HomeMy WebLinkAbout517 E 4th St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Detached garage with 1 circuit
Owner
Rickenbacher
517 E 4TH ST
PORT ANGELES
Permit
Additional desc
Permit pin number 141093
Permit Fee 59 50
Issue Date 1/30/09
Expiration Date 7/29/09
Qty
1 00
1 00
John
Unit Charge
2 0000
57 5000
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983623405
09 00000103
532287
517 E 4TH ST
06 30 00 5 2 6584 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
ELECTRICAL ALTER RESIDENTIAL
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
NORTH PENINSULA ELECTRIC
761 FRESHWATER PARK RD
PORT ANGELES WA 98363
(360) 477 1764
Plan Check Fee 00
Valuation 0
Per Extension
ECH EL ECH ADDNT BRANCH CIRCUIT 2 00
ECH EL R OUTBD /DTCH GAR IN /SEP 57 50
Paid Credited Due
59 50 59 50 00 00
00 00 00 00
59 50 59 50 00 00
DATE
Contractor
z/y/a7
44/0n-7
Date 1/30/09
RESULTS
otcAv
Signature of owner or Electrical Contractor X Date
INSPECTOR.
2009 -01 -29 17.21 3604574535
City of Port Angeles Permit Application
Building Division/Electrical Inspections
321 East Mit Street- P.O. Box 1150
Pori Angeles Washington, 98362
Ph: (360) 4174735 Fax: (360) 411 .4711
Date: 1 2P1 0
1 2 Single Family Dwelling
Multi- Family or Commensal'
Commercial Addition Alteration Remodel Repair'
Plan Review May Be Required, Pleas Complete Electrical Plan Review Information Sheet
Job Address: S I ^1
Building Square Footage:
DescripUon of above A 1 c.,k ('I C'_- -'L r C v' L. L. C
Owner Inform n
Name:
Mailings Address: t>
City fr A
Phone:
License Exp.
Unit Charge
93.75
$113.75
$160.00
3205.00
$291.25
2.00
57,50
2,00
72.50
86.25
8116.25
$131.25
75.00
69.00
75,00
50,00
50.00
93.75
$80.00
e6.25
27,50
57.50
86.25
43.75
Contractor Informsa(t
c�ti, Name; nit pc A-1-. V ,,A 1�S'
m Mailing Ades: aLyr> L tJ API-'
State: Zip: `''1 L •t sly: State: l .L Zi PO' L'3
Fax: Phone:W`\� &'--t Fax: L\ S L 1 C.
License 1 Exp )L)C tr -i.- C, `OA
QL
—I
Signature of owner electrical contractor or electrical administrator
X L i Dace: LC U
3604574535 3604174711
RECEIV
JAN 3 0 2009
LIGHT DEPT
Total Q Mul I Iced by Unit Chan e}
Service/Feeder 200 Amp.
SeMoelFeeder 201.400 Amp,
Service/Feeder 40l -600 Amp.
Service/Feeder 601 -1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit WIO Service Feeder
tDO Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401.600 Amp.
Temp. Service/Feeder 601 -1000 Amp.
Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy Commercial
Signal ClrculU Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
First 1300 Square FL
Each Additional 500 Square Ft or Portion of
c, 1 .S Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
1 Total
Owner as Mined by RW119 -28.26 f: Wawa will occupy the thucrun for two years after this electrical pm*" is flnalked. (2) Owner Is required to him an
elecMCal contrserorffabove said property le for sale, rent or base
After reading the above statement, I hereby certify that 1 am the owner of the above named property or a Banned electrical contractor. l am nuking the electrical
Installation or alteration in compliance with the electricatkw$, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296468, The City of Port Angeles Municipal Code, and
UIIIMy Spedflcations.
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:121 EAST 5TH STREET. PORT ANGELES. WA 911:l62
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00000765 Date
684135
517 E 4TH ST
06-30-00-5-2-6584-0000-
ELECTRICAL ONLY
7/10/07
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
RICKENBACHER, JOHN
517 E 4TH ST
PORT ANGELES
WA 983623405
SHAMP ELECTRICAL CONTRACTING
PO BOX 383
PORT ANGELES WA 98362
(360) 452-1689
permi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
SHAMP/ REWIRE 1300SQ+GAR
105726
SHAMP ELECTRICAL
115.0'0
7/10/07
1/06/08
CONTRACTING
Plan Check Fee
Valuation
.00
o
Qty
1. 00
1. 00
Unit Charge Per
69.0000 ECH
46.0000 ECH
EL-R-SQFT FIRST 1300
EL-R-OUTBD/DTCH GAR SEP
Extension
69.00
46.00
\J\
-
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 115.00 115.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 115.00 115.00 .00 .00
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COMMENTS/ACTION NEEDED
ELECfRICAL PERMIT INSPECfIONRECORD
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
COMMENTS
NO
GENERAL COMMENTS:
PW-II02.1~ /4'961
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
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07-00000713 Date
682507
517 E 4TH ST
06-30-00-5-2-6584-0000-
JOHN RICKENBACHER
RES REMODEL
7/02/07
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 k is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been ted within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know t sal' true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether speci he r;.e I r. ot. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or I al w ea g construction or the performance of
construction.
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
RS7 RESDNTL SINGLE FAMILY
75000
Owner
Contractor
JOHN W. RICKENBACHER
517 E 4TH ST
PORT ANGELES WA 983623405
(360) 457-0467
OWNER
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
ADD BATHROOM, RE-ROOF
104745
845.25 Plan Check Fee
7/02/07 Valuation
12/29/07
338.10
75000
Qty Unit Charge Per
Extension
670.25
175.00
BASE FEE
25.00 7.0000 THOU BL-50,001-100K (7.00 PER K)
Permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
105510
89.65 Plan Check Fee
7/02/07 Valuation
12/29/07
.00
o
Qty unit Charge Per
Extension
50.00
29.00
10.65
BASE FEE
4.00 7.2500 ECH ME-VENT FAN
1.00 10.6500 ECH ME-OTHER APPL. N/R
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
105502
100.00
7/02/07
12/29/07
.00
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Or;p.
Plan Check Fee
Valuation
Qty Unit Charge Per
BASE FEE
4.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE
1. 00 15.0000 ECH PL- EA. BLDG SEWER
Extension
50.00
28.00
7.00
15.00
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
06/29/2007 03:21 PM SROBERDS --The proosal will result
in a residential remodel with no increase in lot coverage.
Signature of Contractor or Authorized Agent
Date
T:\Policics\l102_15 building penni! inspection rccord05.wpd [1/4/2005]
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Burr,DlNG PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTJONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINJMUM 24 HOUR NOTICE. iT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANJ' WORK BEFORE'
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON. ~
KEEP PERMIT CARD AND APPROVED PLANS AT .lOB SITE.
INSPECTION TYI'E DATE ACCEPTED COMMENTS
YES NO
FOUNDA nON:
FOOTINGS
SHEAR WALLS/WALLS
FOUNDA nON DRAiNAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMIlING
UNDER FLOOR / SLAB
ROUGH-TN
WATER LINE (METER TO BLDG)
GAS LINE FTNAL DATE ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMiNG
JOISTS / GIRDERS
SHEAR W ALUHOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERlOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I
MECHANICAL
ROUGH-IN
HEATPUMP/FURNACE/DUCTS
GAS LINE FfNAL DATE ACCEPTED BY:
WOOD STOVE / PELLET I CHIMNEY
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SlURTING
PLANNING DErT. SEPARATE PER.MlT#'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRlCAL
LIGHT DEPT
CONSTRUCTION R.W. / PW I CONSTRUCTION - R.W.
ENGINEERfNG 417-4807 PW I ENGINEERTNG
FIRE 4 I 7-4653 FIRE DEPT.
