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Home My WebLink About523 E 3rd St - BuildingPREPARED 2/02/07 15 42 19 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 2/02/07 ADDRESS 523 E 3RD ST SUBDIV TENANT NBR TOM WATSON CONTRACTOR COZI HOMES CONSTRUCTION INC PHONE (360) 452 9906 OWNER WATSON THOMAS A PHONE PARCEL 06 30 00 5 2 5868 0000 APPL NUMBER 06 00001272 RES DETACHED GARAGE PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BLM 01 1/03/07 JLL BUILDING FOUNDATION MONO SLAB 1/03/07 AP 01/03/2007 08 42 AM PBARTHOL BRETT 360 775 1809 01/03/2007 04 19 PM JLIERLY BL9 01 1/26/07 JLL BUILDING SHEARWALL 1/29/07 DA 01/25/2007 08 48 AM PERMITS KEN 460 0036 CALL FOREMAN 460 6522 TO BE THERE FOR INSPECTION 01/29/2007 04 19 PM JLIERLY 097 shank reqd on abwp jll BL9 02 1/30/07 JLL BUILDING SHEARWALL 1/30/07 AP 01/30/2007 12 28 PM JLIERLY 01/30/2007 12 35 PM JLIERLY BL99 01 2/02/07 JLL BUILDING FINAL 02/02/2007 08 29 AM PERMITS t' lY KEN 460 0036 GARAGE FINAL COMMENTS AND NOTES PREPARED 1/30/07 12 34 30 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/30/07 ADDRESS 523 E 3RD ST SUBDIV TENANT NBR TOM WATSON CONTRACTOR COZI HOMES CONSTRUCTION INC PHONE (360) 452 9906 OWNER WATSON THOMAS A PHONE PARCEL 06 30 00 5 2 5868 0000 APPL NUMBER 06 00001272 RES DETACHED GARAGE PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BLM 01 1/03/07 JLL BUILDING FOUNDATION MONO SLAB 1/03/07 AP 01/03/2007 08 42 AM PBARTHOL BRETT 360 775 1809 01/03/2007 04 19 PM JLIERLY BL9 01 1/26/07 JLL BUILDING SHEARWALL 1/29/07 DA 01/25/2007 08 48 AM PERMITS KEN 460 0036 CALL FOREMAN 460 6522 TO BE THERE FOR INSPECTION 01/29/2007 04 19 PM JLIERLY 097 shank reqd on abwp jil BL9 02 1/30/07 JLL BUILDING SHEARWALL 01/30/2007 12 28 PM JLIERLY COMMENTS AND NOTES for inspection Date BUILDING DIVISION CITY OF PORT ANGELES Correction Notice Job Located at <7? fir Inspection of your work revealed that the following is not irfaccordance with the codes governing the work in this jurisdiction f)cc ¶-h J f v.1,.L 1- to c 1 t :sc 4-1e-_..a 4` 14 t I t /J_. G, 8 r> S 'mac' e S Y� 4-11 t .--7: 601_11 cd 1,\ U S These corrections must be made and are not to be covered until einspection is made When corrections have been made, please call t ii" l C. Irsdecl'or for Building Division DO NOT REMOVE THIS TAG PREPARED 1/26/07 9 50 09 INSPECTION TICKET PAGE 21 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/26/07 ADDRESS 523 E 3RD ST SUBDIV TENANT NBA TOM WATSON CONTRACTOR COZI HOMES CONSTRUCTION INC PHONE (360) 452 9906 OWNER WATSON THOMAS A PHONE PARCEL 06 30 00 5 2 5868 0000 APPL NUMBER 06 00001272 RES DETACHED GARAGE BL9 01 1/26/07 PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BLM 01 1/03/07 JLL 1/03/07 AP BUILDING FOUNDATION MONO SLAB 01/03/2007 08 42 AM PBARTHOL BRETT 360 775 1809 01/03/2007 04 19 PM JLIERLY BUILDING SHEARWALL 01/25/2007 08 48 AM PERMITS KEN 460 0036 CALL FOREMAN F 460 6522 TO BE THERE FOR INSPECTION COMMENTS AND NOTES S1+.41.