HomeMy WebLinkAbout1326 W 4th St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPME1'fI - BUILDING DIVISION
, 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number . . . .
property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
property Use
property zoning . . .
Application valuation
05-00000026 Date
.095808
1326 W 4TH ST
06_30_00_0_1_1925-0000-
RES ADDITION
4/12/05
RS7 RESDNTL SINGLE FAMILY
14000
Contractor
Owner
------------------------
------------------------
ASHLEY, BARBARA
1419 S PACIFIC VISTA
PORT ANGELES
(360) 565-0262
Structure Information
Construction Type
Occupancy Type
Other struct info
WA 983631830
MOORE CONSTRUCTION
1385 E. ELLIOTT CREEK RD.
PORT ANGELES WA 98362
(360) 457-8890
583 SF DETACHED GARAGE
TYPE V NON-RATED
GARAGES, CARPORTS, SHEDS
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
HARD SURFACE AREA
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
29.90
V-N
1. 00
1512.00
7000.00
583.00
2095.00
1. 00
permit . . . .
Additional desc
permi t Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
583SF CARPORT/GARAGE
260.75 Plan Check Fee
4/12/05 Valuation
10/09/05
104.30
14000
oJ
"F'
~.
----------------------------------------------------------------------------
Qty
Unit Charge Per
BASE FEE
14.0000 THOU BL-2001-25K (14 PER K)
Extension
92.75
168.00
~,,~
c.
----------------------------------------------------------------------------
12.00
...:t:
--:!
....
Special Notes and Comments
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
The proposal will add a detached garage and carport in the
RS-7 for a total lot coverage of 30%. setbacks are good.
No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
3.5 foot clearance over new roof required
Other Fees
STATE SURCHARGE
4.50
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 260.75 260.75 .00 .00
Plan Check Total 104.30 104.30 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 369.55 369.55 .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.
~ ~O C;,;>l~.Q.~ y/1~)65 1\
Signature of Contractor or Author. ed Agent Date Signature of Owner (if owner is builder) Date I \
T:\poJicies\1102_15 building permit inspection record05.wpd (1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRlCAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST P.ERMIT IN A CONSPICUOUS LOC~TION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE T ACCEPTED COMMENTS
YES T NO
FOUNDATION: . ,
FOOTINGS t;7~o7ag --:J ~L-
WALLS
FOUNDATION DRAINAGE I DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS I GIRDERS
SHEAR W ALLIHOLD DOWNS 7r/(rC~- :Ju...
WALLS I ROOF I CEILING 77a9/" l~ .5 t.-L
DRYWALL (INTERIO ANEL ONLY)
T-BAR .4
" J I
INSULATION
SLAB
WALL I FLOOR I CEILING I
MECHANICAL
HEAT PUMP I FURNACE I DUCTS
GAS LINE
WOOD STOVE I PELLET I CHIMNEY
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKlNGILIGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 /;;// / tJ ~. ..77{. BUILDING
. . . . C rd05. d 1/li/2005
T.\PohclesIII02_15 bUlldmg permIt mspectlon re 0 wp [
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BUILDING PERMIT - APPLlCA TrON
FOR OFFICIAL USE ONLY:
Date Rec.: 1-10
~it#:C<::;-
Fill out COMPLETELY and in INK. Your application and site plan MUST B '
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Date Approved:
Date Issued:
~:~:~n(or~gent ~~i~a Mrey
Addrcss~ ~~~ j.J , LfH, \t C;tyj?, ~
Architect/Engineer: Eye <.Z;IvYl fZ () lei 1 ~St' 51
Contractor1'1l2D r; -;.~<'.;1 ~T State License #:
Address: _ City: P A
PROJECT ADDRESS: {?> d C:, lAJ \ ~ S+-
Phone: .5 (.;5-W62- ~ 07Jr -F
Phone: S (,S --3udd-- ~)I::.-,
Zip: 0;8, 3 U
Phone:
. ,
- ;)
Exp:
Phone:
Zip: 9g36'L-
ZONING:
LEGAL DESCRJPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
Credit Card Holder Name:
Billing Address: City:
Credit Card Type VISA MC # Exp. Date:
TYPE OF WORK: SIZEN ALUATION:
o Residential 0 New Constr. 0 Re-roof 0 Stove SF. @ $ /SF. = $
o Multi-family 0 Addition 0 Move 0 Garage SF. @ $ /SF. = $
o Commercial 0 Remodel 0 Demolition 0 Deck "'5 8;~ SF.@$/SF.=$7
o Repair 0 Sign 0 Other TOTAL VALUATION (Il.rooo
BRIEFDESCRIPTIONOFTHEPROJECT',cQp~ckp# 3qCZl~'y' j k4r 0',roj<' " Goir
Co (V, d-c
TIAL: Occupancy Group:
No. of Stode" -L Lot Size, 7, ndn Eilidng Sq. Ft I f,~
Total lot coverage ;Ii.... %
Occupant Load:
Construction Type:
& Proposed Sq. Ft. ,';;-J? .~ = TOTAL Sq. Ft. boQ5-
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BUILDING PERMIT APPLICA TION SUBMITTAL: The Building Division can provide you with infonnation on the application and
plan submittal requirements if you have questions.
