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BUILDING DIVISION
CITY OF PORT ANGELES
* *
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this jurisdiction:
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covered until reinspection is made. When corrections
have been made, please call t/ J'? - L/8-1 (
for inspec ion.
V[L
Inspector for Building Division
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 911362
Application Number
Application pin number.
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000010 Date
931120
1901 HAMILTON WAY
06-30-00-9-3-2210-0000-
DAN MILLLER
RES NEW SFR
5/04/06
RS7 RESDNTL SINGLE FAMILY
145057
Owner
Contractor
MILLER DANIEL B & SANDRA K
POBOX 2034
PORT ANGELES WA 98362
(360) 452-9301
Other struct info
TERHUNE CUSTOM
POBOX 97
POULSBO
(360) 697-7000
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
HOMES
WA 98370
27.20
1. 00
9278.00
2526.00
1. 00
-
-D
o
permi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
OLY WIRING/ 2256 SQ FT SFR+REM
75978
OLYMPIC WIRING INC
131.20
5/02/06
10/30/06
----
Plan Check Fee
Valuation
.00
o
"1=
~
Qty Unit Charge
1.00 73.0000
2.00 23.4000
1.00 11.4000
Per
ECH EL-R-SQFT FIRST 1300
5C EL-R-SQFT ADDITIONAL 500
ECH EL-METERS REMOTE INSTALL
Extension
73.00
46.80
11.40
r
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
A residential fire sprinkler system, installed per NFPA
13D, will be required.
2nd option is to install an outside alarm bell that is
inter-connected' to the residence's smoke detectors.
The alarm bell wiil be painted red in color and identified
as "Fire alarm"
01/17/2006 05:17 PM SROBERDS -- Proposal is a new s.f.
res in the RS~7 zone for total lot coverage of 27%. No
land use issues" noted.
Electrical load calculations and elctrical permits are
required.
Connection fee $713. Power source - padmount transformer
s/w property corner.
01/06/2006 09:03 AM GMCLAIN ----------------------------
Sidewalk along' "M" Street to be installed to City standards
required for school walking route.
Sanitary sewer connection is located in easement to north
of lot, inspection is required by Public Works prior to
back fill of ditch. 24 hour advance notice is required.
r
8
t
~
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COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCJtPTKD COMMENTS
YES I NO
I}IT(:H
Will II <i-H-IN I coVER
"""'WVII :....
"TN AT I . 1
GENERAL COMMENTS:
PW-II02.J5(4'961
'~
w
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:'21 EAST 5TH STREET. PORT ANGELES. WA 983()2
~,
'.
Application Number . , . . . 06-00000010
Application pin number 931120
Page
Date
2
5/04/06
Special Notes and Comments
01/13/2006 04:14 PM RVESS ------------------------------
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
RES UNDERGRND SERVICE FEE
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
713.00
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 131.20 131.20 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2787.50 2787.50 .00 .00
Grand Total 2918.70 2918.70 .00 .00
COMMENTS/ACTION NEEDED
r--
ELECfRICAL PERMIT INSPECflON RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr IS UNLA WFUL TO COVER,
,.. INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
DATE
COMMENTS
NO
5~
5-
GENERAL COMMENTS:
PW-U02.IS (41961
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98362
"
I
Application Number
Application pin number _ .
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000010 Date
931120
1901 HAMILTON WAY
06-30-00-9-3-2210-0000-
DAN MILLLER
RES NEW SFR
3/23/06
RS7 RESDNTL SINGLE FAMILY
145057
Owner
Contractor
MILLER DANIEL B & SANDRA K
POBOX 2034
PORT ANGELES WA 98362
(360) 452-9301
Other struct info
TERHUNE CUSTOM
POBOX 97
POULSBO
(360) 697-7000
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
HOMES
WA 98370
27.20
1. 00
9278.00
2526.00
1. 00
-
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
AIR FLO/ T-STAT
73122
AIRFLOW HEATING
36.40
3/23/06
9/19/06
Plan Check Fee
Valuation
.00
o
J)
~
I
Qty
1. 00
Unit Charge Per
36.4000 ECH EL-LVT-FIRST THERMOSTAT
Extension
36.40
r-
J;>
3 I
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
A residential fire sprinkler system, installed per NFPA
13D, will be required.
