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"
ELECTRICAL WORKPERMlT APPLICATION.
~
0,(P<1
Electrical COIHr;\..::tOt name . ~_ liCense llumbe;... i)4tc Expires
.sZ'm /,S'(h7 ~/ec.fr,-e.. o.,J,'''''JOSr.JC- '173/f!...'t'
P~;:Jo3z,add~y /0/ v.J
Cjlj?O~t- ~-t'I@s S'V~
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promE, Li/i.';Y'''B K..O tVlV'
Adde.,; "3'(;:;;"0. If 00 Ie. De..
Clly ?o/2.:t /l-179-f'I.ps
InSli.lllation description
Q Cummerci31 PCSid"Dtial
CJ New 0 Allcn:dlAdditioll
"','
FAS~
9tf3fo.:i
fI;
" .s' 00 .~ />h
'V'M A. e..s l' d en ee-
I
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f~ '7 ~
3&31'
I.
),Jj
Phone number to schedu!J iu!Io cctioo:
S;;'-E,::> 60.:1
Owner U1' difj/led by RCW. /.9.18.26/:(1) OWllf:!r will OCCIIPY Lhe struClIlre for' two
years ufte:r thj~ c/cc:t/"icu/ pcmlil U' filwlized. (2) OWtj(!.1' i$ reqll,rr:rJ tu Mr(' un electrical
CO'llraClDr if aho'llt! .~'ajd PrQpe"ty i,) fll" luk 0:'" ur feta/!.
After rea.ding tho 3bove statement, I hereby certify tltllr I am rhe owner or lhe ;:"bove
named. property or a Iicl,':ns~d ~1~ch'ical COnLr.H;lor. I urn m1.l1dns the .:[cctrical illStal.
latiol) or allcr'.llion in compliuncc with the t:-h:cU'ical laws. N.E.C" RCW. Chupter
19.28, WAC. Chupter 296-466, The City or PorI An~eh:s MLlnicipll1 Colie, ;ind
Utility SpJ:lcificariou.s.
Sicaatur of wiler. eletlricllt eu
-f
am f)~ tn Ii:../rVC.
<$ J I. yo
x
..:tor or electric",1 admll1ISrru.t'uji
- ate: 9/1J"'/t:1b
o Cash 0 Ch~
CJ Credit Card ~ Mast~rcal'd Discover
Cal'd# ~.~ _
EXPiraliOOD1C-- - --""/90- OV-
o1'card 0
EI It I nsan ors r ti
a NO LOAD CHANGES
a Bassboard KW
~ Fumsce 3-0 KW
~ Heal Puma 3- Ton _ LAR
a Fan-Wall _ KW
Service Information
Cl Overhead Service
o Temp Service
)Q Underground SaNiee
Voltage __
Phassala3
Service Size: ~OO ~
Feeder Size:
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
~
ROUGH-IN
~~y
THERMOSTAT
ll~,,;
AppnmllOy
SERVICE
~
~
ANAL L n
7~/
DITCH
A7f$I")",-r<e
?-J. ~-DGa
1)..10; ^,,~ruycll By
FEEDER
!
')III~ .'-P~rclVdd l:Iy
,,:tr;r"
Inspe\:tiulI
Doll,",
Area, Building or E4uipmt;nt Inspected
Action TOJ.L:c:n
flectficul
In.speclor
9-2Z-oC.
t 7/3.o~ {1~I=<r ffF
#/fto~
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.
~
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10 38'V'd
JI~~J3l3 NDSdWIS
0LG5LSP
0P:ST 9006/06/50
~,
-' -
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
PERMIT #
/.36 z.
()&P~
/C
APPROVED NOT APPROVED
o .................... DITCH.................... 0
o. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . .~
X. . . . . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . .~
O.....................AN~....................O
@
CORRECTIONS NEEDED: /'1W,t ~,c~ /;J;.-:T1'A!.T"r:>^_
--all mA5d.L A,/J;Coi)p\.
@ CJ?<--rS7z:JL
7b ~kL
(J) aPr/lfi.
.eA-
.
&r;
6 n:.-D M u-O K.../.AJb
.(};% ~ ./
7/L/J
...