PLANNfNG DEPT. 417-4750 PLANNING DEPT.
BUTLDTNG 4]7-4815 BUILDfNG
T:IPoliciesl] ]02 15 bUlldmg pennll mspectlOn record05.wpd [1/4/20051
~pORT "4:
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32\ EAST 5TH STREET, PORT ANGELES, W A 98362
I:
Application Number . . . . . 07-00000713
Application pin number 682507
Page 2
Date 7/02/07
Special Notes and Comments
Site coverage is 17%.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical load calculations and elctrical permits are
required.
Any modifications to the City's electrical facilities will
be at the customer's expense.
Public Works Utility Engineering has no requirements for
this plan review.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 1034.90 1034.90 .00 .00
Plan Check Total 338.10 338.10 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 1377.50 1377.50 .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 orwork is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building pennit inspection record05.wpd [1/4/2005J
BUILDING PERMIT INSPECTION RECORD
CALL417-4815 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 UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WOPJ{ BEFORE'
l.NSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA TION. .
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDA TlON:
FOOTINGS
SHEAR WALLS 1 WALLS
FOUNDA TJON DRAINAGE 1 DOWN SPOUTS
PIERS I
POST HOLES (POLE BLDGS.)
PLUMIlING A?
UNDER FLOOR 1 SLAB '^ ~ ~Ol -:tLl-
ROUGH-IN I (J .!.Jl!2 ~-fJ7 :rLL.
WATER LINE (METER TO BLDG) 1-4-0<6 \ILL-
GASLJNE FJNAL b-(1......C8 DATE 7 LL ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL \0-23 -0'7 "j'LL
WALLS
CEILING I
FRAMING IO-2-~~l --:;JU
JOJSTS 1 GIRDERS
SHEAR W ALlJHOLD DOWNS
WALLS 1 ROOF 1 CEILJNG
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION 1- 4 ,-()& -SLL-
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
ROUGH-IN
HEAT PUJ\1Y I FURNACE 1 DUCTS
GAS LINE FINAL c'-l1,-Og DATE :Ju.- ACCEPTED BY:
WOOD STOVE 1 PELLET 1 CillMNEY
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKJRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LlGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LlGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 7n ..... t1.... O~ \"u.,. BUILDING
. .
T:\Policies\1102 15 buildmg penTIl! mspection record05.wpd [1/4/2005]
~ (?/25/2007) Linda Pangrle - Permit application #07-713
Page 1 I
From:
To:
Date:
Subject:
Robert Larson
Linda Pangrle
6/22/2007 2:48 PM
Permit application #07-713
The proposed new overhead electric service strike at 517 E 4th St will need to be raised or the existing overhead
communications conductors will need to be removed to comply with NESC clearances from communication conductors.
Thanks, Bob L.
