HomeMy WebLinkAbout222 W Forest Ave - Building CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
v 321 EAST 5TH STREET, PORT ANGELES, WA 98362
'f" Application Number 12- 00001036 Date 8/09/12
X, Application pin number 313540
Property Address 222 FOREST AVE
5 ASSESSOR PARCEL NUMBER: 06-30-09-5-8-0068-0000- REPORT SALES TAX
v
Application type description. RE -ROOF
Subdivision Name On your state excise tax form
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY to the City of Port Angeles
Application valuation 7920 (Location Code 0502)
Application desc
TEAR OFF REROOF W/ 30 YR SHINGLES
11
Owner Contractor
DONALD D LANNOYE LARRY'S ROOFING N I g" (P' 222 FOREST AVE 352 AVIS ST. 1
PORT ANGELES WA 983622518 PORT ANGELES WA 98362
(360) 457 -9190 (360) 452 -2215
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF REROOF
Permit Fee 179.75 Plan Check Fee .00
Issue Date 8/09/12 Valuation 7920
Expiration Date 2/05/13
Qty Unit Charge Per Extension
BASE FEE 95.75
6.00 14.0000 THOU BL- 2001 -25K (14 PER K) 84.00
Other Fees 'STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 179.75 179.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 184.25 184.25 .00 ..00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if req 'r- d inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this ap• 'cation and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complies with ether specified herein or not. The granting of a permit does
not presume to give authority to ate or cancel the p sions o a: sta or local law regulating construction or the performance of
construion.
a (011 6R 1■\
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
.PLEAS PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 -4815 Electrical Inspections 417 -4735 /n
Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water-Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY USE
Inspection Type Date Accepted By
Electrical 417 -4735 r
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
0
Planning 417 -4750
Building 417 -4815 S 1 W 1
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THE .Y. GELE
Clry For City Use 23
o Permit 12 MAO 1> M
W A S H I N G T O N U.S. c
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Date Received: b I ke F
321 East 5th Street <z
Port Angeles, WA 98362 Date Approved: fig m
P: 360- 417 -4817 F: 360- 417 -4711 m_
hcatuzo @cityofpa.us
Building Permit Application
Project Address:
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Main Contact: Phone m.
N ame 1 Phone
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Property Oil r�n0 e.
Owner Mailing Address Email 4 iivIdcz ?_72._ o6, e C
City State W Zip
Contractor Name Phone
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Contractor License rrtj ro X 1 Expiration: L
Project Value: Zoning: Tax Parcel Lot
-11°1ZP---s CAC5 Ft s 60(9
Type of Residential 151 Commercial Industrial Public
Permit Demolition Fire Repair Reroof ear o (flay over) A
For the following, fill out both pages of permit application:
New Construction Remodel Addition Tenant Improvement
Mechanical Plumbing Other
Existing Fire Sprinkler System? Maximum height of structure Proposed Bedrooms Proposed Bathrooms
Yes No
Project q
Qunoue._ r Vj �Q Description t
h
I have read and completed the application and know it to be true and correct. I am authorized to apply for this
permit and understand that it is my responsibility to determine what permits are required, and to obtain
permits prior to working on projects. I understand the plan review fee is not refundable after review has
occurred. I understand that I will forfeit 20% of the review fee if I cancel o ithdraw the application before
plan review has occurred. I understand that if the permit is not is ed wi 0 days of receipt, the
application will be considered ab. 1 1 ed, and the fees forfeit.
