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Home My WebLink About1137 W 16th St - Building_r' Owner Permit Fee Total Plan Check Total Grand Total Date Print Name T:FormsBuilding DivisionBuilding Permit 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 Application desc RE PIPE VENTING ON PELLET STOVE ANDREW AND NICOLE HARRIS 1137 W 16TH ST PORT ANGELES (360) 460 1897 WA 98363 09 00001167 893818 1137 W 16TH ST 06 30 00 0 4 3136 0000 ANDREW AND NICOLE HARRIS MECHANICAL APPL PERMIT RS7 RESDNTL SINGLE FAMILY 807 Contractor Permit MECHANICAL PERMIT Additional desc RE PIPE PELLET STOVE VENTING Permit pin number 156307 Permit Fee 60 65 Issue Date 11/09/09 Valuation Expiration Date 5/08/10 Qty Unit Charge Per 1 00 10 6500 EA Fee summary Charged 60 65 00 60 65 PELLET HEAT CO 230 EAST 1ST SUITE C PORT ANGELES WA 98362 (360) 457 4406 BASE FEE ME STOVE /FIREPLACE /MISC APP Paid Credited 60 65 00 60 65 Signature of Plan Check Fee 00 00 00 A Date 11/09/09 Due 00 0 Extension 50 00 10 65 00 00 00 re,& \v"' 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 orrect. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The :ranting of a .4 it does not presume to gt} rity to violate or cancel the provisions of any state or local law regulating construction or the perfo an e of co 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 FINAL Date MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. T.Forms /Building Division /Building Permit FINAL Date Accepted by Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE —20 Inspection Type Date Accepted By Electrical 417 -4735 I �y Construction R.W PW Engineering 417 -4831 I Fire 417 -4653 Planning 417 -4750 Building 417 -4815 t X 4 c) e I7-- k,b 0 0 L p\ �Fs 'l Applicant or Agent ik Co Owner �rlrP, -/,/2. A i s Owner's Address __//1_7 Ale s.4 c, Co ntractor /Engineer .N.40 Contractor/Engineer's Address z3 e, License# 1= L do iv. 5 PROJECT ADDRESS `I! 3 7 141 S Parcel Number 06 3 6000 iv 3 3 Ammo Project Tvoe Brief Des Check all that apply New Construction Addition Remodel Repair Re -roof Demolition. Sign Heat System Other Floor Areas Basement Floor 2 ',r 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 Total footprint of structures Max height of proposed structures Will a lawn sprinkler system he installed? Will a fire sprinkler system be installed? criotion. Ix/Residential f wall- mounted projecting o freestanding awning other Total sign area sa ft. Maximum allowed sign area sa. ft. o Heat pump wood burning stove gas fireplace Xpellet stove other 2 r?ifee.�/ VG,... +.,.a an/ s. 4-p wss_ ,Fran. )trrt7 Tch iisrt✓t-AL Existing (sq. ft.) Posed (sq. ft.) /L I� I F 11 j j H j v zuu9 sq ft. Lot size Fsr s -t S> Commercial ft. Occupancy group Occupant load Construction type L 1A Phone ?L6 -,'s 7 y LI Phone 3 4 a -yZA .1 1 .Phone 3Ga S/c/a/ Expires 7 57 Lot Zoning Multi- family Industrial per sq ft. TOTAL VALUATION 8'U7 'Er sq. ft. Lot coverage of bedrooms of full baths of half baths I have read and completed this application and know it to he true and correct. I am authorized to apply for this permit and understand that it is my re punsibility to determine what permits are required and to obtain perm,is ter orking on projecfQ Date ti ,r. 6 P int Name 1?1 ci, .L. p.cf z /L Signatur T F i ns /Buiidi g Divisio, i_'•dy Pert lit 4pp1. -2006 Code dot:: For City Use Only Date Received 't —Dq. Permit oq— I I (n 7 Date Approved .... CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 F. ASI 5TIt STREET. PORT ANGELES. WA 98362 ELECTRICAL PERMIT ISSUED: 6/17/2002 PERMIT NO 7703 OWNER/APPLICANT PROPERTY LOCATION N ICOLE & ANDREW HARRIS 1137 16TH ST W 1137 W 16TH Lot: 11&12 Block: 431 [] Long Legal Port Angeles, WA 98363 360/457-2778 Subdivision: TPA T: S: Parcel No: 063000043136000 CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 360/000-0000 PROJECT INFO Project Type: RES. MISC. Project Value: $0.00 Occupancy Type: RESIDENTIAL Construction Type: Occupancy Group: Zoning Use: RS7 Electrical Heat: [] Baseboard 0 KW [] Riser [] Underground Service [] Furnace 0 KW [] Overhead Service Voltage: 0 [] Heat Pump 0 KW [] TempService Phase: [] 1 [] [] Fan Wall 0 KW Service Size: 0 Feeder Size: 20 PROJECT NOTES ADD CIRCUITS FOR 2ND STORY ADDITION FEES ASSESSMENT Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $45.50 Temp Service: $0.00 Misc Fee: $0.00 TOTAL FEE: $45.50 AMOUNT PAID: $45.50 BALANCE DUE $0.00 : COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVEI~ INSULATE OR CONCEAL ANY I4zORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE /~-~ .~ DITCH ROUGH-IN/COVER FINAL I/,o/~ ~/~_ I I z~ -~'~ /~/~ GENERAL COMMENTS: .... CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUiLDiNG DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ~11_1~11~1~.~ I"I~:~IYll I ISSUED: 4/25/2002 PERMIT NO: 13348 OWNER/APPLICANT PROPERTY LOCATION 1137 16TH ST W NICOLE & ANDREW HARRIS 1137W16TH Lot: 11&12 Port Angeles, WA 98363 Block: 431 [] Long Legal 360/457-2778 Subdivision: TPA T: S: Parcel No: 063000043136000 CONTRACTOR ARCHITECT ON SITE CONSTRUCTION N/A 262 GOLDFINCH PORT ANGELES, WA 98363-0000 , 98360-0000 360/928-3200 360/000-0000 PROJECT INFO Project Value: $10,000.00 SFD Units: 0 Commercial: 0 Project Type: DORMERS SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 MFD Units: 0 Occupancy Group: Construction Type: MFD SQ FT: 0 Zoning Use: RS7 PROJECT NOTES ADD SECOND STORY ADDITION 400 SQ. FT. RECEIPT# FEES ASSESSMENT Building Permit: $181.25 Misc Fee 1: $0.00 Plan Check: $72.50 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: $258.25 Plumbing: $0.00 AMOUNT PAID: $258.25 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 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 certi~ 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 haw regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1102.15 [4/2002] 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 IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE l~'~ '~d ~/ INSPECTION TYPE I DATE I ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL CEILING FRAMING JOISTS / GIRDERS BUILDING 41%4815 [ ~- ~-I --~'~ J-~ ~'[~ BUILDING FOROFFIC L EONLY: BUILDING PERMIT- APPLICATION Permit#: The Building Permit application must be filled out completely. Please type or print in ink. If you have any questions, please call 41%4815 Applicant or Agent: 6~ g~'{'~ ~'~'dl-, - C~~ ~Phone: ~- ~O Owner: ~60(~ ~ A~V~ d~C~ 5 Phone: ~SV- ~chitecffEngineer: Phone: Address: ~ ~~¢C, City:~ ~eJ~> Zip: PROJECT ~D~SS: i(gW ~e~ {&~ ZONING: LEGAL DESCmPTION: Lot: t t Block: q~ I Subdivision: CL~L~ CO~TY P~CEL NUMBER: ~ OO~o ~Credit Card Holder Name: Billing Address: City: ~ ~ 00o0 Credit Card g: Exp. Date: ~SA MC T~E OF WO~: SIZE~UATION~ ~ ~ Residential D NewConsm D Re-roof ~ Wood-stove ~ SF.~$ ~ /SF.=$'~1~I 0OO~~ ~ Multi-h~ly D Addition D Move ~ G~age SF. ~ $. /SF. = $ ~ Comercial ~ Remodel D Demolition D Deck SF. ~ $. /SF. = $ Repair D Sign D TOTAL VALUATION $ COMMERCI~SIDENTI~: Occupancy Group: ~ Occupant Load: Cons~ction T~: No. of Stories: ~ Lot Size: ~O * k { OO ' % Lot Coverage: Existing Lot Coverage: /sq. fl. + Proposed Lot Coverage: /sq. ~. = TOTAL LOT COVE~GE: ./sq. PLANING USE ONLY: ~PROV~S: PL~ Notes: BLDG. DPW F~ ES~etland(s): ~ Yes ~ No SEPA Checklist req~red? ~ Yes ~ No O~er: OTHER B~LDING PE~IT APPLICA~ON S~MITT~: Your application and site plan must be filled out completely to be accepted for revi~. The Building Division c~ provide you with more detailed ~fomtion on ~e application ~d plan sub~Ral requkements. Yo~ co~leted application, site plan (for additions) and build~g com~ction plans are to be subdued to the Building Division. V~UATION OF CONSTRUCTION: In all eases, a valuation amount must be entered by ~e applic~t. This fig~e ~11 be reviewed and ~y be revised by the Building Division to comply with cu~ent fee schedules. Contact the Pe~t Coord~ator at 417-4815 for assistance. PL~ CHECK FEE: Your plan check fee is due at ~e time the building pemt application and cons~ction plans are subdued. All o~er pe~t fees are due at the t~e ofpe~t issuance. EXPIATION OF PL~ ~VIEW: If no pemt is issued ~in 180 days of~e date of application, ~s~pplication will expire. The Build~g Official can extend the t~e for action by the applic~t up to 180 days upon ~i~en request by the applic~t (see Section 107.4 of · e Unifom Building Code, c~ent edition). No application can be extended more t~n once. I hereby cert~ that [ have read and examined this application and know the same to be ~ue and correct, and I am authorized to app&for this permit. I understand it is not the Ci~5 legal responsibili~ to determine what permits are required; it remains the applicant5 T:WORMS~PS~uildin~emitresp°nsibili~t° determine what permits are required and tOApplicant:Obtain sV}~~ ~ ~-- Date: 0 CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~-~ - ~ ~ ~) '~-'~ Time Received by /~ L phone, person) Location of Work to be inspected //37 LX-'~ I/? ~ Name of person requesting inspection C~,v' ~'~ Z~'~-'-~_ 777~ Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation~ramlng Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date ~'~ ~ ~(~)'~- Time By Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved r-}Gravel r-]Asphalt I--~PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ~/~ ........... INSPECTION REPORT ........... REQUEST: · ~///~ _ Date (l//~/l~"z.~ Time c~,~--d) //~,l~ Receivedby ~-~ (pho~ Location of Work to be inspected /_/~ ~ ~-- / / ~ ? ~] ?~ Name of person requesting inspection _//r-I <~ (~'~'~./~ ~ t'- Address of person requesting inspection Phone No. Permit No. / '~x/'~ Type of Inspection (~priate one): "'~'~ r Sewer Foundatio ~ ~'~ himney P umbing~., Final .' Sews Excav. Other INSPECTION NOTES: i?~ ~7...~ ~ 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} CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Appl~cat~on Number Application pin number property Address ASSESSOR PARCEL NUMBER: Application type description Subdiv~sion Name Property Use property Zoning . . . Application valuation 5/23/05 05-00000390 Date 980780 1137 W 16TH ST 06-30-00-0-4-3136-0000- RE-ROOF RS7 RESDNTL SINGLE FAMILY 2725 Owner Contractor ANDREW J/NICOLE S HARRIS 786, 'MARSHALL RD SEQUIM WA 98382 o T M SERVICES 309 S ENNIS PORT ANGELES (360) 417-0124 WA 98362 nNAit5Q ~/-r(CJs S~ Permit BUILDING PERMIT - NO PR FEE Additional desc TEAR-OFF, FELT, COMP Permit pin number 49767 Permit Fee 106.75 Plan Check Fee Issue Date 5/23/05 valuation Expiration Date 11/19/05 Qty Unit Charge Per BASE FEE 1.00 14.0000 THOU BL-2001-25K (14 PER K) .00 2725 Extension 92.75 14.00 Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 106.75 106.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 111.25 111.25 .00 .00 Separate Permits are required for electncal 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 penod 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 provisions of laws and ordInances governing thiS ty of work Will be complied with whether specified hereIn or not The granting of a permit does not presume to give aut nty t t or cancel the rovisions of any state or local law regulating construction or the performance of construcf(' ~ ~ ignature of Contractor or Signature of Owner (If owner IS bUilder) Date T \Pohcles\1102_15 bUIldIng permIt InspectIOn record05 wpd [114/2005] -- - \}J ~ ! ! ~ , ~ ~ ~r r 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 UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION FOOTINGS 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 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR / CEILING I I MECHANICAL HEAT PUMP / FURNACE / DUCTS GAS LINE WOOD STOVE / PELLET 1 CillMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKlRTING PLANNING DEPT SEPARATE PERMIT #'s SEPA PARKING/LIGHTING ESA LANDSCAPING SHORELINE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R