~t
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. (360) 452-1381
'; < t~~ ~ 3604172733
! \:l-
;Jit"'".
&
ST OF WA L&I
09:06:53 a.m. 06-23-2006
3/9
1I.fr~- ~ 1fJri~ Qf1tIf-flP J.
CITY OF PORT ANGELES
LIGHT DIVISION
'.
..
FAX TRANSMISSION COVER SHEET
Date;
To:
Fax:
F{e:
Sender:
6/19106
Labor & Induetrias
417-2733
Inspections
Kathy Trainor
Phone: 417-4724
Fax.: 417-4729
OG --- '3D cf
OG -56l
YOU SHOULD RECEIVE 1 PAGE, INCLUDING THIS COVE~ SHEET.
IF YOU DO NOT RECEIVE ALL THE PAGES, PLEASE CALL (360) 417-4724.
Please Inspect for Simpson ElectrIc:
1302 IE ROOk Dr
EV8i'I Brown
4:;2-6562
Ditch Inloection - ditch will be done thIs mom lng, Inspect this aftemoon if at all
possible. Please contact Debbie at Simpson (or call me and I'ff contact her) if you're
unable to do today.
Contact:
Thank you,
Kathy
Debbie
Simpson Electric
457-9270
........**......................~...............~.............****......
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8
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ELECTRICAL WORK PERMIT APPLICATIONI
Job lVired by 'fJ Electrical Contractor 0 Owner
El;.ch;icl.I.l contractor Ilam~/ J___' LIcense number Dat~ 8xpires
.:::iJmp$(7Y) E:,-epr/C-i C S/m{'SeL 97:3 k-j)
P"'':;:;'J~13"!/7.kr.l!J / 0/ tJ
City LJ f" /1 I 8""0 ZIP C;(;.;~ /3
rtJl2- rr/1~.e e-s tA/"'I - 7IJ-.J ro
T~l"phooc: nu.mber .FAX number ....;;.....
'S 7 -'1 ;). 7 0 5-;1,/n.e- '0-
I'relUl'j#v~ .a'2? j-t)z,J11
Addre or iDspection
~
JDstlllJ:uilln d"ltcriptioll
o CODlmercial }iJ Residential
ONew
o Altered/Addition
~.'~
~
6 () /}-In/ T~J" ~..,
City
Phone IHlmber (0 :!ichcdul in!llpectlou;
'15:J.-~Sb;2...
Ownc.'" as drtfilled by RCw'J9.28.261:(J) (JWIIC'r' will (m,:vpy tire j,'(l'UCIW.: J"" two
year,)' a/ler r/l~' cJ('Clricci/ permit i,v ji"aJi;:et/, (]) Owtlel' i;)J' I'eqljired to hlf'l: <ill dL!,wicat
CCJfllractOI' if ahove s~id pr(jpcrry is for ,I'ale. 1'I!flt Or /t'W"it.
After rClldins tbe J.bovc slulemelu, I hCNby certify thill I wn the own~r of tlte "bove:
mnm:d property or 3 licensed c:Iectrical colltr;1ctor, I <1m making the eh:ctrica.1 iflslal.
IMio11 or o:I.Jtc:rdtion in" compliance wiLh the: electrical Jaws. N,E.C" RCW. Chslltcr
19.21!:, WAC"Chapter 296-4613, The City of Port Angeles Municipal Code. and
Uti lily Specilicatiolll),
Sigllutll owner, electl"iclIl c
x
~""'." ., el~l:;;: ';h%~
o Ca.,h 0 Check #
1id Credit C'r~ M,..'tercard Discovel'
Card I! ___~~_________
EXJliration Date
of card
lnspcctioll fee
$ 1ft;. ~
EI t i Addition n
o NO LOAD CHANGES
o Baseboard _ K!N
a FumacQ _ KW
o Heat Pump _ Ton _ LAA
o Fan-Wall _ KW
tractions
Service Information
Q Overhead Service
~ Tamp Service
tJ Underground Service
Voltage
Phase lJ 1 0 3
Service Size:
Feeder $12e:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
D", ROUG~:,,,,,, B, J u.~HEJWOS::~~"
.-lNAL DITCH
~~h -:be
SERVICE
Dill.. APJ)f('O,.,j By
FEEDER
lJaLo
AplllM~IBl'
Dale Appruv~il By
rllsp~ction
0;111:
Area, B u.i Iding or Equipment lnspected
Action Takeu
Elc:t.:.:ti-ical
Inspector
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CITY OF PORT ANGELES
* *
Correction Notice
Job Located at
I ~o 62
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Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
~~DJL
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~8Ut:' I Sp(, L(.:-
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These corrections must be made and are not to be
covered until reinspection is made. When corre tions
have been made, please call
for inspection.
