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Home My WebLink About929 E Front St - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc New circuit Owner KENNETH G NEMIROW 76 FAWN HAVEN RD PORT ANGELES (360) 452 8344 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 1 00 73 5000 ECH Permit Fee Total Plan Check Total Grand Total INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 983629294 ELECTRICAL 179580 73 50 12/29/10 6/27/11 Fee summary Charged 73 50 00 73 50 Signature of owner or Electrical Contractor ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 10 00001504 287136 929 E FRONT ST 06 30 00 6 1 0328 0000 ELECTRICAL ONLY COMMERCIAL ARTERIAL 0 Contractor EXTRA MILE TECH ELECT LLC 418 N RACE ST PORT ANGELES (360) 457 0198 ALTER COMMERCIAL EL BRANCH CIRCUIT WO /FEEDER Paid Credited 73 50 00 73 50 DATE. PERMIT WILL EXPIRE SR (6) MONTHS FROM LAST INSPECTION Plan Check Fee Valuation 00 00 00 1z/17z)/n )2137) Date 12/29/10 WA 98362 q5-7 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 City of anrt AnaGtex permit Appl lcetiun 321 e, WIF Box 1150 Port Anperee Washington, 98382 4711 Ph: (3601 417 4735 Fate (360) r Dolt:. I d Single Family 1110111 t;Ii...F ofnit7 pr Cutr,mercial• Icciordil MDR I Mvretion I Remadei I flat. �i' E1 ae d• Please Complete Eiecir.,.al P an RetlIg It O111I JILLI tan�autew rl. vl 51:1e ET .L Job Add;e6` p,,itarrg Square Foot r De.,rV :ion Cf a(100 Owner nforrnation Name ke l" r n `i i Madrr�l AddreSS'. City F -1 u State..(. 21D U LL_ Phone: :"r- 2_.,6' 21 Fax I.)nif L`harg 5 S '4S.51 S 204.63 63 ttiki T un 5 Se 70 S :C :13 S lab yS S 1 .15" 55 .4iC S tS.2, S 4S S 2Or, !iv S 15 50 s 4 r•; v. S 56.u0 AY signature of owner, r Metrical contractor or elw trtca, awn•nietrator p f I_J r�itrn A C ntractor Information Name, exlItI1- M 1 LE Mailing Address: 1C1 OIL p r t °te: Phone:1�7-5 License 1 Exp_arie..14171 ToQ i i'inlied by i har e• ServicalFeader ZOO Amp, Sake/Feeder 201.400 Amp. SeivicelFeeder 401.600 Amp. SenrlcelFeeder 601.1000 Amp. SelvicelFeeder over 1000 Amp. _Branch Circuit WI Service Feeder Branch Circuit WIO Service Feeder [8C AtlVIIIOga) O1RGn 01f (Vii Temp. Service/ Feeder 200 Amp. Temp ServicelFeeder 201.400 Amp Temp, Service /Feeder 401.800 Amp. Temp. Service /Feeder 601.1000 Amp Portal to Portal Hourly Sign /OuIhne Lighting Signal Circuit Limited Energy Commercial, Additional 150. r I' Signal Circuit/ limited Energy 1 2 Family Dwelling m Sinai Circuit/ Limited Energy Multi•Family /)welling Manufactured Home Connection Renewable Electrical Energy 5KVA System al .eLs Fast 1300 Square Ft Each Additional SOD Square Ft or Portion r.,i Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tun Therm ostat Toral Owne' as dofned by PCW 19,219.261. (1) Owner will octopi the structure for two yeas after this electrical permit Is finalized. l:1 Own abort said property is tar salt, rani or lease. Permit txprram after six months of last inspection. Alter eadtng the above statement, r hereby certify n,.a a the owner of the above named property or a licensed electrical contract, alteration In compliance with the electrical lows, N.IS.r'. R';W Chapter 10 28, WAC. Chapter 296.488, The C ity or Dort Angeles Mumcr Credit Card 4 RECEIVED Ls; DEC 2 9 2010 ELECTRICAL INSPECTIONS rfcJ.L f 6: I Ect Ye.1 Ct °l,. �"t2U N-(. 