HomeMy WebLinkAbout114 Valley Creek Dr - Building CITY OF PORT ANGELES
1 DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
rt '4P 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 09- 00000569 Date 8/11/09
Application pin number 413842
Property Address 114 VALLEY CREEK DR
ASSESSOR PARCEL NUMBER: 06-30-16-5-5- 0430 -0000-
Tenant nbr, name PORT ANGELES PLAT (SA)LLC
Application type description RES NEW SFR
Subdivision Name
Property Use
Property Zoning PLANNED RESDNTL DEVLPMENT
Application valuation 139642
Application desc
1,480 SF SFR, 429 SF ATT. GAR., 81 SF CVRD PORCH
Owner Contractor
PORT ANGELES PLAT (SHERRON DEVELOPMENT CONST GROUP INC
ASSOCIATES) LLC 12301 NE 10TH PL, STE. 303
12301 NE 10TH PL, STE. 303 BELLEVUE WA 98005
BELLEVUE WA 98005 (360) 454 -8900
(425) 454 -8900
Structure Information 000 000 1480 SF SFR, 429 ATT GAR, 81 CVRD PORCH
Other struct info TOTAL LOT COVERAGE 33.44
CONSTRUCTION TYPE VB
NUMBER OF STORIES 1.00
LOT SIZE 5951.00
PROPOSED LOT COVERAGE 1990.00
TOTAL LOT COVERAGE 1990.00
NUMBER OF UNITS 1.00
Permit BUILDING PERMIT RESIDENTIAL
Additional desc 1480 SF SFR, 429 SF GARAGE
Permit pin number 148197
Permit Fee 1244.25 Plan Check Fee 808.76
Issue Date 8/11/09 Valuation 139642
Expiration Date 2/07/10
Qty Unit Charge Per Extension
BASE FEE 1020.25
40.00 5.6000 THOU BL- 100,001 -500K (5.60 PER K) 224.00
Permit MECHANICAL PERMIT
Additional desc
Permit pin number .148205
Permit Fee 104.45 Plan Check Fee .00
Issue Date 8/11/09 Valuation 0
Expiration Date 2/07/10
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 14.8000 EA ME FURN /HP /FAU OR 5 TON 14.80 `J L•
4.00 7.2500 EA ME -VENT FAN (SINGLE DUCT) 29.00
1.00 10.6500 EA ME -STOVE /FIREPLACE /MISC. APP. 10.65
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 co ction.
Date Print Name Signature of Contractor or Authorized Agen Signature of Owner (if owner is builder)
T:FormsBuilding 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
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 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
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
t 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page 2
Application Number 09- 00000569 Date 8/11/09
Application pin number 413842
Permit PLUMBING PERMIT
Additional desc
Permit pin number 148213
Permit Fee 149.00 Plan Check Fee .00
Issue Date 8/11/09 Valuation 0
Expiration Date 2/07/10
Qty Unit Charge Per Extension
BASE FEE 50.00
10.00 7.0000 EA PL- PLUMBING TRAP 70.00
1.00 7.0000 EA PL -WATER LINE 7.00
1.00 15.0000 EA PL -SEWER LINE 15.00
1.00 7.0000 EA PL -WATER HEATER 7.00
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.
June 26, 2009 1:33:57 PM sroberds.
The proposal will result in a new sfr w /atta'ched garage in
the RS -7 zone for total lot coverage of 33% and site
coverage of 44 No land use issues anticipted.
June 17, 2009 8:42:35 AM Brian 417 -4708.
Connection Fee and electrical permits required
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
June 18, 2009 7:24:00 AM rbecker.
If you install a lawn sprinkler system, you will need to
install a double check backflow assembly.
If you have any questions contact Ron Becker at 417 -4886, or
E -mail me at rbecker @cityofpa.us
Other Fees RES UNDERGRND SERVICE FEE 713:00
SEWER SYSTEM DELV CHARGE 1510.00
STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 1497.70 1497.70 .00 .00
Plan Check Total 808.76 808.76 .00 .00
Other Fee Total 2227.50 2227.50 .00 .00
Grand Total 4533.96 4533.96 .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 p
,-o
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS 1
Building Inspections 417 4815 Electrical Inspections 417 4735 Q1
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
_o
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 ",Z —2_7-0 7 L.C.
