HomeMy WebLinkAbout1013 Flores St - BuildingW A S H I N G T O N U S A
Community Economic Development Department
September 29 2010
Mr Brian R Flores
1013 Flores St.
Port Angeles WA 98363
Re Permit #09 -317 for the new single family residence
located at 1013 Flores St Port Angeles WA 98363
Dear Brian
Per our discussion this letter confirms that the Certificate of
Occupancy for your new home is your "finaled building permit. The
City of Port Angeles Building Inspector Jim 'Lierly did a final building
inspection approval for your home on 02 -04 -10 (as shown on the
attached building permit inspection record) From our standpoint, the
home has been legal to occupy since 02 -04 -10
Sincerely
Linda Pangrle Permit Technician
360- 417 -4815
Ipangrle @cityofpa us
Phone 360- 417 -4750 Fax: 360 -417 -4711
Website www cityofpa.us Email smartgrowth @cityofpa us
321 East Fifth Street P 0 Box 1150 Port Angeles WA 98362 -0217
PREPARED 2/04/10 8 09 20 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/04/10
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/11/09 JLL BLDG FOUNDATION FOOTING TIME 09 00
5/15/09 AP May 11 2009 8 18 02 AM 1pangrle
BRIAN 460 3877
FOOTING
MORNING
May 15 2009 3 38 48 PM jlierly
BL2 01 5/14/09 JLL BLDG FOUNDATION STEM WALL TIME 09 00
5/15/09 AP May 14 2009 9 07 32 AM 1pangrle
BRIAN 460 3877
STEMWALL
MORNING
May 15 2009 3 40 49 PM jlierly
BL3 01 6/01/09 JLL BLDG FRAMING TIME 01 00
6/03/09 AP June 1 2009 9 45 27 AM 1pangrle
REED 460 4561
UNDERFLOOR
AFTERNOON
June 3 2009 8 30 46 AM jlierly
BL9 01 6/30/09 JLL BLDG SHEARWALL
6/30/09 AP June 30 2009 8 31 30 AM 1pangrle
BRIAN 460 3877
SHEETING
BAIR 01 7/31/09 JLL BLDG AIR SEAL
7/31/09 AP July 31 2009 3 36 21 PM 1pangrle
AIRSEAL
July 31 2009 4 17 20 PM jlierly
BL3 02 7/31/09 JLL BLDG FRAMING
7/31/09 AP July 31 2009 3 36 44 PM 1pangrle
FRAMING
July 31 2009 4 17 20 PM jlierly
BLI 01 8/10/09 JLL BLDG INSULATION
8/10/09 AP August 10 2009 8 48 56 AM 1pangrle
BRIAN 460 3877
INSULATION
August 10 2009 4 49 48 PM jlierly
PUBLIC WORKS FINAL
January 28 2010 2 39 08 PM rvess
January 28 2010 2 39 26 PM rvess
BL99 01 2/04/10 BLDG FINAL TIME 01 00
February 4 2010 8 06 24 AM 1pangrle
BRIAN 460 3877
BLDG FINAL
AFTERNOON
PLEASE CALL HIM 30 MINUTES BEFORE YOU GET THERE SO HE CAN
PW99 01 1/28/10 RV
1/28/10 AP
CONTINUED ONTO NEXT PAGE
PREPARED 2/04/10 8 09 20 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/04/10
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
MEET YOU THERE
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01
2/04/10
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 6/23/09 PS
6/24/09 AP
