HomeMy WebLinkAbout1936 Village Cir - BuildingFire Permit
1936 Village Cir
12 -1611
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
RES FIRE SPRINKLER SYSTEM
Owner
JENSEN, KAREN D
276 DEER PARK RD
PORT ANGELES
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
WA 983626710
CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East 5t Street, Port Angeles, WA 98362
12- 00001611
756221
1936 VILLAGE CIR
06-30-13-5-7- 0250 -0000-
FIRE SPRINKLER SYSTEM
RESIDENTIAL HIGH DENSITY
2075
Contractor
Date 12/18/12
INNOVATED FIRE SPRINKLERS
81 NEW HAVEN LANE
PORT ANGELES
(360) 452 -7583
FIRE SPRINKLER RESIDENTIAL
RES FIRE SPRINKLER SYSTEM
.00 Plan Check Fee
12/18/12 Valuation
6/16/13
Charged Paid Credited
.00 .00 .00
.00 .00 .00
.00 .00 .00
WA 98362
Due
.00
.00
.00
.00
0
This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
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 recognized standards, laws and ordinances governing this type of work will be compled
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
theprovisions of any state or local law regulating the work specified in the permit.
U
Signature of Contractor or Aut
49 fi r 1 2/20//2
orized Agent Date Signature of Owner (if Owner is builder) Date
Inspection Type
Date Passed
Comments
FIRE SPRINKLER
0
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough -in inspection
Alarm final
LP -GAS
Completed by Contractor:
Test #1
Piping pressure test
psi
Underground piping inspection /pressure test
Above ground piping inspection/pressure test
Time initiated
Tank (container) inspection
Test #2
Piping pressure test
psi
Appliance inspection
LP -gas final
Time initiated
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Removal of flammable /combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final
FIRE PERMIT INSPECTION RECORD
Call 360- 417 -4655 for fire 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.
'At
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
GENERAL COMMENTS:
2/15/00
8025
FIRE -RELA TED PERMIT APPLICATION
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St., Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
Applicant `..A. c_sZ
Property Owner K._ P
Property Owner's Address
Contractor /A/A(0 y�j-� j ,1)n /N )<L. j,a Phone
Contractor's Address 2/ A /-e.w c e t..
License /A/4(Q 2/F," U y -119 Expires 8// E -mail
PROJECT ADDRESS 9 3 U; QS z C,` v c,1 23
Project Business Name 2 vL (g o °tA-S t i y d- t v--.`
Fire Alarm System
Check all that apply
One addressable loop
One zone
Additional zones
List quantity of additional zones
PROJECT VALUATION (labor materials)
Fire Sprinkler .System residential Multi- family
Check all that apply
Installing backflow protection device(s)?
yes ho
<2 inch water line (list.quantity of devices)
>2 inch water line (list quantity of devices)
PROJECT VALUATION (labor materials)
Hood Duct Fire Suppression System
Check all that apply
Will only the fire suppression system be installed or altered?
yes no
Will a hood and /or ductwork be installed or altered?
yes* no
If yes, a mechanical permit will also be needed.
PROJECT VALUATION (labor materials)
Residential Multi- family Commercial Industrial
Briefly describe the project:
Commercial
Briefly describe the project:
s -�r s 4-e
Residential
Commercial
For City Use Only:
Date Received /;'---J() -/:z
Permit
Phone L /S 2
Phone L I 71 c/ 66- 7
Multi- family
Industrial
Briefly describe the project:
Industrial
5, 9 36
1 have read and completed this application and know it to be true and correct. t am authorized to apply for this permit and understand
that it is my responsibility to determine I what permits are required, and to obtain permits prior t working on projects.
Date )2-1 /2_ Print Name U t, vtCt Q e Signature t
T:Forms /BuildinglFire- related permit application
PREPARED 4/01/13, 15:1121
PROGRAM BP521L
CITY OF PORT ANGELES
APPLICATION PROPERTY ADDRESS
STRUCTR PERMIT
INSPECTION HISTORY REPORT
0/00/00 THRU 0/00/00
ASSESSOR PARCEL NUMBER ALTERNATE ID
INSPECTION
12 00001611 1936 VILLAGE CIR 06-30-13-5-7-0250-0000- 063013570250
000 000 FSPK 00 FIRE SPRINKLER RESIDENTIAL FFNL 0001 FIRE FINAL 3/28/13 APPROVED
REQ COMM: March 28, 2013 93155 AM kdubuc.
RES COMM: March 28, 2013 95331 AM kdubuc.
000 000 FSPK 00 FIRE SPRINKLER RESIDENTIAL FFNL 0002 FIRE FINAL 3/28/13 APPROVED
REQ COMM: March 28, 2013 95300 AM kdubuc.
RES COMM: March 28, 2013 95319 AM kdubuc.
PAGE 1
RESULT DATE/STATUS INSPECTOR
KDD
KDD
Electrical Permit
1936 Village Cir
12 -1320
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
io 11b ii_
.R
7=K; I
SERVICE
1 Z (13
46;;)
°VW
ROUGH -IN
1 3
k
i 9
FINAL
311511 3
.4U
4 )1
COMMENTS:
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER,
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
New home
Owner
JENSEN, KAREN D
276 DEER PARK RD
PORT ANGELES
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
WA 983626710
12- 00001320
538120
1936 VILLAGE CIR
06-30-13-5-7- 0250 -0000-
ELECTRICAL ONLY
RESIDENTIAL HIGH DENSITY
0
Contractor
OWL ELECTRIC
PO BOX 536
CARLSBORG
(360) 582 -0833
ELECTRICAL NEW RESIDENTIAL
120.00
10/09/12
4/07/13
Qty Unit Charge Per
1.00 120.0000 ECH EL -R -SQFT FIRST 1300
120.00
.00
120.00
120.00
.00
120.00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
Plan Check Fee
Valuation
Paid Credited Due
.00
.00
.00
Date 10/09/12
WA 98324
.0
0
Extension
120.00
.00
.00
.00
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
DATE:
3 :7 l 3
PERMIT
11- -13 7_0
INSPECTOR
OWNER
CONTRACTOR
Larv�71z.1 G
ADDRESS
)1 J I L 1-4: 4 Ca' 0
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
DO NOT REMOVE
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER
SERVICE
FINAL
CORRECTIONS NEEDED: jr l 1151 4 j C 12-1 Apr L_. I
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
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: le 2
842 Single Family Dwelling
Plan Review a Be Req ire Please Comp to Electric l Plan�teview Information Sheet
Job Address: 1 -1 (,t9�i G' on" ituele --1
Building Square Footage: c
Description of above
Owner Information AIP
Name: 1'-Ilt u9 /4 t4c(�'
Mailing .dress: 2 40,5 S P /4 11e.ZS 9 t
City: State: l(9 i Zip: 3
Phone: I d Fax:
License 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 201 -400 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 CONSTRUCTION ONLY:
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Unit Charge
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
OCT 0 2 +i2
ELECTRICAL
INSPECTIONS
Contractor Informatio
Name:
Mailin Addr s r®` ®1C 3
City: 6B State Zip: »'3'
Phone: .7 8 33 Fax: ''‘IV
Exp. 0 UO L 0 0 I ti
Total (Qty Multiplied by Unit Charge)
120.00 17.V
40.00
74.00
$110.00
(2,r 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 Cod and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature gf own electr'lcal contras or electrical administrator:
Cash Check
y/(y Credit Card#
Dated: v 01/01/2012
Building Permit
1936 Village Cir
12 -251
k
Application Number 12- 00000251
Application pin number 342226
Property Address 1936 VILLAGE CIR
ASSESSOR PARCEL NUMBER: 06-30-13-5-7- 0250 -0000-
Application type description RES NEW SFR
Subdivision Name
Property Use
Property Zoning RESIDENTIAL HIGH DENSITY
Application valuation 107628
Application desc
1499 SF SFD W /ATT SINGLE CAR GARAGE
Owner
JENSEN, KAREN .D
276 DEER PARK RD
PORT ANGELES
.00 5.6000 THOU
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
4.00
1.00
.00
1.00
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
6.00
1.00
3.00
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
7.2500 EA
10.6500 EA
10.6500 EA
14.8000 EA
7.0000 EA
7.0000 EA
7.0000 EA
T:Forms /Building Division /Building Permit
WA 983626710
Contractor
OWNER
Permit BUILDING PERMIT RESIDENTIAL
Additional desc 1499 SF SFR W /ATTACHED GARAGE
Permit Fee 1065.05
Issue Date 8/16/12
Expiration Date 2/12/13
Qty Unit Charge Per
PLUMBING PERMIT
Plan Check Fee
Valuation
BASE FEE
BL- 100,001 -500K (5.60 PER K)
MECHANICAL PERMIT
1499 SF SFR
104.45 Plan Check Fee
8/16/12 Valuation
2/12/13
BASE FEE
ME -VENT FAN (SINGLE DUCT)
ME- HOOD /DUCT -MECH. EXHAUST
ME- STOVE /FIREPLACE /MISC. APP.
ME- HEATER(SUSP /WALL /FLOOR -MTD)
142.00 Plan Check Fee
8/16/12 Valuation
2/12/13
Date 8/16/12
692.28
107628
Extension
1065.05
.00
.0 0
0
Extension
50.00
29.00
10.65
.00
14.80
.00
0
Extension
BASE FEE 50.00
PL- PLUMBING TRAP 42.00
PL -WATER LINE 7.00
PL -DRAIN VENT PIPING 21.00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
Separate Permits are required forelectrical 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 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.
S//4 6e0CS CC) 'f' J Aig
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Inspection Type
Date
Accepted By
Comments
FOUNDATION:
Accepted By
Footings
417 -4735
Stemwall
Construction R.W.
Foundation Drainage Downspouts
417 -4831
Piers
Fire
417 -4653
Post Holes (Pole Bldgs.)
Planning
PLUMBING:
417 -4750
Under Floor Slab
Building
Rough -In
417 -4815
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
FINAL Date Accepted by
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:
FINAL Date Accepted by
Heat Pump Fumace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
SEPA:
ESA:
SHORELINE:
Inspection Type
Date
Accepted By
Electrical
417 -4735
Construction R.W.
PW Engineering
417 -4831
Fire
417 -4653
Planning
417 -4750
Building
417 -4815
PLANNING DEPT. Separate Permit its
SEPA:
ESA:
SHORELINE:
Parking Lighting
Landscaping
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
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.
Special Notes and Comments
March 9, 2012 11:04:43 AM tamiot.
Electrical service will be from pedestal at northeast corner
of property.
March 16, 2012 8:52:21 AM rbecker.
Open or closed system?
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.
All homes in new subdivisions that are outside of the Fire
Department four minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
March 14, 2012 1:19:31 PM sroberds.
The proposal will result in a new sfr w /att garage in the
RHD for total lot coverage of 30W and site coverage of 44%.
No land use issues anticipated.
All connections to City storm drain facilities require an
inspection by Public Works and Utilities Engineering prior
cover. Notice will be given 48 hours in advance of
commencing work. Public Works Inspection request line
417 -4831
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required. Public Works Inspection request line
k 417 -4831
Construct driveway to City Standards. Concrete with exposed
aggregate or other non standard finishes(including colors or
dyes)are not allowed in the City road right of way. Broom
finish only. An inspection by Public Works En
Y� P Y Engineering is
required prior to pouring concrete. Public Works inspection
request line 417 -4831
Application Number
Application pin number
Qty Unit Charge Per
1.00 15.0000 EA PL -SEWER LINE
1.00 7.0000 EA PL -WATER HEATER
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand'Total
T:FormsfBullding DivisionlBullding Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page
12- 00000251 Date
342226
RES UNDERGRND SERVICE_FEE
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
Charged Paid Credited
1311.50 1311.50 .00
692.28 692.28 .00
5294.50 5294.50 .00
7298.28 7298.28 .00
770.00
2260.00
4.50
2260.00
Due
2
8/16/12
Extension
15.00
7.00
.00
.00
.00
.00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
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
'or 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 permit does
pot presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Inspection Type
Date
Accepted By
Comments
FOUNDATION:
Accepted By
Footings
I�� =M.rq
R57It=1-7
4
417 -4735
Stemwall
Foundation Drainage Downspouts
Piers
PW Engineering
417 -4831
Post Hole;.(Pole Bldgs.)
Fire
PLUMBING:
FINAL Date Accepted by
Under Floor Slab
Planning
Rough -In
Water Line (Meter to Bldg)
/0-9- -(2.—
---k--t_.
Gas Line
Back Flow Water
AIR SEAL:
Walls
Ceiling
FRAMING:
dills', A4 kee-v.i. 7
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Stab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Fumace FAU Ducts
Rough -In
Gas Line
Wood Stove/ Pellet Chimney
Commercial Hood Ducts
FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY USE
SEPA:
ESA:
SHORELINE:
Inspection Type
Date
Accepted By
Electrical
417 -4735
Construction R.W:
PW Engineering
417 -4831
Fire
417 -4653
Planning
417 -4750
Building
417 -4815
PLANNING DEPT. Separate Permit #s
SEPA:
ESA:
SHORELINE:
Parking Lighting
Landscaping
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
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.
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 12- 00000251
Application pin number 342226
Property Address 1936 VILLAGE CIR
ASSESSOR PARCEL NUMBER: 06-30-13-5-7- 0250 -0000-
Application type description RES NEW SFR
Subdivision Name
Property Use
Property Zoning RESIDENTIAL HIGH DENSITY
Application valuation 107628
Application desc
1499 SF SFD W /ATT SINGLE CAR GARAGE
Owner
JENSEN, KAREN D
276 DEER PARK RD
PORT ANGELES
WA 983626710
Qty Unit Charge Per
BASE FEE
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
T:Forms /Building Division /Public Works Permit
Contractor
OWNER
Permit DRIVEWAY INSTALLATION
Additional desc DRIVEWAY INSPECTION
Permit Fee 55.00 Plan Check Fee
Issue Date 8/16/12 Valuation
Expiration Date 2/12/13
Permit PUBLIC WORKS RES WATER SERV
Additional desc 3/4" DROP IN METER
Permit Fee 420.00 Plan Check Fee
Issue Date 8/16/12 Valuation
Expiration Date 2/12/13
SANITARY SEWER HOOK UP
Date 8/16/12
0
.00
0
Extension
55.00
.00
107628
Qty Unit Charge Per Extension
1.00 420.0000 EA PW WATER METER DROP IN 420.00
Permit PUBLIC WORKS STORMWATER
Additional desc
Permit Fee 135.00 Plan Check Fee .00
Issue Date 8/16/12 Valuation 107628
Expiration Date 2/12/13
Qty Unit Charge Per Extension
1.00 135.0000 EA SAN SEW STM CON OTHER 135.00
150.00 Plan Check Fee .00
8/16/12 Valuation 107628
2/12/13
Extension
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
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
construc ion.
Signature of Contractor
uthorized Agent
3/
Date
Signature of Owner (if owner is builder) Date
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
YES I NO
PW UTILITIES (Engineering Division) ,s
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL
DATE
YES
NO
COMMERCIAL
DATE
ACCEPTED
YES
NO
CONSTRUCTION R.W. PW/
ENGINEERING 417 -4807
CONSTRUCTION R.W.
PW ENGINEERING
FIRE 417 -4653
FIRE DEPT.
PLANNING DEPT. 417 -4750
PLANNING DEPT.
BUILDING 417-
4815
BUILDING
T:Forms /Building Division /Public Works Permit
PERMIT INSPECTION RECORD
CALL 417 -4831 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
1
e .ORr a
IGJV
Application Number
Application pin number
Qty Unit Charge Per
1.00 150.0000 EA SAN SEWER HOOKUP
Special Notes and Comments
March 9, 2012 11:04:43 AM tamiot.
Electrical service will be from pedestal at northeast corner
of property.
March 16, 2012 8:52:21 AM rbecker.
Open or closed system?
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.
All homes in new subdivisions that are outside of the Fire
Department four minute response area shall be equipped with
residential fire sprinkler systems that comply with the
International Fire Code (IFC) and National Fire Protection
Association (NFPA).
March 14, 2012 1:19:31 PM sroberds.
The proposal will result in a new sfr w /att garage in the
RHD for total lot coverage of 30W and site coverage of 44%.
No land use issues anticipated.
All connections to City storm drain facilities require an
inspection by Public Works and Utilities Engineering prior
cover. Notice will be given 48 hours in advance of
cbmmencing Works Inspection request line'
417 -4831
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required. Public Works Inspection request line
417 -4831
Construct driveway to City Standards. Concrete with exposed
aggregate or other non standard finishes(including colors or
dyes)are not allowed in the City road right of way. Broom
finish only. An inspection by Public Works Engineering is
required prior to pouring concrete. Public Works inspection
request line 417 -4831
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
T:Forms /Building Division /Public Works Permit
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page
12- 00000251 Date
342226
RES UNDERGRND SERVICE FEE
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
Charged .Paid Credited
760.00 760.00 .00
.00 .00 .00
5294.50 5294.50 .00
6054.50 6054.50 .00
2
8/16/12
Extension
150.00
770.00
2260.00
4.50
2260.00
Due
.00
.00
.00
.00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
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
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
YES I NO
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
FIN 1L INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL
DATE
YES
NO
COMMERCIAL
DATE
ACCEPTED
YES
NO
CONSTRUCTION R.W. PW/
ENGINEERING 417 -4807
CONSTRUCTION R.W.
PW ENGINEERING
FIRE 417 -4653
FIRE DEPT.
PLANNING DEPT. 417 -4750
PLANNING DEPT.
BUILDING 41-7-
4815
BUILDING
T:Forms /Building Division /Public Works Permit
PERMIT INSPECTION RECORD
CALL 417 -4831 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
Applicant PLMLtLV k
Property Owner
Property Owner's Address
Floor Areas
Basement
15t Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
BUILDING PERMIT APPLICATION 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
uS tNG, I`1tt NOR-t'T(
'J
ii L•iia
Phone 36o —LfSa -763
Phone
021- CLEcE 9836a
Contractor OWntEfL 6u1 LO GIL 5 c.F t P •2*(p DP. M t
Contractor's Address
License
Y
Expires
Existing (sq. ft.) Proposed (sq. ft.)
3o$
39
8s
30
i s
E -mail
PROJECT ADDRESS 143t, VLLuta,>6' CiRe_c.E Pony Anoisc.e3, WA g836a
Parcel Number 010 3O" j3 S7 0 d SO Lot c S Zoning Rkk13
Project Type Brief Description; (Residential Multi family in Commercial Industrial
Check all that apply
XNew Construction CON STRUGTIOA/ c .F Sl 1•ic.E ET+3-.( R- tOEr.I -C
IA 15i'nLCtE C. 4 4L .14 (.31 I1442 -A2t.0
Addition
Remodel
Repair
Demolition
Re -roof A.House ta.garage other tear off re -roof lay over one layer
J-leat System Heat pump wood burning stove gas fireplace pellet stove other
in,Qther Pi c.. W #'-'6 /iSrt -TefL
per sq. ft.
TOTAL VALUATION 107, 1 o1-8
Total footprint of structures i gq, -1 sq. ft. T Lot size Lt`1 q9 sq. ft, Lot coverageg• Q q
Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalk patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage `ff. S
Max. height of proposed structures `1 ft. Occupancy group of bedrooms
Will a lawn sprinkler system be installed? I Occupant Toad of full baths
Will a fire sprinkler system be installed? "N Construction type of half baths
For City Use Only:
Date Received 7 3 12--
Permit
Date Approved
4 17, c10
r, a4o
4k,8
3
have read and completed this application and know it to be true and correct. t am authorized to apply for this permit and understand
that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects.
Date Print Name 0.Q..6 wt. f w true Siggne
T:FormsIBuilding DivisionlBuilding permit application
lino
S313ONb' 11d0d AO ALIO
Z[OZ 9 NVW
O 3 A 17 3 H
aNT
Ik
(A")
Unlimited
Group R -3
and R-4
Occupancies
Only
CITY GOVERNMENT
PRESCRIPTIVE APPROACH SIMPLE FORM
For the Washington State Energy Code (2006 Edition)
Climate Zone 1
Site Information:
Lot:. 41t. d2 .41/s UL,4
Address: 3 C /gel-
City: P02Fr /h/G fi-Eg
State: 6 1/4 Zip: S'1C
Contact: 9&A Con51 //3fl ilic 'oPPs,I
Phone: 36d- f 7 7- /9 y3
Phone 2: 36o //g-- 067 Y
FAX: 56° 4 i3 a (/4
Building Department Use Only:
Permit
Notes:
Table 6 -1
PRESCRIPTIVE REQUIREMENTS FOR GROUP R OCCUPANCY
CLIMATE ZONE 1
(Unlimited Glazing Option Only)
This Project complies with the following:
The project is a single- family residence or duplex.
The project is a wood frame OR all of the insulation is interior or exterior of the framing.
I All building components meet the requirements listed above.
The project will meet all other provisions of the WSEC and VIAQ.
The Project will take advantage of the following exceptions to the prescriptive option.
602.6 Exception 2. One unlabeled or untested exterior swinging door, 24 sq.ft. or less, may be
installed per unit for ornamental, security, or architectural purposes.
Location of the door taking this exception:
602.6 Exception 2. If a door is mostly glass, it should meet the requirement of the vertical
glazing U- factor listed above.
Location of the door(s) taking exception:
Type of Heat Source: f eig. �G`T2tC C,✓ Z /1- n/9-
a1,96 r A, P e eruc e. °S
T:Forms /Building Division /Prescriptive Approach Simple Form
P G a__ waif keid-ers
pp scant- Information
Permanent service:
Name and address of party
responsible for permanent
service billing?
Name:
Street:
City State ZIP:
Daytime Phone: Home Phone:
Contact Information
Site contact:
(if othP .h,.; 1 ••■■•e%
Name 06/1tc c e eo1 Title: pt'4 -A Co uST. ScvK
Daytime Phone: .34.0- 977- 360- 9/a 0079
Contractor
Name: OW Al4248u /LOf.? Company:
Daytime Phone:
Electrician:
Name: Company: 01.>/i-y )e CI)/ /2 /it/
Daytime Phone: 3G o s$ a 0773
Excavator:
Name: Company: C Y/ Ert eit✓Arod G i n/e-
Daytime Phone: 3GO G83 —77cf/
Project Type Existing 2<aW
M Single-family residence ❑Multi-family residence; of units
Commercial ❑Subdivision; of lots
Overhead service ❑General service
Underground service ❑Other:
Project Information Description of work: iteV/CE To A/ S /d6/€_ /_4,,,, /Ar 2£s /m S
Street address lot number:
/?36 VIIL44-£ CI i ci 2 2o1 2_,5" 11444Prce. M±-
Nearest cross street:
L-/A/D /3 EaG ROAD
Desired connection date:
Electrical transformer serving property is: on a pole on the ground
Electrical Load
Total square footage: sq. ft. Main disconnect size: 1P-C) O amps
20/240 1ph X120/208 3ph ❑277/480 3ph
Voltage: p
1 3/240 3ph 0480 3W 3ph Other
Standard residential to s (Lighting, refrigerator, dishwasher, washer)
Check all that apply: A/C ton) Enge /Oven Hot Tub
ff Dryer Heating Pumps Hp)
No Load Change Water Heater Elevator Hp) ❑Other
Supporting Documentation
Please provide a copy of the following:
*Detailed plot plan (.dwg or .dxf format mandatory for subdivisions).
*Electrical one -line drawing showing the service entrance panel and location.
*Connected load data.
*Size and locked rotor amps of all motors over 50hp.
Applicant's Signature: 75-- Date: a/o 3 AR
I
w
�KORRS b /lC
Please complete and return to Public Works Utilities Department
Electrical Information Form
Public Works Utilities Department (360) 417 -4700
City Electrical Inspector (360) 417 -4735
MAIL OR DELIVER COMPLETED FORM TO: 321 E 5TH STREET; PORT ANGELES, WA 98362
FAX TO: 360 417 -4711
Information form.xls
NI:IPWKS1f-IGH T ,FINGP11101
slfniorrr. form
WS
WF
F:e`,ike6 1-15-09
Option
Glazing
ru
Area
of Floor
Glazing U- Factor
Door 9
U- Factor
2
Ceiling
Vaulted
3
Ceiling
Wa11
Above
Wall- int
Below
Grade
Wall- ext
Below
Grade
s
Floor
Slab
on
Grade
Vertical
Overhead"
i
4a
Air Leakage Control and Efficient Ventilation
4b
Additional Air Leakage Control and Efficient Ventilation
R-49 or
Efficient Water Heating
R -21
R -21
6
Small Dwelling Unit
R -10
13%
0.34
0.50
0.20
R -38
R -38
Int
TB
R -10
R -30
2'
Adv.
R-49 or
R -21
R -21
R -10
On
25%
0.32
0.50
0.20
R -38
R -38
Int.'
TB
R -10
R -30
2'
Adv.
R-49 or
R -21
R -21
R -10
0111
Unlimited
0.30
0.50
0.20
R -38
R -38
Int.'
TB
R -10
R -30
2'
Adv.
r la
High Efficiency HVAC Equipment 1
1b
High Efficiency HVAC Equipment 2
lc
High Efficiency HVAC Equipment 3
2
High Efficiency HVAC Distribution System
3a
Efficient Building Envelope 1
3b
Efficient Building Envelope 2
3c
Super Efficient Building Envelope 3
4a
Air Leakage Control and Efficient Ventilation
4b
Additional Air Leakage Control and Efficient Ventilation
5a
Efficient Water Heating
5b
High Effieciency Water Heating
6
Small Dwelling Unit
7
Large Dwelling Unit
8
Renewable Electric Energy
Prescriptive Energy Code Compliance for Single Family and Duplex Housing: Zone 1
Project Information Contact Information
HACC Kay Kassinger
Peninsula Village
Popular 1152 Plan
Le t
This set of forms has been developed to assist permit applicants documenting compliance with the
Washington State Energy Code, (2009 edition). This set is for structures built under the IRC and located
in Climate Zone 1.
The following forms provide much of the required documentation for plan review. The details noted here
must also be shown on the drawings (WSEC 104.2).
This form is not a substitute for the energy code itself. To obtain a copy of the energy code,
go to the following web address. http: //www.energy.wsu.edu /code
See WSEC table 6-1 for footnotes
Glazing Schedule Attached to Document
0
El
Does not apply. (SEE INSTRUCTIONS) Using Prescriptive Option III. All glazing and
doors meet maximum U- factor. Alternate heating size method submitted.
Option I or II, Glazing to floor area limit (WSEC 602.7.2)
Area weighted window, skylight or door U- factor (WSEC 602.7.2)
As part of the heating system sizing calculation (IRC M1401.3 WSEC 503.2.2)
Radiant slab:
R -10 foam insulation, continuous with thermal break (WSEC 502.1.4.9)
Chapter 9 Options Total of 1 Credit Required
Total Credits
WSEC Prescriptive Worksheet (2010 edition) Zone 1
2603 South Francis Street
Port Angeles, WA 98362
*1200 kwh
1.0
1.00
WSUEEP10-010 Copyright 2010
Giazing•Schedule
Project Information
Peninsula Village
Popular 1152 Plan
Lbfi 2S
Exterior Doors
Plan
ID
Conditioned Floor Area
Sum of All Glazing Areas From Below
Glazing to Floor Area Ratio
Component
Description
3x5 Single Hung Window
2x4 Single Hung Window
0.340
0.340
WSEC Prescriptive Wodcaheet (2010 Edition)
1152
136
11.81%
Contact Information
HACC Kay Kassinger
2603 South Francis Street
Port Angeles, WA 98362
Sum of UA for Heating System Sizing
602.7.2 Exception Ratio (not to exceed 1%)
Door Percent Width Height Glazing Door Door
Ref. U- factor Glazed. Qt. Feet Inch Feet inch Area Area UA
Sum of Glazing Area, Door Area, and UA (do not include exempt door)
Area Weighted U UA/Area
Sum of Area and UA for Heating system size only (include exempt door)
Vertical Glazing (Windows, Glazed doors using Exception 602.6 #1)
Plan Component Glazing
ID Description Ref. U- factor
Width Height Glazing
Qt. Feet inch Feet inch
8
2
3
2
5
4
Sum of Area and UA
Area Weighted U UA/Area
I 54.2
20.0
1 40.0
4.0
0.20
8.0
Area UA
120.0
16.0
40.80
5.44
136.0
46.24
0.34
WSUEEP10-010 Copyright 2010
Garage Door
0.200
1
3
6
8
20.0
4.0
One Exempt Swinging Door 24 Square Feet
0.200
1
3
6
8
20.0
4.0
Giazing•Schedule
Project Information
Peninsula Village
Popular 1152 Plan
Lbfi 2S
Exterior Doors
Plan
ID
Conditioned Floor Area
Sum of All Glazing Areas From Below
Glazing to Floor Area Ratio
Component
Description
3x5 Single Hung Window
2x4 Single Hung Window
0.340
0.340
WSEC Prescriptive Wodcaheet (2010 Edition)
1152
136
11.81%
Contact Information
HACC Kay Kassinger
2603 South Francis Street
Port Angeles, WA 98362
Sum of UA for Heating System Sizing
602.7.2 Exception Ratio (not to exceed 1%)
Door Percent Width Height Glazing Door Door
Ref. U- factor Glazed. Qt. Feet Inch Feet inch Area Area UA
Sum of Glazing Area, Door Area, and UA (do not include exempt door)
Area Weighted U UA/Area
Sum of Area and UA for Heating system size only (include exempt door)
Vertical Glazing (Windows, Glazed doors using Exception 602.6 #1)
Plan Component Glazing
ID Description Ref. U- factor
Width Height Glazing
Qt. Feet inch Feet inch
8
2
3
2
5
4
Sum of Area and UA
Area Weighted U UA/Area
I 54.2
20.0
1 40.0
4.0
0.20
8.0
Area UA
120.0
16.0
40.80
5.44
136.0
46.24
0.34
WSUEEP10-010 Copyright 2010
Simlate Heating System Size: Climate Zone 1
Project lnformatlon
Peninsula Village
Popular 1152 Plan
Indoor Design Temperature
Outdoor Design Temperature
Design Temperature Difference (AT)
AT Indoor Outdoor Design Temp
Conditioned Floor Area
Conditioned Volume
Glazing
Copy Sum of UA from Glazing Schedule
Attic U- Factor
0.027
0.026
R-49
R -38 Advanced
Single Rafter or Joist Vaulted Ceilings
U- Factor X Area
0.027
R-38 Vented
Above Grade Walls
R -21
1
R -30
Sum of UA
Envelope Heat Load
Sum of UA X ST
Air Leakage Heat Load
((Volume X 0.6) X AT) X .018))
Building Design Heat Load
Air Leakage Envelope Heat Loss
Building and Duct Heat Load
Maximum Heat Equipment Output
Building and Duct Heat Loss X 1.50
WSEC Prescriptive Worksheet (2010 Edition)
281
1152
9216
541
X Area
1152
U- Factor X Area
0.056
0.029
1
Below Grade Walls U- Factor X
2' Depth Walls 0.042
3.5' Depth Walls 0.041
7' Depth Walls 0.037
1 1 1
Slab Below Grade F- Factor X
2' Depth 0.59
3.5' Depth 0.64
7' Depth 0.57
1 1 1
Slab on Grade F- Factor X
R -10 2' perimeter 0.54
R -10 Full Heated 0.55
1152
Floors U- Factor X Area
1152
Area
70
42
Length
Length
1
11
If ducts are located in unconditioned space: Sum of Building Heat Loss X 1.15
If ducts are located in conditioned space: Sum of Building Heat Loss X 1
150%
Contact Information
HACC Kay Kassinger
2603 South Francis Street
,Port Angeles, WA 98362
UA
30.0
UA
UA
64.5
UA
33.4
UA
UA
UA
182
7649)
41801
118291
11829
17744
Btu Hour
Btu Hour
Btu Hour
Btu Hour
Btu Hour
WSUEEP10-010 Copyright 2010
Ilf
l
V LJ E
S81 °31'09 "E
a
5
Sal A7'
35I 22'24 "it
P54 V1
CdJ fN OF c4- I4L1_4M
Pal �L 4(p -a9 13 5 2
P-1 N9J LA \/I Lt..,64 a LOT 25
co I419,7cf
9:2-oRy:eo 4 5-
30'/0
May 14, 2012
Nathan A. West AICP
Director
Community and Economic Development
City of Port Angeles
P.O. Box 1150
Port Angeles, WA 98362
Subject: Permit Application Refund Request
Dear Nathan;
Peninsula Housing Authority
Serving Clallam and Jefferson Counties
2603 S. Francis Street, Port Angeles WA 98362
(360) 452 -7631 Ext 41 (360) 452 -9468 Fax
Email: kkassinger(a�peninsulapha.orq
The Peninsula Housing Authority requests a refund of the following fees paid for the Peninsula
Village III building permit applications:
10 -676 1906 Village Circle
Building Permit
Fee $1,109.85
Mechanical Permit Fee $208.05
Plumbing Permit Fee $142.00
P W Res Water Sery Fee $420.00
Sanitary Sewer Hook up Fee $150.00
Public Works Stormwater Fee $135.00
Sewer System Delv Charge $1,980.00
PW Water System Use Fee $1,980.00
$6,124.90
Lot 15
10 -678 1005 Golf Course Road Lot 16
Building Permit Fee $1,042.65
Mechanical Permit Fee $208.05
Plumbing Permit Fee $142.00
Sanitary Sewer Hook up Fee $150.00
Public Works Stormwater
Fee $135.00
Sewer System Delv Charge $1,980.00
$3,657.70
ECsOdE
MAY 152012
C TY OF PORT ANGELES
Dept. of Community Development
egi EQUAL HOUSING OPPORTUNITY BARRIER FREE
10 -679 1015 Golf Course Road Lot 19
Building Permit Fee $1,042.65
Mechanical Permit Fee $208.05
Plumbing Permit Fee $142.00
Sanitary Sewer Hook up Fee $150.00
Public Works Stormwater
Fee $135.00
Sewer System DeIv Charge $1,980.00
PW Water System Use Fee $1,980.00
$5,637.70
10 -680 1920 Village Circle
Building Permit
Fee $1,065.05
Mechanical Permit Fee $208.05
Plumbing Permit Fee $142.00
P W Res Water Sery Fee $420.00
Sanitary Sewer Hook up Fee $150.00
Public Works Stormwater Fee $135.00
Sewer System DeIv Charge $1,980.00
PW Water System Use Fee $1,980.00
$6,080.10
10 -681 1924 Village Circle
Building Permit
Fee $1,042.65
Mechanical Permit Fee $208.05
Plumbing Permit Fee $142.00
P W Res Water Sery Fee $420.00
Sanitary Sewer Hook up Fee $150.00
Public Works Stormwater Fee $135.00
Sewer System DeIv Charge
PW Water System Use Fee
$1,980.00
51.980.00
$6,057.70
10 -682 1928 Village Circle
Building Permit
Fee $1,042.65
Mechanical Permit Fee $208.05
Plumbing Permit Fee $142.00
P W Res Water Sery Fee $420.00
Sanitary Sewer Hook up Fee $150.00
Public Works Stormwater Fee $135.00
Sewer System DeIv Charge $1,980.00
PW Water System Use Fee $1,980.00
$6,057.70
Lot 23.
Lot 21
Lot 22
EQUAL HOUSING OPPORTUNITY BARRIER FREE
10 -683 1932 Village Circle
Building Permit
Fee $1,065.05
Mechanical Permit Fee $208.05
Plumbing Permit Fee $142.00
P W Res Water Sery Fee $420.00
Sanitary Sewer Hook up Fee $150.00
Public Works Stormwater Fee $135.00
Sewer System DeIv Charge $1,980.00
PW Water System Use Fee $1,980.00
$6,080.10
10 -684 1936 Village Circle
Building Permit
Fee $1,065.05
Mechanical Permit Fee $208.05
Plumbing Permit Fee $142.00
P W Res Water Sery Fee $420.00
Sanitary Sewer Hook up Fee $150.00
Public Works Stormwater Fee $135.00
Sewer System DeIv Charge $1,980.00
PW Water System Use Fee $1,980.00
$6,080.10
Regards,
Di
Cc Annette Dotlich
assinger
or of Acquisiti s and Development
Lot 24
Lot 25
Driveway installation fees are not included in the request as they were not charged. I am not
certain if this is due to the drives accessing private streets or not. I have attached a copy of the
City receipts for each permit application used to calculate the request.
Thank you for your assistance and if you need any additional information, please do not hesitate
to contact me.
EQUAL HOUSING OPPORTUNITY BARRIER FREE
PREPARED 10/19/10, 16:51:10 PAYMENTS DUE RECEIPT
CITY OF PORT ANGELES PROGRAM BP820L
APPLICATION NUMBER: 10- 00000684 1936 VILLAGE CIR LoT 2-5
FEE DESCRIPTION AMOUNT DUE
PLAN CHECK FEES
'BUILDING PERMIT RESIDENTIAL
1MECHANICAL PERMIT
1 PLUMBING PERMIT
'PUBLIC WORKS RES WATER SERV
(PUBLIC WORKS STORMWATER
/SANITARY SEWER HOOK UP
-SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
/PW'WA'1'rt SYSTEM USE FEE
TOTAL DUE
692.28
1065.05
208.05
142.00
420.00
135.00
150.00
1980.00
4.50
i980.00
6776.88 V
Please present this receipt to the cashier with full payment.
PREPARED 4/01/13, 11:47:52
PROGRAM BP521L
CITY OF PORT ANGELES
APPLICATION PROPERTY ADDRESS
STRUCTR PERMIT
12 00000251 1936 VILLAGE CIR
000 000 BPR 00 BUILDING PERMIT
000 000 BPR 00 BUILDING PERMIT
06 -30
RESIDENTIAL BL1
REQ COMM:
REQ COMM:
RES COMM: September 1
RES COMM: ufr ok
RESIDENTIAL BL2
REQ COMM:
REQ COMM:
REQ COMM:
RES COMM: September 1
INSPECTION HISTORY REPORT PAGE 1
0 /00 /00 THRU 0 /00 /00
ASSESSOR PARCEL NUMBER
INSPECTION
ALTERNATE ID
RESULT DATE /STATUS
13 -5 -7- 0250 -0000- 063013570250
0001 BLDG FOUNDATION FOOTING 9/10/12 APPROVED
September 10, 2012 9:30:25 AM pbarthol.
Bruce 912 -0079
0, 2012 4:22:32 PM jlierly.
0001 BLDG FOUNDATION STEM WALL 9/12/12 APPROVED
September 12, 2012 8:43:56 AM pbarthol.
Robert 670 -5030
ssss +3 sssssss Pm ******sssss sssssssssssssssssssssssssssssss
2, 2012 3:48:12 PM pbarthol.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BFF 0001 BLDG FLOOR FRAMING 9/27/12 APPROVED
REQ COMM: September 27, 2012 8:59:32 AM pbarthol.
REQ COMM: bruce 912 -0079
RES COMM: September 27, 2012 4:15:40 PM jlierly.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BL9 0001 BLDG SHEARWALL 12/05/12 APPROVED
REQ COMM: December 5, 2012 8:30:33 AM pbarthol.
REQ COMM: Bruce 912 -0079
RES COMM: December 5, 2012 3:57:03 PM pbarthol.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BL3 0001 BLDG FRAMING 1/17/13 APPROVED
REQ COMM: January 17, 2013 9:43:54 AM pbarthol.
REQ COMM: Bruce 912 -0079
RES COMM: January 17, 2013 4:06:08 PM jlierly.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BAIR 0001 BLDG AIR SEAL 1/17/13 APPROVED
REQ COMM: January 17, 2013 9:44:04 AM pbarthol.
REQ COMM: Bruce 912 -0079
RES COMM: January 17, 2013 4:06:08 PM jlierly.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BLI 0001 BLDG INSULATION 1/22/13 APPROVED
REQ COMM: January 22, 2013 8:41:13 AM pbarthol.
REQ COMM: Bruce 912 -0079
RES COMM: January 22, 2013 4:33:48 PM jlierly.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BLDR 0001 BLDG DRYWALL IBWP 1/31/13 APPROVED
REQ COMM: January 31, 2013 8:51:01 AM pbarthol.
REQ COMM: bruce 912 -0079
RES COMM: January 31, 2013 4:22:56 PM jlierly.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL PW99 0001 PUBLIC WORKS FINAL 3/22/13 APPROVED
REQ COMM: March 22, 2013 11:49:16 AM rvess.
RES COMM: March 22, 2013 11:49:31 AM rvess.
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL FFNL 0001 FIRE FINAL 3/27/13 APPROVED
REQ COMM: March 28, 2013 9:54:19 AM kdubuc.
RES COMM: March 28, 2013 9:55:23 AM kdubuc.
RES COMM: fire final
INSPECTOR
JLL
PB
JLL
PB
JLL
JLL
JLL
JLL
RV
KDD
PREPARED 4/01/13, 11:47:52
PROGRAM BP521L
CITY OF PORT ANGELES
APPLICATION PROPERTY ADDRESS
STRUCTR PERMIT
INSPECTION HISTORY REPORT
0 /00 /00 THRU 0 /00 /00
ASSESSOR PARCEL NUMBER ALTERNATE ID
INSPECTION
PAGE 2
RESULT DATE /STATUS INSPECTOR
12 00000251 CONTINUED
000 000 BPR 00 BUILDING PERMIT RESIDENTIAL BL99 0001 BLDG FINAL 3/28/13 APPROVED JLL
REQ COMM: March 28, 2013 9:18:28 AM pbarthol.
REQ COMM: Bruce 912 -0079
RES COMM: March 28, 2013 4:26:14 PM jlierly.
000 000 DWY 00 DRIVEWAY INSTALLATION PW6 0001 PUBLIC WORKS DRIVEWAY 3/22/13 APPROVED RV
REQ COMM: March 22, 2013 11:49:00 AM rvess.
RES COMM: March 22, 2013 11:49:40 AM rvess.
000 000 ME 00 MECHANICAL PERMIT ME99 0001 MECHANICAL FINAL 3/28/13 APPROVED JLL
REQ COMM: March 28, 2013 9:18:43 AM pbarthol.
REQ COMM: Bruce 912 -0079
RES COMM: March 28, 2013 4:26:14 PM jlierly.
000 000 PL 00 PLUMBING PERMIT PL6 0001 PLUMBING WATER SUPPLY 10/09/12 APPROVED JLL
REQ COMM: October 9, 2012 4:08:33 PM jlierly.
RES COMM: October 9, 2012 4:09:04 PM jlierly.
000 000 PL 00 PLUMBING PERMIT PL2 0001 PLUMBING ROUGH -IN 12/11/12 APPROVED JLL
REQ COMM: December 11, 2012 8:30:19 AM pbarthol
REQ COMM: John 460 -6902
RES COMM: December 11, 2012 4:47:56 PM jlierly.
000 000 PL 00 PLUMBING PERMIT PL99 0001 PLUMBING FINAL 3/28/13 APPROVED JLL
REQ COMM: March 28, 2013 9:18:50 AM pbarthol.
REQ COMM: Bruce 912 -0079
RES COMM: March 28, 2013 4:26:14 PM jlierly.
000 000 PWSW 00 PUBLIC WORKS STORMWATER PW4 0001 PUBLIC WORKS STORM 9/27/12 APPROVED JMP
REQ COMM: September 27, 2012 3:42:16 PM jpozerni.
RES COMM: September 27, 2012 3:42:34 PM jpozerni.
000 000 SSHU 00 SANITARY SEWER HOOK UP PW2 0001 PUBLIC WORKS SEWER CONNEC 10/04/12 APPROVED RV
REQ COMM: October 5, 2012 7:38:00 AM rvess.
RES COMM: October 5, 2012 7:38:21 AM rvess.