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HomeMy WebLinkAbout2116 W 12th St - Building 41. CITY OF PORT .ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 12- 00000125 Date 2/06/12 Application pin number 953375 Property Address 2116 W 12TH ST REPORT SALES TAY, ASSESSOR PARCEL NUMBER: 06-30-01-5-7- 0300 -0000- Application type description MECHANICAL APPL. PERMIT on your state excise tax form Subdivision Name Property Use to the City of Port Angeles Property Zoning RS9 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 4432 Application desc DUCTLESS HEAT PUMP SYSTEM f �Q/ Owner Contractor f t a/b 9 -3' CARLSON JUDITH A ALL WEATHER HTG COOLING INC 2116 W 12TH ST 302 KEMP ST PORT ANGELES WA 983635009 PORT ANGELES WA 98362 (360) 452 -9813 Permit MECHANICAL PERMIT Additional desc DUCTLESS HEAT PUMP SYSTEM Permit Fee 64.80 Plan Check Fee .00 Issue Date 2/06/12 Valuation 0 Expiration Date 8/04/12 Qty Unit Charge Per Extension •BASE FEE 50.00 1.00 14.8000 EA ME- FURN /HP /FAU OR 5 TON 14.80 Fee summary Charged Paid Credited Due Permit Fee Total 64.80 64.80 .00 .00 Plan Check Total .00 .00 .00 .00. Grand Total 64.80 64.80 .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. no/1 a 61a0 fYli, Cw3 1 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 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. Q Inspection Type Date Accepted By Comments A 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 Water 1 FINAL Date Accepted by 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 ^�j Commercial Hood Ducts FINAL Datel" 3 i /Accepted by 0 1 MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit its SEPA: Parking Lighting ESA: Landscaping SHORELINE: 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 Planning 417 -4750 Building 417 -4815 H N H 1 M 1 I W C7 E o 1 q M H 0, N o lq N a m w 1 H w w q z O a 0 Q H Fu, 1 cna m� 0 E 7 N N u1 O a I N H 0 1 F ca 4 Ln a, cn u u z z F W 1 a W H N 2 1:4 W cr) Z 1 W Z W 0 0 W Z I a 00 a [n N o Z z z 1 u oO N 0 H a N� a •a u W CL co H H U Z a F M H u a x a 0 a cn cn u q 0 0 0 E 0 a X h U O H H w O 8 0. a w 0 M U FL F c Ad. r ZHO Cn z i w C 1 E W O LO N H 1:4 1 N x F] H V) 1 H 4 Z0 4 1 100 '14 1 cn0 0 W W N N w I LO M 0 E E H H (7 1 H a a 1 H W ,7� 1 H 1-7 11 LD N 0414 H H 7i 1 N a U 0 H O 0 W M M OI E W O r r- x1 x au a o F ao cn cn az H a r a w 0 a E au 4U0a� F E, X 02/03/2012 10:59 13604525177 ALL WEATHER HEATING PAGE 02/03 BUILDING /PLUMBING /MECH N!CAL PERMIT APPLICATIO SHORT FORM (To be used for projects that do not require plan review.) Date Received 1:3 t 2 City of Port Angeles Permit 21-- t• Attn: Building Permit Technician Please print in ink, Date Approved 3- 321 E. 5 St., Port Angeles, WA 98362 Approved by 360 417 -4815 fax: 360- 417 -4711 Credit card payments are accepted Mon -Fri 8 -5 pm (no American E =ss) Hours: Mon through Fri 8 5 pm Cash checks are accepted Mon -Thurs 8:30 -4 pm Fri 8:30 -12:30 pm Contact person; J. C Phon Property owner: —3V n phone; QM Property owner's mailing ddre a11t) WJdihS`t Contractor's business name :All Weal :her Heating Cooling Phone: (or property owner's name if he /she Is doing /overseeing the work) (3 60) 452-9813 Contractor's mailing address: 302 Kemp Street Contractor's L &I license number: ALLWEHC150KU 1 Expiration date: 9/01/1.2 Project Address: ail (v v, Project Type: y.LResidential ca Commercial o Industrial o Multi family Project Business Name: (for commercial, industrial, or multi family protects) The following permits are usually Issued over the counter