HomeMy WebLinkAbout111 W 10th St - BuildingBuilding Permit
111 W lOthSt
12 -1379
Application Number 12- 00001379
Application pin number 733228
Property Address 111 W 10TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-2- 9285 -0000-
Application type description RES ADDITION
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 5760
Application desc
480 SQ FT DECK ADDITION
Owner
CRAIG A AND PATRICA L PATTISON
111 W 10TH ST
PORT ANGELES WA 98362
(360) 496 -1766
Other struct info
Permit BUILDING PERMIT RESIDENTIAL
Additional desc DECK OVER EXISTING PATIO /STAIR
Permit Fee 151.75 Plan Check Fee
Issue Date 11/27/12 Valuation
Expiration Date 5/26/13
Qty Unit Charge Per
BASE FEE
4.00 14.0000 THOU BL- 2001 -25K (14 PER K)•
Special Notes and Comments
November 16, 2012 9:19:04 AM sroberds.
No land use issues anticipated. Lot coverage will be at
30A.
November 16, 2012 10:56:00 AM banders.
Existing footprint of deck will easily provide the minimum 5
foot horizontal clearance from overhead service conductor.
Public Works Utility Engineering has no requirements for
this plan review.
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
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 granting of a permit does
not presume to give authority to violate or cancel the provisions of a state •r local law regulating construction or the performance of
construction.
/17 ‘e k6 8/em /ef
Date
Print Name Signature of Contractor or Authorized Agent
Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Contractor
COUNTER INTUITIVE CONSTRUCTION
2183 OBRIEN RD
PORT ANGELES WA 98362
(360) 477 -1408
'HARD SURFACE AREA
STATE SURCHARGE 4.50
Charged Paid Credited Due
151.75 151.75
98.64 98.64"
4.50 4.50
254.89 254.89
.00
.00
.00
.00
Date 11/27/12
.00
.00
.00
.00
98.64
5760
Extension
95.75
56.00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
Inspection Type
Date
Accepted By
`Date
Comments
FOUNDATION:
417
Footings
Construction R.W.
PW Engineering
Stemwall
Foundation Drainage Downspouts
417 -4653
Piers
Planning
417 -4750
Post Holes (Pole Bldgs.)
Building
PLUMBING:
FINAL
Date
Accepted by
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
FINAL
Date
Accepted by
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /'USE
SEPA:
ESA:
SHORELINE:
Inspection Type'
`Date
Accepted By
Electrical
417
Construction R.W.
PW Engineering
417 -4831
Fire
417 -4653
Planning
417 -4750
Building
417 -4815
PLANNING DEPT. Separate Permit #s
SEPA:
ESA:
SHORELINE:
Parking Lighting
Landscaping
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 IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
T:Forms /Building Division /Building Permit
Contact person: 1 644 is U J ,rh 151e✓
Project Type: 00 Residential o Commercial
Phone: 30C, '7 7, No g
Property owner: f 1 Pa45 a PI
Project Business Name:
(for commercial, industrial, or multi- family projects)
Phone: 3C o 1/1 q 6 /16b
n
Property owner's mailing address: ii I W I0 S /v✓/ in
'1/4 q $3o._
Contractor's business name: C Z,c1t4'f'vC Cons-irk c /inr
(or property owner's name if he /she is doing /overseeing the work)
Phone: 346.`t' 77. /y g
Contractor's mailing address: -2,./ obvi2m h j 0 k IAA 7 0 6Z
Contractor's L &I license number:C O UIUT�L C cj j 1 0B
Expiration date: q /.2. h_Oi3
Project Address: ill I,✓ 16+11 S/ folif Ah (,vA 7Z3 "2
Project Type: 00 Residential o Commercial
o Industrial
o Multi- family
Project Business Name:
(for commercial, industrial, or multi- family projects)
Zoning:
Parcel
,Lot#
BUILDING PLUMBING MECHANICAL PERMIT APPLICATION LONG FORM
(To be used for projects that require plan review.) I
Date Received
Permit#
ate Approved 11113
pproved by o fti
City of Port Angeles
Attn: Building Permit Technician
321 E. 5 St., Port Angeles, WA 98362
360 -417 -4815 fax: 360 -417 -4711
Hours: Mon through Fri 8 5 pm
Commercial
For Additions New Structures also submit:
Please print in ink.
Complete only the portions of this permit that are relevant to your project.
