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HomeMy WebLinkAbout1021 Dunker DriveAddress: 1021 Dunker Drive PREPARED 9/24/14, 9:39:50 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 9/24/14 ------------------------------------------------------------------------------------------------ ADDRESS . : 1021 DUNKER DR SUBDIV: CONTRACTOR ACE MICHAELS INC PHONE (360) 460-6172 OWNER ACE MICHAELS INC. PHONE (360) 460-6172 PARCEL 06-30-01-8-3-0130-0000- APPL NUMBER: 14-00000517 RES NEW SFR ------------------------------------------------------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAT. REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------ BL1 01 6/09/14 PB ----------------------- BLDG FOUNDATION FOOTING 6/09/14 AP June 9, 2014 9:11:37 AM pbarthol. Mike 460-6172 June 9, 2014 4:57:03 PM pbarthol. 13L2 01 6/12/14 JLL BLDG FOUNDATION STEM WALL 6/12/14 AP June 12, 2014 8:37:12 AM pbarthol. Mike 461-6172 June 12, 2014 4:17:32 PM jlierly. BFF 01 6/19/14 JLL BLDG FLOOR FRAMING 6/19/14 AP June 19, 2014 9:36:22 AM pbarthol. Mike 460-6172 June 19, 2014 4:06:30 PM jlierly. BL9 01 7/07/14 JLL BLDG SHEARWALL 7/07/14 AP July 7, 2014 9:09:41 AM pbarthol. Mike 460-6172 July 7, 2014 3:41:17 PM jlierly. BAIR O1 7/22/14 JLL BLDG AIR SEAL 7/22/14 AP * OVERRIDE TAKEN BY PBARTHOL DATE: 07/22/14 TIME: 08:38:30 July 22, 2014 8:41:09 AM pbarthol. Mike 461-6172 July 22, 2014 4:30:44 PM jlierly. BL3 01 7/22/14 JLL BLDG FRAMING 7/22/14 AP * OVERRIDE TAKEN BY PBARTHOL DATE: 07/22/14 TIME: 08:38:08 July 22, 2014 8:40:39 AM pbarthol. Mike 460-6172 July 22, 2014 4:30:44 PM jlierly. BLDR 01 7/31/14 JLL BLDG DRYWALL IBWP 7/31/14 AP * OVERRIDE TAKEN BY PBARTHOL DATE: 07/31/14 TIME: 08:48:49 July 31, 2014 8:51:29 AM pbarthol. Mike 460-6172 July 31, 2014 4:25:08 PM jlierly. PW99 01 9/12/14 RV PUBLIC WORKS FINAL 9/15/14 AP September 15, 2014 3:22:28 PM rvess. September 15, 2014 3:22:48 PM rvess. BL99 01 9/24/14 BLDG FINAL –�q September 24, 2014 8:26:03 AM pbarthol. Mike 460-6172 PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------ — ME99 01 ----------------------------------- 9/24/14J ---------------------------------------------------- MECHANICAL FINAL September 24, 2014 8:26:19 AM pbarthol. Mike 460-6172 --------------------------- PERMIT: - PL 00 PLUMBING PERMIT ----------------------------------------------------------- REQUESTED INSP DESCRIPTION TYP/SQ ------------------------------------------------------------------------------------------------ COMPLETED RESULT RESULTS/COMMENTS ----------------------------------- CONTINUED ONTO NEXT PAGE----------------------------------- PREPARED 9/24/14, 9:39:50 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 9/24/14 ------------------------------------------------------------------------------------------------ ADDRESS . : 1021 DUNKER DR SUBDIV: CONTRACTOR ACE MICHAELS INC PHONE (360) 460-6172 OWNER ACE MICHAELS INC. PHONE (360) 460-6172 PARCEL 06-30-01-8-3-0130-0000- APPL NUMBER: 14-00000517 RES NEW SFR ------------------------------------------------------------------------------------------------ REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL2 01 7/11/14 JLL PLUMBING ROUGH -IN 7/11/14 AP July 10, 2014 9:30:37 AM pbarthol. Mike 460-6172 July 11, 2014 4:00:11 PM jlierly. PL6 01 8/05/14 JLL PLUMBING WATER SUPPLY 8/05/14 AP * OVERRIDE TAKEN BY PBARTHOL DATE: 08/05/14 TIME: 13:45:38 August 5, 2014 1:48:16 PM pbarthol. Mike 460-6172 August 5, 2014 4:02:08 PM jlierly. PL99 01 9/24/14 JLL PLUMBING FINAL September 24, 2014 8:26:31 AM pbarthol. Mike 460-6172 -------------------------------------- COMMENTS AND NOTES-------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION S 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 14-00000517 Date 6/05/14 Application pin number . . . 563878 Property Address . . . . . . 1021 DUNKER DR ASSESSOR PARCEL NUMBER: 06 -30 -01 -8 -3 -0130 -0000 - Application type description RES NEW SFR Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY Application valuation . . . . 136410 ---------------------------------------------------------------------------- Application desc new home w/ attached garage ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ACE MICHAELS INC. ACE MICHAELS INC 1329 W 10TH ST 1329 W. 10TH ST. PORT ANGELES WA 98363 PORT ANGELES WA 98363 (360) 460-6172 (360) 460-6172 --- Structure Information 000 000 SFR ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT -RESIDENTIAL Additional desc NEW 1458SF SFR Permit Fee . . . . 1227.45 Plan Check Fee 797,84 Issue Date . . . . 6/05/14 Valuation . . . . 136410 Expiration Date 12/02/14 Qty Unit Charge Per Extension BASE FEE 1020.25 37.00 5.6000 THOU BL7100,001-500K (5.60 PER K) 207.20 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . NEW SFR Permit Fee . . . . 