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Home My WebLink About123 N Eunice St - Building f pORT ~ ~~O~~~ rea ~ -- ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property zoning . . . Application valuation 05-00000976 Date 10/11/05 453552 123 N EUNICE ST 06-30-00-5-1-2235-0000- MOVING PERMIT COMMERCIAL ARTERIAL 5000 Owner Contractor Bautista Jamie 718 estes ct PORT ANGELES WA 98362 AFFORDABLE SERVICES 258663 HI - WAY 101 SEQUIM WA 98382 (360) 683-9619 permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date RIGHT OF WAY 62265 50.00 10/n/05 4/09/06 Plan Check Fee Valuation .00 5000 Qty Unit Charge Per 1.00 50.0000 ECH RIGHT OF WAY PERMIT Extension 50.00 Special Notes and Comments 10/06/2005 05:05 THE SIGNING CONTRACTOR HEREBY AGREES TO TAKE FULL RESPONSIBILITY FOR CHECKING ALL CLEARANCES FOR THIS MOVING OF STRUCTURE, AND TO CHECK WITH ALL PROPER AUTHORITIES INCLUDING BUT NOT LIMITED TO QUEST, PCI, AND CLALLAM COUNTY, ETC. Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 50.00 50.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 50.00 50.00 .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 of laws and ordi ances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to g! e authori 10 iolate or cancel the provisions of any state or local law regulating construction or the performance of constru9!:io . : ' /I!,' I' )~ L.- .1;' }\ I :,...) Signature of C ntracto or Authorized Agent Signature of Owner (if owner is builder) 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 4]7-4807 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 LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO FOUNDATION: FOOTINGS WALLS FOUNDA nON DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL I FLOOR I CEILING I I I MECHANICAL HEAT PUMP I FURNACE I DUCTS GAS LINE WOOD STOVE I PELLET I CHIMNEY COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKINGILIGHTlNG 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.I 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:\Policies\! 102_[5 building perm.t Inspectlon record05.wpd [1/4/2005] :f pORT ~ ~~O~~~ ~ ~ ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 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 05-00000976 Date 10/06/05 453552 123 N EUNICE ST 06-30-00-5-1-2235-0000- MOVING PERMIT E:/Pl eel? LI- (71 !O {; COMMERCIAL ARTERIAL 5000 Owner Contractor Bautista Jamie 718 estes ct PORT ANGELES WA 98362 AFFORDABLE SERVICES 258663 HI - WAY 101 SEQUIM WA 98382 (360) 683-9619 ------------------------------------------------------..--------------------- 61978 452.00 Plan Check Fee 10/06/05 Valuation 4/04/06 .00 o N ~ Z 7 '" \li -<" c.. ~ Z~ z:: ..,.... 0 C' (T) v0 .::+ Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date M- MOVING PERMIT Qty Unit Charge Per BASE FEE Extension 452.00 ---------------------------------------------------------------------------- Special Notes and Comments 10/06/2005 05:05 THE SIGNING CONTRACTOR HEREBY AGREES TO TAKE FULL RESPONSIBILITY FOR CHECKING ALL CLEARANCES FOR THIS MOVING OF STRUCTURE, AND TO CHECK WITH ALL PROPER AUTHORITIES INCLUDING BUT NOT LIMITED TO QUEST, PCI, AND CLALLAM COUNTY, ETC. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 452.00 452.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 452.00 452.00 .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 ive th rity to violate or cancel the provisions of any state or local law regulating construction or the performance of constryptio,h I . ", / p--l, -oC;-- tor or Authorized Agent Date Signature of Owner (if owner is builder) 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 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 I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR I CEILING MECHANICAL HEAT PUNW 1 FURNACE 1 DUCTS GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W.I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005] ci pORT ~ ....~~.. ~rea~ ~-- ~C~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 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 05-00000976 Date 10/06/05 453552 123 N EUNICE ST 06-30-00-5-1-2235-0000- MOVING PERMIT COMMERCIAL ARTERIAL 5000 Owner Contractor Bautista Jamie 718 estes ct PORT ANGELES WA 98362 AFFORDABLE SERVICES 258663 HI - WAY 101 SEQUIM WA 98382 (360) 683-9619 61978 452.00 Plan Check Fee 10/06/05 Valuation 4/04/06 .00 o N ~ r \li 10 c. <. ~ .,... r- Z- " 0 \:Ii \)'J ~ ---------------------------------------------------------------------------- permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date M- MOVING PERMIT Qty Unit Charge Per BASE FEE Extension 452.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 452.00 452.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 452.00 452.00 .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 construct;on. _ j (!4~~M ~ /O-fo-tY-::,- Signature of 'contractor or-Authorized Agent Date Signature of Owner (if owner is builder) 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 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 r YES NO FOUNDATION: FOOTINGS WALLS FOUNDA nON DRAINAGE 1 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 T T FRAMING JOISTS / GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING MECHANICAL HEAT PUNW/FURNACE 1 DUCTS GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: P ARKINGILIGHTlNG ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRucnONR.W./ PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING . . T:\Policies\1102_15 building perrmt inspectIOn record05.wpd [1/4/2005] HOUSE MOVING APPLICATION and PERMIT CITY OF PORT ANGELES - BUILDING DIVISION PERMIT NO. The following materials are hereby provided in application for a House Move Permit: 1. Name of applicant: :::JAY K'E::TL+t--tJM 2. Address of Applicant: R FFd2.DAl3LE (l.ilH-~ StlVt ( E 3. Telephone of Applicant: l(>8'"5 -- C\4- lCf Date of proposed move and duration: /0 -' 9> -' O.s;-t.'