HomeMy WebLinkAbout1815 W 12th St - BuildingPREPARED 11/20/06 9 02 52 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 11/20/06
ADDRESS 1815 W 12TH ST SUBDIV
TENANT NBR STEVE SCOTT
CONTRACTOR ANGELES PLUMBING PHONE (360) 452 8525
OWNER SCOTT STEVEN MARIE PHONE
PARCEL 06 30 00 0 3 6173 0000
APPL NUMBER 06 00001231 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01 11/20/06 JLL
MECHANICAL GAS LINE TIME 13 00
MARK 477 0626
11/17/2006 09 40 AM DYASUMUR
COMMENTS AND NOTES
Subdivision Name
Property Use
Property Zoning
Application valuation
T \Policies \I IO2_I5 building permit inspection record05.wpd [1/4 /2005]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 06 00001231
Application pin number 553220
Property Address 1815 W 12TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 3 6173 0000
Tenant nbr name STEVE SCOTT
Application type description MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
400
Owner Contractor
SCOTT STEVEN MARIE ANGELES PLUMBING
92 6020 KALEMAKAPALI ST P 0 BOX 1151
KAPOLEI HI 96707 PORT ANGELES'
(360) 452 8525
Fee summary Charged Paid Credited Due
Date 11/15/06
WA 98363
Permit MECHANICAL PERMIT
Additional desc
Permit pin number 90563
Permit Fee 60 65 Plan Check Fee 00
Issue Date 11/15/06 Valuation 0
Expiration Date 5/14/07
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 10 6500 ECH ME -GAS PIPE 1 TO 5 10 65
Permit Fee Total 60 65 60 65 00 00
Plan Check Total 00 00 00 00
Grand Total 60 65 60 65 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 construction or the performance of
construction.
4567_,
Signature of Contractor or Aiithoe�zed Agent Date Signature of Owner (if owner is builder) Date
I MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
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 WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
I POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
SHOWER PAN
MEDICAL GAS LINE
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE /PELLET /CHIMNEY
COMMERCIAL HOOD DUCTS
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
I PLANNING DEPT 417 -4750 I
I BUILDING 417 -4815 I
T Policies \I 102_I5 building permit inspection record05 wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
I
0/74 I (w
1
FINAL
FINAL
SEPA.
ESA.
SHORELINE.
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
I PLANNING DEPT
BUILDING
DATE ACCEPTED BY,
DATE ACCEPTED BY,
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
I I I
I I I
I I I
Fill out COMPLETELY and in INK. You application and site plan 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: Alkier(44 l YV M 'vim Le
Owner
/6 J
Address: City
Architect/Engineer
Contractor State License
Address: VI, City
ty�
PROJECT ADDRESS t 019 II 2.,* Ci�'
LEGAL DESCRIPTION Lot: Block:
CLALLAM COUNTY PARCEL NUMBER.
TYPE OF WORK.
Residential New Constr
Multi- family Addition
Commercial Remodel
Repair Sign
BRIEF DESCRIPTION OF THE PROJECT
RC jr\ dAS U �1
Re -roof Stove
Move Garage
Demolition Deck
Other
COMMERCIAL/RESIDENTIAL Occupancy Group
No. of Stories: Lot Size: Existing Sq. Ft.
OA
AT•\FORMS\B1dgPennitform.wpd Applicant:
BUILDING PERMIT APPLICATION
Total lot coverage
PLANNING USE ONLY
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
Phone.
Subdivision.
Phone:
Exp
SIZE/VALUATION
SF /SF
SF /SF
SF /SF
TOTAL VALUATION
Zip
Phone:
Zip
ZONING
ocd—
Occupant Load. Construction Type:
Proposed Sq Ft. TOTAL Sq Ft.
C. Date: //XS
FOR OFF1 QNLy
Date Rec. 1
Permit Z
Date Approved. .6
Date Issued: 1 4
Phone: b '4 "O 29
APPROVALS.
PLAN
BLDG
DPWU
FIRE.
OTHER.
VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE. IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the apphcant up to 180 days upon written request by the applicant (see Section
R105.3.2 of the International Building/Residential Code, 2003) No application can be extended more than once.
