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Home My WebLink About1021 Caroline St - BuildingApplication Number 08 00001242 Application pin number 442250 Property Address 1021 CAROLINE ST ASSESSOR PARCEL NUMBER 06 30 00 5 3 0440 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning COMMERCIAL OFFICE Application valuation 0 Application desc Adding receptacle Laser Machine Owner Contractor OMC 1021 CAROLINE ST PORT ANGELES Qty Unit Charge Per 1 00 58 0000 ECH EL COMM ALT <5 CIRCUITS Fee summary WA 983623901 SIMPSON ELECTRIC 243036 W HWY 101 PORT ANGELES (360) 457 9270 Charged Paid Credited Date 9/30/08 WA 98363 Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 135491 Permit Fee 58 00 Plan Check Fee 00 Issue Date 9/30/08 Valuation 0 Expiration Date 3/29/09 Due Permit Fee Total 58 00 58 00 00 00 Plan Check Total 00 00 00 00 Grand Total 58 00 58 00 00 00 Extension 58 00 ['NT SPECTION ELECTRICAL TYPE DATE RESULTS IN SPECTOR DITCH SERVICE ROUGH IN F1J AL 'COMMENTS R1v)I8 This certificate is issue Code certifying that a of the City regulatin Business name Business address Property owner Property owner Automatic fire sp t le Use occupancy ass Building permit nub r Type of construction. Occupant load. ttme7of s•suance this structure was in compliance w" ng consznuctzommuse for the follo S .`t n �S" TD' A rge$ry Center M {D;s (xOwner Olympic ME 21 Caroline Clallam Co Publi lii sp.it?i Dis riot F 939 Carol Po:rt,An •syste Pe r 1138 ration. Business Ym CERTIF Cit anager UPANCY ision i'e 2'006 International Building the various ordinances enter) B2 -3909 05/05/08 Re -issue date Post on the premises in a conspicuous place. shall trot be removed except by the Building Official. O I o~ pORT ~~ t~~ ~ ~-- ~"'~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DMSION 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 06-00000082 Date 3/13/06 037486 1021 CAROLINE ST 06-30-00-5-3-0440-0000- OLYMPIC MEDICAL CENTER COMM ADDITION COMMERCIAL OFFICE 100485 Owner Contractor OLYMPIC MEDICAL CENTER 939CAROLINE ST PORT ANGELES WA 983623901 OWNER Other struct info . TOTAL % LOT COVERAGE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS 20.00 1. 00 2885.00 17500.00 609.00 3494.00 1. 00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT - COMMERCIAL 71704 1025.85 3/01/06 8/30/06 Plan Check Fee Valuation 666.80 100485 Qty Unit Charge Per Extension 1020.25 5.60 BASE FEE 1.00 5.6000 THOU BL-100,001-500K (5.60 PER K) Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date PLUMBING PERMIT 71712 64.00 3/01/06 8/30/06 Plan Check Fee Valuation Qty Unit Charge Per Extension 50.00 14.00 BASE FEE 2.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP Special Notes and Comments The Fire Department has reviewed the project application and has no comments Electrical load calculations and elctrical permits are required. Electric meter must remain accessible. 02/01/2006 11:56 AM GMCLAIN ---------------------------- 02/01/2006 11:57 AM GMCLAIN -~-------------------------- Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. r11'l4Lc-O bit/lob ~ " .00 o ~ \ ~ ~ -.... ~ '- ~ ~ ~ ~ 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 e or local law egulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005] Date 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 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. I INSPECTION TYPE DATE ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING I FRAMING JOISTS I GIRDERS SHEAR W ALUHOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB I WALL I FLOOR I CEILING I MECHANICAL HEAT PUMP I FURNACE J DUCTS GAS "LINE WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING I SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKING/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. J PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW J ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102_15 building permit inspection record05.wpd [11412005] :f ~ORT ~ ~.