HomeMy WebLinkAbout735 W 13th St - BuildingNAME OF PREMISES 7 l V 6 4f H /7 �I
SERVICE ADDRESS 3 ,5' A/ 3 c 2 X 6 r
LOCATION OF DEVICE. 7I' r A/ 4 r' AYE
ar
ASSEMBLY /j/ f 6 4 /8 9 G X
Manufacturer Model
IS THIS AN APPROVED ASSEMBLY? YES 141\10 IS ASSEMBLY INSTALLED CORRECTLY? YES fa-'NO
U
DATE OF INSTALLATION L t 61 UNKNOWN❑
Initial
Test
Repairs
Details
Final
Test
COMMENTS
DOUBLE CHECK VALVE ASSEMBLY
CHECK VALVE #I CHECK VALVE #2 RELIEF VALVE PVB /SVB
Leaked
Held at ?psi
Cleaned
Replaced
Held at ?psi
AIR GAP INSPECTION
REQUIRED MINIMUM SEPARATION YES NO
Initial
Test
Repairs
Final
Test
Date'Tirne Tester
REDUCED PRESSURE PRINCIPLE ASSEMBLY
Leaked
Closed Tight
Held at $psi
7 1 V' 1> E e l. t.:k•
Backflow Assembly Test Report
City of Port Angeles
Public Works and Utilities Department
Water/Wastewater Collection. Division
Cleaned Cleaned
Replaced Replaced
Closed Tight
Held at Ppsi
Signature
L t i ce..
Did Not Open
J (c
Size
Opened at psi
3 psi Buffer YES NO
Opened at psi
Cert. Test Kit
WHITE CUSTOMER COPY YELLOW PURVEYOR COPY PINK TESTER COPY
RP RPDA
DC B'"'" DCDA
PVB Air Gap
SVB AVB
AIR INLET
Did Not Open
Opened at psi
Leaked Held at psi
REPAIRS
Cleaned
Replaced
TYPE OF HAZARD 4 /4/
Line Pressure psi
Held Backpressure YES NO
#2 Shutoff Held YES IQ' NO
Relief Valve Exercised YES NO
Official Use Only
Assem.# T
w
Received
/fC 9
Serial No
CHECK VALVE
AIR INLET Opened at psi
CHECK VALVE Held at psi
BACK PRESSURE NO YES
Passed Failed
0
��tt""
/5P ru '7 /n6LC 1 r
0
Owner
JONELLE STEVEN CHAPMAN
735 W 13TH STREET
PORT ANGELES WA 98363
(360) 417 9531
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 08 00000779
Application pin number 896600
Property Address 735 W 13TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 3 7350 0000
Tenant nbr name STEVEN CHAPMAN
Application type description PLUMBING REPAIR
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 100
Application desc
LAWN SPRINKLER SYSTEM BACKFLOW VALVE
Contractor
OWNER
Permit PLUMBING PERMIT
Additional desc LAWN BACKFLOW PROTECTION
Permit pin number 129247
Permit Fee 57 00 Plan Check Fee 00
Issue Date 7/03/08 Valuation 100
Expiration Date 12/30/08
Qty Unit Charge Per
BASE FEE
1 00 7 0000 ECH PL- EA LAWN BACKFLOW
Fee summary Charged Paid Credited
T.Porms /Building Division/Building Permit (05 /13 /08).wpd
Date 7/03/08
Due
Permit Fee Total 57 00 57 00 00 00
Plan Check Total 00 00 00 00
Grand Total 57 00 57 00 00 00
Extension
50 00
7 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
7/3/ 3 e/ 0 7 Cl /4/0,
Date -Print Name 1 Signature of Contractor or Authorized Agent
Signature of Owner Jwner is builder)
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
CALL 417 -4815 FOR BUILDING INSPECTIONS CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES CALL 417 -4886 FOR BACKFLOW PREVENTION 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 AND APPROVED PLANS AT THE JOB SITE.
INSPECTION TYPE DATE 1 ACCEPTED COMMENTS
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 O
BACK FLOW WATER l7 d R
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
PLANNING DEPT SEPARATE PERMIT M's
PARKING/LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT 417 -4735
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
I FIRE 417 -4653 I
PLANNING DEPT 417 -4750
1 BUILDING 417 -4815 1
T 1 dill lrii n,vi ,/R lri5 ermit (05 /13 /081.wnd
BUILDING PERMIT INSPECTION RECORD
YES 1 NO
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
DATE YES NO COMMERCIAL
FINAL DATE ACCEPTED BY.
SEPA.
ESA.
SHORELINE.
