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HomeMy WebLinkAbout1105 W 6th St - Building CITY OF PORT ANGELES 1 DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00000541 Date 6/01/11 Application pin number 351561 Property Address 1105 W 6TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-1- 1345 -0000- Tenant nbr, name MARTIN A MIKELSONS on your state excise tax form Application type description DEMOLITION to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 7800 Application desc DEMOLISH HOUSE AND GARAGE Owner Contractor MARTIN ARLENE MIKELSONS EARTH TECH CONSTRUCTION 1103 W 6TH ST 505 FRESHWATER BAY RD PORT ANGELES WA 983632007 PORT ANGELES WA 98363 (360) 670 -8811 Structure Information 000 000 DEMOLISH THE HOME Permit DEMOLITION Additional desc DEMOLISH HOUSE AND GARAGE Permit pin number 186833 Permit Fee 50.00 Plan Check Fee .00 Issue Date 6/01/11 Valuation 0 Expiration Date 11/28/11 Qty Unit Charge Per Extension BASE FEE 50.00 Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 50.00 50.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 54.50 54.50 .00 .00 'Nail 31(P 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 has 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 n• The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulati construction or the rformance of construction. _...-/Z Date Print Name Signature of Contractor or Authorized /A .ent Signature of Owner (if owner is builder) T:Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECT IONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE'OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments I i FOUNDATION: }L' Footings (L) Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) 0 PLUMBING: Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water FINAL Date Accepted by AIR SEAL: Walls Ceiling FRAMING: Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab Wall Floor Ceiling MECHANICAL: Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts 1 FINAL Date Accepted by MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit #s SE PA: Parking Lighting ESA: Landscaping SHORELINE: t FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417-4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 3 (.or T:Forms /Building Division /Building Permit d' N H 0 W W 0 aq N ro 0 0 O N 0 0 rd H a u H w c 0 co H 0 W F 0 0 0 cn W U] W 0 0 0 0 111 x w 0 0 0 01 F 0 0 0 cn as 0 0 H N .0 Z N U 0 z F w �a 0 fn H b N ..0 0 0 Z y N N S H w W W .1■ H (ZS 2 as X cn rd ow w Z Z 0 0 0 0 01 a .0 H H H 0 0 Sa a' 11 0 H 3 wz u a cn 3H 1 H F 0 w 01 2 0/ 0 0 a 0 u' U 0 0000 1.0 m w 04 H a 0 0 W W 0 N a al ro cnFW OH 2 a U W £h ZUXH 0 0 H o H na La) V1 W rn 0 000 1 0z N X< ct∎ E a a 4 0 F u L H co 01 W 01 0 o 4 U F o 0 0 w 3 z z Z 00 a x H 0 o w C+1 N N W X11 tt F F O O O F F z o< RC 00 O 0 a r- r1 0 0o ,o< W 0o 00(a. 00 ti a u M w zo 0 o a (/)F a Z F d o 0 w H o z z z a w H 01 M 0 au 4EE- -'U0 01 F a ran PROJECT STATUS UPDATE SCti ed (,r led Permit I I I I I ds k S Co I 19-- Date: 1 1 I phoned the: Applicant at Property Owner at Contractor ,a6(7 GO r ritakketh at lf I (left a phone message, or discussed): The permit (has expired, or will expire soon). What is the status of this project? Please call and schedule a final inspection. Or Submit a "permit extension request" letter. Or Let me know if the project is abandoned. T:Forms /Building Division/Project Status Update r ,���''`�H� BUILDING PERMIT APPLICATION Print in ink 1. CITY OF PORT ANGELES For City Use Only:. f Attn: Building Permit Technician Date Received 5-31-it 321 E. Fifth St., Port Angeles, WA 98362 Permit II, 59 (360) 417 -4815 fax (360) 417 -4711 Date.Approved 40 ail- Applicant av, Phone &lc) Property Owner (M 11 i Vo ,1 5 Phone Property Owner's Address t ,3 u c.e ST--. Contractor E ,nom 4 s1 �T Phone 0 Wj( Contractor's Address 1 —e,r ,t5 ___R__b r Tii, License q tr; ;3- 1) e,� Z Expires 3 -s I- iZ E -mail i i c� �r 0i ix., L fok; PROJECT ADDRESS S Parcel Number 663o coo 1 395 Lot Zoning Project Type Brief Description: XResic1 Multi family Commercial Industrial Check all that apply b. v "9106 6dhen kw/ New Construction ge'Vll'kJ rte 1 kn N,� t7VA �Ir'oPe. i Addition J�li t. Ii' eta b ees/\ j kJ Oki -._1- El Remodel 0 oI Q 7) j r f� 0 r (1 1 e ��V PP. �1 `ll I)Q1 �e,. Q'�r- _1-.A "V l'.l 011 Z" �r9 �7U�` Repair L t Y YY !