HomeMy WebLinkAbout517 Lopez Avenue Address:
pez Avenue
PREPARED 2/04/14, 9:54:23 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 2/04/14
------------------------------------------------------------------------------------------------
ADDRESS . : 517 LOPEZ AVE SUDDIV:
CONTRACTOR ANGELES PLUMBING PHONE (452) 8525
OWNER NORTH OLYMPIC REGIONAL VETERAN PHONE
PARCEL 06-30-10-5-0-1606-0000-
APPL NUMBER: 13-00001253 PLUMBING PERMIT
------------------------------------------------------------------------------------------------
PERMIT: PL 00 PLUM13ING PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
PL99 01 2/04/14 PLUMBING FINAL
February 4, 2014 9:30:56 AM pbarthol.
Kyle 461-0043
washer/dryer hookups in unit s A,B,C
-------------------------------------- COMMENTS AND NOTES --------------------------------------
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 13-00001253 Date 11/12/13
Application pin number . . . 626003
Property Address . . . . . . 517 LOPEZ AVE
ASSESSOR PARCEL NUMBER: 06-30-10-5-0-1606-0000- REPORT SALES TAX
Application type description PLUMBING PERMIT
Subdivision Name . . . . . . on your state excise tax form
Property Use . . . . . . . .
Property zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY to the City of Port Angeles
Application valuation . . . . isoo (Location Code 0502)
----------------------------------------------------------------------------
Application desc
INSTALL WASHER/DRYER HOOKUPS IN UNIT A,B,C
------- ------------ ------- -- ---- -----
Owner Contractor
------------------------ ------------------------
NORTH OLYMPIC REGIONAL VETERAN ANGELES PLUMBING
PO BOX 1220 PO BOX 1151
FORKS WA 98331 PORT ANGELES WA 98362
(452) 8525
------------------------------ ---------------------------------
----------
Permit . . . . . . PLUMBING PERMIT
Additional desc WASHER/DRYER HOOKUP UNIT A,B,C
Permit Fee . . . . 113.00 Plan Check Fee .00
Issue Date . . . . 11/12/13. Valuation . . . . 0
Expiration Date 5/11/14i
Qty Unit Charge Per Extension
BASE FEE 50.00
3.00 7.0000 EA PL-PLUMBING TRAP 21.00
3.00 7.0000 EA PL-WATER LINE 21.00
3.00 7.0000 EA PL-DRAIN VENT PIPING 21.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 113.00 113.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 113.00 113.00 .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 req'uired-'inspe ctidns 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.
NOV, 1*2 j 70)3 01P)W&(A eD- "-i 7-P
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
TForms/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 I 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 I Roof/Ceiling
Drywall(interior Braced Panel Only)
T-Bar
INSULATION:
Slab
Wall I 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
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 I Engineering 417-4831
Fire 417-4653
I Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
_7711t�
THE W11
For City Use
0
L S
JL G
C[TY F E
Permit#
I N G T 0 N , U . S . Date Received: LO-2-5_� (3
321 E 51h Street Date Approved
Port Angeles,WA 9836
P: 360-417-4817 F: 360-417-4711
Email: permits0cityofpa.us BUILDING PERMIT APPLICATION
U IT-5
Project Address: L-L
_,_ P Phone:
Primary Contact: _�Lj rv, 171, 'i" r`tA
T1_* f Email: 4:�,o
Name Phone
0 L L,
J,
Property -Mailing Address Email
Owner
City State A
Name Phone
Address
Contractor Email
-7u CA
�4
Information -city
State Zip
pn
Contractor License# 'I
Exp.Date:
Legal Description: Zoning: Tax Parcel # Project Value: (materials and labor)
$
Residential El Commercial 'Q Industrial El Public El
Permit Demolition El Fire El Repair El Reroof(tear off/lay over) El
Classification For the following. fill out both pages of permit application:
(check New Construction 1:1 Exterior Remodel '[] Addition El Tenant Improvement El
appropriate) Mechanical El Plumbing-"& Other F1
Will a fire sprinlder system be instaHed Irrigation System? Proposed Bathrooms Proposed Bedrooms
or modified? Yes 0 No b-,. Yes 0 N(
Project Description 7� V
p� �-p
Is project in a Flood Zone: Yes El Noq Flood Zone Typ e:
If in 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 pern-Lits 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 l,"rithdraw the application before the permit is
issued. I understand that if the permit.is not picked up/issuedwithin 18o days of submittal, the application
will be considered abandoned and the fees will be forfeited.
Date Print Name FSiggnature
qq
0
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NOTES:
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i PROVIDE WMK-WG.
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NOTES:
t 1011OVE EXISTWs K"COWSOM
ICLEM AM MWAIR EXM4 WINICRETE
jjTlX.M=4"TA"M
JW
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6TAIR
fWlovg ExISTM MMCfMCAL cAeMOAM MATM
AT ALL LOCAT06 PROVIDE�W WAMOARD WATERS
,C FWADE�ft VW BLINDS AT ALL WMM AND
8LIDM a.AM
EBUILDING FLOOR PLAN
Address:
517 Lopez Avenue D
PREPARED 2/04/14, 9:54:23 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 2/04/14
------------------------------------------------------------------------------------------------
ADDRESS . : 517 LOPEZ AVE D SUBDIV:
CONTRACTOR : PHONE
OWNER NORTH OLYMPIC REGIONAL VETERAN PHONE
PARCEL 06-30-10-5-0-1606-0000-
APPI, NUMBER: 13-00000449 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
BL3 01 11/0S/13 JLL BLDG FRAMING
11/05/13 AP November 5, 2013 9:24:15 AM pbarthol.
Kyle 461-0043
Code to get in 5381
November 5, 2013 4:45:19 PM jlie�ly.
BL99 01 2/04/14 JL(? BLDG FINAL
February 4, 2014 9:31:59 AM pbarthol.
Kyle 461-0043
Ramp/ADA bathroom/windows. ...
------------------------------------------------------------------------------------------------
PERMIT- PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
PL99 01 2/04/14 J;4r—% PLUMBING FINAL
February 4, 2014 9:45:59 AM pbarthol.
Kyle 461-0043
-------------------------------------- COMMENTS AND NOTES --------------------------------------
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 13-00000449 Date 8/30/13
Application pin number . . . 304190
Property Address . . . . . . 517 LOPEZ AVE D
ASSESSOR PARCEL NUMBER: 06-30-10-5-0-1606-0000-
Application type description COMM REMODEL REPORT SALES TAX
Subdivision Name . . . . . . on your state excise tax form
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY to the City of Port Angeles
Application valuation . . . . 7050
(Location Code 0502)
------------------------------------------------------ ---------------------
Application desc
BATHROOM ADA COMP/REPLACE 2 WINDOW/ADD ADA RAMP
----------------------------------------------------------------------------
Owner Contractor
----- ------- -------- - -----
NORTH OLYMPIC REGIONAL VETERAN OWNER
PO BOX 1220
FORKS WA 98331
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT - COMMERCIAL
Additional desc . . BATHROOM ADA/WINDOWS/RAMP
Permit Fee . . . . 179.75 Plan Check Fee 116.84
Issue Date . . . . 8/30/13 Valuation . . . . 7050
Expiration Date 2/26/14
Qty Unit Charge Per Extension
BASE FEE 95.75
6.00 14.0000 THOU BL-2001-25K (14 PER K) 84.00
----------------------------------------------------------------------------
Other Fees . . . . . . . . . . STATE SURCHARGE 4.50
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
------ --- ----- ------ ------ --- ---
Permit Fee Total 179.75 179.75 00 00
Plan Check Total 116.84 116.84 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 301.09 301.09 '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
constructl . �% k
umemkj) �'t-�Vn MAW I
Date Prin ame Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
TForms/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
Sternwall
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:
Joists/Girders/Under Floor
Shear Wall/Hold Downs
Walls/Roof/Ceiling
Drywall(interior Braced Panel Only)
'f-Bar
INSULATION:
Slab
Wall/Floor/Ceiling
MECHANICAL:
Heat Pump/Furnace/FAU/Ducts
Rough-in
Gas Line
Wood Stove/Pellet/Chimney
Commercial Hood/Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
Skirting
PLANNING DEPT. Separate Permit#s SEPA:
Parking/Lighting ESA:
Landscaping jSHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY1 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
T�HE oft 0
71
CITY OP For City Use
W' A S H I N 0 N, U . S. Permit# 43
Date Received: A-30_ I'a
.30
321 East 51h Street
Port Angeles, WA 98362 Date Approved 57M
P: 360-417-4817 F: 360-417-4711
permits@)cityofpa.us
Building Permit Applic tilon
Project Address: �517 U/k�' /�-
Main Contact: Phone #
�w'4-7'L_ E-Mail:
Property Name 1JoPt'J4 Phone
Owner I P - 6,4D
MailingAddress Kt2--61--7 UZT�_k_' Email
'Fb 6EK/ 17/2,(-)
city State Lk_R_ Zip
Contractor Name Phone
Mailing Address Email
city State
Contractor License# Expiration:
Project Value: Toning: I Tax Parcel# Lot#
$ tJi0-1g;0 06-7 — 0&-'30-o
Type of Residential Commercial El Industrial 0 Public E3
Permit Demolition E3 Fire E3 Repair E3 Reroof(tear off/lay over)
For the following,fill out both page f ermit application:
New Construction 0 Remodel Addition 11 Tenant Improvement
Mechanical 11 Plumbing 0 Other E3
Existing Fire Sprinkler System? Maximum height of structure Proposed Bedrooms Proposed Bathrooms
Yes E3 No 13
Project bf-pl- ra-d-0—6&4-4.- 4D abfee_�'
Descriptip.?
4)
�J
F
I have read and completed the application and know it to be true and correct.I am authorized to apply-for this
permiL I understand that it is my responsibility to determine what permits are required and to obtain perm.I its
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 the application before the
permit is issued. I understand that if the permit is not issued within 180 days of receipt,the application will be
considered abandoned and the fees forfeit
Date Print Name Signature
Residential Structures
For Office Use
Area Description(SQ FT) Existing Proposed $$value
Basement 0 0
First Floor
Second Fl6or
0
0
Covered D6ck/Porch/Entry 0
Deck
Garage
Carport 0
Other(describe) 0
Area Totals
Commercial Structures
For Office Use
Area Descriptions(SQ FT) Existing Proposed $$Value
Existing Structure(s)
Proposed Addition
Tenant Improvement?
Other work(describe)
Area Totals
Lot/Site Coverage Calculations
Footprint(SQ FT)of all§tructures: Lot Size: %Lot Coverage
3?0Uq--1 ,�-C'D L� 1 5 7,
SQ FT Site coverage(all impervious+ %Site Coverage
structures) -1 11R'qVD �
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 #of Outlets:
Appliance Vent # Heater(Suspended,Floor,Recessed wall) #
# Heating/Cooling appliance #
Boiler/Compressor 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 # Fuel gas piping #of Outlets:
Water Heater # Medical gas piping #of Outlets:
Water Line # Vent piping #
Sewer Line # Industrial waste pretreatment #
interceptor
Other(describe):
T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX
----------- --------------
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2013-1292838
Page I of 2 Warranty Deed
O'YT.P."Cp-�'��ti",'"WllashlTingtIteon 111111121111 11:�,. F,,
ci. co.pany
1-k CIO I I I I I
OLYMPIC PENINSULA
Title Company-
NO 4
CLAL M C
Escrow Number:99101-DS TRANSAC CISE x
T
� 201
Statutory Warranty Deed AM UNT . e 0 C.i C
YTR REP
y L44�,L.., ?
