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Fee summary
T:Forms/Building Division/Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 10 00000188 Date 2/24/10
Application pin number 574796
Property Address 524 S CHAMBERS ST
ASSESSOR PARCEL NUMBER 06 30 00 0 1 9285 0000
Tenant nbr name RAYMOND L C LOVELY TTE
Application type description SIDING
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 8000
Application desc
INSTALL VINYL SIDING ON THE HOME
Owner Contractor
RAYMOND /L C LOVELY TTE
LOVELY FAMILY TRUST
524 S CHAMBERS
PORT ANGELES WA 98362
Qty Unit Charge Per
BASE FEE
14 0000 THOU BL -2001 25K (14 PER K)
Charged
G M VINYL SIDING /GUTTER INC
4113 S C ST
PORT ANGELES WA 98363
(360) 457 3949
Structure Information 000 000 VINYL SIDING OF THE HOME
Permit BUILDING PERMIT NO PR FEE
Additional desc VINYL SIDING OF THE HOME
Permit pin number 161414
Permit Fee 179 75 Plan Check Fee 00
Issue Date 2/24/10 Valuation 8000
Expiration Date 8/23/10
STATE SURCHARGE 4 50
Paid Credited Due
Permit Fee Total 179 75 179 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 184 25 184 25 00 00
L z 1 -0 j9, /7 fl,f/R
Extension
95 75
84 00
Date Print Name Signature of Contractor or Authorized Agent
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.
Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECT IONS
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 I 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
Parking Lighting
Landscaping
Separate Permit #s
T.Forms /Building Division /Building Permit
Inspection Type
FINAL Date Accepted by
FINAL Date Accepted by
SEPA.
ESA.
SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
Electrical 417 -4735 I
Construction R.W PW Engineering 417 -4831 I I
Fire 417 -4653 I I
Planning 417 -4750 I �I
Building 417 -4815 I 4
1 k -Z- 10
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
Applicant 5, ,¢,7Z Phone
Property Owner ,Q ,q,, 4L,, Al Phone
Property Owner's Address Z.y 5.0 e,4.4
Contractor 6'f- AI 5,,/,,,, 0 ,A., Phone
Contractor's Address 4 3 c /e /f z„_ r y./a3
License ,i //e iv Al I /%GAL Expires 3 ,7/ E -mail
PROJECT ADDRESS
Parcel Number
Project Type Brief Description.
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
Re -roof
Heat System
Other
2 zi
Max. height of proposed structures ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be installed? Construction type
Lot
ikfzesidential Multi family Commercial
i
1
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq ft.
1 Floor
2nd Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION
For City Use Only
Date Received' 2- 2 -4 `U
Permit i(1 _•g-
Date Approved
Ss'a� 0 3 .rs_
17,4
Zoning
X House garage other tear off re -roof lay over one layer
Heat pump wood burning stove gas fireplace pellet stove other
Total footprint of structures sq ft. T Lot size sq ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel including structures paved driveways sidewalks patios
and other impervious surfaces (see. PAMC 17 94 135 for exemptions) Site. coverage
of bedrooms
of full baths
of half baths
Industrial
/Da 0
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 ,^7y responsibility to determine what permits are required, and to obtain permits prior to working on projects.
Date Z Zy c" Print Name 1;1 7/ Signature "e
T F ms /B,iilding Division /Budding permit appdcation
Clallam County Assessor Treasurer Property Details 57574 RAYMOND/L C LOVE Page 1 of 4
Clallam County Assessor Treasurer
Property Search Results 57574 RAYMOND/L C LOVELY TTE for Year 2010 2011
Property
Account
Property ID
Multi-Family Redev lopmont: N
Location
Address:
Taxes and Assessments Due
Property Tax Information as of 02/24/2010
Amount Due if Paid on
Statement
Year ID Taxing Jurisdiction
2010 40 ST SCH STATE SCHOOL
2010 40565 CC-GEN COUNTY
2010 40565 POnT POaT
2010 40565 PORT ANG PORT ANGELES
57574 Legal Description S2 LOTS 17 18 BL 192
TPA
Geographic ID 0630000192850000 Agent Code
Type Real
Tax Area: 0010 RAl21 PORT GTCNTYM2L Land Use Code 11
Open Space. N DFL N
Historic Property' N Remodel Property N
nz*o�n�wocnoo/ "mvu:v
PORT ANGELES WA 9836
Neighborhood: Cycle 5 Res Map ID.
Neighborhood CD 10955130
Owner
Name. RAYMOND/L C LOVELY TTE Owner |D 37846
Mailing Address: LOVELY FAMILY TRUST °/0 Ownership: 100 0000000000%
524 S CHAMBERS
PORT ANGELES WA 98362
Exemptions:
First Second
MoHalf iHalf
Base Base Base Amoi
Due I Due Penoby.��r��/Pai� Due
$136 42 $136 43 $0 00 $0 00 $0 00 $27'
*72._61 $72159
$OOO $0 00 $14!
$10.20 $1o21 $ouo $0 $0 00 $2(
$168 10 $168 09 $0 00 $0 00 $0 00 $33(
2010 40565 So�z1 ��H{OLD|GTR|OT#121 $176 71 $176 70 $0 00 $0 00 $0 00 $35:
2010 40565 wTHOLYL|a NORTH OLYMPIC �21 10 $21 09 $0 00 $0 00 $0 00 $4.
�O10 4V5O5 MOG 8 $2979 $0 $O 00 *OO-*51
-4-8
2010 40565 Vx8MsTPmo|8T VwLUAMSHORE MET PARK D|GT $9 $947 0 00 $0 00 $0 00 $11
2010 40565 $36 00 $36 00 $0 00 $0 00 $0 00 $7'
-2616-40-6-6--5-
WEED V��DCOm�OL $0 82 $0 81 $0 00 $0 00
2010 4u���n�TAL. $661.22 $��11� V.UV $0.00 $0.00 $1�3:
'5-75742068
2009 STQCM STATE �CMOOL $15532 �155�1 �OOO *OOO �V1VV3
-$78
2009 575742000 CC-GEN COUNTY $78 60 61 $0 00 $0 00 $157.21
VVV 575742008 PORT PORT $11 13 $11 14 �UUU $0 00 $22.27
r o o
$172.41
|u000 575742008 pox/ *ma PORT ANGELES �rz�*� 172.41 $0 00 �o $u44oz m(
i20O9 o75742OO8 SD #121 SCHOOL DISTRICT #121 $192.07 $192.06 $0V0 $0 00 $384 13
2OOg 57574oOO8 NTH OLYUB NORTH OLY�P|CUoRARY $22 84 $22.84 $0 00 $0 00 $45 68
2V�V �7�742UO8 HOSP #2 HOSPITAL #2 $32.24 $32.23 $0 00 $0 00 $64 47
Owner
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
T:Forms/Building Division/Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
Application Number 09 00001224
Application pin number 714472
Property Address 524 S CHAMBERS ST
ASSESSOR PARCEL NUMBER 06 30 00 0 1 9285 0000
Tenant nbr name RAYMOND /L C LOVELY TTE
Application type description RE ROOF
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 2695
Application desc
RE ROOF HOUSE LAY OVER ONE LAYER
RAYMOND /L C LOVELY TTE
LOVELY FAMILY TRUST
524 S CHAMBERS
PORT ANGELES
(360) 452 6180
Structure Information
WA 98362
Qty Unit Charge Per
1 00
Other Fees
Fee summary Charged
Permit Fee Total 109 75
Plan Check Total 00
Other Fee Total 4 50
Grand Total 114 25
Contractor
Date 11/24/09
AFFORDABLE SERVICES
258663 HWY 101 WEST
SEQUIM WA 98382
(360) 683 9619
000 000 RE ROOF HOUSE LAY OVER ONE LAYER
BUILDING PERMIT
RE ROOF HOUSE
157115
109 75
11/24/09
5/23/10
NO PR FEE
BASE FEE
14 0000 THOU BL -2001 25K (14 PER K)
Plan Check Fee 00
Valuation 2695
Extension
95 75
14 00
STATE SURCHARGE 4 50
Paid Credited Due
109 75
00
4 50
114 25
00
00
00
00
00
00
00
00
be complied with whether specified herein or not. The granting of a permit do s not pr
state or local law regulating construction or the performance of cpRSon.
1I 6 '7 t 1a
Date Print Name Signature of C trac or Authorized Agent
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
e to 'e authority to violate or cancel the provisions of any
Signature of Owner (if owner is builder)
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
Electrical 417 -4735
Construction R W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
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
Inspection Type
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
kkpi Il`jr
Date Accepted By
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
Applicant Et^� bl c) f1 .t (0 Phone
Property Ownef �L•lf Phone
Property Owner's ddre s SZ LI Sock -El)
Contractor 'fJ ,p 6to, 1 1 Phone
For City Use Only
Date Received I -2`{ -��`jq
Permit Q— t!L
Date Approved
Contractor's Address 6s jj 'j 7
zrvizig
License e 5' fj Expires E -mail 6rf m6,15
PROJECT ADDRESS ZU 'x-EA 01i.(EyriuL'S
Parcel Number PraY/.Sr) Lot f. 01 Zoning
Project Tyne Brief Description. Residential Multi- family
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
li a -roof X House garage other tear off re -roof t y over one layer
Heat System o Heat pump wood burning stove gas fireplace pellet stove other
Other
Floor Areas
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION ZCQa 6.6
Total footprint of structures sq ft. T Lot size sq ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel including.structures paved driveways sidewalks, patios
and other impervious surfaces. '(see PAMC 17 94 135 for exemptions) Site coverage
Max height of proposed structures
Will a lawn sprinkler system ibe be installed?
Will a fire sprinkler system be installed?
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.
Date it Print Name Signatur
Forms/ uilding Division /Bldg Permit.doc
Existing (sq. ft.) Proposed (sq. ft.)
ft.
Occupancy group
Occupant load
Construction type
Commercial Industrial
per sq ft.
of bedrooms
of full baths
of half baths
a
All material is guaranteed to be as specified. Any alteration or deviation from the above
specifications involving extra costs will be exerted only upon women orders and will
become an extra charge over and above the estimate. All agreements contingent upon
strikes, accidents, or delays beyond our control. Owner to carry fire, tornado and other
necessary insurance.
DEPOSIT
AFFORDABLE ROOFING
258663 Hwy 101 West
Sequim, WA
q.:ffordable Roofing s Representative.
Customer s Signature of Acceptance
Set attached Warranty Statement_
(360) 683-9619 (360) 385 -2724 (360) 452 -0840
N ame Phone #1 FV,If) L157- T
Add s i _lL .0. St k" Phone #2
City m Ali". r. State Zip Code 2 2..
Tarp ho perimeter to protect landscaping
;R emove old roofing and haul to landfill
Install Plywood OSB
Install Roofing Felt Install Drip Edge Metal
Install Pipe Flashing Ins tall Metal W- Valleys
Install Exhaust Vents Install Roof to Wall Flashing
Install Ridge Vents Install Roof to Wall Step Flashing
Install Attic Vents Cut In Chimney Counter Flashing
Install Sun Tube Install Chimney Step Flashing
Install Skylights Install Skylight Flashing
Install
Install
Install
Install
Secure Locate Septic Drain Field Location
Q f Pnce Includes Building Permit
Customer to Secure Building Perrot
Description, `install 10 year i.nminatec{, Niel Wind Shingles, at 6 nails per shingle.
With ..Scotch .Guard Algae Block System. //O rrich
Payment to full upon completion of project,
unless other arrangements accepted SUBTOTAL. .2
We propose hereby to furnish material and labor, SALES TAX
complete in accordance with the above specifications. TOTAL
A cceptance of Proposal the above prig, specifications and conditions
are sansfactory and are hereby accepted. You are authorized to do the
wort as specified. Payment will be made as outlined above.
Note this proposal may be withdrawn by us i f not
accepted within 30 days,
Brand /C.- Year 30
Color Workmanship
10 Year Warranty C
Lifetime Warranty
Date
Date:
PROPOSAL
~ ~ORr ~
$.J...O~~~
,.
L~
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'\.tli:,,~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
07-00000916 Date
759556
524 S CHAMBERS ST
06-30-00-0-1-9285-0000-
RE-ROOF
8/03/07
RS7 RESDNTL SINGLE FAMILY
2329
Owner
Contractor
LOVELY TTE RAYMOND/L C
LOVELY FAMILY TRUST
PORT ANGELES WA 98362
AFFORDABLE SERVICES
258663 HI - WAY 101
SEQUIM WA 98382
(360) 683-9619
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT - NO PR FEE
TEAR OFF/INSTALL COMP
108464
109.75 Plan Check Fee
8/03/07 Valuation
1/30/08
.00
2329
Qty Unit Charge Per
Extension
95.75
14.00
BASE FEE
1.00 14.0000 THOU BL-2001-25K (14 PER K)
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- -'--------- ----------
Permit Fee Total 109.75 109.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 114.25 114.25 .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 'olate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Owner (if owner is builder)
Date
T:\PoliciesIlI02_15 building permit inspection record05.wpd [1/4/2005]
BUll.,DING PERMIT INSPECTION RECORD :3
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4] 7-4735 FOR ELECTRICAL INSPECTIONS. I
CALL 417-4807 FOR PUBLIC WORKS UTILITIES ...0
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UN LA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE ~
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA TlON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSI'ECTlON TYPE DATE ACCEI'TED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDA TION DRA[NAGE / DOWN SPOUTS
PIERS I
POST HOLES (POLE BLDGS,)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW /WATER
AIR SEAL
WALLS
CEILING
FRAMING
JO[STS / GIRJ)ERS
SHEAR W ALLIHOLD DOWNS
WALLS / ROOF 1 CEILING
DRYW ALL (INTERlOR BRACED PANEL ONLY)
T-BAR
INSULA nON
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
ROUGH-IN
HEATPUMP/FURNACE/DUCTS
GAS LINE FINAL DATE ACCEPTED BY:
WOOD STOVE / PELLET 1 CillMNEY
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKJRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARK[NG/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL I DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRlCAL - LI GHT DEPT. 417-4735 ELECTRlCAL
LIGHT DEPT
CONSTRUCTION R.W. / PWI CONSTRUCTION - R.W.
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 4] 7-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 ()~ 10'\( 1\1 1-'\ t".L-- BUILDING
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^'-~ AFFORDABLE ROOFING
_"\. . \\' 258663 Hwy 101 West
) Q} Sequim, W A .
~ (360) 683-9619. (360) 385-2724
C A
-e.s. State
Tarp house pe meter to protect landscaping
Remove old roofing and haul to landfill
PROPOSAL
(360) 452-0840
Plywood
Roofing Felt
Pipe Flashing
Exhaust Vents
Ridge Vents
Attic Vents
Sun Tube
Skylights
OSB .~
...J4
Install
Install
Install
Install
Cut In
Instal I
Install
Install
~Install
Install
Install
Install
Install
Install
Install
Install
Install '\C')V"C-Y\ .~,A.f OAf f7~+
Install
Install
--fl:j]--Secure / Locate Septic / Drain Field Locati07-=r n
~Price Includes Building Permit (2)~A
Customer to Secure Building Pe 'it
Description: V" ffiv
yY)
Drip Edge Metal
Metal W -Valleys
Roof to Wall Flashing
Roof to Wall Step Flashing
Chimney Counter Flashing
Chimney Step Flashing
Skylight Flashing
Payment in full upon completion of project,
unless other arrangements accepted.
We propose hereby to furnish material and labor,
complete in accordance with the above specifications.
SUBTOTAL: .J>Z.3 ~ ~ Gu
SALES TAX ,,'7 Ii 07-(
TOTAL: fL,52-'{ {;(..I
,
.-\11 malerial S guaranteed to be as specified. All worlc to be competed in a professional
mllJ1ncr according to slllndard practices, Any altCl1ll.ion or deviation from the above
;pccilie:uiOllS invoiving exlrll cosli will be executed only upon written orders ll.'1d will
b<.~omc an extra churge over and above the estimate, All agreements contingent upon
;uikcs, llCcidcnLS, or delays beyond our control. Owner to CllJT'Y fire. tornado, and other
necessary insuran'Ce. OUf workers are fully covered by Wor1cer's Compensntion Insurance.
Note: this proposal may be withdrawn by us if nOI
accepted within 30 days.
.Acceplance of Proposal - the above prices, specifications and conditions
are saris factory and are hereby accepted. Youare authorized to do the
work as specified. Payment will be made as outlined above.
Brand Ta.vyU:(o
ColorKLlS-fIc- d/.llc....1<
10 Year Warranty (Jj(
Lifetime Warranty ~
Year -.6 0
Workmanship:
.A.ffordable Roofing's Representative:
9fr{~
Customer's Signature of Acceptance:
See anached Warranty Statement.
I
1:'
Date:
&~1-61-
'j rr
&- i~- 0 /
J
Date:
,----
BUILDING PERMIT.. APPLICATION
FOR OFFICIAL USE ONLY:
. Date Rec.: 08 -0 ~-D.
Permit#: Of J,. CJ @
Date AppTOved: ~ . J -C'7
Date Issued: :!r.:5 -en
Applicant or AgentMFo-rda 'oIL SerU{f1 ~
Architect/Engineer:
Contractor ~M.b(,.{. Sew r (.fl.!;
Address: ZSeoll.3 f.J w y f 0( IA J
PROJECT ADDRESS: 5 2J1 5
LEGAL DESCRIPTION: Lot
CLALLAM COUNTY PARCEL NU11BER:
Phone:
State License #:A-J;J:nf?', )Il~s'I&p: re/Z31 (ji
I
City: \.5-e~1.L.ifY\ fAJfr
[ha rY\bL~
Phone: &. f;~ qfo let.
zipttBJ?J2-7L/2 ~
ZONING:
Block:
Subdivision:
TYPE OF WORK:
o Residential 0 New Constr. lIl-1te-roof
o Multi-family 0 Addition 0 Move
o Commercial D. Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
o Stove
o Garage
o Deck
o Other
;--t:a lr ~
SIZENALUATION:
SF. @ $ /SF. = $
SF. @ $ /SF. = $
SF. @ $ /SF. = $
TOTAL VALUATION $ -z;.S z...'1, /Y)
Cel-/- conrY)
I
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load: .
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESA/Wetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
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: Ifno 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 RI05.3.2
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 I must obtain such permits prior to work.
T:\Policies\BL-l102_13.wpd APPlicant:9i'l/Pbl-- Date: ~. ~Z-6f- . .
Site Address:
,
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO.
.;( 3 4-~
0/ Lij--15i-
.'
ELECTRICAL PERMIT
DATE
.s
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Installed By:
OwnerlBusiness:
Phone:
Owner/Business Address:
Sq. Ft.
o Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/Industrial load
Total Connected load
(attach breakdown)
Total Motor load
(attach breakdown)
I
DetailslDescription:
/
I
o New Construction
o Remodel
o Service update/alter/repair
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
verhead
o Underground
VoltaQJY- ; "lA>/z-<e-o
~ D31i!J
Service size Amps
o Temporary
e .1--<.-
, .
~..I;{ v 10G-
A~4 , -f:
.
W.S. No. Service Size
Capacity: 0 O.K. 0 Not O.K. Comments
o Ditch inspection O.K.
o Rough.in/cover O.K.
o O.K. to connect service
~ ~inal O.K.
~
Date
Hold for: 0 Easement 0 Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
i $"2
Installer:
~ ""-
PermitfReceipt No.
:2.3<f~
Site Address:
New Meters
I~)
,'-c.
Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work
must not be covered or electrically energized before inspection and O.K. for covering or service has been given
by the Inspector in Writing on the Wiring Report or the Building Permi!. PHONE 457-0411, EXT. 158 or EXT. 224.
~~-'-
Inspector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
OLY"lPIC PRI~HERS. INC.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16014
Port Angeles. washlngton......lqm~.t[~_m____mmm..m___m___. 19./__?
In accordance with the City Ordinance to regulate the installation, extension. or repair of elec-
trical equipment in. On. or about any building or other structure in the City of Port Angeles. per-
mission is hereby granted to do electrical work as listed below.
Address h_.:2.__;)._Y...L/,~,,_C~47-<__k--=(...~_______m__m Occupancy____4-f?62_______hh__________m___h__
Owner ------':-:":~.t:r;'t....:m:%~d2rf:!1f:--h'-- ');anL_..___._m__m____m_______mm..h___m_m_m______________.
Wiring Co~tractoP____Y!f:.__.t)t2:i':U~__:.:Q__{!!2-",:.,..___~.. By._____mm__m__m___hhhhmh_m_______h.h..__mh.__....
Light Outlets.___................____________.._.....
Receptacle Outlets........._____..h....._.......
Dryer, KW........hh........____._n__..______.._.
Range, KW m_hm__mm_____m_____
Water Heater:
KW...............................................
Heat: Kw...jL_.y.~",.ju
Motors: sIze, volts and phase:
ServIce, volts ---/.-:d..9/-..'.::i?f.:;C..
:7
No. wIres .____.......0...........;;::;....
SIze wires..$?1~,.........._..
MaIn fuse ....;,;;lr:J:_t2.A..........
Enclosure __..5.._._.._..0.__..............
Type of wiring:
Entrance Cable .._______m._____
Rigid Conduit ___._________..______
Metall1c Tubing h..h_.........
Current transtormers:
No. & Size............____________.___
Ser. NO..._h......._..._..______....._.__..__...n._.
Ser. No. ..........._......._.._0........___
Ser. NO.._h___h_..........................
Type of Wiring:
Armored Cable ..._0...........__.......____.
Non.Metallic .................___.___.___h...
Knob & Tube......._...___._..................
RIgid Conduit ...............................
Metallic Tubing ....._._...................
Raceway .........._....._._............_......_
Circuits, Light................________...............
Utility 0....................__..._..................
Heat _______.._.__.................__......__.._._
Range ...............n._______...____n...........
Water Heater ..............._._.._..........
Motor ..._..........._.............__........_....
Dryer __.__...__...._...n......_________._..._n.......
Furnace _..________...............__....._........._
Total Load............................. Ser. NO...Uh......._..._.._......____n.._....__.. Total .........._..._........................
Remarks: h___m,__<;'_,_if_.~-b.~m....---.-a-.e.,::L.--2:::..4!.e.~-m-m-m--mmmm-m--m___m_mm___m_.m__
m____.__mm____m__m__m___.m__..__m__m_.__..mmmm___m..__hmn_n.__mmm___mn__m_m~m-- ''''....:_m...__...________.m_____m...__._._____
Permit Fee Treas. Receipt J/~" d L
$_____mh________m_______m__m_. NO.__mmm____m__________ By 1Y-:_m..l_m~__"m---?"k:--!r:O~_._(&4.""__
NOTICE-Current 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 betore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
16014
Address....._._....._.........._....__........_....____......__.....______.._____________.__._______...____.__._....__..___.____._._____.____..Date..._......____......_...__..____._...._____________._..
Owner .........._._..............._......__...._...._u.._._......_.._.............0.......................0......_..........0... Tenant.......n...n..__......__.............._...........................
WirlngContractor________._______.__..__.________...........................__..._.............._..._.......____._.._._.___.....______.____By____....._.....____..._._____...____....._..____._..________._
NOTICE-Current 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 betore concealment.
1M nhtTnni.... Print..,.", Tn...