HomeMy WebLinkAbout1015 W Hwy 101 - BuildingElectical Permit
1015 W Highway 101
13 -155
INSPECTION TYPE
DATE:
RESULTS:.
INSPECTOR:
DITCH
SERVICE
2,13 )13
`P
IA
r
ROUGH -IN
FINAL
2_`{ /63
W
COMMENTS:
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
200 amp service change
Owner
HIRSCHEL JR HENRY
1015 W HIGHWAY 101
PORT ANGELES
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
1.00 120.0000 ECH
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
WA 983632336
ELECTRICAL ALTER RESIDENTIAL
120.00
2/11/13
8/10/13
120.00
.00
120.00
Signature of owner or Electrical Contractor X
G:\EXCHANGE\BUILDING
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
13- 00000155
660960
1015 W HWY 101
06-30-08-5-8- 1940 -0000-
ELECTRICAL ONLY
COMMUNITY SHOPPING DISTR
0
EL -0 -200 SRV FEEDER
120.00
.00
120.00
Contractor
ELECTRIC SERVICE
82 DRAPER RD
PORT ANGELES
(360) 452 -6424
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Plan Check Fee
Valuation
Paid Credited Due
.00
.00
.00
Date 2/11/13
WA 98362
.00
0
Extension
120.00
.00
.00
.00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Date:
l
0
0
FEB -8 -2013 03:37P FROM:ELECTRIC SERVICE 4526424
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: 2
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 1 u'
Building Square Footage: 'too
Description of above
Owner Info atlon
Name: 4 v` L) a_�
Malting dd 138 w h.
City: V v State: Zi 4 r.
Phone: 7 u"3 Fax:
License 1 Exp.
Service/Feeder 200 Amp.
Service/Feeder 201 -400 Amp.
SeMcelFeeder 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 Clrcults 1-4
Temp. Service/ Feeder 200 Amp,
Temp. Service/Feeder 201-400 Amp.
Temp. ServicelFeeder 401.600 Amp.
Temp. Service/Feeder 601 -1000 Amp
Portal to Portal Hourly
Signal Circuit/ Limited Energy -18 2 Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
Thermostat
Note: $5.00 for each additional T-Stat
NEW CONSTRUCTION ONLY
First 1300 Square FL
Each Additional 500 Square FL or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
X
_'1t2 Single Family Dwelling
�y 1M Wts
Unit Charge
120.00
146.00
205.00
262.00
373.00
5.00
63.00
5.00
75.00
93.00
110.00
149.00
168.00
96.00
64.00
120.00
102.00
56.00
120.00
40.00
74.00
110.00
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two y
to hire an electrical contractor if above said property Is for sale, rent or lease. Perm
After reading the above statement, I hereby certify that I am the owner of the above
the electrical Installation or alteration in compliance with the electrical laws, N.E.C.,
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding
Signature of owner, electrical retractor or electrical administrator:
1
Contractor Infopatlon
N ame: ∎.�c.
Ailing poress• 1 1- V Z l D f'
City: Y p& State: W a Zip: q 113 u
Flione: `-i v"-'b Y Fax
Lcnse /Exp. et. 6 GT S 1 132.0vN
[2:3
TO:4174711
L...
l:'SPECTV.MS
SltC Total fQty Multlotied by Unit Charnel
a
2n Total
P. 1
ars after this electrical permit is finalized. (2) Owner is required
expires after six months of last inspection.
named property or a licensed electrical contractor. I am making
RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port
Electrical Permit Applications.
Cash chedt
Cron cud
0110112012
C!�
1
Application Number 12- 00000962
Application pin number 819958
Property Address 1015 W HWY 101
ASSESSOR PARCEL NUMBER: 06-30-08-5-8- 1940 -0000-
Application type description DEMOLITION
Subdivision Name
Property Use
Property Zoning COMMUNITY SHOPPING DISTR
Application valuation 0
Application desc
REMOVE SHED AND GARAGE
Owner
HIRSCHEL JR HENRY
1015 W HIGHWAY 101
PORT ANGELES
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
Other Fees STATE SURCHARGE
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
7/ -70/, i4(
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
T:Forms /Building Division /Building Permit
WA 983632336
DEMOLITION
REMOVE GARAGE /SHED
50.00 Plan Check Fee
7/30/12 'Valuation
1/26/13
Per
BASE
FEE
Contractor
WASHKE, BRAD J LENA M
1118 MT PLEASANT RD
PORT ANGELES
(417) 3978
Charged Paid Credited
50.00 50.00 .00
.00 .00 .00
4.50 4.50 .00
54.50 54.50 .00
Date 7/30/12
WA 98362
.00
0
Extension
50.00
4.50
Due
.00
.00
.00
.00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
Vulva M ►Z
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 Taws, 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 e performance of
construction.
