HomeMy WebLinkAbout2603 S Francis St - Building ELECTRICAL PERMIT
CITY OF PORT ANGELES r I
a
360-417-4735
.S
Application Number 11- 00000747 Date 7/21/11 J
Application pin number 461762 REPORT SALES TAX
Property Address 2603 S FRANCIS ST your excise tax form
ASSESSOR PARCEL NUMBER: 06-30-10-5-1-0900-0000- on y
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name
Property Use (Location Code 0502)
Property Zoning RESIDENTIAL MEDIUM DENSTY
Application valuation 0
Application desc
Fire alarm
Owner Contractor
HOUSING AUTHORITY OF CLALLAM HI TECH SECURITY INC 1 \1
eM 2603 S FRANCIS ST 723 E FRONT ST v
PORT ANGELES WA 983626710 PORT ANGELES WA 98362
(360) 452 -2727 "i &5 126
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit pin number 189449
Permit Fee 95.90 Plan Check Fee .00
Issue Date 7/21/11 Valuation 0
Expiration Date 1/17/12
Qty Unit Charge Per Extension
1.00 95.9000 ECH EL- LIMITED 1ST 1500 SQ FT 95.90
Fee summary Charged Paid Credited Due 7
Permit Fee Total 95.90 95.90 .00 .00 7: i
Plan Check Total .00 .00 .00 .00
Grand Total 95.90 95.90 .00 .00 l
V
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH -IN O "gin _._,1
FINAL (B16 ii
r
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
FROM HI -TECH ELECTRONICS FAX NO. 360 452 8560 Jul. 20 2011 02:09PM P1
RECavEik ilk. t�tlM��.ii..
CITY OF PORT ANGELES.PERfvtIT APPLIC�a.TION t f
JUL 2 0 2011 ti„
13 dine, llfei5iutrlLleCUicul [ttsltutitiots v e �:w: 1 Of
321 Eust Filth Street P.O..13oN. 1150 Port :stweird Washington, :)1tif�
ELECTRICAL --1
Pit: 3 INSPECTIONS (560 417-055 Fax: (360) �r7 -37:f \.:„..-...4.L.,...:
r 120/ "\i 1 2 Single Family Dwelling Multi- Family or Commercial' rcial' Commercial Addition Alteration Remodel Repair`
Plan ReVisw May Be Requital. Please Complete Electrical Plan Review Information Shwat
:S:': e .l'vt; al scan: U ?(.r4.1pt)L FQdLws 3�l J 5 T lam
Owrtr tnTOrmat CC11tractcr Information
i•ii,rt. cwombs.. Coos -rtt $ao‘,i. V Na Ili Tech Security, Inc.
%i ;lie..; -,.il;as' ,pngAddress 723 East Front St
Cay. Port Angeles S tout Port An a e
Flu.:c. 1 S" 2- 71' 1 F. u?' City. _o— 452- 27 l Statd WTI 'jo: .4 8' 62
L,:&u&L: E<p Wail HITECTS955BS2 -8560
Licame d E.xp.
Item Unit Charge nR Total (Qty Multiplied by Unit Charnel
Seri,celFeedrr 200 Amp, 11.8 "90
3urvice/Feeder 201 -400 Armp 145.50
ServicE/i•aadcr 401.60ii Aunp 204.50 Service )FaedarS01- 1000;.rrlp. 3262.20 y
Struiceu•eader over 1000 Amp. S 371.50
.ranch Clrouit W/ Srriice Feeder 2,60
Branch Circuit WO Sre•ica Feeder 73.5D
Ea tMd nen:if B arch Circuit 2.60 g,..
Temp, Service/ Feeder 200 Amp. 02.70 5
Temp. Service/Feeder 201 -400 Amp. 5 110.30 m 5
'Tamp. Seri:ceiFeeder 401.600.Arnp. 5 143.70
Temp. Service/Ferule-001-1000 Amp 5167.00
�onei to Portal Hourly 5 05.90 5,.__
SiyrvOuttine Ughtin}1 5 &120 g
Signs) Cireull/ Limited Energy Fast 1500 sf Commercial S 95.90 1 4 S-? 0
Ncw: 55.00 icr each additional 1 sl
Si3nal Circuit/ Lunitod Energy -18 2 Family Dwelling S 63.90 g
Signal Circuit/ Limited Energy -MutiW amily Dwelling S 6390'
Manufactured Horne Connection $119.90 .g
iLln6rrable Elecvical Energy 5KVA System or Less 5.102_30
T hemostat 50.00
N> 1N CONSTRUCTION ONLY
First 1300 Square Ft. 5110.30
aon Additional 500 Squab FLor Portion of 3 35.20
'Each Oinhuilding or Defai:hed Ger 73.50 S w_
5.s.-...ii &inuring Fbct orivtTub 5110,30 5
9 5.9Q Total
Owner as defined by RCW.1928.251: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required
to hire an electrical contractor if above said property is for sale, rent to lease_ Permit expires after sir months of last inspection.
triter reacting the ai;ove statement, I hereby certify that 1 am the owner of the above named property or a licensed elecGical contractor. I am making
the electrical installation or alteration in compliance with the electrical laws, td_E.C_, RCW Chapter 192e, WAC. Chapter 296-46S, The City of Port
MS&(es Municipal Coda, and Utility Specifications and PALIC 14.05.050 regarding Electrical Pernik Applications.
Signatures of owner, electrical contractor or electrical administrator: case, 0 ch.c
I L. crsdii Card s_
X pare -x12411
]tro iii I0
Application Number 06 00001113
Application pin number 842534
Property Address 2603 S FRANCIS ST
ASSESSOR PARCEL NUMBER 06 30 10 5 1 0900 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RESIDENTIAL MEDIUM DENSTY
Application valuation 0
Owner
HOUSING AUTHORITY OF CLALLAM
2603 S FRANCIS ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
WA 983626710
COMMENTS /ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Contractor
EXTRA MILE TECH ELECT LLC
418 N RACE ST
PORT ANGELES WA 98362
(360) 457 0198
ELECTRICAL ALTER RESIDENTIAL
EXTRA MILE/ 1 4 CIRCUITS
88625
EXTRA MILE TECH ELECT LLC
48 10 Plan Check Fee
10/11/06 Valuation
4/09/07
Qty Unit Charge Per
1 00 48 1000 ECH EL -R OR RM 1 4 ALT CIRCUITS
Charged Paid Credited
48 10 48 10
00 00
48 10 48 10
rte
00
00
00
Date 10/11/06
Due
Extension
48 10
00
00
00
00
0
CA
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED
YES I NO
DITCI4
ROUGH -IN COVEk D
SERVICE
FINAL M /16f3o OA I iltifQ I
GENERAL COMMENTS:
1 I I
COMMENTS
102.
