HomeMy WebLinkAbout3515 Galaxy Pl - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
8 kw furnace 2 ton heat pump
Owner
Gilbert James
3515 GALAXY PL
PORT ANGELES
Permit
Additional desc
Permit pin number 149336
Permit Fee 59 50
Issue Date 6/30/09
Expiration Date 12/27/09
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983623752
ELECTRICAL HEATPUMP
59 50
00
59 50
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
09 00000642
865594
3515 GALAXY PL
06 30 15 7 5 0140 0000
ELECTRICAL ONLY
RS9 RESDNTL SINGLE FAMILY
0
DATE
Contractor
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457 9270
Qty Unit Charge Per
1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
1 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT
7/c
Date 6/30/09
WA 98363
Plan Check Fee 00
Valuation 0
Extension
57 50
2 00
Paid Credited Due
59 50 00 00
00 00 00
59 50 00 00
RESULTS
Signature of owner or Electrical Contractor X Date
INSPECTOR.
trAP
Nth?
06/28/2009 21 55 4579270
City of Port Angeles Perintll Application
Building Division!Electrical hmp ettions
321 East Fifth Street- P.U. Box I' :50
Port Angeles Washington, tin
Ph: (360) 4174735 Fax (360) 41'4711
Date: f 0 Y 14_1
1 2 Single Family Dee ling
Multi Family or Corrmer
Commercial Addition i A tt:ration l e model Repair
Plan Review May Be Rev Plea ile t:o plete Electrip�l Plan Review Informal on Sheet
Job Address: L't4
Building Square Footage'
Description of above
_1(j n a yip eoa u
41d2f2.-tr 11 04 —'t 2
Owner Inform non n
Name: G CS f4644-
Mailing Acgre, s:
City 1i` 3tate:.2,jL4 Zip;
Phone Y6, 54P.Z. F ax:
License #1 Exp.
4.
Total (Qty Multiplied by UM Charge)
Service/Feed N 200 Amp.
Service/Feed 201 -400 Amp.
Service/Feed r 401-600 Amp.
Service /Feed r 601 -1000 Amp.
Service/Feed :r over 1000 Amp.
S
Unit Charge !;qty
93.75
$113.75
$160.00
$205.00
$291.25
2.00 Branch Cincu l W/ Service Feeder
57.50 J 4 1SbBranch Circuit W/O Service Feeder
2.00 .pC Each Additioi cal Branch Circuit
72.50 Temp. Servic el Feeder 200 Amp.
86.25 S Temp, Sent elFeeder 201.400 Amp.
$11625 Temp. Servic elFeeder 401-600 Amp.
$131.25 Temp, Salk elFeeder 601 1000 Amp.
75.00 Portal to Pon al Hourly
69.00 Sign /Outline Jghting
75.00 Signal Circuit I Limited Energy Commercial
50.00 Signal Circuit I Limited Energy 1 2 Family Dwelling
50.00 Signal Circud I Limited Energy Multi Family Dwelling
93,75 Manufacture' I Home Connection
80.00 Renewable E lectrical Energy 5KVA System or Less
86.25 First 1300 St uare Ft.
27.50 Each Additio ial 500 Square Ft.. or Portion of
57.50 Each Outbul ling or Detached Garage
86.25 Each Swim ing Pool or Hot Tub
43.75 Thermostat
5 1 7.e5b Total
Owner as defined by RCW.:r9. '6.261. (1) Owner will occupy the structure for two years aA er this electrical permit is ruralized. (2J Owner is revdred to hire an
electrical contractor ifdorm s d pn per l: y.fS for sale, rent or lease.
After reading the above statan ent, here by certify that I am the owner of the above name I property or a licensed electrical contractor. I am making the electrical
Installation or alteration in eor oiance with the electrical laws, N.E.0 RCW. Chapter 19.21, WAC. Chapter 296.489, The City of Port Angeles Municipal Code, and
Utility Specifications.
Signature of owner electrical contractor or electrical administrator
JUN 2 9 2009
ELECTRICAL
INSPECTIOJI
Contrac for I formation L.L. Name: r err:
Mailing g s. _497,1-1.3 g 14/11
ip F
Pho State:
P us7 `1� D Fax:
license 1 Exp y ,��SC 1_9 7 S7
Gsah
et eck
Cr alit Card
PAGE 01
0
a-
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Furnace 8KW and 2 ton HP
Owner
Gilbert James
3515 GALAXY PL
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983623752
ELECTRICAL HEATPUMP
148700
43 75
6/19/09
12/16/09
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
09 00000595
341565
3515 GALAXY PL
06 30 15 7 5 0140 0000
ELECTRICAL ONLY
RS9 RESDNTL SINGLE FAMILY
0
Contractor
Qty Unit Charge Per
1 00 43 7500 ECH EL LVT THERMOSTAT
Plan Check Fee
Valuation
Charged Paid Credited
ALL WEATHER HEATING COOLING
302 KEMP RD
PORT ANGELES WA 98362
(360) 452 9813
43 75 43 75 00
00 00 00
43 75 43 75 00
Date 6/19/09
DATE RESULTS
7/i f c
447
00
0
Extension
43 75
Due
00
00
00
Signature of owner or Electrical Contractor X Date
INSPECTOR.
NTIA>
Jun 17 09 09'49a
City of Port Angeles Permit Application
Budding DivisionlElectrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date: C)9
X 1 2 Single Family Dwelling
Multi Family or Commercial'
Commercial Addition f Alteration Remodel Repair'
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: \5 r la1oac. Imo► ar e_-
Building Square Footage: 1r--4
Description of above cz- fir tk. )a ,'u i- Su,Sk w1 c cp1c c_1(\
_`wro
Owner Information Contractor Information
Name: '.w. o r-, C' .Q»f Name: PM eu? t 1 7 rec 1 r t c1• Q.c •9
Marlin ddress:?5 15 C�►ala.Nc Mailin,9g,�Address: _,5p. Y UC
City k 13mo e-S State: i.1.) A Zip: t=lfV 0 City W.. ckArride-% State: Zip: 9$?2Lo,Q
Phone: 99a-- lt,,81 Fax: Phone:AF,Q -j$ Fax: L1Plq- Gil 1'1
License Exp. License #1 Exp. ALL_ I. t LJ
Unit Charoe
93.75
$1t3.75
$160.00
$205.00
$291.25
2.00
57.50
2.00
72.50
86.25
$11625
$13125
75.00
69.00
75.00
50.00
50.00
S 93.75
S 80.00
S 86.25
27.50
57.50
86.25
43.75
Signature of owner, electrical contractor or elect cal administrator
RECEIVED
JUN 1 8 2009
Total Ql yt Multiplied by Unit Charoe)
Service!Feeder 200 Amp.
Service!Feeder 201 -400 Amp.
S Service /Feeder 401-600 Amp.
Servicelceeder 601 -1000 Amp.
Service!Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service! Feeder 200 Amp.
Temp. Service/Feeder 201 -400 Amp.
Temp. Service/Feeder 401.600 Amp.
Temp. Service/Feeder 601 1000 Amp.
Portal to Portal Hourly
Sign/Outline Lighting
Signal Circuit/ Limited Energy Commercial
S Signal Circuit( Limited Energy 1 2 Family Dwelling
S Signal Circuit/ Limited Energy Multi- Family Dwelling
S Manufactured Home Connection
S Renewable Electri Energy 5KVA System or Less
First 1300 Square Ft.
Each Additional 500 Square Ft or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat Total
Owner as defined byRCW.79.28257: (1) Owner will occupy the structure for Iwo years after this electrical permit is finalized (2J Owner is requited to hire an
electrical contractor if above said property is for sale, rent or lease.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical
installation or alteration in compliance with the electrical laws, N.E.C, RCW. Chapter 19.28, WAC Chapter 296.466, The City of Port Angeles Municipal Code, and
Utility Specifications.
S "v ate:
LIGHT DEPT
Cash
Check
It Credit Card an x
p.2
Owner
Qty Unit Charge
1 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
T:Forms/Building Division/Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
HEAT PUMP INSTALLATION
JAMES /MERCEDES GILBERT TTE
JAMES MERCEDES REV TRUST
3515 GALAXY PL
PORT ANGELES
(360) 452 5681
WA 98362
Permit MECHANICAL PERMIT
Additional desc INSTALL HEAT PUMP
Permit pin number 148676
Permit Fee 64 80 Plan Check Fee 00
Issue Date 6/17/09 Valuation 0
Expiration Date 12/14/09
Per
BASE FEE
14 8000 EA ME FURN /HP /FAU
Charged Paid
64 80
00
64 80
Date Print Name /Signature of C
09 00000594
639670
3515 GALAXY PL
06 30 15 7 5 0140 0000
JAMES /MERC GILBERT TTE
MECHANICAL APPL PERMIT
RS9 RESDNTL SINGLE FAMILY
10264
Contractor
Date 6/17/09
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452 9813
64 80
00
64 80
OR 5 TON
Credited
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and
void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned fora period of 180 days
after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection I hereby certify that I have
read and examined this application and know the same to be true and 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.
/8/;74r C� -e j cOG
or or Authorized Agent Signature of Owner Of owner is builder)
00
00
00
Due
Extension
50 00
14 80
00
00
00
V \GOO
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls
Ceiling
FRAMING
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only
T -Bar
INSULATION
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
T.Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
/Xo I e
3
Jun 17 09 09
Applicant or Agent I r i e_ 6 1i4
Owner J1 )h0 1 1
Owner's Address i geLeAriy '/4 ce
Contractor /Engineer Ott V, il liti4"; y (-f act 7lta -i lr
Contractor /Engineer's Address ;G)2 t? l c'+
License A 1-1-1,1-16/.5t) K l,i
PROJECT ADDRESS i? 1a�o�.�V
Parcel Number C't..e3C7 \S 1S' olik
Protect Type Brief Description. ik Residential Commercial
Check all that apply
New Constrt tion
o Addition
o Remodel
c Repair
o Re -roof
Demolition
o Sign
Eir Heat System
o Other
BUILDING PERMIT
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417-4815 fax (360) 417 -4711
\‘eekcA\
Floor Areas Existing (sq. ft.) Posed (sq. ft.)
Basement
1 Floor
2"d Floor
3` Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
wall- mounted o projecting o freestanding o awning o other
Total sign area sq. ft. Maximum allowed sign area sq ft.
;Heat pump o wood burning stove o gas fireplace o pellet stove other
Total footprint of structures sq ft. Lot size
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
have read and completed this application and know it to be true and correct. t am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required, and to obtain permits prior t working on
project
Date r Print Name �J��/� NIli�� Signature .,�L
.�L� a/�
T. Formsl8 ildin. Division/Bldg Permit Appi. -2006 Code.doc E��/ L. v
ft.
Occupancy group
Occupant load
Construction type
p1
APPLICATION Print in ink
For City Use Only:
Date .Received jn— I i—()1
Permit# (c_ 5q�+
Date Approved
Phone 5 L 2 9 8 3
Phone 9e" -44SZl
Phone 3I9L -'L 913
Expires c( /D
Lot Zoning,
o Multi- family b Industrial
per sq. ft.
TOTAL VALUATION j ('j, (q(- A 40
sq ft. Lot coverage
it of bedrooms
ft of full baths
of half baths
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N~
17515
3'-.;;~ F/
Port Angeles, Washlngtonmmmm..m_____.____.._._m__mm..._m___m__m, 19.____...
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to do electrical work as listed below.
Address ____2.f?-~{4ky-.-~ooo--n.--n-- OCCUpanCy____~~___mm.._.._mmooo__..
~::~;~~-~.2l:~:::~~~~-:~~~;::..::::::::::...~~~.~~:::::::::=::::::::::::::::==:::::::::::::::::::
Light OUlIetBumncf>':(Omm_.._.--- Service, volts -/o/?.!.':~-u.u: Type of Wiring;
Receptacle Outlets___)...._m_.............h No. wires .__~_._~-................---;-.m... Armored Cable .............m........._....
C o/c1 tt?/
Dryer. KW._.......__d.......____n____...._._____. Size wiresn_LI.:".......___...___........_..
- /.. '/~t:J4
Range, KW _n____I_~!.._n_____.n.____n______n. MaIn fuse _._._h.h............__n..._nh_....
S'
Enclosure ....m_m_............m_...........
'Water Heater: /'
KWuuu.ig.~~.---n.---
Heat: KW..__...n__._nd................_n_._...n
Type of wiring:
Entrance Cable ......m_....h.............
Motors: size, volts and phase:
__./~;.uuumm_mnmmm____
.n./Ih..~~_m.mmummmnm.____m..
Rigid Conduit u......nm
MetallIc Tubing ..__n.....
Current transformers:
No, & Size..n........................
Ser. NO........n......h__..........................
Ser,. No. ...__nn..................:__.__.nn_......
<
Ser. NO_nn.......nn....._nnn...h._......_....
Non-Metallic .......___..._....._._.....___...
Knob & Tube.n..._.........._..h_...........
RIgid Condnlt .mmmm__Umnmmm
Metalllc TUbing ..._uuu_nn_m___Um
o~~,:~{~~:=
.;:L
::t:: ~:~~-~~~.~~~~~~~~~~~~~~~~~::~~~~~~
Motor ..._........._.........nn.............n_.
";J.
Dryer .......~_:::__...._....._______._..........._
Furnace ........._................_....._____m......
/7.
Total l.oad....nn..................... Ser. NO.nd............._....nn.....h........... Total ....L..._....nn_n_............n_
Remarks: h_mooo../lLed..u=:::._n_n_C_/"2!.~-g';tj_mooo__.__h__.mmm__ooo.__m______mm______m___m__m.m__.____
n.u_nn_n_n__._h_..nun.nn____n_._nndnun.n.n__.n_.n....nnn...___....nUU.hu..nnuu.n__n..._uun_nn..._nnu.....__u.._..n.nu_n....--'
.h...ooom_m_hh_______mn.mmn_m__mmm__m___.___mmooon____mooo_mnnooonn__mm__~mooo-m-----:'.0------------------....2:-----.
;:~_~;.~~Q~_.__._____..__._.___. ::~~_~:__:_~_~:~~~o._____ By ._._.lf~~L.J~~.___._...___~
,
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con-
cealed due notice must be given the Inspector so that work may be inspected berore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
-{;.
17515
i
i
J
I
\
Address ._..n..nnU....._...._...._nn__.....hun..nnn....................n....._.n..........................................n_.... Date..._....h_.._U_.._nnn...._....__u....__...._...
,
"
Owuer..................__.....___.......__.....__._.....__......_.._._......____...........____...._____..___.___.....__._.....Tenant._..___._...__.______....._.............---...-.--.~.....-.---.-..---
; \ \
IWirtng Contractor ........__..._____......._._......._....__._..........._____............._......___.....__d............................ By____....._..._..______.............................._......-.-
I .{~ " ',,-. ......
~ NOTIC~urrent must not; be turned on until Certificate of./lnspection has been issued. If work Is to be con.
cealed due notice must be given the Inspector so that work may'be inspected befoTe concealment. .
ELECTRICAL PERMIT
")
---' .,.../
1M
Olympic Printers, Inc.
\.
N~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
~1 III ~-t,A,~'~ .r'*~.~..~.a.~T ........
OWNER/APPLICANT PROPERTY LOCATION
3515 GALAXY PL
LEE DARLING
3515 GALAXY PL Lot: 14
Port Angeles, WA 98362 Block: [] Long Legal
360/452-4979 Subdivision: GALAXY ESTATES
T: S: Parcel No: 063015750140000
CONTRACTOR ARCHITECT
AFFORDABLE SERVICES N/A
258663 HWY 101 W
SEQUIM, WA 00009-8382 , 98360-0000
360/452-5264 360/000-0000
PROJECT INFO
Project Value: $2,629.00 SFD Units: 0 Commercial: 0
Project Type: RE-ROOF SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use:
PROJECT NOTES
TEAR OFF / FELT/3TAB
FEES ASSESSMENT
Building Permit: $83.25 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: $87.75
Plumbing: $0.00 AMOUNT PAID: $87.75
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
I Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within '180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby cedify that I have read and examined this application and know the same to be true and correct. All provisions o!
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does no1
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance ol
fconstructio~ /
Signature of C~/actor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\?LANNEVG~,~ORMS\ ] ]02A5 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE I ACCEPTED COMMENTS
YES I No
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB [
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'$:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGltTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTPdCAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERfNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 41%4815 .~-L/~'-<~_ ~--~ BUILDING
T:\PLANNING~FORMS\1102.15 [4/2002]
FOR O~l¢lAL U$£ ONLY:
BUILDING/FIRE PERMIT APPLICATION ,
The ~udd~ng/Fire Pe;'mi! ~pplicarion mus~ be ~E~d out completHy.
