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HomeMy WebLinkAbout3022 S Laurel St - Building 06/13/2013 11 : 19 FAX [&001/001 RECEIVED �. I JUN 17 20D BECTRiCAL CITY OF FORT ANGELES PERMIT APPLICATION ONSPECTIONS Building Divi;lon/Electli Inspections 321 East Fifth S[reer—PA Box 1150 /Port Angeles Washington, 98362 1'h; (360) 417-4?35 Fax; (360) 477-4711 Date _ _ � (;� �-z 1 &2$Ingle Family Dwaliing Plan RevleA'May. Pe aired, Please o I to Eectrical PIGn Review Information Sheet or,Add{z3s — .� f�r�lAr -- Budding Square Foolage _ — Descrplion of above Owner for lion t Contras Inforr�� one' Name, C• Mails Addr s Malin Add J� City:, , Stale ]C� ZIp {C._ M KIM, Sfata: Phan : axe---• Pho a. _ a I ,{ c+canse#r xp• _, __ Ulcensa lExp. Item Unit Charge oty Total i Muttlplled by UnitlGMELej ServicelFeeder 200 Amp 8120 00120 00 $- Service/Feeder 201.400 Amp. 5 146,00 Service/Feeder 401.600 Amp S 205.00 Service/Feeder 601.1000 Arne, $26200 $� Service/Feeder over 1000 Alp $373 00 $ Branch Clrwo Wr Service Feeder $ 5.00 $ orFri C null 6,+0 Sarviw Feeder $ 6300 $ mach Additional Branch Crcull $ 500 $ Branch Ci rcuils 1.4 $ 7500 $ Temp Service/Feeder 200 Arnp $ 93,00 $ Temp Servc&Feadar 201.400 Aii $110.00 $ Temp Servica/Feeq'e+401-604 Amp $14900 $ Temp,Service/Feeder C)01-1000 Amp $168,00 g __ Forlai to Portal Hourly $ 9600 J – °ig.jal Crcu a Limited E:iergy. & Family Owellmc0 $ 6400 $ kAanutacwted Horne Conrecl:o7 $120.00 $ ienevvabe Eiaclrica:Erergy,5KVA Sysrenl or Less $ 102 0C $ T7ermoslat $ 56 cc $ Note 15,00 for each aodriional T.Stat NEW CONSTRUCTION ONLY; First 1300 Square FI $120,00 $ Each Adduronal 500 Square FI or Por011 of $ 40.00 Each Uutbudding or Det range 5 74 00 $ FacJ1 Swimming Pool r of Tub 5;41000 $ HT) - Total Owner as defined by ROW 19,25 261; (1)Owner will occupy the structure for Iwo years after this electrical permit is finalized.(2)Owner is required to hire an elecir cal contractor if above said property is for sale,rent or lease. Perrrk expires after six months of last inspection. After reading the above statement. I hereby ceR;fy that I am the owner of the above named preperty or a licensed electrical contractor.I am making the el • al installation or skerai on In compliance with the electrical laws,N E,C,,ROW, Chapter 19,28,WAC, Chapter 296-46B,The City of Port Angel s Mu 'c+pal Code and U y Specifications and PAMC 14.05 050 regarding Electrical permit Applications, S na re owner,electri ai c ntractor or cal administrator, C csih © Choulk 01 �/� Ld�CWQ Card#�1 Yc� �,1► I x �.f/ v �Jkad; �� /�`Y...dG� / ... � all�- ELECTRICAL PERMIT ! CITY OF PORT ANGELES ©' 360-417-4735 Application Number , , , , 13-00000656 Date 6/17/13 Application pin number . . . 838632 Property Address . , , . . . 