HomeMy WebLinkAbout1124 W 6th St - Building
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32] EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000602 Date
.794844
1124 W 6TH ST
06-30-00-0-1-5535-0000-
RES ADDITION
8/31/04
RS7 RESDNTL SINGLE FAMILY
36000
Owner
Contractor
SOMMERS III WILFRED A/DENAL
1124 W 6TH ST
PORT ANGELES
WA 983632008
K C CONTRACTING
P. O. BOX 2261
PORT ANGELES
(360) 452-4856
288 SF BEDROOM & BATH ADDNT.
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
HARD SURFACE AREA
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
WA 98362
Structure Information
Construction Type
Occupancy Type
Other struct info
11.60
V-N
1. 00
1341.00
14000.00
288.00
1629.00
1. 00
----------------------------------------------------------------------------
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
54.25 Plan Check Fee
8/31/04 Valuation
2/28/05
.00
o
'P
.:r..
1. 00
BASE FEE
7.2500 ECH ME-VENT FAN
Extension
47.00
7.25
1\~
~
~
.... (;0
:1
Qty
Unit Charge Per
----------------------------------------------------------------------------
Permit PLUMBING PERMIT
Additional desc
Permit Fee 68.00 Plan Check Fee .00
Issue Date 8/31/04 Valuation 0
Expiration Date 2/28/05
Qty Unit Charge Per Extension
BASE FEE 47.00
3.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 21. 00
C/)
'i-
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit Fee 525.85 Plan Check Fee
Issue Date 8/31/04 Valuation
Expiration Date 2/28/05
210.34
36000
11.00
BASE FEE
10.1000 THOU BL-25,001-50K (10.10 PER K)
Extension
414.75
111.10
Qty
Unit Charge Per
Special Notes and Comments
r...'\-.c:. ",." ..... ..
'J
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 orwork 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.
S;9~oC=Uilder)
f'5/;-01
Signature of Contractor or Authorized Agent
Date
Date
"\
T:\PLANNING\FORMS\1102.15 (11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 4] 7-48] 5 FOR BUILDING INSPECTIONS. CALL 4] 7-4735 FOR ELECTRICAL INSPECT]ONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BliFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS A T JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA T10N DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL I
WALLS
CEILING I I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERlOR 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 SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRlCAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003]
X VORT ~
$...O~~<\t
r'aii
"- -==-
~
'l.t\-;-vdP
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32] EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number . . . . . 04-00000602
pin number . . .794844
Page
Date
2
8/31/04
----------------------------------------------------------------------------
Special Notes and Comments
wells or piped to approved storm drain locations.
proposal will add 288 sf addition to sf res in RS-7.
Setbacks and lot coverage are good. No land use issues are
noted.
Electrical load calculations and elctrical permits are
required.
----------------------------------------------------------------------------
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 648.10 648.10 .00 .00
Plan Check Total 210.34 210.34 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 862.94 862.94 .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.
Date
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T:\PLANNING\FORMS\1102.15 [11114/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-48]5 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE 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
YES NO
COMMENTS
FOUNDATION:
FOOTINGS 10_ 1- OJ-} )lL
WALLS fcT - ~o,-i IT t.L
FOUNDA TION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
-=::::rii)-JiI_n;J I_I
?I I
CEILING
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DR YW ALL (INTERlOR BRACED PANEL ONL Y)
" r- -/L.., I
I I
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEA T PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
I O-/q~" J, L I
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANIT AR Y
STORM
PLANNING DEPT. SEPARATE PERMIT #'s
SEPA:
PARKING/LIGHTING
RESIDENTIAL
ESA:
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL
DATE
ACCEPTED
YES NO
LANDSCAPING
ELECTRlCAL - LIGHT DEPT.
417-4735
ELECTRlCAL
LIGHT DEPT
CONSTRUCTION - R.W.
PW 1 ENGINEERING
CONSTRUCTION R.W. 1 PWI
ENGINEERING
4] 7-4807
FIRE
417-4653
FIRE DEPT.
PLANNING DEPT.
417-4750
417-4815 77- ').1/ -(t')/-J I" .
PLANNING DEPT.
BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING
tJj
t'
H
tJj
t'
w
tJj
H
tv
tJj
:::
"'
,
,
,
,
,
,
i l:~gggg
: --~ ~ ~ ~ ~
, -'
1--'.('-...
J?fj 1;; fj 1;; fj
Ivt' t' t'
o
H
o
H
o
H
o
H
"''''
'-.'-.
00
W W
'-.'-.
00
......
~c.,
"'t'
t'
o
o
:;::
:;::
OJ
Z
>-3
en
tjttlw.td3 tIll..OC.jto~I"IjCjtJ:l
roc::oC::\llC:: OC::",OOC::
~H::rHrjH;:t::l~HI-30~H
PlL'::lr-'f';'L" ZL'tI:lt-3Zt""
t:l tJ 03: t:l::UHIt:!
.t>H.t:>H.t>H. H Z I H
UlZO'\ZO'IZ ZI-3G)IZ
WG)OG:lOG)HIG)~ .t:>(j)
I I I Z tI:ll'd CJ'\
NH....:J):oI...,JI'1jC/) l"1::1 :;dO"1.j
O'IZUlHIJl:;d"'O Ol"IjtIjlO
:f~~::U~~ri~~8~~~
L' C/) H>--30t:lt-3000t:l
~ ~~ZSO~~Z~~~
H L'I--' ZLnHG) H
o I--' roO H 0
Z ":rjl-'ZHZ Z
tJ" 0 zen
ro ::0 ~c/)'l:I I-r1
HI :t::<l-dtI:I 0
o I'd L'tI:lO 0
I'i ::u L'()t-3 H
CD tIj t-3H H
'"0 HO Z
r'- 0 0 Z G)
::> c:: >-3Z
Ul ::u H ttl
'd :;::~OJ
CD tI:ll-3t-3
n :>:
rT HOJ
1-" t-' -J tI:I
o -.J t-' Z
::l " 1..0
o '"
o ttl..
C::W
>-30
t'
~a
tJ
~
tJ
Z
o
>-3
OJ
en
H
o
o
o
~
:;::
0'
t<
>-"
>-3 'tl
~ ~
en >-<
o >-l
o
>-"
'" "'
'-. '-
00
H >-"
'-. '-
0<>
... .'
tJj
'tl
O",:<l
OOJ
:;::0
"'C::O
t'OJO
OJ en
>-3>-30:>
gltJ S
b
>-<
"' :z:
OJHG"l
enZ
c::en'tl
~'l:I~
>-<
>-l
"'tJl
OJ OJ
enen:<l
C::Ot>)
t'"'tIl
>-3H>-<
en"'tj
'()~tS
00::1
:;::Z>-<
ti1 ~
Z
>-3
en
~ C,
'" t<
t<
1;;~~8E;
",",zZtJ
t'OOJ>-3",
OJ ",",OJ
Zt' ~en
c:: oen
:;::. >-3
tJj 0
OJ . "' .
"'
COW?:......
.f:>.CJ'\O I-'
I I 2:: () I\J
QW:S: .t:>
o otI:J 0
o I ::u 0 ~
oOUJZ
00 1-:30'\
0'\ I H ~ t-3
OOH:t:>'~
WI HO
H >-3en
::u I ::;: H I-j
tI:1UlHZ
{J)U1L'G)
w",
~en",
tJ,OJ
tJOtJ
H 0
>-30~
H 0'-.
O'tJ
Z OJ
Z
~
t'
0'"
H",
>-3 OJ
><'"
~
0"'
",OJ
tJ
'"
OH
",0
>-3'-.
~~
<;)0
OJ'"
t'-
OJ
enH
tv
en
-J
en
o
",,,,en
66&1
zztJ
OJOJH
<
H
HZ
Zen
en",
"'OJ
OJO
0>-3
>-3H
00
",Z
c.,>-3
~~
OJ~
en OJ
>-3
t'
w
'"
o
t'
H
OJ
"'
t'
><
...
en
tv
,
...
CD
en
'"
tJ'"
~~
>-3<;)
OJ OJ
H
o
'-.
H
'"
'-.
o
......
LJ. to 3 to 1..0 ~ to )::i t't:l ~ t::l
OCOJC OC"lOOC
::YHl'iH~::r:Ht-30::r:H
:1r;>;"r. Zr[Tj>-lZt~
t::l t::l3: t::l~HIt::l
o&:>.Ho&:>.H' H ZIH
O'\ZO'\Z Zt-3GJIZ
OQOQH I Q::r: 0&:>. G)
I I Z ttj 'l:l 0'1
...:J)::i.....Jt't:lU) "Ij ~O"Ij
U1HU1~'l:l Ot't:ltI:lIO
~~~~~~~8~~~
{J) Ht-30t::lt-3000t:l
~~Z1o~~z~~~
t"-l....... ZU1HG:l H
l--' 000 H 0
l-Jj~ZHZ Z
o Z{J)
~ ~{J)'l:l
:>>"'[Tj
r[Tjn
rn>-l
>-lH
HO
OZ
>-lZ
H ttl
3::>>[Tj
[Tj>-l>-l
:>:
H[Tj
H-.J[Tj
-.JHZ
.. '"
o '"
o to..
CW
>-lo
r
f:J~
o
,
,
,
,
~: HHH
I 000
~'-.'-.
I 1--'1--'1--'
I 0&:>.1--'1--'
I ..............................
000
, ......
:.c-
I'~
~y :>> y
I r-''l:lt""'
, r r
,
,
,
,
,
,
,
,
,
,
,
n
o
3:
3:
[Tj
Z
>-l
(J)
~
o
Z
o
>-l
[Tj
(J)
ttl
:>>
H
"'
ttl
r
w
ttl
H
tv
o
H
o
H
o
H
"''''
'-.'-.
00
WW
'-.'-.
00
......
:>>y
"'r
r
tJ"
(])
H>
o
"
(])
'"
"'
[Tj
'"
o
C
"'
~.
:1
Ul
'0
(])
o
IT
~.
o
:1
H
o
o
o
:>>
3:
td
t;
>"
>-l 'tl
~ ~
(J) H
o >-l
o
>"
'" '0
'-. "
00
H >"
..........."... I
0<>
... "
Il:!
'tl
n",",
0[Tj
3:0
"'Co
r[Tjo
[Tj{J)
>-lo-'Jll:!
fH1S
El
H
"' 2:
[TjHl;'l
{J)Z
C{J)'tl
~~~
H
>-l
",01
[Tj[Tj
gji!l~
r",cn
>-lHH
{J)"'~
~~~
OO~
3:ZH
~ ~
Z
o-'J
(J)
:>> (<
'" t~
t~
"l
o
o
"3
H
Z5
:>>'Oon:>>
"':>>:>:00
",",ZZO
rn[Tj>-l",
",",",[Tj
Zr :>>{J)
C n{J)
:;0:. >-l
ttl 0
tI:I. ~.
"'
ooU)~1--'
0&:>.0'\0 I--'
I l3:nrv
ow3: ,&:.
oomn
o ~O~
ooC/)Z
00 t-30'\
0'\ I H ~ t-3
OOH~::r:
tv I H n
H o-'J{J)
~I :E;Ht-3
tIjUlHZ
C/)U1t"-lG:l
W"l
:>>en",
t:J , [Tj
000
HO
>-lo:>>
H 0'-.
