HomeMy WebLinkAbout2013 W 4th St - Building CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT ISSUED: 7/02/2001 PERMIT NO: 12771
OWNER/APPLICANT PROPERTY LOCATION
2013 4TH ST W
SHERIDAN SCHROEDER
2013 W 4TH STREET Lot: TX5331/2EXTX6521&EXR/W
Port Angeles, WA 98362 Block: SL29 [] Long Legal
360/715-1175 Subdivision:
T: S: Parcel No: 063000102900000
CONTRACTOR ARCHITECT
DAVES HOME REPAIR N/A
833W 15TH ST
PORT ANGELES, WA 00009-8363 , 98360-0000
360/452-8335 360/000-0000
PROJECT INFO
Project Value: $5,000.00 SFD Units: 0 Commercial: 0
Project Type: GARAGE/CONVER. SFD SC/ FT: 0 Industrial: 0
Occupancy Type: RESIDENTIAL Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0 \ ,.
Zoning Use:
PROJECT NOTES
CONVERTING GARAGE INTO REC. RM. AND ADD A BATHROOM '·~
FEES ASSESSMENT
Building Permit: $111.25 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0·00 TOTAL FEE: $146.50
Plumbing: $0.00 AMOUNT PAID: $146.50
Mechanical: $30.75
BALANCE DUE: $0.00
Radon: $0.00
Separate Permits am required for electrical work, SEPA, Shoreline, ESA, utilities, pdvate 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 tree and correct. All provisions of
aws 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
con 'on.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILD1NG INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 1N A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SiTE
INSPECTION TYPE DATE I ACCEPTED COMMENT~
I
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS/ROOF/CEILING
DRYWALL
T-BAR
INSULATION
MECHANICAL
HEAT PUMP
WOODSTOVE / PELLET/CHIMNEY / INSERT
HOOD/DUCTS
PW UTILITIES / SITE WORK ( Engineering Di vision) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEFT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 ~ FIRE DEFT,
PLANNING DEPT. 417-4750 /_///~g~_,~ ~ PLANNING DEPT.
BUILDING 417-4815 BUILDING
C:',APPLWPD
Plme ~ or print in h~ Hyou have any ~on~ pluse nil 417~81S
on~ctor
PR~ ~D~S:~_ ~ , ' ZO~G
B~F DES~ON OF ~ PRO~:
P~G USR O~Y: ~PROV~: P~
Site PI~
ES~et~d(s):
B~G ~PLICA~ON ~'1'1'~: Your ~p~n and t~e p~ ~ be~ed o~t co~leteiy to be a~t~ for ~.
pl~ ~ m ~ ~bmi~ m ~c Bufl~g Division.
o~er pe~it fees ~ du~ at ~e ~ of p~t ~su~c~.
E~ON OF P~ ~W: If no ~it ~ i~u~ wi~ 180 days of ~e da~ ofappli~fion, ~ appli~fion will cxpi~ by
Section 107.4 of~ Unifo~ BulldOg ~d~, c~nt c~fion). No ~li~tion c~ ~ ~t~ mo~ ~ onca.
C~ OF PORT A~ELES -- C~on Plans
Th~ fss.anc; of this ~rm~ ~ upon the~ plans, x~-
pOR NGELES
WASHINGTON, U.S.A.
PLANNING DEPARTMENT
October 2, 2001
Ms. Sheridan Schroeter
4949 Samish Way #27
Bellingham, WA 98226
RE: Variance Application - VAR 01-10
SCHROETER - 2013 West Fourth Street
Dear Ms. Schroeter:
Following a public heating conducted on October 1, 2001, the City's Board of Adjustment
approved your application for a reduction of the 20-foot minimum front yard setback to 14 feet
to allow the construction of a 12' x 24' garage at 2013 West Fourth Street. In discussion it was
noted that the vegetation planted along your east property line is quite dense and tall enough to
perhaps pose a vision concem. The Board asked that you be aware of this concern.
If you have any questions, or if we can provide further assistance, please don't hesitate to
contact this office.
Sincerely,
· ~ue Roberds --/ -
Planning Specialist
~ Building Division
32 I EAST FIFTH STREET · P. O. BOX 1 150 · PORT ANGELES, WA 98362-02 ~ 7
PHONE: 360-417-4750 · FAX: 360-417-4609 ® TT¥: 360-417-4645
E-IViAJL: PLANNING~CI.PORT ANGELES.WA.US
pORTA. GELES
WASHINGTON, U.S.A.
