and left message/j11 BL99 02 9/29/06 LL BUILDING FINAL TIME 13 00 CLAUSEN 452 3223 rescheduled from thursday to friday 09/27/2006 11 24 AM DYASUMUR COMMENTS AND NOTES PREPARED 9/06/06 11 07 10 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 9/06/06 ADDRESS 1808 W 5TH ST SUBDIV TENANT NBR KERSEY CLAUSEN CONTRACTOR PHONE OWNER CLAUSEN KERSEY C/ K D PHONE PARCEL 06 30 00 0 1 4305 0000 APPL NUMBER 03 00000734 RES ACCESSORY BUILDING PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL3 01 6/06/05 JLL BUILDING FRAMING TIME 17 00 6/07/05 AP 06/01/2005 12 04 PM RVESS KERS 452 3223 First or as soon as possible as he is leaving town 06/07/2005 08 59 AM JLIERLY BAIR 01 7/05/05 JLL BUILDING AIR SEAL 7/05/05 AP 07/05/2005 04 53 PM JLIERLY BLI 01 7/05/05 JLL BUILDING INSULATION 7/05/05 AP 07/05/2005 04 54 PM JLIERLY BL99 01 9/06/06 JLL BUILDING FINAL TIME 13 00 KERS 452 3223 09/06/2006 08 04 AM DYASUMUR COMMENTS AND NOTES 4a ,(?1 We lv 6i47 CITY OF PORT ANGELES PUBLIC WORKS - BUILDING D1VISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 9/24/2001 PERMIT NO: 12992 OWNER/APPLICANT PROPERTY LOCATION 1808 5TH STW KERS CLAUSEN 1808W. 5TH ST Lot: 2 Pod Angeles, WA 98362 Block: 143 [] Long Legal 360/452-3223 Subdivision: TPA T: S: Parcel No: 063000014305000 CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 360/000-0000 PROJECT INFO Project Value: $500.00 SFD Units: 0 Commercial: 0 Project Type: FOUNDATION SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 ~,~ Zoning Use: RS7 PROJECT NOTES CONSTRCTION OF FOUNDATION FOR FUTURE ADDITION TO GARAGE RECEIPT # 8101 FEES ASSESSMENT Building Permit: $23.50 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $28.00 Plumbing: $0.00 AMOUNT PAID: $28.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits am required for electdcalwork, 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 previsions 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 Signature of Contractor or Authorized Agent Date Signature of Owner ([f~bwner is builder) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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 TYPEI DATE ACCEPTED COMMENTS I YES I NO FOUNDATION: WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERM[T: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS I CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOODSTOVE / PELLET/CHIMNEY / INSERT HOOD/DUCTS PW UTILITIES / SITE WORK ( Engi neerlng Di vision) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SAN1TARY STORM PLANNING DEPT~ SEPARATE PERMIT#'s SEPA: PARKING/UIGHTING 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. / PW/ CONSTRUCTION - ENGINEERING 417-4807 PW / ENGINEEPdNG IqRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 //~ ~/~,~ 0 ~ ~'~- BUILDING C:~APPL.WPD ~ I FOP. OFF{CJ.AL U~E ONLy: · BUILDING PERMIT - APPLICATION ~v~ The Building Pomnit - Pre-application ~t bep!!e~_ out completely, o,~ ~ Please type or print in ink. If you have any questh2ns, please call 417-481S~.3;,~/ Applicant .and/or Agent: ( (x3 Phone: 5 % 4 144- Owner: ~--4'&S C,o%0~-~ Phone: Address: ~(~ ~ -.~13~- City:'~OgT ~n,.,c.~,3r.~. '~tOJ~ Zip: ArehitectYF_ugineer: ~.,t~O ~q F_~-J~r~$C-~,J Phone: ~ { 0 f~S ~4 {did( Contractor ~ I C t_ ~Y~ ~ ~-~'Eb License #: Ex'p: Phone: LEGAL D~S~OW: L~.~~ BI~: ~ ~ P~C~ ~: C~ti Card HoMUr Wame: B~g Afld~s: ~:. C~ ~ ~: ~p. Da~: ~A MC ,., ~E OF WO~: S~UA~ON: ~ ~~ ~ M~fi-f~i~~fi~ o Move ~ O~ge Sr. ~ $ ~F. ~ ~ [ ~ ~ ~ S~ ~ :TOT~ V~UA~ON $ B~FDES~ONOF~~: ~,~ 0 ~ ~to.a ~ ~ ~~ ~a~smE~: ~ ~: ~ ~=i~~, C~~: No. ~S~: , Lot S~: , % ~ C~ ' ~:~ % ~gLotC~e:~ . ~ /~;R.+~C~! -~: · /~.J~.~T~L~~OB: B~. D~, ES~s): ~ Yes a No SEPA ~Mht ~7 ~ Y~ = No ~ B~ Di~i~ cm ~ y~u ~ m~ ~ ~o~ ~ ~e a~ ~d p~ su~ ~. B~G PE~ ~P~CATION S~: Yo~mpl~d~pli~ s~pl~ (f~) ~d~gen~ p~ ~ ~ ~ s~ ~ ~e B~l~ ~i~. VALUATION OF CON,h-rKUCTION: In all cases, a valuation amount must be entered by the applicant. This figure wlil be reviewed and may be revised by the Building Div. to comply with enrnmt fee scbedul~. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the lime tho building penuit application and construction plans ~e'submii~ed. All other permit fe~s ar~ due at the t/me of permit issuance. EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this application will expire by limitations. The Building Official can extend the time for action by the applicant up to 180 days, on written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more then once. I hereby certify that I have read and examined this application and Imow the same to be true and correct, and I am authorized to app~for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's responsibility to determine what permits are required and to obtain such. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: '-~ ' ~-~' Time Received by , (phone, person) , ,,:~ :.: ~ Location of Work to be inspected /~:d~:/.~ ,'~' ~ -' Name of person requesting inspection Address of person requesting inspection Phone No. Permit No./ Type of I~cle appropriate one): Sewer~,,~ound~atio. n~)Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date/~ - ~-~ ~'~ Time By Remarks: / ,,Y~-~-z:)//~-~~/,~- .. RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel I-]Asphalt ~]PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ...~.9~"~ · CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DiVISION ~ 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 3/29/2002 PERMIT NO: 13317 OWNER/APPLICANT PROPERTY LOCATION 1808 5TH STW KERS CLAUSEN 1808 W. 5TH ST Lot: 2 Port Angeles, WA 98362 Block: 143 [] Long Legal 360/452-3223 Subdivision: TPA T: S: Parcel No: 063000014305000 CONTRACTOR ARCHITECT CAN-DO CONSTRUCTION N/A 74 Hurricane View Lane Port Angeles, WA 98360 , 98360-0000 360/452-3155 360/000-0000 PROJECT INFO Project Value: $500.00 SFD Units: 0 Commercial: 0 Project Type: PLUMBING SFD SQ FT: 0 Industrial: 0 Occupancy Type: Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: RS7 PROJECT NOTES UNDER SLAB PUMBING RECEIPTf18907 FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: $0,00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $27.00 Plumbing: $27.00 AMOUNT PAID: $27.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomee 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 ot laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does no1 presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of Signature of'Co~tractor or Authorize~'~ent / ' Date Signature of Owner (if owner is builder) Date BUILDING PERMIT/NSPECTION RECORD : CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCE/IL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE ] "~ 3 j ~ INSPECTION TYPE DATE I ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTllqGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # PLUMBING / / ROUGH-IN DERFLOOE' LAB t z/ WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION MECHANICAL HEAT PUMP WOODSTOVE / PELLET/CHIMNEY / INSERT HOOD/DUCTS PW UTILITIES / SITE WORK IEngineefing Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PEKMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTJONS 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, / PW/ CONSTRUCTION - K,W, ENGINI~ERING 417-480? PW / ENG INEEP. XNG FIRE 417-4653 FIP. E DEPT. PLANNING DEPT, 417-4750 7 ~/ //{~/~/~ ~'~ /~'~//~/~// PLANN/NG DEPT. BUILDING 417-4815 HU1LDING C:~APPL.WPD /~0g ~ ~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ..... INSPECTION REPORT .... Date/-~ ~' ~-0 Time Received b ~ phone, person) Location of Work to be inspected /~ ~ ~ Name of person requesting inspection Address of person requesting inspection Phone No. Permit No. Type of inspection (circle appropriate one~ Sewer Foundation Framing Chimne~~ Final Sewer Excav. Other 1ffiS~fiCTlOffi ~OT~S: Inspected: Date ~'~2~' ~ "~ Time By , ? Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel []Asphalt r~PCC [~Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) <ftPORr~o ...-I.,~<'}<> O,..~. .. -- "'<~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name property Zoning . . . Application valuation 03-00000734 Date 1808 W 5TH ST 06-30-00-0-1-4305-0000- RES ACCESSORY BUILDING 7/30/03 3000 OWner Contractor CLAUSEN KERSEY C/ K D 13 2 LARKSPUR PLAZA DR LARKSPUR CA 949391414 OWNER Structure Information Construction Type Occupancy Type . . . . . Other struct info . . . . 130 SF ADDITION TO EXITING GARAGE TYPE V NON-RATED GARAGES, CARPORTS, SHEDS NUMBER OF UNITS 1. 00 Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT -RESIDENTIAL NEW OVER EXISTING SLAB 106.75 Plan Check Fee 7/30/03 valuation 1/27/04 42.70 3000 Qty Unit Charge Per Extension 92.75 14.00 BASE FEE 1.00 14.0000 THOU BL-2001-25K (14 PER K) Other Fees STATE SURCHARGE 4.50 Fee SUJNnary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 106.75 106.75 .00 .00 Plan Check Total 42.70 42.70 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 153.95 153.95 .00 .00 ~ \) Cf0) t 01 ....; NO FI+-lAL ::5 ~ --.J Separate Permits are required lor electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void il 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 iaws 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 pelformance of construction. t0ry ~I /..F Signature of Contracior or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1102.15 [4/2002] ~ ~ E: ~ ~ o 0 ~ ~ .~ *~~ n o 3 3 ~ Z ~ m otcotllo'l:j~olll -..1 C-..1Cm,....trlmc .......H.......H.......t1:;O.......H Ot;<Ot;<OUl[f)Ot"' lJ1tlU1tl-.Jrt i->tJ .......H....... H....... .......H tv Z tv Z tv 0 tv Z oQoG'lot1 oG'l o 0 0 0 lJ1 HU1:r:< lJ1 OJ lJ1 'l:j Z H Ulol>- ~ m ~ ~ oc;o OQ>tvl-' oI>-t;<oI>-[f)COO tvH ~, trl. 0 w, Z lJ1"'llJ1~U1"tvoGl oI>-HWt;<\D tvol>- o . w ~ Z ~ ~~ o " 0," ~e H~ ~~ ~m ~ ~. " ~ o z o ~ o m 0, S o ~ ~ '" 0, S ~ ~ ~ ~ 0- m e " H m . , e o "' n o ~ ~ S ~ ~ ~ ~ m H o ~ o ~ mm " 00 ,m " 00 ~~ ~ n~~ O~ 30 ~~o ~oo ~m ~"~ O~" Oo~ ~ ~ ~ ~ ~H~ mZ "m~ ~'d~ ~ ~ ~o, ~~ i3i!;~ ~~m ~HH m~" '~~ nH 00 3Z~ ~ ~ Z ~ m ,0, "~ ~ "~ 3H 3 ~ ~. " O~ m, m ." o o ~~~8E; 'd::oZZtl t<()trl"'l:>:l trl:>:l:>:ltrl Zt< ~U) ~ nm 3" ~ ~ 0 t>J. :>:I' ~ 00(") l-' W<l\t< 00 I I ~ 0 owe:: 00 oom ~g!i ~ -..1';:<: "'l wotrl :r: . ~ ~m m ::O't>j "'l ~.", mw on .~, n, no, ~o moo mo o ~ ~ ~ S ~ o Z ~ n" H~ ~~ ~~ O~ ~~ o " o ~, ~, ~~ ~o O~ ~- o m~ m ~ . ~ ~ ~"m 88~ Z~o OOH " ZZ mm ~" 00 nn "~ OH ~O Z o,~ ~8 0' mo ~ ~ S ~ ~ ~ ~ 0" .. ~~ 00 , , o ~ , o ~~ " ~ " ~;;:~8~ n" ~ " ~ ~~ w " 'I:I:<l zo ~~ , c<nt>J>-'J:<:I "'" m ~ ttl:<l:<lt'l o~ 0 D ~ ~~ .m ~ nm "~ ~ 0 ~ " 0 " tl n~~ ~. ~. 0 ~ ~m O~ ~, 3D 0 "~o oon ~ ~"'- c~o wmc 00 ~m . 0 00 ~~~ ow~ 00 ~m tH'3 S oom ~- 0' ~ . ~ ~ ooZ m~ 00 m w t~ ~ ~, , ~ ~ . wo~ Z 0 ~"O . ~ 0 mZ ~m m ~~i ~, ~ ~ . ~." ~ mW on ~ 'm, ~ n. no, "'l~otJj ~O , ~o ,....oom<:: ~~ moO '1:<l........H mm~ mo 01 (fJ 0 t'" 0' 0 ~o ~qCJl ~ ," ~"" " 0 ~z m"" " 00 '~~ ~ 0 0 n" S ZZ 3 . m" 00 3 00 . ~ ~ZH ~ mm ~ ~f-'~ ~ ~ 0 "" Z 00 Z ~~ ~ 0 , ~" Z nn m 0 w_ Z ~ 0 ~~ 0 ~00 m 0" ~ ~. ~o . w .. Z 00 "~ ~~ Z ~ 3" ~n 0 0 3 ""m ~ 00 ~ 5Stii ~~ ~ 00 ~ -. m~ m e- < ZZO ~ g ~~ ~~" ~ m~ < m m. S 0 . 0 ~ 00 ~ ~ 0- " m e- 00 ~ m . , e- O "' 0 0 ~ 0" .. ~o ~~ m , 0 m , 0 m~ ~~ '" 8 z n ~ t1 ~ ~ ~ " '" qj v; I : r I~r ,," -T " U' --.l '" o '" n 9 ~ ,. \< '" ~ " ~ Ii ll; <;; 8 :;j ~ 'l? i3 LJ Ii "i: ~ I~ i'l ;}; '" II l[jjl~ !~ I , I I I I I , I I ~,--1 I ~- b: .. I ~ 1:11 ," .,' i\1 " , , ," ", , , " \, " \ II ! II ~ " ~ , '- " " " " " " " ';:< 1\ i ~ '," ~ f \\) ~1,1 ~ ~ ~ z " " " " " " , " " " " " , ", " , , " " " " " " ,,' ~-I\ _.\1 " " " " __-_- ___J~ , , ,- I b: -. --""1 " ~ ~ :;;j ~ ~ '< :,: , , 1 ~' \ , I , I I , I I \ I I I I I I I I I I I I I I I I BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY. DateRec.:7-IB-~ Permit #: ~,?