HomeMy WebLinkAbout2317 Jeri Lynn St - BuildingNAME OF PREMISES L 8 R/) 7/ A jr L/4 A I i v C r'_'
SERVICE ADDRESS 3 E A' R I t ti /1/ /f1 f
LOCATION OF DEVICE. r; A/ Z r 7- L�A S T /r I,/A L X /14 Z 7 C /F
ASSEMBLY (A/ it E /VX 3/c4 i
Manufacturer Model Size Serial No.
IS THIS AN APPROVED ASSEMBLY? YES 040 IS ASSEMBLY INSTALLED CORRECTLY' YES 0'r (1O 0
DATE OF INSTALLATION A t v G UNKNOWN❑
REDUCED PRESSURE PRINCIPLE ASSEMBLY RP RPDA
DC EY DC DA
PVB Air Gap
DOUBLE CHECK VALVE ASSEMBLY SVB AVB
CHECK VALVE #I I CHECK VALVE #2 I RELIEF VALVE I PVB /SVB
Initial Leaked Leaked Did Not Open AIR INLET
6'1. Closed Tight Did Not Open
Test Held at cri psi Opened at psi
Held at psi Opened at psi
Repairs
Details
AIR GAP INSPECTION
REQUIRED MINIMUM SEPARATION YES NO
COMMENTS
/A!)
Initial
Test
Repairs
Final
Test
Cleaned
Replaced
Date Time Tester
G
WHITE CUSTOMER COPY
Backflow Assembly Test Report
City of Port Angeles
Public Works and Utilities Department
Water/Wastewater Collection Division
Cleaned Cleaned
Replaced Replaced
Final Closed Tight
Test Held at psi Held at psi Opened at psi
Signature
3 psi ButTer YES NO
Cert
f
YELLOW PURVEYOR COPY
CHECK VALVE
Leaked Held at psi
REPAIRS
Cleaned
Replaced
Official Use Only
Assem.#
Received
AIR INLET Opened at psi
CHECK VALVE Held at psi
BACK PRESSURE NO YES
TYPE OF HAZARD 1 (2 1 'e
Line Pressure f7 fi psi
Held Backpressure YES Id NO
#2 Shutoff Held YES NO
Relief Valve Exercised YES NO
Test Kit Passed Failed
9 //2/4 i 7 6'"
4 of l
PINK TESTER COPY
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
CHRISTIN LAWRENCE CHRISTINE
M CHANG
1131 COLUMBIA
PORT ANGELES WA 98362
(360) 452 9719
Other struct info
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
1 00
1 00
Signature of Contractor or Authorized Agent
T \Policies \1102 15 building permit spection rccord05 wpd [1/4/20051
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
7 0000 ECH
7 0000 ECH
07 00000587
663540
2317 JERRI LYNN ST
06 30 01 7 6 0310 0000
CHRISTIN LAWRENCE
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
140917
Contractor
HI LINE HOMES
11306 62ND AVE E
PUYALLUP
(253) 840 1849
TOTAL LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
PLUMBING PERMIT
DOUBLE CHECK BACKFLOW
105304
64 00 Plan Check Fee
6/29/07 Valuation
12/26/07
BASE FEE
PL- EA INSTALL WATER PIPE
PL -OTHER BACKFLOW 2
Date
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
All homes in new subdivisions that are outside of the Fire
Department four minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA)
06/12/2007 11 25 AM SROBERDS The proposal will result
in new sfr w /attached garage for total lot coverage of
24% in the RS 9 zone FIRE SPRINKLERS are required No
other land use issues are anticipated
Electrical load calculations and elctrical permits are
required
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
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
6/29/07
24 40
1 00
9000 00
2200 00
2200 00
1 00
Extension
50 00
7 00
7 00
00
0
Date Signature of Owner (if owner is der)
1
\-Go
n S e,cA4 rat/4
a (fr 0 9
Lvd,a_ P
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
0 6 494?
Date
C
5
S�
V
PREPARED 6/21/07 16 19 40
t CITY OF PORT ANGELES
APPLICATION NUMBER
FEE DESCRIPTION
PLUMBING PERMIT
07- 00000587 2317 JERRI LYNN ST
AMOUNT DUE
TOTAL DUE
Please present this receipt to the cashier with full payment
.-\0\rf) eff-
C c s
6(\e C-aA\ lOne)C- \)LtS 4\e- cDA)ko; c_
k 5 1?
V Ci,,CAL,C) tr-.) Cie- A Vc-x- Ael\--0-05_ a-1,000A- v,:)Cni.. ic.)) ns \i--\--)
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wder Vicifc, lirl 1p
h S Ve, C)\--- Ak\e., C",\40
0 d L -7,-L4s\, YY\e) \no_-\i-e-
Y 1v‘, u
4
PAYMENTS DUE RECEIPT
n r Z-o`uicn PROGRAM BP820L
64 00
64 00
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
T \Policies \1102_15 building penult inspection record05 wpd [1/4/2005)
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
07 00000587 Date 6/29/07
663540
2317 JERRI LYNN ST
06 30 01 7 6 0310 0000
CHRISTIN LAWRENCE
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
140917
Owner Contractor
CHRISTIN LAWRENCE CHRISTINE HI LINE HOMES
M CHANG 11306 62ND AVE E
1131 COLUMBIA PUYALLUP
PORT ANGELES WA 98362 (253) 840 1849
(360) 452 9719
Other struct info TOTAL LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
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
All homes in new subdivisions that are outside of the Fire
Department four minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA)
06/12/2007 11 25 AM SROBERDS The proposal will result
in a new sfr w /attached garage for total lot coverage of
24 in the RS 9 zone FIRE SPRINKLERS are required No
other land use issues are anticipated
Electrical load calculations and elctrical permits are
required
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
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
WA 98373
24 40
1 00
9000 00
2200 00
2200 00
1 00
Permit PLUMBING PERMIT
Additional desc DOUBLE CHECK BACKFLOW
Permit pin number 105304
Permit Fee 64 00 Plan Check Fee 00
Issue Date 6/29/07 Valuation 0
Expiration Date 12/26/07
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 7 0000 ECH PL- EA INSTALL WATER PIPE 7 00
1 00 7 0000 ECH PL -OTHER BACKFLOW 2 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
fora period of 180 days after the work as commenced or if required inspections have not been requested within 180 days from the last r
inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of C'
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not 5
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 bC1der) Date
0
CALL 417 -4815 FOR BUILDING INSPECTIONS CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE k MINIMUM 24 HOUR NOTICE. IT IS UNLAM FUL TO COVER IA'SULATE OR CONCEAL ANY WORE BEFORE 1
INSPECTED AND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
ELECTRICAL LIGHT DEPT
INSPECTION TYPE DATE
FOUNDATION:
FOOTINGS
SHEAF WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -IN
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
PLANNING DEPT 417 -4750
BUILDING 417 -4815
T \Policies11102 15 building permit inspection record05 wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
YES
ACCEPTED
NO
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING &HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT 4's SEPA.
PARKING /LIGHTING ESA.
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL DATE YES NO COMMERCIAL
417 -4735 ELECTRICAL
LIGHT DEPT
COMMENTS
FINAL DATE ACCEPTED B.
FINAL
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT
I PLANNING DEPT
I BUILDING
DATE ACCEPTED BY.
