HomeMy WebLinkAbout608 Vashon Ave - Building CITY OF PORT ANGELES 1
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
1111111// 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00000657 Date 6/27/11
Application pin number 313283
Property Address 608 VASHON AVE REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-10-4-3- 0660 -0000-
Tenant nbr, name GEORGIA E FRAKER on your state excise tax form
Application type description PLUMBING PERMIT to the City of Port Angeles
Subdivision Name
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 820
Application desc
REMOVE /REPLACE ELECTRIC WATER HEATER
Owner Contractor
GEORGIA E FRAKER OLYMPIC PENINSULA PLUMBING
PO BOX 1275 61 E ROBERT PL
PORT ANGELES WA 98362 SEQUIM WA 98382
(360) 452 -1219 (360) 477 -7408
Permit PLUMBING PERMIT
Additional desc
Permit pin number 188334
Permit Fee 57.00 Plan Check Fee .00
Issue Date 6/27/11 Valuation 0
Expiration Date 12/24/11
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 7.0000 EA PL -WATER HEATER 7.00
Fee summary Charged Paid Credited Due
Permit Fee Total 57.00 57.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 57.00 57.00 .00 .00
finti IX
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 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 exami -d this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of o k will be co plied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or can el e provis .ns of any state or local law regulating construction or the performance of
construction.
03• 11 �OE S 1�
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD (5"
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
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 FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders /Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling P
Drywall (Interior Braced Panel Only) V)
T -Bar
INSULATION: 0
Slab S
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping _SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831 1 C
Fire 417 -4653 3
Planning 417 -4750
Building 417 -4815 1 C l--
T:Forms /Building Division /Building Permit
CITY OF pORTANGELES
hale. W A S H I N G T O N U. S. A
w vr-
‘1111Pr COMMUNITY ECONOMIC DEVELOPMENT
April 2, 2012
Georgia Fraker
608 Vashon Ave
Port Angeles, WA 98362
RE: Expired Building Permit #11-657
Dear Ms. Fraker:
I am writing this letter to inform you of the status of the above permit. The permit expired on
December 24, 2011. We have attempted to contact Fast Water Heater Company but did not receive
a return call. This will be our final attempt to resolve the status of the permit. If we do not receive a
response from you regarding the above permit by April 20, 2012, we will consider the permit
abandoned and will expire the permit.
Thank you for your prompt attention to this matter.
Sincerely,
l inc n er
ry p
l'Is /�.N` Ct"vv
Heather Catuzo
Building Permit Technician
321 E 5th Street
Port Angeles, WA 98362
hcatuzo @cityofpa.us
360 417 -4817
cc Fast Water Heater
PROJECT STATUS UPDATE
Permit# t k' U�6' LiO� VO�� on e
Date: 11' 17
I phoned the: Applicant fot, \NO4- f Nec f -err at 1 2 i4VIDSLF
Property Owner at
Contractor at
(left a phone message, or discussed):
The permit (has expired, or will expire soon). What is the status of this project?
Please call and schedule a final inspection.
Or
Submit a "permit extension request" letter.
Or
Let me know if the project is abandoned
1 /vn Jt4116 Ctv0V9
T:Forms /Building Division/Project Status Update
542731
0 pokr t4- BUILDING PERMIT APPLICATION Print in ink
0- CITY OF PO ANGELES For City Use Only:
w� 7 Attn: Building Permit Technician Date Received G,- I
w a 321 E. Fifth St., Port Angeles, WA 98362 Permit* II— (p 5-
T'. (360) 417 -4815 fax (360) 417 -4711
Date Approved
Applicant f C/St 14/C74er Peaier L- Phone 425- 636 70$''
Property Owner FRAKER, GEORGIA `J Phone (360)452 -1219
Property Owner's Address 608 VASHON AVE PORT ANGELES, WA 9836:
Contractor Olympic Peninsula Plumbing Phone 425-636-70W
Contractor's Address 12601 132ND AVE NE KIRKLAND. WA 98034
License OLYMPPP900B7 Expires 01 /27/12 E -mail 1ulieCAfastwaterheater.com
PROJECT ADDRESS 608 VASHON AVE
Parcel Number Lot Zonin
Project Type Brief Description: XResidential o Multi- family Commercial industrial
Check all that apply
New Construction
o Addition
o Remodel
o Repair
o Demolition
Re -roof House garage other tear off re -roof a lay over one layer
Heat System ❑Heat pump wood buming stove gas fireplace pellet stove other
IR Other Replace Remove /Replace Electric Water Heater
Floor Areas Existing (sq. ft.) Proposed (so. ft.)
Basement per sq. ft.
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION $V'
Total footprint of structures sq. ft. Lot size sq. ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage
Max. height of proposed structures ft. Occupancy group of bedrooms
Will a lawn sprinkler system be installed? Occupant load of full baths
Will a fire sprinkler system be installed? Construction type of half baths
1 have read and completed this application and know it 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, and to obtain permits prior to working on pro'ects.
Date (1)( 2`t Print Name d C s Signature
T:Forms /Building Division /Bldg Permit.doc
MECHANICAL SUBMITTAL FORM
Fill in the specific quantity of each item that will be installed or relocated at your building project.
Submit this form with the Building Permit Application.
QUANTITY DESCRIPTION
Furnace 5 Ton, 100,000 Btu/h (29.3 kW)
Furnace 5 Ton, 100,000 Btu/h (29.3 kW)
Floor Furnace
Heater (suspended, recessed wall, floor- mounted)
Boiler, compressor, absorption system:
3 hp, 100,000 Btu/h (29.3kW)
3 hp 15 hp (2.24 11.19 kW) 100,000 500,000 Btu/h (29.3 146.48 kW)
15 hp 30 hp (11.19 22.37 kW) 500,000 1,000,000 Btu/h (146.48 292.95 kW)
30 hp 50 hp (22.37 37.3 kW) 1,000,000 1,750,000 Btu/h (292.95 512.66 kW)
>50 hp (37.3 kW) 1,750,000 Btu/h (512.66 kW)
Air handler 10,000 cfm (4.72m
Air handler 10,000 cfm (4.72m 3 /S)
Evaporative. cooler (attached, not portable)
Ventilation fan connected to a single duct
Ventilation system (not part of a heating or air conditioning system)
Hood served by mechanical exhaust, including ducts
Incinerator commercial or industrial
Incinerator domestic -type
Solid -fuel burning appliance
Fuel gas piping, one to five outlets
Fuel gas piping, each additional outlet over five
Hazardous process piping system., one to four outlets
Hazardous process piping system, each additional outlet over four
Nonhazardous process piping system, one to four outlets
Nonhazardous process piping system, each additional outlet over four
1 Miscellaneous appliance vent or equipment (not otherwise listed on this form)
Specify how many repairs, alterations, or additions (not otherwise listed on this form) will
be done regarding heating appliances, refrigeration units, cooling units, evaporative
cooling systems, absorption units, or other mechanical appliances, including installation of
controls, at this building project.
2 1-- 3 k ri\-0- 6 -1-4) 06
e c CA/1,‘ spisE)
CITY OF PORT ANGELES
i DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
l 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 10- 00001305 Date 11 /05 /10
Application pin number 878860
Property Address 608 VASHON AVE REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-10-4-3- 0660 -0000-
Tenant nbr, name GEORGIA E FRAKER on your state excise tax form
Application type description MECHANICAL APPL. PERMIT
Subdivision Name to te City Of Port Angeles
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 3995
Application desc
INSTALL A MINI -SPLIT HEAT PUMP SYSTEM
Owner Contractor
GEORGIA E FRAKER PENINSULA HEAT INC
PO BOX 1275 782 KITCHEN -DICK RD
PORT ANGELES WA 98362 SEQUIM WA 98382
(360) 452 -1219 (360) 681 -3333
Permit MECHANICAL PERMIT
Additional desc MINI -SPLIT HEAT PUMP
Permit pin number 177006
Permit Fee 64.80 Plan Check Fee .00
Issue Date 11/05/10 Valuation 0
Expiration Date 5/04/11
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 14.8000 EA ME- FURN /HP /FAU OR 5 TON 14.80
Fee summary Charged Paid Credited Due
Permit Fee Total 64.80 64.80 .00 .00 f.,)
Plan Check Total .00 .00 .00 .00 06\
Grand Total 64.80 64.80 .00 .00
\AO 0
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 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 th o isions of an -tate or local law regulating construction or the performance of
construction.
00 .,tea r/ 4 /u
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS 0
Building Inspections 417 4815 Electrical Inspections 417 4735 JZ\
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
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bidgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
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:
5
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney p y
Commercial Hood /Ducts FINAL Date I�KCCe —Accepted by Id
MANUFACTURED HOMES: Nkj
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping _SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815 C D
3
T:Forms /Building Division /Building Permit
Linda Pangrle
From: Robert Kajfasz
Sent: Wednesday, June 15, 2011 11:54 AM
To: Linda Pangrle
Subject: RE: Ductless Heat Pump Inspections
Yes, See dates below
From: Linda Pangrle
Sent: Wednesday, June 15, 2011 10:59 AM
To: Robert Kajfasz.
Subject: Ductless Heat Pump Inspections
Hi Bob,
Did you already inspect and approved the ductless heat pumps at the addresses below? If so, please specify the
inspection dates.
3711 Crabapple Place for Frank IVlarvelle, permit #10 -1341 (12/13/10)
518 W Lauridsen Blvd for Sissi Bruch Robert Welch, permit #10 -1342 (12/2/10)
608 Vashon Ave for Georgia Fraker, permit #10 -1305 (12/1/10)
Thanks,
Linda
1
PREPARED 7/22/11 9 59 30 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 7/22/11
ADDRESS 608 VASHON AVE SUBDIV
TENANT NBR GEORGIA E FRAKER
CONTRACTOR OLYMPIC PENINSULA PLUMBING PHONE (360) 477 7408
OWNER GEORGIA E FRAKER PHONE (360) 452 1219
PARCEL 06 30 10 4 3 0660 0000
APPL NUMBER 11 00000657 PLUMBING PERMIT
PERMIT
TYP /SQ
PL99 01
PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
COMPLETED RESULT RESULTS /COMMENTS
7/22/11
di
PLUMBING FINAL TIME 01 00
July 21 2011 9 06 39 AM 1pangrle
GEORGIA 452 1219
PLUMBING FINAL WATER HEATER
AFTERNOON
COMMENTS AND NOTES
11/05/10 08:47 FAX 3606812086 Peninsula Heat a 01
,L BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES For City Use Only:
n Attn: Building Permit Technician Date Received 11-9- t
321 E. Fifth St, Port Angeles, WA 98362 Pernik t# 1 C) 005
(360) 417 -4815 fax (360) 417 -4711 Date Approved
Applicant eh a r/a J de roa Phone 3
Property Owner GPcy pa Phone c 4 g _4a-) 9
Property Owner's Address✓ G Sl I/,r 4 him rd 04,
Contractor e Phone 3 3
Contractor's Address
License Expires E-mail
PROJECT ADDRESS 640S' VeiS%an Awn 1.44;
Parcel Number Lot Zoning
Prxdftf Ivp j grief Description; Residential Mulfdamlly o Commercial o Industrial
Chad( aU that apply
o New Construction
a Addition
o Remodel
Repair
a Demolition
o Re -roof a House o garage o other o tear off re-roof lay over one layer
4leat System o Heat pump o wood buming stove o gas fireplace o pellet stove ether
o Other Mi rr ti J o b,L Al 'air «/14 V SLtm
Fl o r Existing f$a. #L) Proposed fsa..f) `l
Basement per sq. R S
1 Floor
2 ns Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION S 3, 9 S
Total footprint of structures sq. R 4 Lot size sq. ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel. including structures, paved driveways. sidewalks. patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage
Max. height of proposed structures ft Occupancy group of bedrooms
WII a lawn sprinkler system be installed? Occupant load 11 of full baths
0,41I a fire sprinkler system be installed? Construction type of half baths
l have read and completed this application and icnow it to be true and oatr6ot I am auth. apply for th It understand
