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Home My WebLink About113 Whidby Ave - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc 2nd water meter and back flow Owner FOLDON TTE HENRY B /EDNA J 113 WHIDBY AVE PORT ANGELES Permit PLUMBING PERMIT Additional desc Permit pin number 125070 Permit Fee 57 00 Issue Date 4/30/08 Expiration Date 10/27/08 Permit Additional Permit pin Permit Fee Issue Date Expiration Date 1 00 desc number Fee summary Charged WA 983626444 Permit Fee Total 827 00 Plan Check Total 00 Grand Total 827 00 T \P i es \1102.15R [1/05] q/-?o /B3 CITY OF PORT ANGELES PUBLIC WORKS UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 08 00000474 368318 113 WHIDBY AVE 06 30 10 5 0 1556 0000 PUBLIC WORKS UTILITES RS7 RESDNTL SINGLE FAMILY 0 for lawn Irrigation Contractor OWNER Plan Check Fee Valuation Qty Unit Charge Per BASE FEE 1 00 7 0000 ECH PL- EA LAWN BACKFLOW Qty Unit Charge Per 770 0000 EA PW W/M 1 SERV 5/8 METER Paid Credited 827 00 00 827 00 00 00 00 Date 4/30/08 00 0 Extension 50 00 7 00 PUBLIC WORKS RES WATER SERV 2ND METER FOR IRRIGATION 125062 770 00 Plan Check Fee 00 4/30/08 Valuation 0 10/27/08 Extension 770 00 Due 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 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 constructs Sidiraft re ofCeti for or Authorized Ager{t Date Signature of Owner (if owner is builder) Date PW UTILITIES (Engineering Division) WATERLINE METER SEWER'CONNECTION SANITARY STORM SITE. DRAINAGE SITE EROSIONCONTROL PARKING. SIDEWALK CURB &GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 I 'FIRE 417 -4653 I I PLANNING DEPT. 417 -4750 I BUILDING' 417 -4815 I I. T\Policies\1 102.15R [1 /05): •.t RESIDENTIAL PERMIT INSPECTION RECORD CALL 417 -4807 FOR UTILITY 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 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAti' °DATE- ACCEPTED YES` I NO' CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT. I PLANNING DEPT BUILDING 1-" )PC1 ~\ ;1, (_ [; ". Backflow Assembly Test Report City of Port Angeles Public Works and Utilities Department WaterlWastewater Collection Division Official Use Only Assem.# (;, )' r Reeeiwd NAME OF PREMISES: l- I I ~ /J. Vc r:p :4/ j-I l (J /5' t- o ' f ,,(' r I-I t~ I j/t- /f / c /< .;Jv<; q~C)(L( " IS THIS AN APPROVED ASSEMBLY? YES 8'No 0 IS AssiMBL Y INSTALLED CORRECTL Y? DA TE OF INSTALLATION :J () /IIi. 0 S UNKNOWN 0 .:: _ 1/ ........ ( I (},/f SERVICE ADDRESS: .., LOCATION OF DEVICE: ,..,.. ASSEMBLY: Wi L !< " /l1E-ri~ I. C t " ;1fc;;Jr?;- Serial No. Manufacturer Model Size YES D-NO 0 REDUCED PRESSURE PRINCIPLE ASSEMBLY RP 0 RPDA 0 DC ~ DCDA 0 PVB 0 Air Gap 0 DOUBLE CHECK VALVE ASSEMBLY SVB 0 AVB 0 CHECK VALVE #1 CHECK VALVE #2 RELIEF VALVE PVB/SVB Initial Leaked 0 Leaked 0 Did Not Open 0 AIR INLET Held at:J. 7 psi Closed Tight 0 Did Not Open 0 Test Held at J # 'psi Opened at _ psi Opened at _ psi Repairs Cleaned 0 Cleaned 0 Ckaned 0 CHECK VALVE Leaked 0 Held at _pSI Replaced 0 Replaced 0 Replaced 0 J REPAIRS Cleaned 0 Details Replaced 0 3 psi Bulkr YES 0 NO 0 Final Closed Tight 0 AIR INLET Opened at _ psi Held at ;" ~Si Held at ). 'PSi CHECK VALVE Held at _psi Test Opened at _ psi BACK PRESSURE NO 0 YES 0 AIR GAP INSPECTION: !... /1 tv /'\1' REQUIRED MINIMUM SEPARATION: YES 0 NO 0 TYPE OF HAZARD ./ COMMENTS Line Pressure '+ t psi :t /1.1 ~fiC7E{) - Tt. 1- /~)J C I;) J t. } /J Held Backpressure YES e---NO 0 I #2 Shutoff Held YES~O 0 Relief Valve Exercised YESD NO 0 Date/Time Tester Signature Cen.# Test Kit Passed Failed Initial '.)~'C$ f(. ;J E(L t;K A.),p~ 1A i1;111( Test Ix M I fJ yt tf T 0"""'- 0 Repairs 0 0 Final ; .JC . " s f.]/ Gel< el ~ b~k- /? ). if (; r 0/' T'est '" . Alff/! IV C> 7 0 -' ,-" I.f1 S ::r - ~ \) \S ~ ~ E :5 1.__- WHITE - CUSTOMER COpy YELLOW - PURVEYOR COPY PINK - TESTER COPY i` ELECTRICAL WORK ,41\-- 0 `r O Request Inspection O Electrical Contractor 0 Owner ++...e+y 0 Annual Permit 0 Alarm Carnival 0 Commercial 1 Residential 0 Residential Maint. Signs Thermostat Telecom. Installation description Job wired by 0 Electrical Contractor Owner i Electrical contractor na License number r ct. 1 2Ar- 1n AA) t.,c 1 e.A.- Purchaser's mailing addres ,,,_y9 Cin Stste ZIP 14,4 A il w ��3�-z 2 :1 s 7 gir Tele hon number i FAX number p 5 .yc S 2, l 6M4E Promtscs owner's name 1.-- 4 rr +�e. Zi Li Tbt L. Address of Inspect yon r 1 2 II,Lk.L d b City p il-y1 ckti-tb Cash Check 1 hereby certify that I a m the owner of the above named property or a licensed Credit Card Masters d Discover 0 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. Card _C9_ A/A 4. Signature or owner electrical contractor or electrical administrator 1 E on Data /1/5 20 /11/0 Inspection fee X of card I WALLS i CEILING THERMOSTAT SERVICE Insulation Only Insulation Only 47 7 C ve' YV, b S-- D e Appro By Appro y J Fete Approves cY Date Approved Hy 0,./6,5_Cover,ke2., Appro J DTTCH �r ER Approvedd BBy vd By �0 App Date Approved By Electrical Load Additions and or suptractions fr v Service Information O NO LOAD CHANGES O Baseboard KW Voltage O Furnace KW 0 Overhead Service Phase 0 1 0 3 0 Heat Pump Ton LAR Temp Service Service Size: 0 Fan -Wall KW 0 Underground Service Feeder Size: Inspection Area, Building o Equipment Inspected Elecrricall Date g 4 P P Action Taken Inspector O rC) g 0-g- 06) M--, Fi. ->�.e_ i T 1 10 39Cd 17Zt79ZSb09C Z9:90 900Z /bZ /S0 ELECTRICAL WORK PERMIT APPLI °Y N (1 ig Request Inspection t e l u ectrical Contractor Owner An nal permit A Carnival Commercial Residential Residential Maint. Sign Thermostat D Telecom. Installatioq description Job wired by 1 O 'Electrical Contractor Owner Electrical cQntrac or me License number mai I -�VI u, EL r-'i" S.Ti. S..Q'� Y Q .