HomeMy WebLinkAbout2106 W 10th St - BuildingApplication 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 WOOD BURNING STOVE INSERT LINER
Owner
GLENN A /LORI J WOOD
2106 W 10TH ST
PORT ANGELES
(360) 452 3945
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
1 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
10 6500 EA
T:FormsBuilding Division/Building Permit
WA 983635006
MECHANICAL PERMIT
WOOD BURNING STOVE
157172
60 65 Plan Check Fee 00
11/24/09 Valuation 0
5/23/10
Per
BASE FEE
ME STOVE /FIREPLACE /MISC APP
Charged Paid
60 65
00
60 65
09 00001226
895378
2106 W 10TH ST
06 30 00 1 0 5300 0000
GLENN A /LORI J WOOD
MECHANICAL APPL PERMIT
RS9 RESDNTL SINGLE FAMILY
4100
Contractor
EVERWARM INC
257151 HWY101
PORT ANGELES
(360) 452 3366
60 65
00
60 65
Credited
00
00
00
Date 11/24/09
WA 98362
Extension
50 00
10 65
Due
00
00
00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and
void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days
after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have
read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will
be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any
state or local law regulating construction or the performance of construction.
,?L (J+ e i 4411.. (,l) 0i
Date Print Name Signal of)ontractor or Authorized Agent
A`"
g
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
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
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date
Expii2941 8 -I6
Accepted By
Applicant or Agent
VES.11,) i?NM
Owner 6 hoc .f
Owner's Address 2 i a c„,
C ontractor /Engineer ,F' p-72 ►a, .a. Qh
Contractor /Engineer's Address s'7i 5 i
License uityk- 0 g AjG
PROJECT ADDRESS 647 f, ,4 3
Parcel Number
Project Type Brief Des
Check all that apply
o New Construction
a Addition
o Remodel
o Repair
o Re -roof
o Demolition
o Sign
o Heat System
,Other
Floor Areas
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
CMG 3 oon iQ5 30oono
crintion.
o wall- mounted
Total sign area
o Heat pump
Existing (sq. ft.) proposed (sq. ft.)
Total footprint of structures sq ft. Lot size
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
ft.
T.Forms /Building Division/Bldg Permit Appl. 2006 Code.doc
a d L9EC2St
/0 Pa
v fO/
Occupancy group
Occupant load.
Construction type
Phone
Phone
R:36.73
Phone h/y 3 6.6
pa•, uj cL c'-c g 43 2_
Expires TS /7 o
For-City Use Onlx:
Date Received I 1 -2 `tYl
Permit Ca -122(0
Date Approved
452- 336(
3..a3 bat ct'i4362
Lot Zoning
1(Residential Commercial a Multi family o Industrial
o projecting a freestanding a awning other
sq. ft. Maximum allowed sign area sq ft. I r, Sct r f
ood- buming stove a gas fireplace o pellet stove a other
per sq. ft.
TOTAL VALUATION prD
sq. ft. Lot coverage
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 t obtain permits prior to working on
projects. L,„-myet �,c. 1
Date ,,7"f9 Print Name bu O t. t Signe i
wJemJaA3 eas to 60 t'a Aow
PREPARED 9/23/08 11 21 00 INSPECTION TICKET PAGE 17
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 9/23/08
ADDRESS 2106 W 10TH ST SUBDIV
TENANT NBR GLEN LAURIE WOOD
CONTRACTOR ALL WEATHER HTG COOLING INC PHONE (360) 452 9813
OWNER GLENN A WOOD LORI J WOOD PHONE (360) 452 3945
PARCEL 06 30 00 1 0 5300 0000
APPL NUMBER 07 00001137 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 9/23/08
�I
MECHANICAL FINAL TIME 01 00
September 23 2008 8 54 37 AM 1pangrle
LORI 452 3945
MECHANICAL FINAL FURNACE
AFTERNOON INSPECTION
(SHE HAS TO LEAVE THE HOME AT 4 20 PM
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
GLENN A WOOD LORI J WOOD
2106 W 10TH ST
PORT ANGELES
(360) 452 3945
Qty Unit Charge
1 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
WA 983635006
Per
14 8000 ECH
Charged
64 80
00
64 80
T.FormsBuilding Division/Building Permit I 0/0 I /07).wpd
07 00001137
526599
2106 W 10TH ST
06 30 00 1 0 5300 0000
GLEN LAURIE WOOD
MECHANICAL APPL PERMIT
RS9 RESDNTL SINGLE FAMILY
3141
Contractor
Permit MECHANICAL PERMIT
Additional desc INSTALL ELECTRIC FURNACE
Permit pin number 112276
Permit Fee 64 80
Issue Date 10/09/07
Expiration Date 4/06/08
ALL WEATHER HTG COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452 9813
Plan Check Fee
Valuation
BASE FEE
ME INSTALL 100- FAU
Paid Credited
64 80
00
64 80
00
00
00
Date 10/09/07
Due
Extension
50 00
14 80
00
00
00
00
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 any state or local law regulating construction or the performance of
construction.
