Loading...
HomeMy WebLinkAbout119 Forest Ave - Building "'''' 0 ...... r- 0 ...... r- ~~ OE-o <t:<t: 0.0 1Il '" '" 0 , r- 1Il '" 0 W ID .... >< ,., ... ..:I' Cl 0:: <: ~ <1l H :> 0- ..:I H~~ .... E-o OZZ ~Ul @OO ~ ~~ :x::x: ~ E-o ~~ Ulo.o. 0 Z E-o'J r- ~ 0 0 ~ Z .. 0 00:: m 0:: HO Ul 0 , E-oE-o E-o ~ Ul UU Z "'1Il0:: E-o ~~ ~ '" Z 0.0. :>: "''''' ~ UlUl fXlZ:>: 00 :>: ZZ fXlOO HO I H :>: H H l><HU lC(Nt'lC( 0 E-o...... Z lIlZ U o::o.Ul H .", H l><HE-o ~r- ~ 0::..:1 >< , OU::> 0>'00 0 ZUlUl 0....00 0 ~~ ..:I"~..:I 0 '00:: <II'Jo.<II o~ '0 E-o NO H IDO:: ~o.~ it ID , 0 ~ N~ 0 ;( '0:: o.Ul E-oN ZUl '" 0:: , 1Il C!lH~ 1Il E-o ~1Il'" Z 0:: Ul <II , r- H '" ~ omo ~ Ul 0:: 0::00 ~ 0 '0 HOO it -..:I ~ -00 ::>~~ "'~ ~MO <IIE-oE-o 00 m 0::' . Ul~ ~~ .... HID'" :5gj~ .... 000 0 0:>: ......E-o .. .. .. .. .. o.MO r-O:: 0:: OO::U 0 '0:: .~ gj 0. 0 <II 0 E-o .. ~ M~ UlU .... 0::0 gj;;'io::&l E-o 0 0 <t: H Ul 0.>< O::E-oMU..:I ~ ...... m ME-o 015~~g: 0. m O::H >< ..:I o.U ~UOO.<t: 0. E-o <II :f90RT~ tf.O~" ~f'1:a"" 1!::. -- 't.O;:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 32] EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivi~ion Name Property Use Property Zoning . . . Application valuation 08-00000735 Date 715225 119 FOREST AVE 06-30-09-5-2-2662-0000- RE-ROOF RS7 RESDNTL SINGLE FAMILY 700 Application desc tear off install comp Owner Contractor DIRE, ROBERT 119 FOREST AVE PORT ANGELES (360) 457-0845 OWNER WA 98362 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT - NO PR FEE TEAR OFF/INSTALL COMP 128546 56.10 plan Check Fee 6/19/08 Valuation 12/16/08 Qty Unit Charge Per BASE FEE 2.00 3.0500 HND BL-501-2K (3.05 PER C) Other Fees STATE SURCHARGE Fee summary Charged Paid Credited ----------------- ---------- ---------- ---------- Permit Fee Total 56.10 56.10 .00 Plan Check Total .00 .00 .00 Other Fee Total 4.50 4.50 .00 Grand Total 60.60 60.60 .00 6/19/08 Extension 50.00 6.10 4.50 Due .00 .00 .00 .00 .00 700 ~ )> ?CCL' ~~ '\. ~ 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 regula' g construction or the performance of construction. \ r~ , -z])o.~ Print Name T:Forms/Building Divisionll3uilding Permit (05113/08).wpd BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4 I 7-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES. CALL 4 I 7-4886 FOR BACKFLOW PREVENTION 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 AND APPROVED PLANS AT THE JOB SITE. o 09 , ~ lJJ \J'\ INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDA TJON: FOOTINGS SHEAR WALLS I WALLS FOUNDATION DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR W ALL/HOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL I FLOOR I CEILING MECHANICAL HEAT PUMP I FURNACE I DUCTS GAS LINE WOOD STOVE I PELLET I CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD I DUCTS MANUFACTURED HOMES FOOTING I SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. I PWI CONSTRUCTION - R.W. ENGINEERING 4 I 7-4807 PW I ENGINEERING FIRE 4 I 7-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 r-1-I\R -:s U J' BUILDING T.r......."H:/nllildino nivi~inn/Rllilrfinl' Permit (05113/081.wod -- ~ Jl ~ l/) T r :It> (t:l I 8 ~ ~ CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 (360) 417-4815 fax (360) 417-4711 Applicant or Agent Q - - . kCl 1) i \' e Property Owner ~ ~l e Property Owner's Address -----U1 \-6 ({;o t-o.../V <- Contractor/Engineer Contractor/Engineer's Address License # BUILDING PERMIT APPLICA TION Print in ink For City Use Only: Date Received (,-19 --08 Permit # 0.;/... 7 3r1:;;"" Date Approved ~ -/~ ,.O'Y Phone Phone ~ Vt-A-"', ~\.l4 'OJ A q o?>Co "2- f!>hone Expires PROJECT ADDRESS f(; r't/J t-. J -e Parcel Number Lot Zoning Project Type & Brief Description: o Residential o Commercial o Multi-family o Industrial Check all that apply ({OO t' o New Construction Ve. d AYO-- ~ -e.- o Addition l~ I o Remodel o Repair oRe-roof o Demolition o Heat System o Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other )r(Other Floor Areas Existinq (sq. ft.) Proposed (Sq. ft.) Basement @$ per sq. ft. = $ 1 st Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALVA T/ON $ /{(J n ff() Total footprint of structures sq. ft. Lot size sq. ft. = Lot 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 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. an projects. Date~ Print Name ~6 be, Y B -PC\ 1) ire Signature T:Forms/Building Division/Bldg Permit Appl.-2006 Code.doc :Y.... ~;'"}}*~p:J,ication Number '.' ,'Pin number .3257 ",'property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation 03-00000999 Date 3/11/04 ~ pORT ~ ....4.0~<'? ~f'i1iij" 1!::. -- 'l.,;~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 119 FOREST AVE 06-30-09-5-2-2662-0000- RES DETACHED GARAGE RS7 RESDNTL SINGLE FAMILY 10000 Owner Contractor DIRE, ROBERT 119 FOREST AVE PORT ANGELES (360) 457-0845 Structure Information Construction Type Occupancy Type Other struct info OWNER WA 98362 672SF DETACHED GARAGE TYPE V NON-RATED GARAGES, CARPORTS, SHEDS 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 22.60 "- "- "0 V-N 1.00 2153.50 12500.00 672.00 2825.50 1. 