Loading...
HomeMy WebLinkAbout140 W Ahlvers Rd - BuildingCITY OF PORT ANGELES rtiVi DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 07 00000213 Date 3/05/07 Application pin number 132121 Property Address 140 W AHLVERS RD ASSESSOR PARCEL NUMBER 06 30 16 4 1 0000 0000 Application type description DEMOLITION Subdivision Name Property Use Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 4000 Owner Contractor PA PLAT (SHERRON ASS LLC BELLEVUE BELLVUE WA 98005 C &J EXCAVATING PO BOX 430 CARLSBORG (360) 683 7741 Structure Information 000 000 Construction Type TYPE V NON RATED Occupancy Type SINGLE FAM CONGREGATES Roof Type COMPOSITION Fee summary Charged Paid Credited WA 98324 Permit DEMOLITION Additional desc DEMOLITION OF OLD HOUSE Permit pin number 96487 Permit Fee 50 00 Plan Check Fee 00 Issue Date 3/05/07 Valuation 0 Expiration Date 9/01/07 Qty Unit Charge Per BASE FEE 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 Extension 50 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 construct n. cC. ak Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T \Policies\1 102_15 building permit inspection record05 wpd 11/4 /2005] INSPECTION TYPE DATE FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS I CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL 1 FLOOR CEILING MECHANICAL ROUGH -IN HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY 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 COI/ER, IA'SULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. ACCEPTED YES I NO I MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS FINAL COMMENTS 1 FINAL DATE ACCEPTED BY. DATE ACCEP I El) BY. SKIRTING PLANNING DEPT SEPARATE PERMIT s SEPA. PARKING /LIGHTING ESA. LANDSCAPING I I SHORELINE: FINAL INSPECTIGNS REQUIRED PRIOR TO OCCUPANCY/USE I RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ I CONSTRUCTION R.W 1 ENGINEERING 417-4807 I 1 I PW ENGINEERING I FIRE 417 -4653 I 1 I I J .I I FIRE DEPT I I PLANNING DEPT 417 -4750 I r 11 1 J I I PLANNING DEPT I I I I BUILDING 417 -4815 11 j G 1 1 I I I BUILDING I I I I T \Policies \1102 15 building permit inspection record05.wpd [141/20051 ted .1g.ntY maltreTt T• i f 11: 1Fr A,,.;:tf; "Wp:19,1s4ao: §A AVa 1 1 1 1 1 1 A A AA A MA AT, 11 'AT t It ca 'L .?..i'.. 0 1•:t..?;i:: A, 4 tt Y e A itsTORal: 1 i5r4 tr t, -ot't N., Applicant or Agent: C 5,4C se.T, no. c 1 Owner !'��r' Address: Architect/Engineer off' L Phone: Contractor no. State License Exp Phone: Address: K d a( City Qc V ro. Zip aZ PROJECT ADDRESS 1 k 4 ✓b-rS ZONING 1 1 LEGAL DESCRIPTION Lot: Block: Subdivision.' 1'e f�a, ,^Je• Vo.I LV Cetaz. CLALLAM COUNTY PARCEL NUMBER. TXPE OF WORK SIZF/VALUATION 9/Residential New Constr Re -roof Stove SF /SF Multi family Addition 0iove Garage SF /SF Commercial Remodel Demolition Deck SF /SF Repair Sign Other TOW, VALUATION Lo o BRIEF DESCRIPTION OF TAF PROJECT f l w.a o) O COMMERCIAL/RESIDENTIAL. Occupancy Group No. of Stones: Lot Size: Existmg Sq Ft. Total lot coverage PLANNING USE ONLY BUILDING PERMIT APPLICATION 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 PERMITS (360) 417 -4815 FAX(360)417 -4711 ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other Phone: 77 1 Phone: City Zip Occupant Load. Construction Type: Proposed Sq Ft. TOTAL Sq Ft. FOR OFFICIAL USE ONLY Date Rec. 6/07 Permit C9 '7 a 3 Date Approved:_ 3/x/07 Date Issued: 6/5 /07 APPROVALS PLAN BLDG DPWU FIRE. 