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ELECTRICAL PERMIT Al\TD INSPECTION RECORD
CITY OF PORT ANGELES
360-417-4735
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000387 Date 10/23/07
876779
704 E 4TH ST
06-30-00-0-1-7440-0000-
D. SCOTT BURGETT
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
15084
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26.00
1. 00
1301.00
7000.00
528.00
1829.00
1. 00
Permit ELECTRICAL NEW RESIDENTIAL
Additional desc OWNER/ 60A SUB TO GAR.+ WIRE G
Permit pin number 112896
Permit Fee 75.00 Plan Check Fee
Issue Date 10/23/07 Valuation
Expiration Date 4/20/08
.00
o
Qty
1. 00
Unit Charge Per
75.0000 ECH EL-RM-0-200 1ST SRV FEEDER
Extension
75.00
Special Notes and Comments
PERMIT EXTENDED, LETTER ON FILE.
10/24/2006 12:08 PM PERMITS --------
The Fire Department has reviewed the project application and
has no comments
05/15/2006 09:52 AM SROBERDS -- The proposal will allow
a 528 sq. ft. detached garage in the RS-7 for total lot
coverage of 26%. No land use issues noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES, service wires will
be too close to new building.
05/02/2006 10:59 AM GMCLAIN ----------------------------
Electrical load calculations and elctrical permits are
required.
Driveway will be off alley, existing driveway drop when
used will be constucted to City Standards.
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
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SPECTION ELECTRICAL
TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
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f ,ORT~.
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 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
06-00000387 Date
876779
704 E 4TH ST
06-30-00-0-1-7440-0000-
D. SCOTT BURGETT
RES DETACHED GARAGE
3/16/07
RS7 RESDNTL SINGLE FAMILY
15084
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26.00
1. 00
1301. 00
7000.00
528.00
1829.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
97295
50.00
3/16/07
9/12/07
Plan Check Fee
Valuation
.00
15084
Qty Unit Charge Per
1.00 50.0000 ECH RIGHT OF WAY PERMIT
Extension
50.00
Special Notes and Comments
PERMIT EXTENDED, LETTER ON FILE.
10/24/2006 12:08 PM PERMITS --------
The Fire Department has reviewed the project application and
has no comments
05/15/2006 09:52 AM SROBERDS -- The proposal will allow
a 528 sq. ft. detached garage in the RS-7 for total lot
coverage of 26%. No land use issues noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES, service wires will
be too close to new building.
05/02/2006 10:59 AM GMCLAIN --------------~-------------
Electrical load calculations and elctrical permits are
required.
Driveway will be off alley, existing driveway drop when
used will be constucted to City Standards.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---..,------ ----------
Permit Fee Total 50.00 50.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 50.00 50.00 .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 I regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
T:\Policies\1102.15R [1/05]
---.--.-
,
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO Co,VER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS I
YES NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
,
SIDEWALK
CURB & GUTTER
DRlVEW A Y APPROACH
BACK-FLOW DEVICE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
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 BUILDING
. I
T:\Policies\1102.15R [1/05]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TII STREET, PORT ANGELES, W A 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
06-00000387 Date 10/24/06
876779
704 E 4TH ST
06-30-00-0-L-7440-0000-
D. SCOTT BURGETT
RES DETACHED GARAGE
[,<<{ ~~/Ih1J
RS7 RESDNTL SINGLE FAMILY
15084
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26.00
1. 00
1301.00
7000.00
528.00
1829.00
1. 00
Permit SANITARY SEWER HOOK UP
Additional desc CONNECT GARAGE
Permit pin number 77727
Permit Fee 40.00 Plan Check Fee
Issue Date 5/17/06 Valuation
Expiration Date 11/15/06
.00
15084
Qty Unit Charge Per
1.00 40.0000 EA SAN SEW REPAIR
Extension
40.00
Special Notes and Comments
PERMIT EXTENDED, LETTER ON FILE.
10/24/2006 12:08 PM PERMITS --------
The Fire Department has reviewed the project application and
has no comments
05/15/2006 09:52 AM SROBERDS -- The proposal will allow
a 528 sq. ft. detached garage in the RS-7 for total lot
coverage of 26%. No land use issues noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES, service wires will
be too close to new building.
05/02/2006 10:59 AM GMCLAIN ----------------------------
Electrical load calculations and elctrical permits are
required.
Driveway will be off alley, existing driveway drop when
used will be constucted to City Standards.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40.00 40.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 40.00 40.00 .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. :~
. ;;9~~14:4';;i(-- /t1/?/;I;t
Signature of Owner (if owner is p~lder) . I Date
Date
Signature of Contractor or Authorized Agent
T:\Policies\J J02.J5R [1/05]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES 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 I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W./ PW/ CONSTRUCTION - R.W.
