HomeMy WebLinkAbout1119 E Park Ave - BuildingIt
Buildingpern'
1119 E Park Aye
13--35S
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . .
Application pin number . . .
'Property Address . . . . . .
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . .
Application valuation . . . .
13-00000358 Date 4/08/13
241720
1119 E PARK AVE
06 -30 -11 -5 -1 -0690 -0000 -
RE -ROOF
UNKNOWN
16917
Owner
------------------------
Contractor
TIKKA SAMUEL J
------------------------
LARRY'S ROOFING
1119 E PARK AVE
352 AVIS ST.
PORT ANGELES
WA 983622740 PORT ANGELES
WA 98362
(360) 452-2215
----------------------------------------------------------------------------
Permit . . . . .
. BUILDING PERMIT - NO PR FEE
Additional desc .
. TEAR OFF SHEET COMP
Permit Fee . . .
. 305.75 Plan Check Fee
.00
Issue Date . . .
. 4/08/13 Valuation . . .
. 16917
Expiration Date .
. 10/05./13
Qty Unit Charge Per
Extension
BASE FEE
95.75
15.00 14.0000
----------------------------------------------------------------------------
THOU BL -2001-25K (14 PER K)
210.00
Other Fees . . .
----------------------------------------------------------------------------
. . . . . . STATE SURCHARGE
4.50
Fee summary
-----------------
Charged Paid Credited
--------------------
Due
Permit Fee Total
--------------------
305.75 305.75 .00
.00
Plan Check Total
.00 .00 .00
.00
Other Fee Total
4.50 4.50 .00
.00
Grand Total
310.25 310.25 .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 app' tion and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be compl' d with ther specified herein or not. The granting of a permit does
not presume to give authority I
to vio ate or cancel the provisions f any s to r local law regulating construction or the performance of
construction.
4� 6-► �m LS -_A� -
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
-- 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 I Date I 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:
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
Rou.qh-In
Gas Line
Wood Stove / Pellet / Chimney
Commercial Hood / Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing / Slab
Blocking & Hold Downs lj
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking / Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date I Accepted By
Electrical 417-4735
Construction - R.W. PW / Engineering 417-4831
Fire 417-4653,
Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
THE`
ti
CITY GFor
Rff'''
Ci5 Use
Cit
ty
CSF ,'�:�
Permit#
Date Received: J S I r 3
321 East 51 Street
Port Angeles, WA 98362
/
/Date Approved =A1/ 4-�
P: 360-417-4817 F: 360-417-4711
permits@cityofpa.us
`
Building Permit Application
Project Address:
i tiA Otter
Main Contact: r-
(ern ot`�5
Phone #
E-Mail:
Property
Name c� k
SOnrYI �
Phone S 4so
J ®
Owner
_ -
MailingAddress �
i
I
Email
City P�-
r
State
Zip��� Z
Contractor
I Name /
I
Phone
Mailing Address 1
Email
CityI
t. }1�
I
State
I Zip ."IDt3( �
Contractor License #.2nrr rGO )
"t
Expiration:
I1-13
Project Value:
I Zoning:
I Tax Parcel #
Lot #
$ i
Type of Residential M Commercial ❑ Industrial ❑ Public ❑
Permit Demolition ❑ Fire ❑ Repair 0
Reroof (tear off/lay over) ❑
For the following, fill out both pages of permit application:
New Construction ❑ Remodel ❑ Addition ❑ Tenant Improvement ❑
Mechanical ❑ Plumbing ❑ Other ❑
Existing Fire Sprinkler System?
Maximum height of structure
Proposed Bedrooms
Proposed Bathrooms
Yes ❑ No ❑
Project
i
Description
I have read and completed the application and know it to be true and correct. I am authorized to apply for this
permit. I understand that it is my responsibility to determine what permits are required and to.obtain permits
prior to working on projects. I understand that the plan review fee is not refundable after plan review has
occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the
permit is issued. I understand that if the permit is not issued within 180 da s of receipt, the application will be
considered abandoned and the fees forfeit.
Date Print Name Signature
Residential Structures
For Office Use
Area Description (SQ FT) Existing Proposed $$ value
Basement
First Floor} '
Second Floor
Covered Deck%Porch/Entry
Deck '
Garage I .
Carport
Other (describe)
Area Totals
Area Descriptions (SQ FT)
Existing Structure (s)
Proposed Addition
Tenant Improvement?
Other work (describe)
Area Totals
1
Footprint (SQ FT) of all Structures:
SQ FT Site coverage (all impervious +
structures)
Commercial Structures
For Office Use
Existing Proposed $$ Value
Lot/Site Coverage Calculations
Lot Size: % Lot Coverage
Mechanical Fixtures
% Site Coverage
Indicate how many of each type of fixture to be installed or relocated as part of this project.
Air Handler Size:
#
Haz/Non-Haz Piping
# of Outlets:
Appliance Vent
#
Heater (Suspended, Floor, Recessed wall)
#
Boiler/Compressor Size:
#
Heating/Cooling appliance
#
repair/alteration
Evaporative Cooler (attached, not
#
Pellet Stove/Wood-burning/Gas
#
portable)
Fireplace/Gas Stove/Gas Cook Stove/Misc.
Fuel Gas Piping
# of Outlets:
Ventilation Fan, single duct
#
Furnace/Heat Pump/ Size:
#
Ventilation System
#
Forced Air Unit
Plumbing Fixtures
Indicate how many of each type of fixture to be installed or relocated
Plumbing Traps # Fuel gas piping # of Outlets:
Water Heater # Medical gas piping # of Outlets:
Water Line # Vent piping #
Sewer Line I # Industrial waste pretreatment #
interceptor
Other (describe):
T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX
PREPARED 4/26/13, 11:50:29 INSPECTION HISTORY REPORT PAGE 1
PROGRAM BP521L 0/00/00 THRU 0/00/00
CITY OF PORT ANGELES
---- — ---- ------------------------ — ----- --------------- — ----- — ------------ -------------
APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID
STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR
------------------------------------------------------------------------------------------------------------------------------------
13 00000358 1119 E PARK AVE '06-30-11-5-1-0690-0000- 063011510690
000 000 BNOP 00 BUILDING PERMIT - NO PR FEE BL99 0001 BLDG FINAL 4/19/13 APPROVED JLL
REQ COMM: April 19, 2013 8:42:32 AM pbarthol.
REQ COMM: Tom 460-0517
RES COMM: April 19, 2013 2:52:29 PM jlierly.
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
TIKKA.SAMUEL J
1119 E PARK AVE
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
05 00000878 Date 9/15/05
208824
1119 E PARK AVE
06 3&1l 5 1 0690 0000
l QWEST
PUBLIC WORKS UTILITES
RESIDENTIAL MEDIUM DENSTY
0
PORT ANGELES WA 983622740
Contractor
OWNER
Permit RIGHT OF WAY
Additional desc UNDERGROUND PHONE SERVICE
Permit pin number 60269
Permit Fee 00 Plan Check Fee
Issue Date 9/15/05 Valuation
Expiration Date 3/14/06
Fee summary Charged Paid Credited Due
Permit Fee Total 00 00 00 00
Plan Check Total 00 00 00 00
Grand Total 00 00 00 00
00
0
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 andl examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction
Signature of Contractor or Authorized Agent Date
T \Policies\ I 102.15R [1/051
Signature of Owner (if owner is builder) Date
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPEI DATE I 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
CONSTRUCTION R.W / PW/
CONSTRUCTION R.W
ENGINEERING
417-4807
PW / ENGINEERING
FIRE
417-4653
FIRE DEPT
PLANNING DEPT
417-4750
PLANNING DEPT
BUILDING
417-4815
BUILDING
T-\Policies\1102.15R [1/05]
DATE ACCEPTED
YES NO
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street— P.O. Bos 1150 / Port Angeles Washington, 98362
Ph: (360) 417-4735" Fax: (360) 417-4711
Date:Z��/
1 & 2 Single Family Dwelling
MAY 2 8 2(
ELECTRICAL
1N P 4'TIOINS
* Pian Review May Be Required Please Complete Electrical Pian Review Information Sheet
Job Address: .///< ' .eT Ai9-R
Building Square Footage:
Description of above
Owner Information
Contractor Information
Name:
Name: —P1,0
Mailing Address:
Mailing Address:
City: State: Zip:
City: Skate: Zip:
Phone: Fax:
Phone: Fax:
License # ! Exp.
License # 1 Exp. -
Item
Unit Charge
Q—ty Total (Otv Multiolied by Unit Charas
Service/Feeder 200 Amp.
$120.00
$
Service/Feeder 201-400 Amp,
$146.00
$
Service/Feeder 401-600 Amp
$ 205.00
$
Service/Feeder 601-1000 Amp,
$ 262.00
$
Service/Feeder over 1000 Amp.
$ 37100
$
Branch Circuit W1 Service Feeder
$ 5,00
$
Branch Circuit W10 Service Feeder
$ 63.00
$
Each Addilional Branch Circuil
$ 5,00
$
Branch Circuits 1.4
$ 75.00
$
Temp. Service/ Feeder 200 Amp,
$ 93.00
r - $ `
Temp. Service/Feeder 201.400 Amp.
$110,00
$
Temp. Service/Feeder 401-600 Amp.
$149,00
$
Temp. ServicelFeeder601-1000 Amp .
$168,00
$
Portal to Portal Hourly
$ 96.00
$
Signal Circuit) Limited Energy -1 & 2 Family Dwelling
$ 64.00
$
Manufactured Home Connection
$120.00
$
Renewable Electrical Energy - 5KVA System or Less
$102.00
$
Thermostat
$ 56.00
$
Note: $5.00 for each additional T-Stat
NEW CONSTRUCTION ONLY:
First 1300 Square Ft.
$120.00
$
Each Additional 500 Square Ft, or Portion of
$ 40.00
$
Each Outbuilding or Detached Garage
$ 74.00
$
Each Swimming Pool or Hot Tub
$110.00
$
$ ?210.!P— 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 14,05050 regarding Electrical Permit Applications,
Signature o o er, electrical contractor or electrical administrator: Cl Cash �( Check
-�' ❑ Credit Gard 9
x �i _ Dated; ��Jl/ h' 0110112012
l
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . , . 14-00000614 pate 5/28/14
Application pin number 378700
Property Address . . 1119 E PARK AVE REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-11-5-1-0690-0000-
App]ication type description ELECTRICAL ONLY on your exclse tax form
Subdivision Name . . . . . . to the City of Port Angeles
Property Use
Property Zoning . . . . . . . UNKNOWN (Location Code 0502)
Application valuation . . . . 0
-----------------------------------------------------------------------
Application desc
Temp pole
Owner Contractor
TIKKA SAMUEL S
TWETER ELECTRIC
1119 E PARK AVE
423 BLACKHAWK LOOP
PORT ANGELES
WA 983622740
PORT ANGELES
WA 98362
Signature of owner or Electrical Contractor X
(360) 417-1151
G:IEXCHANGEIBUILDING
----------------------------------------------------------------------------
Permit . . . .
ELECTRICAL TEMPORARY SERVICE
Additional desc
.
Permit Fee
93,00
Plan Check Fee
.00
Issue Date
5/28/14
Valuation
0
Expiration Date
11/34/14
Qty Unit Charge
Per
Extenjion
1.00 93.0000
PCH EL -TEMP SRS/ 0-200 SRV FDR
93.00
----------------------------------------------------------------------------
Fee summary
Charged
Paid Credited
Due
Permit Pee Total
93.00
93.00 .00
.00
Plan Check Total
00
.00 .00
.00
Grand Total
93.00
93.00 .00
.00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
! i
ROUGH -LN
FINAL,
lCOMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
Date:
G:IEXCHANGEIBUILDING
�1
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; �/Z3A/-
1 & 2 Single Family Dwelling
SEP 2 4 2[
ELECTRICAL
WSPECTi S
" Plan Review Ma Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address; J11 rC FI ✓rte ��f �A
Building Square Footage; 74nr) _<1—
Description of above
;7
/
Owner Information Contractor Information
Name; Name; 'TePcJ���,�/v�
Mailing Address; Mailing Address:
_/•Cts
City; -L24-- State; Zip; 9 City; State; Zip;
Phone: Fax; Phone; 0/-T% Fax:
License 4 / Exp. License 41 Exp.