-1 l 8,1 ,06 v--) ,dr-C PREPARED 1/03/07 9 21 42 INSPECTION TICKET PAGE 16 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/03/07 ADDRESS 523 E 3RD ST SUBDIV TENANT NBR TOM WATSON CONTRACTOR COZI HOMES CONSTRUCTION INC PHONE (360) 452 9906 OWNER WATSON THOMAS A PHONE PARCEL 06 30 00 5 2 5868 0000 APPL NUMBER 06 00001272 RES DETACHED GARAGE PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BLM 01 1/03/07 BUILDING FOUNDATION MONO SLAB 01/03/2007 08 42 AM PBARTHOL BRETT 360 775 1809 COMMENTS AND NOTES CITY OF PORT ANGELES ems' DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION C) 321 EAST 5TH STREET PORT ANGELES, WA 98362 Aso Application Number 06 00001272 Date 12/11/06 0 Application pin number 727048 1 Property Address 523 E 3RD ST -►J ASSESSOR PARCEL NUMBER 06 30 00 5 2 5868 0000 c Et a/t Tenant nbr name TOM WATSON Application type description RES DETACHED GARAGE Subdivision Name 9 d 7 Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 5256 Owner Contractor WATSON THOMAS A 523 E 3RD ST PORT ANGELES WA 983623401 COZI HOMES CONSTRUCTION INC 324 E 9TH ST PORT ANGELES WA 98362 (360) 452 9906 Permit BUILDING PERMIT RESIDENTIAL Additional desc GARAGE Permit pin number 91256 Permit Fee 151 75 Plan Check Fee 60 70 Issue Date 12/11/06 Valuation 5256 Expiration Date 6/09/07 Qty Unit Charge Per Extension BASE FEE 95 75 4 00 14 0000 THOU BL -2001 25K (14 PER K) 56 00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments 12/07/2006 09 19 AM SROBERDS The proposal will result in a new detached garage in the RS 7 zone No land use issues noted MAINTAIN CLEARANCES FROM SERVICE WIRES Electrical load calculations and elctrical permits are required Public Works Utility Engineering has no requirements for this plan review Other Fees Fee summary T \Policies \1102_15 building permit inspection record05.wpd [1/4/2005] STATE SURCHARGE 4 50 Charged Paid Credited Due Permit Fee Total 151 75 151 75 00 00 Plan Check Total 60 70 60 70 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 216 95 216 95 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 fora 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 give authority to violate or cancel the provisions of any state or local law regulating .construction or the performance of construction. Signature of Contractor or Authfirfred Agent Date Signature of Owner (if owner is builder) Date CALL 417 -4815 FOR BUILDING INSPECTIONS CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. CALL 417 -4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE FOUNDATION: FOO.TIP'CS kn SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) SHOWER PAN MEDICAL GAS LINE AIR SEAL WALLS CEILING I FRAMING JOISTS GIRDERS SHEAR WALL /HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR I INSULATION I SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE /PELLET /CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT T \Policies \I 102_15 building permit inspection record05.wpd [x/4/2065] BUILDING PERMIT INSPECTION RECORD DATE I o I_4_14. I V 91 0 9 p/. CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I >l A PLANNING DEPT 417 -4750 1 I I )1 t1 BUILDING 417 -4815 .10-4/P407 V U-4-1 ACCEPTED YES I NO FINAL SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE I ACCEPTED I YES I NO 1 417 4735 ELECTRICAL LIGHT DEPT COMMENTS FINAL DATE ACCEPTED BY. CONSTRUCTION R.W PW ENGINEERING FIRE DEPT I PLANNING DEPT BUILDING DATE ACCEPTED BY., FOR OFFICIAL USE ONLY BUILDING PERMIT APPLICATION Date Rec. Permit 0 Fill out COMPLETELY and in INK. Your application and site plan MUST BE Date Approved: COMPLETE to be accepted for review If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4711 ylate Issued: Applicant or Agent: a "5iti,Kl Vn1 4�iK� Owner 'Cl.� i7 Address: S Z� F70-4). S City Architect/Engineer Contractor Address: PROJECT ADDRESS 51, 7? LEGAL DESCRIPTION Lot: 2 CLALLAM COUNTY PARCEL NUMBER. O(-r 0 C9 84.53 Q O C7 TYPE OF WORK. Residential New Constr Multi- family Addition Commercial Repair BRIEF DESCRIPTION OF THE PROJECT r COMMERCIAL/RESIDENTIAL. Occupancy Group No of Stories: I Lot Size: iO,Ckb Total lot coverage I 7 Y4 PLANNING USE ONLY Re-roofi Stove Move Garage Remodel Demolition Deck Sign Other ESA/Wetland(s). Yes No SEPA Checklist required? Yes No Other VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and maybe revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE. IF a plan check fee is due it must be submitted 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 If no permit is issue within 180 days of the date of application, the 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 R105.3.2 of the International Building/Residential Code, 2003) 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. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permits prior to work T•\ FORMS \BIdgPennitform. pplicant: State License City P-67ieici Phone: L71-- 2 Phone: (1— 01 a3 O f'chrV Phone: Exp STZF/VALUATION SF /SF SF /.f :GO /SF SF /SF TOTAL VALUATION Zip Phone: Zip ZONING Block: SS Subdivision. ,Op K n t d El} G.( S. 9$3 &Z I ('A) 2 Occupant Load. Construction Type: Existing Sq. Ft. 1O X Proposed Sq Ft_54/9 'TOTAL Sq Ft. g Date: 11 V 7-- t5(. APPROVALS PLAN BLDG DPWU FIRE. OTHER 1 p lg- ->t ..00Ir .11 ( ~ORT ~ -lO~~ 6"~ .. -=-- ~ ~-;-;ii<P CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32] EAST 5TH STREET, PORT ANGELES, WA 98362 Lasered CEO Appl~cat~on Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Appl~cat~on type description Subd~v~s~on Name Property Use Property Zoning . Appl~cat~on valuat~on 06-00001283 Date 160350 523 E 3RD ST 06-30-00-5-2-5868-0000- TOM WATSON DEMOLITION 11/30/06 RS7 RESDNTL SINGLE FAMILY 1000 n~LfJ) lzjl ;bo Perm~t . . . . . Additional desc . Perm~t p~n number perm~t Fee Issue Date Expiration Date DEMOLITION DEMO OF EXISTING GARAGE 91678 50.00 Plan Check Fee 11/30/06 Valuation 5/29/07 .00 o ~\)i \ N ~\}1 ~ ~\\1 \Y- ~ \~ ~ Owner Contractor WATSON THOMAS A 523 E 3RD ST PORT ANGELES WA 983623401 COZI HOMES CONSTRUCTION INC 324 E 9TH ST PORT ANGELES WA 98362 (360) 452-9906 Qty Un~t Charge Per BASE FEE Extens~on 50.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 50.00 50.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 50.00 50.00 .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 of 180 days after the work as commenced, or if required inspections have not been requested withrn 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 governrng thiS type of work will be complied With whether specified herein or not. The grantrng of a permit does not presume to give authority to violate or cancel the proVIsions of any state or local law regulatrng construction or the performance of construction. 