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Home My WebLink About2140 W 4th St - Building J oF b CITY OF PORT ANGELES `IWO PUBLIC WORKS UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00000580 Date 6/24/11 Application pin number 658680 Property Address 2140 W 4TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 00- 9- 4- 0030 0000- on your state excise tax form Application type description PUBLIC WORKS UTILITES Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Plow Bore phone service, RCP# 11 -20 Owner Contractor PARKS, STEPHANIE EXCEL UTILITIES CONSTRUCTION 1573 Doe Run Rd. 54 W..MISTY LN SEQUIM WA 98382 PORT ANGELES WA 98362 (360) 582 -9668 (360) 452 -1110 Permit RIGHT OF WAY Additional desc BORE PHONE SERVICE, RCP #11 -20 Permit pin number 187294 Permit Fee 150.00 Plan Check Fee .00 Issue Date 6/14/11 Valuation 0 Q Expiration Date 12/11/11 9.� Qty Unit Charge Per Extension r 1.00 150.0000 ECH RIGHT OF WAY PERMIT 150.00 Special Notes and Comments Applicant responsible for surface restoration, erosion control, and any necessary traffic control. Bury depth per attached detail. Contractor to saw cut the asphalt one foot beyond the trench opening on each side prior to patching. Fee summary Charged Paid Credited Due Permit Fee Total 150.00 150.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 150.00 150.00 .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 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 auth• o violate or cancel the provisions of any state or local law regulating construction or the performance of construction. ‘'28")) Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T: \Policies \I 102.15 [10 /08] PERMIT INSPECTION RECORD CALL 417 -4831 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 I YES I NO PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. PW/ CONSTRUCTION R. W, ENGINEERING 417 -4831 PW ENG INEERING FIRE 417 -4653 FIRE DEPT. PLANNING DEPT. 417 -4750 PLANNING DEPT, BUILDING 417 -4815 BUILDING T: \Policies \1102.15 [10/08] r CITY OF PORT ANGELES x` DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 12- 00000540 Date 5/10/12 Application pin number 651860 Property Address 2140 W 4TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-9-4- 0030 -0000- Application type description RES ADDITION on your state excise tax form Subdivision Name Property Use to the City of Port Angeles Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 3500 Application desc CONVERT GARAGE TO LIVING SPACE Owner Contractor BOERNER, MARILYN KAY RENOVATION SOLUTIONS LLC 2140 W 4TH ST PO BOX 13 PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 775 -8144 Other struct info HARD SURFACE AREA Permit BUILDING PERMIT RESIDENTIAL Additional desc GARAGE CONVERSION Permit Fee 123.75 Plan Check Fee 80.44 Issue Date 5/10/12 Valuation 3500 Expiration Date 11/06/12 Qty Unit Charge Per Extension BASE FEE 95.75 2.00 14.0000 THOU BL- 2001 -25K (14 PER K) 28.00 Permit MECHANICAL PERMIT Additional desc Permit Fee 64.80 Plan Check Fee .00 Issue Date 5/10/12 Valuation 0 Expiration Date 11/06/12 Qty Unit Charge Per Extension BASE FEE .50.00 1.00 14.8000 EA ME- HEATER(SUSP /WALL /FLOOR -MTD) 14.80 Special Notes and Comments May 9, 2012 4:22:54 PM sroberds. The project will result in enclosure of an attached garage structure to living space. No land use issues. Setbacks are as required. No additional lot or site coverage. Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 188.55 188.55 .00 .00 Plan Check Total 80.44 80.44 .00 .00 Other Fee Total 4.50 4.50 .