HomeMy WebLinkAbout528 W 8th St - Building
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Brief description of proposed business:
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legal Description: lot
Current Use of Property:
Zoning Classification of Property:
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ROUTING SLIP
Certificate of Occupancy
$47.00 Certificate/Inspection Fee
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New Business ............................
Transfer of Business location. . . . . . . . . . . . . . . .
Change of Ownership . . . . . . . . . . . . . . . . . . . . . .
New Building .............................
Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Temporary Business .......................
Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Block ;;) 63
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Subdivision
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Will THERE BE ANY OF THE FOllOWING?
Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . .
Electrical changes. , . . . . . . . . . . . . . . . . . . . . . . , . . , . .
Mechanical (heating, cooling, stoves) . . . . . . . . . . . . . .
Plumbing changes .............,...............
New or relocated signs, . . . . . . . . . . . . . . . . . . . . . . . . .
New septic tanks. . . . . . . . . . . . , , . . . . . . . . . . . . . . . . .
New sewer service .......,.,...................
Admission charged to patrons. . . . . . . . . . . . . . . . . . . .
Is this a home occupation? ...,.............,....
Excavation of filling of lots .......................
Work done in City right-of-way. . . . . . . . . . . . . . . . . . . .
Is there sufficient off-street parking? . . . . . . , . , . . . . . .
New driveway openings . . . . . . . . . . . . . . . . . . . . . . . . .
A grading plan for site drainage. . . . . . . . . . . . . . . . . . .
(parking lots, downspouts, etc.) .......,..........
Are the existing streets paved? ..,.,..............
Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . .
Is there curb and gutter? ........................
Other........................................ ,
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YES NO
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I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the
information I have supplied is correct to the best of my
knowledge.
APPROVED
REJECTED
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
P.B.I.A.
THE FOllOWING Will BE REQUIRED:
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PERMITS
1) Building
2) Plumbing
3) Electrical
4) Mechanical
5) Sewer
6) Sidewalk installation
7) Driveway installation
8) Curb installation
9) Sidewalk obstruction
10) Water meter installation
11) Fire
12) Occupancy
13) Sign
14) Shoreline
15) Home occupation
16) Conditional use
17) Other
BUSINESS LICENSE
1) Taxi
2) Peddlers
3) 2nd Hand Dealer
4) Pawn Broker
5) Dance
6) Hotel - Motel
7) Fireworks
8) Ambulance
9) Tattoo shop
10) Other
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Comments / Conditions8D LA? \/10 ), ~ l'
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ROUTING SLIP
Certificate of Occupancy
$47.00 Certificate/Inspection Fee
DATE q;J 3-0 I
Address of Proposed Business
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Applicant ~ ~ to.. 0 It k<s
Address J &, I 'S ~ I A- R. A L IV
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Phone: business '-I S 7-7C}.oO home45)-d9'7<)"""
New Business ............................ (
Transfer of Business location. . . . . . . . . . . . . . .. (
Change of Ownership . . . . . . . . . . . . . . . . . . . . .. (
New Building . . . . . . . . . . . . . . . . . . . . . . . . . . . .. (
Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. (
Temporary Business ....................... (
Change of Use . . . . . . . . . . . . . . . . . . . . . . . . . . .. (
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Brief description of proposed business: O~ p Pr- .\.. ... ..-A- <!..-)\. Z' Yh Ie ~ [ c1J7: ,.o~ IVcO~,1.;C (
legal Description: lot / Block ~ b3 Subdivision T P t4
Current Use of Property: C-o u" s~ \ ~ .......~ ~i c.e..-
Zoning Classification of Property: (~ tV
WILL THERE BE ANY OF THE FOLLOWING?
Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . .
Electrical changes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mechanical (heating, cooling, stoves) . . . . . . . . . . . . . .
Plumbing changes .............................
New or relocated signs. . . . . . . . . . . . . . . . . . . . . . . . . .
New septic tanks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New sewer service .............................
Admission charged to patrons. . . . . . . . . . . . . . . . . . . .
Is this a home occupation? ......................
Excavation of filling of lots .......................
Work done in City right-of-way. . . . . . . . . . . . . . . . . . . .
