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HomeMy WebLinkAbout611 Georgiana St - Building • �o+�" �:h� �rrr C:UY OF PORT.ANGELES P>ERMff APPLIC'AUON VE xa �a Building;Divisioar/Electrirnl Inspectiptps 321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,9962 Phi(360)417-4735 V= (3160)41.74711 � 1N Date:- �-r 4- !�' a Single Carndly Dwelling AUG 1 �. ELECTRICAL "Plan Review May Be Repired,Plus Camptete Electrical Flan Review Information Sheet Job Address;_ ... .. ��p{ -a A v rt q I Bultding Square Footage: --_ Desdiptlon of above 1 !t X tl �,o Owner Information Contmeorl formation , ~� Name,��.a�� 1 �- Nsms: xfp . 16"%-.. .. IAA Melling A dre s: ..�l3 s& Mailing Address; $ City: 51ate dip: r city: state; s� i'hane:• _ - aM:_ phnne•�"]�•5�._.Fax:...w License if 1 Cxp. _ License#l Eap. Item 0111t Charge tit Total M fylul i led b llnit Char e ServicelFeeder 200 Amp, $320.00 $ Service/Feeder 201.400 Amp. $146.00 $ ServicelFeeder 401.600 Amp $205.00 $� 5ervicelFeader 601-1000 Ainp. $262,00 w $ Service/Feeder over 1000 Amp. $379.00 Branch Circuit W1 Service Feeder $ 6,00 $ %rich Circuit WIO Service Feeder $ 53,00 ch Addillonal Branch Circuit $ 6.00 Branch Circuits 1.4 $ 75,00 Temp.Service/Feeder 200 Amp. $ 93,00 $_�_ M Temp,ServicelFeeder 209-400 Amp, $110z Temp.SenvlcelFoeder 401.600 Amp. $149.00 $ Temp,Service/Feeder 601-1000 Amp. $188,00 Portal to Portal Hourly $ 96.00 $ Signal Clrcult!Limited Energy-1&2 Family Dwelling $ 64.00 Manufactured Home Connection $120.00 $ RenevvaNe Electrical Energy-6KVA System or Leas $102.00 -- Thermostat $ 56.00 $ Note:$5.00 for each additional T-Stat N+~irV CONSTRUCTION ONLY- First 1300 Square Ft, $120.00 Each Additional F00 Square Ft.or Portion of $ 40.00 Each Outbuif&ng or Detached Garage $ 74.00 c� Each 5wimmfng Pool or Hot Tub $110.00 $ $ .,r Total Owner as defined by RCK19.23.261:(1)Owner will occupy the structure for two years after this electrical permit is finalized.(2)Owrner 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,ld,E.C.,ROW.Chapter 19,28,VVAC.Chapter 2964613,The City of Port Angeles Municipal Code,and td 010 Speaification�and PAMC 14.05.050 regarding Electrical Permit Applications, Signatum of owner,electrical c antmete•or electrical administrator; © cash b cheek 0 CMdacaar 3 1 CN ELECTRICAL PERMIT CITY OF PORT ANGELES a 360-417-4735 g Application Number . , , . . 13-00000921 Date 8/21/13 Application pin number , . . 231957 _ Property Address 611 GEORGIANA ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-40-5-1-3550-0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name Property; Use g to the City of Port Angeles Property Zoning . . . . , , . RS7.RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation , , . , 0 Application desc 4 motion lights __ .-_---------------------------------------------------------- Owner Contractor ________________________ ------------------____-- ^ �� CAROL ANN HARTY & EXTRA MILE TECH & ELECT., LLC PATRICIA ANN FOLSOM TIES 418 N, RACE ST, 611 E GEORGIANA ST PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 457-0198 - (360) 417-2956 Permit . . . , , . ELECTRPCAL ALTER RESIDENTIAL Additional desc . . 1-4 CIRCUITS Permit Fee , . . . 75,00 Plan Check Fee 00 Issue Date . . . , 8/15/13 Valuation 0 Expiration Date . , 2/11/14 Qty Unit Charge Per Extension BASE FEE 75,00 --------- ----------------;------ Fee summar y Charged Paid Credited Due ----------------- ---------- --------- ---- ------ -. C°a Permit Foe Total . 75.00 75,0C .00 00 Plan Check Total 00 00 .0o .00 Grand Total 75.00 75.00 00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE - ROUGH-IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:IEXCHANGEIBUILDING Li, CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION ct.. 