PL6 01 6/23/09 PB
6/24/09 AP
PL99 01 2/04/10
JLL
MECHANICAL FINAL TIME 01 00
February 4 2010 8 07 39 AM 1pangrle
BRIAN 460 3877
MECHANICAL FINAL
AFTERNOON
PLEASE CALL HIM 30 MINUTES BEFORE YOU GET THERE SO HE CAN
MEET YOU THERE
PLUMBING ROUGH IN
June 22 2009 3 02 22 PM 1pangrle
JOHN 460 6902
ROUGH IN PLUMBING
June 24 2009 9 12 33 AM pbarthol
PLUMBING WATER SUPPLY
June 22 2009 3 02 52 PM 1pangrle
JOHN 460 6902
WATER SUPPLY LINE
June 24 2009 9 12 33 AM pbarthol
PLUMBING FINAL TIME 01 00
February 4 2010 8 08 22 AM 1pangrle
BRIAN 460 3877
PLUMBING FINAL
AFTERNOON
PLEASE CALL HIM 30 MINUTES BEFORE YOU GET THERE SO HE CAN
MEET YOU THERE
COMMENTS AND NOTES
PREPARED 8/10/09 8 57 56 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 8/10/09
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/11/09 JLL
5/15/09 AP
BL2 01 5/14/09 JLL
5/15/09 AP
BL3 01 6/01/09 JLL
6/03/09 AP
BL9 01 6/30/09 JLL
6/30/09 AP
BLDG FOUNDATION FOOTING TIME 09 00
May 11 2009 8 18 02 AM 1pangrle
BRIAN 460 3877
FOOTING
MORNING
May 15 2009 3 38 48 PM jlierly
BLDG FOUNDATION STEM WALL TIME 09 00
May 14 2009 9 07 32 AM 1pangrle
BRIAN 460 3877
STEMWALL
MORNING
May 15 2009 3 40 49 PM jlierly
BLDG FRAMING TIME 01 00
June 1 2009 9 45 27 AM 1pangrle
REED 460 4561
UNDERFLOOR
AFTERNOON
June 3 2009 8 30 46 AM jlierly
BLDG SHEARWALL
June 30 2009 8 31 30 AM 1pangrle
BRIAN 460 3877
SHEETING
BAIR 01 7/31/09 JLL BLDG AIR SEAL
7/31/09 AP July 31 2009 3 36 21 PM 1pangrle
AIRSEAL
July 31 2009 4 17 20 PM jlierly
BL3 02 7/31/09 JLL BLDG FRAMING
7/31/09 AP July 31 2009 3 36 44 PM 1pangrle
FRAMING
July 31 2009 4 17 20 PM jlierly
BLI 01 8/10/09 JLL BLDG INSULATION
August 10 2009 8 48 56 AM 1pangrle
BRIAN 460 3877
INSULATION
COMMENTS AND NOTES
PREPARED 7/31/09 15 37 36 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 7/31/09
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/11/09 JLL BLDG FOUNDATION FOOTING TIME 09 00
5/15/09 AP May 11 2009 8 18 02 AM 1pangrle
BRIAN 460 3877
FOOTING
MORNING
May 15 2009 3 38 48 PM jlierly
BL2 01 5/14/09 JLL BLDG FOUNDATION STEM WALL TIME 09 00
5/15/09 AP May 14 2009 9 07 32 AM 1pangrle
BRIAN 460 3877
STEMWALL
MORNING
May 15 2009 3 40 49 PM jlierly
BL3 01 6/01/09 JLL BLDG FRAMING TIME 01 00
6/03/09 AP June 1 2009 9 45 27 AM 1pangrle
REED 460 4561
UNDERFLOOR
AFTERNOON
June 3 2009 8 30 46 AM jlierly
BL9 01 6/30/09 JLL BLDG SHEARWALL
6/30/09 AP June 30 2009 8 31 30 AM 1pangrle
BRIAN 460 3877
SHEETING
BAIR 01 7/31/09
BL3 02 7/31/09
COMMENTS AND NOTES
BLDG AIR SEAL
July 31 2009 3 36 21 PM 1pangrle
AIRSEAL
BLDG FRAMING
July 31 2009 3 36 44 PM 1pangrle
FRAMING
INSPECTION TYPE
DATE
RESULTS
INSPECTOR.
