HomeMy WebLinkAbout1137 W 16th St - Building_r'
Owner
Permit Fee Total
Plan Check Total
Grand Total
Date Print Name
T:FormsBuilding DivisionBuilding 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
RE PIPE VENTING ON PELLET STOVE
ANDREW AND NICOLE HARRIS
1137 W 16TH ST
PORT ANGELES
(360) 460 1897
WA 98363
09 00001167
893818
1137 W 16TH ST
06 30 00 0 4 3136 0000
ANDREW AND NICOLE HARRIS
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
807
Contractor
Permit MECHANICAL PERMIT
Additional desc RE PIPE PELLET STOVE VENTING
Permit pin number 156307
Permit Fee 60 65
Issue Date 11/09/09 Valuation
Expiration Date 5/08/10
Qty Unit Charge Per
1 00 10 6500 EA
Fee summary Charged
60 65
00
60 65
PELLET HEAT CO
230 EAST 1ST SUITE C
PORT ANGELES WA 98362
(360) 457 4406
BASE FEE
ME STOVE /FIREPLACE /MISC APP
Paid Credited
60 65
00
60 65
Signature of
Plan Check Fee
00
00
00
A
Date 11/09/09
Due
00
0
Extension
50 00
10 65
00
00
00
re,&
\v"'
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 orrect. All provisions of laws and ordinances governing this type of work will
be complied with whether specified herein or not. The :ranting of a .4 it does not presume to gt} rity to violate or cancel the provisions of any
state or local law regulating construction or the perfo an e of co
Signature of Owner (if owner is builder)
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
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 FINAL Date
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
T.Forms /Building Division /Building Permit
FINAL Date Accepted by
Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE —20
Inspection Type Date Accepted By
Electrical 417 -4735 I �y
Construction R.W PW Engineering 417 -4831 I
Fire 417 -4653
Planning 417 -4750
Building 417 -4815 t X 4 c) e I7-- k,b 0 0
L p\ �Fs
'l
Applicant or Agent ik Co
Owner �rlrP, -/,/2. A i s
Owner's Address __//1_7 Ale s.4 c,
Co ntractor /Engineer .N.40
Contractor/Engineer's Address z3 e,
License# 1= L do iv. 5
PROJECT ADDRESS `I! 3 7 141 S
Parcel Number 06 3 6000 iv 3 3 Ammo
Project Tvoe Brief Des
Check all that apply
New Construction
Addition
Remodel
Repair
Re -roof
Demolition.
Sign
Heat System
Other
Floor Areas
Basement
Floor
2 ',r
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
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
Total footprint of structures
Max height of proposed structures
Will a lawn sprinkler system he installed?
Will a fire sprinkler system be installed?
criotion. Ix/Residential
f
wall- mounted projecting o freestanding awning other
Total sign area sa ft. Maximum allowed sign area sa. ft.
o Heat pump wood burning stove gas fireplace Xpellet stove other
2 r?ifee.�/ VG,... +.,.a an/ s. 4-p wss_ ,Fran. )trrt7 Tch iisrt✓t-AL
Existing (sq. ft.)
Posed (sq. ft.)
/L I�
I F 11
j j
H j v zuu9
sq ft. Lot size
Fsr s -t S>
Commercial
ft. Occupancy group
Occupant load
Construction type
L 1A
Phone ?L6 -,'s 7 y LI
Phone 3 4 a -yZA .1 1
.Phone 3Ga S/c/a/
Expires 7
57
Lot Zoning
Multi- family Industrial
per sq ft.
TOTAL VALUATION 8'U7 'Er
sq. ft. Lot coverage
of bedrooms
of full baths
of half baths
I have read and completed this application and know it to he true and correct. I am authorized to apply for this permit and
understand that it is my re punsibility to determine what permits are required and to obtain perm,is ter orking on
projecfQ
Date ti ,r. 6 P int Name 1?1 ci, .L. p.cf z /L Signatur
T F i ns /Buiidi g Divisio, i_'•dy Pert lit 4pp1. -2006 Code dot::
For City Use Only
Date Received 't —Dq.