Date
Inspector for Building Division
DO NOT REMOVE THIS TAG
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BUILDING DIVISION
CITY OF PORT ANGELES
* *
Job Located at /30 2-
Correction Notice
120 k ,),z
.
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
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have been made, please call ./(12 - LI 12/ r--
for inspection. ~ ) ~
Date ,~;07 .{j)f;-V .
Inspector for Building Division
DO NOT REMOVE nlj~ TAG
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST51HSTREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
Owner
EVAN BROWN
117 VASHON
PORT ANGELES
Other struct info .
Permit . . . . .
Additional desc .
Permit pin number
permi t Fee
Issue Date
Expiration Date
5/16/06
06-00000304 Date
654704
1302 ROOK DR
06-30-14-6-7-0010-0000-
EVAN BROWN
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
222172
Contractor
ALDER ACRES CONSTRUCTION
P. O. BOX 200
WA 98362 SILVANA WA 982870200
(360) 654-1932
TOTAL % LOT COVERAGE 12.70
NUMBER OF STORIES 2.00
LOT SIZE 31190.00
TOTAL LOT COVERAGE 3984.00
NUMBER OF UNITS 1.00
PUBLIC WORKS RES WATER SERV
5/8" DROP IN METER
74237
175.00 Plan Check Fee
Valuation
.00
222172
11/12/06
Qty Unit Charge Per
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BASE FEE
Extension
175.00
RIGHT OF WAY
74229
50.00
Plan Check Fee
Valuation
.00
222172
11/12/06
Qty Unit Charge Per
1.00 50.0000 ECH RIGHT OF WAY PERMIT
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
Extension
50.00
SANITARY SEWER HOOK UP
74211
110.00
Plan Check Fee
. Valuation
.00
222172
11/12/06
Qty Unit charge Per
1.00 110.0000 EA SAN SEWER HOOKUP
Extension
110.00
Special Notes and Comments
Address numbers shall be plainly' visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
04/05/2006 11:45 AM SROBERDS -- The proposal will result
in a new sfr in the RS-9 with 13% lot coverage.
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 atterthe 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.
Date
?~
-~
-- G/C-oG
Signature of Contractor or Authorized Agent
Signature of Owner (if owner is builder)' .
Date
T:\Policies\II02.ISR [I/OS]
-,
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SlDEW ALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE
I
I I
.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W./ PW/ CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING c
T:\Policics\1102.15R [1105)
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~~
CITY OF PORT ANGELES
PUBliC WORKS - UTILITIES DNISION
321 EASTS1HSTREET, PORT ANGELES, WA 98362
Application Number . . . . . 06-00000304
Application pin number 654704
Page 2
Date ,5/16/06
Special Notes and Comments
Electrical load calculations and elctrical permits are
required. Connection fee of $713.00 required.
04/04/2006 10:37 AM 'GMCLAIN ----------------------------
Ditches & 8" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required. '
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 335.00 335.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 2409.50 2409.50 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions 'Of
laws and ordinances goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Owner (if owner is builder) ,
Date
Signature of Contractor or Authorized Agent
Date
T:\Policics\J I02.ISR (liaS)
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECI'IONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
I INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
1
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R W./ PW/ CONSTRUCTION - R W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING -
T:\Polities\11 02.1 SR [1105]
o<C: pORT &.
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
<::';
<r:5'
\
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000304 Date
654704
1302 ROOK DR
06-30-14-6-7-0010-0000-
EVAN BROWN
RES NEW SFR
5/16/06
~
~
~
RS7 RESDNTL SINGLE FAMILY
222172
Owner
Contractor
EVAN BROWN
117 VASHON
PORT ANGELES
ALDER ACRES CONSTRUCTION
P. O. BOX 200
WA 98362 SILVANA WA 982870200
(360) 654-1932
TOTAL % LOT COVERAGE 12.70
NUMBER OF STORIES 2.00
LOT SIZE 31190.00
TOTAL LOT COVERAGE 3984.00
NUMBER OF UNITS 1.00
Other struct info .
Permit . . . . .
Additional desc .
Permit pin number
PEjrmit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
74526
1709.05
Plan Check Fee
Valuation
683.62
222172
11/12/06
Qty Unit Charge Per
Extension
1020.25
688.80
BASE FEE
123.00 5.6000 THOU BL-100,001-500K (5.60 PER K)
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
74559
36.40
Plan Check Fee
Valuation
.00
o
A-~3
11/12/06
Qty Unit Charge Per
1.00 36.4000 ECH EL-LVT-FIRST THERMOSTAT
Extension
36.40
;:)
<3-
~
Permit MECHANICAL PERMIT
Additional desc
Permit pin number 74534
Permit Fee 118.85 Plan Check Fee
Issue Date Valuation
Expiration Date 11/12/06
.00
o
Qty Unit Charge Per
BASE FEE
1. 00 14.7000 ECH ME- INSTALL 100- FAU
6.00 7.2500 ECH ME-VENT FAN
1. 00 10.6500 ECH ME-VENT SYSTEM OTHER
Extension
50.00
14.70
43.50
10.65
Permit PLUMBING PERMIT
Additional desc . .
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
~.I~
Signature of Owner (if owner is builder)
.5-"-oG
Date
T:\Policies\1 102_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 UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLOG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS / GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD / DUCTS
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
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W. / PW / CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PoJicies\1102_15 building pennit inspection record05.wpd [1/4/2005]
J
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 06-00000304
Application pin number 654704
Permit pin number 74542
Permit Fee 163.00 Plan Check Fee
Issue Date Valuation
Expiration Date 11/12/06
page
Date
2
5/16/06
.00
o
Qty Unit Charge Per 'Extension
BASE FEE 50.00
12.00 7.0000 ECH PL- EA. FIXTURE ON ONE TRAP 84.00
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00
1. 00 15.0000 ECH PL- EA. BLDG SEWER 15.00
1.00 7.0000 ECH PL- EA.WATER HEATER 7.00
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background. .. \.
04/05/2006 11:45 AM SROBERDS -- The proposal will ~result ' .. ~.
in a new sfr in the RS-9 with 13% lot coverage.
Electrical load calculations and elctrical permits are
required. Connection fee of $713.00 required.
04/04/2006 10:37 AM GMCLAIN ----------------------------
Ditches & 8" culverts will be installed to City Stanards.
See Public Works Engineering for Standards. . "',~ ..
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
.n'o!:-i~~.~s':r~qu~r~'r ~'; .:-, ~ 't ~ ," .
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
------~~:~~~~~~~:_~~-~~~~~~~-~~~~~_:~-~~~~~~~:_~~~~~~:~?_:~----------;--~~-
Other Fees . . . . . . . . . SEWER SYSTEM DELV C~I!:;', ,.~7~1!i'\ (":.,:
STATE SURCHARGE " .,. 11.50,
PW WATER SYSTEM USE FEE 1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 2027.30 2027.30 .00 .00
Plan Check Total 683.62 683.62 .00 "- " O~"
Other Fee Total . 0'0' ,>
2074.50 2074.50 '.O~ ,l'.
Grand Total 4785.42 4785.42 .00 .00
\... r' 4.