Is there sufficient off-street parking? . . . . . . . . . . . . . . .
New driveway openings . . . . . . . . . . . . . . . . . . . . . . . . .
A grading plan for site drainage. . . . . . . . . . . . . . . . . . .
(parking lots, downspouts, etc.) ..................
Are the existing streets paved? ...................
Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . .
Is there curb and gutter? ........................
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES NO
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I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the
information I have supplied is correct to the best of my
knowledge.
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
P.B.I.A.
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AP D REJECTED
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THE FOllOWING Will BE REQUIRED:
PERMITS
1) Building
2) Plumbing
3) Electrical
4) Mechanical
5) Sewer
6) Sidewalk installation
7) Driveway installation
8) Curb installation
9) Sidewalk obstruction
10) Water meter installation
11) Fire
12) Occupancy
13) Sign
14) Shoreline
15) Home occupation
16) Conditional use
17) Other
BUSINESS LICENSE
1) Taxi
2) Peddlers
3) 2nd Hand Dealer
4) Pawn Broker
5) Dance
6) Hotel - Motel
7) Fireworks
8) Ambulance
9) Tattoo shop
10) Other
Date: q -~ -c> I
Signed~ ! CJ~
Comments / Conditions
".ORT""
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Appl~cation Number
Application p~n number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Appl~cation type descript~on
Subdiv~sion Name
Property Use
Property Zoning . . .
Appl~cat~on valuat~on
06-00000795 Date 7/27/06
403680
525 W 8TH ST
06-30-00-0-2-3660-0000-
LIVING WELL
Lasered
CEO
SIGNS
Owner
Contractor
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COMMERCIAL NEIGHBORHOOD
100
RICK & TERRY HOCH
4201 TUM WATER TRUCK ROUTE
PORT ANGELES WA 98363
( 36) 452-5381
OWNER
Perm~t
Add~t~onal desc .
Perm~t pin number
Perm~t Fee
Issue Date
Expiration Date
SIGN
83501
47.00
7/27/06
1/23/07
Plan Check Fee
Valuation
.00
100
Qty Unit Charge Per
1.00 47.0000 PER S- SIGN LES THAN 25 SF
Extension
47.00
Fee summary Charged Paid Cred~ted Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 47.00 47.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 47.00 47.00 .00 .00
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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 -1l1ave r€ad-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
7__ :P? 7-iJ&
Date
T \Pollcles\ 11 02_15 bUlldmg permlllllspecllon record05 wpd [1/4/2005]
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.
~
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INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS B/I Aloe, ..J L.L
SHEAR WALLS 1 WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS )
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY;
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I I I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY.
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKJRTING -
PLANNING DEPT SEPARATE PERMIT #"s SEPA
P ARKlNG/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 ELECTRICAL
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 BUILDING 10 !~Ill,_... --'l~
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T IPohclesl1 102 15 bUlldmj( permIt inspectIOn record05.wpd [1/4/2005]
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Lasered
CED
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Architect/Engineer:
\
Phone: 3 b6- Lf/57- t17/'i J,
Phone: '-5"0- Lf-5';''''' .5"~3 2/
.
.lht.1f'/e.> Zip: 9%'365
Phone:
A ppllcan t or A gent: ::r 0 h VI IJ, S en s en) J) I (!.,
Owner: 1<' i c K l.J.oc.h d R r/:f N-o c.l-1.
Address: Lj ;20/ r;j n? w/J_fer '[;.i/<f#yfi-'lbrl-
Contractor
State License #:
Exp:
Phone:
City: Zip:
fl.;. .f~ 5t./f}J,f .4nq~k.<; / 11/# q7,p~.?-ZONING:
Block: Subdivision:
(!J)
Address:
PROJECT ADDRESS: ,7 ::?tJ
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA _ MC _ #
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-roof 0 Stove
o Multi-family 0 Addition 0 Move 0 Garage
'16 Commercial ~ Remodel 0 Demohtion
I' 0 RepalT )( Sign 0 Other
BRIEF DESCRfp'TION OF THE PROJECT:
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
~
COMMERCIALIRESIDENTIAL: Occupancy Group:
No. of Stories: L Lot SIze: Existing Sq. Ft.