ENGINEERING 411-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING -
T:\Policies\1102.15R [1105]
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c:J.f'ORT~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32] 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
06-00000387 Date 10/24/06 ~t:ft:T"t;;N~/O~t>'j-
876779
704 E 4TH ST
06-30-00-0-1-7440-0000-
D. SCOTT BURGETT
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
15084
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL %
NUMBER OF
EXISTING
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
LOT COVERAGE
STORIES
LOT COVERAGE
26.00
1. 00
1301.00
7000.00
528.00
1829.00
1. 00
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit pin number 75473
Permit Fee 291.75 Plan Check Fee 116.70
Issue Date 5/17/06 Valuation 15084
Expiration Date 11/15/06
Qty Unit Charge Per Extension
BASE FEE 95.75
14.00 14.0000 THOU BL-2001-25K (14 PER K) 196.00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
77891
86.00
5/19/06
11/15/06
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
BASE FEE
2.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE
1. 00 15.0000 ECH PL- EA. BLDG SEWER
Extension
50.00
14.00
7.00.
15.00
12
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~ ~
YO
(p
Special Notes and Comments
PERMIT EXTENDED, LETTER ON FILE.
10/24/2006 12:08 PM PERMITS --------
The Fire Department has reviewed the project application and
has no comments
05/15/2006 09:52 AM SROBERDS -- The proposal will allow
a 528 sq. ft. detached garage in the RS-7 for total lot
coverage of 26%. No land use issues noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES, service wires will
be too close to new building.
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. $;::tf~<>c~ /IiJ-z-fJd
Signature of Contractor or Authorized Agent Date Signature of Owner (if ownerfs builder) I Date
T:\Policiesl] ] 02_] 5 building penni! inspection record05.wpd [] /4/2005]
BUlLDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 4 I 7-4807 FOR PUBLIC WORKS UTILITIES
PLEAS~ P,B.OVIDE A MINIMl)M 24 HOUR NOTICE. IT IS UN LA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
.. "'. <......, \J.."') 4:. \.~':lii!lp~€.TE7i>A.ND..ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
. - KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDA nON DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMIJINC
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLOG)
SHOWER PAN FINAL DATE ACCEPTED BY:
MEDICAL GAS LINE
AIR SEAL
WALLS
CEILING I I
foRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DR YW ALL (fNTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I I
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY:
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 NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W./ PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 .' FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number . . . . . 06-00000387
Application pin number 876779
Page 2
Date 10/24/06
Special Notes and Comments
05/02/2006 10:59 AM GMCLAIN ----------------------------
Electrical load calculations and elctrical permits are
required. ".'. ~.""~.i -;... ~
Driveway will be off alley, existing driveway drop when"
used will be constucted to City Standards.
, '
./
.
Fee summary Charged Paid Credited
----------------- ---------- ---------- ----------
Permit Fee Total 377.75 377.75 .00
Plan Check Total 116.70 116.70 .00
Grand Total 494.45 494.45 ',00
Due
.00
.00
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~.eparate 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
f9r.Cl 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.
t-
.) .
..
..
~ '!i
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\l 102_15 building permit inspection record05.wpd [1/4/2005]
B~DING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICALlNSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UN LA WFUL 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.
I'
I INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION: .
FOOTINGS ~/,q{~ l7tu
SHEAR WALLS 1 WALLS ,
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING ,
UNDER FLOOR 1 SLAB ~/Iq lor.- 17/"'/;
-r
ROUGH-IN
WATER LINE (METER TO BLDG)
SHOWER PAN FINAL DATE ACCEPTED BY:
MEDICAL GAS LINE
AIR SEAL
WALLS
CEILING
FRAMING ~ I vil0'7 -Oi
JOISTS 1 G1fU)ERS r ,
I ( SHEAR W ALL}-IOLD DOWNS ~1'lg7()i "\, ~L.
WALLS 1 ROOF 1 CEILING I
DRYW ALL (rNTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP / FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
,
SKIRTING
PLANNING [)EPT. SEPARATE PERMIT#'s SEPA:
P ARKING/LICHTING 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 1 ENGINEERING
FIRE 417-4653 ,. FIRE DEPT. '
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 l.t ~ '7:if", /') X "d"L--L- BUILDING
, ,
T:IPolicieslll02_15 bmldmg penmt mspecl10n record05.wpd [1/412005]
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October 17, 2006
City of Port Angeles Building Permit Administrator
321 East 5th Street
Port Angeles, WA 98362
SUBJECT: EXIEN110N OF BUILDING PERMITS REQUEST
Dear Building Permit Administrator, (0 .:;. "'~")
Please extend the following permits for the residence at 704 East 4th Street: for an additional 180 day period:
Building Permit 75473 - Expiration Date 11/13/06
Plumbing Permit 77891 - Expiration Date 11/15/06
Sanitary Sewer Hook Up - Expiration Date 11/13/06
The permits are issued for construction of a residential detached garage. The application number for all the
permits is 06-00000387.
