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HomeMy WebLinkAbout1113 E 5th St - Building C1'rV OF PORT ANG ELES ItRN11T API'LICATION Building Divislon/tIectricni Inspettiolls RECEIVE a -"F 321 East F11111 Streiot—P 0- Box 1150/Port Angeles Waglikkgton,99362 Ph: (360)4174735 FAx: (360)417-4711 1 JAN 16 2014 Date: 1/15/2014 I &2 SIngle Family Dwelling ELECTRICAL INSPECTIONS Plan Review May Be RequlA,Ptna5o Complete Elec*ol Pi an Review Informak-n Sheet ,W Aft�= 1113 F 5th St Duildog SquSreF004',39Q: 1290 Descliplion at above Owner Information Contractor Information flama, Lara Rack.a flWa,, Protect Your Home W4 AdftSg; 1113 E 5th Sty M CIV, Port Angeles atpt�o: WA Zip' 1388624426 IN 46240 MnQ. 35079MS9 FU' - Phorv-s8s-sr)2-3ss9 _P4X 317-564-2547 Lk�'nso#I FYP.— "it Lh_arg_e Total OIti R d nIj ChgQo) GeMcelFudor201400 Amp, S 146D W*e/FaWar 401-6W Amp $20U0 ServIcelFftdor 601-IOW Amp, $WIM UrviceTeader ovio 1000 AnV, $3y DO Beartch Mcult WISepAce Fe lef S U0 Btarmh Citoult WO Service feeder EaO Addltl btaodi CIrcdt Branch CktulG�14 7100 3— Timp,ServicelFaeder200 Amp, $ 03,00 3— T mp,Seryl*Feedor 201.400 AMP, $110,00 -5— Temp,Seivlc0eeder401-600 Amp, $149,01) $— Temp,SoMWFoodst 6014000 Amp. $I Mao — $— podal to 1 W fbUrly $ Koa S- Sgital MoW Wiled Energy•i&2 Family Dwefitg $ 64,011 6400 WrlulwWred Wme'Conadfon $1 M $— Reneviable Ele*ical Eqeqy-BKVA Clem or Liss $102,00 Thefustal $ Nift.SUD W each adcltbRW T-W NVIN CQNSTRUCT12UPNLY Fksl 1341 ware $1200 Each AdMonal V Sqwire R a Pool=0 $ 40,00 Fach DuWuRft cc Delached Gr $ 74.00 Each Swtoning Pool of Hot Tub 11G.00 64-_oo Total Omer as defined tty RCW,%26.261,(1)owpor v40 occupy the structure for two years after this elootrical permit Is fhallzed (2)Owner is required to hire an eleclacal conh-ticler if above$aW pWerty is(Or$ale,root or tease.PeTm.itaxpires after sly months of last inglection, After mtift the above statement,I haraby ceft that I am the owrier of the above named property car-,r f1mased electrical omtrador.I gm making tho electkal inslabUoft or alleration In compliarice pith the electrical laws,NEC,,RCW,Chapter 1128,WA C.Chapter 2H-168,The City of Port Angeles Municipal Code,and Utilly Specif(ralimis and RAM G 14,05,0K regardlog 8eftal Permit Apotcarionz. 619natute,,Df Owner,electrical contractor or olectrical adral nisttator; 0 c1sh 0 Check R1 Ctedjt Card# - 1/15/2014 ELECTRICAL PERMIT CITY OF PORT ANGELES d 360-417-4735 Application Number . , , , . 14-00000061 Date 1/16/14 Application pin number , . 502349 Property Address 1113 E 5TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER; OS-30-00-0-1-7865-0000- Application type description ELECTRICAL ONLY on your excise tax form orm Subdivision Name , . , , , , to the City of Port Angeles Property Use . . . , , . , . Property Zoning , , , , . , . R97 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation . , . , 4 Application desc Alarm Owner Contractor MOLLY M AND LARA M RADKE PROTECT YOUR HOME 37509 HOOD CANAL DR NE 3750 PRIORITY WAY SOUTH .DRTVE HANSVILLE WA 98340 9200 TNDI.NAPOLIS IN 46240 (317) 810-4720 Permit . . , . . . ELECTRICAL ALTER RESIDENTIAL Additional desc Permit Fee 64,00 Plan Check Fee ,00 Issue Date 1/16/14 Valuation . , , , 0 Expiration Date 7/15/14 Qty Unit Charge Per Extension 1,04 64.D000 ECK EL-SINGLE CIR LIMITED RES 64,00 ------------------------------------------------7--------------------------- Fee summary - Charged Paid - Credited Due ----------- --_-___-- ---------- - Permit Fee Total 64,00 64,00 00 .00 Plan Check Total .00 .00 .00 ,00 Grand Total 64,00 64,00 .00 00 I INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN Z! b L FINAL COMMI3NM PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: GAEXCHANGBIBUILD1NG ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . , , . . 14-00000061 Date 1/16/14 Application pin number . . . 502349 Property Address . . . . . . 1113 E 5TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7865-0000- Application type description ELECTRICAL ONLY on your excise fax form Subdivision Name . . . . . . Property Use to the City of Port Angeles Property Zoning , . . . . , . RS7 RESDHTL SINGLE FAMILY (Location Code 0502) Application valuation . . , . 0 Application desc Alarm Owner Contractor MOLLY M AND LARA M RADKE PROTECT YOUR HOME 37509 HOOD CANAL DR NE 3750 PRIORITY WAY SOUTH DRIVE HANSVILLE WA 98340 #k200 INDINAPOLIS IN 46240 (317) 810-4720 Permit . . , , . , ELECTRICAL ALTER RESIDENTIAL Additional desc . Permit Fee . . . 64.00 Plan Check Pee 00 IsBLie Date 1/16/14 Valuation . . , , 0 Expiration Date 7/15/14 Qty Unit Charge Per Extension 1.00 64.0000 ECH EL-SINGLE CIR LIMITED RES 64.00 ------------------------------------------------7--------------------------- Pee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total. 64.00 64.00 ,00 .00 Plan Check Total. .00 .00 .00 .00 Grand Total 64.00 64.00 .00 ,00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGEWILDING 2014-03-19 Ob;Z t LA5UAUL ULU I H11: 3bu3/9yu43}7 3bU 4114 rl'r r lr 1 PORr 41 - 1 CITY OF PORT ANGELES PERMIT APPLICATION � Building Division/Electrical Inspections 321 East Fifth Street--P.O. Box 1150/Port Angeles Washington,98362 RECEIVE Ph: (360)417-4735 Pax: (360)417-4711 Date; 7 l Y _1&2 Single Family Dwelling MAR W [EmL��RICAL 'Plan Review May Be Required,please Cgplete Iectrical Plan Review Information Sheet MPECEOP)S Job Address: // 3 r ._.. '' _ Building Square Footage; T - DwOprlan of above_ j' ownar Ino mallon / / Contra*r InformaVon Name. hi GLC.K � . _ Noma: Ca 5 C Ij 4 e r/4 t-- C- Mailing Address; 1113 5-Al </L Mailing Ad�ress� o G City: State;Pe1�Tlp; Clry: Phone: °l - ax:, . Phone: S Fax. G G 90�j License#!Enp, _ -_____ LICerlse i12R1 Unit Charge [gy Total MAY Multloiled by Unit Charnal ServicelFeeder 200 Amp, $120.00 $ ServicoTeeder 201400 Amp. $146.00 ^_ , _ $ Serv'WFeeder 401.600 Amp $205.00 $ Ser raffeeder 601.1000 Amp. $262.00 $ SenricelFeeder over 1000 Amp. $373.00 Branch Cimu4 WI Service Feeder $ 5.00 $ Branch Circuit WIO Service Feeder $ 63.00 $ Each Additional Branch Circuil $ 5,00 $.,,.T_,,,� Branch Circuits 14 $ 75.00 Temp.SerAmc f=eeder 200 Amp. $ 93.00 Temp.Servi Oeeder 201-400 Amp, $110.00 $_. Temp.Ser*ef ceder 401.600 Amp. $149,00 $ Temp.ServiC&FeedeT 801-1000 Amp. $168.00 $ Portal to Portal Hourly $ 96.00 $ .-„ Signal Orcudl Limited Energy-1&2 Family Dwelling $ 64,00 $ Man+Aactured Rome Connection $120.00 , $ Renewable Electrical Energy-5KVA System or Less $102.0 Thermostat $ 56,00 T $ Note:55.00 for each additional T-Scat NEW CONSTRUCTION ONLY; First 1300 Square Ft. $120.00 $ Each Additional 500 Square Ft.or Portion of $ 40.00 Each D bOding or Delaehed Garage $ 400 $ Each Swimming Pool or Mot TO $110.00 $ $ S .Natal Owner as defined by RCW,19,28,261:(1)Owner will occupy the structure for two years after this electrical pemnA is finalized.