HomeMy WebLinkAbout2903 S Peabody St - BuildingCITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 05 00001027
Application pin number 042358
Property Address 2903 S PEABODY ST
ASSESSOR PARCEL NUMBER 06 30 15 5 1 -2580 0000
Application type description RE ROOF
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 7060
Owner Contractor
Date 10/20/05
ENNIS KATHLEEN W LARIAT CONST RUCTION INC
1505 42 ND AVE #10 P 0 BOX 280
CAPITOLA CA 95010 PORT ANGELES WA 98362
(360) 457 0952
Permit BUILDING PERM IT NO PR FEE
Additional desc TEAR -OFF RESHEET FELT COMP
Permit pin number 63057
Permit Fee 176 75 Plan Check Fee 00
Issue Date 10/20/05 Valuation 7060
Expiration Date 4/18/06
Qty Unit Charge Per Extension
BASE FEE 92 75
6 00 14 0000 THOU BL -2001 25K (14 PER K) 84 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Cre dited Due
Permit Fee Total 176 75 176 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 181 25 181 25 00 00
T•\Policies\ 1102_15 building permit inspection record05.wpd [1/4/2005]
000
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
constructi. n.
0/ i b os
ure Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
FOUNDATION:
FOOTINGS
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
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL./ FLOOR CEILING
MECHANICAL
HEAT PUMP FURNACE DUCTS
GAS LINE
WOOD STOVE PELLET CHIMNEY
COMMERCIAL HOOD DUCTS
MANUFACTURED HOMES
FOOTING SLAB
BLOCKING HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
PARKING/LIGHTING
LANDSCAPING
RESIDENTIAL
ELECTRICAL LIGHT DEPT
CONSTRUCTION R.W PW/
ENGINEERING 417 -4807
FIRE 417 -4653
PLANNING DEPT 417 -4750
BUILDING 417 -4815
h.a.+:......P.,nit mcnectton record05.wad H/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 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 1 NO
1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 I
1 1
1 1 1
1 1 1
1 1 1
1
I 1 1
I 1 1
1 I 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1 1
1 1 1 1
1 1 1
1 1 1
I 1
1 I I
1 1 1
1 1
SEPA.
ESA.
SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES 1 NO
417 -4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W
PW ENGINEERING
I FIRE DEPT
I PLANNING DEPT
1 BUILDING
I I I
1 I I
1 1
k 4; Fh 1.4
f, fe_640
fesr_L tin
LARIAT CONSTRUCTION, INC.
PO. BOX 280
PORT ANGELES, WA 98362
(360) 457-0952
v6T.e
-etpx..?" e 6_ at 4,401
1, „_s (V% frio_v
,j14_ /qti If/ t_C 3o_ j-
i's MJu1 e 4 v4 kliik
c/, 111:3 ___Prr_64_ 4
R hIkJ
o h i (C4r4_, 14€44 14144
Co. P ()key S
/170h
C /i,.0.44fe
Application Number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Property Zoning
Application valuation
Property owner
Owner address
Contractor
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
Qty
1 00
3 00
Other Fees
Unit Charge
46 7000
5 2000
Fee summary Charged
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
T• \PLANNING \FORMS \1102.15 [4/2002]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
4000
3 Ch ri s p..„4 „Qt
r
S
OWNER
ELECTRICAL ALTER RESIDENTIAL
62 30 Plan Check Fee
2/05/03 Valuation
8/04/03
Per
ECH EL -R OR RM 1 4 ALT CIRCUITS
ECH EL -R OR RM ALT ADDNT CIRCUITS
62 30
00
4 50
66 80
03- 00000094
2903 S PEABODY ST
0630155125800000
RES REMODEL
STATE SURCHARGE
Paid Credited
62 30
00
4 50
66 80
Signature of Contractor or Authorized Agent Date
00
00
00
00
Date 2/05/03
Due
Extension
46 70
15 60
4 50
00
00
00
00
00
0
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.
L� S- 0 3
Signature of Owner (if owner is Gilder) Date
G
CALL 417 -4815 FOR BUILDING 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
BUILDING PERMIT INSPECTION RECORD
YES I NO
FOUNDATION:
FOOTINGS
WALLS Y
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT
IT
ROUGH -IN I) 4 o3 9VeW
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL
WALLS ROOF CEILING
DRYWALL
T -BAR
INSULATION
SLAB
WALL FLOOR CEILING
MECHANICAL
HEAT PUMP
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 ESA.
LANDSCAPING I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
ELECTRICAL LIGHT DEPT 417 -4735
T• \PLANNING \FORMS \1102.15 [4/2002]
l 3 D st'0
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW ENGINEERING
FIRE 417 -4653 I I I I FIRE DEPT
PLANNING DEPT 417 -4750 I I I I PLANNING DEPT I
BUILDING 417 -4815 I I I BUILDING
I I I
I I I
I I I
ELECTRICAL PERMIT APPLICATION
FOR OFACI~ U~L y <'
DaldRn:; - - c:l
........., CjLf
lbleApPfllve"';
Oa:leIUUN:
The Electrical Pennit Application must be filled out comDletetv.
Please type or reprint In ink. If you have any questions, please call (360. 417-4735
Fax number: (360) 417-4711
Owner or Elee. Contractor Agent:
properlyOWner,1-5i {I ~--j:~
Address: ;)903 S Pecc ~
Electrical Contractor: tV A
Address: !\JP,il!
Phone:'I{Og-lf'1f<- Fax:
;;o?-- 31 '" 5"
Phone:
City: f. 11 '
Zip:
License #: Exp:
Phone:
City:
Zip:
INSTALLATION WIRED BY: -,s.oWNER
Credit Card Holder Name: W', {{', 0'- rr-,.
Billing Address9. 0 , (3" '" b b If
Credit CardNumber::!;
o ELECTRICAL CONTRACTOR
Y <-a....5 -e. r
City: Cc<-r-(sb:, r~
Exp. Oate'
,
Zip: l''f'3 :2.i
VISA: Md
PROJECT AODRESS:;:;( 1'03 ..s Pe<'-~e~
TYPE OF WORK: Check alllhat apply: 0 New
o Alteration/Addition
~Residental 0 Multi-family
'0 Commercial 0 Mobile Home , Sq. Fl.
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool
Number of Circuits added or altered: / .7
DESCRIPTION OF THE ELECTRICAL PROJECT:..4.c1c~ "'''-'~ !;" w ",--II
C~ rOo''':''-\; -+ C I" \--,,-,sl- -f'-'<.-,0.
o ~eplic P,ump 0 Low Voltage 0 Telecom. 0 S
..'
"~-:t--e ~:.., +( 3d~~09 ~ €; FCC'
'1& .70 oj- fj.:> 0 X 3) =.~ ')..30 L 'J.-.. .f,c...se.1co.."-<C 0-.J.,.-o-s_ .6,f( ~
Electrical Heat Load Additions ..L re.~ e-. - , Service Information
, \ ..- ~ /?2?,t);2:LJ i-tJ,t?{)'
w-d ~~. 6 l<:,J . ,rv'" ~
o Baseboard _KW / ~vU Voltage:
o Furnace _KW 0 Overhead Service Phase: 01 0 3
o Heat Pump _ KW 0 Temp Service Service Size:
o Fan-Wall i- KW 0 Underground Service Feeder Size:
PAMC 14.05,060(6): For industrial, commercial, & residential projects larger than a duplex, a one -line drawing of the Electrical Service ~
Feeders, building size (sq. ft.), load calculations, and the type & 01 conductors andlor raceway is required and shall accompany the
Electrical Permit application.
I hereby certify that I have read and examined this applicatio e and correct, and I ~
authorized to apply for this permit. I understand it is s legal responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such.
PW-9019
Credit Card Holder's Signature: ~~:.. (' !},JO----
Owner or Elec. Cant., Signature: (J k_________. C, UIL-.---
, A;f:,). '1- () 3 -IZf:f2
/p () f!I/ltI('f;- 1- ~3 .tJ'I
L ~ ;(-1-t>~
Date:2-l{-.-03
Date:;2. -<( ~O S
tJL
~.
ELECTRICAL PERMIT APPLICATION
FOR OFFICL\1. USE ONL l'
Dlfo'Rcc:
Pamilfl;
D..rz: Approved.:
Datclanaaf:
Address:
---
The Electrical Permit Application musl be ffll",* out oomolelelY.
.:fI- 7C!^C-
Plea.e type or reprint In Ink. If you have any questionlLoleBI8 call1lK8\ An ..nu (J-.."::)
t"ax "umoer: (3001 411'"4111
REQUEST INSPECTION
Phone:b8(-s-o~~ Fax:
C-If. U- Phone: fflt?# - E( 9 I L
Zip: 9~s>:2..'1'
t;-&~
Owner or Elec. Contractor Agent: W': II ~ ~ __
~s~..~_
Lie nsa #:
City:
Exp:
INSTALlATION WIRED BY: ~WNER
Credit Card Holder Name: Wi 1/ "D-"",-
Billing Address:!;? 0 . (3 o~ b (, V- '
CredIt Card Number::' "'/
Phone:
o ELECTRICAL CONTRACTOR
Zip:
PROJECT ADDRESS: ^ 7'03 fe.a..beS
TYPE OF WORK: Check ;ill that apply: 0 New
c.. Y~":j ~ ,
'City: C.~sbo ~
:Xp.Date:_ " 1
.. /
wq.
Zip: '?fJ';L'I
CV~~MC
"l!!I Res/denial 0 Multi-family
1j1[ Alteration/Addition
Remote Meter 0 Detached garage 0 Hot Tub 0 SWim Pool 0 Septic Pump
o Commercial 0 Mobile Home Sq. Ft
Number of Circuits added Or altered:
DESCRIPTION OF THE ELECTRICAL PROJECT:.,;(OO .....~jQ S-<a- (.J;: c:.."'E'
7!) A .~ClV A Sk-0u_
o Low Voltage 0 Telecom. 0 S
~~c
//.m~
,~
4333'
o Baseboard
o Furnace
~at Pump
r-ran-Wall
(j~
LRA
KW
PERMIT FEE:-!t1.-90 (
l2-k rt 757'.:z..
L jiAe.<k.t
Service Infonnation
Electrical Heat Load Additions
PAMC ".''''Of''' F~ "''''-. """"""'. · ~""'.. ."'... ....' '". . ,""'" ""', ""' '''''''' "<h, "",""" S~,~ .
F...~. .."., ... f", n.' ... ~,",-, ... "'typ,." __ '".~ """". ",",", '"' ,h" """"PO"., ,,_,
Permit application.
mOverhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 0 1
Service Size:
Feeder Size:
o 3-
, """'by <>rlify ~at , hav, "'ad 'nd ex'mln," /his appIfu./km and /m,w /ha/ same to b. !me and "'''''''. and J .
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what Permits c
"',vlmd; ''''m."s the app'kant, "''POnsfblHty 10 -"""", Wh./ pe""" an> "",vlmd and to ob"'n '""" Ble7
AL.- UO rts is - ~epf .fni. MIcsr/?/12I/O<.I<1e f ~<L5 _ -JL
Credit Card Holder's Signature:.L. LU{;,. .... C ~ Date:6'r.zb~-2-
Owner or Elec. Cont. Signature: e)' r:2..b-<l ,
C:/ELECTRICALPERMiTAPPLlCATION --0--
~ C CJ~ ~-2-"0 Z--
.... CITY OF PORT ANGELES
'f.~..~ PUBLIC WORKS - ELECTRICAL DIVISION
32~F. AST 5TH STREET, PORT ANGELES, WA 98362
ELECTRICAL PERMIT ISSUED: 8/30/2002 PERMIT NO 7805
OWNER/APPLICANT PROPERTY LOCATION
WILLIAM YEAGER 2903 PEABODY S
2903 S PEABODY Lot: 38
PORT ANGELES, WA 98362 Block: 25 Long Legal
360/681-5028 Subdivision: GRANTS ADDT.
T: S: Parcel No: 063015512580000
CONTRACTOR ARCHITECT
OWNER N/A
VARIOUS
Port Angeles, WA 99360 , 98360-0000
206/000-0000 360/000-0000
PROJECT INFO
Project Type: RES, MISC. Project Value: $0.00
Occupancy Type: Construction Type: SERVICE CHANGE
Occupancy Group: Zoning Use:
Electrical Heat:
Baseboard 0 KW Riser Underground Service
Furnace 0 KW Overhead Service Voltage: 0 ~. 1
: Heat Pump 0 KW Temp Service Phase: ; 1 ] 3
Fan Wall 0 KW Service Size: 0
Feeder Size: 0
PROJECT NOTES
100 AMP. PANEL CHANGE TO 200 AMP.
RECEIPT# 9592
FEES ASSESSMENT Service: $64.90
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
Misc Fee: $0.00
TOTAL FEE: $64.90
AMOUNT PAID: $64.90
BALANCE DUE $0.00
COMMF~NTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417.4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COl/ER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLAlqS AT JOB SITE
DITCH
ROUGH-IN / COVER
SERVICE
FINAL
GENERAL COMMENTS:
Pw- I IO2.1 $ [4t96]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number ..... 03-00000094 Date 2/05/03
Property Address ...... 2903 S PEABODY ST
ASSESSOR PARCEL NUMBER: 0630155125800000
Application description . . . RES REMODEL
Property Zoning .......
Application valuation .... 4000
Property owner .......
Permit ...... BUILDING PERMIT -RESIDENTIAL
Additional desc . .
Permit Fee .... 120.75 Plan Check Fee . . .00
Issue Date .... 2/04/03 Valuation .... 4000
E~piration Date , , 8/03/03
Qty Unit Charge Per Extension
BASE FEE 92.75
2.00 14.0000 THOU BL-2001-25K (14 PER K) 28.00
Permit ...... PLOMBING PERMIT
Additional desc . .
Permit Fee .... 68.00 Plan Check Fee . . .00
Issue Date .... 2/04/03 Valuation .... 0
Expiration Date . . 8/03/03
Qty Unit Charge Per Extension
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, pdvate and public improvements. This permit becomes
null and void if work or construct[on 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 i~ builder) Date
T:\PLANNTNG\FORMSq 102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BU1LDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT1S UNLAWFUL TO COVER,
INSULATE OR CONCEAL ~4NY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTER COMMENTS
YESI No
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
WATER LINE
GAS LINE
RACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB I
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PWUTILITIES/ SITEWORK (Engine~ringDivision) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'$ SEPA:
PARKING/LIGHTiNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION -
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 ~ · ~ ~ '~'1 .1~ ~ , BUILDING
T:\PLANNING\FORMS\ 1102.15 [4/2002]
o~ eOR~,?e FOR OFFICIAL USE ONLY:
4~ Date Rec.:
° BUILDING PERMIT - APPLICATION
Date Approved:
Date Issued:
The Building Pe~it Application must be filled out completely.
Please type or print in in~ If you have any questions, please call 417-4815
Applic~t or Agent: ~t/[ ~ ~ i~ ~DC~ Phone:
Owner: Phone:
Address: ~ ~ ~ ~ ~ff City: ~ ~,/~ ~[~ ~ Zip:
ArchitecffEngineer: Phone:
Contractor License Exp: Phone:
Address: ~~l(~ City: Zip:,
LEGAL DESC~PTION: Lot: Block: Subdivision:
CL~L~ COUNTY P~CEL NUMBER: Credit Card Holder Name:
Billing Addr~s: City:.
Credit Card ~: Exp. Date: VISA MC
TYPE OF WO~: SI~UATION:
~ Residenhal ~ New Cohsm u Re-roof B Wood-stove sr. ~ $ /sr.
~ Multi-f~ly ~ Addition ~ Move ~ Garage sr. ~ $ /sr. = $
~ Co~ercial ~ Remodel ~ Demolition ~ Deck sr. ~ $ /sr. =
~ Repair ~ Sign ~ TOTAL V~UATION $
COMMERCI~/~SIDENTI~: Occupancy Group:. Occupant Load: Cons~ction T~e:.
No. of Stories: ~ Lot Size: % Lot Coverage: %
Exist~g Lot Coverage: /sq. fi. + Proposed Lot Coverage: /sq. fi. = TOTAL LOT COVE~GE: /sq.
PLANING USE ONLY: ~PROV~S: PL~
Notes: BLDG.
DPW
FI~
ESMWetland(s): ~ Yes ~ No SEPA Checklist required? ~ Yes ~ No Other: OTHER
B~LDING PE~IT APPLICATION S~M1TT~: Your application and site plan must be filled out completely to be accepted for
review. ~e Build~g Division can provide you with more detailed ~omtion on the application and plan sub~aal require~nts. Yo~
completed application, site plan (for additions) and building cons~ction plans are to be subdued to the Building Division.
V~UATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by ~e applicant. T~s fi~e will be reviewed
and ~y be revised by ~e Building Division to comply ~th c~ent fee schedules. Contact ~e Pe~t Coordinator at 417-4815 for assistance.
PL~ CHECK FEE: Your plan check fee is due at the time the building pemt application ~d co~ction pla~ are subdued. All o~er
pe~t fees are due at ~e tree ofpe~t issu~ce.
EXPIATION OF PL~ ~VIEW: If no pe~t is issued wi~in 180 days of the date of application, this application will expire. The
Building Official can extend the t~e for action by ~e applicant up to 180 days upon ~i~en request by the applicant (see Section 107.4 of
the Unifom Building Code, c~ent edition). No application can be extended more than once.
I hereby cert~ that I have read and examined this application and know the same to be ~ue and co~ect, and I am authorized to apply for
this permit. I understand it is not the Ci~'s legal responstbtli~de~mtne what permit&are require& it remains the applicant's
responsibili~ to determine what permits are required and to ob~ s~ ~ ~ ~/
~; ~ SITE PLAN
DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION
APPLICANT: PHONE:
PROJECT/DEVELOPMENT ADDRESS:
See Page 4 for instructions on completing the site plan. For more information, call 417-4815.
[:-
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date O ~--,/~J//~ ? Time ~.~'~ ~'~- Received by~,~
Location of Work to be inspected f)-~(?-~
Name of person requesting inspection ~ /3/
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one)~~ Permit No.
Sewer Foundation Framing Chimne~ Plumbing )Final Sewer Excav. Other
INSPECTION NOTES: ~
Inspected: Date ~ Time . By
Remarks: ///'- ~.
?
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel [~Asphalt ~-~PCC [~]Other
{--I Repaired by City Work Order #
~1 Repaired by Permittee [] COMPLETE
I--I No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)