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
PLANNING DEPT
BU1LDING
DATE I ACCEPTED
YES 1 NO
I I
I I. I
I I. I
FINAL DATE ACCEPTED BY. 1
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
W (360) 417 -4815 fax (360) 417 -4711
Applicant or Agent
Phone 1 7-?_53I
Property Owner 5 Phone
Property Owner's Address 7 3 3f 5-L PA. Q'
Contractor /Engineer 3/L%P// Phone
Contractor /Engineer's Address
License Expires
PROJECT ADDRESS
Parcel Number
Project Type Brief Description. *Residential Commercial Multi- family Industrial
Check all that apply
New Construction
Addition rIDL4J ��J� Welt- /i
Remodel
Repair
Re -roof
Demolition
Heat System Heat pump wood burning stove gas fireplace ❑.pellet stove other
**Other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq ft.
1 Floor
2nd Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
BUILDING PERMIT APPLICATION Print in ink
Total footprint of structures sq ft. T Lot size
Max. height of proposed structures ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant Toad
Will a fire sprinkler system be installed? Construction type
T:Forms /Building Division /Bldg Permit Appl. -2006 Code.doc
For City Use Only
Date Received "7-6;-- 08
Permit 0
Date Approved'
Lot Zoning
TOTAL VALUATION Dv C.90
sq ft. Lot coverage
of bedrooms
of full baths
of half baths
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 permits are required, and to obtain permits prior to working on
projects.
9
Date /08 Print Namc i-T /?l
ef/ /24 C... 3 h 4 h1 Signature /�ij :ice
i
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N'!
17421
Port Angeles, washlngton...___.L.i2___.::.i..___...___...uu___....._.___.___. 19_-,~~::_.(J
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 d6 electrical work as listed below.
Address ..u./..:!...~~.u~../..Jutt.7F---.u----muuum-u Occupancy....,.!1..~~.u___u.__._u___u_u
Owner u..u,,Q~~~:..---~~"f,<<V.eP ,q~r~;-.-------.---.----..m.---.--.---uuu----..u.----..----.....u..
Wiring Contractor ___uu!7-'1C...,i2t2.~:!..~d:2___.u('"'--.."C[1By..uu---...---------...--.---.------u.----um.u___._.._uuu__u
Light Outletsnn___n___n___n.___.________n_.___. Service. volts n./~Yn::-:'n~~.___ Type of Wiring:
Receptacle Outlets....m.............n......... No. wires ........m............_......r.':'..... Armored Cable ..............................
SI I Y / Cl aJ" Non.Metalltc _____.______nn________n_______
ze w res..................................._..
:::Je;>oA
Main fuse ...._............................,....
Enclosure .~5............m.m:....~.~..~
Dryer, KW...n...__................................
Range, KW m..__m.......m..mm..
Water Heater:
KWmmnnFzmun.n.nnn.mn
Heat: Kw.___I.?I",.~:.'7~",.g~g.
~tY.~lzz:..~I;;:*__
Type of wiring:
Entrance Cable .......mmm.............
Rigid Conduit ....................m........
Metallic Tubing m........................
Current transformers:
No. & Size.............................
Ser. No..............................................
Ser. No. .............................................
Ser. No..............................................
Knob & Tube.______.nnn___n._____n___._
RIgid Conduit ___.n________n___nn.n.___.
Metallic Tubing ......._....m......._..
Raceway .......................-.....-.--.-
Circuits, LighL.................................._..
Utility .______._________nn.nnn___n.___________ ~
Heat .......................-........-..----
Range .............................................
Water Heater ...............................
Motor .............................................
Dryer .....................-.......................--
Furnace .........................'h...................
Remark:~ta:u~~,~=:..;.~;.=:;;.:u/~_~:~t__::.L~~~~__:....______.___...u___.:~:::.__:::.::::.:::~::...:__.:::.:::~.:~::
________..______..___u____..___________...__.__.__.___.___.______..__._...__.___...._.._._______.____.____._..--...--------..-..--.....--.---.--.--------......--.---....-----
::~~~=:----::-:?:~=---~~i'Z~~:
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
ELECTRICAL PERMIT
N?
17421
Address..................._...................................................................................................................Date..._......_..~.._.._.........._......-......-..-...-
Owner ..................................._.........._......_......_.._........................................................... TenanL...................................................................
,
Wiring Contractor ..................................._......................_............................................................. By ..............................................................
NGlTICE-Current must not be turned on until Certi!lcate of Inspection bas 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 Olympic Pdnt.", Inc.
'\.'-..
