HomeMy WebLinkAbout422 Vashon Ave - Building
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ELECTRICAL WORK PERMIT APPLICATION\.-:;
,
Job wired by
)!:Electrical Contractor 0 Owncr
Installation description
o Commercial ~Residential
.
.--, lJ /l,<i6',S (j;::/~/. t.,"
~urchaser's mailing address I
y..,,~ 49,
Vno+ ~Jwv
Telephone number ~
36o~S0)-/Z/Z-
Premises owner's name; /
-s,'13 j:.,q-.:r-f'-A-$Z
Addr.'V'i~nsp.~~
City "7J / /L, 5
rtf'Vr /.7/V~4fk-
Phone numberJ tp sche(Jule inspection:
y/ - 471r
Owner as defined hy RCW.19.28.261:(l) OWI/er will OCCl/Py the .~trllctl/re for two
years after this electrical permit is finalized. (2) Owner is required to hire an electrical
contractor if above said property is Jar sale, relit 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 instal-
lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter
19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and
Utility Specificatio
Signature ~
X ~
o New
o Altered/Addition
Slate ZIP
Wll- 9 f3 & z---
FAX number . .--I/r.../
, -0 -</:)2.. -/'>To
Tl~I1.Il((<d?&t
LW,~ ~~
E:'vu.S CgV\:m~
l
o Cash 0 Check #
o Credi t Card
Card #
Visa
Mastercard
Discover
Expiration Date
of card
EI clrical ad Additions and or subtractions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton LAR
o Fan,Wall KW
o Overhead Service
o Temp Service
D Underground Service
Voltage
PhaseD 1 03
Service Size:
Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH-IN
THERMOSTAT
SERVICE
FINAL
DITCH
FEEDER
, ~
~
Date
Approved My
Dale Approved By
Dale Approved By
Dale
Approved By
Dale
Approved By
Date
Approved By
Inspection
Date
Area, Building or Equipment Inspected
Action Taken
Electrical
Inspector
".,~
8ti.~...
D!I
'ltil......,..
CITY OF PORT ANGELES
PUBLIC WORKS . ELECTRICAL DIVISION
,21 EAST 5TH STREET. PORT ANGELES. WA 9R,62
.
.
Application Number
Application pin number _
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property zoning
Application valuation
06-00000489 Date
499449
422 VASHON AVE
06-30-10-5-0-0216-0000-
ELECTRICAL ONLY
5/12/06
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
ROBERT KJAFASZ/MARY ROMSTADT
422 E VASHON AVE
PORT ANGELES WA 98362
THORNES REFRIGERATION
PO BOX 991
PORT ANGELES WA 98362
(360) 461-0158
Permi t
Additional desc
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
THORNESI T-STAT WTR HT-EMS CON
77297
THORNES REFRIGERATION
48. io plan Check Fee .
5/11/06 Valuation
11/07/06
.00
o
Qty
1. 00
Unit Charge Per
48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS
Extension
48.10
Fee summary Charged Paid Credited Due
- --------- ---------- ---------- -------- ----------
Permit Fee Total 48.10 48.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 48.10 48.10 .00 .00
COMMENTS/ACTION NEEDED
.
FOR OFFICIAL USE ONlj
~trIJlA-: -',
PWmit .:
Dale App,,,vcd:
~CI"UN;
br-0 e:> ELECTRICAL PERMIT APPLICATION
The ElectrlcaJ Permit AppJicatKJn must be filled out comDletetv.
.:P=;l..-"Z-o
Please type or reprint In Ink. "you have any questions, please call (360. 417-4735
Fax number: (360) 4t7-4711
Owner or Elee. Contractor Agent:i(\~~T ~A\'S;?: /1)10 R<:uIrf, fiA ~.l. Phone:(3~,\ yS~ '11. OFax:
Property Owner . SA: ~ Phone:
Address: Y,,),} IIA:sf/o,u Au[ City: Pr<< A,uJ.e(rc,
Electrical Contractor: Ucense #: Exp:
S/l."~
Zip: qt3GJ-
Phone:
Credit Card Holder Name:
Billing Address: <;,.)J. (J A<:, 11o;j
Credit Card Number: '
) Date.
.s.
Zip: q,fL~bcJ.-
VISA: t/. MC:_
IM.f AU~'S CO/J.
TYPE OF WORK: Check all that apply: 0 New ~~Add~ion
mResidental 0 Multi-family 0 Commercial 0 Mobile Home Sq. Ft. . "i !< f ()
PROJECT ADDRESS:
It ) ol.