DITCH
SERVICE
ROUGH IN
7/21 IC
SF
YAP
FINAL
)P-4 IC)
4
Tiip
I
COMMENTS
u
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Heat Pump
Owner
FLORES BRIAN R
1315 S 0 ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
WA 98363
ELECTRICAL
150425
43 75
7/21/09
1/17/10
43 75
00
43 75
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
09 00000722
118232
1013 FLORES ST
06 30 99 1 0 5720 0000
ELECTRICAL ONLY
RS9 RESDNTL SINGLE FAMILY
0
Contractor
Qty Unit Charge Per
1 00 43 7500 ECH EL LVT THERMOSTAT
ALL WEATHER HEATING COOLING
302 KEMP RD
PORT ANGELES WA 98362
(360) 452 9813
NEW RESIDENTIAL
Paid Credited Due
43 75
00
43 75
Plan Check Fee
Valuation
00
00
00
Date 7/21/09
00
00
00
00
0
Extension
43 75
Date
INSPECTION TYPE
DATE
RESULTS
INSPECTOR.
DITCH
8 izgcfI
.RCS
-1�
SERVICE
1/S(0/
d ��T
ROUGH IN
7/ /0/
104)
FINAL
022/0
COMMENTS
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
new house
Owner
FLORES BRIAN R
1315 S 0 ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty
1 00
3 00
Unit Charge
86 2500
27 5000
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
WA 98363
150185
168 75
7/21/09
1/17/10
Per
ECH
ECH
168 75
00
168 75
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
09 00000703
281477
1013 FLORES ST
06 30 99 1 0 5720 0000
ELECTRICAL ONLY
RS9 RESDNTL SINGLE FAMILY
0
168 75
00
168 75
Contractor
JEDI ELECTRIC
331 FORS RD
PORT ANGELES
(360) 460 0556
ELECTRICAL NEW RESIDENTIAL
Plan Check Fee
Valuation
EL R SQFT FIRST 1300
EL R SQFT ADDITIONAL 500
Paid Credited Due
00
00
00
Date 7/21/09
WA 98362
00
0
Extension
86 25
82 50
00
00
00
Date
?i
7 5‘
\pi
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. 7-15-0
1 2 Single Family Dwelling
Multi Family or Commercial*
Commercial Addition Alteration Remodel Repair*
Plan Review May Be Required, Please Complete.Electrical.Plan Review Information Sheet
Job Address: 13615 Pee /6 13 T-10 S �6
Building Square Footage. !e O
Description of above
Owner Information
Name: 3r c n Flores
Mailing Address: 5 ST
City' 7 State Zip 50S<9
Phone. Fax:
License Exp
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
86.25
43.75
gly
Total (Qty Multiplied by Unit Charge)
Service /Feeder 200 Amp.
Service /Feeder 201 -400 Amp.
Service /Feeder 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
Temp. Service /Feeder 200 Amp.
Temp. Service /Feeder 201 -400 Amp.
Temp. Service /Feeder 401 -600 Amp.
Temp. Service /Feeder 601 1000 Amp.
Portal td Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy Commercial
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
>c 11 276.6 First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Signature of owner electrical contractor or electr .1 administrator
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.
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
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.
7
Thermostat
?.(.I_rr S Total
Cash
e iK Check
L,'r•rt Carci 11
Contractor Information
Name: Dt EIecTr*C-
Mailing Address: lion 35S'
City POI i 4 i el sl State L x J c Zip 'l 1 3 6 2
P h o n e `(1 d -PS Fax: 1 1(7- r 9 0 7
License Exp SAD t F E 9 5 7C Z
d
3
W
Jul 21 09 07:28a
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 Single Family Dwelling
Multi -Family or Commercial'
Commercial Addition (Alteration Remodel Repair'
Plan Review May ji.e Requi d; Please C
Job Address: ///3 F/ 4.4' S
Building Square Footage: 22-67
Description of above f�
V l�t.J (CAISV
Unit Charge
S 93.75
3113.75
S160.00
3205.00
$29t25
2.00
57.50
2.00
72.50
86.25
$116.25
$131.25
75.00
69.00
75.00
50.00
50.00
S 93.75
S` 80.00
S 86.25
S 27.50
57.50
86.25
43.75
Signature of owner, electrical contractor or electrical administrator
Co piete Electrical Plan Review Information Sheet
Pf
ff-7 G4
t
!TP pit y7 (Al, iii 4,2l '1 zativeLek
Total (Qty Multiplied by Unit Charge)
.Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601 1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit WCService Feeder
Brandt Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service/Feeder 201 -400 Amp.
