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Home My WebLink About612 E 2nd St - BuildingPREPARED 10/14/10 8 12 51 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/14/10 ADDRESS 612 E 2ND ST SUBDIV TENANT NBR CHAD THEISMANN /CLEA ROME CONTRACTOR DAVE S HTG COOLING SRVC INC PHONE (360) 452 0939 OWNER CHAD THEISMANN CLEA ROME PHONE (360) 477 5929 PARCEL 06 30 00 5 2 5900 0000 APPL NUMBER 10 00001084 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME99 01 10/14/10 JLL MECHANICAL FINAL TIME 01 00 October 12 2010 1 39 16 PM 1pangrle JEANNIE (DAVE S HTG) 452 0939 MECHANICAL FINAL HEAT PUMP AFTERNOON COMMENTS AND NOTES Application desc Heat Pump Owner CHAD THEISMANN CLEA ROME 612 E 2ND ST PORT ANGELES (360) 477 5929 WA 98362 Permit Additional desc Permit pin number 174466 Permit Fee 76 10 Issue Date 9/30/10 Expiration Date 3/29/11 INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 10 00001104 058112 612 E 2ND ST 06 30 00 5 2 5900 0000 ELECTRICAL ONLY Contractor ELECTRICAL ALTER RESIDENTIAL Plan Check Fee Valuation 1O /11)f lb why d 42 Date 9/30/10 EXTRA MILE TECH ELECT LLC 418 N RACE ST PORT ANGELES WA 98362 (360) 457 0198 457 $546 DATE. RESULTS 0 0 0 Qty Unit Charge Per Extension 1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER 73 50 1 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT 2 60 Fee summary Charged Paid Credited Due Permit Fee Total 76 10 76 10 00 00 Plan Check Total 00 00 00 00 Grand Total 76 10 76 10 00 00 REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR. Date: c) O r SEP -29- 2010 01 18 PM E JANSSEN City of Port Angeles Permit Application Building DlvlstonlEloctrical Inspections 321 East Filth Street P.0 "Box 115U Pon Angeles Washington, 98362 Ph 1360) 417 -1735 For (360) 417.4711 D9h' I l yl Single Fern:ly Dwelling Multi Family or Commercial' Commercial Addition I ALCralion I Remorol ==Ian Review May Be Requned. Please Cnn'ph rlr,;tl Pijr -<ry t w' 11( •ear■s Shee' ob Address 6./_0 c4,5...:4 1? "1" ire, &c Bo:1d ng Square P00i0 e 1 :)encriplion or above (�J i• C' ._4 t......* 4.0 _L-4.-4 T i. 'I' )wner Iniormatiof Name ICtw.•� iverS re` cr.nN T -L. Mailing Address City 7 t- Mete 1,v/.r :C Phone 5 7 1'7 1_ ex ur'ense >y i Exp Unit Coilrge 511990 S•d! :0 204.60 S 26:. 20 $37'50 260 3 73.50 S 1 60 S 9'70 11010 141 '0 S16r90 S 9i90 S 8920 9r 9(1 S 663 4C 3 63 9) 119 0) 102.3) $11030 3 35 20 S 73.50 $110 56 00 Owner as defined by RCW 19-28.281 CO Owner w°ll occupy the structure for two years after this electrical permit is finalize 2 v'i r r required to hire an electrical contreelnr above said property is for sale, rent or lease, Penmr expves 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 ,n rrra_tnr I am making the electrical Installation or alteration In compliance with the electrical laws N.F'.0 ROW. Chapter 19.28. WAC. Chapter 296460, The City of Port Angaln Mu :Mat Code, and Utility Specifications. Signature of owner electrical contractor or eb,cl' :cal admintstrato' Cash x Ejtvoi4 n a e• ;ervire Feeder 200 Amp ,ervr ;e reuse 201.400 Amp ,evire Feeder 401.600 Amp aervicu T °°der 001-1000 Amp Service :Feeder over 1000 Arti r �4r Oranch .ircuil'WVi SONIC° i-eede- 3 f Branch C rrun'N'0 Service Feeder Each Aldrhonal 9ranCh Circuit amp irrvire, Feeder 200 Amp ti amp ServvreiFeedor 20)40(1 Amp I Prep ,ervrre'Feeder 401.600 Amp /rip devicn;F'eeder 601 10in Amp oriel Io P0118! I booby 791 /C .niine Lighting vgral ,curb L•mited Energy COnnnercial Addition genet rend! Limited Energy 1 8 2 gamily Dwelling rg, al rr.u,t' mned Fnergy Multi.Fa•riiv Dweilir.rl ice,■actu Home Connection F!e'1owable E Cllical Energy SKVA Sy'.tyri Less t -rrsl i i00 Severe Ft. ,dd4idrra1 Severe Ft or Port,or h (bald'nrj or Detached Garage i•anti .wmmIng Pool