HomeMy WebLinkAbout1019 W 15th St - Building e CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
v 321 EAST 5TH STREET PORT ANGELES WA 98362
Application Number 10 00001056 Date 9/22/10
Application pin number 063712
1
Property Address 1019 W 15TH ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER 06 30 00 0 4 1375 0000
Application type description PUBLIC WORKS UTILITES on your state excise tax form
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
RCP# 10 29 Push or Bore Telephone Line
Owner Contractor
HEMPERLY JOHN S EXCEL UTILITIES CONSTRUCTION
1019 W 15TH ST 54 W MISTY LN
PORT ANGELES WA 983637231 PORT ANGELES WA 98362
(360) 452 1110
Permit RIGHT OF WAY
Additional desc RCP #10 29 TELEPHONE LINE
Permit pin number 173823
Permit Fee 150 00 Plan Check Fee 00
Issue Date 9/22/10 Valuation 0
Expiration Date 3/21/11
Qty Unit Charge Per Extension
1 00 150 0000 ECH RIGHT OF WAY PERMIT 150 00 O
Special Notes and Comments
Applicant responsible for all restoration work If alley
closure required, attached traffic control plan to be
implemented
Fee summary Charged Paid Credited Due
Permit Fee Total 150 00 150 00 00 00
Plan Check Total 00 00 00 00
Grand Total 150 00 150 00 00 00
Separate Permits are required for electrical work, SERA, 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 t. •'late or cancel the provisions of any state or local law regulating construction or the performance of
constructio
Signature of Contra tor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T \Policies \1102 15 [10 /08)
PERMIT INSPECTION RECORD
CALL 417 -4831 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
DRIVEWAY APPROACH
BACK -FLOW DEVICE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4831 PW ENGINEERING
FIRE 417 -4653 FIRE DEPT
PLANNING DEPT 417 -4750 PLANNING DEPT
BUILDING 417 -4815 BUILDING
T ,Policies\ 1 102 15 10/08]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000038 Date
385656
1019 15TH ST
06-30-00-0-4-1375-0000-
JOHN HEMPERLY
RES REMODEL
1/20/06
Owner
Contractor
~Ev 4/?kJi:,
:fU/'
RS7 RESDNTL SINGLE FAMILY
4000
HEMPERLY JOHN S
1019 W 15TH ST
PORT ANGELES
WA 983637231
BILL MYERS CONSTRUCTION LLC
391 BROWN RD
PORT ANGELES WA 98362
(360) 452-4557
\)
-
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Pe rmi t BUILDING PERMIT -RESIDENTIAL
Additional desc
Permit pin number 69245
Permit Fee 123.75 Plan Check Fee 49.50
Issue Date 1/20/06 Valuation 4000
Expiration Date 7/19/06
Qty Unit Charge Per Extension
BASE FEE 95.75
2.00 14.0000 THOU BL-2001-25K (14 PER K) 28.00
1
~
c-:
Other Fees
STATE SURCHARGE
4.50
~
\J\
~
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 123.75 123.75 .00 .00
Plan Check Total 49.50 49.50 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 177.75 177.75 .00 .00
t
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
ctio
-alP
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building permit 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.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION: I
FOOTINGS 1/1-.....1 / () C- ..j L L-
WALLS I
FOUNDATION DRAINAGE I DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR W ALL/HOLD DOWNS
WALLS I ROOF I CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING I
MECHANICAL
HEAT PUMP I FURNACE I DUCTS
GAS LINE
WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING I SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL. INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LiGHT DEPT. 417-4735 ELECTRICAL
LiGHT DEPT
CONSTRUCTION R. W. I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 . PLANNING DEPT.
BlliLDING 417.4815 4/3/0(, J.l/u BlliLDING
T:\Policies\1102 15 buildin ennit ins ection record05. d 1'412005
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Area Map
This mop is not intended to be used as a legal description. "..~
This mop/drawing is produced by the City oj Port AngelesJor its own use and purposes. ,~
Any other use oj this mop/drawing shall not be the responsibility oJth. City, _
Feel
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BUILDING PERMIT - APPLICATION
FOR OFFICIAL USEj?,NLY:
Date Rec.il t {tJltl
Permit;';: . '''o~0
Fill out COMPLETELY and in INK. Your application and site plan MUST B
COIvIPLETE to be accepteu for ff.vie\i". Ifyull have any questions, ~al1
PERMITS (360) 417-4815 FA.X(360)417-4711
AppliCaI;W2.T Agent:
Owner: .:.J b Yl J,
9
A.ddress: I {) I q W IS -t "'"
ArchitectlEngineer:_R vJ E
Contractor ~\\ \ mrj ~ <:'~ r C')-nc;t State License #:
Address: ~9 \ ~(",CNJ-<\ ? 1\ City: ? ~,\,
.
PROJECT ADDRESS: \ () \9 w \. S; '"'"'\...
City: ~ C ",-i
Phone: Ys ~-s 451
Phone: ~ 7- I C .310
Av-n. ~ IOS zip:~3 (g3
o
Phone:
Exp:
~,,~~c:.,
Phone:!:J-S~-B-I57
Zip:~ ~ Lo A-.
ZONING:
LEGAL DESCRIPTION: Lot:
CLALLAM COU}rry PARCEL NUMBER:
Block:
Subdivision:
TYPE OF WORK:
~ Residential 0 New Constr. 0 Re-roof 0 Stove
o Multi-family 0 Addition 0 Move 0 Garage
o Commercial D' Remodel 0 Demolition 'Ii( Deck
_ Repair 0 Sign ~ 0 Other
BRIEF DESCRil'TION OF THE PROJECT: ~e ~ ~c..o.
" , '1..... ~
SIZEfVALUATION:
SF. @ $ /SF. = $
SF. @ $ /SF. = $
SF. @ $ /SF. = $
"' T,.OTAL VALUATI~N \i '-f~~
j 'l \ c;. 4, ~ Y\~ A a..Cj;, aX V'Y\P
COMMERCL4LIRESIDENTlAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load: .
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
ESAlWetland( s): 0 Yes 0 No SEP A Checklist required? 0 Yes 0 No Other:
APPRO V ALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the appEcant. 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 ofpemlit issuance.
EXPIRATION OF PLAN REVIEW: If no pemlit 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 R1 05.3.2
of the International Bui1ding/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 ft is my resp~~at pennits are _reqUired ,not the City', :d that ~ must obtain such pennits prior to walt
T'\P&;ci~\BL-1l02_13.wpd Applic,", . ~ Date' \ ~ 0 Co