2nd option is to install an outside alarm bell that is
inter-connected to the residence's smoke detectors.
The alarm bell will be painted red in color and identified
as !'Fire alarm" .
01/17/2006 05:17 PM SROBERDS -- Proposal is a new s.f.
res in the RS-7 zone for total lot coverage of 27%. No
land use issues noted.
Electrical load calculations and elctrical permits are
required.
Connection fee $713. Power source - padmount transformer
s/w property corner.
01/06/2006 09:03 AM GMCLAIN ----------------------------
Sidewalk along "M" Street to be installed to City standards
required for school walking route.
Sanitary sewer.connection is located in easement to north
of lot, inspection is required by Public Works prior to
back fill of ditch. 24 hour advance notice is required.
01/13/2006 04:14 PM RVESS ------------------------------
Construct driveway and Sidewalks to City Standards.
-
r
r)
o
J
l
y.
U
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
~ -\
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr IS UNLA WFUL TO c,bviR. .,
INSULATE OR CONCEAL ANY WORK BEFORE rr IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
UUCtl
lUll r~J..:I_IN / CUV~K
~hK V lCh
t<INAI I 1
GENERAL COMMENTS:
PW.lI02.1~ (4'961
'~
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:m EAST 5TH STREET. PORT ANGELES. WA 98362
,
"
Application Number . . . . . 06-00000010
Application pin number 931120
Page
Date
2
3/23/06
Special Notes and Comments
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 36.40 36.40 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 2110.90 2110.90 .00 .00
COMMENTS/ ACTION NEEDED
J
ELECTRICAL PERMIT INSPECTION RECORD
~,., ."-
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr IS UNLA WFUL TO C(JJIER,
" INSULATE OR CONCEAL ANY WORK BEFORE ITIS INSPECTED AND ACCEPTED. )''''
t
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPEC110N TYPE
DATE
COMMENTS
NO
5-B -0 <0
GENERAL COMMENTS:
PW-lI02.U (4'96)
d'V'lI~.
J(i~~
D8
"\oii..~
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:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000010 Date
931120
1901 HAMILTON WAY
06-30-00-9-3-2210-0000-
DAN MILLLER
RES NEW SFR
3/08/06
RS7 RESDNTL SINGLE FAMILY
145057
Owner
Contractor
MILLER DANIEL B & SANDRA K
POBOX 2034
PORT ANGELES WA 98362
(360) 452-9301
Other struct info
TERHUNE CUSTOM
POBOX 97
POULSBO
(360) 697-7000
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
HOMES
WA 98370
27.20
1. 00
9278.00
2526.00
1. 00
Plan Check Fee
Valuation
.00
o
"--.
~~
\)
~l "-
~ t
~
~ f
r~,
",-.
~
~
'-
t
~
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL TEMPORARY
OLY WIRING/ TEMP SVC
72215
OLYMPIC WIRING INC
42.20
3/08/06
9/04/06
SERVICE
Qty
1. 00
Unit Charge Per
42.2000 ECH EL-TEMP SRV - 0-60 SRV FDR
Extension
42.20
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
A residential fire sprinkler system, installed per NFPA
13D, will be required.
2nd option is to install an outside alarm bell that is
inter-connected to the residence's smoke detectors.
The alarm bell will be painted red in color and identified
as "Fire alarm"-
01/17/2006 05:17' PM SROBERDS -- Proposal is a new s.f.
res in the RS-7 zone for total lot coverage of 27%. No
land use issues noted.
Electrical lO?d calculations and elctrical permits are
required. -
Connection fee $713. Power source - padmount transformer
s/w property corner.
01/06/2006 09:03 AM GMCLAIN ----------------------------
Sidewalk along "M" Street to be installed to City standards
required for school walking route.
Sanitary sewe~ connection is located in easement to north
of lot, inspection is required by Public Works prior to
back fill of ditch. 24 hour advance notice is required.
