HomeMy WebLinkAbout1104 Cathleen St - BuildingPREPARED 11/03/10 8 20 56 INSPECTION TICKET PAGE 19
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 11/03/10
ADDRESS 1104 CATHLEEN ST SUBDIV
TENANT NBR ELLEN WITTMANN
CONTRACTOR FERRELLGAS LP PHONE (816) 792 1600
OWNER ELLEN WITTMANN PHONE (253) 514 5705
PARCEL 06 30 01 7 7 0050 0000
APPL NUMBER 10 00001193 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
MEG 01 10/15/10 PB MECHANICAL GAS LINE TIME 01 00
10/15/10 AP October 14 2010 4 54 23 PM 1pangrle
ELLEN 253 514 5705
GAS LINE
AFTERNOON
October 15 2010 4 26 09 PM pbarthol
ME99 01 11/03/10 LL MECHANICAL FINAL TIME 01 00
November 2 2010 11 48 54 AM 1pangrle
ELLEN 253 514 5705
MECHANICAL FINAL TANK SET GAS LINE FOR EXISTING
GAS FIREPLACE
AFTERNOON
COMMENTS AND NOTES
PREPARED 10/15/10 8 18 59 INSPECTION TICKET PAGE 13
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/15/10
ADDRESS 1104 CATHLEEN ST SUBDIV
TENANT NBR ELLEN WITTMANN
CONTRACTOR FERRELLGAS LP PHONE (816) 792 1600
OWNER ELLEN WITTMANN PHONE (253) 514 5705
PARCEL 06 30 01 7 7 0050 0000
APPL NUMBER 10 00001193 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01 10/15/10 JLL
MECHANICAL GAS LINE TIME 01 00
October 14 2010 4 54 23 PM 1pangrle
ELLEN 253 514 5705
GAS LINE
AFTERNOON
COMMENTS AND NOTES
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
ELLEN WITTMANN
PO BOX 2536
GIG HARBOR
(253) 514 5705
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Permit MECHANICAL PERMIT
Additional desc TANK SET GAS LINE
Permit pin number 175570
Permit Fee 121 30
Issue Date 10/14/10
Expiration Date 4/12/11
Qty Unit Charge
1 00
1 00
1 00
10 6500 EA
10 6500 EA
50 0000 HR
WA 98335
Per
Fee summary Charged
Permit Fee Total 121 30
Plan Check Total 00
Grand Total 121 30
T.Forms /Building Division /Building Permit
10 00001193
270699
1104 CATHLEEN ST
06 30 01 7 7 0050 0000
ELLEN WITTMANN
MECHANICAL APPL PERMIT
RS9 RESDNTL SINGLE FAMILY
300
Application desc
TANK SET GAS LINE FOR EXISTING GAS FIREPLACE
Contractor
FERRELLGAS LP
1 LIBERTY PLAZA
ATTN OPERATING TAX DEPT
LIBERTY MO 64068
(816) 792 1600
FRPLC
Plan Check Fee
Valuation
BASE FEE
ME STOVE /FIREPLACE /MISC APP
ME FUEL GAS PIPING 1 5 OUTLETS
ME INSPECTION MIN 1 HR
Paid Credited
121 30 00
00 00
121 30 00
Date 10/14/10
Due
0
0
Extension
50 00
10 65
10 65
50 00
00
00
00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
6A k\Q41
Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities private and public improvements This permit becomes
null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction. r
r l y 1 CD 0 e.eN t i T Con ra
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
BUILDIING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Biggs
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls
Ceiling
FRAMING
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab 4
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
10 -l5-(b 'S
FINAL Date
PLANNING DEPT Separate Permit 1S SEPA.
Parking I Lighting I ESA.
Landscaping I SHORELINE.
T Forms /Building Division /Building Permit
I FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Electrical 417 -4735
Construction R W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
Accepted by cJ l
Date Accepted By
O
s
Applicant 1 c,� -r
Property Owner
Property Owner's Address t
Contractor
Contractor's Address 1 4-t
License Expires
PROJECT ADDRESS e_Aes
Parcel Number Lot Zoning
Project Type Brief Description. Residential Multi family Commercial Industrial
Check all that apply
New Construction ti QL. N om
Addition qI Chre fArk .e h r p K s-04-
Remodel (f -1-60
Repair ci'reolace.'is
Demolition a�t1°a� tn44 h oMa.
Re -roof House garage other tear off re -roof lay over one layer
Heat System Heat pump wood burning stove gas fireplace pellet stove other
Other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq ft.
1 Floor
2nd Floor
3 Floor
Garage I
Carport
Covered Porch
1
Deck
Shed
Other
Total footprint of structures
Site Coverage the amount of impervious surface on
and other impervious surfaces (see PAMC 17 94 13
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
V r r- L. \v �1�7rC' SS
BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
sq ft. T Lot siz
S T l cw tw�c-. P S
Phone 83 aq
E -mail
including structures
exemptions)
Oc pancy group
Occu..ant load
Constr ction type
4 TAL VALUATION J 3
Phone a s
Phone
a5
t833S
p
ed driv
For City Use Only
Date Received_16- 14-16
Permit# )p_ 103
Date Approved
sq ft. C6t2aveiaye "/o
ays sidewalks patios
Site coverage
of bedrooms
full baths
o alf baths
I have read and completed this application an I know it to be true and correct I aim authorized to apply for this permit and understand
that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects.
Date Imo- I Print Name e, on r-‘ v•-\. Signature C"-- o
T Forms /Building Division /Building permit application
e ti
Clallam County Assessor Treasurer Property Details 63348 ELLEN WITTMANN f Page 1 of 6
Clallam County Assessor Treasurer
Property Search Results 63348 ELLEN WITTMANN for Year 2010 2011
Property
Account
Property ID 63348 Legal Description CATHLEEN ESTATES V15
P21 LOT 5
Geographic ID 0630017700500000 Agent Code.
Type Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11
Open Space: N DFL N
Historic Property' N Remodel Property' N
Multi- Family Redevelopment: N
Township Section
Range
Location
Address: 1104 CATHLEEN ST Mapsco
PORT ANGELES WA 98363
Neighborhood Cycle 5 Res Map ID 3
Neighborhood CD 10955130
Owner
Name. ELLEN WITTMANN
Mailing Address: PO BOX 2536
GIG HARBOR, WA 98335
Taxes and Assessment Details
Property Tax Information as of 10/14/2010
Amount Due if Paid on 11.
