HomeMy WebLinkAbout222 W 12th St - BuildingPREPARED 11/08/10 8 08 48 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 11/08/10
ADDRESS 222 W 12TH ST SUBDIV
TENANT NBR KENNETH NORMAN JACOBSON
CONTRACTOR THURMAN SUPPLY PHONE (360) 457 8591
OWNER KENNETH NORMAN JACOBSON PHONE (360) 775 7786
PARCEL 06 30 00 0 3 7830 0000
APPL NUMBER 10 00001307 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESUL RESULTS /COMMENTS
ME99 01 11/08/ fli
MECHANICAL FINAL TIME 01 00
November 5 2010 1 40 17 PM permits
ERIC 775 7786
MECHANICAL FINAL HEAT PUMP
AFTERNOON
COMMENTS AND NOTES
Date
Owner
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Permit Fee Total
Plan Check Total
Grand Total
T:Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
INSTALL A PELLET STOVE
KENNETH NORMAN JACOBSON
1003 S L ST
PORT ANGELES
(360) 775 7786
Qty Unit Charge
1 00
Fee summary
10 6500 EA
WA 983635319
MECHANICAL PERMIT
INSTALL A PELLET STOVE
177022
60 65
11 /05 /10
5/04/11
Per
Charged
60 65
00
60 65
10 00001307
160068
222 W 12TH ST
06 30 00 0 3 7830 0000
KENNETH NORMAN JACOBSON
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
3464
Contractor
THURMAN SUPPLY
1807 E FRONT ST
PORT ANGELES
(360) 457 8591
BASE FEE
ME STOVE /FIREPLACE /MISC APP
Paid Credited
60 65 00
00 00
60 65 00
Print Name Signature of Contractor or Authorized Agent
Date 11/05/10
WA 98362
Plan Check Fee 00
Valuation 0
Due
Extension
50 00
10 65
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 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 r not. Th granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regu constr tion or the performance of
construction.
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
Signature of Owner (if owner is builder)
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.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION.
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date
MANUFACTURED HOMES.
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
T:Forms /Building Division /Building Permit
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
FINAL Date Accepted by
Date
11 off 10
Accepted by
Accepted By
Applicant
Property
Property
Contractor
Contractor's
License
Parcel Number
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
//1v t i/I rit
Owner ,JQ /r (7 6 oSa�i
Owner's Address
Address
PROJECT ADDRESS
Expires
I !%I /A. G^.41,-7 S 1 5 5:e
/7 f
Project Type Brief Description. Residential
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
Re -roof
4 -leat System
Other
T Forms /Building Division /Building permit application
Multi- family
Phone
Phone
Phone
E -mail
Lot
For City Use Only
Date Received 1 -(0
Permit 1So'
Date Approved
_9/
7 7 2 7 �0
Zoning
Commercial Industrial
House garage other tear off re -roof lay over one layer
Heat pump wood- burning stove gas fireplace A stove other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq ft.
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION ,Y/ 5 7
Total footprint of structures sq ft. T Lot size sq ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel including structures paved driveways sidewalks patios
and other impervious surfaces (see PAMC 17 94 135 for exemptions) Site coverage
Max. height of proposed structures ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be installed? Construction type
I have read and completed this application and know it to be true and correct. I am authorized to appl
that it is my responsibility to determine what its are required, and to obtain permits prior to work'
Date g— J() Print Name a z' 'ct N c e /i)/ Signature
of bedrooms
of full baths
of half baths
r this p
projec,
it and understand
Clallam County Assessor Treasurer Property Details 59960 KENNETH NORMAN Page 1 of 6
Clallam County Assessor Treasurer
Property Search Results 59960 KENNETH NORMAN JACOBSON for Year 2010 2011
1 Property
Account
Property ID
Geographic ID
Type
Tax Area:
Open Space.
Historic Property
Multi Family Redevelopment: N
Township
Range.
Location
Address: 222 W TWELFTH ST
PORT ANGELES WA
Neighborhood:
Neighborhood CD
Owner
Name.
Mailing Address.
59960
0630000378300000
Real
0010
N
N
Amount Due if Paid on.
Cycle 5 Res
10955130
Taxes and Assessment Details
Property Tax Information as of 11/05/2010
Year Statement IDs Taxing Jurisdiction
2010 42841 ST SCH STATE SCHOOL
12010
2010
2010
1 2010 42841
2010 42841
2010 42841
42841 COUNTY
42841 PORT PORT
42841 PORT ANG PORT ANGELES
2009 599602008
2009 599602008
1 2009 599602008
2009 599602008
2009 599602008
PA 121 PORT ST CNTY H2 L Land Use Code
DFL
Remodel Property*
KENNETH NORMAN JACOBSON
1003 S L ST
PORT ANGELES WA 98363 -5319
SD #121 SCHOOL DISTRICT #121
NTH OLY LIB NORTH OLYMPIC LIBRARY
HOSP #2 HOSPITAL #2
2010 42841 WSMET PK DIST WILLIAM SHORE MET PARK DIST $11 50
2010 42841 CITY_STORMWATER
2010 42841
CITY STORMWATER
WEED CONTROL WEED CONTROL
2010 42841 TOTAL.
ST SCH STATE SCHOOL
CC -GEN COUNTY
PORT PORT
PORT ANG PORT ANGELES
SD #121 SCHOOL DISTRICT #121
12009 599602008 NTH OLY LIB NORTH OLYMPIC LIBRARY
Legal Description
Agent Code
Section.
Mapsco
Map ID
Owner ID
Ownership
Exemptions:
$0 82
$794.07
$189 19
$95 75
$13 56
$210 02
$233.95
$27 82
LOT6 BL 378
11
N
N
2
32518
100 0000000000%
NOTE If you plan to submit payment on a future date make sure you enter the
click RECALCULATE to obtain the correct total amount due.
First 'Second
Half Half
Base Base
Amt. Amt. Penalty i Interest 1 Base Paid p
$165 45 $166 $0 00 $0 00 6 630 90
$88 06 $88 04 $0 00 $0 00 $176 10
$12.38 $12 37 $0 00 $0 00 $24 75
$203 85 $203_87 $0 00 $0 00 $407 72
$214 31 $214 30 $0 00 $0 00 $428.61
$25 $25 $0 00 $0 00 $51_17_
$36 12 $36 12 $0 00 $0 00 $72.24
$11 49 $0 00 $0 00 $22 99
$36 00 $36 00 $0 00 $0 00 $72.00
$0 81 $0 00 $0 00 $1 63
$794.04 M $0.00 $0.00 $1588.11
$189 19 $0 00 $0 00 $378 38
$95 74 $0 00 $0 00 $191 49
$13 56 $0 00 $0 00_ $27 12
$210 00 $0 00 $0 00 $420 02
$233 99 $0 00 $0 00 $467 94
$27 82 $0 00 $0 00 $55 64
http. /vpn.clallam.net.8084 /propertyaccess /Property aspx ?cid =0 &year= 2010 &prop_id =59 11/5/2010
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
200 AMP SERVICE 2 CIRCUITS FOR JETTED TUB
Owner
JACOBSON KENNETH MARILYN
1003 S L ST
PORT ANGELES
Permit
Additional desc
Permit pin number 164350
Permit Fee 125 10
Issue Date 4/28/10
Expiration Date 10/25/10
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
WA 98363
125 10
00
125 10
Lz l 1 I r.fl
INSPECTION TYPE DATE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
10 00000412
717256
222 W 12TH ST
06 30 00 0 3 7830 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
Contractor
APS ELECTRIC
546 BENSON RD
PORT ANGELES
PORT ANGELES
(360) 452 6753
ELECTRICAL ALTER RESIDENTIAL
Plan Check Fee
Valuation
Qty Unit Charge Per
2 00 2 6000 ECH EL BRANCH CIRCUIT W /FEEDER
1 00 119 9000 ECH EL 0 200 SRV FEEDER
Paid Credited
125 10 00
00 00
125 10 00
Date 4/28/10
LZJ IOtiv
tz)--4-b/ ca
WA 98363
RESULTS
0 0
0
Extension
5 20
119 90
Due
00
00
00
Signature of owner or Electrical Contractor X Date
INSPECTOR.
r.
0
0
City of Port Angeles Permit Application
Building Division /Electrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 4174735 Fax: (360) 4174711
Date: 4 ?17' 2:3 10
Y 1 2 Single Family Dwelling
Multi- Family or Commercial*
Commercial Addition 1 Alteration I Remodel I Repair*
Plan Review May Be Required, Please Complete electric I Plan Review Information Sheet
Job Address: ___ZI& hje 6 f 1 —r'e`f P. A
Building Square Footage: Pf 00
Description of above ct Y1 PJ
Owner Information
Name: kaQ 4/ MP
Mailing Address: lQ0 3
City' P �b
Phone
License 1 Exp.
Unit Charge
119.90
$145.50
204.60
262.20
372.50
2.60
73.50
2.60
92.70
$110.30
$148.70
$167.90
95.90
88.20
95.90
63.90
63.90
$119.90
$102.30
$110.30
35.20
73.50
$110.30
56.00
l u n 7caceb5nn
St.
State: IN A, Zip: 3L.3
Fax:
i� II�� C P.�/
is �U;. itt Date: tZ° 10
A
RECE
APR 2 7 2009
ELECTRICAL
INSPECTIONS
Contractor Information I
Name: P 6)P�`t`1 0.4,
Mailing Address:
City
Phone:
License Exp.
Total (Qtv Multiplied by Unit Charge)
9 a Service /Feeder 200 Amp.
Service /Feeder 201-400 Amp.
ServicelFeeder 401 -600 Amp.
Service /Feeder 601 -1000 Amp.
ServicelFeeder over 1000 Amp.
Branch Circuit WI Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service /Feeder 201 -400 Amp.
Temp. Service /Feeder 401 -600 Amp.
Temp. Service /Feeder 601 -1000 Amp.
Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy Commercial. Additional 1500 $5.00
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
$VIKEW Total
State Zip:
Fax:
Owner as defined by RCW.19.28.261 (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if
above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above Statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor I am making the electrical installation or
alteration in compliance with the electrical laws, N.E.C. RCW. Chapter 19.28, WAC. Chapter 296.468, The City of Port Angeles Municipal Code, and Utility Specifications.
Signature of owner electrical contractor or electrical administrator Cash
Credit Card #6-4 lb, /.Lard Aa2429
0
C7'
1
O
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000223 Date
.439288
222 W 12TH ST
06-30-00-0-3-7830-0000-
RE-ROOF
3/19/04
RS7 RESDNTL SINGLE FAMILY
3700
Owner
Contractor
SCHULTZ MATT A
PO BOX 125
RAINIER
WA 985760125
LARIAT CONSTRUCTION
P. O. BOX 280
PORT ANGELES WA 98362
(360) 457-0952
----------------------------------------------------------------------------
Permit BUILDING PERMIT - NO PR FEE
Additional desc TEAR OFF FELT COMP
permi t Fee 120.75 Plan Check
Issue Date 3/19/04 Valuation
Expiration Date 9/15/04
Qty Unit Charge Per
BASE FEE
2.00 14.0000 THOU BL-2001-25K (14 PER K)
Fee
.00
3700
Other Fees
STATE SURCHARGE
4.50
<p
~
<p
Extension
92.75
28.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 120.75 120.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 125.25 125.25 .00 .00
t
-
~
~
.:r
~
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.
~c/~
Sig' ture Contfactor or Authorized Agent
3M/Ot
Date
Signature of Owner (if owner is builder)
Date
T:IPLANNINGIFORMSI] ]02.15 [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 UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
'.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION 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
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEA T PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'5:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL. LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLAJo..'NING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 ~--:J1f- CJ4 1-.1, AI BUILDING
T:IPLANNINGIFORMS\l 102.15 [11/14/2003]
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CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16406
/ - / J ?k.
Port Angeles, Washlngton__m.._.m..m__...._mm.m.m..m.m.....__._...., 19.m:___
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to d6 electrical work as listed below.
Address __m!!.t?.._~..J~/#...9f..m___________.__m__mmm.h____. Occupancy.__"'A,.::?__..__..____m____._.__..m..
~:=:~-~:::i::::~~:=::::::::::::::::::::::m_~~:~~~;:::::::::::::..:.::.~::::::::::~:::::::::::::::::::::::::::::::::::::::
LIght Outlets..__mmm__m.._m._...m..._.....
Service, volts ___:___n_n___......_..............__.
Receptacle Outletsm__m..................._...
No. wires ..h...................................
Type ot WIring:
Armored Cable .h..m_m.................
Non-Metallic ................____._........___
Knob & Tube___...._n..h._................_
RIgid Cc>ndult ..mmmmm...........__.
Metallic Tubing ..._m_n..m......_.....
Raceway _......................_......_._..._
Dryer, KW.n_u..u....__u....._..........._.__
Size wlres..........................h......._..
Range, KW nn...hn_hmnn_____n._hn
Main fuse .......................................
Water Heater:
Enclosure ....__.._n____.._......________.......
KW......___'___:..._.___________________.________.
Hea" KW.m..P.!..I&.r"...........m...m....
Type of wirIng:
Entrance Cable ..................
Motors: sIze. volts and phase:
Rigid ConduIt
Circuits, Light..n......__..____.____................
Utility ........m.....h_.m.m__n....mm....
Metallic TUbing ......__._.h....
Current transformers:
Heat __.__.._._._.._..._......___._._......._..___
Ser. NO.._____.___...._h__.h.....__...__..______.._.
Range ___._______....._._____.____..._.___.........
Water Heater ............._...._.__......._.
Motor ..._...__........_...._.__..______..........
No. & Slze_..........._......._______..
Ser. No. .........___..__._...........................
Dryer ____________...........____...................__
Furnace ____..................._.._._.................
Ser. No.___......__......_................_._........
Total wad.......____.............___.. Ser_ No. ......____....._._.........._.h........... Total ____....____.__..__.n__....___......__
Remarks: ____.m....._______t..<~:.mfi.~?".'__.m-::"?.'-?"cP..___..~~;t._..k_'m..~=,'.f2...'-__mmm__
.. /
Permit Fee
$:__.m.....____hmm__m.m_____
Treas. Receipt
NO__.mm__...m..m.__.___
By__,1L:L%~<~~.m.
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con-
cealed due notice must be given the Inspector so that work may be inspected berore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N~
16406
Address........._.........___...__.____._._............................_...._........_.............._~.___.___.....__......~...............Date..__....._.._._.___._.........._.._..._......_..__.....
'-- i..
Owner ________.............._............_......_.._..n___......._.._.._....__.__......_....__............h..h__.__._______.... TenanLh__________....J...._._................._...............h_____..
1
,
WiringContraetor......._____....................................._............_..........____....._....___._....._.....___._...__.._.____.By.._.._...__.__~__._._____........__........_.___....__........
\ NOTICE-Current must not be turned on until Certificate ot Inspection has been issued. It work is to be c.on-
cealed due notice must be given the Inspector so that work may be inspected before concealment. ~-'"'-__
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1M Olvmtlic Printers. In~_