HomeMy WebLinkAbout1134 E Front St - BuildingPREPARED 3/07/07 9 04 31
CITY OF PORT ANGELES
ADDRESS 1134 E FRONT ST
TENANT NSR JOHN L SCOTT
CONTRACTOR
OWNER WILCOX LINDA A
PARCEL 06 30 00 7 1 0200 0000
APPL NUMBER 07 00000172 SIGNS
PERMIT SIGN 00 SIGN
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
SUBDIV
PHONE
PHONE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL99 01 3/07/07 JLL BUILDING FINAL
03/06/2007 02 00 PM PERMITS
MIKE MILLER 452 7785
COMMENTS AND NOTES
PAGE 5
DATE 3/07107
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 4
321 EAST 5TH STREET PORT ANGELES, WA 98362
�t
Application Number 07 00000172 Date 2/21/07 J
Application pin number 596860
Property Address 1134 E FRONT ST
ASSESSOR PARCEL NUMBER 06 30 00 7 1 0200 0000
Tenant nbr name JOHN L SCOTT
Application type description SIGNS
Subdivision Name
Property Use
Property Zoning COMMERCIAL ARTERIAL
Application valuation 750
Owner Contractor
WILCOX LINDA A OWNER
82 ISLAND VIEW RD
PORT ANGELES WA 98362
Permit SIGN
Additional desc
Permit pin number 95729
Permit Fee 94 00 Plan Check Fee 00
Issue Date 2/21/07 Valuation 750
Expiration Date 8/20/07
Qty Unit Charge Per Extension
2 00 47 0000 PER S SIGN LES THAN 25 SF 94 00
Fee summary Charged Paid Credited Due
Permit Fee Total 94 00 94 00 1,00 00
Plan Check Total 00 00 00 00
Grand Total 94 00 94 00 00 00
n _r
VVV�Iw C�
d
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
2 . 2— t o'�
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T-\Policies\1102_15 building permit inspection record05 wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLA N FUL TO COVER, INSULATE OR CONCEAL ANI' WORN BEFORE
INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE I ACCEPTED I COMMENTS t
I I YES I NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE/ DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDERFLOOR/SLAB
!j ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
I BACK FLOW / WATER
AIR SEAL
WALLS
I CEILING
I FRAMING
JOISTS/ GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I(
MECHANICAL
ROUGH -IN I
HEATPUMP/FURNACE/DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
MANUFACTURED HOMES
FOOTING/SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING/LIGHTING
LANDSCAPING
IRESIDENTIAL
FINAL
FINAL
I I I
SEPA.
I ESA.
I I J l SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES I NO COMMERCIAL
ELECTRICAL LIGHT DEPT 417-4735
CONSTRUCTION R.W /PW/
ENGINEERING
417-4807
FIRE
417-4653
PLANNING DEPT
417-4750
BUILDING
417-4815.._���
T \Policies\l 102 15 building permit inspection Tecord05.wpd [ 1/4/20051
DATE ACCEPTED BY.
DATE ACCEPTED BY.
DATE I ACCEPTED
YES NO
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW / ENGINEERING
FIRE DEPT I
PLANNING DEPT I I
C`0,
FOR OFFICIAL USE ONLY
BUILDING PERMIT - APPLICATION
pt. Rec. -/3""p%
Temlito.
" *Qhw� or Fill out COMPLETELY and in INK. Your application and site plan MUST BE Date Approved:�
COMPLETE to be accepted for review If you have any questions, call Date Issued..
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: C rot � VG ri
Owner- 11 CIA1 N -7 -7 rr
Address. City-
Architect/Engineer- PvQ L e, -j -
Contractors S L G >J State License
Address: \ 3. 2-a c!!F (Z S 7 City. (119al
PROJECT ADDRESS 14 c -r
Phone: *75'2 S_
Phone:
Zip
Phone:
r/ C_ to Exp Phone:
,0-"4 C' -'d L.-} zip g P.? (. P
LEGAL DESCRIPTION Lot: \ 6- Z-- Block: -&— Subdivision.
CLALLAM COUNTY PARCEL NUMBER. 0 (_ 0 e:N C>_1 k0 -Z- c> cl
ZONING
TYPE OF WORK. SIZE/VALUATION
• Residential n New Constr 13 Re -roof 11 Stove SF @ $ 2_4 /SF = $ '7 U -r,,
• Multi -family 0 Addition 0 Move 11 Garage SF @ $ /SF = $
El Commercial El Remodel n Demolition 11 Deck SF @$ /SF = $
0 Repair 0 Other TOTAL VALUATION $ 7S o
IC
BRIEF C L G -,,j v.
DESCRIPTION OF THE PROJECT 4=
�22
COMMERCIAL/RESIDE-NTIAL.-6cc'upancy G+p- Occupant Load. Construction Type:
No. of Stones. Lot Size: Vxistmg Sq Ft. & Proposed Sq. Ft. = TOTAL Sq Ft.
Total lot coverage %
RECEIVED
PANN�r USE ONLY6;:0,11,��.IW_ W1 APPROVALS FEB 13 2007 PLAN:-,-,
��72'
BLDG
CITY OF PORT ANGELES DPWU
[3U)1L3iNG-9+V1S1W;J FIRE.
ESA/Wetland(s) El Yes 0 No SEPA Checklist required? 0 Yes C1 No CIL- OTHER.
VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and maybe revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 4174815 for assistance.
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 permit issuance.
EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the 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
R105.3.2 of the International Building/Residential Code, 2003) No application can be extended more than once.
I hereby certify that / have read and examined this application and know the same to be true and correct / am authorized to
apply for this permit and understand that it * is ility to determine what permits are required not the City's, and that
must obtain such permits prior to work.
TAF0RMS\I31dgPermitfbrm.wpd Applicant: Vl' Date: 21 il 0—?
