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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUll-DING 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
04-00001122 Date
.433744
716 S I ST
06-30-00-0-2-4784-0000-
RES REMODEL
12/15/04
RS7 RESDNTL SINGLE FAMILY
1000
Owner
Contractor
COLWELL LARRY L/MYRA J
656 LEWIS RD
PORT ANGELES WA 983628440
OWNER
----------------------------------------------------------------------------
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
ENCLOSE FRONT PORCH
62.25 Plan Check Fee
12/15/04 valuation
6/14/05
24.90
1000
Qty unit Charge Per
Extension
47.00
15.25
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BASE FEE
5.00 3.0500 HND BL-501-2K (3.05 PER C)
----------------------------------------------------------------------------
Other Fees
STATE SURCHARGE
4.50
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
62.25
24.90
4.50
91. 65
62.25
24.90
4.50
91.65
.00
.00
.00
.00
.00
.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 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
co~~)On. ,J c7 n " ,^
: -. rt:\.0--€ I t ~/5- LI q:-
tractor 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 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 I NO
FOUNDATION:
FOOTINGS j ~2b-t>'? ...J L-t-
WALLS I-.~ j ~6.?r I J
FOUNDATION DRAINAGElDOWN SPOUTS ""'//.5 IDe; '1u.
,
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS I ROOF I CEILING .1l.-v
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I 69/(,yli)b I JtU
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE I PELLET / CHIMNEY
HOOD I DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'5:
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKlNGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R W. / PW/ CONSTRUCTION - R W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 / / PLANNING DEPT.
BUILDING 417-4815 Y~4-1 0(, .::J U-> BUILDING
T.\PLANNING\FORMS\1102.15 [11/1412003]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32] EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
05-00000381 Date
250888
716 S I ST
06-30-00-0-2-4784-0000-
PLUMBING REPAIR
5/20/05
RS7 RESDNTL SINGLE FAMILY
500
Owner
Contractor
COLWELL LARRY L/MYRA J
656 LEWIS RD
PORT ANGELES WA 983628440
OWNER
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
49577
68.00
5/20/05
11/16/05
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per
Extension
47.00
21.00
BASE FEE
3.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 68.00 68.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 68.00 68.00 .00 .00
"l
........
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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 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
co",'cuet;O". ~ -I t! /J, !/l
/o-VU((i - ~A1/
Signature of Contractor or Authorized Agent Date (Signature' ofc(dwner (If owner is btjilder) Date
T:\Policies\1102_15 building permit inspection record05,wpd [114/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS, CALL 417-4735 FOR ELECTRICAL INSPECTIONS
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
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 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
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF 1 CEILING
DR YW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEA T PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT, SEP ARA TE PERMIT #' s 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 PW/ 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:\Policies\1102_15 buIldIng pennlt InspectIon record05,wpcl []/4/20051
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT. . . . . .
REQUEST:
---
Time 10 j).tl1- Received by .:5;f:P.u"- ~ person I
Date I . .J-) -0 J
Location of Work to be inspected-7 I c::, ~
Name of person requesting inspection )--u r ra
Address of person requesting inspection
Type of Inspection (circle appropriate one):
't T ~ ~T
Phone No.l-jS9- -)3 1-..')-
Permit No. (3) /..I - it')-2-
Sewer Foundfltion Framing Chimney Plumbing Final Sewer Excav. Other
~ht)
INSPECTION NOTEf: .
Inspected: Date ~
Remarks: /)
t1/" dl'~3 j ,.~ -po" r
Time
"frM
By ~
/t-ff.e v--
10 !lln "
RESTORATION REQUiRED...... YES NO
(~~ 1 F;,~J_
l(~ .1> -o-r:c.
Fov\-(.~ o....J
.
~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST Bt
COMPLETE to be accepted for review. If you have any questions, call lA
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: I-AR R /,1 .J._. e.r)L~~t..... Phone:3~o-152..} 3g 5
Owr"r: l4RRY ~. Co LwG"jJ- Phone:
. t
Address: !o,5"6:> LC?tV)S Rp city:.poff j/If'IG-~ (vif- Zip: 9'83 b 2-
.
