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HomeMy WebLinkAbout2620 S Francis St - Building'INSPECTION TYPE ELECTRICAL PERMIT D ATE RESULTS CIT), 'OF PORT ANGELES DITCH 360-417-473 5 Application Number. 09 00001339 Date 12/-22/09 -Applicatidn pin nuffiber 059804 Property Address 2620 S- FRANCIS St r ASSESSOR PARCEL NUMBER 06-30 1:0 4 3 0360 0000 FINAL -Application type description . Y ELECTRICAL ONLY- Subdivision Name CQN4MENTS Property Use Property Zoning RESIDENTIAL MEDIUM DENSTY Application valuation 0 -Application desc- -Circuit. for oven Owner Contradtof- HOUSING AUTHORITY OF CLALLAM SIMPSON ELECTRIC 2603 S FRANCIS ST 2430,36 W HWY,101 PORT ANGELES WA'983626710 PORT ANGELES WA 98363 (-360), 457 9270 Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit-pin number 158576 -- ---- PermitTee 57 50 Plan Check Fee 00 Issue Date _12/22./09 VdIuatidh .0 Expiration Date 6/.20/.1,0 Qty Unit-Charge Per Extension - .1. 0 0. 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER 51 50 Fee summary --C4aa-r-ged___ :Paid- dredi:ted! :Due Permit Fee Tot,a1 -57 -50 57 50___ 00 00 1 \ Plan Check Total 00 0.0 X00 00 Grand Total 57 50. 57 50_ 00 00 'INSPECTION TYPE D ATE RESULTS -INSPECTOR. DITCH SERVICE ROUGH IN- FINAL T CQN4MENTS Sjunatui-e of- oN•vner or Electrical Cb.-fiffamr'N --Date City of Pont Angeles Permit Application Duilding Dlvision/Ele mss inspections 321 East Fifth Street- P.O, Box 1150 Port Angeles Washington, 98362 Ph: (360) 417 -4735 Fax: p6o) 417.4711 Dater -- DEC 18 2009 1 & 2 Single Family Dwelling Multi- Family or Commercial* 1 Commercial Addition / Alteration / Remodel 1 Repair* ' Plan Review May Be Required, Please Complete Electrical Plan Review Job Address: _ 2 ;1, - , s Building Square Footage: ELECTRICAL INSPECTIONS Description of above Own11n radon Contractor Information -Nam �%�S /ii..is aV( �iIE' DG ,ame: �le a , -C Maillre s' "'u"�'-p- - ,•� Mailing A�dessss;� 0 pry' zip, City-", ity �r�_. e:/ Phone: ��i� �/ Fax: State: dip: 3 _ Phone: License # / Exp. _ 7 - Fa License # 1 Exp. �EL 73 Unit Charge Qty $ 93,75 Total Qty Multiplied by Unit Charge) $113.75 $�� $ Service/Feeder 200 Amp. $160.00 $ Service/Feeder 201AOO Amp. $205.00 Service/Feeder 401 -600 Amp. $291.25 $ Service/Feeder 601 -1000 Amp. $ 2.00 $ Servlce/Feeder over 1000 Amp. $ 52.60 $ Branch Circuit WI Service Feeder —�-- 2.00 $_ 7 • i) Branch Circuit W/O Service Feeder $ 7250 $ $ Each Additional Branch Circuit $ 66.25 Temp. Service/ Feeder 200 Amp. $116.25 $ Temp. Service/Feeder 201-400 Amp. $131.25 $ Temp,Ser%te/Feeder401.600Amp. $ 75.00 $ Temp. Service/Feeder 601 -1000 Amp. $ 69,00 $ Portal to Portal Hourly $ 75.00 $ Sign/Outline Lighting $ 50.00 $ Signal Circuit/ Limited Energy Commercial $ 50.00 $ Signal Clrcull/ Limited Energy 1 & 2 Family Dwelling $ 93.75 $ $ Signal Circuit/ Limited Energy Multi - Family Dwelling $ 86.00 $ Manufactured Home Connection $ 86 Renewable Electrical Energy 5KVA System or Less .25 $ 27'50 $ $ First 1300 Square FL $ 57.50 Each Additional 