HomeMy WebLinkAbout1501 E 4th St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
Ann Dacy Linda Carroll JT
115 NW Columbia St
BEND
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
1 00 48 1000 ECH EL R OR RM 1 4 ALT CIRCUITS
Special Notes and Comments
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
OR 97701
ELECTRICAL ALTER
OWNER BATHROOM
79335
48 10
6/26/06
12/27/06
Charged
48 10
00
4 50
52 60
COMMENTS /ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES. WA 98362
06 00000581
512820
1501 E 4TH ST
06 30 00 5 6 0022 0000
ANN DACY
RES REMODEL
RS7 RESDNTL SINGLE FAMILY
8000
STATE SURCHARGE
Paid
Contractor
ANGELES PLUMBING
P 0 BOX 1151
PORT ANGELES
(360) 452 8525
RESIDENTIAL
REMODEL
48 10
00
4 50
52 60
Plan Check Fee
Valuation
Credited
00
00
00
00
Date 8/07/06
WA 98363
Due
4 50
00
00
00
00
00
0
Extension
48 10
w
ELECTRICAL PERMIT INSPECTION RECORD
J CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS 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 DATE ACCEPTED COMMENTS
YES 1 NO
DITCH
ROUGH -IN COVEk
SERVICE
FINAL
GENERAL COMMENTS:
fO-iO -trt6712aM
1 1
1 1 1
1 1
1 1 1
611.)! 6-4- eh
PW- 1102.314'91
Job wired by
Electrical contractor name
Purchaser's mailing address
City
Telephone number
'Premises owner's name
City
ATI N
Inspection
Date
tr- %7
Electrical Contractor g Owner
State ZIP
FAX number
License number Date Expires
/Installation description
Commercial I°I? Residential
Area, Building or Equipment Inspected
ELECTRICALWORKPER1VIITAPPLICATIOlsr r
r
New
Addition
(O? Ian,- i3,fn tm'v
kez ado voz-f
A r-sHor° /Zc .vl1't$
Address of inspection
`7 ,(cs A 3( z
Phone number to schedule inspection.
5l 3R0 —C9 F3e.c
Owner as defined by RCW 19 28.261 (I) Owner will occupy the structure for two
years after this electrical permit is finalized. (2) Owner is required to hire an electrical
contractor if above said property is for sale, rent or lease.
After reading the above statement, I hereby certify that I am the owner of the above
named property or a licensed electrical contractor I am making the electrical instal-
lation or alteration in compliance with the electrical laws, N.E.C. RCW Chapter
19.28, WAC Chapter 296 -46B The City of Port Angeles Municipal Code, and
Utility Spec 'cations.
/Signat roof owner electrical contractor or electrical administrator Expiration Date
Date (D6 of card
Electrical Load Additions ani r subtractions
NO LOAD CHANGES
Baseboard KW Voltage
Furnace KW Overhead Service Phase 1 3
Heat Pump Ton LAR Temp Service Service Size:
Fan -Wall KW Underground Service Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7.00 AM 360- 417 -4735
ROUGH -IN THERMOSTAT SERVICE
Cash Check
Credit Card Mastercard Discover
Card
S D Appr ved By Date Appr ed By Date Appr ed By
FINAL DITCH FEEDER GiSi �(E
V/D /o
Dat r ed By Date Approved By D e Approved By
Action Taken
Inspection fee
/IT. /0
Service Information
Electrical
Inspector
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
nl EAST 5TH STREET. PORT ANGELES. WA 98J()2
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000724 Date
556652
1501 E 4TH ST
06-30-00-5-6-0022-0000-
ELECTRICAL ONLY
7/07/06
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
BASEY, ANN
1501 E 4TH ST
PORT ANGELES
(541) 390-6824
WA 983624802
ANGELES ELECTRIC
524 E. 1ST ST.
PORT ANGELES
(360) 452-9264
WA 98362
Permi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
ANGELES/ 100A PANEL GARAGE
81950
ANGELES ELECTRIC
66.90 Plan Check Fee
7/07/06 Valuation
1/03/07
.00
o
~
\)
~
Qty Unit Charge Per
1.00 66.9000 ECH EL-R OR RM 0-200 ALT SRV FDR
Extension
66.90
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 66.90 66.90 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 66.90 66.90 .00 .00
~
&
C\
~j
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
I INSPEC110N TYPE DAn ACCEPTED COMMENTS
YIS I NO
vlIet!
llnUnJ.l_IN / CUV,hK
-sERVICE
1.11\.141 I/J>-/O-Cb Ac-'D I
GENERAL COMMENTS:
PW-I 102.1' 141961
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EASTS1HSTREET, 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
06-00000581 Date
512820
1501 E 4TH ST
06-30-00-5-6-0022-0000-
ANN DACY
RES REMODEL
6/26/06
RS7 RESDNTL SINGLE FAMILY
8000
Owner
Contractor
Ann Dacy / Linda Carroll JT
115 NW Columbia St.
BEND OR 97701
ANGELES PLUMBING
P. O. BOX 1151
PORT ANGELES
(360) 452-8525
WA 98363
Permit .. . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
80812
110.00
6/26/06
12/23/06
Plan Check Fee
Valuation
.00
8000
Qty Unit Charge Per
1.00 110.0000 EA SAN SEW ADD DIR CON
Extension
110.00
Special Notes and Comments
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 110.00 110.00 .00 .00
Plan Check Total .00 .00 .00 .00.
Other Fee Total 4.50 4.50 .00 .00
Grand Total 114.50 114.50 .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
presume to give authority to violate or cancel the provisions of any state or local law regulating constructio'n or the performance of
construction. .
Signature of Contractor or Authorized Agent
Date
;J; iJtJe~
Signature of Owner (if own IS builder).
& -;,2& ~
Date
T:\Policies\1102.15R [1/05]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECfIONS. 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
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I I I
1
1 i 1
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W./ PW/ CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\II02.15R [1105]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
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;-l-hereby-certify--that-l-have-read-aACi--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 perfo ance of
construction.
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000581 Date
512820
1501 E 4TH ST
06-30-00-5-6-0022-0000-
ANN DACY
RES REMODEL
RS7 RESDNTL SINGLE FAMILY
8000
Owner
Contractor
Ann Dacy / Linda Carroll JT
115 NW Columbia St.
BEND OR 97701
ANGELES PLUMBING
P. O. BOX 1151
PORT ANGELES
(360) 452-8525
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit pin number 79269
Permit Fee 179.75 Plan Check Fee
Issue Date 6/26/06 Valuation
Expiration Date 12/23/06
Qty Unit Charge Per
BASE FEE
6.00 14.0000 THOU BL-2001-25K (14 PER K)
Permit ELECTRICAL 'ALTER RESIDENTIAL
Additional desc OWNER / BATHROOM REMODEL
Permit pin number 79335
Permit Fee 48.10 Plan Check Fee
Issue Date 6/26/06 Valuation
Expiration Date 12/23/06
Qty Unit Charge Per
1.00 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
79277
100.00
6/26/06
12/23/06 '
Plan Check Fee
Valuation
Qty Unit Charge Per
BASE FEE
3.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE
1. 00 15.0000 ECH PL- EA. BLDG SEWER
1. 00 7.0000 ECH PL- EA.WATER HEATER
Special Notes and Comments
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Other Fees
STATE SURCHARGE
Signature of Contractor or Authorized Agent
Date
T:\Policies\1102_15 building pennil inspection record05.wpd [1/4/2005]
6/26/06
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WA 98363
71.90
8000
Extension
95.75
84.00
./
.00
o
Extension
48.10
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Extension
50.00
21.00
7.00
15.00
7.00
4.50
!h LJa
u cJ. (,
Signature of Owner (if owner builder)
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
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 I 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 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
P ARKlNG/LIGHTlNG 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.I 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\1102_15 building permit inspection record05.wpd [1/4/2005]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number . . . . . 06-00000581
Application pin number 512820
Page 2
Date 6/26/06
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 327.85 327.85 .00 .00
plan Check Total 71.90 71.90 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 404.25 404.25 .00 .00
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J 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.
