HomeMy WebLinkAbout417 S A St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT
ISSUED: 9/23/2002
PERMIT NO: 13736
OWNER/APPLICANT
PHILLIP CHE
417 S. A STREET
Port Angeles, WA 98363
360/452-8412
T:
PROPERTY LOCATION
417 ASTS
Lot:
Block:
S:
Subdivision:
Parcel No:
11
99
TPA
CONTRACTOR
SQUARE CONSTRUCTION
805 EAST 5TH. STREET
PORT ANGELES, WA 98362-0000
360/452-6234
PROJECT INFO
Project Value: $5,221.00
Project Type: RE-ROOF
Occupancy Type: RESIDENTIAL
Occupancy Group:
Construction Type:
Zoning Use:
D Long Legal
ARCHITECT
N/A
, 98360-0000
360/000-0000
SFD Units: 0 Commercial: 0
SFD SQ FT: 0 Industrial: 0
Garage: 0
MFD Units: 0
MFD SQ FT: 0
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PROJECT NOTES
TEAR OFF, INSULATE WITH 1 1/2" INSULATATOIN BOARD, COMP ROOF
RECEIPT#9714
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$125.25
$0.00
$4.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
:po
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-I
Misc Fee 1:
Misc Fee 2:
Misc Fee 3:
$0.00
$0.00
$0.00
TOTAL FEE:
AMOUNT PAID:
BALANCE DUE:
$129.75
$129.75
$0.00
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 of 180 days aflerthe 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 give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
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Signature of Contractor or Authorized Agent
'f 1~1/oz.
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\\ 102.\5 [412002]
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY,
Date Rec.:
Permit#:
Date Approved:
Date Issued:
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The Building Permit Application must be filled out completely.
Please type or print in ink. If you have any questions, please call 417-4815
Applicant or Agent: I( \J \ , t t L r1 .,., Y ,7 f ,v
Phone: <r r l - { l ? 't
Owner: !'.-/iLLI('
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Phone:
Address: <i I 1
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City: f',
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Zip:
CJ.r.. "6 t.
ArchitectlEngineer:
Phone:
Contractor ~'Vj),nf Le.\.'.'> ;(1V(",';I(',-" License#:s-L~I)At?,,,,,'j"jl(:.'Exp: t-i/~7f(.,<' Phone: 'fSZ..(.i)"'i
Address: F (.:; i; ~-1"':i)" A f ';" ;1 1\ C
City: ('~ ,\: \" Ai"'; f..- ( t t ~.
Zip: e,.t: 1{.~
PROJECT ADDRESS: Lit 7 , ,. p, > ,
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Billing Address: I.. i 1 S v~ \ I
Credit Card #:
WNING:
Subdivision:
Credit Card Holder Name:
City: f'( .11 AN t [t.I~ 5
Exp. Date: VISA
MC
TYPE OF WORK:
liiI Residential 0 New ConslT. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
o Wood-stove
o Garage
o Deck
o
SIZENALUATION:
SF. @$ ISF. =.$
SF. @ $ ISF. = $
SF. @ $ ISF. = $'
TOTAL VALUATION $
BRIEF DESCRIPTION OF THE PROJECT:
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COMMERCIALlRESIDENTIAL: Occupancy Group:
Occupant Load:
Construction Type:
%
Isq. ft. = TOTAL LOT COVERAGE:
APPROVALS: PLAN
BLDG.
DPW
FIRE
ESAlWetJand(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER
BIDLDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must bejilled 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.
No. of Stories: _ Lot Size:
Existing Lot Coverage:
PLANNING USE ONLY:
Notes:
% Lot Coverage:
Isq. ft. + Proposed Lot Coverage:
Isq. 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. Contact the Pennit Coordinator at 417-4815 forassistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building pennit application and construction plans are submitted. All other
permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno pennit is issued within 180 days of the date of application, this application will expire. The
Building Official can extend the 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.
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 is not the City's legal responsibility to determine what permits are required; it remains the applicant's
responsibility to determine what permits are required and to obtain such"
T:\FORMS\APPS\Buildingpermit
Applicant: 1: . b.' h ~..
Date:
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