I hereby certify that 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.
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CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number'-
Property A~dress
ASSESSOR PARCEL NUMBER:
Application\description
Subdivision'Name
Property Use
Property zoning . . .
Application valuation
04-00000374 Date
.131778
1815 W 12TH ST
06-30-00-0-3-6165-0000-
RES NEW SFR
5/19/04
RS7 RESDNTL SINGLE FAMILY
89795
Owner
Contractor
RYKER CONST & ENGINEERING
3558 DEER PARK RD.
PORT ANGELES
(360) 417-6619
Structure Information
Construction Type
Occupancy Type
Other struct info
OWNER
WA 98362
NEW 1510SF SFR WITH 953SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
22.30
V-N
2.00
1. 00
7000.00
1561.50
1561.50
1. 00
~,
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-----------------------------------------------------------------------------
Permit MECHANICAL PERMIT
Additional desc
Permit Fee 86.65 plan Check Fee .00
Issue Date 5/19/04 Valuation 0
Expiration Date 11/15/04
Qty Unit Charge Per Extension
BASE FEE 47.00
4.00 7.2500 ECH ME-VENT FAN 29.00
1. 00 10.6500 ECH ME-GAS PIPE 1 TO 5 10.65
;s.
?
---..
----------------------------------------------------------------------------
Permit PLUMBING PERMIT cy
Additional desc
Permit Fee 139.00 Plan Check Fee .00
Issue Date 5/19/04 Valuation ~
0 ~
Expiration Date 11/15/04
Qty Unit Charge Per Extension
BASE FEE 47.00
9.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 63.00
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00
1. 00 15.0000 ECH PL- EA. BLDG SEWER 15.00
1. 00 7.0000 ECH PL- EA.WATER HEATER 7.00
----------------------------------------------------------------------------
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit Fee 947.25 Plan Check Fee 378.90
Issue Date 5/19/04 Valuation 89795
Expiration Date 11/15/04
Qty Unit Charge Per Extension
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 b, n reques ithin 180 days from the last
inspection. I hereby certify that I have read and examined this application and know thesa e to brand correct. All provisions of
laws and ordinances governing this type of work will be complied with whether ,specified her n or n he granting of a permit does not
presume to give authority to violate or cancel the provisions of any state 'local laW r gu i onstruction or the performance of
construction. '
+
Signature of Contractor or Authorized Agent
Date
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF 1 CEILING
DRYW ALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR 1 CEILING
MECHANICAL
HEA T PUMP
GAS LINE
WOOD STOVE / PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEP ARA TE PERMIT #' s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
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
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ 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:\PLANNING\FORMS\ 1102.15 [] 1/1412003]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number . . . .
04-00000374
.131778
Page
Date
2
5/19/04
----------------------------------------------------------------------------
40.00
BASE FEE
7.0000 THOU BL-50,001-100K (7.00 PER K)
Extension
667.25
280.00
Qty
unit Charge Per
special Notes and Comments
proposal is to construct a 1562 sq. ft. s.f. residence in the
RS-7 for a total lot coverage of 22.3%.
Building address sign shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color they are mounted on. (Ord. 14.36.050-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
Electrical load calculations and elctrical permits are
required.
----------------------------------------------------------------------------
Other Fees
. . . . . . . . .
CITY ORA %
DRA FEES PLUS INTEREST
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
54.88
1575.86
745.00
4.50
1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 1172.90 1172.90 .00 .00
plan Check Total 378.90 378.90 .00 .00
Other Fee Total 3405.24 3405.24 .00 .00
Grand Total 4957.04 4957.04 .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 construction or the performance of
construction.
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\PLANNING\FORMS\1102.15 [11114/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 4]7-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVID'E 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 h.,:)6- - n;./ Rl/
WALLS -r -{, -O~ " .L
~
FOUNDA TION DRAINAGE/DOWN SPOUTS .f; -It -e'l L
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN J I
PLUMBING fii'tc.-/I//'-2-for JJ.J.- M
UNDER FLOOR 1 SLAB
ROUGH-IN II' '--}oj .L 1..
