HomeMy WebLinkAbout1202 E 3rd St - BuildingL. w
Owner
4.
:RICHAR AND.;DOREEN »ROSS
:12:02: .E: 3RD
;P,ORT :ANGEILS
(36'0,)' %4;60;,:0'4'9
`.Permit
4-Additiona3..desc
Permit ;piii"number'
Per i.i t ;Fee
I s sue 1Dat e
:Expiration :bate.
;Application;Numbe,r
Applidation ;pin ;number
sProper-.ty, Address,
ASSESSOR ;PARCEL :NUMBERS
.Tenant' nbr :name
_Application type::,descr'iption'
'Subdivision Named
Property =Use
Property ,Z onin
,Application valuation;
Appli cation =desc
LAWN .SPRINKLER :BACKFLOW 'P.REV, NTION
6/2 it
Date
3, :0'0;
CITY OF,PORT ANGELES
:DEPA'RTMENT =OF COMMUNITY. &:ECONOMIC DEVELOPMENT-- :BUILDING.DIVI'SION
,32'1 EAST'5TH_STREET YORT•ANGELES, WA 98362,
y.•„9 -era:=
Pint Marne'
T.Forms /Building Division)Building.Permit
WAk,9,83'.6,2;
;50068:6
T202 ,E :3RD ST
r.00 '7 ,9':04'25, :0000
y YRICHARD .DOREEN :ROSS
P.LUMBING_'PERMIT'
RS7. RESDNTL SINGLE ;FAMILY
156!
T1 .0.0,0 00654 ;Date 46 ,24/1'1
:Contractor'
:OWNER
iPLUMBING
LAWN,$SPR :BACKFLOW'
:57 :0.0 .P.laii. :Check .F,ee
s 6%24/;T1 `Valua'tion..
;1'2''44/..11;
5.T 0 0
=57 ;6o
!Q Un:- t. 'Charge' ;Per.` ,a
'BASE
7 600:00 EA'r ,,PL'- LAwN- :S BCKFLW :P.REV
;Fee csuiinmary ,c -•4arge
,Chd' ?P.a da ;Cr-edited
SPerni ,t ;Fee Tot ?1 .".5'.7' ;0'0
:Plan ,Ch eck Tota'1,,c2 '"',4 ;Q'0•
'Grand `Tota"1 ':57 0:0
rte
00
00
;Signature: of ContractOf 6i Authorized Agent:
NK
;Eicteneigri
:50 :00
7 40
;Due
;0,0
;00
0.0
REPORRTSAvES TAX
456ryour,state .excisetaX4formb: r
to the of Port Aqgeles
T. e:
00`
10.
Signatur_e'of Owner Of, owner. is b'uilder)a'"'
a'.
Se "aratetP.ecmits; are.' re' piredcforelecfricalwork, SEPA :S hor..eline,IESA,Autilities;; riva #;rand ukilictim rouements iThisY'eirriitbecomes
a q,yrk',KO. t Z p p -r p-
mulland voi.d'ifwork orwconstructiodiauthor :�zetl within 18 eons tructlon =or•,work,tssuended :or abandoned;
8 ldi +y G i w.. f 4,i'?; 4v.•.'�'�.., r
fioraµp /days after,tlii work� has<cpmrnenced nor ifirequired> inspections },ha been irequested :within480'days'frotithe�;
ast inspection ,I hereby certify thatIl have read'and d t
examinehrs;applrcation and;know theasame<to4be true and orrect: •All provrsrons
of laws a nd'rtlin
foan 'ove th s f `S etof4work.wilIibeGom 6iiediwitlirwhethe'r-4s ecifed herein';or not The °i ranting 4of:a ermit�doe
tlot !presurne'(to to cancel�ithe. pro.vision any:, state :or local constructi orr;the,performance of:
-4
OF pORT A
w
%Airs AO
NAME OF PREMISES. Rick V\ Off
0 /y 6
SERVICE ADDRESS 1 6 3 x Fie e e r
LOCATION OF DEVICE. 6 h' E f 'a T EA S G 1 A T 6 R
ASSEMBLY t L K 6!, f 5 x4 3/,
Manufacturer Model Size Serial No
IS THIS AN APPROVED ASSEMBLY? YES 0'.10 IS ASSEMBLY INSTALLED CORRECTLY' YES Q—NO
DATE OF INSTALLATION ,1 I/ L r, ,2 Gi) UNKNOWN 0
Initial
Test
Repairs
Details
COMMENTS
DOUBLE CHECK VALVE ASSEMBLY
CHECK VALVE #I CHECK VALVE #2 RELIEF VALVE
Leaked
Held at d
Cleaned
Replaced
I Date 'Time Tester
Backflow Assembly Test Report
City of Port Angeles
Public Works and Utilities Department
Water/Wastewater Collection Division
REDUCED PRESSURE PRINCIPLE ASSEMBLY
Leaked
Closed Tight
Held at 7 psi
Final r� Closed Tight 0 7 Test Held at il'psi Held at 1, psi Opened at psi
AIR GAP INSPECTION
REQUIRED MINIMUM SEPARATION YES NO
7 N5 C(7c)� T 76
Cleaned Cleaned
Replaced Replaced
Signature
Cie
Did Not Open
Opened at psi
3 psi Butler YES NO
(4 erg
Cert. Test Kit
Initial
Test 2 6 1 J F i3 1.1 e C,e ��,,d i l v1• S� t .o
Repairs
Final
Test 7 /1 \7 1 K c 1( jell" 22 F .a. `�'f 'l r Er"-
WHITE CUSTOMER COPY YELLOW PURVEYOR COPY PINK TESTER COPY
Official Use Only
A ssem.
Received
AC /e,?
Y3 172
RP RPDA
DC i70/ DCDA
PVB Air Gap
SVB AVB
PVB /SVB
AIR INLET
Did Not Open
Opened at psi
CHECK VALVE
Leaked Held at psi
REPAIRS
Cleaned
Replaced
AIR INLET Opened at psi
CHECK VALVE Held at psi
BACK PRESSURE NO YES
TYPE OF HAZARD L .A 14 At
Line Pressure 74 psi
Held Backpressure YES E] NO
#2 Shutoff Held YES,OI NO
Relief Valve Exercised YES NO
Passed Failed
1
of
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description PLUMBING PERMIT
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
LAWN SPRINKLER BACKFLOW PREVENTION
Owner
RICHARD AND DOREEN ROSS
1202 E 3RD ST
PORT ANGELES
(360) 460 0490
WA 98362
Qty Unit Charge Per
1 00 7 0000 EA
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
11 00000654
500886
1202 E 3RD ST
06 30 00 7 9 0425 0000
RICHARD DOREEN
RS7 RESDNTL SINGLE FAMILY
150
Contractor
OWNER
Permit PLUMBING PERMIT
Additional desc LAWN SPRINKLER BACKFLOW
Permit pin number 188300
Permit Fee 57 00
Issue Date 6/24/11
Expiration Date 12/21/11
BASE FEE
PL -LAWN SPRNKLR BCKFLW PREV
Paid Credited
57 00 57 00 00
00 00 00
57 00 57 00 00
Date
ROSS
Due
6/24/11
Plan Check Fee 00
Valuation 0
Extension
50 00
7 00
00
00
00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
\\INci°
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 has 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
6 /2-q /1( /2-af
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
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 Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
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
T:Forms /Building Division /Building Permit
Inspection Type
Electrical
Construction R W PW Engineering
Fire
Planning
Building
417 -4735
417 -4831
417 -4653
417 -4750
417 -4815
FINAL Date 1
FINAL Date
SEPA.
ESA.
SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date
v Accepted by I ovl
(3e(Aer
Accepted by
Accepted By
6�
r
N
N
Applicant ja.k ass
Property Owner
Property Owner's Address
Contractor ak ass
Contractor's Address
License
PROJECT ADDRESS
Parcel Number
Project Type Brief Description.
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
Re -roof
Heat System
Other
Floor Areas
Basement
1St Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
BUILDING PERMIT APPLICATION -Print in ink
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
Max. height of proposed structures
Will a lawn sprinkler system be install
Will a fire sprinkler system be instalj.�d?
Expires
/2o
Existing (sq. ft.)
Total footprint of structures
Site Coverage the amount of impervious
and other impervious surfaces (see PAMC
X Residential Multi family
Lawn S KIPX' �rK-� 1oc,�� Pt'�vPM
House garage other tear off re -roof lay over one layer
Heat pump wood burning stove gas fireplace pellet stove other
Proposed (lc. ft.)
Occupancy roup
Occupan oad
Construction type
Signature
Phone q619 0 y- 9O
Phone
Phone
E -mail Peic%ross/a o /yae l caw/
Lot
For City Use Only
Date Received) 9
Permit
Date Approved
Zoning
Commercial Industrial
per sq ft.
TAL VALUATION I SO
s• ft. T Lot size sq ft. Lot cov age
ce on a parcel including str ures paved driveways sid w ks patios
7 94 135 for exemptions) Site cover e
of b rooms
ull baths
of half baths
1 have read and completed this 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 towa+,icing on p ects
Date '/Z'f /11 Print Name 2, /20s
T Forms /Building Division /Building permit application
-y
Clallam County Assessor Treasurer Property Details 62507 RICHARD AND DORE Page 1 of 2
Clallam County Assessor Treasurer
Property Search Results 62507 RICHARD AND DOREEN ROSS for Year 2011 2012
Property
Account
Property ID
Amount Due if Paid on 2
62507
Legal Description.
Geographic ID 0630007904250000 Agent Code
Type: Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11
Open Space: N DFL N
Historic Property N Remodel Property N
Multi Family Redevelopment: N
Township: Section:
Range
CAIN SUBD OF
SUBURBAN LOT 18
LTS10 &11 &N10'
LT12 &VCALY BL4
Location
Address: 1202 E THIRD ST Mapsco:
PORT ANGELES WA
Neighborhood: Cycle 5 Res Map ID 2
Neighborhood CD' 10955130
Owner
Name: RICHARD AND DOREEN ROSS Owner ID 49583
Mailing Address: 1202 E 3RD ST Ownership 100.0000000000%
PORT ANGELES, WA 98362
Taxes and Assessment Details
Property Tax Information as of 06/24/2011
Exemptions:
NOTE. If you plan to submit payment on a future date make sure you enter the date and
click RECALCULATE to obtain the correct total amount due.
First Second
Half Half
Base Base I
I Year Statement ID I Taxing Jurisdiction Amt. Amt. Penalty Interest I Base Paid Amount Due
1 6 2011 156836 ST SCH _STATE SCHOOL_ $211 $211.04 $0.00 $0.00 $211.05 $211.04
2011 156836 CC -GEN COUNTY CLALLAM $116.52 $116 49 $0 00 $0.00 $116.52 $116.49;
12011 156836 SD #121 SCHOOL DISTRICT #121 $275.87 $275.87 $0.00_ $0.00 $275.87 $275.87
2011 156836 CITY PORT ANG CITY OF PORT ANGELES $268.96 $268.95 $0.00 $0.00 $268.96 $268.95
12011 156836 PORT PORT OF PORT ANGELES__ $16.40 $16739 $0.00 $0.00 $16.40 $16.39
2011 156836 NTH OLY LIB NORTH OLYMPIC LIBRARY $48.86 $48.86 $0.00_ $0.00 $48.86 $48.86 t
2011 156836 HOSP #2 HOSPITAL #2 $47.83 $47.82 $0.00 $0.00 $47.83 $47.82
2011 156836 WSMET PK DIST WILLIAM SHORE MET PARK DIST $14.54 $14.53 $0.00 $0.00 $14.54 $14.53
2011 156836 CITY_STORMWATER CITY STORMWATER $36.00 $36.00 $0 00 $0 00 $36.00 $36.00
2011 156836 WEED_CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0.00 $0.82 $0.81
2011 156836 TOTAL. $1036.85 $1036.76 $0.00 $0.00 $1036.85 $1036.76
2010 45114 ST SCH STATE SCHOOL $208.93 $208.93 $0.00 $0 00 $417.86 $0.00
2010 45114 CC -GEN COUNTY CLALLAM $111 18 $111 19 $0 00 $0 00 $222.37 $0.00
12010 45114 SD #121 SCHOOL DISTRICT #121 $270.62 $270.63 $0.00 $0.00 $541.25 $0.00
2010 45114 CITY PORT ANG CITY OF PORT ANGELES $257 43 $257 44 $0.00 $0.00 $514.87 $0.00
2010 45114 PORT PORT OF PORT ANGELES $15 62 $15.63 $0 00 $0.00 $31.25 $0.00
2010 45114 NTH OLY LIB NORTH OLYMPIC LIBRARY $32.31 $32.31 $0.00 $0 00 $64.62 $0 00
2010 45114 HOSP #2 HOSPITAL #2 $45.61 $45.61 $0.00 $0.00 $91.22 $0.00
2010 45114 WSMET PK DIST WILLIAM SHORE MET PARK DIST $14.52 $14.51 $0.00 $0 00 $29.03 $0.00
2010 45114 CITY_STORMWATER CITY STORMWATER $36 00 $36.00 $0.00 $0.00 $72.00 $0.00
2010 45114 WEED_CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0.00 $1.63 $0.00
http. /websrv8 clallam. net propertyaccess /Property.aspx ?cid =0 &year =2011 &prop_id =62507 6/24/2011
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N?
15360
if -J -, '.
-- cT oL - ) S.
Port Angeles, Washington_m__h ______m___m__mhmm_____mh___.________h' 19::_um
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 _/<2u~___d._ums;;:__uu;J.:~d2h_m____m_u____mm__u___u___uu Occupancy____,_g-'~_mm_________u___u_____uu.
f )
Owner _____/.;~'!::!:=__m____::_"::'''':__2_f'.7._"=''___muumm__ Tenant_u_m_____um.u__u____.muU____Uh______Umm_______Uh___U
r
Wiring Contractor ___:._(_~_u:.,t-c-6-:--:2-J-__:;-'~--:m-:mu-muuu Byh________mumu_m__h___um_m__u___.___hmmm___hh_
./
Light Outletsu.mum..___.mm........_.m....,
Receptacle Outlets..u....m.m.........m....
Drye" KWl___m........_____............hh.
Range, KW.....u.n
Water Heater:
KW.mhh hhh'hhhmh hhmmhmhm
" , (;
Heat: RW ......:;:'.:.--:...mlb:!:-::.1,...-::.'~u-=:-:.r...~
Motors: size, volts and phase:
Total Load.umum......m.........
/"'j (, / :') ,/ C
Service, volts mmummmmm:.....m.__....
'?
No. wires ...............mu..........m...m
Size wiresm..~uu./:.~!..l:::'..:/!//' /
/'-' oj>
Main fuse .mm'.......;;.=rmm.m........
CO I/.?
Enclosure ..__....u'.n.n.un..................
Type of wiring:
Entrance Cable ......nm...m.___...m..
Rigid Conduit ..mm........m.___n......
Metallic Tubing .m..mmm............
Current transformers:
No. & Size...n...n..........__...........n....
Ser. NO................n...__.....__......n....n..
Ser. No...............................................
Ser. N 0........__.....................,...............
Ser. NO...,.....n.........n.........................
Type of Wiring:
Armored Cable ...
Non-Metallic ......_
Knob & Tube....m..m....u..........._...
Rigid Conduit ............___nmm.m.___
Metallic Tubing ....n
Raceway.
Circuits, LighLm...mm.........mmm....m
UtjJjiy .un...n_...nn.................u........
Heat
Range ................_............................
Water Heater uu...um.._..m___'m.."
Motor ....n.n................n..................
Dryer ...un.........,..........................u..n.
Furnace .....__.........nn......_.......m..__..
Total.......................................
Remarks: ___uuu_____mmm_.4~~.d__",_~_':!~______n___m_nm_nnu_h_________n___unn_nmmm__n_______nmu_n_n_______m_
Permit Fee
$____u_______m______m______n___..
Treas. Receipt
NO.m_m________n________n_
By m_________________m_m_u_u____nn_________n___m___n__mu
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con.
cealed due noUce must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
15360
Date called for illSpectionn...............n.................n..n...n..............n_..............................n...n...................................................._.....................
Preliminary inspection dates............................... ........................._~.........................__.............................._.............................._.....................
Inspection completed...____..............._.......h............................hm.....~...........m....m......
1M 3.72 Olympic Printers, Inc.
Total Load ....................._...........................................