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00000836 Date 8/08/11 Application pin number 749040 Property Address 611 GEORGIANA ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-5-1- 3550 -0000- Tenant nbr, name C HARTY P FOLSOM TTES on your state excise tax form Application type description PLUMBING PERMIT to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 4 t50 Application desc 1 WATER LINE (FROM THE NEW METER LOCATION) Owner Contractor CAROL ANN HARTY MORRISON EXCAVATING INC PATRICIA ANN FOLSOM TTES P. O. BOX 3051 611 E GEORGIANA ST PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 452 -7179 (360) 417 -2956 Permit PLUMBING PERMIT Additional desc WATER LINE (METER MOVED) Permit pin number 190561 Permit Fee 57.00 Plan Check Fee .00 Issue Date 8/08/11 Valuation 0 Expiration Date 2/04/12 Qty Unit Charge Per Extension r 1 BASE FEE 50.00 1.00 7.0000 EA PL-WATER ATER LINE 7.00 2.1) Fee summary Charged Paid Credited Due Permit Fee Total 57.00 57.00 .00 .00 8 1 i Plan Check Total .00 .00 .00 .00 Grand Total 57.00 57.00 .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 has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. 1 A M c c Ce- C51t,lf--- Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS 6 Building Inspections 417 -4815 Electrical Inspections 417 -4735 Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: Under Floor Slab Rough -In Water Line (Meter to Bldg) g"g I r� L�/ r Gas Line Back Flow Water FINAL Date Accepted by-3- AIR SEAL: Walls Ceiling FRAMING: Joists Girders Under Floor Shear Wall Hold Downs v, Walls Roof Ceiling C L 7 Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab Wall Floor Ceiling S MECHANICAL: 2 Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts FINAL Date Accepted by 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 a Inspection Type Date Accepted By Electrical 417 -4735 p G Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 5 Planning 417 -4750 fl S Building 417 -4815 T- rlivisinn /Ruildina Permit 'C3 1d H H H 0 1 CO i a F W H 1 0 W H Z 0 U H 0 0 a q H 0 H H 0 w m m o o H r n H m m n H r N 4 4 1 N h H 0 If) H a 0 H 0 0M 0 U/ 01 Ch H H H• a a U la 00 0 0 01 H 01 z 0 0 l0 G 0 C7 Y 19 M t ro rt a a a 0 a H a I Hi H H H 0 0 0 a 0 H i a a I H W W E H. 4 0 01 0 N 00 I a OO I� RC 01 W x 4 1 4 0 x x, 0 0 H 0 VI F H I [n a a 0 a to a 0 0 Z H h 1 a o 1 0 0 o l O 0 0 0 Ix 0 w o 0 Z Za H 0 1 (n 1 HI Z H 0 1 H E. E. I H 00 a c!) U 0 Z I a H m a 1 .0 a H 0) a F Ell 0 I0HI0 <H Z 0 s X I Ho0>+0Z0 cot W 01 ci) v) I ,7. '0 1 Q N 1 a H H N Ifl H H E H .00 I •r OtIl r 3 0 F •(-4\ 1 000V1000000 U acf) I z /4v)00 /4 Z N H H H U CD H JJ FI x a as 10 m[/)0 0 mcnaH cf) U I W U 0 Z/4 C.14.14.1 01 tr /4 4.1X w Z 0 a 40 1/1 rn F z H H H 0 w w a< a H a/4 4 a a H 0 0 o 01 0 0 01 0 oz o ff H p H W 0 0) H v H i 4 r c a H i <a a azN a r r.4 "kx I io 0H47 0 1 H w 'z 7,Z� In 41 Z a f] Wiz,. a z a o o 0 v) 1 0Y.0 00 a 0 01 1 a o 0 4 Q W H 0 W I 4 00m 0.1 F HI 0 H Cry I HI x a a I I V) W co< H o 4 0 H O W a co 0 I v0 U Z U o H 0 20 o o o 0 E H W 0 0 co co al a a 00 1 Z O Y 0 C a l 0 0 01 0 Y H 0 a0l0[ a F 0 o 0 aY1 a<aHwua H 01 E=1 H O z z z a a a l0 01 a P.0 <HOOaa a H a 4 O.QON7 BUILDING PERMIT APPLICATION Print in ink O•- CITY OF PORT ANGELES 5 0M. f t or o r F C Use Only: Attn: Building Permit Technician r Q Date Recei 3-4-1( NIIiier 321 E. Fifth St., Port Angeles, WA 98362 \5 Permit* 11 -536 (360) 417 -4815 fax (360) 417 -4711 Date Approved Applicant r 'la w Itvr;S 6 Vick�ri a 51) Phone 51 58 ii Property Owner Karol 1\ vm k At Pa-1-ti at, A►�h n Phone 411- Q56 Property Owner's Address 61( E ,'&n4 S± P1. w4 c154 Contractor 'f\o r t 45e h Ekoa.va nj ;1 Phone -9 52_7 171 Contractor's Address Po 0ax 305k pet, L A q 8362. License (Y1p R R 1 E 1070 Pii) Expires 01_ 04. (z_ E -mail PROJECT ADDRESS G Gep�- ravA, Parcel Number �J Lot Zoning Project Type Brief Description: XResidential Multi- family Commercial Industrial Check all that apply New Construction ID Addition The uJerK will 6Q- eione. on 61S Vic1 SF +he Remodel Map A ek Ic t'lriim A s_- Repair. N p c..t w- 4,4 -eAr line, -Fire rr' .The. In w i m e,-Ve r k o cce n to 1-n Demolition CUY1r1eG wifirt 14 Lo t ih-e -4-la t,ec -Eo C. a G Irgiano, Si Re -roof House garage other ❑gear off re -roof lay over one layer Heat System Heat pump wood- burning stove gas fireplace pellet stove ID other XOther P I U bC111 pOr l+ Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq. ft. 1 Floor 3 ntl Floor Pr 3 Floor Garage Carport A A Covered Porch AIM Deck Shed Other 7 TOTAL VALUATION D. 17 0 Total footprint of structures sq. ft. Lot size e '0 Site Coverage the amount of impe iou surface on a parcel, including structu pa -d driveways, sidewa patios and other impervious surfaces. (see '0 MC 17.94.135 for exemptions) Site coverage Max. height of proposed structure- ft. Occupancy group of bedrooms Will a lawn sprinkler system be stalled? Occupant load ull bath Will a fire sprinkler system be stalled? Construction pe of half baths I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine wh_at permits are required, and to obtain permits prior to working on project D ate 8" 8- t Print Name V t -v c,S C 1 AV' /1--- Signatur T:Forms /Building Division /Building permit application liWr W s u t y ui (C o �o b u s t y „J aa t at it ''''44.101, .!C::::IN4.;,::::::‘..:,,, -4 41:',!'lk .7 1 l WC t i 4±'f 'f' n" eR i'%' `b 4 .9..( Pr" 2 d :n x. s J a 9 a uOn _-c) vl A t o cy .9 g O t y 5 x Sl V 4. ''''''',..14,1 r �Y a a r s ..y 'p t k i i 4 3 1. 1 J F\ -4) c`22 s moo- 0 d ri tp _8 -F, T. 3 VVV [7,/ z IN Q Q ‹c, jy rcpt sci TT 3 9 .4 Ic tjj o ±-a 5 S oo fr, 3 0� 3 Q 3 xs w 3 as i ti^`h N S'&. S.'.� 9 T^A�fW �y�y (�\1 R3� '""�tlf s,'''. b "ti's (��I db :B S n ^:."4g p. E(i `Q BRt r9 y e we V.l ra asp v O ru J a n�dw to •tflgg,,^" wra e M aye �a Clallam County Assessor Treasurer Property Details 61602 CAROL ANN HARTY Page 1 of 3 Clallam County Assessor Treasurer Property Search Results 61602 CAROL ANN HARTY AND PATRICIA ANN FOLSOM TTES for Year 2011 2012 Property Account Property ID: 61602 Legal Description: SMITH, NORMAN. R PTS LT6878ALL 10 128VC ALY B35 SURVEY V55 P91 Geographic ID: 0630005135500000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 Open Space: N DFL N Historic Property: N Remodel Properly: N Multi Family Redevelopment'. N Township: Section: Range: Location Address: 611 GEORGIANA ST Masco PORT ANGELES, WA 98362 Neighborhood: Cycle 5 Res Map ID: 2 Neighborhood CD: 10955130 Owner Name CAROL ANN HARTY AND PATRICIA ANN FOLSOM TTES Owner ID: 193252 Mailing Address: 611 EAST GEORGIANA STREET Ownership: 100.0000000000% PORT ANGELES, WA 98362 Exemptions: Taxes and Assessment Details Property Tax Information as 05 08/04/2011 Amount Due if Paid on L NOTE: If you plan to submit payment on a future date, make sure you enter the date and click RECALCULATE to obtain the correct total amount due. Click on "Statement Details" to expand or collapse a tax statement. i First Half Second Half Year Statement ID Base Amt, Base Amt. Penalty Interest Base Paid Amount Due Statement Details e 2011 156028 $2099.73 $2099.68 50.00 90.00 $2099.73 $2099.68 0. Statement Details 2010 44305 $2009.43 $2009.43 $0.00 $0.00 54018.86 90.00 Values +1 Improvement Homesite Value: N/A (0) Improvement Non Homesite Value: N/A +1 Land Homesite Value: N/A Land Non Homesite Value: N/A Ag Timber Use Value (0) Curr Use (HS): N/A N/A +1 Curr Use (NHS): N/A N/A Market Value: N/A Productivity Loss: N/A =1 Subtotal: N/A 1 Senior Appraised Value: N/A Non Senior Appraised Value: N/A Total Appraised Value: N/A Senior Exemption Loss: N/A Exemption Loss: N/A Taxable Value: N/A Taxing Jurisdiction Owner: CAROL ANN HARTY AND PATRICIA ANN FOLSOM TTES Ownership: 100.0000000000% Total Value: N/A Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Levy Code Description Levy Rate Appraised Value, Taxable Value.' Estimated Tax STATE 5 C STATE SCHOOL N/A N/A N/A N/A CC GENERAL CLALLAM COUNTY N/A N/A N/A N/A GENERAL DEVDISIBLT DEVELOPMENT N/A N /A' N/A N/A DISABILITIES COUNTY LND ASSMT LAND N/A N/A N/A N/A ASSESSMENT COUNTY TAX REFUND TAX REFUND N/A N/A N/A N/A FUND COUNTY VET RELIEF VETERANS N/A N/A N/A N/A RELIEF COUNTY CAPT IMP CAPITAL N/A N/A N/A N/A IMPROVEMENT PORT DISTRICT LIB LIBRARY COUNTY N/A N/A N/A N/A LIB BD PORT ANGELES N/A N/A N/A N/A CITY LIBRARY BOND PRT ANG PORT ANGELES N/A N/A N/A N/A http: /websrv8.clallam. net /propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =61602 8/4/2011 ELECTRICAL PERMIT z 11 CITY OF PORT ANGELES d' 360 -417 -4735 c Application Number 12- 00000519 Date 5/01/12 Application pin number 536269 Property Address 611 GEORGIANA ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 00 -5 -1 -3550 -0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc 200 amp service Panel replacement Owner Contractor CAROL ANN HARTY EXTRA MILE TECH ELECT., LLC PATRICIA ANN FOLSOM TTES 418 N. RACE ST. 611 E GEORGIANA ST PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 457 -0198 (360) 417 -2956 