HomeMy WebLinkAbout1125 E 4th St - Building ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 11- 00001419 Date 12/20/11
Application pin number 655507 REPORT SALES TAX
Property Address 1125 E 4TH ST
ASSESSOR PARCEL NUMBER: 06- 30- 00 -7 -9- 0315 -0000- on your excise tax form
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
New garage
Owner Contractor
RENNE' GRALL TTE APS ELECTRIC
710 E SCRIVNER RD 546 BENSON RD.
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360) 457 -1000 (360) 452 -6753
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit Fee 73.50 Plan Check Fee .00 v
Issue Date 12/20/11 Valuation 0
Expiration Date 6/17/12
Qty Unit Charge Per Extension
1.00 73.5000 ECH EL- R- OUTBD /DTCH GAR IN /SEP 73.50
Fee summary Charged Paid Credited Due
Permit Fee Total 73.50 73.50 .00 .00.
Plan Check Total .00 .00 .00 .00
Grand Total s 73.50 73.50 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH -IN r/rZ t
FINAL 1/1011
":414
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X mate:
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CITY OF PORT ANGELES PERMIT APPLICATION R /Cq
E(ECT t trt ht Building Division /Electrical Inspections /CAL
321 East Fifth Street P.O. Box Port Angeles Washington, 98362 �NSPEC11
Ph: (360) 417 -4735 Fax: (360) 417 -4711 ',fi%"
Date: r f 2 )t 201
ir 1 2 Single Family Dwelling Multi Family or Commercial* Commercial Addition Alteration Remodel Repair*
*Plan Review May Be R wired Pi ase Complete Electrical Plan Review Information Sheet
Job Address: 1 a g;' 0-' 5 t
Building Square Footage:
Description of above h IA..) Tx. is- 4.9e—
Owner Information /1 Contractor 1 ormationy,
Name: Z orIZQi'iNP.e, 0 r4 1 Name: 5 ectrr
Mailing ess: 7 1 0 6- 6 Gr ih 1ve ei.1 Mailing Address: 0'4
City: State: Zip: City: State: r 4 Zip:
Phone: s. fo Fax: Phone: Fax:
License Exp. License Exp.
Item Unit Charge (qty Total (Qty Multiplied by Unit Charge)
Service /Feeder 200 Amp. $119.90
Service/Feeder 201 -400 Amp. $145.50
Service/Feeder 401 -600 Amp 204.60
Service/Feeder 601 -1000 Amp. 262.20
Service/Feeder over 1000 Amp. 372.50
Branch Circuit W/ Service Feeder 2,60
Branch Circuit W/O Service Feeder 73.50 T
Each Additional Branch Circuit 2.60
Temp. Service/ Feeder 200 Amp. 92.70
Temp. Service /Feeder 201 -400 Amp. 110.30
Temp. Service /Feeder 401 -600 Amp. 148.70
Temp. Service /Feeder 601 -1000 Amp 167.90
Portal to Portal Hourly 95.90
Sign/Outline Lighting 88.20
Signal Circuit/ Limited Energy First 1500 sf Commercial 95.90
Note: $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy -1 2 Family Dwelling 63.90
Signal Circuit/ Limited Energy Mutti- Family Dwelling 63.90
Manufactured Home Connection 119.90
Renewable Electrical Energy 5KVA System or Less 5,102.30
Thermostat 56.00
NEW CONSTRUCTION ONLY:
First 1300 Square Ft. 110.30
Each Additional 500 Square Ft or Portion of 35.20
Each Outbuilding or Detached Garage 73.50 1 13 '50
Each Swimming Pool or Hot Tub 110.30
$`73 4.5 Total
Owner as defined by RCW.19.28.261: (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. Permit expires after six months of last inspection.
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 installation 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 Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owner, electrical contractor or electrical administrator: Cash Check
P Credit Card C604 b� .Gt�,
R
e k Da ted: l 1 /1 '020 777 o l tro z� >no 10
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CITY OF PORT ANGELES
94_ I DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
-r 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00001170 Date 10/25/11
Application pin number 783860
Property Address 1125 E 4TH ST
ASSESSOR PARCEL NUMBER: 06- 30- 00 -7 -9 -0315 -0000- REPORT SALES TAX
Tenant nbr, name RENEE GRALL on your state excise tax form
Application type description RES DETACHED GARAGE
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 21600
Application desc
720 SF DETACHED GARAGE
Owner Contractor
RENNE' GRALL TTE OWNER
710 E SCRIVNER RD
PORT ANGELES WA 98362
(360) 457 -1000 I/
Structure Information 000 000 720 SF DETACHED GARAGE
Other struct info HARD SURFACE AREA
Permit BUILDING PERMIT RESIDENTIAL
Additional desc 720 SF DETACHED GARAGE
Permit pin number 194795
Permit Fee 375.75 Plan Check Fee 244.24
Issue Date 10/25/11 Valuation 21600
Expiration Date 4/22/12
Qty Unit Charge Per Extension
BASE FEE 95.75
20.00 14.0000 THOU BL- 2001 -25K (14 PER K) 280.00
Special Notes and Comments
October 18, 2011 3:45:23 PM tamiot.
Existing electrical service is 17' 4" above construction
site. With max bldg height of 13'8" there will be enough
clearance to meet code requirements.
The Fire Department has reviewed the project application and
has no comments
October 24, 2011 12:51:24 PM sroberds.
Detached residential garage in the RS -7 zone for total lot
coverage of 275 and site coverage of 290. No land use
issues.
October 18, 2011 3:42:19 PM tamiot
Overhead power line at 17' -4" above construction site. i 2
with 13' 8" max bldg height clearance is good. �/A l
1
The existing building sewer may be located at the same �/V
location of the proposed construction. Any modification or
damage to the existing building sewer will require other
permits and inspections.
Other Fees STATE SURCHARGE 4.50
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 has 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 re .lating construction or the performance of
construction.
o P ?ell
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD 4
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE,
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SERA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
T:Forms /Buildinq Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page 2
Application Number 11- 00001170 Date 10/25/11
Application pin number 783860 REPORT SALES TAX
Fee summary Charged Paid Credited Due on your state excise tax form
Permit Fee Total 375.75 375.75 .00 .00 to the City of Port Angeles
Plan Check Total 244.24 244.24 .00 .00 (Location Code 0502)
Other Fee Total 4.50 4.50 .00 .00
Grand Total 624.49 624.49 .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 has 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.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735 Q om
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 `3
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION: i
Footings j/ ('7
Stemwall It
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling 1 /i. I
Drywall (Interior Braced Panel Only)
T Bar
INSULATION: /,hry
Slab
Wall Floor Ceiling L. /8
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping _SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750 j
Building 417 -4815
T:Forms /Building Division /Building Permit
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BUILDING DIVISION
CITY OF PORT ANGELES
Correct Notice
Job Located at
Inspection of your work revealed that the following is
not in accordance with the codes governing the work in
this jurisdiction:
ift
PE cueli &M
POOY
These corrections must be made and are not to be
covered until reinspection mase. Whe c rr- tions
have been made, please call I f
for inspection.
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Date ///1
1
Inspector for Building Division
DO NOT REMOVE THIS TAG
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BUILDING PLUMBING MECHANICAL PERMIT APPLICATION LONG FORM
t (To be used for projects that require plan review.) I
Date Received 1 1 7
Permit 6
City of Port Angeles Please print in ink. Date Approvirlan 'l
Attn: Building Permit Technician Approved b
321 E. 5 St., Port Angeles, WA 98362 it
360- 417 -4815 fax: 360- 417 -4711 Credit card payments are accepted Mon -Fri 8 -5 pm (no American Express)
Hours: Mon through Fri 8 5 pm Cash checks are accepted Mon -Thurs 8:30 -4 pm Fri 8:30 -12:30 pm
Contact person: i�' ene ma &fa ll Phone: 3(00 y 5 7 oon
Property owner: r
COCa r ru-S+ ,Zl'l e_e. a- l 1 (as Phone: S�.►'1,Q
Property owner's mailing address;
j; �g 3
10 Sc,riUr Q Rot 1"D�, �►1_ la.`- Phone:
Contractors business name. �...e, C viz1�� ea
(or property owner's name if he she is doing /overseeine
Contractor's' mailing address:
Contractor's L &I license number: Expiration date:
Project Address: 1 25 E. l S
Project Type: 114 Residential E3 Commercial D Industrial D Multi- family
Project Business Name: Zoning: 12
(for commercial, industrial, or multi- family projects)
Parcel Lot L7-
06 30 'OD 7- 7- 03/ 5' Dada
Complete only the portions of this permit that are relevant to your project.
Pay the plan check fee (based on the.valuation of the project) at the time of submittal
Residential Projects submit:
V Two sets of plans* (including engineering calcs, geotech reports, etc. if applicable)
Commercial •'ects submit:
Three se of plans* (including engineering calcs, geotech reports, etc. if applicable)
-.e ork confirming conformance to the Energy Code
Fo ge projects, a pre- construction meeting with various City department
.erson -1 is highly recommended. To schedule a pre- construction meeting, contact
the Planni Managerat (360) 417 -4750.
