HomeMy WebLinkAbout436 E Front St - BuildingPREPARED 11/22/10 8 26 38 INSPECTION TICKET PAGE 7
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 11/22/10
ADDRESS 436 E FRONT ST SUBDIV
TENANT NBR CHRIS AND KATHRYN LUCK
CONTRACTOR PHONE
OWNER CHRISTOPHER G LUCK AND PHONE (626) 441 2468
PARCEL 06 30 00 5 1 1900 0000
APPL NUMBER 10 00001336 SIGNS
PERMIT SIGN 00 SIGN
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 11/22/10
JLL BLDG FINAL
November 19 2010 4 16 52 PM 1pangrle
MIKE 461 2815
BUILDING FINAL SIGN
(FREESTANDING SIGN ON THE SW CORNER OF VINE ST FRONT ST
COMMENTS AND NOTES
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
40 SQ FT FREESTANDING SIGN
Owner
CHRISTOPHER G LUCK AND
KATHRYN E LUCK TTES
317 OAKLAWN AVE
S PASADENA
(626) 441 2468
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
1 00 115 0000 PER .S F /S OR.PROJ SIGN 25 SF
Special Notes and Comments
November 16 2010 4 52 16 PM sroberds
The proposal will recognize an off premise free standing
sign in the CA No land use issues are anticipated
Fee summary
Permit Fee Total 115 00 115 00 00
Plan Check Total 00 00 00
Grand Total 115 00 115 00 00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
con truction. r' k ;No-
1(, 0 C6ael �eV 76
T Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
CA 91030
10 00001336
679568
436 E FRONT ST
06 30 00 5 1 1900 0000
CHRIS AND KATHRYN
SIGNS
RESIDENTIAL HIGH DENSITY
100
SIGN
40 SF FREESTANDING SIGN
177378
115 00
11/18/10
5/17/11
Charged Paid Credited
Contractor
OWNER
Date 11/18/10
LUCK
Plan Check Fee 00
Valuation 100
Due
Extension
115 00
00
00
00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
cf\b\ 0
\P4
2
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
FOUNDATION.
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water
AIR SEAL.
Walls
Ceiling
FRAMING.
Joists Girders Under Floor
Shear Wall 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
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
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
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I I ESA.
Landscaping I I SHORELINE.
T•Forms /Building Division /Building Permit
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Comments
FINAL Date Accepted by
1 FINAL Date Accepted by
Date Accepted By
Electrical 417 -4735 I I CA
Construction R.W PW Engineering 417 -4831 I I
Fire 417 -4653 I I 5
Planning 417 -4750 I I
Building 417 -4815 I I 1(2 I P A
NNW
Contractor /Engineer's Address
License
Sign #1
Sign #2
Sign #3
Sign #4
$47 00 x
$85 00 x
$115.00 x
Date I l/l 6 /10
it
SIGN PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
Applicant or Agent LUCK Fa fl1 4 'Mug ka+Gley nt Lock i rro5-keh ?id (o210 -y. I -21+1 25
Property Owner LVCi(< F wi I LY K4 c. I.uck as Trv5ke. Ph ne 5q 0 (oq q4- 021.1
Property Owner's Address 3 Oakl am) n 4k So Posac to 1 CO (4103r)
Contractor /Engineer Mgr A-PPLI G--I t, 3 Phone
Project Address So ictiae cornor of on 51 avdl Vine (crt Lf 3(0 Er Fro rvF(S'fre_d
Business Name AdVtf (GU rrt if) cl) OLy Alp (C PO vJei'ZSP0 R
Parcel ?Number ()IDS 0005 Ilq 000006 Lot Zoning
Submit an 8 4 "x 11 "site plan three sets of plans that include.
Type of sign (wall- mounted, projecting, freestanding, illuminated, other
Placement and sq. ft. area
How the sign will be securely attached (Engineering specs may be required for freestanding signs)
Separation,distance between the bottom of projecting and freestanding signs and the surface below
See "Chapter 14.36 Sign Code" of the City of Port Angeles Municipal Code for sign requirements.
Sign Type Brief Description. (Type, location, sq. ft.)
f'ireestind lnq Po sf t panel 6IQn `)a 5'F3' g6 5q{ q6 e Fri S+
r fhe sign airtc:;0,a p.x tin -th 1ac �c� +�b� It tS
0. 'Haan y Dr e vJBuS sign for Bonn Bakker- y per-mil-44
4t firr7 q 5 fl -l-, i 24 s;
Totals (Unit charges
Unit Charge Quantity multiplied b _guantitiesl
GRAND TOTAL
C p p
Existing sign(s) area H sq. ft. Proposed sign(s) area
Building facade area (height t t' ft. X width ft.)
sq. ft. (If a building has more than one
business in it, only measure the area of the building facade that is used by the business applying for this permit.)
I have read and completed this 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
Print Name Iiaa-f Iia.(ri E Luck- cts TV05) er Signature
C 5f-o j hey c 1X,14 45 VS
T:Forms /Building Division /Sign Permit Application.aoc
Expires
For City Use,
Date Received 1i 5 -1O
Permit its --IS
(Date Approved 1 fl
Sign(s) ,50
Type of Sict Valuation PU
All signs less than or equal to 25 sq. ft.
Wall sign or marquees, over 25 sq. ft.
Freestanding sign or projecting sign, over 25 sq. ft.
Make Checks Payable to. City of Port Angeles
Credit Cards (Except American Express) are accepted
sq. ft. Total sign(s) area sq. ft.
P
G
401-
405 t7 415
BLOCK g
L. B STRATTON' S SUBDIVISION
S tl
T62 E,. �f
D0 0 f(flC via
q�3b2
cS�
G CP NORMAN R. SMITH'S SUBDIVISIOP
IC‘ 0
00
0
ao
This sketch is provided. without charge. for your information. It is not intended to show all matters related to
the property including. but not limited to. area. dimensions. easements. encroachments or location of boundaries.
It is not part of. nor does It modify the commitment or policy to which it is attached. The Company assumes
NO UABILI'IYfor any matter related to this sketch. Reference should be made to an accurate
survey for further information.
Clallam County Assessor Treasurer Property Details 33 CHRISTOPHER G AND K. Page 1 of 4
Clallam County Assessor Treasurer
61433 CHRISTOPHER G AND KATHRYN E LUCK TTES for Year 2010 2011
Property
Account
Property ID
Geographic ID 0630005119000000
Type Real
Tax Area. 0010 PA 121 PORT ST CNTY H2 L WMP
Open Space N
Historic Property N
Multi Family Redevelopment: N
Township Section
Range
Location
Address. 436 E FRONT ST Mapsco
PORT ANGELES WA
Neighborhood Cycle 5 Comm Map ID
Neighborhood CD 20953140
Owner
Name CHRISTOPHER G AND KATHRYN E LUCK TTES Owner ID
Mailing Address. 317 OAKLAWN AVE Ownership
SO PASADENA, CA 91030
Taxes and Assessment Details
Property Tax Information as of 11/15/2010
Amount Due if Paid on. Ml.
Year Statement ID Taxing Jurisdiction
61433 Legal Description. SMITH NORMAN
R LOT 1 BL 19
Agent Code
Land Use Code 91
DFL N
Remodel Property N
Exemptions.
2
37935
100 0000000000%
NOTE If you plan to submit payment on a future date make sure you enter the
click RECALCULATE to obtain the correct total amount due
First 'Second 1
Half Half
i
iBase Base 1
Amt. Amt. Penalty Interest Base Paid A
2010 44146 ST SCH STATE SCHOOL $80 14 $80 15 $0 00 $0 00 $160.29
2010 44146 �CC_GEN COUNTY CLALLAM T $42.64 $42.65 $0 00 $0 00 $85.29
2010 44146 PORT PORT OF PORT ANGELES $6 00 $5 99 $0 00 $0 00 $11 99
2010 44146 PORT ANG CITY OF PORT ANGELES $98 75 $98 76 $0 00 $0_00 $197 51
2010 44146 SD #121 SCHOOL DISTRICT #121 $103 81 $103 81 $0 00 $0 00 $207 62
2010 44146 NTH OLY LIB NORTH OLYMPIC LIBRARY $12.40 $12.39 $0 00 $0 00 $24 79
2010 44146 HOSP #2 HOSPITAL #2 w $17 50 $17 49 $0 00 $0 00_ $34 99
2010 44146 WSMET PK DIST WILLIAM SHORE MET PARK DIST $5 56 $5 57 $0 00 $0 00 $11 13
2010 44146 CITY STORMWATER _CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $72.00_
6
2010 44146 WEED_CONTROL WEED CONTROL $0 82 $0 81 �$0 00 $0 00� $1 63
1 2010 44146 TOTAL. $403.62 $403.62 $0.00 $0.00 $807.24
2009 614332008 ST SCH_ STATE SCHOOL $93 53 $93 53 $0 00 $0 00 $187 06
2009 614332008 CC -GEN COUNTY CLALLAM $47 33 $47 34 $0 00 $0 00 $94 67
12009 614332008 PORT PORT OF PORT ANGELES $6 70 $6 71 $0 00 $0 00 $13 41
2009 614332008 PORT ANG CITY OF PORT ANGELES $103 82 $103 84 $0 00 $0 00 $207 66
12009 614332008 SD #121 SCHOOL DISTRICT #121 $115 66 $115 66 $0 00 $0 00 $231 32
http. /vpn.clallam.net• 8084 /propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =6 11/15/2010
(10/20/2010) Linda Pangrle Fwd Re Sign at Front &Vine St. __._____v.�._ Page-1 -!I
From: Linda Pangrle
To keluck @srmassociates corn
Date 10/20/2010 2:24 PM
Subject Fwd Re Sign at Front Vine St
Also I noticed you have your zoning listed as CA on your sign application The
zoning is really RHD Please amend your application Thanks
Linda Pangrle 10/20/2010 2.22 PM
Hi Kathy
Your north property line appears to start approximately 3 1/2 feet south of the
south edge of the sidewalk Your east side properly line appears to start
approximately 15 feet east of your retaining wall Those figures come from
looking at our GIS maps which may be 1 or 2 feet off A survey is the best way
to find the specific property lines
My supervisor Sue Roberds and I discussed the placement of the sign She
stated that no setback is needed The sign may be placed anywhere on your
property as long as it is entirely within your property line boundaries and not on
the right of way
I hope this is helpful
Linda
Kathy Luck <KELuck @srmassociates.com> 10/19/2010 5.32 PM
okay Linda can I assume my property line is at curb or sidewalk? do you know
what setback is required? Is it from property line? I can work on getting rest of
info Kathy
Original Message
From Linda Pangrle
To Kathy Luck
Subject Sign at Front Vine St
Sent Oct 19 2010 4 40 PM
Hi Kathy
I received your faxed information Thanks
We need some more information
I noticed on the County Assessor's website it states that the legal
owner is
1(10/29/2019) Linda Pangrle Fwd Re Sign at Front Vine St. Page 21
Christopher G and Kathryn E Luck TTES
317 Oaklawn Ave
So Pasadena CA 91030
Is that still accurate?