Stemwall g 8 -0 q Ti-L-
Foundation Drainage Downspouts 9 1 o- n q T LZ-
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In I —22 —Oct S _L
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date 9• Ill Accepted by Zf
AIR SEAL: 10 -1.51 0 q r
Walls ....2
Ceiling aezei Q.tl
FRAMING: 10 -23• -01. 7a, U _/s�,'-L 2
Joists /Girders /Older Floor X' J `�rr�25
N OD qi— ILI--oct "Su dated 3j3ojlo it "bill
Shear Wall Hold Downs I
Walls Roof Ceiling 11..
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION: 1 1_ (D 0 1. ILA- 1 —�q
Slab
Wall Floor Ceiling l
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney 4-15
Commercial Hood Ducts FINAL Date Accepted by S &L--
MANUFACTURED HOMES:
Footing Slab �Q�
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE V
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW. Engineering 417-4831 ,5 °2- 0 PNV
Fire 417 -4653
Planning 417 -4750
Building 417 -4815 +2-0 rtA/ I V)
T:Forms/Building Division /Building Permit
�wF. CITY OF PORT ANGELES
Y w��� PUBLIC WORKS UTILITIES
s 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 09- 00000569 Date 8/11/09
Application pin number 413842
Property Address 114 VALLEY CREEK DR
ASSESSOR PARCEL NUMBER: 06 0430 -0000-
Tenant nbr, name PORT ANGELES.PLAT (SA)LLC
Application type description RES NEW SFR
Subdivision Name
Property Use
Property Zoning PLANNED RESDNTL DEVLPMENT
Application valuation 139642
Application desc
1,480 SF SFR, 429 SF ATT. GAR., 81 SF CVRD PORCH
Owner Contractor
PORT ANGELES PLAT (SHERRON DEVELOPMENT CONST GROUP INC
ASSOCIATES) LLC 12301 NE 10TH PL, STE. 303
12301 NE 10TH PL, STE. 303 BELLEVUE WA 98005
BELLEVUE WA 98005 (360) 454 -8900
(425) 454 -8900
Structure Information 000 000 1480 SF SFR, 429 ATT GAR, 81 CVRD PORCH
Other struct info TOTAL LOT COVERAGE 33.44
CONSTRUCTION TYPE VB
NUMBER OF STORIES 1.00
LOT SIZE 5951.00
PROPOSED LOT COVERAGE 1990.00
TOTAL LOT COVERAGE 1990.00
NUMBER OF UNITS 1.00
Permit SANITARY SEWER HOOK UP
Additional desc
Permit pin number 149203
Permit Fee 135.00 Plan Check Fee .00
Issue Date 8/11/09 Valuation 139642
Expiration Date 2/07/10
Qty Unit Charge Per Extension
1.00 135.0000 EA SAN SEWER HOOKUP 135.00 CM
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.
June 26, 2009 1:33:57 PM sroberds.
The proposal will result in a new sfr w /attached garage in
the RS -7 zone for total lot coverage of 33% and site
coverage of 44 No land use issues anticipted.
June 17, 2009 8:42:35 AM Brian 417 -4708.
Connection Fee and electrical permits required
Sanitary sewer connection inspection.is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
June 18, 2009 7:24:00 AM rbecker.
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
c ion.
on
L• 0) 69
Signature of Contractor or Authorize Agent Date Signature of Owner (if owner is builder) Date
T: \Policies \1102.15 [10/08]
PERMIT INSPECTION RECORD
CALL 417 -4831 FOR UTILITY INSPECTIONS. 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
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W. PW/ CONSTRUCTION R.W.
ENGINEERING 417 -4831 PW ENGINEERING
FIRE 417 -4653 FIRE DEPT.
PLANNING DEPT, 417 -4750 PLANNING DEPT.
BUILDING 417 -4815 BUILDING
T: \Policies \1102.15 [10/08]
°ar, CITY OF PORT ANGELES
7��� PUBLIC WORKS UTILITIES
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page 2
Application Number 09- 00000569 Date 8/11/09
Application pin number 413842
Special Notes and Comments
If you install a lawn sprinkler system, you will need to
install a double check backflow assembly.
If you'have any questions contact Ron Becker at 417 -4886, or
E -mail me at rbecker @cityofpa.us
Other Fees RES UNDERGRND SERVICE FEE 713.00
SEWER SYSTEM DELV CHARGE 1510.00
STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 135.00 135.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2227.50 2227.50 .00 .00
Grand Total 2362.50 2362.50 .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\ 1 102.15 10108]
PERMIT INSPECTION RECORD
CALL 417 -4831 FOR UTILITY INSPECTIONS. 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
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W. PW/ CONSTRUCTION R.W.
