HomeMy WebLinkAbout1210 E Front St C - BuildingELECTRICAL PERMIT
1210 E FRONT ST C
12 -026
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
fO iri j
cg,Fr
144" 7
FINAL
fO‘311 f
CW
COMMENTS:
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
TI improvement 1 circuit
Owner
WINGED INVESTMENTS
367 WALKABOUT WAY
PORT ANGELES
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Permit Fee Total
Plan Check Total
Grand Total
WA 98363
Fee summary Charged
12- 00000026
947842
1210 E FRONT ST C
06-30-00-7-1- 0100 -0000-
ELECTRICAL ONLY
COMMERCIAL ARTERIAL
0
Contractor
APS ELECTRIC
546 BENSON RD.
PORT ANGELES
(360) 452 -6753
ELECTRICAL ALTER COMMERCIAL
74.00
1/11/12
7/09/12
Qty Unit Charge Per
1.00 74.0000 ECH EL -COMM BRANCH CIR WO /,S /F
74.00
.00
74.00
Paid Credited
74.00
.00
74.00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
Plan Check Fee
Valuation
.00
.00
.00
Date 1/11/12
WA 98363
Due
Extension
74.00
.0 0
.00
.00
.0 0
0
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
FROM A.P.S. ELECTRICAL CONTRACTOR FAX NO. 360 452 6753 Jan. 10 2012 08:03AM P1
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division /Electrical Inspections
321 East Fifth Street P.O. Box 1 150 Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Dater -ate 1a Mufti- Family
Plan Review May Be Recited, Please Complete glectricil Plart Review 19formation Sheet
Job Address: __19.1 S1 ra u 11 L
Building Square Footage:
pesaiption of above
Owner info oration
Name: nQ 0. d/ <1 it EST/1'1Q
Mailing Address
City: State: Zip
Phone. ,fax:
license I Exp.
Service/Feeder 200 Amp.
Service/Feeder 201.400 Amp.
Service/Feeder 401 -600 Amp
Service/Feeder 601 -1000 Amp.
SenricelFeeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit WiO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1.4
Temp. Service' Feeder 200 Amp.
Temp. Service/Feeder 201 -400 Amp.
Temp. Service/Feeder 401.600 Amp.
Temp. Service/Feeder 601 -1000 Amp
Portal to Portal Hourly
Sipn1ONline lighting
Signal Circuit/ Limited Energy Multi
Signet Circuit/ limited Energy First 1500 sf Comnsarclal
Note: 55.00 for each additional 1500 sf
Renewable Electrum! Energy 5KVA System or Less
Thermostat
Note: $5.00 for each additional TStat
Unit Charlie
5132.00
160.00
5 225.00
288,00
410.00
5.00
74.00
5.00
86.00
5102.00
121.00
164,00
$185.00
96.00
5 88.00
5 64.00
96.00
$113-00
56.00
3 r Lt 1. ‘,P1''-4 mod: 1- e P-C
UV
/JAN 1 0 2011
ELECTRICAL
INSPECT /O,
L' or raglan= i► It111 m
Contractor Infprr1at n CA
Name: •t"- /2Gt�1
Mailing Address:
City: S'hate Zip
Phone: ,,,._Fax:
license Exp.
Owner as defined by RCW19.28.261: (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 saki 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 296468, The City of Port
Angeles Municipal Code. and Utility Specifications and PAMC 14.05 -050 regarding Electrical Permit Applications.
Signature of owner, electrical contractor or electrical administrator: cam Check
TotalAty Multiplied by Unit ChameJ
5
S•
`I z►O
e,O Total
01/0tr2012
0 (1S
ELECTRICAL PERMIT
121OEFRONTST-C
12 -1296
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
it JLJ) jI^Z__
W
ili tlf
FINAL
J
t�
l
c�
COMMENTS:
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Seperate circuits from 2 dif. services
