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HomeMy WebLinkAbout507 E 3rd St - Building $~ L -- ~>.::;;.p 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 03-00001013 Date 10/15/03 50? E 3RD ST 06-30-00-5-2-5856-0000- MECHANICAL APPL. PERMIT 524 OWner Contractor WOOLETT JAMES J 507 E 3RD ST PORT ANGELES WA 983623401 FERRELLGAS LP ONE LIBERTY PLAZA LIBERTY (360) 683-9029 MQ 64068 Permit Additional desc Permit Fee Issue Date Expiration Date MECHANICAL PERMIT ZERO CLEARENCE FIRE PLACE 57.65 Plan Check Fee 10/15/03 Valuation 4/13/04 .00 o Qty Unit Charge Per Extension 47.00 10.65 ~ C1 -.....} BASE FEE 1.00 10.6500 ECH ME-GAS PIPE 1 TO 5 Fee "unwary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.65, 57.65 .00 .00 Plan Che.ck Total .00 .00 .00 .00 Grand Total 57.65 57.65 .00 .00 \\1 \,lJ ~ \!\ "l Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void jf 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 nol presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. - Signature of Contractor or Authorized Agent Date T:\PLANNING\FORMS\II02.15 [412002] BUILDING PERMIT INSPECTION RECORD CA LL 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 A CCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES I NO - FOUNDA lION: FOOTINGS WALLS FOUNDA lION DRAINAGE ELECTRICAL (UGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I I PLUMBING - UNDER FLOOR I SLAB ROUGH-IN WATER LINE GAS LINE In-Vl.-O>' \,L BACKFJ.OW/WATER AIR SF,AL WALLS I CEILING I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYWALL T-BAR INSULATION SLAB I I I WALL / FLOOR I CEILING I I I MECHANICAL HEAT PUMP WOOD STOVE I PELLET I CHIMNEY 1-1000/ DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERIJNE I METER SEWER CONNECTION SANITARY STORM PLANNING IlErT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA; LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL PATE 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 I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 3-/7-Q5- PLANNING DEPT. RUILDlNG 417.4815 Vf,l/re. "- BUILDING T:\PLANNING\FORMS\1102.15 [412002] ~ " . >,'Uo,,:p n~ 00 " ~ 'U;oo::E:ot:J H~ m ~ 'I:I:u:Z::Z:t:J "00 , L'()t:r1>-,l::>;:l ,,~ " H t>l:d:<ltrl )> 0 " ~ zr )>m O~ H ~. om ~m " 0 ~ m 0 ~ 00 ~. OH H O~ ~ ~O 0 om "' , 3" w w t:l~g OO:l::"ll1l ~-::. 0 ""'0'\ 0 trI 0 , 00" o~, QO 0 ;;i;i~ owt":u mw w ootrltrltrl r. oo~ 0 ~r 00 OO>-Jt:"w "~ HO O~ ~ 0 0>0 ~ H ~';'~[fj{J] H OOH~ H "Z NtIlt:"'>-c3 0" 3 ~~ ~ r~ mm w ~ . 0000 ~ ~m ~~ H '0 3 ooo~ no , 00 0000 )>0 0 0 "" ro '0 ~ 00 . ~ roo > 0 "H ~ m ~~ ~ 0 0 ,~ r 0 en > OH HZ 3 . r 00 3 00 3Z ~ zm 00 Q 3 00 "~ z H> 00 ~ ~oo ~ " " z ~ 000 " 0 " n" m r " " ~H ~ ~ 00 ~Z 00 0" z >H 0 ~~" 30 " ~~o m~ 00 oom "00 " ZZO ~ OOOOH r < r w 00 ~ m r 0 " m 00 w ~ 0 N ~ O~ >> "Q 0000 H 0 , w 0 , 0 w, ti . -- ""<~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 03-00000647 Date 507 E 3RD ST 06~30-00-5-2-5856-0000- RES ADDITION 7/07/03 Application Number Prope~ty Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 8000 Owner Contractor WOOLE1'T JAMES J 507 Ii) 3RD ST PORT ANGELES GREAT IMPROVEMENTS POBOX 726 PORT ANGELES (360) 417-2960 NE330 SF DECK TYPE V NQN-RATED SINGLE FAM & CONGREGATES NUMBER OF UNITS WA 983623401 WA 98362 Structure Information Construction Type Occupancy Type . . . . . Other struct info . . . . 