500 Square FL or Portion of $ 86'25 �^ $ Each Outbuilding or Detached Garage $ 43.75 $ Each Swimming Pool or Hot Tub $ Thermostat Total OmW as defined byRCW, to 2MI. (f) owner will occupy the strurxune fvrtwo years alter this 010cuica /permit is f wlffed (2) Owner Is required to hire an e/eaft/ condor Ifabove said property is forsalr, rent or lease. After reading time 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 Installatlon or alteration In compliance with the electrical laws, N.E.C., RCW, Chapter 19,28, WAC. Chapter 296468. The City of Port Angeles Municipal Code, and Utility speclBcations- signatum of owner, otectdcal Contractor or electrical administrator ❑ Cash ❑ Check Credit Card Y.__GG�� 1 C� V" VI CITY OF PORT ANGELES FO PUBLIC WORKS -BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 4a� ISSUED: 3106/2002 PERMIT NO: 13265 OWNER/APPLICANT PROPERTY LOCATION INTERIOR REMODEL OF BOYS & GIRLS CLUB 1. CCHA 2620 FRANCIS S State Surcharge: — - -' 2603 S FRANCIS Lot: 91 RECEIPT#8800 (� Port Angeles, WA 98362 Block: ❑ Long Legal l - 360/452 -7631 Subdivision: CCHA Plumbing: $0.00 AMOUNT PAID: T: S: Parcel No: $0.00 CONTRACTOR ARCHITECT $0.00 OWNER N/A VARIOUS Port Angeles, WA 99360 98360 -0000 206/000 -0000 360/000 -0000 PROJECTINFO Project Value: $2,000.00 SFD Units: 0 Commercial: 0 Project Type: INT. REMODEL SFD SQ FT: 0 Industrial: 0 N Occupancy Type: Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: PROJECT NOTES $69.25 Misc Fee 1: INTERIOR REMODEL OF BOYS & GIRLS CLUB 1. $0.00 Misc Fee 2: 1 State Surcharge: $4.50 Misc Fee 3: $0.00 S RECEIPT#8800 (� FEES ASSESSMENT $0.00 Building Permit: $69.25 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $73.75 Plumbing: $0.00 AMOUNT PAID: $73.75 Mechanical: $0.00 Radon: BALANCE DUE: $0.00 $0.00 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 o1 construction. x rkGg0L" of Contractor or Authorized Agent Date Signature of Owner (if own builder) BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING INSPECTIONS. 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 f 3�S INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH -IN PLUMBING UNDERFLOOR /SLAB LL& ROUGH -M WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS/ GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T -BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOODSTOVE /PELLET /CHIMNEY /INSERT HOOD /DUCTS PW UTILITIES/ SITE WORK (Engineering Division) 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 OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ ENGINEERING 417 -4807 CONSTRUCTION - R.W. PW / ENGINEERING ARE 417 -4653 FIRE DEPT. PLANNING DEPT. 417 -4750 PLANNING DEPT. BUILDING 417 -4815 2-1 p ' -O 3 �.L�i� BUILDING C:WPPL.WPD BUILDING PERMIT - APPLICATION v The Building Permit - Pre- application must be filled out completely. Please type or print in ink If you have any questions, please call 4174815 FOR OFF19LAL USE ONLY: Date Rec.: Petit #:_l Date Approve Date Issued: Applicant or Agent: S.„tsA(Pt,.t. e_w65,f -6 04w4u�N"i",JQ Phone: _ 1n83-6&41S Owner: 66%,%A, t`r lkn., 44 if -k.,. (Iw�W cF6aligm Cm-1.L H cL)e) Phone: 4GZ-7L2,l x bL Address: 24da S • R-a n 1'. CA-. City: Pw+ A,.,S el.-s , l vA Zip: °t S�3y-L Architect/Engineer: 4,-e O,ttL. i Amec.l hc. Phone: An o517 i Contractor Owv ey License #: N / R Exp: N 1 A Phone: Address: City: PROJECT ADDRESS: 2ta2o S s SF- ZONING: t74 -7 LEGAL DESCRIPTION: Lot: Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: Ao-/» - 43o atoo Credit Card Holder Name: Billing Address: City: Credit Card #: Exp. Date: VISA MC TYPE OF WORK: SIZE/VALUATION: • Residential ❑ New Constr. ❑ Re -roof ❑ Woodstove SF. @ $ /SF. = $ • Multi- family ❑ Addition ❑ Move ❑ Garage SF. @ $ /SF. = $ ❑ Commercial Remodel ❑ Demolition ❑ Deck SF. @ $ /SF. = $ ❑ Repair ❑ Sign ❑ TOTAL VALUATION $ q -Zt nm a BRIEF DESCRIPTION OF THE PROJECT: (tA l ov,e ewweel oP e,c,,J -t,. 6,44, l6nd0 CI b (old6- rL wtU.K. %Wg.l�St aAo( Zwalls ly�d k all. �-.t aL s _. -,K �N, �f. rt;�syLewtc COMMERCIAL/RESIDENTIAL: Occupancy Group: A-5 Occupant Load: So Construction Type: V M No. of Stories: 1 Lot Size: tJ / P, % Lot Coverage: N/A % Existing Lot Coverage: /sq. ft. + Proposed Lot Coverage: /sq. ft. = TOTAL LOT COVERAGE: /sq.ft PLANNING USE ONLY: APPROVALS: PLAN Notes: BLDG. DPW ESA/Wetland(s): ❑ Yes ❑ No SEPA Checklist required? ❑ Yes ❑ No Other: OTHER BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be filled out completely to be accepted for review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. 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: Your plan check fee is due 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, this 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 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's responsibility to determine what permits are required and to obtain su h. Applicant: Date: .3( S lU y TAFORMS\APPS \BuiIdingpert it 0 0 N a0 m N O U O d 3 o, s i O 0 / m U m 0 0 O d O ti Y W L O 3 O ZE 2 m 3 U 269.2 X X270.8 X271.4 SITE PLAN 1' . W 269.0 X VE z I N r� — risim, OWN AN&YM PER ja W, OCCUPANCY OR011: A7 TYK Or CONSTMXT*k V- M LOCATION ON PROMTU: 7Y SETBACK TO MDO 1 EAST 40`4 SETBACK • NORM 211' SETBACK To EDGE Or RoW • SOUTH m TB noo, TTr To EDGE or R.ox • NEST FLOOR AREA PROPOSED AREA - 4360 ALLOWABLE FLOOR AREA -SO. I NAM ROCK BOOC sa AT. . INCREASES FOR SETBACKS NENCNT : PROPOSED HDONT . IV -S' N ALLOWABLE HEIGHT . W NUMBER Or STOME& PROPOSED : 910.E STORY ALLOWABLE : T -STORY OCCUPANT LOAD: NIB TOTAL OCMANTS EXITS S REWIRED S EXITS PWOM 2 WLRVN s ppNc 4 PL 70 s lock" pk2m '1 PLAN" A s rj w 0 CWA 14'-8 1/2* , } w.,/2' Ar [ »r [ Ar [ w« [ w„, . 14'-8 1/2" L � r E r ,'-0" _\2\:as ` 2 \ |\ƒk§e QQ�I!l6I= ( ƒ.i!£ ;7k ; ! so SL kSL \k {| x $•2�k�■ (sJ 7. E N § /r ,>m « : :� q\ ^ \ / } § � \ ) � r E r ,'-0" _\2\:as ` 2 \ |\ƒk§e QQ�I!l6I= ( ƒ.i!£ ;7k ; ! so SL kSL \k {| x $•2�k�■ (sJ 7. E N 2 y - x r•; PR 9 p9p _N � m OVy 1 Q m X r � 0 O O Z y y 2 9 a a � o � Z 0 � 0 m 7' -8 1/2" 1 1 CA O N 7, -6„ 2668 N �m m O x 00 o m z 2068 O Crj D O z O 2668(E) n m --i z =m g90T �n mz w Om cr `° C-- o o W > O � z D m m m C r a g O cn m N Co n? ® � — m D I m O K co x D—; Nm Z� 'O O D � Z � O O O O O m 2060(E) 14' -8 1/2" i ELECTRICAL PERMIT CITY OF PORT ANGELES 360 -417 -4735 Application Number , . , . . 14- 00001273 Date 10/20/14 Application pin number 558433 Property Address . ; . . . . 2620 S FRANCIS ST ASSESSOR PARCEL NUMBER: 06- 30- 10- 4- 3 -036Q -0000- REPORT SALES TALC Application type description ELECTRICAL ONLY on excise Subdivision Name your tax form Property Use . . . , . . . . to the Clty Of Port Angeles Property Zoning . , . . . , . Application RESIDENTIAL MEDIUM DENSTX (Location Code O5O2j valuation , . , . .--- ---- 0 - - - --- Application desc ____ ___ _ adding two circuits Owner Contractor PENINSULA HOUSING AUTHORITY KIRSCH ELECTRIC INC, - 2603 S FRANCIS ST P. 0. BOX 3396 PORT ANGELES WA 983626710 SEQUIM WA 98382 - ^ -1 -- - -__ -(360) 683 -6829 5- Permit , , , . . . ELECTRICAL ALTER COMMERCIAL Additional deec . . Permit Fee 79.00 Plan Check Fee Issue Date 10/20/14 ,40 Valuation , , , . 0 Expiration Date 4- /18/15 1 Qty Unit Charge Per Extension 1100 74,0000 ECH EL -COMM BRANCH CIR WO/ S/F 74.00 1,00 5.0000 ECH EL -ECH ADDNT BRANCH CIRCUIT 5.00 --- ° - - - - -° - -- - - - -- Fee summary Charged - - - - - -- - - -:--------------------------- paid Credited Due - -- ---------- Permit Fee Total 79.00 - --- - - - -- - --- -- - ° -- 79.00 ,00 .0.0_- Plan — Cheelc Total - - . 00 - - .00 .00 .00 Grand Total 79,00 79.00 .00 .00 PERMIT WILL EMPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X GAEXCHANGEWILDING Date: CITY OF PORT ANGELES PERMIT APPLICATION RECEIVED Rulldittg )l [Division/Electrical Inspections r 321 Last Plfth Street —P.O. Box 1150/ Port Angeles Washington, 98362OC T 2 0 201k �l Ph., (360) 417 -4735 Fax., (360) 417 -4711 Eurfax Date; 7- * plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet 62 Job Address; 1171, 2Q Building Square Footage: Description of above Owlneer Information C 1 Contractor Information Name: Mailing Address: t Mailing Address: 5 City: State, kgx- Zip: 4x62 City: " rv^ State:. W lip: Phone,, Fax' `ns� � Phone; Fax: _ 45- • 8 3• License 41 Exp.J�. __, License #!Exp. G - Item Unit Charge L yt Tonal fQty Multiplied by Unit Charge) Service /Feeder 200 Amp. $1200.00 $ ServicelFeader 201-400 Amp. $146.00 $ ServicelFeeder401- 600 Amp $ 205.00 Service /f=eeder 601 -1000 Amp- $ 2,62,00 ServicelFeeder over 1000 Amp. $ 373.00 Branch rvi ch Circuit W/ Sece Feeder $ 5.00 B Brannch Circuit WIC Service Feeder $ 63.00 �_ $ Each Additional Branch Circuit $ 5.00 $ -7y Branch Circuits 9 4 $ 75,00 $ 5— Temp. Service/ Feeder 200 Amp. $ 93 -00 $ Temp. Servtcell seder 201 400 Amp. $110.00 Temp. Servtce)Faeder401 -60D Amp. $149.00 $ Temp. Sarvice /Feeder 601 -1000 Amp . $168.00 $ Portal to Portal Hourly $ 96.00 $ Signal Clrcultl Limped Energy -1 & 2 Family Dwelling $ 64.00 $ Manufactured Home Connection $120.0D $ Renewable Electrical