HomeMy WebLinkAbout1630 W 4th St - Building CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDiNG DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number ..... 03-00000623 Date 7/23/03
Property Address ...... 1630 W 4TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-2932-0000-
Application description . . . RES NEW SFR
Subdivision Name ......
Property Zoning .......
Application va ~l~uat ion .... 134420
Owner Contractor
BLANCT{A~D, ROGER E R & N BUILDERS
P 0 BOX 2904 171 CEDAR GLEN LN
POET ANGELES WA 98362 POET ANGELES WA 98362
(360) 460-0979
...... Stzn/cture Information NEW 2068 SF SFR W/ATTACHED 364SF GARAGE
Construction Type ..... TYPE V NON-Pu%TED
Occupancy Type ...... SINGLE FAM & CONGREGATES
Other struct info ..... NUMBER OF UNITS 1.00
............................................................................Permit ...... BUILDING PERMIT -RESIDENTIAL
Permit Fee .... 1213.25 Plan Check Fee . . 485.30
Issue Date .... 7/23/03 Valuation .... 134420
Expiration Date . . 1/20/04
Qty Unit. Charge Per Extension
BASE FEE 1017.25
35.00 5.6000 THOU BL-100,001-500K (5.60 PER K) 196.00
Additional dose . .
Permit Fee .... 97.95 Plan Cheek Fee . . ,00
Issue Date .... 7/23/03 Valuation .... 0
Expiration Date . . 1/20/04
Qty Unit Charge Per Extension
BASE FEE 47.00
1.00 14.7000 ECT~ ME- INSTALL 100- FAU 14.70
5.00 7.2500 ECqq ME-Xq~gT F~LN 36.25
Per.it ...... PLUMBING PERMIT
Additional desc . .
Permit Fee .... 153.00 Plan Check Fee . . .00
Issue Date .... 7/23/03 Valuation .... 0
Expiration Date . . 1/20/04
Qty Unit Charge Per Extension
11.00 7.0000 ECH PL- EA. FIXTURE ON ONE TP. AP 77.00
1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00
1.00 15.0000 ECH PL- EA. BLDG SEWER 15.00
1.00 7.0000 ECH PL- EA.WATER HEATER 7.00
Other Fees ......... SEWER SYSTEM DELV CHARGE
PW WATER SYSTEM USE FEE
Fee summary Charged Paid Credited Due
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
[or 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
Signature of Contractor or Authorized Agent Date Sig~ure of Owner (if owner is builder) Date
:\PLANNING\FORM S\ [ 102.15 [4/2002]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page 2
Application Number ..... 03-00000623 Date $/23/03
Permit Fee Total 1464,20 1464.20 .00 .00
Pla~ Check Total 485.30 485.30 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 3724.00 3724.00 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within '180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within '180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORMS\1102.15 [4/2002]
FOR OFFICIAL US,~ ONLY:
' ' BUILDING PERMIT - APPLICATION
Permit#:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE Da~ ~mv~:
COMPLE~ to be accept~ for review. If you have any questions, call
(360) 4174815 ~te Issued:
Applicant or Ag~t: ~n~ ~ ~ L~ ~ Phone: 3~ ~- ~ 3~7 q
~cMtcc~nginccr: ~ E ~L~d~ ~'g~dic~5 ~ Phone: .~O q57
Address: ITt ~ ~ ~ CiW: ~ ~c~ % Zip:
LEG~ DESC~TION: Lot: ~ Block: / ~ 9 Subdivision: ~o~ e-,~ ~
Credit Card Holdej' Name: /~0~ ~(2-.. /.~.
Billing Address: ~OO ~t3% o2~lOq City: ~,0/~7'-
Credit CardType VISA MC ~{ # Exp. Date:
TYPE OF WORK: SIZE/VALUATION:
gl. Residential ~NewConslr. [] Re-roof [] Stove ,~O/-,~ SF.~$ ~"- /SF.=$ ~.~
0 Multi-family [] Addition 0 Move !~ Gar'age .~e,,-,~ ~/~ q SF. ~ $ /SF. = $.
[] Commercial [] Remodel [] Demolition [] Deck SF. ~ $ ." /SF.--$
[] Repair [] Sign [] Other TOTAL VALUATION $ ,t_~ t/., y zo
BRIEFI~ESCRIPTIONOFTt~PROJECTi ~eta., ~'/:~ u~,/t-/~ _~,~
COM~ER~$IDENTIAL: Occupancy Group: Occupant Load: Cons~amction Type:
No. of Stories:.~ Lot Size: _'~"D A ~ q~O Existing Sq. Ft. ~- & Proposed Sq. F~_~---~--~ 3 -- TOTAL Sq. Ft.
Existing lot coverage .~- % & Proposed lot coverage % = Total lot coverage !.~ ~ ~-f ~
.ad'PROVAL$:
PL~d~IING USE ONLY: PL.~I:
BLDG:
DPWU:
FIRE:.
ESAf~etland(s): [] Yes [] No SEPA Checklist required? [] Yes [] No Other: OTRER:
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 ali 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 41%4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it mast be submiRed at the time the building permit application and construction plans are
submi~ed. 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 applicafien, 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 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 tr~e 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 wor~.
T:WORM S~,PPS~Buildingpermit.wpd Applicant: }f~
WASHINGTON, U.S.A.
DEPARTMENT OF COMMUNITY DEVELOPMENT
January 7, 2003
Mr. Roger Blanchard
P.O. Box 2904
Port Angeles, WA 98362
Re: Variance - VAR 03-01
1634 West Fourth Street
Dear Mr. Blanchard:
As you know, following a public hearing conducted on January 6, 2003, the City's Board of
Adjustment approved a reduction of the minimum rear yard setback from 20' to 10' and of the
minimum side yard from 7' to 5' in the RS-7, Residential Single Family zone at 1634 West
Fourth Street to allow development of the site. The variance is approved with the following
condition:
Condition:
Development of the site shall be in accordance with the geotechnical report submitted
by the applicant and prepared by Zenovic and Associates dated April 15, 2002.