/I Date Approved: Date Issued: Fill out COMPLETELY and iu INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 " Applicant or Agent: '(EXLc, Lc 4-0s.-s-.J ~ Cvw>t:::N l 7 2.. 7 c;, tp+{ -6, City: Architect/Engineer: \C.~C; L J"rVc:.. s.-J Contractor Dv1 N fL-(13 J <-()K- State License #: Address: City: PROJECT ADDREss:_1 CO 0 &3 kJ S'M< ST 2.. Block:~ ft. :3 ~C:,3000o Phone: 5\ D 0S S 4) 44- Phone: SIO bS'<'- 41L(~ f' vY1 ~-<Lt lJ II l-F fA- Zip: ~4-& OK Phone: '5 \ 0 - G" C; '<; 4 144. Owner: Address: Exp: Phone: LEGAL DESCRIPTION: Lot: Zip: ZONING: Subdivision: J P A \4-30C;ODO CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: Billing Address: Credit CardType VISA .....--- MC T~ OF WORK: l>VResidential 0 New Constr. 0 Re-roof o Multi-family ov::\ddition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: \3o~~ 'FS01101""'J A O{)If->'iI....... OtjeI'L -Pt1;E^,CIAJ~All'EO 5/-A;'?;./P::;",'T1^,v COMMERCIALIRESIDENTlAL: Occupancy' Group: e 3:> Occupant Load: ConstructIon Type: V IJ No. of Stories: l Lot Size: 7000 Existing Sq. Ft. \ 9> 7 0 & Proposed Sq. Ft. I:; 0 ~ TOTAL Sq.Ft. I., sv Existing lot coverage.2Lf)% & Proposed lot coverage ~% ~ Total lot coverage 2-:7. 8 % # ' . AJ'PRO~ PLANNING USE ONLY: PLAN: BLDG: DPWU: FIRE: ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER: - BillLDING PERMIT AJ'PLICA TlON SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time t 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 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I hereby certify thaf I have read and examined this application and know the same fa be true and correct. I am authorized to apply for this pennff and understand fhat it is my responsibilffy fo detennine what pennits are require of the City's, and thaf I must obtain such pennifs prior to work. T:IFORMSIAPPSlBuildingpermit."l'd Applicant: Date: ~ 4wJ.3iJ.20D4 gt.Jt'-PI/.J-~ j)&~~ ?tl--r-~~ . {2.e:J8of> W'~SI .p~~~ - ~ i<Iz G.. c.,.,c'1e (t;,t-'<4L N,4~A..o /:Ie Ru,''7a_ ~f:r4-"I ~..( OJ. oo.:,,~'Oo /34 l'b,,-18o O"YJ ;;'5 a~~ ~ ........e,-- S "'lr....,.. CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 12\ EAST 5TH STREET. PORT ANGELES. WA 91l~62 Application Number Applicat~on pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . Appl~cation valuation 4/26/05 03-00000734 Date 8637 1808 W 5TH ST 06-30-00-0-1-4305-0000- RES ACCESSORY BUILDING RS7 RESDNTL SINGLE FAMILY 3000 Owner Contractor CLAUSEN KERSEY C/ K D 132 LARKSPUR PLAZA DR LARKSPUR CA 949391414 OWNER Structure Information 000 Construction Type Occupancy Type Other struct info 000 130 SF ADDITION TO EXITING TYPE V NON-RATED GARAGES, CARPORTS, SHEDS TOTAL "'% LOT COVERAGE CONSTRUCTION TYPE HARD SURFACE AREA NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS GARAGE 27.80 V-N 1 00 1820 00 7000.00 130 00 1950 00 1. 00 Permit Add~t~onal desc Permit p~n number Permit Fee Issue Date Expiration Date EL-DETACHED GARAGE NO 220 V CIRCUITS 33365 48.10 9/03/04 10/22/05 Plan Check Fee Valuat~on .00 o Qty Unit Charge Per 1 00 48 1000 ECH EL-R-OUTBD/DTCH GAR SEP Extension 48 10 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 48.10 48.10 .00 .00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 52.60 52 60 00 00 COMMENTS/ACTION NEEDED ........... ~ o \P (, l..\ \}. tI\ "1 ~ ELECfRICAL PERMIT INSPE~JON 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 rr IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE COMMENTS NO JO~Oy,~ (p rfL I 6/6e1!ft;L PrN~ ;4f7 /1-3-"~ ~ GENERAL COMMENTS: PW.II02.1' (4196) ,." ~ . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles. WA 98362 (206) 457-0411 ;;lo:J.V PERMIT NO. ,j r;: T> ,')-- DATE ~-'d-r-:r- Site Address: ELECTRICAL PERMIT 6111 Installed By: , READY FOR -0 INSPECTION License Number: 0 'Ii GI?C"'O"i'10 D WILL CALL FOR INSPECTION Phone: OwnerfBusiness: Phone: Owner/Business Address: Sq. Ft. 1{f RESIDENTIAL '~ COMMERCIAL r1i-i.! ~ BASEBOARD KW ~ D FURNACE KW _ D FAN/WALL KW _ D HEAT PUMP KW_ D TEMPORARY SERVICE D PERMANENT SERVICE D NEW CONSTRUCTION 'tit' REMODEL 'd ADD/ALTER CIRCUITS D SERVICE UPGRADE/REPAIR \2( OVERHEAD SERVICE "Ci UNDERGROUND SERVICE ~LTAGE: SINGLE PHASE THREE PHASE SERVICE SIZE ,")()('""'J AMPS D SIGN D SPECIAL EQUIPMENT (LIST BELOW) (fkflJ(.f, -IAUEJjL4/ ":'8 '--!p~iIL. ~~:~~~~ DetailslDescription: . WS. No. SERVICE SIZE CAPACITY: D OK NOT O.K. ACTION REQUIRED: D CHANGE TRANSFORMER D INSTALL SERVICE POLE DATE ENGR. D CHANGE SERVICE WIRE D OTHER D Ditch Inspection OK D Rough.in/cover O.K. AfItI\fJ O.K. to connect service - f1fP Final O.K. Site Address: Permit/Receipt No. Date: /J'd- 'l;)- . Notify Port Angeles City Light by Street Address and Permit Numberwhen 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. -I/" TS ! /) fJ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ lifO, 0 0 Electrfcallnspector Permit Fee WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall OLYMPIC PRINTERS INC. ELECTRICAL PERMIT "/- 3 .. Port Angeles, washlngtonm..!.~.m..m__...._.mm.m_........mm.__mm., 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 dO electrical work as listed below. // c; y tv S- (;( /~;;'-<-.i- ~:~::s__:;::2b;'~::;::q:::::::22::~~::::::::::::::m.;~:~:~:::m~::~~~.~~~:::=::=::::::::::::::::::::::::=::=::::::::: - / Wiring Contractor ___~~".~E'!::-:C__'__..______mmm.m_.nn_m By..__n__mm__m__nn_m.mm..___m__n____m._.m__n__.__ /a 0/;5 yo Service, volts hOon_._.............................. "3/' . No. wires ..n...'::.................__............ '-;::/.;:; c::.V" SIze wires........................__........._.. /004- Main fuse ...........:...::__._.___.....__....... :. S . Enclosure ...._.............___.___.........__... ../-J CITY OF PORT ANGELES LIGHT DEPARTMENT Light Outlets......._.._........................_..... Receptacle Outlets............................... Dryer, KW.n....n_.n.............._____._.._..... Range. KW __nnn.h...hh______.h" Water Heater: KW.n.hn...n.h.mmhhnhm. Heat: KW......................n....n..........n... Motors: size, volts and phase: .......!...............................;..................- Type of wiring: Entrance Ca.~le .....~.U....h....m R~7id Conduit .m.........___...u.,__~..... Metallic Tubing~....... Current transformers: , No. & Size............___......__..u... Ser. NO....h.___..................__................. Ser. No. ...__..____.u............__n............... N~ 17947 19.f'.,5 Type at Wiring: I . Armored Cable ..__.......................... / N;on.Metallic ................................. , . Knob 8< Tubeh............n................_ RIgid Conduit .............................h Metallic Tubing ___........................ Raceway ...............................__..._ Circuits, Light....................................... Utility h..............................hn....._... Heat ............_.........................._...... Range .............._._.......n.................n Water Heater 00...........00.......__....... Motor ................nn.n....n................ Dryer ...n.....nnn....._.................n.__.__ Furnace .........................'_................... Ser. No. n..................n.............n........ Total Load...n.n__u....~........n.. Ser. No. .n.............._n..............__.n..... Total ..........n...n......n............__ Remarks: ..------.~:~---.!{~.?'=1.;_c__/!C_....m..::5.'?_?m_:!..:.2!.~k_____...__....___...___m.______......._____..___m_...... (/ .............__.._.__.._____.__._n___.___.__...______._....._._.__.._..._.._.____._......._.___..._.._._._......._______.....__._..'_u..__.__....__...__._._..._..____.___..... ..nnn.u...u-.---..u..n.__...n.uh..nn.nunnnnu.hn.nnn..uuu.n-..n..--nnuhu...nn.u....._nnn._.._..nhn...nn...._nnn.u...unn...n. Permit Fee 0 /' (./ . Co' $.m_____.._.m___.m.________..m. Treas. Receipt NO......_____.___.........__m B >f/94:~-N- {'r '---' Y ......