3022 S LAUREL ST ASSESSOR PARCEL NUMBER: 06-30-16-5-0-1200-0000- REPORT SALES TAX Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name Property Use to the City Of Port Angeles Property Zoning . . . . , . . RS7 RESDNTL SINGLE FAMILY (Location Code 0502). Application valuation , , , . Q Application desc Hot tub Owner Contractor ------------------------ ------------------------ GILLIAM, LESLIE & ANN SHAMP ELECTRICAL CONTRACTING 3022 S LAUREL ST PO BOX 383 PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 452-1689 ( �� Permit ELECTRICAL ALTER RESIDENTIAL !71 Additional desc �J Permit Fee 110.00 Plan Check Fee .00 Tesue Date , , . 6/17/13 Valuation , . , . 0 `+ Expiration Date . 12/14/13 Qty Unit Charge Per Extension 1.00 110,0000 ECH EL-SWIMMING POOL/HOT TUB 110.00 Fee summary 'l`-f Chargedf`f --------Paid Credited ____DUe WUY Permit Fee Total 110.00 110,00 00 DO Plan Check Total .00 .00 00 .00 Grand Total 110.00 110.00 .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: GAEXCHANGE;BUILDING CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 08 00001452 Date 11/17/08 Application pin number 923416 Property Address 3022 S LAUREL ST ASSESSOR PARCEL NUMBER 06 30 16 5 0 1200 0000 Tenant nbr name LESLIE GILLIAM /ANN HAIRST Application type description MECHANICAL APPL PERMIT Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 4000 Application desc WOOD BURNING STOVE INSERT WITH LINER Owner Contractor LESLIE GILLIAM /ANN HAIRSTON 3022 S LAUREL ST PORT ANGELES WA 983626913 (360) 457 8763 B B ENTERPRISES 520 ROSE ST PORT ANGELES (360) 417 0436 WA 98362 Permit MECHANICAL PERMIT Additional desc WOOD -STOVE INSERT Permit pin number 138032 Permit Fee 60 65 Plan Check Fee 00 Issue Date 11/17/08 Valuation 4000 Expiration Date 5/16/09 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 10 6500 ECH ME OTHER APPL N/R 10 65 Fee summary Charged Paid Credited Due Permit Fee Total 60 65 60 65 00 00 Plan Check Total 00 00 00 00 Grand Total 60 65 60 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 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. r 4h 7� 8. Cr) GTo H B�� d ,(��,PJ Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building DivisionBuilding Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 \SI 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) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing I Slab Blocking Hold Downs Skirting Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T Forms /Building Division /Building Permit FINAL Date FINAL Date PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Accepted by Accepted by Date Accepted By W 0 N N g 1 ->(010--d‘ I1 10 I/ Applicant or Agent Co 1-TO vi an dot, Phone Property Owner L S G. ',Lis et& Phone Property Owner's Address 3o 22 S Lerr,r.el. Contractor /Engineer Co Ct m p y ag EJ Phone Contractor /Engineer's Address 5 a o R as e. s7 Po' iti- v)o -e.L s License /3 13 E'p»- Oy3 Expires /Q/ 2107 E -mail PROJECT ADDRESS '30D-9-- S Ccc I, r- Po /1 eeMS Parcel Number Project Type Brief Description. Check all that apply New Construction Addition Remodel Repair Re -roof Demolition Heat System Other Floor Areas BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 Heat pump j wood- burning stove gas fireplace pellet stove other Sv► s e✓T ine✓ Existing (sq. ft.) P posed (sq. ft.) Basement per sq. ft. 