Total lot coverage %
=-TOTAL Sq. Ft.
ESAfWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
APPR}tfh~
PLAN:~ .
BLDG:
DPWU:
FIRE:
OTHER:_
V ALUA TION OF CONSTRUCTION: Inall cases, II valuation IImount must be entered by the applicant.
TIllS figure will be reviewed and may be revised by the Building DiviSIOn to comply with current fee schedules. Contact the 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: If no permit is issued WIthin 180 days of the date of applicatIOn, the Ilpplication will expire. The
Building Official can extend the time for action by the applicant up to 180 dllYs upon wntten request by the applicant (see Section
RI05.3.2 of the International BuildinglResidential Code, 2003). No application 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. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required .not the City's. and that I
must obtain such permits prior to work.
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APPIiCan1~) ;f: Ut$4L----
Dale:
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PREPARED 10/04/07, 11:34 25
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES LIERLY
PAGE
DATE
3
10/04/07
ADDRESS
TENANT, NBR.
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
525 W 8TH ST
LIVING WELL
SUBDIV
RICK & TERRY HOCH
06-30-00-0-2-3660-0000-
06-00000795 SIGNS
PHONE
PHONE
( 36) 452-5381
PERMIT: SIGN 00 SIGN
REQUESTED INSP
TYP/SQ COMPLETED RESULT
DESCRIPTION
RESULTS/COMMENTS
BL1 01 8/18/06 JLL BLDG FOUNDATION FOOTING TIME: 13, 00
8/18/06 AP DONNA 417-9094
08/17/2006 11:48 AM DYASUMUR ---------------------------
08/18/2006 04:40 PM DYASUMUR ---------------------------
BL99 01 10/04/07 -Jf BLDG FINAL
V\ October 4, 2007 8 29.53 AM Ipangrle
LINDA 417-4815
(TO FINALIZE THIS OLD PERMIT)
BLDG FINAL - SIGN (LIVING WELL 10 SQ. FT FREESTANDING SIGN)
-------------------------------------- COMMENTS AND NOTES --------------------------------------
PREPARED 8/18/06, 13:02.52
CITY OF PORT ANGELES
ADDRESS
TENANT, NBR:
CONTRACTOR
OWNER
PARCEL .
APPL NUMBER
525 W 8TH ST
LIVING WELL
RICK & TERRY HOCH
06-30-00-0-2-3660-0000-
06-00000795 SIGNS
PERMIT: SIGN 00 SIGN
REQUESTED INSP
TYP/SQ COMPLETED RESULT
BL1 01
8/18/06
~
INSPECTION TICKET
INSPECTOR: JAMES L LIERLY
PAGE
DATE
8
8/18/06
SUEDIV:
PHONE
PHONE
( 36) 452-5381
DESCRIPTION
RESULTS/COMMENTS
BUILDING FOUNDATION FOOTING TIME: 13:00
DONNA 417-9094
08/17/2006 11 48 AM DYASUMUR ---------------------------
-------------------------------------- COMMENTS AND NOTES --------------------------------------
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRlCAL DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
ELECTRICAL PERMIT
Issued: 6/20/97
Permit No:
5961
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
VICKIE & LARRY SUTTON 528 8TH ST W
528 W.8TH ST Lot: 7
Port Angeles, WA 98362 Block: 263 Long Legal:
360/452-2443 Sub: TPA
T: S: Parc No:
CONTRACTOR-----------------------------DESIGNER---------------------------------
OWNER
VARIOUS
Port Angeles, WA 99360
206/000-0000
,
000/000-0000
PROJECT INFO----------------------~---------------------------------------------
prj Type: RES.REMODEL ~ I"\~ ~:Jt~o_<:,~ prj Value: $0.00 .
