HomeMy WebLinkAbout1205 Rook Dr - Building
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REllJRN ADDRESS
2007-1212810
Page 1 of 3 Easement
Dc Margene Company
Clallam County Washington 11130/2007 10;48,08 ~M
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Document Title(s)
6dcJn.-,C'N7
(u 7;1. 17'1./J/1-N17M-'1 S~.:PL.)
Reference Number of related documents
Grantor( s) (Last, First and Middle initial)
7hc: Dc.. MJl}.tLLH::Nci ~#I}N'"1 LL~
kJ;VIAJ IZv 1).,=./1
/l1,1J-tv;j'tJ,I "" Ij /hC'-1 ,3 c0--.
Grantee( s) (Last, First and Middle initial)
7h td= D c /VI I9tf.,b rf.J~~ tI (IW,/?;;IN If L.....L.<.
/c:&-v/-V' /Cujj,,;-// ~JhV~N" 'IA~-;"";;$cY<-
Brief Legal Description (abbreviated form: lot, block, plat or section, township, range, quarter/quarter)
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L.>'T 2r; ; ,l.,/HN-I'1- ,5,.,61>1111)1"'" ;1h'9;J,: t. (OL';",' /'1 16 it, 70
1P7 It ;t./t:.J<E/ ;!-- $~ ~MJ",", r?I7Mr: :J- y~ Lv....~ /I/.P'v 8'(.
Assessor's Property Tax Parcel! Account Number
l.J'T 20 ' ' Lt:> 7' 2-/
O(p.;3D/'1 "70200 70 c>~ 30 /V 4>7 O,2-/D
The AudItor/Record wlll rely on the information provided on this form. The staff wlll not read the document to verify the accuracy or
completeness of the indexing information provided herein.
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04/12/2007
EASEMENT
The purpose of this document is to grant a utility/sanitary sewer easement from
Lot 21, Riedel II Subdivision, Phase II, Volume 14, PG 86 through the "north
twenty five feet" of Lot 20, Riedel II Subdivision, Phase II, Volume 14, PG 86 and
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connect to Port Angeles City Sewer System that borders the western portion of
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the development. (See attached map)
The DC Margene Company LLC, is the owner of both parcels/property and grants
this easement to Lot 21 to allow the installation of utilities and sanitary sewer
(built to City of Port Angeles specifications and approved by the city of Port
Angeles, As built/Inspection is approved and on file with the city of Port Angeles).
Granted, April1ih , 2007
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CITY OF PORT ANqELES
PUBLIC WORKS - ELECTRICAL DIVISION
321 EAST 5TH STREET. PORT ANGELES. WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000893 Date
293072
1205 ROOK DR
06-30-14-6-7-0210-0000-
KEVIN RUSSELL
RES NEW SFR
1/18/07
RS9 RESDNTL SINGLE FAMILY
234970
Owner
Contractor
DC MARGENE, LLC
PO BOX 1509,PORT ANGELES,WA
PORT ANGELES WA 98362
CLAWSON CONSTRUCTION
P. d. BOX 2683
PORT ANGELES
(360) 457-1473
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
LLC
WA 98362
Other struct info .
14.00
1.00
17859.00
25891.00
1.00
Permi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
DAVE'S H&C/ T-STAT
93237
DAVE'S HEATING
35.00
1/18/07
7/17/07
& COOLING
Plan Ch,eck Fee
Valuation
.00
o
\;
a
~
Qty
1. 00
Unit Charge Per
35.0000 ECH EL-LVT-FIRST THERMOSTAT
Extension
35.00
f
~
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from t~e background.
08/21/2006 11:49 AM SROBERDS --New SFR in RS-9. 14% lot
coverage. 25' front and rear setbacks.
Electrical load calculations and elctrical permits are
required.
Ditches & 8" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
Sanitary sewer copnection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway and Sidewalks to City Standards.
No concrete witp exposed aggregate allowed in the city
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
~
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
Permit Fee Total 35.00 35.00 .00 .00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION .RECORD
. CALL 4 J 7-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PR0VIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COJIER.
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATI ACCEPTED COMMENTS
YIS I NO
urfCH I
RnTTnl-l_IN Il.,;UY~K
ShK VICh
-cThT AT I I
GENERAL COMMENTS:
PW.II02.I' (4'96)
'~
w
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
J2\ EAST 5TH STREET. PORT ANGELES. WA 98362
..