ENGINEERING 41.7 -4831 PW ENGINEERING
FIRE 417 -4653 FIRE DEPT.
PLANNING DEPT. 417 -4750 PLANNING DEPT.
BUILDING 417 -4815 BUILDING
T: \Policies \1 102.15 [10/08]
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T:Fonns /Building Division /Notes
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am A rmStror3 President of controxbr Co (I) eu elq .nf itCb lst-Wc-fioh
oc.pow BUILDING PERMIT APPLICATION Print in ink
L e rr P U f
,r *s CITY OF PORT ANGELES 4 Q s b �sr Y
4 For City Use Only:
Attn: Building Permit Technician eft nc5 y1 °m
Date Received (r^ I I 0
Iiiimoor NSW 321 E. Fifth St., Port Angeles, WA 98362 Permit
(360) 417 -4815 fax (360) 417 -4711 Ce,t� I
Date Approved
i
Applicant CL /WT, $E1:Z.& Avt 014+ Phon 360-4,81 -L-! 139
Property Owner po R-r ANiGaLles pt 4i -Cc)J anon/ moat) Phone Las- Lis q- 'goo X 12.1
Property Owner's Address 0 301 0,E. jo -pi,, 50,TE 303 LLC f3e11evne_ 4BooS
Contractor DV£LoPM eiur .1- Coos-rave-now) Gam) P, IA/C. Phone 4„25- ysy B9oox iV
Contractor's Address p3ot -Ai. io3 CL, so tr= 303 /3eLi- .Evde, wR. ei Soo
License •;EV ELe G. 974) Rq Expires h2.29.0ei E -mail .E- ,,64..roa, G 5 L ervo.0
PROJECT ADDRESS I L/ Vfl• -L-1 'r' Citea e Piz 11v E
Parcel Number a G 30 1 5 5 O Lf 3O Lot 3 Zoning PRO
Project Type Brief Description: lQ Residential Multi- family Commercial Industrial
Check all that apply
gNew Construction NI k) S P g 4. a Ch4
Addition
Remodel
Repair
Demolition
Re -roof House o'garage d other *r; tear off re -roof lay over one layer
Heat System Heat pump wobd burning `stove .gas fireplace pellet stove gotherF, A /,E.L gC..
Other
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement p 0 per sq. ft.
l Floor O 4 190 RS, e 0 /07, $0sa:
2nd Floor 0 o
3r Floor o
Garage O y 9 41 30.00 /2, 07.0 ...94
Carport 0
Covered Porch Q R 1 I /2. o o
9'7; 0 0
Deck 0
Shed a
Other 0
TOTAL VALUATION 3i,4.y2 1
Total footprint of structures egci 0 sq. ft. Lot size S 15/ sq. ft.. Lot coverage 33,.51']
Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage h/%38
Max. height of proposed structures i 4 {o ft. Occupancy group of bedrooms 3
Will a lawn sprinkler system be installed? Too Occupant load of full baths
Will a fire sprin system be installed? No Construction type of half baths p.
t 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 y at permits are required, and to obtain permits prior to o 'rig on projec
Dateee- -L0' Print Name /J /,t) j, 23,X 2. Signature t e
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PRESCRIPTIVE APPROACH SIMPLE FORM
*.in
For the Washington State Energy Code (2006 Edition)
Climate Zone 1
CITY OOVERNKENT Site Information: Building Department Use Only:
Lot: a il 3 E5erwe ¥ALLEK Ci2 K Permit 0 c 1 5 6
Address: 19- VRLL 4' CitEEK- D12, Notes:
City: PO LING
State: VI/ A-. Zip: 9834A
Contact: rC L.1 E.e,60
Phone':' C" 73/,„ O 73 8 4 3
Phone 2 :1. Y— /v g 1- 1 -1119'
FAX: oLY PB1J
Table 6 -1
PRESCRIPTIVE REQUIREMENTS FOR GROUP R OCCUPANCY
CLIMATE ZONE 1
(Unlimited Glazing Option Only)
Glazing Glazing U Factor Doo`r Wall Wall Wall
;Vaulted Interi E xter.►or Slab o n
Option Area o of Vertical Overhead' Factor Ce►I►ng Grade Floor
Floor
•Ce►ling Below Below Concrete"
'G rade Grade
Unlimited
Group R -3
IV and R -4 0.35 0.58 0.20 R -38 R -30 R -21 R -21 R -10 R -30 R -10
Occupancies
Only
This Project complies with the following:
1 The project is a single family residence or duplex.
'V The project is a wood frame OR all of the insulation is interior or exterior of the framing.
