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HomeMy WebLinkAbout1602 W 6th St - Building ,,-:-:"..~'~," :~';.'. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number . . . . Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use . . . . Property zoning . . . Application valuation 3/15/04 04-00000174 Date .155506 1602 W 6TH ST 06-30-00-0-1-5000-0000- RES ADDITION RS7 RESDNTL SINGLE FAMILY 29800 Owner Contractor REED, JUDITH A 1249 CAMPBELL AVE PORT ANGELES (360) 452-9026 REYNOLDS CONSTRUCTION 1039 SPRUCE PORT ANGELES,WA PORT ANGELES (360) 457-1488 480 SF ADDNT TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE CONSTRUCTION TYPE HARD SURFACE AREA NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE !l.TlJMBER OF UNITS 17.90 WA 983620191 WA 98363 Structure Information Construction Type occupancy Type Other struct info V-N 1. 00 2032.00 14000.00 480.00 2512.00 1.00 Permit .. '.--,_- Additional desc Permit Fee l;ssue.-Date Expiration_Date BUILDING PERMIT -RESIDENTIAL Plan Check Fee Valuation 465.25 3/15/04 9/11/04 186.10 29800 Qty- Unit Charge Per Extension 414.75 50.50 BASE FEE 5.00 10.1000 THOU BL-25,001-50K (10.10 PER K) Permit . . . . Additional desc Permit Fee Issue Date Expiration Date MECHANICAL PERMIT 61.50 Plan Check Fee 3/15/04 Valuation 9/11/04 .00 o Qty Unit Charge Per Extension 47.00 14.50 2.00 BASE FEE 7.2500 ECH ME-VENT FAN Permit . . . . Additional desc Permit Fee Issue Date Expiration Date PLUMBING PERMIT 82.00 3/15/04 9/11/04 Plan Check Fee Valuation .00 o Qty Unit Charge Per Extension 47.00 35.00 5.00 BASE FEE 7.0000 ECH PL- EA. FIXTURE ON ONE TRAP e 0 r ""i'\ - E :z. ~ \ (" t ~l 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 perlQ.d ()f 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. J 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 Owner (if owner is builder) T:\PLANNING\FORMS\1102.15 [11114/2003] Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUND A TlON DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULA TlON SLAB WALL / FLOOR / CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CIDMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANIT AR Y STORM PLANNING DEPT. SEPARATE PERMIT #'5 SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRlCAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERlNG 417-4807 PW / ENGINEERlNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT_ 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNINGIFORMSIl 102.15 [111I4/2003J 'J;-r:'""7;:: ; ",-" CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000174 pin number . . . . . . .155506 Page Date 2 3/15/04 ---------------------------------------------------------------------------- Special Notes and Comments Electrical load calculations and elctrical permits are required. ---------------------------------------------------------------------------- Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 608.75 608.75 .00 .00 Plan Check Total 186.10 186.10 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 799.35 799.35 .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 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:IPLANNINGIFORMSIII02.15 [l1/14/2003J BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: iWe"'';; 51ab :5 -11- 04 J ,J-I FOOTINGS WALLS FOUNDA TlON DRAINAGEiDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN PLUMBING ~aJ-f1iJ-'1 f3vIIJI~(j'~u..u'V ., - ?