HomeMy WebLinkAbout112 W Front St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
WW BROWN LW BROWN INC
112 W FRONT ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
TAPolicies \1102.15R [1/05]
Qty Unit Charge Per
Fee summary Charged
WA 983622607
RIGHT OF WAY
RUP #06 33
91173
30 00
1/02/07
7/01/07
Permit Fee Total 30 00
Plan Check Total 00
Grand Total 30 00
Signature of Contractor or Authorized Agent
06 00001266
052662
112 W FRONT ST
06 30 00 0 0 1506 0000
PUBLIC WORKS UTILITES
CENTRAL BUSINESS DISTRICT
0
Contractor
OWNER
BASE FEE
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
/a o 7
Date
Plan Check Fee
Valuation
Paid Credited
30 00 00
00 00
30 00 00
Date 1/02/07
Due
00
00
00
0 0
0
Extension
30 00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances goveming 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 Owner (if owner is builder) Date
CALL 417 -4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
CONSTRUCTION R.W PW/
ENGINEERING
FIRE
PLANNING DEPT
BUILDING
\Policies \1102.15R [1 /05]
RESIDENTIAL
417 -4807
417 -4653
417 -4750 1
417 -4815
PERMIT INSPECTION RECORD
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
I 1
1 1
1 1
1 1
11
I 1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
YES NO
CONSTRUCTION R.W
PW ENGINEERING
1 FIRE DEPT
1 PLANNING DEPT
BUILDING
1 1 1
1 1 1
1 1
1 1
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000705 Date
410305
112 W FRONT ST
06-30-00-0-0-1506-0000-
ELECTRICAL ONLY
8/03/05
CENTRAL BUSINESS DISTRICT
10000
~R 12tj/
4/z-r lOb
Owner
Contractor
WW BROWN & LW BROWN, INC
112 W FRONT ST
PORT ANGELES WA 983622607
PENINSULA HEAT
502 W. 8TH ST.
PORT ANGELES
(360) 457-2775
WA 98362
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit pin number 56556
Permit Fee 36.40 Plan Check Fee
Issue Date 8/03/05 Valuation
Expiration Date 1/30/06
.00
o
Qty
1. 00
Unit Charge Per
36.4000 EC EL-LOW VOLTAGE
Extension
36.40
~
~
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
56549
61.70 Plan Check Fee
8/03/05 Valuation
1/30/06
.00
o
z
~
Z
')
V)
"'1
J
1. 00
BASE FEE
14.7000 ECH ME- INSTALL 100- FAU
Extension
47.00
14.70
Qty
Unit Charge Per
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 98.10 98.10 .00 .00
plan Check Total .00 .00 .00 .00
Grand Total 98.10 98.10 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
~~~;;oOn~ive authorit / flate or cancel the/pro/ViSions of any state or local law regulating construction or the performance of
c;tI~ ~) 8/'3/tfS- .
Signature of Contractor or Authorized Agent / / Date Signature of Owner (if owner is builder) Date
T:\Policies\1102_15 building pennit 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. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEIUNG
DR YW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULA TION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COlVlMERClAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKING/LIGHTlNG 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.\V. 1 PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
-
T:IPolicieslll02 _15 bulldmg pennlt mspectlon record05.wpd [1/4/200)]
08/02/05
14:01 FAX 3604572864
Peninsula Heat
14101
FOR OFFIC~U& ONLY:
'DalcRcc.:~ ~'O8
Permit #: 05 -1 oS'
Dale ApproYal:
Date Isslled:
BUILO'ING PERMIT. APPLICATION
Fill out COMPLETELY and in INK. Your application Ind site.plan MUST BE
COMPLETE to be aCcepted for review. If you have any questions, caD
(360) 4174815
Applicant or Agent:~ A-nJ~
Owner: '~
Address: /)2- W ~t- "!!5T City:
. Phone: 46'1- ~ 7 7 S-
If? 7-'-1/5 1)
Zip: 'f636 J....