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures sq. ft. Lot size Max. height of proposed structures ft. Occupancy group Will a lawn sprinkler system be installed? Occupant load Will a fire sprinkler system be installed? Construction type 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 what permits are required, and to obtain permits prior to working on projects. Date II Print Name COurovl 130 dl/ Lot Zoning Residential Commercial Multi- family TOTAL VALUATION Signature For City Use Only Date Received lk —\1 Permit 14 �i2 Date Approved 7 -&-7 t1/7-0V3 tr 3‘2 (vim g 8 Industrial sq. ft. Lot coverage of bedrooms of full baths of half baths U)'" o , U) o , rl "'''' OE-< ..;..; 0.0 M rl <Xl '" , N U) .,. >< .'l ~ '" H .'l E-< "'Ul :><'" ~~ E-<>J Z O~ HO E-<E-< UU "'''' 0.0. UlUl ZZ H H o \0 M :> H"'''' OZZ (QOO bxx Ulo..o. ~~ '" U) CJZ ZO HE-<' HUlO....:t O~O"; OHOU U.ct;OH ..-;~~~ f-; r.zJO;:r: Ult!J NU f-l(ilt""'ir.zJ ....:!::r:HI::E '" .'l0 O::O::UlIN ~WWU10 ~~H~~ (/)f;1~~~ :3:HOO N HMO N H....:t I I O....:! H\"O 00 M":(000 r- .,. <Xl Ul '" -.'l "'''' 00 ;;,~ o 'E-< rl~ o 0. ~ . P::: . W o <Il Ult; .~ gj ;;i ~ ,p O:::E-t~U....:t OZZ~o. 00:':";0. ";UOo...; o "'''' ~O ..; 0.>< "'E-< ~H o.U E-< H :E ~ '" 0. Ul E-< Z '" :E Z:E 00 HU E-<' o.Ul HE-< ~.'l Ub UlUl "'''' Eo<O~ H ~ '" 0. E-< 0..c1 ~~~ UH'" ~O: ~~~ Ul'" O"'.'l Obo. O:E "'0 ~U ~ .'l 0. 0. ..; Eo< i 0. QJ .-< '" Ol 0: rO 00. , 0'-< rl 0:E 0. "'u) :E'" H .. E-<o .,. N .'l .'l ..;'" ..; ZO Z HO H ~NM~ \0 H ~ r--- H ";N<Xl";Z u 'U 0 H>,r--HO ~~~~12 ::r:;::I :I:r.zJ UCUlUE--t WltlWW!:L. :E>J.'l:E"; ~ '" o , U) o , rl o Ul , 0. >< E-< rl o '" '" '" :E 0. ~ 0.. E-< " '" X Ul '" E-< o Z o ~ Ul E-< Z '" :E :E o u f VORT..v.,. (Jt:-.J..O~~~ F\1ii 'L -=-- ~ "4il:;--~ 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: Application type description Subdivision Name Property Use Property Zoning . . . . . . . Application valuation . . . . 08-00001002 Date 923464 3022 S LAUREL ST 06-30-16-5-0-1200-0000- MECHANICAL APPL. PERMIT 8/18/08 RS7 RESDNTL SINGLE FAMILY 11527 Application desc HEAT PUMP INSTALLATION Owner Contractor GILLIAM LESLIE E/HAIRSTON ANN 102 DEER TRAIL WAY SEQUIM WA 98382 ALL WEATHER HTG 302 KEMP ST PORT ANGELES (360) 452-9813 & COOLING INC WA 98362 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date MECHANICAL PERMIT HEAT PUMP INSTALLATION 132324 64.80 Plan Check Fee 8/18/08 Valuation 2/14/09 .00 o Qty Unit Charge Per Extension 50.00 14.80 BASE FEE 1.00 14.8000 ECH ME- INSTALL 100- FAU Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 64.80 64.80 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 64.80 64.80 .00 .00 0; /} / q0~ sy O? 