that It is my responsibility to determine what permits we required, and to obtain permits pri r -n
Date PA Print Name CAGc /V1 %4/e
T:ForradBulding Division/Bldg Permit_doc
Clallam County Assessor Treasurer Property Details 64833 GEORGIA E FRAKER Page 1 of 6
Clallam County Assessor Treasurer
Property Search Results 64833 GEORGIA E FRAKER for Year 2010 2011
Property
Account
Property ID: 64833 Legal Description: TX #1838 EXC EASE
LT2 .14A SURVEY V13 P22
Geographic ID: 0630104306600000 Agent Code:
Type: Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11
Open Space: N DFL N
Historic Property: N Remodel Property: N
Multi- Family Redevelopment: N I
Township: Section:
Range: i
Location
Address: 608 E VASHON AVE Mapsco: 5/
PORT ANGELES, WA
Neighborhood: Cycle 5 Res Map ID: 2
P
1 Neighborhood CD: 10955130
Owner
Name: GEORGIA E FRAKER Owner ID: 25259
Mailing Address: PO BOX 1275 Ownership: 100.0000000000%
PORT ANGELES, WA 98362
Exemptions: SNR /DSBL
Taxes and Assessment Details
Property Tax Information as of 11/05/2010
Amount Due if Paid on: NOTE: If you plan to submit payment on a future date, make sure you enter the
click RECALCULATE to obtain the correct total amount due.
First Second
Half Half
i :Base ;Base
Years Statement ID i Taxing Jurisdiction Amt. Amt. Penalty Interest 1 Base Paid
1 2010 47116 ST SCI-1- STATE SCHOOL $139.89 $139.89 $000 $0.00 $279.78
2010 47116 CC -GEN COUNTY $74.46 $74.43 $0.00 $0.00 $148.89
j 2010 47116 PORT PORT $10.46 $10.47 $0.00 $0.00 $20.93
2010 47116 PORT ANG PORT ANGELES $149.96 $149.95 $0.00 $0.00 $299.91
2010 47116 SD #121 SCHOOL DISTRICT #121 $0.00 $0.00 $0.00 $0.00 $0.00
2010 47116 NTH OLY LIB NORTH OLYMPIC LIBRARY $21.63 $21.63 $0.00 $0.00 $43.26
2010 47116 HOSP #2 HOSPITAL #2 $30.54 $30.54 $0.00 $0.00 $61.08
1 2 010 47116 WSMET PK DIST WILLIAM SHORE MET PARK DIST $9.72 $9.71 $0.00 $0.00 $19.43
2 471.
16 CITY STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $72.00
1 2010 47116 WEED _CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0.00 $1.63
2010 47116 TOTAL: $473.48 $473.43 $0.00 $0.00 $946.91
12009 648332008 ST SCH STATE SCHOOL $246.07 $246.06 $0.00 $0.00 $492.13
2009 648332008 CC -GEN COUNTY $124.54 $124.52 $0.00 $0.00 $249.06
2009 648332008 PORT PORT $17.64 $17.64 $0.00 $0.00 $35.28
12009 648332008 PORT ANG PORT ANGELES $273.16 $273.13 $0.00 $0.00 $546.29
2009 648332008 SD #121 SCHOOL DISTRICT #121 $304.29 $304.33 $0.00 $0.00 $608.62
http: /vpn.clallam. net :8084 /propertyaccess /Property. aspx ?cid =0 &year= 2010 &prop_id =64... 11/5/2010
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Ductless heat pump
Owner
FRAKER GEORGIA E
PO BOX 1275
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
ZtW
B
WAV aS
WA 98362
ELECTRICAL HEATPUMP
176941
76 10
11/05/10
5/04/11
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
10 00001301
257919
608 VASHON AVE
06 30 10 4 3 0660 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
Contractor
OLYMPIC ELECTRIC CO INC
4230 TUMWATER
PORT ANGELES WA 98363
(360) 457 5303 Lt
Plan Check Fee 00
Valuation
Qty Unit Charge Per
1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
1 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT
Charged Paid Credited
Permit Fee Total 76 10 76 10 00
Plan Check Total 00 00 00
Grand Total 76 10 76 10 00
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
DATE RESULTS
21-71t1 ciq
2!7!I1
Date 11/05/10
00
00
00
0
Extension
73 50
2 60
Due
INSPECTOR.