50.00 Plan Check Fee .00 Issue Date . . . . 6/05/14 Valuation . . . . 0 Expiration Date 12/02/14 Qty Unit Charge Per Extension BASE FEE 50.00 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . NEW SFR Permit Fee . . . . 50.00 Plan Check Fee .00 Issue Date 6/05/14 Valuation . . . . 0 Expiration Date 12/02/14 Qty Unit.Charge Per Extension SASE FEE 50.00 ----------------------------------------------------- Special Notes and Comments May 14, 2014 9:51:23 AM rbecker. Are you installing a fire or lawn sprinkler system. If you are you will need to install a backflow assembly. Call Ron Becker at 360-417-4886, fax:360-452-4972, or REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisio6s of any state or local law regulating construction or the performance of construction. i Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building Division/Building Permit 1, QS Y_ v Q-1 a t BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS — Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Construction - R.W. PW / Engineering 417-4831 Footings Stemwall Foundation Drainage / Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: FINAL Date Accepted b 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: FINAL Date Accepted b Heat Pum / Furnace / FAU / Ducts Rough -in Gas Line Wood Stove / Pellet / Chimney Commercial Hood / Ducts MANUFACTURED HOMES: Footing / Slab Blocking & Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: ESA: SHORELINE: Parkin / Lighting Landscaping FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417-4735 Construction - R.W. PW / Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit CITY OF PORT ANGELES S DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 14-00000517 Date 6/05/14 Application pin number . . . 563878 ---------------------------------------------------------------------------- Special Notes and Comments e-mail:rbecker@cityofpa.us 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. A full acceptance test will be required for the fire sprinkler system. Call for cover inspection for all sprinkler installations. All homes in new subdivisions that are outside of the Fire Department four -minute response area shall be equipped with residential fire sprinkler systems that comply with the International Fire Code (IFC) and National Fire Protection Association (NFPA). May 19, 2014 11:03:37 AM sroberds. The proposal will result in a new sfr in the RS -9 for total lot cov of 20W. No land use.issues anticipated. Electrical load calculations and electrical permits are required. 1. Establishing Construction Access. 2. Install sediment controls BMPs. 3. Stabilize exposed soils. 4. Protect slopes from erosion. 5. Protect drain inlets. 6. Control pollutants including but not limited to spills, concrete wash out, exposed aggregate processes, concrete grinding and saw cut waste water. 7. Maintain temporary and permanent erosion control BMPS during project. Consider applying for the City Green Infrastructure Rebate of up to $750.00 towards the materials to install rain garden to control roof and driveway runoff. Also rebates available for downspout disconnections.Contact Jonathan Boehme at 360 417-4811 Trench safety per applicable laws. Temp erosion control and surface restoration responsibility of applicant. Contact City inspector prior to start of work @ 360 417-4831. No attachment to sanitary sewer of stormwater roof leaders, foundation drains, yard drains, or any other CSO contribution is allowed. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Public Works Inspection request line 417-4831. Use existing driveway access to property. ---------------------------------------------------------------------------- Other Fees . . . . . . CITY DRA % 47.32 DRA FEES PLUS INTEREST 1320.25 RES UNDERGRND SERVICE FEE 770.00 SEWER SYSTEM DELV CHARGE 2260.00 STATE SURCHARGE 4.50 PW WATER SYSTEM USE FEE 2260.00 REPORT SALES TAX on your state excise tax fonn to the City of Port Angeles (Location Code 0502) Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD — PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Electrical 417-4735 Footings Stemwall Foundation Drainage / Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: FINAL Date Accepted b 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: FINAL Date Accepted b Heat Pum / Furnace / FAU / Ducts Rough -In Gas Line Wood Stove / Pellet / Chimney Commercial Hood / Ducts MANUFACTURED HOMES: Footing / Slab Blocking & Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: ESA: SHORELINE: Parkin / Lighting Landscaping FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417-4735 Construction - R.W. PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit co� CITY OF PORT ANGELES r��'`� DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION `� 321 EAST 5TH STREET, PORT ANGELES, WA 98362 REPORT SALES TAX on your state excise tax form to the City of Pat Angeles (Location Code 0502) Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building Division/Building Permit Page 3 Application Number . . . . . 