THE GRANTOR Peni nsula Housing Authority, successor entity to "Sin!,-A ori f unty of
onsiderat in
Clallam,a Washington Special Service Government Agency for and d at) fTEN , LLARS
s ,
AND OTHER GOOD AND VALUABLE CONSIDERATION in han s an, warrants to North
Olympic Regional Veteran's Housing Network, a Washin t IVUL �-()17110 tion the following
qr was tngt
E on
lf
described real estate,situated in the County of Clallam,State ;hi
Abbreviated Legal:
LTAH0USrNGAlJTH.BLASVYV61P77&AM MENT
For Full Legal See Attached Exhibit"A"
Subject to exceptions to title also appearing on Exhibit"A"
Tax Parcel Number(s):06-30-10-501606 65066
Dated March 26,2013
Peninsula Housing Authority,succe e ' to
Housing Authority of County of Clal ,
hington S ecial Service Go ern 9
By:Pamela J.T tz, x cu tor
STATE OF A
COUNTY OF L AM SS:
I certify that I kn or e s factory evidence that Pameig.J.Tietz
i are the person(s)who appeared before
me,and saiil p"n ac owledge that she signed this instrument,on oath stated she
is/a Jt the instrument and acknowledge that as the
Ex 1) ofPeninsula Housing Authority,successor entity to Housing
to be the fre and-,y4DJJjwmea act of such party(ies)for the uses and purposes m ntion i this in !J3,7nt.
D te
Dawn L.Shi eller
in
CNotary�Publi in and for the State of Washington
at Port e,
at Port Angeles
My appointment expires: 4/9/2015
LPB 10-05(i-])
Page I ol`2
2013-1292838 04/04/2013 11:38:51 AM' 2 of 2 Clallam County,WAWD
OLYMPIC PENINSULA TITLE COMPANY
EXHIBIT A
LOT A OF HOUSING AUTHORITY BOUNDARY LINE ADJUSTMENT SURVEY, ED
SEPTEMBER 05,2006 IN VOLUME 61 OF SURVEYS,PAGE 77,UNDER CLAL4A�mftk',� TY
RECORDING NO.2006 1187208 AND AMENDMENT THERETO RECORDED IN \�ME 65
OF SURVEYS,PAGE 24,BEING A PORTION OF LOTS 6,7,8,9 AND IOINBL C -\,I I AND
r NY S
LOTS 11, 12, 13, 14, 15,AND 16 IN BLOCK 16 OF PUGET SOUND COOPERATIV — LO
SECOND ADDITION TO PORT ANGELES,AS RECORDED IN VOLUME I OF S
PAGE 12,RECORDS OF CLALLAM COUNTY,WASHINGTON.
SITUATE IN CLALLAM COUNTY,STATE OF WASHINGTON.
TOGETHER WITH AN EASEMENT FOR CONSTRUCTION AND MAINTENANCE
WATER LINE WITH NECESSARY APPURTENANCES AS SET FROTH E S NT
RECORDED APRIL 30,2008,UNDER RECORDING NO.2008-1220249.
SUBJECT TO:
I LIABILITY FOR FUTURE ASSESSMENTS AND/OR CHAR MPOS BY LOT
OWNERS'ASSOCIATION,WHICH THE GRANTE
�E�l A E ASSUME AND
Uk�
:---I-A-
-EM
ImPO
s —
A E
PAY ACCORDING TO ITS TERMS AND C( 6c
ND I
6U
2. ALL COVENANTS,CONDITIONS,RESTRIC I S,RESER4�\�ONS,EASEMENTS OR
OTHER SERVITUDES,IF ANY,DISCLOSED HOUSING AqT- ORITY BOUNDARY
R CLALL�
A
LINE ADJUSTMENT SURVEY RECORDED R CLALLA OUNTY RECORDING
NO.2006 1187208,
AMENDED SURVEY RECORDED DECEMBER 2 , 00 , R CLALLAM COUNTY
RECORDING NO.2007-1213974.
3. ALL COVENANTS,CONDITIONS, ICTIONS,RESERVATIONS,EASEMENTS OR
OTHER SERVITUDES,IF ANY,DISC S.E Y SURVEY RECORDED UNDER
CLALLAM COUNTY RECORDING NO.59 1
4. COVENANTS,CONDITIONS AND R 10 S-1 POSED BY DOCUMENT
RECORDED ON OCTOBER 26,20 LAM COUNTY RECORDING NO.2006
1190319,
5. EASEMENT RECORDE R L UNTY:RECORDING NO.: 333260
6. EASEMENT RECORDED COUNTY RECORDING NO.: 400161
7. EASEMENT RE RDE R C M COUNTY RECORDING NO.RECORDING
NO.: 2008_1 Z2�0 204 8
Read,Accepted 0
North Olym i c eran's using Network
By:
Cheri Reck rest t
LPB 10-05(i-1)
Page 2 of 2
Address:
517 Lopez Avenue
PREPARED 2/04/14, 9:54:2 3 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 2/04/14
------------------------------------------------------------------------------------------------
ADDRESS . : 517 LOPEZ AVE SUBDIV:
CONTRACTOR : PHONE
OWNER NORTH OLYMPIC REGIONAL VETERAN PHONE
PARCEL 06-30-10-5-0-1606-0000-
APPI, NUMBER: 13-00000493 RE-ROOF
------------------------------------------------------------------------------------------------
PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
---------------
BL99 01 2/04/14 BLDG FINAL
------ ----February-4,-2014-9:29:14-PM--pbarthol---------------------------
.....................
Kyle 461-0043
---------- COMMENTS AND NOTES --------------------------------------
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES,WA 98362
Application Number . . . . . 13-00000493 Date 8/30/13
Application pin number . . . 833420
Property Address . . . . . . 517 LOPEZ AVE
ASSESSOR PARCEL NUMBER: 06-30-10-5-0-1606-0000-
Application type description RE-ROOF REPORT SALES TAX
Subdivision Name . . . . . . on your state excise tax form
Property Use . . . . . . . .
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY to the City of Port Angeles
-----Application-valuation----------------5000------- -------- -------------- (Location Code 0502)
----------- --------- - - - - ----
Application desc
RE-ROOF
----------------------------------------------------------------------------
Owner Contractor
-----f------------------ ------------------------
NORTH OLYMPIC REGIONAL VETERAN OWNER
PO BOX 1220
FORKS WA 98331
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Permit . . . . . . BUILDING PERMIT - NO PR FEE
Additional desc . . RE-ROOF
Permit Fee . . . . 137.75 Plan Check Fee .00
Issue Date . . . . 8/30/13 Valuation . . . . 5000
Expiration Date 2/26/1 4
Qty Unit Charge Per Extension
BASE FEE 95.75
3.00 14.0000 THOU BL-2001-25K' (14 PER K) 42.00
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Other Fees . . . . . . . . .� STATE SURCHARGE 4.50
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 137.75 137.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 142.25 142.25 .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
construe
�jl*DDY,-VO(A GO IqN4 A)2ZA
Date Print e 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 Backfiow Prevention Inspections 4174886
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:
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/Chimney
Commercial Hood/Ducts FINAL Date Accepted by
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 I Engineering 417-4831
Fire 417-4653
1 Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
THE
CITY OF RIF R
For City Use
Per 31
W A S H I lsl mit# 13 - zl ,3--
G;� 1" 0 N. U S.
Date Received:
321 East Slh Street
Port Angeles, WA 98362 Date Aprproved
P: 360-417-4817 F: 360-417-4711
permits0cityofpa.us -
Building Permit Applic tion
Project Address:
Main Contact: Phone #
0"41 ell
E-Mail: 46Z-- (�"//O
Property Name /Jotz-tv Phone
Owner - (,4D
MailingAddress KZ7"-b1T1t5 Email
' "V I?�2�,-)
Fb 6�p -ii�—
Cit3r State Zip q-
Contractor Name Phone
MailingAddress Email
city State
Contractor Licens # Expiration:
Project Value: �Zo�ning:��Tax Parcel # Lot#
$
-0 -
mmprri'l n
Type of Residential v Commercial D Industrial Public 0
Permit Demolition 1:1 Fire 13 Repair E3 Reroof(tear off/lay over)
For the following, fill out both pages of permit application:
New Construction El Remodel bl Addition 11 Tenant Improvement El
Mechanical El Plumbing El Other 1:1
Existing Fire Sprinkler System? Maximum height of structure Proposed Bedrooms Proposed Bathrooms
Yes 11 No
Project
DescriW
I have read and�0—mpleted the application and know it to be true and correct.I am authorized to apply for this
permiL I understand 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 the application before the
permit is issued. I understand that if the permit is not issued within 180 days of receipt,the application will be
considered abandoned and the fees forfeit.
Date DPrint Name Signature