00 46.70 3/11/04 9/07/04 Plan Check Fee Valuation .00 o ~ ~ ~ Permit AdditionaL.desc perinit_ Fee" . Issue__Date.' " _, . E;xPiration.riate ELECTRICAL NEW RESIDENTIAL Qty Unit Charge Per 1.00. - _ 46.7000 ECH EL-R-OUTBD/DTCH GAR SEP Extension 46.70 ~ 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 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 -'~.................~. Separ#e'Perlnlfs-are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and'vpici If,..wQrk or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180. dC!ys 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 ordinancss 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 o.sJoea la regulating construction or the performance of construction. : /' Signature ?f Contractor or Authorized Agent Date T:\PLANNINGIFORMSIJ 102.15 [1 J/14/2003] 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: FOOTINGS WALLS FOUNDATION DRAINAGEIDOWN 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 W ALL/HOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE / METER SEWER CONNECTION SANITARY 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 ELECTRJCAL - LIGHT DEPT. 417-4735 R j~/I?q .ib/J ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. / PW/ , CONSTRUCTION - R.W. ENGINEERJNG 417-4807 PW / ENGINEERJNG FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\l ]02.15 [11/14/2003] ....00 NO ....... N N ....... .,. f>lf>l 0E-< ..:..: o..Q ltl .,. 00 0 . ... ltl .,. OJ .... l-< 0 01 \D <: >< M '" ..:I 0. I>: .-< f>l H :> ..:I Hf>lf>l ~ E-< QZZ en f>len glOO 0 f>l >Gf>l :I::I: o CD f>l E-< 8~ en 0.. 0.. uN en 0 .... u ::> Z E-<'"> O\D 0 N :I: ~ Z u 01>: f>lo f>l HO en :E.... f>l E-<E-< 0 E-< H I>: en UU Z Z ~OO\DE-4 E-< f>lf>l H f>l Oltl l'i 0..0.. Q fIlZ~ 00' en en ..:I N.,. ~ ZZ H fIlOO ..:I ...:1 HH ::> fl<HU ..: -N":Z 0 <Il E-<....... Z..-iu>ZO U ~o..en HN<o::t'HO >< "'HE-< "'.-<><"'iii I>: 055 '0 0.... 0 Cl f>l oen Zenen Ql-<ClQE-< oen f>lf>l ..:I 0. f>l ..:I '" of>l 'I'll>: <Il..:o..<Il": oU .U E-< N": H \D ~o..~ ~ \Den \D f>l Nf>l M :> 'I>: "'en::> ..: E-<N zen ..-i I>: , M ClHf>l u> E-< f>lltlM Z I>: en <Il , M H 00 f>l omo 9 en I>: 1>:00 f>l 0 '0 SQQ -..:I '" -00 f>lf>l 00 oof>l f>lMO lllE-<E-< 0 oCl m 1>:' , enf>l ....... ~~ .... H\DOO ~n:Ji N .... Cloo N N 0:;: ....... .......E-< "'f>l0 .,. .,.1>: I>: OI>:U 0 .1>: .f>l ~ 0.. 0 <Il Cl E-< . . ~ f>l'" enu .... ~o gj~l>:t;'j E-< 0 0 H en 0..>< 1>:E-<f>lU..:I ~ ....... m f>lE-< Q~~~:t P- m I>:H >< ..:I o..U ~uoo....: '" E-< <Il CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 08-00000333 Date 675288 119 FOREST AVE 06-30-09-5-2-2662-0000- RES ACCESSORY BUILDING 3/12/08 RS7 RESDNTL SINGLE FAMILY 499 Application desc MOVE ACCESS STRUCTURE (TREE HOUSE) Owner Contractor DIRE, ROBERT 119 FOREST AVE PORT ANGELES (360) 457-0845 Other struct info OWNER WA 98362 HARD SURFACE AREA Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT - NO PR FEE MOVE TREE HOUSE 122911 50.00 Plan Check Fee 3/12/08 Valuation 9/08/08 .00 499 Qty Unit Charge Per BASE FEE Extension 50.00 Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 50.00 50.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 54.50 54.50 .00 .00 ~ C7. 7<( < ,,~ ~~ 0/ \.. ~ Separate Perm its are required for electrical work, SEP A, 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 p-rovisions of any state or local law regulating construction or the performance of construction. Signature of Owner (if owner is builder) T: Forms/Building DivisionlBuilding Permit (1010 1/07). wpd BUILDING PERMIT INSPECTION RECORD o oQ \ vJ vJ \}J CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES 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 FOUNDA TION: FOOTINGS SHEAR WALLS / WALLS FOUNDA TION DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLOGS.) PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR W ALL/HOLD DOWNS WALLS I ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB . WALL / FLOOR / CEILING MECHANICAL HEA T PUMP / FURNACE / DUCTS GAS LINE WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING 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 ELECTRICAL - LIGHT DEPT. 4 17-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R. W. I PW/ CONSTRUCTION - R.w. ENGINEERING 4 I 7-4807 PW I ENGINEERING FIRE 4 I 7-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 DY-22-0~ BUILDING - ~ dl ~ V' vf- f 3 o f ~ :r: 0> C ~ ~ T:Forms/Bllilding Division/Building Permit (1010 1/07). wpd '" BUILDING PERMIT APPLICA TION Print in ink Applicant or Agent Property Owner Property Owner's Address Contractor/Engineer Contractor/Engineer's Address License # ~Q CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 (360) 417-4815 fax (360) 417-4711 Expires PROJECT ADDRESS (( ct f20r &J + CVv ( 7J~ r+ A-(\Oj ~ (\ij) W It Cff)3(jJ 5-. Parcel Number Lot Zoning Project Tvpe & Brief Description: 0 Residential 0 Commercial 0 Multi-family 0 Industrial Check all that apply o New Construction o Addition L T ~<:L. U S ~ o Remodel o Repair oRe-roof o Demolition o Heat System 0 Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other o Other Floor Areas Existinq (Sq. ft.) Proposed (sq. ft.) Basement @$ per sq. ft. = $ 151 Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALVA TlON $ 6(fD \CfD Total footprint of structures sq. ft. Lot size sq. ft. = Lot 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 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, a to obtain permits prior to working on projects. ~::~m?