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C4
03 0".-1 c.q.>w T
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PROPOSEO SIGN 32"X 71-
C9
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
WILCOX LINDA A
82 ISLAND VIEW RD
PORT ANGELES WA 98362
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
;21 FAST 5TH STREET PORT ANGELES, WA 98.362
07 00000172 Date 3/09/07
596860
1134 E FRONT ST
06 30 00 7 1 0200 0000
JOHN L SCOTT
SIGNS
COMMERCIAL ARTERIAL
750
Contractor
OWNER
Permit ELECTRICAL SIGN PERMITS
Additional desc ANGELES/ SIGN CIRCUIT
Permit pin number 96727
Sub Contractor ANGELES ELECTRIC
Permit Fee 35 00 Plan Check Fee
Issue Date 3/09/07 Valuation
Expiration Date 9/05/07
Qty Unit Charge Per
1 00 35 0000 ECH EL COMM 1ST SIGN
Fee summary Charged Paid Credited
Permit Fee Total 35 00 35 00 00
Plan Check Total 00 00 00
Grand Total 35 00 35 00 00
COMMENTS/ACTION NEEDED
00
750
Extension
35 00
Due
00
00
00
ELECTRICAL PERMIT INSPECTION RECORD
CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A M QMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INS MM014 TYPE I DATE IACCZVM � COMMEMS
YSS ! m
DITCH
ROUGH -IN J COVER
SERVICE
FINAL l I
GENERAL COMMENTS:
7W -11021514%j
PREPARED 3/05/07 10 00 33 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 3/05/07
ADDRESS 1134 E FRONT ST SUBDIV
TENANT NBR LINDA FRENCH
CONTRACTOR DAN SMITH CONSTRUCTION PHONE (360) 683 6040
OWNER WILCOX LINDA A PHONE
PARCEL 06 30 00 7 1 0200 0000
APPL NUMBER 06 00001200 COMM REMODEL
PERMIT HPC 00 BUILDING PERMIT COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL3 01 1/03/07 JLL BUILDING FRAMING
1/03/07 AP 01/02/2007 10 09 AM PBARTHOL
PARTIAL FRAMING REQUEST ON COMMERCIAL REMODEL
01/03/2007 04 18 PM JLIERLY
BAIR 01 1/08/07 JLL BUILDING AIR SEAL
1/08/07 AP 01/05/2007 04 56 PM PBARTHOL
DOUG 461 9090
01/08/2007 03 23 PM JLIERLY
BLWS O1 1/09/07 JLL BUILDING INSULATION WALL/FLOOR
1/09/07 DA 01/08/2007 01 24 PM PBARTHOL
DOUG 461 9090
01/09/2007 03 12 PM JLIERLY
door locked no inspection/jll
BLWS 02 1/11/07 JLL BUILDING INSULATION WALL/FLOOR
1/11/07 AP 01/10/2007 09 57 AM PBARTHOL
DOUG 461 9090
01/11/2007 03 19 PM JLIERLY
BL99 01 3/05/07LL BUILDING FINAL
03/02/2007 01 31 PM PERMITS
xt DOUG SMITH 461 9090
03/05/200 09 59 AM JLIERLY
COMMENTS AND NOTES
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
�i 321 EAST 5TH STREET PORT ANGELES. WA 98362
^rrii�aL1Ull nuuwer 06 0000120U Date 2/01/07
Application pin number 702800
Property Address 1134 E FRONT ST
ASSESSOR PARCEL NUMBER 06 30 00 7 1 0200 0000
Tenant nbr name LINDA FRENCH
Application type description COMM REMODEL
Subdivision Name
Property Use
Property Zoning
COMMERCIAL ARTERIAL
Application valuation
25000
Owner
Contractor
WILCOX LINDA A
DAN SMITH CONSTRUCTION
82 ISLAND VIEW RD
1482 HOOKER ROAD
PORT ANGELES
WA 98362 SEQUIM
WA 98382
(360) 683 6040
Structure Information 000 000
Construction Type
TYPE V NON RATED
Occupancy Type
BUSINESS OFF/PRO/MED/REST
Permit
ELECTRICAL ALTER COMMERCIAL
Additional desc
KIRSCH/8 CIR + 100A SUB
Permit pin number
92965
Sub Contractor
KIRSCH ELECTRIC INC
Permit Fee
148 00 Plan Check Fee
00
Issue Date
2/01/07 Valuation
0
Expiration Date
7/31/07
Qty Unit Charge
Per
Extension
1 00 75
0000 ECH EL COM ALT 0 200 SRV FDR
75 00
1 00 58
0000 ECH EL COMM ALT <5 CIRCUITS
58 00
3 00 5
0000 ECH EL COMM ALT ADDTNL CIRCUITS
15 00
Special Notes and
Comments
Public Works Utility
Engineering has no requirements for
this plan review
Other Fees
STATE SURCHARGE
4 50
Fee summary
Charged Paid Credited
Due
Permit Fee Total
148 00 148 00 00
00
Plan Check Total
00 00 00
00
Other Fee Total
4 50 4 50 00
00
Grand Total
152 50 152 50 00
00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MQdlMIN.24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE I DATE IACCM10 COMNTS
ME
YES I m
DITCH
ROUGH -IN / COVER
SERVICE
FINAL I 'V 3o 0-7 1-,41,641
n
GENERAL COMMENTS:
FW -1102.1314"
PREPARED 1/11/07 10 42 23 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/11/07
ADDRESS 1134 E FRONT ST SUBDIV