/-C:Y-! J.~ UNDER FLOOR 1 SLAB '~~~H ,() J/ J 11...., ROUGH-IN J..1-1()-o4 J,J-., WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS 5"-7-0 ~ L~. CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS "if -11}.--0 i/ J. h. WALLS 1 ROOF 1 CEILING tr=. 7 -U~ \ L , DRYW ALL (INTERlOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING S;".. /lJ - 0 ..:,/ I f<. V MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SAN IT ARY STORM PLANNING DEPT. SEPARATE PERMIT#'s SEPA: PARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL - LIGHT DEPT. 417-4735 ELECTRlCAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W. ENGINEERlNG 417-4807 PW 1 ENGINEERlNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 '1,-7-{),,';; ~} L) BUILDING T:\PLANNINGIFORMSII 102.15 [1111412003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property zoning . . . Application valuation 04-00000174 Date .155506 1602 W 6TH ST 06-30-00-0-1-5000-0000- RES ADDITION RS7 RESDNTL SINGLE FAMILY 29800 Owner Contractor REED, JUDITH A 1249 CAMPBELL AVE PORT ANGELES (360) 452-9026 REYNOLDS CONSTRUCTION 1039 SPRUCE PORT ANGELES,WA PORT ANGELES (360) 457-1488 480 SF ADDNT TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE CONSTRUCTION TYPE HARD SURFACE AREA NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS WA 983620191 Structure Information Construction Type Occupancy Type Other struct info 5/13/04 WA 98363 17.90 V-N ~ ~. ~~ ~ ( (' 1. 00 2032.00 14000.00 480.00 2512.00 1. 00 Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER ADD 4 CIRCUITS SHAMP ELECTRICAL 46,70 5/13/04 11/09/04 RESIDENTIAL ---------------------------------------------------------------------------- CONTRACTING Plan Check Fee Valuation Qty 1. 00 Unit Charge Per 46.7000 ECH EL-R OR RM 1-4 ALT CIRCUITS Special Notes and Comments Electrical load calculations and elctrical permits are required. Other Fees STATE SURCHARGE .00 o ~ '" \~ " ~ 1 ~ \' '( Extension 46.70 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit 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 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\l ]02.]5 [] l/l4/2003J BUILDING PERMIT INSPECTION RECORD CALL417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDA TION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I :j-/' / /hJl../ I PLUMBING , , UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERlOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING MECHANICAL HEA T PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL - LIGHT DEPT. 417-4735 V-4/()~ A-cO ELECTRlCAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W. ENGINEERlNG 417-4807 PW 1 ENGINEERlNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 4) 7-4815 BUILDING T:\PLANNING\FORMSII 102.15 [1111412003] ,~~ , '" , , :~ ' t' , t' , , , , , , , , , , , , () o 3: 3: t'l Z >-l [f) 1:; tJ Z o >-l t'l [f) ytrllf.lZrty!Jj " c:: >-,. (D :T" c:: o.HP.roroo.H "< t""' CD 0. 11 '< r-' tj :( 00 ro t:l .s:>o H OJ .t::> H O'IZl--'rT 0'12; OG)~O oC) , , CT\ I-rj (T n 0'1 l"Jj -JHOO -JH ~Z 3 .s:>-Z N;:r::.n'O N;:t:- t"l~l--' t""' fi (D () 0""" P> (D r" r" () P> r" r" 0" (D en o fi (D '< o " LO o rn o rn (D (D n P> "' ;3 (D (D "" '< o " "" :T (D fi (D tJj t' \0 \0 o '" :> o P> "" >-'- fi "" o rn (D n p> >-'-r" "" '< p> fi rn 0 """ p> :> :> 0. 0. p> :>: fi >-'- 0.:> rn 0. o :>: rn '" :>: >-,. 