Immediately, without the need for plan review. Complete only the portions of this permit that are relevant to your project, Re -roof; o house garage o other c tear off re -roof o lay over one layer Licensed contractoG Submit a copy of your re -roof bid. Project Valuation (labor materials, not including sales tax) Re- side: a house c garage t other Project Valuation (labor materials, not including sales tax) Repair: (explairtthc aroiect), Project Valuation *Homeowner: If you will be doing overseeing the work, then the project valuation will be determined by doubling the cost of materials, to reflect the v�,L the repair adds to your property. Cost of materials x 2 Project Valuation T :Forms /Building Division /Building /Plumbing /Mechanical Permit Application Short Form (Revised 2011) Page 1 of 2 02/03/2012 10:59 13604525177 ALL WEATHER HEATING PAGE 03/03 Swimming Pool or Spa (a 24" deep): For prefabricated swimming ppgl or s,oe projects that do not roauirm fan re y«w Obtain the City of PA handout entitled "Pools Spas" follow the requirements. Project Valuation Demolition: A demolition permit Is needed when an entire building gets demolished, What will be demolished? a house garage n other Note: some demolition permit applications need to be reviewed by various City departments, and may take approximately two weeks to obtain. (1) Agree to ensure that all utilities are /will be properly turned off (and capped off If needed) prior to demolition, Obtain (from the City of PA) an aerial view map of the parcel and put an "x" over the structure(s) to be demolished. Submit the map with this application, Obtain (from the City of PA) a copy of the Olympic Region Clean Air Agency (ORCAA) Demolition Permit Application, Contact ORCAA at 360- 417 -1466 to discuss whether or not an ORCAA Demolition Permit will also be needed, yes no Will the debrls be going to the Regional Transfer Station in Port Angeles? yes No If yes, will a licensed contractor be taking It there? If yes, obtain (from the City of PA) a copy of the Waste Disposal Application. Complete and submit the waste disposal application to the Building Permit Technician, now (or later If asbestos testing Is needed), Plumbing Permit: (explain the project) Project Valuation Mechanical Permit: (explain the project), Inata11 ta.on of dV h Q V Project Valuation wI X 1 S O4 t L4 l have reed and completed this application end know /t to be true and correct, I an 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 1 1 3D) 1k Signature Print Name Karen McKeown Page 2 of 2 PROJECT STATUS UPDATE Permit Z 2-S Date: Ill r( I phoned the: Applicant All v\itAAW at 4s2- Cl lZ) Property Owner tkV'V A, iii 44a► Contractor at I (left a phone message, r discuss The permit (has expired, r will expire soo What is the status of this project? Please call and schedule a final inspection Ot Submit a "permit extension request" letter. Or ,nnn��Q Let me know if the project is abandoned. I r ►V' �l T:Forms /Building Division/Project Status Update ELECTRICAL PERMIT CITY OF PORT ANGELES 1 360- 417 -4735 Application Number 12- 00000870 Date 7/11/12 Application pin number 109060 Property Address 2116 W 12TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 01 -5 -7- 0300 -0000- your excise tax form Application type description ELECTRICAL ONLY on y Subdivision Name to the City of Port Angeles Property Use Property Zoning RS9 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 0 Application desc 1 circuit relocate switches at front door Owner