Activities, such as constructing a building, which have not been previously analyzed by
Zenovic and Associates will be substantiated by further engineering/geotechnical review
prior to any such activity.
The use to which the variance has been approved must be begun within one year of variance
approval or the variance will become invalid.
If you have any questions, or if we can provide further assistance, please don't hesitate to
contact this office.
Sincerely,
Sue Roberds ?
Assistant Planner
cc: Neal and Phyllis Mischke
321 EAST FIFTH STREET ® PO BOX 1150 · PORT ANGELES, WA 98362-3206
PHONE: 360-417-4750 · FAX: 360-417-471 ~ · TTY: 360-417-4645
E'MAIL: PLANNING~CI.POIRT-ANGELES.WA.US Or PE~tMItS~CI.PORt ANGELES.WA.US
Appendix E: ~ample Checkll.te & Worksheet.
~ A~~t C
PI~ ~miner and I~e~r Checkli~
B) ~mWi~ to minimum venfilati~ ~eda ~ ~r~;~ ~mugh en~ ~Mti~ ~ ~o~ te~ng,
E-82
City of Port Angeles
Applicant Project Review Sheet
Do~ ~ ~o~x~l u~ mquir~ a a~w I li~ I-I~: .mq~maCC ~no:~
0 ~ ~ 0 ~ ~
~t Ca~g~ g (ste ~rse side) B~d~ P~t g ~ T~ng g
R~to: OBD DCC ~ D~ DPD ~PW DF~ ~
~ ~ E~ple~ oJ ~ is ~d f~ all cate~ lb, 2 & ~ ~i~ C~Ie~ ~ not
~ui~d f~ c~ I a ~i~ ~ ~ ~lt ~ a ~al ch~ ~ ~ ~n~.
April 15, 2002
Mr. Neil Mischke
1634 West Fourth Street.
Port Angeles, WA 98363
Re: Lot 7, Block 129, Townsite of Port Angeles
Par. No. 06-30-00-012935
Dear Nell:
Zenovic & Associates, Inc. presents herein the results of our geotechnical review of the
referenced properly, located at the east end West Fourth Street, east of "K" Street, along
the south margin of Hill Street in the City of Port Angeles. The property consists of Lot
7, Block 129, Townsite of Port Angeles and the vacated portion of the roadway that
crosses the subject Icl.
We understand that your intent is to determine the limits for the construction a single-
family residence and associated appurtenances on the property. The residence will be
of conventional wood-framed construction on a concrete foundation.
PURPOSE AND SCOPE OF SERVICES
The purpose of the geotochnical review is to provide information regarding the soil and
slope stability in order to deveiop the site in a manner that will not induce soil erosion or
endanger on-site or adjacent off-site properties, consistent with the requirements of
Chapter 15.20 of the Port Angeles Municipal Cede (Env[ronmentatly Sensitive Areas
protection). The scope of the review included a field inspection of the sile and
determination of site and adjacent property slopes using a hand-held clinometer. No
topographic mapp[ng services have been provided.
Research of available data included a review of the USGS Topographic Map, Angel'es
Point quadrangle, aerial photos on file at the Clailam County Road Department (DNR,
1971, 1981, 1990, and 1997), aerial topographic mapping completed by David Smith &
Associates, Inc. for the City of Port Angeles (Mar. 1995), and the Soil Survey of Clallam
County Area, Washington {USDA/SCS, February, 1987).
Page 2
Mr. Neil Mischke - Lot 7, Block 129, Townsite ct Port Angeles
April 15, 2002
REGIONAL GEOLOGIC AND SOIL COI',IDTIONS
According to the Soil Survey of Clatlam Area, General Soil Map, the City of Port Angeles
area and the surrounding region are comprise~ of E~wha-C~aliam-Catla soil association_
These soils are typically moderately well-drained, nearly level to very steep slopes on
hills, ur~dedain by compact glacial till. ~nspection of the soil maps of the site indicate that
the property lies along the north edge of an extensive Elwha soil area that extends from
the Elwha River on the west to the Oungeness River on tt~e east, from the foothills of the
Olympic Mountains on the south to the Strait of Juan de Fuca on the no~th.
The Elwha-Clallan-Catla soils are derived from weathered glacial till. These soils were
deposited by the ice sheet during the Vashon stade glaciation. The Vashon Glacial Till
consists of a poorly sorted mixture of rock fragments deposited directly by the Vashon-
age ice sheet. Finer portions of the soil consist of clay, silt, and sand. These fine
particles comprise a moderately to highly compact matrix in which the coarser
components (gravel, cobbles, and boulders) are firmly imbedded.
SITE OBSERVATIONS
An engineer from Zenovic & Associates, Inc. conducted a site visit on March 29, 2002 to
observe the site slopes, vegetation, surface and immediate subsurface hydrology, and
evaluate in-situ soils for density.
Existing Slopes
The site currently has a small garage located adjacent to the alley that runs along the
south side of the lot, a small deck just north of the garage, a. nd a series el small banks
and walls dropping down to an exisling roadway that runs diagonally through the Icl.
The roadway previously extended southerly and easterly to Fifth Street, but that portion
of the roadway south of the lot has been abandoned and is not longer usable. The
portior~ through the lot is paved for the northerly 40 feet, and then is a grass covered
roadbed exlending to the east line of the property.
The property to the east slopes sleeply to the bottom of a ravine, approximately 85 feet
below the roadway. This ravine starts at the northerly limits of Fifth Street and extends
to the level industrial area south of Marine Drive. Hill Street crossee the ravine
approximately 250 feet north of the property. The slope of the edge of the ravine
reaches a maximum of 0.75 horizontal to 1 vertical in several localized spots, but more
typically ranges from 1 horizontal to I vertical to 1.3 horizontaf Io 1 vertical. The steeper
slopes are adjacent to the noted roadway, and were probably adificially created during
the construction of the roadway.
Page 3
Mr. Nei1 Mischke - Lot 7, Block 129, Townsite oi Port Angeles
April 15, 2002
Soil Conditions ·
The site was extensively regraded to create the roadway and the building area 'where
the garage is located. It appears that the grading in the area of the garage was relatively
minor, but the grading for the roadway was significant. This grading has created over-
steepened slopes that have the potential to slough and could, under extreme conditions,
have a large scale fai!ure.
