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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32 I EAST 5TH STREET, PORT ANGELES, W A 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
08-00000001 Date
103930
602 E 4TH ST
06-30-00-0-1-7345-0000-
DIANNE E. ARNHEIM
RE-ROOF
1/02/08
RS7 RESDNTL SINGLE FAMILY
2945
Owner
Contractor
DIANNE E. ARNHEIM
. 8 MAGPIE CIRCLE
WALPOLE
ME 02081
WESCO ENTERPRISES
PO BOX 1527
PORT ANGELES WA 98362
(360) 452-1430
TEAR OFF, INSTALL COMPo ROOF
Structure Information 000 000
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT - NO PR FEE
TEAR OFF, INSTALL COMPo
118364
109.75 Plan Check Fee
1/02/08 Valuation
6/30/08
.00
2945
Qty Unit Charge Per
Extension
95.75
14.00
BASE FEE
1.00 14.0000 THOU BL-2001-25K (14 PER K)
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 109.75 109.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 114.25 114.25 .00 .00
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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 orwork is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
CJ -0 -Or
Date
Signature of Owner (if owner is builder)
T: Forms/Building DivisionlBuilding Permit (I % 1/07). wpd
BUILDING PERMIT INSPECTION RECORD
CALL 4 17-4815 FOR BUILDING INSPECTIONS. CALL 4 I 7-4735 FOR ELECTRICAL INSPECTIONS.
CALL 4 I 7-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
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INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS / ROOF / CEILING
DR YW ALL (INTERIOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP/FURNACE/DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 4 I 7-4735 ELECTRICAL
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 I - "2 -t) ~ :\ L-t..- BUILDING
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Applicant or Agent J!c/'r y L Ic/' CC J v-
Property Owner I mil s. fJr//4c//11
Property Owner's Address 8 m QYJ'Jc CirCle ,W.J1L.)oL.c::-
Contractor/Engineer tA/C:JCo /?"'1-!<./d'/(fC'.t '
Contractor/Engineer's Address / (J &" l.r;) 7
License #
BUILDING PERMIT APPLICA TION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St., Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
For City Use Only:
Date Received~ '2 J 0 ~
Permit # O~..:. , I
Date Approved
0:1 CJcS' /
/62
t:?
t;ft
Parcel Number
PROJECT ADDRESS
Lot
Zoning
Proiect Type & Brief Description:
Check all that apply
o New Construction
o Addition
o Remodel
o Repair
.'" Re-roof
o Demolition
o Sign
o Heat System
o Other
~esidential
o Industrial
o Commercial
o Multi-family
?O /'
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o wall-mounted 0 projecting 0 freestanding 0 awning
Total si n area s . ft. Maximum allowed si n area s . ft.
o Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other
o other
Floor Areas Existinq (sq. ft.) Proposed (sq. ft.)
Basement @$ per sq. ft. = $
151 Floor
2nd Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUA TlON $ 2 ?L1J3d-
sq. ft.
Lot size
sq. ft. = Lot coverage
# of bedrooms
# of full baths
# of half baths
%
Total footprint of structures
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
Occupancy group
Occupant load
Construction type
ft.
I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on
projects. ~ J/ / /r
Date?l/-02-o$" Print Name ~rrY I'jercAv Signature C 0- K~
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T:Forms/Building Division/Bldg Permit Appl.-2006 Code.doc
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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:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000948 Date
948632
602 E 4TH ST
06-30-00-0-1-7345-0000-
DIANNE E. ARNHEIM
RE-ROOF
8/28/06
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RS7 RESDNTL SINGLE FAMILY
900
Owner
Contractor
ARNHEIM, DIANNE E.
8 MAGPIE CIRCLE
WALPOLE
WALPOLE
ME 02081
WESCO ENTERPRISES
PO BOX 1527
PORT ANGELES
(360) 452-1430
WA 98362
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT - NO PR FEE
TEAR-OFF,TORCHDOWN GAR
85720
62.20 Plan Check Fee
8/28/06 valuation
2/24/07
.00
900
Qty Unit Charge Per
Extension
50.00
12.20
BASE FEE
4.00 3.0500 HND BL-501-2K (3.05 PER C)
Other Fees
STATE SURCHARGE
4.50
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 62.20 62.20 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 66.70 66.70 .00 .00
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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-certifythat-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.
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PO' -2.r-dt
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
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BUILDING PERMIT INSPECTION RECORD
CALL417-4815 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
SHEAR WALLS 1 WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALUHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKJRTING -
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKlNG/LlGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 4 I 7-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R W. 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:\Policies\1 102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT - APPLICATION
FOR OFFJClAL USE~LY:
Date Rec.: o8/~ ~6
Pennit #: t9 G - q Ii
Date Approved:
Date .l5sued:
Fill out COMPLETELY and in INK. Your application and site pial] MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent:
Owner: fV1 /? J.