DATE
ACCEPTED
YES I NO
Application Number
Application pin number
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
07 00000587
663540
Page 2
Date 6/29/07
Other Fees SEWER SYSTEM DELV CHARGE 1000 00
STATE SURCHARGE 4 50
PW WATER SYSTEM USE FEE 1230 00
Fee summary Charged Paid Credited Due
Permit Fee Total 64 00 64 00 00 00
Plan Check Total 00 00 00 00
Other Fee Total 2234 50 2234 50 00 00
Grand Total 2298 50 2298 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 Signature of Owner (if owner is builder) Date
T Policies \1102 15 building permit inspection record05 wpd [1/4 /2005]
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE/ DOWN SPOUTS
PIERS
I POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
(BACK FLOW) WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL /HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
ROUGH -IN
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
CONSTRUCTION R.W PW/
ENGINEERING 417-4807
FIRE 417 -4653
I PLANNING DEPT 417 -4750 I
I BUILDING 417 -4815 I
T- \Policies11102 15 building permit inspection record05 wpd [1/412005]
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 UNLAWFUL TO COVER, INSULATE OR CONCEAL 4NI' WORK BEFORE
INSPECTED 4ND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES
NO
417 -4735 ELECTRICAL
LIGHT DEPT
FINAL 62 ?DATE
FINAL
SEPA.
ESA.
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT
I PLANNING DEPT
I BUILDING
DATE
ACCEPTED BY.
DATE ACCEPTED BY.
ACCEPTED
YES I NO
I I I
I I I
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BUILDING DIVISION.
CITY OF PORT ANGELES
* *
Correction' Notice
Job Located at ;23 17 :::rcee-~ LyNv.J 5r
Inspection of your work revealed that the following is
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ELECTRICAL PERMIT AND INSPECTION RECORD
CITY OF PORT ANGELES
360-417-4735
u
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00000587 Date 11/09/07
663540
2317 JERRI LYNN ST
06-30-01-7-6-0310-0000-
CHRISTIN LAWRENCE
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
140917
Owner
Contractor
CHRISTIN LAWRENCE
M CHANG
1131 COLUMBIA
PORT ANGELES
(360) 452-9719
Other struct info
/ CHRISTINE HI-LINE HOMES
11306 62ND AVE E
PUYALLUP
WA 98362 (253) 840-1849
WA 98373
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
24.40
1. 00
9000.00
2200.00
2200.00
1. 00
Pe rmi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
EL SVC/ SVC DITCH ONLY
114629
ELECTRIC SERVICE
75.00
11/09/07
5/07/08
plan Check Fee
Valuation
.00
o
Qty
1. 00
Unit Charge Per
75.0000 ECH EL-RM-0-200 1ST SRV FEEDER
Extension
75.00
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.
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
06/12/2007 11:25 AM SROBERDS --The proposal will result
in a new sfr w/attached garage for total lot coverage of
24% in the RS-9 zone. FIRE SPRINKLERS are required. No
other land use issues are anticipated.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
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
222.00
"
INSPECTION ELECTRICAL
TYPE DATE: RESULTS: INSPECTOR:
DITCH
. .
SERVICE
ROUGH - IN
FINAL
COMMENTS:
ELECTRICAL PERMIT AND INSPECTION RECORD ·
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . . 07-00000587
Application pin number 663540
Page 2
Date 11/09/07
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
1000.00
4.50
1230.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total . 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2456.50 2456.50 .00 .00
Grand Total 2531.50 2531.50 .00 .00
[INSPECTION ELECTRICAL
TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH - IN
FINAL
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CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
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
07-00001176 Date 10/29/07
125816
2317 JERRI LYNN ST
06-30-01-7-6-0310-0900-
CHRISTIN LAWRENCE
FIRE SPRINKLER SYSTEM
RS9 RESDNTL SINGLE FAMILY
2700
Owner
Contractor
CHRISTIN LAWRENCE & C. CHANG
1131 COLUMBIA
PORT ANGELES WA 98362
Structure Information 000 000
INNOVATED FIRE SPRINKLERS
81 NEW HAVEN LANE
PORT ANGELES WA 98362
(360) 452-7583
INSTALL FIRE SPRINKLER SYSTEM
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
FIRE SPRINKLER RESID
FIRE SPRINKLER SYSTEM
113050
50.00 Plan Check Fee
10/29/07 Valuation
4/26/08
.00 '
o
Qty Unit Charge Per
BASE FEE
Extension
50.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50.00 50.00 .00 .00
Plan Check Total '. .00 .00 .00 .00
Grand Total 50.00 50.00 .00 .00
j
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This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
180 days from the last inspection. I hereby certify that I have read and examimd this application and know the same to be
true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the rovisions of any state or 10callaw regulating the work specified in the perm it.
- "-"- .. #- C"'-' .-.
-;at(C7signature of Owner (if Owner is builder)
Date
,
~
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FIRE PERMIT INSPECTION RECORD
o
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,
Call 360-417-4655 for fire inspections. Please provide a minimum 24-hour notice. It is unlawful to cover, insulate':::
or conceal any work before inspected and accepted. Post permit in a conspicuous location. ~
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final l-n-O& ~()
FIRE ALARM W
Rough-in inspection -
-.l
Alann final
LP-GAS Completed by Contractor: ~
(C
Underground piping inspection/pressure test Test # I "")
........
Above ground piping inspection/pressure test Piping pressure test pSl
Tank (container) inspection Time initiated
Test #2 -c
Appliance inspection Piping pressure test pSI S
Time initiated :s
LP-gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT (j)
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final
1\
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Inspection Type
I Date Passed I
Comments
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ELECTRICAL PERMIT AND INSPECTION RECORD
CITY OF PORT ANGELES
360-417-4735
II
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Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00000587 Date 10/24/07
663540
2317 JERRI LYNN ST
06-30-01-7-6-0310-0000-
CHRISTIN LAWRENCE
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
140917
Owner
Contractor
CHRISTIN LAWRENCE
M CHANG
1131 COLUMBIA
PORT ANGELES
(360) 452-9719
Other struct info
/ CHRISTINE HI-LINE HOMES
11306 62ND AVE E
PUYALLUP
WA 98362 (253) 840-1849
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
DOUBLE D/ 2200 SQ FT SFR
111948
DOUBLE D ELECTRICAL
113.00
10/24/07
4/21/08
Plan Check Fee
Valuation
Qty
1. 00
2.00
Unit Charge Per
69.0000 ECH
22.0000 5C
EL-R-SQFT FIRST 1300
EL-R-SQFT ADDITIONAL 500
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.
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
06/12/2007 11:25 AM SROBERDS --The proposal will result
in a new sfr w/attached garage for total lot coverage of
24% in the RS-9 zone. FIRE SPRINKLERS are required. No
other land use issues are anticipated.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
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 concre~e.
WA 98373
24.40
1. 00
9000.00
2200.00
2200.00
1. 00
N
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.00
o
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Extension
69.00
44.00
~
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..
...
INSPECTION ELECTRICAL
TYPE DATE: RESUL TS: INSPECTOR:
DITCH
SERVICE '.
ROUGH - IN
FINAL
COMMENTS:
ELECTRICAL PERMIT AND INSPECTION RECORD
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . . 07-00000587
Application pin number 663540
Page 2
Date 10/24/07
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
1000.00
4.50
1230.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 113.00 113.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2234.50 2234.50 .00 .00
Grand Total 2347.50 2347.50 .00 .00
..
INSPECTION ELECTRICAL
TYPE DATE: RESULTS: INSPECTOR:
DITCH
fI/S/G -; fJ-<p ~
SERVICE
I hD/o I AP- 11L.