Bob Larson
Electrical Engineering Specialist
360-417-4706
rlarson@cityofpa.us
BUILDING PERMIT - APPLICATION
FOR OFF1ClAL USE ONLY:
-I
Fill out COMPLETELY and ill INK. Your application and site plan MUST B
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Phone:
Applicant or Agent:
Owner:
:SOh", !he/' ()11j,C1v~r:r
/2 I&. 2.rjJst
City: forI- Ihr e/~.J
;1.4
Phone: 'fT? 0 t/ b '7 '16 / t/<~
Zip: 9;r3b ~
Address:
Phone:
ArchitectlEngineer:
Contractor
JJI
State License #:
Exp:
Phone:
Zip:
ZONING:
PROJECT ADDRESS:
City:
S' /7 t 'f!J $ r
Address:
LEGAL DESCRlPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
TYPE OF WORK: SIZEIVALUATION:_
o Residential 0 New Constr. ~Re-roof 0 Stove SF. @$ /SF. = $ 0, CO 0
o Multi-family D Addition 0 MoveD Garage SF. @ $ /SF. = $ J
D Commercial j Remodel % Demolition 0 Deck SF. @$ /SF. = $ G 9 ooU
D Repair D Sign 0 Other TOTAL VALUATION sf 7~ 000- h:.-pl
BRIEF DESCRIPTION OF THE PROJECT, t e", oJ e / h 0 "" e - F 9 <-.Jd/o" r. ," o"r - t7e v w.~'" b
sA ee+ (0 C - delrlo S '-"'01/ o.dJdt'v/1 o~.h r<-ck 0c:' M o;e II) I,~
.b" . I
Occupant Load: Construction Type:
Existing Sq. Ft. /2. 0 U & Proposed Sq. Ft.__ . = TOTAL Sq. Ft./2 Dc)
Q..n e k c...iV\' c. Ca n-ttuc't-or
wi Il r-e-wiv-e. ih~ hovs.e
No. of Stories: L
Total lot coverage
UJ\ \\ Y'e-vse. SoI"Y)e MCt.~(jjs
APPROVALS:
PLAN:
BLDG:
DP"WU:
FIRE:
OTHER:
PLANNING USE ONLY:
ESAJWetland(s): DYes 0 No SEPA Checklist required? 0 Yes D No 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 tlle 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
RI05.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
T:\FORMS\BldgPermitform.wpd Applicant:
thi a{:J r a . n and know the same to be true and correct. f am authorized to
re n ifity to determine what permits are required ,not the City's, and that I
Date: ,,/Is- /0"7
I '
I hereby certify that f have read and examine
apply for this permit and understand that'
must obtain such permits prior to work.
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Prescriptive Approach-Simple Fom1
For the Washington State Energy Code (2003 Edition)
Climate Zone 1
Site Information
Building Department Use Only:
f2
Yth~
Pemtit #
07-((3>
Lot:
Address: , \ 1
Notes:
City:
State:
Zip:
Contact:
Phone:
Phone 2:
FAX:
Table 6-1
PRESCRIPTNE REQUIREMENTS FOR GROUP R OCCUPANCY
CLIMATE ZONE 1
( Unlimite Glazmg OptlOn Only.
Option Glazing Glazing U-Factor Door Wall Wall Wall Slab I
Area % ,U- Vaulted Above Interior Exterior on
of Floor Vertical Overhead Factor Ceiling Ceiling Grade Below Below Floor Grade
Grade Grade
Unlimited
III Group R-3 0.40 0.58 0.20 R-38 R-30 R21 R-21 R-I0 R-30 R-10
Occupancy
Only
d
I )
This Project complies with the following:
.I The Project is a single family residence or duplex.
.I The Project is wood frame OR all of the insulation is interior or exterior of the framing.
.I All building components meet the requirements listed in Table 6-1, Option Ill.
.I The Project will meet all other provisions of the WSEC and VIAQ.
The Project will take advantage of the following exceptions to the prescriptive option.
o 602.6 Exception 1. One door, that is 24ft. Or less, that does not meet the standards allowed.
Location of the door taking this exception
o 602.6 Exception 2. Doors with a V-Factor of 0.40 allowed without calculations, Option III only.
Location of the Door (s) taking exception
Type ofReat Source:
Ylc -~ - wC1ft
EXlllBIT A
I
@ f r1 (vr~e B vC( JOJ (
6> (/he off f tv vi (OV-lf e~ 1'.1f"r doc;.,
(C) NellJ dOOr wvy
@ Nt'LJ ,;iV,I( v/''] IMJ-U- ofJ dOl/f""",!
(j) fJ(rJfU)<J) tV'fl. (clvr-, I;' hCoJ eV1 -e~7
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OLYMPIC PENINSULA TITl f CO
When r"corded return to:
OLYMPIC PENINSULA
TITLE COMPANY
_0 &n'Z-'1
CLALLAM COUNTY 19~.=
1 HANSACTlON EXCISE TAX
:c.:;;.o.. .)
