HomeMy WebLinkAbout1021 Fountain St - BuildingSite Address: /O&-
FOR
INSPECION
471/X-1 /READY FOR INSPECTION INSPECTION
Installed By:
1‘,2 S
e G
License Number:
Phone:
Owner/Business:
n C.
l
Phone:
Owner /Business Address:
Sq. Ft.
Residential
Heat KW (0
Baseboard Furnace /Boiler
Heatpump Other
Commercial /Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
Details /Description:
W.S. No. Service
Capacity: O.K. Not O.K.
Ditch inspection O.K.
-91/4 Rough -in /cover O.K.
*AK O.K. to connect service
Final O.K.
Site Address:
I -7' �G- a.�.,.
Installer:
Permit /Receipt No.
3O9
New Meters
Date:
S 2& 9/
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspect 'n Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 1llpr EXT. 224.
yo
Amount paid
WHITE file by address YELLOW file by number PINK Top: Eng, Bottom: Customer GREEN Top: Inspector, Bottom: City Hall
OLYMPIC PRINTERS. INC.
Inspector
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
New Construction
Remodel
Service update /alter /repair
Add /alter circuits
Auxiliary power
(list below)
Special equipment
(list below)
Overhead
Undergroun
Voltage TA
10 3 .1?l
Service size C7 Amps
Temporary
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
PERMIT NO.
DATE S ZQ '—Q�
Size Date Hold for: Easement Letter
Comments
Signed up for service /meter
Meter Department notified for installation
Fire Department notified of inspection
Plan Review approved /pending
J
Fairmount Restaurant
1121 Fountain
Port Angeles, WA 983(,3
The City is changing; he current ;address 1 121 Fountain which is the Fairmount Restaurant
address to 1 127 H'vv 101 West.
This change will help facilitate 911 response time.
Address numbers must hen minimum of(," in height, contrasting in color and visible from the
s(rcel.
II' you have questions please contact me at 3(,10 417-4712.
Sincerely, I Vess
Permit Coordinator
Copy to: I);tn i \IcKecn. Fire (:hie(
Utility billing, ludo Il;unilton
I:.nginecring- Gary Kcnn r1hy
I'rn('om. Naomi \Nu
L'lallain ('ounly, 111th'. I iv. llcvcrly Nelson
321 EAST FIFTH STREET PO 80X 1 150 PORT ANGELES, WA 98362-3206
PHONE: 360 117-4750 FAX. 3GO-417 -471 I TTY: 360-417-4645
E- MAIL: PLANNING (TCI.I'ORT- ANGELES.WA.US OR PERMITS@C1.PORT- ANGELES.WA.US
city aP CITY OF PORT ANGELES PUBLIC WORKS
BUILDING DIi� YSION PERMIT APPLICATION
0 0834 3
Date Received e ZL Date Issued 6 2 9,S
D
5
c
Na C
Address
�i(
Phone
Lic. No
J
Contractor�/fi/l,�� ,t aze e
?Z g_.;dc'•.�
A1_
1O Mt= 3 x S
Arch Engr.
1,�_�./ a
Class of Work: N Addition I• A teration Repair Move molition
Description of Work
Type of Permit:
Building
Plumbing Contractor
Mt)
Valuation 1. Z
No.
Fixture Type
Fee
N.
Water Closet
Lavatory
Permit Fee 6..s e}
athtub
Plan Check Fce Recci pt
Sho cr
Invesli_ation Fec
Kitchen ink
Other "'7�', b
Dis{loser
Total 6 Receipt N 2'
Floor Drain F Sirk
Clothes Washer
But in F
Occii anc Gmu
Urinal
Occupant Load No. of Stories
Water Heater
T c of Construction
Drinking F; :::ntain
ccu inc Permit Issued
Lawn Sprinkler
Vacuum Breaker
J
Legal Description: Lot /6
Block
Soar Panels
Subdivision
Other
dal
)..and Usc Zone 41.,
Sub Total
Lot Arca
P;rmii Fcc
Lot Coverage Sq. Ft. j
Receipt 11 Total
I..IS Contractor
Mechanical Contractor
Sign•Ty c
t
Nn. Type of G.yuipmell: Fec
Illumina
I'
Elc
Overall Hcij h
Heat Pump
Sign Ilcight
O:I Furnace
_Sq. Ft.
