HomeMy WebLinkAbout619 E 4th St - Building f CITY OF PORT ANGELES
r DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
32 1 EAST 5TH STREET, PORT ANGELES, WA 98362
-mg.-
Application Number 11- 00001415 Date 12/19/11
Application pin number 606545
Property Address 619 E 4TH ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-1-0- 2200 -0000-
Application type description RE -ROOF on your state excise tax form
Subdivision Name to the City of Port Angeles
Property Use
Property Zoning (Location Code 0502)
Application valuation 5840
Application desc
TEAR OFF INSTALL COMP
Owner Contractor
CITY OF PORT ANGELES NORTHWEST HANDYMAN
PO BOX 1150 428 ORCAS AVE
PORT ANGELES WA 983620217 PORT ANGELES WA 98362
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF INSTALL COMP
Permit Fee 151.75 Plan Check Fee .00
Issue Date 12/19/11 Valuation 5840
Expiration Date 6/16/12
Qty Unit Charge Per Extension
BASE FEE 95.75
4.00 14.0000 THOU BL- 2001 -25K (14 PER K) 56.00
Other Fees STATE SURCHARGE 4.50 c' Y 4 M (fill l
Fee summary Charged Paid Credited Due
Permit Fee Total 151.75 151.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 156.25 156.25 .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 clays, 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 o local law regu ating construction or the performance of
construction.
I 1/ 1- t°s
'Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM N 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.
i lI l s
I nspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab 1
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling i
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 Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
.Skirting I
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
II
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W.. PW Engineering 417 -4831
Fire 417 -4653 (J
Planning 417 -4750
Building 417 -4815 (19'7 I a SL�
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ORf BUILDING PERMIT APPLICA TION Print in ink
L' 1-
;ham CITY OF PORT ANGELES
ffi Attn: Building Permit Technician For City Use Only:
321 :3' Date Received (,z L u
(36 E. Fifth 0) 417-4815 Port Angeles, WA 911 Permit Lt tc{-l�
(36 E.
fax (360) 417-4711 Date Approved 17-- 11
44
Applicant Ad" r4,aLS 7 i2fGQ 6 *tn c s F Phone 4 1 l
Property Owner C't.ry, n (((,4L ,0 L c Coe ,e ,/Phone
Property Owner's Addifess J 7 L 5'7-
Contractor ►k uy �j� v `'P, Q j Phone
Contractor's Address 1 145 0 PCd-
License Ale t?rll j/-? 6 ExpiresL /G1 E -mail
PROJECT ADDRESS (,v/ l i 4
Parcel Number Lot Zoning
Project Type Brief Description: Residential Multi family )(Commercial Industrial
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
House garage other 'tear off re -roof lay over one layer
Heat System Heat pump wood burning stove gas fireplace pellet stove other
Other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq. ft.
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck t
Shed
Other .5
TOTAL VALUATION 4 r C
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
Max. height of proposed structures ft. Occupancy group of bedrooms
Will a lawn sprinkler system be installed? Occupant load of full baths
Will a fire sprinkler system be installed? Construction type of half baths
I have read and completed this application and know it to be true and correct. I am authorized to ap.ly for this pe lit and understand
that it is my responsibility to determine what permits are required, and to obtain permits prio on jec s. r
Date l l( Print Name 'F'S Fo K Sig ,:ture j y dr
T: Forms /Building Division /Building permit application
Northwest Handyman
PHONE: 460-7801
428 ORCAS 7•-• 2 2 5
4
PORT ANGELES, WA 98362 77714'
NORTHH*901KG
DATE ORDERED NI ORDER TAKEN BY
t:
TO S 1\ if PHONE NO. Nt.. CUSTOMER ORDER
;r
Oa i 9' V C'... i kr -0
ADDRESS i
JOB LOCATION A,- 1
r C.,
1
1 1 7 r:- L.7 0 f 7 'v 1
•-f-
JOB PHONE i STARTING DATE
t .r\
t -1:1--e1-.,.: 1 --(2 Lis.
ATTENTIbN TERMS
CI
QTY. DESCRIPTION MATERIAL LABOR
......t...