~__'--4
Sincere}y, --;
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32\ 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
06-00000387 Date
876779
704 E 4TH ST
06-30-00-0-1-7440-0000-
D. SCOTT BURGETT
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
15084
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
77891
86.00
Plan Check Fee
Valuation
11/15/06
Qty Unit Charge Per
BASE FEE
2.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE
1. 00 15.0000 ECH PL- EA. BLDG SEWER
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/15/2006 09:52 AM SROBERDS -- The proposal will allow
a 528 sq. ft. detached garage in the RS-7 for total lot
coverage of 26%. No land use issues noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES, service wires will
be too close to new building.
05/02/2006 10:59 AM GMCLAIN ----------------------------
Electrical load calculations and elctrical permits are
required.
Drivew~y will be off alley, existing driveway drop when
used w111 be constucted to City Standards.
5/19/06
26.00
1. 00
1301.00
7000.00
528.00
1829.00
1. 00
.00
o
Extension
50.00
14.00
7.00
15.00
Fee summary Charged Paid Credited Due
------------ ---------- ---------- ----------
----------
Permit Fee Total 86.00 86.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 86.00 86.00 .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. ~Jb.7I S://,tft6
Signature of Contractor or Authorized Agent Date Signature of Own (if owner is builder) Date
T:\Policies\1102_15 building pennit inspection record05.wpd [1/412005]
BUILDING PERMIT INSPECTION RECORD
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 PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLOG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I
MECHANICAL
HEAT PUNWI FURNACE I DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD / DUCTS
MANUFACTlJRED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING 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. / PW / CONSTRUCTION - R.W.
ENGINEERING 4 I 7-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005)
,--
s
~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST'STHSTREET, 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
06-00000387 Date
876779
704 E 4TH ST
06-30-00-0-1-7440-0000-
D. SCOTT BURGETT
RES DETACHED GARAGE
5/17/06
RS7 RESDNTL SINGLE FAMILY
15084
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26..00
1. 00
1301.00
7000.00
528.00
1829.00
1. 00
Permit SANITARY SEWER HOOK UP
Additional desc CONNECT GARAGE
Permit pin number 77727
Permit Fee 40.00 Plan Check Fee
Issue Date Valuation
Expiration Date 11/13/06
.00
15084
Qty Unit Charge Per
1.00 40.0000 EA SAN SEW REPAIR
Extension
.40.00
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/15/2006 09:52 AM SROBERDS -- The proposal will allow
a 528 sq.ft. detached garage in the RS-7 for total lot
coverage of 26%. No land use issues noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES, service wires will
be too close to new building.
05/02/2006 10:59 AM GMCLAIN ----------------------------
Electrical load calculations and elctrical permits are
required.
Driveway will be off alley, existing driveway drop when
used will be constucted to City Standards.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40.00 40.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 40.00 40.00 .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 pennit does not
presume to give authority to violate or cancel the provisions of any state or I aw r ulating construction or the perfonnance of
construction.
Signature of <:ontractor or Authorized Agent
Date
T:\Policics\1 102. 15R [1105]
i--U
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNEcnON
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUcnON R W.I PWI CONSTRUcnON - RW.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-46S3 FIRE DEPT.
PLANNING DEPT. 417-47S0 PLANNING DEPT.
BUILDING 417-481S BUILDING -
T:\Policies\1102.ISR [I/OS]
If 90RT ~
tw~
... ---
----
~"'~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
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
06-00000387 Date
876779
704 E 4TH ST
06-30-00-0-1-7440-0000-
D. SCOTT BURGETT
RES DETACHED GARAGE
5/17/06
RS7 RESDNTL SINGLE FAMILY
15084
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26.00
1. 00
1301.00
7000.00
528.00
1829.00
1.00
Permit . . . . .
A~ditional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
75473
291.75
Plan Check Fee
Valuation
116.70
15084
11/13/06
Qty Unit Charge Per
Extension
95.75
196.00
BASE FEE
14.00 14.0000 THOU BL-2001-25K (14 PER K)
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/15/2006 09:52 AM SROBERDS -- The proposal will allow
a 528 sq.ft. detached garage in the RS-7 for total lot
coverage of 26%. No land use issues noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES, service wires will
be too close to new building.
05/02/2006 10:59 AM GMCLAIN.----------------------------
Electrical load calculations and elctrical permits are
required.
Driveway will be off alley, existing driveway drop when
used will be constucted to City Standards.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 291. 75 291. 75 .00 .00
Plan Check Total 116.70 116.70 .00 .00
Grand Total 408.45 408.45 .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
Date
T:\Policies\1102_15 building pennit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4 I 7-4735 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 PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION: I
FOOTINGS ~/rq Itx. J"t..-
SHEAR WALLS 1 WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALUHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING ~
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE ~~
WOOD STOVE I PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD 1 DUCTS ,~
MANUFACTURED HOMES I~ J
FOOTING 1 SLAB I~~
BLOCKING & HOLD DOWNS
SKJRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTlNG 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 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
~
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~
~
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T:IPoliciesllI02_15 building permit inspection record05.wpd [1/412005]
FOR OFFI~ USE ONLY:
BUILDING PERMIT - APPLICATION Date Rec.: ?!3/0&
/ ,~pennit #: .-
Fill out COMPLETELY and in INK. Your application and site plan MUST :&E h llDate Approved. 1
COMPLETE to be accepted for review. If you have any questions, call L!I e--.
PERMITS (360) 417-4815 FAX(360)417-4711 . Date Issued: ~
Applicant or Agent: D. Seo-H- 15 u..~I..e...*
Owner: D. S (! 0 tt- tSv. '7 --e-rt-
Address: 7 0 Lj E I tj G City:
Architect/Engineer:
Contractor
Phone: 20&:, - ~ ;;)-s-o - g 7 g '7
Phone: 2-cJ6 - Z-S-Q -87 g-'7
[Po rf /1-n7..(l /-es Zip: Qg.-302-
Phone:
State License #:
Exp:
Phone:
Address:
City:
70Cj G 1f12L
Zip:
ZONING:
PROJECT ADDRESS:
LEGAL DESCRlPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
SIZEIV ALUATION:
SF. @$ ISF. = $
SF. @ $ 30 ISF. = $
SF. @ $ ISF. = $
TOTAL VALVA TION $
Co 71 ff.-0-C 7"" /7 .etA.J 9 cR ..-zi.9 e
/
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-roof./ 0 Stove
o Multi-family 0 Addition 0 Move~Garage S~:3
o Commercial 0 Remodel 0 Demolition 0 Deck
o Repair 0 Sign 0 Other
BRIEF DESCRIPTION OF THE PROJECT:
o -P p r () ~ ,,z.-r-+j
/);cJ,}-Y
Oh }-~~r-
COMMERClALIRESIDENTIAL: Occupancy Group:
No. of Stories: _ Lot Size:'7 ~oO Existing Sq. Ftl30 I
Total lot coverage bl& %
Occupant Load: Construction Type:
& Proposed Sq. Ft.828 = TOTAL Sq. Ft.~
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESA/Wetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
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 permit 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
R105.3.2 of the International BuildinglResidential 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 thjjlt it is responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits pri~r to work. . / _ /
nFORMS\BldgP=itl'~wpd Applicant: ~ g~ ~ Date, 'I !dF!tt6
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000959 Date
.691649
704 E 4TH ST
06-30-00-0-1-7440-0000-
RE-ROOF
10/18/04
RS7 RESDNTL SINGLE FAMILY
4000
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
(206) 250-8789
EMERALD ROOFING
114 MT PLEASENT CREST
PORT ANGELES WA 98362
(360) 452-8173
---------------------------------------------
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT - NO PR FEE
TEAR OFF, SHEET, COMP
120.75 plan Check Fee
10/18/04 Valuation
4/17/05
.00
4000
.J
\)
.,.C
~ If)
Qty Unit Charge Per
Extension
92.75
28.00
BASE FEE
2.00 14.0000 THOU BL-2001-25K (14 PER K)
----------------------------------------------------------------------------
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
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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 t . a 'or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Owner (if owner is builder)
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 UNLA WFUL 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.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
W r" TER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR'SEAL
WALLS
CEILING I I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLIHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT 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/.. / f).4 BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - 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
05-00000159 Date
.577988
704 E 4TH ST
06-30-00-0-1-7440-0000-
DEMOLITION
3/09/05
RS7 RESDNTL SINGLE FAMILY
200
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Structure Information
Construction Type . . . .
Occupancy Type . . . . .