Kitchen hood
Clearance
Woodstovc /Pellet Stove/Insert
Land Use Zonc
Other
Fcc
Total Receipt
Rcccip: Total
APPLICATION ACCEPTED FlY
PLANS C.ItiCK ED By I APPROVED FOR IS ONCE BY
Special Conditions:
SEPARATE: PERMITS are required for electrical work, utilities. private and punlic
improvements. This permit becomes null and void if work or constrctirn authorized is
not commenced within .Rn da)s, if construction m work is suspended or 4bandoned for a
period of IRO days after work has commenced, or if required iospecttons have not peen
requested within 180 days from the last inspection. I hereby cenify that 1 have .':ad and
examined this application and know the sane to be true and correct. All provisions of
Incas and ordinances governing this type of work will he complied with whether specified
herein or not. The granting of a permit does not presume to give authority to violate or
can the provisions of any state or 1 al law regulating construction nr 0-e perforr..ance
of c coon.
l
Other Construction/P.W. Permits:
fens ontra:t uthuniat Agent (Date)
Driveway Other
Signature of (honer If owner rs Builder) Mato
Watcr
∎.t' tor tvr
FOUNDATION
YES.
'IQ
Footin s
Walls
Found. drainage
ELECTRICAL
Rough in/Light Dcpt.
PLUMBING
Uldcr floor slab
Rough -in
Water line
Back flow/water
./1 IB_SEAL
Walls
Ceiling
EBAMNQ
Joists girders
Shear wall
Walls roof eciiing
wall
_yr
T -bar
INSULATION
Slab
Wall floor ceiling
CkIMJICAL
Chimney
Woodstovc/Pellet
Ducts
P•W.
WORK
Waterline meter
Sewer Connection
Sanitary
Storm
Site Drainagc/Erosion Control
Parking
Other
FINAL INSPECTIONS
DATE
REQUIRED
YES
NO
PRIOR TO OCCUPANCY
COMMERCIAL
Electrical/Light Dept.
USE
DATE.
Al
II
W1DENTIAL
Electrical/Light Dept.
Phone Ext. 224
Construction -RW PW-
Ext. 124 Engineering
Construction RW
PW/Enginccring
Fire (Multi -flm. only)
Ext. 252
Fire De.t.
Building
Ext. 125
�<I
9'f` A
Building
BUILDING PERMIT INSPECTION RECORD
CALL 457 -C411 EXT. 125 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MIN. 24 HOUR NOTICE. IT IS UNLAWFUL TO
COVER. INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
z
O
U
IX
O
GENERAL COMMENTS:
PEN PRINT, INC. IPM
INSPECTION TYPE
KEEP PERMIT CARD AND APPROVED PLANS AT JOBSITE
DATE
ACCEPTED
COMMENTS
I
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
INSPECTION REPORT
REQuES
Date th `'1 Time F:eceived by (phone, person)
Location of Work to be inspected --_.l Z
Name of person requesting inspection
requesting inspection Phone No.
Address of person eq g p
Type of Inspection (circle appropriate one): Permit No.
Sewer
Foundation Framing Chimney Plumbi inal S: er Excay. Other
INSPECTION NOTES:
Inspected: Date 9 7.2 Time By
Remarks:
4
r
i I
RESTORATION REQL:IRED YES NO
41,111121111•10111P Ali■IONIMINOLUNMEINI
r
f
SURFACE RESTORATION:
SURFACE TYPE: Unimproved EGravel Asphalt PCC Other
Repaired by City Work Order
U Repaired by Permi: tee COMPLETE
No Damage Found INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
COMMENTS/CONDITIONS
WATER MAIN
SANITARY SEWER
STORM DRAIN
TELECABLE
TELEPHONF. UNDERGROUND
UTILITY POLE
RAY $30.00
Sidewalk 50.00
Curb/Gutter 50.00
Driveway 50.00
Sanitary Sewer
Resleentlai 75.00
Commercial
After, repair 25.00
Mailing Address
Ms anise Nn to mow wire' spser4 1 Print Pa 10 ae f+1 .40
*PAW MO IS M Ind M M W" 0' A N.. .se w nd soft and M
1e o el 1. a r w«
Co s.a M N lode of ow COr of ►«t ane«.1 W roevq e1r «et10 n «w,ftd«
010 0. eeowM M Mw Al M Nee, r' w w.•
4.• r°`
APPLICATION FOR PERMIT
OWNER
JOB ADDRESS bZii f !J 7S Qe.e.c' act
LOT CLOCK SUBDIVISION
(Print Name) hereby makes application for the following
1. Work to be completed by (date)
2. Location of work: Outside Inside traveled roadway (if within traveled roadway, complete hems 3, 4 A 5)
Value of work to be performed (If over $2,000, complete item 6)
3. Contractor name OR
4. Performance Bond Amount
5. Proof of insurance
Work $2,000, and less: $50,000 personal In;ury, S100,000 per Incident, $20.000 property
Work $2,000 and more: $200,000 personal injury, $500,000 per Incident, $100,000 property
6. Permtttee understands that no street may be closed to traffic unless approved by the City Englneer and Chief of Police and
notifications pen to the Chief of Fire Department.