TENANT NBR LINDA FRENCH
CONTRACTOR DAN SMITH CONSTRUCTION PHONE (360) 683 6040
OWNER WILCOX LINDA A PHONE
PARCEL 06 30 00 7 1 0200 0000
APPL NUMBER 06 00001200 COMM REMODEL
PERMIT BPC 00 BUILDING PERMIT COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL3 01 1/03/07 JLL BUILDING FRAMING
1/03/07 AP 01/02/2007 10 09 AM PBARTHOL
PARTIAL FRAMING REQUEST ON COMMERCIAL REMODEL
01/03/2007 04 18 PM JLIERLY
BAIR O1 1/08/07 JLL BUILDING AIR SEAL
1/08/07 AP 01/05/2007 04 56 PM PBARTHOL
DOUG 461 9090
01/08/2007 03 23 PM JLIERLY
BLWS O1 1/09/07 JLL BUILDING INSULATION WALL/FLOOR
1/09/07 DA 01/08/2007 01 24 PM PBARTHOL
DOUG 461 9090
01/09/2007 03 12 PM JLIERLY
door locked no inspection/jll
BLWS 02 1/11/07 JLL BUILDING INSULATION WALL/FLOOR
k DOUG 2007 09 57 AM PBARTHOL
DOUG 461 9090
COMMENTS AND NOTES
PREPARED 1/09/07 12 52 17 INSPECTION TICKET PAGE 6
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/09/07
ADDRESS 1134 E FRONT ST SUBDIV
TENANT NBR LINDA FRENCH
CONTRACTOR DAN SMITH CONSTRUCTION PHONE (360) 683 6040
OWNER WILCOX LINDA A PHONE
PARCEL 06 30 00 7 1 0200 0000
APPL NUMBER 06 00001200 COMM REMODEL
PERMIT BPC 00 BUILDING PERMIT COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL3 01 1/03/07 JLL BUILDING FRAMING
1/03/07 AP 01/02/2007 10 09 AM PBARTHOL
PARTIAL FRAMING REQUEST ON COMMERCIAL REMODEL
01/03/2007 04 18 PM JLIERLY
BAIR 01 1/08/07 JLL BUILDING AIR SEAL
1/08/07 AP 01/05/2007 04 56 PM PBARTHOL
DOUG 461 9090
01/08/2007 03 23 PM JLIERLY
BLWS 01 1/0 9,/07 yj�,L _ BUILDING INSULATION WALL/FLOOR
t (/\�,/� 01/08/2007 01 24 PM PBARTHOL
DOUG 461 9090
COMMENTS AND NOTES
PREPARED 1/08/07 8 22 06 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/08/07
ADDRESS 1134 E FRONT ST SUBDIV
TENANT NBR LINDA FRENCH
CONTRACTOR DAN SMITH CONSTRUCTION PHONE (360) 683 6040
OWNER WILCOX LINDA A PHONE
PARCEL 06 30 00 7 1 0200 0000
APPL NUMBER 06 00001200 COMM REMODEL
PERMIT BPC 00 BUILDING PERMIT COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL3 01 1/03/07 JLL BUILDING FRAMING
1/03/07 AP 01/02/2007 10 09 AM PBARTHOL
PARTIAL FRAMING REQUEST ON COMMERCIAL REMODEL
01/03/2007 04 18 PM JLIERLY
BAIR 01 1/08/07 L 1 BUILDING AIR SEAL
ap 01/05/2007 04 56 PM PBARTHOL
i DOUG 461 9090
COMMENTS AND NOTES
PREPARED 1/03/07 9 21 42 INSPECTION TICKET PAGE 14
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/03/07
ADDRESS 1134 E FRONT ST SUBDIV
TENANT NBR LINDA FRENCH
CONTRACTOR DAN SMITH CONSTRUCTION PHONE (360) 683 6040
OWNER WILCOX LINDA A PHONE
PARCEL 06 30 00 7 1 0200 0000
APPL NUMBER 06 00001200 COMM REMODEL
PERMIT BPC 00 BUILDING PERMIT COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL3 01 1/a0 /07BUILDING FRAMING
J
l v 01/02/2007 10 09 AM PBARTHOL
fVT PARTIAL FRAMING REQUEST ON COMMERCIAL REMODEL
COMMENTS AND NOTES
LUUr/ll�W llIMUN 11 1J AM (1-1-Y Ur FA BLDG DEFT PAX No 360 417 4711 P 001/001
E
SO
BUILDING PERMIT - APPLICATION D�.,�.
Fill out COAVLETELY and in E%C Your application and site plan MT S_T BE. pane Approved: `
COMPLETE to be accepted for review If you have any questions, call
IFERMUS-(360)417-4815 FAX(360)417-4711 Issued
Applicant or Agent: Li i� t� Phone: -- _--
/
----_-- �{-owner:• �' "--- - •---- ---�
ho
Address• - -
-- - - ziP_t`3 - - - --
Phone
Contractor State'License 4-
Exp:Phone.
- _ _- --
:
Address: -City' /� P onezip:
PROJECTAbDRESS:.04 ZONING: .
dVC5T 6 fA
LEGAL b1iSCRiPTION: Lot:Bloch. Subdivislo
CLALLAM.COUNTY PARCEL NUNMER. ;l/Z "P_61)
TYPE OF WORK. SIZE/VALUATION-
13 Residential ❑'New Constr. o Re -roof a Stove SF @-S /SF =S
❑ Multi-familyAddition ❑ Move ❑ Garage. SF @$ /SF = $
❑ -Commercial -Remodel ❑ Demolition 0 Deck SF @t •/SF
.❑ Repair ❑ Sign ❑ Other TOTAL VALUATION $
BRIEF DESCRIP'T'ION OF THE PROJECT ` u
��Aw oh Pr
COMiv/ MCIAIAZFSEDENTLAL. Occupancy Group: Occupant Load:
No. of Stories: i Lot Size: Existing Sq_ Ft & Proposed Sq. Ft
Total lot coverage
PLANNING USE ONLY
ESA/Wetland(s): d Yes o No SF -PA Checldist.required? ❑ Yes ❑ 14. Other:
Construction Type:
= TOTAL Sq_ Ft.