VALUATION 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 Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no pennit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section Rl 05.3.2
of the International Building/Residential Code, 2003). 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. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permits prior to work.
nRVESS\BI.DG-f~'-b=h"re'~003_B"Od;"gpo="'WPd . AppH,,,,,, ~'-g. a 6.M:j Date, 00/o~
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CITY OF PORT ANGELE'
DEP ARTl\~~i'>JT OF COMMUNITY DEVELOPMEN - - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Application pin number
property Address
ASSESSOR PARCEL NUMBER:
Application .type description
Subdivision Name
property Use
property zoning . . .
Application valuation
05-00000026 Date
095808
1326 W 4TH ST
06_30_00_0_1_1925-0000-
RES ADDITION
7/11/05
RS7 RESDNTL SINGLE FAMILY
-HMO ~1j'Vi\V---
contractor
owner
------------------------
------------------------
000
MOORE CONSTRUCTION
1385 E. ELLIOTT CREEK RD.
PORT ANGELES WA 98362
(360) 457-8890
000 583 SF DETACHED GARAGE
TYPE V NON-RATED
GARAGES, CARPORTS, SHEDS
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
HARD SURFACE AREA
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
29.90
ASHLEY, BARBARA
1419 S PACIFIC VISTA
PORT ANGELES
(360) 565-0262
Structure Information
construction Type
occupancy Type
Other struct info
WA 983631830
V-N
1.00
1512.00
7000.00
583.00
2095.00
1.00
permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
PROPANE INSERT
54189
PA SWIMMING
57.65
7/11/05
1/07/06
HOLE & FIREPLACE S
plan Check Fee
Valuation
~~'V
---
~~
~~ ~
~ ~
\ C' ~
~\~
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-%-~ ~
v" 1 \
~
----------------------------------------------------------------------------
.00
o
Qty
Unit Charge Per
BASE FEE
10.6500 ECH ME-GAS PIPE 1 TO 5
Extension
47.00
10.65
----------------------------------------------------------------------------
1.00
special Notes and Comments
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
The proposal will add a detached garage and carport in the
RS-7 for a total lot coverage of 30%. SetbackS are good.
No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
3.5 foot clearance over new roof required
----------------------------------------------------------------------------
----------------------------------------------------------------------------
Other Fees
. . . . . . . . .
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
permit Fee Total 57.65 57.65 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 62.15 62.15 .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 Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\Policies\ 1102_15 building permit inspection record05.wpd [1/4/2005]
R" DING PERMIT INSPECTION REC( ')
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 A CCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
r YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEIUNG
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF 1 CEILING
DR YW ALL (INTERIOR BRACED PANEL ONL Y)
T-BAR
INSULA TION
SLAB
WALL / FLOOR I CEILING
MECHANICAL .5N ~t:l",.,O fi9>> t--
HEAT PUNW 1 FURNACE 1 DUCTS ~P~L-rA-Mk. ~,(~-~ 3U-
GAS LINE ~ 1'-0 5 .1.l.. )...
WOOD STOVE 1 PELLET 1 CffiMNEY
COMlvIERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKlRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKINGILIGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRroR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - UGHT DEPT. 4] 7-4735 ELECTRICAL
UGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 I~ -Io-os J.LJ... BUILDING
T:Woliclcs\ I 102_15 buildlllg permit IIlspectlon record05.wpd [1/4/2005J
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98~62
AppLlcatlon Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
05-00000640 Date
511040
1326 W 4TH ST
06-30-00-0-1-1925-0000-
ELECTRICAL ONLY
7/26/05
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
ASHLEY, BARBARA
1419 S PACIFIC VISTA
PORT ANGELES WA 983631830
( 36) 565-0262
OWNER
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- -- - - - - - - - - - - - - - - - - - - - - - - - - - --
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
JEDI/RES. GARAGE
55863
48.10 Plan Check Fee
7/26/05 Valuation
1/22/06
.00
o
~
\J
S'
Qty
1. 00
Unit Charge Per
48.1000 ECH EL-R-OUTBD/DTCH GAR SEP
Extension
48.10
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 48.10 48.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 48.10 48.10 .00 .00
c
~
~
'-
COMMENTS/ACTION NEEDED
~
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE J ACCEPTED COMMENTS
I YES NO
III LH
RJUuti-IN I COV.ER
~bKVICb
FIN AT II, ".j.1K"1 kJJ I
GENERAL COMMENTS:
PW.II02.13 (4196)
(i
'~PliOO'ion Numbo"
Application Din nl1rnh""'......
