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Home My WebLink About2238 Lindberg Rd - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner MANTOOTH JAMES E 2238 E LINDBERG RD PORT ANGELES WA 983628611 Permit Additional desc Permit in number 112367 Permit Fee 120 00 Issue Date 10/10/07 Expiration.Date 4/07/08 Qty Unit Charge Per 1 00 120 0000 EA SAN Other Fees Fee summary Charged Permit Fee Total 120 00 Plan Check Total 00 Other Fee Total 1000 00 Grand Total 1120 00 CITY OF PORT ANGELES PUBLIC WORKS UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 07 00001140 276140 2238 LINDBERG RD 06 30 13 2 1 0150 2001 PUBLIC WORKS UTILITES UNKNOWN 0 Contractor OWNER SANITARY SEWER HOOK UP SEWER HOOKUP SEWER SYSTEM DELV :CHARGE Paid Credited 120 0,0' 00'4 1000 00 1120 00 Plan Check Fee Valuation 00. .00 00 00 Date 10/10/07 00 0 Extension 120 00 .1000 '0.0 Due 00. 00 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private arid'public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if co_ nstruction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required' inspections have not been requested within 180 days from the last inspection I hereby certify that .I .have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Sig nature of Contractor or Authorized Agent Date .Signature of Owner (if owner is builder) Date 7 T•\Policies 1102.15R [1/05] PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE T•\Policies \1102.15R 1/05] RESIDENTIAL CONSTRUCTION R W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I PLANNING DEPT 417 -4750 I BUILDING 417 -4815 PERMIT INSPECTION RECORD CALL 417 -4807 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 CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT BUILDING Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner MANTOOTH JAMES /ROBERTA TRUST 2238 E LINDBERG RD PORT ANGELES WA 98362 Permit RIGHT OF WAY Additional desc EXTEND SAN SEWER Permit pin number 111013 Permit Fee 50 00 Issue Date 9/14/07 Expiration Date 3/12/08 Qty Unit Charge Per 1 00 50 0000 ECH Fee summary Permit Fee Total Plan Check Total Grand Total T•\Policies\ 1102.15R 1/05] Charged 50 00 00 50 00 CITY OF PORT ANGELES PUBLIC WORKS UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 07 00001065 162555 2238 E LINDBERG RD 06 30 13 2 1 0110 1000 PUBLIC WORKS UTILITES RS9 RESDNTL SINGLE FAMILY 0 RIGHT OF WAY Contractor Date 9/14/07 CRESCENT DEVELOPMENT INC P 0 BOX 41 JOYCE (360) 928 2560 LINBERG RD Paid Credited 50 00 00 50 00 Plan Check Fee Valuation PERMIT 00 00 00 WA 98343 00 0 Extension 50 00 Due 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 fora period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date CALL 417 -4807 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 CONSPICUOUS LOCATION PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE RESIDENTIAL CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I PLANNING DEPT 417 -4750 I BUILDING 417 -4815 T•\Policies \1102. I5R 1/051 PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED YES 1 NO COMMENTS FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT BUILDING Owner MANTOOTH JAMES /ROBERTA TRUST 2238 E LINDBERG RD PORT ANGELES WA 98362 Fee summary Permit Fee Total Plan Check Total Grand Total COMMENTS /ACTION NEEDED CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 121 EAST STH STREET PORT ANGELES. WA 98362 Application Number 06 00000080 Date 1/27/06 Application pin number 233440 Property Address 2238 E LINDBERG RD ASSESSOR PARCEL NUMBER 06 30 13 2 1 0110 1000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 0 Contractor ANGELES ELECTRIC 524 E 1ST ST PORT ANGELES (360) 452 9264 Qty Unit Charge Per 1 00 97 8000 ECH EL -RM 201 400 1ST SRV FEEDER Charged Paid Credited 97 80 97 80 00 00 00 00 97 80 97 80 00 WA 98362 Permit ELECTRICAL NEW RESIDENTIAL Additional desc ANGELES/ 320A SVC Permit pin number 69823 Sub Contractor ANGELES ELECTRIC Permit Fee 97 80 Plan Check Fee 00 Issue Date 1/27/06 Valuation 0 Expiration Date 7/26/06 Due Extension 97 80 00 00 00 CALL 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. DITCH I N ROUGH -IN COVER N S L /.