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Home My WebLink About1004 W 16th St - Building AUG-6-2013 20:23 FROM:BOBS ELECTRIC 3604529943 TO:4174711 P.1/1 CITY OF PORT ANGELES FERMT A.PpucAnON Building Division/Electrical inspections � ' 321 last Firth Street--F-D.Box 1150/Port Angeles Washington,95362 Ph; (360)417-4735 Fax: (360)447-4711 ELECTRICAL Date: ^Multi-Family or Commercial' INSPFCTIQNS "Plan Revie1 f Please Comp�e e ical Plan Review Information$heel Job Address: Q _ T Building Square Footage: Descrlow of above 44�V1 OwneAddrw"=. ' rmation �°' Contra r Infomtatl Name; Name: Malling Mailin g dress: 1j a City: State. p. Clty: State: 21p: Pfio Fax: Phon zz2o JaK, Ucanso#I Exp. Uoeas x Item Unit Charao gty tti lied p limit Ch ServiWFeeaer 200 Amp. $132.00 $ ServicWFeeder 201-400 Amp, $160.00 ServloalFeedor 401.600 Amp $226.00 -- - $--� Service/Feeder 601-1000 Amp, $288,00 $m--- ServicalFeader over 1400 Amp. $410.00 Branch Clmult WI Service Feeder $ 5.00 $ Branch Circuit W10 Service Feeder s 74,00 Each Additional Branch Circuit $ 5.00 Branch 0=11$1-4 $ 86,00 Tamp.Serv(cel Feeder 200 Amp. $102.00 __Tom p-ServicelFooder201-400 Amp. $121.00 — $ — Temp.ServicOooder401-600 Amp_ $164,00 $------�-~ Temp.ServloeJFeeder 801-1000 Amp. $185.00 $ Portal to Portal Hourly $ 95.00 — $--------- SlgnlOubine lighting $ 88,00 $— Signal Circuit!Limited Energy-Multi-Family $ 64,00 Signal Clraultl Limited Energy I Fast 1500 6f-CamW W $ 96.00 Note: $.5,00 for eaO additional 1ti00 ef $ Renowable Electrical Energy-5KVA System or tees $113.00 $ Thsmtostat $ 56.00 ��- Note:$5.00 for each additional T-Stat s '0Trstal Owner as defined by RCW.19,28,261:(1)Owner will occupy the structure for two years after this electrical permit is Pnalized,(2)Owner is required to hire an electrical contractor if above said property is for sale,rent or lease.Permit expires after six months of last inspection, After reading time above statement,I hereby certify that l am the owner of the above named property or a licensed electrical contractor,I am making the electrical installation or alteration in compliance with the electrical laws,N,E.C,,RCW,Chapter 19,28,WAG,Chapter 296.468,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner,electrical contractor or electrical administrator: 0 CA o enr. Cndlt Caro K lam; —___ otm,r�alz ELECTRICAL PERMIT 1 CITY OF PORT ANGELES 360-417-4735 Application Number 13-00000894 Date 8/07/13 Application pin number 999184 Property Address , , , • . , 1004 W 16TH ST REPORT SALES TAX ASSESSOR PARCEL NUM13ER: 06-30-00-0-4-4115-0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name . . , . . . to the City of Port Angeles Property Use Property Zoning , , . . , . COMMERCIAL NEIGHBORHOOD (Location Code 0502) Application valuation . , . . 0 --------------------------------------------- ------------ Application desc xray and circuits Owner Contractor PENINSULA BEHAVIORAL HEALTH SOB'$ ELECTRIC INC 118 E 8TH ST 2293 PEER PARK RD, PORT ANGELES WA 983626129 PORT ANGELES WA 98362 (360) E457-6887 . _ --°--------------- --`--Permit ------- . ELECTRICAL ALTER COMMERCIAL Additional desc , . .00 J Permit Fee , . . , 84,00 Plan Check Fee , . 0 r� Issue Date , . . . B/07/13 Valuation . . . Expiration Date . , 2/03/14 Qty Unit Charge Per Extension 1,00 74.0000 ECH EL-CORM BRANCH CIR WO/ S/F 74,00 2,00 5,0000 ECH EL-ECH ADDNT BRANCH CIRCUIT -----` 10,00 --°---------------m----- -----------------.