Temp. Serv;ceJFeeder 401.600 Amp.
Temp. Service/Feeder 601 1000 Amp.
Portal to Portal Hourly
Sign/Outline Lighting
Sgnal Circuit/ Limited Energy Commercial
Sgnal Circuitl Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi- Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
Total
0 Cash
Q Check
X Credit Card q
p.2
N
Owner Information Contractor Info matt n
Name a •Name:41i INIO t //1
Mailing Address: ONE, Mailing Address: ,31J.2. ifP S
�T pP'Y
City 7 /O S State: bf/f' Zip: l r% City:Polibfrtleip 5 State: Net Zip: 9R3197--
Phone: 'Sr Fax: Phone: W- /3 Fax. 4 1.52 11 7 5
License Exp. License I Exp. .4 SDK U
r
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalised (2) Owner is required to hire an
electrical contractor if above said property is for sale, rent or lease.
After reading the above statement, I hereby certify that I am the ovmer of the above named property or a licensed electrical contractor. l 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 Port Angeles Municipal Code, and
Utility Specifications.
PREPARED 6/30/09 8 35 41 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/30/09
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/11/09 JLL BLDG FOUNDATION FOOTING TIME 09 00
5/15/09 AP May 11 2009 8 18 02 AM 1pangrle
BRIAN 460 3877
FOOTING
MORNING
May 15 2009 3 38 48 PM jlierly
BL2 01 5/14/D9 JLL BLDG FOUNDATION STEM WALL TIME 09 00
5/15/09 AP May 14 2009 9 07 32 AM 1pangrle
BRIAN 460 3877
STEMWALL
MORNING
May 15 2009 3 40 49 PM jlierly
BL3 01 6/01/09 JLL BLDG FRAMING TIME 0 00
6/03/09 AP June 1 2009 9 45 27 AM 1pangrle
REED 460 4561
'UNDERFLOOR
AFTERNOON
June 3 2009 8 30 46 AM jl erly
BL9 01 6/30/09 �L0 BLDG SHEARWALL
AIO June 30 2009 8 31 30 AM 1pangrle
1 I BRIAN 460 3877
SHEETING
COMMENTS AND NOTES
PREPARED 6/23/09 8 44 24 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/23/09
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 6/23/09 JLL n PLUMBING ROUGH IN
June 22 2009 3 02 22 PM 1pangrle
JOHN 460 6902
ROUGH IN PLUMBING
PL6 01 6/3/09 JLL PLUMBING WATER SUPPLY
June 22 2009 3 02 52 PM 1pangrle
JOHN 460 6902
WATER SUPPLY LINE
COMMENTS AND NOTES
PREPARED 6/01/09 9 46 52 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/01/09
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/11/09 JLL BLDG FOUNDATION FOOTING TIME 09 00
5/15/09 AP May 11 2009 8 18 02 AM 1pangrle
BRIAN 460 3877
FOOTING
MORNING
May 15 2009 3 38 48 PM jlierly
BL2 01 5/14/09 JLL BLDG FOUNDATION STEM WALL TIME 09 00
5/15/09 AP May 14 2009 9 07 32 AM 1pangrle
BRIAN 460 3877
STEMWALL
MORNING
May 15 2009 3 40 49 PM jlierly
BL3 01 6/01/09 J L BLDG FRAMING TIME 01 00
June 1 2009 9 45 27 AM 1pangrle
REED 460 4561
'UNDERFLOOR
AFTERNOON
COMMENTS AND NOTES
o%.)-.^ Spov(1-r-,
PREPARED 5/14/09 9 11 28 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/14/09
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/11/09 BLDG FOUNDATION FOOTING TIME 09 00
It May 11 2009 8 18 02 AM 1pangrle
BRIAN 460 3877
FOOTING
MORNING
BL2 01 5/14/09 JLL BLDG FOUNDATION STEM WALL TIME 09 00
May 14 2009 9 07 32 AM 1pangrle
BRIAN 460 3877
STEMWALL
MORNING
COMMENTS AND NOTES
PREPARED 5/11/09 8 28 15 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/11/09
ADDRESS 1013 FLORES ST SUBDIV
TENANT NBR BRIAN R FLORES
CONTRACTOR PHONE
OWNER FLORES BRIAN R PHONE
PARCEL 06 30 99 1 0 5720 0000
APPL NUMBER 09 00000317 RES NEW SFR
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL1 01 5/11/09
1,
BLDG FOUNDATION FOOTING TIME 09 00
