HomeMy WebLinkAbout620 E 9th St - Building CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
riar— VII- 321 EAST 5TH STREET, PORT ANGELES, WA 98362
y Application Number 11- 00000129 Date 2/24/11
Application pin number 986454
Property Address 620 E 9TH ST
ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -2 -8620 -0000- REPORT SALES TAX
Tenant nbr, name SAMUEL J WOOD
Application type description RES DETACHED GARAGE on your state excise tax form
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 30600
Application desc
DETACHED 30X34 FT GARAGE DEMO 216 SF CVRD PORCH
Owner Contractor
SAMUEL J WOOD R N BUILDERS INC
620 E 9TH ST 171 CEDAR GLEN
PORT ANGELES WA 983627922 PORT ANGELES WA 98362
(360) 457 -7284 (360) 460 -0979
Other struct info HARD SURFACE AREA
Permit BUILDING PERMIT RESIDENTIAL
Additional desc DETACHED GARAGE
Permit pin number 181321
Permit Fee 478.35 Plan Check Fee 310.93
Issue Date 2/24/11 Valuation 30600 f1
Expiration Date 8/23/11 n,
Qty Unit Charge Per Extension
BASE FEE 417.75
6.00 10.1000 THOU BL- 25,001 -50K (10.10 PER K) 60.60
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
February 24, 2011 2:06:49 PM sroberds.
The proposal will result in construction of a detached
garage and partial demo of a covered patio to meet the 300
max lot coverage. No land use issues anticipated as
proposed.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical load calculations and electrical permits are
required.
The existing building sewer may be located at the same
location of the proposed construction. Any modification or
damage to the existing building sewer will require other
permits and inspections.
Other Fees STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 478.35 478.35 .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 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 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.
di ,r /l &tale .(,)oei aZezzt GCS
Date Print Name Signature of Contractor or Authorized Agent 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 INSPECTIONS
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 r Date Accepted By Comments
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 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 FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
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
T:Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
E
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page 2
Application Number 11- 00000129 Date 2/24/11
Application pin number 986454
Plan Check Total 310.93 310.93 .00 .00 REPORT SALES TAX
Other Fee Total 3.50 3.50 .00 .00 on your state excise tax form
Grand Total 793.78 793.78 .00 .00 Y
to the City of Port Angeles
(Location Code 0502)
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 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.
Date Print Name Signature of Contractor or Authorized Agent 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 INSPECTIONS
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
FOUNDATION: ()fig n 93 E s S i et2
Footings (11
Stemwall 11 i-- r'
Foundation Drainage Downspouts t rtTAMAL 9) ti 1
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL: N
Walls
Ceiling
FRAMING: 1
Joists Girders Under Floor
40 T-�TiU'Fvi Hold Downs l x —t, 71-1—
Walls Roof Ceiling
Drywall (Interior Braced Panel Only) Satager cJ'--
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting Gf
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA: qV
Landscaping F SHORELINE:
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 1.5' a' Pt5 �rn
T:Forms /Building Division /Building Permit
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4 °Hr44. BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Q r 1 For City Use 02 ly:
11 w -Attn: Building Permit Technician Date Received �I -%f
321 E. Fifth St., Port Angeles, WA 98362
Permit 9
(360) 417 -4815 fax (360) 417 -4711 Date Approved
re d l
pp i
Ap Property d and r ene. �OQ� �5 e!
p y Owne e S GYn GS hC Phone 4i q`1y
Property Owner's Address (9a0 r,
Contractor Ri- '0 O∎ev s IVC Phone L( 091 C4
Contractor's Address 1 Cedo. (,ktrr
License Expires E -mail C TO 3v k10i 0 r3 a5 P hliW,),coi
PROJECT ADDRESS (9 o E 0 1•
Parcel Number Lot Zoning K5 -7
Project Type Brief Description: \Residential Multi family Commercial Industrial
Check all that apply
New Construction 3t X 3 3 4
Addition MO COrSt'r C+NwN r c a c cif (dust d. 0H r' t. 7 0{Cc
Remodel (3�ytQr-s, r J J
Repair
Demolition AePr 430 dv /610 'PO lam 4
Re -roof House garage other tear off re -roof lay over one layer
Heat System Heat pump wood- burning stove gas fireplace pellet stove other
Other No Me -chant al nr o lurnb ?i? chan9'es
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq. ft.
1 Floor
2 Floor
3rd Floor
Garage I OQ O 59 '0 30 6 00
Carport
Covered Porch 3�,t�s 1 j SV r_ co
Deck h
Shed
Other
TOTAL VALUATION 30 Goo
Total footprint of structures 2).(e sq. if Lot size q 2- sq. ft. Lot coverage. .2q 3
Site Coverage the amount of impervious surface on a parcel, includin structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage
Max. height of proposed structures :)..C. ft. Occupancy group 1 thWEIR of bedrooms L{-
Will a lawn sprinkler system be installed? No Occupant load of full baths
Will a fire sprinkler system be installed? 'pa Construction type 51 /c1 of half baths 1
have read and completed this application and know it to be true and correct. l am authorized to apply for this permit and understand
that it is my responsibility to deterrnine what permits are required, and to obtain permits prior to or in. .n projects.