Address: 6 () 'I
,4, /J,{ ~/';"
E t//4
Phone:
Ph011e:
City: lo/' f
~do
,
Zip: PJ 5'62
ArchitectlEngineer:
Contractor Wc..t (,,0 En r
Address: / t) go)C )">;2 7
PROJECT ADDRESS: 60 z
VC/~5c.o<F
State License #: 09 tjI tJ F
City: ~/f- A-/l~/r:,I
.
Phone:
Exp: ot-(.1J'-~7Phone: Z-/y)'o
Zip: 7';>36 2-
ZONING:
c
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LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Subdivision:
TYPE OF WORK:
D Residential D New Constr. rfr Re-roof D Stove
D Multi-family D Addition D MoveD Garage
D Commercial D Remodel D Demolition D Deck
D Repair D Sign D Other
BRIEF DESCRIPTION OF THE PROJECT:
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SIZENALUATION:
SF. @$ /SF. = $
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION. $ r~
/l. A. ~ ).14 -r: ,t)(
sAcc'r
COMMERCIAL/RESIDENTlAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
ESA/Wetland(s): DYes D No SEPA Checklist required? DYes D No 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 time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRA TION 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
Rl05.3.2 of the International BuildinglResidential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits prior to work. -
T:\FORMS\BldgPennitform.wpd Applicant: ~ ~ !(~ Date: 0(-25- 06
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I AUG 2 8 2006 ~
CITY OF PORT ANGELES
BUILDING O..MSlO
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FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT.
A
571
PERMIT NUMBER
.-
TOTAL FEE
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TIMETo"COMPLETE
NO. STORIES
LEGAL OCCUPANCY
51\e Address
- ELECTRICAL PERMIT ONLY .,NO OC~~jfNC~ USE ESTABLISHED UNDER THIS PERMIT
(002- ~ ~Ih Lj4-+aftIft-H. .'..
. CORRECT ODRESS 15 RESPONSIB TY OF APPLlCA T PERMITS WITH WRONG AD~S ARE CANCELLED -#-
.5': Installation By J, sell E tea< '
Installers Address / </7/ 1:/:7 /17/ 4./-
Installers Phone 6 /i"1~- t??/ r .
Owner
Owner's Address'
Day Phone
Application is hereby made for ~ermit to install Electr!cal Equipment as follows:
$DMt.- ()JILL LH-~1L
F ( tU... - (' fi.AI..:-"j [. SIC /L.tJ I C L_
Wiring Method
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NUMBER AMP 120V 240V - NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PEA 10QR FEE USE OF CIRCUIT CIRCUITS PEA 10 100R FEE
CIA 10 30 CIA 30
LIGHT N{t S~ \lILt.. SIGN
-
LIGHT . f.fw N.E- 'Jk.h~ fJ 50 VOlTS ,
OR LESS -
~O.J , MOTOR .
CONVENIENCE .L(.- I......''''"'
CONVENIENCE Rt",. IU. "f.I.N MOTOR
APPLIANCE {t.~vJ Itt-t _ gll,-~ ~ MOTOR .' .
DISHWASHER tt:... /1--<.-- nJIU ~M- -'( FIRE ALARMS
DISPOSAL ttl>'V ,t - H 4't\ ",,,, k BUAGLAA ALAAM
RANGE tJ~\;J (.f dl ~ ou-H t-t ,... ~fJ ~'" MISC. .
.
OVEN ,.n
WATER HEATER /.: ..J"",
/- 11 :A' V ~ -
LAUNDRY
DRYER if/J./' Vl - ^ .. REINSTALLATION LIGHT FIXTURE #
FURNACE .1 / r,pJ I SUB TOT~L F:EE
GAS - OIL
FURNACE .- / ENERGY FEE
ELECTRIC .
BASIC FEE
ELECTRIC HEAT
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT '1-,,,, AMP / PHASE
.
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE A.W.G.
, I SUB-TOTAL . .
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I certify that the work tD be performed under this permit Will be done by the Installer a~~ In c7r;'" :e~ N.E.C. lectrical Code.
Date Application made ~.-t _ / t; ,19 .?" G By ( 'A -, A~,
. - .P6NTRACTOR OR OWNEA (OA AUTHOAIZED" AGENT)
-.
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Permission is hereby given to do the above described work,.according to the conditions hereon and according to the approved plans and
specifications pertammg thereto, subject to compliance With the Ordinances of the C ty f:port An eres~ ~ 4 " .:' <I"
DIRECT OF I LIG T
4-f If. (0 (' BY. D - : .;:. :.,
Date Permit Issued II I) 'I ;- PLANS APPRO ~ r
. .
Notify Department of, City light by Street Address and Permit.Number whEm'ready'for inspection. Work'-must not
be covered or current 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.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WARNING
WHITE. OrIginal CANARY. Duplicate PINK Triplicate WHITE CAAD . Inspector's Report
OLYMPIC PAINTERS, INC.