1. 00 Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT NO PR FEE NEW 330 SF DECK 84.00 Plan Check Fee 7/07/03 Valuation 1/04/04 .00 8000 Qty Unit Charge Per 6.00 14.0000 THOU BL-2001-25K (14 PER K) Extension 84.00 Other Fees STATE SURCHARGE 4.50 Fee "unwary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 84.00 84.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 88.50 88.50 .00 .00. , , U) C) -......:J \t1 , ~ ~ '=L:. ~ Separate Permits are required for electrical work. SEPA, Shoreline, ESA, utilities, privale and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if conslruction 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 Ihat I have read and examined Ihis application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied wilh whether specified herein or not. The granting of a permit does not presume to g' uth ity to violate or cancel the provisions of any state or local law regulating construction or the performance of constructio Date Signature of Owner (if owner is builder) T:\PLANNING\FORMS\I 102.15 [4/2002] Dale BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS ?~/'!f -0::' .). J.... WALLS FOUNDA TlON DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT; # ROUGH-IN I I I PLUMBING UNDER FLOOR I SLAB I ROUGH.IN WATERLINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS I I I CEILING I I I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYWALL I-BAR INSULA liON SLAB T T WALL I FLOOR I CEILING I I I MECHANICAL HEAT PUMP WOOD STOVE / PELLET / ClllMNEY HOOD I DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARA IE PERMIT #'5: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARA IE PERMIT #'5 SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL. LIGHT DEPT. 4]7-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. 1 PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLA!\.'NING DEPT. 4]7-4750 ? -/7-0..5- ~ PLANNING DEPT. BUILDING 417-4815 :,,'l. ~A KU BUILDING T:\PLANNING\FORMS\] ]02.]5 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. .... Y7f / REQUEST: Date 7 It'l/o J { { Time r' - -0 Received by Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer ~~ Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: (.~\. n ~- Inspected: Date 1~~Time~BY...J'-- Remarks: <')'0'7 G'" /J') s (?rd Phone NoJ..j t 7 J--f (" 'l Permit No. ,(0 '/ 7 { ~ RESTORATION REQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC o Other [] Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) Fill out COMPLETELY and in INK. Your application and site plan MUST COMPLETE to be accepted for review. Uyou bave any questions, call (360) 417-4815 FOROFFIClAL USE ONLY: DaleReC."&~" '1 '~ Permit #: (.. Date Approved: 1) Date Issued: BUILDING PERMIT - APPLICATION Address: ArchitectlEn Contractor 'I( <It. Address: PO. BCJ,K 7..2 b PROJECT ADDRESS: bO 7 Phone: '1/ ?-::l.. 9 b 9' Phone: 'I S- 7-'/ f J J Zip: fa5t..2 . hone: ..!L/7il r/J ~ State License #:~UAd"rti'70tiExp: rir/t;y Phone: If /7 .....2~ City: fb~T AvwU.E~ Zip: fa .5~2 lEA . J Aft e:.. T; . ZONING: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Block: Subdivision: Credit Card Holder Name: Billing Address: Credit Card Type VISA MC # TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: City: Exp. Date: o Stove o Garage (i(' Deck o Other SIZEN ALUATION: 3$0 SF.