APPROVALS:
PLAN.
BLDG:
,DPWU:
FIRE:
OTHER:
VALUATION OF CONSTRUCTION- In all cases, a valuation ammount must be entered by the applicant.
This figure will be reviewed and may be revised'by the Building Divis:icku to comply with current fee schedules. Contact the permit
Coordinator at 41711815 for assistance_
PLAN CHECK FEE. IF a plan -check fee is due it must be submitted -at the time the building permit application and contor=tion platys are
.submitted. All other permit fives are due at the time of permit issuance -
EXPIRATION OF PLAN REVIEW If no permit is issued wiihin•180 days of the date of application, the appneation 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
R105.3.2 -of the International Building/Residential Code, 2003). No application can be extended more than once_
! hereby certify that 1 have read and ex&mi d this application and know the same to.be true and correct_ I am authorized to
apply for this permit and understand th it my responsibility to determine what permits are required, not the City's, and that /
must obtain such permits prior to work /
T.\FORMS\BldsPcrw!/ -wpd Applicant: U Date. '-9-
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
32! EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 06 00001200 Date
11/30/06
Application pin number 702800
Property Address 1134 E FRONT ST
ASSESSOR PARCEL NUMBER 06 30 00 7 1 0200 0000
Tenant nbr name LINDA FRENCH
e Application type description COMM REMODEL
Subdivision Name
Property Use
Property Zoning COMMERCIAL ARTERIAL
Application valuation 25000
Owner Contractor
WILCOX LINDA A DAN SMITH CONSTRUCTION
82 ISLAND VIEW RD 1482 HOOKER ROAD
PORT ANGELES WA 98362 SEQUIM WA 98382
(360) 683 6040
Structure Information 000 000
Construction Type TYPE V NON RATED
Occupancy Type BUSINESS OFF/PRO/MED/REST
Permit BUILDING PERMIT COMMERCIAL
Additional desc
Permit pin number 90191
Permit Fee 417 75 Plan Check Fee
271 54
Issue Date 11/30/06 Valuation
25000
Expiration Date 5/29/07
Qty Unit Charge Per
Extension
BASE FEE
95 75
23 00 14 0000 THOU BL 2001 25K (14 PER K)
322 00
Special Notes and Comments
Public Works Utility Engineering has no requirements for
this plan review
Other Fees STATE SURCHARGE
4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 417 75 417 75 00
00
Plan Check Total 271 54 271 54 00
00
Other Fee Total 4 50 4 50 00
00
Grand Total 693 79 693 79 00
00
Separate Permits are required forelectrical 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 owner is builder) Date
T-\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4847 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COYER, INSULATE OR CONCEAL ANY WORK EEFORE
INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE{ DATE ACCEPTED COMMENTS
YES ' NO
FOUNDATION:
SEPA.
PARKING/LIGHTING
FOOTINGS
ESA.
LANDSCAPING
SHEAR WALLS / WALLS
( SHORELINE.
FOUNDATION DRAINAGE / DOWN SPOUTS
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USL
PIERS
POST HOLES (POLE BLDGS.)
YES
PLUMBING
COMMERCIAL
UNDER FLOOR / SLAB
417-4735
ROUGH -IN
WATER LINE (METER TO BLDG)
ELECTRICAL
SHOWER PAN
'KEMCA S LINE
LIGHT DEPT
LWRSEAMA
yl�7
(FRAMIN%fiRCEDERS }
ENGINEERING
417-4807 I
SHEAR WALLMOLD DOWNS
FIRE
417-4653
WALLS I ROOF/ CEILINGI!
fid IO 7
DRYWALL (INTERIOR BRACED PANEL ONLY)
, f
417-4750
LATION
BUILDING _
CL LSLAB---�
f
WALL / FLOOR / CEILING
i
MECHANICAL,
HEAT PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE/PELLET/CHIMNEY
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
`I SKIRTING
1
I
I FINAL DATE ACCEPTED BY.
L)��
FINAL
PLANNING DEPT SEPARATE PERMIT#'s
SEPA.
PARKING/LIGHTING
ESA.
LANDSCAPING
( SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USL
RESIDENTIAL
DATE
YES
NO
COMMERCIAL
ELECTRICAL LIGHT DEPT
417-4735
ELECTRICAL
LIGHT DEPT
�CONSTRUCTIONR.W /PW/
i(
CONSTRUCTION R.W
ENGINEERING
417-4807 I
PW / ENGINEERING
FIRE
417-4653
FIRE DEPT
PLANNING DEPT
417-4750
PLANNING DEPT
BUILDING _
4174815 1
BUILDING
TAPolicies11102_15 building permit inspection record05.wpd (1/4/20051
DATE ACCEPTED BY.
DATE ( ACCEPTED
I YES ( NO
I/1-
1 Gtrs FOR OFFIC }4 US LY'
°� BUILDING PERMIT - APPLICATION 1 Date Rec.
/1,/�n
-� opt
Permit
Fill out COMPLETELY and in INK. Your application and site plan MUST B
/Date Approved:
COMPLETE to be accepted for review If you have any questions, call 6
PERMITS (360) 417-4815 FAX(360)417-4711 j Date Issued.
Applicant or--Prgea . / � � � ��fC %�i Phone:
�- j X[ D l- �— ��.711' - -- - — Phone: ` p
Owner-
Address k �a t'ld&/ GdCity U Zip
Architect/Engmeer• Phone:
Contractor J i94/ �>'A elbd_-%')State License #• pd Y5�W93iN `1Exp. Phone:_,&,e3 %OCID
Address: ,` City / Zip -
PROJECT ADDRESS 113 Y" E- r—kf /lt ST /Ot - /�x rk ZONING 'p--
LEGAL DESCRIl'TION Lot: Block: Subdivision.