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 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 .rovisions of any state or local law regulating construction or the performance of construction. v /Z $/v$ Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit F BUILDING 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 Bldgs.) PLUMBING: Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water FINAL Date Accepted by AIR SEAL: Ceiling Ceiling FRAMING: Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab Wall Floor Ceiling MECHANICAL: Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit Its SEPA: Parking Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T /Riiiiriinn nivisinn /Ruilriinn Permit 1 CITY OF PORT ANGELES r DEPARTMENT OF' COMMUNITY &ECONOMIC DEVELOPMENT BUILDING DIVISION c 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number 12- 00000540 Date 5/10/12 Application G pin number 65182 0 Grand Total 273 .49 273.49 .00 .00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 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. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD a PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECT IONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water FINAL Date Accepted by AIR SEAL: Walls Ceiling FRAMING: 571G IY* �L(/ Joists Girders Under Floor (Shear Wall old Downs a' 3" walls oof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab �7 (o' 1' J Wall Floor Ceiling MECHANICAL: Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts 1 FINAL Date 1 (4,10 byJ MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permits SEPA: Parking Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417 -4735 Construction R -W. PW Engineering 417 -4831 1 Fire 417 -4653 Planning 417 -4750 l Building 417-4815 5 �I vv C T•Fnrrns /Ruilrlinn rlivisinn /Ruildinn Permit N N H V H M <:.S W W aq O 0 c H m r o !ice 0 r�'�' rn N tO H U a H W W 4 W v] MOO W \T H F m a a Z V NIMIX oa r z 00 Z Omm H 2 w z z -[�H Horn! o n, H\ W H4 u C 4 F F m 4 off NU. Q TOQ cn�.o H 1 Oa m. fir 5 O V] N H O H O I Cx QI z m r 1 `-b mmac U� 4 mil4 xzm� z a h Ho H q111110 M H •o 0 o A W 3 441 o 1 H U' ,r z W o o N W W O N O W .a l0 w N\ i0 W NA Paoli o0 0, H uia a x z° in in as o 0 w J 0 H W w N u a H H WO a 4 F+F 0 o 0 x a u uu o a,4 a H m m H N H HI N WW 0 H 0 O. 0 d' 0 H 0 0) N r 0 0 0 01 ri N r1 H HI HI a N 0 s-1 s S. C4 N .Li U) O) N U) W .H N -H H ri U H, r-1 HI H Ha H W W •r, .0 o •0 r 0 0 0 0 0) W0) 0)00 W H0 U) a a a a a 0 Z H 7 a N In 01 r 01 r1 r.0 If1 H dH 0) 0) 0 M 0 Z a o 0 0) en rn co W H m H 0 (0 0 co co 1, co d' UI a rl H H H Z H K' CO 0 U Z 0 0) 0 co In d' w d Z Z o H a s X 000100) N ,E w N Cr) Cr) CO HZ£ FCH 1 HZH H 0X H Z Z 00 o) 0 Homo H 0,) 0 00 00 E H )-00 N N 0 N 0 N o N H 0 FC N 0 H- U) CO H Z H� U U gaol H x -x -o0 a CO H H H l U) w )o [i, 1.0 H H ,.o U Z N x .a H H H H H H 0 H 4 i 0 Prq U 0 0 0 H 0 0 U 0 x 4 0 EE- 0 w CO Q 0) >i, 41004 0 m Q Itl 0 w w m m 0H 1 00 0700)041000)000 000 00 0X °0 0 H O 0 0Z 0 >H o CO H a H H O a I, O i a a cr) O 8 cA m Hw a ,40 H AlOP .4. 0)0) Z a h 0< b H 0) HI E- G i .