If so then please amend the sign application to show the above
For the property address on the sign application we need a specific
address The sign will be on the property of 436 E Front St won't it?
If so please write that specific address on the application
We need some details about the footings (length width and height)
Will they be made of concrete? How will the posts attach to the
footings? Write these details on your plans that you submit
We also need to know how high off the ground the bottom of the sign
will be If the land slopes then what are the ranges (example the
bottom of the sign will be one foot off the ground on the south side and
two feet off the ground on the north side or whatever)
How do the posts attach to the sign (screws /nails /etc
We need specific details dimensions showing where the footings and
edge of the sign will be placed How many feet or inches away from
your north east property lines will the sign be placed? At the very
least give us a measurement from the retaining wall on the east and
from the south side of the sidewalk on the north edge of your property
We want to be sure the sign is entirely on your property and not in the
right -of -way
Please provide those details
Thanks
Linda
Sent from my Verizon Wireless BlackBerry
Oct 19 10 11:26a Kathryn Luck
5 1 7 Qaklawn Avenue
South Pasadena, CA 9 1 030
Please deliver to
To. Linda rangrle raxNo 5 60 -4 17 -47 I
Number of Pages sent (including tk1s cover sheet) 5
Re Sign at front and vine street
See attached.
Kathrcgn E. Luck
FAX TKAN5MITTAL
PRIVACY NOTICE
626 -441 -4716 p 1
tele,kone (626)1-1-1-2+68
fax (626) +41-471 6
Iceluck @srmassociates.com
THIS MESSAGE AND ATTACHED DOCUMENTS, IFANY IS INTENDED ONLY FOR THE ADDRESSEE AND MAY
CONTAIN INFORMATION THAT IS PRIVILEGED CONFIDENTIAL OR PROTECTED FROM DISCLOSURE UNDER
FEDERAL OR STATE LAW IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR THE
EMPLOYEE OR AGENT RESPONISIBLE FOR DELIVERING THIS MESSAGE TO THE INTENDED RECIPIENT YOU ARE
HEREBY NOTIFIED THAT ANY DISSEMINATION. DISTRIBUTION OR COPYING OF THIS MESSAGE OR THIS
INFORMATION ATTACHED HERETO IS STRICTLY PROHIBITED
IF YOU HAVE RECEIVED THIS MESSAGE IN ERROR, PLEASE NOTIFY THE ABOVE SENDER IMMEDIATELY SY
TELEPHONE AND EITHER DESTROY OR RETURN THE ORIGINAL TRANSMISSION TO THE ABOVE ADDRESS VIA
THE U.S POSTAL SERVICE, THANK YOU!
Oct 19 10 11:26a Kathryn Luck
October 19 2010
City of Port Angeles
Attn. Linda Pangrle
321 East Fifth Street
Port Angeles, WA 98362
Dear Linda,
Kathy Luck
(626) 441 -2468
keluck @srmassociates.com
KATHRYN E LUCK
Re Small free standing sign at Front and Vine
626 -441 -4716 p2
I bought the two residential lots at 432 and 436 East Front Street in 2007 There is a
house at 432 East Front and the corner lot, at intersection of Front and Vine is a vacant
lot. The corner vacant lot does have a small sign facing Front Street on which Olympic
Powersports advertises their business a on Peobody Street.
At the time I purchased this lot, I was told by someone at the City that since the sign was
erected so long ago, it was classified as legal, but that if I wanted to enlarge it or change
it, I might have to re -apply for City approval.
This past August, I received a letter from the State Department of Transportation that said
I needed to apply for a sign permit from the State. The State requested that I move the
sign 10 feet though so it is not within 100 feet of the giant billboard on the north side of
Front Street, currently advertising the casino After application and payment of $300 fee,
the State has issued me a metal permit tag to display on the sign.
So, with all of this in mind, I am trying to move the sign 10 feet and comply with all City
requirements. In our discussion, you have indicated I need to complete a sign application,
which is attached. I do not have a survey of this property, nor do I hope to incur the
expense. I have contacted a sign company Wade Leinaar of OlySigns, who is willing to
relocate the sign 10 feet away from its current location, on the hillside of 436 East Front
Set (the vacant lot) The current sign is two wood posts set in concrete and we would
propose moving and installing in the same manner on my corner vacant lot.
I would really like to get an indication from the City that there are no further issues with
moving the sign, before I incur that cost. Can you look over this application and let me
know what else you might need from me. If it is satisfactory I can forward it all in the
mail with my check.
I will be up in Port Angeles the week of Nov 8 12.2010 and happy to meet on -site ifvou
wound like. Thank you.
Oct 19 10 11:26a
Sign #1
Sign #2
Sign #3
Sign #4
Kathryn Luck
SIGN PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
Applicant or Agent 101- rt- i-r,\N LU c_16
Phone 2-to 4 2-y b'3
Property Owner L( K WC ,V. as 11)5+ Phon 6210-31 C') t cJa-
Property Owner's Address c 4 aai E Fra t St 'Pow CLviae 1N` 0. s (0 Z
Contractor /Engineer 00 S iGti S Wade. Lei nac P one 3(,:e 19 -5a4
Contractor /Engineer's Address i F
',,a)c( le Rock P 6 9 `6
License cz, c-ici 5 J Expires
Project Address eOf rtev' (Smdtiwe.'A e f Fv wit of 14 ,vl Iv /Sect'#
Business Name 618vef.,1 AeAr 0 t t rv►i) lc. .esp0
Parcel Number x I i9 000000 Lot
Submit an 8 "x 11 "site plan five sets of plans that include.
Type of sign (wall- mounted projecting freestandin9/illuminated, other
Placement and sq ft. area
How the sign will be securely attached (Engine
Separation distance between the bottom of pr
See 'Chapter 14.36 Sign Code of the Cf
Sian Tvoe Brief Description. (Type, loc ion, sq. ft.)
?are s■q ap prat L wide, ci- t7erc,i1 ink,
■a tc, p Pa-1,l
Totals (Unit charges
Unit Charae Quantity/ multiplied by auantitiesl Type of Sign
$47 00
$85 00
$115 00
x
x
T:Forms/Building Division/Sign Permit Application.doc
626 -441 -4716
For City
Date Recei -d
Permit
Date proved
Zoning C A
se Only
ing specs may be required for freestanding signs)
jecting and freestanding signs and the surface below
of Port Angeles Municipal Code for sign requirements.
Sign(s) c
Valuation
(re ioeahat cob@
All signs less than or equal to 25 sq ft
Wall sign or marquees, over 25 sq. ft.
Freestanding sign or projecting sign, over 25 sq ft.
GRAND TOTAL Make Checks Payable to City of Port Angeles
Credit Cards (Except American Express) are accepted
p.3
4AtJ
Existing sign() area 7- sq. ft. Proposed sign(s) area 29' sq. ft. Total sign(s) area Z-4 sq. ft.
ade area (height ft. X width ft.) sq. ft. (If a building has more than one
Building fa
business it, only measure the area of the building facade that is used by the business applying for this permit.)
