HomeMy WebLinkAbout1116 S D St - Building CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number ..... 03-00000949 Date 9/26/03
Property Address ...... 1116 S D ST
ASSESSOR PARCEL NI~BER: 06-30-00-0-3-5495-0000-
Application description . . . RES ADDITION
Subdivision Name ......
Property Zoning .......
Application valuation .... 395
Owner Contractor
cOLBATH FOP. REST D O~ER
1116 S D ST
PORT ANGELES WA 983637050
...... Structure Information 170 SF DECT COVER .....
Construction Type ..... TYPE V NON-RATED
Occupancy Type ...... SINGLE FAM & CONGREGATES
Other struct info ..... NUMBER OF UNITS 1.00
Per~it ...... BUILDING PERMIT -RESIDENTIAL
Additional desc . ,
Permit Fee .... 47.00 Plan Check Fee . . .00
Issue Date .... 9/26/03 Valuation .... 395
Expiration Date . . 3/25/04
Qty Unit Charge Per Extension BASE FEE 47.00
Other Fees ......... STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 47.00 47,00 .00 ,00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 ,00 .00
Grand Total 51.50 51.50 .00 .00
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 o['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 kr~ow the same to be true and correct. All provisions of
laws and ordinances governing this typo of work will be complied with whether specified herein or not. The granting of a permit does not
~o e of
construction.presume to give authority to violate or cancel the provisions of any state or Iocal~ 7-~~~law regulating~-' ,/ ) construction or the p
Signature of Contractor or Authorized Agent Date Signature~bf Owner (if owner is builder) Date
T:\PLANNING~FORMS\I 102.15 [4/2002]
~ port ~l~ ~~~FOR OFFICIAL USE ONLY:
&.~o ~ Date Rec.:
BUILDING PERMIT - APPLICATION
· Date Approved:
The Building Permit application must be filled out completely.
Please type or print in ink. If yon have any questions, please call 417-4815
Applicant or Agent: ~'~'C.I-,0 e ~), ~-~ O I. b o. 'l' k Phone: ~
Owner: F. ~' ~ l} I ]~{X [' h Phone: ,t ti
Address:IJt , Go. 0 City:~ea,r{~ ~1 ,-~la~lo,$ [Otks'~_, Zip:
i
Architect/Engineer: I~ ff ~I f~ I I ~. Phone:
Contractor I)[[ ,I ,r O., [ '{' License #: --' Exp:. ~' Phone:
t
Address: ~- City:. -- Zip:
PROJECT ADDRESS: Ill ~ ~.~ D ~.~:~. ZONING:
LEGAL DESCRIPTION: Lot: Block: Subdivision:
CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name:
Billing Address: City:
Credit Card #: Exp. Date: VISA MC
TYPE OF WORK: SIZE/VALUATION:
[] Residential [] New Constr. [] Re-roof [] Wood-stove SF. ~ $ /SF. = $
[] Multi-farmly [] Addition [] Move [] Garage SF. ~ $ /SF. = $
[] Commercial [] Remodel [] Demolition [] Deck SF. ~ $ /SF. = $
[] Repair [] Sign [] TOTAL VALUATION$
BRIEF DESCRIPTION OF THE PROJECT: ~..O~f-~It'' O ~/ ~ flJ e..,,¢.., k
COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load! Construction ,Type:_
No. of Stories: __ Lot Size: ~'~O(_~ % Lot Coverage: '~ ~ ~ ~-- %
Existing Lot Coverage: i q-/t~. /sq. fir. + Proposed Lot Coverage: '~ ~/d) /sq. fir. -- TOTAL LOT COVERAGE: /~ ~t~:~ /sq. fir.
PLANNING USE ONLY: APPROVALS: PLAN
Notes: BLDG.
DPW
FIRE
ESA~Vetland(s): [] Yes [] No SEPA Checklist required? [] Yes [] No Other: OTHER
BUILDING PERMIT APPLICATION SUBMITTAL: Your application and siteplan must be filled out completely to be accepted for
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.
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. Contact the Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building pemfit application and construction plans are submitted. All other
permtt fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no pernUt is issued within 180 days of the date of application, this'application will expire. The
Building Official can extend thc time for action by 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.
1 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. 1 understand it is not the City's legal responsibility to determ~ what permits are required; it remains the applicant's
responsibility to determine what permits are required and to obtain such./~'"~ Jif_ ' lQ __
CI'I'~ OF PORT ANGELES -- Construction