HomeMy WebLinkAbout217 N Laurel St - Building ,0 -t CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
ti l 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00000353 Date 5/09/11
Application pin number 149524
Property Address 217 N LAUREL ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-5-0- 5030 -0000-
Tenant nbr, name NECESSITIES TEMPTATIONS on your state excise tax form
Application type description SIGNS to the City of Port Angeles
Subdivision Name
Property Use (Location Code 0502)
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 1350
Application desc
TWO 32 SQ. FT. WALL MOUNTED SIGNS
Owner Contractor
FLORENCE M CHAMBERLAIN ET AL JACKSON'S SIGNS GRAPHICS
1607 E BEACH RD 472 MT. PLEASANT RD
PORT ANGELES WA 983637161 PORT ANGELES WA 98362
(360) 457 -3703
Permit SIGN
Additional desc TWO, 32SF WALL -MNTD SIGNS
Permit pin number 184333
Permit Fee 170.00 Plan Check Fee .00
Issue Date 5/09/11 Valuation 1350
Expiration Date 11/05/11
Qty Unit Charge Per Extension
2.00 85.0000 PER S -WALL SIGN OR MARQUEE 25 SF 170.00
Special Notes and Comments
May 2, 2011 5:30:55 PM sroberds.
The project will permit 2 new single sided wall mounted
signs (north and south walls) for total sign area of 89 \-e-e-‘
sq.ft. in the CBD.
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Fee summary Charged Paid Credited Due
c?\ \6'd
Permit Fee Total 170.00 170.00 .00 .00
Plan Check Total .00 .00 .00 .00 Grand Total 170.00 170.00 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
k7 q 411. /21)-1-1-
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735 W
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs Z
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by i
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By n
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815 1 Z, 11 Pe)
T:Forms /Building Division /Building Permit
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CITY OF PORT ANGELES
For City li e Only: Attn: Bviiding Permit Tecl�ni Date Received l�Y�'
WA 98362
i 321) Fifth i Angeles, I Permit# t y
X350) 417 -4815 fax X360) 47 -4711
966wnex. ge'Jr count() tJQ125a.e.: F Iortnnce_ M. Cho mbe, -i gin 1 Date Approved
Applicant or Agent Edna Petersen i r“r7 E GQB1Ch 4Z-4
p_IR.,.w.}�4&3 63 11bt Phil e 45 -6400
Property Owner X d Ph e 206- 443 -2325
Property Owner's Address
Contractor /Engineer Jack igns Phone. 7 -3703
Contractor /En ineer's Address
5 472 Atit nt R. Por eles_WA 9836
License ACKS5G022M1 Expires g 3
Project Address .17_Na_La_ ure) St.
Business Name L oeasities_ -arid Te_lj4t- tiot15
Parcel Number 0630 0050 pO R0 Lot Zoning i P
Submit an 8 "x 11 "site plan three sets of plans that include:
Type of sign (wall-mounted, projecting, freestanding, illuminated, other...)
Placement and sq. ft. area
How the sign will be securely attached (Engineering specs may be required for freestanding signs)
Separation distance between the bottom of projecting and freestanding signs and the surface below.
See "Chapter 14.36 Sign Code" of the City of Port Angeles Municipal Code for sign requirements.
Sign Type Brief Description: (Type, location, sq. ft)
Sign #1 1- single sided 1/4 "Aluminum 4' x 8' Wail mounted South wall
Sign #2 1- inale, side 114 "Al uminum 4' x 8' Wall mounted North Wall
Sign #3
Sign #4
Totals (Unit charges Signs)
Unit Charge Quantity multiplied by quantities} Type of Sign Valuation 1350.00
S47.00 x All sign as an s te th or equal to 25 sg, ft,
$85.00 x 2 170.00 Wall si n or mar, uees over 25 s ft.
$115.00 x Freestanding sign or pectin. si•n, over 25 s.. ft:
GRAND TOTAL Make Checks Payable to: City of Port Angeles
Credit Cards (Except American Express) are accepted
Existing signs) area 2 sq. ft. Proposed sign(s) area 64 sq. ft Total sign(s) area 89 sq. ft.