�s fr) 1 FINAL 1 i3 14C .1 GENERAL COMMENTS: ELECTRICAL PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED YES 1 NO 1 1 1 1 1 1 1 1 1 COMMENTS Pw- I102.151 1 Application Number 05 00000011 Date 1/05/05 Pin number 921195 Property Address 2238 E LINDBERG RD ASSESSOR PARCEL NUMBER 06 30 13 2 1 0150 2001 Tenant nbr name CLALLAM CONSERVATION DIST Application description CLEARING GRADING Subdivision Name Property Use Property Zoning UNKNOWN Application valuation 0 Owner Contractor MANTOOTH JAMES E OWNER 2238 E LINDBERG RD PORT ANGELES WA 983628611 Structure Information STROM WATER FILTRATION POND Qty Unit Charge Per Extension BASE FEE 60 00 Permit CLEAR GRADE Additional desc S/ W FILTRATION POND #04 18 Permit Fee 60 00 Plan Check Fee 00 Issue Date 1/05/05 Valuation 0 Expiration Date 7/04/05 Fee summary Charged Paid Credited Permit Fee Total 60 00 60 00 00 Plan Check Total 00 00 00 Grand Total 60 00 60 00 00 T•\Policies \1102.15R [1/05] CITY OF PORT ANGELES PUBLIC WORKS UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Due 1 00 W 00 00 RX Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date C 1 l�- c CALL 417 -4807 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 CONSPICUOUS LOCATION. PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE CONSTRUCTION RW PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I PLANNING DEPT 417 -4750 I BUILDING 417 -4815 T•\Policies \1102.15R [1/05] INSPECTION TYPE RESIDENTIAL PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE DATE ACCEPTED YES 1 NO COMMENTS FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO CONSTRUCTION RW PW ENGINEERING I FIRE DEPT I PLANNING DEPT BUILDING CLEARING AND GRADING PERMIT APPLICATI n 0, /1 CITY OF PORT ANGELES �Vf APPLICANT C(a'l(tM -PtS•r OCT 1 2 200 APPLICANT MAILING ADDRESS 111 g• 110 4 SI reit WA 78UD 1 APPLICANT PHONE NUMBER: (3fov) 79 X 112-. %G(en- Av .1. PLAN PREPARER (Architect /Engineer): MoU 4 SlµttL, 5K:4 r ret- 1 PREPARER ADDRESS PHONE 111 "14 St Pict'', (.Aft `l 83G2_ LOCATION OF PROPOSAL(street addressor lot a block Z2.3S 6 Lin ;ital. go0.9 fv,¢ liKtgAs.4 Li OWNER OF PROPERTY(tf not applicant. include letter of authorization from property owner). 1 IM Q.v►al 20191.1e_ Mah►+'a DESCRIPTION OF PROPOSAL (Also include plans, sketches or other information which would assist in our review). SPD_ c p t [Lid Gf pho4 aY 'Ilia "Aai I Hitt: o (1 Estimated amount of material, in cubic yards, to be excavated, imported, or exported: If the answer to any of the following questions is yes, an ESA application with a SEPA check list is required to be submitted with this application and will be processed according to the City's consolidated permit procedures. N 1 Is the excavation or fill associated with the development of a parking lot for more than 20 vehicles? 2. Does the total amount of excavation or fill exceed 100 c.y .c 5 3. Will any portion of the grading, excavation or filling occur withih 200 feet of any of the following; Shoreline, Stream, g 40% or grater slope? If the answer to yes, please check the appropriate condition. The applicant hereby affirms and commits that the information submitted for this permit application is accurate and that the applicant will comply with the terms and conditions of the permit and the City of Port Angeles aring and Grading Ordinance. (Appl ant or authoriz representative) The following pages are for City use only PERMIT EXEMPTION DUE TO: f9 NOT EXEMPT. C G PERMIT' REQUIRED o A. Land clearing, grading, filling, sandbagging, diking, ditching, or similar work during or after periods of extreme weather or other emergency conditions that present immediate danger to life or property as authorized by the City Engineer. o B. Land clearing order by the City Council for abatement of a public nuisance. a C. Removal of dead, diseased, or damaged trees which might constitute a hazard to life or property o D. Clearing by a public agency of a franchised utility within a public right of-way or upon an easement, for the purpose of installing and maintaining water, storm, sewer power cable, or communications lines. o E. Cemetery graves. NOTE: EXEMPTIONS "F" THRU 1" SHALL NOT APPLY IN SITUATIONS WHERE PROPERTIES INCLUDE ENVIRONMENTALLY SENSITIVE AREAS o F Land is one acre or less, except where an adjacent area under the same ownership or chain of ownership has been similarly exempted so that the combined area is a greater than one acre and erosion control has not been re- established. o G. If a building permit is issued, no additional clearing, grading, or filing permit or associated fee will be required; provided that the standards established in this manual shall be applied to the issuance of said building permit. o H. Developments larger than one acre in improved areas served by paved streets, curbs, gutters, storm drains, and other drainage facilities, as authorized by the City engineer. a I. Work, when approved by the City Engineer in an isolated, self- contained area, if there is no danger to private or public property_ The proposed action has been determined to be exempt from a Clearing and Grading Permit based upon the ,information provide by the a The basis for this exemption is as checked above. C G APPLICATION No. J Dept of Community Development Moo cv. ud 11 OGT DelL (Date) 3entor PI tel ate City Engineer Date pORTg PERMIT CONDITION REVIEW ROUTING. o To Public Works for Engineering requirements Date to To Planning Department (with engineering's requirements) F ESA and SEPA requirements. Date Retum to Engineering Permitting. Date Copy of conditions to applicant Date PERMIT FEE CALCULATIONS: A. Grading and Filling Plan review and permit fee 0 -250 cy and less then 4' of cut or fill •251 1,000 cubic yards ($22.50) 1001 10,000 cubic yards ($30) •10,000 +cy ($30 +$15/10,000 cy) 3. Clearing and Drainage Plan review and permit fee •Less then one acre ($30) •One acre -5 acres ($50) •Over 5 acres ($10 per acre) SEPA review ($100) Total Permit SEA Review Fees Clearing and Grading Permit 1 44101 Additional plan review for changes, additions or revisions to approved plans at $30 per hr reg. and $60 per hr overtime. III. PERMIT APPROVAL. Page 2 Permit No. Jo This certifies that the named applicant is granted a Clearing and Grading Permit for the work described and the purpose shown in the application. This permit is granted subject to the terms of the agreement contained in the application, subject to the terms of the provisions of the City of Port Angeles Municipal Code and subject to all special conditions which are attached to this permit or as noted in sections IV thru VIII following. Nothing permitted hereunder shall be deemed to override the provisions of any applicable law of the City, County State or Federal Government. This permit expires one year from the date of issuance, unless otherwise specified by the City Engineer 1112-9 jot/ Ci iginee t Date Senior Pia er SEE REVERSE SIDE FOR PERMIT CONDITIONS /1 ,.Qq° Date Proposed Pond on Jim and Robbie Mantooth's Property The proposed project is construction of a pond and adjacent bioretention area designed to clean and filter stormwater entering Ennis Creek. Currently, a ditch runs along the south edge of the Mantooth property carrying stormwater run -off from the Peninsula Golf Course and Lindberg Road to a ravine emptying into Ennis Creek. The proposed project will divert stormwater from an existing ditch to the vegetated pond, allowing for sedimentation and breakdown of pollutants to occur before it is returned to the ditch. Currently water from two roadside ditches is coming into a ditch that runs along the South side of the property This ditch will remain in place and ultimately act as a bypass to proposed pond. In the existing ditch an area will be excavated out to create a sedimentation basin. From the sedimentation basin the water will go into a 12" pipe that will be fitted with a slide gate (this gate will allow the property owners to allow as much water as they desire into the pond). The slide gate will be a Waterman. C -10 Type 4 or similar and will be installed to manufactures specifications. This 12" pipe will lead to the pond and the outfall will be reinforced with rock to discourage erosion to the side of the pond. As an alternative and for periods of high flow, the sedimentation basin will also have a rock chute overflow This overflow will be able to accommodate all of the water that currently goes down the ditch in the event that the landowner does not want water going into the pond. There will be 6" of freeboard in this basin. The pond itself will include several different water depth areas. The landowner does not want any berms associated with this project so all work will be below the existing ground surface. There will be a deep pool (no less than 8' deep to allow for circulation) that will be surrounded by an aquatic bench, which will be planted with water loving native plants. The normal high water level will be up to the aquatic bench area. The aquatic bench will be a minimum of 4' wide. Surrounding the aquatic bench will be a shallow area that will only be under water during Large storm events. The maximum high water level in the pond will be 1.5' from the existing ground surface at the emergency overflow area. The emergency overflow will be a biwall pipe that will be dug into the bank of the pond and will empty into the existing ditch along the South side of the property As an extra precaution (in case the inlet to the biwall pipe clogs) there will be another opening to the pipe from the top of the pipe. At the discharge in the ditch rock, will be placed to avoid erosion of the ditch. Also this portion of the ditch will need to be over excavated to meet grade of the biwall emergency overflow Currently there is an 18" culvert in the open ditch that goes under a footpath and then outfalls into a ravine. This culvert should be replaced with a larger diameter culvert to help minimize the erosion to the ravine. Because the project is a demonstration of various best management practices for stormwater management, it will have a positive impact on existing stormwater facilities in the area. During the construction process, best management practices for site construction will be used according to the standards and specifications of MRCS. The project has been prepared under the supervision of the City of Port Angeles. A description of how the proposed project will or will not impact the following: A. Erosion and Landslide Hazard The proposed project is within 100 feet of the Geohazard areas defined by the Clallam County's Critical Areas Ordinance. Best management practices for general site construction and slope protection will be practiced in accordance with NRCS standards and specifications for minimizing erosion and run -off during construction to minimize any effect the project will have on the steep slopes of the nearby ravine. Final project approval will be subject to City of Port Angeles engineers. B. Seismic Hazards The proposed project is not within the Seismic Hazard areas defined by the Clallam County's Critical Areas Ordinance. Best management practices for general site construction and slope protection will be practiced in accordance with NRCS standards for minimizing erosion and run -off dunng construction. Final project approval will be subject to City of Port Angeles engineers. C. Drainage, surface and subsurface hydrology, and water quality The function and holding capacity of the existing stormwater ditch will not be altered. Due to space limitations on the Mantooth property, the pond will not be sized with the intent of capturing all the stormwater in the ditch. Instead, a small amount of stormwater will be diverted to the pond for cleaning as a demonstration project, thereby improving water quality of stormwater entering Ennis Creek. The bottom of the pond will be below the high water table, however, no detrimental effects are expected to occur in the subsurface hydrology of the area. The design of the pond includes a large bioretention area that is periodically inundated and will increase groundwater recharge. D Flood prone areas The proposed project is not within the Flood Prone Areas identified by FEMA. E. Existing vegetation as it relates to steep slopes, soil stability, natural habitat value The proposed project will not alter the existing vegetation on the nearby steep slope. Not only will the project not exacerbate the current erosion taking place where the mouth of the stormwater ditch empties into the ravine, the pond and biorentention area may have positive effect on the erosion by reducing the quantity and speed of stormwater reaching the ravine. The project will be planted with native wetland and wet meadow plants, thereby enhancing the natural habitat of the area. F Locally unique landforms The project will not alter locally unique landforms such as the existing ravine. The clearing and grading will be limited to the area of the pond and bioretention area in what is currently an old field. G Slopes between 15 -25 25 %-40 and greater than 40% The clearing and grading will be within 100 feet of slopes greater than 40 No existing vegetation will be altered on the steep slopes. Best management practices for general site construction and slope protection will be practiced in accordance with NRCS standards for minimizing erosion and run -off during construction. Final project approval will be subject to City of Port Angeles engineers. r/'ORT~ l~"'\. r~ .... ~- ~"'" CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ()7-/J4D Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning Application valuation 07-00001140 Date 10/10/07 276140 , 2238 LINDBERG RD 06-30-13-2-1-0150-2001- PUBLIC WORKS utI LITES o ~ ;/,3 g I-/nd/J(f J;n~ UNKNOWN Owner Contractor MANTOOTH JAMES E 2238 E LINDBERG RD PORT ANGELES WA 983628611 OWNER Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date SANITARY SEWER HOOK UP 112367 120.00 10/10/07 4/07/08 Plan Check Fee valuation .00 o Qty Unit Charge Per 1.00 120.0000 EA SAN SEWER HOOKUP Exten 120.00- Other Fees SEWER SYSTEM DELV CH Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 120.00 120.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1000.00 1000. 00 .00 .00 Grand Total 1120.00 1120 .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 ;,ot been requested within 180 days from the last inspection. I hereby certify that I have read and examined this appiication 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 constructio"n or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder)' Date T:\Policies\1102.15R [1/05] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . #-1/1::.8 s'Z. REQUEST: Date /6 ~C(, 67 Time Received by i<V (phone, person) Location of Work to be inspected '2 Z 39 L, 'vtd be,:] J<J Name of person requesting inspection e,"'.,..:s C:"r-<!..s.c.-e""t_b~v Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. 01 -II '-10 Sewer Foundation Framing Chimney Plumbing Final ~wer'E~~. Other INSPECTION NOTES: Inspected: Date /0 - Cj - 07 Remarks: /,le<-v c.""Yi"e-c,-t,'",., ro'l F'Vc. (/6 To By Rv -frQ. \l1\O~1 I u.S fq lie d Time -f,.. 0 ""- ~ 0 u.S e. RESTORATION REQUIRED. . . . .. YES NO X- c';y, ~h' 'I .,q cl; I've:.. ..J .1 Net..JJ (" "p()C " N t NQ.oJ 1/ Lj I'Ve. \ ) SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) I I STREET SUPERINTENDENT (DATE) :f-2<1-206 3, 18PM FROM ANGELES ELECTRIC INC 360 <152 9265 P_ 1 t JAN 2 0 2006 Job wired by 5~. ~i .~....~ EJ,ECTRICAL WORKPERMJT APPLICATION, . Electrical Contractor 0 Owner Inslallalion description o Commercial ~Iectrical contractor !lame License number Date Expires o New Residential ~"'Cd/AdditiOn . Purcba$cr':; mailing addr~ A1J~c.J60RS ~ 3~ ~KE . C;ly Ali(;[L[$ [L[CT~'C, I~~. Stato ZIP 524 EAST FIRST PORr AMGWS "'f; 98352 Te1epnone number I.. , H FAX number pre:r/~";;;;P~6h./1;_ h1~ Addr.ss O~1-CS~ E. i.JM:.bee.a- City ~1ZT k~ 1?h Phone number to schedule in.~p~ctinn; '-iS7-61f8 Owner GIS define-d by RCWJ9.28.26/:(J) O....ner will occupy the slruc1urefo" two )'ears' a;te7' this €1i:<"lricc~fpcr:nil is finalized. (2) Ownt'l" h; required to IIire an eleclriml . , . colltru(./or if fl~W(~ .,'aid p"openy is for ,1"Uh-, relJI (If' lea.<:c. After reading the OIOO"c stalcmcn~. hereby certify that 1 am .the owncr of. the .<Ibove named property or .a licensed eleclm;i!ll contractor. , .am makmg the dl:ClnCal In!,ul- 13tion or alteration in compliance V>ith the electric.,,1 laws, N.F...C.. RCW. Cbapter 19.28, WAC. Chap1er 29~-46D. Th; City of Port Angeles Municipal Code, ~nd Utilil)' Specifications. SiCb,UU re of nw. r, eledric I contra o Cash . 0 Cheek # ~ Card Visa Mastercard Discover Card# ______-_d_-Ai.F- -____ ~ical Load Additions sad or subtractions NO LOAD CHANGES '. o Baseboard KW o Fl"lrnaee KW o Heat Pump Ton LAR o Fan-Wall KW Date: Expiration Date of card Inspection fee $ ffi ...- X o Overhead Service o Temp Service o underground Service Service Inlor.mation Voltage lU kiP Phase ~ Service Size: 4/J'J Feeder Size: ~ SAME DAY INSPECTJON, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN THERMOSTAT D:l.Ct; ....Pf""'l...:.l ~y ~- ^Pfll'Ovcdily SERVICE /~;J<.nL ~ l.)4le Ap ruv FINAL kJ AVPl'''V~ HI' DITCH FEEDER O~lt; Apf>n""'~d 9y l.Hle Appruve<tDy Inspection Date Area, Buildi.l1g or Equipment Inspected Action Tl1ken Electrical h\SpcctClr ae5lncce- /tJ- b4w '\, /Q}IJ--5 "Dt€I ;;;- -tJ6