Date Print y7 Signature
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
f 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00000423 Date 5/04/11
Application pin number 292865
Property Address 222 FOREST AVE REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-09-5-8- 0068 -0000-
Tenant nbr, name DONALD LANNOYE on your state excise tax form
Application type description MECHANICAL APPL. PERMIT to the City of Port Angeles
Subdivision Name
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 6911
Application desc
GOODMAN HEAT PUMP
Owner Contractor
DONALD D LANNOYE ALL WEATHER HTG COOLING INC
222 FOREST AVE 302 KEMP ST
PORT ANGELES WA 983622518 PORT ANGELES WA 98362
(360) 457 -9190 (360) 452 -9813
Permit MECHANICAL PERMIT
Additional desc GOODMAN HEAT PUMP
Permit pin number 185082
Permit Fee 64.80 Plan Check Fee .00
Issue Date 5/04/11 Valuation 0
Expiration Date 10/31/11
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 14.8000 EA ME- FURN /HP /FAU OR 5 TON 14.80
Fee summary Charged Paid Credited Due
Permit Fee Total 64.80 64.80 .00 .00 Y'�
Plan Check Total .00 .00 .00 .00
Grand Total 64.80 64.80 .00 .00 ,1
n d
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction. �A
5 /9111 can w
i l k Kto r\ 1140.,/
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 -4815 Electrical Inspections 417 -4735
Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab �rnrn
Wall Floor Ceiling l t
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough-In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PVV Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 4815 -�3
3
T:Forms /Building Division /Building Permit
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o� �q"tr BUILDING PERMIT APPLICA TION Print in ink
Nh CITY OF PORT ANGELES For City Use 'Nil
A ttn: Building Permit Technician
IL_
Date Received
321 E. Fifth St., Port Angeles, WA 98362 Permit
N MI (360) 417 4815 fax (360) 417 4711
Date Approved
Applicant IA �.�•uti_ r 11.4 t L_1 ,1r Phone t r1 ItGiN•
Property Owner /o otra 1 c Phone Ii M]d •11
Property Owner's Address t...1 IEF
Contractor 1 0 64i i- ddb ;l /il Phone MENIF 1 .,R�,'ts
Contractor's Address 'L. i /i it, ,t
License IL_ 1.._ E -mail OWN e a..
PROJECT ADDRESS t Z
Parcel Number Lot Zoning
Project Type Brief Description; RResldential o Multi family o Commercial o Industrial
Check all that apply
New Construction With(,Ufi Of Soodmeyi hDrtI p 0
._ra Addition
o' Remodel
o Repair
Demolition
o Re -roof o House o garage o other tear off re -roof o lay over one layer
i Heat System ljHeat pump n wood buming stove o gas fireplace u pellet stove o other
u Other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.
Basement per sq. ft.
1` Floor
2 Floor
3i Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION .5g.
Total footprint of structures sq. ft. T Lot size sq, ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage
Max. height of proposed structures ft. Occupancy group of bedrooms
Will a lawn sprinkler system be installed? Occupant load of full baths
Will a fire sprinkler system be Installed? Construction type of half baths
1 have read and complefed this application and know it to be true and correct, 1 am authorized to apply for this permit and understand
that it is my sponsibilify to determine wh are e gu iro l Viand to obtain permits prior orking 9n projects.
Datev�0��11 Print Name T�t V hj Jl I /T Signatu
T:Forms /SulldIng olvisloweidg Permit.doc
bO /170 39Vd 9NIL BH d3Hlv3M 11v LLTSZSb0SET 0S:et ITOZ /60 /S0
Clallam County Assessor Treasurer Property Details 64768 DONALD D LANNOY... Page 1 of 2
Clailam County Assessor Treasurer
Property Search Results 64768 DONALD D LANNOYE for Year 2011 2012
Property
Account
Property ID: 64768 Legal Description: SOUTHWOOD LOT
35
Geographic ID: 0630095800680000 Agent Code:
Type: Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11
Open Space: N DFL N
Historic Property: N Remodel Property: N
Multi Family Redevelopment: N
Township: Section:
Range:
.4
Location
Address: 222 W FOREST AVE Mapsco:
PORT ANGELES, WA
Neighborhood: Cycle 5 Res Map ID: 3
Neighborhood CD: 10955130 J
Owner \XJ
Name: DONALD D LANNOYE Owner ID: 36109
Mailing Address: 222 FORREST AVE Ownership: 100.0000000000%
PORT ANGELES, WA 98362 -2518
Exemptions:
Taxes and Assessment Details
Property Tax Information as of 05/04/2011
Amount Due if Paid on: NOTE: If you plan to submit payment on a future date, make sure you enter the date and
click RECALCULATE to obtain the correct total amount due.
