HomeMy WebLinkAbout115 N Eunice St - Building
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CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000483 Date
.847049
115 N EUNICE ST
06-30-00-5-1-2230-0000-
SIGNS
6/08/04
COMMERCIAL ARTERIAL
200
Owner
Contractor
HOWARD PRIEST
PO BOX 844
PORT ANGELES, WA.
PORT ANGELES
( 36) 457-8834
WA 98362
ADVERTISING SALES & MORE
1327 E. 1ST STREET
PORT ANGELES
PORT ANGELES WA 98362
(360) 452-7785
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Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL SIGN PERMITS
2 SIGNS ON SAME BUILDING
SIMPSON ELECTRIC
52.10 Plan Check Fee
6/08/04 Valuation
12/05/04
.00
200
~
Qty
1. 00
1. 00
Unit Charge Per
35.3000 ECH EL-COMM-1ST SIGN
16.8000 ECH EL-COMM-ADD SIGN
Extension
35.30
16.80
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 52.10 52.10 .00 .00
Plan Check Totar .00 .00 .00 .00
Grand Total 52.10 52.10 .00 .00
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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:\PLANNING\FORMS\I 102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE 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 DRAINAGElDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
,
SLAB
WALL / FLOOR / CEILING I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
I
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANIT AR Y
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 7'fJ-B-o<l At:;O ELECTRICAL I
. 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
T:\PLANNING\FORMS\1102.15 [11/1412003]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
property Zoning . . .
Application valuation
04-00000108 Date
.097672
115 N EUNICE ST
06-30-00-5-1-2230-0000-
MECHANICAL PERMIT
2/11/04
COMMERCIAL ARTERIAL
4420
Owner
Contractor
HOWARD PRIEST
PO BOX 844
PORT ANGELES, WA.
PORT ANGELES
( 36) 457-8834
WA 98362
DAVE'S HEATING & COOLING
PO BOX 413
PORT ANGELES WA 98363
(360) 452-0939
Permit . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER COMMERCIAL
35.30
2/11/04
8/09/04
Plan Check Fee
Valuation
.00
o
"'-
"-
~
Qty Unit Charge Per
1.00 35.3000 ECH EL-LVT-FIRST THERMOSTAT
Extension
35.30
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35.30 35.30 .00 .00
.Plan-Check Total .00 .00 .00 .00
Grand Total 35.30 35.30 .00 .00
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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.
Date
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T:\PLANNING\FORMS\1102.15 [11/1412003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 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
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I I
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYW ALL (INTERIOR BRACED PANEL ONLY)
ToBAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL ~h /In/. J4N
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 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\1102.15 [11/1412003]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Zoning . . .
Application valuation
03-00001156 Date 12/07/03
115 N EUNICE ST
06-30-00-5-1-2230-0000-
ELECTRICAL ONLY
COMMERCIAL ARTERIAL
o
Owner
Contractor
HOWARD PRIEST
PO BOX 844
PORT ANGELES, WA.
PORT ANGELES
(360) 457-8834
OWNER
WA 98362
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER COMMERCIAL
CONVERT RES. TO COM.
59.40 Plan Check Fee
12/07/03 Valuation
6/05/04
.00
o
ll'\
Qty Unit Charge Per
1.00 59.4000 ECH EL-COMM ALT <5 CIRCUITS
Extension
59.40
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 59.40 59.40 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 59.40 59.40 .00 .00
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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.
Date
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T:\PLANNING\FORMS\I 102.15 [11/1412003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CO!,/CEAL 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
FOUNDATION:
FOOTINGS
WALLS
FOUNDATiON DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS / GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I I I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTiON
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 b'lo.04 ..k.Q ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTiON - R.W.
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNlNG\FORMS\1102.15 [11/14/2003]
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ROUTING SLIP ':Pee-M ;+ *-05.- ttbfS\
Certificate of Occupancy ..~
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]iiJ.i Certificate/Inspection Fee =-
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DATE /;(,- :2.- 03 New Business ........................... . ( J )
Address of Proposed Business Transfer of Business location. . . . . . . . . . . . . . . . ( )
//5 N. 6.l.1nir.e- S-treet Change of Ownership . . . . . . . . . . . . . . . . . . . . . . ( )
Applicant .Ilowa r d Pr/psf: New Building ............................ . ( )
Address BO.13oX ~Lf'f Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
fbrt:;M~ ~. 'lB~~ Temporary Business ...................... . ( )
Phone: business - g home 'f&);). - ~ ~ ~1 Change of Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
Brief description of proposed business: m. 0 r-/;J ()., j e. 13roke,,11v.3 ~
legal Description: lot q Block ~.;t. Subdivision Norman R. Sm I'th
Current Use of Property: f<.. fJ_"'l; det)*-i 6.-l C.onverrti nj -to Gom m e;-.c...i 6l L
Zoning Classification of Property: C()Jr1MP.r~; aJL A rt.e,.1 0.. L
Will THERE BE ANY OF THE FOllOWING? YES NO THE FOllOWING Will BE REQUIRED:
Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . . ~.- PERMITS BUSINESS LICENSE
Electrical changes. . . . . . . . , , . . . . . , . . . . . , . . . . . . . . V_ 1) Building 1) Taxi
Mechanical (heating, cooling, stoves) . . . . . , , , . . . . . . V_ 2) Plumbing 2) Peddlers
Plumbing changes ............................. ~- 3) Electrical 3) 2nd Hand Dealer
New or relocated signs. . . . . . . . . . . . . . . . . . . . . . . . . . ~- 4) Mechanical 4) Pawn Broker
New septic tanks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ V 5) Sewer 5) Dance
New sewer service ............................. -~ 6) Sidewalk installation 6) Hotel - Motel
Admission charged to patrons. . . . . . . . . . . . . . . . . . . . -~ 7) Driveway installation 7) Fireworks
Is this a home occupation? ..................... . -~ 8) Curb installation 8) Ambulance
Excavation of filling of lots ..... . . . . . . . . . . . . . . . . . . -~ 9) Sidewalk obstruction 9) Tattoo shop
Work done in City right-of-way. . . . . . . . . . . . . . . . . . . . -~ 10) Water meter installation 10) Other
Is there sufficient off-street parking? . . . . . . . . . . . . . . . ~- 11 ) Fire
New driveway openings . . . . . . . . . . . . . . . . . . . . . . . . . -~ 12) Occupancy
A grading plan for site drainage. . . . . . . . . . . . . . . . . . . -~ 13) Sign
(parking lots, downspouts, etc.) ................. . -~ 14) Shoreline
Are the existing streets paved? ................... -L_ 15) Home occupation
Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . . ~- 16) Conditional use
Is there curb and gutter? . . . . . . . . . . . . . . . . . . . . . . . . ~- 17) Other
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . --
I hereby apply for a Certificate of Occupancy and acknowl- ~.z ~ 03
edge that I have read this application and state that the Date:
information I have supplied is correct to the best of my
knowledge. Signed: m~ 71ip4b
~~~JECTED Comments / Conditions
Building Section
Public Works Department
Planning Department
~QO Fire Department
-1.9 -Il-ol! .-2;,u City Clerk
P.B.I.A.