@$ ISF.~$ SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ li",~ COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: _ Lot Size: I 0 .~i"J{) Existing Sq. Ft. 1.',50 & Proposed Sq. Ft. 3 30 ~ TOTAL Sq.Ft. I flfll::) Existing lot coverage 1)/.705' % & Proposed lot coverage~% = Total lot coverage 1'7. C.O % APPROVALS: PLANNING USE ONLY: PLAN: BLDG: DPWU: SEPA Checklist required? 0 Yes 0 No Other: FIRE: ESA/Wetland(s): 0 Yes 0 No OTHER: - BmLDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. f hereby certify thai I have read and examined this applicstion and know the same to be true and correct. f am authorized to apply for this permit and understand that ft is my responsibility to determine what permits are required ,not th Ci ' and s bta' such permfts for t70m. HFORMSIAPPSIBuildingpennit.wpd Date: 6/1 f'/ P ;$ - S I iE P LfI H Fo;e P/lfJPCl;,e,f) COI/&,lfcD DECK ON EllS'> 11>[; OF 11o/7/E, -/lD!){<.GSS 507 ell, 3rJ 5r. Pfl, t(lIfSrI. Cft',$6e2 t{ FIE ',/ ~ ... ,- J '~ " 3D' 4. ~ \I.l 7SO' ~ I L-)o --r Jt;/ 11:( "ii:. \.!l . ~ ~ ff)O Ip I "- I '- I N , ./ ,+5' '- LIO~ ~ I U\ r-\+- I ~ -1J 4 ~ '::t::- ~\ I Il9 6) \ j~?,o~:r~a 1 ----,- .j " "-It ""- c..'1f-0~ ~i (p' I 6'J1 CITY OF PORT AN( The Issuance of this per cations and other data s from thereafter requirin plans, specifications an buik1ing operations bel vi'.li;J(iQO of all codes a [S! i:iJN 3'13(c). Unit?; i+, :\ile _~ , , I ..----..-.---.-.-- ,., ~ , C:'l q- ........ ELE - Construction Plana ft ba upon these plans, specffi. II no prever:~ the building official the orrection of errors in said oth data. or from preventing car ed on thereunder when in d or Inances of this jurisdiction. Bull 109 Coo..) BY~ 7C/ l' W" .100(1 uapu,(1 c., ~ ~I ~" '3-1\: ~ ~ tA ....-- 0_ .1Z Va1 ""-' )U-. ~J @-~. " -Jl i\ ~ ~ ~ 'C. 'fl:, 11... O~c..1c ~' ~~ "( I t'-.. ~ ~ I :if t c ~a-- ':r- <:> r.>cJ --- 00 - .)(J! 's-J-.)npOJd 1t!!J21dw! ~1i,1f p",1nl:JIIJnOllW fil:JnpD,Id JlI!/IInh GO/-lnl""T ~ -- A N - ~ I. '" ~ ~\ ~t\~ / ~ r( \ () 0' . 4~' ~\ .!\ ~) '\ . {' fba 1J / ~ .~ ~--------~. \). , "'. ~ ~ ] ) ~ e-,8\ r ~ / '0'( II V;~cfJ~ ~~ . 60 ~.4J4-;~ 100-11000-008 ,,"96 [ iJ;JU!S iJ;J.mos l/.lOmlUW W .iOQ,a .1n " O:JNI S'HO~n.gI'H~SIa 'Hooa ~ DOOR DISTRIBUTORS INC. "Your Door & Millwork Source Since 1964" 800-DOOR-DDI Jf r,;- ~ Jrt(.Gr ~5r:;S' ~&>$15 ~ 1'S#hr:r(jj; (o"'r~'(~) 5 "if"" ", ~C/..lP @ s; wfSt>., (cl/l{ v\Y C{\ ~ '9' ~ o:~ r.t" I \0 - II.) G- rt J 1 - '" /~ p Q ~ ~~ 1/'1 (, 1((&'1 De;c.t6 . / J.v(, ,,-\li" f'T. 1(~@l.(131rt \ibUi~(' r-I-II p!q,..,f..,q i I ~t !/ ~I.f P. F (1J..., : 'lrif1)6ffi)A$$ .. ../Mturing IJulllitl/ imp<ll'ial J",oduct-s. ioc- 00 * Y :UGh( ft' 0" lflf'l (' r yJt>$T .,., , (nine/v f(tr~ ?(c>Cj,( L I) Lynden Door ™ .J..')(J/ J.e~ _S', , .:') ,I' ' ,7v (" /A'A-e. , . t "(,,. .. . ,.., I"d:- -6 CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . INSPECTION REPORT . . . . . . REQUEST: Date (f) rl h,/ ()~ ( Time '7 !.?<J Received by c-<)'j;, <> ~erson) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle a ropriate one): ,-~7 Z- ~;/d(}- -rh Ir-d sf: Phone No, 1--f-[,?