~u~!'~2o:'::tp~:::py,;Jtf!o~eQ 7) !'~ l ... ,,&;J.~~';~~t~(~ii,ii'lil~,);~,;~;~~S~{~I~~lJ~~J~i~;~~:,,,,1~ Al\e. ./ /0' ~af" Se-I-...l:4CK. r- 2<../6 ~i-__/6' .~ IX ... ~ (I( 2 10 C\l - , - .lo 1 --...~-- ~ ~ "\f\ J?' ~ Jai-il-fc"i!! l gd:)l f ii" ~ a. ~::3'" "" 5F'.., ~ 0 ~ R~JHll!~ W' ~h.a!r.:!I m~:~gll ~ ..c:ii&_ll_:l-[" "a.llall~J:;; e.il=[~j~Il" !I !~!.gtHf' ~ Hia:! if' ~ ~ J f N' o' i~~3:'" ~ !P~,,~~ .. ?5~~E.:;n~ ........ - .-= '" J 10007 L. 1/9 ---4- F"o'(edJ Ave, L e3al fk.sc....; rtinY) u._--._..-..__Site.2laJ'L lC\~ (6 Cl,!)Q 17 81ac..'La.fQ:Ja:d~_(Uld. OOff!J).u..___.__ ..._.__.__ _'_.. _. Pc,.d: An~~le~ LJ!\"hl1'lq:bn. I-- "~ I ~ ~ ~ ~*~ ~ Vi E ~ ~")C I r WI- ~ ~ ~Iu ~ ~rn ~l1- . 9 ...:!.) '~~ ~~ llJ -::- _ x Ql :s~ ~lu ~\-- ~ ~ to ~ V\ ~~ ~V\ 3t ..411{,'1 ~ ~ o~ h,s+/Il<{ aaYC,?~ 'N \) - I'I l 1 . .. ''''-'''''''- _=-. QLO_ ______ ~r6.ti;i~i:;~(.~~f(..::~!;;fL~~~9f.l~;li!;!!K~1G.~j~:J~i/,...~);~:~:~~~;~~!I';;;:.;:;;;.". .,..:':,' ".' ,,'", .' ~~i~" .... :- .." .:.:,':~ ~'..{:~::J r;j' /- ~ ~ I - C () ~ ~ A- ~ - n.. , - c() ~'L. ~ --,/- ..- ~<::e-\>- ~--r -'f> . - t's::- ~ ? . (9; ~ '-~ \,of -~ - "<~ ~ e., ';..f~ c 0 <;-'- ~~ '}. ~ ...>..> ~~ ~~;~ , - I . ,D1 \. \ :- ~ ~Id- ID - \. ~~~ . ~; t- ~ 00 (j ~ \0 ~ ~ .~ r t ~ -J S- ~ - J * ~ ~'>~ "7- ~ ~ Nf~ -.... P- ':r cS' ~ \.u -* \- <J\ Q; \t cs-- - -- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ~,,~s~.~v~ r~.r~vns ISSUED: 6~04~2002 I-'t:HMII NO: 13465 OWNER/APPLICANT PROPERTY LOCATION 119 FOREST "SUSAN HENNINGS 119 FOREST Lot: 16&17 Port Angeles, WA 98362 Block: 26 [] Long Legal 360/400-0000 Subdivision: FORGARTY & DOLAN ADDITION T: S: Parcel No: 063009522662000 CONTRACTOR ARCHITECT FEELEY CONSTRUCTION N/A 2606 DEER PARK RD. Port Angeles, WA 98362 , 98360-0000 360/452-7559 360/000-0000 PROJECT INFO Project Value: $6,000.00 SFD Units: 0 Commercial: 0 Project Type: SIDING SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: PROJECT NOTES REMOVE LP SIDING/INSTALL HARDIE RECEIPT ~'9183 FEES ASSESSMENT Building Permit: $125.25 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $129.75 Plumbing: $0.00 AMOUNT PAID: $129.75 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All previsions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the previsions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authori;~ed Agent Date Signature of Owner (if owner is builder) Date :\PLANNING\FORMSX 1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A M1NIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSUL4TE OR CONCEAL ANY WORK BEFORE INSPECTED AND/~CCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT .lOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES ] NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: g PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'$: WATERLINE / METER SEWER COI~NECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 41%4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIKE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 /L-'~ "~" ~ ~ ~.. ~/~7d- BUILDING T:\PLANNING\FORMS\1102.15 [4/2ff02] ~ ~ORT ~ l'O~~~ ha "- -=.... ~ "41i~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Zoning . . . Application valuation 03-00000999 Date 10/24/03 119 FOREST AVE 06-30-09-5-2-2662-0000- RES DETACHED GARAGE 10000 Owner Contractor DIRE, ROBERT OWNER 119 FOREST AVE PORT ANGELES WA 98362 (360) 457-0845 Structure Information 672SF DETACHED GARAGE Construction Type TYPE V NON-RATED Occupancy Type . . . .. GARAGES, CARPORTS, SHEDS Other struct info . . .. NUMBER OF UNITS 1. 00 Permit Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT -RESIDENTIAL 672 SF DETACHED GARAGE 204.75 Plan Check Fee 10/24/03 Valuation 4/22/04 81. 90 10000 -0 Qty Unit Charge Per Extension 92.75 112.00 BASE FEE 8.00 14.0000 THOU BL-2001-25K (14 PER K) Other Fees STATE SURCHARGE 4.50 "T\ i \) ~ <t r (\) f.P ~ ---------------------------------------------------------------------------- Special Notes and Comments Electrical load calculations and elctrical permits are required. Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 204.75 204.75 .00 .00 Plan Check Total 81. 90 81. 90 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 291.15 291.15 .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 presu~ 've authority to violate or cancel the proviSions of any state or loc w regulating construction or the performance of con,struction. 