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. ~ Signature of Owner (if owner is builder) T:Forms/BuiJding D;visionlBuilding Permit (05/i':l/08)'wpd BUILDING PERMIT INSPECTION RECORD INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS SHEAR WALLS I WALLS FOUNDATION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR W ALLIHOLD DOWNS WALLS I ROOF I CEILING DR YW ALL (INTERIOR BRACED PANEL ONL Y) T-BAR INSULATION . SLAB W ALL I FLOOR I CEILING MECHANICAL HEAT PUMP/FURNACE/DUCTS GAS LINE DATE JLL WOOD STOVE / PELLET / CHIMNEY FINAL \-<:)- 0'1 ACCEPTED BY: COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT I/'s SEPA: I' AR KING/L1 GHTI NG 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 CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES. CALL 417-4886 FOR BACKFLOW PREVENTION INSPECTIONS. PLEASE PROVlDE 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. \]V KEEP PERMIT AND APPROVED PLANS AT THE JOB SITE. \J N lJ /' ~ f ~ T'\:nnn<::/r:tlt;ldinn nivi<::ir.n/Hllilrlilw Permll ro5/13/08tWDd () ~ \ ....... ~ ~ (\i , ~ ~\ .Jet- Aug 07 08 10:17a p.1 BUILDING PERMIT APPLICA TJON Print in ink CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 (360) 417-4815 fax (360) 417-4711 For City Use Only: Date Received ~-/~-a5 Permit# ~) -/01;/2- Date Approved 2, ~ I'P;. - q. Parcel Number PROJECT ADDRESS Lot Zoning Proiect Tvpe & Brief Description: Check alllhal apply o New Constr~ion-: , o Addition o Remodel o Repair oRe-roof o Demolition o Sign ~Heat System o Other Floor Areas . Basement 1s1 Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other o Commercial o Multi-family o Industrial o wall-mounted 0 projecting 0 freestanding 0 awning Total si n area s . ft. Maximum allowed si n area . ft. Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other lJ other Exist/no (sa. ft.) Proposed (sa. ft.) @$ per sq. ft. = $ TOTAL VALUA TION $ 00 sq. ft. -:- Lot size % Total footprint of structures Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? sq. ft. :: Lot coverage # of bedrooms jf. of full baths # of half baths ft. Occupancy group Occupant load Construction type ! 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 what permits are required, a proje~ 1-1/' ; ',c;..., r.. V r-l Date~ilillU Print Name\. C\~i\f\'\N DOl) \lJ\'( 8- Signature T:FormslSuilding Division/6ldg PerP.1it Appl.-2006 Code. doc / & <}>r When recorded return to: OLYMPIC PENINSULA TITLE COMPANY NO, 8cf1 ~ / _^/ J\ 0 ClALLAM COUNTY (pUlC'U. "TO TRANSACTION EXCISE TAX ~:~E ~L 3 1 2008 ' AMOUNGt./o, ~()Q - COU RSER 2008-1224676 Page 1 of 2 Warranty Deed Olympic Peninsula Title Company Clallam County Washington 07/31/2008 12:53:03 PM 1111 ~'I'i. 'l,1~~""~f,~~"UIlUIiIUir'~f ril',lr,', Mir,~I~ IIIII File Number 01091028ds LPB 10-05 STATUTORY WARRANTY DEED THE GRANTOR(S) LYDIA COURNEY, WHOSE HUSBAND IS JOHN S. COURNEY, AS HER SEPARATE ESTATE for and in consideration of TEN DOLLARS AND OTHER GOOD AND VALUABLE CONSIDERATION in hand paid, conveys, and warrants to LESLIE E. GILLIAM, A S'INGLE MAN AND ANN HAIRSTON, A SINGLE WOMAN, AS JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON the following described real estate, situated in the County of CLALLAM , State of Washington: LOT 10 ALDERWOOD ACRE TRACTS AS RECORDED IN VOLUME 4 OF PLATS, PAGE 13, RECORDS OF CLALLAM COUNTY, WASHINGTON. SITUATE IN CLALLAM COUNTY, STATE OF WASHINGTON. The Grantees by signing the acceptance below, evidence their intention to acquire said premises as Joint Tenants with Right of Survivorship and not as Tenants in Common. ~~Z .c...