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7 1 /VI r)
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(f)/
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WORK ORDERED BY TOTAL LABOR
i i:-/ 1: 1
NJ 1 I L
DATE ORDERED
/4
DATE COMPLETED 4:4 77' :7 "7 77' 7-7.
TOTAL L'I 0 S 7 0. o 6 c
A SUBTOTAL
,...,-c i
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CUSTOMER APPROVAL SIGNATURE -:,.i,: TAX
7
GRAND TOTAL ,-7,.
AUTHORIZED SIGNATURE
Contractors or Tradespeople Printer Friendly Page Page 1 of 1
General /Specialty Contractor
A business registered as a construction contractor with LEtI to perform construction work within the scope
of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance.
Business and Licensing Information
Name NORTHWEST HANDYMAN UBI No. 602045229
Phone 3604574742 Status Active
Address 428 Orcas License No. NORTHH *901KG
Suite /Apt. License Type Construction Contractor
City Port Angeles Effective Date 5/7/2010
State WA Expiration Date 5/7/2012
Zip 98362 Suspend Date
County Clallam Specialty 1 Handyman
Business Type Individual Specialty 2 Unused
Parent Company
Other Associated Licenses
License Name Type Specialty 1 Specialty Effective Expiration Status
2 Date Date
FOXS Construction
FOXSRR"004L8 REMODELING a Contractor Carpentry/Framing Roofing 6/28/2000 6/26/2004 Archived
ROOFING
FOXSRR *944N1 FOX'S Construction Out Of
General Unused 8/21 /2006 8/21/2010
REMODELING Contractor Business
Business Owner Information
Name Role Effective Date Expiration Date
FOX, LESLIE EARL Handyman 05/07/2010
Bond Information
Bond Bond Account Effective Expiration Cancel Impaired Bond Received
Bond Company Number Date Date Date Date Amount Date
Name
PLATTE RIVER Until
CLB2712058 05/03/2010
1 $6,000.00 05/07/2010
INS CO Cancelled
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Company Policy Effective Expiration Cancel Impaired Amount Received
Insurance Name Number Date Date Date Date Date
1 CBIC C11S16102 05/03/2010 05/03/2012 $1,000,000.00 04/26/2011
Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period
Warrant Information No unsatisfied warrants on file within prior 6 year period
https: fortress .wa.gov /lni /bbip /Print.aspx 12/19/2011
'~
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98J()2
Laserer
CED
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivis~on Name
Property Use
Property Zoning .
Application valuation
06-00001217 ~"~-"\'7~:';;:.t.C: :.: Date '11/27/06
964676
619 E 4TH ST
06-30-00-1-0-2200-0000-
ELECTRICAL ONLY
o
Owner
Contractor
CITY OF PORT ANGELES
PO BOX 1150
PORT ANGELES WA 983620217
--.~~------~=~~---~~-----
'. HI TECIi' 'SECUJ~ITY INC
72 3 E FRONT ST
PORT ANGELES WA 98362
(360) 452-2727
Permit
Additional desc .
Permit pin number
Sub Contractor
Perm~t Fee
Issue Date
Expiration Date
ELECTRICAL ALTER COMMERCIAL
HI- TECH/ SECURITY SYSTEM
90373
HI TECH SECURITY
42 20
11/27/06
5/26/07
INC
Plan Check Fee . .
Valuation
.00
o
~
............
-..0
Qty Unit Charge
1.00 42.2000
Per
~ ~t "",........~\~~.t.^",..."~~
. . """" -\,' *"..~..~~>.1'.." ',: .
-- -...~ ~ _1- .~~....:i~...'~,~"", ""--'-
- ,,,~_' ~~~.V1 ~~z..t ~:l.JI,. Extension
EL-LOW VOLT SYS <=2500 SQFT 42.20
C"\
Fee summary Charged Paid Credited Due
----------------- . ---------- ---------- ---------- ----------
Permit Fee Total 42.20 42 20 .00 .00
Plan Check Total .00 .00 .00 00
Grand Total 42 20 42.20 .00 00
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COMMENTS/ACTION NEEDED
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ELECTRICAL PERMIT INSPECTION RECORD
CALL 4174735 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 TYPIt DATE ACCEPTED COMMENTS
YES I NO
11.... 'H
RUUUH-IN I CUVbK
ShRVICh
-
1/..2#< -t)~ JhL/ I
GENERAL COMMENTS:
PW-II02.J5(4'96J
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N?
