HomeMy WebLinkAbout2620 A & B Orchard Ave - Building
fate Rec.:
fennil #:
/Date Approved:.
, I Dale Issued:
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Applioant or Agent' (l.lf"nY'il ~~ J o-u.A J'honc I' - 0 I S'z-
Owner:~ (LU~ I ~, Phone: ~ l -, - 0 )
Address: ~ , 0 \ ~(j'j:. 2f;2- City:?OYi: ~~{.es 0
i'uchitectlEngineerT y- ~ 1 If ..e a~ / Z().Il{)\.{\ r::...- Phone:
Contracto~OJ.,Ve/ ( Oil' CO State License #: ~~R6t.JC!.JE'qoOJ 0 Exp:4-
Address: P, 0, 8::>0'?< 2..'02- City: GJ~ S
PROJECT ADDRESS:2~2D A + ~ on:lr'i).~-d. Ave. 2(,,2-1 A t-P-> Ct
LEGiu~ DESCRIPTION: Lot: L?l7
CLALLAM COUNTY PARCEL NUMBER:
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Fill out COMPLETELY and ill INK. Your application and site plan MUST BE :.,
COMPLETE to be accepted for review. Ifyoll have any questions, call
PERJ\1ITS (360) 417-4815 Fi'''x(360)417-4711
BU!LDING PERMrT - APPLICATION
Phone:~ 17 -() IS /.
Zip:-9~3(o 2-
M b l:::'
.
PLANNING USE ONLY:
~
6'
6
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TI~ OF WORK: SIZEIV DATION:
~esidential lff'New Constr. 0 Re-roof 0 Stove ~ ~ Z- & SF. g,$ 7.J..... I b /SF. = $
o Multi-family D Addition 0 MoveD Garage S . @ $ /SF. = $
o Commercial D Remodel 0 Demolition 0 Deck F. @ $ /SF. = $
o Repair D Sign 0 Other OTAL VALUATION $ 3\ lo) 4q 1
BRIEF DESCRIPTION OF THE PROJECT:
COMMERClAL/RESIDENTlAL: Occupancy Grou . \
No. of Stories: 2. Lot Size:30b CO
Total l~t coverage ...:z. ~ %
Construction Type:
& Proposed Sq. Ft.
ESAJWetland(s):DYesDNo SEPA hecklistrequired?D YesD No Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
V ALDATION OF CONSTRU ION: In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 4 1 7-4815 for ssistance.
PLAN CHECK FEE: IF plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other pe 't fees are due at the time of permit issuance.
EXPlRATION OF P AN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official c extend the time for action by the applicant up to 180 days upon \vritten request by the applicant (see Section
Rl 05.3.2 of the In mati anal BuildingfResidential Code, 2003). No application can be extended more than once.
I hereby certi that I have read and examined this application and know the same to be true and correct. I am authorized to
apply for thi permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I
must obtai such permits prior to work.
T:\FORMS\BJdgPemritfonn.wpd Applicant: \~ ~
Date:
q !-;18{01o
,
PREPARED 10/17/06, 11:56:25 PAYMENTS DUE RECEIPT
CITY OF PORT ANGELES PIrUL. ~rJAU tefZ- PROGRAM BP820L
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APPLICATION NUMBER: 06-00001075 2620 ORCHARD AVE A
-FEE DESCRIPTION AMOUNT DUE
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MILW DRIVE ASSESSMENT
BUILDING PERMIT - RESIDENTIAL
MECHANICAL PERMIT
PLUMBING PERMIT
SANITARY SEWER HOOK UP
PUBLIC WORKS RES WATER SERV
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
TOTAL DUE
960.00
2235.45
215.40
320.00
134.00
700.00
3480.00
12.00
4800.00
12856.85
Please present this receipt to the cashier with full payment.