or Hot tub r'laam lids Ti bta al i ,2iv t_dbnhCd by Unit Chary Mr p i C 1 Credit Card* 360 452 2982 P 01 II f II Ptlkr i,%, 1� SEP 2 9 2009 ELECTRICAL INSPECTIONS .d rryl. c- .r,7 Contractor Infor v,t•� Ex•tray wart 'r -e, 1'4• E C tae. I Ct� L Aa'I Address 4 l fi /�.!?tc" 'ty p A atatr'' JALA n jsa Phone Ys71. Fax 15 :peso>i TI Min 7 •'t L /L'6 Awn `ia Application desc T stat heat pump 2 ton Owner CHAD THEISMANN CLEA ROME 612 E 2ND ST PORT ANGELES (3601 477 5929 Permit Fee Total Plan Check Total Grand Total WA 98362 Permit Additional desc Permit pin number 174318 Permit Fee 56 00 Issue Date 9/29/10 Expiration Date 3/28/11 Fee summary Charged ELECTRICAL ALTER RESIDENTIAL Qty Unit Charge Per 1 00 56 0000 ECH EL LVT THERMOSTAT 56 00 00 56 00 INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 10 00001091 091848 612 E 2ND ST 06 30 00 5 2 5900 ELECTRICAL ONLY Paid 56 00 00 56 00 DATE. Contractor DAVE S HTG COOLING SRVC INC PO BOX 413 PORT ANGELES WA 98362 (360) 452 0939 Plan Check Fee Valuation Credited A 61lyh a W46 00 00 00 Date 9/29/10 REPORT STATE SALES TAX 0000 on your excise tax form to the City of Port Angeles (Location Code 0502) RESULTS Ap App 00 0 Extension 56 00 Due 00 00 00 INSPECTOR. Date: 1• Sep 28 10 09 46a Dave s Heating Cooling City of Port Angeles Permit Application Building DivisionlElectricat Inspections 321 East Fifth Street- P.O. Box 1150 Port Angeles Washington, 98362 'Ph: (360) 417.4735 Fax: (360) 417-4711 Date: so 61& 2 Single Family Dwelling Multi -Family or Commercial` Commercial Addition Alteration i Remodel Repair' Plan Review May Be Required Please Complete Electrical Plan fonnatiQqn Sheet Job Address: C a s f c� Tt Building Square Footage: P 0 r• is d O::5 Description i e of above 0 4 c R -'z-- "'1 v m�` -i w e.¢� r ifN 1 Owner Information. Contractor Information Name: Ch ca cd 71n Z l s yr c r C(-e g RorneName DcUFce,ls t t o Tr Mailin Address: 2._..e. t- �'9t -r--:-X Mailing ddress. i'. C. Sc� Ac Y 3 City: .vrState: Ce1> Zip: '�3F, City: c --1 Stare: e.-A Zip: 9834,a Phone: 1 -0-7 -5 r t q Fax: Phone: 45,9—Der 3'iFax: Y5 q License /Exp. License fir /Exp. DA V65 lei C.gct l 2-c. Unit Charge 119.90 $145.50 204.60 262.20 372.50 2.60 .S 73.50 2.50 92.70 S 110.30 5 148.70 167.90 95.90 89.20 S 95.90 S 63 90 63.90 119.90 $102.30 110.30 35.20 733.50 5110.30 S 56.00 1 Owner as defined by RCW.19.28,261- (1) Ownerwill 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 t 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 296.468, The City of Port Angeles Municipal Code, and Utility Specifications. Signature of owner electrical contractor or electrical administrator 0 Cash Check 1 a r l Date: 61!`� Total (Ory Multiplied by Unit Charnel Service!Feeder 200 Amp Service/Feeder 201-400 Amp. Service/Feeder 401-600 Amp. Service/Feeder 601 -1000 Amp. Service&Feede• over 1000 Amp. Branch Circuit Wi Service Feeder Branch Circuit WiO Service Feeder Each Additional Branch Circuit Temp. Servicer Feeder 200 Amp. S Temp. ServicetFeeder 201.400 Amp. Temp. Service!Feeder401 -600 Amp. S Temp. Service/Feeder 601 -1000 Amp. Portal to Portal Hourly SgriOu0rneLghting Signal Circuit/Limited Energy- Commercial. Additional 150C $5.00 Signal Circuit/ Limited Energy 1 8 2 Family Dwelling Signal Circuit/ Limited Energy Multi -Family Dwelling 5 Manufactured Home Connection Renewable Electrical Energy 51CUA System or Less Fns: 1300 Square Ft. 5 Each Additional 500 Square FL or Patton of S Each Outbuilding or Detached Garage S Each Swimming Pool or Hot Tub S SG o Thermostat Total Credit Card k ECfl if E SEP 2 c 2009 ELECTRICAL INSPECTIONS 3604520939 p 4 Date CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc INSTALL A HEAT PUMP Owner CHAD THEISMANN CLEA ROME 612 E 2ND ST PORT ANGELES (360) 477 5929 Permit MECHANICAL PERMIT Additional desc INSTALL A HEAT PUMP Permit pin number 174235 Permit Fee 64 80 Issue Date 9/28/10 Expiration Date 3/27/11 Qty Unit Charge 1 00 14 8000 EA Print Name T Forms /Building Division /Building Permit WA 98362 Per Fee summary Charged Permit Fee Total 64 80 Plan Check Total 00 Grand Total 64 80 10 00001084 558364 612 E 2ND ST 06 30 00 5 2 5900 0000 CHAD THEISMANN /CLEA ROME MECHANICAL APPL PERMIT RS7 RESDNTL SINGLE FAMILY 5610 Contractor Plan Check Fee Valuation BASE FEE ME FURN /HP /FAU OR 5 TON Paid Credited 64 80 00 00 00 64 80 00 Date 9/28/10 DAVE S HTG COOLING SRVC INC PO BOX 413 PORT ANGELES WA 98362 (360) 452 0939 Due 00 0 Extension 50 00 14 80 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) (0 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 y state or local law regulating construction or the performance of r7)) ft"' 0/'4 construction -7 Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 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 I 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 FINAL Date MANUFACTURED HOMES. Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. 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 Inspection Type I FINAL Date Accepted by `I Acccepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By Sep 28 10 08 Dave s Heating Cooling BUILDING PERMIT CITY OF PORT ANGELES Attn: Building Permit Technician '321 E. Fifth St. Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant I a 0-2-k s c.- -t n Q Phone Property Owner C C c� 7j,,,z i s hi n 4 6( R o l „ephone Property Owner's-Address a E a 54 c 5 h -e e .Contractor v°-e) s r 9 Phone Contractor's Address R o.. x 9'13, (o —i. AaQ (a_-,5 License# .1j,4 UE5 H c 9 K_ C. Expires a, 2 t E -mail 3604520939 p1 APPLICATION Print in ink PROJECT ADDRESS Sacs -l Parcel Number Project Time 8 Brief Description: Residential o Multi family o Commercial Check all that apply o New Construction o Addition o Remodel o Repair o Demolition o Re -roof Heat System o Other Floor Areas Existing (sq..ft.) Proposed (sa. ft.) Basement per sq. ft. 1 Floor 2 Floor 3"' Floor Garage Carport Covered Porch Deck Shed Other 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 T.Forms/Building DrvisionBtdg Permit.doc t/ For City Use Only :Date Received q -25- Permit-# 10 Iri$4 Date Approved Lot Zoninp �FSa_o'93 9 q 9 9 4C awes <1.ei1/4J -e-cc 1:..•c a Industrial o House a garage o other o tear off re -roof o lay over one layer J pump wood burning stove a gas fireplace o pellet stove o other TOTAL VALUATION OF -9-9 Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94 135 for exemptions) Site coverage °lo of bedrooms of full baths of half baths I 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 7g1 lL' Print Name -`f -ea r1d.-e.- I�icet, k4v h0 Signature Clallam County Assessor Treasurer Property Details 61716 CHAD THEISMANN Page 1 of 5 Clallam County Assessor Treasurer Property Search Results 61716 CHAD THEISMANN CLEA ROME for Year 2010 2011 Property Account Property ID Geographic ID 0630005259000000 Type Real Tax Area: 0010 Open Space N Historic Property N Multi Family Redevelopment: N Township Range. Location Address. 612 E SECOND ST PORT ANGELES WA Neighborhood. Neighborhood CD Owner Name. Mailing Address: Taxes and Assessment Details Cycle 5 Res 10955130 Property Tax Information as of 09/28/2010 Amount Due if Paid on. 61716 Legal Description. Agent Code PA 121 PORT ST CNTY H2 L Land Use Code DFL Remodel Property Section Mapsco Map ID CHAD THEISMANN CLEA ROME Owner ID 612 E 2ND ST Ownership PORT ANGELES WA 98362 Exemptions. Year Statement ID Taxing Jurisdiction 2010 44412 ST SCH STATE SCHOOL 2010 44412 CC -GEN COUNTY 2010 44412 PORT PORT 2010 44412 PORT ANG PORT ANGELES 2010 44412 SD #121 SCHOOL DISTRICT #121 2010 44412 NTH OLY LIB NORTH OLYMPIC LIBRARY 2010 44412 HOSP #2 HOSPITAL #2 2010 44412 WSMET PK DIST WILLIAM SHORE MET PARK DIST 2010 44412 CITY STORMWATER CITY STORMWATER 2010 44412 WEED_CONTROL WEED CONTROL 2010 44412 TOTAL. 2009 617162008 ST SCH STATE SCHOOL 2009 617162008 CC -GEN COUNTY 2009 617162008 PORT PORT 2009 617162008 PORT ANG PORT ANGELES P S CO -OP COLONY SUBD LOT 23 LTS 13 &14 BL 59 SURVEY V58 P15 11 N N 2 55806 100 0000000000% http. /vpn.clallam.net 8084 propertyaccess /Property.aspx ?cid =0 &year 2010 &prop_id =61 }f NOTE If you plan to submit payment on a future date make sure you enter the click RECALCULATE to obtain the correct total amount due First Second Half Half Base Base Amt. Amt. Penalty Interest Base Paid $188.26 $188.25 $0 00 $0 00 $188.26 $100 17 $100 19 $0 00 $0 00 $100 17 $14 08 $14 08 $0 00 $0 00 $14 08 $231 96 $231 95 $0 00 $0 00 $231 96 $243.85 $243 84 $0 00 $0 00 $243 85 $29 11 $29 11 $0 00 $0 00 $29 11 $41 10 $41 10 $0 00 $0 00 $41 10 $13 08 $13 07 $0 00 $0 00 $13 08 $36 00 $36 00 $0 00 $0 00 $36 00 $0 82 $0 81 $0 00 $0 00 $0 82 $898.43 $898.40 $0.00 $0.00 $898.43 $215 80 $215 80 $0 00 $0 00 $431 60 $109.20 $109.23 $0 00 $0 00 $218 43 $15 47 $15 47 $0 00 $0 00 $30 94 $239 55 $239 56 $0 00 $0 00 $479 11 9/28/2010 CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15074 5- - ,:) 0 . ?Y Port Angeles, Washingtoll.__.................__.m..u______.___.______.___.._________, 19.....00. In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, on, or about any building or other structure in the City of Port Angeles, per- mission is hereby granted to do electrical work as listed below. Address ..uur;I2:::...__E;.:__~_______________________________.mmm.. Occupancym..-"__~.~m__...um...__...__..__.. I - Owner u..____huh.__....__.......___.___..___.___.___....________m__..... TenanL....___..........___...__....._._______....______.hh___.......m.__ 'I" Wiring Contractor ./;;;.~J.if.:~u.~~!:'";..:.----mu....h-- Byu.um...__..__h.______....___....m____u__._______..___hU.u.. Light Outletsuuuuuumuuuuumu.____..u. Service, volts __.IO?.9./.P.::..1!..I!__m Type of Wiring: 'J No. wires .________...........________.........__ Size wires...~fm~!!..m.-u Main fuse .__~..~:_..;...9./1:.-m___----- .- Enclosure ____~_____.....m_____.....m___ Receptacle Outlets................____....__..._. Dryer, KWj ........___.._nn_...n____n_________ .__ Range, KW nm__n Water Heater: KW..m__m.uuuuum.u.mm.m__mm. Hea" RWmP.?rL"'~Z Motors: size, volts and phase: Type of wiring: Entrance Cable .____.___mm_...___..m__ Rigid Conduit _____.....____..........___..__ Metallic Tubing ...._______...__...____n__ Current transformers: No. & Size..............._________m_______..m Ser. NO..____.._______n.______.__............____.. Ser. No..___________._____......................__.___ Ser. NO......_......__.___.__________........__n___ Armored Cable .....m____..............._. Non-Metallic .............._.__..........____. Knob & Tube__......_.___ Rigid Conduit m____.u______mm__.______ Metallic Tubing ...... Race"\vay __n____...._....__................_...... Circuits, LighL__mm...___________.___m______.__ Utllity Um.mm__Um____.m.UUU__Uuuu. Heat Range __......____...___..._______...._....._______ 'Vater Heater n..____._______...._______.__. Motor __________.____________________.__._._______ Dryer______.....__._____.........._____................ Furnace ..........................__..__....... Total Load.___m___m__m_.......... Ser. NO......_..___..______...___m__............___ Total ............____________....___________ Remarks: ..uuuuuu._<t."r?""2._d{l.-:r,::'J!:.h.______._h.hUUu_________.__muum.....u.___m___mmummu...___......___._________ ,- . ..