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Home My WebLink About112 E 12th St - Building f~O"''''-4~ .....t.O~~ (;~~ 'L -=-- ---- "l.Oi:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 0.3--- :3 ~ '1 Application Number Property Address ~SESSOR PARCEL NUMBER Application description Property Zoning Application valuation 03-00000339 Date 3/31/03 112 E 12TH ST 0630000380300000 PUBLIC WORKS UTILITES o Owner Contractor STRINGER EDWARD/EVELYN PO BOX 1504 SEQUIM WA 98382 OWNER ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date DRIVEWAY INSTALLATION 145 00 3/31/03 9/27/03 Plan Check Fee Valuation 00 o ~ --.. ~ \\\ --- ~ Qty Unit Charge Per BASE FEE Extension 145 00 Fee summary Charged Paid Credited Due Permit Fee Total Plan Check Total Grand Total 145 00 00 145 00 145 00 00 145 00 00 00 00 00 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if c~nstruction 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. ,/J, . 4 / In?t Signature of Contractor or Authorized Agent Date T-\PLANNINGIFORMS\llil2.IS [4/2002] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT . . . . . . REQUEST Date C> ^I "-:.,,'-:;:: - 0 ~ Time ~ ~ .:>- )... Received by ~~_ Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one) ---" . I1-'TJ, ~ I g...::. ,S' II~' I (:) J2 <- Phone No )..ft)1 - 6 9o~ Permit. No., 0 -3 -31-31 Sewer Foundation Framing Chimney Plumbing Final Sewer Exca0the-;',~Ji ,,,,,,,-I Jc . j),1.I....~ l-U~ (PhOne II 9- J ? 1 ' 1/_a-- INSPECTION NOTES Inspected Date 4 /4/l..~> )// . Remarks ( . f- Time dl. {/ 2,-..=: .AJ-;} By E/:-I L. RESTORATION REQUIRED YES NO UJOJ1 t 70 j J IS))-e L + ( 0 ; ! {)OU Y ~(Ar-~ /11 1}lorI1JM~) )lp~ d ;),;)),. CJ SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DA TE) BUIl.DING PERMIT INSPECTION RECORD CALL 417-4815 FOR BlJILDING 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 LOCA nON INSPECTION TYPE DATE ACCEPTED COMMENTS ~ I YES NO FOUNDATION: FOOTINGS WALLS FOUNOA TlON ORAINAGE ELECTRICAL (LIGHT OEPT) SEPARATE PERMIT II .. ROUGH-IN PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR 1 CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM -- PLANNING DEPT SEPARATE PERMIT II's SEPA. PARKING/LIGHTING ESA: LAN.DSCAPING SHORELINE: t- - FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE - RESIDENTIAL DATE YES NO COMMIi;RCIAL DATE ACCEI'TED ELECTRJCAL YES NO LIGHT DEPT 417-4735 ELECTRJCAL - LIGHT DEPT CONSTRUCTION R.W / PW/ ENGINEERJNG 417-4807 CONSTRUCTION R. W PW / ENGINEERJNG FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE T \PLANNING\FORMS\1102.IS [4/2002J d': pORT "'-\-0 A...-l..~~ G,....a~ 'IL~ ~ ~lC~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property zoning . . . Application valuation 04-00000465 Date .691505 112 E 12TH ST 06-30-00-0-3-8030-0000- RES DETACHED GARAGE 6/14/04 RS7 RESDNTL SINGLE FAMILY 20000 Owner Contractor STRINGER EDWARD/EVELYN PO BOX 1504 SEQUIM WA 98382 STRINGER CONSTRUCTION 64 COUGAR LANE PORT ANGELES (360) 457-6902 440 SF DETACHED GARAGE TYPE V NON-RATED GARAGES, CARPORTS, SHEDS TOTAL % LOT COVERAGE CONSTRUCTION TYPE HARD SURFACE AREA NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98362 Structure Information Construction Type Occupancy Type Other struct info 25.60 V-N 1. 00 1352.00 7000.00 440.00 1792.00 1. 00 Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT 440 SF DETACHED 344.75 6/14/04 12/11/04 -RESIDENTIAL GARAGE Plan Check Valuation Fee 137.90 20000 - ~ \i :z (\{ - to/~/04: '\ \ rJ J~ + $'" ---------------------------------------------------------------------------- 18.00 14.0000 THOU BASE FEE BL-2001-25K (14 PER K) Extension 92.75 252.00 Qty ,Unit Charge Per ---------------------------------------------------------------------------- Special Notes and Comments When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. Electrical load calculations and elctrical permits are required. ' Any modi~ications to the City'S electrical facilities will be at the customer's expense. ---------------------------------------------------------------------------- Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 344.75 344.75 .00 .00 Plan Check Total 137.90 137.90 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 487.15 487.15 .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 ~he performance of construction. \ Signature of Contractor or Authorized Agent Date o - I</-- C',-/- Date T:\PLANNING\FORMS\1102.15 [11/14/2003] BillLDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE 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 FOUNDATION: FOOTINGS 1 '7- '/( ---OJoj J,L WALLS 1-7- i J..r-O~ ~l . 1-, FOUNDATION DRAINAGEIDOWN SPOUTS If)-/t; -04 J "L L, ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I PLUMBING DeLLi" ~pCiVh::. 7 ...I/'; '(!JJ./ I).f. J.t... UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW I WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS I GIRDERS SHEAR WALL/HOLD DOWNS V- ~...U ~ .L L..1. WALLS I ROOF I CEILING DRYWALL (INTERJOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL I FLOOR I CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTlNG ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W. ENGINEERJNG 417-4807 PW I ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. - BUILDING 417-4815 t. ';~~ , , ;-;0 BUILDING T:\PLANNING\FORMSllI02.15 [11114/2003] , tIJ tIJ tJ tIJ tIJ >-l '" ~~~8E; n'O , I:" I:" m H I:" >< ~ H;o , '" '" tJ to H '0 'O;oZZtJ >-lOJ , '" , I:"nOJ>-l;O ><'0 , Ul >-< tl1:::d::dtI:l ;J> , 0 0 0 0 0 0 .; ZI:" ;J>m 0;0 , H H H H H ~. nm ...,OJ >-l tJ tIJ tIJ 0 '0 -E '" OJ. ;0. OH , H n;o~ ;0 ;00 I OCOCO-..J-...] oJ oJ oJ oJ OOJ >-l' I . ................................................... " " 3:0 to I 001--'1--' H H 00 'Oc:o o O(f){/) I--' ~;:: I tv I\JI\J C7\0'\ "'''' OOOO I:"OJo ol:>.Q'\l-jl-jf-' I ................................................... 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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 Applicant or Agent: st;\~Q~C ~~\S~\-6i-- . 0. , Owner: ;Jytl'Ct.w1 Jltv\~'S. S~-\~-er Phone: Address: \. \ <:L COl-~'\ \?..1\,.. 5>t~r City: rl>r-\ ~"'S -<e\...Qs,. Architect/Engineer: ~CL*~1.. ~~\&-\~~ c::o~~ Phone: Contractor ~~V\.~-e("' CC5Y>...e:.~1.e-\-(Ji!ate License #:~. xp: /rP-s/ 0 S Address: \ \'1- eels-\- t'J-.~ ~,=e~ City: fl!>'f"\t\~J..e s- PROJECT ADDRESS: ~ \ ':L ec...p:>t ,~-\'" S\-~ Phone: I~GD -Lj <;7~G,q6-:L L.{ <; 1- - G LI C\ 0 Zip: qc ~ G?--. Phone: i 5')- 61 02..., Zip: Cl&'1:,b 0--. ZONING: LEGAl DESCRIPTION: Lot: CLAlLAM COUNTY PARCEL N1JJV!BER: Block: Subdivision: Credit Card Holder Name: Billing Address: It ~ ec.-.;r:- Credit CardType VISA TYPE OF WORK: ~ Residential a New Constr. 0 Re-mof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel s:. Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: l~t~~-t MC # City: (J~'t ~€~ Lco...s1., Exp. Date: SIZENALUATION: L14 [) SF. @ $ SF:-@ $ SF. @ $ /SF. = $ TOTAL VALUATION &.. 0.. "1-1-.x.. 0--0 %~~€--- COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: --L- Lot Size: 7 ODd Existing Sq. Ft.i ~5-Z & Proposed Sq. Ft. i..( t{ 0 = TOTAL Sq. Ft. il9Z Total lot coverage :~= ~4!'% 25' , k ~ APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER: PLANNING USE ONLY: ESAfW etland(s): 0 Yes 0 No SEP A Checldist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUB MITT AL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with cunent fee schedules. Contact the Pennit Coordinator at 41 7-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other pemIit fees are due at the time of pern1it issuance. EXPIRATION OF PL:AN REVIEW: IfrlO pemIit is issued within 180 days ofthe 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 107.4 of the Uniform Building Code, cunent edition). 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 thai it is my responsibility to determine what permits ~re required ,not the City'S; .and that J must obtain such permft~to work nFORMSIAJ'PSlBmldmgp=""'" Apphcmt ~~,tc } ,; ()<; I F-Ec--.icE: ~! . ~ti"'\ \\~..v ~~ '- ~~. ,0 q '~ . ~ .. ~ '7 ~_ ntt.I ~ ' 'tr- :\7 CZ:e1 ?: _ 'Iv .Ii 1\ ~ - . ~ . .JU ,,>( ('\ )s- \I ~ ~l)O "" 0-'> (J / .y',?\}1 > \ - - - --t ,.0 V l J.I \,J... E fJtv /'- f.~:;.- J- ~, E V~r... y N-f0~- SiR. I r\J G E... f<.oJ II 2. E::AS;- I 2.. TH ST ""iSE.. T <'- 6\ I ! '-. '../ --'-" /-~ _ (, L-J t -If.- ~ L I lL o EX\ S,\( I'JG- q.Jj\R.kl~')G- & UtlLlTY SPACE... _~t___. I I i.... bI\~jl..(; t. '2 (,.)(. '2'). i etMEr-,I" , (2.')( J.. L.-1 : L1 YOcP , I L ----- '1\ /-- l\ IV) l.l) ~- JfF"r X ;,2f-i'" W/'>LkwAY --r-'--'l-- ~~~. ! . !~ !"" '3 1 ~ , 1,--. !- ~ 1- ::t t\.x ::-. k- ~~i -Jk II " ,Ii '0- f>, vJIJ POKJCH \OH 7-- 2D f-T ;..0'> r:p '7FT <-> Y1 .-:? '.1 F - ----.-.----.---.------- ~._ Ov'fR HAt--l G- 2-' '1 [<:1 <-> -" !~ ,f-- IV. il"J I'V) ::< STO R. Y M-O USE "?'2..x 36"'?rf 1151:. , " i! I; 2 I <,:?VEn.HA ',e,... ---' .I 38 F-r t ~ ,r '~/ L^~HJ ---.