REPORT OF INSPECTOR
,
DATE OF VISIT . }fADE BY REMARKS
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4 " zS' gc, I O.K. TO CONNECT SERVICE
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RECEIVE4
CITY OF Pou ANGELES PERMn' APPLICATION JULw 1 2014
Building Division/EkOrival lnspectiows
321 East Fifth StMet — P.O. Box 1150 / Port Angeles Washing(on, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711
L),,ile: 7/112014 — I & 2 Single Family Dwelling
" Plan Review May Be Requlfed, Please Complete EInlrical Plan Review InformMon Swat
b Address- —�0_2L4t_h5t,.__
HOIdIng qwva Fowaae 830
Descrip1mi (0 zwe
Ovinar Information
tjaMe, Napoe Lloyd
hi a" Adftss: Gu2 c 4th st
ulf Port Angeles Sjjto; 'AA Zip: 983625408
_Z0246
NO": M_70 fx:
FF
lktmo 01 &P.
—
Item
Unit C bLrL
SerlficaFooder 200 AM,
$ Q0,00
Service* oedef 201AGO Amp,
$146,00
Service*eedw 401.6W Amp
$205.00
Service ffindet 601-100 Amp.
$262,00
Serviceffae&r over Mo Ang
S 371W
f� anch Circuit V11 Sapke Fender
S 6.00
Branch Ckcult WM Service Feeder
S 63,00
Ew,h Addiliw r CitcW
5,00
Womb Ckcuits 1.4
75M
Temp, geryicel Feeder 2W Artil
9100
Tomp, SOP&eFndor 201.00 Amp,
S 1 KOO
TvmR SeMceffeeder 401.600 Amp,
$149,00
Temp, Se*WFeeder 601 a WOO Amp
$ I MOD
poa1s to .f3 lioudy
$ Mil
,%0 C"�00 Limited Energy -1 A 2 Family Owding
$ 61.00
MWnufatared Home Connection
$120,00
Reny wtl* Electrical Energy - MA System or Leas
$102,00
Thorm-ostal
S KOO
stole: 55.00 kg each addlional T-SW
CONSTRUCTION I.Y.
F 1300 Square R
$120,00
Each Ad banal $00,5quxe R as Pb9ion d
S 40.00
Each OutbtAft or Deltarhed Garage
S 74.()0
Each S4mmlng Pol of Hol Tub
$110.00
Contractor Information
RaMQ: Protect Your Home
M&UqAddrer,s 3 ORrlorltyWay5outhl)r
C# jLcljlanaea[l .vim, y . Va16:,_1N_ 7* 1,6240
P11004,'_155-502-35,59 r-,SX.' 317-564-2547
Total LCLty �Mulfi
S---.�4-�c_o Total
Owner as del'W by RCM 9,29-26 1: (1) Owner Mlt oGcopy the strmttire for two years after this eledri0al Permit Is finatized. (2) Owne! is roqvired
to hire an 01W(l CW contractor if above said property is for sale, fen( or tease. Pe it ex*t after six moflt4s of last Inspection,
Alter teadiag the above statement, 1 hereby oerlify that I am the owner of the above named property or a licensed fJectdcal contractor. I am makfrig
ft elec*al installaWn or afteraWn in coal wM time eleclftal laws, N.E.C., RCS. Chapter 19,28, WAC, 0-bapter 296468, The City of Port
ArWles, Muol Code, and Ujil SpecirTafions and PAMC 14,05,050 regarding Elactriml Permit Apoicalions.
Signature of owner, electrical contractor or electrical admInistratcl 0 Cash 0 Check
0 U00 Card 0
7/1/2014
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 14- 00000784 Date 7/01/14
Application pin number , . . 399392
Property Address . . . 1 602 E 4TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-1- 7.345 -0000-
Application type description ELECTRICAL ONLY
Subdivision Name . , , . . ,
Property Use
Property Zoning . . , . . , . R97 RESDNTL .SINGLE FAMILY
Application valuation . . , 0
Application desc
Prokect' your home
Owner Contractor
STEPHEN V LOPRESTT PROTECT YOUR HOME
374 RIFE RD 3750 PRIORITY WAY SOUTH DRIVE
PORT ANGELES WA 98362 4200
INDINAPOLIS IN 46240
(317) 810 -4720
-- Permit I . . , ELECTRICAL ALTER RESIDENTIAL
Additional desc . ,
Permit Fee 64.00 Plan Check Fee ,00
Issue Date 7%01/14 Valuation , , 0
Expiration Date 12/26/14
Qty Unit Charge Per Extension
1,00 64,0000 ECH EL- SINGLE CIR LIMITED
RES 64.00
_-- --- ---- - - - - --- - - -- ----_-----------------------__------------
Fee summary charged Paid Credited Due
Permit Fee Total 64,00 69.00 .00 00
Plan Check Total DO .04 .00 .00
Grand Total. 64.00 64.00 .00 .00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Coate 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature. of owner or Electrical Contractor X Date:
G:IEXCHANGEIBUILDING
0
NJ
NOW�
�I