____h___.n_.nnunnn__nnnnnnnn__hdnn__.u~hh.U...n._.__h.n_.____nnuhnn.__unn_n_u...dnn.U..n._.n..._..n.nnu.n__.__Uu.h..u.__ .i~.~~~.~~~~:...~........~--.~.~~~~.....U--hU--i~~.~.~:~~~.~.~i.~.~~.:~~~~--m-mum---:~.:~ll:l~~Z~:,:~=::::::::: NOTICE-Current must n()t be turned on until Certificate of Inspection has been issued. If work is to be con. cealed due noUce must be g;tven the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION r J/ f/J -<d:-'-' ,.. '-- if {..-- t:~,-~ '- (..-1-../ ! A;/ ; .. ELECTRICAL PERMIT N? 15074 Date called !of irke'C7ionnf:.m.J:..~m...........n..........n_.un..nnn.....nnnn.nnnnnnnn...unnnnnn.nmnmn__mmnmm...__mUmm.m... Prellminary inspect17t~~e:ifi:;;;::m..--Zht~QI:.hn...n.hmu...mm.m....h.m.n..huuhmm.mm.mn.mhhm_____mm_mu.nn....___ ::t::c::dc=~i~~~::::~::~~!.:::~::::~::::::::::::::.::::::..:':::::':'::..::::::::..-':::':':::::::::'.::::..:::':::::::::::::::::::::::::::::::::::~::::::::::=:::::::..::::::= 1M 3-72 Olympic Printers, Inc. ELECTRICAL WORK PERMIT APPLICATION ., Job wired by rID:lectrical Contractor 0 Owner Installation description Q Commercial )1bResidential Electrical contractor name 7J/,;/(j(f(JS ,e6p License number f7-1oI'U-l"K.-f!U?J/ LH- Date Expires OR- DNew ~ltered/Addition Purchaser's mailing address /:&, 99/ City / ,4- Stale ZIP t1r3~2-- '77f{)7CH<RS ;;.r uJ~ #if47Z^- Telephone number S-0S" -/2-1?-- W./I- , FAX number YJ,;)-'1-s:Y,r Premises owner's name CII~ 77/ttr/5/1?/hV Address of inspection ~/z- 6 z,v.a CHy .~ Phone number to schedule inspection: ~/? - .s-9'2- Owner as defined hy RCW 19.28,26/ :(1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire all electrical con/rae/or If above said property is for ,\'ale, relit or lease. After reading the above statement, I hereby certify that I am the owner of the above namcd property or a licensed electrical contractor. [ am making the electrical instal- lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296~46B, The City of Pori Angeles Municipal Code, and Utility Specifications. o Cash 0 Check # o Credit Card Card # Visa Mastercard Discover ractor or electrical administrator x Date:S::;1-P' G Expiration Date of card Inspection fee $ yr ~ Service Information flee . al L d Additions and or subtractions o NO LOAD CHANGES o Baseboard KW o Furnace KW o Heat Pump Ton LAR o Fan-Wall KW o Overhead Service o Temp Service o Underground Service Voltage Phase 0 1 03 Service Size: Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN / THERMOSTAT SERVICE Date Approved By "- Dale Approvell Jly Dale Approved By FINAL / DITCH FEEDER "- Dale Approved By Dale Approved By Date Approved By Inspection ,... - Area, Building or Equipment Inspected Action Taken Electrical Date Inspector l!.../RPlj)Ji>o_ "lTij "-u rf4{J s-, , / f) -:l, L. / / d""~ a~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION ,21 EAST 5TH STREET. PORT ANGELES. W A 98,62 Application Number Application pin number. Property Address ASSESSOR PARCEL NUMBER; Application type description Subdivision Name Property Use Property Zoning Application valuation 06-00000475 Date 497850 612 E 2ND 8T 06-30-00-5-2-5900-0000~ ELECTRICAL ONLY 5/12/06 RS7 RESDNTL SINGLE FAMILY o Owner Contractor THEISMAN, CHAD 612 E 2ND 8T PORT ANGELES (360) 477-5929 WA 983623330 THORNES REFRIGERATION PO BOX 991 PORT ANGELES WA 98362 (360) 461-0158 Permit Additional desc Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL THORNES/ T-STAT WTR HT 77149 THQRNES REFRIGERATION 48. io Plan Check Fee 5/11/06 Valuation 11/07/06 .00 o Qty Unit Charge Per 1.00 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48.10 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 48.10 48.10 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 48.10 48.10 .00 .00 COMMENTS/ACTION NEEDED