may be closed to traffic from to
(sU
City Engineer Chief of Police Fire Chief
M pwyldwtkre d dta yrw+dny N bide pew 11 M hrnhar agreed by Ms epplla+t that be City of Port
AnpMw and ono( Ito 'Mom M erlQloy+ee shall 1» fond hotmbes le tha sppneont from any nobility
twpertefbdMy Ix wry ao lLont. loss or damage to persons or property, happn.np or occuninp es
the preslrnsa mull of wry Man undMSben under the tarn of Inn appnnuon end t0. prm0 or
psnMta lonitdt moy to granted In noon** lharato,'Pd that all of $kid II.Mllntee an hereby assumed
by the epplkorb.
Permanent $300.00
Gravel 150.00
Non traveled 150.00
Curb Removes 150.00
RFSTORAT'ION DEPOSITS
Surface Excavation
Driveway culvert $30.00
Storm Drain, CB 15.00
Sower Tap 100.00
Sewer Cap 200.00
(includes removal of
Water meter)
Water Motor 5/8' 450.00
3/4' 475.00
Permit total
Restoration total
TOTAL
Receipt No.
24 HOUR MINIMUM NOTICE Issued by
REQUIRED PRIOR TO Dale
ermru -c my Io.tcnr `TIr'5II
SURFACE RESTORATION:
SURFACE TYPE: J Unimproved OGravel
Repaired by City
0 Repaired by Permittee
0 No Damage Found
REQUEST:
Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
INSPECTION REPORT
Time /.3D Received by, k),5
Location of Work to be inspected /0 I Z.L.11_____ALLile_z-,,,,. ,,1
Name of person requesting inspection /r 1 /::-//„1" ivgi? 7.'
Address of person requesting inspection Al i 4- ff!rr -0 1 Phone No.
Type of Inspection (ci:cle appropriate one): Permit No. f 7
Sewer Foundation Framing Chimney Plumbing Final Sewer Excnv. Other 7 i 99
INSPECTION NOTES:
Inspectod: Date Time ti By
Remars: ie_ki a../..•:.r___Gt/g.. 7 .Re x ,2k A./ 7/
F c?" yfr c t o 4-
RESTORATION REQUIRED
sk4
it ACV.,
•+A.
Sg. Ft.
APPLICATION FOR BUII.DING PERMIT AND CEPTIFICATE
DEPARTMENT OF PUBLIC WORKS;- CITY. OF.PORT•ANGELES,::
DING DIVISION, 'App1kant fo 1111 in between he
Building
Address
Moil Addrets' Zit (4/16,4.44.1/5.-4.-"'
City Ph. No.
o NAME L d..az..,41.
Address F c.fts
tS
I City PA Ph. Nc.
et
1 2 City
0
so
NAME
X Address
et City
License No:
Plane and Specifications submitted.
3707A REV 202
Ph. No,
■.0
PROPOSED
OR EXISTI1Z)
BUILDING
Street
New '1
Alteration
1 Lemolish
epatr
Move
FteltAf
Addition
Use of buildingA
Sive of building
No. of rooms
I Na. of Families
No. of floors
Now on lot
New en carfr-'=/-
SPECIFICATONS
FOUNDATION.
ter■or I Piers
Material
Width of Wall
Beams
Joist ht FL
leis, 2nd FL
Joist
Roof Rafters
Interior Studs
Exterior Studs ._,Z.X47"
COVERING
SIGNATURE OF
PERMITEE
Crt-
LEGAL DESCRIPTIGiq
OF OCCUPANCY
WASHINGO
avy Imes
CLASS OF WORK
fr
o mg Stem
Height
Material Sire
Exterior Waft/ C
Interior Wc.:74 Retoo_fintf_
Heat: Wood os i! Electric
I hereby acknowledge that have read this application
and state that the above is :aid agree to comply with
all City Ordinances and State regulating building con-
struction.
