HomeMy WebLinkAbout1233 E 1st St - Building Certificate of Occupancy
1233 E 1St St
13 -589
O. , -O
CERTIFIC`A TE OF OUPANCY
Cit of Port Angeles - Building Division
This certificate is issued ursuant to the requirements of Section 111 of the 22 9 International Building
Code certi in that ate.time o(issuance this structure was in compliance with the various ordinances
.f'� S � P
of the City regulator i g uilding construction or use for the following •
Business name: ' Ravi food Mart'
6
,-:!..-,_-;,,,Z-ia., -7:: _
6Business address F,, , 339 1St Strre„et �„ . 7 !? y;z*` °
9 Business owner. - -Ravi K Bansal r p
Business owner's ddr ss : 35742 30th#Ave S sFederal Way;%, 98.803
Automatic fire sp kle ystem: N/ zzra
A--- - A ` y-=- - �.
Use &occupancy 'ossification: Business
Occupant load: -. Per 2009 IBC, Table .1004.1.1
Type of construction &Y1C111111
�` •-. 4 8/8/14
• rE, }t e"l Fft, i}! 42.;I!% 't •i e i Date
Post on the premises in a conspicuous place r i cer ateA allmot be removed except by the Building Official.
8
• C- <:<>>> <>O
/3--56cy
c"o,� IF� CERTIFICATE OF OCCUPANCY APPLICATION Permit#
If 'I CITY OF PORT ANGELES FEES
L r $50 Certificate/Inspection
Attn: Permit Technician
321 E. Fifth St., Port Angeles,WA 98362 $100 Parking Business Improvement Area (PBIA)
(360)417-4815 fax(360)417-4711 fee charged for Downtown locations
PLEASE PRINT IN INK
Check one: New business in P.A.?❑ Change of ownership only? Moving location from within P.A.? ❑ Zoning
BUSINESS NAME 1/AMESR= A/1AM Atrl , J/ ( it
Business address 113 3 i aer A y, hili g address
Phone number 6°- - _. A'0 Opening date 061'2/i 3 Days &hours of operation 7 - % a "M
Business owner's name (Avi • ANSA( Contact phone
Business owner's address 35741 3 1-11_ Ave,- <, FE0,,6,cAL "4 Y, LM 1' oaf
Brief description of business 4'4 s Sfk� �, ��, vr,,,04
Property owner's name )A 1-5C75.1- U,, k Contact phone 360 67090
Property owner's address/contact IZ.33 F_ /5+ st , c'R1 l4,v4gl,65, A 41g 36 Z
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No X
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering stairways, ramps, bathrooms, electrical, heating/cooling/ventilation systems, etc).
Work planned:
FIRE DEPARTMENT phone 417-4653 Fire approval by on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No,
Work planned:
PBIA (Parking Business Improvement Area-Downtown) phone 417-4623
Square footage of business? ti-)//4 PBIA notified on
Is business moving within the PBIA? Yes ❑ No ❑
CITY CLERK phone 417-4634 City Clerk approval by on
Second-hand dealer/pawnbroker business?Yes ❑ No
Will there be dancing at this business?Yes ❑ No,
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second-Hand Dealer, Pawnbroker, Dance,
Hotel-Motel, Fireworks,Ambulance, and Tattoo Businesses.
Page 1 of 2
COMMUNITY&ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on
Number of off-street parking spaces available for employees and
customers? NC
(A parking plan may be required.)
Signs?(wall-mounted, freestanding, projecting, awning, A-frame, etc?)
Signs planned:
PLEASE NOTE: NO flashing,intermittent,or chasing signs are permitted in the City of Port Angeles.
PWE approval by on
PUBLIC WORKS DEPARTMENT-ENGINEERING phone 417-4812
Is site work planned (new or re-located sewer or water service,
excavation, grading or filling, work in City right-of-way,
new driveway openings, site drainage, parking lots, downspouts,
irrigation system backflow devices, etc.). Yes LI No
Work planned:
PUBLIC WORKS WASTEWATER phone 417-4845 PWW approval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ii No J
If yes,what will be discharged:
Call for Certificate of Occupancy inspections BEFORE opening business.
Building Department Inspection 417-4815
Fire Department Inspection 417-4653
Please sign up for utility services at the cashiers' counter.
I hereby apply for a Certificate of Occupancy. I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect i ormation may result in revocation of
permit. �i
‘,3Z
Date` 1/ Print Name 41, /` 67,44L Signature
T:\Forms\Building Division\Certificate of Occupancy Application(2010).doc
Page 2 of 2
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
SANDHU VIRK INC
1233 E 1ST ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 98362
ELECTRICAL
SIMPSON/ 200A
165266
151 10
5/13/10
11/09/10
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
10 00000476
195552
1233 E 1ST ST
06 30 00 7 5 0130 0000
ELECTRICAL ONLY
COMMERCIAL ARTERIAL
0
Contractor
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457 9270
ALTER COMMERCIAL
PNL+ CIR
Plan Check Fee
Valuation
Qty Unit Charge Per
12 00 2 6000 ECH EL BRANCH CIRCUIT W /FEEDER
1 00 119 9000 ECH EL 0 200 SRV FEEDER
Charged Paid Credited
151 10 151 10 00
00 00 00
151 10 151 10 00
DATE
Date 5/13/10
2
WA 98363
0 0
0
Extension
31 20
119 90
Due
00
00
00
RESULTS
Signature of owner or Electrical Contractor X Date
INSPECTOR.
1--crAs?
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street I'.O. Box 1150 Port Angeles Washington, 98362
Ph (360) 417 -4735 Fax: (360) 417 -4711
Date: 1 /D
1 2 Single Family Dwelling Multi- Family or Commercial* K. Commercial Addition Alteratlal I Remodel i Repair*
Plan Review May Be Required, Pleas orn_Vte Electrical Plan Review Information Sheet
Job Address: 4 2 7 F- 1�L-
Building Square Footage:
Description of above (�201L�+- 1 /i�Gs1 R t1 �L f A 49 k' 7S
i ,7 —7
Owner tnformatlon. vr►
Name:
Mailing Ac en: r;2 a g
Phone. Fax:
License 1 Frp.
item
Service /Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp
Service/Feeder 601 -1000 Amp.
Service /Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Cin;ult
Temp, Service/ Feeder 200 Amp.
Temp. Service/Feeder 201.400 Amp,
Temp. Service/Feeder 401.600 Amp.
Temp, Service/Feeder 601.1000 Amp
Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy First 1500 sf- Commercial
Note: $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit! Limited Energy Multi- Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
Thermostat
NEW CONSTRUCTION ONLY:
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Unit Charge
119.90
145.50
204.60
262,20
372.50
260
73.50
2.60
92.70
110.30
$146.70
167.90
95,90
88.20
95,90
43.90
63,90
$119.90
102.30
56,00
$110.30
35,20
73.50
110.30
Contracto information
Name: E 2 1�C.
Melling Address
State; 11 /t Zip: C. 61
Fax:
23l
Total Igr Multiilliedby Unit Chara .1
!..1
.a.
ar
/5/ /6
Owner as defined by RCW 19.26.261 (1) Owner will ocuupy' structure for two years after this electrical permit Is finalized. (2) C wrner is required
to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contras tor. I am making
the electrical installation or alteration in compliance with the electrical laws, N.E.C. RCW. Chapter 19,28, WAC Chapter 296 468, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications,
Signatur owner, electrical contra r or electrical administrator 0 Coon 0 chock
1 r Credit card 0'71
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lO~(J~",
M vI\! Certificate of Occupancy ~~1"
~--
$47.00 Certificate/Inspection Fee -'
"'<....
DATE //B /Zc::6) New Business ............................ ( )
I
Address of Proposed Business Transfer of Business location. . . . . . . . . . . . . . . . ( )
/d33 E. Fp?.5.1- Change of Ownership . . . . . . . . . . . . . . . . . . . . . . ( X )
Applicant S 1/ ;n.'0 fr'd.-1..b / J- New Building ............................. ( )
Address sa/"^L Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
business~/'151-1~) home Temporary Business ....................... ( )
Phone: Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
/
Brief description of proposed business: sa W] e...
legal Description: lot 19-24 Block ~ Subdivision ionck.n f?,. f' k
Current Use of Property: I1P~r1~~ 94 rf :5hre.. f/YIuMI/
Zoning Classification of Property: C,4
WILL THERE BE ANY OF THE FOLLOWING? YES NO THE FOllOWING Will BE REQUIRED:
Construction changes. ... ....... ................ -~ PERMITS BUSINESS LICENSE
Electrical changes. .... ... ........ ....... .... ... -5 1) Building 1) Taxi
Mechanical (heating, cooling, stoves) . ...... .... -- 2) Plumbing 2) Peddlers
Plumbing changes .. . . . . . . . . . . . . . . . . . . . . ..... _ V 3) Electrical 3) 2nd Hand Dealer
New or relocated signs. . . . . . . ......... \./' - 4) Mechanical 4) Pawn Broker
New septic tanks. ........ ..... .......... -~ 5) Sewer 5) Dance
New sewer service ... ...... ......... .... ...... ---J,.L::' 6) Sidewalk installation 6) Hotel - Motel
Admission charged to patrons. ..... _-LL 7) Driveway installation 7) Fireworks
Is this a home occupation? .. ........ .. -~ B) Curb installation B) Ambulance
Excavation of tilling ot lots ... . . . . . . . . . . . . . . ... _ V 9) Sidewalk obstruction 9) Tattoo shop
Work done in City right-ot-way . . . . . V 10) Water meter installation 10) Other
--
Is there sufficient off-street parking? ........ ....... V'" _ 11) Fire
New driveway openings . . . . . . . . . . . . , . . . . . . . . . . V 12) Occupancy
A grading plan for site drainage. . . . ......... .,." =~ @Sign
(parking lots, downspouts, etc.) .. ....... -- 14) Shoreline
Are the existing streets paved? ......... .... ...... -1L' 15) Home occupation
Are there existing sidewalks? . . .. ......... ...... ~ 16) Conditional use
Is there curb and gutter? .. ... .... ..... 17) Other
Other....... . ........ ...... ......",,, .. .. ....