01/13/2006 04:14 PM RVESS ------------------------------
Construct driveway and Sidewalks to City Standards.
COMMENTS/ ACTION NEEDED
r ---
ELECfRICAL PERMIT INSPECfION RECORD
e
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE I ACCEPTED COMMENTS
I YES NO
Ull Ct1.
lUll T~H_IN I COVER
SERVICE
.
i.e"I!\.' ^ I I I
GENERAL COMMENTS:
PW-II02.J' (4196]
\
s~
Vi!
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
.121 EAST 5TH STREET. PORT ANGELES. WA 911362
.
Application Number . . . . . 06-00000010
Application pin number 931120
Page
Date
2
3/08/06
Special Notes and Comments
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 42.20 42.20 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 2116.70 2116.70 .00 .00
COMMENTS/ACTION NEEDED
1-
/4
ELECfRICAL PERMIT INSPECTION RECORD
.
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER.
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT lOB SITE
INSPECl10N TYPE DATE ACCKPTKD COMMENTS
I YES I NO
UIlCH
ROUnH-lN I CUVbK
SERVICE
1<TN AT I :3~/~~L}0 I~JJ
GENERAL COMMENTS:
PW.II02.1S 14'96]
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~~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
Owner
1/23/06
06-00000010 Date
931120
1901 HAMILTON WAY
06-30-00-9-3-2210-0000-
DAN MILLLER
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
145057
Contractor
MILLER DANIEL B & SANDRA K
POBOX 2034
PORT ANGELES WA 98362
(360) 452-9301
Other struct info
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
TERHUNE CUSTOM
POBOX 97
POULSBO
(360) 697-7000
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
HOMES
WA 98370
27.20
1. 00
9278.00
2526.00
1. 00
DRIVEWAY INSTALLATION
68825
170.00
1/23/06
7/22/06
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BASE FEE
Extension
170.00
PUBLIC WORKS RES WATER SERV
68809
715.00
1/23/06
7/22/06
Plan Check Fee
Valuation
.00
145057
Qty Unit Charge Per
1.00 715.0000 EA PW W/M 1" SERV 5/8" METER
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
Extension
715.00
SANITARY SEWER HOOK UP
68817
110.00
1/23/06
7/22/06
Plan Check Fee
Valuation
.00
145057
Qty Unit Charge Per
1.00 110.0000 EA SAN SEWER HOOKUP
Extension
110.00
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
A residential fire sprinkler system, installed per NFPA
13D, will be required.
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.
~
/ )~ot
.
Date
4c
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
'-
--
T:\Policies\1102.15R [1/051
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.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
I I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [1/05]
cf .0Rr ~
~~~~<;.
~r....a~
L~
~
'\tt"'~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number . . . . . 06-00000010
Application pin number 931120
Page
Date
2
1/23/06
Special Notes and Comments
2nd option is to install an outside alarm bell that is
inter-connected to the residence's smoke detectors.
The alarm bell will be painted red in color and identified
as "Fire alarm"
01/17/2006 05:17 PM SROBERDS -- Proposal is a new s.f.
res in the RS-7 zone for total lot coverage of 27%. No
land use issues noted.
Electrical load calculations and elctrical permits are
required.
Connection fee $713. Power source - padmount transformer
s/w property corner.
01/06/2006 09:03 AM GMCLAIN ----------------------------
Sidewalk along "M" Street to be installed to City standards
required for school walking route.
Sanitary sewer connection is located in easement to north
of lot, inspection is required by Public Works prior to
back fill of ditch. 24 hour advance notice is required.
