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Home My WebLink About1011 Hazel St - Building 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 03-00000909 Date 9/16/03 1011 HAZEL ST 06-30-08-5-8-0776-0000- ELECTRICAL ONLY @ o Owner Contractor WALDRON PATRICIA 525 E 10TH ST PORT ANGELES OWNER WA 98362 ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL 46.70 9/16/03 3/15/04 Plan Check Fee -Valuation .00 o Qty Unit Charge Per 1.00 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 46.70 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 46.70 46.70 .00 .00 Plan Check Total .00'- .00 .00 .00 Grand To.tal 46.70 46.70 .00 .00 ~ '- ........... ~ ~ ~~ ~ ~V\ \ '\ 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 kn the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether s ci ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or. oc law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date T:\PLANNING\FORMS\1102.15 [412002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL 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 \ ~....\.... ~ IOf'>l , YES NO FOUNDATIoI'i:' . FOOTINGS WALLS FOUNDATION DRAINAGE - ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING - UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW /WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL - . HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engmeenng DIVISIOn) SEPARATE PERMIT #'s. l/f?~ 87 WATERLINE / METER SEWER CONNECTION /.Ar!IJ!L 7' fjJ'rJa.5r.e-./L.S SANITARY STORM PLANNING DEPT SEP ARA TE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED I I YES NO ELECTRICAL - LIGHT DEPT. 417-4735 II/If /0:3 .L4~ ELECTRICAL LIGHT DEPT CONSTRUCTION R. W./ PW/ I / 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 [412002] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32 J EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 03-00000914 Date 1011 HAZEL ST 06-30-08-5-8-0776-0000- RES REMODEL 9/17/03 2200 Owner Contractor WALDRON PATRICIA 525 E 10TH ST PORT ANGELES OWNER WA 98362 Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT -RESIDENTIAL CONVERT EXISTING TO BEDROOM 106.75 Plan Check Fee 9/17/03 Valuation 3/16/04 42.70 2200 Qty Unit Charge Per Extension 92.75 14.00 BASE FEE 1.00 14.0000 THOU BL-2001-25K (14 PER K) ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date MECHANICAL PERMIT --- 54.25 Plan Check Fee 9/17/03 Valuation 3/16/04 .00 o \J ......... -- Qty Unit Charge Per Extension 47.00 7.25 BASE FEE 1.00 7.2500 ECH ME-VENT FAN Other Fees STATE SURCHARGE 4.50 Fee sununary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 161. 00 161. 00 .00 .00 Plan Check Total 42.70 42.70 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 208.20 208.20 .00 .00 :t:.. ,n ~ ~ (fi ~ ---------------------------------------------------------------------------- ~ 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 penod 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 spe . Ie herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or I al w regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date T IPLANNlNGIFORMSIII02.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLA WFUL TO COVER, 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 YES NO FOUNDATION: FOOTINGS WALLS rOUNDA TION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIl # ROUGII-IN I PLUMUING - UNDER FLOOR / SLAB ROUGII-IN WATER LINE GAS LINE BACK I LOW / WATER Am SEAL WALLS CULlNG I FRAI\IING JOISTS / GIRDERS SIIEAR WALL WALLS / ROOF / CEILING rj, ~n-(') I I. l . IP-Io -<>7 J. J... I}r Frd-ml~ DRYWALL T-BAR INSULATION SLAB I VI t..e rto_ (..V~ Il ~ ft"Got- V'U ""d-: WALL / FLOOR / CEILING 1"t'),..nJ-o~ ....1 ~ L.. rb-I ()-o-a, W' -" ( . . . . MECHANICAL HEAT PUMP WOOD ~ TOVE / PELLET / CHIMNEY 11000/ DUCTS PW UTILlTn~S / SITE WORK (Engmccnng DIVISIOn) SEPARA 110 PERMIT II"s WATeRLINE / METER SEweR CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA PARKING/LIGHTING ESA LAND~CAPING SHORELINE FINAL INSI'ECTlONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R W / PW/ CONSTRUCTION - R W. ENGINEERING 417-4807 PW / ENGINEERJNG FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 II-/~"'? J.L- BUILDING T.\PLANNING\FORMS\1102 15 [4/2002] PREPARED 11/06/03, 12 08 21 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER. 1011 HAZEL ST INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 4 11/06/03 WALDRON PATRICIA 06-30-08-5-8-0776-0000- 03-00000914 RES REMODEL SUBDIV. PHONE PHONE ------------------------------------------------------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS "/"/'; ~ -------------------------------------. COMMENTS BL3 01 9/30/03 JLL 10/01/03 AP BLI 01 10/01/03 JLL 10/01/03 AP BLWS 01 10/10/03 JLL 10/10/03 AP BL3 02 10/10/03 JLL 10/10/03 AP BL99 01 BUILDING FRAMING TIME 17 00 CONVERTED GARAGE TO LIVING SPACE NEEDS FRAMING INSPECTION FOR RAISED FLOOR SYSTEM, TO COVER PATRICIA 452-1763 floor fram1ng okay to 1nsulate floor onlY/)lm BUILDING INSULATION BUILDING INSULATION WALL/FLOOR BUILDING FRAMING Framlng for lnterlor walls, prevlous framlng has been completed on exter10r wall/garage and bU1ld-up floor system C1ndy 452-1763 BUILDING FINAL f1nal 452-1763 TIME 17 00 AND NOTES --------------------------------______ BUILDING PERMIT = APPLICATION 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: (;) oJi' \ ~ io. h. )cJ/Cl Yl5Y) Owner: 0~\~ \u \ 0 QldviSY) Address: , b \ \ -\.\ 0.. { \..Q i fA- I Architect/Engineer: ( '2\-eJ ~ ) Contractor ( ~ -el b ") State LIcense #: Address: ll:') \ \ t\ 0{)..eJ ~. City:---P I A . PROJECT ADDRESS:_t () ~ \ ~ 0.. 7 ~ ~ 'bd- p, A I LEGAL DESCRIPTION: Lot: City: \lJ\ IA.JM'v\ Phone: -15'd- \0/~3 Phone: 1'5;:)- 1'7103 Zip: OJ '63La~ Phone: -<45;;> - J r; 10 '?> Exp: Phone: (J~'v\ Zip: ZONING: q<63(o3 Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: - - --- Credit Card Holder Name: Billing Address: Credit CardType VISA MC # TYPE OF WORK: o Residenttal 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel 0 DemolItIOn o Reparr 0 Sign BRIEF DESCRIPTION OF THE PROJECT: City: Exp. Date: o Stove o Garage o Deck ~ Other SIZEN ALUATION: SF.@$ SF.@$ SF @$ (XlV, TO'tAL VALUATI COM ERCIALIRESIDENTIAL: Occupancy Group: No. of Stories: Lot Size: EXlstmg Sq. Ft. & Proposed Sq. Ft. Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage Construction Type: = TOTAL Sq .Ft. % PLANNING USE ONLY: ?~^ ~ ....<' ~~t ^J.:'" /'u ~~-D ~ /~o - ESA/W etland( s): 0 Yes 0 No SEP A Checklist requrred? 0 Yes 0 No Other: APPROV PLAN:q/ BLDG: DPWU: FIRE: OTHER:_ BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and plan subrmttal requirements 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 Perrmt 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 permit application and constructton plans are subrmtted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: If no permit is Issued within 180 days of the date of applicatton, the application will expire. The Building Official can extend the ttme for action by the applicant up to 180 days upon wntten request by the applicant (see Section 107.4 of the Uniform Budding Code, current edition). No applIcation can be extended more than once. Approval Da ijJCL-t'(\e.AfI u.)(}j(\V(j\ .:,-~~-J ~UI p{A\'V\\-t (QJ ~~~ ~ :' ::> c9x4 t.\)o.J.1~ 9~1 c... e,~ \i\ e. v\:t" (\ ~~ ~,' ~ !if' Ut!tV\e:~ V\.vJJ \ BAFFl.E, MAINT ~rO\J-~~O I" MIN. AIRSPACE ~ R- ~~ INSUl.ATlON ( / PRE-EN6D/MFR'D ;/'" TI<U55E5 .. 24" DC. ," T_! ~L- ~ !qDf ~__"'"__, ce.~y)el-* ..... . (2:\ \~'. 6';) ,J<: Le' '~b(~~~~)'~:, c.. d.~' -/ M V" Qi','f (:L I ~>JrU 'i)oiJ ,\jI -- _ e. fj 1/\ .' <'}C.l nN~Wl' - 1,.,i",-.,.o..;) ~ COMPOSITION ROOFING 30- 6UILDfNG FEl. T In II PL "T11JOOD ROOF ~EA Tf-HNG 2X alRD BlOCKING WI 2". &CREENED VENT. (2) FER RAFTER 5PACE CONT. METAL OR ViNYL RA~TTER 2Xh CEDAR FASCIA In" 0..5.6. ~EAT~1NGs SIDING AS 5ELECTED eY' OUNER &/8" C:.UJ.6. CEilING - --' DeL. TOP PLATE R- ,SeATT. IN5ULATIClN In" ~unolboo.rd ,;liB ,pTUD5 · 1f)1- OC. Sir I' sheLkro~ By 3/411 T4G COMFL Y FLOOR R.;;30 INSULATION JOI5T5 PER ~xl~ FRAMING FLMl J, ~ oS:S\ b\f..1 2.;<. 'l' 11.: \01.0(( e.f\d /1~e.e bY'o,tv~,rl.o0"Po.~ 2><4 F.T. &ILl PLATE Ovt:R INeuL. FOAM - umL Vt:\JPo, bo./lri~j/ , 112-. X 10" Al3 48" o.c exf~f,~ 1'_0" FROM EA END w(~ S I q, b ~UJ'oI!e WIYS....e..J2S -4 VERT. _\8" o.c. WI AlT. ~OK -4 I-IORIZ. _24" OJ::,. (2) -4 CONT. ~6 MIL BLACK POLY VAPOR 6ARRIER , "Tl'VEK. f.4OU5E 'URAP CITY OF PORT ANGELES - Construction Plans The Issuance of this permit based upon these plans, speclfi. cahons and other data ~hall not prever:l the building officl~1 from therea er requiring plans, specIfications and other data, or from preventl~g RIM JOIS1dm, ~ti~~ed on thereunder when In violation tilaiT''CO~'d ~nances 0 IS JUriS Ie . (SECTION 30 Uniform BUlldmg Code) FINI~ GRADE TIGHTLINE &T~ DRAIN IF REQID. "-0" FREE D~INING ~VEL 411. F1:~ RATED FOOTiNGs ORAIN UND'&~D EART.... &11 61~ &11 ~llE ,_ A~ HO-1cJtee/ 1D J !DU~~~<:- _~~. ___ (L I " - '.,' @.- 5\:;ar:~l 'I', /17<5'/04- J! D" , ~ '.11 5i i :' '~"i)lb 0'o~~)~ i3 ~ <( - ~ ,'~~ t;i~, ~ ~~:' i -.,@, ~2." '.t..' 'g, '56r ilrLJo;' e ' . ,l ~~=..., _~~ I,: i, G ',t: (5)$"~ /-LT' " . ,:::::f--'U'J'--@-::--- -_.~-~'.- ~ / ,~- .""" ~. :' 3~1I l' ~~ ~~ LOvU.N\C~V(;' oeonm ~'----, -~>-- \ c?lr~+-~ - . ~. -, . , ~ ~ I (\ D <s l-Lb p.,l010'/( Ij c....\ uS z..,1- :30 I H-ClvU <J, S 6+- . ~ ! b-"//..t>4" _ r, I ~'7 I ~~~-~ - - - -' 6~;C"~ - - -(' -- - D~ . . -~:;;':;';RT:~~~;~:;;~ ~, ~:~: ;J(E_~~~~::~~ o~l~ cations and otlle data shall not prevel~l the bUilding olfk,al, ~. . " ...- from thereafter equmng the correctIOn 01 errors In Silld. - ',: (? ~b '\ U~ cd-~ 0'/\ 1l..t ~ ,\ plans, speclflcatl ns and other data, or Irom preven~ng , \'=-....) l) ~o/ t) bUilding operatlo s being earned on thereunder when] In , ...../ ,.... ~ \ ~, . '." .' ""'''"'' ,II ""-'0"""""1 ,lIh.. ,'''''''''0" V"/ (P M L 111\ All fi( 6 0- ~. L (.t' a.J ,+ '\ IS[clION1G3I'r,ut'i~ rid'" o,d'l ~,.. _. .. ,. - . -!" " ' .- r ,- I ,y __ __ '''''''''''' '4f '123L By ~ ~ ' I .. 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Q ......0;. -, -"\;I ",.;- ('" PREPARED 10/01/03, 13 41 11 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 1 10/01/03 ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 1011 HAZEL ST SUBDIV PHONE PHONE WALDRON PATRICIA 06-30-08-5-8-0776-0000- 03-00000914 RES REMODEL PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 9/30/03 10/01/03 JLL AP BUILDING FRAMING TIME 17 00 CONVERTED GARAGE TO LIVING SPACE NEEDS FRAMING INSPECTION FOR RAISED FLOOR SYSTEM, TO COVER PATRICIA 452-1763 floor framlng okay to lnsulate floor onlY/)lm BUILDING INSULATION BLI ~LO ---------------------~--------- 01 10/01/03 COMMENTS AND NOTES ----------------------------__________ PREPARED 10/10/03, 12 18 47 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 1011 HAZEL ST INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 4 10/10/03 WALDRON PATRICIA 06-30-08-5-8-0776-0000- 03-00000914 RES REMODEL SUBDIV PHONE PHONE BL3 01 9/30/03 JLL 10/01/03 AP BLI 01 10/01/03 JLL 10/01/03 AP BL3 02 10/10/03 ~ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BUILDING FRAMING TIME 17 00 CONVERTED GARAGE TO LIVING SPACE NEEDS FRAMING INSPECTION FOR RAISED FLOOR SYSTEM, TO COVER PATRICIA 452-1763 floor framlng okay to lnsulate floor onlY/Jlm BUILDING INSULATION BUILDING FRAMING Framlng for lnterlor walls, prevlous framlng has been completed on exterlor wall/garage and bUlld-up floor system. Clndy 452-1763 -------------------------------------- COMMENTS AND NOTES -------------------------------_______ PREPARED 9/30/03, 12 51 59 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER. 1011 HAZEL ST WALDRON PATRICIA 06-30-08-5-8-0776-0000- 03-00000914 RES REMODEL INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE SUBDIV PHONE PHONE PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 9/30/03 ~ BUILDING FRAMING TIME 17 00 CONVERTED GARAGE TO LIVING SPACE NEEDS FRAMING INSPECTION FOR RAISED FLOOR SYSTEM, TO COVER PATRICIA 452-1763 4 9/30/03 -------------------------------------- COMMENTS AND NOTES -------------------------------_______ . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT PERMIT NO. S-,/ z{, ~;1hF DATE Installed By: L-- o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Site Address: Owner/Business: Phone: Owner/Business Address: Sq. Ft. ~ECTRIC HEAT I BASEBOARD KW ~ FURNACE KW _ o HEAT PUMP KW_ o FAN/WALL KW ~. RESIDENTIAL tJ COMMERCIAL ~ NEW CONSTRUCTION b REMODEL o ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE o RISER o OVERHEAD SERVICE ~NDERGROUND ERVICE /VOLTAGE: a z-y'V 11J1 r/J 0 3 SERVICE SIZE CaOAMPS FEEDER SIZE AMPS Details/Description: !lw~ . 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. j JlI~ROUgh-in/cover O.K. /l,<f ~O.K.to connect service ~Final O.K. Site Address: lOll Permit/Receipt No. S-( c- C, Installer: . Notify Port Angeles 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 ~PHONE 457-0411, EXT. 224. ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ ,I' SD Electrical Inspector Permit Fee WHITE - File by address PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall OLYMPIC PRINTERS INC. ~ .... .v . ELECTRICAL PERMIT APPLICATION FOR OFFICIAL USE ONL.,. DalclR<:c. Pamit/!: Date Approved: Date Issued f The Electrical Permit Application must be filled out completelv. Please type or reprint in ink. If you have any questions, please call (360) 417-4735 Fax number: (360) 417-4711 . Owner or Elec. Contractor Agent: 00.:;1;\,,\(' io. \.)(). \(\V'OV'\ Property Owner: \J~\(\ ~\rA \0('). ~r\ IfL5Y\ .we17i' J "i;:)-t Electrical Contractor: (. c.,-{J l b '\ Address: Phone~5c9-I'7 Ir3 Fax:~ ,c:.amC) Phone: Address: 11)\ \ City: P,A. . Zlp.q~3Io~ License #: Exp: Phone: City: Zip: INSTALLATION WIRED BY: Ifl(OWNER D ELECTRICAL CONTRACTOR Credit Card Holder Name: Sifling Address: City: Zip: Credit Card Number: Exp. Date: V1SA:_ MC: PROJECT AODRESS~.w().l ~ 1 TYPE OF WORK: Check E!! that apply: 0\- Rp,.I.,)Af<,Yl C\ "fin! Q3 . o New fi Alteration/Addition fkJ... Residential 0 Multi-family o Commercial 0 Mobile Home Sq. Ft o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septicrump Number of Circuits added or altered: o Low Voltage 0 Telecom. 0 Sign DESCRIPTION OF THE ELECTRICAL PROJECT: Electrical Heat Load Additions and or Subtractions o Baseboard _ KW o Furnace _ KW q Heal Pump _ TON ?0'ZFan.wall _KW /'dD V. LRA o Overhead Service o 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 am 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. Credit Card Holder's Signature: ~ ~ Date: Owner or Ele/ Cant-Signature: ita tilt ~ Date: C:/ElECTRICALPERMIT APPLICATION PERMIT FEE: $f 4/', 70 ~ "1"1"" "," 3504174729 PORT ANGELES CITY LT PAGE 01 Hit- Cjo9. CITY OF PORT ANGELES .$'(1 '7 LIGHT DIVISION '-- b, 0 ., . , j(' FAX TRANSMISSION COVER SHEET Date: II -Olf -t:> 3 #q0cr To: L&I Fax: 417-2755. Re: Inspections Sender: ~ YOU SHOULD RECEIVE 1 PAGE, INCLUDING THIS COVER SHEET. IF YOU DO NOT RECENE ALL THE PAGES, PLEASE CALL (360) 417-4724. , (\y, ~~Y.// / Please inspect the following: 10fl N~~' f~ ~/-W~," {J~ -1JJ~ Ft Jf5~ - I7b3 ~q t!P/Jvt:f:S(~;1J H;JfJL- /Abr, ~ --- ....~ , ~ # 03-00000-'101 II 4d? ~ ((;Jf.V: 4itfJ fhJ(f(- -i-Vr#~-