Owner
WINGED INVESTMENTS
367 WALKABOUT WAY
PORT ANGELES
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc SEPARATE CIRCUITS
Sub Contractor APS ELECTRIC
Permit Fee 79.00 Plan Check Fee
Issue Date 10/03/12 Valuation
Expiration Date 4/01/13
Qty Unit Charge Per
1.00 74.0000 ECH EL -COMM BRANCH CIR WO/ S/F
1.00 5.0000 ECH EL -ECH ADDNT BRANCH CIRCUIT
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
WA 98363
Charged
79.00
.00
79.00
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
12- 00001296
102800
1210 E FRONT ST C
06-30-00-7-1- 0100 -0000-
ELECTRICAL ONLY
COMMERCIAL ARTERIAL
0
APS ELECTRIC
546 BENSON RD.
PORT ANGELES
(360) 452 -6753
Paid Credited
79.00
.00
79.00
Contractor
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
.00
.00
.00
Date 10/03/12
WA 98363
Due
Extension
74.00
5.00
.00
.00
.00
.00
0
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
V)
fi
FROM A.P.S. ELECTRICAL CONTRACTOR FAX NO. 360 452 6753 Oct. 02 2012 09:24AM P1?'
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division /Electrical Inspections
321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date: I ct a Multi. Family o
Plan Review May Be Required, Please Compl Electrical Plan Review Information Street
Job Address:
Building Square Footage:
D tion of above
Owner Infon9ation
Name: 'gU 11T M
Mailing Address: .(71 w ttlw
City: SM.. State: Zip:
Phone: Fax:
License 1 Exp.
IBM
Service/Feeder 200 Amp.
Servlce/Feeder 201.400 Amp.
ServicelFeeder 401-600 Amp
Service/Feeder 601 -1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/ Feeder 200 Amp.
Temp, Service/Feeder 201 -400 Amp.
Temp. Service/Feeder 401 -600 Amp
Temp. Service/Feeder 601 -1000 Amp
Portal to Portal Noudy
Sign/Outline Lighting
Signal Circuit/ Limited Energy —Multi -Family
Signal Circuit/ Limited Energy First 1500 sf Commercial
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy 5KVA System or Less
Thermostat
Note: $5.00 for each additional T-Stat
Unit Charge
132.00
160.00
225.00
288.00
410.00
5.00
74.00
5.00
86.00
102.00
121.00
164.00
$185.00
96.00
88.00
64.00
96.00
113.00
56.00
Contractor Information
Name: A 4i S e.me_rp CQ.
Mailing Address:
City:
Phone:
License 1 Exp.
Sti
4
OCT 0 2 2012
ELECTRICAL
INSPECTIONS
State:
Fax:
Zip
Total (Qty Multiplied by Unit Charnel
0110112012
4 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 -46B, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical PermitAppliications.
Signature of owner, electrical contractor or electrical administrator: case chock
ek Creek Care ft_
43 -a-c-,20/0
PREPARED 2/19/10 8 15 53 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/19/10
ADDRESS 1210 E FRONT ST C SUBDIV
TENANT NBR WINGED INVESTMENTS
CONTRACTOR ASM SIGNS PHONE (360) 452 7785
OWNER WINGED INVESTMENTS PHONE
PARCEL 06 30 00 7 1 0100 0000
APPL NUMBER 09 00001349 SIGNS
PERMIT SIGN 00 SIGN
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 2/19/10 JLL
BLDG FINAL TIME 01 00
February 19 2010 8 12 29 AM 1pangrle
MIKE (ASM SIGNS) 452 7785
BLDG FINAL SIGN
(24 SQ FT TENANT SIGN ADDED TO EXISTING F/S SIGN)
AFTERNOON
PLEASE CALL MIKE SO HE CAN MEET YOU THERE
Application Number 09 00001349
Application pin number 044460
Property Address 1210 E FRONT ST C
ASSESSOR PARCEL NUMBER 06 30 00 7 1 0100 0000
Tenant nbr name WINGED INVESTMENTS
Application type description SIGNS
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
WINGED INVESTMENTS
367 WALKABOUT WAY
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
T :Forms/Building Division/Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
WA 98363
COMMERCIAL ARTERIAL
2000
Application desc
24 SQ FT TENANT SIGN ADDED TO EXISTING F/S SIGN
Contractor
ASM SIGNS
1327 E 1ST ST
PORT ANGELES
(360) 452 7785
SIGN
24 SF ADDITION TO F/S SIGN
158725
47 00 Plan Check Fee
12/23/09 Valuation
6/21/10
Qty Unit Charge Per
1 00 47 0000 PER S ALL SIGNS OR TO 25 SF
Special Notes and Comments
December 23 2009 10 08 23 AM sroberds
A Zoning Lot Covenant has been filed such that the site
frontage along the abutting arterial allows 200 sq ft of
free standing signage however only 1/2 of the allowed
signage can be visible from any one location The proposal
will result in 86 sq ft of free standing signage along the
abutting arterial
Charged Paid Credited
Permit Fee Total 47 00 47 00 00
Plan Check Total 00 00 00
Grand Total 47 00 47 00 00
Date 12/23/09
WA 98362
Due
00
00
00
00
2000
Extension
47 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 provisions of any
state or local law regulating construction or the perforri�aa o construction.