property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98~(,2
05-00000640 Date
-- ~: 1:
1326 W 4TH ST
06-30-00-0-1-1925-0000-
ELECTRICAL ONLY
7/20/05
,
I
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
ASHLEY, BARBARA
1419 S PACIFIC VISTA
PORT ANGELES WA 983631830
( 36) 565-0262
OWNER
-----------,-----------------------------------------------------------------
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc JEDI ELEC. / RAISE SVC. MAST
Permit pin number 54981
Permit Fee 36.30 Plan Check Fee
Issue Date 7/20/05 Valuation
Expirat'ion Date 1/16/06
.00
o
Qty
1.00
Unit Charge Per
36.3000 ECH EL-R OR RM REPAIR METER/MAST
Extension
36.30
---------------------------------------- -----------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 36.30 36.30 .00 .00
Plan Check Total .00 .00 '.00 .00
Grand Total 36.30 36.30 .00 .00
COMMENTS/ACTION NEEDED
ELECfRJCAL PERMIT INSPEQJON RECORD
CALL 4) 7-4735 FOR ELECTRlCAL INSPECTIONS: PLEASE PROVIDE A MINlMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
COMMI.NTS
NO
GENERAL COMMENTS:
PW-II02.U lolI96I
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 15873
5'-/3 }>r-
Port Angeles, Washlngtoll..___.___.___..______..'-__.__.__...__......___.......mm.. 19.____~
In accordance with the City Ordinance to regulate the Installation. extension. or repair of elec-
trical equipment In. on, or about any building or other structure In the City of Port Angeles. per-
mission Is hereby granted to dO electr;t.c .work as listed below.
/
/3 ;; C;; tJ-. yz( . - -"'J...............
Address .---.:-3e~e:a:~---~-~.-----:-::i~.--.~;;.:4;;t.7>.""-- Occupancy___._____._.________..m_____..______________..
~:::~-~:~~~~~~.::4~~~~Y:~::::----~~::~~;:::::::::::::--.:.....~::::::::::=:::::::::::::::::::::::::::::::::::::::
.$0
Light Outlet.................7..._____.................
5-'U
Receptacle Outlets.....................nn......
:::::, ::._.:_..:_..-;~:::_._.....:...._._:-_:-.._-_.
Water Heater: /
KW..........y.~..!..___..___..___.___..___..
Heat' KW...../.X..._JlfJ........u..uu
Motors: size, volts and phase:
/ /, ,~
.c...L~~.....1'.......................................
/1(1/ .r-
:..._._..~................_......--..................
Service, volts .........00............................
No. wires .......................................
Size wires...n................n...n......._..
Main fuse .............00........................
Enclosure 00..............0000...................
Type of wiring:
Entrance Cable ....00..........
Rigid Conduit .......n.mm
Metallic Tubing .....0000
Current transformers:
No. & Size.......................................
Ser. NO.................................n............
Ser. No. ...00........................................
Ser. NO....__nn....................................
Type at Wiring:
Armored Cable ..............................
Non-Metallic .....nnn.n...................
Knob & Tube.......................n......._
Rigid Conduit ...._______....................
Metallic Tubing ...........................
Raceway ......................._......__..._
,-r
Circuits, Light..,~>:?...............................
. t;-
~:~:ty..::/?::::::::::::::::::::::::::::::::::
Range ..,t.:..........,,_,______...................
<1-
Water Heater ...............................
Motor ..._........................................
Dryer.....d...n.......nnnn....................
Furnace .........................._......_...........
;;'1
Total Load............................. Ser. No. ..0000..........._.......................... Total .........n....nu....................
Remarks: _u.u.u.u.u-;.t:1J.f2.::!u_....r:::..hL_..('J:'2.:.__\.-.J-c..~;t..~h.nn.un.uuu.uu..uuunnnunn.nu.un_n_n.nn.n_n.n....Uh._U"
-;~~;~"~J~---m---.-------m---------;~~~~...;~~~;~~-----m..----.m------------------~-------"P--~lJ--'-----;g-------------
$_____.lt.L/!...._____m__._____ No...___.___________.__________ By ._,~---!-----lf&..---..~.'::!::..'=~'!::?:!:.<:=:~.