1-r1I r r ,s evoked to hire an electrical conuacioi I ark making the electrical inswllaunn •r Tar Chan, and Utility Specifications Casa _L. Application Number 10 00000483 Date 5/13/10 Application pin number 520367 Property Address 929 E FRONT ST ASSESSOR PARCEL NUMBER 06 30 00 6 1 0328 0000 Tenant nbr name CHESTNUT COTTAGE REST Application type description PLUMBING REPAIR Subdivision Name Property Use Property Zoning COMMERCIAL ARTERIAL Application valuation 350 Application desc ADD A CARBONATED BEVERAGE BACKFLOW PREV DEVICE Owner Contractor KENNETH G NEMIROW 76 FAWN HAVEN RD PORT ANGELES (360) 452 8344 T:FormsBuilding Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 983629294 ANGELES PLUMBING INC P 0 BOX 1151 PORT ANGELES (360) 452 8525 Fee summary Charged Paid Credited Due WA 98363 Permit PLUMBING PERMIT Additional desc CARE BEV BACKFLOW PREV Permit pin number 165381 Permit Fee 57 00 Plan Check Fee 00 Issue Date 5/13/10 Valuation 0 Expiration Date 11/09/10 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 7 0000 EA PL- BACKFLOW PROTECTION <OR =2 7 00 Permit Fee Total 57 00 57 00 00 00 Plan Check Total 00 00 00 00 Grand Total 57 00 57 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 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. 5A' Zert/" Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner 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 J 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 T:FormslBuilding Division /Building Permit 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 Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping SHORELINE. FINAL Date b� 1 A Accepted by Roh FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE BecKza- Date Accepted By OQ W fi 4a.L we- "t5 Appdacat ion Hurither Appli:CatiOn '.pin .Property Addresa ASSESSOR 'PARCEL-NUMBER: Tenant mbr nate :ApPla'cataOri type,:desCriPtiOn :Subdivision ;Nan* Property Ilse 'Property :Zoning .ApPlacat ion valuat:ion ADD A,7CARBONATED B 12,EviCE- :ApPlicati on tde c Owner 'KENNETH iG 76 .FAWN -HAVEN =RD 'PORT .ANGELES r ,452 ;8344' 'Permit :Additionai .desO' Permit 1pin :Fee issue !Da±e CITY OF PORT ANGELES 1:3!EPARP4ENT4COMMUNITY 8c'ECONOMIC:DEVELOPMENT BUILDING DIVISION... EAST'STFI;STREE-T 'PORT ANGELES, V08.362 472, 9 "16 000 Date j,503 129 1 :FRONT ST. g0.6 :3;0,0.0 '6 ;0326 :00.00- r; CHESTNUT; COTTAGE REST' ;PLUMBING REPAIR :COMMERCIAL ;ARTERIAL 350 Contract-or ANGELES- :PLUMBING. INd 4P '9: *-0ktf4d1.6g;'4 *.183568! (3fgO;): :8 1 'PLUMBING PERMIT, '5'i' 00 Plan Check Fee 00' 14.0' ':CinA3R-" BEV '1 CA 6 -4 -Ttt: V' ':5 /4.4i,"&yr4w4- 5 2 71; 9, A 7.4;,, 47 Q Unit Charge Per ,L. V 4' Extension A't 4, f; :BASE' :FEE 77 4 50•70,.0,.1: 7 :p.o 4 l a. 'cr6 7 -6 oo a 'EA. '.i TitOT ok12 'I''- '3'. :Fee ;summa', ;t4S,ar.:404: .1D4r#t ;,.'6;,*0.k.io:ci: ir --v. ^i Zi: '5?