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Home My WebLink About1107 Georgiana Street Address: 1107 Georgiana Street ( c 9 ,� G0-0 7-C e--4, S� PREPARED 6/11/15, 11:08:04 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 6/11/15 ------------------------------------------------------------------------------------------------ ADDRESS . : 1107 GEORGIANA ST SUBDIV: CONTRACTOR : PHONE OWNER CL CNTY PUBLIC HOSPITAL DIST 2 PHONE PARCEL 06-30-00-8-1-0135-0000- APPL NUMBER: 15-00000600 RE-ROOF ------------------------------------------------------------------------------------------------ PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS --------------------- ---------------------------------—------------------------—- --- BL99 01 6/11/15 J BLDG FINAL June 11, 2015 11:11:31 AM jlierly. ROB GALE 460-1284 i -------------------------------------- COMMENTS AND NOTES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 15-00000600 Date 5/28/15 Application pin number . . . 455400 AddressProperty ASSESSOR PARCELNUMBER: 06o30G00RA 8I1N--0135-0000- REPORT SALES TAX Application type description RE-ROOF on your state excise tax form Subdivision Name . . . . . . Property Use . . . . . . . . to the City of Port Angeles Property Zoning . . . . . . . COMMERCIAL OFFICE (Location Code 0502) Application valuation . . . . 3600 Application desc tear off comp single ---------------------------------------------------------------------------- Owner Contractor CL CNTY PUBLIC HOSPITAL DIST 2 OWNER DBA OLYMPIC MEDICAL CENTER 939 CAROLINE ST PORT ANGELES WA 98362 --------------------------------- ------------------------------------------ Permit . . . . . . BUILDING PERMIT - NO PR FEE Additional desc . . TEAR OFF COMP SHINGLE Permit Fee . . . . 123.75 Plan Check Fee .00 Issue Date . . . . 5/28/15. Valuation . . . . 3600 Expiration Date . . 11/24/15 Qty Unit Charge Per Extension BASE FEE 95.75 2.00 14.0000 THOU BL-2001-25K (14 PER K) - 28.00 \ - ---------------------- - Other Fees . . . . . . . . . STATE SURCHARGE 4.50 -------------- ----------------------------- Fee summary Charged Paid Credited Due ---------- ---------- ---------- ---------- ---------- Permit Fee Total 123.75 123.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 128.25 128.25 .00 .00 t\ N 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 Oof 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 Q construction. \ Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit f } 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 Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-in Water Line Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b 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 Pum /Furnace/FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: 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 1 'ORT LGELES For City Use CITY OF j\ j 1 Permit# &OD WASH I N G T O N, U. S. Date Received: -Lail e—' 321 E 5th Street Date Approved 1 C0-- Port Angeles,WA 9836 P:360-417-4817 F:360-417-4711 Email:permits@cityofpa.us BUILDING PERMIT A PLICATION Project Address: 1107 eos � S4 Phone: .3 bo L468 - 12QL/ Primary Contact: 206 (9 4I Email: ,e of ,z wt`c-4� • �� Name U Phone (9 3 ( t (o Property Mailing Addrest Email Owner 231 C-Ld-ol'oteSl- City State Zip Name Phone Contractor Address Email Information city State Zip Contractor License# Exp.Date: Legal Description: Zoning: Tax Parcel # Project Value: (materials and labor) $ 3� 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 New Construction ❑ Exterior Remodel ❑ Addition ❑ Tenant Improvement ❑ appropriate) Mechanical ❑ Plumbing ❑ Other ❑ Fire Sprinkler System Proposed Irrigation System Proposed orProposed Bathrooms Proposed Bedrooms or Existing? Yes 0 No 13 Existing? Yes 0 No O In addition to standard hard copy submittals please send a PDF copy of all Stormwater plans and Engineering to www.stormwaterPcityofpa.us Project Description ec , 0-F - la er 0,P AS-j--, 6 r: 46co. CCl at 61., k �� i 4� S- Is project in a Flood Zone: Yes ❑ NoEL 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 i8o days of submittal,the application will be considered abandoned and the fees will be forfeited. Date -57/Zl Print Name )2a5 (Oct L Si nature �. a Residential Structures Existing Proposed Construction For Office Use Area Descriptions(SQ FT) Floor area Floor area $Value new area Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30" or z" floor) Garage Carport Other(describe) Area Totals Commercial Structures Area Descriptions(SQ FT) Existing Proposed Construction For Office Use Floor area Floor area $Value new area 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)foot print of %Lot Coverage (Total lot cov_lot size) Max Bldg Height all structures sq ft Site Coverage(Sq Ft of all impervious) %of Site Coverage (total site cov_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/Compressor Size: # Heating/Cooling appliance # repair/alteration Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove/Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # Water Heater # Plumbing Vent piping # Medical gas piping #of Outlets: Water Line # Fuel gas piping #of Outlets: Sewer Line # Industrial waste pretreatment interceptor Grease Trap) Size Other(describe): T:\BUILDING\APPLICATION FORMS\Current BP Application\Building Permit4-17-13.docx