01/13/2006 04:14 PM RVESS ------------------------------
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 995.00 995.00 .00 lOO
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 3069.50 3069.50 .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 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
~ /8 /"~
,
Signature of Owner (if owner is builder)
/ ) ~3/o{
Date
T:\Policies\1102.15R [1/05]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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
YES NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W. I PW / CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [1/05J
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00006010 Date
931120
1901 HAMILTON WAY
06-30-00-9-3-2210-0000-
DAN MILLLER
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
145057
Owner
Contractor
MILLER DANIEL B & SANDRA K
POBOX 2034
PORT ANGELES WA 98362
(360) 452-9301
Other struct info
TERHUNE CUSTOM
POBOX 97
POULSBO
(360) 697-7000
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
HOMES
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
69211
1277.85
1/23/06
7/22/06
Plan Check Fee
Valuation
Qty Unit Charge Per
BASE FEE
46.00 5.6000 THOU BL-100,001-500K (5.60 PER K)
1/23/06
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WA 98370
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27.20
1. 00
9278.00
2526.00
1.00
~t
-
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Z
511.14
145057
Extension
1020.25
257.60
Permit MECHANICAL PERMIT
Additional desc
Permit pin number 69229
Permit Fee 100.95 Plan Check Fee .00
Issue Date 1/23/06 Valuation 0
Expiration Date 7/22/06
Qty Unit Charge Per Extension Fe.
BASE FEE 50.00
1. 00 14.7000 ECH ME- INSTALL 100- FAU 14.70
5.00 7.2500 ECH ME-VENT FAN 36.25
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
69237
156.00
1/23/06
7/22/06
Plan Check Fee
Valuation
Qty Unit Charge Per
BASE FEE
11.00 7.0000 ECH PL- EA. FIXTURE ON ONE TRAP
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE
1. 00 15.0000 ECH PL- EA. BLDG SEWER
1. 00 7.0000 ECH PL- EA.WATER HEATER
<:
~
.00
o
Extension
50.00
77.00
7.00
15.00
7.00
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 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.
~
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Signature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner is builder)
T:\Policies\11 02_15 building permit inspection record05. wpd [11412005]
BUILDING PERMIT INSPECTION RECORD
....
CALL 417-4815 FOR BUILDING lNSPECTIONS. 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
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I I I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR I CEILING I
MECHANICAL ~.--
HEAT PUMP I~~hs
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTlNG 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 R. W. 1 PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policiesll 102_15 building permit inspection record05.wpd [1/4/2005]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 06-00000010
Application pin number 931120
Page
Date
2
1/23/06
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
A residential fire sprinkler system, installed per NFPA
13D, will be required.
2nd option is to install an outside alarm bell that is
inter-connected to the residence's smoke detectors.
The alarm bell will be painted red in color and identified
as "Fire alarm"
01/17/2006 05:17 PM SROBERDS -- Proposal is a new s.f.
res in the RS-7 zone for total lot coverage of 27%. No
land use issues noted.
Electrical load calculations and elctrical permits are
required.
Connection fee $713. Power source - padmount transformer
s/w property corner.
01/06/2006 09:03 AM GMCLAIN ----------------------------
Sidewalk along "M" Street to be installed to City standards
required for school walking route.
Sanitary sewer connection is located in easement to north
of lot, inspection is required by Public Works prior to
back fill of ditch. 24 hour advance notice is required.
01/13/2006 04:14 PM RVESS ------------------------------
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 1534.80 1534.80 .00 .00
Plan Check Total 511.14 511.14 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 4120.44 4120.44 .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 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.
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Date
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T:\Policies\11 02_15 building permit inspection record05. wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
-.
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 UNLA WFUL 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 ACCEPTEb COMMENTS
YES NO
FOUNDATION: ~ - Sjt(!f7f-.y;v
FOOTINGS "?Ijl !~ -JW
WALLS ~ '?f';.lo~ Tw
FOUNDATION (DRAINAGE 1 DOWN SPOUTS\ ~ /"1/ ()y ~/AJ
PIERS '" Pf~- 'r/?"(Ob .JZl/
POST HOLES (POLE BLDGS.)
.~ f"'" - o/~/o v V4
PLUMBING
UNDER FLOOR 1 SLAB I
ROUGH-IN .s /t'/I ~(... vW
WATER LINE (METER TO BLDG) ! /~.. ' (){.,. :rw
GAS LINE / FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL , I
WALLS >;"j /if ! t)G :rvu
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING ~ / CV/D'- ~
DRYWALL (INTERIOR BRACED PANEL ONLY) ~/1A_ /t;-/ n--
I '<
T-BAR
INSULATION
SLAB _I .