ROUGH - IN
I!l -, fd6 1+~ ~
FINAL
COMMENTS:
~----------,..-----....-~---=----- ,....-~ ...,,;...,. _ - .... "'~" _;;.~-' ",,00- ~ ~ ~ _.......... ~-~
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BUILDING DIVISION
CITY OF PORT ANGELES
* *
Correction Notice
Job Located at d- ~ II ~~I LyHP S I
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
.
g~l~ 61V~ ~~LU) TO
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t ([(,4 ~ AI rL~ TL-b - .Ii LI .{
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((14.10 7 ~Fc.:.6~ U~\Lr /~sALc(7Ov)
These corrections must be made and are not to be
covered until reinspection is madV~en<Mrections
have been made, please call 7- f r
for inspec. tion. %&
Date /c rU~7 b . (
/
Inspector for Building Division
DO NOT REMOVE THIS TAG
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PORT ANGELES FIRE DEPARTMENT
102 East Fifth Street, Port Angeles, Washington 98362
(360) 417-4650 FAX (360) 417-4659
Fire Sprinkler System Plan Review
Project Name: Private Residence Address: 2317 Jeri Lynn Street
Installer: Innovated Fire Sprinkler Installer Telephone: 452-7583
Type of System: Open 130 13RO 13 D [gJ
Date: 10.11.2007 PAFD Permit #: 07-31
We have checked this plan and find that it conforms to the requirements of the code.
Additional Comments:
All systems, including underground mains, shall be installed by a state licensed and certified
company. Systems shall be installed per the applicable NFP A Standard.
All electrical components shall be compatible with the fire alarm system.
All underground piping must be inspected and hydrostatically tested by the Port Angeles Fire
Department PRIOR to being covered. A witnessed flush ofthe underground piping is required.
A design sprinkler flow test and alarm test are required for all 13D systems.
Before final acceptance of the system, an inspection will be conducted to ensure that the
installation complies with the applicable NFP A Standard. This 13D system will require a
measured flow test.
Contractor
Reviewed by: ~ O() .4-Q
Date: 10' Il- 07
o
II
o
Building Department
Fire Department
I ..
I DATE: 10- 10-071
[:J
FIRE DEPARTMENT
PLANNING DEPARTMENT
PUBLIC WORKS/ENGINEERING DIVISION
LIGHT DIVISION
o ENERGY
o ENGINEERING
o POLICE DEPARTMENT
o ADMINISTRATI~N
o CITY CLERK
o RISK MANAGEMENT
I FROM: PUBLIC WORKSIBUlLDlNG DIVISION ~
~
o
o
RE: ADDRESS: :2 :, l[ '0 Vr-i LJ h Y\ 'S t-
NAME/CONTACT: V "V\Ge-V\t- 6e. t-.:fj e.,y-
PHONE: L..f 5 L. ~ l 5 &"""3 .
PERMIT NUMBER: C) {- t t ( r.o
PROJECT DESCRIPTION: .~5+o. C l ~-eS ~ J e-h--h' Ov \
f;"'v-e- spn\'\ K(ey-- 5JS~
.a NEW CONSTRUCTION
o ADDITION/ALTERNATION
COMMENTS/CONDITIONS:
)&REVIEWIRETURN
o FILE
~~r}:) 0"1 - 'S ,
,
BUILDING PERMIT - APPLICATION
F01~ OFfiCIAL USE ONLY:
Dalt/tee.: \0-01'01
l'cnnilll 0, - 111 (t,
Dale ".ppr(l\,~:
Dalt Issued:
Fill out COMI'LETEL Y and in INK. Your application and site plan MUST BE
COMPLETE to he accepted for review. If you have any questions, caU
PERMITS (360) 417-4815 FAX(36())417-4711
Applicant or Agent: ~ ~ + ~ /' Phone: '-IS' 2 - 7 S 8 3
Owner: C h. r :s t-: ~ L ~ vJ.Lr- V\ C. L. Phone:
Address: 113/ C c ) '^ "'-\ .b~~ City: Po ,/..J- A ......,S-e lLf J' Zip: l1E.r<o ~<
ArchitectlEngineer: Phone:
ContractorJAlNlf J,I}:-/ ELJ FI1<EState License #:/IVNOV?SOi.{'IOllExp: W.9Phone:4S2 -7S&..;
Address:R / Nu...v f}(Atl-'l ~ L ~ . City: 'R~ r.f- !h-s,.ll..jJ-.1' Zip: 9.3,? (L) :<.
PROJECT ADDRESS: 2 :3 / 7 T ..Q. r: L '7 Vl. V\ S .+- ZONING:
LEGAL DESCRlPTlON: Lot: Block: Subdivision:
CLALLAM COUNTY PARCEL NUMBER:
TYPE OF WORK: SIZEIV ALUATION:
~~eSidential 0 New Consn-o D Re-roof 0 Stove SF. @$ /SF. = $
D Multi-family 0 Addition D MoveD Garage SF. @$ /SF. = $
o Commercial 0 Remodel 0 Demolition D Deck SF. @$ /SF. = $
o Repair 0 Sign D Other . JOT ~ Y ALVA TION $ 2- 700 0 d
BRlEFDESCRIPTIONOFTHEPROJECT: Lk...r;;..-I-v./( J-I'.r.e. sp."-.',-",,k-/~^- S' J .s+e~
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of.Stories: Lot Size: Existing Sq. Ft
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft
Construction Type:
= TOTAL Sq. Ft
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
ESAlWetIand(s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other.
VALUATION OF CONSTRUCTION: In aU cases, a valuation amount must be entered by the applicant
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 41 7-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section
RI05.3.2 of the International BuildingIResidential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I
must obtain such pennfts prior to war, ... .
T\FORMS\BMgl'ami"~wpd Apph""'t \I~ r .t3 R..1ijR - Da""ltJ )0/-07
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BUILDING DIVISION
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CITY OF PORT ANGELES
* *
Correction Notice
Job Located at ;;) 3 / 7 y-l2fJ/' ~V#4' 5;-
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
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These corrections must be made and are not to be
covered until reinspection is mad~e/ Whep corrections
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Date 9- )g'C7) ~
Inspector for Building Division
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BUILDING.-DIVISION
CITY OF PORT ANGELES
* *
Correction Notice
Job Located at ;2. 3J r; ,J,::-p P T L)/}, I,.....{
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
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These corrections must be made and are not to be
covered until reinspection is ma e. When corrections
have been made, please call
for inspection.
Date
DO NOT REMOVE THIS TAG
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
32\ EAST 5TH STREET. PORT ANGELES. WA 911362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00000830 Date
032880
2317 JERRI LYNN ST
06-30-01-7-6-0310-0000-
ELECTRICAL ONLY
7/30/07
RS9 RESDNTL SINGLE FAMILY
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Owner
Contractor
CHANG, CHRISTINE
2317 JERRI LYNN ST
PORT ANGELES WA 98362
ELECTRIC SERVICE
82 DRAPER RD
PORT ANGELES
(360) 452-6424
WA 98362
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL TEMPORARY SERVICE
EL. SVC./ TEMP SVC
106955
ELECTRIC. SERVICE
40.00 Plan Check Fee
7/30/07 Valuation
1/26/08
.00
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Qty Unit Charge Per
1.00 40.0000 ECH EL-TEMP SRV - 0-60 SRV FDR
Extension
40.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40.00 40.00 .00 .00
Plan Check Total .00 .00 .00 ..00
Grand Total 40.00 40.00 .00 .00
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COMMENTS/ACTION NEEDED
ELECfRlCAL PERMIT INSPECfION .RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PR0VIDE 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
lNSPECTION TYPE
DATE
COMMENTS
NO
GENERAL COMMENTS:
PW.lI02.1S 14'961
~'PORr~
$~O~~~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
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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
CHRISTIN LAWRENCE
M CHANG
1131 COLUMBIA
PORT ANGELES
(360) 452-9719
Other struct info
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
07-00000587 Date
663540
2317 JERRI LYNN ST
06-30-01-7-6-0310-0000-
CHRISTIN LAWRENCE
RES NEW SFR
6/13/07
RS9 RESDNTL SINGLE FAMILY
140917
Contractor
/ CHRISTINE
HI-LINE HOMES
11306 62ND AVE E
PUYALLUP
(253) 840-1849
WA 98373
WA 98362
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
24.40
1. 00
9000.00
2200.00
2200.00
1. 00
BUILDING PERMIT -RESIDENTIAL
1716 SF SFR, 484 SF GARAGE
102608
1249.85 Plan Check Fee
6/13/07 Valuation
12/10/07
499.94
140917
Qty Unit Charge Per
Extension
1020.25
229.60
BASE FEE
41.00 5.6000 THOU BL-100,001-500K (5.60 PER K)
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
103945
111.60 Plan Check-Fee
6/13/07 Valuation
12/10/07
.00
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<
~
Qty Unit Charge Per
BASE FEE
1.00 14.7000 ECH ME- INSTALL 100- FAU
5.00 7.2500 ECH ME-VENT FAN
1. 00 10.6500 ECH ME-OTHER APPL. N/R
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
Extension
50.00
14.70
36.25
10.65
PLUMBING PERMIT
103937
142.00
6/13/07
12/10/07
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
Extension
50.00
63.00
BASE FEE
9.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
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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
T:\Policies\1102_15 building pennit inspection rccord05.wpd [1/4/2005]
(/)
~
BUILDING PERMIT INSPECTION RECORD
CALL 4]7-4815 FOR BUILDING INSPECTIONS. CALL 4]7-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLlC WORKS UTILlTIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL AN}' WORK BEFORE .