The soils on the up'~and area, that area above the roadway, are mapped as Clallam~
Hoypus gravelly sandy loams in the Soil Survey. The soils within Ihe ravine and along
the bluff that Hill Street traverses are mapped as Dystdc Xerother~ts, extremely steep, in
the Survey. The Clallam-Hoypus soils are a mix of the outwash material that was
deposited along the edge of the glaciers as they receded and the finer, unsealed sands
and gravels that were deposited directly by the glacier. Both soil types are relatively
free-draining; the difference is that the Hoypus soils extend for significanl depths, while
the Clallam soils are underlain wilh a glacial till, a fine sand and silt that has been
compressed by the overlying glacier. This glacial till layer is essentially impervious to
water.
Vegetation
The area of the properly above the roadway has vegetation typical of residential
development - lawn areas, ornamental shrubs and trees. The ravine slope area has an
understory of brush with fairly dense stand of aiders. At lhe base of the ravine slope, in
the colluvial soils, the trees tend to be primarily alders, although some conifers were
noted,
The trees on the property do not exhibit a pistol~grip growth form that is indicative of
slopes with soil movement or creep. The vegetation on the properly indicates that the
slopes are generally stable.
Hydrology and Drainage
No surface depressions or runoff channels were observed on the property. The silo has
a very limited upgradient tributary area and moderately well*drained soils. No
groundwater seepage was observed on the property or on the face ct the ravine bluff.
Given the unusually wet winter in the area, it appears that neither surface nor' subsurface
water impacts are ct concern.
Uniform Building Code Site and Soil Categorization
The site is within Seismic Zone 3 as per the Uniform Building Code. Soil typing is
required by the Uniform Building Code to determine building response under seismic
conditions. No test pit excavations were completed for this analysis, so underlying soil
types are nol known. Given the geologic data available, however, and the conditions
observed, it is our opinion that Soil Type Sd should be used when calculating horizontal
and vertical accelerations at the site.
Page 4
Mr. Nell Mischke - Lot 7, Block 129, Townsite of Port Angeles
April 15, 2002
The site soits can be classified as a sand or silty sand consistent with Class 4 ma~:eriafs
as set forth in Table 18-I-A of the Uniform Building Code. Allowable foundation
pressure, lateral bearing, and lateral sliding values as set fodh in the table are
appropriate for this site. increases for depth and width as set forth in the tabte footnotes
are not recommended for this site due to Ihs proximity to the steep bank.
CONCLUSIONS
The subject property has been significantly disturbed by past grading and site
preparation activities. The fact that the lot is situated on the edge of a ravine and that
the ravine slope has had prior grading will limit the area on the lot that can be developed
without substantial technical solutions. The attached sketch shows the recommended
limits on which a structure can be built using conventional methods, This area covers
approximately 40% of the lot, generally that area adjacent to the alley south of the
property.
RECOMMENDATIONS
General
The proposed preject shall be construc~d in conformance with a{I requirements of the
City of Port Angeles including, but not limited to, the Uniform Building Code and
applicable clearing, grading, drainage, and erosion control requirements.
Excavation and Grading
Excavation for the proposed dwelling and associated foundation components shall be
carried to firm, substantial, unyielding subsoil. All excavations shall be kept free of
standing water. Temporary excavation s~opes ir~ excess of four feet in height shall be
sloped at not less tha¢~ 1 horizontal to 1 vertical, Permanent excavation and
embankment (cut and filD slopes shall be no steeper than 2 horizontal to 1 vertical.
Excavation work shall occur not earlier than April 1, and all slopes shall be complete to
their permanent condition before November 1. Temporary excavation slopes steeper
than 2 horizontal to 1 vertical shall be protected with 8n impervious covering (visquene)
during any rainfall periods.
Drainage and Erosion Control
Site clearing should be limited Io those areas where actual construction is occurring or
where adequate construction clearance is needed, in no case, shall the construction
area be closer than 20 feet from the top of the ravine bluff. Afl disturbed areas between
the dwelling and the top of the bluff should be revegetated with native plantings at the
conclusion of dweltin9 construct[on. Such revegetation should occur not tater than
October 1.
Page 5
Mr, Neil Mischke - Lot 7, Block 129, Townsite of Pon Angeles
April 15, 2002
Drainage from impervious areas on the site (structure roofs, driveways, patios,
walkways, etc.) shou!d be collected and directed to the existing City of Port Angeles
storm sewer system. No discharge should be allowed into the ravine.
Slope Maintenance
Finished slopes should be adequately vegetated to prevent surficial runoff. No organic
material, including grass clippings and tree or brush trimmings should be placed on any
slopes steeper than 3 horizontal to 1 vertical. These materials may help hold water on
the slope, thereby reducing slope stability,
USE OF THIS REPORT
This report has been prepared at the request of Mr. Nell Mischke for the purpose of
determining the appropriate development standards for a single-family residence and
associated appurtenances on the subject property. This report is specific to this site and
the information conlained herein is the property of Mr. Mischke and may not be used
without his permission.
The findings set forth in the report are based on a site inspection and review of available
data. The conclusions and recommendations derived from these findings assume that
the site conditions do not vary radically throughout the site. tf excavations and/or
construction activities discover that site conditions are significantly different than those
documented herein, Zenovic & Associates, inc. must be contacted to verify or modify the
conclusions, as appropriate.
The earthwork contractor for the project is responsible for pedorming all work in
conformance with all applicable WISHA,/OSHA regulations. There are inherent risks
associated with construction on or adjacent to steep slopes that the owner and
contractor must assume. This report is intended to reduce, but not eliminate, uncertainty
rega. rding the stability of the slope.
We appreciale the opportunity to provide this information to you. Please contact this
office if you have any questions regarding the contents.
Sincerely,
Zenovic & AssOciates, Inc.
~ Zenovic, P.E.
Principal Engineer
Enclosures
Fc: JN 02043
:~ APP ROXiMA1~ PROF1L~ ~1 E~S~NC~
_ ' ............ ,'"~' ~1 .... ,~'~/"", ........