3 Signature of Contractor or Authorized Agent Date T \PLANNING\FORMS\I 10215 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLAWFUL 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 I INSPECTION TYPE DATE I ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS II-/O-OS. ..JLL. WALLS /J-/3.-D3 \LL FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT. # ROUGH-IN PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL ~-o.~ -oJ./ ~).lk WALLS / ROOF / CEILING ~_^"). L"'t.J -:U.. .1-. DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engmeenng DIVISIon) SEPARATE PERMIT #'5 WATERLINE / METER SEWER CONNECTION SANITARY 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 ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT 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 r;3- I fP -c;jiJ J )... , BUILDING T.\PLANNING\FORMS\1102 15 [4/2002] PREPARED 8/16/04, 12 20 20 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 1 8/16/04 ADDRESS CONTRACTOR OWNER PARCEL . APPL NUMBER 119 FOREST AVE SUBDIV PHONE PHONE (360) 457-0845 DIRE, ROBERT 06-30-09-5-2-2662-0000- 03-00000999 RES DETACHED GARAGE PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 11/10/03 11/10/03 11/13/03 11/13/03 3/23/04 3/23/04 3/23/04 3/23/04 JLL AP JLL AP JLL AP JLL AP BUILDING FRAMING BI2 01 BUILDING FOUNDATION FOOTING TIME. 17 00 20' ground rod #4 1n foot1ng/J1m BUILDING FOUNDATION WALL BL3 01 BL9 BUILDING SHEARWALL BUD 457-0845 th1S 1nsppect1on was not needed, subst1tuted shear wall for frame 1nspect1on and structure lS approved/Jll BL99 01 ~16 04 &:r7 BUILDING FINAL ~ bub dyers 457-0845 ------------ ------------------------- COMMENTS AND NOTES -------------------------------------- 01 PREPARED 3/23/04, 12 19 19 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 2 3/23/04 ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 119 FOREST AVE SUBDIV, PHONE PHONE (360) 457-0845 DIRE, ROBERT 06-30-09-5-2-2662-0000- 03-00000999 RES DETACHED GARAGE PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS 11/10/03 JLL 11/10/03 AP 11/13/03 JLL 11/13/03 AP BL9 01 .;':3~~~.1 ~Lt:) BUILDING SHEARWALL ~ ~ BUD 457-0845 -------------------------------------- COMMENTS AND NOTES -------------------------------------- BL1 01 BUILDING FOUNDATION FOOTING TIME 20' ground rod #4 ln footlng/Jlffi BUILDING FOUNDATION WALL 17 00 BI2 01 - \-~e ~r~ / S~~l\..- ~~~Jc0 PREPARED 11/13/03, 12 29 26 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 4 11/13/03 ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER. 119 FOREST AVE SUBDIV PHONE PHONE (360) 457-0845 DIRE, ROBERT 06-30-09-5-2-2662-0000- 03-00000999 RES DETACHED GARAGE PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 11/10/03 JLL BUILDING FOUNDATION FOOTING TIME. 17 00 11/10/03 AP 20' ground rod #4 ln footlng/]lffi BI2 01 11/13/03.~ BUILDING FOUNDATION WALL ____________________1~_________ COMMENTS AND NOTES ------------------____________________ PREPARED 11/10/03, 13 00 40 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 119 FOREST AVE DIRE, ROBERT 06-30-09-5-2-2662-0000- 03-00000999 RES DETACHED GARAGE INSPECTION TICKET INSPECTOR JAMES L LIERLY PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL1 01 11/10/03 JLL ,-., rJ' ~. ~ \l" --------------------- --iJ------------ SUBDIV PHONE PHONE (360) 457-0845 BUILDING FOUNDATION FOOTING TIME- 17.00 COMMENTS AND NOTES l &0 Of dl- -~5-? -~ r~~A\~~ PAGE DATE 1}l 5 11/10/03 FOR OFFICIAL USE ONLY' BUILDING PERMIT.. APPLICATION Date Rec. Permlt#. C} ~q ~ ~ Date Approved. , h If I Date Issued I Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 Applicant or Agent--.ffD k~1\ Ire) Phone: 3{pf)-4'Jf7~oo-'i~---- Owner:--17 (0 ber+- ~eJ Phone~ 00-111 e.. Address: II q ~f?'l5t~~ City: ~7~~, CtJA- ZiP:q:;/,><,!p /__ Architect/Engineer: _ ~..fov_ u. r(,ruC.1fl7 ';[)~ Phone: Contractor 7th her+- Dt (€J State License #: Exp: Phone: Address: /;q Fb~5~ 4; V City: Zip: PROJECT ADDRESS: II q klest- 4.J V ZONING: LEGAL DESCRIPTION: Lot Ij,r- /7 Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: Billing Address: Credit CardType VISA MC # TYPE OF WORK: o ResidentIal 0 New Constr. 0 Re-roof 0 Stove o Multi-family 0 Addition 0 Move 0 Garage o Commercial 0 Remodel 0 Demolition 0 Deck o Reparr 0 Sign 0 Other BRIEF DESCRIPTION OF THE PROJECT: Ccr/'a C;e.. City: Exp. Date: SIZENALUATION: SF. @ $ /SF. = $ SF.@$ /SF.=$ SF.@$ /SF.=$ ( TOTAL VAI,UATION $ / I 0 . CCC cc; COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: ConstructIon Type: 1'2.5'00 '" . No. of Stories: L Lot Size: EXlstmg Sq. Ft. ?..J5~5 & Proposed Sq. Ft. (;72. = TOTAL Sq.Ft. z9Z5~S- Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage '22.. . '=' % APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: ESAlWetIand(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Oilier: BUILDING PERMIT APPLICATION SUBMITTAL: The BuIlding DivIsion can provIde you wiili information on ilie apphcation and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by ilie applicant. This figure wIll be reviewed and may be revised by the BUlldmg Division to comply wIth current fee schedules. Contact the PefIDlt Coordmator 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 apphcation and construction plans are submitted. All oilier permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: lfno permit is Issued Within 180 days ofilie date ofapplication, 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 Umform Budding Code, current editIon). No apphcatIon 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 quired ,no the City's, nd that I must obtain such permits prior to work. JJU Date: q //10 Ii) '3 / / T.\FORMS\APPS\Buildmgpenmt wpd ~ Ro~t'v't-- Ol'-Ie... \,q FOI(stAv'e.. Pt-At15fl-es vVt4- Qg"3(,2 fiLED FOR RECORD ^ T THE REOUUT Of 1<, O,'V~ lECORDtO IN R~G(,"o',:r: t.LtAI1 CO 2003 SEP 16 AM II: I 9 //111/1/11111111/111111//1///11/1/11//111//11111111111IIIIIIIIII~IIII/IIIIIIIII ;[) 2003 1117281 Clallam County ZONING LOT COVENANT IiWE the understgned owner(s) of the followmg descnbed property: / (Insert legal description here} .f ~ ;77;; Z / /J ! A~ ~t.bq.r2Z tbfOz" /.oI-s /60na / / ^-J oC!.k co fa,rde -{.....Al...J0' FCXJ4r/y anda~cI ~fof1 IICj FOre.sf- /7ve.- - "g,f-/lnre/e~t.Josh, do hereby covenant that said property shall be designated as one zoning lot as defmed in Section 17.08032 "l" of the Port Angeles Municipal Code. TIus covenant creates one inseparable building lot which may onlY be removed through compliance with Chapter S 8.17 RCW (subdivision regulations) and/or the City of Port Angeles short subdivisIon regulations (Ordinance No, 2222, as amended). 11\1s covenant shall be bindmg on the owner(s), helr(s), assign(s), and successor(s) In mterest and shall be filed With the County Auditor's Office. This covenant IS for the mutual benefit of said owner(s), hetr{s), asslgn(s), and successor(s) in interest and IS for the further purpose of compliance with state and loca land use and bUIlding regulauons, This covenant may be enforced by injunction or other lawful procedure and covenant by the recovery of any damages resultmg from non comphance. ~ DATED tins 1(0 day of "Y:P.fY!r:!' Iff .6er- r 4& d{1. (Q ~ () ~wner). r9il n .( (Owner) ,200,3 <P (Owner) ""') (\) \II -+ (Owner) ~ C ('> STATE OF WASHINGTON) COUNTY OF CLALLAM) ss I, .:!fl-'5f-J;' 7. 7Ue.k.er ,Notary Pubhc in and for the State ofWashmgtQ.!!, do hereby certify that on t1us / day of SepiY"J7'Lber" . 2~. personally appeared before me Knb""r-t 'A . 'J)/r.e. and P,e>q9~ ,g. D/r~ to -7h;wn to be the indivldual(s) desnbed in and who execute the wlthm Instrument and acknowledged that Signed and sealed the same as -f-tll"!/ Y" free and voluntary act and deed for the purposes herem mentlone . G~~~k~~!;l^ND AND OFFICIAL SEAL thiS / b day of ~terTt_bel"" 20B ~} f...~) " :.:'~ \ ~ ,[ , >... ..: ,~.s ! ~f:' :', ,I \ '::1 .'}~~i~ :'-:~ -' - --Jif ;10 :. to> /.1 /J 0 \... G ~:tltf <1" .. ~g;..Ill: k .. ". '(' ..~"!7( .~ '1'", '.,. ........;......: fl:1 It ......,. .~ ttl'" OF \': r,~,.'i" , AUDITOR'S CERTIFICATE Flied for record at the request of thts_ day of 20_, CLALLAM COUNTY AUDITOR By: ....~~,.. ;. ~-'~:.-.=~-,:'_...." - ~ ~~.. < ' , .~..:: ,~, ". :: ,'. ;: .: :::.": .,: ;-- ,;~f,;<: /.: ::-- : :..:: ~~~;~,!\~,;,":f:' ~;' '.~;:.:~ ~~/~. .,! ;~ ~ ~i~i~!~ ~;~~~~~~~~~~ ~~~~~ ,,~'l. .' -.:J?V9F!!.S f>>E1h ;/"S" ~ 0, f: I I V: (] ~ 0)1 \.. <J ::::::J <:::::t \ \ J.,. . .... " ~ \ ... ~ '-0 '" N ~ - .,. iO "3 \D ~ I~~ ( ~ ::> ~S , ~~ ~U ~ \ ~ ,/9 "..'l..~t7 \'~ ~oo 'X~I I ... ~ I I I ... c:-- \ ., I~;' (0" -~ - Dq. 0- ~ ~ ~o-- ....~ ~~ . . r I I 20 CITY OF PORT ANGELES - Construction Plans The Issuance of this permit based upon these plans. speclfi. cations and other data shall not preverot the building official from thereafter requiring the correction of errors In said plans, specifications and other data, or from preventmg bUlldmg operations being carried on thereunder when In Violation of all codes and ordmances of this jUrisdiction. (SECTION 303(c) .~;fo.:m BN"dmg Cod~ Approval Date ~q,.,~ By 'd~'l QJ ::> <t 'fiLE ~ ~ 8 ~ ...... ~ (J'\ - ~ .~~ r i I I I I I I : I.... ! 10 Id -' I 1- ,II .... I I- I I I I ~ --.:.; 0...1 I ~ -f-.J . -.; \./), I I I I I ) I ! ! i I ! ~I I .:::r-- ' ~I t1J , &~ , ...gi ~~ rJ S::lj S . ....1 ~ ...d co, ~I~ WI c, Q) tn' d~1 ,-! .' Ii: ~. [ Ii' r~;_ _ K. 'C ~ ,- I~ ' f J !t> " I'~'- ':',,,\~'~;;- >\ :..., '.. ,. ': . ~ ," I , l~,.... (,. " .' .:}..... : t, ': \, '," , , ':;' ,- '~: :' " . '" :~. ::;;:X~" ,.-' : ", I . ";,:: '" '; , : " ,-.,~ ')';. ;.: :~: ~<~~: :.' : " ' " . ". ""<:~,:'"t:;> -,' '. ," , " " ",' ," :' ,>', .~ I ~ ,-' '(' , -. ~'d~.J~~~~:""'.\"'~" t': k, '. ':._: ;_......: : :': r '\~ I ;, " .. .. i~..(., ,-", , ... .':... ........ .......~- l ... " - " - -~---~- l ~I'- , I ! r "- ~ 'j 0 ~ ~ \ 1 ~ ...:l I 1 ~ 'I ~ 1 1 ~~ ;1 1 j Q ~ ~~ t' I Co ~ ~ ~ / \ r '\ \. 