2.
2 C� c O
Date Print Name Signature of Contractor or Authorized Agent
Signature of Owner (if owner is builder)
Inspection Type
Date
Accepted By
Parking Lighting
Comments
FOUNDATION.
Date
Accepted By
Footings
Stemwall
Foundation Drainage Downspouts
R.W
PW En•ineerin•
Piers
Fire
Post Holes (Pole Bldgs.)
417 -4653
PLUMBING
Planning
Accepted by
Under Floor Slab
417 -4750
Rough -In
Building
Water Line (Meter to Bldg)
417 -4815
.2-1 1
Gas Line
Back Flow Water
FINAL Date
AIR SEAL.
Walls
Ceiling
FRAMING
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL.
Accepted by
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
FINAL Date
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
SEPA.
ESA.
SHORELINE.
Parking Lighting
Inspection Type
Date
Accepted By
Electrical
417 -4735
Construction
R.W
PW En•ineerin•
417 -4831
Fire
417 -4653
Planning
417 -4750
Building
417 -4815
.2-1 1
1'5
PLANNING DEPT
Separate Permit #s
SEPA.
ESA.
SHORELINE.
Parking Lighting
Landscaping
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.
T.Forms /Building Division /Building Permit
N
V 1
c`i
(12/23/2009) Linda Pangrle Winged Investments ZLC Page 1'
From Sue Roberds
To Starla Jodoin
Date: 12/22/2009 2 44 PM
Subject: Winged Investments ZLC
CC.
Starla.
Further regarding the zoning lot covenant recorded as 2009 1246555 on 12 18 -09 for Winged Investments, the document combines
two existing parcel numbers into one building site, so I assume you will use one of the existing numbers for the new parcel? It may
be something that can be reviewed more quickly than a newly created lot? We have a permit pending that needs a PNUM to issue
is why the Permit Tech asked earlier today Something you can 'spit out' pretty quickly? The existing PNUMs are 063000710100
and 063000750110
Thanks for your help,
Sue Roberds
Planning Manager
City of Port Angeles, WA
(360) 417-4750
sroberdscityofpa.us
Linda Pangrle
Y
T Forms /Building Division /Sign Permit Application.doc
SIGN PERMIT APPLICATION
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
Applicant or Agent iS C r
Property Owner \r.i tom c- 7
Property Owner's Address 2 io
Contractor /Engineer Ots
Contractor /Engineer's Address t 3 2 6
License oar
vv 1—rM 6.3 e-G3 C
Total sign area ire sq. ft.
+r' e_s
Signature
P
Phone
Phone
e'Q- c c s
Expires
Print in ink
For City Use Only
Date Received
9 ermit r
bate Approved
Project Address 2 o
Business Name j e M42--,i
Parcel Number 063 c50o -1 k p t o Lot
SoI- ei tit ties
0` Gta \t a Count)
Zoning CA
Submit two sets of plans a site plan that includes
Type of sign (wall- mounted projecting freestanding illuminated other
Placement and sq ft. area
How the sign will be securely attached (Engineering specs may be required for freestanding signs)
Separation distance between the bottom of projecting and freestanding signs and the surface below
See "Chapter 14.36 Sign Code of the City of Port Angeles Municipal Code for sign requirements.
Sign Type Brief Description. (Type, location, sq. ft.)
Sign #1 24- F,,, ak.rr C t G
Sign #2
Sign #3
Sign #4
S'7 -4G C16 J
Totals (Unit charges
Unit Charge Quantity multiplied by quantities)
$47 00 x
$85 00 x
$115 00 x
y-1
e.
GRAND TOTAL
Type of Sign
Sign(s)
Valuation -2 ua
All signs less than 25 sq ft.
Wall or marquees, over 25 sq ft.
Freestanding and projecting, over 25 sq ft.
Make Checks Payable to City of Port Angeles
Credit Cards (Except American Express) are accepted
Maximum allowed sign area to sq. ft.