-1 S >Zo o 0 W CO N N N N N N W W 01 N (.1 0) o00mo 0)00 ■4 0H Hr1H LHH H H 0 i4i 2 W i cc) 01 U) 0) H 0 0 )0 0 0 W 4 c0 10 10 0 10 10 O PI Ha 10 io 000 H H H o 0 a H N 0.', fa (X a 0 ul N 01 In In In �,q a 0 to P 0 0.i W C4 w w mu 0) H H H H H IX 0 c0 0 Z E. 0 0 0 0 0 0 0'' o w >H aE-W U.] i Cr) x a) 1 0) 1.10 On a H cn r1 m a m W 0 r.0 O U 0 W< a 0 al w w 0) a 0 E 0 .4. c., BUILDING PERMIT APPLICATION Print in ink 0 CITY OF PORT ANGELES A ttn: Building Permit Technician For City Use Only: Date Received S i i I r a 1 321 E. Fifth St., Port Angeles, WA 98362 Permit ja —54( (360) 417 -4815 fax (360)417-4711 Date Approved 5 7 /7 T LL Applicant R lov /o So C t-t-`roevs Li_....0 Phone t e y Property Owner /14,} 2/ L pti 13 ��Rtl -.2 Phone Property Owner's Address Ll'4 o W 4114 Contractor 5 G. ,-7 r 5iti4,1A5 -fro- Z-e..,,e- .Aare,? S d‘.K� io,,, Phone Contractor's Address y,, ox (3 License K- -CNO ■tJ, b I N Expires E -mail (5con S /Mwt.S/9b/WA PROJECT ADDRESS 214-() \,J 4 5 Parcel Number 0(0 000 a�0 Lot t Zoning Project Type Brief Description: Residential Multi family Commercial Industrial Check all that apply New Construction Addition 0( Remodel cci /off f/a 7xb /4 f i l l 4 'E TAE► f -eve w> vi Repair GM/ eilS1 On O-f 0 (1,rct cJ e b 1 t t-\ 5l�",t.c Demolition cJ c J o Re -roof House garage other tear off re -roof lay over one layer Heat System Heat pump o wood- burning stove o gas fireplace pellet stove other Other Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq. ft. 1 Floor 4r 2 Floor 3` Floor Garage Carport Covered Porch R E C Deck 2 Shed 123°l Other MAY 4 ZUJZ e.g.. t -y. CITY OF PORT ANGELES TOTAL VALUATION P 0 outt INQTYIVI iuiv Total footprint of structures sq. ft. Lot size sq. ft. Lot coverage 'Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage Max. height of proposed structures ft. Occupancy group of bedrooms Will a lawn sprinkler system be Installed Occupant toad of full baths Will a fire sprinkler system be installed? Construction type of half baths have read and completed this application and know it to be true and correct. t am authorized t. .p ly for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to or. u •ro'= s.l Date 5 —`I• 12 Print Name 5'7 T∎SW A t"`� Sig re T:Forms /Building Division /Building permit application Clallam County Assessor Treasurer Property Details 62780 MARILYN KAY BOE... Page 1 of 1 Clallam County Assessor Treasurer Property Search Results 62780 MARILYN KAY BOERNER for Year 2011 2012 Property Account Property ID: 62780 Legal Description: LOT 10 REPLAT OF EDGECLIFF MAP F4 Geographic ID: 0630009400300000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 Open Space: N DFL N Historic Property: N Remodel Property: N Multi Family Redevelopment: N Township: Section: Range: Location Address: 2140 W FOURTH ST Mapsco: PORT ANGELES, WA 98363 Neighborhood: PA Sublots Res Map ID: 3 Neighborhood CD: 5201000 Owner Name: MARILYN KAY BOERNER Owner ID: 142998 Mailing Address: 2140 W 4TH ST Ownership: 100.0000000000% PORT ANGELES, WA 98363 Exemptions: Taxes and Assessment Details Values Taxing Jurisdiction Improvement Building Sketch Property Image Land Roll Value History Deed and Sales History I Payout Agreement Website version: 9.0.32.2200 Database last updated on: 5/4/2012 3:53 2012 True Automation, Inc. All Rights AM Reserved. Privacy Notice http: /websrv8.clallam. net propertyaccess /Property.aspx ?cid =0 &year 2011 &prop_id= 62780 5/4/2012 .6P 11- ''..r, o.‘f ('F r' i 4 ...,•1 rr rt 1 r i a ,1 l':,. r ..'.-:,,,r4,7.. 1 1 2 i: ,,,3 i 5 '1 v, ,L' ‘t•--1.- 1 i ;Z t 1 1 0, -t-- •Lii j 1/2 l k 1- 5. t 1 1 1•4 i f.. 1 3 s 7' 4 „g ,4.,.... 1.1 ‘4 i J.) C .t.„ 0 ,0•1\ •1. 1 3`..,,,,,,,..„--' I li,. .r.---. ,4 7 4,17...- 7 5.•' 4 ..;-1 C 1. k 'k 4 „4,,,,, A „e„-^,-,S1..,„..,:, r.t...t. c •;1• .c., .0 1 (0.1, 1 .C7* 7 L.2. 4 i 1 ''',i 75 7)i 74 t.1 7 ""i 7 11 t.' A.,.; Q° 5:- 1 5. 5 err .1. 0 "s----".r-1 i .0 l tt.:,,•-• .