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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
321 EAST 5TH STREET. PORT ANGELES. WA 98362
Appllcatlon Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER;
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000598 Date
923166.
1140 GRANT AVE
06-30-14-5-6-9090-0000-
SMITHSON
RES REMODEL
8/21/06
UNKNOWN
6600
Owner
Contractor
MICHAEL T/LIZBETH V SMITHSON
1140 GRANT ST
PORT ANGELES WA 983622729
OWNER
Pe rmi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER
JEDI/ 200A ALTER
82073
JEDI ELECTRIC
66.90
8/21/06
2/17/07
RESIDENTIAL
SVC.
Plan Check Fee
Valuation
.00
o
"-
"
~
\)
Qty
1. 00
Unit Charge Per
66.9000 ECH EL-R OR RM 0-200 ALT SRV FDR
Extension
66.90
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.
06/19/2006 11:16 AM SROBERDS -- ADA improvements in the
RS-9 zone to an existing garage structure. No structural
additions.
Electrical load calculations and elctrical permits are
required.
Seperate meter and account required.
06/12/2006 03:34 PM GMCLAIN ----~-----------------------
Electrical load calculations and elctrical permits are
required.
Public Works Utility Engineering has no requirements for
this plan review.
(0
~
1
~
Other Fees
STATE SURCHARGE
4.50
"
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee TotaJ. 66.90 66.90 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 71.40 71.40 .00 .00
COMMENTSI ACTION NEEDED
ELECfRICAL PERMIT INSPECfIONRECORD
CALL 4) 7~735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr IS UNLA WFUL TO COVER.
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
DATE
COMMENTS
NO
7-
GENERAL COMMENTS:
PW-II02.U (4'96)
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUU,DING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
06-00000598 Date
923166
1140 GRANT AVE
06-30-14-5-6-9090-0000-
SMITHSON
RES REMODEL
6/22/06
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
UNKNOWN
6600
Owner
Contractor
MICHAEL T/LIZBETH V SMITHSON
1140 GRANT ST
PORT ANGELES WA 983622729
OWNER
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit pin number 79640 fv
Permit Fee 165.75 Plan Check Fee 66.30
Issue Date 6/22/06 Valuation 6600
Expiration Date 12/19/06
Qty Unit Charge Per Extension
BASE FEE 95.75
5.00 14.0000 THOU BL-2001-25K ' (14 PER K) 70.00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL ,PERMIT
80796
64.50 Plan Check Fee
6/22/06 Valuation
12/19/06
.00
o
Qty Unit Charge Per
Extension
50.00
14.50
BASE FEE
2.00 7.2500 ECH ME-VENT FAN
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date'
PLUMBING PERMIT
80804
107.00
6/22/06,
12/19/06
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
BASE FEE
4.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE
1. 00 15.0000 ECH PL- EA. BLDG SEWER
1. 00 7.0000 ECH PL- EA.WATER HEATER
Extension
50.00
28.00
7.00
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 high and be
of contrasting color from the background.
06/19/2006 11:16 AM SROBERDS -- ADA improvements in the
<a
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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 requ~sted 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.
Date
Signature of Owner (if owner is builder)
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
Date
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 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
r YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE I DOWN SPOUTS
PIERS
POST HOLES (POLE BLDOS.)
PLUMBING
. UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW I WATER
AIR SEAL
I
WALLS
CEILING I I
FRAMING
JOISTS / GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS I ROOF I CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR I CEILING I
MECHANICAL
HEAT PUMP I FURNACE I DUCTS
GAS LINE
WOOD STOVE I PELLET I CmMNEY FINAL . DATE ACCEPTED BY:
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKlNGILIGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL.INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 4 I 7-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W. I PW I CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T.'n_"_:~_'"m 1~ h,,;ln;no nP.rTT1.1 in.oectlOn record05.wpd [11412005]
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CITY OF PORT 1\l'\JGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application' Number . . . . . 06-00000598
Application pin number 923166
, Page 2
Date 6/22/06
Special Notes and Comments
RS-9 zone to an existing garage structure. No structural
additions.
Electrical load calculations and elctrical permits are
required.
Seperate meter and account required.
06j12/2006 03:34 PM GMCLAIN ----------------------------
Electrical load calculations and elctrical permits are
required.
Public Works' Utility Engineering has no requirements for
this plan review.
Other Fees
STATE SURCHARGE
4.50
--------------------------------------------------------------------,-------
Fee summary Charged Paid Credi ted _~..... Due:':J~ .~}.. ~
. \
----------------- ---------- ---------- ---------- ---------- '\
Permit Fee Total
Pian Check Total
Other Fee Total
Grand Total
337.25
66.30
4.50
408.05
337,25
66.30
4.50
408.05
.00
.00
.00
.00
.00
.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 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 [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
o!
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 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
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING cg~ '1>1/0' ,ftv
UNDER FLOOR / SLAB .
ROUGH-IN '1l/nll/% ~
WATER LINE (METER TO BLDG) , ,
. FINAL I ')..pt /0 h DATE
GAS LINE J ~L- ACCEPTED BY:
BACK FLOW / WATER
,
AIR SEAL
WALLS
CEILING'
FRAMING
JOISTS / GIRDERS
. SHEAR W ALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED pANEL ONLY)
T-BAR
INSULATION
SLAB , I
WALL / FLOOR / CEILING 7lfQrwu VV
( " ,.
MECHANICAL
HEAT PUMP/FURNACE/DUCTS
GAS LINE
WOOD STOVE / PELLET / CillMNEY FINAL I rrjlVjof; DATE 1 J- L-- ACCEPTED BY:
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL.INSPECTlONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL' DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 4 I 7-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W. / PW/ CONSTRUCTION - R. W.
