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Home My WebLink About1111 Georgiana St - BuildingPREPARED 5/13/09 8 50 05 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/13/09 ADDRESS 1111 GEORGIANA ST SUBDIV TENANT NBR STEVE /LYNETTE DRYKE CONTRACTOR GREAT IMPROVEMENTS PHONE (360) 417 2969 OWNER STEVE /LYNETTE DRYKE PHONE (360) 452 8545 PARCEL 06 30 00 8 1 0140 0000 APPL NUMBER 09 00000387 RE ROOF PERMIT BNOP 00 BUILDING PERMIT NO PR FEE REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 5/13/09 r BLDG FINAL May 13 2009 8 47 23 AM 1pangrle GORDY 417 2969 BLDG FINAL RE ROOF COMMENTS AND NOTES Owner Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge 11 00 Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee 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 TEAR OFF RE ROOF GARAGE STEVE /LYNETTE DRYKE 1111 GEORGIANA ST PORT ANGELES WA 98362 (360) 452 8545 Structure Information 000 000 BUILDING PERMIT NO PR FEE TEAR OFF RE ROOF GARAGE 145151 83 55 Plan Check Fee 5/01/09 Valuation 10/28/09 Per 3 0500 HND Charged 83 55 00 4 50 88 05 09 00000387 083848 1111 GEORGIANA ST 06 30 00 8 1 0140 0000 STEVE /LYNETTE DRYKE RE ROOF COMMERCIAL OFFICE 1556 Contractor GREAT IMPROVEMENTS 153 BLUE JAY PLACE PORT ANGELES (360) 417 2969 TEAR OFF RE ROOF GARAGE BASE FEE BL 501 2K (3 05 PER C) STATE SURCHARGE Paid Credited 83 55 00 4 50 88 05 00 00 00 00 Date 5/01/09 WA 98362 00 1556 Extension 50 00 33 55 4 50 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 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. D P Name Signature of Contractor or uthori ed Agent Signature of Owner (if owner is builder) Inspection Type 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 I Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor;/ Ceiling MECHANICAL. Heat Pump/ Furnace 1 FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting i T Forms /Building Division /Building Permit 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. Date Accepted By Comments PLANNING DEPT Separate Permit #s SEPA. Parking Lighting 1 ESA. Landscaping I SHORELINE. FINAL Date Accepted by FINAL Date Accepted by 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) Date Accepted By 7 5 -13 -09 I Applicant 0 Zed'_ 4h�l/LF Property Owner Property Owner's Address ///7 Y Contractor i'p L j9, Contractor's Address 1 53 PAue P t o■Ce j PA t J eta License G�n4-I q S n Expires qj i lo E -mail PROJECT ADDRESS 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 Proiect Tvae Brief Description. Check all that apply New Construction Addition Remodel Repair Demolition e -roof Heat System Other Floor Areas Existing (sq. ft) Proposed (sq. ft.) Basement 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other Lot Residential Multi- family 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 Phone Phone Phone For City Use Only Date Received 5-1-0t Permit at-3V Date Approved e rip--2r02 Zoning Commercial Industrial House Xgarage other Atear off re -roof lay over one layer Heat pump wood burning stove gas fireplace pellet stove other per sq ft. TOTAL VALUATION /9 e 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 of bedrooms of full baths of half baths have read and completed this application and know it to be true and correct. I am autnorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to vygrking on pt Date g- Print Name C n L Signatures T FormsiBuilding Di son /Bldg Permit doc . ' CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 03-00001067 Date 10/31/03 1111 GEORGIANA ST 06-30-00-8-1-0140-0000- RE-ROOF COMMERCIAL OFFICE 1830 @) Owner Contractor DRYKE STEVE/LYNETTE 719 SOUTH N STREET PORT ANGELES WA 98363 AFFORDABLE SERVICES 258663 HI - WAY 101 SEQUIM SEQUIM WA 98382 (360) 452-5264 Permit BUILDING PERMIT - NO PR FEE Additional desc TEAR OFF, FELT, COMP Permit Fee 89.70 Plan Check Fee .00 Issue Date 10/31/03 Valuation 1830 Expiration Date 4/29/04 Qty Unit Charge Per Extension BASE FEE 47.00 14.00 3.0500 HND BL-501-2K (3.05 PER C) 42.70 ........... ~ - Other Fees STATE SURCHARGE 4.50 ~ ~ C\1 -... ? ~ P Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 89.70 89.70 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 94.20 94.20 .00 .00 C/l ~ 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 CJtJ FiLE Signature of Contractor or Authorized Agent Date Signature of Owner (if owner IS builder) Date T \PLANNlNG\FORMS\II02 15 [4/2002] 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 KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS I YES I NO FOUNDATION FOOTINGS WALLS FOUNDA TION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WAfER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR [NSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEA T PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engmecnng DIVISIOn) SEPARATE PERMIT #'5 WATERLINE / 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 ELEC fRICAL - LIGHT DEPT 4[ 7-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R W / PW/ CONSTRUCTION - R W ENGINEER[NG 417-4807 PW / ENGINEERING FIRE 417-4653 F[RE DEPT PLANNING DEPT 4 [7-4750 PLANNTNG DEPT BUILDING 417-48[5 J -$0,.,04 JLL BU[LDING T \PLANNlNG\FORMS\1 [0215 [4/2002] OCT-29-2003 07:33 PM 2D673A53.73784237 360 582 9029 P.01 ~/ s "l"'1""ri'...:/~,~t;'~~_.. " ". '.- ~ \ " BUILDING PERMIT - APPLICATION FO~ Ol'P1C1A1. us Jl ONI. Y Dac.Rec.: If) -3/-03 Ptnnlt*: 1067 Date Appro'Yed:__ 0... blued: FllI out COl\ULETXL Y alld In INK. Your appJtUtiollllnd sUe plu MUST BE COMPLETE to be ac~cptl:ld rur "vie", If )'vu have any qUllIuollI, eaU (360) 417-481!l Applicant or All"Ilt.A:a:f.jY7~d: 0enJ I (P::L Phone 3f to {/C/5 -Cj ~/Q Owner; ..:5+.r V'€' () I,....\./"G _ _. Phone: Add.c..:JL VI Ai ')1}-f' f: f- _ City: P/;y+ ,q.~.J, J.r.; /)./<1, Zip~~ 1F?4 3 Arcbitx:ctlEngincer: Phone: 'T_ - A-r:c:::orz..~GJ7S0~ 7J_hro., . Contractor~"-t b. Kekhu ~16.. State LIcense #:_---.::..~: - r..Jj~ rhone:~~~~/,t Add.c..: 2. <;~ 2, t-Iwy Inf w, _ City: 0'1)" i M IA,! Pr Zip:(IPJ'Se' -7~ PROJECT ADDRl:SS: {Ill (Yf'LYl}ILJ./V\CC _ZONINGI ~GAL DBSCRIPTION: Lot: Block: Subdivision: _. CLAllAM COUNrY PARCEL NUMBER: __ ~=~~1~~~3~1~'1 ~;fyJ~U ,CIty: ~I.lilld W~~0j''''<-7~'''<' CrlHllt CU'dTypa VlSA-k::::..MC _ N on ':::'1 I e; __~. Datel ~ <S lWidenti.&J 0 New Canrtr. rd b-roof [:J Sto"c . SF. @ ST /S1'.. S CJ Mulll-tiimity [J Addition D Move I:l Omge SF. @ S ISP. .. S a Coamaroial C Rmwdel C I>cmol.ltioIl D Deck SF, @$ /SF." S ~ C R.tlpair c::J Sign 0 Other l'OTAL/VA'LUATIO~ $'''1 f/)CIJ '"'-" BlUEP DESCRIPTION OP TIlE PJiOJEC'r: '"J-('(AAr, i")C1::- J OJ.U- _ {loY'r\.U.' . ( l =. COMMItRClAI.IK:I:SIDJ:NTtAL: Occupancy Group: Occupant Load, NQ. of Stories: _ Lot Size: &.I'ling Sq. Pt &: Propo,sod ~'l' Fl B:cistUl& lot oavc:np _ % '" Propc')lCd lot COv~ge _% . Total Jot cOYc:nlge C01U~tion Type; -TOTAL Sq.Ft.