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HomeMy WebLinkAbout1502 Bldg D E Lauridsen Blvd - BuildingPREPARED 3/31/10 8 12 10 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/31/10 ADDRESS 1502 BLDG D E LAURIDSEN BLVD TENANT NBR PENINSULA COLLEGE CONTRACTOR OLYMPIC ELECTRIC CO INC OWNER WA PENINSULA COLLEGE PARCEL 06 30 14 1 2 0000 0000 APPL NUMBER 10 00000138 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL3 01 3/29/10 J H BLI 01 3/31/10 J SUBDIV BLDG FRAMING TIME 01 00 March 29 2010 8 39 26 AM 1pangrle BILL 461 2309 FRAMING AFTERNOON BLDG INSULATION TIME 08 45 March 31 2010 8 08 16 AM 1pangrle BILL 461 2309 INSULATION HE REQUESTED AN 8 45 AM INSPECTION COMMENTS AND NOTES PHONE (360) 457 5303 PHONE (360) 417 6553 67 PREPARED 3/29/10 9 01 33 INSPECTION TICKET PAGE 8 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/29/10 ADDRESS 1502 BLDG D E LAURIDSEN BLVD f SUBDIV TENANT NBR PENINSULA COLLEGE CONTRACTOR OLYMPIC ELECTRIC CO INC PHONE (360) 457 5303 OWNER WA PENINSULA COLLEGE PHONE (360) 417 6553 PARCEL 06 30 14 1 2 0000 0000 APPL NUMBER 10 00000138 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL3 01 3/29/10 L BLDG FRAMING TIME 01 00 March 29 2010 8 39 26 AM 1pangrle BILL 461 2309 FRAMING AFTERNOON COMMENTS AND NOTES WA PENINSULA COLLEGE 1502 E LAURIDSEN BLVD Construction Type CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Application Number 10 00000138 Date 2/23/10 Application pin number 725100 Property Address 1502 BLDG D E LAURIDSEN BLVD ASSESSOR PARCEL NUMBER 06 30 14 1 2 0000 0000 Tenant nbr name PENINSULA COLLEGE Application type description COMM REMODEL Subdivision Name Property Use Property Zoning Application valuation 55000 Application desc REMODELING TWO RESTROOMS Owner Contractor PORT ANGELES WA 98362 1 4 36 TurrviA 'le (360) 417 6553 R A ngeles W 9 g 3( Structure Information 000 000 REMODEL TWO RESTROOMS 1 1197-5303 UNKNOWN (3641 Occupancy Type BUSINESS OFF /PRO /MED /REST Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 5 00 7 0000 THOU Other Fees Fee summary Charged Permit Fee Total 705 25 Plan Check Total 458 41 Other Fee Total 4 50 Grand Total 1168 16 Z /23/10 ockciao( Date Print Name T:Forms/Building Division/uilding Permit BUILDING PERMIT COMMERCIAL REMODEL TWO RESTROOMS 160739 705 25 2/23/10 8/22/10 BASE FEE BL -50 001 100K (7 00 C3\3i ‘to coy 01 E lectv-'C T.oc eiro:\ STATE SURCHARGE Plan Check Fee 458 41 Valuation 55000 Paid Credited 705 25 458 41 4 50 1168 16 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 or not. The granting of a p mit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performanc PER K) 00 00 00 00 f rction. Extension 670 25 35 00 4 50 Due 00 00 00 00 0,\ e-e \2 Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT 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 Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s Parking Lighting I Landscaping I T.Forms /Building Division /Building Permit 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 4831 Backflow Prevention Inspections 417 4886 S -V1-lo JLL- --3 I- t FINAL Date I FINAL Date SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 Accepted by Accepted by Date Accepted By A l7 Yt CbtnAlf cior phonc irrFo, �,e,1( pi-HA (:i CYQool' poRT Attn Building Permit Technician 321 E. Fifth St. Port Angeles WA 9836 i Y- (360) 417 -4815 fax (360) 417 -4711 \�j ac v Applicant Co (k -e Phone Property Owner WA reiliLlsvi4 t1ee e Phone Property Owner's.Address F tAurt cis 131.1 PA ,1n,1Pr *Contractor O A_�j 1 G. t i �L C I c. Phone Contractor's Addre' s g23e v ,rwcci -vr PA-, iiu pt q(R 363 License OLI pi( 415W,„ 'Expires 1126124a PROJECT ADDRESS CO L,,j Bi■td