WALL 1 FLOOR 1 CEILING :1/lb/Ob I~ I
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS , ,
GAS LINE Sf' (&(, IJk/
WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKlNG/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL.lNSPECTIONS 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. 1 PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 " , .... PLANNING DEPT.
BUILDING 417-4815 ~"'7 (~ -u- BUILDING
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T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
~.. .
BUILDING PERMIT - APPLICATION
. The Building Permit - Preapplication must hefdled out completely.
Please type or print in ink. If you have auy questions, please caU 417-4815
Applicantand/orAgent:~ It SA~ fvtlU~
Owner: DAN d ~j:),et\- (Y\ LLl FAe
Address:j)() Bt>)( :2L&g City:(be'l A1'{Gu&~
ArchitectlEngineer:T ~ I~ V "16:"_ ~(OIV\. ~~l6.-~
Contractor S~ License #:TFR HJJr.j.Jc{s4JttJEx.p:
Address:_~{) &ry- 17 City:-9>(}I-J)~ V VIA Zip: 9f616
PROJECt' ADDRESS: 1""1 Ik1 In} I 'k, N W4:Y \il1Z(~elISZONINO
LEGAL DESCRIPTION: Lot: .2l Block: .:z Subdivision: wa l 11/ ew
CLALLAM COUNTY PARCEL NUMBER: 0'.0 '3 .. ~ - Cl:<,z - 2- i a
Phone: ~ -452-Gt30/
Phone:
\V A . Zip: ~3h?-"
Phone: 1-6co- 77Z- 3Z75
07j.
Vh Phone:-"17 -7 tf2fJ
TYPE OF WOR.T(: _
~ Residential 0 New Constr. 0 Reroof
o MUlti-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
UATION: ~
' F.@S7C?O'f !SF.==S /~g.:f"~
SF. @SRI. 33 !SF." S (~'1 '1-'1-
..t.14.S SF. @ S (~.n> /SF. == $ ~,S7~
TOTAL VALUATION $ Ill-51 OS 7
___) r' /<
A./~W
COMMERClAlJRESIDENTlAL: O~ancy Group: Occ1!Pant Load: Construction Type: I<.
No. of Stories: / Lot Size: ~.z "7: ~fI- % Lot-Coverage: :<. 7.:( % _.
Existing Lot Coverage: Isq. ft. + Proposed Lot Coverage: Isq. ft. == TOTAL WT COVERAGE:~ 5Z5:'J)Jsq.ft
PLANNING USE ONLY;
Permits Required:
Max. Height: Setbacks:
Site Plan and Use Approved by:
ESAlWetland(s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No
APPROVALS:
PLAN
BLDG
DPW
FIRE
OTHER
Notes:
Zoning:
Date:
Other:
BUILDING APPLICATION SUBMllTAL: Your application and site plan must be flIIed out completely to he acceptedfor review.
The Building Division can provide you with more detailed information on the application and pian submittal requirements.
BUILDING PERMIT APPLICATION SUBMllTAL: Your completed application. site plan (for additions) and building construction
plans are to be submitted to the Building Division.
V ALUA nON 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 Div. to comply with current fee schedules. Contact the 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 are submitted. All
other permit fees are due at the time of permit issuance. .
EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date ofapplication, this application will expire by
limitations. The Building Official can extend the time for action by the applicant up to 180 days, on written request by the applicant (see
Section 107.4 of the Uniform Building Code, current edition). No applicatio~ .can be extended more than once.
....
I hereby certify that I have read and examined this application and hzow the same to be true and con-eet, and I am authorized to apply
for this permit. J understand it is not the City's legal responsibility to determin'::' ermits are required; it remains the applicant's
responsibility to determine what permits are required and to obtain such.
PW-II02_13[n:v.2l99]
j
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-. .. .
City of Port Angeles
Applicant Project Review Sheet
Applicant:
Owner:
DA;t-..l 6:3.A1'~J)RA- fY\iUEitProperty address: d M IJ ~t(fJd 1 HItr11/? Imj~f. I
'tY\N A ~ A ~ILLEe.. Proposed use: ~ F f!- Zoning: '
Is Uie proposed use listed as a "pcnnittcd use" or an "accessory use" in this zone?
