HomeMy WebLinkAbout1228 E 6th St - BuildingPREPARED 10/12/10 8 03 46 INSPECTION TICKET PAGE 13
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/12/10
ADDRESS 1228 E 6TH ST
TENANT NBR LORNA M KONOPASKI
CONTRACTOR DAVE S HTG COOLING SRVC INC
OWNER LORNA M KONOPASKI
PARCEL 06 30 00 0 2 1110 0000
APPL NUMBER 10 00001131 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 10
JLL
SUBDIV
PHONE (360) 452 0939
PHONE (360) 457 7401
MECHANICAL FINAL TIME 01 00
October 11 2010 3 53 31 PM 1pangrle
JEANNIE (DAVE S HTG) 452 0939
MECHANICAL FINAL HEAT PUMP
AFTERNOON
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Heat pump
Owner
LORNA M KONOPASKI
1228 E 6TH ST
PORT ANGELES
(360) 457 7401
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
WA 98362
ELECTRICAL HEATPUMP
174920
73 50
10/07/10
4/05/11
Charged
73 50
00
73 50
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
10 00001139
039887
1228 E 6TH ST
06 30 00 0 2 1110 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
Contractor
EXTRA MILE TECH
418 N RACE ST
PORT ANGELES
(360) 457 0198
Qty Unit Charge Per
1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
Paid
73 50
00
'73 50
Plan Check Fee
Valuation
INSPECTION TYPE I DATE.
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Credited
00
00
00
rfillzhe
Date 10/07/10
ELECT LLC
WA 98362
y 5 `569.---
RESULTS
00
0
Extension
73 50
Due
00
00
00
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
Date:
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
T stat 3 ton heat pump
Owner Contractor
LORNA M KONOPASKI
1228 E 6TH ST
PORT ANGELES
(360) 457 7401
WA 98362
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 174813
Permit Fee 56 00 Plan Check Fee 00
Issue Date 10/06/10 Valuation 0
Expiration Date 4/04/11
Qty Unit Charge Per Extension
1 00 56 0000 ECH EL LVT THERMOSTAT 56 00
Fee summary Charged Paid Credited Due
Permit Fee Total 56 00 56 00 00 00
Plan Check Total 00 00 00 00
Grand Total 56 00 56 00 00 00
C
INSPECTION TYPE DATE.
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
10 00001132 Date 10/06/10
158540 REPORT STATE SALES TAX
1228 E 6TH ST
06 30 00 0 2 1110 0000 on your excise tax form
ELECTRICAL ONL to the City of Port Angeles
(Location Code 0502)
DAVE S HTG COOLING SRVC INC
PO BOX 413
PORT ANGELES WA 98362
(360) 452 0939
iO )r z.9/0
Z� &2 1r0 2
RESULTS INSPECTOR.
Signature of owner or Electrical Contractor X Date:
OCT -05 -2010 09 09 PM E JANSSEN 360 452 2982
City of Port Angeles Permit Application
Building OlvteionlEtectrIcal Inspections
321 East FiMt Street P.O. toes 1160
Port Angeles Washington, 98362
Ph: (360) 411.4735 Fax: (360) 417.4111
Date o/ S,Ls.
2 Single Family Dwelling
Multi- Family 01 Commercial"
Commercial Addition Alteration) Rents` e Repot
Plan Review May Be Required, Pteaee Comp' gig cle,trical Plan Review Infonnallpn Sheet
Job Address _a_. t t ...f r gJ. en
Building Square Footage. r____.
Descfipbort 01 above
o4 ...Z":: x ',..:1= ./.:.4y)._-- roc_ ef.J
Uwner Information l C ntraotor Information
Name, L
.4o• kv 4l _k _I Name eX 4' /l/1' r_e'_/', eiC '{'ielC.i' "L
Mailing Address
5 !t 'e.. L_ Mailing Address: -t. I 0 t:1 iL1�(C _R: 5{-
City State: A -ii .5 >ya. City P A. State 4- lip rl ce 3 iy Z
phone: _4! c7- .ZC. i Fax:
Phone YS7 -51 1 Fax 4 4 -.`r1'
Licensee I Exp t'cense I Etta Tle1}f I 5 1;,.C,. s /...7 t. /J..0 f
41A1lSdEsE
3 119.90
3 145.50
3 204 60
262.20
372.50
S 2.60
S 7350
2.60
5 9270
511030
S 148.70
S 167.90
S 95.911
S 66.20
S 95.90
S 03.90
S 03 90
S 119.00
5 102.30
S 110 30
S 3520
S '350
S 1 10.30
S 50 00
I, 3
Owner as defined by RCW 19.28.261 (1) Owner 411 occupy the structure for Iwo years after thls electrical permit Is finalized 111 Owner Is required to hire an electrical contractor rr
above said property is for sale. rent or lease, Permit expires after six months of last inspection.