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DiVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT ISSUED: 9/12/2001 PERMIT NO: 12949
OWNER/APPLICANT PROPERTY LOCATION
TOM GAULT 115 EUNICE N
P.O. BOX 1033 Lot: 9
SEQUIM, WA 98382 Block: 22 [] Long Legal
360/683-4562 Subdivision: N R SMITH
T: S: Parcel No: 063000512230000
CONTRACTOR ARCHITECT
OWNER N/A
VARIOUS
Port Angeles, WA 99360 , 98360-0000
206/000-0000 360/000-0000
PROJECT INFO
Project Value: $550.00 SFD Units: 0 Commercial: 0
Project Type: REROOF SFD SQ FT: 0 Industrial: 0
Occupancy Type: Garage: 0
Occupancy Group: MFD Units: 0 ~..f~
Construction Type: MFD SQ FT: 0
Zoning Use:
PROJECT NOTES
TEAROFF, FELT, COMP
RECEIPT # 8011
FEES ASSESSMENT
Building Permit: $26.55 Misc Fee 1: $0.00
Plan Check: $0.00 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: $31.05
Plumbing: $0.00 AMOUNT PAID: $31.05
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
Separate Permits am 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 Eom 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 'g f-Owner (if owne is builder) Date
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 1N A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE ~
INSPECTION TYPE DATE ACCEPTED COMMEN~S
YES ] NO
FOUNDATION:
BUILDING 4174815 /O-/~ ~( ,~C'& BUILDING
4.0fi:\'ORT~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
03-00001165 Date
115 N EUNICE ST
06-30-00-5-1-2230-0000-
COMM REMODEL
1/13/04
COMMERCIAL ARTERIAL
10000
Owner
Contractor
HOWARD PRIEST
PO BOX 844
PORT ANGELES, WA.
PORT ANGELES
( 36) 457-8834
Structure Information
Construction Type . . . .
Occupancy Type . . . . .
OWNER
WA 98362
CONVERT RES TO COMM ADD ADA RESTROOM
TYPE V NON-RATED
BUSINESS:OFF/PRO/MED/REST
Permit BUILDING PERMIT - COMMERCIAL
Additional desc
Permit Fee 204.75 Plan Check Fee 133.09
Issue Date 1/13/04 Valuation 10000
Expiration Date 7/11/04
Qty Unit Charge Per Extension
BASE FEE 92.75
8.00 14.0000 THOU BL-2001-25K (14 PER K) 112.00
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Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
54.25
1/13/04
7/11/04
Plan Check Fee
Valuation
.00
o
rTI
~
5
Qty Unit Charge Per
Extension
47.00
7.25
...,
BASE FEE
1.00 7.2500 ECH ME-VENT FAN
68.00
1/13/04
7/11/04
Plan Check Fee
Valuation
.00
o
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(0
Permit
Additional desc
permi t Fee
Issue Date
Expiration Date
PLUMBING PERMIT
Qty Unit Charge Per
Extension
47.00
21.00
BASE FEE
3.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 327.00 327.00 .00 .00
Plan Check Total 133.09 133.09 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 464.59 464.59 .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 regulatln nstruction or the performance of
construction.
--t
I 13 ()
Date
Signature of Contractor or Authorized Agent
Date
Si
T \PLANNING\FORMS\1102 15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH-IN I
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN !.- J.J -0 4 JLL
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS ., Ad ~ d r ~
CEILING V.....f ..... I 'l ,r' I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING '4 -0#-04 J ,).,
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING '5 .f} ("'{-OJ/ IJ _l ,
MECHANICAL n1ec.-h f; Y\o.--J f./ - :x:; - 01 .1., 1.,
HEAT PUMP
GAS LINE
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
P ARKING/LlGHTlNG 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. 1 PWI CONSTRUCTION - R W
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 PLANNING DEPT I f
BUILDING 417-4815 BUILDING r::- k. h ~J J.J...)
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T.\PLANNING\FORMS\1102 15 [11/14/2003]
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~t Certiflc ell 'spectlon Fee ~
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DATE I~- 2- 03 New BUSiness .. . . . , . . . .. .. .. .. ( .j )
Address of Proposed Business Transfer of BUSiness location, . , , , , , , , . . . . . . . ( )
//5 N. E..11 f) i ('. ~ S-tr eet Change of Ownership . . . . . . . . .. . . . . ( )
Appllcan~ j!ow4,rdp,..,/t'sT: New BUilding . . . .. . .. . .. ... . . .. . . ( )
Address B O. BoX !3 'f'f Remodel. .. ....... .. .. . . . ( )
Pori::./+!}JeJt?JS., WA. 98~2- Temporary BUSiness . .... ... . . ( )
Phone: bUSiness 1/:<"7-8g34- home7'6~ -b~ ~1 Change of Use. . . . . . . . . . . . . ... . .. . . . . ( )
Brief deSCription of proposed bUSiness: Irl 0 r-tv (J., j e- 13ro kepo..::J eJ
legal DeSCription: lot q Block .;l.;l.. SubdiVIsion Norm4.n R. Smith
Current Use of Property: R e_C?; del)*-i 6...L C.onver-/:in!1 --to Gomm e.;-.c./a.{
Zoning Classification of Property. COWlrYlp.rcitLL Arter-t'o..L
WILL THERE BE ANY OF THE FOLLOWING? YES NO THE FOllOWING Will BE REQUIRED:
Construction changes V"_ PERMITS BUSINESS LICENSE
Electncal changes V_ 1) BUilding 1) TaXI
Mechanical (heating, cooling, stoves) ...... . V_ 2) Plumbing 2) Peddlers
Plumbing changes ~- 3) Electncal 3) 2nd Hand Dealer
New or relocated signs ~- 4) Mechanical 4) Pawn Broker
New septic tanks _ V 5) Sewer 5) Dance
New sewer service -~ 6) Sidewalk Installation 6) Hotel - Motel
AdmiSSion charged to patrons -~ 7) Dnveway Installation 7) Fireworks
Is this a home occupation? -~ 8) Curb Installation 8) Ambulance
Excavation of filling of lots -~ 9) Sidewalk obstruction 9) Tattoo shop
Work done In City nght-of-way -~ 10) Water meter Installation 10) Other
Is there sufficient off-street parking? ~- 11 ) Fire
New dnveway openings _ V 12) Occupancy
A grading plan for site drainage -~ 13) Sign
(parking lots, downspouts, etc ) -~ 14) Shoreline
Are the eXisting streets paved? . ~- 15) Home occupation
Are there eXisting sidewalks? --L_ 16) Conditional use
Is there curb and gutter? ~- 17) Other
Other --
I hereby apply for a Certificate of Occupancy and acknowl- ~;;.. ~ 03
edge that I have read this application and state that the Date.
information I have supplied IS correct to the best of my
knowledge Signed: m~~b
~~~JECTED Comments / Conditions
BUilding Section
PubliC Works Department
Planning Department
Fire Department
City Clerk
P.B.I.A.