0. r" o r" o fi ;3 rn (D (D "" tJj tJj tJj IIJ t' t' t' ),0 \.D H W H \0 ;<l o 0 0 0 f-' I-' I-' I-' f-"f-" OOlJ1lJ1lJ1UlUlL1l ........................................................................ 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(J)t'lU>-l t' t' H t'l ;<l t' >< w w "'''' 00 "" '" '" "'...., , , \Of-" 0" "'''' "'''' 0'0 ),0),0 >-lGl t'lt'l w '- o ...., '- o "''' BUILDING DIVISION CITY OF PORT ANGELES * * Correction Notice /-I:L Job Located at I b02 L.U 'C ~I Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: -1\ : .r- see, \. / UJeC<.- t~\ey- s 1 t :p. LL) ,'.ubw ~ ~ I 't ' -& ~r- J J.I~ l W~r c~~V\"~ S;~ {\.:>>, ke: t ~b(.\ C U ')c~...k~ b~rt: 0--60 lA.. t ,~ \, d e _ LLJ o.J l<.. reo L.L ,,\~e. I/l..{ '2.J-Lf,S' II \ '1-"*'Cl r Lh-pu...bl lie.. v-l:3"" C\ ~ These corrections must be made and are not to be covered until reinspection is made. When corrections have been made, please call Lr'/7- e:;rS/:s-- for inspection. 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If you have any questions, call (360) 417-4815 FOR OFFICIAL USE ONL V: Date Rec.: 2- 24-<:3L( Permit #: (")4 ,,1ft..! Date Approved: ~) 7;1 CLI Date Issued: BUILDING PERMIT - APPLICATION Applicant or Agent: '1?OI1 1?t;{nuldl ()I,<d1 tzar! I Z 41 tit mb htJl !flit I Phone: Phone: '-157- /~I ~~ 452 - ~~1 Djt7 . Zip: 7831:. Z Owner: Address: City:~ Architect/En Phone: State License #: 'REYIJ061r/)Q ~P? 2/22/0t; Phone: L/57 ~/'I S<6 /ifU St,-t City: fir Zip: 'Is;/:;} PROJECT ADDRESS: J bL>Z W 6# 5r- ZONING: r.5 7 LEGAL DESCRIPTION: Lot: / ,d 2.. Block: / 5"0 Subdivision: CLALLAM COUNTY PARCEL NUMBER: 01::>3 DDD f.) J r:; D I) Db D i)D Credit Card Holder Name: Billing Address: City: Credit CardType VISA MC # Exp. Date: TYPE OF WORK: SIZEN ALUATION: _ .." '.. . {~ p(" Residential 0 New Constr. ~ Re-roof 0 Stove L/ ~ 0 SF. @ $ /SF. = $ ..::;.{ 'I) 'jjuO . o Multi-family ~. Addition 0 Move 0 Garage SF. @ $ /SF. = $ o Commercial ~ Remodel 0 Demolition 0 Deck SF. @ $ /SF. = $ ~ Repair 0 Sign q pther TOTAL VALUATION $ BRlEFDESCRlPTIONOFT~PROJECT: Ad", 1tJ1I?j--W Pu4l 6Uifl;/ /n/)IHJ LtilAhd{J Ey....rvt! C>CJ)Ahi Bdl'l>()W) ~ ,6ro'i / h14kL hallS<- L, ,-~6/~ f ~~~~~~I . COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: ConstructIon Type: No.ofStories:L Lot Size: iLjtX:.;C) Existing Sq. Ft. 2Dsz.. &ProposedSq.Ft. l.J{i1L _ =TOTALSq.Ft. Zc::;/Z Existing lot coverage o/c & Proposed lot coverage % = Total lot coverage If 9 % - 0 - , APPROVALS: PLANNING USE ONLY: PLAN: BLDG: DPWU: SEPA Checklist required? 0 Yes 0 No Other: FIRE: ESAlWetland(s): 0 Yes 0 No OTHER: - BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and 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' nd that I must obtain such permits prior to work. T:\FORMS\APPS\Buildingpermit.wpd Applicant: Date: o/Z.3/ () 7' /" rl (j\ + ~ ~: .. Ayt i /) DD J T I D IV [Di:' ; ZrDft AC1;;I:'CY; ) SOl.. . 6[/fLE.1 A-,S NDTi D i ! 5;.1 U:..T 5 ./ r" ;;?"y.or' i I I. L/ONTf!)\L TDK: /DD \ L) UZ)'j)<E EO W (, rA r t'r DATE ;:/2...3/ Dtf 1) R,iHV/V B'1' - f'..O/\/ f"'i');'''; .!..f-:;7-("-t!58 0- } /' t '/ U " ,J L...D s Cblu5T -----........~_~__~.c..____.___.~~. '._",...... _,_., ._..' __._.. . . '_.____.._. I I .,/6 I': (- "." ;1.'1 ;),0 ff.D PO:;,CO J'L rI-.,... . '(~ r:r])vl :rI,Drv ./ Y00, l?/ '2.D' ..-----.--...-- - -._----'----_.~._.._._.""_. e.\{,1.~;'7 ,IF):..... ;: b (32 C...-NI2 B3Z'P 20' r J~~-- ,::-.> -...._- rz.O[)~ E y: /;(' //'1!