15069
., -jY . >y.
Port Angeles, Washlngton______________________________________________________________, 19________
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.
C: / '1 c. ref
~:::s_c;:=::~~;::::::~~:::::(~;.:J;~::~~~~;;.:;:~~~~~:::___~:::~~:~-~:::::::~:::::::::::::::::::::::::::::::::::::::
Wiring Contract~r n_~~~_~~_~:::_::_m_~.3:.::~l~__..___..__u Byh_h_.___.nn__.nnnn____n___h___________U__un....nn___h_
Light OutletS.....m....mmnm........_..._._n.
Receptacle Outletsm__m..n...............n_.
Dryer, K\Vj ........__n___..n...........nU..__u..
Range, KW nnhUmnnnm
Water Heater:
KW._mmmmmmm nmmmmmmn.
Hea.: RWm_'r....!U3._nmnnm..mn.
Motors: size. volts and phase:
Service. volts .jm?:n:L~.2ut!."'..._.......
?
No. wires n..hn_nn.nnn....n..........h.
Size wireS.......~~n::?:-.r!.m_mm
Main fuse hn.:j.0.'!./lu...m.......
<:;
Enclosure .......__....u....hn....uuuu.u
Type of wiring-:
Entrance Cable hhum"hn'''m.'''''u
Rigid Conduit mnm___unmnnunn...
Metallic Tubing '_.nmmmnnmhnn
Current transformers:
No. & Size._..................nnnn.nnnnn
Ser. NO........_..._nn......u_............._......
Ser. NO....n__n....nnn_nn.._n__n..n__._.._.
Ser. NO.....n....hn_.._nnnn.n___nnn_n...
Type of Wiring:
Armored Cable .nmnmmn____..........
Non-Metallic ...mnn.._mn...._..........
Knob & Tubemm.nmm..................
Rigid Conduit mnmmnmn_..n.n__m
Metallic Tubing
Raceway .n.m.mmn......_...._...n.........
Circuits. LighL.h.....mm....h.h....._...._m_
Utility nn............................nnn__n...
Heat
Range .nnn.nnn.._nn.n_n.__nn...h_n...
"Tater Heater ........._..._......._.....nn
Motor _______._____________..____._______.........
Dryerun.n____nnn.nn_nnn_n...__nn......._
Furnace .u...._._..__.._n_......_..nn_.._
Total Loadn_.nnn_.n.nn_n_____ Ser. NO...__nn...nnn_nn..nn_n__nnn._... Total ._nn....nn_nnnn...._...........
Remarks: ______________,__--"::!__-'___~___________~~=________:.___.:___~_____:_~_7.:__'::CS_______~""",Z__________.___________________
-i~_~~_~~~~~_-_~~-__-_~-_-_~-__-_~~-_~~----------i~~_~:~~~~_~~~_~~~_-~_~~-_~------m-mm--:~-::.iZ:~.!d~~~Z;.::~=:-:-
NOTICE-Current must not be turned on until CerUficate of Inspection has been issued. If work Is to be con-
cealed due noUce must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
15069
Date called for iDspectioD_.______..._.n._____________...___________n_...nnun____.___....h.....n_____...__.....h...__.._.._......h______...~...h_____._nn.................__0000..........
Preliminaryinspectiondates..........................._.....b.___.........._.....___......_.._........__.___..............____...__..............__.._....______..___....._......._......._
Inspectloncompleted_.._.....__....___...____.__..__.....___....____..______._______...._..._.__..__........._00_.......____.........____......__....__..__.__...........____..___................._
1M 3-72 Olympic Printers, Inc.
Total Load __..._____.._____hn___....____..........__h....____..h........n....__nn_.hn_..__ ............n.__nn_.__.............n
\
,
Cl Electrical Contractor
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ELECTRICAL WORK PERMIT APPLICATION
o Request Inspection
o AonUlll Permit 0 Alum 0 Carnival 121"" Commercial 0 Residential 0 Rc:sideDtiaJ Mainl. Q Signs 0 Thermostat 0 Telecom.