{O~~ ~ ~ -- ~,,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 06-00000082 Application pin number 037486 Page 2 Date 3/13/06 Fee sununary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1089.85 1089.85 .00 .00 Plan Check Total 666.80 666.80 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 1761.15 1761.15 .00 .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 construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:IPoliciesl] 102_]5 building permit inspection record05.wpd (1/412005] .' 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 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 -q;;, / ~ /Ob --I1A..; 3/3/0' ~ WALLS FOUNDATION DRAINAGE/DOWNSPOUTS PIERS ~ POST HOLES (POLE BLDGS.) PLUMBING ~ [ UNDER FLOOR / SLAB I ROUGH-IN o(FVV (01... :t'~ IJ) WATER LINE (METER TO BLDG) l GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW / WATER ~ AIR SEAL r WALLS IJ /iJ lOr... ~ CEILING I I I FRAMING ~ JOISTS / GIRDERS SHEAR W ALL/HOLD DOWNS I WALLS / ROOF / CEILING S {"YV {Or- rw DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB /1 I. ~[ ....u jV'- J~ -~ - . WALL / FLOOR / CEILING -. MECHANICAL HEAT PUMP/FURNACE/DUCTS GAS LINE WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: P ARKING/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 BUILDING W,/To 6 ,...1 j..J.,. . \ ~ ~ ~ ~ ~ l ~ t 't O't \1\ ~ T:\Policie5\1102_15 building permit inspection record05.wpd [1/412005] ri'PORT~ I ~.J"O~<}~ Or-&ii~ ~ -- ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES 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 06-00000082 Date 3/13/06 037486 1021 CAROLINE ST 06-30-00-5-3-0440-0000- OLYMPIC MEDICAL CENTER COMM ADDITION COMMERCIAL OFFICE 100485 Owner Contractor OLYMPIC MEDICAL CENTER 939CAROLINE ST PORT ANGELES WA 983623901 OWNER Other struct info . TOTAL % LOT COVERAGE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS 20.00 1. 00 2885.00 17500.00 609.00 3494.00 1. 00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date SANITARY SEWER HOOK UP ALTER TO SAN SEWER 71001 40.00 Plan Check Fee 3/01/06 Valuation 8/30/06 .00 100485 Qty Unit Charge Per 1.00 40.0000 EA SAN SEW REPAIR Extension 40.00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments 02/22/2006 11:12 AM SROBERDS -- Needs landscaping plan identifying "significant" landscaping along bluff to justify bluff parking area. 02/22/2006 11:11 AM SROBERDS -- Need landscaping plan identifying "significant" landscaping on bluff to justify bluff parking area. 02/22/2006 11:09 AM SROBERDS c- Need landscaping plan identifying "significant" landscaping on bluff for parking area. Electrical load calculations and elctrical permits are required. Electric meter must remain accessible. 02/01/2006 11:56 AM GMCLAIN ---------------------------- 02/01/2006 11:57 AM GMCLAIN ---------------------------- Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Due Credited 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 stat or local law reg lating construction or the performance of construction. Signature of Contractor or Authorized Agent Date T:\Policies\1102.15R [1/05] $/B[~ Date PERMIT INSPECTION RECORD -- . CALL 417-4807 FOR UTILITY 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 YES NO PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W.I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policiesll102.15R [1/05] ~ ~ORr ~ ~..O~':"" U,.~ "--~ ~ ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number . . . . . 06-00000082 Application pin number 037486 Page 2 Date 3/13/06 Permit Fee Total Plan Check Total Other Fee Total Grand Total 40.00 .00 4.50 44.50 40.00 .00 4.50 44.50 .00 .00 .00 .00 .00 .00 .00 .