HomeMy WebLinkAbout2121 W 12th St - BuildingPREPARED 1/04/08 9 24 53 INSPECTION TICKET PAGE 14
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 1/04/08
ADDRESS 2121 W 12TH ST SUBDIV
TENANT NBR GEORGE WELCH
CONTRACTOR THURMANS SUPPLY PHONE (360) 457 8591
OWNER GEORGE B WELCH JR PHONE (360) 452 1719
PARCEL 06 30 01 5 0 0250 0000
APPL NUMBER 07 00001480 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01 12/12/07 JLL MECHANICAL GAS LINE TIME 01 00
12/12/07 AP December 12 2007 8 16 59 AM 1pangrle
DARRAN 457 8591
GAS LINE
AFTERNOON
ME99 01 1/04/08 JLL 0 MECHANICAL FINAL TIME 02 00
P
January 4 2008 8 21 32 AM 1pangrle
GEORGE 452 1719
MECHANICAL FINAL GAS FIREPLACE
AFTER 1 30 PM
COMMENTS AND NOTES
PREPARED 12/12/07 9 07 55 INSPECTION TICKET PAGE 11
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 12/12/07
ADDRESS 2121 W 12TH ST SUBDIV
TENANT NBR GEORGE WELCH
CONTRACTOR THURMANS SUPPLY PHONE (360) 457 8591
OWNER GEORGE B WELCH JR PHONE (360) 452 1719
PARCEL 06 30 01 5 0 0250 0000
APPL NUMBER 07 00001480 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01 12/12/07
MECHANICAL GAS LINE TIME 01 00
j December 12 2007 8 16 59 AM 1pangrle
DARRAN 457 8591
GAS LINE
AFTERNOON
COMMENTS AND NOTES
Date
GEORGE B WELCH JR
2121 W 12TH ST
PORT ANGELES
(360) 452 1719
k Ct /A
Print Name
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 07 00001480 Date 12/11/07
Application pin number 759080
Property Address 2121 W 12TH ST
ASSESSOR PARCEL NUMBER 06 30 01 5 0 0250 0000
Tenant nbr name GEORGE WELCH
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning RS9 RESDNTL SINGLE FAMILY
Application valuation 3000
Owner Contractor
WA 98363
Permit MECHANICAL PERMIT
Additional desc GAS FIREPLACE INSERT
Permit pin number 117564
Permit Fee 60 65 Plan Check Fee 00
Issue Date 12/11/07 Valuation 3000
Expiration Date 6/08/08
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 10 6500 ECH ME GAS PIPE 1 TO 5 10 65
Fee summary Charged Paid Credited Due
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 has commenced, or if required inspections have not been requested within 180 days from the
last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction
T.Forms /Building Division/Building Permit (10 /01 /07).wpd
THURMANS SUPPLY
1807 EAST FRONT STREET
PORT ANGELES WA 98362
(360) 457 8591
/1)4
Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
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
YES I NO
FOUNDATION•
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
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 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
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
ELECTRICAL LIGHT DEPT 417 -4735
FIRE 417 -4653 I
6, PLANNING DEPT 417 -4750 I
-BUILDING
417 -4815 I
/ormslBuilding Division/Building Permit (I0 /01 /07).wpd
BUILDING PERMIT INSPECTION RECORD
12.-1? -61 1 1.
FINAL
PLANNING DEPT SEPARATE PERMIT It's SEPA.
PARKING /LIGHTING ESA.
LANDSCAPING SHORELINE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW ENGINEERING
FIRE DEPT
PLANNING DEPT
BUILDING
COMMENTS
DATE ACCEPTED BY.
N
FINAL 1-1- 10g DATE 1 6 ACCEPTED BY.
DATE
ACCEPTED
YES NO
0
0
N
I I I
I I I II J
Applicant or Agent VW/ /LS
Owner 60
Owner's Address 2 tai w 2 7
Contractor /Engineer 7 A bl .v
Contractor /Engineer's Address ryo
License z7 s 7 ,S L7 ,4
PROJECT ADDRESS
Parcel Number
Project Type Brief Des
Check all that apply
New Construction
Addition
Remodel
Repair
Re -roof
Demolition
Sign
Floor Areas
eat System
ther
Basement
1st Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures
criotion.
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
I have read and completed this application
understand that it is my responsibility to
projects.
Date /2- G 7 Print Name A.
BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
T Forms /Building Division /Bldg Permit Appl. -2006 Code.doc
r4Residential Commercial
Existing (sq. ft.) Proposed (sq. ft.)
sq ft. Lot size
ft. Occupancy group
Occupant load
Construction type
Lot
per sq ft.