(2)Owner is required to hire an electrical contractor if above said properly is for sate,rent or lease_Permit expires after six months of last inspection. After reading the above statement,I hereby cedily 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 18,WAC,Chapter 296.468,The City of port Angeles Municipal Code,and Utility Speeifitcaticns and PAMC 14.05.050 regarding Electrical Permit Applications, Signatu of owner,electrical ntracto r electrical administrator. © C$jh C3 Cheok V Cred”Card .. ELECTRICAL PERMIT �. CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 14-00000337 Date 3/19/14 Application pin number . , . 534274 Property Address , . , , , . 1113 E 5TH ST ASSESSOR PARCEL NUMBLR; DG-30-00,0-1-7865-0000- REPORT SALES TAX Application type description ELECTRICAL ONLY on your excise tax form Property Name to the City of Port Angeles Fro ert Use Property Zoning . , . . , . , RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation , , p Application desc Ductless heat pump Owner Contractor - MOLLY M AND LARA M RADKE CASCADE ELECTRIC & VAC INC 37509 HOOD CANAL DR NE PO BOX 369r HANSVILLE WA 98340 PORT HADLOCK WA 98339 �--� (360) 379-5347 -------__-.-___- ----__._____.-_.-------------------------------------- �1 Permit , . . . , , ELECTRICAL ALTER RESIDENTIAL. Additional desc 1-4 CIRCUITS Permit Fee 75.00 Plan Check Fee '00 Issue Date 3/19/14 Valuation 0 Expiration Date 9/15/14 Qty Unit Charge Per Extension BASE FEE 75,00 Fee summary Charged ------Paid Credited Due - - r Permit Fee Total 75,00 75.00 00 .00 1V1� Plan Check Total. .00 .00 .00 .00 Grand Total 75,00 75.00 00 .00 INSPECTION TYPE DATE, RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN l FINAL 2 COMMENTS: PERMIT WILL EXPME SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: GAEXCHANGEIBUILDING ELECTRICAL PERMIT CITY OF PORT ANGELES C� 0 360- 417 -4735 Application Number 11- 00000315 Date 4/12/11 Application pin number 621155 REPORT SALES TAX Property Address 1113 E 5TH ST ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -1- 7865 -0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc 200 amp service, 13 circuits remodel Owner Contractor LIVERMORE SIDNEY R NORTH PENINSULA ELECTRIC 1113 E 5TH ST 761 FRESHWATER PARK RD PORT ANGELES WA 983624426 PORT ANGELES WA 98363 (360) 477 -1764 "z8 c`f D Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit pin number :.83632 Permit Fee 153.70 Plan Check Fee .00 Issue Date 4/12/11 Valuation 0 Expiration Date 10/09/11 Qty Unit Charge Per Extension 13.00 2.6000 ECH EL- BRANCH CIRCUIT W /FEEDER 33.80 1.00 119.9000 ECH EL -0 -200 SRV FEEDER 119.90 Fee summary Charged Paid Credited Due Permit Fee Total 153.70 153.70 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 153.70 153..70 .00 .00 (1� V INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE c") )171 uTi ROUGH IN FINAL 7 I2511/ 11•0? COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING 2011 -04 -12 09:16 NORTH PENINSULA ELEC 3609289409 360 417 4711 P 1/1 RECE 0 APR 12 2011 1:), ELECTRICAL t INSPECTIONS r-- City of Pon Angeles Permit Application 0- I Building OlvlelonIEleclrical Inspections 321 East Fl th Stroh P.O- Box 1150 Port Angeles Washington. 98382 Ph: (380)417-4735 Fee: (38014174711 Dale- f 4 r 1 2 Single Family Dwelling Multi-Family or Commercial' Commercial Addition Alteration Remodel Repair' Plan Review May Be uire Please C,{cplete E ;rival Plan Review Information Sheet Job Address. 1 1- r Building Square Footage: Description.. of above 1 JT rh 1 n.1) +le 1 i ..V'.1. t -.L. Owner nformation Ap Co lraclur I fob inatio 1 1Y Na: me i')•II,RsiL�. Narns L 0_ fr 4 r L' I IC, Mailing 4 dd res s Li aw- Mailing aridr�s5, __c' City State.4i. ZIp C Iii I t__,& Stare Z ;p 2n. Phone Fax: Phone. �1)1— JC. Rax TT_ 1 "...a...';'. C7 Licerse a Exp. License _xp. /1 1_ fS 1 C r -2 Unit Char Q 'Of Multiplied by l rj_t haroel S 1 19 90 S entice/Feeder 200 Amp S 145 50 5 ServicaFeeoer 201 -400 Amp S 204.04 S_...... Service/Feeder 401.000 Amp 5 262.20 S ServicerFeeder 601.1000 Amp. 372 50 rvice&Feeder over 1000 Amo S 2.50 2--• ranch ClrcJll W! Service Feeder 5 73 50 5 Branch Circuit W!C Service Feeder 5 2. 00 5 Each Additional Branch Grad S 92 70 S_ _Temp Service! Feeder 200 Amp. 5 110.30 Tamp Service;Feedet 201.400 Amc 5 148 70 S Temp Service/Feeder 401-600 Amp. 1A 90 5_ Terrp ServiceiFeeder 601 -1000 Amp 95 90 5_ ?brass to Ponei Hourly s 88 20 5 Sign:Outline Lighting 5 959C 5 Signs. Circuit/ Limited Energy Cornmercial. Addiudnar 1500 S5.00 5 63.90 S Signal circuit; 'soiled Energy -1 2 Family Dwelling S 63.90 5_.. Sgne. Circvltf Lensed Energy i 1ulti- Famr:y Owelling 119.90 S Manufactured Home Connection 5 102 30 5 Renewable Electrical Energy 51WA System or Less 5 110 30 5 First 1300 Square Ft. 5 35 2 0 S Each Adeiional 500 Square or Ponwn or S 73.50 5_ Each Outb:liloing or Detacned Garage 5 110 30 5 Swimming Poor or Not Tub 5 56.00 5 7 4hermostat Owner as defined by RCW. 19.28-281: (1) Owner will occupy the structure for hem years after thin electrical permit is finalized. (2) Owner Is required fo hire an eleeer /eai contractor it above said properly Is for sale, rent or Nose. Permit expires after six months of last inspection, ',Iteration in omplt the electrical lewe, certify C. Chapter 19 26, WAC. Chapter property 98 6, The City f Pon Angeles Municipal Code, and Utility Specification or Specifications :Stpnetura of owner :electrical contractor or electrical administrator C= Cash 0 Check x L r Date: y' i/ Ged1t Card 8 L:) Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner LIVERMORE SIDNEY R 1113 E 5TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary Permit Fee Total Plan Check Total Grand Total T\Policies\ 1102.15R 1/05) WA 983624426 RIGHT OF WAY INSTALL SIDEWALK 104364 00 6/12/07 2/17/08 CITY OF PORT ANGELES PUBLIC WORKS UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 07 00000688 978400 1113 E 5TH ST 06 30 .00 0 1 7865 0000 PUBLIC WORKS UTILITES RS7 RESDNTL SINGLE FAMILY 0 Contractor CLEAR HORIZON PO BOX 38 PORT ANGELES WA PORT ANGELES Plan Check Fee Valuation Charged Paid Credited 00 00 00 00 00 00 00 00 00 Date 8/28/07 WA 98362 Due 00 00 00 00 0 .\ce _X 0- `C c'' \cri Rw 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 periodof180 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 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 \1 IO2.15R 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 1 NO CONSTRUCTION RW PW ENGINEERING I FIRE DEPT I PLANNING DEPT BUILDING O ttucAocco Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner LIVERMORE SIDNEY R 1113 E 5TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary Permit Fee Total Plan Check Total Grand Total T•\Policies \1102.15R [1/05] WA 983624426 RIGHT OF WAY INSTALL SIDEWALK 104364 00 6/12/07 12/09/07 CITY OF PORT ANGELES PUBLIC WORKS UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 07 00000688 978400 1113 E 5TH ST 06 30 00 0 1 7865 0000 PUBLIC WORKS UTILITES RS7 RESDNTL SINGLE FAMILY 0 Contractor CLEAR HORIZON PO BOX 38 PORT ANGELES WA PORT ANGELES Plan Check Fee Valuation Charged Paid Credited 00 00 00 00 00 00 00 00 00 Date 6/12/07 WA 98362 Due 00 00 00 00 0 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 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 KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS 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 R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I PLANNING DEPT 417 -4750 I BUILDING 417 -4815 T•\Policies \1102.15R [1/051 RESIDENTIAL PERMIT INSPECTION RECORD YES NO FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO CONSTRUCTION LW PW ENGINEERING I FIRE DEPT I PLANNING DEPT BUILDING d,ORT"""O l~\ r&l L~ ~ ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 07-&3'9 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning Application valuation 07~00000688 978400 1113 E 5TH ST 06-30-00-0-1-7865-0000- PUBLIC WORKS UTILITES Date 8/28/07 & //2--/07 RS7 RESDNTL SINGLE FAMILY o Owner Contractor :3, LllJevVYIOVG I/J3 ESt::/) LIVERMORE SIDNEY R 1113 E 5TH ST PORT ANGELES WA 983624426 CLEAR HORIZON PO BOX 38 PORT ANGELES PORT ANGELES WA. WA 98362 .00 plan Check Fee 6/12/07 Valuation 2/17/08 .00 o j{j 0 Fe<€- S/w InS~ Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date RIGHT OF WAY INSTALL SIDEWALK 104364 Fee summary Charged Paid Credited Due ----------------- ---------- - - ~ - - - - ~ - - - - - - - - - - - ~ ---------- Permit Fee Total .00 .00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total .00 .00 .00 .00 , , .,'" ~~ 0;/uIAJ1 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 wiii 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 locai law regulating constructlo'n or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\Policies\ll 02.15R [1/05] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . INSPECTION REPORT. . . . . . . REQUEST: Date <:{J'[/ - Df Time Received by (phone. person) J~~ fi c--<:::h .~ Location of Work to be inspected <.:) ~ Name of person requesting inspection' 0 m p~ - LL..I Ve.,v...... Address of person requesting inspection Phone Nc( ?? oq -D7~J. Type of Inspection (circle appropriate one): Permit No. 67-& 5? S/ Sewer Foundation Framing Chimney Plumbing(gewer Excav. Other "31 P4vdJG - INSPECTION NOTES: Inspected: Date 9 - Z 1- 0 '{ Remarks: Time By ~v OK RESTORA TION REQUIRED . . . . .. YES NO x , SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other o Repaired by City D Repaired by Permittee D No Damage Found Work Order # D COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT /DATE I . . . . . . CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 6 -:5--D, Time Received by R V (phone, person) I , I? t:. r7~ Location of Work to be inspected -LLJ ~ ;7 Name of person requesting inspection C. h.u..c.. k sin Y1IQ v C. ( ~ r- 1+01'"' ~ 7,(") vL Address of person requesting inspection I' Phone No. P-.l\9 -C7? I Type of Inspection (circle appropriate one): Permit No. (:)7- b~<A Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other S:Je ala Ik. INSPECTION NOTES: , Inspected: Date ca - b - 07 Remarks: OK 70 pC>lLr Time AM By RESTORATION REQUiRED...... YES NO '><-- SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC 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) STREET SUPERINTENDENT (DATE)