-_._ __..___...____ .. u______._.~'P c W A L. S. . ~ ,,1.I~Fj f2~~ ST~e~T C~NT~~ v - --,--------.-------- '5'Hj,,: 1:.. [... A r-<..~f' FpOPc:>SEI 1- ' ./. J.:: tIE !~) Co t) S. ! R..- \.) CTl or- )' \t d 1. (') ~ Q. jJ U ? \!J LL 'i'~ORT~ ,,-l.O~~ G~~ "- -=..JI' ~ ~-;;'p CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDINGDNISION- 32] EAST 5TH STREET, PORT ANGELES, WA 98362 04-00000447 Date .609544 112 E 12TH ST . __ .116.",3.0.=..0.0. =..0.=.3=.8.03.0._..00 DO-- DEMOLITION 6/16/04 Application Number Pin number . . . . Property Address 1\$ 9E$SQR...l'ARC:a;r.,..,..NUMB-ER;.. Application description Subdivision Name Property Use Property Zoning . . . Application valuation RS7 RESDNTL SINGLE FAMILY o Owner Contractor STRINGER EDWARD/EVELYN PO BOX 1504 SEQUIM WA 98382 STRINGER CONSTRUCTION 64 COUGAR LANE PORT ANGELES WA 98362 (360) 457-6902 Structure Information Construction Type . . . . Occupancy Type . . . . . DEMO GARAGE TYPE V NON-RATED GARAGES, CARPORTS, SHEDS ---------------------------------------------------------------------------- permi t . . . . Additional desc Permit Fee Issue Date Expiration Date DEMOLITION 47.00 6/16/04 12/13/04 Plan Check Fee Valuation .00 o Qty Unit Charge Per Extension 47.00 BASE FEE ---------------------------------------------------------------------------- Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 47.00 47.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 51.50 51. 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 orwork is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Owner (if owner is builder) T:\PLANNING\FORMS\1102.15 [11114/2003] -==- ~ Y\ ~ rr, ~ '-- - ~ c4- S Date rf<.""T~ l~~ ~ 'IL~ ~ ~~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name property use property zoning . . . Application valuation 04-00000877 Date .901508 112 E 12TH ST 06_30_00-0-3-8030-0000- ELECTRICAL ONLY 9/29/04 RS7 RESDNTL SINGLE FAMILY o contractor Owner STRINGER EDWARD/EVELYN PO BOX 1504 SEQUIM WA 98382 JARMUTH ELECTRIC PO BOX 635 SEQUIM SEQUIM (360) 683-4104 WA 98382 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit Fee 48.10 plan Check Fee Issue Date 9/29/04 valuation Expiration Date 3/29/05 .00 o ,\t\ (j ~ r- ~ / tJ":, (" ~ ---..J ~ "'-. \) , --. (/) ~ N \J ,..., \\:l .......... '. - f'J * r ~ -------------- ------------- ------------ Qty unit Charge Per 1.00 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48.10 Charged Paid Credited Due Fee summary ---------- ---------- ---------- ---------- -------------- Permit Fee Total 48.10 48.10 .00 .00 plan Check Total .00 .00 .00 .00 Grand Total 48.10 48.10 .00 .00 Separate Permits are required for electrical work, SEP A, 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. Date Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) T:\PLANNING\FORMS\1102.15 [11114/20031 BIDLDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS r YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAJNAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # <0 K. 0/~j i!Ii1;7- ROUGH-IN I e:j' ~ ""C"_ F) (/ I PIt'. ~/~ D. i PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW I WATER AIR'SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR W ALLIHOLD DOWNS WALLS I ROOF / CEILING DRYWALL (INTERJOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL / FLOOR I CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET I ClliMNEY HOOD / DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED - YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 /0 - S'-C '1 7(,c ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W./ PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\1102.15 [1111412003] \: ~ORT ""V .....c...O~(I'(<" GRiii ~ ....~ ~ "ti,~'" CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number . . . . Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation 04-00000447 Date .609544 112 E 12TH ST 06-30-00-0-3-8030-0000- DEMOLITION 6/16/04 RS7 RESDNTL SINGLE FAMILY o Owner Contractor STRINGER EDWARD/EVELYN PO BOX 1504 SEQUIM WA 98382 STRINGER CONSTRUCTION 64 COUGAR LANE PORT ANGELES WA 98362 (360) 457-6902 Structure Information Construction Type . . . . Occupancy Type . . . . . DEMO GARAGE TYPE V NON-RATED GARAGES, CARPORTS, SHEDS 47.00 6/16/04 12/13/04 Plan Check Fee Valuation .00 o ..",.- 0 ~ ::s rr, ~ --- - rJ ~. s ---------------------------------------------------------------------------- Permit . . . . Additional desc Permit Fee Issue Date Expiration Date DEMOLITION BASE FEE Extension 47.00 Qty unit Charge Per ---------------------------------------------------------------------------- Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 47.00 47.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 51.50 51.50 .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 orwork is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction..:-- ~ ~---_. " Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1102.15 [11114/2003] BUILDING PERivIIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 LOCA TION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS "'" ..~ "" FOUNDATION: FOOTINGS WALLS FOUNDA TlON DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEP ARA TE PERMIT: # ROUGH-IN I PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW I WATER AIR SEAL WALLS CEILING I FRAMING JOISTS I GIRDERS SHEAR WALL/HOLD DOWNS WALLS I ROOF I CEILING DR YW ALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR I CEILING MECHANICAL REA T PUMP GAS LINE WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEP ARA TE PERMIT #'s: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. I PWI CONSTRUCTION - R.W. ENGlNEERJNG 417-4807 PW I ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 If}-IH-O;.J .\ ,1, BUILDING T:\PLANNING\FORMSIII02.15 [I 11I4/2003] to >-3 '" i';;:;;~8Ei n'tl Ie' .-< ~ H'" '" 'tl 'tl"'ZZO >-3t'l '" "- le'nt'l>-3'" .-<'tl U'J H t'l"''''t'l ;.. 0 0 >-3 ZIe' ;"U'J 0'" H !ii. nU'J 'tlt'l >-3 tJ 0 to 0 'tl t'l. ",. 0 n"'~ '" "'..., t~ Ot'l >-3"- 3:0 H 'tlGO OO{f)(1)1-' ~~ le't'lo tP-0'\1-3~f-' t'lU'J , , "''''tv G"l0 >-3""'0 OW H H t'lol> rool> t'lt'l~ OaZZtI1 Ie'- 00 0 , G"lG"l t'l - o otI:l tr1...... U'JH t"' OO:u:urv tv ~~ H ol> , >-3 '" >-3 ,l:>.Ott:!O::r: w t'lHH .....]ltlO '" U'JZO W~Z{J) GU'Jl2: t:l1~(J)t--3 ol> Ie''tl tIjCD:;d1-3 lJ1 >-3 3:otl:u OW.........c: C-+Otrj() H I <: t--3 .,OtI:lH 3: to "'0 HOt"iO HG t'lt'l OO.-<Z "H U'JU'J ZoZ t'lle' Gn , 0 Ie'''' Z >-3H U'J'tl n , G"l "->-3 0 nH H 3: 'tl 00 HZ 3: H 3:Z ZU'J t'l ol>Z 3: U'J'tl Z "';.. t'l 'tlt'l >-3 Ole' Z t'ln U'J , >-3 n>-3 '" U'J >-3H ~ lJ1 00 lJ1 "'Z 0 0 '-'>-3 Z ~~ 0 'tl'tlU'J ...., 88liJ t'l" t'l U'Jt'l U'J ZZO >-3 t'lt'lH Ie' < Ie' H t'l w '" '" Ie' 0 .-< ol> lJ1 ..., , '" '" 0 tv O'tl ;..;.. >-3G"l t'lt'l ..., "- H ol> "- a ol>lJ1 BUILDING PERMIT - APPLICATION FOR OFFICLi\L USE ONLY: Date Rec':<.5" - '}J-/ -Or} Pennit #: ,:) '-/..... '14 7 Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 Date Approved: Date Issued: Applicant or Agent: S t, 1~<S 0,\ L OlA.st {'tJ...C -t \ ~ Phone: / '6' 0 ~ ~I $ ') - b C( 0 ~ Owner:-h ~-h-\V\...~-a..r- Phone: 1~6 0 '-{S~~ 4 '10 Address:-Ll d- t: A~T j--;;\h City:--POC\ A~'\~-R-.\ ~ to If Zip: q 87.. b ?- Architect/Engineer: f/C(.1'1\~~ ( b Iu..J~'V"'J <;~') pi ":::> Phone: Contractor~t~V\.':1LI (()",~-\rl.<....oil ~ State License #:5rf,...,l"..1(' t-lftoE.Exp: IO) 1.5/ os. n t { , Address: (y'-( (cX\c"~"-!~ ~f.ote.. City: ,.....tJc A\t\~.ek~s.. PROJECT ADDRESS: I f'J- t=.+.st Il-tl.... ~'t (-\~c;;..Q\Q..s.. Phone: 'iSr6QCJ ')...._ Zip: qg'"-) (.,~ ZONING: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Block: Subdivision: Credit Card Holder Name: Billing Address: Credit CardType VISA TYPE OF WORK: o Residential ~ New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel ..8l.. Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: :L~ x:. ").. 0 City: MC # Exp. Date: o Stove ~ Garage o Deck o Other ('e. Mo\l'''"- SIZEN ALUATION: ~crO SF.@$ /SF.=$ SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ ettJ... Cf:,a...I1~ C;tl,0.. lp(,\,dJ.... <'{ I'\.t:?( < ') ~l\~€... COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: & Proposed Sq. Ft. Construction Type: Existing Sq. Ft. Total lot coverage = TOTAL Sq. Ft. No. of Stories: Lot Size: % AFPROV ALS: PLAN: BLDG: DPWU: FIRE: OTHER: PLANNING USE ONLY: ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BillLDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the tinle the building permit application and construction plans are submi.tted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: If 110 permi.t is issued within 180 days of the date of application, the application will expire. The Building Official can extend the tinle for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of the Unifonn Building Code, current edition). 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 '1};!