HomeMy WebLinkAbout1503 W 10th St - BuildingApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
MOREHEAD -MULIS MARY A
1503 W 10TH ST
PORT ANGELES
(206) 216 5066
Sig iat of Con acto uthorized Agent
T"\Policies \1102_15 building permit inspection record05.wpd [1/4/2005]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
WA 98362
05 00001165
674265
1503 W 10TH ST
06 30 -00 0 3 0677 0000
MECHANICAL APPL PERMIT
RS7 RESDNTL SINGLE FAMILY
500
Date 11/22/05
Contractor
MOUNTAIN PROPANE
P�'1� CH CUM RD
O�
bQCK WA 98339
(360) 385 6883
Permit MECHANICAL PERMIT
Additional desc PROPANE TANK INSTALLATION
Permit pin number 65912
Permit Fee 50 00 Plan Check Fee 00
Issue Date 11/22/05 Valuation 0
Expiration Date 5/21/06
Qty Unit Charge Per Extension
BASE FEE 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
iketogAr 064g
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 emiming this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give au ority to violate or cancel the provisions of any state or local law regulating construction or the performance of
constru n.
01
Date Signature of Owner (if owner is builder) Date
BUILDING 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
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS ROOF CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
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
CONSTRUCTION RW PW/
ENGINEERING 417 -4807
FIRE 417 -4653 I
PLANNING DEPT 417 -4750 I
BUILDING 417 -4815 I
T•.Policies \1102_15 building permit inspection record05.wpd [1/4/2005]
YES NO
417 -4735 ELECTRICAL
LIGHT DEPT
FINAL
DATE ACCEPTED BY.
FINAL DATE ACCEPTED BY.
SEPA.
ESA.
SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
CONSTRUCTION RW
PW ENGINEERING
FIRE DEPT
PLANNING DEPT
BUILDING
East,
ARRANT(
5300 Deny Street, Harrisburg, PA 17111
Pic 717 -561 -4480 Fox 717- 561.4494
1 Builder Name
2. Lot /Job 20 Block
House Number and Street Name
City PORT ANGELES
Township
THE:'S Thig
Residential Warranty Corporation -New Home Warranty
Complete ALL information in spuces pro uad.
Attach a copy of the settlement sheet to this form.
NORTH PENINSULA BUILDING
306 Development /Subdivision
1503 iJ 10TH ST
3 If the mailing address to be used for this home is different from #2, please indicate below
4 Settlement/Closing Date:
Effective Date Of Warranty is the Settlement /Closing or Occupancy date,
5 Final Sales Price
6. Type of Financing (check one)• Conventional
7 Exclusions. The Purchaser acknowledges that the listed
Builder, are excluded by contract or are not included in
Builder
Builder
C. 1N Fee
D. Total Due
Purchaser
Purchaser
a.
b.
9 WARRANTY FEE •CALCULATION
A. Warranty Fee
B Processing Fee
:L,t. r;i
Builder. Purchaser c.
8. Type of S oil (check one). Virgin'Sail 0 Active Soil Fill
$6.95
10. Purchaser's E -mail Address: /VI /1IOr1 h tlt.L
11 SIGNATURES
I/We have read and understand the RWC Warranty book.
lidtt
-r's`: gnature
Aocu
Purchase's Name (print or typ
o/
Purcha
x
LtL L'
whichever occurs first.
i
Purchaser's Name print or type) Phone
Purchaser's Signature Date
15.
�r �r�
Phone if
1 1Izak
Date
41,1A4, di bra -'Pr^.ga
30
-$'1 6
Name /Title of Person Completing Application (print or type) Phone
i 1)k/2 /1 –O5
Builder Repy trce s Sig Date
BUILDER send to RWC: (5300 Derry Street, Harrisburg, PA 17111 3598)
A copy of the settlement sheet
A check for TOTAL DUE (see calculation above)
2[•25377 wr'IC 31 Rz :.02/05
06/11/2003
flON OR
r,_ Application No
2625397
FDICt AItRLkME i .j5€"std.
STATE WARRANTY
RIC 3193 Rev 02/05
First Occupancy bate.
State
County
Other
x
nitials
WA Zi p
CLALLAM
date
Registration Number
98363
x
initials date
370950
Cash MaximuA Warranty Coverage '4100,000 00
items, if any will not be warranted by the RWC Warranty since they were not furnished by the
the final sales price. (Builder and Purchaser m ust initial any listed exelasions:) ii
i
i,.
Your Builder certifies that hear she is registered with the RWC Program and
that the home is in compliance with RWC standards, has been properly inspected
and all necessary approvals for processing of the home have been obtained.
Both the Purchaser(s) and the Builder must sign this Application acknowledging
that: (a) this warranty is an express limited warranty administered by RWC; (b)
WPIC's liability is specifically limited by the terms and provisions of the RWC
Warranty Program, (c) a copy of this Application, the appropriate RWC war
ranty book and any forms needed to comply with state or local governmental
requirements have been provided to the Purchaser(s); and (d) this warranty in-
cludes a provision for binding arbitration. After signing this Application, the
Builder must send the designated copies to RWC with a check for the Total Due.
This signed Application is to be received by RWC before your warranty can be
validated. Validation is not guaranteed, but is conditioned on the satisfactory
completion of all required inspections, upon Builder's compliance with all RWC
enrollment procedures, and upon Builder remaining a member in good standing of
the RWC Warranty Program. Your validated warranty will consist of this Appli-
cation For Warranty the RWC warranty book and any endorsements added
thereto. This warranty is invalid until a validation sticker, issued by RWC, is at-
tached to the RWC warranty book. Purchaser understands and agrees that, if the
warranty is validated, it is provided by the Builder in lieu of all other warranties,
oral agreements or.representations, and Builder makes -no warranty express or
implied as to quality fitness for a_ particular purpose, merchantability habitability
or otherwise, except as is ekpressly set forth in the Program.
Notice: This Warranty will be found tole invalid if this Application is not fully
completed, if revisions or alterations are made to this Application without
written consent of RWC or if the requested copies and fees from the Builder are
not received by RWC within ten (10) business days after the Effective Date of
Warranty #4 above.) Only original Applications will be accepted unless an RWC
Representative has signed here:
IN GEORGIA AND TENNESSEE. By signing your initials hi the space pro-
vided, you acknowledge that you have carefully read and understand the
section in your warranty book explaining arbitration procedures.
RWC #316F Rev 11/04
02001 Harrisburg, PA
~ pORT "'-\!
$~O~~~
ha
'L ~
~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000783 Date
.103992
1503 WIDTH ST
06-30-00-0-3-0677-0000-
ELECTRICAL ONLY
9/03/04
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
NORTH PENINSULA BUILDERS ASSOC
P. O. BOX 748
PORT ANGELES WA 98362
(360) 452-8160
SHAMP ELECTRICAL CONTRACTING
PO BOX 383
PORT ANGELES WA 98362
(360) 452-1689
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL TEMPORARY SERVICE
60 A. TEMP
SHAMP ELECTRICAL
42.20
9/03/04
3/03/05
CONTRACTING
Plan Check Fee
Valuation
.00
o
,.,
...
Qty Unit Charge Per
1.00 42.2000 ECH EL-TEMP SRV - 0-60 SRV FDR
Extensijon
42.120
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 42.20 42.20 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 42.20 42.20 .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 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 Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNINGlFORMS\1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
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 I NO
FOUNDATION:
FOOTINGS
WALLS
FOUND A TION DRA1NAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS 1 ROOF 1 CEILING
DR YW ALL (INTERJOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR I CEILING
MECHANICAL
HEA T PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKING/LlGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 f /3./ '-/ ~ ELECTRJCAL
LIGHT DEPT
, CONSTRUCTION - R.W.
