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HomeMy WebLinkAbout816 1/2 S C St - Building ELECTRICAL PERMIT AND INSPECTION RECORD CITY OF PORT ANGELES 360-417-4735 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00001224 Date 10/23/07 843320 816 1/2 C ST 06-30-00-0-2-5880-0000- ELECTRICAL ONLY COMMUNITY SHOPPING DISTR o Owner Contractor SOMMERS, MIKE 816 1/2 S C ST PORT ANGELES WA 98362 ELECTRIC SERVICE 82 DRAPER RD PORT ANGELES (360) 452-6424 WA 98362 permi t . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL EL. SVC./ METER BASE TAMPER 113738 ELECTRIC SERVICE 34.00 10/23/07 4/20/08 Plan Check Fee Valuation .00 o ~I ~ Qty 1. 00 Unit Charge Per 34,0000 ECH EL-R OR RM REPAIR METER/MAST Extension 34.00 ~' Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 34.00 34.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 34.00 34.00 .00 .00 V\ ... ~ ~ SPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE OUGH - IN FINAL ,4fJ Re~?~ mpU~ IJ.etL 10 OMMENTS: ~e;e f pORT ~ ctO~~~ ,. ~ -- "'C~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Property Zoning . . . Application valuation Property owner Owner address . . . . 03-00000078 Date 2/07/03 816 1/2 S C ST 0630000258800000 ELECTRICAL ONLY Contractor o GOOCHY INVESTMENTS LLC 422 EAST FRONT STREET PORT ANGELES WA 98362 ( ) ELECTRIC SERVICE Permit Additional desc Permit Fee Issue Date Expiration Date ELECTRICAL ALTER RESIDENTIAL 57.10 2/07/03 8/06/03 Plan Check Fee Valuation .00 o Qty 1.00 2.00 Unit Charge Per 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS 5.2000 ECH EL-R OR RM ALT ADDNT CIRCUITS Extension 46.70 10.40 ~ :-.:: ~ .JI\ ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.10 57.10 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.10 57.10 .00 .00 , \1\ ~ 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 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. ~ Signature of Owner (if owner is builder) Date T:\PLANNlNG\FORMS\1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE 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 NO FOUNDATION: FOOTINGS I WALLS I FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL I DATE I YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 1/...-19-0.3 K; ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERJNG 417-4807 PW / ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\1102.15 [4/2002] ~ ?ORT ~ 8'!'o~~~ ,. ...~ ~ 'ttO:~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 03-00000057 Date 1/28/03 Property Address 816 1/2 S C ST~ ASSESSOR PARCEL NUMBER: 0630000258800000 Application description RES REMODEL Property Zoning . . . Application valuation 3500 Property owner .-=t GOOCHY INVESTMENTS LLC Owner address . . . . 422 EAST FRONT STREET PORT ANGELES WA 98362 ( ) Contractor . . . . . . . . . OWNER Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT -RESIDENTIAL 120.75 1/28/03 7/27/03 Plan Check Fee Valuation .00 3500 Qty Unit Charge Per Extension 92.75 28.00 BASE FEE 2.00 14.0000 THOU BL-2001-25K (14 PER K) 54.00 1/28/03 7/27/03 Plan Check Fee Valuation .00 o ro <() ~ r-J Permit Additional desc Permit Fee Issue Date Expiration Date PLUMBING PERMIT Qty Unit Charge Per Extension 47.00 7.00 BASE FEE 1.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP Other Fees STATE SURCHARGE 4.50 U' Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 174.75 174.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 179.25 179.25 .00 .00 o \[\ 1" 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 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. ()N FfLc Signature of Owner (If owner is builder) Date Signature of Contractor or AuthOrized Agent Date T \PLANNING\FORMS\II02 15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULA TE 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 NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN l -?-'t-O) J;:::;-J- WATER LINE GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I I . FRAMING JOISTS 1 GIRDERS SHEAR WALL WALLS 1 ROOF 1 CEILING i -7-'I'-b3 ? EI-I DRYWALL T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING 1!J.'