•:.,;r:, 1 ,4 .I4' (4.S.,?=' "f i 1 2— -'In 1 5 IS ..v=;' ..;:e..1c 4.4 ,y '7. ti-r, .5 -...-1 iry ic-:, r.... 01 "i V R Ci C 'V V. rx: Oc ."`5....... ?it G 1,, 7 t, 7-- 0 y ---1 e C_ 40, .4). ,L.,-'. F Z 0 (n) a It g 1 -,7---- co -0 co 1 1 15. g cv •S o to .r. -0 ti4 0 .0 e is-. 2 's 3 t LI P.. .t c% 1 s 1 Z Vs. IS 'S 0 -8 4, 5 5 5 V 0 A M I' r.,,, V ti ---Z I 1 /2 sn max W5, R I7' CUB 2xq 1:J1 set., War/ rit/5 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner PAR STEPHANIE 1573 Doe Run Rd SEQUIM (360) 582 9668 Permit Addifi'onal-desc Permit Tin number Sub. Contractor. Permit Fee Issue Date Expiration Date Qty Unit Charge Per 1 00: Fee summary Permit Fee Total Plan Check Total Grand Total WA 98382 PORT ANGELES (360) 457 9270 ELECTRICAL ALTER RESIDENTIAL SIMPSON/ SUB PANEL•'GARAGE 109207 SIMPSON ELECTRIC 64 00 Plan Check 8/29/07 Valuation 2/25t08 64 00 00 64 00 COMMENTS /ACTION NEEDED CITY OF PORT. ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321 FAST .5TH STREET PORT ANGELES. WA'911362 07 00000961 441418 2140 W 4TH ST 06 30 00 9 4 0030 0000 ELECTRICAL ONLY RS7 RESDNTL SINGLE FAMILY 0 Cont SIMPSON ELECTRIC 24303'6 in 'HWY 101 ..E'L, R 'OR'..RM 0 200' A'LT 'SRV' -FDR Charged Paid Credited 64 00 00 64 00 Date 8/29/07 00 00 00 WA 98363 Fee 00. 0 Due Extension 64 00 .00 '00 '00 DITCH ROUGH IN COVER SERVICE FINAL I GENERAL COMMENTS: ELECTRICAL PERMIT INSPECTION RECORD CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL 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 ACCEPTED COMMENTS YES I NO rw- I 1oi.15 (awl ELECTRICAL WORK PERMIT APPLICATION 01 c"...1 Installation description Job wired by 34 ElectriCal Contractor 0 Owner 1:1 Commercial /V Residential Electrical contractor name License number Date Expires 0 New jilAltered/Addition t; it c: ._/_//1/ 5:Z 73 Jc, (V Purchaser mailing address 3 C tj Dab J City State ZIP 1, C.) 3 l e--- f s i,ii)--. i:, ,Y I 5, 19-krt."? 1:14-%( 1 ii Telephone number FAX number t.] '7.:,2_ 7 b _.7)Hi-ne .S a. r. c 1 .21s.. PremixArwner's name 1 Address of ins 1 c" .2 I ti 0 IA) L I -.f City r. \5-1k Phone number to schedule itispection: '7 c 7 V) Owner as defined by RCW.19.28.261:(I) Owner will occupy the structure fur 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. 0 Cash 0 Check After reading the above statement, Ihereby certify that I am the owner of the above named property or a licensed electrical contractor. 1 am making the electrical instal- 91 Credit Card Visa ,.2 Mastercard Disc wer lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 7 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Card Utility Specifications. Signature of owner, electrical contractor or electrical administrator Expiration Date Inspection fee X\ e /4 4; TL Date: 3/ 7 of card G., 4 °-c- Electrical Load Additions and or ubtractions Service informaton O NO LOAD CHANGES O Baseboard KW Voltage O Fumace KW 0 Overhead Service Phase 0 1 0 3 0 Heat Pump Ton LAR 0 Temp Service Service Size: (,c 1, O Fan-Wall KW 0 Underground Service Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN Date Appmved By FINAL e Da 4. ppl4Q Date Approved By Date Date E THERMOSTAT Date DITCH Approved By Date SERVICE FEEDER Approved By Approved By Inspection Area, Building or Equipment Inspected Electrical ate D Action Taken Inspector 08/07/2007 21 31 4579270 /Installation description Job wired by .a Electrical Contractor Owner 0 Commercial Residential Electrical contractor name Purchaser t mailing address L(3 o3G k 14 /Of AJ City Po e4 -eJes St Lo 9 k3IJ Telephone number FAX number L-15?