CONSTRUCTION R.W. 1 PWI
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\1102.15 [11114/2003]
CONTRACTOR
OWNER
VARIOUS
Port Angeles, W A 99360
206/000~000
PROJECT INFO
Project Value: $0.00
Project Type: TEMP .JOB TRL.
Occupancy Type:
Occupancy Group:
Construction Type:
Zoning Use:
-~
W
',I'"~
BU/~DING PERMIT
OWNER/APPLICANT
NPBA
3430 E. HWY 101
Port Angeles. W A 98362
360/452-8160
T:
,I
CITY ,OF PORT ANGELES
PuBLIC woRKs ~ ~Un..DING DIVISION
321. EAST 5TH SJRFT,. ~RT ANGELES, VfA 98~2,.,
',~ " .:
\1f'j':';
S:
ISSUED: 12108/2000 PERMIT NO: 12391
" \~.~
PRQI:!ERTYIOCATION
. 1503.:10TH STW
Lot: 20
Block: 306 D Long Legal
Subdivision: TPA
Parcel No:
ARCHITECT
N/A
, 9836~000
360/000~000
SFD Units:
SFD sa FT:
Commercial:
Industrial:
Garage:
U',
o
(}),
o
o
o
0.,
o
_.
MFD Units:
" '. '''I' .
MFDsa FT:
o
o
PROJECT N()TES , ' ','" ," ",
JOB SHACK TRAILER FOR FUTURE BUILDERS PROJECT
<:
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
'""",,,,,"-,,,..,.;;.,'-
"""--
"""::",
.;',<
o
+
s
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
~j~p' Fee 1:
Misc Fee 2:
Misc Fee 3:
$0.00
$0.00.
$0.00
TOTAL FEE:
AMOUNT PAID:
,.,.
$0.00
$0.00
$0.00
,
BALANCE DUE:
RW SANITARY WATER DWY STORM DRAOTH:ER
Separate~ermlts are required;or electrical work, utilities. private a~d public improvements. ThlspermitbecomesQu~.8ritS',Yoid if work or
c:onstrudiOrtauthorizedis not commenced within 180 d~.!,if co~~n or WOrk ,is suspended ,or 8bandOnedfrJr,aperiOd 01-'180 days after
the work as commenced, or if required inspec:tions hav!! not been~ueSted:witbin t80'days from the last inspectioll' I h~rebycertifythat I have
read ar;1d examined thisappication and know the same to be trueR correct, All provisions of 1iIwS' and ordiMnCEll.{,goVBi1ingthis type of work
WiU..becomplied withwt!ether specified herein or not The,granting o( a permit does not presume to give authority to violate or cancel the
,sofany te or I ~ regulating constructi. or performance of construction.
Si nature of Owner if owner is bu~der Date
~,;<'f)i, ~,~~;rlC '[i~li"(L'}-
"""':'imt~;~GPE~:~;Edl~~-ImCORD
: F-:; :~':.~'V,~ }ilt " ~.{
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>-";,,.;~<.~':;(*';
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CIJ.L 417-48l~ FO~ B~d ~~~l1()NS;Pi.EAsE PR9VIDEA ~241;10UR}IlOTICE. n: ISUNL4.~ ..... J;bVER,
INsuu.TEoi!2l!JI!P~;~f!}1,iJ!~ll~lljJl!~9~AJf!l..~~.,-,,~~~~,A~~$~I<:.YPlLl~TION.
KEEP PERMIT ~ARD AND APPROVED PLANS Atl0B SITE
'.' ,',!,i;: i , ,':to'
.
INSPECTION TYPIt ~l+, I:..;, ACCKP'I'ED ~~i-~~)'L,:~:~;:-j-::::' ~:':'c- .,'-
.. - -;...:;~' .' ". .,
,.....j., I . YES I NO
J'OUNDAnON: ".' . (., '"
FOOTINGS , ..
wALts .
FOuNDATION DRAINAGE , .....
EI.EC'i1UclI.' i -
(UGHI'DBPT)
ROUaH-IN I J I .. " .'. ..,.:'
'/ .,
PLtlMBING .'
UNDBR. FLOORlSLAB
ROUGH-IN ...., .j'.
Wf.rRRLINB -;\(',c;," 'J I
BACK-now I WATER . 'Co . I
AIR SEAL .' ..',.," ~~?}.
,'.'
'Jn1' J ,I . !
WALLS
CEILING '!)i't; T..,... I 1\ \. " ......, ""'... \J~
; , .
J'9AMING :' : +:.
'I ".
GIRDERS .... ') .' .... I ',.
lOlSTS I I
.-
SHEAR. WALL : :' 1
~
WALLS I ROOF I CBILINO
1
DRYWALL . .. . ., 1
T-BAR '0
INSULAnON ---pi . ::}}:' : .' i '"
SLAB I I
WALL I FLOOR I,CElLING I . I I
MECHANICAL ", .'
'. ..
~X;., . .... .. .....
WOODSTOVE I PELLET
DUCTS :'f" ,. ( ',' I,' ..,' ,-" : '.:
~ ,. ",~ < .
l'WUTnnUSI SITE WO~1 (Ell&iDcering Divisim) .
WATERLINE I METER .t .
SEWER CONNECTION . ,.
SANITARY -.
STORM .
SITE DRAINAoE I EROSION'CONTROL . """.
PARKING ; ,,~;i2:, I:.'., ...
". ,"
. .Jr-, "
OTHER
, J'lNALINSPEC110NSRXQUIRED PRIOR TO OCCUPANCY~SE (. r ". .' .....
RESlDENllAL DATE YES NO COMMERciAL DATE I ACCEPTED
. YES NO
ELEc:nuCAL - LIGHT DJW'r' 417-4746 ; :i:.LEcriUCAL [~:S!::;,: .' '
;51(( :V ;".
1 -,< "'_M. , - .J..19H'r.1?!W!,.,,,,> -.
CONStRUCTION R. W.:I PWt , '. : cONS'tRUc1id'N i'I( \V!~.'j . '?-ff "'';':' ;,.:
,: '~;<.
ENGINEElUNO i":' : v-r.-"..h ';" 41!~07 " ...... '" ;~~QINEE~ >;';"; ,): .... ..' ,
FIRE (MULTI-FAM ONLY);',,"}i';' ., 417-46W't (:';;}1. :Ji~"'~ ". FiREt.mPr: <..,' I ; ;"..
.
'..' ,...... ',.;,.".' "417.48t:s' .~~ 4-<1/' I.. ~._;~.." -" ,....-... ..... 'I ..
Bl.IILDING ,'- '-""i'" BUILOIftQ:--, !..... I.' '. ,;-11
.... ,.;f ; ""'f~F' ...
GENERAL COMMENTS:
,S~-~?~ -- )-
.j
. PW. II 02. 15 141961
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BuildingfUtility/ElectricIFire Permit Application
Please fill out completely. Type or print in ink. If you have questions
please call (360) 417-4815 or Fax: (360) 417-4711
e--mail: www.ci.port-angeles.wa.us
FOR OFFICIAL USE ONLY:
Date~=:ri-~~
Pemnt #: ~
Pre-Appl Complete:
SHBl724:_Y_N
Letter of Completeness:_
Bldg. Permit Appl:
B.P. Issued:
Address:
ArchitectlEngineerlDesigner:
Contractor: bI..0 f-j
Address:
PROJECT ADDRESS::
LEGAL DESCRIPTION1 Lot:
Phone: 15" 2- - z? ( (0 0
Phone:
City:--P r A '
Zip: Cf f!; '3 h 2-
Exp:
Phone:
Phone:
~-
City:
Zip:
ZONING
.~
.r
';300 ..