1 j j 1 1 :1 ~ j ./ I ,.t ...... , -------.,. ~...""P""<>~-'M I --; -----...; t..J 1;:)' r ~ ~' ~ I 1 1/ / . _.__.__.._-'--'_.,-------_.,.~'".- .' .:..:c.:~:j:;;:f;:::~~[';l b:i::i,:\'\', >:,..:' .' . .,j'~""'''~''~'''''W'' ~ , ' . , '\"'~1",,~~.-x,"'!>''''''^"'''f\o~'''''1'~:::''~~.J\::J,.~~A-!l-~''' ,- .' ' ',' """"'.r_""'__",^",""","'"*,,,""""^""''''''''';;''''''''''''_''<''~---~~''''_-;~'"-~..''~~'~'~;~~'- ".~: i", " , . " .,1!<1"'r;:1r;:;{~~~~~'>") ,~.'? '}2~,"~</J~)/""'t~r?;~L;J~'~ '\ ~YlOol 'q I ~t.'IO\(OW ~Ollrv 1,7- . , I. -------- - .. ,-- .. ~)~,,'1't :+I o~ ,J(lfo ~fI all::i~ r~"!/. 6o.x~ <<> - -L (, q ~- ~~~ ,~~ ~ r'~~ .,~ (109J\ €V ~ '"fi "oC, ~\a.~ ~\J)VJ,~ t -- ~~ C; b'~ 5\~ 3'~ ~ '\ F~ ~'p# _ ?"VlQf1 ~v~\U Q-r-~'flS dwl1 b\l'fl'n~ j o"j1 /1 ~ ~Q '1/- 17X7"',8 II 0,/ -~~ ~~4~ C; ,6 .~~ ,,-~ ------t-- m~;l;~- "'t~ ~~~ f?(J~ a~ ~q ... ~<'A ~ ~ ~ ~ ~~ I~ ....()-~ \;J ~\. , 1 Ii ~ ",- I ' . .~ 'CJ b:vso~ 6"' ~ I '5' ("1?f/- . wQ- I " I " C. ~ :::. ~ ~--::-- ... - ... . . -. .. .\ ~ ~~ y ~~A ~~ \h '0 ~ · ~'( c-.. ii'~ ~ · ~, ~ . ~. '\ ~ - ~ . . . , . " ~"v '~........~~,: ." I' ," ,',' ;,'" " ." ,,:; "To 1\,; ; ~ - .' ~-:} ..~-:~." ., ~',..~ "'7, \ .' ' " , ,. " \ - . - ~ ~ , -,. ,.,.., . "'.' ~.;':!/ .. ~'. "..~l'~-.f;~J,,:~...~r_l~~7^ ~:;tJ~;.~ , ." ',:;: ", " ";,, i, ,,~i, :" .,. ..>,:;, ,'i . .~ / " ~\,' ",,..,, , " , ,/ , " , ,.' .; " :'" ";.' j " " ",'. " ";::,~<::.:.,,.,,;:..:!.. ,: /:'::.' : ," ~ ~ J,' , _:"" ' ' , .' ",' \ "e, ~ pORT ""'" A.,4.0~~ <J,.~ ...~ ~ 'l.tii:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 04-00000547 Date .118285 119 FOREST AVE 06-30-09-5-2-2662-0000- RES ADDITION 7/01/04 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation RS7 RESDNTL SINGLE FAMILY 1000 Owner Contractor DIRE, ROBERT 119 FOREST AVE PORT ANGELES (360) 457-0845 Structure Information Construction Type Occupancy Type Other struct info OWNER WA 98362 112SF DECK COVER 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 23.50 V-N 1. 00 2825.50 12500.00 112.00 2934.50 1. 00 ---------------------------------------------------------------------------- Permit BUILDING PERMIT -RESIDENTIAL Additional desc Permit Fee 62.25 Plan Check Fee 24.90 Issue Date 7/01/04 Valuation 1000 Expiration Date 12/28/04 Qty Unit Charge Per Extension BASE FEE 47.00 5.00 3.0500 HND BL-501-2K (3.05 PER C) 15.25 ---------------------------------------------------------------------------- Special Notes and Comments Site is zoned RS-7. Setbacks and lot coverage are fine. No land use issues are noted. MAINTAIN CLEARANCES FROM SERVICE WIRES, SEE ATTACHED ---------------------------------------------------------------------------- Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 62.25 62.25 .00 .00 Plan Check Total 24.90 24.90 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 91. 65 91.65 .00 .00 .....() "1i ::z.. "J\ ~ r '") (\ -.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 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 locana regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date \ S' :Jl~) T:\PLANNING\FORMS\1102.15 [11/14/2003J ofJcJ 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 I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGEfDOWN SPOUTS ELECTRICAL (LIGHT DEPn SEPARATE PERMIT: # ROUGH-IN I I 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 DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEP ARA TE PERMIT #' s SEPA: PARKINGfLlGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT 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 ~- Ih"OJ-! ....\.1, BUILDING T:\PLANNING\FORMS\1102.15 [11/1412003] , tJj ., "d ;;;~~8E; n"d , t-< >< ; H:<1 , \0 '0 'O:<1ZZtJ .,t>J , \0 ..... t-< nt>J >-3:<1 ><'0 , Ul .... zl'1:<1~f:l O~ , 0 0 >i , f-' ~. nUl "'OJ , ., tJ it III tJj 0 '0 "d OJ. :<1. 0 n:<11ll :<1 :<100 OOJ >-3..... :<:0 f-' , f-' ~gg ootJ f-' S;~ , '" '<>"'H f-' , "- OJUl , , :<1 '" QO , 0 >-3.,1Il oWOJ OJ.<> ,.<> OJOJd 00' '" t-<. , tltlH 0' 0 OJ , S 00:<1 :<1 Ulf-' .f1 0\00 OJ '" H Ul , tJj Ul :<1 iii .<>UlOJ ., '" , t-< OJHCl oJ , :<1 0 , t" UlZ "''' ~ , t::Ul"d :<1' '" ~'O; OJ'" OJ 0 , Ul'" , '" , .... E;':" , >i , tJo , tJj :<1tJ, H 0 , t:: OJ OJ >-30 , H UlUl~ H 0 t-< 0' , tl flQCIl Z , H .,H.... Z Ul'Ot:l n Q .....>-3~ 0 nH H ~ '" 00 HZ Z ~ZH ZUl OJ OJ ~ Ul'O Z ;,. '0 OJ ., t-< Z OJn Ul >-3 n>-3 Ul .,H ~ 00 :<1Z c.,., Z ~~ 0 'O'OUl ., 55fa OJ?: OJ UlOJ Ul ZZtl >-3 OJOJH t-< <: t-< H OJ w :<1 '" t-< 0 >< .<> Ul oJ , 0 00 .<> Ul tJ'O ;,.;,. >-3Q OJ OJ 00 ..... f-' '" ..... 0 .<>oJ BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY: Date Rec.~- I, ~i Pel1l1it #: ~ '/-- ~~ q Date APproved:!:4" , . f. Date Issued: Fill out COMPLETELY and in INK. Your application and site plan MUST COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 Address: Architect/Engineer: 5 Applicant or Agent: ~i? D be ~-\. '1:) i e) J/q mest- e,$ to Phone: Contractor Address: ~<)amb, PROJECT ADDRESS: Phone: ait- 11.9 (' fe>s 4. ~~'J -08 A( S-- Zip: C( R' 310 2-- Owner: Phone: Exp: Phone: If q City: ~~rf<; + ik) e- Zip: ZONING: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Block: Subdivision: Credit Card Holder Name: Billing Address: Credit CardType VISA MC # TYPE OF WORK: 'Iii Residential 0 New Constr. 