Phone:
Contractor
Address: 6C>2 W gt!:L
PROJECT ADDRESS: 11'iA W
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNIY PARCEL NUMBER:
Phone:L/ 5~-~77
Zip: qm2-
ZONING:
Credit Card Bolder Name:
Billing Address: City:
Credit CardType VISA . MC #
mE OF WORK: ."1' .'
[J Re~idential [J New Constr. 0 Re-roof C Su)'Ve .
o MUlti-family' [J Addition 0 MOve 0 Guage
)(Commercial 0'. Remo:del C Demolition.c '0 Deck. .
. . O. ~air . _ 0 Sip: :. [J Other.
. BRIEF DESCRIP'l'ION OF THE P.RO.JECf: ':
. ..
COMMERClALIRESOlENTIAL: Occupancy Group:
No. of Stones: _ Lot Size: Existing Sq. Ft &. Prop sed Sq. Ft.
Existing lot coverage _ % &, Proposed lot coverage _% = Total lot co
Exp. Date:
Construction Type;
= TOTAL Sq.Ft.
%
PLANNING USE ONLY;
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE :
OTHER:~
ESAlWetlaud(s): 0 Yes. 0 No SEPA Checldistrcquired'! 0 Yes 0 No Other:
BUILDING PERMIT APPLICATION SUBMITIAL: The Bwlding Division provide you with infonuation on the application and
plan subniittal requirements if you have questions.
V ALUA nON OF CONSTRUcnON: In all cases, a valua.tion amount must b entered by the applicant nus figure will be reviewed
and may be revised by the Building Division to comply with CUlTentfee schedules. C nact the PermitCoordinatont417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tUne tb building .pennit application and construction plans are
submitted.. All other pmnit n:es ue due at the time of pcnnit issuance.
EXPIRATION OF PLAN REVIEW: Ifno p~mUt is issued within 180 days of date ofapplicatiou, the application will expire. The
Building Official can extend the1ime for action by the applicant up to 180 days up written request by the applicant (see Section 107.4 of
the Uniform Building Code, CUIre1lt edition). No application can be e,ctendcd 1110 than once.
Applican
correct. I am authoriZed to apply for this permit and
t I ust 0 in such permits prior to work.
ate: 8/ :J../t1 S-
f" ,
T:\FORMS\Al'PS\BuildingpcnniLwpd
Rug 02 05 03:15p
Ol~mpic Rero Services Inc 360-352-3945
p. 1
5143 82nd Ave SE
Olympia, WA 98501
Phone: 360.352.3891
Fax: 360.352.3945
Olympic Aero
Services
Fax
To:
City of PA
From: Mike and Yvette Reynolds
Fax: 360417-4711
Pages: 2 (incl cover)
Phone: 360-457 -()411
Date: 08102/05
Re:
1637 W. 11th
CC:
-.
o Urgent
o For Review
o Please Comment 0 Please Reply
o Please Recycle
_Comments:
We are the owners of the above rental property. Please turn on the power and water at the above
address effective Thursday, August 4th, 2005. 'do not need the garbage, just the power and water to
clean the property.
If you have any questions, then please call me at 360-352-3891.
Yvette Reynolds
08/02/05 14:01 FAX 3604572864
Peninsula Heat
14J02
FAX
Thtutl ~ fir ~ ht~.I Ii / ca'1!
b~~ .r(~ In ~/)f'J7JW' -!tJ fi4Z-
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CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East yh Street, Port Angeles, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000731 Date
684712
112 W FRONT ST
06-30-00-0-0-1506-0000-
BROWNS OUTDOOR INC.
FIRE ABANDON TANK INSPECTION
8/09/05
CENTRAL BUSINESS DISTRICT
900
Owner
Contractor
WW BROWN & LW BROWN, INC
112 W FRONT ST
PORT ANGELES WA 983622607
PETTIT OIL CO.
638 MARINE DRIVE
PORT ANGELES
(360) 457-9404
WA 98362
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
UNDERGROUND TANK COMM
SLURY FILL IN PLACE
57042
100.00 Plan Check Fee
8/09/05 Valuation
2/05/06
.00
900
BASE FEE
Extension
100.00
.--
?
(
~
~
-=1
'^
'1
Qty Unit Charge Per
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 100.00 100.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 100.00 100.00 .00 .00
This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
180 days from the last inspection. I hereby certify that r have read and examimrl this application and know the same to be
true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the IJ9vis~oJs i a",ny ~e ~~c,l ~ regulating the work specified in the permit.
r~OJ I.;r,~, g~c;~
Signature of Contractor or Authorized Agent Date Signature of Owner (if Owner is builder) Date
FIRE PERMIT INSPECTION RECORD
Call 360-417-4655 for fire inspections. Please provide a minimum 24-hour notice. It is unlawful to cover, insulate
or conceal any work before inspected and accepted. Post permit in a conspicuous location.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough-in inspection
Alarm final
LP-GAS Completed by Contractor:
Underground piping inspection/pressure test Test # I
Above ground piping inspection/pressure test Piping pressure test pSI
Time initiated
Tank (container) inspection Test #2
Appliance inspection Piping pressure test pSI
Time initiated
LP-gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final
Inspection Type
I Date Passed I
Comments
GENERAL COMMENTS:
2/15/00
~
'100..",,"'"
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
'21 EAST 5TH STREET. PORT ANGELES. WA 91\162
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
05-00000705 Date
410305
112 W FRONT ST
06-30-00-0-0-1506-0000-
ELECTRICAL ONLY
8/29/05
CENTRAL BUSINESS DISTRICT
10000
Owner
Contractor
WW BROWN & LW BROWN, INC
112 W FRONT ST
PORT ANGELES WA 983622607
PENINSULA HEAT
502 W. 8TH ST.
PORT ANGELES
(360) 457-2775
WA 98362
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER COMMERCIAL
SIMPSONI FURN. & H.P.
56648
SIMPSON ELECTRIC
61.30 Plan Check Fee
8/29/05 Valuation
2/25/06
.00
o
Qty
1. 00
Unit Charge Per
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
~
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~
~\
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~
~"'~
y-;""
\\.
(' "
V'
co!vnvWNTSI ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417~735 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 I NO
I III '1-1
lUll rc;.H_IN I COVER
~bRVICb
,
FINAl tl/.sc /b~ -A?t7 ")
, ,
GENERAL COMMENTS:
PW-1102.IS [4196]
~,.-
~ pORT ~
t:o"O~~..,
()~lfo
if 'EiiiI
~ --
't9t-;;--~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
8/16/05
05-00000755 Date
168515
112 W FRONT ST
06-30-00-0-0-1506-0000-
MECHANICAL PERMIT
CENTRAL BUSINESS DISTRICT
11275
Owner
Contractor
WW BROWN & LW BROWN, INC
112 W FRONT ST
PORT ANGELES WA 983622607
PENINSULA HEAT
502 W. 8TH ST.
PORT ANGELES
(360) 457-2775
WA 98362
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc LOW VOLT T-STAT
Permit pin number 57877
Permit Fee 72.80 Plan Check Fee
Issue Date 8/16/05 Valuation
Expiration Date 2/12/06
.00
o
Qty Unit Charge Per
2.00 36.4000 EC EL-LOW VOLTAGE
Extension
72.80
Permit MECHANICAL PERMIT
Additional desc HEAT PUMP
Permit pin number 57869
Permit Fee 76.40 Plan Check Fee
Issue Date 8/16/05 Valuation
Expiration Date 2/12/06
Qty Unit Charge Per
BASE FEE
2.00 14.7000 ECH ME- INSTALL 100- FAU
.00
o
Extension
47.00
29.40
-n
1:-'
~~
,-- c
lL
r-
o
V'
\
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 149.20 149.20 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 149.20 149.20 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
nu II 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
?!l~~ ~ ~S-
Signature of Contractor or Authorized Agent ~ate
Signature of Owner (if owner is builder)
T:IPoliciesll 102_15 building permit inspection record05.wpd [1/4/2005]
,
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1
Date
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. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED, POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS I
WALLS I
FOUNDATION DRAINAGE I DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
Gl'\S LINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS I GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS I ROOF / CEILING
DR YW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULA TlON
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEATPUNW/FURNACE/DUCTS
GAS LINE
WOOD STOVE I PELLET / CHIMNEY
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKlRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W./ PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERlNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 s;::;- .z,:Z.....l:> ) TV- BUILDING
T:IPolicieslll 02_15 building permit InspectIOn record05. wpd [1I4/2005]
08/12/05
12:03 FAX 3604572864
Peninsula Heat
14102
FOR OPFICIAL USE ONLY:
- ...-"
. DaJe Rr.c..: ~~p --0'"
Permit #: f?:; ~- l~
Dare Approved:
Date ls$u~/110 ) cJs7
BUILO'ING PERMIT - APPLICATION
FiB out COMPLETELY aDd 5D INK. Your applieatiOJl and lite.ple MUST BE
COMPLET.$ to be aCcepted for review. If you have aay qUestlODS, uD
(360) 417...815
. .
