HomeMy WebLinkAbout1215 Campbell Ave - BuildingW A S H I N G T O N
U S A
Public Works Utilities Department
February 3 2009
Bank of Amenca
Attn. Tnna Cook
134 West 8 Street
Port Angeles, WA 98362
Re Assignment of Savings Habitat for Humanity of Clallam County
Stephen S rr, P.E.
City Engineer
cc: Habitat for Humaity of Clallam County
DCD
File: Habitat for Humanity
Phone 360- 417 -4805 Fax 360-417-4542
Website www cityofpa.us Email publicworks @cityofpa.us
321 East Fifth Street P C Box 1150 Port Angeles WA u8-.62 -0217
PS
^1
AIECEDVIE1
FEB 132009
CITY OF PORT ANGELES
Dept. of Community Development
Public Works and Utilities has determined that Habitat for Humanity of Clallam County has
completed the required dnveway and parking pavement improvements in accordance with
PAC 14 40
N
The assignment of savings under Account 22043326 in the amount of $13,000 00 copy
attached) may be released to Habitat of Humanity of Clallam County
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CITY OF PORT ANGELES '"
PUBLIC WORKS - ELECTRICAL DIVISION
J21 EAST 5TH STREET. PORT ANGELES. WA 98~62
~
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
06-00000297 Date
123807
1215 CAMPBELL AVE
06-30-14-5-3-0346-0000-
RICHARD CHAMBERS
RES NEW SFR
6/02/06
RESIDENTIAL HIGH DENSITY
56115
Owner
Contractor
DUNGENESS VALLEY HABITAT HMTY
PO BOX 1957
SEQUIM WA 983821957
OWNER
Other struct info .
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT. SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
8.00
2.00
14104.00
1247.00
1. 00
Plan Check. Fee
Valuation
.00
o
---
r
U"\
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
I~sue Date
Expiration Date
ELECTRICAL
HHCC/ 1247
76646
73.00
5/25/06
11/21/06
NEW RESIDENTIAL
SQFT SFR
Qty
1. 00
Unit Charge Per
73.0000 ECH EL-R-SQFT FIRST 1300
Extension
73.00
()
1
-s--
~
~
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
04/05/2006 02:33 PM SROBERDS -- No land use issues
anticipated. The project is one of four in a cluster
development in the RHD zone.
Electrical load calculations and elctrical permits are
required.
A cost estimate for the extension of u/g power is being
prepared.
03/30/2006 04:06' PM GMCLAIN ----------------------------
Ditches & 12" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
~
Other Fees
RES UNDERGRND SERVICE FEE
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
713.00
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
Permit Fee Total 73.00 73.00 .00 .00
COMMENTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
#
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PL~SE 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 ACCEPTED COMMENTS
YES I NO
III I"H
I{( H I{ iH-IN / COVER
:Sh.K V lCb
.FiNAL 1 17../'2{0., "1Jti) I
I
GENERAL COMMENTS:
PW.II02.1' (4196]
,o.,~
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........,ijrI"
CITY OF PORT ANGELES
PUBLIC WORKS . ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98362
\
,
Application Number . . . . .
Application pin number
Plan Check Total
Other Fee Total
Grand Total
.00
2787.50
2860.50
COMMENTS/ ACTION NEEDED
Page
Date
2
6/02/06
06-00000297
123807
.00
2787.50
2860.50
. .00
.00
.00
.00
.00
.00
ELEcrRICAL PERMIT INSPEcrION RECORD
I
,
,
CALL 4) 7-4735 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 ACCEPTED COMMENTS
YES I NO
I JlTI 'H
KUUUH-IN / CUVbK
~~K V lCb
FINAl 12.11'1,/,......, I~ I
I
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PW-II02.1' (4191I)
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST"SllISTREET, 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
06-00000297 Date
123807
1215 CAMPBELL AVE
06-30-14-5-3-~346-0000-
RICHARD CHAMBERS
RES NEW SFR
4/13/06
RESIDENTIAL HIGH DENSITY
56115
Owner
Contractor
DUNGENESS VALLEY HABITAT HMTY
PO BOX 1957
SEQUIM WA 983821957
OWNER
Other struct info .
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
8.00
2.00
14104.00
1247.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
73916
715.00
Plan Check Fee
Valuation
.00
56115
10/10/06
Qty Unit Charge Per
1.00 715.0000 EA PW W/M 1" SERV 5/8" METER
Extension
715.00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
73908
50.00
Plan Check Fee
Valuation
.00
56115
10/10/06
Qty Unit Charge Per
1.00 50.0000 ECH RIGHT OF WAY PERMIT
Extension
50.00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
73882
110.00
Plan Check Fee
Valuation
.00
56115
10/10/06
Qty Unit Charge Per
1.00 110.0000 EA SAN SEWER HOOKUP
Extension
110.00
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
04/05/2006 02:33 PM SROBERDS -- No land use issues
anticipated. The project is one of four in a cluster
Separate Permits are required for electrical wOr1<, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if wor1< 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 wor1< 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 wor1< 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
~~
Signature of Contractor or Authorized Agent
9'-/ 3-es C
Date
Signature of Owner (if <>wner is builder) .
Date
T:\Polities\J J02.JSR [JlOS)
\...
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 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
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIVSE
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 [11D5]
-,
.s
~~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST'STIISTREET, PORT ANGELES, WA 98362
Application Number . . . . . 06-00000297
Application pin number 123807
Page 2
Date 4/13/06
Special Notes and Comments
development in the RHD zone.
Electrical load calculations and elctrical" permits are
required.
A cost estimate for the extension of u/g power is being
prepared.
03/30/2006 04:06 PM GMCLAIN ----------------------------
Ditches & 12" culverts will be installed to City St"anards.
See Public Works Engineering for Standards.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 875.00 875.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 2949.50 2949.50 .00 ".00
Separate Permits are required tor electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void it work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
tor 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 ot
laws and ordinances governing this type ot 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:\Policics\II02.ISR [IIOS]
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
I YES I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUlTER
DRIVEWAY APPROACH I
BACK-FLOW DEVICE I I
I
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 417-46S3 FIRE DEPT.
PLANNING DEPT. 417-47S0 PLANNING DEPT.
BUILDING 417-481S BUILDING -
T:\PoJicies\11 02.1 SR [I/OS]
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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:
Tenant nbr, name . .
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
Owner
06-00000297 Date
123807
1215 CAMPBELL AVE
06-30-14-5-3-0346-0000-
RICHARD CHAMBERS
RES NEW SFR
RESIDENTIAL HIGH DENSITY
56115
Contractor
DUNGENESS VALLEY HABITAT HMTY
PO BOX 1957
SEQUIM WA 983821957
Other struct info .
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
OWNER
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
BUILDING PERMIT -RESIDENTIAL
1247 SF SFR PLAN B
74393
719.25 Plan Check Fee
Valuation
Qty Unit Charge Per
10/10/06
BASE FEE
7.00 7.0000 THOU BL-50,001-100K (7.00 PER K)
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
74443
89.65 Plan Check Fee
Valuation
10/10/06
Qty Unit Charge Per
BASE FEE
2.00 7.2500 ECH ME-VENT FAN
1. 00 10.6500 ECH ME":OTHER APPL. N/R
2.00 7.2500 ECH ME-INSTALL APPL. VENT
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date .
Expiration Date .
PLUMBING PERMIT
74401
142.00
Plan Check Fee
Valuation
10/10/06
Qty Unit Charge Per
BASE FEE
8.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE
1. 00 15.0000 ECH PL- EA. BLDG SEWER
4/13/06
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8.00
2.00
14104.00
1247.00
1. 00
287.70
56115
Extension
670.25
49.00
.00
o
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Extension
50.00
14.50
10.65
14.50
.00
o
Extension
50.00
56.00
7.00
15.00
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
~~
Signature of Contractor or Authorized Agent
,(/-/8 -,6.c..
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\1102_15 building pennit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
r '
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 UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO
FOUNDATION:
FOOTINGS
SHEAR WALLS 1 WALLS
FOUNDATION DRAINAGE 1 DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I 1
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLlHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL(INTE~ORBRACEDPANELONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP 1 FURNACE I DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
P ARKlNG/LlGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECT~CAL - LIGHT DEPT. 417-4735 ELECT~CAL
LIGHT DEPT
CONSTRUCTION R. W. I PW I CONSTRUCTION - R.W.
ENGINEE~G 417-4807 PW 1 ENGINEE~G
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 4 I 7-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102_15 building permit inspection record05.wpd [1/412005]
. ._ORT""
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Application pin number
06-00000297
123807
Page
Date
2
4/13/06
Qty Unit Charge Per
2.00 7.0000 ECH PL- EA.WATER HEATER
Extension
14.00
Special Notes and Comments
Address numbers shall be plainly visible from the street. . ~
Address numbers shall be a minimum of six inches high and be~ ;'.
of contrasting color from the background.
