HomeMy WebLinkAbout916 C St - BuildingDATE:
zb I cl
OWNER
CONTRACTOR
EATR.A
ADDRESS
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APPROVED
0
0
0
CORRECTIONS NEEDED' jf c 1
li r D
b2
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
PERMIT
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1-/ v T"04, t n/ SO K_
DITCH
ROUGH IN /COVER
SERVICE
FINAL
sPrzo r o ,4 (te_ou►4P_1D
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
INSPECTOR
NOT APPROVED
0
0
PREPARED 2/23/11 8 17 23 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/23/11
ADDRESS 916 C ST SUBDIV
CONTRACTOR HUTCHINSON CONSTRUCTION LLC PHONE (360) 417 0575
OWNER JP MORGAN CHASE BANK NA PHONE
PARCEL 06 30 00 0 3 0193 0000
APPL NUMBER 10 00001357 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BAIR 01 12/09/10 JLL BLDG AIR SEAL TIME 01 00
12/10/10 AP December 8 2010 4 45 18 PM 1pangrle
PHIL 460 2151
AIRSEAL
AFTERNOON
PLEASE CALL HIM 10 MINUTES BEFORE YOU GET THERE
December 10 2010 4 21 18 PM jlierly
BL3 01 12/09/10 JLL BLDG FRAMING TIME 01 00
12/10/10 AP December 8 2010 4 44 35 PM 1pangrle
PHIL 460 2151
FRAMING
AFTERNOON
PLEASE CALL HIM 10 MINUTES BEFORE YOU GET THERE
December 10 2010 4 21 18 PM jlierly
BL99 01 2/23/11 J L BLDG FINAL
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
February 23 2011 8 15 17 AM 1pangrle
HUGH 640 8293
BUILDING FINAL
ME99 01 2/23/11 J
FebruaIyA2 FINAL
February 23 2011 8 15 58 AM 1pangrle
HUGH 640 8293
MECHANICAL FINAL
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 12/09/10 JLL PLUMBING ROUGH IN TIME 01 00
12/10/10 AP December 8 2010 4 45 39 PM 1pangrle
PHIL 460 2151
ROUGH IN PLUMBING
AFTERNOON
PLEASE CALL HIM 10- MINUTES BEFORE YOU GET THERE
December 10 2010 4 21 18 PM jlierly
PL99 01 2/23/11 February FINAL
February 23 2011 8 16 21 AM 1pangrle
HUGH 640 8293
PLUMBING FINAL
COMMENTS AND NOTES
PREPARED 12/09/10 8 09 47
CITY OF PORT ANGELES
ADDRESS 916 C ST
CONTRACTOR HUTCHINSON CONSTRUCTION LLC
OWNER JP MORGAN CHASE BANK NA
PARCEL 06 30 00 0 3 0193 0000
APPL NUMBER 10 00001357 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RES LT RESULTS /COMMENTS
BAIR 01 12/0$/10
V
BL3 01 12/09/10 JL�
PL2 01 12/09/10
lit
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
INSPECTION TICKET
INSPECTOR JAMES LIERLY
BLDG AIR SEAL TIME 01 00
December 8 2010 4 45 18 PM 1pangrle
PHIL 460 2151
AIRSEAL
AFTERNOON
PLEASE CALL HIM 10 MINUTES BEFORE YOU GET THERE
BLDG FRAMING TIME 01 00
December 8 2010 4 44 35 PM 1pangrle
PHIL 460 2151
FRAMING
AFTERNOON
PLEASE CALL HIM 10- MINUTES BEFORE YOU GET THERE
PLUMBING ROUGH IN TIME 01 00
December 8 2010 4 45 39 PM 1pangrle
PHIL 460 2151
ROUGH IN PLUMBING
AFTERNOON
PLEASE CALL HIM 10 MINUTES BEFORE YOU GET THERE
COMMENTS AND NOTES
)NQ,
SUBDIV
PHONE (360) 417 0575
PHONE
PAGE 8
DATE 12/09/10
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ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
DATE
INSPECTO
6a 13ft0
OWNNE
ZJxrrzx 1r- SLam.. Tif_ K t cl_g_C_/C
ADDRESS
S r
APPROVED NOT APPROVED
DITCH 0
ROUGH IN /COVER
0. SERVICE 0
FINAL 0
PERMIT
r0 1 38 D
CORRECTIONS NEEDED: w M C „IcF 4 L
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5 .Va IE.- ¥xls`r tai t rzbu -L> c Xt 33
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
2 circuits washer dryer
Owner
PHILIP J MARTHA H HUTCHINSON
916 C ST
PORT ANGELES WA 98362
(360) 460 2151
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
H z lth 1 n
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
10 00001380
401880
916 C ST
06 30 00 0 3 0193 0000
ELECTRICAL ONL
COMMERCIAL NEIGHBORHOOD
0
Contractor
EXTRA MILE TECH
418 N RACE ST
PORT ANGELES
(360) 457 0198
ELECTRICAL ALTER RESIDENTIAL
177949
76 10
11/24/10
5/23/11
Qty Unit Charge Per
1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
1 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT
Charged Paid Credited
76 10 76 10 00
00 00 00
76 10 76 10 00
DATE.
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Plan Check Fee
Valuation
RESULTS
a 2,4 a) .14?
Zl» Ih
Date 11/24/10
ELECT LLC
WA 98362
00
0
Extension
73 50
2 60
Due
00
00
00
INSPECTOR.
el=hp
ir9u
Date
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
d
C1
F:13'
NOV -23 -2010 12 33 PM E JANSSEN
City of Port Angeles Permit Application
Sultding OlvIslonIElacttleel Inspections
3216eel Fifth Street P,0. Floe 1150
Port Angeles Waohington,96362
Ph (3601417 -4735 Fat (36014114711
Dale I
1 2 Single Family Dwelling
MuIU F amily or Comrnerc101"
Commercial Addition 1 Atleration Remodl'
Plan Review May Be Required, Please Cn l Iettl Electrical Plan Review Information Sheet
Job Address. e
Building Square Footage;
Description of above _,,,_,1_Q„ p
Owner Inior 11.etion
Name 1 1 �4 jl
Malting Address c 1 {{,2
City' r State tCC, ZIP y Gam_
Phone. 9 6 0 S 1. Fax: License x Exp
Unit S,hargq
5 11990
5 145 50
5 204 60
520220
5 372.50
250
5 7350
5 2.60
5 92 70
S 110 30
S 148 70
510'x.90
91.90
85.20
5 95.90
3 0:1.90
S 63.90
5 119.90
5 102.30
S 110.30
5 3;.20
3 73 50
5 110.30
3 56 00
�1Y
Toil f Qty Mulliplied by Unit ChArQe)
SurvlcelFeedor 200 Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401.600 Amp.
Service/Feeder 601.1000 Amp
Service/Feeder ever 1000 Amp.
Branch Circuit WI Service Feeder
Branch Circuit W10 Service Feeder
I Each Additional Branch Circuit
rump. Service/ Feeder 200 Amp.
tamp. Service /Feeder 201.400 Amp.
Temp Service/Faedereal -600 Amp.
Temp Service/Feader601.1000 Amp
E Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy mdital ,nn ;q
Signal Circuit/ Limited Energy 1 Co B 2 mer I itro y al. Dwel ion
Signal Circuit/ Limited Energy Mu1U•Family Dwelling
Manufactured Home Conneceon
Renewable Electrical Energy 5KVA System or less
First 1300 Square Ft
Each Additional 500 Square Ft. or Ponion or
Each Outbuilding or Detached Garage
Each Swimming Pool or Not Tub
Thermostat
ll Total
Signature of owner, electrical contractor or eIecmral adutlnlatratoi
360 452 2982
Gqntractor Intoimelion
Name: eX142/F MILE -`G c, O. 8/ till -le iC_
Mailing Address: `4 1 a I i� WC ..,.t_,__,
City P A State: J 1_Zi 5
o: 44.
I hone. S.
7 -2 ?2 Fax: S' S
License f11 Exp. E.X 77,C,4 0 17 7. (511.,x„_....1 i tp 6 f r
r c.
Owner as defined by KW 19.21.261: (1/ Owner wi occupy the structure for Iwo years alter this electrical permit' is finalized
above said property is for sole rent or lease. Permit expires after six months of last inspection.