Contractor CARLSON JUDITH A EXTRA MILE TECH ELECT., LLC A 2116 W 12TH ST 418 N. RACE ST. PORT ANGELES WA 983635009 PORT ANGELES WA 98362 (360) 457 -0198 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit Fee 63.00 Plan Check Fee .00 Issue 'Date 7/11/12 Valuation 0 Expiration Date 1/07/13 Qty Unit Charge Pe'r 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 O INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE o ROUGH -IN 7/11 J1 FINAL 7/11/1 "IV VP COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING CE D os ntI slri CITY OF PORT ANGELES PERMIT APPLICATION JUL 1 c Building Division/Electrical Inspections h a 321 East Fifth Street—P.O. Box 1150 Port Angeles Washington, 98362 ELECTRICAL a CO Ph: (360) 417 -4735 Fax: (360) 417 -4711 INSPECTIONS NWINIIINPF Date: 7 0 l Z 11 2 Single Family Dwelling d Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 1/ l,J -4 St/t..-Fee r Building Square Footage: Description of above 1R- c'_.) o c.c., f-€. 5 c:.) i.4 c.l'.re..n ett- f P I CJO/L. P/ o u• /A v'/ i ck >c4-4 Owner Information Contractor Information Name: T -t T C I Sc. Name: G".�ch -14 MIL reek Mailing Address: ,22 t:, L. J i' S �rc'/wc rc.�. J mJ f Mailing Address: e-I I 1.J �Z t }C E S 1 City: i? /9- state: 1,4/11- Zip: 4.55'3', City: Q A- State:y.i Or Zip: ct a Z Phone: 4'S -.5n? 6 7 Fax: Phone: 40 -5_4.11 Fax: .At2 s 6 S License !Exp. License /Exp. 4F' yA14M`r 973R'‘ item Unit Charge L1ty Total (Qty Multiplied by 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 I 3. cc 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 Circuit/ Limited Energy -18 2 Family Dwelling 64.00 Manufactured Horne Connection 120.00 Renewable Electrical Energy 5KVA System or Less 102.00 Thermostat 56.00 Note: $5.00 for each additional T-Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. 120.00 Each Additional 500 Square Ft. or Portion of 40.00 Each Outbuilding or Detached Garage 74.00 Each Swimming Pool or Hot Tub 110.00 3. 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, l 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 -46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: Cash Check 7 Creda Cod It X j.t..#1 Dated: 7 -1 C.) (2-- 09!0112012 I I ELECTRICAL PERMIT 'k s i. CITY OF PORT ANGELES t 0 360- 417 -4735 "C V4 Application Number 12- 00000431 Date 4/17/12 c� Application pin number 290089 Property Address 2116 W 12TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 01 -5 -7 -0300 -0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 0 Application desc 1 -4 circuits kitchen remodel Owner Contractor N CARLSON JUDITH A EXTRA MILE TECH ELECT., LLC C—"' 2116 W 12TH ST 418 N. RACE ST. PORT ANGELES WA 983635009 PORT ANGELES WA 98362 (360) 457 -0198 1 01 p C 56 Permit ELECTRICAL ALTER RESIDENTIAL 1 ll /3,515" 7 Additional desc 1 -4 CIRCUITS Permit Fee 75.00 Plan Check Fee .00 Issue Date 4/17/12 Valuation 0 Expiration Date 10/14/12 S U Qty Unit Charge Per Extension BASE FEE 75.00 Fee summary Charged Paid Credited Due Permit Fee Total 75.00 75.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 75.00 75.00 .00 .00 V ...