~ ~~ m /./ i . ,
~ : / ~ ~: i~: :
. . SECTION
, , DI~Y SKET~ FOR ~O~NIC~ RENEW
AL ' P~T ~GE~ WA 9~3 J ,02043
I~ ~b~l I~bII~ENOVIC& ,,,~.~s~..~ ~JAPRtC 2002
I
Residence
Limited Lateral Design
for
Roger Blanchard
1630 W. 4th St
Port Angeles, WA 98362
4 SEASONS ENGINEERING, INC.
619 SOUTH CHASE STREET
PORT ANGELES, WA 98362
" February 17, 2004
Jim Llerly
City of Port Angeles Building Officia!
PO Box 1150
Port Angeles, WA 98362
Subject: Scope of Engineering for:
Limited Lateral Design
Roger Blancherd
1630 W. 4th St
Port Angeles, WA 98362
Dear Jim,
Enclosed is the Limited Lateral Design for the Residence for Roger Blanchard.
At this time, portions of th{s structure that have been reviewed by the engineer
include:
1. Lateral Forces
2. Beams and Headers
3. Foundation
Please give me a call if you need any additional information.
Sincerely
Donna J. Peteraen P.E.
Limited Lateral Design
Roger Blanchard
1630 W. 4th St
Port Angeles, WA 98362
DESIGN CRITERIA DESIGN STRESSES
ELEVATION LESS THAN 500 FT DOUGLAS FiR/LARCH ~t2- 2 & 4 x
Fb = 900 PSi
SNOW LOAD GROUND= 25 PSF Fv= 95 PSI
E= t.6 (10)s PSI
LIVE LOAD = 40 PSF (FLOOR)
DOUGLAS FIR/LARCH #1- 2 & 4 x
DEAD LOAD = 10 PSF (FLOOR) Fb= 1200 PSI
Fv= 96 PSI
DEAD LOAD = 10 PSF (ROOF) E= 1.8 (10); PSI
DEAD LOAD = 7 PSF (CEILING) HEM FIR #2- 2 & 4 x
Fb = 850 PSI
WIND SPEED = 80 MPH Fv= 75 PSi
E= 1.3 (10)6 PSi
EXPOSURE C
GLU-LAM BEAMS 24F-V4
SEISMIC ZONE 3 Fb= 2400 PSI (T) BOTTOM
Fb= 1850 PSI (T) TOP
SOIL BEARING = 1500 PSF Fy= 165 PSI
E= 1.8 (10)6 PSI
REFERENCES
(1) UNIFORM BUILDING CODE 1997
(2) TIMBER CONSTRUCTION MANUAL 3RD ED by AITC
(3) CONNECTORS FOR WOOD CONSTRUCTION by SIMPSON STRONG
(4) WESTERN WOODS USE BOOK by WESTERN WOOD PRODUCTS
ASSOCIATION MAY 1996
(5) NATIONAL DESIGN SPECIFICATION FOR WOOD CONSTRUCTION t 997
(6) WOODFRAM, TIMBER DESIGN, STRUCT.ETC VERSION 2.5 FOR WINDOWS
95, by RESEARCH ENGINEERS,INC 1998
(7) ROSBORO-APA WOODCAD, VERSION 1.t by ROSBORO GLULAM
RESOURCES 2000
General Notes
t. Ground enow to~d" 2E P~F
2. Maximum soil bearing capacity · tE00 PSF
3. Seismic Zone 3
4. Wind, 80 MPH, Expssum "C".
$. Not~tione on drawing Iliat~ng to framing clips, Joist hangars end other connecting devices refer to catalog
numbers of connector/manufactured by the Simpson Strong-Tie Company, San Leandro, CA. Equivalent devices
by other menofecthrsl~t may be euhalJbJted, provldsd they have ICBO approval for equal load capacities.
Roof To.sss: Tmssss ebell be designed by the manufacturer end design calculations shall be submitted for
approval grlor to f~tbrlcation. Each wood truss shall carry a grading stamp. Top chord member/shall be sized to
· ccommo(blte Z6 pal e~.ow ~ and apgropflato snow dn~ts ~ noted In the UBC. No field modification of trusses
will be allowed without the engineer's approval. Live load trsss detiect]on shall be limited to 1/360. Total load
deflectJon will be Ilmlfed to 1/240.
7. Girder trusses shag be attached to wall framing with $1mp~on LGT2, minimum 2000 pounds upll~ or equal.
8. Contractor shall pmvlds temporap/bracing and shoring for the structure and structural components until all final
connsctior~ have been completed In eccordsnca with the plans.
9. Contractor shall be responelbia for all the required safety precautions and methods, techniques, sequences or
procadurse required to perform his work.
10. Contractor Inldsted changca shall be submitted In writing to the structural englnesr for approval prior to
fabrication or construction.
t t. Drawings Indicate general and typical dsteJia of construction, where conditions are not specifically Indicated but
are of similar ohar/cter to detalia shown, similar dstelia of construction shall be used.
General Concrete Notes
(The Following apply unless shown on the plans)
All materials and wodunenshlp shall oonform to the requlr/mente of the drawings, specifications, and the Uniform
Building Code.
2. Concr/to shall etteln· 28 day strength of F'c~ 2500 pel, 6 saclm of cement per cubic yard of concrete.
3. Reinforcing steel shall conform to ASTM A61E-76A, Grade 40, fl~ 40,000 p~l.
4. Reinforcing steel shall be dsteliad (Including hooks and hands) In accordance with 30 bar diameters or 2'-0"
minimum. Provide comer bar/In ell wall Intersections. Lap corner bars 30 bar diameter/or 2'0" minimum.
6. Lap adjacent mate of welded wire mesh one full mesh at sides and ends.
NO bar/par'dally omhadded in band,ned co~cr/to ahaU be tield bent unease specifically lo deteliad or approved by
the structural engineer.
7. Concrete protection (cover) for ralntorcfeg steel shall be u follow~:
FooUnge end other unformed eud~c~:
earlh face 3"
Formed aurfaoes expossd to italia, walls below ground, or weather:
#6 bars or larger 2'
f~8 bars or arnebar 1-t/2"
Walls Interior feca 3/4'
8. Footing~ ah;iii bear on solid unyteldlng nMur/I ssrth free of organic material
$1ogls etory et~Jcturas 12# below original grade
Two story structures t8" below original grads
Three story structures 24" below original grade
$1abe shall be placed upon ccmpacthd granular fill, 2" minimum thlcknm.
Wood Framing Notes
(Tho Follow/no apply unlcee shown on tho pasha)
1, All wood f~mln$ detells not nhowo otherwise akall be constructed equal to or better then tho minimum standards
of the 1997 U.B.C.
2_ Minimum nailing requirements: Unl~ otherwise noted, minimum nailing cheil be in accordance with Table 23-1f-B-
t of the Uniform Building Code.
3. Alt structural ft~mlng lumber auGh as 2x_ Jolatu, end rsfters to be Douglas Fir No. 2, Spruce/Pine/Fir No. 2, o~
Hem/Fir No. 2 kiln drlsd.
4. All lumber oxpo~d to v~othar, indoor molsto~e shall be pmasu~ treated.
$. Procure treated retention levels recommended for wood In contact with soil are:
9.40pcf for Alkaline Copper quet (ACQ) end Chromated Copper Arsenate (CCA-C)
0,41 pcf for Copper Azoln (GBA-A}
0.21 pcf Copper Azole {CA-B)
Fasfonara In contact with pressure t~ wood ileal hive the following ftulsl~as:
Galvanized for CCA-C and DOT 8odium Borate ($BX)
Post Hot-Dip Gelvenlzed In accordance with AaTM A1~3 or AaTM 0695 CL 65 or Stainless Steel for ACQ-
C, ACC-O, CeA-A, CA-B, Otl~r
8telolnaa Steel for Ammonlsnal Copper Zinc Arsenate (ACZE) end other pressure ~ceted woode.
7. Stainless Steel hrs'mnara shall not be u~e In applications where contact with Galvanized end Post Hot-Dip
Galvanized metals will occur.
9. Ali 2x_ studs and blocking to be Douglas Fir construction, Spruce/Pine/Fir construcUon, or Hem/Fir construct]on
grade.
9. All at~uctursl poste to ha Douglen Fir No. 2 kiln dried.
10. All structural headers to be 4x__ Douglas Fir No. 2 kiln dried.
11. NS Glu4am beams to conalot of Douglna Fir kiln dried 24F-V4 standard grade unlsse noted ~,hefwiee on plans.
12. Individual members of bullt~p pcete end beams shell each be attached with 10d spikes at t2" c.c. staggered.
13. All columns In framed wails to be well nellsd Into adjacent framing In order to resist lateral movement.
14. Provide solid blooklr, g fo~ v.)~d columns and multJpls etude tl~rou~h tioors to eupporte below.
1K. Provide 4xt0 headers, or double 2xt0 headers over and double studs each aide of ell openings In stud bearing
walls not becalmed
16. Provide 4x8 headers, or double 2x8 beaderl over end double studs each side of ell openings In non-structural stud
wails not detailed otherwlna.
t7. At Jolct anna: Provide solid blooklng at bearing polflte. Provide double Jolste under all load bearing pertitions.
Provide double Joists each side of openings unless detailed utherwlas.
18. Provide double Joist headers end double Jolste each side of ;ill openings In floors and roofs unless detailed
othenMee
10. Tnanall Jolste to eupporta with 2.16d nails, 2-1 Od box nails for TJI Joists, Attach all beams at the roof exceeding
8'0" In length with 81mpeon BT 292 ab'ap asch end.
20. Att-ch Jolste to flush headers and beams with Slmpeon "U" Cerlce metal Joist hangers to suit the Jolot size.
2t. .NJ wood stud walla slmll Imve lower wood plm atteched to wood fzamlng below with 16d oslla at 12'. o.c.
sf=ggsrsd, unlm o~herwloe noted In the sbearw~ll schedule.
22. Plywood roof and floor sbeathlng unloe, otherwlae ooted on plan shill be laid up with f~ce grain perpa,dlcular to
supports and nailed with gd niles ~ 6" o.c. to framed panel edges end over stud Walls shown on the plans ~ 12"
o.c. to Intellnedilto supports. Provide approved plywood clips ~ 18" o.c. st unbloched roof shnathlng edges.
Provide solid blocking st Ilne~ of support at floors. Toenail blocking to supports with 16d ~ 12" o.c,, unless
otherwise noted In the ehesrwlll achedula.
23. Provide continuous solid blocking at mid-height of all stud w, lla over t0' In height unless wall la blocked per shear
walJ note.
24. Plywood wall ebe~thlng for noted ehnar walls shall have solid blocking at all sheathing panel edges. See shear
wall schedule for furlhsr notes.
SHEAR WALL SCHEDULE,.
Bottom plate nailing Maxlumum Nates
Mark ' S~eoting F~t&'Mr arpneing , ~t~ate Framing ~ ~ b~t~ aa aflowble
~ alt edges ~g hOE ba~hg ~lfled ~ ~r
~ ~ stud ~g ~ 24'
3'
pl~d ~ ~ stud ~m~g ~ 24' 2-16d ~ I5'~, t~ slde; 980 P~
f~ stud ~g ~ 16'
both sides
bath sides
Pl~o~ ~ s~ ~g 0 24' 3-16d 0 3'~ two sfas 1~ P~
ad box -O.,3'd~ X 2-I~'m~. ed O~ -O. Og2 ate ~ f-7/a m~:
2. PRO,DE ~A RA~ ~ING
A~ EX~ WA~
4. 7/~6' O~ UAY ~ ~BS~ ~ ~/2' ~X ~ IF ~ING tS ~A~ AT ~6' ~ ~N~. ~ PANELS ARE
6. NAILS ~ BE ~1~ ~U~ ~ ~G. O0 NOT O~ ~1~ NAILS.
DA~: ~BRUARY 2004
BLANCHARD ~ [~ ~~ SCALE: NONE
NOTES ENGINEERING, INC. f~o) ~-~2~ CH¢C~D:
Limited Lateral Design
Roger Blanchard
1630 W. 4th St
Port Angeles, WA 98362
WIND CALCULATIONS EXPOSURE C
BUILDING DESCRIPTION - HEIGHT FT
UPPER FLOOR + FLOOR SYSTEM = 9.5
MID FLOOR + FLOOR SYSTEM = 9
BASEMENT -- 8
½ ROOF HEIGHT = 2.75
ROOF SLOPE = 6/12
AVERAGE HEIGHT OF BUILDING ~ % ROOF HEIGHT 29.25
WIND PRESSURE
P=CeCqQslw
Ce= 1.22 Cq=t.3 HORZ Cq=.7 UP
Cq=1.2 DISC. UP Qs=16.4 PSF Iw=l
Ce CcI (;;is Iw PINPSF
Phorz= 1.22 1.3 16.4 1 26.01
P horz~indward= 1.22 0.8 16.4 1 16.01
P UP = 1.22 0.7 16.4 1 14.01
Pup@disc. 1.22 1.2 16.4 1 24.01
Limited Lateral Design
Roger Blancherd
1630 W. 4th St
Port Angeles, WA 98362
LATERAL CALCULATIONS
(AREA)(PRESSUREyLENGTH = SHEAR
~WALL AREA PRESSURE LENGTH SHEA~ StlEARWALLTYPE. PIERHEIGHT UPUFT
!UPPER EEO ~ PSF PI' PM= SEE SCHEDULE FT LB8
~, 77 26.01 8 250.3 2 8.5 2128
laid FLOOR
6, 179 26.01 26 179.1 2 8 1433
BASF. NF_NT FLOOR
~ I 286 26.01 8 929.9 (2 S~DES) 3 7 65O9
FLOOR TO FLOOR TIE
MSTC48B3, OR MSTC40
HOLD DOWNS
HDQ8-SDS3 TO 4X6 POST Pmax= 8325f~
SSTB28 W/24 718" EMBEDMENT
I~SEASONS
6~9 S. Chase St., Port Angeles, WA 98362
~ [SEASONS
ENGINEERING, INC
619 S. Chase St., Port Angeles, WA 98362
Boise:* BC CALC® 2003 DESIGN REPORT - US Tuesday, February 17, 2004 15:49
Single 7" x 11 7/8" VERSA-LAM® 3080 DF File Name: BC CALC Project: FB01
Job Name: Description:
Address: Specifier:
City, State, Zip:, Designer: DONNA J. PETERSEN P.E.
Customer: Company: 4 SEASONS ENGINEERING, INC
Code reports: ICBO 5663, NER 442 Misc: PORT ANGELES, WA 98362
Tribu[ar
BO B1
5868 lbs LL 5868 lbs LL
4225 lbs DL 4225 lbs DL
Total Horizontal Length - 14-00-00
General Data Load Summary
Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur.
S Standard Load Unf, Area Left 00-00-00 14-00-00 Live 40 psf 12-10-00 100%
MemberType: Floor Beam Dead 17 psf 12-10-00 90%
Number of Spans: I 1 Unf. Lin. Left 00-00~00 14~00-00 Live 325 plf n/a 115%
Left Cantilever: No Dead 364 plf n/a 90%
Right Cantilever: No
Controls Summary
Slope: 0/12 Control Type Value % Allowable Duration Load Case Span Location
Tributary: 12-10-00 Moment 35326 fi-lbs 72,7% 115% 3 1 - Internal
Neg. Moment 0 ft-lbs nla 100%
End Shear 8666 lbs 47,7% 115% 3 1 - Left
Total Load Deft. !_/263 (0.638") 91.1% 3 1
Live Load: 40 psf Live Load Deft. I,/453 (0.371") 79.5% 3 1
Dead Load: 17 psf Max Deft. 0.638" 63.8% 3 1
Partition Load: 0 psf
Duration: 100 Notes
Disclosure Design meets Code minimum (L/240) Total load deflection criteria.
Design meets Code minimum (L/360) Live load deflection criteria,
The completeness and accuracy of Design meets arbitrary (1 ") Maximum load deflection criteria,
the input must be verified by anyone Minimum bearing length for BO is 1-5/8".
who would rely on the output as Minimum bearing length for B1 is 1-5/8".
evidence of suitability for a Entered/Displayed Horizontal Span Length(s) = Clear Span + 1/2 min, end beadng + 1/2 intermediate bearing
particular application, The output
above is based upon building
code-accepted design properties
and analysis methods. Installation
of BOISE engineered wood
products must be in accordance
with the current Installation Guide
and the applicable building codes.
To obtain an Installation Guide or if
you have any questions, please call
(800)232-0788 before beginning
product installation.
BC CALC®, BC FRAMER®, BCI®,
BC RIM BOARDTM, BC OSB RIM
BOARDTM, BOISE GLULAMTM,
VERSA-LAM~, VE RSA-RIIVI~,
VERSA-RIM PLUSh,
VERSA-STRAN DTM,
VERSA-STUD~, ALL JOIST® and
AJSTM are trademarks of
Boise Cascade Corporation.
Page 1 of 1
.
~.
I
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I
,I . CITY OF PORT ANGELES
'DEPARTMENT OF COMMUNITY DEVELOPMENT ~ BUILDING DIVISION
i 321 EAST 5TH STREET, PORT ANGELES, WA 98362
i
I
. ]
,.
Applic;:ati,on !fumber .1,
pin number . . . .... I'
Property ~dress .. i.
ASSBl?SOR .. CEL NUMBER:
Appllcati '. description
Subdivision Name :!.
propert.y Use
Property. Zoning . .' . I.
AppliCation valuation i .
Owner I
--~~---------------~-4--
ElLANCHARD, ROGER EI
POBOX 2904 I
PORT ANGBLES WA 98362
R & 'NBUILDERS
In. CEDAR, (;LEN LN
PORT ANGELES
(360).460-0979
NEW 2068BF SFRW/ATTACHED 364SF GARAGE u___
TrP!ll 'V' NON-RATED . . .
SINGLS.PAM & .CONGREGATES
TOTAL t LOT. COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
LOT BUE
PROPOSED LOT COVERAGE
TOTAL LOT. COVERAGE
NUMBER OF UNITS
, -., .
03~00000623
Date
.7527
1630 W4TH ST
06.30-00- 0-1-2932.-0000-
RES NEW SFR
'.
RS7' RESDNTL SINGLE PAMILY
,134420
Contractor
1
__~_L_ Structure Information
construction Type , . I.
'. ......OccupanCyType. . :.
'; .:Other struct info. .,.
. '~.....-.- ~ -...... - ~ -.. -... - ------ - - - - -." ..,'- ......-.... ...."'-:...-~-,- - - --- --- ..:.._..;.-- -- .'-- -- - ~-'- - - - --- ........-
Permit . .. . tLEcTRI~ NEW RESIDENTIAL
Additional desc. 2432 SQ. FT SFR
Sub Contractor SIMPSON ELECTRIC
Permit Fee 1138.90
Issue Date I 5/1.3/04'
ExpirationOate : 11/09/04
!
Qty Unit Charge! Per Extension
1.00 70.8000 IECH EL--R.-SQli"l' FIRST 1300 70.80
3.00 . 22.700(1 i se. Bi,..,R~S(Jli"l' J\IlDITIONAL 50.0 68.10
~-------------._----------1----:-----~-----------~-----..,---------------------
Otb.er FeElS .. . "1' ... SEWER SYSTEMDELV CHARGE 745.00
I STATE SURCHARGE. 4. SO
i PW WATER SYSTEM USE' FEE 1025.00
,
I
CMrged
I
----~------------ ~~i-~~~~~~ .~_.."---- ____~__~w_ -.._~~~---
j :ua.90
.. . .00
li.1... 774. .50
:r.$:t:;l.40
I.'
permit .Fee Total
Plan Check Total
Other. Fee Total
Grand T<ltal
Plan Check Fee .
Valuation . .
paid
Credited
#~,
.00
.00
.00
.0()
WA 98362
13.40
V"N
3.00
7000.00
'936..00
936.0.0
1.00.
,.
'\
.00
o
Due
.00
.00
.00
.00
i
i
I
I
Separate Permits are requiTfJd fo~electrjcalwork, SE,PA,Shoreline, EsA, utililie&; private and public improvements. This per,nlt ~omes ..'
"",II and void if work or construction authorlzed.is notcqmmen,cedwlthin 180 days;ifcon'structiOh or.work Is ~uspended~rabal)doned'
for a p$riodof.1 ~O dayS after the work ascommenced. or ifrequlred Inspections haye not bElen.requestedwithin 180days,frol'!1 the. last
In~pectlon~ Jhereby certify that (have read and examined thisapplicatlon' imcl know the, ~ame to be true and correct.' All provisi()n~ of
laW$ and. ordinances goveming th's type of work will becomplied;with whether sMcified herein or not... The granting of aperrni,t does not
pn~sume to give authority to violate orcancet the provi~lons of.any"stateor local. law regulating c6nstl1,Jction or the performance .of
construction. !' '.. .
i
I
. . . '.' ", .... I
SignatiJreofContractof()T Authorized Agent . Date ; Si9natUJ:~ofOwner (if owner is builder) Date
, ....1
T:\PLf\N1'lING\FORMS\1102.1S [UlI4l2003'J
i
!
BUll,DING PERMIT INSPECTION RECORD
CALL 4] 7-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECrRICAi;ftIi~~ECnONS..,
PLEASe PROVIDE A MINIMUM 24 HOURNOTICE. .IT IS UNLA WF"UL TO COVER,l/VSJlkATEpRCONCE4L ANY WORK B#FORE
INSPECTED AND ACCEPTED POST 'PERMIT IN A CONSPICUOUS LOCATION
!f~
i KEEP PERMITCARI) AND APPROVED PLANS AT JOB SITE. , <i" . ,
.
INSPECTION TYPE "'DATE ACCEPTED .. . COMMENTS .... .y.,
YES NO
FOUNDATION: i .'
FOOTINGS
WALLS
.' FOUNDATION DRAlNAGEIDOWN SPOUTS . , .
: . .
ELECTRICAL (LlGHTDEPT) SEPARATEPERMlT:# .
, .'
ROUGH-IN ~/tJh.t/ 1.:A7f" ~ .
PLUMBING , I' '" ,'.
UNDER FLOOR I SLAB
ROUGH-IN
<- WATER LINE (METER TO BLDG)
GAS LINE .' ,
BACK FLOW I WATER ,,'
AIR SEAL
.,
WALLS
CEILING , .
FRAMING .
JOISTS I GIRDERS
SHEARWALLIHOLP DOWNS .
WALLS I ROOF I CEILING
DRVW ALL (INTERIOR BRACED PANEL ONLY) '.
T-BAR '.,
INSULATION . I
SLAB
WALL I FLOOR I CEILING I '.
MttHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE I PEUET I cmMNEY .,.
HOOD I DUCTS
rw UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: .
...
WATERLINE I METER
SEWER CONNECTION
. ,
SANITARY
STORM .
PLANNING DEPT. SEPARATE PERMlT #'s SEPA:
PARKINGILIGHTING ESA:
LANDSCAPING . SHq~LINE: .t", .
. :c. FINAL INSPECTIONS REQUIRED PRIOR TO OCqJPANC)'IUSE, " .. 'C''''
. ,
RESIDENTIAL DATE YES ' "NO '" " tOMMkRCIAL " DATE '. ACCEPTED
. .
. . ..' . .' ; ,YES .NO'
,
ELECTRICAL. LIGHT DEPT. 5jzhr . ELECTRt2AL',' '.' ",' , . .
417-4735 A<f) '.
UGHT'DEPT , ."
CONSTRUCTION R. W.l PWI , , CONSTRUCTION - R. w.
ENGINEERING 417-4807 PW I ENGINEERING ..
-
'~IW 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING .... . ,0417-4815 BUILDING . .
,~
1
T:\PLANNlNG\FORMS\1102.15 (1111412003]
S'''''T
1'1!1-
~~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Zoning . . .