.
Application Number . . . . .
Application pin number- . . .
plan Check Total .00
Other Fee Total 2'074.50
Grand Total 2109.50
COMMENTS/ ACTION NEEDED
06-00000893
293072
Page
Date
2
1/18/07
.00
2074.50
2109.50
.00
.00
.00
.00
.00
.00
ELEcrRICAL PERMIT INSPECfION.RECORD
. CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCf4L ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
t
INSPEC110N TYPE
DATE
COMMENTS
NO
I .
GENERAL COMMENTS:
rw.II02.1514'961
I
g
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 983()2
, ..
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000893 Date
293072
1205 ROOK DR
06-30-14-6-7-0210-0000-
KEVIN RUSSELL
RES NEW SFR
1/18/07
RS9 RESDNTL SINGLE FAMILY
234970
Owner
Contractor
DC MARGENE, LLC .
PO BOX 1509,PORT ANGELES,WA
PORT ANGELES WA 98362
Other struct info .
CLA~SON CONSTRUCTION
P. O. BOX 2683
PORT ANGELES
(360) 457-1473
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
LLC
WA 98362
14.00
1. 00
17859.00
25891.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
OLYMPIC EL./ 2539 SFR
93229
OLYMPIC ELECTRIC
135.00
1/18/07
7/17/07
Plan Check Fee
Valuation
.00
o
"
\J'
l\)
.~
Qty
1. 00
3.00
Unit Charge Per
69.0000 ECH
22.0000 5C
EL-R-SQFT FIRST 1300
EL-R-SQFT ADDITIONAL 500
Extension
69.00
66.00
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
08/21/2006 11:49 AM SROBERDS --New SFR in RS-9. 14% lot
coverage. 25' front and rear setbacks.
Electrical load calculations and elctrical permits are
required.
Ditches & 8" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
~
~
~
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
COMMENTS/ ACTJON NEEDED
c -
ELECfRICAL PERMIT INSPECfION.RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MIN1MUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COJlER,
. INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
. I YIS NO
. u.... .H
!l.OUGP-IN I CUV-hK
ShK V lCh
li'TN A 1 I I
GENERAL COMMENTS:
pwolI02..' 141961
I
'~
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:121 EAST 5TH STREET. PORT ANGELES. WA 983(,2
~
Application Number . . . . .
Application pin number- . . .
Permit Fee Total 135.00
plan Check Total .00
Other Fee Total 2074.50
Grand Total 2209.50
COMMENTS/ ACTION NEEDED
06-00000893
293072
135.00
.00
2074.50
2209.50
Page
Date
2
1/18/07
.00
.00
.00
.00
.00
.00
.00
.00
ELECfRICAL PERMIT INSPECfION.RECORD
CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NonCE. IT IS UNLA WFUL TO COrER,
~ .
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. .
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPEC'ItON TYPE
DATE
COMMENTS
NO
GENERAL COMMENTS:
PW.II02.I'I41961
01/09/2007 10:39
3504523498
OLYMPIC ELECTRIC
PAGE 01.
.;
'! G-to1
......
.,
.
ELECTRICAL WORK PERMIT APPLlCATIClN
. ,
Ina1slluliDn Il1cKrip\ion
Job wired bj o Electrical Cenlr..tor o Owner C ~omlll.rcIal Q"ii.sJdeutlaI
E1errlcul contractor I\eme License number Oll.IC' B:\p1ros ON... C A11.red/Addltlo.
o ympic Electric Co. OLYMPEC285D1 .
p~hlJerts raailina IddRIu 7>:77 5<< ~T- ~U/ ~erJ(;-
4230 Tumwater Truck Route
. ,
City SJ;llIC ZIP
Port Angeles, WA 98363
T.cIephonc nwnbcr pAX numbc:r
(360) 452-5303 (360\ 452-3498
Premhu owaer's a.me r /90 9
~/;;ws~/? /-'5":.
AddTtl1 or 'a.peelloD p/. 63D
/k/,S- I?~/t'
CI~ ~,/,. ';/"5"3'7 ;/ Jfr
~~ r"/: ,.../" .
Phou D~,Dbcr \0 c:bedule IIl'pecCloo: ~7- #'...J-'t'.7
OWM,. tU f1{lflned by RCw'JS1.28.26/:(I) Ow"" will occt4P)' Ih4 $fM,lcr~ for two
J'fJfVI 4fIu ,"I: .Jre,ri021 ~f7tlll I.r jlnalfnNI. (2) OriIutr U f'eqwfrrd to Ittn all ueclrlct11
cofUlYlClor If tJbo1'6 smd propsrry u for ,0It, r""t ,,, tQtUt. Cl Cash Cl Check #
AI'tcr rcadina !he above statement. 1 hereby certi(y (hill I 1m Ole owner or thfl abo"e ~ditCard
aamed prvpeny or . Jil:cnsed eloctriea1 COntlBCt.Ot'. I 1m ""llCIng tbe elec1rlcallnslal. VISll Masterear~ Discover
luion or allerallon in oompH.nce with the electrical laws, H.E.C., RCW. Chapter
J9.28, WAC, Chapler 296-4~B, The City or Pon AJ'lseles MunIcIpal COlic:, and Card # - - .
UllJlty SpeclficatiooJ. -------------'---
SI'D_ture of awaer, ,Ietlrlcsl cClntracror or cleelrlClll Iclmlnblnlor Expiration Oate
X/' ",/:;'/ -~ e!? - Date: ef card (~ntpj1~ .~
ftft~n., Sarvleo InformatIon
o NO LOAD CHANOES
o B...boanl K!N
o Furnace _K!N 0 Ove,hood Service
D Heel Pump _ Te" _ LAR D Temp SOMe.
D Fan-Wall _K!N Q"Ondorground Sorvlce
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
VehaQe }!. y,,;?
Phase ra'1 Q J
50"'100 $12.: .MtZ
Feeder Sin:
r / /;;lZGB-rN TIIERMOSTAT SERVICE
'J 0"./ ~ 0/0"7 ~cf)
"- O.W AP'fI'I'O~(ld by "W-~
r L. AI. DITCH r FEEDER '.
I //1"1/1)7 ~I Z4c /0. -f.!?, / "
P". ~l'nlIdBJ ..
In.peelloD . Area, Building or Equipm.ntInspecl.d Action TU.eo electrical
Dlle Il"l.spcctor
I -It. - 07 111'1;,.0' ().NtJn-r- ~ IofJkvtt:. 13X
1
,
..
'/1crQ. /- C; ~ t? 7
Jan 10 07 08:32a
DAVE'S HEATING & COOLING
p.1
"
"
Job wired by
~":";'.
J; . '~'._~.
. ......
~~ ~~j
......
~Iectrical Contractor 0 Owner
ELECTRICAL WORK PERMIT APPLICATION
;
Installation description
D Commercial rg'Residential
Electrical contraclor name
VVe's €",H <>I- 6:>01,'
PUI::huser's mailing address 5c!v V \'
f 0 flax <f / :3
City
IN-/- ~:
Telephone number
"f5~-CJ'13
{ov.; VO(-t-",':f- ~",,"S+a:f-W"I""e..
...
JI
License number
IltNm
o AltnedJAdditiOD
State ZIP
u..tA Qg3t',?
FAX number
P..-emises owner's name
61", '-'-' So n COhsrv,^ c.-h'on
Address or iaspection
I ;;J..o5 /(oo/<- 'O.....il/<1...
C'H'
'(or.\-- ~~I "!!lIB'
Phone number to scht' UICOin!iP~ion: D kev \ r"'
Q' RCAs,s,eJI
Owner as defined by RCWJ9.28.26J:(I) Owner will occupy ,he structure/or two
years after litis electrical permit is fi"alized. (2) Ow/ler is rcql/ired to hire m, eleclrical
co"/racror if above said property ;5 for sale. ren, or lease.
After reading the a.bove statement, I hereby ccrti[y dlal 1 am the owner of the above
named property or a licensed eleclrical ccntracto:". I am makint the e1ectric<l1 instal-
lallon Of <llteralion in compliance with the ekc!rical l<lws, N.E.C.. RCW. Chapter
19.28, WAC. Chapter 296-468. The City of Por' Angeles Municipal Code, and
Uti lily Specifications
Sia::nalurc of owner. electrical conlrnelor or electrical administrator
o Cash 0 Check #
~editCard ~
Card #
Mastercard
Discover
x
Date: I
Expiration Date
of cord
Inspection fee
$ ;3 (.. c.fo
lee lcalload Ad itions and or subtra tions
o NO LOAD CHANGES
o Baseboard KW
~ Furnace ~ KW
Cll"Hea' Pump :;z.Y.l Too J..lfi LAR
o Fan-Wall KW
Service Information
o Overhead SeNiee
u Temp Service
o Underground Service
Vollage
Phase0103
Service Size:
Feeder Size:
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
ROUGH-Il'i THERMOSTAT SER\-lCE
O~IC AppmHd lly nUt ,\pproycd U-:, Dale App<oYcj fly
,.- DlTCH FEEDER
I. FINAL
11," /"7 :kLJ
0.. Approvw By / OaLe .o\,pprovcd 8r '-- O~lc ."ppfovoofl:-
Inspection Area, Building or Equipment Inspected Action Taken Electrical
DOlte . Inspector
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BUILDIN'G DIVISION
CITY OF PORT ANGELES
* *
Correction Notice
Job Located at /;;'or Z&k ~ .
,
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
~;/-tE~nt<l~ /I/hL-~ &vCtZ )R;VEA/ tJ#
eA/n.R.+!: 7"kv~r,
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;f/;//tZ-o' 5!tlcrr7#~ ~~~ ~M/ ~~r
$zf;A# c)amc~ ~ / Srh:::Lr
These corrections must be made and are not to be
covered until reinspection is made. When corrections
have been made, please call 1/7- ~g/ {--
for inspection.
Date ~j,~6
or for Building Division
DO NOT REMOVE THIS TAG
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 51HSTREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000893 Date
293072
1205 ROOK DR
06-30-14-6-7-0210-0000-
KEVIN RUSSELL
RES NEW SFR
9/01/06
RS9 RESDNTL SINGLE FAMILY
234970
Owner
Contractor
DC MARGENE, LLC
PO BOX 1509,PORT ANGELES,WA
PORT ANGELES WA 98362
Other struct info .
CLAWSON CONSTRUCTION
P. O. BOX 2683 .
PORT ANGELES
(360) 457-1473
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
LLC
WA 98362
14.00
1. 00
17859.00
25891.00 .
1. 00
Permit PUBLIC WORKS RES WATER SERV
Additional desc 5/8" DROP IN WATER METER
Permit pin number 85928
permi t Fee 175.00 Plan Check Fee
Issue Date 9/01/06 Valuation
Expiration Date 2/28/07
.00
234970
BASE FEE
Extension
175.00
Qty Unit Charge Per
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
85910
50.00
9/01/06
2/28/07
Plan Check Fee
Valuation
.00
234970
Qty Unit Charge Per
1.00 50.0000 ECH RIGHT OF WAY PERMIT
Extension
50.00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
85902
110.00
9/01/06
2/28/07
Plan Check Fee
Valuation
.00
234970
Qty Unit Charge Per
1.00 110.0000 EA SAN SEWER HOOKUP
Extension
110.00
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
08/21/2006 11:49 AM SROBERDS --New SFR in RS-9. 14% lot
coverage. 25' front and rear setbacks.
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. 6.J // p /. tJb
Date
Signature of Owner (if owner is builder) .
Date
Signature of Contractor or Authorized Agent
T:\Policics\1102.1SR [1105]
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 I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE
I I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R W./ PW/ CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING -
T:\Policies\1102.15R [Jl05]
d ,000T~_
.t~~
Ra
~--
~~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 06-00000893
Application pin number 293072
Page 2
Date 9/01/06
Special Notes and Comments
Electrical load calculations and elctrical permits are
required.
Ditches & 8" culverts 'will be installed to City Stanards.
See Public works Engineering for Standards.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works .
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 335.00 335.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 2409.50 2409.50 .00 ;00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required Inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction. .
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)' .
Date
T:\Policics\l\ 02.\ SR [1I0SJ
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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
I YES NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W./ PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING -
T:\Policies\1102.15R [1105]
pORT t
-fi
lL ~
~
~~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUll-DING DMSION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
~
~
9/01/06
~
~
CLAWSON CONSTRUCTION LLC
P. O. BOX 2683
PORT ANGELES
(360) 457-1473
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000893 Date
293072
1205 ROOK DR
06-30-14-6-7-0210-0000-
KEVIN RUSSELL
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
234970
Owner
Contractor
DC MARGENE, LLC
PO BOX 1509,PORT ANGELES,WA
PORT ANGELES WA 98362
Other struct info .
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc 1909 SF SFR,630 SF ATTGAR
Permit pin number 84772
Permit Fee 1776.25 Plan Check Fee
Issue Date 9/01/06 Valuation
Expiration Date 2/28/07
Qty Unit Charge Per
BASE FEE
135.00 5.6000 THOU BL-100,001-500K (5.60 PER K)
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
85985
122.25 Plan Check Fee
9/01/06 Valuation
2/28/07
WA 98362
14.00
1. 00
17859.00
25891.00
1. 00
710.50
234970
Extension
1020.25
756.00
-
~
.00
o
711
~
CO
~
~
"'\
Qty Unit Charge Per Extension
BASE FEE 50.00
1. 00 14.7000 ECH ME- INSTALL 100- FAU 14.70
5.00 7.2500 ECH ME~VENT FAN 36.25
1. 00 10.6500 ECH ME-VENT SYSTEM OTHER 10.65
1. 00 10.6500 ECH ME-GAS PIPE 1 TO 5 10.65
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
85993
163.00
9/01/06
2/28/07
Plan Check Fee
Valuation
Qty Unit Charge Per
BASE FEE
12.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE
.00
o
'>?
?9~
~..~
~ .
o
,
O~
Extension
50.00
84.00
7.00
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..j- have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not
~~~~~::;~ti~n~ive authority to violate or cancel the provisions of any state~or loea: la~ ~~J1ating construction or the performance of
~tf ~ 7' /. ?lh
Signature of Contractor or Authorized Agent Date Signa of Owner (If owner IS bUilder) Date
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
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
FOUNDATION:
FOOTINGS
SHEAR WALLS I WALLS
FOUNDATION DRAINAGE I DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO SLOG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS I ROOF I CEILING
DRYWALL(INTE~ORBRACEDPANELONL~
T-BAR . "4
INSULATION .,
SLAB I
WALL I FLOOR I CEILING I I I
MECHANICAL
HEAT PUNW I FURNACE I DUCTS
GAS LINE
WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT#'s SEPA:
P ARKING/LlGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECmCAL - LIGHT DEPT. 417-4735 ELECmCAL
LIGHT DEPT
CONSTRUCTION R. W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 4]7-4815 BUILDING
. .
T:\Policies\1 102_15 bUlldmg peroul mspechon record05.wpd [1/412005]
,
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~~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
06-00000893
293072
Page
Date
2
9/01/06
Qty
1. 00
1. 00
Unit Charge Per
15.0000 ECH PL- EA. BLDG SEWER
7.0000 ECH PL- EA.WATER HEATER
Extension
15.00
7.00
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches highoJnd be
of contrasting color from the background. '.
08/21/2006 11:49 AM SROBERDS --New SFR in RS-9. 14% lot
coverage. 25' front and rear setbacks.
Electrical load calculations and elctrical permits are
required.
Ditches & 8" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
.,.., . . .,)
"II(.. f
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 2061. 50 2061.50 .00 .00
Plan Check Total 710.50 710.50 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 4846.50 4846.50 .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-certifythat-lhave-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
T:\Policies\1102_15 building permit inspection record05.wpd [1/412005]
I~
BUILDING PERMIT INSPECTION RECORD
.'
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECfIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
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.
~
I
~
..0
~
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO
FOUNDATION:
FOOTINGS /OJ/31th <jW
SHEAR WALLS / WALLS " I
FOUNDA nON DRAINAGE / DOWN SPOUTS <-'flr.,,/ V" JW
PIERS ' I I
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN J r. .~ I I L....
WATER LINE (METER TO BLDG) It:..!,.,." 1'1 I .;' FINAL \ 0"'1 0.< () lDATE
GAS LINE 7 -/( , JL1-
ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS I !LIllA /,,-, j"J"j/
CEILING I I I
FRAMING
JOISTS / GIRDERS
SHEAR W ALUHOLD DOWNS - H -0 7 J-w
WALLS / ROOF / CEILING
DRYWALL(INTE~ORBRACEDPANELONL~
T-BAR
INSULATION
'SLAB I / I
WALL / FLOOR / CEILING r:> 7'i 1., 107 I J 1- L/ I
-,-
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY ~'O-()1DATE -SU- ACCEPTED BY:
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMlT#'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECT~CAL - LIGHT DEPT. 417-4735 ELEC~CAL
LIGHT DEPT
CONSTRUCTION R. W./ PW/ CONSTRUCTION - R. W.
ENGINEE~G 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 H....."',O....Ol "JUr BUILDING
~
o
~
(V
'i:t
~
~
~
'\
~
T:\Policies\1102_15 building pennit inspecl10n record05.wpd [1/4/2005]
F-: 'J-/
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: ~uv (l.v.J.Jt:?7.-c--
Owner: j) C. /1IJ~(7tWC I'~f'
Address: Ie) day:; /)09
ArchitectlEngineer: ('t74/1--fti;J ~^,f) 6G1. c)
Contractor tLI/4N.Jv.,J I()1VJT LL.( State License #:
Phone: 3 ~c) "1".s- fj 2- tf 1
Phone: Jvb' ~S1 a z '17
City:
I'&'c 7 ~lJ<r4?
Zip:
Phone: 3" () rJ-z.. ~ 11r"
Exp:
Phone:
Zip:
ZONING:
Address:
PROJECT ADDRESS: /20)
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
City:
lbJo JC- 1J tf-I v'./
Block:
Subdivision:
/1
TYPE OF WORK:
~ Residential 0 New Constr. 0 Re-roof 0 Stove
o Multi-family 0 Addition 0 Move1Zl Garage
o Commercial 0 Remodel 0 Demolition ~ ~
o Repair 0 Sign 0 Other ~;,
BRIEF DESCRIPTION OF THE PROJECT: SIN b lC'
/9oll
I/JO
,0
SIZEN ALUATlON:
SF.@$ /SF.=$
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION $
.a.. /79-M't.. 'f D"",';-/ // '" t;
23f,t;10
COMMERCIALIRESIDENTlAL: Occupancy Group:
No. of Stories: L Lot Size: ~ Existing Sq. Ft. ~
Totallot coverage I It! %' 171)7
Occupant Load: Construction Type:
& Proposed Sq. Ft. ""'" = TOTAL Sq. Ft. lS 8 'J
'259>1
PLANNING USE ONLY: APPROVALS:
PLAN:
BLDG:
DPWU:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: FIRE:
OTHER: -
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section
Rl05.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits prior to work. r:"'"\ 1
V , ;-./ '/. c;C:.
T:\FORMS\BldgPermitApp1..wpd Applicant: ~ Date:
A. PLYWOOD OR 0.S.8. SHEAR WALLS
j-
1. MAXIMUM SHEAR = 250 P.L.F.
USE ~" SHEATING - ONE SIDE OF WALL. NAIL ALL EDGES WITH 8d NAILS AT 6"
O.C. FOR FRAMING, USE DF NO.2. PROVIDE~" DIAMETER ANCHOR BOLTS AT
32" O.C. MAXIMUM SPACING AT THE FOUNDATION. FOR TIE DOWNS AT EACH
END OF THE WALL, SEE FRAMING/SHEAR WALL PLANS.
2.. MAXIMUM SHEAR = 315 P.L.F. .
USE ~" SHEATING - ONE SIDE OF WALL. NAIL ALL EDGES WITH 8d NAILS AT 5"
O.C. FOR FRAMING, USE DF NO.2. PROVIDE~" DIAMETER ANCHOR BOLTS AT
32" O.C. MAXIMUM SPACING AT THE FOUNDATION. FOR TIE DOWNS AT EACH
END OF THE WALL, SEE FRAMING/SHEAR WALL PLANS.
3. MAXIMUM SHEAR = 375 P.L.F.
USE }'z" SHEATINc;3 - ONE SIDE OF WALL. NAIL ALL EDGES WITH 8d NAILS AT 4"
O.C. FOR FRAMING, USE 3X DF NO.2. PROVIDE W DIAMETER ANCHOR BOLTS
AT 24:' O.G. MAXIMUM SPACING AT THE FOUNDATION. FOR .TIE DOWNS AT
EACH END OF THE WALL, SEE FRAMING/SHEAR WALL PLANS.
4. MAXIMUM SHEAR = 490 P.L.F.
USE W SHEATING - ONE SIDE OF WALL. NAIL ALL EDGES WITH 8d NAILS AT 3"
O,C. FOR FRAMING, USE 3X DF NO.2. DOUBLE BOTTOM PLATES ARE
REQUIRED, BOLT THROUGH 80TH PLATES WITH ANCHoR BOLTS. PROVIDE 5/8"
DIAMETER ANCHOR BOLTS AT 32" O.C. MAXIMUM SPACING AT THE
FDUNDA TION. FOR TIE DOWNS AT EACH END OF THE WALL, SEE
FRAMING/SHEAR WALL PLANS.
5_ MAXiMUM SHEAR = 560 P.LF.
USE~" SHEATING-ONE SIDE OF WALL. NAIL ALL EDGES WITH 10dNAILSAT3" .
O.C. FOR FRAMING, U$E 3X OF NO.2. DOUBLE BOTTOM PLATES ARE
REQUIRED, BOLT THROUGH 80TH PI,A TES WITH ANCHOR BOLTS. PROVIDE 5/8"
DIAMETER ANCHOR BOLTS AT 24" O,C. MAXIMUM SPACiNG AT THE
FOUNDATION. FOR TIE DOWNS AT EACH END OF THE WALL, SEE
FRAMING/SHEAR WALL PLANS.
6. MAXIMUM SHEAR = 685 P.L.F.
USE %" SHEATING - ONE SIDE OF WALL. NAIL ALL EDGES WITH 10d NAILS AT
21/2" O.C. STAG~ERED: FOR FRAMING, USE 3X DF NO.2. DOUI?LE BOTTOM
PLATES ARE REQUIRED, SOL T THROUGH BOTH PLATES WITH ANCHOR BOLTS. .
PROVIDE 5/8" DIAMETER ANCHOR' BOLTS AT 20'~ O.C. MAXIMUM SPACING AT THE
.. FOUNDATION. FOR TIE DOWNS AT EACH ENO OF THE WALL, SEE .
FRAMING/SHEAR WALL PLANS.
7. .MAXIMUM SHEAR = 770 P.L.F. .
USE 7f" SHEArING -ONE SIDE OF WALL. NAIL ALL EDGES WITH 10d NAILS AT
2" O.C. STAGGERED. FOR FRAMING, USE 3X DF NO.2. DOUBLE BOTTOM
'. PLATES ARE REQUIRED, BOLT THROUGH BOTH PLATESWITHANCHOR BOLTS.
~Rc>.viDE 5(8" DIAMETER ANCHOR BOLTS AT 18" O.C. MAXIMUM SPACING AT THE:
FOUr\IDA TION. FOR TIE DOWNS AT EACH END OF THE.WALL, SEE .
. FRAMING/SHEAR WALL PLANS.
f
,
8. MAXIMUM SHEAR = 870 P.L.F.
USE %" SHEA TING - BOTH SIDE OF WALL. NAIL ALL EDGES WITH sd NAILS AT
3 1/2" O.C. FOR FRAMING, USE 3X OF NO.2. DOUBLE BOTTOM PLATES ARE
REQUIRED, BOLT THROUGH BOTH PLATES WITH ANCHOR BOLTS. PROVIDE 3/4"
DIAMETER ANCHOR BOLTS AT 20" O.C. MAXIMUM SPACING AT THE
FOUNDATION. FOR TIE DOWNS AT EACH END OF THE WALL, SEE
FRAMING/SHEAR WALL PLANS.
9. MAXIMUM SHEAR = 980 P.L.F.
USE %" SHEATING - BOTH SIDE OF WALL. NAIL ALL EDGES WITH Sd NAILS AT
3" O.C. FOR FRAMING, USE 3X OF NO.2. DOUBLE BOTTOM PLATES ARE
REQUIRED, BOLT THROUGH BOTH PLATES'WITH ANCHOR BOLTS. PROVIDE 3/4"
DIAMETER ANCHOR BOLTS AT 1S" O.C. MAXIMUM SPACING AT THE
FOUNDATION, FOR TIE DOWNS AT EACH END OF THE WALL, SEE
FRAMING/SHEAR WALL PLANS.
10. MAXIMUM SHEAR = 1.200 P.L.E
USE~" SHEATING - BOTH SIDE OF WALL. NAIL ALL EDGES WITH 10d NAILS AT-
3" O.C. STAGGERED. FOR FRAMING, USE 3X DF NO.2. DOUBLE BOTTOM
PLATES ARE REQUIRED. BOLT THROUGH BOTH PLATES WITH ANCHOR BOLTS.
PROVIDE'3/4" DIAMETER ANCHOR BOLTS AT 14" O.C. MAXIMUM SPACING AT THE
FOUNDATION. FOR TIE DOWNS AT EACH END OF THE WALL, SEE
FRAMING/SHEAR WALL PLANS.
11. MAXIMUM SHEAR = 1,540 P.L.E .
USE~" SHEATING - BOTH SIDE OF WALL. NAIL ALL EDGES WITH 10d NAilS AT
2~ O.C. STAGGERED. FOR FRAMING, USE 3X DF NO.2., DOUBLE BOTTOM
PLATES ARE REQUIRED. BOLT THROUGH BOTH PLATES WITH ANCHOR BOLTS.
PROVIDE 3/4" DIAMETER ANCHOR BOLTS AT 11" O.C. MAXIMUM SPACING AT THE
FOUNDATION: FOR TIE DOWNS AT EACH END OF THE WALL. SEE
FRAMING/SHEAR WAll PLANS.
12. MAXIMUM SHEAR = 1.740 P.L.E .
USE 5/8" SHEATING - BOTH SIDE OF WALL. NAil ALL EDGES WITH 10d NAILS AT
2" O.C. STAGGERED. FOR FRAMING, USE 3X DF NO.2. DOUBLE BOTTOM
P/-ATES ARE REQUIRED, BOLT THROUGH BOTH PLATES WITH ANCHOR BOLTS.
PROVIQE 3/4" DIAMETER ANCHOR BOLTS AT 9" O.C. MAXIMUM SPACING AT THE
FOUNDATION. FOR TIE DOWNS AT EACH END OF THE WALL, SEE
FRAMING/SHEAR WALL PLANS.
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Application Number . . . . . 23-00000365 Date 4/20/23
Application pin number . . . 439450
Property Address . . . . . . 1205 ROOK DR
ASSESSOR PARCEL NUMBER: 06-30-14-6-7-0210-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
DHP
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN AND SUSAN THATCHER BLACK DIAMOND ELECTRICAL CONTR
1205 Rook Dr 502 BLACK DIAMOND RD
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(503) 780-0788 (360) 565-1035
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee . . .00
Issue Date . . . . 4/20/23 Valuation . . . . 0
Expiration Date . . 10/17/23
Qty Unit Charge Per Extension
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 63.00 63.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 63.00 .00 .00
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLICATION
Pub! ic \Yorks and ULili ties Department
32 l E. 5th Street. Port ;\ngeles. WJ\ 98362
300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us
Project Address:--------------------------------------
Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _
OWNER JNFORMATtON
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRfCAL CONTRACTOR fNFORMATION
Name: ___________________________ License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge)
Service/Feeder 200 Amp. $120.00 $
Service/Feeder 201-400 Amp. $146.00 $
Service/Feeder 401-600 Amp. $205.00 $
Service/Feeder 601-1000 Amp. $262.00 $
Service/Feeder over 1000 Amp. $373.00 $
Branch Circuit W/ Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $63.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 $
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder 401-600 Amp. $149.00 $
Temp. Service/Feeder 601-1000 Amp. $168.00 $
Portal to Portal Hourly $96.00 $
Signal CircuiULimited Energy - 1 &2 DU. $64.00 $
Manufactured Home Connection $120.00 $
Ren ewable Elec. Energy: 5KVA System or less $102.00 $
Thermostat (Note: $5 for each additional) $56.00 $
First 1300 Sql;Jare Feet $120.00 $
Each Additional 500 square feet" $40.00 $
Each Outbuilding / Detached Garage $74.00 $
Each Swimming Pool/ Hot Tub $110.00 $
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-
468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
'"'CJ CD
PREPARED 4/13/23,14:32:04 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
---------------------------------------------------------------------------
APPLICATION NUMBER:23-00000365 1205 ROOK DR
FEE DESCRIPTION AMOUNT DUE
---------------------------------------------------------------------------
ELECTRICAL ALTER RESIDENTIAL 63.00
TOTAL DUE 63.00
Please present reciept to the cashier with full payment
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
11/16/2023 23-365
TAP
OWNER
CONTRACTOR
Black Diamond Electric
PROJECT ADDRESS
1205 Rook Dr