HomeMy WebLinkAbout216 W 4th St - BuildingELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 09 00001228 Date 11/25/09
Application pin number 993164
Property Address 216 W 4TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 8708 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RESIDENTIAL HIGH DENSITY
Application valuation 0
Application desc
Detached garage
Owner Contractor
Feller Rob OWNER
216 w 4th st
PORT ANGELES WA 98362
Permit
ELECTRICAL
ALTER RESIDENTIAL
RESULTS
Additional desc
DITCH
Permit pin number
157206
SERVICE
Permit Fee
115 00
Plan Check Fee
00
Issue Date
11/25/09
Valuation
0
Expiration Date
5/24/10
AE
Qty Unit Charge
Per
Extension
1 00 57
5000 ECH EL BRANCH
CIRCUIT WO/FEEDER
57 50
1 00 57
5000 ECH EL R
OUTBD/DTCH GAR IN/SEP
57 50
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
115 00
115 00 00
00
Plan Check Total
00
00 00
00
Grand Total
115 00
115 00 00
00
INSPECTION TYPE
DATE
RESULTS
INSPECTOR.
DITCH
SERVICE
ROUGH IN
FINAL
AE
COMMENTS
Signatuue of owner or Electrical Contractor X Date
s
I"
City of Port Angeles Permit Application
Building Division/Electrical Inspections
321 East Fifth Street - P.O. Box 1150
Port Angeles Washington, 98362
Ph (360) 417-4733 Fax: (360) 417.4711
Date. , _zM _0�
V 1 & 2 Single Family Dwelling
_ Mtilti-Family or Commercial*
Commercial Addition 1 Alteration / Remodel / Repair*
* Plan Review May Be Required, Please Complete Electrical
Job Address: Z/� &e,s -f 4�1 fr1
Building Square Footage. ^-' YO S !&'
NOV 25- 2009
ELECTRICAL
INSPECTIONS
Review nformation Sheet
o r � i... le S
Description of above &A Z/
J
Owner er Information o` ADA
Mailing Address: -36; -c
City- pA State. L-tl,4 Zip V?G 2 -
Phone.
Phone. 36o-917-v46C Fax: 6e/l SGS -1022
License # / Exp 1®23
Contractor mation
Nao�l�
ailing Address.
City State Zip'
Phone Fax:
License # / Exp.
Unit Charge
Total (Qty Multiplied by Unit Charge)
$ 93.75 _
$
Service/Feeder 200 Amp.
$113.75
$
Service/Feeder 201-400 Amp.
$160.00
$
Service/Feeder 401-600 Amp.
$205.00
$
ServicelFeeder 601 1000 Amp.
$291.25
$
ServicelFeeder over 1000 Amp.
$ 2.00$
—�
Branch Circuit W/ Service Feeder
$ 57.50
$�—
Branch Circuit W/O Service Feeder
$ 2.00
$
Each Additional Branch Circuit
$ 72.50
$
Temp. Service/ Feeder 200 Amp.
$ 86.25
$
Temp. Service/Feeder 201-400 Amp,
$116.25
$
Temp. Service/Feeder 401-600 Amp.
$131.25
$
Temp. Service/Feeder 60.1 1000 Amp.
$ 75.00
$
Portal to Portal Hourly
$ 69.00
$
Sign/Outline Lighting
$. 7.5.00
$
Signal Circuit/ Limited Energy Commercial
$ 50.00
$
Signal Circuit/ Limited Energy 1 & 2 Family Dwelling
$ 50.00
$
Signal Circuit/ Limited Energy Multi -Family Dwelling
$ 93.75
$
Manufactured Home Connection
$ 80.00
$
Renewable Electrical Energy 5KVA System or Less
$ 86.25
$
First 1300 Square Ft.
$ 27.50
$
Each Additional 500 Square Ft. or Portion of
$ 57.50
$ -S77SO
Each Outbuilding or Detached Garage
$ 86.25
$
Each Swimming Pool or Hot Tub
$ 43.75
$
Thermostat
$
Total
1' 1J 00
04 p 7" AA,
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.
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.