~~ . Permit No. t9 17 Sewer Foundati imney Plumbing Final Sewer Excav. Other INSPECTION NOTES: I l Inspected: Date g ~ V':) Remarks: Time---f ~rv; r--. By J lJ t\lJ RESTORATION REQUiRED...... YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE {Continue on reverse side if necessary} STREET SUPERINTENDENT (DATE) ~ ~;;;;.> CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DMSION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ELECTRICAL PERMIT Issued: d-/:> /9 7 Permit No: 5827 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ JIM WOOLETTE 507 3RD ST E 507 E. 3RD Lot: Port Angeles, WA 98362 Block: Long Legal: 360/000-0000 Sub: T: S: Parc No: CONTRACTOR-----------------------------DESIGNER----------------------------_____ KEYTE'S ELECTRIC 126 KENDALL RD. SEQUIM, WA 98382 360/683-3780 , 000/000-0000 PROJECT INFO------------------------------------------------____________________ prj Type: RES. MISC. prj Value: $0.00 Occ Type: Cnstr Type: RAISE MAST Occ Grp: Occ Load: Land Use: Electrical Heat Baseboard KW: Furnace KW: Heat Pump KW: Fan/Wall KW: o o o o Service Type Riser X Overhead Service Underground Service Temp Service Voltage: Diameter: Service Size: Feeder Size: 120,240 X-1 -3 200 AMPS o AMPS PROJECT NOTES----------------------------------------___________________________ RAISE MAST PROJECT FEES ASSESSMENT-------------------------------------____________________ Service: $30.00 Additional Feeders: $0.00 Circuit Wiring: $0.00 Temp Se~ice: $0.00 $0.00 Misc TOTAL FEE: Amount Paid: $30.00 $30.00 ================================= -------------------------- TOTAL FEE: $30.00 Balance Due: $0.00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 4 17-4735 FOR ELECTRICAL INSPECTIONS, PLEASE PROVIDE A MiNIMuM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED, KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES NO' DlTCH ROUGH-IN / CUVl:'.K SERVILE Jh~ . . FINAl I r GENERAL COMMENTS, PW-II02.1$14I96] r> / Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT ,.. . I ELECTRICAL PERMIT - PERMIT NO. o:z/f.s 6 fr-/J? , , DATE Site Address: o READY FOR \&WILL CALL FOR INSPECTION INSPECTION License Number: Phone: Owner/Business: Phone: Owner/Business Address: Sq. FL 'fA Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction {1!l: Remodel o Service update/alter/repair o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) o Overhead o Underground Voltage 010' 03.0' Service size o Temporary Amps Detai I slDescri pt ion: R~9-rtJ . ~ W.S. No. Service Size Date Hold for: 0 Easement 0 Letter Capacity: 0 OK 0 Not O.K. Comments o Ditch inspection O.K. 0 Signed up for service/meter \~ Rough.in/cover O.K. 0 Meter Department notified for installation \0 O.K. to connect service 0 Fire Department notified of inspection ~.K.~ 0 Plan Review approved/pending 'e Address: Permit/Receipt No. \ \::)0 Z d../fs lller: / New Meters \ 'It!. 0 ~ :S 't \the Department of City Light by Street Address and Permit Number when ready for inspection, Work ~t be covered or electrically energized before inspection and O.K. for covering or service has been given \spector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. Iy ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT / t ~ \ Inspector Amount paid tyaddreSs YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall ~.,ER5. INC. ELECTRICAL PERMIT CITY Or PORT ANGELES 360 -417 -4735 Application Number . . . . . 