CLALLAM COUNTY PARCEL NUMBER. lO 7/V c2 GD
TYPE OF WORK.
SIZE/VALUATION
❑ Residential
❑ New Constr
❑ Re -roof ❑ Stove
SF @$
/SF = $
❑ Multi -family
❑ Addition
❑ Move ❑ Garage
SF @ $
/SF = $ -
❑ Commercial
/Remodel
❑ Demolition ❑ Deck
SF @$
/SF = $ ?_5. 000
5eRepair
1"ign
❑ Other
> �-t o
TOTAL V
!,r/�w
UATION $
; J�oG� ' ' /zLX
BRIEF DESCRIPTION OF THE PROJECT
COMMERCIAL/RESIDENTIAL. Occupancy Group // /` Occupant Load. onstruction Type -
Lot of Stories: Lot Size: Existing Sq. Ft.�k� 7' &Proposed Sq Ft.� = TOTAL Sq. Ft.�
Total lot coverage %
PLANNING USE ONLY APPROVALS.
PLAN
BLDG
DPWU
ESA/Wetland(s)- 1:1Yes ❑ No SEPA Checklist required? E:1Yes ElNo Other- FIRE.
OTHER.
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 tune the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the 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
R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
1 hereby certify that l have read and examined this application and know the same to be true and correct. 1 am authorized to
apply for this permit and understand that it i my respon 'bility to determine what permits are required ,not the City's, and that I
must obtain such permits prior to work. /
TAFORMS\BIdgPermitform.wpd Applicant: L(lf i //U� �`� Date:
-J/
711k,
07 tt t
9XK
7"
-4
to
0�e
Aro
fix
OF POT ANES CGEL— onVnueti Plans
'LoLr?ETY
The Issuance of this permit based upon these pia s, specifi-
Cal oil', allU U L' Idl g official.
from thereafter requiring the correction of errors in said
plans, specifications and other data, o - r from preventing
thereunder -n' being carried on t nder when in
A.. nQ 60�, and ordinances of this jurisdiction.
Approval Date /; wlo'(e, B,
01
A-1
r
lit
we-
'�EJ� CITY OF PORT ANGELES — Constructit-n Plans
The Issuance of this permit based upon these plays, specifi-
uellvi'a ai,d V"Im, Ja«, :,'JI .. 1.4
g official
from thereafter requiring the correction of errors in said
plans, specifications and other data, or from preventing
1� �1 ,✓�� $ r� bu' ng ��rn wing carried thereunder when in
rco and ordinances
s of this jurisdiction.
Approval Date�� 2 DY J,_._S
1
II
.,.S..Y p1.... '.:'•eke
d9Sc�'v$:.���
14k,
CE RTI IC, ATE -0 -`# O�C2C:U RA IU CY
City of Port Angel;;es="Buildrng'kDi�„ision
•R; ,x
This certificate is issued pursuant-to..the requirements of Section 116'6fthe 2003 International Building.Code
'. i� Y...
�,�':' « .
certifying that at the tithe ,Of issuance. thas,•strueture was in compl ance.,j4;iih the V&ious ordinances of the City
?ale Y Y,y • k
regulating building cpnstrufio"`n:<<oi :use for,tlie fo'llowIng .F
'
fpr4..a
Business name ,JL.Scoft, Real yEstate:
11134E St:
Business address Front
Owner of business, iP11-Anda' Lape French, n,
Owner s address 1•;62`appy Valley'R "S''00b"'W'A'48'382:
Use & occupancy clasfcation Business'-'fi=_M z'
Building permit nunlbdr'-,; 06-11;31
Type of construction V-I.;-x� . ,+..
5d T `
11/01/06
Sue Roberds, eningManse �n; �� Date
Post on the premises in a conspicuous place,�his `e ` �fica'tE sl►all,notie removed except by the Building Official.
1
�
Q�
—Q, �Q
r ROUTING'SUP E IFN
Certificate. of Occupancy O
$50 00 Certificate/Inspection Fee
DATE N ® ® New Business ( )
Addreof Proposed Business Transfer of Business Location
�q C , P-" Kt S_I Change of Ownership ( )
Applicant. L I tnla L d f7to P" rP /1(A New Building ( )
Address b n4 Vo d? 12d Remodel ( )
73t —ccyy Temporary Business ( )
Phone businessO�' -_ .543 home 6,q"; " �� f 7 Change of Use ( )
Brief description of proposed business. P (-/, / �_: S i -e,
Legal Description Lot Block
Current Use of Property- V a tYA_r'l-
Zoning Classification of Property*
WILL THERE BE ANY OF THE FOLLOWING? YES NO
S
Construction changes L4j l�
1)
Electrical changes
Mechanical
UU
(heating, cooling, stoves)
2)
Plumbing changes
2)
New or relocated signs
3)
New septic tanks
3)
New sewer service
4)
Admission charged to patrons
4)
Is this a home occupation?
5)
Excavation of filling of lots
5)
Work done in City right-of-way
Is there sufficient off-street parking?
6)
New driveway openings
6)
A grading plan for site drainage
7)
(parking lots, downspouts, etc.)
7)
Are the existing streets paved?
8)
Are there existing sidewalks?
8)
Is there curb and gutter?
9)
Other
9)
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the
information I have supplied is correct to the best of my
knowledge
APPROVED REJECTED
Building Section
Public Works Department
Planning Department
k Fire Department
City Clerk
PB I.A.
