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HomeMy WebLinkAbout206 1/2 W 7th St - BuildingPREPARED 2/12/09 8 16 54 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/12/09 ADDRESS 206 1/2 W 7TH ST SUBDIV TENANT NBR PAMELA BOYD CONTRACTOR PHONE OWNER PAMELA BOYD PHONE (360) 460 0392 PARCEL 06 30 00 0 2 3308 0000 APPL NUMBER 08 00000245 RE ROOF PERMIT BNOP 00 BUILDING PERMIT NO PR FEE REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 2/12/09 JLL BLDG FINAL February 11 2009 1 49 47 PM 1pangrle BOB 461 5465 BLDG FINAL RE ROOF HOUSE COMMENTS AND NOTES Date Application Number 08 00000245 Date 2/27/08 Application pin number 046880 Property Address 206 1/2 W 7TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 3308 0000 Tenant nbr name PAMELA BOYD Application type description RE ROOF Subdivision Name Property Use Property Zoning RESIDENTIAL HIGH DENSITY Application valuation 650 Application desc TEAR OFF RE ROOF W /30 YR COMP Owner Contractor PAMELA BOYD OWNER 2830 E BAY ST PORT ANGELES WA 98362 (360) 460 0392 Structure Information 000 000 TEAR OFF RE ROOF W /30 YR COMP Permit BUILDING PERMIT NO PR FEE Additional desc TEAR OFF RE ROOF Permit pin number 121723 Permit Fee 56 10 Plan Check Fee 00 Issue Date 2/27/08 Valuation 650 Expiration Date 8/25/08 Qty Unit Charge Per Extension BASE FEE 50 00 2 00 3 0500 HND BL -501 2K (3 05 PER C) 6 10 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 56 10 56 10 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 60 60 60 60 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 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 o not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law rec4lating construction or the performance of construction 2 2162 t1 0 i Print Name T Forms /Building Division/Building Permit (10 /01 /07).wpd CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 ktS\h) Llaik iJiO4 Signature of Contractor or Authorized Agent f Signature of Owner (if owner is bilder) 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 FOUNDATION• FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS 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 SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP /FURNACE /DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING BUILDING PERMIT INSPECTION RECORD YES 1 NO 1 FINAL PLANNING DEPT SEPARATE PERMIT 8's SEPA. PARKING /LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE RESIDENTIAL DATE YES NO COMMERCIAL ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 I 1 1 FIRE DEPT PLANNING DEPT 417 -4750 I G7 1 1 PLANNING DEPT I BUILDING 417 -4815 1 0 12— 0 6i 1 3 A 1 BUILDING T Forms /Building Division/Building Permit (10 /01 /07).wpd DATE ACCEPTED BY. FINAL DATE ACCEPTED BY. V e DATE ACCEPTED YES 1 NO I 1"5-) Applicant or Agent Property Owner Property Owner's Address Contractor /Engineer Contractor /Engineer's Address License PROJECT ADDRESS 70(o tA) Parcel Number Proiect Type Brief Description. Check all that apply New Construction Addition Remodel Repair e -roof Demolition Sign Heat System Other BUILDING PERMIT CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 tc L2-Residential l eaf C �C(� wall- mounted projecting freestanding awning other Total sign area sa ft. Maximum allowed sign area sa ft. Heat pump wood burning stove gas fireplace pellet stove other Floor Areas Existing (sq. ft.) Proposed (sq. ft) Basement 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures sq ft. T Lot size Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? TForms /Building Division /Bldg Permit Appl -2006 Code.doc Phone 4W) Phone 1/) S 7B L 13, 6 1 Wr. tA9JYY2 5F Phone ft. Occupancy group Occupant load Construction type APPLICATION Print in ink Expires For City Use Only Date Received 7!7 --oS Permit (55k— 215 Date Approved Lot Zoning Commercial o Multi family Industrial per sq