!t}" ~. Name of insurance company and agent and copy of certificate of insurance: .<k-c VhJ-bt-1 ~~ 1 CSvcs _ 5. Original location (address) of building: 1z.:3 AI. [;;I-'NIc:E ~~4^"qL:'-FS, \;VA '7cB3b.2... Legal description of original location of building: ()~ $ OOS/Z235"cooo 6. New proposed location of building: 51 0 Z C o~J\J W()L1n 7. Route to be taken from old location to new location: -.l4 ' } 8. Description of current building: )( ..-:S 8 LeT Ll-4 1:>\~. 3 Legal description of new proposed location of building: &~-KL-1!. b5..3c...., 1"7 S-SC"'2..3~ l=ovf2.- S>t=-Ft5.f!f;. A r-I<..... 4-{VV\l 101 To CIfnotJ\I\JODJ"} L.J../# I SuJ6Lf .Sr,,~y ~TRUCf1)RE. , 9. Written confirmation that the following have been contacted including individual's name, telephone and date: AGENCY CONTACT PERSON DATE PHONE NO. -1 I i \ 4(1 ~ - 4=10":> ) Otherz, s~~e~of Transp. '/ 0"/ I hereby acknowledge that I am responsible for injuries, damages, and any expenses incurred by the City or other agencies during the moving of this structure and that the structure is to be restored to minimum Building Code requirements at its new location and ready for use within one (1) year from the date of moving the structure. In consideration of the granting of this permit, it is further agreed by the applicant that the City of Port Angeles and any of its officers or employees shall be saved harmless to the applicant from any liability or responsibility for any accident, loss or damage to persons or property, happening or occurring as the proximate result of any work undertaken under the terms of this application and the permit or permits which may be granted ~h" ,II of "'d II,bUme, 'co hecoby ,,,,.mOO by the '00"""1. /O-Lf-O:;- Date move took place: Treasurer's Receipt No.: Date ***OFFICIAL USE ONL Y:*** Bldg. Permit # Right of Way Constr. Permit # Damage and.or incidents enroute and comments: Original Site Restoration completed:_ Date ok for occupancy:_ Refund Date:_ Refund Amount$ Check No. APPROVED BY BUILDING INSPECTOR: DATE: PW-1105_02 [2/99)] I ACORDTM' CERTIFICATE OF LIABILITY INSURANCE T DATE (MMIDDIYYYV) 02104105 r PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION i Security Insurance Svcs., Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE I P.O. Box 510925 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I New Berlin, WI 53151-0925 ! I 262 785-9490 INSURERS AFFORDING COVERAGE NAte # rlNSURED INSURER A' Tudor Insurance Company , i Affordable Crane Service INSURER B: i Jay Ketchum DBA INSURER C: 258663 Hwy. 101W INSURER D: Sequim, WA 98382 INSURER E: Cllent#. 9737 AFFOCRA2 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L TR iNSRi TYPE OF INSURANCE POUCY NUMBER Pci}lJ~ri~~8tWIE P~~fJ 1~'lA"Jo~~N UMITS A! ~NERAL L1ABIUTY PGL0725372 10/15/04 10/15/05 EACH OCCURRENCE $1 000000 ~ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100000 i t:J CLAIMS MADE ~ OCCUR ~ MED EXP (Anyone person) s1 000 ~ Over the Road PERSONAL & ADV INJURY $1.000000 IX Riggers L1ab GENERAL AGGREGATE s2.000 000 nL AGGREGATE LIMIT APAS PER: PRODUCTS - COM PlOP AGG sinc!. i POLICY n ~~ LOC -- I ~OMOBIl.E UABILITY . COMBINED SINGLE LIMIT S i i ANY AUTO (Ea accident) r~ ALL OWNED AUTOS --- BODIL Y INJURY S H SCHEDULED AUTOS (Per person) , ' HIRED AUTOS BODILY INJURY ~ NON-OWNED AUTOS (Per accident) $ ~--~~ , I H PROPERTY DAMAGE S ' I (Per aCCldenl) -- , GARAGE UABILITY AUTO ONL Y - EA ACCIDENT $ ~ ANY AUTO OTHER THAN EA ACe s I I AUTO ONL Y: AGG $ i I EXCESs/UMBRELLA LlABIUTY EACH OCCURRENCE $ o OCCUR D CLAIMS MADE -- I AGGREGATE S I S q DEDUCTIBLE S ! RETENTION S s i WORKERS COMPENSATION AND I T~8N~Ws I IOJbI- : EMPLOYERS' UABILITY I ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ : OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ : ~~~C:J~s~rk~Vu'~~(/NS below E.L. DISEASE - POLICY LIMIT $ , OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER Proof of Insurance CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POlICIES BE CANCELLED BEFORE THE EXPIRATiON DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ---1.