tc,A, 7 �R. d,...∎
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
CALL 417 -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 UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE I
INSPECTED AND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE
FOUNDATION•
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT 417 -4735
BUILDING PERMIT INSPECTION RECORD
DATE ACCEPTED
YES NO
FINAL DATE ACCEPTED BY.
FINAL DATE ACCEPTED BY.
SEPA.
ESA.
SHORELINE.
COMMENTS
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW ENGINEERING
FIRE 417 -4653 I I I I FIRE DEPT
I PLANNING DEPT 417 -4750 I I I I PLANNING DEPT
I BUILDING 417 -4815 19 -2:2,-Q 8 I -To-- I I BUILDING
T Forms /Building Division /Building Permit (10 /01 /07).wpd
0
6
10/02/2007 08 11 13604525177 ALL WEATHER HEATING
Applicant or Agent
Owner (iir 111M e_WOOt9t.
Owner's Address 710 co L1101 sfi
Contractor /Engineer [�i71_I/�Ot7ht?ir�� PGlT7N)dl (OOft tate License #/1LLf LJWC Lif Expires c1 -1-02
Contractor/Engineer's Address 7)Z. Leine/ .p Phone CZ.
PROJECT ADDRESS: 'Z) 0 (p CAL /0 St ZONING
LEGAL DESCRIPTION Lot Block:
CLALLAM COUNTY PARCEL NUMBER.
f pt esidentlal
hh Multi- family
Commercial
O Repair
2ICP11 fi, WOU
o Now Constr 0 Re -roof Steve
to Addition G Move G Garage
C Remodel 0 Demolition Det:k
Sign 0 Other
BRIEF DESCRIPTION OF THE PROJECT'
COMMERCIALJRESIDENTIAL: Occupancy Group:
Existing Structures) basement Sq. Ft.
I" floor Sq. Ft.
2" floor Sq. Ft.
J" floor Sq. Ft.
Existing Sttucntce(s) TOTAL Sq. Ft.
Maximum Height of Proposed Structures) Ft.
Lot size Sq. Ft
Existing Structure(s) Sq. Ft. Footprint
Proposed Structure(s) Sq. Ft. Footprint
TOTAL Structure(s) Sq. Ft. Footprint
Total Lot Coverage (Divide Total Structure(s) Sq. Ft. Footprint by Lot Size Sq. Ft.)
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 4174815
for assistance.
PLAN CHECI< FEE. The p lati check fee trust be paid at 'the time the building permit application is submitted. All other permit fees arc
due at the time of permit Issuance.