- '-"'.. Hi}i,' " ;' ~ .-.----..-.. --. _.__..~~~ r.l"\' "" ~:Jc-. , /- I ;~ 5" };!l<J --_._---...._-~-.-...- ~-..--.-.- "'-'-. -.-..------ / .........r-'E C;,... <"'" [ iF' ....-. i t..-.), i~.. -- ,I /I JOT 7D :5LALE 1 -t I I i ! ~ .s:- o I I ;,,~I 30' , i J I i I I i I I i i I ' I_~ /~&7JZ ,Iv, & -LPi_ FILEO FOR RfC()RD .~ T THE: !/EOUfsr ~:i~.!'<! 0).J2t~ IN ReCORi)"lCl ;'.'.l,~H CO " Ilillllllllll""~I~1 2004 1129359 Clallam County 20DHfAR II AM II: 58 CD ZONING LOT COVENANT I/WE the undersigned owner(s) of the following described. property: (Insert legal description here) Lots 1 & 2, Block 150, Townsite of Port Angeles, as per Plat there of recorded in Volume 1 of Plats, page 27, records of Clallarn County, Washington. do hereby covenant that said property shall be designated as one zoning lot as defined in Section 17.08.032 "Z" of the Port Angeles Municipal Code, This covenant creates one inseparable building lot which may ontY be removed through compliance with Chapter 58,17 RCW (subdivision regulations) and/or the City of Port Angeles short subdivision regulations (Ordinance No, 2222, as amended). This covenant shall be binding on the owner(s), heir(s), assign(s), and successor(s) in interest and shall be filed with the County Auditor's Office. This covenant is for the mutual benefit of said owner(s), heir(s), assign(s), and successor(s) in interest and is for the further purpose of compliance with state and lac a land use and building regulations. This covenant may be enforced by injunction or other lawful procedure and covenant by the recovery of any damages resulting from non compliance. DATED this 9th day of March 2004 '-' ~ ~(2d (Owner) (Owner) (Owner) (Owner) STATE OF WASHINGTON) COUNTY OF CLALLAM ) I, ~#? /7J at,tf that on this 7~day of /'.JJ/;/rA ss , Notary Public in and for the State of Washington, do hereby ~fY( , 20Ql(personally appeared before me JI../(';;:".j~ CC-o and to me )mown to be the individua1(s1 desribed in ahd who executed the within instrument and acknowledged that Sh c:. signed and sealed the same as e,r free and voluntary act and deed for the purposes herein mentioned. a~ rn ,-/ L dayof ///O/C/l 109 GIVEN Notary Public State of Washington ElVA M. HULETT My AppOintment Expires Nov 4, 2006 @4~ ~4~d///- NOTARY PUBLIC in and for the State of Washington residing at Port Angeles. AUDITOR'S CERTIFICATE Filed for record at the request of --JC) 0 ITH ~~ H ft1~(+ 20Qf. this II T\ky of ~AUDrrOR B. .C:- ~ 05/10/2004 08:42 13504521589 SHAMP ELEC PAGE 01... 'L ~ . Fon. OPflCJAllJSf t3tK Y Ll:ltrlll~~: __._ _"_._.__._ I'llnnio.'; ____. ...____.. Dnc:",,,~t;'Ivt;I" __ D~l~ f.=uetl_____ :fpO~TAI.." ",0.,-, . , ,0<; ~ . '''' ~ (. -'if J( r t/\rI ELECTRICAL PERMIT APPLICATION Tho Electrical Pem'1il ADD/lcation mu~t be filled out comDletelv. Please type or reprint In ink. If you have any queslions, please call (360) 4174735 Fa. number: (360) 4174711 0'"1- /7</ Owner or Elee. Contractor Agent: 8f1ltmr' fLfNR /C/tLC ON Tt'tCl1 NI:: 11-1 C. Property ownoc X-e..11- n~. \ cot <;; , \<.~ Address: \<:nO'L- L-J- \0"" :>\-. Florlric..1 Gon~"dnr' S!-1fImj) \::;l g'ilV.ALC D \..lTI A;:-n~) & Phone: i.f5'2..-lbS'Q Fex: 3?m.I:'- Phone: Clly; '~-\ -f\n;<.,k So .)I-lAryw [;;C023li;, . . n~. L1cens.'If Exo: I -1)- 0'-\ Clly: -P6'Q.T A1\> WlJ-~, i.v'~ . Zip 3.K:l, (? 1- Address:_k.j~DY 38?