-d~~ SEE BELOW L~SLIE E. GILLIAM "ANN HAIRSTON Abbreviated Legal: (Required if full legal not inserted above.) LOT 10 ALDERWOOD ACRE TRACTS Tax Parcel Number(s): 063016 501200 Dated: July 22, 2008 Pt:2 . "" ; .. ~ ~ a 2/ r..._Jiu/ LYDI COURNEY I {', (JLfi j. ()VAw-<-v' JO~N S. COURNEY I ./ .., ~~~ ..c. /~ __ ..,~ .. lRS State of WASHINGTON County of CLALLAM I certify that I know or have satisfactory evidence that --------------LyDIA COURNEY AND JOHN S. COURNEY----------------------------- 55. (i~l~) the person(s) who appeared before me, and said person(s) acknowledged that THEY signed this instrument acknowledged it to be THEIR free and voluntary act for uses and purposes mentioned in this instrument. Dated :7 -;,-3 ~1:(2t ~,... II_ ff ~~2~~~i,(;:i,{l;;,';~;::111 _ ..:,~~,\.~ ,.t; .~J' --:;~.;'. ..,~ - -:t ,. r ";' J, :: 56'~' ,J ~tp ,~.~ ~ :: ~ A:6~ ~ ~I>>::: m;:; ~ ~~~~. 0g E -~:,;?>t~i 7V&'L\() .ff: ~, ~ }",,:0.9_1 0 ,,".o-~ ff "IY,{'- :tll\I\\\\',,':~~~O~ lIJ,.~/ASI-nN .\."......... >.\\\\\\\\\,..... and the c~- Notary name printed or typed: DAWN L. Notary Public in and for the State of WA Residing at: SEQUIM My Appointment Expires: 4-9-2010 FLEMING , 'HOMEOWNER'S POLICY OF TITLE INSURANCE ONE.TO.FOUR FAMILY RESIDENCE Issued by Transnation Title Insurance Company .---. Transnation Title Insurance Company is a member of the LandAmerica family of title insurance underwriters. 1i.1\l ~ ,",.mf~i}. ,.~.~,-".::~..... ...~ ~l_C.~ ':"',I.;o;!'i<,"'..:..'~ ..._<<;:1 Transnation POLICY NUMBER 869-Z001149 OWNER'S INFORMATION SHEET Your Title Insurance Policy is a legal contract between You and Us. It applies only to a one-to-four family residence and only if each insured named in Schedule A is a Natural Person. If the Land described in Schedule A of the Policy is not an improved residential lot on which there is located a one-ta-four family residence, or if each insured named in Schedule A is not a Natural Person, contact Us immediately. The Policy insures You against actual loss resulting from certain Covered Risks. These Covered Risks are listed beginning on page 2 of the Policy. The Policy is limited by: Provisions of Schedule A Exceptions in Schedule B Our Duty To Defend Against Legal Actions on page 2 Exclusions on page 3 Conditions on pages 3 and 4. You should keep the Policy even if You transfer Your Title to the Land. You do not owe any more premiums for the Policy. If You want to make a claim, see paragraph 3 under Conditions on page 3. This sheet is not Your insurance Policy. It is only a brief outline of some of the important Policy features. The Policy explains in detail Your rights and obligations and Our rights and obligations. Since the Policy - and not this sheet - is the legal document, YOU SHOULD READ THE POLICY VERY CAREFULLY. If You have any questions about Your Policy, contact: Consumer Affairs Department Transnation Title