HomeMy WebLinkAbout202-208 S Lincoln St - Building CiTY OF PORT ANGELES ,
°~ DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DiVISION
321EAST 5TH STREET, PORT ANGELES, WA 98362
Issue Date .... 1/16/03 Valuation .... 2915
Fee summary Charged Paid Credited Due
Separate Permits am 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 pmvisions 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
pORT 464 I FOR OFFICIAL USE ONLY:
BUILDING PERMIT APPLICATION
Date Approved: - ' ~
Date Issued:
The Building Permit Application must be filled out completely, t ~ -
Please type or print in ink. If you have any questions, please call 417-4815
Applicant or Agent: ~ ~ ~CDs'~ Phone:
Owner: ~ ~ ~, Phone: ~ ~
Address: ~ ~. ~oc~ City: ~ ~~ Zip:
~chitect/Engineer: Phone:
Con,actor ~s ~ License~: Exp: Phone:
Address:~ M~ ~~ City: ~ ~~ Zip:
eRO CX V SS:
LEG~ DESC~PTION: Lot: Block: Subdivision:
CL~L~ CO~TY P~CEL NUMBER: Credit Card Holder Name:
Billing Address: City:.
Credit Card ~: Exp. Date: ~SA MC
T~E OF WO~: SIZE~UATION:
~ Residential ~ New Consm ~ Re-roof ~ Wood-stove SF. ~ $ /SF. =$
~ Multi-fa~ly ~ Addition ~ Move ~ Garage SF. ~ $ /SF. = $
~ Co~ercial ~ Remodel D Demolition ~ Deck SF. ~ $ /SF. = $
~ Repair ~Sign fl TOTAL VALUATION $ ~1 ~,q~
BmEFnESCmPTION OFTHE PROJECT: [ ~-~ I~ ~~~ ~l&~
COMMERCI~SIDENTI~: Occupancy Group: Occupant Load: ~ Cons~ction T~e:
No. of Stories: ~ Lot Size: % Lot Coverage: %
Existing Lot Coverage: /sq. ff. + Proposed Lot Coverage: /sq. ~. = TOTAL LOT COVE~GE: /sq. ff.
PLANING USE ONLY: ~PROV~S:
c~ FI~
ES~ctland(s): D Yes D No SEPA Check,st required? D Yes D No O~cr: OTHER
BUILDING PE~IT APPLICATION SUBMITT~: Your application and site plan must befEed out completely to be accepted for
review. Thc Building Division can provide you wi~ mom detailed i~o~ation on ~hc application and plan sub~al requirements. Your
completed application, site plan (for additions) and building cons~cfion plans arc to be subdued to ~c Building Division.
V~UATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by thc applicant. ~[s fig~c will bc reviewed
and ~y be revised by ~c Build[n~ Division to comply wi~h c~cn~ fcc schedules. Contact ~c Pc~t Coordinator at 417-4815 for assistance.
PL~ CHECK FEE: Your plan check fcc is duc at ~c time thc building pe~t application and cons~cfion plans arc subdued. All
pc~t fees arc duc at ~e time ofpe~t issuance.
EXPIATION OF PL~ ~VIEW: If no pc~t ~s issued wi~in 180 days of thc date of application, ~is application will expire. ~e
Building Official can extend ~c t~c for action by ~c applicam up to 180 days upon ~i~cn request by ~c applicant (sec Section 107.4 of
the U~fo~ Building Code, cu~ent edition). No application can bc extended more than once.
I hereby cert~ that I have read and examined this application and know the same to be t~e and correct, and [ am authorized to apply for
this permit. I understand it is not the Ci~'s legal responsibility to determine what pe~its are required; it remains the applicant's
responsibili~todeterminewhatpermitsarerequiredandtoobta~.~
Applicant:~~{ {J[~W Date: [ ~7
T:~O~S~PPS~uildin~emit
CLMJ T BU]LD] G
Jackson's
45?-3?03
60"
Clallam Title Co.
64" Title & Escrow
Ten F~orward !'
18"
24"
472 Mt. Pleesa~t St. Pot An~WA
It ts not to be reproduced In ~flole or I~rt
without written permission.