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ELECTRICAL WORK PERMIT APPLICATION
Job wired by
~ical Contractor 0 Owner
lnst' lalion description
Commercial 0 Residential
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License number
Date Expires
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o New
o Altered/Addition
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Premises owner's "lime
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Address of inspection
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Slate ZIP
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FAX number
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I'hone nll~ber to schedule ill~ection:
bO - to 3 7
Owner as defined hy RCW19.28.J61--(1) Owner wif/ occupy the structure for two
years (!ftc:r this eleCTrical permit ix finalized. (2) Owner ,;\' required to hire an electrical
contm('/or !f above said property is for sale. rent or Icase.
AneT reading the above statement. I hereby certifY that I am the owner of the ahove
named property or <I licensed electrical contractor. I am making the electrical instal-
lation or alteration in compliance with the electrical laws, N.E.C., RCW. Ch<lpter
19.28, WAC. Chapter 296-46B, The Cit)' of Port Angeles Municipal Code. and
Utility Spccifications.
Signature of owner, electrical contractor or electrical administrator
o Cash ~#
o Credit Card Visa
Card #
Mastercard
Discover
x
Expiration Date
of card
EleclricaLL~d.Add ilions.am;LQLsublracJions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton LAR
o Fan-Wall KW
Service.lnformalion
o Overhead Service
o Temp Service
o Underground Service
Voltage
PhaseD 1 03
Service Size: _
Feeder Size:
SAME DAY I~SPECJ:ION. CALL BEFOREJ:OO AM_l@=4li4115
/ ROUGH-IN'(trD / THERMOSTAT SERVICE
uk/; f~t "- Dale Appro,-ed By ./ [)~te Approved By
"- a I Appw\l,d By
/ DrrCH FEEDER
1'\11 ~ },tIN~~
'-.. j)~le Appro\~) "- Dale Approved By ./ "- Date Appro\edlJy/
Inspection Area, Building or Equipment Inspected Action Taken Electrical
Date Inspector
Application Number
Pin number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
HARVEY HELEN L
515 SOUTH I STREET
PORT ANGELES
36) 417 6919
WA 98362
T• \Policies \1102_15 building permit inspection record05 wpd [1/4/2005]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
05 00000112
200976
515 S I ST
06 30 00 0 1 2745 0000
RE ROOF
RS7 RESDNTL SINGLE FAMILY
3870
Contractor
Date 2/16/05
DIAMOND ROOFING ENTERPRISES
P 0 BOX 2963
PORT ANGELES WA 98362
(360) 452 9518
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF FELT METAL
Permit Fee 120 75 Plan Check Fee 00
Issue Date 2/16/05 Valuation 3870
Expiration Date 8/15/05
Qty Unit Charge Per Extension
BASE FEE 92 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 120 75 120 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 125 25 125 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 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
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
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 I'ERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
FOUNDATION.
FOOTINGS
WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDERFLOOR /SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING/LIGHTING ESA.
LANDSCAPING SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
ELECTRICAL LIGHT DEPT 417 -4735
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
PLANNING DEPT 417 -4750
BUILDING 417 -4815
T \Policies \1102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
YES 1 NO
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
FIRE DEPT
I PLANNING DEPT
1 BUILDING
1 I
I 1 I
I I I
PREPARED 1/21/05 12 27 34 INSPECTION TICKET PAGE 10
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/21/05
ADDRESS 515 S I ST SUBDIV
CONTRACTOR PA SWIMMING HOLE FIREPLACE S PHONE (360) 565 1163
OWNER HARVEY HELEN L PHONE (360) 417 6919
PARCEL 06 30 00 0 1 2745 0000
APPL NUMBER 05 00000045 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01
0,/:(te
MECHANICAL GAS LINE TIME 17 00
SETH 461 1511
COMMENTS AND NOTES
OF pORT,WO
Application Number
Pin number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
691( f j L
Signature of Contractor or Authorized Agent
T•\PLANNING\FORMS \1102.15 [11/14/2003]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
05 00000045
773655
515 S I ST
06 30 00 0 1 2745 0000
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
3600
Contractor
Qty Unit Charge Per
BASE FEE
1 00 10 6500 ECH ME -GAS PIPE 1 TO 5
Date
Date 1/19/05
HARVEY HELEN L PA SWIMMING HOLE FIREPLACE S
515 SOUTH I STREET 518 W 8TH ST
PORT ANGELES WA 98362 PORT ANGELES WA 98362
(360) 417 6919 (360) 565 1163
Permit MECHANICAL PERMIT
Additional desc PROPANE INSERT LINES TANK
Permit Fee 57 65 Plan Check Fee 00
Issue Date 1/19/05 Valuation 0
Expiration Date 7/18/05
Fee summary Charged Paid Credited Due
Permit Fee Total 57 65 57 65 00 00
Plan Check Total 00 00 00 00
Grand Total 57 65 57 65 00 00
Extension
47 00
10 65
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 Owner (if owner is builder) Date
ELECTRICAL LIGHT DEPT.
