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Home My WebLink About723 E Front St - BuildingCITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321 EAST 5TH STREET PORT ANGELES. WA 98362 Application Number 06 00001080 Application pin number 671320 Property Address 723 E FRONT ST ASSESSOR PARCEL NUMBER 06 30 00 5 1 3975 0000 Tenant nbr name HI TECH Application type description SIGNS Subdivision Name Property Use Property Zoning UNKNOWN Application valuation 16990 Owner Contractor POLITIKA GARRETT /DIANA 1534 W 11TH ST PORT ANGELES WA 98363 COMMENTS /ACTION NEEDED OWNER Date 5/15/07 Permit ELECTRICAL SIGN PERMITS Additional desc OWNER/ WIRE SIGN Permit pin number 100958 Permit Fee 35 0.0 Plan Check Fee 00- Issue Date 5/15/07 Valuation 16990 Expiration Date 11/11/07 Qty Unit Charge Per Extension 1 00 35 0000 ECH EL COMM 1ST SIGN ,35 :00 Fee summary Charged Paid Credited Due Permit Fee Total 35.00 35 00 00 00 Plan Check Total 00 00 00 00 Grand Total 35 00 35 00 00 00 CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO DITCH ROUGH -IN COVER SERVICE FINAL GENERAL COMMENTS: ELECTRICAL PERMIT INSPECTION RECORD PW- 1102.15 14161 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 32! EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 06 00001080 Application pin number 671320 Property Address 723 E FRONT ST ASSESSOR PARCEL NUMBER 06 30 00 5 1 3975 0000 Tenant nbr name HI TECH Application type description SIGNS Subdivision Name Property Use Property Zoning UNKNOWN Application valuation 16990 Owner Contractor POLITIKA GARRETT /DIANA 1534 W 11TH ST PORT ANGELES WA 98363 OWNER Permit SIGN Additional desc Permit pin number 88161 Permit Fee 115 00 Plan Check Fee 00 Issue Date 11/15/06 Valuation 16990 Expiration Date 5/14/07 Qty Unit Charge Per Extension 1 00 115 0000 PER S SIGN FREE OR PROJ 25+ 115 00 Fee summary Charged Paid Credited Due Permit Fee Total 115 00 115 00 00 00 Plan Check Total 00 00 00 00 Grand Total 115 00 115 00 00 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 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 T .Policies \1 102_15 building permit inspection record05 wpd [1/4/2005] Date 11/15/06 Signature of Owner (if owner is builder) Date 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 YES NO FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) SHOWER PAN I MEDICAL GAS LINE AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL /HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) I T -BAR I 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 I FIRE 417 -4653 PLANNING DEPT 417 -4750 BUILDING 417 -4815 I T• \Policies \1102_15 building permit inspection record05.wpd [1/4/2005] BUILDING PERMIT INSPECTION RECORD FINAL FINAL SEPA. ESA. SHORELINE. COMMENTS DATE ACCEPTED BY, DATE ACCEPTED BY. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED I YES I NO I 417 -4735 ELECTRICAL LIGHT DEPT I I CONSTRUCTION R.W PW ENGINEERING FIRE DEPT I PLANNING DEPT 1 BUILDING Q rI FOR OFFI BUILDING PERMIT APPLICATION DateRec. .f'ennit #1 Fill out COMPLETELY and in INK. Your application and site plan MUST BE Date Approved COMPLETE to be accepted for review If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4711 Date ]sued Applicant or Agent: i T recA Owner. (rv., C&Trs r, G S Phone. 6 15 ,1 Address: 7.7 6 l Cvs7 ST Architect/Engineer Contractor Address: p PROJECT ADDRESS 7?-3 f' �rvn r S7 7 �nQGi- gy Zi vi ii/ii Z N ONING CA LEGAL DESCRIPTION Lot: Block: Subdivision. CLALLAM COUNTY PARCEL NUMBER. TYPE OF WORK. Residential New Constr Multi family Addition Commercial Remodel Repair 'Sign Other BRIEF DESCRIPTION OF THE PROJECT COMMERCIAL/RESIDENTIAL. Occupancy Group No. of Stones: Lot Size: Existing Sq. Ft. Total lot coverage PLANNING USE ONLY ESA/Wetland(s) es No SEPA Checklist required? o Yes No Other Lour-to e le s Re -roof Stove Move Garage Demolition Deck alp i 0 Phone: (330) 4s 277 City Ptv %v-ra -4 w# Zip a l 3 G Q, Phone. Exp Phone. State License STZF/VALUATION SF ('S /SF SF /SF SF /SF TOTAL VALUATION 6 CO iU w, 7`i /7Cw 1 L CD q ■ler) Mx Occupant Load. Proposed Sq Ft. r Date: Tom, Construction Type. TOTAL Sq Ft. E (9 NI,1' 1 Oro irk APPROVALS PLAN BLDG DPWU FIRE. OTHER. 114,/06 k t /IQ 1� 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 CAFCK 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 wntten request by the applicant (see Section R105.3.2 of the International Building/Residential Code, 2003). 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 true 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 1 must obtain such permits prior to work. X TAFO s\B1 ermitform.wpd App tel •b Main Iden.titt From. To. Sent: Attach Subject: 'Dale Vargo' <dale @adsled com> Joe Politika' <joe @gotohitech.com> Monday September 25 2006 4 17 PM PAHiTech Electronics. pdf 202639a.jpg Revised LED Sign Order Info Joe, Attached is the revised order showing the reduction in price What is your timeline for installation? It will require 6 weeks to deliver this system to you. We also offer customized graphics to get you started on your LED advertising campaign with this sign system You can expect outstanding long -term LED display performance because AdsLED maintains and supports our clients' LED display systems with a proven program premier quality LED display equipment, expert personnel, operator training, comprehensive and on -site LED display services, 5 Year Warranty, and complete LED system support for its service life Dale Vargo ADSIed, Inc 800 455 -1955 x105 512- 784 -8524 cell 512- 343 -9211 fax dale@adsled.com httn. /www.adsled.com CITY OF PORT ANGELES Construction Plans The Issuance of this permit based upon these plans, specifi- cations and other data shall not prevent the building official from thereafter requiring the correction of errors in said plans, specifications and other data, or from preventing building operations being carried on thereunder when in violation of all codes and ordinances of this jurisdiction e CTze Approval Date 1/ De By 1A»1 (200 �Jk- 1 ti Page 1 of 2 9/25/2006 LED Sign System# s626 -5 Single -Sided Op Pixel Displays 26 standard 4 9" characters per 6 lines or 17 standard 7" characters per 4 lines or 17 standard 10 5 characters per 3 lines or 17 standard 14" characters per 2 lines or 17 standard 21 characters per 1 line Graphics, Animations, Time/Temp Illuminated ID Cabinet Included All Aluminum /Steel Frame Construction UL Listed Approved GE Solargrade Lexan Panned Face with Subsurface 3M Vinyl Graphics (graphics subject to change per client) Display Capabilities Plus basic graphics and animations LED Electrical Requirements. 120V 14 n ID Electrical Requirements: 120V 15 mi (two separate leads)(ID 2 wire LED 2 vt (recommended to be wired on separate cir LED Display Specs: 48 x 160 matrix 125 Approx. LED Sign System Weight: 46211 Transmission. Wireless Mounting. Base plate mount Existing poly www GOTOHITECH Com Existing pole �L�t Page 2 of 2 C a T L+ 9/25/2006 t LINDLE A R C H I C T S 319 s. peabody, suite b, port angeles, wa 98362 360.452.6116 fax 360.452.7064 Project: P aleo) M Subiect: Date: 4G'l' 2C»47 Pro No. By lit7 Sheet 1 of Ag_36 A S 11 x 1 1 -2." 23/0 f P Igo d b 30-40 Nirr w!, WON ei)(4s4 ate) 6'0, 60 nr) m 11 -aJ )1 -3)6X )2) I '34- F1 .12. )73 X I')( 2 1)144 �A Z l..l�`t'/ Nei 4'-5 i u 4 L� Vi 2 ;i0) 2 64-) 5 5336, 0,41aq a s �lOf"e7�� r D e o�I� A C -)01".) 0 3 beim 'L; FROG' H.; —TECH ELECTRONICS FAX NO. Gpxr•el Displays 26 standard 4 9" characters per 6 lines or 17 standard 7• characters per 4 lines or 17 standard 10 5" characters per 3 lines or 17 standard 14" characters per 2 lines or 17 standard 21" characters per 1 line Graphics, Animations, Time /Temp Illuminated ID Cabinet Included All Aluminum /Steel Frame Construction LIL Listed Approved CE Solargrade Panned Face with Subsurface iii? Vinyl Graphics (graphics subject to change per client) 0 as tit Display Capabilities Plus basic graphics and anirrtatipra'S :N t`. 0 tt F o R A• Y •_I Hi -Tech Electronics 360 452 8560 Oct. 23 2006 09 17AM P2 lea &iecrrrcal Regurrernenes 1 'c1V 1-' max amps (two separate leads)(1D 2 wire LED 2 wire GILD) (recommended to be wired on separate circuits) LED Display Specs 48 x 160 matrix 125' viewing angle Approx. LED Sign System Weight: 462 Ibs total Transmission Winless Mounting Baste plate mount Existing pole 9 -2 Existing pole v Et ce 'ar c•;. 4 i iS:r.. {aF!e. §w4' �Nr Notes Unless otherwise specified, No time switches or electrical service to the signs shall be installed by ADSIed, Inc Cabinet /Reveal: 9000 Black Background: 3M White 3M Sultan Blue Text: 3M Sultan blue 3M White Lego: 3M Sultan Slue u�.., I {lv Alt On s20/a0+A aid micron- at ✓tot kY OhSLriPJt,W, coaled, co 0. rRe :Wawa! wo....134pveins FA r. t( Aciaka 4 Drawing No 202639a FROM 'HI —TECH ELECTRONICS pper4 el Displays 26 standard 4 9" characters per 6 lines or 17 standard 2° characters per 4 lines or 17 standard 10 5" characters per 3 lines or 17 standard 14" characters per 2 lines Or 17 standard 21" characters per 1 line Graphics, Animations, Time /Temp illuminated ID Cabinet Included All Aluminum /Steel Frame Construction UL Listed Approved GE Solargrade Lexan Panned Face with Subsurface 3M Vinyl Graphics (graphics subjett to change per client) c-t Display Capabilities Plus basic graphics and aniratatiOn$ FAX NO SY' fat e.GRFO RA'Y•�I Hi -Tech Electronics 360 452 8560 Oct 23 2006 09 17AM P2 lv tleczricaI Requirements l.!uV .i max amps (two separate leads)(1D 2 wire LED 2 wire CND) (recommended to be wired on separate circuits) LED Display Specs. 48 X160 matrix 125' viewing angle Approx. LED Sign System Weight: 962 lbs total Transmission Wireless Mounting Base plate mount Existing pole 9 -2 Existing pole Notes Unless otherwise specified, Ne time switches or electrical service to the signs shall be installed by ADSIed, Inc Cabinet /Reveal: 9000 Black Background: 3M White 3M Sultan Slue Text: 3Nt Sultan blue 3M White Lego: 3M Sultan Blue 1 'k bcrr -wi• iii )i sAtURAg�i[; 4i )k iu.• Cat4.. ;�:u tL41Nl uxieir'i`iwu"ua4iu i B Ciu w iVaitt; AiP x't emot.to cCiriaxpL, era I1 :n La oiitrt });itac, cooled to thdra4 Withuu; Wog, prang R4on from AOS,k le Drawing No 202639a Purchaser's mailing address 703_ E Cro Inspection Date FINAL //t Date Appr ed By Date REC MAY n 2?IT LTONY DEPIr. Approved By .br 'tem No /Installation description Job wired by Electrical Contractor 'Owner Si Commercial Electrical contractor name License number Date Expires N I TtC H SIEr u,i2.i R 1%,,A f\A„ a c, W4t `te n 3 `d Telephone number U FAX number 360 E S a a� a� 3 C o Pre tC ner na e Jc_c, Address of inspection 3- 3 FrQ r. ctv ,:w ek Phone number to schedu' inspection s a a- a 1 Owner as defined by RCW 19.28.261 (I) Owner will occupy the structure for Iwo years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical instal- lation or alteration in compliance with the electrical laws, N.E.C. RCW Chapter 19.28, WAC Chapter 296 -46B The City of Port Angeles Municipal Code, and Utility Specifications. "Si nat re of ow er e e al c nt ac Qr or electrical administrator Date SI /0 Electrical Load Additions and or subtractions NO LOAD CHANGES Baseboard KW Furnace KW Heat Pump Ton LAR Fan -Wall KW Overhead Service Temp Service Underground Service SAME DAY INSPECTION, CALL BEFORE 7 00 AM 360 -417 -4735 ROUGH -IN 7 THERMOSTAT Date Appr ed By DITCH Date Appr ed By Area, Building or Equipment Inspected ELECTRICAL WORK PERMITAPPLICATION t J' New Cash Credit Card Expiration Date of card Date ee Residential Altered/Addition t1c.—■ StS A U Card C2_-\ C2_\ 6L Date Mastercard Discover Inspection fee 3S.00 Service Information Voltage Phase 1 3 Service Size: Feeder Size: SERVICE FEEDER Approved By Appr ved By Action Taken Electrical Inspector C E RT I F I Cam?. C U PA N CY mow pity of Port ngeles Build ngyDivision:_ This Certif aation:zssued pursuant to the requirements of Sectio 109 of the Uniform i uilding°Code;cgrtify ng:that.at the time of uance this st ucture was in c pliance with :vckrio..us rdirtan of the_City_regul¢ting uzlding .,construef4on orhuse. For the followi Use Classification. Permit No 2.6`46 r: m iariiea lei= ech Elect onlcs Group: M Owner of Business /Residence: @aiv Pohtika Aadaart534 1 tth.. Port7Ati eles. WA 98362 X Building Address: 723 E T i M 62 f Construction: Post on t ous place Shall not be rem o_ .e. .except by Building Official C> 0 BUILDING PERMIT OWNER/APPLICANT GARY POLITIKA 1534W 11TH ST PORT ANGELES, WA 98363 360/452 -2727 T CONTRACTOR HOCH CONSTRUCTION 4201 TUMWATER TRUCK TRAIL Port Angeles, WA 98362 360/452 -5381 PROJECT INFO Project Value $195 000 00 Project Type COMML BLDG Occupancy Type. COMMERCIAL Occupancy Group Construction Type. Zoning Use CA PLANS D -12 FEES ASSESSMENT Building Permit: Plan Check: State Surcharge. House Moving: Manufactured Home Sign. Plumbing. Mechanical Radon. $1 525 75 $915 45 $4.50 $0 00 $0 00 $0 00 $55 00 $59.30 $0.00 S ISSUED 6/12/2001 Misc Fee 1 Misc Fee 2: Misc Fee 3. PROPERTY LOCATION 723 FRONT E Lot: Block. Subdivision: Parcel No ARCHITECT LINDBERG ASSOCIATES 319 S PEABODY SUITE 'B' Port Angeles, WA 98362 360/452 -6116 SFD Units. SFD SQ FT MFD Units. 0 MFD SQ FT 0 PERMIT NO 12646 14 15,16PC#06300051398000 39 n Long Legal N R. SMITH 063000513965000 0 Commercial. 0 0 Industrial Garage 0 PROJECT NOTES CONSTRUCT A SINGLE -STORY WOOD FRAMED COMMERCIAL BUILDING WITH PARKING FRONT AND REAR TOTAL FEE. AMOUNT PAID BALANCE DUE. $0.00 $0.00 $0.00 $2,560.00 $2,560 00 $0 00 0 CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98~62 ELECTRICAL PERMIT ISSUED: 7/16/2001 PERMIT NO 7330 OWNER/APPLICANT PROPERTY LOCATION GARY POLITICA 723 FRONT E 1534 Lot: 14,15,16PC#06300051398000 W 11TH ST, WA 98362 Block: 39 [] Long Legal 360/452-2727 Subdivision: N.R. SMITH T: S: Parcel No: 063000513965000 CONTRACTOR ARCHITECT SHAMP ELECTRICAL CONTRACTING IN¢ N/A P.O. BOX 383 Port Angeles, WA 98362-0000 , 98360-0000 360/452-1689 360/000-0000 PROJECT INFO Project Type: COML.NEW Project Value: $0.00 Occupancy Type: Construction Type: COMMERTIAL Occupancy Group: Zoning Use: CA Electrical Heat: [] Baseboard 0 KW [] Riser [] Underground Service [] Furnace 0 KW [] Overhead Service Voltage: 120,240 [] Heat Pump 0 KW [] TempService Phase: [] 1 [] 3 [] Fan Wall 0 KW Service Size: 320 ,.~ Feeder Size: 0 PROJECT NOTES 600 amp service. 2- 200 amp panels. C.T. metered. .-). FEES ASSESSMENT Service: $271.20 Additional Feeders: $0.00 Circuit Wiring: $0.00 Temp Service: $0.00 Misc Fee: $0.00 TOTAL FEE: $271.20 AMOUNT PAID: $271.20 BALANCE DUE $0.00 COMMt~NTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 4 ! 7-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PRO'fIDE A MINIMUM 24 HOUR NOTICE· IT IS UNLAWFUL TO CO INSULATE OR CONCEAL ANY WORK BEFORE IT 15 INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE DITCH /~/2 ~/~,/ ROUGH-IN / COVER ! SERVICE r~./~z t/~-~r GENERAL COMMENTS: CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 12/16/2002 PERMIT NO: 13910 OWNER/APPLICANT PROPERTY LOCATION GARY POLITIKA 723 FRONT E 1534 VV 11TH ST Lot: 14,15,16PC~06300051398000 PORT ANGELES, WA 98363 Block: 39 [] Long Legal 360/452-2727 ,,Subdivision: , * N. R. SMITH T: S: Parcel No: 063000513965000 CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 360/000-0000 PROJECT INFO Project Value: $2,500.00 SFD Units: 0 Commercial: 0 Project Type: SIGN/WALL SFD SQ FT: 0 Industrial: 0 Occupancy Type: COMMERCIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: CA PROJECT NOTES INSTALL 61 SQ. FT. WALL MOUNTED SIGN RECEIPT#9972 FEES ASSESSMENT 'Jr' Building Permit: $0.00 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $85.00 TOTAL FEE: $85.00 Plumbing: $0.00 AMOUNT PAID: $85.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 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 as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certif~ that I have read and examined this applicat on and know the same to be true and correct. All provisions of laws and ordinances governing th s type of work will be complied with whether specified herein or not. The granting of a permit does not constructio~..___._presume to give authority~to violate or cancel the provisions of any state or local law regulating construction or the performance of 'g ature of,~ontraoto~,i,~:] Agent / D~, Signature of Owner (if owner iS builder) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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 I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEFT) SEPARATE PERMIT: # 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 J DUCTS PW UTILITIES / SITE WORK IEngineering Division) SEPARATE PERMIT #'s: WATERLINE / METEK SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s 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 - RW. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. BUILDING 417-4815 ~ BUILDING T:~PLANNING\FORMS\1102.15 [4/2002] FOR OFFI IAL~USE ONLY: [ Date Rec.:~-~ /~_~ BUILDING PERMIT - APPLICATION Date Approved: Date Issued: The Budding Pe~it Application must be filled out completely. Please type or print in ink. If you have any questions, please call 417-4815 Applicant or Agent: Phone: Address: ~ ~ ~ ~, L.n~ %+~City:~c~ g ~¢ Zip: ~chitecCEngincer: _, ~ Phone: Contractor l License : Exp:. Phone: LEGAL DESC~PTION: Lot: Block: Subdivision: CL~L~ COUNTY P~CEL NUMBER: Credit Card Holder Name: Billing Address: City: Credit Card g: Exp. Date: VISA MC T~E OF WO~: SIZE~ALUATION: ~ Residential D New Co~. ~ Re-roof ~ Wood-stove SF. ~ $ /SF. ~ ~ulti-fa~ly ~ Addition ~ Move ~ Garage SF. ~ $ /SF. = $. ~ Co~ercial ~ Remodel ~lition ~ Deck SF. ~ $ /SF. ~ Repair ~ign ~ TOTAL VALUATION $ BmEF DESCmPTION OF THE PRO.CT: ~9or~ ffo,~ /~ ~r/X 7q COM~[RCI~SIDENTI~: Occupancy Group: Occupant Load: Cons~ction No. of Stories: ~ Lot S~c: % Lot Coverage: % Existing Lot Coverage: /sq. fl. + Proposed Lot Coverage: /sq. ~. = TOTAL LOT COVE~GE: /sq. Notes: DPW FI~ ES~Wetland(s): D Yes D No SEPA Checklist requffed? D Yes D No Other: OTHER B~LDING PE~IT ~PLICATION S~MITT~: Your application and site plan must be filled out completely to be accepted for review. The Building Division can provide you ~th more detailed info~ation on ~e application and plan sub~l requffe~nts. Your completed application, site plan (for additions) ~d building cons~ction plans are to be subdued to the Bulldog Division. V~UATION OF CONSTRUCTION: In all eases, a valuation amount must be entered by the applic~t. ~s fi~e will be reviewed and ~y be revised by the Building Division to co~ly wi~ cu~ent fee schedules. Contact the Pe~t Coordinator at 417-4815 for assistance. PL~ CHECK FEE: Your pl~ check fee is due at the time ~e building pe~t application and co~ction pla~ are subdued. All o~cr pem~t fees are due at ~e time of pe~t issuance. EXPIATION OF PL~ ~EW: If no pe~t is issued wi~ 180 days of the date of application, t~s application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon ~i~en request by the applicant (see Section 107.4 of the U~fo~ Building Code, cu~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 true and correct, and 1 am authorized to apply for this permit. 1 understand it is not the Ci~'s legal responsibili~ to determine what permits are required; it remains the applicant's responsibili~ to determine what permits are required and to ob~inFuch ~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date I ~_ /~=- ~)~* Time Received by (phone, person) Location of Work to be inspected Name of person requesting inspection ~-oO~- ~,/ Address of person requesting inspection / Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing~na~Sewer Excav. Other INSPECTION NOTES: Inspected: Date ~' ~ · Time. By Remarks: RESTORATION REQUIRED ...... YES_ NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel i-]Asphalt ~-IPCC []Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE r-I No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)