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 construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\Policies\1102.15R [1/05] ,- PERMIT INSPECTION RECORD CALL 417 -4807 FOR UTILITY 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 YES NO PW UTILITIES (Engineering Division) WATERLINE / METER SEWER CONNECTION SANIT AR Y STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRlVEW A Y APPROACH BACK-FLOW DEVICE I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO 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 BUILDING T:\Policies\1102.15R [1/05] p",,'~. ~ "qp CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION :12I 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 06-00000082 Date 5/12/06 037486 1021 CAROLINE ST 06-30-00-5-3-0440-0000- OLYMPIC MEDICAL CENTER COMM ADDITION COMMERCIAL OFFICE 100485 Owner Contractor PUBLIC HOSPITAL DISTRICT #2 939 CAROLINE ST PORT ANGELES WA 983623901 OWNER Other struct info . TOTAL % LOT COVERAGE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS 20.00 1. 00 2885.00 17500.00 609.00 3494.00 1. 00 " ~ ~ ....... Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER COMMERCIAL OLY EL./ ADDITION 77214 OLYMPIC ELECTRIC 61.30 5/11/06 11/07/06 plan Check Fee Valuation .00 o ~ ~ t } (f\ Qty 1. 00 Unit Charge Per 61.3000 ECH EL-COMM ALT <5 CIRCUITS Extension 61.30 Special Notes and Comments The Fire Department has reviewed the project application and has no comments Electrical load calculations and elctrical permits are required. Electric meter must remain accessible. 02/01/2006 11:56 AM GMCLAIN _____________________c______ 02/01/2006 11:57 AM GMCLAIN ---------------------------- Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. lI\ ~l Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 61.30 61.30 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Tot ail. 4.50 4.50 .00 .00 Grand Total 65.80 65.80 .00 .00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. 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REQUEST: Date~ Olp Time Received by (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No. Type of Ins (circle appropriate one): Permit No. Sewer Foundatio) Framing Chimney Plumbing Final Sewer Excav. Other (02.( e: c..~~\ IU~ INSPECTION NOT~~_:, _, _ Inspected: Date ~ Rema~s: , '- Time A. M By JLL ~~~~ " r ~.) i ~~~/ \"\O..L'1 ,~ ~~V\ I RESTORATION REQUIRED . . . . .. YES ~ NO ~ei-:l u's L~~~rL , ----- A.. .....1.. ~ "f -- 1-~ ~v\2.b,~J ~~ ~)\ \0\0 4~o - I~~t{ ~~ SURFACE RESTORATION: SURFACE TYPE: D Unimproved D Gravel D Asphalt 0 PCC D Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE -, )0- W --1 --1 -<( ~~ I I I ~ ~ ~I 11 ~', 11 "'. ~ I' II I' [I '-ll li! ~ :d i ..... i ~j; B i~5 ~&~ ,,~..... . x~a w~a~ I~~ ~ 2( :d ~ -' ~ w ~ ~ li! ~ i ..... ~ lI:~~ ,U. ~ I~~ \. "I' I ~~w w~lf\!:! I Q~8 L 63'-> _ _ fi!Wlf _ _ _ _ _ - - - - - - - - ~ - 3H~-- C''' '110 In ,,"v.. ~J BUILDING PERMIT - APPLICATION ~~~) ..~ . ,..~ . ~_.._ ;L::;.::.~_.:~. Fill out COMPLETELY and in INK. Your application and site plan MUST B '!".-- I ", -----=--- / COIvIPLETE ta be act:epLeu [oJ' review. If you have aDY questions, c::.11 PERMITS (360) 417-4815 FAX(360)417-4711 Applicant or Agent: ~l..JIJ eOrlS () -f~C(Q Owner: O/~ ~~ iL fl1.~_ct'LA.1 Ce.Y\. +eLf Address:~ 1=-. Cc--rc};1\O 5'1, City: PD,..tAl}Q~ Architect/Engineer: L;"J b..M-1 <f 5m,+~ (1<<1, Contractor l)lyrvtf ,'t.. fl'l.ej;cc,\ ~tate License #: Address: ~ E (CA.lf'o\;I\JL 5f, City: fJor-1- PROJECT ADDRESS:~:2.1 . ~ L-a.ro('1I\D Sf. t!v\ \ ~i (\j Phone: Phone:(5'bO) Lf II - 7 J <C3 Zip: Phone: '-/)d - bl/Cr, Exp: Phone: A ~Q..,l.r..5> W..\ Zip: <t ~ -5 b ~, ,pol'lr A~l~,> ZONING: (,ty of for-'rA~ 1~ LEGAL DESCRIPTION: Lot: Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: 0(, ~O 00 S 3 0 4-40 ottJ C?O TYPE OF WORK: SIZENALUATION.;.:/. c- ^ r 00 o Residential 0 New Constr. 