May 11 2009 8 18 02 AM 1pangrle
BRIAN 460 3877
FOOTING
MORNING
COMMENTS AND NOTES
c_z;
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
FLORES BRIAN R
1315 S 0 ST
PORT ANGELES
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Permit
Additional desc
Permit pin number
Permit Fee
T \Policies \1102 15 [10/08]
WA 98363
RIGHT OF WAY
145011
135 00
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
321 EAST 5TH STREET PORT ANGELES, WA 98362
09 00000317
629931
1013 FLORES ST
06 30 99 1 0 5720 0000
BRIAN R FLORES
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
210117
Application desc
2 265 SF SFR 500 SF ATT GARAGE 216 COVERED PORCH
Contractor
OWNER
Date 5/01/09
Structure Information 000 000 2 265 SF SFR 500 SF GARAGE 216 PORCH
Other struct info TOTAL LOT COVERAGE 16 90
CONSTRUCTION TYPE VB
FIRE SPRINKLERS REQUIRED NO
NUMBER OF STORIES 2 00
LOT SIZE 11999 00
PROPOSED LOT COVERAGE 2031 00
TOTAL LOT COVERAGE 2031 00
NUMBER OF UNITS 1 00
PUBLIC WORKS RES WATER SERV
145029
980 00 Plan Check Fee 00
5/01/09 Valuation 210117
10/28/09
Qty Unit Charge Per
1 00 980 0000 EA PW W/M 1 SERV 5/8 METER
Qty Unit Charge Per
1 00 50 0000 ECH RIGHT OF WAY PERMIT
SANITARY SEWER HOOK UP
Plan Check Fee
Extension
980 00
145003
50 00 Plan Check Fee 00
5/01/09 Valuation 210117
10/28/09
Extension
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 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 ontractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
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/
ENGINEERING 417 -4831
CONSTRUCTION R.W
PW ENGINEERING
FIRE 417 -4653
FIRE DEPT
PLANNING DEPT 417 -4750
PLANNING DEPT
BUILDING 417 -4815
BUILDING
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
T \Policies \1102 1 [10/08]
Application Number 09 00000317
Application pin number 629931
Issue Date 5/01/09 Valuation
Expiration Date 10/28/09
Qty Unit Charge Per
1 00 135 0000 EA SAN SEWER HOOKUP
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
A residential fire sprinkler system installed per NFPA
13D will be required
2nd option is to install an outside alarm bell that is
inter connected to the residence s smoke detectors
The alarm bell will be painted red in color and identified
as Fire alarm
April 24 2009 4 29 58 PM sroberds
The proposal will result in construction of a new sfr in the
RS 9 for total lot and site coverage of 17t No land use
issues are anticipated
April 15 2009 9 10 48 AM banders Brian 417 4708
Contact engineering for specifications on underground
service to primary pole Electrical permits required
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
An easement from adjacent property owner will be required
for sewer connection in Milwaukee Dr
Other Fees
Fee summary
T' \Policies \I 102 15 [10/08]
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
321 EAST 5TH STREET PORT ANGELES, WA 98362
Page 2
Date 5/01/09
210117
Extension
135 00
RES OVERHEAD SERVICE FEE 410 00
SEWER SYSTEM DELV CHARGE 1510 00
STATE SURCHARGE 4 50
PW WATER SYSTEM USE FEE 1510 00
Charged Paid Credited Due
1165 00 1165 00 00 00
00 00 00 00
3434 50 3434 50 00 00
4599 50 4599 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 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
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
YES 1 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/
ENGINEERING 417 -4831
CONSTRUCTION R.W
PW ENGINEERING
FIRE 417 -4653
FIRE DEPT
PLANNING DEPT 417 -4750
