HomeMy WebLinkAbout414 1/2 E 6th St - BuildingJob wired by "alectrical Contractor 0 Owner
Electrical contractor name License number Date Expires
tp..A..4 Elect' cct.I Cerl4 .5HriThtbroz.ifig
Purchaser's mailing address
f® 7'oX 36 3
City State ZIP
fof A'i c le c t c.
Telephone number •J FAX number
Premise owne,r's name
Address of Inspection
/-1/ 4 1/ /z.. e 5
city
Apo .j 1.
Phone number to schedule inspection.
Owner us defined by RCW I J 28.261 (1) Owner will occupy the struclure for two
years alter 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- 0 Credit Card
lotion 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 Codc, and Card
Utility Specifications.
/Signature of owner. electrical contractor or electrical administrator Expiration Date
\X r Date 3 J /3/O‘ `f card
EleoLoad Ad,p ctions
NO LOAD CHANGES
Baseboard KW
D Furnace KW
Heal Pump Ton LAR
O Fan.Wall KW
SAME DAY INSPECTION, CALL BEFORE 7.00 AM 360- 417 -4735
ROUGH-IN THERMOSTAT
Inspection
Date
Dote
Loo/LOOM
Approved H
FINAL
Ap rove y
//i.4/
Q Overhead Service
Temp Service
Underground Service
Date.
nide
Approved By
DITCH
Area, Building or Equipment Inspected
ELECTRICAL WORK PERMIT APPLICATION
/Installation description
Commercial Residential
0 Now
0 Cash 0 Check
Approved By
Altered /Addition
G q t M.a.s 4. 11 O e,
I 1
r
i
Visa Mastercard
Due
IJou
D FIL-E
Voltage
Phase 1 3
Service Size:
Feeder Size:
SERVICE
Approved By
FEEDER
Action Taken
Approved By
Discover
lnepectio
d//77 r
Service Information
eneenemmt
Electrical
Inspector
P.
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000992 Date 10/20/05
412896
414 1/2 E 6TH ST
06-30-00-0-2-0330-0000-
RES NEW SFR
RESIDENTIAL HIGH DENSITY
25000
Owner
Contractor
RICKENBACHER, JOHN
121 E 2ND ST
PORT ANGELES
(360) 457-0467
Other struct info
OWNER
WA 983626206
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
27.00
2.00
1098.00
7000.00
797.00
1895.00
1. 00
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Permit . . . . .
Additional desc .
Permit pin number
permi t Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
63131
414.75
10/20/05
4/18/06
Plan Check Fee
Valuation
165.90
25000
ttl
Qty Unit Charge Per
Extension
92.75
322.00
~
;1.1
BASE FEE
23.00 14.0000 THOU BL-2001-25K (14 PER K)
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/20/2005 08:42 AM SROBERDS -- The proposal will result
in the placement of a second residential structure in the
RHD zone for a total lot coverage of 27%. Setbacks are
good. No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical permits are required.
10/10/2005 03:06 PM JHEBNER ----------------------------
$410 Connect Fee. Ref 10008 WF43086/01
10/10/2005 03:07 PM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
A seperate water meter is required for the new residence
and a sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
F6.
Other Fees
STATE SURCHARGE
4.50
~
/.-J ? /'
/:~
~/
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b
Fee summary Charged Paid Credited Due
Permit Fee Total 414.75 414.75 .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 s ction authorized is not commenced within 180 days, if construction orwork is suspended or abandoned
for a period of 180 ys are work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I h by c that I have read and examined this application and know the same to be true and correct. All provisions of
laws and 0 Ices rning this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume 0 e aut ity to violate or cancel the provisions of any state or local law regulating construction or the performance of
constru i
)
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building permit inspection record05.wpd (1/4/2005]
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BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FORELECTRlCAL 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 COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRMNAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALUHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR I CEILING
'.. filii- '. ,,~
MECHANICAL
HEATPUNW/FURNACE/D~TS~~
"
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT II's SEPA:
P ARKlNGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W.
ENGINEERING 4 I 7-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102_15 building permit inspection record05.wpd [1/412005]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . .
Application pin number
Plan Check Total
Other Fee Total
Grand Total
165.90
4.50
585.15
05-00000992
412896
165.90
4.50
585.15
Page
Date
2
10/20/05
.00
.00
.00
.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 orwork 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
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building pennil inspection record05.wpd [1/412005]
~
BUILDING PERMIT INSPECTION RECORD
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.
~
,
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INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION: I
FOOTINGS -);}/ f / C( ~St-L S j/'Yloc ,7'(-
WALLS li!J:Jar -:r u....
-, f
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG) "!>k,IOra JVV
GAS LINE
BACK FLOW 1 WATER
AIR SEAL .
WALLS Yj"" Inc. ,JI/
CEILING
FRAMING
JOISTS I GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB /
WALL 1 FLOOR I CEILING 7/I-vj U(p Vy
MECHANICAL I
HEATP~/FURNACE/DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 , PLANNING DEPT.
BUILDING 417-4815 11i}.!fltl n h J LL BUILDING
T:\Policies\1102_15 building permit inspection record05.wpd [1/4120051
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CITY OF PORT ANGELES
PUBLIC WORKS - UTll..ITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000992 Date 12/14/06
412896
414 1/2 E 6TH ST
06-30-00-0-200330-0000-
RES NEW SFR
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
27.00
2.00
1098.00
7000.00
797.00
1895.00
1. 00
'~
~
1
~
~
RESIDENTIAL HIGH DENSITY
25000
Owner
Contractor
RICKENBACHER, JOHN
121 E 2ND ST
PORT ANGELES
(360) 457-0467
Other struct info
OWNER
WA 983626206
Permit . . . . .