NOTICE-Current must not be turned on until Certificate at Inspection has been issued. If work is to be con.
cealed due noUce must be given the Inspector so that work may be inspected belore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
15873
Address.........................................................................................__.............................................Date..._......_.._.._.._.........._......_......_.........
Owner ...............n.................._n........_......_......_.._........................un............................... Tenant..........................u.............__.........................
Wiring Contractor....................................... ...................................................................................By..............................................................
NOTIC~urrent must not be turned on untH Certificate of Inspection has been issued. If work Is to be con-
cealed due notice must be given the Inspector so that work may be Inspecte~.. before concealment.'
1M Olympic Printers, Inc.
ELECTRICAL INSPECTiON
WIRING REPORT
417-4735
I
I
i
Pl::RMIT II
05/
/
'let{)"""":
ADORES~ u.--.
.~ W
APPROVE~~ NOT APPROVED
~. ..... : : .... '\ '.~\' ~~~G~I~~/~O~E~ . . . . . . . . . . . . . . . ~
D. . . . . . . . . . . ."" . . . . . SERVICE. . . . . . . . . . . . . . . . . . . 0
'" \ .
D................~ FINAL....................)if
@~
CORRECTIONS NEEDED /-lu . ',dt;,fJ k?~
bF'"C!.-1 ~-;e.L).
Z: Au- <~
Id I'
~)
#4"/.(.~
Go I-'
~
LA) o/-f-K:6
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS,INC_ (360) 452-1381
4
,.
ELECTRICAL WORK PERMIT APPLICATION"
f "' I Installation description 'I
Job wired by IllElectrical Contractor DOwner o Commercial ,!G'" Residential
Electrical contractor name License number Date Expires !iJ. Altered/Addition
.~O; Efa:rh',,- ~""1)f EE i)'1S7c2.. D New
Purchaser's ~ng a~drcss Rt:\fSe. Serul'ce '{V\",-sr 5 (,.3:0
p,o. X <~5J>
City State ZIP ?!"_A:!Jk1 ~-
PorT it,^')ekr tJ~ 't,f.~a l1) ~ ..l~
Telephone number FAf;7mber
1.-/&0-0550- 65 - 1/7,5' -{- (..l_ /f<;;./6
Premises owner's name
--.ROrbCArc-.. A~h ie 'I
Address of inspection 1{Th.
15) 6 WeST
City PDI T A II\J e/.eJ
Phone number to schedule inSpeCtion:r ~~ 5"- 30.:Le.\ ,
Owner as defined hy RCW19.28.261:(J) Owner will occupy the .\.truclure}~)r 111'0
years after this electrical permit is finalized. (2) OWller is required to hire an electrical
contractor if above said property is for sale, rent or lease. D Cash D Check #
After reading the above statement, I hereby certify thai I am the owner of the above r:9
named property or a licensed electrical contractor. I am making the electrical instal- prtredit Card Mastercard Discover
lalion or alteration in compliance with the electrical laws, N.E.C., RCW. Chapler
19.28. WAC. Chapter 296-46B, The City of Port Angeles Municipal Code. and Card # - - -
Utility Specifications. ----------------
Signature of ~er. electrical contractor or electrical administrator Expiration Date ( r8e;~~O
X 4'-/ --;;z::; Date: 7ii-c?5 of card
..
c
(J
I
~
..c
o
Electrical Load AddItIons and or subtractIons
)"l"NO LOAD CHANGES
o Baseboard _ KW
CI Furnace KW
o Heat Pump _ Ton _ LAR
D Fan-Wall KW
o Overhead Service
o Temp Service
o Underground Service
Service Information
Vollage (2~/;2.f(' ()
Phase"5ill D 3
Service Size: ;J 00
Feeder Size:
SAME DAY INSPECTION CALL BEFORE 7.00 AM 3604174735
, - - A-
ROUG'k ) THERMOSTAT '\ SER~~
7 -d-..7- 05 ~':<f2.,-tJS A",o'O' By /'
'- Dale Approved By Dale Approved By ../
FINAL f DITCH ;' FEED~_
/1-2-8-<< hD 7-.:11- OS :.,J
.
Date Approved By/ '-. Dale Approved By Dale Approved~/
Inspection Area, Building or Equipment Inspected Action Taken Electrical
Dale Inspector
/#h~hS- P/N~ ~'~O,.;L Ae-~ o-t'l.A"' C//J /Jzp(J
/ /
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