ft. I have read and completed this application and know it to be true and correct. I a understand that it is my responsibility to determine what permits are required, a Date Print Name jig CI Signatures JIM /Jr projec l 1(JlZ64 TOTAL VALUATION (60 sq ft. Lot coverage of bedrooms of full baths of half baths �autG(orized to apply obtain permit this permit and r to working on \000 0 '- .., N '- 0 ri r>l r>lr>l Ul (:>E-< ::> ..:..: 0 0.0 :x: 0 E-< ~ r>l N E-< m r>l .., lE 0 , lE 0 0 \0 Q) ~ " ..... '" >< 01 r>l 0 <: ;"j \0 <1l >< .., 0. ..:l ..:l ..... ~, >< r>l ..:l H > ~ 0. ..:l H r>lr>l 0. E-< 0 ZZ ::> Ul r>lUl gJ 00 l!) Ul r>l "'''' 0:'" ri ... 8~ Ul 0.0. ~ 0 " '" Z E-<'":> " E-< ..: 0 Z .. 3: ~ O~ HO Ul 00 E-<E-< E-< 0 Ul UU Z ..:lo ..:l E-< r>lr>l r>l ":N ..: Z 0.0. lE Z NZ r>l UlUl ZlE H _m H lE ZZ 00 ~("')r>'l~ lE H H HU NO 0 ~ E-<'- (:> ,(:> U H o.Ul Zl--loZ ..: HE-< HQJ\,,()H 0. ~..:l l1l.Qo::rlIl 'r>l U::> ~2~~ O~ UlUl 0 r>lr>l ..:l U ..:l 0(:> O~ Ol 004 0.. OZ , H E-< oolIl H E-< :;~ ~o..~ ~ Ul m ..,..:l l!) :x: 0 '0. o.Ul::> E-< ><N ZUl m "0 0 '" ~Hr>l 0 >< lIlON :z: ~ 3:0 ,.., H '" III ..:lOri ~OO Ul N 00 r>l '-": ..: '0 It -..:l ri..:l ..:loo ..:lr>lr>l oor>l r>l r>l..,0 "-E-<E-< 0(:> ~~ ~ ' , Ulr>l ~~ \000 Or>l..:l NO. 0.00 0::>0. N OlE '-E-< r>l0 O~ ~ ~ ~U riO . III ~ .r>l ..:l 0. ZO III "- 0 E-< .~ r>l'" Ul -U ri ~O UlE-<": ..:lZ E-< 0 0 ..: ~~~el~L H Ul 0.>< ~ '- '" r>lE-< OZZZ~o. 0. '" ~H ~r>l03:":0. >< ..:l o.U E-<UOo...: "- E-< 0. fPORf""'r t,':O~<( (j~"" 1L -=...:or ~ "I.f<1C~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32] EAST 5TH STREET, PORT ANGELES, W A 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 08-00001324 Date 10/16/08 601788 206 1/2 W 7TH ST 06-30-00-0-2-3308-0000- PAMELA BOYD PLUMBING REPAIR RESIDENTIAL HIGH DENSITY 700 Application desc WATER LINE BETWEEN THE METER AND THE HOUSE Owner Contractor PAMELA L BOYD 2830 BAY ST. PORT ANGELES (360) 460-0392 OWNER WA 98362 Permit PLUMBING PERMIT Additional desc WATER LINE METER TO HOUSE Permit pin number 136515 Permit Fee 57.00 Plan Check Fee .00 Issue Date 10/16/08 Valuation 0 Expiration Date 4/14/09 Qty Unit Charge Per Extension BASE FEE 50.00 1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 57.00 57.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.00 57.00 .00 .00 ~ ? /' ~ ct ~ ~ ....... C{p 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 h In r not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law re71ati g construction or the performance of construction. b -/10 < 13cJ D Signature of Contractor or Authorized Agent T:Fonns/Building Division/Building Pennit BUILDING PERMIT INSPECTION RECORD - PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS - Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4807 Backflow Prevention Inspections 417-4886 IT IS UNu\WFUL TO COVER. INSUU\TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN CONSPICUOUS LOCA TlON. KEEP PERMIT AND APPROVED PLANS A T JOB SITE. Inspection Type Date Accepted By: Comments FOUNDATION: Footings Stemwall Foundation Drainage / Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: Under Floor / Slab Rough-In Water Line (Meter to Bldgl Gas Line Date: \0- 23-(A~cep;JbrL. Back Flow / Water FINAL AIR SEAL: Walls I Ceiling I FRAMING: Joists / Girders Shear Wall/ Hold Downs Walls / Roof / Ceiling Drvwall (Interior Braced Panel Onlv) T -Bar INSULATION: Slab I Wall/ Floor / Ceiling I MECHANICAL: Heat Pump / Furnace / Ducts Gas Line Wood Stove / Pellet / Chimney Commercial Hood / Ducts FINAL Date: Accepted bv: MANUFACTURED HOMES: Footing / Slab Blocking & Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: Parking / Lightino I f ESA: Landscaping I I SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY / USE RESIDENTIAL DATE Accepted By: Commercial Date Accepted By: Electrical 417-4735 Electrical Construction - R.W. Construction - R.W. PW / Enoineerino 417-4807 PW I Enqineerinq Fire 417-4653 Fire PlanninQ 417-4750 Planninq Building 417-4815 Buildino T:Forms/Building Division/Building Permit o r;/:) , ~ ~ ~ ~ \ ~ L -J ~ ~ t~ t-~ 6~ ~ (b " Applicant or Agent ~ Property Owner ~~ ~~ f'\ Property Owner's Address _, j} I ."'f1., Contractor/Engineer ~.