Item Unit Charge Qty Total [Qtv Multiplied by Unit Chargel
Service/Feeder 200 Amp. $ 120,00
$
ServicelFeeder 201-400 Amp. $146,00 _
$ .
Service/Feeder 401-60C Amp $ 205.00
$
Service/Feeder 601-1000 Amp, $ 262.00
ServicelFeeder over 1000 Amp. $ 373.00
$
Branch Circuit W/ Service Feeder $ 5,00
$
Branch Circuit W)O Service Feeder $ 63.00
$
Each Additional Branch Circuit $ 5,00
$
Branch Circuits 1.4 $ 75.00
$
Temp. Service/ Feeder 20C Amp. $ 93.00
$
Temp. Service/Feeder 201400 Amp. $110.00
$
Temp. Service/Feeder 401-600 Amp. $149.00
$
Temp, Service/Feeder 601-1000 Amp , $168,00
$
Portal to Portal Hourly $ 96.00
$
Signal Circuit/ Limited Energy - T & 2 Family Dwelling $ 64.00
$
Manufactured Home Connection $120.00
$
Renewable Electrical Energy - 5KVA System or Less $102.00
$
Thermostat $ 56.00
$
Note: $5.00 for each additional T-Stat
NEW CONSTRUCTION ONLY:
First 1300 Square Ft. $120.00 f3
$ "iZ'gC)
Each Additional 500 Square Ft. or Portion of $ 40.00
$
Each Outbuilding or Detached Garage $ 74,00
$
Each Swimming Pool or Hot Tub $ 110,00
$
$ OP '- 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 296-4613, The City of Port
Angeles M nicipal Code, and Utility Specifications and PAMC 14,05.050 regarding Electrical Permit Applications.
Signal: of owner, electrical contr to-ror electrical administrator: ❑ Cash 15, Cheek
❑ Credit Card ii
/
Bated; ��� /,�
0110112012
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . .
14-00001145 ]late 9/25/14
Application pin number . , .
409400
Property Address . . , .
1.119 E PARK AVE
ASSESSOR PARCEL NUMBER;
06--30-11-5-1-0690-0000-
Application type description
ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . , , . , , , „
Property Zoning . . . . , . ,
UNKNOWN
Application valuation . . . .
0
----------------------------------------------------------------------------
Application desc
New home
-----------------------------------------------------------------------------
REPORT SALES TALC
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Owner Contractor
------------------------ ------------------------
TIKKA SAMUEL J TWETER ELECTRIC
1119 E PARK AVE 423 BLACKHAWK LOOP
PORT ANGELES WA 983622740 PORT ANGELES WA 96362
(360) 417-1151
----------------------------------------------------------------------------
Permit , , , , , . ELECTRICAL NEW RESIDENTIAL
Additional desc ,
Permit Fee 280.00 Plan Check Fee 0,0
Issue Date 9/25/14 Valuation . , . . 0
Expiration Date 3/24/15
Qty Unit Charge Per Extension
1,00 120,0000 ECH EL-R-SQFT FIRST 1300 120.00
4.00 40,0000 ECH EL-R-SQ?T ADDITIONAL 500 160,00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
Permit Fee Total 280,00 260.DQ .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 280,00 280,00 00 Do
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH 1
SERVICE
ROUGH -IN
� FINAL
COMMENTS:
PERMIT WILT, EXPIRE SIX (6) MONTI-IS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
G:IEXCFIANGEIBUILDING
Date: '
VV/L5/6V14 'THU 14:14 kAX .5bu bt5,i still Air i'lp Hearing ua. j"VUI/VUI
�4
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections RECEIVED
321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711 SEP 2 6 201
Date: 9 A5" 1 a 2 Single Family Dwelling ELECTRICAL
INSPECTIONS
* Plan Review May a Re ired�Ple,�se Co�npleie�Ele�
cal Plan Review Information Sheet
Job Address:
Building Square Foolage:
-_
Description of above
Owner Informations
Contracto Inform 1
Name; . ' / i
/'S I�
Name:
MONA! t at -
Mailln d ess:
City: State: W 4 Zip; 91AG Z.