For City Use Only 7
Date Receivedj7_- U '0
Permit 0 1
Date Approved
Phone X 7 5 c1
Phone 95 7
Phone L 5 7 5
0-
Expires
Zoning
Multi- family Industrial
wall- mounted projecting freestanding awning other
Total sign area sq ft. Mayimum allowed sign area sa ft.
Heat pump wood burning stove ,,&gas fireplace pellet stove other
G1. C 7fri-5- -c. L j ALL 1 c4 S" `i v--r
TOTAL VALUATION .3 O PJ G
sq ft. Lot coverage
of bedrooms
of full baths
of half baths
and know it to be true and correct. I am authorized to app, for this permit and
termine what permits are required, and to ob n permit' prior to working on
kvOt rn Signature
(Y)
ivw
N
0
va
r No
91
.... CITY OF PORT ANGELES
~*~ OF COMMUNITY DEVELOPMENT BUILDING DIVISION
DEPARTMENT
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT ISSUED: 4/23/2002 PERMIT NO: 13377
OWNER/APPLICANT PROPERTY LOCATION
GEORGE WELCH 2121 12TH ST W
2121 W.12TH ST Lot: 26
Port Angeles, WA 98363 Block: [] Long Legal
360/000-0000 Subdivision: SEABREEZE ESTS
T: S: Parcel No: 06300150025000
CONTRACTOR ARCHITECT
HOME SERVICE N/A
223 MARSDENRD
Port Angeles, WA 98362 , 98360-0000
206/457-1708 360/000-0000
PROJECT INFO
Project Value: $500.00 SFD Units: 0 Commercial: 0
Project Type: SEIMIC RETRO SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use: RS9
PROJECT NOTES
ADD TIE DOWNS, WEDGE ANCHORS AND JOIST ANCHORS
RECEIPT ~-8978
FEES ASSESSMENT
Building Permit: $23.50 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $28.00
Plumbing: $0.00 AMOUNT PAID: $28.00
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
ISeparate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of '180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
I construction.
[Si~ture of C~ontractor dr ~,uthorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORJVlS~ t t02.i5 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE 1TIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE } '~'~ ~
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'$:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHOKELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEFT
CONSTRUCTION ILW. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 41%4815 ~'~ 5- ~ ~-~ ~/--~ BUILDING
T:'d?LANNING\FORMS\I 102.15 [4/2002]
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date ~-~- Z -- ~'~ ~ Time Received by (phone, person)
Location of Work to be inspected ~ f '~ [ ~) / ~ ''~
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. ?
Sewer Foundation Framing Chimney Plumbir~F~nal~) Sewer Excav. Other
INSPECTION NOTES: ',~_~.
Inspected: Date ~ . ..... Time By
Remarks:.
RESTORATION REQUIRED ...... YES NO,
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved [~Gravel [~Asphalt [-~PCC [~Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[]No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles. WA 98362
(206) 457-0411
PERMIT NO. JS7S-
s ,1/r- z
DATE
ELECTRICAL PERMIT
Site Address:
o READY FOR
INSPECfION
License Number:
~ WILL CALL FOR
INSPECfION
Phone:
Installed By:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
~ RESIDENTIAL
o COMMERCIAL
o BASEBOARD KW _
o FURNACE KW _
I8I FAN/WALL KW :::JK,.}
o HEAT PUMP KW_
o SIGN
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
~ REMODEL
o ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o SPECIAL EQUIPMENT
(LIST BELOW)
o OVERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
o SINGLE PHASE
o THREE PHASE
SERVICE SIZE AMPS
Details/Description:
/J-dc/ r5fh
,
('
(
:J,ctJ ~I
.
WS. No. SERVICE SIZE
CAPACITY:
o O.K. NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
~ Rough-in/cover O.K.
. .I"lu 0 O.K. to connect service
-{l/"( ~Final O.K.
Site Address:
Installer:
2/4
~
Permit/Receipt No.
3S1s
New Meters
-
.
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the Building Permit. PHONE 457-0411, EXT. 224.
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ C::<O ~
Electrical Inspector
Permit Fee
WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meier Dept., Bottom: City Hall
OLYMPIC PRINTERS INC.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16133
gJ -jr;; ). S-
Port Angeles. Washlngton..m......:.mm..................m...............m.m. 19.hh...
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 electricaltork as listed below.
Address .h.c?!..?:..L...m.0!oml..pi;....__hm.......h__~..h... OccupancY..A~..__..mh..hm..m.....
Owner --.m~-1fJ...l"!.~-<.'~J2/2.m.--.c~~..h..--...............m..m....mm.m'.mh..__..m...mm."
Wiring Contractor ___.__~~~~m....:.:m:m BY...mmm.m..m.....m.m...__....mh.....m..m..m.....
