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HomeMy WebLinkAbout136 E Front St - Building PREPARED 8/03/11 8 08 55 INSPECTION TICKET PAGE 10 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 8/03/11 ADDRESS 136 E FRONT ST SUBDIV TENANT NBR LC & LC & RR TTES CONTRACTOR EMERALD ROOFING INC PHONE (360) 452 4681 OWNER JOHN W REHLEN PHONE PARCEL 06 30 00 5 1 1601 1000 APPL NUMBER 11 00000817 RE ROOF PERMIT BNOP 00 BUILDING PERMIT NO PR FEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL99 01 8/03/11J BLDG FINAL August 3 2011 8 07 52 AM 1pangrle TRAVIS 452 4681 BUILDING FINAL RE ROOFED DELANEY S COMMENTS AND NOTES ate, ' CITY OF PORT ANGELES ffi g DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 11 00000817 Date 8/02/11 Application pin number 620278 Property Address 136 E FRONT ST REPORT SALES TAX ASSESSOR PARCEL NUMBER 06 30 00 5 1 1601 1000 Tenant nbr name LC & LC & RR TIES on your state excise tax form Application type description RE ROOF Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning CENTRAL BUSINESS DISTRICT Application valuation 15700 Application desc TEAR OFF & RE ROOF DELANEY S Owner Contractor JOHN W REHLEN EMERALD ROOFING INC PO BOX 385 P 0 BOX 879 CASTLETON VT 57350 PORT ANGELES WA 98362 (360) 452 4681 Structure Information 000 000 RE ROOF DELANEY S Permit BUILDING PERMIT NO PR FEE Additional desc RE ROOF DELANEY S Permit pin number 190322 \ Permit Fee 291 75 Plan Check Fee 00 Issue Date 8/02/11 Valuation 15700 Expiration Date 1/29/12 Qty Unit Charge Per Extension BASE FEE 95 75 14 00 14 0000 THOU BL-2001 25K (14 PER K) 196 00 � Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 291 75 291 75 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 296 25 296 25 00 00 Separate Permits are required forelectrical 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 Si ure 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 INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION. Footin s 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 b AIR SEAL. Walls rV�" Ceiling v FRAMING Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceilin Drywall(Interior Braced Panel Only) T-Bar INSULATION. Slab Wall/Floor/Ceiling MECHANICAL. Heat Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT Separate Permit#s SEPA. Parkin I Li Lighting ESA. Landscaping SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By m� Electrical 417-4735 \" Construction R W PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Q- 2 Building 417-4815 �'�-- L. T rn--/Ri it iinn n,iisinn/Rnildina Permit N Y pORr.4'A, BUILDING PERMIT APPLICATION Print in ink L` (lr I�•�- CITY OF PORT ANGELES ® Attn Building Permit Technician For City Use Only Date Received 321 E Fifth St. Port Angeles WA 98362 (360)417-4815 fax (360) 417-4711 Permit# M_$►'1 Date Approved Applicant /l� �(,� lC+'��1 NvJ N�, Phone �Q Property Owrser Phone Property Owner's Address Contractor Phone C7 Contractor's Address V p C30X License # LMem�_T I 17q PP Expires ;?oil E-mail PROJECT ADDRESS 3� ro-F 5 � Parcel Number Lot Zoning Project Type & Brief Description. ❑ Residential ❑ Multi-family y Commercial ❑ Industrial Check all that apply ❑ New Construction ❑Addition ❑ Remodel ❑ Repair ❑ Demolition XRe-roof ❑ House ❑ garage ❑ other Xtear off& re-roof ❑ lay over one layer ❑ Heat System ❑ Heat pump ❑wood-burning stove ❑ gas fireplace ❑ pellet stove ❑ other ❑ Other Floor Areas Existin_g(sq. ft.) Proposed(sq. ft.) Basement @ $ per sq ft. _ $ 1 st Floor 2n Floor 3ftl Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION $ )5, 700 Total footprint of structures