-A INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN 9 jig)) W °114* FINAL 516//7-- lki 'Irk' COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING 0 i/A oF poRT4N ELECTRICAL INSPECTION WIRING REPORT 417 -4735 DATE PERMIT INSPECTOR 631 /-z-- 1-01m) OWN R/CONTRACTOR K 0 ADDRESS APPROVED NOT APPROVED DITCH ROUGH IN /COVER SERVICE FINAL 1,ORRECTIONS NEEDED: PL A L IN) V4 1 X a L 54-• t 1 �Z 1 LL 4 11 1� i 'To l rJ�zG ITLLD�A I/Z lr 4,4) f h \\J 12_11 11- NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DO NOT REMOVE OLYMPIC PRINTERS, INC. (360) 452 -1381 APR-16-2012 12:35 PM E. JANSSEN 360 452 2982 P. 01 r Eirm i'\17,i ,,j L L L I. A t vilin 0 APR 1: .Y V4 CITY OF PORT ANGELES PERMIT APPLICATION ELECTRICAL ',.'to.:_ Bnikling DhIslon/Electrical Inspections INSPECTIONS 321 East Fifth Street P.O. Rm. 11501 Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4'711 Date: ....'.7_6 .."'..Y. 1 2 Single Family Dwelling Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheel Job Address: I i.rtZ I i &during SquareFootecre: De4criplion at above .....),_,4 reLCAC C-4, __C■,e,leAs-_.___._ :.":...i. I Owner Information Contractor Infonnation Name C.... ck rt l c c Name: sar 44 a raw 0 ele.ceiticift, MalivitAddreSli:2,11.L__ 1 -L .f 1 L r i Mai Address: ilargi r r;re- 14.- TZ. ikt c 41...11-_,i_LA, <12.' Stale .:1:7 ZIP: .........LIL..._‘'J._ City: 4- 1..1 _state: r /?..77.0: _711'40 Phone: Fax: Phone:...f127.. lel.x 21 Fa1r- ...tri.. iik_r______ Bga unit Cha_ms Qtr. Torg_(_Qty.MultipYed by Unit Otrargg ServItx#Feeder 200 Amp, 5 120.00 Service/Feeder 201400 Amp. 5146.00 Service/Feeder 401.800 Amp 205.00 ii Service/Feeder 601-1000 Amp. 262.00 0_ Service/Feeder over 1000 Amp. 373.00 Brandi Circuit W/ Service Feeder 5,00 Branch Circuit WK) Service Feeder 83.00 Eardi Additional Branch Circuit 5.00 Branch Circuits 1-4 75.00 $_..7<.,•_`.:.L...... Temp. Service/ Feeder 200 Amp. 5 93.00 Temp. Service/Feeder 201-400 Amp. 110.00 Temp. Service/Feeder 401-800 Amp. 149.00 Temp. Service/Feeder 001-1000 Amp 188.00 Portal to Portal Hourly 96,00 Signal armit/ Limited Energy 1 2 Family Dwelling S 64.00 Manufactured Home Connection 5120.00 Renewable Electrical Energy 5KVA System or Lifts 3102.00 Tbomostat 58.00 1 Note: $5.00 for each additionai T-Stal NER.GMEGIUMIOriVi FIrs11300 Square Ft. 120.00 Each Additional 500 Square FL or Portion •JI 40.00 Each Outbuilding Of Writhed Garege 74.00 Each Swimming Pool or Hot Tub 110.00 Total Owner as defined by RCVV.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. i 2) Owner Is required to hire an electrical contractor if above said oroperty Is for sale, rent or lease. Permit expires after S months of last inspection After reading the above statement, I hereby certify that I ant 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 296-488. The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit ApplIcetions. Signature of owner. electrical contractor or electrical administrator: 0 Cash El Credit Carl I x A Qom, 0110112E112 ELECTRICAL PERMIT i CITY OF PORT ANGELES 0 360 -417 -4735 Application Number 12- 00000128 Date 2/07/12 Application pin number 342400 Property Address 2116 W 12TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 01 -5 -7- 0300 -0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Ductless heat pump Owner Contractor CARLSON JUDITH A BLACK DIAMOND ELECTRICAL CONTR 2116 W 12TH ST 502 BLACK DIAMOND RD PORT ANGELES WA 983635009 PORT ANGELES WA 98363 (360) 565 -1035 t^ Permit ELECTRICAL ALTER RESIDENTIAL Additional desc 1 -4 CIRCUITS Permit Fee 75.00 Plan Check Fee .00 Issue Date 2/07/12 Valuation 0 Expiration Date 8/05/12 Qty Unit Charge Per Extension E BASE FEE 75.00 Fee summary Charged Paid Credited Due Permit Fee Total 75.00 75.