PLANNING DEPT
BUILDING 417 -4815
BUILDING
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
T' \Policies \1102 15 [10/081
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
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
09 00000317
629931
1013 FLORES ST
06 30 99 1 0 5720 0000
BRIAN R FLORES
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
210117
Application desc
2 265 SF SFR, 500 SF ATT GARAGE 216 COVERED PORCH
Owner Contractor
FLORES BRIAN R
1315 S 0 ST
PORT ANGELES
WA 98363
OWNER
Structure Information 000 000 2 265 SF SFR 500 SF GARAGE 216 PORCH
Other struct info TOTAL LOT COVERAGE 16 90
CONSTRUCTION TYPE VB
FIRE SPRINKLERS REQUIRED NO
NUMBER OF STORIES 2 00
LOT SIZE 11999 00
PROPOSED LOT COVERAGE 2031 00
TOTAL LOT COVERAGE 2031 00
NUMBER OF UNITS 1 00
Permit BUILDING PERMIT RESIDENTIAL
Additional desc 2 265 SF SFR 500 SF GAR
Permit pin number 144105
Permit Fee 1641 85 Plan Check Fee 1067 20
Issue Date 5/01/09 Valuation 210117
Expiration Date 10/28/09
Qty Unit Charge Per Extension
BASE FEE 1020 25
111 00 5 6000 THOU BL 100 001 500K (5 60 PER K) 621 60
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
T:FormsBuilding DivisionBuilding Permit
MECHANICAL PERMIT
144196
122 35
5/01/09
10/28/09
Plan Check Fee 00
Valuation
Date 5/01/09
0
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 14 8000 EA ME FURN /HP /FAU OR 5 TON 14 80
5 00 7 2500 EA ME VENT FAN (SINGLE DUCT) 36 25
2 00 10 6500 EA ME STOVE /FIREPLACE /MISC APP 21 30
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
9
Print Name Signature of retractor 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 Engineering
Piers
Fire
Post Holes (Pole Bldgs
417 -4653
PLUMBING
FINAL Date
Accepted by
Under Floor Slab
417 -4750
Rough -In
Building
Water Line (Meter to Bldg)
417 -4815
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.
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 Engineering
417 -4831
Fire
417 -4653
Planning
417 -4750
Building
417 -4815
PLANNING DEPT
Separate Permit #s
SEPA.
ESA.
SHORELINE.
Parking Lighting
Landscaping
BUILDING PERMIT INSPECTION RECORD
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.
T.Forms /Building Division /Building Permit
rt
Other Fees
Fee summary
T.FormsBuilding DivisionBuilding Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
Application Number 09 00000317
Application pin number 629931
Permit PLUMBING PERMIT
Additional desc
Permit pin number 144204
Permit Fee 184 00 Plan Check Fee
Issue Date 5/01/09 Valuation
Expiration Date 10/28/09
Qty Unit Charge Per Extension
BASE FEE 50 00
15 00 7 0000 EA PL- PLUMBING TRAP 105 00
1 00 7 0000 EA PL -WATER LINE 7 00
1 00 15 0000 EA PL -SEWER LINE 15 00
1 00 7 0000 EA PL -WATER HEATER 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
A residential fire sprinkler system installed per NFPA
13D will be required
2nd option is to install an outside alarm bell that is
inter connected to the residence s smoke detectors
The alarm bell will be painted red in color and identified
as Fire alarm
April 24 2009 4 29 58 PM sroberds
The proposal will result in construction of a new sfr in the
RS 9 for total lot and site coverage of 17% No land use
issues are anticipated
April 15 2009 9 10 48 AM banders Brian 417 4708
Contact engineering for specifications on underground
service to primary pole Electrical permits required
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
An easement from adjacent property owner will be required