DEPARTMENT Of COMMUNITY DEVELOPMENT
September 17, 2001
TO: tq$ruilding Division, DCD
Public Works Utilities
Fire Department
SUBJ: VARIANCE - VAR 01-10
SCHROETER - 2013 West Fourth Street
The applicant is requesting a DECREASE in the minimum fi:om yard setback fi:om 20' to 6' to allow
the construction of a garage to a single family residence in the RS-7, Residential Single Family zone.
Please review the proposal for those issues that relate to your departmental concerns and respond to
the Planning Department no later than S~tember 21. 2001. ~_.
Don't hesitate to ask if you have any questions.
I
APPLICATION FEE I ~:~ FOR OFFICE [J, TE ONLY
Total: $225] Date Rec'd:
File Nuraber:/~/~'~
Received by:
$r ~ IMPORTANT gr PLEASE READ ~k
Only completed applications will be accepted. To be considered complete, an application must include all of the following
information:
[] A completed application signed by the applicant and the property owner (if different than the applicant).
[] A vicinity map showing the site in relation to surrounding uses and cross streets.
[] A site plan drawn to a logical scale (1 "=20' is good) with complete dimensions showingall property lines, existing
and proposed structures, setbacks, and any significant vegetation. The site plan must be on 8 ~' x 11" paper and
prepared with a permanent marking instrument such as a black ballpoint or flair pen. (Pencil or colored pen will
not doll
[] A building elevation identifying the proposed construction by cross hatching.
[] Mailing labels (legibly typed or printed) containing the names and addresses of property owners within 300' of
the proposed site. A list of the property owners may be obtained from the County Assessor's Office
[] Supporting narrative information that you feel is needed.
[] $225 Application fee.
It is important to be accurate and complete with the information regarding all aspects of your project. The Boad
of Adjustment's decision will be based on the information co~tained in this application, and, if approved, will be limited
to the proposal as presented and potentially conditioned. Changes to the application or erroneous information may
result in the delay of your project review.
Don't hesitate to ask if you have any questions regarding the permit process, time periods, or resthctions of
certain applications. Planning Department personnel may be reached at 417-4750 between the hoars of 8 a.m.
and 5 p.m. Monday through Friday.
APPLICANT INFORMATION:
Applicant: ~'~i~.IL:~D~ ~Cdrl~'l~ Address: ~-~/.~, t~. q~ ~,
Da~ime phone g: (~) 6S-O ~ ~5 ('4*q~ ~y ~zT; S~u~
*Representative ifo~ ~ applic~t: ~0 ~ ~ .~ m ,~C Da~ime phone
ProperW owner (if other ~ applic~t):
Address: Da~ime phone g:
SITE INFORMATION:
Street address: 201 ~ (,Ii, ~-/'~ Sr
Leg~ deschption: Sg~ ~xcTx 6,2 I, ~x~o S~ LT 2~ lb~ 102q0~00
Zoning desi~ation: ~ ~-7 Property ~ensions: 7ff X
Prop~y ~ea (tot~ squ~ feet): I ~t ~ t ~. t L
Physic~ ch~acteristics ~d c~ent improvements (i.e., flat~eveloped, yacht, etc.
V~CE INFO~ATION:
~at st~d~ are you requesting a v~ce from? State ~e v~ce you ~e requesting:
~ Lot Coverage Setback (stateside, re~) ~ /
O~er (expl~n)
State ~e ~usual prope~ ch~te~sfics (Lc., slope, bluff, ravine, d~se vegetation, other) ~at exist on
yo~ prop~ ~t prevent you ~m obsc~g ~e st~d development regulations:
on for a v~i~ce (a~ach ad~tional pages if necess~):
I ce~ that all of the above statements are ~e and complete to the best of my ~owledge and ac~owledge
that will m~representation of info~ation will termiaate this permit application. I have read this appfication in
it; entire~ and understand that ~y ~ubmittal will be r~i~ed for completeness and, ~found to be complete, will
be scheduled for the n~ilable Board o~j~tment meeting.
Om~ (if o~ th~ applic~t): I am the owner of the subject proper~ ident~ed herein and approve of this
application.