Subdivision:
TPA
Block:
CLALLAM COUNTY PARCEL NUMBER:
Billing Address: ~ ~
Credit Card #
Credit Card Hobler Name:
City: ,
Exp. Date:
Zip:_
VlSA_MC_
"
,
TVPEOFW9RK: ., SIZENALUATION:
o Residential'" 0 New Constr. 0 Reroof 0 StoveJInsert SF. @ S,
o Multi-faniily 0 Addition 0 Move 0 Garage SF. @ $
o Commercial 0 Remodel 0 Demolition 0 Deck SF. @ $
o Electrical ' 0 LP-gas 0 Sign 0 UST TOTAL VALUATION S
BRIEF DESCRIPTI., '. ON OF mE PRQJE. CT: -SSi::::::tc;B -6 H~~lLE12- F-m::.. ~c..J"iU62.E7
. ;..' '~ulL-D~S~(7(Z.o~\ · '
COMMERCIALIRESIDENT(AL: qccupancy Group: : Occupant Load: Construction Type:
No. of Stories: ' Lot Size: % Lot Coverage: %
Existing Lot Coverage: /sq: ft. + Proposed Lot Coverage: /sq. ft. = TOTAL LOT COVERAGE:
ISF. = S
ISF. = S
ISF. = S
Isq.ft
f
PLANNING USE ONLY: l
Permits RtxluirW: ~,
Max. Height: '" 'SCtbaclCs: "
Site Plan and Use Approved by:' "
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No
APPROVALS:
PLAN
BLDG
DPW
FIRE
OTHER
,,, Notes:
Zoning:
Date:
Other:
i_~' '""il ~ ;I:.~, I.l'1J ;,.,.-~
PRE-APPUCATION Sl1llMITTAL: Your application and site plan must be filled out completely to be acceptedfor review. The
Building Division can prO\gde you with more detailed information on the application and plan submittal requirements.
BUILDING PERMIT APPLICATION SUBMITfAL: Your oompleted 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 bCreviewed
and may be revised by the Building Div. to oomply with currmt fee schedules. Contact the Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: Your plan chock fee is due at the time the building peroni 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 wiD 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 co"ect, 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.
PW-Il02_13[rev.6/00]
Applicant: 1M.~ ~ ~P@A
Date:
{! /30/ trO
I I
"
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(il SITE PLAN
DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION
APPUCANf: r-JP6A / PI\- ~C-rtroL- D~. PHONE:
I 150T IOI1t Sol. W
PROJECfIDEVELOPMENT ADDRESS:
See Page 4 for instructions 011 completing the site plan. For more informoJioll, caU 457-0411, extDuicm 125.
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PAGE 5
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:121 EAST 5TH STREET. PORT ANGELES. WA 98362
,
'>
Application Number
pin number
Property Address
ASSESSO~ PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000766 Date
.261162
1503 W 10TH ST
06-30-00-0-3-0677-0000-
RES NEW SFR
1/31/05
RS7 RESDNTL SINGLE FAMILY
87525
......
Owner
Contractor
NORTH PENINSULA BUILDERS ASSOC
P. O. BOX 748
PORT ANGELES
(360) 452-8160
Structure Information
Construction Type
Occupancy Type
Other struct info
OWNER
WA 98362
1945 SF SFR W/ATT795 SF GARAGE
TYPE V NON-RATED
SINGLE ~AM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
30.00
V--N
1.00
1.00
10500.00
3150.00
3150.00
1. 00
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW RESIDENTIAL
2700 SQ. FT. SFR. / SHAMP
SHAMP ELECTRICAL CONTRACTING
143.20 Plan Check Fee
1/31/05 Valuation
7/30/05
.00
o
.........
~
tAl
Qty
1. 00
3.00
Unit Charge Per
73.0000 ECH
23.4000 5C
EL-R-SQFT FIRST 1300
EL-R-SQFT ADDITIONAL 500
Extension
73.00
70.20
t
Special Notes and Comments
Building address sign shall not be less than 6" & not more
than 1~" in height. Nu1l)lJers colors must contrast with wall
color they ate mounted .o~. (Ord. 14.36.05~E)
When roof gutters are. installed, drains will located in dry
wells or piped to approved storm drain locations.
Sidewalk to City standards required for school walking
route.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Building water line connection to water meter requires a
Pub~ic Works inspection prior to back fill of ditch.
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Other Fees SEWER SYSTEM DELV CHARGE 745.00
STATE SURCHARGE 4.50
PW WATER SYSTEM USE FEE 1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 143.20 143.20 .00 .00
COMMENTS! ACTION NEEDED
,
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EAST 5TH STREET. PORT ANGELES. WA 98362
,
Application Number
pin number . . .
Plan Check Total
Other Fee Total
Grand Total
Page 2
Date 1/31/05
04-00000766
. .261162
.00
1774.50
1917.70
.00
1774.50
1917.70
.00 .00
.00 .00
.00 .00
"
COMMENTS! ACTION NEEDED
,
ELECfRICAL PERMIT INSPE~JON RECORD
I
"
..
i CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT 1~ UNLA WFUL TO COJlER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
NO
COMMENTS
GENERAL COMMENTS:
PW.II02.1S (4'96)
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
----------------------------------------------------------------------------
!
NORTH PENINSULA BUILDERS ASSOC
P. O. BOX 748
PORT ANGELES
(360) 452-8160
Structure Information
Construction Type
Occupancy Type
Other struct info
Application Number
pin number . . . .
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
Owner
Permi t . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
04-00000766 Date
.261162
1503 W 10TH ST
06-30-00-0-3-0677-0000-
RES NEW SFR
9/21/04
RS7 RESDNTL SINGLE FAMILY
87525
Contractor
OWNER
WA 98362
1945 SF SFR W/ATT795 SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
30.00
V-N
1. 00
1. 00
10500.00
3150.00
3150.00
1. 00
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MECHANICAL PERMIT
FEE'S WAIVED PER MIKE QUINN
.00 Plan Check Fee
9/21/04 Valuation
3/21/05
.00
o
-------------------------------------------------------------
permi t
Additional
permi t Fee
Issue Date
Expiration
desc
Date
t
PLUMBING PERMIT
FEE'S WAIVED PER
.00
9/21/04
3/21/05
MIKE QUINN
Plan Check Fee
Valuation
.00
o
'"'
\:f
'j
------------------------------------------------
Permit
Additional desc
Permi t Fee
Issue Date
Expiration Date
BUILDING PERMIT
FEE'S WAVED PER
.00
9/21/04
3/21/05
-RESIDENTIAL
MIKE QUINN
Plan Check
Valuation
.00
o
~
Fee
-------------------------------------------------------
Special Notes and Comments
Building address sign shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color they are mounted on. (Ord. 14.36.050-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
Sidewalk to City standards required for school walking
route.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Building water line connection to water meter requires a
Public Works inspection prior to back fill of ditch.
-------------------------------------------------------------
Other Fees
SEWER SYSTEM DELV CHARGE
745.00
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 0 bandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days fr m the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All pro isions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit oes not
pr e to give autho' to violate or cancel the provisions of any state or local law regulating construction or the perform nce of
ons tion.