04/05/2006 02:33 PM SROBERDS -- No land use issues
anticipated. The project is one of four in a cluster
development in the RHD zone.
Electrical load calculations and elctrical permits are
required.
A cost estimate for the extension of u/g power is being
prepared.
03/30/2006 04:06 PM GMCLAIN ----------------------------
Ditches & 12" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
sani7ary sewer 7onnection inspection is required by
PubllC Works prlor to back fill of ditch. 24 hour advance
notice is required.
Other Fees
. . . . . . . . . SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
870.00
4.50
1200.00
Fee summary Charged Paid Credited Due
----------- ---------- ---------- ----------
----------
Permit Fee Total 950.90 950.90 .00 .00
Plan Check Total 287.70 287.70 .00 .00
Other Fee Total 2074.50 2074.50 .00 .00
Grand Total 3313 .10 3313.10 .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_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
YES NO
COMMENTS
FOUNDATION:
FOOTINGS
SHEAR WALLS 1 WALLS
FOUNDATION DRAINAGE 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 ALLlHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING
MECHANICAL
HEAT PUMP 1 FURNACE 1 DUCTS
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
I I
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FINAL I 2 -2 (-67DATE :fLL
ACCEPTED BY:
~/n'107 SU:.-
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-
~
-
1/~/o'1 JhL.. &,
~ If) 07 .r~c... ()
& ZOJbt -:1"LL ~
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, . FINAL \2-21-61 DATE TLL
ACCEPTED BY:
,._._~.
PLANNING DEPT.. SEPARATE PERMIT #'s
PARKING/LlGHTING
LANDSCAPING
SEPA:
ESA:
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL
DATE
YES
NO
COMMERCIAL
DATE
ACCEPTED
YES NO
CONSTRUCTION R.W.I PWI
ENGINEERING
FIRE
PLANNING DEPT.
BUILDING
417-4807
417-4653
4 I 7-4750
417-4815 \2-2-1-f)i :rLL.
ELECTRICAL
LIGHT DEPT
CONSTRUCTION - R.W.
PW 1 ENGINEERING
FIRE DEPT.
PLANNING DEPT.
BUILDING
ELECTRICAL - LIGHT DEPT.
417-4735
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
<......
,---------
-~
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COIvIPLE.TE to he accepted [(.01' review. If you have any questions, cuB
PERMITS (360) 417-4815 FAX(360)417-471l
. Applicant or Agent: 02 c kAf'"lr.:. L. c?,t?J-r /._,.,r- Phone: ""3(;,0 -L. '70- 4/'"NQ
Owner: -L~UA'J''-I,.rr-..,..~ UA /1r-1 ~/j"f/;(~__ Jlu~A-""'?j Phone: -=3(.,D-6.:SJ -, f70c
Address: ~_ D. 'dc.y ICe sl") City: -:5E?J<-'H~"" Zip: '=to 36 ~
Architect/Engineer: Z-NGU-'-c:... $'" .4~J)c-<r;;-r;:;, Phone: t. Ei' ~ r ,,..,... ~/J7-o 01
Contractor 4/-:r4/" Jl. d.-A-A", State License #: Ex~V-( Exp: Phone: 6d1-/' ?t5o
Address: 7_0. 6o.";7C 1~,-rv /2.15: City:5C-=-~lA./H1' Zip: '9<5'"3c'S?,
PROJECT ADDRESS: C't4vIA"krl/ 4c..... AJ. .,;,d... E:=-I ~~fd, ZONING: RIIP
, .,
LEGAL DESCRIPTION: Lot: ~o '2, ';[ 'Z.. Block: "'3 Subdivision: ""B1?.4ro..-v /.,!,. i /
... J
CLALLI\M COUNTY P
3'03'1L
TYPE OF WORK.:
~esidential ~w Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
BRJEF DESCRIPTION OF THE PROJECT:
2~f) DJ }oc...(1
'--
SIZENALUATION:
o Stove /24'7 SF. @$ 4/r /SF. = $ 6-C., II \
-
o Garage SF. @ $ ISF. = $
o Deck SF. @ $ ISF. = $
o Other TOTAL VALUATION $
-S;^Jk ~;':J' ::z -1f/G1( r ~ chr/
0--.. ~;r fY'.-r.c~/
hGU--'5'C
COMMERCL4LIRESIDENTlAL: Occupancy Group:
No. of Stories: 1., Lot Size: 14, I ~4- Existing Sq. Ft.
Total lot coverage 0.f; %
Occupant Load: . Construction Type:
& Proposed Sq. Ft. rz41 = TOTAL Sq. Ft. 1741
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLMw:NGUSE 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.
EXPIR4..TION OF PLAN REVIEW: !fno 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 Rl 05.3.2
of the International BuildinglResidential Code, 2003). No application can be extended more than once.
I hereby cerlify 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: Q~ ~
Date:
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST5TI1'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
06-00000297 Date
123807
1215 CAMPBELL AVE
06-30-14-5-3-0346-0000-
RICHARD CHAMBERS
RES NEW SFR
4/13/06
RESIDENTIAL HIGH DENSITY
56115
Owner
Contractor
DUNGENESS VALLEY HABITAT HMTY
PO BOX 1957
SEQUIM WA 983821957
OWNER
Other struct info _
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
8.00
2.00
14104.00
1247.00
1. 00
Permit
Additional desc .
Permit pin number
Permi t Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
73916
715.00
plan Check Fee
Valuation
.00
56115
10/10/06
Qty Unit charge Per Este .
1. 00 715.0000 EA PW WIM 1" SERV 5/8" METER 715.00
----------------------------------------~-------------------------- ~-~ --
Permi t RIGHT OF WAY
Additional desc .
Permit pin number 73908
Permit Fee 50.00 plan Check Fee .00
Issue Date Valuation 56115
Expiration Date 10/10106
Qty Unit Charge Per E~'
1.00 50.0000 ECH RIGHT OF WAY PERMIT 50.00
-----------------------------------------~------------------------ -------
Permit SANITARY SEWER HOOK UP
Additional desc .
Permit pin number 73882
Permit Fee 110.00 plan Check Fee .00
Issue Date Valuation 56115
Expiration Date . 10/10106
Qty Unit Charge Per ~.
1. 00 110.0000 EA SAN SEWER HOOKUP 110.00
---------------------------------------------------~~------------- ----- -
Special Notes and Comments .
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be
of contrasting color from the background.
04/05/2006 02:33 PM SROBERDS -- No land use issues
anticipated. The project is one of four in a cluster
O&-zq
J
(\ (\ o~
\ q/
. \/v
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 goveming 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:\Policics\1102.1SR (1105)
'f~
~ii<i'"
CITY OF PORT ANGELES
PUBLIC WORKS - UTll.ITlES DNISION
321 EAST STIISTREET, PORT ANGELES, WA 98362
Application Number
Application pin number
06-00000297
123B07
Page
Date
2
4/13/06
special Notes and Comments
development in the RHD zone.
Electrical load calculations and elctrical'permits are
required.
A cost estimate for the extension of ufg power is being
prepared.
03/30/2006 04:06 PM GMCLAIN --------------------:---~---
Ditches & 12" culverts will be installed to City Stanards.
See Public Works Engineering for Standards.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
--------------------------------------------------------------~--r-?--)--
Other Fees . . . . . . _ . _ SEWER SYSTEM DELV CHARGE '--Ja2Q-OO---
STATE SURCHARGE ~
PW WATER SYSTEM USE FEE 1200.00
------------------------------------------------------------- ----- -----
Fee summary Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
875.00
.00
2074.50
2949.50
875.00
.00
2074.50
2949.50
.00 .00
.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, ff 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 permn does not
presume to give authority to violate or cancel the provisions of any state or local law regulating constructi6n or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)-
-Date
T:\Policies\1102.ISR [1I0S}
~e)
/
,
APPLICATION FOR WATER
City Water Division
Port Angeles, Washington 4?~.f ;:3 ,20=~
I hereby apply tor water to be furnished in accordance with rates and rules of the City for the
follOWing premises: ~l c..h.uz.&-. (!j,~
\!, n._l'.. u7t;- 4-7q-
Name of Applicant: 't>U 1ttj-e.I1.9SS A{L~ J-i,tW,', ITA-7" ~ n..a VI \ ~ '
Address: 1 z.. t.c; C A-IIYIf' bell A-v-Q.. I ~1~3n/~:36':;;~1\-.
Renewal 0 New servicislk;; 3 Lot~,U,72.Add !3ep.c.oh 1-J..o (I
Size of Service I 'I ~ Meter Number ~~o9~<( ~O<:ldO
Service Left On 0 Service Left Offp Signed G~ ~.
Installed by
<$, J '5~ -}- '$} ZLO~
Remarks: R r 1141 T-::l1 0 ftr '2 q7
,t
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date J./-Ol fc -0 k,
Time
Received by
TF
(phone.~rs~)
Location of Work to be inspected J.::J.. / SeA yY\. p b-e l t A v s...
Name of person requesting inspection C:...+ i. 1::)( (" A lJA.\-:" ~ (;/1'16 ;/<> I /!ow5 il1;l)
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): 0<0 - ') q 7
Sewer Foundation Framing Chimney Plumbing Final
Other
INSPECTION NOTES: -- /J
Inspected: Date [:; -/G-6b Time "3; OC PIn B~~ y0 j7
Remarks: C_OO"lt"<Lc. -k,.,.. ; ^ s -l--.<+Il eel '-{ II PvL~~o..... .\.-t 1:: &"14 fI (t: JL~ 5...,( .\.e, -t--l.__
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f0ck:
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C.OffTl"'lON
RESTORATION REQUiRED...... YES
NO t.
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
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I CiTY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . .. . INSPECTION REPORT. . . . . .
REQUEST:
/51- /~-o7
---, F-
. _ (phone. person)
/ .
location of Work to be inspected /$(F5 //2-21 Ctl~.A'tJ1/~./iI1')
Name of person requesting inspection t/fd /?;.fl A-
Address of person requesting inspection Phone No. 46tJ -.:?c5' 75
Type of Inspection (circle appropriate one): ~ Permit No. C. '-- <. 97
Sewer Foundation Framing Chimney PIUmbing~eWer Excav. Other 06 ~ s~ ~
Date
Time
Received by
INSPECTION NOTES:
Inspected: Date /51-/;;' -07 Time
/? . / J . \ (
Remarks: uw..p"" (" SfoDs:. r; u strrtvr'3
. /-2'1-6'1 F~~~t'. Ok 1<.
By
/10fG6w<p/~f€- j2-(c-67
.
RESTORATION REQUIRED . . . . .. YES
NO lC
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
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ELECTRICAL WORK PERMIT APPLICATION
Job wired by
o Electrical Contractor 0 Owner
Installation ~escription ~
o Commercial B"'1{esidential
Date Expires
icense number
~
e<4
Purchaser's mal ing address
'po,'R-x I 'is?
City
~ . ,-"./VI
Telephone number
3(,.0-6&;- c. '766
Slate ZIP
wA
C:;cSoo
FAX number
3"600 -b:5/-r;;. l70a
Premises owner'sl'1ame
;IAJ...-rA7- ..J.;'" t!c.......:::r; a.j ClAd.....
Address of inspection
/~/-S- E.d''''Db-<"'il Aue.
C"'Porrr .AN~Je;'
Phone number to sche . ule inspection: _
'0 (.6- 4'0- 33"7.i
Co...j~
.
/.J '17
Owner as defined by RCW /9.28.261:(1) Owner will occupy the structure for two
years after 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.
lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter
19.28, WAC. Chapter 296-46B, The Cily of Pori Angeles Municipal Code, and
Utility Specifications.
Sig~ owner, electrical co ractor or electrical administrator
xC.::,~~ Date:~..E-c:::;C
Electrical Load Additions and or subtractions
o NO LOAD CHANGES
o Baseboard KW
o Furnace KW
o Heat Pump Ton LAR
o Fan-Wall KW
o Cash 0 Check #
o Credit Card
Card #
Expiration Date
of card
o Overhead Service
o Temp Service
o Underground Service
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH-IN
"- Dale Approved By
/ FINAL
'02/67 ~y
Dale
THERMOSTAT
~1/ J'Z/tJ'7 ~
Dale Approved By
DITCH '\
~~DJ..'f- ",/b be)
"- Dale Approved By
Inspection
Date
Area, Building or Equipment Inspected
&1'1
:;,=",1'
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.
[J Altered! Addition
.5'-' ,:::.r-
Visa
Mastercard
Discover
Service Information
Voltage
PhaseD 1 03
Service Size:
Feeder Size:
SERVICE
A{)
Approve..! By
.
FEEDER
Dale
Approved By
Action Taken
Electrical
I~spector
/
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~
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
IN~
OWNHCO~RACTOA
ADDRESS
fl.)
-It V fZ-
APPROVED NOT APPROVED
o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0
D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0
D. .. . . . .. . . . . .. . . . . . . SERVICE. . . . .. . . . . . . . . . .. . . 0
D.....................RN~......._..........._D
CORRECTIONS NEEDED: OoiL1i-T FoR. th~OSE::L ,
,
Co~.JZ, 'YLA'TlL. nJ2, '2..4 \-(0 oE-.T L~ ~i2.)
1<.~?f'>\:g, ~'TH~;f~~~ 1 '
~ l-TW_1L- ,,?~l;. '--
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
OLYMPIC PRINTERS, INC. {360} 452-1381
~