HomeMy WebLinkAbout519 W 16th St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Property Address .
ASSESSOR PARCEL NUMBER:
Application description
property Zoning . . .
Application valuation
03-00000155
519 W 16TH ST
0630000425750000
SIDING
Date
2/21/03
6822
Owner
Contractor
FIELD KIMBERLY A
519 W 16TH ST
PORT ANGELES
WA 98362
K DESIGNERS
PO BOX 276977
SACRAMENTO
(961) 631-9300
CA 958160762
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT
NO PR FEE
162.75
2/21/03
8/20/03
Plan Check Fee
Valuation
.00
6822
5.00
BASE FEE
14.0000 THOU BL-2001-25K (14 PER K)
Extension
92.75
70.00
o
----
Qty Unit Charge Per
Other Fees
STATE SURCHARGE
4.50
-.....;.,'\
Fee sunnnary Charged Paid Credited Due
----------------- ---------- ---------- ----------
----------
Permit Fee Total 162.75 162.75 .00
.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 4.50 4.50 .00
.00
Grand Total 167.25 167.25 .00
.00
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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 ,!l-i4 authority to violate or cancel the provisions of any state or local iaw regulating construction or the performance of
const~n. / ,j /7"
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Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORMS\ 11 02.15 {4/2002]
BUILDING PERMIT - APPLICATION
FOR OFFICiAL USE ONLY;
Date Rec.; 2~ 26..67
Permit #: j "'-:::0 ....-;
Date Approved:
Date Issued:
The Building Permit Application must befilled out completely.
Please type or print in ink. If you have any questions, please call 417-4815
Applicant or Agent:
Owner: ,.L:.P7}PCY/Y ,;;c/tkl
Address: <;/'9' J /;t7 C;-/
Phone:
Phone:
City: 7~d A~e/e5
'157- Lf'3 b~
Zip: 'lJ? 3 b.2
Architect/Engineer: '
k jJc..-f'I
Contractor e J) c" 5~)1// r15
t? ~
Phone:
License #:
Exp:
Phone: '1"-' 1- b31-'i'~CO
Address:
City:
Zip:
ZONING:
PROJECT ADDRESS:
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Billing Address:
Credit Card #:
Subdivision:
Credit Card Holder Name:
City:
Exp. Date: VISA
MC
SIZENALUATION:
SF. @ $ /SF. =.$
SF.@$ /SF.=$
SF.@$ /SF.=$
TOTAL VALUATION $~, 822, ) 2
'7/15't'
'I;.~ OF WORK:
1] Residential 0 New Constr.
o Multi-family 0 Addition
o Commercial <tJ.IRemodel
o Repair
ORe-roof
D Move
o Demolition
o Sign
o Wood-stove
o Garage
o Deck
o
~
BRIEF DESCRlPJlON OF THE PROJECT: ~
O/1~/ L C Vo ? /,rPt?-~ VIr
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COMME CIALIRESIDENTIAL: Occupancy Group:
cupant Load:
Construction Type:
%
/sq. ft. = TOTAL LOT COVERAGE:
APPROVALS: PLAN
BLDG.
DPW
FIRE
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER
BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be filled out completely to be accepted/or
review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your
completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division.
% Lot Coverage:
/sq. ft. + Proposed Lot Coverage:
No. of Stories: Lot Size:
Existing Lot Coverage:
PLANNING USE ONLY:
Notes:
/sq. ft.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contaclthe Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE; Your plan check fee is due at the time the building permit application and construction plans are submitted. All other
permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application, this application will expire. The
Building Official can extend the time for action hy the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for
this permit. I understand it (s not the City's legal responsibility to determine what permits are required; it remains the applicant's
responslbility to determzne what permzts are required and to o~ -7
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ApplcagV'_ ~/Z'A~A/~Date: L!. ~ = ./
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