.... ,
:>
~
\
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\Policies\] 102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 4 I 7-48 IS FOR BUILDING INSPECTIONS. CALL 4 I 7-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES ,
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE
DATE
ACCEPTED
YES NO
COMMENTS
~
\
~
t
FOUNDATION:
FOOTINGS
SHEAR WALLS I WALLS
FOUNDATION ( DRAINAGE1Jx>WN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS I GIRDERS
SHEAR WALUHOLD DOWNS
WALLS I ROOF I CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING
MECHANICAL V _. -- .I .,; W
HEAT PUMP I FURNACE't DUCTS
GAS LINE
WOOD STOVE I PELLET I CHIMNEY
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKIRTING
'/r;,/~, tJe
1" ,
(., / /5/ q;, J k-
&/h5/ot. vt
7ft '3f()b .:Jf[i
1f17I'OJro(, Vt:i/
I ACCEPTED BY:
FINAL DATE
I , .
I/lJIL. I,-r~ Vi-"
. . I
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, .
Il{)j' / a,. \TW
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1()/~'dJ ~
.
FINAL
DATE
ACCEPTED BY:
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z~
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~~
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~
PLANNING DEPT. SEPARATE PERMIT #'s
P ARKING/LlGHTlNG
LANDSCAPING
RESIDENTIAL
SEPA:
ESA:
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
DATE YES NO COMMERCIAL,
DATE
ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT.
417-4735
ELECTRICAL
LIGHT DEPT
CONSTRUCTION - R.W.
PW I ENGINEERING
CONSTRUCTION R.W. I PWI
ENGINEERING
FIRE
417-4807
417-4653
.
\\ \ \
, \\
\ V\
FIRE DEPT.
PLANNING DEPT. 417-4750 I
BUILDING 417-4815 .~ /i7iTiJ7
T:IPoliciesll 102_15 building permit inspection record05.wpd [1'412005]
PLANNING DEPT.
BUILDING
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST nl
COMI'LETE to be accepted for review. lfyou have any questions, caul"';
PERMITS (360) 417-4815 FAX(360)417-4711
jJ'
Phone: Lf5J-u5CP ~ Lf5'7-4JS()
4Sd~~5(P?..
Address:J\ I) \/o.<::,\r1on Ave. CitY:Y('lr-r A-r11f Lt S Zip: C) g3& ;2
Architect/Engineer: L i cd.h.r..q. .:! S11; th Phone: '-15 d- ~ II (p
ContractorA\'\py flCreS C~ <'~U(kM\ State License #: ~LDf t<ACq?l>DU Exp: o3,b~/D'7 Phone: 3fto-65'-1-/Q 3d..
Address: p. Q. &~ dCO City: S I \IQnfA Zip: g?l;) <37
PROJECT ADDRESS: I 30;;) R.ooK Dr. ZOl\TJNG: /(,S: 9
LEGAL DESCRIPTION: LOt:~ Block: Subdivision: 2 - Q 'If AiJ
CLALLAM COUNTY PARCEL NUMBER: ()( f)3 0 IIf 'Jy LO...J 00
Applicant or Agent: f::.Vl1n ~ YOlJn
Owner:_EVCln V)r()w(l
Phone:
TYPE OF WORK: Hov56- SIZEN ALUATION: ('
}:(Residential )It New Constr. 0 Re-roof 0 Stove :J5VJ1..j SF. @ $ 7~. oq /SF. = $ I q~, oqS"
o Multi-family 0 Addition 0 Movel&'Garage (~1070 SF.@$Z,[.38 /SF.=$ "l"l,fJ/7-
D----Commercial 0 Remodel 0 Demolition -il Dec]} ~5o SF. @ $ 1'2-.'" /SF. = $_ 4.1--00
o Repair 0 Sign 0 Other Vd:~ TOTAL VALUATION $_1..1..1" '1~-
BRIEF DESCRIPTION OF THE PROJECT: .
MIA) CCx)'::::,kc.t;'lVl Gx- Sina)e -\ClFn,lj rlw~\ l"n3'
COMMERCIAL/RESIDENTIAL: Occupancy Group: R- .0
No. of Stories: L Lot Size: .~ I \ gO Existing Sq. Ft.
Total lot coverage ! 1'J.-, 7 %
Occupant Load: Construction Type: 1/- N
& Proposed Sq. Ft. .'395?L/- =TOTALSq.Ft.
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tim~the"'huilding permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRA TION 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
Rl05.3.2 of the International BuildinglResidential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permits prior to work. .
