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HomeMy WebLinkAbout734 W 5th St - Building RECEIVED-CITY OF PORT ANGELES PERMIT APPLICATION APR 19 2013 ►+ Building Division/Electrical Inspections ,_•, 321 East Fifth Street--P.O.Box 11501 Port Angeles Washington, 98362 ELECTRICAL ±�;;� PPS: (360) 417-4735 Fax: (360) 417-4711 Date; 4 - j- ` 1 2 Single Family Dwelling *Plan Review Ma yy Be Re uir ease Complete Electrical Plan Review Information Sheet Job Address: 734 Building Square Footage; Description of above Own e In rmation ` Contrac Qr Information Name: to ICT !�i l-L w A RA 5 Name: 8W&A F e M '' Address:7 4 lr1 9 Mailing Address: w City State: Zip;,,,•,,;_. S City: State: zip; Phone(aD C,,77..,Fax: Phone: Fax: License#I Exp. License#1 Exp. Item Unit Charge Total{Qty Multiplied by Unit Charge) ServicelFeeder 200 Amp. $120.00 $ ServicelFeeder 201-400 Amp. $146.00 $ ServicelFeeder 401-600 Amp $205.00 $ ServicelFeeder 601.1000 Amp, $262.00 $ ServicelFeeder over 1000 Amp, $373.00 $ Branch Circuit WI Service Feeder $ 5.00 $ Branch Circuit W10 Service Feeder $ 63.00 $ Each Additional Branch Circuit $ 5.00 $ Branch Circuits 1-4 $ 75.00 $ Temp,Service/Feeder 200 Amp. $ 93.00 $ Temp.ServicelFeeder 201-400 Amp, $110.00 $ Temp,ServicelFeeder 401-600 Amp. $149.00 $ Temp,ServicelFeeder 601-1000 Amp• $168.00 $ Portal to Portal hourly $ 96.00 $ Signal Circuit/Limited Energy-1 &2 Family Dwelling $ 64,00 $ Manufactured home Connection $120.00 $ Renewable Electrical Energy-5KVA System or Less $102.00 $ Thermostat $ 56.00 $ Note,$5,00 for each additional T-Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. $120.00 $ Each Additional 500 Square Ft.or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 — $ Each Swimming Pool or 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 safe, 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.,RCK Chapter 19.28,WAC• Chapter 296-46B,TH6 City of Pork Angeles Municipal Code,and Utility Specifications and PAMC 14.05,050 regarding Eectrical Permit Applications. Signature of owner,electrical contractor or electrical administrator: © cash ❑ Check ('e— El CreditCard# lt� Dated: 3 01!01!2012 ELECTRICAL PERMIT 1 CITY OF PORT ANGELES 360-417-4735 Application Number . . , . , 13--00000405 Date 5/08/13 V Application pin number . . . 806215 } Property Address 734 w 5TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-1-0040-0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name , , , , , . to the City of Port Angeles Property Use 1 P1eA Property Zoning . , . . . , RS? RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation . . , . 0 Application desc new garage Owner Contractor WIT,LIAMS ROBERT M OWNER 734 W 5TH ST PORT ANGELES WA 983632248 ------- ------------------------------------------------------------------ Permit . . . , ELECTRICAL ALTER RESIDENTIAL Additional desc . Permit Fee , , . , 74.00 Plan Chec]c Fee 00 Issue Date 5/08/13 Valuation . , , , 0 Expiration Date 13/04/13 Qty Unit charge Per Extension 1.00 74.0000 ECH EL-R--OUTBD/DTCH GAR IN/SEP 74,00 Fee summary Charged Paid Credited Due Permit Fee Total 74.00 74.00 .00 .00 Plan Check Total. .00 p0 00 00 1 Grand Total 74.00 74.00 .00 .00 ' V INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH 1 SERVICE ROUGH-INN FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: QTXCHANTGMBUILDING v CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 12- 00000319 Date 3/21/12 4 At 11 Application pin number 166170 Property Address 734 W 5TH ST ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -1- 0040 -0000- REPORT SALES TAX r Application type description PLUMBING PERMIT on your state excise tax form