Application va~~ation
Owner
03-00000623 Date
1630 W 4TH ST
06-30-00-0-1-2932-0000-
RES NEW SFR
7/23/03
134420
Contractor
BLANCHARD, ROGER E
POBOX 2904
PORT ANGELES
R & N BUILDERS
171 CEDAR GLEN LN
PORT ANGELES
(360) 460-0979
NEW 2068 SF SFR W/ATTACHED
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
NUMBER OF UNITS
WA 98362
WA 98362
Structure Information
Construction Type
Occupancy Type . . . . .
Other struct info . . . .
364SF GARAGE -----
1. 00
-------------------------------------------------------------------------
Permit . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT -RESIDENTIAL
q13. 2~:J
.I..J/U
1/20/04
Plan Check Fee
Valuation
C485.~
1)4":1..&
Qty Unit...Charge Per
Extension
1017.25
196.00
BASE FEE
35.00 5.6000 THOU BL-100,001-500K (5.60 PER K)
--------,-------------------------------------------------------------------
Permit . . . . MECHANICAL PERMIT
Additional desc
Permit F~e
Issue Date
Expiration Date
~7. 9~~
7 .J/U
1/20/04
Plan Check Fee
Valuation
Qty Unit Charge Per
Extension
47.00
14.70
36.25
BASE FEE
1.00 14.7000 ECH ME- INSTALL 100- FAU
5.00 7.2500 ECH ME-VENT FAN
--------------------------------------------------------------------------
Permit PLUMBING PERMIT
Additional desc
Permit Fee Plan Check Fee .00
Issue Date Valuation 0
Expiration Date
Qty Unit Charge Per Extension
BASE FEE 47.00
11. 00 7.0000 ECH PL- EA. FIXTURE ON ONE TRAP 77.00
1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 7.00
1. 00 15.0000 ECH PL- EA. BLDG SEWER 15.00
1. 00 7.0000 ECH PL- EA.WATER HEATER 7.00
-----------------------------------------------------~----------------------
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
C 745.00~
4.50
~25.00:::>
Fee sununary Charged
Paid
Credited
Due
----------------- ----------
O.~~~2~
.00
o
~(J.." ~ .........
~
~
c
~~2 t
..
~
'i
~
er
~
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. ~
Z ~~.6 ~ ~lA/1...Q 7-)-3-03
Signature of Contractor or Authorized Agent Date Sig ure of Owner (If owner IS bUilder) Date
L\PLANNING\FORMS\1102.15 [4/2002]
.
~
120Rl"fAN"GELES
CI1Y-OF
WAS H I N G TON, U. S. A.
.... '-'\iJi~';wA.v:' dl.'1}~/-';.~;~;~::i:'"
," . '~,".:~:lti~~~7,;' .
NAME OF APPLICANT i( D <0 2: fL B l- 1t,.J C-- fI 11 R. b
MAILING ADDRESS P () J ~ 0 X d---.9 6 t/
PHONE NUMBER ,-~b() '-IS- ~ 3.=)'7 9
STREET ADDRESS OF PROPOSED STREET USE 1630 LA.)
DATE
4TH s"/
7' IV'
A Lf......e V
/
DESCRIPTION OF REQUEST (include drawings required for clarity): [If street closure is requested, please state the name
of the street and limits of closure, together with the duration of closure.]
,I
HOW LONG WILL THE OBSTRU N BE IN PLACE?
"V,;i-1A7ARE'THEHOURSOFOPERATION? ..-'
HOW ITWILL BE LIGHTED?
EXPLAIN THE NECESSITY TO USE THE PUBLIC STREET, SIDEWALK OR PLANTING STRIP. ARE THERE
ALTERNATE AREAS THAT COULD BE ~S~?,:j ptJ t))c;.e. (i r,.... 'D,.:;;R: At,... t.- ci-! Y
. 5'-.=- GLJ ..::: z '-I T (-I "So ~ "
HOLD HARMLESS and INDEMNIFICATION AGREEMENT
In compliance with the Port Angeles Municipal Code, and in consideration of the issuance by the City of Port Angeles of a Street Use
Permit to the undersigned allowing the placement of the above described street use or obstruction, the undersigned for himself and
for his successors in interest, hereby agrees to indemnify, hold harmless, and defend the City of Port Angeles against any claims or
lawsuits for personal injury or property damage arising out of, or in any way connected with, the placement of the use or obstruction , >
on the City street, sidewalk, or planting strip. /0 dOC! 'I R<:iJ
'\\\\\\1111111111/ DA~ this -L da~ f ' ~9i
~,,\\ N 4 //11,," _
~"',""'.9-f....!;1..Q.......:.t'..,., ,
~ c...~ .......... V...t\. ~_ '
$t i -~ ..... ....:'U" ~ Applicant
... 0 . 0 T . ,nO,;
;:: ! I~ .q~ \ \I'!~
~ J f E)(P.d.1~ J.. \ 1 ~ SUBSCRIBED and sworn to before me this .L...f. day of
= 4 '\ R Jt:CM'-DS: : :::
~~ USL.,C l~~
~ ~ '. .. 0: ~
~ ~... .. ..- " :",
~: 0 ... .. r.... ~
.....~ 'J:t ......... ~v ~
~"'J......w,lt5~\.....~...~1
'1// \\\
1111/ 11111\\ \\\\
~~I./
'~Jy
(OFFICE USE ONLY]
Copies sent to:
Police
Fire _
Planning _
Finance
Date: _
Fee paid $ Receipt #
Agreement to Remove Encroachment signed and
recorded on N/A
*************
Application reviewed and recommendation by City Engineer
deny or approve and with the following conditions:
Date application received
Certificate of Insurance per PAMC 11.12.140(B)
on N/A
Date
is to
Application approved or denied by the Director of Public Works
Date
......................................................................................................................................................................................................................................................
Copies to: Applicant 0 Fire 0 Police 0 Street 0 Other
o Address file 0 RUP file 0
RUP#
;r;y&:;~
~..-?-f/1 ?::// ;Z,. ~.z>~-k--
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'04/16/2004 04: 16 4579270
.
SIMPSON ELECTRIC
PAGE 01
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