LNSPECTED AND ACCEPTED. POST PERMIT I~ A CONSPJCUOUS LOCA TJON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDA nON:
FOOTINGS
SHEAR WALLS I WALLS
FOUNDA TION DRAINAGE I DOWN SPOUTS
PIERS I
POST HOLES (POLE BLDGS)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS I GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS I ROOF I CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL I FLOOR I CEILING I I
MECHANICAL
ROUGH-IN
HEAT PUMY I FURNACE I DUCTS
GAS LINE FINAL DATE ACCEPTED BY:
WOOD STOVE I PELLET I CIDMNEY
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT#'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LlGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. IPWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUlLDING 417-4815 BUlLDING
T:IPoliciesl1102 15 building pennit 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, W A 98362
Application Number
Application pin number
07-00000587
663540
Page
Date
2
6/13/07
Qty
1. 00
1.00
1. 00
Unit Charge
7.0000
15.0000
7.0000
Per
ECH
ECH
ECH
PL- EA. INSTALL WATER PIPE
PL- EA. BLDG SEWER
PL- EA. WATER HEATER
Extension
7.00
15.00
7.00
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.
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
06/12/2007 11:25 AM SROBERDS --The proposal will result
in a new sfr w/attached garage for total lot coverage of
24% in the RS-9 zone. FIRE SPRINKLERS are required. No
other land use issues are anticipated.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
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
1000.00
4.50
1230.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 1503.45 1503.45 .00 .00
Plan Check Total 499.94 499. 94 .00 .00
Other Fee Total 2234.50 2234.50 .00 .00
Grand Total 4237.89 4237.89 .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
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building penni! inspection rccord05.wpd [1/4/2005]
,--------
BUILDING PERMIT INSPECTION RECORD
CALL417-4815 FOR BUILDING INSPECTIONS. CALL 4]7-4735 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 ANJ' WOPJ( EEFORE
I.NSPECTED AND A CCEPTED. POST PERMIT IN A CONSPI CUOUS LOCA TION.
KEEP PERMIT CARD AND APPROVED PLANS AT .lOB SITE.
~
o
-.i
,
W
-J
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUN[}ATION:
FOOTINGS r. S~W~\\ Q?>}07!Jf07 t>e
SHEAR WALLS I WALLS "q! ~o-Ol jl.L D~we\\ ~ 111 /07 Jt.-L
FOUNDA TION DRAINAGE I DOWN SPOUTS ~T\'l/o" :fLi.-
PIERS I
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGI-J-IN , 0 -2~.- 01 'J"LL-
WATER UNE (METER TO BLDG) 11-03-07 7LL-
GAS LlNE FINAL (j \, - l~ .....DtATE "SLL- ACCEPTED BY:
BACK FLOW I WATER
AIR SEAL 10 -2b-Ol Pe> I( - 0 '=1 -crt Air s~\ :n.....<.....
WALLS
CEILING
FRAMING q .....I'S-O' "J"L-L 9 - \1-01 "JL.L fmMI"'~ lo-z6-o7 Jl.I..
JOISTS I GIRDERS II -0 I;) -01 -:r~L ~lnJ
SHEAR W ALUHOLD DOWNS ~-ZO-ol Roof Sh~h1 91zelo7
WALLS I ROOF I CEILING
DRYWALL (lNTERJOR BRACED PANEL ONLY) i Z. -,--07 '":rlk
T-BAR f
INSULATION
I,.
SLAB
WALL I FLOOR I CEILING
MECHANICAL
ROUGH-IN IT - 2-/-01 pp...,
HEAT PUMY I FURNACE I DUCTS J'LL-
GASLJNE FINAL 6 t -rlH -O~A TE ACCEPTED BY:
--'
WOOD STOVE I PELLET I CHIMNEY
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMlT#'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W. IPWI CONSTRUCTION - R.W.
ENGINEERJNG 417-4807 PW I ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 I I ~ / PLANNING DEPT.
BUlLDJNG 417-4815 "/71'OY It-. '1// BUILDING
T:IPoJiciesll ] 02 15 building pennil inspection record05.wpd [Tt4/200!] ~V (
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES 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
07-00000587 Date
663540
2317 JERRI LYNN ST
06-30-01-7-6-0310-0000-
CHRISTIN LAWRENCE
RES NEW SFR
6/13/07
RS9 RESDNTL SINGLE FAMILY
140917
Owner
Contractor
CHRISTIN LAWRENCE
M CHANG
1131 COLUMBIA
PORT ANGELES
(360) 452-9719
Other struct info
/ CHRISTINE HI-LINE HOMES
11306 62ND AVE E
PUYALLUP
WA 98362 (253) 840-1849
WA 98373
TOTAL \ LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
24.40
1. 00
9000.00
2200.00
2200.00
1. 00
Permit PUBLIC WORKS RES WATER SERV
Additional desc 3/4" DROP IN METER
Permi t pin number 104406
Permit Fee 230.00 Plan Check Fee
Issue Date 6/13/07 Valuation
Expiration Date 12/10/07
.00
140917
Qty Unit Charge Per
BASE FEE
Extension
'230.00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
104414
120.00
6/13/07
12/10/07
Plan Check Fee
Valuation
.00
140917
Qty Unit Charge Per
1.00 120.0000 EA SAN SEWER HOOKUP
Extension
120.00
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.
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
06/12/2007 11:25 AM SROBERDS --The proposal will result
in a new sfr w/attached garage for total lot coverage of
24\ in the RS-9 zone. FIRE SPRINKLERS are required. No
other land use issues are anticipated.
Electrical load calculations and elctrical permits are
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 180eJays after the work as commenced, or if required inspections have riot 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 constructio'n or the performance of
construction.
Signature of Contractor or Authorized Agent
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 UNLAWFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRlVEW A Y APPROACH
BACK-FLOW DEVICE I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
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]
c1 ,ORT ~G
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 07-00000587
Application pin number 663540
Page 2
Date 6/13/07
Special Notes and Comments
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
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
1000.00
4.50
1230.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 350.00 350.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2234.50 2234.50 .00 .00
Grand Total 2584.50 2584.50 .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
Signature of Owner (if owner is builder)
Date
T:\Policies\1102.15R [1105]
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
P~ UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER.
DRIVEWAY APPROACH
BACK-FLOW DEVICE
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]
.\.
..
BUILDING PERMIT - APPLICATION
I
_ ...... Fill out COMPLETELY and in INK. Your application and site plan MUSll BE
~ COMPLETE to be accepted for review. If you have any questions, caU\
C(!; }\1<bq PERMITS(360)417-4815 FAX(360)417-4711
0...\)\ 'NOy\L., l.\ \1- ,l~l
Applicant or ~gent~~-Hr\ La Ujre.i1~f ~ Phone: ~5Z.- 9.:1J~
Owner l'.\'\n~~, Ch~ C'.IYI5!-io'\ UttVY'P~one ~'O'2.. - q 1 L:>r
Address:~ II ~~ CD\ Y..m.bi.&L City: r: Zip: ~CO ~ ~ L
Architect/Engineer:---Hil~1 V\ 0 Phone: ~UO -":6"79 -8l o()O
Contractor~i U ~ State License #: Exp: Phone:~D
Address: City: Zip:
Ju-i ltjY'\V\ <e::k ZONING:
Block: Subdivision:
FOR OFFICIAL USE ONLY:
/ Date Rec.: 05 -Z3 -07
/ Pennit#: C)( - ~ <67
, ate Approved: tJ,; ~ ~.
Date Issued: () L, .-
PROJECT ADDRESS: '2.. -"3 \ J
LEGAL DESCRIPTION: Lot: ~\
CLALLAM COUNTY PARCEL NUMBER:
OU300 IJ lfO~\D
T'YE OF WORK: SIZEN ALUATlON' 0
~Residential 0 New Constr. 0 Re-roof 0 Stove~ SF. @$ 1l.q.~ISF. = $ l"ao ~:f~. 0
o Multi-family 0 Addition 0 Move ~ Garage ~ SF. @ $ 'Z-\. ?~ /SF. = $ \ D l I. 00
o Commercial 0 Remodel 0 Demolition 0 Deck SF. @ $ /SF. = $
o Repair 0 Sign 0 Other TOTAL VALUATION $IU-Ol ~J I. 00
BRIEF DESCRIPTION OF THE PROJECT: lIJ::a
NWJ ~e. \,01 t1%-a.e
COMMERClAL/RESIDENTIAL: Occupancy Group:
No. of Stories: l Lot Size: &f,ooo Existing Sq. Ft.
Totallat coverage 24. L.{ %
:t\~s
~~ So v-; \'l \<Ie. r .s
~cu-~~
lS(
Occupant Load: COl1stmction Type:
& Proposed Sq. Ft.?... 'tOO = TOTAL Sq. Ft. 2, zoo
No \ttn45,c
y- ) v\l<. lees
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPWU:
FillE:
OTHER:_
ESAlWetland(s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other:
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPffiATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section
RI05.3.2 ofllie International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand that itJs my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits prior to work.
"\FORMS\BldgPomi~-wpd Applioant {l ~ 1)ILP J1 u.. Date: .f2/Z =6/'Dl
I
Prescriptive Approach-Simple F0TI11
For the \Vas11ington State Energy Code ( 2003 Edition)
Climate Zone 1
Site InfolTIlation Building Department Use Only:
Penuit#
or-Sg7
Lot:
Address: 2.. s II
0pr I
L:JhY1 s+
Notes:
City:
State:
Zip:
Contact:
Phone:
Phone 2:
FAX:
Table 6-1
PRESCRlPTNE REQUIREMENTS FOR GROUP R OCCUP ANCY
CLIMATE ZONE 1
c-
Option Glazing Glazing u-FaotN\ Dom Wall Wall Wall Slab
.Area % .U- Vaulted Above Interior Exterior on
of Floor Vertical Overhead! Factor Ceiling Ceiling Grade Below Below Floor Grade
Grade Grade
Unlimited .
ill Group R-3 0.40 0.58 0.20 R-38 R-30 R21 R-21 R-IO R-30 R-IO
Occupancy
Only
(Unlimited Glazinu Option Only)
This Project complies with the following:
.I The Project is a single family residence or duplex.
.I The Project is wood frame OR all of the insulation is interior or exterior of the framing.
.I All building components meet the requirements listed in Table 6-1, Option ill.
.I The Project will meet all other provisions of the WSEC and VIAQ.
The Proj ect will take advantage of the following exceptions to the prescriptive option.
o 602.6 Exooption 1. One door, !bat is 24ft. Or l"s, that do" not moot tho standards ,JIowod.
Location of the door taking this exception
o 602.6 Exception 2. Doors with a U-Factor of 0.40 allowed without calculations, Option ill only.
Location of the Door (s) taking exception
Type of Heat source:X p,. U
EXBJBIT A
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When recorded return to:
OLYMPIC PENINSULA
TITLE COMPANY
'v 'f;l:Xo if 7 f.
CLALLAM COUNT) /4-2tf,cP
fJ1ANSACTION EXCISE TA:A
~:,6E MAY 3 . 2007
'~C70 -
AMOUNT 0 ,600
(;(~~a~AJ.A~A
lj)f~.~ '
2007-1202200
Por;",~ I~' P:nl ,,~U I.. 1oI~~~r~1 ~()~~:~y
CIOiII,J.m County LJOIshlnglon 0':1/31/2007 " 4) 07 AM
1111 ~IIII.- rtr,IIlll,~;rI~I~UlwlLI~',Iw.,tl.H~lo&Jl:I~'~ ~IW 11111
File Number 01088138DS LPB 10-05
STATUTORY WARRANTY DEED
THE GRANTORIS) ANDRE\'\I J. WILLIS AND DEBORAH MARIE NELSON, WHO
ACQUIRED TITLE AS DEBORAH NELSON WILLIS, AS TENANTS IN COMMON
lor and In consideration 01 TEN DOLLARS AND OTHER GOOD AND VALUABLE
CONSIDERATION
in hand paid, conveys, and warrants to CHR ISTIN LAWRENCE, A SINGLE WOMAN AND
CHRISTINE M. CHANG, A SINGLE WOMAN I AS JOINT TENANTS WITH
RIGHT OF SUVIVORSHIP AND NOT AS TENANTS IN COMMON
the following described real estate, situated in the County of CLALLAM . Stale 01 Washington:
LOT 31, THE ESTATES AT MILWAUKEE, FORMERLY KNOWN AS MOUNTAIN
VIE\'i ESTATES, AS PER PLAT RECORDED IN VOL~lE 14 OF PLATS, PAGE
71, RECORDS OF CLALLAM COUNTY, WASHINGTON, PURSUANT TO
ORDINANCE NO. 3209.
SITUATE IN CLALLAM COUNTY, STATE OF WASHINGTON.
SUBJECT TO:
SEE EXHIBIT IlA" ATTACHED HERETO AND MADE A PART HEREOF:
Abbreviated Leg"l: (Required illullleg'" not inserted above.)
LT 31 ESTATES AT MILWAUKEE, FKA MTN VIEW ESTATES
Tax P"rcel Number(s): 063001-760310
i{jZlt:t~'
AND~JI. WILLIS
t c&? -
DEBORAH MARIE NELSON
State of ~~"<1-
County of C.hA,,:~'ncu..u 55.
I certify that I know or have satisfactory evidence that
/>KREJ.l J. WilllS
tJ,~/Uie) the person(s) who appeared before me, and said
person(s) aCknowledged that HE signed this instrument and
acknowledged it to be HIS free and voluntary act for the
uses and purposes mentioned in this instrument.
Dated: 5/ ra. /7f:f)7
f!l~~t-ll;j /A~ III t"~
Notary name printed or typed: G;l
Notary Public in and for the State of ..
Residing at: 3c 1\01 €'e' TIN G <;(. . .- '.
My Appointment Expires: fo/24- /.J-cc I' ,
, - -' ..
EUlABE1li H. WAlKER
NOTARY PUBUC
0iAnw.t COlMY, GEOR3IA
IlY COI.IlII5Sa/ fX1'lRES OCTOOER 2e, au
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File Number
os
EXHIBIT A
ALL COVENANTS, CONDITIONS, RESTRICTIONS, RESERVATIONS,
'EASEMENTS OR OTHER SERVITUDES, IF ANY, DISCLOSED BY THE
RECORDED PLAT OF MOUNTAIN VIEW ESTATES. '
COVENANTS, CONDITIONS AND RESTRICTIONS IMPOSED BY DOCUMENT
RECORDED UNDER CLALLAM COUNTY RECORDING NO. 2005 1158111.
~~xmxXDmX}UlIJXn>JiOOXJlX)?mX~~~~~
~OOK~~XOOXXX~~4<2:XX
STATE OF WASHINGTON
County of CLALLAM
I certify that I know or have satisfactory evidence that
DEBORAH MARIE NELSON is the person who appeared before me,
and said person aCknowledged that she signed this instrument
and aCknowledged it to be her free and voluntary act for the
uses and purposes mentioned in the instrument.
D~~\)"~~lil ~ - d-OO'+
,.... :.JI,OEL I"
~- ~ ...'''''''\\''''11 I"
.= V._.:-"~~ EXPI'i'III", "
:~:"'OP "R>' ~~", ~
;:~::~ ... <.'t.~
;; < ff~ 0 - ,0
~ D~:t z ~. u : t-
""0 ..........:<-'_
~ '1,,0 P\J~" ,,'f~=
'I, "'" 4.00;....,<:><,.=
II, 8'j.I'l'h\\\""...~t'.......:"
'I" ,q TE 01' ",....
11\\\1\\\\\'"
~
L. SHIDELER, NOTARY PUBLIC
ointment expires; 04/09/2011
THE GRANTEES~Y SIGNING THE ACCEPTANCE BELOW, EVIDENCE THEIR
INTENTION TO ACQUIRE SAID PREMISES AS JOINT TENANTS WITH
RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON.
(li~-t,'f:l1-I/!r (2 ~ ~ ~
1ST N REN CHRISTINE M. CHANG
-
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
07-- Sg7
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdi vi::1 i on Name
Property Use
property Zoning .
Application valuation
07-00000587 Date
663540
2317 JERRI LYNN ST
06_30_01_7_6_0310-0000-
CHRISTIN LAWRENCE
RES NEW SFR
6/13/07
RS9 RESDNTL SINGLE FAMILY
140917
27/1kL~
L~
contractor
Owner
------------------------
------------------------
I CHRISTINE HI-LINE HOMES
11306 62ND AVE E
PUYALLUP
WA 98362 (253) 840-1849
WA 98373
CHRISTIN LAWRENCE
M CHANG
1131 COLUMBIA
PORT AJ\:GELES
(360) 452-9719
Other struct info
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
24.40
1. 00
9000.00
2200.00
2200.00
1. 00
----------------------------------------------------------------------------
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS
3/4" DROP IN
104406
230.00
6/13/07
12/10/07
RES WATER SERV
METER
104414
120.00
6/13/07
12/10/07
plan Check Fee
valuation
.00
140917
"J
\Y\ ~
J/\
plan Check Fee
valuation
.00
140917
----------------------------------------------------------------------------
Qty
unit Charge Per
Extension
. 230.00
BASE FEE
Permit
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
----------------------------------------------------------------------------
City
1 00
Unit Charge Per
120.0000 EA SAN SEWER HOOKUP
Extension
120.00
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.
All homes in new subdivisions that are outside of the Fire
Department four-minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code {IFC} and National Fire protection
AS~:ociation (NFPA).
06/12/2007 11: 25 AM SROBERDS - -The propos"al will result
in a new sfr w/attached garage for total lot coverage of
241; in the RS-9 zone. FIRE SPRINKLERS are required. No
other land use issues are anticipated.
Electrical load calculations and elctrical permits are
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 of180 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. AIi provisions of
laws and ordinances governing this type of work wili be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to vioiate or cancel the provisions of any state or locai law regulating construction or the performance of
construction.
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\policies\1102.15R [1/05]
-
_.'OIIT....
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Applica1:ion pin number
07-00000587
663540
Page
Date
2
6/13/07
Special Notes and Comments
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road r"ight of way. An inspection by Public Works
Engineering is requirE7d prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
1000.00
4.50
1230.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 350. 00 350.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2234 .50 2234.50 .00 .00
Grand. Total 2584 .50 2584.50 .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 n'ot 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
iaws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a pennit does not
presume to give authority to violate or cancei the provisions of any state or locai law regulating constructio'n or the performance of
construction.
Date
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T:\Policies\1102.l5R [1/05]
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . 0 . INSPECTION REPORT . . 0 . . .
REQUEST:
Date--lL~ 7- 07
Time
Received by k> V
(phone, person)
. \
Location of Work to be inspected :2. 5 I ( .1".e r-f' .
Name of person requesting inspection W ~ l \
Address of person requesting inspection
Type of Inspection (circle appropriate one):
LYV\I^ "::> \
Phone No. 1..f77 - 1168
Permit No. 6'7 -58'7
Final ~we(Ex~0 Other
Sewer Foundation Framing Chimney Plumbing
INSPECTION NOTES:
Inspected: Date 1/- 7- or Time
Remarks: Na-w .s"'-w<2.~ c:..",....."'toQC.+,''''vl +6 ~x;s{"'
-?ro~...'1v I \,€... I
I
By R. V
",111>(1(. /a. 1-<C V' 0.. I <\.
RESTORATION REQUIRED. . . . .. YES
NO "j,
-,
;
I q~r~~
t
N
I _
;;7 ~ Ne.w
, J> 7''' ;b...v
7 "Of ~s"
l
-
18'1 '
~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
.IC!'mtinue o_n reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
----
--
APPLICATION FOR WATER
City Water Division, Port Angeles, WA
lssueddate:~ Installed by & date: 112../7"S-bi Permit# 07-6B7
r
I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises:
,
Applicant Name & Phone: CJ.t~ I <, LAtI)~~lF. l.f"S Z. - qll q
Site Address: Z~ II Jerl Ly"" Sf MailingAddress: )1':2,\ C{'\Il""hv'
Blk: Lot: 3 \ Add:~SJ~@ Parcel#: (){03(y)'1~n::...1 D
Svc:ON/8> Meter#'sC, F ~~lW/O#: ?,b!:>4<D,l::,'-/5
'd'. ?J,CP"i." 7t-.. '-Z/>,,,!E- ~~"'"" '~ill.'
Signature: _ ~ _ /( fl A'? _ _ " Remarks:
N"
r"
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<1
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . . . .
v'
REQUEST:
Date I - !!j - 68
Time
Received by
RV
(phone, person)
\
Location of Work to be inspected 23/7 3e Y' N L~ lA.-1Il 51
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. 07- 5:87
Sewer Foundation Framing Chimney Plumbing ~ Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date 2. - /2-D e Time
Remarks: Fr''''a.l 2 - 12 -O'd
Sew-Q.t- 11-1-D7
~")h, jl'^;Y I ~??- o~
By 12\/
() j'\
RESTORATION REQUIRED . . . . ,. YES NO X.
.Dl'llIew","y :~.,.o""^ bo..ck 60( ex/~~~~ dd~wo..lk. +--0
P/'Op-e-.,.'J.y 1J^e. nof CO"'f'/e.kc{ -Gowtpfr~d..~dl-2.'3-08
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
If.'':nntinlle.Dn.revers~ side if necessary)
STREET SUPERINTENDENT
(DATE)
fl,~
o
.' -
Job wired by
a'
~~:~~
- ~
'to "#"
""'...