-TAA=.
Date.
I.
4-
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
11/05/2010 06 27 FAX 360 452 3498
City of Port Angeles Permit Application
Building DIvlslonlEleetrlcal Inspections
321 Ent Fifth Strout —P.O. Box 1150
Port Angeles Washington, 98382
Ph: (360) 417-4735 Fax (380) 4174711
Date: .4
1/1 2 Single Family Dwelling
Multl•Famlly or Commercial'
Commercial Addition Alteration Remodel Repair'
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 14
Building Square Footage:
Description of above ar�fICSS 9 1,361g ef/ r'
Owner Information
Name: r
Mailin 4.7, 4/ Abta,5
City: S a t e 7 Zip: 7Ji 2
Phone: vilirr 44i Fax:
License f Exp.
kit Charq
119.90
$145,50
204.60
262.20
372,50
2.60
73.50
5 2.80
92.70
110.30
148.70
187,90
5 95.90
88.20
95.90
83.90
83.90
119.90
5 102.30
S 110.30
35.20
73,50
110.30
58.00
�lY
Check
ars: /1, //J
Olympic Electric Co PA CITY INSPECT Ij001 /001
Gs
EC E
NOV 5 200J
ELECTRICAL
INSPECTIONS
Contractor Informa
Name: c74 4' f' &le U
Mellin Ad
City State: 1 Zip: •tfe1
Phone: Fax: S/4 Y?".
License Exp, /3,�ypr o
Total (Qtv Multiplied by Unit Chero@j
5 Service /Feeder 200 Amp.
S SeMeelFeader 201-400 Amp.
5 Service/Feeder 401.800 Amp,
Service /Feeder 601.1000 Amp,
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
4,--- Branch Circuit W/O Service Feeder
2 411-e— Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp,
Temp, Service /Feeder 201400 Amp.
Temp. Service/Feeder 401-800 Amp-
Temp, Service /Feeder 601.1000 Amp.
S Portal lo Portal Hourly
5 Sign /Outline lighting
Signal Circuit/ Limited Energy Commercial. Additional 1600 56.00
Signal Circuit/ Limited Energy 1 2 Family Dwelling
5 Signal Clrcult/ Limited Energy Multi Family Dwelling
5 Manufactured Home Connection
5 Renewable Electrical Energy 5KVA System or Less
First 1300 Square FL
5 Each Additional 500 Square Ft, or Portion or
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
i Total
Owner ea defined by RCW.19.29.251 (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor /f
above said property Is ferrule, rent or leese, Permit expires Etter elx months of last Inspection.
After reading the above eteloment, I hereby certify that I em the owner of the above named property or E Ilceneed 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 296-408, The City of Port Angeles Municipal Code, end Udlly Specification..
Signature of owner, electrical convector or electrical adminletrator Cosh
Crodlt Card/
. Site Address:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
.
ELECTRICAL PERMIT
PERMIT NO. /c5 () f?
.
DATE I If' / !?l
Ow~er/Business:
51"1'1
Installed By -:fA '/ 13 Inb Ji. j, /t.t. ,I{I c....
~ AN{)~ $tJd
Owner/Business Address: f". tJ, l3 Cl 'I. (.; fD
I
~ 1, '"
~sident~lA1 f( V ~ Construction
Heat KW v D Remodel
D Baseboard D Furnace/Boiler D Service update/alter/repair
D Heatpump IlI""Other fAil ptA(,~O B"S'" sMl\b
D Commercialllndustrial load D Add/alter circuits
Total Connected load D Auxiliary power
(attach breakdown) (list below)
Totai Motor load D Special equipment
(attach breakdown) (I ist below)
~head
D Undergrou'1d
Voltage ,7 'L 0
1M"'10 D 30
Service size ~~t) Amps
D Temporary
Details/Description:
;f)l~' /h;~
, I'
.
