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1229 Columbia St - Building
• ;v ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 10-00000131 Date 2/12/10 Application pin number, . . . 894168 Property Address . . . . . . 1229 COLUMBIA ST ASSESSOR PARCEL NUMBER: 06-30-00-5-3-0175-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . EXPIRED Property Zoning . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 4 circuits -------- - ------------------------------------------- Owner Contractor ANDREA MOTYKA / TAMARA SMITH EXTRA MILE TECH & ELECT. , LLC 1229 COLUMBIA ST 418 N. RACE ST. PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 477-5170 (360) 457-0198 -------------:-------------------------------------------------------------- Permit . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit pin number . 160606 Permit Fee . . 145.20 Plan Check Fee .00 Issue Date . . . . 2/09/10 valuation . . . . 0 Expiration Date 8/10/10 Qty Unit Charge Per Extension 1.00 73.5000 ECH EL-BRANCH CIRCUIT WO/FEEDER 73.50 3.00 2.6000 ECH EL-ECH ADDNT BRANCH CIRCUIT 7.80 1.00 63.9000 ECH EL-SINGLE CIR LIMITED RES 63.90 ------------------------------------- - Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- Permit Fee Total 145.20 145.20 .00 :00 Plan Check Total .00 .00 .00 .00 Grand Total 145.20 145.20 .00 .00 V INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-1N 2z hl I 60 FINAL COMMENTS: Signature of owner or Electrical Contractor X Date: 0,,�V-ORT I A ELITEICTMAL WSPECTION fflMNO REPORT G 4i KS 417-4735 DATE PERMIT# IN ECTOR 2-111 11 C) OWNEWCONTRACTOR F-X P1 -v-- v-L-PEC--rrz-Ir c- ADDRESS 1 -2-2-C7 APPROVED NOT APPROVED 0 . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . 0 A . . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . . . 0 0. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . 0 0. . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . 13 CORRECTIONS NEEDED: uo D Af //0 - NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DO NOT REMOVE — FEB-08-2010 08 :05 PM E. JANSSEN 360 452 2982 P. 01 RUCHWED FEB �, 2009 ELECTRICAL INSPECTIONS :ly of Port Angeles Permit Application \,'o J•:iIGing OlVisionIElactrfral Inspections 1':.i Eaut Fes ash n-on, Sox t1'f0 F %.M Angeles Washington,9e362 r Q (3GU1A77.a735 Pax:►360)A17�1111 Y. 1&2 S,no r;F9inily Dwelling 11111!,F3mlly or,;;0mrnem at'. {,ornmr rcr U.AdCrhon i Allerfllion I Romirlrii a inn Review May +e Requirpd,Please Cnmt11E-,�DectriC I Plan Review information Sheet err eddies vrei In(o:mah n d Contractor information Name: EtrFl F_Lf-410 1-41 jiririg7ciress. Mallin Address: — 18. .J!T... � Ic ..ST y.- ?—* --,.tate .JnC�.r-'p: ._.��..�lir� City: tt State: ..f�+.l�_Zio:. y�.��►L._ 'one:.-..fC2_7_ a.7�..FaA. Phone: - S.�a3Fax: yS 'l - Sfsf tl - '„til Cha�la Total(0ty Multiplied by Unit Charge) 'ig 90 SetvicelFeeder 200 Amp. i4S 50 -. Service►Feeder 201.400 Amp. Servicelreedor A01-600 Amp. _ Servlcelrioder 6014000 Amp. !' i0 Service/Feedef over 1000 Amp. 110 Branch Cirrull W/Sarvka Feeder 1 Si) ( S , o8ranch Circuit W/O Service feeder Y69 4... •_•xy,xp leach Additional Branch Circuit ;170 Tem?.Serulcel Feetler 200 Am _..._... __._._...,_Temp.SelviceTeeder 201400 Amp. .-.- -,Temp Temp.SeIvIcelFeeder 401.600 Amp —. temp.Service/Feeder 601.1000 Amp. Portal to Portal Houfly . Slgftllina Lighting 9” Si nal ClrcO/Limited Energy -Commercial.Addiuonoi iCr?gt,l;b 63.90 _Signa!Circuit/Limited Energy-1 8 2 Family Dwelling 63.90 Signal Clrcultl Limited Energy-Multi•Family Dwelling !9.90 _Manufactured Home Connection '01.30 :; _ Renewable Electrical Energy•5KVA System or Less S:-.