I First I Second 1
I i ?Half Half i
I I i Base =Base 1 I j
I Year Statement ID I Taxing Jurisdiction Amt. Amt Penalty Interest Base Paid Amount Due
2011 158760 ST SCH STATE SCHOOL $194 42 $194.42 $0.00 $0 00 $194.42 $194 42
2011 158760 CC -GEN COUNTY CLALLAM $107.34 $107.32 $0.00 $0.0 0 $1077 3
.334 4 $107.32:
2011 158760 SD #121 SCHOOL DISTRICT #121 $254 15 $254 13 $0 00 $0 00 $254 15 $254 13
2011 158760 CITY PORT ANG CITY OF PORT ANGELES $247 78 $247 76 $0 00 $0 00 $247 78 $247 76 I
2011 158760 PORT PORT OF PORT ANGELES $15.11 $15.10 $0.00 $0.00 $15.11 $15.10
2011 158760 NTH OLY LIB NORTH OLYMPIC LIBRARY $45.01 $45.01 $0.00 $0.00 $45.01 $45.01
2011 158760 HOSP #2 HOSPITAL #2 $44.06 $44.06 $0.00 $0.00 $44.06 $44.06'
2011 158760 WSMET PK DIST WILLIAM SHORE MET PARK DIST $13.39 $13.39 $0.00 $0.00 $13.39 $13.39:
2011 158760 CITY_STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $36.00 $36.00
2011 158760 WEED CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0.00 $0.82 $0.81
2011 158760 TOTAL: $958.08 $958.00 $0.00 $0.00 $958.08 $958.00
2010 47056 ST SCH STATE SCHOOL $192.47 $192.47 $0.00 $0.00 $384.94 $0.00
2010 47056 CC -GEN COUNTY CLALLAM $102.44 $102.42 $0.00 $0.00 $204.86 $0.00
2010 47056 SD #121 SCHOOL DISTRICT #121 $249 30 $249.31 $0.00 $0.00 $498.61 $0.00
2010 47056 CITY PORT ANG CITY OF PORT ANGELES $237.16 $237.14 $0.00 $0.00 $474.30 $0.00
2010 47056 PORT PORT OF PORT ANGELES $14.40 $14.39 $0.00 $0.00 $28.79 $0.00
2010 47056 NTH OLY LIB NORTH OLYMPIC LIBRARY $29.76 $29.77 $0.00 $0.00 $59.53 $0.00
2010 47056 HOSP #2 HOSPITAL #2 $42.02 $42.02 $0.00 $0.00 $84.04 $0.00
2010 47056 WSMET PK DIST WILLIAM SHORE MET PARK DIST $13.37 $13.37 $0.00 $0.00 $26.74 $0.00
2010 47056 CITY_STORMWATER CITY STORMWATER $36 00 $36.00 $0 00 $0 00 $72 00 $0 00 E
2010 47056 WEED CONTROL WEED CONTROL $0 82 $0 81 $0.00 $0.00 $1.63 $0.00
http: /websrv8.clallam. net /propertyaccess /Property.aspx ?cid =0 &year =2011 &prop_id =64768 5/4/2011
I
ELECTRICAL PERMIT
CITY OF PORT ANGELES d
360-417-4735
Application Number 11- 00000426 Date 5/05/11
Application pin number 439652 REPORT SALES TAX I'
Property Address 222 FOREST AVE on your excise tax form
ASSESSOR PARCEL NUMBER: 06-30-09-5-8- 0068 -0000-
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name (Location Code 0502)
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
3 ton heat pump
Owner Contractor
DONALD D LANNOYE ALL WEATHER HTG COOLING INC
222 FOREST AVE 302 KEMP ST
PORT ANGELES WA 983622518 PORT ANGELES WA 98362 v
(360) 457 -9190 (360) 452 -9813 L�Z. 5 t�
Permit ELECTRICAL HEATPUMP 1
Additional desc c'N v
Permit pin number 185116 I
Permit Fee 56.00 Plan Check Fee .00
Issue Date 5/05/11 Valuation 0
Expiration Date 11 /01 /11
Qty Unit Charge Per Extension
1.00 56.0000 ECH EL- LVT- THERMOSTAT 56.00 t Special Notes and Comments
May 5, 2011 11:43:30 AM Brian 417 -4708. OK 0
Fee summary Charged Paid Credited Due
1
Permit Fee Total 56.00 56.00 .00 .00 (�f{
Plan Check Total .00 .00 .00 .00 ill
Grand Total 56.00 56.00 .00 .00
,....1
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH IN GJI /i 4tt
vn1�
FINAL I/b I/
I
11
COMMENTS:
...Zile
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:AEXCHANGE \BUILDING
I
City of Port Angelus Permit Application EC E r O vc�h
Building DivislonlElectrical Inspections MAY J.