OWNER
DEMO GARAGE
TYPE V NON-RATED
GARAGES, CARPORTS, SHEDS
----------------------------------------------------------------------------
permi t
Additional desc
Permit Fee
Issue Date
Expiration Date
DEMOLITION
DEMO GARAGE
47.00
3/09/05
9/05/05
24' X 20'
Plan Check Fee
Valuation
.00
o
BASE FEE
Extension
47.00
Qty Unit Charge Per
----------------------------------------------------------------------------
Other Fees
STATE SURCHARGE
4.50
~
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 47.00 47.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 51.50 51.50 .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.~ ive th rity to violate or cancel the provisions of any state or local law regulating construction or the performance of
constructip' .
~ \
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
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 PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKJRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LlGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 I ~ PLANNING DEPT.
BUILDING 417-4815 ~lz?/(.)( J{,[. BUILDING
. . ection record05. d 1/4110051 L
T.\PohcJes\1102_15 bUl1dmg pennlt msp
wp[
BUILDING PERMIT - APPLICATION
FOR OFFIClt\L USE ONLY:
Date Rec.:..:3 -q-oS-
Permit #: OS - lS'cr
Date Approved:
Date Issued:
Fill out COMPLETELYaudinINK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
'AppJiCanlorA_I,12-~d j$ur~ Phone: .
Owner: Z/ &C&.7rf ~&trd~ Phone.
Address: /0 L/ cE: L-/ V City: B ..- f A 7.e ILs
c2t:Jh - 2--,~O- ~7 ct7
~~-G
9~302---
Zip:
ArchitectJEngineer:
.....Contractor ..
Phone:
-StateLicense #:
Exp:
. Phone:
Zip:
ZONING:
Address:
City:
PROJECT ADDRESS:
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
Credit Card Holder Name: D S co Cl tt- '6V\ r"1 -< tt
BiIlingAddress: c7-9oJ rv'E 8/QI<L/eySI' 1F2c?$ City: SJLC<./f/e v-JA qf,ic<;
Credit Card Type VISA ^ MC #
TYPE OF WORK: SIZEN ALUATION:
D Residential D New Constr. D Re-roof D Stove SF. @ $ /SF. = $
D Multi-family D Addition D Move D Garage SF. @$ /SF. = $
D Commercial D Remodel ~ Demolition D Deck SF.@$/SF'=$$ ~ "'-'''-'
D Repair . D . Sign D Other TOTAL VALUATION _
BRIEF DESCRIPTION OF THE PROJECT: D--e. vY> ~ G 0.. .r-c...~ e (") i.!..f~.o r UJ 1.\ I \
l 4- + l f,' I ( J
S_ V r" 5 -e. Y'n oc:::..\ ) ron'f' 0 ~vt.O r- _ _ ~
COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type:
No. of Stories: Lot Size:
Total lot coverage
Existing Sq. Ft.
& Proposed Sq. Ft.
= TOTAL Sq. Ft.
%
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESNWetland(s):DYesDNo SEPAChecklistrequired?D YesD No Other:
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 41 7-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit applicatio
itted. All otheI permit fees are due at the time of permit issuance.
EXPIRATION-OF-PI:a\:N-REVIEW-:--If-n0-permitis-issuedwitb.in-1-80-days'0f the-date-ofapplication,theapplicationwill-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 R105.3.2
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 ru 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 Cit 1 a th -, st obtain such permits prior to work.
gh~s-
Applicant:
T:\RVESS\BLDG-forms-brochures\2004-Buildingpermit. wpd
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ELECTRICAL INSPECTION
WiRiNG REPORT
417-4735
7GC>\T
'&U 'Il.G. FE:.- '\ ~
70
s~
ADDRESS
APPROVED NOT APPROVED
o .................... DITCH . . . . . . . . . . . . . . . . . . . . 0
D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . .. . . . 0
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D. . . . . . . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . ~
CORRECTIONS NEEDED:
, GFCl
Y\Z.('JTEC-T
G~J2N",~ l</Z.~fT"~Lf<;
J'lf'L-C- 2{o.8 A 2.
b\L Yo v
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>1 NJ..L-!E- j2..c;;:ClE-'?TAC" I 'J="
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRUHERS, INC. (360) 452-1381
DAT'"
2-{7-.( 0
OWNER/CONTRACTOR
ELECTRICAL iNSPECTION
WiRING REPORT
417-4735
INSPECTOR
~
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O. . . . . . . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . . . 0
CORRECTIONS NEEDED:
I
I
I
I
I
!