Additional desc .
Permit pin number
permi t Fee
Issue Date
Expiration Date
STREET ALLEY RESTORATION
92221
270.00
12/14/06
6/12/07
Plan Check Fee
Valuation
.00
25000
Qty Unit Charge Per
1.00 270.0000 ECH STREET ALLEY RESTORATION
Extension
. 270.00
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/20/2005 08:42 AM SROBERDS -- The proposal will result
in the placement of a second residential structure in the
RHD zone for a total lot coverage of 27%. Setbacks are
good. No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical permits are required.
10/10/2005 03:06 PM JHEBNER ----------------------------
$410 Connect Fee. Ref 10008 WF43086/01
10/10/2005 03:07 PM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
A seperate water meter is required for the new residence
and a sanitary sewer connection inspection is required by
public Works prior to back fill of ditch. 24 hour advance
notice is required.
R
~-
\\1
Other Fees
STATE SURCHARGE
4.50
~
Cf?-
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 270.00 270.00 .00 .00
Plan Check Total .00 .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 0 ork is suspended or abandoned
Signature of Contractor or Authorized Agent
Date
e ted within 180 days from the last
true and correct. All provisions of
1. The granting of a permit does not
g construction or the performance of
for a period of 180 days after the work as commenced, or if required inspections have not been [
inspection. I hereby certify that I have read and examined this application and know th J>a
laws and ordinances governing this type of work will be complied with whether specifie rEf /,
presume to give authority to violate or cancel the provisions of any state or local r /
construction. / /,
i
(
(
T:\Policies\1102.1SR [lI0SJ
PERMIT INSPECTION RECORD
..
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 I ACCEPTED COMMENTS
I YES I NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
.
I I
.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W. I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [1/05]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number . . . . .
Application pin number
Other Fee Total 4.50
Grand Total 274.50
Page
Date
2
12/14/06
05-00000992
412896
4.50
274.50
.00
.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
Date
Signature of Owner (if owner is builder)' .
T:\Policies\1102.ISR (1/05)
I
I
PERMIT INSPECTION RECORD
....
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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
I INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W. / PW / CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [I/05J
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 91B62
Application Number
Application pin number.
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000992 Date
412896
414 1/2 E 6TH ST
06-30-00-0-2-0330-0000-
RES NEW SFR
3/23/06
RESIDENTIAL HIGH DENSITY
25000
Owner
Contractor
RICKENBACHER, JOHN
121 E 2ND ST
PORT ANGELES
(360) 457-0467
Other struct info
OWNER
WA 983626206
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
27.00
2.00
1098.00
7000.00
797.00
1895.00
1. 00
Permi t . . . . .
Additional desc .
Permit pin number
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
SHAMP/ ALTER MAST
72884
SHAMP ELECTRICAL
66.90
3/23/06
9/19/06
CONTRACTING
Plan Check Fee
Valuation
.00
o
--tl
-......
* I
~\,
Qty
1. 00
Unit Charge Per
66.9000 ECH EL-R OR RM 0-200 ALT SRV FDR
Extension
66.90
~
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/20/2005 08:42 AM SROBERDS -- The proposal will result
in the placement of a second residential structure in the
RHD zone for a total lot coverage of 27%. Setbacks are
good. No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical permits are required.
10/10/2005 03:06 PM JHEBNER ----------------------------
$410 Connect Fee. Ref 10008 WF43086/01
10/10/2005 03:07 PM JHEBNER ----------------------------
Any modificat~ons to the City's electrical facilities will
be at the customer's expense.
A seperate water meter is required for the new residence
and a sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
~
1-
1
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 66.90 66.90 .00 .00
COMMENTS/ACTION NEEDED
ELECfRICAL PERMIT INSPECfION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPEC110N TYPE DATE I ACCEPTED COMMENTS
YES I NO
DITCH
IH)1T~l-I_IN I \';UY~K
:ShK Y lCh
~"' TAT 1 I
GENERAL COMMENTS:
PW.II02.l~ (4'961
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
.l21 EAST 5TH STREET. PORT ANGELES. WA 91B62
~
Application Number . . . . .
Application pin number
Plan Check Total
Other Fee Total
Grand Total
.00
4.50
71.40
COMMENTS/ACTION NEEDED
Page
Date
2
3/23/06
05-00000992
412896
.00
4.50
71.40
.00
.00
.00
.00
.00
.00
ELECfRICAL PERMIT INSPECfION RECORD
;
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCKPTED COMMENTS
I YES NO
UlfCH
ROIIGH_lN I CUV-hK
~~K VICE
.
.. 3 -";"J,--Ob I ~
GENERAL COMMENTS:
PW-lI02.1~ (4196]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000992 Date 11/22/05
412896
414 1/2 E 6TH ST
06-30-00-0-2-0330-0000-
RES NEW SFR
RESIDENTIAL HIGH DENSITY
25000
Owner
Contractor
RICKENBACHER, JOHN
121 E 2ND ST
PORT ANGELES
(360) 457-0467
Other struct info
OWNER
WA 983626206
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
27.00
2.00
1098.00
7000.00
797.00
1895.00
1.00
~I
-
~
~-
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
M- MOVING PERMIT
HOUSE MOVE FROM 1025 GEORGIANA
65516
115.00 Plan Check Fee
11/22/05 Valuation
5/21/06
.00
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BASE FEE
Extension
115.00
\\
&
~
Qty Unit Charge Per
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/20/2005 08:42 AM SROBERDS -- The proposal will result
in the placement of a second residential structure in the
RHO zone for a total lot coverage of 27%. Setbacks are
good. No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical permits are required.