I have ead and completed this 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
Date 1 )1` J 10 Print Name K�'1�. YZ 1 Signature
(9/27/2010) Linda Pangrle RE. Vine/ Front Street Sign Abatement File 8 -1 10 W m Pa 1;1
From Sue Roberds
To Pat O'Leary
Date: 9/27/2010 2 38 PM
Subject: RE Vine /Front Street Sign Abatement File 8 -1 10
CC: Linda Pangrle
Thank you Pat. Our very efficient Permit Technician is Linda Pangrle, loanorleCalcitvofoa.us, or phone at 360 417 -4815
Sue
On 9/27/2010 at 2.20 PM, in message DC88C435795FC04EA8463FE469D270FF0102517E Calhaolvmmail05.WSDOT.LOC>
'O'Leary Pat' <OLearvPCalwsdot.wa.aov> wrote:
Hi again Sue, OK, I'll move forward and issue the permit. In the award letter I'll let them know they'll need to contact the city
regarding update on the city permit. Can you give me name /contact info for your staff who will do the update? Thanks in advance,
Pat
From:Sue Roberds fmailto:Sroberdsacitvofoa.usl
Sent: Monday September 27 2010 2:14 PM
To: O'Leary Pat
Cc: Linda Pangrle
Subject: Vine /Front Street Sign Abatement File 8 -1 10
Dear Pat:
The location of the sign does not pose a problem as a nonconforming sign. The size and location are not changing. But, your
application information identifies the applicant as Kathryn Luck, not Bonnie Kelly who was our applicant. We do need to have the
correct information for our property records. I don't know that we would require a new sign permit, but we will need to have the
applicant stop in to correct the record with our Permit Technician. If you could let her know as part of your process, I will also let
the Permit Tech know
Thank you,
Sue Roberds
Planning Manager
City of Port Angeles, WA
(360) 417-4750
sroberdsCo citvofoa.us
On 9/27/2010 at 7.57 AM, in message DC88C435795FC04EA8463FE469D270FFO102516DCalhoolvmmail05 .WSDOT.LOC>
'O'Leary Pat' <OLearvPewsdot.wa.00v> wrote:
Morning Sue, Kathryn Luck has now applied for a WSDOT permit on this sign. As part of my review I want to double check that the
permit you sent me is still valid and no other City permit is required for this sign. Thanks in advance for taking a minute to look at
this,
Pat O'Leary
WSDOT Highway Advertising Control Program
1'
4
I (9/27/2010) Linda Pangrle RE. Vine /Front Street Sign Abatement File 8 -1 10 Page 2
(360) 705 -7296
From:Sue Roberds rmailto:Sroberds(citvofoa.i_js1
Sent: Wednesday August 11, 2010 12.44 PM
To: O'Leary Pat
Subject: Re: RN Vine /Front Street Sign
Dear Pat:
Thank you for the contact information. Here is the sign permit info for the sign we conferred about.
Sue Roberds
Planning Manager
City of Port Angeles, WA
(360) 417 -4750
sroberds(citvofoa.us
eSafe2 scanned this email for malicious content
from unrecognized senders
IMPORTANT Do not open attachments
CITY OF PORT ANGELES PUBLIC WORKS
BUILDING DIVISION PERMIT APPLICATION
Date Received 2 2 i /q.5 Date Issued .j
Name I Addr43s ('»v 1 1
Owner Be»LAf I .5r)- I If j- 1 7.4 T c 'Sr
Contractor r 1 I r 1
Arch Engr. I
Class of Work: U New U Addition U Alteration U Repair U Move U Demolition
Description of Work:
I Permit Fee
Pion Check Fee
Investigation Fcc
Other
Total
�n o
Occunancv Cretin
Occupant Load
Type of Construction
Occupancy Permit Issued
Legal Description: Lot
Block
Subdivision
Land Use Zone
Lot Arco
Cot Coverage
IJSIah Contractor
`fit C -b 6e fi oca teJ 4-Ist E h ,5T
Type of Permit: I U Building 0 Plumbing Contractor
No. I Fixture Type I Fee
Valuation S 2../ O 1 I Water Closet
11 I Lavatory 1
11 Bathtub 1
Receipt It li Shower I
11 I Kit�hcn Sink I
II Dispo 1 1
Receint H i1 Floor DrainlCFloor Sink 1 J
II Clothes Washer\ 1 1
11 Urinal 1
i
No. of Stories 11 Wa.er Heater 1
11 Drinking Fountain 1 i
I.I Lawn Sprinkler I
1 Vacuum Breaker 1 I
11 Solar Panels 1 t
11 Other 1
I I Sub Total 1 4
II i
Permit Fee I
So, Ft. e. II Receipt 4 Total
ii Mechanical Contractor
Sign Type I t FS I 12 I I No. ,I Type of Equipment Fee I
111rminatinn I I■1 n I 1 II "k Elec. Furnace
1 Overall Heicht 1 4 I I II I Pleat Pump
I Sinn Height 1 I I 11 1 Oil FpR14Ce
Sri, Ft. 1 2�1-' I 1 1I I Kitchen Hbo.
Clearance I 1 1I 1 Wnodstove pellet S§e/jnsen
1_ L'tnsl Ure zone i At I II 1 Other
Total ��,c.� r Receipt Zp 11 Receipt N Total S"
Awrl.IeAi7 l1TIED aY P LANS CNrCKE) II APPROVED poR ISSUANCE BY Special Conditions: .1-7? e,&) $o
to ca5 c4 boa Q 6h?,) Glp-' s pt•+vi. 1 S 1 NO
SEPARATE PERMITS am required for electrical work, utilities, private and public
Impwveme nts, Thus pored talcums null and void if work or oonaltuction authorized Is
not commented within IRO day, ifennatructionor work is auapeaded or abandoned for a
mind of HO dryx erica work has commenced, or If required tnspentrnu have not been
quested within 1Rtl days horn the teat inspection, I hereby certify that I have read and
anahoatt mt., applicnllon And know the sane to be true and correct. All provisions of
it Ws 1rd ordinances governing 11th type of work will be complied with whether specified Other Construction/P W Pemrits.
Itc:oln or not. The gamins of a penult does net pmuunn to give authority In violate or
it 'el the provisions of any Stale or 1.x 1 eratsbuetiotl or the proutma
M r rtshucllon.
Xtnu re it rMcha Avthee
��r/� 7 .r orfvcway
S�t e a(Uw•er Ut nvrGt rs ho e 7 it% water
I Ili Pa1hT I'L
Other
007945 i PI
Z
4:44
ti
'INSPECTION TYPE DATE ACCEPTED
FOI INDATION yES- .I12.
1~obtines
I Walls
I Found. drainage I
guzzolIcAL
Rough In/Light Dept.
PI.IIMBINQ..
I Under fluor slab
I Rough -in I
Water line I
p I Back flow/water I
Walls
I Ceiling
O Qi
U Joists rirdcrs
IQ Shear wall
4 !Walls/ roof ceiling
I Drywall I
pp I T -bar
IIISELAJiQ1L
Slab_
11 floor ccilin-
J�(:��L��le
Chimney
BUILDING PERMIT INSPECTION RECORD
CALL 457 -0411 EXT 125 FOR BUILDING INSPECTIONS. PLEASE PROVIDE ,A MIN. 24 HOUR NOTICE. IT IS UNLAWFUL ,TO
COVER,, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCbriliD. POST PERMIT IN A CONSPICUOUS LOCATION-
KEEP PERMIT CARD AND APPROVED'PLANS AT JOBSITE
_J.
ITVoodatov
I. I7tIctS
W. I ITiitniES1.L
Waterline meter
Sewer Connection
'sanitary
Storm
Site Drainage/Erosion Contrail
r
Parking
Other
I COMMENTS
FL bL INSP1EC'I'IONS l2EOUllu PRIOR TO OCCUPANCY I USE
Bl,��IP.1�� (i IA __.._.--RAP Y r� 1 MO CQMMItRCIAT. I„I,kTE ,1
lilcc{rical/Light Dept. Electrical/Light Dept.
p _Phone Est. 224
C"onatruction -RW PW I Construction RW
n
c 1 Ext,124 En, fincet ing PW/Enitinccring _I.
4 Fire (Mulii•i'arn, only)
Ext. 252 I 'in Dept. IiuiT� i 4 Ext.1 I j Building
GENERAL COMMENTS:
Mi' 1 tf7,1ttc..14N
0
M�-
tP•in
Ysa Na
7M Building Permit Application must be filled out completely. Pkase type or print in Ink. If you hart any questions, please coil 457.0414 a d. 125.
0 B. Ownen
ca
ca
L
A. Applicant and/or Agents 4/WM Y VA e
CM'AAY 5 /�✓l��✓
C. Architect/Engineer.
D. Contractors
PROJECT ADDRESS: /7' 6 (MY T 4l,�ls ZONING
LEGAL DESCRIPTION (on Decd of Sale or available from the County Assessor's Office):
—HIY
TYPE OF WORK.
O Residential 0 New Constr 0 Reroof 0
O Multi-family O Addition 0 Move Cl
O Commercial 0 Remodel s O Der, .dition 0
0 Repair ;Sign O
BRIEF DESCRIPTION OF THE PROJECT
67',/'( a' v A a' t' 4.71,,iarY
COMMERCIAL. Occupancy Group:
Lot Area Occupant Load:
PLANING USE ONLY
Permits Required:
Max. l (eight: Setbacks:
Site Plan and Use Approved by'
Wetland(s): 0 Yea 0 No SEPA checklist required O Yes D No
PLAN CIIECI(. FEE' S
BUILDING PERMIT APPLICATION
DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION
License it:
Woodstove.
Garage
Deck
BUILDING PERMIT FEE: S DATE PAID:
SIZE/VALUATION'
sf, S isfei
SC S Isf.
sf. S /sf.
TOTAL VALUATION:
Q1L
14N- v. //l/2,91.' r 7
Construction Type:
No. of Statics: 96 Lot Coverage:
,.y. DA'T'E PAID:
Notes:
Zoning:
rx• Date:
Oth
APPLICATION SUBbIITTA1,: Your application and plans must be Complete in order lobe accepted for plan review. Please MI out the
„pplk i liun completely and follow the plan submittal checklist on the reverse of this form. The Permit Coordinator can provide,you with
melee detailed information on the application and plan submittal requirements.