All building components meet the requirements listed above.
The project will meet all other provisions of the WSEC and VIAQ.
The Project will take advantage of the following exceptions to the prescriptive option.
602.6 Exception 2. One unlabeled or untested exterior swinging door, 24 sq.ft. or less, may be
installed per unit for ornamental, security, or architectural purposes.
Location of the door taking this exception:
602.6 Exception 2. If a door is mostly glass, it should meet the requirement of the vertical
glazing U- facior listed above.
Location of the doors) taking exception:
Type of heat Source: FO2CV A l R f::-,LEc, 1`U 120 =1`C
T Forms/Building Division /Pescriptive Approach Simple Form
1
m
m
r <r l ec t r i ca i information Form a
'V P ublic Works Utilities Department (360) 417 -4700 m
5 City Electrical Inspector (360) 417 -4735 .g
Please complete and return to Public Works Utilities Department
ApplicantInformaton
Permanent service: Name:DEVELOP/I ehrr 4- COUSTtVUCTIOM G(OCJ` I INIC. LL.G
Name and address of party Street: /230 N E, /5r 1i.-ACS 4 S ITE 30 3
responsible for permanent City State ZIP: `13r..Li..-EYU E. W A, 9 80 0.5
service billing? Daytime Phone:WS"- 41S 8900 Home Phone:
Contact lnfornation (if other than above)
Site contact: Name: CL /iJT, Seac, Title: AGEAJT
Daytime Phone: 34,0- -73/ -84./3 366-443/-
Contractor:
Name:1 t/�In5Tiva,o6 Company:'�V, d- e.oubr- GetOUP .�G -1-e-
Daytime Phone:: 4.75' y r3e /e✓o'-. lu4
JM
Name: /f S n
i li Company: Ser4 w. of /#'j. '-Lc
Electrician:
Daytime Phone: 360 69 1 li
Excavator:
Name: Company:
Daytime Phone:
Project Type Existing New
X Single family residence El Multi-family residence; of units
Commercial El Subdivision; of lots
Overhead service General service
Underground service Other:
Pro•ect. Infor Description of work: 5 1u6LE FAM /L'( 2F 5/ Ds t1JE
Street address lot number: I /AL.I.EY C /Z. E K D2. 1--e)-7- gt 3 ?2 $tIZ.UE. (2-V
Nearest cross street: r -c E ST
Desired connection date: W #F) J 2,PeCTEo A-OJD ,Q- PvIzev
Electrical transformer serving property is: on a pole tg, on the ground
Electrical: Load
Total square footage: /'fob sq. ft. Main disconnect size: amps
120/240 1 ph 0120/208 3ph 277/480 3ph
Voltage:
❑120/240 3ph ❑480 3W 3ph Other
f g Standard residential loads (Lighting, refrigerator, dishwasher, washer)
Check all that apply: A/C ton) 7K Range /Oven Hot Tub
Clothes Dryer Heating Pumps Hp)
No Load Change gl Water Heater Elevator Hp) Other
Su ortin Doc p
pp 9 �umentatl ®n Please provide ,a copy of the following:
-tailed plot plan (.dwg or .dxf format mandatory for subdivisions).
*Electrical one -line drawing showing the service entrance panel and location.
*Connected load data.
*Size and locked rotor am s of.all motors over 50hp.
Applicant's Signature: am
(1-------1 Date: C� -I 9
pP
MAIL OR DELIVER COMPLETED FORM TO: 321 E 5TH STREET; PORT ANGELES, WA 98362
FAX TO: 360 -417 -4711
WS
WF
Information form.xls
1 PWKS! l_ IG{- I r\ i7rsh'i:iR \#kor!gi: fort r, Revise: -15. 00
ELECTRICAL .PERMIT
CITY OF PORT ANGELES
360 417 -4735
Application Number 09- 00000944 Date 4/20/11
Application pin number 063680
Property Address 114 VALLEY CREEK DR REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06- 30- 16 -5 -5- 0430 -0000- your excise tax form
Application type description ELECTRICAL ONLY on y
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning PLANNED RESDNTL DEVLPMENT
Application valuation 0
Application desc
New home 1909 sqft
Owner Contractor
SHERRON ASSOCIATES, L.L.C. SEQUIM ELECTRIC
325 E WASHINGTON ST. #111
BELLEVIEW SEQUIM WA 98382
BELLEVUE WA 98005 (360) 681 -3794
Permit ELECTRICAL NEW RESIDENTIAL 1
Additional desc
Permit pin number 153452
Permit Fee 141.25 Plan Check Fee .00
Issue Date 9/14/09 Valuation 0 -y-
Expiration Date •5/01/10 y
Qty Unit Charge Per Extension
1.00 86.2500 ECH EL -R -SQFT FIRST 1300 86.25 -p
2.00 27.5000 ECH EL -R -SQFT ADDITIONAL 500 55.00 1 V
Fee summary Charged Paid Credited Due K
Permit Fee Total 141.25 141.25 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 141.25 141.25 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH -IN /Z—C) FINAL t� 'C' COMMENTS: 111
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE■BUILDING
bF PORT' ,A04,. ELECTRICAL INSPECTION
WIRING REPORT
\R �y�W 417 -4735
DATE PERMIT a INSPECT R
D
OWNER/CO TRACTOR ,s ill
ADDRESS
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER
SERVICE
FINAL
CORRECTIONS NEEDED:
NOTIFY. INSPECTOR WHEN CORRECTIONS
F;
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
5
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number 09- 00001064 Date 4/20/11
Application pin number 409480
Property Address 114 VALLEY CREEK DR REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06- 30- 16 -5 -5 -0430 -0000- your excise tax form
Application type description ELECTRICAL ONLY on Y
Subdivision Name to the City of Port Angeles
Property Use
Property Zoning PLANNED RESDNTL DEVLPMENT (Location Code 0502)
Application valuation 0
Application desc
New home furnace T -stat
Owner Contractor
SHERRON ASSOCIATES, L.L.C. AIR FLO HEATING CO INC
221 W. CEDAR
BELLEVIEW SEQUIM WA 98382
BELLEVUE WA 98005 (360) 683 -3901
Permit ELECTRICAL NEW RESIDENTIAL
Additional desc
Permit pin number 155135 ti+
Permit Fee 43.75 Plan Check Fee .00
Issue Date 10/15/09 Valuation 0
Expiration Date 10/17/11
Qty Unit Charge Per Extension I
1.00 43.7500 ECH EL- LVT- THERMOSTAT 43.75
Fee summary Charged Paid Credited Due
Permit Fee Total 43.75 43.75 .00 .00 C2F
Plan Check Total .00 .00 .00 .00
Grand Total 43.75 43.75 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH -IN l
FINAL 1 JZ01 co
COMMENTS: l
PERMIT .WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
oFpORr,4,, ELECTRICAL INSPECTION
Az, WIRING REPORT
°'MIMI/ S 417 -4735
RKS 6
DA PERMIT INSP C
i f I 7
OW ER/CO T ACT ACTOR
ADDRESS
I A 4
APPROVED NOT APPROVED
I DITCH
ROUGH IN /COVER
SERVICE'
FINAL
CORRECTIONS NEEDED:
4.
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
New home furnace T stat
Owner
SHERRON ASSOCIATES L L C
BELLEVIEW
BELLEVUE
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 98005
155135
43 75
10/15/09
4/13/10
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
09 00001064
409480
114 VALLEY CREEK DR
06 30 16 5 5 0430 0000
ELECTRICAL ONLY
PLANNED RESDNTL DEVLPMENT
0
DATE
Contractor
ELECTRICAL NEW RESIDENTIAL
Qty Unit Charge Per
1 00 43 7500 ECH EL LVT THERMOSTAT
AIR FLO HEATING CO INC
221 W CEDAR
SEQUIM
(360) 683 3901
Plan Check Fee
Valuation
Charged Paid Credited
Permit Fee Total 43 75 43 75 00
Plan Check Total 00 00 00
Grand Total 43 75 43 75 00
113 ,1
Date 10/15/09
WA 98382
Extension
43 75
Due
00
00
00
RESULTS
00
0
Pk?
ii)/it pcF,
Si gnature of owner or Electrical Contractor X Date
INSPECTOR.