Alter reading the above statement, I hereby certify that I am the owner of the above named property or a licensed etoctrlcal contractor I em making the electrical Installation or
eltnretion In compliance with the electrical taws. M.E.C. RCW. Chapter 19.20, WAC Chapter 296.469, The City or Port Angeles Mu Code, and Utility Specifications.
Signature or owner, electrical contractor or eiec inset administrator 0 Cash
o 2BE
ELECTRICAL
INSPECTIONS
Total it?ty tikEiolled bq Unit Charge)
:r
Servicel5aeder 200 Amp.
Service/Feeder 201-400 Amp.
Service /Feeder 401.600 Amp
Servicclf -ceder 601 -1000 Amp
Service/Feeder over 1000 Arno.
Branch Circuit Wl Service feeder
Branch Circuit W!0 Service Feeder.
Each Additional Branch Circuit
Temp Service/ Feeder 200 Amp
417% SemcelFseder 201400 Amp
Temp Serviceli seder 401 -800 Amp.
Temp Service /Feeder 601 -1000 Amp
Portal to Portal Hourly
Sign /Outline Lighting
Signs' Circuit! Limited Energy Commercial. Additional
Signal Circuit/ Limited Energy 1 2 ramlly Dwelling
Signe. Circuit/ Limited Energy Multi- Family Dwelling
Manufactured Home Connection
Renewable ErecVical Energy SKVn System or t.o is
Van 1300 Square Ft
Each Additional 500 Square Ft or Portion of
I Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
L:273 5"c Total
Credit Card
l-
P 01
Oct 05 10 11 20a Dave s Heating Cooling
City of Part Angeles Permit Application
Building DivisionlElectrical Inspections
321 East Fifth Street- P.O. Box 1150
Port Angeles Washington, 98362
Ph. (360) 417.4735 Far. (360) 417.4711
Owner Information
Name: L o r
Maibnq Address;
City'
Phone.!
License 1 Exp.
Unit Charge
S 119.90
514550
S 204.60
26220
372.50
S 2.60
S 73.50
S 2.60
92.70
110.30
$146.70
5 167.90
S 95.90
s 88.20
595.90
S 63.90
63.90
S 119.90
102.30
5110.30
S 35.20
73.50
110.30
56.90
vi K o oAo`s �t
State: (OA Zip:
Fax:
QL
0/1 0 Check
X, DarAl/D
IV E E FT
CCU 5 2C!g
ELECTRICAL
INSPECTIONS
Total (Qty Mulbolied by Unit Charnel
Service/Feeder 200Arne.
Service/Feeder 201-400 Amp
Service/Feeder 401 -6G0 Amp
Service/Feeder 601 -1000 Amp.
5 Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
S Branch Circuit N! /0 Service Feede.'
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
.S Temp. Service/Feeder 201-400 Amp
Temp. Service/Feeder 401 -600 Amp
Temp. Service/Feeder 601 -1000 Amp.
S Portal to Portal Hourty
S Sgn /Oulme Lighting
Signal Circuit/ Limited Energy Commercial. Additional 1500 55.00
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Mulb Family Dwelbng
S Manufactured Home Connection
S Renewable Electrical Energy 5iWA System or Less
S First 1300 Square Ft.
S Each Additional 500 Square FL or Portion of
S Each Outbuilding or Detached Garage
Each Swimming Pcol or Hot Tub
S 54 o 0 Thermostat
SC, on Total
Credit Card a
3604520939
Date I 6 6
2 Single Family Dwelling
Multi- Family or Commercial'
Commercial Addition 1 Alteration l Remodel I Repair`
`Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: l a a 3 6
Building Square Footage: aDA✓ar .u, Sao
Description of above /o w V o f a c .o a s fc. W a OG v o�
3 -fir }1 g ra�F !1 cl v d 5 1 s-/�.� f n S �n.C.t cl^
Contractor Info lion
Name: D avEis c 1
Mailing dress: n .4* 1c
Zip:
City n
Phone:_ Fax: !{C=� r93
License #IExp.
l/t I C9.°Jlca
5
Owner as defined by RCW.19.28.261- (I) Owner will occupy the structure for two years a her this electrical permit is finalized. (2) Owner is required to hire an electrical contractor it
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 1 am the owner of the above named property ora licensed electrical contractor. I am making the electrical installation or
alteration in compliance with the electrical laws, N.E.C. RCW. Chapter 1928, WAC. Chapter 296.468, The City of Port Angeles Municipal Code, and Utility Specifications.