0' 0
Z [Tj
Z
:>>
t"'
n'"
H",
>-l[Tj
><'"
:>>
0",
"l[Tj
o
'"
OH
",0
>-l'-.
~~
Glo
[Tj'"
t"'-
[Tj
(J)H
tv
...
en
...
W
"''''{J)
66~
ZZO
[Tj[TjH
<
H
HZ
Z{J)
{J)'"
'O[Tj
",n
n>-l
>-lH
00
",Z
y>-l
~;:;
[Tj;>:
{J)[Tj
o-'J
t"'
t"'
H
[Tj
"'
t"'
><
W
'"
o
...
en
tv
,
...
CD
en
'"
0'0
:>>:>>
o-'JGl
[Tj[Tj
H
o
'-.
H
...
'-.
o
...'"
1
:1"-<
1 t:-<
1 t:-<
1
1
1
1
Cl
o
Z
>-3
Z
c::
t>l
t:l
o
Z
>-3
o
Z
t>l
>:
>-3
'0
:t>
Q
t>l
~
S
tJj
t:-<
w
tJj
H
N
o
>-'
o
>-'
I.D \D \D IJ)
.................... ................,
00 00
W W I-' jo-"
.................... .................,
00 00
of:>. of:>. ,t:>.,r;..
:t>"-<
"'t:-<
t:-<
:;:I lJj \D Cj lJj )::> t'Ij C.j OJ
"'C:: OC::",OOC::
I'iH~::r:Hr-JO::r:H
;:>:;'~. Zt"ltrj.,Zt~
03: t:l~H t:1
,(:::. H' H Z I H
cnZ Z~G) I Z
o G') H I Q:r: of:>. G}
Z tzjlOm
-..J l'lj en I"Jj ::u 0 ":1
Ulid'1:l O'"IjtI:lIO
~~~~~8~~~
H.,Ot:!t--3000tj
~Z1o~~z~l-'~
....... ZUlHG) H
I-' 000 H 0
I-rjl-'ZHZ Z
o Z(J)
:::d ~C/)tO
:t>"'t>l
t:-<t>lCl
t:-<Cl>-3
>-3H
HO
OZ
>-3Z
H tJj
3::t>t>l
t>l>-3>-3
:€
>-'t>l
>-'-.Jt>l
-.J>-'Z
.. '"
o "'
o trI..
c::w
>-30
t:-<
~g
t:l
0-
m
....,
o
"
m
'0
:<l
t>l
'0
o
~
,....
:0
m
'0
m
()
IT
,....
o
:0
>-'
o
o
o
:t>
3:
01
t'
...
>-3 '0
~ ~
(J) H
10 >i
o
...
:t> c,
'0 t'
t'
tll
'tl
Cl:<l~
Ot>l
3:10
'Oc::o
t:-<t>lO
t>l(J)
>-3>-3tll
gHl S
e;
H
:<l :z:
t>lHQ
(J)Z
C::(J)'O
~'1:1~
H
>i
:<It:l,
t>lt>l
~~~
t:-<:<l(J)
>-3HH
(J)'Ot;!
'O~~
00::1
3:ZH
~ ~
Z
>-3
(J)
"1
o
o
"3
H
Z
Q
::;~~8E;
'O:<lZZt:l
t:-<Clt>l>-3:<l
t>l:<l:<lt>l
Zt:-< :t>(J)
c:: Cl(J)
3: . >-3
tJj 0
tr:I. :::0.
:<l
OO{J)~f-'
tt:>oO'\O I-'
I l3:nf'V
QW:S: of:>.
QotJ::I()
o I ::u 0 ~
ooooZ
00 1-30\
0\ I H::U 1-3
OOH)::>::r:
tv I H ()
>-' >-3(J)
:;dl ~HI-3
tI:lUlHZ
(J)U1t"lG)
w"'
:t>U1:<l
t;!I t>l
t:lot:l
HO
>-30:t>
H 0'-
01 t:l
Z t>l
Z
:t>
t:-<
Cl'O
H:<l
>-3t>l
><'0
:t>
O:<l
"'t>l
t:l
'0
0>-'
:<lo
>-3'-
~E.
Qo
t>l...
t:-<-
t>l
(J)>-'
N
w
o
U1
CD
"''O(J)
5551
ZZt:l
t>lt>lH
<:
H
HZ
Z(J)
(J)'O
"'t>l
t>lCl
Cl>-3
>-3H
00
:<lZ
"-<>-3
~8
t>l~
(J)t>l
>-3
t:-<
t:-<
H
t>l
:<l
t:-<
><
w
'"
o
...
U1
N
,
...