___L...__............mm...___.___..._________.___________ 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~ 17947 Address..................._...................................._......................................._......................................Date..._......_.._.._.._......n.._......_......_......... Owner __n......n.......nn.........n._nn.._.._......_n...._.._.....n....nnnn........................................ Tenant..................n__..............n..n........h.n...........__ WiringContractor.................__........................................_.............................................................By.............................................................. NOTICE--Current must not be turned on untU Cert1!1cate of Inspection has been issued. If work 18 to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. 1M Olympic Printers, Inc. \ CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15135 )....,v )/~ Port Angeles, Washlngtonn.......n...m.....L.:.m.m..__...mnm...mm.., 19m__:.: 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 do ele~rical work as listed below. -- tf'/ ~=' ~~~~~:':~~2:~~~:;,=;~;;~~~-:~?=::~~:_ Light Outletsm...m...........m...._u....___.._ Receptacle Outlets........_........mu..m____ Dryer, K\Vl .....n..._.._u...._u..u.u.....n__.._ Range, KW m.._.hm........ Water Heater: KW...___oon______n___n Heat: R~r.....u......mummmu Motors: size, volts and phase: ~. n c,~':e:.;:;;;CE.[j------.mm.m..mm.m.m Total Loadmum....ummmuu.. /:)O/;JYc; Service, volts .nnm___nnnnm._..........n... 7 No. wires nn._nnn.u_n_....._nnnn__..n ;/:"tL Size wires....._..n...:nnn..nm___......... ,/rJ4 Main fuse _....._...m..............m.___.m.. ,,;;: Enclosure ....m.m.....u.......__.......m.. Type of wiring: Entrance Cable ....mnmmu............ Rigid Conduit m._m_m__.___m.......... Metallic Tubing .___n..................... Current transformers: No. & Size.n.m.m.___mn.....___..n....... Ser. NO..nnnnmn...nnnnnnn_nnn_.n_u Ser. No..___________._____________..________.......... Ser. NO...nn...n........n...n.nn_.nnn_...... Ser. NO..._nn.unnn......_u_................_n Type of Wiring: Armored Cable u.... Non.MetalUc nnnnnnnnmmn"mnn Knob & Tube........n___nnnnm..nn... Rigid Conduit m____mn.mm.nmmm Metallic Tubing .m_n.........___........ Race'\vay nnnn.............._................._ Circuits, Light...nnnmnnnmm....nn..n... Utility nn............................_n......un Heat Range ............................................. 'Vater Heater .nnnnmmnnnm....-n Motor ..._n_..n....n...nnn......nnu...... 1) ryer..... .nn......nnn.n.n......__nn....n___. Furnace nnnn..unn..n_nn_..... Total h"..nnn_nnnn..._unn.nn.u . Remarks: ...moooomoo..{.'..~~).m~.oom--f-,9,,~!.,~'.~5t.-!?.mm....m..--....m.--.m...mm__..mmm__...____oom___oooooo..__m Permit Fee $......m...__.____.....______.____oo. Treas. Receipt NO...m____.m...._______m By __Jt..ooL.i~0~~__~~:.~~.>,_/ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It 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 C ,cttf'c/t-6'-(r~Q..-. Uy';'j '1 . E':LECTRICAL PERMIT N? 15135 .- '1--/ .,. /f'fl Y t.J j!A. . :::~I~~~:r:l;:~~:=::~~~::;j;;;~;;;~=.::::::::::::::~:.::::::::.::::::::::::::::::.:::::::':::::::::.::::::::::::::::::::::::::::::::..:::::::=:::::..::::::::..: ~vc.- Inspectloncompleted..._.._..._.......__._.............._..._.........._....._..._................................._.............__........................._......._._...................__...___... 1M 3-72 Olympic Printers, Inc. Total Load .....__..._.........................__........__................._... ........_nnn....nn........nnnn.u........n.n......_......n.nn.......-.........-...-.- ~ CITY OF PORT ANGELES LIGHT D)::PARTMENT ELECTRICAL PERMIT N? 15127 , -/~' ^. Port Angeles, Washlngton.......Lmn..n.__:.-::........h..___..m...mmn.._... 19::0..... 