2007 JUlI-5 pn 3: 45
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JUN 0 5 2007
CLALLAM COUNTY AUDITOR
2007-1202823
File Number
LPB 10-05
STATUTORY WARRANTY DEED
THE GRANTOR(S) AUGUST T. BUETTNER AND SANDRA K. STROM, EACH AS
HIS/HER SEPARATE ESTATE
for and In consideration of TEN DOLLARS AND OTHER GOOD AND VALUABLE
CONSIDERATION
In hand peld, oonveys, DIld warrll11ts to JOHN W, RICKENBACHER , A SINGLE MAN
the following deeerlbed real estate, .Ituated In tha County of CLALLAM , State of WlIOhlngton:
LOTS 27 AND 28, BLOCK 65, PUGET SOUND COOPERATIVE COLONY'S
SUBDIVISION OF SUBURBAN LOT 23 OF THE TOWNSITE OF PORT ANGELES,
AS PER PLAT RECORDED IN VOLUME i OF PLATS, PAGE 1, RECORDS OF
CLALLAM COUNTY, WASHINGTON.
SITUATE IN CLALLAM COUNTY, STATE OF WASHINGTON.
SUBJECT TO: NONE
W$FIWlt.TIOO /rtWT/AtNEirf /tN/ IdrjrtuMmtN WBr:fcbRf:!Itrj /&Nf:Jii / 1:!1lp,i'iM1
OOWN!IN /RECC/f1.T!Jt.m /WD/.! /10tJjtJ /'i.1UYifit,1.
Abbrevleted Legal: (Required If full legal not Inserted above.)
LTS 27 & 28 BLK 65, PUGET SOUND COOP COLONY'S SUBD VI PI
Te. Porcel Numberl.): 06-30-00-526584
Daled: June 01, 2007
~\' ~-~--,
AUGUST T. BGE
., S;/;) ;C;;a 1:91:0777
SAMTRA K, STROM
ss.
I cfirtify that I kn~ or have satisf~ctory evidence that
J-h^~(A c:;+- T. "BVje h t'.v- O,,'nd ~1'1ct.rn ~. S-tV7:>W")
(.~ the person (s) who ap8ta~td before me, and said
person(s) acknowledged that signed this instrument and
acknowledged it to be~€~V- ree and voluntary act for the
uses and purposes mentioned in this instrument.
Dated: 10-1--07 """\\'\11
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I1III !1'I\SHIl'\C",--, Residing at: 'F6r+ Al1qelcs J
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
121 EAST 5TH STREET. PORT ANGELES. WA 98J62
Laserec
CEO
Application Number
Appllcatlon pin number
Property Address
ASSESSOR PARCEL NUMBER:
Appllcatlon type description
SubdivlSlon Name
Property Use
Property Zoning
Application valuation
07-00000800 Date
000800
517 E 4TH ST
06-30-00-5-2-6584-0000-
ELECTRICAL ONLY
7/15/07
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
RICKENBACHER, JOHN
517 E 4TH ST
PORT ANGELES
WA 983623405
SHAMP ELECTRICAL CONTRACTING
PO BOX 383
PORT ANGELES WA 98362
(360) 452-1689
Permit
Additional desc
Permit pin number
Sub Contractor
Permlt Fee
Issue Date
Expiration Date
ELECTRICAL TEMPORARY
SHAMP/ TEMP SVC
106393
SHAMP ELECTRICAL
40 00
7/15/07
1/11/08
SERVICE
CONTRACTING
Plan Check Fee
Valuatlon
00
o
Qty
1 00
Unlt Charge Per
40 0000 ECH EL-TEMP SRV - 0-60 SRV FDR
Extension
40.,00
U\
-
.J
Fee summary Charged Paid Credlted Due
----------------- ---------- ---------- ---------- ----------
Permlt Fee Total 40 00 40.00 00 00
Plan Check Total 00 .00 00 .00
Grand Total 40.00 40 00 00 .00
rn
~
l.IJ
ei
,
COMMENTS/ACTION NEEDED
ELECfRICAL PERMIT INSPECfION RECORD
CALL 4) 7-4735 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 ACCEPTED COMMENTS
YES I NO
vrfCH
lH)T 1(';'H_lN I COVER
SERViCE
I 7 ~[; - 0, I f\;rO) I
GENERAL COMMENTS:
PW-ll02 IS (4'96)
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDiNG DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number ..... 03-00000290 Date 3/19/03
Property Address ...... 517 E 4TR ST
ASSESSOR PARCEL NUMBER: 0630005265840000
Application description . . . ELECTRICAL ONLy
Property Zoning .......
