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HomeMy WebLinkAbout602 B St - BuildingApplication desc TEAR OFF RE ROOF Owner T.Forms /Building Division. Building Permit (05 /13 /08).wpd CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 08 00000765 Date 6/30/08 Application pin number 062330 Property Address 602 B ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 5700 0000 Tenant nbr name JOE F MARY ALICE B Application type description RE ROOF Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 15875 Contractor JOE FISK MARY ALICE BOULTER LARRY S ROOFING 602 S B ST 352 AVIS ST PORT ANGELES WA 983635714 PORT ANGELES (360) 452 2215 Structure Information 000 000 TEAR OFF RE ROOF WA 98362 Permit BUILDING PERMIT NO PR FEE Additional desc TEAR OFF RE ROOF Permit pin number 128991 Permit Fee 291 75 Plan Check Fee 00 Issue Date 6/30/08 Valuation 15875 Expiration Date 12/27/08 Qty Unit Charge Per Extension BASE FEE 95 75 14 00 14 0000 THOU BL -2001 25K (14 PER K) 196 00 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 291 75 291 75 00 Plan Check Total 00 00 00 Other Fee Total 4 50 4 50 00 Grand Total 296 25 296 25 00 00 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 ow the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with hether s eci I herein or not. The granting of a permit does not presume to give authority to violate ncel the provisions of any t to or loc I law' lating construction or the performance of construction Date Print Name Signature of Contractor or Authorized Agent Signa of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD o CALL 417 -4815 FOR BUILDING INSPECTIONS CALL 417 -4735 FOR ELECTRICAL INSPECTIONS 0 9 CALL 417 -4807 FOR PUBLIC WORKS UTILITIES. CALL 417 -4886 FOR BACKFLOW PREVENTION INSPECTIONS. :J 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 AND APPROVED PLANS AT THE JOB SITE. (1\ INSPECTION TYPE DATE ACCEPTED COMMENTS FOUNDATION• FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT /Ps PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT 417 -4735 CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 I FIRE 417 -4653 I PLANNING DEPT 417-4750 BUILDING T r• day a,r n. n /fly dr Pe it (05 /13 /081.wod 417 -4815 I 1�` I ✓j YES I NO 11-7,2-- 10 FINAL FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED BY. I FINAL DATE ACCEPTED BY. SEPA. ESA. SHORELINE. ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING FIRE DEPT PLANNING DEPT BUILDING DATE ACCEPTED YES I NO I I I I I. I I I I V J PROJECT ADDRESS Parcel Number Floor Areas Basement 1St Floor 2nd Floor 3 Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures T Forms /Building Division /Bldg Pe•mit Appl. 2006 Code doc BUILDING PERMIT APPLICATION CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles WA 98362 (360)417 -4815 fax (360) 417 -4711 Applicant or Agent 10 110 Property Owner 11 Property Owner's Address (o9 Contractor /Engineer rf U Contractor /Engineer's Address License Project Tvpe Brief Description. )4 Residential Check all that apply New Construction Addition Remodel Repair Re -roof Demolition Heat System Other *--itt+,41 Existing (sq. ft.) Proposed (sq. ft.) sq ft. Lot size Max. height of proposed structures ft. Occupancy group Will a lawn sprinkler system be installed? Occupant load Will a fire sprinkler system be Installed? Construction type Phone 1191 ,Phone Phone Expires Lot Commercial Multi- family 1' ot e Iv qi' s Zoning Heat pump wood burning stove gas fireplace pellet stove other For City Use Only Date Received, '3 8 Permit Date Approved z cZ 63 per sq ft. Print in ink Industrial TOTAL VALUATION IS ,EDS sq ft. Lot coverage of bedrooms of full baths of flalfbaths I have read and completed this application and know it to be true and correct. I am authorized .o a.: for this permit and understand that it is my responsibility to determine what permits are required, and tt' btain p =r'- s �.y or to working on projects P1,1)0(6 Date C�'� o.. Inrn Signature If c .,k 110 ES Z± Lo 3S L 6,SZ_ —C410 34)1 ?:_s0 E f ~ORr ~ tO~~~ hi' lL ~ ~ ~..,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 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 07-00000915 Date 655015 602 B ST 06-30-00-0-1-5700-0000- JOSEPH FISK RE-ROOF 8/03/07 RS7 RESDNTL SINGLE FAMILY 2200 Owner Contractor JOSEPH FISK / MARY-ALICE BOULTER 506 S 6TH AVE POKITELLO ID 83201 (360) 457-6410 OWNER Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT - NO PR FEE TEAR OFF AND RE-ROOF 108456 109.75 Plan Check Fee 8/03/07 Valuation 1/30/08 .00 2200 Qty Unit Charge Per Extension 95.75 14.00 BASE FEE 1.00 14.0000 THOU BL-2001-25K (14 PER K) Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 109.75 109.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 114.25 114.25 .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 egulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date y --I ~ Date T:\Policies\1102_l5 building permit inspection record05.wpd [1/4/2005] Bun.,DING PERMIT INSPECTION RECORD o ,...J CALL 417-48]5 FOR BUILDING INSPECTIONS. CALL 4] 7-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UT1LIT1ES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UN LA WFUL TO COVER, INSULATE OR CONCEAL AN}' WORK BEFORE , I.NSPECTED AND ACCEPTED, POST PERMIT IN A CONSPICUOUS LOCA TJON. ~ KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSf'ECTION TYPE DATE , ACCEPTED COMMENTS ~ YES I NO FOUNDATION: FOOTINGS SHEAR WALLS / WALLS FOUNDA TJON DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW i WATER AIR SEAL WALLS CEILING FRAMING 0 JOISTS / GIRDERS SHEAR W ALLiHOLD DOWNS WALLS i ROOF / CEILING DRYWALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULA TJON SLAB WALL / FLOOR / CEILING ~ MECHANICAL ROUGH-IN , HEATPUMP/FURNACEiDUCTS GAS LINE FINAL DATE ACCEPTED BY: WOOD STOVE / PELLET i CHlMNEY MANUFACTURED HOMES FOOTING i SLAB BLOCYJNG & HOLD DOWNS SKIRTING PLANNING VEPT. SEPARATE PERMIT #'s SEPA: P ARKING/LlGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO /Q ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LlGHT DEPT (t> , CONSTRUCTION R.W. I PW I CONSTRUCTION - R.W. g ENGINEERJNG 417-4807 PW / ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLANNING DEFT. 417-4750 PLANNING DEPT. '-1\ BUILDING 417-4815 '1 t u> t Of -rLL.-- BUILDING ~ p \P " T:\PoJicies\1102 15 building permit mspecrion record05.wpd [1/4/2005] "''' r-i0 , r-i N , 0\ r>lr>l ~E-< <l;<l; PoO 0 r-i '" \J) , " ll) '" 0 \J) ;.. 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APPLICATION Fill out COMPLETELY and in INK. Your application, prescriptive energy form, plans, specs, and a 8 W' x 11" site plan MUST BE COMPLETE to be accepted for review. (360) 417-4815 FAX (360) 417-4711 FOR OffiCIAL USE ONLY: Date Rec.: ~-o 3-':-'0-' Permit#: 01- 9 It;" . Date Approved: 8-'3--07 Date fssued: , I Residential projects: submit two sets of plans Commercial projects: submit three sets of plans Applicant or ;ent If! ff j/( Owner ( ;34M6 ) Owner's Address t/tJ~ (~, B .:5TRf3ET. fJA / Contractor/Engineer -rl3]? Contractor/Engineer's Address PROJECT ADDRESS: 6CJ~ Jt7, 13 d'mG6r: M ./ LEGAL DESCRIPTION: Lot: Block: CLALLAM COUNTY PARCEL NUMBER: ~Phone (:3k) (.57- 6~/D Phone State License # Expires Phone ZONING: Subdivision: TYPE OF WO~~ SIZENALUATION o Residential 0 New Constr. ~ ~e-roof 0 Stove SF. @ $ /SF. = $ o Multi-family 0 Addition 0 Move. 0 Garage SF. @$ /SF. = $ o Commercial 0 Remodel 0 Demolition 0 Deck SF. @ $ /SF. = $ o Repair 0 Sign 0 Other TOTAL VALUATION $ r4~(JO ~~. BRIEF DESCRIPTION OF THE PROJECT: . /.. . . ReMtJ YO tfL-P ,IJ()t!r/a/6 F'.-ftJlVl ~~6€;I.JIItJ~ /A/':;TkLt-- A/~ ~ . ~~~ ~~ tU;/#d;A.b~1jO!1JtJf~~--, ... . .. : COMlYIERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: Existing Structure(s) basement Sq. Ft & Proposed Structure(s) basement Sq. Ft. 1 st floor Sq. Ft. & 1 st floor Sq. Ft. 2nd floor Sq. Ft. & 2nd floor Sq. Ft. 3rd floor Sq. Ft. & 3n1 floor Sq. Ft. Existing Structure(s) TOTAL Sq. Ft. & Proposed Structure(s) TOTAL Sq. Ft. Ma.'{imum Height 6fProposed Structure(s) Ft.. TOTAL Sq. Ft. of existing & . proposed structures LOT COVERAGE Lot size Sq. Ft. Existing Structure(s) Sq. Ft. Footprint Proposed Structure(s) Sq. Ft. Footprint TOTAL Structure(s) Sq. Ft. Footprint Total Lot Coverage % (Divide Total Structure(s) Sq. Ft. Footprint by Lot Size Sq. Ft.) 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: The plan check fee must be paid at the time the building permit application is submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF. PLAN REVIEW: An application for a permit for any proposed work shall be deemed to have been abandoned 180 days afterthe date offiling unless such application has been pursued in good faith or a permit has been i~sued;except that the building official is authorized to grant one or more extensions of time for additional periods not exceeding 180 days (90 days for commercial projects) each: The extension shall be requested in writing and justifiable cause demonstrated. (IRC/IBC 2006 105.3.2) . I hereby certify that f 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 t determine what per its are required, and that I must obtain such-permits rior t work." . { Date Applicant ILDING DIVISION\BldgPermitAppl.-2006 CODE.X\lpd '. CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT 16825 jt-.-/? p? Port Angeles. Washlngton........................L............................h..... 19...,.~.. 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 t~o ,?-';Jtrical work as listed below. " ... ~ (p Address ..__.c.?J'!....~...__.__.....____h__....................__.__.hh____.h.hh__. Occupancy....,..-1.,C__ltLd.__...__............... ~::~~::~~:~~~.:~:~~:~~~~~:~~~;:::::::::::::...:.....~::::::::::=::::::::::::::::::~::::::::::::::::::: servi~e. volts '7/.':13o.,./..;)..-~el' Type of Wiring: ~o. wires ----....w:;r;;/7.. SIze wtresm...)"/_......._.....A.._.. Main fuse ....__.._~'!!.m_...n__... ~ Enclosure n.._....nmnnmm.h__mn...._ Light Outlets....................___...._____.._..... Receptacle Outlets.........___.....___..__....... Dryer, KW _._.....____.___.......__.__.___h.__.____ Range, KW.___....______._n______u_____n___.__n. Water Heater: Heal~;~:::::.~i?..::;E..:::::::---... Motors: size, volts and phase: Type of wiring: Entrance Cable .d........................_. Rigid Conduit .____...nnhunm.......... Metallic Tubing ...__..._......._.......... Current transformers: No. & Size.m.........._........__.............. Ser. No.........__...........__....................... Ser. No. ..._......................................... Nt.-' Armored Cable m.mm.......m........_ Non-Metallic m.m....._...............m._ Knob & Tub.____.............................. RIgid Conduit ......__....................... Metallic Tubing mm................__... Raceway ..............................._._..._ Circuits, Light..................................__.. Utillty ...............__..._.._.............._.... lIeat ......................................._...... Range ...................._........._.............. Water Heater .........._.................... Motor ..........................................._. Dryer ..............................................__ Furnace ............._............_...._.... ..._ ...... Ser. No.....__........................................ Total Load............................ 5". No.........._____..._.......................... . ...:rS.tal {j..........:;..........~ Remarks-: ........--....:?:::~:.~....I1:..,~q.::::.h......'"::?~~~i1...........4L!.??~:~f:..~~...:p..~:..Z0.r ......_<~:!::::~::.g.."g_........................................................................f.................__......................................... I .;~:;~.;~~....................--.......;~~~~...~~:~;~~...............----...............~?~.~:..........2 $...................................... No.............................. By /::...__......t..............C:....__.~:.t!:~-::~.:..."!.!.:!..~ NOTICE-Current must not be turned on until CerUficate 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 I ELECiRICAL PERMIT :::::s~:o:=~~~~:::::::::::::::~::::::::::~::::::~::::::~::~::::::::I~:::::::::.:::.::.::::::::::::::::::::::::::::~:~:a.::::::~::::::~::~::~::~::::::::::~::::::~::::::~::::::::: ~ ~ ( ~ N? ","'<0';\:,:",,",- 16825"~\ " \ NOTICE-Current must not be turned on unttl Certtffcate 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. 1M Olympic Printers, Inc. " CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT 16705 ~ .. . 1_ Port Angeles, washlngtolLm/[_=-L~mm...m...m.......__m..., w?:( 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 d6 electrical work as listed below. Address .~__-2"__?:'m._~.____(~~m__m.__mm.._____.____________m_m OccupanCY.__L:'"Jr_~m.mm__._.mmm__._ ~:=~~~:~~:~~~.:~:~:~::=:::::::::::~i.~E~~~:~~~;:::::::::::::::..:..~::::::::::=::::::::::::::::==::::::::=::::::::: /(J-O/<f;/"d' " . Light Outlets....................__............._n... Service, volts "..._........_......................... Type at Wiring. Receptacle Outlets........................__..... No. wires .....-.~.~..__..__..';>;........n. Armored Cable ..--.--......-----..........- , Wdq.t/ Size wlre~;/.,:?~~.4._........-.. Main fuse ....-r~.:..~.....!..~.~.:............. ,- Enclosure .___._~n~...__...__nh..__.. Dryer, KW nnn......................_.........._.. Runge, KW......._______n"____n______.._______ Water Heater: KW.--n---...............-.-.---.rs--'--------n" H.." KW.....//...J'1.I:?............. r " , Motors: size. volts a.nd phase: ., ::::::::::__:::::::::::::::~:::s::::::::::::::::::: '\ __..._............_d__...___.._.__......_'?:............... , \ ................._-_.._--------..-....-.................- Total Load_c...____.....___............ Type of wiring: Entrance Cable n__..:n___.________ Rigid Conduit ........_........._......._.... MetalUc Tubing ..___mm_______....m.. , Current transformers: No. & Size..__..._nn__.._...;_......_n...._... Ser. NO..__........nn..._n...n.~.......n....... Ser. No. n___.___.__..._....__..__....___.___......n Ser. NO..n..n.___.___n__nn_..___nn............. Ser. No. ..___..___n__..._.n_.n.._..._............ N<.' Non.MetalUc _.......___..__.._...._..__..... Knob & Tub.___.....__............___._..____ RIgid Conduit .....___.............___.______ Metallic Tubing .._.........._..._....__.. Raceway _................._...._......__..._ Circuits. Light........._...._..._............___._ Dtl!lty....._________.____.______..___..__..______. I-Ieat ......................................._.._ Range ...n................__.__....__............. Water Heater .........._........n......n.. Motor ._____.n...............................n.. Dryer ..........._........._..._._____.___.____.__.__ Furnace n...__......_..........."w.__......._._....." " Remarks: __m__.______af""!.":e~,,~..=_________________._____.__mm.m..mm.m.m.mm__m.____________.__.___...__mm..__.__.__ Total ............__......................... .............~.._....-~...........................-...-..............................-........--.........................-..................................................... .:i.=.~~.::~___:....:..:..::....:m.m..::~~.~:.::~.~:~.~~~._._..:..-.----------m---:~-..:;;,lz~~:~i.:~;~:::~;:l:;;.~~, /" NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It 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? 16705 Address.......__.___.............................._.........._....._.._...._._..................._d...._..__.___...................._...._....Date..._.....__.._____._._........_.__;._._.______...._ Owner___.......__.__.._____..........._.___n......_......_......_.._.........._..._............______._.___.___.____..........Tenant..._............._______...___...______.___..._..................... WtrtngContractor............__.____..___..........._...._.___.._........._.............................__..._...__....__.._............By.____............_..................................._..._.... \-' NOTICE-Current must not be turned on untl1 Certificate ot Inspection has been issued. It work is to be con. \_~~-al.dldMu. notlc. must b. glv.n the rnsp.crr so that work may be Insp.cted b~rore con~,~alm.nt. Olympic Printers, Inc. \ M ELECTRICAL PERMIT CITY OF PORT ANGELES 360- 417 -4735 Application Number 16- 00000413 Date 3/23/16 Application pin number. 455033 Property Address . . , 602 B ST ASSESSOR PARCEL NUMBER; os- 3a- oo- a- 1- 57oa -oaoa- REPORT STATE SALES TAX Application type description ELECTRICAL ONLY on your excise tax form Property Name to the City of Port Angeles Pro ert Use Property Zoning . . , , , , , RS7 RESDNTL SINGLE FAUN (Location Code 0502) Application valuation , . . , 0 Application desc Ductless heat pump Owner Contractor RESULTS: INSPECTOR: JOE RISX & MARY ALICE BOULTER EXTRA MILE TECH & ELECT_ LLC 602 S B ST SERVICE 418 N, RACE ST. PORT ANGELES WA 983635714 PORT ANGELES WA 99362 FINAL (360) 457 -5222 Permit , , , , , , ELECTRICAL ALTER RESIDENTIAL Additional desc .. . Permit Fee 68.00 Plan ChecJc Fee .00 Issue Date 3/23/16 valuation 0 Expiration Date 9/19/16 Qty Unit Charge Per Extension 1.00 5.0000 ECH EL-ECH A➢DNT BRANCE CIRCUIT 5.00 1,00 63.0000 ECH EL -R- BRANCH CTR WO/ SER FEED 63.00 Fee summary Charged Paid Credited Due Permit Fee Total 68.00 68,00 .00 00 Plan Check Total 00 a0 00 .00 Grand Total 68.00 68.00 .00 DO 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 Contractor X Date: Cffy oF PoRT ANGELEs PFRmff ArrucAmN RE (; Li 321 East F'Mh Street —P.O. Box 1150 /Port ADgeles WasNire n, 99362 MAR 2 e) ME, Ph: (360) 4174735 Fax: (364) 417-4711 412 lnL�.i���RaICA UT, .3 °-��� ,..1 a �Single Far�rtlly Dwelling INSPEU IO * Plan Review May Be Required, Please Compute Elecliriml Plan Review In rrriation Sheet Job Addrew: � :5_ Building Square Footage: t 1868cripgonofabMe— A. }.-t L'J d,//,? C7,3" 441 Lt c, t�.f f3Gluyr� � C_i� 1 Owner Infor 'l— "on Name: *.l OT Mailing Address: y %' city :._ Phone; 9'7 7,_ )�'f ��- �F c -_ L1CenSe #lExp. Item Mn it Chants Servic elFeedar246 Amp. $ 12€0.00 Senriceli+ ter 201 -440 Amp. $141x0D SeMcelFeeder401400 Ante $ 205,00. $en+icelFeeder 6DI -1000 Amp. $ 262.00 $WcelFeeder over 1000 Amp. $ 373.00 Branch Circu t Wl Seruice f=eeder $ 5.40 Branch CirWt W10 Service Feeder $ 63.00 Each Additional Branch Circuit $ 5.00 Branch CircuRs 1-4 $ 75.00 Temp. SerAcel Feeder 200 Amp. $ 03.00 Temp. ServicelFeeder 201 -400 Amp. $110140 Temp, SenricelFeeder 401 -640 Amp. $149.00 Temp. ServicWeWer 6014000 Amp . $166,00 Porter to Portal Hourly $ 96.00 Signal Circuit! Umited Energy -1 & 2 Family Dwelling $ 64.07 Manufactured Hoare Connection $120.00 Renewable gectrical Energy -5FNA System or less $102.00 Thermostat $ 5800 Mote: $5.00 for each additional T-Stal NEIN t,",t]N TRUCnON ONLY: First 130D square Ft: $ 120.00 Each Additional 600 Square Ft, or Portion of $ 40.00 Each Outbuilding or Detached Gam9e $ 74.00 Each Swimming Pool orHot Tub $110.00 Contactor Information cry ss`raate WA-ZIP: R?3, Phone: — Fat N3 A incense #lExp. �"�i: _� A Total M Multiplied by Unit Charge) $ $ $ -- $ E k Total owner as defined by RCW.19.28.261: (1)13wnerwiii occupy the structure for two years after this eiectrical perm€t Is finalized. (2) Owner is required to dire 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 vA the electrical laws, N.E,C., RCW. Chapter 19.28, WAC. Chapter 2964613, The City of Part Angeles Municipal Coale, and utility Specifications and PAMC 14,05.054 regarding Electrical Pen'nitApplic ations. Signature of owner, electrical contractor or electrical administrator; 0 cheat r dcanst '7 Al Fra x Aa%d ,� l % 41(aif20i2