HomeMy WebLinkAbout504 S Lincoln St - Building4
CERTIFICATE. Of OCCUPANCY
City of Port Angeles Building Division
This certificate is issuedpursuant to the requirement k of Section I10-oftbe 2006 International Building
Code certifying that at this structure was in compliance with the various ordinances
of the City regulatingbailding:cOnStriiptiOn.oruse for the follOWifig
PaurS,Classib,,8hell LLe (Owner-Paurj tewiS Laurie L Lewis)
Business name
Business address 504 S Lincoln St
Property owner "I''.° Pettit Oil COtil yi,
Property owner s!.ableke:0- 820 Myrtle;WHitipiatil
uk‘
Automatic fire spri,inkierTsystem Pee
Use occupancy claSSification Mercantile
Building permit number 09-1092.
Type of construction. PTIP:c;
Occupant load p6
-011 '411 P4Rvv
0
.:4286T
WintL
ttm.,
12/21/09
Date
Sue,R
0 ,4x
Post on the premises in a conspicuous place. This certificate,.shalfbot be removed except by the Building Official.
z
7.1
0
Ne,`I\ed,
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Fuel tank monitors 1 circuit
Owner
PETTIT OIL COMPANY
820 MYRTLE ST
HOQUTAM
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
1 00 57 5000 ECH EL BRANCH
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 985504236
ELECTRICAL ALTER COMMERCIAL
155721
57 50
10/28/09
4/26/10
57 50
00
57 50
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
09 00001116
765460
504 S LINCOLN ST
06 30 00 0 1 6700 0000
ELECTRICAL ONLY
COMMUNITY SHOPPING DISTR
0
Contractor
INNOVATIVE ELECTRIC
PO BOX 6783
LYNNWOOD
CIRCUIT WO /FEEDER
Paid Credited Due
57 50
00
57 50
Plan Check Fee
Valuation
DATE RESULTS
16/ 29 i o,
00
00
00
Date 10/28/09
WA 98036
cPP
00
00
00
00
0
Extension
57 50
Signature of owner or Electrical Contractor X Date
INSPECTOR.
s•
Oct 27 2009 8 53AM Innovative
City of Port Angeles Permit Application
Building Division/Electrical Inspecaone
321 East Fifth Street P.O. Box 1150 Port
Angeles Washington, 09362
Ph; (380) 417.473e rex: (360) 411 -4711
Date: 10
Owner Informslioon
N ana; Torty'a Service Center
Mew Add: 504 S Lincoln St.
City. po A des State: �4A Zip: ISM
phone: Fax:
License/it Exp.
93.75
5113,75
$180,00
$205,00
$291.76
2.00
57,60
$200
72,50
5 88.25
$116.25
$131,26
3 75.00
69.00
3 75.00
50.00
50.00
93.75
80.00
86.25
27.50
57.50
$86.25
43.75
1
Signature of owner, electrical contractor or aMoMvel administrator
Electric, Inc 425- 355 1985
RECEVED
OCT 2 8 2009
ELECTRICAL
INSPECTIONS
1 2 Single Family Dwetling
Multi- Family or Commercial
R Commercial Addition Alteration Remodel I Repair
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 504 South Lincoln Street
Building S Footage: ZtAtAi
Description of above: Install tank level monitor for 5 under ?round fuel tanks, system to be installed is UL listed
lntrinskaily safe
Contractor Information
Narita; Innovative Electric Inc.
Mating Address: P.O. 83
Dry. L nnwooci State: WA ay
Pben -Z90 -7803 Fax 4255.38b)
Uterus E. i 1NOVE1QE5KE, 5(552511
Total (Oty Multitie Un e 2 Amp
p
S Se e rvice/Feeder 201-400 Amp,
Servlcoe/Feeder 401400 Amp.
Service/Feeder 601 1000 Amp.
ServicelFeeder over 1000 Amp.
Branch Circuit WI Service Feeder
Branch Clmult W/0 Service Feeder
Each Additional Branch Circuit
Temp, Service! Feeder 200 Amp,
Temp. Service/Feeder 201.400 Amp.
Temp. Service/Feeder 401 Amp,
Temp, SevicelFeeder 601.10()0 Amp.
Portel to Portal Hourly
SIgnlOutline Lighting
Signal Circuit/ United Energy Commercial
Signal Circuit/ Limited Energy I 2 Family [swelling
Signal Circuit/ Limited Energy Multi -Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy SKVA System or Less
Find 1300 Square Ft.
Each Additional 600 s A. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
Total
page 2
Ceeh
Check
nesiCandg
NAME. GUNNAR PETZOLD
Negras deinsdbyRCIV101261: rnl wrw a dog trssbuclire tr6wyasrs Ore* psmdls haled M t7ttete lash leedtoMa
shahor1contrarctory above sold pap* ls tarsals, rant orlon
After reading the above statement, I hereby certify that I am the owner piths above named property or a licensed electrical contractor. I am malting the oatmeal
Imbibition or ateraton In compliance with the aisahlcel wive, N.E.C., KW. Chapter 10.28, WAC. Chapter 286.488, The City of Port Angela Mualclpel Code, and
Utility Speoficatlons.
Print in ink
BUSINESS NAME f�4.49Ls GJ�1SSrL
BUSINESS ADDRESS s-
Business mailing address j3-).
Opening date not 1 A.00 9
Washington State Tax I D
(o-- 96d-- 999
Brief description of proposed business
CERTIFICATE OF OCCUPANCY APPLICATION
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
S4e// L L c.
Permit O I I lZ
FEES
$50 00 Certificate./ Inspection
$1.: 00 Parking Business Improvement Area (PBIA)
fee charged for downtown locations
So iA L shLotri Poe r err /e$
iv P,6 'e wr4 9 03
Days hours of operation my"_- srq
If known list the name of the previous
business at this location MA,
6 S7 Se ft LA e_ 5'4
Phone
`7. r9in
Zoning C S�
TO 7 P071
S eitvf ct 6.4vrit
Business owner's name P,g✓ 3'.G 3 d- L, 'v' e L
Business owner's home address /3 a
PLEASE NOTE.
A Business License is also required for the-following businesses. Taxi Peddlers, Second- hand-dealer Pawnbroker Dance Hotel-
Motel Fireworks Ambulance Tattoo shop Contact the City Clerk at 417-4634 for additional information.
ACTION
New business
Transfer of business
location from a
PBIA location
Transfer of business
location from a
non -PBIA location
Change of ownership
Remodel
Temporary business
Change of use
Call for Certificate of Occuoancv inspections before opening business.
Building Department Inspection 417 -48.15 Fire Department Inspection 417 -4653
Please provide a minimum 24 -hour notice for inspections
1 hereby apply for a Certificate of Occupancy I acknowledge that I have read this application
supplied is correct to the best of my knowledge
Date /0�a )4mq Print Name
For City use only:
Department
Building
Fire
PBIA
Planning
City Clerk
f jbiic Works
L
'ms /Bui!di a
Approved
Initials date
�j�
J/4 9
scale of Or ancy Apphc;
Rejected
Initials date
vvYl-
WILL THERE BE ANY OF THE FOLLOWING?
Electrical changes
New or relocated signs
Construction changes
Mechanical changes (ventilation, heating, cooling, etc.)
Plumbing changes
Fire sprinkler system changes
Fire alarm system changes
New or relocated sewer or water service
Excavation or filling of lots
Work done in the City right -of -way
New driveway openings
Grading site drainage (parking lots, downspouts, etc.)
Landscape irrigation system (backflow devices)
Is this a home occupation?
Is this a second -hand dealer or pawnbroker business?
Is there off street parking for this business?
Is the street in front of this business paved?
Is there a sidewalk in front of this business?
Is there a curb gutter in front of this business?
ey .41 -ivy sf� sue$
Li 1 5 Signatur
Type of construction
Automatic fire sprinkler system required
Phone
638
NOV YES/
t.�
1/'
CPlease sign up for utility services
at the cashier counter
and state that the information I have
Comments Conditions
Occupant Load
no
VG r33 Jd W/
IF YES CONTACT
Electrical Dept. at 417 -4735
Building Div at417 -4815
Public Works at 417 -4807
Water Dept. at 417 -4886
Planning Div at 417 -4750
City Clerk at 417 -4634
How many spaces? la.
yes
1
Fire
PBIA
Print in ink
CERTIFICATE OF OCCUPANCY APPLICATION
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
BUSINESS NAME P4-uLs GI,#1j5►`L S4e
BUSINESS ADDRESS s by .500-k L, h co I n .pvoif i9nt -t /eS
Business mailing address J3,1 sync P /eiLe wr+ 133E1c)--
Opening date Y10v I 4009 Days hours of operation moil— 3fr '7, Ain ro Port
Washington State Tax I D If known list the name of the previous
('Qd-- 964-- 999 business at this location 1-on, s cc 6.en1'P2
Brief description of proposed business (Pts Stn T' r SP/lv\ce_ x'4
Business owner's name Pi¢ ✓L LE'v, S J- Lmven e L Lew. S Phone y6/ -33 /a %6 -3 8'i
I Business owner's home address 13a T,.�e Plr s.a,l 1E138 a_
PLEASE NOTE.
A Business License is also required for the following businesses Taxi Peddlers, Second hand dealer Pawnbroker
Motel Fireworks Ambulance, Tattoo shop' Contact the City Clerk at 417 -4634 for additional information.
ACTION
New business
Transfer of business
location from a
PBIA location
Transfer of business
location from a
non -PBIA location
Change of ownership
Remodel
Temporary business
Change of use
For City use only
Departmeeit
Building
Planning
City Clerk
Public Works
1.F rms /Building Di
Its
Approved I Rejected
Initials 'ate Initials date
C
R Ib -11 -d9
RV to
n'Cer 'cafe of Occupancy Application
WILL THERE BE ANY OF THE FOLLOWING?
Electrical changes
New or relocated signs e
Construction changes
Mechanical changes (ventilation, heating, cooling, etc.)
Plumbing changes
Fire sprinkler system changes
Fire alarm system changes
New or relocated sewer or water service
Excavation or filling of lots
Work done in the City right -of -way
New driveway openings
Grading site drainage (parking lots, downspouts, etc.)
Landscape irrigation system (backflow devices)
Is this a home occupation?
Is this a second -hand dealer or pawnbroker business?
Is there off street parking for this business?
Is the street in front of this business paved?
Is there a sidewalk in front of this business?
Is there a curb gutter in front of this business?
Call for Certificate of Occupancy inspections before opening business.
Building Department Inspection. 417 -4815 Fire Department Inspection 417 -4653
Please provide a minimum 24 -hour notice for inspections
I hereby apply for a Certificate of Occupancy I acknowledge that have read this application and state that the information I have
supplied is correct to the best of my knowledge
Date /v /01mi Print Name Fr4 v L s L 1= w, Signatur f
$50 00 Certificate Inspection
$1
00 Parking Business Improvement Area (PBIA)
fee charged for downtown locations
Phone
FEES
Comments Conditions
Type of construction Occupant Load
Automatic fire sprinkler system required no
Dance
Hotel-
Permit 01 Q l2
Zoning CSI
YES_ IF YES CONTACT
Electrical Dept. at 417 -4735
Building Div at 417 -4815
Public Works at 417 -4807
Water Dept. at 417 -4886
Planning Div at 417 -4750
City Clerk at 417 -4634
How many spaces?
Please sign up for utility services
at the cashier counter
yes
;Yr
t
Clallam County Assessor Treasurer Property Details 57280 PETTIT OIL COMPAN Page 1 of 4
Clallam County Assessor Treasurer
Property Search Results 57280 PETTIT OIL COMPANY for Year 2009 2010
Property
Account
Property ID 57280 Legal Description LOTS 1,2 BL 167 TPA
Geographic ID 0630000167000000 Agent Code
Type Real
Tax Area. 0010 PA 121 PORT ST CNTY H2 L Land Use Code 55
Open Space. N DFL N 1 11‘ 6�
Historic Property N Remodel Property' N 12
Multi Family Redevelopment: N Q
Location r
Address: 504 SOUTH LINCOLN STREET Mapsco N
PORT ANGELES WA 98362
Neighborhood Cycle 5 Comm Map ID
Neighborhood CDs 20953140
Owner
Name PETTIT OIL COMPANY
Mailing Address 820 MYRTLE ST
HOQUTAM, WA 98550 -4236
Taxes and Assessments Due
Property Tax Information as of 12/21/2009
Amount Due if Paid on.
Owner ID 46165
Ownership 100 0000000000%
Exemptions.
First Second
Half Half
Statement Base Base Base Amount
Year ID Taxing Jurisdiction Due Due Penalty Interest Paid Due
2009 572802008 ST SCH STATE SCHOOL $500 96 $500 95 $0 00 $0 00 $1001 91 $0 00
2009 572802008 CC -GEN COUNTY $253 53 $253 52 $0 00 $0 00 $507 05 $0 00
2009 572802008 PORT PORT $35 91 $35 91 $0 00 $0 00 $71 82 $0 00
2009 572802008 PORT ANG PORT ANGELES $556 10 $556 08 $0 00 $0 00 $1112 18 $0 00
2009 572802008 SD #121 SCHOOL DISTRICT #121 $619 50 $619 55 $0 00 $0 00 $1239 05 $0 00
2009 572802008 NTH OLY LIB NORTH OLYMPIC LIBRARY $73 67 $73 66 $0 00 $0 00 $147 33 $0 00
2009 572802008 HOSP #2 HOSPITAL #2 $103 98 $103 97 $0 00 $0 00 $207 95 $0 00
2009 572802008 CITY_STORMWATER CITY STORMWATER $111 76 $111 75 $0 00 $0 00 $223 51 $0 00
2009 572802008 WEED_CONTROL WEED CONTROL $0 81 $0 82 $0 00 $0 00 $1 63 $0 00
2009 572802008 TOTAL. $2256.22 $2256.21 $0.00 $0.00 $4512.43 $0.00
2008 572802007 ST SCH STATE SCHOOL $531 98 $531 98 $0 00 $0 00 $1063 96 $0 00
2008 572802007 CC -GEN COUNTY $257 42 $257 39 $0 00 $0 00 $514 81 $0 00
2008 572802007 PORT PORT $37 60 $37 60 $0 00 $0 00 $75 20 $0 00
2008 572802007 PORT ANG PORT ANGELES $554 34 $554 32 $0 00 $0 00 $1108 66 $0 00
2008 572802007 SD #121 SCHOOL DISTRICT #121 $620 50 $620 49 $0 00 $0 00 $1240 99 $0 00
2008 572802007 NTH OLY LIB NORTH OLYMPIC LIBRARY $74 79 $74 79 $0 00 $0 00 $149 58 $0 00
2008 572802007 HOSP #2 HOSPITAL #2 $25 56 $25 56 $0 00 $0 00 $51 12 $0 00
2008 572802007 CITY_STORMWATER CITY STORMWATER $111 76 $111 75 $0 00 $0 00 $223 51 $0 00
2008 572802007 WEED CONTROL WEED CONTROL $0 82 $0 81 $0 00 $0 00 $1 63 $0 00
http /vpn clallam.net.8084 /propertyaccess /Property aspx ?cid =0 &year= 2009 &prop_id =5 12/21/2009
.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
DATE
Site Address:
o READY FOR
INSPECTION
o WILL CALL FOR
INSPECTION
Phone:
Installed By:
Phone:
Owner/Business Address:
Sq. Ft.
o New Construction
o Remodel
o Service update/alter/repair
o Add(al~
o Auxiliary power
(list below)
o Special equipment
(list below)
o Overhead
o Underground
Voltage
010 03.0
Service size
o Temporary
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)
Amps
DetailslDescription:
--Y/f/-/J~L~
.
t2/ ~/~/:
V
'tfch/./ ~ ./7/~
~G- ~.-d.A-?Y-4':1
W.S. No. Service
Capacity: 0 O.K. 0 Not O.K.
o Ditch inspection O.K.
o Rough-in/cover O.K.
o O.K. to connect service
~ 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:
Permit/Receipt No.
d003
{)
New Meters
.
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 i Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224.
nspec r Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
(;20,() 0
OLYMPIC PRINTERS. INC.
CITY OF PORT ANGELES PERMIT APPLICATION RECEIVED
Building Division /Electrical Inspections JUL
321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362�f
Ph: (360) 417 -4735 Fax: (360) 417 -4711 FCECTRICAj
Date: 7/20/2015 X Multi - Family or Commercial* INSPECTIog
* Plan Review May Be
Job Address: 504 S Li
Building Square Footage: _
Description of above _Er
ired, please Complete Electrical Plan Review information Sheet
Owner Information
Contractor Information
Name: Jncksnn Oil Pt Angeles Eud
Name: _ Innovative Electric, Inc
Mailing Address:
Mailing Address: pn Rnu
4:ggg
City: �tatee: Zip: y$362
City: Everett
State: WA Zip: 98204
Phone'. Fax:
Phone:425- 290 -7803
Fax:
License #IExp.
License #1Exp. ninvKin��k�
r;rer201?
Item
Unit Charge
Qt
Total (Qtv Multiplied by Unit Charge)
ServicelFeeder 200 Amp.
$ 132,00
$ 00
ServicelFeeder 201 -400 Amp.
$ 160.00
$
Service/Feeder 401 -600 Amp
$ 225,00
$
Service/Feeder 601 -1000 Amp.
$ 288.00
_
$
ServicelFeeder over 1000 Amp.
$ 410.00
$
Branch ClrcuitWlService Feeder
$ 5.00
Branch Circuit W10 Service Feeder
$ 74.00
$
Each Additional Branch Circuit
$ 5.00
$
Branch Circuits 1 -4
$ 86.00
$
Temp. Service/ Feeder 200 Amp.
$102.00
$
Temp. ServicelFeeder 201 -400 Amp.
$121.00
$
Temp. ServicelFeoder 401 -600 Amp.
$16400
$
Temp. SorvicelFeeder 601 -1000 Amp .
$185,00
$-
Portal to Portal Hourly
$ 96.00
$
SignlOutiine Lighting
$ 88.00
$
Signal Circuit/ Limited Energy -- Multi- Family
$ 64.00
_
$
Signal Circuit/ Limited Energy 1 First 1500 sf – Commercial
$ 96.00
$
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy - 5KVA System or Less
$113.00
$
Thermostat
$ 56.00
$_
Note: $5.00 for each additional T -Stat
$ i� 0tal
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this 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 -46B, 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
Credit Card
r
A 01101012
G,,v, e Pc T z oz �)
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number . . . . .
15- 00000889 Date 7/20/15
Applicatiari pin number . . .
015237
INSPECTOR:
Property Address , , . 1
504 S LINCOLN ST
ASSESSOR PARCEL NUMBER;
06-30-04-0-1- 6700 -0000-
SERVICE
Application type description
ELECTRICAL ONLY
Subdivision Name . . . . . .
ROUGH -IN
Property Use . . . . . . . .
Property Zoning . . . . . . .
COMMUNITY SHOPPING DISTR
Application valuation . . . ,
0
COMMENTS:
Application desc
Fuel station remodel
Owner
Contractor
DASHMESH PETROLEUM 13 INC
INNOVATIVE ELECTRIC
1133 HWY 6
PO BOX 6783
CHEHALIS WA 98532
BRIER
WA 98036
(360) 751 -4905
Permit . . . . . . ELECTRICAL
ALTER COMMERCIAL
Additional desc . .
Permit Fee 157.00
Plan Check Fee
Oa
Issue Date 7/20/15
valuation . . . .
0
Expiration Date 1116116
Qty Unit Charge Per
Extension
5.00 5.0000 ECH 'E1-
ERANCH CIRCUIT W /FEEDER
25.00
1,00 132,0000 ECH EL -COM
0 -200 SRV FEEDER
'132.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 157.00
157.00 .00
.00
Plan Check. Total .00
.00 .00
.00
Grand Total 157,00
157.00 .00
'0Q
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 (G) MONT14S FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:TXCHANGEIBUILD ING
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number , , , , .
15- 00000956 pate .8/20/15
Application pin number , , ,
383420
INSPECTOR:
Property Address . , . , ,
504 S LINCOLN ST
ASSESSOR PARCEL NUMBER.
06-30-00-0-1- 6700 -0000-
SERVICE
Application type description
ELECTRICAL ONLY
Subdivision Name , . , . . .
ROUGH -IN
Property Use . , . . . . . ,
4V
Property Zoning , . . . , . .
COMMUNITY SHOPPING DISTR
7
�l
Application valuation . . . ,
0
COMMENTS:
Application desc
3 new signs
----------------------------------------------------------------------------
Owner
Contractor
---- -- ---- --- ----- - - - ---
DASHMESH PETROLEUM 13 INC
------------------------
PHOENIX SIGN COMPANY
INC
1133 H.WY 6
PO BOX 497
CHEHALIS WA 98532
A3ERDEEN
WA 98520
(360) 751 -4905
(360) 532 -1111
----------------------------------------------------------------------------
Permit . , . . . . ELECTRICAL
ALTER COMMERCIAL
Additional desc ADDITIONAL
SIGNS X2
Permit Pee 98.00
Plan Check Fee
.00
Issue Date 8/20/15
Valuation . . . .
0
Expiration Date 2/16/16
Qty unit Charge Per
Extension
SASE
FEE
10.00
1.00 8810000 ECH EL-COMM
-SIGN
85,00
Fee summary Charged
- - -- --- - - - - --
Paid Credited
- --- -- - - -- -- - - - - -- ----
Due
- - - - --
-- --------- - - -
Permit Fee Total 98.00
--
98.00 .00
.00
Plan Check Total. .00
.00 .00
.00
Grand Total 93.p0
98,00 .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
} y t2
4V
FINAL
7
�l
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
GAEXCHANGEIBU[LDMG
r
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street -- F.O. Box 1150 / Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date:
Multi- Family or Commercial*
* Plan Review l y Be Required, Please Complete Electrical Plan Review information Sheet
Job Address: 8
Building Square Footage:
Description of above _
e format
Nam top �G1 _r
Name: WWLL
Mailina Address: i I V4 1. lilts G
City: CI s State: / ,/_IZip: L �-5-Ze
Phone: Fax:
License #! Exp.
Item
Unit Char e
Service /Feeder 200 Amp.
$132.00
ServicelFeeder 201 -400 Amp.
$160.00
Service/Feeder 401 -600 Amp
$ 225.00
Service/Feeder 601 -1000 Amp.
$ 288.00
Service/Feeder over 1000 Amp.
$ 410.00
Branch Circuit Wl Service Feeder
$ 5.00
Branch Circuit W10 Service Feeder
$ 74,00
Each Additional Branch Circuit
$ 5.00
Branch Circuits 1-4
$ 86.00
Temp. Service/ Feeder 200 Amp.
$102.00
Temp. ServicelFeeder201 -400 Amp.
$121,00
Temp, ServicelFeeder401- 600 Amp.
$164.00
Temp. ServicelFeeder 601 -1000 Amp ,
$185.00
Portal to Portal Hourly
$ 96.00
Sign /Outline Lighting
$ 88.00
Signal Circuit/ Limited Energy — Multi- Family
$ 64.00
Signal Circuit/ Limited Energy / First 1500 sf — Commercial
$ 96.00
Note: $5.00 for each additional 1600 sf
Renewable Electrical Energy - 5KVA System or Less
$113.00
Thermostat
$ 56.00
Note: $5.00 for each additional T -Stat
:11 1 f - - - •
Contrqgtot Inform tion
Name:_
Mailin A dress:
City: State: /.114 Zip,
Phone. Fax r 't "7
License # l Up. D lki9� -�
4j►t Total (gty Multiplied by Unit ChaWe)
$
$
$
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this 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 -465, The City of fort
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
❑ Credlt Card #
Dated:"
0110112012
I f
CITY OF PORT ANGELES
360-417-4735
Application Number 16-00000030 Date 1/07/16
Application pin number 199120
Property Address . . . . . . 504 S LINCOLN ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-6700-0000- REPORT SALES TAX
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name . . . . . .
Property Use to the City of Port Angeles
Property Zoning . . . . . . COMMUNITY SHOPPING DISTR (Location Code 0502)
Application valuation . . . 0
Application desc
Sign power
Owner
Contractor
DASHMESH PETROLEUM
13 INC
SIMPSON ELECTRIC
1133 HWY 6
243036 W HWY 101
CHEHALIS
WA 98532
PORT ANGELES
WA 98363
(360) 751-4905
(360) 457-9270
Permit . . . .
ELECTRICAL
ALTER COMMERCIAL
Additional desc
Permit Fee
88.00
Plan Check Fee
'00
Issue Date
1/07/16
Valuation
Expiration Date
7/05/16
Qty Unit Charge Per
Extension
1.00 88.0000 ECH -EL-COMM-SIGN
88.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
88.00
88.00 X00
100
Plan Check Total
.00
.00 00
100
Grand Total
88.00
88.00 .00
:00
Signature of owner or Electrical Contractor X Date:-,
GAEXCHANGEWILMNG
CITY OF PORT ANGELES PERMIT APPLICA,nm
Building Divi8ion/Electricall Inspections
321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date: /-7—/k
�(J Multi - Family ororftrl+erc'. I -
Gdii)K)
1alw 111(")t )()�° ))
* Plan Review May Be Required, Please ompletee lectri Plan Review Information Sheet
Job Address: "r ,_i' '" ,�"
Suilding Sgtmre Footage: dj
Description of apove .�
Owner Information
Name:
Mailin Address, � +•
City: ,pr 5talo: 6 Zip:
r
70%� # 1 Fxp.,
'0) 0
item
U 0-0-M e
Service/Feeder 200 Amp,
$132.00
ServiceJFeeder 201.400 Amp.
$160.00
service/Feeder 401.600 Amp
$ 225.00
Service/Feeder 601 -1000 Amp,
$ 288.00
ServicelFeeder over 1000 Amp.
$ 410.00
Branch Circuit W/ Service Feeder
$ 5.00
Branch Circuit W/0 Service Feeder
$ 74,00
Each Additional Branch Circuit
$ 5.00
Branch Circuits 1-4
$ 86.00
Temp. Servicel Feeder 200 Amp.
$102.00
Temp. Servlce/Feeder 201 -400 Amp.
$121.00
Temp. Service /Feeder 401.600 Amp.
$' 164.00
Temp. Service/Feeder 601 -1000 Amp .
$ 185.00
Portal to Portal Hourly
$ 96.00
Sign /Qutllne Lighting
$ 88.00
Signal Circuit/ Limited Energy — Multi - Family
$ 64.00
Signal Circuit/ Limited Energy I First 1500 sf — Commercial
$ 96.00
Note; $5.00 for each additional 1500 sf
Renewable Electrical Energy - 51NA System or Less
$113.00
Thermostat
$ 56.00
Note: $5.00 for each additional TStat
Contractor Information
Name:— ZZ ,
Mailing ArtOm x -
City, State, 2i .
Phone, Fax:
License # I Exp_'�� `.
"i,,ertalL trlti �IiedC e
S
$
$
$ °'0 ° Total
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. l 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 co ,itractor. I am making
the electrical installation or alteration in compliance with the electrical laws, N.E,+C., RCW. Chapter 19.28, WAC. Chapter 296 - 11611, The City of Pout
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Sig of owner, el contractor or electrical administrator: o cash o check
credit Card #
onftd: eVe11201Z
J
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . .
16-00000750 Date
5/24/16
Application pin number
700750
Property Address
504 S LINCOLN ST
ASSESSOR PARCEL NUMBER:
06 -30 -00 -0 -1 -6700 -0000 -
Application type description
ELECTRICAL ONLY
Subdivision Name
Property Use
Property zoning . . ,
COMMUNITY SHOPPING DISTR
Application valuation . . . .
0
Application desc:
Alarm sy,stern
Owner
Contractor
DASHMESH PETROLEUM 13 INC..",
ADT LLC
11.33 HWY 6
11524 N CREEK PARKWAY,
N
CHEHALIS WA 98532
STE 105
(360) 751-4905
BOTHELL
WA 98011
(206) 719-0347
Permit . . . „ ELECTRICAL
ALTER COMMERCIAL
Additional desc . ,
Permit Fee . . . 96.00
Plan Check Fee
.00
Issue Date 5/24/1.6
valuation
0
Exp:.i..:ratiozd idate 11/20/16
Qty Unit Charge Per '"
Extension
1100 96.0000 ECH EL -LIMITED
1ST 1500 SQ FT
96.00
Fee summary Charged
Paid Credited
Due
Perrn.i.t Fee Total 96.00
96.00 .00
.00
Plan Check Total .00
.00 .00
00
Grand Total 96.00
96.00 .00
.00
U
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
G:\EXCHANGE\BUILDING
;late;
To: Page 2 of 2 2016-05-24 12:37:47 (GMT) 18884000383 From: Deborah Shields
CITY OF PORT ANGELES PERAHT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711
Date: 05124/2016
Multi -Family or Commercial's
* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 504 s Lincoln si
m W.
Building Square Foota e: gz°, ._. -... ...... ._ w_. u.___. _....- -_, •.» .•._ _ _..».--... .m.-_..
Description of above 's;raffo'v ac�1t tge lnttrs�lfarrn syddrr�
,NK Val ¢257.U0 w.,•»»»-...,.»,......m.,.w-»»».�.»»..».....�..�,»,........�w..
Owner Information
Contractor Information
Name Ua nmes7 PetroPeum
Name: AD7 LLC
Mailing Address -104s U coh St
Mailing Addre$5: 1 a14 N G tkLK Y1t4VY M u@ rE#1°J5
City: PO r Ar ALir State: WA Zip #a
_
City �o,o-��L _ State to Zip:,!!)
...x.-�
Fax
...........
Phone:zos�ro�a���x Fax a9.ac�9
�.._.,.....,.m.._ .��... .,.......,.,,,,, ...e......_ .... ...........
License # / Exp• _.-.._............. ........ ........................
..
......,..,».....-...--._a�-- ........._._,._. �.....�_...
License # 1 Exp •^p" LL ea,no
Item
tYnft Cttartse
Tonal 'ttyMultiplied by Unit Charge!
Service/Feeder 200 Amp.
$132.00,
$__
Service/Feeder 201-400 Amp.
$160.00
.............................. $_.
Service/Feeder 401-600 Amp
$ 225.00
$ __
Service/Feeder 601-1000 Amp.
$ 288.00
..... $
Service/Feeder over 1000 Amp.
$ 410.00
Branch Circuit W/ Service Feeder
$ 5.00
$.
Branch Circuit W/O Service Feeder
$ 74.00
Each Additional Branch Circuit
$ 5.00
Branch Circuits 1-4
$ 86.00
Temp, Service/ Feeder 200 Amp.
$102.00
$
Temp. Service/Feeder 201400 Amp.
$ 121.00
Temp. Service/Feeder 401.600 Amp.
$164.00
_.-r..._- $r ----- —--- -
Temp. Service/Feeder 601-1000 Amp .
$185.00
Portal to Portal Hourly
$ 96.00
.........- $_ ................m,- .......,.....
SignlOutline Lighting
$ 88.00
Signal Circuit/ Limited Energy- Multi Family
$ 64.00
$..
Signal Circuit/ Limited Energy /First 1500 sf- Commercial
$ 96.00
M,
Note: $5,00 for each additional 1500 sf
Renewable Electrical Energy - 5KVA System or Less
$113.00
Thermostat
$ 56.00
S
Note: $5.00 for each additional T-Stat
-~
$ Total
Owner as defined by RCW.19.28,261: (1) Owner will
occupy the structure for two
years after this 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 296-46B, 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
Credit Card #—
Jennifer CoveIlO
05/24/2010
fit' ;°,"" ret"
Dared
0110112012
ELECTRICAL PERMIT
C OF PORT ANGELES
360-417-4735
Application Number
1,6 00000599
Date 4/27/16
Application pin number
048064
DITCH
Property Address
504 S LINCOLN S`.T.'
ASSESSOR PARCEL NUMBER:
06 30 00 0 .1....6700 0000 --
Application type description
ELECTRICAL ONLY
Subdivision on Name
Property Use
Property Zoning
COMMUNITY SHOPPING DISTR.
Application valuation .
0
Application desc
..
`I -" stat
Owner
Contractor
DASHMESH PETROLEUM 1.3 INC
PENINSULA HEAT :INC
1.1.33 HWY 6
782 KITCHEN -DICK
RD
CHEHALI.S WA 98.532
SEQUIM
WA 98382
(360)..7 ] 4905._......,.w..,...a.,.,,..
..._a...3F0....681 .3333
;2.. 4p'...
Permit . . . ELECTRICAL
ALTER COMMERCIAL,
Additional desc . .
Permit Fee . . . . 56.00
Plan Check Fee
.
Issue Date 4/27/16
Va.iu.ation
Expiration Date 10/24/16
Qty t1 :it Charge Pe ii.
Extension
1.00 56.0060 ECH EL
I..0\T THERMOS".I:.A"I'
56.00
Fee ,swum.akry Charged,
Paid Credited
Dias=
Pe:rniit Fee `I'ota.l. 56.00
56.00 .00
.00
Plan,, Cheek "P'o1::a1 00
.00 .00
.00
Grand Total 56.00
.561.00 .00
.00
13
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 (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X.- Date: -
GAEXCHANG&BUILDING
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711
Date; 4dZ r ! 6
Multi -Family or Commercial*
* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: ..W_� . L n c a� ,
Building Square -.. ..--_. ---
.......
Description of
Nai
Owner Ind'
Mailing Adrs
City: Vela kZip:
Phoft� n °J... Fax:.
License # / Exrr.
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp
Service/Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/ Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp .
Portal to Portal Hourly
Sign/Outline Lighting
Signal Circuit/ Limited Energy — Multi -Family
Signal Circuit/ Limited Energy / First 1500 sf— Commercial
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy - 5KVA System or Less
Thermostat
Note: $5.00 for each additional T-Stat
Unit�Charg
$132.00
$160.00
$ 225.00
$ 288.00
$ 410.00
$ 5.00
$ 74.00
$ 5.00
$ 86.00
$102.00
$121.00
$164.00
$185.00
$ 96.00
$ 88.00
$ 64.00
$ 96.00
$113.00
$ 56.00
Contractor Information
C
S r State: Name:l rZ ..
hdaniVng Address:�' . � � p ... �r a �• ��,
State: fax _SeG� P '
Lcense # I Ex:, t
Total Multiplied by Unit Charge)
$
.-----_ $...... ..—
$
$— ......... _
_
.......... $._._...................
....._
_-----....... $............. -_
$
$.m.... — Total
Owner as defined by RCW,19.28.261: (1) Owner will occupy the structure for two years after this 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 296-466, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signatu„ of owner, e C r cai c tractor or electrical administrator: ❑ Cash (2 Check
❑ Credit Card # � �....._.........����.........
j �.
,+��, �.„~�"'� ICated "✓ ..��.2��__ ..... ...._ 01!0112012
�uy
Application Number
16-00000760 Date 5/25/16
Application pin number
940560
INSPECTOR:
Property Address .
504 S LINCOLN ST
ASSESSOR PARCEI, NUMBER:
06 -30 -00 -0 -1 -6700 -0000 -
SERVICE
ROUGH -IN
FINAL
Application type description
ELECTRICAL ONLY
Subdivision Name . . .
COMMENTS:
Property Use . . .
Property Zoning . . . . . . .
COMMITNITY SHOPPING DISTR
Application valuation . . . .
0
Application desc
Propane tank.
Owner
Contractor
DASHMESH PLTROLEUM 13 INC
OLYMPIC ELECTRIC CO
INC
11.33 HWY 6
4230 TUMWATER
CHEHALIS WA 98532
PORT ANGELES
WA 98363
(360) '751-4905
(360) 457-5303
pe:nrlit ELECTRICAI,
ALTER COMMERCIA1,
Additiona:1 desc
Permit Fee 74.00
Plan Check Fee
00
Issue Date 5/25/1.6
Valuation
Expiration Date 1112.1.116
Qty it Charge Per
Extens.ion
1.00 74,0000 ECH ''EL -COMM
BRANCH CIR WO/ SIR
'74.00
Fee summary Cli a z g e d
Paid Credited
Due
Perfm t Fee Total '74,00
74.00 00
00
Plan Check Total 00
.00
00
Grand '1'otal, '74 . 00
74.00 .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 (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:,
GAEXCHANGEWILDING
d", J
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street— P.O. Box 11301 Port Angeles Washington, 98362
Ph; (360) 4174735 Fax: (360) 4.17-4711
Muhl -Family or Commercial*
" Plan Review M u I Ired, Please Complete Electrical Plan Review I nformation Sheet
Job Address,—C 11 ............
Building Square Footage:
Desorption of above
Owned
M or'"" 'o"
Name:4'
Contractor Information
Name: -a'—c —e—RIr
1,A d(tres
Mailing Address: 42—o—R
Is i'��
7—Jax
City: ±OR'rANM- ES ___State: WA Zip: .28363
Phoncrt
FW %0'4SZ3404
License #! Exp.
License # 1 Exp. RL P-Fc2$%)1
Item t r 1r
10 (9tt MAgedbAnil, 9how)
Service/Feeder 200 Amp. $132.00
Service/Feeder 201-400 Amp. $160.00
Service/Feeder 401-600 Amp $ 225.00
ServicelFeecler 601-1000 Amp. $288.00
.......
SeNoe/Feeder over 1000 Amp. $41000
Branch Circuit W/ Service Feeder $ 5.00
Branch Circuit W10 Service Feeder $ 74,00
$_
Each Additional Branch Circuit $ 5.00
$—L
Branch Circuits 1-4 $ 86,00
$
Temp. Service( Feeder 200 Amp. $102.00
Temp. ServicelFeadef 201-400 Amp. $121.00
Temp. Sarvice/Feader 401-600 Amp. $ 164LOO
Temp. Service/Feeclar 601-1000 Amp . $185,00
Portal to Portal Hourly $ 96.00
Sign/Outline Lighting $ 88.00
Signal Circuit/ Limited Energy - Multi -Family $ 64.00
Signal Circuit/ Limited Energy I First 1500 af - Commercial $ 96.00
Notc $5.00 for each additional 1600 sf
Renewable Electrical Energy - 5KVA System or Less $113.00
Thermostat $ 5600
Note: $5.00 for each additional T-Stat
Owner as defined by RCW, 19,28,261: (1) Owner will occupy the structure for two years after this electrical permit is finalized, (2) Owner is required
to hire an electirical: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
narroed 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 296-468,.The CRY Of Port
Angeles Municipal Codle, and Utility Specifications and PAMC 14,05.050 regarding Elec*al Permit Applications,
Signature of ownqr,,'*IectrIcaI contractor or electrical administrator:
0 CaA 0 Check
M Credit CArd -2
OV00012
i, a6ed XeJ dH WdVOZO 91.02 'VE AeW
ELECTRICAL PERMIT
CITY OF PORTANGELES d
360....x. 1 7 4735
App].A.cat ion Number 16.00000407 Date 3/22/16
Applicatic,m p.i..n nLIMber. 303999
Property Addre504 S LINCOLN ST
ASSE.SSOR PARCEN., NUMBER. 06 30-00 0.1-6700.0000 REPORT STATE SALES TAX
P
pplication type d.cscr.:i.ptJ..ori ELECTRICAL ONLY on your excise tax form
uivis ion Nameroperty Use to the City of Port Angeles
Property Zoning COMMUNITY SHOPPING DISTR (Location Code 0502)
Application 0
Application desc
Se:rvice station remodel
Owner Contractox
DASHMES11 PETROLEUM 13 T.[IC SIMPSON ELECTRIC
1.133 HWY 6 243036 W HWY 101
CHEIIAL1 S WA 9BS32 PORT ANGELES WA 9836,.5
(360) '7':i::1.--4:'905 (360) 457 9270
Permit ELECTRICAF., ALTER COMMERCIAL
Additional desc
Permit Fee 265,00 Plan Check Fee 00
Issue Date 3/22/16 Valuation
Expiration Date 9/18/16
Qty Unit Charge Petr Extension
21.00 5,0000 ECH El, BRANCH CIRCUIT W/FEEDER 1.05 00
1..00 160.0000 ECH EL -COM 201 400 SRV FEEDER 160A)0
Vee summary Cha.&jed Paid Credited Due
Permit Fee Total 265.00 265,00 .00 .00
Plan Check Total '00 00 .00 00
Grand Total 265.00 265.00 .00 00
_...T] . .......................................... i
II INSPECTION TYPE DATE: RESULTS:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS.
PER -MIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTOR:
Signature of owner or Electrical Con for X Date:
*I ---- -1 . . . ....... ............ . . . . . ...... . .....
Z�l
IRI.41,
CiTY oF ftRT ANGELm ftRmff AjvLxcATioN
ftiming WhisiolmhX*kal blspecfiom
321 East rdkb Sbrftt —P.O. Box 1150 / Ptwt Angeks W&sbington, 96.162
Ph: (360) 417-4735 Fax: (360) 417-471,1
,e
Date:
'?
_1s or
Plan Review Ma Be Rqred� Please
0Elecftal Plan Review Information Shad
Job Adder: ri 5
BWk*q Squmv FoobW.
D&Xfk*n of
OWW I flommom
Nam' MPIX ing e,t A 1 1 3, 1 rl Name. 1',
WAN AA*SSS; -7 *21, /L/ 4,c) v t, ln,% e"14,
p h �CZI L-2 =—L 11 JIM W_.
I EXP
ROM alyT Inti
SWlbVFWW200AM4►. $132.00
SOMCRIFeeder 201400 Amp. $160.00
SmWFeedff 401-600 Amp $225.00 $
SerikelFeeder6014000amp. $288.00, $
SaMcalFeeder aver 1000 Amp. $410.00
Branch CkcA VW Somme Feeder 1 5.00
ftnch Ckctdt W/O Service Feeder $ 74M
Each AdMmW &wKh Uscuit $ 5.00
Brandi Ckuls 1-4 $ 86.00
Temp SwWW Feeder 200 Amp. $102.00
Temp. SerikeFeederMMWAmp. $121.00
Temp. S~em*4M-M0Amp. $164-00
Temp. SnlcsWeeder6M4000ArrV. $185.00
PINtId to Portal Hm* $ 96.00
ftnWkw was $ 8&00
S4WCWWLW"8WW—mu*FW* $ 64.00
SOW CkmW LkmW Energy I Fid 1500 sf — Cmmmdal $ 96.00
NOW, $5.00 for each adSoW 1500 sf
RenewaMe EkckkW Energy - 5KVA System or Los $113.00
Thermostat $ 56.00
Note, $&00 for each adftwW T -W
Tabi
Owner as deffned by RCW.1928261: (1) Owner will occupy the structim for two years after this dewmi pennit is firufted. (2) Owner is mWkW
to hire an contractor If above said properly is for sale, rent or Wase. Permit e*m after six mmft of Wd Impecdon.
I= M
...............
. r r #,mTlT#7t7T7j7
. . . . . . . . . .
in
zk v f, W�i,w��, � ELECTRICAL INSPECTION
d'm
APPROVED NOT F)FIF' (°N ED
El ..„,.,..W..........,mwW Drr(-.IIS°'i.„. .,....... .... 'q
ID.......SERVICE....., , ........ ,..
mml
CORRECDONS NEEDED:
�� ��..n _......_�..e� _. ... _..._
._.....m...,u. m _. ?... .mm... _.
... .....
TIFYIIIINSPE w rm WREN CORRECTIONS
ARE COMPLETED WITHIN "15 DAYS
- DO NOT REMOVE