OCT -08 -2006 08 50 PM E JANSSEN 360 452 2982
0 Request Inspection
m Ele trical Contractor Owner tee .0
0 Amine) Permit Alarm 0 Carnival *Commercial L'1 Residential Residential Malnt. 0 Signs Thermostat 0 Telecom. I
I (Insmllation description
Ju wired by Electrical Contractor L7 Owner 444./1 Ai eL4, a,,_ 1-"If
Electr L al contractor name
KAIL
Purcht tea's mailing address
"A oriet Sr
City i State ZIP
___monk 4-Ada-c, lea 0 A 1 t4 C L
'I'elepionc number f FAX number
3 (e10 4t'7- 501P
'Preen .ee owner's name
LA
Adds ee of Inspection
(pO S 'FRAI.) CA
CIt
1
betty certify that I am the owner of the above named property or a licensed
elects cal contractor (or the firm N authorized agent) and am makinE the electrical
instal ation or alteration in compliance with the electrical law Chapter 19.28 RCW
"Signature of owner, electrical
X
Uale
WALLS
Insulation Only
Utspcctton
Date
rover
Apprnvdn By
UI
uptown By
I//v./1L
A +-k arc. irq
sr (0. Wv
contract r or electrical dminlstrator
I),
EdsltokeIi&ad Additions amt or 6UbtraotiO l4
O NO LOAD CHANGES
Bat aboard KW
Fur lace KW
O
Het tPump Ton LAR
Fer KW
License number
CEILING
Insulation Only
Approve BY
J
TIIERMOSTAT
Paw APpIvud By
Orr .a nw DITCH
Di it
Li Overhead Service
Temp Service
U Underground Service
Area. Building or Equipment Inspected
Expiration Date
of card
1
1 1
i i'
1 1
let0 /0/0.6
Cash Check
CRAM. Card Visa Mastercard Discover
Card
Action Taken
C Inspecea
r
Out
Voltage
Phase 1 3
Service Size:
Feeder Size:
SERVICE
Service Information
P 01
t
ELECTRICAL WORK PERMIT APPLICATION
Applovud By 1
FEEDER
App wed By w Dore Appti ed ny
Electrical
Inspector
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
05-00000750 Date
275500
2603 S FRANCIS ST
06-30-10-5-1-0900-0000-
TRUCK PORT
COMM ADDITION
9/01/05
~ ~
.....,
RESIDENTIAL MEDIUM DENSTY
27000
Owner
Contractor
HOUSING AUTHORITY OF CLALLAM
2603 S FRANCIS ST
PORT ANGELES WA 983626710
OWNER
Other struct info .
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
1. 00
89832.00
1128204.00
960.00
90792.00
1. 00
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT - COMMERCIAL
58917
434.95
9/01/05
2/28/06
Plan Check Fee
Valuation
282.72
27000
Qty
Unit Charge Per
Extension
414.75
20.20
2.00
BASE FEE
10.1000 THOU BL-25,OOl-50K (10.10 PER K)
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
08/29/2005 11:51 AM SROBERDS ---- proposal is a storage
building in the RMD. Site may not take up required parking
spaces. No land use issues are noted.
Electrical load calculations and elctrical permits are
required. $0 Connect Fee.
08/16/2005 07:50 AM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
Public Works Utility Engineering has no requirements for
this plan review.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 434.95 434.95 .00 .00
Plan Check Total 282.72 282.72 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 722.17 722.17 .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.
./
a -oS
Date
Signature of Owner (if owner is builder)
T;\PoliciesII102..15 buildingpennit 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.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS I ..r-\
POST HOLES (POLE BLDGS.) qjqjr::{ f/f"f )
-
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYW ALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULA TION
SLAB
WALL / FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE / PELLET 1 CHIMNEY
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKINGILIGHTING ESA;
LANDSCAPING SHORELINE;
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL. LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R. W. 1 PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING Ff- ?Oo_ c;- u/...J-
T:\PolicieslI102_15 building pennit inspectIon record05.wpd [1/412005]
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . .
REQUEST; /
Date 1] 'i? {/(----
I t
Time
1; .-{J/
Received by IV
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
sewer~Framing Chimney
- f~~{U)
~
;JIPO 3 ,<) PIte1JUs
~o~
Phone No. ~~- ~&7r
Permit No. CJ ':) I )V
Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
By
RESTORATION REQUIRED . . . . .. YES NO
1f);6 ~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
BUILDING PERMIT - APPLICATION //1
Fill out COMPLETELY and in INK. Your applicatior: and site plan MUSfr BE! /.
COMPLETE to be accepted for review. If you have any questions, cd I "
PERMITS (360) 417-4815 FAX(360)417-4711
FOR OFFICIAl USE ONLY:
Dale Rec. ~ ~ I!-o~
Pom'" 09~
Date Approved' .' b
Date Issued:
Applicant or Agent V.,cRAM;J S:;:-/1 A LISE.If' G Phone: '56 () - -152- 7t'j" / E.x-r II
Owner: Ht') // s: /AJ G /jf./T/I j) I? / / Y nr C L /l( c.A m Phone:
Address: 2 r; Gl ~ ~ou -, H FhJNCI ~. City: I~ R r ,4;(,1/-;.E: Lrf S Zip: 7'8"? (( ;;:
Architect/El1gineer:
Contractor
Phone:
State License #:
Exp:
Phone:
Address: City: Zip:
PROJECT ADDRESS: '2 b 0 S S;r'5uT'H FR,:f/IJC IS ZONING:R/h D
LEGAL DESCRIPTION: Lotbav'EI?N1'1t:qBloclcS".€C. T 10 ~Bdiyi[Jion: T?CJ ^', I?~ W
CLALLAM COUNTY PARCEL NUMBER: #- (}.b:? 0 I 0 4- S () $ I- f1
Credit Card Bolder Name:
Billing Address: 2.~ 11 5 c;-. F R,(JflJ <: is
Credit Card Type VISA Me #
TYPE OF WORK:
o Residential X New Constr. D Re-roof
o Multi-family 0 Addition D Move
o Commercial 0 Remodel D Demolition
o Repair D Sign
BRIEF DESCRIPTION OF THE PROJECT:
City: ,PblPr AA/,,(ELE.s
Exp. Date:
o Stove
o Garage
o Deck
o Other
'10 X ;2 4-
SIZEN ALUATION:
Cft,. () SF. @$ ISF. = $
SF. @ $ ISF. = $
SF. @ $ /SF. = $
TOTAL VALUATION $. 27 t:J ~ t?