Date
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-48 I 5 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 UNLA WFUL 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 / WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING /
UNDER FLOOR / SLAB rol;.o~ p~
ROUGH-IN ~/~O /tJL p~
WATER LINE (METER TO BLOG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALLlHOLD DOWNS ,
WALLS / ROOF / CEIUNG to tJ.--/ a? \/tv
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB ..~ -
WALL / FLOOR / CEILING IV. V/A/
.
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE FINAL If~
WOOD STOVE / PELLET / CHIMNEY DATE (:/'W 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. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 ~ / PLANNING DEPT.
BUILDING 417-4815 /7,,/1. /~ \7Jv BUILDING
T:IPolicieslll02 15 buildin nnit ins ction record05.wpd [lf4/20lli]
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BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST
COIvIPLETE to be accepteu [or revievL Ifyoli have any questions, c~11
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: AN N b IrCf Phone:
Owner: A-r-r N bTtc --r Phone:
Address: ISO I E 4- ~ &T City: (oLe r'JY[(~L(>J
Architect/Engineer: N fA Phone:
1M tJlj....6 5
Contractor $LL.~ t1/JJA/UbJP(r State License #: Exp:
I .
5L/ 1- 3qo~ &9;)..'/
Zip: 983ft Z.
Phone:
Address:
City:
Zip:
PROJECT ADDRESS: /50 ( E_ ..;.. {.4 &-:r ZONING: t:-S-- (
LEGAL DESCRIPTION: Lot: foBLe. Block: ~( 5. Subdivision: 7'{fuwvt:s W
CLALLAM COUNTY PARCEL NUMBER: n(,,30 (')()S-& co22- 0000
TYPE OF WORK:
__ Residential 0 New Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial '5!J.. Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRll'TION OF THE PROJECT:
/N$..TA-LL Ibl/-r/f(rcom 1t1 m Y f'ti-~-t{J17tJ& ,ncTftCrteD
<tHItf,j~ ~ 4 -nvo W7WDO-VS
o Stove
o Garage
o Deck
o Other
SlZEN.A..LUATION: .if
70 SF. @$ wi /SF. = $ 8 <X:D E-
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION $
~
COMMERCLA.LJRESIDENTIAL: Occupancy Group:
No. of Stories: L Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load: .
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
ESA/Wetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
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 tinle of peront issuance.
EXPIRATION OF PLAN REVIEW: lino 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 Bui1ding/Residential Code, 2003). No application can be extended mOTe 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 n is my responsibtmy to deten:::.:;;; are required ,not the City., and that ~ust obtain such permns priorlo work.
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CITY OF PORT ANGELES - Construction f'lans
Tpp Issuance of this permit based upon these plans, spedfi-
r?\ions and other data shall not prevent the building official
from thereafter requiring the correctioll of errors in said
o!? os, specifications and other data, or from preventing
builrling operations being carried on thereunder when in
"inl~tlon of all codes and ordinances of this jurisdiction.
~ IU" ",OJ\C) _ dllllulIlI l3ullClilll', eude:r ~ 00 3. ~ L.
Approval Date ~BY 21LL
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City of Port Angeles
Applicant Project Review Sheet
Applicant:
Owner:
AN"I DIK--(
A-N N i) Ifci
Property Address:
Proposed Use:
Zoning: ~ -7
I~OI €- '-If-<- ST
Is the proposed use listed as a "permitted use" or an "accessory use" in this zone?
Is this the only use (business, residence, etc.) on this site?
Has there ever been a subdivision, shortplat, or PRD approved for this site, or has one been
submitted and is pending approval?