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 apphcation 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 apphcation, 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 RI 05.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that 1 have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required not the City's, and that I must obtain such permits prior to work. (5/b-) T•�FORMS\BIdgPermitform.wpd Applicant: 2c.A Date: W A S H I N G T O N U S A Public Works Utilities Department February 22, 2007 C and J Excavation P O Box 430 Carlsborg, WA 98324 RE Port Angeles, Landfill Transfer Waste Disposal Apphcation, WDA 07 -04, Building demolition at 140 West Ahlvers Road. We have received your application for disposal ofbuildmg demolition debns from the referenced site and reviewed the testing results for lead content. Based on the testmg results the debris appears to be acceptable for disposal at the transfer station. A copy of your approved application is attached. This approved application must be .shown to the transfer station scale attendant at the time of disposal. Please be advised that this disposal application is only for the materials and quantities listed in the application. Matenals not listed or m excess of the quantities noted may require separate applications and approval. Please caii if you nave questions. Very truly yours, Gary W Kenworthy, P.E. City Engineer Deputy Director of Engmeenng Services GWK:tf Encl. WDA 07 -04 Copy Claudia Stromski N:\P W K S\ENG INE E R\ W DAPPL I C \07 -04 Phone 360- 417 -4805 Fax: 360 417 -4542 Website. www cityofpa.us Email publicworks @cityofpa.us 321 East Fifth Street P 0 Box 1150 Port Angeles, WA 98362 -0217 To City of Port Angeles City Engineer 321 E Fifth Street P O Box 1150 Port Angeles Washington 98362 NOTE. 1 Generator Information Company Name. -c. a--1 -J a•� -i iv G Mailing Address co. D oz 11 ls bc,r A- c 3 3 E L/ Contact: Phone Project Name Project Location 2. Other Contacts (if applicable) Consulting Firm N o tj c Contact: Phone Contractor Name Contact: Phone Laboratory Contact: Phone k 2 r ,e -r- iQ-s SO C PORT ANGELES LANDFILL WASTE DISPOSAL APPLICATION 3e0- 'i7- oso C..}- tGi}uA -T( NG. t?u lZco VL (A n47n.eift- NI J. LY D)00 City of Port Angeles Landfill Waste Disposal Application Phone (360) 417 -4803 FAX. (360) 417 4709 All questions must be answered for waste to be approved. 34.d 6 S 3- ?7 41 2GSe.rV e_ 4 1r Us4t -Lt Y 1LS '/n kt. R-A- I v I,uDA- n 7- b+ Page 1 3 Source of Waste Check the appropriate box below and briefly describe the project, process and /or cleanup that will or has produced the waste requiring disposal Include the gasoline service station number (if applicable) CERCLA/NITCA Remediation Agency Contact: Independent Remedial Action UST Removal Unused Chemical Product Spill /Other Source ©lr) L-LJ Q ,cJ5T. >v, i5 Ls 4.1 is4(A A N4J 44 hizelA r -r 4 Waste Material Composition (check all that apply and include percent of total) Soil Concrete /Asphalt Preserved Wood Coal Ash Wood Ash NOTE. Total must equal 100% Unknown Foundry Slag Dredge Sediments Debris Other (list) 5 Waste Material Contaminants (check all that apply) Gasoline Metals Solvents Heating Oil Unused Motor Oil Used Motor Oil /Waste Oil Other Other Petroleum Product NOTE Supply any MSDS information with application if available Diesel PCBs City of Port Angeles Landfill Waste Disposal Application Page 2 6 Estimated Quantity of Waste for Disposal Other Cubic yards Tons (estimate both) NOTE. Estimated quantity for disposal must be within 20% of the quantity actually disposed (10% for projects over 7 500 tons or 5 000 cubic yards 7 Frequency of Disposal One time Monthly 8 Waste Sampling Proper characterization of the waste for disposal requires the collection of representative samples The methods and equipment necessary for obtaining representative samples of a waste, and the frequency of sampling will vary with the type and form of the waste Check the appropriate box and briefly describe how and where the waste was sampled Include site maps with sampling locations if possible Number of COMPOSITE samples number of discrete samples per composite .S Number of DISCRETE samples C (9 LEy28 COAAPoSi 7 k S a4 54FfP((4P 5Op,.< I K 4y- ficroce 7. 7- u.... 6 toC 1xq NOTE 1 Unless prior approval has been granted by Port Angeles the following sampling frequency will be used 0 25 25 100 101 500 501 1000 1001 2000 >2000 Drums Tons (estimate both) cubic yards cubic yards cubic yards cubic yards cubic yards cubic yards NOTE 2. One composite sample shall contain a minimum of three /maximum of five discrete samples City of Port Angeles Landfill Waste Disposal Application Annual Other 1 composite sample 3 composite samples 5 composite samples 7 composite samples 10 composite samples 10 plus one sample for each additional 500 cubic yards Page 3 9 Waste Analysis The Dangerous Waste Regulations (WAC 173 -303) shall be utilized to determine the appropriate analytical requirements for waste characterization Ecology Publication #91 -30 (Revised April 1994) `Guidance for Remediation of Petroleum Contaminated Soils shall also be used to characterize petroleum contaminated soils from UST releases Submit all laboratory analytical results, QA/QC data and Chain of Custody sheets along with this application (NOTE. The laboratory must be accredited by the Washington State Department of Ecology a) List all analytical test methods used fPAt31Il 1ncog b) Provide a narrative as to why the above analytical methods were selected AL)4 lit 466.. 0 5 LLa-s Joss 14/L, 7 f C Q ,44- PAp -J-r US 'L4 J S ?2cl�Tui2'� NOTE. Additional sheets attached 1G YES NO 10 Soil Classification *FOR PETROLEUM CONTAMINATED SOILS ONLY Based on the analytical data and Ecology Publication #91 30 the soil classification is (check one) Class 1 Class 2 Calculated Hazard Index 11 Dangerous Waste Affidavit: Class 3 Class 4 Based on a review of the analytical test results site history and the applicable regulations this waste is classified as (check one) Neither Dangerous Waste (DW) nor Extremely Hazardous Waste (EHW) Dangerous Waste (DW) and Waste Code Extremely Hazardous Waste (EHW) and Waste Code City of Port Angeles Landfill Waste Disposal Application Page 4 Yj 12 Certification We THE UNDERSIGNED certify that this app)ication is true to the best of our knowledge All information provided is correct and the enclosed analytical results represent the propOsed waste material to the best of our abiiities °R Waste/Generator Signature a Printed Name rn ~T .J 16. /\u\ Company -7 Date NAPOLICY_P \1000_SVM 009_01 WPD J z/^40 City of Port Angeles Landfill Waste Disposal Application Page 5 f Figure C.3 Problem Waste Dis Generator contacts City of Port Angeles or CCEHD* regnesting to dispose of problem wastes at the PALF* City sends an approval letter to the generator. Ycs Upon receipt of the waste at the landfill, the gate attendant verifies that the quantity received is within 20% of