�"L'P1 Si 9 r-r„ U a I Li Rel Purchaser's urchaser's maili ng nddcee City 1 A State 7.1P o i- l ri v v! `7 1K3 G 2_, 0 ez F Telephone, number 1 FAX number 5 qr e Premisos m owner amine Address of inspection y )1'3 1 LI �C City I Cash Check p. 1 hereby certify that 1 a the owner of the above named property or a licensed Credit Card Visa Mast rdazd Discover electrical contractor (or the fum's authorized agent) and am making the electrical installation or alteration m compliance with the electrical law. Chapter 19.28 RCW. Card 0—Aft— /Signature of owner, electrical contractor or electrical administrator -4 ExpirationDate Inspection fee x of card o i J11uw 1 1 WALLS CEILING THERMOSTAT SERVICE Insulation Only insulation Only Date Approved ay Dare Approval By Date Approved By Date Approved By FEEDER Cover I Cover DITCH Dart %lpprovcd By Date Approved By i Dace Approval By Date Approved By Electrical Load Addition§ and or subtractions V1V Service Information NO LOAD CHANGES Baseboard Kali Voltage Fumace .KW 0 Overhead Service Phase 1 3 Heat Pump Ton LAR 0 Temp Service Service Size: Fan -Wall KW Underground Service l Feeder Size: Inspection Area, Building or Equipment Inspected Action Taken Electrical Date Inspector o< 1 0 d Vie. pp 5/47 d S' P svr.... f 0 ZO 39V t ZS :90 5002 /t2Z /S0 09/07/2006 13:58 3604523498 OLYMPIC ELECTRIC PAGE 01 414-46"-- ELECTRICAL WORK PERMIT APPLICATIO/4 l Installation description wired by n Electrical Contractor GI Owner Commercial lJrir sidcntlal Electrical contractor name License number Date Expires 0 New Altered/Addition 1 l O :x ...7' i Purc ee ailing address X32 7 11 417-- 4 g /d C ity Stoic ZiP 4/ 6 t Telephone numb FAX number ys j -1 yS� 77rfi, Premises owner's name Address of Inspection i/3 illh,� A Cit re Phone number to NC aide 1I nspection: j ��j7 Owner as defined by RCW,19.28,261: (l) 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 reuse. Cash Check After reading the above statement, I hereby certify that I am the owner of the above __LL named property or a licensed electrical contractor. I am making the electrical instal- Efd'(;redit Card Visa Mastercard Discover lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28. WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code. anti Card Utility Specifications. Signature of owner, electrical contractor or electrical administrator --4. Expiration Date Inspection fee X Date: /7 /Q6 of card. Iect I I Load Addition end ar su bjra c tl nnl `f Servlc formation V..... NO LOAD CHANGES T' LA Baseboard KW Voltage Furnace KW 0 Overhead Service Phase 1 3 Heat Pump Ton LAR Temp Service Service Size: Fan -Wall KW Q Underground Service Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360 -417 -4735 ROMII IN THERMOSTAT SERVICE Dpte Approvfn Fy Dote Approved Dy pole Approved By FiNAL DITCH FEEDER Dote A pproved BY Dnte Approved By D Approved Hy Electrical inspection Arca, Building or Equipment inspected Action Taken inspector Date 0 21 6 7: ~ 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 05-00000269 Date 958881 113 WHIDBY AVE 06-30-10-5-0-1556-0000- RES NEW SFR 5/23/05 RS7 RESDNTL SINGLE FAMILY 178470 Owner Contractor ESTES, LARRY 6~1 WASHINGTON ST PORT ANGELES (360) 417-6649 Other struct info MOUNTAIN VIEW P. O. BOX 754 WA 983622556 SEQUIM (360) 683-2484 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS BUILDERS INC. WA 98382 21. 80 1. 00 14000.00 3054.00 1. 00 P~rmit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT -RESIDENTIAL 1923SF SFR W/ATT 821SF GARAGE 49098 1459.65 Plan Check Fee 5/23/05 Valuation 11/19/05 583.86 178470 ,.~ do ~~ - Qty Unit Charge Per 79.00 BASE FEE 5.6000 THOU BL-100,001-500K (5.60 PER K) Extension 1017.25 442.40 Permit ELECTRICAL NEW RESIDENTIAL Additional desc THERMOSTAT Permit pin number 48892 Permit Fee 36.40 Plan Check Fee Issue Date 5/23/05 Valuation Expiration Date 11/19/05 -- .00 o ().} .00 o (~ r~Mt:\;L- Pl22 \ {i', c Qty 1. 00 Unit Charge Per 36.4000 EC EL-LOW VOLTAGE Extension 36.40 Permit MECHANICAL PERMIT Additional desc Permit pin number 48876 Permit Fee 108.60 Plan Check Fee Issue Date 5/23/05 Valuation Expiration Date 11/19/05 Qty Unit Charge Per BASE FEE 1. 00 14.7000 ECH ME- INSTALL 100- FAU 5.00 7.2500 ECH ME-VENT FAN 1. 00 10.6500 ECH ME-GAS PIPE 1 TO 5 s' Extension 47.00 14.70 36.25 10.65 P- (!:r C\C ~ C b Permit . . . . . Additional desc . Permit pin number PLUMBING PERMIT 48884 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. .----, 7' ,-' h:aLl( ~{.~ (,..C"00- Signature of Contractor or Authorized Agent Date Signature of Own T:\Policies\ II 0215 building penn it inspection record05.wpd [1/4/2005] ~s \~~"'" ='".A '}'", .....r..,. - . '-t]" ~~), .. ,} t.'\\, , 4~ . \ .' ~' 'O6.-.00~00'983 ':-}O: f. 680360 .' 113 WHIDBY~VE " ~ 06-30-10-5-0-1556-0000~ ELECTRICAL ONLY ". Application~ Number ~.! Applicatiqn.pin nu~er Property "Address ASSESSOR PARCEL NUMBER Appl~cat~on type description Subd~v~s~on Name Property Use Property Zoning Application valuation /, , ,- "! '" RS7 RESDNTL SINGLE FAMILY o Owner SMITH, PAT 113 WHIDBY AVE PORT ANGELES (360) 452-5880 WA 983626444 Permit Additional desc Perm~t pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER OLYMPIC/ HOT TUB 86595 OLYMPIC ELECTRIC 48 10 9/13/06 3/12/07 Con~ractor OLYMPIC ELECTRIC 4230 TUMWATER PORT ANGELES (360) 457-5303 WA 98363 RESIDENTIAL Plan Check Fee Valuation 00 o Qty 1 00 Unit Charge Per 48 1000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48 10 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 48.10 48 10 .00 00 Plan Check Total 00 .00 .00 .00 Grand Total 48 10 48.10 00 00 {OMME:TS/AC,~~9N NEf.D~p , J 't , " , ,,' l;.oo ,... : \ ~ ,..:. Lasered CEO j. "- """ UJ ~ ~ \) Ch Ls ~ ELECTRICAL PERMIT INSPECTION RECORD CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. rr 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 ACCEPTED COMMENTS I YIS I NO '-? UITCH III 1IIlTH-IN I CUYbK ~hK VICh . FINAl 1~1-JI-ob I ktA 11 GENERAL COMMENTS: PW-II02." (41961 '5 "I.tir"""-'" CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 121 EAST 5TH STREET. PORT ANGELES. WA 9R~62 " i Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER' Application type descript~on Subdivision Name Property Use Property Zoning Application valuation 05-00000269 Date 958881 113 WHIDBY AVE 06-30-10-5-0-1556-0000- RES NEW SFR 5/25/05 RS7 RESDNTL SINGLE FAMILY 178470 " Owner Contractor ESTES, LARRY 621 WASHINGTON ST PORT ANGELES (360) 417-6649 Other struct info MOUNTAIN VIEW POBOX 754 WA 983622556 SEQUIM (360) 683-2484 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SWE TOTAL LOT COVERAGE NUMBER OF UNITS BUILDERS INC WA 98382 21 80 1 00 14000.00 3054.00 1. 00 Permit Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Exp~ration Date ELECTRICAL NEW RESIDENTIAL ELECTRIC SVC/ 2744 SQFT SFR 49825 ELECTRIC SERVICE 143 20 5/25/05 11/21/05 ~ ~ Plan Check Fee Valuation~ ,00 o Qty 1 00 3 00 Unit Charge Per 73 0000 ECH 23 4000 5C EL-R-SQFT FIRST 1300 EL-R-SQFT ADDITIONAL 500 Extension 73,00 70 20 t l ~ "J Special Notes and Comments Building address s~gn shall not be less than 6" & not more than 12" ~n height Numbers colors must contrast with wall color they are mounted on (Ord 14 36 050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations 04/20/2005 11 06 AM SROBERDS --------------------------- The proposal will result in residential construction ~n the RS-7 zone for a total lot coverage of 22% Setbacks are good. No land use ~ssues are noted Existing residence must be removed from site prior to the removal of the existing structure prior to ~ssuance of permit Electrical load calculations and electrical permits are required Connection Fee DOES NOT APPLY 04/20/2005 02:08 PM JHEBNER ---------------------------- MAINTAIN CLEARANCES FROM SERVICE WIRES (Ground Clearances) 04/20/2005 02 09 PM JHEBNER ---------------------------- Any modiflcations to the electrical facilities will be at the customer's expense 04/20/2005 02 09 PM JHEBNER ---------------------------- Sanitary sewer r~-connection ~nspection ~s required by Public Works prior to back fill of ditch. If new dr~veway is installed or replaced,construct driveway to City Standards. Separate perm~t will be required No concrete with exposed aggregate allowed in the City road ~ COMMENTS/ACTION NEEDED ,(; "I,lr.....,... CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 121 EAST 5TH STREET. PORT ANGELES. WA 98J62 t " Application Number . Application pin number 05-00000269 958881 Page Date 2 5/25/05 Special Notes and Comments right of way. Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 143 20 143 20 .00 .00 Plan Check Total 00 .00 00 .00 Other Fee Total 4.50 4.50 .00 00 Grand Total 147.70 147.70 .00 00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPE~,10N 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 GENERAL COMMENTS: PW.II02.l~ (4196) d'O'I'~_ $~~~ Da ""~,... CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION .~21 EAST 5TH STREET. PORT ANGELES. WA 9R~62 Appllcatlon Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00000269 Date 958881 113 WHIDBY AVE 06-30-10-5-0-1556-0000- RES NEW SFR 5/25/05 RS7 RESDNTL SINGLE FAMILY 178470 Owner Contractor ESTES, LARRY 621 WASHINGTON ST PORT ANGELES (360) 417-6649 Other struct info MOUNTAIN VIEW "P. O. BOX 754 WA 983622556 SEQUIM (360) 683-2484 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL~OT COVERAGE NUMBER OF UNITS BUILDERS INC. WA 98382 21.80 1.00 14000.00 3054.00 1.00 , " \J\\ ---------------------------------------------------------------------------- Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL TEMPORARY EL. SVC . / TEMP. 49817 ELECTRIC SERVICE 48.10 5/25/05 11/21/05 SERVICE Plan Check Fee Valuation .00 o t \\ ~ ~ ~ {~ Qty Unit Charge Per 1.00 48.1000 ECH EL-TEMP SRV - 0-100 SRV FDR Extension 48.10 -~-------------------------------------------------------------------------- Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contras"t with wall color they are mounted on. (Ord. 14.36.050-EI When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. 04/20/2005 11 : 06 AM SROBERDS _ _ _ _ __ _ _ _ __ _ __ _ __ _ _ _ _ __ __ _ _ The proposal will result in residential construction in the RS-7 zone for a total lot coverage of 22%. Setbacks are good. No land use issues are noted. Existing residence must be removed from site prior to the removal of the existing structure prior to issuance of permit. Electrical load calculations and electrical permits are required. Connection Fee DOES NOT APPLY 04/20/2005 02:08 PM JHEBNER ____________________________ MAINTAIN CLEARANCES FROM SERVICE WIRES (Ground Clearances) 04/20/2005 02:09 PM JHEBNER ____________________________ Any modifications to the electrical facilities will be at the customer's expense. 0~/20/2005 02:09 PM JHEBNER ____________________________ Sanitary sewer. re-connection inspection is required by Public Works prior to back fill of ditch. If new driveway is installed or replaced,construct driveway to City Standards.separate permit will be required. No concrete with exposed aggregate allowed in the City road right of way. ~ ($ ~ COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPEGT,ION RECORD ~ALL 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 r INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO I1ITCH ~OUGH-IN / COVER SERVICE .t'INAI I I GENERAL COMMENTS: PW-II02.lS 141961 d'OII'~_ $~~~ Da ""~,... CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION ~21 EAST 5TH STREET. PORT ANGELES. WA 9R~62 Application Number . . . . . 