Date -L /1 Print Name Sh lr►'► (,--JocrD Signature i
\vormslBuiJdlng Division /Building permit application
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Building Sketch
_BnrrowerlClient WOOD
Property Address 620 E 9th St
City
PORT ANGELES Coun CLALLAM State WA Zip Code 98362
Lender PROVIDENT FUNDING ASSOCIATES. L.P.
"SC Patio
248140tq ft]
F sort
reenhoup
ti Cement Patio [80e1to ft]
[328 Sq ft]
m
35ft in
Bath (half) Laundry m
Bedroom tut
35k
Il B ath Kitchen
01
r i f Bedroom
Bedroom
Bedrooms Dining
Illsn Living
0,511 35ft
re'Po h
1u: .4 Second Floor
a.9c [315 Sq ft]
Fist Floor
[924 Sq ft]
izrt
20ft
N
2 Car Detached,.
C A
I [872 So ft]
24ft
q
es
Area.Calculatione Summary
QeYinci by e V made, Calculation Details
iq x 8•
Living Area f 924 Sq ft 35 x 24 84i
Rrst Floor
9x35 31
315Sg9
Second Floor
123$ Sq ft
Total Living Area (Rounded): 8.5 x 6' -z
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
200 amp service 3 new circuits
Owner
SAMUEL J WOOD
620 E 9TH ST
PORT ANGELES
(360) 457 7284
Permit
Additional desc
Permit pin number 181396
Permit Fee 127 70
Issue Date 2/15/11
Expiration Date 8/14/11
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983627922
127 70
00
127 70
11 00000135
050615
620 E 9TH ST
06 30 00 0 2 8620 0000
ELECTRICAL ONLY
RS7 RESDNTL SINGLE FAMILY
0
garage
Signature of owner or Electrical Contractor X
G \EXCHANGE \BUILDING
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
Contractor
OWNER
ELECTRICAL ALTER RESIDENTIAL
Plan Check Fee
Valuation
Qty Unit Charge Per
3 00 2 6000 ECH EL BRANCH CIRCUIT W /FEEDER
1 00 119 9000 ECH EL 0 200 SRV FEEDER
Paid Credited
127 70 00
00 00
127 70 00
DATE.
/6/1)
3 21
5] bt �ll
ti
&4U Robs
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Date 2/15/11
RESULTS
00
0
Extension
7 80
119 90
Due
00
00
00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
Date:
5
ER
SAn-
CONTRACTOR
ADD ESC
gc 9 g\)
APPROVED
0
0
0
CORRECTIONS NEEDED:
Ft nitx, n1 L
;3 FE.- C-oi.1N c
1.-vV 7 R, I Z ig--Q U r7-- ?EP F rL Gp �I C2E� 1E
4 t- 1 Jr_cr t)17 E co .1 ALe i o
H 141" 1 4
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
PERMIT
�ti -c�13�
1-
DITCH
ROUGH IN /COVER
SERVICE
FINAL
S re z I-t 0 S tez-
INSPECTOR
1 saxg_S Ceow-i'P4
Irr C- )0V C.617.. 1.9 tnir��
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
NOT APPROVED
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections REC E�� E 321 East Fifth Street P O Box 1150 Port Angeles Washington, 98362
Ph. (360) 417 -4735 Fax: (360) 417 -4711
Date:.— B lI
1 2 Single Family Dwelling
Multi Family or Commercial*
Plan Review. May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: G .-C:J
Building Square Foota e:G g(LQ —F ,"r) 4f OP,
D scription of above 6-- cP— 1 s ��Z
D Al 1`1 u t. V....01.1 02 ON aR c X J�
Tn c1-01(2.44e, re% 1- i� •'X"
Item
Service /Feeder 200 Amp.
Service /Feeder 201 -400 Amp.
Service /Feeder 401 -600 Amp
Service /Feeder 601 1000 Amp.
Service /Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service /Feeder 201 -400 Amp.
Temp. Service /Feeder 401 -600 Amp.
Temp. Service /Feeder 601 1000 Amp
Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy First 1500 sf Commercial
Note: $5.00 for each additional 1500 sf
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
Thermostat
NEW CONSTRUCTION ONLY.
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Unit Charge
$119.90
$145.50
204.60
262.20
372.50
2.60
73.50
2.60
92.70
$110.30
$148.70
$167.90
95.90
88.20
95.90
63.90
63.90
119.90
$102.30
56.00
110.30
35.20
73.50
$110.30
Dated: I
FEB 9 2011
Commerci k ti Alteration Remodel Repair*
INSPECT I\
Owner Information Contractor Information
Name: l rY) L- ConD Name:
Mailin' Address: MC i I Mailing Address:
City ■r ,r& tate: ii JR Zip: 9 R "S M. City State: Zip:
Phon•. 1: :x: Phone: Fax:
License Exp License Exp.