Building facade area (height 20 ft. X width 112 ft,) 132 sq. ft. (If a building has more than one
business in it, only measure the area of the building facade that is used by the business applying for this permit.)
1 have read and completed this application and know it to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are
required, and to obtain permits prior to working on projects.
411110-
Date 4 -1E3-2011 Print Name acksori Smart Signature r I
T,Fomtsteuitding Div-ski:WS:9A Permit Apptt tion,doe
4-15-2011
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Necessities and Temptations
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217 No. Laurel Street
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
OWNER/APPLICANT
J. ANTHONY HOARE
600 MARKET PL. ONE
SEATTLE, WA 98121
3601000-0000
T:
S:
ISSUED: 12128/2001
PROPERTY LOCATION
217 LAUREL N
Lot: 9
Block: 1 0 Long Legal
Subdivision: TLE
Parcel No: 063000500090000
PERMIT NO: 13157
BUILDING PERMIT
CONTRACTOR
RANDY HOCH CONSTRUCTION
379 BENSON RD
PORT ANGELES, WA 98363-0000
360/452-6901
PROJECT INFO
Project Value: $2,000.00
ProjectType: INT. REMODEL
Occupancy Type: COMMERCIAL
Occupancy Group:
Construction Type:
Zoning Use: CBD
ARCHITECT
NIA
, 98360-0000
3601000-0000
SFD Units: 0
SFD SO FT: 0
MFD Units: 0
MFD SO FT: 0
Commercial:
Industrial:
Garage:
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PROJECT NOTES
cut opening in south wall to allow for use of addition space
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FEES ASSESSMENT
Building Permit: $69.25 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $73.75
Plumbing: $0.00 AMOUNT PAID: $73.75
Mechanical: $0.00 BALANCE DUE: $0.00
Radon: $0.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work Is suspended or abandoned
for a period of 180 days after the work as commenced, or ifrequired 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 re9ulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent Date
BmLDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVE.7,
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 I ACCEPTED COMMENTS
I YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TlQN DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS I I I
CEILING I I I
FRAMING
JOISTS I GlRDERS
SHEAR WALL
WALLS I ROOF I CEILING 1-11-0 L LEft
DRYWALL
T.BAR
INSULATION
SLAB I I
WALL / FLOOR I CEILING I I
MECHANICAL
HEAT PUMP
WOODSTOVE / PELLET/CHIMNEY I INSERT
HOODIDUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'s:
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'g SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W./ PWI CONSTRUCTION - R. W.
ENGINEERING 4174807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417.4815 BUILDING
C:\APPL.WPD
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~~
BUILDING PERMIT - APPLlCA nON
I'OROmCIAL ~ONLY:
DaRcc:.:1 'Z.-2'l'-~
PcmIiI ,: . I :? I :>
Da AppnIYed;
DIIIl -Z/r;
Owner:
The Building Permit - Pre-applicatitm _ be f1Ild IIIIt completely.
Please type or prlat Ia iak. /~~ bn IIlIY quatioas, pIeue caD 417-4815
dlor Agent: ~ \. TRA ~ Phone:%7-?, -"J CY)
I
Address:,;? /7' /J.
Arcbiteca::
Contrac viJ. L
r
Address:
Zip: qfSh~
Phone:
License #:
Exp:
Phone:
Zip:
ZONING:
PROJEcr ADDRESS: dP /7
LEGAL DESCRIPTION: Lot
CLALLAM COUNTY PARCEL NUMBER:
BlIIIq Add.....:
Credit Card ##:
Subdivision:
Credit Card Holder Name:
City:
Exp. Date: VISA MC
SJZElVALUATION: ,4_
,SF.@$ ISF.=$~
SF.@$ ISF.=$
SF.@$ ISF.=$
TOTAL VALUATION $
TYPE OF WORK:
D Residential D New Constr. D Re-roof
D Multi-family D Addition D Move
D Commercial ~odel D Demolition
D Repair D Sign
BRlEFDESCRJPrI~nr~~
tl Woodstove
D Garage
tl Deck
tl
: ,
~ /Y7 0 c.t....L I.L'.L (7 a.D' ./Jr-J
()
CO~CIALlRESIJ)ENpAL: ,Occ:upancy Group: . Occ:upantu;.a{ Construction Type:
No. of Stories: , . Lot size: , : % Lot c.:iverag~:c,. .%, , , '
Exislin$ Lot~" ' ':"/sq. ft. + Proposed Lot Cowrage::i.", ,,',' Isq.:fti'" ToTAL LOT COVERAGB: '"''''~'. ',;'; Isq.f
PLANNINGUSll:ONLY: APPROVALS: PLAN
Notes: BLDG.
