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HomeMy WebLinkAbout910 W 11th St - Building CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 12- 00000186 Date 2/22/12 Application pin number 360868 Property Address 910 W 11TH ST ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -3 -5210 -0000- REPORT SALES TAX Application type description MECHANICAL APPL. PERMIT on your state excise tax form Subdivision Name Property Use to the City of Port Angeles Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 4500 Application desc INSTALL FREESTANDING WOOD BURNING FIREPLACE Owner Contractor VICKI L FOSZCZ /DOUGLAS HARSH DAVIS MASONRY LLC 910 W 11TH ST P. O. BOX 357 PORT ANGELES WA 983637207 QUILICENE WA 98376 (360) 765 -3577 Permit MECHANICAL PERMIT Additional desc FREE STANDING WOOD STOVE Permit Fee 60.65 Plan Check Fee .00 Issue Date 2/22/12 Valuation 0 Expiration Date 8/20/12 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 10.6500 EA ME- STOVE /FIREPLACE /MISC. APP. 10.65 Fee summary Charged Paid Credited Due Permit Fee Total 60.65 60.65 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 60.65 60.65 .00 .00 fi Rat (1 1' 1 2 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. A4 1 1 Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) T:FormsBuilding Division /Building Permit BUILDING PERMIT INSPECTION RECORD G 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. 13 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 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 II fr Commercial Hood Ducts FINAL DateU'?) 1'3 by3w 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 N ti Inspection Type Date Accepted By 00 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 lD 0 H 0 0 W W U' H KC g as r r 0 0 0 r 0 th 0 i0 4) N N M •.L 0 a E 0 a N 0 0 U H H 0 a a H W W lti X W 0 0 0 F UZ V)PA PA 0 H o H Z F h 0 o 0 z 0 0 zd O a H 0 H O F 0 a a HF H F• I‹ 00 0 r.(oo 0 W W a W z N 0 H N 0 Z a s W 2 a H m W H m 0 0 0 a 0 0 O i 0 Z z 0 0 a N r a N r 0 H H 0 H U in g in 0 0 a 00 0 -a 0 -a u 0 a a a H H o�yy M H M a a s F[ H SA Iy HI S, C.) 0 0 m AA 0 a C0 V] u N tr0 U 0 0 0 0 C.1 0 0 4 0 0 4 0 0 O H H 00H w H a N N 0 PA PA a s 0 N C 0 iC VO a 0 20) 00 H W �7� a 0 00000 H a F] H Ul W I H 0 H v) 0 o 0 ,000 W I 0 100 -a 00 -,00 ga4141 N� N 00 00U' mw �J HI 0< 0 0> 0 H 0 0 0 0 0 J 0 0£ H W 0 a■ 0 wa a pg au 0 0 40 PG 40 0 0) U H N a 0 cn•■Q z F 0 o 0 WF 0 Z a m m 00 <U 00 a H 0 2 0 v.0 ry J BUILDING P Is rint in ink o°�,tik.. CITY OF PORT ANGELES Ty e =.mow'' For City Use Only: Attn: Building Permit Technician 321'E, Fifth St., Port Angeles, WA 98362 Date Received 8 (360) 417 -4815 rx (360) 417 4711 Permit Date Approved Applicant -qt0 e-h FC S ZG Z Phone 45'7 8 3 3 d Property Owner leo p.,,_ X11, Fo Sz-Z eIVI c Lips Phone Property Ow er's A q'L0 w, /t.5 F. P, 9c?34 3 Contractor k/ X S f a v Phone 6O _76, 3 r77 Contractor's Address O o) C 3 j Q tct c i i, X3 Co License D X SA\ L q64 0 L, Expires it(pv. E -mail PROJECT ADDRESS 9/0 w 1 s fi A Cl� 34 3 Parcel Number 962? -0 30006 3s a IQOO Lot .