sq ft. T Lot size sq ft. = Lot coverage % Site Coverage = the amount of impervious surface on a parcel, including structures, paved driveways sidewalks patios and other impervious surfaces (see PAMC 17 94 135 for exemptions) Site coverage % Max. height of proposed structures ft. Occupancy group #of bedrooms Will a lawn sprinkler system be installed? Occupant load #of full baths Will a fire sprinkler system be installed? Construction type #of half baths /have read and completed this application and know it to be true and correct. /am authorized to apply for this permit and understand that it is my responsibility to determinewh/a�t ermits are required, and to obtain permits prior to working on projects. Date l-2- 11 Print Name gAV i s Signatur T Forms/Building Division/Building permit application 114 135 j R - 118 »r "122 . - 124 .. a " 130 �= Y fit " 136" ". 114 204 123 . 117 127 142 - p l "p�f� 129 106 h- Ef3 §� W U . ? Clallam County Assessor& Treasurer - Property Details - 61400 JOHN W REHLEN for Page 1 of 1 Clallam County Assessor&Treasurer Property Search Results > 61400 JOHN W REHLEN for Year 2011 2012 Property Account Property ID61400 Legal Description, SMITH,NORMAN R 1/3 IN LT 1 BL 16 Geographic ID 0630005116011000 Agent Code Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 58 Open Space: N DFL N Historic Property N Remodel Property N Multi-Family Redevelopment: N Township: Section: Range: Location Address: 136 E FRONT ST Mapsco: �. PORT ANGELES,WA 98362 Neighborhood: Cycle 5 Comm Map ID 2 Neighborhood CD' 20953140 Owner Name JOHN W REHLEN Owner ID 48139 Mailing Address, PO BOX 385 %Ownership: 100 0000000000% CASTLETON,VT 57350 Exemptions: Taxes and Assessment Details Property Tax Information as of 08/02/2011 Amount Due if Paid on.jn�. 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 Click on 'Statement Details' to expand or collapse a tax statement. First Half Second Half Year Statement ID Base Amt. Base Amt. Penalty Interest Base Paid Amount Due R Statement Details 2011 155839 $548.29 $548.20 $000 $0 00 $548.29 $548.20 R Statement Details 2010 44115 $54648 $546.47 $000 $000 $1092.95 $0.00 Values Taxing Jurisdiction Improvement/Building Sketch Property Image Land Roll Value History Deed and Sales History Payout Agreement This year is not certified and ALL values will be represented with N/A Website version:9 0 32.2200 Database last updated on:8/2/2011 3:53 AM ©2011 True Automation,Inc.All Rights Reserved. Privacy Notice http.//websrv8 clallam.net/propertyaccess/Property.aspx?cid=0&year=2011&prop_id=61400 8/2/2011 soxidd ;Zwpf'5�, Proposal Post Office Box 879 Date Quote# Port Angeles, WA 98362 3/11/10 1522 PH. 360-452-4681 — FX. 360 452-4429 www.emeraldroofmg.20m.com Job Name/Location DELANNEYS BUILDING 114 THRU 120 LINCOLN ST TO PT ANGELES WA Properties By Landmark ' r r C nt 5+ C\O Sandra �K�` �O G rl'U Port Angeles,WA 98362 330 �1 JOB PHONE it�e¢�r9, Desc REROOF COMMERC BUILDING(SMALL R SECTION SOUTH R TEAR OFF EXISTING S OF ROOFING) PREP DECKING FOR REROOF(POUND FLAT OR PULL EXISTING FASTENERS) REMOVE 1 LARGE SKYLIGHT TO DECKING INSTALL LUMBER FRAMING AND SHEET OVER TO ELIMINATE SKYLIGHT REMOVE ALL OBSOLETE CURBS AND BOXS NOT IN USE REPAIR DECKING WITH SAME KIND OF SHEETING OR ON LARGER SECTIONS 3\4' CDX PLYWOOD INSTALL MINERIAL SURFACE BASE SHEET TO ROOF AREA INSTALL SMOOTH TORCHDOWN UNDER NEW DRAIN AND INSTALL NEW CUSTOM METAL DRAIN WITH THE LARGEST DROP WE CAN FIT TO EXISTING DRAIN PIPE INSTALL GRANULATED TORCHDOWN ROOF SYSTEM TO ROOF AREA INCLUDING ALL WALLS INSTALL NEW LEAD FLASHINGS TO ALL