- ------- ee summary Charged Paid Credited Due F Y Permit Fee Total 84.00 84.00 OD •00 Plan Check Total 00 .00 00 .00 Grand Total 84,00 84,00 .00 •00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN And 1 FINAL COMMENTS: PERMIT WILL EXPME SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: GAIEXCFIANGE1BUILDING PREPARED 6/12/09 9 22 25 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/12/09 ADDRESS 1004 W 16TH ST SUBDIV TENANT NBA PEN COM MENTAL HEALTH CONTRACTOR PHONE OWNER PENINSULA COUNSELING CENTER PHONE (360) 457 0431 PARCEL 06 30 00 0 4 4115 0000 APPL NUMBER 09 00000143 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL3 01 5/08/09 JLL BLDG FRAMING TIME 01 00 5/08/09 AP May 7 2009 3 38 33 PM 1pangrle MIKE 461 7464 FRAMING AFTERNOON May 8 2009 4 04 42 PM jlierly BL99 01 6/12/09 JLL BLDG FINAL TIME 01 00 i June 11 2009 3 27 46 PM 1pangrle MIKE 461 7467 BLDG FINAL AFTERNOON COMMENTS AND NOTES PREPARED 5/08/09 8 15 17 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/08/09 ADDRESS 1004 W 16TH ST SUBDIV TENANT NBR PEN COM MENTAL HEALTH CONTRACTOR PHONE OWNER PENINSULA COUNSELING CENTER PHONE (360) 457 0431 PARCEL 06 30 00 0 4 4115 0000 APPL NUMBER 09 00000143 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL3 01 5/08/09 JLL BLDG FRAMING TIME 01 00 May 7 2009 3 38 33 PM 1pangrle MIKE 461 7464 FRAMING AFTERNOON COMMENTS AND NOTES Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Circuits for old garage Storage space Office? Owner PENINSULA COUNSELING CENTER 118 E 8TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER 2 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT Fee summary Permit Fee Total Plan Check Total Grand Total INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 ANGELES ELECTRIC 524 E 1ST ST WA 983626129 PORT ANGELES (360) 452 9264 ELECTRICAL ALTER COMMERCIAL 145433 61 50 5/07/09 11/03/09 09 0(000406 1581E2 1004 W 16TH ST 06 3( 00 0 4 4115 0000 ELECTRICAL ONLY COMMERCIAL NEIGHBORHOOD 0 Charged P id Credited 61 50 61 50 00 00 00 00 61 50 61 50 00 DATE Contractor Plan Check Fee Valuation Date 5/08/09 RESULTS WA 98362 00 0 Extension 57 50 4 00 Due 00 00 00 Signature of owner or Electrical Contractor X Date INSPECTOR. 05/05/2009 19 25 FAX 360 452 9265 City of Port Angeles Permit Application Building Division /Electrical Inspections 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 Ph: (360) 417-4735 Fa (360) 417 -4711 Date: 9,2 Single Family Dwelling _/Multi- Family or Commercial" Commercial Addition Alteration Remodel Repair` Plan Review May Be Required, P Mete Electrical Plan Review Information Sheet Job Address: ___00 h Building Square Footage: Description of above Unit Charge 93.75 $113.75 $160.00 $205.00 $291.25 2.00 57.50 2.00 72.50 86.25 $116.25 $131.25 75.00 69.00 75.00 50.00 $50.00 93.75 80.00 86.25 27.50 57.50 8625 43.75 x Owner In Name: _iA7c�stlJ�t flQ Mailing Address: 1l tf City IPA' State: Zip: 36 Z Phone: 0/ 01- 2 10111'14E4 e. 7 License Exp. OIL Da Total (qty Multiplied by Unit Charge] 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 57g'r Branch Circuit W/O Service Feeder Q Each Additional Branch Circuit Signature of ow r, electrical contractor or electrical administrator IllieGARV 'ED MAY 6 2009 LIGHT DEPT Temp. Service/ Feeder 200 Amp. Temp. Service/Feeder 201 400 Amp. Temp. Service/Feeder 401-400 Amp. Temp. Service/Feeder 601 -1000 Amp. Portal to Portal Hourly Sign/Outline Lighting Signal Circuit Limited Energy Commercial. Signal Circuit/ Limited Energy 18 2 Family Dwelling Signal Circuit/ Limited Energy Multi- Family Dwelling Manufactured Home Connection Renewable Electrical Energy 5KVA System or Less First 1300 Square Ft. Each Additional 500 Square Ft. or Portion of Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Thermostat Total Ii0001/0001 *oI Contractor Info matron e Y Name: l�otin Mailing Address: City State; Zip: Phone: License $1 Exp. 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 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 18.28, WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code, and Utility Specifications. PREPARED 4/07/09 8 43 53 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/07/09 ADDRESS 1004 W 16TH ST SUBDIV TENANT NBA PEN COM MENTAL HEALTH CONTRACTOR PHONE OWNER PENINSULA COUNSELING CENTER PHONE (360) 457 0431 PARCEL 06 30 00 0 4 4115 0000 APPL NUMBER 09 00000143 COMM REMODEL PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS PL1 01 4/07/09 ```'''Ln PLUMBING UNDER SLAB 1 4 April 6 2009 9 44 26 AM 1pangrle ART 477 1247 SEWER LINE UNDER SLAB COMMENTS AND NOTES CITY OF PORT ANGELES DEPARTMENT OF COM,vIUNITY 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 COMMERCIAL NEIGHBORHOOD 15000 Application desc CONVERT OPEN AREA TO 3 BEDROOMS BATH ETC 09 00000143 Date 00599 1004 W 16TH ST 06 3000 0 4 4115 0000 PEN COM MENTAL HEALTH COMM REMODEL Owner Contractor PENINSULA COUNSELING CENTER OWNER 118 E 8TH ST PORT ANGELES WA 983626129 (360) 457 0431 Structure Information 000 000 CONVERT ROOM TO 3 BEDROOMS BATH ETC Construction Type UNKNOWN Occupancy Type RESIDENTIAL Permit BUILDING PERMIT COMMERCIAL Additional desc ADD 3 BEDROOMS BATH ETC Permit pin number 141572 Permit Fee 277 75 Plan Check Fee 180 54 Issue Date 2/25/09 Valuation 15000 Expiration Date 8/24/09 Qty Unit Charge Per Extension BASE FEE 95 75 13 00 14 0000 THOU BL- 2001 -25K (14 PER K) 182 00 Permit MECHANICAL PERMIT Additional desc Permit pin number 141580 Permit Fee 116 45 Plan Check Fee 00 Issue Date 2/25/09 Valuation 0 Expiration. Date 8/24/09 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 7 2500 EA ME VENT FAN (SINGLE DUCT) 7 25 4 00 14 8000 EA ME HEAT R(SUSP /WALL /FLOOR MTD) 59 20 Permit PLUMBING PERMIT Additional desc Permit pin number 141606 Permit Fee 107 00 Plan Check Fee 00 Issue Date 2/25/09 Valuation 0 Expiration Date 8/24/09 Qty Unit Charge Per Extension 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 inspect ons 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. 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. -041 7 1 1 I I< r z Z rn m Date Print Name Signature of Contractor or Authorized Agent re of Owner (if owner is builder) T.FonnsBuilding Division/Building Permit 2/25/09 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 Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting 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 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 Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 PLANNING DEPT Separate Permit #s SEPA. Parking /Lighting I ESA. Landscaping I SHORELINE. FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By Application Number Application pin number 4 00 1 00 1 00 1 00 T:FormsBuilding Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Qty Unit Charge Per 7 0000 EA 7 0000 EA 15 0000 EA 7 0000 EA 09 00300143 005993 BASE FEE PL- PLUMBING TRAP PL -WATER LINE PL SEWER LINE PL WATER HEATER Special Notes and Comments February 25 2009 10 16 30 AM sroterds The proposal will convert a covered area to 3 additional bedrooms and 1 bath for a total of 6 bedrooms in the CN zone Lot coverage is not increased by the development Other Fees STATE SURCHARGE Page 2 Date 2/25/09 4 50 Fee summary Charged Pa id Credited Due Permit Fee Total 501 20 5 ,01 20 00 00 Plan Check Total 180 54 7180 54 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 686 