0 Re-mof o Multi-family ~ Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: City: Exp. Date: o Stove o Garage o Deck Dr Other a x 1,-/ SIZENALUATION: SF. @ $ /SF. = $ SF. @ $ /SF. = $ SF. @ $ /SF. = $ ,x,TOTAL VALUATION $ -c:- II 2 )V' j)p (> 1< c..o u (0 r- / OCl() ~ COMMERCIALfRESIDENTIAL: Occupancy Group: Occupant Load: No. of Stories: Lot Size: l"2. 500 Existing Sq. Ft. z9zS.5 & Proposed Sq. Ft. Total lot coverage 2. ~ . S- % Construction Type: / j Z. = TOTAL Sq. Ft. Cf.<7. S- APPROVALS: PLAN: BLDG: DPWU: FIRE: OTHER: PLANNING USE ONLY: ESAlWetland(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. 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 CUlTent fee schedules. Contact the Pennit 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 pennit application and construction plans are submitted. All other pemrit fees are due at the time of pennit issuance. EXPIRATION OF PI.:AN REVIEW: Ifno pemrit 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,., . e ,no he City's, an at I must obtain such permits prior to work. T:\FORMS\APPS\Buildingpermit.wpd Date: t{.:> / /7/ I'J 1- A\.\~ /0' &a.., Se!-.11c~ 41'6'1 /u v '=' -<:> ~ ~ ---- 2Z/6 /6' _ ... ~ << Cl () ~ N -. :J ~ \S\ ... -- 4J 1 /7' 24'-_1 l -) d?, (\'~ I f1o-?- ?X1s+mo/ Cia vo.? e.. (l) '" '" ~ I::: It IOO~ - - ------J L fl9 -it- Fo'(ed> Ave, L e3aLD~"L~Y'" (A-toY1 .. _mm_------___Sjte_ela'I'L -~{~ClndLrLBIo.c..~2h }-o5Q'('-t~a,t1c1 Gol3n -llil..~~bSb!-flq-b~ LI/~ IO,QI-- ~ .__.,----_._-_._----'--~-----~------_.~--_.~._~.,- ~', ~ t _,"', ", !i''!,(,P,"_"'l:,.;, _""'10_: ':.', I,l~.,~ I.., ' ,r_"._,"'_l\m,r,__ rq 'J7 ~ ~ORT ANGELES CITY OF \^/ ASH ! f'1 G TON, U. S. A Economic & Community Development September 19,2005 Ms. Kristina Larsen 123 Forest Avenue Port Angeles, W A 98362 Re: Conditional Use Pennit - CUP 05-04 \ ~orest Avenue Dear Ms. Larsen: As you know, following a public hearing conducted on September 14,2005, the City's Planning Commission approved a conditional use pennit to allow an accessory residential unit at 123 Forest Avenue with the following conditions: Conditions: 1. Building permits must be obtained and separate water and electrical meters are required for each dwelling unit. Addressing for the accessory residential unit shall be clearly identified as 123 1/2 for emergency purposes. 2. Two (2) off-street parking spaces are required for each residential dwelling unit for a total of four (4) spaces. Additionally, as long as the home occupation is active on- site, an additional two (2) off-street spaces shall be maintained within the dedicated parking area on the subject property for a total of six (6) spaces. Parking for the use must be located on the site. A building pennits must be obtained for the construction and utility placement and the accessory residential unit shall be clearly identified by address letters visible from the accessing right-of-way. The decision of the Planning Commission is final unless appealed within 14 days of the decision to the City Council. If you have any further questions, please don't hesitate to contact this office. Sincerely, .~ ~~yJeJ)~ Sue Roberds, :s-~:(C:ate Planner Community Development Coordinator cc: Building Division Public Works and Utilities Phone: 360-417-4750/ Fax: 360-417-4711 Website: www.cityofpa.us / Email: smartgrowth@cityofpa.us 321 East Fifth Street - P.O. Box 1150 - Port Angeles, WA 98362-0217 Al\~ LO ~ tf<a.,. Sd..litcK__..,__.._ _...__._._.. z (, I b 16~ "~___I ------ 44-'6'/_.-- 8 ~ ~: ~ '\J o r ,. . . Q....U..J /1. "'I<. (!p ver- \De.G e -4' ..... ~ ct ... <:) <:) ~ N - - ..J ~ "\1\ .... -- 10 ..L_ -j <pI .... G' ..... .... i ~ ".0..- J;(ls+m9 aa.vo.1~ II II ' II II 'I I I j i , /7' -----24 f __ I U \ i . I "------: c------------.""-_.-' l /' ~ .~ ~ " " I: I Ii !: ~ i'! I: il Ii ..... .-.----....-.---.....---------....--------;00. CIX-..---.-.. .~~~J L 1/9 -Il- Poves!; A 1Je. , ~.aL,D~~~rL.---.----_--.--m....--.-.-----...Sjte--e{a.fl-~.--.-....--_...________.... ___"... ....._. _,_. __ ____m__.... ......t.-- _---..L'n +~____{~__C?nd_L2....Blf.2~~.2_')}_o~ Q'ft ~.o. ndOo fa n L~/-:. 10/ al ---.f?cd.A~e..;JJ.&sh l_tL~'f\ .._.... ............ .. ....... . ......... ... ___..__......_____.__._____.__._._______.___.__________.__... ~------.,.--- S;~~~~~M~-~"~~.~--~-~~~~ ~~""'~~r .~ ~ I z 0 7lJ -\ I ~ ~ II ~ ~ -- ! I L ~ I l'H~ I- I-- - I-- I-- LF'- I D= ~ U5::::. g-!2.. ~r g :;:! (') -c m 0 -, ~ 3 ~. (p =i a ~g.~'O~ gift"'" c.; C5g~(J)~~~ 0 ~ ~oo?6Cti~~"T1 ~ ~-~~~og ~ m E~~[~ ~s. ~ I g ~ g" ~ ~ [ -t ~. (/1 g ~ 5: lit ~ z "j-.~=r5.Ji:i~3G') ~ e 3E.O'Qo......~~rn .---. o E. g & st ffi ~ g n1 _ t', ~ ~ :::!. ~ n .- ~ en _ .,5' ~ ~ 0.. ~ ~ 0. I OJ ~;:;o~~~.g 0 '" fHHU I - ff~~=r~~~ ~ ~ ~ 5~ S a' _. ~ ("";) ~. ::s ? :;- ~ 5:. 