CERTI FICAT'E~"\O'P'~(lCCU P ANCY
J.P "<~F_
City of Port Angeles""
t
Building Division
This Ce,rtific~tion issued pursuant to the requirements of Secti 301 of the
Internatio!!tl Building Code'certifying that at the time of issuance this:structure was
in cdinpliance with the various ordinances of the City regulating 'Building
;' construction or use. For the following: \~
Use ClassificatIOn OffiC\:~ Bmldm, p,~" No 03-1165 B",i~" N,""" NOrlhieSI Morl~a~e
Group B 'Type of Construction, V -N Use Zone ~.CA
I 1 'JfJ
Owner of Busmess Howa~d Priest Address ':P. O. Box 844. Port An2eles. W A 98382
\ ,9
BUlldmg Address 115 North Eunice Street. ~ : Port Angeles. vilA 98362
\~~ 'f\J1?1 --.rT_!_~__~.~:.s:~~"~1~!ij(I;~~"",P~~lFPi:';(l"(T.i~"~~rfe;:fl~. ~j1J1~r,~;;r1i1tlp~01 ,'if"
". ~ __, -"':';1",' ,'_. ,; '. ,~!;r1i J~t.~" ,:~;~:: ;:/"",::/.:Ji'( ';,,:J' 1 JIi
.'< ,,' '..;- ",:,,'I,~,;,_ ~.;11\- "::,,,,:1, IN'\,:' ':\'r:l"A,"; :,:!..~'" ",' \\~ September 23.2004
/B~': l~ ,&~ ,m~~~C",;::;,"'\-;;:c" _ _"":":::~: :';:;;:,;,:'; :';.:>:::.:~';~;;,yDate
p ~t II;, 'h~~'~~~~':'\ 1 rl~~:~l@S~~,,:;%t6d6us lace.
. '''h p~" u 1'~1" - ,.,,^' ,11,." ....,'. . J ~J;-" P
Sh not be 'remQ;)j~cP'exc~Qt6y;;Building Official.
.~"'j)1-~~"",~~~
T---- -------.------'
.
PREPARED 5/10/04, 12 35.00
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
3
5/10/04
------------------------------------------------------------------------------------------------
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
115 N EUNICE ST
SUBDIV
PHONE
PHONE
( 36) 457-8834
HOWARD PRIEST
06-30-00-5-1-2230-0000-
03-00001165 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
BL3
01
3/04/04
3/04/04
3/04/04
3/04/04
JLL
AP
JLL
AP
BUILDING AIR SEAL
BAIR 01
BUILDING FRAMING
HOWARD 457-8834 CALL AHEAD FOR KEY
alr seal approved wlth thlS lnspectlon/)ll
BUILDING INSULATION WALL/FLOOR
HOWARD 457-8834 CALL AHEAD FOR KEY
BUILDING FINAL
flnlsh ada ramp and hand rall on steps front and rear/)ll
also strap water heater to S€lZmlC requlrements
~~~~_::__~_!::~______::~~~~N:o::::::7~:1:0TES ______________________________________
3/09/04
3/09/04
4/30/04
4/30/04
JLL
AP
JLL
DA
BLWS 01
BL99 01
PREPARED 4/30/04, 13.32.45
CITY OF PORT ANGELES
115 N EUNICE ST
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
\..
------------------------------------------------------------------------------------------------
1
4/30/04
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
HOWARD PRIEST
06-30-00-5-1-2230-0000-
03-00001165 COMM REMODEL
SUBDIV
PHONE
PHONE
( 36) 457-8834
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
--------~---------------------------------------------------------------------------------------
BAIR 01
3/04/04
3/04/04
3/04/04
3/04/04
BUILDING AIR SEAL
BL3
01
JLL
AP
JLL
AP
BLWS 01
BUILDING FRAMING
HOWARD 457-8834 CALL AHEAD FOR KEY
alr seal approved wlth thlS lnspectlon/)ll
BUILDING INSULATION WALL/FLOOR
HOWARD 457-8834 CALL AHEAD FOR KEY
BUILDING FINAL
3/09/04 JLL
3/09/04 AP
BL99 01 4t.30/04 $A-
------------~---------------
CONTINUED ONTO NEXT PAGE ----------------------_____________
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S+~?~/~\
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C-.. t) C-
~
PREPARED 4/30/04, 13 32 45
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
2
4/30/04
------------------------------------------------------------------------------------------------
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
115 N EUNICE ST
SUBDIV'
PHONE
PHONE (36) 457-8834
HOWARD PRIEST
06-30-00-5-1-2230-0000-
03-00001165 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
M"'~O'~~~~f;"~~~~~"":::::~::.::'" .", 'AO, ~~~~~~~~~~~~~~~~~~~___~_~_____~~__~
PREPARED 4/30/04, 13 32 45
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
3
4/30/04
------------------------------------------------------------------------------------------------
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER.
115 N EUNICE ST
SUBDIV:
PHONE
PHONE: ( 36) 457-8834
HOWARD PRIEST
06-30-00-5-1-2230-0000-
03-00001165 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
PL2 01
2/04/04
2/04/04
4/30/04
JLL
AP
JLL
~
PLUMBING ROUGH-IN TIME 17 00
Howard 457-8834 Call ahead
PLUMBING FINAL TIME 17 00
PL99 01
-------------------------------------- COMMENTS AND NOTES ----------------______________________
~u{Q
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PREPARED 3/04/04, 12 59 42
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
3
3/04/04
ADDRESS
CONTRACTOR
OWNER
PARCEL .