Light OUtletB............~...~......_.._..... Service, volts ...!.?:..,:?/-.a.:..~.c:...... T)"pe of Wiring:
Receptacle Outlets.......l::.qh............ No. wires ........:!......................c... Armored Cable ..............................
<:: SI . )::/' /i"" // Non.Metalllc .................................
Dryer. KW _uun.....~......................... ze .wlres....;:/.~.....=-.........;;...._..
/ ") {(J'Jt& .hI- Knob & Tube................................_
RD.nge. KW....... ...:-5:..................... Main fuse .....~;.:-:f......:.....................
e
Enclosure .."~l:..;1:............................
Water Heater: ,
KW.........Z)~..................
Heat Kw.....l.:3......R.I3.............
Type of wiring:
Entrance Cable ......................
RIgid Conduit ...............................
Metallic Tubing ...........................
C irc:::.e ::;h.~::~::E:~::~~~~~~~:~~~~~~::~~~~~~~
Co
~ :~ti ty ..~:::~~:~::~~~~~:~~::::::~:~~::~::::~
};J..
Range .......:::....................................
"fItlater Heater ~'2........................
Motors: size. volts and phase:
/ rfI r "..;-h
:;:(ii.~~:;;::::::::::::::::::::::::::::::
I
Rigid Conduit ................
MetalJlc Tuhlng ............
. Current transformers:
No. & Size..............................
Ser. No..............................................
Motor ..._........................................
Dryer .....@.:.......................................
Ser. No..........:....................................
Ser. No..............................................
Total wad............................. Ser. No.................._.......................... Total .2.;.~.........................
Remarks: .m___..m..m..m.m.'""'....P.."'..<.~...h...L.,<:?:?.~~.~..h.__....__..m...__...m.....m.h.....m__..............mm..
;" , --
Furnace .........................._......_...........
.:.:.~:.5~.::.::..::::::::...::--m....::~.~.~::..~.~.~.~~~.~.:....~._---..--m--m..~~jli!jIL~l:2;~::::::
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It 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
ELECTRICAL PERMIT
N?
16133
Address..................._...................................................................................................................Date..._......_.._......_.........._......_......_.........
Owner ...............nn................_.........._......_......_.._......................................................_.... Tenant....................................................................
Wiring Contractor..................................._..................................................................................... By..............................................................
NOTICE-Current must not be turned on until Certtftcate 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.
1M _ ~_ Olvmoic Printers. Ine.
INSPECTION TYPE
DATE: RESULTS:
INSPECTOR:
ELECTRICAL PERMIT
SERVICE
CITY OF PORT ANGELES
360-417-4735
z'R
�Z
Application Number . . . . . 18-00000573 Date 4/20/18
l
Application pin number . . . 196634
Property Address . . . . . . 2121 W 12TH ST
REPGRIr �SALES TAX
ASSESSOR PARCEL NUMBER: 06 -30 -01 -5 -0 -0250 -0000 -
Application type description
on ymw excfsolax form
ELECTRICAL ONLY
Subdivision Name . . . . . .
t0 the City 40 04 Ange%S
Property Use . . .
�s t
(Locaatuui OW21
Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
DHP
------------------------ `---------------------- =-----------------------------
Owner Contractor
RYAN J AND LINDSAY E GANN BLACK DIAMOND ELECTRICAL CONTR
2121 W 12TH ST 502 BLACK DIAMOND RD
PORT ANGELES WA 983635008 PORT ANGELES WA 98363
(360) 565-1035
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee . . . . 63.00 Plan Check Fee .00
Issue Date . . . . 4/20/18 Valuation . . . . 0
Expiration Date . . 10/17/18
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL -R- BRANCH CIR WO/ SER FEED 63.00
f
-----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
---------------------------
---------- --------------------
Permit Fee Total 63.00 63.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 63.00 .00 .00
INSPECTION TYPE
DATE: RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
z'R
�Z
COMMENTS:
l
PERMIT WILL EXPIRE SIX(6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
1 - 2 SINGLE-FAMILY t
ELECTRICAL PERMIT APPLICATION 3
Public Works and Utilities Department \j
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 www.cityofpa.us electricalpermitsC,cityofpa.us
Project Address: 1-2-774-
P . ect
Z774-
Pro'ect Description: SJ
Single -Family Residential ❑ Duplex / ARU Building Square footage. -
OWNER •' i
Name:Email:
Mailing Address: -Z( 2- I / Z
Name: 7f: C_
Mailing Address:
Email:
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 for each additional)
First 1300 Square Feet
Each Additional 500 square feet'
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
Phone: 90 -1 - G Sy - 1-74-7
License: TSLA-c-k_a dgq.P7-
Expiration Date:
Phone: _,) 6D - L/(, t - 71 S 7
Unit Chargg Quantity
Total (Quantity x Unit Charge)
$120.00
$
$146.00
$
$205.00
$
$262.00
$
$373.00
$
$5.00
$
$63.00
$
$5.00
$
$75.00
$
$93.00
$
$110.00
$
$149.00
$
$168.00
$
$96.00
$
$64.00
$
$120.00
$
$102.00
$
$56.00
$
$120.00
$
$40.00
$
$74.00
$110.00
$
$
IV I^1 .p V ✓
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 owne of the above named property or a licensed electrical contractor. I
am making the electrical installation or alteration in complian ith lectricaI laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
466, The City of Port Angeles Municipal Code, and Utility S c' ' and PAMC 14.05.050 regarding Electrical Permit Applications.