Credit card payments are accepted Mon -Fri 8=5 pm (no American Express)
Cash checks are accepted Mon -Thurs 8:30 -4 pm Fri 8:30 -12:30 pm
Pay the plan check fee (based on the valuation of the project) at the time of submittal
Residential Projects submit:
(1) Two sets of plans* (including engineering calcs, geotech reports, etc. if applicable)
Prescriptive Approach Simple Form (confirming conformance to the Energy Code)
Projects submit:
Three sets of plans* (including engineering calcs, geotech reports, etc. if applicable)
Paperwork confirming conformance to the Energy Code
For large projects, a pre- construction meeting with various City department
personnel is highly recommended. To schedule a pre construction meeting, contact
the Planning Manager at (360) 417 -4750.
Additional information may need to be submitted including:
landscape plan, parking plan (including ADA spaces, ramps, etc.), utilities
(existing proposed), curbs, sidewalks, storm water.plan, etc.
Site plan (8 1/2" x 11 showing all structures (existing proposed), setbacks, new driveways
If an architect or engineer drew the plans or calculations, include at least one "wet- stamped" set of plans
and /or calculations.
T:Forms /Building Division /Building /Plumbing /Mechanical Permit Application Long Form (Revised 2011)
Page 1 of 4
Repair I Solar Panels Miscellaneous: (explain the protect)
Remodel: (explain the protect, including how the building space is currently being used and what the new,
remodeled use will be)
Project Valuation
If the space will change from commercial to residential, submit:
"Checklist Converting Commercial Space into Residential Space"
Addition: (explain the protect and complete submit page 3) L(Vew cl( €c.k (16 bk; /'f o ve- exist ;n
24.-6 ar V-AV 0 7 1 Acm4e. d k 1c 1s �o l
Maximum height of the new addition g feet Project Valuation ,57 CO
New Structure: (explain the project and complete submit page 3)
Maximum height of the new structure feet Project Valuation
PLUMBING PERMIT: Will there be ANY plumbing changes (items moved, added, replaced, or altered)
Check one:
No Yes If yes, complete submit page 4 "Plumbing Changes"
MECHANICAL PERMIT: Will there be ANY mechanical changes (items moved, added, replaced, or altered)
Check one:
No Yes If yes, complete submit page 4 "Mechanical Changes"
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
Page 2 of 4
Occupancy group
Occupant Toad
Construction type
*Homeowner: If you will be doing overseeing the work, then the project valuation will be determined by doubling the
cost of materials, to reflect the value the repair adds to your property.
Cost of materials x 2 Project Valuation
I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit
and understand that it is my responsibility to determine what •ermits are required, and to obtain permits prior to
working on projects.
Date /o /1s /12 Signature
Print Name /_oils 44evnel'7ev
Project Valuation
of bedrooms
of full baths
of half baths
4
Floor Areas
Existing square New square Price per new
footage footage square foot
Basement x
1s Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck y g 1 2 #570
30 high)* 0
Deck
(s 30" high)
Shed
Other
Other
Page 3 of 4
Remodel project valuation
TOTAL VALUATION 5760
*Walking surface of the deck above ground
For residential building projects the minimum square foot valuation we accept is:
Dwelling $85.00 per sq. ft. garage /utility /misc.structure $30.00 per sq. ft. porch /deck /carport $12.00 per sq. ft.
LOT COVERAGE SITE COVERAGE
Lot coverage is the amount or percent of ground area on which buildings are located.
It includes: houses, garages, carports, covered patios, cantilevered portions of buildings, roof overhangs that are longer
than 30- inches, uncovered decks or porches having walking surfaces higher than 30- inches off the ground, etc.
Total footprint of structures 2.07 T sq. ft. lot size 1 80 0 sq•ft. Lot coverage -29,
Site Coverage is the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks,
patios, and other impervious surfaces. (see Port Angeles Municipal Code 17.94.135 for exemptions)
Does the project include a new driveway? yes ono
If yes, what will the driveway be made of? cement in asphalt gravel other
(NOTE: 18 feet is the recommended minimum driveway length for residential projects) cry
Does this project include a new parking pad? en yes mino 070
If yes, what will the parking pad be made of? cement asphalt gravel other
a) Total footprint of structures sq. ft. (existing new) 41/
b): Total concrete, asphalt, other impervious surfaces sq. ft. (existing new)
c) Add lines 'a" "b" above to get the total impervious sq. ft. (existing new)
Total impervious sq. ft. .lot size )LXDD sq. ft. Site coverage
cirf-
:n
PLUMBING CHANGES
Check "No" or "Yes" (and enter quantities) for each line item.