Alter reading the above statement, 1 hereby certify that 1 rem the owner of the above named properly or a licensed electrical cuntractor 1 em making the electrical Installation or
alteration In compliance with the electrical laws, N E WV/ Chapter 19 21, WAC. Chapter 296468, The City of Port Angelo: Muc w pal Coda. and Utility Speeiticationr
C7 Credit Card ti
tiw••rer is required to hire an electrical contractor 4
n Cash
P 01
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
Application desc
move laundry room
Owner
JP MORGAN CHASE BANK NA
7301 BAYMEADOWS WAY
JACKSONVILLE FL 32256
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
3 00 14 0000
Permit
Additional
Permit pin
Permit Fee
Issue Date
Expiration Date
desc
number
Qty Unit Charge
BUILDING
MOVE LAUNDRY
177626
137 75
11/17/10
5/16/11
Per
BASE FEE
THOU BL 2001 25K
MECHANICAL PERMIT
177634
57 25
11/17/10
5/16/11
Per
10 00001357
636924
916 C ST
06 30 00 0 3 0193 0000
RES REMODEL
COMMERCIAL NEIGHBORHOOD
5000
PERMIT
ROOM
Contractor
HUTCHINSON CONSTRUCTION LLC
P 0 BOX 1161
PORT ANGELES
(360) 417 0575
RESIDENTIAL
(14 PER K)
BASE FEE
1 00 7 2500 EA ME VENT FAN (SINGLE DUCT)
Qty Unit Charge Per
1 00
1 00
1 00
7 0000 EA
7 0000 EA
7 0000 EA
T:Forms /Building Division /Building Permit
BASE FEE
PL- PLUMBING TRAP
PL -WATER LINE
PL -DRAIN VENT PIPING
Date 11/17/10
WA 98362
Plan Check Fee 89 54
Valuation 5000
Extension
95 75
42 00
Plan Check Fee 00
Valuation 0
v
Extension
50 00
7 25
Permit PLUMBING PERMIT
Additional desc MOVE PLUMBING FOR NEW LAUNDRY
Permit pin number 177659
Permit Fee 71 00 Plan Check Fee 00
Issue Date 11/17/10 Valuation 0
Expiration Date 5/16/11
Extension
50 00
7 00
7 00
7 00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
"7:
V
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 1 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 pe nce of
construction.
Ili /7 /I pi), l�l� l 6 -(c1ti0at
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
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
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
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
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 Date Accepted By Comments
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting 1 ESA.
Landscaping 1 SHORELINE.
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
T /Building Division /Building Permit
FINAL Date Accepted by
I FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
4.
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
T:Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Charged
266 00
89 54
4 50
360 04
10 00001357
636924
Other Fees STATE SURCHARGE
Paid
266 00
89 54
4 50
360 04
Credited Due
00
00
00
00
Page 2
Date 11/17/10
4 50
00
00
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 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)
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
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
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES.
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT Separate Permit #s
Parking Lighting
Landscaping
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 Date Accepted By Comments
0 2 23 11
(FINAL Date Accepted by
3LL. I
OL,23 t1--
FINAL Date Accepted by
SEPA.
ESA.
SHORELINE.
1
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815 I 02 I 3L
d
3-
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
Applicant t" k 11 19 1- I S 0
Property Owner ('11., L t r H-A i ti J o
Property Owner's Address F— P d
Contractor 1,4 Ck. i S °A. Co S+ir"4
Contractor's Address Po 13 o )c l( 6 Po
License 6j t'4 Pr Expires 7 /1/12—
PROJECT ADDRESS
Parcel Number
Project Time Brief Description.