EXPIRATION OF PLAN REVIEW An application for a permit for any proposed work shall be deemed to have been abandoned 180
days.atter the date. of filing unlesl such application has been. pursued,in good.faith orr a.permithas been issued;, except that the.buildiog
official is authorized to grant one or more extensions of tittle for additional periods not exceeding 180 days (90 days for commercial
projects) each. The;extension shall be requested in writing end justifiable cause demonstrated, (IRC/IBC 2006 1105,3 ..2)
I hereby certify that have read and examined this application and Know the same to be true and correct. 1 am authorized t4
apply for this permit an understand that'll' is my responsibill to determine what permits are required and that must obtain
such• armies• r to. nk
Date le 2∎ 7 Applicant
BUILDING PERMIT APPLICATION
Fill out COMPLETELY and in TIM Your application, prescriptive energy
form, plans, specs, and a 8 !r." >i: 11" site plan MUST BE COMPLETE to be
aCeepted for review (360) 417i.4815 FAX (360) 417 -4711
Residential projects: submit two sets of plans
Commercial projects: subtait three sets of plans
/I l Si di ate t it
TVORMSIBUILQN4G OIVISION1eIdgPermitAppl, -2006 COOE.wpd
LOT COVERAGE
Phone 4 67 -C1 r .:a
Phone 'i iZ Z 1
Subdivision:
pIZVVALUATION
SF (c}� /SF e
SF(a;S /SF =S
SF (41 S /SF
TOTAL VALUATION S la.04J
Occupant Load. Construction Type:
Proposed Structure(s) basement
1" floor
2"d floor
3' floor
Proposed Structures) TOTAL
TOTAL Sq. Ft. of existing proposed structures
PAGE 02/02
FOR OFFICIAL USE ONLY•
Data[tea.. I('1 ^n7- -077
Permit iI; I U
Dam Approved;
Date issued:
Sq. Ft.
Sq. Ft
Sq, Ft,
Sq. Ft.
Sq. Ft.
,o,T CITY OF PORT ANGELES
% PUBLIC WORKS - BU1LDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
~-.~';~..~'m'~'~'~-~ ~-~.,~-~'~'~- ISSUED: 4/08/2002 I-'lZr(M~ NU:
OWNER/APPLICANT PROPERTY LOCATION
2106 10TH ST W
GLENN WOOD
2107 w. 10th street Lot:
Port Angeles, WA 98362 Block: [] Long Legal
360/452-9518 Subdivision: PORTION OF SL 53
T: S: Parcel No: 0630001053000
CONTRACTOR ARCHITECT
ALLEN HUNT CONSTRUCTION N/A
489 CAMERON DR.
PORT ANGELES, WA 98362-0000 , 98360-0000
360/417-2939 360/000-0000
PROJECT INFO
Project Value: $15,000.00 SFD Units: 0 Commercial: 0
Project Type: ROOF REPAIR SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0 ~-,
Construction Type: MFD SQ FT: 0
Zoning Use: RS7
PROJECT NOTES
Repair wind damaged roof over Master bedroom
FEES ASSESSMENT
Building Permit: $251.25 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $255.75
Plumbing: $0.00 AMOUNT PAID: $255.75
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
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 pedod 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 previsions of
laws and ordinances governing this type of work wilt 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 cens~ction or t.~e performance of
construction. , /'~--~) .. 2 ~
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 1N A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE I DATE IYEsACCEPTEDI NO COMMENTS
FOUNDATION:
FOOTINGS
WALLS
?LANNING DEPT. 417-4750 ,,¢~/~ ~/ PLA~G DEPT.
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT
REQUEST'
Date~' Time Received by (phone, person)
Location of Work to be inspected k~
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. ,/'?~
Sewer Foundatio~'~raF~mi~', Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES: ~_ ~-.
Inspected: Date ~ ' Time By
Remarks:
RESTORATION REQUIRED ...... YES_ NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved [~Gravel ~]Asphalt [~PCC [~Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
$~
W
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:m EAST 5TH STREET. PORT ANGELES. WA 98:162
Application Number
Application pin number _
Property Address
ASSESSOR PARCEL NUMBER,
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00001079 Date 11/05/05
333586
2106 W 10TH ST
06-30-00-1-0-5300-0000-
ELECTRICAL ONLY
RS9 RESDNTL SINGLE FAMILY
o
Owner
Contractor
HOLMAN JAY
2106 W 10TH ST
PORT ANGELES
WA 983635006
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457-9270
WA 98363
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - --
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
SIMPSONI 200A SVC.
64535
SIMPSON ELECTRIC
66.90 Plan Check Fee
11/05/05 valuation
5/04/06
.00
o
~
"-
C)
~
Qty
1. 00
Unit Charge Per
66.9000 ECH EL-R OR RM 0-200 ALT SRV FDR
Extension
66.90
----------------- ----------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 66.90 66.90 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 66.90 66.90 .00 .00
c:
..
"-
'0
I)..