Silage Date
C:~yFiles~O~S~PPSWAR.APp Page 2 of 2
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Data--Time Received by /~V (phone, person)
Location of Work to be inspected ~ I ~ ~ ~-~-~[
Name of person requesting inspection ~-~P--
Address of person requesting inspection Phone No. '~ - '
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing ~ Sewer Excav. Other
INSPECTION NOTES: ,tx
Inspected: Date ~/' ?~? ' ? -~"'' Time. By
Remarks:
RESTORATION REQUIRED ...... YES. NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel []Asphalt I~PCC ~-]Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
~--} No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST: ~ ~- (~pho~ne
Date ~ ~- '~7~ ~ / Time Received by person)
Location of Work to be inspected ~_~C; ( '~ ~,~
Name of person requesting inspection ~ ~-
Address of person requesting inspection Phone No. LI~-
Type of Inspection (circl~riate one): Permit No. ~-~-/-~ /
· "~ '~aming~x~Chimney Plumbing Final SewerExcav. Other
Sewer Foundation ~F
INSPECTION NOTES:
Inspected: Date '~-- ~ · Time. By
Remarks:
RESTORATION REQUIRED ...... YES. NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel [-]Asphalt []PCC []Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[]No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date Time Received by ~:~' (p~//~e~person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney~/ Plumbing \Final Sewer Excav. Other
Inspected: Date ~7 '-~ ' ~/ Time By
Remarks:
RESTORATION REQUIRED ...... YES. NO_
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel [~]Asphalt ~-]PCC []Other
[] Repaired by City Work Order #
~-] Repaired by Permittee [] COMPLETE
[]No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date .~C~ ~.~ --~ f Time Received by ~'~- (ph~
Location of Work to be inspected -~_~ [.-~> [/~jI ~_~ ~
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. 4f ~-7 7 /
Sewer Foundation Framing Chimney~} Final Sewer Excav. Other
INSPECTION NOTES: ,~
Inspected: Date ~' ~* * ~'/ Time By ,
Remarks:
RESTORATION REQUIRED ...... YES. NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel ~-]Asphalt I~PCC []Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
]21 EAST 5TI! STREET, PORT AN(}ELES. WA 98362
ELECTRICAL PERMIT ISSUED: 8/01/2001 PERMIT NO 7355
OWNER/APPLICANT PROPERTY LOCATION
SHERIDAN SCHROEDER 2013 4TH ST W
2013 W 4TH STREET Lot: TX5331/2EXTX6521&EXR/W
Block:
SL29
Pod Angeles, WA 98362
Long
Legal
360/715-1175 Subdivision:
T: S: Parcel No: 063000102900000
CONTRACTOR ARCHITECT
ANGELES ELECTRIC N/A
524 E. 1ST ST.
PORT ANGELES, WA 98362-0000 , 98360-0000
360/452-9264 360/000-0000
PROJECT INFO
Project Type: RES.REMODEL Project Value: $0.00
Occupancy Type: Construction Type: ADD CIRCUITS
Occupancy Group: Zoning Use:
Electrical Heat:
[] Baseboard 0 KW [] Riser [] Underground Service
[] Furnace 0 KW [] Overhead Service Voltage: 120,240
[] Heat Pump 0 KW [] TempService Phase: [] 1 []
[] Fan Wall 0 KW Service Size: 200
Feeder Size: 0
PROJECT NOTES
turn garage into den. adding 3650 w. in fan forced heat
FEES ASSESSMENT Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $45.50
Temp Service: $0.00
Misc Fee: $0.00
TOTAL FEE: $45.50
AMOUNT PAID: $45.50
BALANCE DUE $0.00
('()MMI:NTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COLOR,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERM]T CARD AND APPROVED pI~MNS AT JOB SITE 7~-~
DITCH
ROUGI~-I~/COWR 2~'q/o, .~ ~
SERVICE
FINAL { ~j?/ffv! I :F d" {
GENERAL COMMENTS:
~.
1" \tIP '
I'sa;~;!
, BUILfJlNG PERMIT
OWNE~APPL.ICANT
SHERIBANSCHROEDER.