PIPE VENTS INSTALL 5 TURBO VENTS TO REACH VENTING CODES FLASH 1 LARGE ROOF HATCH BOX WITH TORCHDOWN FLASHINGS INSTALL 1 PITCH PAN TO CABLE ANCOR FOR POWER POLE INSTALL NEW METAL WALL COPEING TO ALL PERIMETER WALLS(FLASHING TO BE HEMMED ON FRONT AND BACK BENDS) CLEAN UP AND HAUL AWAY ALL ROOFING DEBRIS $12,073 00+TAX 1014 13=$13,087 13 haSe, 2 LARGE BUILD S SAME DETAILS JUST ALOT MORE OBSOLETE ITEMS(INCLUDES CHIMNEY CONDUIT VENT DUCTS, ECT) TURBO VENTS FOR VENTING CODE,AND ARE 2 LARGE SKYLIGHTS. BOTH BUIL GS WILL BE LEFT AS CLEAN AS POSSABLE(NO OBSOLETE ITEMS THAT CAN CAUSE PROBLEMS LATER)WALL CONNECTING UILDINGS WILL BE ROOFED IN AS WELL. METAL WILL B INSTALLED ON ALL BUT STORE FRONT WALL WITH DECORATIVE METAL. $15,711.00+T 1319 72=$17,030.72 PERMITS WILL UN APX$255.00 FOR SOUTH SECTION AND$297.00 FOR LARGER SECTION NORTH STAX LOC 0502 & \3� e r1ro SC- ALL COMPOSITION TO BE WIND NAILED(6 NAILS PER FULL SHINGLE AND 4 NAILS PER RIDGE PIECE) ALL WORK NOT ABOVE TO BE A CHANGE ORDER(TIME AND MAIL)MANUFACTURERS WARRANTY ON MATERIAL,2YR LABOR WARRANTY WE PROPOSE' ereby to furnish.material and:labor—Icompleie in accordance with the above specifications. Please choose.an item where required,sign&return to the above address. Payment is due upon completion unless other arrangements have been made. All material is guaranteed to be as specified.All work to be completed in professional manner according to standard practices.Any alteration or deviation from above specifications involving extra costs will be executed only upon written or verbal orders,and will become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents Authorized Signature or delays beyond control.Owner to carry fire,tornado and other necessary insurance. Our workers are fully covered by Worker's Compensation insurance. A,ote. Thisproposal nrcn-be tvllhdratrrr by us If not accepted within 60 daps. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby Signature accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Signature Date of Acceptance: 0,90R, CITY OF PORT ANGELES PUBLIC WORKS &UTILITIES 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 09 00000389 Date 5/01/09 Application pin number 990724 Property Address 136 E FRONT ST ASSESSOR PARCEL NUMBER 06 30 00 5 1 1601 1000 Application type description PUBLIC WORKS UTILITES Subdivision Name Property Use Property Zoning CENTRAL BUSINESS DISTRICT Application valuation 0 Application desc Pressure wash & paint bldg RUP#09 17 Owner Contractor REHLEN JOHN W OWNER PO BOX 385 CASTLETON VT 057350385 Permit RIGHT OF WAY Additional desc PRESSURE WASH/PAINT BLDG Permit pin number 145177 Permit Fee 75 00 Plan Check Fee 00 Issue Date 5/01/09 Valuation 0 Expiration Date 10/28/09 Qty Unit Charge Per Extension BASE FEE 75 00 Vim' Special Notes and Comments Follow attached ROW Use permit 09 17 conditions Fee summary Charged Paid Credited Due Permit Fee Total 75 00 75 00 00 00 Plan Check Total 00 00 00 00 Grand Total 75 00 75 00 00 00 Separate Permits are required for electrical work,SEPA,Shoreline ESA,utilities private and public improvements This permit becomes null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work as commenced or if required inspections have not been requested within 180 days from the last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to iolate or cancel the provisions of any state or local law regulating construction or the performance of construction _ Signatu e of contractor or Authorized Agent 6 ate Signature of Owner(if owner is builder) Date T\Policies\1102 15[10/08] PERMIT INSPECTION RECORD CALL 417-4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL 4NY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PW UTILITIES (Engineering Division) WATERLINE/METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB&GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W /PW/ CONSTRUCTION R.W ENGINEERING 417-4831 PW/ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING TAPolicies\1102 15[10/081 '0,pORT,�,O� CITY OF PORT ANGELES o v T N PUBLIC WORKS -UTILITIES DIVISION 321 EAST 5TH STREET PORT ANGELES,WA 98362 t Application Number 07 00001067 Date 9/20/07 0 Application pin number 632247 Property Address 136 E FRONT ST ASSESSOR PARCEL NUMBER 06 30 00 5 1 1601 1000 Application type description PUBLIC WORKS UTILITES Subdivision Name Property Use Property Zoning CENTRAL BUSINESS DISTRICT Application valuation 0 Owner Contractor REHLEN JOHN W COZI HOMES CONSTRUCTION INC PO BOX 385 324 E 9TH ST CASTLETON VT 057350385 PORT ANGELES WA 98362 (360) 452 9906 Permit RIGHT OF WAY Additional desc RUP# 07 44 Permit pin number 111047 Permit Fee 70 00 Plan Check Fee 00 Issue Date 9/20/07 Valuation 0 Expiration Date 3/18/08 Qty Unit Charge Per Extension BASE FEE 70 00 Fee summary Charged Paid Credited Due Permit Fee Total 70 00 70 00 00 00 Plan Check Total 00 00 00 00 V� Grand Total 70 00 70 00 00 00 v 1 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.1'80 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 constr�uction. / ✓� S' nature of Contractor or Aut d Agent Date Signature of Owner(if owner is builder) Date T•\Policies\1102.15R[11051 PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY 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 PW UTILITIES (Engineering Division) WATERLINE/METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB&GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W /PW/ CONSTRUCTION R.W ENGINEERING 417-4807 PW/ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING TAPolicies\I 102.15R[1/05] • P ORT" NGELES �- W A S H I N G T O N U S A City Manager's Office May 4, 2007 Karen McCall, Acting Director Washington State Liquor Control Board ,t. 3000 Pacific Ave SE h Olympia, WA 98504-3098 RE Objection to Liquor License Renewal Licensee David Michael Delaney # 355375 The City of Port Angeles objects to the renewal of the liquor license for David Michael _. Delaney, License# 355375, doing business as Delaneys Restaurant and Lounge at 136 E t N Front Street. The City's objection is based on the following facts E` 1 Closure of operation at this location. Delaneys Restaurant and Lounge has ceased operations Mr Delaney continues to operate a bar known as The m Other Side located at 130 E. Front Street. The City does not believe that license # 355375 is valid for that establishment. 2 This licensee is delinquent on payment of taxes and assessment to the City in —n .,, excess of$61,000 3 Mr Delaney does not implement adequate controls and safeguards in his liquor sales operations Both of Mr Delaney's operations serving liquor have had a high incidence of 911 calls for disturbances U) Therefore the City respectfully requests that license# 355375 for David Michael Delaney not be renewed. eta Sincerely .. Mark E Madsen !�a City Manager :Q� Eh� Cc PAPD >' City Attorney g Mayor Rogers .k: P Phone 360-417-4500/ Fax 360-417-4509 Website www cityofpa.us / Email citymanager@cityofpa.us '' 321 East Fifth Street P 0 Box 1150 / Port Angeles WA 98362-0217 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Application Number . . . . . 03-00000413 Date 4/21/03 Property Address . . . . . . 136 E FRONT ST ASSESSOR PARCEL NUMBER: 0630005116010000 Tenant nbr, name . . . . . . DELANELYS REST Application description . . . COMM FOUNDATION ONLY Property Zoning . . . . . . . Application valuation . . . . 2000 Owner Contractor -----"'---------------- ---------------___------ PETE CAPOS OWNER 217 WEST 4TH STREET PORT ANGELES WA 98362 ------ Structure Information NEW SATELITE DISH POLE ----- Construction Type . . . . . TYPE V NON-RATED Occupancy Type . . . . . . ASSEMBLY <300 W/O STAGE ------------------------ ----------- - Permit . . . . . . BUILDING PERMIT COMMERCIAL Additional deac . . Permit Fee . . . . 92.75 Plan Check Fee .00 Issue Date . . . . 4/21/03 Valuation . . . . 2000 Expiration Date . . 10/18/03 Qty Unit Charge Per Extension BASE FEE 47.00 �j ) 15.00 3.0500 HND BL-501-2K (3.05 PER C) 45.75 _______________ _-____ _____-_- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due --- ---------- ---------- ---------- .. Permit Fee Total 92.75 92.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 97.25 97.25 .00 .00 Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned for a period of 180 days after the work as commenced,or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner(if owner is builder) Date T:\PLANNING\FORMS\1102.15[4/20021 'cr,Lyr FOR OFFICIAL USE ONLY: ` BUILDING PERMIT - APPLICATION Date Rec.:y/—/6-6� Permit#: _ Fill out COMPLETELY and in INK.Your application and site plan MUST BE Date Approved: COMPLETE to be accepted for review. If you have any questions,call (360)417-4815 Date Issued: Applicant or Agent: Ar-- -r� V Phone: cls`� Owner:---7s <` k C Z'C-7 Phone: Address:- y--2-y—s— 6' 7 co wJ City: ✓ Laz cw�P Zip: `(&'l (. 2 Architect/Engineer: C4'#t'- ' LkC` 5x'' �ZC Q- Phone: Contractor P-Q'M C W ..1 S State License#: 7 O nl Fecct Exp: Phone: Address: \ 2 Z I 6/ -Z_ .r,tcs 7 City. O 4tA c e "<s zip: cRi S-1 6 2- PROJECT PROJECT ADDRESS: ZONING: LEGAL DESCRIPTION: Lot: Block: Subdivision: rj ocLw -3 K -rti CLALLAM COUNTY PARCEL NUMBER: D 6 3 a p cD S 1 \ b o b Credit Card Holder Name: Billing Address: City: Credit CardType VISA MC # Exp.Date: TYPE OF WORK: SIZE/VALUATION: ❑ Residential ❑ New Constr. ❑ Re-roof ❑ Stove SF. @$ /SF._$ ❑ Multi-family ❑ Addition ❑ Move ❑ Garage SF. @$ /SF. _$ ❑ Commercial ❑ Remodel ❑ Demolition ❑ Deck SF. @$ /SF._$ ❑ Repair ❑ Sign P�bthervC ti TOTAL VALUATION $ BRIEF DESCRIPTION OF THE PROJECT: C- ow Roc-'s fvcL COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: Lot Size: Existing Sq. Ft. &Proposed Sq.Ft. =TOTAL Sq.Ft. Existing lot coverage %&Proposed lot coverage %=Total lot coverage % APPROVALS: PLANNING USE ONLY: PLAN: BLDG: DPWU: FIRE: ESA/Wetland(s): ❑ Yes ❑ No SEPA Checklist required? ❑ Yes ❑ No Other: 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 maybe revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application,the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant(see Section 107.4 of the Uniform Building Code,current edition). No application can be extended more than once. 1 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 CQ3firTt iraThn obtain such permits prior to work. TAFORMS\APPS\Buddingperrnit.wpd Applicant: t Date: 4- - Is:— . Oa 6� = 79 . 574- 7 4, . 1,4 s¢74, . 1,4 i �49ca P7- - z= -v 1. 3Sxl (ox loo0 4-96'9c�a�°t' 13®pz �r�z'° !7r i► • 1�� 97�' .c t 1 rs 2 � J I/ Com_x/12 d � = 7S . 54- .— i WIr p Ptz*74 (MWIPk4 or�w 4, /JS Px 14 (��b� • +4Ya5) = 17 I&D , g5 ® C r-7)4o® •a�,)C iz� e tog r. °563x UP x la®o ue16- 4,054 &T7';puwT --� � la rfc,"°(" )=a 3��s" !moi p • �� p�' 1 • 3x `►l (ox 1,000 � '1'- 44 07 T� Q�� 1 _ ,' ;3