HomeMy WebLinkAbout1201 Forest Trail - BuildingSeptember 13, 2010 4 49.24 PM 1pangrle
PER SUE R'S DIRECTION, ON 07 -26 -10 I CONTACTED BRUCE EMERY (417-
3669) AT GREEN CROW TO SEE IF THE CC &R'S ALLOW AN ADULT FAMILY
HOME AT THIS LOCATION BRUCE STATED THEY DON'T, BUT MAYBE THE
APPLICANT COULD GET A VARIANCE. THEN I PHONED THE APPLICANT
AND TOLD HIM ABOUT THE CC &R'S NOT ALLOWING THE ADULT FAMILY
HOME, BUT THAT A VARIANCE MAY BE POSSIBLE
ON 09 -13 -10 I PHONED THE APPLICANT, TODD SIRES, TO ASK WHETHER OR
NOT HE IS GOING TO OPEN THIS BUSINESS HE STATED NO, NOT AT THIS
TIME DUE TO THE CC &R'S
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PREPARED 6/30/10 8 08 39 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/30/10
ADDRESS 1201 FOREST TR SUBDIV
TENANT NBR 2ND CHAPTER ADULT FAM HM
CONTRACTOR PHONE
OWNER TODD BARBARA SIRES PHONE (360) 461 9566
PARCEL 06 30 14 6 7 0180 0000
APPL NUMBER 10 00000674 CO- CHANGE OF OCCP /USE
PERMIT CO 00 CHANGE OF OCCUP /USE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
CO99 01 6/30/10
BLDG C/O FINAL TIME 01 00
OVERRIDE TAKEN BY LPANGRLE DATE 06/30/10 TIME 08 08 26
June 30 2010 8 07 24 AM 1pangrle
TODD 461 9566
C OF 0 FINAL 2ND CHAPTER ADULT FAMILY HOME
AFTERNOON
COMMENTS AND NOTES
rC)Rr CERTIFICATE OF OCCUPANCY APPLICATION Permit 0 Off
4>
CITY OF PORT ANGELES
Attn Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
PLEASE PRINT IN INK
Check one New business in P.A.?iit Change of ownership only? Moving location from within P.A.?
BUSINESS NAME 2 hd') C_. r �d.rj 1+ 1 1 b ti'- e t-L-C
Business address 12,0 I Eige_s- 1- ra.`, Mailing address I ZO1 1jve4-I- 1td
Phone number 461 9544 -Opening date 9 /O Days hours of operation Z4/7
Business owner's name t bGl' Sires Contact phone 34p 4L,/ q54„6
Business owner's address I2.!)1 R yep f' '1
Brief description of business Adu /f -Cann, /y. `t,,n.e 4- n v k
Property owner's name 1pc/,f C b4rc S, -es" Contact phone 5'1"
Property owner's address /contact /7 1 4 I
BUILDING DEPARTMENT phone 417 -4815
FIRE DEPARTMENT phone 417 -4653
Is the business a restaurant or bar that will seat 50 or more people? Yes El No
Construction changes planned (moving walls, adding /enlarging windows or doors roofing siding foundation work,
adding /altering stairways ramps bathrooms electrical heating /cooling /ventilation systems etc)
Work planned Aft5Vf
Changes to a fire sprinkler system or fire alarm system? Yes No
Work planned
PBIA (Parking Business Improvement Area Downtown) phone 417 -4623
Square footage of business? C, (5b
Is business moving within the PBIA? Yes No X.
COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750
Number of off street parking spaces available for employees and customers?
(A parking plan may be required
Signs? (wall- mounted freestanding projecting awning A -frame etc
Signs planned /)0 l, b
PLEASE NOTE NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
Page 1 of 2
FEES
$50) Certificate Inspection
-$tee. Parking Business Improvement Area (PBIA)
fee charged for Downtown locations
Bldg approval by 1,1l on CI t3r) O
Fire approval by on
PBIA notified
CED approval by
it /A
S on _3
e_
C /TY CLERK phone 417 -4634
Second -hand dealer /pawnbroker business? Yes No ;f
Will there be dancing at this business? Yes No
A City of Port Angeles Business License is required for Taxi, Peddlers, Second -hand dealer Pawnbroker Dance,
Hotel- Motel, Fireworks, ambulance, and Tattoo businesses.
PUBLIC WORKS DEPARTMENT ENGINEERING phone 417 -4812
Is site work planned (new or re- located sewer or water service excavation grading or filling work in City right -of -way
new driveway openings site parking lots downspouts irrigation system backflow devices etc.)
Yes No XI
Work planned
PUBLIC WORKS WASTEWATER phone 417 -4845
Will waste other than domestic household waste be discharged into the sewer system? Yes No
If yes what will be discharged:
I hereby apply for a Certificate of Occupancy I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge Incorrect information may result in revocation of
permit.
1
Date Zq Print Name 1 601 j d 1 re S Signature
T' \Forms\Building Division Certificate of Occupancy Application (2010).doc
Page 2 of 2
City Clerk approval by SN on 7- 13 --1,O
PWE approval by RV on Z-2-6 Ito
No C oninteXt#S
t
PWW approval by on
d
G-tJl�'
e,a52 call Kex\ 1 uc Rrv. Marsha
417- `-f 6s 3 -F0 v- o- ee_4- -e
of occv pan fift'
C519-th Yl�
.k.
.u3+
Clallam County Assessor Treasurer Property Details 67504 TODD /BARBARA SIR. Page 1 of 5
Clallam County Assessor Treasurer
Property Search Results 67504 TODD /BARBARA SIRES for Year 2010 2011
Property
Account
Property ID 67504 Legal Description: RIEDEL II SUBD PHASE II
LOT 18 31A
Geographic ID 0630146701800000 Agent Code
Type Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11
Open Space. N DFL N
Historic Property N Remodel Property N
Multi Family Redevelopment: N
Township Section
Range
Location
Address: 1201 FOREST TRAIL DR Mapsco
PORT ANGELES WA \X
Neighborhood' Cycle 4 Res Map ID
Neighborhood CD 10952130
Owner
Name TODD /BARBARA SIRES Owner ID 52552
Mailing Address. 1201 FOREST TRAIL DR Ownership 100 0000000000%
PORT ANGELES WA 98362
Taxes and Assessment Due
Property Tax Information as of 06/29/2010
Amount Due if Paid on. M.
Exemptions.
Year Statement ID Taxing Jurisdiction
2010 49337 ST SCH STATE SCHOOL
2010 49337 CC -GEN COUNTY
2010 49337 PORT PORT
2010 49337 PORT ANG PORT ANGELES
2010 49337 SD #121 SCHOOL DISTRICT #121
2010 49337 NTH OLY LIB NORTH OLYMPIC LIBRARY
2010 49337 HOSP #2 HOSPITAL #2
2010 49337 WSMET PK DIST WILLIAM SHORE MET PARK DIST
2010 49337 CITY STORMWATER CITY STORMWATER
2010 49337 FIRE PATROL FIRE PATROL
2010 49337 WEED CONTROL WEED CONTROL
2010 49337 FP Fee FIRE PATROL COUNTY FEE
2010 49337 TOTAL.
2009 675042008 ST SCH STATE SCHOOL
2009 675042008 CC-GEN COUNTY
2009 675042008 PORT PORT
2009 675042008 PORT ANG PORT ANGELES
2009 675042008 SD #121 SCHOOL DISTRICT #121
First Half Second Half
Base Due Base Due Penalty Interest Base
$518 96 $518.96 $0 00 $0 00 $51
$276 17 $276 18 $0 00 $0 00 $27
$38 82 $38 81 $0 00 $0 00 $7.
$639 42 $639 45 $0 00 $0 00 $6Z
$672.18 $672.20 $0 00 $0 00 $67
$80.25 $80.25 $0 00 $0 00 $E
$113 30 $113.29 $0 00 $0 00 $11
$36 05 $36 05 $0 00 $0 00
$36 00 $36 00 $0 00 $0 00
$8 70 $8 70 $0 00 $0 00
$0 82 $0 81 $0 00 $0 00
$0.25 $0.25 $0 00 $0 00
$2420.92 $2420.95 $0.00 $0.00 $242
$541 89 $541 89 $0 00 $0 00 $10E
$274.26 $274.22 $0 00 $0 00 $54
$38.85 $38 84 $0 00 $0 00 $7
$601 54 $601 52 $0 00 $0 00 $12C
$670 15 $670 13 $0 00 $0 00 $134
http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =67 6/29/2010
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
SIRES TODD BARB
942 STRAIT VIEW DR
PORT ANGELES WA
PORT ANGELES
Other struct info
Permit
Additional desc
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
Qty
1 00
5 00
Other Fees
Fee summary
WA 98362
Unit Charge Per
69 0000 ECH
22 0000 5C
Charged
COMMENTS/ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
06 00001208
942448
1201 FOREST TR
06 30 14 6 7 0180 0000
TODD BARB SIRES
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
274748
Contractor
TOTAL LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
ELECTRICAL NEW RESIDENTIAL
EXTRA MILE/ 3728 SQ FT SFR
100891
EXTRA MILE
179 00
5/10/07
11/06/07
TECH ELECT LLC
Plan Check Fee
Valuation
EL R SQFT FIRST 1300
EL R SQFT ADDITIONAL 500
Special Notes and Comments
12/04/2006 11 36 AM SROBERDS Project is a sfr in the
RS 9 No land use issues are noted
Address numbers shall be plainly visible from the street
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background
Electrical load calculations and elctrical permits are
required
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
Construct driveway to City Standards No concrete with
exposed aggregate allowed in the City road right of way An
inspection by Public Works Engineering is required prior to
prouring concrete
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
Paid Credited Due
Date 5/10/07
ACCENT CONST OF SEQUIM INC
942 STRAIT VIEW DRIVE
SEQUIM WA 98382
(360) 683 3307
27 50
1 50
14418 00
3966 00
3966 00
1 00
870 00
4 50
1200 00
0 0
0
Extension
69 00
110 00
CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT I S UNL,4WFUL TO COMA
s INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED
DITCH
INSPECTION TYPE DATE ACCEPTED
YES I NO
ROUGH -IN COVER
SERVICE
FINAL
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
COMMENTS
PW -I IOI.IS 14/901
Application Number 06 00001208
Application pin number 942448
Permit Fee Total 179 00 179 00 00
Plan Check Total 00 00 00
Other Fee Total 2074 50 2074 50 00
Grand Total 2253 50 2253 50 00
COMMENTS /ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Page 2
Date 5/10/07
00
00
00
00
ELECTRICAL PERMIT INSPECTION RECORD
'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.
GENERAL COMMENTS:
�r=
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED
YES I NO
DITCH 3 s Y o 7
ROUGH -IN COQ 5 07
SERVICE 15=Y- o )I
FINAL �4 d JI
COMMENTS
rw uo2.j5I4/96J
MAY -01 -2007 10 22 PM E JANSSEN
CAC ectrical Contractor Owner
D Arauni Permit 0 Alarm O Carnival 0 Commercial
1
4b wired by
Eicc rical contractor name License number
X tr[ tC Cl -1C f4'/
Purc peer's mailing address
t. ►.l RACE 5
Ct
Tclel hone number
-4C
Pre Ices owner's name
ck a 1. -E S
Add eat of Inspection
I her certify that I am thc owner of the above named property Or a licensed
elect[ ical contractor (or the firms authorized agent) and ant making the electrical
instal ation or alter [ton in compliance with thc electrical lacy Chapter 19.2S RCW
/Slgrtioture o owner, cicctrienl contractor or ad min Is(rator
WALLS
(nsulativn Only
Dgle Approv
C over
'Approve.
O NO OAD CHANGES
O as. board KW
Ilf ace if KW
Ili'Heir Pump ILITon LAP
O Fan Nall KW
Q 2 2001
__IOC(
Ca'�lectrlcai Contractor Owner
State LIP �r
FAX, number
346 7 SP S ts
sr
CEILING
Insulation Only
.r vel
11,
n&ent2r subtractions
Inspection
hate
,5 *7/3, CoN,cy
I
I rx JJ'a3 Fi ,4L
F
Arca, Building or I .guipmcnt Inspected
ELECTRICAL WORK PERMIT APPLICATIO
Cl Request Inspection
is Residential Residential Maine. Signs CI Thermostat O Telecom.
/Installation description 1
Of.t4D al") tk,
4
3 5 0
372
O Cash Check
Credit Card Visa
C
Expiration Date
of card
'I'HERMOSI'AT
nnte
DITCH
:S- 9 -v 7
nntr
L] Overhead Service
v Temp Service
IA/underground Service
360 452 2982
S4 rt
Ns, 7 SERVICE
npprnv d tt J bate Approval Py f
FEEDER
Mastercard Discover
rov d nay J Dart: npprnvrp By
Sgrylco Irttbrmat'Q l
voltage
Phaso Get
03
Service Size: !to A
FFoeder Size: 'Liar 910
ANNINIMINIMINEIN
Action Taken
P 01
i
Inspection fee
Electrical
Inspector
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
SIRES TODD BARB
942 STRAIT VIEW DR
PORT ANGELES WA
PORT ANGELES
Other struct info
Other Fees
Fee summary
WA 98362
Charged
COMMENTS /ACTION NEEDED
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
06 00001208
942448
1201 FOREST TR
06 30 14 6 7 0180 0000
TODD BARB SIRES
RES NEW SFR
RS9 RESDNTL SINGLE FAMILY
274748
Owner Contractor
ACCENT CONST OF SEQUIM INC
942 STRAIT VIEW DRIVE
SEQUIM WA 98382
(360) 683 3307
TOTAL LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
Permit ELECTRICAL NEW RESIDENTIAL
Additional desc DAVES HEATING LV T STAT
Permit pin number 99739
Sub Contractor DAVE S HEATING COOLING
Sub Contractor DAVE S HEATING COOLING
Permit Fee 35 00 Plan Check Fee
Issue Date 4/25/07 Valuation
Expiration Date 10/22/07
Qty Unit Charge Per
1 00 35 0000 EC EL LOW VOLTAGE
Special Notes and Comments
12/04/2006 11 36 AM SROBERDS Project is a sfr in the
RS 9 No land use issues are noted
Address numbers shall be plainly visible from the street
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background
Electrical load calculations and elctrical permits are
required
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch 24 hour advance
notice is required
Construct driveway to City Standards No concrete with
exposed aggregate allowed in the City road right of way An
inspection by Public Works Engineering is required prior to
prouring concrete
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
Paid Credited Due
Date 4/25/07
27 50
1 50
14418 00
3966 00
3966 00
1 00
870 00
4 50
1200 00
00
0
Extension
35 00
U
0
7
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
DITCH
ROUGH -IN COVER
SERVICE
FINAL
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
YES I NO
PW- 1102.15 141961
CITY OF PORT ANGELES
PUBLIC WORKS ELECTRICAL DIVISION
121 EAST 5TH STREET PORT ANGELES, WA 98362
Page 2
Application Number 06 00001208 Date 4/25/07
Application pin number 942448
Permit Fee Total 35 00 35 00 00 00
Plan Check Total 00 00 00 00
Other Fee Total 2074 50 2074 50 00 00
Grand Total 2109 50 2109 50 00 00
COMMENTS /ACTION NEEDED
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
SERVICn
FINAL
INSPECTION TYPE
GENERAL COMMENTS:
ELECTRICAL PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
I /a /s/' '7 I oriteki
I
I. I
I I
DATE
ACCEPTED
YES I NO
COMMENTS
Pwa 102.1514 1
Apr 11 07 04
Electrical contractor name
Job wired by
Da ve- 1 5 14e4+1
Pur haler s ailing address
D 6a,c 413
6r-i-Anes49.5
T 1 h b11
4,
r
Daves Heating Cooling
FAX number
Ele ical Load Additions and or subtrdetions
O kb LOAD CHANGES
Baseboard KW
S urnace KW
(Heal Pump Ton 1155 LAR
Fan -Wall KW
Lif Electrical Contractor CI Owner
License number
/Avt-sHc99I� C,
Stale ZIP
oth '7 3 6 a
Date Epires
4.57c 9
c cp on nu
(3t5��4st- c0T3
'Premises owner's name
c cer,+ con -k-c-1i or 7;4 cf, 5t
Ad Jc i ress of inspecti n
Pore 5+ Trot
Ci
r -r e-1 es
Phone number to Ithedule inspection
(8'New
Owner as defined by RCW 19 28.261 (1) Owner will occupy ,ht. structure for two
sears after thus electrical permit is finalized (2) Owner is required to hire an electrical
contractor if above scud 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 ant making the electrical Metal
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.
/Sig lure of owner electrical contractor or electrical admi istr tor ExptrationDate
X �,�i Date ofcard
Overhead Service
O Temp Service
O Underground Service
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360 417 -4735
ROUGH -IN t THERMOSTAT
Inspection
Date
Date
N Date
y z3 -D7 I
Appro ed By
FINAL
Dau.
Approved uy IYalc,
ELECTRICALWORKPERMITAPPLICATION
1(Installation description
Commercial rU Residential
Approved By J
DITCH
Area, Building or Equipment Inspected
o (4) �V o +4c
'f o S'A'N* CA'
Cash Check
Er'C,i dit Card
Card
360- 452 -0939 p 1
Altered/Addition
Atquo d By Date
Mastercard
Voltage
Phase 0 t 3
Service Size:
Feeder Size
re.
Discover
C
Inspec 35--
Service Information
r SERVICE s\
Date Approved By
FEEDER
Approved By
Action Taken
Electrical
Inspector
siD) CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
32\ EAST 5TH STREET. PORT ANGELES. WA 98362
~
,......-~-- "' " "-
"" -.. , ----
Applicat20n Number 07-00000054 Date 1/24/07
App12cat2on pin number 404078
Property Address 1201 FOREST TR I
ASSESSOR PARCEL NUMBER' 06-30-14-6-7-0180-0000-
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning . RS9 RESDNTL SINGLE FAMILY
Application valuation 0
Owner Contractor
------------------------ ------------------------
SIRES, TODD & BARB EXTRA MILE TECH & ELECT., LLC
942 STRAIT VIEW DR 418 N RACE ST
PORT ANGELE~, WA PORT ANGELES WA 98362
PORT ANGELES WA 98362 (360 ) 457-0198
----------------------------------------------------------------------------
Permit ELECTRICAL TEMPORARY SERVICE
Additional desc EXTRA MILE/ 60A TEMP SVC
Permit p2n number 93591
Sub Contractor EXTRA MILE TECH & ELECT , LLC ,",
Permit Fee 40.00 Plan Check Fee 00
Issue Date 1/24/07 Valuation 0 \.)
Expiration Date 7/23/07
Qty Unit Charge Per Extension \)
1. 00 40 0000 ECH EL-TEMP SRV - 0-60 SRV FDR 40 00 -..
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40.00 40 00 .00 00 .......
Plan Check Total .00 .00 .00 .00 '(\
Grand Total 40.00 40 00 .00 .00 t>
{'
~
1.\
?
:
COMMl~NTS/ACTION NEEDED
ELE\..l IdCAL PERMIT INSPECfION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COJlERo
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE .
.. \oh' ,!,{:110N TYPE I DATE I ACC... ...... COMMENTS
YES I NO
DITCH
RUU<.iH-lN I CUVER
SERVICE
FINAL I j- J jj.~o7 I M.t.?~ I
I
I
GENERAL COMMENTS:
.PW-II01.IS 14I96l
.
:
.
~.., I.';:JPORT~ CITY OF PORT ANGELES
6"!~~~
ha DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
.. ~ 32! EAST 5TH STREET, PORT ANGELES, WA 98362
~
-, "_. --
-- ._-,
Application Number . . 06-00001208 Date 12/07/06
Application pin number 942448
Property Address 1201 FOREST TR
ASSESSOR PARCEL NUMBER: 06-30-14-6-7-0180-0000-
Tenant nbr, name. . . TODD & BARB SIRES
Application type description RES NEW SFR
Subdivision Name
property Use
Property Zoning . RS9 RESDNTL SINGLE FAMILY
Application valuation 274748
Owner Contractor
------------------------ ------------------------
SIRES, TODD & BARB ACCENT CONST. OF SEQUIM INC. ""
942 STRAIT VIEW DR. 942 STRAIT VIEW DRIVE
PORT ANGELES, WA SEQUIM WA 98382
PORT ANGELES WA 98362 (360) 683-3307
,~.
...
Other struct info . TOTAL % LOT COVERAGE 27.50
NUMBER OF STORIES 1. 50
LOT SIZE 14418.00
PROPOSED LOT COVERAGE 3966.00
TOTAL LOT COVERAGE 3966.00
NUMBER OF UNITS 1. 00
----------------------------------------------------------------------------
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc .
Permit pin number 90282
Permit Fee 2000.25 plan Check Fee 800.10 ~
Issue Date 12/07/06 Valuation 274748
Expiration Date 6/05/07
Qty Unit Charge Per Extension
BASE FEE 1020.25
175.00 5.6000 THOU BL-100,001-500K (5.60 PER K) '980.00
----------------------------------------------------------------------------
Permit MECHANICAL PERMIT
Additional desc .
Permit pin number 91652
Permit Fee 111.40 Plan Check Fee .00
Issue Date 12/07/06 Valuation 0
Expiration Date 6/05/07
Qty Unit Charge Per Extension
BASE FEE 50.00
7.00 7.2500 ECH ME-VENT FAN 50.75 1?
1. 00 10.6500 ECH ME-VENT SYSTEM OTHER 10.65
----------------------------------------------------------------------------
Permit PLUMBING PERMIT I)
Additional desc . ~. ~
Permit pin number 91660
permi t Fee 184.00 Plan Check Fee .00 '~ V
Issue Date 12/07/06 Valuation 0
Expiration Date 6/05/07 y
Qty Unit Charge Per Extension "0
BASE FEE 50.00 /
15.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 105.00
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00
Separate Permits are required foreJectrical work, SEPAl 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. v8OJJ~
~ ~/74p
Signature of Contractor or Authorized Age::i Date Signature of Owner (if owner is builder) . ,
Dale
- -.
T:IPoliciesll 102_,5 building pc=!! ;,,"pection record05.wpd [1/4/2005]
-
BUILDING PERMIT INSPECTION RECORD '.
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL AN}' WORK BEFORE
INSPECTEI}A./YP A..(CE~T~I1~POST PE~MIT IN A SQ)'lSPICUOUS LOCATION.
_~ ,.KEEP"PERMIT~CARD AND APPROVED PLANS ATJOB SITE.
"'''''= "'o';:"INSPECTION.TYPE~~" "ACCEP,TED~ COMMENTS:t.."":.~'-~''''''
'"~~,~, YES "',"- '~O ~'"-, ',,.:,' .,,,-ftii~,.15!1'~
FOUNDATION:
FOOTINGS I I
I SHEAR WALLS 1 WALLS I I
r FOUNDATION DRAINAGE 1 DOWN SPOUTS I I
I PIERS I I I
i POST HOLES (POLE SLOGS.) I I I i
I PLUMBING I
, UNDER FLOOR 1 SLAB I I
ROUGH.IN I
-WATER LINE (METER TO BLDG) j I
S'1g~~R PAN, I?;.;+;.'i ;"ij f DATE ACCEPTED BY:
~"n"~ME"DI-GAGGASLiNE. ,.... . ,,'j";:-:::;'-::::'.1~1
"1 'Ai'~SEAL~ ,', . __.. .". ... __ .._".. ~'4 -'.'="'';?''
~ WALLS I I I '.
. --,(;0"'--
....; '-"CEILlNGL~;.,..c,~~, ;......""'''''''.". ' I I.. _..~--I-..~ "~;:.~:
'~ FRA~ING . ., f'\--" --:--.. . . ''''...
d:.,j '~J61StS~GlfiDERSr;,}~.. .*'r~~.,;.') I I -"
:00 :;;_._-~~ ~.~f..ItU".?~e._ "';~W~~'n~~~ I?.,,~ ' "',' . I
"~.'.'.'..j '7""SHMRWlAiWn6ITD!DOWNS~""""~-:"'''.-~7 -',-', . "I
,~" r-l'~. _:-". '~', -~~' ~ ,~1.;s;~-""", >. ,;>",Y :.';:;-"I'U",: ~S-h'l'V~:.'
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""r~::AttrrNTeRiOR.IOO:EO<PANELONLY) · ~.. IT i j
INSULATION
SLAB I \ I
W AL.:l1 FLOOR 1 CEILING I
MECilANICAL 'c -
HEAT POMP / FURNACE 1 DVCfS I
01\5 LINE I
WOOD STOVE 1 PELLET 1 CHIMNEY I FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD 1 DUCTS j I
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING &: HOLD DOWNS
~~ ~
I I I i
I PLANNING DEPT. SEPARATE PERMIT#'s SEPA:
r :ut;AA---;RN~KD"'S!NC-:GA!P~-IIN~GH.~~N~.:-:,.. ,.::'" - , SESHAO:RELJNE
_ "'::~~~t, ~ -;. - . .::: ::-=:--1:, . .
- -. ,"~. "" .
, -" FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL I DATE I YES I NO COMMERCIAL DATE I ACCEPTED
~ YES.. NO.
ELECTRICAL" LIGHT DEPT. 417-4735 L ELECfRlCAL I ,<
LIGHT DEPT
I CONSTRUCTION R.W.I PWI 'CONSTRUCTION - R.W.
ENGINEERING'. 417.4807/,. PW 1 ENGINEERING
FIRE 417-4653.' ". ,FIRE DEPT."
PLANNING DEPT. n' __ 4 i 7-4750 I _ PLA~G DEPT,
II BUILDING 417.d8!5 BUILDING _...
T:Ipoliciesli !02 15 huiiding pennit inspection reconl05,wpd [l/4/2005J
~;<O;:~'('" cui OF PORT ANGELES
J~~ DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
~ 32!EAST 5TH STREET, PORT ANGELES, WA 98362
~cv;;..<"
Page 2
Application Number 06-00001208 Date 12/07/06
Application pin number 942448
Qty Unit Charge Per Extension
1.00 15.0000 ECH PL- EA. BLDG SEWER .15.00
1.00 7.0000 ECH PL- EA. WATER HEATER 7.00
.t~ ______________________________________________________----~---~-------------
'"'[ .. Special Notes and Comments '. '-
12/04/2006 11:36 AM SROBERDS --Project is a sfr in' the
j. RS-9. No land use issues are noted.
,.' Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
.._~. of contrasting color from the background.
0/1 Electrical load calculations and elctrical permits are
c.':' required.
."'S.. Sanitary sewer connection inspection is required by
:r ) Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway to City Standards. No concrete with
- exposed aggregate allowed in the City road right of way. An
inspection by public Works Engineering is required prior to
prouring concrete.
----------------------------------------------------------------------------
Other Fees SEWER SYSTEM DELV CHARGE 870.00
STATE SURCHARGE 4.50
PW WATER SYSTEM USE FEE 1200.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 2295.65 2295.65 .00 .00
Plan Check Total 800.10 800.10 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 5170.25 5170.25 .00 .00
i
,./ .-....
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f.~ ,}
'~': ":~
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fi .
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11
, --
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, jf 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.
I Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date.
- - ---- !
T;iPoliciesll 102_15 buildillc "crmil inspccli01l Jecord05.wpd [1/412005]
BUILDING PERMIT INSPECTION RECORD -
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CA~L 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS uNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTEDANDACCEPTED. PO~T PEB.M!T IN ~ ,cgl'ls.p!~aJOUS LOCATION.
::.' .'_' _.KEEP.,P.ERMIT.;CARD AND A~~ROVED P.LANS'A'I',UOB;SITE.' ,.,o";,C,;r;,.,,,.,,.
INSPECTIoNTYPI!:;'~;'~'F~""#'1 DATE""'~C)lc:-";-~ACCEBJ2E~~~~IIi~-;:"';;S:;::;~'*~if.cqfvIM~NTS";c;'~h~'.:~~~~f~~
YES 1 NO .. -~..._, ..... _._,~
FOUNDATION: I
.1 FOOTINGS 11!)'I~j k {; -.J ~. I ~
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, ,';J 0" ~
i FOUNDATION DRAINAGE / DOWN SPOUTS ~,'~^1 Lv
I PIERS I I
POST HOLES (POLE BLDGS.l I I I I I ,
...... ~
PLUMBING 5 {I~ (OJ. Go.. $ Ii he.- :)LL
UNDER FLOOR / SLAB I I
ROUGH.IN I 75 J If;, J Or I :S'.LL-
'WATERL;I~E(METI3R TO BLDGl I' '".:,{...' .; ;., - ,'; "'.": ,.;-~,. -. .
..' ..-. ~". '~-" .,. .'-_.'-~ -".<
"jSHOWER'PAN;;,'.;;: -ry l;M-Qi~l; "4jp~ -';:;;'::''- .~ ~,Fi~~L[{~~J:~-~O~;DATE '~E}~:;AE-~rirIED BY:
",;:'.' ~.~~-"""".-.,'-' "--~"""-
i' ~'!;f!6?(JAS,UNE:;...,~.~i ~~;;~i;'T~~:~: ;:-: -~,~~ ~::~:\':':~:"::i7E1~t~: "'--~~~' -;~-t~~~~~_~~-
-. 'AlR}SEALf:' ~}t$f.g;t:f;~i:~~~:~ -:-- ..
I - -IJil~I--'" 'I~~ I ....-....,:. ."~--~' _.-
WAl.;LS ,~..,t JC;~ 'n\'77. ' " i ....,. .,'
': I' ~;cEiL:iN(f",.,;;t....,;; '~".-;........"'''''' e"=- ,'" 'r~M'~I*",",;;;c,'-"" " ., '-'" ,
~,~..:..-
_.l'i7~~..L ";:~_.._... ... - --- --... -.....--.-. --.._- ._~'C'1:__ I ;''i.';:po.;'.
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,. . 'j\ '..:.:=::s::: - -€'
~l ~~~l!:~?:00rW{C~~~NJ~~~~~~~~~3 ~...\~;EY'-._ =" ,
~DRy,WALC:(rNTERIOR'BRACED PANEL"ONLY) oj,! ~ '/ J vV
I T.BAR I I
I INSULATION
I SCAB 1,' ( I Q) I
tl~",W:AU~~OO~(fEI~ING ))/7;~ .' D 7 t!!.....
~ -,.r...,. -,~,..., ".
-MECHANICAL" -
"HBAT PUMPI FURNAcE / DUCTS -
z.~
GAS LINE '9> I Hi I 0, :JlA..,.- I 0 - ZG:. --Oi G~~ \I h~ :r~L
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ACCEPTED BY:
COMMERCIAL HOOD / DUCTS I I
I MANUFACTURED flaMES
FOOTING / SLAB I
" BLOCKING'&:' HOLD DOWNS I
I .SKlRTING i I
~ PLANNI~G DEPT. SEPARATE PERMIT II's I
SEPA: ~
J'ARKING/LIGHTIII/G 1 I I ESA:
.;;':'.-='''~' ",.!,..~...,._<"____.._,.-..w .'
-;UANDSQ!\P,~q~~~s;:~3~;~~~~~~41;;~~~~f~4~1~.fi1L~ ~~j ~Q.~llii;in....,i~~~~~~::: ,.::.
~
_ ." ,.. '-'. ~ .., ,.."" FINAuiNSPECTIONS REQUlREO'PR10R,TO OCCUPANCY/USE~1l:-'''';.,,,~;:t .n~.-,,~::'Y" "
'. . ".. .',,-.-. ....-. . .. .
.., . RESIDENTIA~< ., DATE ~,' YES. NO,::: __ ;:;~~M:n:CI~~ _.. _I... ~ATE
EL~cffucAL:GGHT DEPT. .'!.'0~' 417.4735' .o'.-,~IECTRICALi;;,hs, \,.'-.'i
- L.tOHT DEPT .. . '~~.;'.-~.:...:'t:" 't:'.
.- "::'. '.,.. ..
I
CONSTRUCTION R.W.; PWI __I CONSTRUCTION. R,W.
ENGINEERING 417.4807 PW / ENGINEERING
.-
j FIRE ~ 17-4653 ',.r FIRE DEPT.-::- o' ~ ...
- -".-,
I PLAN)\lING DEPT. --. ~--_... ..... - .--~ ,
417-4750 PLANNING DEPT. I I
.. - -
I BUILDING 417-4815 -::r w--- BUILDING
T."n..l;";~.\ll(J) ~;iidinl! nennit inspeclion rewld05.wpd [1/4/2005] '"
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--- --------- ----------
^ t, CITY OF PORT ANGELES
iJ~,", DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
~I- -=--- 321 EAST 5TH STREET, PORT ANGELES, WA 98362
~
Application Number 06-00001208 Date 12/07/06
Application pin number 942448
Property Address 1201 FOREST TR
ASSESSOR PARCEL NUMBER: 06-30-14-6-7-0180-0000-
Tenant nbr, name TODD & BARB SIRES
Application type description RES NEW SFR
Subdivision Name
Property Use
Property Zoning . RS9 RESDNTL SINGLE FAMILY
Application valuation 274748
Owner Contractor
------------------------ ------------------------
SIRES, TODD & BARB ACCENT CONST. OF SEQUIM INC.
942 STRAIT VIEW DR. 942 STRAIT VIEW DRIVE
PORT ANGELES, WA SEQUIM WA 98382
PORT ANGELES WA 98362 (360) 683-3307
Other struct info . TOTAL % LOT COVERAGE 27.50
NUMBER OF STORIES 1. 50
LOT SIZE 14418.00
PROPOSED LOT COVERAGE 3966.00
TOTAL LOT COVERAGE 3966.00
NUMBER OF UNITS 1. 00
----------------------------------------------------------------------------
Permit BUILDING PERMIT -RESIDENTIAL
Additional desc .
Permit pin number 90282
Permit Fee 2000.25 Plan Check Fee 800.10 ~
Issue Date 12/07/06 Valuation 274748
Expiration Date 6/05/07
Qty Unit Charge Per Extension
BASE FEE 1020.25
175.00 5.6000 THOU BL-100,OOl-500K (5.60 PER K) 980.00
----------------------------------------------------------------------------
Permit MECHANICAL PERMIT
Additional desc .
Permit pin number 91652
Permit Fee 111.40 Plan Check Fee .00
Issue Date 12/07/06 Valuation 0
Expiration Date 6/05/07
Qty Unit Charge Per Extension
BASE FEE 50.00
7.00 7.2500 ECH ME-VENT FAN 50.75 12
1. 00 10.6500 ECH ME-VENT SYSTEM OTHER 10.65.
----------------------------------------------------------------------------
Permit PLUMBING PERMIT I)
Additional desc . ~ ~
Permit pin number 91660
Permit Fee 184.00 plan Check Fee .00 "~ ~
Issue Date 12/07/06 Valuation 0
Expiration Date 6/05/07 y
Qty Unit Charge Per Extension "0
BASE FEE 50.00 /
15.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 105.00
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 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 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. v8QJJ.~
~ ~Jp
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\Policies\] 102_15 building pennit inspection record05.wpd [1/412005]
------
- .
BUll.,DING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
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 I DATE I ACCEPTED COMMENTS
I YES I NO
FOUNDATION:
FOOTINGS I I I 1
SHEAR WALLS / WALLS I I I
FOUNDA nON DRAINAGE / DOWN SPOUTS I I I
PIERS I I I
I I I I I
I POST HOLES (POLE BLDGS.)
I PLUMBING
UNDER FLOOR / SLAB I
ROUGH-IN I
WATER LINE (METER TO BLDGl I
SHOWER PAN I I FINAL DATE ACCEPTED BY:
I MEDICAL GAS LINE I I I
I AIR SEAL 1
I WALLS I I I
i CEILING I I I I
I fo'RAMING r~i .....,"'-
- .
I JOISTS / GIRDERS 't~ . I I
I SHEAR WALL/HOLD DOWNS . I
WALLS / ROOF / CEILING I I
DRYWALL (fNTERIOR BRACED PANEL ONL Yl I I
T-BAR I I I
INSULATION I
SLAB I I I I
WALL / FLOOR / CEILING I
MECHANICAL I
I HEAT PUMP / FURNACE / DUCTS 1
I GAS LINE 1 FINAL
I WOOD STOVE / PELLET / CHIMNEY DATE ACCEPTED BY:
r COMMERCIAL HOOD / DUCTS I I
MANUFACTURED flOMES
I FOOTING / SLAB I
I BLOCKING &. HOLD DOWNS I
I SKJRTING I I
I I
PLANNING DEPT. SEPARATE PERMIT#'s SEPA:
PARKING/LIGHTING I I L ESA:
LANDSCAPING SHORELINE:
-' FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE I
-- ..
RESIDENTIAL DATE YES , NO I COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 I I ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W./ PWI I I CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
I FIRE 417-4653 ,., GDEPT.
I PLANNING DEPT. 417-4750 I I . PLANNIN~ DEPT. I
I BUILDING 417-4815 BUILDING I
T:\Policies\1102_15"btilldi~g pennit inspection record05.wpd [1/4/2005]
. _ ~l"ORT"'-'\.! CITY OF PORT ANGELES
,::-C~~~
G~~ DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
~~. 321 EAST 5TH STREET, PORT ANGELES, WA 98362
-- .y
~" y;;;:;
Page 2
Application Number . 06-00001208 Date 12/07/06
Application pin number 942448
Qty Unit Charge Per Extension
1. 00 15.0000 ECH PL- EA. BLDG SEWER 15.00
1. 00 7.0000 ECH PL- EA.WATER HEATER 7.00
----------------------------------------------------------------------------
Special Notes and Comments
12/04/2006 11:36 AM SROBERDS --Project is a sfr in the
RS-9. No land use issues are noted.
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
. of contrasting color from the background.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway to City Standards. No concrete with
exposed aggregate allowed in the City road right of way. An
inspection by Public Works Engineering is required prior to
prouring concrete.
----------------------------------------------------------------------------
Other Fees SEWER SYSTEM DELV CHARGE 870.00
STATE SURCHARGE 4.50
PW WATER SYSTEM USE FEE 1200.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 2295.65 2295.65 .00 .00
Plan Check Total 800.10 800.10 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 5170.25 5170.25 .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 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 Signature of Owner (if owner is builder) Date
T:\Policies\! 102_15 building pennit inspection record05,wpd [1/4/2005]
~-
BUll.,DING PERMIT INSPECTION RECORD - .
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEALANJ' WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
. .
INSPECTION TYPE I DATE I ACCEPTED I COMMENTS
I YES I NO
FOUNDATION:
I FOOTINGS ''i;!J.bfe (, ..J S-L-. *
I SHEAR WALLS 1 WALLS , ,'?J/'o~ c:-)J.L,.. 1f/2.0/or ~\"€4KWtk.H TLL ~i+
. FOUNDATION DRAINAGE 1 DOWN SPOUTS I I-.;Ti? J Lv
I PIERS ' ,.
i POST HOLES (POLE BLOGS,) I I I '
-
PLUMBING r N
UNDERFLOORISLAB I I S/I;(Of Gc...S IIVl€... :rLL t)
ROUGH-IN 5' JIb 10-' I :r LL-I ()\
WATER LINE (METER TO BLDG) .
SHOWER PAN I "1/? II tJ[ I ~ t.-l.-- FINAL 12 -I ~ ~o 7 DATE :J t-L-- ACCEPTED BY:
MEDICAL GAS LINE I \,
AIR SEAL
WALLS I 511'::ijl'\l I~LL I
CEILING
I rRAMING
I JOISTS 1 GIRDERS I I
I SHEAR W ALlJHOLD DOWNS I
I WALLS 1 ROOF 1 CEILING f / I
DRYWALL (rNTERIORBRACED PANEL ONLY) (;/~/~ -j .JVV I
T-BAR I I I I
INSULATION
SLAB I ' I I /5\ I
I WALL! FLOOR 1 CEILING ~ /7/ , J D / C!..!:- J
I MECHANICAL · ~
I HEAT PUMP / FURNACE 1 DUCTS I ~
I GAS LINE ~) 15! flf ~~ I I 0- Z~--(jl Go..$\Ih~3'L.L z.. ~
I WOOD STOVE 1 PELLET 1 CHIMNEY FINAL /2-.-(Lj.-07 DATE -:rL.-l.-- ACCEPTED BY: ~ -
I COMMERCIAL HOOD 1 DUCTS I I I c.. .
MANUFACTURED HOMES \n i
FOOTING 1 SLAB ~
BLOCKING & HOLD DOWNS
I SKIRTING I -4
I PLANNING DEPT. SEPARATE PERMIT#'s j SEPA: w;\
I PARKING/LIGHTING I I I J ESA ~
I LANDSCAPING h_ SHORELINE: -
F'iNAL INSPECTIONS REQUIRED PRIORTO'OCCUPANCYIUSE \
RESIDENTIAL DATE I YES I NO COMMERCIAL I DATE ACCEPTED
YES NO
ELECTRICAL- LIGHT DEPT. 417-4735 I ELECTRICAL I
LIGHT DEPT
I CONSTRUCTION R.W.I PWI I I CONSTRUCTION - R. W. I
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 I I FIRE DEPT. I
PLANNING DEPT. 417-4750 PLANNING DEPT. I I
BUILDING 417-4815 BUILDING
T:\Policies\1102_15 building pennit inspection record05.wpd [1/4/2005J.. '"
-- ------- --------------------
~ CITY OF PORT ANGELES
PUBLIC WORKS - UTILnlliS DIVISION
~ 321 EAST 51HSTREET, PORT ANGELES, WA 98362
Application Number 06-00001208 Date 12/07/06
Application pin number 942448
Property Address 1201 FOREST TR
ASSESSOR PARCEL NUMBER: 06-30-14-6-7:0180-0000-
Tenant nbr, name TODD & BARB SIRES
Application type description RES NEW SFR.
Subdivision Name
Property Use
Property Zoning . RS9 RESDNTL SINGLE FAMILY
Application valuation 274748
Owner Contractor
------------------------ ------------------------
SIRES, TODD & BARB ACCENT CONST. OF SEQUIM INC.
942 STRAIT VIEW DR. 942 STRAIT VIEW DRIVE
PORT ANGELES, WA SEQUIM WA 98382
PORT ANGELES WA 98362 (360) 683-3307
Other struct info . TOTAL % LOT COVERAGE 27.50
NUMBER OF STORIES 1. 50
LOT SIZE 14418.00
PROPOSED LOT COVERAGE 3966.00
TOTAL LOT COVERAGE 3966.00
NUMBER OF UNITS 1. 00
----------------------------------------------------------------------------
Permit PUBLIC WORKS RES WATER SERV
Additional desc . 5/8" DROP IN METER
Permit pin number 91942
Permit Fee 175.00 Plan Check Fee .00
Issue Date 12/07/06 Valuation 274748
Expiration Date 6/05/07
Qty Unit Charge Per Extension
BASE FEE 175.00
----------------------------------------------------------------------------
Permit RIGHT OF WAY
Additional desc .
Permit pin number 91926
Permit Fee 50.00 Plan Check Fee .00
Issue Date 12/07/06 Valuation 274748
Expiration Date 6/05/07
Qty Unit Charge Per Extension
1. 00 50.0000 ECH RIGHT OF WAY PERMIT 50.00
----------------------------------------------------------------------------
Permit SANITARY SEWER HOOK UP
Additional desc .
Permit pin number 91934
Permit Fee 110.00 Plan Check Fee .00
Issue Date 12/07/06 Valuation 274748
Expiration Date 6/05/07
Qty Unit Charge Per Extension
1. 00 110.0000 EA SAN SEWER HOOKUP 110.00
----------------------------------------------------------------------------
Special Notes and Comments
12/04/2006 11:36 AM SROBERDS --Project is a sfr in the
RS-9. No land use issues are noted.
Address numbers shall be plainly visible from the street.
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. ~Jr JJ;; --------./
7\ . b_/r2.-7~~
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder). Date
T:\Policies\J J 02. J SR (1/05]
PERMIT INSPECTION RECORD .
".
CALL 417-4807 FOR UTILITY 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 I DATE I ACCEPTED COMMENTS
YES I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTIER
DRIVEWAY APPROACH I I I
BACK-FLOW DEVICE
I I I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W./ PW/ CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
-
T:\Policies\1 102. I 5R [1105] .
~of:~~ CITY OF PORT ANGELES
~ PUBLIC WORKS - UTILulliS DNISION
~ 321 EAST 51HSTREET, PORT ANGELES, WA 98362
Page 2
Application Number 06-00001208 Date 12/07/06
Application pin number 942448
----------------------------------------------------------------------------
Special Notes and Comments
Address numbers shall be a minimum of six.inches high and be
of contrasting color from the background.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway to City Standards. No concrete with
exposed aggregate allowed in the City road right of way. An
inspection by Public Works Engineering is required prior to
prouring concrete.
----------------------------------------------------------------------------
Other Fees SEWER SYSTEM DELV CHARGE 870.00
STATE SURCHARGE 4.50
PW WATER SYSTEM USE FEE 1200.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 335.00 335.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 2409.50 2409.50 .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.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) . Date
T:\Policies\1102.15R [1/05]
- -.--
.
PERMIT INSPECTION RECORD
..
CALL 417-4807 FOR UTILITY 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 LOCA,TION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE I DATE I ACCEPTED COMMENTS
YES I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GtJ I I r....
DRIVEWAY APPROACH I I I
BACK-FLOW DEVICE
I I I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W./ PW/ CONSTRUCTION, R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING -
T:\Policies\11 02.1 5R [1105] .
r~ -
I ~-=-("
0\ pOln ,tv' FQR OFFICJJ;.L}:!SE pNL Y:
~~b'?; BUILDING PERMIT - APPLICATION D"'R"I/ftbfOc"
(hr-~~\ permit~-I-:2CJe>
\;~;._ 2':.:..:.:~::.:.::C/ Fill out COMPLETELY and in INK. Your application and site plan :M1JST BE Date A roved' If)~ l~
~~ COIVIPLET~~~~I;:;~~~~~ ~~J;~:~'~~w. ;~(~:~):~ ;~~,;~~cstiGns, c~l1 ate ls::ed:.Ij~ I
.
Applicant or Agent: I(} d d ~ 6t\.~ b ~"'Ire~ Phone: '3 <00 - 45 L - q s <a s-
Owner: :1(/" vn e..' Phone:
Addres~ g 4- Z. ~+V"~~ ~ \f;ewdVCity?nrt- ,Af\5-e\e-s Zip: q~3~A..
l\rchitectlEngineer: Phone:
Contractor A c.c..e '" ~ Co nsf State License #: Ace,: NCS o~~D BJUJIOJ Phone: 4' (-qs ('L
Address: CfLt2 51 ra.l J Il ;~w d..- City: Por;' 1+ ~d't's Zip: 9 83 b 7-
PROJECT ADDRESS: /'201 Jov(~~-f 1Mfl..;.--<'-,.;; ZONING:
LEGAL DESCRIPTION: Lot: I B Block: ,Subdivision: K,' e.d ~ i -D 17 h.a s~ f I
CLALLAM COUNTY PARCEL NUMJ3ER: 0 to ~ D I 4 fa 7 D I B 0
TY"PE OF WORK: SIZE/V.UUATION: , '
~ Residential 9<New Constr. 0 Re-roof ~ Stove '2-17 j, SF.@$7fP,.,oq/SF.= $ Z:-1.-lZt-~
o Multi-family 0 Addition 0 Move 0 Garage)i..A.J!:- qS Z. SF. @ $1t) t.* /SF. = $- ?/t:PbC>
o Commercial 0 Remodel 0 Demolition 0 Deck llfin SF. @ $ .' /SF. = $-:V1:M:.Z: .. -
o Repair 0 Sign 0 Other TOTAL VALUATION $ "'L~
BRIEF DESCRIPTION OF 1.J:::U!; PROJECT: /\!-(w '3 ~t:l.t:.AJ>Yh. kt;'\W' ~ W/ bo"".s ran ~
~holl"< q~r~f!..
COl\1JVIERCLU/RESIDENTIAL: Occupancy Group: Occupant Load:. Construction Type:_
No. of Stories: Iii. Lot Size. i44 J 'lL: Existing Sq. Ft. pi' & Proposed Sq. F1 ?;tj 1t7& = TOTAL Sq. Ft.~Cd.?
Total lot coverage 1,1. f7 %
I PLANNING USE ONLY: APPROVALS:
I PLAN:
BLDG:
DPWU:
FIRE:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: 01.J:::U!;R:
j
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 tin1e of permit issuance.
EXPIRATION OF PL.A.N REVIEW: If no peront 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 Mitten request by the applicant (see Section R1 05.3.2
of the International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that I have read and examined this application and kn the same to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to d~~are e i d ,not the...City's, and t7t I must obtain such permits prior to work.
T:\Policies\BL.IIOU3.wpd Applicant: _ /~~~ I . Date: II 6-10' .
UJ2I>/J., l~\IU) ~cJ )Jt;OO f"l14 00.. '~iJl<2-'; p'~ Jt.1:
>
'f~ CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION O{p-/~t!8
321 EAST 51H STREET, PORT ANGELES, WA 98362
~;;Oi<'"
- -
Application Number 06-00001208 Date 12/07/06
Application pin number 942448 --
Property Address 1201 FOREST TR /9{J) r;; I(~<;;-r I y
ASSESSOR PARCEL NUMBER: 06-30-14-6-770180-0000-
Tenant nbr, name TODD & BARB SIRES
Application type description RES NEW SFR
Subdivision Name
Property Use
Property zoning . RS9 RESDNTL SINGLE FAMILY
Application valuation 274748
Owner Contractor
------------------------ ------------------------
SIRES, TODD & BARB ACCENT CONST. OF SEQUIM INC.
942 STRAIT VIEW DR. 942 STRAIT VIEW "DRIVE
PORT ANGELES, WA SEQUIM WA 98382
PORT ANGELES WA 98362 (360) 683-3307 j;ctl5/K-€b
Other struct info TOTAL % LOT COVERAGE 27.50
NUMBER OF STORIES 1. 50
LOT SIZE 14418.00
PROPOSED LOT COVERAGE 3966.00
TOTAL LOT COVERAGE 3966.00
NUMBER OF UNITS 1. 00
----------------------------------------------------------------------------
Permit PUBLIC WORKS RES WATER SERV
Additional desc . 5/8" DROP IN METER
Permit pin number 91942
Permit Fee 175.00 Plan Check Fee .00
Issue Date 12/07/06 valuation 274748
Expiration Date 6/05/07
Qty Unit Charge Per Extension
BASE FEE ?.l.1'J.00 ~
--------------------------------------------------------------- ------------
Permit RIGHT OF WAY
Additional desc . -~
Permit pin number 91926
Permit Fee 50.00 Plan Check Fee .00
Issue Date 12/07/06 Valuation 274748
Expiration Date 6/05/07
Qty Unit Charge Per Extension \('
1.00 50.0000 ECH RIGHT OF WAY PERMIT ~
---------------------------------------------------------------- ----------
Permit SANITARY SEWER HOOK UP
Additional desc
Permit pin number 91934
Permi t Fee 110 _ 00 plan Check Fee .00
Issue Date 12/07/06 Valuation 27474"8
Expiration Date 6/05/07
Qty Unit Charge Per ~
________=~~~______==~~~~~~_~~____:~_:~~~~_~~~~~~_____________ ______::~~oo_
Special Notes and Comments
12/04/2006 11;36 AM SROBERDS --Project is a sfr in the
RS-9. No land use issues are noted.
Address numbers shall be plainly visible from the street.
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utililies, 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 Agenl Date Signature of Owner (if Owner is builder) Date
T;\Policies\1102.15R [1105)
.
df'OR"'~ CITY OF PORT ANGELES
-.,.l~
"-&ii PUBLIC WORKS - UTILITIES DNISION
..... -- 321 EAST 5TIfSTREET, PORT ANGELES, WA 98362
~:?
- -
Page 2
Application Number 06-00001208 Date 12/07/06
Application pin number 942448
------~--------------------------------------------------------~------------
Special Notes and Comments
Address numbers shall be a minimum of six. inches high and be
of contrasting color from the background.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Construct driveway to City Standards. No concrete with
exposed aggregate allowed in the City road right of way. An
inspection by Public Works Engineering is required prior to
prouring concrete.