Energy -SKVA System or Less $102.00 $ Thermoatat $ 56,00 $ Note: $5.00 for each additlonal T -Star NEW G T Tl0N QNLY' First 1300 Square Ft. $120.00 $ Each Additional 600 Square Ft. or Portion of $ 40.00 $ Each (building or Detached Garage $ 74.00 Wirri ©0 1 ach Swimming Pool or Hot Tub $110,00 $0j=T otab Owner as defined by RCW,19.28.261: (1) Owner will occupy the sbuctute fartwo 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 certlfy 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 2913 -46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator; 0 Cash © Check (� t j Credit Catd 0 dud Gated: Z6 —! 0110112012 ELECTRICAL PERMIT CITY OF PORT ANGELES 360- 417 -4735 Application Number . . . . 14- 00001273 Date 10/20/14 Application pin number . . . 558433 INSPECTOR: Property Address . . , . 2620 S FRANCIS ST ASSESSOR PARCEL NUMBER: 06-20-10-4-3-0360-0000- SERVICE Application type description ELECTRICAL ONLY Subdivision Name . . . , , , ROUGH -IN Property Use . , . . _. . . . Property Zoning . . . . . . . RESIDENTIAL MEDIUM DENSTY Application valuation . . . . 0 COMMENTS: Application desc adding two circuits ---------------------------------------------------------------------------- owner Contractor PENINSULA HOUSING AUTHORITY KIRSCH ELECTRIC INC, 2603 S FRANCIS ST P. 0. BOX 3396 PORT ANGELES WA 983626710 SEQUIM WA 98382 --------- ---- ---- ---------------- - - - (360} 683 -6819 --- ---- - - - - -- c� Permit . , , . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . , . . 79.00 Plan Check Fee ,00 Issue Date . . . . 10/20/14 valuation , , . , 0 Expiration Date . . 4/18/15 Qty Unit Charge Per Extension 1.00 74,0000 ECH EL -COMM BRANCH CIR WO/ SIP 74,00 1.00 5.0000 ECH Eh -ECH ADDNT BRANCH CIRCUIT 5.00 Fee summary Charged Paid Credited Due ----- -- ---- - - - - -- ---- - - - - -- Permit Pee Total 79.00 ---- - - - - -- --- - - - - -- ---- 79,00 .00 --- - -- .00 Plan Check Total 00 00 00 .00 Grand Total. 79,00 79.00 .00 ,00 REPORT SALES TAX on your excise fax form to the City of Port Angeles (Location Code 0502) 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:TXCHANGEMUILDING Kirsch Electric, Inc. P.O. Box 3396 quim, WA 98389 10 DAY NOTICE OF PERMIT EXPIRATION DATE: April 29 2015 ADDRESS: 2620 S. Francis Street PERMIT NUMBER / DESCRIPTION 14- 00001273 Electrical -- Residential The above referenced permit(s) is /are about to expire. Please call 417 -4735 within 10 days from the date of this notice to arrange for one of the following: 1. If work has been completed, call to schedule an inspection. 2. Request cancellation of the permit if work was never started. 3. Request an extension if work is not complete. City of Port Angeles Electrical inspections - (360) 417 -4735 Thank you for your cooperation "I' Trent Peppard Electrical Inspector ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 16-00000130 Date 1/27/16 Application pin number 673560 Property Address . . . . 