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HomeMy WebLinkAbout814 W 5th 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 Owner LIPMAN RODNEY /TINA 2840 E HIGHWAY 101 PORT ANGELES Other struct info Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge 10 00 3 0500 HND Fee summ ary Permit Fee Total Plan Check Total Grand Total WA 983629080 Per Signature of Contractor or Authorized Agent T•\Policies \1102_15 building permit inspection record05.wpd [1/4/2005] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Charged 80 50 32 20 112 70 05 00001269 318891 814 W 5TH ST 06 30 -00 0 1 0120 0000 RODNEY LIPMAN RES DETACHED GARAGE RS7 RESDNTL SINGLE FAMILY 1500 Contractor OWNER TOTAL LOT COVERAGE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS BUILDING PERMIT RESIDENTIAL 67744 80 50 Plan Check Fee 12/22/05 Valuation 6/20/06 BASE FEE BL -501 2K (3 05 PER C) Paid Credited 80 50 00 32 20 00 112 70 00 Due 00 00 00 Date Date 12/22/05 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 s, if construction or work is suspended or abandoned inspection. I hereby certify that I have read and examined this applicatio for a period of 180 days after the work as commenced, or if required inspec o I a not been requested within 180 days from the last anthe same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whet er sd herein or not. The granting of a permit does not presuna to give authority to violate or cancel the provisions of any stat or w regulating construction or the performance of Signature o 1 00 1 00 1 00 1 00 1 00 1 00 1 00 32 20 1500 Extension 50 00 30 50 /2 2-mod r (if owner is builder) Date PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING BUILDING PERMIT INSPECTION RECORD 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 INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDERFLOOR /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 RESIDENTIAL 1 I 1 1 I I 1 1 I 1 1 1 1 1 1 1 1 1 1 I 1 1 I I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 FINAL FINAL SEPA. ESA. SHORELINE. DATE ACCEPTED BY. DATE ACCEPTED BY. FINAL. INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION kW PW/ CONSTRUCTION RW ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 1 1 1 1 FIRE DEPT 1 1 1 PLANNING DEPT 417 -4750 1 1 11 1 PLANNING DEPT I 1 1 BUILDING 417 -4815 1 Ek0irr4 1 7".1.A -mot )I`7 1 BUILDING 1 1 I T•\Policies \1102_15 building permit inspection record05.wpd [1/4/2405] Applicant or Agent: Owner ,K OD Address R' /4 Architect /Engmeer• Contractor Fill out COMPLETELY and in INK. Your application and site plan MUST BE COTv! rLETi to be aecepteu fui i evien If you ha e an. questions. call PERMITS (360) 417 -4815 FAX(360)417 -4711 Address City PROJECT ADDRESS g/4e. LEGAL DESCRIPTION Lot: 8L Block. /0/ CLALLAM COUNTY PARCEL NUMBER. O 43 ©0 D c O/ TYPE OF WORK. Residential New Constr X Re -roof Multi- family Addition Move Commercial Remodel Demolition X Repair Sign BRIEF DESCRIPTION OF THE PROJECT R oZ),"4" Phone 452--S e s'© "VE"Y l./ ,Phone _S" T^f sr cit /'y"'■V -d S Zip .2 Phone State License e U 7?iA✓& 004 t 2 F, RED Po5 T COMMERCIAL/RESIDENTIAL. Occupancy Group No of Stories Lot Size. Existing Sq Ft. Total lot coverage PLANNING USE ONLY BUILDING PERMIT APPLICATION Stove Garage Deck Other ,i4l /c ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other T•\Policies\BL 1102_13.wpd Applicant: Date: Exp Subdivision. Phone. Zip ZONING _ItC 7 SIZE/VALUATION e' b SF /SF SF /SF SF /SF TOTAL V4LUATION 15CY Occupant Load. Construction Type. Proposed Sq Ft. TOTAL Sq Ft. FOR OFF1CIAL SE NLLY Date Rec. (Z. l� Permit n 9Z Wq Date Approved: tiV /O Da' issued. 19d aJ APPROVALS PLAN BLDG DPWU FIRE OTHER VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the apphcant. This figure will be reviewed and may be revised by the Builduzg Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE IF a plan check fee as due it must be submitted at the time the building pe=t application and construction plans are subrmtted. All other permit fees are due at the time of pernnt issuance. EXPIRATION OF PLAN REVIEW If no 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 apphcant (see Section R105.32 of the International Building/Residential Code, 2003). No apphcation can be extended more than once I hereby certify that I have read and examined this application and know the same to be true and correct. 1 am authorized to apply for this permit and understand that if is my responsibility to determine what permits are required ,not the City's, and that 1 must obtain such permits prior to work. 30 Feet Vertical Datum .NAND dA Horizontal Dana NAD 33i9 1 Y This map u nor intended to be used as a legal desrripiron This map is produced by the City of Pori Angeles for Us own use and ouroose NO!, 4. e-2/ Z1C ov' /1C ti 4 ./IL 40-57-5 v.) ro- To City of Port Angeles City Engineer 321 E Fifth Street P O Box 1150 Port Angeles, Washington 98362 NOTE. 1 Generator Information. Mailing Address* Contact: Phone Project Name* Project Location. 2. Other Contacts (if applicable) Consulting Firm Contact: Phone Contractor Name Contact: Phone. Laboratory Contact: Phone City of Port Angeles Landfill Waste Disposal Application PORT ANGELES LAN WASTE DISPOSAL APPL Phone (360) 417 -4803 FAX. (360) 417 -4709 All questions must be answered for waste to be approved. '/4 X45 z SS-CD A //l dC 2 2 2005 N77 /)//Z CeetA -iy '*.Z)O> Page -1 3 Source of Waste Check the appropriate box below and briefly describe the project, process and /or cleanup that will or has produced the waste requiring disposal Include the gasoline service station number (if applicable) CERCLA/MTCA Remediation Agency Contact: Independent Remedial Action UST Removal Unused Chemical Product Spill Other Source O O 4 Waste Material Composition (check all that apply and include percent of total) Soil Foundry Slag Concrete /Asphalt Dredge Sediments Preserved Wood Debris Coal Ash X Other (list) Wood Ash 04 .6 W O© 4 NOTE. Total must equal 100% 5 Waste Material Contaminants (check all that apply) Gasoline Metals Solvents Heating Oil Unused Motor Oil Used Motor Oil /Waste Oil Other Other Petroleum Product Unknown AidA L /999 &iivr NOTE. Supply any MSDS information with application if available e arn Diesel PCBs O k City of Port Angeles Landfill Waste Disposal Application Page 2 6 Estimated Quantity of Waste for Disposal Other NOTE. Estimated quantity for disposal must be within 20% of the quantity actually disposed (10% for projects over 7 500 tons or 5 000 cubic yards 7 Frequency of Disposal 8 Waste Sampling Proper characterization of the waste for disposal requires the collection of representative samples The methods and equipment necessary for obtaining representative samples of a waste and the frequency of sampling will vary with the type and form of the waste Check the appropriate box and briefly describe how and where the waste was sampled Include site maps with sampling locations if possible Number of COMPOSITE samples number of discrete samples per composite Number of DISCRETE samples NOTE 1 NOTE 2: L,, Cubic yards O BS ms-(estimate both) Drums Tons (estimate both) One time Monthly 0 -25 25 100 101 500 501 1000 1001 2000 >2000 cubic yards cubic yards cubic yards cubic yards cubic yards cubic yards City of Port Angeles Landfill Waste Disposal Application Annual Other Unless prior approval has been granted by Port Angeles the following sampling frequency will be used 1 composite sample 3 composite samples 5 composite samples 7 composite samples 10 composite samples 10 plus one sample for each additional 500 cubic yards One composite sample shall contain a minimum of three /maximum of five discrete samples Page 3 9 Waste Analysis The Dangerous Waste Regulations' (WAC 173 -303) shall be utilized to determine the appropriate analytical requirements for waste characterization Ecology Publication #91 -30 (Revised April 1994) `Guidance for Remediation of Petroleum Contaminated Soils' shall also be used to characterize petroleum contaminated soils from UST releases Submit all laboratory analytical results QA/QC data and Chain of Custody sheets along with this application (NOTE. The laboratory must be accredited by the Washington State Department of Ecology a) List all analytical test methods used. b) Provide a narrative as to why the above analytical methods were selected NOTE. Additional sheets attached YES NO 10 Soil Classification *FOR PETROLEUM CONTAMINATED SOILS ONLY Based on the analytical data and Ecology Publication #91 -30 the soil classification is (check one) Class 1 Class 2 Calculated Hazard Index /A/4 Class 3 Class 4 11 Dangerous Waste Affidavit: /A Based on a review of the analytical test results site history and the applicable regulations this waste is classified as (check one) Neither Dangerous Waste (DW) nor Extremely Hazardous Waste (EHW) Dangerous Waste (DW) and Waste Code Extremely Hazardous Waste (EHW) and Waste Code City of Port Angeles Landfill Waste Disposal Application Page 4 12 Certification We, THE UN information pr material to th Waste Generator Situe 4A Printed Name 7 \//‘Z Company Date beer RSI vided L. best :if certify that this application is true to the best of our knowledge All ct and the enclosed analytical results represent the proposed waste abilities APProv te NAPOLICY_P\1000_SVV\100901 WPD City of Port Angeles Landfill Waste Disposal Application Page 5 Application Number 08 00000385 Application pin number 884315 Property Address 814 W 5TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 0120 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Owner Contractor LIPMAN RODNEY /TINA 2840 E HIGHWAY 101 PORT ANGELES WA 983629080 BOB S ELECTRIC INC 2293 DEER PARK RD PORT ANGELES (360) 457 6887 Date 3/31/08 WA 98362 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc TRIP FEEE Permit pin number 123786 Permit Fee 46 00 Plan Check Fee 00 Issue Date 3/31/08 Valuation 0 Expiration Date 9/27/08 Qty Unit Charge Per Extension BASE FEE 46 00 Fee summary Charged Paid Credited Due Permit Fee Total 46 00 46 00 00 00 Plan Check Total 00 00 00 00 Grand Total 46 00 46 00 00 00 II TIN 4' SPECTION TYPE DATE RESULTS DITCH ERVICE ROUGH IN FIl\ AL COMME] TS skP M (,rurot•iP R©p ELECTRICAL INSPECTOR . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles. WA 98362 (206) 457-0411 ELECTRICAL PERMIT Site Address: PERMIT NO. S.s8C, ~//",/~~ DATE o READY FOR INSPECTION License Number: Installed By: A..-v1 Owner/Business: Owner/Business Address: ELECTRIC HEAT o BASEBOARD KW _ ! FURNACE KW ~ o HEAT PUMP KW_ o FAN/WALL KW _ )l'CI RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION 'poll REMODEL o ADD/ALTER CIRCUITS ~ SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE DetailslDescription: ~e ~o~ ;:::1;:;; . o WILL CALL FOR INSPECTION Phone: Phone: Sq. Ft. o RISER ~ OVERHEAD SERVICE o UNDERGROUtjD SERVICE VOLTAGE: /Ztl~'/U }l'f1!1\ D3i1\ SERVICE SIZE ~O AMPS FEEDER SIZE AMPS W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER ~Ditch Inspection O.K. Q '. '\Rough-in/cover o.K. ~ ,...) ;1,0 O.K. to conn~service ~~Final O.K.''', (1;(" ~ ~,4~ Li"'w."':") I Site Addresscf/ W r ~ '1-4 Q~ d~ Permit/Receipt No. ,b~6'& New Meters Date" b Notify Port Angeles City Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT A $ , Electrical Inspector Installer: .. / '" ~HITE - File by address 'MPIC PRINTERS INC ~ . PINK - Top: Eng, Bottom, Customer #5D / I GREEN - Top' Meter Dept" 81 Permit Fee . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 PERMIT NO. .:5'..377 I /7' /16 , . DATE ELECTRICAL PERMIT Site Address: Installed By: I W ~ Li s I~ o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: Sq. Ft. Details/Description: 't$" RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION ~ REMODEL o ADD/ALTER CIRCUITS ~ SERVICE UPGRADE/REPAIR Y SERVICE o RISER 3" OVERHEAD SERVICE o UNDERGROUN SERVICE VOLTAGE: cO 2.. 0 ')a q5 0 3 95 SERVICE SIZE 0200 FEEDER SIZE AMPS AMPS ELECTRIC HEAT o BASEBOARD KW _ o FURNACE KW _ o HEAT PUMP KW_ o FAN/WALL KW , ~ . W.S. No. CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. q}iO.K. to connect service o Final O.K. Site Address: tIJ . S~ Permit/Receipt No. S.377 (, Installer: New Meters --- . Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not e covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. 01/ ~AAJ1 NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT It .s-o , ~ $ Electrical Inspector Permit Fee WHITE - File by address PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall OLYMPIC PRINTERS INC FROM BOB'S Electric FAX NO. 1 360 452 9943 Mar. 27 2008 10:10AM P1 \ I og --6?:RJ;;' ~ ELECTRiCAL WORKPERMlT APPLJCAT1UN ~ ~~AJ~ J06 ",ired by )(ElectriCal Contractor a Owner InslallatiQn d~criptioD a CODlluerclal 0 Resideutial Ele.;trical COl\tl'3.CfOr name License number ""f?np, I::;. El F~I? Purchaser's mailing IIddn:.ss ^_ ~'i3 1) E r= tQ.. rAR- r( r-'\Y j JII Stale Zlr ~Al~.:=c. &:xL &fc;(:Nn~ Telepbone number mbl:r sr -46.9- a Altered/Addition ~~/-,n' _ q~IJ'~ pN'R, 4::-~.... . da d ~ City Co "2.