CONSTRUCTION R.W PW/
ENGINEERING
FIRE
PLANNING DEPT
BUILDING 417 -4815
T•\PLANNING\FORMS \1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION
KEEI' PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES 1 NO
FOUNDATION:
FOOTINGS I
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT
ROUGH -IN 1
PLUMBING
UNDER FLOOR SLAB I
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR 1
INSULATION
SLAB I
WALL FLOOR CEILING 1
MECHANICAL
HEAT PUMP I I
GAS LINE 1- 0-1—(93 I _is L s I
WOOD STOVE PELLET CHIMNEY I
HOOD DUCTS 1 1
PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM I
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING/LIGHTING I I I ESA.
LANDSCAPING I I 1 SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
417 -4735 ELECTRICAL
LIGHT DEPT
417 -4807
417 -4653
417 -4750
I I I
1E444 7-24 K
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT
PLANNING DEPT
BUILDING
01/18/2005 16 00 FAX
PLANNING USF ONE a
h ill fill r OMPI I?I V and in INK. Your application and site plan N(UST BE
COMPLETE to he accepted for review if von hate any questions, cull
(360) a17 -4815
C1 Repair ri S1g11
BUILDING PERMIT APPLICATION
Applicant or At.,cnt a
Owner Cier1 1 Cq i' u
Address S, C'tly
Architect /En¢tneer•
Contractor PA SO i/14,1 iA 1 I) State License !t Exp
Address Si (d,) 55 54-, City fo An ode:5
PROJECT ADDRESS _517.c t y r 5+
LEGAL DLSCR[PTION Lot Block.
Credit Card Holder Name 4E1.J I L[. Cam.
Billing Address:
Credit CardTypc VISA
TYPE OF WORK
R Residential 0 New on ;1r Re -ninf
rvlulti- timily 0 Addinun Move
Commercial Remodel E.1 Demolition
Occupancy Group
No. of SLUMS: Lot Sin Existing Sq ht.
Existing lot coverage Proposed lot coverage
F A/Weilttnd(s) Yes Li 1'rb L..PA Checklist required'! 0 Yes Z] No Other
I Oft1�4 AM I'S•f3uildi p�nrul.,�, J
Applicant.
Phone _C //6..
Phone d q/j :f?
Subdivision
Phone
CLALLAM COUN•n 1'I,R( LL NUMBER 01 e2oal,,, 7G, Q(pClr5
City
Exp. irate.
SIZE /VAL OATI ON
J ,Stave SI (a), /SI' S
I hereby certify that 1 have read anJ examined this application and know the same o be true an
understand that if is my responsibili'y to determine what permits aro required ,not 1�� ity's and
l• Its C91
Phon ti
lip 9g3C.A
ZONING
r1 (iaragc 5f (c' `fi 'SF 1
Deck SF (u) SF `I
11 other
1411 011 I.41 I SI ()NI.?
PC 111 °I CJS
eau- Approval:
Dare Ise u:d
'1'OTA1. ALUA'1'tON '6ari, v
t t
BRIEF DESCRIPTION OF HE PROJECT .1 by 4P ,/2 Sr' r)' L q C�
aao T1 LP "Tent !c L
OMMERCLAL /RFS1t)I'fTIA1
Occupa ,U d:
Proposed Sq. F.
'Coral lot coverage
BTJILDING PERMIT APPLI StIBiyll The T3uikLiii, Division can provide you with intnrnlatu,ti on t11c application and
plan submittal requirements if you Imt, questions.
ALUATION OH CONSTRl' TION In ad cases, valuation amount trust be entered by the applicant phis figure t^ ill be reviewed
and may be revised by epee I iuilrli it Division to comply with current tee sebedule5. Contact the Permit C. oordinator at 417 -481' for assistance
1'1 AN CHECK FEE 11 ,I plar check fee i. rluc. It most be submitted at the titre the building permit application and cnustructtorl plans are
.uhmitted All other p.•t'mtt (ha are due at tic tine 01'1)c:rrrlil Issuance.
F'XPiRATION OF Pi AN RE I'1! W Ifno permit is Issued within 180 dav: o f the date of application, LLe application will expire The
Iuilding
Official can.extend the lime for action by the applicant up to 1811 days upon written r .quest by the applicant >ce Section 107 4 or
the Uniform Building C-ode, orient edition) No application can he extended more than on
Cot1SIC LCt1a11 Type
1'U'I Al, Sq Et.
ect. 1 am authorized to apply for this permit and
t obtain such permits prior to work.
Late t/[I ts-
a 001/001
APPROVALS.
PLAN
DPWU
FIRE
OTHER.