HomeMy WebLinkAbout915 W 6th St - Building RECEIVED c?� 0 4*
CITY OF PORT.A,N�GELES PERMIT APPLIO.A nON UN 201
or
Building Division/Electrical IBspectivas fp
321 East Fifth Street—P.O.Boar 1150/Fort Angeles Washington,983 ELECTRICAL
62 �IUNS �"°,,••
Ph:(360)417-4735 Fax: (360)417-4711
Date: 1 &2 Single Family Dwelling
*Plan Review May Be Required, Please Complete Electricai Plan Review Information Sheet
Job Address: i
Building Square Footage:
Dascdption of above
Fg teal C-- 48-0 co 4 r +-0 (YL&Aer-G a.S.R
Owner Information Contractor fnformatf on
Name: ✓7 Name l�f�srtt iLGti'r'c.
Mailing Address: 2- Mailing Address: P c3, 00 K -3 In
City: 4 l 1 Nr1 tats: (&Lr ,,.Zip-, C?X��ss"72- City: 3-4 Lt i acv State:, W gn dip: 9 9,5k
Phona: -+�5 ax., _ Phone�_G,, sx3-A2 tVax-.
Ucense 9I Exp Lioense 1#1 Exp.., _. _........
Item Unit Clfarge 9k Total flay MulfigQed by Unit Charge)
Service/Feeder 200 Amp, $120,00 —j— $--L2=0
ServicelFeeder 201400 Amp. $146.00 $
Service/Feeder 401-600 Amp $205.00 $
Service/Feeder 601-4000 Amp. $262.00
Sorviw,f eeder over 1000 Amp. $373.00 $
Branch Circuit WI Service Feeder $ 5.00 $
Branch Circuit W!0 Service Feeder $ 6100 $ T
Each Additional Branch Circuit $ 5.00 $,_.,_, _ 400 d-ln4
Branch CiriuUTA $ 75.00 $ �qL�) W)'XL�-
Temp,Servical Feeder 200 Amp, $ 83,00 $_- _ - r~(n£C (Gy
Temp.Servin/Feeder 201-400 Amp, $110.00
Temp.ServiciJ-Feeder401-600 Amp, $149.00 $
Temp.ServloelFeeder601-1000 Amp. $168.00 +A i 5
Portal to Portal Hourly $ 86.00
Signal Circuit/Limited Energy-1&2 Family Dwelling $ 64.00
ManufaOurad Home Connection $120.00 $ fcnUL0
Renewable Electrical Energy-5KVA System or Less $102.00 $ Y`Y r
Thermostat $ 56,00 $ a�a+��
Note:$5.00 for each additional T-Scat rye►z'�
NEW CONSTRUCTION ONLY:
First 1300 Square Ft. $120.00 $
Each Additionat 500 Square Ft.or Portion of $ 40.00 $
Each Outbuilding or Detached Garage $ 74.00 $
Each Wmming Pool or Not Tub $110.00 $
$Total
Owner as defined by RCW.19.28,261,(1)Owner will occupy the structure for two years after this electrical peimit 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 th at I am the owner of the above named property or a Ilcensed electrical contractor.I am making
the electrical installation or alteration in compliance with the electrical laws,RE.C.,RCW.Chapter 19.28,WAG.Chapter 296.466,The City of Fort
Angeles Municipal Code,and Utility Specifications and PAMC 94.05.050 regarding I`lectAml Permit Applications.
Signature of owner,electrical contractor or electrical administrator: ❑ caah ❑ Chock
t Credit card dt
dated: f4� 7° �� 1311DU2012
ELECTRICAL PERMIT l
CITY OF PORT ANGELES
360-417-4735
Application Number , , . . . 13-00000610 Date 5/06/13
Application pin number , . , 513660
Property Address , , . . . , 915 W 6TH ST B RCP�n��+n��� TAX
ASSESSOR PARCEL NUMBER; 06-30 00 0-1-.p 780 OOOp- REPORT A 1
Application type description ELECTRICAL ONLY on your excise tax form
Property Name to the City of Port Angeles
Pra ert use
Property Zoning . . , , . , . RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . . , . 0
Application desc
200 amp service
Owner Contractor
RAWLINS TTE, ROBERT J KIRSCH ELECTRIC INC.