Architect/Engineer: ~/-1- Phone:
Contractor S ~i;=:- State License #: Exp: Phone:
Address: City: Zip:
PROJECT ADDRESS: 7/~ SO:r sr ~I<TItf'JG{..~G"S ZONING:,RS' 1/
LEGAL DESCRIPTION: Lot: ~~~~~o.PBIock: 217 Subdivision: 7(JWj,fSTTF (>JJ r f5Q'!I\TIfIJ~!-~
CLALLAMCOUNTYPARCELNUMBER: DIP!?; ODD C?2f7B4 OOOe>
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA
TYPE OF WORK:
'l\t Residential 0 New Constr. 0 Re-roof 0 Stove
,fr Multi-family 0 Addition 0 Move 0 Garage
o Commercial ""1jl'L Remodel 0 Demolition 0 Deck
o Repair 0 Sign D:Qther_
BRIEF DESCRIPTION OF THE PRUJECT: f N~ j='"1?trrrf-
City:
MC
#
Exp. Date:
SIZENALUATION:
SF.@$ /SF.=$
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION ~ ~
;P~ . I=~ 9-~~ _s:.J_~
COMMERC~SIDENT~ Occupancy Group: Occupant Load:
No. of Stories: L Lot Size: G 9 ?/) Existing Sq.~. q /'1 & Proposed Sq. Ft.
Total lot coverage---1....3 ~v _
Construction Type: ~ M~ ~
(:J = TOTAL Sq. Ft. '7 14-
ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes DNo Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide 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 permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance. '
EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application, the application will expire. The
Building Official can ext~d the time for action by the applicant up to 180 days upon written request by the applicant (see Section Rl 05.3.2
of the 'dtemational Building/Residential Code, 2003). 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
undelStand thai ft ~ my responsibiDty to determine what pennits are required ,not the City's, and:"7. that I ust/. obta~h ./.$: WOrlt, n "
T:\RVESS. '>DG-forms-brochures\2003-Buildingpermit.wpd Applicant: ~~1...--'A /' ~ .t I". . Date:/l4'A~
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The Issuance of th' , Const~Uctitl" "1_
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 91B62
~~~~~ca~10n Number
Application pin number
property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
property zoning . . .
Application valuation
04-00001122 Date
433744
716 S I ST
06-30-00-0-2-4784-0000-
RES REMODEL
5/24/05
RS7 RESDNTL SINGLE FAMILY
1000
Owner
Contractor
------------------------
------------------------
COLWELL LARRY L/MYRA J
656 LEWIS RD
PORT ANGELES WA 983628440
OWNER
----------------------------------------------------------------------------
Permi t . . . , ,
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
HALVORSEN/ 1000 SQ FT SFR.
49700
HALVORSEN ELECTRIC
73.00 plan Check Fee
5/24/05 valuation
11/20/05
,00
o
Qty Unit Charge Per
1.00 73.0000 ECH EL-R-SQFT FIRST 1300
Extension
73.00
--------------------------------------------------------------------------
Other Fees
STATE SURCHARGE
4.50
. . . . . . . . .
-----------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- --.-------- ---------- ----------
Permit Fee Total 73.00 73.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 77.50 77.50 ,00 .00
COMMENTS/ACTION NEEDED
--J
()
Xl/'
o
t H
r'
~
\
ELECTRICAL PERMIT INSPECfJON RECORD
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 IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
DATE
COMMENTS
NO
/J...n. - 61_ ON J
/7Pu..:>~ ~j
GENERAL COMMENTS:
PW'IJ02.131~
s~
",,"r~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98362
Application Number
Application pin number
property Address
ASSESSOR PARCEL NUMBER:
Application type description
subdivision Name
property Use
property Zoning , . .
Application valuation
04-00001122 Date
433744
716 I ST
06_30_00_0_2_4784-0000-
RES REMODEL
1/18/06
RS7 RESDNTL SINGLE FAMILY
1000
Contractor
Owner
------------------------
--- --- --- --------- - -----
OWNER
COLWELL LARRY L/MYRA J
656 LEWIS RD
PORT ANGELES WA 983628440
----------------------------------------------------------------------------
Permit . . . , ,
Additional desc .
permit pin number
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
HALVORSEN/ DETACHED GARAGE
68833
48.10 plan Check Fee
1/18/06 Valuation
7/17/06
-J
.00
o
-
f)
----------------------------------------------------------------------------
Qty
1. 00
Unit Charge Per
48.1000 ECH EL-R-OUTBD/DTCH GAR SEP
Extension
48.10
----------------------------------------------------------------------------
Other Fees
. . . . . . . . .
STATE SURCHARGE
4.50
fU
f\1
~
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 48,10 48.10 .00 ,00
Plan Check Total .00 .00 .00 .00
other Fee Total 4,50 4.50 .00 .00
Grand Total 52.60 52.60 .00 .00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
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 IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE I ACCEPTED COMMENTS
YES r NO
I II ""H b~~_
IU1T TGH.IN I CUYhR ONL~
SERVICE
FINAL I/J -~7'O~- ~ I
GENERAL COMMENTS:
PW-I 102.U (4'96)
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000497 Date
072174
716 S I ST
06-30-00-0-2-4784-0000_
RES DETACHED GARAGE
7/14/05
RS7 RESDNTL SINGLE FAMILY
6600
0wner
Contractor
------------------------
COLWELL LARRY L/MYRA J
'656 LEWIS RD
PORT ANGELES WA 983628440
------------------------
--1
OWNER
~
--------------------------
Construction Type
Other struct info . .