- Owner os defint:d by RCW.J9.18.26J :(1) Owner 'will occupy [he .flrllcture fo'l' two y~.(l1'$ after this electrical permit is finalued. (2) Owmer is ref{llircd tQ hire llII dec:tricol cOIlU'Dclar if ab""" said p1YJT>Uty ~ for sale. !'en' or lcos('~ Aner tc~ing the aboyc stD.tcment. I hereby ceniry that I am the OWIlCt or the .1bo'Ve (lnmed property or 3. IiceDsed c:lec::tt1C:11 cooltactor. 1 am makin.g the electrical instal. lo.ticlIl or alteration in compliance with lhe electrical laws:. N.n.C.. RCW. Chapter \9.1&, WAC:. Ch~pter 296-468. The City of Port Angelts Municipal Codc.,3.nd Utility SpecitiC::Sliuns. nt owner. electrical x D C.sh D Check # DCreditCard ~ Mastercard Discover Card # t:Jt< '~_"_"_'__'. Expiration Date of card 7 '" Electrical Load AdditIons and or s 1:1 NO LOAD CHANGES o Baseboard KW o Furnace KW o Heat Pump _ Ton _ lAA IJ Fan-Wall KW [J Overhead Serl/ice (J Temp Service D Underground Service VOltage ___ Phase a , IJ 3 Service Size: FQeder Siu: SAMF.. DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN r THERMOSTAT SERVICE ~ D." Appl'OYc4 \'It \.. D~. Apprnl'od 8)' J)ute ^pproy~1l 0)' & FINAL r DITCH FEEDER zj)z.'1 b~ 'n.P OIIC AppI'D"cll B~ DO' ^P/llOvcd 8)' 1l.t~ ~rovodo.,. Inz;pection Area. Buildil1g or Equjproent 1m.-pected Action Taken Electrical Dste In.speC:lur ~hl JOY, /"n- ~ "::>- 4QV It:sL. VHI . ~ I Application Number . . . . . 23-00000079 Date 1/31/23 Application pin number . . . 705150 Property Address . . . . . . 814 W 5TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-1-0120-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc DHP ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ LETA M LAWHEAD EXTRA MILE TECH & ELECT., LLC 814 W 5th St 418 N. RACE ST. PORT ANGELES WA 98362 PORT ANGELES WA 98362 (509) 981-9809 (360) 457-5222 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 63.00 Plan Check Fee . . .00 Issue Date . . . . 1/31/23 Valuation . . . . 0 Expiration Date . . 7/30/23 Qty Unit Charge Per Extension 1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 63.00 63.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 63.00 63.00 .00 .00 1 - 2 SINGLE-FAMILY ELECTRICAL PERMIT APPLICATION Pub! ic \Yorks and ULili ties Department 32 l E. 5th Street. Port ;\ngeles. WJ\ 98362 300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us Project Address:--------------------------------------­ Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _ OWNER JNFORMATtON Name: ________________________ Email: ______________ _ Mailing Address: ________________________ Phone: ___________ _ ELECTRfCAL CONTRACTOR fNFORMATION Name: ___________________________ License: ___________ _ Mailing Address: ________________________ Expiration Date: ________ _ Email: Phone: ___________ _ PROJECT DETAILS Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge) Service/Feeder 200 Amp. $120.00 $ Service/Feeder 201-400 Amp. $146.00 $ Service/Feeder 401-600 Amp. $205.00 $ Service/Feeder 601-1000 Amp. $262.00 $ Service/Feeder over 1000 Amp. $373.00 $ Branch Circuit W/ Service Feeder $5.00 $ Branch Circuit W/O Service Feeder $63.00 $ Each Additional Branch Circuit $5.00 $ Branch Circuits 1-4 $75.00 $ Temp. Service/Feeder 200 Amp. $93.00 $ Temp. Service/Feeder 201-400 Amp. $110.00 $ Temp. Service/Feeder 401-600 Amp. $149.00 $ Temp. Service/Feeder 601-1000 Amp. $168.00 $ Portal to Portal Hourly $96.00 $ Signal CircuiULimited Energy - 1 &2 DU. $64.00 $ Manufactured Home Connection $120.00 $ Ren ewable Elec. Energy: 5KVA System or less $102.00 $ Thermostat (Note: $5 for each additional) $56.00 $ First 1300 Sql;Jare Feet $120.00 $ Each Additional 500 square feet" $40.00 $ Each Outbuilding / Detached Garage $74.00 $ Each Swimming Pool/ Hot Tub $110.00 $ TOTAL $ Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296- 468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us] '"'CJ CD PREPARED 1/28/23,12:29:46 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:23-00000079 814 W 5TH ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER RESIDENTIAL 63.00 TOTAL DUE 63.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: DHP NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 2/6/2023 23-79 TAP OWNER CONTRACTOR Extra Mile Electric PROJECT ADDRESS 814 W 5th St