__ Contractor/Engineer's Ad ress License # Expires - PROJECT ADDRESS Parcel Number BUILDING PERMIT APPLICA TION 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 For City US,e_ Onlr, _ Date Received~g Permit # 0$$...- I ~?-C; Date Approved Phone Phone 41:D ~D~2 Phone E-mail Lot Zonin Proiect Tvpe & Brief Description: esidential 0 Commercial 0 Multi-family 0 Industrial Check all that apply o New Construction o Addition o Remodel o Repair oRe-roof o Demolition o Heat System 0 Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other o Other Floor Areas Existinq (Sq. ft.) Proposed (Sq. ft.) Basement @$ per sq. ft. = $ 1 sl Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION $1fi7J. Max. height of proposed structures ft. Occupancy group # of bedrooms Will a lawn sprinkler system be installed? Occupant load # of full baths Will a fire sprinkler system be installed? Construction type # of half baths I have read and completed this application and know it to be true and correct. I am 7f1Wn. ed to appl for this permit and understand that it is my responsibility to determine what permits are required, and 0 0 ain permi p ior to working on projects. Datel6' )~{O~ Print Name~flA- ~'I iJ Signature Total footprint of structures sq. ft. + Lot size % sq. ft. = Lot coverage :f ,ORT ~ lO~~ ,. ~-- "4\~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . . . . . Application valuation . . . . 08-00000869 . Date 482202 206 1/2 W 7TH .sT 06-30-00-0-2-3308-0000- PUBLIC WORKS UTILITES 7/21/08 RESIDENTIAL HIGH DENSITY o Application desc new water meter to second unit Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV SEPERATE 2 ON ONE 130427 770.00 Plan Check Fee 7/21/08 Valuation 1/17/09 .00 o \D ~ ~ ~ ~ [ Owner Contractor BOYD PAMELA 2830 E BAY RD PORT ANGELES OWNER \' WA 983628261 Qty Unit Charge Per 1.00 770.0000 EA PW W/M 1" SERV 5/8" METER Extension 770.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 770.00 770.00 .00 .00' plan Check Total .00 .00 .00 .00 Grand Total 770.00 770.00 .00 .00 ~ ~- \2 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:\Policies\1102.15R [1/051 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 YES NO PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKlNG SIDEWALK CURB & GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO c COMMERCIAL~- ~. DATE-,' -- ACCEPTED YES NO CONSTRUCTION R. W. I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 P\V I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING - T:\Policies\1102.15R [1/05] c!~ORr~a l'~~ r-Bi !- -- ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT I,NGELES, W A 98362 08-'8(01' Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning Application valuation 08-00000869 . Date 482202 206 1/2 W 7TH .ST 06-30-00-0-2-3308-0000- PUBLIC WORKS UTILITES 7/21/08 O2D&16, VV 7l7l RESIDENTIAL HIGH DENSITY o PO/mJtc B~ Application desc new water meter to second unit Owner Contractor BOYD PAMELA 2830 E BAY RD PORT ANGELES OWNER \IJJfUIZ(JIL Z on J W)VVi WA 983628261 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV SEPERATE 2 ON ONE 130427 770.00 Plan Check Fee 7/21/08 Valuation 1/17/09 .00 o Qty Unit Charge Per 1.00 770.0000 EA PW W/M 1" SERV 5/8" METER Extension 770.00 Fee summary Charged Paid Credited ----------------- ---------- ---------- ---------- Permit Fee Total 770.00 770 .00 .00 Plan Check Total .00 .00 .00 Grand Total 770.00 770, 00 .