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 75.00 75.00 .00 .00 I^ 1 V INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN Z I t 5 I FINAL 2,'S'( Z "-gyp COMMENTS: Cl*, PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING ir 11 3 0 Rr.1,,. J i `a J' 1"3 CITY OF PORT ANGELES PERMIT APPLICATION Building Division /Electrical Inspections r� 0 t I d 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 Ph: (360) 417 -4735 Fax: (360) 417 -4711 ELECTRICAL NREPIr O i IN SPECTIONS Ov Date: 3 1 L 1 2 Single Family Dwelling Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 2.-11 (6 [A.), 12... Building Square Footage: Description of above NO t) C. i iLC et- n v `11e43 i) Owner Information Contractor Information Name: 7VUD4 CPdZLSbt Name: b(}) Jt •u a.Ilt Mailing Address: `.,iii 6 W. 1(, 1 Mailing Address: St 2- i>i w t t «a City: PA, State: 1.-4 Zip: 1 $3 0 City: t? State: Zip: 'Well Phone: Fax: Phone: Fax: License Exp. License Exp. L4 C.4 f s94 O L Item Unit Charge ON Total (Qty Multiplied by 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 1 c" 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 Circuit/ Limited Energy -1 2 Family Dwelling 64.00 Manufactured Home Connection 120.00 Renewable Electrical Energy 5KVA System or Less 102.00 Thermostat 56.00 Note: $5.00 for each additional T -Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. 120.00 Each Additional 500 Square Ft. or Portion of 40.00 Each Outbuilding or Detached Garage 74.00 Each Swimming Pool or Hot Tub 110.00 75 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 -46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: Cash k Check Credit Card X f Dated: 2- 3 -1z_ 01/0112012 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 NEW IRRIGATION SYSTEM DOUBLE Owner JUDITH A CARLSON 2116 W 12TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary T.Fuirns /Buildinc i_ iswn/Buildina CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Qty Unit Charge Per 1 00 7 0000 EA WA 983635009 PLUMBING PERMIT IRRIGATION BACKFLOW 142125 57 00 2/24/09 8/23/09 Charged Permit Fee Total 57 00 Plan Check Total 00 Grand Total 57 00 2. z r) J(2L, S, n 09 00000180 394860 2116 W 12TH ST 06 30 01.'5 7 0300 0000 JUDITH A CARLSON PLUMBING REPAIR RS9 RESDNTL SINGLE FAMILY 2800 CHECK BACKFLOW DEVICE Contractor DOWN TO EARTH LANDSCAPING 306 S VALLEY PORT ANGELES (360) 457 8555 BASE FEE PL -LAWN SPRNKLR BCKFLW PREV Paid Credited 57 00 00 00 00 57 00 00 on B 4).)e,c+e-4 a YoUe-d Re*urn+c Uvc1&f 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 clays after the work has commenced, or if required inspections have not been requested within t80 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 r ranting of a permit does not presume to give authority to violate or cancel the provisiors of any state or local w regulating construction or the performe'ice of construction. Plan Check Fee Valuation Date WA 98362 Due 2/24/09 00 00 00 V t Cc�]..t. Dare Print Name S -r 1itI of ContraciJr or ALL prized Agent 3c* f Cht X0_3 yell 3(&L) D 00 0 Extension 50 00 7 00 o Signats -c of Owner (if owner owIr.er` NAME OF PREMISES SERVICE ADDRESS LOCATION OF DEVICE. ASSEMBLY A 7 Initial Test Repairs Details Final Test COMMENTS Initial Test Repairs Final Test Cleaned Replaced I DateTime Tester Leaked Held at (psi Held at psi f e 1' 2 t i A l AIR GAP INSPECTION REQUIRED MINIMUM SEPARATION YES NO WHITE CUSTOMER COPY Backflow Assembly Test Report City of Port Angeles Public Works and Utilities Department Water/Wastewater Collection Division ti/ g C... Manufacturer Model IS THIS AN APPROVED ASSEMBLY? YES 0' IS ASSEMBLY INSTALLED CORRECTLY'' DATE OF INSTALLATION f' UNKNOWN 0 REDUCED PRESSURE PRINCIPLE ASSEMBLY DOUBLE CHECK VALVE ASSEMBLY