Owner ID 194834
Ownership 100 0000000000%
Exemptions.
NOTE If you plan to submit payment on a future date make sure you enter the
click RECALCULATE to obtain the correct total amount due
First Second
Half Half
Base Base
Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest Base Paid
2010 45822 ST SCH STATE SCHOOL $249 88 $249 88 $0 00 $0 00 $249 88
2010 45822 CC -GEN COUNTY $132 98 $132.97 $0 00 $0 00 $132.98
2010 45822 PORT PORT $18 69 $18 69 $0 00 $0 00 $18 69
2010 45822 PORT ANG PORT ANGELES $307 89 $307 88 $0 00 $0 00 $307 89
2010 45822 SD #121 SCHOOL DISTRICT #121 $323 66 $323 66 $0 00 $0 00 $323 66
2010 45822 NTH OLY LIB NORTH OLYMPIC LIBRARY $38 64 $38 64 $0 00 $0 00 $38 64
2010 45822 HOSP #2 HOSPITAL #2 $54 55 $54 55 $0 00 $0 00 $54 55
2010 45822 WSMET PK DIST WILLIAM SHORE MET PARK DIST $17 36 $17 36 $0 00 $0 00 $17 36
2010 45822 WEED CONTROL WEED CONTROL $0 82 $0 81 $0 00 $0 00 $0 82
2010 45822 TOTAL. $1144.47 $1144 44 $0.00 $0.00 $1144 47
2009 633482008 ST SCH STATE SCHOOL $286 94 $286 93 $0 00 $0 00 $573 87
2009 633482008 CC -GEN COUNTY $145.21 $145.21 $0 00 $0 00 $290 42
2009 633482008 PORT PORT $20 57 $20 57 $0 00 $0 00 $41 14
2009 633482008 PORT ANG PORT ANGELES $318 51 $318 53 $0 00 $0 00 $637 04
2009 633482008 SD #121 SCHOOL DISTRICT #121 $354 84 $354 85 $0 00 $0 00 $709 69
2009 633482008 NTH OLY LIB NORTH OLYMPIC LIBRARY $42.19 $42.20 $0 00 $0 00 $84 39
http. /vpn.clallam.net 8084 /propertyaccess /Property aspx ?cid =0 &year 2010 &prop_id =6 10/14/2010
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BUILDING DIVISION
CITY OF PORT ANGELES
* *
Correction Notice
"
Job Located at ( ( (9 cf
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Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
72-~ ~ S
l-LD lCt~)' Lot!-lL '--
tJ~c;- TWas'~ ~~
(~~pr.r
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These corrections must be made and are not to be
covered until reinspection is ma e. When correctio
have been made, please call __ L
for inspection.
Date Ifl30/0ff
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Inspector for Building Division
DO NOT REMOVE THIS TAG
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Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
08-00000289 Date
222393
1104 CATHLEEN ST
06-30-01-7~7-0050-0000-
ELECTRICAL ONLY
3/11/08
RS9 RESDNTL SINGLE FAMILY
o
Owner
Contractor
Glenn Terra, INC>
136 e 8 st #223
PORT ANGELES
OWNER
WA 98362
Permit ELECTRICAL NEW RESIDENTIAL
Additional desc
Permit pin number 122309
Permit Fee 35.00 Plan Check Fee
Issue Date 3/11/08 Valuation
Expiration Date 9/07/08
Qty Unit Charge Per
1. 00 35.0000 EC EL-LOW VOLTAGE
.00
o
CY
L
Extension
35.00
~
~
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~
7
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35.00 35.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 35.00 35.00 .00 .00
~
SPECTION ELECTRICAL
TYPE DATE: RESULTS: INSPECTOR:
DITCH
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CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
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
07-00001237 Date 11/05/07
081684
1104 CATHLEEN ST
06-30-01-7-7-0050-0000-
GLENN-TERRA, INC.
FIRE SPRINKLER SYSTEM
RS9 RESDNTL SINGLE FAMILY
2700
Owner
Contractor
GLENN-TERRA, INC.
136 E. 8TH ST. #223
PORT ANGELES WA 98362
(360) 565-0100
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
113985
50.00 Plan Check Fee
11/05/07 Valuation
5/03/08
.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
~
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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 examimrl 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
th provisions of any state or local law regulating the work specified in the permit.
~~
Signature of Owner (if Owner is builder)
Date
., .,' ,t '7l't:t' 1
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FIRE PERMIT INSPECTION RECORD
~
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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 \-n-O~ KDtJ
FIRE ALARM
Rough-in inspection
Alarm final
LP-GAS Completed by Contractor:
Underground piping inspection/pressure test Test # 1
Above ground piping inspection/pressure test Piping pressure test pSI
Tank (container) inspection Time initiated
Test #2
Appliance inspection Piping pressure test pSI
Time initiated
LP-gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final
Inspection Type
I Date Passed I
Comments
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GENERAL COMMENTS:
PORT ANGELES FIRE DEPARTMENT
102 East Fifth Street, Port Angeles, Washington 98362
(360) 417-4650 FAX (360) 417-4659
~(:)1/ ~~ '1;1
Fire Sprinkler System Plan Review
Project Name: Private Residence Address: 1104 Cathleen Street
Installer: Innovated Fire Protection Installer Telephone: 452-7583
Type of System: Open 130 13RO 13D~
Date: 10.31.2007 PAFD Permit #: 07-32
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 of the underground piping is required.
A design sprinkler flow test and alarm test are required for all13D 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: _\&Q",-l'do
Date: lo.~t.o'"7
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Building Department
Fire Department
, ._;' ~.....,'/ -';r ... 7,'"
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BUILDING O-IVISION
CITY OF PORT ANGELES
* *
Correction Notice
Job Located at / !f) 4
tllmuu:d .
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 made. When corrections
have been made, please call LI/'7 - ~P/r-
for inspection.