Date Print Name Signature of Contractor or Authorized Agent Signattre of Owner (if A ner is builder)
Inspection Type
Date
Accepted By
Comments
FOUNDATION:
Electrical
Footings
Stemwall
PW Engineering
417 -4831
Foundation Drainage Downspouts
Fire
Piers
417 -4653
Planning
Post Holes (Pole Bldgs.)
417 -4750
PLUMBING:
FINAL Date
Accepted by
Under Floor Slab
c1.4. 1-
TL..
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
Wall Floor /Ceiling
MECHANICAL:
FINAL Date
Accepted by
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY USE
SEPA:
ESA:
SHORELINE:
Inspection Type
Date
Accepted By
Electrical
417 -4735
Construction R.W.
PW Engineering
417 -4831
Fire
417 -4653
Planning
417 -4750
Building
417 -4815
c1.4. 1-
TL..
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•Fnrmc /RuiIrlinn I7ivisinn /R1 tilrlinn Permit
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Project Address:
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Main Contact:
K.k 1 4)`Z C,- GL L_
lame
Phone
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Property
Owner
yr r� r t o,= ltfN R`( (H,Scf f L
Phone
Mailing Address
y id (A)/ 6 Y S%
Email
City
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State
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Zip
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Contractor
Name
c A- J7 W k
Phone
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Mailing Address
Email
City
State
Zip
Contractor License i p w w C TV 5 B 2__
Expiration:
Project Value:
Zoning:
Tax Parcel
Lot
Type of
Permit
Residential Commercial Industrial Public
Demolition A Fire Repair 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?
Yes No
Maximum height of structure
Proposed Bedrooms
Proposed Bathrooms
Project
Description
)1.._(4,1021_ it A tJ D S' >7 D PG a) PR P RT1
I have read and completed the 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. I understand the plan review fee is not refundable after review has
occurred. I understand that I will forfeit 20% of the review fee if I cancel or withdraw the application before
plan review has occurred. I understand that if the permit is not issued within 180 days of receipt, the
application will be considered abandoned, and the fees forfeit.
Date
r 3°
Print Name
1M kAV Id v,(r-z__
Signature
WA, A 144-4---,-, ,e,
THE
o ORTANGELES
45 W A S H 1 N G T O N. U. S
321 East 5th Street
Port Angeles, WA 98362
P: 360 417 -4817 F: 360- 417 -4711
hcatuzo @cityofpa.us
Building Permit Application
1
For City Use
Permit 1 5(0a
Date Received: 11301
Date Approved: 1 141
0
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,Contractors or Tradespeople Detail Page 1 of 2
Washington State Department of
J Labor Industries
Contractors or Tradespeople Detail
Return to List Start a New Search E Printer friendly
Verify Workers' Comp Premium Status Check for Dept. of Revenue Account
About General /Specialty Contractor
A business registered as a construction contractor with L &I to perform construction work within the scope of its
specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and
carry general liability insurance.
Business and Licensing Information
Name BRAD WASHKE CONSTRUCTION INC
Phone No. (360) 417-3978
Address 11 18 Mt Pleasant Rd
Suite /Apt.
City Port Angeles
State WA
Zip 98362
County Clallam
Business Type Corporation
Parent Company
UBI No. J 602569956
Status I) Active
License No. BRADWWC945BZ
License Type Construction Contractor
Effective Date 1/9/2006
Expiration Date
Suspend Date
Specialty 1
Specialty 2
1/9/2014
General
1) Unused
9 Other Associated Licenses
License Name
BRADWC "981 D2
8 Bond Information
BRAD WASHKE
CONSTRUCTION
H Business Owner Information 9 Hide All
Type
Construction
Contractor
https: fortress .wa.gov /lni/bbip /Result.aspx
Specialty Specialty Effective Expiration Status
1 2 Date Date
General Unused 3/22/2002 3/22/2006
Re-
Licensed
Name Role Effective Date Expiration Date
WASHKE, BRAD J President 01/09/2006
WASHKE, LENA M Secretary 01/09/2006
Bond Bond Company Bond Account Effective Expiration Cancel Impaired Bond
Received
7/30/2012
Contractors or Tradespeople Detail
1 CBIC
5E2990
Until
12/28/2005
Cancelled
$12,000.00 01/09/2006
Name Number
Date
8 Assignment of Savings Information
No records found for the previous 6 year period
9 Insurance Information +J
Insurance Company Name Policy Number Effective
Date
Expiration Cancel Impaired Amount
Date
Date Date
Received
Date
8
7
6
5
4
3
2
North Pacific Ins
Co
North Pacific Ins
Co