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit Fee 120.00 Plan Check Fee .00 Issue Date 5/01/12 Valuation 0 Expiration Date 10/28/12 Qty Unit Charge Per Extension C 1.00 120.0000 ECH EL -0 -200 SRV FEEDER 120.00 Fee summary Charged Paid Credited Due O Permit Fee Total 120.00 120.00 .00 .00 Plan Check Total .00 .00 .00 .00 w Grand Total 120.00 120.00 .00 .00 D P ■V c,f INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE c 1 Z b ri1 ROUGH IN 2— OF .q ki FINAL i` cip COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING APR -30 -2012 06:00 PM E.JANSSEN 360 452 2982 P.01 n r, 1 27, ,,aa:i V CITY 01W PORT ANGELES .PEILMIT APPLICATION ELECTRICAL an y s; Building Division/Electrical Inspections INSPECTIONS 321 East Filth Street —P.O. Box 1150 Port Angeles Washington, 90362 y -,,gluo®r, Ph: (360) 417 -4735 Fait (360) 417 -471 1 Date: 0 t Z. 1 2 Single Family Dwelling Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet -(a .11-_______(::;1_0_....i.: T Job Addross; i L !�'�.'�eJ..`�...._._.... `:e�" rZ_ F F Building Square Footage:.. Description of above Owner Information Contractor Infonnati n Name: .....C. Q,..1 L L... 1.- i_ Name: _0.1!1 0 GE reeve 4t eisea CtC.� C. Ma(Ilr ,gQ�s:. •,I. iS' _i tlr�- _kY•a:j :i"-i7: i Mailin Address:_ 9/ njp&L{;(_ ET Cdy -..e a n h Sbtfe: _1.x4: Z.ip. City, Slate: 9_$1�.. Pfrone:_1 I' 2-:.......Fax: ./,71 0 5" rG f License Exp•_ �F.>s'.AelM r 1_2.- .1.Q fe___..__ Item unit Char Qht TLoi ft9 M IV- SULaili1SchilL stl Service/Feeder 200 Amp $120.00 1 b Service/Feeder 201400 Amp. 146.00 Service/Feeder 401.600Amp 20500 ServiaAIFfleder 001••1000 Amp. 262.00 b Service /Feeder over 1000 Amp. 37:100 y Branch Circuit W/ Servkie Feeder 5.00 [Branch Circuit W/O Service Feeder 63.00 Each Additional Branch Circuit S 5.00 Brandt Cirt•.uits 14 75.00 Temp. Service/ Feeder 200 Amp. 93.00 S Temp. Service/Feeder 201 -400 Amp, 110.00 S Temp. ServiceiFeeder 401.800 Amp. 149.00 Temp. Service/Feeder 001.1000 Amp 168.00 $w_ti Portal to Portal Hotarty 96.00 Signal Circuit/ Limited Energy -1 2 Family Llwel(ieg 64.00 Manufactured Home Connection 120.00 Renewable Elect it Energy 5KVA System or Less 102.00 t Thermostat 56.00 Note: $5.00 for each additional T•Stat N ..SQdl LR lQlj.00_ First 1300 Square F1. 120.00 Each Additional :500 Square Ft. or Portion of 40.00 Each Outbuilding or Detached Game 74.00 East Swimming Pool or 1401 Tub 110.(10 1.�1 v_.._ Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical perrmit is finalized. (2) Owner is required to hire an electrical contractor if above said property k For sale. rent or lease. Permit expires after six rncmth, of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a license° electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.EC., RCW, Chapter 19.29, WAC. Chapter 296 -4613. The City of Pori Angeles Municipal Code, and Utility Specifications and PAMC 14.05,050 regarding Electrical Permit Apolicatlons. Signature of owner, electrical contractor or electrical administrator: f") cacti 13 coact. Mini t.:. creea ir' Z. X,,, 411A o.oa naln! 01/0112012 Application Number 05 00000845 Application pin number 225250 Property Address 611 GEORGIANA ST ASSESSOR PARCEL NUMBER 06 30 00 5 1 3550 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Owner Contractor HARDY CAROL 611 GEORGIANA ST PORT ANGELES Fee summary Permit Fee Total Plan Check Total Grand Total WA 983623323 ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452 6424 Permit ELECTRICAL NEW RESIDENTIAL Additional desc ELECT SVC 200A GAR Permit pin number 59527 Sub Contractor ELECTRIC SERVICE Permit Fee 78 70 Plan Check Fee 00 Issue Date 9/09/05 Valuation 0 Expiration Date 3/08/06 Qty Unit Charge Per 1 00 78 7000 ECH EL -RM 0 200 1ST SRV FEEDER COMMENTS /ACTION NEEDED Charged Paid Credited Due 78 70 78 70 00 00 78 70 78 70 CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 121 EAST 5TH STREET PORT ANGELES. WA 98362 00 00 00 Date 9/09/05 WA 98362 Extension 78 70 00 00 00 INSPECTION TYPE DATE ELECTRICAL PERMIT INSPECTION RECORD ti CALL 417 -4735 FOR ELECTRICAL INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE ACCEPTED YES 1 NO DITCH 1 I I ROUGH -IN /COVER I 1 1 SERVICE I I 1 FINAL 1 70 ?e 195 a .;1 1 1 1 1 1 I 1 1 1 1 1 I GENERAL COMMENTS: COMMENTS PW- I1O2.13 (491 1,P lectrical Contractor O Owner Annual Permit 0 Alarm 0 Carnival O Commercial Residential 0 Residential Maint. O Signs 0 Thermostat 0 Telecom. /installation description Job wired by h'Electrical Contractor 0 Owner Electrical contractor nam License number Purchases) L aitiUddre� t 11 %12-61 City 4A Telephone number FAX number t4 5 L S s. premises ewers name blAw o 6L,hi11 Address of inspection i (p t t. (P E 4-.t,.