APPL NUMBER
( 36) 457-8834
------------------------------------------------------------------------------------------------
115 N EUNICE ST
SUBDIV
PHONE
PHONE
HOWARD PRIEST
06-30-00-5-1-2230-0000-
03-00001165 COMM REMODEL
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL3 01 3/04/04 JLL BUILDING FRAMING
____________________~___~~~~:~ :::~:::: :::LN:::~-:~:-~:~------------------------------
i\\~
s'? ~ ) r It r) c01
.J-Vt I 5
b~~e ~_
OL
PREPARED 3/09/04, 12 49 21
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
5
3/09/04
------------------------------------------------------------------------------------------------
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER-
115 N EUNICE ST
SUBDIV
PHONE
PHONE
( 36) 457-8834
HOWARD PRIEST
06-30-00-5-1-2230-0000-
03-00001165 COMM REMODEL
--------------------------------~---------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
BL3
01
3/04/04
3/04/04
3/04/04
3/04/04
JLL
AP
JLL
AP
BUILDING AIR SEAL
BAIR 01
BUILDING FRAMING
HOWARD 457-8834 CALL AHEAD FOR KEY
alr seal approved wlth thlS lnspectlon/]ll
BLWS 01 ~09/04 l' JLL BUILDING INSULATION WALL/FLOOR
~ HOWARD 457-8834 CALL AHEAD FOR KEY
------------ ------- -'~-~------------ COMMENTS AND NOTES -------------------------------_______
BUILDING PERMIT - APPLICATION
ate Issued
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call ,
(360) 417-4815 ,?-\
ApplIcant or Agent:
Owner: !fowo.:rd Pr les-c
Address: P.O. Box ~Lfl/-
Phone:
Phone: 1/5z-fo;{ 9'1
CIty: PortItnJe/es/ WA.. ZIp: 78362-
Phone:
ArChI tect/Engmeer.
Contractor
State LIcense #.
Exp:
Phone:
Address: CIty: ZIp:
Co/furl e.r t: I,\L.
PROJECT ADDRESS: / /S N. E un/CJJ J si:; ZONING: jirt::.e,.[4[,
LEGAL DESCRIPTION: Lot: '1 Block: JJ.;" SubdIvlSlon: lYot'lJ1~n ft Smit.h
CLALLAM COUNTY PARCEL NUMBER: 06- 30 - DO - S.1 :;":l ~C
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA
TYPE OF WORK:
o ReSIdential 0 New Constr 0 Re-roof 0 Stove
o MultI-fanuly 0 AddItion 0 Move 0 Garage
o CommercIal ~Remodel 0 DemohtlOn 0 Deck
o Reparr 0 SIgn 0 Other
BRIEF DESCRIPTION OF THE PROJECT: l?8S/cJi!.-YlfJA.L
AD A ~-l- .,-OOIMv ~ ~o..~r
COMMERCIAL/RESIDENTIAL: Occupancy Group:
City:
MC
#
Exp. Date:
SIZEN ALUATION:
SF. @ $ /SF = $
SF @ $ /SF = $
SF. @ $ /SF = $
TOTAL VALUATION $ /O,.OOC)
&JIJ /A.1'te.J, i:D (!.,DM/YIe.N'.J4.1 t:;f' of /I'J~'
Occupant Load'
Construction Type'
No. of Stones Lot SIze' EXlstmg Sq. Ft & Proposed Sq. Ft.
Existmg lot coverage _ % & Proposed lot coverage _% = Total lot coverage
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetiand(s)' 0 Yes 0 No SEPA Checkhst reqmred? 0 Yes 0 No Other:
BillLDING PERMIT APPLICATION SUBMITTAL: The Bmldmg DlVlslon can provIde you Wlth mformahon on the apphcatlOn and
plan subnuttal requuernents If you have questlOns.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the apphcant. ThIS figure WIll be revIewed
and may be reVIsed by the Buildmg DiVIsion to comply WIth current fee schedules. Contact the Perrmt Coordinator at 417 -4815 for aSSIstance.
PLAN CHECK FEE: IF a plan check fee IS due It must be subnutted at the hrne the bmlding permit apphcatIon and construction plans are
subrmtted. All other perrmt fees are due at the time of perrmt Issuance
EXPIRATION OF PLAN REVIEW: Ifno perrmt IS Issued Wlthm 180 days of the date ofappltcatlOn, tlte application will expire. The
BUlldmg OffiCIal can extend the time for action by the appltcant up to 180 days upon wntten request by the appltcant (see Sechon 107.4 of
the Uruform Bmldmg Code, current edItion). No apphcation can be extended more than once.
I hereby certify that I 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 reqUire , t the C 's, d hat lust obtam such permits pnor to work
T \FORMS\APPS\BUlldmgpermlt wpd
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ction Plans
ConstrU 'Ii
RT ANGELES - ese plans. speClI-
CITY OF PO . rmit based upon t~he budding OffiCIal
The Issuance of th~ar: shall not prevet n of errors in said
cations and other uiring the correc 10 r from preventing
thereafter reQ d other data, 0 der when m
~~;s, specifications b:~ng carned on th~r~u~s I IsdlctlOn.
bUlldmg oper~:IOc:~es and ordman~~~eo
violation 01 ;( ) . Umform Ildmg
(SECTION 30 c B
Approval Date
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PREPARED 2/04/04, 13:15:07
CITY OF PORT ANGELES
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
115 N EUNICE ST
HOWARD PRIEST
06-30-00-5-1-2230-0000-
03-00001165 COMM REMODEL
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP
TYP/SQ COMPLETED RESULT
PL2 01
2/04t4
;;21 ~ <>t-I
JLL
Af
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
SUBDIV
PHONE
PHONE
( 36) 457-8834
DESCRIPTION
RESULTS/COMMENTS
PAGE
DATE
4
2/04/04
-------------------------------------- COMMENTS AND NOTES --------------------------------------
PLUMBING ROUGH-IN TIME 17 00
Howard 457-8834 Call ahead
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CITY OF PORT ANGELES - Con$tfuctlon Plans
The Issuance of this permit based upon these plans. speclfl.
cations and other data shall not prevent the building official
frllm thereafter reQuiring the correction of errors In said
plans, specifications and other dala, or from preventing
buihJlng operations bemg carried on thereu er when in
vhl~';'Jr of all clldes and nrdmsl1ces 01 i Isdlction.
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CITY OF PORT ANGELES
Dep!. of COJT1munity Development
'- .....-
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COMMERCIAL ARTERIAL
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEV,ELOPMENT -Btm.DING DMSION
321 EAST STH STREET, PORT ANGELES,WA 98362
Applic~tion Number . .
Pin nurilber .." <. . . .
property Address .. .
ASSESSOR, PARCEL NUMBER:
Application description
SubdivisionName . . .
Propj!rtyUse
PrOperty, Zoning . . .
Appli9ation valuation
04-00000108
.097672
115 N EUNICE ST
06-30-00-5-1-2230-0000-
~CHANICAL PERMIT
Date
2/11/04
Owner,
COntractor
- -- ~--!' ~ ~ - -, ..-- -:-------~ -..
---------~----~--~------
HOWARD" PRIEST
POBOX, 844 "
p<)RTANGELBS, WA.
PORT ANGBLBS " WA 98362
(36)457-8834
DAVE I S HEATING & COOLING
PO BOX 413
PORT ANGELES WA 98363
(360) 452-0939
Permit ....
Additionaldesc
permit Fee . . .
Issue Date
Exp1rat::LonDate
MECHANICAL PERMIT
FURNACE & HEAT PUMP
61.70 Plan Check Fee
2/11/04 Valuation . .