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~\
COMMENTS/ACTION NEEDED
ELECfRICAL PERMIT INSPECfION RECORD
CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
I INSPECTION TYPE DATI!: ACCEPTED COMMENTS
I YES I NO
Ul1\;t1
IUlll~H::rn CUV-h.K
'...KVIl.t....
"IN A I 111'1/:1 -D$ I ~'Tl
GENERAL COMMENTS:
PW-Il02.J.5 (4196]
10/01/2007 22:46
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4579270
SIMPSON ELECTRIC
PAGE 01
.
ELECTRICAL WORK PERMIT APPLICATION
C,ty P I 11
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Job wilwl by .pleetrital Co.trod"r 0 OWn..
Blee:p;e,,1 ~f'ltrt\tl~f~~~t l..iCCNenuMbcr p,< ~~reI
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Owl'llll:r 1J~ d:djinf!tl by R.CW.19.28. 61:(1) Owner wlU occupy tll~ .,tr,~ctu~ ftJl' two
J'tll'r.! a/'I/;- lhis electrlctfll1t!f'IHiJ it jiMliP!d. (2) Owrter' i4 t'tttf/l.i,-cJ If) ftf,-" "n eJ~t:lrtcal
eQ!1troclor t abol'" .laUf fH'OP"''fY is In' .ale. rent or fUle,
After reading the aboYe 3tftteft'lent, I hereby certifY thlt lAm the ~ of the above
nI'IbCd property or III I;~en~ct electrical eonltactor. f ll1t'I tbfl.kirtt tbe -eleetnCllI insCal.
lation or .Itcratiq,n il'l ~l)ftlf:Jli.MO with the electrical laws., N.H.C.. RCW. Chapter
19.28, WAC. Chapt~r 19~B. The, Chy 01 ~brt Aflge1C\',$ MUR1el",.1 Cot!lI), *"d
Utility Sp<<ificadons.
SIe..fUr r' OWRrf. el~etr
X c 1 .
etG~1 Load AddltlQll'-
;0 NO LOAD CHANGES
, 0 Baoel)osrd ' _ KW
~umoc:e 15.1<W Q Ovorne.d SOrvIoo
. 0 H.., Pump __. Ton _I.AR Q Temp SeMee
: 0 Fan.w"" , _ KW 0 Underground Servioa
'SAME DAY INSPECTION. CALL BEFORJ: 7:00 AM 360-417....7~5
-JDate:
[J Cash Q Cheek #
;s.Cre(lItCIlI:d Vms MoSlercar(l OI""over
CIlI:d# -__"-6:1~~___'____
Expi",tiOll Dote
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of card $" Q52
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13604525177
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Job wired by
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Owner 4'< dafi"(Jd by !CCW./9.28.26J:(J) Owner wifJ OCCUPJI th~ .<rtruC(lIre!Qr two
ytMr.' qfttr fhfs e/(!ctrical permit L.. finalized. (2) Owner i, requimJ to hfl"e an e!t:ctrlcal
con/mclor If o.hOWl said prof1<<1TJI fJ for Jail!:. renl or ll!a.ft:.
A ftcr rending tho nbove statement. I hereby certify lh~ , :\n1 the owner of the above
no.med property or n licensed deetrlef'1 eonlmclor. I am TTUlking tho clectrienl in:Jtal-
b.tion ar nJttTation in co'mpll:\ncc with the electrical Jaws. N.e.C., RCW. Chapter
19.28, WAC, Chnl'tcr 296.465, The City or Port Angeles Municipal Code. and
U\ilit)' Spccificetions.
SI2nR~ :,or nwn or, elecCr
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Date: /()
d o.uubtractlol!.~
o NO L AD CHANGE
o ea:>ebosrd T1'" 'r'NV
J5. FUm:lCQ 19- 't/YII
o Hsst pump _ Ton _ LAR
o Pen.Wall _ KW
ALL WEATHER HEATING
PAGE 01/02.,
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ELECTRICAL WORK PERMIT APPLICATION , ~
tnAl3113tlon description
Q Commercial "';(Re!idCfttlal
o New Q ^lte.odlAdcUdon
~~
"
o Cllsh 0 Cheek #
~ Credit Card Vi"" Mastercnrd o;SOOVCl'
Card # ____"____"____ ____
Expirat;on Date
ofC3Td
~rvlce Inl.o~
tJ OvertU3Iad Servlcg
IJ Temp Servlee
[J Undtarground SeMel
Voltage
Phs.eO 1 0 3
Servlcg Size:_
Feeder Site;
SAME DAY INSPECTION CALL BEFORE 7'00 AM 360-417-4735
. .