- o 1 4 Terniit 76e. 75-'i o,o. -.4! T:57- 'DO» :00 '6" r011 .v ,P.Iari Check :TOtal ,t: 06 t d -a& do. A' 1 -,,-4- .6 iGrand ',Total '5 7' q:; ;57 ;00, 00 )601, 47 4 47 749 "I :e If,`; 4 4 72 44' 4- 'Separate Permits 'are :required Shoreline, ESA, eS,„priyate:and',.ptibl fejMproV,ements. 'ThisTerritit become s 'null -and' void :if work or.corikructi On authorized is not commenced .within ..180 days, if Constructiorr or abandoned for:a,periodof 180 days' after the work has bommenced,-Or within ISO days from the last inspection have) 'read'and'..examined this .application and know the s ame to be true and correct All pro■ii§iOnsooflaws;ancrordinances„koyerning.this.:type of work will ;Oe...complied.with herein or not 'lle`granting-of a permit does not presurne:.to 0 'State or local 'la' regulating ConStrbetion or the performance. ofoonStructioti: Date lifint Narne; Signature df, or Authorized -Agent: Signature of OWne owner is builder) ,i T:F9TTpmil;)dirig.i)i:risjoy-iii;iiiitciti:pp 4. -'1,.., -6i -.4' t k' --F -7,- 4 4 6.6 p 1.' t; PORT 440 Backflow Assembly Test Report City of Port Angeles Public Works and Utilities Department Water/Wastewater Collection Division NAME OF PREMISES. rA r c o r SERVICE ADDRESS LOCATION OF DEVICE. SI R F 111AA/ ASSEMBLY t/ 4 f G Manufacturer Model Size Serial No IS THIS AN APPROVED ASSEMBLY? YES Cr-NO IS ASSEMBLY INSTALLED CORRECTLY'? YES NO DATE OF INSTALLATION M 4 r P6 UNKNOWN 0 Initial Test Repairs Details DOUBLE CHECK VALVE ASSEMBLY CHECK VALVE #1 CHECK VALVE #2 Leaked Held at S J'psi Cleaned Replaced Final Closed Tight Test Held at.6�• psi Held at psi Opened at psi AIR GAP INSPECTION REQUIRED MINIMUM SEPARATION YES NO COMMENTS l ij> f EG j Cc/ e 5 Cam, f��` 'Initial Test Repairs Final Test I Date:Time Tester I !G et 2 e GA./ 7 s 7 -,r e G /'a..9 /Vf' e: REDUCED PRESSURE PRINCIPLE ASSEMBLY Leaked Closed Tight CJ Held at psi Cleaned Cleaned Replaced Replaced Signature RELIEF VALVE Did Not Open Opened at psi 3 psi Butler YES NO w C 4 5 7 efT CL— WHITE CUSTOMER COPY YELLOW PURVEYOR COPY PINK TESTER COPY Official Use Only Asscm.# Received g TG' 3 5 15 RP 13Y' RPDA DC DCDA PVB Air Gap SVB AVB PVB /SVB AIR INLET Did Not Open Opened at psi CHECK VALVE Leaked Held at psi REPAIRS Cleaned Replaced AIR INLET Opened at psi CHECK VALVE Held at psi BACK PRESSURE NO YES TYPE OF HAZARD d 4' Line Pressure psi Held Backpressure YES El/NO #2 Shutoff Held YES 0 NO Relief Valve Exercised YES 0/NO Cert. Test Kit Passed Failed 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 Applicant ;P =i 14 /i Property Owner /1/�� Property Owner's Address f avr57 Contractor 61 9 g �`g.,j? Contractor's Address License Expires PROJECT ADDRESS SVi�% 47 6",E Parcel Number Project Type Brief Description. Check all that apply New Construction Addition Remodel Repair Demolition Re -roof Heat System -AOther Floor Areas Basement 1 Floor 2nd Floor 3 Floor Garage Carport Covered Porch Deck Shed Other House garage other tear off re -roof lay over one layer Heat pump wood burning stove gas fireplace pellet stove other Existing (sa. ft.) f ,C, o vrsT Lot Zoning Residential Multi family Commercial Industrial proposed (sq. ft.) 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 Phone Phone Phone E -mail For City Use Onl Date Received k0 Permit #___(c t-L Date Approved XS per sq ft. TOTAL VALUATION .3_$0.0e7 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 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,5 Print Name Signature T Forms /Building Division /Building permit application '~ \l!! CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 121 EAST 5TH STREET. .PORT ANGELES. WA 98162 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00001227 Date 12/16/05 919578 929 E FRONT ST 06-30-00-6-1-0328-0000- ELECTRICAL ONLY COMMERCIAL ARTERIAL o Owner Contractor NEMIROW KENNETH G 76 FAWN HAVEN RD PORT ANGELES WA 983629294 SIMPSON ELECTRIC 243036 W HWY 101 PORT ANGELES (360) 457-9270 WA 98363 ------------------~---------------------------------------------~----------- Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER COMMERCIAL SIMPSONI ADDING HEAT STRIPS 67207 SIMPSON ELECTRIC 61.30 Plan Check Fee 12/16/05 Valuation 6/14/06 .00 o ~ ~ --J) Qty Unit Charge Per 1.00 61.3000 ECH EL-COMM ALT <5 CIRCUITS Extension 61.30 - -------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 61.30 61.30 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 61.30 61.30 .00 .00 ~ ~ <: \ ~. j COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO liT. 'H R IIIUH~IN I CUYbK i:)nK vICE 1/~1Pt, IkJ) GENERAL COMMENTS: PW-1I02.l~ (4196) Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT '. ELECTRICAL PERMIT PERMIT NO. ::!? 3 ~ DATE~O-d<c;-q / Site Addfess: o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Owner/Busine Phone: Owner/Business Address: Sq. Ft. D Residential Heat KW D Baseboard D Furnace/Boiler D Heatpump D Other D Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) D New Construction D Remodel D Service update/alter/repair 4"J'erhead ~~dergrOUnd Voltage D 10 D 3.0' ~vice size /tJO Jb Temporary DetailslDescription: D Add/alter circuits D Auxiliary power (list below) D Special equipment (list below) /7;;'nf7tt74A ~ (ltf2d~ LfrIap p2~ Amps . W.S. No. Service Capacity: D O.K. D Not O.K. D Ditch inspection O.K. D Rough.in/cover O.K. . ""Ifp O.K. to connect service kJr b Final O.K. Size Comments Date Hold for: D Easement D Letter D Signed up for service/meter D Meter Department notified for installation D Fire Department notified of inspection D Plan Review approved/pending Installer: Permit/Receipt No. ~ Date: Site Address: New Meters ~ I /tJ-.,JC-1/ . Notify the epartment of City Light by Street Address and Permit Number when ready for inspection. Work must not e covered or electrically energized before inspection and O.K. for covering or service has been given by the ,nspect7 Writing on the Wiring Report or the BUilding Permit. PHONE 457.0411, EXT. 158 or EXT. 224. L'2J U NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT .2 0, on In pector -fJ- Amount paid WHITE - file by address YELLOW - file by number PINK - Top Eng, BoUom Customer GREEN - Top. Inspector, Bottom City Hall OLYMPIC PRINTEFlS. INC. Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO. ~..!'..r3 //-/ - 9/ I. ELECTRICAL PERMIT DATE Site Address: o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: ~ Sq. Ft. ! D Add/alter circuits D Auxiliary power (list below) D Special equipment (list below) ~ Overhead D Underground/ .........,. Voltage /p(.7~ D 10 '%30 Service size 67.s- Amps D Temporary " D Residential Heat KW D Baseboard D Furnace/Boiler D Heatpump D Other ? Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) )!!r' New Construction D Remodel D Service update/alter/repair DetailslDescription: #("&0 KrrkL4-vr f . UJIVV{chj $;~~ . J 4/ ;f t/ If /J 7T1'f Tel, Eel l'tv /0 W.S. No. Service ca~~r~r D O.K. D Not O.K. . : /7."" I(i ~. . 0 K / . tJr. -r-' .. Inspection.. j/-"f:> Rough-in/cover O.K. ... '$ O.K. to connect service -1/'~Final O.K. Size Comments Date Hold for: D Easement D Letter D Signed up for service/meter D Meter Department notified for installation D Fire Department notified of inspection D Plan Review approved/pending Installer: (. dl- Permit/Receipt No. ::.? 3S" :3 Site Address: / -9/ New Meters . Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.04}). EXT. 158 or EXT. 224. ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT IJ& J 80 t!!::!? Inspector Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMPIC PRINTERS. INC. , q:l 'f. r. Fto,,;t .jI'tR V\t<z ~ GA/t/""I<'A... ~J.G/' rI-Ll6 ~OAi-' . /J~~ ii4S,tC ;;::<) -:' ~ KVA ...., ........ .. ::); .:; (/ ~j _. -\> F :=t.=r ;^.). '/4 - .;." ,: .', '; V.A IV/::C- ;1,=-0 -/O(b) (., "10 V A , . -,-"I f X/'.-- -. .,..,........ ,"l go, :: o..~ ,/... 6.3 l<v,4 G:c:'Uc '<'''''- PUR POS~ Re::.epr~G..s IJL:=c.. ?. ~ 0 - 3 (c: ') (f) /1 )( /80 v/t.:: ;z, I !:::,-:), 0 vA- :J. S-:;Z 1< I/A j;';KT~I<JC> R.. LZ::GI-ITI^J<S- 350 VA ;X IJ..~'('> 0 = ~/3 7, 5v',4 ~X~I<.r;of<.. Sxs/'J >y-<; )(V,h -. :).:fco vA X /:;;"'50/., .- :/ "0<.; ,/,4 '-". ../ . 3~ 0 /<V/f K~Tc..;./",rJ E~L)IfJ.A./:.;A)T I~~ J<-vA NEe ;}";;I..o-;40 / 31 l<v,4 X 050/0 - 90. 3~ kVA HVAC ,A/f~ t-JANDt-.t: ~ 150OO\/A- f-IEAr RJ,,-,\p 000C>VA A'I R. To ;411<' Go CCO Vl"l TOTAL. l<.vA == 131. (;.( X 1000 ,. /0.::;-:::' f. . , .' IS-.t<VA G:. 1<. VA t,;, K VA- 13 I . 'I /WA ==3C:S,58'A . :;ZO&' x 1.73 . "" ~ :J ~ ~ r , , 1 " :;2 1;;/ p/Dr,,' '-->VJL -c=177 ~ - ;:;: '" I "-- ""'. .Ljyll NE701\ :2 R C. T CAN '.r-IITJ-I CT M()UAJT/uC~ [>,ASc 13 ::rA ,,j tJi E rn'~ \3,ASF- 'AI 1m TeST H 13;,0--1::. ~ ~DAC~ ! 1 I I ! . " i I , -------1- , I :\;;lSA i :;J,~ 1< Ale 'l,),A I,',) . ~;~~;~ ---,:~J-,-~ (iJD/;;OI> I' / 3yS 'fIN' [00" " / . Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT . ELECTRICAL PERMIT PERMIT NO. .3~.;2 '1 DATE / z.