HomeMy WebLinkAbout520 E. 1st Street Address:
ls' Street
Tkifl� V'r
CITY OF GLV JL NGELES For City Use
-&. N
P A Permit# 4:5—/Z '2'7
W A S H I N G T 0 N , U . S .
321 East Slh Street - Date Received:
Port Angeles, WA 98362 Date Approved
P: 360-417-4817 F: 360-417-4711 E IV E n I
permits@cityofpa.us
Building Permit Application 0 C T '33"".12013
Project Address: CITY OF PORT ANGELET
52.,9 fi,4j--r BUILDING DIVISION
Main Contact: Phone # q60 V7
k-jumj Ale6t)5 --1-A- c,.,Il A441. E-Mail: J<Qvin,,
Property Name Phone
Owner gaece, &C 01(� -5-6r- &-7 9 q
Mailing Address Email
�_ c). do-,.
City, State Zip
7"-r 11-14 15�63 6 W 4
Contractor Name Phone
Mailing Address Email
city
State
P�
Contractor License # Expiration:
N I
Project Value: Zoning: Tax Parcel # Lot#
11
Type of Residential I industrial 13 Public _0
Permit Demolition gy� ,OF�' kepair 0 Reroof(tear off/lay over) 0
I V ,V
For the following,fiH ovt bofh pages of permit application:
New Construction El P\emodel 97 Addition El Tenant Improvement El
Mechanical R Plumbffi. 59 Other El
)xn�
Existing Fire Sprinkle Maximum Reight of structure Proposed Be
No 4 '/,drooms � Proposed Bathrooms
Yes 0
Project
Description
5'4 0fJ 1-ft IAf /Lh.-�
I have read and completed the application and know it to be true and correct.I am authorized to apply for this
permit. 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 Print Name Signature
Residential Structures
For Office Use
Area Description(SQ FT) Existing Proposed $$value
Basement
First Floor
Second Floor
Covered Deck/Porch/Entry
Deck
Garage
Carport
Other(describe)
Area Totals
Commercial Structures
For Office Use
Area Descriptions(SQ FT) Existing Proposed $$Value
Existing Structure(s)
Proposed Addition
Tenant Improvement?
Other work(describe)
Area Totals
Lot/Site Coverage Calculations
Footprint(SQ FT) of all Structures: Lot Size: %Lot Coverage
slrw — 7boo S,1-* 7 e, t3/o/..-
SQ FT Site coverage(all impervious+ %Site Coverage
structures) 0
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) #
Boiler/Compressor # 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 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 #
Other(describe):
T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX