HomeMy WebLinkAbout1738 W. 14th Street Address:
1738 W 1411 Street
1 -778- U 1Lf St .
PREPARED 6/04/15, 9:28:45 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY - DATE 6/04/15
-----------------------------------------------------------------------------------------------
ADDRESS . : 1738 W 14TH ST SUBDIV:
CONTRACTOR : PHONE
OWNER LOGAN DAVID P PHONE
PARCEL 06-30-00-0-4-0650-0000-
APPL NUMBER: 15-00000113 RES ADDITION
------------------------------------------------------------------------------------------------
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ ' COMPLETED RESULT RESULTS/COMMENTS - -
------------------------------------------------------------------—--------------------—------
BL1 01 3/11/15 PB BLDG FOUNDATION FOOTING
3/12/15 AP March 11, 2015 11:43:33 AM pbarthol.
Jeff 461-6246
March 12, 2015 12:40:07 PM pbarthol.
BFF O1 3/17/15 JLL BLDG FLOOR FRAMING
3/17/15 AP March 17, 2015 10:03:37 AM pbarthol.
JEFF 461-6246
March 17, 2015 4:40:11 PM jlierly.
BAIR O1 4/22/15 JLL BLDG AIR SEAL
4/22/15 AP April 21, 2015 9:41:17 AM jlierly.
April 22, 2015 3:47:51 PM jlierly.
BL3 01 4/22/15 JLL BLDG FRAMING
4/22/15 DA April 21, 2015 9:40:52 AM jlierly.
jeff 460-6246
April 22, 2015 3:49:47 PM jlierly.
verify electrical rough inspection frame would have passed
inspection if elec insp was complete. JLL
BLI O1 4/27/15 JLL BLDG INSULATION
4/27/15 DA * OVERRIDE TAKEN BY JLIERLY DATE: 04/27/15 TIME: 10:04:58
April 27, 2015 10:08:49 AM jlierly.
April 27, 2015 4:05:55 PM jlierly.
Replace old insulation around bathroom in furred out walls
to meet R value required/jll
BL3 02 4/27/15 JLL BLDG FRAMING
4/27/15 AP * OVERRIDE TAKEN BY JLIERLY DATE: 04/27/15 TIME: 10:04:40
April 27, 2015 10:08:29 AM jlierly.
April 27, 2015 4:05:45 PM jlierly.
BL99 01 5/26/15 JLL BLDG FINAL
5/26/15 DA May 26, 2015 12:01:48 PM jlierly.
461-6246
May 26, 2015 4:08:11 PM jlierly.
Electrical final reqd/ smoke/co detectors reqd/ JLL
BL99 02 6/04/15 BLDG FINAL
June 4, 2015 9:30:43 AM jlierly.
Jeff 461-6246
--------------------------- --------- COMMENTS AND NOTES --------------------------------------
CITY OF PORT ANGELES
a DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT-BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES,WA 98362 (�
-I
Application Number . . . . . 15-00000113 Date 3/09/15
Application pin number . . . 730643
Property Address . . . . . . 1738 W 14TH ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-4-0650-0000-
Application type description RES ADDITION on your state excise tax form
Subdivision Name . . . . . .
Property Use . . . . . . . . to the City of Port Angeles
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . . . . 30000
----------------------------------------------------------------------------
Application desc
add bed room and bath
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
LOGAN DAVID P OWNER
1738 W 14TH ST
PORT ANGELES WA 983636810
Other struct info . . . . HARD SURFACE AREA
---------------------------------`------------------------------------------
Permit . . . . . . BUILDING PERMIT -RESIDENTIAL
Additional desc . . ADD BED AND BATH ROOM
Permit Fee . . . . 468.25 Plan Check Fee 304.36
Issue Date . . . . 3/09/15 Valuation . . . . 30000
Expiration Date 9/05/15
Qty Unit Charge Per Extension
BASE FEE 417.75
5.00 10.1000 THOU BL-25,001-50K (10.10 PER K) 50.50
----------------------------------------------------------------------------
Permit . . . . MECHANICAL PERMIT
Additional desc . . MECH. BEDROOM BATHROOM ADDITIO
Permit Fee . . . . 57.25 Plan Check Fee .00
Issue Date . . . . 3/09/15 Valuation . . . . 0
Expiration Date 9/05/15
1�
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 7.2500 EA ME-VENT FAN (SINGLE DUCT) 7.25
------------------=----------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . . PLUMBING BED/BATH ADDITION
Permit Fee . . . . 93.00 Plan Check Fee .00
Issue Date . . . . 3/09/15 Valuation . . . . 0
Expiration Date 9/05/15
Qty Unit Charge Per Extension VS
BASE FEE 50.00 I
.2.00 7.0000 EA PL-PLUMBING TRAP 14.00
1.00 7.0000 EA PL-WATER LINE 7.00 IV/
1.00 7.0000 EA PL-DRAIN VENT PIPING 7.00
1.00
-------- -------15.0000 EA PL-SEWER LINE 15.00
- ---- - ----------------- -
Special Notes and Comments
The Fire Department has reviewed the project application and
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
const uction.
t
Date Print Name Signa ure of Contractor or Authorized Agent nature 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
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 I Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
i CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT- BUILDING DIVISION
= 321 EAST 5TH STREET, PORT ANGELES,WA 98362
Page 2
Application Number 15-00000113 Date 3/09/15
Application pinnumber . . . 730643
-----
- - - - ------------------------------------------------ REPORT SALES TAX
Special Notes and Comments on your state excise tax form
has no comments 4
February 27, 2015 12:38:18 PM sroberds. to the City of Port Angeles
Proposal will result in remodel to sfr in RS-7 for total lot (Location Code 0502)
cov of 29% and site cov of 40%. No land use issues
anticipated.
Electrical load calculations and electrical permits are
required.
1. Establishing Construction Access.
2. Install sediment controls BMPs.
3. Stabilize exposed soils.
4. Protect slopes from erosion.
5. Protect drain inlets.
6. Control pollutants including but not limited to spills,
concrete wash out, exposed aggregate processes, concrete
grinding and saw cut waste..water.
7. Maintain temporary and permanent erosion control BMPS
during project.
All disturbed area's on site not covered by new improvements
should meet the attached soil quality and depth standard.
No downspouts shall be connected to sanitary sewer.
Consider applying for the City Green Infrastructure Rebate
of up to $750.00 towards the materials to install rain
garden to control roof and driveway runoff. Also rebates
available for downspout disconnections.Contact Jonathan
Boehme at 360 417-4811
The existing building sewer may be located at the same
location of the proposed construction. Any modification or
damage to the existing building sewer will require other
permits and inspections.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE SURCHARGE 4.50
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 618.50 618.50.. .00 .00
Plan Check Total 304.36 304.36 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 927.36 927.36 .00 .00
Separate Permits are required forelectrical 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)
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
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 I Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
THE For City Use
CITY OFP1_
R ANGEUS,
Permit# 1
vv A s H i N G'�T o N, U. S. Date Received:
321 E 5th Street Date Approved
Port Angeles,WA 9836
P:360-417-4817 F:360-417-4711
Email:permits@cityofpa.us BUILDING PERMIT APPLICATION
Project Address: f 54 .
Phone: Z
Prima Contact: jq (/' Email:
Name Q Phone fco qV Z
Property MailingAddress Email
Owner I W l q 5-1-
City State,,/
Zi
rd- 4 � eJA5 f �
Name TQ rt Pho7,36
o / 6 z bO
Contractor AddressEmail
15 J 2 Ce-1X 0 i~/o der/' 2�
Information
City � State w 14 1 Zip $'3.93
Contractors License# JV6 3 0 L Exp.Date: 51 41o /
Legal Description: Zoning: Tax Parcel# Project gue: (materials and labor)
w�yct- �.L t- -� 0630o�o�,e6�"00ew $ 30,000
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 09 Tenant Improvement ❑
appropriate) Mechanical ❑ Plumbing ❑ Other ❑
Fire Sprinkler System?7 Irrigation System? Proposed Bathroomsoposed Bedrooms
Yes 0 No G I Yes 0 No 13 1 1
PrJ_
Project Description Ig ly A011 ' ed6ac)r1 one 6r,+k.-oo rv--, 0 `
t
Is project in a Flood Zone: Yes ❑ No Flood Zone Type:
If in a Flood Zone,what is the value of the cture 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 of'$� Print Name 13 ea Signature
Residential Structures
For Office Use
Area Description(SQ FT) Existing Proposed ss value
Basement
First Floor Lf
Second Floor 77&mi- tar
Covered Deck/Porch/Entry O _
Deck(over 30"ori' floor) . q,y �V+j
Garage 169
Carport OQ
Other(describe)
Area Totals 3 S-o Z3 7,5-"/
Commercial Structures
For Office Use
Area Descriptions(SQ FT) Existing Proposed ss Value
Existing Structure(s)
Proposed Addition
-Tenant Improvement?
Other work(describe)
-Site Area Totals
Lot/Site Covera a Calculations
LotSizeize sq ft) Lot Coverage(sift) %Lot Coverage(Tota lot cover of size)
• 9 i
Site Coverage(Sq Ft o all impervious) %of Site Coverage(total site coverage T lot size)
Y 'C.O
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 I �-
Plumbing Fixtures
Indicate how many of each type of fixture to be installed or relocated
Plumbing Traps # 2 Fuel gas piping / #of Outlets:
Water Heater # Medical gas piping #of Outlets:
Water Line # j Plumbing Vent piping I #
Sewer Line # Industrial waste pretreatment
interceptor Grease Trap) Size
Other describe
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PREPARED 5/26/15, 11:59:58 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/26/15
------------------------------------------------------------------------------------------------
ADDRESS . : 1738 W 14TH ST SUBDIV:
CONTRACTOR : PHONE
OWNER LOGAN DAVID P PHONE
PARCEL 06-30-00-0-4-0650-0000-
APPL NUMBER: 15-00000113 RES ADDITION
------------------------------------------------------------------------------------------------
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
---------------------------------------------------------------------------------------------—-
PL2 01 4/22/15 JLL PLUMBING ROUGH-IN
4/22/15 AP April 21, 2015 9:41:40 AM jlierly.
April 22, 2015 3:47:59 PM jlierly.
PLSP 01 5/13/15 JLL PLUMBING SHOWER PAN
5/13/15 AP May 13, 2015 8:41:23 AM jlierly.
jeff 461-6246
May 13, 2015 4:01:31 PM jlierly.
PL99 01 5/26/15 PLUMBING FINAL
May 26, 2015 12:03:28 PM jlierly.
------------------------ - ----------- COMMENTS AND NOTES
PREPARED 5/26/15, 11:59:58 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/26/15
------------------------------------------------------------------------------------------------
ADDRESS . : 1738 W 14TH ST SUBDIV:
CONTRACTOR : PHONE
OWNER LOGAN DAVID P PHONE
PARCEL 06-30-00-0-4-0650-0000-
APPL NUMBER: 15-00000113 RES ADDITION
------------------------------------------------------------------------------------------------
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION ,
TYP/SQ COMPLETED RESULT . RESULTS/COMMENTS
----------------------------—----------——----------——--
BL1 01 3/11/15 PB BLDG FOUNDATION FOOTING
3/12/15 AP March 11, 2015 11:43:33 AM pbarthol.
Jeff 461-6246
March 12, 2015 12:40:07 PM pbarthol.
BFF O1 3/17/15 JLL BLDG FLOOR FRAMING
3/17/15 AP March 17, 2015 10:03:37 AM pbarthol.
JEFF 461-6246
March 17, 2015 4:40:11 PM jlierly.
BAIR 01 4/22/15 JLL BLDG AIR SEAL
4/22/15 AP April 21, 2015 9:41:17 AM jlierly.
April 22, 2015 3:47:51 PM jlierly.
BL3 01 4/22/15 JLL BLDG FRAMING
4/22/15 DA April 21, 2015 9:40:52 AM jlierly.
jeff 460-6246
April 22, 2015 3:49:47 PM jlierly.
verify electrical rough inspection frame would have passed
inspection if elec insp was complete. JLL
BLI 01 4/27/15 JLL BLDG INSULATION
4/27/15 DA * OVERRIDE TAKEN BY JLIERLY DATE: 04/27/15 TIME: 10:04:58
April 27, 2015 10:08:49 AM jlierly.
April 27, 2015 4:05:55 PM jlierly.
Replace old insulation around bathroom in furred out walls
to meet R value required/jll
BL3 02 4/27/15 JLL BLDG FRAMING
4/27/15 AP * OVERRIDE TAKEN BY JLIERLY DATE: 04/27/15 TIME: 10:04:40
April 27, 2015 10:08:29 AM jlierly.
April 27, 2015 4:05:45 PM jlierly.
BL99 01 5/26/15JL BLDG FINAL
May, 26, 2015 12:01:48 PM jlierly.
461-6246 z_,
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
ME1 01 4/27/15 JLL MECHANICAL ROUGH-IN
4/27/15 AP * OVERRIDE TAKEN BY JLIERLY DATE: 04/27/15 TIME: 10:05:28
April 27, 2015 10:09:19 AM jlierly.
April 27, 2015 4:05:45 PM jlierly.
ME99 01 5/26/15 J MECHANICAL FINAL
May 26, 2015 12:03:08 PM jlierly.
PERMIT: PL 00 PLUMBING P IT -
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
----—--------—------------------- CONTINUED ONTO NEXT PAGE -----------------------------------
Address:
1738 W 1411 Street
fiPREi '7 3 X Lj f `f r�- St-
PREPARED
PARED 9/26/13, 9:05:50 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 9/26/13
------------------------------------------------------------------------------------------------
ADDRESS . : 1738 W 14TH ST SUBDIV:
CONTRACTOR PELLET HEAT CO. PHONE (360) 457-4406
OWNER LOGAN DAVID P PHONE
PARCEL 06-30-00-0-4-0650-0000-
APPL NUMBER: 13-00000990 RES MECHANICAL PERMIT
------------------------------------------------------------------------------------------------
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
- ------------------------------------——----—-—-----
ME6 01 9/13/13 JLL MECHANICAL GAS LINE
9/13/13 AP September 13, 2013 8:32:47 AM pbarthol.
Mike 457-4406
September 13, 2013 4:36:28 PM jlierly.
ME99 01 9/26/13 MECHANICAL FINAL
September 26, 2013 8:30:21 AM pbarthol.
David 452-3535
-------------------------------------- COMMENTS AND NOTES --------------------------------------
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 13-00000990 Date 9/10/13
Application pin number 709640
Property Address . . . . . . .1738 W 14TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-4-0650-0000- REPORT SALES TAX '
Application type description RES MECHANICAL PERMIT
Subdivision Name . . . . . . on your state excise tax form �
Property Use . . to the City of Port Angeles
Property Zoning .. RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 4600 (Location Code 0502)
--------------- - -------
Application desc
GAS FIREPLACE INSERT
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------
LOGAN DAVID P PELLET HEAT CO.
1738 W 14TH ST 230C EAST 1ST ST uJ
PORT ANGELES WA 983636810 PORT ANGELES WA 98362 Th
(360) 457-4406
--------------------------------------------------------_-------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . . GAS FIREPLACE INSERT
Permit Fee . . . . 121.30 Plan Check Fee .00
Issue Date . . . . 9/10/13 Valuation . . . . 0
Expiration Date 3/09/14.
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 10.6500 EA ME-STOVE/FIREPLACE/MISC. APP. 10.65
1.00 10.6500 EA ME-FUEL GAS PIPING,1-5 OUTLETS 10.65
1.00 50.0000 HR ME-INSPECTION, MIN 1 HR 50.00
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Special Notes and Comments
Per Washington State Code 51-51-315,
installation of Carbon Monoxide
detector(s) is required if you are
installing or replacing a fuel burning
appliance (wood, pellet, gas)and must be
in place prior to the final inspection
of this permit. They are required to be
place directly outside of each sleeping
area and at least one on each floor of
the house.
--------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 121.30 121.30 - .00 .00
Plan Check Total 00 .00 .00 .00
Grand Total 121.30 121.30 .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 theperformance of
construction.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS—
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT 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
P&-
BUILDING/PLUMBING I MECHANICAL PERMIT APPLICATION - SHORT FORM
(To be used for projects that do not require plan review.)
Date Received
#
City of Port Angeles Permit
Please.print in ink. Date Approved 57
Attn: Building Permit Technician Approved by
321 E. 5 St., Port Angeles, WA 98362.
360-417-4815 fax: 360-417-4711 Credit card payments are accepted Mon-Fri 8-5 pm (no American Express)
Hours: Mon through Fri 8--5 pm Cash & checks are accepted Mon-Thurs 8:30-4 pm & Fri 8:30-12:30 pm
Contact per on: Phone:
Propert�owner:
64 A.1 Phone:
Property owner's mailing address:
l — cr2T-' A;Nc,4L,43 W4, W363
Contractor's business name:,SpA S QE,��; 11644— ep., Phone:
or property owner's name if he/she is d in /overseein the work 5400 -qyS —yIYO41
Contractor's mailing address:.
Mractor'I&I license number: Expiration date:
L
Project Address:
W' 1L
Project Type: qNResidential o Commercial o Industrial o Multi-family
Project Business Name:
(for commercial, industrial, or multi-family projects)
The following permits are usually issued over-the-counter immediately, without the need for plan review,
Complete only the portions of this permit that are relevant to your project,.
lie-r o house n garage o other
c tear off& re-roof o lay over one layer
(✓) ensed contractor: Submit a copy,of your ev-roof:bjd.
Valuation * (labor & materials, riot in00.
g sales tax)
Re-side: o house o e a other
Project Valuatio (labor& .Is not including sales tax)
h
Repair: (explain the project)
Project Valuatio
'Homeowner: If you doing /overseeing the work, then the proj luation will be determined by doubling the
cos aterials, to reflect the value the repair adds to yo erty.
of materials x 2 = Project Valuation.$
T:Forms/ mg Division/Building/Plumbing/Mechanical-Pe'�mit;Application'=ShprtFor m (Ravi
Pa l of t
I 'd Ll9Z ''N dOHS PdS WdSZ :q EIOZ 'g '2ny
Swimming Pool o_r Spa (>_ 24" deeM: For prefabricated swimming pool.or spa projects that
do not require plan review:
(✓ Obtain the City of PA handout entitled"Pools & Spas" &follow the requirements.
Project Valuation 5
t:
Demolitio A demolition permit is needed when an entire building gets demolished
What will be demolished? o house o garage c) other
,rr
Ni
Note: some dde AeriS tion permit applications need to be reviewed by various City rrients, and may take
approximately two eks to obtain. %
(✓) .Agree ensure that all utilities are/will be properly turnei,' and capped off if needed)
prior to olition. � '
(✓) Obtain (frog . e City of PA) an aerial view map a parcel and put an "x" over the structure(s) to
be demolishe` , ubmlt the map with this ap atlon.
(✓) Obtain (from the of PA) a copy'of th ',Dlympic.Re•gion:Clegn'Air'Agerley (ORCAA)
Demolition Permit ' lication.
Contact ORCAA at 360 7-1466 s discuss whether or not an ORCAA Demolition Permit will also
be needed.
❑yes o no Will the debris be going to t ional Transfer Station in Port Angeles?
❑yes ❑ No If yes, will a licensed tractor b' .• king it there?
(✓) If yes, obtain (fro. e City of PA) a co f the Waste Disposal Application.
Complete and bmit the waste digppsal app tion to the Building Permit Technician, now
(or later i bestos testing is needed),.
Plumbinp Permit: a ain the ro'ect
Project Valuation $
Mechanical Permit: (explain the proiect)
/w o &its JS (zrn1�L c�ia�£S
Project Valuation 00
1 have read and completed this application and knew itJo be true and correct, /.am authorized to apply for this permit
and understand that it is my responsibility t determine what etmlts are required, and to obtain permits prior to
working on projects.
Date g�- 0—1-3 Signature
Print Name
Page 2 of 2
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