VALUATION Or CONSTRUCTION: Vaivatione for new construction and additions are calculated by the Building Di vlslon,,Departtnent of
Public t4.trks, before the application is submitted. Contact the Permit Coordinator at 457 -0411 ext. 125 for asiistance. In all cases, a'valbition
(=NIA be entered by the applicant. This figure will be reviewed and may be revised by the Building Divisi: n to comply with current fee
schedules,
PLAN t'IUECIC FF 1 Your pion check fee is due at the time of the building permit application submittal. AU other permit fees are due at the
time of lasut:nce,
BUILDING O WNF.R. /AUTHOII1LED AGENT: If the applicant is not the owner, registered architect/engineer or contractor licensed by the State
of Washington. a n+,tanzed letter from the property owner authorizing the applicant lobe his/her agent for submitting this permit application and
obtaining this permit will be required as part of this submittal,
EXPIRATION OF' P1.AN REVIEW: if no permit is issued within 180 days of the dale of application, this application will expire by limitations.
The Building Official c,+n extend the time for action by the applicant up to 180 days, on wntten request by the applicant (sec Section 304(d) of the
iUniform Building Code Current Edition), No application can be extended more than once,
I hereby certify that I have rend and examined !hat application and know the tarns: t.z.ba true pad ccrt, and I am authorized to apply for
this prrtait. understand i1 Lt not the City's legal responsibility to detcrminro6lr1rmitx 9/e regk e it remains the applicants responsl•
rm:
bility to determine what pe rte are required and to obtain such. 7 #7 r"
4ppikatttt r f
APPROVALSs PLAN
BLDG
DP'W
TIRE'
OTTIER
RECEIPT NO.
RECEIPT NO.
FOR OFFICE USE ONLY:
Data Rae—
Permit R:
Pres•Ap. Completes
Data Approved:
Phone: e 7 C 5 7r 7 i��
Phone: I' 757
Phone:
Phone:
Dote:
S
S
S
l'
L I r...
t-^
Z.• ■••4 7 .1 .V"s!fr
n••••• ••J
5;
h)5 e
I 1
1
1
1 1
t
...2L... 1 i
ad
w c,?../
pp
Uk..164.
SI
Ae• AAA,. I V. .11,1••••.•
0
I 1 1
0
..0 ....t .2■4•...........1. •F 6......•.“....*
I
1
I 1
I
I
I 1
C
1
Dear Doctor Bettger,
This letter Is to confirm our conversation of last week relating to Bonny's Bakery placing
a sign on your property on the south -west corner of Vine Front streets In Port
Angeles.
The Bakery will keep the grass out around the sign, so the area looks presentable.
The sign area will be about 24 square feet built on wood uprights set Into crushed stone
or cement as required by city regulations. The placement of the sign also falls under city
rules which state the sign shall be a given distance from the corner, and not on city
right -of -way
We agree that the rent will be $120.00 a year with the payments to be made semi-
annually
Please, sign this document to indicate your acceptance of the content of our agreement.
Our thanks to you and Sandra for your support.
Sincerely,
Edward elly
Acceptance Signature
79 e
Doctor Betiger
f)
'4 P *WObe !AmariW.7011041fe 0
Bonny's Bakery
Port Angeles, Wa.
February 7, 1995
Date
i.
4, r
February 20, 1995
!n ADDITIONAL BAKERY SIGN ON VINE FRONT
5. SIGN
THE CITY OF Fi?r A',GEr. E
8750012026
02/2/'75
BDNNY'S BAKERY
Check
BONNY S BAKERY 7745/7 425.00
125,
dc?
b
I. V 1 D BETTGER PERMISSION DONE
4 120.00 PER YEAR PAID AT SIX MONTH INTERVAL
J PHONE OFFICE 452 -2361 HOME 452 -2176
t.
r r
TALK TO BETTGER RENTER. MIKE SHIELDS DOES NOT LIKE
`r rt POLITICAL SIGNS 436 FRONT DONE
DOC AGREES TO NO POLITICAL SIGNS
GET PERMISSION IN WRITING FROM MR. BETTGER DONE
ti.
2, CITY FILL OUT APPLICATION DONE
FEE $25.00 A THE MINIMUM FOR SIGN LESS THAN 25 SQ FT
OURS= 3x8 =24
3. STATE APPLICATION NOT NECESSARY IF USE CITY RULES
CHECK THIS WITH OLY
4 RON CAMPBELL SIGN 683 -6790
$265.00 for sign
PRESSURE TRREATFD POLES INTO CRUSHED GRAVEL
GET PLANS CHECKED SUBMIT WITH APPLICATION
r te:
•rn, 4.4.: y ry
4445M1+1- "r'w``'
N
TY OF PORT ANGELES Constiaction Plans
he Issuance of this permit based upon these plans, specifi-
cations and other data shell not prevent the building official
from thereafter requiring the correction of errors in said
piers specifications and other data, or from preventing
building operations being carried on thereunder when in
violation of all codes and ordinances of this urisdic
Approval Date fl By AC-
Rk ,4)61-4-•
J-8i aft' (4411
vo'
9v
'It 40 1:
c f"
0riggd
I I
/h.*. io 4.4 4 0.#1014.16.
110.1."„e•A
kitktattgookitteitafigilkiii
...v. h ..wato•■■••••‘..
I I
1
I i
1 .1
I I
7
fit
I- 1,1
Dear Doctor Bettger,
This letter Is to confirm our conversation of last week relating to Bonny's Bakery placing
a sign on your property on the south -west corner of Vine Front streets In Port
Angeles.
The Bakery will keep the grass out around the sign, so the area looks presentable.
The sign area will be about 24 square feet built on wood uprights set into crushed stone
or cement as required by city regulations. The placement of the sign also falls under city
rules which state the sign shall be a given distance from the corner, and not on city
right -of -way
We agree that the rent will be $120,00 a year with the payments to be made semi-
annually
Please, sign this document to indicate your acceptance of the content of our agreement.
Our thanks to you and Sandra for your support.
Sincerely,
Edward ally
Acceptance Signature
rl
Doctor Betiger
Bonny's Bakery
Port Angeles, Wa.
February 7, 1995
'Date
'S{
Permit Pee
Plan Check Fee
Investigation Fcc
Other
Total S
Building S. n.
Occttnancv Croup
Occupant Load
Type of Construction
I Occunnncy Permit Issued
Leval Description: Lot
Block
Subdivision
Land Use Zone
L Arcs
L.ot Coverage rx
I- -JSinn Contractor
Sign Type I I FS I a
111 :'.minatinn I i
Overall Hcieht I 44
Sign Height i I
Sq, Ft. I 24
1 1'
Owner Bo At'i
Contractor
Arch Engr
Class of Work:
Description of Work:
Ty I pc
Valuation
Clearance
of Permit:
Date Received
Name
U New
Land Ur Zone
I Re
vt�.aru e ,r srn art vrM
w aT at owiti 4-t
1 1 �Wyr V
rs lwi
11.74 PRINT Vet.
CITY OF PORT ANGELES PUBLIC WORKS
BUILDING DIVISION PERMIT APPLICATION
/'2 I 4• Date Issued 7 I`7
/lddrela I y 1�hope
15(v7. P. f �y�t -1 17.4
U Building
/p
Receipt p
Receipt ft
U Addition 11 U Alteration
G N 6e
No. of Stories
So. Ft. sr
Total S -Z. 4 3 e 2. Receipt fi 2,0 2✓
APPI.t :A1 tP ED BY t'i.AN5 P.IrnCkEO AY API'ROVAA r-0R MSSUANCa BY
r1
SItilARATE VERMiTS are required for electrical work, utilities, private and public
Improvements, This pemrli imams null and void if work or conauuctlon authorised Is
not cnnurxnred within 180 days, if tmramrdton or work It suspended or abandoned for a
petal of 180 days Oki wok has commenood, or if mquired tmpa tiom have not been
rquened within 180 days anon the bat IllAp!Ci kV. n. 1 hereby calf) that I have read and
aran:ned IN, application and know the same to be taro and correct. All provisions of
h wt 6t1 odic cea governing this type of work will bo complied with whethat speelfied
Ircrelit or not. 'iha granting of a penult does not prostunn to give authority to violala or
v,'et the prnvt:dons of any mote or 14c I lin m elating canetractioa arils prttmmance
nl '.rUtruclion.
Sewer
Driveway
Water
I Waler Closet
II I Lavatory
II 'K Bathtub
i{ I Shower
II I
II I
II I
Il i
I
I I
Ir i
It i
►1 I
II I
II
Receipt a
I I
I i
U Move U Demolition
Li Repair
Oea.Jek 0 4-U, E .T
U Plumbing Contractor
No. I Fixture Type
Kitche Sink
Disooset.
Floor Drainloor Sink
Clothes Washer
Urinal N
Wax: Heater
Drinking Fountain
Lawn Sprinkler
Vacuum Breaker
Solar Panels
Other
l Ne.
Sub Total
Permit Fee
Total S
Mechanical Contractor
No. Type of Equipment Fee
Elec. Furnace
I Neat Pump
I Oil Fuh *ce
I Kitchen
I Woodstove/Petlet Slat's/Insert
Other Constructiott/P W Permits.
Other
007945
rn
Z
M Fee
1 Other
Receipt tY Total S
Special Conditions: bill 'O'(2.. l ag) N A.) 513
to C,a e-Q W j a W o j iap-a s pet +v.11 s 1 oda
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
05-00000506 Date
995556
436 E FRONT ST
06-30-00-5-1-1900-0000-
DEMOLITION
6/21/05
RESIDENTIAL HIGH DENSITY
3000
Owner
Contractor
DOCKENS, JAMES/JANET
432 E FRONT
PORT ANGELES WA 98362
(360) 452-7499
Structure Information 000 000
RJ SERVICES
122 S. BROOK
PORT ANGELES,WA
PORT ANGELES
(360) 457-1420
DEMO SFR
WA 98362
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
DEMOLITION
DEMO SFR
52464
47.00
6/21/05
12/18/05
Plan Check Fee
Valuation
.00
o
Qty
Unit Charge Per
BASE FEE
Extension
47.00
Other Fees
STATE SURCHARGE
4.50
z
C;j
G'\
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 47.00 47.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 51.50 51. 50 .00 .00
tt-,
l'
~
i
~
'f
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
nu II 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\ 110215 building permit inspection record05.wpd [1/4/2005 J
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, 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
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN I
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF I CEILING
DR YW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR I CEILING I
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKlRTING
PLANNING DEPT SEPARATE PERMIT #'s SEPA:
P ARKING/LlGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION RW 1 PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT. 417-4750 l'L~1'-IING DEPT.