0 Re-roof 0 Stove ta oq SF. @ J. JiIi::..:> /SF. = $ IOV1 ~ BJ · o Multi-family ~ Addition 0 Move 0 Garage SF. @ $ /SF. = $ ~ Commercial 0 Remodel Ji{ Demolition 0 Deck SF. (cV, $ /SF. = $ o Repair 0 Sign 0 Other TOTAL \T ALVA TION $ 100. 4"8'':'-' eJO BRIEFDESCRIPTIONOFTREPROJECT: o...~d{^1 ^-Jell) 5inrO~t. <;pG..U' ) fleLV <?](C.~ ~()~v-'\) CA-v0. J1J:;.J-JJ O~: C~ I (ni~,^ S~MQ.. A" W\.b vG- T 'v\-\-ev~e{ ~ lls. . ()PJ..~ r~\ \-\~~ ()C)J rfLJ. GA S~.1 ~I w\\-h UJoe>J ~\N\~ f\), ~k\ R-c.e9.. r ~ 11 ~ COMMERCLA.LIRESIDENTIAL: Occupancy Group: ~~i~~ B Occupant Load:' Construction Type: ~ l'y(1<2. V- B . I I No. of Stories: ~ Lot Size: 12..5 X I yo Existing Sq. Ft. .;;885" & Proposed Sq. Ft. faDq = TOTAL Sq. Ft. 3LjCf '1 Total lot coverage 2..0 % ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: APPRO V ALS: PLAN: BLDG: DP'WU: FIRE: OTHER:_ PLANNING USE ONLY: VALUATION OF CONSTRUCTION: In all cases, a valuation amount mllst be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CRECK FEE: IF a plan check fee.is due it must be submitted at the time the building pemrit application and construction plans are submitted. All other permit fees are due at the time of pern:nt issuance. EXPIR.l\.TION OF PLAN REVIEW: lino peront is issued within 180 days oftlle date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R1 05.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that.! have read and examined this application and know the same 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 ,not the City's, and that I must obtain such permits prior to work. T:\Policies\BL-II02_13.wpd APplicant:~ ~ Date: 1--2.& -o{P . . . tf . ~ CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 96362 (206) 457-0411 ELECTRICAL PERMIT Site Address: PERMIT NO. ~ h 0 $I DATE .-S-: //- 9?- . Installed By: D READY FOR INSPECTION license Number: WILL CALL FOR INSPECTION Phone: Owner/Business: Owner/Business Address: D RESIDENTIAL D COMMERCIAL D BASEBOARD KW _ D FURNACE KW _ D FAN/WALL KW _ D HEAT PUMP KW D SIGN D TEMPORARY SERVICE D PERMANENT SERVICE D NEW CONSTRUCTION D REMODEL D ADD/ALTER CIRCUITS D SERVICE UPGRADE/REPAIR Details/Description: D SPECIAL EQUIPMENT ~ (LIST BELOW) ~ {/~A~ ~ r<!/~/L<-.t: o~ 1 Phone: Sq. Ft. D OVERHEAD SERVICE D UNDERGROUND SERVICE VOLTAGE: D SINGLE PHASE D THREE PHASE SERVICE SIZE AMPS W.S. No. SERVICE SIZE CAPACITY: D O.K. NOT O.K. ACTION REQUIRED: D CHANGE TRANSFORMER D INSTALL SERVICE POLE DATE ENGR. D CHANGE SERVICE WIRE D OTHER D Ditch Inspection O.K. "$->Rough-in/cover O.K. D O.K. to connect service \y Final O.K. Installer: New Meters Site Address: Permit/Receipt No. :3~o'l Date: 5-/1 Notify Port Angeles City Light by Street Address and Per it Number when 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 eitherthe Wiring Report or on the Building er it. PHONE 457-0411, EXT. 224. NO OCCUPANCY OR USE ESTABLISHED UNDEA THIS PERMIT $ WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer OLYMPIC PAINTERS INC. 2,(J. ()O Permit Fee GREEN - Top: MeIer Dept., Bottom: City Hall . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT Site Address: r> II , l..-!IW( DATE 3S.33 "Jj;,/f<:- PERMIT NO. Installed By: D READY FOR INSPECTION license Number: D WILL CALL FOR INSPECTION Phone: Owner/Business: Owner/Business Address: D jlESIDENTIAL IH'COMMERCIAL D BASEBOARD KW D FURNACE KW ~ D FAN/WALL KW _ D HEAT PUMP KW--S.