Does the proposed use require a new buisiness license?
Does the project extend into any required setbacks or cross any lot lines (interior or
exterior)?
Does the project exceed the permitted height allowance or cause the property to exceed
the allowed lot coverage in this zone?
Does the project require any additional parking or special design/landscape
improvements in this zone?
Does the project eliminate any existing parking spaces?
Is the project located within 200' of the shoreline?
Are there any environmentally sensitive areas on or within 200' of the property, including:
. wetlands or areas of standing water (year round or seasonal);
. streams (year round or seasonal);
. areas with a slope of 40% or greater; or
. areas that have evidence of past ground movement or erosion?
Have all the required submittals been provided by the applicant?
o Site Plan 0 Construction Drawings
o ParkinglDrainage Plan 0 Civil Drawings
o Energy Calc 0 Supporting Engr. Calc
o Landscape/Lighting Plan 0 Other
J&fyes: ok
~'yes: ok
Dyes: requires PD
D yes: requires CC
review
D yes: requires PD
review
D yes: requires PD
review
D yes: requires PD
review
D yes: requires PD
review
D yes: requires PD
reVIew
D yes: requires PD
reVIew
Dno: requires PD
reVIew
Dno: requires PD
ij'no: ok
~. no: ok
I~rno: ok
tB1 no: ok
JQ no: ok
~fno: ok
cst no: ok
~ no: ok
If Planning Department review is required, the processing time may be extended. If it is determined a separate Planning Department permit(s) is
needed, the Plannin De artment ermit(s) must be a roved rior to the issuance of any other ermit.
The information provided above is true to the best of my knowledge, 1 understand that in the event that any of this information is determined by
the City to be in rect, this project will be stopped until such time the City determines the correct information is provided and any
subsequently eq ired rev' wa approvals are completed and granted. /'. ./
I a u-Lf-c:h
Date
Applicant
Permit Category #
Route to: 0 BD
Staff Initials
(see reverse side)
o CC 0 FD 0 LD
Building Permit #
o PD 0 PW 0 File
Master Tracking #
o Other
Date
Completion of this form is required for all category 1 b, 2 & 3 permits. Completion is not required for
.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
PERMIT NO. .:233"7
'7//3 a'J
/ r ,
DATE
Installed By:
50/ E
- /ecfr G
~
o READY FOR 0 WILL CALL FOR
INSPECTION INSPECTION
License Number: Phone:
Site Address:
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 ...c::::J
,$I: Service uPda~/repair
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
o Overhead
o Underground
Voltage
010 03.0'
Service size
o Temporary
Amps
Detai IslDescription:
aMi/Ill!} /n/fS f
.
Fade><- {;: ~;;; ~:r~ ;~
(del /LJ /' f1 ~-I)
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
~ Rough-in/cover O.K.
O.K. to connect service
Final O.K.
~
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
Installer: E;,€C!..r
/ b iJ I .'13" )L-;*--
&rt/ I ~-L..
New Meters
-
13//(7
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.
.rj s / ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT :3 0 ' 0 0
/ Inspe or Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYMPIC PRINTERS. INC.
1~/3
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
,S-/~
PE IT NUMBER
.
TOTAL FEE
30\~
~lJ1:'V
TIME TO COMPLETE
NO. STORIES
LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
/6 D I ~..,7' Jf1li
_ CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT
Owner ,) oc..- G ~de..-:#-: -
Owner's Address J S p ~ 'i 71 .
17.')7 - 7e>J.<?
Site Address
Day Phone Installers Phone
Applicatil;m is hereby made fo~ Permit to inst.all Electrjcal Equipment as follqws:
Ne-ul (l-eo 4-0 S' eru ......e -
.- ,. . .
PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Instailation By ~ e../8_< 'E/ Btl. -I--/'J~c.
. Installers Address ,.er ~ L; 115 r,,>r I.rr-
17 G:l -"i,.26~
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c., -& Kw /k7/
Wiring Method
.