Subdivision
THE FOLLOWING WILL BE REQUIRED -
PERMITS
BUSINESS_ LICENSE
1)
Building
1)
Taxi
2)
Plumbing
2)
Peddlers
3)
Electrical
3)
2nd Hand Dealer
4)
Mechanical
4)
Pawn Broker
5)
Sewer
5)
Dance
6)
Sidewalk installation
6)
Hotel Motel
7)
.Driveway installation
7)
Fireworks
8)
Curb_ installation
8)
Ambulance
9)
Sidewalk obstruction
9)
Tattoo shop
10)
Water meter installation
10)
Other
11)
Fire
12)
Occupancy
13)
Sign
14)
Shoreline
15)
Home occupation
16)
Conditional use
17)
Other
Date
Signed
Ja
Comments / Conditions
r.y
5TILC fEl l%INCA qtr I'- �1 J
ROUTING SLIP
<m
Certificate of Occupancy
$50 00 Certificate/Inspection Fee
t ,
DATE �� �. 0 \ New Business
Address of Proposed Business
Transfer of Business Location ( )
®,
1 ! ?31+ a - F:16 / I -t -S Change of Ownership ( )
Applicant L t viii to LQrt7e New Building ( )
Address 1 Lo *A h y VA `% lv� Remodel ( )
� r U If t -A € 1,(1 `� 73 Temporary Business ( )
Phone business457 75-23 homeC4�/ ! ' / Change of Use ( )
Brief description of proposed business !fit It / A ':�:477 t C,
Legal Description Lot Block Subdivision
Current Use of Property- V 4 (7 k /-1
Zoning Classification of Property- /4 CA
WILL THERE BE ANY OF THE FOLLOWING?
YES
NO
Construction changes t l) t ��� 60,-
0 -Electrical
1)
Taxi
Electricalchanges <� i
Mtn
2)
Mechanical (heating, cooling, stoves)
L
Electrical
Plumbing changes
2nd Hand Dealer
4)
New or relocated signs
4)
Pawn Broker
New septic tanks
Sewer
5)
New sewer service
6)
Sidewalk installation
Admission charged to patrons
Hotel Motel
7)
Is this a home occupation?
7)
Fireworks
Excavation of filling of lots
Curb installation
8)
Work done in City right-of-way
x
Sidewalk obstruction
9)
Is there sufficient off-street parking?
10)
Water meter installation
New driveway openings.
Other
11)
A grading plan for site drainage
(parking lots, downspouts, etc.)
Occupancy
Are the existing streets paved?
X
Sign
Are there existing sidewalks?
14)
Is there curb and gutter?
x
Other
Home occupation
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the
information I have supplied is correct to the best of my
knowledge
APPROVED REJECTED
1%42a
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
PB I.A.
THE FOLLOWING WILL BE REQUIRED
PERMITS
BUSINESS LICENSE
1)
Building
1)
Taxi
2)
Plumbing
2)
Peddlers
3)
Electrical
3)
2nd Hand Dealer
4)
Mechanical
4)
Pawn Broker
5)
Sewer
5)
Dance
6)
Sidewalk installation
6)
Hotel Motel
7)
Driveway installation
7)
Fireworks
8)
Curb installation
8)
Ambulance
9)
Sidewalk obstruction
9)
Tattoo shop
10)
Water meter installation
10)
Other
11)
Fire
12)
Occupancy
13)
Sign
14)
Shoreline
15)
Home occupation
16)
Conditional use
17)
Other
A -"' I7j
Date
P ,/
Signed �� � )Lt flu X11
Comments / Conditions ��� t V77 7' S
Cn
�,p�')k1' !r ���' �� �2 1 1
o
-:rL Sa - RQ_&k E 5-4nt�
DATE 10 I _.� D 50
-#c;&-1131
ROUTING SLIP
ificate of Occupancy
(250 00 ertificate/Inspection Fee
Addres of Proposed Business
/-
Applicant � rAd a �-Gi��il Lli
Address
- T3 z
Phone business 3 home
New Business
Transfer of Business Location
Change of Ownership
New Building
Remodel
Temporary Business
Change of Use
Brief description of proposed business Rn / Vis- - >✓
Legal Description Lot j �y Block
Current Use of Property- `/
Zoning Classification of Property -
WILL THERE BE ANY OF THE FOLLOWING(? . S YES NO
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the
information I have supplied is correct to the best of my
knowledge
Construction changes �
BUSINESS LICENSE
Electrical changes
Mechanical
U
(heating, cooling, stoves)
Taxi
Plumbing changes
Plumbing
New or relocated signs
Peddlers
New septic tanks
Electrical
New sewer service
2nd Hand Dealer
Admission charged to patrons
Mechanical
Is this a home occupation?
Pawn Broker
Excavation of filling of lots
Sewer
Work done in City right-of-way
Is there sufficient off-street parking?
Dance
New driveway openings
Sidewalk installation
A grading plan for site drainage
Hotel Motel
(parking lots, downspouts, etc.)
Driveway installation
Are the existing streets paved?
Fireworks
Are there existing sidewalks?
Curb installation
Is there curb and gutter?
x
Other
Sidewalk obstruction
%PP ED REJECTED
Building Section
Public Works Department
Planning Department
Fire Department
d-1�_06 DU City Clerk
PB I.A.
