HomeMy WebLinkAbout4616 Old Mill Rd - Building RECEIV
ti r
CITY OF PORT ANGELUS PERMIT APPLICATION
ION
Building Division/Electrical Inspections MAY 2 20
:. >..:.
321 East Fifth Street—P.O.Box 1150/Port Anger Washington,9$362
Ph.(360)417-4735 Fax-(360)417-4711 ELECTRICAL, •, �.:,:F.�°
Late:- 1 - t ✓1 &2 single Family Dwelling INSPECTIONS
*Plan Review May Be Required,Please Complete Electrical Plan Review Wormation Sheet
Jab Address: _ ,t� Oil) tMJ_L.__.,,f 1?QAb T
Building Square Footage:
nesccipticn 0 above T._ E� A
Owner Information Contractor Information
Name:_f'rr✓s�� 9�{ Name: �X-k � � "is k C4.
Mailing Address: f /5012 hb ll a 1 Ma€Iin Address:
Cily;' � - 4ujds State:_�2°:k Ztp�
Phnna:_ = Fax: _ Fhona: = LS Fax
License'4 l Cxp.T 4 orr?T r a
Item Unit Charge TAtat(City Multip ietl by(tryst Cttarraet
ServicelFeeder 200 Amp. $120.00
Servicelreeder 701400 Amp. $146.00 -_-
ServicelFeeder401-6010 Amp $205.00
ServicelFesder601-1000 Amp. 3262.00
ServicelFeeder over 1000 Amp. $373.00
Branch Circuit Wl Service Feeder $ 5.00 $
Branch Circuit W10 Service Feeder
EachAdditlonal Branch Circuit $ 5.00 � $
Branch Circuits 1-4 $ 75.00
Temp.Servicel Feeder 200 Amp, $ 03.00 $--
Temp.Service/Feeder 201400 Amp. $110.00
Temp.SerVice1Feeder 401.6(10 Amp. $149.00
Temp.Servicell=eeder 601-1000 Amp. $166.00 - $-
Portat to Portal Hourly $ 96.00 $
Signal Circuiti Limited Energy-1$2 Family Dwelling $ 64.00
Manufactured Fiume Connection $120.00 _ $
Renewabte Electrim?l Energy-5KVA System or Less $102.00 $
Thermostat $ 56.00 — $,
Nate:$5.00 for each addigonal T-Stat
NEW CONSTRUCTION ONLY-
First 1309 Sgre Ft. $720.(10 _ $
Ea&Additional 500 Square Ft,orPortion of $ 40,00
Each Outbuilding or Oeleched Garage $ 74.00 _ $
Each Swimming Pool or Hat Tub $110.00
$ _Total
Owner as defined by RGW.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 snaking
the electrical installation or alteration in compliance with the electrical laws,N.E.C„ROW.Chapter 19.28,WAC.Chapter 296-46B,The City of fort
Angeles Municipal Code,and(Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owner,electrical contractor or electrical administrator: 0 cash 0 Check
[ f 0 Credit Cart(#
�✓ifi N! —gated:, �_ AtfU1}dt92 v
ELECTRICAL PERMIT
CITY OF PORT ANGELES d
360-417-4735
Application Number , , . , . 14-00000514 Date 5/02/14
Application pin number . . , 739936
Property Address , , , , 4616 OLD MILL RD REPORT SALES TAX
ASSESSOR PARCEL NUMBER! 06--30-22-2-2-9090-0000-
AppliCation type description ELECTRICAL ONLY on your excise fax form
Subdivision Name . . . , . , to the City of Port Angeles
Property Use
Property Zoning , , . , . . . UNKNOWN (Location Code 0502)
Application valuation , . , . 0
Application desc
RV outlet on garage
Owner Contractor
GREGORY G HOPF EXTRA MILE '.TECH & ELECT, , LLC
4616 OLD MILT, RD 418 N. RACE ST.
PORT ANGELES WA 98362 PORT ANGELES WA 98362
(360) 461-3992 (360) 457-5222
--__----------------------°_-------------------_-- ------------------_---__--
Permit , . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit Fee 63.00 Plan Check Fee 00
TSsue Date 5/02/14 Valuation . . , . 0
Expiration Date 10/29/14
Qty Unit Charge Per Extension
-- 1100 -- 63`0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63,00
Fee summary Charged Paid Credited Due
Permit Fee Total 63.00 63.00 .00 'Co
Plan Check Total .00 .00 .00 .40
Grand. Total 63.00 63.00
.r
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN .
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAEXCHANGRBUILDING
Owner
GREGORY G
4616 OLD MILL RD
PORT ANGELES
(360) 461 3992
INSPECTION TYPE
DITCH
:SERVICE
ROUGH IN
COMMENTS
Application Number
Application pin
PropertyAddres
ASSESSOR PARCEL 'NUMBER
Application type description
SubdiViSion-Nate
Property USe
Property-Zoning
Application valuation
Qty Unit Charge Per
1 00 .93'7.500 ECH
Application desc
200 amp .service change OH to
WA 98362
Permit ELECTRICAL
.Additional desc
Permit pin number 158931
Permit Fee 93 75
Issue 12/3 0/09
Expiration Date 6/28/10
09 00001366
215048
4616 OLD MILL RD
06 30 22 2 2 0125 0000
ELECTRICAL ONLY
UNKNOWN
0
UG
Signature of owner or Electrical ContraetOTX
ELEGTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Contractor
EXTRA MILE TECH &ELECT LLC
418 N RACE ST
PORT ANGRLES. WA 983:62
(360) 457 0198
ALTER RESIDENTIAL
EL 0 200 ERV FEEDER
Fee summary__ Charged_.
Tel Fee_Total 93 75 93 75
PIsn_Check.Totsl oci 00.
Grand Total 93 75 93 75
DATE
Plan Check Fee
Valuation
Credited _Due
(0
Oho
00
oo-
00'
Date 112/3
00
00
RESULTS
00
0
Extension
93 75
INSPECTOR.
°IftitP.
Date
DEC -29 -2009 11 44 PM E JANSSEN
City of Port Angeles Permit Application
Bolding DivIelonlEI.etrlaal Inspections
321 last ttlfh Street P.O. Box 1190
Port Angels Weehington. 98362
Ph: (360) 417 -4735 Fax: (360) 417.1711
Date: 12 -2.1 09
/I& 2 Single Family Dwelling
Multi- Family or Commercial'
Commercial Addition Alteration 1 Remodel Repair"
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 44.1k �9 LL keg
Building Square Footage:
r ,,p r) o IJ-4 5 ;L
_'!oo A W) d cr-A P S1Jcl/ t t °13 ___ASP
Description of above
Unit Charge
93.75
$113.75
3160.00
3205.00
5291.25
2.00
3 57.50
2.00
72.50
88.26
3116.25
3131.25
75.00
5 69.00
76.
50.00
50.00
S 93.75
80.00
86.25
5 27.50
57.50
86,25
43,75
Natter Information
Name: f'0 RE (2 11_0 PE
Malin2_Address cap m114_ rep
City' 11,4 1 ti► '.7.__3321_2,. r is State: Zip: q,�,b
Z
Phone: "fib!
license Exp,
Owner es dented by RCW.19.28.281: (1) Owner rrdN occupy the structure for two years after this electrical permit is finalized. (2) Owner Is required to hire an
eMc$o l oonbacter If above said property is for sale, rent or lease.
Attar reading the above statement. l hereby certify that 1 am the owner of the above named property or a licensed electrical contractor. I am making the electrical
installation or alteration In compliance whit the electrical taws, N.EC. RCW. Chapter 19.28, WAC. Chapter 296.488, The City of Port Angeles Municipal Code, Land
Utility Specifications.
Signature or owner, electrical contractor or electrical administrator
Thermostat
13.7$ Total
Date: A Fn0
RE END
DEC 2.0 2009
ELECTRICAL
INSPECTIONS
360 452 2982 P 01
Contractor Information
Name: E 'CTt[.1k 1N_11.h 1 �'Q 4 12r fct4a,
Mailing Address: L4 L2 ra ..E s T,
City P-a&k....A. reJ- State' 42-&-- Zip: 510'74 z
Phone: V& o- �ST r?Dy- 46o- 1¢( ..r37B
license /Exp. gerR 111 yr 3R(. r3.lars off
PAC f 7 -85
Tot I Qty Iti lied by Unit Charge).
Servlce!Feeder 200 Amp.
Service/Feeder 201-400 Amp.
S._._ ServicelFeeder 401 -800 Amp.
Service/Feeder 601 -1000 Amp.
ServioeJFeeder over 1000 Amp.
Branch Circuit WI Service Feeder
5 Branch Circuit W/O Service Feede
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp
Temp. ServicelFeeder 201.400 Amp
S__ Service /Feeder 401.800 Anip.
Temp. Service/Feeder 001 -1000 Amts
Portal to Portal Hourly
Sign/Outline Lighting
3 Signal Circuit/ Limited Enemy Commercial
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi -Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5K \iA System or Less
First 1300 Square Ft,
Each Additional 500 Square Ft. of Portion of
Each Ou%bullt6ng or Detached Garage
5 Each Swimming Pool or Hot Tub
Application desc
Septic tank
Owner Contractor
Hope Greg
4616 OLD MILL RD
PORT ANGELES
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983621911
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
Application Number 09 00000124
Application pin number 381468
Property Address 4616 OLD MILL RD
ASSESSOR PARCEL NUMBER 06 30 22 2 2 0125 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning UNKNOWN
Application valuation 0
EXTRA MILE TECH ELECT LLC
418 N RACE ST
PORT ANGELES WA 98362
(360) 457 0198 `i T2 2t5 7
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 141374
Permit Fee 59 50 Plan Check Fee 00
Issue Date 2/05/09 Valuation 0
Expiration Date 8/04/09
Qty Unit Charge Per Extension
1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER 57 50
1 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT 2 00
Fee summary Charged Paid Credited Due
Permit Fee Total 59 50 59 50 00 00
Plan Check Total 00 00 00 00
Grand Total 59 50 59 50 00 00
DATE
Date 2/05/09
RESULTS INSPECTOR.
GAP TAO
Signature of owner or Electrical Contractor X Date
FEB -04 -2009 11 09 PM E JANSSEN
Owner Information
Name: _61. rue
Mailing ,Address:
City :g40 State: JA/ Zip: 1 b 2
Phone tie ...4 j1 Pi
Uceneell Exp.
Unit chat
93.75
8113.75
$160.00
$205.00
$291.25
2.00
57.50
2.00
72.50
86.25
$11825
$131.25
76.00
69.00
75.00
60.00
50.00
93.75
80.00
86.25
27.60
57.60
$86.25
43.75
/fir} n t.L JZoA&
3lgnsesPselsumer, electrical contractor or electrical edminlevator
Thermostat
S 9.5 Total
RECEIVED
FEB 5 2009
360 452 2982
Cllr of Port Angeles Permit Application
Building Divhdonl8lectriem inspection
321 tiee1P1Rh Street- P.O. Box 1150
Pert Ante* Washington, 96362
Ph: (890) 4174736 Far: (360) 4174711
Date: 1 '1 e T
e1 &2 Single Family Dwelling
Mull- Family or Commercial'
Commercial Addition Alteration Remodel Repair'
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 4 /Yell p d R1a L L 4_
Building Square Footage:
Description of above 44.NJ"k1s }-o t.J&k J �c... 5 Lpf 44.rol
LIGHT DEPT
Contractor Information
N ame: EKTki.tI.JL rec. ti 0).6 c,1 K.tco t i
Mailing Address: 4 LS 1.1 1'2 A .E
City 904.4- Ikni State: i.J or- Zip: q s( y' t
Phone: $p o 'i_ tea›. ,IG v61 -r376
License Exp. ExTP,12,M 43It g og
Total (OW MuIUolled b y Unit Char* A i r P s 6 S
Servlce/Feeder 200 Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401 -600 Amp.
Service/Feeder 601 -1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W10 Service Feeder
1 Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Servloe/Feeder 201 400 Amp.
S Temp. SeMce/Feeder 401 600 Amp.
Temp. Servlce/Feeder 601 1000 Amp.
Portal to Portal Hourly
Sign/Outline Lighting
Signal Circuit/ Limited Energy Commercial
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Eledrieel Energy 6KVA System or Less
First 1300 Square Ft.
Each Additional 600 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
P 01
Oemer 4a inbred by RCW.19.81.161: ft) Owner will occupy the structure for two years after this electrical /muftis finalized (2) Donner /s required to hire an
decided connecterW above said property is for sere, rent or lease.
Alter rending the above statement, 1 hereby certify that I am the owner otitis above named property or a licensed electrical contractor. I am making the electrical
Installation or alteration In compltance with the electrical laws. N.E.C. RCW. Chapter 1929, WAC. Chapter 296 -4613, The City of Port Angeles Municipal Coda, and
uudty 9;lecllkatlons.
0
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
T\Policies \1102.15R [1/051
Qty Unit Charge Per
Fee summary Charged
CLEAR GRADE
C/G #06 19
84129
70 00
8/11/06
2/07/07
Permit Fee Total 70 00
Plan Check Total 00
Grand Total 70 00
Signature of Contractor or Authorized Agent
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
06 00000842
565448
4616 OLD MILL RD
06 30 22 2 2.0125 0000
CLEARING GRADING
UNKNOWN
0
BASE FEE
Contractor
HOPF GREGORY OWNER
2421 EDGEWOOD DRIVE
PORT ANGELES WA 983621911
(360) 461 3992
Structure Information 000 000 C/G SITE SURVEY
Plan Check Fee
Valuation
Paid Credited
70 00 00
00 00
70 00 00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required Inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances goveming 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 la W regulating construction or the performance of
construction.
eN-06
Date Signattur(ilof r (if owner is builder) Date
Date 8/11/06
00
0
Extension
70 00
Due
00
00
00
PERMIT INSPECTION RECORD
CALL 417 -4807 FOR UTILITY 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.
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
T•\Policies\ 1102.15R [1/05]
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED
YES 1 NO
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
RESIDENTIAL
CONSTRUCTION R W PW/
ENGINEERING 417 -4807
FIRE 417 -4653 1
PLANNING DEPT 417 -4750 I
BUILDING 417 -4815
1 1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
I 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 I
1 1 1
1 1 1
COMMENTS
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
CONSTRUCTION RW
PW ENGINEERING
1 1 I FIRE DEPT 1 I 1
I 1 1 PLANNING DEPT 1 1 1
1 I BUILDING 1 1
1 1 1 1
PREPARED 8/25/06 8 08 44 INSPECTION TICKET PAGE 26
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 8/25/06
ADDRESS 4616 OLD MILL RD SUBDIV
TENANT NBR GREG HOPF
CONTRACTOR DUNGENESS PLUMBING PHONE (360) 582 1227
OWNER HOPF GREGORY G PHONE
PARCEL 06 30 22 2 2 0125 0000
APPL NUMBER 06 00000794 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01 8/04/06 JLL MECHANICAL GAS LINE
8/04/06 AP 08/04/2006 04 18 PM PBARTHOL
08/04/2006 04 20 PM PBARTHOL
ME99 01 8/25/06 JL MECHANICAL FINAL TIME 13 00
greg 461 3992
08/24/2006 04 15 PM DYASUMUR
COMMENTS AND NOTES
PREPARED 8/04/06 16 19 08 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 8/04/06
ADDRESS 4616 OLD MILL RD SUBDIV
TENANT NBR GREG HOPF
CONTRACTOR DUNGENESS PLUMBING PHONE (360) 582 1227
OWNER HOPF GREGORY G PHONE
PARCEL 06 30 22 2 2 0125 0000
APPL NUMBER 06 00000794 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01 8/04/06 JLL
MECHANICAL GAS LINE
08/04/2006 04 18 PM PBARTHOL
COMMENTS AND NOTES
flea
qa
Application Number 06 00000794
Application pin number 259776
Property Address 4616 OLD MILL RD
ASSESSOR PARCEL NUMBER 06 30 22 2 2 0125 0000
Tenant nbr name GREG HOPF
Application type description MECHANICAL APPL PERMIT
Subdivision Name
Property Use
Property Zoning UNKNOWN
Application valuation 280
Owner Contractor
HOPF GREGORY G
2421 EDGEWOOD DR
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
DUNGENESS PLUMBING
21 STEVE PL
WA 983621911 SEQUIM
(360) 582 1227
MECHANICAL PERMIT
Fee summary Charged Paid Credited Due
Signature of Contractor or Authorized Agent
T• \Policies \1102_15 building permit inspection record05 wpd [1/4/2005]
Date 8/04/06
WA 98382
83022
60 65 Plan Check Fee 00
8/04/06 Valuation 0
1/31/07
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 10 6500 ECH ME -GAS PIPE 1 TO 5 10 65
Permit Fee Total 60 65 60 65 00 00
Plan Check Total 00 00 00 00
Grand Total 60 65 60 65 00 00
r/A /A C7 7,
etz6/06
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 that4 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 regula)ing construction or the performance of
construction.
Date Signatt f& f dwn4r owner is builder)
Date
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
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
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
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
PLANNING DEPT 417 -4750
BUILDING 417 -4815
T. \Policies \1102_15 building permit inspection record05.wpd [A/4/2005]
BUILDING PERMIT INSPECTION RECORD
YES I NO
I I 1 r
V
1 I No
I I
1 1
I I
I I
I
I I FINAL DATE ACCEPTED BY.
I I
I I
I I
I I
I I
I I
I I
I I
I I
I I
I g 4 P- 6 -1-1 1
I I
I I
I I
I I
I I
I I
FIN DATE
SEPA.
ESA.
SHORELINE.
V ACCEPTED BY.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
417 -4735 ELECTRICAL
LIGHT DEPT
I ..i .4 I ,I
IY// zdhyr, I V w
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT I
I PLANNING DEPT
I BUILDING I
PROJECT ADDRESS
TYPE OF WORK.
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
PERMITS (360) 417 -4815 FAX(360)417 -4711
Applicant 6 or Cd
Agent: r 4 /407 Phone d Y /7- $'y 7
Owner c 7 r Phone
Address _f old /el. City Ar T ASC/l Zip 9i3 6 2_
Architect/Engineer Phone
Contractor n9 •ene_55 State License bUW(EPP Exp .S/7
7 Phone V77 773
953/C7
Address 2-1 .cle t/t' t' /Ac t°, City cc.47/tA4 L. Zip 9 •S 8' Z
4 o/d /l, 2o(
LEGAL DESCRIPTION Lot: 43 Block Subdivision SUYVey_p$ J nS4#N /SAX4n,
CLALLAM COUNTY PARCEL NUMBER 0630 22- 2.2...a b
Credit Card Holder Name j /e
Billing Address Z4/2/ 6 e *,../eeel dr. De, /Qnyr /rc tsj.j. 91141
Credit Card Type VISA x MC
SIZE/VALUATION
Residential New Constr Re roof Stove SF /SF
Multi- family Addition Move Garage SF /SF
Commercial Remodel Demolition Deck SF /SF
Repair Sign Pr Other LP Ti4Nk +P# /✓•sf TOTAL VALUATION y.. QV
BRIEF DESCRIPTION OF THE Tn s /,4.// /Z0, Alre✓t 9rnund LP 77emae 4,,n
1/44/9roan.al O ..z S> 'AI' i1/ fr/ „a in heritt 1e li A Eenk� a I 4r-
T ..lr,I-
FOR OFFICIIAL USE NLY
Date Rec. 1 -razz-
Date 00
Penn it #•C/R�
Approved. 7 7ido o
Date Issued: -rh/
ZONING XS 9
COMMERCI L/RESIDE p
TIAL Occupancy Group Occupant Load Construction Type:
No of Stories: 1i i oSize' 1. S4e/tS Existing Sq Ft. 2350 Proposed Sq Ft. TOTAL Sq Ft. 13.50
Total lot coverage
PLANNING USE ONLY
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
y Applicant:
r
APPROVALS
PLAN
BLDG
DPWU
FIRE
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 must be submitted at the time the building permit application and construction plans
are submitted. 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 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 Building/Residential Code, 2003) No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits prior to work.
k Date: 7
CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East 5'h Street, Port Angeles, WA 98362
Application Number 06 00000060 Date 1/19/06
Application pin number 033120
Property Address 4616 OLD MILL RD
ASSESSOR PARCEL NUMBER 06 30 22 2 2 0125 0000
Tenant nbr name JERMY SAXTON
Application type description FIRE ABANDON TANK INSPECTION
Subdivision Name
Property Use
Property Zoning UNKNOWN
Application valuation 500
Owner
SAXTON PAUL E
4616 OLD MILL RD
PORT ANGELES
Qty Unit Charge Per
WA 983621911
BASE FEE
Contractor
OWNER
Permit UNDERGROUND TANK RES
Additional desc
Permit pin number 69161
Permit Fee 15 00 Plan Check Fee 00
Issue Date 1/19/06 Valuation 500
Expiration Date 7/18/06
Fee summary Charged Paid Credited
Due
Permit Fee Total 15 00 15 00 00 00
Plan Check Total 00 00 00 00
Grand Total 15 00 15 00 00 00
Extension
15 00
This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
180 days from the last inspection. I hereby certify that I have read and examinal this application and know the same to be
true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the provisions of any state or local law regulating the work specs d i the permit.
4 9/9
Signature of Contractor or Authorized Agent Date Se owner (if Owner is builder) Date
N-r
0
Removal of flammable /combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final
GENERAL COMMENTS
FIRE PERMIT INSPECTION RECORD
Call 360 417 -4655 for fire 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 Passed
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough -in inspection I
Alarm final
LP -GAS
Underground piping inspection /pressure test
Above ground piping inspection/pressure test
Tank (container) inspection
Appliance inspection
LP -gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Comments
Completed by Contractor
Test #1
Piping pressure test psi
Time initiated
Test #2
Piping pressure test psi
Time initiated
2/15/00
rte ri
Applicant or Agent:
Owner Get'4 54 7 L.'
Address. gj /I G Gf) ,'yy L /c City
Architect/Enb veer
Contractor
Address.
PROJECT ADDRESS
LEGAL DESCRIPTION Lot:
CLALLAM COUNTY PARCEL NUMBER.
TYPE OF WORK.
Residential
Multi- family
Commercial
New Constr
Addition
O Remodel
Repair
BRIEF DESCRIPTION OF THE PROJECT
COMMERCIAL/RESIDENTIAL. Occupancy Group
No of Stones. Lot Size.
Total lot coverage
PLANNING USE ONLY
BUILDING PERMIT APPLICATION
Fill out COMPLETELY and in LNK. our application and site plan MUST BE
COMPLETE to be acceptee Sol 1 C If voLL have an q uestions. call
PERMITS (360) 417 -4815 FAX(360)417 -4711
v
Re -roof
Move
Demolition
Sign
State License Exp
City
Existing Sq Ft.
Block. Subdivision.
ESA/Wetland(s) Yes No SEPA Checklist required? Yes 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 P emut Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE IF a plan check fee as due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of perrmt issuance.
EXPIRATION OF PLAN REVIEW If no 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 RI 05.3 2
of the International Building/Residential Code, 2003) No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to deter e what permits are required ,not the City's, and that I must obtain such permits prior to work.
TAPolicies\BL 1102_13.wpd Applicant: i i J de L .i.c _I /4 4
Phone
Phone
yj -2
$3 Zip
SIZE/VALUATION
Stove SF /SF
Garaae SF /SF
Deck SF Cu /SF
Other TOTAL VALUATION
Occupant Load. Construction Type.
Proposed Sq Ft. TOTAL Sq Ft.
Phone
Phone.
Zip
ZONING
FOR OFFICIAi ONLY
Dm,. Rec. ff f O
Permian vv 04
Date Approved :I f
Dal issued.
J -0o
APPROVALS
PLAN
BLDG
DPWU
FIRE
OTHER.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N~ 1 77 2 5
. ,41_ /5-
POrt Angeles. Washlngton......._,.............._..................................... 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.
.d/ of''!r/) "j "'J-' // ((} /7
Address 0..=1.&1. ...~......(?!!'.~~...:....:!.-::;,,,ef<j2/.!:!f,,J:::.:... Occupancy.....,(.!..,~.:.::-::::::........................
~ J,/ Lb4- .
Owner ___nn__~_:__~~.n_nnu__.~:..~~:::._~__o_.n~nun_.nnno Tenant.n_nnnn_unno_nn.n.h_~nn_n___~..n.n_n..n.nonnn_~_
. r
Wiring Contractor .....,~,",!~.':::':'................................._... By......................................................................
C
LIght oUU.ts....h..m.h73nnmhhhh...
Receptacle Outletsm_.m..__m__m___...._...
Service, volts ......................._...__n__......
No. wires ..........._.............__._...._..__
Dryer, KW nn......n..__n....____..____.__._.....
Size wires.....................________......_..
Range, KW h__h___n_nn._n_..h__.
Main fuse ........................__n______...__
Water Heater:
Enclosure .................n____n.nmn__....
KW........nm..mn......hhhn..n.n......
Type of wiring:
Entrance Cable ......._......__m_____...__
Heat: KW............____.....n__.........._.........
Motors: size, volts and phase:
Rigid Conduit ...00____00....._.....
Motalll. Tubing ....hmmnm
Current transformers:
No. & Size....m__n.m___.......__...
Sec. NO.n.................................._.........
Sec. No. .........h....__...................._.._....
Ser. No. ......_...._................__......__.......
Typ. ot Wiring:
Armored Cable ....mn...._...............
Non-Metallic ......._....___.............._.__
Knob & Tub..................................
RIgid Conduit hn........nn...nn........
Metallic TUbing ...........................
Raceway .................................._...._
Circuits, Light..........m.mmm...n......____
UtilIty ....m.........................hh.m.h..
lIeat .._n__.____h_.___.._..._............._......
Range .............................._........______
Water Heater ...._mmm_m....._.......
Motor ..._.............__..........._.............
Dryer ....__n_n..____.............................__
Furnace ..........................~_........n..._....
Total _~ad....;nm._m.m__........ Sec. NO......_....;....._...........h.::mm__:.. T~;al .......;{,..__._;_________.._......._.._._
. /" . r -I r : ~I.",.; ./, I I ,;1"., ~.--", r.
Remarks: (_ l~~' ut ;,.. ~ ;" ,: ~ -. ,_' r;,.' t" ....':/' . _..; ~/- &.,.-:~ ':..{o_.(
.............'.............................................................7..;....7.....................................................<..............
...nn.nn.unnu._unnnnnnunnnu.n.nnunnnu..nn.nnn...nnnnhn_--_nu.unOh..._.nooon.nu......nnn.nn.nu.nonnn.un.........nn
.;~~;~.;~~.............................;~~~~...~~~~;~~......................................)>:..y...;.....Z.,....;:/........._.~...............
f..................................... No............................. By ...!:....:..?:.:.....,......~~.:.:...:...C:..,....":.,,,..........
,
NOTICE-Current must not be turned on until Certificate of Inspection has been Issued. If work Is to be con.
cealed due notice must be given the Inspector so that work may be Inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
Address
.....-........................-...................._................_._............................................n_..._..............
Owner.._..___..........................._.....__.._n...._......_n_.......__......_.__........_________.__.........._._______.Tenant______........_n__________.........___.________.........._._____._.
Date..._......_n_.._.._.........._._n.._......_.........
N~'17 72 5
\Viring Contractor .n.._..............................................__....._...._........................._............_............_._.. By.._..._..........................._................._...____..
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work Is to be con.
cealed due notice must be given the Inspector so that work may be Inspected before concealment. '.
1M Olympic Printers, Inc.