15- 00000109 Date 2/11/15 Application pin number , . , 241817 DITCH Property Address 507 E 3RD ST ASSESSOR PARCEL NUMBER: 06-30-60-5-2- 5856 -b000- Application type description ELECTRICAL ONLY Suhdivision Name Property Use FINAL Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation , , . , 0 Application desc Circuit fcor garage Owner Contractor JUAN M AND LISA E ARBALLO OWNER 507 E 3RD ST PORT ANGELES hA 983623401 (415) 419 -7503 ---------------------------------------------------------------------------- Permit . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . Permit Fee 68,00 Plan Check Fee 00 Issue Date 2/11/15 Valuation . , . . 0 Expiration Date 8/10/15 Qty Unit Charge Per Extension 11Q0 5.0000 ECH EL-.NCH ADDNT BRANCH CIRCUI.T 5100 1.00 5310600 ECH EL -R- BRANCH CIR WO/ SER FEED 63.00 Fee summary Charged Paid Credited Due Permit Fee Total 68,00 68.00 .00 00 flan Checlz Total. .00 .00 ,00 .00 Grand Total 68,00 68.00 .00 .00 REPORT SALE'S TAX on your excise tax form to the City of Port Angeles (Location Coate 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN FINAL COMMENTS: PERMIT WILL EXFM SIX (6) MONTHS FROM LAST INSPECTION ✓ Signature of owner or Electrical Contractor X Date: G:IEXCHANGE BUILDING C?Sy0F pair �;��efr v 1 CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections ? 321 East Fifth Street — P.O. Box 11561 Port Angeles Washington, 98362 Ph: (360) 417 -4735 Fax: (360) 417 -4711 Date: _ 1 & 2 Single Family dwelling fu Job Review May Be- Re��u4ir d, Please.E om lete Electrical Plan Review Information Sheet Building Square Footage; !,,,(r Description of above r el— Owner In oormation�l Contractor Information Name: Name: Mailing Address: r..) � '' Malling Address: City: .� ! Stale: Zip, / �_ City: State: Zip: Phone: VIS" - Ll ff- 2'S i Fax: Phone: Fax: License # 1 Exp, License # I Exp. Item Unit Charge Qty Total (Qty Multiplied byUantt-Char e Service /Feeder. 200 Amp. $120.00 $ Service /Feeder 201 -400 Amp. $146.00 $ Service /Feeder 401 -600 Amp $ 205,00 $ Service /Feeder 60 1 -1000 An p. $ 262.00 $ Service /Feeder over 1000 Amp, $ 373,00 $�� Branch Circuit W1 Service Feeder $ 5.00 = $ Branch Circuit WIO Service Feeder $ 63.00 i $ /� s Each Additional Branch Circuit $ 5.00 $ Branch Circuits 1-4 $ 75.00 $ Temp. Service/ Feeder 200 Amp. $ 93.00 $ Temp. ServicelFeeder 201 -400 Amp. $110.00 $ Temp Service /Feeder 401.600 Amp. $149.00 Temp, Service /Feeder 6.01 -1000 Amp . $168.00 $ Portal to Portal Hourly $ 96,00 $ Signal Circuit/ Limited Energy - 1 & 2 Family Dwelling $ 64.00 $ Manufactured Home Connection $120.00 $ Renewable Electrical Energy -5KVA System or Less $102.00 $ Thermostat $ 56,00 $ Note: $5.00 for each additional T -Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. $120.00 $ Each Additional 500 Square Ft, or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $ Each Swimmin 9 Pool or Hot Tub $110.00 $ $ Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor, I am making the electrical installation or alteration in compliance with the electrical laws, N.E,C„ RCW, Chapter 19,28, WAC. Chapter 296 -4613, 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: ❑ Cash C1 Check ❑ Credit Card # X ' r Dated: / 01X112012 r