S
321 East Fifth Street P,O. Box 1150 MAX 5 2011
Port Angeles Wash(ngton, 98362 el 3
y i Cr
Ph: (360) 4 7.473 Fax: (360) 4174711
c- 3 ELECTRICAL
Date: INSPECTIONS
1 1 8 2 Single Family Dwelling
Multi- Family or Commercial'
Commercial Addition Alteration Remodel Repair'
Plan Review t .e Re. fired, PI ase omplete Electrical Plan Review Information Sheet
Job Address: t Wilt'
Building Square Footage: T 111
Description of above 1.1. /t y._ l llir h A 1 VY
Owner formation Contractor �Inform Ion t
h �-r�
Name: Name: �'a- I h i rci
Mailin Address: Mailin Address: a A 4 4
City: State: V PS Zip: ra City: yw State: .O� Zip:
Phone, 1 5:r6 0 Fax: Phone, 1 1 t :J Fax: 0.0 A-
License Exp. License Exp. r►' E ,A
Unit Charge ay Total (Qty Multiplied by Unit Charoel
93.75 Service /Feeder 200 Amp.
$113,75 Service /Feeder 201.400 Amp.
$160.00 Service /Feeder401 -600 Amp.
$205,00 Service /Feeder 601 -1000 Amp.
$291.25 Service /Feeder over 1000 Amp.
2.00 Branch Circuit W/ Service Feeder
57.50 Branch Circuit W/0 Service Feeder
2.00 Each Additional Branch Circuit
72.50 Temp. Service/ Feeder 200 Amp.
86.25 Temp. Service /Feeder 201 -400 Amp,
$116.25 Temp. Service /Feeder 401 -600 Amp.
$131.25 Temp, Service /Feeder 601-1000 Amp,
75.00 Portal to Portal Hourly
69,00 Sign /Outline Lighting
75.00 Signal Circuit/ Llniilad Energy Commercial
50.00 Signal Circuit/ Limited Energy 1 2 Family Dwelling
50.00 Signal Circuit/ Limited Energy Multi Family Dwelling
93,75 Manufactured Home Connection
80.00 Renewable Electrical Energy 5KVA System or Less
86.25 First 1300 Square Fl.
27.50 Each Additional 500 Square Ft. or Ponlon of
57.50 Each Outbuilding or Detached Garage
66,25 Each Swimming Pool or Hot Tub
43.75_ Thermostat
l Total
Ownor as defined by RCW.19.28.261: (1) Owner will occupy the structure for two yours after this electrical permit Is finalized. (2) Owner is required to hire an
electrical contractor if above said property is for sale, rent or lease.