CHECK VALVE #1 CHECK VALVE #2 Leaked Closed Tight Held at) psi Cleaned C Cleaned Replaced Replaced Closed Tight Held at 2 psi Signature Cert f sl i RELIEF VALVE Did Not Open Opened at 3 psi Butter YES NO Opened at se b p /t Size psi psi Line Pressure psi Held Backpressure #2 Shutoff Held Test Kit t YELLOW PURVEYOR COPY PINK TESTER COPY Assem. Received Serial No YES C RP RPDA DC ❑o" DCDA PVB Air Gap SVB AVB PVB /SVB AIR INLET Did Not Open Opened at psi TYPE OF HAZARD Official Use Only yr 9 CHECK VALVE Leaked Held at psi REPAIRS Di• Cleaned Replaced AIR INLET Opened at psi CHECK VALVE Held at psi BACK PRESSURE NO YES YES 0- NO YES 0"NO Relief Valve Exercised YES NO Passed Failed 7 D p 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 09 00000180 394860 2116 W 12TH ST 06 30 01 5 7 0300 0000 JUDITH A CARLSON PLUMBING REPAIR RS9 RESDNTL SINGLE FAMILY 2800 Application desc NEW IRRIGATION SYSTEM DOUBLE CHECK BACKFLOW DEVICE Owner Contractor JUDITH A CARLSON 2116 W 12TH ST PORT ANGELES 1 ^z1-1 to <S. T:Forms/Building Division/Building Permit WA 983635009 Date 2/24/09 DOWN TO EARTH LANDSCAPING 306 S VALLEY PORT ANGELES WA 98362 (360) 457 8555 Permit PLUMBING PERMIT Additional desc IRRIGATION BACKFLOW Permit pin number 142125 Permit Fee 57 00 Plan Check Fee 00 Issue Date 2/24/09 Valuation 0 Expiration Date 8/23/09 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 7 0000 EA PL -LAWN SPRNKLR BCKFLW PREV 7 00 Fee summary Charged Paid Credited Due Permit Fee Total 57 00 57 00 00 00 Plan Check Total 00 00 00 00 Grand Total 57 00 57 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. Q r�r 1.2A-414 Date Print Name Signat &/e of Contra r or Authorized Agent C, 9 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 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 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 (p -3 -04 Inspection Type II F Date PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Accepted by FINAL Date Accepted by Date Accepted By PROJECT ADDRESS Parcel Number Project Type Brief Description. Check all that apply New Construction Addition Remodel Repair Demolition Re -roof Heat System. Other BUILDING PERMIT CITY OF PORT ANGELES Attn Budding Permit Technician 321 E. Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant 17, (j 1f In lEckvik d A/ rna Property Owner C is p mt v Property Owner's Address I t c JZ Contractor Dmu9AT F C (,d Phone Contractor's Address 30( s Li et 11-c License .a Expires z 3 -zOte E -mail nr� is z 2 1, Date e2- 24 O Print Name okA v1 CIA M-s co T Forms /Building Division /Bldg Permit.doc 9 12- �S XResidential Multi- family 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 APPLICATION Print in ink Lot TOTAL VALUATION For City Use Only Date Received 02r Permit ,S0 Date Approved Phone J -9 -O 33 c>il Phone Zoning Commercial Industrial T bo ,A.to kf C J( -k htu lc e(rJ u.' House garage other tear off re -roof lay over one layer Heat pump wood burning stove gas fireplace pellet stove other v rtc►dTi o SVSic vtn Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq ft. 1st Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other 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 of bedrooms of full baths of half baths 2, $©O have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Signature L.. Q U CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 16783 d2 -- ;;)." 77 Port Angeles. Washlngton.mnn_n.....n.____............n..mm.m...m_m. 19.