~e 9tyl~that I must obtain such per~~ts prior to work. T\FORMSIAPPSIB,i1di,,,,rmi<.wpil APP1"ant'/~/W A?/JY.?-z."-,,= Dot" 5~ Y 0 f;jf ~ORTANGELES WAS H I N G TON, U. S. A. PUBLIC WORKS & UTILITIES DEPARTMENT June 4, 2004 ~ ~ ~ ~ ~ Mr. Stringer 112 East 12th Street Port Angeles, W A 98362 RE: Port Angeles Landfill Waste Disposal Application, WDA 04-12; Building demolition at 112 East 12th Street, Port Angeles, Washington We have received your application for disposal of building demolition debris from the referenced site and reviewed the testing results for lead content. Based on the testing results the debris appears to be acceptable for use in the landfill. A copy of your approved application is attached. This approved application must be shown to the landfill scale attendant at the time of disposal. Please be advised that this disposal application is only for the materials and quantities listed in the application. Materials not listed or in excess of the quantities noted may require separate applications and approval. Please call if you have questions. Very truly yours, ~~~ Gary W. Kenworthy, P.E. tJ City Engineer Deputy Director of Engineering Services GWK:tf Encl.: WDA 04.12 Copy: Ken Loghry Zenovic & Assoc. N :\PWKSIENGINEER\ WDAPPLIC\04-12. WPD FILE: Landfill Solid Waste Disposal Applications 321 EAST FIFTH STREET · P. O. BOX 1150 · PORT ANGELES, WA 98362-0217 PHON E: 360-417-4805 · FAX: 360-417-4542 · TTY: 360-417-4645 E-MAIL: publicworks@cityofpa.us p . . . I PORT ANGELES LANDFILL \V ASTE DISPOSAL APPLICA TION WPA- 01-/1- To: City of Port Angeles, City Engineer 321 E Fifth Street P.O. Box 1150 Port Angeles, Washington 98362 Phone: (360) 417-4803 FAX: (360) 417-4709 NOTE: All questions must be answered for waste to be approved. 1. Generator Information: Company Name: P.JJ i h)/~YflJ .Yr-u.,J6~ Mailing Address: f 1"2... h.. 12 ~ 5'-r. fJM., ~ Ai"6~^ S IA JA. q B '1. 1.. 2- I Contact: ~ c:>~ hUIi.Y,-v Phone: 4.<:'2-l:H 90 Project Name: /7A'fA 4.t &.......dU ~ -.> Project location: --1, "2.. ~. I Z~ S7 2. Other Contacts (if applicable): Consulting Firm: 7 fli;V.oVI ~ , Ac$:t:CJ joNC-. Contact: jt; Al:.'(' A' u1~4G Phone: If r-, "05"0 \ Contractor Name: (J~o&.U;v Contact: ....-...-. Phone: Laboratory: tJVLlA~"f~AJ<'~1 t.Ne- Contact: ffou-y ~-t'fi4 Phone: 2o~- 5tt1-O'O::> City of Port An[)clos . Landr,ll Wasto Oq)():;al Applicntion PilOll 1 . . t r-----__ _. ._-~ - ------ ---.- - -- ----- ----- 3. Source of Waste: Check the appropriate box below and briefiy describe the project, process, and/or cleanup that will or has produced the waste requiring disposal. Include the gasoline service station number (if applicable). CERCLNMTCA Remediation Agency Contact: Independent Remedial Action - UST Removal Unused Chemical Product Spill )(. Other Source: ~~<. k ctd <\ -tI..J4. (;~''''' ~ a< A.-cus~ % dII~ ~ fb.,.. ~ ~-uf6~ 4. Waste Material Composition: (check all that apply and Include percent of total) Soil % Foundry Slag _% Concrete! Asphalt % Dredge Sediments _% Preserved Wood % JL Debris ..../.i..:)a.. % . Coal Ash % Other (list) Wood Ash % _% - % NOTE: Total must equal 100%. 5. Waste Material Contaminants: (check all that apply) Gasoline Metals Heating Oil Used Motor Oil/Waste Oil Other Petroleum Product PCBs Diesel Solvents Unused Motor Oil Other ~ ~ 7"-S-(vJ6, K.. Unknown ---..----- NOTE: Supply any MSDS information with application, if aVllilnble City 01 rort AlIlWllls I i1ndlill Wasto Dispo~;ill Appllc;lllOIl PllUO . 2 , . . . - 6. Estimated Quantity of Waste for Disposal: ?-- <}" Cubic yards I Drums I ~D Tons (estimate both) Tons (eslimate both) Olher NOTE: Estimated quantity for disposal must be wilhin 20% of the quantity actually disposed. (10% for projects over 7,500 tons or 5,000 cubic yards.) 7. Frequency of Disposal: ;( One time Monthly Annual Other 8. Waste Sampling: Proper characterization of the waste for disposal requires the collection of representative samples. The methods and equipment necessary for obtaining representative samples of a waste, and the frequency of sampling, will vary with the type and form of the waste. Check the appropriate box and briefly describe how and where the waste was sampled. Include site maps with sampling locations If possible. Number of COMPOSITE samples l & number of discrete samples per composite ~ Number of DISCRETE samples to{ 041,QI1- ().},N\P8,. .(..c. S-~P<<tt ,.,I:- lJN;)".vf,r.) ~(.J-6;l f2)C ~.AA44.4A,....x;J I~ n. \'-"f'~~", 74.4__ &~Y ~,-) ~ I~ 5d,)J(<4'p ~y.1/..v' Lt.vt+l.,:) NOTE 1: Unless prior approval has been granted by Port Angeles, the following sampling frequency will be used: 0-25 25 - 1 00 101 - 500 501 - 1 000 1001 - 2000 >2000 cubic yards cubic yards cubic yards cubic yards cubic yards cubic yards = 1 composile sample 3 composite samples 5 composite samples 7 composite samples 10 composile samples 10 plus one sample for each additional 500 cubic yards = = = = = NOTE 2: One composile sample shall contain a minimum of three/maximum of five discreto samples. Cily 01 Por1 Angelos - Lanlllill Waste Disposal Applicallon PIIOO . 3 .... ----------------- 9. Waste Analysis: --- -.....- -...-------.. . The "Dangerous Waste Regulations" (WAC 173-303) shall be utilized to determine the appropriate analytical requirements for waste characterization. Ecology Publication #91-30 (Revised April 1994) MGuidance for Remediation of Petroleum Contaminated Soils" shall also be used to characterize petroleum contaminated soils from UST releases. Submit all laboratory analytical results, ONQC data, and Chain of Custody sheets along with this application. (NOTE: The laboratory must be accredited by the Washington State Department of Ecology.) a) List all analytical test methods used: fi/JA.700a/3 b) Provide a narrative as to why the above analytical methods were selected: l>v~ '1'0 ~ 46~ ?4.~r (),.(. ~-r-1A.X '1'v"t1.. '7 dS~ hV IS 7)k 6htl..4f ~ l,..v...~ s;.~tAt< . I NOTE: Additional sheets attached: X. YES NO 10. Soil Classification: (....FOR PETROLEUM CONTAMINATED SOILS ONL Y"*) Based on the analytical data and Ecology Publication #91-30, the soil classification is: (check one) Class 1 Class 2 Class 3 Calculated Hazard Index Class 4 11. Dangerous Waste Affidavit: Based on a review of the analytical test resulls, site history, and the applicable regulations, this waste is classified as: (check one) ~ Neither Dangerous Waste (OW) nor Extremely Haznrdous Waste (EHW) Dangerous Waste (OW) and Waste Code: ~' [xtrcmely Hazardous Waste (EHW) and Waste Code: City of Port An!Jt!l4's Landfill Wuslo Disposal AppIH<lIIOIl PUGO 4 . . . 12. Certification: We, THE UNDERSIGNED. certify that this application is true to the best of our knowledge. All information provided Is correct and the enclosed analytical results represent the proposed waste material to the best of our abilities. - ~~J wafd:Generator Signature ~ 't4cY' Q U{}&-4 Printed Name ~lk..kc... Lt4csac, :f.vc ....- Company t, -/~ - 0'-( Date :~':'~l~h . . ':'::~'. .. . . ... ..:.)t~lfl'I(li\~:r~~~I~jJI~[~~~I:.~~1fi.l:'ll NIJlOLlCY _P\1000_5W\1009_01.WPD City uf Port AIlUelos - Londrill Waste Disposal Applicnlion Pa()o 5 NVL Laboratories, Inc. & 4708 Aurora Ave. N., Seattle, WA 98103 AIH" Environmental LeM Tel: 206.547.0100, Fax: 206.634.1936 AIHA - IH .ndlndu~~IHv.~ www.nvllabs.com Analysis Report #101861. ACCREDITED LABORATORY Toxicity Characteristic Leaching Procedure - Lead (Pb) Client: Zenovic & Associates, Inc. Address: 519 South Peabody Street, Suite 22 Port Angeles, WA 98362 Attention: Mr. Tracy Gudgel Project Location: 112 E. 12th St., Port Angeles, WA LablD 24040981 Client Sample # 04179A Sampled by: Client Analyzed by: Holly Tuttle Reviewed by: Nick Ly Date Analyzed: 06/04/2004 Date Issued: 06/04/2004 mg/ L =Milligrams per liter ppm = parts per million Note: Method QC results are acceptable unless stated otherwise. Bench Run No: 24-0603-5 RL mgl L 0.5 Batch #: 2407409.01 Matrix: Bulk Method: EPA 7000B Client Project #:04179 Samples Received: 1 Total Samples Analyzed:1 Results in mg/L < 0.5 Results in ppm < 0.5 RL = Reporting Limit '<' = Below the reporting Limit Page 1 of 1 CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15371 (,/-?6 "\ Port Angeles, Washlngtonm.m../.....mm.:'m...mm....m__m_.mmmm, 19__::'__., In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, on, or about any building or other structure in the City of Port Angeles, per- mission is hereby granted to do electrical work as listed below. / j ,", , " : I I -" 'c- - I v I., Address _____.-__m____________'__m..______m______mm__.m.______________._.__.___________ Occupancy. ..___.__..~_~._____m______.m.__.__.... t.k-' Owner n_n~f.__~~:_:'::_'______n~l::_:_::;~.:___~~_n':ih__n__uh___.....----.nnn Tenant.n_n_nnhnnn_nnmuuu..uu.__nnnn__unnn.nnn_m__. . ' J . ~ " Wiring Contractor~.":::.::*:~:.'"c---!:.j,i::,-~,:L-----.-------- By.________"" .___".________._____.___.m._______m____m________. (' .', - f...r ':_''l.,,':)(/t~ Light Outlets_...nmmm._m__._.._____n.h... Service, volts _.......__._..._____.....00:......".... /." ., Receptacle Outlets....__mnm_c_.........__nn No. wires m.:nnmn;.:.mmm.nnnnm Dryer, K\Vi.nm____nS:m__.__m__. Size wiresmm__n..~n...mmm__..._m__. j- ,).\f f Range, KW ._."n_____._~_n__.__ Main fuse h_......:..n:.mm___m.nmmnn <C" Enclosure _mn...::~~mnnn..._'mmnn_ Water Heater: KW.n_____.-'_~_:___~______ ___._.___ Hea" RWhn.../nz,iS!:5.. Type of wiring: Entrance Cable mnnnnm___.mm.m_ Rigid Conduit nmmnnmnn....mnm Motors: size, volts and phase: _..L.(.~_!'~'_:-:.:nmm_n.n......n. - '"lj , 'f' l ) _!._.----:--.::------- ...............----...-.--_.-...... 1 Metallic Tubing nnmmn__.mn___nn Current transformers: No. & Size....._.............o........n__..._.n Total Loadn.m._._......_...._....... Ser. NO._......_____nnnnn...nn__._..nnnn__ Ser. NO..nn__.....'.._.......n.,;.-::................ . , Ser. 'NO.'"__m_m_....~n.n.:-!!__________m___ Ser. NO.......mm_.~n__._~mm___.nm_.n... - Type of Wiling: Armored Cable _ Non-Metallic mmm Knob & Tube Rigid CfJnduit . Metallic Tubing n Cil'C:::,e:=h~~~<;~~~..~_.~~~~~~~~~~~~~~_-~~~~~~~~~~ Utility ....<:?.............h......... /.> Heat ______n......_n______n______..._.____....... ;) Range _._____n______n____._..........__n________ :.ff. V.later lIeater ....n.......nm.nmnnm l\f otor .__n______._______n_.............._._______ Dryerum.:_:::;~m_.._..u...._m...n__mnmm Furnace ............_n_n__.____'__._n... Total ..3.<1.........n_........ . , Remarks: ..__n__nn_:_)..!.._~.:::;;."-~....:_:__..___nu~n__n<.._C__~_~~.~~__~:_..!:_::...:u__u.._n____n__hu___.h._.'+~-U.hn~u-.u.n__u...--.un.nnn_'::\.... .~ ' ~ ., :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::~::::::::::::::::i:::::::~::::::::::::::::::::::::~::::::n::::::::::::::::::::::::::::::::::::::::::::::: perm~' Fee Treas.Receipt _.;)/' C';/,l:,':" /, I.' . , 7/,-,;r . 11"'. /.1 $.__.___ .t.._~.!::'_..u_._._.____n.. No.__.__________.___________u By.____u_____.2__:____n__~_:L__CL=!_~L_~~:-;'-!'Q~:?.!_.~.."- . -) oil, ' NOTICE--Current must not be turned on until Certificate 'of Inspe~t1on has been issued. If work is to be con. cealed due notice must be given the Inspector 5-<?: .that work m6-Y~ be'>insp,ected before concealment. """'="- NOTIFY THE INSPECTOR BY PERMIT NUMBER,WHEN READY FOR INSPECTION , 1(!(Jt3lJ --,,' . f '_ -L._...'1.,.... '''"'''''So. _/"1 ,"'{ ',-.- ,.".:0 ELECTRICAL PERMIT N? 15371 11." ("? / ""'I 1;( Date called for insPectiOD.___n_..h__-::-:.....!._____n_____n______..___.___n____._..._......__n_______________._____..._..._. ._____.n__..___..h_._.______.____.n_____n___.....____.............. preliminarY~p~~e~tIhnd~~~--~---.:.::~~::..;~:...--....._.......__.-o.n---.----..-n-.-___.-.-..-.-......_......_m------.---------....___.._.__....________________m.____.....m.....__... I",.. .. ".; .(../.;' ..C -r:.."...-t"'...-.<t. - ~ '-- ...-..., Inspection completed~.._n___...nnn_...____........___...._...n_h nn_..__h__U .~. .. ... n_nnn___un. .n. ...........n_n.nn__...n....._...........hh..._h........_u....._ Total Load .__..__.........___..._____._______n__..___.............."'u__.u.___.u....n_.n..... ..n..___ 1M 3-72 Olympic Printers, Inc. 09/28/2004 07:30 ~ 360-681-7272 JARMUTH ELECTRIC PAGE 01 .............. ~~. .~.C'..' "'.7' I . " &_ =' M (, ~ ; "'I'."'''~.:': ,'T. "'('AT .....~..I...I.. cJlf - '671 ELECTRICAL PERMIT APPLICATION tIQ&~C.UII(HI.' -. .......; -- til "ntee.~p""'ft~IA.."""" --....-. . ,-lJ,.................. .,..h_."'. - ~._IOII.....If. - Pel _ (11II11'''1 o..nw 0/ I... C.,trl..... A;...t ~o-,;;-oI ~~Je~n , 1/')... E I- 5 -"~ h:-. ._... ~.;..: Jarmuth EleetTic ~:34g W washin~ton St PI_ "EQUIIT IN.P,C'T1ON Ia'" <j-:J..'1-dj 'eo: _: ~s;>, -(/190 Iue ..sfr,~I1~ I' Qly.JA JAlKUE1438BB u.. t: CIly. SequilD. WA lQI.E~~Co'l. COl'fTIUloCTOII 11/30/2004 -..: ZIp. ~83-4104 ZIp: 98382 INSTAl.LATlOI< YVlR!O IT: COWNe" C.-II c.td Holder N.",.' ON FILE ZIp: lIraA:-/llllC~ '''III"" A....... C#WIJf cw.- Numb-.. ClI)/: bp. ....: a ,-\:::. \ 0ft0.IKT ADM.'" SIIllIe As Property Owner Addu.. Above , nH: 0' _It: Ch8Ck IIIlIh8t apply: c:J fII.. 0 A1~dlllon ~lIIIdInlIaI I:) Mulll4amlty I:) Comrn-*I CJ Mabile H_ Sq. Fl Remote Mete' ~IICI ga~" CJ Hat Tub 0 SwIm ~ 0 "plIc Pump rj) --.J ---.J o Low Voila,,, 0 Tataoom. Cl Sign ., NUIIIIlor '" ~ IICIdecl or ._: DEBClUPTIOII 0' THI IL!C'l'ltiCAl. ~CT: j I re... A~e- n....,.g CI~4. rl J N'r....fk, '" <.!!!f...~~1- v:1J ~~~r'"~r- ~1.ctrtmI fit... '. -_.01 A~dltioM PI!ItMIT '11: .....IIl. ~~ D 0\.... n.c:t .... t:l T.".lIerwlce o Undll'll",ufld ..-- v......: _:0103 ~ SIN: ,,_lll1e: C: 8aoe1l108rd C Fum.~ CJ Heat I"ump Cl F.".WII1 _I<W _IIW _TON_LRA _I<W IlIet'eby c.1tIfy t/l~t 1 "ave re81/ Md '1I,,"I",,d ",it .""r/C-,*," Md /mow"'" ..,... fD be five and~, I/f\d 1 .m euthorlzad 10 'pply ror this perm/!. /und.rs11md 1/ is "01 the CIlyw ,.,. fNPOMIb/IIry lD delermlfIfJ wfI., Pfjlm/ls are required; It rtlma/rllt the appllcerrt, reeponltltJl/fty fD d.,.""/,,. IIf#lat pe1'IfIlts .,. required ."d fD oM.l" such. Crad" ea'" H.,.,.. ...__: Owft<< or !!eo. Coni. 1lgNtu..: C:IELeC'Tl'lICALPE~IIAITAPPLICATlON Date: 081.: , . ' , .. ~ IEllECTIRWCAl ~NSIPIECTI(Q)N 'WIRlING RlIEIPOIRT 417-4735 DATE PERMIT" q -:L'i-OL( flJ'(- - cg 7 OWNER/CONTRACTOR =r~ ADDRESS ~--JL I / 2. c::- , I 2 -tl", ::;yf' APPROVED NOT APPROVED D ................... DITCH ................... kr D .............. ROUGH IN/COVER. . .. . .. . . .. . . . . ~ D .................. SERVICE .................. D D .................... FINAL. . . . . . . . . . . . . . . . . . .. D CORRECTIONS NEEDED: (I--r~;J- ~ "UJ ~ QA,,7f- -gr-u.): <"J .j) r:: '-V{.lL ./)L, ~ I," A J!.'/'_~ ~-tb r;rd' -e~_e..L' ~L~' NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452.1381 Application Number . . . . . 23-00000299 Date 3/28/23 Application pin number . . . 923488 Property Address . . . . . . 112 E 12TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-3-8030-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc DHP ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ WILLIAM J ZUZICH EXTRA MILE TECH & ELECT., LLC 1006 E 6TH ST 418 N. RACE ST. PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 457-5222 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit Fee . . . . 63.00 Plan Check Fee . . .00 Issue Date . . . . 3/28/23 Valuation . . . . 0 Expiration Date . . 9/24/23 Qty Unit Charge Per Extension 1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 63.00 63.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 63.00 63.00 .00 .00 1 - 2 SINGLE-FAMILY ELECTRICAL PERMIT APPLICATION Pub! ic \Yorks and ULili ties Department 32 l E. 5th Street. Port ;\ngeles. WJ\ 98362 300.417.47]5 ! www.cilyofjJa us I electricalpcnnitsr21/cityofpa.us Project Address:-------------------------------------- Project Description:--------------------------------------□Single-Family Residential D Duplex/ ARU Building Square footage: _______________ _ OWNER JNFORMATtON Name: ________________________ Email: ______________ _ Mailing Address: ________________________ Phone: ___________ _ ELECTRfCAL CONTRACTOR fNFORMATION Name: ___________________________ License: ___________ _ Mailing Address: ________________________ Expiration Date: ________ _ Email: Phone: ___________ _ PROJECT DETAILS Item Unit Charge Qy51ntit3£ :To1s.l (Quantity x Unit Charge) Service/Feeder 200 Amp. $120.00 $ Service/Feeder 201-400 Amp. $146.00 $ Service/Feeder 401-600 Amp. $205.00 $ Service/Feeder 601-1000 Amp. $262.00 $ Service/Feeder over 1000 Amp. $373.00 $ Branch Circuit W/ Service Feeder $5.00 $ Branch Circuit W/O Service Feeder $63.00 $ Each Additional Branch Circuit $5.00 $ Branch Circuits 1-4 $75.00 $ Temp. Service/Feeder 200 Amp. $93.00 $ Temp. Service/Feeder 201-400 Amp. $110.00 $ Temp. Service/Feeder 401-600 Amp. $149.00 $ Temp. Service/Feeder 601-1000 Amp. $168.00 $ Portal to Portal Hourly $96.00 $ Signal CircuiULimited Energy - 1 &2 DU. $64.00 $ Manufactured Home Connection $120.00 $ Ren ewable Elec. Energy: 5KVA System or less $102.00 $ Thermostat (Note: $5 for each additional) $56.00 $ First 1300 Sql;Jare Feet $120.00 $ Each Additional 500 square feet" $40.00 $ Each Outbuilding / Detached Garage $74.00 $ Each Swimming Pool/ Hot Tub $110.00 $ 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- 468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us] '"'CJ CD PREPARED 3/27/23,11:02:07 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:23-00000299 112 E 12TH ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER RESIDENTIAL 63.00 TOTAL DUE 63.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS Wall insulation NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 3/31/2023 23-299 TAP OWNER CONTRACTOR Extra Mile Electric PROJECT ADDRESS 112 E 12th St