the quantity reported In the WDA (within 10% for >7500 tons or 5000 cy CCEHD or City of Port Angeles forwards the generator a copy of the PALF WDA* (Attachment A to Waste Acceptance Policy) *CCEHD Clallam Counth Environmental Health Division osal Acceptance Process No Generator completes and submits to City the WDA including laboratory analytical results and quality control information. City of Port Angeles Engineer, or designated representative signs WI» and forwards a copy to CCEHD for their review and authorization. Yes City of Port Angeles, City Engineer or designated representative reviews WDA for completeness and accuracy PALF Port Angeles Landfill WDA. Waste Disposal Application City notifies generator in writing of reason for disapproval and forwards copy to CCEHD. Generator may resubmit WDA after addressing City and or CCEHD concerns. NVL Laboratories, Inc 4708 Aurora Ave N Seattle WA 98103 Tel 206 547 0100 Fax: 206 634 1936 www nvllabs.com Client: Zenovic Associates Inc Address 301 E 6th St. #1 Port Angeles WA 98362 Toxicity Characteristic Leaching Procedure Lead (Pb) Attention Mr Tracy Gudgel Project Location 140 W AHLVERS Road Port Angeles Analysis Report 4 Mk AIHN AIHA IH 101861 jerg=fis=0 ACCREDITED LABORATORY, WA DOE C1765 Batch 2702200 00 Matrix: Bulk Method EPA 1311/7000B Client Project 04428 Date Received 02/09/2007 Samples Received 1 Samples Analyzed. 1 RL Results Results in Lab ID Client Sample mg/ L in mg /L ppm 27012979 04428 0 4 0 5 0 5 Sampled by Client Analyzed by Michael Dougherty Reviewed by Nick Ly Date Analyzed 02/16/2007 Date Issued 02/16/2007 mg/ L Milligrams per liter ppm parts per million Note Method QC results are acceptable unless stated otherwise Unless otherwise indicated, the condition of all samples was acceptable at time of receipt. Bench Run No 27- 0215 -4 RL Reporting Limit Below the reporting Limit Page 1 of 1 NVL Laboratories. Inc. 4708 Aurora Ave N, Seattle, WA 98103_ Tel; 206.547 0100 Emerg. Pager 206.344.1878 1.888.NVL.LABS (685.5227) Client Zenovic Associates, Inc. Street 0\ G (.0 c ef:k li Port Angeles Project Manager '7�.4c/ C„ pl.cc Project Location yn CJ. 4 104.4.5 d�Dgp J zuat /4 Phone: (360) 417 -0501 Fax: (360) 417 -0514 1 Asbestos Air 1 PCM NIOSH 7400) TEM (NIOSH 7402) LJ TEM (AHERA) TEM (EPA Level I1) Other I Asbestos Bulk I PLM (EPA/600/R- 93/116) PLM (EPA Point Count) PLM (EPA Gravimetry) TEM Bulk Condition of Package: Good Damaged (no spillage) Severe damage (spillage) 1 14 15 METALS Dot _Limit Matrix Total Metals 21;p (AAS) f. Air Filter wrap 0 ppb (GFAA) Drinking water U Dust/wipe Soil Other Types Fiberglass Nuisance Dust of Analysis Silica Respirable Dust Seq. #1 Lab ID 1 2 3 4 5 6 7 8 9 10 11 12 13 Print Below Sian Below 1 f Sampled by 1 �a,.4c 66,04ac I r �czt 7 Relinquished by j, c K�p6e -C. 1 jJ Received by Frji�/7 ‘..M,/,1_5 Analyzed by_I .P f� Results Called by i Results Faxed by 1 Special Instructions Client Sample Number f A CHAIN of CUSTODY SAMPLE LOG RCRA Metals All 8 Arsenic (As) Lead (Pb) Barium (Ba) Mercury (Hg) Cadmium (Cd) Selenium (Se) Chromium (Cr) Silver (Ag) Rotometer Calibration Other (Specify) Mold/Fungus Paint Chips Paint Chips (Area) Waste Water Comments NVL Batch Number Client Job Number Total Samples Tum Around Time Email address )O(44s( ,L 4 Asc.z,>s Unless requested in wrilina. all samples will be disposed of two (2) weeks after analysis. BATCH ID 2702200 00 1 -Hr 24 -Hrs 4 ys 2 -Hrs 2 Days Days 4-Hrs 3 Days 6 to 10 Days Please call for TAT less than 24 Hrs cY 24•✓ochc.4.147 Other Metals Li All 3 Copper (Cu) Nickel (Ni) Zinc (Zn) Company Date 12 G sl l4, .2:-< 1Z/ 7 13 �P.