10/10/2005 03:06 PM JHEBNER ----------------------------
$410 Connect Fee. Ref 10008 WF43086/01
10/10/2005 03:07 PM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
A seperate water meter is required for the new residence
and a sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 115.00 115.00 .00 .00
Plan Check Total .00 .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
Signature of Owner (if owner is builder)
Date
T:\Policies\1102.15R [1/05]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W. / PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\II02.15R [1/05]
. d pO"f ....\i
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . .
Application pin number
Other Fee Total 4.50
Grand Total 119.50
05-00000992
412896
4.50
119.50
Page 2
Date 11/22/05
.00 .00
.00 .00
~
~
-
Z
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 ave read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governi IS type 'fwork will be complied with whether specified herein or not. The granting of a permit does not
presume to giv t I 0 olate or ancel the provisions of any state or local law regulating construction or the performance of
construction.
J\J. 'kL <J :s
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1 J02.15R [1/05]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE 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 NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W./ PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\11 02.15R [1/05]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000992 Date 10/20/05
412896
414 1/2 E 6TH ST
06-30-00-0-2-0330-0000-
RES NEW SFR
RESIDENTIAL HIGH DENSITY
25000
owner
Contractor
RICKENBACHER, JOHN
121 E 2ND ST
PORT ANGELES
(360) 457-0467
Other struct info
OWNER
WA 983626206
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
27.00
2.00
1098.00
7000.00
797.00
1895.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
62331
715.00
10/20/05
4/18/06
plan Check Fee
valuation
.00
25000
Qty Unit Charge Per
1.00 .715.0000 EA PW W/M 1" SERV 5/8" METER
Extension
715.00
permi t . . . . .
Additional desc .
Permit pin number
permi t Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
62349
110.00
10/20/05
4/18/06
Plan Check Fee
valuation
.00
25000
Qty Unit Charge Per
1.00 110.0000 EA SAN SEWER HOOKUP
Extension
110.00
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/20/2005 08:42 AM SROBERDS -- The proposal will result
in the placement of a second residential structure in the
RHD zone for a total lot coverage of 27%. Setbacks are
good. No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical permits are required.
10/10/2005 03:06 PM JHEBNER ----------------------------
$410 Connect Fee. Ref 10008 WF43086/01
10/10/2005 03:07 PM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
A seperate water meter is required for the new residence
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or con . n authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days erthe ork as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereb certify, a have read and examined this application and know the same to be true and correct. All provisions of
laws and ord. c gove this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume uthor" violate or cancel the provisions of any state or local law regulating construction or the performance of
constru io
Signature of Owner (if owner is builder)
Date
T:\Policies\1102.15R [1/05]
I'
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. 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 COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRlVEW A Y APPROACH
BACK-FLOW DEVICE I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W. / PW / CONSTRUCTION - R.W.
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [1/05]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000992
Application pin number 412896
Page 2
Date 10/20/05
Special Notes and Comments
and a sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 825.00 825.00 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 829.50 829.50 .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 Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\Policies\1102.15R [1/05]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE 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 NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEW ALK
CURB & GUTTER
DRlVEW A Y APPROACH
BACK-FLOW DEVICE I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W./ PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [1/05]
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11/23/2005 13:08
2506568850
NICKEL BROS
PAGE 01
Nickel Bros. House Moving
2060 Mills Rd. Sidney, BC V8L SX4
Tel: 250 656-2237 Fax: 656-8850
Email: vic@nickelbros.com
Website; www.nickclbros.com
NICKELIIRDI.
HDUIE ..""11I6 ~ TD.
Fax Transmission
Date: ~DV. a3 Jc6
Attention:---11.t
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From:
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11/23/2005 13:08 2506568850
1l/;:;'/U~ ~l::ll 1:5:0-1 FAX HlJ279811281
NICKEL BROS
DA\~ PIZUR ASSOC
PAGE 02
~002
~COR~~
...-.,._...........
~RQgIJOI~
DAve ~IZUR & AlaOCIATI!S. LTD.
20800 IlI\l!NSON DRIVE. SUITIl110
WAUK18IotA. WI 1311.
PH: (212) 7N-1280
UII TS (IHI1DCJn')
11:231200e
THIS C TI"CATE II I SUED AS It MATTiR OF INFORMATION
ONLY AND CCNFE~1S "'0 RIGHTS ~~ THE CERTI'ICA~
1'40lDl!fl. 111411 CEIHIFICATI POQ NOT AMIi"D, EXT!ND OR
ALfl!lt TMI CCVI:AACIE AFFOItDeC IY THIi flOLIClES l!lOW.
COMPANIIi' AFFORDING COVI!RAGE
TRAVELERS INSURP.NCE C::lMPANY
NICKEL 91'105. HOUSE MOVING USA., INC.
ZOllO I\I:IU,S R.OAD
SIDNEY Be veL 11)(4
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THta II! 'ft) CERTI?1' T~'f THI POLICIES of 'NSL:RANCE LISTED 81!LOW HAve 'EI:~ ISSUED "TO THE IfjSUREO HAM!D ...eOVl! I'CR THE POUCV PERIOD
IMDICATED. IIfOTWIT"'TANDI~C /l,HY REQUIIU:'..EIlIT. "Tf"'" OR CONOIT'lON OF ANY CONTRAcT OR OTHER DOCUMEt. T W!TH "llipeCT TO WHICH 'Ofl.
CERTlFlc.Tl! ~y IE ISSUED 0" t,AAV IIERTAIN, THE 1'I6URA"CE """0"1>10 ..., T"E! iJO~It;lES DESeR.ED ...EREIN I! $IIIJICT'O ALL THE TER""lI.
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a
House Move Permit
Nickel Bros. House Moving Ltd.
2060 Mills Road
Sidney B.C. V8L5X4
250-656-2237
Date of move: November 25 2005 Time: 4:00 AM - 6:00 AM
Read before signing:
This permit is issued under authority of RCW 35A.82.090 and P AMC adapting the
Washington State Traffic Code with the specific understanding that all Washington State
Laws, Administrative Codes, Regulations and Conditions, including those not listed
herein will be complied with. The undersigned permittee hereby certifies the
information supplied to the City of Port Angeles is true and correct. I understand that the
permittee shall be liable as set forth in RCW 46.44.110 for all damages to any property
resulting from the movement ofthis structure. The permittee shall hold harmless and
indemnify the city, its officers, agents and employees against any accident, liability, loss,
injury, action and the costs thereof arising from the conduct or operations ofthe permittee
in connection with this permit.
Agent signature:
Date: Jlbv~ ~1-03
C/file
Port Angeles Police Dept.
NICKEL BROS
PAGE 03
. INSURED
.-.-._--.....~~.-._-_..
OA Ti:' iMwDDfYYj '1:
( 01/01/2005 ~
THIS CERllFICATE 1$ ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CElnlFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
.._~ ....--.-....---.....
COMPANY TRAVELERS INSURANCE COMPANY
A
DAVE PIZUR & ASSOCIATES. LTD.
20800 SWENSON DRIVE. SUITE 160
WAUKESHA. WI 53186
PH: (262) 798-9280
NICKEL BROS. HOUSE MOVING USA, INC.
2060 MILLS ROAD
SIDNEY, Be V8L 5X4
COMPANY
B
-----~ .-....-.. .. .__... ..... ..-...---
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COVED'~~ !i..l'>,~.:,\" 1'.......1 .
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THIS 1$ TO CERTIFY THAT THE POLICies OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTlFICA TE MA Y BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Al.l THE TE:RMS.
E)(ClUSIONS AHD CONDITIONS OF SUCH POUCIES, LIMITS SHOWN MAY HAVE BEEN REDUCEO By PAID CLAIMS.
co
UR
TYPE OF INSURANCE
POLICY HUMBER
~ouey E'FlC;nYE POLlCV UPIMTlON
~n (lIIWDllIYYl DATI! IMIIIOIllYYI
.--..---------- '. ._~_.-.... ....---....
UMITS
aENERAlllABIUTY 660-0081<444-0
A X COUME~ClAL GENERAL L1ABILITV
CLAIMS MADE 00 OCCUR
OWNER'S & CO/llTRACTOR'S PROT
AUTOM081lE LIABIUTY
ANY AUTO
ALL OWNED AUTOS
SCHEDUl.ED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LlABIUTY
ANY AUTO
.._--
EXCESS LlABIUTY EX86BK445-2
A UMaRELLA FORM
X OTHER TtiAN UMBRE..v. FORM
. WORK"R'S COWEMlIATlON ANO
.IPLOVE,..' L1A.1UTY
1/1105
1/1/06
GENERAL AGGREG^TE S
...._- .---.
PRODUCTS. COMP/OP ^GG ,
PERSON~ " ADv INJURY
EACH OCCURRE/IlCE J
FIRE DAMAGE (Ally one rlAll I
MED EXP (Anyone I*lonl S
2,000,000
2,000,000
1,000,000
1,000,000
100,000
5.000
COMBINED SINGLE UMIT
800lL \" INJVRY
(pa, .....0..1
800IL Y INJURY
(pe, ac:dclanu
PROPERTY DAMAGE
AUTO ONLY. E^ ACCIDENT
OTHER TtiAN ^UTO ONLY:
EACH ACCIDENT S
AGGREGATE S
1/1/05
1/1/06
EACH OCCURRENCE
-'GGREGATE
1,000,000
I 1,000.000
INet
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s
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THe Plla.ouETORI
PNnN~CUJ~
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OTHER
El, EACH ACCIDENT
EL DISEASE. POLICY LIMIT
EL DISEASE. EA EMPLOYEE S
,SCRII'T1OI1 Of O~EMTlOIISlLOCATlOlllUVII!HICLEIIIS~_L IT"'"
..... , .. .(
STATE OF WASHINGTON
DEPARTMENT OF LABOR AND INDUSTRIES
CONTRACTOR REGISTRATION SECTION
221 HERITAGE FARM LANE
FRIDAV HARBOR, WA 96250
'WOULO ANY OF THIi A.OVE D&ICRlBED .oue.ea BE CANCELLEIl aEfORt: TME
liX"ItATlOIt DATa '~OF. THE .UUlNG CO.'AIIY WILL IiNDEAvOl\ TO MAIL
30 OAYI *RITTEN~~ CElmflCATE HOLD"t HAMED TO THE LEfT,
aUT" UI\E TO a"'CH NOTlCi I POlE NO DBUGA TION DR LIAIILlTY
OF IIY KIIID UI' THE CO_AllY, IT AGENTS OR REPRESENTATlVEO.
COR. D'~'2' ..~J... :. ),,;;')";r:;1;' J:;;-",;;.;~.,~~Jt.",i.l5i~~)"':d"\\";.::~1~~~~\"''*i.il~;;'J:'~).,.!f~~,,'(.'~;.~',
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11/15/2005 10:40
250656885El
NICKEL BROS
PAGE Ell
Nickel Bros. House Moving
2060 Mills Rd. Sidney, Be V8L 5X4
Tel: 250 656-2237 Fax: 656-8850
Email: vic@nickelbros.com
Websitc: www.nickelbros.com
NICKEL BRD.!Y.
HilL/IE ..wDV'N6 ~ TD.
Fax Transmission
Date: Nov IJ) 1010)
Attention:~
Pages (inc!. cover): 7
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embers of the "International Structural Movers Association. & Be Structural Movers Associatio
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.... HOUSE MOVING APPLICATION and PERMIT
CITY 01' ~O",T ANGElES. IUIUJING l)IVlSJON
Thelo/lOwlno m.aerlal. ... herwbV pravlCl~ lr; allpl[catlon for _ I1OU.. fJlPYSt Permt!:
NN.4IT NO.
1. N'~'Cf~tcm"t:. NI(V~J ~j ~ nnlj~
2. Addr~, \'1f ~pllC3nt.P ~t"i~ ~ J-n "" \ ~dn) t'tr~....., l~)l} ~j2
3. Tllepf1ant af~plleallt{~3m~.~ D.oIprapoeed mcw.en~ (l1.I'.lIor!:~v~k ~~ ~
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fi: OrIOMIIDC*~ (~tjdrea)ofbulidlng::~ ~l'^'1I\A ~..,,'*.. .";' iU-;t..-..--.---. ......-.. ,,-.~.
~ deacrlptlOn d arl~t1"ll)oa'cm ~ buUdil~ .....
ft. NllW propc>>" lo~IIDn ct bu:l~ir.a: ~ E.... ~ ~ , Pt. ~~ r at>>
Lag.1 d!NcrilltlClI\ d n_ ~ropoMd IoceIiDI'l of bllldl!)f:
T. ~le ea t.-. ..en Ircm 011I fooaticn '0 "" lo.-tton:_~---<.t ~ ~ ~~~~ .. ~ o~J-l'" ~ ~ Ol'\
8. c.'Oril)ftln Of OUlT1Jnt O~ldr.g; ~ - ,
8. wcm.n COI'lItrrn.lion IhIt It'.. ~9 t'law b.n eor'IIIcacf includltlQ If'Idlvldull&'s tlatnl. t81.p"o~ lII1d dl-':
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;!rUClile fItd Nt ..UNUI I.t ID bII "hid tit rriI\Irnurn ~C"'1I C;~ "~"II .111".... ,..... 11113 'teIti lor _ l4ttblh till. 11) ~llr lrOfll tlla
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PAGE 02
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HOUSE MOVING APPLICATION and PERMIT
cmr OF PORT ANGELES. eUILDING OIVISION
The following mare:"ials ,are hBi"8by provided In apl)lIel!ltlon for 8 HOUie MOVEl PQmlit:
~~MIT NO.
1. Natr.& of applicant: l\ll (uj ~c;.. ~ N'DI i ~
.2. Addr~1S Of ~ppIlCllnt; fP\ \otl.r", ~- ~ Ln 1M 1 .~ t:fJ'J j Hr.l.rh.>Y'"iu 1A q~:lq)
3. Telephone of ApPIiCant'~~.. .~, Date of propo&e~ move and duretiQ": ~",.a"Vhs- 40". ~ ~
'''. 4. Name of insurance c:ompeny~d agent and copy of certlrIc.ate C1f in~ur.ance;
- - ;-~~~:;i~~~:~) ~ b:,id~~:~:"~-~~-;:~~~~~$ ~.~~-~.. .-1,;;,' -,".,,-, --"-' .'.., '.' ,..
Lllgal descrlptlon of arlclnal ((lcdon 01 building:,
ij. Ne\'\' proposec ICCOIt!Dn of bUlldlng;~ E.. ~ ~ fibt(j,!;., U""',
Legal ~sc.:rlption of n8W projXJ:J.d location of bulldlrlg: "
~~ ~ ~ On ~~b", ... Ai;.ct- OYl f, ~ ~ ld+ 0"\
7, Route to be taken from olClloeatlon to new location: ~. ~ c;r. ~ tlal6loct ".",. ct. ~ Fit: -In ~I" E.<~ St-.
S, Description Cf current building: ~l)~
9, Written exmflrmallon that the following hllVe been contacl.ad incll,Jdlng indiVidual's name, telephoho and date:
A.GENCY
CONTACTPE~OIll
OA-;E
PHONE NO.
Poiclt
WlIt,r. SIl\'IIer
(-47u" O~
aw.! CoIrvrwnQ~o:lll
Walta a~lUItl Tel"cable
Gtatll Dllpl otlr4lns.
CPI (A....r Ol'ClCl!l )
! herioby acknowledg" that I am I1IepoftSlble for ''''Unlltl, darl\:lgel. .nd any e~n&G1C InCl.lrl'8d by the City or oilier ag9l'lclaa eluring tl18 m::>\.'il1ll ~ \l)ls
alnJ~,.. II'ld that fh$ S1l'lJc:tur. Is 10 tllIlMlPfllC/ 10 mifllmum Bulidlng Code requ1f8ffi1lll1l .1" I1lt'N IoClltklrl .00 read)' for"" Wllbfll onlll (1) rear from the
dIri!o ar mC\o1nllltl" lSlru~re. In con~J~ra1ign (If tllo '"'ntlnq ar lhi, permtt, it i!l1urthet acreell by 1Il4l1lpplioel1\ !hilt t"'- City of Part AngeilSll: and .oy ot i1B
cfflClll'S O~ arnplQlljeft ahall b6 aavad harmlNllo 1h(lllppllcllnt from .-!y l~bNItY or rw'PDl1fI/jlIIl~ 1'cr anr elll:ld8l'lt, IDIII I,)f cllrnnQII ro Pt$1\Il or prol>lrty.
haPlltlnlng D:' 0I::UIT1r1I;; ~ tflo pI'Ollirnllll reault t;lany wort: llIIdllt12k8n dlr rI1I! II!IrmI r;tI Dlit IPIIKCII&lon lUll! lfIe perm't or perml15 \MIj~ may be cmnlell
in to, .,t11hat all df "Id IGl1ItI.. are heratly saallmed ~)l11le .pi'llcel'lt.
.tbit. 1/4r
De"
-OFFICIAL U8fi QMLY;-
Om:.: n'lO'JU 10:* ;:MC1I: rnlls6urer'tl RllC1lIP1Io1o.; SIdt). Pennlt. ~ht d W:w eonttr. Pel'1"l'lll tI
Oilll'NlQl: III'l<I Of inoldenl2l en IOU" Ilnd OOII'ltI'Iett13:
OriQll'lal S~ ~lIltft11ion compW8d:~ Dat. ok ftJr ~patlCy:_ Retund ~..~_ RllfOntl Amollnt:L
Ctl<<k 1'10.____
APPJIlOVED I;V BUILDING INSPECT~
DATE.:
8L.1'O~..DZ 1~/Cl4l
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1 1 - 1 - 0 5; 1: 36 PM
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2506568850;# 2
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HOUSE MOVING APPLICATION and PERMIT
CITY OF PORT ANGELES - 8UILDING DIVISION
PERMIT NO.
The fOllowing male~ials are ho.-eby provided in sppllc!tion for a House Move Permit:
'1. Nama of applicanLA11(~j eroc.. ~ N'nv iiYj
2. AddTe~l'l olp'ppl1c8nt:_~ \{.tci.~ ~ -LoV\l-. ~rIrfoJ Hru-kny"ll1'~ q~"V
3. Telephone of AppliC8nt:{~)~' -~ Dato of proposed move and duretio'i: kh\l..1.-ybS- ~ ~
4. Name of Insuranco ccmp21nyand .agent and copy of certlflcate of in~ur.ance:
... -... - -. '.-- '...., ....---., --~- _.._-~---~---- .......... -..-~_."""''',""... ....-- -.......-.... . --.---..-.,.--...... -........-. ... '-' ---.-......
5: Orl~jnal i~~U~~ i8ddres~) ofbulidl;,g:~ IQ~ ptn~;o.J{\Jl $-,'*. ~es I LUA-."-'-'-' .....
Lll'lgel de~crlption d orlginallccstion of bUilding:
6. New proposed locstlon of buildll"lg:~ E:... ~ ct. , Qt~:.. I lilI\-
Legal df)sc.:rlption of naw proposed locatio,., Or building; _
7. Rout~ to be tDk~ from Old location to new lOCation: ~g.~ ~ ~~~~ -+o:~ o4,.f'l' ~ ~ 0""_
8. Descripllon Of current building; Hnu~
e. Written confirmatJon that the following herve been contacted including individual's name, tolGphone and date:
AGENCY
CONTACT PERSON
OA'rE:
PHONE NO.
PoIce
QWut CoIMlUnicabo.18
WIIVII Broa:ltlland TQI~cable
State DIlr,1t DfTrano:,
CPJ (Fiber ()pCja )
! h8~by acknowledge that I am IUpoMlb~ lOr In)Ul1l1ll. !Jirn:agel. and .n( elCfll!ln!lllc InCUl'1'8d by the City or otllbf a~anclooa cluring tld mo~ing of It.i~
iOlnIclLl,.. ~d rhDt thell1ruchxe ~ te be ~s!l:lllld to minImum alljid~.ll Code requltl'llTllll115 ;It 1111 ne'IV I~ .nd relWY for ~. wltbln tlnll (1 i year from the
dill!! ar mCl'flnlllh1l tllroDluI'll. In oonsldllratiDn Of thil grllntlng afti'll, permit, it is 1IJrther agreod Ily tJ')Q Ilppllcent !hilt thQ C,;fly of Po~ A.n~18Il !lnd any of l1!I
offlellf!l o~ .~loye" ..hall ee ~ tlarml_ to the applicant trOll't Wly IletlYlty (lr ruponlltllJlty tor 2nr IDllldri Ion or d~nlllgO to ~l\Il .or p/Of)ertt.
happei'llng O~ QCC\lmng lII! tho Dr'O)omalll rfllUIt of an)' WtlIt: und8l'lalcen under tile terms Df DlI. aJ)1)lIoatiOlllllnrllhe permit 01' permits v.tJjch may be w.anlell
~~. to, ..,d hI 1111 of 'al~ K;abl111l8ll are: htll"llby ..IUlT\lld by tie appnc.nt
~~ ~1/tJJ
. 1711ture ::lB'"
-oFJIllc;;W.. U8E ONL Y:-
Oa;e /nOVlI tooII ::IIIC.:___ l'relll~Ll/'Ofc Receipt No.: Bldg. P8rmltj RIgIl! or Way Conatr. PermIt'
Dal'l\lIOe ISI'Id or ;,oi:len!$ er, ItlUlllllncl oomm911ts:
OriQlnBI Sitll Ri:oOlomtiQI\ COI'!'\pletad:_ Dat. ok fer OCCLlpal'll:y;_ ~!lfund DAr.~_ RllltJnd Amcunt-L.
Che(:k No
APPROVED BY BUILDING II"SP!;CTOR:
DATE:
BL.llG~_02 191041
,-
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NICKEL BROS
nx No. 36C 41'7 4659
PAGE 04
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HOU8EMOVING APPLICATION and PERMIT
CfTY OFI't>Prr N4i~iIJ . JtL1ILOI"'~ OMSION
Th..folIDWlng ma-.:....II. '*-)1 PfMU fn applbllon far a H~ ...,. Pormlt.
t. N-"_af~~ UI(~J ~. ~ 'Nlt'W;~
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L.aoel dMcrll:ll", t:A ~ "rollOl_" loaallon of b6IIttnO~ _' . ... _ .
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HOUlE MOVING APPUC""ON and PERM',.
Cl1" Oft ItORT ANGtU.lll . BUlI.DIMQ Ol'IasION
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. UfO" ~l!J1lon d lIrlO'-'. 1G1l1I., rI ~"g; & ..... _.~_.___.._...__.
O. N_' P'lIPDlC lecdon of Dl/1cJfto; 1ti4 ~ ~ F} . ot ~U4.. . U 1It '_'_
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. .
NICKEL BROS. HOUSE MOVING USA Inc.
221 Heritage Farm Lane, Friday Harbor, WA USA 98250
Tel: 38~378.3328 Fax: 250-656-8650
Email: vlctoria@nickelbros.com
Website: www.nickelbros.c.om
House Moving Application
1il~...u;;.U . ':a~~ ."::' .i'IM05 602
~~~BQh~W'1'i!'ir@Q.i~1m ~
Date: November 1, 2005
fu: ~~
Port Angeles Police Department.?1
Port Angeles Fire Department
Public Works Engineering
Port Angeles Building Division
City Light Department
Qwest Communications
Wave Broadband
CPI
-zm>l (M./; /r /
A!tJ1: Terry Gallaghert Deputy Police Chief
~ttn: Ken Debuc, Fire Marshall
JAttn: Trenia Funston
~n: John Hebner -- /
Attn: Frank Lockha~ e>>J~,e '0)~~~UJP - C~
Attn: Mike Sturgeon ~ ,",\" ~tt.s
Attn: Bob Jensen ~~LP~F\OO~U?n.
From: Christy
Please see listed below the details of a structural move that is to take place on public roads:
Structure:
Moved from:
To new location:
House
1025 Georgiana St, Port Angeles
414 E. 6th St., Port Angeles
Dimensions Loaded:
HEIGHT: 17'
WIDTH: 24'6"
LENGTH: 52'
ROUTE:
1025 Georgiana St., Port Angeles to Left on Washington To Right on E. 5th St. to Left on S.
Vine 51. to Right on E. 6th St. to 414 E. 6th S1.
Proposed Moving Date: Friday, November 25, 2005
Proposed Moving Time: 4:00 AM - 6:00 AM
Please sign the attached House Moving Application and Permit and fax back to
(250)656-8850 or call 1-866-606..2237.
Thank you,
Nickel Bros. House Moving Ltd.
, ~~",".~'''~''~
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Members of the "International Structural Movers Association.
11/01/2005 13:33
2506568850
NICKEL BROS
PAGE 01
NICKEL DRD$.
HDL/IE IWOV'N, ,L. TQ,
NrCKEL BROS. HOUSE HOVrNG USA rnc.
221 Heritage Farm Lane. WA USA 98250
Tel: 360..378-3328 Fax: 250-556-8850
Email: victoria@nickelbros.com
Webl>ite: www.nlckelbros.cQm
Fax Transmission
Date: November 1, 2005
Pages (incl. cover): 4
To: ~n ~vvr
From: Christy
Fax #: ~~I-Lf70q
Re: AQplication for House Move, Port Anqeles
Good mornil1fL.
The following paQes include an application for a house move in the Port Anaeles area. which reQuires
a sianature from your aQency. I have also included the details of the move and the dimensions of the
house as well as a map of the move route.
Please call me if you have any Questions.
Thank YOU,
C.~_~i~~__ n n -. _n__. n - - n - n. n n - n n --. - ".n _ n _ -- '''u u-_n__..unnn n_ -.._______u _ '" nn_. __._."^ __ _ __ _ _ n n_. __n n_ ____on ___
if you do not receive all pilgGS pleate call (2501858.2237
{(~ (.<' ~jl~J F ~~
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IMembers of the "International Structural MOvenl Association. & Be Structural Movers Associatioi$l"o\
l..~),:
'lS~
11/01/2005 13:33
2506568850
NICKEL BROS
PAGE 01
NrCKEL BROS. HOUSE NOVrNG USA J'nc.
221 Heritage Farm Lane. WA USA 98250
Tel: 360-378-3328 Fax: 25Q..856-8850
Email: victoria@nickelbros.com
Website: www.nlckelbros.com
N'CKE~ BHD-*-
HOUlE MOV'N6 ,<< T'~
Fax Transmission
Date: November 1 J 2005
Pages (Incl. cover): 4
To:..:hhn ~vvr
From: Chrisb'
Fax #: ~11-470q
Re: A2Plication for House Move, Port Anqeles
Good mornin...a..