BUILDING 417-4815 BUILDING
T:Il'ol icies\ I 102_15 huildll1g perrTll t inspectIOn record05. wpd [1/4/20051
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec ~ -9-1-0 ')
Pem1it#:D5 - SOb
Fill out COMPLETELY and in INK. Your applicatiorr and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Date Approved:
Date Issued:
Applicant or Agent: ..J6. iMJ-V--'!-. .iJe;c......lL...e vvs
Owner: .s.--..A~
Phone: '-l S""d.- -, '1 "'t ~
Phone: ...5c?A-D
AddTess: '1'3 d.. ~ ~~+ S-t
Architect/Engineer: t-J / A
. ,
Contractor .1\ ...L ~ rU ICe..~
City:r-'"JIL\: A\~.2..~
.'
Zip: q~3b ~
Phone:
State License #:
Exp:
Phone:
City:
F'R 0 .JJt. S-=r'
Block: I '9
Zip:
ZONING:
AddTess:
PROJECT ADDRESS: Y ~ b (..
LEGAL DESCRIPTION: Lot: I
Subdivision:
.eLALLAM COUNTY PARCEL NUMBER: RP ("'1.o30<x? S-ll'100 C')O(?O
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA MC #
TYPE OF WORK:
JC'J: Residential 0 New ConstT. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel ~Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
City:
Exp. Date:
SIZEN ALUATION:
o Stove SF. @ $ /SF. = $
o Garage SF. @ $ /SF. = $
o Deck SF. @$ /SF. = $
o Other TOTAL VALUATION $:3 Jl~
D~M-O s 1-fLOC;TU ~~
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
V ALUATION 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 cunent fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the tinle of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit 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 R1 05.3.2
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 determ' e what permits are required ,not the City's, and that I must obtain such permits prior to work.
Date: b - a I - 05-
T:\Policies\BL-1102_13.wpd Applicant:
Jun 14 05 03:20p Jim & Jan Dockens
UV'L~"vua ~J;~~ ~AA J6D 491 6308 ORCAA
c
DIlle:
AnlL~nded: 0
l/lidnl
Completion: [J
I\rumaJ:
a $500
360-417-1854
p. 1
IiJOOll002
2940 B Umlted Lane NW
Olympia. WA 98502
Phone: (360) 566-1044
Fax: (380) 491-8308
WWW.ORCAAorg
tVeDd
JUN 1 5 20Wi
A.
4.
B.
sbestos Rcnio~--- ..... '--"-
DCfllolitiolL. . '___...
Permit Application for an Asbestos Project
7< O..A..J T
Mailin Addreu:
No. ofStrUCUlrcs:
AHERA Building
Inspector Name:
/
..w AH1;'JlA .\'lfIlr7,7 h; IU&I}./tIt47J turl-Tl"I;' .ITJ.I1I\U1JU)"lnN
,.RrJ)"fi("'rN
F. Demolition
IACormarioa:
DeJnOIition
Coatrac:tor:
, G. AsbCIcas
Projed
lufarmatlo.:
No.ofStnaotures:
Mainlcnancc
Other:
----- -,.-....----
Phone:
-r
Ci : Stllte:
Contractor Owner/CEO:
Phone:
. _Pax~__J.. .
-...--....-....
Stale:
Zi
Phone:
D9le Asbe:>to$ SUrYl.'Y Conducted; W s Asbeslos FOund?
es
o ffNo, A.naeb SUJVc
Certification No.: Expiration Date:
Stut Traillin!VF. ire (USt Fire DepL il$ demolition COl1tr8ClOr below)
Date; 0 Ordered" Oemolition allach copy of Order)
rnlCl",,.-/ttp-r"'" rIfdI~ll'"~ar/fr_Jf'lIIlI/I<<tq{AfI''' JfV'tfl.JttIl~ _!In ~11r1rllillHaet1f'1k'...~llfItrJ4/~'e
PAID
~?5Z-
.JJ7 /~
No. of Structures: (see
back if> I)
H.
I.
2-
3.
4.
S.
6.
7.
8,
9,
10.
b -J.~ --0,-
1l.dv. 01/07l(J4
CIC. NQ
DAlE
Phone: ( )
Wk. Days; M T W Th F Sa SU
'al be removtd by
Yes Q No
~ONftEFUNO""BU;
t<a,:a,:
.$25
0525
S25
SIOO
$2.50
S500
$'-000
$500
$50
$25
~
12-TYVl
JUN-20-2005 21:28 FROM:N W ASBESTOS
360-385-0584
TO: 13604171954
P.l
Date;
lob Location:
Owner:
Sublect:
Inspector:
eel
.1
Northwest Asbestos CQns .ltants
~06 Reed S. :
Port ToWnsend, W
360-385-05
nortbwestasbesto$consultant
6/20/05
I
,1
James Dockens
436 E. Fron~ St.
Port Angele$, WA
I
i
James Dock~ns
436 E. Front St.
Port Angele$, W A
Regards to ~e-lnspectl OJ f .
The purpos~ of re-Ins ctlon .
the owner. :
This area th~t was not
been abated and all
ready for d$1011tlon
Region Cleap Air Agen
I
I
]
ter ACBM was removed by
30/05 inspection report has
s ;we left clean. I find this building
acto 'ing to the regulations of Olympic
and P A guidelines.
Bob Wlther1~ge
EPA-AHERA!- Building In~pe r I Management Planner
WAMOA-00,42-04
i
Explres- lO.{13/05
i
I
I
Olympic Re310n Clean FAxeD €"21-oS- ,.3:W-
City of Port Angeles P
, !
Date:
lob Location:
Owner:
Subject:
Inspector:
Northwest Asbestos Consultants
406 Reed St.
Port Townsend, W A 98368
360-385-0584
northwestasbestosconsultants@cablespeed.com
5/30/05
James Dockens
436 E. Front St.
Port Angeles, WA 98362
James Dockens
436 E. Front St.
Port Angeles, WA 98362
Demolition
Bob Witheridge
AHERA - Building inspector / Management Planner
WAMOA - 0042-04
Expires - 10/13/05
~orc G-~ \(e~'2-~A
~ '" ~0e \j.:>\-.ei:> \_
- . \- I/.P"":> f()
~. . ~\~ \) 4\P'\
\..00 ('\ \ ,\ \ .
~.JX~y
Scope of work
1) Inspect for asbestos containing building materials (ACBM).
2) Survey, sample and record suspect materials.
3) Report to owner with results of testing by Clayton Services.
4) Copies for owner, City of Port Angeles Permit Center, Olympic Region
Clean Air Agency and on site for demolition.
Inspection Report
The inspection started with a visual survey looking for Asbestos
Containing Building Material (ACBM).
Sample results are as follows:
Sample #1:
Kitchen, laundry and top layer of bathroom 12"x12" floor
tile with mastic. White and gray.
Sample #2:
Bathroom bottom layer 12 "x12" floor tile with mastic.
Brown and gold.
Sample was sent to lab. See results.
To Clayton Services
Date:
Tob Location:
Owner:
Sample #1:
Sample #2:
Inspector:
ASBESTOS BULK SAMPLE DATA
Northwest Asbestos Consultants
406 Reed St.
Port Townsend, WA 98368
360-385-0584
northwestasbestosconsultants@cablespeed.com
5/19/05
James Dockens
436 E. Front St.
Port Angeles, WA 98362
James Dockens
436 E. Front St.
Port Angeles, WA 98362
Kitchen, laundry and top layer of bathroom 12"x12" floor
tile with mastic. White and gray.
Bathroom bottom layer 12"x12" floor tile with mastic.
Brown and gold.
Bob Witheridge
AHERA - Building Inspector / Management Planner
WAMOA - 0042-04
Expires - 10/13/05'
Please call with test results when completed.
See attachment.
Thank you,
~~~
Bob Witheridge, EFM
1"1I1'-C~ LJ'_
~Cla&.""'nft. ASBESTOS B1JLK SAMPLE DATA
. _ " '10,3 LU.... rM.APLd(.'IDDBfteI....
"" GROU' SllVI CIS /4..~ --~""lU""
~a........ ..........
.... ..IIIM
()Q8 '7t$o>>li6
Client Name; Nordtwat...... c.....
Job ~436 EMt J'nDt St. Port.A.apl" WA. 9I.16'l
r-
r. D.Lra.a.
Let':
3895l
......
-."
~
r.....Il).
......
~ -...... I~
OLl - ft.... WJIIaeddte
JOIJoIiI:
~ IllmaUI
~
SAMPLe ##: 0 )
!aJI.; '8951.1
SOURCB: 1~2" ftMIr"'l'lla" MaItk
.
LOCAnON: Net....
1.lI;rIn.... YI i11t fir ~
No.;.fd f-~'MA
Ad&fJ'08"1'Yft nacatft
wr- 1lA~
...... ......
~...........
....0.-.
MATBlUAL ntteI"1flofM'laN; LAY.I!:IIItD
""...",.,.... ......... . - w
.u .".