After reading the above statement, t hereby certify that I am the owner of the above named property or a licensed electrical contractor. 1 am making the electrical
installation or alteration in compliance with the electrical laws, N.E.C„ RCW, Chapter 19.28, WAC. Chapter 296.46e, The City of Port Angeles Municipal Code, and
Utility Specifications,
Signature of owner, electrical contractor or electrical administrator Cash
Chock
X Date' I Credit Card it
Pe /60 3E d ONILV H H_L 3M 1V1 !LTSZSVOSEI 0S :9T IIO� /E0 /S0
r--
ELECTRICAL PERMIT 1
CITY OF PORT ANGELES
360- 417 -4735
Application Number 11- 00000435 Date 5 /16/11
Application pin number 112830 REPORT SALES TAX
Property Address 222 FOREST AVE on your excise tax form
ASSESSOR PARCEL NUMBER: 06-30-09-5-8- 0068 -0000-
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name (Location Code 0502)
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
200 amp service and 3 circuits
Owner Contractor
DONALD D LANNOYE SIMPSON ELECTRIC
222 FOREST AVE 243036 W HWY 101
PORT ANGELES WA 983622518 PORT ANGELES WA 98363
(360) 457 -9190 (360) 457 -9270
Permit ELECTRICAL ALTER RESIDENTIAL
Additional numb
P N
Permit pin number 185272
Permit Fee 127.70 Plan Check Fee .00
Issue Date 5/09/11 Valuation 0
Expiration Date 11/05/11
0
Qty Unit Charge Per Extension
3.00 2.6000 ECH EL- BRANCH CIRCUIT W /FEEDER 7.80
1.00 119.9000 ECH EL -0 -200 SRV FEEDER 119.90
Fee summary Charged Paid Credited Due
Permit Fee Total 127.70 127.70 .00 .00 n�
Plan Check Total .00 .00 .00 .00
Grand Total 127.70 127.70 .00 .00
1
71;
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE 611 i C( 44) o04)
ROUGH -IN 61,,,I ii cl,i,7 —'43A'
FINAL 61/17/11
7AF'
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BU ILDING
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Application Number 11- 00000435 Date 5/16/11
Application pin number 112830 REPORT SALES TAX
Property Address 222 FOREST AVE on your excise tax form
ASSESSOR PARCEL NUMBER: 06-30-09-5-8- 0068 -0000-
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name (Location Code 0502)
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
200 amp service and 3 circuits
Owner Contractor
DONALD D LANNOYE SIMPSON ELECTRIC
222 FOREST AVE 243036 W HWY 101
PORT ANGELES WA 983622518 PORT ANGELES WA 98363
(360) 457 -9190 (360) 457 -9270
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 185272
Permit Fee 127.70 Plan Check Fee .00
Issue Date 5/09/11 Valuation 0
Expiration Date 11/05/11
Qty Unit Charge Per Extension
3.00 2.6000 ECH EL- BRANCH CIRCUIT W /FEEDER 7.80
1.00 119.9000 ECH EL -0 -200 SRV FEEDER 119.90
Fee summary Charged Paid Credited Due
Permit Fee Total 127.70 127.70 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 127.70 127.70 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
C: \EXCHANGE \BUILDING
ELECTRICAL PERMIT
CITY OF PORT ANGELES t•
360-417-4735
Application Number 11- 00000435 Date 5/09/11
Application pin number 112830 REPORT SALES TAX
Property Address 222 FOREST AVE on your excise tax form
ASSESSOR PARCEL NUMBER: 06-30-09-5-8-0068-0000-
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
200 amp service and 3 circuits
Owner Contractor
DONALD D LANNOYE SIMPSON ELECTRIC
222 FOREST AVE 243036 W HWY 101
PORT ANGELES WA 983622518 PORT ANGELES WA 98363
(360) 457 -9190 (360) 457 -9270
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 185272
Permit Fee 127.70 Plan Check Fee .00
Issue Date 5/09/11 Valuation 0
Expiration Date 11/05/11
Qty Unit Charge Per Extension
3.00 2.6000 ECH EL- BRANCH CIRCUIT W /FEEDER 7.80
1.00 119.9000 ECH EL -0 -200 SRV FEEDER 119.90 1
Fee summary Charged Paid Credited Due v
Permit Fee Total 127.70 127.70 .00 .00
Plan Check Total .00 .00 .00 .00 l
Grand Total 127.70 127.70 .00 .00 t
a
V
L
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE q `1 ;'4
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
,f�PPLIICATIION ECEflIEt1
1
CITY OF PORT ANGELES PERMIT 0
Wading Division/Electrical brapectioas MAY 6 2011 i
321 East MI6 3tn set P.O. Don 1150 Port Angeles Washington, 9&362 1 C
Ph: (360) 417-4735 Fay: (360) 417 -4711 ELECTRICAL v
INSPECTIONS
Date: _5-
