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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
RE ROOF LAY OVER ONE LAYER
F D/L G HANSEN
606 S C ST
PORT ANGELES
(360) 457 7863
Structure Information 000 000
WA 983635716
Permit BUILDING PERMIT
Additional desc RE ROOF LAY OVER
Permit pin number 139899
Permit Fee 109 75
Issue Date 1/06/09
Expiration Date 7/05/09
09 00000015
504815
911 W 6TH ST
06 30 00 0 1 0785 0000
LARRY HANSEN
RE ROOF
RS7 RESDNTL SINGLE FAMILY
2990
THE ROOF GURU INC
93 TONDA VISTA RD
PORT ANGELES
(360) 683 4125
RE ROOF LAY OVER ONE LAYER
Qty Unit Charge Per
1 00 14 0000 THOU BL -2001 25K (14 PER K)
Other Fees STATE SURCHARGE
Fee summary Charged Paid Credited
BASE FEE
Contractor
NO PR FEE
ONE LAYER
Plan Check Fee
Valuation
Permit Fee Total 109 75 109 75 00
Plan Check Total 00 00 00
Other Fee Total 4 50 4 50 00
Grand Total 114 25 114 25 00
Date 1/06/09
WA 98362
Due
0
2990
Extension
95 75
14 00
4 50
00
00
00
00
Date Print Name Signature of Contractor or Authorized Agent
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 Thereby 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 ofa permit d es not presume to give authority to violate or cancel the provisions of any
state or local law regulating construction or the performance of c 1
C, y 1. /c /f 4 4g/
Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
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
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 Accepted By
FINAL Date
FINAL Date
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping SHORELINE.
T Forms /Building Division /Building Permit
Comments
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Accepted by
Accepted by
Date Accepted By
n
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831 1 I
Fire 417 -4653 I I I
Planning 417 -4750 i y�/�
Building 417 -4815 I xp gAl ;0
C-
Applicant or Agent
Property Owner
Property Owner's Address
Contractor /Engineer
Contractor /Engineer's Address
License
PROJECT ADDRESS
Parcel Number
Project Tvne Brief Description.
Check all that apply
New Construction
o Addition
Remodel
o Repair
7 e -roof
Demolition
o Heat System
Other
Basement
1 Floor
2nd Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
projects
Date 6
BUILDING PERMIT APPLICATION 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
Print Name U
Coo( 6CA
Goc S G P-
rcCoi✓ r
Expires
Residential Commercial
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
o✓'VV l /cyc�.S
2_ 3 (24ei /3c7
Total footprint of structures sq. ft. T Lot size
Max. height of proposed structures ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be installed? Construction type
Signat ire
Phone cocK3
1 -f 7 -"V Cg
Phone
Phone
E -mail
Lot
TOTAL VALUATION
For City Use Only
Date Received 1 -05-01
Permit Oq I S
Date Approved
Zoning
o Multi- family Industrial
a Heat pump wood- burning stove gas fireplace o pellet stove other
per sq. ft.
sq. ft. Lot coverage
of bedrooms
of full baths
of half baths
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 s my responsibility to determine what permits are required, and to obtain .:m XiTOTto working un
Proposal Submitted To
Address
Phone c7 ac i Fax
ObJ
We hereby submit specifications and es'jmates for
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with payments to be made as follows
Any alteration or deviation from above specifications involving extra costs will be
executed only upon written order and will become an extra charge over and
above the estimate. All agreements contingent upon strikes, accidents, or delays
beyond our control.
The above prices, specifications and traditions are .satisfactory and are
here: -cepted. You are authorized •ie work specified.
Payments •ii be made as Jtlined above.
09 oF
Date of Accer .mince Signature
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Job Name
Job Location
Date
or) 1 G.
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of 1G/ea Cd
Respectfully
submitted
a of Prop°
Si:. F Are
g' 911
Architect
Page of
Job
Date of Plans
62c
f7 0
We propose hereby to furnish material and labor complete in accordance with the above specifications for the sum Of
c_oy ),I it' ll
Note this proposal may be withdrawn by us if not accepted within
i
7 A o s 6
cr- r
pages
Dollars
days.
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