Permit oq— I I (n 7
Date Approved
.... CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL
DIVISION
321 F. ASI 5TIt STREET. PORT ANGELES. WA 98362
ELECTRICAL PERMIT ISSUED: 6/17/2002 PERMIT NO 7703
OWNER/APPLICANT PROPERTY LOCATION
N ICOLE & ANDREW HARRIS 1137 16TH ST W
1137 W 16TH Lot: 11&12
Block: 431 [] Long Legal
Port Angeles, WA 98363
360/457-2778 Subdivision: TPA
T: S: Parcel No: 063000043136000
CONTRACTOR ARCHITECT
OWNER N/A
VARIOUS
Port Angeles, WA 99360 , 98360-0000
206/000-0000 360/000-0000
PROJECT INFO
Project Type: RES. MISC. Project Value: $0.00
Occupancy Type: RESIDENTIAL Construction Type:
Occupancy Group: Zoning Use: RS7
Electrical Heat:
[] Baseboard 0 KW [] Riser [] Underground Service
[] Furnace 0 KW [] Overhead Service Voltage: 0
[] Heat Pump 0 KW [] TempService Phase: [] 1 []
[] Fan Wall 0 KW Service Size: 0
Feeder Size: 20
PROJECT NOTES
ADD CIRCUITS FOR 2ND STORY ADDITION
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: $45.50
BALANCE DUE $0.00 :
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVEI~
INSULATE OR CONCEAL ANY I4zORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
/~-~ .~
DITCH
ROUGH-IN/COVER
FINAL I/,o/~ ~/~_ I I z~ -~'~ /~/~
GENERAL COMMENTS:
.... CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUiLDiNG DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
~11_1~11~1~.~ I"I~:~IYll I ISSUED: 4/25/2002 PERMIT NO: 13348
OWNER/APPLICANT PROPERTY LOCATION
1137 16TH ST W
NICOLE & ANDREW HARRIS
1137W16TH Lot: 11&12
Port Angeles, WA 98363 Block: 431 [] Long Legal
360/457-2778 Subdivision: TPA
T: S: Parcel No: 063000043136000
CONTRACTOR ARCHITECT
ON SITE CONSTRUCTION N/A
262 GOLDFINCH
PORT ANGELES, WA 98363-0000 , 98360-0000
360/928-3200 360/000-0000
PROJECT INFO
Project Value: $10,000.00 SFD Units: 0 Commercial: 0
Project Type: DORMERS SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
MFD Units: 0
Occupancy
Group:
Construction Type: MFD SQ FT: 0
Zoning Use: RS7
PROJECT NOTES
ADD SECOND STORY ADDITION 400 SQ. FT.
RECEIPT#
FEES ASSESSMENT
Building Permit: $181.25 Misc Fee 1: $0.00
Plan Check: $72.50 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: $258.25
Plumbing: $0.00 AMOUNT PAID: $258.25
Mechanical: $0.00 BALANCE DUE: $0.00
Radon: $0.00
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 as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certi~ 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 haw regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORMS\1102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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 l~'~ '~d ~/
INSPECTION TYPE I DATE I 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
CEILING
FRAMING
JOISTS / GIRDERS
BUILDING 41%4815 [ ~- ~-I --~'~ J-~ ~'[~ BUILDING
FOROFFIC L EONLY:
BUILDING PERMIT- APPLICATION Permit#:
The Building Permit application must be filled out completely.
Please type or print in ink. If you have any questions, please call 41%4815
Applicant or Agent: 6~ g~'{'~ ~'~'dl-, - C~~ ~Phone: ~- ~O
Owner: ~60(~ ~ A~V~ d~C~ 5 Phone: ~SV-
~chitecffEngineer: Phone:
Address: ~ ~~¢C, City:~ ~eJ~> Zip:
PROJECT ~D~SS: i(gW ~e~ {&~ ZONING:
LEGAL DESCmPTION: Lot: t t Block: q~ I Subdivision:
CL~L~ CO~TY P~CEL NUMBER: ~ OO~o ~Credit Card Holder Name:
Billing Address: City: ~ ~ 00o0
Credit Card g: Exp. Date: ~SA MC
T~E OF WO~: SIZE~UATION~ ~
~ Residential D NewConsm D Re-roof ~ Wood-stove ~ SF.~$ ~ /SF.=$'~1~I 0OO~~
~ Multi-h~ly D Addition D Move ~ G~age SF. ~ $. /SF. = $
~ Comercial ~ Remodel D Demolition D Deck SF. ~ $. /SF. = $
Repair D Sign D TOTAL VALUATION $
COMMERCI~SIDENTI~: Occupancy Group: ~ Occupant Load: Cons~ction T~:
No. of Stories: ~ Lot Size: ~O * k { OO ' % Lot Coverage:
Existing Lot Coverage: /sq. fl. + Proposed Lot Coverage: /sq. ~. = TOTAL LOT COVE~GE: ./sq.