NMI: f.NIII...........", n r T~ -.....
~
U.l"'~ 1iIIUZJUI
~~B~~ )
LAllJt '19$1.2
~ 12"XU- ......'186...MMk
~JlON!""'"
Cdt ·
.tWatrr t1aJllf1 T......., (ACII)
1IfP1'O&TYl'& ~
0......... 15
Il.l"d MA.....t4t.S
............
VillI PIIIIr.........
, hU"I"IlItJAr. __11I'IW'D&. LAYJaD
V... ....",.""",.. ...."... Lr 'P9
l"'--
'--
Nt1Ic ,.,...............",.. r.~ ~......
1
'\
~
5
,.
10
.,
:zo
~
%
5
%
45
JS
~
SAMPLED BY: ... 'WMIc"14r DATI: SllW2GOS
CXJMPANY: ~JlJIbr_ 0--"'-
ANALYDD BY; ... ~.... DAD SI2.SIXI05
:R1ICI1YBD BY; 1ta1Ie:1Ba11e
DA'I'Ik 5f.IOfJa05
D.JlAIT
c.g....____=~ - - ....,.....~I 1:1 1 - I 1"'-.".............-........ ...1rA...."..._~... f" ......
===.... _!:~~"~It;: -!"~=-~~;;.._.;.-:-,. "'- :---~~-:-'...:.--.. !~~~
................._,......,..... ............_.. _ r" .=-...............- - l """11.-_ .. ....__~a~~ ,.jQ~._~
~u.lQ I'" '.a/t,.............r ~ ,......... ..11 r - .A..__..........._.__..........._....
...........-.....................
~,.. .... "'..
Summary of Inspection
This survey includes all areas of inspection with the report results from
Clayton Environmental Testing Labs.
Sample #1:
Kitchen, laundry and top layer of bathroom 12"x12" floor
tile with mastic. White and gray.
No asbestos detected.
Sample #2:
Bathroom bottom layer 12"x12" floor tile with mastic.
Brown and gold.
15% Chrysotile asbestos.
All asbestos containing building materials with a reading of 1 % or greater is
to be removed by owner or a certified abatement contractor which follows
the rules of the EPA and governed by Olympic Region Clean Air Agency.
During building demolition or remodeling, it is possible that additional
suspect asbestos containing building material (ACBM) may be found
with in a wall, floor, ceiling or other areas not accessible at the time of
the survey. Should such suspect material be discovered an AHERA
certified inspector will have to sample and test the material to prove
it is of non-asbestos.
Northwest Asbestos Consultants is not responsible for identification of
hidden materials that are not identifiable with reasonable diligence.
After the facility is completely cleaned out a walk through and inspection
is required by the original AHERA building inspector (NW Asbestos) after
abatement, then a copy of the letter certifying that abatement has been
completed needs to be received by the City of Port Angeles Permit Center
and Olympic Region Clean Air Agency.
Thank you,
l3o{.~
Bob Witheridge, E.F.M.
~ORTANG~J..ES
WAS H I N G TON, U. S. A.
PUBLIC WORKS & UTILITIES DEPARTMENT
May 18, 2005
Jim Dockens
432 East Front Street
Port Angeles, \V A 98362
RE: Port Angeles Landfill Waste Disposal Application, WDA 05-14; Building demolition
at 436 East F~ont St, Port Angeles, W A 98362
We have received your application for disposal of building demolition debris from the referenced
site and reviewed the testing results for lead content. Based on the testing results the debris
appears to be acceptable for use in the landfill A copy of your approved application is attached.
This approved application must be shown to the landfill scale attendant at the time of disposal.
Please be advised that this disposal application is only for the materials and quantities listed in
the application. Materials not listed or in excess of the quantities noted may require separate
applications and approval.
Please call if you have questions.
Very truly yours,
~{~~
City Engineer
Deputy Director of Engineering Services
GWK:tf
Encl.: WDA 05-14
Copy: Ken Lol:hry
N:\PWKSIENGINEER\WDAPPUC\05-14. WPD
FILE: Landfill Solid Waste Disposal Applications
321 EAST FIFTH STREET · P. O. BOX 1150 · PORT ANGELES, WA 98362-0217
PHONE: 360-417-4805 · FAX: 360-417-4542 · TTY: 360-417-4645
E-MAIL: publicworks@cityofpa.us
. MAY. 16. 2005 11:31AM NVL LABORATORIES INC
'v'WL laboratories. Inc. _ CHAIN of CUSTODY
4706 Aurora A.,. N. Seattle. W,. 98103.. ~ unlE LOG
Tel: 206.647,0100 Emerg. Pager. 206.344.1878 ~l"\Iw.r',}f-
Ul88.NVUABS (685.5227)
Client lenovic & Associates. Inc. NVL Batch Number
......., street 1519 South PeabOdY Street. Suite 4 Client Jab Nwnber (') ~/6~
Total lamp_ t
Port Angeles . Tun1 Around Time 0 1-Hr 0 24.Hrs. 04.,Pays
Projool Manager -r/btlcf tf~ 02--HrI 02 Days ~ Days
Project Locadon - 1.1.1 t. ~ 5"?j PNl.". ,A.utt<<r'U. 0 4-H1$ 0 3 Da~ 06 to 10 Days
Allase CIfI rot TAT leu '""hn 24 HIs
f...a IMJdress """'eV ff ~,,,. """~
_-----NO.5588 P. 3
BATCH \0
2506464.00
Phone: (360) 417..0501 fp: (360) 1IS17..0514
o Aw_toS 1M o PCM (NIOSH 70i00) 0 TEM (NIOSH 7"102) [J TEM (AHERA) Cl TEM (EPA Level II) OONr
o AabMtos Blfftc o PLM (EPAI6OQIR-93/116) D PLM (EPA Point Count) 0 PUI (EPA GravirnlitM 0 T.EM8ulk
METALS ~(AAS) Matrix RCRA MotalS 0 All 8 Other .......
~~. [i t-Jr Filter 0 P.ak\t Chips o Arsenic (AI) 0 Lead (Pbl U Alia
o pPb (GFAA) o Drinking water . 0 Pairlt Chips (~) o BarkIm (~~ CJ Mercury (Hg) CJ Copper (04
LJ Du8t/Wipe 0 waste W8* o Cadmium ~ [] Selenl::J&J) o Nickel (NQ
o Soil o Chromium (Ct) C1 Silver o line (Zn)
o Other Typa o FbMgIass 0 NuIaance Dust 0 Ro(omeler Cellbrallan 0 Ott\ef '(Specify)
or AnalYSIs o SlIic;a Cl Respirable Dust 0 MoIdIFI.RIUS
Condition of Packagr. 0 Good 0 Damaged (no IpIUage) n SeV!f'8 ~h (~e)
~.
- ~
Seq. . tabID ClIent s...pll Number Com..... AIft
1 {"'} ~ I::S it . ,pu+~ kl# 4__ 0#
2 c,
3
4
6 .
6
7
8
9
10
11 "
'2
13 l
--
14
f--- --
1$ I
- --.--_. --
1;0
\"".....t
"
{- "ORr.04~
" -l.O~Q~
.~ "~ - ......~~
(J~",
-~.
~~- '#
~NtO ,
, "J
...." .
To:
WbA- 0 6-411
.>
~
rORT ANGELES LANDFILL
\V ASTE DISPOSALAPPLICA TION
City of Port Angeles, City Engineer
321 E Fifth Street
P.O. Box 1150
Port Angeles, Washington 98362
NOTE:
Phone: (360) 417-4803
FAX: (360) 417~4709
AU questions must be answered for waste to be approved.
1. Generator Information:
Company Name:
Mailing Address:
.
Contact:
Phone:
Project Name:
Project location:
..:)/vVl jJCC.1~5
'-41 2 G. ;: Au1/? <(*-4"1"
P(J'27 A..,.J4'<<"H 4P4 .1'6362
,
'- ""'Ci~ /.jo~ bvv s
YS'7- 4't'8t<6v\ 4~Z-7i.f91(H)
J.l.rllJ5.1z &""'OU~~D.J
Y "< L /2. ,cA..>-v7" ~.,. I AI) ~ 4v4'€l.'<(
~
-
2. Other Contacts (if applicable):
Consulting Finn:
Contact:
Phone:
Contractor Name:
Contact:
Phone:
Laboratory:
Contact:
Phone:
t
- - --. ---'--~-- -_.
7-YVrHhL :I AS~L ;;Vc
J
-;1"~CY' CtA\"(
l.f I ) -C6lJ I
Uv~""o~
NlL ~47o~6f, :Lvc
~d~1'rW jJ/j-U'1
!#Jt.. - ')"47-- 0 I rx"'"::;
-- --------..-. ..-.. - ...
-.. ..0_._- _.._ ___0.. .
Cily or Port A"ge/os . lilfI<Uilf Waslu Di:ipo:.;al Appliculioll
Pallo 1
'.
I
~ -- -- ----- - - -- -- --~- --------.-. "----- ----- --------
3. Source of Waste:
. ,
~
Check lhe eppropriale box below end brieRy describe lhe project, process, end/or cleanup thai
will or has produced the waste requiring disposal. Include the gasoline service station number
(if applicable).
CERCLNMTCA Remediation Agency Contact:
Independent Remedial Action - UST Removal
Unused Chemical Product Spill X Other Source: /)" ~L-{ 5
kv--(!,~,Jt; MDJSrL "/'6 ~ /,)~~lJ~~~
.
, .
4, Waste Material Composition: . (check aUlhalapply and Include percenl of 101al)
NOTE:
Soil
Concretel Asphalt
Preserved Wood
Coal Ash
Wood Ash
Total must equal 100%.
% Foundry Slag _%
% Dredge Sediments _%
% J6 Debris .i1li:L %
% Other (list)
% _%
_%
t
5. Waste Material Contaminants: (check all that apply)
X'
NOTE:
Gasoline
Metals
Heating Oil
Used Motor Oil/Waste Oil
Other Petroleum Product
PCBs
Diesel
Solvents
Unused Motor Oil
Other ~7"oi1 k/L L~ fJA,4
~aP~
Unknown
o. _.____...___. _...______. _.________
--.-..--- ------ ----'-
Supply any MSDS information with application, if available.
Cily of POll AfI{ll!/o~ landfill Wasto Dispo~al Applicnlioll
Pouo . 2
..~
.
t
i,
,--- -- - ------------.---------- ----.---- - _n
6. Estimated Quantity of Waste for Disposal:
75'
/10
Cubic yards /
Drums I
Tons (estimate both)
Tons (estimate both)
Other
NOTE:
Estimated quantity for disposal must be within 20% of the quantity actually disposed.
(10% for projects over 7,500 tons or 5,000 cubic yards.)
7. Frequency of Disposal:
~
One time
Monthly
Annual
Other
8. Waste Sampling:
Proper characterization of the waste for disposal requires the collection of representative
samples. The methods and equipment necessary for obtaining representative samples of a
waste, and the frequency of sampling, will vary with the'type and form of the waste. Check the
appropriate box and briefly describe how and where the waste was sampled. Include site maps
with sampling locations if possible.
Number of COMPOSITE samples t & number of discrete samples per composite ~
Number of DISCRETE samples ~-r- .s;~/A4 ~J/l7'i )_ }It 7~1 ~-t.J'l-{LvJ/,-4:)
6 '-D~/t'- a~a<>t 7-'l ~,.o[lt if
)t .:1/\)~t<l 'L ~/~J {~Ad,\ ~1<C-t f.e~ \ ~"- 4 ;::/1..,a~t'VC
NOTE 1: Unless prior approval has been granted by Port Angeles, the fOllOwing sampling
frequency will be used:
0.25
25. 100
101 - 500
501 - 1000
1001 - 2000
>2000
cubic yards
cubic yards
cubic yards
cubic yards
cubic yards
cubic yards
=
1 composite sample
3 composite samples
5 composite samples
7 composite samples
10 composite samples
10 plus one sample for each additional 500
cubic yards
=
=
=
=
=
NOTE 2: One composite sample shall conlain a minimum 01 U"ee/maximum 01 fivo discrete
samples.
City or Port Angelos - Lundri" Wasto Disposul Appticutioll
PU(jO - 3
9. Waste Analysis
..- ---------.---------.---
---. - --. ----~--
.
The "Dangerous Wasle Regulalions" (w1..c 173-303) shall be ulilized to determine tha
appropriate analytical requirements (or wasle characterization. Ecology Publication #91-30
(Revised April 1994) "Guidance for Remediation 01 Pelroleum Conlaminated Soils" shall also be
used 10 characterize pelroleum conlaminaled soils from UST releases. Submit alllaboralory
analytical rcsulls, QNQC data, and Chain o( Custody sheets along with this application.
(NOTE: The la,bor.llory musl be accrediled by Ihe Washington Slale Department of ECOlogy.)
a) List all analytical test methods used:
fiPA 13/ ()70Dc6
.
b) Provide a narrative as to why the above analytical methods were selected:
,f\ ( )t? ~
()I- L-<4.(1
441.-
ih.YJ^
are 51"-W?"7"'~
fJ4r.A.J""f ("),I'J
7'~ IS
5=7-"'JC7" <.J/Z.i.
jJ D$51.(31L1'?"V
I
NOTE:
Additional sheets attached:
x-~ YES
.
NO
10. Soil Classification: (....FOR PETROLEUM CONTAMINATED SOilS ONLY..)
Based on the analytical data and Ecology Publication #91-30, the soil classification is: (check
one)
Class 1
Class 2
Calculated Hazard Index
Class 3
Class 4
11. Dangerous Waste Affidavit:
Based on a review o( the analytical test resulls, site history,and the applicable regulations, this
waste is classified as: (check one)
~
Dangerous Wasto (OW)
Neither Dangerous Waste (OW) nor Extremely Hazardous Waste (EHW)
~
and Waste Code:
[xtremely Hazardous Waste (EI1W) and Waste Code:
"- - ..----."-- - --- -
City of POlt An!I(!/(!S ' Lundflll Wusto Disposal Application
Pooo 4
..
.
I
12.
Certification:
~_f'-
We, THE UNDERSIGNED, certify that this application is true to the best of our knowledge. All
information provided Is correct and the enclosed analytical results represent the proposed waste
material to the best of ou bilities.
--h
-7tl4?y ~W-
Printed Name
%ac/tC- -f As~ ZvL
Company
,)~/7-0\
Date
. .~
, I. . :~~~~!!~I~t..'.....~;.
.. .,,:'
N:lPOlICY _P\ 1000_ SW\ l00Q _ 01.WPO
City of Port Angelos - Landfill Wusto Disposal Application
Pogo 5
~AY.16. 2005 11:31AM
NVL LABORATORIES INC
NO. 5588 p 2
NVL Laboratories, Inc. .
.
4708 Aurora Ave. N., Seattle, WA 913103 AIHI>o.
Tel: 206.547.0100, Fax: 206.834.1938 Analysis Report AIKA . IH ~
www.nvIlebs.con'l #101861 ACC-:::'ITIlD
LABO ~ORY
Toxicity Characteristic leaching Procedure .. Lead (Pb)
Client Zenovic & Associates, Ine. Batch #: 2506464.00
Address: 519 South Peabody Street, Suite 22 Matrix: Bulk
Port Angeles, WA 98362 Method: EPA 1311/7000B
Attention: Mr. Tracy Gudgel Client Project ':08188
Project Location: 436 E Front St Port Angeles Samples Received: 1
Total Samples Analyzed: 1
Lab 10
25040576
Client Sample fI.
05168A
RL
mgl L
0.5
Results
in mglL
< 0.5
Results In
ppm
< 0.5
-
sampled by: Client
Analyzed by: Cheston Perry
Date Analyzed: 05/16/2005
DRAFT
RL = Reporting limit
'<' ;:: Below the rvporting Limit
mgl L =Mllligrams per liter
ppm ;:: parts per million
Note : Method QC results are acceptable unless stated otherwise.
Bench Run No: 25-0613-10
Page 1 of 1
t
f
Ths Building Permit Application must be filled
A. Applicant and/or Agent:
p e t B. Owners 11 /l'kY
ur+ w
4 4rWs
C. Architect/Engineer.
D. Contractor:
BUILDING PERMIT APPLICATION
DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION
7
PROJECT ADDRESS: i /4 th7f/47.., /f ZONING
LEGAL DESCRIPTION (on Deed of Sale or available from the County Assessor's Office):
TYPE OF WORK. SIZE/VALUATION
O Residential sf S /sf. S
O Multi- family sf S Isf. S
O Commercial sf S Isf. a S
TOTAL VALUATION: S ekag2
O New Constr
O Addition
O Remodel
O Repair
O
O
BRIEF DESCRIPTION OF THE PROJECT
6 /Cy t, t' 7
Reroof
Move
Dc:, Jiition
Sign
COMMERCIAL. Occupancy Group:
Lott Area: Occupant Load:
out completely. Please type or print in ink. If you hare a
44x, Y
J
i
License
Woodstove
U Garage
O Deck
O
PLANNING USE ONLY
Permits Required:
Max, Il.tig!tt Setbacks.
Site Plat and Use Approved by
v`r etiand(s): 0 Yes 0 No SEPA checklist required?' O Yes 0 No
PLAN CHECK FEE 3 DATE PAID'
BUILDING PERVITT FEE. S DATE PAID'
Construction Type:
No. of Stones: Lot Coverage:
Notes:
Zoning.
Date:
Otha-
mrn
FOR OFFICE USE ONLY
Date Rec..
Permit t:
Pre -Ap. Complete?:
Date Approved:
ny questions, please call 457.0411, as. 125.
Phone: 1 r 7 C
Phone:
Phone:
APPROVALS: PLAN
BLDG
DPW
FIRE
OTHER
RECEIPT NO.
RECEIPT NO.
APPLICATION ST..13 11TTA1 Your application a nd plans must be complete in order to be accepted Mr plan rev :ew Please NI out the
applfcytiun conapictely and follow the plan submittal checklist on the reverse of this form. The Permit C aordinutor can provide. you with
erre detailed information on the application and plan suhm^ttal requirements. y
VALUATION OF CONS ('R1 CTION valuations for new construction and additions are calculated by the Bpiiding Division, Department of
Public V. J ics, before the appl;eauon is submitted. C Intact the Permit Coordinator at 457.0411 ext 123 for assistance. in all eases, a•valuation
amount trust be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee
schedules.
PLAN t'(IECIC FEE: Your plun check fee is due at the time of the building permit application submittal. AU other permit fees are due at the
time of Issucrtce
BULLDLNG O WNFR'AUT HORII. AGENT If the appiicant is not the owner registered architect/engineer or contractor licensed by the State
of w ashington, a .w 'tanzed lrter from me properry owner authorizing the applicant to be his/her agent for submitting this permit application and
obtaining this permit will be required as part of this submittal.
EXPIRATION OF PL.A N REVIEW If no permit ie issued within 180 days of the date of application, this application will expire by limitations.
The Building Official c.tn extend the urea for action by the applicant up to 180 days, on written request by the applicant (see Section 304(d) of the
Uniform Building Code urrent EEalitiont No application can be extended more than once.
I hereby cernfy that I have read and examined this npplictx'ton and know the same tribe- true and curxect, and I am authorized to apply for
this permit. 1 understand a is not the City's legal responsibility to determiner rmits q/e rege ire it remains the applicants respond.
bility to Sect mine wha pe fir us are required and to obtain such.
Dante; f
Owner Boat
Contractor
Arch Engr
Class of Work:
Description of Work:
Type of Permit: I
Valuation
Permit Fee
I Plan Check Fee
Investigation Fee
Other
Total S
Building So. Ft.
Occupancy Group
Occupant Load
Type of Construction
I Occupancy Permit Issued
Legal Descrintion: Lot
Block
Subdivision
Land Use Zone
a
Lot Coverage
LJSign Contractor
Sign Type I PS
Iil:.minatinn 1 1
)vergli licight I
Sian Height I t
Sit. Ft. I 2./4 r
Clearance I 1
L Land lice Zone L Aed
Tot »I E ,-,e.
CITY OF PORT ANGELES PUBLIC WORKS -P.
BUILDING DIVISION PERMIT APPLICATION
Date Received 2 /2 1 4.5 Date Issued 73
I Address
U New U Addition U Alteration
iniertrl
CI Building
2.
AMU 4-
Att pt: BY PLANS cm :cm CK _J.,.
ay APpaovao tba ISSUANCE BY
/3
Phone I Lie. No.
I
Z
I I
--1-0 6e. 1o ca..�e� b E rF OAiT
Receint k
Receint M
No. of Stories
So. Ft.
1 I'
I I
I I
I I
I i
I I
I I
Receipt N 2i
J Plumbing Contractor
No. I Fixture Type
1 I Water Closet
I Lavatory
1, Bathtub
I 'Shower
I Ki iten Sink
I DisposZel`
Floor DrainN.Floor Sink
Clothes Washe
Urinal
Waver Heater
II No. A I Type of Equipment
II 1. Elec. Furnace
1.1 i n
II Oil Fu I
II I Kitchen Hoc t I
II I Woodstove/Pellet Sthve/Insert I
II I Other 1
II 1 I
1 1 Receipt It Total Ste` r
Special Conditions: *1 6N f=pm, BO /JA5 Vah
W (ow Ai® P s p rM
sto
SEPARATE. PERMITS are royuired for electrical worm, utilities. private and public
improvements. This permit becomes null and void If work or construction authorised Is
not commented within IRO days, if 'onamaction or work Is suspended or abttndomed for a
pelind of ISO dsye aRet work has comsne,wed, or if required inspections have not been
requested within IRO days from the list hooactian. t hereby cenlff that I have read and
earoraf Ihl, application and know the sane to be true and correct. All provisions of
h ws i.rd nillr vanes governing this type of work will hn compiled with whether specified Other Construction/P W Permits:
heroin or not. The granting of a permit does net presume to give authority to violate or
,r, •el the provisions of any state or Ioc I lacy regutruing coatsduction or the performance
01 C 'nsttuction.
'1tg'•41Wr voweN 0[ Audit
.1,i ,t 1 1wra tit
I IN PRINT lA
Sewer
Driveway
ttfaiti
Water
Li Repair U Move U Demolition —1
Drinking Fountain
Lawn Sprinkler
Vacuum Breaker
Solar Panels
Other
Contractor
Other
007945 rn�
I Fee
I
Sub Total I
Permit Fee I
Total
Fee I
It
i.
a
BUILDING PERMIT INSPECTION RECORD
CALL 457-0411 EXT 125 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MIN. 24 HOUR NOTICE. IT IS UN LAWF.UI ,TO
COVER, .INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACLtviED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVE PLANS'AT JOBSITE
'INSPECTION TYPE DATE ACCEPTED
FOUNDATION YES_ I3
FobtingS
Walls
Found. drainage i I I
RLECTRICAL
Rough in/Light Dept.
PISIMSINQ,-
dcn tivor /s
P,
Rough -in
Water line
Z Back flow /water
a sEA1.
c p Wails
Ceiling I.
Egamits
4 Q
Joists girders
(,D 1 Shear wall
14 Walls/ roof ceiling
g Drywall I
02 T -bar
ItiSi. LA71GIL
L Slab
Wall floor ceilin ta r .----12---.. l_
AlIctiAtillCAiJ
Chimney
W >odsrovc/Pi;ilet I I
a_riin -4 _r .T
y Ducts +Yy
1Ynt :rline i meter__ a ,I
Sewer Connection
s anitary
AC Storm
Site Drainugetrosion Control
Psrtcing
Other
phS
1
COMME'NTS'--:
Conswction -R W FW 1- 1 Construction RW
Ext. 12L„ Enfirreera2g_� P ineering
a Tire (MuIN• tam. only)
,A Ext. 252 Fire Dept,
Ext. 125 Building
GENERAL, COMMENTS.
In;• PRINT, INC. 1744
I INSPECTIONS REQUIRED PRIOR 1'0 OCCUPANCY USE
ItTSI j0 E COMMERCIAL I DATE I
13lectrical/Lighl Dept. Electrical/Light Dept.
Phone Ext. 224
1.,
-1 q
�r
Yal
t i
si
ti
.,-a.
4
,X t
Na
9'
t+
.R
r1
ii
I
i
t
tii A
r
February 20, 1995
U }L
3•". ADDITIONAL BAKERY SIGN ON VINE FRONT
7 t7 fft 1n D BETTGER PERMISSION DONE
il C 7 ,t PER di 4 r7
$120 00 PE YEAR PAID AT SIX MONTH INTERVAL
PHONE OFFICE 452 -2361, HOME 452 -2176
n 7
n rt
4 TALK TO BETTGER RENTER. MIKE SHIELDS DOES NOT LIKE
POLITICAL SIGNS 436 FRONT- DONE
5 SIGN
THE CITY 1f,
P95001202(,
'2/21/9
'g Y•
BONNY S NAKI:f'Y
Check
SONNY S BAKERY 7' d'5/ 7
dc"'
'F A13:
f �p
•0 j O i' DOC AGREES TO NO POLITICAL SIGNS
e 1 7
GET PERMISSION IN WRITING FROM MR. BETTGER DONE
:1 a
u
0 ,I 2. CITY FILL OUT APPLICATION DONE
fil c f
FEE $25 00 A THE MINIMUM FOR SIGN LESS THAN 25 SO FT
OURS 3x8 =24
3 STATE APPLICATION NOT NECESSARY IF USE CITY RULES
CHECK THIS WITH OLY
4 RON CAMPBELL SIGN 683 -6790
$265 00 for s n
PRESSURE TkREATED POLES INTO CRUSHED GRAVEL
GET PLANS CHECKED SUBMIT WITH APPLICATION
.4� in1 f- fi
1 t f 7
*r••::1c.xcrM 'f,�, A!+� ro .�.5+7aa• r_.ys'�3'r�r�or" -v, *�S'r'
er
C.
1c 4.
ti I *9
#3
".3 I
4 6
1.. ..r, f
i sl I)
,IN
et,
4
C. t .1, *t.‘( .3
t ',4
0 41, 0 te Vt 1' 6.'“*144.:'
4 ..1" 4 ".t. y
0 P ,4, kl 9'0-
1 V :0 t t i
4 4 1
',94 4- '1 4 4 j, 4 •6 II,.
,,,^4 'V '-r l i
e, V".0 t
9
.t• tit, v, 9
1.' d 9 #V 1:4
11
r 4
a
09 ,t ,1:
t
q 43
er4 4
tryg C
a
10 3. 4,
r
3 4.3
'44
O c o 4 g4
4 3. 4.7 a VC41
a• 1
4
y 4 II
I 4.4.
0.• 3'
4
,47 41 e
f
0
4 37 '74 T It
r-
4
a
Jr
a
I. 4 6. 4
lb 4 k '4 't 1
OA",
1,
a
o 3 :74' i'
4 1' .-1 o' n, 4 -t.:
i Ir 0
AV -1
9
4.. i'. o r 9 9 5
S 4 4 r n
C 9 4
u Q.P 3
4
:A
1 3'
to
4
.11
•r•
14,
4
4 a,
.474
n c.4
P
o't
.4
SdIatikr
J
,er II a :78
I) t4;
l•
3
3.
;94 9.
'1 5 3'
g 4 r
t
.3
Cit
wao
:I a,
9 i 0
P
3
4
3,
4,
a 1;
1, 4
asawlael
r
34,
*.3
4143 13
r;r,
ft' 0,7
t
.44
t
7\
5,
V
43.
t
fr
Sincerely
4 I
Edward elly
Dear Doctor Bettger,
,w
r
This letter is to confirm our conversation of last week relating to Bonny's Bakery placing
a sign on your property on the south -west corner of Vine Front streets in Port
Angeles.
The Bakery will keep the grass cut around the sign, so the area looks presentable
The sign area will be about 24 square feet built on wood uprights set into crushed stone
or cement as required by city regulations The placement of the sign also falls under city
rules which state the sign shall be a given distance from the corner, and not on city
right -of -way
We agree that the rent will be $120 00 a year with the payments to be made semi-
annually
0
0
Bonny's Bakery
Port Angeles, Wa.,,av
February 7, 1995
Please sign this document to indicate your acceptance of the content of our agreement.
Our thanks to you and Sandra for your support.
Acceptance Signature C. ,.e,0 i
Doctor Bettger 'Date
44
Fl
.4
6 +i•
I ztl Imo ac pin‘
S.
f
1f