I U"'f. J.
WATER LINE (METER TO BLDG) 'J-J-oJ-j - \ L-L
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS 1<7 -'1J -<,"01-/ ,J~
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS rJ. 'J -01-1 ,b-I.--
WALLS / ROOF 1 CEILING _" i\ ..I.,.."J -L J--L.
(T;or V"'
DR YW ALL (INTERJOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR / CEILING cr -14' A')!oJ J '--\ J
MECHANICAL , +;1-10..1 If !J.-'7.! or J J-t- f}p
HEA T PUMP
GAS LINE ~(h'-Orl 1>..),1
WOOD STOVE / PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
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
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W. / PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
,
BUILDING 417-4815 t.} /~/ 0 r j j-J- BUILDING
..
T:\PLANNING\FORMS\ 1102.15 [11114/2003]
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BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN T
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF 1 CEILING
DRYWALL (INTERJOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR / CEILING I I
MECHANICAL
HEA T PUMP
GAS LINE
WOOD STOVE / PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKING/LlGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W. / 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:\PLANNING\FORMS\1102.I5 [11/14/2003]
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec. '1-27 -'04
Porn," # Ci-j ~ f
Date Approved: ~
Date ]ssued:
Fill out COMPLETELY and in INK. Your application and site plan MUS
COMPLETE to be accepted for review. If you have any questions, c I
PERNIITS (360) 417-4815 FAX(360)417-4711
Appl1cant or Agent: ;J;/2.k;(1/ J:::eL
Owner: ~ ~.
Address: ~t,s-r~] i~-At..' ~/?jC-_g City:
Architect/Engineer: ;;;~, 4 A:::::..6R_
Contractor ~~~ ,c: State License #:
r...s-/fiy7 /!E
PROJECT ADDRESS: I <6 \ ~
LEGAL DESCRIPTION: Lot: /1 Block:
, ,
CLALLAM COUNTY PARCEL NUMBER: Db.'?, 6OC~ .? b ( bS~
#7--~6/9
r ,
Phone: tk4-':;~..?<'3/2- '92 7)
~r #Y6r-LEI Zip: c/'?Sj{; ?-
, ,
S'~6
Phone:
Phone:
Phone:
Address:
City:
Subdivision:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA MC #
T}pEOFWORK: SIZ~ALUATION:
~ Residential Ji.New Constr. 0 Re-roof 0 Stove ~ SF. @$ 0:)0 /SF. = $
o Multi-family 0 Addition 0 Move 0 Garage ~ SF. @$ /~ /SF. = $
o Commercial 0 Remodel 0 Demolition 0 Deck SF. @ $ /SF. = $
o Repair 0 Sign 0 Other TqTAL Y-4LUATION $
BRIEF DESCRIPTION OF THE PROJECT: ....6/'"/60;::. (~r' I ~/ner/(~
~- f(? - p
) bl'Js~,,,,-) ~4;-<4.5e qq/ Pc:.~cta ~%
COMMERCIALIRESIDENTIAL: Occupancy Group: J?S - 7 Occupant Load: Construction Type: /k ~
No. of Stories: ~ Lot Size: <50 X/t/o Existing Sq. Ft.. / _ & Proposed Sq. Ft. i 5'{'L-$ = TOTAL Sq. Ft.) 5"6. r I~
.L -:J . f..,l. Total lot coverage_'Z.~ %
T I'I!7Y;-';L v.JM / ,
APPRO V ALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
City:
Exp. Date:
:?t5'a> .--=.-
:. ~~:s
----
,q~ ~1S:-
,
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BillLDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
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 pennit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no pemut is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the tinle for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
T:\FORMS\APPS\Bui ldingpermit. wpd
Applicant:
Date:
I hereby certify that I have read and examined this application and know the same to ru and c rrect. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are require{ ,not th eit , nd t I must obtain such permits prior to work.
EJ1r.-~~~~------t)~"~--~'~~~SL1EJJEC:"______~~~::__~~~!~~_____________________
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number . . . .
