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Home My WebLink About520 Georgiana Street Address: 520 Georgiana Street PREPARED 12/18/14, 16:30:47 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 12/18/14 ------------------------------------------------------------------------------------------------ ADDRESS . : 520 GEORGIANA ST SUBDIV; CONTRACTOR : PHONE OWNER DANIEL M BLOOD PHONE PARCEL 06-30-00-5-1-4120-0000- APPI, NUMBER: 14-00000413 RES ADDITION ------------------------------------------------------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BL3 01 12/18/14 JLt� BLDG FRAMING December 18, 2014 9:39:53 AM pbarthol. Danj 683-5007 Cal Ahead so he can meet you there EL99 01 12/18/14 JLL /7 BLDG FINAL December 18, 2014 9:40:22 AM pbarthol. Dan 683-5007 --------------------- --------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION C01 ) 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 14-00000413 Date 4/24/14 Application pin number . . . 302034 Property Address . . . . . . 520 GEORGIANA ST ASSESSOR PARCEL NUMBER: 06-30-00-5-1-4120-0000- REPORT SALES TAX Application type description RES ADDITION Subdivision Name . . . . . . on your state excise tax form Property Use . . . . . . . . to the City of Port Angeles Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 6384 (Location Code 0502) ---------------------------------------------------------------------------- - Application desc Add new deck ---------------------------------------------------------------------------- Owner Contractor ------ - ----- ----- DANIEL M BLOOD OWNER 1137 W 5TH STREET PORT ANGELES PORT ANGELES WA 98363 Other struct info . . . . . HARD SURFACE AREA --------------------------------------7------------------------------------- Permit . . . . . . BUILDING PERMIT -RESIDENTIAL Additional desc . . ADD NEW DECK Permit Fee . . . . 165.75- Plan Check Fee 107.74 Issue Date . . . . 4/24/14 Valuation . . . . 6384 Expiration Date 10/21/14 Qty Unit Charge Per Extension BASE FEE 95.75 5.00 14.0000 THOU BL-2001-25K (14 PER K) 70.00 ---------------------------------------------------------------------------- Special Notes and Comments April 14, 2014 11:34:45 AM sroberds. The proposal will result in a new deck and handicap ramp in the RS-7 zone on a property that contains an ESA. An admin deviation to intrude 81 into the front yard was approved by Dept. Dir. The ESA is previously disturbed. Revegetation with native plants is required. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE ' 4.50 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ----------- ---------- Permit Fee Total 165.75 165.75 .00 .00 Plan Check Total 107.74 107.74 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 277.99 277.99 .00 .00 Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements This D irpdbecomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is susl�endf dir abandoned for a period of 180 days after the work has commenced,or if required inspections have not been requested withi.. 80 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and orre 11 provisions of laws and ordinajpces governing this type of work will be complied with whether specified herein or not. Th ti - f a permit does not pr Xe authority to violate or cancel the provisions of any state or local law regulating constp- 'es� to 9 i the performance of �uc'? consti /ate Print Zame Signature of Contractor or Authorized Agent Signature of�ner(if owner is builder) TForms/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 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 MANUFACT RED HOMES: Footing/Slab Blocking&Hol Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parking/Lighting ESA: Landscaping —i-- 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 TmF- CITY OF For City Use 10 ]�IGELI�S P-RTA Permit# ell 3, W A S H I NGTON, U. S. Date Received: qhl lef 321 E 51h Street Date Approved ifid Port Angeles,WA 9836 P:360-417-4817 F:360-417-4711 Email: permits6l)cIty BUILDING PERMI APAICATION Project Address: 20 Phone: Primary Contact: Email: Phone Property 'MailingAddress Imall Owner ZZ32 —M 10A city<p Stati- zip I�Vle I Ndine Phone Contractor Address Email Information city State r7ap F—contractors]License# Exp.Date: Legal Description: Zoning: Tax Parcel# ProjectValue- ( terials and labor) I R I . $ (P/ *U1 .