2620 S FRANCIS ST ASSESSOR PARCEL NUMBER: 06-30-10-4-3- 0360 -0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . Property Use Property Zoning . . . . . . . RESIDENTIAL MEDIUM DENSTY Application valuation 0 Application desc Move wiring for window Owner Contractor PENINSULA HOUSING AUTHORITY EXTRA MILE TECH & ELECT., LLC 2603 S FRANCIS ST 418 N. RACE ST, PORT ANGELES WA 983626710 PORT ANGELES WA 98362 (360) 457-5222 Permit . . . . ELECTRICAL ALTER COMMERCIAL Additional desc Permit Fee 74.00 Plan Check Fee ,00 Issue Date 1/27/16 Valuation Expiration Date 7/25/16 Qty Unit Charge Per Extension 1.00 74.0000 ECH -EL-COMM BRANCH CIR WO/ S/F 74.00 Fee summary Charged Paid Credited Due Permit Fee Total 74.00 74.00 .00 .00 Plan Check Total .00 .00 .00 100 Grand Total 74.00 74.00 .00 100 N3 REPORT SALES TAX on your excise tax form to the Cit y of Port Angeles (Location Code 0502) Signature of owner or Electrical Contractor X Date: GAEXCHANGEWILDING I m CITY OF SPORT ANGELES PERMIT APPLICATION J riim IJit j Bundling Division/Electrical Inspections 121 East Fifth Street —P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 4174735 Fax: (360) 4174711 )ate: ,. / — ° C' � /' � Multi- Family or Commercial* 'Plan Review May Be ec�i p Please C Review I o aton Sheet �A� ,p 5 3uilding Square Footage: Description of above I r! � C - . ;4.1 " "t 4,,,r :. t? k l lkta 4- )weer Information Jame: A,4 c . F k Contract r information Name 1h.4 . C I-C40 k "`" ., t' - N ' Addr� E, c . Maitt Address: State Zip: r r_ G L 'E�* 5. lat 4 — 6 C State. l a' G_ _ Phone: �- _ - icense # /Exp. License # /l*xp.. y " ?_Cr 7�?;ZZ0 tern Unit Charge f3ty Total QAM Multi sled by Unit Charge 3ervice/Feeder 200 Amp. $13200 $ 3ervice/Feeder 201 -400 Amp. $160.00 $ 3ervice/Feeder401 -600 Amp $ 225.00 3ervicx:/Feeder 601 -1000 Amp. $ 288.00 3ervice/FeWer over 1000 Amp. $ 410.00 Branch Circuit W/ Service Feeder $ 5.00 3ranch Circuit W/O Service Feeder $ 74.00 1 $ q . -ach Additional Branch Circuit $ 5.00 3anch Circuits 1A $ 86.00 'emp. Service/ Feeder 200 Amp. $102.00 $ temp. Service/Feeder201A00 Amp. $121.00 Temp. Service/Feeder 401 -600 Amp. $164.00 Temp. Service/Feeder 601-1000 Amp. $185.00 Portal to Portal Hourly $ 96.00 $ iign/Outline Lighting $ 88.00 $ >ignal Circuit/ Limited Energy — Multi- Family $ 64.00 $ signal Circuit/ Limited Energy /First 1500 sf — Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional TStat % " Total )weer 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 D 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 he electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port 4ngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. signature of owner, electrical contractor or electrical admeriabator: ❑ cash ❑ Check ❑ credit Cara 0 C n� 0�0� '`'✓ °r�1 01101012 `t V' ELECTRICAL PERMIT CITY • PORT ANGEL 360-417-4735 1 Application Number . . . . 16-00000502 Date 4/12/16 Application pin number 185020 Property Address . ... 