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Home My WebLink About519 Rose St - BuildingPREPARED 6/04/07 10 35 11 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/04/07 ADDRESS 519 ROSE ST SUBDIV CONTRACTOR PHONE OWNER LARRY R FOX /NANCY PRINCE FOX PHONE PARCEL 06 30 15 5 4 0380 0000 APPL NUMBER 05 00000803 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 10/11/05 JLL BLDG FOUNDATION FOOTING 10/11/05 AP 10/11/2005 11 49 AM DYASUMUR STEVE 460 0070 10/11/2005 04 13 PM JLIERLY BI2 01 10/20/05 JLL BUILDING FOUNDATION WALL TIME 09 30 10/20/05 AP 10/19/2005 04 01 PM PBARTHOL LARRY 452 8632 MORNING PREPOUR BY 10 00 A M 10/20/2005 11 45 AM PBARTHOL BAIR 01 3/21/06 JLL BLDG AIR SEAL TIME 13 00 3/21/06 DA 03/20/2006 11 06 AM DYASUMUR LARRY 452 8623 03/21/2006 04 54 PM PBARTHOL NOT READY FOR AIRSEAL AT THIS TIME BAIR 02 3/31/06 JLL BLDG AIR SEAL TIME 13 00 3/31/06 AP 03/30/2006 03 24 PM DYASUMUR LARRY 452 8623 03/31/2006 03 26 PM JLIERLY BL3 01 4/06/06 JLL BLDG FRAMING 4/06/06 AP 04/06/2006 09 19 AM PBARTHOL 04/06/2006 04 26 PM JLIERLY BLI 01 4/12/06 JLL BLDG INSULATION 4/12/06 AP 04/12/2006 01 31 PM JLIERLY 04/12/2006 03 40 PM JLIERLY J BLDG FINAL TIME 01 00 06/01/2007 BL99 01 6/04/07 I' 09 04 AM LPANGRLE LARRY 452 8623 REQUESTED AFTERNOON INSPECTION CALL FIRST BLDG FINAL HE LL GIVE YOU AN EXPIRED PERMIT EXTENSION REQUEST LETTER AT THE TIME OF THE INSPECTION PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME99 01 6/04/07 MECHANICAL FINAL TIME 01 00 06/01/2007 09 32 AM LPANGRLE LARRY 452 8623 AFTERNOON CALL FIRST MECHANICAL FINAL PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS PL2 01 3/31/06 JLL PLUMBING ROUGH IN TIME 13 00 3/31/06 AP 03/30/2006 03 24 PM DYASUMUR LARRY 452 8623 03/31/2006 03 26 PM JLIERLY PL99 01 6/04/07 JLL PLUMBING FINAL TIME 01 00 CONTINUED ONTO NEXT PAGE PREPARED 6/04/07 10 35 11 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR JAMES LIERLY ADDRESS 519 ROSE ST SUBDIV CONTRACTOR PHONE OWNER LARRY R FOX /NANCY PRINCE FOX PHONE PARCEL 06 30 15 5 4 0380 0000 APPL NUMBER 05 00000803 RES ADDITION REQUESTED !SP DESCRIPTION TYP /SQ COMPLETED '�.ULT RESULTS /COMMENTS i, 06/01/2007 09 33 AM LPANGRLE LARRY 452 8623 AFTERNOON CALL FIRST PLUMBING FINAL COMMENTS AND NOTES PAGE 8 DATE 6/04/07 PREPARED 4/12/06 13 36 46 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 4/12/06 ADDRESS 519 ROSE ST SUBDIV CONTRACTOR PHONE OWNER LARRY R FOX /NANCY PRINCE FOX PHONE PARCEL 06 30 15 5 4 0380 0000 APPL NUMBER 05 00000803 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 10/11/05 JLL BUILDING FOUNDATION FOOTING 10/11/05 AP 10/11/2005 11 49 AM DYASUMUR STEVE 460 0070 10/11/2005 04 13 PM JLIERLY BI2 01 10/20/05 JLL BUILDING FOUNDATION WALL TIME 09 30 10/20/05 AP 10/19/2005 04 01 PM PBARTHOL LARRY 452 8632 MORNING PREPOUR BY 10 00 A M 10/20/2005 11 45 AM PBARTHOL BAIR 01 3/21/06 JLL BUILDING AIR SEAL TIME 13 00 3/21/06 DA 03/20/2006 11 06 AM DYASUMUR LARRY 452 8623 03/21/2006 04 54 PM PBARTHOL NOT READY FOR AIRSEAL AT THIS TIME BAIR 02 3/31/06 JLL BUILDING AIR SEAL TIME 13 00 3/31/06 AP 03/30/2006 03 24 PM DYASUMUR LARRY 452 8623 03/31/2006 03 26 PM JLIERLY BL3 01 4/06/06 JLL BUILDING FRAMING 4/06/06 AP 04/06/2006 09 19 AM PBARTHOL 04/06/2006 04 26 PM JLIERLY BLI 01 /1 06 #LC. BUILDING INSULATION 04/12/2006 01 31 PM JLIERLY COMMENTS AND NOTES PREPARED 4/06/06 12 07 13 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 4/06/06 ADDRESS 519 ROSE ST SUBDIV CONTRACTOR PHONE OWNER LARRY R FOX /NANCY PRINCE FOX PHONE PARCEL 06 30 15 5 4 0380 0000 APPL