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 do electrical work as listed below. 17 cJ ;r -'f -;./ :::" ~:~_~:~~;:{~~~~:=:_;="~~;~OO~"~O~~:~~?~::::=: Light Outlets__._.m____.__...................._.__.. Service, volts 1..~m~.'L__::.!m:?:..-'::m..__ Receptacle Outletsm.mm.__m..m___....... ~- No. wires m______?.__.__..__mmm______m Size wires..m__r:m.(!':~~.>.::mm__.. ~ ')".1 Main fuse ....__'__..mm_____...._..m________ .5 Enclosure ___.m.____..........__..__m____.... Type of wiring: Entrance Cable _______m___ Drye" KWI.hhh_..h.nm..mm.mhmuu. Range, KW m_m__ Water Heater: KW.mmu Heat: RW.___________..__.__...______..._________m__...__. Rigid Conduit "__mm__m_ Motors: size, volts and/fhase: f) 0 <' n ,.' .~-~~....--_....~-------_:_---------------_.-_... Metal11c TUbing ____..__mm__mm__m Current transformers: No. & Size.m.....mm_.__m_______m_____._ Ser. NO._....._.__.__....__h_..__________.____..._.. Ser. No.-______________.______________.......________ Ser. NO.__________._____________n.._...._____________ Total Load___...__..mmm_m____.. Ser. No. _._________.____________________...__..._____ Type of Wiring: Armored Cable mm__m.m.m.____m__. Non-Metalllc __..___.m.mm_m________.._ Knob & Tubem__m___m___ Rigid Conduit "nmmmm Metall1c Tubing. Race\vav _________n______________________________ Circuits, Li~htm~::~~-nm./--....------- Utility I_.'u............./................u Heat Range ___n_____n_____.n___._____________________ Water Heater __.nm....___._____m..____. Motor ____________n.___________n..______________. Dryer_....._____.....____n___.___________________..__ Furnace ____n___n.___n___..__. _nmm . , Total _______-:..~_:._.._.....__.._......._..__ Remarks: n__I-_u!n!'._:..u;....__.____~___:._nn_:;:._~..u__...~.::~."J__.n_.~_7~_nn~n__u_.nnnn_nnn_u___..unnn__._n.n...n.hnnnn.nnn_n .~~:~~.;~~nhm.-nmnnm..m.-.;~:~:.--~:~:;~~nmnnmm.m.m.hhnh...:.;;;--.:;..-.:.r.:m.-7-----n?..--...--.m.mn--.. $..._/t.__~__::'__...__........____. NO.nh..___m...____________ By .<.'!._:.;./..m..:.::.h6:;.,~::.L""6.dL:.".:.L__hnnnn. NOTIC~urrent must not be turned on until Certificate of Inspection has been issued. If work is to be con. cealed due notice must be given the,In_spector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION /f ",;: ( 1.....- f..d'.-r -~ <' C~ I /- ELECTRICAL PERMIT N~ 15127 J,E-r 7.. (~t III 7-/',; - )y Date called fo:f)..nSPeCtlon~.:r--mm...mm___mm.-m.-----...h.-...h--....n.---mm..--...mm___......mmu........m...._..:__.......:___m__nn.............mm.........___.. /' c- {,,,,,;V'<I<"~---- ~::;~::::ryc::~:t::~(!:;~~~;::~~~:~::~:::::::::::::.::::::'::::::::::::::.:::::"::::::::::::::::::::..:::::::.::::::::::::=::::::::::::~::::::::.:::::::::~:::::::::::::::::::~ Total Load ......_____.._._........___.........._...______..______.______..____._...___.____________ ._._ \ 1M 3-72 Olympic Printers. Inc. 00 nnn___...._"_n .__ _.. ....__ _____n........._............_____n___........_.._______._......_ ELECTRICAL PERMIT APPLICATION FOR OFFlCJAL USE ONLY DaldRec' Pennit# Dale Approved Dale {ssueu . ~~ .-l The Electrical Permit Application must be filled out completely, Please type or reprint in ink. If you have any questions, please calf (360) 417-4735 Fax number: (360) 417-4711 (}3- 731 1Ie:#& ~ftvJI:-..J Phone 45Z'~ z.u Fax: S'1"bS-.r~ 4S2-~ Z 2 i$ Property Owner: Phone: Address: City R~6e;;'.J Zip: Electrical Contractor: License #: Exp: Phone: Address: City: Zip: iNSTALLATION WiRED BY: ~NER 0 ELECTRICAL CONTRACTOR KeJ;S ((p" Cd. - Credit Card Holder Name: Billing Address: 17.'07 {ltwl1~.A. '~l. City: !l,C#(M.....P Credit Card Number: ~_Date: Srn ~~ Zip: !?> :7 I VISA: MC: PROJECT ADDRESS: I gOB w. TYPE.0F WORK: ~sidential Check g!l that apply: DNew o AlterationlAddition o Multi-family o Remote Meter ~tached garage ~ o Commercial o Mobile Home Sq. Ft 8~o o Hot Tub 0 Swim Pool o Septic Pump o Low Voltage 0 Telecom. o Sign Number of Circuits added or altered: .. 