CD
U1
'"
t:l'O
:t>:t>
>-3Q
t>lt>l
>-'
o
'-
>-'
>-'
'-
o
"'U1
"l >-l 'tl :;;:;l~8Ei n"l
t< "" ~ H:d
.J 'tl "l:dZZt:l >-It>1
'- t<nt>1>-l:d ",,'0
Ul H tI:I~~tI:I ;l>
0 0 ... Zt< ;l>Ul O:d
,~ ji. nUl "It>1
>-l t:l
'tl tJj 0 '0
t" t>1. ",. OH
n", "' , ",0
0t>1 >-l'-
3:0 H
'OCo 00(/):;0;:1--' ~t::
t<t>1o "',,",0 H
t>1Ul , , 3:ntv Qo
>-l>-l'tl ow3: '" t>1'"
t>1t>1t" o atI:I 0 t<-
t:lt:l~ 0 , ",0:;; t>1
OOUl2: UlH
00 >-l""' tv
$ H ""' , H;d>-l
"' III OOH::P'::X:: W
t>1HQ tv , Hn 0
UlZ H >-lUl
CUl'tl ::u I ::E H ~ IJ1
~~~ tI:llTlHZ (p
Cf}\J1t:'"lQ
W"l
, H EiIJ1;d
, ... 't>1
, t:lot:l
, "l "'t:l HO
, t< t>1t>1 >-lop
, c. UlUl H 0'-
? cn 0 t:l
, tJj t<"' Z t>1
, Z >-lH Z
Ul"l ;l>
n Gl '->-l t<
0 nH H
3: ~, 00 HZ
3: 0 3:Z ZUl
t>1 c: 3: Ul'O
Z Gl t>1 'Ot>1
>-l ~: Z t>1n
Ul >-l n>-l
H Ul >-lH
~ Z 00
:dZ
t:l
c..,>-l
Z "3 ~~
0 H 'O"lUl
>-l 3: SS~ t>1?:
t>1 t>1 Ult>1
Ul ZZt:l >-l
t>1t>1H t<
" <:
_J t<
H
0 t>1
OJ W ;d
""' t<
0 ""
'"
IJ1
tv
,
'"
(p
IJ1
- ""'
..::::==:>
3- t:l'O
;l>;l>
>-lQ
t>1t>1
H
0
'-
H
H
'-
0
"'''"'
tp tp tp tp tp tp .., "0 ::;~~8~ n'tl
t" t" ;:: t" H t" >< ; H:<l
'" H W N H "0 'tl:<lZZO ..,t>1
'" :<l , t"nt>1..,:<l ><'0
m H t>1:<l:ut>1 :l'
0 0 0 0 0 0 10 .., Zt" :l'm O:<l
H H H H H H ~. nm "'t>1
.., 0
Il:l tp 0 '0
"0 t>1. :<l' OH
Jmm n:<l~ :<l :<lH
000000 "'''' "'''' 0t>1 .."
...................................................................... " ,..... 3:10 N
tvf-'f-'f-'t-'t-'I--' 00 00 'tlc::o OO(J)~f-' ~.::
~1.D1.D~.z:,.1-'1--' ww H H t"t>10 """'0 H
.......................................................................... " ,..... t>1m , , 3:nN Glo
0000000 00 00 ..,..,Il:l ow3: "" t>1""
~~.s:::..t::..:::.,t::..,t:. """" """" t>1t>1C:: ootI:l() t"-
OOH 0 , :<l0:>: t>1
e; OO(J)Z mH
00 ..,'" w
H '" , H:<l..,
-;;"'"'"'" :l'y :l'y :<l il!i OOH;p.~ W
t-t"dt'1'"Ot'1"Ot'1 'tlt" 'tlt" t>1HGJ N , Hn ""
t" t" t" t" t" t" mz H ..,m
c::m"O :<l :>:H.., ""
~tO; tI:!UlHZ '"
({)Ult"lGl
w'"
H ~"':<l
o-l 't>1
000
~ (f) b::l t:l b:l LJ. lJ:l 3 tI1 I.D L..i b::l )::> I'lj ~ b::l :<l0, HO
rooc::roc::oc::",c:: 0C::"'00c:: t>1t>1 ..,o:l'
::I3H;:1H:::rHI-iH~::r:HI-30::r:H gJ~~ H 0'
3 t" '" t"::l t",... t". Z t" t>1.., Z t" 0 , 0
ro 0 0 0 03: O:<lH 0 t":<lcn Z t>1
I-iH~Hol::>H,(::>.H' H Z , H ..,HH Z
UlZUlZO"IZO"IZ Z..,Gl Z m'tltl :l'
n G)ruQOG)OQH , Gl:I: ""Gl '..,~ t"
0 -.I I I I Z t>1'tl'" nH H
3: -.I ~NH..J~-']I'ljC/) '" :<lo", 00 HZ
3: '" HO"\ZUlHUl:::O'"O 0"'t>1 , 0 3:ZH zm
t>1 ~~~~~~:u~~~~~g~~~ 3: ~ m'tl
Z t>1 'tlt>1
.., ,l:>.lJ1t"l t'1 C/) HI-:30t::l1-30oo0 Z t>1n
m ON :l' tJjOZHI);>IHC:::I--');> .., n..,
"" , .., :l''''GlO-.l..,Z:<l .., m ..,H
~ H H t".... ZUlHG) H 00
H 0 .... 000 H 0 :<lZ
0 -.I Z I'yjl--'ZHZ Z
'" t1 0 Zm y..,
Z ro :<l :>:m'tl '" ~8
0 ...., :l''tlt>1 0 '0 'Om
.., 0 '0 t"t>1n 0 1313lii t>1?:
t>1 'i :<l t"n.., .., mt>1
m ro t>1 ..,H Z ZZO ..,
'0 HO t>1t>1H t"
". 0 OZ Gl <:
::l ~ ..,Z t"
rn H tp H
'd 3::l't>1 t>1
ro t>1..,.., w :<l
" :>: '" t"
rT Ht>1 0 ><
,,- H-.lt>1
0 -.1HZ
::l .. '" ""
0 '" '"
o trl.. N
c::w ,
"'0 ""
t" 00
~~ '"
'"
0
H
0
0
0 0'0
:l':l'
:l' ..,Gl
t>1t>1
3:
H
H
,
N
""
,
, 0
""H
"'
H
IV
o
H
l
-v
n
o
3:
3:
01
Z
>-l
rn
l.OC.jtJj~I-Jj~1Jj
OC:I"IjOOC~
~::r::HI-30::r::H
ZO-<01>-lZo-<
3: t:l::u H I t::l
H Z I H
Z ~ Q :;:~
H I G:l::r:: ,t:. G)
Z tI1'"d0'l
(j) "lj :u 0 "::1
"0 O"'IjtIjIO
~~~g~~~
1-30t:lt-30cot:l
o~~z~~~
ZUlHQ H
000 H ()
t-rj I-' Z H Z :<:~
o Zrn
::u ~ (f) '1:1 11:)
~'"dtIj 0
to t"itr:!o 0
::u t"' () 1-3 f-l
tIj I-3H H
'"d HO Z
o 0 Z G)
c::; >-lZ
'" H "'
3:)>01
01>-l>-l
:>:
Ht'l
H.....t'l
.....HZ
.. '"
o '"
o to..
c::;w
>-lo
0-<
~g
tJ
~
tJ
Z
o
>-l
t'l
rn
H
o
o
o
)>
3:
to
tc
>~
>-l '"
~ ~
rn H
10 >"l
o
>~
'" '0
'- "
00
H f~
tll
'"
n"'i<l
Ot'l
3:10
'OC::;O
o-<t'lo
t'lrn
>-l>-ltll
fH1S
e;
H
'" 21
t'lHQ
rnZ
c::;rn",
Si"O~
H
>"l
"'tJ,
t'lt'l
rnrni<l
c::;n~
O-<"'Ul
>-lHH
rn'Oo
?;-;j~
Oo:!
3:ZH
~ ~
Z
>-l
rn
00
'" "'
)> c~
'0 t~
t~
~~i18E;1
'0 ",ZZtJ
t""()tI1l-j::U
tI:l:::d:;dtI:l
ZO-< )>rn
c::; nrn
3: . >-l
"' 0
tIj. ::d.
'"
OO{J)~I-'
.f:>mO ......
I , 3: () t\)
ow3: P
OQtIj()
o :::oO~
00(1)2:;
00 1-30"\
0'1 H:::d1-3
OQH:J::-::r::
t0IH()
H ~rn
::u I ~ H 1-3
MlJlHZ
{J)lJ1L'G1
W"l
)>en",
tJ't'l
tJotJ
H 0
>-lo)>
H 0 '-
o , tJ
Z t'l
Z
)>
0-<
n'O
H'"
>-It'l
><'0
)>
0",
''It'l
tJ
'0
o
"''''
>-l'-
~~
G)o
t'l'"
0-<-
t'l
rnH
IV
w
w
o
en
'O'Orn
33iii
ZZtJ
t'101H
<:
H
HZ
Zrn
rn'O
"'01
O1n
n>-l
>-lH
00
"'Z
c...>-l
'~8
01;<
mOl
>-l
0-<
w
en
o
0-<
H
01
'"
0-<
><
'"
en
IV
'"
'"
en
en
tJ'O
)>)>
>-lG)
01t'l
'"
'-
o
w
'-
o
"'.....
OJ >-l '0 I :>>'Oon:>> n'O
I:""' >< ~ I '0:>>:>::00 H:<l
H '0 I 'O:<lZZO >-l",
'- I I:""'n",>-l:<l ><'0
W H I tIj~::U[1J :>>
0 10 >-l I 211:""' :>>W O:<l
H .. I ~. nw ",OJ
I >-l 0
IX! I OJ 0 '0
i '0 I OJ. :<l. 0
n:<l~ I :<l :<l'"
0"' I >-l'-
310 0
'OC::o OOC/);;:O;:f-' ?;::::
1:""'",0 "'""'0 H
",w , I 3ntv Qo
>-l>-l1X! ow3 "'" ",,,,"
"'"'e::: ootIj() 1:""'-
00>-< 0 :<l0:>:: "'
b oO(f)Z WH
00 >-l'" tv
~ >-< ~~~~~
:<l Z en
",HCi') tv Hn tv
wZ H >-lW
c::w'O ::UI ::EH~ 0
~~~ tI:lVlHZ -J
(J)V1r-'G)
w'"
>-< Ejen:<l
>-l I",
000
):>'"IjCjtri :<l01 H 0
"'OOC:: ",OJ >-lo:>>
~O::r::H gji!l~ H 0 '-
",>-lZI:""' 0 0
:<lHI 0 I:""':<lUl Z "'
21 Z >-lH>-< 21
>-lQI (JJ'OO :>>
n :I: ","Q '->-l~ I:""'
0 OJ"'''' nH H
3 :<lo", 00 HZ
3 ",OJ , 0 321>-< Zw
"' g~~~ 3 ~ w'"
21 "' '0"'
>-l t-30cnu 21 I ",n
W HC:!-'~ >-l n>-l
Z:<l >-l W >-lH
?;: Q H 00
H 0 :<lZ
0 HZ 21
Zw '-<>-l
Z W'" '" ~8
0 '0"' 0 ",'O(JJ
>-l ",n 0 i3i3@ "'"'
"' n>-l >-l W"'
W >-lH Z 21210 >-l
HO ",",H I:""'
021 Q <
21 I:""'
OJ H
:>>"' "'
>-l>-l w :<l
:>:: '" I:""'
H", 0 ><
-J",
HZ
'" "'"
'" en
OJ .. tv
c::w ~
>-lo
I:""' ro
f;J?;: en
'"
0
H
0
0
0 0'"
:>>:>>
:>> >-lQ
",OJ
3
'"
'-
0
H
'-
OH
","0
I r,r-.n r'\r'r?Tr"T A T T Tl'T: r\1'..H ~~.
1 VI'\.. Ul'j.l\.......u-\..L U0L:, Vl'l'Ll.
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COMPLETE to be accepted for review. Uyou have any questions, cal ~
PERMITS (360) 417-4815 FAX(360)417-4711
Date Rec.: ? -J:)- -01
fuflil:D'f - 66 2-
Date Approved: II/bioi
, I
Date lsslled:
BUILDING PERMIT - APPLICATION
t.:
\
Applicant or ~gent: C C!___ C! ..c~ ~q(C --tr ~ Phone: 3 c:;(")
Owner: ~ i (I ~ VlC( . ~ vr1 ~./' oS . Phone:
t:t- 0 A ( I If L
Address: ) 1:2 '-l uU ~ 'Sr City:' rO{~ r . vsc-k-:) ~-~
"-lc..,- '2 ,..., iLfA'S-C2.
Zip:
0'8% 3
Architect/Engineer:
Contractor ~<2. / (' .e(.,tv-~Q, ff-~
Phone:
State License #:
Exp:
Phone:
Address:
City:
Zip:
ZONING:
PROJECT ADDRESS:! ) ~ t.j LU G t;:h
LEGAL DESCRIPTION: Lot: 7 6- 83
CLALLAM COUNTY PARCEL NUMBER:
Block: J l.::JC;- Subdivision:
0(:3 cr::nO'- ~,1 ~-~ ~ cs-
Credit Card Holder Name:
Billing Address:
Credit CardType VISA MC #
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-roof
o Multi-family )'t Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
~ h->~
City:
Exp. Date:
o Stove
o Garage
o Deck
o Other
AJr-uJ ~ F3~ .p
SIZEN ALUATION:
71 ~ ~ SF.@$ /SF. =$ i5~~
SF. @ $ /SF. = $
SF. @ $ /SF. = $
19TAIr VALUATI?l1I $dE~ Oct
q.dof..., +1 ~'Yl (/J J Tb ~ vn;:U1S
COMMERCIALfRESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size: JJ../(Tot) Existing Sq. Ft. 13 ~ (
Total lot coverage I r . F
Occupant Load: Construction Type:
& Proposed Sq. Ft. 2g ~ = TOTAL Sq. Ft. / C "J. 0;
%
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
PLANNING USE ONLY:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with infOllllation on the application and
plan submittal requirements if you have questions.
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 Pennit Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building pennit application and construction plans are
submitted. All other pemlit fees are due at the time of pennit issuance.
EXPIRATION OF PL'AN REVIEW: Ifno permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the tinle for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, cunent edition). 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. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required ,not t~e City's, and tha ust obtain such permits prior to work.
Date: 7 -CJ -6 Y
T:\FORMS\APPS\B llildingpermit. wpd
"7 ashington State Energy Code
Plan Review Checklist
Applicant please Check, write in N/A, or fill in value on boxes or lines.
Project Address:-ll ~ 'i
.1h
UJ G~ -
f\l\
\.
Compliance Approach:(check one) 0 Systems analysis
o Component performance
.E\Prescliptive path
HEATING SYSTEM
'~one Heating
,
o Electric Fumace
DHeat Pump
FOUNDATION PHASE
o Slab R-_ Exterior down to u'ostline/slab bottom; Interior 24" horizontal or vertical; or, If radiant under entire slab
o Below grade exterior wall insulation: R- _ (If interior -see Insulation Phase)
FRAMING PHASE
~ Standard 0 Intermediate 0 Advanced
~Standard air seal: sole plate/sub floor; rimjoist; window & door frames; wires, plumbing, ducts, light fixtures
i(Source specific exhaust fans: bath & laundry(50 coo) kitchen(100 cfm)
o Whole house exhaust fan _ cun intemrittent system has manual & auto controls: Outdoor air supply reg. for habitable rooms
or
o Integrated forced -air system, fan _ cfm, outside air duct(with motor damper) allowing .35 and .5 ACH
INSULATION PHASE
o R-a Wall insulation(above grade)
o R-BWall insulation(below grade): Interior wall insulation
o R-~ Floor insulation
o R-3!1 Ceiling insulation: Including attic hatch
o R-_ Vaulted Ceiling insulation
o Vapor retarders: Walls, Ceiling: 0 4 mil poly )(perm rated paint Dkraft faced batts
o Vapor retarders: Floors: 04 mil poly J(,kraft faced batts
-p&.Ground cover: 6 mil Black polyethylene, 12" lap at joints & extending to foundation wall
T:\ROG ER\BLDG-FORMS-BROCHURESIEl'-.'ERGYPLANREVIEW
Over: Fill in back side also.
WINDOW GLAZING
Please fill out window information, inclued skylights, glass doors, and all other glazing on this form, Use rough opening area for calculations.
SIZE QUANTITY ARE~ U-VA UE & MANUFACTURER
5'~ 'x. ,2.. ~ :2 ;S S- tp L1' 11..-:. rI ~v1nA .. 3-;- u --I)C.,JII-e
,j
Total glazing area:
Total conditioned floor area:
Percentage of glazing:
DOORS
List doors by type(solid core, insulated, Etc.)quantity, U-value, and Manufacture,
SIZE QUANTITY AREA U-VALUE & MANUFACTURER
~
T J
T:\ROGERIBLDG-FO RMS-BROCH U RESIEN ERGYPLAN REVI EW-2
2000 EDITION
TABLE 6-1
PRESCRIPTIVE REQUIREMENTS 1 * * FOR GROUP R OCCUPANCY
CLIMATE ZONE 1 · HEATING BY ELECTRIC RESISTANCE
Glazing Glazing U-Factor Wall Wall- Wall- SIab4
Area 1 0; Door 9 Ceiling2 Vaulted Above int4 ext4 Floor5 on
Option
% of Floor Vertical Overhead 11 U-Factor Ceiling3 Grade Below Below Grade
Grade Grade
I. 10% 0.46 0.58 0.40 p...3~ R-30 R-2I R-21', R-lO R-3Q , R-I0
II. 12% 0.43 0.58 0.20 (R-38../ ...R-OO- -R ]9 g;::re- (R-.~f) . -R-Hl-
III. 12% 0.40 0.58 0.40 R--38 R-30' R-2] R-21 R-lO R-30 R-I0
IV.* ]5% 0.40 0.58 0.20 R-38 R-30 R-]9 R-19 R-lO R-30 R-IO
V. ]8% 0.39 0.58 0.20 R-38 R-30 R-2] R-2] R-I0 R-30 R-IO
VI. 21 % 0.36 0.58 0.20 R-38 R-30 R-2] R-2] R-lO R-30 R-lO
VII. 7 25% 0.327 0.58 0.20 R-38 R-30 R-19 R-2] R-lO R-30 R-lO
+ R-58
VIII.7 30% 0.297 0.58 0.20 R-38 R-30 R-]9 R-2I R-lO R-30 R-lO
+ R-58
* Reference Case
** Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601.1.
1. Minimum requirements for each option listed. For example, if a proposed design has a glazing ratio to the conditioned
floor area of 19%, it shall comply with all of the requirements of the 21 % glazing option (or higher). Proposed designs
which cannot meet the specific requirements of a listed option above may calculate compliance by Chapters 4 or 5 of this
Code.
2. Requirement applies to all ceilings except single rafter or joist vaulted ceilings. 'Adv' denotes Advanced Framed
Ceiling.
3. Requirement applicable only to single rafter or joist vaulted ceilings.
4. Below grade walls shall be insulated either on the exterior to a minimum level of R-lO, or on the interior to the same
level as walls above grade. Exterior insulation installed on below grade walls shall be a water resistant material,
manufactured for its intended use, and installed according to the manufacturer's specifications. See Section 602.2.
5. Floors over crawl spaces or exposed to ambient air conditions.
6. Required slab perimeter insulation shall be a water resistant material, manufactured for its intended use, and installed
according to manufacturer's specifications. See Section 602.4.
7. The following options shall be applicable to buildings less than three stories: 0.35 maximum for glazing areas of 25 % or
less; 0.32 maximum for glazing areas of 30% or less.
8. This wall insulation requirement denotes R-19 wall cavity insulation plus R-5 foam sheathing.
9. Doors, including all fire doors, shall be assigned default V-factors from Table 10-6C.
10. Where a maximum glazing area is listed, the total glazing area (combined vertical plus overhead) as a percent of gross
conditioned floor area shall be less than or equal to that value. Overhead glazing with V-factor of V =0.40 or less is not
included in glazing area limitations.
11. Overhead glazing shall have V-factors determined in accordance with NFRC 100 or as specified in Section 502.1.5.
Effective 7/01/01
37
\N,t.,SHINGTON STATE ENERGY CODE
TABLE 6-2
PRESCRIPTIVE REQUIREMENTS 1 * * FOR GROUP R OCCUPANCY
CLIMATE ZONE 1 . HEATING BY OTHER FUELS
, I I I I I I I I I I II
HVAC9 Glazing Glazing U-Factor Door '0 Vaulted Wall Wall- Wall- SIab6
Option Equip. Area": Overhead' U-Factor Ceiling2 Ceiling3 Above int4 ext4 Floors on
Effic. % of Vertical Grade Below Below Grade
2
Floor Grade Grade
I. Med. 10% 0.70 0.68 0.40 R-30 R-30 R-15 R-15 R-IQ R-]9 R-IO
II. Med. ]2% 0.65 0.68 0.40 R-30 R-30 R-]5 R-]5 R-IQ R-]9 R-IO
Ill. High 21% 0.75 0.68 0.40 R-30 R-30 R-19 R-19 R-I0 R-19 R-IO
IV.'" Med. 21 % 0.65 0.68 0.40 R-30 R-30 R-19 R-]9 R-IO R-]9 R-IO
V. Low 2] % 0.60 0.68 0.40 R-30 R-30 R-19 R-19 R-IO R-]9 R-IO
VI.7 Med. 25% 0.457 0.68 0.40 R-38 R-30 R-19 R-]9 R-IO R-25 R-IO
VII. 7 Med. 30% 0.407 0.68 0.40 R-30 R-30 R-]9 R-]9 R-IQ R-25 R-IO
VIII. Med. unlimited 0.25 0.40 0.40 R-30 R-30 R-19 R-]9 R-]O R-25 R-1O
* Reference Case
** Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601.1.
1. Minimum requirements for each option listed. For example, if a proposed design has a glazing ratio to the conditioned
floor area of 19%, it shall comply with all of the requirements of the 21 % glazing option (or higher). Proposed designs
which cannot meet the specific requirements of a listed option above may calculate compliance by Chapters 4 or 5 of this
Code.
2. Requirement applies to all ceilings except single rafter or joist vaulted ceilings. 'Adv' denotes Advanced Framed Ceiling.
3. Requirement applicable only to single rafter or joist vaulted ceilings.
4. Below grade walls shall be insulated either on the exterior to a minimum level ofR-10, or on the interior to the same level
as walls above grade. Exterior insulation installed on below grade walls shall be a water resistant material, manufactured for
its intended use, and installed according to the manufacturer's specifications. See Section 602.2.
5. Floors over crawl spaces or exposed to ambient air conditions.
6. Required slab perimeter insulation shall be a water resistant material, manufactured for its intended use, and installed
according to manufacturer's specifications. See Section 602.4.
7. The following options shall be applicable to buildings less than three stories: 0.50 maximum for glazing areas of 25% or
less; 0.45 maximum for glazing areas of 30% or less.
8. Reserved.
9. Minimum HV AC equipment efficiency requirement. 'Low' denotes an AFUE of 0.74. 'Med.' denotes an AFUE of 0.78.
'High' denotes an AFUE of 0.88. Minimum HV AC equipment efficiency requirement for heat pumps. 'Low' denotes an
HSPF of 6.35. 'Med.' denotes an HSPF of 6.8. 'High' an HSPF of7.7. Water and ground source heat pumps shall be
considered as medium efficiency and have a minimum COP as required in Table 5-7.
10. Doors, including all fire doors, shall be assigned default U-factors from Table 10-6C.
11. Where a maximum glazing area is listed, the total glazing area (combined vertical plus overhead) as a percent of gross
conditioned floor area shall be less than or equal to that value. Overhead glazing with U-factor ofU=0.40 or less is not
included in glazing area limitations.
12. Overhead glazing shall have U-factors determined in accordance with NFRC 100 or as specified in Section 502.1.5.
38 ~D1m1
Lot- ~
8'
B \ LL 4. DENA SOMMERS
\\ lAW. Co T~ ST.
Alle.f
10D'
Tl2 -ct
SC It:: \" ~ 2.0~ ~
5)1.~5:~~"'1 5~
12.'
;!J ~A~DN:,.' E~\ST.
~
~ ~ ST.
~
\
o
..r
L.t-:> S""~~
c..:k q .....'c
f ,ORT :'\\i
~~O~~...
~ha~
...~
----
~.,~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use . . . .
Property Zoning . . .
Application valuation
04-00000878 Date
.975512
1124 W 6TH ST
06-30-00-0-1-5535-0000-
ELECTRICAL ONLY
9/29/04
RS7 RESDNTL SINGLE FAMILY
o
<0
-+::.:
\
SOMMERS III WILFRED A/DENAL
1124 W 6TH ST
PORT ANGELES WA 983632008
ELECTRIC SERVICE
82 DRAPER RD
PORT ANGELES
(360) 452-6424
WA 98362
cP
~
~
Owner
Contractor
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 66.90 66.90 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 66.90 66.90 .00 .00
T\
r
~~ _.
~ N
.--.. ~
--
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit Fee 66.90 Plan Check Fee .00
Issue Date 9/29/04 Valuation 0
Expiration Date 3/29/05
Qty Unit Charge Per Extension
1. 00 66.9000 ECH EL-R OR RM 0-200 ALT SRV FDR 66.90
s
U\
l
<Y E;
~~
~
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 performa~e of
construction. '\
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4]7-4735 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 I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS /I
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # /""\ 4J..Y~-=-^ I(~ ~""'/"\ hJL(
ROUGH-IN IQ ,~c:; . {,If [f//(' I 1/-/2-04' DK-' ~...<"-,
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF I CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKlNGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
.n YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 11- (5-0'1 f/{K ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W. 1 PWI \ CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNINGIFORMS\1102.15 [11/14/2003]
"
., . ~......
OLf-~7q
ELECTRICAL PERMIT APPLICATION
The Electrical Permit Application must be filled out completelv.
f'OR O!'FJCJAL USE O~JL y
JJ~I.:f(n __.___~__.._____~
h,,,,,i\ p .. '._~___.
JMI~Alll'l"~cd ~
D~I~ h",tJ __.,_.___~
&rvy
Please type or reprint in ink. If you have any questions, please call (360) 417-4735
Fax number: (360) 417 -4711
Owner or Elec Contractor Agent E \ I! _e.JYIL- S60i CJl. '1:YIC... Phone:}-J 52- G'-i ;4 Fax:
~ J' L\ . .so 11) rn-<-x'';
Address 11 ~ L.f \A) 19 Clly ell
Electrical contractor:$~h-l0 .~;('\I\'('J, J [hC ~ Lrcense#: ?!-f-';~:r-m1'xp '/1''110.<::'
~':l.... ~v- '(Clift"!; f2JJ Clty_PA.
Property Owner:
Phone:
L.t D J... - f!" '-t 2_-7"
'i52-/l'/u
Zip 9~3 "^S
Phone 1.JS2- "lt~
Zip 9~3(.,'::l...
Address:
tNST ALLA TION WIRED BY:
o OWNER
~LECTRtCAL CONTRACTOR
Credit Card Holder Name:
Billing Address:
err\.
~.~~
Xp. ~a e:
. -----
Zip:
Credit Card Number:
VISA: MC:
TYPE OF WORK: ' Check i!1l that apply: ,NeW ~lteration/Addition
p\feSidential 0 Multi-family 0 Commercial 0 Mobile Home Sq, Ft
o Remole Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
Number of Circuits added,' or altered: 3
J.-f (j()
OJ~J
c:
..4.
J
'I:J
I. t l-t..-f
\A ). ~ ~
-"..
PROJECT ADDRESS:
o Low Voltage 0 Telecom.
o Sign "
o
\AJ \rV
_\..f"_~'V j 00
CL c~At..~ I O~
cliO n ~/
DESCRIPTION OF THE ~LECTRICAL PROJECT:
Electrical Heat Load Additions and or Subtractions
Service Information
o Baseboard
::::J Furnace
::J Heat Pump
"'!fan-Wall
_KW
KW
TON LRA
4KW~
~ Overhead Service
o Temp Service
o Underground Service
Voltage: 1'20 I::JYtl
Phase: ,1; 1 0 3( ",:'
Service Size: ;1...ooA
Feeder Size:
IR '!h)sp:>,e...lVj..(? e... :5 (~ Cr- <of.- '5 Ve... ill I R G- O~ C13 0 T pCZG7T, '=e.""!)
, hereby'certify that I:have read and examined this application and know that same to be true and correct, and I am
3uthorized to apply for this permit. I understand it is (1Ot the City's legal responsibility to determine what permits
3re required, it remains the applicants responsibility to determine what permits are required and to obtain such.
Date: 0; /J.f I 0 ~
.
Date: CJ/~8"J 'OJ
. , Credit Card Holder's Signature:-.fJ(~....c(7Il u.vJ
V 'i' ~~1fl>\oi OW""" ""' 00"' "'""'" VC!tM 7J (j' ~
~, PERMIT FEE: $ 67, TCJ
::/ELECTRICALPERMIT APPLICATION