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
Re -roof
Heat System
Other
Floor Areas
Basement
1St Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
BUILDING PERMIT APPLI6A TION Print in ink
1
J
tvk o VC 1
Existing (sq. ft.) Proposed (g. ft.)
h Ck\
r Residential Multi family
Max. height of proposed structures ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be installed? Construction type
For City Use
iS
ate Receive
P ermit
rr
one
Phone
t5 I I G I
Phone
E -mail
C S ±r-e 2t (V aft
Lot
ate Appro
Commercial
Zoning
House garage other tear off re -roof lay over one layer
Heat pump wood burning stove gas fireplace pellet stove other
per sq ft
TOTAL VALUATION
Total footprint of structures sq ft. T Lot size sq ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel including structures paved driveways sidewalks patios
and other impervious surfaces (see PAMC 17 94 135 for exemptions) Site coverage
of bedrooms
of full baths
of half baths
I have read and completed this application and know it to be true and correct. 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 on prgts
Date L i G7` iOPrint Name j 1 11 t t r 14 (1 4- C 1 1 I "Signature
T Forms /Building Division /Building permit application
v
L-14 0
Po v"t r (e
Industrial
d o
l7
L4-4-
1
frit
G 1 1 C∎
FIL
CITY OF PORT ANGELES Cons euct on Plans
The Issuance of this permit based upon the se plans, specifi- j l
cations and other data shall not prevent thJ building official
from thereafter requiring the correction of errors in said
plans, specifications and other data, or from preventing
building operations being carried on thereunder when in
violation of all codes and ordinances of this jurisdi
Uf
.�1 o,k, F
Approval Date
4--e F
S titL 'Wt+
me--‘
Rem it u
if3 r C(
S e
i3 co
(3 to
lac 0)
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
JP MORGAN CHASE BANK NA
7301 BAYMEADOWS WAY
JACKSONVILLE FL 32256
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
ELECTRICAL ALTER RESIDENTIAL
163758
119 90
4/14/10
10 /11 /10
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
10 00000362
722116
916 C ST
06 30 00 0 3 0193 0000
ELECTRICAL ONLY
COMMERCIAL NEIGHBORHOOD
0
Qty Unit Charge Per
1 00 119 9000 ECH EL 0 200 SRV FEEDER
Special Notes and Comments
April 14 2010 9 20 16 AM Brian 417 4708
Minimum clearances of 12 over walkable surface and 16 over
driveable surface must be obtained Meter height to be
between 4 6 and 6
Charged Paid Credited
119 90 119 90 00
00 00 00
119 90 119 90 00
DATE
Contractor
BOTERO SON ELECTRICAL
940 TAMARACK WAY
PORT ANGELES
Plan Check Fee
Valuation
L/ G/'6
Date 4/14/10
Due
RESULTS
WA 98362
,10 41,0/
00
0
Extension
119 90
00
00
00
Signature of owner or Electrical Contractor X Date
INSPECTOR.
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street P 0 Box 1150 Port Angeles Washington, 98362
Ph (360) 417 -4735 Fax: (360) 417 -4711
Date.
r�1 2 Single Family Dwelling
Owner Information -T? 't"‘oQl." 4l•
Name: Z.-bij/L t -r✓
Mailing Address:
City State: Zip:
Phone: Fax:
License Exp.
Item
Service /Feeder 200 Amp.
Seryice /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 to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy First 1500 sf Commercial
Note: $5.00 for each additional 1500 sf
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
Thermostat
NEW CONSTRUCTION ONLY.
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
1
Multi- Family or Commercial* Commercial Addition Alteration Remodel Repair*
Plan Review May Be Required Please Complete Electrical Plan Review Information Sheet
Job Address: S C ST 77 il
Building Square Footage:
Description of above �/1
i"Y) t, v 4. 'A..,. P, 7-�-, in_ 1-11""
C 4 Contractor Inf�rm. ation
Name: Z 7.-N r.
Mailing Address: 9, v `Tin A. r. f. ce. y v
City Y' A State:C- Zip: —7
Phone:,_ A 9 Fax: u y f:.„.
License 7
Unit Charge
119.90
145.50
204.60
262.20
372.50
2.60
73.50
2.60
92.70
110.30
148.70
167.90
95.90
88.20
95.90
63.90
63.90
119.90
102.30
56.00
110.30
35.20
73.50
110.30
225,
Signature of owner electrical contractor or electrical administrator
y
Dated:
i v
Qt
RECENED
Cash Check
ZS Credit Card
APR 14 2009
ELECTRICAL
INSPECTIONS
Total (QV Multiplied by Unit Charm
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.0 RCW Chapter 19.28, WAC Chapter 296 -46B, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14 05 050 regarding Electrical Permit Applications.
001110112010