Signature of owner, electrical contractor or electrical administrator 0 Cash
p1
d
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
INSTALL A HEAT PUMP
Owner
LORNA M KONOPASKI
1228 E 6TH ST
PORT ANGELES
(360) 457 7401
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Qty Unit Charge
1 00
Fee summary
14 8000 EA
T Forms /Building Division /Building Permit
WA 98362
MECHANICAL PERMIT
INSTALL A HEAT
174805
64 80
10/05/10
4/03/11
Per
Charged
Permit Fee Total 64 80
Plan Check Total 00
Grand Total 64 80
10 00001131
524864
1228 E 6TH ST
06 30 00 0 2 1110 0000
LORNA M KONOPASKI
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
6270
Contractor
DAVE S HTG COOLING SRVC INC
PO BOX 413
PORT ANGELES WA 98362
(360) 452 0939
PUMP
Plan Check Fee
Valuation
BASE FEE
ME FURN /HP /FAU OR 5 TON
Paid Credited
64 80
00
64 80
00
00
00
Date 10/05/10
Due
00
00
00
00
0
Extension
50 00
14 80
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
ok,
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
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Inspection Type
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
PLANNING DEPT Separate Permit #s
Parking Lighting
Landscaping
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.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
T.Forms /Building Division /Building Permit
Date Accepted By Comments
1 FINAL Date (0' (2/ cepted by PIg
FINAL Date Accepted by
SEPA.
ESA.
SHORELINE.
Date Accepted By
Oct 0510 09 48a
Applicant Pali -es r` Phone
Property Owner L a r In 0. K o r c> 0. s K t Phone
Property Owner's Address t a 53 ea- 54 C,-1:1z- S
Contractor .D0.Ue -ts K ±1 Phone
Contractor's Address 0 goK c{ I PC) r"--4- A c
License .D,4- Es f-( G1'9 I (;_c_ Expires f I f E mail
PROJECT ADDRESS s C fr
Parcel Number
Dave s Heating Cooling
Floor Areas Existing (set. fL Proposed (sq. ft.)
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
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
BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
3604520939
Lot Zoning
Project Type Brief Description: }Residential a Multi family a Commercial
Check all that apply
o New Construction
o Addition
a Remodel
o Repair
o Demolition
o Re-roof
Heat System
o Other
a House a garage a other o tear off re -roof a lay over one layer
)(Heat pump o wood burning stove o gas fireplace a pellet stove a other
TOTAL VALUATION g; 7 O Cr-'
Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17 94 135 for exemptions) Site coverage
f 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 P151/0 Print Name ()rden k4 vn,ia Signature
T:Forms/Building Division /Bldg Permit.doc,
For City Use Only
Date Received 16-5 -1 O
Permit# 10- iii(
Date Approved
9
fS1-o13
'-(51 7<Fo 1
per sq. ft
of bedrooms
of full baths
of half baths
p1
a Industrial
Clallam County Assessor Treasurer Property Details 57853 LORNA M KONOPAS Page 1 of 6
Clallam County Assessor Treasurer
Property Search Results 57853 LORNA M KONOPASKI for Year 2010 2011
Property
Account
Property ID 57853 Legal Description. LOTS 3 &4 E30' LT5
BL211
Geographic ID 0630000211100000 Agent Code
Type Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11
Open Space N DFL N
Historic Property N Remodel Property N
Multi Family Redevelopment: N
Township Section.
Range
Location
Address: 1228 E SIXTH ST Mapsco
PORT ANGELES WA 98362
Neighborhood Cycle 5 Res Map ID 2
Neighborhood CD 10955130
Owner
Name LORNA M KONOPASKI Owner ID 194653
Mailing Address: 1228 E 6TH ST Ownership 100 0000000000%
PORT ANGELES WA 98362
Exemptions.
Taxes and Assessment Details
Amount Due if Paid on 7.
Property Tax Information as of 10/05/2010
NOTE If you plan to submit payment on a future date make sure you enter the
click RECALCULATE to obtain the correct total amount due.