05-00000269 Application pin number 958881 Page 2 Date 5/25/05 Other Fees STATE SURCHARGE 4.50 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, 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 GENERAL COMMENTS: PW-II02.1S 141961 CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 ()')"- 2.((;q Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER; Application type description subdivision Name Property Use Property Zoning . . . Application valuation 05-00000269 Date 11/22/05 958881 113 WHIDBY AVE 06-30-10-5-0-1556-0000- RES NEW SFR RS7 RESDNTL SINGLE FAMILY 178470 Owner Contractor ESTES, LARRY 621 WASHINGTON ST PORT ANGELES (360) 417-6649 Other struct info MOUNTAIN VIEW P. O. BOX 754 WA 983622556 SEQUIM (360) 683-2484 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS BUILDERS INC. WA 98382 21.80 1. 00 14000.00 3054.00 1. 00 Permit . . . . . Additional desc . Permit pin number permi t Fee Issue Date Expiration Date DRIVEWAY INSTALLATION 65680 170.00 11/22/05 5/21/06 plan Check Fee Valuation .00 o Qty Unit Charge Per ~xt . BASE FEE 170.00 ---------------------------------------------------------------- --------. Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. 04/20/2005 11:06 AM SROBERDS --------------------------- The proposal will result in residential construction in the RS-7 zone for a total lot coverage of 22%. Setbacks are good. No land use issues are noted. Existing residence must be removed from site prior to the removal of the existing structure prior to issuance of permit. Electrical load calculations and electrical permits are required. Connection Fee DOES NOT APPLY 04/20/2005 02:08 PM JHEBNER ---------------------------- MAINTAIN CLEARANCES FROM SERVICE WIRES (Ground Clearances) 04/20/2005 02:09 PM JHEBNER ---------------------------- Any modifications to the electrical facilities will be at the customer's expense. 04/20/2005 02:09 PM JHEBNER ---------------------------- sanitary sewer re-connection inspection is required by Public Works prior to back fill of ditch. If new driveway is installed or replaced,construct driveway to City Standards.separate permit will be required. No concrete with exposed aggregate allowed in the City road right of way. . Other Fees STATE SURCHARGE 4.50 )J":$ w~~ ~E~ ~'Y\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 or work is suspended or abandoned for a period of 180 days after the work as commenced, or ifrequired 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 Iype 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 iaw regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Date Signalure of Owner (if owner is builder) T:\Policies\1102.15R [1/05] ... o~ 1'(,,:\,r ........0'" $~~ ,.~ . ~~ "t.iii.1Cw$~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 05-00000269 Application pin number 958881 Page 2 Date 11/22/05 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 170.00 170.00 .00 .00 plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 174.50 174.50 .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. 15R [1/05] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . .. .. INSPECTION REPORT. . . REQUEST: Date S-2.{,- OS Time ~ ;roA'~" Received by 1<.1/ (phone. person) \ Location of Work to be inspected ! l.s w hI d6~1 Name of person requesting inspection IVJ; k E' E) IS c... 0 Address of person requesting inspection Type of Inspection (circle appropriate one): ~e;;;;~Foundation Framing Chimney Plumbing Final Sewer Excav. Other bR'<- <::/9S:- (t5r-;sc.o G-<:<:1.U:l.~:L<.~ Phone No. YbD-C-o /1 Permit No. ns-z&Cj INSPECTION NOTES: Inspected: Date S-2..f:,-of> Time q~cOA..... By Bemarks: ~o I ~c?_..- ('l t""ln. ~~ C {;c LA.. u...J~< r .(~...,..e. r-~ d. 1~"'<;rrc-f"oV\. WlLli"> o.{ ,'u<;!.,::d/aJ-i<'J..... f'r-ovvderA. !-,>, IAS ~IIQA RV a-\- 1:'~ ~ <C, of' ~ niA tr<:>.c. +O/'- Co.":'" RESTORATION REQUiRED...... YES NO l( S"=-<<... D~c.k SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel OAsphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) "-'~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date ( C> / J ~ /0 ,- I I (J..j7 / 0 ~ Time 10 ,4-M Received by b/~ (phone, person) L""rry 6-sies . 'I17-bC.HQ Location of Work to be inspected / ( '$ W 4.i j !.// Name of person requesting inspection 1?~o,,:- 6~";'tr"';i.t; / Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. 2/5.... Zbtfl Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other t),,'v'/!l1.nv / DW""'''''' INSPECTION NOTES: Inspected: Date (tJj;,,/t;> Time '3 ,PM By &,,~ Remarks: c:::'v".b ~,.'d q(J.Lie~ ~...""'~ ;".-r - C).e. / RESTORATION REQUiRED...... YES vi NO x.- S'Z44/t ctspho./f po,-tc4 0,+ 1Jf'~-k.. wa.y c.4t"b 3- 1/" weep hc.le~ it..iO~.j>t c.1...\/"'.b N'l.e..Js 1-a ?~'1 for b".~V\e.;UJo..y "Pe(-"",,~+- eo..\W O/..UY\e.... Le..F"+ / 7'J <-J- I WI.. ess, 11- Ie -050- l.fYecJ ~r rerm!; 1:jf-22-Cb ------ 8// X ;2'1// SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 pcc 0 Other o Repaired by City :foJ'k Order # 3 '/0 LfO - / o Repaired by Permittee 6!;i;V COMPLETE I'Wf=:.--. o No Damage Found 0 INCOMPLETE J /J;; ,)lreef /~/ {P/05 rF (Continue on reverse side if necessary) STREET SUPERINTFNnFNT lOA TEl BUILDING PERMIT INSPECTION RECORD c~. J.,1,(j CALL 417-4815 FOR BUILDlNG INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTlOj..,:, CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANi' 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 .'