I
-;- /';:I,.J c. J< Pi') 12 r
.
COMM:ERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: POL. E 8A f: U
No. of Stories: -.L Lot Size: 2'5;'7 f\C R't~sting Sq. Ft. ~<t 832.. & Proposed Sq. Ft. qbo = TOTAL Sq. Ft. 90.77 Z
I I
Total lot coverage R % 2 S ','1 /Ie R E..s:: " i 2 b i .9 '1 t. s,,c.
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
ESAlWetland(s): DYes 0 No SEPA Checklist required? 0 Yes 0 No Other:
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 Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it mustbesubmitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the tinle of pemrit issuance.
EXPIRATION OF PLAN REVIEW: Ifno 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 to 180 days upon written request by the applicant (see Section R105.3.2
of the International BuildinglResidential Code, 2003). No application can be extended IDore 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 :::Jt:t:J!!the City's, and that I.must obtain such permits prior to work.
npoh""IBL"11 02_13.wpd Applioont %__ /' ~~ Date 0 11-' (- 0 "
{HE:. Ilo..l'S'//V 6' '#tJr/.,/c/?,T'7 {.:r (;:x ,CXCvt-~1
cPJOUSING AlJ'THORrrY
OF CLALLAM COUNTY
2603 SOUTH FRANC\S STREET
-_~T ANGELES. WA 98362
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4SEASONS
ENGINEERING, INC
(360) 452-3023 . Fax (360) 452-3047
619 S. Chase Street. Port Angeles, WA 98362
August 30, 2005
Jim Lierly
City of Port Angeles Building Official
PO Box 1150
Port Angeles, W A 98362
Subject: New Pole Building for Clallam County Housing Authority, 2603 S. Francis St.,
Port Angeles
4 Seasons Engineering, Inc. has been contacted to provide an alternate truss connection, girt
framing, and purl in attachment for this project.
~
~
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Approved alternate design may be constructed per the attached truss connection detail.
Ifthere are any questions, please give me a call at (360) 452-3023.
Sincerely,
\P
~~
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. ,......--~ 1 n -\- n--;:-
-- y61-t-t--- . \' ..QA_P_j\_.illLY~ \~\;:-
Donna J. Pet sen P.E.
.
cc. John Helgeson
Clallam County Housing Authority
~ . "7:> 0 . 05'
~~
I ~PlRW'i:
.
3" NOTCH IN POST
FOR DBL TRUSS
(2) 5/8" BO/. TS
W/ WASHER
2X12 CLEA T
(2) 9(,"_ BO/.TS 1HRU
fMrn WASHER
7l-11 SIDING
2X6 GIRTS 024" OC
Mf7H 2X6 FREEZE
BLOCKING
29 GAGE METAL ROOF
CONDENSA 710N BLANKET
2X6 PURUNS PER
PLAN W/7H HANGAR
TEE-BRACE OR CROSS BRACE
PRE -ENGINEERED TRUSS
o TR~ l~?~~:.CTlON
~. ~. os-
CxpWV' =1. 0'( . _~ ~
DA TE: AUGUST 2005
SCALE: NONE
DRAWN BY: DJP
CHECKED:
SHEET: OF
4SEASONS
ENGINEERING, INC. (360) 452-3023
619 S. Chase Sf. Port Angeles, WA 98362
POLE BOG
~ pORT ~
....:-l..O~~
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't9l~
CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
05-00000841 Date
433366
2603 S FRANCIS ST
06-30-10-5-1-0900-0000-
RE-ROOF
9/07/05
RESIDENTIAL MEDIUM DENSTY
48129
Owner
Contractor
HOUSING AUTHORITY OF CLALLAM
2603 S FRANCIS ST
PORT ANGELES WA 983626710
L & K SMITH CONSTRUCTION INC.
817 THOMAS ST.
ABERDEEN WA 985200040
(360) 532-3900
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT - NO PR FEE
OVERLAY CaMP, ONE LAYER
59485
657.15 Plan Check Fee
9/07/05 Valuation
3/06/06
.00
48129
Qty unit Charge Per
Extension
414.75
242.40
BASE FEE
24.00 10.1000 THOU BL-25,001-50K (10.10 PER K)
Other Fees
STATE SURCHARGE
4.50
'P
~
\J
CJl
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 657.15 657.15 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 661.65 661.65 .00 .00
fL/
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Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
nu II and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
CO~~fJl#
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
9--7~~3--
Date
T;IPo1icies\11 02_15 building pennit inspection record05.wpd [1/4/2005]
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
I YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA nON DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS I ROOF I CEILING
DRYW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR .
"
INSULA nON
SLAB
WALL I FLOOR 1 CEILING I
MECHANICAL
HEAT PUNW 1 FURNACE I DUCTS
GAS LINE
WOOD STOVE I PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKlRTING
PLANNING DEPT. SEPARATE PERMIT #"s SEPA:
PARKINGILIGHTlNG ESA;
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE
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.
BUILDING 417-4815 q -/5- (!)S' ~r)/ BUILDING
T;\Policies\1102_15 budding pennlt inspectIon record05.wpd [1/412005]
---------
Re-Roofing Project W A4003-39
001
FORM OF CONTRACT
THIS AGREEMENT made this 24 T #.j day of IV) IJ Y , in the year Two
Thousand 2005 by and between L.R. Smith Construction a corporation organized and existing
under the laws ofthe State of Washington or individual trading as L.R. Smith Construction
Hereinafter called the "Contractor", and the Housing Authority of the County of Clallam
hereinafter called "H.A.C.C.".
WITNESSETH, that the Contractor and the RA.C.C. for the consideration stated herein
mutually agree as follows:
ARTICLE 1. STATEMENT OF WORK Project No. WA4003-39
The Contractor shall furnish all labor, material. equipment and services, and perform and
complete all work required for the completion ofthe said project. With the specifications for and
Addenda thereto numbered One and Two dated 04/07/05 and 04/14/05, all as prepared by the
H.A.C.C. which said specifications and addenda are incorporated herein by reference and made a
part hereof.
ARTICLE 2. THE CONTRACT PRICE
The RA.C.C. will pay the Contractor for the performance of the Contract, in the current funds,
subject to additions and deductions as provided in the Specifications, the sum of ($52.525.00).
Cost per foot to remove & replace soffit material and cut plastic away from soffit vent. $4.00
ARTICLE 3. CONTRACT DOCUMENTS
The Contract shall consist of the following component paits:
Advertisement and Forms. (Advertisement for Bids, Instructions to Bidders, Form of Bid,
Form of Bid Bond, Form of Non-Collusive Affidavit, Form of Performance and payment
Bond or Bonds, and other assurances of Performance and payment, and this instrument ).
General Conditions
Certified Payroll Requirements
Addendum to the General Conditions
Supplement to the General Conditions
Special Conditions
Technical Specifications
Drawings
The following Exhibits, each of which has been initialed by the parties or otherwise
appropriately identified.
This instrument, together with the other documents enumerated in this AlticIe 3, which said other
documents are as fully a part of the Contract as if hereto attached or herein repeated, from the
Contract. In the event that any provision in any component pmt
Page] of2
002
FORM OF CONTRACT
Of this Contract conflicts with any provision of any other component part, the provision of the
component part first enumerated in this Al1icle 3 shall govern, except as otherwise specifically
stated. The various provisions in Addenda shall be construed in order of preference of the
component part ofthe Contract which each modifies.
IN WITNESS WHEREOF, the parties hereto have caused This Instrument to be executed in
Two original counterparts as ofthe day and year first above written.
Attest:
X
Contractor LX. Smith
By
Title
Business Address:
817 Thomas Street
Street
Aberdeen, W A. 98520
By Pamela J. Tietz
Title: Executive Director PHM
Business Address:
'2603 South Francis St.
Street
Port Angeles, W A. 98362
City, State, Zip Code
CERTIFICATIONS
I, , Certify that I am the of the
corporation named as the Contractor herein, who signed for and in behalf of said
corporation by authority of its governing body, and is within the scope of its corporate
powers.
Federal LD. #
UBI#
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License Name UBI City Type Status
LKSMICI055PN L & K SMITH CONSTRUCTION INC 601641467 ABERDEEN CONSTRUCTION ACTIVE
Start a new Sean:h
About Uti I Find a job at Uti I Informacion en espanol I Site Feedback I
1-800-547-8367
\Vashington 5trJtc< Cie'pL of L.aboi' and lndustric~" Use of n~"i:;. L subject to the law::; of (he
~:;t.atP of \Ndshingtoi1,
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u\c/e>d.erna! c:)nl".e.nt. !)olic/ l\lj\1t 2CCcss,\--va,pov
Staff onty link
https://fortress.wa.gov/lnilbbip/search.aspx
9/7/2005
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4SEASONS
ENGINEERING, INC
(360) 452-3023 · Fax (360) 452-3047
619 S. Chase Street. Port Angeles, WA 98362
August 30, 2005
.I im LierIy
City of Port Angeles Building Official
PO Box 1150
Port Angeles, W A 98362
Subject: New Pole Building for ClalIam County Housing Authority, 2603 S. Francis St.,
Port Angeles
4 Seasons Engineering, Inc. has been contacted to provide an alternate truss connection, girt
framing, and purIin attachment for this project.
Approved alternate design may be constructed per the attached truss connection detail.
If there are any questions, please give me a call at (360) 452-3023.
Sincerely,
~';)~t__Q, y~~~y~0~-
Donna 1. pebsen P .E.
cc. John Helgeson
Clallam County Housing Authority
~':p'oS-
f.l:XJIIRI9:'.~ :1
~
~
\:)
\;Jl
\j)
~
t
~-
J" NOTCH IN POST
FOR DBL TRUSS
(2) 518" BOL TS
WI WASHER
2X12 CLEAT
(2) *"" BOL TS THRU
Iwrn WASHER
Tl-l1 SIDING
2X6 GIRTS 0 24" OC
WITH 2X6 FREEZE
BLOCKING
29 GAGE METAL ROOF
CONDENSA nON BLANKET
2X6 PURLlNS PER
PLAN WITH HANGAR
PRE -ENGINEERED TRUSS
o TR~~: 24~~~:.CTlON
~ ~ ,oS"-
If'
<~)~)C"
4SEASONS
ENGINEERING, INC. (360) 452-3023
619 S. Chase Sf. Port Angeles, WA 98362
POLE BOG
DA TE: AUGUST 2005
SCALE: NONE
DRAWN BY: DJP
CHECKED:
SHEET: OF
SEP 07 2005 2:50PM
CALLAM CNTY HOUSING AUTHO 13604577001
p. 1
2603 South Francis Street
Port Angeles. WA 98362
Phone: (360) 452-7631
Fax: (360) 457-7001
Housing Authority
of the County of Clallam
Fax
To: Steve - Building Depl
From: Sonya - Maintenance
Fax: (360) 417-4711
Phone: (360) 417-4815
Date: September 7, 2005
Pages: 5
Re: Roofing Project
cc:
Urgent
o For Review 0 Pi.... Comment 0 Pi.... Reply 0 Pie... Recycle
Steve - Thank you for the heads up. I am hoping this will provide you
with the information that you need. There are 9 buildings being worked
on.
If you have any questions please contact me at (360) 452-7632 Ext. 37
&'1
Sonya Elwood ............
Admin. Asst. - HACC
SEP 07 2005 2:50PM
CALLAM CNTY HOUSING AUTHO
13604577001
p.2
ROOFING PROJECT: NO. WA400339
HOUSING AUTHORITY of CLALLAM COUNTY
PORT ANGELES, WASHINGTON
SECTION 01010
SUMMARY
A. The Owner is: HOUSING AUTHORITY OF CLALLAM COUNTY
2603 SOUTH FRANCIS STREET
Port Angeles, W A. 98362
B. Section Includes:
Project description.
Access to site
Contractor's use of the premises
C. Related Sections:
Coordinate related requirements specified in other parts of the Project Manual,
Including but not limited to the following:
Section 01030 - Alternates
PROJECT DESCRIPTION
A. REROOFING OF 9 (NINE) BUILDINGS: The Project includes the removal and
disposal off-site of the existing roofing materials and substrate materials, and the
Installation of new ridge and sheathing, removal and reinstallation of all vented
Soffit after removing vapor barrier material covering opening of soffit, and the
Removal of existing roof jacks and the installation of new roofing materials, drip
And vent flashing, the cleaning of all existing gutters and downspouts, and the fmal
Cleaning of the site including the removal of all nails, fastners, and waste generated
By the work of this project.
Project Location: The Project is located in Port Angeles, Washington
B. Work of separate Contracts: Contractor shall verify with Owner the existence of any
Separate contracts with the Owner that may require coordination with this contract
Prior to executing the work of this contract.
IDENTIFICATIONS:
Owner: Whenever the term "Owner" is used in these documents it means: The Housing
Authority of Clallam County 2603 South Francis Street, Port Angeles Washington, 98362
Owner's on-site field representative: Where documents require.' coordinate with Owner"
Or similar language, such activity shall be referred to: Vern Sohlberg .
OlOlO~l
SEP 07 2005 2:50PM
CALLAM CNTY HOUSING AUTHO 13604577001
p.3
4. ACCESS TO THE SITE AND USE OF THE PREMISES
A. The space available to the contractor for the performance of the work, either exclusively
or in conjunction with others performing other constluction as part of the proJect, conslsts
of the entire site.
B. Access to site will be limited to entry from Lauridsen Court and Whidby Circle.
C. Storage areas will be available on site.
D. Signs; Provide signs adequate to direct visitors.
1. Do not allow posting of unauthorized signs.
2. Do not install signs other than specified sign(s) and signs identifying the principal
Contractors or Subcontractors.
5. APPLICABLE CODES
A. All references to codes, specifications, and standards referred 10 in the Specification Sections
shall mean, and are intended to be, the latest edition, amendment, and/or revision of such
reference standard in effect as off the date of these Contract Documents.
6. SECURITY PROCEDURES
A. Limit access to the site to persons involved in (he work.
1. Contractor is to take all necessary and requinng precautions to ensure the safety of
the Tenants and his own forces while occupying the job site, at all times.
B. Provide secure storage for materials for which the Owner has made payment and which
are stored on site.
END OF SECTION 01010
01010-2
SEP 07 2005 2:50PM
CALLAM CNTY HOUSING AUTHO 13604577001
p.4
"",-:;
RECEIVED .JlIN 1.. "7 2005
Re-Roofing Project W A4003-39
001
FORM OF CONTRACT
THIS AGREEMENT made this "2:6# TJi day of M", Y , in the year Two
Thousand 2005 by and between L.K. SmithConstructioD a corporation organized and existing
under the laws of the State of Washington or individual trading as L.K. Smith Construction
Hereinafter called the "Contractor", and the Housing Authority ofthe County of Clallam
hereinafter called "H.A.C.C.".
WITNESSETH, that the Contractor and the H.A.C.C. for the consideration stated herein
mutually agree as follows:
ARTICLE 1. STATEMENT OF WORK Project No. W A4003-39
The Contractor shall furnish all labor, material, equipment and services, and perform and
complete aU work required for the completion of the said project. With the specifications for and
Addenda thereto numbered One and Two dated 04/07/05 and 04/14/05, all as prepared by the
H.A.C.C. which said specifications and addenda are incorporated herein by reference and made a
part hereof.
ARTICLE 2. THE CONTRACT PRICE
The H.A.C.C. will pay the Contractor for the perfonlJance of the Contract, in the current funds,
subject to additions and deductions as provided in the Specifications, the sum of ($52,525.00 ).
Cost per foot to remove & replace soffit material and cut plastic away from soffit vent. $4.00
ARTICLE 3. CONTRACT DOCUMENTS
The Contract shall consist of the following component pal1s:
Advertisement and Forms. (Advertisement for Bids, Instructions to Bidders, Form of Bid,
Form of Bid Bond, Form of Non-Collusive Aftidavit, Form of Performance and payment
Bond or Bonds, and other assurances of Performance and payment, and this instrument),
General Conditions
Certified PayroU Requirements
Addendum to the General Conditions
Supplement to the General Conditions
Special Conditions
Technical Specifications
Drawings
The following Exhibits, each of which has been initialed by the parties or otherwise
appropriately identified.
This instrume11t, together with the other documents enumerated in this Article 3, which said other
documents are as fully a part of the Contract as if hereto attached or herein repeated, from the
Contract. In the event that any provision in any component part
Page lof2
SEP 07 2005 2:50PM
CALLAM CNTY HOUSING AUTHO 13604577001
p.5
FORM OF CONTRACT
002
Of this Contract conflicts with any provision of any other component part, the provi sion of the
component part first enumerated in this Article 3 shall govern, except as otherwise specifically
stated. The various provisions in Addenda shall be construed in order of preference of the
component part of the Contract which each modities.
IN WITNESS WHEREOF, the parties hereto have caused This Instmment to be executed in
Two original counterparts as of the day and year first above written.
Attest: x<i'~
Contractor L. . Smith
By
Title C (0
Business Address:
817 Thomas Street
Street
Aberdeen, W A. 98520
By Pamela 1. Tietz
Title: Executive Director PHM
Business Address;
2603 South Francis St.
Street
Port Anaeles. W A. 98362
City, State, Zip Code
CERTIFICATIONS
I, <-&FA;72 f ~)..r, Certify that I am the E [. D of the
corPoration named as the Contractor herein, who signed for and in behalf of said
corporation by authority of its governing body, and is within the scope of its corporate
powers.
FederaII.D. ## jIlt 310..5~BI # 6o! tllll t ~7
Page 20f 2
d'OlIl'~
(i
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98:l62
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000175 Date
.348850
2603 S FRANCIS ST
06-30-10-5-1-0900-0000-
ELECTRICAL ONLY
3/14/05
RESIDENTIAL MEDIUM DENSTY
o
Owner
Contractor
HOUSING AUTHORITY OF CLALLAM
2603 S FRANCIS ST
PORT ANGELES WA 983626710
HI TECH SECURITY INC
723 E FRONT ST
PORT ANGELES WA 98362
(360) 452-2727
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER COMMERCIAL
HI-TECH/ SMOKE-HEAT DET.
HI TECH SECURITY INC
53.60 Plan Check Fee
3/14/05 Valuation
9/10/05
.00
o
Qty
1. 00
1. 00
Unit Charge Per
42.2000 EL-LOW VOLT SYS <=2500 SQFT
11.4000 EL-LOW VOLT SYS >2500 SQFT
Extension
42.20
11.40
~
~
<0'
f
\A
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 53.60 53.60 .00 .00
plan Check Total .00 .00 .00 .00
Grand Total 53.60 53.60 .00 .00
G.
~
~
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'.
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~\
COMMENTS/ ACTION NEEDED
ELECTRICAL PERMIT INSPEc:rJON RECORD
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 IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPEC110N TYPE
DATE
COMMENTS
NO
GENERAL COMMENTS:
PW-II02.1S (4/96]
'&J
"I.4i;.....~
CITY OF PORT ANGELES
PUBUC WORKS - ELECTRICAL DNISION
121 EAST 5TH STREET. PORT ANGELES. WA 9R]('2
ELECTRICAL PERMIT
Issued: 8/04/99
Permit No:
6710
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
HUD 2603 FRANCIS S
2603 S FRANCIS Lot: GOVERNMENT
Port Angeles, WA 98362 Block: Long Legal:
360/000-0000 Sub: SEC 10, T30N, R6W
T: S: Pare No:
CONTRACTOR-----------------------------DESIGNER---------------------------------
OLYMPIC ELECTRIC
1805 TlfMWATER
PORT ANGELES, WA 98362
360/457-5303
,
000/000-0000
PROJECT I:NFO---------------~----------------------------------------------------
prj Type: COML.REMODEL prj Value: $0.00
Occ Type: Cnstr Type: ADD CIRCUITS
Occ Grp: Occ Load: Land Use: RS7
Electri.cal Heat Service Type
Baseboard KW: 0 Riser voltage: 120,240
X Furnace KW: 0 X Overhead Service Diameter: X-I -3
X Heat Pump KW: 0 Underground Service Service Size: 320 AMPS
Fan/Wall KW: 0 Temp Service Feeder Size: 0 AMPS
PROJECT NOTES-------------------------------------------------------------______
REMOVE ALL EXISTING ELECTRIC HEAT.
ADD HEAT. 3 HEAT PUMPS- 5KW, 5KW, 10KW
3 FURNACES- 10KW, 10KW, 20KW
PROJECT FEES ASSESSMENT------------------------------------------_______________
Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $54.00
Temp Service: $0.00
$0.00
Mise:;
TOTAL FEE:
Amount Paid:
$54.00
$54.00
---------------------------------
----~.~---------------------------
--------------------------
TOTAL FEE:
$54.00
Balance Due:
$0.00
COMMENTS/ACTION NEEDED
~
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINJMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER.
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
VnLH , /
lUJUGH-IN I Lv y ~ft !IJ{C"{'ff: rz--,
l;:P1H717'Y:C
r /
"INd. I/O/Z4Yyr;-1 /P'- I .
GENERAL COMMENTS,
P'W.IJ02.1~(4'961
~
, ~
.~'~
.~
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
12\ EAST 5TH STREET. PORT ANGELES. WA 98162
ELECTRICi\.L PERMIT
Issued: 3/06/98
Permit No:
6252
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
HUD
2603 S FRANCIS
Port Angeles, WA 98362
360/000-0000
T:
S:
2603
Lot:
Block:
., \Sub:
Parc No:
FRANCIS S
GOVERNMENT
Long Legal:'
SEC 10, T30N, R6W
CONTRACTOR-----------------------------DESIGNER---------------------------------
ELECTRIC SERVICE
924 DRAPER RD.
PORT ANGELES, WA 98362
360/452-6424
,
000/000-0000
PROJECT INFO--------------------------------------------------------------------
prj Type: COML.REMODEL prj Value: $0.00
Occ Type: Cnstr Type: ADD CIRCUITS
Occ Grp: Occ Load: Land Use: RS 7
Electrical Heat
Baseboard KW:
Furnace KW:
Heat Pump KW:
Fan/Wall KW:
o
o
o
o
Service Type
Riser
Overhead Service
Underground Service
Temp Service
Voltage:
Diameter:
Service Size:
Feeder Size:
120,240
X-I -3
200 AMPS
o AMPS
PROJECT NOTES-------------------------------------------------------------------
ADD ON TO SHOP BUILDING, WIRE CIRCUITS
wiR.~ S~l.. U/'^'~
PROJECT .FEES ASSESSMENT-------------------------------------------------'--------
Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $52.00
Temp Service: $0.00
$0.00
Misc
TOTAL FEE:
Amount Paid:
$52.00
$52.00
---------------------------------
---------------------------------
TOTAL FEE:
$52.00
Balance Due:
$0.00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 4 17-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COlIER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPJtC110N TYPE
DATE
ACCEP'l1W
YES NO
COMMENTS
GENERAL COMMENTS:
PW.II02.U(06]
.,.