CY'iZ:C:)r'l!C-1Z "V ,c",c..o J...lE-C}1 N (c I~) YAN:?/ "i-
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, Yli=l ~TZ- V? AU-. L.1Ul1? tJ l> c.O "I~7~?"i>)
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360) 452-1381
"
ELECTRICAL WORK PERMIT APPLICATION
Electrical contractor name
License number
Date Expires
D New
Residential
~d/Addition
Job wired by
o Electrical Contractor
~ner
Installation description
o Commercial
Purchaser's mailing address
S~
h
City
State ZIP
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Telephone number
FAX number
Premises owner's name
Se;.o+7'-
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;;;:~t//~ .
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70"'/
City r::>
ITor+
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Phone number to schedule inspection:
?-SO.
'f17~
~~
Owner us defined by RCIV.19.28.26/:(I) Owner wi/! occupy the structure for two
years after this electrical permit is finalized. (2) Owner is required to hire an electrical
contractor if abOl'e said property is for sale, rem or lease.
After reading the above statement, I hereby certify that 1 am the owner of the above
named property or a licensed electrical contractor. I am making the electrical instal.
lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter
19.28, WAC. Chapter 296-468, The City of Pori Angeles Municipal Code, and
Utility Specifications.
Signature of owner, electrical contractor or electrical administrator
o Cash 0 Check #
o Credit Card
Card #
Visa
Mastercard
Discover
x
Date:
Expiration Date
of card
/VI
Electrical Load Addltlo s and or subtractions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton
o Fan-Wall KW
LAR
o Overhead Service
o Temp Service
o Underground Service
Service Information
Voltage 110/ 'Z.-2-t!>
Phase Iia1' 0 3
Service Size:
Feeder Size: to (7 """"p
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
THERMOSTAT
ROUGH-IN I SERVICE
31:261cB ~
D, ' Approved By "- Dale Approved By
I' FINAL I FEEDER
~ ~
Approved By ../ Dale Approved By
Inspection Area, Building or Equipment Inspected Action Taken Electrical
Date Inspector
IEtICf'Cn ~lC:n
",,_
OCT U ::J il ~lJt
. ' . .
uJ:r rl. . , . .
-
Dale
Approved By
DITCH
/D
Dale
7
&/ ~f
ELECTRICAL PERMIT APPLICATION
FOR OFFICIAL USE ONLY
DatdJlA":
Pm1\ir.:
Dale Appnlved:
Datelssue,J:
The Electrical Permit Application must be filled out comDletelv.
Please type or reprint In Ink. If you have any questions, please call (360. 417-4735.j/ "'}tJq t
Fax number: (360) 417-4711 I D
Owner or Elee. Contractor Agent: ,;;;;~"" # ,II", ri./ 7J
Property Owner gce:>#-~$
Address: 70(( f.,~ ~,,' /? '
Phone:
Fax:
City:
firl /-711ep'~ ~
Phone: ;?of{, -)-50 - f 7~i
Zip: 9.f3~;;2
Electrical Contractor:
License #:
Exp:
Phone:
Address:
I~ER
City:
o ELECTRICAL CONTRACTOR
Zip: .
INSTALLATION WIRED ;:lV:
Credit Card Holder Name:
Credit Card Number:
Exp. Date:
Zip:
VISA:_MC:_
Billing Address:
City:
PROJECT ADDRESS:
rOt( E.
vJ3.-
,
TYPE OF WORK:
Check all that apply: 0 New
o Alteration/Addition
o Residental 0 Multi-family
o Commercial D Mobile Home . Sq. Fl.
o Remote Meter 0 Detached garage 0 Hot Tub D,S~im Pool 0 ~ptic Pump 0 Low Voltage O,Telecom. . 0 Sigl
DESCRIPTION OF THE ELECTRICAL PROJECT:
PrJt:..
CA '"9 J- "'- d -<-,
f9-:>~
~>< .y'"
/c:Jc1"~1'
br;,:q ~~'r
Number of Cire.uits added or altered:
. 'fl".
<" ~
'((;'(,."16' ~# 9786"
:, Service Information
Electrical Heat Load Additions
o Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 0 1 0 3
Service Size:
Feeder Size:
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
_KW
_KW
_KW
_KW
PAMC 14.05.060(B): For industrial, commercial, & residential projects larger than a duplex. a one -line drawing of the Electrical Service &
Feeders, building size (sq. ft.), load calculations, and the type & of conductors andlor raceway is required and shall accompany the
Electrical Permit application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and I an
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such,-..""