-S-b'=S L~H MECHANICAL HEAT PUMP WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engmeenng DIVIsIon) SEPARATE PERMIT #'s WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA P ARKING/LIGHTING ESA LANDSCAPING SHORELINE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE 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 4 17-4750 PLANNING DEPT BUILDING 417-4815 (!) .'):(") <1 -()'2. JQ\J BUILDING T.\PLANNING\FORMS\1102.15 [4/2002] -:% liq ,25' BUILDING PERMIT - APPLICATION ? 4") FOR OFFICIAL USE ONLY Date Rec I-~'" D~ PermIt #. 7 , "- Date Approved ~ '/ -/")~ Date Issued . .- The BUlldmg Permit ApplzcatlOn must be filled out completely. Please type or print in ink. If you have any questions, please call 417-4815 VUuhae \ R. ~t1W1~($ Sfrm~ Address: ~ ',,- ':i,.~ City: "Z1- z: , -I- ielW< ArchitectlEngineer: . 'Sfrnl& Applicant or Agent: Phone: 1{~2 -22(P g Owner: / PaR-I f4,J7cks Phone: LJ <tJ " Phone: Zip: 18?1z.. qfi2 - 22? f{ Contractor License #: Exp: Phone: Address: {JIb {~ ~. Block: City: ~, Zip: ZONING: PROJECT ADDRESS: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Billing Address: q 21. f., T~vr Credit Card #: SubdIVision: Credit Card Holder Name: /(/ City: PtJ~ lHJ re (tJ ~ t(/ N, Exp. Date: VISA r gJ~L- MC TYPE OF WORK: riYResIdentIal 0 New Constr. o MuJtI-farmly 0 AddItIon o Commercial 0 Remodel o RepaIr ORe-roof o Move o DemolItIon o SIgn o Wood-stove o Garage o Deck o SIZEN ALUATION: SF. @ $ /SF. =.$ SF.@$ /SF =$ SF. @ $ /SF. = $" TOTAL VALUATION $ ?J.S'tV q<L I BRIEF DESCRIPTION OF THE PROJECT: IAJ/ ffL(l}!L R 'i.tJlfRm it./5 COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: % /sq. ft. = TOTAL LOT COVERAGE: APPROVALS: PLAN BLDG. DPW FIRE ESA/Wetland(s): 0 Yes 0 No SEPA ChecklIst required? 0 Yes 0 No Other: OTHER BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be filled out completely to be accepted for review. The BuIlding Division can proVIde you with more detaIled InformatIon on the applIcation and plan subnuttal requirements. Your completed application, SIte plan (for addItIons) and budding construction plans are to be subnutted to the BUIldmg DivisIOn. No. of Stories: Lot SIze: EXlstmg Lot Coverage: PLANNING USE ONLY: Notes: % Lot Coverage: /sq. ft. + Proposed Lot Coverage: /sq. ft. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applIcant. Tills figure wdl 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 : Your plan check fee is due at the time the buIlding perrmt application and constructIon plans are submitted. All other permit fees are due at the tIme ofperrmt Issuance. EXPIRATION OF PLAN REVIEW: Ifno permit IS Issued wIthm180 days of the date of applicatIOn, tills application will expire. The Buildmg Official can extend the tune for actIon by the applIcant up to 180 days upon written request by the applIcant (see SectIon 107.4 of the Umform Bmlding Code, current edItIon). No application can be extended more than once. I hereby certify that J have read and examined thiS applzcatlOn and know the same to be true and correct, and J am authOrized to apply for this permit J understand It is not the City's legal responsibility to determine what permIts are required,' It remazns the applicant's responsibility to determine what permits are required and to obtain such Applicant: till: U R. ~ Date: \- ~j.o3 T \FORMS\APPS\Bulldmgpermlt REQUEST: Date / - z,f'-O.3 CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . Received by cJ:? (phone. person) cS~ c2g::r Time Location of Work to be inspected g/ h Vz.,.. Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle a opriate one): Sewer Foundatio Framing ChimneY~b~ Final I ~\ ~d /(2fJu9H INSPECTION NOTES: Inspected: Date (- 2--fr <o-{) 3 Remarks: Phon~ NO'-%~ Permit No. Sewer Excav. Other Time By RESTORATION REQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC D Other D Repaired by City [] Repaired by Permittee D No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) ~TRI=I=T ~IIPI=RINTI=NnI=NT lnA TEl CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . INSPECTION REPORT. . ------ REQUEST: ') F=" ~~ Date ~p-'~ ~ u:5 Time . . .~. Received by C/) (phone, person) I \" -~ \", ~t/ )1 ....~ I "-~- j ~ /? // fY ,!; Location of Work to be inspected /'\ I ~ ~ Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. 57 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other -72J:::i1-i(l INSPECTION NOTES: c:-A (c?