Subdivision Use Name Pro e t the City of Port Angeles i Code Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502 Application valuation 1200 w Application desc g NEW WATER SERVICE Owner Contractor 16' WILLIAMS ROBERT M GARY'S PLUMBING INC 734 W 5TH ST PO BOX 255 PORT ANGELES WA 983632248 PORT ANGELES WA 98362 (360) 457 -8249 Permit PLUMBING PERMIT Additional desc NEW WATER LINE Permit Fee 57.00 Plan Check Fee .00 Issue Date 3/21/12 Valuation 0 Expiration Date 9/17/12 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 7.0000 EA PL -WATER LINE 7.00 Fee summary Charged Paid Credited Due Permit Fee Total 57.00 57.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 57.00 57.00 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes m ull 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 pot presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of 'construction. x"/ (o)I NS Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit Z ff BUILDING PERMIT INSPECTION RECORD 7 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 IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. 0:, egg Inspection Type Date Accepted By Comments FOUNDATION: 4 Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: Under Floor Slab Rough -In Water Line (Meter to Bldg) 7--1 17- 37 IA Gas Line Back Flow Water FINAL Date 3 '2- 1 b w 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 b MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit #s ing Lighting SEPA: Parking ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE j Inspection Type Date Accepted By U Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T•Fnrmc /Rnilriinn niuicinn /Rnilriinn PRrmit N N H H H 0 W W ED F 4 Q O q 0 N of r- E 10 P. w N O 0 N 0 N Sa 1.0 7 N a, M J-) 1J m u w U rti a u a C .4 I 1 H w w 01 E W vl 000 Q o W w a x x oo 1n H u ma a r i H o H r �,L z E I a ino C i 0 a m z o a o m 0 H° E, rfl yam- H 00 2 12 1+ F W W W 10 H t H Z a w E F. o C7 0 w Z 2 0 0 3 KC N 4 N HH HU aJ 0 0 al to 2 0 3 IN 0 E H F H c it tr a a a M 04 W 0 0 0 U r O o 0 !n U] 1. .i SA o W W N 11 0 0 0 0 1010(]10 U oz H E o W N Cr H W N 0 0 O N 0 a 0-4 x H a X 10 1 M H o FP. U) 10 0 0 W u 4 0 g00 0 W 10 a r o aE 10 100 0 as mw ...a Z H l0 N O(0 a H J H x 0 3 0 H 0 0 1 N N 0 E F W 0 0 M a 100 0 a w .7 P. 0 (0 0 O F a w rka w z H 0 W El q Q Z 2 a a a 4o a u 4 u o a a a H W rouri;t,J BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn: Building Permit Technician For City Use Only: Date Received 3 1?- x- 321 E. Fifth St., Port Angeles, WA 99362 Permit* 12.-319 (360) 417 -4815 fax (360) 417 -4711 Date Approved V)-. Applicant eO (.J, I l iA M s Phone y57- O 9 a� Property Owner j V) t t t VY15 Phone Property Owner's Address 1-?4 W S 5t 'Fora Ann W-A, IT 3 (03 Contractor Y S v AA 8 1 \1 Ph ne t 51— g a H 9 Contractor's Address Po BOX, 255 1. 6) r+ v P,tes, WA Gig 3(1,22. License Expires E -mail PROJECT ADDRESS 73� Sr 5 Parcel Number Lot Zoning Project Type Brief Description: Residential o Multi family Commercial a Industrial Check all that apply o New Construction Addition Remodel o Repair o Demolition o Re -roof House garage other o tear off re -roof o lay over one layer o Heat System Heat pump a wood- burning stove gas fireplace pellet stove o other %Other N Al-C `L>/'V Floor Areas Existing (sq, ft.) Proposed (sq. ft.) Basement per sq. ft. 1 Floor 2 Floor 3` Floor Garage Carport Covered Porch Deck Shed Other 2-1 12 po i Y f -i�' I TOTAL VALUATION A00 Total footprint of structures sq. ft. Lot size sq. ft. Lot coverage Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage Max. height of proposed structures ft. Occupancy group of bedrooms Will a lawn sprinkler system be installed? Occupant load of full baths Will a fire sprinkler system be installed? Construction type of half baths have mad and completed this application and know if 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 w rking on projects. Date l e. Print Name 6t`1'!