- D SIGN D TEMPORARY SERVICE D PERMANENT SERVICE D lilEW CONSTRUCTION Io'IREMODEL D ADD/ALTER CIRCUITS D SERVICE UPGRADE/REPAIR D SPECIAL EQUIPMENT (LIST BELOW) DetailslDescription: Phone: Sq. Ft. D OVERHEAD SERVICE D UNDERGROUND SERVICE VOLTAGE: D SINGLE PHASE D THREE PHASE SERVICE SIZE AMPS ~ 8 /(uJ ~ ( F s-J'cu /I. f>. r . W.S. No. SERVICE SIZE CAPACITY: D O.K. NOT O.K. ACTION REQUIRED: D CHANGE TRANSFORMER D INSTALL SERVICE POLE DATE ENGR. D CHANGE SERVICE WIRE D OTHER D Ditch Inspection O.K. ;(tM A Rough-in/cover O.K. D O.K. to connect service D Final O.K. Site Address: /O.:l! ;/J()E- I f ( New Meters Installer: Permit/Receipt No. . Notify Port Angeles City Light by Street Address and Permit Number when 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 Permit. PHONE 457-0411, EXT. 224. NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ :l:~tor WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer OLYMPIC PRINTERS INC (1.-0 c;2f)- Permit Fee GREEN - Top: Meter Dept., Bottom: City Hall CYs--Dfl' FEE RECEIPT NUMBER CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND. ELECTRICAL PERMIT A 000350 PERMIT NUMBEA '. , (/~ -. TOTAL FEE' " \, . . " CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY ELECTRICAL PERMIT ONLY NO OCCUPANCY OA USE ESTABUSHED UNDER THIS PERMIT PEAMITS WITH WRONG ADDRESSES ARE CANCELLED Owner Installation By rg7V/A/slLA- 8€C://l2frr Installers Address 20 t: F pp-",u --v-- Day Phone - - Installers Phone jj C;-7 - 9~ 0"7 r-: I ~ -- Application is hereby made for Permit to install Electrical Equipment as follows: / 1J S~L r nrf 8,. 'Rv/26.'-1f1Z.. J::rl2E" 4-L-.bf-tZM / i'-n..ve ~_ , - Wiring Method . NUMBER AMP 120V 240V NUMBER AMP 120V 24QV USE OF CIRCUIT CIRCUITS PEA '0 100R FEE USE OF CIRCUIT CIRCUITS PEA '0 100R FEE CIA 30 CIA 30 LIGHT SIGN LIGHT 50 VOLTS OR LESS CONVENIENCE . MOTOR CONVENIENCE. MOTOR APPLIANCE. MOTOR DrSH.WASH~R FIAE ALAAMS / /., DISPOSAL BUAGLAA ALAAM / 11.t~ RANGE MISC. OVEN WATER HEATER LAUNDRY DRYER REINSTALLATION LIGHT FIXTURE # / FURNACE SUB TOTAL FEE ?/~ GAS - OIL FURNACE ENERGY FEE ElECTRIC BASIC FEE 1-. ELECTRIC HEAT - 1'0 /h vv TOTAL FEE ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.C. UNIT PHASE AMP FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICE A.W.G. . I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH I certify that the work to be performed under this permit will be done by the Installer and in conformance with the N.E.C. Electncal Code. DateApplicationmade / ~ ,19 ?~y + CONTRACTOR OR OWNER (OR AUTHORIZEO AGENT) ~ Permission is hereby given to do the above described work, according to the conditions hereon and accordtng to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances oJ the City of Port Angeles. " . /k- _~E~ OFCI~:~HT \. By~Cet!~~ PLANS APPROVED ;- '~ ' -, . Date Permit Issued WARNING 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 Writing on Permit Placard, A. - Permits Phone: 457.0411 Ext. 158. PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ WHITE - Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report "', VLIIPIf". PRINTERS. INC. " '. (. ., . REPORT OF INSPECTOR ...:.....--~'<'> '(. j ~ -' OATEOFVISIT MADE BY REMARKS - ~-16r '1J -?If Y, /?f( ji-If/(# 5 YSreN! Po;f.' C'tJ t/ .e. /? Srr/..L ct "q . (,^, 11ft? J IS '!. <<r rl tf'e SV!:'/e/Vt ,- , \ - - , " , ---, '_'\ _ AI \\ . , -- -'\ .- . - - ~.-' \': \-, }:.\.... , ..,\....\ : ~ ....\'J\.,~' . .,). \ -\ ;\( ,.,..... ~- , \ ( . ' '..1 ~! \, . - , , ~ .' , " ~ " J \.-Y'\\ J , ',) .\.. '.::"" \'"""' ~~ ''", , .. "oJ _ ., , ... " .4 ~.... ... .4 _-., " \ - - \' , - , - "'-',1.\ " \ . '\ .' . I ,\ \ . J. ~ .. . .. :,\ - \ ~.\\\ , ;,. :' - ~"'J - , .; _, + .l.r-4. :4~ , . , H. - - . . , , . . ...:".\ "'- " , '~ ~"'" ;:\~ ~ \ . .\-\. ')\ ' " . , , " " ....} , .\. ;~ ~) \ \i - ,-- \, "- 5/ }-.)- (? ---;y;n O.K. FOR COVERING . . , 1/'.2' tI "jilf )? .- ... , ~') " O.K. TO CONNECT SERVICE . -~ ". "- (;2. , L( 8') 11l~' .~ , , ~ "- , . - FINAL O.K. I ,. .' z Cl II: < :!E ~ :I: I- Z W l- . I- o Z o C . tJ)1f70 CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A 000301 FEE RECEIPT NUMBEA PERMIT NUMBEA . g!2. 1 ~I'MIe-(ei' 7"60 I'S ('oM Nt , TOTAL FEE 80. \..CONT. Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY " ELECTRICAL PERMIT ONLY NO OCCUPANCY OA USE ESTABLISHED UNDER THIS PERMIT OJ-I E ~RECT ADDRESS IS"RESPONSIBILlTY OF APPLlCAN ~:~:;'SAd~h, "'.~.:2r~~~':-'~q'''' " Day Phone 4.< '7 - ~ ;:, ~ ", Installers Phone Application is hereby made for ~ermit to install Electrical Equipment as follows: ~t-. (!)~ Installation By Installers Address Site Address Wiring Method \={~~ . NUMBER AMP USE OF CIRCUIT CIRCUITS PER CI~ LIGHT LIGHT CONVENIENCE CONVENIENCE APPLIANCE DISHWASHER DISPOSAL .~ RANGE OVEN WATER HEATER LAUNDRY DRYER FURNACE GAS - OIL FURNACE ELECTRIC ELECTRIC HEAT ELECTRIC HEAT A.C. UNIT FEEDER SERVICE 120V '0 240V 100R 30 FEE USE OF CIRCUIT NUMBER C.IRCUITS AMP PER CIR 120V '0 240V 100~ 30 FEE SIGN _ 50 VOLTS OR LESS MOTOR MOTOR MOTOR FIRE ALARMS BURGLAR ALARM MISC, REINSTALLATION LIGHT FIXTURE # SUB TOTAL FEE ENERGY FEE BASIC FEE TOTAL FEE r':?~,~ SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER ~CO AMP I af SIZE OF SERVICE ENTRANCE CONDUCTORS PHASE ,%- A.W.G. I SUB-TOTAL SIZE OF GROUND 7" SIZE OF ENTRANCE SWITCH ~ I certify that the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code. Date Application made <.~R,I R:5 ,19 By ~~~ / .......CONTRACTOR OR OWNE (OR AUTHORIZED AGEN~ Permission is hereby given.to do the above described. work, according to the conditions hereon and according to the approved plan~ and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. Date Permit Issued ~CANSA1:~17~~' " . ~-~r,rs I WARNING I Notify Department 01 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 Writing on Permit Placard. A. ' Permits Phone: 457.0411 Ext. 158. PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ WHITE. Original CANARY - Duplicate PINK. Triplicate WHITE CARD. Inspector's Report OLYMPIC PRINTERS,INC. DATE OF VISIT 11>-7-'1):> /J--tt-i !,- ~-l z..-?L (;-1.1.- -6> 'J--/t -rS- /0-10-15"':> 3-/l.--n, MADE BY -1ff.)? /}/ fY ::; r JAr, k.. c.h....(l'- f1j~ /f1~ J 1;Y /; '/-9 . IJ. V , I REPORT OF INSPECTOR REMARKS ~j( I/? rf'<"J/ (lor/Pln'f fA( I/rTc'( Flcct{ ou7b7 ill .5t(f{~ef/.Y IJ ;f'~tf. /fsepf'DL Af'{ITy J/RDllrYf) '--"Dr liS/ 1~._"fI,r(',{j1 ,<;,1f{l~- E)(4-M.l"'lllJ.. -t..,^\i. .- , ~H.r (,,~C,,/73 M()Sr ~ ;P.~ ..... 1/,( v.J rile ;./U T.5 VAl tk' ,t?e 5 J IJ 'rl~ a.V' A~ -. 7/s ~ - L/..> 'f b/...U ~ l /.J'f I C I' n .p.A L-v f?e f'J",( p --r;.,." Po rt.u<JR5C<'rVT 5 /NPC.Hh.AN'7 Lt c.I'fs Ct./tT4 ~R''1 /) If r D,f f) t-4A O.K. FOR COVERING O.K. TO CONNECT SERVICE FINAL O.K. . z CI a: cl: ::!! !!! :z:: I- z W I- [e I- o Z o c . rl &~bC FEE RECEIPT NUMBER CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A 000256 PERMIT NUMBER '. - ~ele)~~ t.../' -- (! oMJIIl TOTAL FEE It (>0- ~ \.CONT. Lie. NO. TIMETOCQMPlETE NO. STORIES LEGAL OCCUPANCY ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT Site Address lO;),/- t:-.'" QarD(')Yl~ Owner <7'-. '-- ~CO~RR~~CT~ADDnRE~SS IS7RESPONSIBIUTY OF APPLICANT PERMITS WITH WRON~ ADDRESSES AAE CANCELLED ...L.... Y.JL;, Installation By ;:;0. p fes <:;;./ ~r'r' ~ Owner's-Address I ~;>t f"-R , Installers Address ,,~l/b.,;Y- I.~'-- Day Phone Ltf) 7 - ~ ~ ~ '1 Installers Phone J7 oS ;}..-C}:L(; 'f Application;5 hereby made}or Permit to install Electrical.Equipment as follows: -reN\-O CAr~ S;<E-/'t) tr./ , '\J Wiring Method USE OF CIRCUIT NUMBER CIRCUITS AMP PEA CIA 120V '0 24QV 100R 30 FEE USE OF CIRCUIT A NUMBER CIRCUITS AMP PEA CIA 120V. '0 240V 100R 30 FEE LIGHT LIGHT CONVENIENCE CONVENIENCE APPLIANCE DISHWASHER DISPOSAL -. RANGE OVEN WATER HEATER lAUNDRY- - DRYER FURNACE GAS - Oil FURNACE ELECTRIC ELECTRIC HEAT ELECTRIC HEAT - A.C. UNIT FEEDER SERVICE ., SIGN /''':' \ ~O~TSS----"::,> . M'0fo~; <'7 ~OTO~<> ~.~.