Subdivision
��
THE FOLLOWING WILL BE REQUIRED
PERMITS
BUSINESS LICENSE
1)
Building
1)
Taxi
2)
Plumbing
2)
Peddlers
3)
Electrical
3)
2nd Hand Dealer
4)
Mechanical
4)
Pawn Broker
5)
Sewer
5)
Dance
6)
Sidewalk installation
6)
Hotel Motel
7)
Driveway installation
7)
Fireworks
8)
Curb installation
8)
Ambulance
9)
Sidewalk obstruction
9)
Tattoo shop
10)
Water meter installation
10)
Other
11)
Fire
12)
Occupancy
13)
Sign
14)
Shoreline
15)
Home occupation
16)
Conditional use
17)
Other
Date I l y 0
SignedA4Ct Gf of n a"
Comments / Conditions ,�) et'o u4" / f/ es-
rryj
-1f <<5jr-e 4 a-_/4
lS
11
•
Op pORT 9NC
A' ���
�''�S�
CITY OF PORT ANGELES
/�� /
�
LIGHT DEPARTMENT
PERMIT NO ay`9
�e<
TY
ELECTRICAL PERMIT
DATE /a aaI�
LION
Site Address: / ss
1 17 C,
�� q
=
El READY FOR )(!WILL CALL FOR
INSPECTION /` INSPECTION
Installed By:
1806's
TJ7 ,4"e .r,
License Number: Phone:
Owner/Business.
1
46 _ /
/�� /
Phone:
Owner/Business Address:
Sq. Ft.
❑ Residential
Heat KW
❑ Baseboard ❑ Furnace/Boiler
❑ Heatpump ❑ Other
Commercial/Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
Details/Description:
❑ New Construction
XRemodel
❑ Service update/alter/repair
XAdd/alter circuits
❑ Auxiliary power
(list below)
❑ Special equipment
(list below)
Aa /.P cels yo
,)T.c'
I
XOverhead
❑ Underground
Voltage
❑ 10 ❑3^-�Z�!1
Service sizep�C9,0 Amps
❑ Temporary
(q Ku))
,al4. C10 Kuk�)
W.S. No. Service SizA
Capacity: ❑ O.K. ❑ Not O.K. Commentq
❑ Ditch inspection O.K.
PRough-in/cover O.K.
❑ O.K. to connect service
i/e 41 � Final O.K.
Date
1.4 P
Hold for: ❑ Easement ❑ Letter
❑ Signed up for service/meter
❑ Meter Department notified for installation
❑ Fire Department notified of inspection
❑ Plan Review approved/pending
Site Address: Permit/Receipt No.
Installerp New Meters Date:
• 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
I by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT / /
1 Inspector Amount paid
I WHITE —file by address YELLOW —file by number PINK —Top: Eng, Bottom. Customer GREEN —Top: Inspector, Bottom: City Hall
OLYMPIC PgINTE RS. INC
A
CITY OF PORT ANGELES
LIGHT DEPAMTENT
N° 17572
ELECTRICAL PERMIT
Port Angeles, Washington----•-•- 19L -----
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.
Address �� +s -
y . • Y ----------------- Occ"upacy-----�.•,aa-------- __------
=-•-•,` -Owner ----- =---'-'-=...... -.... •. Tenant.---- ----------------- ---
-•-------
"7� WiringContractor_,",:�_---------- ------------- By
- -
-------------------
Light Outlets ................................ ... ....
,
Receptacle Outlets ...............................
Dryer. KW. .......... 5 ..............................
Range. KW
Water Heater:
KW_ ---------------------------------------�
�-
.^.."..-•
Heat: KW..:�
e" io �-� ., �'e....°:CC, /g
Motors:
size, volts and phase:
r ,r.•
•yy�
---
..........._...
..y.. ---- .................................
.......J _....................
Total Load .............................
Service, volts l U
No. wires -------- 4i.................
Size wires ..... i'. .....
:r: _`r.. ":...._..
rl
Main fuse.........................
Enclosure .. .............................
Type of wiring:
Entrance Cable
Rigid Conduit ------.
Metallic Tubing ......._.................
Current transformers:
No. & Size -----------------------------------_..
Ser. No ..................................'--.......
Ser. No ..............................................
Ser. No ..............................................
Ser.
Type of Wiring:
Armored Cable
Non -Metallic ...
Knob & Tube ..................................
Rigid Conduit ...
Metallic Tubing
Raceway ....-----`--------- ------ ---------_
Circuits, Light ...... ...............................
Utility .-'s
Heat
Rane-----------------
i.... ----------
*..........
Water Heater ...............................
Motor---- ----------------------- ................
Furnace ............ ........................
Total
Remarks:------------- c.c4 n
J-----------_--------- -- .... ----------------- ------------- -------------------
$ 3 < .rf. !_,.rte ,..
Permit Fee Tress. Receipt
_.rt-rr' No. By --;-t------------
----------------- ----------------------
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
I-
N° -' 17572
ELECTRICAL PERMIT
Address---............_-------`----....................---.................--`-`--............---`---.............................. Date ........................... .... _...... _..... ...........
Owner.................................... ... ............................ ..................................................... Tenant. --- .....-----------......-'----------------------------------
WiringContractor......................................................................................................................... By..............................................................
NOTICE_�.-Current must not be turnedron 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.
iM Olympic Printers, Inc.
CITY OF PORT ANGELES
LIGHT DEPARTMENT ELECTRICAL PERMIT N? 17050
Port Angeles, Washington -------./ -0
~.'e4 -----------------------•-------- 19e�F
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 granteedod to doelectrical work as listed below.�,-
Address ../13 E - -' Occupancy ,'"---~--- -
Owner----
-------------------- ----- - Tenant------------------------- ----- ------------------ ---------- -- ......
WiringContractor ------- ----------------------------- By ------------------------------------------------ -------
Light Outlets..... /.._ � r .. Service, volts ....................................... Type of Wiring:
Receptacle Outlets----- ................. No. wires ....................................... Armored Cable ..............................
Dryer. KW ............. ............... .------------
Size wires ............---------------------.._..
Non -Metallic .............................
Knob & Tube .................................
Range. KW ----------------------------- ---------
Main fuse .......................................
Rigid Conduit ...............................
Water Heater:
Enclosure ---------------------------------------
Metallic Tubing
KW -------------------- ---------------- ------
Type of wiring:
Raceway .............. ................... _._
Heat: KW............................................. .....
Entrance Cable -----------------------------
Circuits, Light .......................................