•, j I -s c >F sec .t..c I,2,1,0 ;a /A—. 1 1 I f I i_ °c l I, 1 i(54ittl Aiucwieb Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner PA PLAT (SHERRON ASS LLC BELLEVUE BELLVUE Structure Information 000 000 CONST OF SUB DIVISION Permit Additional Permit pin Permit Fee Issue Date Expiration Date Fee summary T•\Policies \1102.15R [1/05] desc number WA 98005 Qty Unit Charge Per CLEAR GRADE C/G #06 18 80937 525 50 11/17/06 5/16/07 06 00000671 742275 140 W AHLVERS RD 06 30 16 4 1 0000 0000 CLEARING GRADING UNKNOWN 0 BASE FEE CITY OF PORT ANGELES PUBLIC WORKS UTILITIES DIVISION 321 EAST '5TH STREET -PORT ANGELES, WA 98352 Contractor OWNER Plan Check Fee Valuation Charged Paid Credited Permit Fee Total 525 50 525 50 00 Plan Check Total 00 00 00 Grand Total 525 50 525 50 00 Date 11/17/06 Due 00 00 00 0 0 0 Extension 525 50 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 goveming 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 cd]' struction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date CALL 417 -4807 FOR UTILITY 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. PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE T•\Policies■ 102.15R (1/05] RESIDENTIAL CONSTRUCTION R.W PW/ ENGINEERING 417-4807 FIRE 417 -4653 1 PLANNING DEPT 417.4750 1 BUILDING 417 -4815 PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED YES 1 NO FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES 1 NO 1 1 1 1 1 1 1 1 CONSTRUCTION kW PW ENGINEERING 1 FIRE DEPT 1 PLANNING DEPT BUILDING COMMENTS 1 1 1 1 1 1 1 1 i /{3& FEE RECEIPT NUMBER CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT _ A_... ;:)R7 PERMit NUMBER ." TOTAL FEE Ih, oV CONT. LIC. NO. TIMETOCOMPLETE NO. STORIES LEGAL OCCUPANCY Site Address NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT PERMITS WITH WRONG ADDRESSES ARE CANCELLED Owner Installation By Owner'sAddress / #~ 1'1/. /1;7; Iv'e;r f" Installers Address Day Phone . -;I ; - T ~ V ~;;:, <(. Installers Phone .. . Applicatiqn is hereby made for PerrT!itto install Electrical Equipment as follows: ((, /l'iJ "4~ A" /Lr -L.- lI/s /S ;I J-/<W {'Ill-rOC #,,11.< I/L/?<!'APt lJyiring Method . NUMBER AMP 120V 24QV NUMBER AMP 120V 240V USE OF CIRCUIT PER 100R FEE USE OF CIRCUIT PER 100R FEE CIRCUITS CIR 10 30 CIRCUITS CIR 10 30 LIGHT SIGN LIGHT - -:-. 50 VOLTS OR LESS CONVENIENCE - MOTOR CONVENIENCE .. MOTOR APPLIANCE -- - -.. MOTOR DISHWASHER FI RE ALARMS DISPOSAL BURGLAR ALARM RANGE MISC. OVEN WATER HEATER LAUNDRY DRYER . REINSTALLATION LIGHT FIXTURE # FURNACE SUB TOTAL FEE GAS - OIL FURNACE I . ENERGY FEE ELECTRIC - - BASIC FEE ELECTRIC HEAT /6,00 TOTAL FEE ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER .. A.C. UNIT AMP PHASE FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICE A.W.G. 1 SUB-TOTAL' - SIZE OF GROUND SIZE OF ENTRANCE SWITCH I certify that the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code. Date Application made . .,5-:f()- fr- ,19 By . Date Permit Issued CONTRACTOR OR OWNER (OR AUTHORIZED AGENT) Permission is hereby. given to do the above described work, according to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. . DIRECTOR OF CITY LIGHT By 77v/ ~A'/t PLANS APPROVED Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in Writing on Permit Placard. A. - Permits Phone: 457.0411 