Occ Type: CUWl-. v~r-~ - Cnstr Type: ADD HEAT
Occ Grp: Occ Load: Land Use: CN
Electrical Heat
X Baseboard KW:
Furnace KW:
Heat Pump KW:
Fan/Wall KW:
4
o
o
o
Service Type
Riser
X Overhead Service
Underground Service
Temp Service
Voltage:
Diameter:
Service Size:
Feeder Size:
120,240
X-l -3
200 AMPS
o AMPS
PROJECT NOTES-----------------------------------------------------------~-------
ADDING 4KW BASEBOARD
PROJECT FEES ASSESSMENT---------------------------------------------------------
Service: $55.00
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
$0.00
Misc
TOTAL FEE:
Amount Paid:
$55.00
$55.00
=================================
TOTAL FEE:
$55.00
Balance Due:
$0.00
COMMENTS/ACTION NEEDED
ELECfRICAL PERMIT INSPECfION RECORD
CALL 417-4735 FOR ELECTRlCAL 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
lNSPECTION TYPE
DATF.
ACCEPTED
COMMENTS
IYESINO
vnCH
ROUGH-IN / CUVt.K
"FRVIf'P
7/.:>t1 qi ~
?/Olil/t/7 7Pm
PThT A T
I <inN, 7(71."1.. I
GENERAL COMMENTS,
PW.ll02.1~[4I961
(/0/
FEE RECEIPT NUMBER
. . . CITY OF PORT ANGELES
.; DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
~~1
PERMIT NUMBER
.
TOTAL FEE
~al{roV
CONT. Lie. NO.
TIMETOCOMPLETE
NO. STORIES
LEGAL OCCUPANCY
Site Address S:z. S1' \...l.J
CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH ~AON~A.A1'DRESSES ARE CANCELLED i-I _. .
Owner' r;:..1r..~u<; 'S.~)A''';J:OJ'\,l Installation By VV\.\...l"'oN'tV'S '" '5 C- ..<{l(le
Owner's Address -=l "It \.-.-? 'is T ~. .. Installers Address ~:3".......... 'it" I '"
Day Phone 'i~'7 .5'':2.0'"2. Installers Phone '-\..s-7 Sl,.. yq
Application is hereby made for Permitto install Electrical Equipment as follows: :r::- "" $ I .. II ....... I ( T4.. ~.-..
~ F>< IsT,:""7 h~"'I-r",q,~
ELECTRICAL PERMIT ONLY
'irT2..
- NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Wiring Method
tel<...
.
NUMBER AMP 24QV NUMBER AMP 120V 24DV
USE OFCIACUIT PER .120V FEE USE OF CIRCUIT PER 100R FEE
CIRCUITS 100R CIRCUITS '0
CIR '0 30 CIJ:! 30
LIGHT.,. SIG~_ ~ \ ", ~. , , '.
-. , . ., . . " " ... ;". " '. y .,-:: .
50 VOLTS ,
LIGHT OR LESS
,. .
" . '. .-
CONVENIENCE MOTOR
CONVENIENCE . MOTOR
APPLIANCE MOTOR
DISHWASHER . FIRE ALARMS
DISPOSAL BURGLAR ALARM
RANGE "C' MISC.
OVEN
-
WATER HEATER
LAUNDRY
DRYER REINSTALLATION LIGHT FIXTURE # .
FURNACE SUB TOTAL FEE
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC
BASIC FEE
ELECTRIC HEAT
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
..
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
- -
SERVICE A.W.G.
I SUB-TOTAL . -
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
. - .
I certify that the work to be performed under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code!
Date Application made .;1;-, :2' '-I ,19 ,?i By ~~~)
CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Perm!ssion is h~rebygiven to d9.t~e ~bove desc;:ribed wprk, according to the conditions hereon and according to the approved plans and
specifications pertaining thereto, subject to compliance with the Ord!nances ,qf the City of Port Angeles.
'-~TOR F I
By
PLANS A
" .
.
Date Permit Issued
WARNING
Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in
Writing on Permit Placard. A:. Permits Phone: 457.0411 Ex!. 158. .
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY - Duplicate PINK. Triplicate WHITE CARD . Inspector's Report
DATE OF vtSIT
7,;lz~f/-
I 7
.
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TfuTiZ
I J
MADE BY
" .
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A.
I/)dr
I ,.
