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Home My WebLink About217.5 E 11th Street Address: 217 Y2 E 1 11h Street PREPARED 7/05/17, 10:58:28 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 7/05/17 ------------------------------------------------------------------------------------------------ ADDRESS . : 217 1/2 E 11TH ST SUBDIV: CONTRACTOR : PHONE OWNER HANKINS, ASHLEY PHONE PARCEL 06-30-00-0-3-2965-0000- APPL NUMBER: 16-00001169 RES REMODEL ------------------------------------------------------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BAIR 01 12/28/16 PB BLDG AIR SEAL 12/29/16 AP December 27, 2016 2:06:58 PM pbarthol. John 406-579-8203 December 29, 2016 10:02:25 AM pbarthol. BL3 01 12/28/16 PB BLDG FRAMING 12/29/16 AP December 27, 2016 2:05:49 PM pbarthol. John 406-579-8203 December 29, 2016 10:02:25 AM pbarthol. BLI 01 2/08/17 JLL BLDG INSULATION 2/08/17 AP February 8, 2017 9:04:57 AM jlierly. key under log next to door/ please call when complete 670-6627 February 8, 2017 3:54:21 PM jlierly. BL99 01 7/05/17 BLDG FINAL TIME: 17:00 7) 9 --------------------- --------------------------------------------------------------- PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ PL2 01 11/22/16 JLL PLUMBING ROUGH-IN 11/22/16 AP November 22, 2016 9:46:40 AM jlierly. 809-5019 November 22, 2016 4:39:59 PM jlierly. PL6 01 11/22/16 JLL PLUMBING WATER SUPPLY 11/22/16 z&� November 22, 2016 9:47:10 AM jlierly. November 22, 2016 4:39:59 PM jlierly. PL99 01 7/05/17 PLUMBING FINAL TIME: 17:00 --------------------- r------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION to 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 16-00001169 Date 9/06/16 Application pin number . . . 904508 Property Address . . . . . . 217 1/2 E 11TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-3-2965-0000- Application type description RES REMODEL on your state excise tax form Subdivision Name . . . . . . to the City of Port Angeles Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation . . . . 48620 ---------------------------------------------------------------------------- Application desc CUP 16-04 ARU improvement ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HANKINS, ASHLEY OWNER 1371 3 CRABS RD SEQUIM WA 98382 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT -RESIDENTIAL Additional desc . . CUP 16-04 ARU IMPROVEMENT Permit Fee . . . . 660.15 Plan Check Fee 429.10 Issue Date . . . . 9/06/16 Valuation . . . . 48620 Expiration Date 3/05/17 Qty Unit Charge Per Extension BASE FEE 417.75 24.00 10.1000 THOU BL-25,001-50K (10.10 PER K) 242.40 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc Permit Fee . . . . 78.55 Plan Check Fee .00 Issue Date . . . . 9/06/16 valuation . . . . 0 N Expiration Date 3/05/17 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 7.2500 EA ME-VENT FAN (SINGLE DUCT) 7.25 1.00 10.6500 EA ME-HOOD/DUCT-MECH. EXHAUST 10.65 F 1.00 10.G500 EA ME-STOVE/FIREPLACE/MISC. APP. 10.65 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc Permit Fee . . . . �8.00 Plan Check Fee .00 Issue Date . . . . 9/06/16 Valuation . . . . 0 Expiration Date 3/05/17 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 7.0000 EA PL-PLUMBING TRAP 7.00 1.00 7.0000 EA PL-WATER LINE 7.00 L 1.00 7.0000 EA PL-DRAIN VENT PIPING 7.00 1.00 7.0000 EA PL-WATER HEATER 7.00 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 the performance of construction. C? 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.) �;LUMBING: 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/Ceil ing Drywall(Interior Braced Panel Only) T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pump/Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs ISkirting PLANNING DEPT. Separate Permit#s SEPA: Parking/Lighting ESA: Landscaping ISHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction - R.W. PIN I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 16-00001169 Date 9/OG/lG Application pin number . . . 904508 REPORT SALES TAX ---------------------------------------------------------------------------- Special Notes and Comments on your state excise tax form August 30, 201G 9:43:24 AM pbarthol. to the City of Port Angeles application of hold waiting for revisions to show egress through garage. (Location Code 0502) August 30, 2016 9:59:45 AM pbarthol. Revisions received 8-24-16. CUP 16-04 for an ARU was approved 8-5, letter included in documents. Setbacks appropriate. No change in lot coverage. No land use problems anticipated. pb September 6, 2016 10:24:12 AM banders. A second electric meter will be required for separation of accessory dwelling unit and main house. Additional electric permits required. All construction work within the City right of way requires a separate Right of Way Construction application to be completed by the contractor and approved by Public Works Engineering prior to the start of work. A pedestrian or traffic control plan is to be submitted for approval with the application as necessary. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Public Works Inspection request line 417-4831 Trench safety per applicable laws. Temp erosion control and surface restoration responsibility of applicant. Contact City inspector prior to start of work @ 360 417-4831. No attachment to sanitary sewer of stormwater roof leaders, foundation drains, yard drains, or any other CSO contribution is allowed. Construct driveway to City Standards. Concrete with exposed aggregate or other non-standard finishes(including colors or dyes)are not allowed in the City road right of way. Broom finish only. An inspection by Public Works Engineering is required prior to pouring concrete. Public Works inspection request line 417-4831 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ------ --- ---------- ---------- ---------- Permit Fee Total 816.70 816.70 .00 .00 Plan Check Total 429.10 429.10 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 1250.30 1250.30 .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. Inspec tion Type Date Accepted By Comments FOUNDATION: Tootings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) '�LUMBING: Under Floor/Slab Rough-In Water Line(Meter to Bldg) Gas Line Back Flow/Wate AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceil ing Drywall(Interior Braced Panel Only) 00 T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pump/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: Parking/Lighting ESA: Landscaping ISHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY1 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 Ti-iF- For City Use CITY F Permit# tV7-�11 -X, $" W A S H I N G T 0 N, U. S. Date Received: 19 6-1116 321 E Slh Street Aate Approved g:f ftg2 Port Angeles,WA 9836 P:360-417-4817 F:360-417-4711 Email:permits Ocityofpa.us BUILDING PERMIT APPLICATION ProjectAddress: ;07Y25, C-4C-UF-1urtq 5,7. PoR7 1,Qo&e1-zs Phone: -366 -4 70 -9.31�-41 PrimaryContact: AS14LEXl 1-1,qUV1AJ5 Emait-)LAALmnd A011.1 0 & " Nam' Phone 3 60-6 70 --S'J-35 41 Property Mailing Address Email Owner 71 7-1-149 5 0 13 City!�EO .- . State 'zip&392 U1 M 64!�� I Name Phone 5-3,5-q 0 U yXg,", 36o -c 7o Contractor Address E Information city State zip qg-38 Contractor Licen!k# Exp.Date: Legal Description: Zoning: Tax Parcel# Project Value: (materials and labor) Z-6T/Z/ 3Z-;Qq TPA eF;�-7 063006-3,2q65-b000 8 y Residential 19 Commercial El Industrial 11 Public El Demolition 1:1 Fire 0 Repair 11 Reroof(tear off/lay over) Permit Classification For the following,fill out both pages of permit application: (check NewConstruction 11 ExteriorRemodel 11 Addition El Tenant Improvement appropriate) Mechanical 11 Plumbing 11 Other 11 Fire Sprinkler System Proposed Irrigation System Proposed or posed Bathro roposed Bedrooms or Existing? Yes 0 No )0 1 Existing? Yes E3 No R I �MT In addition to standard hard copy submittals please send a PDF copy of all Stormwater plans and Engineering to www.stormwater(&cityo a.us Project Description rl)ui S p ra6o it o r &Aielic-c AP.PizrwElur Is project in a Flood Zone: Yes 0 NoEl Flood Zone Type: Ifin a Flood Zone, what is the value of the structure before proposed improvement? $ 1 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 befor�\the permit is issued. I understand that if the permit is not picked up/issued within iL8o days of submit 1,the application Will be considered abandoned and the fees will be forfeited. A V—/ Date 5-/5-A,&� llerigka�e 4" si5,,s )L� 0 Residential Structures Existing Proposed Construction For Office Use Area Descri#�io#s(SQ FT) Floor area, Floor area $Value new area Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or 2'd floor) Garage fU .2 Y1 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 13 all structures 437(, sqft Site Coverage(Sq Ft of all impervious) %of Site Coverage(total site cov-- lot size) V Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler I Size: # Haz/Non-Haz Piping Outlets: Appliance Exhaust Fan # Heater(Suspended,Floor,Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance # I 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 fixtu e to be installed or relocated Plumbing Traps # Water Heater # Plumbing Vent piping # Medical gas piping #of Outlets: Water Line # Fuel gas piping #o f Outlets: Sewer Line # Industrial waste pretreatment interceptor(Grease Trap) Size Other(describe): T:\Forms\2015 CED Form Updates\Building&Permitting\BP\Building Permit 2015041S.docx Residential Structures Existing Proposed Construction For Office Use Area Descrigoop's(SQ FT) Floor area, Floor area $Value new area Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or 2 nd floor) Garage YI Do 0 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) roposed 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 --74-'�';Oc) I all structures 4, 37L sqft /;? C70 Site Coverage (Sq Ft of all impervious) %of Site Coveraje(total site cov�lot size) 0 �Q-1 J=i Me), I , V Mechanical Fixtures Indicate how many of each type of ture to be installed or relocated as part of this project. Air Handler I 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 fixtu. e 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:\Forms\2015 CED Form Updates\Building&Permitting\BP\Building Permit 20150415.docX AD- T)JwAti, LU C, w IUD< ML vixa < LU F- LLI CL ;n An 1< = 3: U) LU < Lule— 0 z IOA—ly LLJ w CO ::M< L .9 LU o-.e % 02� M� -, %V -A IR L b b NZ x b LU LU R X:Z: LU 9 LU 4 I�A&40 b, v r-rl,4 ,"+ 'Pixa FILE Wisixa OCO&pamb%%W up=these Plan OW OOW dda"Ot FVCM ft e> id *Ora dwomw "Quiring do a Toc ma onrewallon arm in said plaw spedflWions SPA c-.kcjb ember dae,i r from preventing buPAing operation beingcarrio on thereunder when lavlokftofag e vades and oi Jinances of tbisjWsMC*NL ALLWO SUPJECTTOP e-e7j 1111-6 Zo I Silo, 94'k77 %J&&Z, +-c> EXISTING TOP OF LID OVER CLOSET EXISTING WALL F TO BE AT V-3" A50VE FLOOR wl 10' PLATE 2xb FRAMINGm 16" OC wl 1/2" PLYWD EXTG EXTG 0 GAS (L SHELF HIGH STOVE TOP OF SHELF AT V-Y ABV FLOOR 5EDROOM O"VE 211 SHIPS LADDER TO STORAGE LIVING 2i.all ; L PLATFORM Sn 11 211 21.011 31.011 , 2,-2" 31-411 zzzzzzzz C14 R STORAGE PLATFORM PANTRY %`Q -..a— U4 Dw REFI C4 C4 OVER BATH 0 PLATFORM FRAMING To BE 24 DF 02 -s 1611 O/C w/ 1/2" PLYWOOD SHEATHING b EATH WALL PLATE AT T-1511 A50VE FLOOR KITCH. 1, TOP OF SHEATHING AT V-3" A50VE FLOOR 2'.12" 42' WALL I d:Do 100 CFm FAN DN TUB/ SHOWER EXTG E I E EXISTING WALL—/ M-1- w/ 10' PLATE 4 2016 CITY OF POn - ,:�&ZELE S COMMUNITY&ECON04C DEVELOPMENT f= L f=L o4 11 319 South Peabody St NEW APARTMENT FOR SCALE: 1/4" V-0 9p"I 2 OF= Suits B E><ISTINc-x Port "Seln. WA 98302 ASHLEY HANKINS ARCHITECTS Pbolw.(wo) 452-alle ftm(380) 4U-?044 A -1 EXISTING EXISTING WALL w/ 10' PLATE - - - - - - - - - --- PROVIDE 5/8" TYPE 'X' GWB WALL$ AND CEILING IN EXISTING GARAGE EXISTING GARAGE Cot) q cl 0 LU co 41-011 EXISTING E STING x 00% LU NEW WALL 4 v FIRE RATED DOOR DN SELF-CLOSING -7 —1 1— T_ -T -7 —1 1 %1 UP EXTG 319 South Peabody St. NEW APARTMENT FOR 8-24-16 12 Of= Suits B 1=-><IOTINC-s lJNDBERq&pffMPort Angelm, WA 98362 ASHLEY HANKINS ARCHITECTS Phons:( 2-6116 — FIZZ 11062-70" A 'Wl VZ Ilk, 41V' lw ULLES OR NeNln iA W A S H I N G T 0 N, U. S. A. V--NO--3V Community Economic Development Department August.8, 20-16 Ashley Hankins '13:713 Crabs Road Sequim, WA 98382 RE: CUP 16-04 Dear Ms. Hankins: As you know, followin' a'public comment period ending Jul 29,10i'6 9 y ..the Clty�s Director of Community and Economic Development approved your'request for a'Conditibnal Use Permit to allow an accessory residential,unit at 217 East, I IthStreet on August 5, 2016'.'The- decision of the Director is final unless appealed within 14 days to,the Port Angeles,Hearing Examiner. Conditions on the permit must be fulfilled prior to,occupancy: t. Separate electrical meters are required for each,dwelling unit. Addressing for each dwelling unit shall be clearly iddntified as 217 and 217V2 East I Ph.Street. Address numbers must be at least six(6) inches'in height and readily visible from the street and of contrasting color from their background.. 21.- Two (2)off;,..street parking spaces are required for each residential dwelling unit for a total f f 0 our(4) spaces. Par'king spaces shall be constructed to Public Works and Utilities Department stand ards. 3. Driveway and site access shall beconstructed to Public Works and Utilities Department standards. 4. All utility improvements including water, sanitary sewer, storm,drainage and electrical are to be completed to the satisfaction of the Public W,6rks�and Utilities Department. Separate water and electric meters are requi,red for the Accessory Residential Unit. If you have any questions,please'don't hesitate to contact this department. Sincerely, Benjamin G.L. Braudrick.. Assistant Planner Phone:360-417-4150/,Faj(: 360-417-4711 Website:www:cityofpa.us Email: smartgrowth@cityofpa.us 321 East Fifth Street- P.O. Box 1150 Port Angeles, WA 9836M217 L--J S thL 17 E Etjcejjk ALLE 06t 00(r C3 I 0#� .2 pvlrir-l^) y ace S 21 t4 IT S-0 FORtA.,, BUILDING PERMIT APPLICATIONPrint in ink CITY OF PORT ANGELES For City se On ly- �L__ go—N Aftn. Building Permit Technician Date Receiv 9>-Iq-oq 321 E. Fifth St. Port Angeles,WA 98362 Permit# n q�_Vlo ts (360)4174815 fax(360)417-4711 ate Approved 4:� go�r Applicant Pho ce t Property Owner itAA Phone Property Owner's Addregs I ITLE 1111 7aa Wa 1 -02-:- Contractor Phon'e V Contractor's Address License# Expires E-mail PROJECT ADDRESS c�l ParcelNumber Lot Zoning PIS Proiect Type&BilefElescrhotion: Residential 0 Multlefamily o Commercial o Industrial Check all that apply W, ew Construction o Addition Ull ij� :9-ty tA4 e- e)lr� Se_"mJ +too V-- o Remodel ri Repair No4.e—,- nk, o —of-oq 15P_+6o_c_k o Demolition fyzwm ti:%+ed�- -2t3,):RA 'J •Re-roof o Hous� o garage o other o tear off&re-roof o lay16 p�b layer •Heat System o Heat pump c wood-burning stove o gas fireplace o pellet stove o other If •Other Ofi_m A A -rrv*& P 0jr— QK 11 I'MA I S5 V I V) I 4-ve-a�=" t",4h If f%cP- U>-,tyaq- Floor Areas Existing(sa.ft.) Pronosed Ism ft.) Basement @$ per sq.ft. $ I"Floor 2 nd Floor 5_7Z 5�>��Moje_ VI; 1(00 3rd Floor av) ve- _,4, Garage T1.1 Carport Covered Porch Deck Shed Other TOTAL VALUATION $ Total footprint of structures sq.ft. Lot size 7000 sq ft. = Lot coverage IS-% Site Coverage=the amount of impervious surface on a parcel, incl;ding structures, paved driveways, sidewalk tios, and other impervious surfaces. (see PAMC 17 94 135 for exemptions) Site cover AY Max. height of proposed structures ft. Occupancy group #of bedrooms Will a lawn sprinkler system be installed? Occupant load #of full baths Will a fire sprinkler system be installed? Construction type #of half baths I have read and completed this apfilication and know it to be true and correct. I am th ' d t n, , r is pegrmita understand au' onze ro S7 that it is;myyre�sponsib its pfior to wo, ponsipyity to determine h t e7nits are rq d to obtain perm, go projects. ,w a P Pired Dateg R-061 Print Nam Signatore wr " ' 4 TTorms/Buildig DMsion/Bldg Permit.doc C177 A M 5' 61-6144111 -rxp C17A- v eo N, ZY e�,.s 5,_s;P.�./r- 54 -r o v e Y, 7/y 00-C -C�17- �PVe" OSE ovee- 117 .230 7-�r-T7-2 3 0 7=77- 4�c, 7-5:1 OVel- ,S CIS13 ove,- ti 0 0 Z—. 4 '1y 6 le- ki) 61. U74 qt -7-TZ 7,T-- //7/g oZ--')C) it Do,,61c 7-�r-,- 0 V\ 09 /01 ( O-q prk4� cjk"zj rew 5"mK JO +D 2-0 11'r"" FTI /l/07-7rO ?-Iflc,se