�i'.1►.rl I LA Altai- •_..4 .Demolition G 4d 4 D7 i1 7 100 Re roof House rage other tear off re of�❑ lay over one layer Heat System Heat pump wood- burning stove gas fireplace pellet stove other Other e, .vc In A Al-/ -r :mho AJ le oire--- Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement 4 tiouNi n• The Vlorne, wi 11 leove@ per sq. ft. 1 Floor i C a i .'n i 2nd Floor S .4nlcl +he- co t ier ■N-_ e Orr 'e., c vi'r� 3 Floor C a.v f m-�m m o e 4, ci`vnn shvavlre Garage OrN -P_ •rce Carport Al Yl a _lo oVeV'ClO+ Covered Porch Deck Shed Other Q• TOTAL VALUATION l -=C Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage Max. height of proposed structures ft. Occupancy group of bedrooms Will a lawn sprinkler system be installed? Occupant load of full baths Will a fire sprinkler system be installed? Construction type of half baths I have read and completed this application and know if to be true and correct. I am authorized to apply for is permit and understand that it is my responsibility to determine wh t permits are required, and to obtain permits prior to worki to• rojects. Date /(Print Name C) !j//e Signat i'' A T:Forms /Building Division /Building permit application y /4" 5e/ TN, :;i ''',„,,,iy ,,r ;11 :,,,,e .:1•4n4,:;,.*41:4111-41.,'1,' 11 •..4cr '141 a 6/ "N 2 ...'r,:• 4 ,o•,•• A,, -1,a•41. /4, -°,0 "A. ,1 7 v Ilk „.7. ,:jt '6 1,?.?.4!., •L„ •,t, ..,,,,1,,, `1444,„: ..ttct.' 1 ft y t■.;?:!..iri'lL' '•ii,y•?-4":11400 r 7 4 .4.,7. ,..ii, t,,tiev -f.--:_-__...„.,,,..",..-„,--„,..„4- ,,,-,:t ,i, v a ...N.,. i ///:,4,' 4 t..?,...„, e `,..tt, t i. ---„.„.7 „,J ,,N: i: 1 .7....,,,,,,,„,,t,.• 7 w",„ •,,i';'''',,,";.,',„,:,'",:,","•:''4'1103! 05/25/2011 11:34 0604524972 3093 P.001/012 CORPYARD I i'41:1:•:?'':'" v ;:;:;]',::1'' r Cs I Y ::::..ar T I-.NGELE,S P WAS ING ;.....k:' .Artv vii HTON., U.S.A. 'P."' v-•:, ,.:1, .t......-- T.::: :mow Public Works Utilities Department ,1; 0 0...\:11, .4:;;.4:,,.`,?.;%',kk,.. 7 V rt.,.4 .14 A'': ?4,17,..0,71:.;•.' Vej.1 C-g.1° 9ej 4; A t ,.....,...,„,•,,,;.:','..::%rr':;'..."' \i‘l 4 M \\06 tk ?..11.?i!.:4:'''.;:g:V:::':;'..,•:) y.25,.2011 A:Vrs -A{ ~,;;',:;?..1.it,...:];;,,.:',::•;.:"i.: nofiel\N 05 Fre 5shwater By Road ...v,,, ...t.;;;••.::.: .7:.:v,;...r.. RE: Port Angeles Landfill Transfer Waste Disposal Application, WA #117:14 for Earth Tech .,:.i, Construction, ::::iri:•-•.'fi;''.'.1 ..1):',:•:;.': We have received your application for disposal of demolition materials from the referenced .:•;:r.f.•.:.': site and reviewed the testing results, Based on the testing results of the materials It appears to be -•.'1. acceptable for disposal at the transfer station, A copy of your approved application is attached. This approved application must be shown to the transfer station scale attendant at the time of disposal. I. 1 ;;I ..t. ;r E:.c i f 2 1P.4 Please be advised that the disposal application is only for the materials and quantities listed in the ,:::;.',.:•.T. ,'-:•:•!:"..",•:,'•••="11..''&•';",.:.,:: application, Materials not listed or in excess of the quantities noted may require separate :1,: applications and approval, Pi:'.•:1.1..''.:%:::'? i '.'4,i.•,:A 1, .:.1.:.., Please call Tom McCabe, Solid Waste Superintendent at 350-417-4872 or e-mail ..R r...1: :lt.::,•,''',.:: :!...i.7'... tmccabescitvota.us if you have any questions. r f:';.t ,:ii,'!: 4 1...