-'''''.'1L.~~. FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE / DOWN SPOUTS ,.,....,,<-....''--~'..:.-,...~~c. PIERS POST HOLES (POLE BLDGS.) _''''.'"".'.~'''''~-~- PLUMBING UNDER FLOOR / SLAB ROUGH.IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER ~w.~......,...~_u.~~_ AIR SEAL WALLS CEILING I I I ""'"_~. .:...."...~. .n"",-;,,,,',. FRAi\1Ii\'G JOISTS / GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DRYW ALL (rNTERIOR BRACED PANEL ONLY) T.BAR ,..--....:,..'., " "::,-,.. Ii\'SULATlON SLAB WALL / FLOOR / CEILING '-"".~,'-';;I. MECHAi\'ICAL HEAT PUMP / FU~'lACE I DUCTS GAS LINE WOOD STOVE / PELLET / CHIMNEY COMMERCIAL HOOD / DUCTS 7..:'.......~ 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 RESIDEi\'TlAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL. LlGIIT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. /PW/ CONSTRUCTION. R.W. ENGINEER1!\:G 417.4807 PW / ENGINEERING - FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417.4750 PLfu'\!NING DEPT. BUILDING 4 I 7-4815 BUILDING T:\Policies\1102_15 building pennit inspection record05.wpd [1/4/2005J --~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Permit Fee Issue Date Expiration Date Page 05-00000269 Date 958881 146.00 Plan Check Fee 5/23/05 Valuation 11/19/05 2 5/23/05 .00 o Qty Unit Charge Per Extension BASE FEE 47.00 10.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 70.00 1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00 1. 00 15.0000 ECH PL- EA. BLDG SEWER 15.00 1. 00 7.0000 ECH PL- EA.WATER HEATER 7.00 Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. 04/20/2005 11:06 AM SROBERDS --------------------------- The proposal will result in residential construction in the RS-7 zone for a total lot coverage of 22%. Setbacks are good. No land use issues are noted. Existing residence must be removed from site prior to the removal of the existing structure prior to issuance of permit. Electrical load calculations and electrical permits are required. Connection Fee DOES NOT APPLY 04/20/2005 02:08 PM JHEBNER ---------------------------- MAINTAIN CLEARANCES FROM SERVICE WIRES (Ground Clearances) 04/20/2005 02:09 PM JHEBNER ---------------------------- Any modifications to the electrical facilities will be at the customer's expense. 04/20/2005 02:09 PM JHEBNER ---------------------------- sanitary sewer re-connection inspection is required by Public Works prior to back fill of ditch. If new driveway is installed or replaced,construct driveway to City Standards.Separate permit will be required. No concrete with exposed aggregate allowed in the City road right of way: Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1750.65 1750.65 .00 .00 Plan Check Total 583.86 583.86 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 2339.01 2339.01 .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 penn it inspection record05.wpd [l/4/2005] BUILDING PERMIT INSPECTION RECORD rJ~ '2?J( 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 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 YES NO COMMENTS FOUNDATION: FOOTINGS WALLS FOUNDA TION DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) . (# It::[ /1C7 y (j:>jr e; I () '5 )w J/'V PLUMBING -i'LL' ~ 1l:njlJ'i ~:IJlj, ,:. Vi ~2 \ ,:'t~~ L. ' ?~1) J G' UNDER FLOOR 1 SLAB ROUGH. IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER .(':::1-7-a.c:; I~ )...L, AIR SEAL WALLS f'P1-?-o oS Ir \ 1- L /Iq-? -oS II' \ j...L CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS ,93/ ( t1 ./ () Y It-L-- WALLS 1 ROOF 1 CEILING ;. . q - I:J-os' \ J... L..-- DRYW ALL (INTERIOR BRACED PANEL ONLY) ,/q - 2~.~S J)...1- T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEA T PUMP 1 FURNACE 1 DUCTS 1\'\lU:.\- PII\N~ IZ (}'l-/ L'" GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES ...'I2-/l{ /01 fh . FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKlRTING PARKING/LlGHTlNG LANDSCAPING SEPA: ESA: SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE PLANNING DEPT. SEPARATE PERMIT #'s RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL. LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI ENGINEERING 417.4807 CONSTRUCTION. R.W. PW 1 ENGINEEIUNG FIRE 417-4653 FIRE DEPT. 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UlO'\OOOt-' ~~~~w GlO l'l\Jl 00(/)1-3::8 t<- 0 , - ;top:: l'l o H H H {J)H oat"'Ztl '" tvl;J;>l txl O'll11::d<:O< en '" , :OH 0 ot<tI:I~ :0 , :>;:<: ... l'lH l'l ..... {J)\Jl tIl \Jl c:: Z'" H l'l t< :>;:0 tJ 0 l'l (J)O :0 "l0 (J) :0 H Z n H H ZZ (J){J) '0'0 l'll'l nn >-l>-l OH :00 ,. Z y>-l 'O'O{J) ~8 6653 l'l:>': {J)l'l zZtJ >-l tJj"tJl H t< <: t< H l'l ..... ..... :0 "'''' t< 00 >< ...'" HOO ...,..... , , "'''' "'... ...00 "'... tJ'O ;to;to >-lGl l'll'l '" '- 0 ..., '- 0 \Jl'" BUilDING DIVISION CITY OF PORT ANGELES * * Correction Notice Job Located at 1,[-::, \4J<kt 0I?l7 Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: ~L.z..e. BLDeU- ~\ ~ CIA-t"'-1.'f ~- ~tTt'- ~.o&--'))lNut~ . MUAL We.n:. (OJ,.JrJ~ -Yb2c1" ~dn~. These corrections must be made and are not to be covered until reinspection is ma e. When corrections have been made, please call I r for inspection. 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PERMITS (360) 417-4815 FAX(360)417-4711 Applicant or Agent: Phone: Owner: !-CA.. ,. ryE C; te~ {;Z I Lt6...c:..k:--jioi\ . S't- Phone: Address: \ \S '_.^)~\OtS6~ City: h~ j::::,.I' )6t8-E. S .Architect/E1]gineer: ~ ~ \, t;:.., \0 . CAy S Phone: 'YH-\L CDl...L\t-J.$ (V)o0~v'BOJS''2-gG Contractor fIl\f'JTN, \J l~w e,u\'-::OE'\Z..S State License #: Exp: ; - I - 0 f Address: To tsDY rS,-! City: ~Q',,)\(V\ , PROJECT ADDRESS: \ \ S ''-.