__ ~ PLANNING USE ONL YI _n ESAlWoUw1(a): C y~ C No SEPA Checldist requlrtd7 0 Yes 0 No Other: APPROVALS: PLAN, SLQG: -- DPWu, l1'IRJ:: -- O'I'llEll,_ BUILDING J'ERMlT APPLICATION SUBMn'TAL: The Buildlni DIvision can provide)'eu with informauQrI Ol1lhe application and plan IUlxmtml requiremcum it you haVe questiotw, VALUATION OF CONSTRUCTION: Io all e..nl . valual10n amount lDlJIt be utered by tha applicant. 'thia flggro will be revic~ IUl.4 Zll.&ybe mlJcd by me Bull4ln; DlVilion to comply with CUErent fee !chodulea. Co.tthc Permit CoordiDarorat 417 481 , t'oualtst&nce. PLAN' CHECK FEE: IP 'pla:n d1c:ck fee is due il muat be aubmllIed at the time lbo builditla permit application IJ1d oODBtnlctiClJ1 plans are rubunttcd. All other pe:an1f f.. are due a.t tIu tima of pc:nnit ia'l.UlnCe. !XPIRAnON OPPLAN UVlEWr lt~ permit l.luued witlUD 18G /fay. of tho dale ofapplico1ioo" the appllcatloD ~lI elpUe. The Building Oflkial QU extend tb.o time for action by the applJca.ct up to 180 dA,.. upo!l vmneo ~UUf by tho applicant (BOO Section 107.4 of the Uciform BulldU1g Code, ~t od1t1ol1) No IIppLtcatioZl CIlQ be !l\teuded more th123 ODC8. I h8l8by CfUtIfy tflst I ~9WJ ffid and .xamiled this 'pplicatlon ood know the ~ame to bo true find comtd. , E/I7J Blihor/z9d ID 'P~ for tJlls PirrM tnd l.tlootatS'ld Ihm ~ ~ my ~blllty to dBlermftle what pennlts IlI'8 r&qulrsd , nQt tire Clty8, .1Id that I must obtain such pennI, prior to worlc. T''1'OJl.MSWPSl3uII4h\~I.~ Applicant: lilt t?-ft ~ _ Date: 1'0 -l Cf -0 z, PREPARED 1/30/04, 10 47 32 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 11 1/30/04 ------------------------------------------------------------------------------------------------ ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 1111 GEORGIANA ST AFFORDABLE SERVICES DRYKE STEVE/LYNETTE 06-30-00-8-1-0140-0000- 03-00001067 RE-ROOF SUBDIV PHONE PHONE (360) 452-5264 -----------------~~----------------------------------------------------------------------------- PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ ~~~~_::__~_~---~~:~~:NG FINAL COMMENTS AND NOTES -------------------------_____________ of ,ORT :Via ...4.~~~ ~F'Eii~ '" -- 'l.Ol",~ 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 04-00000504 Date .877928 1111 GEORGIANA ST 06-30-00-8-1-0140-0000- PLUMBING REPAIR 6/09/04 COMMERCIAL OFFICE 900 H N-ALT7~ I i)q/C4- Owner Contractor ------------------------ ------------------------ DRYKE STEVE/LYNETTE 719 SOUTH N STREET PORT ANGELES WA 98363 OWNER ---------------------------------------------------------------------------- Permit Additional Permit Fee Issue Date Expiration desc PLUMBING PERMIT REPLACE BATH TUB & 54.00 6/09/04 12/06/04 SINK DRAINS plan Check Fee valuation .00 o Date BASE FEE 1.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP Qty unit Charge Per Extension 47.00 7.00 --- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 54.00 54.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 54.00 54.00 .00 .00 \\ S\ i ~ .~~~ ~ ... ~ t ~ 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 orlthe performance of construction. \ ~~ Sig~ature of Owner (if own is builder) Signature of Contractor or Authorized Agent Date b~q -61 'f Date T:\PLANNING\FORMS\1102.15 [11/14/20031 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 LOCA nON. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN ~:r 10.- oJ-{ J.L.. WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS 1 GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DR YW ALL (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 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: PARKING/LlGHTING 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. 