Type
Plumbing Changes
Sink (hand, mop, floor etc.) No Yes
Toilet No Yes
Bathtub No Yes
Shower No Yes
Washing Machine No Yes
Hot Water Heater No Yes
Water Line (meter to structure) No Yes
Re -plumb the structure No Yes
Sewer Line No Yes
Backflow Prevention Device Types:
Beverage Machine No Yes
Landscape Watering System No Yes
Fire Sprinkler System s 2 inch line No Yes
Fire Sprinkler System 2 inch line No Yes
Please list all other planned plumbing changes or additions that aren't listed above.
MECHANICAL CHANGES
Check "No" or "Yes" (and enter quantities) for each line item.
Mechanical Changes
Type
Furnace, heat pump, or
forced air unit 5 5 tons No Yes
Furnace, heat pump, or
forced air unit 5 tons No Yes
Ductless heat pump No Yes
Wall (recessed) heater No Yes
Baseboard heater No Yes
Steffes room heater No Yes
Wood- burning stove No Yes
Pellet stove No Yes
Radiant floor heat No Yes
Gas fireplace or freestanding stove No Yes
Gas cooking stove No Yes
Propane tank set No Yes
Gas line No Yes
Boiler No Yes
Clothes Dryer No Yes
Ventilation fan (single duct) No Yes
Hood &duct mechanical exhaust No 7 Yes
Ventilation system (not part of a heating or air
conditioning system) No Yes
Air handler No Yes
Evaporative cooler (non portable) No Yes
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Alle' Quantity
Quantity
Quantity
Quantity
Page 4 of 4
(Moved, Added, Replaced,
or Altered
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
Quantity
(Moved, Added, Replaced,
or Altered)
Quantity
Please list all other planned mechanical changes or additions that aren't listed above.
S T R
DESIGNED BY:
PROJECT:
FOR:
SHT: OF
c
DATE:
SChic
NT/
NTI ENGINEERING SURVEYING
NORTHWESTERN TERRITORIES, INC.
Engineers Land Surveyors Geologists
Construction Coordination Materials Testing
717 SOUTH PEABODY PORTANGELES, WASHINGTON 98362 (360)452 -8491
www.nti4u.com info @nti4u.com
PREPARED 4/01/13, 10:16:05 INSPECTION HISTORY REPORT PAGE 1
PROGRAM BP521L 0 /00 /00 THRU 0 /00 /00
CITY OF PORT ANGELES
APPLICATION PROPERTY ADDRESS
STRUCTR PERMIT
ASSESSOR PARCEL NUMBER ALTERNATE ID
INSPECTION
RESULT DATE /STATUS INSPECTOR
12 00001379 111 W 10TH ST 06- 30- 00 -0 -2- 9285 -0000- 063000029285
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BL99 0001 BLDG FINAL 12/31/12 DISAPPROVED
REQ COMM: December 31, 2012 9:43:15 AM pbarthol.
REQ COMM: Louis 477 -7408
RES COMM: December 31, 2012 2:41:37 PM pbarthol.
RES COMM: Needs: Handrail on stairs. 10 3/4" min tread width with a
RES COMM: min 3/4" overhang. Center beam must be trimmed back to the
RES COMM: rim joist on the west side of deck.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BL99 0002 BLDG FINAL 1/09/13 APPROVED
REQ COMM: January 8, 2013 10:31:32 AM pbarthol.
REQ COMM: Louis 477 -1408
RES COMM: January 9, 2013 4:20:56 PM jlierly.
PB
JLL
ELECTRICAL PERMIT
OWNER/APPLICANT
MIKE CURRIE
111 WEST 10TH STREET
Port Angeles, WA 98362
360/452 -3909
T:
CONTRACTOR
JARMUTH ELECTRIC
P.O. BOX 635
SEQUIM, WA 98382
360/683 -4104
PROJECT INFO
Project Type: RES. MISC.