1/ A S}/otJ
q I.'], G ,j
o Remote Meter 0 Detached garage 0 HotTub 0 Swim Pool 0 SeplicP,u~p 0 Low Voltage 0 Telecom. 0 Si
Number of Circuits added or altered; !.,',
','
DESCRIPTION OF THE ELECTRICAL PROJECT:
I-a.
/
f\/O 11D.O&:>' UJ/JO
Electrical Heat Load Additions
7b.30 'f-
. / >/. ..1M2-;'1<-t:..
::v...70 ;:::.'1,1>>0
/1$ r .: . Service Information . fr? "'l.--d)C
~rl3U>t:k.
Voltage; d yl1
Phase: 8 1 0 3
Service Size: N,.. (\
Feeder Size:
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
_KW
_KW
_KW
_KW
o Overhead Service
o Temp Service
o Underground Service
PAMC 14.05.060(B): For Industrial, commercial, & residential projects larger than a duplex. a one . line drawing 01 the Electrical Service I
Feeders, building size (sq. fl.), load calculations, and the type & of conductors and/or raceway is required and shall accompany the
Electrical Permit application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and Il
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
are required; it remains
Ho Signature: /2(;> / ,/
.
Date:
-dYO)
Owner or Elec. Cont.. Signature:
Date;
PW-9019
tlKc~
3h/>3
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DMSION
32t EAST 5TH STREE'[, POR'r AN(}ELE~, WA 95362
BUILDING PERMIT ISSUED: 7/25/2000 PERMIT NO: 12088
OWNER/APPLICANT PROPERTY LOCATION
422 VASHON
ROBERT KAJFASE Lot: 5,6,S68' OF 7
422 VASHON
Port Angeles, WA 98362 Block: 2 [] Long Legal
360/000-0000 Subdivision:
T: S: Parcel No:
CONTRACTOR ARCHITECT
OWNER N/A
VARIOUS
Port Angeles, WA 99360 , 98360-0000
206/000-0000 360/000-0000
PROJECT INFO
Project Value: $2,000.00 SFO Units: 0 Commercial: 0
Project Type: SHED SFD SQ FT: 0 Industrial: 0
Occupancy Type: Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use: RS7
PROJECT NOTES
12' X 22' STORAGE SHED
FEES ASSESSMENT
Building Permit: $69.25 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: $73.75
Plumbing: $0.00 AMOUNT PAID: $73.75
Mechanical: $0.00 BALANCE DUE: $0.00
Radon: $0.00
RW SANITARY WATER DWY STORM DRA OTHER
Separate Permits are required for electrical work, utilizes, private and public improvements. This permit becomes null and void if work or
construction autho~zed is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days affe~
the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby ce~'y that I have
read and m(amined this application and know the same to be tree and con'ecL All provisions of ~ 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 autholffy to violate or cancel the
~rovisions of any state or local law regulating construction or the performance of construction.
Si~lnature of Contractor or Authorized A~ent Date Signature ~)f Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD , !
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A ~ 24 HOUR NOTICE. ITIS UNLAWFUL TO COVE&'
INSUI~ TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP pER-MIT CARD ~ APPROVED PLANS AT JOB SITE
ENGINeERiNG 417-4807 PW / ENGINEERING
~,onr FOR OFFICIAL USE ONLY;
BUILDING PERMIT PREAPPLICATION
Pr~ C~pl~e?~
The Building Pe~it - P~appIication mu~ hefted out completely. Date ~d:
~ Please typo or print ~ In~ If you haw any questions, please call 417~81
~c~tect~n~neer: ,C~/~ Phone:
Contracto~ ~/~ License g: Exp: Phone:
Ad&ess: City:. Zip:
~g OF WO~: SIZ~ALUATION:
n Resid~fial o New Co~. u Rer~f u W~tove ~ ~ q SF. ~ $_ /SF. = $ ~ ~ o
~ M~ti-f~y n A~aon n Move u O~age SF. ~ $ ~F. = $.
~ R~ o Si~ d~ TOT~ V~UATION $
· ~F DESC~ON OF ~ PR~CT:
COMMERCIAL/P. ESII)ENTIAL: Occupancy Group:_ Occupant Load: __ Construction Type:
No. of stories: f Lot Size: 1/-/~/,,~ .~;rf77 % Lot Coverage: __,/. ~'5' __ %
Existing Lot Coverage: -2z¢~.'7 ]s~. ft. + Proposed Lot Coverage: ~.'9'7 __/sq. it = TOTAL LOT COVERAGE: 2---70~' -_/SCl. It
I~LANNI~G USE ONLY: APPROVALS.' PLAN
,'Notes: - BLDG
DPW
ESA/WeOand(s): [] Yes o No SEPA Checklist required? gl Yes n No 'Other: OTHER
PREAPPLICATION SUBMITI'AL: Your application and site idan rn~ beJ'dled out complete{V to be accepted for re~ie~,. The Building
Division can provide you with more detailed information on the application and plan submittal requirements.
BUILDIlNG PERM1T APPLICATION SUBMiTI'AL: Your completed application, site plan (fur additions) and building construction
plans arc to be submitted to the Building Division.
VALUATION Ol~ CONSTRUCTION: In all cases, a valuation amount mast be entered by the applicant. This figure will be reviewed and
may be revised by thc Building Div. to comply with current fee schedules. Contact thc Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans arc 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 thc date of application, this application will expire by
limitations. The Building Official can extend the time fur action by the apphcant up to 180 days, on written request by the applicant (see Section
304(d) of the Uniform Building Code, current edition). No application can be extended more than once.
I hereby cert~ that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for
this permit. 1 understand it is not the City5 legal responsibility to determine what permits are require& it remains the applicant's
r. pon,,b,,, todeie,'m,.e.ha, perm..arerequ,redandioo to,u= .
~ Applicant: ate:
PW-1102_13[rev. 2/96]
MONOLITHIC CONCRETE FOUNDATION DETAIL
5'2,:,t £. ~J4.. ,'qo,,,O -SC_c..L~_: ~ : i'- 0"
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
' " (phone, person)
Date ' ~ Time Received by
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation ~t~min~g_~himney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:~ _ ~ ~/
Inspected: Date -__ Time By
Remarks:
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved [-~Gravel [~Asphalt []PCC [~Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[]No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:/~
Date ~'- ~--~[~') Time Received by ~ (phone, person)
Location of Work to be inspected '~Z/2 '~ ~//'/~~"'~
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other~,/~-~
INSPECTION NO]'ES: .
Inspected: Date / ~ - (J~'~ Time By
Remarks:
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved [~Gravel []Asphalt []PCC []Other
[] Repaired by City Work Order #
~--] Repaired by Permittee [] COMPLETE
[]No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date ~-I.~ ~_~ Time Received by ~F (phone, person)
Location of Work to be inspected ~-/2~--_,
Name of person requesting inspection ~-'~>
Address of person requesting inspection Phone No. ~//"~/
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing~ewerExcav. Other
INSPECTION NOTES: ~
----~', Time By ,,,_~
Inspected: Date ~ "- } ~
Remarks: ,.
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel ~-~Asphalt []PCC []Other
[] Repaired by City Work Order #
[--} Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
321 EAST 5TH STREET. PORT ANGELES. WA 98362
ELECTRICAL PERMIT ISSUED: 6/06/2001 PERMIT NO 7293
OWNER/APPLICANT PROPERTY LOCATION
ROBERT KAJAFASZ 422 VASHON
422 VASHON ~\ Lot: 5,6,S68' OF 7
/' J(~ Block: 2 [] Long Legal
Port Angeles, WA 98362 ~p 0
360/000-0000 ~__ r Subdivision:
T: (~ S: 5 Parcel No:
CONTRACTOR ARCHITECT
OWNER N/A
VARIOUS
Port Angeles, WA 99360 , 98360-0000
206/000-0000 360/000-0000
PROJECT INFO
Project Type: RES. OUTBUILD Project Value: $0.00
Occupancy Type: Construction Type: OUTBUILDING
Occupancy Group: Zoning Use: RS7
Electrical Heat:
[] Baseboard 0 KW [] Riser [] Underground Service
[] Furnace 0 KW [] Overhead Service Voltage: 120,240
[] Heat Pump 0 KW [] TempService Phase: [] 1 []
[] Fan Wall 0 KW Service Size: 0
Feeder Size: 0
PROJECT NOTES
Feeder to garage and circuits
FEES ASSESSMENT Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
Misc Fee: garage $44.25
TOTAL FEE: $44.25
AMOUNT PAID: $44.25
BALANCE DUE $0.00
)MMI:?'I S/'ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL I~SPECTIONS. PLF~SE PROVIDE A MINIMIfM 24 HOUR NOTICE. IT IS UNLA FFFUL TO CO}~P~
INSUi~ TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
DITCH
ROUGH-IN / COVER 6~/~'/-/ ,?
SERVICE "~ _ r'
FINAL I ~rS;/, ( [ ~ I
GENERAL COMMENTS:
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number ..... 03-00000220 Date 3/16/03
Property Address ...... 422 VASHON ST
ASSESSOR pARCEL NUMBER: 0630105002160000
Application description . . . ELECTRICAL ONLY
Property Zoning .......
Application valuation .... 0
Owner Contractor
Additional desc . .
Expiration Date . . 9/12/03
Fee summary charged Paid Credited Due
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within '180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within '180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
7:\PLANNING\FORMS\1102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 1N A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED 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
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PWUTILITIES/ SITEWORK (EngineeringDivi$ion) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPAP~ATE PERJvlIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION RW. / PW/ CONSTRUCTION - RW.
ENGINEER/NG, 417 4807 PW / ENGINEERING
FIRE 417~4653 FIRE DEPT
PLANNING DEP'I. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLAN~NING~FORMS\] 102.15 [4/2002]
.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
PERMIT NO. sstvs
& !/gwt
DATE
ELECTRICAL PERMIT
Installed By:
6 ;},.A ()
/11/ C / ' /(.A
Q~
.;;r~
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Site Address:
Owner/Business:
Phone:
Owner/Business Address:
Sq, Ft,
DetailslDescription:
, 14-1'7 cis A.I
-r:/ .
-ir!
P'&I"-l.i!I) .
tr' RESIDENTIAL 0 RISER
tJ COMMERCIAL ~ OVERHEAD SERVICE
o NEW CONSTRUCTION 0 UNDERGROUND SERVICE
o REMODEL VOLTAGE: /Zc'J /2-t/D
Jl'l' ADD/ALTER CIRCUITS . '" '",
\Z! SERVICE UPGRADE/REPAIR F- 1 p 0 3 p ":>-'0
SERVICE SIZE ,./0><- AMPS
o TEMPORARY SERVICE ~ j FEEDER SIZE /t9.() AMPS
..IA. J.s-M II J,;:;O m.!/oe 'ti::t;;;.u tJ' (,9,.)
hZr!.) IV! fIf> ..9&c1 /ru
/hy:, fJM{/<; Eic/s '11.1,/
r' /JdJl /04J " ~c:
c'(bp?f 6/./' ;It}, 2t''v /l7z~
ELECTRIC HEAT
o BASEBOARD KW
13' FURNACE KW /0
~ HEAT PUMP KW-----4-
o FAN/WALL KW ~
.
~U{) /11 cl-r/2. r; '- tU/I/ MeV ,.1If!-c/E
SERVICE SIZE DATE
tJ I{IL--
ENGR.
J~/) jJ7[:~.
!)bLS ~.
W.S. No.
CAPACITY:
o OK 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection OK
/., 0 Rough-in/cover O.K.
/(jj'IiA -~OK to connect service
o Final O.K.
Sile Address: ,1' /'
4/22- {//ftlttl/1
Y1c..,,/ ~t Itr?
Permit/Receipt No.
Installer:
d~(L-
New Meters Date:
.
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and 0. 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.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
$
#tff.>
-/~
EleClrj~lnspector
Permit Fee
WHITE - File by address
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept., Bottom: City Hall
OLYMPIC PRINTERS INC
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16326
Ii: ...,..,. 1.\;,,; '0,
J g o' I
Port Angeles, Washlngtonumm___:mmu______m_mmmm..m.._m_m_m_, 19.:mn_
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.
tY ,; ,- -" ~ '."" I
/-- .; '\, 1,/ .I . ,.,
Address _.n._m.~_m_._mL~:u___.c!_____~m:___L.:m'_nmnuuummumuuum_ Occupancym,~_,::-:__._c:....._m..n..u__m_m.n
Owner nnnm:-;_~~;_:L_:.,___.___mJ_:u.......,...____m__um'u.. Tenant...._.______m__um___m_m._m...mnmmmm____..mm.m
Wiring Contractor _mmum~...:~:~_:_m_5_~_~___,/..:__:.:.nunn_._.__u By_uu_mm_mm____.n..nm____..mm.m_.._._n..m___.____
IF] ....,.. t". 'i:.-ti
Service, volts ...~......~.:'....;=......~....:..... Type of Wiring:
!
Light Outlet.........._...........m......._..__....
Receptacle Outlets....m..................._m.
:I:'e w~:::..:~~;if~:.:f::~::
f ", ~ ~,
Main fuse ...!:..._.'m..m.....................
Dryer, KW n.n...............____._..__.__.......__
Range, KW ____:::'~hi1::;.::d_::::r:C'.___.....
.. ,
Water Heater:
,
Enclosure mm..m:m....m.................
KW...m.........h.....m......n
<:?
Heat: KW........t...................._........._.....
Type of wiring:
Entrance Cable .._mm_
Kotors: size, volts and phase:
",-",:!.:.......L<.r:.lf.mm.m.mmmm...
Rigid Conduit ....................--...
Metallle Tubing ....m....................
Current transformers:
No. & Size_mm_......m.......m...
Ser. No..............._...._._.....__..........__..__
Ser. No. ..........._................_........._.._...
Ser. NO......n.......................................
Total Load...._...__.__..__________._o.
Ser. No. ....__....00...."......_."....".._00.."_.
~
Remarks: mm._mummm_mummumm_..____..Un._._m. uhm________uuu.mm.m____..u_____n..._.m_.....__.____m_....ummmm
Total ....._.._____..__..._.._...............
Armored Cable .._m__m.....h_...........
Non.Metallic ......._..___m......._.........
Knob & Tube................._............._..
Rigid Cc>ndult .....m.mm............_...
Metallic Tubing .m............m.n...__
Raceway __....._.__.._.____............_......_
Circuits, Light................_.n.........____.__...
Utility ............._._.._....._....................
Heat ..___...._..________....___............_......
Range ....._.._.._.....______.......__.............
Water Heater ....n..............._._....._.
Motor ____.......___........._n_.._.___.nn.....
Dryer______..._..........._........._......___..__....
Furnace .__..............._...___.___._____._..__._._.
Fermit Fee Treas. Receipt /1.1 I /
l~' / !~ .
$ .m____.._.__._m___.___.____m__. NO._m________________________ By .__'__'_m~~_____m____m._m___.".:~.___._:.h~.___...m~_.m_.
i .
NOTICE-Current ust not be turned on until Certificate of Inspection has been issued. If work is to be con.
c['aled due notice mUB be given the Inspector so that work may be inspected before concealment.
....,--
E INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
l
ELECTRICAL PERMIT
Ajdress
N?
16326
o wner n_................................___u..____...._.__._...____._......_..._u._n_.__.......n_nn__n_n_..n_..n____. Tenant..................n.........n_.....................n..n......_..
Date_..___._._____..____...___________..._h_____..______..
V..iringContractor........_._..._._......................._____..._.__.......................__.........____._..............................By.....__..____........_........................................
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con.
c(':aled due notice must be given the Inspector so that work may be inspected before concealment.
{
1M ()lvmT1;/", Prinf<>r". Tn/'"
Application Number . . . . . 23-00000994 Date 9/18/23
Application pin number . . . 558882
Property Address . . . . . . 422 VASHON AVE
ASSESSOR PARCEL NUMBER: 06-30-10-5-0-0216-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
T-stat
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
ROBERT KJAFASZ/MARY ROMSTADT DAVE'S HTG & COOLING SRVC INC
422 E VASHON AVE PO BOX 413
PORT ANGELES WA 98362 PORT ANGELES WA 98362
(360) 452-0939
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 56.00 Plan Check Fee . . .00
Issue Date . . . . 9/18/23 Valuation . . . . 0
Expiration Date . . 3/16/24
Qty Unit Charge Per Extension
1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 56.00 56.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 56.00 56.00 .00 .00
1 - 2 SIN G LE-FA M ILY
E.LECIRICAL PERMIT APELICAIION.
Public Works and Utili ties Department
32 l E. 5th Street. Port Angeles, \,VA 98362
360.417.4715 I www.cilyufpu.us I ctectricalpcrmitsrc.cityofpa.us
-422 Vashon Ave
ProjectAddress: --------------------------------------
Low voltage thermostat wire for thermostat as part of a ducted installation
Project Description:-------------------------------------
0 Single-Family Residential D Duplex/ ARU Building Square footage: ....;.1...;..44-'-0.;__ _
. . . - . . OWNER INFORMATION . . . ,·
Name: Bob Kajfasz & Mary Romstadt
Mailing Address: 422 Vashon Ave, Port Angeles, WA 98362
Email:~--------------
Phone: 3608085028
·-· -- _ .. , ... -·· . -. , ... ELECTRICAL.CONTRACTOR iNFORMATION :· · . · ,_. .---~-<-f1 . . . .,_ .. ,, ..