Parcel Number 0(0 3 0 I LI 12- 0 0 00 Lot Project Type Brief Description, Check all that apply 'New Construction Addition A Remodel Repair Demolition Re -roof Heat System Other Floor Areas Existing. (sq, ft.) Basement 1 Floor 2 Floor 3` Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures Site Coverage the mount of and other impervious urface Max. height of proposed Will a lawn sprinkler sys Will a fire sprinkler sys BUILDING PERMIT APP L1\ CITY OF PORT ANGELES 0 Residential o Multi- family Commercial Industrial j� P c, a 2 !i✓l d aI Y1C;.1 1 Cpl os I tab 2112 t2 S [mot LN 4 kA ate l ry tit 4.2. 1 v y House garage other tear off re -roof lay over one layer 0 Heat pump wood- burning stove o gas fireplace pellet stove other /1 ctures be installed? installed? Date_ Z.1 A NN to Print Name T Forms /Building Division /Building permit application i Proposed (ac, ft.) ft. sq ft. T Lot size ervious surface on a parcel inclu (see PAMC 17 94 135 for exemptio I have read and comp eted this application and know it to be true and correct. that if is my responsibility to determine what permits are required, and to obtain 1dL L_ 14 CI ing struct Occupancy gro Occupant Loa Constructio- type jermits poor to wor, Signature E -mail T 3 J ito TION Print in ink For City Use Only Date Received 1 10 Permit# 1.0 Date Approved Li( vc 3 8 3 ro J 3G�C Li 51- 53o J Zoning per sq ft. TOTAL VALUATION &5, OD l sq ft. Lot coverage s paved driveways sidewalks patios Site coverage of bedrooms of full baths of half baths l am authorized to apply for this permit and understand p1•jects Permit \O l 3 g P) 3 (10 LP— F'v i cam who --44 4 (1, 1 vim- v\ A .c n H 1 Z F. L I ai9 ge,v\ tub u c s a l c&oe,s h'-4- h Ste, o I vl 1 Forms /Building I ?ivisioni1Nc_tc NOTES Clallam County Assessor Treasurer Property Details 66786 WA PENINSULA COL Page 1 of 3 Clallam County Assessor Treasurer Property Search Results 66786 WA PENINSULA COLLEGE for Year 2010 2011 Property Account Property ID Values 66786 Legal Description LOT 2 EXC EASE NWNE 41 03A Geographic ID 0630141200000000 Agent Code Type Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 68 Open Space N DFL N Historic Property N Remodel Property N Multi Family Redevelopment: N Location Address. 1502 E LAURIDSEN BLVD Mapsco PORT ANGELES WA 98362 Neighborhood Exempt All Exmpt Reference Map ID Neighborhood CD 50110030 Owner Name WA PENINSULA COLLEGE Owner ID 57920 Mailing Address. 1502 E LAURIDSEN BLVD Ownership 100 0000000000% PORT ANGELES WA 98362 Taxes and Assessments Due Property Tax Information as of 02/09/2010 Amount Due if Paid on :M. Exemptions. EX First Second Half Half Statement Base Base Base Amount Year ID Taxing Jurisdiction Due Due Penalty Interest Paid Due 2009 667862008 ST SCH STATE SCHOOL $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 2009 667862008 CC -GEN COUNTY $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 2009 667862008 PORT PORT $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 2009 667862008 PORT ANG PORT ANGELES $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 2009 667862008 SD #121 SCHOOL DISTRICT #121 $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 2009 667862008 NTH OLY LIB NORTH OLYMPIC LIBRARY $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 2009 667862008 HOSP #2 HOSPITAL #2 $0 00 $0 00 $0 00 $0 00 $0 00 $0 00 2009 667862008 CITY_STORMWATER CITY STORMWATER $90 00 $90 00 $0 00 $0 00 $180 00 $0 00 2009 667862008 WEED CONTROL WEED CONTROL $3 48 $3 48 $0 00 $0 00 $6 96 $0 00 2009 667862008 TOTAL. $93.48 $93.48 $0.00 $0.00 $186.96 $0.00 NOTE If you plan to submit payment on a future date make sure you enter the date and