Sebdivieee
Lot .16 No
Variance or Conditional Use Permit
le
Permit. No:
40.0-8.34
APPROVE
te Pertit hsued
z il eic!
do
C..e:_
,:....:Vatuation
f '1, .t.k. 4 1.-.4,4 7 I .5
Building' Pormit Fee' t :k
Plan ClwcItEnn Foe
Treasurer's Receipt
Life of Permit
•"4"•'7.
Application taken by'
Date review completed
Ditottof of Dept. of Inspections
SPECIAL and UNUSUAL CONDITIONS
tz 0 fiq C
g (z#7..'
5
EQUEST:
Location of, Work to ,,he inspected
Name Of person requesting inspection
Address of erson requesting
P inspection
T ype of Inspection (circle appropriate one
Sevver F oundation,$, Framing Chimney
N SPECTION NOTES.
nspected: y Date C' f Time L
i emarks O !4 d /J /J n
(-111 f lc 11'vc, .rf
ontinue' revarse side If necessar
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved [J Gravel
Repaired by City
Repaired by Permittee
D No Damage Found
(phone,
fTREt SUPERIfVTENDENT�� DATE)
'16.040:x,
r
-;;A441,` i
!r
'Vt..; 9 .41-
w raw ,tir`
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING DIVISION
ective Date September 26 1g66 Ti 8:OOAM
Permit No.
cation of Work Fairmont RestuxAnt
me of Permit Holder None
dress of Permit Holder
rmission to continue construction, alteration, maintenance or repair work of any kind is hereby revoked or
!s not exist until conditions set forth in the ordinances and building codes of tEe City of Port Angeles are
nplied with. Any such continuation of work will be in violation of these codes and punishable as provided
rein.
is notice is n part of the building inspection record of this project and as such is not to be removed or de.
ed by anyone other than the building official. Absence of this card in no way removes the work restraint
dition wiihout also receiving a written "Stop-Work release" from the City Building Department.
4 b,N�.
PLICA'E70td F®RIBUILDING .PERMIT ?AND CERTIFICATE Ofr''OCCUPANC
D EPARTMENT JFPUBLICIWORKS7CITY OFziPO?T WA SHINGT N
ANGELES
BUII2DI I SION x
P+t
A p p i l c a n t a e en He crvyedi r t s
y
ME �isOdx' _�r�- 1are"4rr
'sat' ^7 Yk_.. «3 =r se.�c,„e ur+Yx
ROPOSED
Property Ono
Alteration 1, k ,�s Reparl.
c l Mow
7 the6elii. banding ti o 1iG i0M. n T:.
Si:o` oV baildin9 ?G`SL Q ti' Height x$ tf' xe IX.V y c;s
No.`i of. room$ .t A k No: %'of. :Families y'�� ?,r..
NO`:of floors /"9; "s =1:1 Sias 'of, Luf s
No of Bld kd s _.3 3°� tom
g� E y r U se of.� B1dg.