Ext. 158. '. b- dO~8S;-- WARNING I d{J PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER - WHITE. Original CANAAY. Duplicate PINK. Trlpllcate WHITE CARD. Inspector's Report -- ~ REPORT OF INSPECTOR ,... ,.' DATE OF VISIT MADE BY REMARKS . . , . " l " , . ,- .' . , , , ,. , , - ". , . - . . ; , , , . . . . . . . . ., " " . , ., 5- ~'-6) 7. O.K. FOR COVERING " S-~I- t~ '7 111 f .l> O.K. TO CONNECT SERVICE 0- -.?.I- i'> I . FiNAL O.K. V. '\ , '. . I ,,: z Cl a: < ::E !!! J: I- Z W l- . l- e z e Q . '~ w CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION J2\ EAST 5TH STREET. PORT ANGELES. WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type descr~pt~on Subdivision Name Property Use Property Zoning Applicat~on valuation 07-00000049 Date 506580 140 W AHLVERS RD 06-30-16-4-1-0000-0000- ELECTRICAL ONLY 1/24/07 UNKNOWN o Owner Contractor PA PLAT (SHERRON ASS ) LLC BELLEVUE BELLVUE WA 98005 RW BECKER ELECTRIC 1532 TAYLOR CUTOFF RD SEQUIM WA 98382 (360) 683-5839 Permit Add~tional desc Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL TEMPORARY SERVICE RW BECKER/ 60 A TEMP SVC 93526 RW BECKER ELECTRIC 40 00 Plan Check Fee 1/24/07 Valuation 7/23/07 .00 o """ ~ \) Qty Unit Charge Per 1.00 40 0000 ECH EL-TEMP SRV - 0-60 SRV FDR Extension 40.00 ~ 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 ~ '- r- "- ~ ?> V1' ~ ()-. COMMENTS/ACTION NEEDED ELECfRICAL PERMIT INSPECfION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE I ACCItPTED COMMENTS I YES I NO IJITLH IU11IlTH.lN /l,;UV.hK ~.c.l\. V ll,;,h ''-:.1'JJD1'1,1 .~C"\ I , GENERAL COMMENTS: rw.II02.1514'96J Jan 15 07 0859a ;sJ:lectrical Contractor ~-~~,. J" ---w~ ~~~ '!..\~i ~.".~... o Owner ~.....;f- p.1 ELECTRICAL WORK PERMiT APPLICATION , o Request Inspection o Annual Permit 0 Alarm 0 Carnival D Commercial D Residential 0 Residential i\'laint. 0 Si~lIs 0 Th(!rmost:Jt 0 Telecom. ~ Overhead Service ~ Temp Service o Underground Service Job wired by -:::aElectrical Contractor DOwner Electrical contractor mime License number 72 W !, C-e.. /C..C---.L /Z.. W 61iCe~b3C Purchaser's mailing address /.5'""3 L-; r k I'~ c.u rn:=,::: City . State ZIP Sc3-Q U f't-~ TC'lcphone number . J/77 13t;~ Premises owner's na'me, ~(""'A s: /lcr.4;.td '0-'- rr:=, Addres!'i j)! inspec~on_ .-r.,. {3 -p '- ,,~. at ' y t? 7't7 ~ M.4f t} K'3 r "Z- FAX nu,beC/7 b O:Jc.tO<( L- C- C- {/'10 ~A1 ,l-LJ r ,4w1i (J'-us5 w" r hereby certify that I am the owner of the above named property or a licensed electrical contractor (or the fiml's authorIZed agent) and am making tbe electrical installation or alteration- in compliance with the clectrical1aw, Chapter 19.28 RCW. x WALLS Insulation Only Dille Approved By Cover Oale Approved By CEILING Insulation Only Date Approval By Cover Dall~ Approval By "- Electrical Load Additions and or subtractions o NO LOAD CHANGES o Baseboard KW o Furnace KW o Heal Pump Ton LAR o Fan.Wall KW J nspection Date Area, Building or Equipment Inspected /. / ':'07 Installation description / )J So " 7 b-?;f// ';7) lIz,:J'71'" SC7h'.-''',J . - r/ L vM'....;5 ~D) o Cash D Cheek # ptcrcditCard~: Mas-lercard Discover Card# P--'t' _-,,,'::/ (-L-fC____-~___ Expiration Date of card Insp~.c~;..{ee C) 0 $ 7(/'~ THERMOSTAT r SERVICE '\ "- ');ole Aoprowcd lly r FEEDER 0:0": ^prrovcd By / Dow ^l'l'ro'.c<l fly DITCH D~t" ^f'I'I.,nd Hy Service \nformation VOllageZ- 'IcY)-LV Phasefll.,i:l3 Service Size: hl").4. Feeder Si2e: I\ction Taken Electrical Inspector ED cO