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Home My WebLink About2122 W 12th St - Building Building Permit 2122 W 12`h St 12 - 1548 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 0 Application Number . . . . . 12-00001548 Date 11/27/12 Application pin number . . . 156584 Property Address . . . . . . 2122 W 12TH ST ASSESSOR PARCEL NUMBER: 06-30-01-5-7-0400-0000- REPORT SALES TAX Application type description MECHANICAL APPL. PERMIT Subdivision Name . . . . . . on your state excise tax form Property Use . . . . . . . . to the City of Port Angeles Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY �LOCaLsIOn Code 0502) Application valuation . . . . 4612 -------------------------- Application desc GAS FIREPLACE INSERT AND GAS LINES ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HALL DIANE S EVERWARM INC 2122 W 12TH ST 257151 HWY101 PORT ANGELES WA 983635009 PORT ANGELES WA 98362 (360) 452-3366 Permit . . . . . . MECHANICAL PERMIT Additional desc . . PROPANE INSERT AND GAS LINES Permit Fee . . . . 121.30 Plan Check Fee .00 Issue Date . . . . 11/27/12 'Valuation . . . . 0 Expiration Date 5/26/13' Qty Unit Charge Per Extension BASE FEE 50.00 1.00 10.6500 EA ME-STOVE/FIREPLACE/MISC. APP. 10.65 1.00 10.6500 EA ME-FUEL GAS PIPING,1-5 OUTLETS 10.65 1.00 50.0000 HR ME-INSPECTION, MIN 1 HR 50.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 121.30 121.30 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total- 121.30 121.30 .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 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. ate 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 INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. \. Inspection Type7 Date 7 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 FINAL Date Accepted b 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 Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPE"C.TIONS REQUIRED PRIOR•TO OCCUPANCY/USE Inspection Type` " "' Date Accepted By v� Electrical 417-4735 Construction-R.W. PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit THE C3Tl ,G_ ELE CITY OF For City Use .. Permit# W A SHI N G T O N . U . S . 321 East Th Street Date Received: Port Angeles, WA 98362 Date Approved 0: 360-417-4817 F: 360-417-4711 permits@cityofpa.us Building Permit Application Project Address: t,s Main Contact: P one # 45z- h"*4ZP0-9811 .= E-Mail: d.m G_h cL J 1 @, o f e.n. Com Property Name Phone *r tf ioo-98 it Owner Mailing Address Email o� City State zip aa Contractor Name Phone Home- S Mailing Address Email S @_ City State tipf Por+ Contractor License #. Expiration: Project Value: Zoning: Tax Parcel # Lot# $ w -F AX- Type of Residential Commercial ❑ Industrial ❑ Public ❑ Permit Demolition ❑ Fire ❑ Repair ❑ Reroof(tear off/lay over) ❑ For the following, fill out both pages of permit application: New Construt'on 11 Remodel 13 Addition 13 Tenant Improvement 13Mechanical Plumbing ❑ Other ❑ Existing Fire Sprinkler System? Maximum height of structure Proposed Bedrooms Proposed Bathrooms Yes ❑ No Project Description - E' A � . I have read and completed the application and know it to be true and correct.I am authorized to apply for this permit. I understand that it is my responsibility to determine what permits are required and to obtain permits prior to working on projects. I understand that the plan review fee is not refundable after plan review has occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the permit is issued. I understand that if the permit is not issued within 180 days of receipt,the application will be considered abandoned and the fees forfeit. Date Print Name Signature Residential Structures For Office Use Area Description(SQ FT) Existing Proposed $$value Basement First Floor Second Floor Covered Deck/Porch/Entry Deck Garage Carport Other(describe) Area Totals Commercial Structures For Office Use Area Descriptions (SQ FT) Existing Proposed $$Value Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) Area Totals Lot/Site Coverage Calculations Footprint(SQ FT) of all Structures: Lot Size: %Lot Coverage SQ FT Site coverage(all impervious+ %Site Coverage structures Mechanical Fixtures Indicate how many of each pe of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Non-Haz Piping #of Outlets: Appliance Vent # Heater(Suspended,Floor,Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance # repair/alteration Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # Fuel gas piping #of Outlets: Water Heater # Medical gas piping #of Outlets: Water Line # Vent piping # Sewer Line # Industrial waste pretreatment # interceptor Other(describe): T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT NV 16806 I' -p' Port Angeles, Washington----------.��__--.-___.._�- •--------------•-•-------, 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 doss,,electri al work as listed below. Address 4 ' .� Gt.l"l d v'- ----------------. Occupancy----- -`�G-e-4-� = -------------- r -�- Owner !_T �Tenant------------------------------------------------------•-------------- WiringContractor--- •---------- .,•--------------------------- ------ By--------------------------------------------------------•------------ Light Outlets........ .....r. ..._,....._.._..-. Service, volts -�`-'�-`--}r/�.'YU... Type of Wiring: 11 e Receptacle Outlets.r_?...:-?................... No. wires .. �. .................. Armored Cable ..................-........... r % i' Non-Metallic ................................. Dryer.KW................y„ Size wires------..._._t...--_-----------. : .6'4 Knob & Tube................................. Range,KW---------...-___-------____._.-.. Main fuse --- -------------------------------- ----................ Rigid Conduit ......-.....-................ Water Heater: Enclosure ......._4........................ c'�/ Metallic Tubing ........................... KW......-_.....!-�---- ..._ Type of wiring: Raceway ..............................._......_ Heat: KW........./ �-_? ..' ! _... Entrance Cable ---------.._------_...._- Circuits, Light. Motors: size, volts and hese: Rigid Conduit ._._..........._.._........ Utility `"" ....................------.....- .....................p Y .................._...................--..... ... .......... . .................. �y Metallic ........................... Heat ../.C'. .......................__....... Current transformers: Range .-...GK------------- *--. ------------- '. �.d��............................... �G No. & Size....................................... Water Heater .` ........................ ........................................................... Ser. No."............................................... Motor ............................................. Dryer-----......_--------------------------------__ --------------------------------------------------------._ Foresee.............................................. .......... Ser. No..........._........_......_...-......._.. Y" Total Load r------------- Total Ser. No.----'--------._----------. ........_........---'......-'-._... _ a Remarks- ----------------- xkt��G 2'_.. -----��2:: ---------------------------------------------------- ------------------------------------------------------------------------------------------------------------------- --------------------- Permit Fee Tress. Receipt a 1 . $ --•---•-------------------- No.._.._.. _..........._.. By - -- - i NOTICE—Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- 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 ELECTRICAL PERMIT N° 16806 Address ........................................................................................................................................ Date..._--...._.._.._.._....-----._....-._....-------....- Owner ....................................................._........._........................................................... Tenant.................................... WiringContractor..........................................................._............................................................. By.-.......--.........---............----------------------.---- NOTICE—Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- led due notice must be given the Inspector so that work`may be inspected before concealment. 1M Olympic Printers, Inc.