Now on I.if y Now, on..Lo
,SPECIFICATIONS
M
�s G vroA FOUNDATION
Moteriai 5' 3. t�, r x a
s :Eicterior:+.. ienir
:of th =ef'.Watl *s Y r y r c 5
....t'. r". r If rz
:mot;::
Footing Sins. ff`' y ti.a'�.wfi n a,
'Height is s r ti, s
typf',, Materia) i si :e Spaan& Span
Baoms,itlIai` "ri* �•s ,i r i 3.' "2. r 'r,f
Joist -1st F1.5,,, j, a'4 4;., r `zr
r^-
Joist: 2nd FL% 3 t', 1 s l',
�xr 7 ?e
laid Cei$n L k
Exterior Studs: k k sr 4x, r" a
Interior Studs'= ,C Z X
Roof Rafters s' 1 za r, u r 4
p; COVERING'- r
6rMi /i q I Ra f 44•s, v- xht
lnterier..Wals
Reroofing L '4�;
H G '11" Oil 's,.. El eNrie?"a `'3
'1 heieby- acknowledge that 1 have read this•application
and state.thatthe above: is correct and agree to"cOrlpiy
'all City Ordirarces and State Laws regulating building con.:
struction TM t
SIGNATURE OF xz
PERMITEF
LEGAL: DESCRIPTION
Sobdvisio P►it c i
Lot No 0U' =x Block No e i
t ?lt .l� 2 0z"€
gAt5W, 4a t i"riA AS
a 'yA ;�ee'Sr i'.,e3^;a"�7s` i �£`ev' .?1' 'k.�i Yom, At}•tr_f_ 1�6 e'i•',edr' Cy, Ma
�y.` L y}. �•s...� w�,�.,ry'•�{7 'R Kr y�..,.. r:;F2 »`h'i'G'M,
_y.� '1` 2 G ^',}2"°` t'�+ f
j� d9i'A
B 1 g P rno,a a r
Plaii Checki
s I
ta:»= t+ x`,: :8
Tol x
T reasurer's Receipt No:. r
s
tit• �`���r t
Ls fe'of r
Pemit �Q" d
ClCCU
i rte.
Total"Sq, ft Area of
u' i ,7Wrts. }s„y.,Lfip „+r� r •gy 'S yi'. e:'iYSCs.S gsi ..n
ss SPECIAtSan d UNUSUAL CON DiTtONS A r s
Qi '"LLt rdY t4z �N k Alm?
aluation
'�,�.*.�"�Y� �h,�"��.M.E� F�i�'.��Y�&`�S+�r�:•c�f �*a ".L.,
•:rfa''E`` &tea'
�f 'R ode
4
z
Date Ze/ 5 7 6 e
:CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING DIVISION
REQUEST FOR INSPECTION
Time C 3 AL/I Received ersor2P
Location of Work to be inspected___±..t.. .7
Name of person requesting inspection._
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney lumbing Final Other_
Phone No.
Inrpected: Date
1 iv t.r.‘ I 7 by A.
Remarks: hei.J
(continue on reverse side necessary)
4 4. 4 4 **44** *A* ****4 4
ate 0
ispmmhw6: 'Dotm a
emarks: C9 /r
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
UL� �V>LN �Jl W\��\L' YV U|\y\`�
BUILDING DIVISION
REQUEST FOR INSPECTION
Time Received by e2 eraon)
7
nation of Work to be inspected
me of persn requesting inupection
ddress of person requesting inopectinn-__'--__-________-_________-______ Phone No.
ype of Inspection (circle appropriate ore):
Sewer ;Foundation Framing Chimney Plumbing Final
k tic
Tim by
(continue on reverse side if necessary)
L
BMW
It
APLJCATION FOR UILDING PERMITAND CERTIFICATE OF OCCUPANCY
4DEPRTMENT.OUBL1CWdRKS CTY!OF,
Permit
IL S.
t B
DATE 'AppIgc�nt fo flII in between hey 1 Z s Valuation r
AddrnsfZ c OF WORK Che c k ing
p
feih h;l
NAME 1
1 'fRepaur Treosu,er s ecept N 7 f
ass City 3 '_,_,'z. _:L
No:'
Life Perm,,
AppIcatp taken by 1?
Mars j
te completed
Now on 09�
T aJ Floor Area Ph N use or Bid
-j----------------__-___... SPECJFCATIONS V
o La
Z FOUND! ON
Add 1 ii
lype nstruct,on i
Exterior
Wd *1 W0H j
P
N
C ty Foin9 S. r
o 11
Ph Ho Heigbt use ne
1
•NAME B 7:777
;4 OCCupancroup i
1 2 34 5
n
PJans OD4 Sp.c ficct1 .vbmm,d Exterior
Plot Plan Pro •rty Lrn. APPROVE
I 'A T
1 and state that theatpp
112 9,' uilding con-
IlTU
R EXJSTING DESCRIPTION LDI
;/3-
F ye ...P r -A, ,-.t.-. z ^cgi r `VO_ 7' k r xw z,' r' r. .r a
PL FOR' BUILDING PERMIT, AND CERTIFICATE ;OF OCCUPANC
D EPARTME PUB1.IGklY, RKS' CI T i 1' O F PORT-IANGE W�15HiNGfTON'
..tom .S t r e 4'''.
s
6 "fa k a z N h kq .n s�"' [s x, in e tv ee w• hat,.. 1 vs
AppLcont tcl? 1111 =1n: btwea.6 t .r
"r•A} 41.i
Beifding ?Pennitjee
Pfo hACheckiny' F» t
Total arf wr
Treasurer s Receipt',No.