A l 2 Single Family Dwelling Multi-Family or Commerciar Commercial Addition Alteration Remodel 1 Repair`
Plan Review May nil',, Please C Electrical Plan Review Infotmalion Sheet
Job Address: a e. W
Building Square Footage e G Nti n I 62 1.0,/1 ace
Desmipfron of abova_ r
Owner biennaVoq C m MptIo l<
Nmna: i on g rt Pi Doe. Name: A pr' L Meng
C fi� Stets J: ZIP
City: Pliant_ a r Fax:
Phone 1 .ni �i ILl' at License* /Exp. Llama* /Exp. ii 4r
=�N
RUM T *CQW Mit' idIby ChM,/ Service/Feeder 200 Amp. $1 1199 90� e J --11q O
Service/Feeder201.400 Amp. 145.50
Service/Feeder e01- 600Amp $204.60
Service/Feeder6011000 Amp. 262.20
Service/Fseder over 1000 Amp. 372.50
8ranclr Ckm It WI sante Feeder 2.60 7
Branch Circuit WO Service Feeder 73.50
Each Additional Branch Clreult 2.80
Temp. Seivlcel Feeder 200 Amp. 92.70
Temp. Service1Feeder201-400 Amp. 110.30
Temp. SeruicelFeeder401 -600 Amp. $148.70
Temp. Servise1Feeder601 1000 Amp $167.90
Portal to Portal Hourly 95.90
Sign/OrAllne Lighting 8820
Signal Circuit/ limited Energy First 1500 sf Commercial 95.90
Note: $5.00 for each addleonal 1500 sf
Signal Cimui3 Limited Energy 1 &2 Family Dwelling 63.99
Signal Circuit/ hotted Energy Morn Family Dwelling 63.90
Manufactured Home Connection $119.90
Renewable Electrical Energy 5KVA System or Less $102.30
Thermostat 56.00
MEIN CONSTRUCTION Ot1.X:
First 1300 Square Ft. $110.30
Each AddAional 900 Spore FL or Portion of 35.20
Each outbuilding or Detached Game 73.50
Each Svpimmtny Pool or Hot Tub $110.30
$1 iu. Total
Owner as defined by RCW.19.28.261: (1) Owner will occupy the stnrcture for two years after this electrical permit Is &oath ee 2) Owner is required
to hire an electrical contractor If above said property Is for sate, rent or lease. Permit expires after six months of lest inspecfi n
After reading the above statement, I hereby certify that am the owner ate above named property or a frcensed electrical x *actor. I am making
the electrical instelltdion or intonation in compliance with the electrical Taws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 29 3. i8R. The Gty of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Apphcelions,
Signs of owner, electrical contra w eleerctrical administrator: ED cash 13 Chevy
cirrto.as+����= iP
b "..1 01101010
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use . . . .
Property Zoning . . .
Application valuation
05-00000225 Date
.312475
222 W FOREST AVE
06-30-09-5-8-0068-0000-
MECHANICAL PERMIT
3/31/05
RS7 RESDNTL SINGLE FAMILY
1500
Owner
Contractor
LANNOYE DONALD D
222 FORREST AVE
PORT ANGELES
WA 983622518
PELLET HEAT CO.
230 EAST 1ST SUITE C
PORT ANGELES WA 98362
(360) 457-4406
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
GAS LOG SET AND TANK
FERRELLGAS LP
57.65 Plan Check Fee
3/31/05 Valuation
9/27/05
.00
o
Qty Unit Charge Per
Extension
47.00
10.65
BASE FEE
1.00 10.6500 ECH ME-GAS PIPE 1 TO 5
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 57.65 57.65 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 57.65 57.65 .00 .00
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Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
/..r) L I - -
\..../ 0L 1- I J- t::::.'
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 A CCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
FOUNDATION:
FOOTINGS I
WALLS
FOUNDATION 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 I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERJOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE ~ - 3; -(('J.' _l J-l-
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:
PARKINGILIGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
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 I I PLANNING DEPT.
BUILDING 417-4815 ' lJ.fJjr! ~ .. ."l .~~ 1705 - BUILDING
. . . . / /
T:\PohCles\1102_15 bUlldmg permIt mspecl10n record05.wpd [11412005]
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360
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452
0503
Uale Jtee,:
Perl'llil /I.:
P.01
MAR-31-2005 11:26 AM
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SPA.
SHOP
www.cityofpa.ul
Print Ollt form BRel till Ollt COMPLETELY In INK. YeIlr application and site
pllll MUST BE COMPLETE to b. acc.pted 'or review.