`. -'-ff:'Z rAV...:F..:?r...';; .4. i ..r.I.,'."'''r. 4:.,: Sincere Iv v;;;,.1?:.:,,:;... ..1. .1. 1.... 4 7 9 ::::.'r. /2- +1, :',,,,;•67. +4.',. :.2.:,.SC..).30.;;•.7,/p7 T h A r. I 8 4:! I oil] iyic%..a,.., .4■'1,..•iie .7:01,:.'01:•,,k.,:::i4.;':::: go L 'IF Solid Waste Superintendent ;1 I i 1 !...i yTA ..t. +1 4 1 V 1 j., ....i :.;rii:■q4'1.54;7''tWW.1 D.':i.i16!4:0‘i:P}Va4.14 Cc: Brian Tate, Operations Manager, Port Angeles Transfer Station r 4 '.-.744** :).::4•'::?.qkisl'tvi''AtgSP'..."‘' Sonja Coventon, Scale Attendant City of PA :,;;:::7,:f4';'.014,..e.7;',..i.‘; ;•.W. •g; [V:•?.4'0;7.*:'!!•;0•:',.:::;q Enc: WPA ''''-ir..04,,,P01.) ...i'..i;!• ..1' ,„•P:„."...„„..:•:,•‘,..: C:Waste Disposal/correspondence ...,:,::::;;;N:..::-.!..,41 i '.:g•::***. r6. c,;74:71-:,.,!.,,7,,,•"::::•7....,,,,:fyi PhortiO; 360 Fax: 360 -.,..f...,....,....,,5.,.;:, Webetto: 1 Emell: oublicvvork,s@cityaipe,u8 1 321 East Fifth Street P.O. Box 1150 POrt Angeles, WA 98362-0217 i tA) c) f P O 4'OB 7pry. 4s WASTE DISPOSAL APPLICATION PORT ANGELES SOLID WASTE TRANSFER STATION h fi 14 DRKS 40 To: City of Port Angeles Phone: (360) 417 -4872 TOm McCabe, Attn: Solid Waste Superintendent Fax: (360) 452 -4972 321 E. Fifth Street P.O. Box 1150 Port Angeles, Washington 98362 NOTE: All questions must be answered for waste to be approved. 1. Applicant Information: Company Name: v Mailing Address: Contact: c V6c,v1 N\ Phone: (,p10 t Project Name: tnA�L�e (*jc Project Location: 05 c,J 2. Other Contacts (if applicable): Consulting Firm: Contact: f- 1\1A,W chi _Phone: 0 O5 Contractor Name: Contact: Phone: Laboratory: Contact: Phone: 3. Source of Waste: Check the appropriate box below and briefly describe the project, process, and /or cleanup that will or has produced the waste requiring disposal. Include the gasoline service station number (if applicable). CERCLA /MTCA Remediation Agency Contact: Independent Remedial Action UST Removal Unused Chemical Product Spill U.9ther Source: City of Port Angeles —Waste Disposal Application Page 1 of 4 (last updated January 2011) 4. Waste Ma terial Composition: (Check all that apply and include percent of total) Soil Foundry Slag Solvents Dredge Sediments Preserved Wood Debris �O Coal Ash Other (list) Wood Ash C� Cep NOTE: Total must equal 100 5. Waste Material Contaminants: (check all that apply) Gasoline Metals Diesel Solvents Heating Oil PCBs Unused Motor Oil Used Motor Oil /Waste Oil Other Other Petroleum Product Unknown Note: Supply and MSDS information with application, if available. 6. Estimated Quantity of Waste for Disposal: AD Cubic yards 203 Tons (estimated both) Drums Tons (estimated both) Other: NOTE: Estimated quantity for disposal must be within 20% of the quantity actually disposed. (10% for projects over 7,500 tons or 5,000 cubic yards) 7. Fre uency of Disposal: One time Monthly Annual other 8. Waste Sampling: Proper characterization of the waste for disposal requires the collection of representative samples: The methods and equipment necessary for obtaining representative samples of a waste, and the frequency of sampling, will vary with the type and form of the waste. Check the appropriate box and briefly describe how the waste was sampled. Identify site and location where material is being removed from. Number of COMPOSITE samples: Number of DISCRETE samples: City of Port Angeles Waste Disposal Application Page 2 of 4 (last updated January 2011) NOTE 1: Unless prior approval has been granted by Port Angeles, the following sampling frequency will be used: 0 25 cubic yards 1 composite sample 25 —100 cubic yards 3 composite samples 101— 500 cubic yards 5 composite samples 501 -1000 cubic yards 7 composite samples 1001— 2000 cubic yards 10 composite samples >2000 cubic yards 10 plus one sample for each additional 500 cubic yards NOTE 2: One composite sample shall contain a minimum of three /maximum of five discrete samples. 9. Waste Analysis: The "Dangerous Waste Regulations" (WAC 173 -303) shall be utilized to determine the appropriate analytical requirements for waste characterization. Ecology Publication #91 -30 (Revised November 1995) or any future updates "Guidance for Remediation of Petroleum Contaminated Soils" shall also be used to characterize petroleum contaminated soils from underground storage tanks releases. Submit all laboratory analytical results, QA /QC data, and Chain of Custody sheets along with this application. (NOTE: The sampling laboratory must be accredited by the Washington State Department of Ecology.) a) List all analytical test methods used: b) Provide a narrative as to why the above analytical methods were selected: NOTE: Additional sheets attached: YES NO 10. Soil Classification: *FOR PETROLEUM CONTAMINATED SOILS ONLY Based on the analytical data and Ecology Publication #91 -30, the soil classification is: (check one) Class 1 Class 2 Class 3 Class 4 Calculated Hazard Index 11. Dangerous Waste Affidavit: Based on a review of the analytical test results, site history, and the applicable regulations, this waste is classified as: (check one) Neither Dangerous Waste (DW) nor Extremely Hazardous Waste (EHW) Dangerous Waste (DW) and Waste Code: Extremely Hazardous Waste (EHW) and Waste Code: City of Port Angeles Waste Disposal Application Page 3 of 4 (last updated January 2011) 12. Special Notes for Asbestos Disposal All asbestos containing materials (with the exception of roofing material in good condition that is not peeling, cracking or crumbling, with _petroleum_binder that still exhibits plasticity to prevent release of asbestos- fibers) -must: Be tightly wrapped or bagged in 6 mil plastic with no excess air in the packaging Not exceed 50 pounds per bundle Be labeled as asbestos with required information regarding its origin Be transported with a manifest in the vehicle Arrive at the transfer station only by appointment with Brian Tate of Waste Connections at 360 452 -0427 or cell phone 360 912 -7080, so that the material can be deposited in a lock box. Certification: We, THE UNDERSIGNED, certify that this application is true to the best of our knowledge. All information provided is correct and the enclosed analytical results represent proposed waste material to the best of our abilities. Waste Generator's Signature: Printed Name Company Position Company: Date: If you have any questions please contact Tom McCabe, Solid Waste Superintendent at 417 -4872 or email tmccabe@citvofpa.us. THIS SECTION TO BE FILLED OUT I3Y AUTHORIZED STAFF Approval: Environmental- Health Specialist Date Approval with the following conditions if applicable: I certify under penalty of law that the statements made on this form are true and correct to the best of my knowledge, information and belief. Tom McCabe, Solid Waste Superintendent Date Contractor shall present their copy of approved application to Scale House. A Demolition Permit must be obtained if demolition occurs in the City. Permit forms are available at the building counter at City Hall or on the City's website under the link hhtp: /www.cityof pa.us/ Phone 360-417 4815 City of Port Angeles Waste Disposal Application Page 4 of 4 (last updated January 2011) Clallam County Assessor Treasurer Property Details 56659 MARTIN AND ARLE... Page 1 of 2 Clallam County Assessor Treasurer Property Search Results 56659 MARTIN AND ARLENE MIKELSONS for Year 2011 2012 Property Account Property ID: 56659 Legal Description: E2 LOT 18 W25' AND N40' OF E25' LOT19BL113 Geographic ID: 0630000113450000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 