Job wired by
I<l Electrical Contractor a Owner
InstnUillion description
Elcctrical Contractor name
-\..\:I. T~~ St:.c..u~,"''t-"
,
P\lfCbi!ser's mailing aJdrcss
-:023 ,,~~.,.--
c;\>'.- " \
~\ 1"..o<l6(..I.!::.~
Telephone number
3<.0- '-IS 2 -'2":12""1--
:I;~
License number
>'>:I:Tcl:-\"S 9S5RS,
'/'"
,
r...,;;,,",A\\ Sc.c.~\","y
~ RQ->' 5-r- ,
State ZIP
~I'>- '78:51. '2-
> dS"l-e............
FAX number
3"0- '-157..- 8S't.O
PrelUhes owncr'~ name
CF>-""~ <='''"-:':'- u.>A-
Address of ltUipcdioll
.J T~
~ I q ;Ef'>.s., ....
City
. Ro,"" A,.)6i.1'Z:<;..
I hereby certify that 1 am the owner of the above named property or a licensed
electrical contractor (or the finn'~ atLlhonze."d agcnt) and am making the electrical
installation or alUmUion in compliance with the cleel.r.icallaw, Chapter 19.28 RCW.
I:l Cash I:l Check #
a Credil Card Visa
Card #
02l
~,,~
Mastercard
Discover
-----------------
Expiration Date
of card
Inspection fee
$ '-/2..20
WALLS
Insulation Only
CEILING
rnsuJatiol1 Only
TIIERMOSTAT
SERVICE
Dale
Approved Ily
D~,
AWl'Uvecll3y
llnle
^l'llm\le(16,.
DAtc
Co....~r
CO....CI'
AflJlrt'\lccl ~y
DITrn
FEEDER
D~l~
A.PtlN~~~ By
DAIC
^r-pmvcl1J;;ly
i)Ale
Arfll'O\led I:ly
OMC
Approved 13)'
Electrical L.oad Additions a,nd or subtractio"_s
o NO LOAD CHANGES
o Baseboard KW
o Fu(nace KW
a Heat Pump ~~ Ton _LAR
a Fan-Wall KIN
ServiGg Information
D Overhead Service
o Temp Service
CJ Underwound Service
Voltage
Pha.se 0 1 CJ 3
Service Size: __
Feeder Size;
Inspection
Date
Area., R\liJdillg or Equipment Inspected
Aclion Taken
Electrical
Inspector
.'J;/;:;.. ~
L~6
Td W~9S:L0 900G 80 '~oN
09S8 GS17 091::
'ON X~"
SJ I NOdl.:J3i3 HJ31- I H " WOd"
Building ] NYtslr;n/Elect°ileal.Inspections
321 East Fifth tr °eeyt - P.0, Box 1150 f Port Angrics W asitington, 9836
]Ih: (3611) 4174735 Fa v. (30) 41747] ]
Date; _6_(E
1 Mufti-Family or Commercial'
1
JUN j� .
ELECTRICAL
WpEcTlas
Page 1 of 1
. Flan Review May Be Requires, Please ComrAele Electrical Pte n Review Information Sheet
JCOAddre£s, 619 Fast *h
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.....a....., ... _......... �..... rm.
n.--,.. ....«.._..._...,_- ....�..... « -, «.._ _.. - ..... ... .... ....... ..... ... ...nm
n,....._� � w�:.�..�»».
....,a..,.e,..,.
W0qG.Te`: CiMri 41f above.
urra�rin%rrriaklart
Contractor lr€fcrmatitr€
Name:
W, NrgAddfe s: 13, pst.4th
wt iwd�sss:.723 east Front St
t .P rt t l s�„�. _date: m . . ,m... . �'.
N an :,
4y € et 5 »,..
ftn
, 2 if Al. k rar, s, It t _. _ _ __
: _4
0rr.i0lxr•.M_.,..,.,.. m..,.,_
L€nse��fCxra'
er
tJtal her
Total 10ty NUWqLakbjkn It a ,g
Setvlre;Feader2f00Amp,
$ 132.00
.« ....... ..._. _ «..,_... � ....... .... ... �...__.,..
