HomeMy WebLinkAbout1216 Columbia St - Building CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT ISSUED: 12/03/2001 PERMIT NO: 13124
OWNER/APPLICANT PROPERTY LOCATION
1216 COLUMBIA
BEULAH WILKENS
1216 COLUMBIA Lot: 5
Port Angeles, WA 98362 Block: 6 [] Long Legal
360/457-6413 Subdivision: PSCC
T: S: Parcel No: 063000520620000
CONTRACTOR ARCHITECT
AFFORDABLE SERVICES N/A
258663 HWY 101 W
SEQUIM, WA 00009-8382 , 98360-0000
360/452-5264 360/000-0000
PROJECT INFO
Project Value: $3,565.00 SFD Units: 0 Commercial: 0
Project Type: RE-ROOF SFD SQ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use:
PROJECT NOTES
TEAR Off/FELT/3 TAB
FEES ASSESSMENT
Building Permit: $97.25 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $101.75
Plumbing: $0.00 AMOUNT PAID: $101.75
Mechanical: $0.00 BALANCE DUE: $0.00
Radon: $0.00
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 laat
inspection. I hereby certify that t 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 wilt 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~J(~ntractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
fOR OFFICIAL USE ONLY:
BUILDING/FIRE PERMIT APPLICATION
The Building/Fire Pcr~it ~pplicarton m~st b~ fi~d out completely,
Plea*e Wpe or p~nt tn In~ If you have any qucffions, pl~e ~all (~60) 417-4815
F~ number: (360)
LEGAL D~SC~TION: ~t: ~ Block: ~ Subdivisiom~
CLALLAM CO~TY P~CEL~ER: ~ ¢ ~ ~ ~
T~PE OF WORK.:
o Resideadal u Multi-family n Commercial ~'R~oof ~:LP-g~,,
VALUATION (Co~t of project mlnu~ s~es ta~) S~
BUILDING PERMIT APPLICATION SUBMITTAL: Your mmpla~ ~li~m, aiteplm (tbr additiona) mtd bml~g mn~m~oa
pi~s ~e to be ~ubmitt~ lo the Build~g Di~sion.
V ~UA~ON OF CO~U~ION: h · ~, a ~u~ mo~t must ~ ~t~ ~ ~e applies, ~i8 fi~o ~11 be r~
=d may ~ r~s~ ~ ~c B~l~g Div, lo ~mply ~ c~t ~ s~<~, C~ct ~c F~t Coor~m~ at 417-4815 tbr ~i~
~I~TION OF PLAN ~VI[W: if no p~mit is i~u~ ~ i~ d~yf of~e date of ~plicatioa, ~is application wll e~ire
by [imtati~x %~ ~8 ~dd ~ ~d ~ time Br ~ion ~ the ~plic~t up to 180 days, aa ~a~ r~u~t by ~c ~li~t
(~ S<~on 107.4 of~e Uuifom ~il~ng Code. c~t Mi~oa), No ~lication ~ be ~t~d~ more lh~ once.
/ hereby cert~, that ] have read and &tamined tht~' application and/mo w the .fame to be trl~e and correcl, and I am autfiori~d to apply
for th~ ~'l. l unde~tand ff is not the CiO,'$ legal r~po~t'bf[l~ Io detern,);~ ~&at permit~ are ~qtti~d; ;t remains the applicant ~
res~m;sibt'liO',to determine ~at permit~ are required and to obtain such.
eW.:~o: ~l~,'~t.00l Cr~ilC~dHold~'sSi~a~e: __ . Date: [~[