0€A'- f -3 /~ J? Signature of Contractor o~n ed Agent / f.- 3D- &0 Date Signature of Owner (If owner is builder) Date T \Pohcles\1102_IS bUlldmg penmt mspectlOn record05 wpd [1/4/2005] B~DING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS CALL 417-4735 FOR ELECTRICAL INSPECTIONS CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTiCE IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION. FOOTINGS SHEAR WALLS I WALLS FOUNDA TION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLOGS ) PLUMIlING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) SHOWER PAN FINAL DATE ACCEPTED BY MEDICAL GAS LINE AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR WALL/HOLD DOWNS WALLS I ROOF I CEILING DRYWALL (rNTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB W ALL I FLOOR I CEILING I MECHANICAL HEAT PUMP / FURNACE I DUCTS GAS LINE WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING I SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT#'s SEPA P ARKING/LIGHTING ESA LANDSCAPING SHORELINE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R W {PWI CONSTRUCTION - R W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT. 4] 7-4750 _' I .... PLANNING DEPT BUILDING 417-48]5 &,./1 If)(/? '\./ W BUILDING T IPohcleslll 02 15 building pennlt InspectIOn record05 wpd [lr412005] PREPARED 12/01/06, 9 32 23 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 4 12/01/06 ADDRESS TENANT, NBR CONTRACTOR OWNER PARCEL APPL NUMBER 523 E 3RD ST TOM WATSON C02I HOMES CONSTRUCTION INC WATSON THOMAS A 06-30-00-5-2-5868-0000- 06-00001283 DEMOLITION SUBDIV PHONE PHONE (360) 452-9906 PERMIT: DEMO 00 DEMOLITION REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ~~~~-~~---~;/ii/~~----tt~----~~~~~~~~:~~~~~---~~~~--~;-~~------------------------------------ ~ 12/01/2006 09 21 AM DYASUMUR --------------------------- -------------------------------------- COMMENTS AND NOTES -------------------------------------- Laserer! CEO ~ ~ORTANGELES Lasered CEO WAS H I N G TON, U. S. A. Public Works & Utilities Department October 6,2006 Tom Watson 523 East 3 rd Street Port Angeles, Wa 98362 RE: Port Angeles Landfill \Vllste Disp(\snl Applif'..ation, V/DA 0'6-14; Building demolition at 523 East 3 rj Street, Port Angeles. We have received your application for disposal ofbuilding demolition debris from the referenced site and ieviewed the testing results for lead content. Based on the testing results the debris appears to be acceptable for use in the landfill. A copy of your apprvved application is attached. This approved application must be shown to the landfill scale attendant at the time of disposal. Please be advised that this disposal application is only for the materials a.l1d quantities listed in the application. Materials nOl listed or in excess of the quantities noted may require separate applications and approval. Please can if you have questions. Very truly yours, J/UAUa-~ r Gary W. Kenworthy, P.E. City Engineer Deputy Director of Engineering Services GWK:lf Encl.: WOA 06-34 Copy: Ken Logluy N:\PWKSIENGINEER\WDAPPLlC\il6-34 FIle: I..llndfil1 Solid Waste Dj5po~al Apphcau1l1lS '-, Phone: 360-417-4805 / Fax: 360-417-4542 'A/aha;.".. unA/UlI ",in,,,,f,,,o ll~ J C~all. "'. Ihli,..u,,,,.l,co trIJ ,..ihJ...."I,....e 'It:.' -'e I , ~ 'i'Oflt It-ll: ,,~~ ~~ 1# ~-4 t\"f:=- --~JJ1 ~1~~~' w~.o&-~4 rORT ANGELES LANDFILL WASTE DISPOSAL APPLICA TJON LaserF;r; eED To: CI!y of PortAngeles, City Engineer 321 E Fifth Street p,O. Box 1150 Port Angeles, Washington 98362 NOTE: Phone: (360) 417.4803 FAX: (360) 417-4709 An questions must be answered for waste to be approved. 1. Generator Infoi~~tion; _ ------- ---- --- Company Name: ~ tvA.:r-~ "....- Mailing Address: :i ~~. 3$::6 57. -;;;; ~~, ~ 9& if; , = Contact ' ~~ Wi ~S_ Phone: ~ lU". 01 ~ '; ~ t Project Name: : ~ ~o ~ Proje.ct location: <::r~ A-r 4~ot/i(, J - r Olher Comacts (if applicable): ConsuUing Firm; 21"NDV',- J ~'-''''~t Contact: ~- ~ C,d&<<. Phone: =- 'if., -ar-ol Contractor Name: ~ U...,;k,.....JI....-J Contac.t: Phone: laboratory; Conlacl: Phone: ~ ...... .----- .....- J''''fJc. - ~ ~ ~t V;~~~.. Uc. ~ ~-W1 -d'l'2 ~ :- ~ - ----... - -- City of Por1 Aro{}olos ' LElndtll1 Waslo Di:;"(i:;al ^pphcullon J. Source of Waste: -~ _. - - - -.- .-----.- --- ---- --- , l Lasered CEO '. Check the appropriale box below and briefly describe the project process, andlor cleanup tha~ will or has produced lhe waste rcquinng disposal. Include lhe gasoline sCi"Vice statton number (if applicable). CERCLNMTCA Remediation Agency Contact: Independent Remedial Action _ UST Removal Unused Chemical Producl Spill X Other Source: LJrg.c,s '''/~u.,J4 Lr4~~ ~ t1i. I~~USIJ.~ fu ,.;, /7'S -- ~~ ~'tb.-.J 4. Waste Material Composition: (check all that apply and Include percent of total) Soil % Foundry Slag % . Concrete/Asphalt % Dredge Sediments % Preserved Wood % v Debris lb~ % . Coal Ash % Other (list) Wood Ash % _% -- _% NOTE: Total must eQual 100%. 5. Waste Material Contaminants: (check all th~t apply) Gasoline Metals )< Solvents Heating Oif Unused Motor Oil Used Motor Oil/Waste Oif Of her ~~ 4(. 7'cUJ ~~ Other Pqtroleum Product ~~S ~lIIe"1' (t-I v...~ C~ ~) Diesel PCBs Unknown .... .ao -. .____._..~ 4_",___ __ ~ . - ... -.... NOTE: .....-.- -- -- Supply any MSDS information with application, if available. City or Pmt Anon/us l CIIl{HiI' Wnstc Dir.pu:;a/ ApphciltlOIl Pogo - ,,' '. 6 Estimated Quantity of Waste for Disposal. - - -~ --------- ---- Z~ Cubic yards I Drums I Other - ..------- - -. -I Laserel I CEO ~ Tons (estimate both) Tons (estimate both) NOTE: Eslimaled quanlily lor disposa!musl be Wilhin20% o( the quanlily aelually disPosed. (10% (or projects Over 7,500 tons or 5,000 cubic yards.) 7. Frequency of Oisp,osal: .\C One time Monthly _ Annual Other - 8. Waste Sampling; l Propor characterization o( the waste (or disposal requires lhe collection of repreSentalivel samples. The methods and equipmenl neeessa/)' for oblainlng representalive samples of a waste, and the (requency o( sampling, Will va/)' with the type and (orm of the WSste. Check the appropriate box and brielly describe how and where Ihe waste was sampled. Include site maps with sampling locations If Possible. . Number of COMPOSITE samples -L & number of discrele samples per COlllposlte '1.._ Number of DISCRETE samples 4 ~ - . ~.J"" ,0; 9/-Pt<t <').c . J-k f:.!.:....0IJ...) 74.._ 6.._c = ~ ~~, (; ~) 2J<,'1 ,(;,.,....,""'.r, -L JkJ 4"~.,... I~ = NOTE 1; Unless prior approval has been granted by Port Angeles, the following Sampling frequency will be used: 0-25 25. 