Date rint Name ignature�Owner ❑ Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted t i Hall or electrical perm its@cityofpa.us or faxed to 360.417.4711]
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4174735
Application'Number . . . . . 18-00000911 Date 6/14/18
Application pin number . . . 630621
Property Address . . . . . . 2121 W 14TH ST
ASSESSOR PARCEL NUMBER: 06 -30 -01 -6 -0 -3000 -0000 -
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . .
Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------- ----------------------------------------------------------
Application desc
1 circuit
----------------------------------------------------------------------------
Owner
Contractor
------------------------
AHRNDT MARK B
------------------------
TWETER ELECTRIC
2121 W 14TH ST
423 BLACKHAWK LOOP
PORT ANGELES
WA 983635120
PORT ANGELES
WA 98362
(360) 417-1151
----------------------------------------------------------------------------
Permit . . . : .
. ELECTRICAL ALTER RESIDENTIAL
Additional desc .
. 1-4 CIRCUITS
Permit Fee . . .
. 75.00
Plan Check Fee
.00
Issue Date . . .
. 6/14/18
Valuation
0
Expiration Date .
. 12/11/18
Qty Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE
FEE
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
INSPECTION TYPE DATE: RESULTS:
J DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MqNTHS FROM LAST INSPECTION .
Signature of owner or ElectrW Contractor X
v
1
3 ID
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR:
Date:
1 — 2 SINGLE—FAMILY EG- LIVED
ELECTRICAL PERMIT APPLICATIO_
ut { ., ,�a
Public Works and Utilities Department �w':
321 E. 5th Street, Port Angeles, AA 98362
350.417.4735 ! www.cityofpa.us ; electricalpermitsCcityofpa.us
Project Address:
Project Description: % —
ingle-Family Residential ❑ Duplex /ARU Building Square footage:
Name:r ��� /< 14>�IPiID 77 Email:
Mailing Address: ;/g/ Lr -l' ;4/;11`
Name:
Mailing Address:2�3/lli9Z�/�
Email: �_/'�73�c t` C/4%G. •i�
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 for each additional)
First 1300 Square Feet
Each Additional 500 square feet'
Each Outbuilding / Detached Garage
Each Swimminq Pool / Hot Tub
Unit Charae, Quantity
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$120.00
$40.00
$74.00
$110.00
Phone:
License:
Expiration Date:
Phone: -7:',7
Total (Quantity x Unit Charge)
$ 7 oU
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-
468, The Ci y of Port Angeles Municipal Code, and Utility eci cations and PAMC 14.05.050 regarding Electrical Permit Applications.
D to Print Name Signature (❑ Owner Electrical Contractor/ Administrator)
[Electrical Permit Applications maybe subitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]
-0
3
4t
V
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application'Numkzer 18-00000911 Date 6/14/18
Application pini number 630621 _ _..
Property Address 2122 W 14TH $T
REPORT STATE SALES TAX
ASSESSOR PARCEL NUMBER: 06 -30 -01 -.6 -0 -3000 -0000 -
Application type description ELECTRICAL ONLY an your GXcise fax form
Subdivision Name - Ch Ch -of PC3Cf AhgWeS
Property Use
Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . . . . 0
Application desc
1 circuit
----------------------------------------------------------------------------
owner
Contractor
ARP-70DT MARK B
TWETER ELECTRIC
2121 W 14TH ST
423 BLACKHAWK LOOP
PORT ANGELES
WA 983635120
PORT ANGELES
WA 98362
(360} 417-1151
Permit . . . .
. ELECTRICAL ALTER RESIDENTIAL
Additional desc .
. 1-4 CIRCUITS
permit Fee . . .
. 75.00
Plan Check Fee
.00
Issue Date
6/14/18
valuation
0
Expiration Date
12/11/18
Qty Unit Charge
.Per
Extension
BASE
FEE
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
INSPECTION TYPE DATE:
DITCH
SERVICE
ROUGH -IN
FINAL "
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
RESULTS:
INSPECTOR:
Signature of oder or Electrical Contractor X Date: