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Home My WebLink About612 W 10th St - BuildingOF von,.' Application Number Pin number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Use Property Zoning Application valuation Owner WOOLMAN PATRICK C 612 W 10TH ST PORT ANGELES Structure Information Construction Type Occupancy Type Other struct info Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date Other Fees Fee summary Charged Permit Fee Total 46 70 Plan Check Total 00 Other Fee Total 4 50 Grand Total 51 20 T• \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 0337 WA 98362 03 00000706 612 W 10TH ST 06 30 00 0 3 2210 0000 RES ADDITION RS7 RESDNTL SINGLE FAMILY 20000 Contractor J R CUSTOM SON INC 141 PATRIOT WAY SEQUIM (360) 461 1911 357 SF ADDNT TYPE V NON RATED SINGLE FAM CONGREGATES HARD SURFACE AREA ELECTRICAL NEW RESIDENTIAL GARAGE PANEL O/H FROM HOUSE BLUE MOUNTAIN ELECTRIC 46 70 Plan Check 5/18/04 Valuation 11/14/04 46 70 00 4 50 51 20 00 00 00 00 Date 5/18/04 WA 983820136 Fee 00 0 Qty Unit Charge Per Extension 1 00 46 7000 ECH EL- R- OUTBD /DTCH GAR SEP 46 70 STATE SURCHARGE 4 50 Paid Credited Due 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 FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN 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 GAS LINE WOOD STOVE PELLET CHIMNEY HOOD DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 PLANNING DEPT 417 -4750 I BUILDING 417 -4815 I F \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 ACCEPTED COMMENTS YES 1 NO 1 c p1 44 SEPA. ESA. 1 1 7 SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE DATE YES NO COMMERCIAL DATE ACCEPTED YES 1 NO 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT I BUILDING Application Number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Zoning Application valuation Other Fees T• \PLANNING FORMS \1102.15 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Owner Contractor WOOLMAN PATRIC K C J R CUSTOM SON INC 612 W 10TH ST 141 PATRIOT WAY PORT ANGELES WA 98362 SEQUIM (360) 461 1911 Structure Information 357 SF ADDNT Construction Type TYPE V NON RATED Occupancy Type SINGLE FAM CONGREGATES 03 00000706 612 W 10TH ST 06 30 00 0 3 2210 0000 RES ADDITION 20000 Date 9/15/03 Fee summary Charged Paid Credited Due Permit Fee Total 64 90 64 90 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 69 40 69 40 00 00 WA 983820136 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc EXTEND MAST/ 4 CIRCUITS Sub Contractor BLUE MOUNTAIN ELECTRIC Permit Fee 64 90 Plan Check Fee 00 Issue Date 9/15/03 Valuation 0 Expiration Date 3/14/04 Qty Unit Charge Per Extension 1 00 64 9000 ECH EL -R OR RM 0 200 ALT SRV FDR 64 90 STATE SURCHARGE 4 50 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 1 0 BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING 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 FOUNDATION- FOOTINGS WALLS FOUNDATION DRAINAGE KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED 1 YES I NO 1 ELECTRICAL LIGHT DEPT 417 -4735 CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 PLANNING DEPT 417 -4750 BUILDING 417 -4815 T•\PLANNING \FORMS \1102.15 [4/2002] ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT 5t /77.4fT ROUGH -IN I 1 14 /TIO/✓ e,( fe&e Colo PLUMBING UNDERFLOOR /SLAB ROUGH -IN WATER LINE GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL WALLS ROOF CEILING DRYWALL T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP WOOD STOVE /PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING /LIGHTING ESA. LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES 1 NO sh /y fr,0 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING FIRE DEPT I PLANNING DEPT 1 BUILDING COMMENTS I 1 1 I I I I I I ~ s.. """'~ . CITY0F PORT ANGELES DEPARTMENT OF CO~ DEVELO~MENT - BUll..I}ING DI,VISION . . 321 EAST 5TH STREET, PORT ANGEtES,WA 98362 344.75 7/22/03 1/19/04, Plan Check Fee ,Valuation 137.90 20000 Application Number Property Address ASSBSSOR PARCEL' NUMBER: Application description Subdivision' Name Property Zoning'. . . Application valuation .:-:,tr}< 03-00000706 Date 612 W 10TH...ST. 06~30-00~0-3-2210~0000- RES ADDITION 7/22/03 20000 ~ \ Owner Contractor , . ------------------------ - - -'- --~.. --'- - .,;"- - - - - - _\.."-'- -- J R CUSTOM &. SON INC 141 PATRIOT WAY SBQUIM" " (360) 461-1911 ------ Structure Information 357 SF ADDNT ' Construction Type . . . ',' TYPB V NON-RATED OccupancY Type . . . . . . SINGLE FAM & CONGREGATBS wootm PATRICK. C 612 " '10TH ST PORT ANGELES WA 98362 WA 983820136 ------7--~~-~-~-~----------------------------------~---------~-------------- Permit .. . . Additional desc Permit Fee Issue Date ,'Expiration Date BUILDING PERMIT -RESIDENTIAL Qty unit Charge Per ~tension 92.75 252.00 BASE FEE 18.00 14.0000 THOU BL-2001-25K (14 PER K) Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 344.75 344.75 .00 .O{) Plan Check Total 137.90' 137.90 .00 .00 Other Fee Total 4.50 4.50 .00 .00, t Grand Total 487.15 487.15 .00 ' .00. ---------------------------------------------------------~-----------------'- Other Fees' . " ..... STATB$URCHARGB' 4.50 . Signature of Contractor or Authorized Agent Date ~);jl ~ Slgl1ature of Owner (if owner is builder) Separate~ermItf5are, required for electrical work, SEPA, Shoreline, E~A. utilities, private and public improvementi>.J~isp~rTlt,~coT~s null al1dvoId if work or construction authorized is notcommenc;edwifhin 180 days, if construction or work Issuspendedorabandcmsd for a period of 180 days after the work as commenced,.or.if.reQ41red Inspections have not been reqll~steq within 189 ~,iI~;,f!:Q.m,th.e,l~st InspectIon. ,I hereby certify that I have read and examined this application and, know the same to be true and qqlT~r.;t'i f\lliproyisions,of laws and ordinances governing this type of work will be complied WithwhE:l~er specified herein or not. The grantinQof a permit.~oeshot presume to give authority to violate or cancel the provisions pf any state or local law regulating constructionor,lhepeifofrr\aqceof construction. T:\PLANNING\FORMS\\\ 02.\ S [412002] r I I I "' "';;.,><:,.;'i,<,....,:..~. 0'"',i-','!"'-' ~'f.:, ,:,-,'";'\,,.,i, ';' "':Y'J~,~f?~~~:;:;~~,.~\'rt!'-jIfi!~';1f'~' , F~"':""" .. ~I i' BUlLDIl'lG P,E~.TJN~PECTI()N RECORD :, . , ,',; _ ,~ _: " " ". ,"', ,. > ';, ' ,',;- ,.::.",-:- ',;>,",-- ,;,-::' , .' _:.-,'-, -"':":: "",';:~,,:,~,,:-,,' C:;i;'7~8~~~i~D~~:i~~~~~~~iz.jk~EA=mf~~~g?~::g,~sWMgfJ~~' KEEP PE,~T CARD.-}tlD APPROVED PLA:NS .1,' JOB SItE ,,/ ..' "'~ " '. .' '., .y'....". INSPECTION TYPE DATE ACCEPTED , . " COMMENTS\..it, . NO . ..".'{"~' ....,.;'.;, YES , '.- ... . . ,.' FOUNDATION: - . ~...IJ-O~ 0 FOOTINGS .\ I WALLS FOUNDATION D~AGE '. e. ,'". '. . ,. ELECTRICAL . (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING '. : 't; .,'\ UNDER FLOOR I SLAB .' I ROUGH-IN, . . I WATER LINE I GAS LINE ." .. '" BACK FLOW I WATER ,',,". " .', '. ,. . ,.,' AIR SEAL WALLS 0" '. I CEILING --::- I "" FRAMING ( . ~ 1-1r.-()~ pl)-J~L. '. . ': ....~: JOISTS I GIRDERS SHEAR WALL .. r q,..... - . W ALI,.S l ~ooF I CEILING , ... ....~, ~r "j:., DRYWALL -::- ,',- I ,- '" T-BAR '.' INSULATION SLAB W ALLl FLOOR I CEILING 1c1_~ -D 7, ~, 1-. I I A - f] ;"''2,. /J.p 11 I,.. C', .1 :..J ~ , . . MECHANICAL HEAT PUMP i WOOD STOVEl PELLET I ClllMNEY HOOD I DUCTS I PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: -:- -:c- WATERLINE I METER ! SEWER CONNECTION i SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTING ESA: ! LANDSCAPING SHORELINE: c, - .. -, .- FlNAlTINSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE ... .' .. '; -.' R~IDE~TIAL DATE YEs NO -'~. COMMERCiAL' ~ D;\n:' ,; ..,. "ACCEPTED > '. .'", : " V," . f ' ',; ,,;' ~ '. . YES.". NO" ELECTRICAL - LIGHT DEPT.'; . ,-, - 417-4735 ,ELECTRICAL , " ..' ", . " ,-. LIGHT DEPT . - CONSTRUCTION R. W.' I PWI .d. :, . .. , , CONSTRUCTION-IlW. .... ENGINEERING 417-4807 PW I ENGINEERING , FIRE , .C' ., ,. -.-..~ 417-4653 FIRE DEPT. PLANNING DEPT. ' 417-4750 9'..mjr~~cl PLANNING'DEPT... , ~ .. II'J~ I'" /(>v .' '~.: ;: c' BUILDING 417-4815 BUILDING .,-"." .. -- T:\PLANNING\FORMS\1102.15 [412002] The Electrical Permit Application must be filled out completelv. FOR OFFICIAL USE 01'1L Y DatelRec. Permit#: Date Approved: Ddtelssued ~ . , I ,"( /" c~ ELECTRICAL PERMIT APPLICATION Please type or reprint in ink. If you have any questions, please call (360) 417-4735 Fax number: (360) 417-4711 )I~ 70b BL.LLIS V\-(ljJ. elerJr:c Property Owner: SAI0D1Z.4 ;;::A/,J(S~ Al - R.o5~ Address: " 17- I, J. / D'it, 'S -I- . City: Electrical Contractor: KhA ~ fU..!;. , Ii /.ed.~; t'. Address: ? D t>~ IL 3~ 10 I Phone: C,7tJ-QtLj;i- Fax: .51.;2.- 3~/3 Phone: . k . "7.,L License #: p,)/J.kI'1li:Jf? I Exp: 5e.gu )~ Zip: 5" Phone: City: Zip: "ff'3f Z- INSTAllATION WIRED BY: DOWNER ~lECTRICAl CONTRACTOR Credit Card Holder Name: PA if L fUll, LDo/ll A DD Biffing Address: 3 I ) w est lurnkrti/J/ ~ J~ .,.1:& Zip: Ira '(.;:;L VISA:-L MC:_ F'ROJECT.ADDRESS;! L. /2 w /D'1t, sf .S TYPE OF WORK: ~sidential Check all that apply: 0 New o Multi-family o Commercial o Mobile Home Sq. Ft 4C>D o Remote Meter Number of Circuits added or altered: o Detached garage 0 Hot Tub if o Swim Pool o Septic Pump o Low Voltage 0 Telecom. 0 Sign DESCRIPTION OF THE ELECTRICAL PROJECT: k 7lffilO .f~,z.0t!41' _ n?A5:r of Ot/UtM-75,j / "'I /1oa eo SHL5 -,.,LJ~~:-L Electrical Heat Load Additions and or Subtrac AzJ~ ~ _ ~. .1//,,/ ~m 6~L-_~ -&8LLJ_~ _/ /j;z.-'...$'L I hereby certify that I have read andexaminr-~t!'/:6:-t--~!~).LJ~ ~ true and correct, and I am authorized to apply for this permit. I underst._ - .. ... 1-tP/-tL,- . _ ~etermine what permits are required; it remains the applicants resPol~Z- ~O ~ 'red and to obtain such. Credit Card Holder's Si, hlttiJ 5 Date: '1- 9 - D 3 Service Information o Baseboard o Furnace o Heat Pump o Fan-Wall _KW KW TON KW Voltage: Phase: 0 1 Service Size: Feeder Size: o 3 LRA - Owner or Elec. Cant. Signature: ~AlP~'~ v03 D,~, q~(/o5 xf~ --; //16 Date: PERMIT FEE: $ltL/, 90 ;:ftJe..- I/..! (?6 1'7 c)".J Tho fcxF I PREPARED 10/07/03, 12:48:36 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 4 10/07/03 612 W 10TH ST J R CUSTOM & SON INC WOOLMAN PATRICK C 06-30-00-0-3-2210-0000- 03-00000706 RES ADDITION (360) 461-1911 SUBDIV: PHONE PHONE : PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 8/13/03 8/13/03 9/18/03 9/18/03 01 BL3 01 BAIR 01 9/22/03 9/23/03 9/22/03 9/22/03 BL3 02 BLI 9/24/03 9/24/03 10/07/03 01 BLI 02 JLL AP JLL DA BUILDING FOUNDATION FOOTING BUILDING FRAMING Framing inspection. Sandy Ross 808-4263 air seal top plate and j-box in exterior wall/sheathing right of bath room nails missed stud add nailer and renail closing air gap/jim BUILDING AIR SEAL JLL AP JLL AP BUILDING FRAMING Reinspect framing corrections Andy 808-4263 BUILDING INSULATION JLL AP JLL BUILDING INSULATION tt Owner requesting Sheetrock nailing and Ceiling insulation inspection PH# 808-4263 -------------------------- ----------- COMMENTS AND NOTES -------------------------------------- PREPARED 9/24/03, 9:53:40 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 2 9/24/03 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 612 W 10TH ST J R CUSTOM & SON INC WOOLMAN PATRICK C 06-30-00-0-3-2210-0000- 03-00000706 RES ADDITION SUBDIV: PHONE PHONE : (360) 461-1911 PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS 8/13/03 8/13/03 9/18/03 9/18/03 BL1 01 JLL AP JLL DA BUILDING FOUNDATION FOOTING BL3 01 BUILDING FRAMING Framing inspection. Sandy Ross 808-4263 air seal top plate and j-box in exterior wall/sheathing right of bath room nails missed stud add nailer and renail closing air gap/jim BUILDING AIR SEAL BAIR 01 9/22/03 JLL 9/23/03 AP BL3 02 9/22/03 JLL 9/22/03 AP BLI 01 9/24/03 I*f?- BUILDING FRAMING Reinspect framing corrections Andy 808-4263 BUILDING INSULATION Called in by Sandy Ross at 808-4263 for an Insulation inspection. -------------------------------------- COMMENTS AND NOTES -------------------------------------- "-.I PREPARED 9/22/03. 13:06:59 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 4 9/22/03 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 612 W 10TH ST J R CUSTOM & SON INC WOOLMAN PATRICK C 06-30-00-0-3-2210-0000- 03-00000706 RES ADDITION SUBDIV: PHONE PHONE : (360) 461-1911 PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 8/13/03 8/13/03 9/18/03 9/18/03 JLL AP JLL DA BUILDING FOUNDATION FOOTING BL3 01 exterior wall/sheathing stud add nailer and renail BL3 02 corrections len,(L - ~f PREPARED 9/18/03, 12:06:00 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 4 9/18/03 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 612 W 10TH ST J R CUSTOM & SON INC WOOLMAN PATRICK C 06-30-00-0-3-2210-0000- 03-00000706 RES ADDITION SUBDIV: PHONE PHONE : (360) 461-1911 PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 8/13/03 JLL BUILDING FOUNDATION FOOTING 8/13/03 AP BL3 01 9/18/03 JLL BUILDING FRAMING ~ Framing inspection. Sandy Ross 808-4263 ------------------ -- --------------- COMMENTS AND NOTES -------------------------------------- BUILDING DIVISION CITY OF PORT ANGELES * * Job Located at Correction Notice l{)+~ ~}IJ LJ Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: 4112 !J h~,~ . iiJNl +-1- * Sk",J-t,,'lU S --- --' 6, ?e-J-'f/ ~bJh f\A ('sspo ~--Lit J ;,ud ,s't-o,[) (JEl-i TL- ~P-f. ) I I These corrections must be ma and ar 'not to be covered until reinspection is d. Whe corrections have been made, please call - 117 - t/f/t? for inspec ion ~ Date } 181-cJ, ~,S"~~~~'i~:':3c/ DO NOT REMOVE THIS TAG /' CITY OF P()RT ANGELES DEPARTMENT OF PUBL.IC WORKS . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST: Date g -//- 0.3 v Time Received by /2\/ (phone, person) Location of Work to be inspected b /2 \}.J JD'i '1 Name of person '. requesting inspection ~ ~ r-o..... Address of person requesting inspection Type of Inspection (circle appropriate one): Sew Foundation Framing Chimney Plumbing Final Sewer Excav. ,Other ~b~ Phone No.Qt5)-illl Permit No. 7~ 6 INSPECTION NOTES: Inspected: Date Remarks: Time By RESTORATION REQUIRED. . .. .. YES NO SURFACE RESTORATION: SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC D Other D Repaired by City D Repaired by Permittee o No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENOENT< (OA TE) ",i">-::;-;:-;' ;<<";"":;<:'.'-l-V''-}'-:/-';' BUILDING PERMIT - APPLICATION o~ FOR OFFICIAL USE %L Y: Date~ec,: ~~,t; D~ PermIt #: Date Approved: Date Issued: The Building Permit application must be filled out completely. ~lCw::Ii'-.p "7. _0 ( J Please type or print in ink. If yo ve any questions, please call 417-4815 f'&-b\ 1 It o~ Applicant or Agent: ~ N ~ Phone: ~O. ~O'8. 4Z.LDO Owner:~-nzIck C. \rU:v\~ Address: uD'-\ W \0""" b\ Phone: Cit; ~ Q('\~\e~ zip:.98~ Architect/Engineer: Contractor ~~ ~ ~ Address: 4 \ PROJECT ADDRESS: lo\'2 W \D"1W,b\ LEGAL DESCRIPTION: Lot: 3 Block: ~Q;) Subdivision: I pA CLALLAM COUNTY PARCEL NUMBER: ()p Woo- ()~22\ [) Credit Card Holder Name: Billing Address: City: Credit Card #: Exp. Date: Phone: License #: City:~~QU\fn Exp: Phone:3Il>O~J /q J / zip:9'8?)&2 e1 ZONING: VISA MC TYPE OF WORK: SIZE~ ALUATION: ~l:}2 )d""'Residential 0 New Constr. 0 Re-roof 0 Wood-stove ~ro SF. @ $.~ ISF. = $ OO)C<:.X:> o Multi-family )2l"'" Addition 0 Move 0 Garage SF. @ $ ISF. = $ o Commercial 0 Remodel 0 Demolition 0 Deck SF. @ $ ISF. = $ o Repair 0 Sign 0 TOTAL VALUATION $cS:OJcro BRIEF DE. SCRIPTION OF THE ~~CT' ~.nq_2J2~hl2.cJ:":m6 0"\ SoUTII ~ ~ JDh O"\~ \P'L . COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: .-L Lot Size: ~D" \~ % Lot Coverage: ~ % Existing Lot Coverage: ,~ Isq. ft. + Proposed Lot Coverage: ,$5 ''iI,::,r I'q. ft. ~ TOTAL LOT COVERAGEjCo~..,\ ft. PLANNING USE ONLY: 7'" ...., APPROVALS: PLAN "',;',"_ ';c~'Jr' '~'"'.... Notes: BLDG. DPW FIRE ESAlWetland(s): 0 Yes ~ No SEPA Checklist required? 0 Yes 0 No Other: OTHER BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be filled out completely to be accepted for review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. 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 Coordinator at 417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other permit fees are dUe:: at the time' of permit issuance. ,,~ - '1;.f~;}- EXPIRATION OIr,PLAN REVIEW: If no permit is issued within 180 days of the date of application, this application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant(see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. ~ .' ~ . ,.'.,',>::.... I hereby certify that [hpve read and examined this application and know the same to be true and correct, and [am authorized to apply for this permit. I underst9hdit is not theCity'~'1egal responsibility to determine what permits are re~!!lred;jtremaifzs the applicant's respon,ibility to de/ermine .who/perlni" are required obi in ,nc .'t~:. ..; h \ 03 'f~\FORMSwiPS\Buildir~gpemiit . l' I II ~ r. . ~ B 50'" ,., '" " a ,..,. 2'-1 "'" " -2 '" ~ '" ~ I I " ~ ,+ =1= i , += I t--- ; +i- n i1/i' ~, p:: ;+ ,-:- 1=1= , ~-+ , -r-+- , I , , I t-+t i It:t:tJii '+H-i-H+ t-+- ,hi! : T , T T t- ! -r-+ ; "H -t- I, '--t =tttj+r I . i-+---t- ;:tI , H+ht t4=FFt; t--8 Ih~ '-+: - +-tJ t:: I +,' : :rr:: uI~ t t--+-H .*+ '~ ----r--H- : 1 ,-' + t:P=tt ! -r r- , .L ~ + ,T '+_~ 'IL i...:.+ --t-i ,-+- ;-- I :'~- ::;:+- I I I I -L I 1 . , .r ():l ,- n< !i , ~ .dl je7 I~ /h' ~ A' g... r- L- r. .- I (l a.:. h ,... 'l> I\::l I ,.... ~ j\j", '/ IJ IV -, 'Jl pZ ~ 1/ .\ .4 I (...., I I II I '~'. " 9'.5 1 '.1 " 5' " 4'~ "- j J \ IJ , ~t ! I -'k 1 I .... I -+ ,I ... 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