-6. City 7 ,:r 1 hereby certify that I am the owner of the above named property or a licensed electrical contractor (or the firm's authorized agent) anti am making the electrical installation or alteration in compliance with the electrical law, Chapter 19.28 RCW. (Signature of owner. elect I eontrac or elee deal administrator X l WALLS Insulation Only Date Approved BY Date Approved By Inspection Date 1 Cover zt- State ZIP w_ x!8`3 9 7 1 4 Date Approved ay Date Electrical LoadAdditlnns and or subtractions NO LOAD CHANGES O Baseboard KW O FU mace KW 0 Heat Pump Ton LAR O Fan -Wall KW Insulation Only Cover Approved by ELECTRICAL WORK PERMIT APPLICATION •O, U Request Inspection l Area, Building or Equipment Inspected Date nun D Ovemeaa Service O Temp Service O Underground Service gr— v 312.21lzck. oN t ilk. �/kGt iL4 Expiration Date �fcard D1TCl3 cfp►`L lde___ Otz- CHAR -or E O Cash O Check 0 Credit Card Visa Mastercard Discover Card Approved By Date Voltage Phase 0 1 0 3 Service Size: Feeder Size: Action Taken MP Inspection fee 78,70 CEILING THERMOSTAT SERVICE FEEDER Approved By Approved By Lime Apptvvod By Service Information Electrical Inspector 44-t° TO 39tid t'VZP9Z5tb09E 8S 90 500Z/L0/60 o~ pORT ~G' F...~~~~ ~na~ "-- oo;;;;..;w "t&;:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use . . . . Property Zoning . . . Application valuation 05-00000898 Date 124152 611 GEORGIANA ST 06-30-00-5-1-3550-0000- MECHANICAL PERMIT 9/21/05 RS7 RESDNTL SINGLE FAMILY 4700 t3xP('~~1 L7 /1'{ 0 r", Owner Contractor CAROL HARTY/PATRICIA FOLSOM JT 17779 BENTLEY CT. LINDEN, CA LINDEN CA 95236 EVERWARM 257151 HWY101 PORT ANGELES (360) 452-3366 ~ WA 98362 -------------------------------------------------------------- 60632 57.65 Plan Check Fee 9/21/05 Valuation 3/20/06 .00 o T G) ~ 0i ~ ~ ~ ;...> -' ~ L- t> * Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date MECHANICAL PERMIT Qty Unit Charge Per Extension 47.00 10.65 BASE FEE 1.00 10.6500 ECH ME-GAS PIPE 1 TO 5 ------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.65 57.65 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.65 57.65 .00 .00 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. /OrS'-cJS"" Date Signature of Owner (if owner is builder) Date T:\Policies\II02_ ] 5 building pennit inspection record05.wpd [1/4/2005] BUILDING PERMIT INSPECTION RECORD CALL 4] 7-48] 5 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 FOUNDA nON 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 I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T.BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEAT PUMP 1 FURNACE 1 DUCTS i I /C', /1/J/6S ~ /0 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/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.I PWI CONSTRUCTION - R.W. ENGINEERING 417.4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. 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Zt" ;p.Ul C nUl :;::. >-i OJ 0 t>:! . :0 . :0 o o(}tJj 0'\ lJl O'\)::f <:1-' I 1::0 trj t-' QwO::d oot"'::E:G:l o I ;t:>' tI:l oo::I:::tlO oo;p.:;:::o CD 1:;C G) I.OLnl-i H oo~~ ~ 3:1"0 )::f t>:!W;p. ()\.Jl~ [f) tS~~ ~ z,n HOH no;p. ;p.o t<o"1 '0 t" Ul o :s: y >-i '" t>:! :0 :s: H >-i n'" H:O >-it>:! ><'" ;p. 0:0 "1t>:! o '" OH :00 >-i'- ~~ Glo t>:!ll' t"- t>:! UlH W ll' en H ll' HH ZZ UlUl "'''' t>:!t>:! nn >-i>-i OH :00 .. Z y>-i ~~ t>:!~ Ult>:! >-i t< t" H t>:! :0 t" >< 0'" ;p.;p. >-iGl t>:!t>:! H o '- H '" '- OH ll'0 4-30-03; 8: 1ZAM;CITY PORT ANGELES e~r~ - Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 ;3604174711 ;; 1 / BUILDING PERMIT - APPLICATION APPliCi:rAgent:~:;fR;~~~ f: Y O\Qber a ya ( 'C)J/ ' a;. ~ /.5tJM / P Address: (j, / / ?< D'" "'- City: .. CL. ArchitectJEngineer: 'E \J ce uJ ,J:- ContractorEy ~R ,,' J4 eAt State License #(t>f( if NL Address: a::?57/5/ ~y /0/ City: _ ~. PROJECf ADDRESS: Phone:3t,..o ~ --9'5.2 ~ ..3:3 ~ ~ Phone:3~o - ~// 7- ..:295~ Zip: q cf 3~Z- Phone: Exp: $? //7/ 0. ~ Phone: ..J-j~"5' .;z .