Structure Information 000 000
TYPE V NON-RATED
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
----------------------
\.f\
----------------------------------------------------------------------------
19.00
1. 00
890.00
7000.00
440.00
1330.00
1. 00
'"
,~
1:
V'
+-
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
NEW DETACHED GARAGE
53058
162.75 Plan Check Fee
7/14/05 Valuation
1/10/06
65.10
6600
Qty
Unit Charge Per
5.00
BASE FEE
14.0000 THOU BL-2001-25K (14 PER K)
Extension
92.75
70.00
~~
t -z( 1-,( 0(-
----------------------------------------------------------------------------
Special Notes and Comments
06/23/2005 08:46 AM SROBERDS
---------------------------The detached garage in the RS-7
zone will result in 19% lot coverage. Setbacks are good.
No land use issues are anticipted.
06/23/2005 08:41 AM SROBERDS ___________________________
blah blah blah
MAINTAIN CLEARANCES FROM SERVICE WIRES. It appears that
there will be clearance over the Garage Roof.
06/20/2005 04:44 PM JHEBNER ____________________________
Electrical load calculations and electrical permits are
required.
06/20/2005 04:45 PM JHEBNER ____________________________
$0.00 Connection Fee
06/20/2005 04:45 PM JHEBNER ____________________________
Any modifications to the City'S electrical facilities will
be at the customer's expense.
Public works utility engineering has no requirements for
this plan review.
----------------------------------------------------------------------------
Other Fees
. . . . . . . . .
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
J?~ /-f--(!)5
Date
T:\Policies\1102_15 building permit inspection record05,wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS, CALL 417-4735 FOR ELECTRlCAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
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 NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE I DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS I GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF 1 CEILING
DR YW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
W ALL I FLOOR I CEILING
MECHANICAL
HEAT PUMP 1 FURNACE I DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKJRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKING/LlGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT, 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W,
ENGINEERING 4 I 7-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT, 417-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
- -
T:IPoliciesllI02_15 building pennit mspeclton recordOo,wpd [1/4/2000 ]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000497
Application pin number 072174
Page 2
Date 7/14/05
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
162.75
65.10
4.50
232.35
162.75 .00 .00
65.10 .00 .00
4.50 .00 .00
232.35 .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
T:\Policies\1102_15 building pennit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
"'
CALL 417-48]5 FOR BUILDING INSPECTIONS, CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
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
FOUNDA TION DRAINAGE 1 DOWN SPOUTS
...ru.:....~..__
PIERS
POST HOLES (POLE BLDGS.) --,,'...-
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING 0
FRAMING
JOISTS! GIRDERS
SHEAR WALL/HOLD DOWNS ;
WALLS / ROOF! CEILING t1- /2-1 /~)~ , -f"t\L--"
DR YW ALL (INTERIOR BRACED PANEL ONLY) . ,
T-BAR -
INSULATION
SLAB
WALL 1 FLOOR! CEILING
MECHANICAL
HEATPUMP/FU~~ACE/DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING! SLAB
BLOCKING & HOLD DOWNS
SKlRTING
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT, 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W.! PW! CONSTRUCTION - R.W,
ENGINEERING 417-4807 PW ! ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 / i PLANNING DEPT.
J r;,lJ-i I (.K ~ (J U-,..
BUILDING 417-4815 BUILDING
T:IPoliciesll10215 buildingpennit inspection record05.wpd rI!4/~0051 "
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BUILDING PERMIT - APPLICATION!
Fill out COMPLETELY and in INK. Your application and site plan MUST B~!!
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711 r
Applicant or Agent: J-AR P,Y .f..- .l!f)L~t.t,- Phone:3~o-1-52..} 3g 5'
Owner: J..J) R R. Y ~. Co L We: )J... Phone:
. t
Address: lobe;, L(;?tV)S !?p City:pod't4/VG~~ evif- Zip: 9'83' 2.-
.
ArchitectJEngineer: ~/qz- Phone:
Contractor :-::; t:;;1.. ;::=::- State License #: Exp: Phone:
Address: City: Zip:
PROJECT ADDRESS: 7/~ SO:r sr ~I<TIiJVG~LGr:; ZONlNG:Rs 7
tJt!iP-T# &0;::: ~ ,-] Jt:'~
LEGAL DESCRIPTION: Lot:. ;rrr~p Block: 217 Subdivision: 7bW)JS~ of f>ol<ll9.A16~.-"::l
CLALLAMCOUNTYPARCELNUMBER: Q05 ODD 02f-7A4 OOOe>
Credit Card Holder Name:
Billing Address: '
Credit Card Type VISA
TYPE OF WORK:
YResidentiaJ 0 New Constr. 0 Re-roof 0 Stove
,-6" Multi-family 0 Addition 0 Move )( Garage
o Commercial 0 Remodel 0 Demolition 0 Deck
. 0 Repair 0 Sign 0 ,Other
BRIEF DESCRIPTION OF THE PROJECT: '- ~ ~ 'R.~f
MC
#
City:
Exp. Date:
SIZENALUATION: otJ
4 "'10 SF. @ $ tC;- /SF. = $
SF. @ $ /SF. = $
SF.@$ /SF.=$
IPTAL VALlJATION ,~.
t)~ ..Loc l~l.,...n
/
t:"fPOO
.
~r(l?~ ~ ___ I
"'. . C' v. . ~.
I
COMMER~SIDEN~ Occupancy Group: }O cupant Load: Construction Type: ~ MfJ.-r- ~
No. of Stories: L LotSize: ?~ Existing Sa. Ft. -eye & Proposed Sq. Ft.~4D~=TOTALSq.Ft.. J 330rP
Total lot coverage. J~ ~
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetIand(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
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 reYised 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 permit application and construction plans are
submitted AD other permit fees are due at the time of permit issuance. .
EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application, the application wiIJ expire. The
Building Official can ext!nd the time for action by the applicant up to 180 days upon written request by the applicant (see Section Rl05.3.2
of the International Building/Residential Code, 2003). 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 tru~rla~'j'j,rrect. I am authorized to apply for this permit and
understand thti it is my responsibility to determine what permits are required ,not the City's, an~, must obtain uc rmits . r to work.
T:\RVESS\BLOO-forms-brochures\2003_Buildingpermit.WPd r>\....APPlicant: ' tv' Date: 6-1?-- 05
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CITY OF PORT ANGELES - Construction Plans
The Issuance of this permit based upon these plans, specifi.
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
pla~s, specifications and other data, or from preventing
building operc,tions being carried on thereunder when in
violation of ail codes and ordinances of this jurisdiction.
(S~j\CJ -llnllli-;-;;; Bu;ld,log Belli.) Qp d-OD ~ :c.fl-..t2.-
j"pproval Date ~BY ,~'--
tfi R fC-J ). Itu L wcl..J-.....
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Feet
Vertical Datum = NA VD 88
Horizontal Datum = NAD 83/91
N
Area Map
1hi... map is not in/ended 10 he used as u legal description.
This map drawing is produced by the City ofPoTt AngelejIor its own use and purposes.
Anv other use of this mQlJ/{}raw;nI! shall 1101 he the res/JoIIsihilitv of the Cill!.
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o Request Inspection
~. Electrical Contractor 0 Owner
o Annual Permit 0 Alarm 0 Carnival Cl Commercial
ELECTRICAL WORK PERMIT APPLICATION
Residential 0 Residential Maint. 0 Signs (J Thermostat 0 Telecom.
Job wired by
il!{ Electrical Contractor 0 Owner
Installation description
Electrical contractor name .
License number
RI2BflJ6J-fC5. 1'(12./4-0/)01 ItJ(?(J >'1' -fT
IIA/ll/I>RS:Ei/VS ELGcrPlC
Purchaser's mailing address
PL/'JCF. R. 0
I!/JL VIlETtJ <;1CL
;J14?
City
Pili?! AtJr;EL~S
Telephone number
State ZIP
7Jf ~.J~ ()
b.~t:
9~3&3
FAX number
..- -
Premises owner's name
lJpRRY /' IJLW;:;IL
Address of inspection
7/C7 J:
City
Signature of owner, electrical contractor or electrical administrator
o Cash 0 Check #
~Credit Card ~ Mastercard
Card# __~-r//r;_ -
blrut6 L
Discover
I hereby certify that I am the owner of the above named property or a licensed
electrical contractor (or the firm's authorized agent) and am making the electrical
installation or alteration in compliance with the electrical law, Chapter 19.28 RCW.
.
x
Expiration Date
of card
Inspection fee
$ '73-
J
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Approved By
#31C Approved By
S Z COW k.J:}
D. C Approved By
THERMOSTAT
Dale Approved By
DITCH
Dale Approved By
SERVICE
S/~I! ,- .tIW
, D e Approved By
FEEDER
Dale Approved By
WALLS
Insulation Only
CEILING
Insulation Only
Date
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Approvcd By
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Electrical Load Additions and or subtractions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump _ Ton LAR
o Fan-Wall III KIN
~ Overhead Service
o Temp Service
o Underground Service
Service Information
Voltage /Z"':'/;-1P
Phasoil, 1 0'3
Service Size: ~
Feeder Size:
Inspection
Dale
Area, Building or Equipment Inspected
Action Taken
Electrical
Inspector
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