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HomeMy WebLinkAbout434 E 5th St - Building 'S BUILDING' PERMIT ~ "'/.' CITY OF PORT ANGELES PUBLIC WORKS - BUILDINGDMSION 321. EAST 5TH STREET, PORT:ANGELES,'WA98362 OWNER/APPLICANT GREGLANGMACK 434 E 5TH STREET Port Angeles, W A 98362 360/457-9447 T: ISSUED: 8/18)2001 PERMIT NO: 12869 . PROPERTYI.OCATION 4345TH STE Lot: 1 Block: 198 0 . LOQg L~al.. Subdivision: TOWNSITE Parcel No: ,063000019800000 .. CONTRACTOR OWNER VARIOUS Port Angeles, W A 99360 206/000-0000 PROJECT INFO Project Value: $10,000.00 ProjectType: DORMERS Occupancy Type: . Occupancy Group: Construction Type: Zoning Use: SFD Units: "'SFDSQ FT:. 4 V'l' ~ ,0 o Commercial: Industrial: Garage: MFD Units: MFDSQ FT: ~ U) \t PROJECT NOTE$. .' .... . ..... . ." ADD TWO DORMERS OF 860 SQ. FT. TOTAL LIVING SPACE FEES ASSESSMENT Building Permit: Plan Check: St~feSlircl1arge: House Moving: Manufactured. Home: Sign: Plumbing: Me.chanical: Radon: $181.25 $0.00 .$4.50 $0.00 $0.00 $0.00 $41.00 $0.00 $0.00 Misq Fee 1: Mise Fee 2: MiscFee 3: TOTAL FEE: > - - - , ~ AMOUNT PAID: Separate Pel1Tllts are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements; Thi$ipel11lltbecomes null. and..volcfifwork orcon~truction authorized !s notco~~en~~ln18p.d~~!if C()nstruction or work Is !~_s~",q~'$I.:2t~~~l'Id~ed for a periooof 180 days after the work ascomrnenced, or it required Inspections have not been requested withi,,;t8.ClP...Jrgm~~last Inspection. I hereby certify that I have read ande~mi"edlhi$application and know the semelo be true andcorrr~ctAn provisions of laws and ordinances govemil'lg this type of work win beCOmpli~(fwith whether" specifieo herein or not. Thegrantingofap~\'mlt <:IgeS opt presume to giveauthorlty to violate or. cancel the provisions'of any state or local law regulating construction or the performance ()f construction. ..... ... .... . '. BUILDING PERMIT INSPECTION RECORD I rrrfrl OJ . . CALL 4174815 FOR BUILDING INSPECfIONS.PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT ISUNLAWFlILTO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. 'P6ST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED I YES INO . COMMENTS .. FOUNDATION: FOOTINGS WALLS FOUNDATION ELECTRICAL ROUGH.IN PLUMBING UNDER FLooR.! SLAB ROUGH.IN WATERLINE PRAINAGE (LlGHrDEPT) SEPARATEPERMIT:# ~ T I . .- GAS UNE BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I Roof'! CEILING DRYWALL T.BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP wOODSTOVE / PELLET/CHIMNEY /INSERT HOODIDUCTS PW UTILITIES! SITE WORK (Engineering Division) SEPARATE PERMIT #'s: I I J I I ~/j ~ /7..1.>'i6l..- ~f-:-;U I/.. , I I /J/J 1 ~ 1704 IVrz,. ~'h- / I. .-- WATERLINE / METER SEWER CONNECTION SANlTAR.Y STORM PLANNING DEn. SEPARATE PERMIT #'s PARKINGILIGHTING LANDSCAPING . MSIDENTIAL SEPA: ESA: SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE DATE YES NO.. COMMERCIAL , .. DATE ACCEPTED YES NO - . ELECTRICAL - LIGHT DEPT. - 417-4735 . ELECTRICAL LIGHT DEPT . ~~WJ1~~g.W. . FIRE DEPT. PLANNING DEPT. BUILDINC, CONSTRUCTION R. W./ PW/ ENGINEERING FIRE PLANNING DEPT. BUILDING 417-4807 417-4653 417-4750 417-4815 C:\APPL.WPD .,pOftT ~ w ~~ CITY OFPORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT . BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application. Nwnber . . Property Address . . . . ASSESSOR PARCEL NUMBER: Tenant nbr,' name . . . Application description Property Zoning . . . . Application valuation ~ 03-00000296 434 E 5TH ST 0630000198000000 GREG LANGMACK RES APDITION Date 3/20/03 10000 Owner Contractor STAPLETON RICHARD L PO BOX 3123 SEQUIM WA 98382500$ OWNER -- -- - - Structure Information ADD TWO DORMERS I PLUMBING I RENEW PERMIT -- --- Construction Type . . . .. TYPE V NON-RATED Occupancy Type . '.' . . . SINGLB FAM & CONGREGA'l'ES Other stroot info . . . . . NUMBER OF WITS 1.00 --------------_._--~------------------~.