8/09/04
.00
o
unit Charge Per
Extension
47.00
14.70
BASE FEE
1.00 14.7000 ECH ME- INSTALL 100- FAU
Fee summary Charged Paid credited Due
----------------- ----_._---- ---------- ---------- ----------
;,Per:zni~ Fee Total 61.70 61.70 .00 " .00
Plan Check Total .00 .00 .00 .00
," Grand Total 61.10 61.70 .00 .00
..: ~~i'l.. :;
";'It-;';":: _.
" ?;~o.9': ..
:-~::6'o~ ":t::"
;~:P't):~.f, ;a:~'.
. ::tt
SlitparalePermltsare required for electrical work, SEPA, Shoreline;ESA, utilities, private and public improvements. This Perrllltb8comes
m.dlilncivoi,difworkor construction authorized is, not commenced within 180 days, if construction or work Issuspendecfor aba:lldoned
for:a period of.180 days after the work as commenced, or if required Inspections have not been requested within180da~fr():m:~he:lasf
IJlfS~c;tion:lherebycertlfythatl have read and examined this application and know the same to be trueahd correcLAllprO~isionsof
laWS ana~rdiri~nces,goveming,this type of work will be complied with whether specified herein or not Thegrantirlgof,.~'.P~~~,~9~s,not
presunie tog~ve authority to violate or cancel the provisions of any state or local law regulating construction or the perfonnsrice of
construction.;.~, .
tlL&-
Date
Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECI10N RECORD
CALL 417-4815. FOR BUILDING INSPECTIONS. CALL 4174735 FOR ELECTRICAL INSPECI10NS.
'.' .;, c....... ". .... ........ . '., .. . . :!
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFlfL TO COVER,rINSULATEOR CONCEAL ANYW()RI(BEFORE
INSPECTED.4NDoACgJPTED' POST.PERMIT IN A CONSPICU()USLoeATlON. .
KEEP PERMIT CARD AND APPROVED PLANS A T JOB SITE~
,
~
INSPESti,ON TYPE/ '. \ DATE ACCEPTED .'; " ., COMMENTS' , ,.
"'1
I I ;
.... .' YES NO ". <" "'--j
FOUNDA110~:. '. ,. 0 '. . , ..
.., '. ,
fOOuNQS "
WALLS
FOUNDATION! DRAINAGEIDOWN SPOUTS .' .
c:-c
ELECl'R.lCAL .(LIGHT DEPT) SEPARATE PERMIT: II ,'. '"
ROtiGH~,iN; .. I . ,
~> """-. '. .. . r ,
PL.U~G .
UNDE~FLOOR! SLAB
RQUGH:IN
W A~LINE (METER TO BLDG)
. .
GAS.LINE
BACKELOW ! WATER .'
AIRSI!;AL " ., i
WALLS
cim.rnG I I "
FRAMING ....
JOISTS /9IRDERS
SimAIt:WAWHOLD DOWNS
W AI+S! ROOF! CEILING
DRYWALL (iNTERIOR BRACED PANEL ONLY) . I
T-BAR
-c;-
INSULA:;nON
SLAB . .
WALL! FLOOR! CEILING I
.
MECHAilPCAL ,
HEAT PUMP
GAS LINE .
WOOD STOVE/ PELLET! CHIMNEY .
HOOD/DUCTS .
PW UTILITIES/.SITE WORK (Engineering Division) . ,
SEPARATE PERMIT II's:
WATERLINE! METER
SEWER CONNECTION
" SANITARY '. ..
STORM . .
PLANNING DEPT. SEPARATE PERMIT II's SEPA:
.
" PARJqNGlLIC!~NG ESA:
LANDSCAPING ' ~ SllpRE4NE=
c. FI1\lAlilNSPIWQONS REQUIRIID, PIUOR TO QCXUP~q""SJ!: .! .
.'. . ,-.
RESIDENTIAL DATE ." YES NO COMMERCIAL DATE o ACCEPTED
, yEs....'
'. . I, ". ". . -- " .. NO
;""
wcrlUEk ~ UGHTDEPTo .. .,
417-4735 ELECTRICAL
UGHT DEPT . .
CONSTRUCTION R. W.! PW/ CONSTRUCTION _ R. W.
ENGINEERING 417-4807 PW! ENGINJmRIN5.;, .\. . .\
. ..... ,
FIRE 417-4653 'FIRE DEPT. '-.
-' If ...
PLANloUNG DEPT. 417-4750 I / /j PLANNING DEPT. '.
lS'h"h,;.( ..
BUILDING 417-4815 rj;~ BUILDING
T:\P~G\FORMS\1102.15 [1111412003]
r----
- FROM" : Dave' s Heating & Cooling Srvc FAX NO. : 13604520939
Feb. 04 2004 08:41AM Pi
(I. P<JlI.!,\;.c
"...~.
.~~.&
"
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BUILDING PERMIT. APPLICATION
FOR OFFICIAL USE ONLY:
T.>atcRec,:~
Permit#: 04- 768
bate Apptovllll:
Date Issued:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
.ba.v-e.. O\d.-enkamp
Applicant or Agent:.J)a.\Ie.'-o tt-eo..hh.c:r~\\hl Sev-lIj'~z;,c::Phone: L./S;;J~OCf31
Owner: HbW~V-~ '*' 5a..n<., P~l'est Phone: tlSI-'1'i3'1
Address: City: f61.,.....I-.An~t CA..JA Zip: qro~~
Architect/Engineer: Phone: .
'TL' . . :DA"GSHGq~IKc..
Con1ractor~Ve~ H~-f1Y1.~ ~CooI Ir\(J)tate License #: Exp: ()5/~!S Phone: t.(6~37
~e.vvl c:e( ~ c:.... '
Address: fJ. D. &'X 'Y/3 City: . I'ot'"'+ A,,~, w.,+ Zip: ~ g-a~d-
PROJECT ADDRESS: 115 IV.. Gu.n,' c..e i for"'..f- A,.~~ ZONING:
LEGAL DESCRIPTION: Lot: Block: Subdivision:
CLAL~AM COUNTY P AReEL NUMBER:
Credit Card Bolder Name: J)AIIIO L. Old<'I\ Ka.""
Billing Address: P.O. a 0)( '1.-' '3
Credit C~~Type VISA .......-: MC #
TYPE OF WORK: SIZEIV ALUATION:
o Residential [J NewConstr. 0 Re.roof 0 Stove <l00 .. SF. @$ ISF. = $
o Multi-family 0 Addition 0 Move 0 Garage .SF. @ $ /SF. = $
El Commercia" :~Remodel C Demolition 0 Deck SF. @$ ISF. = $. .
