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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDlNG 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
07-00001501 Date 12/19/07
909212
1313 GEORGIANA ST
06-30-00-5-3-0960-0000-
MELISSA DERMA
MECHANICAL APPL. PERMIT
RS7 RESDNTL SINGLE FAMILY
2823
Owner
Contractor
DUSTIN & MELISSA DERMA
1313 GEORGIANA ST
PORT ANGELES WA 983624516
(360) 417,-8195
ALL WEATHER HTG & COOLING INC
302 KEMP ST
PORT ANGELES WA 98362
(360) 452-9813
permi t . . . .'.
Additional desc .
Permit pin number
Permit Fee
Issue Date
I
Expiration Date
MECHANICAL PERMIT
INSTALL ELECTRIC FURNACE
117812
64.80 plan Check Fee
12/19/07 Valuation
6/16/08
.00
2823
Qty
Unit Charge Per
1. 00
14.8000 ECH
BASE FEE
ME- INSTALL 100- FAU
Extension
50.00
14.80
Fe'e 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
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Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days; if construction or work is suspended or abandoned
for a period of 180 days after the work 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.
Signature of Owner (if owner is builder)
T:Forms/Building OivisionlBuilding Permit (10/Ol/07).wpd
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, 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.
s
,
-
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS'
PIERS
POST HOLES (POLE BLDGS.)
I'LUMllING
UNDER FLOOR / SLAB
ROUGH-IN
.
WATER LINE (METER TO BLDG) .
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEA T PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY FINAL q -2..4 -(jl?DATE p~ ACCEPTED BY:
COMMERCIAL HOOD / DUCTS
MANUFACTURlm HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEI'T. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - RW
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
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Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00001500 Date 12/19/07
035500
1313 GEORGIANA ST
06-30-00-5-3-0960-0000-
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
DERMA DUSTIN/MELISSA
1313 GEORGIANA ST
PORT ANGELES WA 983624516
ALL WEATHER HEATING & COOLING
302 KEMP RD
PORT ANGELES WA 98362
(360) 9813
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
117804
ALL WEATHER
35.00
12/19/07
6/16/08
HEATING & COOLING
Plan Check Fee
valuation
.00
o
Qty
1. 00
Unit Charge Per
35.0000 EC EL-LOW VOLTAGE
Extension
35.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35.00 35.00 .00 .00
Plan Check Total .. 00 .00 .00 .00
Grand Total 35.00 35.00 .00 .00
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SPECTION ELECTRICAL
TYPE . DATE: RESULTS: INSPECTOR:.
DITCH
SERVICE
OUGH - IN
FINAL
. OMMENTS:
10/
Dee 17 07 08:29a
p.1
BUILDING PERMIT APPLICA TION 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
For City U~~ Only:..... .
Date Reeeived~ 1
! Permit # o"l- I ~(') I
, Date Approved
Phone
Phone
L.1es L . OJ <Q , ~
01.'- CO\C1V)
PROJECT ADDRESS
'I
\ (\\11(\
Parcel Number
Pro;ect Tvpe & Brief Description: ~esidential o Commercial o Multi-family o Industrial
Check all that apply
o New Construction
o Addition
o Remodel
c Repair
eRe-roof
o Demolition
o Sign o wall-mounted o projecting o freestanding Dawning c other
Total si~n area sq. ft Maximum allowed sign area SQ. ft
-,(Heat System o Heat pump c wood-burning stove 0 gas fireplace o pellet stove )(other
o Other E\ ('('Mr ruV-V'\U\t P
Floor Areas ExistinQ (SQ. ft.' Proposed (sq. ft.)
Basement @$ per sq. ft. = $
1 sl Floor
2nd Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUA nON $ Z?J Z. ~. <O"L.
Total footprint of structures
sq. ft.
ft.
Lot size
sq. ft. = Lot coverage
# of bedrooms
# of full baths
# of half baths
%
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
Occupancy group
Occupant load
Construction type
I have read and completed this application and know it to be true and correct. 1 am authorized to apply for this permir and
understand that it is my responsibility to determine what permits are required, an
projects G ~' ~
DateJ2.::.O.:.ID Print Name 0.. (. if1 () e Ul Cf f ~ Signature
T:FormslBuilding DivisionJBldg Permil Appl.-2006 Code.doc
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Of pORT ~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
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
Owner
2/09/06
03-00000251 Date
5887
1313 GEORGIANA ST
06-30-00-5-3-0960-0000-
DUSTIN DERMA
RES REMODEL
RS7 RESDNTL SINGLE FAMILY
1500
-Ft i JA,l,Bt)
"3/t /2)0
~/
Contractor
DERMA DUSTIN/MELISSA
1313 GEORGIANA ST
PORT ANGELES WA 983624516
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
OWNER
BUILDING PERMIT -RESIDENTIAL
70797
80.50
Plan Check Fee
valuation
32.20
1500
8/08/06
Qty
Unit Charge Per
BASE FEE
3.0500 HND BL-S01-2K (3.05 PER C)
Extension
50.00
30.50
10.00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
989749
54.25
3/11/03
3/25/06
Plan Check Fee
Valuation
.00
o
Qty
Unit Charge Per
BASE FEE
7.2500 ECH ME-VENT FAN
Extension
47.00
7.25
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
PUMB BATHROOM ONLY
739127
61.00 Plan Check Fee
3/11/03 Valuation
3/25/06
.00
o
Qty
Unit Charge Per
BASE FEE
7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
Extension
47.00
14.00
2.00
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 195.75 195.75 .00 .00
Plan Check Total 32.20 32.20 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 232.45 232.45 .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 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
~cti~ ~ J..-. Or S) l" 'D-~~ :L. c\_ Cl \0
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\Policies\II02_15 building permit inspection TecoTd05.wpd [1/4/20051
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN '1-/t4-loe:. \I~
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLIHOLD DOWNS
WALLS 1 ROOF 1 CEILING "Z./tt! O~ 1U/
DRYWALL (INTERIOR BRACED PANEL ONLY) . .
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINALINSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W. 1 PWI CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BillLDING 417-4815 -? /1 / () f.::, -/?V BUILDING
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BUILDING PERMIT ":&&.APPLlCATION
~. ~-'tt 08-Z~1
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
tz~~~~...,., - ~ ~
FOR OFFICIAL ~E ONLY:
Dale IZec.: * 0(,
Pel111i\ #: O~W-,
D"" APTffov;;tJl:v
Dale l:"ucd:
Applicant or Agent: b Q S-\ ,~ 0 e.. '(' ~ c;.....
Ovmer: D~~\l ~"" \.9 ~"'VV""c......