~-v ,1::":'/1 ,~. , ' ,~,,~ '.. (/',:-"' -...::; 'V REINSTAllATION LIGHT FIXTURE # SUB TOTAL FEE ENERGY FEE BASIC FEE TOTAL FEE 1';; t}JZ- SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER , &0 AMP / b SIZE OF SERVICE ENTRANCE CONDUCTORS PHASE AW.G. ISUB:TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH . Date Permit Issued - , I certify that the work to be performed under thIs permit will be done by the Installer and in conform Date A~p;,catlon made ~b i 8"LS ' ,19 By I ~ CONTRACTOR OR OWN (OR AUTHORIZED AGENTf PermJssio.n is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City 9f Port Angeles. lr~. ..... /I~~tf-t~ By ~~?JJ:~L0- --( PLANS APP OVED . . ~ ,_' _.~ 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 Writing on Permit Placard. A. . Permits Phone: 457.0411 Ext. 158. :r-l v":' ....~/ WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER - WHITE. OrIginal CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report 01 YMPIr. PRINTFR~ INr. '<..: :.~;~'~.;~; DATE OF VISIT MADE BY ..' T. '" J ..' u- U.-!S ~ Ii-rU - <(5 ""7- r//f~ 1+, J-t -~~,) v REPORT OF INSPECTOR , \, " '. \.. REMARKS "- '. \ (,r, , lC</, , ~ " O.K. FOR COVERING , O.K. TO, CO~NECT SERVICE FINAL O.K. "'~"', "'.. ., ":, ''\, '~" '\ ~ ,/' . , '.l'" -. . " " - -, . ...~ ( , \ \ ~~ 1 .' z CI II: <C :E ~ J: I- Z W l- . I- o Z o o . CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . INSPECTION REPORT. . . . . . . . REQUEST: Date S.- I { - {i b Time 7 t4 ~. Received by ~....'" ,',; E (phone. person) Location of Work to be inspected 10 Z{ C"'--ro (I ~ Name of person requesting inspection DLiA......, S ,c'. Address of person requesting inspection ~ rv:J Vc...r'; I Type of Inspection (circle appropriate one): 17 ~BPhone No. iff? -'-{ !?q'jl Sewer Foundation Framing Chimney Plumbing Permit No. Final Sewer Excav. Oth~"--+~~ INSPECTION NOTES: Inspected: ))ate 8 -( ( -010 Remarks: /(e;26-., red SLr v l 'coe.. p Time c:; AM By tJ<Hvt'C, C. 1e.",kolA. t>,,-<=-k5 id:L b~ s.>-rvl~,,-. RESTORATION REQUiRED...... YES J>( NO ttJ ; -,~~,', CC>I'\_<:..vdc.. ,1-y...: aek;~ M+" bolC " .~' {' lU ~ ..... o C:," ~L. (:) SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel 0 Asphalt OPCC ~therGvt. cfc.. +~ )X!.l Z'l<3'. /", {J~II'" k'':'5 ~i-. 3'1/77-( o Repaired by City Work Order # [] Repaired by Permittee ~ COMPLETE [] No Damage Found [] INCOMPLETE -f(; S-ked-- F b1:!O& IF (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . INSPECTION REPORT. . . . . . REQUEST: Date 5"'?r o~ Time 5 AM- Received by /Je......,-~ F- (phone, person) ~ Location of Work to be inspected 102-1 &'0 ( ; vL.L Name of person requesting inspection 'i)e...."'.' ';) p-. Address of person requesting inspection Cc,r,o Y,;..rei I Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing Final (7of.-!S Phone No. L{(7-'f&c.f"j Permit No. Sewer Excav. Ot~tJ4\...+e') INSPECTION NOTES: Inspected: Date S -5" -0 Co Time (0 11 M By &'1."1;5 €. Re~arks: ~e"'^-Dve.d old 5^/B'tt L"rf Oe-;-Ic.j)) P",,'h:.kA l,o(e. w:-I-i.. <'L 10" vV,te. Ir;(",;r b3V\.d - Re..+e;..(Jf~J. vS':5 "" c"KI--r--",t' sA.ddl<=. ~J LO..o) Ie uc.e~ -to I<{ PE:.. ",-V\.d ......"'" .... 3/,/" P./E . -to i-vI.L-te.r. I v RESTORATION REQUiRED...... YES X NO ~ W~(..<-+~ , -.. Or,vL. ~~ ,f'r;ili C l ~ '}.. 4.J~ B c~ro/;"'-e - 'l..- ~ ".._IN ~ ';:;';N 4;) f " ~ 2.'iI~'.,.. Zoo , i .: ~ ~ I i L .~ - or) "'--' j'-' ~ '-i ~ ~" ,4-c- 3 ' tJe.e.f } 0 'f: 'i VJ Ri "'!'ra " N 00 5 , SURFACE RESTORATION: SURFAGE TYPE: 0 Unimproved DGravel o Repaired by City o Repaired by Permittee o No Damage Found :; )(.~. e<nlu..!. ""..Ttl BIS}t o Asphalt 0 PCC gJ Other G:,"'-CT<e..+~ Work Order # $o5'1c.-/03 C2lZ1' COMPLETE -g'l:/f77-::-IJ y~ INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT !DATE) fRllE (C IE u vfflr SEP 2 9 2008 ELECTRICAL WORKPERMlT APPLICATION UBHT DEPT. 09/26/2008 05:01 4579270 08 -l2L( 2 " Job wired by )ll EledrlC1lI Contractor tJ Owber D3~ &piTe~ 01 W ~~e ZIP W!f q 8'3.63 FAX number #. 'YU?