DPW
FIRE
BSAlWetland(s): DYes tl No SBPA Checklist required? tl Yes D No Olher: OTHER
BUILDING APPLICATION SUBMITrAL: Y_IIpJ1iIcIItJtm""" aJkplmt _kf1lld _~ to k.upl8lfor nvlew. Th.
Building Division can provide you with more detailed infonnation On the application and plan submittel requirements.
.'
BUILDING PERMIT APPLICATION SUBMrITAL: Your completed application, site plan (for additions) and building CODSlructioo
plaus are to be submitted to the Building Division.
VALUATION OF CONSTRUCl'ION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and
may be revised by the Building Div. to comply with current fee schedules. Contact the Permit Coordinator at 417-481 S for assistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building pennit application and constJUction plans are'submitted. AIl olhm
permit fees are due at the time of pennit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this applkatiGD wID expire by
limitations. The Building Official can extend the time for action by the applicant up to 180 days, on 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 certiJj that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for
this permit. I understand it is nat the City's legal respomibility to determine what permits are required; it remains the applicant's
respomibi/ity 10 determine what permits are required and to obtain suc~ n
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date /-/0 -0 L
Time
Received by
lc
e. person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation \Framin9') Chimney
2/7 IJ Molle /
E dA./lA-
Phone No. YS7- b Cf 00
Permit No. f ~ 1 S 7
Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date !-- / I - 0 Z
Remarks:
Time
By
u
0)
{j f~
RESTORATION REQUiRED...... YES
NO
r0
-
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<.
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~
p
-
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
[] Repaired by Permittee
D No Damage Found
Work Order #
D COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
"'~'~I
"~~
~,
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
.'21 EAST 5TH STREET. PORT ANGELES. WA 9R'62
ELECTRIC~L PERMIT
Issued: 6/25/99
Permit No:
6676
OWNER/APP,LICANT------------------------PROPERTY LOCATION------------------------
J. ANT~ONY HOARE 217 LAUREL N
600 MARKET PL. ONE Lot: 9
SEATTL$, WA 98121 Block: 1 Long Legal:
360/000-0000 Sub: TLE
T: I S: Parc No: 063000500090000
CONTRACT~R-----------------------------DESIGNER---------------------------------
ANGELE$ ELECTRIC
524 E. :FIRST ST.
PORT A*GELES, WA 98362
360/45~-9264
,
000/000-0000
PROJECT +NFO--------------------------------------------------------------------
Prj Type: COML. MISC. prj Value: $0.00
Occ T1pe: Cnstr Type: ADD CIRCUITS
Occ $rp: Occ Load: Land Use: CBD
Electrical Heat Service Type
Ba$eboard KW: 0 Riser
Furnace KW: 0 Overhead Service
I
He~t Pump KW: 0 Underground Service
Fa~/Wall KW: 0 Temp Service
voltage:
Diameter:
Service Size:
Feeder Size:
-1
o
-3
o AMPS
o AMPS
PROJECT ~OTES-------------------------------------------------------------------
CIRCUItS FOR ESSPRESSO MACHINE
,
I
PROJECT FEES ASSESSMENT---------------------------------------------------------
I . $
, Serv~ce: 0.00
Additional Feeders: $0.00
, Circuit wiring: $54.00
Temp Service: $0.00
$0.00
MisCi
TOTAL FEE:
Amount Paid:
$54.00
$54.00
-------------~-------------------
---------------------------------
TOTAL FEE:
$54.00
Balance Due:
$0.00
COMMJ~NTS/ACTlON NEEDED
,
I
,
,./
". -'1"
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COlIER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. .
ELECTRICAL PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECIlON TYPE DATE ACCEPTED COMMENTS
YES I NO
<>nTT{'u:m!COVER
~VTrP
, ,
II'~IZc;/Y'f I ~
-.
GENERAL COMMENTS:
pW-IJ02.I)(4'9t:i]
"". --I "
I.'
:1 I
J~I
~,
ELE~T1rlqAL PERMIT
I
OWNER/A~PLICANT------------------------PROPERTY LOCATION------------------------
J. AN~HONY HOARE 217 LAUREL N
600 MARKET PL. ONE Lot:
SEATTUE, WA 98121 Block:
360/odo-oooo Sub:
T: I S: Parc No:
CITY OF PORT ANGELES
PUBLIC WORKS. ELECTRICAL DIVISION
.'21 EAST 5TH STREET. PORT ANGELES. WA 9R:162
Issued: 5/26/98
Permit No:
6315
Long Legal:
CONTRAC~OR-----------------------------DESIGNER---------------------------------
APS EUECTRIC
546 B~NSON RD.
PORT ~NGELES, WA 98362 ,
360/45~-6753 000/000-0000
PROJECT ITNFO----- - - - - - - - - - - - - - - - - - - ----------------- - - - - - - -- ---- - -- - - - ----- - - ---
prj '11vpe: COML.REMODEL prj Value: $0.00
Occ ~Iype: Cnstr Type: SERVICE CHANGE
Occ Grp: Occ Load: Land Use:
Electrl.ical Heat Service Type
B~seboard KW: 0 Riser
Fuirnace KI-,: 0 X Overhead Service
I
HEp.t Pump KW: 0 Underground Service
F1n/Wall KW: 0 Temp Service
I
PR~~~~;J~o~~~-;~~;~~;-;;~;-~~~~~------------------------------------------------
800 AMP SERVICE, 4 UNITS @ 200 AMP FEEDERS, 1 200 AMP HOUSE PANEL
,
OIL HEAT, ONE HOT WATER TANK
I
I
Voltage:
Diameter:
Service Size:
Feeder Size:
120,240
X-I -3
800
200
AMPS
AMPS
I
PROJECT IFEES ASSE~~~~~~:~-----$;;~~~~-------------------------------------------
Adbitional Feeders: $260.00
I Circuit Wiring: $0.00
, Temp Service: $0.00
Misc. $0.00
----~----------------------------
----~-----------------------------
TOTAL FEE:
Amount Paid:
$495.00
$495.00
TOTAL FEE:
$495.00
Balance Due:
$0.00
COl\lMllNTS/ACTlON NEEDED
,
ELECfRICAL PERMIT INSPECfION RECORD
_,0.
r _ '.,..
~
,
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANI' WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMlT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
DATE I ACCEPTED
IYESI~O
COMMENTS
DITCH
KUUlili-IN I CUYbK
SEK VICE
c'1f('lo ~
7/919ir
FINAL
1712il9K I
GEl'(ERAL COMMENTS:
PW.II02.1~14i96J
,,;....~ .
CITY OF PORT ANGELES
LIGHT DEPARTMENT
.
ELECTRICAL PERMIT
PERMIT NO. ~ ;J 7?
DATE /O~fj/;r?
I nstalled By:
o READY FOR
INSPECTION
LIcense Number:
u WILL CALL FOR
INSPECTION
Phone:
Site Address:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
o Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
)& Commercial/lndustrial 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
Voltage
o 10 030
Service size
o Temporary
J! Add/alter circuits
o Auxiiiary power
(list below)
o Special equipment
(list below)
Amps
Detai IslDescription:
cAr ~a-<~~~
.
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough.in/cover O.K.
..E: O.K. to connect service
11f'~ Final O.K.
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department nolified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
Installer:
Site Address:
.
Notify the De rt nt 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.
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT / ({, !!!!?
Inspector ArTlOunt paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYMPIC PRINTERS. INC.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
.
ELECTRICAL PERMIT
PERMIT NO. /7 t9 0
DATE S:k~/:??
.