•3 Zoning CO r4 Project Type Brief Description: Residential Multi- family Commercial Industrial Check all that apply New Construction Addition Remodel o Repair o Demolition Re -roof o House garage other tear off re -roof lay over one layer Heat System Heat pump wood- burning stove gas fireplace pellet stove other o Other Floor Areas Existing (sq. ft.) Proposed (sq. ft.) Basement per sq. ft. l Floor /00W 1 P/il4 AVA 2 Floor 3 Floor Garage ),9.0 NM VII /V/`1 Carport Covered Porch Deck Shed Other ,,Qp Ft lee ?lace I\t1MOdl ei TOTAL VALUATION L IC00•et Total footprint of structures I 7a-& sq. ft. Lot size S `(C D sq. ft. Lot coverage a- Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, optics, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage Max. height of proposed structures Wfr ft. Occupancy group of bedrooms Will a lawn sprinkler system be installed? NO Occupant load of full baths Will a fire sprinkler system be installed? Yo Construction type of half baths I have read and completed th&application and know if to be true and correct. t 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 working on projects. Date 19-- c 04 Print Name M F' S ZCZ Signature /�l t e. 5_ T :Forms /Building Division /Building permit application Contractors or Tradespeople Printer Friendly Page Page 1 of 2 General /Specialty Contractor A business registered as a construction contractor with MI to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name DAVIS MASONRY LLC UBI No. 602375444 Phone 3607653577 Status Active Address P 0 Box 357 License No. DAVISML9660L Suite /Apt. License Type Construction Contractor City Quilcene Effective Date 9/13/2004 State WA Expiration Date 12/14/2012 Zip 98376 Suspend Date County Jefferson Specialty 1 General Business Type Limited Liability Company Specialty 2 Unused Parent Company O ther Associated Licenses Specialty Specialty Effective Expiration License Name Type 1 2 Date Date Status DAVISBC1200A DAVIS BROTHERS Construction General Unused 9/1/1988 8/22/1990 Archived CONSTRUCTION Contractor DAVISM "101Q0 DAVIS MASONRY Construction General Unused 11/20/1990 4/29/2006 Re- Contractor Licensed Business Owner Information Name Role Effective Date Expiration Date DAVIS, LOREN S Partner/Member 09/13/2004 DAVIS, SHONA R Partner /Member 09/13/2004 Bond Information Bond Company Bond Effective Expiration Cancel Impaired Bond Received Bond Name Account Date Date Date Date Amount Date Number 2 AMERICAN 6456762 11/08/2006 Until STATES INS CO Cancelled $12,000.0011 /07/2006 ACCREDITED Until 1 SURETY Ft CAS 8371 09/01/2004 Cancelled 02/05/2007 $12,000.00 09/13/2004 CO Assignment of Savings Information No records found for the previous 6 year period Insurance Information Company Effective Expiration Cancel Impaired Received Insurance Name Policy Number Date Date Date Date Amount Date https: fortress .wa.gov /lni /bbip /Print.aspx 2/22/2012 Contractors or Tradespeople Printer Friendly Page Page 2 of 2 6 Bankers 460440001717602 05/01/2011 05/01/2012 $1,000,000.00 05/11/2011 Ins Co 5 BANKERS 460440001717601 05/01/2010 05/01/2011 $1,000,000.00 05/07/2010 INS CO 4 BANKERS 4960440001717 05/01/2009 05/01/2010 $1,000,000.00 05/05/2009 INS CO 3 BANKERS 460440000837800 08/24/2008 08/24/2009 01/21/2009 $1,000,000.00 08/21/2008 INS CO AMERICAN 2 STATES 01CG5866064 08/24/2004 08/24/2009 $1,000,000.00 08/12/2008 INS CO AMERICAN 1 STATES 01CG58660610 08/24/2004 08/24/2007 $1,000,000.00 08/23/2006 INS CO Summons /Complaint Information Cause County Complaint Judgment Status Payment Paid By 09- 2- 00516 -1 Date: 09/08/2009 Date: Date: RICK BRODERSON a DEBBIE MACMILLAN CLALLAM Amount: $0.00 Open Amount: $0.00 Amount: InterPlead: No Bond(s): 6456762 Warrant Information No unsatisfied warrants on file within prior 6 year period https: fortress .wa.gov /lni /bbip /Print.aspx 2/22/2012 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc 3 circuits repair work done by plumber Owner VICKI L FOSZCZ /DOUGLAS HARSH 910 W 11TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date WA 983637207 ELECTRICAL ALTER RESIDENTIAL 179325 78 70 12/22/10 6/20/11 Qty Unit Charge Per 1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER 2 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT Fee summary Permit Fee Total Plan Check Total Grand' Total Charged 78 70 00 78 70 Signature of owner or Electrical Contractor X G. \EXCHANGE \BUILDING INSPECTION TYPE DATE. DITCH SERVICE ROUGH -IN FINAL COMMENTS PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 10 00001485 113880 910 W 11TH ST 06 30 00 0 3 5210 0000 ELECTRICAL ONLY RS7 RESDNTL SINGLE FAMILY 0 Contractor NORTH PENINSULA ELECTRIC 761 FRESHWATER PARK RD PORT ANGELES WA 98363 (360) 477 1764 Paid Credited Due 78 70 00 78 70 Plan Check Fee Valuation 00 00 00 Date 1/05/11 RESULTS 00 00 00 00 0 Extension 73 50 5 20 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR. *TRJ Date: w,f 2010 -12 21 12.30 NORTH PENINSULA ELEC City of Port Angeles Permit Application Building Division /Electrical Inspections 321 East Fifth Street-P.O. Box 1150 Port Angeles Washington, 98382 Ph; 1360) 117-4735 Par: (360)417.4711 Date: :T X 18 2 Single Family Dwelling Multi- Family or Commercial' Commercial Addition Alteration Remodel Repair' Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: Building Square Footage; Description of above Owner Inform ti on Name Mailing Address' City' -0 Phone. License 0 Exp. Unit Chime 11990 14550 S 204.60 S 262.20 372 50 S 2.60 S 73.50 Y 2.60 92.70 S 110.30 148 10 167 90 S 95 90 6 68 20 95.90 63.90 63.90 S 119.90 102.30 110.30 6 35 20 S 73.50 110.30 S 56.00 (d'- S c L LI 0 8t) i State: i 1. ?Zip: 1 'S Z Fax. Thermostat Total Signature of owner electrical contractor or electrical adminietrator C h ete: I eck A 0 hi O Z 2 3609289409 360 417 4711 RECEIVE DEC 21 2010 ELECTRICAL INSPECTIONS Total iQr1 M,g.linlied by Unit Charm 5___ Service/Feeder 200 Amp S Sennce/Feeder 201-400 Amp Service/Feeder 401-600 Amp S Service/Feeder 601 1000 Amp. S Service/Feeder over 1000 Amp S Branch Circuit WI Service Feeder 1 3 '7 Branch Circuit W!O Service Feeder Each Additional Branch Cnait S Temp. Senncel Feeder 200 Amp. S._._ Temp Service/Feeder 201-400 Amp. Temp Semce/Feeder 401 -600 Amp S Temp. Service /Feeder 601.1000 Amp Portal t0 Portal Hourly SigniOutline Lighting S Signai Circuit' Limited Energy Commercial. Additional 1500 55 00 S Signal Circuit/ Limited Energy 1 8 2 Family Dwelling S Sgnal Circuit/ Limited Energy Multi -Famay Dwelling Manufactured Home Connection S Renewable Electrical Energy SKvA System or Less S First 1300 Square Ft Each Additional 500 Square Ft or Portion of Each Outbuilding or Detached Garage S_. Each Swimming Pool or Hot Tub a Contracto Inform on Name 1`1C_. Ma ling Addj ss __Er S( City ‘1‘ L _Stale I Zip e 3 Phone: t jl 1 I��_�Fax. 1 r, Licensed Exp 1U h •L, After reading the above statement, I hereby unify that I am the owner of the above named property or a licensed electrical contractor I am making the electrical installation or alteration In compliance with the electrical laws, N.E.C. RCW. Chapter 19.20. WAG. Chapter 296.458. The City of Port Angeles Municipal Code, end Utility Specifications. 0 Cash redlt Card M__ i Owner ae defined by RCW 19.18.261• (1) Owner will occupy the structure for two years after this electrical permit Is finalized. (2) Owner is required to hire on electrical contractor If above said property Is for sale, rent or loose. Perm /t asp ires after slr months of lest Inspection. DATE )2) 6 to OWNER/CONTRACTOR O 4. L'N'S Ho,-rLS)F- ADDRESS 1 1 1 S5 APPROVED CORRECTIONS NEEDED: 'j'f1 j I� Fo rd b 0 ,t i f J CC ELECTRICAL INSPECTION WIRING REPORT 417 -4735 PERMIT INSPECTO NOT APPROVED DITCH ROUGH IN /COVER SERVICE FINAL ?4s r2, w, L r r? r �.r 431 R 1 wf c. r NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DO NOT REMOVE Application Number 10 00001194 Application pin number 238754 Property Address 910 W 11TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 3 5210 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Generator 5 kw Owner VICKI L FOSZCZ /DOUGLAS HARSH 910 W 11TH ST PORT ANGELES Permit Fee Total Plan Check Total Grand Total Permit ELECTRICAL ALTER RESIDENTIAL Additional desc 5 KW GENERATOR Permit pin number 175596 Permit Fee 102 30 Issue Date 10/14/10 Valuation Expiration Date 4/12/11 Qty Unit Charge Per Fee summary Charged WA 983637207 102 30 00 102 30 BASE FEE Contractor OWNER Paid Credited 102 30 00 00 00 102 30 00 INSPECTION TYPE DATE. DITCH SERVICE ROUGH IN FINAL COMMENTS PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X ELECTRICAL PERMIT CITY OF PORT ANGELES 360- 417 -4735 Plan Check Fee RESULTS ildir ioNe? Date 10/14/10 00 0 Extension 102 30 Due 00 00 00 REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) Veki INSPECTOR. Date Owner I rmation Name: £.r O ii:r i Q C ZG Mailing ddres t/i/ Cr City: State: 4CI Zip: y�3 C Phone: S `7 if? OFax: License Exp. 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 x 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 Credit Card It r /r Dated: t T G br CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections et31 2fmg 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 Ph. (360) 417 -4735 Fax: (360) 417 -4711 ELECTRICAL INSPECTIONS Date: �a D ei& 2 Single Family Dwelling Multi Family or Commercial* Commercial Addition Alteration Remodel Repair* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: k.) 11 S Y Building Square Footage: Description of above f IP7 n) FL Kk) Contractor information Name: Mailing Address: City Phone: License Exp. State: Zip: Fax: (qty Total (QV Multiplied by Unit Chargel pORT c-� 6 $162 ci 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 licensed electrical contractor I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C. 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 0110112010 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 change Owner VICKI L FOSZCZ /DOUGLAS HARSH 910 W 11TH ST PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 1 00 93 7500 ECH EL 0 200 SRV FEEDER Fee summary Permit Fee Total Plan Check Total Grand Total INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 983637207 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 Contractor 155424 93 75 10/21/09 4/19/10 09 00001089 059406 910 W 11TH ST 06 30 00 0 3 5210 0000 ELECTRICAL ONLY RS7 RESDNTL SINGLE FAMILY 0 ELECTRICAL ALTER RESIDENTIAL NORTH PENINSULA ELECTRIC 761 FRESHWATER PARK RD PORT ANGELES WA 98363 (360) 477 1764 Plan Check Fee Valuation Charged Paid Credited 93 75 93 75 00 00 00 00 93 75 93 75 00 /D f2Zfo 9 Date 10/21/09 4Z� f go, DATE RESULTS fazzle 00 0 Extension 93 75 Due 00 00 00 Signature of owner or Electrical Contractor X Date INSPECTOR. City of Port Angeles Permit Application Building Division /Electrical Inspections 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 Ph. (360) 417 4735 Fax: (360) 417.4711 Date:\ O Z O— O 1 2 S Family Dwelling Multi- Family or Commercial* Commercial Addition Alteration Remodel Repair* Description of above RECEVED OCT 2 0 200 ET IN PECTiONS Plan Review May Be Required, Please Complete Electrical Plan Review information Sheet Job Address: O \n1 Building Square Footage. 7 rn `P‘ x Y L— 0 NN Owner Information Contractor InformatioQQ Name: t bu &t.--R e- )-1 A1zG-1 Name. C �h Ve...`C\. n ,C c-71-\(:) Ml c_ Mailing Address: 9/n t.J 11 ST Mailing Address MVco Y _S 1-, kl� City' 4 Pr State. (,J t. Zip _78 City' \f P\ State Ai k>z\_ Zip: oc 31.o Phone:. Fax: Phone'u'1T -V .nv1 Fax: Z CC L \A C-. License Exp License Exp `I\- 1 k\-. Wit° g 31 Y"\ 22 Unit Charae Total IOW_ Multiplied by Unit Charae) 93.75 1 Li Ti, S Service /Feeder 200 Amp. $113.75 Service /Feeder 201 -400 Amp. $160.00 Service /Feeder 401 -600 Amp. $205.00 Service /Feeder 601 -1000 Amp. $291.25 Service /Feeder over 1000 Amp 2.00 Branch Circuit W/ Service Feeder 57.50 Branch Circuit W/O Service Feeder 2.00 Each Additional Branch Circuit 72.50 Temp. Service/ Feeder 200 Amp. 86.25 Temp. Service /Feeder 201 -400 Amp. $116.25 Temp. Service /Feeder 401 -600 Amp. $131.25 Temp. Service /Feeder 601 1000 Amp 75.00 Portal to' Portal Hourly 69.00 Sign /Outline Lighting 75.00 Signal Circuit/ Limited Energy Commercial 50.00 Signal Circuit/ Limited Energy 1 2 Family Dwelling 50.00 Signal Circuit/ Limited Energy Multi- Family Dwelling 93.75 Manufactured Home Connection 80.00 Renewable Electrical Energy 5KVA System or Less 86.25 First 1300 Square Ft. 27.50 Each Additional 500 Square Ft, or Portion of 57.50 Each Outbuilding or Detached Garage 86.25 Each Swimming Pool or Hot Tub 43.75 Jhermostat 3 .1 STotal Si. nature of u electrical contractor or electr tI admini later Cash t ck -04:\ L f L —i' ,.5� �o r ,r l _4/3 Owner as defined by RC W 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. After reading the above statement, I hereby certify that I am tho owner of the above named property or a licensed electrical contractor I am making the electrical installation or alteration in complia.ice with the eiectrical laws N E.0 RC'W Chapter 19 28, WAC Chapter 296 -,6B, The C'ty of Port Angeles Municipal Corte and Utility Specifications. PREPARED 10/08/08 11 11 15 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/08/08 ADDRESS 910 W 11TH ST SUBDIV TENANT NBR VICKI L FOSZCZ CONTRACTOR DAN DODD INC PHONE (360) 670 6552 OWNER VICKI L FOSZCZ PHONE PARCEL 06 30 00 0 3 5210 0000 APPL NUMBER 08 00001273 RE ROOF PERMIT BNOP 00 BUILDING PERMIT NO PR FEE REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 10 /0 /08 JLL BLDG FINAL 7) October 8 2008 8 46 20 AM 1pangrle Ge DAN 670 6552 BLDG FINAL RE ROOF .i COMMENTS AND NOTES v/ v V Application desc RE ROOF LAY OVER ONE LAYER Owner Qty Unit Charge Per 10 00 Other Fees Fee summary b 06 7N Do ors T Forms /Building Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 32] EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 08 00001273 Date 10/06/08 Application pin number 135088 Property Address 910 W 11TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 3 5210 0000 Tenant nbr name VICKI L FOSZCZ Application type description RE ROOF Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 1500 Charged Contractor VICKI L FOSZCZ DAN DODD INC 910 W 11TH ST 3021 EDEN VALLEY RD PORT ANGELES WA 983637207 PORT ANGELES (360) 670 6552 Structure Information 000 000 RE ROOF LAY OVER ONE LAYER WA 98363 Permit BUILDING PERMIT NO PR FEE Additional desc RE ROOF LAY OVER ONE LAYER Permit pin number 135871 Permit Fee 80 50 Plan Check Fee 00 Issue Date 10/06/08 Valuation 1500 Expiration Date 4/04/09 BASE FEE 3 0500 HND BL 501 2K (3 05 PER C) Extension 50 00 30 50 STATE SURCHARGE 4 50 Paid Credited Due Permit Fee Total 80 50 80 50 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 85 00 85 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 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. r- Date Print Name signature of tontra`ctor or Authorized Agent Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD Inspection Type FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace Ducts Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting RESIDENTIAL T:Forms /Building Division /Building Permit PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 4174815 Electrical Inspections 417 4735 Public Works Utilities 417 4807 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Date Accepted By PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. Comments IFINAL Date: Accepted by FINAL Date. Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE DATE Accepted By Commercial Date Accepted By G 09 V Electrical 417 -4735 I I I Electrical I I \.J Construction R W Construction R:W I PW Engineering 417 -4807 PW Engineering Fire 417 -4653 I I I Fire I L___L Planning 417 -4750 I I (Planning Building 417 -4815 III? -$_n5 I PP, IBuilding I Applicant or Agent DA L) Property Owner i C 2 k v kcKk L,'FO z r L Property Owner's Addres 9 Contractor /Engineer Phone Contractor /Engineer's Address v License tt o- '0v\1 Expires 3 -\6- 2cxP PROJECT ADDRESS °t 10 W -kA Parcel Number Lot Project Tvpe Brief Description. Check all that apply New_Construction Addition Remodel Repair N -roof Demolition Heat System Other Floor Areas Basement 1 Floor 2nd Floor 3 Floor Garage Carport Covered Porch Deck Shed Other Total footprint of structures 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 Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? )4( Commercial Multi family 0oCt1 4 -k 7 C.o 0 1 t2 Heat pump wood- burning stove gas fireplace pellet stove other Existing (sq. ft.) Proposed (sq. ft.) ft. Occupancy group Occupant load Construction type Phone 360 e 6 SSa Phone E -mail For City Use Onl Date Received 10 Permit 0 g —►Z�' Date Approved Zoning per sq. ft. TOTAL VALUATION I S ©v sq. ft. T Lot size sq. ft. Lot coverage of bedrooms of full baths of half baths 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 p r?its prior to working on projects 1 t Date tb b6 Print Name aN )o�t� Signatu Industrial d'~'~ .~ ELECTRICAL PERMIT CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION :121 EAST 5TH STREET, PORT ANGELES. WA 9R362 ISSUED: 1/26/2000 PERMIT NO 6856 OWNER/APPLICANT ROGER FOSZCZ 910W.11THST Port Angeles, WA 98362 360/457-8330 T: S: ARCHITECT N/A CONTRACTOR HALVORSEN ELECTRIC 1426 W. 11TH PORT ANGELES, WA 98362 360/457-7803 PROJECT INFO Project Type: Occupancy Type: Occupancy Group: Electrical Heat: D Baseboard D Furnace D Heat Pump D Fan Wall PROPERTY LOCATION 910 11THSTW Lot: 3 Block: 352 D Long Legal Subdivision: TPA Parcel No: 0630000352100 , 98360-0000 360/000-0000 Project Value: $0.00 Construction Type: ALTER SERVICE Zoning Use: RS7 RES.GARAGE o KW o KW o KW o KW D Riser D [8J Overhead Service D Temp Service Underground Service Voltage: 120,240 Phase: [8J 1 D 3 Service Size: 200 Feeder Size: 0 PROJECT NOTES INSTALL FEEDTROUGH PANEL ON GARAGE. REFEED HOUSE OVERHEAD METER WILL NOW BE ON GARAGE, WIRE GARAGE (NO NEW LOAD) FEES ASSESSMENT . Service: Additional Feeders: Circuit Wiring: Temp Service: . Mise Fee: TOTAL FEE: AMOUNT PAID: BALANCE DUE COMMENTS/ACTION NEEDED $44.25 $0.00 $0.00 $0.00 $0.00 $44.25 $44.25 $0.00 ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINJMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER. INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPItC110N TYPE DATE I ACCEPTED COMMENTS I YES I NO KUUUt!-IN / C ~ II zi'T2;.Wt 17P'""" , I//Z.YI WU</ I GENERAL COMMENTS: PY{-I 102.1$ 14'96l