Application valuation .... 0
Owner Contractor
BUETTNER AUGUST J OLYMPIC ELECTRIC
517 E 4TH ST 4230 TUMWATER
PORT ANGELES WA 983623405 PORT ANGELES WA 98363
(360) 457-5303
Permit ...... ELECTRICAL NEW RESIDENTIAL
Additional desc
Sub Contractor . . OLYMPIC ELECTRIC
Permit Fee .... 76.30 Plan Check Fee . . .00
Issue Date .... 3/19/03 Valuation .... ' 0
Expiration Date . . 9/15/03
Qty Unit Charge Per Extension
1.00 76.3000 ECR EL-P~M-0-200 1ST SRV FEEDER 76.30
Fee summary Charged Paid Credited Due
Permit Fee Total 76.30 76.30 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 76.30 76.30 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT C^R ' ANX, ^PPROVE , PLANS AT,OB SITE o 3- 9-
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS I
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATEKLINE / 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 LIGHT DEPT
CONSTRUCTION R.W. / pW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLAN~ING DEPT. 4 ] 7-4750 PLANNING DEPT.
BUILDING 417~4815 BUILDING
T:\PLANNING\FORMS\1102.15 [4/2002]
07/06/2007 12:41 FAX
_ _.__--n. .__
4/7- (/7 II
G-- - GO
S-
. ~
". ..
_...
Job wired by
o Electrical Contractor 0 Owner
Dale Expires
?:.
Own('/' a.5 defin.ed by RCw'/9.28.26J:(/) ()wller 'KI(/( occupy (hi' ~'rucW,.t!lQ" rwo
year:r ajle,. tM.r elalric'aJ permit is finQli~ed. (2) 0""'''(7" i~' required In hir-e an e/('cfr!c'ul
cmtl,.aC'Or if "bove said properly is fur sale. renl Q" lease.
After relldin!; the above !itatemenI. I hereby.cenify ehst I am (hi: owner of the ahove
nrlmed propcny or a licensed electrical cOntt3ctor. I am makins the electrical in~tal.
latiOTl Or ~Iteration in compliam;c with the clccnic",llaws. N.E.C., RCW. Chaplet
19.28. WAC. Chapter 296-468, The City of Port Angeles Municipal Code. Hnd
U\ilit)' Specifications.
re of owner. eleerri.., ,ontr"tor or eleerr;u..d l;t~o7r
X . Date1
Electrical Load Additions and or 9Llbtraetlons
o NO LOAD CHANGES
o Baseboard tQN
o Furnace _ KW
o Heat Pump _ Ton _ LAA
D Fan-Wall _ KW
~001/001
I
ELECTRICAL WORK PERMIT APPLICATION
InslaUiltion description _ ./
CJ Commen:ial lJ,..KesideDtial
O~ew
o Altered! Addition
=rJf'M. pJ~htb.JJ
I:J Cash 0 Check #
\V'
&t\. '+<. \.V
o Credit Card
VISa
Mastercard
Discover
~d#________________
Expiration Date
of card
S@rvlce Information
D Overhead Service
CI Temp Service
CJ Underground Service
Voltage
Phas.01Da
Service Size: _
Feeder Size:
SAME DAY lNSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH-IN TIIER:\I0STAT
n(llC
AI'Il"lovcJ Oy
D~Lll
FlNAL
7 -0-01 ~
D:it~ Appr(l"~l1 By
DlTCH
SERVICE
ArpnJ"od Oy
Dutc
Al'IlrClv,liBy
FEEDER
rnspection
Dale
Area. BuiJding Or Equipment Inspected
Oil.;; Appro"od Dy
D~lc AIlIlI'll"od By
7-/3 -0 7
tY/.