~.-~--~----------------------------- Permit . . . . . Additional desc Permit Fee . . . . Issue Date . . Expiration Date BUIWINGPERMIT-RESmIDIT~ RENEW PERMIT OLD #12869 90.62 ~lan Check Fee. 3/20/03 Valuation . . 9/16/03 .00 10000 .~ ~ ..::t. Qty unit Charge Per BASE FEE Extension 90.62 Fee summary Charged . Paid credited Due Permit Fee Total Plan Check Total Grand Total 90.62 .00 90.62 90.62 .00 90.62 .00 .00 .00 .00 .00 .00 ttJ. , .. ~ 1 0)' 'i.. Signature of Contractor or Authorited Agent Date 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 inspectlonshave not been requested within 180 days from the last inspection. I hereby certify that J 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. T:\PLANNING\FORMS\I I02.IS {412002] Bun.J)1N~~ERMITINSPE.CTIONRECORD ~ ,.: ," --' ''>-; " --'-:-;-'" . ,- - ^ ,,/~',,;..,_ ;Y,j><,-;~~-';~~_'; :-:,~~..:;'__ ",: _-:--j':--',r,<;:. --, -"':':.~-;:_-:~~~-~-..---:. ;-:::'~" .-. r ,'-;"":-<;:t-";:'.:,:,:"-i~:-,_~~",,_ ',J<EEP PERMIT CARD AND APPROVEOPLANS'AT JOB SITE "',' :.r" .' ," ','.' , c(:'~'~_ ' , , '," ,:{"" 'c';:", , INSPECTION TYPE ,DATE I ..~.. ,''^ ,', ~ :' ,: ~9MMENTS,'" ',~:,:, U,,),' ACCEf'lED""nn;: : """ :' ' ," " " , , , " , , I YES :'1" :';, NOt' ;', , , :'. '," "" <;;:' FOUNDATJONI , ' " ,,~, I"Y, ,', '" . ",.! ,. ..,' , ':,,' ~',' . FOOTINGS ,: I" : WALLS ' " ' , I:E' ':'.' ;, :....'.~ DRAINAGE " , , . , '," , FOUNDATION " ' , " , ELECTRICAL (LIGHT DEPT> SEPARATE PERMIT: II , . ROUGH.IN , I ' " II ' ," , . ::> , PLUMBING : ,,'hl';;::':,:' ,'" , ; , , ''', ' ' , -" UNDER FLOOR I SLAB :' , I ROUGH-IN , , ,'" WATER LINE ' " "', ' , GAS LINE . $./,:: ," ."~" BACK FLOW I WATER : , '" '; AlR SEAL " , ,". ' , , ,,';, " WALLS " . cmlNo :, ," ,,' , l ," " I ,c ", 's,:" ,;,: : , , FRAMING ,: :-_"c~ JOISTS I GIRDERS : , , '. I SHEAR WALL " , ','. WALLS/ ROOF/CEILING il DRYWALL , ," '. T-BAR '. , " , '. , .' " : INSULA TJON , : :' " . SLAB, . , ' I. WAtL I FLOOR 1 CEILING " MECllANlCAL , , " , HEAT PUMP . " , WOOO STOVE I PELLET I CHIMNEY HooDIDUCTS '., " . , ' '" , , , . PW VTILITtES I SITE WORK (Engi~~ring Division) SEPARATE PERMIT II's: .- ,: WATERLINE I METER ' ' , , SEWER CONNECTION :'- , SANITARY .' , STORM , " , PLANNING DEl'T. SEPAMTE PERMIT II's , SEPAl ; PARl{lNClLlGlfTlNG ;' .> , ESA: LANDSCAPING' , ", ,', . SHORELll'lE; " , . ,. , , " "c' ",'" ~. "-, ,,' ;,~,. -:~"~ ,FIM1,:'tNS!!(;:m~~S"~E:QPIRED ,,!,~r(j~t<:foc,t;1;lP~NJi\:Ig~~:~7;;:,: ,,~,,: , ,":;",." '" ; ;;:.r.,.. -" RE:SID~rJ"A!-, ' , ~" ' DAt~". " ;9,,':' ,:'G9)f~ERCi~..., " :;, iD~'Qt '~~1t ,,/{., ~~CP:J'ED!;" ; ", j,,'" " : ,..YES ,NO > . , i: ' ,,', ,L ,;. ' ,',-:,'j," " . :,," ,{,v. ": j ;, ;,."; :; "" , ~<):).;,;~,-yt,;\r~~;;}Y:l .:~:"~) .;"l~~:~':'-',Qf' l' ,~ ,{~:~ ,~~' :;~~,~: RYES';, ,,''''NO / ELEcjRlCAL. bGHTbEl'i.",,; " /'417.4735"; :'r, ,: >,,"": ", . . "I~ '}. ", :Ncr~gf" _,,:;': J' 'C ,,:'. ':, '1;dkj , " ': ,:...... : ';i.; " "" ': \' ;," X~:., ""J" 1'; ;',,,,, " , ;. , .' ,:" , ;' , . , , , COJIIStRUgwN p:'w:/pwi " '. ,''',", ,~,j -, '.' '.'/ !~NSTROciioN~~ i\V. ': ,;' . : ,'" " , , ,", ; ENGINEE . . 