2I ~ (I) " 1r=:L =-r:J:-' I Jr-r----r-I~-I I rl \~ 1\ \ \ \ \ 1\ 1\ \ \ 1\ \ \ '\ I) / I / 1/ / 1/ / l- i / I ~fl , .. ~'- ,- , I~n\ 1\ '\ 1\ \ \, .1\ \ 1\ \ I I \ \ \\ \ \1\\ \\ \1\: 1))\ \ r\ I ~ I}; \ 1\) o )j / // I~\I I II I II; / / / ) / / / / I 1I/ I I IIV rei / / I jp TJ -:;~-. = t~~, +--" -0 ...' - ( F'Cf "'p \ -rt) ('" ~r 0 iD~ '5 ~,< Om \ ~. 7lJ -<: m ~ z o U) () )> r m /, \. , 0:'\/ 11 I I I l '~ ~. <>-==0. -- - I I I -- 'J ~ o " [h 'J u- I 0 ~ (j) m U) m -\ ~ ~ Q b. II ~ ~~ Ir - II II ~ ~ ~'" I-- I-- = 1= I-- J= n III / / '~ // ~ / / '~/ L-1: 1T1 -' \l EYESTONE BUILDING DESIGN OWNER: Bud Dire 7'J Cl ~ >- m >- Ci) S -\ f:1 m BUILDER: Owner 215 S. Lincoln St. Port Angeles, WA. 98362 G (D , s; ~ (360) 457-3410 LOCA TION: 119 Forest Ave P.A. I~ '" I~ 19'~411211 8'-511 10'-1111211 11 r o o ~ \S r > Z ~ I CJ; -" o i: -" I ' +- +-1 --Ix x --I +- +- I -" 0"'1l:'1 ~I~@I ~ Cl X 0-1, - _I z 1".." ( rn o~ )> r;:.)\i..... () ." 1 r-:_ -0 '7':' ~ 1 OJ :.' tv ,- ,,' "'1l1~C""'I~ @ irl ~ - -I m8!'" I m ~ i?l~ I )> ~o s:: iC I;:J I I "~""j':) n ~ Q~ gJ ~ '~ c<. ?q / ,-. ~ .. / / ~ '-J;<' 7< / 01 ~ ~ / () I' '+ ~~ , / / ~ t lUy ~ ~ //:t/ Q,,\ ' ~ +-/, ;~c>"J / /' <j. ~ ' / ~\) ~ / ~ ,~ ~ / // $ \\',' /~, A", i"\ / ~ <. ~'" ~'\.... /~;s: ('.~ I / / (';J' ~\ ~\c.;< / / ~,\1 Q, 7\J o \1 o (j) rrt a It:. -~ ~' .......~-J :To, -" -".?~ "'"U_'" ~) rr; -f.i " (j). ? I<J ~ - ~ ~- ;l.. ;" \/.l --.Q 1') __ _ _ C\_ _ _ _ _.---1 -..:.. ~ II -..:.. -- \l OWNER: Bud Dire ?3 '0 (}l )> EYESTONE BUILDING DESIGN rn >- G> :'> -1 !TI m Owner 215 S. Lincoln St. fort Angeles, WA. 98362 BUILDER: 0 (0 ~ (360) 457-3410 ~ LOCATION: 119 Forest Ave f.A. I 0 !! ():I .., . . . ~1 CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 PERMIT NO. .3.s-71 DATE ?;I< J' /;rl. ELECTRICAL PERMIT Site Address: II In'stalled By: I OwnerfBusiness: I Owner/Business Address: I I )(, RESIDENTIAL o I COMMERCIAL o ' BASEBOARD KW ~ : FURNACE KW /0 tJ . FAN/WALL KW ~: HEAT PUMP KW ~ DiSIGN j I Details/Description: ! o READY FOR INSPECTION License Number: o Will CAll FOR INSPECTION Phone: Phone: Sq. Ft. ~ OVERHEAD SERVICE o UNDERG"QU~ICE VOLTAGE: ?d'l &r SINGLE PHASE tJ THREE PHASE SERVICE SIZE ~ AMPS o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION ~ REMODEL ADD/ALTER CIRCUITS SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) 9~dJd ~ ~,4// .?dtJ ~ I I I I I I W.S. No. CArACITY: o O.K. NOT O.K. ACJION REQUIRED: 0 CHANGE TRANSFORMER : 0 INSTALL SERVICE POLE I I I I I \ S'~ SERVICE SIZE DATE ENGR. o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. ~ fJ rough-in/cover O.K. A!"1t p.K. to connect service )r&fi. f'nal O.K. SI\e Address: , II In1taller Ob..! d~ New Meters " Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or qn the Building Permit. PHONE 457-0411, EXT. 224. : (l1-vvr NO OCCUPANCY aA USE ESTABLISHED UNDEA THIS PEAMIT $ ~ 0 ~ \ Electrical Inspector Permil Fee i WHilE - File by address YElLOW - file by number PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall / / ! J OLYMPIC PRINTERS INC ELECTRICAL PERMIT APPLICATION FOR OFFICL..!.L USE aNt y Dat~R",c Pennit#: Date Approved: Datelssued , The Electrical Permit Application must be filled out completelv. Please type or reprint in ink. If you have any questions, please call (360) 417-4735 o.'? _ OQQ Fax number: (360) 417-4711 ..... J 7 / Owner or Elec. Contractor Agent: /;\},J'PI1"+ bl 'veJ Phone: 4..'JfJ-0~ Fax: Property Owner: 7?'rnhH-t ';J)'-i~C' , Phone: Address 110 ~.-(-:S+ A)G" City ~,+.4-r?p!e<:, Zip: Y?i:3i /'. Electrical Contractor: License #: Exp: Phone: Address: City: Zip: INSTAllATION WIRED BY: \l(OWNER 0 ELECTRICAL CONTRACTOR 2, hewt- :t)1 (eJ FOre"5f Me City: Zip: Credit Card Holder Name: Billing Address: Ilq Credit Card Number: Exp. Date: VISA."- MC: PROJECT ADDRESS: If q ji; cI f/J f- Aut!,- TYPE OF WORK: Check all that apply: o New 't;iKAIteration/Addition ,JiJ' Residential 0 Multi-family o Commercial o Mobile Home Sq, Ft o Remote Meter )\1 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump o Low Voltage 0 Telecom. 0 Sign Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT:!:!. rI- pI; If;:'/ -;f:; (fO);('J ?,~1 eeJ f7~eJ r . 7 ?ffji,H Electrical Heat Load Additions and or Subtractions Service Information o Baseboard o Furnace o Heat Pump o Fan-Wall _KW KW TON KW lRA o Overhead Service o Temp Service o Underground Service Voltage: Phase: 0 1 0 3 Service Size: Feeder Size: , hereby certify that I have read and examined this application and know that same to be true and correct, and I am 3uthorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits 3re required; it remains the applicants responsibility to deter he what permits are required and to obtain such. ~ 'fl, ' It' G\ <J Credit Card Holder's Signature) / f'Ul y ,,'~ A ) Date: i~f1 /)~ j) (; . Owner or Elec, Cant. Signatu~:: )'-/- () UU Date: ~/ ;uf- fi . PERMIT FEE: ~% ' 70 ::/ElECTRICAlPERMITAPPLlCATION fPN/Y(..- f3 -/6 - 0 7' ffa/ 3/8/oL/