> Phon.: '151.. (Ir-!;n. Zip: QZ3 t''/.. INSTALLATION WIRED BY: DOWNER '6fLECTRICAL CONTRACTOR Crerlir Cara Holder Name: Mi\~ K 'w. >l-inmr BillingAddress: ClIO W. IO't! 3l-y(.d Credit Card Number: ~()$' Zip: 9830,:" V/SA:1L Me; \(oO'l... Lu. (o-rM TYPE OF WORK: Check ~ that apply: ~-t- New -6' Alteration/Addition \P.:1'Resldentlal 0 Mulli-fClmily I"'] CUlrllllt:,cial 0 MoLJile Hom\:: Sq. Fl IJ Remote Meter 0 Detached garage [J Hot Tub [J Swim Pool 0 Septic Pump o Low Voltage 0 Telecom. 0 Si Number of Circuits added or altered: Adcl,..d_ Y- C\(CV.\-\) . DESCRIPTION OF TilE EL.E(;TR,ICAL I'ROJ~CT: Electrical Heat Load Additions and or Subtractions Service Information o Baseboard CJ Furnace Cl Hecst PUIIlV o Fan-Wall _IWI IWI TON ~KW lRA o Overhead Service Ll Temp Servic;;e o Underground Service Voltage: Phase: 0 1 0 3 Service Size: Feeder Size: o~ fV6\~ I hereby eertify that I have read and examined this Dpp/ieotion ond Imow that same to be true ond cormet, Bnd I e 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. C...."C...H.'~.. "'""~' -:Ji~ e ~~,~ OWner or Elec. COnt. Signature: /2,(~ .4. (~ Dale:~ PERMIT FEE: $-3/0. r:ro C:/ELECTRICAIYloKMII A1-'t'L1CATION /Ie() q;, /tt'-/ ~~ORT ..... lO~"(,,", "'-&Ii ~1L -- . ~C;;;p CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 00-Q38 Application Number ,Application pin number Property Address ASSESSOR PARCEL NUMBER: "Application type description Subdivision Name Property Use property Zoning . . . Application valuation 05-00000938 Date 719348 1602 W 6TH ST 06~30-00-0-1-5000-0000- PUBLIC WORKS UTI LITES 9/26/05 RS7 RESDNTL SINGLE FAMILY o I uOZ W~-tj] J, \3~ OwneI: Contractor BRANDT JUDITH ANNE ,-1602 W. 6TH ST. PORT ANGELES WA 983620191 ( 36) 452-9026 ABSOLUTE CONC. INC. 816 S. VALLEY ST. PORT ANGELES,WA PORT ANGELES WA 98362 (360) 457-8739 ~ Permit Additional desc . Permit pin number , Permit Fee Issue Date Expiration Date RIGHT OF WAY REPLACE CURB 61119 50_00 9/26/05 3/25/06 plan Check Fee Valuation .00 o Qty Unit Charge Per . Extension ________:~~~_______=~~~~~~_~=~___~=~~_~~_~~=_~~~==_______________~50.00~ Fee sununary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 50.00 50.00 .00 .00 plan Check Total .00 .00 .00 .00 Grand Total 50.00 50.00 .00 .00 I\~J \ DO~ r 1\4 rr 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, jf 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;\Pnlic.ies\1102.15R[l/U5] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST: Date I - ? - c " Time Received by R,V (phone. person) Location of Work to be inspected . j be Z LA) b 11,-, Name of person requesting inspection T-=,."" z.; e ~ Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing Phone No. Time Permit No. ~- 9-:? 9 Final Sewer Excav. Other e,M..../;, ~ <eu,#e;-- s.~dQ.u..lCLI \< RV F:\O\..cd By Inspected: Date Remarks: INSPECTION NOTES: I - L{ - oS- Ok RESTORATION REQUiRED...... YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . .. .. INSPECTION REPORT. . . . . . REQUEST: / Date (0/#// /)5 Time Received by (phone, person) 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 Chimney Plumbing Final / /p /J:;). ,It! fZ;Lfri &IUJ_11_U/, / Phone No. 46/ --3'2Z0 Permit No. 05-:Q:S9 Sewer Excav. Other ~/~ INSPECTION NOTES: Inspected: Date /P!PI /f)~ Remarks: - /i () . -.-1-r7SfieC-l-<?-Q -r(VYf'l.", ON /0 --:21 -0 S f Time By ~ -o~ .~. RESTORATION REQUiRED...... YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDFNT !DATEl