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 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 constructi6n or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\Policies\l 102.15R [1/05] . APPLICATION FOR WATER City Water Division, Port Angeles. \VA Issued date: 7 - ?'l- c,e,Inotalled by & date: 1/)/'1'5 -c8 Poomt # <0'2.. - 84" Cj / I hercb: apply for water (0 be: furnished In accordance with rate~ and rules of the City for the followmg premls-:s: ApplIcant :-'<ame & Phone: /lJ meAz &rl Po L), tio 'Ir-3-5'/ SileAddress: ;'./)(p1"", 1-'11 7 tJh MailmgAddress: 6)55' ~ e: ~~_ wz.tr '2 Blk: 2i23Lot{:Zc.r0 Add: r~rJ- Parcel. (Jib ~CCOO ~a?C'C 5\0: 0:-'< r!!iJ Meter.'s C F ISZ7C,7Cj.j W 0#: ,:<;0<,'1.8 - '-I; Z Svc: Size / i, *- Fees: ::1770 f!:. RestoratIOn Required: No . Signature: if Remarks: L..c<:- .;;:-/yt?,2.?O 5fj?.e-rtl-h Z on ) C/2t-//7aj /77U-t--R. 7'f; he. t1$S17~d h dOg w7"i7--. N #1.# iA).l7i. 51' E " W 2 CI zfik~ /<E-114~ ;JJ ~ ~ ~ ";) ~ s Application Number . . . . . 15-00001591 Date 12/22/15 Application pin number 217777 Property Address . . . . . . 206 1/2 W 7TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2- 3308 -0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . Property Use . . . . I . I I Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY Application valuation ... . 0 Application desc Rewire existing house Owner Contractor BOYD, PAMELA OWNER 31 SHAMROCK LN PORT ANGELES WA 98362 (360) 460-0392 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit Fee 190,00 Plan Check Fee .00 Issue Date 12/22/15 Valuation 0 Expiration Date 6/19/16 Qty Unit Charge Per Extension 14.00 5.0000 ECH 'EL-BRANCH CIRCUIT W/FEEDER 70.00 1.00 120.0000 ECH EL-0-200 SRV FEEDER -120.00 Fee summary Charged Paid credited Due Permit Fee Total 190,00 190.00 100 "00 Plan Check Total c00 .00 .00 ,00 Grand Total 190,100 190.00 '00 '00 a REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical C,6,�tractor X Date:, G:\EXCHANGE\BUILDING CITY OF PORT ANGELES PERMIT APPLICATION Building Division /Electrical Inspections 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417 -4735 Fax: (360) 417 -4711 Date: p_I 5' * Plan Review a Job Address: — Building Square Footage: Description of above _ , V1 & 2 Single Family Dwelling Complete Electrical Plan Review Information Sheet Owner i on-nation �� Name: Mailhrag Address' City: _� Zip: cV Phonee # / Fan _ hon�_. Exp, ............ .............. - Item Service /Feeder 200 Amp, Service /Feeder 201 -400 Amp. Service /Feeder 401 -600 Amp Service /Feeder 601 -1000 Amp. Service /Feeder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Branch Circuits 1-4 Temp. Service/ Feeder 200 Amp. Temp. Service /Feeder 201400 Amp. Temp. Service /Feeder 401 -600 Amp. Temp. Service /Feeder 601 -1000 Amp . Portal to Portal Hourly Signal Circuit/ Limited Energy -1 & 2 Family Dwelling Manufactured Home Connection Renewable Electrical Energy - 5KVA System or Less Thermostat Note: $5.00 for each additional T -Stat NEW C IN TRUgPN NLY:. First 1300 Square Ft. Each Additional 500 Square Ft. or Portion of Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Contractor Information Name: Mailing Address: City: ___ State: Phone: Fax; License # / ExD. Zip: Unit Cba[g Q_yt Total (Qtv Multiplied by Unit Char„ $120.00 $ ° $146.00 $ $ 205.00 $ - - -_ - - -_ $ 262.00 $ 373.00 $ 5.00 � $ $ 63.00 $ $ 5.00 $ $ 75.00 $ $ 93.00 $110.00 $___ $149.00 $ $168.00 $�.... $ 96.00 $ $ 64.00 $ $120.00 $102.00 $ 56.00 $. $120.00 � $ 40.00 $.�............��. $ 74.00 $_ �� $110.00 -� ._.........._ 4 _ . --Total 1 ( V Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical perm' 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 Past 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 -4613, The City of Port Angeles M&ii " i Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature 9f o n , electrical contractor or electrical administrator: ❑ Cash ❑ Check !� ��.._ .. Card # ... . x t J Dated L !� Creditµ