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 ') - I ~/-OI-I J.t.... BUILDING T:IPLANNINGIFORMSIII02.15 [11/14/2003] 'U 'U o-J 'U i\;~~8E; n'U r< r< ><: ~ H:<J \0 N 'U 'U:<JZZt1 o-J01 \0 ...... r<n01o-J:<J ><:'" Ul H 01:<J:<J01 :t- o 0 0 >-l Zr< :t-Ul O:<J H H ~. nUl "101 o-J t1 'tI tD 0 'U t I:" 01. :<J. 0 n:<J :<J :<J-..l "'''' 001 o-J...... ............ 3:0 H HH 'UCo 00t1 H ~~ 00 r<010 ""':<J H ............ O1Ul , , ><: H Qo 00 o-Jo-J'U ow?: H 01" . .. .... 01011:" 0001 r<- t1t1i 0' Q 01 OOUl 01 UlH 00>-3 0 w ~ .... 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H \0 ...... 0 ..w BUILDING PERMIT - APPLICATION FOR OFFICLALgE ONLY: Date Rec.: 6- -C>Lj Permit #D4 - 56'-1 Date Approved: Date lssued: Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMI'LETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 Applicant or Agent: S1eve A;I!J Lt/~i11? - /' Owner: _~%:(/~ ~~ Ll(I!~~ Address: 7(7' ~> it! c ~ I Architect/Engineer: IJR;lfr Phone: (3~j f~2-- f~-t:f.5~ /JRfIce:: Phone (J6q- t~2'-P5~ City: /JbY!.T #I~E<<-~- uYlf.:Zip: ~?J""~ S- Phone: Contractor State License #: Exp: Phone: Address: City: /111 ~~E:ff?iLA--A/r{ Block: Zip: ZONING: PROJECT ADDRESS: LEGAL DESCRIPTION: Lot: Subdivision: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: Billing Address: Credit CardType VISA TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel 0 Demolition ,@ Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: City: MC # Exp. Date: o Stove o Garage o Deck ~ Other. . .' -J!~ ~fL~ COMMERCIAL/RESIDENTIAL: Occupancy Group: SIZEN ALUATION: SF. @ $ /SF. = $ SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ ~t!=lv-Azr€ bAftlrt/r' J: ~/ ~ " -/"v' /?Il&q A:~ Occupant Load: & Proposed Sq. Ft. Construction Type: = TOTAL Sq. Ft. No. of Stories: Lot Size: Existing Sq. Ft. Total lot coverage % ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: AFPROV ALS: PLAN: BLDG: DPWU: FIRE: OTHER: PLANNING USE ONLY: BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with infonnation 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 CUlTent 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 tinle the building pennit application and construction plans are submitted. All other pemlit fees are due at the time of pennit issuance. EXPIRATION OF PLAN REVIEW: Ifno pemlit is issued within 180 days ofthe 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, cun-ent 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 the City's, and that I must obtain such permits prior to work. TIFORMSIAPPSIB,;Id;''''=;'.wpd AppJicon" "V h_~~ Dato' 6 -<i'- PI"- '0 o-J 'U i\;~~8E; 0'U r< ><: ~ H~ '" 'U 'U~ZZt:J >-3 OJ "- t"l()tt:lI-3~ ><:'U (fJ >-< OJ~~OJ O~ 0 0 ... Zr< ;l>(fJ H ~. 0(fJ ...,OJ o-J t:J '0 OJ 0 'U ~ r< OJ. ~. 0 O~ ~ ~'" OOJ o-J"- 3:0 H 'UC:O 00t:J H ~~ r<OJO .."'~ H OJ(fJ , , ><: H QO >-3>-3'U ow'" H OJ" OJ OJ I:'" OOOJ r<- t:Jt:J~ 0' Q OJ $ 00(fJ OJ (fJH OOo-J 0 '" H 1Il , OJ ~ ~ Z 000< Q 1Il OJH!;l ",OJ ~ 0 (fJZ H "- C:(fJ'O 'U' r< H ~~~ r<0><: ;l> w ~HZ "OJ (fJ >-< tJjOo-J o-J ... H , o-J ZOOJ 0(fJ'O ~t:J QO ;l>o-Jr< OJ OJ 0 g;~~ (fJ(fJ ~O C:O OJ, OJ OJ r<~ 'U (fJ H o-JH ~ o-J Z (fJ'U OJ'Q "-o-J ~ 0 < OH H ~ OJ ~ 00 HZ "0 3:Z Z(fJ OJ >-3"'C: 3: (fJ'U Z OOQ OJ '0 OJ o-J , :r: Z OJO (fJ 3:1I1' o-J Oo-J OJOOH (fJ o-JH ~ OJlIlZ 00 >-3 ~Z t:J ><: ,-<o-J Z 0 ::l ~~ 0 c: 'U'U(fJ o-J 3: 6651 OJ," OJ ;l> OJ (fJOJ (fJ >-3 ZZt:J >-3 OJOJH r< (fJ H < H ..., r< >-3 H OJ 0 OJ 0 ~ r< ><: t:J'U ;l>;>>O o-JQ OJ'" '" "- H o "- o .....,