726 W ANDERSON RD P. O, BOX 3396
SEQUIM WA 98382 SEQUIM WA 98382
(360) 651-2584 (360) 683-6819
-=------------------------------- ----------------- -_----------------------
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee 120,00 Plan Check Fee
Issue Date . . . . 6/06/13 Valuation 0
Expiration Date . . 12/03/13
Qty Unit Charge Per Extension
1.00 120,0000 ECH EL-0-200 SRV FEEDER 120.00
--- ---___- -_ -------------------- ------------------ .._-.-- -----
Fee summary Charged Paid Credited Due
Permit Fee Total 120,00 120.00 .00 00
Plan Check Total .00 .00 .00 00
Grand Total 120.00 720,00 .00 00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL �z
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:IEXCHANGE\BUILDING
PREPARED 12/22/09 8 04 18 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 12/22/09
ADDRESS 915 W 6TH ST SUBDIV
TENANT NBR R HOLDING CO
CONTRACTOR LARRY S ROOFING PHONE (360) 452 2215
OWNER R HOLDING CO PHONE (360) 681 2584
PARCEL 06 30 00 0 1 0780 0000
APPL NUMBER 09 00001314 RE ROOF
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01
12/22/09
BLDG FINAL
December 21 2009 3 37 06 PM 1pangrle
TOM 452 2215
BLDG FINAL RE ROOFED THE HOUSE
COMMENTS AND NOTES
Date Print Name
T:FormsBuilding Division/Building Permit
CITY OF PORT ANGELES
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
Application desc
TEAR OFF RE ROOF THE HOUSE
09 00001314
182428
915 W 6TH ST
06 30 00 0 1 0780 0000
R HOLDING CO
RE ROOF
RS7 RESDNTL SINGLE FAMILY
8560
Owner Contractor
R HOLDING CO LARRY S ROOFING
ROBERT RAWLINS 352 AVIS ST
726 W ANDERSON RD PORT ANGELES
SEQUIM WA 98382 (360) 452 2215
(360) 681 2584
Structure Information 000 000 TEAR OFF RE ROOF HOUSE
Fee summary Charged Paid Credited Due
Date 12/14/09
WA 98362
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF RE ROOF HOUSE
Permit pin number 158246
Permit Fee 193 75 Plan Check Fee 00
Issue Date 12/14/09 Valuation 8560
Expiration Date 6/12/10
Qty Unit Charge Per Extension
BASE FEE 95 75
7 00 14 0000 THOU BL -2001 25K (14 PER K) 98 00
Other Fees STATE SURCHARGE 4 50
Permit Fee Total 193 75 193 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 198 25 198 25 00 00
N
2 2 0
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 ovisions of laws and ordinances governing this type of work will
be complied with whether specified herein or not. The granting of a pNnit d of pre ime to give authority to violate or cancel the provisions of any
state or loc tI law regulating con, tructiory the performance of const
Signature of Contractor or Autho zed Agent Signature of Owner (if owner is builder)
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.
Inspection Type Date Accepted By Comments
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
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 Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION.
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Fumace 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.
Parking Lighting 1 ESA.
Landscaping 1 SHORELINE.
T:Forms /Building 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
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831 1
Fire 417 -4653
Planning 417 -4750
Building 417 -4815 I2- Z2. -01 I a Li_
uT,
c s
PROJECT ADDRESS
Parcel Number
Project Type Brief Description.
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
1] Re -roof
Heat System
Other
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be insta ied?
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
1
Applicant tom
Property Owner J am W tb I i r,
Property 9 O per's dr s
Contractor 0 i n1
Contractor's Address iS St 't foOlcs
License opt C0$$LY1 Expires j 11
Residential
,ki Multi family
3A House garage other tear.off re -roof lay over one layer
Heat pump wood- burning stove gas fireplace pellet stove other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq ft.
1st Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION OJ p0
Total footprint of structures sq ft. T Lot size sq ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel including structures paved driveways sidewalks patios
and other impervious surfaces (see PAMC 17 94 135 for exemptions) Site coverage
Occupancy group
Occupant load
Construction type
I have read and completed this application a, d know it to be true and correct. I air a 'Ihorize
that it is my responsrbrid} to determine what permi are required and to obtain permits prior to
Date I —0 q t Print Name (,Gm Signature
T Form 'Building Division /Building permit applica is
Phone
Phone
Phone
E -mail
Lot
to appl
ork, '3g
For City Use Only
Date Received I I4
Permit# Chi 1314
Date Approved
Zoning
Commercial
of bedrooms
of full baths
of half baths
this permit and ,inderstand
o ejects
Industrial
Clallam County Assessor Treasurer Property Details 56562 R HOLDING CO for Y Page 1 of 5
Clallam County Assessor Treasurer
Property Search Results 56562 R HOLDING CO for Year 2009 2010
Property
Account
Property ID
Geographic ID
Type
Tax Area:
Open Space:
Historic Property
Multi Family Redevelopment:
Location
Address.
Neighborhood:
Neighborhood CD
Owner
Name
Mailing Address'
Taxes and Assessments Due
Amount Due if Paid on.
Statement
Year ID
2009 565622008
2009 565622008
2009 565622008
2009 565622008
2009 565622008
56562
0630000107800000
Real
0010
N
N
N
915 W SIXTH ST
PORT ANGELES
Cycle 5 Res
10955130
R HOLDING CO
ROBERT.RAWLINS
726 W ANDERSON RD
SEQUIM WA 98382
Property Tax Information as of 12/14/2009
Taxing Jurisdiction
ST SCH STATE SCHOOL
CC -GEN COUNTY
PORT PORT
PORT ANG PORT ANGELES
SD• #121 SCHOOL DISTRICT #121
Legal Description
Agent Code
PA 121 PORT ST CNTY H2 L Land Use Code
DFL
Remodel Property
Mapsco
Map ID
Owner ID
Ownership
Exemptions:
First
Half
Base
Due
Second
Half
Base
Due
$219 67 $219 67
$111 17 $111 18
$15 75 $15 75
$243 85 $243 84
$271 67 $271 65
2009 565622008 NTH OLY LIB NORTH OLYMPIC LIBRARY $32.30 $32.31
2009 565622008 HOSP #2 HOSPITAL #2 $45 59 $45 60
2009 565622008 CITY_STORMWATER CITY STORMWATER $36 00 $36 00
2009 565622008 WEED_CONTROL WEED CONTROL $0 82 $0 81
2009 565622008 TOTAL. $976.82 $976.81
2008 565622007 ST'SCH STATE SCHOOL $233.28 $233.27
2008 565622007 CC -GEN 'COUNTY $112.89 $112 86
2008 565622007 PORT PORT $16 49 $16 49
2008 565622007 PORT ANG PORT ANGELES $243 08 $243 07
2008 565622007 SD #121 SCHOOL DISTRICT #121 $272 10 $272 08
2008 565622007 NTH OLY LIB NORTH OLYMPIC LIBRARY $32 80 $32.79
2008 565622007 HOSP #2 HOSPITAL #2 $11 21 $11.21
2008 565622007 CITY_STORMWATER CITY STORMWATER $36 00 $36 00
2008 565622007 WEED CONTROL WEED CONTROL $0 82 $0 81
LOT 17 BL 107
12
N
N
Penalty
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0.00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
47493
100 0000000000%
Interest
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0.00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
Base Amount
Paid Due
$439 34 $0
$222.35 $0 00
$31 50 $0 00
$487 69 $0 00
$543 32 $0 00
$64 61 $0 00
$91 19 $0 00
$72 00 $0 00
$1 63 $0 00
$1953.63 $0.00
$466.55 $0 00
$225 75 $0 00
$32.98 $0 00
$486 15 $0 00
$544 18 $0 00
$65 59 $0 00
$22 42 $0 00
$72.00 $0 00
$1 63 $0 00
ke/ cc\\'
http /vnn clallam net 8084 /nrooertvaccess /Property asnx?k d= 0 &vear== 2009 &aron id =5 12/14/2009
v
I.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
PERMIT NO. Z 77 &
DATE B-/4-"")D
Site Address:
~/? W, Con+ ~.