14-00000517 Date 6/05/14 Application ---------------------------------------------------------------------------- pin number . . . 563878 Fee summary ----------------- Charged ---------- Paid ---------- Credited Due Permit Fee Total 1327.45 1327.45 ---------- .00 ---------- .00 Plan Check Total 797.84 797.84 .00 .00 Other Fee Total 6662.07 6662.07 .00 .00 Grand Total 8787.36 8787.36 .00 .00 REPORT SALES TAX on your state excise tax form to the City of Pat Angeles (Location Code 0502) Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS — Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Electrical 417-4735 Footings Stemwall Foundation Drainage / Downspouts Piers Post Holes (Pole Bldgs) PLUMBING: FINAL Date Accepted b 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: FINAL Date Accepted b Heat Pump / Furnace / FAU / Ducts Rough -In Gas Line Wood Stove / Pellet / Chimney Commercial Hood / Ducts MANUFACTURED HOMES: Footing / Slab Blocking & Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: ESA: SHORELINE: Parking / Li htin Landscaping FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417-4735 Construction - R.W. PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit CITY OF PORT ANGELES PUBLIC WORKS & UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 14-00000517 Date 6/05/14 Application pin number . . . 563878 Property Address . . . . . . 1021 DUNKER DR ASSESSOR PARCEL NUMBER: 06 -30 -01 -8 -3 -0130 -0000 - Application type description RES NEW SFR Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY Application valuation . . . . 136410 ---------------------------------------------------------------------------- Application desc new home w/ attached garage Owner Contractor ------------------------ ------------------------ ACE MICHAELS INC. ACE MICHAELS INC 1329 W 10TH ST 1329 W. 10TH ST. PORT ANGELES WA 98363 PORT ANGELES WA 98363 (360) 460-6172 (360) 460-6172 --- Structure Information 000 000 SFR Permit . . . . . . SANITARY SEWER HOOK UP Additional desc . . Permit Fee . . . . 150.00 Plan Check Fee .00 Issue Date . . . . 6/05/14 Valuation . . . . 136410 Expiration Date . . 12/02/14 Qty Unit Charge Per Extension 1.00 150.0000 EA SAN SEWER HOOKUP 150.00 Special Notes and Comments May 14, 2014 9:51:23 AM rbecker. Are you installing a fire or lawn sprinkler system. If you are you will need to install a backflow assembly. Call Ron Becker at 360-417-4886, fax:360-452-4972, or e-mail:rbecker@cityofpa.us 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. A full acceptance test will be required for the fire sprinkler system. Call for cover inspection for all sprinkler installations. All homes in new subdivisions that are outside of the Fire Department four -minute response area shall be equipped with residential fire sprinkler systems that comply with the International Fire Code (IFC) and National Fire Protection Association (NFPA). May 19, 2014 11:03:37 AM sroberds. The proposal will result in a new sfr in the RS -9 for total lot cov of 20t. No land use issues anticipated. Electrical load calculations and electrical permits are required. 1. Establishing Construction Access. 2. Install sediment controls BMPs. REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work 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. Signat re of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:Forms/Building Division/Public Works Permit PERMIT INSPECTION RECORD r - Ak 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 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. / PW/ ENGINEERING 417.4807 CONSTRUCTION - R.W. PW / ENGINEERING FIRE 417.4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 4'17- 4815 BUILDING T:Fortns/Building Division/Public Works Permit CITY OF PORT ANGELES PUBLIC WORKS & UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 14-00000517 Date 6/05/14 Application pin number . . . 563878 ---------------------------------------------------------------------------- Special Notes and Comments 3. Stabilize exposed soils. 4. Protect slopes from erosion. 5. Protect drain inlets. 6. Control pollutants including but not limited to spills, concrete wash out, exposed aggregate processes, concrete grinding and saw cut waste water. 7. Maintain temporary and permanent erosion control BMPS during project. Consider applying for the City Green Infrastructure Rebate of up to $750.00 towards the materials to install rain garden to control roof and driveway runoff. Also rebates available for downspout disconnections.Contact Jonathan Boehme at 360 417-4811 Trench safety per applicable laws. Temp erosion control and surface restoration responsibility of applicant. Contact City inspector prior to start of work @ 360 417-4831. No attachment to sanitary sewer of stormwater roof leaders, foundation drains, yard drains, or any other CSO contribution is allowed. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Public Works Inspection request line 417-4831. Use existing driveway access to property. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . CITY DRA % 47.32 DRA FEES PLUS INTEREST 1320.25 RES UNDERGRND SERVICE FEE 770.00 SEWER SYSTEM DELV CHARGE 2260.00 STATE SURCHARGE 4.50 PW WATER SYSTEM USE FEE 2260.00 ---------------------------------------------------------------------------- Fee summary ----------------- Charged ---------- Paid Credited ------------------------------ Due Permit Fee Total 150.00 150.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 6662.07 6662.07 .00 .00 Grand Total 6812.07 6812.07 .00 .00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work 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:Forms/Building Division/Public Works Permit PERMIT INSPECTION RECORD 0 CALL 4174831 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 INA CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. / PW/ ENGINEERING 4174807 CONSTRUCTION - R.W. PW / ENGINEERING FIRE 41711653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417- 4815 BUILDING T:Forms/Building Division/Public Works Permit THE ALMES CITY OF V1! A S H I N G—T O N, U. S. i r 321 E Sth Street Port Angeles, WA 9836 P: 360-417-4817 F: 360-417-4711 Email: permitsCDcityofpa.us BUILDING PERMIT, For City Use Permit# Date Received: Date Approved CATION Project Address: /0 \3 A KZI- b'' v � Contact: WIN4,,tI L Phone: �/ p 1�aPrima Email: A) AC C 1A e L 5 X (J t60viA Property Property Owner Name ^ � f S ��• hone Phone— Mailing Address i Email City^ State Zip Contractor Information Name Phone Address Email city State Zip Contractors License# Exp. Date: Legal Descriptio4• fir " /3 Zoning: XS -'7 :,:.. Tax Parcel # 3 64el;a m l 6 3,0 A1W Project Value: (materials and labor) $ Permit Classification (check appropriate) Residential Ef Commercial ❑ Industrial ❑ Public ❑ Demolition ❑ Fire ❑ Repair ❑ Reroof (tear off/lay over) ❑ For the following, fill out both pages of permit application: New Construction 19 Exterior Remodel ❑ Addition ❑ Tenant Improvement ❑ Mechanical 11Plumbing 11Other 11Fire Sprinkler System? Yes 0 No 0 Irrigation System? Yes 0 No a Proposed Bathrooms Proposed Bedrooms Project Description wlk W; Is project in a Flood Zone: Yes ® NoW Flood Zone Type: If in a Flood Zone, what is the value of the structure before proposed improvement? $ I have read and completed the application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required and to obtain permits prior to work. I understand that plan review fees are not refundable after review has occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is issued. I understand that if the permit is not picked up/issued within 18o days of submittal, the application will be considered abandoned and the fees will be forfeited. Date 57 -op - i Print Name t - v- Signature Residential Structures Area Description (SQ FT) Existing Proposed $$ value For Office Use Basement First Floor �g a Second Floor Covered Deck/Porch/Entry Deck (over 30" or nd floor) a /� t� Garage 04 � a o00 Carport Other (describe) Area Totals -F Commercial Structures Area Descriptions (SQ FT) Existing Proposed ss Value For Office Use Existing Structure (s) Proposed Addition Tenant Improvement? Other work (describe) Site Area Totals Lot/Site Coverage Calculations Lot Size (sq ft) g3L-o Lot Coverage (sq ft) 8'?a %Lot Coverage (Total lot coverage _ lot size) Site Coverage (Sq Ft of all impervious) % of Site Coverage otal site coverage = lot size) a� Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Non-Haz Piping Outlets: Appliance Exhaust Fan # Heater (Suspended, Floor, Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance repair/alteration # Evaporative Cooler (attached, not portable) # Pellet Stove/Wood-burning/Gas Fireplace/Gas Stove/Gas Cook Stove/Misc. # Fuel Gas Piping # of Outlets: Ventilation Fan, single duct # Furnace/Heat Pump/ Forced Air Unit Size: # Ventilation System # Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # -L Fuel gas piping # of Outlets: Water Heater # l Medical gas piping # of Outlets: Water Line # Plumbing Vent piping # Sewer Line # , Industrial waste pretreatment interceptor Grease Trap) Size Other (describe): T:\BUILDING\APPLICATION FORMS\Current BP Application\Huuaing Permit 4-iL7-is.aocx wzy 2 �0 �)o�Ka,57- -75 i3 k e - k? c 3( � 3y0 Way Goo P1 c �e c #€ l+ 11002 l 2402 70, k �4 F 1003 1014 09 1015 ri j 3 IUUIL a 1020 rt �5. 1015 "`�•' — ., aiA •' 1006 1007