o~. CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
321 EAST 5TH STREET, pORT,AN~ WA 98362
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ELECTRICAL PERMIT ISSrC / V.- Permit No: 6053
oWNER/APPLICANT-----------------------~PROEERTY LOCATION------------------------
HUD 2603 FRANCIS S
2603 S FRANCIS Lot: GOVERNMENT
Port Angeles, WA 98362 Block: Long Legal:
360/000-0000 Sub: SEC 10, T30N, R6W
T: SHOP S: Parc No:
CONTRACTOR-----------------------------DESIGNER---------------------------------
OLYMPIC ELECTRIC
1805 TUMWATER
PORT M~GELES, WA 98362
360/45'1-5303
,
000/000-0000
PROJECT INFO--------------------------------------------------------------------
prj Type: COML. MISC. prj Value: $0.00
Occ Type: Cnstr Type: SERVICE CHANGE
Occ Grp: Occ Load: Land Use: RS7
Electrical Heat
BaSeboard KW:
Furnace KW:
Heat Pump KW:
Fan/Wall KW:
o
o
o
o
Service Type
Riser
X Overhead Service
Underground Service
Temp Service
Voltage:
Diameter:
Service Size:
Feeder Size:
120,240
X-I -3
200 AMPS
o AMPS
PROJECT I~OTES-------------------------------------------------------------------
CHANGE SERVICE AT CLALLAM CO. HOUSING AUTH. SHOP
PROJECT FEES ASSESSMENT---------------------------------------------------------
Service: $67.00
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
$0.00
Misc
TOTAL FEE:
Amount Paid:
$67.00
$67.00
---------------------------------
---------------------------------
TOTAL FEE:
$67.00
Balance Due:
$0.00
COMMENTS! ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE T ACCEPTED COMMENTS
I YES T NO
DITCH
ROUGH-IN / COVER . .
~ QIZdfl{') -r IhM-
~AT I T T
GENERAL COMMENTS:
PW.II02.ljl4'96]
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CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
PERMIT NO. S z-S Co
'9' ,1t1;'?-.r
DATE
ELECTRICAL PERMIT
Site Address:
Sq. Ft.
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Installed By:
Owner/Business:
Phone:
Owner/Business Address:
ELECTRIC HEAT
o BASEBOARD KW _
o FURNACE KW _
o HEAT PUMP KW
o FAN/WALL KW
~ RESIDENTIAL
o COMMERCIAL
o NEW CONSTRUCTION
;g REMODEL
~. ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o TEMPORARY SERVICE
o RISER
o OVERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
D1lZ\ D3~
SERVICE SIZE
FEEDER SIZE
AMPS
AMPS
Details/Description:
~ ~ ::'7- 2iJ ~
~Z;)
W.S. No. SERVICE SIZE
CAPACITY:
o OK 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
ENGR.
DATE
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
o Rough-in/cover O.K.
:7 O.K. to c~nnect service
ifX Final OK
SiteAddr:;2603 ~
(9L
Permit/Receipt No.
5.;;2S'L
New Meters
Installer:
s-
Notify Port Angel 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. ..(,. 4,,'-1? ~
~ NO OCCUPANCY OA USE ESTABLISHED UNDEA THIS PEAMIT $ ~ o/1fV -
Elect callnspector Permit Fee
WHITE - File by address
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept., Bottom: City Hall
OLYMPIC PRINTERS INC
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UNIT
NO.
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-
D .. Wl--lIPB''[' AvE. 801.~ "- 1\
D Wl-lIDP,Y AVE. 802. ',Jj
D . Wl-l!DBy'AVE. 803' "~..JJ
D Wl-liDB1-- AVE: 804 ,.:-J)
C 'W~!P6Y AvE. 80S" =~
C UJJ-lIDBY AVE, 80b . ,,,.;.J
C WHID61' AVE. 801 . 'J
C Wl-lIDBY AVE.___ 808 -i'l~v ()
B-2 Wf-.lIDBY .AVE. 810~.
. ..
6-2 Wl-IIDBY AVE. 811 .. iJ0rj)
6-2 Wl-IIC'B'( AvE. 812 ~ (
B-2 Wf-JIP!3'f AVE. 813.17 .'AI
,13-2 Wl-lIDBY AVE. S.!.1---.j~
5-2 Wl-11Dt31' AVE. BI!:;> I'~
8-2 Wl-IID6'!" AvE. 816 ~ - 0
6-2 WHIDS'!" .AvE. B11' ")l
C LAURIC'SEN 6L YD. 802, i/~
LAURIQ5EN f2LVD. 804 ,~ (J
LAURiDSEN BLVD 80b' yp.....x
.. . . .. "-
LAURIDSEN BLVD. 808-
LAURIDSEN BL YD. BiO rlk~
LAURIJ:)SEN !3L YD. 812'1' ~
LAURIDSEN"SLVD. /814 -;.~
LAURlr.)SFN F3L-vD T8ib ;.~
LAURIDSEN BLVD. '818 ;~:~
LAURiDSEN 6LvD. 820 li.,-.....
LAURIDSEN BLvD. 822 ...~L'.~
.L-AURiDSENB..h\iD. 824't~~
LAURIDSEN BLvD. 826 ;11-;J
LAURiDSEN BLVD. 828 -~~
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Site Address:
Installed By:
Owner/Business:
Owner/Business Address:
ELECTRIC HEAT
o BASEBOARD KW _
o FURNACE KW _
o HEAT PUMP KW
o FAN/WALL KW _
Details/Description:
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
PERMIT NO. .s~V3
(/ btyhr
~ P'
DATE
ELECTRICAL PERMIT
- r
r~
T~
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Phone:
Sq. Ft.
o RESIDENTIAL
o COMMERCIAL
o NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
7TEMPORARY SERVICE
~ISER
/,'2'?VERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
D1!15 D3!15
SERVICE SIZE
FEEDER SIZE
AMPS
AMPS
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
1.... == Rough-in/cover O.K.
/()r'tf-O.K. to connect service
tJ Final O. K.
F~.. 0
Ealle'.4'1. . New Mete'(i
Notify Port Ang 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 6n the BUildi~it. PHONE 457-0411, EXT. 224.
r ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ I" ..:?O
Electfical Inspector Permit Fee
\
WHITE - File by address
OLYMPIC PRINTERS INC.
.5"'.;2
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept., Bottom: City Hall
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CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
PERMIT NO. 'fE.3 s-....(
-
/() PO /?-J
, I
DATE
Site Address:
d
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Installed By:
Owner/Business:
Phone:
~
Sq. Ft.
o RESIDENTIAL
o COMMERCIAL
o BASEBOARD KW _
o FURNACE KW _
o FAN/WALL KW _
o HEAT PUMP KW_
o SIGN
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
~ REMODEL
ADD/ALTER CIRCUITS
SERVICE UPGRADE/REPAIR
)::SPECIAL EQUIPMENT
(LIST BELOW)
o OVERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
o SINGLE PHASE
o THREE PHASE
SERVICE SIZE AMPS
Details/Description:
/ OJ.. (p
~
~r
M~;
~OXn~
(11 ~)
.