REPORT OF INSPECTOR
REMARKS
... ",
,. \ '
\ ., ~-
INsTfHlfd AlII..J ~rr ",.J ,,,,p,.u.. 1) ,t'CAoI/L
5r", ri .., IV 8. 3. 1+ \A.-r1 A .S'
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:121 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
05-00001019 Date 10/lg/05
639917
528 W 8TH ST
06-30-00-0-2-6326-0000-
ELECTRICAL ONLY
COMMERCIAL NEIGHBORHOOD
o
Owner
Contractor
SUTTON LARRY R/VICKIEL
528 W 8TH ST
PORT ANGELES WA 983625810
ANGELES ELECTRIC
524 E. 1ST ST.
PORT ANGELES
(360) 452-9264
WA 98362
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER COMMERCIAL
ANGELES/ MAST REPAIR
62554
ANGELES ELECTRIC
66.90 Plan Check Fee
10/19/05 Valuation
4/17/06
.00
o
Qty
1. 00
Unit Charge Per
66.9000 ECH EL-COMM ALT- REPAIR METER/MAST
Extension
66.90
V,
\'J
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
~
(~
l;~
fi
'"'
V1,
"\
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,
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-lI02.1~ 141961
10-13-205 1, 43PM
FROM ANGELES ELECTRIC INC 360 452 9265
P.1 "
5......
,........
--
~:1
"l_.._
ELECTRICAL WORK PERMIT APPLICATION'
Job wired by
o Electric.1 Contractor 0 Owner
Installation description
o Commercial D Residential
electrical contraclor name
License number Date hpires
A-Nr~E!FIt-fr-'O RS
o New
IJ A IInedl Addllioll
Purch..M~~h~b~rJHC. INC.
4 AST FIRST
City PORT I,N(J(L(3. 'fiA ~8:'l6l
State ZIP
. . r- .('P-0 i r A.M'./.?.r.,1,1 a5r+--
~
Telephone: number
3&0 45;;2.. lIlliP
Premises owner's name
_VIUt-1 Xl-l.-tf1Yl
Address of inspection .
I?U W..gm
~:~wJt" .oM WFf
Phone l'luml)er to ~~utc inspcetioa:
q g,:sto'L
Owner Q.~ dt:;'-ined by RCJY.19.28.26/:(1) Own...' will occupy (h~ structure: fur tKiO
YC.'Ur.i (ifIu thi~ (~lt!ctriCQil)ermit i~ finalized. (2) Owm:r is I'l~uired to hire an elitclrical
contractor if abnve said prop('I'ly is jr" '''/lIe, ,.,~nt 0" JI!Q!U!'
Aitct tcading the 1bove 5tatemenL I hcn:by certify' that I am the owner of tbe abuve
rumcd property or a licensed e1ectric31 contractor. I am malcing tbe elecuic..l instal-
lation or alteration i1\ compliance with the elecLrical laws. N ,f.C., RCW. Chapter
19.2ti, WAC, Chapter 296-468. The City of Port Anseles Municipal Code, and
Utility Specifications.
Sign.aturc of OWDcr, electrical contractor or elutric:al sdminlstrarOf
(A{)1f, iO!i3jfJ<" ,'(,wi)
o Cash 0 Check It
\l'Credil Card Visa Mastercard Discover
Card# ____()N1jLh___~-_____
x
Date:
C-
Expiration Date
of card
Electrical Load Addition~.l!1.I.l!. or subtractions
IJ NO LOAD CHANG ES
o Baseboard KW
o -Fumace KW
o Heal pump Ton LAR
IJ Fan-Wall _ tWJ
~~~ Information
Cl Overf1ead Service
CI Tamp Service
o UnctergrounCl Service
Voltago _.m'__
Pha.. 0 , IJ 3
Service Size:_
Feeder Size:
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
ROUGH-IN THERMOSTAT SERVICE
D'It~ "rp""~"'l fly DlI!t AW"\,..~~.R) OJ.tc AIl'P""'I;\ll3y -
FlNAL DITCH FEEDER
jOh.:s/6< Ac:D '- D&le
/ D~lc AC'\>ro)~cd By ./ 'D:lle Apll'l'\I~~ By / Appl'OVcd By
Inspec1ion Area, Building or Equipment Inspected Ac.:tiun Tllhn Elcctnc;\!
D31e Inspector
- ._.
_..
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