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Peabody Street Address: Peabody Street 7�t 5- pe-A �. �L PREPARED 5/13/15, 8:3 9:0 7 INSPECTION TICKET PAGE 31 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/13/15 ------------------------------------------------------------------------------------------------ ADDRESS . : 3415 S PEABODY ST SUBDIV: CONTRACTOR PENINSULA HEAT INC PHONE (360) 681-3333 OWNER REVOLUTION CHURCH PHONE (360) 477-3834 PARCEL 06-30-lS-5-0-1610-0000- APPL NUMBER: 15-00000399 COMM MECHANICAL PERMIT ------------------------------------------------------------------------------------------------ PERMIT: ME . 00 ME(MMICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ ME99 01 5/13/1S JLL MECHANICAL FINAL K n May 13, 2015 8:40:45 AM jlierly. it 477-2025 ------------------- --- ----------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 15-00000399 Date 4/20/15 Application pin number . . . 257797 Property Address . . . . . . 3415 S PEABODY ST ASSESSOR PARCEL NUMBER: 06-30-15-5-0-1610-0000- REPORT SALES TAX Application type description COMM MECHANICAL PERMIT Subdivision Name . . . . . on your state excise tax form Property Use . . . . . . . . to the City of Port Angeles Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY Application valuation . . . . 29320 (Location Code 0502) ---------------------------------------------------------------------------- Application desc REPLACE 3 FURN W 3 HP ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ REVOLUTION CHURCH PENINSULA HEAT INC 2018 WEST VIEW DR 782 KITCHEN-DICK RD PORT ANGELES WA 98363 SEQUIM WA 98382 (360) 477-3834 (360) 681-3333 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc Permit Fee . . . . 94.40 Plan Check Fee .00 Issue Date . . . . 4/20/15 Valuation . . . . 0 Expiration Date 10/17/15. Qty Unit Charge Per Extension BASE FEE 50.00 3.00 14.8000 EA ME-FURN/HP/FAU < OR = 5 TON 44.40 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ------ --- ----- ----- ----- --- --- Permit Fee Total 94.40 94.40 00 00 Plan Check Total .00 .00 .00 .00 Grand Total 94.40 94.40 .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 the performance of construction. 6, 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 by AIR SEAL: Walls Ceiling FRAMING: t Joists/Girders/Under Floor Shear Wall/Hold Downs Walls I Roof/Ceiling 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 I Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Pkirting 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 T:Forms/Building Division/Building Permit THE S For City Use 0 L K I CITY OF V�' A S H I N G�'T 0 N . U . S . Permit# 321 East S" Street Date Received: zo - Port Angeles, WA 98362 Date Approved q P: 360-417-4817 F: 360-417-4711 permits@cityofpa.us Building Permit Application Project Address:3+15' S 5� Main Contact: J Phone # SAScN MJAAAie-LBua4,E34, E-Mail: Property Name IR e-VO I LL+j olk Ck o rek Phone Owner MailingAddress Email A0 0 0 Ao I fs/ W Ifs, V Dr-- 7ip City Tort A State NA/A Zip 1 ?347— Contractor Name honj, ; _ 4 f —33.33 Mailing Address Email Box 173 pem city (!�&rk_6v!3 State A/V Zip Contractor License# �93 2-!� PENIN I I ()qq-a%Ai Expiration: 10 Project Value: Zoning: Tax Parcel # $ 222 3 A 0 41 To" Typ�--Of Resid-ential 13 Commercial Industrial 13 Public 0 Permit Demolition 13 Fire 13 - Re�air 0 R-eroof(tear off/lay over) [3 For the following,fill out both pages of permit-application: New Construction 0 Remodel 11 Addition 11 Tenant Improvement Mechanical Plumbing El Other 0 F-Asting Fire Sprinider System? -tructure Bedrooms Proposed Bathroom: Yes 13 No 0 Project Ma3dmum height of s Description dnA re-lo iac&- 3 3 Air WaA6a I have read and completed the application and know it to be true and correct.I am authorized to apply for thi permit. I understand that it is my responsibility to determine what permits are required and to obtain permi prior to worldng 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 I considered abandoned and the fees forfeit. Date Print Name Signature Residential Structures For Office Use Area Description(SQ FT) Existing Proposed $$value Basement First Floor Second Floor Covered Deck/Porch/Entry Deck Garage Carport Other(describe) Area Totals Commercial Structures Area Descriptions(SQ FT) Existing Proposed $$Value For Office Use Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) Area Totals Lot/Site Coverage Calculations Footprint(SQ FT)of all Structures: Lot Size: %Lot Coverage SQ FT Site coverage(all impervious+ %Site Coverage structures) Mechanical Fixtures Indicate how many of each type of flxture to be installed or relocated as part of this projecL Air Handler Size: # — Haz/Non-Haz Piping #of Outlets: Appliance Vent # Heater(Suspended,Floor,Recessed wall) # Boiler/Compressor # Heating/Cooling appliance # repair/alteration r Evaporative Cooler(attached,not # Pellet Stove/Wood-burmnEing/Gas # _portable) Fireplace/Gas Stove/Gas Cook Stove Misc. Fuel Gas Piping #of Outlets.— Ventilation Fan,single duct # Furnace/Heat Pu;m�ip/ Size- Ventilation System # LForced Air Unit L 3 Plumbing Fixtures Indicate how many of each type of flxture 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 pretrea�ent # Other(describe): nterceptor T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX Address: 3415 V; Peabody Street 3� (y, PREPARED 9/18/13, 13:37:16 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 9/18/13 ------------------------------------------------------------------------------------------------ ADDRESS . : 3415 S PEABODY ST SUBDIV: CONTRACTOR DIAMOND ROOFING ENTERPRISE INC PHONE (360) 452-9S18 OWNER OLYMPIC VINEYARD CHRISTIAN FSP PHONE PARCEL 06-30-15-5-0-1610-0000- APPI, NUMBER: 13-0000081S RE-ROOF ------------------------------------------------------------------------------------------------ PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BL99 01 9/18/13 JLA BLDG FINAL 0410 September 18, 2013 8:27:24 AM pbarthol. IT Donald 452-9518 -------------------------------------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 13-00000815 Date 7/23/13 Application pin number . . . 412115 Property Address . . . . . . 3415 S PEA13ODY ST ASSESSOR PARCEL NUMBER: b6-30-15-5-0-1610-0000- Application type description RE-ROOF REPORT SALES TAX Subdivision Name . . . . . . on your state excise tax form Property Use . . . . . . . . Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY to the City of Port Angeles Application valuation . . . . 22115 (Location Code 0502) ------------------------------------------------------ --------------------- Application desc TEAR OFF/INSTALL COMP ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ OLYMPIC VINEYARD CHRISTIAN FSP DIAMOND ROOFING ENTERPRISE INC 3415 S PEABODY ST 1295 BLACK DIAMOND RD PORT ANGELES WA 98362 PORT ANGELES WA 98363 (360) 452-9518 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT - NO PR FEE Additional desc . . TEAR OFF/INSTALL COMP Permit Fee . . . . 389.75 Plan Check Fee .00 Issue Date . . . . 7/23/13 Valuation . . . . 22115 Expiration Date . . 1/19/14 Qty Unit Charge Per Extension BASE FEE 95.75 21.00 14.0000 THOU BL-2001-25K (14 PER K) 294.00 ---------------------------------------------------------------------------- Other Fees . . . . . . . . .I STATE SURCHARGE 4.50 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 389.75 389.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 394.25 394.25 .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 the performance of construction. ?s 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 Bidgs.) PLUMBING: Under Floor/Slab Rough-in Water Line(Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted by 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 Pump/Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet I Chimney Commercial Hood/Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs iSkirting 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 1 I Building 417-4815 T:Forms/Building Division/Building Permit THE For City Use CITYOF L Ai Permit# W A S H I N G T 0 N , U . S . 321 East Sth Street Date Received: Port Angeles, WA 98362 Oat? Approved P: 360-417-4817 F: 360-417-4711 permits@city,ofpa.us Building Permit Application Project Address: t ,�% Main Contact: Phone! # E-Mail: Property Name Phone 1 C_ Owner Maili Addrdss Email . '�L� I-S7 city-k State zip UA-. I I Contractor N.a Phone 2CJme MailingAddress Email &L G �P' city— State Zip Y\�(f-� (-J (A Contractor License 'b 9 q Expiration: Priect Value. Zoning: --l-Tax Parcel # Lot# $ 3L, 115— Type of Residential 0 Commercial 0 Industrial Public Permit Demolition 11 Fire [3 Repair 0 Reroof(tear olf/lay over) For the following, fill out both pages of permit application: New Construction 11 Remodel El Addition 11 Tenant Improvement 11 Mechanical 13 Plumbing El Other M Existing Fire Spririkler System? Maximum height of structure Proposed B, roposed Bathrooms Yes 0 No [3 Project -7��- Fm a )4 r- V"neAc- Description F I have read and completed the application and know it to be true and correct.I am authorized to apply for this permit. I unders�tand 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;,:he application before the permit is issued.; I understand that if the permit is not issued within 180 days t-4 receipt,the application will be considered abandoned and the fees forfeit. Date Print Name Signature State Contractor Registration# D 1A M 0 R E 9 4 6 D Z Invoice # 1, 046 Since 1971 IN 1295 Black Diamond Rd. Po� Angeles, WA 98363 (360) 452-9518 - Cliff Fors & Duffy Fo�'s Bid Proposal Contrac,01 -C C Date Name ar � Address S'� 1�bcA qF<,4N63,- Specifications: j k T\C 'Y1\ kcLry\-,cs� J ry\ -i NQ:- ?-c,L4 c- A cz�C--, C �OQXV\— (ACS r) cAc A CV\ A C- �E)J V Price Payment Tax A A k- TOTAI 66