//0-/ Site Address: D READY FOR INSPECTION License Number: WILL CALL FOR INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: Sq. Ft. o Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction o Remodel o Service update/alter/repair o Overhead o Underground Voltage 01003.0 Service size o Temporary o Add/alter circuits o Auxiliary power (list below) i'fSpecial equipment (list below) Amps Detai IslDescription: ~{T /f~r . W.S. No. Service Capacity: 0 O.K. 0 Not O.K. o Ditch inspection O.K. o Rough.in/cover O.K. ~ O.K. to connect service ~ Final O.K. Size Comments Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Site Address: <1;2f ~ !:" . New Meters Installer: .- . Notify the Department of City Light by St et Address and Permit Number when ready for inspection. Work must not be covered or eiectrically energized before inspection and O.K. for covering or service has been given by the Inspec~riting on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. ('! ~ . NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT :Z, ~ nspector Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall 12/12/2005 20:34 4579270 SIMPSON ELECTRIC PAGE 01 /.,)../3/0$ S' .- ~.'~i ...... ELECTRICAL WORK PERMIT APPLICATION. :Job" i2- 1,-/-0$ )ll Electrical Contractor In!l:tallation dCl'locripfion .Tnb wired by DOwner )1J.. Commercial l:I RlI:sideDtial SlcctriC81 contractor ""me license number Dutc Expires ~Alter.d/Addition ~SOfJ ~/..C.tv-I'C. 'Si ",pse.L f(13~ 12/11107 DNew "';43'03bP ~j 101 W JLdJ " n..5 IJeA.J s-Jy,. P 5 C;/JO(.+ AI'\-5 eks ~,.(rp 'J rr 3 /.,3 T'kQOS7~~ ';l?r) FAX number 'H:; ~ premiseS;;'WDtrlS n8me: C-Ci>~e C es+ n.""'" Adq',i' ; ;n~d;r-A'on 6 ::;-1. Clly fa;e + /in Cje./e.,s, WI1. Phone number 4_l'C'.2dtl1e in~l"i~on: ~ -~.$"" OW1:Ie-r D,; defined hy ROJ~/9.28,261:(1) Ottl/f("r l1'jl/ occupy fhe: .r/rut:f"r~ for twC) year,\' O;nc!r fhi.f l'lecll'icol pcrmil i.v finalized. (2) Ownl!'r j,; reqrtirl!d 10 hrre 1111 declI;ca/ contractor- if ahove .;aid prnpe"'J' L'i fo" .'iok "('", or lCU$c. o Cash o Check # After reading the above .<:.tatement. , hereby eCl'\iry tl\;l1 I 3m the owner or the above )0 CrcditCard .9 Mas!eTCard Discover named property or II licensed elcctric:'ll ecmtmctl)r, , i'l0l m~king the electrical inSf"]- lltlil)t1 or "ltcr,llion in' complillTleC with the electrical'law!;. N.E.C.. RCW. Chapter --pF.--~-------- 19.28. WAC. ChDptcr 29()-4()R, The City l)f Port Angeles Munieip.,l Code. "nd Card # Utility SpceificBtions. s;cn~~r nwner, 'JctTlc~ntrocror or ,1,,,,;,,1 .dm;n;"'..o, Expiration Date X 'jl'l L_ /_ - _; ~J. Date: /..:l~$/e>5' (Inspection fce of card $ ~/. 50 Electrical LQi!.dAdJlltlons and or subtractions o NO LOAD CHANGES o Baseboard KW D Fumace KW a Heat Pump Ton LAR o Fan-Well KW Service Information o Qv9rhead Service a Temp Service o Underground Service /' Vottage . PhaseD 1 03 ~ Service Size: -V t:-O r<"-rr'--V Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7;00 AM 360-417-4735 ROUGH-IN /' THERMOSTAT SERVICE I)~le "'l\r/O('l~e,1 ~y [\;tlt ^r-pmv~d fly DMo ^fl1'1'""d Oy / /' ANAL /' 'ffiEDER DITCH /-;'1-0(, ~ [)n1~ Jl,f1llI'(lV, By/ "- 0;111: ^ppmved f:ly "- Dnle ^ppToveel ~y Inspection Area, Building or F..quipment. Inspected Action T:'lken Electricnl Dille Tns"ector /l /'"\ ,/7OfY7 ~ 13/os-'