Address: ) 1 \ .~ G~c (\~~~ S\ ~City:
Architect/Engineer: Ge If\e. \.) h<J<' r-
Contractor State License #:
Phone: :J ~ a - <0 I 0 - \ \ 1 ~
Phone: ~ ~O .. '{, -la 1,1 S-
Zip:
Phone:
Exp:
Phone:
Address:
PROJECT ADDRESS: f-'1\'\
City:
(')QO'~I r",~c, ~~
Block:
Zip:
ZONING:
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Subdivision:
TYPE OF WORK:
~ Residential "'QI New Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
o Stove
o Garage
o Deck
o Other
Y"'\~\....)J
S~N ALUATION:
L.J t; SF. @ $ /SF. = $
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION $. i ;Sc;:)C) . O~
~c;.~\.,,^ \r-()C;~
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno permit is issued witlrin 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R1 05.3.2
of the International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permit re required ,not the City's, and that I must obtain such permits prior to work.
Date: ~- ~ - () <.0
T:\Policies\BL-1102_13.wpd Applicant:
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WoodWorks@ Sizer
SOFTWARE FOR WOOD DESIGN
J
03005B..wbd
WoodWorks@ Sizer 2002
Feb. 19,2003 17:14:51
COMPANY
Gene Unger Engineering INC.
1401 W. 7th Street
Port Angeles, WA 98363
360-452-2098
PROJECT
Derma
Ridge Beam
DESIGN RESULTS
OOS-1997
Beam DESIGN DATA:
===========================================================================
Material: Glulam Simple
Lateral support: top= full, bottom= at supports;
Total length: 15.00 [ft]
Load combinations: ICC-IBC;
LOADS: (force=lbs, pressure=psf. udl=plf, location=ft)
>>Self-weight automatically included<<
===========================================================================
===========================================================================
Load 1 Type I Distribution 1 Magnitude 1 Location 1 Pattern
I I 1 Start End I Start End 1 Load
-----1--------1--------------1-----------------1-----------------1--------
Load1 Dead Full UDL 220.0 No
Load2 Snow Full UDL 375.0 No
SUGGESTED SECTIONS that PASSED the CODE CHECK:
===========================================================================
===========================================================================
I Species I bxd 1 Axial I Bending I Comb'd I Shear 1 Disp./
1 Grade 1 in I fe/Fe' 1 fb/Fb' 1 I fv /Fv' 1 Allow.
1--------------1-----------1-------1--------1--------1-------1--------
VG West.DF
24F-V4
24F-V4
24F-V4
more detailed
3 . 125x13 .5
5.l25xl0.5
8.75x9
output, select a
0.78
0.79
0.64
Suggested Section
0.63 0.74
0.51 0.96
0.36 0.89
the Data Bar.<<
1
2
3
>>For
from
DESIGN NOTES:
---------------------------------------------------------------------------
---------------------------------------------------------------------------
---------------------------------------------------------------------------
---------------------------------------------------------------------------
1. Please verify that the default deflection limits are appropriate
for your application.
GLULAM: The loading coefficient KL used in the calculation
is assumed to be unity for all cases. This is conservative
where point loads occur at 1/3 points of a span (OOS Table
GLULAM: bxd = actual breadth x actual depth.
Glulam Beams shall be laterally supported accordin3 to the provisions
of OOS Clause 3.3.3.
5. GLULAM: bearing length based on smaller of Fcp(tension) , Fcp(comp'n).
2.
of Cv
except
5.3.2) .
3.
4.
/0
WoodWorks@ Sizer
Ie
~
i I
'-----~
SOFTWARE FOR WOOD DESIGN
03005B1.wbg
Critical Results
WoodWorks@Sizer 2002
Feb. 19,2003 17:14:51
REACTION [lbs]
Maximum. . .
Uplift: 0
Bearing: 4462
t,
r
0'
15'
SHEAR [lbs]
+v max: 4462
-v max: -4462
Load Combination
0'
15'
BENDING [lbs-ft]
+M max: 16734
Load Combination #2: D+S
16734
'~
6
~
6
0'
7'-6"
15'
DEFLECTION [inl
Max Live: 0.37
Max Total: 0.71
Load Combination #2: D+S
~
-0.39
.0.37
~
0'
,
7'-6"
15'
'7
o
,
WoodWorks@ Sizer
SOFTWARE FOR WOOD DESIGN
0300582.wbd
WoodWorks@Sizer2002
Feb. 19, 2003 17:21:45
COMPANY
Gene Unger Engineering INC.
1401 W. 7th Street
Port Angeles, WA 98363
360-452-2098
PROJECT
Derma
Central Floor beam
DESIGN RESULTS
NDS-1997
Beam DESIGN DATA:
===========================================================================
Material: Glulam Simple
Lateral support: top= full, bottom= at supports;
Total length: 15.00 [ft]
Load combinations: ICC-IBC;
===========================================================================
LOADS: (force=lbs, pressure=psf, udl=plf, location=ft)
>>Self-weight automatically included<<
---------------------------------------------------------------------------
---------------------------------------------------------------------------
Load I Type I Distribution I Magnitude 1 Location 1 Pattern
1 1 I Start End 1 Start End 1 Load
-----1--------1--------------1-----------------1-----------------1--------
Load1 Dead Full UDL 225.0 No
Load2 Live Full UDL 600.0 No
===========================================================================
SUGGESTED SECTIONS that PASSED the CODE CHECK:
===========================================================================
1
2
3
4
>>For
I Species 1 bxd I Axial I Bending 1 Comb'd I Shear 1 Disp./
1 Grade 1 in 1 fc/Fc'l fb/Fb' 1 I fv/Fv'l Allow.
1--------------1-----------1-------1--------1--------1-------1--------
VG West.DF
24F-V4
24F-V4
24F-V4
24F-V4
more detailed
3.125x1S
S.12Sx13.5
6.75x12
8.75x10.5
output, select
1. 00
0.76
0.73
0.75
a Suggested Section
0.88 0.86
0.61 0.72
0.53 0.78
0.48 0.90
the Data Bar.<<
from
---------------------------------------------------------------------------
----------------------------------------------------------------------------
DESIGN NOTES:
---------------------------------------------------------------------------
---------------------------------------------------------------------------
1. Please verify that the default deflection limits are appropriate
for your application.
2. GLULAM: The loading coefficient KL used in the calculation of Cv
is assumed to be unity for all cases. This is conservative except
where point loads occur at 1/3 points of a span (NDS Table 5.3.2).
3. GLULAM, bxd = actual breadth x actual depth.
4. Glulam Beams shall be laterally supported according to the provisions
of NDS Clause 3.3.3.