24 686 24 00 00 Extension 50 00 28 00 7 00 15 00 7 00 Separate Permits are required for electrical work, S1PA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commer ced 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 inspect ons 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 sante 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. Date Print Name Sid nature of Contractor or Authorized Agent Signature of Owner (if owner is builder) 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 I Furnace 1 FAU I Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting 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. Inspection Type Date Accepted By Comments 1 -1-f7—fig PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. T /Building Division /Building Permit FINAL Date Accepted by Inspection Type FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 Date Accepted By Applicant or Agent J4 t KE Z 1 r» r►., F 12 Property Owner t�erviNSsg Corm,,+ fV1€ j »c Property Owner's Address T g t 8'7N s r t Contractor /Engineer IV u "g r Contractor /Engineer's Address License Project Tune Brief De all that apply ID New Construction Addition ›.Remodel Repair Re -roof Demolition Heat System Other Floor Areas er CA Basement 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other $RBgz.e(,tt escriution. LIDO Total footprint of structures 70 Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? wo sAe OJ IeJr Is Qexn■nsuta, Ceuhy &tinj C ite.► 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 Expires PROJECT ADDRESS c Parcel Number Heat pump n wood burning stove gas fireplace pellet stove other Existing (sq. )4.) Posed (sq. ft.) 9� 4 4 90 Occupancy group Occupant load Construction type Phu l hid Phik Aguc°s41-zs W'4 Phone 1 .TN ST Lot E -mail TOTAL VALUATION For City Use Only Date Received a;I 2.- O Permit 09 Date Approved( 4 1 ST -o51-,z cfs3e,a_.- -G.,12A Zoning Cil \I Residential Commercial c Multi- family Industrial RP M `or Voi■ nSv1 r Carr) Coovepr e+Peni AApA?8 -3 2,023gaprn s 9►+ rg/C. 04413 ROOMS T'b 2 be .•s per sq. ft. sq ft. T Lot size sq. ft. Lot coverage of bedrooms of full baths of half baths Or7 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. Date 9,-1 —UQ Print Name /l t tC Fr '2. in in c Signature y CRY GOVERNMENT City State Contact: Phone Phone 2 FAX. PRESCRIPTIVE APPROACH- SIMPLE FORM Fcr the Washington State Energy Code (2006 Edition) Climate Zone 1 Site Information. Building Department Use Only* Lot: Permit Address i-d L- .)E. 7 l r. sr Notes 1�- oirzr INAAE L e• l,() er Zip 51.3L3 nit k Z I Dfl 2 1 4 kf 7'/1.' 45 -0431 Table 6 -1 PRESCRIPTIVE REQUIREMENTS FOR GROUP R OCCUPANCY CLIMATE ZONE 1 (Unlimited Glazing Option Only) Glazing Glazing U� Facto boor:' wall 'Wall' Wall Vaulted: .:Interi E x t erio r Option A rea of Vertical Overhead .;'=actor Ceiling C eiling Grade Belo* Below Floor Grade.. Unlimited Group R -3 IV and R -4 0 35 0 58 0.20 R -38 R 30 R 21 R 21 R 10 R 30 R 10 Occupancies Only This Project complies with the following: The project is a single family residence or duplex. The project is a wood frame OR all of the insulation is interior or exterior of the framing. All building components meet the requirements listed above 4 The project will meet all ether provisions of the WSEC and VIAQ The Project will take advantage of the following. exceptions to the prescriptive option. El 602.6 Exception 2. One unlabeled or untested exterior swinging door, 24 sq ft. or less, may be installed per unit for ornamental, security or architectural purposes. Location of the door raking this exception. 