100 101 - 500 501 - 1000 1001 - 2000 >2000 c.ubic yards cubic yards cubic yards cubic yards cubic yards cubic yards = = = = = = 1 composite sample 3 composite samples 5 composite samples 7 composite samples 10 composite samplos 10 plus one sample for each additional 500 cubic yards NOTE 2: One composile sample shall eonla.n a minimum or three/maximum of five discrete samplos, Cdy or Port Angelos. Lnndllll Wasto Dis"osal Applicul'llll Plino . '1 . . 1\:10 Waste Analysis The "Dangerous Wasle Regulalions" (WAC 173.303) shall be ulilized 10 delermlne the I appropriale analytical require".,enls lor wasle characlerizalion. Ecology Publication '91'30 (Revised April 1994) "Guidance lor Remcdialion of Pelroleum Conlaminated S01ls" shall also be used 10 characlerize pelroleum contaminaled soils Irom UST releases. Submn all laboratory analytical resulls, OAfOC dala, and Chain 01 CuslOdy sheels along with Ihis aPPlication. (NOTE: The laboralory must be accredited by Ihe Washlnglon Slale~Ocpartmenl of ECOlogY.)1 - ..- ------.--__.. M, -. --_o~ Las q) Ct:. -. . a) list arl analy1ical test methods used: _ht1A-I"!I' !76thie, b) Provide a narrative as 10 why Ihe above analytical methods were selected; ~ .~ ?Q ~6< &540 ~ ~1"""""''I. ~ ~ 1~<$'Li rr"Y ~ A,( ",-,..,. ~ - 7"~ S" 7'"'4Ic~ . NOTE: AddWonal shee'ls attached: 0= YES _ NO 10. Soli Classificalion: ('''FOR PETROLEUM CONTAMINATED SOILS ONLY") Based On the a""'ytical data and Ecology PUblicali"" #91,30. the soil classification Is: (check one) Class 1 Class 2 Class 3 Crass 4 Calculated Hazard Index 11. Dangerous Waste Affidavit: BaSed on a reView 01 Ihe analytical lesl resulls, sile history, and the applicable regulatiOns, ihis waste is classified as: (check one) , --K. Neilher Dangerous Wasle (OW) nor EXlremely Hazardous Wasle (EI-fW) Dangerous WllSto (OW) and Wasto Coda: eXlremely Hazardous Was!e (EIlW) and Waste Code: _ M. .. _ _____ ___ _~.. ~..- ---- . .... City of Port ^'ll./llll.!> lUfl{J(df Wuslo Disl>osa"-ApP"(~;l DR"..... ~ .. J ~ . . . 12. Certification: '. \Ve, THE UNDERSIGNED, certify lhat Ihis application Is true ~o the best or our knowledge. All Information provided Is correct and the enclosed analytical results represent the proposed waste male rial 10 Ihe besl of Our abilllles. la eSe/en ED - ~~r" 6~<L Printed Name C~)UI '- f A-J~c, Z-t. , Company _ 11)1'110 c: Date , . - ~ . , .., ~J . ~.~I~,~\ ...t.: r If: N If'OllCY _ P\ 1000_ 6W\ lOO9_01.WPO - Cily of Port Atlgolos . Landfill Wuslo Dbposul Appli:::ollon n___~ .. NVllaboratories, Inc. 4708 Aurora Ave. N.. Seattle, WA 98103 Tel: 206.547.0100. Fax: 206.634 1936 www.nvllabs.com A~ AIHA -IH#101S61 ~ WA - DOE # C1765 ~O:iiiel'U Attention: Mr. Tracy Gudgel Project Location: 523 East 3rd St., Port Angeles Toxicity Characteristic Leaching Procedure - Lead (Pb) _ Client: ZenOVIC & Associates. Inc. Batch #: 2612780.00 Address: 301 E. 6th 51. #1 Lasered Matrix: Bulk Port Angeles, WA 98362 CED Method: EPA 1311/70008 Client Project #: 06253 Date Received: 0912212006 Samples Received: 1 Samples Analyzed' 1 l8b~D 26083018 Client Sample # 06253A Rl mg/l 0.4 Results in mg/l 1.8 Results In ppm 1.8 Sampled by: Client Analyzed by: Ahmad Izzat Reviewed by: Nick Ly Date Analyzed: 09/29/2006 Date Issued: 09/29/2006 ~-- mgl L =Milligrams per liter Rl = Reporting Limit ppm = parts per million '<' = Below the reporting Limit Note: Method QC results are acceptable unless stated otherwise. Unless otherwise indicated, the condition of all samples was acceptable at time of receipt 0___..... 