-) '\-\ \'0 g, Y LEGAL DESCRIPTION: Lot: 14 -I S- Block: CLALLAM COUNTY PARCEL NUMBER: 'I11-bbY9 C{8%rL Zip: Phone: G'b>-L~<t:.q. Zip: (1 31 g "L ZONING: /5 [)(;3 0 \ () 50 I S5 b C)~".)() Subdivision: P)OGE--;- ::".o.")10D CD-,---P Credit Card Holder Name: Billing Address: Credit Card Type VISA MC # TYPE OF WORK: ~Residential ~New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: City: Exp. Date: SIZENALUATION: "'"'> o Stove )C1L~ SF, @$ J?>")':- /SF. = $ ~Garage '?:.:.. \ SF. @ $ 40 /SF. = $ o Deck SF. @$ /SF. = $ o Other TOTAL VALUATION $ I 7g '-I700c....) NG2-V CO.lJ.s.-re.vc---{\O.N. 2..S --cD^-> ~-e~"'r f'01V\P \ s.....:. ,i '--1,0 2.~ .';" '" COMMERCIAL/RESIDENTIAL: Occupancy Group: IL d No. of Stories: I Lot Size: I,/ODD Existing Sq. Ft. Total lot coverage L \ I g' % Occupant Load: Construction Type: ~S "ot; l--.:rnA "- & Proposed Sq. Ft. '.7: 0 5 1..1 = TOTAL Sq. Ft. '3 () 5 Lf APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER: PLANNING USE ONLY: ESAlW etland( s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other: 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 pennit fees are due at the time of pennit 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 RlOS.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 true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are requirftd the Cit0 ~fd that I must obtain such permits prior to work. T:\RVESS\BLDG-fonns-brochures\2004-Buildingpennit.wpd Applicant: [.. ~ Date: .::::.{ -I 'L-O S- . - /-' -::s. 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Z 0 Z ;J> '-l>-l ~ Z ","1 ~;:; 0 0 "''<IUl >-l 0 66[iJ t'lX b t'l O>-l (JJt'l (JJ ><H ZZO >-l ;J>Z t'lt'lH t< (JJ<;) < !j1 t< H G t'l :u w w :u '" '" t< 00 >< "'''' H'" J::- -.J W , , "'to> "'''' ...'" "'... --tl 0'<1 ;J>;J> >-l<;) \) t'lt'l ~ --r '" '- ... 0 ( '" '- 0 enw q..rl x- ~o~r ~ t.J.,O~~'t ~ "- ~ -- 'LSucw:Ji'''''' CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES 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 05-00000269 Date 958881 113 WHIDBY AVE 06-30-10-5-0-1556-0000- RES NEW SFR 5/23/05 RS7 RESDNTL SINGLE FAMILY 178470 Owner Contractor ESTES, LARRY 621 WASHINGTON ST PORT ANGELES (360) 417-6649 Other struct info MOUNTAIN VIEW P. O. BOX 754 WA 983622556 SEQUIM (360) 683-2484 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS BUILDERS INC. WA 98382 21. 80 1. 00 14000.00 3054.00 1. 00 ---------------------------------------------------------------------------- Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date SANITARY SEWER HOOK UP 48900 110.00 5/23/05 11/19/05 Plan Check Fee Valuation .00 178470 Qty 1. 00 Unit Charge Per 110.0000 EA SAN SEW RECON Extension 110.00 ---------------------------------------------------------------------------- Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. 04/20/2005 11:06 AM SROBERDS --------------------------- The proposal will result in residential construction in the RS-7 zone for a total lot coverage of 22%. Setbacks are good. No land use issues are noted. Existing residence must be removed from site prior to the removal of the existing structure prior to issuance of permit. Electrical load calculations and electrical permits are required. Connection Fee DOES NOT APPLY 04/20/2005 02:08 PM JHEBNER ---------------------------- MAINTAIN CLEARANCES FROM SERVICE WIRES (Ground Clearances) 04/20/2005 02:09 PM JHEBNER ---------------------------- Any modifications to the electrical facilities will be at the customer's expense. 04/20/2005 02:09 PM JHEBNER ---------------------------- Sanitary sewer re-connection inspection is required by Public Works prior to back fill of ditch. If new driveway is installed or replaced,construct driveway to City Standards.Separate permit will be required. No concrete with exposed aggregate allowed in the City road right of way. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 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. ~ I..-:/::C l-t.c . Signature of Con~~ -).3- u.;: Date Signature of Owner (if owner is builder) Date T:\Policics\1102.15R [1/05] PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY 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 LOCA nON. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PW UTILITIES (Engineering Division) WATERLINE / METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEW ALK CURB & GUTTER DRlVEW A Y APPROACH BACK FLOW DEVICE I I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. / PW/ CONSTRUCTION. R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417.4653 FIRE DEPT. PLANNI0.'G DEPT 417.4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15R [1/05] CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES 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 05-00000269 Date 958881 113 WHIDBY AVE 06-30-10-5-0-1556-0000- RES NEW SFR 5/23/05 RS7 RESDNTL SINGLE FAMILY 178470 Owner Contractor ------------------------ ESTES, LARRY 621 WASHINGTON ST PORT ANGELES (360) 417-6649 Other struct info ------------------------ MOUNTAIN VIEW P. O. BOX 754 WA 983622556 SEQUIM (360) 683-2484 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS BUILDERS INC. WA 98382 ---------------------------------------------------------------------------- 21.80 1. 00 14000.00 3054.00 1. 00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date SANITARY SEWER HOOK UP 48900 no.Oo 5/23/05 n/19/05 Plan Check Fee Valuation .00 178470 Qty 1. 00 Unit Charge Per 110.0000 EA SAN SEW RECON Extension 110.00 ---------------------------------------------------------------------------- Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. 