Lv -n
L7~
Action Taken
Elcctric8.1
Inspector
;/;'f',2<>vro
j],i>(.
DATE
b-Z-b
OWNER/CONTRACTOR
s
ADDRESS
517 Ti...
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
INSPECTOR
0/-0'7107>
l..-fG.c... .
L./
APPROVED NOT APPROVED
o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0
D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0
D. . . . . . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . . 0
D.....................R~...................~
CORRECTIONS NEEDED:
-f< IT Cr:>I) NTI'E.IL
WTlO \.( I N (~ .
1
<e, F ('
NoT
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360) 452-1381
~
~ VORT JI~
~O~Q~
J"r~-. ~
,.~
!~~e
~-<'
?...C'.....--~....
~AKS&.
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
PERMIT #
D7-~
'--'"'
t-/
APPROVED NOT APPROVED
o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0
';;zf-,...- A~. . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0
~ . . .~~. . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . . 0
D. . . . . . . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . . . 0
CORRECTIONS NEEDED:
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360) 452-1381
06/28/2007 10:01 FAX
141001/00.1
~~-crl
G-/l.-O
U/1-L{ (II
"
fd
-...
ELECTRICAL WORK PERMIT APPUCATION
:~
'2--
Installation dc:sc:r;ption /
D Commercial ~ResideDtla1
tSNt!w CJ Altered/Addition
l~~.it-:- \0ld1J~&
~t1"OJ
Job ",ired by
CJ Electrical Contractor CJ Owner
-I' ~f frO
I' /ft, tW
O",..,.er as dejlnM by RCW.J9,28.26J:(J) Ow"~r wi/1 occupy rhe nru.cture lor lWO
years after' this electrical permit is jifloJi:ed. (2) (M'Ile,. Is required 10 hire (in elec'rical
contractor if ahove said property is f(Jr JQ(e. rent or lease.
After reoding the above $tatemenl, I hereby certify lh.ull nm the owner of the above
nsn1Cd. propeny Or 3. licenscc.l electrical contractor. I un mal(ins the electrical instal.
lalian or alteration ;11 compliance with tbe electrical laws, N.R.C.. RCW, Ch3l>ler
19.2a, WAC. Chaptet 296-46B, The City of Port Angel-:s Municipal Code, Il.nd
Utility Specifications.
SiCn e of owner. elecrrlcal contractor or electrical ad
CJCash ~Check~ ~0
CJ Credit Card Visa' Mastercard Discover
Card #
x
Date
ExpirarionDate
of card
:/
Electrical Load Additions and Dr subtractions
[J NO ~OAD CHANGES
D Baseboard KW
C Furnace KW
o Heat Pump _ Ton ~ LAR
Cl Fan.Wall KW
o Overnead Service
a Temp Service
D Underground Service
Voltage
Pha,. IJ 1 IJ 3
Service Size: _
Feeder SIze:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
J RO~GH:;W THERMOSTAT
~ ^"""'.y Do<. Arr'"'' By
B7 ~
."....,J:RVIkh
~ ^pl'r"~c4~y
0~.
J FlNAL
'jet?;;
^FPttl"Cu"r
Ih/"""
D~lo
DITCH
~
Appra\'fd Ily
FEEDER.
D.l~
^pprl)ved &y
Inspection
Dale
Area, Buildins Or 'Equipment Inspected
Action Token
Electrical
Inspector
~.-LL.
<: