HomeMy WebLinkAbout2312 W 12th St - Building
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CITY OF PORT ANGELES
DEP ARTMENT 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
04-00000301 Date
.179721
2312 W 12TH ST
06-30-01-5-8-0240-0000-
MECHANICAL PERMIT
4/13/04
RS9 RESDNTL SINGLE FAMILY
7425
Owner
Contractor
FOX JOHN/NANCY
2312 W 12TH ST
PORT ANGELES
WA 98362
PENINSULA HEAT
502 W. 8TH ST.
PORT ANGELES
(360) 457-2775
WA 98362
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Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit Fee 35.30 Plan Check Fee
Issue Date 4/13/04 Valuation
Expiration Date 10/10/04
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Qty unit Charge Per
1.00 35.3000 EC EL-LOW VOLTAGE
Extension
35.30
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Permit MECHANICAL PERMIT
Additional desc
permi t Fee 61.70 Plan Check Fee .00
Issue Date 4/13/04 Valuation 0
Expiration Date 10/10/04
Qty unit Charge Per Extension
BASE FEE 47.00
1. 00 14.7000 ECH ME- INSTALL 100- FAU 14.70
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-
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 97.00 97.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 97.00 97.00 .00 .00
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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 ()f
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.
o/v ;CIL-c
Signature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner is builder)
T:IPLANNINGIFORMSI! 102.15 [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 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
FOUNDA TlON DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I I
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
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION RW. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 S;-/7-oL/ RJ<.. BUILDING
T:IPLANNINGIFORMSIl 102.15 [11/14/2003]
BUilDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec.: if.-/Z -Dc.;
Permit #: 04 --- .3 (j (
Date Approved:
Date Issued:
Fill out COMPLETELY and in INK. Your application and site.plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
Applicant or Agent: (Jju~,. /~f-Ie- A 7~/t?r>cYY7
Owner: ..::ft');11 1b.>L.
Address: "'.~ 3 /.,;l U/ .
Phone:
'-/57-;;;1 775-
~S 7-cJLf7V
Zip: 9'7136'3
Phone:
l~ M sf City: fi//r-./lJ~~s
Architect/Engineer: Phone:
Contractorh>Jt ~n??(.la &?l-f- State License #I!EIf)//VITI~
Address: 5??";~ /,L/ B cf2 City: n/j- ~'1?/~1/5
. ./
PROJECT ADDRESS: ,jl- 3/ ~ t.tl. /~~ J;:!2 ~3T..
Phonei/57-';? 7 7J'~
Zip: ~%36:::;L
ZONING:
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Subdivision:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA MC #
TYPE OF WORK:
irResidential 0 New Constr. 0 Re-roof 0
o Multi-family 0 Addition 0 Move
o CommerciaI 0 Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
t1>/In~ /
City:
Exp. Date:
'SIZENALUATION:
SF. @ $ ISF. = $
SF. @ $ ISF. = $
SF. @ $ ISF. = $
TOTAL V ALUAJ. ION; $....
,? /-1, 'C'/1c:1. n,' t"'d-
COMMERC /RESIDENTIAL: Occupancy Group:
Occupant Load:
Construction Type:
= TOTAL Sq,Ft.
%
No. of Stories: _ Lot Size: Existing Sq. Ft. & Proposed Sq. Ft.
Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
APPROVALS:
PLAN:
RLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
BUILDING PERMIT APPLICATION SUBMITI AL: The BuiIding Division can proyide you with information 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 Permit 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 permit fees are due at the time of permit issuance. .
EXPIRATION OF PLAN REVIEW: Ifno pennit is issued within 180 days of the date of application, the 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 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 ~re reqUi~.. 'the pti/ nd /9f I ~st ~btain such permits prior to .w~rk.
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