__ First 1300 Square FL 3i 20 _ - Each Additional 500 Square FI.or Portion of ?3.50 ;_ ,_ _Each Outbuilding or Oetached Garage 10.3E ___._ Each Swimming Pool or Hol Tub 5600 �`+� Thermostat ?vnoras dahnrd by RCW,19-16.161:(1)Owner witl occupy tho structure for two years after this electrical permit Is finalized.(li Owner is required to hire an eleetdcel contractor If above said proporfy is for sale,rent or lease.permit expires after six months of last Inspoeflon. !,Iter reading the above statement,I hereby certify that I am the owner of the above named property or a licensed electrical contractor.l am making 1110 electrical instailetlon of F!Pration in comUllance with the electflcal laws,N_`C.,ACW,Chapter 19,28,WAC,Chapter 296.469,The City of Port Angetne Municipal Code,and Utnity Speciticatlons, I7 Cash '•ignalure or uwnor.Clectriral conlraclor or elerlricdl otlminlstrntcr , ChochL.) Credit Card r R t PREPARED 3/26/10 8 38 46 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/26/10 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR C A DOTSON CONSTRUCTION PHONE (360) 928 9535 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 457 5890 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 09 00000106 RES REMODEL PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 5/06/09 JLL BLDG FRAMING TIME O1 00 5/07/09 AP May 6 2009 8 24 12 AM 1pangrle CHRIS 460 3490 FRAMING AFTERNOON May 7, 2009 9.11.54 AM jlierly. BAIR O1 5/07/09 JLL BLDG AIR SEAL TIME O1 00 5/07/09 AP May 6 2009 4 55 45 PM 1pangrle CHRIS 460 3490 AIRSEAL AFTERNOON May 7 2009 4 10 42 PM jlierly BL99 01 3/26/10 BLDG FINAL TIME O1 00 March 24 2010 9 02 10 AM 1pangrle ANDREA 477 5170 BUILDING FINAL BATHROOM IN GARAGE AFTERNOON PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 3/26/10 J 1 MECHANICAL FINAL TIME O1 00 March 24 2010 9 02 48 AM 1pangrle ANDREA 477 5170 MECHANICAL FINAL BATHROOM IN GARAGE AFTERNOON - -- -- -- --- -------- PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL1 01 4/21/09 JLL PLUMBING UNDER SLAB TIME 09 00 4/21/09 AP April 21 2009 8 18 40 AM 1pangrle JOHN 460 6902 UNDERSLAB PLUMBING MORNING INSPECTION THEY PLAN TO POUR THIS AFTERNOON April 21 2009 4 07 00 PM jlierly PL2 01 5/05/09 JLL PLUMBING ROUGH IN 5/05/09 AP May 4 2009 4 22 37 PM 1pangrle JOHN 460 6902 ROUGH IN PLUMBING May 5 2009 4 03 07 PM jlierly PL99 01 3/26/10 JLL PLUMBING FINAL TIME O1 00 CONTINUED ONTO NEXT PAGE PREPARED 3/26/10 8 38 46 INSPECTION TICKET PAGE 8 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/26/10 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR ALPHA BUILDERS CORPORATION PHONE (360) 775 0759 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 477 5170 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 10 00000033 RES REMODEL PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 2/12/10 JLL BLDG FRAMING 2/12/10 AP February 9 2010 3 39 08 PM 1pangrle KEN 775 0404 FRAMING February 12 2010 4 44 43 PM jlierly Partial-inspection-of-ceiling-and-walls-,-beam-requires positive connection at floor and post and beam connection verify during insulation inspection/jll BLI 01 2/24/10 JLL BLDG INSULATION TIME 01 00 2/24/10 AP February 24 2010 8 18 31 AM 1pangrle KEN 775 0404 INSULATION AFTERNOON February 24 2010 4 44 55 PM jlierly BL3 02 2/24/10 JLL BLDG FRAMING TIME 01 00 2/24/10 AP February 24 2010 8 16 47 AM 1pangrle KEN 775 0404 FRAMING AFTERNOON February 24 2010 4 44 55 PM jlierly BL99 01 3/26/10 ,�,7L,� BLDG FINAL TIME 01 00 I� t}'�j{`-�,— March 24 2010 9 01 20 AM 1pangrle ANDREA 477 5170 BUILDING FINAL REMOVED A WALL & INSTALLED A BEAM AFTERNOON COMMENTS AND NOTES PREPARED 3/26/10 