Is this the only use (business, residence, etc.) on this site?
Has there ever been a subdivision. shortplat, or PRD approved for this site, or has one
been submitted and is pending approval?
Does the proposed use require a new buisncss license?
Does the project extend into any required setbacks or cross any lot lines (interior or
exterior)?
Does the project exceed the pennittcd height allowance or cause the property to exceed
the allowed lot coverage in this zone?
Does the project require any additional parlcing or special designllandscape improvements
in this zone?
Does the project eliminate any existing parking spaces?
Is the project located within 200' of the shoreline?
Are there any environmentally sensitive areas on or within 200' of the property,
including:
. wetlands or areas of standing water (year round or seasonal);
. streams (year round or seasoilal); ,
. areas with a slope of 40% or greater; or
. areas that have evidence of past ground movement or erosion?
Have all the required submittals been provided by thc applicant?
)( Site Plan . , jr:(Construction Drawings
o ParkinglDrainage Plan 0 ,Civil Drawings
o Energy Calc 0 Supporting Engr. Calc
o LandscapelLighting Plan 0 Other
~es: ok 0, no: rcq~es PO
revIew
~:ok o no: requires PO
review
o yes: requires PO ~o:ok
revicw
o yes: rcq~ CC ~no: ok
revICW
o yes: requires PO ~. no: ok
review
o yes: requires PO Vno: ok
revicw
o yes: re~ PO ~no: ok
revIew
o yes: req~s PO Pfno: ok
revICW
,Dyes: requires PO flFno: ok
revicw
o yes: req~ircs PO J;a:no:ok
revICW
')iyes: ok
o no: mark
required
itcm(s)
If Planning Department review is required, the processing time may be extended. If it i$ determined a separate Planning
Department pennit(s) is needed, the Planning Department permit(s) must be approved prior to the issuance of any other permit.
The information provided above istTue>trithebest Of my mowledge, I undenlaTid that in thBe\lent thatany of this information ;3 determined
by the City to be incorrect, thi~project::will:j,e:-stopped until mch:time the Cit)"detenninesthe correctinfonnation is provided and any
subsequently uir "ew andapprovaliare'completed and granted. "
( Z-Z-7-Q..S
Date
P~t Category #
(see reverse side)
Building Permit #
Routc to:
o BO 0 CC 0 FD 0 LD 0 PD 0 PW 0 File 0 Other
Master Tracking #
Staff Initials
Date
Completion oj this fonn is required far all category 1 b, 2 &: J permits. Completion is not
required for category 1 a permits unle.ss they result in a potential change of use or ocevpancy.
APRS.J
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f)t ~I.... (..nl"11'\Sc .Lt.c...
Purchaser'lman'bg address "-oJ
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City State ZIP
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Telephone number FAX number
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RPR-28-2006 04:20P FROM:OLYMPIC WIRING
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Job wired by
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AddrC5Il or inspection
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Phone number to JChC~le lnspecllon:
(360)692-3680
TO: 13604174711
P .1/1
ELECTRICAL WORK PERMIT APPLICATION
.
DOwner
Instollation descriplion
Q Commercial .,k. Residential
J(Nc:w
D AIt.r.d! Addition
7_2.5(..
w.t"
~,R. S,#,,(,
r,.N\ok.. m~
.
,
tf&60
.
6~'^
:z31.;1
tp 5J~
Owner (f.t d~fined by RCIV.J9.28.26J:(J) Ollltler will occupy tlte slrllcllIre for two
years after 'his electrical permit is finalized. (2) Owner is required 10 hire all electrical
contractor if above said property is jor sale. rent ()r' lease.
After rending the above st01tement, I hereby certiry that I om the owner of the above
named property or 1I licensed electrical contractor. I nm making lhe electrical inst3\.
lation or nlteralion in compliance wilh the electrical laws, N.E.C., RCW. Chnpter
19.28, WAC. Chapler 296.468, The City of Port Angeles MuniciplIl Code, Dnd
Utility Specifications.