. [J Repair'.. . .0 Sign 0 Other TOTAL VALUATION $ #ji.fZt:; 00
BR~'..ll~S~ON:O.~TH.EPROJECT: ."H.,.e,rrn6~..f W,"r-.e' q.. he.~+ flA.mp in~+a.\r~-\1ol
...u' ~ 'RGAnV 70 rtV.sf~c-r-;k
COMMERCIALIRESIDENTIAL:. Occupancy Group: Occupant Load:
No. of Stories: .....:.... Lot Size: Existing Sq. Ft. &. Proposed Sq. Ft.
Existing lot coverage _ % & Proposed lot coverage: _% = Total lot coverage
Construction TyPe:
= TOTAL Sq.Ft.
%
APPROV Al's:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required'? [:J Yes D No Other:
BUILDING PERMIT APPLICA nON SUBMITTAL: The Building Division can provide you with infonnation on the application and
plan submittal requirements if you have questions.
V ALVA nON OF CONSTRUCTION: In all cases, a valuation amount must 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 PeIIDit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building pennit application and construction plans are
submitted. All other pennit fees are due at the time of pennit issuance.
EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date ofapplication, the application will e;xpire. The
Building Official can extend the time for action by the applicant up to 1 RO days upon written request by the applicant (see Section 107.4 of
the Unifonn Building Code, current edition). No application ean be extended more than once.
I hereby certify that I have read and examined this applicatio.n and kno~ the same to .b~ true and correct. I e~ authorized ~o ap~/y for this permit and
lHIde1s1and ttJsI N Is my responsibility '" _ what pen1lJ1S are U'.1he CUrs, and ttJsIl must obIam """ penn'" _ to worlc.
T:\FORMS\APPS\Buildingp~il.wpd Applicant: w11... Ol,;4.1~ Date: :2./ 'f IOf
~~
.\1
CITY OF P.ORT ANGELES ....
DEPARTMENT oFcdMMUNrrYDEVELOPMENT - BUtij)~G DMSION
321 EAST 5TH STREET,PORTANGELES, WA98362
Application Number
Pin number . . . .
Property Address
ASSESSOR PARCE~ NUMBER:
Application description
Subdivision Name
Property Use.
Property Zoning . . .
Application valuation
04-00000483 Date'
.847049
115 N EUNICE ST
06-30-00~5-1-2230-0000-
SIGNS
6/04/04
OWner
Contractor
r'~-~'--~'J .~-~~-
\ rIN".'-D~j,
1. ~~~~
COMMERCIAL ARTERIAL
200
HOWARD PRIEST
PO BOX 844
PORT ANGELES, WA.
PORT ANGELES
( 36) 457-8834
WA 98362
,ADVERTISING SALES & MORE
1327 E. 1ST STREET
PORT 'ANGELES
PORT ANGELES , WA 98362
(360) 452-7785
----------------------------------------------~-----------------------------
Permit . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
SIGN
115.00
6/04/04
12/01/04
Plan Check Fee
Valuation
.00
200
Qty
1.00
1.00
Unit Charge Per
85.0000 PER S- SIGN WALL 25 SF+
30.0000PER S- SIGN ALL 25-
Extepsion
85.00
30.00
-
-
bt
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 115.00 115.00 .00 .00
Plan Check' Total .00 .00 .00 .00
Grand Total 115.00 115.00 .00 .00
~
~
c.
~
- ,
(\
~
Separate Permits are, required fclrelectrical work, SEPA,Shoreline, ESA, utilities, private and public improverTlents. Tbis pel111lt ~omes
null and void ifWOrko..-constroction-authorizedis-notcomm~rrcedwithirr180lfags;itconstmction-or wo.1c-ls-suspendeCt:Orabandoned -.
for a period of.180 days after the work as commenced, or if required Insp9.ctions have not been request~dwithin 180 days fromthe last
inspection. l,herebycertifythat I ha'{e read and examined this application and know the same to be true and correct. All prpvisions of
laws and,,9rcJiriarices governing this type of work will be complied with whether specified herein or not. The granting ~fa permit does not
presum~ to . or cancel the. provisions of any state or local law regulating construction or e performance of
construct" n.
\
(;
\L O~
Date
Signature of Owner (if owner is builder)
Date
Signature of Contract9r or Authorized Agent
T:\PLANNING\FORMS\1l02.1S (1111412003]
CALL 417-4815 FOR BcilI"DING\~SPECFIONS.~ALL 417-4735' FOR -ELECnUCAL INSPECTIONS.
.r;'.'
~
"
\ ' !f\~ <:~;;t\:~?~:::'~~'~1t:.~'-r ,~":~t:~'~'.~<' :- ,t~t~f:~:~;'~,_,i: ~-~~.<, ~ ~-~. ,:,~<<-?-;' ?_~~";:i_'_ ~~~:~'~~~?~~;~':~~~'~.'.- ~"':~<"
'BUlLDJ;NG"PERMITINSPECTIONRECORD . !
. , '~" _: " \ ," < - ,'_ .' - .' , - . - ;, ' ' ,_, I . ' " ~"
PLEASEP}{OVIDE AMINIMU~'Z4'HOU~NqTI€E:IT ISUNM WFUL'TO COVER, INS.U1!J4TEOR qqNCEAL ANY WORKBEFQ!lE
. . INSPECTE>>.Alfp;tq,@)';TW>. POST PERMIT IN A CONSPICUOJJS LOCATION. .' . .
KEEP;l)ER.Mtt:e~ANDAPPR.QVED PLANS AT JeB$lTE~ '.
DATE . .~CCEPTED ..;,~:; CQ!\fMENTS ....
"'..:4. YESt NO' . ' '. . i
.'. . ......
INSPECTION TYPE".
. ..
'.
.
.
,
.. .'
'.
" . .. ,.
FOUNI!4>l'ION: _. -. -",.,' .
. FOOTINGS' .... ..... m ."'..
-~. ..:..;.....
. .', ,- ':,' .'
.'I!:~~~""1mFIji.T~~~..~:
ROOOK;IN"i.:" .... "T,.:,
'. 'PI.U~'G~) '"",i', .
UJiIDER~OOR,/SLAB '.' '., ..../.
ROUGH~IN .' '., "., ..... <"" ..
W A~ LINE (METER TO BLOO))' .,..
GASLINE ". ..' .".': ',,>
BACK FLOW I WATER '",,:Y' ". "c' f'
'.
" ,"
.'
.
-
:'.
.
'.
.
A--
.
,
.
,,,'
/
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....
.
.
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;
'. ;.
.
AIR SEAL
WALLS
CEILING
."
".
. "'."
.... ". '. :. >.>;J". .' ..
;) .,;;."":.-.,:", "',' .~": ,..
.... ,,'
I
. ,
.
,
, f.
" .'
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..
"
FRAMING
. .
,
,
]OIS!:~ IGIRDBRS .
s~wAWH6i.DDOWNS
WALLSI!\OOF1CElLlNG.. '" .' ',\ ....
