HomeMy WebLinkAbout515 C St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT
ISSUED: 11/05/2002
PERMIT NO: 13674
OWNER/APPLICANT
CLEARENCELUNDSTORM
515 SO. C STREET
Port Angeles, W A 98363
360/000-0000
T:
S:
PROPERTY LOCATION
515 CST S
Lot: N 40 L TS 11 & 12
Block: 107 D Long Legal
Subdivision:
Parcel No: 063000010755000
CONTRACTOR
DAVES HEATING & COOLING SERVICE I
991 FRESHWATER PARK RD
PORT ANGELES, W A 98362-0000
360/928-0245
PROJECT INFO
Project Value: $5,000.00
Project Type: ELECTRIC FURN.
Occupancy Type:
Occupancy Group:
Construction Type:
Zoning Use:
ARCHITECT
C N/A
, 98360-0000
360/000-0000
U)
-.
U)
SFD Units' 0 Commercial: 0
SFD SQ FT: 0 Industrial: 0
Garage: 0
MFD Units: 0
MFD SQ FT: 0
~
PROJECT NOTES
INSTALL NEW HEAT PUMP AND LOW VOLTAGE THERMO
r
If\
"1
RECEIPT#9897
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$34.15
$0.00
Misc Fee 1 : THERMOSTAT
Misc Fee 2: THERMOSTAT
Misc Fee 3:
$31 .15
$4.15
$0.00
TOTAL FEE:
AMOUNT PAID:
BALANCE DUE:
$69.45
$69.45
$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 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
co~~ctionj 2afJiLp
S'~ t 'VVf etA h . d A t
Igna ure 0 on ractor or ut onze gen
/I/os/1L
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. IT IS UNLA WFUL 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
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL
WALLS 1 ROOF 1 CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP 7;-5~OZ, f<V
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engmeenng DIVISIOn) SEPARATE PERMIT #'s.
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARATE PERMIT #'s SEPA
PARKING/LlGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R W.I PWI CONSTRUCTION - R W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT 417-4750 r PLANNING DEPT
BUILDING 417-4815 j l-,S=-C:rL J.<\J BUILDING
T:\PLANNING\FORMS\1l02.15 [4/2002]
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date /1-6-0"'2-- Time
Received by
RV
(phone, person)
INSPECTION NOTES:
Inspected: Date / I,.. 6~ Cl-z.-
Remarks:
Location of Work to be inspected ~ ~ I c.e::;:- 66
Name of person requesting inspection ~ v~k.
Address of person requesting inspection
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing@ Sewer Excav. Other
&4-1-
.. YU V14p
Time By
I:?:? 6 71
Qt/
oA/
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
D Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT
ISSUED: 11/05/2002
PERMIT NO: 13674
OWNER/APPLICANT
CLEARENCELUNDSTORM
515 SO. C STREET
Port Angeles, W A 98363
360/000-0000
T:
S:
PROPERTY LOCATION
515 C ST S
Lot: N 40 L TS 11 & 12
Block: 107 D Long Legal
Subdivision:
Parcel No: 063000010755000
CONTRACTOR
DAVES HEATING & COOLING SERVICE I
991 FRESHWATER PARK RD.
PORT ANGELES, W A 98362-0000
360/928-0245
PROJECT INFO
Project Value: $5,000.00
Project Type: ELECTRIC FURN
Occupancy Type:
Occupancy Group:
Construction Type:
Zoning Use:
ARCHITECT
C N/A
, 98360-0000
360/000-0000
U)
-.
V)
SFD Units: 0 Commercial: 0
SFD SQ FT: 0 Industrial: 0
Garage: 0
MFD Units: 0
MFD SQ FT: 0
~
PROJECT NOTES
INSTALL NEW HEAT PUMP AND LOW VOLTAGE THERMO
r
If\
1
RECEIPT#9897
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$34.15
$0.00
Misc Fee 1: THERMOSTAT
Misc Fee 2: THERMOSTAT
Misc Fee 3:
$31.15
$4.15
$0.00
TOTAL FEE:
AMOUNT PAID:
BALANCE DUE:
$69.45
$69.45
$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 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
co~~ction12a~1!
