HomeMy WebLinkAbout1009 S. Pine StreetAddress:
1009 S Pine Street
PREPARED 6/04/13, 11:57:39 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 6/04/13
------------------------------------------------------------------------------------------------
ADDRESS . : 1009 S PINE ST SUBDIV:
CONTRACTOR : PHONE
OWNER TROY T AND TRISHA K TIS PHONE
PARCEL 06-30-00-0-3-2442-0000-
APPL NUMBER: 13-00000594 PLUMBING PERMIT
------------------------------------------------------------------------------------------------
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESU RESULTS/COMMENTS
----------------------- --------------------------------------------- - -----------
PL6 01 6/04/13 J PLUMBING WATER SUPPLY
June 4, 2013 9:40:06 AM pbarthol.
Troy 460-2382
PL99 01 6/04/13 JLL PLUMBING FINAL
June 4, 2013 9:40:31 AM pbarthol.
Troy 460-2382
------------------------
---------------------- ------------ COMMENTS AND NOTES --------------------------------------
S,
------------------------------------
- CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . .
13-00000594 Date 6/03/13
Application pin number . . .
451094
Property Address . . . 1
1009 S PINE ST
ASSESSOR PARCEL NUMBER:
06 -30 -00 -0 -3 -2442 -0000 -
Application type description
PLUMBING PERMIT
Subdivision Name . . . . . .
. 57.00
Property Use . . . . . . . .
Fee
Property Zoning . . . . . . .
Issue Date . . .
Application valuation . . . .
0
------------------
Application desc
- ---------------------
water line replace
----------------------------------------------------------------------------
. 11/30/13
Owner Contractor
------------------------ ------------------------
TROY T AND TRISHA K TIS OWNER
PO BOX 2195
PORT ANGELES WA 98362
----------------------------------------------------------------------------
Permit . . . . .
. PLUMBING PERMIT
Additional desc .
. REPLACE WATER LINE
Permit Fee . . .
. 57.00
Plan Check
Fee
.00
Issue Date . . .
. 6/03/13
Valuation
. . .
. 0
Expiration Date .
. 11/30/13
Qty Unit Charge Per
Extension
BASE FEE
50.00
1.00 7.0000
----------------------------------------------------------------------------
EA PL -WATER LINE
7.00
Fee summary
-----------------
Charged Paid
Credited
'----------
Due
Permit Fee Total
--------------------
57.00 57.00
----------
.00
.00
Plan Check Total
.00 .00
.00
.00
Grand Total
57.00 57.00
.00
.00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
1 rv,mbrounumg uiwsionicwnamg vermit
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 INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type
Date
Accepted By
Comments
FOUNDATION:
Electrical 417-4735
Footings
Stemwall
Foundation Drainage / Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
FINAL Date Accepted b.
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:
FINAL Date Accepted b
Heat Pum / Furnace / FAU / Ducts
Rough -in
Gas Line
Wood Stove / Pellet / Chimney
Commercial Hood / Ducts
MANUFACTURED HOMES:
,Footing / Slab
IBlocking & Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s
SEPA:
ESA:
SHORELINE:
Parkin / Lighting
Landscaping
FINAL INSPECTIONS REQUIRED PRIOR
TO OCCUPANCY/ USE
Inspection Type
Date
Accepted By
Electrical 417-4735
Construction - R.W. PW / Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
THE�' GELES
CITY OFP
WASH R
I N GT O N, U.S.
321 East 51h Street
Port Angeles, WA 98362
P: 360-417-4817 F: 360-417-4711
permits@cityofpa.us
For City Use
Permit# G'
Date Received: Le 3 13
Date Approved (o 13 I r' -_a.
Building Permit Application
Project Address:
Main Contact: -LLSC��2
Phone # Z1c>O4b0 2382
E -Mail: A�' S6cA,5 & qmcgo,am
Property
Owner
Name -� \\S�
Phone 1-3
Mailinddress
�i g�C 2185
Email
City PccA e9 eA.e S
State
Zip
Contractor
ameq,,,�Cpwmb�c>
Phone.0\�'j\moi
Mailing Address
Email
City
State
Zip j --
Contractor License #
Expiration:
Project Value:
$ ALO .C)d
Zoning:Tax
1 7
Parcel #
Lot #
Type of
Residential Commercial ❑ Industrial ❑ Public ❑
Permit
Demolition ❑ Fire ❑ Repair 0 Reroof (tear off/lay over) ❑
For the following, fill out both pages of permit application:
New Construction ❑ Remodel ❑ Addition ❑ Tenant Improvement ❑
Mechanical 1:1Plumbing Z Other 1:1Existing
Fire Sprinkler System?
Yes ❑ No E
Maximum height of structure
Proposed Bedrooms
Proposed Bathrooms
Project
Description
�4o
I have read and completed the application and know it to be true and correct. I am authorized to apply for this
permit. I understand that it is my responsibility to determine what permits are required and to obtain permits
prior to working on projects. I understand that the plan review fee is not refundable after plan review has
occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the
permit is issued. I understand that if the permit is not issued within 180 days of receipt, the application will be
considered abandoned and the fees forfeit.
Date
Print Name
Signature
Residential Structures
Area Description (SQ FT)
Existing
Proposed
$$ value
For Office Use
Basement
Existing Structure (s)
#
Heater (Suspended, Floor, Recessed wall)
#
First Floor
Proposed Addition
#
Heating/Cooling appliance
repair/alteration
#
Second Floor
?Tenant Improvement?
Pellet Stove/Wood-burning/Gas
Fireplace/Gas Stove Gas Cook Stove/Misc.
#
Fuel Gas Piping
Covered Deck/Porch/Entry
`Other work (describe)
#
Furnace/Heat Pump/
Forced Air Unit
Size:
Deck
Area Totals
#
Garage
Carport
Other (describe)
Area Totals
Commercial Structures
Footprint (SQ FT) of all Structures:
Area Descriptions (SQ FT)
Existing
Proposed
$$ Value
For Office Use
Existing Structure (s)
#
Heater (Suspended, Floor, Recessed wall)
#
Boiler/Compressor
Proposed Addition
#
Heating/Cooling appliance
repair/alteration
#
Evaporative Cooler (attached, not
portable)
?Tenant Improvement?
Pellet Stove/Wood-burning/Gas
Fireplace/Gas Stove Gas Cook Stove/Misc.
#
Fuel Gas Piping
# of Outlets:
`Other work (describe)
#
Furnace/Heat Pump/
Forced Air Unit
Size:
#
Area Totals
#
Lot/Site Coverage Calculations
Footprint (SQ FT) of all Structures:
Lot Size:
% Lot Coverage
SQ FT Site coverage (all impervious +
structures
Haz/Non-Haz Piping
% Site Coverage
Mechanical Fixtures
Indicate how many of each type of fixture to be installed or relocated as part of this project.
Air Handler
Size:
#
Haz/Non-Haz Piping
# of Outlets:
Appliance Vent
#
Heater (Suspended, Floor, Recessed wall)
#
Boiler/Compressor
Size:
#
Heating/Cooling appliance
repair/alteration
#
Evaporative Cooler (attached, not
portable)
#
Pellet Stove/Wood-burning/Gas
Fireplace/Gas Stove Gas Cook Stove/Misc.
#
Fuel Gas Piping
# of Outlets:
Ventilation Fan, single duct
#
Furnace/Heat Pump/
Forced Air Unit
Size:
#
Ventilation System
#
Plumbing Fixtures
Indicate how many of each type of fixture to be installed or relocated
Plumbing Traps
#
Fuel gas piping
# of Outlets:
Water Heater
#
Medical gas piping
# of Outlets:
Water Line
#
Vent piping
#
Sewer Line
#
Industrial waste pretreatment
interceptor
#
Other describe
T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX
Address:
1009 S Pine Street
PREPARED 1/27/15, 9:29:26 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 1/27/15
------------------------------------------------------------------------------------------------
ADDRESS . : 1009 S PINE ST SUBDIV:
CONTRACTOR : PHONE :
OWNER TROY T/TRISHA K TISDALE PHONE : (360) 457-4436
PARCEL 06-30-00-0-3-2442-0000-
APPL NUMBER: 14-00001519 RE -ROOF
-------------------------------------------
PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT' RESULTS/COMMENTS
-----------------------
� -- --------—————
---------------------------------------------------
BL99 01 1/27/15 J L BLDG FINAL
January 26, 2015 4:37:30 PM pharthol.
Troy 460-2382
- — ---------------------- ------- - __ COMMENTS AND NOTES--------------------------------------
fi CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 14-00001519 Date 12/18/14
Application pin number . . . 051304
Property Address . . . . . . 1009 S PINE ST
ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -3 -2442 -0000 -
Application type description RE -ROOF
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . .
Application valuation . . . . 5000
----------------------------------------------------------------------------
Application desc
SNAP LOCK METAL ROOFING OVER 1 LAYER
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
TROY T/TRISHA K TISDALE OWNER
PO BOX 2195
PORT ANGELES WA 98362
(360) 457-4436 -
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT - NO PR FEE
Additional desc . . METAL ROOF
Permit Fee . . . . 137.75 Plan Check Fee .00
Issue Date . . . . 12/18/14 Valuation . . . . 5000
Expiration Date 6/16/15.
Qty Unit Charge Per Extension
BASE FEE 95.75
3.00 14.0000 THOU BL -2001-25K (14 PER K) 42.00
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE SURCHARGE 4.50
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 137.75 137.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 142.25 142.25 .00 .00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
ate Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms/Building Division/Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS --
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type
Date
Accepted By
Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage / Downspouts
Piers
Fire 417-4653
Post Holes (Pole Bldgs.)
PLUMBING:
FINAL Date Accepted b
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:
FINAL Date Accepted b
Heat Pum / Furnace / FAU / Ducts
Rough -In
Gas Line
Wood Stove / Pellet / Chimney
Commercial Hood / Ducts
MANUFACTURED HOMES:
Footing / Slab
Blocking & Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s
SEP&
ESA:
SHORELINE:
Parkin / Lighting
Landscaping
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Date
Accepted By
Electrical 417-4735
Construction - R.W. PW / Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
THE
CITY OF -01-19-11
W A S H 1
321 E 5th Street
-)N L .
N G T O N, U. S.
Port Angeles, WA 9836
P: 360-417-4817 F: 360-417-4711
Permit#
Date Received:
Date Approved
For City Use
BUILDING PERMIT APPLICATION
/�-
Project Address:l<oo9 S. Pine St.
Phone: 460-2382
Primary Contact: Troy Tisdale
Email: tttisdale@gTail.com
Name
Phone 457-4436
Troy T & Trisha K Tisdale
Property
Mailing Address
Email tttisdale@gmail.com
Owner
PO Box 2195
City
State WA :=P
911362
Port Angeles
Name
Phone 46o-2382
Troy Tisdale - Homeowner
Contractor
Address
Email tttisdale@gmail.com
PO Box 2195
Information
City Port Angeles
State WA
Zip 98362
Contractor License#
Exp. Date:
Legal Description:
Zoning:
Tax Parcel #
Project Value: (materials and labor)
� ,000.00
Residential ® Commercial ❑ Industrial ❑ Public ❑
Permit
Demolition ❑ Fire ❑ Repair ❑ Reroof (tear off/lay over)
Classification
For the following, fill out both pages of permit application:
(check
appropriate)
New Construction ❑ Exterior Remodel ❑ Addition ❑ Tenant Improvement ❑
Mechanical ❑ Plumbing ❑ Other ❑
Will a fire sprinkler system be installed or
Irrigation
Proposed Bathrooms
Proposed Bedrooms
modified? Yes ❑ No ❑
System?
Yes ❑ No ❑
Project Description
Install new snap lock metal roof over existing asphalt shingle (lay over) on dwelling.
Approximate 1500 sq.ft.
Is project in a Flood Zone: Yes ❑ No® Flood Zone Type:
If in a Flood Zone, what is the value of the structure before proposed improvement? $
I have read and completed the application and know it to be true and correct. I am authorized to apply for
this permit and understand that it is my responsibility to determine what permits are required and to
obtain permits prior to work. I understand that plan review fees are not refundable after review has
occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is
issued. I understand that if the permit is not picked up/issued within 18o days of submittal, the application
will be considered abandoned and the fees will be forfeited.
�zInL2C)k
-Tr-o��Tk aLQ_
Date
Print Name
Residential Structures
Area Description (SQ FT)
Existing
Proposed
$$ value
For Office Use
Basement
First Floor
Second Floor
Covered Deck/Porch/Entry
Deck (over 30" or 2"d floor)
Garage
Carport
Other (describe)
Area Totals
Commercial Structures
Area Descriptions (SQ FT)
Existing
Proposed
Proposed
$$ Value
For Office Use
Existing Structure (s)
Proposed Addition
Tenant Improvement?
Other work (describe)
Site Area Totals
Lot/Site Coverage Calculations
Lot Size (sq ft)
Lot Coverage (sq ft)
%Lot Coverage (Total lot coverage : lot size)
Site Coverage (Sq Ft of all impervious)
% of Site Coverage (total site coverage =. lot size)
Mechanical Fixtures
Indicate how many of each type of fixture to be installed or relocated as part of this project.
Air Handler:
Size:
#
Haz/Non-Haz Piping:
Outlets:
Appliance Exhaust Fan:
#
Heater (Suspended, Floor, Recessed wall):
#
Boiler/Compressor77rSize:
#
Heating/Cooling appliance
repair/alteration
#
Evaporative Cooler (attached, not
portable):
#
Pellet Stove/Wood-burning/Gas
Fireplace/Gas Stove/Gas Cook Stove/Misc.
#
Fuel Gas Piping:
# of Outlets:
Ventilation Fan, single duct:
#
Furnace/Heat Pump/
Forced Air Unit:
Size:#
Ventilation System:
#
Plumbing Fixtures
Indicate how many of each type of fixture to be installed
or relocated
Plumbing Traps
#
Fuel gas piping
# of Outlets:
Water Heater
#
Medical gas piping
# of Outlets:
Water Line
#
Plumbing Vent piping
#
Address:
1009 S Pine Street
tool S' p%7e S�
PREPARED 4/20/15, 12:18:42 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 4/20/15
------------------------------------------------------------------------------------------------
ADDRESS . : 1009 S PINE ST SUBDIV:
CONTRACTOR : PHONE :
OWNER TROY T/TRISHA K TISDALE PHONE : (360) 457-4436
PARCEL 06-30-00-0-3-2442-0000-
APPL NUMBER: 15-00000243 RE -ROOF
------------------------------------------------------------------------------------------------
PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------- - ----------
BL99 01 4/20/15 BLDG FINAL
April 20, 2015 11:13:39 AM jlierly.
460-2382 TROY
---------- COMMENTS AND NOTES
uVirQ'Im"',
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 15-00000243 Date 3/12/15
Application pin number . . . 519929
Property Address . . . . 1009 S PINE ST
ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -3 -2442 -0000 -
Application type description RE -ROOF
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . .
Application valuation . . . . 2000
----------------------------------------------------------------------------
Application desc
res snap lock metal roof over shingle
----------------------------------------------------------------------------
Owner Contractor
TROY T/TRISHA K TISDALE OWNER
PO BOX 2195
PORT ANGELES WA 98362
(360) 457-4436
Permit . . . . . . BUILDING PERMIT - NO PR FEE
Additional desc RES SNAP METAL OVER A -S
Permit Fee . . . . 95.75 Plan Check
Fee
.00
Issue Date . . . . 3/12/15 Valuation
. . .
. 2000
Expiration Date 9/08/15
Qty Unit Charge Per
Extension
BASE FEE
50.00
15.00 3.0500 HND BL -501-2K (3.05 PER C)
45.75
----------------------------------------------------------------------------
Other Fees . . . . . . . . STATE SURCHARGE
----------------------------------------------------------------------------
4.50
Fee summary Charged Paid Credited
-----------------------------------------------
Due
Permit Fee Total 95.75 95.75 .00
----------
.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 4.50 4.5.0 .00
.00
Grand Total 100.25 100.25 .00
.00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within.180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
1.r 111twoununly viviswwouuamg rermn
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 INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type
Date
Accepted By
Comments
FOUNDATION:
Electrical 417-4735
Footings
Stemwall
Foundation Drainage / Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
FINAL Date Accepted b
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 Onl
T -Bar
INSULATION:
Slab
Wall / Floor/ Ceiling
MECHANICAL:
FINAL Date Accepted b
Heat Pum / Furnace / FAU / Ducts
Rough -in
Gas Line
Wood Stove / Pellet / Chimney
Commercial Hood / Ducts
MANUFACTURED HOMES:
Footing / Slab
Blocking & Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s
SEPA:
ESA:
SHORELINE:
Parkin / Lighting
Landscaping
FINAL INSPECTIONS REQUIRED PRIOR
TO OCCUPANCY/ USE
Inspection Type
Date
Accepted By
Electrical 417-4735
Construction - R.W. PW / Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
THE TCITY OF
)W A S H i
321 E 51h Street
'LES
NF G' T O N, U. S.
Port Angeles, WA 9836
P: 360-417-4817 F: 360-417-4711
Email: Vermits@ci!yofVa.us
For City Use
Permit# 2 y 3
Date Received: 3 t2 ) 2,e, t S�
Date Approved % t 2-) -1-0 t J
BUILDING PERMIT APPLICATION
Project Address: ioo9 S. Pine St.
Phone: 46o-2382
Email: tttisdale@gmail.com
Primary Contact: Troy Tisdale
Name
Phone 457-4436
Property
Troy T & Trisha K Tisdale
Mailing Address
Email tttisdale@gmail.com
Owner
PO Box 2195
City
State WA
Zip 98362
Port Angeles
Name
Phone 46o-2382
Troy Tisdale - Homeowner
Contractor
Address
Email tttisdale@gmail.com
PO Box 2195
Information
City Port Angeles
State WA
Zip 98362
Contractor License#
Exp. Date:
Legal Description:
Zoning:
Tax Parcel #
Project Value: (materials and labor)
$2,000.00
Residential ® Commercial ❑ Industrial ❑ Public ❑
Permit
Demolition ❑ Fire ❑ Repair ❑ Reroof (tear off/lay over)
Classification
For the following, fill out both pages of permit application:
(check
appropriate)
New Construction ❑ Exterior Remodel ❑ Addition ❑ Tenant Improvement ❑
Mechanical ❑ Plumbing ❑ Other ❑
Will a fire sprinkler system be installed or
Irrigation
Proposed Bathrooms
Proposed Bedrooms
modified? Yes ❑ No ❑
System?
Yes ❑ No ❑
Project Description
Install new snap lock metal roof over existing asphalt shingle (lay over) on detached garage.
Approximate 500 sq.ft.
Is project in a Flood Zone: Yes ❑ No® Flood Zone Type:
If in a Flood Zone, what is the value of the structure before proposed improvement? $
I have read and completed the application and know it to be true and correct. I am authorized to apply for
this permit and understand that it is my responsibility to determine what permits are required and to
obtain permits prior to work. I understand that plan review fees are not refundable after review has
occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is
issued. I understand that if the permit is not picked up/issued within 18o days of submittal, the application
will be considered abandoned and the fees will be forfeited.