for sewer connection in Milwaukee Dr
RES OVERHEAD SERVICE FEE 410 00
SEWER SYSTEM DELV CHARGE 1510 00
STATE SURCHARGE 4 50
PW WATER SYSTEM USE FEE 1510 00
Charged Paid Credited Due
Page 2
Date 5/01/09
Permit Fee Total 1948 20 1948 20 00 00
Plan Check Total 1067 20 1067 20 00 00
Other Fee Total 3434 50 3434 50 00 00
Grand Total 6449 90 6449 90 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 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)
Inspection Type
Date
Accepted By
Comments
FOUNDATION
Footings
5 —II pt
--J
Stemwall
5-111-0q
JCL-
Foundation Drainage downspouts
'I J,
Piers
1
Construction
Post Holes (Pole Bldgs
PW Engineering
417 -4831
PLUMBING
q9 J
Under Floor Slab
Fire
Rough -In
4.-2.3-061
i Qe
Water Line (Meter to Bldg)
z 3-01
`P A
Gas Line
417 -4750
Back Flow Water
I
FINAL Date J I 0 Accepted by JtL
AIR SEAL. 7 -31- Oq SLi-
Walls
A LI 10
L-I^
Ceiling
FRAMING 7 jW
G. -I —U 01-1-
Shtei-619 630 -0i etc,
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION S I 0 4 i 'I t-L-
Slab
Wall Floor Ceiling
MECHANICAL.
FINAL Date LH Accepted by v
Heat Pump Furnace FAU Ducts
Rough-in
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
l
Separate Permit #s
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Parking Lighting
Inspection Type
Landscaping
Date
Accepted By
Electrical
417 -4735
Construction
R W
PW Engineering
417 -4831
Fire
417 -4653
I
Planning
417 -4750
I
Building
417 -4815
A LI 10
L-I^
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
if
Applicant UR /,4A/ F G
Property Owner 8,21. -A-) FL o/LE-S
Property Owner's Address 13
Contractor g I4,4)
Contractor's Address
License
PROJECT ADDRESS
Parcel Number
Floor Areas
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
BUILDING 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
Expires
o i3 PI ors t r
mf ?9 5' 72o
Existing (sq. ft.) Proposed (sq. ft.)
1
Sao 30
Zi& 12.
Lot
Total footprint of structures g) sq ft. Lot size sq ft.
Site Coverage the amount of impervious surface on a parcel including structures paved
and other impervious surfaces (see PAMC 17 94 135 for exemptions)
RAPEL/lor
Max. height of proposed structures 25 ft. Occupancy group
Will a lawn sprinkler system be installed? Ato Occupant load
Will a fire sprinkler system be installed? i((0 Construction type
WI 11 do ou t ,E /,Qero
Phone
E -mail
For City Use Only
Date Received 10 0
Permit 0 7
Date Approved J
Zoning
per sq ft.
Print in ink
Project Type Brief Description.
Check all that apply
New Construction
Residential Multi- family Commercial
Industrial
Addition
Nak- s F
Remodel
Repair
Demolition
Re -roof
,House )4 garage other
tear off re -roof lay over one layer
Heat System Heat pump "wood- burning stove gas fireplace pellet stove other
Other
n1 115.
8@
`5. 000
z 592
TOTAL VALUATION 210 l 7
Lot coverage 16
driveways sidewalks patios
Site coverage l b.q
of bedrooms 3
of full baths
of half baths
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 0 a Print Name f f4A1 JGL6.P S Signature. 137.Cee,f
T Forms /Building D,vision /Bldg Permit.doc
4
Site Plan
Keynotes
rnxn rx imam
0 =CREW SIDDIOLS
0 CORERED ATIO
O WARM ca.
CD CONCRETE PAD AT CWAGE DOOR
Lot Coverage
W S AREA (ATW AOpi7:
Zara 55.
bak
ASSOCIATES
SST TM lO
Rif i0
Flores
Residence
1013 Florae Street
Port Angeles, We
DAME
00 2008
JOB NO.
DRAWN P
MET
A2.1
Option
Glazing
Area of
Floor
Glazing U;Factor
:Door
U-
"Factor
Ceiling
Vaulted
Ceiling
Wall
A bove `'.rr
Grade.
w
Inteio
;Below:
Grade.
Wall
Exterior
-Below
Grade
Floor
I
S lab. on
Concrete
Ver ica1=
:Overhead
IV
Unlimited
Group R 3
and R -4
Occupancies
Only
0 35
0 58
0.20
R 38
R 30
R 21
R 21
R 10
R 30
R 10
CITY
FAX
ERNMENT
Site Information.
Lot:
Address j TJ /3 F1oi2 -S S Y/E -t
City. PO Ser 4-11/C-ES
State u/ A- Zip
Contact. pe/,4 -Ai F(,O,eES
Phone C30) 460
Phone 2
Table 6 -1
PRESCRIPTIVE REQUIREMENTS FOR GROUP R OCCUPANCY
CLIMATE ZONE 1
(Unlimited Glazing Option Only)
This Project complies with the following:
The project is a single family residence or duplex.
The project is a wood frame OR all of the insulation is interior or exterior of the framing.
All building components meet the requirements listed above
'J The project will meet all other provisions of the WSEC and VIAQ
The Project will take advantage of the following exceptions to the prescriptive option.
602.6 Exception 2. One unlabeled or untested exterior swinging door 24 sq.ft. or less, may be
installed per unit for ornamental, security or architectural purposes.
Location of the door taking this exception
602.6 Exception 2. If a door is mostly glass, it should meet the requirement of the vertical
glazing U factor listed above
Location of the door(s) taking exception.
Type of Heat Source- //,+t 7 ij t p WOO,1) 5Thi /E
T Forms /Building Division /Prescriptive Approach- Simple Form
PRESCRIPTIVE APPROACH SIMPLE FORM
For the Washington State Energy Code (2006 Edition)
Climate Zone 1
Building Department Use Only
Permit
Notes
Applicant Information
Permanent service. Name ee /04A) F L®KE.-S
Name and address of party Street: /0)3 pLo,ecs s ec_...Er
responsible for permanent City I State I ZIP: Po/er ,4t'e t S G!i 96563
service billing? Daytime Phone ,74 44o -38'77 Home Phone.
Contact Information (if other than above)
Name B /444 �G04E-5 Title 002/Nee
Site contact:
Daytime Phone 4-60 --3A7 7
Name' /32t4ti FG02t-5 Company
Contractor
Daytime Phone
Name Company
Electrician
Daytime Phone
Name Company
Excavator.
Daytime Phone
Project Type Existing Oew
Single- family residence Multi-family residence of units
N/ To Al
�e �6b(Q
Commercial Subdivision of lots
Overhead service ❑General service
Underground service Ig Other O :.:1 VI At
Project Information Description of work: A-7 /°OLE al J—(
Street address lot number /b F-[- 0leF__s sreceE?
Nearest cross street: (p"
Desired connection. date
Electrical transformer serving property is Jon a pole on the ground
Electrical Load
Total square footage O sq ft. Main disconnect size amps
Voltage 20/240 1 ph ❑120/208 3ph 277/480 3ph
❑120/240 3ph 0480 3W 3ph Other
Standard residential loads (Lighting refrigerator dishwasher washer)
Check all that apply NC ton) Range /Oven Hot Tub
Clothes Dryer Heating Pumps Hp)
No Load Change ❑Water Heater Elevator Hp) Other
Supporting Documentation Please provide a copy of the following
*Detailed plot plan (dwg or dxf format mandatory for subdivisions)
*Electrical one -line drawing showing the service entrance panel and location
*Connected load data.
*Size and locked rotor amps of all motors over 50hp
Applicant's Signature Date 4//O/Bg
Please complete and return to Public Works Utilities Department
MAIL OR DELIVER COMPLETED FORM TO 321 E 5TH STREET PORT ANGELES WA 98362
FAX TO 360- 417 -4711
Information form.xls
N'1PWKS11 IGHTIFNGR\ #Original ^,Inforrnation form
Electrical Information Form
Public Works Utilities Department (360) 417 -4700
City Electrical Inspector (360) 417 -4735
WS
WF
Revised 1 15.09
A