NORTH PACIFIC 004168414
INS CO
NORTH PACIFIC
INS CO CO3168414
NORTH PACIFIC 002168414
INS CO
LIBERTY
NORTHWEST INS C01 168414
CORP
AMERICAN
STATES INS CO
C06 168414 .03/20/2012 03/20/2013
CO5168414 03/20/2011 03/20/2012
03/20/2010 03/20/2011
03/20/2009 03/20/2010
03/20/2008 03/20/2009
03/20/2007 03/20/2008
01CG313358 03/20/2006 03/20/2007
4
I $500,000.00 02/13/2012
$500,000.00 03/01/2011
5500,000.00 03/24/2010
$500,000.00 02/24/2009
5500,000.00 02/28/2008
5500,000.00 03/12/2007
5500,000.00 02/21/2006
8 Summons /Complaint Information
No unsatisfied complaints on file within prior 6 year period
U Warrant Information '4
No unsatisfied warrants on file within prior 6 year period
Date Date
Date
Amount
Date
Page 2 of 2
c; Washington State Dept. of Labor Industries. Use of this site is subject to the laws of the state of Washington. Access
Ala. ngton
https: fortress .wa.gov /lni/bbip/Result.aspx 7/30/2012
of P 1'g
110961- I
14 .1C NCO
T.Forms /Building Division /Building Permit
Application Number 08 00001227 Date 9/25/08
Application pin number 780932
Property Address 1015 W HWY 101
ASSESSOR PARCEL NUMBER 06 30 08 5 8 1940 0000
Application type description RE ROOF
Subdivision Name
Property Use
Property Zoning COMMUNITY SHOPPING DISTR
Application valuation 3850
Application desc
TEAR OFF INSTALL COMP
Owner Contractor
HIRSCHEL JR HENRY
1015 W HIGHWAY 101
PORT ANGELES
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
32] EAST 5TH STREET PORT ANGELES, WA 98362
WA 983632336
LARRY S ROOFING
352 AVIS ST
PORT ANGELES
(360) 452 2215
WA 98362
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF /INSTALL COMP
Permit pin number 135335
Permit Fee 123 75 Plan Check Fee 00
Issue Date 9/25/08 Valuation 3850
Expiration Date 3/24/09
Qty Unit Charge Per Extension
BASE FEE 95 75
2 00 14 0000 THOU BL -2001 25K (14 PER K) 28 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 123 75 123 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 128 25 128 25 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 compile with wh= specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions o't y s -local law regulating construction or the performance of
construction
0
Date` Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Inspection Type
Date
Accepted By
Accepted By
Comments
FOUNDATION
Accepted By
Electrical 417 -4735
Footings
Electrical
Stemwall
Construction R.W
PW Engineering 417 -4807
Foundation Drainage Downspouts
Construction R:W
PW Engineering
Piers
Fire 417 -4653
Post Holes (Pole Bldgs.)
PLUMBING
FINAL Date:
Accepted by
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls r
Ceiling J
FRAMING
Joists Girders
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION
Slab r
Wall Floor Ceiling
MECHANICAL.
FINAL Date.
Accepted by
Heat Pump Furnace Ducts
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
RESIDENTIAL
DATE
Accepted By
Commercial
Date
Accepted By
Electrical 417 -4735
Electrical
Construction R.W
PW Engineering 417 -4807
Construction R:W
PW Engineering
Fire 417 -4653
Fire
Planning 417 -4750
Planning
Building 417 -4815
Building
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 417-4807 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 /Building Division /Building Permit
lyP g -24 -io
Applicant or Agent
Property Owner
Property Owner's Address
Contractor /Engineer
Contractor /Engineer's Address
License Ott; fj Q p (q.J.4)
PROJECT ADDRESS
Parcel Number
Project Type Brief Description. ,4 Residential
Check all that apply
New Construction
Commercial
Multi- family Industrial
Addition
-M61)e- faX14)
if)% qu'
Remodel r
Repair ��i 001'4
X Re -roof
Demolition
Heat System Heat pump wood burning stove gas fireplace pellet stove other
Other
Floor Areas
Basement
1 Floor
2" Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures
10
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
BUILDING PERMIT APPLICATION Print in ink
■iL 1.hL
A
ne
For City Use Only
Date Received ZS =Df'
Permit
Date Approved
J i
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
Phone
Phone
Mr= r .s Ph
Expires I
I015 t lob 6)
Lot
Existing (sq. ft.) Proposed (sq. ft.)
ft. Occupancy group
Occupant load
Construction type
TOTAL VALUATION
Zoning
per sq. ft.
sq ft. T Lot size sq. ft. Lot coverage
of bedrooms
of full baths
of half baths
38So
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 detegmjne what permits are required, and to btain s prior to working on
projects.
Date 1 7 0 Print Name IOTA, Signature
'TT
Yrt
FRAM :
FAX N0.