Motors: size, volts and phase:
Rigid Conduit ...............................
Utility ...................-----------------------.-.
z.^..r.'C:............._...........----------....
Metallic Tubing ........................._
Meat ------- `-'---......._"_......... ...
Current tranelormers:
Range .............................................
-----------------------------------------------------------
No. & Size .......................................
Water Heater ...............................
Ser. No.-......" --------------------------------
- Motor .............................................
Dryer---------------------------------------------- __
...........................................................
Furnace ......................... ...................
TotalLoad .............................
Ser. No. .................. ............ .-------------
Total ...................................... -
Permit Fee Treas. Receipt /,f)/ /J { 11 0
$ -------------------------------------- No ------------------_--------- By --
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° 17050
Address
Owner
WiringContractor..................... ................................... .............. .................................... .--------------- By ..............................................................
NOTICirCurrent 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.
the n6......:.. n....,..-_ I....
01/03/2007 12:47 3606830869 KIRSCH ELECTRIC INC PAGE 01
ELECTRICALWORKPERN Tx'APPLSCATION
'-/ia tallation description
✓oh suited by Eleetticsl Contractor QOwner Commcrclal U Residential
Electrical contractor name Licence number Dam Capires ❑ New ,f,.
k j R sc. -k �.LeC I C i4ascE IOC St J e1AlteretUAddldoe
Purchaser's mailing address tt __
city9E&\1LIM �N� znr
Tele one number PAX num r
"Premises owner's name t .
_
Address t�6ot.,'✓1Rtmpcetion
b
- City C 'iE
T-
Phone number to schedule inspection: 3 t ,.l
-_ Owner ac defined by RCW. Owner will oocccopry the sttmcteurle fivr two
,utas after this electrical permit is fitudL•ed, (2) Owner is required to hire on electrical
enetractor if above, said property Lr for sole. rens or lease. 13 Cash #
Atter reading the above statement, I hereby certify that I am the owner or the above
named property or a liconscd electrical contractor. I am making the electrical intent- Q Cte ' Card VMa Ma-Mma Discover
lotion as- attention in compliance With the electrical laws. N.E.C., RCW. Chapter
19.28. WAC. Chapter 296-4613, The City of Port Angeles Municipal Cada, and Card
Utility specifications.
/Siena r owner, electrical c mater or elaotrlcal administrator �' Exp ire nDatC
In tion fcc
Date: �'21�� ��ofcard -SAF CTL?
Eiectrica'i"totW+9 ioftsa L%s4nions a�6Lt'icsirtiormtgion
❑ NO LOAD CHANGES
O Baseboard _--_ KW Voltage
O Furnace —KW ❑ Overhead Service Phase O t ❑ 3
❑ Heat Pump Ton LAA Q Temp Service Service Size:
U Fan -Wall KW ❑ unnarground Service Feeder Size:
SANM DAY INSPECTION, CALL BEFORE 7:00 AM 360-4174735
ROiIGIN-IN Ti ERMOSi`AT 1 SERVICE 1
` Pnto nao'� owe naarovm
as J ane nWgmce 9y J
e� Eil•IALi IiIICIi )rID>eTit
7 `O V
per nenrav v av perm npomvcn �r Dvm npamvm eY
inspection
Date
AV ����
Area. Building or Equipment Inspected
Action Takeo Electrical
Inspector
i
3—OG-207 4:19PM FROM ANGELES ELECTRIC INC 3GO 4S2 92GS P.11
�1, ELECTRICAL WORK PERMITAPPLICAVON
'N/lnstallati description
Electrical Contractor ❑Owner ommercial L)Residential
Job wired by i7
Electrical contractor name License number Date Expires
ANGELES ELECTRIC, INC.
Purchaser's mailing address JL4 CAJI "KJI
PORT ANGELES, WA 93362
City State ZIP
Telephone number FAX number
Yrcmisca uwn� nq/
Address of iq.(/�/�tI/� ; e �r ��—
City �� /
Phone number to schedule Inspection:
Owner as defined by KCW.19.28.261:(I) Owner will occupy the rimcrure fur two
years alier rhia electrical ptmii( is f+nalced. (1) Owner is required iu hire an elettrical
canuactor if above .said property afar sale, rent or Icune.
After reading the above statement, I hereby certify that I am the owner of the above
named property or a licensed electrical contractor I ant making the electrical labial-
latinn or alteration in campltance with the electrical laws, N.E.C., RC'W. Chapter
19.25, WAC. Chapter 296-468, The City of Port Angeles Municipal Code, and
Utility Specifications.
O New O Altered/Addition
-- /7;N��
U
CI Cash O Check tt
reditCard Visa Mastercard Discover
C:ard# ---. —� —40/LL ----
r Signature of own clectri on actor electrical administrator Expiration Date -
hap c
X _ Date: of card $
Electrical Load Additions am or sTSbtractionsrytpe Information
O NO LOAD CHANGES �r
O Baseboard —KW
`� l� �� Voltage
O Furnace _ KW Cl Overhead Service Phase 1�
O Heat Pump _ Ton _ LAR Cl T )p -Service Service Size:
O Fan -Wall _ KW nderground Service Feeder Size:
SAME DAY INSPECTION. CALI. BEFORE 7:00 AM 360417-4735
CROUGH -IN -- 1 THERMOSTAT 1
Date 1rPro�cU ay J De+e AporovcJ ny J
DITCH 1
D,ta O � nvr+vw ey Uam nnoro•aJ Dr J
Inspection Arca, Ruilding or Equipment Inspected
Date
--T�'�E P Z°(s�
MAR 0 7 107
CSERVICE, 1
Dmc nvnro+sn Dy J
CFEEDER
Dmc nvvwsJ Pv
Action Taken ... 'I '. Electrical
Inspector
i