DATE
l!2IC)
OW1■ER/C"ONTRACTOR
ADDRESS
APPROVED
0
CORRECTIONS NEEDED
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
PERMIT
C i r_C TIZ-t
DITCH
ROUGH IN /COVER
SERVICE
FINAL
INSPECTOR
20 1)'AC Y GIZ.g.C.14 D
_iko l S1 -I1 Q
�nl LLg_L7 aF' CSa9t
/Z. r3 C Vin a.l lac c_DM gc-rt
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
NOT APPROVED
0
0
0
10/14/2009 WED 9 52 FAX 360 683 3971
Owner 1 formation 6 i rn,lr)
Name: l leilL 5 P zakf re f;
Mailin Address: 12 4M i 1 t 1 Pi.- '30.5
City .1C3)v" State: WA- Zip:aQ fr)
Phon� t Fax: E�f T‹ )751# 541 4',
License 1 rp.
Unit Charge
93.75
$113.75
$160.00
$205.00
$291.25
2.00
57.50
2.00
72.50
86.25
$116.25
$131.25
75.00
69.00
75.00
50.00
50.00
93.75
80.00
86.25
27.50
57.50
86.25
43.75
Signatyre of owner electrical contractor or electrical administrator
Air ftECE
OCT 14 2009
ELECTRICAL
INSPECTIONS
City of Port Angeles Permit Application
Building DivislonlElectrical Inspections
321 East Fifth Street P.D. Box 1150
Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417.4711
Date: 10- i L4_09
2 ,L 1 2 Single Family Dwelling
Multi -Family or Commercial*
Commercial Addition I Alteration I Remodel Repair'
Plan Review May Be Required, Please C mplete Electrical Plan Review Information Sheet
Job Address: 111.4 va,1 i C� t t 1 CJ rep-P t v eaK: r Llt C p
Building Square Footage;
Description of above 9 -{-"P IA, o N T y J r n 1. v YV) U.0L-
1 to 12
Qty Total (Qtv Multiplied by Unit Charael
Contractor Information
Name: A i r i, 0 4-1 CA f(�_
Mailing ,Qddress: i N N. [1�.( 1'/_
City S L I State: Zip:
Phone:jnk Fax: S
License I Exp. fL) r P 1 .l-I- 0 0 0 4 /0
ServicelFeeder 200 Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401 -600 Amp.
ServicelFeeder 601 1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service! Feeder 200 Amp.
Temp. Service/Feeder 201 -400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service /Feeder 601 -1000 Amp.
Portal to Pedal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy Commercial
Signal Circuit! Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi-Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
First 1300 Square Ft
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Y Thermostat
Total
I�J 001 /001
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure /or 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
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.
Cash
Check
Date: 1 0 11.4 .iOoti NI Credit Card KI t I i t;
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
New home 1909 sqft
Owner
SHERRON ASSOCIATES L L C
BELLEVIEW
BELLEVUE
Permit
Additional desc
Permit pin number 153452
Permit Fee 141 25
Issue Date 9/14/09
Expiration Date 3/13/10
Qty
1 00
2 00
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 98005
Unit Charge Per
86 2500 ECH
27 5000 ECH
141 25
00
141 25
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Date 9/14/09
09 00000944
063680
114 VALLEY CREEK DR
06 30 16 5 5 0430 0000
ELECTRICAL ONLY
PLANNED RESDNTL DEVLPMENT
0
Contractor
ELECTRICAL NEW RESIDENTIAL
SEQUIM ELECTRIC
325 E WASHINGTON ST #111
SEQUIN WA 98382
(360) 681 3794
EL R SQFT FIRST 1300
EL -R SQFT ADDITIONAL 500
Plan Check Fee 00
Valuation
Paid Credited
141 25 00
00 00
141 25 00
DATE RESULTS
0
Extension
86 25
55 00
Due
00
00
00
INSPECTOR.
4$4. *9)
4.P vc?'
6 KF ize I
mature of owner or Electrical Contractor X Date
City of Port Angeles Permit Application
Building Division /Electrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date: 9" ff of
1 2 Single Family Dwelling
Multi Family or Commercial*
Commercial Addition Alteration Remodel Repair*
Owner Information C_-t jr �c2L
Name. rte S1- berzR?)gl
Mailin Address:
City 1 0e_ State. !f1 P Zip 7D
Phone. Fax.