Additional inf. ation may need to be submitted including:
landscape pla parking plan (including ADA spaces, ramps, etc.), utilities
(existing propo ed), curbs, sidewalks, storm water.plan, etc.
For Additions New Structures also submit:
(1) S plan 8 1/2" x 11") showing all structures (existing proposed), setbacks, new driveways
If an architect or engineer drew the plans or calculations, include at least one "wet- stamped" set of plans
and /or calculations.
T:Forms /Building Division /Building /Plumbing /Mechanical Permit Application Long Form (Revised 2011)..
Page 1 of 4
G�
Repair Solar Panels Miscellaneous: (explain the project)
Project Valuation
Remodel: (explain the project, including how the building space is currently being used and what the new,
remodeled use will be)
Project Valuation
If the space will change from commercial to residential, submit:
"Checklist— Converting Commercial Space into Residential Space"
Addition: (explain the project and complete submit page 3)
Maximum heighi of the new addition Meet Project Valuation
New Structure: (explain the project and complete submit page 3) l
DET)c'i4 O GAM &E. o X 30
Maximum height of the new structure 13',112.! feet Project Valuation d1 (o
PLUMBING PERMIT: Will there be ANY plumbing changes (items moved, added, replaced, or altered).
Check one:
No X Yes If yes, complete submit page 4 "Plumbing Changes"
MECHANICAL PERMIT: Will there be ANY mechanical changes (items moved, added, replaced, or altered)
Check one:
No k' Yes If yes, complete submit page 4 "Mechanical Changes"
Occupancy group of bedrooms
Will a lawn sprinkler system be installed? p Occupant load of full baths
Will a fire sprinkler system be installed? no Construction type of half baths
*Homeowner: If you will be doing overseeing the work, then the project valuation will be determined by doubling the
cost of materials, to reflect the value the repair adds to your property.
Cost of materials x 2 Project Valuation
I have read and completed this application and know it 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, and to obtain permits prior to
working on projects.
Date 0 X71 Signature
Print Name e>e. r4
Page 2of4
Floor Areas Existing square New square Price per new
footage footage square foot
Basement X
1' Floor 11-15'
2nd Floor
3rd Floor
Garage 1 12.0 34. Oo 21(WO.DO
Carport
Covered Porch (op
Deck
30" high)* 1 ('L
Deck
30" high)
Shed
Other
Other
Remodel project valuation
I TOTAL VALUATION 21 b00. 1
Walking surface of the deck above ground
For residential building projects the minimum square foot valuation we accept is:
Dwelling $85.00 per sq. ft. garage /utility /misc.structure $30.00 per sq. ft. porch /deck /carport $12.00 per sq. ft.
LOT COVERAGE SITE COVERAGE
Lot coverage is the amount or percent of ground area on which buildings are located.
It includes: houses, garages, carports, covered patios, cantilevered portions of buildings, roof overhangs that are longer
than 30- inches, uncovered decks or porches having walking surfaces higher than 30- inches off the ground, etc.
Total footprint of structures I do3 7 s q. ft. =lot size S 15 5 sq.ft. Lot coverage Z7.„ I
Site Coverage is the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks,
patios, and other impervious surfaces. (see Port Angeles Municipal Code 17.94.135 for exemptions)
Does the project include a new driveway? Xl yes no
If yes, what will the driveway be made of? cement asphalt ix gravel other iet* (0.-
(NOTE: 18 feet is the recommended minimum driveway length for residential projects) 1 o
r
‘,.1.e.._ \�rov) )01).-k-- )01).-k-- Nat cJ �t� Le 4 v
�S so ■ar
ro�a asoN w Z �Jh&k 1� 9 1
Does this project include a new parking pad? yes X no
If yes, what will the parking pad be made of? cement asphalt ,gravel other
a) Total footprint of structures I 7 sq. ft. (existing new)
b) Total concrete, asphalt, other impervious surfaces_ 3 sq. ft. (existing new)
c) Add lines "a" "b" above to get the total impervious 1 "l SO sq. ft. (existing new)
Total impervious 11_30 _sq. ft. .lot size I 1 sq. ft. Site coverage 27. 0
Page 3of4
PLUMBING CHANGES NONE
Check "No" or "Yes" (and enter quantities) for each line item.
Type Plumbing Changes (Moved, Added, Replaced,
or Altered)
Sink (hand, mop, floor etc.) )C No Yes Quantity
Toilet No Yes Quantity
Bathtub X No Yes Quantity
Shower __x Yes Quantity
Washing Machine No Yes Quantity
Hot Water Heater X' No Yes Quantity
Water Line (meter to structure) X No Yes Quantity
Re -plumb the structure XC No Yes Quantity
Sewer Line X No Yes Quantity
Backflow Prevention Device Types:
Beverage Machine 5( No Yes Quantity
Landscape Watering System X' No Yes Quantity
Fire Sprinkler System s 2 inch line X No Yes Quantity
___Eire_Sprinkler_Systern> 2_inch_ line _?G__No Yes__ Quantity
Please list all other planned plumbing changes or additions that aren't listed above.
MECHANICAL CHANGES Nprvs
Check "No" or "Yes" (and enter quantities) for each line item.
Type Mechanical Changes (Moved, Added, Replaced,
Furnace, heat pump, or or Altered)
forced air unit s 5 tons X No Yes Quantity
Furnace, heat pump, or
forced air unit 5 tons X No Yes Quantity
Ductless heat pump X No Yes Quantity
Wall (recessed) heater ')C No Yes Quantity
Baseboard heater 'X No Yes Quantity
Steffes room heater 'X No Yes Quantity
Wood- burning stove x No Yes Quantity
Pellet stove )cNo Yes Quantity
Radiant floor heat X No Yes Quantity
Gas fireplace or freestanding stove y No Yes Quantity
Gas cooking stove x No Yes Quantity
Propane tank set No Yes Quantity
Gas line X No Yes Quantity
Boiler x No Yes Quantity
Clothes Dryer X No .Yes Quantity
Ventilation fan (single duct) X No Yes Quantity
Hood duct mechanical exhaust No Yes Quantity
Ventilation system (not part of a heating or air
conditioning system) X No Yes Quantity
Air handler X No Yes Quantity
Evaporative cooler (non portable) X No Yes Quantity
Please list all other planned mechanical changes or additions that aren't listed above.
.Page4of4
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PREPARED 10/11/11 9 03 28 INSPECTION TICKET PAGE 6
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10 /11 /11
ADDRESS 1125 E 4TH ST SUBDIV
TENANT NBR RENEE GRALL TTE
CONTRACTOR PHONE
OWNER RENNE GRALL TTE PHONE (360) 457 1000
PARCEL 06 30 00 7 9 0315 0000
APPL NUMBER 11 00000943 DEMOLITION
PERMIT DEMO 00 DEMOLITION
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 10/1111
BLDG FINAL
October 10 2011 2 38 37 PM pbarthol
461 9934
COMMENTS AND NOTES
Application Number 11 00000943
Application pin number 283731
Property Address 1125 E 4TH ST
ASSESSOR PARCEL NUMBER 06 30 00 7 9 0315 0000
Tenant nbr name RENEE GRALL TTE
Application type description DEMOLITION
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
DEMOLISH THE GARAGE
Owner
RENNE GRALL TTE OWNER
710 E SCRIVNER RD
PORT ANGELES WA 98362
(360) 457 1000
Structure Information 000 000 DEMOLISH THE GARAGE
Permit DEMOLITION
Additional desc DEMOLISH THE GARAGE
Permit pin number 191874
Permit Fee 50 00 Plan Check Fee 00
o Issue Date 9/15/11 Valuation 0
Expiration Date 3/13/12
Qty Unit Charge Per
Special Notes and Comments
It is the responsibility of the building owner and /or
demolition contractor to contact ORCAA (Olympic Region Clean
Air Agency)for demolition permit needs regarding asbestos
abatement
Olympic Region Clean Air Agency
116 W 8th St Suite 113
Port Angeles WA 98362
(360) 417 1466 or 1 800 422 5623
www ORCAA org
The Fire Department has reviewed the project application and
has no comments
August 30 2011 1 37 23 PM tamiot
No electrical to garage
Public Works Utility Engineering has no requirements for
this plan review
Other Fees
Fee summary
Permit Fee Total
TForms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Charged
BASE FEE
STATE SURCHARGE
50 00 50 00
Contractor
Paid Credited Due
Date 9/15/11
Extension
50 00
4 50
00 00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
‘ncW'
Separate Permits are required forelectrical 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 has 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.
9)151R Y\eYvh:u6ick,V\
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
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 Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
T.Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECT IONS
Building Inspections 417 -4815 Electrical Inspections 417 -4735
Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886
Inspection Type
Date Accepted By
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
Comments
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Plan Check Total
Other Fee Total
Grand Total
T:Forms /Building Division /Building Permit
00
4 50
54 50
11 00000943
283731
00
4 50
54 50
00
00
00
Page 2
Date 9/15/11
0 0
0 0
0 0
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
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 has 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.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED
POST PERMIT IN CONSPICUOUS LOCATION KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type
FOUNDATION
Footings
Stemwall
Foundation Drainage Downspouts
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 Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION
Slab
Wall Floor Ceiling
MECHANICAL.
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts
MANUFACTURED HOMES
Footing Slab
Blocking Hold Downs
Skirting
T Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
Date
Inspection Type
Electrical 417 -4735
Construction R W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
Accepted By Comments
FINAL Date Accepted by
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
10 -I1 -1I
w
Applicant
Property
Property
Contractor
Floor Areas
Basement
1S1 Floor
2 Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
r
G�- )EFt= P u--
Owner nc)nra.vr 7 5
mer's Address al
c_ re f .1/410_--F CD
Contractor's Address 1 i b d Rd. 0{ Pk C,'toS 1,0A gSY�(�.-
Licerise N/4- `xpires t E -mail coc�hr�n_ ctf�1 tP1�J�c�ec�b7e
c:ovn
PROJECT ADDRESS 1 l 9 5 E 14_1-h York P vc,d 1,.1f1- (3 3
Parcel Number 0(0 Z "1 Ct O (5'0000 Lot IS V.- Zoning
Project Type Brief Desc
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
Re -roof
Heat System
Other
Total footprint of structures
Site Coverage the amount of impervious su
and other impervious surfaces (see PAMC
Max. height of proposed structures
Will a lawn sprinkler system be installe
Will a fire sprinkler system.be instal?
BUILDING PERMIT APPLICA, 'TION Print in ink
CITY OF PORT ANGELES
Attn. Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
ription. Residential
&r a
u--1 P up 11
For City Use Only
I Date Received_�
Permit fl— 4
f Date Approved
3G0-y5 1oao
11 G6-4 c, 7
Por-E RINCII.lts cJ3r\ 9gal
Phone ,lop- L)S t
Multi family Commercial Industrial
House garage other tear off re -roof lay over-one layer
Heat pump wood- burning stove gas fireplace pellet stove other
Existing (sq. ft.) Proposed (sq. ft.)
i
i
I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand
that it is my responsibility to determine at permits are required, and to obtain permits prior orking on projeq s.
Date 5 I Print Name en e` ("Ca. l Signature LQ
T.Forms/Building Division/Building permit application
ft. Lot size
n a parcel including struct
4 135 for exemptions)
Occupancy grou
Occupant load
Construction pe
TOTAL VALUATION
sq Lot coverage
ved driveways sidewalks p
Site coverage
of bedroo
#offullb s
of h_ •aths
Permit UA
T Forms /Building Divislon/Notes
NOTES
f A-
!.8,� o ,9 �lr
661-1;1 -fo
decooll 11,e-et
HUtr /LO /Lull /rnl u4 4i riff u1tl,Hfi PAX No ibU4y1b3Ub
Aug 26 11 04:01p Jeff Renee Grail 360 457 5700
A#v- "kP Olympic Region Clean Air Agency Agency ?940 B Limited Lane NW
Mailing Address:
Mailing Address:
v
4, Olympia, WA 98502
(360) 539.7610 FAX (360) 491 -6308
Part Angeles office (360) 417 -1466
Raymond Office (360) 942 -2137
wwtr.ORCAA.otg
DEMOLmON CONTRACTOR
1 Business Name:
pewits Comet
a
p a Jcd
AUG 2 6 2011
Check if same as property owner information
Phone:
FAX
I Phone
FAX
Payment Info.
J Cash
J Check:
Ca-edit Card LAO
Receive dare _v,1.
4pe cry L'!r Orly
OVER
P 001
Demolition Permit
I J Owner occupied residential dwelling Permit fee 035.00 Prior Notice Nonrefundable
Other St auras Permit fee: �p,00 10 waning day wait period Nonrefundable
PROPERTY O R
ante: C
'11D Scx iNillrier
Site Adelman
cl
Email;
Mobile:
I Scare
i
DEMOLITION INFORMATION
of Structures being demolished: I Start Date: I Completion Duey
.Asbestos present j.Yes ,Pia Sury
L.4.5‹ "tTh4V1 -irri 55 e t n.
DEMOLITION PROJECT CATEGORY
ompleve Demolition
j l Training Fite -Fire ,Agency:
j Renovations. Ale:o ion, Remodeling, Uuntrnanoc or other Construction
1 1 Emereeney- Additional Fee of $50.00 (muse be a ccamrpaoded by Government Ordered Declaration- Camreereird only)
l ha re aieadand Waal abide byd the eandit ipp,y met laird la this permit and amaddendatm there m. file ircreby o ei*
rhatatl identified asbestos has been weaved and the iafa an in tbis appbicatiaa end snppleme#ral data
described herein'*, to the bear army lsrtos 9edg e, accurate Ad cuja eer.
attached Yes _No Has all ideadthed asbestos been
anIOLle± removed fen No
Qor Iii .2.s kos
I Zip:
4 tp &at _51/14-0. twa/1(
Applicant Name Signature Date
j Approved Asbestos Permit
I Disapproved Feaoic ASB00
Demolition emit
Review else: Permit DEM00 30 /0
Reviewed by:
ev llJrr Ord? Array c. 04
p.1
J Phone: p) 4.4-5: J-1obb I Email r41
City
J f F.AX t44) 1 -1i51-57 OD 1:viobile: t '-b r-4"1:114
.?c,(4 Pt nq eeltz State; 1.41 31.P.
or i -ae. 4, s Wp,
Clallam County Assessor Treasurer Property Details 62499 RENEE' GRALL TTE f Page 1 of 1
Clallam County Assessor Treasurer
Property Search Results 62499 RENEE' GRALL TTE for Year 2011 2012
Property
Account
Property ID
62499
Geographic ID 0630007903150000 Agent Code:
Type: Real
Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11
Open Space: N DFL N
Historic Property' N Remodel Property' N
Multi Family Redevelopment: N
Township: Section:
Range:
Location
Address: 1125 E FOURTH ST
PORT ANGELES, WA
Neighborhood: x ref Cycle 5 Res
Neighborhood CD' 10955130
Owner
Name' RENEE GRALL TTE
Mailing Address. 710 E SCRIVNER RD
PORT ANGELES, WA 98362
Taxes and Assessment Details
Property Tax Information as of 08/29/2011
Amount Due if Paid on. El.
Legal Description.
Mapsco:
Map ID' 2
Exemptions:
CAIN, SUBD OF
SUBURBAN LOT 18
LT 6 VAC ALLEY
ABUTTING BL 3
Owner ID 27425
Ownership: 100 0000000000%
NOTE If you plan to submit payment on a future date make sure you enter the date and
click RECALCULATE to obtain the correct total amount due
Click on 'Statement Details' to expand or collapse a tax statement.
First Half Second Half
Year Statement ID Base Amt. Base Amt. Penalty Interest Base Paid Amount Due
Statement Details
2011 156828 $602.39 $602.31 $0 00 $0 00 $602.39 $602.31
R Statement Details
2010 45106 $577 61 $577 59 $0 00 $0 00 $1155.20 $0.00
Values
Taxing Jurisdiction
Improvement Building
Sketch
Property Image
Land
Roll Value History
Deed and Sales History
Payout Agreement
This year is not certified and ALL values will be represented with N/A
2011 True Automation, Inc. All Rights
Reserved. Privacy Notice
Website version: 9 0 32.2200 Database last updated on: 8/29/2011 3.46 AM
http. /websrv8 clallam. net propertyaccess /Property.aspx ?cid =0 &year =2011 &prop_id =62499 8/29/2011
PREPARED 10/13/05 12 39 12 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 10/13/05
ADDRESS 1125 E 4TH ST SUBDIV
CONTRACTOR PHONE
OWNER GRALL RENNE TTE PHONE (360) 457 1000
PARCEL 06 30 00 7 9 0315 0000
APPL NUMBER 05 00000448 RES REMODEL
6/27/05 AP
PERMIT BPR 01 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BAIR 01 8/09/05 JLL BUILDING AIR SEAL
8/11/05 AP BUILDING AIRSEAL
08/09/2005 08 22 AM
DAVE 670 8961
08/11/2005 08 54 AM JLIERLY
BLDR 01 8/09/05 JLL BUILDING DRYWALL IBWP
8/11/05 AP DRYWALL
08/09/2005 08 23 AM
DAVE 670 8961
08/11/2005 08 55 AM JLIERLY
BL3 01 8/09/05 JLL BUILDING FRAMING
8/11/05 AP FRAMING
08/09/2005 08 19 AM
DAVE 670 8961
08/11/2005 08 55 AM JLIERLY
BL99 01 10/13/.5 LL BUILDING FINAL
10/12/2005 11 16 AM PBARTHOL
JEFF 670 8961
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 6/27/05 JLL PLUMBING ROUGH IN TIME 17 00
OVERRIDE TAKEN BY DYASUMUR DATE 06/27/05 TIME 12 00 25
06/27/2005 12 00 PM DYASUMUR
DALE 452 8529
06/27/2005 04 20 PM JLIERLY
PL99 01 10/13/95 JLL PLUMBING FINAL TIME 17 00
OVERRIDE TAKEN BY PBARTHOL DATE 10/12/05 TIME 11 22 08
10/12/2005 11 22 AM PBARTHOL
COMMENTS AND NOTES
`1s FA— Uoos
c
PREPARED 8/09/05 13 28 02 INSPECTION TICKET PAGE 6
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 8/09/05
ADDRESS 1125 E 4TH ST SUBDIV
CONTRACTOR PHONE
OWNER GRALL RENNE TTE PHONE (360) 457 1000
PARCEL 06 30 00 7 9 0315 0000
APPL NUMBER 05 00000448 RES REMODEL
PERMIT BPR 01 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BAIR 01 8/09/05
BLDR 01 r 8/09/05
BL3 01 8/09/05
JLL
f
JLL
JLL
BUILDING AIR SEAL
BUILDING AIRSEAL
08/09/2005 08 22 AM
DAVE 670 8961
BUILDING DRYWALL IBWP
DRYWALL
08/09/2005 08 23 AM
DAVE 670 8961
BUILDING FRAMING
FRAMING
08/09/2005 08 19 AM
DAVE 670 8961
COMMENTS AND NOTES
PREPARED 6/27/05 12 37 33 INSPECTION TICKET PAGE 7
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 6/27/05
ADDRESS 1125 E 4TH ST SUBDIV
CONTRACTOR PHONE
OWNER GRALL RENNE TTE PHONE (360) 457 1000
PARCEL 06 30 00 7 9 0315 0000
APPL NUMBER 05 00000448 RES REMODEL
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 /27/05
PLUMBING ROUGH IN TIME 17 00
OVERRIDE TAKEN BY DYASUMUR DATE 06/27/05 TIME 12 00 25
06/27/2005 12 00 PM DYASUMUR
DALE 452 8529
COMMENTS AND NOTES
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 05 00000448 Date 6/15/05
Application pin number 895616
Property Address 1125 E 4TH ST
ASSESSOR PARCEL NUMBER 06 30 -00 7 9 0315 0000
Application type description RES REMODEL
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 7700
Owner Contractor
GRALL RENNE TTE
719 E SCRIVNER RD
PORT ANGELES
(360) 457 1000
Qty Unit Charge Per
WA 983628922
OWNER
Permit BUILDING PERMIT RESIDENTIAL
Additional desc REMODEL KIT /BATH
Permit pin number 51979
Permit Fee 176 75 Plan Check Fee 70 70
Issue Date 6/15/05 Valuation 7700
Expiration Date 12/12/05
BASE FEE
6 00 14 0000 THOU BL -2001 25K (14 PER K)
Extension
92 75
84 00
Permit MECHANICAL PERMIT
Additional desc
Permit pin number 51557
Permit Fee 68 75 Plan Check Fee 00
Issue Date Valuation 0
Expiration Date 12/12/05
Qty Unit Charge Per Extension
BASE FEE 47 00
3 00 7 2500 ECH ME VENT FAN 21 75
Permit PLUMBING PERMIT
Additional desc
Permit pin number 51565
Permit Fee 96 00 Plan Check Fee 00
Issue Date Valuation 0
Expiration Date 12/12/05
Qty Unit Charge Per Extension
BASE FEE 47 00
6 00 7 0000 ECH PL- EA FIXTURE ON ONE TRAP 42 00
1 00 7 0000 ECH PL- EA WATER HEATER 7 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 341 50 341 50 00 00
Plan Check Total 70 70 70 70 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 416 70 416 70 00 00
const ct': on
i 6 /J7rT
Signature of Contractor or Authorized Agent
l Date
T \Policies\1 102_15 building permit inspection record05 wpd 1/4/2005]
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 authpty to violate or cancel the provisions of any state or local law regulating construction or the performance of
Signature of Owner (if owner is builder) Date
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
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
I 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
ELECTRICAL LIGHT DEPT
BUILDING PERMIT INSPECTION RECORD
qoc
z q of
$q o‘--
\J[ L
YES NO
417 -4735 ELECTRICAL
LIGHT DEPT
IFINOO- tO -I£ 'OS Ar t)
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING/LIGHTING ESA.