_ .5t.i/eg~ rrembe, owner', ,,_me Om c..- Addrenr ;::2t.~ sI CIty fbltf- .ej.e-5 . '''one nllmb~!Jo s:ebtdule nJptc:tlon: . -'. - 0 OWller-lu dclinrd h)' RCJfI./.9.28.26J:(fJ OM'""r wif1 OCCllp)' ,hI! ~1f'UCIIJP.~JQ" 1Wf) yean q/ie" fht.f ,-1(:~lriC(11 J1{'mlil ;t finolirEd. (2) Owner- i.' reqllJ'r-ed M "iN! mI ~lccf1ical r=ntllNU:'"'' if ~~ J:lflJ f""O~r1y is for stlk r~t or ItOSf!. After rCBding the above mtcmml, I hereby CCf1ify that I am the owner of the above namtd property or a licensed Elcctl:'ical conne'('It. , am making the tl~cal iu.qal~ lanon or alteration in ccmpli:J.nct wi 1 r: elet.:trical lawl. N.E.C., RCW. Chapter 19.28. WAC. Chapler 296-4tiB, Tl C y of Port Angeles Municipal Code. and Utility S'Peeificl:\tinn~_ Signa' ern 'Der. tIe rh:llII . .. . ""1. Electrical Load AddlllAnltl!. d o NO LOAD CHANGES o Baseboard KW a Fumace KW 1:1 Heal PUMP _ Ton _ L.AR CI Fan.Wall _ KW .l!trsc;.\lI'Jll; ELECTRIC PAGE Iftstall:ation d~C1'jption )4 Comm.rdlll 0 aeolcktilbl ON... )(AltondlAddltlnn /-5 t:/KlJu/r/-5 fjddj ~ )- d R(7~ (..~ /Mf>Ie-H I N ~ o CB9h tJ Check # CredilCanl C~ Mastetcllrd Discover C~#___~~__~____ Expirntion Date ofcard Inspection ~ S .-. .$ervlce~ Q Overhead Service 1:1 Temp SoMCO 1:1 Underground Service VolIBge Phaoe0103 Sorvk:o SIze, _ F_r SIze, SAME DAY INSPECTtON, CALL BEFORE 7:00 AM 360-417-4735 r ROUGB-IN r THERMOSTAT 9/:.o/oa W Oolle U.lc "".........,d Ry \.. A..,.......,.. A,. 1'JNAL Drrat ':1./ ;:jaR 'WSi7 ^ R,/ "- ON, AOproYed by Inspection Date Areu., Build;ng or Equipment In.'lpectcd ;' SERVICE 0.. ^~'n,.. FEmm. '- "'" ^",",~By./ Action Takt1t Electrical Inspeclor 01 \) O'Q \ N -C. rJ ~ ~ ........ Job ",ired by o Electrical Contractor 0 Owner lio'r' v;;t~ ;-"Z &15 t:; Lieen" IIwnl><, Dale Ii.p,,"' Purchaser"s mailing ilddress '1:2.3l> "n)MWar~'/ c i~ I Sta.t~ ZIP f:.pff l}f\jt.J a /,,(/11 q~363 Tc:l~phone R\,1mbe1 FAX nwnber -; jo S ] q g Premises uwuer'$ name OL'/m!,"c, Me,J?;C~ I UhTe,y Ad.dres.s of huptldion / . ri \ _~ C.a rtJ .11..e... l::J-O Z I J ell /I ./ YYt,~-r/1-n9'/~f w,t'; qf:JI;;- Phunt: Dumber 10 scbed.ule lD:alpc:cdon: '117 7/ , 3 Owner Cl,y dejined by /l.CW.J9.JH.161 :(1) Owner will occupy the ,)"lructUrc: flJr (Wu yeary ajWf' rnu d~ctrical !Jc!.I"mit j,). ji'lali:r:d. (2) Owner U' (~CJuircd to hire: un IilJI:!ClriCul CDI1,,.UC(or if ubove :iaid property u for ,talc. rem or t~$t!. Atttr reading the above statement, t hereby certify thut I am t.h~ owner of the ;above named property or jJ licensed ~leClric3.1 conlr3.ctOr. , alll makinG the el~ctri.cal illStal- latian or alteration in conlpllancc with. th.e eh:clfic31 lawS. N.f.C.. RCW, ChapleJ' 19.28. WAC. Chuplec 296-46S. The City of por( Angeles Municipal Cude. Ilnu Utility Specitl.cations, Si.enature or cr. electrical COIUr , x tor 01" cleccril:i\l admll\lstratot Date:5/;o/d~ Ele~tric81 Load Additions and or suhtractlons IJ NO LOAD CHANGES o Baseboard __ KW o Furnace _ KW o Heal pump ~ Ton _ LAR IJ Fan-Wall _ KW ELECTRICAL WORKPERMlT APPLICATION ~ InstaJllS(iult description ~ Commercial lJ Residential DNew ;1(AlteredlAddition /0 wty fiNK! L-I'CHfJ~:J Fp/ AlJJ!J,'r/tli-1 ee~M.. t'JIC wAsH 'fJ- tUuuJ;l~ /-5 C/~r.5 Q Cash 0 Check # '1 o Credit Card Vi", Mastercard Discover C~#________________ Expiration Date of card Voltage I).d/;'<{() Phase li{11J a Service Siz;e: _ Feeder Size: a Overhead Service o Temp ServlcQ &' Underground Service SAME DAY INSPECTiON. CALL BEFORE 7:00 AM 360-417-4735 I I ~ I SERViCE ROUGH-IN TOERMOSTAT !/;,j ?, ~T I I DotlC: App","cd &)" Dill" ApptOvl:A.ll'y /' / /' FINAL DrrcH FJ(EJ)ER ..., - Iii.,,' ..kQ " Dill.;: I't.Llllrovul5y / blll~ ^PPNV" By ./ 1)4111 .A.l'provc:IJtJy In~Jl~ction Area, Building or Equipment lm:;pectcd Aclion Taken Elcctricd Date Inspector I - Zl'J( / "-/1' /_/ ~ / .1 .' 10 39vd 8I~183l3 8IdWAlO 86PEZSP09E EP:0I 900Z/0I/S0