,~ VV~- P
Sfgnature of Contractor or Authorized Agent
ll/osj1L
Date
Signature of Owner (if owner is builder)
Date
T.IPLANNINGIFORMSII102 15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING 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 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. #
ROUGH-IN
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
SLAB
WALL / FLOOR / CEILING I I
MECHANICAL
HEAT PUMP 11-5~OZ- ev
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engmeenng DIVISIOn) SEPARATE PERMIT #'s
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA
PARKING/LIGHTING ESA
LANDSCAPING SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R W / PW/ CONSTRUCTION - R W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 ,. PLANNING DEPT
BUILDING 417-4815 I {--yDL J;?V BUILDING
T \PLANNING\FORMS\1102.15 [4/2002]
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date /1-6-0'"2-- Time
Received by
RV
(phone, person)
INSPECTION NOTES:
Inspected: Date / /,... 6~ CJ-z..-
Remarks:
Location of Work to be inspected ~ ~ j '^~ 66
Name of person requesting inspection ~ v-c:..k.
Address of person requesting inspection
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing@ Sewer Excav. Other
&c.-f
.. YUVfltP
Time By
csJ-
lI,""f>{.~
( one No.
l~n7i
r:;V
DA/
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
"
ELECTRICAL iNSPECTION
WIRING REPORT
457-0411 Ex\. 158
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CiB~/vvU;.t I... u,."d~ 'f-f,fM.'\. ,
ADDRESS
S/~~).~/ sf.
INSPECTOR
J~
APPROVED NOT APPROVED
o ................... DITCH ................... 0
o .............. ROUGH IN/COVER. . . . . . . . . . . . .. 0
o .................. SERVICE .................. 0
}It . . . . . . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . .. D.
CORRECTIONS NEEDED Q) Il j JJ i 17 &vI If.! oS -ko/ s
ON m #s--f,
I~) &''10 bn<,~ c-lr.n-...,tIs &vI LtJ ~~ IL)/'tt){.<j
l::; I f I I
r
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PAINTERS, INC. (206) 452.1381
r
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FEE RECEIPT NUMBER
I
CITY OF PORT'ANGELES ,',
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A557 /)
PERMIT NUMBEA
..
\ 50_00,' I.
, "
, TOTAL FEE ,
) I CqNT. LI,C. NO. TI",!~ TO COM,PLET~ . NO. STORIES rLEGAlOCCUPANCY , "
.\ .
/
~
ELECTRICAL PtRM1T ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
SileAMreds ,L)l5'"' Sovr1-/ ~("'I'.. ~.' ,',' (,'
CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ADDREJPrS ARE CANCELLED
Owner Installation By QV1 ).J1!7e.-
Owner's Address ,"):2 ( ,,; . Installers Address 5' A-M e-
D~YPhane, ~lJ/ 765g InstallersPh?n!'- ,
APPllcatio~ is hereby made for Permit to install ElectricalEquipment as follows: N ~ J/t;CJ 58 U-//ZOO/J- :J J.J Q
"1 ..... - . /
Wiring Method /?OI'1E)/
.
NUMBER AMP 120V ~f NUMBER AMP 120V 240V
USE O:F CIRCUIT PER ., R FEE USE OF CIRCUIT PER 100R FEE
CIRCUITS CIR 10 0' CIRCUITS CIR 10 30
LIGHT , SIGN
LIGHT I 50VQLTS'
OR LESS
, .. MOTOR
CONVENIENCE
CONVE~IENCE MOTOR
APPLlA~CE MOTOR .
, FI'1E ALARMS
DISHWASHER . . . ..
,
, BURGLAR ALARM
DISPOSAL
,
RANGE I MISC.
-
OVEN ,
,
WATER:HEATER
LAUND~Y .
DRYER' - REINSTALLATION LIGHT FIXTURE #
,
FURNACE SUB TOTAL FEE .
GAS - OIL
FURNACE ENERGY FEE
ELECTF:l:IC BASIC FEE
ELECTRIC HEAT
I . TOTAL FEE
ELECTfllC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT //J71 AMP / PHASE
FEEDER ,
SIZE OF SERVIC~ ENTRANCE CONDUCTORS
- :J~ I Z/J 00 . -1-~ - 4---;;:; - Z? IhtiA.
SERVICE rI- A.W.G.
I SUB. TOTAL . ::7","'" SIZE ~ ~ROUND / SIZE OF ENTRANCE SWITCH
I certify that the work to be performed under this permit witl be done by the installer and in conformance with
. ?
Date Application made ,19 By ~/
. co TRACTOR OR NER (OR AUTHORIZED AGEND
Permission is hli!reby given to do the ~bove described work, according to the conditions hereon and according to the approved plans and
speclflcation.~ p~rt~ining ,thereto" subje~t ,t? complj?nce ~Ith the Ordln~nces e City of Port Angeles. .' (,->
_'. Ie "'. "., ,11,1, )J" .), .-'\.1 .~~~Hr"
,I' \ .- "'/'.'7e pe~2rmi'1t 155.U. e8':dr
)- ~ Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
be covered or current turned on before inspection and O.K. for covering or service has.been given by Inspector in
I I Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158.
WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER-
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD - Inspector's Report
OL YMI19 PRINTE~S, INC..
- --- ------
-.-- - ------ ---
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OATE OF VISIT
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MADE BY
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REPORT OF INSPECTOR
REMARKS
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I- /L ri-<- -f.o t)/1 4 IA/M-~ [y'L.-
t, t:u< ~ w~ j},OL
,
O.K. FOR COVERING f) k 7D r> ~ u (tL Gila ~ [ f' /J 0 "," In, {2 .s
, .
O.K. TO CONNECT SERVICE
II;:INAL~
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ELECTRICAL WORK PERMIT APPLICATION
Job wired by ~ctrical Contractor 0 Owner
~ c L;;me /,,-~ Li:~;~ Date Expires
Purp6>~d23
Citv State ZIP
j34-Lt~ U-H'- 9.r:3"2--L.-
Telephone num~ j'AX. number t:::J-,
3Co (j-<J>8f3 - 36:90;.
premis0~&- ~ C&r-
Address o~;c;~ So~fL c. ~
.s- -C:, A'-Y
Installation description
~ommercial 0 Residential
o New
o Altered/Addition
~
I
-
...(:
N
(;'>
C,rc?-
CHy C /fI- &f(>O w
-
"ZC()b-7
Phone number to schedule inspection:
W /0.3 >
Owner as d4i"ned hy ReW 19.28.261:(1) Owner will occupy the structure for two
J'ears qfler this electrical permit is finalized (2) Owner is required to hire an electrical
contractor if ahove said property is for sale. rent or lease
After reading the above statement, I hereby certify that I am the owner of the <lbovc
named properly or a licensed electrical contractor. [ am making thc clectrical instal-
lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter
19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and
Utility Specifications.
Signature of owner, electrical contractor or electrical administrator
o Cash ~eck #
o Credit Card
Card #
Visa
Mastercard
Discover
x
Expiration Date
of card
Service Information
Elec~lrj~al.LQadMdilions.and.or_sublra~liQOs
o NO LOAD CHANGES
D Baseboard KW
D Furnace KW
D Heat Pump Ton LAR
o Fan-Wall KW
D Overhead Service
D Temp Service
D Underground Service
Voltage
PhaseD1D3
Service Size:
Feeder Size:
SAME DAY_'~SPECTJON, CALL UF.E.ORE-1:00 AM 360-417-4735
ROUGH-IN THERMOSTAT / SERVICE
J//U/"g. ltEHY
\. . Dale Date Appruved By "- Date Approved lly
/
FINAL DITCH FEEDER
II J'U, Ir/i- oyWJ "-
I Dale Apprmed By../ Date Approved Hy Dale Approved By
Inspcction Area, Building or Equipment [nspected Action Taken Electrical
Datc Inspector
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ELECTRICAL PERMIT APPLICATION
FOR OFFICIAL USE ONLY
Dato'Ra::
Pennitll:
Due Approved:
Oalc:lssuaI:
The Electrical Permit Application must be filled out comaletefv.
<It 78fZ
Please type or reprint In Ink. If you have any questions, please call (360) 417-4735
Fax number: (360) 417-4711
REQUEST INSPECTION 0
Owner or Elec. Contractor Agent:
Property Owner. {} /4i7 r P 'N e ;: u '" r,t; I y- en-.--
Address: 5/ f7 ~ C, Sf, City:
Electricel Contractor: tY?d Jt/~
Phone:
Fax:
7?:-.,/ Il-'),-?,o/~ "
License #: Exp:
Phone:j'5'7 76 51\
Zip: 9/;3 &. "So
Phone:
Address:
INSTALLATION WIRED BY:
)<(OWNER
City:
o ELECTRICAL CONTRACTOR
Zip:
Credit Card Holder Name:
Billing Address:
City:
Credit Card Number:
Exp.Date:
Zip:
VlSA:_MC:
PROJECT ADDRESS: 515' S
C. .s T.
TYPE OF WORK:
Check all that apply: 0 New
o Alteration/Addition
~ReSidental
Remote Meter
o Multi-family
o Commercial
o Mobile Home
Sq. Ft
Number of Circuits added or altered:
o Detached garage
'f
o Hot Tub 0 Swim Pool
o Septic Pump
o Low Voltage 0 Telecom. 0 S
DESCRIPTION OF THE ELECTRICAL-PROJECT:
/l-D l)
/lenT ~f'
o Baseboard
o Furnace
'fill Heat Pump
o Fan-Wall
KW
KW
.J!i!.....TON
KW
PERMIT FEE/It ,7/J c'
~7I 7731
Servlcelnfonnatlon
Electrical Heat Load Additions
LRA
o Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 0 1 0 3
Service Size:
Feeder Size:
PAMC 14.05.060(8): For industrial, commercial, & residential projects larger than a duplex, a one - line drawing of the Electrical Service 8
Feeders, building size (sq. fl.), load calculations, and the type & of conductors andlor raceway Is required and shall accompany the Electric
Permit application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and I a
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits,
required; it remains the applicants responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature:
f~~~~<< ,~~
Date:
Date: 9~>> 02.
Owner or Elec. Cont. Signature:
C:/ELECTRICALPERMIT APPLICATION
~ C ~ j!30joz-
AI--
ELECTRICAL PERMIT APPLICATION
=~. /
The Electrical Permit Application must be filled GUt comDletelv.
FOR OfPJClAL USE ONLY
D~ec:
Pamitl#:
[)as AppRoved:
Dalo: Iaucd:
Pleaselype or roprlnt In Ink. tfyou have any questions, ploase call (360) 417-4735
Fax number: (360) 417-47t 1
REQUEST INSPECTION 0
. Owner or Elec. Contractor Agent:
ProperlyOwner. tll.:?.-,o,,,.,q /, u-,.,r/;!...-c:n-.---
Address: .::> / 5" ~ C, S T, City:
Electrical Ccnlractor. rJtd Jt/~
Phone:
Fax:
phone:1S-7 76 s1\
Zip: 9'!5'3c;. "S
1i:-./ l1-?<-o~/.-.- 5-
1/
license #: Exp:
Phone:
Address:
INSTALlATION WIRED BY:
fitOWNER
City:
o ELECTRICAL CONTRACTOR
Zip:
Credit Catd Holder Name:
BIlling Address:
City:
Credit Catd Number:
l:xp. .Date:
Zip:
VISA:
MC:,
PROJECT ADDRESS:
TYPE OF WORK:
Check roJ that apply: 0 New
o Alteration/Addition
?1jltReSidental
Remote Meter
o Multi-family
o Commercial
o Mobile Home
Sq. Ft
Number of Orcults added or altered:
o Detached garage
(
o Hot Tub 0 Swim Pool
o Septic Pump
o Low Voltage 0 Telecom. 0 S
DESCRIPTION OF THE ELECTRICAL PROJECT:
/fl)J),
/lenT ~~,
..
Electrical Heat Load Additions
PERMIT FEE:
I.