~ ROUGH-IN r THERMOSTAT ( SERVICE '""
'- """ ....~.,.mvcd lily ".,~ ^wrovCldlly "- Dftl.. AflPTO"odD)'
FIN^T" DITCH /" FEEDER
"Oftlt' , ~Bl'/ O.,e ~B.L/ Oftle Aflpnn-od D)"
1 n:;pcctign'
Date Moo, Building or Equipment In.pcctcd Action Tak.en Eh:ctrieal
Inspector
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.' II:. n " Il: IUI
nr.r 0 2 ?nn7
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UGHT DEPT.
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ELECTRICAL WORK PERMIT APPLICATIOt.
Job wired by " Electrical Contractor 0 Owner
Electdcal contractor n~I\lQ License nu.mber Oute Expires
, ,
JnsUaHation d'lOs..::ription
o Commercia" )ill ResidtDth:tl
o New
)tl Altorudl Addition
e
Purchas. '5 mailing address ~
.t)..<'(3C73~ 1__: 10( W
City , Stat~ ZIP
Pnd- ~~/ /.()'l-. qr.~~2.
1\:lcphonc nl.lmbcr FAX nUOlbel'
.5 ~
premi5e~w7~a:IUJoool
Addn:SS of Inspection
;)../ () low. ) o-i6 s{.
City P&rt '~ fl~Jeg,
}thoae bumber 10 5d~ed\lle intipuction:
U-f~
Serw /'C e.....
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Owner Qt, d(!fifj~" by Rl::.:W.J9.28.261 :(1) Ownc:r will occupy lh.~ .\'/rUl:1UI'f! fur two
yell,.,:,' after lhis dr:drica';permit is jillalbed. (]) Owm:r is r-t:(fllirt'd lu hire t41l i,!./~~t,.jcal
L,'unlruc/Qr if ~bO\le said ~p'Dpe,.ty i~ fur ,mil:, ref/tvr leus(!.
After re;Jdin~ rhe 3bov~ Ist3tcnlel\t, 1 hereby certify that 1 am th~ owner of the ll.bovc
llam~d property or a lie~nscd clt:drical comractor. I am muking the eleclr!l.:al instal.
ladon or alleratioll ill c~mpliBllcC with the electrical lawS. N.E.C., Rf:W. Chllpter
19.28, WAC. Chuplcr 296-468. The Cit)l of Port Allgeles Municipal Code, and.
Utility Spec:ificalions. ~
Signat dWOe .::t'eCr19, "I nlradul" or r:Icctrical admlnIstratQr
X r, ""'" Date://-o;z.-OS-
traction
o Cash 0 Check #
o Credit Card @ Mastercard Discover
Cardtl --Jts;-.~"Th-k----------
EXPirationDateV '- tJ -' , ' '
. d Inspe5[1on fec"dJ
olear $ P6. ~
Service Information
Ir; I La d A dl
D NO WAD CHANGES
a Baseboard KW
Q Fumaca KW
o Heat Pump Ton __ LAR
Cl Fan.Wall - KiN
')( Overhead Service
o Tamp Service
Q Underground Service
Voltage
Phase Cl 1 Cl 3
Service Size: ~ ~
Feeder Size:
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
r ROUGH-IN THERMOSTAT J, SERVICE
, ; AJ;)
/// f( /1K'
"- OllIe AI",rQV~-d fly D"t~ ApprovuliBy / Dljfu Appnm.\l By
I' , /' FEEDER
FINAL DITCH
, /- I~~ ~t;?-
l', ^PfllOv~ lh/ "- O~lu Atlm'M.;,Jlty Pllie: Appro\lu.i By
inspecLion , Area, Building or Equipmell.t inspected Action Taken Elcctricu1
Dale Inspector
Il/8/00 AIL.. 4(J(J~J\1C:;n A-Y
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At'/J it/ ~ In <"
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1:8 39\1d
8I~183l3 NOSdWIS
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