f hereby apply for a Certificate of Occupancy and acknowl. 01 -C€f J
edge that I have read this application and state that the Date: 01
,
information I have supplied is correct to the best of my Signed: c- k '.~ --..:> _Q~"
knowledge. 61
~1D REJECTED Comments / Conditions
Building Section
Public Works Department
I./i)'n! Se Planning Department
I
J.2J. of} rnll<D.P Fire Department
/'/n .01 (1) City Cierk
P.B.I.A.
CITY OF PORT ANGELES
PUBLIC WORKS BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
~UILI.,IIN¢,~ I~[:I~MIT ISSUED: 2/25/2002 PERMIT NO: 13244
OWNER/APPLICANT PROPERTY LOCATION
D. J. UIRK 1233 1ST ST E
1233 E 1ST ST Lot: 19-24
Port Angeles, WA 98362 Block: 1 [] Long Legal
3601000-0000 Subdivision: LONDON PARK
T: S: Parcel No: 063000750130
CONTRACTOR ARCHITECT
ALTERNATIVE TECHNOLOGIES N/A
1415 S. OAK
PORT ANGELES, WA 00009-8362 , 98360-0000
3601404-7000 360~000-0000
PROJECT INFO
Project Value: $500.00 SFD Units: 0 Commercial: 0
Project Type: DEMOLITION SFD SQ FT: 0 Industrial: 0
Occupancy Type: Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use:
PROJECT NOTES
DEMO MUFFLER SHOP
PERMIT ISSUED TO JAMES EASTMAN
RECEIPT#8776
FEES ASSESSMENT
Building Permit: $23.50 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $28.00
Plumbing: $0.00 AMOUNT PAID: $28.00
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
Separate Permits ara requirad for electrical work, SEPA, Shoraline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work I$ suspended or abandoned
for a pedod of 180 days after the work as commenced, or if required inspections have not been raquested within 180 days from the lam
inspection. I heraby certify that I have raad 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 herain 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.
~rfature of Contractor o ' g Date Signature of Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BU1LDING 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 I DATE IyEsACCEPTEDI NO COMMENTS
FOUNDATION:
FOOTINGS
WALLS
STORM
BUILDING 417-4815 BUILDING
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT ISSUED: 9/11/2002 PERMIT NO: 13383
OWNER/APPLICANT PROPERTY LOCATION
REINHARD PETROLEUM LLC 1233 1ST ST E
931 VALENTINE AVE S.E. Lot: 19-24
PACIFIC, WA 98047 Block: 1 [] Long Legal
360/000-0000 Subdivision: LONDON PARK
T: S: Parcel No: 063000750130
CONTRACTOR ARCHITECT
HANSON SIGN CO N/A
1533 SHOREWOOD DR
BREMERTON, WA 98312 , 98360-0000
360/613-9550 360/000-0000
PROJECT INFO
Project Value: $4,500.00 SFD Units: 0 Commercial: 0
Project Type: SIGN/FREESTAND SFD SQ FT: 0 Industrial: 0
Occupancy Type: COMMERCIAL Garage: 0
Occupancy Group: MFD Units: 0 /"J
,~J
Construction Type: MFD SQ FT: 0
Zoning Use:
PROJECT NOTES
REPLACE FREESTANDING SIGN WITH NEW CABNET AND NEW SUPPORT POLE
RECEIPT#9679
FEES ASSESSMENT
Building Permit: $0.00 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $0.00 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $115.00 TOTAL FEE: $115.00
Plumbing: $0.00 AMOUNT PAID: $115.00
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNEqG\FOPuM$\] t02.]5 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 1N A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE /"~ '3 ~3
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DKAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
IOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES ! SITE WORK (Engineering Division) SEPARATE PERMIT g's:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PEKMIT g's SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTKICAL - LIGHT DEPT. 417-4735 ELECTKICAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 ~--~--/~,~t~ ~-f~ BUILDING
T:\PLANNING\FORMS\1102.15 [4/2002]
o~ { I~O~ omc~ u~mm, v.
Please lype or prlnl In Ink, lfyou have any ~u~tl~a~, pl~as~ call 417~15
Applicant and/or Agent: ~1~ ~ ~ Phone:
~c~itee~ngin~er: .............. Phone:
Address: ~ ~x ~ Cibt: ' . Zip:~
LEGAL DESCR~TION: ~t: Bl~k:, Subdivision: ....
TYPE OF WORK: SIZENALUATION:
~ Residential r~ New Constr. a Retool [] Woods:ave _ 8F. ~ $ ,,, ~F. = $
D MuRi-family [] Addition ~: Move ca Om'age SF. ~ $ ,, /SF. = $
ia Corrumerclal D Remodel O Demolition c~ Deck SF, ~ $ /$F. = $
D Repair "~ $ig~ t~ · TOTAL VALUATION
[IRIEP DE$CRIPTIONOF THE PROSEC~ ~,~/.~ ~.tt~-~oe '~--~-~r~a~.
COMNIEP, CIALfKESII)~,IWI'IAL: Occup~cy ~oup;. O~up~n( ~ad: ~ Co~io~ T~e:_
No. of Static: ~ ~( S~: % ~t ~agc;
E~g ~t Cov~ag¢: Isq. ~, + Pmpo~ ~t ~a~: /sq. ~. = TOT~ LOT
BLDG.
P~ USE O~Y:
~ ES~efl~d(s): ~ Y~ m No S~ACh~klist ~quir~? m y~ o No OOze?: O~R
PREAPPLICATION SUBMu'rlTAL: Your appllca~n tmds~l)lan rtutabefdled out oot~iol~tely to b~ a¢¢¢fftedfor re~iew. Thc Building
Division can provide you with more detailed i:fformation on {he application and plal~ submittal requirement,s,
BUILDING PERMIT APPLICATION SUBMITTAL: Your completix:l application, site plan (for ltdditions) and building censtru¢tian
plans arc: to be submitled to tho Building Division,
VALUATION OF CONSTRUCTION: In all ~,:~, a valuation amounl must be enter'cA by the applicant, This figu~c will be reviewed and
may be revised by the Building Div, to o~nq)ly with curronl f~¢ sc. hcdules. Contact thc Pemfit Coordinator at 41'7-4815 fat assistance,
PLAN Ci'~CK FEE: Your plan check fee is duc at the timc thc building pc)mit application and construction plans are submittexL All oth~-
l>ennit fo~s are duc at thc time of permit issuance,
EXPIRATION OF PLAN REVIEW: If no permit is isst.'cd within 18,0 dttys uf (,Itc date of applica0.ot~, this application will expire by
{imi~tlons. 'I~.¢ B',lilding Official can cxte~ld the time for action hy tI~¢ appllc~ua up to 180 days, on written rcqucst by ~hc al)plicant (see S~tlon
. 30/ltd) of tile l Jtlifc}rm BuildinE, Code, curt'ertl edition), No application can be extended Inore Ihan atica,
I hereby cee'lily I/tat I have tvad and exatnl/ted thl,~ application andknow lite ,~ame to be t/~e attd correct, a.d I am authorized lo apply for
Htl$ permit, I u.derxta.d It lz ,tot the Clty': legal responsibility to d¢lermi~ ~eba/~l~rmlt~ are ~zqulred; it rema#;~ tile appllcant9
r¢~po~tslblllty to deletwd.e what petvnll;r are reqglt'ed a.d Io obtaht ~ucb.
Pw-I S0~o13[rev.2~961 ...
FROM : HRNSON SIGNS FAX NO. : 360 615 9515 Apm. 24 2002 09:$5AM P4
~ ~t~"
- ~
FROM : HANSON SIGNS FAX NO. : 368 613 9515 Apr, 24 2002 09:35AM P5
IIIII I I III
.... CITY OF PORT ANGELES
£~ PUBLIC WORKS - ELECTRICAL DIVISION
321 EAST 5TH STREET, PORT ANGELES. WA 98362
ELECTRICAL PERMIT ISSUED: 5/16/2002 PERMIT NO 7664
OWNER/APPLICANT PROPERTY LOCATION
REINHARD PETROLEUM LLC 1233 1ST ST E
931 VALENTINE AVE S.E. Lot: 19-24
PACIFIC, WA 98047 Block: 1 [] Long Legal
360/000-0000 Subdivision: LONDON PARK
T: S: Parcel No: 063000750130
CONTRACTOR ARCHITECT
HANSON SIGN CO N/A
1533 SHOREWOOD DR
BREMERTON, WA 98312 , 98360-0000
360/613-9550 360/000-0000
PROJECT INFO
Project Type: COML. MISC. Project Value: $0.00
Occupancy Type: COMMERCIAL Construction Type:
Occupancy Group: Zoning Use:
Electrical Heat:
[] Baseboard 0 KW [] Riser [] Underground Service ~'
[] Furnace 0 KW [] Overhead Service Voltage: 0
[] Heat Pump 0 KW [] TempService Phase: [] 1 [] 3
[] Fan Wall 0 KW Service Size: 0
Feeder Size: 0 t'l
PROJECT NOTES ~
INSTALL NEW ELECTRIC CIRCUIT TO ID SIGN '1
RECEIPT#9024
FEES ASSESSMENT Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
Misc Fee: SIGN $34.40
TOTAL FEE: $34.40
AMOUNT PAID: $34.40
BALANCE DUE $0.00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
DITCH
ROUGH-IN ! COVER
SERVICE
GENERAL COMMENTS:
.s
"-lr.."