Open Space: N DFL N Historic Property: N Remodel Property: N Multi Family Redevelopment: N Township: Section: Range: J 7.XJ" Location Address: 1105 W SIXTH ST Mapsco: PORT ANGELES, WA 98363 Neighborhood: Cycle 5 Res Map ID: 3 Q Neighborhood CD: 10955130 \V Owner Name: MARTIN AND ARLENE MIKELSONS Owner ID: 41046 Mailing Address: 1103 W 6TH ST Ownership: 100.0000000000% PORT ANGELES, WA 98363 -2007 Exemptions: Taxes and Assessment Details Property Tax Information as of 05/31/2011 Amount Due if Paid on: 7. NOTE: If you plan to submit payment on a future date, make sure you enter the date and click RECALCULATE to obtain the correct total amount due. I First Second I }Half Half I !Base ;Base i I i Year Statement ID Taxing Jurisdiction Amt. i Amt. Penaltyj Interest [Base Paid Amount Due 2011 151398 ST SCH STATE SCHOOL $79.27 $79.27 $0.00 $0.00 $79.27 $79.2 2011 151398 CC-GEN CO UNTY CLALLAM $43.78 $43.75 $0.00 $0.00 $43.78 $43.75_1 2011 151398 SD #121 SCHOOL DISTRICT #121 $103.62 $103.61 $0.00 $0.00 $103.62 $103.6, 2011 151398 CITY PORT ANG CITY OF PORT ANGELES $101.02 $101.02 $0.00 $0.00 $101.02 $101.02 2011 151398 PORT PORT OF PORT ANGELES $6.16 $6.16 $0.00 $0.00 $6.16 $6.16 2011 151398 NTH OLY LIB NORTH OLYMPIC LIBRARY $18.35 $18.35 $0.00 $0.00 $18.35 $18.35 2011 151398 HOSP #2 HOSPITAL #2 $17.97 $17.96 $0.00 $0.00 $17.97 $17.96 2011 151398 WSMET PK DIST WILLIAM SHORE MET PARK DIST $5.46 $5.46 $0.00 $0.00 $5.46 $5.46 2011 151398 CITY STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $36.00 $36.00 2011 151398 WEED CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0.00 $0.82 $0.81 1 2011 :151398 TOTAL: $412.45 $412.39 $0.00 $0.00 $412.45 $412.39 1 2010 39695 ST SCH STATE SCHOOL $78.48 $78.47 $0.00 $0.00 $156.95 $0.00 2010 39695 CC -GEN COUNTY CLALLAM $41.76 $41.77 $0.00 $0.00 $83.53 $0.00 2010 39695 SD #121 SCHOOL DISTRICT #121 $101.65 $101.64 $0.00 $0.00 $203.29 $0.00' 2010 39695 CITY PORT ANG CITY OF PORT ANGELES $96.70 $96.69 $0.00 $0.00 $193.39 $0.00 2010 39695 PORT PORT OF PORT ANGELES $5.87 $5.87 $0.00 $0.00 $11.74 $0.00 2010 39695 NTH OLY LIB NORTH OLYMPIC LIBRARY r $12.14 $12.13 $0.00 $0.00 $24.27 $0.00 2010 39695 HOSP #2 HOSPITAL #2 $17.13 $17.13 $0.00 $0.00 $34.26 $0.00 2010 39695 WSMET PK DIST WILLIAM SHORE MET PARK DIST $5.45 $5.45 $0.00 $0.00 $10.90 $0.00' 2010 39695 CITY_STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $72.00 $0.00 I http: /websrv8.clallam. net /propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =56659 5/31/2011 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 10 00000264 Date 3/18/10 Application pin number 548768 Property Address 1105 W 6TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 1345 0000 Tenant nbr name PATRICK /STACEY NICKERSON Application type description RE ROOF Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 8500 Application desc TEAR OFF RE ROOF AND RE SIDE THE HOUSE Owner Contractor PATRICK G STACEY M NICKERSON WIKER WIKER CONSTRUCTION INC 75 PAULINE RD 43 SENZ RD PORT ANGELES WA 98362 SEQUIN WA 98382 (360) 461 7537 1 (360) 681 4800 Structure Information 000 000 RE ROOF RE SIDE HOUSE Permit BUILDING PERMIT NO PR FEE Additional desc RE ROOF RE SIDE HOUSE Permit pin number 162511 Permit Fee 193 75 Plan Check Fee 00 Issue Date 3/18/10 Valuation 8500 Expiration Date 9/14/10 Qty Unit Charge Per Extension BASE FEE 95 75 7 00 14 0000 THOU BL -2001 25K (14 PER K) 98 00 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 193 75 193 75 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 198 25 198 25 00 00 T:Forms/Building Division/Building Permit 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 has 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 co r t. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a s not presu o give authority to violate or cancel the provisions of any state or local la regulating construction or the performance of c 43/ /�0/D X G /Die Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) Inspection Type FOUNDATION. Footings Stemwall Foundation Drainage Downspouts 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 Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In 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 I T.Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Date Accepted By FINAL Date Comments FINAL Date Accepted by SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 Accepted by Date Accepted By 0 N Vt Sot 9- Applicant Property Owner Property O 9er's Address Contractor Contractor's Address License Floor Areas PROJECT ADDRESS Parcel Number Project Type Brief Des Check all that apply New Construction Addition Remodel Repair Demolition Re -roof Heat System Other Basement 1 Floor 2 Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn Building Permit Technician 321 E Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 AP 2 cription. ExistingJg. ft.) X 1 ft. esidential Expires House garage other o Heat pump wood- burning stove Multi family Proposed (sq. ft.) 1 Occupancy group upant load Con uction type Total footprint of structures q ft. of size Site Coverage the amount of impervious surfa.- o parcel including structures, p and other impervious surfaces (see PAMC 17 9. .135 for exemptions) Phone 3ti• 9 hone 360 v(/- 2543 2 Phone E -mail For City Use Only Date Received 3.--f g 10 Permit 10—Z6 Date Approved 2/ d���3 Lot Zoning Commercial Industrial j%tear off re -roof lay over one layer s fireplace pellet stove other per sq ft. TOTAL VALUATION ,c(90 °(-2 sq ft. coverage ways, sidewalks, patios, Site coverage f bedrooms o II baths of ha •aths I have read and completed this application and know it to be true and correct. I am authorized to •r his permit an derstand that it is my respo sibility to determine w at ermits a required and to obtain permits prior to .•n ?r*'! ��o ect A re Signature Date Q3 Print Name ri' v��•c�, Si nature T Form /Bui ding Division /Building permit application Clallam County Assessor Treasurer Property Details 56659 PATRICK G /STACEY Page 1 of 4 Clallam County Assessor TrE Property Search Results 56659 PATRICK G /STACEY M NICKERSON for Year 2009 2010 Property Account Property ID 56659 Legal Description E2 LT 18 LT 19 EXC S100' OF E2 BL 113 Geographic ID 0630000113450000 Agent Code Type Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 Open Space: N DFL N Historic Property* N Remodel Property' N Multi Family Redevelopment: N Location Address. 1105 W SIXTH ST Mapsco PORT ANGELES Neighborhood: Cycle 5 Res Map ID Neighborhood CD 10955130 Owner Name PATRICK G /STACEY M NICKERSON Owner ID' 43246 Mailing Address: 75 PAULINE RD Ownership: 100 0000000000% PORT ANGELES WA 98362 Exemptions: Taxes and Assessments Due Property Tax Information as of 03/18/2010 Amount Due if Paid on Statement Year' ID Taxing Jurisdiction 2010 39695 ST SCH STATE SCHOOL 2010 39695 CC -GEN COUNTY 2010 39695 PORT PORT 2010 39695 PORT ANG PORT ANGELES 2010 39695 SD #121 SCHOOL DISTRICT #121 2010 39695 NTH OLY LIB NORTH OLYMPIC LIBRARY 2010 39695 HOSP #2 HOSPITAL #2 2010 39695 WSMET PK DIST WILLIAM SHORE MET PARK DIST •I 2010 39695 CITY_STORMWATER CITY STORMWATER 2010 39695 WEED_CONTROL WEED CONTROL 2010 39695 TOTAL. ST SCH STATE SCHOOL 2009 566592008 2009 566592008 CC -GEN COUNTY 2009 566592008 PORT PORT 2009 566592008 2009 566592008 2009 566592008 2009 566592008 2009 566592008 PORT ANG PORT ANGELES SD #121 SCHOOL DISTRICT #121 NTH OLY LIB NORTH OLYMPIC LIBRARY HOSP #2 HOSPITAL #2 CITY_STORMWATER T CITY STORMWATER First Second Half Half Base Base Base Amour Due Due Penalty Interest Paid Due $78 48 $78 47 $0 00 $0 00 $0 00 $156 $41 76 $41 77 $0 00 $0 00 $0 00 $83 $5 87 $5 87 $0 00 $0 00 $0 00 $11 $96 70 $96 69 $0 00 $0 00 $0 00 $193 $101 65 $101 64 $0 00 $0 00 $0 00 $203 $12.14 $12.13 $0 00 $0 00 $0 00 $24 $17 13 $17 13 $0 00 $0 00 $0 00 $34 $5 45 $5.45 $0 00 $0 00 $0 00 $10 $36 00 $36 00 $0 00 $0 00 $0 00 $72.