NUMBER 05 00000803 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 10/11/05 JLL BUILDING FOUNDATION FOOTING 10/11/05 AP 10/11/2005 11 49 AM DYASUMUR STEVE 460 0070 10/11/2005 04 13 PM JLIERLY BI2 01 10/20/05 JLL BUILDING FOUNDATION WALL TIME 09 30 10/20/05 AP 10/19/2005 04 01 PM PBARTHOL LARRY 452 8632 MORNING PREPOUR BY 10 00 A M 10/20/2005 11 45 AM PBARTHOL BAIR 01 3/21/06 JLL BUILDING AIR SEAL TIME 13 00 3/21/06 DA 03/20/2006 11 06 AM DYASUMUR LARRY 452 8623 03/21/2006 04 54 PM PBARTHOL NOT READY FOR AIRSEAL AT THIS TIME BUILDING AIR SEAL TIME 13 00 03/30/2006 03 24 PM DYASUMUR LARRY 452 8623 03/31/2006 03 26 PM JLIERLY BL3 01 41/06 JLL BUILDING 0UI06IN FRAMING 04/06/2006 F 09 19 AM PBARTHOL BAIR 02 3/31/06 JLL 3/31/06 AP COMMENTS AND NOTES PREPARED 3/31/06 13 12 55 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 3/31/06 ADDRESS 519 ROSE ST SUBDIV CONTRACTOR PHONE OWNER LARRY R FOX /NANCY PRINCE FOX PHONE PARCEL 06 30 15 5 4 0380 0000 APPL NUMBER 05 00000803 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 10/11/05 JLL 10/11/05 AP BI2 01 10/20/05 JLL 10/20/05 AP BAIR 01 3/21/06 JLL 3/21/06 DA BAIR 02 .3/3 /06 PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS PL2 01 ,3/31]06 BUILDING FOUNDATION FOOTING 10/11/2005 11 49 AM DYASUMUR STEVE 460 0070 10/11/2005 04 13 PM JLIERLY BUILDING FOUNDATION WALL TIME 09 30 10/19/2005 04 01 PM PBARTHOL LARRY 452 8632 MORNING PREPOUR BY 10 00 A M 10/20/2005 11 45 AM PBARTHOL BUILDING AIR SEAL TIME 13 00 03/20/2006 11 06 AM DYASUMUR LARRY 452 8623 03/21/2006 04 54 PM PBARTHOL NOT READY FOR AIRSEAL AT THIS TIME BUILDING AIR SEAL TIME 13 00 03/30/2006 03 24 PM DYASUMUR LARRY 452 8623 PLUMBING ROUGH IN TIME 13 00 03/30/2006 03 24 PM DYASUMUR LARRY 452 8623 COMMENTS AND NOTES PREPARED 3/21/06 11 25 11 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 3/21/06 ADDRESS 519 ROSE ST SUBDIV CONTRACTOR PHONE OWNER LARRY R FOX /NANCY PRINCE FOX PHONE PARCEL 06 30 15 5 4 0380 0000 APPL NUMBER 05 00000803 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 10/11/05 JLL BUILDING FOUNDATION FOOTING 10/11/05 AP 10/11/2005 11 49 AM DYASUMUR STEVE 460 0070 10/11/2005 04 13 PM JLIERLY BI2 01 10/20/05 JLL BUILDING FOUNDATION WALL TIME 09 30 10/20/05 AP 10/19/2005 04 01 PM PBARTHOL BAIR 01 3/21/06 JLL LARRY 452 8632 MORNING PREPOUR BY 10 00 A M 10/20/2005 11 45 AM PBARTHOL BUILDING AIR SEAL TIME 13 00 03/20/2006 11 06 AM DYASUMUR LARRY 452 8623 COMMENTS AND NOTES 4 15 a,✓ ,�3 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner LARRY R FOX /NANCY PRINCE FOX PO BOX 1611 PORT ANGELES Other struct info Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total WA 983620196 Charged 73 00 00 4 50 77 50 COMMENTS /ACTION NEEDED CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321 EAST 5TH STREET PORT ANGELES. WA 98362 05 00000803 533657 519 ROSE ST 06 30 15 5 4 0380 0000 RES ADDITION RS9 RESDNTL SINGLE FAMILY 34000 Contractor OWNER TOTAL LOT COVERAGE NUMBER OF STORIES. EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS Permit ELECTRICAL NEW RESIDENTIAL Additional desc OWNER/ ADDITION Permit pin number 72959 Permit Fee 73 00 Issue Date 3/20/06 Expiration Date 9/16/06 Plan Check Fee Valuation Qty Unit Charge Per 1 00 73 0000 ECH EL R SQFT FIRST 1300 Special Notes and Comments The Fire Department has reviewed the project application and has no comments 09/03/2005 03 12 PM SROBERDS Remodel of sft 18% lot coverage in RS 9 No issues $0 Connect Fee 09/02/2005 08 14 AM JHEBNER Any modifications to the electrical facilities will be at the customer s expense 09/02/2005 08 15 AM JHEBNER Public Works Utility Engineering has no requirements for this plan review Other Fees STATE SURCHARGE Paid 73 00 00 4 50 77 50 Credited 00 00 00 00 Date 3/20/06 14 1 00 1400 00 10000 00 1745 00 17 80 1 00 Due Extension 73 00 4 50 00 00 00 00 00 0 ELECTRICAL PERMIT INSPECTION RECORD CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. DITCH ROUGH -IN COVER SERVICE FINAL GENERAL COMMENTS: KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED YES I NO pw -I 102.» (4/96] COMMENTS PREPARED 10/20/05 11 28 30 INSPECTION TICKET PAGE 20 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 10/20/05 ADDRESS 519 ROSE ST SUBDIV CONTRACTOR PHONE OWNER LARRY R FOX /NANCY PRINCE FOX PHONE PARCEL 06 30 15 5 4 0380 0000 APPL NUMBER 05 00000803 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 10/11/05 JLL BUILDING FOUNDATION FOOTING 10/11/05 AP 10/11/2005 11 49 AM DYASUMUR STEVE 460 0070 10/11/2005 04 13 PM JLIERLY BI2 01 10 20 05 JL„L� BUILDING FOUNDATION WALL TIME 09 30 `0 OW D T h7 10/19/2005 04 01 PM PHARTHOL LARRY 452 8632 MORNING PREPOUR BY 10 00 A M COMMENTS AND NOTES PREPARED 10/11/05 13 58 37 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY ADDRESS 519 ROSE ST SUBDIV CONTRACTOR PHONE OWNER LARRY R FOX /NANCY PRINCE FOX PHONE PARCEL 06 30 15 5 4 0380 0000 APPL NUMBER 05 00000803 RES ADDITION PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL1 01 10 BUILDING FOUNDATION FOOTING 10/11/2005 11 49 AM DYASUMUR STEVE 460 0070 COMMENTS AND NOTES PAGE 8 DATE 10/11/05 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner LARRY R FOX /NANCY PRINCE FOX PO BOX 1611 PORT ANGELES Other struct info Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 9 00 10 1000 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per BASE FEE 1 00 7 2500 ECH ME VENT FAN Permit PLUMBING PERMIT Additional desc Permit pin number 60046 Permit Fee 75 00 Plan Check Fee 00 Issue Date 9/15/05 Valuation 0 Expiration Date 3/14/06 Qty Unit Charge Per CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 983620196 05 00000803 533657 519 ROSE ST 06 30 -15 5 4 0380 0000 RES ADDITION RS9 RESDNTL SINGLE FAMILY 34000 Contractor OWNER TOTAL I LOT COVERAGE 14 NUMBER OF STORIES 1 00 EXISTING LOT COVERAGE 1400 00 LOT SIZE 10000 00 PROPOSED LOT COVERAGE 1745 00 TOTAL LOT COVERAGE 17 80 NUMBER OF UNITS 1 00 BUILDING PERMIT RESIDENTIAL 60020 505 65 Plan Check Fee 9/15/05 Valuation 3/14/06 BASE FEE THOU BL -25 001 50K (10 10 PER MECHANICAL PERMIT 60038 54 25 Plan Check Fee 9/15/05 Valuation 3/14/06 BASE FEE 4 00 7 0000 ECH PL- EA FIXTURE ON ONE TRAP Special Notes and Comments The Fire Department has reviewed the project application and T Policies \1102_I5 building permit inspection record05 wpd [1/4/2005] K) Date 9/15/05 202 26 34000 Extension 414 75 90 90 00 0 Extension 47 00 7 25 Extension 47 00 28 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 Signatur of Owner Of owne i s builder) I Date 6hate a b _oy_0 FOUNDATION FOOTINGS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) BACK FLOW WATER GAS LINE AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I PLANNING DEPT 417 -4750 I BUILDING 417 -4815 I T- \Policies \1 102 15 building permit inspection record05.wpd [1/4/20051 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 SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT I BUILDING CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 05 00000803 Application pin number 533657 Special Notes and Comments has no comments 09/03/2005 03 12 PM SROBERDS Remodel of sft 18% lot coverage in RS 9 No issues $0 Connect Fee 09/02/2005 08 14 AM JHEBNER Any modifications to the electrical facilities will be at the customer s expense 09/02/2005 08 15 AM JHEBNER Public Works Utility Engineering has no requirements for this plan review Page 2 Date 9/15/05 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 634 90 634 90 00 00 Plan Check Total 202 26 202 26 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 841 66 841 66 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_15 building permit inspection record05.wpd 1/4/2005] FOUNDATION FOOTINGS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT 417 -47'4 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 I NO Igo -/i-os ,1i..L I lio-ao -off t1 t-L. I I-- I I t N Pcl i) 0(1O4 11711 I I t I I I Y/ lo(- I4r I CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 j I I PLANNING DEPT 417 4750 I I I r BUILDING 417 -4815 loci I G/J_ I A)v I T \Policies \1102_15 building permit inspection record05 wpd [1/4/2005] NIA SEPA. ESA. SHORELINE. ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING I FIRE DEPT I PLANNING DEPT I BUILDING COMMENTS FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO I I I I I I I I I '1. Applicant or Agent J Owner' Uc'1' City Architect /Engineer' 6 a M50 ii Contractor State License Address PROJECT ADDRESS 615' 5 P Address. 5P LEGAL DESCRIPTION Lot Block: ry, `71 r Subdivision. CL AT .T .AM COUNTY PARCEL NUMBER.. O (aL0 921- 0,) b o DD Credit Card Holder Name: Billing Address: Credit Card Type VISA MC TYPE OF WORK. Residential New Constr. Multi- family 2"Addition Cw t °re a l Remodel Fill out COMPLETELY and in INK. Your application and site plan MUST BE CO1\1PT,FTE to be accepted for review If you have any questions. call PERMITS (360) 417 -4815 FAX(360)417-4711 Repair PLANNING USE ONLY T•\Policies'BL 1102 13.wpd Applicant BUILDING PERMIT APPLICATION COMMERCIAL/RESIDENTIAL. Occupancy Group City' Re-roof Move Garage Li reA 1 7'7 SF Demolition Deck SF Sign O er TOTAL VALU ATT O BRIEF DESCRIP T? TION OF E P JECT CO I )P ,A ie �-r `r eZork 'x.. No of. Stones: 1L Lot Size: D7i) Existing Sq Ft Total lot coverage 9 City Phone Phone. i Phone: Exp SIZE/VALTJATION Stove t �7 y SF ESA/Wetland(s). Yes No SEPA Checklist required? Yes No Other Occupant Load. R. Proposed Sq Ft h Zip ZONING S O ,.4/ <hi ,i Construction Type: TOTAL Sq Ft. /27, /SF /SF /SF ate .l dlo Date Pic. 'ZE rQ regi Phone. Exp. Date: en �y. Dat pprov Da d t IsJsued Zip ZtJAP'. 910 1 74 r. r APPROVALS. PLAN BLD G DPWU FIRE OTHER. VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by.the Building Divisionto Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CIIECR FEE. IF a plan.chenk fee is due'it mustbe submitted at the time the building permit application and consl action plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW If no 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 8105.3.9 of the International Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required ,note City's, and that I must obtain such permits prior to work SITE PLAN DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION AP_AC ANT i V 9 ail ■Y 0.X PHONE 42 :S �a 3 PROJECT /DEVELOPMENT ADDRESS. 0 .58, See Page 4 for instructions on completing the site plan. For more information, call 417 -4815. II II MEMEMMOOMEMMEMINIMMEMEMEM MEMEMMEMMINIMMINIMMEMMEMEM MINIMOMMMEMEMMEMMEMMEMMEM 11111111111M111111111111 MINIMUMMEMEMWMINIMMEMMEMM mumagammumommummummomm 11111111111111111111111 'III mouniumplIIIIII III !iIiI III 1 111111 Lisoy /-2 fio7e r�3 /c42%,, co z CIailam 2005 1163418 county ZONING LOT COVENANT 1/WE the undersigned owner(s) of the following described property. (Insert legal description here) Li c77 2 3/k 3 Fo FILED FOR RECORD A T THE REQUEST JF ECORDED IN F F, (2 ,r 2005 AUG 23 A1111 37 C!