PLANING USE ONLY: ~PROV~S: PL~
Notes: BLDG.
DPW
F~
ES~etland(s): ~ Yes ~ No SEPA Checklist req~red? ~ Yes ~ No O~er: OTHER
B~LDING PE~IT APPLICA~ON S~MITT~: Your application and site plan must be filled out completely to be accepted for
revi~. The Building Division c~ provide you with more detailed ~fomtion on ~e application ~d plan sub~Ral requkements. Yo~
co~leted application, site plan (for additions) and build~g com~ction plans are to be subdued to the Building Division.
V~UATION OF CONSTRUCTION: In all eases, a valuation amount must be entered by ~e applic~t. This fig~e ~11 be reviewed
and ~y be revised by the Building Division to comply with cu~ent fee schedules. Contact the Pe~t Coord~ator at 417-4815 for assistance.
PL~ CHECK FEE: Your plan check fee is due at ~e time the building pemt application and cons~ction plans are subdued. All o~er
pe~t fees are due at the t~e ofpe~t issuance.
EXPIATION OF PL~ ~VIEW: If no pemt is issued ~in 180 days of~e date of application, ~s~pplication will expire. The
Build~g Official can extend the t~e for action by the applic~t up to 180 days upon ~i~en request by the applic~t (see Section 107.4 of
· e Unifom Building Code, c~ent edition). No application can be extended more t~n once.
I hereby cert~ that [ have read and examined this application and know the same to be ~ue and correct, and I am authorized to app&for
this permit. I understand it is not the Ci~5 legal responsibili~ to determine what permits are required; it remains the applicant5
T:WORMS~PS~uildin~emitresp°nsibili~t° determine what permits are required and tOApplicant:Obtain sV}~~ ~ ~-- Date:
0
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date ~-~ - ~ ~ ~) '~-'~ Time Received by /~ L phone, person)
Location of Work to be inspected //37 LX-'~ I/? ~
Name of person requesting inspection C~,v' ~'~ Z~'~-'-~_ 777~
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation~ramlng Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date ~'~ ~ ~(~)'~- Time By
Remarks:
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved r-}Gravel r-]Asphalt I--~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
DEPARTMENT OF PUBLIC WORKS ~/~
........... INSPECTION REPORT ...........
REQUEST: · ~///~ _
Date (l//~/l~"z.~ Time c~,~--d) //~,l~ Receivedby ~-~ (pho~
Location of Work to be inspected /_/~ ~ ~-- / / ~ ? ~] ?~
Name of person requesting inspection _//r-I <~ (~'~'~./~ ~ t'-
Address of person requesting inspection Phone No.
Permit No. / '~x/'~
Type of Inspection (~priate one): "'~'~ r
Sewer Foundatio ~ ~'~ himney P umbing~., Final .' Sews Excav. Other
INSPECTION NOTES: i?~ ~7...~ ~
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
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Appl~cat~on Number
Application pin number
property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdiv~sion Name
Property Use
property Zoning . . .