417-4807 pW I ENGINEElUN(,3 , " FIRE" >"', '---. , .. ,.417-4653 :' . FIRE DEPT. ,:',,, . ' " . ' " , '. , ,," PLANNING DEPT~ ' . ~-",_,_:1;." :~,_ ~:s.",..,-..::,./ 41~t'l7S9, ;;. ,-L ,. "PLANNING DEPT: "'''''' , "," :"" ",:,,;, :: '~:' ~;;;,; "", ."" ..: 11., .^ -, ,-" ' ": ,c' ~ , " BUILDIN<'l ' , . 417-4815'''- ~i//I'lS J'(A/ ::,'" ''', , BUILDING :" . , , '/ ,,- ,', ,: " L_,,~ T:\PLANNING\FORMS\1102.IS (412002) f !,ORT ~ S C},.~ ~~ ~~ BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY: Date Rec:.: ~ -i1~-6~ Pennit#: r tn, Date Approve : Date Issucdg -~ ~ ~ The Building Permit. - Pre-application must be filled out completely. Please type 0:- print ie ink. Ifyal: have any questioDs, pleas~ can 417-4815 Applicant and/or Agent: GId:6 lANGMACK Phone: 300 457 -1447 Owner: SA-rtf" Phone: SA- Jot t: Address:~ ~4 k-, sm Sf: City: fbcr MWEs Wit- Zip: 9 ~ :Yo 2- SAME: Cf1 M C Contractor -Xl ( \1-- License #: Address: Sft;M6 City: PROJECT ADDRESS: t.J ~ .('; . sm sr: LEGAL DESCRIPTION: Lot: Block: 1'18 Subdivision: TPA CLALLAM COUNTY PARCEL NUMBER: mD 00 3CJOOOIQ2,OCCredit Card Bolder Name:' Billing Address: City: Credit Card #: Exp. Date: ArchitectJEngineer: Phone: Exp: Phone: Zip: ZONING: VISA MC TYPE OF WORK: 14 Residential 0 New Constr. 0 Re-roof 0 Woodstove o Multi-family 0 Addition 0 Move 0 Garage o Commercial p( Remodel 0 Demolition 0 Deck o Repair 0 Sign 0 BRIEF DESCRIPTION OF THE PROJECT: C6AJ \fEElI A)G A ~D\J\)(o A ~12.MER- <'4- STAle..WA'I SIZEN ALUATION: SF.@$ ISF.=$ SF.@$ ISF.=$ SF. @ $ ISF. = $ TOTAL VALUATION $ Ie. 000.00 AlllC- 5PA<:-E 11) f\cb~K -+ Mnl fri COMMERCIALJRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: Lot Size: % Lot Coverage: % ,. Existing Lot Coverage: Isq. ft. + Proposed Lot Coverage: Isq. ft. = TOTAL LOT COVERAGE: Isq.ft PLANNING USE ONLY: APPROVALS: PLAN Notes: BLDG. DPW FIRE ESAlWet1and(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER BUILDING APPLICATION SUBMITrAL: Your application and site plan must befllled out completely to be acceptedfor review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. BUILDING, PERMIT APPLICATION SUBMITTAL: Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. V ALVA nON OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Div. to comply with current fee schedules. Contact the Permit Coordinator at 4174815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the buildfug permit application and construction plans are'submitted. All other permitfees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this application will expire by limitations. The Building Official can extend the time for action by the applicant up to 180 days, on written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for this permit. 1 understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's responsibility 10 determine what permits are required and to obtain such. . / PW. IJ 02_13 [""'JO I] Applicant: JG.A~~ Dale: ~ r I I ...,. ANGfY I SITE PLAN I DEPARTMENT OF PUBUC WORKS. BUILDING DIVISION APPUCANf: G (ofc') LOo<')0 ilhc::rJC .../ U '.J/,' 4 z (j -c / r '1 Cf ..;? A /\ fA G ~ I \ PROJECfIDEVELOPMENT ADDRESS: .I I [; '] I /. . " W r-! v I r,,' ,7\0 "^ /111 -I'v1 - See Page 4 for instructions on completing lhe site plan. For nlore ilifonnalion, caU 457-0411, utension 125. ~~ ~ I'. ~~ ~, C.. ~-- :::::~ """- .~(: K'- ~ l/ille <7~ hi h 1" - I' c, ...( ~ ~ r A'.....,... l 'llll v .. ,~ r- C C;/i!!!