CLyt Total (Qty Multiplied by Unit Charael
119 So
3 et)
0110112010
f- Rao vv) 12h1
Total
Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required
to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above. statement, I hereby certify that I am the owner of the above named property or a.Iicensed electrical contractor I am making
the electrical installation or alteration in compliance with the electrical laws, N.E.0 RCW Chapter 19.28, WAC Chapter 296 -46B, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14 05.050 regarding Electrical Permit Applications.
Signature of owner electrical contractor or electrical administrator Cash Check
Credit Card
Date
Application Number 11 00000063
Application pin number 495802
Property Address 620 E 9TH ST
ASSESSOR PARCEL NUMBER 06 30 00 0 2 8620 0000
Tenant nbr name SAMUEL J WOOD
Application type description DEMOLITION
Subdivision Name
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY
Application valuation 0
Application desc
DEMOLISH THE GARAGE SHED GREENHOUSE
Owner
SAMUEL J WOOD
620 E 9TH ST
PORT ANGELES
(360) 457 7284
Structure Information 000 000
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
Other Fees
T Forms /Building Division /Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Fee summary Charged
WA 983627922
Permit Fee Total 50 00
Plan Check Total 00
Other Fee Total 4 50
Grand Total 54 50
1-) .51=o-ti o
Contractor
OWNER
DEMO GARAGE SHED GREENHOUSE
DEMOLITION
DEMO GARAGE SHED GREENHSE
180554
50 00
1/19/11 Valuation
7/18/11
BASE FEE
Plan Check Fee
Special Notes and Comments
It is the responsibility of the building owner and /or
demolition contractor to contact ORCAA (Olympic Region Clean
Air Agency)for demolition permit needs regarding asbestos
abatement
Olympic Region Clean Air Agency
116 W 8th St Suite 113
Port Angeles WA 98362
(360) 417 1466 or 1 800 422 5623
www ORCAA org
STATE SURCHARGE 4 50
Paid Credited Due
50 00
00
4 50
54 50
00
00
00
00
Print Name Signature of Contractor or Authorized Agent
Date 1/19/11
Extension
50 00
00
00
00
00
00
0
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
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 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 perfor ance of
construction
Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
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
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
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping SHORELINE.
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
C
n
3-
T:Forms /Building Division /Building Permit
PREPARED 2/04/11 8 13 42 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/04/11
ADDRESS 620 E 9TH ST SUBDIV
TENANT NBR SAMUEL J WOOD
CONTRACTOR PHONE
OWNER SAMUEL J WOOD PHONE (360) 457 7284
PARCEL 06 30 00 0 2 8620 0000
APPL NUMBER 11 00000063 DEMOLITION
PERMIT DEMO 00 DEMOLITION
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01
2/0,/11
BLDG FINAL TIME 01 00
February 3 2011 4 46 51 PM 1pangrle
SAM 477 9744
BUILDING FINAL DEMOLISHED THE GARAGE SHED GREENHOUSE
r` AFTERNOON
COMMENTS AND NOTES
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
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
Applicant r, L)CC3D
Property Owner S hkr
Property Owner's Address 2O f' Gd-
Contractor Shim) (,Jce2E)
Contractor's Address 7__Q p
License
cription.
cre—
Expires
)(Residential Multi family
Aerno Ciaraa, she awn hc)i
Hi Q, cie.Ynda ,nnA ls t ub' II N h0._ a n i v► P. `l .t1s3e./.
J Li 54aA -ion
Cl c;} it wader will ba proper) s ed be¢nrn 44 e- d.emo
House garage other 1 d tear off re -roof lay over one layer
Heat pump wood- burning stove gas fireplace pellet stove other
Existing (sq. ft.) Proposed (fit. ft.)
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
and other impervious surfaces (see PAMC 17 94 135 for exemptions) Site coverage
Max. height of proposed structures ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be installed? Construction type
For City Use Only
Date Received I I%- I t
ermit f 6
ate Approved ed
I 'ej
Phoned c}
Phone Z-j- 77 c1 7
Phone
E -mail
Lot Zoning R5-7
Commercial Industrial
CD'LA SEi +C
_4_44 r) FOP-- 1461 X io
t <A L �I
a
TOTAL VALUATION
of bedrooms
of full baths
of half baths
Ok
patios
I have read and completed this application and know it 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, and to obtain permits prior to wor n projects
Date Print Name h(1 fr..) Cl Signature
T Forms /Building Division /Building permit application
Clallam County Assessor Treasurer Property Details 58706 SAMUEL J WOOD for Page 1 of 5
Clallam County Assessor Treasurer
Property Search Results 58706 SAMUEL J WOOD for Year 2011 2012
Property
Account
Property ID 58706 Legal Description: LOT 5 BL 286
Geographic ID' 0630000286200000 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:
Range:
Location
Address: 620 E NINTH ST
PORT ANGELES, WA
Neighborhood: Cycle 5 Res
Neighborhood CD' 10955130
Owner
Name: SAMUEL J WOOD
Mailing Address: 620 E 9TH ST
PORT ANGELES, WA 98362 7922
Taxes and Assessment Details
Property Tax Information as of 01/18/2011
Amount Due if Paid on. E.
Section:
Mapsco:
Map ID
Owner ID'
Ownership:
Exemptions:
2
60622
100.0000000000%
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
First Second
Half Half
Base Base
Year Statement ID Taxing Jurisdiction Amt. Amt. Penalty Interest Base Paid Amount Due
2010 41625 ST SCH STATE SCHOOL $148 49 $148.49 $0 00 $0 00 $296.98 $0 00
2010 41625 CC -GEN COUNTY CLALLAM $79.02 $79 02 $0.00 $0.00 $158.04 $0.00
2010 41625 PORT PORT OF PORT ANGELES $11 10 $11 11 $0 00 $0.00 $22.21 $0 00
2010 41625 PORT ANG CITY OF PORT ANGELES $182.96 $182.96 $0.00 $0.00 $365.92 $0.00
2010 41625 SD #121 SCHOOL DISTRICT #121 $192.33 $192.34 $0.00 $0.00 $384 67 $0.00
2010 41625 NTH OLY LIB NORTH OLYMPIC LIBRARY $22.96 $22.96 $0 00 $0.00 $45.92 $0.00
2010 41625 HOSP #2 HOSPITAL #2 $32.42 $32.41 $0 00 $0 00 $64 83 $0.00
2010 41625 WSMET PK DIST WILLIAM SHORE MET PARK DIST $10 32 $10.31 $0.00 $0 00 $20 63 $0.00
2010 41625 CITY_STORMWATER CITY STORMWATER $36 00 $36.00 $0.00 $0 00 $72.00 $0 00
2010 41625 WEED_CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0 00 $1 63 $0 00
2010 41625 TOTAL. $716.42 $716.41 $0.00 $0.00 $1432.83 $0.00
2009 587062008 ST SCH STATE SCHOOL $169 39 $169 39 $0 00 $0 00 $338.78 $0 00
2009 587062008 CC -GEN COUNTY CLALLAM $85.74 $85 71 $0 00 $0 00 $171 45 $0 00
2009 587062008 PORT PORT OF PORT ANGELES $12.14 $12.15 $0 00 $0 00 $24.29 $0.00
2009 587062008 PORT ANG CITY OF PORT ANGELES $188 04 $188.02 $0.00 $0 00 $376.06 $0 00
2009 587062008 SD #121 SCHOOL DISTRICT #121 $209 47 $209 50 $0.00 $0 00 $418.97 $0 00
2009 587062008 NTH OLY LIB NORTH OLYMPIC LIBRARY $24 91 $24 91 $0.00 $0.00 $49 82 $0.00
2009 587062008 HOSP #2 HOSPITAL #2 $35.16 $35.16 $0.00 $0.00 $70 32 $0.00
2009 587062008 CITY_STORMWATER CITY STORMWATER $36 00 $36.00 $0.00_ $0.00 $72.00 $0.00
2009 587062008 WEED_CONTROL WEED CONTROL $0 81 $0 82 $0 00 $0.00 $1 63 $0.00
2009 587062008 TOTAL. $761.66 $761.66 $0.00 $0.00 $1523.32 $0.00
Values
Improvement Homesite Value: N/A
http. /websrv8 clallam. net propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =58706 1/18/2011
(1/18/2011) Linda Pangrle ##11 -63 620 E'9TH ST:
From: Linda Pangrle
To: Roger Vess
Date* 1/18/2011 3:24 PM
Subject* #11-63 620 E 9TH ST
Attachments: #11 -63 620 E 9TH ST pdf
cc.
Hi Roger
Linda
Bill Hale
Attached is a demo for your review approval in HTE The materials aren t
going to the transfer station I m only routing it to you Jim L and Bill H since it is
only a garage shed and greenhouse
ui,
PQ Royr
svi-- vv
Page 1
-r
. ~"':"
.".S:.fi.~...'
'.".
~~'
CITYOFPORT'ANGEI.:.ES
DEPARTMENT OF COMMUNITY DEVELOPM;E1-:IT ~ BUILDING DMSION
32tEAST 5TIJ sTREET, PORT ANOgLES, W A 98362
APplication Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
. Property Zoning . .' .
. Application valuation
03.-00000356
620 E 9TH ST
0630000286200000
RES REMODEL
Date 5/22/03
3000
Contractor
OWNER
WA 983627922
--,,---,,- ~ ~ ,:-~ ~--- ~ -,- - ~,- - -.... ~ ~ ~.- - - - - - - - -- - - - - -- - - - -- - - - -.. - - - - - -'- - - - - - - - - - -.. - - - - - --
perpU.t . .. .