I have read and completed this application and know it to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are
required and to obtain permits prior to working on projects
Date S1 0 1 Print Name 1 A
When recorded return to 2009- 1246555
Page 1 of 2 Protct Covenant
Winged Investments
VN Clallam County Washington 12/18/2 009 02 27 04 PM
1111 In 11110 11471:101K fig rill Wit Mill II III
W ■..,4.`1
s ‘A/A- c 5 3G.=
ZONING LOT COVENANT
I /WE the undersigned owner(s) of the following described property
(Insert legal description and parcel number here)
o. ►a0
c3cc. 3E 0
s vZ- A
do hereby covenant that said property shall be designated as one zoning lot as defined in Section
17 08 130 "Z" of the Port Angeles Municipal Code. This covenant creates_one inseparable
building lot which may only be removed through.compliance with Chapter 58 17 RCW
(subdivision regulations) and /or the City of Port Angeles short subdivision regulations
(Ordinance No 2222, as amended)
This covenant shall be binding on the owner(s), heir(s), assign(s), and successor(s) in
interest and shall be filed with the County Auditor's Office. This covenant is for. the mutual
benefit of said owner(s), heir(s), assign(s), and successor(s) In interest and is for the further
purpose of compliance with state and local land use and building regulations. This covenant may
be enforced by injunction or other lawful procedure and covenant by the recovery of any
damages resulting from non compliance.
DATED this t 'a day of Dec-A!: S 20 09
W i oV
(et C--1P. CN v' 'r 3 VAr4GtE-a_it4 viC'STS`. et'
int Name OL p eaPrint Name llr i∎A S p
(Owner Signature) (Owner Signatu
Phone el 5 2
Phone. 4(1/C' S 8 3
STATE OF WASHINGTON)II111U���
COUNTY OF CLALLAM 0° 11t E RAN �4��
I, Corte'CR.46A`:.ej VI�� lotary Public in and for the State of Washington, do hereby
certify that on this 1 t bday if V i 39 Y 200` personally appeared before me ,4, .,id t,,
,>NvVtY1 6N Jq •S UP 41141 known to me to be the individual(s) described in and
who executed the within ms a Ia$ aklf tllli4o i 'that 1\41e4 signed and sealed the same as TWIN
free and voluntary act and de it'rd t'pt�riY1Wli i n mentioned.
GIVEN UNDER MY HAND A <IV*A1 -.1 this l 4 6 day of TIC 2069.
.C..-k .iri n ta c•t
NOTARY PUI3LIC in and for the State u!
Washington residing t Port Angeles
File Number 01088939DS
EXHIBIT A
PARCEL A )ra j Ooo 7l y �C)
LOTS 1 TO 6 BOTH INCLUSIVE IN BLOCK 1 OF WESTPHALS FIRST
SUBDIVISION TO PORT ANGELES WASHINGTON PER PER PLAT' THEREOF
RECORDED IN VOLUME 3 OF PLATS PAGE 43 RECORDS OF CLALLAM
COUNTY WASHINGTON
PARCEL B. 3 0 C 7 6 0 06 ll 0
LOTS 8 9 10 11 AND 12 IN BLOCK 1 OF LONDON PARK SUBDIVISION
TO PORT ANGELES AS PER PLAT RECORDED IN VOLUME 2 OF'PLATS
PAGE 60 RECORDS OF CLALLAM COUNTY WASHINGTON
SITUATE IN CLALLAM COUNTY STATE OF WASHINGTON
5.5'
EXISTING SIGN
A
B
9'
C
D
6'
8'
3 TENANT SPACES
8'
WINGED INVESTMENTS
1210 EAST FRONT ST
PORT ANGELES
WA 98362
6" SCHED 40
GRADE
FRONT VIEW
BRACKETS SECURED TO CAN BY HALF INCH BOLTS
I DETO POLE
SIDE VIEW
CITY OF PORT ANGELES Constriction Plans
The Issuance of this permit based upon these plans, specifi-
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
plans specifications and other data, or from preventing
building operations being carried on thereunder when in
violation of at codes and ordinances of this jurisdiction.
j Z
Approval Date 2 I3 O4 By .JL
,rte t t sog,)t,i
cIcQ 1
WINGED INVESTMENTS
1210 EAST FRONT ST.
PORT ANGELES
WA 98362
r
INSPECTION TYPE
DATE
RESULTS
INSPECTOR.