#/■) 60 1, N5 Signature T:Forms /Building Division /Building permit application ELECTRICAL PERMIT 3- CITY OF PORT ANGELES 360- 417 -4735 Application Number 12- 00000126 Date 2/07/12 Application pin number 375660 Property Address 734 W 5TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -1- 0040 -0000- on our excise tax form Application type description ELECTRICAL ONLY y Subdivision Name to the City of Port Angeles Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 0 Application desc Ductless heat pump Owner Contractor WILLIAMS ROBERT M OWNER 734 W 5TH ST PORT ANGELES WA 983632248 Permit ELECTRICAL ALTER RESIDENTIAL W Additional desc SINGLE CIRCUIT Permit Fee 63.00 Plan Check Fee .00 Issue Date 2/07/12 Valuation 0 Expiration Date 8/05/12 Qty Unit Charge Per Extension BASE FEE 63.00 Fee summary Charged Paid Credited Due Permit Fee Total 63.00 63.00 .00 .00 !\J Plan Check Total .00 .00 .00 .00 Grand Total 63.00 63.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN 43 /1 1;4 7 FINAL Li 13 1 2- -1• COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING ��j(� tJ Ecr V Lam, pTt r oi CITY OF PORT ANGELES PERMIT APPLICATION FEB 2011 1 Building Division /Electrical Inspections v 0 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 ELECTRICAL Ph: (360) 417 -4735 Fax: (360) 417 -4711 INSPECTIONS NIIIIIP m N Date: Z 3. 12- 1 1& 2 Single Family Dwelling V Plan Reviet May Be Requirgi P e Complete Electrical Plan Review Information Sheet Job Address: /,34 p1T iikib£LES Building Square Footage: 11.00 Description of above Owner IpfQrmation Contractor formation Name: Ka 13 T N le 1L61AMS Name: HoO1 o w LL Mailir ddress: T34 �l 5 h Mailing Address: City: vgl State: AijA_ Zip: 99365 City: State: Zip: Phone:4S 7 024 Fax: Phone: Fax: License Exp. License Exp. Item Unit Charge Q yt Total (Qtv Multiplied by 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 1 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 Circuit/ Limited Energy -1 2 Family Dwelling 64.00 Manufactured Home Connection 120.00 Renewable Electrical Energy 5KVA System or Less 102.00 Thermostat 56.00 Note: $5.00 for each additional T -Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. 120.00 Each Additional 500 Square Ft. or Portion of 40.00 Each Outbuilding or Detached Garage 74.00 Each Swimming Pool or Hot Tub 110.00 (3 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 -46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: Cash Check 5..r\---.1 Credit Card Dated: 23./ 2_ 01101/2012 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION wmpr 321 EAST 5TH STREET, PORT ANGELES, r ELES, WA 98362 Application Number 12- 00000149 Date 2/09/12 Application pin number 907660 Property Address 734 W 5TH ST q �q ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -1- 0040 -0000- REPORT SALES THY Application type description MECHANICAL APPL. PERMIT on your state excise tax form Subdivision Name Property Use to the City of Port Angeles Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 3345 Application desc DUCTLESS HEAT PUMP SYSTEM Owner Contractor WILLIAMS ROBERT M DAVE'S HTG COOLING SRVC INC 734 W 5TH ST PO BOX 413 PORT ANGELES WA 983632248 PORT ANGELES WA 98362 (360) 452 -0939 Permit MECHANICAL PERMIT Additional desc DUCTLESS HEAT PUMP SYSTEM Permit Fee 64.80 Plan Check Fee .00 Issue Date 2/09/12 Valuation 0 Expiration Date 8/07/12 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 14.8000 EA ME- FURN /HP /FAU OR 5 TON 14.80 Fee summary Charged Paid Credited Due Permit Fee Total 64.80 64.80 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 64.80 64.80 .00 .00 I(l(l- I '2 i 1011 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. 07 0 i I L 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 IN CONSPICUOUS 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, 'y epted by MANUFACTURED HOMES: Footing I Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: Parking Lighting ESA: Landscaping SHORELINE: 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 417 -4815 10) 12 Building �.l In N H 1 i d' N N W W Q an M D 0 H N H 0 N 0 .L .1 ,C H L A 0 0 0 H 0 0 1 0 ,H A PO 1 .0 rl CL 14 M a a 1 r' HI a 4 a\ a I H w w 7) H F 1 0 00 1 H AJ (n W V1 Pi 0 0 rn (I) 0 0 J 0 N w W 1 a 0 0 1 H n t-1 rn 0 U< (n a s 0 l 1 fl N 0 H 0 1 H r C Z F'7 1 1 O o 0 U H H 0' 1 1 1 N N U H I In FC H F 1 F-1 1 V] H H o o p, 0 N �l 0 n F F 1 H Z F Zry ZN N (n U U I 0 1 z rn N 0 1-1 I F W W 1 a' W H t• C H Z a a 1 W X w 01 0 l0 w o W cf) Z Z a l 0 0, C' O N S Z z l 0 O o 1-7 H H H -7 N d' E H H z I H u a p1 m KC 0 H 1 E-• U H >v U U (1 u U a 1 a U] H EI H O O SA 01 1 HF 0 ra a ro w a 1 C.) 0 S S 0 0 N 0 (n o.] 1 (nvl 0.4 .0 .4 aI C.) .0 C o 0 1 01 01 0 0 Q 1 1 01 0 0 0 0 o0 1 Egfk Ew W w NXwA z O o r x O F o U l a F r U a o w l a s c w E1 cn�0 Hw as (0 0[.x oa 1 H a 00 0 Fx(n00 H CO 1 Ifl X 0 0 1 W 1 (n g 1 0 1 0 0 a 1 3- H 0 O 1 w W W 10 10 N N W 1 W m 0 1 X EE E H H 1 NQ3oH 1 0]w H, N N 1 0 X F 1 W o N N co N at a1 a0 as o a 0 F 1 (z7 w 1 Cn U 1 H N 0 0 1 (fl ■a z 1 E 0 o 0 a›. OK WU 7 1 H (1) al 01 W F q o Q Z z a a 1 a a, m a 1 FCuoag i a E x a) ry O O H ry W W 0 a 0 A 0 I I I �p r 0 0 N N 0 0 Tr O d 4' N O N A n rn a a 4Z:14'■ E a 0 z z H 0) U) W 0 0 00 r.i m W H a cn W W 0 r1 0 0. F h 01 0 0 0 0 i 0 E to a E E H I E o o cn U 0 X 2 Z 0 M E W W a 1 0) o Z 4 1....41/4 a s 1 E w 1 r W U) u) a 1 Z oo 0 I-1 I-1 Z 1 °o a '"r 0 0 0 1 E C.)›..-1 U a 1 00) H Sa d* O a 1 1-I E z N a 0 0 x 1 cn o0] 1 to 01 U AA opt' ww wa)o O ou I F01 Eao O H H I H 0� 0 E o U I W E a) 0 0 0 0 l 0,1 0)(0I0)(0 E 11 0. 1 Z O) o C0 0' 01 H W a rn 00O C 1 H p: o E cn o .-1 U) N X O O 0) cn 0.4 1 o 1 q q 0 (0- 1-1001(00)0 ry 01 41 war,o I EE r1 U a 0) 0 (-0300 a H 0 014,4 0 o 1 0(00 0 0 a 0 o 01 E 1 W 0 ry ry a a 1 a u 0 0 (0 i S a0 a O Z F 0 o o. --1 g003 <a 1 (0 0) 0.0 0 0 a< 1 E X Feb 09 12 08:30a Dave's Heating Cooling 3604520939 p.1 I BUILDING PLUMBING /MECHJ4NICAL PERMIT APPLICATION SHORT FORM (To be use d for projects that do not require plan review.) Date Received Z-1 -17. Permit# 12- —lam( City of Port Angeles 1 Please print in ink. Date Approved q Attn: Building Permit Technician Approved by 321 E. 5`" St, Port Angeles, WA 98362 I 360 417 -4815 fax: 360 -417 -4711 Credit card payments are accepted Mon -Fri 8 -5 pm (no American Express) Hours: Mon through Fri 8 5 pm Cash checks are accepted Mon -Thurs 8:30 -4 pm Fri 8:3D -12:30 pm 1 Contact person: Phone: Property owner: Q c b L J o r n i e t C S 4 7 1 6 7- 6 a d� I P hone: cf Property owner's mailing address: Contractor's business name: D V Phone: (or property owner's name if he /she is doing /overseeing the work) D c7 3 Contractor's mailing address: Contractor's L &I license number: 0 j Expiration date 7.c) Project Address: Project Type: Lesidential o Commercial c Industrial e Multi- family Project Business Name: (for commercial, industrial, or multi family projects) The following permits are usually issued over- the counter immediately, without the need for plan review. Complete only the portions of this permit that are relevant to your