�"1-1� . Residential Commercial 13 Industrial 0 'Public 0 Permit Demolition 0 Fire E3 Repair E3 Reroof(tear off/lay over) 11 Classification For the followil1g,fill out both pages of permit application: (check New Construction q Exterior Remodel 0 Addition 13 ovement 13 Tenant Imp.Lc Mecliw�cg U Plumbing Ll Other Fire Sprinkler System? I Irrigation System? ] Proposed Bathrooms Proposed Bedrooms Yes 0 No E3 Yes 0 No 0 Project Description IAJ `7�,r=e!7J d= /1 Ad Is project in a Flood Zone: Yes 13 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 --; s obtain permits priorto work. I understand that plan review fees are not refundable after review s' L p occurred. I understand that I will forfeit review fees if I withdraw the application before the p mit' issued. I understand that if the permit is not picked up/issued within i8o days of submittal, e lication will be conside;4d Aandoned and the fees will be forfeited. V 4Date3 L.1�1 PrRnNa�me Signature Residential Structures For Office Use Area Descriojion.(�Q FT) Existing Proposed Ss value Basement First Floor Second Floor Covered Deck/Porch./Entry Deck(over 30"or 2"'floor) Garage Carport -2 Other(describe) Area Totals Commercial Structures For Office Use Area Descriptions(SQ F17) Existing Proposed ss Value Existing Structure(s) Proposed Addition Tenant Improvement? ,Other work(describe) Site Area Totals Lot/Site Co erage Calculations Lot Size sq ft) Lot Coverage(sq ft) %Lot Coverage(Total lot coverage+lot size) e� /9J4 . ��.f(� Z Site 0 Co K'grage(Sci Ft of W4n %i�f Site Coverage(total site coverage+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-buming/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 Plumbing Fixtures Indicate how many of each type of fixture to be Installed or relocated Plumbing Traps # Fuel gas piping #of Outlets: Water Heater # 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\Building Permit 4-17-13.docx I T'y 0 F PO R T pit IV c Co V .,r v The -cc o"f(his Perrru Cation's"d0larda�—,-, frcm therea-i't, t planS, rer. he 4614(11,ui (?inj off; b Specifi-ahor- f errors in -:4 in 0�erations',:'.; rn ViO* tion 0, all cod n APR 14 e,� r "Jor CITY OF PORT ANGELES Ap�roval Date L Dept.of Community Development S Y F (.it L-V— El 14 :5�0.,rr H#Ix 4 If SOP Ll 0 00 f-j B-wB P05+ ON BLOCKS P/T /C ab)L-1 14 )(4 094.%^ 1 D, ,-- oo 0 X t)" P't to' El [A'000'7- VA 2,It PT Porcoj% �B' — E3 -A '�4 ?CM o v--5 e- s%f- To 4 L IIJ c, LLC, C7 so Ts HOLA.5 e 0 L-�,54 t, k I Ow- PO,4- ----------- Rome ro e, —7�T-=—Zol Ha V—S,- L PL P,,O it 9t- Aq 'NU IZZ*Fll' �371.j Address: 520 Georgiana Street PREPARED 12/18/14, 16:30:47 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 12/18/14 ------------------------------------------------------------------------------------------------ ADDRESS . : 520 GEORGIANA ST SUBDIV: CONTRACTOR : PHONE OWNER DANIEL M BLOOD PHONE PARCEL 06-30-00-5-1-4120-0000- APPL NUMBER: 14-00000255 RES REMODEL ------------------------------------------------------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BAIR 01 5/09/14 JLL BLDG AIR SEAL 5/09/14 AP May 9, 2014 4:13:47 PM jlierly. May 9, 2014 4:14:45 PM jlierly. BL3 01 5/09/14 JLL BLDG FRAMING 5/09/14 AP, May 9, 2014 9:31:1S AM pbarthol. Mike 461-1402 May 9, 2014 4:12:55 PM jlierly. BL99 01 12/18/14 JLL BLDG FINAL December 18, 2014 9:40:54 AM pbarthol. ,:�.V v Dan 683-5007 Call ahead so he can meet you there -------------------------------------------------------------------------------------- PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ ME1 01 S/09/14 JLL MECHANICAL ROUGH-IN S/09/14 AP May 9, 2014 4:14:11 PM jlierly. May 9, 2014 4:14:45 PM jlierly. ME99 01 12/18/14 L MECHANICAL FINAL December 18, 2014 9:41:24 AM pbarthol. Dan 683-SO07 Call ahead so he can meet you there ---------------------- -------------------------------------------------------------------- PERMIT: PL 00 PLUM13ING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ PL2 01 5/09/14 JLL PLUMBING ROUGH-IN 5/09/14 AP May 9, 2014 4:14:24 PM jlierly. fl May 9, 2014 4:14:45 PM jlierly. PL99 01 12/18/14 ZL PLUMBING FINAL 9:41:37 AM pbarthol. December 18, 2014 Dan 683-SO07 Call ahead so he can meet you there -------------------------------------- COMMENTS AND NOTES -------------------------------------- PREPARED 1/28/15, 14:31:03 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 1/28/15 ------------------------------------------------------------------------------------------------ ADDRESS . : 520 GEORGIANA ST SUBDIV: CONTRACTOR : PHONE OWNER DANIEL M BLOOD PHONE PARCEL 06-30-00-5-1-4120-0000- APPI, NUMBER: 14-00000255 RES REMODEL ------------------------------------------------------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTTAT REQUESTED TNSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BAIR 01 5/09/14 JLL BLDG AIR SEAL 5/09/14 AP May 9, 2014 4:13:47 PM jlierly. May 9, 2014 4:14:45 PM jlierly. BL3 01 5/09/14 JLL 13LDG FRAMING 5/09/14 AP May 9, 2014 9:31:15 AM pbarthol. Mike 461-1402 May 9, 2014 4:12:SS PM jlierly. BL99 01 12/18/14 JLL BLDG FINAL 12/18/14 DA December 18, 2014 9:40:54 AM pbarthol. Dan 683-5007 Call ahead so he can meet you there December 18, 2014 4:36:08 PM jlierly. Complete electrical final before building can be signed off. JLL BL99 02 1/28/15 BLDG FINAL January 28, 2015 2:33:19 PM jlierly. Dan 683-5007 -------------------------------------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 14-00000255 Date 3/07/14 Application pin number . . . 237755 Property Address . . . . . . 520 GEORGIANA ST ASSESSOR PARCEL NUMBER: 06-30-00-5-1-4120-0000- REPORT SALES TAX Application type description RES REMODEL Subdivision Name . . . . . . on your state excise tax form Property Use . . . . . . . . to the City of Port Angeles Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 4000 (Location Code 0502) ---------------------------------------------------------------------------- Application desc remodel bath ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ DANIEL M BLOOD OWNER 1137 W 5TH STREET PORT ANGELES PORT ANGELES WA 98363. ----------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT -RESIDENTIAL Additional desc REMODEL BATH Permit Fee . . . . 123.75 Plan Check Fee 80.44 Issue Date . . . . 3/07/14 valuation . . . . 4000 Expiration Date 9/03/14 Qty Unit Charge Per Extension N;1 BASE FEE 95.75 2.00 14.0000 THOU BL-2001-25K (14 PER K) 28.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . ADD BATH FAN Permit Fee . . . . 57.25 Plan Check Fee .00 Issue Date . . . . 3/07/14 valuation . . . . 0 Expiration Date . . 9/03/14 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 7.2500 EA ME-VENT FAN (SINGLE DUCT) 7.25 ------------------------------------------------------------------------------ Permit . . . . . . PLUMBING PERMIT Additional desc . . REMODEL BATH Permit Fee . . . . 99.00 Plan Check Fee .00 Issue Date . . . . 3/07/14 Valuation . . . . 0 Expiration Date . . 9/03/14 Qty Unit Charge Per Extension BASE FEE 50.00 4.00 7.0000 EA PL-PLUMBING TRAP 28.00 1.00 7.0000 EA PL-WATER LINE 7.00 2.00 7,0000 EA PL-DRAIN VENT PIPING 14.00 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilitiell�l va s ri and public improvements. This per it mes 01 r le r( nul I and void if work or construction authorized is not commenced it in 186�4 6nstruction or work is suspended/or ndoned for a period of 180 days after the work has commenced, or if req i 'i i s have not been requested within 1.8/ ys from the last inspection. I hereby certify that I have read and examined thi I' i and know the same to be true and corr All provisions of laws and ordinances governing this type of work will be complie ether specified herein or not. The rant'rgaf a permit does not presu toAive authority to violate or cancel the provisions o state or local law regulating constructi q - he performance of trL uctt cons, - �/ate Print Name Signatdeeof Contractor/Authorized Agent 1<�gnature`oorXfOwner(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 ��alls/Roof/Ceiling Drywall(Interior Braced Panel Only) T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: .Heat Pump/Furnace I FAU/Ducts Rough-In (�as Line Wood Stove/Pellet/Chimney Commercial Hood I Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parking/Lighting ESA: Landscaping ISHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY1 USE Inspection Type Date Accepted By Electrical 417-4735 Construction- R.W, PW /Engineering 417-4831 Fire 417-4653 I Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 14-00000255 Date 3/07/14 Application pin number . . . 