The followinQ paQes include an application for a house move in the Port Anaeles area. which reauires
a siQnature from vour 8Qencv. I have also included the details of the move and the dimensions of the
house as well as a map of the move route.
Please call me if you have any auestions.
Thank you.
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Area Map
This map is not intended to be used as a legal description.
This map/drawing is produced by the City of Port Angeles for its own use and purposes.
Any other use of this map/drawing shall not be the responsibility ~r the City.
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BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUS
COMPLETE to be accepted for review. If you have any questions, ca
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent:
Owner: ,10 hI') tJ
Address: 16 / z I E
!?(t~t'N> t, CfC 4 (' ('
2 YlcJ Sr- City:
I2rf Aq ek.J
J
Phone:
Phone: 3 (; 0
tv'1I- Zip:
L/fl tf2.8'c.
9<f36<
Phone:
State License #: 'J), ICkfdF9'1l'li'bExp: 01 la'll€) (, Phone: 'I' / C/Z S' C
1 {
City: i?rI 4.~~ll I.J b Zip: Cff3( (.
~l S1 ZONING: Rl/lJ
Block: 2 03 Subdivision: r p /l
CLALLAMCOUNTYPARCELNUMBER: - a b:'~.~ E)@:oaJ3JC0060
Contractor
Address:
P OJECT ADDRESS:
E..
SIZENALUATION: /
SF. @ $ /SF. = $ 2- ~ 000
SF.@$ /SF.=$
SF. @ $ /SF. = $
TOTAL VALUATION $
#'0 ""I", Fro^,", IU#'....-J.- GC"nrolc...,c,
v
Por c ( Oorf,G"~ C r"t off .far IL. I^oI tllJ ~ .
I
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-roof 0 Stove
o Multi-family 0 Addition ji1 Move 0 Garage
o Commercial 0 Remodel 0 Demolition 0 Deck
7)f. Repair 0 Sign 0 Other
BRIEF DESCRIPTION OF THE PROJECT: /'7 ("M!'
L! / ~ E ~~~ Reale-a;) Roof <1
I
<'>11 tl e",J Co/l~,,~ffJ -h,,,,,,,j<;,,ho"l
COMMERCIALIRESIDENTIAL: Occupancy Group:
No. of Stories: 1i Lot Size: 7/)()o'" Existing Sq. Ft. 1098
Total lot coverage '27 %
:/-0
5"f
Occupant Load: .
& Proposed Sq. Ft.
Construction Type:
?l/i! = TOTAL Sq. Ft. I?J 'rJ
,
7'7
';
ESAIW etland(s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
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 wi' 80 days of the date of application, the application will expire. The
Building Official can extend the time for action by appli to 80 days upon written request by the applicant (see Section R105.3.2
of the International Building/Residential Code, 2 a 'ca' n can be extended more than once.
know the same to be true and correct. I am authorized to apply for this permit and
e required ,not the City's, and th I mu obtain such permits prior to work.
)05
I hereby certify that I have read and examined t
understand that it is my responsibility to determ' e
LOli'i~\BL-1102_13.WPd
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . .. .
/ REQUEST: _! J ~
Date 7jLCftJ(P Time ~~ Received by ir (phone. parsor
~~' /. f'~ /- ""21
Location of Work to be inspected ~ ~ cp
Name of person requesting inspection J'l!{2W E~ - ~p.
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. &'5_ <94~
c5>FoundatiOn Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES: J 4
Inspected: Date ;L/I tJ 0 ~
Remarks: O. t:. - 1.-,.".... '..,....
~\-k '-4'...."'-e ,t- ~ (\~....
3~
Time
~.... on (.. -ili rIM ~
(...11 - ~"- 'f1,...l-
By
1,Jr> .L.,
altey h-.~~.
/:./ - ~
~ I / )
/ /';XIG "\
RESTORATION REQUIRED . . . . .. YES X NO )
.
t '-A /i'-- ~ .-/
"
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u /1 t\-It-e-y q !.
~T'l;> o~ (, I' l~ be Iou...< Ihf'- ~......~ '
~
---..
---
----....
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel
Q"Repaired by City:
o Repaired by Permittee
o No Damage Found
C6Asphalt 0 PCC 0 Other
Work Order #
~ COMPLETE 3//;)../07- wO---
o INCOMPLETE
0\ \d- g:d-<"-
J/(f..7
"
,
,
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . .. .
REQUEST: ~r J (l J1!-
Date ~?t;; Time 0 Received by -r-,=- (phone, person)
~ / I
Location of Work to be inspected ,,-1'/L! F ~ ~
Name of person requesting inspection ~ J'l'lUU E"~ - ~~.
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. CJ5_ t1/4;;;,
e Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTE~ ~ / ("
Inspected: Date f I [) L 0
Remarks: O. C. - \- i........ ~~..,....
'F:,...'\-k c:-...,.,..,,~ ./:-.. ~-e.....
3~
Time
~... on (.. -fu rIM !o
L.~ - 5.coc ~I-.
By
IJ... .Lu.
alter h.....s. e.
t ' i. ' \
L".,-c co.......,,'~ i 414 z .
Lot....... .... (,.~
r~tl ~"'er f' ~;'L
~-
U, Lt= l". II !('\i,- h Co
\t
. ~
lO-
T" - --
--~ - .
- -- --- -~
0/1 ~lI.~y q !.
~T.l" o~ (, I' l~ ~lo"'-' /h'F' S-",p
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
0Repaired by City -:
o Repaired by Permittee
o No Damage Found
[}-Asphalt 0 PCC
o Other
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)