First Second
Half Half
Base Base
Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest Base Paid
2010 40834 ST SCH STATE SCHOOL $345 97 $345 97 $0 00 $0 00 $345 97
2010 40834 CC -GEN COUNTY $184 12 $184 11 $0 00 $0 00 $184 12
2010 40834 PORT PORT $25 88 $25 87 $0 00 $0 00 $25 88
2010 40834 PORT ANG PORT ANGELES $426 30 $426.27 $0 00 $0 00 $426 30
2010 40834 SD #121 SCHOOL DISTRICT #121 $448 12 $448 13 $0 00 $0 00 $448 12
2010 40834 NTH OLY LIB NORTH OLYMPIC LIBRARY $53 50 $53 50 $0 00 $0 00 $53 50
2010 40834 HOSP #2 HOSPITAL #2 $75 53 $75 53 $0 00 $0 00 $75 53
2010 40834 WSMET PK DIST WILLIAM SHORE MET PARK DIST $24 04 $24 03 $0 00 $0 00 $24 04
2010 40834 CITY_STORMWATER CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $36 00
2010 40834 WEED_CONTROL WEED CONTROL $0 82 $0 81 $0 00 $0 00 $0 82
2010 40834 TOTAL. $1620.28 $1620.22 $0.00 $0.00 $1620.28
2009 578532008 ST SCH STATE SCHOOL $394 03 $394 02 $0 00 $0 00 $788 05
2009 578532008 CC -GEN COUNTY $199 40 $199 43 $0 00 $0 00 $398 83
2009 578532008 PORT PORT $28.25 $28.24 $0 00 $0 00 $56 49
2009 578532008 PORT ANG PORT ANGELES $437 39 $437 39 $0 00 $0 00 $874 78
2009 578532008 SD #121 SCHOOL DISTRICT #121 $487.29 $487.28 $0 00 $0 00 $974 57
http. /vpn.clallam.net.8084 /propertyaccess /Property aspx ?cid =0 &year= 2010 &prop_id =57 10/5/2010
. ~.~o~ CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
A~plicat ion N=mber ..... 03-00001159 Date 12/05/03
Property Ad~ress ...... 1228 E 6TH ST
A~SESSOR PA~C~L N~MBE~: 06-30-00-0-2-1110-0000-
Tenant nbr, n~me ...... PROPANE INSERT
A~lication description . . . MECHANICAL APPL. PERMIT
Subdivision Name ......
Property Zoning ....... RS7 RESDNTL SINGLE FAMILY
Application valuation .... 3000
O~ner Contractor
KONOPASKI WARREN H EVERWARM
1228 E 6~ ST 257151 HW~101
~.5-q- g40; {*60) 462-3366
Permit ...... ME C~ANI CAL PERMIT
Additional desc . .
Per, it Fee .... 57.65 Plan Check Fee . . .00
Ieeue Date .... 12/05/03 Valuation .... 0
E~iration Date . . 6/03/04
Qty unit Charge Per Extension
1.00 10.6500 ECH ME-GA~ PIPE 1 TO 5 10.65
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 Authorized Agent Date Signature of Owner (if o'~;~'wner~ builder) Date
T:q°LANNINGkFORMS\1102.15 [l 1/14/2003]
Fill out COMPLETELY and in INK. Your application and site plan MUST B
you
any
CO~LE~ to be accepted for review, If have quesflons~ call /~ Date Appmved:~
(360) 4174815
O~er: ~ ~,
Phon~
~hitee~n~neer: '~ Phone:
Ad~ess:~lS--~ ~ tO~ ~ Ci~:~o,~r ~/~ Zip:
LEO~ DESC~ON: Lot: 1. d ~ Block: ~ ~ I SuMi~sion: .... 0~ ~
Credit Card Holder Name:
Billing Afldress: City:
Credit CardType VISA __ MC __ # Exp, Date:
TYPE OF WORK: SIZE/VALUATION:
Residential [] NewConsl~. [] Re-roof /5;~.,Stove SF,~$. /SF.=$
[]
[] Multi-family El Add~tion El Move [] Garage SF. ~ $ /SF. = $
13 Commercial [] Remodel El Demolition 12 Deck SF. ~ $ /SF.--$~
[] Repair r~ Sign [] Other TOTAL VALUATION $~L~/~ ~"-- ,
BRIEF DESCRIPTION OF THE PRO3ECT:
COMMERCIAI.TRESIDENTIAL: Occupancy Group: , Occupant Load: __ Conslruction Type:
No. of Stories: Lot Size: Exis'dng Sq. Ft. & Proposed Sq. Ft. = TOTAL Sq. Ft.
Existing lot coverage % & Proposed lot coverage % -- Total lot coverage. %
APPROVALS:
PLANNING USE ONLY: PLAN: __
BLDG:
DPWU:
FIRE:
ESAJWetland(s): [] Yes [] No SEPA Checklist required? t3 Yes t3 No Other: i
: OTffER:__
BUILDING PERNIIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the appllcafion and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all eases, 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.