Name: Dave's Heating & Cooling Services, Inc.
Mailing Address: PO Box 413, Port Angeles, WA 98362
Email: davesheatinq@.wavecable.com
License: DAVESHC9912C
Expiration Date: _0_5/_2_0_2_5 _
Phone: 3604520939
twn.
Service/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 W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
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
Signal CircuiULimited Energy - 1 &2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
First 1'300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Detached Garage
Each Swimming Poof/ Hot Tub
Unit Cbacge. .QuaD.ti!Jl
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00 1
$120.00
$4 0.00
$74.00
$110.00
TOTAL
Tom! (Quantity x Unit Charge)
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ _
$ 56.00
$ _
$ _
$ _
$ _
$ _
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 o r of the ove named PJ:9Perty or a licensed electrical contractor. I
am making the electrical installation or alteration in compliance it th ele~ ica laws, N.E.C. RCW. Chapter 19.28, WAC. Chapter 296-
468, The City of Port Angeles Municipal Code, and Utility Spe fi atio s an PA C 14.0 0 regardfng Electrical Permit Applications.
9/15/2023 Laci Williams
Date Print Name ctor I Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
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
10/2/2023 23-994 TAP
OWNER
CONTRACTOR
Dave’s Heating
PROJECT ADDRESS
422 Vashon Ave
Application Number . . . . . 24-00000252 Date 3/20/24
Application pin number . . . 806120
Property Address . . . . . . 422 VASHON AVE
ASSESSOR PARCEL NUMBER: 06-30-10-5-0-0216-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Battery Back-up
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
ROBERT KJAFASZ/MARY ROMSTADT ANGELES ELECTRIC
422 E VASHON AVE 524 E. 1ST ST.
PORT ANGELES WA 98362 PORT ANGELES WA 98362
(360) 452-9264
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 95.10 Plan Check Fee . . .00
Issue Date . . . . 3/20/24 Valuation . . . . 0
Expiration Date . . 9/16/24
Qty Unit Charge Per Extension
1.00 95.1000 ECH EL-R- 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
1-2 SINGLE-FAMILY
ELECTRICAL PE RMIT APPLICATION
Pu[:Iie Woi:hs arr<J {JtiIjtir:s i}e1:artmenI
321 p..Stlr Sh'eet. iooll z\rrg;r:les, 1,Vz\ 98362
3 60.4 l l .4l 3 5 l wrvr,v. c i tyo $ra. ir s l el ec l rica l l;errnits(4cityo tpa.us
idential n Duplex /U Building uare footage
Email
-U
o-3
;;-.
+t
Project Address
Name:
Mailing Address Phone: fu-W-&ry
Name: An eles Electric lnc.
Mailing Address 524 E. First Street, Port Angel es, WA 98362
Email ksim SO s.net
License ANGELEI46ORS
Expi ration Date: 313112024
Phone: 360-452-9264
Item
Service/Feeder 200 Amp.
Service/Feeder 20 1 -400 Amp.
Service/Feeder 401 -600 Amp.
Service/Feeder 60'l-1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits'l-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 60'1 -1 000 Amp.
Poftal to Portal Hourly
Signal Circuit/Limited Energy - 'l&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: SKVA System or less
Thermostat (Note: $5.30 for each additional)
Pool I Hot Tub
Unit Charqe
$190.20
$190.20
$285.30
$380.40
$475.50
$5.30
$95.10
$47.55
$95.1 0
$e5.'10
$190.20
$285.30
$380.40
$95.1 0
$95.1 0
$190.20
$190.20
$95.1 0
$190.20
: $47.55
$s5.10
$190.20 ---ma-
--44:-
Quantitv Total (Quantity x Unit Charge)
$
$
$
$
$
$
$
$
$
$
U
$
$
$
$
$
$
$
:.$
:$
$
$
$
-7---7{,2
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 S a PAMC 14,05.050 regarding Electrical Permit Applications
Ken Sim son
Print Name Signatu p Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711]
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
CORRECTIONS NEEDED:
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
5/14/24 24-252 TAP
OWNER
Contractor
Angeles Electric
ADDRESS
422 Vashon Ave