HomeMy WebLinkAbout02 ApplicationDepartment of Community & Economic Development
321 E. 5th Street, Port Angeles, WA 98362
360.417.4 | www.cityofpa.us | SHUPLWV@cityofpa.us
BPGEN GENERAL
BUILDING PERMIT APPLICATION
PROJECT INFORMATION
Ƒ Single-Family Residential ƑMulti-Family Residential Ƒ Commercial Ƒ Industrial Ƒ Public
Project Address:
Tax Parcel No.: Zoning:
Primary Contact: (Property Owner: Ƒ Yes Ƒ No)
Phone: Email:
OWNER INFORMATION
Name: Phone:
Mailing Address: Email:
CONTRACTOR INFORMATION
Name: License #:
Mailing Address: Expiration Date:
Email: Phone:
CONSTRUCTION CLASSIFICATION
Ƒ New Construction Ƒ Manufactured Building Ƒ Addition Ƒ Remodel Ƒ Repair Ƒ Foundation Ƒ Fence (If >6’ high) Ƒ Retaining Wall (If >4’ high or >2’ high with surcharge)
PROJECT DESCRIPTION
Project Value (Materials + Labor): $
Please summarize proposed work:
APPLICATION MATERIALS CHECKLIST
A General Building permit Application (BPGEN): Complete front and back of the application
A Building Permit Stormwater (BPSW): Submit if the project adds or replaces any hard surfaces
A Scaled Site Plan : Please submit a detailed site plan. No larger than 11”x17” paper. (Scale 1”=20’)
A Building/Construction Plans (x2): Detailed drawings/engineering of construction plans and elevations
A Other Applications when Applicable : Fire related, Wastewater Questionnaire, Waste Disposal
A A Digital Copy of Site and Building 3lans: (PDLOHGWo: permits@cityofpa.us
I have read and completed the application and know it 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 and to obtain permits prior to work. I understand that plan review fees are not
refundable after review has occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is issued. I
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up/issued within 180 days of submittal, the application will be considered abandoned and the fees will be forfeited.
Date Print Name Signature (Ƒ Owner Ƒ Contractor Ƒ Representative)
CITY USE ONLY
App. #:
Received:
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✔
063000-10-3130 R9
JACOB GOODFELLOW ✔
970-531-2226 jacobtgoodfellow@gmail.com
DAGNY LORD AND SCOTT SCHAEFER 360-460-6938
818 S. L ST., PORT ANGELES, WA 98363 dagnylord@hotmail.com
JACOB GOODFELLOW/TIMELESS CONTRACTING TIMELCL821RQ
227 W 9TH ST., PORT ANGELES, WA 98362 12/18/2020
jacobtgoodfellow@gmail.com 970-531-2226
✔
$300,000
Construction for new, wood-framed, one-story single-family residence
approximately 1107 sf with crawlspace foundation and vaulted ceilings.
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✔
✔
✔
✔
8/31/20 JACOB GOODFELLOW
✔
602 Milwaukee Dr
20-1042
9-10-2020
PROJECT DETAILS
PROJECT ADDRESS:
NEW STRUCTURES & ADDITIONS
Ƒ Single-Family Residential ƑMulti-Family Residential Ƒ Commercial Ƒ Industrial Ƒ Public
Location Description Existing (sq.ft) Proposed (sq.ft) Total (sq.ft) Proposed Value Comments
Main Floor $
Upper Floor(s)$
Basement $
Covered Deck / Porch / Entry $
Deck $
Garage (Attached / Detached)$
Carport (Attached / Detached)$
Other (Describe):$
TOTAL $
LOT & SITE COVERAGE CALCULATIONS (For new construction and additions only)
Lot Details Dimensions _______ ft. x _______ ft. or Ƒ Irregular total sq.ft.
Lot Coverage*Total footprint area of all structures on the property total sq.ft. %
Site Coverage*Total area of all impervious surfaces total sq.ft. %
*Lot Coverage: The percent of ground area of a lot on which buildings are located. (PAMC 17.08.065)
*Site Coverage: The amount of impervious surface on a parcel, including structures, driveways, sidewalks, patios, and
other impervious surfaces. (PAMC 17.08.095)
MECHANICAL DETAILS (If Applicable)
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Air Handler Size: #: Heater (Suspended/Floor/Recessed Wall) #:
Furnace/Heat Pump/ Forced air Unit Size: #: Heating/Cooling Appliance (Repair/Alter) #:
Appliance Exhaust Fan #: Pellet/Wood/Gas Stove, Fireplace, Misc. #:
Evaporated Cooler (Attached) #: Vent Fan (Single Duct) #:
Fuel Gas Piping # of outlets: Vent System #:
Hazard / Non-Hazard Piping # of outlets: Other:____________________________ #:
PLUMBING DETAILS (If Applicable)
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Plumbing Traps #:Water Heater #:
Plumbing Vent Piping # of outlets:Medical Gas Piping # of outlets:
Water Line # of outlets:Fuel Gas Piping # of outlets:
Sewer Line # of outlets:Industrial Waster Pretreatment Interceptor (Grease Trap)#:
Vent System #:%DFNÀRZ3URWHFWLRQ'HYLFH VL]H LQ
#:
Other:
ADDITIONAL DETAILS (If Applicable)
Irrigation System YES NO Proposed Proposed Bedrooms/Baths #: /
Fire Sprinkler System YES NO Proposed Proposed Dwelling Units #:
Is the project in Flood Zone? YES (Zone ID: ) NO Structure Value $
+=
PARCEL# 063000-10-3130
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1107 1107
75 75
648 648
walkway, parking, driveway 2061 2061
36024
1107 3
4091 11.4
2
1
2 1
4
9 1
3
1
1
3
✔22
✔ 1
✔$300K