Occupancy Type: RESIDENTIAL
Occupancy Group:
Electrical Heat:
n Baseboard
M Furnace
Heat Pump
n Fan Wall
PROJECT NOTES
NEW CIRUIT TO AIR HANDLER
RECEIPT #8988
S:
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98162
0 KW
10 KW
0 KW
0 KW
M
FEES ASSESSMENT Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $45.50
Temp Service: $0.00
Misc Fee: $0.00
TOTAL FEE: $45.50
AMOUNT PAID:
BALANCE DUE
COMMENT S /ACTION NEEDED
ISSUED: 5/09/2002
PROPERTY LOCATION
111 10TH ST W
Lot: 18
Block: 292 Long Legal
Subdivision: TPA
Parcel No: 063000029285000
ARCHITECT
N/A
98360 -0000
360/000 -0000
Project Value:
Construction Type:
Zoning Use:
$45.50
$0.00
PERMIT NO 7647
$0.00
Riser Underground Service
Overhead Service Voltage: 120,240
Temp Service Phase: M 1 n 3
Service Size 200
Feeder Size: 0
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
YES NO
DITCH
ROUGH -IN COVER
deft l
4
SERVICE
FINAL 1 ;file z 1 .z J4 1
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
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
7
PW- 1102.15 [496]
BUILDING PERMIT
OWNER/APPLICANT
MIKE CURRIE
111 WEST 10TH STREET
Port Angeles, WA 98362
360/452 -3909
T:
CONTRACTOR
OWNER
VARIOUS
Port Angeles, WA 99360
206/000 -0000
PROJECT INFO
Project Value: $500.00
Project Type: ABANDON OIL TNK
Occupancy Type: RESIDENTIAL
Occupancy Group:
Construction Type:
Zoning Use:
PROJECT NOTES
ABANDON OIL TANK IN PLACE
RECEIPT#9990
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East 5th Street, Port Angeles, WA 98362
S
ISSUED: 12/09/2002
PROPERTY LOCATION
111 10TH ST W
Lot: 18
SFD Units:
SFD SQ FT:
Block:
Subdivision:
Parcel No:
ARCHITECT
N/A
98360 -0000
360/000 -0000
MFD Units: 0
MFD SQ FT: 0
Misc Fee 1: ABANDON TANK
Misc Fee 2:
Misc Fee 3:
TOTAL FEE:
AMOUNT PAID:
PERMIT NO: 13900
292
TPA
063000029285000
$15.00
$0.00
$0.00
$15.00
$15.00
BALANCE DUE: $0.00
Long Legal
0 Commercial: 0
0 Industrial: 0
Garage: 0
This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
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 recognized standards, laws and ordinances governing this type of work Will be compiled
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the provisions of any state or local law regulating the work specif the permit.
z- 9-oz,
Signature of Contractor or Authorized Agent Date Signature of Owner (if •wrier is builder) Date
G
4
S
Inspection Type
I Date Passed
Comments
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough -in inspection
Alarm final
LP GAS
Completed by Contractor:
Test #1
Piping pressure test psi
Underground piping inspection/pressure test
Above ground piping inspection/pressure test
Time initiated
Tank (container) inspection
Test #2
Piping pressure test psi
Appliance inspection
Time initiated
LP -gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final Xi)
/Z Z7 -0t
FIRE PERMIT INSPECTION RECORD
Call 360-417-4655 for fire 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 /3 70
GENERAL COMMENTS:
2/15/00
Roger Vess Tank permit
From: Ken Dubuc
To: Roger Vess
Date: 12/27/02 1:37PM
Subject: Tank permit
Roger
Permit no. 13900, a tank abandonment at 111 West 10th St. for Currie, has been finaled as of today,
12/27/02.
Thanks.
Ken
Page 1
CITY OF PORT ANGELES
LIGHT DEPARTMENT
Port Angeles, Washington d 19 2
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.
Address to Occupancy__ L-r?- _,,z...
,t2
Owner
Wiring Contractor
Light Outlets
Receptacle Outlets
Dryer, KW
Range, KW
Water Heater:
KW
Heat: KW
Motors: size, volts and phase:
Permit Fee
Total Load
1M Olympic Printers, Inc.
ELECTRICAL PERMIT
Service, volts
No. wires
Size wires 5/ Pe`
Main fuse
Enclosure C7
Type of wiring:
Entrance Cable
Rigid Conduit
Metallic Tubing
Current transformers:
No. Size
Ser. No
Ser. No.
Ser. No
Ser. No.
Treas. Receipt
No
ELECTRICAL PERMIT
Tenant
By
4
N? 15694
Type of Wiring:
Armored Cable
Non Metallic
Knob Tube
Rigid Conduit
Metallic Tubing
Raceway
Circuits, Light
Utility
Heat
Range
Water Heater
Motor
Dryer
Furnace
Total
Remarks:
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.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
N? 15694
Address Date..._
Owner Tenant
Wiring Contractor 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.
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Application Number , . . , .
1.5- 00001533 Date
12/09/15
Application pin number . . .
511151
DITCH
Property Address
111 W 10TH ST
ASSESSOR PARCEL NUMBER:
06-30-00-0-2- 9285 -0000-
Application type description
ELECTRICAL ONLY
Subdivision Name , , . . , .
2
Property Use
FINAL
Property Zoning , . , . , , .
RS7 RESDNTL SINGLE FAMILY
Applicatiail valuation . . , .
0
Application desc
1 circuit garage
Owner
Contractor
CRAIG A AND PATRICt-1 L PATTISON
ELECTRIC SERVICE
111 W 10TH ST
503 RHODES RD
PORT ANGELES WA 98362
PORT ANGE'LE'S
WA 95362
(360) 496 -176G
(360) X52 -6424
Permit I . , . . . ELECTRICAL
ALTER RESIDENTIAL
Additipnal desc 1 -4 CIRCUITS
Permit Fee 75.00
Plan Checic Fee
DO
Issue Aare . . . . 12/09./15
Valuation
0
Expiration Date , , 6106116
Qty Unit Charge Per
Extension
-BASE FEE
75 , 00
- - - - --
Char ed
Fee summary g
Paid Credited
---------- ----------
Due
----------------- ----------
Permit Fee Total 75.00
----------
75.00 QO
.00
Plan Check Total 00
.00 .00
.00
Grand Total 75,00
75,00 .00
.00
1-21A,9/14'
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
2
FINAL
COMMENT'S:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAIEXCHANGEII3 UILDING
a
Cps
CITY of PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections ' 0
321 East Fifth Street — P.O. Box 11501 Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711
Date: & 2 Single Family Dwelling
Plan Review May Be Requ !red, Please Complete Electrical Plan Review Information Sheet
Job Address: -
Building Square Footage;
Description of above
Owner Inform Ion r"O'M14"
Name:_�
N;
4 - &J spe-_
MallIng Add
'J W_ -Xig
city., 3=,r ja 44 rip; G 1534 clt State; Zip:
Phone! Phone; ax:
License Exp, Ucem V Up. 9jrLQj S1 132:0M
Nem Unit Charm e Total M MultIpIlled by Unit Chargs)
Serviceffeeder 200 Amp, $120.00 $
Serviceeedef 201-400 Amp. $146,00 $_
SeNlce/Feeder 401-600 Amp $ 205,00
$ervlve/Fe%Isc 601 -1000 Amp. $262.00
Service/Feeder over 1000 Amp- $ 373,00
Branch Circuit Wt Service Feeder $ 5.00
Branch Circuit W/O Service Feeder $ 63-00
Each Additional Branch Circull $ 5.00
Branch 01=111s 1-4 $ .75,00
Tamp. Service/ Feeder 200 Amp. $ 93.00
Temp. Sorvice/Feeder 201-400 Amp, $110,00
Temp. SaryicPJFeeder 401-60D Amp, $149.OQ
Temp. ServiceNeeder601-11000 Amp $168,00
PortM to Portal Hourly , $ 96.00
Signal Circuit/ Limited Energy -1 & 2 Family Dwelling $ 64,00
Manufactured Horne Connection $120-00
Renewable Eladdcal Energy - 5KVA System or Less $102.00
Thermostat 56.00
Note., $5.00 for each additional T-Stat
NEW CONSTRUCTION ONLY
First 1300 Square Ft. $120-00 $
Each Additional 500 Square Ft or Portion of 5 40.00 $
Each Outbuilding or Detached Garage $ 74.00
Each Swimming Pool or Hot Tub S 110.00
Total
Owner as defined by RCW. 19,26,261: (1) Owner will occupy the structure for two pars after this electrical permit is finalized, (2) Owner is required
to hire an electrical contractor if above scald property is for sale, rent or lease. Permit expires after six months of last inspection.
Aftir 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 ft electrical lam, NZ C,' RCW. Chapter 19.28, VVAC, Chapter 296-468, The City of Pod
Angeles Municipal Code, and Utility Specifications and PAMC 114.06.050 regarding ElecWcat Permit Applications,
Signature of owner, electrical contractor or electrical ad MInistratov: ❑ cash ❑ cheek
❑ Cradit UN A
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