Date /{)1~-~7
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BUILDING PERMIT - APPLICATION
FCJ!~ OFFICIAL USE ONLY:
Dalt !(ec.:JO -2. Lt:.Q]
l'cnnilll Of - \731
Dal~ )'.ppro\'ec:
Dale Issued:
Fill out COMJ'LETEL Y and in INK. Your application and site plan MUST BE
COMJ'LETE to he accepted for ,'eview, If you have any questions, caU
PERMITS (.160) 417-4815 FAX(360)417-4711
Applicant or Agent: i v\.c e. 'V\ ~ .e.., ++0.. Q..r
-- .-:"" ;;:J
Owner: G J.Q, '^ '-'\.. 1..Q. V' 'If' ~ .l- k C- Phone:
Address: / J b ~ e + '-"'- .s i- #223 City: P (}.r of /) ~ e- {e.J'
ArchitectfEngineer: Phone:
Contractor INAI{)'U/f-/;{;jJ r/ ~ State License #:IN./VtJUf-sal.{4fJ1-. Exp: J'/hl"e- Phone: YS'-2-7S9.1
Address:8/ N-€,..LJ Ha...vQ.",,- LV\. City: P~.r.J /J-""-J,~/0 Zip: 9S36"2-
PROJECT ADDRESS: I J () 1-1 CQ.+~ 1.e...R..'-"'.. S +-""~lLt ZONING:
S'
Phone: LfS2.-7~83
Zip: 98-3 G 2.
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
TYPE OF WORK: SIZE/VALUATION:
I'Residential 0 New COliStr. 0 Re-roof 0 Stove SF. @$ /SF. = $
o Multi-family 0 Addition 0 MoveD Garage SF. @$ /SF. = $
o Commercial 0 Remodel 0 Demolition 0 Deck SF. @ $ /SF. = $
o Repair 0 Sign 0 Other TO;(AL VALUATION $ 2. 70'0 ( 0 C)
BRIEF DESCRll'TION OF THE PROJECT: :r ,---,y 1'1. J ( i-:\r'e s p Ytt~/<l JV' .s '7~ I- e VI.A-. ,
COMMERClAL/RESIDENTlAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft
Construction Type:
=TOTALSq.Ft J 7S Lf
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
ESAlWetIand(s): 0 Yes oNo SEPA 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 417-4815 for assistance.
PLAN CHECK FEE: IT 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.
EXPffiA nON 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 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 itis my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits prior to work.
nFORMSlBIdg}'"",,;"_wpd Applicant tJ~ fj~
Date: / cJ /'2. 2- / (j 7
, t
.".,~.
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
121 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
07-00000535 Date
671920
1104 CATHLEEN ST
06-30-01-7-7-0050-0000-
GLENN-TERRA INC.
RES NEW SFR
7/15/07
RS9 RESDNTL SINGLE FAMILY
146055
Owner
Contractor
GLENN-TERRA INC
136 E. 8TH ST. #223
PORT ANGELES
(360) 565-0100
Other struct info
GLENN-TERRA, INC.
136 E. 8TH ST. #223
WA 98362 PORT ANGELES WA 98362
(360) 565-0100
TOTAL % LOT COVERAGE 27.00
CONSTRUCTION TYPE V-N
NUMBER OF STORIES 2.00
LOT SIZE 9238.00
PROPOSED LOT COVERAGE 2428.00
TOTAL LOT COVERAGE 2428.00
NUMBER OF UNITS 1.00
-
--
CY
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Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
EL. SVC. 1860 SQ FT SFR
106492
ELECTRIC SERVICE
113.00
7/15/07
1/11/08
Plan Check Fee
Valuation
.00
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Qty
1. 00
2.00
Unit Charge Per
69.0000 ECH
22.0000 5C
EL-R-SQFT FIRST 1300
EL-R-SQFT ADDITIONAL 500
Extension
69.00
44.00
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).
OS/25/2007 03:44 PM SROBERDS --The proposal will result
i a new sfr in the RS-9 for total lot coverage of 27%. No
land use issues anticipated.
Electrical load calculations and elctrical permits are
required.
Customer electrical connection fee: $713.00.
05/17/2007 01:51 PM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
~
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
1000.00
4.50
COMMENTS/ ACTION NEEDED
ELECfRlCAL PERMIT INSPECflONRECORD
.-
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 ACCEPTED COMMENTS
YES NO
UITCH
Rlll J{~l-I-LN I CUYbK
SERVICE
FINAL
GENERAL COMMENTS:
PW.lI02.1' (4'96)
d'''.'~
$ti~~
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~~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:121 EAST 5TH STREET. PORT ANGELES. WA 98:\62
..
~
Application Number
Application pin number
07-00000535
671920
Page 2
Date 7/15/07
Other Fees
PW WATER SYSTEM USE FEE
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
COMMENTS/ACTION NEEDED
ELECfRlCAL PERMIT INSPECfION.RECORD
J
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 JOB SITE
~
INSPECTION TYPE
DATE
COMMENTS
NO
GENERAL COMMENTS:
PW.1101.U (4196]
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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
07-00000535 Date
671920
1104 CATHLEEN ST
06-30-01-7-7-0050-0000-
GLENN-TERRA INC.
RES NEW SFR
6/27/07
RS9 RESDNTL SINGLE FAMILY
146055
Owner
Contractor
GLENN-TERRA INC
136 E. 8TH ST. #223
PORT ANGELES
(360) 565-0100
Other struct info
GLENN-TERRA, INC.
136 E. 8TH ST. #223
WA 98362 PORT ANGELES WA 98362
(360) 565-0100
TOTAL % LOT COVERAGE 27.00
CONSTRUCTION TYPE V-N
NUMBER OF STORIES 2.00
LOT SIZE 9238.00
PROPOSED LOT COVERAGE 2428.00
TOTAL LOT COVERAGE 2428.00
NUMBER OF UNITS 1.00
Permit PUBLIC WORKS RES WATER SERV
Additional desc 3/4" DROP IN METER
Permit pin number 103614
Permit Fee 230.00 Plan Check Fee
Issue Date 6/08/07 Valuation
Expiration Date 12/22/07
.00
146055
Qty Unit Charge Per
BASE FEE
Extension
230.00
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
103622
120.00
6/08/07
12/22/07
Plan Check Fee
Valuation
.00
146055
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).
OS/25/2007 03:44 PM SROBERDS --The proposal will result
i a new sfr in the RS-9 for total lot coverage of 27%. No
land use issues anticipated.
Electrical load calculations and elctrical permits are
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.
Oh
f1~ le-
7
Signature of Contractor or Authorized Agent
Signature of Owner (if owner is builder)
Date
T:\Policies\1102.1SR [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
PW UTILITIES (Engineering Division)
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRlVEW A Y 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. 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:\Policiesll102.15R [1/05]
I.