PREPARED 1/22/09 8 32 46 INSPECTION TICKET
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY
ADDRESS 216 W 4TH ST SUBDIV
TENANT NBR ROB FELLER
CONTRACTOR BRYAN ANDERSON CONCRETE CONST PHONE (360) 452 3527
OWNER ROBERT JR / ADAR FELLER PHONE (360) 417 0666
PARCEL 06 30 00 0 0 8708 0000
APPL NUMBER 08 00001457 RES REPAIR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL1 01 12/12/08 JLL BLDG FOUNDATION FOOTING TIME 09 00
12/12/08 AP December 12 2008 8 31 21 AM 1pangrle
BRYAN 460 0053 OR 452 3527
FOOTING
MORNING
December 12 2008 3 31 14 PM jlierly
BL2 01 1/06/09 JLL BLDG FOUNDATION STEM WALL
1/09/09 AP January 6 2009 9 54 19 AM 1pangrle
BRIAN 452 3527
STEMWALL
January 9 2009 4 26 34 PM jlierly
PAGE 5
DATE 1/22/09
BL99 01 1/22/09 JL PST"?T--TIME O1 00
January 22 2009 8 24 51 AM 1pangrle
ROB 582 7503 e
BLDG FINAL
AFTERNOON
PLEASE CALL HIM 30 -MINUTES BEFORE YOU GET THERE
COMMENTS AND NOTES
PREPARED 1/06/09 9 55 35 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 1/06/09
ADDRESS 216 W 4TH ST SUBDIV
TENANT NBR ROB FELLER
CONTRACTOR BRYAN ANDERSON CONCRETE CONST PHONE (360) 452 3527
OWNER ROBERT JR / ADAR FELLER PHONE (360) 417 0666
PARCEL 06 30 00 0 0 8708 0000
APPL NUMBER 08 00001457 RES REPAIR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL1 01 12/12/08 JLL BLDG FOUNDATION FOOTING TIME 09 00
12/12/08 AP December 12 2008 8 31 21 AM 1pangrle
BRYAN 460 0053 OR 452 3527
FOOTING
MORNING
December 12 2008 3 31 14 PM jlierly
BL2 01 1/06/09L d BLDG FOUNDATION STEM WALL
January 6 2009 9 54 19 AM 1pangrle
BRIAN 452 3527
STEMWALL
COMMENTS AND NOTES
PREPARED 12/12/08 9 09 04 INSPECTION TICKET
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY
ADDRESS 216 W 4TH ST SUBDIV
TENANT NBR ROB FELLER
CONTRACTOR BRYAN ANDERSON CONCRETE CONST PHONE (360) 452 3527
OWNER ROBERT JR / ADAR FELLER PHONE (360) 417 0666
PARCEL 06 30 00 0 0 8708 0000
APPL NUMBER 08 00001457 RES REPAIR
PERMIT BPR 00 BUILDING PERMIT
REQUESTED INSP
TYP/SQ COMPLETED RESULT
BL1 01 12/12/08 J
RESIDENTIAL
DESCRIPTION
RESULTS/COMMENTS
BLDG FOUNDATION FOOTING TIME 09 00
December 12 2008 8 31 21 AM 1pangrle
BRYAN 460 0053 OR 452 3527
FOOTING
MORNING
COMMENTS AND NOTES
PAGE 3
DATE 12/12/08
CITY OF PORT ANGELES
1 DEPARTMENT OF COMMUNITY & ECONOMIC 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
08 00001457 Date 11/25/08
716451
216 W 4TH ST
06 30 00 0 0 8708 0000
ROB FELLER
RES REPAIR
RESIDENTIAL HIGH DENSITY
2500
Application desc
REPAIR FRONT PORCH & ADD HANDRAILS
Owner
Contractor
ROBERT JR / ADAR FELLER BRYAN ANDERSON CONCRETE CONST
216 W 4TH ST
549 S MCCRORIE
PORT ANGELES
WA 98362 PORT ANGELES
WA 98362
(360) 417 0666
(360) 452 3527
Permit
BUILDING PERMIT RESIDENTIAL
Additional desc
REPAIR PORCH/ADD HANDRAILS
Permit pin number
138099
Permit Fee
109 75 Plan Check Fee
43 90
Issue Date
11/25/08 Valuation
2500
Expiration Date
5/24/09
Qty Unit Charge Per
Extension
BASE FEE
95 75
1 00 14
0000 THOU BL -2001 25K (14 PER K)
14 00
Special N a
omments
Call for er i
on for all ri ' stallations
Other Fees
STATE SURCHARGE
4 50
Fee summary
Charged Paid Credited
Due
Permit Fee Total
109 75 109 75 00
00
Plan Check Total
43 90 43 90 00
00
Other Fee Total
4 50 4 50 00
00
Grand Total
158 15 158 15 00
00
s Gb\,j
CP
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 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 gra/,+of a permit doe not resume to give authority to violate or cancel the provisions of any
state or local law regulating construction or the perform ce f nstru '
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:FonnsBuilding Division/Building Permit
BUILDING PERMIT INSPECTION RECORD
— PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS --
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type
Date
Accepted By
Comments
FOUNDATION
Electrical 417-4735
Footings ?_ e'Z
Stemwall l _
Foundation Drainage / Downspouts
Piers
Post Holes (Pole Bldgs )
PLUMBING
FINAL Date Accepted b
Under Floor / Slab
Rough -in
Water Line (Meter to Bldg)
Gas Line
Back Flow / Water
AIR SEAL.
Walls
Ceiling
FRAMING
Joists / GirdersUnder Floor
Shear Wall / Hold owns
Walls / Roof / Ceiling
Drywall Interior Braced Panel Only)
T -Bar
INSULATION
Slab
Wall / Floor / Ceiling
MECHANICAL.
FINAL Date Accepted b
Heat Pum / Furnace / FAU / Ducts
Rough -in
Gas Line
Wood Stove / Pellet / Chimney
Commercial Hood / Ducts
MANUFACTURED HOMES
Footing / Slab
Blocking & Hold Downs
Skirting
PLANNING DEPT Separate Permit #s
SEPA.
ESA.
SHORELINE.
Parkin / Lighting
Landscaping
FINAL INSPECTIONS REQUIRED PRIOR
TO OCCUPANCY! USE
Inspection Type
Date
Accepted By
Electrical 417-4735
Construction R.W PW / Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
ISI
T.Forms/Building Division/Building Permit
%L-. nor
BUILDING PERMIT APPLICATION
CITY OF PORT ANGELES
Attn. Building Permit Technician \.Sofil�5PW
321 E. Fifth St. Port Angeles, WA 98362oy(
(360) 417-4815 fax (360) 417-4711 P`-
A P
rV
Print in ink 1,Km°
Purrs
For City Use Only*
Date Received h-17-6$
Permit # 0 S—
bate Approved D
Applicant or Agent o b ��/ P'� S//-7- 06,/ 6
Property Owner / Pht 4117- a �6G
Property Owner's Address 2-
Contractor/Engineer
Contractor/Engineer cri Cr)oc_,,c_ Phone ?_G
Contractor/Engineer's Address S q y S --N cc' -U, e__ bi,
License # # g)rW /f C i`,?U d tl Expires E-mail
PROJECT ADDRESS 2/4 Psi 7'
Parcel Number Lot Zoning
Proiect Tvpe & Brief Descrintion.
Che all that apply
uction
❑ Addition ��
pl:Temodel
O'Repair 04:;
❑ Re -roof
❑ Demolition mQ
❑ Heat System ❑ Heat pump ❑
❑ Other
Floor Areas
Basement
1st Floor
2nd Floor
3`d Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures
E1
❑ comme cial
V
Dar �
stove ❑ gas
Existing (sq. ft.) Proposed (sq. ft.)
❑ Multi -family ❑ Industrial
❑ pellet stbve ❑ other
per sq. ft. = $
sq. ft. - Lot size
TOTAL VALUATION $ ,6 500
sq. ft. = Lot coverage %
Max. height of proposed structures ft. Occupancy group # of bedrooms
Will a lawn sprinkler system be installed? Occupant load # of full baths
Will a fire sprinkler system be installed? Construction type # of half baths
I have read and completed this application and know it to be true and correct. 1 am authonz?j to apply for this permit and
understand that it is my responsibility to determine what permits are required, and to ob in per its prior to work' g on
projects.
Date 11' 1`_-09' Print Name ��`�/'" Signature 0�__
7217
l09
205,
205'
224 201
218-
216
Z
/AQ-�
+
204
2,09
416
205 42T
138
46
4 11
IV
y
I FILE
CITY OF PORT ANGELES — Construction plans
The Issuance of this permit based upon these plans, spe,;ifi"
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
pla :s, specifications and other data, or from preventing
building operations being carried on thereunder when in
violation of all codes and ordinances of this judsdicfon.