S. GLULAM: bearing length based on smaller of Fcp(tension), Fcp(comp'n).
la
nl
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WoodWorks@ Sizer
SOFTWARE FOR WOOD DESIGN
l
C300SB2.wbg
Critical Results
WoodWorks@ Sizer 2002
Feb. 19, 2003 17:21 :45
I REACTION [lbs]
Maximum. . .
Uplift: 0
Bearing: 6187
t, i
0' 15'
SHEAR [lbs]
+V max: 6187
-V max: -6187
6187
6
'-----
0'
15'
BENDING [lbs-ftj
+M max: 23203
Load Combination #2: D+L
23203
~
6
~.
6
0'
,
7'-6"
15'
DEFLECTION [in]
Max Live: 0.43
Max Total: 0.69
Load Combination #2: D+L
/~c
-0.39
.0.41
~
0'
,
71-6"
15'
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CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
property Address
ASSESSOR PARCEL NUMBER:
Application description
Property zoning . . .
Application valuation
03-00000251
1313 GEORGIANA ST
0630005309600000
RES REMODEL
Date
3/11/03
Owner
Contractor
Ptv1Jul :if})
~(1 (0&
3000
DERMA DUSTIN/MELISSA
1313 GEORGIANA ST
PORT ANGELES WA 983624516
OWNER
-----~~~~~--~-~-~-~------;~~~~~~-~;~~;-=;;~~~~~~----------------------
Additional desc CONVERT 1/2 EXIST GARAGE
Permit Fee 106.75 Plan Check Fee
Issue Date 3/11/03 Valuation
Expiration Date 9/07/03
42.70
3000
Qty Unit Charge Per
Extension
92.75
14.00
~
-.
~
BASE FEE
1.00 14.0000 THOU BL-2001-25K (14 PER K)
-----~~~~~--~-~-~-~------~;~~~~-~;~~;---------------------------------
Additional desc
Permit Fee
Issue Date
Expiration Date
54.25
3/11/03
9/07/03
Plan Check Fee
Valuation
.00
o
-----~~~~~---------------~~~;~~~-~;~~;-----------------------------------
Additional desc PUMB BATHROOM ONLY
Permit Fee 61.00
Issue Date 3/11/03
Expiration Date 9/07/03
Plan Check Fee
Valuation
.00
o
(0
(t
~
cii
p
-
~
~
Qty Unit Charge Per
Extension
47.00
7.25
BASE FEE
1.00 7.2500 ECH ME-VENT FAN
Extension
47.00
14.00
-----~~~~~-;~~~--------~-~-~-~-~----~;~;;-~~~~;;----------------~~~~-----
Qty
Unit Charge
Per
2.00
7.0000 ECH
BASE FEE
PL- EA.FIXTURE ON ONE TRAP
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ----------
----------
Permit Fee Total 222.00 222.00 .00 .00
Plan Check Total 42.70 42.70 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 269.20 269.20 .00 .00
(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 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 sta~local '"a,w r~ating const,ruction or the performance of
construction.
~ .~.._-._. . ~-\ \--C:!'\
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORMS\1102.15 [4/20021
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS ~ ' "3 } ~t5 ~ 'xV
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEP ARA TE PERMIT: #
ROUGH-IN
PLUMBING ~_. -r;.cf ~f) S; ~ S(IIlrv J.)
.... .
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL
WALLS 1 ROOF 1 CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION. R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\l102.15 [4/2002]
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec.:ol-25 -0'.::5
Permit #: "2.<!) (
Date Approved:
Date Issued:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
,..
Applicant or Agent: \) \)S \-'\ \"\ ~,\~\-e..\v:.l.,'" D-e \ \\-',?', Phone( } CoO) Lf b,o - -/-) if J
\L~ '.)' L.\'\',\ ,- \' (' Phonl. ""1,1,,(:1..>. /'/' i.,(..')" . -7"7 .\ (~.
Owner: ~'.;, .'\-c' '.."/''''- ':...J({'r\..--.&-... ~,::::~ '-). ~~ ,.
Address: \'~ ! J (~t'or-c)\ a- l ~\ ~<1' . City: Po ,1, ~\~"\"~' 't' \ c'-. Zip: ":1 :J':.~ (,.. )
/' L ) -' h '),f - r. I. I 5- <\-- :) orA ,}
ArchitectlEnJineer:, \......:7ey\ ~ ''-(j e \- P one: ~'-?v ~, .=J..\;l
Contractor ~e \~' State License #: Exp: Phone: t--l (') (j - -7il.13
Address: \~\') (.)"Con-,\c,J S\:o City:Part \,--\\,....\,c:, l~fi Zip: C'i\~~l
~I /"\ .) J
PROJECT ADDRESS: fJ.,"~ C:>C"(",r,~.'w'\'\i'" ~)1. JOl ry.,(......\f,:.. ZONING:
LEGAL DESCRIPTION: Lot: l'"'1' 1 ,; Block: \'1GC: Subdivision:
CLALLAM COUNfY PARCEL NUMBER:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-roof 0 Stove
o Multi-family 0 Addition 0 Move 0 Garage
o Commercial . Remodel 0 Demolition 0 Deck
o Repair 0 SigniL 0 Other
BRIEF DESCRIPTION OF mE PROJECT: Q~)~ ;\ \ v\ (<.(
City:
MC
#
Exp. Date:
SIZENALUATION:
J-j~ 0 SF. @$ lo~t., /SF. = $
SF.@$ /SF.=$
SF. @ $ /SF. = $
TOTAL VALUATION $
\'""60 1"\"". W /, he t-\"v 90 ""
'~ Q\X)
COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load:
No. of Stories: 1 Lot Size: 50 /1 C::O Existing Sq. Pt. <1 CO & Proposed Sq. Ft. L
Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage
Construction Type:
IC;-O = TOTAL Sq.Ft.l+~:;(J
%
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BIDLDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and
understand that ft is my responsibility to determine what permits are requ' d ,not the Cfty's, an~ ~t I must obtain such permfts prior to work.
\ '. ~ d., I}:"-.- ~
T:\FORMS\APPS\Buildingpennit.wpd Applicant: J. '\('")0' ". --, Date:. -. ~ -.0
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ADMINISTRATION
5. State the valuation of the proposed work.
6. Be signed by the applicant, or the applicant's authorized
agent.
7. Give such other data and information as required by the
building official.
RIOS.3.1 Action on application. The building official
shall examine or cause to be examined applications for per-
mits and amendments thereto within a reasonable time af-
ter filing. If the application or the construction documents
do not conform to the requirements of pertinent laws, the
building official shall reject such application in writing,
stating the reasons therefor. If the building official is satis-
fied that the proposed work conforms to the requirements
of this code and laws and ordinances applicable thereto,
the building official shall issue a permit therefor as soon as
practicable.