( $0 82 $0 81 $0 00 $0 00 $0 00 $1 E $396.00 $395.96 $0.00 $0.00 $0.00 $791 t $88 53 $88 52 $0 00 $0 00 $177 05 $0 $44 80 $44 81 $0 00 $0 00 $89 61 $0 $6 35 $6 34 $0 00 $0 00 $12.69 $0 $98.28 $98.26 $0 00 $0 00 $196 54 $0 $109 47 $109 48 $0 00 $0 00 $218 95 $0 $13 02 $13 02 $0 00 $0 00 $26 04 $0 $1837 $1838 $000 $000 $3675 $0( $36 00 $36 00 $0 00 $0 00 $72.00 $0 http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2009 &prop_id =56 3/18/2010 Application Number 07 00000640 Date 6/01/07 Application pin number 531840 Property Address 1105 W 6TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 1345 0000 Tenant nbr name PATRICK NICKERSON Application type description RES REMODEL Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 2302 Owner Contractor PATRICK G STACEY M NICKERSON 1105 W 6TH ST PORT ANGELES WA 98363 (360) 461 7537 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 OWNER Permit BUILDING PERMIT NO PR FEE Additional desc RE ROOF NEW SIDING Permit pin number 103655 Permit Fee 109 75 Plan Check Fee 00 Issue Date 6/Q1/07 Valuation 2302 Expiration Date 11/28/07 Qty Unit Charge Per Extension BASE FEE 95 75 1 00 14 0000 THOU BL -2001 25K (14 PER K) 14 00 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 109 75 109 75 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 114 25 114 25 00 00 EN/ I o -z7 -o ff 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 to gay/ regulatin, 1 construction or the performance of construction S 7 Ocr� /D 7 Signature of Contractor or Authorized Agent Date Signature of Owner I oner is builder) w Date 1 V T' \Policies \1102 15 building pennit inspection record05 wpd [1/4/2005) f_ Y o 4_ O S CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS CALL 417 -4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE k MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK _BEFOR INSPECTED 4ND 4 CCEPTED POST PERMIT IN 4 CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. ELECTRICAL LIGHT DEPT INSPECTION TYPE DATE FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDERFLOOR /SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL /HOLD DOWNS W ALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL ROUGH -IN HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY BUILDING PERMIT INSPECTION RECOM) ACCEPTED YES NO FINAL FINAL 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 I 1 1 I FIRE DEPT PLANNING DEPT 417 -4750 I I 1 I PLANNING DEPT BUILDING 4]7 -4815 I Ib 2.3 1 ..,X0 MI BUILDING T' \Policies \l 102 15 building permit inspection record05 wpd (1/4/2005) COMMENTS DATE ACCEPTED BY. DATE ACCEPTED BY. MANUFACTURED HOMES FOOTING' /SLAB BLOCKING R HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT II's SEPA. PARKING /LIGHTING ESA. LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE I ACCEPTED YES I NO I 1 1 1 I I I I I I Applicant or Agent: Owner Address: i/o .a/ City ;f Architect/Engineer Contractor State License Address. TYPE OF W Residential Multi- family Commercial Repair ORK. New ConstrRe -roof Addition Move Garage Remodel Sign Other BRIEF DESCRIPTION OF THE PROJECT PLANNING USE ONLY 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 Deck COMMERCI /RESIDENTIAL. occupancy Group: No. of Stories: J Lot Size: Existing Sq Ft. Total lot coverage d_ 0 9 City Stove ESA/Wetland(s): Yes No SEPA Checklist required? Yes No Other PROJECT ADDRESS /ar t r'-'' _(4� LEGAL DESCRIPTION Lot: A..-i Block: Z47 Subdivision. CLALLAM COUNTY PARCEL NUMBER. 00? o 74 Phone: 364 4/ 6 7 Phone: :s')t) 4/1f/ 7t Zip 4 Phone: Exp: SIZE/VALUATION ?N SF (C, /SF 6f7 SF 00 /SF SF /SF TOTAL VALUATION `12 ;e er-C 4 i t Phone: Zip ZONING FOR OFFICIAI. I ISE ONI Y Date Rec. 06 I O� Permit#! 0 Date Approved: 0 Co- 01--0 Date Issued: O(n -0I--0 oa i z_pctor Occupant Load. Construction Type: 7ZO Proposed Sq. Ft. 1er TOTAL Sq. Ft. 2e) APPROVALS. PLAN BLDG: DPWU FIRE. OTHER. 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 If no 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 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 r:. 1,: bility to termine w t permits:are required not the City's, and that I must obtain such permits prior to work. T \FORMS\BldgPermitAppl. wpd Applicant: f Date: ©tr��� CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT .",-~,-,-,. Nt.' 16619 r -- ~ :> ;:-:--. Port Angeles, Washlngton_uu_muLmu__L_m_mmu__mummm_m_, 19_uu~u In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, o~, or about any building or other structure in the City of Port Angeles, per- mission is hereby granted to do electrical work as listed below. Address -u<~-:f.uf:i!-i~---muuummmu-m-u Occupancyuu_~i~~m__muunmu_uuu Owner um__~u~_~u:~."'m_~.m_~C_r:v?_ ;I;~nant.munuum-mu_.m-um--mmuummmm-m---mmu Wiring Con~actor __L_~":~I,~.-mc.;Kt?~:m BY_uu_uummuuuumumumuum_m_nuuummm___ Light OUtletB..........u~............_.._..... Service, volts ..1~.1r/..:?f.!!..... Type ot Wiring: Receptacle Outlets...__.~.............__... No. wires --...':::f77jU--....V...... Armored Cable ..-.............--.-........- Si i // p ~ - Non-Metallic ............m.__m_._h._m.. Dryer, KW mun..___.___u..___.___.____.__n_____ ze w res....;:74A9..-;.;...;r...-.. ~.,v I'T' Knob & Tube......._.__....................._ Range, KW __.....n___........____. _____n___'.__.. Main fuse h_..m.n...__mm__:m_mh..... Water Heater: Enclosure ......___~..~.mnn......_......... Rigid Conduit ......................u....... Metallic Tubing nmn..._.....m_____.. KW.mm.}.umunmmn__m__ . Heat: Kw.............<L8.J.l....__. Type of wiring: Entrance Cable ___m_.h.. Ser. NO.....___n_.........................nn..__n Raceway ________......................._.__ Circuits. Light....h.........._..._m..........._._ Utillty ..................................._......u. }Ieat ..___,..._..................h........._...... Range ________._.........,______...__......._______ Water Heater ............nn............... Motor ._.................-.______..__............... , Rigid Conduit .0....0......._. Metallic Tubing ...nm........ Current transformers: Motors: size, volts and phase: No. & Size............__.._m___...___ Set. No. ..........nnnnnnn_n_..n....u....... Dryer _...........____________...........__.____......_ Furnace .-........................w._.._._.__....... Ser. N 0...0.__...._....____..____..__._0.._........... Remark:~ta:._:~~;;_;g;Q__~:_____=.ld::3?___._.~:~:Q:_~::~fl,e=~__u_~::I~_:=;::_:~::~d&JL: By nn'fj~=ft.~-~~~,A-,__ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected betore concealment. Permit Fee Treas. Receipt $_____u__...._m_mum..mmm. NO.m_____....__m______m NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT Nt? 16619 Address Date______.____..____.._.........._......_._...._......... Owner..........__.......................__.......____.._.____..._.._...........__.............._.................__._.......__.Tenant....._......___.___.._______________________..._....__.............. \ \ 1 WiringContractor....__...____._____..___.___.__.............._._______.....__...................._..._.__._...._.__.__.___._.___.________By.___._____...______.__.............................._....___.. NOTICE-Current must not be turned on untH Cert1ficate ot Inspection has been issued. If work f,l! to be con- cealed ~ue notice must be given the Inspector so that work may be inspected betore concealment. 1M Olympic Printers, Inc.