T:\FORMS\BJdgPennitfonn.wpd Applicant: ~ ~3~
Date:
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OLYMPIC PENINSULA TITLE CO
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OLYMPIC PENINSULA
TITLE COMPANY
;l tCOiW"[Dlrt;'-l~'~~~;;':-;~ ~';:'~'Ll:;~';lCO-
No.7/?/~t; JliJy;;lt)
CLALLAM COUNTY Tl./({)-
TRANSACTION EXCISE TAX
2005t1/H -6 Prf 3: 52
~~~E MAY, 6 2005
AMOUNTjj 1q 00002,
COU!lITI TREAS!iB~R I. /,)
f!Yty{1eJa YW(VU/ Wf- .
File Number 01080944DS
III~IIII~IIIII~I~IIIIIII~II'II~I~I~II
2005 1156036 Clallam
County
8
LPB-10
STATUTORY WARRANTY DEED
Legal Description (Brief):
LT 1 RIEDEL II SUBDIVISION (PH I)
add'l on page _
Tax Parcel #: 063014 310100
THE GRANTOR GREEN CROW PROPERTIES, INC. A WASHINGTON
CORPORATION
for and in consideration of TEN DOLLARS AND OTHER GOOD AND VALUABLE
CONSIDERATION
in hand paid, conveys and warrants to EVAN W. BROWN AND HOLLY J. BROWN,
HUSBAND AND WIFE
the following described real estate, situated in the County of CLALLAM , State of Washington:
LOT 1 OF RIEDEL II SUBDIVISION (PHASE I), AS PER PLAT RECORDED
IN VOLUME 14 OF PLATS, PAGE 68, RECORDS OF CLALLAM COUNTY,
WASHINGTON.
SITUATE IN CLALLAM COUNTY, STATE OF WASHINGTON.
SUBJECT TO:
SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF:
Dated: May OS, 2005
GREEN CROW PROPERTIES, INC.
BY~~ -- ~ !M~4
DENNIS YAKOfiCH, President
By
By
By
State of WASH INGTON
County of CLALLAM
On this --5..ilL day of MA Y
appeared DENNIS YAKOVICH
to me known to be
described in and who executed the within and
instrument, and on oath stated that he
to execute the instrument and acknowledged
PRESIDENT
GREEN CROW PROPERTIES, INC.
.,...............",,,,. to be the free and voluntary act of such
party f.oi:-x\t~'re:~)i~sel3'"and purposes mentioned
~f:yEfN;~1lin'aiii:;...mY\hand and official sea
1 t ~b . ,I. ." 1\.'. ,
as ,a.""qy:e l'{J:i. t-celJ.~- ~
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"'I '.Y;ATE 0';- ,-~"
· ~~\ ,,-,..\.,\,..,.,"'t,,'''~~~''
, 20~, personally
the individualCs)
foregoing
was authorized
it as the
of
&.
File Number 01080944DS
EXHIBIT A
LIABILITY FOR FUTURE ASSESSMENTS AND/OR CHARGES IMPOSED BY THE
LOT OWNER'S ASSOCIATION, WHICH THE GRANTEE HEREIN AGREES TO
ASSUME AND PAY ACCORDING TO ITS TERMS AND CONDITIONS.
ALL COVENANTS, CONDITIONS, RESTRICTIONS, RESERVATIONS, EASEMENT.
OR OTHER SERVITUDES, IF ANY, DISCLOSED BY THE RECORDED PLAT OF
RIEDEL II SUBDIVISION (PHASE I).
AGREEMENT RECORDED UNDER CLALLAM COUNTY RECORDING NO. 2005
1155367.
COVENANTS, CONDITIONS AND RESTRICTIONS IMPOSED BY DOCUMENT
RECORDED ON APRIL 28, 2005, UNDER CLALLAM COUNTY RECORDING NO.
2005 1155368, INCLUDING, BUT NOT LIMITED TO, LIABILITY FOR
ASSESSMENTS LEVIED BY THE COMMUNITY ASSOCIATION.
RESERVATIONS CONTAINED IN DOCUMENT RECORDED UNDER CLALLAM
COUNTY RECORDING NO. 518253.
ZONING LOT COVENANT AND THE TERMS AND CONDITIONS THEREOF
RECORDED UNDER CLALLAM COUNTY RECORDING NO. 2001 1074543.
ZONING LOT COVENANT AND THE TERMS AND CONDITIONS THEREOF
RECORDED UNDER CLALLAM COUNTY RECORDING NO. 2001 1074544. SAID
DOCUMENT IS A RE-RECORDING OF DOCUMENT RECORDED UNDER CLALLAM
COUNTY RECORDING NO. 2001 1072929.
DEVELOPMENT AGREEMENT AND THE TERMS AND CONDITIONS THEREOF:
RECORDED UNDER CLALLAM COUNTY RECORDING NO. 2004 1140199.
READ, ACCEPTED AND APPROVED:
~ tv: ~)~~
EVAN ~ BROWN
HoQQTr \ J. AIliJW\ I
HOLLY J! BROWN
g
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
J21 EAST 5TH STREET. PORT ANGELES. WA 98362
06-00000587 Date
389559
1302 ROOK DR
06-30-14-6-7-0010-0000-
ELECTRICAL ONLY
6/11/06
Application Number
Applicatlon pln number
Property Address
ASSESSOR PARCEL NUMBER
Applicatlon type descrlption
Subdivision Name
Property Use
Property Zoning
Application valuatlon
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
BROWN, EVAN
1302 ROOK DR
PORT ANGELES
(360) 452-6562
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457-9270
WA 983620312
WA 98363
Permit
Additional desc
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL TEMPORARY SERVICE
SIMPSONI 60 A TEMP
79376
SIMPSON ELECTRIC
42 20 Plan Check Fee
6/06/06 Valuation
12/03/06
.00
o
Qty Unit Charge Per
1 00 42 2000 ECH EL-TEMP SRV - 0-60 SRV FDR
Extension
42.20
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 42 20 42 20 00 00
Plan Check Total .00 .00 00 00
Grand Total 42 20 42 20 00 00
COMMENTS/ACTION NEEDED
Lasered
CEO
~
~
N
~
~
~
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
III '('W
---
lHlllGH-IN I COVER
~.hK V l(;,h
~ll\T A T I /"'/7 /^~ ~f, )
, ,
GENERAL COMMENTS:
PW-II02.1'14I96)
'tm;
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98:\62
. .
Application Number
Applicat~on p~n number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr, name
Appl~cation type description
Subdivision Name
Property Use
Property Zoning
Application valuat~on
9/26/06
06-00000304 Date
654704
1302 ROOK DR
06-30-14-6-7-0010-0000-
EVAN BROWN
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
222172
Owner
Contractor
EVAN BROWN
117 VASHON
PORT ANGELES
ALDER ACRES CONSTRUCTION
POBOX 200
WA 98362 SILVANA WA 982870200
(360) 654-1932
TOTAL % LOT COVERAGE 12.70
NUMBER OF STORIES 2.00
LOT SIZE 31190 00
TOTAL LOT COVERAGE 3984 00
NUMBER OF UNITS 1 00
Other struct info
Permit
Additional desc .
Permit p~n number
Sub Contractor
Permit Fee
Issue Date
Exp~ration Date .
ELECTRICAL NEW RESIDENTIAL
SIMPSONI 3634 SQ FT SFR
87452
SIMPSON ELECTRIC
190 00
9/26/06
3/25/07
plan Check Fee
Valuation
00
o
Qty
1 00
5 00
Unit Charge Per
73 0000 ECH
23 4000 5C
Extension
73 00
11 7 00
EL-R-SQFT FIRST 1300
EL-R-SQFT ADDITIONAL 500
Spec~al Notes and Comments
Address numbers shall be plainly v~s~ble from the street.
Address numbers shall be a m~nimum of six inches high and be
of contrasting color from the background
04/05/2006 11.45 AM SROBERDS -- The proposal will result
~n a new sfr in the RS-9 with 13% lot coverage.
Electr~cal load calculations and elctrical permits are
required Connection fee of $713.00 required.