Service Information
o Baseboard
o Furnace
,j!!( Heat Pump
o Fan-Wall
~
KW
.k.... TON
KW
LRA
[) Overhead Service
[] Temp Service
[) Underground Service
Voltage:
Phase: 0 1 [) 3
Service Size:
Feeder Size:
PAMC 14.05.060(B): For industrial, commercial, & residential pmjects larger than a duplex, a one -line drawing of the Electrical Service 8
. Feeders, bui~ing size (sq. ft.), load calculations, and the type & of conductors and/or raceway is required and shall accompany the Electric
Pennit application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and I a
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits c
required; it remains the applicants responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature,:
Date:
f~/~&< ~~ Date:9-~D2
Owner or Elec. Cont. Signatum:
C:/ELECTRICALPERMIT APPLICATION
~ e ~ f30joz.-
Yfm R-
D. ~,
,- iJO ~.C I\L'<:C'E<;' fEct'l.'((ZC'\J
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CITY OF PORT ANGELES PERIMIT APPLICATION
Building DivisionlElectrical Inspections
321 East Fifth Street — P.O. Box 11501 Port Angeles Washington, 48362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date: l _ 1 & 2 Single Family Dwelling
* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address:
Boding Square Footage:
Description of above
1
Owner Information r
li
Contractor Information
Name: G %air t_-'yLce i� c1
ut Name:
_
Maifin Addres -5 Mailing Address:
City: 4fikstate: WA Zip: Grd a City: Stale: Zip:
Phone: Fax:
Phone: Fax:
License # 1 Exp.
Liven e # 1 Exp,
Item
Unit Charge Total {Qty Multiplied by Unit Charge)
ServicelFeeder 200 Amp.
$ 12100
Service /Feeder 201.400 Amp.
$145.00
$
Service /Feeder 401 -600 Amp
$ 205.00
$
ServicelFeeder 801 -1000 Amp.
$ 262.00
$
Service /Feeder over 1000 Amp,
$ 373.00
$
Branch Circuit W1 Service Feeder
$ 5,00
$
Branch Circuit WlO Service Feeder
$ 6100
$
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[Feeder601 -1000 Amp .
1158,00
$
Portal to Portal Hourly
$ 96.00
$
Signal Circuit] Limited Energy -1 & 2 Family Dwelling
$ 64.00
$
Marufactured Home Connection
$120.00
$
Renewable Electrical Energy - 5KVA System or Less
$102.00
$
Thermostat
$ 56.00
$
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
$
$ Total
Owner as defined by RCW.19.28.281: (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.
Signature of owner, electrical contractor or electrical
administrator: ❑ cash ❑ Check
❑ Credit Card 9
cT-- 2-7 —
MOV2012
INSPECTION TYPE
ELECTRICAL PERMIT
a
RESULTS:
CITY OF PORT ANGELES
DITCH
360- 417 -4735
Application Number
14- 00001027 Date 8/27/14
Application pin number
100823
Property Address
515 C ST
ASSESSOR PARCEL NUMBER;
06- 30- 00 -0 -1- 0755 -0000-
REPORT SALES TAX
Application type, desoription
ELECTRICAL ONLY
COMMENTS:
on your excise tax form
Name
Property
Prppert Use
to the Clay of Port Angeles
Property Zoning
RSV RESDNTL SINGLE FAMILY
(Location Code 0502)
Application valuation . , .
0
Application desc
_ _______
Replaae panel
Owner
Contractor
LUNDSTROM CLARENCE D
OWNER
515 S C ST
.PORT ANGELES WA 983632131
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Permit . . , . . . ELECTRICAL
- - - - - - - - - - - .- - - - - - - - - _ - - - - - - - - - - - - - - - - - - -
ALTER RESIDENTIAL
Y ,
Additional desc . ,
Permit Fee . . . . 120,00
Plan Check Fee ,00
Issue Date 8/27/14
Valuation . . , . 0
Expiration Date 2/23/15
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 .e0
Grand Total 120.00
120,00 .00 .00
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
G:IEXCHANGE\BUiLDING
w
x