Slgnolu of ower, electrical contractor or electrical admlnlS'trator
x
~
ElectrIcal Load Additions and or subtractions
D NO LOAD CHANGES
Q Baseboard ~w
)I. Furnace J.t KW
~ Hea. Pump -!o. Ton _ LAR
D Fan-Well KW
1:1 Cash 1:1 Check #
~editCard Visa M.stercard Discover
C.rd# ____(:)~.s:;\-~__-____
Dote: 01/-
Expimtion Date
of card
-6(.
Service Information
(J Overhead Service
1:1 Temp Service
}l Underground Service
VolIBge I Ul -1.'<0
Phase S,1 D 3
Service Size: ~
Feeder Size: JfO-
"
. /
)
,.
.5J
THERMOSTAT
kO
Apl',(wrol Tly
SERVICE
S-/'1- -I.. J.z-0
Dale Al'proved fly
\
'.
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
Building or Equipment Im..pected
OUGH-IN
t/ . , A..D
APf'rov~d U)'
FlNAL
8-~"Ob - L..n
[}~'e ~.
o
5,
DITCH
~:iP
FEEDER
IJllle Approved Il}'
Action Token
Electrical
IPrspcclor
./0/, '-'-:..
.....,.,.
.
Ft-r;6 71.300
Arpo-
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I ,.
~'l-ZR-5-2005
04:59P FROM:OLYMPIC WIRING
(350)592-3580
TO: 13504174711
P.1").
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ELECTRICAL WORK PERMIT APPLICATIO*
.'
Job wired by
)(EleClrlcal Conlraclor IJ Owner
Installation description.i
IJ Commercial A Reoldenllll
Electrical coni roc tor name License number
()U.U~('h' L It.')\~,^!... '1t''''
:ll;Qrip;~~~T ~r
City <" State ZIP
,,;ll\lll.rdM.~ L\.Jl).. q~~ ~
Telephone number F~X number
Date Ex.pires
IJ New
IJ Altered/Addition
~
SerloJ\c...-"~
Premise! owner', namc\.-\e
_Te.rh..lN_ ('iIe..,S
Addrels of Inspection H
-'C\O\ W. A 1"\ \ \~~
City ~()i \- At-. c..\....\
Phone number tn 'Che~le Inspection:
~A1
Owner as defined. by RCW19.28.261:(I) OWller wilJ occupy lhe slrrlclure for tWI)
years after this electrical permit is finalized. (1) OWller ;s required 10 IIirc an electrical
contractor if abo..,~ 50id property is for sale, rent or lease.
After reeding the above statement, 1 hereby certify Ihot 10m 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. Chapler 296.46B, The City of Port Angeles Municipal Code, Bnd
Utility Specifications.
Signature
IJ Cash CI Check #
~ Credit Card Visa
Card #
" or*'lr=-H"C.
~ Discover
x
Date: 03-0Ir1>(,.
Expiration Date
of cord
t
o NO LOAD CHANGES
[J Sa.abolrd _ KW
Q Furnace _ KW
CJ Heat Pump _ Ton _ LAR
IJ Fan-WIll _ KW
Service Inlormetlon
a Overhead Service
~Temp Service
~ Underground SANies
Vollage
Ph... IJ 1 IJ 3
Service Size: _
Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH-IN THERMOSTAT
Dille
Approved By
Dille
Approved By
SERVICE
DICe Appn:IV~By
FEEDER
OIlIC Approv~By
Action Taken Electrical
Inspector
D
3
DITOI
"
pprov By
Olle
Approved By
Inspection
Dote
Area, Building or Equipment Inspected
..3.7 ob
C!llJI>.\l'e~-r (,i) '{(!/.J t- (}':;1)
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03/1i/06 FRI 14:09 ~~ 360 683 39il
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ELECTRICAL PERMIT APPLICATION
The Eledr1ca1 Permit App6catfon mus:1 be 'mod out comalef.tv.