1'....,..sT7N' C~ DESCRIPTION OF THE ELECTRICAL PROJECT: 11-00 / iD: &,-t /{o!>___ 7:; -n,\ l <- 1"-. A 1 -' I J I ~ J(~ , 1 IJ (-r --!J-J.. 'I.I-I-J l. i 1)~ - K("h:':[",~LJ 1< 111.L I.LG6I[L Ilt:)_ --;;;Fl9J'i-&? A-t 5:- . A.( L/)( JYe.l ") M-eT€:~l~d@ I Electrical Heat Load Additions and or Subtractions D'31' Service Information o Baseboard o Furnace o Heat Pump "'"Fan-Wall _KW KW TON_LRA KW o Overhead Service o Temp Service o Underground Service Voltage: 211-0 Phase: 0 1 0 3 Service Size: / tl ~ Feeder Size: D~ JJvdJ il\\Dr . I hereby certify that I have read and examined this application and know that same to be true and correct, and I am ;. authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants responsibility to ~;e~mine ~at permits are required and to obtain such. . Credit Card Holder's Si9nature:----IVf- Date: ~(J./.:A-- Owner or Elec. Cant. Signature: Date: h Aj!H- II - 3 - CTC:, ~ PERMIT FEE: $ -18 r /0 C:/E LE CTRI CALPE R MIT AP PLICATION /Jeo 9/ ~<J" a Application Number . . . . . 22-00001445 Date 12/28/22 Application pin number . . . 839450 Property Address . . . . . . 1808 W 5TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-1-4305-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Heat pump ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLAUSEN KERSEY C/ K D BLACK DIAMOND ELECTRICAL CONTR 132 LARKSPUR PLAZA DR 502 BLACK DIAMOND RD LARKSPUR CA 949391414 PORT ANGELES WA 98363 (360) 565-1035 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 63.00 Plan Check Fee . . .00 Issue Date . . . . 12/28/22 Valuation . . . . 0 Expiration Date . . 6/26/23 Qty Unit Charge Per Extension 1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 63.00 63.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 63.00 63.00 .00 .00 1 - 2 SINGLE-FAMILY ELECTRICAL PERMIT APPLICATION Pub! ic \Yorks and ULili ties Department 32 l E. 5th Street. Port ;\ngeles. WJ\ 98362 300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us Project Address:-------------------------------------- Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _ OWNER JNFORMATtON Name: ________________________ Email: ______________ _ Mailing Address: ________________________ Phone: ___________ _ ELECTRfCAL CONTRACTOR fNFORMATION Name: ___________________________ License: ___________ _ Mailing Address: ________________________ Expiration Date: ________ _ Email: Phone: ___________ _ PROJECT DETAILS Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge) Service/Feeder 200 Amp. $120.00 $ Service/Feeder 201-400 Amp. $146.00 $ Service/Feeder 401-600 Amp. $205.00 $ Service/Feeder 601-1000 Amp. $262.00 $ Service/Feeder over 1000 Amp. $373.00 $ Branch Circuit W/ Service Feeder $5.00 $ Branch Circuit W/O Service Feeder $63.00 $ Each Additional Branch Circuit $5.00 $ Branch Circuits 1-4 $75.00 $ Temp. Service/Feeder 200 Amp. $93.00 $ Temp. Service/Feeder 201-400 Amp. $110.00 $ Temp. Service/Feeder 401-600 Amp. $149.00 $ Temp. Service/Feeder 601-1000 Amp. $168.00 $ Portal to Portal Hourly $96.00 $ Signal CircuiULimited Energy - 1 &2 DU. $64.00 $ Manufactured Home Connection $120.00 $ Ren ewable Elec. Energy: 5KVA System or less $102.00 $ Thermostat (Note: $5 for each additional) $56.00 $ First 1300 Sql;Jare Feet $120.00 $ Each Additional 500 square feet" $40.00 $ Each Outbuilding / Detached Garage $74.00 $ Each Swimming Pool/ Hot Tub $110.00 $ 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 alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296- 468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us] '"'CJ CD PREPARED 11/17/22, 8:52:59 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00001445 1808 W 5TH ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER RESIDENTIAL 63.00 TOTAL DUE 63.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 11/20/2023 22-1445 TAP OWNER CONTRACTOR Black Diamond Electric PROJECT ADDRESS 1808 W 5th St