(L DAYS WRITTEN NOTiCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENT A TIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) 1 of 2 #S987221M94980 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the tenns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the Issuing Insurer(s), authorized representative or producer, and the certificate holder, nor does It affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. , . ACORD 25-8 (2001/08) 2 of 2 #S98722/M94980 . S.treet LookUp Page 1 of 1 Parcel Number 0630005122350000 Site Address: 123 N EUNICE ST PA I Quit I Taxpayer: BAUTISTA JAIME 718 ESTES CT PORT ANGELES, WA 98363 718 ESTES CT PORT ANGELES, WA 98363 Title Owner: BAUTISTA JAIME Description: SMITH, NORMAN R N70 L T 9 BL 22 Value Summary: Note: Listed values do not reflect adjustments made for exemption programs such as Senior/Disabled or Current Use programs (except Commercial Forestland properties). Land Value: 43,225 Improvements Value: 19,275 Total Assessed Value: 62,500 Property Characteristics: Note: Use Code is for Assessor's purposes only. Contact the appropriate planning or building departments for Zoning and allowable usage of property.. Use Code: 1112 TWO BEDROOM Land Size (acreage): .00 Note: Acreage is not listed for all properties in the Assessor's records. More information about land size. Tax Status: Taxable Tax Code Area:: 0010 Zoning Code: P _CA Note: Zoning and zoning codes change constantly. Verify all zoning with the appropriate planning or building department. Building Characteristics: (Click on Bldg. # for more details.) # Bldjl,Type_ BLdg.~tyl~ IotllLS.E, . BD SA 01 House One Story 448 2 1 Tax History Sales History Other parcels at this address: [ Quit I http://65.161.1 0.164/website/sitis _s.pgm?address=123%20%20%20%20%20&street=EUN... 10/6/2005 o Purchase and Sale Agreement This agreement is entered into by Jaime Bautista, hereby referred to as Seller, and John T. Jenkins, hereby referred to as Buyer. Both parties recognize that this agreement is a legal and binding contract. Seller agrees to sell and Buyer agrees to buy a certain home located currently at 123 North Eunice, Port Angeles, W A. and further referenced as an improvement to Parcel #0630005122350000 ofClallam County, WA. Real Property Records. This agreement involves only the residential structure on this parcel and in no way involves the land itself. The residential structure referenced here refers to the house (approximately 448 square feet) and an attached garage (approximately 200 square feet). Both parties agree to the following conditions and stipulations of this contract. 1. Sale price of property is agreed to be $10. 2. Seller affIrms that there are no liens, written or otherwise, that encumber this structure. 3. Seller affirms that there are no delinquent taxes associated with this structure or the parcel to which it currently belongs. 4. Structure is sold AS IS, WHERE IS. It is buyer's responsibility to move or cause to be moved the aforementioned structure. 5. Duration for this project shall not exceed forty-fIve days beginning on the date of this agreement. 6. Buyer assumes full responsibility for disconnecting utilities and preparation for transportation. 7. Buyer assumes full responsibility for any liabilities incurred related to this structure, or transportation of, from the date break-down commences on and in no way is seller responsible for any accident or liability from that same time forward, except by gross negligence or malicious misconduct. Buyer agrees to forever hold harmless seller against any claim resulting from the transportation of this structure. 8. Seller makes no warranties about the condition of the structure, its portability, or habitable condition. 9. It is buyer's responsibility to obtain all permits related to this transaction. Seller also affirms that all liens and encumbrances have been addressed in the above listed conditions and stipulations. Seller agrees to forever defend buyer's right to said property and to forever hold a less John T. Jenki , is employees, assigns and heirs against any action, legal or otherwi , re arding the exch ge d possession of stnicture. Buyer reserves the right to cancel th. co act within fIve usi ss days of signing if it is determined that permits cannot be issued 01 th lome cannot be ove for an reason. ! .' D Q.; -- \ .s.-~ Date ~S'/(5r Da / - From: To: Date: Subject: Trenia Funston Glenn Cutler 10/6/054:42PM House move from 123 N. Eunice Street Here's the story...... The little grey house at 123 N Eunice Street is to be moved to 4 Seasons Park. Andrew Martin, the contractor hired Evergreen Collision to move the structure. Jay Ketchum's name and signature is on the application for the house moving application. He told David that he would be placing the structure on the trailer and that Evergreen Collision was the responsible party for the moving of the structure. The actual building ( moving) permit was signed by Andrew Martin. Mr. Martin has gone to the various agencies for sign offs. I signed off for the water and sewer, which requires( a cap off of the sewer and pull of the water meter), police signs off on route, as does fire etc. I told the contractor he needed to contact Qwest for their approval. A permit was issued to the contractor this morning for a scheduled move on 10/8/05. This afternoon I received a call from Frank Lockhardt (Qwest) and Greg (CPI), they had concerns about lines at Golf Course Rd and at Walmart intersections. Due to the height of the trailer and the house combination clearances for telephone or fiber optic lines may not be met. I then talked with David, building division and relayed the concerns about the building not being able to clear the phone or fiber optics lines and that we would need to put a stop to the scheduled move until these issues were resolved. Dave, called the phone number for the contractor. He left a voice mail message regarding the concerns and that at this time the permit would be on hold until further notice. He asked the contractor to return a call to him. Dave called Jay Ketchum to let him know that until the issues were addressed that the structure would not be moved. Dave then called Evergreen and spoke with a Jim Johnson (457-4484) and asked if the trailer had hydrualic capibilities. It does not. Dave told Mr. Johnson the permit would be on hold until the issues of the clearances were resolved. I received a call from Andrew Martinthis afternoon, I explained that until I have a call and approval from Frank Lockhardt, the building was not to be moved on the trailer as proposed. David has since talked with Mr. Martin. Mr. Martin indicated what the clearances were at Golf Course Road, David said he would still need to talk with Frank @ Qwest regarding the line clearances. Until the clearance information is passed on to me the permit is on hold. Trenia cc: David Yasumura; Mark Madsen; Mike Quinn; Roger Vess jDavid Yas.umura - Building Application Review 10-5-05 Page 11 From: To: Date: Subject: Ron Becker David Yasumura 10/5/05 12:24PM Building Application Review 10-5-05 1. Is there water going to the building for any type of use? If so I need to know, to determine if backflow assemblies are needed. Ronald D. Becker rbecker@cityofpa.us FORT ANGELES WAS H I N G TON, U. S. A. RIGHT OF WAY USE PERMIT NAMEOFAPPLlCANT 3c'\-f~~t==tJWI\\s. Ie. A~ ~'t-JDATE MAILING ADDRESS If[)3 C;, LllJ~~. s1E4 ~ 47 PHONE NUMBER L'1 ?SC~ - 7-~CZ -L~57fl3 STREET ADDRESS OF PROPOSED STREET USE 12-3 E:DN ICE PA g~b7- IS THE USE TEMPORARY OR PERMANENT? TEYV'Y , HOW LONG WILL THE OBSTRUCTION BE IN PLACE? ~ t-f~uR <., WHATARETHEHOURSOFOPERf\TION? 7 AM - HOW lTWILL BE LIGHTED? ~'TI2f?-fH- EXPLAIN THE NECESSITY TO USE THE PUBLIC STREET, SIDEWALK OR PLANTING STRIP. ARE THERE ALTERNATE AREAS THAT COULD BE USED? THE S tJc LTC,j I A-: C b HOLD HARMLESS and INDEMNIFICATION AGREEMENT In compliance with the Port Angeles Municipal Code, and in consideration of the issuance by the City of Port Angeles of a Street Use Permit to the undersigned allowing the placement of the above described street use or obstruction, the undersigned for himself and for his successors in interest, hereby agrees to indemnify, hold harmless, and defend the City of Port Angeles against any claims or lawsuits for personal injury or property damage arising out of, or in any way connected with, the placement of t~se or..obstruction on the City street, sidewalk, or planting strip. JL ~ DAT})~~YOI-'f../~ .~ !..,~;2:..~~...~9~~A:>: ('-: . ~~. .~ - j,/ ~ ~c:.S\ON I:,,"pt, .~P<p ~pplicant } if:~01AR ~\l>r. " .o~ .. p.. ;, . ~eal~ vi. : ... pua\."-:~/ ~ !, cP... .[J<-2/J,''\)..: ~ . '.d. . orA ,.il'L' ...... .:-".'V . <" ^ '~\"~ :...... ....\:.:Ip..vt~S.......:. C" [OFFICE USE ONL Y] Copies sent to: Police Fire Planning _ Finance Date: Fee paid $ Receipt # Agreement to Remove Encroachment signed and recorded on N/A ************* Application reviewed and recommendation by City Engineer deny or approve and with the following conditions: Date application received Certificate of Insurance per PAMC 11.12.140(B) on N/A Date is to Application approved or denied by the Director of Public Works Date ~...._.-.........._..................................................................................................................................................................................................................... Copies to: Applicant 0 Fire 0 Police 0 Street 0 Other N:\PWKS\L1GHT\CONS\CA TEIROWPER.wpd o Address file 0 RUP file 0 RUP# .R~RTANGELES WAS H I N G TON. U. S. A. RIGHT OF WAY USE PERMIT Public Works & Utilities If:' ~ WHAT IS IT? A Right of Way Use Permit is used to allow certain approved uses within the public right-of-way which includes streets, alleys, planting strips, and sidewalks. The purpose of the permit is to ensure that structures or activities do not obstruct, hinder, jeopardize. injure or delay the use of the right-of-way for its primary functions which is for vehicular and pedestrian travel. The permit is not a construction permit; it only provides the approval to use the public right-or-way for a specific period of time. The information in this handout is only a brief summary of city ordinances. It is recommended that you check with the ordinance and/or counter staff to assure that your proposal is compatible with the requirements. STREET USES NOT NEEDING A PERMIT . Merchandise being moved into or out of an adjacent business, provided that such merchandise does not remain on the sidewalk or planting strip for more that 30 minutes; . Improvements placed or granted by the city, such as: o Fire hydrants; o Planters and other landscaping; o Benches and bicycle racks; o Telephone, television cable, and light poles; o Flagpoles or standards; o Traffic control devices; o Refuse containers . Newspaper dispensers or news racks; . Solicitation by civic or non-profit organizations; . Landscaping which is semi-permanent in nature and can be removed from the sidewalk area or planting strip. Such landscaping is to be less than 30" above the established grade at the curb or roadway shoulder. It includes fences which are 30" in height but allow room for pedestrian area and car doors to open; . Street musicians who are permitted outright without any other permit required provided the normal public use of the right-of-way is not interfered with. STREET USES NEEDING A PERMIT . Benches; . Litter