RIOS.3.1.1 Substantially improved or substantially
damaged existing buildings in areas prone to flood-
ing. For applications for reconstruction, rehabilitation,
addition, or other improvement of existing buildings or
structures located in an area prone to flooding as estab-
lished by Table R301.2(l), the building official shall ex-
amine or cause to be examined the construction
documents and shall prepare a finding with regard to the
value of the proposed work. For buildings that have sus-
tained damage of any origin, the value of the proposed
work shall include the cost to repair the building or
structure to its predamage condition. If the building offi-
cial finds that the value of proposed work equals or ex-
ceeds 50 percent of the market value of the building or
structure before the damage has occurred or the improve-
ment is started, the finding shall be provided to the board
of appeals for a determination of substantial improve-
ment or substantial damage. Applications determined by
the board of appeals to constitute substantial improve-
ment or substantial damage shall meet the requirements
of Section R323.
RIOS.3.2 Time limitation of application. An application
for a permit for any proposed work shall be deemed to have
been abandoned 180 days after the date of filing, unless such
application has been pursued in good faith or a permit has
been issued; except that the building official is authorized to
grant one or more extensions of time for additional periods
not exceeding 180 days each. The extension shall be re-
quested in writing and justifiable cause demonstrated.
RIOS.4 Validity of permit. The issuance or granting of a per-
mit shall not be construed to be a permit for, or an approval of,
any violation of any of the provisions of this code or of any
other ordinance of the jurisdiction. Permits presuming to give
authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid. The issuance of
a permit based on construction documents and other data shall
not prevent the building official from requiring the correction
of errors in the construction documents and other data. The
building official is also authorized to prevent occupancy or use
of a structure where in violation of this code or of any other or-
dinances of this jurisdiction.
4
RIOS.S Expiration. Every permit issued shall become invalid
unless the work authorized by such permit is commenced
within 180 days after its issuance, or if the work authorized by
such permit is suspended or abandoned for a period of 180
days after the time the work is commenced. The building offi-
cial is authorized to grant, in writing, one or more extensions
of time, for periods not more than 180 days each. The exten-
sion shall be requested in writing and justifiable cause demon-
strated.
RIOS.6 Suspension or revocation. The building official is au-
thorized to suspend or revoke a permit issued under the provi-
sions of this code wherever the permit is issued in error or on
the basis of incorrect, inaccurate or incomplete information, or
in violation of any ordinance or regulation or any of the provi-
sions of this code.
RIOS.7 Placement of permit. The building permit or copy
thereof shall be kept on the site of the work until the completion
of the project.
RIOS.8 Responsibility. It shall be the duty of every person who
performs work for the installation or repair of building, struc-
ture, electrical, gas, mechanical or plumbing systems, for
which this code is applicable, to comply with this code.
SECTION R106
CONSTRUCTION DOCUMENTS
RI06.1 Submittal documents. Construction documents, spe-
cial inspection and structural observation programs, and other
data shall be submitted in one or more sets with each applica-
tion for a permit. The construction documents shall be prepared
by a registered design professional where required by the stat-
utes of the jurisdiction in which the project is to be constructed.
Where special conditions exist, the building official is autho-
rized to require additional construction documents to be pre-
pared by a registered design professional.
Exception: The building official is authorized to waive the
submission of construction documents and other data not re-
quired to be prepared by a registered design professional if it
is found that the nature of the work applied for is such that
reviewing of construction documents is not necessary to ob-
tain compliance with this code.
.~
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I
RI06.1.1 Information on construction documents. Con-
struction documents shall be drawn upon suitable material.
Electronic media documents are permitted to be submitted
when approved by the building official. Construction docu-
ments shall be of sufficient clarity to indicate the location,
nature and extent of the work proposed and show in detail
that it will conform to the provisions of this code and rele-
vant laws, ordinances, rules and regulations, as determined
by the building official.
RI06.1.2 Manufacturer's installation instructions. Man-
ufacturer's installation instructions, as required by this
code, shall be available on the job site at the time of inspec-
tion.
2003 INTERNATIONAL RESIDENTIAL CODE@
;..
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WoodWorks@ Sizer
-~~]
SOFTWARE FOR WOOD DESIGN
0300581.wbd
WoodWorks@ Sizer 2002
Feb. 19,2003 17:14:51
COMPANY
Gene Unger Engineering INC.
1401 W. 7th Street
Port Angeles, WA 98363
360-452-2098
PROJECT
Derma
Ridge Beam
DESIGN RESULTS
NDS-1997
Beam DESIGN DATA:
===========================================================================
Material: Glulam Simple
Lateral support: top= full, bottom= at supports;
Total length: 15.00 [ft]
Load combinations: ICC-IBC;
===========================================================================
LOADS: (force=lbs, pressure=psf, udl=plf, location=ft)
>>Self-weight automatically included<<
===========================================================================
Load I Type 1 Distribution I Magnitude 1 Location 1 Pattern
1 1 1 Start End 1 Start End 1 Load
-----1--------1---------------1-----------------1-----------------1--------
Load1 Dead Full UDL 220.0 No
Load2 Snow Full UDL 375.0 No
===========================================================================
SUGGESTED SECTIONS that PASSED the CODE CHECK:
===========================================================================
I Species 1 bxd I Axial I Bending 1 Comb'd 1 Shear I Disp./
1 Grade 1 in 1 fc/Fc'l fb/Fb' 1 1 fv/Fv'l Allow.
1--------------1-----------1-------1--------1--------1-------1--------
VG West.DF
24F-V4
24F-V4
24F-V4
>>For more detailed
1
2
3
3.125x13.5
S.12Sx10.S
8.7Sx9
output, select
0.78
0.79
0.64
a Suggested Section
0.63 0.74
0.51 0.96
0.36 0.89
the Data Bar.<<
from
========================:==================================================
DESIGN NOTES:
---------------------------------------------------------------------------
---------------------------------------------------------------------------
1. Please verify that the default deflection limits are appropriate
for your application.
2. GLULAM: The loading coefficient KL used in the calculation of Cv
is assumed to be unity for all cases. This is conservative except
where point loads occur at 1/3 points of a span (NOS Table 5.3.2) .
3. GLULAM: bxd = actual breadth x actual depth.
4. Glulam Beams shall be laterally supported according to the provisions
of NDS Clause 3.3.3.
5. GLULAM: bearing length based on smaller of Fcp(tension) , Fcp(comp'n).
If:,
[_] C______u___~oodWorks@ Sizer
fb
J
SOFTWARE FOR WOOD DESIGN
03005B1.wbg
Critical Results
WoodWorks@ Sizer 2002
Feb. 19,2003 17:14:51
REACTION [lbs I
Maximum. . .