237755 ---------------------------------------------------------------------------- REPORT SALES TAX Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- on your state excise tax form Permit Fee Total 280.00 280.00 .00 .00 to the City of Port Angeles Plan Check Total 80.44 80.44 .00 .00 Other Fee Total 4.50 4.50 . .00 .00 (Location Code 0502) Grand Total 364.94 364.94 .00 .00 Separate Permits are required forelectrical 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: 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 I 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 OCCUPANCY1 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 T H 1-: 11 LES, For City Use CITY OF 73,0-RT AN,,G, ,E Permit# v,7 A S H I N G T 0 N, U. S. Date Received: 1 321 E 51h Street kate Approved Port Angeles,WA 983 6 11111114-- P:360-417-4817 F:360-417-4711 Email: l2ermits0city F-- — BUILDING PERMIT AP �JLICATION Project Address: -5 Phone: PrimaaContact: Email: ?--XAJei;q zwo Na Phone Property Mailing Addre H Ema,-_ Owner A, 1W 0 6 Wki- C&4 City State — Z ""Oor Name-L. Phone Contractor Addr 3;�l Email 7/� e2W Information City 2�A Sta-t-e zip�� Contractors License#, Exp.bate: Z9 '/-.Ae-AJ a: 6 Legal Description: V KP Zoning: ' Tax Parcel# Project VaJue: (materials and labor) NR $ Residential Commercial 11 fndustrial Public [3 Permit Demolition Fire 11 Repair Reroof(tear off/lay over) Classification For the following, fill out both pages of permit applicatiom (check New Construction 11 Exterior Remodel El Addition 11 Tenant Improvement appropriate) Mechanical 0 Plumbing Other Fire Sprinkler-!Lystem? �Irrigation Syst?m? Proposed Bathrooms Proposed Bedrooms Yes E3 No Yes 13 No iX It Project Description AIDD NN� JPW*-- kf�IAkl 4; -3 'Rols — 6r-:rji9iv# Wnon��&4,v uJ Flood Zone Type: Is project in a Flood Zone: Yes 13 No If in a Flood Zone,what is the value of the structure before proposed improvement? $ 1 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 s �s occurred. I understand that I will forfeit review fees if I withdraw the application before the e-r-rr.it - issued. I understand that if the permit is not picked up/issued within i8o days of submittal/ he'application. will be considered ap ndoned and the fees will be forfeited. Date Print Name Signat, 0:� Residential Structures For Office Use Area Description(SQ FT) Existing Proposed ss value Basement First Floor Second Floor Covered Deck/Porch/Entry Deck(over 30"or 2 d floor) Garage Carport Other(describe) Area Totals I Commercial Structures For Office Use Area Descriptions(SQ FT) Existing Proposed ss Value Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) Site Area Totals Lot/Site Co erage Calculations Lot Size(sq ft) Lot Coverage(sq ft) %Lot Coverage(Total lot coverage lot size) Site Coverage (Sq Ft of all impervious) %of Site Coverage(total site coverage-. lot size) Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler t-R�ze: # 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 Plumbing Fixtures Indicate how many of each type of flxture to be installed or relocated Plumbing Traps # Fuel gas piping #of Outlets: Water Heater # 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 13P Application\Building Permit 4-17-13.docx 'OY CHRIs C �ARjy-j- - Pl-A tl E D ROS m 71 ism 73. m �3Pt T r !iz fA ai it-IV VE' Uos 6"r 5; c Jos Vr p cc BED Z. L SToAA(ve 0 C7 SATN 'ei:7 -�� BATH AhL 3' -x IV 5 ?"Oposiiii SCALJ5 C)A\ F-Iq 0 C&IVT R A CT I NG L LC 8ATN PIAN �111.111 �`djm; — . __——11 . �-,--_'. 7 d� Z, Irl 1; :7 A=1 Jj A L L UK_ SAW M%. Ws% UN "':% - -1 if- 'Y6 4-0., < LL Ae T"Ti % i4L, iR ON Ili c Wo W"! ak 4!X qi' 1;"" Wfr, �4z A, jv