DITCH
SERVICE
ROUGH IN
Oto/09
FINAL
2 O Jc 9.
COMMENTS
Application Number 09 00001001
Application pin number 204122
Property Address 1210 E FRONT ST C
ASSESSOR PARCEL NUMBER 06 30 00 7 1 0100 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning UNKNOWN
Application valuation 0
Application desc
Feeder panel and 4 circuits
Owner Contractor
WINGED INVESTMENTS
367 WALKABOUT WAY
PORT ANGELES
WA 98363
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
APS ELECTRIC
546 BENSON RD
PORT ANGELES
PORT ANGELES
(360) 452 6753
Date 9/30/09
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit pin number 154336
Permit Fee 101 75 Plan Check Fee 00
Issue Date 9/30/09 Valuation 0
Expiration Date 3/29/10
Qty Unit Charge Per Extension
4 00 2 0000 ECH EL BRANCH CIRCUIT W /FEEDER 8 00
1 00 93 7500 ECH EL 0 200 SRV FEEDER 93 75
Fee summary Charged Paid Credited Due
WA 98363
Permit Fee Total 101 75 101 75 00 00
Plan Check Total 00 00 00 00
Grand Total 101 75 101 75 00 00
Signature of owner or Electrical Contractor X
Date
FROM A.P S. ELECTRICAL CONTRACTOR
City of Port Angeles Permit Application
Building Division/Electrical inspections
321 East Fifth Street- P.O. Box 1150
Part Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417 -4711
Dater oP. 200T
Dmiption of above Sr is 4.1
}'cos rn) cat ea
Owner information Q.t`4c i d e- Itowl.e. f► Z i nt
Name: L i' n$M TM/ awl'ren%t s
Mailing Address: 3_I I sy �jh
City' PA, (._,r State; Zip:
Phone: 1 4.2 aili Fax: A.T4
License Exp /try
Unit Charge
93.75
$113.75
$160.00
$205.00
$291,25
2,00
57.50
2.00
72.50
86.25
$116.25
$131.25
75.00
69.00
75,00
50.00
50.00
93.75
80.00
86.25
27.50
57.50
$6.25
43,75
FAX NoRL{/EIrLD
SEP 2 9 2009
Signature of owner, electrical contractor or electrical administrator
ELECTRICAL
INSPECTIONS
1 2 Single Family Dwelling
Multi Family o Commercial'
Commercial Ad ibon Alteration Remodel fRepair"
Plan Review Ma$ Be Required, Please Comp! to Electrical Plan Review Inform tion Sh
Job Address;! Z O f a Sr C e,� a n f
Building Square Footage:
Sep 29 2009 08 52AM H P1
Contractor j n €orrr lion
Name: _'1 Y ,S 6f/� f
Mailing Address:
City
Phone:
License Exp.
Total LQty uI lied by Unit charge)
Servioe!Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401$00 Amp.
Service/Feeder 601 -1000 Amp,
Service/Feederover 1000 Amp.
Branch Circuit W/ Service Feeder
ranch Circuit W/O Service Feeder
Each Additional Branch Circuit
/O(
If
State: Zip
Fax:
Temp. Service/ Feeder 200 Amp.
Temp. Service/Feeder 201 -400 Amp
Temp. Service /Feeder 401-600 Amp.
Temp. Service /Feeder 801 -1000 Amp.
Portal to Portal H our l y
fir. Sign/Outline Lighting
Signal Crcuit/ Limited Energy Commercial
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ limited Energy Multi-Femdy Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
Fast 1300 Square Ft.
Each Additional 500 Square Ft or Portion of
Each Outbuilding or Detached (garage
Each Swimming Pool or Hot Tub
Thermostat
$431ifia Total
OWner defiled by RCW.19.28.251: (1) Owner will occupy then 'uetreg for two yeas after this electrical permit is limbed (2) owner isrequked to hire en
einfricai contractor If above sale property is for sale, rent or leas®.
After reading the above statement, 1 hereby certify that 1 we the owner of the above named property or a licensed electrical contractor.1 am making tine electrical
installation or alteration In compliance with the electrical laws, N_EC, RCW. Chapter 19.28, WAC. Chapter 296.463, The City of Port Angeles Municipal Code, and
Utility Specifications.
D Cash
Check J
Credit Card $4 {A6,