Uplift: 0
Bearing: 4462
1..,
-1
0'
-
15'
SHEAR [lbs I
+V max: 4462
-v max: -4462
Load Combination
0'
----..J
15'
BENDING [lbs-ft]
+M max: 16734
Load Combination #2: D+S
~
6
,16734
~
0'
7'-6"
---'
15'
DEFLECTION [in]
Max Live: 0.37
Max Total: 0.71
Load Combination #2: D+S
o.
0'
7'-6"
- -,__._~_~____.__---------1
15'
_______~..___._______.,..~~__._J
17
[J
,f]
SOFTWARE FOR WOOD DESlGN-~--==]
WoodWorks@ Sizer
03005B2.wbd
WoodWorks@ Sizer 2002
Feb. 19,2003 17:21:45
COMPANY
Gene Unger Engineering INC.
1401 W. 7th Street
Port Angeles, WA 98363
360-452-2098
PROJECT
Derma
Central Floor beam
DESIGN RESULTS
NDS-1997
Beam DESIGN DATA:
---------------------------------------------------------------------------
---------------------------------------------------------------------------
Material: Glulam Simple
Lateral support: top= full, bottom= at supports;
Total length: 15.00 [ftl
Load combinations: ICC-IBC;
---------------------------------------------------------------------------
---------------------------------------------------------------------------
LOADS: (force=lbs, pressure=psf, udl=plf, location=ft)
>>Self-weight automatically included<<
---------------------------------------------------------------------------
---------------------------------------------------------------------------
Load 1 Type I Distribution I Magnitude I Location 1 Pattern
I I 1 Start End 1 Start End I Load
-----1-------- --------------1-----------------1-----------------1-__-----
Load1 Dead Full UDL 225.0 No
Load2 Live Full UDL 600.0 No
---------------------------------------------------------------------------
---------------------------------------------------------------------------
SUGGESTED SECTIONS that PASSED the CODE CHECK:
---------------------------------------------------------------------------
---------------------------------------------------------------------------
I Species 1 bxd I Axial 1 Bending I Comb'd 1 Shear I Disp./
1 Grade 1 in 1 fc/Fc'l fh/Fb' 1 I fv/Fv' I Allow.
1--------------1-----------1-------1--------1--------1-------1--------
VG West.DF
24F-V4
24F-V4
24F-V4
24F-V4
more detailed
3.125x15
S.12Sx13.5
6.75x12
8.75x10.S
output, select
1. 00
0.76
0.73
0.75
a Suggested Section
0.88 0.86
o . 61 0 . 72
0.53 0.78
0.48 0.90
the Data Bar.<<
1
2
3
4
>>For
from
---------------------------------------------------------------------------
---------------------------------------------------------------------------
DESIGN NOTES:
===========================================================================
1. Please verify that the default deflection limits are appropriate
for your application.
2. GLULAM: The loading coefficient KL used in the calculation of Cv
is assumed to be unity for all cases. This is conservative except
where point loads occur at 1/3 points of a span (NDS Table 5.3.2).
3. GLULAM: bxd = actual breadth x actual depth.
4. Glulam Beams shall be laterally supported according to the provisions
of NOS Clause 3.3.3.
5. GLULAM: bearing length based on smaller of Fcp(tension) , Fcp(comp'n).
la
(/3
i-~J [=_~_~==:~WoodWorks@ Size~-~--~--soFiW~RE-FOR-W~OD DESIGN
'~-I
J
03005B2.wbg
Critical Results
WoodWorks@ Sizer 2002
Feb. 19, 2003 17:21 :45
REACTION [Ibs]
Maximum.. .
Uplift: 0
Bearing: 6187
1"
-1
0'
-----'
15'
SHEAR [Ibs]
+V max:
-V max:
6187
_6167~
-~
0'
15'
BENDING [Ibs-ft]
+M max: 23203
Load Combination #2: D+L
,23203
~
~
D
0'
7'-6"
---J
15'
DEFLECTION [in]
Max Li ve : 0 . 43
Max Total: 0.69
Load Combination #2: D+L
L~-~-.---~.~~-_._--~-~-----
-0.39
0.4
0'
--~~--- --------_._~~--_.__...__._-.
__--------L--__ _
7'-6"
- ---=~~5~__ I
. . II . .
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . .
J
.....
REQUEST:
Date :53 I .-() '3
Time
Received by
R V: (phone, person)
Location of Work to be inspected 131 3 b ec :/'.~\A. _ C\
Name of person requesting inspection JJ c..t.5{..,.' v-t.
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer ~ Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION ~;J.ES:
Inspected: Date ~;>-_~/ ..L-d..:s:
Remarks:
Phone No. t.160 ~ 77f.1 ~
Permit No. ''2.5 I
Time
By
R L~//
RESTORATION REQUIRED . , , , .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel o Asphalt OPCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT. . . . . .
/
REQUEST:
Date .s- - z ,~ - 03
Time
Received by
Rv
_ (phone, person)
INSPECTION NOTESM. lAp
Inspected: Date ~
Remarks:
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney ~bi'9Final
Sewer
CO'\. s; ,: i e.
Tim{J~
Sewer Excav. Other
BV~/
O\"L;
X
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
[] No Damage Found
Work Order #
D COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUiLDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application NLunber ..... 03-00000251 Date 3/11/03
Property Address ...... 1313 OEOReIANA ST
ASSESSOR PARCEL NUMBER: 0630005309600000
Application description . . . RES REMODEL
Property Zoning .......
Application valuation .... 3000
Owner Contractor
DERMA DUETIN/MELISEA OWNER
1313 GEORGIANA ST
PORT ANGELES WA 983624516
Permit ...... BUILDING PERMIT -RESIDENTIAL
Additional desc . . CONVERT 1/2 EXIST GARAGE
Per, it Fee .... 106.75 Plan Check Fee . . 42.70
Issue Date .... 3/11/03 Valuation .... 3000
Expiration Date . . 9/07/03
Qty Unit Charge Per Extension
BASE FEE 92.75
1.00 14.0000 THOU BL-2001-25K (14 PER K) 14.00
Per~it ...... MECHANICAL PERMIT
Additional desc , ,
Permit
Fee .... 54.25 Plan Check Fee . . .00
Issue Date .... 3/11/03 Valuation .... 0
Expiration Date . . 9/07/03
Qty Unit Charge Per Extension
......... STATE SURCHARGE 4.50
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 hast
inspection, I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
{aws and ordinances governing this type of v~rk 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 sta~co~.local law rel~JJ~ting construction or the performance of
construction. /~X "...~,~~~~-~--_ ~--'~--~'--%
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 UNL~qWFUL TO COVER,
INSULATE OR CONCE/IL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE I DATE IYEsACCEPTEDI NO COMMENTS
FOUNDATION:
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
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 ( E nglneering Division) SEPARATE PERM1T #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\ 1 [ 02.15 [4/2002]
FOR OFFICIAL USE ONLY:
BUILDING PERMIT - APPLICATION Date Rec+
Permit.:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE Date Approved:
COMPLETE to be accepted for review. If you have any questions, call
Date Issued:
(360) 417-4815
Mchitec~ngineer: ~e¥~ c :..),~(~, e 'w Phone:
Con,actor <~ State License ~: Exp:. Phone:
Address: ~" ~ ~' C ¢' ' ' "~ · ' ~
PRO~CT~D~SS: ~ ~ ~o~,: .o ,.,~ : :' ~, ,5 ';, ZO~G:
LEG~ DESC~ION: Lot: ~ q ~ $ Block: ~.~.~ Subdivision:
CLALL~ CO~ P~CEL ~BER:
Credit Card Holder Name:
Billing Address: City:.