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000374 Date
.131778
1815 W 12TH ST
06-30-00-0-3-6165-0000_
RES NEW SFR
Owner
------------------------
RYKER CONST & ENGINEERING
3558 DEER PARK RD.
PORT ANGELES
(360) 417-6619
Structure Information
Construction Type
Occupancy Type
Other struct info
WA 98362
Permi t
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
2463 SQ FT SFR./ ELECT. SER.
ELECTRIC SERVICE
143.20 Plan Check Fee
9/15/04 Valuation
3/15/05
Qty
1. 00
3.00
Unit Charge Per
73.0000 ECH
23.4000 5C
RS7 RESDNTL SINGLE FAMILY
89795
Contractor
9/15/04
------------------------
OWNER
NEW 1510SF SFR WITH 953SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
-----------------------------------------------------------
EL-R-SQFT FIRST 1300
EL-R-SQFT ADDITIONAL 500
----~-----------------------------------------------------------------------
Special Notes and Comments
Proposal is to construct a 1562 sq. ft. s.f. residence in the
RS-7 for a total lot coverage of 22.3%.
Building address sign shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color they are mounted on. (Ord. 14.36.050-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
Electrical load calculations and elctrical permits are
required.
Other Fees
. . . . . . . . .
-----------------------------------------------
-----------------------------
Fee summary Charged
----------------- ----------
Permit Fee Total 143.20
CITY DRA %
ORA FEES PLUS INTEREST
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
Paid Credited
---------- ----------
143.20 .00
22.30
V-N
2.00
1. 00
7000.00
1561.50
1561.50
1. 00
-.
~. ~
\"\ -
~ V'1
~ L
.00
o
1'1
-
Extension
73.00
70.20
t f'.j
.l>
r \):.
-----------------
(J,
~\
54.88
1575.86
745.00
4.50
1025.00
Due
.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
T:\PLANNINGIFORMS\1102.15 [11/14/2003]
Signature of Owner (if owner is builder)
Date
-.
BillLDING PERMIT INSPECTION RECORD
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
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAlNAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPn SEPARATE PERMIT: #
ROUGH-IN T
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING T
FRAMING
JOISTS / GIRDERS
SHEAR W ALLIHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYW ALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R. W. 1 PWI CONSTRUCTION - R. W.
ENGINEERJNG 417-4807 PW 1 ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\1102.15 (11/14/2003]
:ft>ORT~
$~O~~~
,.
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~
'tiii:~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Pin number
Plan Check Total
Other Fee Total
Grand Total
04-00000374
.131778
.00
3405.24
3548.44
Page
Date
2
9/15/04
.00
3405.24
3548.44
.00
.00
.00
.00
.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 construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNINGIFORMS\I 102.15 [I 1/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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.
I INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # C!--tJ.,V '(- y~ .
ck. <') .
ROUGH-IN q~-nt./ ..()(. 1 K ~t./t,)
.,
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLiHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYW ALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
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
ELECTRJCAL - LIGHT DEPT. 417-4735 tj /z-' l!c j' ItcO ELECTRJCAL
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 BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003]
rJ:t>ORT~
t~'(<;.
na
ilk --
'tiii:C~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
property Use
property Zoning . . .
Application valuation
04-00000374 Date
.131778
1815 W 12TH ST
06_30_00_0_3_6165_0000-
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
89795
Owner
Contractor
------------------------
------------------------
RYKER CONST & ENGINEERING
3558 DEER PARK RD.
PORT ANGELES
(360) 417-6619
Structure Information
construction Type
Occupancy Type
Other struct info
OWNER
WA 98362
NEW 1510SF SFR WITH 953SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
6/11/04
22.30
"'"
\J3
""'-
~. '\
~t
V-N
2.00
1. 00
7000.00
1561.50
1561.50
1. 00
----------------------------------------------------------------------------
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL TEMPORARY SERVICE
60 A TEMP SERVICE MAX.
ELECTRIC SERVICE
40.90 Plan Check Fee
6/11/04 Valuation
12/08/04
Qty . unit Charge Per
1.00 40.9000 ECH EL-TEMP SRV - 0-60 SRV FOR
.00
o
"
~ ~~
~'"
'\
----------------------------------------------------------------------------
Extension
40.90
Special Notes and Comments
proposal is to construct a 1562 sq. ft. s.f. residence in the
RS-7 for a total lot coverage of 22.3%.