RECALCULATE to obtain the correct total amount due Improvement Homesite Value N/A Improvement Non Homesite Value N/A Land Homesite Value N/A Land Non Homesite Value N/A Ag Timber Use Value Curr Use (HS) N/A N/A http. /vpn.clallam. net• 8084 /propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =66786 2/9/2010 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Door opener circuits Owner WA PENINSULA COLLEGE 1502 E LAURIDSEN BLVD PORT ANGELES WA 98362 (360) 417 6553 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS 162677 73 50 3/22/10 9/18/10 ELECTRICAL PERMIT CITY OF PORT ANGELES 360- 417 -4735 10 00000278 Date 3/22/10 741024 1502 BLDG D E LAURIDSEN BLVD 06 30 14 1 2 0000 0000 ELECTRICAL ONLY 0 Contractor ELECTRICAL ALTER COMMERCIAL OLYMPIC ELECTRIC CO INC 4230 TUMWATER PORT ANGELES (360) 457 5303 Plan Check Fee Valuation Qty Unit Charge Per 1 00 73 5000 ECH EL- BRANCH CIRCUIT WO /FEEDER Charged Paid Credited Permit Fee Total 73 50 73 50 00 Plan Check Total 00 00 00 Grand Total 73 50 73 50 00 Signature of owner or Electrical Contractor X DATE WA 98363 Due RESULTS Z 00 00 00 00 0 Extension 73 50 Date INSPECTOR. -1-4? Ter 03/22/2010 09 13 FAX 360 452 3498 City of Port Angeles Permit Application Building Division /Electrical Impactions 321 East Filth Street— P.O. Box 1150 Port Angeles Washington, 98362 Ph: (3601417.4735 Fax: (36014174711 Date: 3/2a/ t O Owvnerinfgyna8oq Name: Van A 5O /d £S /t yC Mailing Address; J So r Lot v a r, b Cs yJO City: State: 1.4/4 Zip: 3 Phone;jheARMEIFax: License Exp. Ail Charge 119.90 145.50 204.60 28220 372.50 2.60 S 73.60 2.80 5 92.70 110,30 148,70 167,00 95.90 5 88.20 95.90 63.90 3 63.80 119.90 3102.30 5110.30 5 35.20 73,50 110.30 5 56.00 gly Chock Date: 3 Olympic Electric Co PA CITY INSPECT a 001/001 RECEIVED MAR 2 2 2009 ELECTRICAL INSPECTIONS 1 2 Single Family Dwelling Mulli•Fam(ly or Commercial' Commercial Addition Alteration Remodel Repair` Plan Review May B R ulredijeaqe Complete ctr al Plan Revle Inform li on Sheet Job Address: r e V e) en cf 1/ p Building Square Footage: Description of above OXTei7) Ale i Oep i/ Contractor Informal a Name: Malin f City:; '9.r.... State: h ip/.r Zip Phone; x- Fax; e• License Exp. eyi„,y Total (Qtv Multiplied by Unit Cheri, Service /Feeder 200 Amp. 5 Service/Feeder 201 -400 Amp. 5 Service /Feeder 401.600 Amp. ServkelFeeder601 -1000 Amp. 5 Service /Feeder over 1000 Amp. 3 Branch Circuit W/ Service Feeder breach Circuit W/O Service Feeder Each Additional Branch Circuit 5 Temp. Service/ Feeder 200 Amp. Temp. Service/Feeder 201 400 Amp. 5 Temp. Service/Feeder 401.600 Amp. Temp. Service /Feeder 601.1000 Amp, Portal to Portal Hourly Slgn /Oulllne Llghung 5 Signal Circuit/ Limited Energy Commercial. AddtUonel 1500 35.00 5 Signal Circuit/ Limited Energy 1 2 Family Dwelling Signal Circuit/ Limited Energy MA-Family Dwelling Manufactured Home Connection Renewable Electrical Energy 5KVA System or Leae First 1300 Square Ft, Each Addlional 500 Square Ft, or portion of Each Outbuilding or Detached Geroge Each Swimming Pool or Hot Tub Thermostat 5J� Total Owner as defined by RCW.18.28.261 (1) Owner will occupy the structure for two years after this electrical permit la finalized. (2) Ownerls required to hire an electrical contractor N above said property Is for sale, rent or lease. Permll explree after alt months of last lnapecdon. After reading the above statement, I hereby certify that ram the owner of the above named property ora licensed electrical contractor. I am making the electrical Installation or alteration In compliance with the electrical Iowa, N.E.C. RCW. Chapter 19.28, WAC. Chapter 29848B, The City of Port Angeles Municipal Code, and Utility Specification. Signature of owner, electrical contractor or electrical administrator O Cash Credit Card* From:POWERCOM 5094354708 CITE' 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; 1113/15 x Multi - Family olr ammercial* 01/13/2015 09r30 * Plan Review May Be Required Please Complete Electrical Plan Review Information Sheet Job Address' 1502 East Lauri Bldg 0, Port Angeles, WA 98362 Building Square Footage: 15,000 Description of above f1333Jocations .... . f ". g a +"SAN 1,3 LEC'Tn o Mpreflof 0153 P.001/001 Owner Information Contractor Information Name: Peninsula College Name: PowerCom, Inc. Mailing Address'. 1502 Lauridsen Blvd port Angeles Mailingg�Address: 11824 North Creek Pkwy N. #103 City, Slate: WA Zip; City Eothell State: WA Zip, 98011 a Phone; 360,417.6500 Fax: Phone: 425 Fax; T(T9_,_435.47UF- License Al Exp. License#lExp. POWERC'937MJ / 7110115 Item Unit Charge Qtv Total (Qtv Multiplied by Unit Charge) ServicelFeeder 200 Amp. $ 132,00 $ Service /Feeder 201 -400 Amp. $160.00 $ Service /Feeder 401 -600 Amp $ 225,00 $ Service /Feeder 601 -1000 Amp. $ 288.00 $ Semite /Feeder over 1000 Amp, $ 410.00 $ Branch Circuit WI Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 74.00 $ Each Additional Branch Circuit $ 5.00 $ Branch Circuits 1-4 $ 86.00 $ Temp. Service! Feeder 200 Amp. $102.00 $ Temp. ServicelFeeder 201400 Amp. $ 121.00 $ Temp. ServicelFeeder 401 -600 Amp. $16400 $ Temp. Service /Feeder 601 -1000 Amp. $185.00 $ Portal to Portal Hourly $ 96,00 $ SignlOutfine Lighting $ 88,00 $ Signal Circuit/ limited Energy -- Multi - Family $ 64.00 $ Signal Circuit! Limited Energy 1 First 1500 sf -- Commercial $ 96.00 10 $ $141 00 Note: $5,00 for each additiora11500sf Renewable Electrical Energy - 5KVA System or Less $113.00 $ Thermostat $ 56,00 $ Note: $5,00 for each additional T -Stat $141.00 Total Owner as defined by RCW.19.28,261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, 'rent or lease. {permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C„ RCW. Chapter 19.28, WAC. Chapter 296.468, The City of Part Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: ❑ Cash ❑ Check 0 Credit Card #..,.,,.,.._ x >7�Z %'. !l n Bated: r2012 ;3' q t� W a$WA� ELECTRICAL INSPECTION URK5 >k WIRING REPORT 4 ��4%°;�J � DATE; j PERMIT# INSPECTOR OW ER CONTRACTOR aogR�s's APPROVED NOT APPROVED ...................DITCH ..........,.........I .......... ROUGH IN /COVER ...... . ........ C� <� ............ ........SERVICE................ ® ............. ........FINAL.................. CORRECTIONS NEEDED: NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS I, . ;. ELECTRICAL PERMIT CITY OF PORT ANGELES 360 -417 -4735 Application Number . . , . . 15- 40000036 Date 1/15/15 Application pin number . . , 738852 Property Address , . . . . . 1502 BLDG D E IAURIDSEN BLVD r /� ASSESSOR PARCEL NUMBER: 06- 30- 14 -1 -2 -0000 -0000- REPORT SALES TA X Application type description ELECTRICAL ONLY . , . . on your @XC15e tax form Subdivision Name Property Use . , , , , , , , to the City Of Port Angeles Property zoning . , . . , . , (Location Code 0502) Application valuation , , . , 0 Application desc 137 data lines Owner Contractor RESULTS: INSPECTOR: DITCH WA PENINSULA COLLEGE POWERCOM INC SERVICE 1502 E LAURIDSEN BLVD 11824 NORTH CREEK PARKWAY N PORT ANCELES 417-6553 WA 98362 BOTHELL {425} 459` 8549 WA 98011 �- __ -- - . ---- --- Permit , , , , ---------- ELECTRICAL - - - - -- - _______.__.. ALTER COMMERCIAL -_- -- 7� (/ Additional desc b Permit Fee . . . 141.Q0 Plan Check Fee .00 Issue Date , . , . 1/15/15 Valuation 0 Expiration Date 7/14/15 Qty Unit Charge Per Extension. 1.00 96.0000 ECH EL- LIMITED 1ST 1500 SQ FT 96.00 9. D0 5,0000 ECH EL -ADDNT LIMITED 1500 SQ FT 45.00 Fee summary Charged Paid Credited pue Permit .Fee Total 151.00 141.00 0p .oQ Plan Check Total 00 .00 .00 co Grand Total 7:41.00 141,00 ,Q0 ,Co it 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:IEXCHANGEIBUILDING �� s Application Number . . . . . 23-00000200 Date 2/28/23 Application pin number . . . 683000 Property Address . . . . . . 1502 BLDG D E LAURIDSEN BLVD ASSESSOR PARCEL NUMBER: 06-30-14-1-2-0000-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . PUBLIC BUILDINGS & PARKS Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ WA PENINSULA COLLEGE JOHNSON ELECTRIC COMPANY 1502 E LAURIDSEN BLVD 3129 S REGENT PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 417-6553 (360) 728-4327 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 202.00 Plan Check Fee . . .00 Issue Date . . . . 2/28/23 Valuation . . . . 0 Expiration Date . . 8/27/23 Qty Unit Charge Per Extension BASE FEE 86.00 4.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 20.00 1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 202.00 202.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 202.00 202.00 .00 .00 MULTI-FA MILY/ COMMERCIAL ELE CTRICAL PERMIT APPL ICATION Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:--------------------------------------­ Project Description:--------------------------------------□Multi-Family Residential D Commercial I Industrial/ Public Building Square footage: __________ _ OWNER INFORMATION Name: ________________________ Email: ______________ _ Mailing Address: ________________________ Phone: ___________ _ ELECTRICAL CONTRACTOR INFORMATION Name: License: ___________ _ Mailing Address: ________________________ Expiration Date: ________ _ Email: Phone: ___________ _ PROJECT DETAILS llim! 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 201-400 Amp. Temp. Service/Feeder 401-600 Amp. Temp. Service/Feeder 601-1000 Amp. Portal to Portal Hourly Sign / Outline Lighting Signal Circuit/Limited Energy -Multi-Family Signal Circuit/Limited Energy/First 1500 sf -Commercial (Note: $5.00 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5 for each additional) Unit Charge Quantity $132.00 $160.00 $225.00 $288.00 $410.00 $5.00 $74.00 $5.00 $86.00 $102.00 $121.00 $164.00 $185.00 $96.00 $88.00 $88.00 $96.00 $113.00 $56.00 Total (Quantity x Unit Charge) $ ____ _ $ ____ _$ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ _____ 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- 46B, 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] lJ CD PREPARED 2/27/23, 8:16:06 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:23-00000200 1502 BLDG D E LAURIDSEN BLVD FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER COMMERCIAL 202.00 TOTAL DUE 202.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS Wall Cover NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 4/6/2023 23-200 TAP OWNER CONTRACTOR Johnson Electric PROJECT ADDRESS 1502 E Lauridsen Blvd D ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS Ceiling cover 142-143-144-145-135-136-137-138-141-139 NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 6/6/2023 23-200 TAP OWNER CONTRACTOR Johnson Electric PROJECT ADDRESS 1502 E Lauridsen Blvd D ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS Ceiling cover 146-147-148-142-149 NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 6/26/2023 23-200 TAP OWNER CONTRACTOR Johnson Electric PROJECT ADDRESS 1502 E Lauridsen Blvd 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 6/29/2023 23-200 TAP OWNER CONTRACTOR Johnson Electric PROJECT ADDRESS 1502 E Lauridsen Blvd D