ELECTRICAL WORK PERMIT APPLICATION
l:l Owner
/1.11\: r.::-
Insl.llot;on descriplion _ :--oat g/2-tl (t Q
o Commercl.1 O~nti!"" e - () .
- - Initials ~ /
Q New Q Allered/Addltlon
Elc.e.t1C<l1 contractor nOme rl ... _ License number ~l1lC Expires
\2...~Ic:... ~~ ~cr;\1~20
Purchaser's nt:1ilini-(ddress . J~
BL U"'-"t-"" V_
Cit~ A. n Stale ZIP
~O'" ~=- W ~
Telephone number FAX number
"-I" 2-IP '12..-{
'\'1'3\0-1..
Premises ,",[H,r'S name ..
~'-~!.'"~-
Address of Inspecllon
""2..."'>:, 17
City _fJ A-
\
,,,,,-,-,,,-\
I
..k..... L1-
\j;.- ,. -"'")
Phone number 10 schedule inspection:
Owner 0.\' dcjj"ed b)' RCW/9.28.261:(I) OWller will nccupy the structure for 'wo
yean- aftcr this electrical permit is flfJofized. (2) Owm:r i.s required fo hire an ('fcctrlC/I/
contractor if abuvll said property ;!j for salt!. rent ('Jr lease.
Ancr rending the above statement, I hereby cwiry that I am the O"'"tlcr of the above
named property or a licensed clcclrical ,contractor. I ani ll1aking the el<<trical instal.
lation or alll!rntion in compliance with the electrical laws, N.E.C., RCW. Chapter
19.28, WAC. Chapter 296-469, The Cily of Port Angcles Municipol Code, and
Utility Spec' alions.
l:l Cosh l:l Check #
l:l Credit Card Visa ~astercard
Card # 0'----_ -
Discover
contractor or electrical admlnlslralor
x
Dale:
Expiration Date
of card
Electrical load Additions and or subtractions
Q NO LOAD CHANGES
Q Baseboard KW
a Furnace KW
a Heat Pump Ton LAA
Q F.n.Wall KW
Service Information
Voltage \.J' J 2. '-l \;)
pnase~
Service Size: ~
Feeder Size: 'l.. - .l...... '-I
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH-IN
THERMOSTAT
SER\-lCE
l):;UC:
^flJlro~ed Oy
ODIC
AI'fll'Oyed U)'
O.lc
Appl'O~cd D)'
1.
DITCH
FEJj,"DER
DOle
Approyed By
DAle
AppIOYed By
Inspection
Date
Are3, Builclingor Equipmenl Inspected
Action Token
Eleetrienl
Inspector
aQ
..
1/1 'd
TTLt>LTt> :01
-----
)
t>2t>92St>
3)In~3S )I~1)3l3:WO~~ ~02:80 t>002-9-lnr
.,
ELECTRICAL WORK PERMIT APPLICATION
Job wire,/ by
Electrical Contractor 0 Owner
Installation description
D Commercial i:X.Residential
New
o Altered/Addilion
sp_ r" l C-t.-
2..0
ki 1 r.tl
u
tb;////MIr
,?/NbJ
.;- t/ /7C{-I
Owner as defined by RCW19.28.26/:(J) Owner Will occupy the slruclllre for two
years after this electrical permit isfinaljzed. (2) Owner is required 10 hire an electrical
contractor if ahove said property is for ~'ale, renl 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
] 9.28, WAC. Chapler 296-46B, The City of Port Angeles Municipal Code, and
Utility Specifications.
Si~llaturc
o Cash 0 Check #
x
Visa AS+b Discover
Card# -f\n-*-~---------
Expiration ~
of card
o Credit Card
Electrical Load Additions and or sub ractions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton LAR
D Fan-Wall KW
Service Information
o Overhead Service
o Temp Service
o Underground Service
Voltage
PhaseD 1 D 3
Service Size:
Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 1:00 AM 360-417-4735
ROUG:4Q THERMOSt'AT j
Dale .. Approved By Dale ApprovcU By - )
FINAL
~
Approved By
DITCH
7~
FEEDER
Date Approved By
Inspection
Date
Area, Buildipg or Equipment Inspecled
Action Taken
Elcctrical
Inspeclor
.",
NU V 0 5 Z 07
UGHT 0 .
~
Sep 27 07 04:52p
Double D Electrical Inc
3603855761
,I'
\ p. I
~/~~
~
~
ELECI1UCAL WORK pERMIT APPLICA'rION
fO-...)c: 31t:D-- 4/7-Lj 7/1
Job wired by
)is Electrical Contractor a Owner
lutalllltion description
a Commercial )l..Resldential
~cclri(:al contractor name
UOl'-bie. b €-ltt
PurctnSCf"'S m"iling address
P.O. €'Ox QS7
C~OR \-- ~a...cl. lock.-
Telephone number FAX number C" I -I'
1&0--. '35-/13D "3 "'0-3B 6-u 71&'
Premises owner's "ame
0.h R.i~\I\. LA-Wi2.MII.~
Address or Inspection, . ~ C'L
#~i1 ;.)e.P-RI I\VI J\-
Ctp. . A eks ~0 0-..
o New
(] Altered! Addition
State ZIP
[,0c~
Qg3'3'7
W llU I '-il &, .r;r----!Dtu>--L-
/
_ 1(15 ct
1..-(..0 r> SQ
Phon~ ~~D to scbe~l~peCtiOn:
Owner as defin~d by RCW.19.28.161:(I) Owner will occupy the strutlJUtlor two
J~(JTS after lllix tlec/rirCll,,"mil is fitlDli:ed. (2) Ow/Jer is requireJ ro hire QIJ ekctrical
contraclor if abo,'c said property is for solc. Ten' Qr leose.
After ~:l.ding the above statement, I hereby certify thai I am the owner of the above
named property or a licensed electrical contraClor. I 8m making the cleelrical instal.
lation or aheration in compliance with the electrical Jaws, N.E.C.. RCW. Chapter
19.28, WAC. Chapter 296-46B, The City or Port Angeles Munic:ip.l Code. and
Utility Specifications.
~'?1dE o'e< I"
tr' d d iti 5 a or subt tl
D NO LOAD CHANGES
[J Baseboard _ KW
o Furnace I()N a Overhead Service
o Heat Pump _ Ton _LAR 0 Temp Service
o Fan-Wall _ t<m Q Underground Service
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417.4735
,^/._R1UGH~ THERMOSTAT '\
~7 '\PPf'l)ve40y Cite ApprovodBy
)hy~AL~,
o Cash 0 Check n
l:(,Credit Card Visa Mastercard Discover
Cardn __f!J.R-...ELLE:- ------
Date:
Expiration Date
of card
r or eleetfleal ;ldmlDlsUllcor
'?
Servlce Information
Voltage
Phas.D'D3
Service Size: _
Feeder Size:
SERVICE
//..5'..tJ7
Olle
DITOI oj.
8~ f.U>c.1'L1C.. S \I
Dllt~
FEEDER
Appro..e4 8y
DIIC
AfIp......d By
ActiDn Taken
Electrical
Inspector
~--"
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~~
~ I ~ f'r L..-
~
trlE
UGHT DEPT.
... ~.', '"
~
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
1 It
OWNER/CONTRACTOR
"\)bv\3UL
PERMIT # INSPECTOR
t>7- 58, "'iW
,r ADDRESS
~l
2
;::r \,.:')Z, Q \
APPROVED NOT APPROVED
o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0
D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0
D. . .. . . . . .. . . . .. . . . .. SERVICE.. . . . .. . . . . . .. . . . ..0
D.............. ...... . FINAL ................... ~
CORRECTIONS NEEDED:
1'Sc..I'\t-l\'> ()\ITLR:\ S1'A~1< StiJ:ILl:>
31'-(. 20
,-
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360) 452-1381
OCT 24 1013 nzsW `.
ELECTRICAL
CITY OF PORT 111NGCUs PERMIT APPLICATION INSPEC'Fi0b1s
I3Rrticiit~:� t(�ivisin.�tnli�,trz: #t•ic,°zf 1���ectinnx
321 East Fifth Street — P" 0. Box 11501 Port Mige^les Washington, 98362 'r...iA■I�
11h: (360) 417 -4735 hay: (360) 417 -4711 �
Oat : 10n4n013 1 & 2 Single Family Dwelling
'Plan Review May Be Required, Please Complete Electrical Plan Revlewr Information Sheet
,kb Aiffty 2317 Jerl Lynn St
Buildriig$qvateFao4g,e 1715
tscripirm of ab r.
ovi ner I nformatio n
N,Vnn; Christine Chang
e.,,011s _ SOW IN 46240 ��•�ie
Mai A,i s: z3171er14 n+ nst
tl
WA
CI _ Port Angeles _ SJOIiOT ._
963631463
FWne�: 3604601729 __Fdy
—�
ttensir 9 P Fxp
Item
UnitmA CChaaLq
5r 4c0esder 2W Ar .
$ 120M
Mc0eeder 201400 Acne.
$146.00
&r,wiQeJFwder 401,6M Amp
S 265.1 1
Serulce der 501 -1000 Arvp.
$ 262.00
;ryicsf eedsr over 1000 Amp,
S 373,DO
Branch ChcM wll Service Feeder
S 5.
Branch CScuit Flit) SerVice Feeder
$ 6100
Each Additional Bra Ghent
$ 5.0
Branch Ucvils 1.4
S 75.430
Temp.SArvicalFaMer2W Amp,
W40
Tornp. ServiteaFeedof 201 -400 Amp,
$1 W.00
"temp. SantloedFe ier401aOAmp.
$ 149.00
Temp. SeMWFeeder 601 4000 Amp,
$168,00
putial to Aorta I' (iy
$ 96,00
Signal CirwiV UfWiW Energy - 13 2 Family f3', ing
S 6I.t10
Wnufadwed Name Connedion
$120.00
Ren mat E[ecto 81 Energy - 5KVA SyMam at Lew
$1432.00
Thormostet
S 56.00
We: S5.Bi3 for each add na T -Slat
NEW CQ STRttC1'tC�3J 434�it,Y:
f i t 1300 Square Ft.
S QUO
Each Adifilionat $00 safe F1. or Portin ni
S 40.00
Earls Oulb or Detached Garage
S 700
Eadl 5w6imminq furzel w Hot Tub
$110.03
Contmoor information
�1Orne: Protect Your Home
M Addtm: 3750 priority Waysouth Dr
Coy- Indlawnap u
e.,,011s _ SOW IN 46240 ��•�ie
Phone. 866 -502 -3559
�rU' 917 -564 -2547
n, Yi i Eyp, PROTEYYH - ;4R5 exp 12/10/2013
Tot1l tn:.ptic by lJntt Ctnarpe)
...1�,
_ L. 0C _
�w
S
$ _ ...4.00 Total
Ownw as defined by FICi1,118.26-261: (1) Owner will mcupy the stroolure for two years after this eln1ri l pennit is finalized. (2) 0 er is Toquired
to hire an eledrical tontrador it ante said property Is for sale, rent or lease, Permit exp�es a €tar six months of last inspectioin,
After reading the above statement, I heratry cartly glad I am the owner of tine ague named property or a Ikensed elecWcal contractor. I am making
the electrical inslaWon or a4eration In comphame Wth the electrical laws, f .E.C., RCW. Chapter 19.28, VVAQ Chapter 296468, The, City of fort
Angeles Municipal mole, and Ut ley ipeciftations and PAMC 14,05,050 regarding Efectzical Perm l A*cati ns,
Signature of owner, electrical contractor or electrical administrator, 0 Cash 0 ch*rk
1xi
o P��teete 1 iS : 10/24/2013 4t1Qar sal
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number . , , . . 13- 00001244 Date 10/25/13
Application pin number 635328
Property Address 2317 JERI LYNN ST
ASSESSOR PARCEL NUMBER: D6-30-D1-7-6- 0310 -0000-
Applicataon type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning . . . . . . . RSS RESDNTL SINGLE FAMILY
Application valuation . , . , 0
Application desc
Security system
Owner Contractor
CHRISTINE M CHANG PROTECT YOUR HOME
2317 7FRI M LYNN ST 3750 PRIORITY WAY SOUTH DRIVE
PORT ANGELES WA 98363 #200
INDINAPOLIS IN 46240
{31)} 810 -4720
Permit . , . , , , ELECTRICAL ALTER RESIDENTIAL
Additional desc ,
Permit Fee 64.00 Plan Check Fee ,00
Issue Date 10/25/13 Valuation 0
Expiration Date 4/23/14
Qty Unit Charge Per
1.00 64,0000 ECH E
Fee summary Charged
Permit Fee Total 64,00
Plan Check Total ,00
Grand Total 64,Q0
Extension
L- SINGLE CIR LIMITED RES 64,00
Paid Credited Due
64.00 .00 .00
,00 00 .00
64.00 00 .00
-7111 N &A-
M
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Cody: 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH-IN
14
iv
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or EIectrical Contractor X Date:
G:IEXCHANGEIBUILDING
N
N
z
l
Application Number . . . . . 23-00000087 Date 1/31/23
Application pin number . . . 687950
Property Address . . . . . . 2317 JERI LYNN ST
ASSESSOR PARCEL NUMBER: 06-30-01-7-6-0310-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
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Application desc
DHP
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Owner Contractor
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CHRISTINE M CHANG EXTRA MILE TECH & ELECT., LLC
2317 JERI M LYNN ST 418 N. RACE ST.
PORT ANGELES WA 98363 PORT ANGELES WA 98362
(360) 457-5222
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee . . .00
Issue Date . . . . 1/31/23 Valuation . . . . 0
Expiration Date . . 7/30/23
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
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Fee summary Charged Paid Credited Due
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Permit Fee Total 63.00 63.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 63.00 .00 .00
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Pub! ic \Yorks and ULili ties Department
32 l E. 5th Street. Port ;\ngeles. WJ\ 98362
300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us
Project Address:--------------------------------------
Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _
OWNER JNFORMATtON
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRfCAL CONTRACTOR fNFORMATION
Name: ___________________________ License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 $
Service/Feeder 201-400 Amp. $146.00 $
Service/Feeder 401-600 Amp. $205.00 $
Service/Feeder 601-1000 Amp. $262.00 $
Service/Feeder over 1000 Amp. $373.00 $
Branch Circuit W/ Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 $
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder 401-600 Amp. $149.00 $
Temp. Service/Feeder 601-1000 Amp. $168.00 $
Portal to Portal Hourly $96.00 $
Signal CircuiULimited Energy - 1 &2 DU. $64.00 $
Manufactured Home Connection $120.00 $
Ren ewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat (Note: $5 for each additional) $56.00 $
First 1300 Sql;Jare Feet $120.00 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding / Detached Garage $74.00 $
Each Swimming Pool/ Hot Tub $110.00 $
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 Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
'"'CJ CD
PREPARED 1/28/23,12:48:58 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
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APPLICATION NUMBER:23-00000087 2317 JERI LYNN ST
FEE DESCRIPTION AMOUNT DUE
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ELECTRICAL ALTER RESIDENTIAL 63.00
TOTAL DUE 63.00
Please present reciept to the cashier with full payment
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS:
DHP
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
1/31/2023 23-87 TAP
OWNER
CONTRACTOR
Extra Mile Electric
PROJECT ADDRESS
2317 Jeri Lynn St