Additional. desc
PerlliitFee
Issue Date
EXpiration Date
ELECTRIc1iLALTER RESIDENTIAL
46.70
5/22/03
11/18/03
Plan Check Fee
Valuation'
.00
o
Qty Unit Charge Per
1. 00 46 ~ 7000 ECH EL-R OR :aM 1-4 ALT .CIRCUITS
Extension
46.70
-----------~-------------------------------------------------"---------------
Other Fees
STATE SURCHARGE
4.50
Fee sununary Charged Paid Credited . Due
----------------- ---------- ---------- ---------- ----------
P'ermit Fee .Total 46.70 46.70 .00 .00
Plan Check Total .00 .00 .00 .00
Other" Fee Total 4.50 4.50 .00 .00
Grand Total 51.20 51.20 .00 .00
Sepafclte Permits are required forelectricalwork, SEPA, Shoreline;'~$A,utIlitIes, private and public improvements."'Ihis pennit~ecomes
null and void if work or construction authorized is noteommenced within 180 days >'if construction or work is suspended Or ClbClnc:ton~c:1
for a period of180 days after the work as commenced,or if required . Inspections haxe nolbeen requestedwithlo180.c:tIlYi.ft~iD;the}.a.t
i...n.. .5. p.....ec.. .t.l. .0.. n.. '. I. ...he. ':e. by ceo rti..JYt.h. a.t1 h. ave,re.a. da.nd. exa,.min. ed tho I.S a..OO! . .. .1.i.<L.cti.. .'00. n. .a. n. ~~n.w.w. '!~... ~ sam.. e to. be true an.c:t co....r.r. e....c:t...".A. U'p.' ..r....o.......V.iS..i.....p...n..... s. p.... f. .
lawsandordinanees governing this type of work wUl be qomplied ~$Wi'tttth<<spe.ClfTed.htlrein or not. The granting of a permit does not
presumeJogive authority to violate or cancel the provisions of any state or local la~ regulating construction or the.j>ei(orifiance()f
construction, . '., '.
T:\PLANNING\FORMS\1 102. 1 5 [4/2002)
I
I
. "~:f:~j ",
';"',;,'0>s,'~~'T;\{ .' ,;'i;P;~7:'{:Mt",\"~},
";,'te:>>::L'~:;t'5
I
I
.<, ' i "/". .. C'
~. ",~,.-~; : "';" .,' " " _"';/"">;.>..t'-:(_,' ,~,;,:; .,_.__''':':,;,/-:'t'.;:-p.;:.,',,-;:,,-,:
CALL 417-4815 FOR BUILDINGINSp,ECTIONS. PLEASE PR.OVIDEA MINIMUM 24HOURNOTl<:;E..11:ISll1VMWlfl1l;TO(;(l'f',ER{
INSUhATE OR CONCEAL ANY WiJHBEFORE INSPECTEDAND'A'CCEPTED. }lOST PERMIT IN A GONSPICUOUS.LOci~IQNji'
I ,'- . '':''j.:'' ',; ',' -,;.-..-'<.--+'
I
I
. BUILDING PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT 1013 SITE
,~
. . . { c,; " x.';;- .....,
INSPECTION 'l'YPE DATE ACCEPTED ......;t.. .i: C~iMMENTS ;J..' J>
I NO" I .
.; YES I . . '.
..' . .,:
FOUNDATION: '.
FOOTINGS ..,...
WALLS .' .," ".
.
FOUNDATION DRAINAGE .. .
.... ,
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ..) '.
". ROUGH-IN '.i I I I . '.' '. .., .
'. '. :,'-' .. c; . ;.
PLUMBING '" .
. UNDE,RFLOORISLAB ..'
.... " ."
ROUGll-1N ".
WATER LINE '.
GAS LINE . c, . ...,
..'
BACK FLOW I WATER .... . . . ." .... .... ... " '.
i -c' .' . .' '., . .'
AIR SEAL .
WALLS .,.
. ..
CEILING I I .. .
.
.
FRAMING .
JOISTS /GIRDERS .
SHEAR WALL '.
,
WALLS / ROOF / CEILING
DRYWALL . ......
T-BAA .' .... ,
INSULATION '.
. .
SLAB .
WALL I FLOOR / CEILING I I
MECHANICAL '. -:c-
'.' .
HEAT PUMP
WOOD STOVE / PELLET I CIDMNEY . .
,
. HOOD / DUCTS '. '. c'
PW UTILITIES! SITE WORK (Engineering Division) SEPARATE PERMIT #'s: .
WATERLINE I METER -- .
, SEWER CONNECTION '. .'
SANITARY .
".
STORM .
PLANNING DEPT; SEPARATE PERMIT#'s .... , .' SEPA:
PARKING/LIGHTING .' .... ESA:
LANDSCAPING . SHORELINE: .. f .
......... .... . ..... . ........ .. .. ."'~FINAL INSPECTIONSREQUI.RJ'.D PRIOR.TO OCCUPANC~IUSEcc<, ;:~,'.i,,,~, """":"';"'''. ,. ..,...., .'. ..,.. '.,
. RESIDENTIAL .',.,,-- ." DATE " . YEs .. NO .' '...' 'ciAccltmo
.. .; >i.....' .... '. .,' ,.,/;) h.."DATE'
. .. ;.',', .... j . ,.,i..,;,.. ". .. v,;. c ,." .; "YES .i NO
. . 417-4735' 6/U/~ ~nc 'i 2:,.:
ELECTRICAL - LIGHT DEPT. ,ELECTRICALi".f\";;" c:~$1 lA'
- /"~" ' ., :;n. 0,., , , ;ugH:T,PJ::J'1;"'>l";".' , .' .
CONSTRUCTI()NR. W./ pwr T -';;1 ;T , . 'CONSTRUCTION - R.W; l'
ENGINEERING 417-4807 PW / ENGINEERING .','
FIRE '. 417-4653 . FIRE DEPT. ; ".
PLANNING DEPT. 417-4750 .' '. PLANNING DEPT. .".";
.,' .... ,
BUILDING '. 417-4815 BUILDING";':' T" ..... , .. 1"(' .
.'. ..... --:;;;;c-
T:\PLANNING\FORMS\1 102.15 [412oo2J
,~
/.,
r)
n"."
'~.
1"",11'
~
BUILDING. PERMIT -RESIDENTIAL
106.75
4/02/03
9/29/03
Plan Check Fee
Valuation
42-.70
3000
Per
Extension
92.75
14.00
BASE FEE
14.0000 THOU BL~2001-25K'(14 PER K)
Penni t . . . .
Additional desc
p,ennit Fee.. .
Issue.. Date
EXpiration Date
.' MECHANICAL' PERMIT
57.65 plan Check Fee
4/02/03 Valuation
9/29/03
.00
o
BASE-FEE
ME-GAS PIPE
,
I
':' '.' .' ...... JJ~I)INGfEIWITIN~PtCTIONUCQnD,'J. ....._,'
"CALL 417-4815 F.ORBUILDING 1NS~ECTIONS. PLEASE PROVIPE.A MINIMUM 24 HOUR NOTICK ITlS UNLAWFUL TO caVER,
....INSULATE QRCQNCEAJ.. ANY WQIiKBEFORE iNSPECTED ANJ>'ACCEPTEJ). POST P~RM'iT IN A CONSPICUOUS LOCATlON.
>';'. '. -. .' - "-:-- - - , '. . .' -':',,' -:: -'1- ---' .:' ,- '0 - ,
,
I:
KEEP PER~IT CARD ANP APPROVED PLANS AT JOB SiTE
INSPECTION TYPt:
ACCI!:PTE1>
YES NO.<
.
. C?1\tMENTS . .
1
.
'. '.' . :..
. . .
.. . ....
.. . .
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FQQTINGS'
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SEPAMTEPEiWIT:1# _
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WALLS '..
FO\JNOATJON
t:...~cr~ICAL
ROUGH-IN
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llNQERFLOORI SLAB
RO\lGH-IN ' '
WATERLINE ",
cOJ\~+lNE "
OACKFLOW I WATER
AIRSEAl.
WALLS .'
CElLJNO
FRAMING
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SMEARWALL _
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MECHANICAL
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HOODI DUCTS ":s....., ... """ " ..'>
PW t)TILlTIES 1 SITE ~O~: (E';8ineerl~gDivisiQn) siliARATEI'1;RMtTI#'s: .
WATERLINE/~TER. .' 'el, i': ... '.. .>
SEWER CONNECTION .
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SANITARY
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PLANNING DEPT. SEPAkJ\ttrERM1TI#~s '.'
PARKING/LIGHTING . .
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SEPA:
" .... .' ;ESA: .....
.C.;", .... .i......... .~I:lOR.ELINE: ! .'. "
Ji'INAL INSPI!:C1'~911lS~QllIRED PRI9ItW~9,1PA\I!CY(lJ~E"'.. "f "V:. /.'.r. ...7, .' @~'.
\l~jE. ,. . YES . NO:.....' ~...~0,~O:~f;~c.~~V;-:.1\ I, J.l~ TE .' . ACC~~t:D 1),;/
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,f,." UGHTI)EPT.i <,c. I
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ELECTRJCAL~ LIGHT DEPT. "~<'417-4735 .
:.. ....'),. .'
CONSTRUCTION R. W.I PWI .:; . <'
ENGlNEE~NG: .' 417-4867
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417-4653
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417-4750.
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417-4815
T:\Pl,ANNING\FORMS\1102.15 1412002]
'~ " ,;.
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PREPARED 9/03/03, 11:42:03
CITY OF PORT ANGELES
ADDRESS
CONTRACTOR
OWNER
PARCEL . .
APPL NUMBER:
620 E 9TH ST
WOOD SAMUEL J
06-30-00-0-2-8620-0000-
03-00000356 RES REMODEL
INSPECTION TICKET
INSPECTOR JAMES L LIERLY
PAGE
DATE
SUBDIV:
PHONE
PHONE :
PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL3 01
BL99 01
5/27/03
9/03/03
tf:!:IJ
~
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BUILDING FRAMING
BUILDING FINAL
final addnt.
Arline Wood
Jim, I show 2 open inspections for this permit, I-for
framing and I-for gas line inspection.
I beleave that the owner is calling to get a final
inspection and sign off on the whole thing?
~s-r
~
5
9/03/03
COMMENTS AND NOTES --------------------------------------
L(:V~ t~l>-
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O\[v
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec.:J.!-1--o )
Permit #: 3S-h
Date Approved:
Date Issued:
Fill out COMPLETELY and inlNK. Your application and site plan MUSTBE
COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
Applicant or Agent:-S A YY} (/6' J
Owner<-5An') ~
Address:6 d-0 E. crt'-
\~
Phone(3~O)qt:;J -/9--714-
Phone:
City~ PtJr'-rr::]F-S
zip:.91S36~
Architect/Engineer:
Phone:
Contractor
ro uJ n -e. yo-
State License #:
Exp:
Phone:
Zip:
ZONING:
Address:
PROJECT ADDRESS:b d-.-0
LEO-t\L.,Q:ESCRIPTION: Lot:
,CLAl2~~COUNTY PARCEL NUMBER:
City:
E crt~
" j, ';',
Subdivision:
. Ii
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C d."",~ ;A.;-H"ld N . ,... .".......... ,"-'<..,..,.,.. ''".t~ / ,.,L",., ". ...\..,...:.....:....,............'...:'.l..,......'..,...:..,.".~....;..~:....i~....,:-:~'..,.~<......:.,...>..~.:.'.:-'"
re)~"~~~~fo. er alOe:,',;.",;. ;.:',,\,><7;"> it>>". '$~ . } :: .' <", .
B lima/Address.' . . :;51.)ti.ii'~i;:.;:i;te".j...tY.: . .X!:;f~;A.;C~;d;'J(t({..,~y':'::
EI1:'.tr;Q~;~i~~~'i:~jJevIsA . ;M~ '; # '/i;'K,it4!,;;SIf!r!$'PiY,.bd \t~, ' "':~f\; "'::'p::D,~t~{{k'.ri~I:Ii';>: .;~ .
D;~~~~~~',~e,~,~~;i,.8!j~~~1fJ~;:~)~~~r~!fj~::~; ~"j'!~i,.. .t;~f~~~~tr';;'J1;J" . ....:
... ]".," .'O,.Multi..fannly,D ..Addition" '" 0, Move ""ji",p..Q]aragiL..."',, "., ,'~ ,".'. .,'.!. SF,.@$"-,, "",,"';',.,,;fSF.;- $i...".,...".",,,,,,'o,.,,....,..." .~'(.f ." ". '1.\
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.;~, .~~. ',~ ::...." ',:.., (,_~',;~...;:,::~..kA.' ~ .~, ~~ .,.",;. "oj:' ,:.,'" , '>- ",', " ":,, ,""". ...', .",,', ",,;. "'::"';~-~'--::'.~:'~; '-":~;'~"'~~"':'~.;,""" :'-:: ;~" ::1~,^~~,,':~;_*;.~:'-:;:'~'.:",~ d"" ;'.,., :.- >:: "- ~"-" -,.- ,'-." ',.-c:~'''?~~'7~''~:-',;~':''!':\, :~;'" ,.; '...'d~;.:,~;~,_;:..;r;::",~;, '7'~,~
H' ',.. ;t"LG~l\1.~~CIALfRESIDEN;TIAL: OccuP'\licyGr,qIJP:R;ii'i"'\": .... Occupant Load: .. C9ns..trtiCtiO~:' ')'Pe~'K." ,.
.~i:~tl:~~~v~eLot size:~~p~~~~;~~~~a~;' ~~-:t~al~o;~~~~::;eSq~tsft> \ = T~TAL s~.Ft19 7?-
APPROVALS:
PLAN :
BLDG:
DPWU:
FIRE:
OmER:_
PLANNING USE ONLY:
.
ESNWetland(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. r,
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 ti.m'e of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno penmt 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 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 applicatiofl 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 ity's, and that I must 0 al such permits prior to work.
T:\FORMS\APPS\8uildingpermit. wpd
Applicant:
Date:_~ - d--.) -- a~
DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION
APPLlCANT:~ ~ AW) l ~ PHONE: 4- 5, 'Id-:~I.J--
PROJECT/DEVELOPMENT ADDRESS: ~ ~G, r;;: qtJ--- '-::p A , ,
See Page 4 for instructions on completing the site plan. For more information, caI/417-4815.
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CITY OF PORT ANGELES
PUBLIC WORKS ." BVD..DING DIY,
321 East 5th Slrccl
Port Angeles, WA 98362
REVISED FOUNDATION DETAILS
I.
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8" 2-sTORY
1/2' ANCHOR BOLTS: @7'Z"O,C. I-STORY- '2" Fl<c,,"I eACl-l SILL Er
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. #4 REBAR (SEE REBAR SCHs>UlE)
ANISHEIJ'GRAoE
~ SCHEDULE
HElGHT . VER:Jl,qu. HORI?PNTAl
IN FEET.REINFORCEuerr RBNFoRCEMENl
.1r ONESlORY
1S- TWo SJl?RV
>le
'2<<
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1110
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,"'" , ,AND SlG<<ED PLAN ReaUIRED. .
~: ~4'REBAR" 2 PIECES CO~NUDUS'
2'
, .