~%0 Zip: q P3'd.,-Z- ZONING: LEGAL DESCRIPTION: Lot: Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: IJ ~ ..3 00 () 5 / .3 S -S- 0 0 00 0 Credit Card Holder Name: BillinC Address: Credit CardType VISA TYPE OF WORK: ~ Residential 0 New Constr. 0 Re-roof 0 Stove o Multi-family 0 Addition 0 Move 0 Garage o Commercial 0 Remodel 0 Demolition 0 Deck o Repair 0 Sign 0 Other BRIEF DESCRIPTION OF TIlE PROJECT: ~~ .<a......... 0 '~-"'-'~-L .~~~. COMMER IDENTIAL: Occupancy Group; MC # City: Exp. Date: SIZEN ALUA TION: SF.@$'/SF. "" $ SF. @ S /SF. "" $ SF. @ $ ISF. = $ , TOTAL VALUATION $ ..... ." 1.-0 .# ... -1--. < -1!.... -" ~ ../ .-l/ -roc> , (!) C) --r '~XJ ~. - J Occupant Load: No. of Stories: _ Lot Size: Existing Sq. Ft. & Proposed Sq. Ft. Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage /~-~ Construction Type: ~ ~ = TOTAL Sq.Ft. % APPRO V ALS:.. PLAN: BLDG: DPWU: FfRE: OTHER:_ " PLANNING USE ONLY: ESA/Wetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. 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 Division to comply with current fee schedules. Contact the Pernllt 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 i~suance.. . ' EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the. date of application, the application will expire. The . B.uildingD.fficiaLc.an...eXtciid. the.time..fat.action..by-the.applicant up. to lro.day.-upen.writte.n'request'by the-applicant (see Section 'j 07.4 0 f 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. I am authorize.d to apply for this permit ancJ 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. T:\FORMS\APPS\Buildingpermit.wpd APPlica~ __......:,~ Or Date: 9-...2 0 ~o.s- '"oJ P.01/01 TRANSACTION REPORT 2005/0CT/04/TUE 15:12 RECEIVER TYPE/NOTE NO RESPONSE 4523367 THE FOLLOWING DATA COULD NOT BE SENT. PLEASE GIVE THIS TRANSACTION REPORT TO SENDER. ~_..._____.__ ,.... ._.__.____..__._a.~.___.. _..~M_' ____.M .._.. .._.,.._.._ __.___.._._._..__ ..__0_ . ,__~___._.. OM.' -......-..-- ---.-.--....----..---.-.....- ..__. ..-- i' ..' . ." j COMMUNITY & ECONOMIC DeVELOPMENT POLICY AND PROCEDURES Facsimile & Internet Permit Applications ~_ . ..__.._.._.._..___._j..~urp.P_s_e___...!..._._.__..._.____~.______.___.....__..:..._______.H___.._ ____ ._ _._ _.__ ...--. -.... ._M..... _... 1.1. To define steps in processing permit applications submitted via Facsimile and Internet. 2. Organizations Affected 2.1. Building and Planning Divisions of the Community &.Economic Development Department. .. .. . .... . ..,..3. Authorjty. .... ... ....- .. ..- . .:.. .......--... 3.1. International Building Code and Internation'a! Residential Code Chapter 1, PAMC Title 14 & . Department Director 4. Definitions. 4.1. Facsimile Permit Application: A permit application receiv~d via facsimile transmission. 4.2. Internet Permit Application: A permit application received via City Website or electronic mail. / 5. Policy 5.1. It is our policy tq maintain fast. courtesy customer service, including quick processing of all Permit Applications. . . 5:2. Applications must be signed and p.ermits must be pQsted on the jobsite during all phases of construction. '5.3. No inspection will be conducted without a valid permit on the jobsite. 5.4. Required inspections must be requested as per City ordinance and polley. 5.5. City staff are not responsible for delivering Permits to applicants or to a jobsite. 6. Procedure 6.1. Upon receipt of a Permit Application submitted'vla Facsimile or Internet, Permit Technician shall confirm with the customer that the application has b~en receIved and clarify any issues at that time. 6.2. Permit Technicians shall inform applicants that it is NOT advisable to have Credit Card Numbers kept on file at City Hall or written on applications for security reasons. To eXpedite processing, applicants may provide Credit Carcl Numbers on a separate facsimile sheet transmitted with the appli~ation. . . 6.3. After the Permit Application is processed, Permit Technician will call the Applicant or their Agent and inform them that it is ready for their signature and to be p)c~ed up. Permits so processed will be ready for pickup at the Permit Counter until 4:50 P.M:' . 