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT PER 100A FEE USE OF CIRCUIT PER 1"00A FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT SIGN
LIGHT 50 VOLTS
OR LESS
CONVENIENCE - - MOTOR
CONVENIENCE - -- MOTOR
APPLIANCE MOTOR
DISHWASHER FIRE ALARMS
DISPOSAL BURGLAR ALARM
.. -
RANGE MISC.
OVEN
- -
WATER HEATER
LAUNDRY -.
DRYER --- REINSTALLATION LIGHT FIXTLJRE #
FURNACE .. SUB TOTAL FEE
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC BASIC FEE
ELECTRIC HEAT ... . ~O -ozr
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
..
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
-. -
SERVICE AW.G.
I SUB-TOTAL -.
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 conf with the N.E.C. Electrical Code.
D~te A~Plication made' f I ~/ f~ . ,19 By
. - ." - CONTRACTOR OR OWNER R AUTHORIZED AGENT)
Permis~ion is hereby given to do the aboy:e describ.ed 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.
Date Permit Issued 111'7 kb - ~0.NS APPROVED -. ECTOR 0: C.ITY_LI~HT , . - "
Notify Department of City Light by Street Address and Perm Number when 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 CARD. Inspector's Report
,..." vu",,, ""L~'Tt:"~ I"'"
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REPORT OF'INSPECTOR
OATEOFVISIT MADE BY REMARKS
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, O.K. FOR COVERING
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I \11~ 1VJ ^' O.K. TO CONNECT SERVICE , "
"
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j .h FINAL O.K. ,
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ELECTRICAL WORK PERMIT APPLICATION
P..kctrical C0l1tf3ctOf n:ame
licenSe number
Dale Ellpires
Installation description ~
CI Commen:ial ~sjdenti:d
o New ~cdlAddjti(Jn
DOwner
Purchaser's mailing addrc:'is
ANr.mS ElECTRIC, IrJC
City 524; EAST FIRST SUle ZIP
PORT ANqFI F~, WA ~gJ~2
Telephone number FAX number
~7J2~
81P~ ~L,
17J / t7() ~
p..m~" ~.' e "
Add(es$ or7~~
City ?/I
Phone number to !lc~cdule iU!ipection:
~Sl
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Ownltr (t$ di:.'fin('cf by RCW.J9.28.16/:(1) Owner wi/( occupy thl! structure for [wo
years afte.r Ih.i.~ electrical permit i... finalized. (2) Owner is required to hire a1l r!ledricaJ
conlrac(vr if above ,~ajt{ property is for salt'. rent or JftQSE:.
After Tetlding the above statement, L hereby ccnity that I 3m the owner of Ine above
named pl'operty or'a licemed dCL:lrical contractOr. I am making the electrical insli1l-
latiQn or a.ltcration in ~ompHancc:: wifh Ihe clectdcal laws. N.F...C., RCW, Chapter
19.28. WAC. Chuptcr:296-46B, The City of Port Angelcs Municipal Cudc. and
Urility Specifications. "
Signature or J~rr e~ cOlltnctor or elec(rical admhlislrator
X /~,. " . Date: '" "6
o Cas~ Check II
~itCard Visa Mastercard Discover
Card# ____-_~~-.Eit.JC -____".."
Expiration Date
of card
Electrical Load Additions and or s tractions
Cl Nl)-l:OAb CHANGES ~ 14
IJrllaseooard _ KW 'l5C>w,4'7T Y 'Il
CJ Fumace _ KW 1 1:1",0 /.f'NK.~ervice J.
o Heat Pump _. Ton _LAR 0 Temp Service
o Fan-Wall KW 0 Underground Service
Service Information
Vohage J~~~
Phase i:ri"CIC-W
Service Si,e: ~
Feeder Size; .
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROllGH-1N THERMOSTAT
/iP-/P-P./.
n.lltc
SERVICE
~
^Vl'fovcd By
O;al~
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