D!tYWAt~IiNTEIuOR ~RACEQ PANEeO~"ir .
I ;T"BAA"'" ,'.' i'.i. i'," '. ;;,:,.<', .'
;.- .,
INSULATION...;.....
S~.... .."....1
WALL/FLOOR/CEILING .- -: .;, --':.' 1,'.";<"
. MECIlANI,~ '. '.' .........> ...2',. ',:
"
.
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.
.
.'
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. ,. .,
:'.:
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.
.
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I
I
..' ., i
. .... .-....
.
I
.
"
.:'
HEAT PUMP,
GAS LiNE---
'"
.
.. .;' "".. .'- . '. '
'.1
WOODSTOVE1PBLLET/CHIMNEY . ." ....:
HOOD/,DUCTS ' '. ,;;; ",.{
.
'.. ,~1~ ."
I.
;
.'" .'
I
.'
",
PW UT'ILITIES-I-sITE WORK.'." ':'(Engin~~'rili'PiviSi~n) SE~AilATE P.E~T ##IS:
. ,",.' i'_ . ~. ^ , ' ,- .',' - "!~" ,
WAiERLtNE~~R ...' . ' ."'. ..' . . .'
SEWER coNNECTION ,..... . ..}' '.'
SAmTARV: '. ,-- ..... ". ,."
: '. '--.;, :
,
. ',".,
." .
.' ..'
. ,.-~ .
..
~RM;.-",.:\' -:.,,:--. " ,.',' ",-
P~ING'DEPT: SEP~TE PERMiT /#'S i.,. ..... .'. SBPk
PARKIN~"~IlTIJIlG --S ,...'i' c-.' . .... ESA: ,
LAN,..... DSC.c_.,.".w,.,..N,.G...:.:.:...i,'....:.;........-.' ;~~.;:~~',., '.' "';,:,;~ . ,'sHdRErilNE:':'" "., .,' .....'
.' .". ,:;;;,.. ,"'i.,....... ''''.......,,~.,,"3;.;<i(.. .. "~I,:
, I' ,,,:.:,-t<:/.'~:!f,<' '~"".' ",.:<',;~AJ:;lN~~OJ1~}q:QUI,RED.PRIO~TOQCc:t!'!"J\N..srr!ll~E:<f~S;,:ii ":"0 '.' .;:>~ .::,. ..
r--"'h'"fr,. ~IDENTIAt'" ~:\~~;(:f:",;:,(ir:>;~ .?r YES, NO,i;:t(~M~.~~\ti';:.nh~A:~;;::}~C~:~,~
'. .ELECTRlCAbj,L1GHTDEPT,';' 41:Hrn, ,<{,; ,,<', ~ '\ ..~~;'::..'::':.:;;';:;' ',;,: i 'B;t":
'i,'" '" . .." .'m~H'l)iI:l~':' :,>X;y" ..... ....... 'i'!:'C. th" '.'
CONSTRuCTIoNR.W./PW/ ...., . .,~..I.'.snwcn"ENO",'C:INEE.. ...O..'RlNN.' -G~~~..""." '. .'. ........... I ..
ENGINEERlNI3::" . :.: i417-4807. ~, ....., ..i.... I'
FIRE;~;::...;;:"':''':4p46S.3 ..~:..: I. ,.:FiREnEpt. . .... 7:"'-,' '.:;:~"; ":'" h /
PLANNINI31?~'; : . .i.' 4P-4750,', . PLANNING DEn: ". "''':'-c' '" -':
BUD.:DING'i.j",::',/:' . 417-4ins'J...!J..f{:,u'", OK Vr. .' " 'BlJiLDlNG"?"~c,"'.'.;"'P",,'
T:\I>LANNlNG\FORMS\lI02ilS [1l/1.4I2OO3t ".' --.' .....
PREPARED 7/28/04, 12:59:26
CITY OF PORT ANGELES
ADDRESS
CONTRACTOR
OWNER
PARCEL . .
APPL NUMBER:
115 N EUNICE ST
ADVERTISING SALES & MORE
HOWARD PRIEST
06-30-00-5-1-2230-0000c
04-00000483 SIGNS
PERMIT: SIGN 00 SIGN
REQUESTED INSP
TYP/SQ COMPLETED RESULT
BL99 01
7/28/04
t7K
RV
-Rv-
--------------------- COMMENTS AND NOTES --------------------------------------
INSPECTION TICKET
INSPECTOR ROGER VESS
SUBDIV:
PHONE : (360) 452-7785
PHONE : ( 36) 457-8834
DESCRIPTION
RESULTS/COMMENTS
BUILDING FINAL
I - ::; ;'3"'- 0 "'- I. ~
PAGE
DATE
c~
2
7/28/04
reCLV-(?C-\:S+ ~~d~)
1
, .
BUILDING PERMIT ;. APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec.: b f'? .I I:J t.,
Pemlit#:O"l./- tf'B:5-
Date Approved:
Date Issued:
~
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent:
Owner:
A$~
s\.~~
Phone:
Phone:
4-~a.-1"l8~
Address:
City:
Zip:
Architect/Engineer: Phone:
r
Contractor ~ S l--"'\. ~ \G.Ns.. State License #G:f,s +-, c...€ Exp: Phone:
Address: \ ~ l 6- ;:;~{ City: t::::>{l..rz. ~(}.6~ Zip: ~ c91 '" 2-
PROJECT ADDRESS: i l~ ~ G..J N \. ~ .s.-r:~ (7bc'Z.J1 ~(:U'~ ZONING: (!.A
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA Me #
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-TOof 0 Stove
o Multi-family 0 Addition 0 Move 0 Garage
o Commercial 0 Remodel 0 Demolition 0 Deck
o Repair $ Sign 0 Othrr
BRIEF DESCRIPTION OF THE PROJECT: :L q C'
~-2~ o-f .gD..J,M. ~
CO:MMERClAL/RESIDENTlAL: Occupancy Group:
City:
EAll. Date:
~ \ C:.c-.l
~
SIZEN ALUATION:
;'0.6/ SF. @ $ /SF. = $ ~ 00. 0.0
aG). ~ SF.@$ /SF. =$
SF. @ $ /SF. = $
TOTAL VALUATION $
ONe '{-Eo '0 "q~ " o~ '10" ~
.~1.06;S ~?~ ~~c..CL
.,~t,
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
No. of Stories:
Lot Size:
Existing Sq. Ft.
Total lot coverage
%
ESAfWetland(s): 0 Yes ?<No SEPA Checklist required? 0 yesj( No Other:
APPROV
PLAN:
BL
DPWU:
FIRE:
OTHER:~
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with :i11forrnation on the application and
plan submittal requ:i1'ements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must 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 Pennit Coordinator at 41 7-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tin1e the building permit application and construction plans are
submitted. All other peIIl1it fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If 110 permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up t0180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, cunent edition). No application can be extended more than once.