'4
T:\PLANNINGIFORMSII102.15 [I 1/1412003]
Signature of Owner (if owner is builder)
Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
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
WALLS
FOUNDATION DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPn SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS 1 GIRDERS
SHEAR W ALLIHOLD DOWNS
WALLS 1 ROOF 1 CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE 1 PELLET 1 CIDMNEY
HOOD 1 DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTING 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.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNINGIFORMSI1102.15 [11/14/2003]
of pORT ~
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~~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 04-00000766
pin number . . .261162
Page 2
Date 9/21/04
Other Fees
STATE SURCHARGE
PW WATER SYSTEM USE FEE
4.50
1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total .00 .00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 1774.50 1774.50 .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 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 Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNINGIFORMS\1102.15 [11/1412003]
BillLDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE 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
I YES NO
FOUNDATION:
FOOTINGS '1 -/6 -0'1 -J LL-
WALLS iC: ~-2J-<:)4 ~Ll-
FOUNDATION DRAINAGE/DOWN SPOUTS [21 ~....I'Jj..1 III
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN
PLUMBING ftVYV\kJ. F\~\ - ~/''3/0fi-JLl Afl?'
UNDER FLOOR / SLAB
ROUGH-IN i . {, -() ~ LL
WATER LINE (METER TO BLDG) j"L~~ J L.J-
GAS LINE
BACK FLOW / WATER r
AIR SEAL
WALLS 1~-IJ-(')~ J. l..,
CEILING r I
FRAMING
JOISTS / GIRDERS I ~
SHEAR W ALUHOLD DOWNS IJJ'1 J rOtf 7Ll
WALLS / ROOF / CEILING 4~-111!.c;r _I, L,
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING ~'-I b -O~'- J.. l...
MECHANICAL l\1ev~ . fi Y1tt.1 b/I'3 (or; -\) l,(;. AfP
HEAT PUMP
GAS LINE li-L-f/<;' \ I
WOOD STOVE / PELLET / CHIMNEY ,.
HOOD / DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGILIGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W. / PW / CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 , PLANNING DEPT.
BUILDING 417-4815 7#h0/00 .:rW BUILDING
T:\PLANNINGIFORMSI1102.15 [11/14/2003]
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PREPARED 6/15/05, 13:09:52 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR: JAMES L LIERLY DATE 6/15/05
ADDRESS 1503 W 10TH ST
CONTRACTOR
OWNER NORTH PENINSULA BUILDERS ASSOC
PARCEL 06-30-00-0-3- 0677 -0000-
APPL NUMBER: 04- 00000766 RES NEW SFR
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
SUBDIV:
PHONE
PHONE (360) 452 -8160
PL2 01 1/06/05 JLL PLUMBING ROUGH -IN TIME: 17:00
1/06/05 AP
PL6 01 1/31/05 JLL PLUMBING WATER SUPPLY TIME: 17:00
1/31/05 DA suppy line to be below frostline aproximately 18" or more
/jll
PL6 02 2/01/05 JLL PLUMBING WATER SUPPLY TIME: 17:00
2/01/05 AP
PL99 01 6/15/05 JL 1 I PLUMBING FINAL TIME: 17:00
06/15/2005 01:03 PM JLIERLY
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COMMENTS AND NOTES
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PREPARED 2/01/05, 13:17:03 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 2/01/05
ADDRESS 1503 W 10TH ST
CONTRACTOR
OWNER NORTH PENINSULA BUILDERS ASSOC
PARCEL 06-30-00-0-3- 0677 -0000-
APPL NUMBER: 04- 00000766 RES NEW SFR
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
SUBDIV:
PHONE
PHONE (360) 452 -8160
PL2 01 1/06/05 JLL PLUMBING ROUGH -IN TIME 17:00
1/06/05 AP
PL6 01 1/31/05 JLL PLUMBING WATER SUPPLY TIME 17:00
1/31/05 DA suppy line to be below frostline aproximately 18" or more
/ill
PL6 02 JLL PLUMBING WATER SUPPLY TIME 17:00
COMMENTS AND NOTES
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Fill out COMPLETELY and in INK. Your application and site plan MU~jL (
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
FOR OFFICIAL USE ONL V:
Date Rec.: 8 --3()- tJY
Permit #: 04-
BUILDING PERMIT - APPLICATION
Date Approved:
Date Issued:
M;
t!:... ) L1 tvQ~"1ILt -i,
Applicant or Agent: C~vll; 7 fY\ 1 ~ "3m I rP t1.~.
{
Owner: t6f2.91Q Pt5N I $4A LL.. ~N\" ~~ ~.
Address:
Architect/Engineer: L IIo'V ot5~ ~
Contractor 0 (AI W~
City:
S IYJ'''''''' Ii tu J4 .
Phone: 4-6Z. (PI) V
Phone: 1/52 -AlGO
Zip:
Phone: .j:.~"'Z -~J)V
State License #:
Address:
City:
I~O~
PROJECT ADDRESS: WtJ5T 10 71lj
LEGAL DESCRIPTION: Lot: ~
CLALLAM COUNTY PARCEL NUMBER:
Block: 306 Subdivision:
~ b -3 (!) <::JcQO ? 0 E, 7?
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA MC #
TYPE OF WORK:
.)(Residential )(New Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
.0 Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
G/t9A6tfi"
City:
Exp. Date:
SI~~UATION:
o Stove 1'1 ~_ SF. @ $ +5 /SF. = $ f, ~ ~!?
15 Garage ,c.~ it!:' SF. @ $ /SF. = $
o Deck tb.c."- C) SF. @ $ /SF. = $
o Other TOTAL VALUATION $
N IJt1V ~1 Nf4 ~lt' ~ WJ /Zd'$'I Or1lV c,lr W! A 'fTN.,~/s1:>
&
Occupant Load: Construction Type: V - N
& Proposed Sq. Ft. ~ /50 = TOTAL Sq. Ft. ~ / ~D
COMMERCIAL/RESID~~CCUpancy Group:
No. of Stories: L Lot Size. ~sting Sq. Ft.
Total lot coverage '0
%
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
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: 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: Ifno permit is issued 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 Rl 05.3.2
ofthe International BuildinglResidential 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:\RVESS\BLDG-fonns-brochures\2003-Buildingpermit.wpd Applicant: ~ __.. Date:'ZJ-Af1U.' {)./-
"" "
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date /' -:J.a -0 J../ Time q,'~ Received by ~.A-P ~yperson)
Location of Work to be inspected ~I ~ ~f/flJ ~
Name of person requesting inspection . e. . (<)' ~'f.u v-e h LJ l I d..Q~ .' _
Address of person requesting inspection Phone No. 'I h (J - 9! 7-6
Type of In ction (cir appropriate one): Permit No.
Sew Foundation F: aming Chimney Plumbing Final Sewer Excav. Other
~7eJ?1Wctj;/
IN ECT OTES: ~
Inspected: Date q 1 'l..l ~d Time A-CV\ By --=;JLL...
Remarks: . ~ /),
=!f~():;:Jr 'n;:f: .g~~~rl, YJ1 c>v? 9-,9-/-0)./
-y
RESTORATION REQUIRED. . . . .. YES NO
~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
[] Repaired by Permittee
D No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
- l-{
Date ~ ,-I::::' - 6
Time
Received by
i<v
(phone, person)
/563, kJ {6 '-fCe
Mt'ke c;o~ch
Phone No.
Permit No.
Chimney Plumbing Final Sewer Excav. Other
Inspected:
Remarks:
Time A (lI\
By JLC
RESTORATION REQUiRED...... YES NO
I,^~S~ AM
AfP'~~D
:70' -tt '" ~iJ- I~ "F.,.oh.:.t~ {~j2.Il"oJ..o ~ j
( ()..") ( -Ji:-4 g,s (2. J I
Gti2.'()';- 40 V ~ CL&I- ;::J ea t.{ " (!) e.. -1
~ l7 'II iJ.o
To .J..l O(l.., ~l... 'I 13.e f2- . ·
6}c
4-
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
}20RTANGELES
WAS H I N G TON, U. S. A.