-9,2.7 0 511 m e PremlKner's name Ear (ry%a/ I vR5 Address s ct op e_ ress o ins c i� f,2 1 1- F O LA) To P-- p, o L Phone number to schedule ttiapection s 7 5 4 4 7 7 C Owner as defined by RCW 19 28.261 Owner will occupy the structure for two years eller this electrical permit is .finalized. (2) Owner is required to hire an electrical contractor if above said properly is for sale, rent 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 1 am making the electrical instal- lation or alteration in compliance with the electrical laws. N.E.C. RCW Chapter 19.28. WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code, and Utility Specifications. /Signet' f I t i of contractor or electrical administrator G 7 rJ Date: g-8---0 7 City 0 owner, c ec r c r Electrical Load Additions and ogubtractions U NO LOAD CHANGES Baseboard KW O Furnace KW U Overhead Service 0 Heat Pump Ton LAP O Temp Service 0 Fan -Wall KW O Underground Service SAME DAY INSPECTION. CALL BEFORE 7 :00 AM 360- 417 -4735 ROUGH -1N THERMOS.IAT Inspection Date AUG 13 2gUi LIGHT DEFT. License nnum G Date Expires //e c_4Rft iThi J gz- 17 j New Ks Dam Approved By One FINAL tkk /�L D e Approver By tuu DIrCH Area, Building or Equipment Inspected SIMPSON ELECTRIC ELECTRICAL WORK PERMIT APPLICATION tr O Cash Check 521 Credit Card Card Expiration Datc of card Apee,,w, l By Approved By "Altered/Addition Sub 1')ILe Q y C.64. I 4 14as a F:. rrrF tS. Dole One Mastercard Discover Voltage Phase 0 1 0 3 Service Size: hid ittrp Feeder Size: SERVICE Action Taken Inspection fee 1 4 2 mice IMgQa Approved by FEEDER Approval By PAGE 01 Electrical Inspector r Application Number Pin number\ Property Address ASSESSOR P CEL NUMBER Applicatio description Subdivision Name Property Use Property Zoning Application valuation Owner McKinsey Floyd 1573 Doe Run Rd SEQUIM (360) 582 9668 Permit Additional desc Permit Fee Issue Date Expiration Date Qty Unit Charge 15 00 Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total Per T•\PLANNING \FORMS \1102.15 [11/14/2003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98382 3 0500 HND 04 00000505 624530 2140 W 4TH ST 06 30 00 9 4 0030 0000 RE ROOF RS7 RESDNTL SINGLE FAMILY 2000 Contractor OWNER BUILDING PERMIT NO PR FEE TEAR OFF FELT COMP 92 75 Plan Check Fee 6/07/04 Valuation 12/04/04 BASE FEE BL -501 2K (3 05 PER C) STATE SURCHARGE Charged Paid Credited 92 75 92 75 00 00 00 00 4 50 4 50 00 97 25 97 25 00 Date 6/07/04 Due 00 2000 Extension 47 00 45 75 4 50 00 00 00 00 oq 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 ore ances governing t type of work will be complied with whether specified herein or not. The granting of a permit does not pr u t• •ive thlOty to "!i•I :te or cancel the provisions of any state or local law regulating construction or the performance of Ia /7 c nstructi• n 11 j4 f 1 A/ 1 0 Signature of Con r. ctor or Authdrized Agnt Date Signature of Owner (if owner is builder) Date 0 E BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN 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 HEAT PUMP GAS LINE WOOD STOVE PELLET CHIMNEY HOOD /DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM 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 I NO ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 I I PW ENGINEERING FIRE 417 -4653 I I I I FIRE DEPT PLANNING DEPT 417 -4750 I I I I PLANNING DEPT I I I BUILDING 417 -4815 I 1(h --7 1Y I E Y O NIPli I BUILDING I I I T• \PLANNING FORMS \1102.15 [11/14/2003]