ENGINEERING 4 I 7-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 i/ll. lId I IJ70 J-hv BUILDING
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'T'.\T"_1..........\111\., 1 (; hlU1Amo np.rmlt m,!;Oectlon record05.\vpd [1/412005]
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, .,
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: M 7). 0( K. ~-.r <'( "?" (;;;) 4 <; 2... -z. 6 (] 2-
Owner: h \ -z.. 4 f), i <.of,.,. z v( S .')"\ I + L.. So 0 A.
Phone:
3(.0 q\l...
"2..-f. 0 "1...-
Address:
1\ '-+ 0
G <:) " t-
City:
Phone: 3bO q'5~- '1?S"7-
Po,'\- A"'JJ e) Zip: CJ Ii? g" L
Architect/Engineer:
Contractor
Phone:
State License #:
Phone:
Zip:
ZONING:
Subdivision: I-Itj/l.Ill V/CUJ-r'1<.K\
~, 1010
Exp:
City:
~W').,I-' \--- ~.
Block: "2-
Address:
PROJECT ADDRESS: I ( </D
LEG.AL DESCRJPTION: Lot: ~
CLALLAM COUNTY P.A.RCEL NUMBER:
, -'50
1~
TYPE OF WORK:
1)JC Residential. D New Constr. D Re-roof D Stove
o Multi-family D Addition 0 MoveD Garage
o Commercial ~ Remodel 0 Demolition 0 Deck
D Repair D Sign D Other
BRIEF DESCRIPTION OF THE PROJECT:
~ be ~ voo IV\.
SIZE/VALUATION:
SF. @$ /SF. = $
. I SF. @ $ /SF. = $
~>o~Q SF. @ $ k> /SF. = $ ,. '0'0 ~
,
TOTAL VALUATION $
CJ.. 2.^J< ,'),y 2-j" ljlll-n A 04 IoA-Yl... Y"oo"", ,f _i.!iT('
"' 'S4:uv
COMMERCIAL/RESIDE:t\TTIAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
ESAlWetland(s):oYesDNo SEPAChecklistrequired?O YesD No Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FffiE :
OTHER:
PLANNING USE ONLY:
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
Coordmator 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: Hno permit is issued within 180 days of the date ofapplicatioIl, the application will expire. The
Buildmg 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 ofthe International BuildmglResidential 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. J am authorized to
apply for this permit and understand that itis my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits prior to work.
T:\FORMS\BldgPerrnitform.wpd Applicai:lt: M b In".
1Y1,(~t-f.f ~ z, .>m{fJ...Jo",
Date:
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Job wired by
ELECTRICAL WORK PERMIT APPLICATION
Electrical contractor ame
0::8\\/ j;;-Lu-/rt'e.-
Purchaser's mail~g address
p.C). \:)O~
Cip;
\"'0 ,TA~'5ele)
Telephone number
i-fbo -05S~
Date Expires
~eDI15E J!' qS 7GZ
License number
Installation description
Q commerCia~sidential
o New ?lteredJAddition
/
lectrical Contractor 0 Owner
8Sr-
Stale ZIP
~
cta-.Jt:.:2..
.:;)0 D
ctVVtf">
S e (VICe
d1,<V/ .
Premises owner's name
V'I,' c \"lAe.. S f/1/Tlt..s 0 A
Ave.-
ttv\ 3 de:?"
Phone number to schedule inspection:
por'l
Owner as defined by RCW/9.28.26/:(J) 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, retll or lease.
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 instal-
lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter
19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and
Utility Specifications.
o Cash 0 Check #
o Credit Card
Card #
Visa
Mastercard
Discover
ctrical contractor or electrical administrator
x
~
Date: '7 ~/ c) vc,
Expiration Date
of card
Electric Load Additions and or subtracti ns
D NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton LAR
D Fan-Wall KW
o Overhead Service
o Temp Service
o Underground Service
Voltage
Phase D 1 D 3
Service Size:
Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
/1/, ,lOUGH-IN 0 / THERMOSTAT SERVICE
1.'" b Az; 7- It/-Ok, ko
\. I D<lc ' Approvcd By Dalc Approvcd By Dale Approved By
I~?h~/INAL / "- /
DITCH FEEDER
""" 1!aBY./ "- Date Approved By " Dale Approved By
Inspection Area, Building or Equipment Inspected Action Taken Electrical
Date Inspector
b~
~
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I!- =..1J..
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-..
ELECTRICAL WORK PERMIT APPLICATION
.
,
Job wired by
o Electrical Contractor )( Owner
Installation description
o Commercial .21 Residential
Electrical contractor name
Co '" "-"-C ~ ~ p., \-
Purchaser's mailing address
License number
0' hvv-v- it, "1
Date Expires
-)/].(
DNew
o Altered/Addition
Telephone num?cr
FAX number I
2.. Co '" """-.0
c\.."" "I <..~.z (~o..'" J j',J~
;1' h l" J .roO....... 0,,-\-1-. "0'" {
I
.-
City
State ZIP
Premises owner's name
(Yl: cl-..,.,A
J,-,,~I 'l
.....
L :-\.,
A: IN.
o Check #
Visa
Mastercard
Discover
x f\v~
"Expiration Date
of card
Service Inlormation
o Overhead Service
o Tamp Service
o Underground Service
Voltage
PhaseD 1 03
Service Size:
Feeder Size:
BEFORE 7:00 AM 360-417-4735
THERMOSTAT
SERVICE
Approved By
Dale
Approved By
Dale
Approved By
DITCH
FEEDER
Dale
Approved By
Dale
Approved By
Date
Approved By
Area, Building or Equipment Inspected
Action Taken
Electrical
Inspector
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