Life Of Perm,
Total floor Ar.
Ana
Of.Loft140ra,
Occgpon
APPROVED,
t R F DIrsc or of D.pt of Iyap.chon a g ;t
SPECIA(and UNUSUAL CONDITIONS
4 r w r s1Ei C? s'1�
fd hL I f 4_4_13G rTi r k/
PON
a,f., Aodraa
o. NAME
kiZ f`Addresa�`
i D •p,j r
ti Ph. No "p,,'
¢Addrear,
h
Use` of building :,44-
Size" of budding L T I
No:. of morns La.
No of
�r c vi' Naof Btdgs,
Novr bt
Alteration
Addition"
Moteini
WidNil:of Wo11C
Footing Srtle r t
HeigkY.3
Beo ni-*& a
Joist 1st FLT;
Joist .2nd FL'?
Joist: C.r7rn
Sias of 1.ot"` b 1 u a d er
U »�foF�Btdg �"At t i
Now on tat
SPECIFICATIONS
OU'NDATIOH V fi y y
`c?myY`"a�st,t :Eiterior,'4?
Exterior Studs
1nt.rwr� Studs �s e�
`gr 1.3✓3:f �'3'+d}%i a 3{>'L
Exterior WoW w s� Roof A s x
Interior Walls
Hear: -Wood 1.• Gos O'I ;:Elect i
ri -t :I hereby acknowledge that T have ,read this application
andFstate that the above is correctand agree to comply with
all City Ordinances and State regulating building con
structioII
SIGNATURE OF
PERMITEE
LEGAL DESCRIPTION
SYbdiriabia∎
Lot No gock
J T
Yorks or Conditiorial Use Perrniir .ba
2Y
_s�� •mss_ =.ri
QaGnga At;:tit�.,
fSpon,k
TApplTceitt te fill in between
New
Alteration
Addition
LEGAL 'DESCRIP
a. Nock No,
Mow
Use building k
Size `ef budding .S. Nn kt fi
N of roams _o. a No. of For
No. of !)Dora
Sis_ o_f lot r
No of Bldga Ufa of
:Now on 5 3 t
Now on t
SPECIFICATIONS
FOUNDATION
Material a;
Exterior
Width of Wall
�.r, 5 F eot�a y Sine s w t
H7`7
yyIL
•Roof Roften �s�
E :tenor Stvdf �,al,, k i ti
latenor Stadf
'•x cOVEatNG its r a
Extenor 4
Interior WcRia s a
�9 r Reroofing r,
H eat Wood ti Gas t ums
Olt x Ct �i� SS
Al;; 43I i e.reb acitnovled e'that I have read-
and state that the'abovec s: correct and agree to co n l with
all City Ordin ;aces and State Laws re i Y
strttction x'. 8�attng bttUdlag con
SIGNATURE Of_
PERMITEE :..:'.V
Y� `fi'kl
Total Floor Area
Area of lot
Type Constructtor
..a' `f- •u 3t �4r y 1.
s 2 v�t ^*'ss'
gfqo
n��� k. �q'; a k §,A_rc �?q'���,,
APPROV
.w-
S PECIAL Vi and UNUSUAL CONDITION
yap f.•�'�.r'+YS �R�, c.�' a t
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LICATIOPd FOR BUILDING PERMIT,AND CERTIFICATE OF OCCUPANCY
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D EPARTMENT OF PUBLIC WORKS CITY OF PORT ;ANGELES WASHINGT
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DING: SiON DIVI 4
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ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Application Number , . . , , 15- 00000577 Date 5/26/15
Application pin number 468695
Property Address , , , 1021 FOUNTAIN ST
ASSESSOR PARCEL NUMBER: 06-30-08-5-8- 1872 -0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . , . . ..