HUME
CITY OF PORT ANGELES PERTMIT APPLICATION
Building DivisionCElectrical Inspections
321 East Fifth Street — P.O. Box 11501 Port Angeles 'Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Dated r t �_J q CA 1& 2 Single Family Dwelling
APR 21 20h
(ELECTRICAL
INSPECTIONS
*Plan Review May Be Require , Pie se Com fete. Electrical Plan Review Information Sheet
Job Address: _
Building Square Footage: t 6 oo . E
Description of above GtC v J-c
-Al- 1-1 - q'; -�
Owner Jnformat o
Contractor Information
Name:. `ice
Name; _,��
Mailipg ddress, ' �'
Mailing Address:
City �> State:' zip:
City: Stale: Zip:
Phone Fax: --
Phcne: Fax:
License # 1 Exp.
License #lExp.
Item
Unit Charge
Qty Total (Qty Multiplied by Unit Charge)
ServicelFeeder. 200 Amp.
$120.00
$
Service/Feeder 201 -400 Amp.
$146.90
$
Service/Feeder 401 -600 Amp
$ 205.00
$
Service /Feeder 601 -1000 Amp.
$ 262.00
$
Service /Feeder over 1000 Amp.
$ 373,00
$
Branch Circuit W1 Service Feeder
$ 5.00
$
Branch Circult WIO Service Feeder
$ 63,00
�� $
Each Additional Branch Circuit
$ 5.00
S $ La 01
Branch Circuits 1-4
$.75.00
$
Temp. Service/ Feeder 200 Amp.
$ 93.00
$
Temp. ServicelFeeder201.400 Amp.
$110.00
$
Temp. Service /Feeder 401.600 Amp.
$149.00
$
Temp. Service /Feeder 601.1000 Amp .
$168.00
$
Portal to Portal Hourly
$ 96.00
$
Signal Circuit) Limited Energy • 1 & 2 Family Dwelling
$ 64.00
$
Manufactured Home Connection
$120.00
$
Renewable Electrical Energy - 5KVA System or Less
$102.00
$
Thermostat
$ 55.00
$
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
$ 40.00
$
Each Outbuilding or Detached Garage
$ 74.00
$
Each Swimming Pool or Hot Tub
$110,00
$__ o
$ -73 — Total
Owner as defined by RCW.19.29.261: (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 properly or a licensed electrical contractor, I am malting
the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, VVAC. Chapter 296 -46B, The City of Port
Angeles Municipal Code, and Utility Specifications and PANIC 14.05.050 regarding Electrical Permit Applications. 0V NyX_(Z—
Signature of owner, electric4l,,;ontractor r electrical administrator, ❑ Cash ❑ Chlecckk,�
- "� n, :. .:\ .✓ " j ,r' _.� -y ! ❑ Credit Card U
Dated: 4) Oil 01)2012 ? [ h
0Fp0R'rgNGfi ELECTRICAL INSPECTION
WIRING REPORT
I(s 417-4735
DAT rRVIT # INSPECTOR
),Z
lizz
jj�
OWNrRICONTRACTOR
15-
v C—�
ADDRESS
�7
APPROVED NOT APPROVED
0 .. — . .............. DITCH ...... ...... ...... 0
0 ................ ROUGH IN/COVER .............
Ll ... .............. . SERVICE ............ ...... 0
0 ........... ......... FINAL .................... Ll
CORRECTIONS NEEDED: 4-1ZO1) KI) ALL_ V-nTETV-, -
S-T-F')'F L:Y-1; - - --
L?!; � I 'FZ 2 It
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
OLYMPIC PRINTERS, INC. (360) 452-1381
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number . , , , .
14- 00000473 Date
4/21/14
Application pin number , , .
962507
DITCH
Property Address , . . . . .
735 W 13TH 9T
ASSESSOR PARCEL NUMBER;
06 -30 -00 0-3- 7350 -0000-
Application type description
ELECTRICAL ONLY
Subdivision Name , , , . . .
Property Use , . , , ,
FINAL
Property Zoning . . . . . . .
RS7 RESDNTL SINGLE FAMILY
Application valuation
0
Application desc
3 circuits basement rewire
Owner
Contractor
CHAPMAN JONELLE, STEVEN
OWNER
735 W 13TH STREET
PORT ANGELES WA .98363
{3(50) 417 -9531
Permit , . . . . . ELECTRICAL
ALTER RESIDENTIAL
Additional desc . .
Permit Fee 73.00
Plan Check Fee
00
Issue Date 4/21/14
Valuation , , , ,
0
Expiration Date 10/18/14
Qty Unit Charge Per
Extension
2.00 -?Y!' 5.0000 ECH EL -ECU
ADDNT BRANCH CIRCUIT
10.00
1.00'::,`' +i'' 63.0000 ECH FL -R-
BRANCH CIR WO/ SER FEED
53.00
Fee summary Charged
Paid Credited Due
Permit Fee Total 73.04
73.00 .00
;00
Plan Check Total .00
.00 .00
'Co
Grand Total. 73.00
73.00 .00
.00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Coate 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date.:
GA EXCHANGEIBUILDING
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