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Home My WebLink About2116 W. 12th Street Address: 2116 12 Ih Street PREPARED 7/30/15, 10:05:19 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 7/30/15 ------------------------------------------------------------------------------------------------ ADDRESS . : 2116 W 12TH ST SUBDIV: CONTRACTOR EMERALD ROOFING INC PHONE (360) 452-4681 OWNER CARLSON JUDITH A PHONE PARCEL 06-30-01-5-7-0300-0000- APPL NUMBER: 15-00000955 RE-ROOF ------------------------------------------------------------------------------------------------ PERMIT: BNOP 00 BUILDING PERMIT - NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BL99 01 7/30/15 JkL . BLDG FINAL July 30, 2015 10:09:01 AM jlierly. --------------------- --------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT-BUILDING DIVISION 321 EAST 5 TH STREET, PORT ANGELES,WA 98362 Application Number . . . . . 15-00000955 Date 7/30/15 Application pin number . . . 614565 Property Address . . . . . . 2116 W 12TH ST ASSESSOR PARCEL NUMBER: 06-30-01-5-7-0300-0000- REPORT SALES TAX Application type description RE-ROOF Subdivision Name . . . . . . on your state excise tax form Property Use , . . . . . . . to the City of Port Angeles Property Zoning . . . . . . . RS9 RESDNTL SINGLE FAMILY Application valuation . . . . 6842 (Location Code 0502) ---------------------------------------------------------------------------- Application desc tear off/install comp ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CARLSON JUDITH A EMERALD ROOFING INC 2116 W 12TH ST P. 0. BOX 879 PORT ANGELES WA 983635009 PORT ANGELES WA 98362 (360) 452-4681 ----------------------------------7%------------------------------------------ Permit . . . . . . BUILDING PERMIT - NO PR FEE Additional desc TEAR OFF�/INSTALL COMP Permit Fee 165.75 Plan Check Fee .00 Issue Date 7/30/15 Valuation . . . . 6842 Expiration Date 1/26/16. Qty Unit Charge Per Extension BASE FEE 95.75 5.00 14.0000 THOU BL-2001-25K (14 PER K) 70.00 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 ---------------------------------------------------------------------------- Fee summary charged Paid . .Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 165.75 165.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 170.25 170.25. .00 .00 )Ilk 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 I t' ction or the performance of construction. Date Print Name Signature of Contractor or AZorized 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: Footings Sternwall 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 f Ceiling Drywall(Interior Braced Panel Only) T-Bar INSULATION: Slab Wall I 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: Tandscaping ISHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY1 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 THE For City Use CIT�y 0 -ORT GELES P AN__ -71 Permit# -.9T� WASH INGTON, U . S. Date Received: 3 e) � 321 E 5th Street Date Approved Port Angeles,WA 9836 P:360-417-4817 F:360-417-4711 Email:permits0ci1yofga.us BUILDING PERMIT APPLICATION I Project Address: Q I BT Phone: 6-0-qzl-� PrimaryContact: --�Iuts Email: Name (�k Phone 7 OA) Property Mailing Address�ZHL, TT( Email Owner City V'A State zip Name Phone EIP169-AT-D ��F 6�i t,06 Contractor Address f, P, &A 0 T? Email Information city PA State L41/4- `P cM�2 1 Contractor License# Exp.Date: Legal Description: Zoning: Tax Parcel# Project Value: (materials and labor) $ (06L(�z Residential Commercial Industrial Public 1:1 Permit Demolition Fire 11 Repair 11 Reroof(tear off/lay over) Classification For the following, fill out both pages of permit application: (check New Construction 1:1 Exterior Remodel 0 Addition El Tenant improvement 0 appropriate) Mechanical 11 Plumbing 11 Other El Fire Sprinkler System Proposed Irrigation System Proposed or oposed Bathrooms � Proposed Bedrooms or Existing? Yes E3 No 0 1 Existing? Yes 0 No 0 7 In addition to standard hard copy submittals please send a PDF copy of all Stormwater plans and Engineering to www.stormwaterocityofpa.us Project Description CCMP P6::7PXF C62mp Is project in a Flood Zone: Yes 0 NoO 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 Print Name Si ature I Residential Structures Existing Proposed Construction For Office Use Area Descriptions(SQ FT) Floor area Floor area $Value new area Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or 2"d floor) Garage Carport Other(describe) Area Totals Commercial Structures Area Descriptions(SQ FT) Existing Proposed Construction For Office Use Floor area Floor area $Value new area Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) Site Area Totals Lot/Site Coverage Calculations Lot Size(sq ft) Lot Coverage(sq ft)foot print of %Lot Coverage(Total lot cov lot size) Max Bldg Height I all structures sq ft Site Coverage(Sq Ft of all impervious) %of Site Coverage(total site cov�lot size) 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 # Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove/Gas Cook Stove/Misc. Fuel Gas Piping #of Outlets: Ventilation Fan,single duct # Furnace/Heat Pump/ Size: Ventilation System # Forced Air Unit I Plumbing Fixtures Indicate how many of each type of fixtu e to be installed or relocated Plumbing Traps # Water Heater # Plumbing Vent piping # Medical gas piping #of Outlets: Water Line # Fuel gas piping #of Outlets: Sewer Line # Industrial waste pretreatment interceptor(Grease Trap) Size Other(describe): T:\BUILDING\APPLICATION FORMS\Current BP Application\Building Permit 4-17-13.docx