602.6 Exception 2. If a door is mostly glass, it should meet the requirement of the vertical glazing U factor listed above, Location of the door(') taking exception Type of Heat Source. C L i c T 21 e T:Forms /Building Division /Prescriptive Approach- Simple Form aSE30»Ra H aA 11E7AS S lab on Concrete CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Nt! 17326 Port Angeles, washlngton...........2:.=:..L___:::L___________.......m...., 19.%..0 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 .jJ2jLH..____.l~.J--I0.---..LLC..---mm--mm--m. Occupancy..______.___...._______.________.._______.m... o~er6L:cooi.~T~.:~-;,...--- Tenant.__________mm..___.....______.m__.m__m._..__..m.________.__ Wlrmg Contractor ..."-.".___a.___m.~_~_m__m._____ By__mm___............__.__m_m___m___..___...m...._____...... ~---- '.:.,~l~'- - ""t:: " '. Light Outlets______:. .___~.....:_____._____.. /.5 - Receptacle Outlets.........._.m.m__.......... Service, volts ....................................... No. wires ......................._.............. Dl).er, KW..........n._..n........................ Size wires..................._.............._.. Range, KW............nmn..............n_ Main fuse ....................................... Water Heater: Enclosure ...m..m.....m.................... KW.__..____________.____ __________._____. _______. Heal: KW...___.i.I...s:-.....B...B....____.m Type of wiring: Entrance Cable ....mm..mm Motors: sIze, volts and phase: RigId Conduit ....mm..m................ Metallic Tubing ........................... Current transformers: No. & Size....................................... Ser. No............................................... Ser. No.............................................. SeT. No. ............................................. Type of Wiring: Armored Cable ............................_ Non-Metallic ................................. Knob & Tube.......______........____________ RIgid Conduit .___....___......____..___..... Metallic Tuhlng .........__............_... Raceway ......................._......__..._ Circuits, LIght.........~..,?..................... Utllity.....m__.._...................__.....__.... 4 Heat .......................................-..- Range ............................................. Water Heater ............................... Motor ..._........................................ Dryer ..............................................__ Furnace .........................._......_........... Total Load............................. Ser. No.................._.......................... Total ..............7.................. \R~kS: .____:::::7::'_1I.dd.!....,:'!.._"-~L_!;~m__...z6.....~m..J!~4.~,.=__~--.m ~~------/'L.!...1.~:f.--...=-e#....fJ,---.--./.--J---s::...K_J,4I...[!../d,.-------......----.............__....__....m__ ~3:~;--....---..---..... ::~.~.~:..:~.~:~.~~..___... By ../!.L~..__C"'A(~_a1.~~.__-..--. ;- ...., , NOTICE-Current must not be turned on until Certificate ot Inspection has been issued. If work is to be con. cealed due notice must be given the Inspector so that work may be Inspected betore concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 17326 Address........................................................................................................................................Date..._......_.._.._.._.........._......_......_......... Owner ....................n............._......_.._......_......_.._....................................................n_.... Tenant........................................n..................._...... Wiring Contractor........................................ ..................._.............................................................By............._................................................ NOTICE-Current must not be turned on unt11 Certificate ot Inspection has been issued. If work Is to be con~ cealed due noUce must be given the Inspector so that work may be inspected berore concealment. 1M Olympic Printers, Inc. ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . I I . . 15-00000933 Application pin number .52.1.01.5 Property Address . I . 1004 W 16TH ST ASSESSOR PARCEL NUMBER: 06-30--00-0-4-4115-0000- Application type description ELECTRICAL ONLY Subdivision Name Property Use . . . . . . Property Zoning , . , . . , COMMERCIA1, NEIGHBORHOOD Application valuation 0 Application desc Surgery light Date 7/29/15 Owner Contractor PENINSULA BEHAVIORAL HEALTH APS ELECTRIC 118 E 6TH ST 546 BENSON RD. PORT' ANGELES WA 9836261.29 PORT ANGELES WA 98363 (360) 452-6753 Permit ELECTRrCAL ALTER COMMERCIA1, Additional desc Permit Fee 74.00 Plan Check Fee 00 Issue Date 7/29/15 Valuation 0 Expiration Date 1/25/16 Qty Unit Charge Per Exteris.ion. 1.00 74.0000 ECH El—COMM BRANCH CIR WO/ SIF 74.00 ----------- Fee summary Cl.iarqed. Paid "Credited Due Permit Fee Total. 74.00 74.00 .00 00 Plan Check Total. .00 .00 00 „00 `Grand Total. 74.00 74.00 .00 Do REPORT SALES TAX on your excise tax form to the City of Pod Angeles (Location Code 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; G:\EXCHANGE\BUILDING FROM A.P.S. ELECTRICAL CONTRACTOR FAX NO. 360 452 6753 Jul. 28 2015 10:49AM P2 a Uj CITY OF FORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 Cost Fi tl1 Street`. — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: �� j 6 * Plan Review May Job Address: j 06 � Building Square Footage - Description of above + Multi-Familyr C'ornrnerciaN lu Owner Inform tloq ,I Nome:, � Contract rt ormatlo +� Nemo: Mailing Address,. I &a !l !g2 • t ~u Mailing Address:11 City: State: Zip Phone:; ax City: State ► ZIP: Licensa #� xp! f Phone:– License # I Exp, - 112 t Mu I U 1 h Service/Feeder 200 Amp. $132,00 Servioe(Feeder 201-400 Amp. $160.00 $ ServioelFftder 40"00 Amp $ 225.00 $ ServicelFeeder 601-1000 Amp, $ 288,00 $ ' Service/Feeder over 1000 Amp, $ 410.00 $ Branch Cirelllt W/ Service Feeder $ 5.00 Branch Circuit W/O Service Feeder $ 74.00 Each Additional Branch Circuit $ 5,00 Branch Circuits 1A $ 86.00 $ Temp, Service/ Feeder 200 Amp. $102.00 $ Temp. SoMmIFeeder 201400 Amp. $121.00 Temp. Service/Feeder 401.600Amp. $164,00 __ $ Temp, Service/Feeder 601-1000 Amp . $185.00$�– Portal to Portal Houdy $ 96.00 $ Sign/Outline Lighting $ 88.00 Signal Circuit! Limited Energy–Multifamily $ 64.00 $ Signal Circuitl Limited Energy I First 1500 sf – Commercial $ 96.00 $– Note: $5.00 for each additional 1500 sf Renewable Elecfical Energy - 5KVA System or Less ' $113.00 _ $� Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat Total Owner as defined by RCW.1g.28261: (1) Owner will occupy the strac;Wte for two years after this electrical pannit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Pemlit expires after six months of lest fns `on. After reading the above statement, l' hereby certify that I am the owner of the above named propel or a licensed electrical contractor. I am making ft electrical Installation or al "on in compliance with the electrical lavas, N,E,C,, RCW. Chapter 15.28, WAC. Chapter 296.468, The City of Port Angeles Municipal Code, and utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: Cl cam ❑ chem , kCredlt Card a 1jJ10.,.� . Darted: .- . � r °Z � --. ovovmis