`t
City:A
S Zip:
Phone 41.0 -yy o •ora ax:
Phone - --Aho •
as 3 -LB" 3 - 377/
License # / Exp.
License # l Exp.
-
.ZS- j (0
Lem
Unit Charge
Qt [
Total (4tv Multiplied by Unit Charnel
ServlcelFeeder 200 Amp.
$120.00
$
ServicelFeeder 201400 Amp,
$146.00
$
ServlcelFeeder 401.600 Amp
$ 205.00
$
Service/Feeder 601-1000 Amp.
$ 262.00
$
Service/Feeder over 1000 Amp.
$ 373.00
$
Branch CircuitVVI Service Feeder
$ 5.00
$
Branch Circuit W10 Service Feeder
$ 63.00
$
Each Additional Branch Cfrcuit
$ 5.00
$
Branch Circuits 1-4
$ 75.00
$
Temp. Service/ Feeder 200 Amp.
$ 93.00
$
Temp. Service/Feeder 201-400 Amp.
$110.00
$
Temp. ServI&Feeder 401.600 Amp.
$149.00
$
Temp. Service/Feeder 601-1000 Amp.
$168.00
$
Portal -to Portal Hourly-..... .. ...... ....
..........$._9600.... ........
_.._-.,...._..
$-,.._.w. ._...,.........._.._...... ......,....
Signal Circuill Limited Energy -1 & 2 Family Dwelling
$ 64.00
$
Manufactured Home Connection
$120.00
$
Renewable Electrical Energy - 5KVA System or Less
$102.00
$—
Thermostat
$ 56.00
�_
$
Note: $5,00 for each additional T-Stat
NEW CONSTRUCTION ONLY:
First 1300 Square Ft,
$120.00
$
Each Additional 500 Square Ft. or Portion of
$ 40.00
$
Each Outbuilding or Detached Garage
$ 74.00
$
Each Swimming Pool or Hot Tub
$110.00
$
$ . �6 %� 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 n arced property or a licensed electrical contractor. I am making
the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC Chapter 296-468, The City of Pori
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
&ignature of caner, electrical contr ctor r electrical administrator; ❑ cash ❑ check
/-Xredit Card q
x r fated: / �JS7 - _ 0110112012
r
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-41.7-4735 .
Application Number . . . . 14-00001154 Date 9/26/14
Application pin number . . . 170852
Property Address . , 1119 E PARK AVE
ASSESSOR PARCEL NUMBER: 06-30-11-5-1-0690--0000-
Application type deaCription ELECTRICAL ONLY
Subdivision Name . , . . . .
Property Use
Property Zoning . . . . UNKNOWN
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
T -stat
----------------------------------------------------------------------------
Owner Contractor
TIKKA SAMUEL S AIR FLO HEATING CO INC
1119 E PARK AVE 221. W. CEDAR
PORT ANGELES WA 983622740 ,SEQUIM WA 98382
(360) 683-3901
--- 7 i ---------
-- - --- - -----------------
Permit . , , . , , ELECTRICAL ALTER RESIDENTIAL
Additional desc ,
Permit Fee 56.00 Plan Check Fee 00
Issue Dare 9/26/14 Valuation . . , . 0
Expiration Date 3/25/15
Qty Unit Charge Per Extension
1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
Permit Fee Total 56;00 56.00 .00 00
Plan Check Total 00 .00 .00 00
Grand Total 56.00 36.00 .00 .00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE: RESULTS:
INSPECTOR: 1
DITCH
SERVICE
1
ROUGH -IN
, 1 J ' ( 4�7
1
*7
FINAL
5b�`➢
COMMENTS:
I
PERMH WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor_ X Date:
G:IEXC14ANGEWILDING
all