Credit CardType VISA __ MC __ # Exp. Date:
TYPE OF WORK: SIZE/VALUATION:
[] Residential [] NewCons~'. [] Re-roof m Stove
[] Multi-family [] Addition [] Move [] Garage SF. ~ $ /SF. = $
m Commercial I Remodel [3 Demolition [] Deck SF. ~ $ /SF. = $
[] Repair [] Sign ~ El Other TOTAL VALUATION $
BRIEFDESCRIpTIONOFTHEPROJECT: %~;~ ~/ (
COMMERCIAL/RESIDENTIAL:, Occupancy Group: Occupant Load: __ Construction Type:
.? ~ Existing Sq. Pt. & Proposed Sq. Ft. _ -- TOTAL Sq. Ft. ~ "r, .9
Existing lot coverage % & Proposed lot coverage % = Total lot coverage %
APPROVALS:
PLANNING USE ONLY: PLAN: __
BLDG:
DPWU:
FIRE:
ESA/Weiland(s): [] Yes [] No SEPA Checklist required? El Yes ~3 No Other: OTHER:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the trine of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are requJr~ ,not the City's, and ~t I must obtain such permits prior to work.
0 \ ~"~ , ~ o~
T:W RMSg~PPSBu,ldmgl~rm, t.wpd Apphcant: ~..~ ~ ix.:.._)x.~...._ Date: ~ ...~.~ '~"~
~ SITE PLAN
DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION
APPLICANT: ~) :' ~ ~";~ i' ~'" .~:~ PHONE: ~ ~C
PROJECT/DEVELOPMENT ADDRESS: , :; ' '; ~O r ,r~ :': ¢,
See Page 4 for instmctions on completing the site plan. For mom inf~mation, cal1417-4815.
CffY OF PORT ANGELES -- Construction
t'~ bsu~c, of ~ ~ bned upon t~.e p;~.
p~ s~ns and ~r da~, m imm preve~
[ _ W_oodWorks® S zer FTWA__R E F0R WOOD?ESlG.N
03005Bt.wbd WoodWorks® Sizer 2002 Feb. 19, 2003 17:14:51
COMPANY I PROJECT
Gene Unger Engineering INC. Derma
1401 W. 7th Street I Ridge Beam
Port Angeles, WA 98363
360-452-2098
DESIGN RESDLTS NDS-1997
Beam DESIGN DATA:
Material: Glulam Simple
Lateral support: top= full, bottom= at supports;
Total length: 15.00 [ft]
Load combinations: ICC-IBC;
LOADS: (force=lbs, pressure=psf, udl=plf, location=ft) >>Self-weight automatically included<<
Load I Type I Distribution I Magnitude I Location I Pattern
I Start End Start End Load
Loadl Dead Full UDL 220.0 NO
Load2 Snow Full UDL 375.0 NO
SUGGESTED SECTIONS that PASSED the CODE CHECK:
I Species I bxd Axial Bending Co~,d I Shear I Disp./
I Grade I in fC/FC' fb/Fb' I fy/FY'I Allow.
VG West.DF
1 24F-V4 3.12Sx13.5 0.78 0.63 0.74
2 24F-V4 5.125x10.5 0.79 0.51 0.96
3 24F-V4 8.75x9 0.64 0.36 0.89
>>For more detailed output, select a Suggested Section from the Data Bar.<<
DESIGN NOTES:
1. Please verify that the default deflection limits are appropriate
for your application.
2. GLULAM: The loading coefficient KL used in the calculation of Cv
is assumed to be unity for all cases. This is conservative except
where point loads Occur at 1/3 points of a span (NDS Table 5.3.2).
3. GLUL~24: bxd = actual breadth x actual depth.
4. Glulam Beams shall be laterally supported according to the provisions
of NDS Clause 3.3.3.
5. GLUI~%M: bearing length based on smaller of Fcp(tension), Fcp(comp'n).
Il [ ' Wo~V~)~'ks® Sizer -- SOFTWARE ~O~W0(~DDESIGN
03005B'l.wbg WoodWorks~ Sizer 2002 Feb, 19, 2003
Critical Results
REACTION [lbs]
Maximum...
Uplift: 0
Bearing: 4462
O' 15'
O'
'15'
BENDING [lbs-ft} +M max: 16734
Load Combination #2: D+S
16734
O' 7'-6" 15'
DEFLECTION [in]
Max Live: 0.37
Max Total: 0.71
Load Combination #2: D+S
-0.23 - 3
-0.39 -
7 '-6"
i WoodWorks® Sizer SOFTWARE FOR WOOD DESIGN
03005B2.wbd WoodWorks®Sizer 2002 Feb. 19, 2003 17:21:45
COMPANY PROJECT
Gene Unger Engineering INC. Derma
1401 W. 7th Street Central Floor beam
Port ~geles, WA 98363
360-452-2098
DESIGN RESULTS NDS-1997
Beam DESIGN DATA:
Material: Glulam Simple
Lateral support: top= full, bottom= at supports;
Total length: 15.00 [ft]
Load combinations: ICC-IBC;
LOADS: (force=lbs, pressure=psf, udl=plf, location=ft) >>Self-weight automatically included<<
Load Type I Distribution I Magnitude Location Pattern
I Start End Start End Load
Loadl Dead Full UDL 225.0 NO
Load2 Live Full UDL 600.0 NO
SUGGESTED SECTIONS that PASSED the CODE CHECK:
I Species bxd Axial I Bendingl Comb'd I Shear Disp./
Grade I in I fc/Fc'l fb/Fb' fy/FY'I Allow.
