HomeMy WebLinkAbout211 W. 3rd Street Address:
V Street
TH
E W-V For City Use
CITY OF JL LES
P, A Permit#
W A S H I N G T 0 N, U. S. Date Received: -2_1 I Z4
321 E Sth Street Date Approved
Port Angeles,WA9836
P:360-417-4817 F:360-417-4711
Email:11ermits(@dtyo-fpa.us BUILDING PERMIT APPLICATION
Project Address: tv uo
Primag Contact. AL C 6v Phone:6 DN -�-,-WZ2( -F��,?Q- q 2 71 CeA
Email:
Name'4Phone
LLC,1v 5Au) z"EtZ (Q)4y.�7-FZ2, L Cv.,(I
Property Mailing Address Email
Owner 1960 HARigog reE5T ?I—
CityPoyz-t AWU-05 State w. A Lip
Name Ph6
Address
Contractor Ernzal
Information city State
Contractors License# Exp.Date:
Legal Description: Zoning: Tax Parce"I i lue: (materials and labor)
Project Va
Residential 10" Comm&claf 11 InduL
Public
Demolition F�re Repair 9".Ateroof(tear off/lay over) El
Permit
Classification For the follo�ving. flilt6hA60' th pages of permit application:
(check New Constru6iX644 Exterior Remodef 0- Addition 13 Tenant Improvement 1:1
appropriate) A x jj�'# lip,
. Mechanical El PIumBing El Offier 2"
Fire Sprinkler System? lrrigati4;Mg�s�tem? Proposea Bathrooms/ Proposeo Bedrooms
Yes 13 No Etc Yes 13,-k'k P/ A11A -7 IvJA
'% ' W /"
Project Description 19KOU[p � A A,0f EQK ItIG He)(A5c-- Alta) ZrZec 7c) Coexl
N31
6F�
Is project in a Flood Zone: Yes [3 Noff"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.
Date Print Name Signature
Residential Structures
For Office Use
Area Description(SQ FT) Existing Proposed ss value
Basement
First Floor
Second Floor
Covered Deck/Porch/Entry
Deck(over 30"or 2"d floor)
Garage
Carport
Other(describe)
Area Totals LIVI U L-) , e e-
Commercial Structures
For Office Use
Area Descriptions(SQ FT) Existing Proposed $$Value
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. /L�-&C7rZtCA
Air Handler Size: # Haz/Non-Haz Piping
Appliance Exhaust Fan # Heater(Suspended,Floor,Recessed wall) #
Boiler/Compressor Size: # Heating/Cooling applialwiF7 C Lo-rH e #
repair/alteration D K-yer
Evaporative Cooler(attached,not # Pellet Stove/Wood-burning7Uais #
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 # Fuel gas piping #of d�tlets:
Water Heater # Medical gas piping #of Outlets:
Water Line # Plumbing Vent piping #
Sewer Line # Industrial waste pretreatment
I interceptor(Grease Trap) I Size
Other(describe):
T:\BUILDING\APPLICATION FORMS\Current BP Application\Building Permit 4-17-13.docx