04/04/2006 10'37 AM GMCLAIN ----------------------------
D~tches & 8" culverts will be installed to City Stanards
See Public Works Engineering for Standards
Sanitary sewer connection inspection is required by
Public Works prior to back fill of d~tch 24 hour advance
notice is required
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way An ~nspect~on by Public Works
Engineering is required pr~or to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4 50
1200.00
Fee summary
Charged
Paid
Due
Credited
COMMENTS/ACTION NEEDED
Lasered
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
121 EAST 5TH STREET. PORT ANGELES. WA 9R3(12
, .
Application Number
Application pin number.
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
190.00
.00
2074.50
2264.50
COMMENTSI ACTION NEEDED
06-00000304
654704
190.00
00
2074.50
2264 50
Page 2
Date 9/26/06
.00
.00
.00
.00
00
.00
00
00
'~
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:m EAST 5TH STREET. PORT ANGELES. WA 983112
Appllcation Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning
Appllcation valuation
06-00000304 Date
654704
1302 ROOK DR
06-30-14-6-7-0010-0000-
EVAN BROWN
RES NEW SFR
9/27/06
RS7 RESDNTL SINGLE FAMILY
222172
Owner
Contractor
EVAN BROWN
117 VASHON
PORT ANGELES
ALDER ACRES CONSTRUCTION
P. 0 BOX 200
WA 98362 SpLVANA WA 982870200
;360) 654-1932
TOTAL % LOT COVERAGE 12.70
NUMBER OF STORIES 2 00
LOT SIZE 31190 00
TOTAL LOT COVERAGE 3984.00
NUMBER OF UNITS 1 00
Other struct info
Permit
Additional desc
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
SIMPSONI REMOTE METER FEE
87668
SIMPSON ELECTRIC
11.40
9/27/06
3/26/07
Plan Check Fee
Valuation
.00
o
Qty
1 00
Unit Charge Per
11 4000 ECH EL-METERS REMOTE INSTALL
Extension
11 40
Special Notes and Comments
Address numbers shall be plalnly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
04/05/2006 11:45 AM SROBERDS -- The proposal will result
in a new sfr in the RS-9 with 13% lot~coverage.
Electrlcal load calculations and elctrical permits are
requlred. Connection fee of $713 00 required.
04/04/2006 10 37 AM GMCLAIN ~---------------------------
Ditches & 8" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
Sanitary sewer connection inspection is required by
Publlc Works prior to back fill of ditch 24 hour advance
notlce is required.
Construct driveway and Sidewalks to City Sta~dards.
No concrete wieh exposed aggregate allowed in the Clty
road rlght of way An inspection by Public l10rks
Englneerl~g is requlred prior to prouring concrete:
Other Fees
'SEWER SYSTEM PE:LV CHARGE
STATE SURCHAPGE
PW WATER SYSTEM USE FEE
870 00
4 50
1200 00
Fee summary Charged Pald
Credited Due
COMMENTS/ ACTION NEEDED
~~
'ni
~
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 983lJ2
Appl~cation Number
Application pin numbe~
Permit Fee Total
plan Check Total
Other Fee Total
Grand Total
11 40
00
2074.50
2085 90
COMMENTS/ACTION NEEDED
06-00000304
654704
11.40
.00
2074 50
2085.90
Page
Date
2
9/27/06
.00
.00
.00
.00
.00
.00
.00
.00
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
DATE
COMMENTS
NO
GENERAL COMMENTS:
pw.II02.1'I4'96I
flI'OIlt~_
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DrvISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
06-00000304
654704
Page
Date
2
5/16/06
Special Notes and Comments
Electrical load calculations and elctrical permits are
required. Connection fee of $713.00 required.
04/04/2006 10:37 AM GMCLAIN ----------------------------
Ditches & 8" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
sanitary sewer connection inspection is required by
Public works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
Fee surrunary Charged Paid Credited Due
----~-~----~-~-~- ---------- ---------~ ~~~~~----- ----------
Permit Fee Total 335.00 335.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 2409.50 2409.50 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utililies, private and public improvemenls. 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 slate or local law regulaling constructio"n or the performance of
construction.
.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102.1SR [1105)