HomeMy WebLinkAbout915 E 10th St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner Contractor
BURDICK JOHN C
25293 HIGHWAY 112
CLALLAM BAY
Other Fees
Fee summary
WA 983269607
T \Policies \I 102_15 building permit inspection record05 wpd [1/4/2005]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
07 00000287
844302
915 E 10TH ST
06 30 00 0 2 8376 0000
DAN BURDICK
RES REMODEL
RS7 RESDNTL SINGLE FAMILY
4000
OWNER
Date 3/30/07
Permit BUILDING PERMIT RESIDENTIAL
Additional desc INTERIOR REMODEL REROOF
Permit pin number 97451
Permit Fee 123 75 Plan Check Fee 49 50
Issue Date 3/30/07 Valuation 4000
Expiration Date 9/26/07
Qty Unit Charge Per Extension
BASE FEE 95 75
2 00 14 0000 THOU BL -2001 25K (14 PER K) 28 00
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
03/26/2007 02 42 PM SROBERDS The proposal does not
result in structural addition only remodel No land use
issues anticipated
MAINTAIN CLEARANCES FROM SERVICE WIRES
Any modifications to the City s electrical facilities will
be at the customer s expense
Electrical load calculations and elctrical permits are
required
Public Works Utility Engineering has no requirements for
this plan review
STATE SURCHARGE 4 50
Charged Paid Credited
Due
Permit Fee Total 123 75 123 75 00 00
Plan Check Total 49 50 49 50 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 177 75 177 75 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 as 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 co .truction or the performance of
construction
(2diire,,/ y/z/
Signature of Contractor or Authorized Agent Date Signature of 0 er (if owner is builder) D ate
BUILDING PERMIT INSPECTION RECORD
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS 0
CALL 417 -4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO CODER, INSULATE OR CONCEAL ANY WORK BEFORE k
N
INSPECTED AND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED I COMMENTS
I
FOUNDATION:
FOOTINGS
SHEAR WALLS WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
W ALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL/FLOOR CEILING
MECHANICAL
ROUGH -1N
HEAT PUMP /FURNACE /DUCTS
GAS LINE
WOOD STOVE /PELLET /CHIMNEY
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING &HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING /LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT 417 -47:35
\'ES NO
1 FIRE 417-4653 I I
I BUIL D N G DEPT 417 4815 CX al ill 1. 6
T \Policies \I 102 15 building permit inspection record0` wpd [1/4/2001]
FINAL
FINAL
SEPA.
ESA.
SHORELINE:
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW ENGINEERING
FIRE DEPT
PLANNING DEPT
BUILDING
DATE ACCEPTED BY.
DATE ACCEPTED BY.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE i,
DATE YES NO COMMERCIAL DATE I ACCEPTED
YES I— NO
Cb
V\
it 01--2-7-2
perm �v�
t, Dom.
1 n424(04
145- 154
bu■l. °0 sk'cn,
T Forms /Building pivisloniN
ores
NOTES
PREPARED 10/11/07 8 45 34 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/11/07
ADDRESS 915 E 10TH ST SUBDIV
TENANT NBR DAN BURDICK
CONTRACTOR PHONE
OWNER BURDICK JOHN C PHONE
PARCEL 06 30 00 0 2 8376 0000
APPL NUMBER 07 00000287 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 9/05/07 JLL BLDG FRAMING TIME 01 00
9/05/07 AP 09/04/2007 09 42 AM LPANGRLE
DAN 461 0657
FRAMING
REQUESTED AN INSPECTION BETWEEN 1 00 3 00 PM IF POSSIBLE
09/05/2007 04 22 PM JLIERLY
BL99 01 9/05/07 JLL BLDG FINAL TIME 01 00
9/05/07 AE 09/04/2007 09 43 AM LPANGRLE
DAN 461 0657
BLDG FINAL RE ROOF ONLY PORTION OF THIS PERMIT
REQUESTED AN INSPECTION BETWEEN 1 00 3 00 PM IF POSSIBLE
09/05/2007 04 23 PM JLIERLY
will final on remodel completion/j11
BLI 01 10/11/07 JLL BLDG INSULATION
A, October 11 2007 8 33 22 AM 1pangrle
DAN 461 0657
G INSULATION UPSTAIRS REMODEL
g2.)
COMMENTS AND NOTES
PREPARED 9/05/07 9 10 52 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 9/05/07
ADDRESS 915 E 10TH ST SUBDIV
TENANT NBR DAN BURDICK
CONTRACTOR PHONE
OWNER BURDICK JOHN C PHONE
PARCEL 06 30 00 0 2 8376 0000
APPL NUMBER 07 00000287 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 9/05/07
BL99 01 9/05/07
BLDG FRAMING TIME 01 00
09/04/2007 09 42 AM LPANGRLE
DAN 461 0657
FRAMING
REQUESTED AN INSPECTION BETWEEN 1 00 3 00 PM IF POSSIBLE
BLDG FINAL TIME 01 00
09/04/2007 09 43 AM LPANGRLE
DAN 461 0657
BLDG FINAL RE ROOF ONLY PORTION OF THIS PERMIT
REQUESTED AN INSPECTION BETWEEN 1 00 3 00 PM IF POSSIBLE
w
COMMENTS AND NOTES
1
StGa or_`
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Applicant or Agent: Ruh►'Ck
Owner 34Afte.
Address: 91J E. 1 6°11
Architect/En /2921L
5e1g
Contractor
Address:
PROJECT ADDRESS 9 /ri E
LEGAL DESCRIPTION Lot:
CLALLAM COUNTY PARCEL NUMBER.
TYPE OF WORK.
O'Residential New Constr
Multi family Addition
Commercial 'Remodel
Repair Sign
BRIEF DESCRIPTION OF THE
gtot6M UFO I'rS (id* cc 3
lin 41-e_ <31:rudre.(toahIins
COMMERCIAL/RESIDENTIAL. Occupancy Group.
No. of Stones: n- Lot Size:1 'g x Existmg Sq
Total lot coverage
PLANNING USE ONLY
T•\FORMS\B1dgPermitform.wpd Applicant:
BUILDING PERMIT APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COMPLETE to be accepted for review If you have any questions, call
PERMITS (360) 417 -4815 FAX(360)417 -4711
ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other
State License
City
/0 PA-
1
Block:
City
Ft.
Phone:
Phone.
Subdivision.
STZF/VALUATION
Z Re -roof
Move Garage
Demohtion
Other
PROJECT
Phone:
Exp
Stove SF /SF
SF /SF
Deck SF /SF
TOTAL VALUATION
off' e wl "i!D
0360 L /57 /5
Zip 2
Phone:
Date.
FOR OFFICIAL USE 2INUY
Date Rec. _p
Permit 6
/Pate Approved:
g ate Issued:
Zip
ZONING /P�S/Ja/
y oov (X/
I'd room (l Cbgefs, /1/) ilea c d
lush modell 6f' e
Occupant Load. Construction Type:
Proposed Sq Ft. TOTAL Sq Ft.
APPROVALS
PLAN
BLDG
DPWU
FIRE.
OTAFR.
VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417 -4815 for assistance.
PLAN CHECK FEE. IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section
RI 05.3.2 of the International Buildmg/Residential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for this permit and understand t it is my responsibility to etermine what permits are required not the City's and that I
must obtain such permits prior to w
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CITY OF PORT A
i 5 The Issuance of thi pc
cations and other ata
from thereafter re ;uiri
plans, specificatiot s as
building operations bei
violation of all codes
Approval Date
ELES Construction Plans
mit based upon these plans, spe ifi-
hall not prevent the building official
g the correction of errors in said
d other data, or from preventing
tg carried on thereunder when in
nd ordinances of this jurisdiction.
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Application Number
Pin number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner Contractor
BURDICK JOHN C
25293 HIGHWAY 112
CLALLAM BAY
WA 983269607
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc RES REMODEL (1 4 CIRC
Permit Fee 48 10 Plan Check Fee
Issue Date 1/12/05 Valuation
Expiration Date 7/11/05
Qty Unit Charge Per Extension
1 00 48 1000 ECH EL -R OR RM 1 4 ALT CIRCUITS 48 10
Fee summary Charged Paid Credited Due
Permit Fee Total 48 10 48 10 00 00
Plan Check Total 00 00 00 00
Grand Total 48 10 48 10 00 00
COMMENTS /ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
121 EAST 5TH STREET PORT ANGELES WA 98362
05 00000030
511270
915 E 10TH ST
06 30 00 0 2 8376 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
OWNER
Date 1/12/05
00
0
.l
N.
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
DITCH
ROUGH -IN COVER
SERVICE
FINAL
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED
YES I NO
COMMENTS
ex ,ai dO 5 /a
PW -I 102.15 0/961
Electrical Contractor Owner
Annual Permit Alarm Carnival Commercial
x
Job wired by Electrical Contractor Owner
Electrical contractor name
Purchaser's mailing address
City
Telephone number
'Premises owner's name
,Joke- i�ukd
Address of inspection
City Pe/ Pf- /k
J
I hereby certify that I am the owner of the above named property or a licensed
electrical contractor (or the firm's authorized agent) and am making the electrical
installation or alteration in compliance with the electrical law Chapter 19.28 RCW
/signature of owner, electrical contractor or electrical administrator
Inspection
Date
WALLS
Insulation Only
Date
r /3 [.•iover
Date
/3 -0
Appr
Date
Date p ed �y
ed By Date Appr ved By
J J Date
ved By
Electrical Load Additions and or
NO LOAD CHANGES
Cl Baseboard KW
Furnace KW
Heat Pump Ton LAR
Fan -Wall KW
State ZIP
FAX number
lc
subtractions
License number
CEILING THERMOSTAT
Insulation Only
Overhead Service
Temp Service
Underground Service
Area, Building or Equipment Inspected
ELECTRICAL WORK PERMIT APPLICATION
Request Inspection
Residential Residential Maint. Signs Thermostat Telecom.
\(Installation description
4 /4•r 4 ea s n y sQ
G.ivGtsl /irn /i es; Jwy
.4,1G 54
0 Cash L7 Check
Credit Card Visa Mastercard
Card
Expiration Date
of card
DITCH
Appr ed By
Ins
e'orr� fee/ 0
41
Date
7-
Appr ved By Date
Voltage
Phase 1 3
Service Size:
Feeder Size:
Action Taken
SERVICE
FEEDER
Discover
Service Information
Approved By
Appr ved By
Electrical
ector
Owner Contractor
BURDICK JOHN C
25293 HIGHWAY 112
CLALLAM BAY
WA 983269607
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES. WA 98362
Application Number 07 00000288
Application pin number 143520
Property Address 915 E 10TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 2 8376 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
OWNER
Date 4/04/07
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc OWNER/ UPSTAIRS REMODEL
Permit pin number 97469
Permit Fee 46 00 Plan Check Fee 00
Issue Date 4/04/07 Valuation 0
Expiration Date 10/01/07
Qty Unit Charge Per Extension
1 00 46 0000 ECH EL R OR RM 1 4 ALT CIRCUITS 46 00
Fee summary Charged Paid Credited Due
Permit Fee Total 46 00 46 00 00 00
Plan Check Total 00 00 00 00
Grand Total 46 00 46 00 00 00
COMMENTS /ACTION NEEDED
DITCH
ROUGH -IN COVER
SERVICE
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FINAL
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
PW-I 102.15 14961
I,
Job wired by
Electrical contractor name
Purchaser's mailing address
City
Telephone number
x
State ZIP
FAX number
Electrical Contractor yr Owner
License number Date Expires
'Pr ses owner's nam
acnt y _T., bLI t�C.G(
Addr ss of inspection
/0 plii
W
cit
Doti 44,16,aa /4,4 7 3 6
Phone number to kiedule inspection
Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two
years after this electrical permit is finalized. (2) Owner is required to hire an electrical
contractor if above said property is for sale, rent or lease.
After reading the above statement, I hereby certify that I am the owner of the above
named property or a licensed electrical contractor. I am making the electrical instal-
lation or alteration in compliance with the electrical laws, N.E.C. RCW Chapter
19.28, WAC Chapter 296 -46B, The City of Port Angeles Municipal Code, and
Utility Specifications.
/Siggature o owner
Electrical Lo91i Additioi and or subtractions
NO LOAD CHANGES
Baseboard KW
Furnace KW
Heat Pump Ton LAR
Fan -Wall 5 KW
New
contractor or electrical administrator Expiration Date
Date 3 7 /6 7 .of card
Overhead Service
Temp Service
Underground Service
Up Sautrs
SAME DAY INSPECTION, CALL BEFORE 7 00 AM 360- 417 -4735
ROUGH -IN n THERMOSTAT
Inspection
Date
FINAL
X/�3 O7
PAR Z U
Approved By Date
Appr ed By j Date
DITCH
Area, Building or Equipment Inspected
ELECTRICAL WORK PERMIT APPLICATION
'\(Installation description
Commercial Residential
f P.dl1 nr)e l i(tq U) 1) 1 4
J
II ao CeCed ia€ w �Gl (65 a rl
`T �XfrGS (,t l�G� Ohl 7
Cash Check
Credit Card
Card
Appr ed By
7
Appr ved By
Visa Mastercard
Date
Date
Altered/Addition
Voltage
Phase 1 3
Service Size:
Feeder Size
SERVICE
Action Taken
Discover
Inspection fee
Service Information
Appr ed By
FEEDER
Appr ed By
Electrical
Inspector
~
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CffY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Applicat~on Number
pin number .0417
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
03-00000516
Date
1/10/05
~~V~
915 E 10TH ST
06-30-00-0-2-8376-0000-
RES ADDITION
Owner
Contractor
----a~
7;f?/o~
RS7 RESDNTL SINGLE FAMILY
8000
BURDICK JOHN C
25293 HIGHWAY 112
CLALLAM BAY
OWNER
WA 983269607
Structure Information
Construction Type
Occupancy Type
Other struct info
NEW 220 SF ADDNT. & INT. REMODEL
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE V-N
HARD SURFACE AREA
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
NUMBER OF UNITS
18.50
y
2.00
1320.00
7000.00
1500.00
10.00
-
\J\
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
RENEW EXPIRED PERMIT
88.37 plan Check Fee
1/10/05 Valuation
7/09/05
fT1
35.35
8000
-
Qty Unit Charge Per
Extension
46.37
42.00
o
)..
<.,
~
BASE FEE
3.00 14.0000 THOU BL-2001-25K (14 PER K)
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
54.25 plan Check Fee
5/28/03 Valuation
9/12/04
.00
o
Qty Unit Charge Per
Extension
47.00
7.25
BASE FEE
1.00 7.2500 ECH ME-VENT FAN
Permit PLUMBING PERMIT
Additional desc
Permit Fee 54.00 plan Check Fee .00
Issue Date 5/28/03 Valuation 0
Expiration Date 9/12/04
Qty Unit Charge Per Extension
BASE FEE 47.00
1. 00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 7.00
other Fees
STATE SURCHARGE
9.00
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 as 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.
Signature of Contractor or Authorized Agent
Date
T:\PLANNING\FORMS\1102.15 [11114/2003]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Applicatlon Number
pin number
03-00000516
Page
Date
2
1/10/05
. . .0417
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 196.62 196.62 .00 .00
Plan Check Total 35.35 35.35 .00 .00
Other Fee Total 9.00 9.00 .00 .00
Grand Total 240.97 240.97 .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 as 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
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T.\PLANNING\FORMS\l102.15 [1111412003]
"
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGElDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH-IN I I
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engmeenng DIvIsIOn) SEPARATE PERMIT #'s
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTIONRW IPWI CONSTRUCTION - R W
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 ,,,/./ I(~ PLANNING DEPT.
BUILDING 417-4815 II' /11/ 'fL7 I V tA-/ BUILDING
" /'I'"
I (
T.\PLANNING\FORMS\1102.15 [11/14/2003]
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CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Property Zoning . . .
Application valuation
03-00000516
915 E 10TH ST
0630000283760000
RES ADDITION
Date
5/28/03
8000
Owner
Contractor
BURDICK JOHN C
25293 HIGHWAY 112
CLALLAM BAY
OWNER
WA 983269607
Structure Information
Construction Type
Occupancy Type . . . . .
Other struct info . . . .
NEW 220 SF ADDNT. & INT. REMODEL
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
NUMBER OF UNITS
10.00
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit Fee 176.75 Plan Check Fee 70.70
Issue Date 5/28/03 Valuation 8000
Expiration Date 11/24/03
Qty Unit Charge Per Extension
BASE FEE 92.75
6.00 14.0000 THOU BL-2001-25K (14 PER K) 84.00
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
~
--
err
54.25 Plan Check Fee
5/28/03 Valuation
11/24/03
.00
o
Qty Unit Charge Per
Extension
47.00
7.25
ft,
BASE FEE
1.00 7.2500 ECH ME-VENT FAN
..
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
---
54.00
5/28/03
11/24/03
Plan Check Fee
Valuation
.00
o
a
~
Qty Unit Charge Per
1.00 7.0000 ECH
BASE FEE
PL- EA. FIXTURE ON ONE TRAP
Extension
47.00
7.00
Other Fees
STATE SURCHARGE
4.50
(i)
:-t
Fee swnmary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 285.00 285.00 .00 .00
Plan Check Total 70.70 70.70 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 360.20 360.20 .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 orwork is suspended or abandoned
for a period of 180 days after the work as 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.
Signature of Contractor or AuthOrized Agent
Date
5'-;). fr -t> J
Date
T:IPLANNINGIFORMSll102 15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417 -4815 FOR BUILDING INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS ~-I'2.-n< J.t-
WALLS C---,I";l 0').,. .1.1-
FOUNDATION DRAINAGE ~,.~-o~ J. L
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT. #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN 0-1 C/-oJj J.)....
WATER LINE ~,.,., ,0'3 \ L.
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS Q-jq-O+ J.l
CEILING I I
FRAMING ~ Y"On1 II'l-(t /~JJ...J~s- J.L
JOISTS / GIRDERS
SHEAR WALL r;-=-!l. J -~}.l RIJ
WALLS / ROOF / CEILING 1-:~ f- 0 J.) J .).,
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING 1'Z.-lCn>-J 1.....1 L.
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engmeenng DIVISIon) SEPARATE PERMIT #'s
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARA TE PERMIT #'s SEPA
PARKING/LIGHTING ESA
LANDSCAPING SHORELINE'
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R W / PW/ CONSTRUCTION - R W.
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 4 I 7-4653 FIRE DEPT
PLANNING DEPT. 417-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
T \PLANNING\FORMS\1 102.15 [4/2002]
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COMPLETE to be accepted for review. !fyou have any questions, calJ
(360) 417-4815
FOR OFFICIAL USE ONLY'
Date ReC~. J ~--d5
-- I _^""':l
Permtt #: '-'---J
DateAPP~
Date Issued:
BUILDING PERMIT - APPLICATION
Applicant or Agent: \ Ib h 11 C R u v J~.i
Owner: l.1Jh,,., C- + KC:'Y't Ijl'\. 13 f.Jvdu!~/k
Address: q / 5 E / ~ ~ City:
Architect/Engineer: s..d {
Contractor <eo { t. (Jt'hn c.
Address: tf'L; Ci. bt ,/l-.
CI3. .. ~A 1/r
Phone: 9b3-::J.l{ sf? / 71$7- IS-..s;-r
I
Phone:
R,,,..., A 1'11~j..:.."S,
Zip: 7~ '3~2
Phone:
~ 1361\1-
{5v" ..J,/.jr State License #: 1511(DI c.)/<- Exp:
City:
Phone:
Zip:
PROJECT ADDRESS: QI4,- E; /1'J"77- ZONING:
LEGAL DESCRIPTION: Lot.fr:bl'i- Block: P- f"3 SubdIvision:
CLALLAM COUNTY PARCEL NiwBER: to 6 3~~O ft. f<~ ? 6 (()(!)fX)
Credit Card Holder Name:
Billing Address:
Credit CardType VISA M~ #
TVPEOFWORK: ". ".~,:, SIZENALUATION:..'....,.. .,
llYResidential 0 NewConstr. .0 ;Re~roof 0 Stove 27.-0 SF..@$' 3~:of -/SF. ~$ ~.~
'" 0 Multi-farmly IiJ"J\ddition ~ "[J"M6;~;' '., 0 Garage ~F. @$": ,'.,.:' /SF. = $
o ..Conunercial ci Remodel. "~.Qe~~itioi1.: o~ Deck " SF. @ $._....~-','.. ""/SF. ;='$
o Repai~. '.:: 0 '~ign ; 0 Other .' .TOTA.Ly~.LJi~n9~L. . $
,..,:, BRIEF DEScio:P1iCiJN ORml(PRoiECT, " , ":~~~l"""'~'!~" .....~A '( ~ .~/- 16z;~ ." :
.' . ~~~ ' '~~~'':~4.- ,~,\? ___" __ ~ _
COMMERCIALIRESIDENTIAL~': 6~cup~cy Group: Occupant Load: ~:.'1C~nstruction Type:
- '-It> lJ e ).I{ j) of
No. of Stories: & Lot Size: ? ~ EXISting Sq. Ft. /3.7-& & Proposed Sq. Ft. .2 '?d, - = TOTAL Sq.Ft. / !7(}O
Existing lot coverage I~. l{ % & Proposed lot coverage , ~ 1.. '1... % = T otallot coverage 18'. l. %
L()1:;. ~o3...3 S"l ~h"_
.
City:
Exp. Date:
APPROV AlLS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESA/WetIand(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BIDLDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you WIth information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure wIll be reVIewed
and may be revised by the Building DiviSIOn to comply with current fee schedules. Contact the Permit Coordmator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee IS due it must be submitted at the ttme the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit Issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applIcant up to 180 days upon written request by the applicant (see SectIOn 107.4 of
the Umform Building Code, current edition). No applIcation can be extended more than once.
I hereby certify that I have read and examined this application and know the same 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 ,not the City's, and that I must obtain such permits prior to work.
T.\FORMSlAPPSlBm""""""" wpd Applicant ~ <-. ~ Date,:r -~- d ~
PREPARED 10/16/06, 9 44 41
CITY OF PORT ANGELES
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
915 E 10TH ST
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
BURDICK JOHN C
06-30-00-0-2-8376-0000-
03-00000516 RES ADDITION
SUBDIV
PHONE
PHONE
8/14/03
8/14/03
8/14/03
8/14/03
8/25/03
8/25/03
2/19/04
2/20/04
3/15/04
3/16/04
5/26/04
XXXXXXXXXX
10/16/06
II
JLL
AP
JLL
AP
JLL
AP
JLL
AP
JLL
AP
RV
~
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BUILDING FOL~DATION WALL
BUILDING FOUNDATION FOOTING
BUILDING FOUNDATION DRAINAGE
TIME 17 00
BI2 01
BL1 01
BLFD 01
BL3 01
BLI 01
BL9 01
BL99 01
BUILDING FRAMING
JOHN 963-2438 OR 457-1549
BUILDING INSULATION
dan
BUILDING SHEARWALL
DAN
BUILDING FINAL TIME 13 00
DAN 457 1549 THIS PERSON CLAIMS
FINAL, THIS PERMIT WAS EXTENDED
OF 06
10/16/2006 08.00 AM DYASUMUR
HE SPOKE TO YOU FOR A
ON JAN 05, AND EXPIRED JULY
PAGE
DATE
1
10/16/06
-------------------------------------- COMMENTS AND NOTES --------------------------------------
PREPARED 1/14/05, 12 56 10
CITY OF PORT ANGELES
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
1
1/14/05
------------------------------------------------------------------------------------------------
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
915 E 10TH ST
SUEDIV,
PHONE
PHONE .
BURDICK JOHN C
06-30-00-0-2-8376-0000-
03-00000516 RES ADDITION
------------------------------------------------------------------------------------------------
PERMIT, BPR 01 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
BL3 01
t/14/05 JLL
\ ,\oil \ & S- -f.\-y-
BUILDING FRAMING
JOHN 461--0657
CALL 15 MINUTES BEFORE INSPECTION SO OWNER CAN MEET YOU
THERE
-------------------------------------- COMMENTS AND NOTES -----------------------_______________
PREPARED 5/26/04, 13.26'41
CITY OF PORT ANGELES
-------rNSPECTION TICKET-
INSPECTOR ROGER VESS
PAGE
DATE
5
5/26/04
------------------------------------------------------------------------------------------------
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
915 E 10TH ST
SUBDIV
PHONE
PHONE .
BURDICK JOHN C
06-30-00-0-2-8376-0000-
03-00000516 RES ADDITION
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BI2 01 8/14/03 JLL BUILDING FOUNDATION WALL
8/14/03 AP
BL1 01 8/14/03 JLL BUILDING FOUNDATION FOOTING
8/14/03 AP
BLFD 01 8/25/03 JLL BUILDING FOUNDATION DRAINAGE TIME 17 00
8/25/03 AP
BL3 01 2/19/04 JLL BUILDING FRAMING
2/20/04 AP JOHN 963-2438 OR 457-1549
BLI 01 3/15/04 JLL BUILDING INSULATION
3/16/04 AP dan
BL9 01 5/26/04 RV / BUILDING SHEAR WALL
AP I<'v DAN
-------------------------------------- COMMENTS AND NOTES ----------------------------__________
.--
PREPARED 2/19704~13 02 00
CITY OF PORT ANGELES
INSPECTION-TICKET
INSPECTOR JAMES L LIERLY
ADDRESS
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
915 E 10TH ST
BURDICK JOHN C
06-30-00-0-2-8376-0000-
03-00000516 RES ADDITION
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
8/14/03 JLL
8/14/03 AP
8/14/03 JLL
8/14/03 AP
8/25/03 JLL
8/25/03 AP
2/19/04.l X:n
:;2..\''\~'1 ~
-------------------------------------- COMMENTS
BI2
01
BL1
01
BLFD 01
BL3
01
SUBDIV
PHONE
PHONE
BUILDING FOUNDATION WALL
BUILDING
BUILDING FOUNDATION FOOTING
FOUNDATION DRAINAGE
BUILDING FRAMING
JOHN 963-2438 OR 457-1549
~\(L s~\
?\J~b ~vJ
AND NOTES
~
--
TIME
17 00
~~
~{J
PAGE
DATE
1
2/19/04
PREPARED 3/15/04, 12.15.09--- ---INSPECT.ION-TICKET
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY
PAGE
DATE
1
3/15/04
ADDRESS
CONTRACTOR
OWNER
PARCEL .
APPL NUMBER
915 E 10TH ST
SUBDIV
PHONE
PHONE
BURDICK JOHN C
06-30-00-0-2-8376-0000-
03-00000516 RES ADDITION
-------------------------------------------------------------------------~----------------------
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BI2 01 8/14/03 JLL BUILDING FOUNDATION WALL
8/14/03 AP
BL1 01 8/14/03 JLL BUILDING FOUNDATION FOOTING
8/14/03 AP
BLFD 01 8/25/03 JLL BUILDING FOUNDATION DRAINAGE TIME 17 00
8/25/03 AP
BL3 01 2/19/04 JLL BUILDING FRAMING
2/20/04 AP JOHN 963-2438 OR 457-1549
BLI 01 ~tf ~ ~~~LDING INSULATION
------------------{------------------- COMMENTS AND NOTES -----------------------------------___
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date e-2'5- 6>
Time
Received by
Rt/
(phone, person)
Location of Work to be inspected 9 t ,C;- E 10 'i L.1.
Name of person requesting inspection
Address of person requesting inspection
Type of Inspe"o "rcle appropriate one):
Phone No.
Permit No.
inal Sewer Excav. Other .
Sew Foundation
\
D r-t:<.' "" ~ e
INSPECTION NOTES:,)... ---i_-
Inspected: Date 0 / ~ / i)3
Remarks:
$"1&
Time~
~
Bv-Bl
RESTORATION REQUIRED. . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date t9 r- /11 I (J :3
I
~
Time
?!aU
cr (5" E f 0 ih
(JOA1 f3 u /d l(~_k
Received by ~ A r./
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of circle appropriate one):
Se r Foundatio Framing Chimney Plumbing Final
I SPE~OTE
.-/
Inspected: Date
Remarks:
Phone No. J-fs7 1(~7-{ 9
Permit No. Sib
Time
Sewer Excav. Other
BY~
RESTORATION REQUIRED . . . . .. YES NO
~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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John C. & Karolyn Burdick
25293 Highway 112
Clallam Bay, WA 98326
Phone: 360-963-2438
Residence in Question: Owners: John C. & Karolyn Burdick
915 E. 10th
Port Angeles, W A. 98362
Phone: 457-1549
Parcel # RP063000-028376-0000
Prop. Description: LT13EXCW40'and LTI4EXCE2' (Land DL283)
PROJECT DESCRIPTION: MARCH 2003
1. We propose to remove the kitchen nook 5' by 8' existing on the west side of the
structure, and the front entry porch roof and lattice work.
2. Then we would like to build an addition to the west side 10' by 22' .
3. In addition we would like to remove the west wall in the downstairs bedroom, which
. is also the east wall of the stairway to upstairs, and remove the stair system. The removal
of this wall would require a beam set in its place (to be engineered).
4 . We would like to remove a portion of the north wall of the existing kitchen, and set a
beam in its place. (to be engineered).
Sincerely,
John Burdick
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CITY OF PORT ANGELES - Construction Plans
The Issuance of this permit based upon these plans, specifi.
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
plans, specIfIcations and other data, or from prevenbng
bUlldmg operations being carried on thereunder when in
vIOlation of all codes and ordinances of this jurisdicbOn.
(SECTION 303(c) - Uniform Buildmg Code.) /'"':>. J
Approval Date S -zca -65 By ~
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
121 EAST 5TH STREET. PORT ANGELES. WA 98162
ELECTRICAL PERMIT
PERMIT NO. 6796
ISSUED: 11/05/1999
OWNER/APPLICANT
DAN BURDICK
915 E. 10TH
PCRT ANGELES, WA 98362
360/457-1549
~ &
CONTRACTOR
ANDERSCN ELECTRIC
pc BCX 1638
FCRKS, WA 98331
360/374-7515
PROPERTY LOCATION J/J
"lIS- C /D T""-
Lot:
Block: D Long Legal
Subdivision:
Parcel No:
ARCHITECT
N/A
, 98360-0000
360/000-0000
PROJECT INFO
Project Type: RES. MISC.
Cccupancy Type:
Cccupancy Group:
Electrical Heat:
D Baseboard
D Fumace
D Heat Pump
D Fan Wall
Project Value: $0.00
Construction Type: SERVICE CHANGE
Zoning Use:
o KW
o KW
o KW
o KW
D Riser D
~ Overhead Service
D Temp Service
Underground Servi ce
Voltage: 120,240
Phase: ~ 1 D 3
Service Size: 200
Feeder Size: 0
PROJECT NOTES
CHANGE SERVICE, NO. ADDED LCAD
FEES ASSESSMENT
Service:
Additional Feeders:
Circuit Wiring:
Temp Service:
Misc Fee:
TCTAL FEE:
AMOUNT MID:
BALANCE DUE
COMMENTS/ACTION NEEDED
$59.25
$0.00
$0.00
$0.00
$0.00
$59.25
$59.25
$0.00
.i \l9 7-(0
JJt.
. /0 ...~S
~((~
ELECfRICAL PERMIT INSPECfION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
nrrr:H
~ Cl-IN ICUVhK
'Ir.E Ilk- /9"1
1;'ThTAT T T I
GENERAL COMMENTS:
PW-II02.1514'96l
ELECTRICAL PERMIT APPLICATION
FOR OFF1C!.A.L USE ONLY
Dalc/Rec
Permit/!:
Dale Approved
Dale Issued
"
The Electrical Permit Application must be filled out comoletelv.
Please type or reprint in ink. If you have any questions, please call (360) 417-4735
Fax number: (360) 417-4711
Owner or Elec. Contractor Agent:
,',v1">11 C
c 6.),..-,J,,,,Je
6u I'd; ck Phone: --157- 1,';1 Fax:
Property Owner: '-..\0 h f)
Address: ~ '9 J :5
Phone:
c:~"-
Zip: ~3 3b2
13.
ilJ7h...
City: p/,V} I~""b>
License #:
Exp:
Phone:
Electrical Contractor:
()IA/Yl~"'--
Address:
City:
Zip:
INSTAllATION WIRED BY: ~WNER
Credit Card Holder Name:
o ELECTRICAL CONTRACTOR
Billing Address:
City:
Zip:
Credit Card Number:
Exp. Date:
VISA: MC:
<1,5 E.
IO~
'Sr;- ,
PROJECT ADDRESS:
TYPE OF WORK:
Check;ill that apply: 0 New
'W Alteration/Addition
9\Residential 0 Multi-family
o Commercial 0 Mobile Home
Sq. Ft
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
Number of Circuits added or altered: 7
,
o Low Voltage 0 Telecom. 0 Sign
DESCRIPTION OFTHE ELECTRICAL PROJECT: k),r;", of Md,';',..... {/(e($Y..fo tld,p.,..,.,.,:f 030<>>Nr>':;'b)
I I . ,
. . /,;;11-
K..,,},,-. w^J.....-;',e<0 Moll ;HMI.c..-, Mil ~,;II"I.:, (~./,')' ee'lf./'
-....o~ 'iiI''"''. 1/,0 <;.iO 4'/''!-- ((I'lOVlNb KI~ tl'llle ~01T1bN \
I j
Electrical Heat Load Additions and or Subtractions Service Information
<;-" s 1...dlt ~,
1
:t Z.;)~!-
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
_KW
KW
TON_ LRA
of;/> t KW
/.2... K.0
IV
-
!oJ1 R.~
o Overhead Service
o Temp Service
o Underground Service
Voltage: 1'1.0/ 'to!" "
Phase: ~ f 0 3
Service Size: 1J>c
Feeder Size:
I hereby certify that / have read and examined this application and know that same to be true and correct, and / am
authorized to apply for this permit. / understand it is not the City's lega/ responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such.
I ~- ~4,
I (r III Owner or Elec. Cont. Signature:
( ./ /J rt!: l' /, 1-4 h~l.:lo
4 -/ND ~(,c+ vJ 'tile! tJ-n/ -=- +~JC5,2.o r-,2.:z:.
I'J I . S I S PERMIT FEE: $ 1O ,.JO
C:/ELECTRICALPERMITAPPLlCATION \ 1\-Jf;Z.- 6..-t;.
1~'3 -OLf Aco 10 · It. · ill r.-L-#L-
Credit Card Holder's Signature:
Date:
Date: 1-I3-tJ!
Application Number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
BURDI CK JO HN C
25293 HIGHWAY 112
CLALLAM BAY
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
WA 983269607
Charged
Signature of Contractor or Authorized Agent
T\PLANNING\FORMS \l 102.15 11/14/2003]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
03 00000516
915 E 10TH ST
06 30 00 -0 2 8376 0000
RES ADDITION
RS7 RESDNTL SINGLE FAMILY
8000
Contractor
OWNER
STATE SURCHARGE
Paid Credited Due
Date 2/02/04
Structure Information NEW 220 SF ADDNT INT REMODEL
Construction Type TYPE V NON RATED
Occupancy Type SINGLE FAM CONGREGATES
Other struct info TOTAL t LOT COVERAGE 18 50
CONSTRUCTION TYPE V N
HARD SURFACE AREA
NUMBER OF STORIES 2 00
EXISTING LOT COVERAGE 1320 00
LOT SIZE 7000 00
PROPOSED LOT COVERAGE 1500 00
NUMBER OF UNITS 10 00
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit Fee 62 30 Plan Check Fee 00
Issue.Date 2/02/04 Valuation 0
Expiration Date 7/31/04
Qty Unit Charge Per Extension
1 00 46 7000 ECH EL -R OR RM 1 -4 ALT CIRCUITS 46 70
3 00 5 2000 ECH EL -R OR RM ALT ADDNT CIRCUITS 15 60
4 50
62 30 62 30 00 00
00 00 00 00
4 50 4 50 00 00
66 80 66 80 00 00
Separate'Pe"rmits 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 as 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 Si ature of Owner (if owner is builder)
a :2-
Date
ELECTRICAL LIGHT DEPT 417 -4735
CONSTRUCTION R.W PW/
ENGINEERING
FIRE
PLANNING DEPT
417 -4807
417 -4653
417 -4750
BUILDING 417 -4815
T•\PLANNING\FORMS \1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT
ROUGH -IN
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE PELLET CHIMNEY
HOOD DUCTS
PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING /LIGHTING I I I ESA.
LANDSCAPING I I I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
10.14.•444)
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT
PLANNING DEPT
1 BUILDING
I I I