04/20/2005 11:06 AM SROBERDS ___________________________ The proposal will result in residential construction in the RS-7 zone for a total lot coverage of 22%. Setbacks are good. No land use issues are noted. Existing residence must be removed from site prior to the removal of the existing structure prior to issuance of permit. Electrical load calculations and electrical permits are required. Connection Fee DOES NOT APPLY 04/20/2005 02:08 PM JHEBNER ____________________________ MAINTAIN CLEARANCES FROM SERVICE WIRES (Ground Clearances) 04/20/2005 02:09 PM JHEBNER ____________________________ Any modifications to the electrical facilities will be at the customer's expense. 04/20/2005 02:09 PM JHEBNER ____________________________ Sanitary sewer re-connection inspection is required by Public Works prior to back fill of ditch. If new driveway is installed or replaced,construct driveway to City Standards.Separate permit will be required. No concrete with exposed aggregate allowed in the City road right of way. ------------------------------------------------ ---------------------------- 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 Signature of Owner (if owner is builder) Date T:\Policies\II02.15R [1/05} PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY 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 NO PW UTILITIES (Engineering Division) WATERLINE / METER SEWER CONNECTION SANIT ARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEW ALK CURB & GUTTER DRlVEW A Y APPROACH BACK-FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO 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:\Policics\1102.15R [1/05] CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 05-00000269 Application pin number 958881 Page 2 Date 5/23/05 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 110.00 110.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 114.50 114.50 .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\1102.15R [1/05] PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY 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 LOCA nON INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PW UTILITIES (Engineering Division) WATERLINE / METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEW ALK CURB & GUTTER DRlVEW A Y APPROACH BACK-FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES :-10 CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417.4807 PW / ENGINEERING FIRE 417.4653 FIRE DEPT. PLANNING DEPT. 417.4750 PLAl'-.'N1NG DEPT BUILDING 417.4815 BUILD1NG KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE T:\Policies\1102.15R [1/05J Lopez Ave. Fogarty Ave. \ "- "" ?r~f;f '"",'-" "-''''''''''''''''''''---''''~--",,-, l .....: (f) ~ :J ctl ....J ::""0 ' f:: .;.-.1 ...l J'L> r~.. /.1-0 "l.S'~ ...-0 B~ r'V"\ovecl Whidby Ave. --- Forest Ave. ""....x~".,.,_,>"""_ 20 60 N Area Map This map is not intended to be used as a legal description. ~ This map/drawing is produced by the City oj Pori Angeles Jor its own use and purposes. ,,,- Anyother use oJthis map/drawing shall not be the responsibility oJthe City. .. Feet Prescriptive Approach - Simple Form For the Washington State Energy Code (2003 Edition) Climate Zone 1 Site Information Building DellartlTlent Use Only Lot: Address: \ \ -::s ~>>~ \O~ Y City: ~'(L\ AN 6(;; ~. State: I..JJ f\ Zip: C'\'B% L Contact: LA~fL. 'of ESl ~S )ft:...-r ~M \---t~ / Phone: 4- \\ - Gb~ Phone 2: 451.:- S:-OO D Permit#: Notes: Fax: Table 6-1 PRESCRIPTIVE REQillREMENTS 0,1 FOR GROUP R OCCUPANCY CLIMATE ZONE 1 (Unlimited Glazing 01 tion Only) Glazing Glazing U-Factor Door9 Wall Wall Wall Slab4 Option ArealO U- Ceiling2 Vaulted Above Int4 Ext4 FloorS On % of Floor Vertical Oyerhead 11 factor Ceiling3 Grade Below Below Grade Grade Grade ill Unlimited Group R-3 0.40 0.58 0.20 R-38 R-30 R-21 R-21 R-I0 R-30 R-I0 Occupancy Only See the code text for footnote references This project complies with the following: ./ The project is a single family residence or duplex. ./ The project is wood frame OR all of the insulation is interior or exterior of the framing. ./ All building components meet the requirements listed in Table 6-1, Option III. ./ The project will meet all other provisions of the WSEC and VIAQ. The prflfect will take advantage of the following exceptions to the prescriptive option: [if 602.6 Exception 1. One door, that is 24 ft.2 or less, that does not meet the standards is allowed. Location of the door taking this exception t~l ~ccf.- o 602.6 Exception 2. Doors with a U-factor of 0.40 allowed without calculations, Option III only. Location of the door(s) taking this exception Copyright 2002, WSUCEEP02-056 Copied by permission from the Washington State University Extension Energy Program Prescriptive - Simple Form - Climate Zone 1 7/26/2004 :f",ORT~ $'.J"O~~tfs. r..... ....~ ~ 'l.ti[~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES 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 05-00000269 Date 11/22/05 958881 113 WHIDBY AVE 06-30-10-5-0-1556-0000- RES NEW SFR RS7 RESDNTL SINGLE FAMILY 178470 Owner Contractor ESTES, LARRY 621 WASHINGTON ST PORT ANGELES (360) 417-6649 Other struct info MOUNTAIN VIEW P. O. BOX 754 WA 983622556 SEQUIM (360) 683-2484 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS BUILDERS INC. WA 98382 21. 80 1.00 14000.00 3054.00 1.00 Permit . . . . . Additional desc . Permit pin number permi t Fee Issue Date Expiration Date DRIVEWAY INSTALLATION 65680 170.00 11/22/05 5/21/06 Plan Check Fee Valuation .00 o """'- """'- Qty Unit Charge Per BASE FEE Extension 170.00 ~ Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-El When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. 