receptacles placed by private parties; . Clocks: . Bicycle racks placed by private parties; . Telephone booths; . Private planters and other landscaping higher than 30" above the established grade at the curb or shoulder; . Any other obstruction sought to be placed upon a sidewalk by the city for a public purpose; . Additions to the facades of buildings existing on the effective date of the ordinance which buildings are built up to the right-of-way line of the street, provided that such addition shall not exceed 6" in width; . Sidewalk cafes, provided that such permit shall last for one calendar year and must be renewed each year; . Other sidewalk or planting strip obstructions which is determined to provide a public benefit, although the obstruction constitutes a private use of the public street; . Fences, retaining walls, terracing, and other similar structures; . A property owner adjacent to an unopened or unoccupied street may request a one-year, temporary permit for the use of such an area, which must be renewed each year; . Where the sidewalk and/or street area is used for construction work. which is being conducted on private property, and where an excavation permit is not required to improve the safety of the work, such temporary devices as scaffolding, barricades and/or pedestrian walkways may be permitted under conditions as specified by the City Engineer; . Public markets, street fairs, exhibitions or carnivals; . Parades, demonstrations, running events, and other civic activities. APPLICATION INFORMATION: An application for a Right of Way Use Permit may be made at the Public Works Department Permit Counter in City Hall, 321 E. 5th SI. The application includes: D Name and address of applicant; D Description of nature and location of use; D Hold harmless; D Proof of insurance naming the city as additional insured except for benches, litter receptacles, bicycle racks, private' planters, other landscaping, fences, walls and others as approved D Execution of Agreement to Remove Encroachment for permanent structures placed, such as fences over 30" rockeries, walls, stairs and ramps; , D Non-refundable fee: A. Benches $30.00 B. Litter receptacles $30.00 C. Bicycle racks $30.00 D. Private planters $30.00 E. Landscaping over 30" $30.00 F. Sidewalk cafes $60.00 G. Activities not specified $60.00 H. Parades, exhibitions, sidewalk sales and other civic events $ 5.00 I. Unopened right of way obstruction $175.00 J. Ramps or steps K. Fences L. Retaining walls M. Rockeries N. Temp. SI. Use O. Street Closure $115-.00 $115.00 $175.00 $175.00 $ 60.00 $ 60.00 APPLICATION REVIEW A complete application will be reviewed at the Public Works Permit Counter to see if all of the information is on your application. All permit are routed for review by various departments of the city prior to issuance of the permit. This process normally takes a few days. Additional permits may be required before an application for a Right of Way Use Permit is approved. These could include an excavation permit and permits for sidewalk or other construction in the right of way The City Engineering Division will inspect the work to assure that the conditions or the permit and other city ordinances are met. EXPIRATION OF PERMIT Most Right of Way Use Permits are a one-time-only permit and last for the duration of the structure or use. Exceptions are sidewalk cafes, annual events, and temporary use permits. All permits are, however, subject to termination at any time without cause. As a practical matter, this means that the use would have to be stopped if an overriding public use of the right-of-way came into conflict with the use. STREET CLOSURES Streets may be used for agricultural shows, parades, industrial shows, sports shows, trade shows, or other shows where not less than 7 persons exhibit goods or articles. A sponsoring person or group should be knowledgeable of the State requirements to charge sales tax for any goods sold. Street Closure Permits need the following: o The exhibition shall not constitute a traffic hazard either by itself or by its effect upon the visibility of persons using the street and or sidewalk; o Execute a hold harmless agreement; o Maintain in force, personal injury insurance of $300,000 per incident, $300,000 per person, and $100,000 property damage. The City shall further be provided with an endorsement to such policy, naming the City as an additional insured. o Exhibition must be sponsored by civic, charitable, or other non- profit organization or be a civic event as defined by the City Manager. CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DNISION 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 05-00000976 Date 10/06/05 453552 123 N EUNICE ST 06-30-00-5-1-2235-0000- MOVING PERMIT COMMERCIAL ARTERIAL 5000 Owner Contractor Bautista Jamie 7f8 estes ct PORT ANGELES WA 98362 AFFORDABLE SERVICES 258663 HI - WAY 101 SEQUIM WA 98382 (360) 683 - 9619 ---------------------------------------------------------------------------- Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date M- MOVING PERMIT 61978 452.00 plan Check Fee 10/06/05 Valuation 4/04/06 .00 o BASE FEE Extension 452.00 Qty Unit Charge Per ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 452.00 452.