Insurance Company P.O. Box 27567 Richmond, Virginia 23261-7567 TABLE OF CONTENTS OWNER'S COVERAGE STATEMENT COVERED RISKS OUR DUTY TO DEFEND AGAINST LEGAL ACTIONS SCHEDULE A Policy Number, Premium, Date and Amount Deductible Amounts and Maximum Dollar Limits of Liability Street Address of the Land 1. Name of Insured 2. Interest in Land Covered 3. Description ofthe Land SCHEDULE B - EXCEPTIONS EXCLUSIONS CONDITIONS 1. Definitions 2. Continuation of Coverage 3. How to Make a Claim 4. Our Choices When We Leam of a Claim 5. Handling a Claim or Legal Action 6. Limitation of Our Liability 7. Transfer of Your Rights to Us 8. Entire Contract 9. Increased Policy Amount 10. Severability 11. Arbitration ALTA Homeowner's Policy of Title Insurance (10/22/03) Form 1086-162Z (Modified: Washington) Page 2 2 2 Insert Insert 3 3 3 3 3 By: 3 ..............\\~Elilii'S'li'"",I.. 4 .'....~ ....... '9'l1." 4 f~?"" ......\~\ 4 ~"'\SEALfor:g Attest: 4 \~"" ....~l "'~ ............ ~,.. 4 I"~""~!~,~e~~~..\............ 4 4 TRANSNATION TITLE INSU ~ ~ ~o. b... t. President Secreta r.y Valid only if Schedules A and B are attached Application Number Applicatlon pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivislon Name Property Use Property Zoning Application valuation 08-00000959 Date 772519 3022 S LAUREL ST 06-30-16-5-0-1200-0000- ELECTRICAL ONLY 8/07/08 RS7 RESDNTL SINGLE FAMILY o Application desc 200 amp service Owner Contractor Gllliam, Les 3022 S LAUREL ST PORT ANGELES SIMPSON ELECTRIC 243036 W HWY 101 PORT ANGELES (360) 457-9270 WA 983626913 WA 98363 Permlt ELECTRICAL ALTER RESIDENTIAL Additional desc Permit pln number 131748 Permlt Fee 64 00 Plan Check Fee 00 Issue Date 8/07/08 Valuation 0 Expiration Date 2/03/09 Qty Unit Charge Per Extension 1 00 64 0000 ECH EL-R OR RM 0-200 ALT SRV FDR 64 00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 64.00 64 00 .00 00 Plan Check Total 00 00 .00 00 Grand Total 64.00 64 00 00 00 . ~ o N 10 V' l 17 G ~ ~ ~ Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdlvislon Name Property Use Property Zonlng Appllcation valuatlon 08-00000964 Date 146724 3022 S LAUREL ST 06-30-16-5-0-1200-0000- ELECTRICAL ONLY 8/12/08 RS7 RESDNTL SINGLE FAMILY o Application desc T-stat Owner Contractor Gilliam, Les 3022 S LAUREL ST PORT ANGELES WA 983626913 ALL WEATHER HEATING & COOLING 302 KEMP RD PORT ANGELES WA 98362 (360) 9813 w 0) N N Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit pin number 131805 Permit Fee 35 00 plan Check Fee .00 Issue Date 8/12/08 Valuatlon 0 Explratlon Date 2/08/09 Qty Unit Charge Per Extension 1. 00 35 0000 EC EL-LOW VOLTAGE 35 00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35.00 35 00 .00 00 Plan Check Total .00 .00 .00 .00 Grand Total 35.00 35.00 00 .00 0\ ~ c N m r ~ ~l SPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE OUGH - IN T!/16/CB FINAL OMMENTS: .. " SPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE OUGH - IN FINAL ~ OMMENTS: '1YP ~ ~ CITY OF PORT ANGELES FIRE DEPARTMENT PERMIT 321 East 5"' Street, Port Angeles, WA 98362 Application N~mber ..... 