~PPlicant~Ag~t:~ A1J~. . Phone: Lf67-'l7?S-'
~er:~~~ PhQne: LJ.57~LlJ60
Address:-1G.- W '.~. . City:.J4{~~~l&1S Zip: q~?
ArcbitectlEngineer: Phone:
Con1rac:tor"p~/~ ~I~t-State License #:~uJh.~ .
Address: 002 W ~t1::L City:
PROJECT AnDRESS:...J ,::A uJ - ~
LEGAL DESCRIPTION: Lot; Block:
CI.AI:.LAM'COUNTY P~CEL NUMBER:
Phone: L/ ~Jr-;177
Zip: q~~
ZONING:
Subdivision:
Credit Card Bolder Name:
BWinC Addrea:. City:
Credit CardType VISA _ Me # __ Jbp. Date:. _
TYl'EOF,WORK; '-i;" ~SIZEJVALUATION: .
o Re'Siden~l' O. N~w CIlQ$', C R.c-roof . 0 StOv~ . . ... -.. SF. @ .$ /SF. - S < -'. :
O'Mlilti--fainilY" O~A~OD. . C Mov~ ti Garage . .' : SF, @$ . : ISF..=~ . ~ . .
~Co~ O';~:del C D"molitioJl.~'''O Dtpk . .'.' ..' .:.-SF,@~ .: ISF;.=-$. : ~ . .
'B~DE~~FriIE~ :~~~~. R!;~::..,~~
co:Mi\.t:ERCrluREsmENTIAL: Occupancy Group:' . . Occuprmt Loa~ CODS1IUetion Type:
No_ ofStoriei: _ Lot Size: Existing Sq, Ft, & ~roposecl Sq. Ft, = TOTAL Sq.FL
Existing lot coYetage ~ '& Proposed lot coverage % "'" Total lot eo~emge %
- 0 _II
APPROVALS:
PLANNING USE ONLY: PLAN:
BLDG:
. .. . ~'. ~ DPWU:': '.
ESAlWetIaDd(s): 0 Yes. 0 No SEPA Chec1distrequired? C Yes C No Other: FIIU::
OTHER:
-
BUILDING PERMIT APPUCATION SUBMI1TAL: The Building Division can provide you with infonnatiOD OD the applicatiOD IIDd
pIan sobaiittal ~tI if you have questions.
V ALUATJON OF CONSTRUCTION: Ia an eases, _ valuatioa anuJunt must be entered by the applicanL This figuIC will be reviewed
and may be revised by the Building Division to comply with CUO'eDt fee scbedulei, Contact the PeDDit CoordiDatar at 417-4& IS for assisrance.
PLAN CHECK. FEE: IF a plan check fee is due it ~t be submitted at the time the buildiDg.~t application and comtnlction plans are
submitted. All other~t fees. arc due at ~ time ~f peanit issUance. '. .
EXPIRATION OF PLAN REVIEW: Ifuo p!=JDrit is issued within 180 days of1he date of app1icatiOD, 1hc applJcatioa will upire. The
Building .Offidal eaD.ateod the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107,4 of
the YniformBuDding Co~e. cwrent edition). No application can be extended more than once.
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CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
Site Address:
;;2W
~
~,
j
Installed By:
Owner/Business:
Owner/Business Address:
ELECTRIC HEAT
o BASEBOARD KW _
o FURNACE KW _
o HEAT PUMP KW_
o FAN/WALL KW _
o RESIDENTIAL
~ COMMERCIAL
tJ NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
))i SERVICE UPGRADE/REPAIR
o TEMPORARY SERVICE
DetailslDescription: ~F- ~...y. u9
I?~..f /Hd
,
rh.J;1
PERMIT NO. 4/7~f
/ /.zl/YS;-
/ .
DATE
o READY FOR
INSPECTION
license Number:
o WILL CALL FOR
INSPECTION
Phone:
Phone:
Sq. Ft.
o RISER
;8l OVERHEAD SERVICE
o UNDERGROUNg,.SERVICE
VOLTAGE: /Z?7at/o
~'191 0391
SERVICE SIZE C>t9o AMPS
FEEDER SIZE AMPS
~
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
o Rough-in/cover O.K.
D O.K. to connect service
o Final O.K.
Site Address:
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the Building Permit. PHONE 457-0411, EXT. 224.
.-,;~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ t ...30
Eleclricallnspector Permit Fee
Installer:
.
WHITE - File by address
PINK - Top: Eng, Bottom, Customer
OLYMPICPRINTEASINC.
New Meters
GREEN - Top: Meter Dept., Bottom: City Hall
07/31/2005 18:45
4579270
}dEI.ctrical Contractor
o Annual P.nnit 0 Alarm
(i'N'
~ !
o Owner ~....'"
CI CarntvlI
SIMPSON ELECTRIC
PAGE 01
I:J Request Inspection
ELECTRICAL WORK PERMIT APPLICATION
8 - /-0 s
Comm~rc'aJ D Rc.c;idential 0 Rc~jdential Maint. 0 Signs 0 TbcrmostDt 0 Telecom.
Job wired by
)Q Electrical Contractor 0 Owner
Electrical contractor name License number
0Yl r:; ler-h-tr, SitnLlSeL 9'7~ e.~
Ptircha. '!{ mailing address .,'
d'f :s 03 b IJ.. }~./ 0 / W
Citf") 0 State ZIP
r tJ~i A n o"j~r . Uhl. 9' B'"3..k ~
Telephone number T / FAX number
PrcmilC5 owner'" name
8 J-DI..Jn's
Address' or Inspection
/I,;J.. W.
City 10
U Or
I 8 E~H>rgUl';
() l-/. ~ OlQaY L;jv(' _ ,.,
Frn-n + S'{.
A.
I hereby certify that' am the owner of the abovt named property or a licensed
electrical contractor (or the firm's authorized agent) and am mBk;ng the electrical
installation or alteration in compliance with the electrical law, Chapter 19_28 RCW.
I administrator
x
,r WALLS
Insullllion Only
Dnle A""mYeD ~}I
C('IVer
n.le AJlPf'O"C<! By
'-
CEILING
Insulation Only
Dale ^rr\flwetl By
COvet
D:Jle ^ltP'Ovod Dy
Electrical Load Mdltlon.JlP~tQtsJ!.b.!r.a9tl!ll!~
o NO LOAD CHANGES
o Ba.eboa<<t KW
o Furnace KW
o Heat Pump _ Ton _ LAR
o Fan-Wall KW
In!ltallation dCRcription
-idm;k. up
~....L
~-
C/,eUtJ!5
/l....~ }
,
~.
I~'
~
o Cash Cl Check #
~red;tCard (Vi~..J Mastercard
Card #
Expiration Date
of card
llfERMOSTAT
'- I)~I~. AperoYed By
DTf(]J
DatI; AppnlYod By
CJ Overhead Service
o Temp Service
o Underground Service
lmrpcetinn
Date
Area, Building or Equipmcmt Inspected
frNrl?-
Discover
SERVICE
DMO ^l'l'fO'Vl:d Dy
FEmER
DOle ^l'f1Tllvcd ~)'
Service Information
Voltage
Phasa0103
Service Size: _
Feeder Size:
Action Taken
Electrical
fnspcetoT
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