...<6 ,ORT ~
f,U'~~~
,.
ib. --
~~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 07-00000535
Application pin number 671920
Page 2
Date 6/27/07
Special Notes and Comments
Customer electrical connection fee: $713.00.
05/17/2007 01:51 PM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
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 nof 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 Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\Policies\1102.1SR (1/05]
1
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIVSE
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]
dl'o"-r~",~
t~~
r-&ii
L~
~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
07-533
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant obr, name
Application type description
Subdivision Name
Property Use
Property zoning
Application valuation
07-00000535 Date
671920
1104 CATHLEEN ST
06-30-01-7-7-0050-0000-
GLENN-'TERRA INC.
RES NEW SFR
6/27/07
RS9 RESDNTL SINGLE FAMILY
146055
/104 ('~
t!;~r~
Owner
Contractor
GLENN-TERRA INC
136 E. 8TH ST. #223
PORT ANGELES
(360) 565-0100
Other struct info
GLENN-TERRA, INC.
136 E. 8TH ST. #223
WA 98362 PORT ANGELES WA 98362
(360) 565-0100
TOTAL % LOT COVERAGE 27.00
CONSTRUCTION TYPE V-N
NUMBER OF STORIES 2.00
LOT SIZE 9238.00
PROPOSED LOT COVERAGE 2428.00
TOTAL LOT COVERAGE 2428.00
NUMBER OF UNITS 1.00
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS
3/4" DROP IN
103614
230.00
6/08/07
12/22/07
RES WATER SERV
METER
Plan Check Fee
Valuation
.00
146055
Qty Unit Charge Per Extension
---------------------------------~~~~-=~~------------------------~~
Permit SANITARY SEWER HOOK UP
Additional desc
Permit pin number
Permi t Fee
Issue Date
Expiration Date .
103622
120.00
6/08/07
12/22/07
plan Check Fee
Valuation
.00
146055
(r(\~>>B
4
Qty Unit Charge Per
1.00 120.0000 EA SAN SEWER HOOKUP
~X'
. 120.0
-------------- ----- --
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).
OS/25/2007 03:44 PM SROBERDS --The proposal will result
i a new sfr in the RS-9 for total lot coverage of 27%. No
land use issues anticipated.
Electrical load calculations and elctrical permits are
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"cays 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 construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner Is builder)
T:\Policies\1102.1SR [1/05]
~pORT """
.......O~%~
O~.
~ --
~"'"
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA98362
Application Number
Application pin number
07-00000535
671920
page
Date
2
6/27/07
Special Notes and Comments
Customer electrical connection fee: $713.00.
05/17/2007 01:51 PM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public works prior to back fill of ditch. 24 hour advance
notice is required.
--------------------------------------------------------------~~ ^~ --'--
Other Fees . . . . . . . . . SEWER SYSTEM DELV CHARGE ~ .
STATE SURCHARGE ~
PW WATER SYSTEM USE FEE 1230.00
-----------------------------------------------------------,-- ------ ------
Fee summary Charged Paid Credited Due
Permit Fee Total
plan Check Total
Other Fee Total
Grand Total
350.00
_00
2234.50
2584.50
3$0.00
_00
2234.50
2584.50
.00
.00
.00
_00
_00
_00
_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-Clays after the work as commenced, or if required inspections have not been requested within 180 days from. the last
inspoction. 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\11 02.15R [l/05J
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date 1- (5- 07
Time
Location of Work to be inspected ~J 0 '-f
Name of person requesting inspection C::J" eq
.....J
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing
J--
. . . . .
Received by
RV
(phone, person)
o A tV\,lQQ.,'A S-r
Phone No. '17( - I At...";>
Permit No. 0 7- >s~
Final~ther
INSPECTION NOTES:
Inspected: Date 7 -17 ~ 07 Time
Remarks: /VQ,lAJ c.,Ql.l).e1l'- <:.-=Vlcv1..<E:("".'f,'a.,..
/o:lev-o.../ 0+ '{?t?oe.r-/v J.../I7..f?___ -
/ /
By KV
, c/ I ",/ j)//t'l
e. )(-/ c:; T, "'5 ~ , n......
-10
RESTORATION REQUiRED...... YES
rlL
NO ><:
.;-~t.{~~'lv
~'lp c....
t
~
II DLI
., /
N<'.OI'1?"
pV{.
o/"r~1L
~
c-c..\l\"-e.,,,
51
(C.u.\d'L 50.'-.,
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
[] Repaired by Permittee
o No Damage Found
[] Other
Work Order #
o COMPLETE
[] INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
,
~
'I'!":. ~,.~'\' )..'
-"'1;,./ .,...,'1,;'//'-' ,',.1 ,
.(';)1,--,'
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6'
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APPLICATION FOR WATER
City Water Division, Port Angeles, WA
Issued date:
Installed by & date:
Permit # 0 7 -55'S
I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises:
, '
cfjl7l7 Nrrd:- 3c/;(J-6t:;-5-uJDO
sfMailingAddress: /3(4 /-:- P M :z:!,;;:t..:< 7
arcel#: /J cfJ~ () 17 / (<:Jc;-r;
W/O#: nssl ~ c'o I 8'
-I- cJ/ ~ F:toration Required:
F
ij.;? i7TJ
,
Applicant Name & Phone:
Site Address: /10
Blk:
Svc: 0
Remarks:
N
,
"
1\)~
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w
E
q,
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . INSPECTION REPORT. . . . . . . .
/
REQUEST:
Date 1- IB- O~
Time
Received by
RV
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
It () '-( r,o.,ilA lee"" ;;: +
7o.~ Wc:Xb/
Phone No.
Sewer Foundation Framing Chimney Plumbing Final
Permit No. 07 - 53;;;-
Sewer Excav. Other ]Jr.'lle WI
INSPECTION NOTES:
Inspected: Date {- I P..-O ~
Remarks:
Time
By kV
D!<
'>t.
- --
RESTORATION REQUiRED...... YES NO
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
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
!DATEl
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . .
.f
REQUEST:
Date J..{-"2.8 - 08
Time
Received by
~v
(phone, person)
Location of Work to be inspected tJ DY, CAt,^- te..eVl ST
Name of person requesting inspection ::r6S~
Address of person requesting inspection Phone No. a~ - 6 I,,,,,
Type of Inspection (circle appropriate one): Permit No. 07- S35
Sewer Foundation Framing Chimney Plumbing ~ Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date tf-2"A -68 Time
Remarks: SeoA.1~""" 7 - I?- 07
t>,.iveu.J~Y. I-I~-oe
:])~.\ s~,4~ 7-.... Cu..... b
By ~V
o-k
RESTORATION REQUiRED...... YES
NO X
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
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
Of'OIlT~.
......~
.,.,..a
.. --
~;;o>
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
tJ7~4&O
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name'
Property Use
Property zoning .
Application valuation
07-00000460 Date
265140
1104 CATHLEEN ST
06-30-01-7-7-0050-0000-
PUBLIC WORKS UTILITES
~/OI/07
RS9 RESDNTL SINGLE FAMILY
o
.~eA
/ l"
Owrer
Contractor
NEW VIEW INC.
133 MARlAR WINDS
PORT ANGELES
( 36) 477-9449
OWNER
WA 98362
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
RIGHT OF WAY
DRA PROCESSING PRMIT
100560
.00 Plan Check Fee
5/01/07 Valuation
10/28/07
~oo
o
Special Notes and Comments
04/30/2007 11:52 AM RVESS ------------------------------
ORA 2005-1A $954.15 + City Admin $52.05
ORA 2005-1B $615.18 + City Admin $33.57
Other Fees
CITY ORA %
DRA FEES PLUS INTEREST
85.62
1569.33
Fee summary Charged Paid Credited Due.
----------------- ---------- ---------- ---------- ----------
Permit Fee Total .00 .00 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 1654.95 1654.95 .00 .00
Grand Total 1654.95 1654.95 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utililies, private and public improvements. This permit becomes
null and void if work or corstruction 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 granling of a permit does not
presume to give aulhority 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)
.'
~ pORT ~
$.J..O~~~
hiii
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~
'l.&i:lC~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
o
--l
,
U\
0.>
"\
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
GLENN-TERRA INC
136 E. 8TH ST. #223
PORT ANGELES
(360) 565 - 0100
Other struct info
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
6/27/07
07-00000535 Date
671920
1104 CATHLEEN ST
06-30-01-7-7-0050-0000-
GLENN-TERRA INC.
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
146055
Contractor
GLENN-TERRA, INC.
136 E. 8TH ST. #223
WA 98362 PORT ANGELES
(360) 565-0100
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE V-N
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
WA 98362
27.00
2.00
9238.00
2428.00
2428.00
1. 00
BUILDING PERMIT -RESIDENTIAL
1748 SF SFR, 520 SF ATT/GAR
101790
1283.45 Plan Check Fee
6/08/07 Valuation
12/22/07
-
513.38
146055
0-
....(::.
Qty Unit Charge Per
Extension
1020.25
263.20
~
S
-
~
~
BASE FEE
47.00 5.6000 THOU BL-100,001-500K (5.60 PER K)
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
102756
118.40 Plan Check Fee
6/08/07 Valuation
12/22/07
.00
o
fi:
0.5'< '?o/ecfl
('a
~
Qty Unit Charge Per
BASE FEE
1. 00 14.7000 ECH ME- INSTALL 100- FAU
3.00 7.2500 ECH ME-VENT FAN
2.00 10.6500 ECH ME-OTHER APPL. N/R
1. 00 10.6500 ECH ME-GAS PIPE 1 TO 5
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
Extension
50.00
14.70
21. 75
21. 30
10.65
PLUMBING PERMIT
102749
170.00
6/08/07
12/22/07
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
BASE FEE
Extension
50.00
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
On
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Signature of Owner (if owner is builder)
Date
T:IPoliciesllI02_15 building pennit inspection rccord05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
-l\
CALL 417-48]5 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 4] 7-4807 FOR PUBLIC WORKS UTILITIES .
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANJ' WORK BEFORE ",
I1\'SPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT .lOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDA TlON:
FOOTINGS
SHEAR WALLS/WALLS
FOUNDA TJON DRAiNAGE / DOWN SPOUTS
PIERS I
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-TN
WATER LINE (METER TO BLDG)
GAS LlNE FlNAL DATE ACCEPTED BY:
BACJ~ FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR W ALUHOLD DOWNS
WALLS / ROOF / CEILlNG
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILlNG
MECHANICAL
ROUGH-IN
HEAT PUMY lFURNACE/DUCTS
GAS LINE FINAL DATE ACCEPTED BY:
WOOD STOVE / PELLET / CIDMNEY
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SIURTING
PLANNING DEPT. SEPARATE PERMlT#'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LlGHT DEPT
CONSTRUCTION R. W. / PW/ CONSTRUCTION - R.W.
ENGINEERJNG 4 I 7-4807 PW / ENGINEERJNG
FJRE 417-4653 FJRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDlNG
T:\Policies\1102 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, W A 98362
Application Number
Application pin number
07-00000535
671920
Page
Date
2
6/27/07
Qty
13 .00
1. 00
1. 00
1.00
Unit Charge
7.0000
7.0000
15.0000
7.0000
Per
ECH
ECH
ECH
ECH
PL-
PL-
PL-
PL-
EA. FIXTURE ON ONE TRAP
EA. INSTALL WATER PIPE
EA. BLDG SEWER
EA. WATER HEATER
Extension
91. 00
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).
OS/25/2007 03:44 PM SROBERDS --The proposal will result
i a new sfr in the RS-9 for total lot coverage of 27%. No
land use issues anticipated.
Electrical load calculations and elctrical permits are
required.
Customer electrical connection fee: $713.00.
05/17/2007 01:51 PM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
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 1571.85 1571.85 .00 .00
Plan Check Total 513 .38 513.38 .00 .00
Other Fee Total 2234.50 2234.50 .00 .00
Grand Total 4319.73 4319.73 .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\II02_15 building penni! inspection rccord05.wpd [1/4/2005J
Bun,DING PERMIT INSPECTION RECORD
CALL417-4815 FOR BUILDING INSPECTIONS. CALL 4J7-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA H'FUL TO COVER. INSULATE OR CONCEAL ANJ' WORK BEFORE
I1VSPECTED AND A CCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT .lOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION: Jar UF~
FOOTINGS tplJ.r''/o", '\. TLc..