PL,4aN CHECK FEE: IF a plan cheek fee is due it must be submitted at the time the building permit application and construction plans are
submit/ed. All other perrmt fees are due at the t/me of panini issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
B~aflding_OfficiaI_cana:~end theXime.for_action-by-the.applicant up to ~80-days-upon.~vri~ten request by the-applicant (see Section '107:4 of
the Uaiform Building Code, current eclJtion). No application can be extended more than once.
I hereby ceA'ty that t have read and examined this application and know the same lo be tree and correct. I am authorized to apply for thi~ permit ond
understand that it is my responsibility to determine what permits are required, n at the City's, snd that I must obtain such permits prior to ~york,
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16426
Port Angeles, washlngtonm.L~n_.~:tL.........._....n.mm....m.m, 19')007
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 d6 electrical work as listed below.
Address .__L,'bnn:dn..<iC.__.E.mm!i?!.d:.U<._..__nm.mn.nm__m Occupancynn...___.!~n.._.._._._nm.
. '"
~:~:~~:::~~~.::&g~~:~1~i~J.=::::::____~~~~~~;::..::::::::::..~::.':::::::::::=::::::::::::::::::=:::::::::::::::::::
Light OUtletB...mm.mn.mm.,..mn_n_..(.. Service, volts .mL'l...,@:m",~.Yn~ Type ot Wiring:
Receptacle Outlets......................__.._.... No. wires ......If?................._......_... Armored Cable .............--.--...---.----.
Si . f /" -.L d1,\ "i:./l. Non.Metalllc mmmnmm.nmn'n._'"
ze WlreSnnt_..n__nm_.m.mm.n_.. It'
/ -
11<) o-A-.
Main fuse .....____:_.___..________.._.__...___..
Dryer, KW uunnn____n.....h_.........n._.."_.
Knob & Tube......__....______....__..........
Range, KW.n....h.._.....n._..
Water Heater:
Enclosure _______.____....___........___...
RIgid Conduit n_.m.nn'nnmnmm.n
Metallic Tubing mnmm.mnmnnn.
KW.___.mmmn.m.n
Heat KW...3.0..t;;:'.W:mnI",,~ '
Type of wiring:
Entrance Cable ..___....___mn_____.
Motors: size, volts and phase:
Rigid Conduit ................__....
Metallic TUbing m.___
Current transformers:
Raceway ......................._......_......_
Circuits, Llght.___.__.._____......._..........._....
Utllity nn.mmmm.m.nmnmnn.nnm.
Heat ___...._._............................._.._...
Ser. No.._.........___.....___.____..__....___.._____.
Range .................._..._.________._...........
Water Heater ,.................._____.......
Motor ..._..................._______..__..........
No. & Size..............._....._______..
Ser. No. .____...............__..........._...____....
Dryer ..._......_.._____..._n..___..................._
Furnace ___....___................~n...._...._.....,
Ser. No. ...._.....___..___n.._.__..__..........__...
Total :Load____......___.______....__... Ser. NO.__n______n..._._...____.:___._.____...._.. Total ...____._____.____..___................
Remarks: n~~.:~:\mmn..mnm.~..f:.f.nl!....y..n.j..m~n.'m.nmm"l..<2n~.k'!..mf.~~n..mn__m'_'_
Permit Fee
$:00.000...._......00.000__000.0000000.
Treas. Receipt
NO.n....m.......n.......__.
By / A ) -~,~'.,-
un___n_-.:...__.___..u....___.........._nu.......___n_..____n_
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
30
KvJ
F,-U!l.
ELECTRICAL PERMIT
N? 16426
Address nnL~m__~oum~.__.hm.fi___.n____~___...l.d::l..__m____m______.h.___h._hm...n__ou Datemj, ':n=_~__l..=__2../lm_
Owner {.1).(.!.A.!.)m~;o.1.'(,Af::~U.~...----h--.--n--.--n'..h.h--.. Tenant....mmnmnnmnnn____nm__.mn.m.m.nm____nm
Wiring Contracloroum__h=....___.~"r.---.-ouh--n----.h.-------mmm.---------mmh-------mh____.m__h_____ By.mmmL-"t.J.~.m__mm___hmhh__
NOTICE-Current must not be turned on until Cert1flcate of Inspection has been issued. It' work Is to be con-
cealed due noUce must be given the Inspector so that work may be inspected before concealment."
I U nlvmnic Printers, Inc.