Property Use
Property Zoning , , . , , , , R97 RESDNTIa SINGLE FAMILY
_ - -_- Application valuation- -- — ---- ------------- - - - - --
Application desc
Security system
Owner
Contractor
RESULTS:
FRANK EDWARD PORTER
DITCH
PROTECT YOUR HOME
1021 FOUNTAIN ST
3750 PRIORITY WAY
SOUTH DRIVE
PORT ANGELES
WA 983632318
#200
ROUGH -IN
INDINAPOLIS
IN 46240
FINAL
(317} 810 -4720
----------------------------------------------------------------------------
Permit . , . , , ,
ELECTRI.CAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . , . ,
64.00
Plan Check Fee
00
Issue Date
5/26/15
Valuation . ,
, , 0
Expiration Date
11/22/15
Qty Unit Charge
Per
Extension
1,00 64,0000
ECH EL- SINGLE CIR LIMITED RES
64.00
Fee summary Charged.
Paid •C.redited
Due
Permit Fee Total
64,00
64.00 00
.00
Plan Check Total.
.00
.00 00
.00
Grand Total
64.00
64,00 .00
Op
REPORT SALES FAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contra_ ctor X Date:
GAIEXCRANGEIBIIILDING
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B
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CITY Or� PORT ANGELES PERMIT APPLICATION MAY 2 6 2015
Building Inspections
321 East Fifth Street – P.O( Box I 15W Port Angeles Washington, 98362 ELECTRICAL
Ph. (360) 417-473:5 Fax, (360) 417-4711 WPEOMNS
Date: 5126/2015
.— I & 2 Single Family Dwelling
'Plan Review May Be Requi(ed, Please Complete Elecftal Plan Review Information Sheet
, kOrftv IOZIFauntalnSt
Building Sqvwf, rwogQ7
Owner information
Nafna: Frank Porler
I021 Fountain St
Port Argelles —AaW ,WA_Zp: 98353
ft i exp
UnIt Charma
1;aMc&Fea&r 20 knp,
$ QUO
ServWFadbr 401400 AMP
Urilce/Feeder 601-4000 Amp,
$26ZOO
11W AM,
s
Brands Malt W) S Feedw
Brands Circuit W)O Service Foe&r
Ew) Additional Gramb Ciro€ (
E00
WnCh CkOUNS 1-4
MW
Tomp, SoMcd Feeder 200 Amp,
9100
Tomp, SetvlcelPeedar 201-400 Amp,
$110.90
'erq Serv*&Feedar 401,90 Amp,
SM100
Temp. WWFwdor 601-1000 Amp,
$168,00
Portal to PQdag Houdy
$ W1011
619W Ck"!V Umlled Energy -1 2 Family Oweirg
$ 64,00
MaWadured Home Cofmeclicn
$120-00
Ftenewa* Serkal Energy - 5KVA $Mom or Le
$102.00
Themo,51at
56.00
We, UAD &ot each addil;unW T-Sim
New C NS` RUCIL
WALL Y,
F-ffst 1 $00 Sqmte Ft
120,OD
Bch A4610W 600 Squwe R o(Poolon ®i
9 40,00
EaGh Outbugdqt ot Ntarjjed Garago.
$ 74.00
Each Wnmiq Pool fm Hot Tub -
S fl o,00
Contractor Informatioo
Nye. ProtectKou! Hom�
Ma&q Addreav, 3759 Prlorit Way South Dr
rs
. L
C4, alft, !N Zo 46240
Ph MO-, 866-502-35.59 FU 317-564-2547
LkMa ft I EXP,,tR0TEYH93
fit Total (,Qtv MultivIlad bv.Clint .Char gg)
$---,64--00 Total
Ownef as debried by RCW,19,28,261° (1) Ownor -0 occupythe slmdwe for two years after this eledrical parmil Is finalized, (2) Ovinef is iequirad
10 We on eteCWal ConffacfQrif above said property Is for sale, rent or Jews, Permit expires after six mcflths of last inspection,
After fe4iiq the above stwom em, I hereby cortify 01011 am the owner of the above warned property or a licensed electdcal confrador, I am making
the eW6*0 inslafiaWn or Atetallon In compliane with the electrical laws, N.E.C., RCK Chapter 19,28, WA C. Umpter 296468, Tho City of Part
Angelet khrnidpal Code, and Utilly SpoeiricaWns acid PAMO 14,05,050 rqarding Seftaf Parmit Applicarions.
Signature of owrwr, electrical conlrootor or electrical admlnlstrator; 0 chcc�
5/26/2015