04/20/2005 11:06 AM SROBERDS --------------------------- The proposal will result in residential construction in the RS-7 zone for a total lot coverage of 22%. Setbacks are good. No land use issues are noted. Existing residence must be removed from site prior to the removal of the existing structure prior to issuance of permit. Electrical load calculations and electrical permits are required. Connection Fee DOES NOT APPLY 04/20/2005 02:08 PM JHEBNER ---------------------------- MAINTAIN CLEARANCES FROM SERVICE WIRES (Ground Clearances) 04/20/2005 02:09 PM JHEBNER ---------------------------- Any modifications to the electrical facilities will be at the customer's expense. 04/20/2005 02:09 PM JHEBNER ---------------------------- Sanitary sewer re-connection inspection is required by Public Works prior to back fill of ditch. If new driveway is installed or replaced,construct driveway to City Standards.Separate permit will be required. No concrete with exposed aggregate allowed in the City road right of way. t S- P- ~ b <;:: (\) 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 ction. " Signature of Owner (if owner is builder) Date T:\Policies\1102; 15R [I/05J PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY 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 NO PW UTILITIES (Engineering Division) WATERLINE / METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEW ALK CURB & GUTTER DRlVEW A Y APPROACH BACK.FLOW DEVICE I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO 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:\Policiesl 11 02.15R [1105] :f ~ORT ~ $.)"O~~~ r-Gii '- ~ ~ "l.<i~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 05-00000269 Application pin number 958881 Page 2 Date 11/22/05 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 170.00 170.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 174.50 174.50 .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\1102.15R [1105] PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY 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 NO PW UTILITIES (Engineering Division) WATERLINE f METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRlVEW A Y APPROACH BACK-FLOW DEVICE I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. f PWf CONSTRUCTION - R.W. ENGINEERING 417-4807 PW f ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Po1icies\11 02.15R [1105] Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT . ELECTRICAL PERMIT PERMIT NO. /:;-9 r DATE '3 - / e - 'Z E Site Address: wk, db f S ffl-u let. fl ~1cs o READY FOR , WILL CALL FOR INSPECTION INSPECTION License Number: Phone: Owner/Business: Phone: Owner/Business Address: Sq. Ft. ~esidential ( -Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction o Remodel o Service update/alter/repair ~Add/alter circuits b Auxiliary power (list below) o Special equipment (list below) Overhead o nderground Vol age o 1 03.0" Servi e size o Te orary Amps DetailslDescription: REfJ/ltCl , RPM'i.,'P , , ~ j, 'if. 7/J br IJ-J 1Tt. . W.S. No. Service Size Capacity: 0 O.K. 0 Not O.K. Comments o Ditch inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ~/~ O.K. Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Site Address: tff3 w~ldh (L'ic11.AL Installer: 5<t./l..tJlcL Permit/Receipt No. S-rr New Meters Date: -e- 3~ /8 --a6 . Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT.158 or EXT. 224. JA j- NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT 1.6 ~ Ilnspector Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMPIC PRINTERS, INC. Of"OflT~ f::"'~~<'" 'rSii' '- -- ~""" CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 08-474 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning Application valuation 08-00000474 Date 368318 113 WHIDBY AVE. 06-30-10-5-0-1556-0000- PUBLIC WORKS UTILITES 4/30/08 RS7 RESDNTL SINGLE FAMILY o 113W r;ld~ Application desc 2nd water meter and back flow for lawn Irrigation Owner Contractor FOLDON TTE HENRY B/EDNA J 113 WHIDBY AVE PORT ANGELES WA 983626444 OWNER Permit PLUMBING PERMIT Additional desc Permit pin number 125070 Permit Fee 57.00 Plan Check Fee .O? Issue Date 4/30/08 Valuation 0 Expiration Date 10/27/08 Qty Unit Charge Per Extension BASE FEE 50.00 1. 00 7.0000 ECH PL- EA LAWN BACKFLOW 7.00 . I~ UVVj.(Yl Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 2ND METER FOR IRRIGATION 125062 770.00 Plan Check Fee 4/30/08 Valuation 10/27/08 .00 o Fee summary Charged Exte!!Si-~ 5/8" METER 70. 00--- ---------------~------ Credited Due Qty Unit Charge Per '1. 00 770.0000 EA PW W/M 1" SERV Paid Permit Fee Total plan Check Total Grand Total 827.00 .00 827.00 827.00 .00 827.00 .00 .00 .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 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 oj iaws 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 constructi6n or the performance of construction. Signature of Contractor or Authorized Agent Date Date Signature of Owner (if owner is builder) T:\Policies\1102.] 5R [1105] 0,ccLJ d" c. \ APPLICATIO;'; FOR \\~\TER City Water Division, Port Angeles, WA /ssueddote: 41 >olo~ Installed by & dote: 71"i' S"3"'C3Penmt# D8.- '-171./ I hereby apply for water to be furnished in accordance with rates and rules of the City for the following prelmses: Ll5::z. - '2616 AppiJcant "orne & Phone: J1e.f\r y F <=l \ d o.A Sile Address: J Is L.Jk,'d h)' Jl Jp,. MarlrngAddress: sc.."'-<.e Blk: Lot: Add: Parcel #: C(,,?O /0"> 6/~~ b <Yl"Yl SVC:ON/<2j) Meter#'sC F i%27G912w:o#: :;0'3-18, <;0'1 ~~/ /( L .:d Svc: Size /, '/~ Fees: Z}J nD SIgnature: {_(~~~ RestoratiOn Required: ;J 6 Remarks: .2...J ~....,,~ t;-6 or 1'-1"3<:"+.''01;\. N o w '--' ~ ~lq3~ ~ l.,vl,:,db'- --J 2-,1 c7 E zlDc4' '" Vl s