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 452.00 452.00 .00 .00 ~ Z- -z: '--:~ \J < c-- ~ -<-. rn c. z:- r \f\ =1-' 5.;', 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 Owner (if owner is builder) Date Signature of Contractor or Authorized Agent Date T:\Policies\1102.15R [1/05] PERMIT INSPECTION RECORD CALL 4] 7-4807 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 I ACCEPTED COMMENTS YES I NO PW UTILITIES (Engineering Division) WATERLINE 1 METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL P ARKlNG SIDEWALK CURB & GUTTER DRIVEWAY 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 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15R [1I05J ..L ! ~} ~~ \i \~ ~..... ~ ,r' ,~ ~~ \~ ~ ~ ~ ~~~ ~ ;\~1 ~ ~\ ~~ ,: ..j ~ l ~~ .....0 .~ \.- .J c..\~ ~ ~ r~~~ ~~~ (' '~l ~ ~ ~ t~ ~~> c\ ~ .. ~ ~' ~ . \ ~ ~ v' C- ~ .CD J :.... .------ :r \) p~ <;:.';" '-- ~ ~~ -.---> ,,---""= . -\ -, ~ ~ t It .-, ~~ 11 ~ ~ \/J~ ~ ~1 ~ ~ ..:::> ~ c \ ~ r ) I "'i- ) , / i > I ~ ( I I I I I I ! I ~ I I ~, I~'\\ i I ! I ! / i ~ 1 { ~ { J~ ~ I ~~~\ t ~ ~~t, ~ ~ ,.........:l TRANSACTION REPORT 2005/0CT/07/FRI 16:17 P.01/01 RECEIVER 94527051 ;-I~CI~ #elf''''' ~ ^,~r J:~l..tAdl ~~,,> 610- r/ rr~1- /lLLI&Y 'S~R:!t .; E: f~~... / ~~~ I - t1 I?.t p~ ft./Yv9. j'"t I iC ' " I PLA-'? f:t- f9 ~ .!34g<t ~" ,=>'- f1, ION~4y( M- ~'~ I(.~A:- ~..r .f&~~ . , '~.._. '" .' 7:1?A I ~s ~ I tJl TYPE/NOTE OK FILE ECM 5691 i5A-7t)~) t.J1 fl . I , ~. ~O , 6-,.~"i' d . LJ~e . 1I~17~T 8' P. C#/~*,~y - .- ,/ , i...... J <6 I t1'1 / ti2 ~ v.,f\ ,,,-, <- (., 19/1 _'\ ~t:.# '. :z. i7"~ .~:-. "<-"~ I,N' ~I ,..." /0 5 f}i;(r1. 1 0' ,/ /0 ~ II/HCf ok:..- 6JK.. f/?/c' 0<"- 1<;1 .<111 LJ.? f1"~ VI) ed L.,- C~JU - /5'/ 0/( I ~' -z./r 14 I .> /1 I ~I I "r .. Ilt.A-ll~~ H-e--~~~ -:J.(gJ,: :;. "'%,.'J. w!OIl( ,;,jlll' +--' ~~ '-4- #+otl~ ). I II()~ elf/WldAI l~: , 'NO \/$ ~j -,rM/~,z, k# ~ /I 't=':-AA-l- /) CXtUe<,T c!~/i J d7~.NSlP,J LI5' Z - 7~ 7 ( (3#/l-C/7rf j}tJlvHltf/0/l/~ h70 _ fiff) "30CJ- ?/6'o - '1/.~7 14 fI/1 ;v1 ~1YI~r/ FI i.b ~ U?7/ c S ~v tV 1R!)W~(t:GE .- Tcv0k'-S S./. __?F.:rJ/ :;;/"; ;--;4... Ie. . Locjd/41:. .,CiP 0,-"", . " Tilts "'bi/;'-J'.LJ{) 'i'~ ,;?,T. 0:; '--', {],.e/J/tD t9 e. PI rlfJz.-f. c.t1 ~ ;11//li 2 ~ {' 9r? L T7 #'Z.~ ~ '?-""" iOiJV ~..- . .&~ ~~ CITY OF PORT ANGELES DEPARTMENt OF coMNltJNtrY DEVELOPl\ffiN1' - BUILDING DMSION 321 EAST 5TH S~, PORT ANGELES, WA 98362 ,; Application Number Application pin number property Address ASSESSOR PARCEL NUMBER: . App'tic::ation type description Subdivision Name Property Use . . . . Property Zoning . . . Application valuation 05-00000976 Date 10/06/05 453552 123 N EONICE .ST 06-30-00-5-1-2235-0000- MOVING PERMIT COMMERCIALAR'rERIAL 5000 Owner Contractor Bautista Jamie 718 estes ct PORT ANGELES HA 98362 AFFORDABLE SERVICES 258663 HI - WAY 101 SEQUIM WA 98382 (360) 683-9619 ---------------------------------------------------------------------------- Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date . M- MOVING PERMIT 61978 452.00 Plan Check Fee 10/06/05 Valuation 4/04/0 Qty Unit Charge Per _..... --... =.::... Extension 452.00 -----;~~~:}:~~~~~:~~:~=~:~~:: KG FAX -::-:------------- TAKE .FOLLRESPONSIBILITY FOR DEMO MODE CES FOR THIS MOVING OFSTRUCTORE, AND ROPER AUTHORITIES INCLUDING BUT NOT LIMITED TO QUEST, PCI, . AND . CLALLAM COUNTY, ETC. ------------------------------~-----~--------------------------------------- Fee summary Charged .paid Credited Due -------------_.--- ...--------- --------..... ---------- ---------- Permit Fee Total 452.00 452.00 .00 .00 Plan Check Total .00 .00 ,00 .00 Grand Total 452.00 452.00 .00 .00 ~f\.rzeo 4(r:P1 !()~ .00 o 3: ~ <; ;E ~ N ~ Z \l1 c. z:. f\ ~ to ~. ,,-,':> Separate Permits are required for electrical work, SEPA, Shoreline., ESA, utilities, private and public improvementS;Thlspermltbe~oR1es null and void if work or construction authorized is not commenced\\'ithin 180 days, if construction or work Is s~speJ1de.d or a~aJ1doned for a period of 180 days after the work as commenced, or if requli"edlnspectlons have not been requested ~thI9180~ays fr'9m the last Inspection. I hereby certify that I have read and examined thisappl~t1on and know the same to be true and~rrect.AlI prpvlslons of laws and ordinan~es goveming this type of work will be complied with Whether specified herein or not The granting of apermitdoes not presume to ive h rity to violate or cancel the provisions of any state or local law regulating construction or the perfonnance of cons io /p~Je, -p~ Date T:\I'oli~es\l102_15 building ~it inspection rec0rd05.wpd [1/412005] Signature of Owner (if owner is builder) - ~'''''.'' . ,- i -.'--:;.~","Ji ".~ BUILDING PERMIT INSPECflON RECORD T r ~. CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-473S'POR ELEcrRICAL INSPEcno;NS'. CALL 417-4807 !,:OR PUBLIC WORKS UTILJTlES ' PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE ORC()NCEALANYlfOHBEFORE INSPECTED AND ACCEPTED: POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE ell .. . INSPECTION TYPE DATE.... ACCEPTED .' .' COMMENTS ~- YES NO . FOUNDATION: FOOTINGS WALLS 1 FOUNDATION' DRAINAGE I DOWN SPOlTl'S PIERS I POST HOLES (poLE BLOGS.) :. ,:'. c- ., PLUMBING . UNDER FLOOR I SLAB ROUGH-IN .' \ WATERLINE (METER TO BLOG) ". , GAS LINE '. BACK FLOW I WATER :" AIR SEAL -- .: ~;~ ~:'. WALLS KOFAX CEILING' .. T . FRAMING " DEMO MODE JOISTS I GIRDERS \ SHEAR W ALUHOLD DOWNS WALLS I ROOF I CEILING > DRYWALL (INTERlORB%,-CBD pANBtONL Y) "'. T.BAR "~';::i!:\. .,. INSULATION !"fc;".., ,. SLAB W AQ:;;!