.e; ([,.R "AL~: WALLS c;l)~/07 'fU-
DRAiNAGE 1 DOWN SPOUTS ,
FOUNDA TlON
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING \1.H'~1Z. S () P7~y 1-/10 loq-:ru..
UNDER FLOOR 1 SLAB 8t~\2. l)~AI~S -:r1,olo=1-::!t...\.;
ROUGH-TN
WATER LINE (METER TO BLDG)
GAS LINE FINAL ~~Og DATE JLt,.. ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL II.....b-c1 ""3L-L-
WALLS
CEIUNG
FRAMING 1/- h-O[ :)l...L-
JOISTS 1 GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILTNG
DRYWALL (TNTERlOR BRACED PANEL ONi Y)
T-BAR
INSULATION l , C) -(Yl d"u-
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
ROUGH-TN /l..... lo-ol :fLL..
HEATPU~/FURNACE/DUCTS FINAr'113~ [Oi~ATE -~~C ~
GAS LINE )2/27.....07 PH ACCEPTED BY:
WOOD STOVE 1 PELLET / CHIMNEY
MANUFACTURED HOMES
FOOTfNG 1 SLAB
BLOCKING & HOLD DOWNS
SKJRTfNG
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSI'ECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417.4735 ELECTRlCAL
LiGHT DEPT
CONSTRUCTION R.W. /PW/ CONSTRUCTION - R.W.
ENGINEERlNG 417-4807 PW / ENGINEERlNG
FIRE 417-4653 FIRE DEPT.
PLANNTNG DEPT. 417-4750 PLANNING DEPT.
BUTLDfNG 417-4815 15-z..I--O~ ;JL,.L..- BUILDfNG
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:121 EAST 5TH STREET. PORT ANGELES. WA 91B62
Application Number
Application pin number - .
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00000701 Date
849038
1104 CATHLEEN ST
06-30-01-7-7-0050-0000-
ELECTRICAL ONLY
6/19/07
RS9 RESDNTL SINGLE FAMILY
o
Owner
Contractor
NEW VIEW INC.
133 MARIAH WINDS
PORT ANGELES
( 36) 477-9449
WA 98362
ELECTRIC SERVICE
82 DRAPER RD
PORT ANGELES
(360) 452-6424
WA 98362
permi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL TEMPORARY SERVICE
EL. SVC./ 60A TEMP
104638
ELECTRIC.SERVICE
40.00 plan Check Fee
6/19/07 Valuation
12/16/07
.00
o
-
-
Qty Unit Charge Per
1..00 40.0000 ECH EL-TEMP SRV - 0-60 SRV FDR
Extension
40.00
o
-l:::'
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
ELECfRICAL PERMIT INSPECfION .RECORD
CALL 4 t 7-4735 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
NO
GENERAL COMMENTS:
COMMENTS
PW.II02.1S (4'96] .
.l:;'.
;,;,
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BUILDING PERM!T - APPLICATION
FOR OFFICIAL USE ONLY:
Dale Rec.: 05-14 -07
pe1l11it#:*35
Date Approved: 0
Date Issued: _
COMMERCIALIRESIDENTIAL: Occupancy Group: \"\ ~
No. of Stories:J... Lot Size: q J. 3~ ~ Existing Sq. Ft.
Total lot coverage -:l.. -, %
Fill out COMPLETELY and in INK. Your application and site plan MUS
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711 I
[,ell'. ~(,O 9().I.Qlj33
ApplicantorAgent: {\W\\\\tW N\. lyj,\\-\L.) Phone: 1,b01 <;(/~. 0100
(~ ~I '
\.:fLtl~~.:IHIl...I\ 1Ni Phone: ;'bO-S6s~OIOo
\'~& ~, lj,f-\.- ~l, i:f.ll3 City: ~O\l-1 nNc.IiLr'~ LZip: tstif 9~36d.
~liSI G-IJ Phone: 603-". 61--'-/" c~5r;
. trL~,~NU 'I
Contractor <..rL~N\)-" \~\\\\~ 1-~{,. State LIcense #: cl4J.1J1\ Exp: d,,/,/d-OO~ Phone: 360" {.d.I~ql{n
Address: .~ \3(, t ct,\\.. sll ~>>S City: 90\\\ ~HJ64:L-[L, , I I Zip: ~i )(dl
PROJECT ADDRESS: J\O~ L\\I\\LfOl ST. :ztONlNG:
c (I
LEGAL DESCRIPTION: Lot: -.) Block: Subdivision: 1t-1H~q..r~ fs TATi5
I
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I Exp. Date:
S~E^TALUATION: I
o Stove \1Y1 SF. @$ Ib.OQ /SF. = $
~ Garage S.).u SF. @ $ ~1."31b I /SF. = $
~ ~ ford, Ii{) SF. @ $ \;\.0<\, I ISF. = $
o Other TOTAL VALUATION $
1\3("" {0I\1~1\)..U(..\1-0kJ SFP, I
I
co~truction Type: V N
& Proposed Sq. Ft. "J. J '1 ~lt = TOTAL Sq. Fi:. -;},., \j d- i&
I 11 "I 'f... <;'~Il.. 1'0
;
Owner:
Address:
Architect/Engineer: Su tv " ~ [...
CLALLAM COUNTY PARCEL NUMBER:
Ob 3o~~ (O'::;'(D
0630 0117 0050
Credit Card Bolder Name:
Billing Address:
Credit Card Type VISA
TYPE OF WOrJ(:
~ Residential ~ New Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
City:
Me
#
\ 3 ~) 0 o~. 3 ~
II) 111.60
11~~;L'lO
lY~IO;~.1()..
Occupant Load:
,
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VALVA TION 0 F CONSTRV en ON, In all '""', avalnation amount must b, ,ntmd by tho .Jfli,~nt n.;, figu" will b',,"i,w'd
and may be revIsed by the Bmldmg DlVlSlOn to comply WIth current fee schedules. Contact the Pernnt Coordmator at 417-4815 for assistance.
PLAN CHECK FEE: IFa plan checlcfee is due it musthe:submitted at the time the building permit application and construction plans are
submitted. AU other permit fees are due at the time of permit issuance. I
EXPlRATION OF PLAN REVIEW: lfno permit is issued within 180 days of the date ofapplicati911, 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 Rl 05.3.2
of the International BuildingIResidential Code, 2003). No application can be eA1ended more than oncd.