Ij1� A Approval Date � I 2 g _
'v ✓� Y
Lv
zz-
L
I
i
1
1
1
z6 -
In
iB vc L1k� '')
PBS`lN/-�
Application Number
08 00001321 Date
10/17/08
Application pin number
215005
Property Address
216 W 4TH ST
ASSESSOR PARCEL NUMBER
06 30 00 0 0 8708 0000
Application type description
ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning
RESIDENTIAL HIGH DENSITY
Application valuation
0
Application desc
Remodel
Owner
Contractor
Feller Rob
OWNER
�y\J
216 w 4 st
PORT ANGELES WA 98362
Permit ELECTRICAL
ALTER RESIDENTIAL
Additional desc
Permit pin number 136465
Permit Fee 64 00
Plan Check Fee
00
Issue Date 10/17/08
Valuation
0
Expiration Date 4/15/09
Qty Unit Charge Per
Extension
1 00 64 0000 ECH EL
R OR RM 0 200 ALT SRV FDR
64 00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 64 00
64 00 00
00
Plan Check Total 00
Grand Total 64 00
00 00
64 00 00
00
00
N
I
y
SPECTION
ELECTRICAL
TYPE
DATE RESULTS
INSPECTOR
DITCH
SERVICE
OUCH - IN
FINAL
OMMENTS :
Ajl�W J76ryv1 D f _1Z
�vl32�
`'mss was
Job wired by ❑ Electrical Contractor
RECEIVED
OCT 15 200fLECTRICAL WORK PERMIT APPLICATION
Uwu%"■ v-7Installation description
ner ❑ Commercial Residential
Electrical contractor name License number Date Expires
Purchaser's mailing address
City State ZIP
Telephone number FAX number
❑ New ❑ Altered/Addition ZIAI
Premises owner's name Zo
Address of inspection `
City
Phone number to schedule inspection
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. ❑ Cash ❑ Check #
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- ❑ Credit Card Visa Mastercard Discover
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 Card #
— — — — — — — — — — — — — — — —
Utility Specificatio
Signature =wn,ca ra_rA or electrical administratorIlExpiration Date
Inspection f
�X Date �Q /��f card $ �t 1 66
Electrical
Electrical Load Additions and or subtractions
❑ NO LOAD CHANGES
® aseboard _ KW Skd'�1n.,r��c✓/
❑ Furnace _ KW ❑ Overhead Service
❑ Heat Pump _ Ton LAR ❑ Temp Service
Ulan -Wall _ KW a,®(a IJ 40#1 ❑ Underground Service
SAME DAY INSPECTION, CALL BEFORE 7.00 AM 360-417-4735
ROUGH -IN
Date Appr ed By
FINAL
Date Appr ed By
THERMOSTAT
Date Appr ed By
DITCH
� Date
Service Information
Voltage Z-2�
Phase 1 ❑ 3
Service Size. 1 ZW ^Y
Feeder Size
SERVICE
Date Appr ed By
FEEDER
Date Appr ed By
Inspection
Date
Area, Buildingor Equipment Ins ected
Action Taken
Electrical
Inspector
pa
l
W
N 11
dew CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
��
321 EAST 5TH STREET, PORT ANGELES. WA 98362
L
Application Number . . .
Application pin number . . .
Property Address . . . . . .
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name . . . . . .
Property Use . . . . .
Property Zoning . . . . . . .
Application valuation . . . .
07-00001034 Date 9/12/07
816934
216 W 4TH ST
06 -30 -00 -0 -0 -8708 -0000 -
ELECTRICAL ONLY
RESIDENTIAL HIGH DENSITY
0
Owner Contractor
KENNETH L / VIRGINIA PETERSON OWNER
PO BOX 1120
SEQUIM WA 983821120
----------------------------------------------------------------------------
Permit . . . .
ELECTRICAL NEW RESIDENTIAL
Additional desc
OWNER/ 200A
SVC
Permit pin number
110569
Permit Fee . . .
. 75.00
Plan Check Fee
.00
Issue Date . . .
. 9/12/07
Valuation . . .
. 0
Expiration Date
3/10/08
Qty Unit Charge Per
Extension
1.00 75.0000
ECH EL -RM
-0-200
1ST SRV FEEDER
75.00
----------------------------------------------------------------------------
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
75.00
75.00
.00
.00
Plan Check Total
.00
.00
.00
.00
Grand Total
75.00
75.00
.00
.00
COMMENTS/ACTION NEEDED
E
G
ELECTRICAL PERMIT INSPECTION RECORD
CALL 4174735 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
GENERAL COMMENTS:
PW -1102.1514'961
■zlile�:eui[K•r��: ��
UWE
GENERAL COMMENTS:
PW -1102.1514'961
CITY OF PORT ANGELES
LIGHT DEPARTMENT ELECTRICAL PERMIT
M 17456
/-.1�6.._----------
_
19 E�
Port Angeles, Washington.------
------------ ---------
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-
mission is hereby granted to do electrical work as listed below.
v '
sL_;=
Address ....... ------------------------- Occupancy;!mt
- -------_----------_-_
Owner--------------------------•-•--- ------------------_-------- enant------------------------------------------
----- ----------- ----------
Contractor <_r�:. - By
Wiring .&__ r ----------------------------------
__-------------------------------
�1
.......: .......... .
Light Outlets .......................... ------------ Service, volts ... r" /..f. G....... Type of Wiring:
i
Receptacle Outlets------ ....................... No. wires ........ 3.............................
Armored Cable .---............----........-
..y
Dryer, KW .....................................-... Size wires....- i!�67..�
Non -Metallic ........................._......
r 40,0, 4,
Knob & Tube ................................_
Range, KW ..........................._....__....... Main fuse ... ............
Rigid Conduit ...............................
Water Heater: Enclosure ....:�^3................. ...............
Metallic Tubing
KW.............................. .. Type of wiring:
Entrance Cable
Raceway ....................... _..... -'-'-
Heat: KW..... ..�/.? ...� ............... ------------------------- Clrcults,
Light .................................
Motors: size, volts and phase: Rigid Conduit ...............................
Utility ............... ....... _....................
Metallic Tubing .......... ........ ........
Heat _ .................._......._...._..—
Current transformers:
Range .............................................
.................... .---------- _.---- ------------_-_
No. & Size .......................................
Water Heater ...............................
...........................................................
Ser. No. .... .......----- _.-------
Motor _ .. .................................._....
............ ................... ...........................
Ser. Nn............ ...................... _.........
Dryer ................................................ _
Furnace ........................... ...... _...........
Ser. No ..............................................
Total Load!..:I ASer. No ................... ..........................
Remarks
Total ......_......_ ........................
Permit Fee Treas. Receipt f
------------------------------------ No ----------_---------------- By ' !r.- abf_
NOTICE—Current must not be turned on until Certificate of Inspection has been issued. If work is to be con-
cealed due notice most be given the Inspector so that work may be Inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT N° 17456
'
Address...................................\................................................................................................. Date .......... .................... ........................
Owner\ ..... ......----------- ----- ......_--- .._... ...... ....... ... _.............. ............................................ Tenant ------------------------------------------------------- -----------
Wiring
--._....-WiringContractor........................................... ................ .......................................:.f........................ By
NOTICE—Current must not be turned on until Certificate of Inspection has been issued. If work Is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
IM Olympic Printers, Inc.
ROUGH -IN \ / THERMOSTAT
Approved By 7DatcApprovM By
FINALH
Appmved By
Inspection
Date
ELECTRICAL WORK PERNIITAPPLICATION
Action Taken
r
Installation description
Job wired by ❑ Electrical Contractor la Owner
❑ Commercial Residential
Electrical contractor name License number Date Expires
❑ New QQ Altered/Addition
Purchaser's mailing address
'
Replace �c.,faCa, l�oGtrc_�A
City State ZIP
1
�200
Telephone number FAX number
-
Premises owner's name
Address of inspection y 1� L
v
007
]
City Por
or -L A ra?i6 WA °I 2 3ie,
Phone number to schedule inspection:(360 4 1,1 —06�
_
Owner as defined by, RC W. 19.28.261:(1) Owner will occupy the structure for No
yem'.c 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.
❑ Cash ❑ Check #
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-
ld Credit Card VS Mastercard Discover
lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter
19.29, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and
Card #
Utility Specifications.
Signator of ownerelectric ntrgctor or electrical administrator
Expiration Dale
orepp
X Date:q/�o1U_7
ofcard $spe
4C_ fi-�
Electrical Load Additions and or subtractions
Service Information
Ad NO LOAD CHANGES
Voltage ag
❑ Baseboard _KW
❑ Furnace ar Overhead Service PhaseZI 1 E 3
_KW
❑ Heat Pump _ Ton LAR :1Temp Service
Service Size: Z
❑ Fan -Wall _KW ❑ Underground
Service Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH -IN \ / THERMOSTAT
Approved By 7DatcApprovM By
FINALH
Appmved By
Inspection
Date
Area, Building or Equipment Inspected
Action Taken
Electrical
Inspector
SEP 0'6
007
UGHTDEPT.