X -/-
----------------------------------------------------------------~ - ~
Other Fees . . . . . . . .. SEWER SYSTEM DELV CHARGE 870.00
STATE SURCHARGE 4~
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~~ _ ~~:~~ _ ::::~~ _ USE_ FEEC200. 00 . :__
Fee summary Charged Paid credited vue
----------------- ~~-------- ---------- ---------- ----------
Permit Fee Total 335.00 335.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 2409.50 2409.50 .00 .00
Separate Permits are required foreiectrical 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 Signature of Owner (if owner is builder). Date
T:\Policies\1102.15R {l/05]
,
APPLICATION FOR WATER
City Water Division, Port Angeles, WA
Issued date: 1"2. - 7 ~ 0 b Installed by & date: -/I~ Z- Z0-07 Permit # (J/~ -12-68
I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises.:
Applicant Name & Phone: -kdd.. sf "t>a,l"b '31ve"
,
Site Address: t 7..DL"fb.,asTJbu!MailingAddress: qq.? sf..r.t:I/1- }/1@fL) Dr
Blk: - Lot: I~ Add: Relief J/ 8u~e!L- Parcel #:12fL3I'J/4i'A 7/J IFVJ
Svc: ON / eJj) Meter #'s C F {)(d'D \ \"S W/O#: ~<.(j9; - 2'i<S-
~f 17 ? eR.+ lZOO~ Restoration Required: Wo.
Svc: Size-....---::; ees:
Signature: ~ Remarks:
N
f" Forre s t '/;-..; I
~ i.f70' ~ E
S" C '1= ~
\..
<::;;)
~
~
S
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Oat.. J6-Q;-o"1 Time Received by (phone, person)
Location of Work to be inspected lZ01 h 1U2-eJ::".1~ tL.J..,
Name of person requesting inspection -1'n,..J ,J -~
. -
Address of person requesting inspection Phone No. ~
Type of Inspection (circle appropriate one): Permit No. Ob- )208
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other d-V1i (J.hO"J..UC1J
INSPECTION NOTES: "
Inspected: Date lo-Q-O"l Tim" By "KI/
Remarks:
f)1<( ~ Pc> a ,.-
~
~
RESTORATION REQUIRED . . . . .. YES NO X
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved o Gravel o Asphalt OPCC o Other
o Repaired by City Work Order #
o Repaired by Permittee o COMPLETE
D No Damage Found o INCOMPLETE
~ (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST: 7<f
Oat.. 5~/s--O 7 Time Received by (phone, person I
,
/;?p/
Location of Work to be inspecterl ~<-"';::;:; -; /
}: ~;e$J /0/
Name of person requesting inspection ~t/d. . S I re3
Address of person requesting inspection Phone No. 4t;t/ - q"'5&?
Type of Inspection (circle appropriate one): Permit No. t:J6- /0108
~oundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES: \
Inspected: Date 5"-/:>--07 Timp By 'i2v
Remarks: 5-/f,-67
N.e.IA./ Lfl"/ Pre c::..oVJnf8r +,'0 VI -IA p)(;.sf/rl--=i (" 'I ;:>V( of- :PJL /
- ->
RESTORATION REQUIRED. . . . .. YES NO 'i--
-~I'o;.t:4 t
-. '" "'V\
/AI' ---.
-
- t It~.' (
'J- ro./L <;
o-'oPj
Vj
- ~~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other
o Repaired by City Work Order #
o Repaired by Permittee o COMPLETE
o No Damage Found o INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
DatL.1D- , 7 - 0., Time Received by ~\/ (phone. person)
Location of Work to be inspecterl 126\ 'J:"ore.s:t lro.~ 1
Name of person requesting inspection Todd.
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. ~- I ~a~)
Sewer Foundation Framing Chimney Plumbing (Ji;J) Sewer Excav. Other br:.'l/9 ll/rl~/
INSPECTION NOTES:
Inspected: Date /- /Lf - 6 C(:j Tim" By
Remarks:
10- R- 01 D 1< fa lJ",oJ' J>,:"". u..Ja..../
/ - (Lj-o<;" (') J<:::: ]),..'v.ewo..'/
>-/(,-0'7 S <2...W",,- .r-
RESTORATION REQUiRED...... YES NO X
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved DGravel D Asphalt DpCC D Other
D Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[] No Damage Found D INCOMPLETE
(Continue on reverse side if necessary) !;TRFFT !;IJPFRINTFNnFNT !DATEl
3613 452 2982 P.131
JAN-18-2887 89:23 AM E.JANSSEN L
G--(;) ,t'
~ ELECTRICAL WORK PERMIT APPLlCAT<ON
. ' ,- -' ~~
'"
/ f~~
lob ..Ired ~v a{leClrical Contractor o Owner Illlillnll.ltion deSCrjPliOn~
D Commorclll I\elldentllll
Eltetncnl conlrlletor name License n\.lmber DalC EKpires
fl#t.f. n4,/-t l<.e~ 4. ~/a..koJ o New o Altered/Addllloo
PurchllStr'l lnJli':J addreu -- S-<..wt,..J ,(!.1 () "(,0 ~1,
2l./9 ~ /~""r
C$d/Z..",,)j..rLJl ~~ SIUlC ZIP
,..IA- q,,~(z.
Tc~phonc number FAX rUllnbcr
pr,mhelr}'aer", ftln\e -"
-:r".;. ~,~GS
Addreu of hllpectloll
~. ;R._i ".:.vl.- __I ~/ r~",L<.,- /(
,
CI ~
phqn!::m::r to ..f:::t:!.~'''.n: '/(,,{ -/1JIf
OIV.Qt'r (J,I' d"f1',~d by HCW.J9.28.16J:(J) Oll'1l1'" .viII occuPy rh" s'I'lIrlw('/0I'/1o>iJ
yeQ~.l (ift~r II/j.f l-lrcln'f.'Cl/ pcrmit L\'jl'IP/i;;ccJ. (2) 011"11('" i.r r{!qlfirecllO IJ/r.! an efecll.;C1I/
convnClor if amw(I lioid property is lor .",/e:, I'('nt tlr 1('(I.re. o Cash o Check #
AOcir rel'lding the above 5UllemCllt. I hcrchy eertif}' Ihl\\ I <1m the Owner or the above
nRn1:d propmy or " Jiet"n~d elcClrlcal conlrl'Clor. I anI '''t'lkillS the Illl.'uricnl iIlSlil.l- o Credit Cllrd Visa Mastercard Discover
laliel" or IIItC:IlIlion ill compliance wi!" Lhl: dcctri~'alluw!i, N.E.C.. RCW. ChllPtcr Card #
19.~8. WAC. Chapler 296.469, The City or rort An~d,':s Municiral Code, slld -----.--- -------.-.-
Utility SpecificOliollJ.
SI.n.ru... n nwn." ,I,ml..1 ~' ,)wd,.' .dml."'n.., Expiration Date ($n.p~~ ";1)
x. '$ d Date: I/Ig 107 of card
IDnsan~.8M~D~~ , Sm:ldll.P Inln"".lllllll
IJ 1\10 LOAD CHANGES
Q 9aeBboard - KW Vol lag.
IJ ~urnac. _KW D Ovefnead ServIce PhaS.O 1 1:13
IJ Hoal Pump __ Ton _~ ~F1 D Temp Service Sorvlce Slz.:
o FJen-WBU _ KW CJ Underground Service Feeder Size:
SA!'1E DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 SERVlC:"""... Ur )
ROUGH-IN ( ""~IERMO~:::,, by ) (
11..,,, ^IJIlru.-ctl Bv UIl"
~~AL ~ ( DnUI ) ( FEF.DER^_....y )
L:/i~,- 0 7 ^d,"~
, n~le I\ptJf'O'\'C" HV " UIlI..
:Ift&pcclion I Aren, Ruilding or Equipment Inr;pect~d I Actiun Taken I Elcctrieal
naIl" Inspecto,
1-27....07 I 141' M
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