__..... In accordance with the City Ordinance to regulate the Installation, extension, or If.lpalr of elec- trical equipment In. on. or about any building or other structure In the City of Port (Angeles. per- mission is hereby granted to doelec~ work as listed below. , Address ..rf2I./~.n.n&.?::./n;?~.nmnn.~.hu..mu.mh..m Occupancy..nAd.".!'!m<!..m.nu...u.n..mn o~er ~w...,,~:.,r..'''i2;$~:...tf~:;;~ Tenant..umnmn.mm_nmmunmn.......muuunmm________n WIrIng Contractor mmm....'...nnunnmmmmmh.u..h.un....mm By..mmnmm..nn.h.nnhnhhnm...m.....hnhunnn.. Light outlet.....m.....?;/m?~......._..... servl~e. volts ...J5.~/.:?:..~.9. . " Type of Wiring: Receptacle Outlets :> No wires - Armored Cable .............__.__......h.... Dryer, KW ..nm.nm.i....~~~~...~~~~.....~~~~...~~::~.. Siz'e wires~~~:~f!Ztl;pZ~~~:: Non-Metallic ................................- / 1- ~ 00 A Knob & Tube................__................ Range, KW.........h....................... Main fu.e ..~...,.................... S Enclosure __........................__........... Water Heater: Y;s KW.n....n....n~.......n.nn...m...... ... Heat: KW............t.t...L4./J........... Type of wiring: Entrance Cable .__....____..__n............ MoZ;g;::..lt....:~:..~.~~:::........ Rigid Conduit .....m....................... Metallic Tubing ........................... Current transformers: No. & Size...................____...__........... Sec. NO............h..__...__.....__.______.....h... Sec. No. __.h........................................\. Sec. NO....h........................................ \. RIgid Conduit ............................... MetalUc Tubing ........................... ./ Raceway ........C..........-......---.- Circuit., Light....................................... G Utlllty............................................. ::ge ..:::::~~:::::::::::::::::::::::~:::::: Water Heater ....~.......__......__... Motor ..._............._________......__.......... ...., Dryer .........;.::t~............__.__....__....h..__ Furnace .........................'_......_........... ;J}< Total Load....h.......__.............. Sec. No.....__..........._.......................... Total ..........._.....__.....__......h..... Remarks: ..n~"~--:-!""l:::-.7:"m..hu?~.:.~!f,__..~:mm.nmmumnm.~nmn..mmmn~m.mnnm.m....m___.m ~ -' . ......__....._.nuhuh.n.h_h....__n_nnuu.u.u.u.uu......__.~d____..___hn.;.;.~."...n.:..u..nn_nn.nn.nn.u_nu.n.____.__unu..uu.n_un..... P~~t Fee Treas. ~~eit?';Y V ~.,. ~ ..hI $__n:-?t.P.!?mu__.__...__h__.. NO.--mmm..mm-0 By __.mm______[<:mmu;t!..~~..??:.~~-::.:?:..mm!l...,,-~ NOTICE-Current must not be turned on until CertJfPcate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. .--- NOTIFY TH~J,t.tSF!E0\OR BY PERMIT NUMBER WHEN READY FOR INSPECTION , ", ELECTRICAL PERMIT "--~-_. .,~_. "" .-. N? 16783 Address..................._.........................._.................................................................................._......"'bate:~._...~.__.._.._.._.::......._......_......_......... Owner .......n__.nn..n..............._......_.._......_......_.._...n.....h...............n.nnn....n...n......._.... Tenant.n....n.......__..................................nh_.hn..... WlringContractor..................................._......_.............._.............................................................By.............................................................. ~ NOTICE-;Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- ,_-' cealed due n.otice must be given the Inspector so that work may be inspected before concealment. . " \ 1M Olympic Printers, Inc.