b'V~
PlEase type or ",print in Ink. .f you have aft)' qu.stiDf1~. please call (360) "17-
413S
Faa humber: (360) 417-4711
REQUEST INSPECTION 0
Ownero,Elec Conb'acto<Agent A-llf- F-I-O #/Ah VI{", Pt>on.'{&??~O L Fax' h€:3- ?A::rL
p<opertyOwnet,:!)1J11 Ii ~..Vl(:i..Y~ ltl.WIX (1"'aVLvYV fU4JnM Iht\.ta/~)hone: htf-=r- ~
Add,ess,----ll101 ItQ.WlllfflY1 kJLU{ C;tv,_H)r+- ,4vJ~,&-"", ZJp:q.R:?::.{"",,~
EleclrlcalContTllcW: Aile.. 'FI.() t4--f.-Cl-f1Vlf"7 uc<>n.e~I"'F oc:f/~ ""one'
1...'Z{ w ., &,d () l? _ ClIy ~ tJ I w'\
Add~5;
ZIp: CfP3R?-
INSTAlLATlONWIREO BY:
a OWNER
Credit Card Holder Name. A ~\!..
yli)
o E~ECTRICAL CONTRACTOR
U- p a.--h Yl en
Billing Aclclress'
City:
Zip:
Credfl Card Number'
01\1 8 U'_
Exp. Date:
VISA.
MC:..
PROJECTADURESs~4-z;tAIJ!l\ L-+oYl ~fJ r+ L\-v1'5I(Aff ~
TYPE OF WORK: Check all thaI apply: YJ New 0 AlleralioniAddilion
WA
~ Residential 0 Multi-family
Remole Meter 0 Detached garage
Number of Circuits added or altered:
o Commercial 0 Mobile Home Sq, FI
o Hul Tub 0 Swim Pool 0 Septic Pump jLow Voltage 0 Telecom,
os.
OESCRI,PTION OF THE ELECTRICAL PRO.lECT~_]}tt,v}11X)SW_Wi ')?--L~
PERMIT FEE:J2lL:.!.LO_
Electrical Heat Load Additions
Servic@ InfDnn;ation
o Bsaeboard
iFumace
Heal Pump
Fan-Wall
_KW
/.r.... KW
8-~TON~LRA
~KW
a Ovemead Service
o Temp Service
o Underground Servi""
Voltage:
Phase: 0 1
Service Si~e:
Feeder Size:
03
I hereby certify that I have read and examined this application and know thaI same to be true and correc~ and I a
alJ/horized 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 Holde,'.. Signatu e:
Dale: ~-I '1-f) (t)
Owner or Elec. Cont, Signature:
C:/ELECTRICALPERMITAPPLlCATION .
Date:
;!tV 3/Wft0
(hr\U,JEC-TfDl) (56
)c)
~ 713-'=--
f'
{, r--
---:::::::::=
.-
~
ELECTRICAL INSPECTIOf\.!'
WIRING REPORT
417-4735
P2)6
APPROVED
o .................... DITCH. .................. 0
D. . . . . . . . . . . . . . . . ROUGH IN/ VER............... 0
D. . . . . . . . . . . . . . . . .. . . SERV E................... 0
D. . . . . . . . . . . . . . . . . . . . . FI AL...................)C
CORRECTIONS NEEDED:
----
-_.~
''IIc. (360} 452-1381
~
- DO NOT REMOVE -
,>
ELECTRICAL I NSPECTlON-"
WIRING REPORT
417-4735
PERMIT #
Qc,,-/o
IN~
I c.. ~ / ,e., /N G.
ADDRESS
~/
/
i-7DN
~L- 77~ 7b ..:5n:7/:;>kf
fp/:).--, . >9~ t:' /P~;<;~ t?/
(LJI/#A!: <I '">-7/A/....rp...
~/~ <:'7-rT77D.>-JJ
APPROVED NOT APPROVED
o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0
0................ ROUGH IN/COVER.............. .~'
O. . . . . . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . . 0
O. . . . . . . . . . . . . . .. . . .. . FINAL. .. . . .. . . . . . . . . . . . . . 0
0.
CORRECTIONS NEEDED: t5t.-(.73/ fiL r/"ed, ~
~~.e.. S
r s~51'
,?~
.
"
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360) 452-1381