VG West.DF
1 24F-V4 3.125x15 1.00 0.88 0.86
2 24F-V4 5.125x13.5 0.76 0.61 0.72
3 24F-V4 6.75x12 0.73 0.53 0.78
4 24F-V4 8.75x10.5 0.75 0.48 0.90
>>For more detailed output, select a Suggested Section from the Data Bar.<<
DESIGN NOTES:
1. Please verify that the default deflection limits are appropriate
for your application.
2. GLO: The loading coefficient KL used in the calculation of Cv
is assumed to be unity for all cases. This is conservative except
where point loads occur at 1/3 points of a span (NDS Table 5.3.2).
3. GLULJ%M: bxd = actual breadth x actual depth.
4. Glulam Beams shall be laterally supported according to the provisions
of NDS Clause 3.3.3.
5. GLtrLAM: bearing length based on smaller of Fcp(tension), Fcp(comp'n).
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date ~ ~-~' / '-~-~ Time Received by (phone, person)
Location of Work to be inspected /5/~
Name of person requesting inspection ~ C~(~, ~
Address of person requesting inspection Phone No. /7/~'~)
Type of Inspection (circle appropriate one): Permit No. ~'~
Sewer~oun~ Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION~C-'~C ~t~l'ES:
Inspected: Date ,~- ~/:--~--~ Time By
Remarks:
RESTORATION REQUIRED ...... YES. NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved [~Gravel [~-~Asphalt I-~PCC [~Other
r-j 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 ,~--~ ~--"~ -(~'-~ Time Received by ~ ~/ (phone, person)
Location of Work to be inspected /~.~,~ ~'~(~ ~'~/~
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. '~'~'-~'
Sewer Foundation Framing Chimney ~umbing~Final Sewer Excav. Other
INSPECTION NOTES.' ~ , /~/>
Insl3ected: Date ~\~ Tim~/~ By ~--~
Re~arks: v ~-
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel [~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)
"
Installed By:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
.
ELECTRICAL PERMIT
PERMIT NO. ;;28'00_
7/..3 /yO"""
D READY FOR ~ILLCALLFOR "
INSPECTION INSPECTION ~
Phone:
DATE
Site Address:
License Number:
Owner/Business:
/14,4~~
Phone:
OwnerfBusiness Address:
Sq. Ft.
(& Residential
Heat KW
o Baseboard 0 Furnace/Boiler
[] Heatpump 0 Other
o Commercial/Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
o New Construction
o Remodel
o Service update/alter/repair
o Overhead
o underground:4-. /';")
Voltage ~ 7 ~
cy10 03.0
Service size -<aD Amps
o Temporary
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
Detai IslDescriptlon:
rNS 111-/1
ttl'J
~
kc/ue
10
.
C~E-
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
~~ Rough.in/cover O.K.
o O.K. to connect service
~ ffI Final O.K.
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
Site Address:
PermitfReceipt No.
.
.;;200.:3
Installer: New Meters Date: h. i)
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 Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224.
T~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ~ D ~
Inspector Amount paid
WHiTE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLY.....IC PRI~TERS. INC.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N?
15029
(,/- /1 . ),/
Port Angeles. WasWngton..............-;~.........m...m.m.__mm.....m..m. 19..m.n
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-
mission is hereby granted to do electrical work as listed below.
-I
~::::s..<12::::~~~~%:e~::::::::::n..;:=:=~:::m~~~~:~.~:.~:::~~~~=::::::::::::::::::::::::::::
Wiring co~tractor .m$:~.e':-o?:1,,~.~.......m.n.nn....m By.nn...........nn.m.nm..m..mn.....n....n...............
Light Outlets___....___...........____..__.._______..
ServIce, volts .m_.m___.nm____.................
No. wires ..........00____0.__0000_.__........_..
Receptacle Outlets....___mn_mm.m_.......
Dryer, K\Vj .....n_._..........__________.._..____
Range, KW.__nn_m_._m._._.
Water Heater:
Size wires......_.__..h__m.mm__n....._..
Main fuse nn.nn___m..............nm_..n
Enclosure m_mm_.m___..___.n___........__
Type of wlrin~:
Entrance Cable m___.h__mmnn.....___
Kw.nmmmm.....hm.h.mm.hmmn
Heal: Rw.'.z/...?...!,L,./.1..8...h
Rigid Conduit .....mmn__.mn___n___..
Metallic Tubing _m__mn....n..........
Current transformers:
No. & Size.............n..._n___mn__________
Motors: size, volts and phase:
Ser. No. .._00_____.______________00__......_.........
Ser. NO...n..._n_..____...................h_h...n
Ser. No.._...._.......................___.._______.._
Type of Wiring:
Armored Cable m____n____n...n..hn....
Non.Metallic _.....n___._...____m___..mn
Knob & Tubem__..nmmnmhnhn......
Rigid Conduit mmmmm_.nn....h....
Metallic Tubing ...___n...__.nmnnn__
Raceway n..___.....___.n__....._.n.____..m...
CIrcuits, LfghL.......hnh__.__..m............___
Utility ._.nnnn..n__nnn..nn__..____h......
Heat
Range .........___...._.......00._._..0000____0000.
Water Heater ..............__..........._...
Motor ....__...__..0..__......_................00_.
l)ryer...__nn_nnn___n___..nnnn___._n_.n____.
Furnace .....h_.h_h_..........._n.............
Total Loadnnn_m....___..__....... Ser. NO._.....nn..___...h....m..nmnnm_... Total _.___nn____..___n..m_nm_.:_____
Remarks: ..n.....n'''''d2../2'-:Z.A.:!.~m~n!._<;.._I1(,:f...<!c.9......nn.....h.........n...........m......m.m...........mmm
.;~;::~.;~~nn....mnm--........m;~::...~:~:;~~....--.................m...........:?:1.:7~....~~:..mm..2mmm..m.
$m..m.mm..m.m..m__..__... NO.....mm..__.......__..m By m!.L..L....m__....;...:":'.?.':.!.:-!:..:::__.!..:::.~~
NOTICE-Current must not be turned on until Certificate 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 THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
15029
Date called for inspection.._________.__..______________._____.______..._...00._____..____._.........____..__...........__...............___......._...___.......____._..__________......._....____..._
Prelimlnaryinspectiondates.._.._._.....__.....__..._.....__.._........____.._.__...._____......._.___.___..........._.._____............_.._~__.........___._.__.........._...__..__...._.........
['otal Load __nnnnnn_nnnnnn__nnn_hn.__.nn.._.nn..._nnnn.....n...........h_
lnspectioncompleted..._...____.___._.._.__.____..__.._____hn__.____...__....._......_n.__..............__.._..._.___......._....._____....__........_____.........._._....____._.___._....._._
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ELECfRICAL WORKPERWT APPLICATION
Electrical contractor name License number Date Expires
fIU(^I('(Al\~\fl~IA"" \'1") ~ (rJ1IiI'ii) f11 Jl,\IEtl lW1''--IM 11 Iij-\-O n
Pl.l.rchascr's mailing address
7{j 7 l:'j? VVl P -'7\;"-
v"y
OA f\V1~ If)"
Telephone number
Q New
D Altered'Addition
9
\
<J\
CJ
()
Job wired by
~ Electrical Contractor 0 Owner
lnstallaliofl dcsc~iptio~
o Commercial ~ResideDtial
Statt.- ZIP
()J 0lQ~ 7
FAX ntlmber
S'l-
.1-\\ T-"7tLA.t r A) i v\ V1Qj
Premises owner's name
$V\e\\ c.,SC1\. bE' \f 1fV\ 0\
Address of iDspec1ioD fv1
\~\-; 6{(j\t~i fA "St
~(Aft ITIIJO)-e lfL
Pbone number to sched e inspection:
~.1'S2 e' ,,-w..~
Owr.cr aJ defined by RCW,' 9.28.26f:(l) Owner wiU occupy the structure for two
years aller this declriciJl permit is jinalized. (2) Owr:er is reqIJired to hire an electrical
C(1ntractor if above said property is for sale, Tent or lease.
AfteT reading the above: statement, [ hc:reby certify that ( am !.he owner of thc above
named property or :l licensed elcctricOII contractor. I am making lhe electrical instal-
100tio[1 or alteration in compliance .....ith the electrical laws, N.E.C., RCW. Ch:lpter
\9.28, WAC. Chapter 296-469. The City of Port Angeles Municlpal Code, and
Uilit)' Specitic:l1ions.
re of owner, elect 'cal c(lntnctor or electrical administrator
o Cash 0 Check #
'lj( Credit Card Visa
Card #
Mastercard
Discover
----------------
Expiration Date
of card
x
Service Information
Eleclrical Load Additions and or subtraclions
D NO LOAD CHANGES
o Baseboard _ KW
Cl Furnat:e l$<W
a Heat Pu mp Ton LAA
o Fan-Wall KW
1:1 Overhead Service
o Temp Service
o Underground Service
Voltage
PhaseD1D3
Service Size: _
Feeder Size:
SAME DAY INSPECTlO1\o; CALL BEFORE 1'00 AM 360-417-4135
- ,
ROUGH-l:'I '\ ( TIlERMOSTAT I SERVICE
;'(7;.~I~- ~,-/
,
\:: D~I(l Appro\'ed By "- """ APr-r.>w;C: By
"' /
FINAL DITCH FEEDER
7b,Lf JOb \Jlv
'- ,"'vpIOvedBy~
'D:llev A~r.r'O"ed By "- Dale APl'rovl'rJ By 0:1.11'
I ns.pc~lion Area. Building or Equipment Inspected Action Taken Electrical
Date Inspector
I
I
CITY OF PORT ANGELES PERIMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street — P.O. Box 1150 I Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711 `
Date: _J:- j-- 1 I /
1 & 2 Single Family Dwelling
MAR
EUCTRfGh
k Plan Review May Be Required„ Please Complete Electrical Plan Review Information Sheet
Job Address: 1 -esa.
Building Square Footage; \ \' e) '
Description of above ry Za c.
Owne form tion �c�
Contractor Information
Name: t IN - Z_ �� ;r r., t „
. —� Name;
Mail! n ddress; 1` �+ 10,�6�
Mailing Address:
City; State: Zip; ' i $, (,___ City; State; Zip;
., -Fax:
Phone: ' C5 -A 7
Phone; Fax;
License #
License # 1 Exp,
Item
Unit Charge phy 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 -1 CCO Amp.
$ 262.00
$
Service /Feeder over 1000 Amp.
$ 373.00
$
Branch Circuit W! Service Feeder
$ 5.00
$
Branch Circuit W10 Service Feeder
$ 63.00
$
Each Additional Branch Circuit
$ 5.00
$
Branch Circuits 14
$ 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, ServicelFeader 601 -1000 Amp .
$168.00
$
Portal to Portal Hourly
$ 96.CO
$
Signal Circud 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
$
$ Total
Owner as defined by RCW.19,28,261: (1) Owner will
occupy the structure for two years after lhis 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 -4613, 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
I..
❑Credit Card#
r �� w �'
Dated:
0110112012
U, A 0 Q. ELECTRICAL INSPECTION
,
WIRING REPORT
417-4735
�-RKS &
DATE r
'c4
PERMIT 9
9
OWNS
CONTRACTOR
ADDRESS
APPROVED
NOT APPROVED
[I - . � ................. DITCH ...... — .... ...... 0
13 ... ....... I - ROUGH IN/COVER ...... El
........
w ................ I .. SERVICE ........ ....... El
0... . ................. FINAL .......... — — —. JR�
CORRECTIONS NEEDED- )LL-b ?::1- N' 50 Irk '5
2�
mo ykj WL., 90 V.
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
w
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number . . . . .
14- 00000389 Date 3/28/14
Application pin number . . .
450682
Property Address . . . .
1313 GEORGIANA ST
ASSESSOR PARCEL NUMBER;
06-30-00-5-3- 0950 -0000-
Application type description
ELECTRICAL ONLY
Subdivision Name . . . . . .
120.00
Property Use . . . . . . . .
Fee
Property Zoning . . . . . , .
RS7 RESDNTL SINGLE FAMILY
Application valuation . . . .
0
Application desc
0
200 amp service change
----------------------------------------------------------
--- -- --- ---- -- - ---
Owner Contractor
--- --------------- - - - - -- ------------------ - - - - --
DERMA DUSTIN /MELISSA OWNER
1313 GEORGIANA ST
PORT ANGELES WA 983624516
permit . , . . . .
ELECTRICAL
ALTER RESIDENTIAL
RESULTS:
INSPECTOR:
Additional desc . ,
Permit Pee
120.00
Plan Check
Fee
00
Issue Date
3/28/14
valuation
0
Expiration Date
9/24/14
Qty Unit Charge
Per
Extension
______ 1 0r 120.0000
- - ^^ ^
ECH EL-0 -200 SRV FEEDER
^- ^-- l^'-^ - ^-
-f
120,00
- -` -__ ___
^ Vary
Fee Charged
paid ,Credited
Due
Permit Fee Total.
120,00
120.00
.00
.00
Plan Check Total
00
.00
.00
.00
Grand Total
120.00
120.00
00
.00
REPORT SALES TAX
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 (b) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Dale:
G:IEXCHANGE\BUILDING