I hereby ceriify that I have read and examined this application and know the sam rect. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required) the City's, and that I m st obtain such permits prior to work.
T:\FORMS\APPS\Buildingpermit. wpd
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FILE
CITY OF PORT ANGELES - Construction Plans
The Issuance of this permit based upon these plans, specifi.
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
plans, Specifications and other data, or from preventing
bUilding operations being carried on thereunder when in
violation of all codes and ordinances of this jurisdiction.
(SECTION 303(c) . Uniform Building Code.) R,' /
Approval Date b -Z - ~ '-/ By V
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___________.....---..c.-----.....-_,_~_-"'_________......___,_~._..."~_""',......~__....,.."""'---',~-....;._...,..~'"_..;,.""_~~,~..,__....~.__,.~...,,....._"'__~_~'^~___u._r_".~.w.--..._...~.-....-__._,.",._~.~'d_..
_._----"....------...,._--..-..-,---..;..__.--...,,,..-----.,,...--...,-----~-----_.~,"~-,,._~.----~.._-
._~,..-,-I"_----..-.~......~~"".'~--~--.~.~~~.<-,.._.~_......,.~'.-----=-....-'--"-,...""'"'~_
~_.~~___--_...._,..--<-_-.._-.r~--'"--;.._.--~__-'---.........-.......,.---~.----,...__.__.~~_"'~.;...
___,~~..._,_"',..~,...._-.--."__..,.,.,.;._....,,..~.~i_."'.;"___~~._~__'^___.."'.,.~_~._.____"_~~...."_~_.__,,<._...,..'.__.__".'__.,..~~~__~_.'..____..""__
~~..._-~-_P.---_..._.-------_.-.---------~-----;->_....~.~,-~._.......,.:~~,-----_-"'---"-....._......-..-~<.___._____
.,.,...--'~_"__:__~..__..--_ _.-_~~~,____._..__~...__...,.""'.,.._."~~.....____...;..,-.",,_~~~__"""_....,____,..,~..,~_"_,<_.._~...,~_,~,,~..._-",_._.,_'._____________i_;....;,.;.,._,__,,_.;..........'.-,~.__.--'--..,_~_
Site Address:
I
Installed By:
I
OwnerfBusiness:
I
O\vnerfBusiness Address:
I
I
o RESIDENTIAL
o 'COMMERCIAL
o IBASEBOARD KW _
o 'FURNACE KW
o FAN/WALL KW
o IHEAT PUMP KW_
o SIGN
DeJaiIS/DescriPtion:
=1
I
~
I
t
W.S. No.
I
CAPACITY:
I 0 O.K. NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
I 0 INSTALL SERVICE POLE
I
I
o Ditch Inspection O.K.
I
o rough-in/cover O.K.
~!)ZI p-K. to connect service
o Final O.K.
I
Site Address:
I
In~taller:
I
Nolily Port Angel City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
befbre inspectio and O. K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the BujJ01ng Permi!. PHONE 457-0411, EXT. 224.
, --<I IJ "A NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
. JI'IA $
I I ElectricallnspeClor
WHITE - File by address YELLOW - file by number
I
OLYMf'IC PAINTERS INC
1
.
.
.
--
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles. WA 98362
(206) 457-0411
ELECTRICAL PERMIT
PERMIT NO. .s 'Ie. 0
DATE ~,6 ;;/9-3
o READY FOR
INSPECTION
License Number:
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
~ SERVICE UPGRADE/REPAIR
o SPECIAL EQUIPMENT
(LIST BELOW)
o WILL CALL FOR
INSPECTION
Phone:
Phone:
Sq. Ft.
~ OVERHEAD SERVICE
b UNDERGROUND SERVICE
VOLTAGE: /?P-,zfO
o SINGLE PHASE
o THREE PHASE
SERVICE SIZE ~ AMPS
f' ]t/ J'kP
~~
SERVICE SIZE
DATE
ENGR.
o CHANGE SERVICE WIRE
o OTHER
New Meters
PINK - Top: Eng, Bottom, Customer
.:::s
/ f.~;t~
GREEN - Top: Meier Dept., Bottom: City Hall
Ii
0&/03/2004 22:05 4579270
"/Vlt /l~ ..fin- .Jht;~r><-f,'Dn
I!lLEOTFtlOAL PSAMlT APPLICATION
SIMPSON ELECTRIC
iJ'Ie WI'II ~
PAGE 01
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.
FOR OFt'!CIAL USE ONL V'
DaldRec:
Pennitll
DaleApp~oved:
Date Issued
ELECTRICAL PERMIT APPLICATION
The Electrical Permit Application must be filled out completelv.
Please type or reprint in ink. If you have any questions, please call {360} 4174735 j-/~ 11j/5"0
Fax number: (360) 417-4711
Owner or Elec. Contractor Agent:
Property Owner !If) It } a Y'd PI" i p <: t:
Address P I). 'BOx Bif~
/'7?Jnt
I
Phone:
Fax:
City:
b A-i4t-r-..
Fb,.t AnJe/e<;. WA.
License #: Exp:
Phone: ';6/- '2B'3<f
Zip 983~2.
Electrical Contractor:
Phone:
Address:
City:
Zip:
iNSTALLATION WIRED BY:
)(OWNER
D ELECTRiCAL CONTRACTOR
Credit Card Holder Name:
Billing Address:
City:
Zip:
Credit Card Number:
Exp. Date:
VISA.~ MC:
PROJECT ADDRESS: //5 N. ElAn; c- e. S t: r e e.--/:;
TYPE OF WORK:
Check all that apply:
ONew
)l( Alteration/Addition
o Residential 0 Multi-family
jl( Commercial 0 Mobile Home
Sq. Ft
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
Number of Circuits added or altered: 5
DESCRIPTION OF THE ELECTRICAL PROJECT: (!Pl1l1ei>s iDn -f rDm r 1"5 i d e/JI.;/../A L -60
o Low Voltage 0 Telecom. 0 Sig
Ommert./o.. L of-F-h.e-
Electrical Heat Load Additions and or Subtractions
)/0 Lo/fo C4fmvb6
Service Information
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
_KW
KW
TON
KW
LRA
o Overhead Service
D Temp Service
o Underground Service
Voltage:
Phase: 0 1 0 3
Service Size:
Feeder Size:
I hereby certify that I have read and examined this application and know that same to be true and correct, and I an
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such.
C:lELECTRI CALPERMIT APPLICATION
~ r:~ l'LJ3/f>3
Credit Card Holder's Signature: ~
Owner or Elec. Cont. Signature: -!M4: ' ~
PERMIT FEE: $~r
5. lO. 0-4
Date:
Date: /2-.2 -03
<to
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