- r'" T~ Inspected: Date ,,?~- ~-,~ c- ~_:::' _ :"J: Remarks: Time By ~ /I . /" I: (( ) , -= ,~/ '\ RESTORATION REQUIRED . . . . .. YES NO -~~ ~ ~>~7}.>~_ ,--{",," \---/'/ '(~ , C' ~ ;7 .-/ P/J...---:::-- -( !/~'----- , - SURFACE RESTORATION: SURFACE TYPE: D Unimproved DGravel o Asphalt OPCC o Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) ~TRJ:J:T ~I IPJ:RINTJ:NnJ:NT tnATEI CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 5-I1-0~ Time Received by sF Serson) INSPECTION NOTES: d {:f.e- yo Inspected: Date ~ -q -6? Remarks: Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No..f6/ - :l-r?/8 Type of Inspection (circle appropriate one): Permit No. (!) S7 Sewer Foundation Framing Chimney Plumbine Sewer Excav. Other ~ fl1J ~ flIt: b 1M e~' II il t Time By Rl/ RESTORATION REQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC D Other D Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) ~TR~~T ~IIP~RINT~Nn~NT mATEI CITY OF PORT ANGELES LIGHT DEPARTMENT 'i' N~ 17670 ELECTRICAL PERMIT /~. 30' Port Angeles. Washlngton........................_....................._.............. , In accordance with the City Ordinance to regulate the installation. extension. or repair of elec- trical equipment In, on, or about any building or other structure in the City of Port Angeles. per- J:::: 1~.g2~r:~7&:b~.::~:::..~.~.~~..~~.~~~.~~..~~.IO:~cupancy..dt~~.Ft............................... I ,IU 'J, ~::~~.~:~:~;~;::::::f!k~::~;~:;:::0::::..n~~::~~;:::::::::::::::.:...~::::::::::=::::::::::::::::==::::::::::::::::::: L~ght outlets...................................~..... Service. vo1ts/~.~...~..:~.::...... Type or Wiring: Receptacle Outlets.........._...._..___._.____... No. wires .....n~_n..........n._~........ Armored Cable .............................. Pd 0(/ Size wires.........__....-........._.............. '--9;; Main fuse ....~:.~(?~..!.1~....._....._. '" Enclosure __._.~..___m__..m_...m.m____ Dryer, KW _...uu.______...........hh_...._.. Rhnge, KW.___....___n_____n.n_____..._____...__. I rt:~~....ter:..nm....m.......m..mn Ifeat: KW........................nn.................__.__. , Motors: size, volts and phase: Total Load..n__....______......._._... Type of wiring: Entrance Cable ..n Rigid Conduit ..._...._.....___.............. Metallic Tubing mm._....__... Current transformers: No. &.... Size............._................_........ Ser. NO....n._n_.......n_......n_n.......nn.._ Ser. No. n.._.nn__......n__..__nn__....__....... Ser. No............_................................. Ser. No.................._..:.....-...............__ ,;/ 19........ Non.Metalllc ................................. Knob & Tube.................................. Rigid Conduit ............................... Metallic Tubing .....................___... Raceway ............._._..............._.__._ Circuits. Light.................___.__.___..___..._.. Utlllty ............................................. Heat ---............-.---.--..-..........-.._...... Range ....._............._...n......_............. Water Heater n..n___m................... Motor ..._n....._..nn___.n_.......n.......... Dryer ...........____......_...._____...___._._.....__ Furnace ...nn..hn............'~_n__.m....m___ Remarks: nn._<-::!J..):!::_(,..-'=..!::::.....::::-+.en1.d.!..~~.~............................_......__.......__...._....................... Total ............._____..................... _;::;~.;~:....n.-..hn...h.n.......;~:~:.n~:~~;~~.....-..................n---h---..~~y~~l---.2.'.......... $____....__..................______.... No........................_... By n:._'-:..L.'-..."..........:::.:::L:::......{f!..::~..~ r~~~ NOTICE-Current must not be turned on until Certificate of Inspection 'has been, issued. It work Is to be con- cealed due noUce must be given the Inspector so that work may be inspected. before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WI'fEN READY FOR INSPECTION ,j/,~ ELECTRICAL PERMIT N~ 17670 .r! -. I Address....___.__...____.._..".;-............................................................................................._.....__..___....Date..._.....__.._.._.._.........._......_......_....___.. Owner ..n_..nn......__..n..._........___...._n_..nn_......____...........................__...