Sary a Fatrder 2001.400 Amp,
$ 110,00
�
Sere ,,eiFaader 401-6TJ Amp
$ 225,110
Saralun %der 601-1M Amp,
$288.00
Sense fFeedar ove r 1000 Amp,
$410.00
Branch 0rca0ltW1SefficeFeedar
5O0
Branch0iouil INIk3Sarpftr Feeder
S 7400
_. . ».
fa ir'ddilonall3tambCkauit
SDI
LlranOrckuits 1-1
86,001
_. ,..._..._...__......
Tamp. Sear !' FevJar4jr Amp,
S 1020
. »M.._._...._.,._m._.__.
Tamp. earvfWFe6dof 201,400 Amp,
S 12140
__ �.m...._..,_ »_ ....,....
Tamp, SmvisefFa iar 4d1 -WO Amp,
$ 164Bid
_ - -
iernp, 8erYkWR- .rxiw601.1000Arsp.
$11S5,00
_ --- ----- _
_r.__.
NOW b portal ltur�
96.0
_.._....w._„
___.__..__._ 1�....M.__...__...._........._
S rtrd}r€Y rie ti CYtifi,
Siprol Cimuili UrrMed Energy - KA- Farni#
64,M
Sol OJ gait f Limited ErrergyI Rust 1500sf»- Commeiaal
S 960
We: $5,00 ror each adSthrm1ISM sf
r onaeo o E ottal Energy - SKVA Systom or Less
$113,00
_ :.. ».......... M
Thetnicatat
56A
teate: $.5.40 rar each atiirjRinaiT -Slat
_.._ _..m.. _. ».
$ t)'5-00 Total
Der r as def it tf by RGW 1 , 8.261: (1) Owner x ill
or4upy the structure for
two years after this el€ ctrlcal permit is fi€ lixeti. (2) Ovinerisrequired
to Ire an electrical contra-.tor if above sald property is
for s a,.rr♦ rot or lease.
Permit expires after six monk of last fr pection,
After r&ading the abovestatement, I hereby c rkifi that I am the ow r of the above named pro perty or a fimmod electrical corAmtor, 1 am making
#f electrical irtstallaki ra r alke€ati ra iree rrrpli +�tfkft #lte l tri .l la ats,1V',E,
., RUN. Chapter 19.28, WAG, Ct pter &46B, Tho CityOaf Pori
Angeles Municipal Code, and Utility Spec ifications and PA10C 14.05.05D rep rdiog Electrical PermitApphealiom,
Sfgnature of caner, electrical contractor or electrical administrator:
0 cash 11 c.0wak
Ora* Card# - -_,orb., file_...:.... _..._
X Mike Shirley
1
http:// www. pdfescape. com/ open/ RadPdf. axd? rt= c& dlc= 035EED7ETFT9M65U18KN52QVTJJF... 6/6/2014
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number 14- 00000687 Date 6/13/14
Application pin number 942009
Property Address . . . .. 619 E 4TH ST
ASSESSOR PARCEL NUMBER: D6- 30- 00 -1 -0-2200 -0000-
Application type description ELECTRICAL ONLY
subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . .
Application valuation . , . . 0
Application desc
Security system
Owner
Contractor
RESULTS:
CITY OF PORT ANGELES
DITCH
HI TECH SECURITY
INC
PO BOX 1150
723 E FRONT ST_
PORT ANGELES
WA 963620217
PORT ANGELES
WA 98362
(360) 452 -2727
Permit . . . . . .
ELECTRICAL ALTER
COMMERCIAL
Additional desc . .
COMMENTS:
Permit Fee
96.00
Plan Check Fee
00
TsSue Date
6/13/14
valuation . .
. . 0
Expiration Date
12/10/14
Qty Unit Charge
Per
Extension
1100 96.0000
ECH EL-LIMITED
1ST 1500 SQ FT
96.00
Fee summary Charged
paid
credited
Due
Permit Fee Total
96.00 96.00
00
.00
Plan Check Total
.00
.00 .00
.00
Grand Total
96.00. 96.00
.00
.00
REPORT SALES TAX
on your excise tax forma
to the City of Pore Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPEC'T'ION
Signature of owner or Electrical Contractor X Date:
G:\FXCHANGE\BIJILL?ING
D
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