0.__ 1l..1_. ""'" ^....""",.. ~ . . HVL Laboratories. Inc. - 4708 Aurora Aye N. Seattle. WA 981o:t Tel: 206.547.0100 Emerg. Pager 206.344.1878 t.888.NVL.lABS (685.5227) Client ZenOYic.!. Associates. Inc Stlwt _~ 0'. G lo ~ ~ ee..... 1::l \ Lasered CEO BATCHID 2612780.00 CHAIN of CUSTODY SAMPLE LOG Port Angeles Project Man.ger ~ ~7' 6"~~ Project Locetlon ~ ,~2 ~ ~"1' ~ S?; fh1,r (J.<,",~ Phone: (360) 417-0501 Fax: (360) 417.0514 NVL Batch Number caent Job Number Total Sampl.. t Tum An:Iuncf Time 0 1-Hr 0 24-Hrs 04 Days o 2-Hrs 02 Days g 5 Days o 4-Hrs 03 OaV$ 06 to 10 Davs Plae call for TAT _ tilan 24 Hrs Em&IlIllddrus ~tt- ~.~ 6bZ.5 ~ fo Aab86tD& Air o ?eM (NIOS_H 7-400) 0 TEM (NIOSH 7402) U TEM (AHERA) 0 TEM (EPA Lewlll) 0 Other I rO~BuIk o PLM (EPAlSOOIR-931116) 0 PLM (EPA Point Count) 0 PLM (EPA Gravimetry) 0 TEM Bulk I t~ Del. .J..imft Matrix RCRA .....s 0 A!I 8 ----l ~tai Metal~ ~ ppm (ANE.) [l Ai.r F~r o Paint Chips o Arsenic (As) 0 Lead (Pb) UAI!3 . TCLP o ppb (GFAA) o 0rinlrJng water o Paint Chips (Asu) o Barium (8a) 0 Mercury <Ha) o Copper (Cu) L -. UOustlwipe o Waste Water o CadITllWtl (Cd) 0 Selenium CSe> o Nickel (Ni) o SOll - 0 CfIromium"""{Cr; 0 SilVer (Agf-- ~(2n)- I 0 Other Types OFiberg\alu o Nuisance Oust o Rotometer CSIlibratlon 0 Other '(Specify) -- - I of Analvsla 0 SiIlC8 o Respirable Dust 0 MoIdIFungus t Condition of Package: 0 Good 0 Damaged (no spillaoe) 0 ~ d~ ~!p.lage) .. - -- - Seq." l..Gb 10 CUR SlIImpfe Number Comnlfll\ta AJR 1 ! ""- ?JC"'"{A .."u,I1 ~4/,j i 2 -- 3 4 ..~-~ 5 6 ~ - , =-=t= 7 a ~ Ii ! i--- 10 -. 11 12 13 -- --- - - -- - i 14 --- .- - - 15 I - -- -- - - ---- Sampied bv ___~.linqlJished by Received by Analyzed by Rnutta Called by .. ,--....'.. Recults faxed bv L_____ _._____ .. ___, ___ ___. _ L .__ SpeclaB lnatructions: Unless requested in 'Hl'ilin'9, all samples wiH be dis~.I>~d of ;V:o (2) ~It$ aft~r aNilyais. p(/-AEti /A'yI- R'fJtJi. ~~ ... ""- .. lasered CEO BUILDING PERMIT - APPLICATION Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 ApplIcant or Agent: - ,3 'r cJYY1 (1) ]'1-isc7x J E::1~ E ~td .sf I Address: City: P 14 Phone: t{ S;;l - C; 7C>6 Phone: L../ I 7 61 ~ Zip: 9'9:.lt?- Owner: ArchitectlEngineer: Contractor C n -z...~ Address: State LIcense #: Phone: o~R7< Exp: -. Phone: Zip: PROJECT ADDRESS: .5";23 E LEGAL DESCRIPTION: Lot: ;>...2. CLALLAM COUNTY PARCEL NUMBER: City: ,~,d ZONING: Block: S ~ SubdivisIOn: (' Q () f C c,!rr ~ .so <!)~ oao,'95J?bS 000 TYPE OF WORK: SIZEN ALUATION: o ResIdentIal 0 New Constr. 0 Re-roof ____ 0 Stove SF. @ $ /SF. = $ ~ o MultI-family 0 AddItIon ~veP""Garage SF. @ $ ~) /SF. = $ WI CoO o Commercml 0 Remodel ~olItIOn 0 Deck SF @ $ /SF = $ o Repair 0 SIgn 0 Other . r.... . _ I TOTAL VALUATION $ BRIEF DESCRIPTION OF THE PROJECT: ~ s.,~1U :J..n-r~.." COMMERCIAL/RESIDENTIAL: Occupancy Group: No. of Stones: -L Lot SIze /0500 EXIstmg Sq Ft I Jt:>f) Total lot coverage % Occupant Load: & Proposed Sq Ft. ConstructIon Type' ~t:C> = TOTAL Sq. Ft / tUf(r- PLANNING USE ONLY: APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ ESAlWetIand(s). 