03-00000212 Date 3/04/03 Property Address ...... 3022 S LAUREL ST ASSESSOR PARCEL N~MBER: 0630165012000000 Application description . . . FIRE ABANDON TANK INSPECTION Property Zoning ....... Application valuation .... 700 Owner Contractor WILLEON JOFA~ H PETTIT OIL CO. PORT ANGEI~ES WA 983626913 PORT ANGELES WA 98362 (360) 457-9404 Additional desc . . Expiration Date . . 8/31/03 Qty Unit Charge Per Extension '.3 This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with 180 days from the last inspection. I hereby certify that I have read and examin~ this application and know the same to be tree and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the prffO~sions of any state or local law regulating the work specified in the permit. Signature of Contractor or Authorized Agent Date Signature of Owner (if Owner is builder) Date FIRE PERMIT INSPECTION RECORD Call 360-417-4655 for fire 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 Inspection Type I Date Passed Comments FIRE SPRINKLER Underground piping hydrostatically tested Underground piping flushed Interior piping hydrostatically tested Interior piping inspection Dry system air tested at 40 psi (24 hours) Sprinkler final FIRE ALARM Rough-in inspection Alarm final LP-GAS Completed by Contractor: Underground piping inspection/pressure test Test # 1 Above ground piping inspection/pressure test Piping pressure test psi Time initiated Tank (container) inspection Test #2 Appliance inspection Piping pressure test psi Time initiated LP-gas final UNDERGROUND STORAGE TANK (UST) ABANDONMENT Removal of flammable/combustible liquids Tank appropriately abandoned UST abandonment final PERMIT OTHER (specify) permit final GENERAL COMMENTS: 2/15/00 08/05/2008 08:40 4579270 SIMPSON ELECTRIC PAGE 01 ~ECEBVIE/D) ~ CB~C5tS7 . AUG 0 7 2~CA.LWORKPERMlTAPPL.ICAl1ON .IdJ"",., ill )it., I,bl Coa~ 0 awe. ~1I'icaI contracCDr 18InII l..ic:aIe number Ode ex"...,. _ 'Ji /'haC'm DtXk/e /...LC SPnPSC-t. 9"7-3e(J p ~iliI8iling.addrta 1. I . I , ~,~ b \JW 0) VJ Cloy Ar e I ~s tJj';~/1P q 03103 110',,",,0" fto....... Co PAX - ...L. '5'7 --,;L 7 0 ;;j~ B' ....em... o..ert, ...e /"" / ] . t-e $" <..7-,' J (J. "'" A......... .r 1~1I.. S / '" , .. . IJ "J -60';;'~ . ~ -.),' Cloy p,4. ......11..... _...... lJ C .. ~.,...."".. aN... )QAIlenIIIAMlIIoe Ljf~ SerJrCe.- /.J.uvf.;p~/ r ~7 .' & 6 .4) \Ii ~ 0.... .... dojlrtH by R.CJf:/P'2'.261:(I) _ will _ 1M __ for ...... -" """' tJ,b ...._".,., "'JI-...L (2) 0.-. ,. '"'1-" hire.. -= -1f"--_"j/Ir__,Dr""""- Allo< -iris .... ..... ~ I -,. certllY IIlIlI '"' lllo .....er..r lllo ....... Mmfd prIlIpcIrty or I tie.. ~ ..4.~r. 111II'I .... Ole doeIrbI iGIIDl- hili... Dr .ltentioll in ~_ce with thll "'-"ria" hi... N.S.C.. RCW. ~r 19.28. WAC. Cha_ 2_8. no. Cay of ..... A...... llIoa;e;pal Code. _ Uti,;" S)oeel _. 