W / PW/ CONSTRUCTION - R W ENGINEERlNG 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 I PLANNING DEPT , BUILDING 417-4815 vii /0'7 J tf.., BUILDING T IPohcles\1102_15 bUlldmg penn It mspecllon record05 wpd [1/4/2005] PREPARED 6/07/05, 12 58 19 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 1137 W 16TH ST o T M SERVICES ANDREW J/NICOLE S HARRIS 06-30-00-0-4-3136-0000- 05-00000390 RE-ROOF SUBDIV PHONE PHONE (360) 417-0124 PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL99 01 :V07/05 ~ ~ "'"\\ Or- \ \ \ -, BUILDING FINAL 06/07/2005 11 47 AM DYASUMUR MIKE 775-0863 12 6/07/05 -------------------------------------- COMMENTS AND NOTES -------------------------------------- ar:M SCECJ(o/ICPS I%e 1<<>ofing cprofessionaV' 309 Soutli tEnnis (fun jlngefes 'Wjl. 98362 Offia (360) 417-0124 Ce{{ (360) 775-0863 Contractor ~eistration: OTMSPS*963(j)(JJ Licensed- Insurea-rBorufea 71iis proposa( specifUa(Cy for. drew & Nicole Harris Ref # 131 Invoice# 050205-131-001* 5/3/05 Estimated Start Date Phone: 457-2778 Date 5/1/05 1.) Remove existing roof. 3.) Furnlsh and Install the followmg roofing matenal according to manufacture spec's. Elk 30 Year Laminate Color: Options: The followmg are included in Total Bld Pnce: a.) 30 lb. Felt underlayment. b.) Cora-Vent ridge venting system. c.) New Fascia Boards on front porch. t: Tata! 5Uf price wif( oe aue at tne compfetion of specifiea wort ([of tlie a60w wcn{to 6e compfetetf in. a profcsSW7Ul[ and tmzefy 11Ulnner far a sum of: iJwo iJJiousallcfSe'lJen .1funcfrecf'Twenty ~n)e (Dor(ars P(us 1'J)S5"T 'You are liereGy autlion.zed to provufe a([ 11UltenaIs and !:aGar requIred to compfete tlie warllmentwned m tlie aGow proposa[ as spect.fied and we agree to tlie tenns of payment. X X X X Customer Stgnature q)atc %ta( {j)uf Prue: ,4" Preparu[ by: 1," ~ idUlC[tE. Scfunitt OP.M fProjcct :MatUlfJcr (j)ate "'pfease 110te t/iat due to tfle jfuctuatlol1s 111 tfle marfist t/its proposa[ts 0116' vaEu{for tfl1rty d'ays after date of estimate.'" . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT PERMIT NO. 1It)/.3 DATE c~ -9..q3 Installed By: o READY FOR INSPECTION License Number: WILL CALL FOR INSPECTION Phone: Site Address: Owner/Busines . Phone: Owner/Business Address: Sq. Ft. )! RESIDENTIAL o COMMERCIAL o BASEBOARD KW _ o FURNACE KW _ o FAN/WALL KW _ o HEAT PUMP KW_ o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION o REMODEL )( ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: o SINGLE PHASE o THREE PHASE SERVICE SIZE AMPS o SIGN o SPECIAL EQUIPMENT (LIST BELOW) ttfd~~/.mJ.z ~./A1~ Details/Description: . W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: .D CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ~Final O.K. Site Address: Installer: Permit/Receipt No. "It/ New Meters Date: 3-1-93 . 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 Per It. HONE 457-0411, EXT. 224. NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ ,;2{), 00 Permit Fee WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept.. Bottom: City Hall OLYMPIC PRINTERS INC Application Number . . . . . 23-00000098 Date 1/31/23 Application pin number . . . 303916 Property Address . . . . . . 1137 W 16TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-4-3136-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Heat pump ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CHANDRA M JOHNSON BLACK DIAMOND ELECTRICAL CONTR 1137 W 16TH ST 502 BLACK DIAMOND RD PORT ANGELES WA 98363 PORT ANGELES WA 98363 (360) 460-4235 (360) 565-1035 ---------------------------------------------------------------------------- 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 1/30/23,10:57:18 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:23-00000098 1137 W 16TH 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 NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 11/16/2023 23-98 TAP OWNER CONTRACTOR Black Diamond Electric PROJECT ADDRESS 1137 W 16th St