LANDSCAPING I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE I ACCEPTED
1 YES 1 NO
CONSTRUCTION R.W PW/ CONSTRUCTION R.W
ENGINEERING 417 -4807 PW ENGINEERING
FIRE 417 -4653 1 1 1 1 FIRE DEPT
PLANNING DEPT 417 -4750 I I_ 1 1 PLANNING DEPT
BUILDING 417 -4815 1 1° /—jq eX 013')1 I BUILDING
T \Policies \1102_15 building permit inspection record05 wpd [1/4/200.51
I I
I I I
1 1 I
kpplicant o kgent. ae; F CO.
LEGAL DESCRIPTION Lot:
Credit Card Holder Name
Billing Address
Credit Card Type VISA
TY OF WORK.
Residential New Constr
Multi family Addition
Commercial emodel
Repair
BRIE1 DESCRIPTION OF T
Total 101 coverage t2a
PLANNING USE ONLY
BUILDING PERMIT APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST B:
COMPLETE to be accepted for review If you have any questions. call
PERMITS (360) 417-4815 FAX(360)417 -4711
f
Owner C l ��11.,k R y'.PP rcl.I1 T�_ Phone
t
dciress `119 S�riv�. i'2Ol Cit Q. 5 In)--A
Phone
\.rchttecti7 mincer
Conrractur 0v3C\t.-` State License #t Exp
kddress City
PROJECT ADDRESS 11 r
MC
Block. Subdivision
CI. \LLA M COUNTY PARCEL NUMBER. 61 0&. 1 )0 00 711)31
Re roof Stove
Move arage
Demolition P
Sign 1 th❑O er
HE PROJECT l-I
COM ERCLAL /RESIDENTIAL Occupancy Group Occupant Load. Construction Type n
No cf Stories Lot Size 6� Exastmg Sq Ft. a t 7 Proposed Sq Ft./0 TOTAL Sq Ft./`f I/l 4 1:3
ESA Vyttland(s) es No SEPA Checklist required Yes No Other
•\LL Al ION Of CONSTRUCTION In all cases, a valuation amount niust be entered by the applicant. This figure ,rill h- re\ i w c
and ma} b revised by the Building Division to comply with current fee schedules Contact the Permit Coordinator at 417 -4S 1 fo. assist, nr
1.1. AN CHECK FEE IF a plan check fee is due n must be submitted at the time the building permit epphc. hod and onsru •u it p
submit _u. A 11 other permit fees are clue at the time of permit issuance
EXPIRATION OF PLAN REVIEW' If no per rut is issued witlun 180 days of the date of application. the application will expire. h'
Buildur( Oftir tat can extend the tune for action by the applicant up to 180 days upon written request h the applicant (sec h io' I t!
of the International Buildmg/Residential Code, 2003) No application can be extended more than once.
he,reh; ^erii that I have read and examined this application and know the same to be true and correct. I am authorized to appiy io. th;
undersrand that it is my responsibility to dete mine what permits are required ,not the City's, and that must obtain such permits prix, to work
T oiiciesvRl_ 1!02_13 wpd ApphCant: Date /c9
City
Phone
L ceI, 46( 9'`i
-Jew Le 1 -ttoi `l`(3
Zip IFj �O�
Phone
Zip
ZONING
5StA of
Exp Date
FOR OFFICIAL USE O'i Y
Dar.. Rec <96 3
Permit Cis 4 4e)
Dst Appruvec OT
Date Issued
SIZE/\ ALUATION
SF /SF
SF /SF
SF /SF
TOTAL VALUATION 17 6 Do
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4P1'RO\
PI_ AN
BLDX
DPW 1.1
FIRE
OTHER
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Approval Date
Or By �LL
CITY OF PORT ANGELES Construction Plans
The Issuance of this permit based upon these plans, specifi-
cations and other data shall not prevent the building official
from thereafter requiring the correction of errors in said
Plans, specifications and other data, or from preventing
building operctions being carried on thereunder when in
violation of all codes and ordinances of this jurisdiction.
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Feet
1121
Vertical Datum =NAVD 88
Horizontal Datum NAD 83/91
8
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10
k>.
Area Map
322
314
This map is not intended to be used as a legal description.
This map/drawing is produced br the ON of Port Angeles for its own use and purposes. .1
Anv other use of this map/drawing shall 1701 be the responsibiliti of the Cite