FAX TRANSMITTAL
Department of Community Development
Building Division
321 East Fifth Street, Port Angeles, Washington 98362
Phone: (360) 417-4815 FAX: (360) 417-4711
TO: C. t c>... \' ,.. ~ FROM: i<o~e(' V'2,5. S.
Company:
Fax:
Number of pages: 2
(including transmittal page)
-,- h ~ s da-e..s )'"'\61-
fev (/\A.. ~ t5. 0 V--
'?Q u...J.Q. 1/-
6'
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Print Key Output
5769SS1 V4R5MO 000526 CLALLAM
Page 1
08/31/04 14:05:39
Display Device
User
ASSRPUB8
KKREIDER
Mode: INQUIRY
Real Property
Auto Roll: OFF
Parcel # 063000
* Taxpayer #
* Title Owner #
* Contract Own #
Plat/Condo Type
Description LOT 20
AUseC 9100 SURVEY
F/Bk 570
F/Pg 234 A
PCC 150
Tax Code 0010
Zoning Code RS7
Chg Rs
Land:
030677 0000 Rng 06 Twp 30 Sec
NORT 1450 NORTH PENINSULA HOME
NORT 1450 NORTH PENINSULA HOME
00 Tax Yr 2005
BLDRS ASC Date 12/11/03 By KKRE
BLDRS ASC Aud/File# 1 1070513
Loan #
Unit
Code
& PT R/W BL 306
V47 P91
Blk
Lot
Dock
7/27/04
SCOU
EC
05
Chg Date
Chg By
Chg Rs
ApprCd
UNDEVEL LAND
TAXABLE
PA 121 H2 L
RES SINGLE FAM7
Land Use
Tax Stat
F/P? N
Timber Total
9100
TX
Ac
Land
Reval 5
Improved
Unimp
Improvement
Total AV
Acres
Taxable
Market
New/C
Sr Cit Cd
Lien Date
04CX/SP608
24000
24000
24000
OlAV
Mob Home AV
Sub Cd
Regular Taxable
App#
Int%
24,000
Agr#
Vol/Pg
267 100
As-Tx Yr
FROM NORTH PENINSULA BUILDING ASSOC PHONE NO. 360 452 8197
a~
North Peninsula Building Association
PO BOX 748 3430 E HWY. 101 STE 29
PORT ANGELES WA 98362-0129 TELEPHONE; 360-452-8160
FAX: 360-452-8197 (-mail: npba@olypen,com
September 13, 2004
Mike Quinn, City Manager
City of Port Angeles
P.O. Box 1150
Port Angeles, W A 98362
~ IE ~ IE ~ ~ IE \Dl\
SEP 1 3 2004 :
OF PORT ANGE2ES \
D~~T~f Community oev~.~~
......
Dear Mike:
North Peninsula Building Association wants to thank the City of Port Angeles for
their past support of the Future Builders program. We are grateful for the spirit of
cooperation exhibited and the assistance given by the City and the Department of
Community Development. It is our hope that the City of Port Angeles will continue
their support and consider donating the building fees required for the fifth house.
It is hard to believe but the Future Builders program is starting its fifth house this
month. Classes started September 7 and once the building permit is approved,
construction will begin. Mike Gooch, Construction Superintendent, reports we have
24 students enrolled - 10 are returning students. New students appear very eager
to begin classroom and hands on instruction.
Just as an update, all but one student from the 2003-2004 class were successfully
placed in jobs within the community. One of our goals was to offer positive local
employment opportunities to students demonstrating the willingness to work. Many
students are continuing their education while their employer holds the job open.
Like no other project in the nation, profits from the sale of the house are split three
ways: 1/3 for scholarships to students in Clallam County, 1/3 for grants to teachers
within Clallam County school district and the remaining 1/3 goes into the next year's
construction project. In 2004 alone, we have issued $11,000 in scholarships and
over $14,000 in grants.
If you have any questions regarding this request. please feel free to contact me at
683-2211 or contact Clair at the NPBA office at 452-8160. Look forward to hearing
from you-
P01
FRO~1 NORTH PEt~INSULA BUILDING ASSOC PHm~E ~~O. 350 452 8197
fA
North Peninsula Building Association
PO BOX 748 3430 E HWY. 101 STE 29
PORT ANGELES WA 9836Z-0129 TELEPHONE; 360.452-8160
FAX: 360-452-8197 E-mail: npba@olypen.com
September 13, 2004
Mike Quinn, City Manager
City of Port Angeles
P.O. Box 1150
Port Angeles, WA 98362
IP?1 ~ lC ~ ~ ~~ \0)\
SEP t 3 200~ ·
\
OF PORT ANGELES_. \
D~~T.~f Community Dev.e].~~
--- .
Dear Mike:
North Peninsula Building Association wants to thank the City of Port Angeles for
their past support of the Future Builders program. We are grateful for the spirit of
cooperation exhibited and the assistance given by the City and the Department of
Community Development. It is our hope that the City of Port Angeles will continue
their support and consider donating the building fees required for the fifth house.
It is hard to believe but the Future Builders program is starting its fifth house this
month. Classes started September 7 and once the building permit is approved,
construction will begin. Mike Gooch, Construction Superintendent, reports we have
24 students enrolled - 10 are returning students. New students appear very eager
to begin classroom and hands on instruction.
Just as an update, all but one student from the 2003-2004 clast> were successfully
placed in jobs within the community. One of our goals was to offer positive local
employment opportunities to students demonstrating the willingness to work. Many
students are continuing their education while their employer holds the job open.
Like no other project in the nation, profits from the sale of the house are split three
ways: 1/3 for scholarships to students in Clallam County, 1/3 for grants to teachers
within Clallam County school district and the remaining 1/3 goes into the next year's
construction project. In 2004 alone, we have issued $11,000 in scholarships and
over $14,000 in grants.
If you have any questions regarding this request, please feel free to contact me at
683-2211 or contact Clair at the NPBA office at 452-8160. Look forward to hearing
from you.
POl
'Vashington State Energy Code
Plan Review Checklist
Applicant please Check, write in N/A or fill in value on boxes or lines.
Project Address:
Compliance Approach:(check one) D Systems analysis
D Component performance
D Prescriptive path
HEATING SYSTEM
D Zone Heating
D Electric Furnace
WIeat Pump
FOUNDATION PHASE
D Slab R- _ Exterior down to frostline/slab bottom; Interior 24" horizontal or vertical; or, Ifradiant under entire slab
D Below grade exterior wall insulation: R- _ (If interior -see Insulation Phase)
FRAMING PHASE
D Standard
D Intermediate
D Advanced
D Standard air seal: sole plate/sub floor; rim joist; window & door frames; wires, plumbing, ducts, light fixtures
D Source specific exhaust fans: bath & laundry(50 cfm) kitchen(lOO cfm)
D Whole house exhaust fan _ cfm intemrittent system has manual & auto controls: Outdoor air supply reg. for habitable rooms
or
D Integrated forced -air system, fan _ cfIll, outside air duct(with motor damper) allowing .35 and .5 ACH
INSULA nON PHASE
ijl R - -L1.. Wall insulation( above grade)
D R- _ Wall insulation(below grade): Interior wall insulation
~ R--32 Floor insulation
D R- '38" Ceiling insulation: Including attic hatch
D R- Vaulted Ceiling insulation
_ Dr
~ Vapor retarders: Walls, Ceiling: Ilf 4 mil poly ~Peml rated paint Dkraft faced batts
D Vapor retarders: Floors: D 4 mil poly Dkraft faced batts
~ Ground cover: 6 mil Black polyethylene, 12" lap at joints & extending to foundation wall
T:IROGERIBLDG-FORMS-BROCHURESIENERGVPLANREVIEW
Over: Fill in back side also.
WINDOW GLAZING
Please fill out window informalion, inclued skylights, glass doors, and all other glazing on this form. Use rough opening area for calculations.
SIZE QUANTITY AREA / U-VALUE & MANUFACTURER
ijt7I1O) ~ 11 r;J 'I?
t.0 H 0 ) ~5 / ~
J.; () .~.6 ~ 11_5 I U.;,t!
01& ~f!) ~H " j.Jf)
tJ t' c~ Fi~e J , ~tJ
~tI "C;D rl 'kp,.t ( ~O
~,,~o A-, .",,0\ ~ l~
~ (# it i') cJ b so9r~ I II tJ~ H
I~ f; () C;j.J- ~- it: '
Total glazing area:
Total conditioned floor area:
Percentage of glazing:
p.~.,~
j QJl.5 d7
11. ~ 7 ~
DOORS
List doors by type(solid core, insulated, Etc.)quantity, U-value, and Manufacture.
SIZE QUANTITY AREA U-VALUE & MANUFACTURER
'::? dJ ~ ~ :L J./ 01 ~
T:\ROGER\BLDG-FORMS-BROCH U RES\EN ERGYPLAN REVI EW-2
W,t.,SHINGTON ST.ATE ENERGY CODE
TABLE 6-2
PRESCRIPTIVE REQUIREMENTS 1 * * FOR GROUP R OCCUPANCY
CLIMATE ZONE 1 . HEATING BY OTHER FUELS
HV AC9 Glazing Glazing U-Factor Door 10 Vaulted Wall Wall- Wall- SIab6
Option Equip. Area": Overhead' U-Factor Ceiling2 Ceiling3 Above int4 ext4 Floors on
Effie. % of Vertical Grade Below Below Grade
2
Floor Grade Grade
I. Med. 10% 0.70 0.68 0.40 R-30 R-30 R-15 R-15 R-I0 R-19 R-lO
II. Med. 12% 0.65 0.68 0.40 R-30 R-30 R-15 R-15 R-lO R-19 R-lO
III. High 21 % 0.75 0.68 0.40 R-30 R-30 R-19 R-19 R-I0 R-19 R-I0
IV.'" Med. 21 % 0.65 0.68 0.40 R-30 R-30 R-19 R-19 R-lO R-19 R-lO
V. Low 21 % 0.60 0.68 0.40 R-30 R-30 R-19 R-19 R-lO R-19 R-lO
VI.7 Med. 25% 0.457 0.68 0.40 R-38 R-30 R-19 R-19 R-lO R-25 R-lO
VII. 7 Med. 30% 0.407 0.68 0.40 R-30 R-30 R-19 R-19 R-I0 R-25 R-lO
VIII. Med. unlimited 0.25 0.40 0.40 R-30 R-30 R-19 R-19 R-lO R-25 R-lO
* Reference Case
** Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601.1.
1. Minimum requirements for each option listed. For example, if a proposed design has a glazing ratio to the conditioned
floor area of 19%, it shall comply with all of the requirements of the 21 % glazing option (or higher). Proposed designs
which cannot meet the specific requirements of a listed option above may calculate compliance by Chapters 4 or 5 of this
Code.
2. Requirement applies to all ceilings except single rafter or joist vaulted ceilings. 'Adv' denotes Advanced Framed Ceiling.
3. Requirement applicable only to single rafter or joist vaulted ceilings.
4. Below grade walls shall be insulated either on the exterior to a minimum level ofR-10, or on the interior to the same level
as walls above grade. Exterior insulation installed on below grade walls shall be a water resistant material, manufactured for
its intended use, and installed according to the manufacturer's specifications. See Section 602.2.
5. Floors over crawl spaces or exposed to ambient air conditions.
6. Required slab perimeter insulation shall be a water resistant material, manufactured for its intended use, and installed
according to manufacturer's specifications. See Section 602.4.
7. The following options shall be applicable to buildings less than three stories: 0.50 maximum for glazing areas of 25% or
less; 0.45 maximum for glazing areas of 30% or less.
8. Reserved.
9. Minimum HVAC equipment efficiency requirement. 'Low' denotes an AFUE of 0.74. 'Med.' denotes an AFUE of 0.78.
'High' denotes an AFVE of 0.88. Minimum HV AC equipment efficiency requirement for heat pumps. 'Low' denotes an
HSPF of 6.35. 'Med.' denotes an HSPF of 6.8. 'High' an HSPF of7.7. Water and ground source heat pumps shall be
considered as medium efficiency and have a minimum COP as required in Table 5-7.
10. Doors, including all fire doors, shall be assigned default V-factors from Table 10-6C.
11. Where a maximum glazing area is listed, the total glazing area (combined vertical plus overhead) as a percent of gross
conditioned floor area shall be less than or equal to that value. Overhead glazing with V-factor ofV=0.40 or less is not
included in glazing area limitations.
12. Overhead glazing shall have V-factors determined in accordance with NFRC 100 or as specified in Section 502.1.5.
38 7/01/01
2000 EDITION
TABLE 6-1
PRESCRIPTIVE REQUIREMENTS' * * FOR GROUP R OCCUPANCY
CLIMATE ZONE 1 . HEATING BY ELECTRIC RESISTANCE
Glazing Glazing U-Factor Wall Wall. Wall. SIab4
Option Area 10: Door 9 Ceiling2 Vaulted Above int4 ext4 Floors
on
% of Floor Vertical Overhead" U-Factor Ceiling3 Grade Below Below Grade
Grade Grade
I. 10% 0.46 0.58 0.40 R-38 R-30 R-21 R-21 R-lO R-30 R-I0
II. 12% 0.43 0.58 0.20 R-38 R-30 R-19 R-19 R-I0 R-30 R-lO
III. 12% 0.40 0.58 0.40 R-38 R-30' R-21 R-21 R-lO R-30 R-I0
IV.'" 15% 0.40 0.58 0.20 R-38 R-30 R-19 R-19 R-lO R-30 R-10
V. 18% 0.39 0.58 0.20 R-38 R-30 R-21 R-21 R-lO R-30 R-I0
VI. 21 % 0.36 0.58 0.20 R-38 R-30 R-21 R-21 R-I0 R-30 R-I0
VII.7 25% 0.327 0.58 0.20 R-38 R-30 R-19 R-21 R-lO R-30 R-lO
+ R-58
VIII.7 30% 0.297 0.58 0.20 R-38 R-30 R-19 R-21 R-lO R-30 R-I0
+ R-58
* Reference Case
** Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601.1.
1. Minimum requirements for each option listed. For example, if a proposed design has a glazing ratio to the conditioned
floor area of 19%, it shall comply with all of the requirements of the 21 % glazing option (or higher). Proposed designs
which cannot meet the specific requirements of a listed option above may calculate compliance by Chapters 4 or 5 of this
Code.
2. Requirement applies to all ceilings except single rafter or joist vaulted ceilings. 'Adv' denotes Advanced Framed
Ceiling.
3. Requirement applicable only to single rafter or joist vaulted ceilings.
4. Below grade walls shall be insulated either on the exterior to a minimum level of R-IO, or on the interior to the same
level as walls above grade. Exterior insulation installed on below grade walls shall be a water resistant material,
manufactured for its intended use, and installed according to the manufacturer's specifications. See Section 602.2.
5. Floors over crawl spaces or exposed to ambient air conditions.
6. Required slab perimeter insulation shall be a water resistant material, manufactured for its intended use, and installed
according to manufacturer's specifications. See Section 602.4.
7. The following options shall be applicable to buildings less than three stories: 0.35 maximum for glazing areas of 25 % or
less; 0.32 maximum for glazing areas of 30% or less.
8. This wall insulation requirement denotes R-19 wall cavity insulation plus R-5 foam sheathing.
9. Doors, including all fire doors, shall be assigned default U-factors from Table 1O-6C.
10. Where a maximum glazing area is listed, the total glazing area (combined vertical plus overhead) as a percent of gross
conditioned floor area shall be less than or equal to that value. Overhead glazing with U-factor of U =0.40 or less is not
included in glazing area limitations.
11. Overhead glazing shall have U-factors determined in accordance with NFRC 100 or as specified in Section 502.1.5.
Effective 7/01/01
37
[_Jam~~~~e~IL BuJ!~-i~g=~ssocia_ti~~~!,erm it~-~_n
--pag-e}J
From:
To:
Date:
Subject:
Mike Quinn
Lierly, James
9/16/042:37PM
Building Association Permit
The North Peninsula Building Association is once again applying for a waiver of the building permit fees
associated with the Future Builders Program. The City was an initial sponsor of this program and I have
previously waived their building permit fees as support for this program. I previously felt that the City was
gaining from the AV associated with the building construction, and that the educational training support
was a plus as well.
I offer the following:
1. Allow the waiver of general Building Permit Fees that are controlled totally by in-house labor contained
in the Community Development Department. This would cover the planning fees and general building
permit fees that we did not have to contract with another entity for completion.
2. Charge those fees that are contained within the Utility and Public Works sections such as connection
charges, electrical permits, etc. These are the fees not controlled by CD staff.
In this way we are supporting the program and keeping costs low, but we are not short-changing our
enterprise funds of their respective fees to support a general government function.
TRANSACTION REPORT
200S/0CT/26/WED 08 07
P.Ol/Ol
RECEIVER
94173231
TYPE/NOTE
OK
FILE
SG3 5841
-----
Of."ORT~
~
.. "EiiiI
~--
~~
r50?
lJ
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Ie)
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
. \
y\\ \ ~t- '/
4/7 - 323 ()
~
(. ~ ^ .:3~"7 I
Application Number
pin number . . . .
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use . . . .
Property Zoning . . .
Application valuation
Owner
04-00000766 Date 9/21/04
.261162
1503 W 10TH ST
06-30-00-0-3-0677-0000-
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
87525
Contractor
OWNER
WA 98362
1945 SF SFR W/ATT795 SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
30.00
V-N
1. 00
1. 00
10500.00
3150.00
3150.00
1.00
f'^t~~f
~ - ~
i---~~
.00
o
~,
~,
~Q
NORTH PENINSULA BUILDERS ASSOC
P. O. BOX 748
PORT ANGELES
(360) 452-8160
Structure Information
Construction Type
Occupancy Type
Other struct info
-----------------------------------------------------------------------------
Permit . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
FEE'S WAIVED PER MIKE QUINN
.00 Plan Check Fee
9/21/04 Valuation
3/21/05
----------------------------------------------------------------------------
permi t . . . .
Additional desc
permi t Fee
Issue Date
Expiration Date
PLUMBING PERMIT
FEE'S WAIVED PER
.00
9/21/04
3/21/05
MIKE QUINN
Plan Check Fee
Valuation
.00
o
~GD
-.
0,
C)
(jJ
~
~
~
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BUILDING PERMIT INSPECTION RECORD
Pe~r.-f -J1
...p.~,--~
o L} -7(p(p
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 cq - /6 -C)'-j .J LL-
WALLS C -2) -<::>4 ~Lt:-
FOUNDATION DRAINAGElDOWN SPOUTS Ie -~(( .-I'} "'I ILl
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN
PLUMBING numb. FIl'1CtI- ~/''3/0fi-J'''l A'fP'
UNDER FLOOR 1 SLAB
ROUGH-IN j .f" -DY J . L.
WATER LINE (METER TO BLDG) ~... L-~ ULL..
GAS LINE
BACK FLOW 1 WATER t
AIR SEAL
WALLS I!l. -I J-() ~ J" L,
CEILING r I
FRAMING
JOISTS 1 GIRDERS I ..,...-.
SHEAR W ALUHOLD DOWNS 121'1/()L 7LL
WALLS 1 ROOF 1 CEILING I A. "'-I /J.1 d" J (1,
DRYWALL {INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING l!:t -/ b -05- J.. J...,. I
MECHANICAL ~evl.t . Pi t1A.1 &/r r; lor;,\] U/ Aft?
HEAT PUMP
GASLINE ' -t -n t{' \ I
WOOD STOVE 1 PELLET 1 CIllMNEY - ,.
HOOD 1 DUCTS
PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT#'s:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT#'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHTDEPT
CONSTRUCTION R. W. 1 PWI CONSTRUCTION - R. W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 &/15106 ...:JW BUILDING
T.\PLANNINGIFORMS\1 Hl2.15 [11/1412003]
"
<0
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6'
ADORESS
/5,:.13
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ELECTRICAL INSPECTION
W~R!NG REPORT
417-4735
PE:2'~i~ zc;, 0~~;;Q
~,A"-T.P.A c...
cJ. /0 0
I
J
APPROVED NOT APPROVED
o """.,....,....., DITCH .."".,.,....,.,.. 0
o .............. ROUGH IN/COVER.. .... .. . "'" 0
o ,""..",..,.,... SERVICE .....,.,..,....... 0
o ,."...,....,."..,. FINAL. . . . , . . , . . . . , . . . . . .. 0
@,5""""K<"
CORRECTIONS NEEDED: ?/}')/I/6
?
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
OLYMPIC PAINTERS, INC. (380) 452.1381
- DO NOT REMOVE -
01/27/2005 11:11 FAX
I4i 003/003
.
\
-
-
~V/ ~
)' . ~ ~
I.Q Electrical Cootractor Cl Owner ...._~""
D Annual Permit l:I Alarm 0 Carnhal l:l Commercia~Resldenti9.1
ELECTRICAL WORK PERMIT APPLICATION
'E:J'Request Inspection
.
o Residential Maiot. Q Slgos D Thermostat 1:1 Telecom.
Job wired by
~<trical Contractor 0 Owner
Installstion description
SQte ZIP
lu,\ _ "/1",(.>'2--
FAX number
;-h'uSE
c<rg . fl-.
270()
Electrica\ contractor name
~t1mil -g 1-1
Purchaser's mailing address
1>(') -i5()~ 3
~1Zrf'N ~ P<::;,
Telephone rH.ll1:1lJer
3",D-'---l$'--Io~<l
LiceJ'l.senlJmber
I fLII.A-L LDl\.tTRf\T::l1.:l1-..,
/
Premises owner's Dame
". t3 ,-,-, d.e..- oS
Address or inspection
~Su3 vJ. IO-n-' SIr----t:.L+
Cll~
-tD\Z-.. ANb-'G1- - ,J.:A
"-',-
1
'11s-3 b:.1_
o Cash Cl Check #
I hereby cenify rhat I am the OWner of t.he abQve named property or a licensed
electrical contracmr (or the finn's authorized agent) and am making tne electric:!1
installation or alteratiotl in compliance walh the electrical law, Chapter 19,28 RCW.
Cl Credit Card Visa Mastercard Discover
Card# -..lU-~---------_
\.
x
Expiration Date
of card
. 2-D
...