8(pat .,. wacr, _.101 eq o Casb a.Check# Credit c:...r ~ Mallll:rc8rd Diecovcr ~#_~~~--~---- Dm: . S r",,4 " --- S8rv1ce_ VCIllIlg8 _al0S fH?vI) SItIIIce SIi8: ~ T 'U ""_ SIze: a NO ~OAD CIillNGES aB~1I _KW a FllIhBIIe _ KW 'i'if OWIrI'....' Sen.Ice .0 Hoot ~ _ Tan_1J\A t6 Tomp S&Ivk:e lJ ".....wo. _ KW a UllIIorg_ SenIIc>> SAME DAY INSPECTION. CALL BEFORE 7:lIIlAM 360-417-4735 r JlOUGR.IN 1'III:RMl:l81'A ..., S lJjd3tW1rT~-/ f;;!r'O[rs ~ l ...7"'""'"" ~8y../ '-'- 8)' FINAL I' Dn'CR r 11'J:;U.JUC. ~JE., "- .... -., - ../ Inspecl. ^""" Bw'kfwS CO' Equipmeot lllOpecll:d BI"otnc81 Dot. Adloto Tak.. ID'tIpeuIQf "l-7-or; O~ AI> [3j/j . i . . . ELECTRICAL INSPECTION WIRING REPORT 417-4735 '- A~~~V~~. . . . . . . . . . . . . DITCH. . . . . . . . . . . . ~~T ~PP~OVED ;:g. .f1/1'(>j~~. .. . . . ROUGH IN/COVER. . . . . . . . .. . . . ..0 M-.e/i/p.$. . . . . . . .. . . SERVICE. . .. . . .. . . . .. . . . . . . 0 Ji5.. 8// BICf6. . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . . . 0 CORRECTIONS NEEDED: . . Da..)....l~JZ..... "1)7) UI'Y'f?_'- ~-f'< l....1)ZL NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 Aug 07 08 10:17a p2 Cf6 ~ cfj kif ~~~ ~~~~ ,<t!'a",c.-ffl} ,,'~j t-.......iO<'J' ELECTRICAL WORK PERMIT APPLICATlO,," Job wired bJ' ~lectrical Contractor Q Owner " Installation dcscripti~,./. o Commercial )'l.!esidential q-l-O(} o Ne"'- CJ Altered/Addition ~ electrical contHlctor :lame AI\W~~v~"J:f(('{'Oli,'l"'J Fr/JllF:"IWl~MI] Purcha~f's mailing ncdrc!'.s ~~ lUmp 4, ~M Pw1c)e I ~) Tclephon..: nurnhCf . C'J \ CP's.t;(\\{c.Xr7\ 1; \\V\\'\{ \1G' \V sto VI "ffizzt:s", (Cl\.w~\ 0"\. \'M A~( \ rl10nc Dumber (0 Hhe lule . \, License number Dnte Expires Lll -t-s\TA1 (,~~ \ St (j' f --, Smu.: ZlP v... \ f\ OJ '?l"Z-J. 0 Z. FAX number -'-62.'5\11 OWn~r as defi~led by RC/V19.28.26i:(J) Owner wi/! OC('!IP}' tile strllclurc for h.'(' J'c:ars ,ifter ,hi.. r:lccll'ual permil Lt }inaJized (2) O.-vner is required to hire em ded,'leal {;olilraclfJr if (I.!.,(we stJ.id properry is for .wie, rent or le,He.. Arler :-~aJing 1hl.: abo\-'e Sla;:crnent. I hereby certify [h<ll I am the owner of the abo\'e nam~d property ("It a liccn!>cd electrical contr<lctur. I am making the electrical instal~ Intion or aiteralion in cl)ntplianc..: with the electr;cal law:t N.E.C., RCW. Chapter 19.28, WAC. Chapter 196.46B. The City of Po~t Angcles. Municipal Code, and Utility Sp~dficalions. Si~ X A Date: Etecl~icall.oatl Additio1J5.andor_$Il~traclioJ!S CJ NO LOAD CHANGES CJ Baseboard -.1.. KW o F\Jmace KW U Heat Pump 'Z ti Ton TI t,o,FIL,1!-PI CJ Fan-Wall KIN o Cash 0 Check # ~Credil Card Card # Visa Mastercard Discov.::r ---------------- Expiration Date of card ice oCt SeDlicelnllll'll1a1io.!! l:J Overhead Service CI Temp Service u Underground Service Voltage Phase 0 1 CJ 3 Service Size: __ Feeder Size: __ S.AME..J)ALlliSttC'[ID1i....cALLJ1EEQRE..1:il.O~~L3@.~-4135. ( ROUGH-N "- THERMOSTAT " ~ SERVICE \\ I ) AhP5/tYd ~ I '(" U;;I" API'r<>V':U H~ 1),,1" Arr;mycd ll) "- Dal" ,\pl'....,\'dll,.-/ I FINAL 1 I DITCH I / FEEDER '\ 0}($[(8, ~ '-.. lh'~ A['(Ir,w~clA: '--- n;l\~ ArprClwd Ilv -./ \late Ar.':)"~': Bv -/ Inspection Area, Building or Equipment Inspected Action laken E!ectric:J.\ Datl' lnsrcctor \ , , r:h- Q9~9