Site Address:
:;2/7
o!c
Installed By:
I!/
D READY FOR WILL CALL FOR
INSPECTION INSPECTION
License Number: Phone:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
o Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o 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/alterlrepair
o Overhead
o Underground
Voltage
o 1~ 03.0'
Service size
o Temporary
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
Amps
DetailslDescription:
.R~
.
/t90 /hj .P14-Yl&L-
/
I . /
7' IYI"j / ~ IN E"rlsf;;u(/
/ I /
~~r
I
290
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough-in/cover O.K.
'[] O. K. to connect service
~ Final O.K.
Size
Comments
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o MeIer Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
,;;;2/7
j1/./~
Site Address:
Installer:
~.
\
Notify the D pa ment 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'(~1;!1. EXT.158 or EXT. 224.
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT tr' f5k-7
/1 ,::JO ~
( Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLY"''''IC PRINTERS, INC.
I"! iJ
AIR FLOW HEATING
I4J ooi
10/30/02 WED 16:18 FAX 360 6
.....----
",- I '~~-n:::.:
;,,~,(;4IC4711
t: 1/
LECTRICAL PERMIT APPLICATION
FOR amCIAl. USE QNL V
""~
I'"l:nnlr':
'$-^wroVo:d:
T e Electrical Permit Application ?,ust be rUled out comoletetv.
e type or reprint in Ink. .fyou have :;any quesUons, ploase can (360) ,(17-
47aS
Fa. number: (360) 411-47"
~
Owne,. or Elec. Contractor Agent:
Edna Peterson
Phon.' 457-6400
REQUEST INSPECTION 0
6&3- 3171
FaX'
P rty Ow Edna Peterson/Necessities & Temntations
rop" ner:
217 N. Laurel Street Port Angeles
Address: City:
Phone:
98362
License a;TRFJ ,HC,OOgc'SE.p:
Sequim
Zip'
, 'i
Phone' 683-390
98382
Address:
Electrical Contractor: Air FIo Heatimz
221 W. Cedar
City:
Zip:
^'<P ELECTRICAL CONTRACTOR
U- € t?d4 (I, &7
City: 6 f50 LJ I YV\
EJtp. Date:
z/p:cq ~
V/SA~ Me:..
INSTALLATION WI REO BY: 0 OWNER
Credit Card Ho/der Name~~
B/I//ng Address~!t'\J. (lJ<./~
CredIt Card N..,mber' /
PROJECT ADDRESS'
;)/7
/J
!~.bL,
~n
TYPE OF WORK:
Check ~ that apply: "id New
o Alleration/Addilion
o Residential 0 Multi-family
~ Commercial 0 Mobile Home
Sq. FI
Remote Meter
o Detached garage
o Hot Tub 0 Swim Pool
o Septic Pump
~LOW Voltage 0 Telecom.
1":1
OS..
Number of Circuits added or altered:
DESCRIPTION OF THE ELECTRICAL PROJECT:
o Baseboard
o Furnace
~ Heat Pump
o Fan-Wall
_KW
4- :'N~ LRA
_KW
PERMIT FEE: 'OS - 0 {) Service Information
~14cft. /.
q 7 7 7'\ -tJ.,(
o Overhead !:;ervrce~. V' '" ~
o T emp Service~ ....
o Underground Service ...... ~ ~. /......
'. .. "<;(,
. . .
;/~.
;
Voltage:
Phase: 0 1
Service Size:
Feeder Size:
o 3
Electrical Heat Load Additions
I hereby certify that I have read and examined this application and know that same to be true and correct, aiicf 1 ~!
authorized to apply for this permil. I understand it Is not the City's legal rlilsponsibility to determinlil what perrrl;f~
are req"'lred; it rerr;.ains the applicants responsibility to determlne/wf/at permits are requirw, and to obtain such.
A(- Uf(,tM't~ 5V( 1.^.lIRE -fuAAp'" p/fY~/f(r fo Acc.o,,",,>-to 'fie" fk..,.JP./!'q-'-
rhr: ..J. ~ ../
Credit Card Holder's Signature:~ f1 tJ\. Date:
Owner or Elec. Cont. Signature: . ~p Datel~'hf)1(j15
C:/ELECTRICALPERM1TAPPLlCA TION , .