O;!.le
ApJlm...ed Fly
SERVICE
to /f)~ ficD
otIC A41pl'llved By
/ FEEDER
()~ce A""roJvcd By
'WAlLS
Insulati.on Only"
CEILING
Insulation Only
TIlERMOSTAT
Appllll'ed B)'
D3le
#cover
. .---
De ^PPtQved 8)'
~~
Ap "ed By
Ad?
iCppravccl By
--:;:. Electrical Load Additions and nrsubtractlons
Cl NO LOAD CHANGES
o Baseboard _ KW
o Fumace _ KW
o Heal Pl,Jrnp _ Ton _ LAA
o Fan.Wall _ KW
Service Information
o Overhead Service
o J.emp Service
,;;;rUnderground Service
Vollage
Phase Cl , CJ 3
Service Siz:e:
Feeder Size:
Insl'ection
Date
Arcl.'l, Building or Equipment Inspected
Action Tllken
!;lectrics.1
Inspcctor
) )
\
IL
I9r:rD
.;
mJ
/-,;2 7- oS-
;j
~----------------------------------------------------------------------
J 1/29/05, 22:43:53
~^ PORT ANGELES
PAYMENTS DUE RECEIPT
PROGRAM BP820L
DICATION NUMBER: 04-00000766 1503 W 10TH ST
~E DESCRIPTION AMOUNT DUE
---------------------------------------------------------------------------
pdt!...
222.63
222.63
bvt.. tE.-ut-eJ' qJNNtf:~??I7H
ELECTRICAL NEW RESIDENTIAL
TOTAL DUE
...5-r/rTn-tr U-{:.rt'..:?P-I0
please present
this receipt to the cashier with full payment.
03/04/2005 15:50 FAX
/
~OO'/OO'
Please return this slip along with your Payment
CU~O~R: 61\l:lMF' 15tJ3
f/Ptfl, ?JL, mIre.. Qul'-J.?'.e,t<)
~ake died! for S; €zl,-{,,'3 navable tv:
City ofPort Angeles
Ref. No.: WFOO
()J IO~
Mail check to:
City ofFort Angeles
do Gail McLaio, Public Werks &Utilities Dept.
P.O. Box 1150
Port~eles. WA 98362-0217
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Deliver navment to: or
City Hall cashiers
32 I East Fifth Street
Port Angeles
1: em OF PORT ~l.ES
~ REPRINT
... IllSTOIIER RECEIPT OM
ODer: SODGIN3T Iyo"_(;f-Drawfr,-I:----,.
Dat,: 1/31/05 ~--5Ree'iPt nOI 10330 J'
Descriotion Duantitl R..unt
l T ~l-aECTRIC UTlL TV F\JlID
I. 08 1222. 03
Trani n..ber: 2719''''
CRPI1AL CONTR1EUTIONS
render detail
CC CREDIT rJlRD
To~al tendered
Total pal.ont
1222. 63
1222. .3
. i222. b3
Trans date: 1/31/05 Ti,e: 8:54:47
... Tlillli'. VOO FOR YOUR PA'fIlENl ...
FOR INQIJIRIES PLEJ& CALl. 360457-0411
N:FWXS'Umrl'J!NCiRIGAlLl$,nm"'.........paymoot
Ton fiJI
~1'1 OF PORT RN6El.ES
~ E P R I N T
... OJSTOi'IER RECEIPT ....
Oo,r' SED6IMlT- dloe:_CT ~a"")9
Date: 1/31/05 22- R.c,ipt n.: 10331
O~scril)tion Q.antity A..unt
LT ~1-aECTRIC UTILITY FUND 00"
1.00 . .2=.""
Trani nu.ber: ~71923
CAPITAL CONTR1BUTlONS
T.nd" d,tail '2~. 53
CC cREDIT ~RD . <<-
Total tendered 1m. b3
Total. pay.en\ Im.D3
Trans date: 1131/05 Tiu: 8:$,.0
... 1liANK VOU. FOR YOUR PIl\'I'ENT ....
FOR INQUIRlES PlEfl5E Cl\I..l. ~~57-0411
V'U.T 1'11'1 ''''T ~t('\'I\I ....^"., ,Tro,T,..
09/02/2004 12:11
13604521689
SHAMP ELEC
PAGE 01
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ELECTRICAL PERMIT APPLICATION
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The EIl?c:tri'7"~1 P~rmll Apnlicn1;on must bn fillp.d out comDletelv.
Please type or rl:!print in ink. If you helve an)" questions, please c;lll (360) 4174735
Fax number: (360)417-4711 07/- ?!33
Owne' or Eloe. Conl'Octor Agent :9ffttmP /'LWm IU~ LJ' OAJ re'Jt~l1 Nb I iJ C, Phone:
Propeny Owner: .--fu..l\!.-~ tLj)R~.
Addr.", eo ~ '14 'D
452- kS'(.)
Fax: :3x?IJ't.e..-
Phonf'3:
tf5t-~\l?{)
Zip: -.:J8%'2-
CIIy: :V6~i Ml.4-1.PC::; tAlA
. .)!-JArr\pLC01353 . 'I" 'l\
Ilrp.nM #: EXP:J....:..1...:::l: I.:
City: .ytn{T '~":l t-.ELJ~ L',j.~.
Phone: .+:)7_-1~,,.?~'1
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Elec.trical Contrl\ctor:,5tkT~W t~ij".("l"'fICL\l'''{'l..\:.1J~.A.CllO\JL J6.\~
Address, \);) 'T"" :oS?
INS1ALLATION WIRGD ev:
u OWNER
~LECTHICAL CONTRACTOR
Credit Card Holder Name: ['.;i:'\ iZ I;. ',^I. ) W.fhnf
Rilling Arlrlress: q 111 l.oJ k: 1\; )1Y(<" +
V/SA~ MC:
\(:.0-'1.. Ill. \O"t~
PROJECT ADDRESS: _~ :L ~
TYPE OF WO~
Check ~ that apply; ~ew
o Alteration/Addition
II'::"-Residential 0 Multi-family
U Commercial 0 Mobil" HUIII"
34. Fl
[J Remote Meter CJ Detached Qarage 0 Hot Tub 0 Swim Pool r:J Septic Pump
o Low Voltage [] Telecom. LI Sigr
Number of Circuits added Dr altered: ~_.'''_'_
DESCRIPTION OF THE ELECTRICAL PROJECT;
l.-{~~. ~I~
Electrical Heat Load Additions and or Subtractions
Service Information
LI Overhead Service
u T~tIlV St!rviL;~
n Underground Servico
Voltage:
Phase: Ci 1 [J 3
Service .:5ize:
Feeder Size:
o Baseboard
[J Fumace
Il Heat Pump
Cl Fan.Wall
_KW
KW
TON LRA
KW--
I hereby r;erli(y ii/ill I have read and examined this application and know tl113t same to be true end correot, end / 8ft
authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits
are mquired; it remains the applicants responsibility to determine what permits are required and to obtain such.
1:;:
Credit Card Holdl!r's Signatufl!: ,;r~"
Owner or EIl!c. Cont. Signature: 74 '-".!~
Date: q-t-o~
Date:~~"L 1)\.L
PERMIT FEE: $ 4tto
C ;/ELECTRICAI.PERMIT A
.'
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date 3- Jf5 -0'8 Time 7;cro /lf1^ Received by I (r (phone, e
Location of Work to be inspected I S () 3 {p/ / u I L
Name of person requesting inspection W "\.. f e, tJ~1/ ;.5/~ ~
Address of person requesting inspection i7o-r, .5!!t-l?~r Phone No. '-//7- t/t>'19
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. ~ 4-/t:'I./e /
. ,
INSPECTION NOTES:
Inspected: Date T.;l '([- 0 'if
Remarks:
Time /0: dV --ft"M.
By 7/7
bal1t
,}." c.-C #'1a,,,- b/e<:<.1c r'1all~d- LullL
RESTORATION REQUiRED...... YES NO V
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 1 03'tJ.. - I~ I
~ COMPLETE
b INCOMPLETE
''''__...~____ __ ________ _~...._ ~.I: __________1