License Exp
Unit Charae
93 75
$113.75
$160.00
$205.00
$291.25
2.00
57.50
2.00
72.50
86.25
$116.25
$131.25
75.00
69,00
75.00
50.00
50.00
93 75
80.00
86.25
27.50
57.50
86.25
43 75
gly
Signature of owner electrical cont r or electrical administrator
Date:
2s
RECEIVED
SEP 1 4 zoos
ELECTRICAL
INSPECTIONS
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 1144 thatu Cre..t.Jr fr 1....e t 4 co
Building Square Footage. t doo 4' et>r LlZ.5 110 4e) 5
Description of above A.jec c.) k 1 4_ ct-beih.2. acid it_Ss
w
P
-0
Contractor Information
Name. Sa 9 w ?i. T Terri, ii C
Mailing Address: e ,z4Y o/f ca3410 hicCY
City coq State. wit Zip: Aga
Phone. tax: 4 i 4
License /Exp
q uLE
5 q 5'3 L2.
Total (Qty Multiplied by Unit Charge)
Service /Feeder 200 Amp.
Service /Feeder 201 -400 Amp.
Service /Feeder 401 -600 Amp.
Service /Feeder 601 1000 Amp.
Service /Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service /Feeder 201 -400 Amp
Temp Service /Feeder 401 -600 Amp
Temp. Service /Feeder 601 1000 Amp.
Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy Commercial
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
$G L- First 1300 Square Ft.
or> Each Additional 500 Square Ft. or Portion of
59 Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
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.
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.
Cash
//Check
Credit Card
66Y-.37q1
OAT
g Zsld9
OIANER/CONTRACTOR
ADDRESS
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
PERMIT U
0 086
DO NOT REMOVE
INSPECTOR
A- ssfx_i ATE S LL--C
11 y 1)f
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER
SERVICE
FINAL
CORRECTIONS NEEDED �nrc °'-a %JJ l�S
won-pm iz, Cw_Sts rit∎l r WY �?r
54c„F, uip t-r�� IzU!r
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Temp pole
Owner
SHERRON ASSOCIATES L L C
BELLEVIEW
BELLEVUE
Permit
Additional desc
Permit pin number 152348
Permit Fee 72 50
Issue Date 8/25/09
Expiration Date 2/21/10
Qty Unit Charge
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 98005
ELECTRICAL TEMPORARY SERVICE
Per
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
09 00000865
202895
114 VALLEY CREEK DR
06 30 16 5 5 0430 0000
ELECTRICAL ONLY
PLANNED RESDNTL DEVLPMENT
0
Contractor
OWNER
Plan Check Fee
Valuation
1 00 72 5000 ECH EL TEMP SRV 0 200 SRV FDR
Charged Paid Credited
72 50 72 50 00
00 00 00
72 50 72 50 00
fal
11120-1 94e?
Date 8/25/09
Due
DATE. RESULTS
00
00
00
0 0
0
Extension
72 50
Signature of owner or Electrical Contractor X Date
INSPECTOR.
City of Port Angeles Permit Application
Building Division /Electrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date. 8 -1 o 9
l'1 2 Single Family Dwelling
Multi- Family or Commercial*
Commercial Addition Alteration I Remodel Repair*
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: Ii? V62.l>_ C.ZZEE DrL 1VE
Building Square Footage. f c3 jr3L.
Description of above
Owner Information
Name: D £V -F- C 4 �S i co f2 at)9.
Mailing Address: I .2 3 o I it) I D'" Pt SUP-3v
City c11 r v u State t) A- Zip 00.3
c-/21 4-54 O D Fax: hfaS 4 44 3
License I Exp
Unit Charae
93.75
$113.75
$160.00
$205.00
$291.25
2.00
57.50
2.00
72.50
86.25
$116.25
$131.25
75.00
69.00
75.00
50.00
50.00
93.75
80.00
86.25
27.50
57.50
86.25
43 75
Cy
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.
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. Chaptv19.28, WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code, and
Utility Specifications.
Signature of owner electrical contractor or electrical administrator
X
I
Date: g" -X 04
RECE-VED
AUG 2 5 2009
ELECTRICAL
INSPECTIONS
Total (Qtv Multiplied by Unit Charae)
Service /Feeder 200 Amp.
Service /Feeder 201 -400 Amp.
Service /Feeder 401 -600 Amp.
Service /Feeder 601 1000 Amp.
Service /Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service /Feeder 201 -400 Amp.