~
/
(/d&
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
o Rough-in/cover O.K.
o O.K. to connect service
o Final O.K.
Site Address:
d-fo o'
SD..
.
Notify Port An les ity 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.
~4'1.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
$
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Electrical Inspector
Permit Fee
WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept., Bottom: City Hall
OLYMPICPRINTERSINC
Installed By:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
'.
ELECTRICAL PERMIT
PERMIT NO. di2cf'tf't
///.<9/710
DATE
Site Address:
D READY FOR )i:'WILL CALL FOR
INSPECTION INSPECTION
Phone:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
D New Construction
,g Remodel
J8 Service update/alter/repair
~ Add/alter circuits
D Auxiliary power
(list below)
D Special equipment
(list below)
;&1 Overhead
D UndergrOUnd~$IV
Voltage /.:2~:.2-
~ 113 D 3.([.
Service size dc:l.O Amps
D Temporary
o Residential ,r-
Heat KW /':;'
D Baseboard D Furnace/Boiler
D Heatpump D Other
D Commercial/Industrial load
Total Connected load
(attach breakdown)
Totai Motor load
(attach breakdown)
.
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C. ~C-~
~ dt?tJ
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S- .r /0 /tu
k:u~c9med 4~/
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W.S. No. Service Size
Capacity: D O.K. D Not O.K. Comments
D Ditch inspection O.K.
~ Rough-in/cover O.K.
rl O.K. to connect service
D Final O.K.
Date
Hold for: D Easement D Letter
D Signed up for service/meter
D Meter Department notified for installation
D Fire Department notified of inspection
D Plan Review approved/pending
.
~ite Ad:;~ 03
Installer: New Meters
~ ; - 0
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspector in Writing on the Wiring Report or the Buiiding Permit. PHONE 457.0411, EXT.158 or EXT. 224.
~ ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT / oD ~
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
ciJ
Permit/Receipt No.
;;288C,.
OLYM"lC PRINTERS, INC,
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10...'<::.......
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):::J Electrical Contractor 0 Owner ..."'"iii.....:J:"
o Annual Permit b Alarm 0 Carnival la"CommerciaI t::J Reltidentia.l 0 Rc~idcntial !\1aint. 0 Siglls Q Thermostat 0 Telecom.
ELECTRICAL WORKPERMlT APPLICATION
o Request Inspection
Job wired by
o Electrical Contractor 0 Owner
Installation description
Electrical conlr.1ctor 'name
Is~"...,T1'
~rrz.c... TS
Uccnsc number
C/SS-BS
:r~-.-,c.\\
~l)\ 'nO..... "'- L.-
H \ -1'=.C"-
Purcha.1;cr's Rl\liling address
-::r 23 'Z.J:>,ST i="Ro..;).
C I
~OfO.T ~~E.\.Q.~
Telephone number I
31;0 - '-+5":2. - '2o:f 2. "'1-
s...
S !'<"Oil.€:- ~
~T"
~'"'-~-
State ZIP
l.0A- 98'3~2....
Too.c;..
Tn
~\.S.~u6
Premises oWDcr'~ name
,
L \"'\ "'"__ CO,,'" ,'0(
Addl'"C:5~ of Inspection
,
:zt.o3 So.
FAX number
~O- 452-8500
I-+M'~
i="Ri"oJ~\<:" (s;..~ AA<eA.)
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fl." "~Ot. \ ... Y
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r hereby certify that r am the owner of the above named property or a licensed
electric::!l contrJ.dOT Cdr the tirm's authorized agent) and ,un making the elc=ctrical
in~bllatjon or alleratiuh in compliance with the electrical law, Chapter 19.28 RCW.
I
SigrUIUfc 0 ownu,1 electrtc:.l contrnclOr or du:lrical :admlnlstrntor
1
o Cash 0 Check #
o Credit Card VIsa
Clt.-J
1="\ \"Z:.-
Ma.;;tercard
Discover
C~#________________
x
Expiration Date
of card
Inspection fc=c
$ S3. ~O
W-\LLS
Insulation ()nly
I
I
D:d~ IAflProv~d Ay
Cover I
D~l~ 'ADPl(lvtd B~
I
CElUNG
Insulation Only
D~l~ AM'rov~H)'
Cover
D~I~ AWrov~ By
TIlERMOSTAT
D"lo.:: ^fIIlmv~d 1'1)'
DITCll
Dale Apurov~~ Dr
/' SERVICE
"- Du, ^JlP(1)vr.<l Elr
/' UEDER
"- Illlle Autll'Ovtd fiy
._.'~
I
~c..al Load Addi1ions and or subtractio.O,s..
(J NO LOAO CHANGES
a Baseboard _ KW;
l:l Furnace KW,
- I
l:l Heat Fump __._ Ton _ LAA
(J Fan-Wall _ Kwl
,
~ervlce Information
Cl Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase 0 , Cl 3
Service SizQ:
Feeder Size:
In:>pcctioo Arco.. Building or Equipment Inspected Action Taken Electricill
D3tC Inspector
Cf!; In':1" /II--/n-t.- 4/ .Ar-//
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Application Number . . . . . 24-00001370 Date 12/18/24
Application pin number . . . 900110
Property Address . . . . . . 2603 S FRANCIS ST
ASSESSOR PARCEL NUMBER: 06-30-10-5-1-0900-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RESIDENTIAL MEDIUM DENSTY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Extend circuits to new walls in office
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
PENINSULA HOUSING AUTHORITY ANGELES ELECTRIC
2603 S FRANCIS ST 524 E. 1ST ST.
PORT ANGELES WA 983626710 PORT ANGELES WA 98362
(360) 452-9264
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 95.10 Plan Check Fee . . .00
Issue Date . . . . 12/18/24 Valuation . . . . 0
Expiration Date . . 6/16/25
Qty Unit Charge Per Extension
1.00 95.1000 ECH EL-COMM BRANCH CIR 1-4 95.10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95.10 95.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 95.10 95.10 .00 .00
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
12/19/2024 24-1370 TAP
OWNER
CONTRACTOR
Angeles Electric
PROJECT ADDRESS
2603 S Francis St
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS:
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
1/10/25 24-1370 TAP
OWNER
CONTRACTOR
Angeles Electric
PROJECT ADDRESS
2603 S Francis St