Building address sign shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color th~y are mounted on. (Ord. 14.36.050-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
Electrical load calculations and elctrical permits are
required.
Other Fees
----------------------------------------------------------------------------
CITY DRA %
DRA FEES PLUS INTEREST
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
54.88
1575.86
745.00
4.50
1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40.90 40.90 .00 .00
plan Check Total .00 .00 .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 corr~ct. 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:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR/ SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF / CEILING
DRYW ALL (INTERJOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I I I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
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 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W. / 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:IPLANNING\FORMSII102.15 [11/14/2003]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Other Fee Total
Grand Total
04-00000374
. .131778
3405.24 3405.24
3446.14 3446.14
Page 2
Date 6/11/04
.00 .00
.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 construction or Ithe performance of
construction. \
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BillLDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 A T JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TlON DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
'w A TER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING :
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DR YW ALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I
MECHANICAL
HEA T PUMP
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
hi I I ~/) ELECTRJCAL
ELECTRJCAL - LIGHT DEPT. 417-4735 ill/(,cJ
LIGHT DEPT
CONSTRUCTION R.W. / PW/ / I CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:IPLANNING\FORMSIII02.15 [11/14/2003]
,.
FROM :
FAX NO.
Jun. 09 2004 11:29AM Pi
.
ELECTRICAL PERMIT APPLICATION
POR. OflllLUU_ usa ON~ y
[);>>~: ..-
Pc."",,, _.__"__
OllIe ApprgVlld:
bilC~l.Ie'tl.
TM Electrical Permit Application must be filled OLJt coftlDletelv.
Of- 37'1
Ple.1lI type or reprint in ink. If you have any qLlesnons, please call (360) 41t-473S
Fax numbor: (360) 417-4711
::'':':'"'-1J;i.. - ~ll.~ J '" - ,- ;;~::: '<!' 'l-~'I
Address: lJ~I':> c...V I -- City: ~ ~ Zip: qn,,~
Electrical contraclor~rl~ WVIQ. \1"-<_ , ' Llcenoe#: ~~f~2""""P: q 1''1/0'5 Phone: ~~'2.- t.tH~
Address: 8'2- Dr-u.p..t..... Va Lt." ~,CIIYyl\~+ A:-njl\~ WA- Zip: q Ii"] (,,"'1 .
INSTALLATION WIRED BY:
L:J OWNER
W E~EC1"RICAL CONTRACTOR
Billing Address:
CredIt Card Number:
Ollt
f1~
Credit Card Holder Name:
Exp. Oat8:
Zip:
V/SA:_ Me:
~&)
w
12..)- Vj
"ROJECT IdlDRESS:
TYPE OF WORK:
Check 1!\! thai apply: 0 New
o A1leration/Addltion
o Residential 0 Multi-family
o Commercial D Mobile Home
Sq. FI
[J Remote Meier 0 Delach..d garage 0 HOI Tub 0 Swim Pool 0 Septic Pump
o LOW Voltage 0 Telecom, 0 Sign
Number of Circuli. added or altered:
DESCRIPTION OF THE ELECTRIC,D.L PROJECT: +- -e. rn -rm rc,.:rf _~ (l r A..J '
ft; 0 . Ci ''^''''p
Electrical Heat Load Additions and Dr Subtractions
Service Information
o Ba...board
CJ Furnace
o Heat Pump
C1 Fer>-Waf!
_KW
KW
TON LRA
_KW-
o Overhead S"Mce
Cl Temp Seorvice
o Underground Ssrvice
Voltage:
Phase: 0 1 CJ 3
Service Size:
Fe..der Size;
J hereby certify that I have read and examined this application and know thai same to be true and correct, and I am
authorized to apply for this permit, I understand it is not the City's legal responsibility to determine what permits
are required, it remains the applicants responsibility to determine what permits are required and to obtain such.
&, ":IV . "'"'" "'" H.Id.... S'M,"~'~ 'tl ~ ....,
lb*" ~ J Ow'''''''~ C." "S"'"~'~ ----I D.t"
, ~ (]Ife::n6 (::> f) /JJoE.f- PERMIT FEE: $ ~. 9 D
?:IHECTRICAlPERMITAPPLlCATION _ L KP,Nl f)
" . , :::;1::.676 --(0 (iJ'5Tt- v,,~
iltC t f; ~ y -fO? -ti1G ? GQ2vP )wcJ~rS2 u.J5f17?4
FROM
FRX NO.
Sep. 14 2004 06:50RM P1
ti
.. ... ~
~. "A.
. ~\
~
ELECTRICAL PERMIT APPLICATION
FUR OF'PIC1AL llSB ONL V
l)OUo:lll": ______
f'1II'OI1I1'-_~_
O;a~A.flotI'O""" _
CAle h~llftl:__._.~_.___
nll~ EJec:triear Permit Application must bo fllte-d out comDletl!!ll.....
CJ<( -37r'
Pl.... ty~ or r.print in ink. Iryou hove any questiom;, please 08111360)417-4735
Fl. numb.r: (360) 417-4711
Own.r or Eloe. contra~r Ag.nt:--rr....
Proportyown.r: ~\(..\L ~ ~
Add",." 19\)' W \~ City: .,.
Eloclrteal Conlracw:~ 'c [<i'll" '/\'o.- j t""J Ueonse#: 1~~1Y\'I E",,:
Addre$S: ~ '1 D.~.u- 'if 4 ll-J raJ Ciri P e>rT A n a,t.l.ts
INSTAl.LAT:ON WIRE[) BY: n OWNER' J<EL.ECTRICAL CONTRACTOR
-b=:t Lv
c... Phone:
'1 '5 'J. -(, 't'2'/Fax: '1 '5 '::i.. - (p 'i '2 'i
Phone: c.i77-oq~-,
Zip: '11'3 I. "2-
os- Phone:""I'5':1~ 17'1:1..<1-
Zip: lJg3 "2 .
C2
-T.
\
Credit Card Holder Name:
v.
....
BIlling Address:
Zip:
V/SA:_ Me:
.-{
Credit Card Number;
Exp. Date:
PRO,jEeT ADDRESS:
l Bl') W \ 2..-- -L..... _
Check ell that apply: ~ (] Alteration/Addition
o Multi-family
o Commercial 0 Mobile Home
Sq. Ft
/::)/0 ~ r5.3
,iho ~1 C--eJit':i)
o Low Vollage 0 Telecom. 0 Sign
::J Remote Meter 0 Detached garege [1 Hot Tub 0 Swim Pool 0 Septic Pump
Number of Circuits added or altered: __~__
1\~
k
~- J)
o
~
DESCRIPTION OF THE EI.ECTRlCAI. PROJECT:
Electrical Heel Load Additions and or Subtractions
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
_KW
KW
TON lRA
KW-'
o Overhead Service
o Temp Service
:J Underground Service
Servlce'n'ormatlon
Voltage: 10/11.-'-b
Phase: D1 i:l 3
ServICe 51%.: ',,!.o/::'-,
Feeder Size: -r:r/o
t:.~l;-rI0h
['6 Dr-
....--
I hereby certify that I have read and examined this application and know that same to be true and correct, and I am '
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permjts
aTe required; it remains the applicants responsibility to determine what permits are required and to obtain such,
fr!~ oatg:~/13
_ I. Date: 4/~
i f'['v\IZ-,
Credit Card Holder's Signature:
j
,;
,
I
.1
,
Ownor or Elee. Cant. Signature:
/!v:J
1/t5/0 Y
PERMIT FEE: $ /i/5,,;2.()
~:IELECTRICALPERMIT APPLICATION
r/ttJ
9ft'! ~V
@
i
J ~ I
ELECTRICAL INSPECTION
WIRING REPORT I
417-4735
I
I
ADDRESS I
'IS ~ /.2 75 s;r
AP~~6 L~CI'tL P~""'/7'''''' NOT ~PPROVED
o .................... DITCH. . . . . . . . . . . . . . . . '1" . 0
D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0
D. .. . . . .. . . . . . . .. . . . . SERVICE. . . . . . .. . . ... . . . . . . 0
D. ... . . .. . . . . . . .. . . .. . FINAL. . . .. . . .. . . .. . . . !. . .)1('
([) I
CORRECTIONS NEEDED: /-/~,O~ 6/'-v~~
I
5,,-~-<,,"''''.I' I
r'/RAL ~..-. e.uJ.