Temp. Service /Feeder 401 -600 Amp.
Temp. Service /Feeder 601 1000 Amp.
Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy Commercial
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
Total
6ash
Check
Credit Card
Contractor Information
Name. -560V )111 E L. c,
Mailing Address.
City -5 State:-Zip: 4 ,s?
PhonekYb 3 991- Fax:
License Exp
0
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Water meter
Owner
SHERRON ASSOCIATES L L C
BELLEVIEW
BELLEVUE
Qty Unit Charge Per
1 00 7 0000 EA
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
T SPoiicieT 02 15 [10/08)
WA 98005
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
321 EAST 5TH STREET PORT ANGELES, WA 98362
09 00000567
415336
114 VALLEY CREEK DR
06 30 16 5 5 0430 0000
PUBLIC WORKS UTILITES'
PLANNEb RESDNTL DEVLPMENT
0
Contractor
Permit PLUMBING PERMIT
Additional desc DOUBLECHECK VALVE FOR HOSE BIB
Permit pin number 148163
Permit Fee 57 00
Issue Date 6/17/09 Valuation
Expiration Date 12/14/09
BILL S PLUMBING HEATING INC
P 0 BOX 282
SEQUIM WA 98382
(360) 683' 7996
Plan Check Fee
BASE FEE
PL- BACKFLOW PROTECTION <OR =2
Charged Paid Credited
412 00 412 00 00
00 00 00
1510 00 1510 00 00
1922 00 1922 00 00
Date 6/17/09
PW WATER SYSTEM USE FEE 1510 00
Due
00
00
00
00
00
0
Extension
50 00
7 00
Permit PUBLIC WORKS RES WATER SERV
Additional desc
Permit pin number 148155
Permit Fee 355 00 Plan Check Fee 00
Issue Date 6/17/09 Valuation 0
Expiration Date 12/14/09
Qty Unit Charge Per Extension
1 00 355 0000 EA PW WATER METER DROP IN 355 00
ci v\ o %t-k(2A
C7
to Ron Becker
c reck affia5V4 d (1-4
Revin +v
GrJ Pv
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 iIt owner is builder) Date
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Water meter
Owner
SHERRON ASSOCIATES L L C
BELLEVIEW
BELLEVUE
Permit PLUMBING PERMIT
Additional desc DOUBLECHECK VALVE FOR HOSE BIB
Permit pin number 148163
Permit Fee 57 00
Issue Date 6/17/09 Valuation
Expiration Date 12/14/09
Permit PUBLIC WORKS RES WATER SERV
Additional desc
Permit pin number 148155
Permit Fee 355 00 Plan Check Fee 00
Issue Date 6/17/09 Valuation 0
Expiration Date 12/14/09
1 00
Other Fees
Fee summary Charged
Permit Fee Total 412 00
Plan Check Total 00
Other Fee Total 1510 00
Grand Total 1922 00
T \Policies \1102 15 (10/08]
1 00 7 0000 EA
Qty Unit Charge Per
Qty Unit Charge Per
WA 98005
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
321 EAST 5TH STREET PORT ANGELES, WA 98362
09 00000567
415336
114 VALLEY CREEK DR
06 30 16 5 5 0430 0000
PUBLIC WORKS UTILITES
PLANNED RESDNTL DEVLPMENT
0
BASE FEE
PL- BACKFLOW PROTECTION <OR =2
355 0000 EA PW WATER METER DROP IN
PW WATER SYSTEM USE FEE 1510 00
Paid Credited Due
412 00
00
1510 00
1922 00
Contractor
Date 6/17/09
BILL S PLUMBING HEATING INC
P 0 BOX 282
SEQUIN WA 98382
(360) 683 7996
Plan Check Fee
00
00
00
00
00
0
Extension
50 00
7 00
Extension
355 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 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 Authori Agent Date Signature of Owner (if owner is builder) Date
C
CALL 417 -4831 FOR UTILITY INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND 4CCEPTED POST PERMIT IN A CONSPICUOUS LOCATION
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
T iPolicies` 1 10 15 10 /08]
RESIDENTIAL
CONSTRUCTION R.W PW/
ENGINEERING 417 -4831
FIRE 417 -4653
PLANNING DEPT 417 -4750
BUILDING 417 -4815
PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED
YES I NO
I
I I
I I
I I
CONSTRUCTION R.W
PW ENGINEERING
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
I I