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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Zoning . . .
Application valuation
03-00000860 Date 10/14/03
1634 W 4TH ST
06-30-00-0-1-2935-0000-
RES DETACHED GARAGE
4000
Owner
Contractor
MISCHKE NEAL A/PHYLLISM
1634 W 4TH ST
PORT ANGELES WA 98363
OWNER
Structure Information
Construction Type
Occupancy Type . . . . .
Other struct info . . . .
NEW 624 SF DETACHED GARAGE
TYPE V NON-RATED
GARAGES, CARPORTS, SHEDS
NUMBER OF UNITS
1. 00
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
EL-DETACHED GARAGE
46.70 Plan Check Fee
10/14/03 Valuation
4/12/04
.00
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Qty Unit Charge Per
1.00 46.7000 ECH EL-R-OUTBD/DTCH GAR SEP
Extension
46.70
Other Fee/il STATE SURCHARGE 4.50
Fee sununary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 46.7.0 46.70 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 51.20 51. 20 .00 .00
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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
~ Jll}~~iJ.~L
Signature iOwner (if owner is builder)
10;/7' /D ~
I / Date
T:\PLANNING\FORMS\ll 02.1 S [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 NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: /I
ROUGH-IN
PLUMBING
-
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL
WALLS 1 ROOF 1 CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL ..
HEA T PUMP
WOOD STOVE 1 PELLET 1 CIIIMNEY
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT /I's:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING J>EPT. SEPARATE PERMIT #'s SEPA:
PARKING/LlGHTING ESA: f..)fJ f J rUt. D 7- I -D~
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIJ>ENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\ II 02.15 [4/2002]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
property zoning . . .
Application valuation
03-00000860 Date
1634 W 4TH ST
06-30-00-0-1-2935-0000-
RES DETACHED GARAGE
9/04/03
4000
OWner
Contractor
MISCHKE NEAL A/PHYLLISM
1634 W 4TH ST
PORT ANGELES WA 98363
OWNER
Structure Information
Construction Type
Occupancy Type . . . . .
Other struct info . . . .
NEW 624 SF DETACHED GARAGE
TYPE V NON-RATED
GARAGES, CARPORTS, SHEDS
NUMBER OF UNITS
1. 00
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT
DETACHED 624 SF
120.75
9/04/03
3/03/04
-RESIDENTIAL
GARAGE
Plan Check
Valuation
Fee
48.30
4000
.........
~
u)
-J:::.
Qty Unit Charge Per
Extension
92.75
28.00
BASE FEE
2.00 14.0000 THOU Bb-2001-25K (14 PER K)
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
PLUMBING PERMIT
75.00
9/04/03
3/03/04
plan Check Fee
valuation
.00
o
t
Qty Unit Charge Per
Extension
47.00
21. 00
7.00
..):
BASE FEE
3.00 7.0000 ECH PL- EA. FIXTURE ON- ONE TRAP
1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE
~
Other Fees STATE SURCHARGE 4.50
Fee swnrnary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 195.75 195.75 .00 .00
plan Check Total 48.30 48.30 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 248.55 248.55 .00 .00
(J
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 Ihe last
inspection. I hereby certify that I have read and examined Ihis application and know the same to be true and correct. Ail 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 10 give aulhority to violate or cancel the provisions of any state or locai law regulaling construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
,1 (.,4 f ??:h Hl~,tk
Signa(ure of Owne (if owner is builder)
1/If/o~
Date
T:\PLANNING\FORMS\1102.l5 [412002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE I ACCEPTED COMMENTS
I YES I NO
FOUNnATION:
FOOTINGS ?-V;--o '7 J.I-.
WALLS I,'l-":}-()<' JI-
FOUNIJA TION DRAINAGE
ELECTRICAL (LiGHT DEPT) SEPARATE PERMIT; #
ROllGII-IN I I
PLUMBING
.
LINDER FLOOR / SLAB in -ID -0>, .\ L
ROUGH-IN
WATER UNE
GAS LINE
nACKFLOW/WATER
AIR SEAL
WALLS I I I
CEILING I I I
FRAMING
JOISTS I GIRDERS
SIIEAR WALL .
WAILS I ROOF I CEILING 11).- LLi " 11 .l l I/cM J",""M 10'-"1 -0 or 0.9- J. L,.
DRYWALL ~...<:~-,lI\IUr~ 1'~-I-c,3. ,JLL
T-BAR
INSULATION
SLAB I
W ALL I rr .oOR / CEILING I
MECIIANICAL
HEA T PUMP
WOOD STOVE I PELLET I CHIMNEY
HOOD / DUCTS
rw UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE I METER
SEWER CONNECTION
SAN IT ARY
STORM
PLANNING DEI'T. SEPARATE PERMIT #'s SEPA:
I'ARKING/LlGHTING ESA:
LANDSCAI'ING SI-IORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W./ PW/ CONSTRUCTION _ R.W.
ENGINEERING 4]7-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT. -
PLANNING DEPT. 4]7-4750 p:.:'{11 Y-C> C PLANNING DEPT.
BUILDING 4]7-4815 )f)~ '"is ~< i / BUILDING
T:\PLANNING\FORMS\II02.15 [4/2002]
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date jO-/D-03
Time
Received by
RJ
(phone. person)
Location of Work to be inspected
16'3(/ L.-u
N €..ll (
Lf -i- ~
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney
Phone No.
Permit No.
Sewer Excav. Other
8foG
45?-513~
INSPECTION NOTES:
Inspected: Date IV \ \ ~ I as>
Remarks:
Time
Ar\
By
~--
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RESTORATION REQUiRED...... YES NO
I () / (XJ It/u
MalA.-
I s+ '--L
SURFACE RESTORATION:
SURFACE TVPE: 0 Unimproved OGravel o Asphalt OPCC
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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BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and iu INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. Uyon have any questions, call
(360) 417-4815
Applicant or Agent:-JJ f AL M I 5" C H- I(E
Owner: S ~ Iv1' F
Address: I/, 14 vU 4 TJI 5T
Phone:
452 51ZS-
Architect/Engineer:
.'5FLf=
Phone:
51lMI;
Zip: trtj 3 (,3
N/A
Phone:
City: }??R-t
Phone:
AI\I4E LEr,
Contractor _"l E L i=
Address: 1'1 / Ii
PROJECT ADDRESS: if, -;<? 4- I;l) 4-r1t
8 ex'\" 5T a AU-
LEGAL DESCRIPTION: Lot: OF LOT q Block: BL 121 Subdivision: T PA
CLALLAM COUNTY PARCEL NUMBER: D/., ~ OOD 0 1)""< "i DC7(-1?C?
State License #:
1'4/1'1
Exp:
KiA
City:
~T
~
Zip:
~
9A
ZONING:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA MC #
TYPE OF WORK:
JlI\ Residential )Ill New Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
S
City:
Exp. Date:
o Stove
)Q. Garage
o Deck
o Other
~UI'-O 6A..A~j;:
SIZEN ALUATION:
0-.2'f SF.@$ ISF.~$ ..y~ ~
SF. @ $ /SF. ~ $
SF. @ $ ISF. ~ $
TOTAL VALUATION $ -Y666 '"<...)
2~~AR -4 l2'rAINtN4 U>ALL
COMMERCIALIRESIDENTIAL: Occu Occupant Load: 0 Construction Type:
No. of Stories: ~ Lot Size: HQIB.+2 Existing Sq. Ft. 1.120 & Proposed Sq. Ft. h 2..4 ~ TOTAL Sq.Ft. I q4- 4-
Existing lot coverage.l52...b2. 'X & Proposed lot coverage ~% - Total lot coverage 1 \ (0 %
0 . - .
- APPROVALS:
PLANNING USE ONLY: PLAN:
BLDG:
DPWU:
SEPA Checklist required? 0 Yes 0 No Other: FIRE:
ESAlWetland(s): 0 Yes 0 No OTHER:
-
BillLDING 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 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 107.4 of
the Uniform 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 troe 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.
BFORMSIAPPSIBuildingpenllit.wpd Applicant: '--llJ?./J-f 11 /~J4 Date:?{ h I 1e:3
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d ic.U \)au'~ SOUTH E.~~VATIO~rova'Date
e'M1~~~ GX~~E @ 1634 W 4TH S1. SCALE y.." = l'
9'-0" CLEAR.
CITY OF PORT A ELES - Constru ion Plans
The Issuance of this p mit based upon these p ns, specifi.
cations and other data hall not prevel.': the bu ding official
from thereafter reqlJi g the correction of e ors in said
plans. specifications d other data, or fro prevl';nting
building operations b ng carrlPd on thereun er when in
violation of all codes od ordinances of this jurisdiction.
SHEET # 2.
NOTc.s:
f<l 4-'-o~' ~ 6~o"
I WINOOW I
C>-
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4~X6" f../EAD~R
..EER SPEC. S~te:T
IKC.\llS D" R
r-ROM ~nl.~~ WALL
INTO ..s l/ll~
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W. &"XS" 10 WU~E
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fLOOR PLAN
MISCHKE GARAGE @ 1634 W 4TH S1. SCALE y.," = l'
SHEET # 1
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SEE."REVIS~D 8'
FOUNDATION DE.AllS"
cr-.JCLO.s~D";BY AA.
'WEST SIMILAR
(AS\ l:.lE VAIION
MISCHKE GARAGE @ 1634 W 4TH ST. SCALE X" = l'
SHEET #
CITY OF PORT ANGELES
PUBLIC WORKS .. BUlLOING DIV,
321 East 5th Slreel
Port Angeles, W A 98362
REVISED FOUNDATION DETAILS
o.J...
, -
nil ,0' CNG1NEER:sANALYSIS AND STAMPED
"'" ' AND SlGtlEO PlAN REQUIRED,
~ #. REI3AI1_ 2 PIECES ComlNUOUS
-~
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6" '.STORY
e" 2.STORY
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12" ONe SlORY
15" TWo STORY
~
I/Z- ANCHOA eOl TS: @ 17 D.C I-STORY _ \2" FRc-,.,,, EACI-l '::
@<a'a.c. ',STORY wiz"s<::/.u A/2.f> ,
WI>-.-SHEI
'PRESsuRE TREA TEDSIU. PlATE
. #. REBAEl (SEE REBAR SCHa>UIL)
FlNlSHEDCRAnE
AEINFORca.lerr SDiEoULE
HEIGHT VElmCAL HORIZONTAL.
IN FEET ~ FlEINFoRCEMENl
2'
#'@4ll"O:C.
{l} #4 TOP 8AA
2' TO <r It. @ 24'" O:C.
#4@ 24- O.C.
.' TO 6" #4@ ,,,. O.C.
#4@1B"O.C.
G' TO B' #4@16"O. C.
#c1@10.0.C
..~
: CONCRETE' FOUNo'ATION WALL AND FOOTING DETAIL'
'NO ScAt.E
t- . II
::E Z .... .
. ~ ~ UI I
:E:E .; /'.
:;9 _ ,I'
-. = m ""
~ :E 'l<---' eJ
'),. ..... W I
l/r---WCIJOR.BDLTS LS"ME AS ABoV"'-)
PRESSURE TREATED SILL PLAIT
~
#4 REBAR
114 REBAR. 1 PIECES CONTINUOUS
MONOLITHIC CONCRETE FOUNDATION DETAIL
NO SCALE
CONVENTIONAL BRACED PANELS
RESIDENTIAL CONSTRUCTION
BP (Braced Panel)
4" WIDE, 3/8" WOOD STRUCTURAL PANEL, NAILED 6d @ 6"
O.C., NO HOLDOWNS REQUIRED
IBP (Interior Braced Panel)
48" WIDE Yo" GYPSUM BOARD (BOTH SIDES), NAILED 5d @ 7"
O.C. BLOCK ALL HORIZONTAL JOINTS OR NAILED 5d @ 4"
O.C. W/UNBLOCKED HORIZONTAL JOINTS, NO HOLDOWNS
m REOUlkElJ,-w-PANE[ KI::UOlRl::u It- UN UNI:: SIDI:: ONL y:-- ---- ---
ABP (Altemate Braced Panel) SINGLE STORY
2'-8" WIDE, 3/8" MIN. WOOD STRUCTURAL PANEL,NAllED8d
@ 6" O.C. BLOCK ALL EDGES, TWO ANCHOR BOLTS @
QUARTER POINTS, 1800 Ib CAPACITY HOLDOWNS@ PANEL
END. SEE ATTACHED DETAIL
ABP (Altemate Braced Panel) FIRST STORY OF TWO STORY
2'-8" WIDE, 3/8" MIN. WOOD STRUCTURAL PANEL BOTH
SIDES, NALED 8d @ 6" O.C., BLOCK ALL EDGES, THREE
ANCHOR BOLTS @ 1/5 POINTS, 5000 Ib CAPACITY HOLDOWN
AT PANEL END. SEE ATTACHED DETAIL
--
~..._._-
-..._- -- ~-----
---.. ---- - --- -- -
INSTRUCTIONS FOR WORKING DRAWINGS: WALL SECTIONS
Section Drawings show a cross-section
through the building to show construction details.
Your drawings need not be complex, but they
should include the following:
- How wall frame connects to the foundation.
- Grade and type of materials used (Douglas
fir, etc.).
- Minimum distance of 18" from wood joists to
dirt.
- How walls connect to ceilingslroof.
- Roof/slope.
- Size of framing members (rafters. studs,
joists. etc.).
- Ceiling heights.
- Insulation locations and R-values.
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Page 6
N&AL. MIse H"-E
I b 3~ vJ. 4- TH ~l
CPpe, A,..4J5.1..5S
VJ!'I ~'O3~3
'~EO FOR 1l1;J;AA& .\ UHf REDUfST
?:~~t~!-~chk~ ~.
. ~ .', ",I,' 1,..'r, ,';tLIi,"t CO
lOO3JUL /4 AMI/: /6
CD
2003
1112462
ClaUam
County
ZONING LOT COVENANT
IIWE the undersigned owner(s) of the following described property:
(Insert legal description here)
1. G> r g E'Kr ST d /7t.'- LC>T cr 8l12Cf TPA
Plle8e.L :cr lJ b 3 0 Of> tJ 1:1 q.J b 0 "'<> C'
do hereby covenant that said property shall be designated as one zoning lot as defmed in Section 17.08.032
"Z" of the Port Angeles Municipal Code, This covenant creates one inseparable building lot which mav only
be removed through compliance with Chapter 58.17 RCW (subdivision regulations) and/or the City of Port
Angeles short subdivision regulations (Ordinance No. 2222, as amended).
This covenant shall be binding on the owner(s), heir(s), assign(s), and successor(s) in interest and
shaH be filed with the County Auditor's Office. This covenant is for the mutual benefit of said owner(s),
heir(s), assign(s), and successor(s) in interest and is for the further purpose of compliance with state and loc"
land use and building regulations. This covenant may be enforced by injunction or other lawful procedure
and covenant by the recovery of any damal!:es resultinl! from non comnli""cp
."lED FOR ."~D"
,'>"<'!'~". ,IT TH( RoOUEST
)FfJ~( t1/Schk
"CORDED IN "1;".,;':7;--,. €....
l,.J'\,. ~",'I. ",LU'.~i CO
N&.AI.. MI5CH~
Ib3~ W. 4-TH ~l
'P&>~:r AN 4Ji.'..!;S
VJP< ~'O3"'3
lOO3JUl/4 4"'1/: /6
(!)
2003
1112462
Clallam
County
ZONING LOT COVENANT
I/WE the undersigned owner(s) of the following described property:
(Insert legal description here)
Lc>r g f'KT ~I J I~L'- Lt>r cr 8L12'1 TPA
PItU28e.J..;rr tJf:,3 001> t9/2Q.lt:" Ot>C>C>
do hereby covenant that said property shaH be designated as one zoning lot as defmed in Section 17.08.032
"Z" of the Port Angeles Municipal Code. This covenant creates one inseparable building lot which mav oilly
be removed through compliance with Chapter 58.17 RCW (subdivision regulations) and/or the City of Port
Angeles short subdivision regulations (Ordinance No. 2222, as amended).
This covenant shaH be binding on the owner(s), heir(s), assign(s), and successor(s) in interest and
shall be filed with the County Auditor's Office. This covenant is for the mutual benefit of said owner(s),
heir(s), assign(s), and successor(s) in interest and is for the further purpose of compliance with state and loca
land use and building regulations. This covenant may be enforced by injunction or other lawful procedure
and covenant by the recovery of any damages resulting from non compliance.
DATED this } 4-.t;J,. day of M- , 20..Q.3
/71~A1~ 0 YYJ I-t~~
/ (Owner)
h-yt J'.//0 i..-J?7 .Lvl~" <.*/:fk4... .
(Owner)
(Owner)
(Owner)
STATE OF WASHINGTON)
COUNTY OF CLALLAM )
ss
I, B €l.\\.A1"I p. A r')Ah-J ,NotaryPublicinandfortheStateofWashington,doherebycertify
that on this J.:::L day of SlA" I .202.]., personally appeared before me
{\llS'fl\. A. N'\lSC.""]<:.~ and P\>l"l Lv\.) fY'. fl'\l.se~)::cr
to me known to be the individua1(s) desribed in and who executed the within instIUment and acknowledged that
-r H ttr- Y signed and sealed the same as 'jj-; l:' 1"-- free and voluntary act and deed for the purposes herein
mentioned.
GIVEN UNDER MY HAND AND OFFICIAL SEAL this l '1 day of .::::r \-t '- '7
20J;}
OFFICIAL SEAL
BEULAH P. ADAMS
NOTARY PUBUCSTATE OF WASHINGTON
Mt Carmission Ellpies Dec. 10, 2llO4
A ~r:O~
NOTARY PUBLIC in and for the State of
Washington residing at Port Angeles.
AUDITOR'S CERTIFICATE
Filed for record at the request of
this _ day of
20_.
CLALLAM COUNTY AUDITOR
By:
/~3~ LU. f/4
NeAl.. MIS<.:H~
Ib3~ W. 4-TH ~T
CPPf2,I it,.. 4JE, 1.55
IJlA t)"03~3
~llEO FOR IIrC
~. .,,~n.IT THE R:OUEsr
)F.N~~1::J/~chk
lECOROEO IN i:Ei;O:;7;:.:7l~ t.N ~_.
2003 JUL I ~ AM 1/: I 6
~~~~~~I~ml~~~I~~~~
1'1)
~..
1112462
ClaUam
County
2003
ZONING LOT COVENANT
I1WE the undersigned owner(s) of the following described property:
(Insert legal description here)
;. t:> T g E'XT .57" .J I-)L.L Lt>T Cj 8L )2q TPA
P-1I2f18.L rr lJb3 000 OI:J.q.J~ OOC>t?
do hereby covenant that said property shall be designated as one zoning lot as defined in Section 17.08.032
"Z" of the Port Angeles Municipal Code. This covenant creates one inseparable building lot which may only
be removed through compliance with Chapter 58.17 RCW (subdivision regulations) and/or the City of Port
Angeles short subdivision regulations (Ordinance No. 2222, as amended).
This covenant shall be binding on the owner(s), heir(s), assign(s), and successor(s) in interest and
shall be filed with the County Auditor's Office. This covenant is for the mutual benefit of said owner(s),
heir(s), assign(s), and successor(s) in interest and is for the further purpose of compliance with state and loca
land use and building regulations. This covenant may be enforced by injunction or other lawful procedure
and covenant by the recovery of any damages resulting from non compliance.
DATED this I 4-.t::h. day of h _ , 20R3
<.->lyA~ a 111 ,t~LtA-4
f (Owner)
h/((/;U0 I..Jn .LzJ1.LA cr;..ek4-
. (Owner) .
(Owner)
(Owner)
STATE OF WASHINGTON)
COUNTY OF CLALLAM )
ss
I, (3 ~ \.\ LA )1 p. A r')A l"r-J ,Notary Public in and for the State of Washington, do hereby certify
tbat on this d day of ..:::JIA '-...., , 20~. personally appeared before me
N6'f\\. A, N'lISC\-1K,c and f",..,\...'vu ~. n-.l.s~-I1.kE'"
to me known to be the individua1(s) desribed in and who executed the within instnunent and acknowledged that
-r H fl!-)< signed and sealed the same as "-+1 l::' I ^- free and voluntary act and deed for the purposes herein
mentioned.
GIVEN UNDER MY HAND AND OFFICIAL SEAL this / \.f day of .::::r ~ ~ "7
20~
OFFICIAL SEAL
BeULAH P. ADAMS
NOTARY PUBUC-STATE Of WASHINGTON
M,t Cam1ission Elq:liIes Dec. 10, 2004
~r:..~
NOTARY PUBLIC in and for the State of
Washington residing at Port Angeles.
AUDITOR'S CERTIFICATE
Filed for record at the request of
this _ day of
20__
CLALLAM COUNTY AUDITOR
By:
.............
~
V
.z
t
.J::.
\~
r
,
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N'? 15903
Port Angeles, washlngtonnnnml_::i....._n____m__m_mn_m____m...., 19_c.-<!.
In accordance with the City Ordinance to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to do electrical work as listed below.
Address -<!;;m~__f!_.n{rZ-mn;(d...m-n.-m-----mmn-mm-n..n Occupancy_..A..b~_._m_.mmn.m.nm___n
Owner nncre~_.._4=:~<:sm~-..n..mm-nn TenanL__m._mmmmnm.n_m_mnnmn_m_m.mmnmm_m
Wiring Contractor m______m_nnnmnnm__m__m._n_mn_nnn....___... By___nmnn_nm_m.m__.mmnn._m_h..__m.mmn____n
Light Outlets........____..................._.._.....
Service, volts .....mhnm.....___.___.__._.......
No. wires .__n_nnn_nnn_._............,....
Receptacle OutletSmmnh_nm_______nh._..
Dryer, KW........nn.......n_........hun......
::~n :~::s~~~~~_~~~~:
/
Range, KW m.hmoo________._
Water Heater:
Enclosure .................mm_______._._.....
KW.m.m..h.hmmhhu..u.u...nnmu
::;~:~:;~~~~t:::::mm
Type of Wiring:
Entrance Cable ______unm.m........
Rigid Conduit U___nmnun
Metallic Tubing hnmm
CUrrent transformers:
No. & Size....................._.__.__
Ser. No...----.--..----....---.......................
Ser. NO....n__..n_nnn_n_....__n_...............
Ser. NO.....n_..n......n..nnnnn.__._.n.......
Total Loadm..m..............mn..
Ser. NO.n_...n____._..............._..n...nn.n
Remarks: ____m___.nn_____._______.___mnn____.._m.______..___nn____m..__.mmm._____._________._.nm__________.____.__.._______________mm__m
Total ._.-._.._..............................
Type of Wiring:
Armored Ca.ble ....._..m..m.._...__...._.
Non-Metallle .00..000000.00000000_........
Knob & Tubemmmm..._..._h_mn...._
Rigid Conduit .00......00-...0000......__.
Metallle Tubing 0000"''''00''0000'''''
Raceway _........._.._........................._
Circuits. Lighl....hn._m....mnu.m_......._..
Utility..n.....n.......__nn..n.n......n_..n.
Heat .._............................................
Range ._..._.n_................n...._........n..
Water Heater ___..._h_m_........._.......
Motor .............__..nnn_.._..nnnnn_.....
Dryer ........_..............................h_......_
Furnace ................n.......,_._..._.............
Permit Fee
Treas. Receipt
NO.._m__________........_____
By.Ji..i.t~~~~,~
$__m__m___.....mmm__._______.
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It' work is to be eon-
cealed due notice must be given the Inspector so toat work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
15903
Address._..__............_____...____.................._.__.__.....__......._..............h...____......................._._._............__Date..._....._...._______.................._....._______....
Owner nn__._.........h____n.n......._...n....._..........__.._.._h................n.._................__hn..n__......._ Tenant..........hnnnnn__n_..........n..nnnn.__.._.......nnn
WiringContractor__.____.____._.............___...___....______nn_.__....._....._......................____............_..._..._________.By.______......_......................_......_................_.
NOTIC~urrent must not be turned on until Certificate of Inspection has been issued. It' work is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
,,-,r I"\.n__'_ ........,_.~__ ~__
"0
ELECTRICAL PERMIT APPLICATION
FOR OFFICIAL USE ONLY
DaldRec:
Permi!lI:
Date Approved:
D;stc:Tssucd"
The Electrical Permit Application must be filled out comDletelv.
t~
Owner or Elee. Contractor Agent: I/. f: A L
Property Owner; 51
,,/. Ji T/-i
Address: i C~ ? 4- ~ ~
Please type or reprint in ink. If you have any questions, please call (360) 417-4735
Fax number: (360) 417 4711
#Tl-
#SbO
/'/1 ( 5 c.' 1-1 ;/. 6
, - '3/'
Phone: 1- j 1-; I J
Fax:
Phone:
City: P A
Zip:
Electrical Contractor:
license #:
Exp:
Phone:
Address:
City:
Zip:
INSTALLATION WIRED BY:
\;6 OWNER
o ELECTRICAL CONTRACTOR
Credit Card Holder Name:
Billing Address:
<'7~
City:
Zip:
Credit Card Number:
Exp. Date:
V1SA.~ MC:
PROJECT ADDRESS:
,7" A -"/I C (j"~3'1
Check all that apply: 0 New
l.tJ
~~ s.,.-)
./
o Alteration/Addition
-~/~ ~C.
TYPE OF WORK:
o Residential 0 Multi-family
o Commercial 0 Mobile Home
Sq. Ft
o Remote Meter 18' Detached garage 0 Hot Tub D.Swim Pool 0 Septic Pump
Number of Circuits added or altered: -.l A A f) 6. 0
o Low Voltage 0 Telecom. 0 Sigl
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
_KW
KW
TON
KW
Service Information
DESCRIPTIO~ OF THE ELECTRICAL PROJECT:
Electrical Heat Load Additions and or Subtractions
Voltage: ~ 40
Phase: '1!<I1 0 3
Service Size:1...00 A
Feeder Size: /, () l>.
I hereby certify that I have read an examined this application and kn that same to be true and correct, and I an
authorized to apply for this permit. I understand it is not the City's legal re onsibility to determine what permits
are required; it remains the applicants responsibility to determine what pe~ its are required and to obtain such.
Credit Card Holder's Signature:
Owner or Elec. Cont. Signature: /71M-f' 14- 74/"'~>>-5-
Date:
DK- ~:jJ
C:/ElECTRICAlPERMIT APPLI CATION
Date: w/ ~.3
f I
/cf~/t3
PERMIT FEE: $ ~I-~
Lf /Ie.. 70
I
CNBA
~ AA
17-40
I
f4lci\ DV
~
1640
~ r
17
3
I I
/ I ~ks
/ to
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I ~I
xI z -'
~ ~
I
II
I
I
415
I
--- CNBA
, ~336AA
;l it 4/0
I
~'-
.LVUU
SIT
GRID
16
FOURTH ST.
.J ~
----~
.~
408
I
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ELECTRICAL PERMIT APPLICATION
FOR OFFICIAL USE ONLY
DatclRcc:
PermitII-:
Dale; Approved;
Datclssued
The Electrical Permit Application must be filled out completely.
Please type or reprint in ink. If you have any questions, please call (360) 417-4735
Fax number: (360) 417-4711
f/Tl :1f 8 fRO
Owner or Elee. Contractor Agent:
NCfH t\)15CI-lk:t-
Phone: 452 -{ IS ~ Fax:
Property Owner: ::fA ('V\ .5
4T"
Address: I Ie. 1 4- W, _ ~
Phone:
5T
City:
P,A.
Zip: <i'<;<;> 'lh '3
Electrical Contractor:
N/f/
License #:
Exp:
Phone:
Address:
City:
Zip:
INSTALLATION WIRED BY:
DOWNER
o ELECTRICAL CONTRACTOR
Credit Card Holder Name:
Billing Address:
City:
Zip:
Credit Card Number:
Exp. Date:
V/SA:_ MC:
PROJECT ADDRESS:
.5AHI<=
/("'3Cf tl)
4-rL
TYPE OF WORK:
Check all that apply: 0 New
~A1teration/Addition
Ili1 Residential 0 Multi-family
o Commercial 0 Mobile Home
Sq. Ft
o Remote Meter ~ Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
o Low Voltage 0 Telecom. 0 Sign
Number of Circuits added or altered: Z A'" / A- _ J
faD ~ ~/~T TO (grrC/-K06
DESCRIPTION OF THE ELECTRICAL PROJECT: EXTENT) kJASl-iel? .i DI<:!/,;1;2 C Jt<,evrs FRl?iI/
t7MfMiJ""T 7e:> "'1'l~A4,t;:: I A/fhr/c; J:;"x/s'TftVc; I~O ("IRl'i,JTfiI. P/~,..., VLI)
,
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Electrical Heat Load Additions and or Subtractions
Service Information
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
_KW
KW
TON
KW
LRA
o Overhead Service
o Temp Service
o Underground Service
Voltage: Z 4 CJ
Phase:..1 0 3
Service Size: 2.tJo.JJ
Feeder Size:
I hereby certify that I have read and examined this application and know that same to be true and correct, and I am
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
are required; it remains the applicants responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature:
Owner or EJec. Cont. Signature: VJ1 ~ ~,
Date:
Date: q 11-/03
.
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PERMIT FEE: $/1& . rJiJ
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