2620 S FRANCIS ST ASSESSOR PARCEL NUMBER: 06-30-10-4-3- 0360 -0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RESIDENTIAL MEDIUM DENSTY Application valuation 4 0 Application desc Exit signs Owner Contractor PENINSULA HOUSING AUTHORITY ----------- EXTRA MILE TECH & ELECT., LLC 2603 S FRANCIS ST 418 N. RACE ST. PORT ANGELES WA 983626710 PORT ANGELES WA 98362 (360) 457-5222 Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . , Permit Fee 79.00 Plan Check Fee w00 Issue Date 4/08/16 Valuation 0 Expiration Date 10/09/16 Qty Ufit Charge Per Extension 1.00 74.00,00 ECH "'EL-COMM BRANCH CIR WO/ SIF 74.00 1.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 5.00 Fee summary Charged Paid Credited Due ............ Permit Fee Total 79.00 --------- 79.00 „00 Plan Check Total .00 .00 r00 .00 Grand Total 79.00 79.00 A0 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X GAEXCHANGE\I3UILD[NG Date: *Plan Review May Be R urred, Please o fete 1lectrical Plan k eview inforrnatiorl heet Job Address_ '9 c(a a "' S cot, Bui nil Square e: D ription of above 7 Owner Ino atfor a ki t � c n 6 l uXV j/ 9 Addners: � #1 N rLPhane;: YVy�♦ ( License# /F»xp, ;,, P`�•w ,r V CITY OF PORT ANGELES Ettl1t4i1T ArrucAnoN Service/Feeder 200 Amp. $132.00 $ Building Division/Elecibrical Inspections $160.00 $ SenridetFeeder 401 -600 Amp 321 East FUM Street —P.O. Box 1150 / Port An geles Washn � 98362 � ryrNl Service/Feeder 6014000 Amp. $ 268.00 Ph: (360) 417 -4735 Fa= (360) 417 -4711 Service/Feeder over 1000 Amp. $ 410.00 Date: 2muld-Family or Commercial* $ 5.00 Branch Circuit W/0 Service Feeder *Plan Review May Be R urred, Please o fete 1lectrical Plan k eview inforrnatiorl heet Job Address_ '9 c(a a "' S cot, Bui nil Square e: D ription of above 7 Owner Ino atfor a ki t � c n NCaamwe tra o on af#� 9 Addners: � City t � Zip: rLPhane;: License# /F»xp, Ur. ole M "'r Item Unit her try Tdtal (ft MU1110,11ed by Unit Dfrarge Service/Feeder 200 Amp. $132.00 $ Service r201- l00Amp. $160.00 $ SenridetFeeder 401 -600 Amp $ 225.00 $ Service/Feeder 6014000 Amp. $ 268.00 $ Service/Feeder over 1000 Amp. $ 410.00 Branch Circuit W/ SeWxe Feeder $ 5.00 Branch Circuit W/0 Service Feeder $ 74.00 —� Each Additional Branch Circuit $ 5.00 Branch Circuits 1.4 $ 86.00 $ Temp. Service/ Feeder`200 Amp. $102.00 $_ Temp. Service/Feeder 201 .000 Amp. $121.00 $ Temp. Servi'celFeeder 401-600 Amp. $164.00 $� Temp. SeivlwFeeder 6014000 Amp. $185.00 $ Portal to Portal Hourly $ 96.00 $ S19N0udine Lighting $ 88.00 $_ Signal Circuit! Limited Energy- MulfWamily $ 64.00 $ Signal Circuit/ limited Energy / First 1500 sf - Commercial $ 98.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy -SKVA System or Less $113.00 Thermostat $ 56.00 $ Note: $5.00 for each additional TStat cy 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 elechical installation or alteration in compliance with the electrical laws, N.EC., RCW. Chapter 19.28, WAC. Chapter 296468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical PermitApplications. Signature of owner, electrical contractor or electrical administrraWr. ❑ Cash ❑ check 13 creft6adl4' tz-",e, 1"101=2