I
~/) {iJ
I
//"'~'-"'~G r:'~vtt!-L- I
(~ .../N'4"~ ~?ny~) I
-r/7 ~--I73~ I
@ 2 - b~~ ~ -. ./11'07 ...11"",... l>.N
/'Aw.,u. ..5cH1WJLI.~L A:K.~ ~t//'fr. J..,~_J""
v;,;, . ,. . ..' , I
~/f:>"/T5 .... ,PL._~5 ..t._J'r.t!.~';.;'1 ON: Ja.~,,,,,,Z
/"'lfr n--~p.71C-a ,q €... ,." (1~ ,o;.$c.<U}=> 77 "E
NOTIFY INSPECTOR WHEN CORRECTIONS -
ARE COMPLETED WITHIN 15 DAYS
PERMIT #
O.t./~3'l
~/&-tc:
s
7ZJ
-'n J'9 7'ek"
~/"hu.L; .
f'V
O~T.S"_,CJ-e..
"77 L.p
7Z>
SI'M o~
LJ~~__-n~_ c;:
/'CSf
~"r,/fZ~
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360) 452-1381
Application Number . . . . . 24-00000826 Date 8/16/24
Application pin number . . . 002292
Property Address . . . . . . 1815 W 12TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-3-6173-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Heat pump system
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
SCOTT, STEVEN / MARIE BLACK DIAMOND ELECTRICAL CONTR
92-6020 KALEMAKAPALI ST. 502 BLACK DIAMOND RD
KAPOLEI HI 96707 PORT ANGELES WA 98363
(360) 565-1035
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 95.10 Plan Check Fee . . .00
Issue Date . . . . 8/16/24 Valuation . . . . 0
Expiration Date . . 2/12/25
Qty Unit Charge Per Extension
1.00 95.1000 ECH EL-R- BRANCH CIR 1-4 95.10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95.10 95.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 95.10 95.10 .00 .00
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 | www.cityofpa.us | electricalpermits@cityofpa.us
EL1-2 SF 1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Project Address:
Project Description: □Single-Family Residential □ Duplex / ARU Building Square footage:
OWNER INFORMATION
Name: Email:
Mailing Address: Phone:
ELECTRICAL CONTRACTOR INFORMATION
Name: License:
Mailing Address: Expiration Date:
Email: Phone:
PROJECT DETAILS
Unit Charge Quantity Total (Quantity x Unit Charge)
$190.20 $
$190.20 $
$285.30 $
$380.40 $
$475.50 $
$5.30 $
$95.10 $
$47.55 $
$95.10 $
$95.10 $
$190.20 $
$285.30 $
$380.40 $
$95.10 $
$95.10 $
$190.20 $
$190.20 $
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 Circuit
Branch Circuits 1-4
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
Signal Circuit/Limited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5.30 for each additional)$95.10 $
First 1300 Square Feet $190.20 $
Each Additional 500 square feet``$47.55 $
Each Outbuilding / Detached Garage $95.10 $
Each Swimming Pool / Hot Tub $190.20 $
TOTAL $
Owner as defined by RCW.19.28.261: (1) 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. 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 contractor. I
am making the electrical installation 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 Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (□Owner □Electrical Contractor / Administrator)
Pe
r
m
i
t
#
:
New
Construction
Only
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711]
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN / COVER
SERVICE
FINAL
CORRECTIONS NEEDED:
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
9/3/2024 24-826 TMC
OWNER
Contractor
Black Diamond Electric
ADDRESS
1815 W 12th St