Application valuation
5/23/05
05-00000390 Date
980780
1137 W 16TH ST
06-30-00-0-4-3136-0000-
RE-ROOF
RS7 RESDNTL SINGLE FAMILY
2725
Owner
Contractor
ANDREW J/NICOLE S HARRIS
786, 'MARSHALL RD
SEQUIM WA 98382
o T M SERVICES
309 S ENNIS
PORT ANGELES
(360) 417-0124
WA 98362
nNAit5Q
~/-r(CJs
S~
Permit BUILDING PERMIT - NO PR FEE
Additional desc TEAR-OFF, FELT, COMP
Permit pin number 49767
Permit Fee 106.75 Plan Check Fee
Issue Date 5/23/05 valuation
Expiration Date 11/19/05
Qty Unit Charge Per
BASE FEE
1.00 14.0000 THOU BL-2001-25K (14 PER K)
.00
2725
Extension
92.75
14.00
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 106.75 106.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 111.25 111.25 .00 .00
Separate Permits are required for electncal 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 penod 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 ty of work Will be complied with whether specified hereIn or not The granting of a permit does not
presume to give aut nty t t or cancel the rovisions of any state or local law regulating construction or the performance of
construcf('
~
~ ignature of Contractor or Signature of Owner (If owner IS bUilder) Date
T \Pohcles\1102_15 bUIldIng permIt InspectIOn record05 wpd [114/2005]
--
-
\}J
~
!
!
~
,
~
~
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r
BUILDING PERMIT INSPECTION RECORD
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 UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION
FOOTINGS
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 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR / CEILING I I
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET 1 CillMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKlRTING
PLANNING DEPT SEPARATE PERMIT #'s SEPA
PARKING/LIGHTING ESA
LANDSCAPING SHORELINE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R W / PW/ CONSTRUCTION - R W
ENGINEERlNG 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 I PLANNING DEPT
,
BUILDING 417-4815 vii /0'7 J tf.., BUILDING
T IPohcles\1102_15 bUlldmg penn It mspecllon record05 wpd [1/4/2005]
PREPARED 6/07/05, 12 58 19
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
1137 W 16TH ST
o T M SERVICES
ANDREW J/NICOLE S HARRIS
06-30-00-0-4-3136-0000-
05-00000390 RE-ROOF
SUBDIV
PHONE
PHONE
(360) 417-0124
PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL99 01
:V07/05 ~
~ "'"\\ Or-
\ \ \ -,
BUILDING FINAL
06/07/2005 11 47 AM DYASUMUR
MIKE 775-0863
12
6/07/05
-------------------------------------- COMMENTS AND NOTES --------------------------------------
ar:M SCECJ(o/ICPS
I%e 1<<>ofing cprofessionaV'
309 Soutli tEnnis (fun jlngefes 'Wjl. 98362
Offia (360) 417-0124 Ce{{ (360) 775-0863
Contractor ~eistration: OTMSPS*963(j)(JJ
Licensed- Insurea-rBorufea
71iis proposa( specifUa(Cy for.
drew & Nicole Harris
Ref #
131 Invoice#
050205-131-001*
5/3/05
Estimated Start Date
Phone: 457-2778
Date
5/1/05
1.) Remove existing roof.
3.) Furnlsh and Install the followmg roofing matenal according to manufacture spec's.
Elk 30 Year Laminate Color:
Options: The followmg are included in Total Bld Pnce:
a.) 30 lb. Felt underlayment.
b.) Cora-Vent ridge venting system.
c.) New Fascia Boards on front porch.
t: Tata! 5Uf price wif( oe aue at tne compfetion of specifiea wort
([of tlie a60w wcn{to 6e compfetetf in. a profcsSW7Ul[ and tmzefy 11Ulnner far a sum of:
iJwo iJJiousallcfSe'lJen .1funcfrecf'Twenty ~n)e (Dor(ars
P(us 1'J)S5"T
'You are liereGy autlion.zed to provufe a([ 11UltenaIs and !:aGar requIred to compfete tlie warllmentwned m tlie aGow
proposa[ as spect.fied and we agree to tlie tenns of payment.
X X
X X
Customer Stgnature q)atc
%ta( {j)uf Prue:
,4"
Preparu[ by: 1," ~
idUlC[tE. Scfunitt
OP.M fProjcct :MatUlfJcr
(j)ate
"'pfease 110te t/iat due to tfle jfuctuatlol1s 111 tfle marfist t/its proposa[ts 0116' vaEu{for tfl1rty d'ays after date of estimate.'"
.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
PERMIT NO. 1It)/.3
DATE c~ -9..q3
Installed By:
o READY FOR
INSPECTION
License Number:
WILL CALL FOR
INSPECTION
Phone:
Site Address:
Owner/Busines .