J hereby certify that J have read nd ex ine this applicatiDn a d knDw the same tD be true and CDrrect. J a1 authorized tD apply for this permit and
understand that it is my respDnsib' ity tD te) ell(' s required ,nDt the City's, and that Just DbtaiA such permits priDr to work.
T:\PoIicies\BL-l102_13.wpd Ap lic . Date: D \ 0 I
I,
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPVVU:
FillE :
OTHER:_
ESNWetlaud(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
\
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Prescriptive Approach - Simple Form
For the Washington State Energy Code (2003 Edition)
Climate Zone 1
S
Address: \ 10 \.{ L 1\ 11\ L~ UJ
City: ,J()\1.1 R~IG6-L,f.;(,
~l
..... '. . . .j" . ..
BuiIdin.gDepartmentUseOn!y' .'
p~r~it:#:'''O~='~3'S' c, ....,...".
'Notes: .. . ....1
Site Information
Lot:
State: ~~
Zip: Qc&3 GJ..
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'!t:, ;..;: :" \ ,"i' ':;:.! i. .', . ,." . ~',;:, ~'.' . '. "~:'.':, ':, '.',-:,"~: ,",-.l.::."" :,:,,,~.:. ,; . 'l~".." ~I t;~ :;" "'<.,. ". :! i. f}
.' "''''''1''.'',''':' . .~. :'. 'F""
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':\;J.\t ;~~i;:,-J~,~ ~~,~;~:~"2~,':.~,:~:~, :,( '.~;~',l:~::;;':~. :,;,i: ~!~. ,: :~,' ;', :i'N,~-f,;.;:)i; ." : .;.~:_.' : r"l:...~.",i ,..',,:.;,!~, ,t;, ~l;! ;_::~t:,.l ;,;_:~.;, :!,\ ",;:1,~ t!j tiT';;,' :.f.i:. i/:"}_I
~ ~;~r;~\::,~.,i;,:'{'!~,;=~~::::: ;;~j~~ !:,~,~'>it,~;;: i,; 1\~:~;~:7~!~ ~i3X.~:,t,~;~/r~}~:: ~ i.t'J ~:,;,~;':t~:~iJ~r::fl:;'!;.~ '.i:;~',~;l~~';.,:)f:,;";:!~'c~; ,.i{:/~;jr!~o':i:/l:i~ ;:::,\:,.i,\~~!f
:.'""7,;::U,,"i','
, : '\'i:! ~f!-:' ,; ':'." -'i' - :~: . ~ "
. '. ; :!. ~ '.' ..
Contact: ~!\,\\)\\CW k\, \'i\l..~\S
Phone:)60- S(,~- 0100
Phone 2:~00 - bd-. \ - qt~ ~ ~r Li~
Fax: ~bO- (,l.S- 0\0\
I" .'
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. ,'_"I.:
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... ,:;.',,: ,i!-.' ,. ";:':~
;';i:J'!-;'; :1:'
'.' ".';.:1
.: -j ~ ~~-ii, j!i(:\,~,
',.J;'h,',
n Imlte azmg J) tlOn ny
Glazing Glazing U-Factor Door9 Wall Wall I Wall SIab4
Option Area 10 u- Ceiling2 Vaulted Above Int4 Ext4 FloorS On
% of Floor V erti cal Overhead II factor Ceiling3 Grade Below Below Grade
I
Grad~ Grade
ill Unlimited 8 e I 18
Group R-3 0.40 0.58 0.20 R-30 R-2j R-IO R-IO
Occupancy
Only
Table 6-1 I .
PRESCRIPTIVE REQUIREMENTS 0,1 FOR GROUP R OCCUPKNCY
CLIMATE ZONE 1 I
(u I' . d GI . O' 0 I )
See the code text for footnote references
This ,project complies with the following:
~ The project is a single family residence or duplex. I
V The project is wood frame OR all of the insulation is interior or exterior of the framing.
. All building components meet the requirements listed in Table 6-1, Option III.
The project will meet all other provisions of the WSEC and VIAQ.
TypE:.
The project will take advantage of the following exceptions to the prescriptive optibn:
o 602.6 Exception 1. One door, that is 24 ft.2 or less, that does not meet the stand~rds is allowed.
Location of the door taking this exception I
o 602,6 Exception 2. Doors with aU-factor df 0.40 allowed without calculations, O~tion III only,
Location of the door(s) taking this exception I
D F . l-h:A+- 'SOQi2.C..E' ( ~O~G1, \:\ \1 \ ~ ~/ L S~ \' ~ \(.,
O~DGI\"'" \' I
Copyrighl2002, WSUCEEP02.056 \ l\ '\ q \\Jt~, \' \ \!"Ll..- ~ \ !\c{
Copied by permission from the Washington State University Extension Energy Program I
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7/26/2004
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CITY OF PORT ANGELES .
PUBLIC WORKS -UTILITIES DIVISION
321 EAST 51H STREET, PORT ANGELES, W A 98362
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Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning .
Application valuation
07-00000460 Date 5/01/07
265140
11 04 CATHLEEN ST
06-30-01-7-7-0050-0000-
PUBLIC WORKS UTILITES
RS9 RESDNTL SINGLE FAMILY
o
Owner
Contractor
NEW VIEW INC.
133 MARIAH WINDS
PORT ANGELES
( 36) 477-9449
OWNER
WA 98362
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
RIGHT OF WAY
DRA PROCESSING PRMIT
100560
.00
5/01/07
10/28/07
Plan Check Fee
Valuation
.00
o
~
-
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......(:
Special Notes and Comments
04/30/2007 11:52 AM RVESS ------------------------------
DRA 2005-1A $954.15 + City Admin $52.05
DRA 2005-1B $615.18 + City Admin $33.57
Other Fees
CITY DRA %
DRA FEES PLUS INTEREST .
85.62
1569.33
~
~
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Fee summary Charged Paid Credited Due.
----------------- ---------- ---------- ---------- ----------
Permit Fee Total .00 .00 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 1654.95 1654.95 .00 .00
Grand Total 1654.95 1654.95 .00 .00
If'
-t
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 Owner (if owner is builder) .
