HomeMy WebLinkAbout113 E 10th St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
BACKFLOW PROTECTION FOR LAWN
Owner
BARBARA JEAN PERRY
313 KING ST
PORT ANGELES
(360) 452 7163
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
1 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
T:Forms/Building Division/Bu Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
7 0000 EA
WA 983631721
PLUMBING PERMIT
LAWN SYSTEM BACKFLOW
165894
57 00
5/20/10
11/16/10
Per
57 00
00
57 00
10 00000518
590182
113 E 10TH ST
06 30 00 0 2 9160 0000
BARBARA JEAN PERRY
PLUMBING REPAIR
RS7 RESDNTL SINGLE FAMILY
400
IRRIGATION SYSTEM
Contractor
OWNER
57 00
00
57 00
PREV
Plan Check Fee
Valuation
BASE FEE
PL -LAWN SPRNKLR BCKFLW
PREV
Charged Paid Credited Due
00
00
00
Date 5/20/10
00
00
00
00
0
Extension
50 00
7 00
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.
2 /O Iu 1... Pe- r ru
Date Signature Name J Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
Inspection Type
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs
PLUMBING
Under Floor Slab
Rough -ln
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
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
Electrical
Construction R.W PW Engineering
Fire
Planning
Building
Date Accepted By
417 -4735
417 -4831
417 -4653
417 -4750
417 -4815
Comments
1 BacKf rdrlecf-iQorftr
LtuAln i rr-i 3 ct4-i ot^ 5j54 -ern
FINAL Date 1O q�2
®r1
Accepted by ,L•
FINAL Date Accepted by
SEPA.
ESA.
SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
ApplicationfNuniber
AppYi onapin .number'
.Property Address
`ASSESSOR. PARCEL ;,NUMBER
'Tenant :nbr .name+
Application type decrition,
a "SUbd vi= sion'Name',
"Property 'Use,
;Property ;zoning
Application' Value tibn,
"App3'icatio .4
q_:BACKFLOW PROTECT .SON.:FOR.'LAWNt�SRRIGATION.. YSTEM
,Owner
:'BARBARA ;JEAN. 'PERRY
-3'13 KING' ST
:PORT .:ANGELES,
rt ('3 "6, 452- ',7163
:Perttii't
Additional ;desc
Permit pin number.
'Permit =Fee•.
ssue ;Date
Expirat'ion.;Date,
:D EP ARTiVI°EN;T
sWA,
.:983831.'721!
5i, -a5 %'2;0 T0:
Per
.,Qty,. "Unit :Charge
1, 0 0= 7' ,0 00,0
^ee' summary "Charged
.:Permst tee' ,Tota1 "5 „7; ?0'
'Plan ,Check ::Total 0.0•
Grand `Total 5;7 `0'
',T: Forms /Bui l ding' Diyision/B iiilding, Peimit
CITY 'OF=PORT,ANGELES
FYCOMMUNI:TY'& ECONO:MIC'D B;UILDING'=DhVISION
:321 ;EAST'5TH :STREET' .PORT.ANGELES;'`WA 98362.
i 0 ;0'0,0,00.5'38
:5'9:0P82
l'13: E .1'OTH ST
'3'0 =<00 'O 2' `9:16'0 `000'0
BARBARA JEA'N'' "'P.ERRY,`
;PLUMBING REPAIR
RS7 :RESDNTL, °SINGLE';FAMILY
400',
Contractor
OWNER
`P.LUMBING, '•PERM
LAWN= SYSTEM.rBACKFLOW PREY'
1'658'94j,
5'7. 00` Plan 'Check ;Fee-
"Valuation:
A
,rEASE:.FEE
-PL- =LAWN rSPRNKLR ,BCKFLW:
Paid, 'Credited'
.b
00r
;0 0'
3
;Date ?5/2,0%;10•
a7
Due
00
00`
J r ...,q..
Date; rint- Name""' Signature of`Contractor.. or "Authorized Agents
:Ex
55 0 :0„0
N
.A.
aturetof:Owper (if owner. is,builder)
Separ Permits are required;' for electrical: work, SEPA,•Shoreline. ESA, utilities private °and,public improvements, Thi spermit becomes.:null;and
work or construction authorized is not commenced within 180 days, construction.orwor.k:is suspended or abandoned. for+a:per'iod:of I80%days
after:the work ha`s requi red.ins,pections'have not'been requested twit}iint180 days: frm, o th e' last;• inspection'. hhereby certify' that'1hav
read'; and: examined' this•:application and know' be.true and.correct. All.provisions of .laws and• ordinances: governing'this.type.ofawork •will
be comp Iiedwith whether specified herein:ornot. The granti of`a'permit'doe""s;notpresuine to give authority-to;.vi or: cancel the. provisions'of any;
state',or local law: regulating c performance of:construction.
pORTg
co
NiINMEW
Backflow Assembly Test Report
City of Port Angeles
Public Works and Utilities Department
P Water/Wastewater Collection Division
NAME OF PREMISES P i '/D 1 j(
SERVICE ADDRESS l 3 63 /t2 .S i L G�
LOCATION OF DEVICE. 1 1 V rAl V r G G' S f /w'<'
ASSEMBLY (rl/ 75' 0 /1 f 31.5 3 S
Manufacturer Model Size Serial No
IS THIS AN APPROVED ASSEMBLY'? YES 13 0 IS ASSEMBLY INSTALLED CORRECTLY YES B-IO
DATE OF INSTALLATION M UNKNOWNO
REDUCED PRESSURE PRINCIPLE ASSEMBLY
DOUBLE CHECK VALVE ASSEMBLY
CHECK VALVE #I
1 CHECK VALVE #2
1 RELIEF VALVE I PVB /SVB
Initial
Test
Repairs
Details
COMMENTS
Initial
Test
Repairs
Final
Test
Leaked Leaked Did Not Open AIR INLET
Closed Tight Did Not Open
Held at 2 psi Opened at psi
Held at psi Opened at psi
Cleaned
Replaced
AIR GAP INSPECTION.
REQUIRED MINIMUM SEPARATION YES NO
Cleaned Cleaned
Replaced Replaced
3 psi Buf'f'er YES NO
Final Closed Tight
Test Held at t� psi Held at •6' psi Opened at psi
Replaced
TYPE OF HAZARD .G. ,f
Line Pressure f psi
WHITE CUSTOMER COPY YELLOW PURVEYOR COPY PINK TESTER COPY
Official "Use Only
Asscm.#
Received
RP RPDA
DC 0-- DCDA
PVB Air Gap
SVB AVB
CHECK VALVE
Leaked Held at psi
REPAIRS
Cleaned
AIR INLET Opened at psi
CHECK VALVE Held at psi
BACK PRESSURE NO YES
Al Y/e C 7 E, g ,45). fl Held Backpressure YES ct ---NO
#2 Shutoff Held YES L.I NO
Relief Valve Exercised YES NO
I Date Time Tester Signature Cert. Test Kit Passed Failed
/G do leckt ,4e 'f to
Applicant
Property
Property
Contractor
Contractor's Address x,
License
PROJECT ADDRESS
Parcel Number
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
Soh o f bw V
�Prr�n
Owner Y>a r�9 rec rH
Owner's Address 113 /D S r
Project Type Brief Description. &Residential Multi- family
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
Re -roof
Heat System
gOther
)o. w
Expires
i� E /o7A Sfi
1 R nA-4-o h c", di— no 1.4'
House garage other tear off re -roof lay over one layer
Heat pump wood- burning stove gas fireplace pellet stove tg.other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement
1 Floor
2 "d Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
ft
Date c Print Name
J< H 1 r
T Forms /Building Division /Building permit application
Occupancy group
Occupant load
Construction type
Lot
1>et''G`O V\
pp per sq ft.
:7_
T TAL VALUATION L 6 O
anc
Total footprint of structures sq ft. —Lot size sq ft.
Site Coverage the amount Im rvious surface on a parcel including structures paved driveways sidewalks
and other impervious surf es (se PAMC 17 94 135 for exemptions) Site coverage
Phone
Phone
Phone
E -mail
Signature
For City Use Only
Date Received 5- 2-G
Permit #lo C
Date Approved
3 6 o 6 /cz. 7/63
3 „6 L /Sz -7/6
Zoning
Commercial Industrial
of bedrooms
of full bath
of half t the
patios
I 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 to working on projects
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 15806
Port Angeles, washlngtonoom.~oo=m..L..5:=.._m..mmoo...m....., 19.7.m~ -
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 _JL;~m.n~mm!ooo.oo=Lf___'_m_noo.m.________._____.__.__ Occupancy_._m....ll.L......:mh_nun____nun
Owner ..~oooooo.~..moomoon-.---noo Tenant_n__..m.moooomu....._.oo___.____mmmmoooooooomm..m.oo
Wiring &ntractor __C-Ut,=~___s:.JJ.d:._.____ooh_oo..__m By..mm.m_.m._._n.__.hn_moo_m____n____.oom.m_.moooo
Light Outlets......____..3__i..............____ Service, volts __/..(J.,..C1..~.:;)....':-I..D..... Type of WIring:
Receptacle Outlets...#...~........_... No. wIres _..___..3.......................... Armored Cable ........-..............-...-..
D'ye" KW __n__h.m._5.n.____.__nnm.__m. Size wires....~.--A-__h.----..-- Non.Metallic .__n...___._..................
" .-") _ ..?t: Knob & Tube__.._.............___.___.__.....
Range, KWnn..__/-=__mnm____..__. Main fuse ..6"'-Q"'U.__n n n____'
Rigid Conduit ................__..n____....
Water Heater:
Enclosure ______._______..___..__......_.........
KWh.__mn.!i.'n~_.m_nm_
Heat: Kw/-i.J..J.._....1.S..:_..B:B
Type of wiring:
Entrance Cable _..._......._.._.._...
Motors: size, volts and phase:
Rigid Conduit ..m__m....m....m.......
Metal11c Tubing ....hd.............._.__.
Current transformers:
No. & Size..m....m__..________._.__....______
Ser. No..._........_..........._...........__.__..__.
Ser. NO.d__..__.......................d............
Ser. No.....__.....................__.................
Metallic Tubing h_.m..m__......"d'"
Raceway _...._................._........._..._
Circuits, Light......__..dht::....._..._...._....
-
Ut!llty .._..............,6...___..__...........
If eat .........-..---...-.g::::...........-......
Range ....__............k......___________
'Water Heater .....__.~......_._..__.__
Motor __...................{..._......_...___......
Dryer..........._.__.__.._~....................
Furnace ..___.._._.___.nn.......___..__..h__......
Total Load...____....____..__.m...... Ser. NO..n........._____.._......_h_.._.md....__ Total .....;J.....~...mh-----...
Remarks: __~-~---..nnn--.---n-n--hmmoooooommoomoooooomoo.mm..nmmmmm.mmmm--..oooomoo
Permit Fee
$_n3.'-':/..t2m.moooooom.
Treas. Receipt
No._...........................
By ___.oo___.J..d.J..._~__.mmmm.mmm..oo
NOTICE-Current must not be turned on until Certificate of Inspection has been Issued. If work is to be eon.
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
~ C4v~
/ 'J." 7~-KW~J].
ELECTRICAL PERMIT
N? 15806
AddreSs......i..l..3........8..,......Lo....U...,.......................................................... Date..._..6....c...L<;;;.~.""...]...4,.......
:::::~E~~a:~:::::::::.:::::::::::::.::::~::..~::a.:t.~~::::::::::.Z;~:~=:.:::::::__:::::::::::::
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 that work may be inspected before concealment.
1M Olympic Printers, Inc.