- )I'" .f i, "3 rJ 1\"1 ~ I In l{ Vi......) .. .' /(, rt'or I l , T ,'I-' " r- .. \(. - , ~ f fl){ ~ \ ~~ ~..: _. , I~ "OJ :~ \h "\ ~ ~ -...::.. .tz. '~0 ~~ . ~ , - I JA I I I ~ i.f (P" I . ::::: ..... '( ~P/Y dlf.J!~ I -ISU) S PHONE: Xt; - 't f)- Cj r r 7 a. I~ \~ I~p City of Port Angeles I f)J-6 b 9 Applicant Project Review Sheet ' Applicant: Owner: [V/-fJ) L CA (l J 111~ G/~ LVt~ (Y)i1cK- Property address: 'f 3 Lj E S;4, 5 f Proposed use: ~ Zoning: Re);jpfl.jt~) Is the proposed use listed as a "pennitted use" or an "accessory use" in this mne? Is this the only use (business. residence. etc.) on this site? Has there ever been a subdivision, shortplat, or PRO approved for this site, or has one been submitted and is pending approval? Does the proposed use require a new buisness license? Does the project extend into any required setbacks or cross any lot lines (interior or exterior)? Does the project exceed the permitted height allowance Or cauSe the property to exceed the allowed lot coverage in this mne? Does the project require any additional parking or special design/landscape improvements in this zone? Does the project eliminate any existing parking spaces? Is the project located within 200' of the shoreline? Are there any environmentally sensitive areas on or within 200' of the property, including: . . . wetlands or areas of standing water (year round or seasonal); · streams (year round or seasoDal); . areas with a slope of 40% or gRater; or · areas that have evidence ofpast gI'011Dd movement or erosion? Have all the required submittals been provided by the applicant? o Site Plan 0 Construction Drawings o ParkinglDrainage Plan 0 Civil Drawings o Energy Calc 0 Supporting Engr. Calc o LandscapelLighting Plan 0 Other )ryes: ok .yes: ok o yes: requires PO review o yes: requires CC review o yes: requires PO review o yes: requires PO review o yes: requires PO review o yes: requires PD review o yes: requires PO review o yes: requires PJj review o yes: ok o no: re'l.Wres PO l'eVlew o no: requires PO review ~no: ok .. no: ok ~ no: ok at' no: ok ~ no: ok ~ no: ok ~ no: ok 'trno: ~k o no: mark required item(s) UPlanning Department review i3 required. the processing time may be extended. Ifit is determined a seporate Planning Department pennit(.J) is needed. the Planning Department pennit(s) must be approved prior to the issuance of any other pennit. :':'. '.:" ".: ::::-:.";'.:',':":. .. ......."~.~~........~..P~"i.;.,......,:;1.......:L<,=.~,;m...... .j;~;.L",;L<<0:;.::jL;'.,L;.;[i:L~,~~ (see reverse side) Permit Category ## Building Permit # Route to: o BD 0 CC 0 FD 0 LD 0 PD 0 PW 0 File 0 Other Staff Initials Date Master Tmcking # Completion oj this form is required for all category 1 b. 2 & 3 permits. Completion is not requiredfor category 1 a permits unless they result in a potential change of use or occupancy. APRS.l (6-2S-971ria1 vonion) . Planning - - E'Ns-nAJ~ ~t= .21<3 ~13rrs .[]. s~ -ro -nIt:".. ' f1.&1N& r?A~ . . l~ It G.e. langmack upper level k'JaJ tb/GM~ Monday, August 13, 2001 l~r~1 ~ ~ [x.lSll,Jc" 2-~4 ~fAJ~ f )(.(STIAlC:, Cf~. U FblhJbAllotJ PI~n!1ing Abt>lW,L,v ~71 langmack upper level 1 Monday, October 15,2001 I~~G' <D '!! o ~ 1-(3'--1 E .b +V\ ffJS77tJ~ f2T))F " Planriing - '. langmack remodel ~^(STlNG. f1L\/'u FLOOIC "' n 0 ~ I- ~ ~ r--. N ~ ~ .~ ....... ~ ~ L- ~ ~ I ^ N ::'! c:l r--. ~ ~ ., ~ . . . . T ,. ,. . Monday,August13,2001 l').5{b 1 ), CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST: Date ,~-28 -Dc.. Time Received by RV (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle a ropriate one): Sewer Foundation Chimney Plumbing Final rn ~ c:;Y- L1 G-r-~ INSPECTION NOTES: Inspected: Date "3 - 2~-() 7- Remarks: Time Phone No~D- 9447 Permit No. /2869 Sewer Excav. Other ? By ~UL o~J( RESTORATION REQUIRED . . . . .. YES NO '" SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved o Gravel 0 Asphalt 0 PCC o Other o Repaired by City o Repaired by Permittee D No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ELECTRICAL ICAL PEI T CITY OF PORT ANGELES 360-417-4735 Application Number 16-00000595 Date 4/27/1.6 Application pin number 444900 Property Address . . . . 434 E 5TH ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -1 -9800 -0000 - Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning , . . . . . , RESIDENTIAL HIGH DENSITY Application valuation 0 Application desc Not Tub Owner Contractor. I.,A:u GMAC'IK., GREG, v ku: KEI..J,Y J KIRSCH ELECTRIC INC, 434 E 5TH ,'.3':[' P. 0, BOX 3396 PORT ANGELES WA. 99362 SEQUIM WA. 98382 (360) 683-6819 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc 1-4 CIRCUITS Permit Fee 75.00 Plan Check Fee .00 Issue Date 4/2.7/1.6 valuation . , , , 0 Expiration Date 10/24/16 Qty L it Charge PeiExtension, BASE SEE 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 IP REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X GAEXCHANGEWILDING Date: CITY OF PORT ANGELES PERMIT AppmcAmN Building Division/Electrical Inspections 321 East Fifth Street— P.O. Box 1150 /Port Angeles Washington, 98361 Ph: (360) 417-4735 Fax: (360) 4174711 Date: I & �2 Single Family Dwolflnq,, Plan Review aw Be Re aired, Ple%omplete Electrical Plan eview Information Sheet Job Address: Building Square Footage., Desorlption of above OwnerI f ro ao ti Nance: dY" Contractor Information Name. lviaj� Address Malling Addrew, 7th Stater. ZiP City_ $IaleWA Zip; Ph Fax Phone,, ax. License #1 Exp. License # I Exp. Item, Unit.Chgme C& Total (Bitty Multiplied by Unit CLaMej 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 ServiceTeeder over 1000 Amp. $313.00 $ Branch Circuit W1 Service Feeder $ 5.00 Branch Circuit W/O Service Feeder $ 63.00 $_ Fach Additional Branch Circuit $ 6,00 Branch Circuits 1-4 $ 75.00 Temp. Service/ Feeder 200 Amp. $ 95_00 Temp. Servloe/Feeder 201-400 Amp. $110.00 $ Temp. Servicelreader 40 1 -600 Amp. $149.00 Temp. Service/Feeder 601-1000 Amp.. $ 168M Portal to Portal Hourly $ 96.00 Signal Circuit/ Limited Energy - 1 & 2 Family Dwelling $ 64.00 ManuWured Home Conneotion $120.00 Renewable Electrical Energy - 5KVAystern or Less $102,00 Thermostat 56.00 Note: $5,00 for each�ratat First 1300 Square rt. $120.00 $ Each Additional 500 Square R or Portion of $ 40,00 $_ Each Outbuilding or Detached Garage $ 74.00 $_ Each Swimming Pool or Hot Tub $1110-00 $_ Total Owner as defined by KCvV. 19. 281011, (1) Owner will occupy the structure for two years after this electrical pernrift is finalized. (2) Owner is required to hire an electrical contractor it move Bald property is for sale, rent or lease. Permit expires after six months of last inspection. . After reading the above statement� I hereby cortify that I am the owner of the above named property or a licensed electrical cantractor. I am making the electrical installation or alteration In compliance with the electrical laws, NE.C., RCW, Chapter 19,28, WAC. Chapter 2964613, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05,060 regarding Electrical Permit Applications. Signature of owner, electrical c�ntractor or electrical administrator: M Cash 11 Check —Pow* 91191IM112 Z*_