� do hereby covenant that said property shall be designated as one zoning lot as defined in Section 17 08 032 "Z' of the Port Angeles Municipal Code This covenant creates one inseparable building lot which may only be removed through compliance with Chapter 58 17 RCW (subdivision regulations) and /or the City of Port Angeles short subdivision regulations (Ordinance No 2222, as amended) This covenant shall be binding on the owner(s) heir(s) assign(s), and successor(s) in interest and shall be filed with the County Auditor's Office. This covenant is for the mutual benefit of said owner(s), heir(s), assign(s) and successor(s) in interest and is for the further purpose of compliance with state and local land use and building regulations This covenant may be enforced by injunction or other lawful procedure and covenant by the recovery of any damages resulting from non compliance. DATED this C d day of 20 /95 7 `C, 7(613 (Owner) STATE OF WASHINGTON COUNTY OF CLALLAM ss that on thisd3 day of /7�Lr'dl t 9 and me known to be the individual(s) desribed in and signed and sealed the same as mentioned. (Owner) I, e ,y)ge i l GIVEN UNDER MY HAND AND OFFICIAL SEAL this --,2qrd day of r ROXANNE E. DILL NOTARY PUBLIC STATE OF WASHINGTON COMMISSION EXPIRES Filed for record at the request of /Id c (Owner) (Owner) Notary Public in and for the State of Washington, do hereby certify 2t', personally appeared before me Lfi/ who executed the within instrument and acknowledged that free and voluntary act and deed for the purposes herein Lew, eFO 20 DS CLALLAM COUNTY AUDITOR By lC �'1•c.,C. NOTAR PTAILIC in and for the State of Washington residing at Port Angeles. this 3 day of LLAH CO 20 D-5" Of 'Rhodes Rd 0) a) 603 L 3905 511 512 516 504 4 5.() Thistle St. 526, ,530 527 527 3630 4617 6Q3 60 51 3631 0 0 k. 0 7 \I o -wor.040:20-4 Jr. rel;_291.46 lIII""? "'-'" , ....~~( '~. ..~ '1.. r::=.L.. l\+ :t-/ ""'.' ELECTRICAL WORK PERMIT APPLICATIQN Electrical contractor name License number Date Expires Installation description o Commercial 0 Residential o New ~tered/Addition Job wired by o Electrical Contractor 0 Owner Purchaser's mailing address '-" City State ZIP 4WIT7,)IV r-tdlZll--l? ,- ~ Telephone number FAX number ------- Ie i~ection: OWI/r as defined by RCW./9.28.26/:(J) OWI/er wU/ occupy the struclurefor two years after this electrical permit is finalized. (2) Owner is required (0 hire an electrical cOIl/ractor 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 thc c1ectrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46D, Thc City of Port Angeles Municipal Code, and Utility Specifications. Signature 0 or electrical administrator //~ o Cash 0 Check # o Credit Card Card # Visa Mastercard Discover Date;3-/5-:::'O Expiration Date of card dditions and or subtractions HANGES KW KW Ton 3-KW SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 LAR o Overhead Service o Temp Service o Underground Service Service Information Voltage /::7/,J ~4() Phase ~ Service Size: Feeder Size: . / ;OUG:::td7 /' THERMOSTAT / SERVICE ~ Appnn,dBy Date Approved By "- Date Approved By /' g;1- ~~/7 F1NA~/ DITCH FEEDER \ Date Approved Ily.-/ Dale Approved By Inspection Area, Building or Equipment Inspected Action Taken Electrical Date Inspector ~~ \