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110 S Penn St - Building
CITY OE PORT ANGELES PUBLIC WORKS UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00001291 Date 11 /15 /11 Application pin number 461704 Property Address 110 S PENN ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 00 -7 -0 -0325 -0000- on your state excise tax form Tenant nbr, name BLACK HAWK CONST Application type description PUBLIC WORKS UTILITES to the City of Port Angeles Subdivision Name (Location Code 0502) Property Use Property Zoning PUBLIC BUILDINGS PARKS Application valuation 0 Application desc Extend 6" water main, install power across Penn St Owner Contractor USACE LAKESIDE INDUSTRIES PO BOX 3755 P. 0. BOX 7016 SEATTLE WA 98124 ISSAQUAH WA 980277016 (425) 531 -3260 Permit RIGHT OF WAY Additional desc Permit Fee 150.00 Plan Check Fee .00 Issue Date 11/15/11 Valuation 0 Expiration Date 5/13/12 Qty Unit Charge Per Extension 1.00 150.0000 ECH PW RW CONST'EXCAVTION OTHER 150.00 •Special•Notes and Comments Notify Public Works Engineering 24 hours in advance of start work. Public Works inspection request line (360)417 -4831 Construction work for driveways within the City right of way requires a separate Right of Way Construction application to be completed by the contractor doing this work and approved by Public Works Engineering prior to the start of work. A pedestrian or traffic control plan is to be submitted for approval with the application as necessary. "Any and all contractor(s) and subcontractor(s) doing work under this permit in the City Right of Way is required to provide written documentation that the City has been named as an additional insured" Work per City Urban Services Standards and Guidelines. Call dispatch (360)417 -4970 to notify Re:Street closer and when open. Fee summary Charged Paid Credited Due Permit Fee Total 150.00 150.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 150.00 150.00 .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 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 goy- -g this of work will be complied with whether specified herein or not. The granting of a permit does not presume to give a ority t. ate o cancel the provisions of any state or local law regulating construction or the performance of construction. ji Sign. ure of ontractor or Aut -d Agent Date Signature of Owner (if owner is builder) Date T:Forms /Building Division /Public Works Permit PERMIT INSPECTION RECORD CALL 417 -4831 FOR UTILITY 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 CONSI'ICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS VJ YES NO PW UTILITIES (Engineering Division) 1 WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK t CURB &GUTTER DRIVEWAY APPROACH ..BACK -FLOW DEVICE; FINAL INSPECTIONS. REQUIRED PRIOR TO OCCUPANCY /USE MERCIAL DAfE 'ACC EPTED RESIDENTIAL DATE I E8 c 'NO COM„ .CONSTRUCTION R.W., -PW CONSTRUCTION R W ENGINEERING`. 417-4807" PW ENGINEERING FIRE 417 -4653. FIRE DEPT. PLANNING DEPT. 417 -4750 PLANNING. DEPT. BUILDING QI7 BUILDING 4815 T Forms7Building Division/Public Works Perrrui> E 1 ELECTRICAL PERMIT d CITY OF PORT ANGELES 360 -417 -4735 Application Number 11- 00000507 Date 5/24/11 Application pin number 295184 Property Address 110 S PENN ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-7-0- 0325 -0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name to the City of Port Angeles Property Use Property Zoning PUBLIC BUILDINGS PARKS (Location Code 0502) Application valuation 0 Application desc 400 amp temp service Owner Contractor USACE VECA ELECTRIC CO INC PO BOX 3755 5614 7TH AVE S SEATTLE WA 98124 PO BOX 80467 SEATTLE WA 98108 !/7I (206) 436 -5200 Permit ELECTRICAL TEMPORARY SERVICE Additional desc Permit pin number 186353 cl Permit Fee 110.30 Plan Check Fee .00 v Issue Date 5/24/11 Valuation 0 Expiration Date 11/20/11 �j Qty Unit Charge Per Extension w/ 1.00 110.3000 ECH EL -TEMP SRV 201 -400 SRV FDR 110.30 Fee summary Charged Paid Credited Due 7 Permit Fee Total 110.30 110.30 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 110.30 110.30 .00 .00 V INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE 5/5( Ill 1 ROUGH -IN FINAL ti 4 J[ C .3/4.11:11 OMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING ECEVE Y RECEIVED c ,c)wr...„ CITY OF PORT ANGELES PERMIT APPLICATION MAY 2 4 2011. 0 Building Division/Electrical Inspections 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 ELECTRICAL d Ph: (360) 417 -4735 Fax: (360) 417 -4711 INSPECTIONS W Date: 1 2 Single Family Dwelling Multi Family or Commercial* Commercial Addition Alteration Remodel Repair* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 110 Pr/.3,i r h7cr (,-EZ C S 1/4 k T Building Square Footage: Zy, nOO Sr' Description of above c. A atga....... '(COA E t LC- Owner Information Contractor Information V E C° Name: UA.31701 S rATes (a s c.,F c i') ris Name:`1>L4,cb 1-1,41,..3 1- �,0- t.„-rLE-5, 3 C00 S rV 430 Z Mailing Addr t &r LLt Mailing Address'P.O. R3 tz6 6JZUR L City: State: Zip: City: hii urnic7 State: TX Zip: s 2-E3 206 Phone:2oc. `70.307 Fax: Phone:Z 7o -zzs 907.3 Fax: 270 ci z. e6 683 License Exp. License 41 Exp. V ec A `*-C. jSci Z 1 60/31 /20/ 39. Item Unit Charge Qty Total (Qty Multiplied by Unit Charge) Service /Feeder 200 Amp. 119.90 Service /Feeder 201 -400 Amp. 145.50 Service /Feeder 401 -600 Amp 204.60 i Service /Feeder 601 -1000 Amp. 262.20 Service /Feeder over 1000 Amp. 372.50 Branch Circuit W/ Service Feeder 2.60 Branch Circuit W/0 Service Feeder 73.50 Each Additional Branch Circuit 2.60 Temp. Service/ Feeder 200 Amp. 92.70 Temp. Service /Feeder 201 -400 Amp. 110,30 1/0 3D Temp. Service /Feeder 401 -600 Amp. 148.70 Temp. Service /Feeder 601 -1000 Amp 167.90 Portal to Portal Hourly 95.90 Sign /Outline Lighting 88.20 Signal Circuit/ Limited Energy First 1500 sf Commercial 95.90 Note: $5.00 for each additional 1500 sf Signal Circuit/ Limited Energy -1 2 Family Dwelling 63.90 Signal Circuit/ Limited Energy Multi- Family Dwelling 63.90 Manufactured 'Home Connection 119.90. Renewable Electrical Energy 5KVA System or Less 102.30 Thermostat 56.00 NEW CONSTRUCTION ONLY: First 1300 Square Ft. 110.30 Each Additional 500 Square Ft. or Portion of 35.20 Each Outbuilding or Detached Garage 73.50. Each Swimming Pool or Hot Tub 110.30 i/o 3;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. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permitexpires 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 X ...c1 Dated: S7z'.i f 1 1 01/0112010 A Appli cat i on.'Number. ,Application pin number Property Address :ASSESSOR PARCEL NUMBER :Tenant. -nbr 'name ?l Application .type :des criptionoe .Subdivision 'Name 1:. :Property' 'Use. Pron�rty •Zorii:ng. 'Applieation' :ualuation. 'Applicat ;:desc- REDUCED, �P. EESSURE,:BACKFI:OW. DRINK 'DSSP.` Owner Qty '7 :0:00:0• 'Fee. ,summary ,Permit Pee ',Total, :Plan 'Check Total Grand `Tot 1 0 „ODeec, Date P. ririt:Nap e, y T. FormsBuiiding "Divisio n%B'uiiding P,ennit GI.TYµO F'PORT :ANGELES: :DEPARTMENT 'OF COMM.UNITY EC- ON.OIvM.I&DEVEL .INTENT- BU.IL'DING,DIVISION 321 EAST :5TH "STREET :PORTANGELES,'V✓A 9 8362 :PORT ANGELES ER'I'E .:W4 8:3 >OF .„FOE -34 PENN' :ST 'PORT !ANG 3344' ;Permiit L EI U MBI NG "PERMIT' Additional ;3esc:. „..t -BPC CF -L`OWe ;GARB 3Perm't pin :number; 164'11 is Pe'rmt °Fee On :IS'sue =Date; 4;/'2`0,/'30. Expir- ati'"'Date' m ':Unt', Ter ;JOHN `I ;GILBERTSON' ":4,1A98'3:624 °63.1•. ',PORT,_ANGELES: Charged' .k4K. ,TO 000003'83 403`994'7' "14'0 A. PENN `ST 06 .3.0'=00 '7 "0 'D'32•5 '0000 PORT ;ANGELES 'AERIE`'4 483: ;P.LUMBIN',REPAIR P_UBI;I.0 "BUILDINGS r 433 ;Paid 5'7 !0:0� t =Contractor BEU" ;Dt`SP' ;lan Check Yee; zaluati'on pt. ,PARKS Crediaed' 00 0 :Date °!BASEL EE. ;PL- :BACKFLOW P.ROTBCTS ON; <OR =2` :Due. "1" WA 583;63. r Extension `50: ;00 r r- !a Separate :Perin its! are! required :for =electrical;:work, :SEPA, Shoreline ESA utilities prlvate and piiblictimprovements This permit becomes null and void, if work;orconstruction'authorized is:not commenced;within`1'80,days,: ifconstruction:or*ork;is suspended'. or: abandoned' for :aperiod%of 180 days' .after the work has:cornmenced, ortif:required.inspections'have not'been requ with 180. days'fromAhe inspection. I:hereby- certify that ,I have; .read and examined -.this. application and'knowthe same to be true and correct. Al!':provisions of laws `and ,ordinances,governing: 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 of local.'laiv regulating construct >:0rorthe`pe'rformanceof construction. Signature Contractor or Authorized Agent Sianatiire ofOwner.'.(if owner is. builder) *7' NAME OF PREMISES. SERVICE ADDRESS °A 4 /f/ Fa /ft, "3 64 G e r I /o Pc A fr r LOCATION OF DEVICE. //)v t c $7' '4 0l f�/V S'F� ASSEMBLY 4 T 1 s i2 q 1, 4 Manufacturer Model Size IS THIS AN APPROVED ASSEMBLY? YES /�EjNO IS ASSEMBLY INSTALLED CORRECTLY' YES K O 0 DATE OF INSTALLATION 41 A 3 G /4JNKNOWN 0 Initial Test Repairs Details COMMENTS Initial Test Repairs Final Test REDUCED PRESSURE PRINCIPLE ASSEMBLY DOUBLE CHECK VALVE ASSEMBLY CHECK VALVE #I Leaked Held at 7_ psi Cleaned Replaced Backflow Assembly Test Report City of Port Angeles Public Works and Utilities Department Water/Wastewater Collection Division CHECK VALVE #2 Leaked Closed Tight gl "'"1 PrJ o Held at Held at psi r 'Cleaned f4 RELIEF VALVE Did Not Open 3 Opened at psi Cleaned Replaced Replaced 't4 3 psi Butler YES Nd r III Final Closed Tight Test Held at 7 psi I, Held at psi Opened at 3. psi l� AIR GAP INSPECTION /I .t .T f f 1' REQUIRED MINIMUM SEPARATION (YES NO /V Pc C i 7E 1 4 f5 e 0 CHECK VALVE .r ti Leaked Held at psi REPAIRS Cleaned ned Replaced TYPE OF HAZARD 5 6 A P 4 1111 ,ItcE f Line Pressure 6 C psi WHITE CUSTOMER COPY YELLOW PURVEYOR COPY PINK TESTER COPY Official Use Only Assem.# 4' 7 Received RP Er RPDA DC DCDA PVB Air Gap SVB AVB r13,l,r�' g9 Serial No PVB /SVB AIR INLET Did Not Open Opened at psi AIR INLET Opened,at psi CHECK VALVE Held at psi BACK PRESSURE NO YES J.� Held Backpressure YES Er NO #2 Shutoff Held YES CF NO Relief Valve Exercised YES III NO I Date'Time: Tester Signature Cert. Test Kit Passed Failed a .3- 7 G t KCl2 S /1-11v yes Ev CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Application Number 10 00000389 Date 4/20/10 Application pin number 039047 Property Address 110 S PENN ST ASSESSOR PARCEL NUMBER 06 30 00 7 0 0325 0000 Tenant nbr name PORT ANGELES AERIE #483 Application type description PLUMBING REPAIR Subdivision Name Property Use Property Zoning PUBLIC BUILDINGS PARKS Application valuation 433 Application desc REDUCED PRESSURE BACKFLOW CARBONATED DRINK DISP Owner PORT ANGELES AERIE #483 OF FOE 110 PENN ST PORT ANGELES (360) 452 3344 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge 1 00 Fee summary Permit Fee Total Plan Check Total Grand Total 7 0000 EA q -20 -/0 ODeaO,/„ Date Print Name T:Forms/Building Division/Building Permit WA 983624631 PLUMBING PERMIT BACKFLOW CARB BEV DISP 164111 57 00 Plan Check Fee 00 4/20/10 Valuation 0 10/17/10 Per BASE FEE PL- BACKFLOW PROTECTION Charged Paid 57 00 00 57 00 Contractor JOHN L GILBERTSON PORT ANGELES 57 00 00 57 00 <OR =2 Credited Due 00 00 00 WA 98363 Extension 50 00 7 00 00 00 00 F�'nal�c( 6 -3-10 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 Contractor or Authorized Agent c Signature of Owner (if owner is builder) 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 AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs 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 MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting 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 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 PLANNING DEPT Separate Permit #s SEPA. Parking Lighting 1 ESA. Landscaping 1 SHORELINE. Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 I FINAL Date 1� -3— Accepted by RO h FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By C> Applicant f Property Owner 7 .ls, s.F s s Property Owner's Address o 5, >a� s j Contractor J a cp /u n em u Zok\ L. G br'Phone Contractor's Address License C;, L R e.7 L l0 3t C. ci PROJECT ADDRESS Parcel Number Project Type Brief Description. Check all that apply New Construction Addition Remodel Repair Demolition Re -roof Heat System XOther Floor Areas Existinq (sq. ft.) Basement 1St Floor 2 Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other BUILDING PERMIT APPLICATION 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 At)Ic 5 17 frP //U ,J ,i Residential S 7i. s70. r OCu e e.l.fes House garage other tear off re -roof lay over one layer Heat pump wood- burning stove gas fireplace pellet stove other Expires P.- on E -mail Multi- family Proposed (sq. ft.) V Total footprint of structures q ft. Lot size Site Coverage the amount of impervious surfac on. .arcel including structures p and other impervious surfaces (see PAMC 17 9 5 for exemptions) Max. height of proposed structures ft occupancy group Will a lawn sprinkler system be installed? 0 pant load Will a fire sprinkler system be installed? Construction type Phone I 6.0 .Sbf t'/p P Phone (36o0) -33 6 #h For City Use Only Date Received Z©— 1 0 Permit# -34k Date Approved !D, .T /rS j L('o .F09 9AP3do 2 Lot Zoning Commercial BAG ze f ✓OW Asfeevi /N m/1 /.J 1T e .O•t. 7,.g4'R per sq ft. i TOTAL VALUATION Industrial 4/ 33 (op ways sidewalks patios Site coverage of bedrooms .f full baths of If baths I 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 Date Print Name �ofig 5 7,,i',/- 1 Signature T Forms /Building Division /Building permit application J CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION y 321 EAST 5TH STREET PORT ANGELES. WA 98362 Application Number Pin number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Use Property Zoning Application valuation Owner Contractor PORT ANGELES AERIE #483 OF FOE 110 PENN ST PORT ANGELES WA 983624631 Permit ELECTRICAL ALTER COMMERCIAL Additional desc FIRE ALARM WIRING/ HI TECH Permit Fee 42 20 e Plan Check Fee 00 Issue Date 4/08/05 Valuation 0 Expiration Date 10/05/05 Qty Unit Charge Per Extension 1 00 42 2000 EL LOW VOLT SYS =2500 SQFT 42 20 Fee summary Charged Paid Credited Due Permit Fee Total 42 20 42 20 00 00 Plan Check Total 00 00 00 00 Grand Total 42 20 42 20 00 00 COMMENTS /ACTION NEEDED 05 00000245 446410 110 S PENN ST 06 30 00 5 6 0086 0000 ELECTRICAL ONLY PUBLIC BUILDINGS PARKS 0 HI TECH SECURITY INC 723 E FRONT ST PORT ANGELES (360) 452 2727 Date 4/08/05 WA 98362 DITCH ROUGH -IN COVER SERVICE FINAL GENERAL COMMENTS: ELECTRICAL PERMIT INSPECTION RECORD •5ALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO PW -I 102.15 (4/961 Electrical Contractor Owner Annual Permit Alarm Carnival Commercial Residential Residential Maint. D Signs 0 Thermostat 0 Telecom. /Installation description Job wired by Electrical contractor name Purchaser's mailing address 7 z Fo-a r City Rn_16 Telephone number 340 -.4 S 272 Premises owner's name Address of inspection 1 0 So �.a r`7 x N',. III WALLS Insulation Only Date Date Approved By Cover Inspection Date 05 Date Date Td Wti£S 80 SOOE 90 ..tdd 'lectrical Contractor Owner Appnrvcd By Dote I License number HtrEa' 5 c ssB5 s Electrical Load Additions and or subtractions O NO LOAD CHANGES Baseboard KW Furnace KW Heat Pump Ton LAR C1 Fan -wall KW State ZIP L 9 x8.3( 2 FAX number 340 y5 2 85 ci 83G2.- /Signature of owner ctrical 'onlractor or electrical adntlnistrator Insulation Only Cover Approved By Request Inspection Dote Approved Hy Overhead Service Temp Service Underground Service Arca. Building or Equipment inspected 0958 ESV 092 '0N Aid ELECTRICAL WORK PERMIT APPLICATION ter' C RE. 4 a Loo.ibe anc2 Cash 0 Chcck I hereby certify that 1 am the owner of the above named property or a licensed electrical contractor (or the firm s authorized agent) and am making the electrical installation or alteration in compliance with the electrical law, Chapter 19.28 RCW Card 0 Credit Card Visa Expiration Date of card CEILING THERMOSTAT' Date Approved By J DITCH Mastercard Da te S.W.!'1P.R.101.9rmation Voltage Phase 0 1 3 Service Size: Feeder Size: Action 'Taken SERVICE Discover inspection fee 9— Zfl ApprOvcd By FEEDER Approved By Dote Approved By Electrical Inspector SO I NOid1081d H081— I H woad .(iil "'..... I II CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION ~21 EAST 5TH STREET. PORT ANGELES. WA 9R~62 SCAN~~,?, ~ Date~ Initials h'l./ ELECTRIC~L PERMIT Issued: 12/16/97 Permit No: 6159 OWNER/AP!ILICANT------------------------PROPERTY LOCATION------------------------ EAGLES LODGE 110 PENN S 110 S jlENN Lot: 1 TH 22 BLOCKS 3 & 4 Port Atlgeles, WA 98362 Block: Long Legal: . 360/009-0000 Sub: VERGINIA PARK TERfACE T: II S: Parc.No: CO~~~~i~~~;~~-------------------------DESIGNER---------------------------------. 546 BEI,SON RD. PORT Al,GELES, WA 98362 360/45l1-6753 , 000/000-0000 PROJECT ~NFO-------------------------------------------------------------------- prj T~pe: COML. MISC. prj Value: $0.00 Occ Tvpe: Cnstr Type: ADD CIRCUITS Occ Wrp: Occ Load: Land Use: ACD . Electr:ical Heat Ba$eboard KW: Furnace KW: Helilt Pump KW: Fap/wall KW: Service Type o Riser o Overhead Service o X Underground Service o Temp Service Voltage: Diameter: Service Size: Feeder Size: -1 o -3 o AMPS o AMPS PROJECT ~IOTES-------------~----------------------------------------------------- INSTAL CIRCUIT FOR WALK IN COOLER II PROJECT 'PEES ASSESSMENT--------------------------------------------------------- " Service: $0.00 Adr,ii tiona1 Feeders: $0.00 Circuit Wiring: $52.00 . I! Temp Service: $0.00 M1SC. : $0.00 ====~============================ , . TOTAL FEE: Amount Paid: $52.00 $52.00 TOTAL FEE: $52.00 Balance Due: $0.00 I COMMENTS/ACTION NEEDED :1 i. .. ,~ I . . , ~ ELECfRlCAL PERMIT INSPECfION RECORD r CALL 4174735.FORELECTRlCAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr IS UNLA WFUL TO COVER, INSULA ~ OR CONCEAL ANY WORK BEFORE rr IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTIID COMMEmS YES I NO Ulll.,n KUUUtl-IN / r ~ I/Z/(i./Q( I jtJi.v'-l. I . GENERAL COMMENTS: PW-II02.1514'96l II 1 II' ,I II CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles. WA 98362 (206) 457-0411 II :t Si~~ Address: ELECTRICAL PERMIT PERMIT NO. floC? /' DATE ::1/ ;:r/9 J I , . In: ailed By: ~ o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: O~fner/8usiness: Ii O~ner/BUSjneSs Address: Phone: Sq. Ft. o IhESIDENTIAL o COMMERCIAL o ,BASEBOARD KW o IfURNACE KW == o FAN/WALL KW _ o HEAT PUMP KW o ilSIGN - o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION o REMODEL o ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: o SINGLE PHASE o THREE PHASE SERVICE SIZE AMPS De~ails/Description: ~j \l~/ II . -;1 ----:t Ii W.$. No. SERVICE SIZE CAPACITY: 'L 0 O.K. NOT O.K. ACalON REQUIRED: 0 CHANGE TRANSFORMER , 0 INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER . " 'I I, I o Ditch Inspection O.K. I o Rough-in/cover O.K. I o OK to connect service ~~Irinal O.K. " Site Address: II I 0 SiJ. ~ " '1raller: ~.~ NewM~ ~:.:?.3 'I Nqlify Port Angeles City Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report cr'bn the Bu~ermit. PHONE 457-0411, EXT. 224. &-0 II IIYJIIII NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ .;;2.[;" - II Electrical Inspector Permit Fee wlilTE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept.. Boltam: City Hall ~ OLY~PIC PRINTERS INC II Ir II ,I I ,I II il .1 II I 'I II ,I ,j Ii , !I 'I II I I I, " :1 :' ;",... "" ~r iSJON t:{fc 'PtfC4'L ., CITY OF PORT ANGELES * * Correction Notice Job Located at f~1t6 //0 ~ ItrtltJ1 Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: {7J Pr/c /Joi :; (.J ffu,(-7li? rM;Jst-!1{ , g; fUr:. /LhT nu! ~~h VIA-- 7,uv-J 3 luc bfl:,lc'i..-V' t- L-e MI\\f C-"J-!"v. if) G!z'ou f-/ d 'S~f?tD<--r Jlo6L Ii 11M"?, c fuJ Jv,('i. . p()~ . f Q rr A A I { _0 /Vlrr-J~ 1)uj(r~ , ," Date .2/~/17 il/J- v nspector for BUIlding DiVIsIon DO NOT REMOVE THIS TAG '. ~ BUILDING" jlSION CITY OF PORT ANGELES * * Correction Notice ot/r 5 5:'1'1'#. Job Located at I/o s; PF#tv I Inspection of your work revealedthat the following is not in accordance with the codes governing the work in this jurisdiction: (j);tJff j ~/€- {j GL. /' k.,/t; . s fr--/tfl AI.. , 0-"'" I!iJ.C, I 4 T ..J/.,.v I ,/ /.A> /./'-1-1..., I > r A , h,-tI.! These corrections must be made and are not to be covered until reinspection is made. When corrections have been made, please call for inspection. Date 2//2/;; 1 / !' Ins DO NOT REMOVE THIS TAG . . . /153. A ftR?;:MBER CITY OF PORT.ANGELES DEPARTMENT OF LIGHT APPj.ICATION AND ELECTRICAL PERMIT .. "1 FEE RrElPT NUMBER .' .' , , I niTAL FEE' I , ,.,1G~ .r1 CONT. Lie. NO. TIMETOCOMPLETE NO. STORIES LEGAL OCCUPANCY . I ELECTRICAL PERMIT ONLY Site Addfess I/o - s- ~Cj./A:/, Owner ~; fA-7 cr;:.? ADDRESS IS RES. ONSIBILlTV OF AP~L1~ANT Owner'slf~ddre5S - ~. NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT .PE~MITS ~ITH WRONG AD~SSES ARE C~NCELLE.ft- Installation By Y9tv-o- C/ , Histallers Address Day Pho e Installers Phone -. Applieat f)n is here,by made.for Permit!o ,install EI~9trical Equipm~}~.t as folio r - .It AJ . ~ ,~~ ~-- : Yr;((. r I . . Wiring Method , AMP 24QV AMP 240V US~OF CIRCUIT NUMBER PER 120V 100R FEE USE OF CIRCUIT NUMBER PER 120V 10QA FEE ! CIRCUITS CIR 10 30 CIRCUITS CIR 10 30 L1GHTI SIGN "L1GHTl .. -. 50 VOLTS OR LESS CONve;NIENCE ... MOTOR I CONve:NIENCE .. ".--.._. n . - - MOTOR. .. I , MOTOR ~:NCE ._.. n DISHWI\SHER --- - ~IRE ALARMS .. . . . f----i. . DISPO~AL BURGLAR ALARM , MISC. RANGE: I OVEN i I WATE~ HEATER ----;' - .. - lAlJNn:AY I DRYE9 .- REINSTAllATION'L1GHT FIXTURE # FURN'peE -- SUB TO:rAl FE~ ' GAS- Il FURNACE ENERGY FEE EtECl1~IC .. ELEC'TIC HEA.~ BASIC FEE TOTAL FEE - ELEC-ry:.IC HEAT .. SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER AC. U~IT AMP PHASE FEEDef SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICE . p , , A.W.G. I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH I certiJ that the work to be performed under this permit will be done by the installer and in: conformance with the N.E.C. Electrical Code: I. . - .... --... . · Date Ar;plication made ,19 By 1- - - - '.. .,. -.- CONTRACTOROROWNER(ORAUTHORIZEDAGENTj . Petn,ission is h~reby given to ~o the a,bove described wqrk, according!o the qonditions hereon and according to the approved plans and: specifi~;:ltions pertaining thereto, subject to compliance with the Ordinances f the.City of Port Angeles. . _ '1 DIR~OF Date P~i'mit Issued , I W~RNING . .. Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be co.vered or l;a~rrent turned o.n bef9re inspection and O.K. for covering or s€!rvice has been given by Inspector in Writing on Permit Placard. A.. Permits Phone: 457.0411 Ext. 158, PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ I OLYMPIC PRINTERS. INC. WH!TE - Original CANARY. Duplicate PINK. Triplicate WHITE CARD -Inspector's Report REPORT OF INSPECTOR r .. DATE OF VISIT MADE BY REMARKS '. 1..-, ., '. " '. \ , " , , , , J ~ , , O.~VER'NG ')j/z, / f7 /1/1 ~J O.K. TO CONNECT BrR .IBE I f ~. . z " II: <I: ::E !!! J: I- Z W . I- o Z o Q . eI'n OF PORT ANGELES tIGHT DEPARTMENT ELECTRICAL PERMIT Nt? 17248 Port Angeles, washlngtonmm_~_m:__~L._.u.__...._.m.m__m_m, 19uE-'? In aceordance with the City Ordinance to regulate the installation, extension, or repair of elec- trCcal 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. Address u_mu.I/..CZ_.____~_'?_._~'!_~'::?L_"IJi!.-(.umm-m- occupancy_____m.k7.~m____mmm.u_ Owner u_i.i~~.~~m_uum.,_fi?_~---m.,uum Tenant_m..m_.._m_...._.u_u_~__u__mu_muuum__.__.__m___.. Waring contf:ictor _u~_,d?..:?-_m'!!~'d?._"(i_~:-r,,l.._____m By_uuum_mmuum__m___ummu_u____um__mm_____.u Light Outlets____...______......_......_..._________. Service, volts ___..___....___.................__..... Re~eptacle Outlets.................___........... Dr)'er. KW.................d.....n......u........ No. wires ............__..................n..... Size wlres..................................._.. Range, KW............____..___................ Main fuse ............................_.......... Water Heater: Enclosure ....................................... KW.___u__mm_________m__uum Type of wiring: Entrance Cable ....................... Hea~: KW............................................ Moiors: size, volts and phase: Rigid Conduit _____________________ Meta1Uc Tubing ..___......___. Current transformers: No. & Size....................................... Ser. No.............................................. Ser. No.............................................. Type of Wiring: Armored Cable .............................. Non.Metalllc ................................. Knoh & Tube____.........__......_n..._____ Rigid Conduit _..._......_...n_n___n__.___ Metallic TUbing .....___...___............. Raceway ............._.................__..._ Circuits, LlghL................................._.. Utility n......n......____............__________n_ Heat ....................._................._...._ Range ..................................._......... Water Heater ............................... Motor ............................................. Dryer ..............................................__ Furnace .........................._................... Ser. No.............................................. fr Total Load............................. Ser. No.................._.........._.............. Total _...........n..~~.~.......... ReIuarks: _mu2_U!_dt;_-::f!??_mu./2r!?._~__.d..-<1<!d__dt_mJZ~":t._:::~:__:'..__5L_.m__k_________ v,.., '?7 /'C.' ./- .....d,2.. __(.f!!..,_<:!;L:':42:~_""'::.:!'-(.~,__:?c.::e________1!'.___~_::_.!3::_~~d._L'.:~'--.---7!-sl:----~-~-t:~-t;.-;g-.--.=-:V----------------------- .UU-1.....n.nnnnnuu..nunu,uuuU.'..n.._n_nnunununn.nnnn._nn._nu..nnunn...uuu.nuu...uun._n.._n_._..nnnn.n....nnnu.n Permit Fee . 'fiC:O $___~~.._m___m__mmu_______.. NO._____u.........m...._.._ Bf)fLJK;?J.t..~i~LL, 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. Treas. Receipt NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION .ELECTRICAL PERMIT N? 17248 Add~ss...................-.-..........................................._................................_.__.........._......................Date..._......_.._......___.....____......_......__......_ Owncr.......................__.......____......_.__._........._.._.._...................._......................................Tenant........................................................_........... Wir~ng Contractor _._..........................._............................_..................................................._....._... By.............................................................. rifOTIC~urrent must not be turned on until Cert1f1cate of Inspection has been issued. If work Is to be con. ceal8j due notice must be given the Inspector so that work may be inspected before concealment. 1M Olympic Printers, Inc. , . /10 .' -' CI iY OF PORT ANGELES tIGHT DEPARTMENT ELECTRICAL _ PERMIT N? 15631 Port Angeles, washlngtonn.mLnm.iZ...mn.u...mmm..m.mm, 19/b In aocordance with the City Ordinance to regulate the Installation, extension, or repair of elec- t! ical equipment in, on, or about any building or otl1er structure In the City of Port Angeles, per- rr.ission is hereby granted to do electrical work as listed below. cL"" 'I" /1J I, +- I .. Address r;Z{cM'f.)!m(LL-zt."'L1..m,~nnmn___n..nnm..m. OccupancY.#~~.m.n. Owner e?.~I?.._.~mmn:..mmnn.mnu._u..nmnm TenanL.n.___.u.m........n__..__.__.m...___.mm......mn.m.m... Wiring ~~ntra~to~...QR(Jn(l!.,~....;)l.~un.__nn.__..n By..nmmmmmm.mm.m.m.nnnnn..__..nu.....mnn --'-'"_m.''' 1<;0 /.f!) Y CJ Light Outlets......................d......._.._..... Service, volts ...:':':':'.....:I-'..~..h_...._______. Type of Wiring: Receptacle Outlets......_mmm..__......____. No. wires .%-__m_n._m....................-=- Armored Cable .._.n....._._._____n__.___. D.'Ye" KW m.m..___..__m________n____________. Size wlres..2..~..1111---(:C--!1..--;.....-X Non.Metalllc ...........n..................n " ,_ n Knob & Tube........___..................____ Rnnge, KW mnu_._.__m._.._ Main fuse __mm_.___m_..._...._._........... Enclosure __e..L(.a................. Type of Wlrln$O d A r Entrance Cable .......h.....____________.__ 'Water Heater: RIgid Conduit .............................__ Metallic Tubing ____._____................. KW..________.__n...____..____________ Hat' KW.__.-/-/...I..yJ....__.._________.....__ Raceway ......................................._ 1\: :ltors: size, volts and phase: .J a...CU4-,_0k...__m.. d ~m>r-d:?:---..3.}$.~~.. { -___5.~....;J.l/((.r................ Rigid Conduit m.m........................ Metalllc Tubing ___......m.. Circuits. Light....................................... Utility ........__................................... Ser. No.............................................. Heat ............................................... Range ............................................. Water Heater ....,..d...................... Motor ........__.......__.......................... Current transformers: No. & Sizem.___.................. Ser. No. ............................................. Dryer __..u.....u_..................__._,.........__ Furnace .........................-_...nn... ......... r-'V Total Load........_...__............... Ser. No. .....n.........._......................__.. Total ......~........................... , R ,marks: .m.m.,,4I'--<:_t;,."..=-----n.W~e_iZ.m..m.n..--......nmnnmmnn.mm--.nm...____...___.mmn.__.nmn Ser. No............................................... P~nnit Fee '1 {)() $....,..I..........m.mmmn.__.. Treas. Receipt NO.m..mmn..m.......... By .~J(rL%~,:.~.i:e.~~"'~.~ " NOTICE-Current must not be turned on until Certificate of Inspection haa 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 \,' i / i .' , .N?' 15631 A( dress ..... .m..........___....___m.....................__....... ___... ___ ___ ..........................__.......___.........."'L........_.._.......___......._......_......... /' O,,.ner .................................,.__....._.._......_......_.._........................................................... Tenant............................._..u_...............n..u............ ELECTRICAL PERMIT W _ring Contractor .......................................................................................~............................~.~y....................._....._..............._.................. NOTICE-Current must not be turned on untU Certmcate of Inspection has been issued. If work is to be COD- CE. Iled due notice must be given the Inspector so that work may be inspected before concealment. 1M n1vmn;I'" 'Dr,.,t",,.,, f.,,...