Que.t1onl1 Call: PERMITS (360) 417-4815 Fn (360) 417.4711
0.10 Appro\led:
Date lUlled:
Applicant or Agent: PI.. III.'" ).Je.,.,f ('0,
Owner:Jetn. L.......... .Y~
Address:_ '2.. 2.- 'l- _.....kl.. ~r L S L.ft 1I.c.. _ City: ~,. /- lll'\'.o(.IL) ..
ArcbitectlEngineer: Phone:
Contractor ?Ulvl J.lu..J- ~ , State License #:pelll!/k4>fD'EJ,: 0/-) 7 -(.IS"
Address; .2:- 3 0 ~ G.1'" ,c.;,I'S J- s r - City: ---ilr.J- )4,..., t,J,cl
..-
PROJECT ADDRESS: 2. Z. "1- WI . 1~e.S /- A,;~_
LEGAL DESCRIPTION: Lot: '3 ~-Block: Subdivision: 5o...1'J..l4Jt/Jo,l
CLALLAM COUNTY PARCEL NUMBER: 0' 3 ot:) qr g Of!) ''i'OOdO
Phone:
Phone:
~r 7-"'t,I~ ~
'7S'7-'7 I t1j t:>
_ Zip:__ l' I~ u..1.:..___...
Phone: Y'j- '/-tt6fDi.
Zip: #J {I " L..
ZONING:
Credit Card Rold.r Name: A7h;.Js.....'- J~&..... ~ Ie.
BUIIIlIAddr...: 2..10.., IE.~-r h'd~ $-1-.. City: P.l"f J4,....',j~r
Credit Card Type VISA, MC)t"" j - t:!J IV J:I'I... - Esp. Date:
TYPE OF WORK: SIZEIVAL\lATIONt
IF- Residential D New Conser, IJ Rc:.roof D Stove SF, @ S /SF. = S
D MultHamily D Addition 0 Move 0 Garage SF, @ $ ISF. .. S
D Commercial D Ildodel 0 Demolition Cl Deck SF. @ $ /SF, - S
D Repair D Sian Cl Other TOTAL VALUATION S L~ .s2:!it
BRIEF DESCR.IPTlON 011 THE PROJECT: & AS LD, se.+ . f!.., I""~ II- r CD_
=- k P '7"",~t. <<-tl &A S 1'(",,,, &}' n".,.....L.- 6As
COMMERCIAL/RESIDENTIALl Oocupancy Group: Occupant Load: Construction Type:
No. of Stories: Lot Size: Exilltint SIl. Ft. " Proposed Sq. Ft,
Total lot coveraie %
PLANNING USE ONLY:
ESAfWetland(II): [J Yes 0 No SEPA Cbeckllst I1lquired? Cl Yef i::l No Otber:
BUILDING PERMIT APPLICATION SUBMITTAL:
plan lllbmittal requuemellts if you hlln que.tions.
VAL U A TION OJ' CONSTRUCTION: In.1I eale., . ,..Iuatioll amOllar mast be ~lItllred by the applioant. This flgwc will be roviewed
aDd may be revised hythe Bulldlni Division to comply with current fee scbedules, Cootact the Permit Coordinator at 417 .481 ~ for assistance,
. l!J.,.~ ~M..E;~~ F~E:Jt:. a plan check f;; is due it must be submitted at the time the buildin8 permit appliclltion and construction planll ar;
lit fees are due It the timo of permit IlIlllnco.
,() A./ ,& N REVIEW: Ifno permit is issued within 180 day. ofthc date of appliC;ltioll. the appllcatloJl will uplre. The
~l.:Y L'\ V . r"K ad tho time for action by the applicant up 10 110 daYI upon wrirtea request by the applicant (Ice Section R10S.3.2
,... .V,;' ~r~ IDs/Residential Code, 2003). No application CUI be extonded more than once,
Cl~'
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.lId and ex. mined this .pplloatlon and know the 8.ma kl be true end co",ct. I 8m Buthorlzed to epply for this permit and
lonslblHty to determine whit ptrm/fl ere required, not the City'" end thet I muat Iln such permits prior to work.
Applicant:
J - Jt:J-- ~i-