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
m EAST 5TH STREET. PORT ANGELES. WA 9RJ62
ELECTRICAL PERMIT
Issued: 2/06/98
Permit No:
6218
OWNER/APPLICANT------------------------PROPERTY LOCATION--------------__________
NEBERT BROTHERS 1233 1ST ST E
1233 E 1ST ST Lot:
Port Angeles, WA 98362 Block: Long Legal:
360/000-0000 Sub:
T: S: Parc No:
CONTRACTOR-----------------------------DESIGNER_________________________________
ANGELES ELECTRIC
524 E. FIRST ST.
PORT ANGELES, WA 98362
360/452-9264
,
000/000-0000
PROJECT INFO--------------------____~-------------------________________________
prj Type: COML. MISC. prj Value: $0.00
Occ Type: Cnstr Type: ADD CIRCUITS
Occ Grp: Occ Load: Land Use:
Electrical Heat
Baseboard KW:
Furnace KW:
Heat Pump KW:
Fan/Wall KW:
Service Type
o Riser
o Overhead Service
o Underground Service
o Temp Service
Voltage:
Diameter:
Service Size:
Feeder Size:
-1
o
-3
o AMPS
o AMPS
PROJECT NOTES------------------_________________________________________________
WIRE PROPANE DISPENSING UNIT
I
I
I
PROJECT FEES ASSESSMENT---------------_____________________________-----~------- I
Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $52.00
Temp Service: $0.00 TOTAL FEE: $52.00
Misc $0.00 Amount Paid: $52.00
---------------------------------
---------------------------------
--------------------------
TOTAL FEE:
$52.00
Balance Due:
$0.00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPKCT10N TYPE DATE ACC1lPTEll COMMENTS
YES I NO
-IN I
ShRVICh
.
FINAl I !:if I
GENERAL COMMENTS:
PW.I 101.1' 10ISJ
e.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457.0411 PERMIT NO.
ELECTRICAL PERMIT
Site Addres~
Installed By:
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
o RESIDENTIAL
o COMMERCIAL
o BASEBOARD KW _
o FURNACE KW _
o FAN/WALL KW
o HEAT PUMP KW_
~SIGN
DetailslDescription:
/ /
-f//b
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o SPECIAL EQUIPMENT
(LIST BELOW)
II/i}ttJ2fler
o OVERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
o SINGLE PHASE
o THREE PHASE
SERVICE SIZE AMPS
C7 / 'I
~/) D P
~IfIAI~I-/";, to eXfshN9 (lll7J:<d-
.
WS. No. SERVICE SIZE
CAPACITY:
o O.K. NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
o Rough-in/cover O.K.
o O.K. to connect service
,Arfl Final O.K.
Site Address:
New Meters
.err
.
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 Permi!. PHONE 457-0411, EXT. 224.
T..<; / ,lJ f1 NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $
IEtectricallnspector
~OC>
Permit Fee
WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept.. Bottom: City Hall
OLYMPIC PRINTERS INC.
4
.
.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO. 02c?o? ~
DATE ~t7~ t?
ELECTRICAL PERMIT
Site Address:
Sq. Ft.
o READY FOR 0 WILL CALL FOR
INSPECTION INSPECTION
License Number: Phone:
~
Installed By:
Owner/Business:
~~
Phone:
Owner/Business Address:
o Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/lndustrial 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
010 03.0
Service size
o Temporary
Amps
~Add/alter circuits
tJ Auxiiiary power
(list below)
o Special equipment
(list beiow)
Detai I s/Descri ption:
dr-U&,-,
~4:
J7d~
/ 'f!Nr'
rJu 1ft€.-
~,4,/,vs;C7
W.S. No. Service Size
Capacity: 0 O.K. 0 Not O.K. Comments
~Ditch inspection O.K.
o Rough.in/cover O.K.
o O.K. to connect service
~Final O.K.
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for instailation
o Fire Department notified of inspection
o Plan Review approved/pending
Site Address:
Permit/Receipt No.
;28~
New Meters
Installer:
f
Notify the Depart nt of City Light by Street Address and Permit Number when ready for insp ction. 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 457.0411, EXT. 158 or EXT. 224.
r / ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT c20 a:z.i)
- Inspector \ Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYMPIC P~INTERS. INC.
Installed By:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
.;
ELECTRICAL PERMIT
PERMIT NO. .:1 5 0 7
DATE /-IBI9U
,
Site Address:
o READY FOR
INSPECTION
License Number:
~ WI LL 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)
o Special equipment
(list below)
Amps
Detai I s/Descri ption:
.-:?/>(0(~
.
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough-in/cover O.K.
o 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
Installer:
,..-
Permit/Receipt No.
dS;-O
New Meters---- Date:
/-/8 9u
Site Address:
.
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 457.0411, EXT.158 or EXT. 224.
~ / Jp NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ;JS--: 0 ()
Insplactor Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYMPIC PRINTERS. INC.
~.
"
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
PERMIT NO. .;:2tJ (,2-
;;) /~O //9
DATE
Site Address:
/61- 33
[,
/!f
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Installed By:
O(
Owner/Business:
G-~
Phone:
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
o 10 03.0'
Service size
o Temporary
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
Amps
Detai IslDescri ption:
Lui'e.[
/-.V4 L
de-kf.LYf!
e
,,~
I
1~ PlVf,.io
,
W,S, No. Service
Capacity: 0 OX 0 Not O.K,
o Ditch inspection O,K.
o Rough'in/cover O.K.
o O,K, to connect service
.~ Final O,K.
./tP~
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
New Meters
o
Site Address:
/d.. 3"3 ~
/.s/
e
Notify the Dep rtm nt 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 In~tor in Writing on the Wiring Report or the Buiiding Permit. PHONE 457-04,11, EXT. 158 or EXT. 224.
I ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ~ It ~
Inspector. Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
Ol-Y~PIC PRINTERS. INC.
,/
~
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Other States
Fax ~r~.ber
(206) 281-5000
(800) 552-7132
(SCO) 426-2830
(206) 281-5030
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FEE RECEIPT N\JMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
000116
PERMIT NUMBER
.
lb. '06J ' ;VA- - I C"oMMeAlc /jL-.\
'TOTAL FEE ',~
CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY
Site Address
FIR..~T
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
fo I? T /IN C-~ u: ~
PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Instaliation By Ot:-tJ II-e A
Installers Address
J).<.)) EAS'!
CORRE T ADDRESS IS RESPONSIBILITY OF APPLICANT
I<.
Owner's Address.5 It ^1 ~ .
U-r7- y3 1 t9
Owner
Installers Phone S"k A1 Z
evlAN&-t> (I(
Day Phone
Applicatior'l is hereby made (or Permit to ins!all.Electrical Eql,lipment as follows:
P/;O r
Se I:tI f< f'
Wiring ~ethod
17(1/'Lex
.
AMP 240V NUMBER AMP 120V - 240V
USE OF CIACUIT NUMBEA PEA 120V "100R FEE USE OF CIRCUIT PEA 100R FEE
CIRCUITS CIA 10 -- CIRCUITS CIA 10 30
LIGHT SIGN
LIGHT 50 VOLTS
OR LESS
- . MOTOR -
CONVENIENCE ,
CONVENIENCE MOTOR
APPLIANCE .. MOTOR
DISHWASHER FIAE ALAAMS
DISPOSAL BUAGLAA ALAAM
..
RANGE MISC.
OVEN
WATER HEATER
LAUNDRY
DRYER REINSTALLATION LIGHT FIXTURE #
FURNACE SUB TOTAL FEE.
GAS-OIL
FURNACE ENERGY FEE
ELECTRIC' BASIC FEE
ELECT~IC HEAT TOTAL FEE It.. l'LQ-.
,
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BAEAKER .
. -. -.
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE V V (b j1P- A.W.G.
- I SUB-TOTAL /ZOO
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
. -..
I certify that the work to be performed under this permit will be done by the installer and in confor
?-7 ,19?fBY' ~
I CONTRACTOR OR OWNE (OR AUTHORIZED AGENT)-
Permission is hereby given to do .the above described work, according to the conditions hereon and according.to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles.
/'/- ~ 7 -C6~ By4!<< ?~~ '
Date Permit Issued 0' PLANS APPROVED '. .
Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
be cqvered or cur~ent turned on before inspection and O.K. for covering or service has been given by Inspector in
Writing on Permit Placard. A. - Permits Phone: 457-0411 Ext. 158.
Date Application made
/l~
.
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER-
WHITE - Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
OLYMPIC PRINTERS, INC.
. J ~
. .
REPORT OF INSPECTOR
DATEOFVISIT MADE BY REMARKS
Jj..3-1'f /f!/~ C ill! e TeMfa {?ov e /<. r/..ey Nlr.{S'"r
~,,(~./C'e T.J> 5 A;::-c ,r-;:.t y ~ysTeA/J
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O.K. FOR COVERING
/1. '? $'1 /}ff'.f O.K. TO CONNECT SERVICE
{1 .5-. 1t.f 11 /,y FINAL O.K.
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16790
Port Angeles, washlngtonmmu3.=..=.L..u___..___.............mm., 192./
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
'NU
. .
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-
~;.jij~;~~"::';~~::.~;"~=~"=:'~=::::::::
Wiring Contractor .u~....__....__.U..__.Uh.h...m. By..ummmuum.ummummumu..uu..mmm..m....
Light Outletshhmhm. .hmmhhm..h.m.. Service, volls h!cf!pLi!.f.f:!. Type ot Wiring:
R I 1 OUl1 Is Ko. wIres h~.m.".mhhhm Armored Cable hhhh.hhhh..hmm.
ecep ac e e ....___mn......._.._.______. ____
Sl i Non-Metallic .__......__n._____m__.__......
Dryer, KW..u.....__......__..______.____.____.____ ze w reSnJh....;~.;;.,----A......-..
/ '" V" /y Knob & Tube................................_
Range, KW __nhn......._.h._ "hu____n______m Main fuse ____....h.....m__:______.____.......
S
Enclosure ___m___...........__________.........
Water Heater:
KW.mmmh/t;~:zmmnm
Hea~::~;~~;::-l:::~:.m...
'~'1 u.'~&.~(.,~~.~mmm
~~e.."~..L""'hm
( ~i~~:~zi~:::
Type of wiring:
Entrance Cable _.___nnn______............
Rigid Couduit mmhhhh,h.hhhh..
Metallic Tubing ........................___
Current transformers:
No. & Size....h............__...................
Ser. No..............................................
SerF NO........:..........h....h.........__..__....
RIgid Conduit ................m..m.......
Metal11c Tubing .mh....mmh.........
Raceway ..............................._._..._
f2
CIrcuits, Llght..................................._..
UlililY ........~..m.m....m...........
=:tge ..:~:::::::::::::::::::~::::::
Water Heater m.___mm....mm........
5t-
Motor ..........h..n..............................
be-t?__..Ii2....m.............mm.....
Furnace ..........._............_~......_..... ......
SerF No...............................................
. I /-(2;.
Remark:~ta:h::;~~~__S~'~.~~____..:__..:..:__~:::.:::~::.:::~.::__..__.mnm.mmn.m.~.~~.~m~__~__.~.:~:::.::::.:::~.:~.:~::
__.n_~nn__.__nn.~.n_nn_________u~_.~~.n__n_n___.un.nn~n.._________n.._....._h___.__..n.__...__u.u.._..__n____._____u....~.._n.__n__.__.~.__~u...nu..
..U__h...__.__n__u.hn.~.n._~~~__....__hnn~.~.n__..u.hnh..nn.u.nn..nn__hhn~~n..~.....n..__.nn..h________...h._._.~n__.nn_u__....n_..~_u__.._
Permit Fee
. 9.00
$.mu~Lm__mm.____m.__...
Treas. Receipt
NO.um.mm__mm.mm.
By h--fi~.IA.~~.~~~~A~
,
NOTICE-Current must not be turned on untn Certificate of Inspection has been issued. If work is to be con.
cealed due noUce must be given the Inspector so that work may be inspected belore concealment.
'.
"
NOTIFY THE INSPECTOR BY PERMIT"NUMBER WHEN READY FOR INSPECTION
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ELECTRICAL PERMIT
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.....-..................--...........-.-....___...........__.______..___............____.___._...............__.h____................._
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N?
16790
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Date..__._._______.........................._.._...l~__......
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.r Owner... .-.--.--............._._____..._._._.........._....____._...__.___....................._...._.._______..._..........__...._ Tenant......._...._..._.........._.____________...........____________._..
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Wiring Contractor.........._._._._........................._..__.__._______.........................__..___.................._..._. ._..___. By____.................__.___......_..!...,.........._.._.._._..
. ,
, . ;
"-r- --- . . NOTICE-Current must not be turned on untn Certlffcate ol 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.
\
1M Olympic Printers, Inc.
\
DATE:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
�� Signature of owner uc Electrical Contractor
X Date:
REPORT SALES TAX
on your excise tax form
to the City of Pott Angeles
(Location Code 0502)
RESULTS: INSPECTOR--
~~
ELECTRICAL
PERMIT
CITY OF PORT ANGELES
' 360-417-4735
Application Number . . . . ,
15 -00000248
Date �/16/15
Application pin oom»ec
469336
Property Address . ...
1233 E zaz oz
uoem000n nAocEn mnMoEo.
06-30-00-7-5-0130-0000-
Application type uooccintiuo
ELocTczcAn ONLY
Subdivision Name . . . . . ,
Property Use . . . . . . . °
Property xuuioe . . . . . .. `
commERczAL AozEozxu
xnnzicaciuo valuation
o
Application u000
.........................
,
~
Feeder replacement and clean n»
----------------
existing
..................
^
Owner
Contractor
soNoen u vzou, INC
xmoEzno ELmcrozc
zzaz E zoz or
sx« E. 1ST ST.
eoaT ANGELES wa 98362
enor AnonLmo
WA 9e362 ,
(seo) 452-9264
--------�_------=---=-�-=--�--.�-_-�-_-=__-=~__--~--~�-_--_=~----~~~-�-~~-
^ Permit � `. ELECTRICAL
uLzue coMmErczuL
Additional u a
- --~`
Permit Fee 202.00
nzao check nee
° ° -oo
Issue Date � � m� 3/16/15
Valuation � �
� � o
Expiration Date 9/12/15
Qty Unit Charge per
~
Extension
14.00 5.0000 Eco *EL'BrANCo
czncUrz w/FEEoER
70.00
1.00 132.0000 Eco oL'com
0-200 aRv FEEDER
zau.00
�---^--~-�-----^-�-�--*---°�---^--~-------~--==�r=---~--~-~-~-�-~-~-�-~-~-~
Fee summary Charged
paid Credited
Due
Permit Fee Total 202.00
202.00 ,on
.00
^' Plan Check Total ' .00
.00 '.00
.00
ozauu Total 202.00
202.00 °oo
/oo
DATE:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
�� Signature of owner uc Electrical Contractor
X Date:
REPORT SALES TAX
on your excise tax form
to the City of Pott Angeles
(Location Code 0502)
RESULTS: INSPECTOR--
~~
03/13/2015 14:26 FAX 360 452 9265 Angeles Electric
IQ 0001 /0001
Owner as defined by RCW.19.28.261: (1) Owner will occupy a structure for two years after this electrical permit is finalized. (2) Owner is required
to hire an electrical contractor 9 above said property is for sal' rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am i owner of the above named property or a licensed electrical contractor. I am maldng
the electrical installation or alteration in compliance with the a tical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port
Angeles Munidpal Code, and Utility Specifications and PAM 4.05,050 regarding Electrical Permit Applications.
Signature of owner, electrical contractor or electrical art Istmilor: ❑ nun ❑ cmMdc
t Credn cord l
w tllyArda° �J�" +� 01/0112012
t ,, " 01� r,
CITY OF PORT ANGELES PERMIT APP
CATION
Building Division/Electrical Inspections
321 East Fifth Street — P.O. Box 1150 / Port Anj
eles Washington, 98362
Ph: (360) 417.4735 Fax: (360) 417 -4711
Date:
Wamily or Commercial`
' Plan Review May Be Required, Please Complete Ele '"cal
Plan Review Information
Sheet
Job Address:
Building Square Footage:
Description of above
Contra
•
r InformatiNam
OwnAfmm4atlan a
NameMalll
�'�r "^�--
Melling
-
City. State: , . " ip,
fi
City:
Stale: Zip:
Phone: Fax:
Phona°
ax"
License ht I E
License e / Esp.
Item
91111
T I W1901114 bx —Unit
Service/Feeder 200 Amp.
$132.
Service/Feeder 201 -00 Amp.
$160.0
S
Service/Feeder 401 -600 Amp
$225.0
3 r
SeMce/Feeder 601 -1000 Amp.
3 266 y
S
Service/Feeder over 1000 Amp.
S410..
3
Branch Circuit WI Service Feeder
$ &
Branch Circuit W10 Service Feeder
$ 74:
3
Each Additional Branch Circuit
Branch Circuils 14
$ 5,
$ S6.f ,
i
$
Temp. Service/ Feeder 200 Amp.
$101, 0 ,—
Temp. Servioe/Feeder 201400 Amp.
$ 121.
3
Temp. Service/Feeder 401-600 Amp.
$164.
$ .
Temp. Servlce/Feeder 601.1000 Amp ,
$186.
3
Portal to Portal Hourly
$ 96,
$
SlgnlOudine Lighting
$ 0&
Signal CircuW Limited Energy— Muld- Femlly
$ 64.
3
Signal Circultf Limited Energy 1 First 1500 sf — Commercial
$ 96.
3
Note: $5.00 for each additional 1500 d
Renewable Electrical Energy - 5KVA System or Less
$ 113.
S
Thermostat
$ 66. ;
3
Note: $5.00 for each additional T-Stet
$ TruN
Owner as defined by RCW.19.28.261: (1) Owner will occupy a structure for two years after this electrical permit is finalized. (2) Owner is required
to hire an electrical contractor 9 above said property is for sal' rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am i owner of the above named property or a licensed electrical contractor. I am maldng
the electrical installation or alteration in compliance with the a tical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port
Angeles Munidpal Code, and Utility Specifications and PAM 4.05,050 regarding Electrical Permit Applications.
Signature of owner, electrical contractor or electrical art Istmilor: ❑ nun ❑ cmMdc
t Credn cord l
w tllyArda° �J�" +� 01/0112012