CjTV OF PORT ANGELES PERMIT APPLICATION
Building Division/Eleetrica1 Inspections
321 East Fifth Street —.P.O. Sox 1150 I Port Angeles Washington, 98362
Ph: (360) 4174735 Fax: (360) 417 -4711
Rate. '!� `'
�.a- 'ISin7a Family Dwelling
Mar. 17 2018 11:59AM P1
* Plan Revlew N�Va Required, Please Complete l;lecttu al Plan review Information Sheet
Job Address: 3 t�
'4Y1
BulldN Square Foolage: _ t f o b
Desaiption of Mme
...� ._.. - -
Owner Info tion
9, 5 1; AX V
Contractor Igrn Mott-iU C S +� V 1.
Nam9 r
Name 1 ___ _ _
lJlrtilirv� w t 4.w - A40 I
ct..zfa
MaAi 'a- o , t O'
tiw. - Stelae zip; t-N�
C 1°1- .w
-4,
Phatd— G4 — - FWC
Phone a -C. ex: 4 (. y 7
License # 1 Ex p.
Lioertga # 1 Exp. %.- s-r t l I-% `x. Ohl
Item
Unit Ghame
Total fQty muldolied by Unik q:ome)
Swvice, FwAer 200 Amp.
$120.00
$ .. .
SeMcOeader20140MV.
$146A0
$
5ervicelFeeder401 -WAnV
$245.00
$ - - -. - - -'
SenricalFeeder 601 -1000 Amp.
$ 262.00
.-
SeMcelFeWer over 9000 Amp.
$ 373.00
$
Bmch Circig W! Service Feeder
$ 5.04
Branch Ckctdt W10 Servk a Feeder
$ 63.00
S
Each Additiorwl Brandt OrCirit
Bmnoh Cimub 1.4
$ 5.00
$ 75.00
$
$?'
Temp. Service! Feeder 200 Arrp.
$ 930
� S
Temp. ServicelFeeder 201400 Amp.
$110.00
$_ -- -. -- — -
Temp. ServiceFeeder40l4M' p.
$1d9.00
$
T". StMV Wff eerier 601 -10Y Amp .
$166.00
$
Portal to Portal Hourly
$ 96A0
S
Signal Circuit! limited Energy -1 & 2 Ferny Dwepirti rg
$ 64.00
Me nufa*md Home C6nnedlon
$120.00
S
Renewable EleftA Energy - $KVA System or teas
$102.00
$
That
$ 56.00
S
Note; $5.00 for sett addital T-Slai
NEW CONSTR
First 13W Square rt
$120.00
Each Additional SW Square Ft or Portion of
$ 40.00
S
Each outbuklbV or Relachad GaMs
$ 74.00
$
Each Swimming Pod or Hot Tub
$110.00
$
S �Total
Owner as defined by RM19.26.261, (1) Owner will ocogy the struture for two years aliter this 4WWC21 permit Is finalized. (2) Owner Is reWlred
to hire an ei(xtr t contras iT above said property is for self}, rent or lease. Pem►it expires attar six rnontfts of last Inspedlen.
After reading the above statement, I hereby certify
that I am the owner of the above named property or a kensed deciical cmtractar. I am making
the electrical installation or mbar lJon in compllattoe with the electrical
laws, N.E.C., RCW. Chapter 19.28, WAG. Chapter 296468, The City of Port
Angeles Munidpal Code, and utility Speckadons
and PAMC 14.05.050 regarding Electrical Perm#Apoi xt 0s.
Slgnawra of own , el l conW r or electrtael adminlatratnr: 11 cash ❑ cr"ar
C1 Cr0&Qffd# ..424
1
a
V
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . , . 14- 00000736 Date 6/24/14
Application pin number . . . 494400
Property Address , . . . , , 1015 W HWY 101
ASSESSOR PARCEL NUMBER: 06- 30- 08 -5 -8 Application type, type, description ELECTRICAL ONLY
Subdivision Name . . , , , .
Property Use . . , , . . ,
Property Zoning . . . , , . . COMMUNITY SHOPPING DISTR
Application taluatign , , . 0
Application desc
4 circuits
Owner Contractor
-- -- -------------- -- - - -- ------------------------
HIRSCHEL JR HENRY ELECTRIC SERVICE
1015 W HIGHWAY 101 62 DRAPER RD
PORT ANGELES WA 983632336 PORT ANGELES WA 98362
(360) 452 -6424
Permit . , . , ELECTRICAL ALTER RESIDENTIAL
Additional desc 1 -4 CIRCUITS
Permit Fee , , _ 75.00 Plan Check Fee ; 00
Issue Date . , , , 6/24/14 Valuation . , . . 0
Expiration Date . , 12/21/14
Qty Unit Charge Per Extension
BASE FEE 75,00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 00 00
Plan Check Total 00 .00 .00 .00
Grand Total 75,00 75,00 .00 .00
REPORT SALES TAX
on your excise fax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS.
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAEXCHANGEIBLIILDING
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