Plcas~ ~pe or prim In Ink. ]f you hav~ any q~on~, pl~e call 060) 41%4815
ContractorJ~
LEGAL DESC~IONi
TYPE OF a,¥ORK:
a KmidcaliaJ o Multi-family o Comnl~c[~l ;z'R~rOo[ o LP-g~,.
VALUATION (Cosl of project mina* ~et ta~) $~.
aL'ILDING pER.MTF APPLICATION SU'BlVirI"IAL: Your complcmol applicaion, rite plan (tbr ~dditiuns) and. building COnmm. rucoou
VALUATION OF CONSTRUCTION: tn all cas~, a ~ualim mount must be a~ta'~l by ~he ap!01icanl, This l~g~lra will be renewed
and may be rcdso:l by the Building Div. lo comply w~rg currmt ,fig scha'tulm, Contact ~e Fa'mit Coordiaalor al 417-4815 for ~siilanc. c
LXYlRATION OF PL~.N R.~VIEW: If no I~ermit is i~au~ wltl~ ltg} ~ayt ~f'~e ilale of ~plkatio~, this ~pp~lc,,rlou wltl ~plr~
by }iIII.HaIlOlIi The Blhldilllt O~cinI ~ C~'letld the time for action by the aoplicant up to 180 days, on writlm requ~.~ by the al~l.ieaat
(~ S~:non 103.4 of the Uniform BuitdJuil Code, curr~! ~iitJou). No applicatioo can be extended more tha.a once.
h~ ebv cerI~l~ that / I av~ read and e~amined t/il~ apFl ~aho~ a d ~a~ t/e ~ame to be tt~e and carrier, and / am authorized to apply
for th~ pe~it ] unde~land ft ~ nat the C~O~ legal r~pon~tbi[~ to det~rmt'ne ~at permil~ are rtqtd~d; it remains t~e appllca,t~
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Pub! ic \Yorks and ULili ties Department
32 l E. 5th Street. Port ;\ngeles. WJ\ 98362
300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us
Project Address:--------------------------------------
Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _
OWNER JNFORMATtON
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRfCAL CONTRACTOR fNFORMATION
Name: ___________________________ License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 $
Service/Feeder 201-400 Amp. $146.00 $
Service/Feeder 401-600 Amp. $205.00 $
Service/Feeder 601-1000 Amp. $262.00 $
Service/Feeder over 1000 Amp. $373.00 $
Branch Circuit W/ Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 $
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder 401-600 Amp. $149.00 $
Temp. Service/Feeder 601-1000 Amp. $168.00 $
Portal to Portal Hourly $96.00 $
Signal CircuiULimited Energy - 1 &2 DU. $64.00 $
Manufactured Home Connection $120.00 $
Ren ewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat (Note: $5 for each additional) $56.00 $
First 1300 Sql;Jare Feet $120.00 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding / Detached Garage $74.00 $
Each Swimming Pool/ Hot Tub $110.00 $
TOTAL $
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I
am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-
468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
'"'CJ CD
PREPARED 4/26/23, 7:33:46 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
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APPLICATION NUMBER:23-00000418 3515 GALAXY PL
FEE DESCRIPTION AMOUNT DUE
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ELECTRICAL ALTER RESIDENTIAL 75.00
TOTAL DUE 75.00
Please present reciept to the cashier with full payment
Application Number . . . . . 23-00000418 Date 4/27/23
Application pin number . . . 538244
Property Address . . . . . . 3515 GALAXY PL
ASSESSOR PARCEL NUMBER: 06-30-15-7-5-0140-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
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Application desc
EV charger
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Owner Contractor
------------------------ ------------------------
HERBER, THOMAS & CONNIE SERVICE MAX HEATING & AC LLC
3515 GALAXY PL 3405 172ND ST NE #5
PORT ANGELES WA 98362 ARLINGTON WA 98223
(360) 333-5904
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . . 1-4 CIRCUITS
Permit Fee . . . . 75.00 Plan Check Fee . . .00
Issue Date . . . . 4/27/23 Valuation . . . . 0
Expiration Date . . 10/24/23
Qty Unit Charge Per Extension
BASE FEE 75.00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 75.00 75.00 .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
5/4/2023 23-418 TAP
OWNER
CONTRACTOR
Service Max Heating
PROJECT ADDRESS
3515 Galaxy Pl