HomeMy WebLinkAbout625 W 13th St - BuildingT•\PLANNING\FORMS \1102.15 [11/14/2003]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 04 00000862
Pin number 711362
Property Address 625 W 13TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 3 7465 0000
Application description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning
Application valuation 0
Owner Contractor
SCHUBA DONALD OWNER
1122 W 10TH ST
PORT ANGELES WA 983627507
Date 10/05/04
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc REPLACE SVC
Permit Fee 66 90 Plan Check Fee 00
Issue Date 10/05/04 Valuation 0
Expiration Date 4/04/05
Qty Unit Charge Per Extension
1 00 66 9000 ECH EL -R OR RM 0 200 ALT SRV FDR 66 90
Fee summary Charged Paid Credited Due
Permit Fee Total 66 90 66 90 00 00
Plan Check Total 00 00 00 00
Grand Total 66 90 66 90 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
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS I 1
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT
ROUGH -IN
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN I
WATER LINE (METER TO BLDG) y
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS I I�
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION yy
SLAB I I�
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE PELLET CHIMNEY 11
HOOD! DUCTS
PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE METER
SEWER CONNECTION f
SANITARY
STORM
PLANNING DEPT SEPARATE PERMIT #'s
PARKING/LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
CONSTRUCTION KW PW/
ENGINEERING 417 -4807
FIRE 417 -4653 1
PLANNING DEPT 417 -4750 I
BUILDING 417 -4815
T\PLANNING\FORMS \1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL 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 1 ACCEPTED
YES I NO
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
417 -4735 n i X.
/a l3
11-2 -0
SEPA.
ESA.
SHORELINE:
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT.
I PLANNING DEPT
1 BUILDING
COMMENTS
ELECTRICAL PERMIT APPLlCATIOt\1
FOt( O!'I'IC1AL ~JS!, ()~!LY
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The Electrical Permit Application must be filled out completely.
lMIC.41'I''''VI"j
Ddlo h~"..1 ._._.____~~
Please type or reprint in ink. If you have any questions, please call (360) 417-4735
Fax number: (360) 417-4711
Owner or Elec. Contractor Agent:
VOl'-! 56HGLP:,,L\
>,c./-tUf-:,1'I
Isf-<.. S r: City
Phone: t-fr:; 2 -020 7 Fax:
-
Property Owner: [Y; "- )
Address: b 'J- C; W,
Phone:
4-52- 07.-07
Zip ?f2'N 2-
ft;>12--( AN&-eU::-s
wA--
Electrical Contractor:
License' #:
Exp:
Phone:
Address:
,
Cily:
Zip:
INSTAllATION WIRED BY:
)1:0VvNER
o ELECTRICAL CONTRACTOR
Credit Card Holder Name:
Billing Address:
City:
Zip:
~
Credit Card Number:
Exp. Date:
VISA: MC:
r:f)
()
~
PROJECT ADDRESS: b 2-5 0U
/3+>- fr
TYPE OF WORK:
Check !ill that apply:
ONew
)8. Alteration/Add ition
~ Residential 0 Multi-family
o Commercial 0 Mobile Home
Sq. Ft
&S>D s-,:::..
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
o Low Voltage 0 Telecom. 0 Sign
Number of Circuits added or altered:
DESCRIPTION OF THE ELECTRICAL PROJECT: jZ~Pt-A'u6
,4E7ZIAL.-/~Ef2.VIC[; ME71:12. 7/?4fJEl---
I
Electrical Heat Load Additions and or Subtractions
Service Information
!::iBaseboard _ KW Voltage: Z-YiJ/rZA:;
:J Furnace KW 3'Overhead Service Phase: ~1 0 3
o Heat Pump TON_ LRA 0 Temp Service Service Size -:20", AI\'f
o Fan-Wall KW 0 Underground Service Feeder Size. L / rJ
, hombftrlifY ,~ dl, ;~",~;Lm;o" /h" 'Ppll,,'mo '0' lIorw /h,' ",me '0 be 'rue oM 00"':" 00' / pm
3uthorized to apply for this permit. / understand it is not the City's legal responsibility to determine what permits
3re required; it remains the applicants responsibility to determine what permits are required and to obtain such.
{'rnrl;U'- III"I.I~, s ~i"..altlT'th ~~/t~ M~
Owner or Elec. Cant. Signature:
Date:
<1 '2f'Of
Date:
::/E lE CTR ICAlPERM IT APPLI CATION
r/I-lt4'L /1- ,)-t?'-!
/ qo
PERMIT FEE: $ 0t, -
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417-4735
APPROVED NOT APPROVED
o ................... DITCH ................... 0
o .............. ROUGH IN/COVER. .. .. ... . ... .. 0
o .................. SERVICE .................. 0
o .................... FINAL. . . . . . . . . . . . . . . . . . .. 0
is> CORRECTIONS NEEDED: fi.Jl~.J ~
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360)452.1381