W.S. No. Service Size
Capacity: D O.K. D Not O.K. Comments
D Ditch inspection O.K.
1;li{ Rough-in/cover OK .
)i O.K. to connect service
f1rJlf Final O.K.
Date
Hold for: D Easement D Letter
D Signed up for service/meter
D Meter Department notified for installation
D Fire Department notified of Inspection
D Plan Review approved/pending
Site Address:
Permit/Receipt No.
1c30 ~
New Meters
I
tll the Department of City Light by Street Address and Permit Number when ready for inspection. Work
mu not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspector in riting on the Wiring Report or the Building Permit. PHONE 457.0411, EXT.158 or EXT. 224.
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT <2'
q /? ~()" r:9V
Inspector 1} Amount paid
WHITE - file by address YELLOW - fjle by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
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OLYMP'IC PI'IINTEI'IS, INC.
~
-ijidMBER
CITY OF PORT ANGELES.
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT.
A
1272------
PERMIT NUMBER
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TOTAL FEE
II
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LEGAL OCCUPANCY
CONT. Lie. NO.
TIMETOCOMPLETE
NO. STORIES
. ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
(, () 'V iL i t/ A.5, lIl'! AI
CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT
l' "",- "'fj"'''' " '"
II <, V -' ",AlC, ;,-
Owner's Address (/1 (') 1; F.. /) A::; 1M i/J
Site Address
!?O/fr 4;v't. j E:.- ;;
PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Installation By :1AfJ B fll:~ ..' 5,1 6:::- ~~! :- .
Installers Address r /.J,"./)'} X v/,-, . ,,;1'1;.;1', t,M.?'//.
"""/L - :> 7' 1-
lft:,., _;. ~o(:;"
Owner
Day Phone .~~~. - J / Installers Phone.
Application i~ hereby made for Permit,to install Electrical Equipment as follows:
Wiring Method
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NUMBER AMP 120V 240V NUMBER AMP 120V 24QV
USE OF CIRCUIT CIRCUITS PEA 10 10'OA FEE USE OF CIRCUIT CIRCUITS PEA 10 100R FEE
CIA . 30 CIA 30
LIGHT SIGN
LIGHT -c-. 50 VOLTS
OR lESS
CONVENIENCE . MOTOA
CONVENIENCE - . -MOTOR
APPLIANCE MOTOR ..
DISHWASHER ---- V "'" FIAE ALAAMS
DISPOSAL ~ / ~ / J BURGLAR ALARM
RANGE / ~ L.. /J y MISC.
OVEN A .// ( ,
,
WATER HEATER I
LAUNDRY . I .
DAYEft REINSTALLATION LIGHT FIXTURE #
FURNACE . SUB TOTAl.f.EE
GAS - Oil
FURNACE ENERGY FEE
ELECTRIC . .-
BASIC FEE
ELECTRIC HEAT
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE AW.G.
I SUB.tOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I'certify that the work to be performed under this permit will be done by t~;faller and in&pnformance ~h the N.E.C. ~ctrical Code.
Date Application made (]?~ ,19~ By" ...."., lJ. ~,A
- . . -<. -. ~/ /".. CrJACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is hereby given to do the above described~OJ~, ac<;:o~ding to the conditions hef60n and according to the approved plans and'
specifications pertaining thereto, subject to compliance \vito the Ordinances of he Cit of Port Angeles. '
<-.-
01 C OF CITY LIGHT
.
Date Permit Issued
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Notify Department of City Light by Street Address and Permit Number when re y for inspection. Work.must not
be covered or current turned on before inspection and O.K. forcovering or service has been given by Inspector in
Writing on Permit Placard. A. - Permits Phone: 457-0411 Ext. 158.
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD . Inspector's Report
1'"\1 VUPIf"o PRII\ITI=R"l. Il\1r
REPORT OF INSPECTOR
',.
DATE OF VISIT MADE BY REMARKS
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O.K. FOR COVERING !
O.K. TO CONNECT SERVICE
BIIt/x1 T~ FINAL O.K. '.
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