.N- - lJp~rP;-\)t.- b/H- S'Uc. vJl~ - XfM.(L J.I1tA-tt, N&&f v/"1fM)<(,.P &-1fYlt. ~
\ \ '7.-r;/:-vl'l - ~ ~.~ icrfe/ ~~+ - M~h-e A illY I.J-rt.~ ~~
\ \ 'b\ Credit Card Holder's Signature: Date:
Owner or Elec. Cont.. Signature:
Date:
PW-9019
6a3/07"Y>~rC.. ~U17^l..5. /6a:r ItV~.-c.)M Ir.l'n> B/t.tTWN e>lo<-f:
at c f}~
/ / - e -c?Z-
f~ORT~
/O~~
~
~ --
~"'"
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
O~-387
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning .
Application valuation
06-00000387 Date 3/16/07
876779
704 E 4TH ST
06-30-00-0-1-7440-0000-
D. SCOTT BURGETT
RES DETACHED GARAGE
RS7 RESDNTL SINGLE FAMILY
15084
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26.00
1. 00
1301.00
7000.00
528.00
1829.00
1. 00
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
9729S
SO.OO
3/16/07
9/12/07
Plan Check Fee
Valuation
.00
lS084
City Unit Charge Per Ex~e 'n
1.00 SO.OOOO ECH RIGHT OF WAY PERMIT SO.O
~------------------------------------------------------------------ --------
, Special Notes and Comments ,
PERr..UT EXTENDED, LETTER ON FILE.
10/24/2006 12:08 PM PERMITS --------
The Fire Department has reviewed the project application and
has no c'omments
OS/lS/2006 09:S2 AM SROBERDS -- The proposal will allow
a S2:8 sq. ft. detached garage in the RS-7 for total lot
coverage of 26%. No land use issues noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES, service wires ,will
be too close to new building.
OS/02/2006 10:S9 AM GMCLAIN _u________u___u__u____u
Electrical load calculations and elctrical permits are
required.
Driveway will be off alley, existing driveway drop when
used will be constucted to City Standards.
Fee summary charged Paid Credited Due
----------------- --------- ---------- --.,.~------ ----------
Permit Fee Total 50.00 SO.OO .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 50.00 50.00 .00 .00
7D4 Ect r::h
nuv~&
D \AJ\./t
/- ttt
(:f17 . IljoB
0/'ULf
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 nol been requested wilhin 180 days from the last
inspection. I hereby certify lhat I have read and examined this application and know the same to be true and correcl. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or nol. The granting of a permit does not
presume to gille aulhority to violale or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner is builder)
T:\Policies\1102.15R [1/05]
t.~
r~
~ii?
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST5TIfSTREET, PORT ANGELES, WA 98362
0&-387
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . .
Application valuation
06-00000387 Date
876779
704 E 4TH ST
06-30-0Q-Q-l-ry44Q-QOOQ-
D. SCOTT BURGETT
RES DETACHED GARAGE
5/17/06
RS7 RESDNTL SINGLE FAMILY
15084
704 E 4-th
J, BVt V"qe:tT
Owner
Contractor
BURGETT, JEANETTE/DAVID
2901 NE BLAKELEY ST #208
SEATTLE WA 98105
( 20) 250-8789
Other struct info
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26.00
1. 00
1301.00
7000.00
528.00
1829.00
1. 00
Permi t SANITARY SEWER HOOK UP
Additional desc CONNECT GARAGE
Permit pin number 77727
Permit Fee 40.00 Plan Check Fee .00
Issue Date valuation 15084
Expiration Date 11/13/06
________=~~~___:~~:~~~~~~~_~~:~__~~_:~~_~~~~=~________~__________~e~
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/15/2006 09:52 AM SROBERDS -- The proposal will allow
a 528 sq.ft. detached garage in the RS-7 for total lot
cov€:rage of 26%. No land use issues noted.
MAI1'TAIN CLEARANCES FROM SERVICE WIRES, service wires will
be too close to new building.
05/02/2006 10:59 AM GMCLAIN --------~-------------------
Electrical load calculations and elctrical permits are
requ.ired.
Driveway will be off alley, existing driveway drop when
used. will be constucted to City Standards.
Fee summary Charged Paid Credited Due
-~--------------- ---------- ---------- ------- ----------
Permit Fee Total 40.00 40.00 .00 .00
plan Check Total .00 .00 .00 .00
Grand Total 40.00 40.00 .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 constructi6n or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner is builder)
T;\Policies\1102.15R [tlOS)
~
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
/
REQUEST:
Date ~-I:S ....()7 Time
Received by
(phone, person)
76~E: 4~
S 13..L~~.