"2013 W4TH STREET
Port Angeles, WA 98362
360/715-1175
T:
CQNTRACTOR
DAVES HOME REPAIR
833 W 15TH ST
PORT ANGELES, WA 00009-8363
360/452,.8335
PROJEC1;INFO
Pr6jectValue: $8,640.00
Project Type: GARAGE ADDITION
Occupancy Type: RESIDENTIAL
Occupancy Group:
Construction Type:
Zoning Use:
,CFI:Y PE)~ORTANGELES
PUBLIC WORKS- BUD.l)ING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
,',"..-
;;-\] "'S.'~'
,ISSUED: 10/26/2001 PERMIT NO: 13056
.'.PROPERTY LOCATION
2Q134TH ST W
Lot: TX5331/2E>g)(E?521 &EXRfYV
Block: SL29 o Long Legal
Subdivision:
,S: Parcel No: 063000102900000
I
i
ARCHITECT
N/A
" ,98360-:9000
360/000-0000
. SFID'Unlts:
SFD SQ FT:
Commercial:
Industrial:
Garage:
o
o
o
o
o
MFDOnits:
MFD SQ FT:
o
o
~
o
vJ
~.,.
PROJECT NOTES
CONSTRUCT A 12'X24' GARAGE WITH A 6; CANTILEVERED ROOF OVERHANG
"FOR A TOTAL OF 432 SQ;FT.
~CEIPT# 8201
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$167.25
$0.00
$4.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
.^,,,,,"".
Mise Fee 1 :
Mise Fee 2:
''''Mise Fee" 3:
.c
t
J'-
$0.00'
$0.00
$O.po'
TOTAL FEE:
,P-MOUNT PAID:
. "", BALANCE DUE:
$171.75
$171.75
$0.00
.Sepa~ .F.>>.4trmlts al'$~quired forelectricalWork,SEP~Shoreline, E~A,utIlitie~,p~vate a'Jld public impf()ven'lE!~~t.T~,~~It~
~;I~ :~~cH~~::.:::~~::~~:.~~~~~;%~;,:~t~:W;~~I:~h!V~~~r:::~~~r:J~~l.~;q~~~~e:
Inspection. I hereby certify that I have read and examined this application and know the same to be true andeorrect. All provisions of
laws ard ordinances governing ,this type of Work wi!1'6e complied witlfWhether speCified herein or not The g~dting gT,a,penniU:foes not
presurre to give aQrity to violate or cancel the provisions of any state or local law regulating construction or the, Perfonnati~ of
~ction. (" J
~'~ /6:-Z6--2J5ul .
Signature of Contractor or Authorized Agent Date ~ignatu~"ofOwner (itown~r is build~r) ;
I:' ,
BUllIDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS, PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE, IT IS UNLAWFUL T~COVER/
INSULATE ORCONCEALANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION, I
KEEP PERMIT CA-RD AND APPROVED PLANS AT JOB SITE
~
INSPECTION TYPE I:, DATE ,~ I ACCEPTED COtt1MENTS ., ,
'. , " I YES NO
" ". .
FOUNDATION:", , } rrto ftf!J' SlOb., If :..1P'6 l' " J I----ef AI.
FOOTINGS ; ">
WALLS
FOUNDATION DRAINAGE ...',
ELECTRICAL (LIGHT DEPl) SEPARATE PERMIT: #
ROUGH-IN I L -. ,.,
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN .JV::',
WATERUNE .' '. .
GAS LINE
BACK FLOW / WATER ,
.... ", '. '.
AIR SEAL
WALLS , " ,
CElUNG .. " I I "
.
"
FRAMING i
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF /CEILING
DRYWALL '. .. . .
,.
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I I
MECHANICAL
HEAT PUMP ,
WooDSTOVE / PELLET/CHIMNEY /INSERT
HooDIDUCTS , ,
PWUTILlTIES/SITE WORK' (EliSineering Division) SEPARATE PERMIT#'s: -c
WATERLINE / METER
SEWER CONNECTION ,
SANITARY
STORM .. .' ., 0., ,
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDE~IAL . DATE ;, YES NO;.... '. ~OM.ME!PIAL ,PATE ',i'AP9~}'iJ:'ED ;
, , c
, ,.t " .' . >.5,,,'.':;'; .' . ': .:: ". ~. ., , r::- YES<lt '" NO'.
. .
ELEC1iuct\L'-bGuT DEPT. """ , 417-4735 .':' 0~ ' . } '};' :t .i
' ELECTRICAL
" " ;.1 :',8' , UlGHT,DEPT t, ,'x;,;,
,
CONSTRucTIoN Ii. W.fPW/ '. " . : CONSTRUcittlN -R.'<v: "'" ' .
; I., , ,i
ENGINEERING ' . ,.'417-4807 PW /ENGINEERlNmn:.,. " '.'
,;. ",
FIRE 417-4653 FIRE DEPT. , \
PLANNING DEPT. 417-4750 ~'lb\~ PLANNING' DEPT. !>. fR} ,
-:. , 417-48i5 ' )" ..A" '1) " BUILDING " . ..' " 't,' I:c~"'., ,'C'. I:';, . "
BUILDING 'J,'
C:\APPL.WPD
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BUILDING PERMIT -APPLICATION
The Building Permit - Pre-application must be j1lled out completely.
Please type or print in ink. Uyou have any questions, please caD 417-4815
APplicant'and/or Agent: l)a u', 0 D..c.V\\o11:~ ( C'i./f b 70 -8q(p r) Phone: ~tD - 52--
Owner: ~ he,idQ if S c.. h nsed er ' Phone: ,to - 715- " 7~
Address: ~ 0 13 W liST t-{i l, City:]:bC2.\ . a. \1<] e{~ Zip: Cj' 2{ 3 b 5
ArchitectlEngineer: Phone:
Contractor Dft~lg'DuV\ ml"E. License #: DlJvllSYf<. Ol''t-xp:' 3/Z/:ZbD2 Phone: 452 -~~'3S-
Address: g:33 W.e.-ST IS- City: ~(2I-tt-lIqele5 Zip: l:J8'3'.3
PROJECfADDRESS: ::20. \3 4J~ST '1-tlt ZONING:4S-7
LEGAL DESCRIPTION: Lot: Block: Subdivision:
CLALLAM COUNTY PARCEL NUMBER: Ob'3ooo IO~Cf()t>&>O Credit ~ard Holder Name:
BiUing Address: City:
Credit Card #: Exp. Date: VISA Me
TYPE OF WORK:
o Residential 0 ~ew Constr. 0 Re-roof
o Multi-family ..r-Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
o \yoodstove
~arage .
o Deck ..
o
c.,,1e./ 4
SIZEN ALUATION:
Y 32-- . SF. @ $ 2.0 ISF. = $
SF.@$ ISF.=$
SF.@$ ISF.=$
_ TOTAL VALUATION $
/2... )L 2.f{ ~a ('OJ e-
~6 '10
B~'YO
~a
COMMERc::IALIRESIDENTIAL: Occupancy Group: ;;;. Occupant Load: Construction !ype:
No. of Stories: Lot Size: I 82 'b. .... % Lot Coverage:' 3 t '1 ~o % . <,
~;t::,Existing Lot Coverage: I 2C'O Isq. ft. +PJ:oposed ~t Coverage: L-/ .3 Z Isq. ft. = TOTAL LOTICOVERAGE: , ~-3 2.. Isq.ft
" ~,;
PLAN _~
BLDG.
DPWjp
FIRE
ESA/WetIand s):o Yes 0 No SE Checklist required? 0 Yes 0 No Other: OTHER~
Bun.DING APPLICATION SUBMITTAL: Your appliclltion and site plan must befdled out completely to be accepted/or" . . The
Building Division can provide you with more detailed information on the application and plan submittal requireme~ts.
BUILDING PERMIT APPLICATION SUBMITTAL: Your completed application, site plan (for additions) and building construction
plans are to be submitted to the Building Division.
V ALUA nON OF CONSTRUCTION: In all cases, a valuation an10unt must be entered by the applicant This figure will be reviewed and
may be revised by the Building Div. 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 permit application and construction plans are'submitted. All othbr
permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days ~fthe date ofappI'ication, this application will expire by
limitations. The Building Official can extend the time for action by the applicant up to 180 days, on 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. n ~ f\
PW-l102_13[revSJOl] Applicant: ~ Q~ Date: (0;"'2-'2. -2~(
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1
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
::~/i~~1 -&1 Time Received by a::
CJ Lj~
(phone, person)
Phone No.
Permit No. / S05:'f.p
Plumbing Final Sewer Excav. Other
#
Time
. By
IIIJt1/tJ - ~
I
(tj:
RESTORATION REQUIRED . . . . .. YES NO
.
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved o Gravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
1_
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE) .