#4'@-48'"O;C.
(1)-#4 TOP BAR
2' TO 4"
#4 @ 24" O;C.
#4 @ 24'" O.C.
JS'TO 6"
#4@ 18"'O.C.
#,4 @ 18" O.C.
6'TOS'
#4 @ 16" O. C.
,
#4 @ 10" O,C,
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" CaNCRI;TE';FOUNDA'nON WAll Ai-.i[j~&bTIR1G b'El'AI L
"NO ScAU:' .
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l/2"AN.CJ:iOR.B.OLTS. (SAME AS p...ecv__)
t-
"., ::e z
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I/~ REBAR. 2 PIECES CONTINUOUS
I\'!PNOLITHIC CONCREtE FOUNDATIO
NO SCALE :
ETAIL
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUES!: / )
Date 6ILl7ftl~ Time &:/8 Received by /lee ~ersonl
96-
Wtmj?~
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing himney Plu
Ir- 1cJU
Phone No. Y5"7" ,?-Be!
Permit No. 3Sr:;
,...~
Other
.:2.: 30
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
By
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved 0 Gravel 0 Asphalt D PCC
D Other
D Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
I
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
Installed By:
CITY OF PORT ANGELES
LIGHT DEPARTMENT
PERMIT NO.
.
ELECTRICAL PERMIT
DATE
;?3/S.-
ill. '>113-
Site Address:
9+...h.
o READY FOR
INSPECTION
License Number:
o WILL CALL FOR
INSPECTION
Phone:
Owner/Business:
Owner/Business Address:
Phone:
iA-'fI7&
Sq. Ft.
o Residential
Heat KW
o Baseboard 0 Furnace/Boiler
o Heatpump 0 Other
o Commercial/Industrial load
Total Connected load
(attach breakdown)
Totai Motor load
(attach breakdown)
o New Construction
o Remodel
o Service update/alter/repair
o Overhead
o Underground
Voltage 11..<>/t.<..(o
R"10 0 3 Ii;
Service size '26.1> Amps
o Temporary
o Add/alter circuits
o Auxiliary power
(list below)
o Special equipment
(list below)
DetailslDescription:
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W.S. No. Service Size
Capacity: 0 O.K. 0 Not O.K. Comments
o Ditch inspection O.K.
.* ffRough-ln/cover O.K.
IJJ [<('O.K. to connect service
~ Final O.K.
Date
Hold for: D Easement D Letter
o Signed up for service/meter
o Meter Department notified for installation
o Fire Department notified of inspection
o Plan Review approved/pending
Installer:
New Meters
.;?
Site Address:
&0
e-
q ~L
.
Notify the Department 01 City Light by Street Address and Permit Number when ready lor inspection. Work
must not be covered or electrically energized before inspection and O. K. for covering or service has been given
by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457-0411, EXT. 158 or EXT. 224_
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT J 0 ~
I;s~ector Amount paid
WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall
OLYMPIC PRINTERS. INC.
~
ELECTRICAL PERMIT APPLICATION
FOR OFFICIAL USE ONLY
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The Electrical Permit Application must be filled out comDle\elv.
Please type or reprint In ink. II you have any questions, please call (360. 417-4735
Fax number; (360) 417-4711
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Owner or Elee. Contractor Agent:
Property Owner: ,<'" A VY\ vcx::fL)
Address: 6 ';l CJ F 9-t+--
Phone:
Fax:
City: 'fbel J-tl\le>--I;/ b--;
Phone:.:t -5 7 'I d-- '3 q...
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Electrical Contractor:
Ucense #:
Exp:
Phone:
Address:
City:
o ELECTRICAL CONTRACTOR
Zip:
INSTALLATION WIRED BY: ~OWNER
Credit Card Holder Name:
Exp. Date"
Zip:
VISA:
Billing Address:
City:
Credit Card Number:
MC:_
PROJECT ADDRESS:
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TYPE OF WORK:
Check all that apply: 0 New
..2l Alteration! Addnion
~esidental 0 Multi-family 0 Commercial 0 Mobile Home , Sq. Fl.
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 ~ptic P,ump '0 Low Voltage 0 Telecom. 0 S
Number of Circuits added or altered: /.>, "
DESCRIPTION OF THE ELECTRICAL PROJECT:
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Electrical Heat Load Additions
<$ "It, 70
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Service Information
o Overhead Service
o Temp Service
o Underground Service
VOltage:
Phase: 0 1 0 3
Service Size:
Feeder Size:
o Baseboard
o Fumace
o Heat Pump
o Fan-Wall
_KW
_KW
_KW
_KW
PAMC 14.05.060(B): For industrial. commercial, & residential projects larger than a duplex. a one -line drawing of the Electrical Service,
Feeders, building size (sq. ft.), load calculations. and the type & of conductors andlor raceway is required and shall accompany the
Electrical Permit application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and I .
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 applicants responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature: ~
Owner or Elec. Cont. Signature: ~ ~
. .
Date:
Date;~- 'i7---()')
PW-9019