0 Yes 0 No SEPA ChecklIst required? 0 Yes 0 No Other. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. Tills figure will be reviewed and may be revised by the Buildmg DIVISIon to comply WIth current fee schedules. Contact the Pefilllt Coordmator at 417-4815 for assistance PLAN CHECK FEE: IF a plan check fee IS due it must be sublllltted at the tIme the bUll ding permit applIcatlon and constructIon plans are sublllltted. All other pefilllt fees are due at the tlille of pefilllt issuance. EXPIRATION OF PLAN REVIEW: Ifno pefilllt IS issued WIthm 180 days of the date of applIcatIOn, the application will expire. The Building OffiCIal can extend the tIme for actIOn by the applIcant up to 180 days upon wntten request by the applIcant (see SectIOn R105.3.2 of the InternatIonal BUlldmg/ResIdentIal Code, 2003). 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. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required ,not the City's, and that I must obtain such pennfts prior to work. ~- T IFORMSlBldgP,""",= wpd Applicoot: ~~ f. 3- ~ Date: /1- 30-0t;.. &?f/<1 FEE RECEIPT NUMBER CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A 000250 PERMIT NUMBER TOTAL FEE /5. t)o LECTSI340B7 ~ / lloM< Owner CONT- Lie. NO. TIME TO COMPLETE NO. STORIES LEGAL OCCUPANCY NO OCCUPANCY OR USE ESTABLJSHED UNDER THIS PERMIT Installation By Installers Address PERMITS WITH WAONG ADDRESSES ARE CANCELLED ELECTRIC SERVICE INC. Day Phone Application is h Installers Phone 1168 Mt. Pleasant Rd. 457-5010 Wiring Method NUMBER AMP 120V 240V NUMBER AMP 120V 240V PER l00R FEE USE OF CIRCUIT PER 10QA FEE USE OF CIRCUIT CIRCUITS 10 CIRCUITS 10 CIR 30 CIR 30 LIGHT SIGN 50 VOLTS LIGHT OR LESS CONVENIENCE MOTOR CONVENIENCE MOTOR APPLIANCE MOTOR DISHWASHER FIRE ALARMS DISPOSAL BURGLAR ALARM RANGE MISC. OVEN WATER HEATER LAUNDRY DRYER REINSTALLATION LIGHT FIXTURE # FURNACE SUB TOTAL FEE GAS - OIL FURNACE ENERGY FEE ELECTRIC BASIC FEE ELECTRIC HEAT TOTAL FEE ELECTRIC HEAT , SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.G. UNIT AMP PHASE FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICE rt~/'h,J.. <? //I).H5 1;1)0 "7J 1'0" AW.G. .). I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH I certify that the work to be performed under this permit will be done by the installer an~nce with the EI:ctrical Code. Date Application made I{- ~ / {; ,19 ,,?:~ By <</ -1. ~/L- CONTRACTOR OR OWNER (OR AUTHORIZED AGENT) Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. By JJ!, ~'T;J.F CITY LIGHT Date Permit Issued Lf - ((' - r) PLANSA~ ~ Notify Department of City Light by Stre.et Addr~ss and Permit Numb~r when re?dy for inspection. Work must not be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in Writing on Permit Placard. A. - Permits Phone: 457-0411 Ext. 158. PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ WARNING WHITE. OrigInal CANARY. Duplicate PINK. Triplicate WHITE CARD. 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