___........n.....____n.n Tenant..............nnnnn_...n__n__n_nn...__._...._..._......... Wiring Contractor ....._........__........____......._......_.............._..............._...........................................__ By ._____......._................................................ NOTICE-Current must not be turned on until Certlflcate ot 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. . ,. 1M Olympic Printers, Inc. ~ ELECTRICAL PERMIT APPLICATION ~=CI^LI'~ t"1-o ~ ......., 7 Dale App..uvc:u: Dareh.suC1J: The Electrical Permit Application must be filled out comoletelv. Please type or reprint In ink. II you have any questions, please call (360. 417-4735 Fax number: (360) 417-4711 ~ z.1 --- Owner or Elec. Contractor Agent..tJ 0 f ,tt ~~r\J {~.P Property Owner fI1ilG CO..,...Lr}" Address: ~ ")'"2_ p. ~ovJ--- Electrical Contractor: E~+\',c, ~\I:"" Jk/ Address: h fk~ if t'tJ,. RJ INSTALLATION WIRED BY: 0 OWNER ,I JrC ". , Phone: '-tC;'Y -<<:'4'~ Fax: Phone: S,. <::{ .,............ i.(C;?- 2 ') {r,~ . Zip: 9K? 0 "L Phone: '152, <:"f 1"1- Zip: <J~3 b-., City:YOri 8~".... I" ~'t' Ucense #: <:!: '1:.. ? (':W\o\. Exp: City:~V'? A",~(<" o ELECTRICAL CONTRACTOR Credit Ca,d Holde, Name: Exp.. Date' Zip: VISA: Billing Address: City: C,edit Cal'd Numbe,: MC:_ PROJECT ADDRESS: r" K l (0 '~ \...--------~ s c..... TYPE OF WORK: Check all that apply: 0 New o Alteration/Addition ~eSidental 0 Multi-family" .. 0 Commercial 0 Mobile Home Sq. Ft o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic p.u~p D Low Voltage 0 Telecom. Number of Circuits added or altered: ~ .. -' .' , " i-t-vvu&) OSi DESCRIPTION OF THE ELECTRICAL PROJECT: ..'~.. . ;4 iff:, -;10 +(;S. u> ct2-) - Electrical Heat Load Additions --'! '-57.\0.' Service Information o Baseboard o Furnace o Heat Pump E[Fan-Wall _YJN _YJN ~~ o Overhead Service o Temp Service o Underground Service Vollage: fii'1O/;z.-o Phase: 1 I 0 3 Service Size: 7,&-0 Feeder Size: PAMC 14.05.060(6): For industrial, commercial, & residential projects larger than a duplex, a one ..line drawing of the Electrical Service I Feeders, building size (sq. ft.), load calculations, and the type & of conductors and/or raceway is required and shall accompany the Electrical Permit application. PW-9019 I hereby certify that I have read and examined this application and know that same to be true and correct, and I ~ authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants responsibility to determine what permits are required and to obtain such. ot - 4 ~ Card H~~~nature: Date: (j3NI j~) oate:I/:l-'S' JV3 frrJ ~tDl/Jq,IJ'3 Owner or Elec. Cant., Signature: (Uca- t. 2.~. e.~ Job wired by cf.-""~_ $~~~ ,,'E!iC ~~.; t-~;;.o;t" ~ntractor 0 Owner ELECTRICAL WORK PERMIT APPLICATION I Installation description, ________ o Commercial IJI...1fesidential E'aL~o~fLt~e purc~r'smailing City Date Expires o New o Altered/Addition Te'ePtf~1:~ t, '4 \.,\of 3"'"L ~ vn-e1tv (' -<....-Fc.....L,- Premises owner's name r. M\\~ ~m(!.-s Address of inspection X I ~ '1'2- PA= <; '~.: City rhone number to schedule inspection: Owner as defined by.RCIY./9.28.261:(l) Owner will occupy the structure for two year.)' ajier this electrical permit is finulized. (2) Owner is required Iv IJjre an dec.'trim! contractor if above said property is for sale. rent or lease. After reading the above statement, I hereby certify that 1 am the owner of the above named property or a licensed electrical contractor. [ am making the electrical instal- lation 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. or owner el ctrica ontractor or electrical administrator o Cash 0 Check # ~ar~r:dltCard _~ i~~~ _,D~scove~_ x Date: 10 't-) Expiration Date of card Inspection fee $ Ele rical Load Additions and or subtractions NO LOAD CHANGES o Baseboard KW o Furnace KW o Heat Pump Ton LAR o Fan-Wall KW Service Information o Overhead Service o Temp Service o Underground Service Voltage PhaseD 10 3 Service Size: __ Feeder Size: SAME DAY INSPECTION, Cc\LL BEFORE 7:00 AM 360-417-4735 ROUGH-tN Dare Approved Ill' THERMOSTAT Dale Approved By ;' DITCH "- Dale Approved By SERVICE Dale Approved By FEEDER Dale Approved By Approved By Inspection Date Area, Building or Equipment Inspected Action Taken Electrical Inspector 2 007