project. Re -roof: house o garage other 0 tear off re -roof c lay over one layer (i) Licensed contractor: Submit a copy of your re -roof bid. Project Valuation (labor materials, not including sales tax) Re -side: o house c garage other Project Valuation (labor materials, not including sales tax) Repair. (explain the project) Project Valuation "Homeowner: If you will be doing overseeing the work, then the project valuation will be determined by doubling the cost of materials, to reflect the value the repair adds to your property. Cost of materials x 2 Project Valuation T:Forms /Building Division /Building /Plumbing /Mechanical Permit Application Short Form (Revised•2011) Page 1 of 2 Feb 09 12 08:30a Dave's Heating Cooling 3604520939 p.2 Swimming Pool or Spa (a. 24" deep): For orefabricated swimming pool or spa projects that do not require plan review: Obtain the City of PA handout entitled "Pools Spas" follow the requirements. Project Valuation 1 I Demolition: A demolition permit is needed when an entire building gets demolished. What will be demolished? house o garage o other Note: some demolition permit application's need to be reviewed by various City departments. and may take approximately two weeks to obtain. Agree to ensure that all utilities are /will be properly turned off (and capped off if needed) prior to demolition. (1) Obtain (from the City of PA) an aerial view rnap of the parcel and put an "x" over the structure(s) to be demolished. Submit the map with this application. Obtain (from the City of PA) a copy of the Olympic Region Clean Air Agency (ORCAA) Demolition Permit Appli Contact ORCAA at 360 417 -1466 to discuss whether or not an ORCAA Demolition Permit will also be needed. c yes o no Will the debris be going to the Regional Transfer Station in Port Angeles? o yes o No If yes, will a licensed contractor be taking it there? If yes, obtain (from the City of PA) a copy of the Waste Disposal Application. Complete and submit the waste disposal application to the Building Permit Technician, now (or later if asbestos testing is needed) Plumbing Permit: (explain the project) Project Valuation S Mechanical Permit: (explain the project) 1I'►5ri- l a-4-IL n. c4 c "C-9--sls 1.--13-af- t p, mi p �sc- -s-i-q -ca Project Valuation 3 4 l have read and completed this application and know it to be true and correct. 1 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 working on rojec Date of 1 0 Signature 6 Print Name 011 1- Page 2of2 ~ pORT ~ rS~O~~~ Ra "'-~ ~ ~~ 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: Appl~cation descr~pt~on Subdivision Name Property Use Property Zoning . . . Application valuat~on 04-00000526 Date .289800 734 W 5TH ST 06-30-00-0-1-0040-0000- RE-ROOF 6/14/04 RS7 RESDNTL SINGLE FAMILY 3000 Owner Contractor WILLIAMS ROBERT M 734 W 5TH ST PORT ANGELES WA 983632248 TOPNOTCH ROOFING & GUTTER 1235 W. 9TH PORT ANGELES WA 98362 (360) 457-0066 Permit BUILDING PERMIT - NO PR FEE Add~tional desc TEAROFF/FELT/COMP permi t Fee 106.75 Plan Check Fee .00 Issue Date 6/14/04 Valuat~on 3000 Expiration Date 12/11/04 Qty Unit Charge Per Extension BASE FEE 92.75 1. 00 14.0000 THOU BL-2001-25K (14 PER K) 14.00 Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 106.75 106.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 111.25 111.25 .00 .00 ., ta<pttz.eo 1'2-//l/~ ~ ~~!~J ~ W -C t V'1 of. 5 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 exammed 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 regulatmg construction or the performance of construction. /~ /J ( ~ &.-/4' "P/" Date Signature of Owner (if owner is builder) T \PLANNING\FORMS\1102 15 [11/14/2003] Date