6.4. All payments shall be made payable to the City of Port Angeles.' 6.5. Facsimile and Internet Permit Application service shall not beavailab!e to Contractors who violate Policy(s) 5.2, 5.3. 5.4 and/or 5.5. 6.6. Permit TeChnicians shall inClude a copy of this Policy & Procedu~e w)t~ each permit issued. P.01/01 TRANSACTION REPORT 2005/0CT/04/TUE 15:17 RECEIVER TYPE/NOTE BUSY 4523367 THE FOLLOWING DATA COULD NOT BE SENT. PLEASE GIVE THIS TRANSACTION REPORT TO SENDER. ___._.._., '.___""_'___'H ....._.___. .__.... .,._ __.__. .. ... .. _ .__.:..H_._.._....~_'__H_. ._hH._.... ............h._...... ~h ........... .,........- . ...'.' .,. ........ ~.~...- ....._. ....' ....-... ..... COMMUNITY & ECONOMIC DEVELOPMENT POLlCY AND PROCEDURES Facsimile & Internet Permit Applications ... ____.___. _____ ..1~.J_ur.p.Ps.e--_- _.._.._.._....____..__._ ..-.-.------- --- . 1.1_ To define steps in processing permit a~plicatlons su6rriifte-dVia"Facsiffiileah-alhlemet:-....-_.... --. . 2. Organizations Affected 2.1 ,Building and Planning Divisions of the Community & Economic Development Department. .__ 3.. Authority.. '. .......-. ." U." .... -,_. ". .... ... ..u.. . '.' .... '3.1. International Building Code and JntemationalResid'ential Code Chapter 1, PAMC',itle 14&' Department Director 4. Definitions 4.1. FacsimHE?PermitApplication: A permit application received via facsimile transmission. 4.2. Internet Permit Application: A permit application received via City Website or electronic mail. 5. Policy 5.1. It is our policy to maintain fast, courtesy customer service, including quick processing of all Permit Applications. 5.2. Applications must be sIgned and permits must be posted on the jobsite during all phases of construction. 5.3. No inspection will be conducted without a valid permit on the jobsite. .5.4. Required inspections must be requested as per City ordin.ance and policy. 5.5. City staff are not responsible for delivering Permits to applicants or to a jobslte. 6. Procedure 6.1. Upon receipt of a Permit Application submitted via Facsimile or Internet, Permit Technician shall confirm with the customer that the application has been received and clarify any issues at that time. 6_2. Permit Technicians shall inform applicants that it is NOT advisable to have Credit Card Numbers kepton file at City Hall or written. on ap'plications for security reasons. To expedtte processing, applicants may provide Credit Card Numbers on a separat~ facsimile sheet transmitted with the application_ . '6.3. After the Permit ApplicatiC?n is processed, Permit Technician will call the Applicant or their Agent . and inform them that it is ready for their signature and to be picked up. Permits so processed will be ready for pickup at the Permit Counter until 4:50 P.M.' 6.4. All payments shali be made pay~ble to the City of Port Angeles. 6.5. Facsimile and Internet Permit Application service shall not be available to Contractors who ViolatePolicy(s) 5.2,5.3,5.4 and/or 5.5. 6.6. Permit "!"echnicians shall include a copy of this Policy & Procedure with each permit issued. ~ORTANGELES WAS H I N G TON, U. S. A. DEPARTMENT OF COMMUNITY DEVELOPMENT Everwarm Hearth & Home 257151 Hwy 101 Port Angeles, W A. 98362 To: General Manager, Dear Sir / Madam The attached is a copy of our Policy and Procedures Jor Facsimile & Internet Permit Applications. Please read it and if you have any questions please call me at 360-417-4712. < _~relY' David Yasumura Permit Technician 321 EAST FIFTH STREET · PO BOX 1150 · PORT ANGELES, WA 98362-3206 PHONE: 360-417-4750 · FAX: 360-417-471 1 · TTY: 360-417-4645 E-MAIL: PLANNING@CI.PORT-ANGELES.WA.USORPERMITS@CI.PORT-ANGELES.WA.US P.Ol/Ol TRANSACTION REPORT 2005/0CT/05/WED 09:50 RECEIVER TYPE/NOTE NO RESPONSE FILE 5659 4523367 THE FOLLOWING DATA COULD NOT BE SENT. PLEASE GIVE THIS TRANSACTION REPORT TO SENDER. ~ ~ ~. -==...s '~' - COMMUNITY & ECONOMIC DEVELOPMENT POLICY AND PROCEDURES Facsimile & Internet Permit Applications 1. Purpose 1.{ To define steps in processing permit appli~ations submitted via Facsimile and Internet. .. . 2. Organizations Affected , . 2.1. Building and Planning Divisions of the Community & Economic Development Department. 