Phon~ No. ~~~~k
Permit No. Z
ft789
Location of Work to be inspected
Name of person requesting inspection
Address IOf person requesting inspection
~ll1spection (circle appropriate one):
C7 Foundation Framing Chimney Plumbing
Final Sewer Excav. Other
INSPECTION NOTES: _ ,,~
Inspected: Date ~ ~ 14. ~ Time
Remarks: #.e.w <:"""..ne.Clf,41h ~"""..... 3o."'c:...jQ.. +1'::>
+,0"- l.fe::>e..,.$ e-
By KV
, .., (
~X/J:i. I ^~
"7 // PVC-
RESTORATION REQUIRED . . . . .. YES NO
:r.1L--
. c
70~
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()J
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.
y
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z.~~~
-p) l.-
ILl/.
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved o Gravel o Asphalt OPCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
/
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT. . .
REQUEST: / /
Date tf-'-(-7J7 Time
Received by 7f= (phone. person)
4?i 7~ f7t1~ ioLj E 4 -t 0
1--1-, ,
cY4vIPSDh
Phone No. ~()-01ql
Permit No. Db-J87
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTE~
Inspected: Date -~'/07
Remarks:
Time
By
RV
~~~
RESTO A TION EQUIRED...... YES
NO X
() r< +0 :p bV- r
t,u..f 10 'iY (bu. tf-e~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
IContinue on reverse side if necessary)
!':TRFFT !':IIPFRINTFNnFNT
tnA TFI
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date '1-1 'j-07
Time
Received by (i=
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
70 <j E <jt:A
5Cotl f3
Phone No.~-Z:5'?-8 7!YJ
Permit No. Ob- .$~ 7
Sewer Excav. Other dw'1
Sewer Foundation Framing
Chimney Plumbing Final
Inspected: Date
Remarks:
INSPECTION NOTES:
Lj-V) --07
Time
By
121/
() K +0 ;P:y u-"r
RESTORATION REQUIRED . . . . .. YES
NO )L
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC
D Other
D Repaired by City
D Repaired by Permittee
D No Damage Found
Work Order #
D COMPLETE
D INCOMPLETE
(~ontinue on reverse s,ide if necessary)
STREET SUPERINTFNDFNT
/DATEl
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . INSPECTION REPORT. . . . . . .
~
REQUEST:
Date3-2Lf- 68
Time
Received by
/?v
(phone. person}
Location of Work to be inspected 709 C
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer f:oundation Framing Chimney Plumbing
""/'" 0
Phone No.
Permit No.
@ewer Excav. Other
O/'- 3fJ7
INSPECTION NOTES:
Inspected: Date uI.f - 2 S/ - 0 €3
Remarks:
Cttb 41-5"-07
lh-:vp Wt1'/ L/-ZO-C7
.:; €~~e.,1'- ~ -I ~ - D7
Time
By
tdV
ot.
~
RESTORATION REQUiRED...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC 0 Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
C:TAi:J:T <:. (DI:'Dll\.rTI:'I\,nC"'T
InATJ:}
Application Number . . . . . 22-00000537 Date 5/18/22
Application pin number . . . 799861
Property Address . . . . . . 704 E 4TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7440-0000-
Tenant nbr, name . . . . . . CLEMCO
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
heat pump
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
Zach Addleman BLACK DIAMOND ELECTRICAL CONTR
32558 7th Pl S 502 BLACK DIAMOND RD
FEDERAL WAY WA 98003 PORT ANGELES WA 98363
(360) 461-7098 (360) 565-1035
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee . . .00
Issue Date . . . . 5/18/22 Valuation . . . . 0
Expiration Date . . 11/14/22
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 63.00 63.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 63.00 .00 .00
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Pub! ic \Yorks and ULili ties Department
32 l E. 5th Street. Port ;\ngeles. WJ\ 98362
300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us
Project Address:--------------------------------------
Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _
OWNER JNFORMATtON
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRfCAL CONTRACTOR fNFORMATION
Name: ___________________________ License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge)
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 $
Service/Feeder over 1000 Amp. $373.00 $
Branch Circuit W/ Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 $
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder 401-600 Amp. $149.00 $
Temp. Service/Feeder 601-1000 Amp. $168.00 $
Portal to Portal Hourly $96.00 $
Signal CircuiULimited Energy - 1 &2 DU. $64.00 $
Manufactured Home Connection $120.00 $
Ren ewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat (Note: $5 for each additional) $56.00 $
First 1300 Sql;Jare Feet $120.00 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding / Detached Garage $74.00 $
Each Swimming Pool/ Hot Tub $110.00 $
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.C., RCW. Chapter 19.28, WAC. Chapter 296-
468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
'"'CJ CD
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
12/12/2023 22-537 TAP
OWNER
CONTRACTOR
Black Diamond Electric
PROJECT ADDRESS
704 E 4th St