Installed By:
ELL. KosBAr8>
Owner/Business:
S","/JIe
Owner/Business Address:
o READY FOR 0 WILL CALL FOR
INSPECTION INSPECTION
License Number: Phone:
4 7-
Phone:
Sq. Ft.
'li-Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
o New Construction
o Remodel
~Service update/alter/repair
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
o Overhead
o Underground
Voltage /Ze>/"Z-AO
~10 03.0
Service size ,'2$
o Temporary
Amps
DetailslDescription: C-1+.A1J6ItJl::1 EILI?TluG 'Z.. M.E.Te..~ OUpLeX. Tb
"5llJbLE. MBTElZ SIN.C:7Le r,a...MI~ l2E~lD8Ma:
r.tH!\-r-lC:lE 2.- Z.oOA M.eTEll-S 10 1- 3z6A MeTelC..
.
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough-in/cover O.K.
~if?l O.K. to connect service
tf'''P Final O.K.
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for Installation
o Fire Department notified of inspection
o Plan Review approved/pending
Site Address:
Permit/Receipt No.
~ 1'7 vJ. l..r:m+ ?t; 7.. 77~
Installer: New Meters Date:
o-:,P.>AP.>
a-C4--"'Jo
.
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224.
~-Z-,?qg E'>~
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYMPIC PRINTERS. INC.
~
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 15914
;7 ,-reI )>
port Angeles, Washington______m__m__m__...______m_m__m__m__m______m_. 19_m_~-
In aCilordance 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 ajCal work as listed below. ,
Address ...__.'l(~:.?!::!___0__:g:.mY_-.tl.;[-!iJ~:!.--fi~upancy---.------......-----....---__.__._mm.____..
~:;::~.~~~::~~~-:?~~-=~:::~::__._~~:~~~;:::::::::::::-..:.....~~:::::::::=:::::::::::::::::::::::::::::::::::::::
Light Outl.ts..____.__._........._....._........__.... S.rvlc., volts ...I...?c:/...?.-?:f..--__ Typ. of Wlrtog:
Receptacle Outlets___......__________........_... No. wires ..__..-:;!..............______.__..... Armored Cable .............---............-
Dryer, KW m_____mm_____.____________._________ Slz. wir.s__~:;......-----...----- Non.M.talllc -.-----------...------..--------.
,. ,.~" A Knob & Tube____............................._
Range, KW h......h.................._......._ Main fuse ......~:..:-----... -- ------.......
Enclosure __.....2..__..______...____.........
Rigid Conduit .______..._____________..._____
Water Heater:
~;X Kw______7.______?I.y.__i!P
Metallic TUbing .___n_._........__........
Heat: KW.............__...............____n__n__...
Type of wiring:
Entrance Cable _______.__..
Motors: size. volts and phase:
Rigid ConduIt m____.h......
Metalltc Tubing ...'....
Current transfonners:
No. & Size.______________.....___.....____.......
Raceway ..............................._......_
Circuits. Light................________...............
Utlllty ____.._____.__..._____________........._____.
Ser. No.__.....__..............................____..
Heat ...................................._.._......
Range ...................__........._._......._....
Water Heater ...........____................
Motor ...n...................________........__...
Ser. No. ____....................____..._.............
Dryer ....______.................__...............__.._
Furnace . .........................~......_...........
Ser. No.._________.................................__.
Total Load__...____....____............
S"-lc No.____________________________...________.__.__
Total ................._..................___
Remarks: _______________________m_/L#....~~~",!iL_________m......_.___________m_mm_......__________.______m__m......____m_mm__
;~_=.~~__~::_.._____.__.____m. ::~_~_~:__~~_~.~~.~.~........ By ;ttf!..la~lLL~:.~------.---
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con.
cealed due noUce 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?
15914
Address
Date..._......_.._.._.._.........._......_......_.........
"...
Owner ................_......_.~......._......_.._......_......_.._.................__.................._..................... Tenant........................nn..........u............................