+APOR I CEILING I I MEC~ HEAT P~ I FURNACE I DUCTS GAS LINE <. . WOOD STOvE I PELLET I CHIMNEy ! COMMERCIAL HOOD I DUCTS ... MANUFAcnJRED HOMES . FOOTING I SLAB . BLOCKING'" HOLD DOWNS SIQRTING PLANNING DEPT. SEPARATE PERMIT #'5 ,0 SEPA: PARKINGlLIGBTlNG ESA: .. .' V: LANDSCAPING SHORELINE: . FIN..ruc1NSP~ONS ~~ PRlpR TO OCgJPANCYIUSE .' .. DATE YES' NO .. CO&fMERCIAL DATE ACCEPTED ..... RESIDENTIAL , YES NO .' .. ELECTRICAL. LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTIONR.W.I PWI CONSTRUcTION'. R. W. ENGINEERING 417-4807 PWI ENGINEERING 417-4653 - FIRE DEPT. FIRE . pLANNING DEPT. 417-4750 .PLANNING DEPT. BUILDING 417-4815 BUILDING .' T:\PoIicies\1102 _15 building permit inspection rec0rd05. wpd [1I41200S} .e. ~ CITY OF PORT ANGELES DEPARTMENT OF CoMM'UNrrYDEVELOPMENT ~BtmDING DIVISION 321 EAST511I STREET,PORT ANGELES, WA 98362 ::,,:,<', Appligation Number r 05-00000976 Date 453552 123 N EUNICE ST 06-30-00-5-1-2235-0000~ MOVING PERMIT 10/06/05 P _..... --... =.::... : KOFAX ~ DEMO MODE ription COMMERCIAL ARTERIAL 5000 OWner Contractor Bautista Jamie 718 estes ct PORT ANGELES WA 98362 AFFORDABLE SERVICES 258663 HI -WAY 101 SEQUIM WA 98382 (360) 683-9619 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date .. . Expiration Date . M- MOVING PERMIT 61978 452.00 Plan Check Fee 10/06/05 Valuation . . 4/04/06 .00 o Qty Unit Charge Per Extension 452.00 BASE FEE Fee summary Charged Paid Credited Due ----------------- ---------- ---.------- ---------- ---------- Permit Fee Total 452.00 452.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 452.00 452.00 .00 .00 Separate Permlts~~,requiredforelectrical work, sePA. Shoreline"ESA. utilities, private and pu"blic improvements. ThlsperrriltbeCornes nul,' and void If WOrK or constrtlctlon authorized, Is not CQmmenced within 180, days. If construction or work Is, susf'el1de~o..~~cindcmed for a period of 18() d,YI after the work as commenced,orlf required Inspections have not been requested within 180days from the last Inspectlon./ hereby certify that I have read and examined this application and know the same to be true and COrrElct. ~, proVisions of laws,and ordinancesgoyeming 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 C~ .. ID-to~W . , Signature of Contractor or Authorized Agent , Date Signature of Owner (if owner Is builder) Date " T:\Policies\1102.J5 builcling pcI1nit inspecliOllJeCOl'd05.wpd (i/4f2005) ~ \}) r \Tl t) c- <. ~ ~ ,-- ~ ~'.~ ~ BUILDING PERMIT INSPECTION RECORD ,. ,\,.,.;,; C~L417-4815 FORBUILD~G INSPEC110NS. CALL 417-4735 FOR ELECTRICAL INSPEC110NS. . . cALL 417-4807 FOR PUBLIC WORKSUflLITIES .'. . . PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT is UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFQRE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPIqJOUS LOCATION; KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE. I ACCEPTED COMMENTS I YES I NO .. '. , FOUNDATION: FOOTINGS WALLS .' FOUNDA SPOUl'S PIERS -- .: ~;~ .... POST HO KOFAX ~ _'i-," ~. .~ i) PLUMBIN4 UNDER :E DEMO MODE ROUGH- N '. . ", WATER LINE (METER TO BLDG) ...... GAS LINE BACK FLOW I WATER c" A4t SEAL WALLS I CEnlNG' I I T . ~G . 'r\. JOISTS I GIRDERS }. SHEAR W AUlHOLD DOWNS "w ALLSI ROOFI CEIUNG . cc7'.. i DIlYW ALL (lNTERIORBRACED PANm;;ONLY) "" T-BAll ... _.:c.'t;;i, ..... . INSULATION ""v.;>" . . .. I I I SLAB W Al;fit,JiLOORI CEILING I I I ..,.;...'''....,:,.'''.. MECHANlGAt '. HEATPmI,r I FURNACE I DUCTS GAS1.lNE ; , '. WOOD STOVE I PELLET! CHIMNEy "J COMMERCIAL HOOD! DUCTS , MANUFACTURED HOMES . "'i ~ FOOTING! SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PBRMJT.#'s ., SEPA: p~GIJ,.IGHTlNG ". ESA: -'1" "\\. .. ~DSCt\PING '. .' SHORELINE: ,: . ~ ,., FI~~S.P,ECTlONS REQ~PRI0RT9P(:CUPAJlicylti;~: RESIDENTIAL " ,DATE YES NO CO~CIAL DATE .' ACCEPTED YES NO . ELECTRICAL <. .' ELECTRICAL - LIGHT DEPT. 417-4735 '. UGHT DEPT , a>NSTRUcnON R. W.! PW! CONSTRUCTION. R. W. .' ENGINEERING 417-4807 . .PW!~ . ,. FIRE 417-4653 FIRE DEPT. . PLANNING DEPT. 417-4750 . PLANNING DEPT. BUILDING 417-4815 .' BUILDING -,-' T;\PQl!91~,ltl~!s..:l!\!1"Mi'!8.~t,~!Kl record05'~ [11412005) _.~.u~ .. f VORT ~ ,I,"'~~~ CJ~~ 1L -=:or ~ "t&i:1C~ HOUSE MOVING APPLICATION and PER CITY OF PORT ANGELES - BUILDING DIVISION _..... --... =.::... 1. Name of applicant: KOFAX DEMO MODE The following materials are hereby provided in application for a House Move Permit: E:1t# M 2. Address of Applicant: R FFD2.DA13LE l' JlA.~ St:-rVI ( h 3. Telephone of Applicant: lc>83 -<1~ lq Date of proposed move and duration:/O -' 9..... O~l'~~fv ~. Name of insurance company and agent and copy of certificate of insurance: '~LVhJ~ ~~.. <SVC s _ 5. Original location (address) of building: 1Z3 AI. };;UNIc:E: ~J?'I NE,€l.-i.2 ~ Legal description of original location of building: 0 3 S 2235"0000 6. New proposed location of building: ~OZ CO~^, Wf"lr)~ LoT Lj~ ]:)\~. 3 Legal description of new proposed location of building: '&.et:;Kl...