Date
Signature of Contractor or Authorized Agent
Date
T:\Policies\1102.ISR [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 I 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 I I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W./ 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\1 I02.15R [1105]
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Job wired by
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ELECTRICAL WORK PERMIT APPLICATION
DOwner
Installlltioll description ~
o Commercial lI)oo1[esidentlal
E1~to~_k
pureZ \l1ai'i1)~rcss U
C;I>I.J
.k"l)"?....
Telephone number "
Ll- (""' 1..--<.. '-fL"
pre~L:~~"
Address or InspeCClorn
_\ \01..\ ~\.u-.-
cu, \) A
I)hone number to schedule lospecllon:
License nUl1lber Date E~pires
"L\..~c.,,' 3"Wl-
B.J
o New 0 AUered/AddUlon
St3tCllJ.,..
Cfl1' L
""'\
~e~ ~'i a-
(Jwllf':r us de filled by RCW-/9.28.26/:(I) Owner will occupy the structure fur two
years after this electrical permit is finalized. (2) OwmH'is reqllired 10 hire an electric:ul
cuntractor if "boye said pTClperly is for sa/f!, r('"1 or lecU'(!.
Ancr reading the above statement, I hereby certify Lhal I 3m the owner of the above
named properly or a licensed electrical contractor. I am making the clCClrical illstal-
li1lion or alteration in compliance with the electrical laws, N.E.C.. RCW. Chapter
19.28, WAC. Chaptcr 296.469, The City of Port Angeles Municipal Code, and
Utility Sp ificalions.
o Cash 0 Check #
hiscover
o Credit Card Visa ~card
Card# _~-____.________
Signal
onlratlor or @Ieclrical adml senior
x
Dote:"""1
Expiration Date
ofcard
InspeClion fcc
$ //3. era
SaNies Information
Vollage l~v ("'2-.... 0
Pha.old"'fo 3
Service Size: ~
Feeder Size:
rt~
: <4;,1,.;.
Electrical Load Additions and or subtractions
IJ NO LOAD CHANGES
~ J!asaboard KVV
'er'Furnoco IDKw
Cl Heat Pump _ Ton _ LAR
IJ Fan-Wall . KW
Cl Overhead Service
o J.8mp Service
B""'" Underground Service
SAME DAY INSPECTION, CALL BEFORE 1:0tJ AM 360-417-4735
ROUGH-IN THERMOSTAT
7Jf/
Appro~cd lJy
D~IC
App"l~ed By
SERVICE
1l)7/rn ::.J)
'Omfc ~
FEEDER
FINAL
'1-/7-7!~
Omle
~aY
D;C~
AppN~ed By
OlIO
ApplV~ed By
Electrical
Inspector
~
Inspection
Date
Are~, Building or Rqutpmentlnspected
Action Taken
A U
~
.
9/S-d
TTLbLlb:Ol
b2b92Sb
3Jln~35 JI~lJ3l3:WO~~ ~b2:80 b002-[-lnr
ElECTRICAllNSPEClilON
WIRING REPORT
417-4735
PERMIT #
OWNER/CONTRACTOR
'E~~L-
ADDRESS
lZ.vV:::-L"S.
~
APPROVED NOT APPROVED
o .................... DITCH................. ... 0 ~
D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . [fV"' ~
D. . . . . . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . . ~
D. . .. . . . . .. . . . . .. . . . . . FINAL... . . . . . .. . . . ... . . . . 0
CORRECTIONS NEEDED:
,p""oIl,(..-P;: '\)
FA~lE-L
~ ,,-1J. b \)C..\t:rl2-::,
C JJ~ ~ t- <l"s'"A2.Vl.2
W 1l>2...1L. ""r", - J;'lL- 7ti___~ 14 H-J.StPL
~t>N./E.CT7>1L~,., ~ .\....
~ 1><-1 L- '?LA"TE.- ~ADe Il7
L!1>sun...lJ7/C. tr
"
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
,"
OLYMPIC PRINTERS, INC. (360) 452-1381
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fi:
ELECTRICAL WORK PERMIT APPLICATION
o
03
Job wired by
o Electrkal Contractor 0 Owner
Installation description
1:1 Commerdal IlI1 Resld""tlaI
Electrical contractor neme
~\v\e- ~\,,-;{\( ,
Purchaser's mailing address
t'l':,7n F. \1"n, \0\
Ci~ ~J
\tt\- f.\..rv..,PI ,,~ VJA
Telephone ~
) " " 1-"19-\ y
License number Date Expires
Eu.oA\J.~LA\qqDI\)!\l ~"ZlfC1
o New
1:1 A1teredlAddltlo.
S)
-D
State ZIP
Qi\6l.CL
FAX number
I(w \kJHn~':l }\nermoStr4
Premises owner's a.me
G ,-('('W, TtYrC,-
Addre5S of Inspection r .
i I 014 Clt-hIUf\
CI'.\t) (\- ~t;LeJ,.
Pbone Dumber to schedule inspedlon:3~ 4.
Owner as defined by RCW/9.28.26/:0) Ow"er will occupy the structure for ~o
years qfier this electrical permit is finalized. (2) Owner is required to hire an electrical
contractor if above said property is for sale, rent or JN3~ .
After reading the: above statement. I hereby certify that I am the owner of the above
named property or II licensed electrical contractor. I am making the electrical instaJ-
lation or alterntion 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.
SlgD.tore 0 0 De1!le'CtrJ~.1 COli tractor or electrical administrator
X, J); Date:3-t{-0'6
-ls'4'-! "'
Lol6
~.
o Cash 0 Check #
o Credit Cant Visa
Card #
Mastercard
Discover
----------------
Expiration Date
of card
Inspection fee
$ 5,00
ServIce Informatlon
Q NO LOAD CHANG' S
I:lBaseboald KW
Il!I Furnace 1L KW
o Heat Pump _ Ton _ LAR
1:1 Fan-Wall KW
1:1 Overhead Service
1:1 Temp Service
1:1 Underground Service
Voltage
Phase 0 1 1:13
Service Size: _
Feeder Slz.:
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
/ ROUGH-IN r THERMOsTAT " r SERVICE
IJlb-zb7 ~BY } J
'- """ _By J Date "- Dale ApptoYai By
/ r DITCH /" FEEDER
~bjoes FINAL
o.ill -~B)' D~. ApProYed By 0... _8y
Inspection Area. Building or Equipment Inspected Action Taken Electrical
Date Inspector
67~ go "5 ">