\
Wiring Contractor..........................................................._..............................._......._......,........._.... By......_..................._..........._.......................
NOTICE-Current must not be turned on until Cert1tJcate of Inspection has been issued. I.f work is to be con.
_._cealed due notice must be given the Inspector so that work may be inspected before concealment.
'"
-----
n1..~~.~ D~,~......t:: f__
--
--
CITY OF FORT ANGELES PEMT APPLICATION
Building Divisioru/Electrical Inspections
321 East Fifth Street — P.G. Bax x.11.90 / Port Angeles Was6iragton, 95362
Ph: (360) 417 -4735 Fax.: (360) 074711
Date: 1.3
_ 1 & 2 Single Family Dwelling
* Plan Review May Be Reguired, Please Complete Electrit;al Plan Review Information Sheet
Job Address:
Building Square Footage:
Description of above
Owner Intonation
Name: e W) i n
Mailing Addressi 7 is iii .
Qity:A. ►_� ►. _ __ _ State: _ Zip: A i� � �m-
Phone-" ax:
Licanse l Exp.
Item
SorviceiFeeder 200 Amp.
SeNice/Feeder 201 -400 Amp.
Servlce/Feader401.600 Amp
ServlcelFeeder 601 -1000 Amp.
ServiCelFeadar over 1000 Amp,
Branch Clrcult W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service! Feeder 200 Amp.
Temp, Servlce/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 Family Dwelling
ivlanuiactured Home Connection
Renewable Electrical Energy - 5KVA System or Less
Thermostat
Note: $5,00 for each additional T -Star
NEKQQNSTRUCTION ONLY:
First 1300 Square Ft,
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hat Tub
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
$ ies.00
$ 96.00
$ 64,00
$120,00
$ 102.00
$ 56.00
$120.00
$ 40.00
$ 74,00
$110.00
Contractor tnformaUon �� r n �� 10
Noma, c,
Mailing Address: _e &X
City. ,a. State: !g -Zip: -
Phone: -(a Fax:.3
Ucenso # 1 Exp.
Total (Qtv Muitielle Sr nit.Charoe)
$
$
$ �1 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 afteration in compliance with the ebctrical laws, N.E.C., RCW. Chapter 19.28, WAC, Chapter 29646f3, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC'14.05.050 regarding � cbical Permit Applications.
Signature of owner, elactrtcal contractor or electrical administrator: O cash ❑ Check
'c ditCard* dn'�Q
X Wed_ _ ��� �i f� 01J0112012
V~
lit
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . . 13- 00000429 Date
6/06/13
Application pin number . . . 286111
RESULT'S:
Property Address . . . . . . 915 W 6TH ST A
DITCH
ASSESSOR PARCEL NUMBER: 06-30-00-0-1- 0780 -0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use
Property Zoning . . . RS7 RESDNTL SINGLE FAMILY
ROUGH -IN
Application valuation . . . . 0
h z7
Application desc
1--4 circuits outlets
----------_--__--------------------------__----------------------__°__-_-------
Owner Contractor
RAWLINS TTE, ROBERT J KIRSCH ELECTRIC INC.
COMMENTS:
726 W ANDERSON RD P. 0. BOX 3396
SEQUIM WA 98382 SEQUTM
WA 98382
(360) 681 -2584 (360) 663 -6819
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional de8c 1 -4 CIRCUITS
Permit Fee 195.00 Plan Check Fee
.00
Issue Dade 4/25/13 Valuation
0
Expiration Date 10/22/13
Qty Unit Charge Per
Extension
BASE .FEE
75,00
1.00 120,0000 ECH EL -0 -200 SRV FEEDER
- 120`00
Fee summary - Charged Paid Credited
Due
Permit Fee Total 195.00 195.00 .00
.00
Plan Check Total .00 .00 .00
.00
Grand Total 195.00 195.00 .00
.00
? I
1
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULT'S:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
h z7
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX {6} MONTHS FROM LAST INSPEC'T'ION
Signature of owner or Electrical Contractor X Date:
G:; EXCHANGEII3UILDING
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IV