3. Authority 3.1. Intemational8uildingCode and International Residential code Chapter 1, PAMC Title 14 & Department Director 4. Definitions . 4.1. Facsimile Permit Application: A permit application received via facsimile transmission. 4.2. Internet Permit Application: A permit application received via City Website or electronic mail. 5. Policy 5.1. It is our policy to maintain fast, courtesy customer service, including quick processing of all Permit Applications. 5.2. Applications must be signed af.1d permits must be posted on the jobsite during all phases of construction. 5.3. No inspection will be conducted without a valid permit on the jobslte. 5.4. Required. inspections' must be requested as per City ordinance and policy. 5.5. City staff are not responsible for deliv~ring PermIts to applicants or to a jobsite. 6. Procedure 6.1. Upon receipt of a Permit Application submitted via Facsimile or Internet, Permit Technician' shall confirm with the customer that the application has been received and clarify any issues at that time. . 6.2. Permit Technicians shall inform applicants that it is NOT advisable to have Credit Card Numbers kept on file at City Hall or written on applications for security reasons. To expedite proce'ssing. . applicants may provide Credit Card Numbers on a separate.facslmllesheet transmitted with the application. 6.3. After the PermitApplication is processed, Permit Technician will call the Applicant or their Agent . and inform them that it is ready for their signature and to be picked up. Permits so processed will be ready for pickup at the Permit Cou~ter until 4:50 P.M. 6.4. All payments shall be made payable to the City of Port Angeles. 6.5. Facsimile and Internet Permit ApplicatIon service shall not be available to Contractors who violate POlicy(s) 5.2. 5.3, 5.4 and/or 5.5. .' . 6.6. Permit Technicians shall include a copy of this Policy & Procedure with each permit issued. ~ ~ ~ORT ~ ....4.0~~ t; 't'i:f!!ij"'" lL -==>r ~ ~IC~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 03-00000558 Date 6/09/03 611 GEORGIANA ST 06-30-00-5-1-3550-0000- RE-ROOF 8473 Owner Contractor IDE YVONNE E 611 GEORGIANA ST PORT ANGELES WA 983623323 WESCO ENTERPRISES PO BOX 1527 PORT ANGELES (360) 452-1430 WA 98362 Permit BUILDING PERMIT - NO PR FEE Additional desc Permit Fee 190.75 Plan Check Fee .00 Issue Date 6/09/03 Valuation 8473 Expiration Date 12/06/03 Qty Unit Charge Per Extension BASE FEE 92.75 7.00 14.0000 THOU BL-2001-25K (14 PER K) 98.00 Other Fees STATE SURCHARGE 4.50 \)\ Fee sununary Charged Paid Credited Due -----,------------ ---------- ---------- ---------- ---------- Permit Fee Total 190.75 190.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 195.25 195.25 .00 .00 -- ---- ~ (\) ~ Q] - ? ::s p ~ 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 exammed 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)6-U -01 ure of Contractor or Authorized Agent Date Signature of Owner (If owner is builder) Date T \PLANNlNG\FORMS\1102 15 [4/2002] '" BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLA WFUL TO COVER, 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 YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION' DRAINAGE ELECTRICAL' (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATERLINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engmeenng DlVlslOn) SEPARATE PERMIT #'s WATERLINE / METER SEWER CONNECTION SANITARY STORM 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 ELECTRJCAL - LIGHT DEPT 417-4735 ELECTRJCAL 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 1(;,-10- 0 ?:> ~ , l BUILDING T \PLANNING\FORMS\1 102 15 [4/2002] ... CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . INSPECTION REPORT. . . . . ~ Date Time-U SA 70 Received by (phone, person) REQUEST. Location of Work to be inspected toll ~~ql'~{t4 ~(- Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit NO~~ Sewer Foundation Framing Chimney PIUmbing8 Sewer Excav. Other Inspected: Date Remarks: Time~BY 01~ INSPECTION NOTES: v\e- RESTORATION REQUIRED. . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC o Other o Repaired by City D Repaired by Permittee D No Damage Found Work Order # o COMPLETE o INCOMPLETE /Continue on reverse side if necessary) STREET SUPERINTENDENT /DATEI