Phone:
Owner/Business Address:
Sq. Ft.
)! RESIDENTIAL
o COMMERCIAL
o BASEBOARD KW _
o FURNACE KW _
o FAN/WALL KW _
o HEAT PUMP KW_
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
o REMODEL
)( ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o OVERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
o SINGLE PHASE
o THREE PHASE
SERVICE SIZE AMPS
o SIGN
o SPECIAL EQUIPMENT
(LIST BELOW)
ttfd~~/.mJ.z ~./A1~
Details/Description:
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. NOT O.K.
ACTION REQUIRED: .D CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
o Rough-in/cover O.K.
o O.K. to connect service
~Final O.K.
Site Address:
Installer:
Permit/Receipt No.
"It/
New Meters
Date:
3-1-93
.
Notify Port Angeles City Light by Street Address and Permit Numberwhen 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 Per It. HONE 457-0411, EXT. 224.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
$
,;2{), 00
Permit Fee
WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept.. Bottom: City Hall
OLYMPIC PRINTERS INC
Application Number . . . . . 23-00000098 Date 1/31/23
Application pin number . . . 303916
Property Address . . . . . . 1137 W 16TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-4-3136-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Heat pump
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Owner Contractor
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CHANDRA M JOHNSON BLACK DIAMOND ELECTRICAL CONTR
1137 W 16TH ST 502 BLACK DIAMOND RD
PORT ANGELES WA 98363 PORT ANGELES WA 98363
(360) 460-4235 (360) 565-1035
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee . . .00
Issue Date . . . . 1/31/23 Valuation . . . . 0
Expiration Date . . 7/30/23
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
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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
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Pub! ic \Yorks and ULili ties Department
32 l E. 5th Street. Port ;\ngeles. WJ\ 98362
300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us
Project Address:--------------------------------------
Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _
OWNER JNFORMATtON
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRfCAL CONTRACTOR fNFORMATION
Name: ___________________________ License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 $
Service/Feeder 201-400 Amp. $146.00 $
Service/Feeder 401-600 Amp. $205.00 $
Service/Feeder 601-1000 Amp. $262.00 $
Service/Feeder over 1000 Amp. $373.00 $
Branch Circuit W/ Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 $
Temp. Service/Feeder 201-400 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 CircuiULimited Energy - 1 &2 DU. $64.00 $
Manufactured Home Connection $120.00 $
Ren ewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat (Note: $5 for each additional) $56.00 $
First 1300 Sql;Jare Feet $120.00 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding / Detached Garage $74.00 $
Each Swimming Pool/ Hot Tub $110.00 $
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 City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
'"'CJ CD
PREPARED 1/30/23,10:57:18 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
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APPLICATION NUMBER:23-00000098 1137 W 16TH ST
FEE DESCRIPTION AMOUNT DUE
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ELECTRICAL ALTER RESIDENTIAL 63.00
TOTAL DUE 63.00
Please present reciept to the cashier with full payment
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
11/16/2023 23-98
TAP
OWNER
CONTRACTOR
Black Diamond Electric
PROJECT ADDRESS
1137 W 16th St
Application Number . . . . . 24-00000233 Date 3/13/24
Application pin number . . . 874597
Property Address . . . . . . 1137 W 16TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-4-3136-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
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Application desc
Car Charger
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Owner Contractor
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CHANDRA M JOHNSON DOUBLE D ELECTRICAL
1137 W 16TH ST PO BOX 957
PORT ANGELES WA 98363 PORT HADLOCK WA 98339
(360) 460-4235 (360) 385-1130
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 95.10 Plan Check Fee . . .00
Issue Date . . . . 3/13/24 Valuation . . . . 0
Expiration Date . . 9/09/24
Qty Unit Charge Per Extension
1.00 95.1000 ECH EL-R- BRANCH CIR 1-4 95.10
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95.10 95.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 95.10 95.10 .00 .00
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
CORRECTIONS NEEDED:
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
3/14/24 24-233 TAP
OWNER
CONTRACTOR
Double D Electric
ADDRESS
1137 W 16th St