-ll n6.3Dl"1 S":So2.3D Fovf2- '5>e:f't5.p:f; AIK.. 7. Route to be taken from old location to new location:_3./V\l\l 101 To C~\AJOOf') ~.. tA' J I 8. Description of current building:~ )( 3 -3 S/kU5U=: S11)~Y "STRUCf1)RE". , 9. Written confirmation that the following have been contacted including individual's name, telephone and date: 1f~.., "6" tJ'I ~ 'r ~ ~~..p DATE .PHONE NO. 1 \ Othenz, Sta.t~eBt-of Transp. '/!:> 07 I hereby acknowledge that I am responsible for injuries, damages, and any expenses incurred by the City or other agencies during the moving of this structure and that the structure is to be restored to minimum Building Code requirements at its new location and ready for use within one (1) year from the date of moving the structure. In consideration of the granting of this permit, it is further agreed by the applicant that the City of Port Angeles and any of its officers or employees shall be saved harmless to the applicant from any liability or responsibility for any accident, loss or damage to persons or property, happening or occurring as the proximate result of any work undertaken under the terms of this application and the permit or permits which may be granted in response thereto, and that all of said liabilities are hereby assumed by the applicant. ~ /0-4-0:;- Date move took place: Treasurer's Receipt No.: Date ***OFFICIAL USE ONL Y:*** Bldg. Permit # Right of Way Constr. Permit # Damage and.or incidents en route and comments: Original Site Restoration completed:_ Date ok for occupancy:_ Refund Date:_ Refund Amount:$ Check No. APPROVED BY BUILDING INSPECTOR: DATE: PW-1105_02 [2199)] . ::~ KOFAX DEMO MODE . ~.i =z):::.. ~bN~5 ~ M~ D v r- ",t~.$ -, 'v\Af- J::>wE"'i~' - y/lo'" [1J~ - ~ t1-~~,7~ ~ " ACORDTM' CERTIFICATE OF LIABILITY INSURANCE T DATE (MMIOOIYYYY) 02104105 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Security Insurance Svcs., Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 510925 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. New Berlin, WI 53151-0925 262785-9490 INSURERS AFFORDING COVERAGE NAle # INSURED INSURER A: Tudor Insurance Company Affordable Crane Service INSURER B: Jay Ketchum DBA ., INSURER C: , 258663 Hwy. 101W INSURER 0: Sequim, WA 98382 INSURER E: Cllent#: 9737 AFFOCRA2 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IINSR ~~~ TYPE OF INSURANCE POUCY NUMBER PD~.J~ri'~8m\E Pg~W ~~P1RATI.gN UM ITS LTR A MIODIYY A ~ERAL UABIUTY PGL0725372 10/15/04 10/15/05 EACH OCCURRENCE s1 000 000 ~ 3MERCIAL GENERAL LIABILITY DAMAGE TO RENTED S100 000 f-- CLAIMS MADE ~ OCCUR MED EXP (Anyone person) s1 000 X Over the Road PERSONAL & ADV INJURY s1 000000 ~ Riggers L1ab GENERAL AGGREGATE s2 000 000 ~'L AGGREnE LIMIT APAS PER: PRODUCTS - COMPIOP AGG sine!. POLICY rb'lg: LOC ~TOMOBILE UABILrrY . COMBINED SINGLE LIMIT (Ea accident) $ f-- ANY AUTO f..- ALL OWNED AUTOS BODIL Y INJURY $ SCHEDULED AUTOS (Per person) f-- f-- HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per accident) f-- f-- PROPERTY DAMAGE S (Per accident) RRAGE UABILITY AUTO ONLY - EA ACCIDENT $ I ANY AUTO OTHER THAN EA ACC S AUTO ONL Y: AGG $ OESSlUMBRELLA UABIUTY EACH OCCURRENCE S OCCUR 0 CLAIMS MADE AGGREGATE $ S R DEDUCTIBLE $ . RETENTION S _..... $ --... =.::... WORKERS COMPENSATION AND WC STATU-.I IOJ~- EMPLOYERS' UABlLrrY ANY PROPRIETOR/PARTNER/EXECUTIVE KOFAX E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ ~ml~~~Vls'lOrNS balow DEMO MODE E.L. DISEASE - POLICY LIMIT $ 'i.~'--;-~:~~ OTHER c.t' ~.-o;: - ',~ f:....:\i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS '", ~~~I~,: "';.:;,\.:T:r " ~ i-. > " CERTIFICATE HOLDER Proof of Insurance CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .....1JL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILITV OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) 1 of 2 #S987221M94980 , ACORD CORPORATION 1988 IMPORTANT ~::: KG FAX holder Is an '<ADDITIONAL INSURED, the policy(les) must be endorsed. A statement DEMO MODE le does not confer rights to the certificate holder In lieu of such endorsement(s). . If SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy, cartaln policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the Issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies Iisted'thereon. , . ACORD 25-5 (2001/08) 2 of 2 #S987221M94980 , S.treet LookUp Page 1 of 1 Parcel Number 0630005122350000 Site Address: 123 N EUNICE ST PA I Quit I Taxpayer: BAUTISTA JAIME 718 ESTES CT PORT ANGELES, WA 98363 718 ESTES CT PORT ANGELES, WA 98363 Title Owner: BAUTISTA JAIME Description: SMITH, NORMAN R N70 L T 9 BL 22 Value Summary: Note: Listed values do not reflect adjustments made for exemption programs such as Senior/Disabled or Current Use programs (except Commercial Forestland properties). Land Value: 43,225 Improvements Value: 19,275 Total Assessed Value: 62,500 Property Characteristics: Note: Use Code is for Assessor's purposes only. Contact the appropriate planning or building departments for Zoning and allowable usage of property.. Use Code: 1112 TWO BEDROOM Land Size (acreage): .00 Note: Acreage is not listed for all properties in the Assessor's records. More information about land size. Tax Status: Taxable Tax Code Area:: 0010 Zoning Code: P _CA Note: Zoning and zoning codes change constantly. Verify all zoning with the appropriate planning or building department. Building Characteristics: (Click on Bldg. # for more details.) JL Bldg. Type Bldg. Style Total S.F. BD BA 01 House One Story 448 2 1 Tax History Sales History Other parcels at this address: I Quit I _..... --... =.::... KOFAX DEMO MODE http://65.161.10.164/website/sitis_ s.pgm?address= 123%20%20%20%20%20&street=EUN... 10/6/2005