8 38 46 INSPECTION TICKET PAGE 11 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/26/10 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA & T SMITH CONTRACTOR EVERWARM INC PHONE (360) 452 3366 OWNER ANDREA MOTYKA & TAMARA SMITH PHONE (360) 477 5170 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 10 00000170 MECHANICAL APPL PERMIT ---- ---- -- --- -- ------ --- PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 3/26/10Lys L^ MECHANICAL FINAL TIME 01 00 IA _ 1�\d�}--�\— March 24 2010 8 59 53 AM 1pangrle ANDREA 477 5170 MECHANICAL FINAL WOOD-BURNING STOVE AFTERNOON COMMENTS AND NOTES PREPARED 3/26/10 8 38 46 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/26/10 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR C A DOTSON CONSTRUCTION PHONE (360) 928 9535 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 457 5890 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 09 00000106 RES REMODEL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS RE u March 24 2010 9 03 13 AM 1pangrle 1 ANDREA 477 5170 PLUMBING FINAL BATHROOM IN GARAGE AFTERNOON COMMENTS AND NOTES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES,WA 98362 I Application Number 10 00000170 Date 3/08/10 Application pin number 659140 Property Address 1229 COLUMBIA ST ASSESSOR PARCEL NUMBER 06 30 00 5 3 0175 0000 Tenant nbr name ANDREA MOTYKA & T SMITH Application type description MECHANICAL APPL PERMIT Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 4300 Application desc INSTALL A WOOD-BURNING STOVE Owner Contractor ANDREA MOTYKA & TAMARA SMITH EVERWARM INC 1229 COLUMBIA ST 257151 HWY101 PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 477 5170 (360) 452 3366 Structure Information 000 000 312 SQ FT BOAT CARPORT Other struct info HARD SURFACE AREA Permit MECHANICAL PERMIT Additional desc WOOD-BURNING STOVE Permit pin number 162024 Permit Fee 60 65 Plan Check Fee 00 Issue Date 3/08/10 Valuation 0 Expiration Date 9/04/10 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 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 coiisVuction. C-� Date Print Name Signature of C ntractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit Q 1 BUILDING PERMIT INSPECTION RECORD -J O — PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type r Date Accepted By Comments FOUNDATION: L 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 b AIR SEAL. Walls Ceiling FRAMING Joists/Girders/Under Floor C Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall(Interior Braced Panel Only) �.a T-Bar INSULATION. Slab Wall/Floor/Ceiling MECHANICAL. Heat Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney7 I0 V Commercial Hood/Ducts FINAL DatAccepted b MANUFACTURED HOMES Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT Separate Permit#s SEPA. Parking/Lighting ESA. Landscaping SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By - 1 Electrical _ 417-4735 Construction R.W PW I Engineering 417-4831 C Fire 417-4653 S Planning 417-4750 Building 417-4815 T.Forms/Building Division/Building Permit °X r°"`,4BUILDING PERMIT APPLICATION Print in ink rW�.1� CITY OF PORT ANGELES For Cit Use OnI Attn. Building Permit Technician Date Received 3-$-(O 321 E. Fifth St. Port Angeles, WA 98362 17-4815 fax (360)417-4711 Permit# __1L- 360)4 Date Approved Applicant or Agent iy t2�,�R 2M Phone Owner ��JZ ��LL �_ b Phone 44^7 -7 l -7o Owner's Address 2 mag S -t- ContractorAETghm� E4LD grz_tA Phone Lk�SZ - ��, `contractor/Engineer's Address �577�7 ¢,,� i vl P�q- LJg 9��4-2 License # IE,/-45 I A D f' 9- AJ L Expires Fs- f 7_ /C i PROJECT ADDRESS Z Z Urn61'a, Parcel Number 0(1 3 --361 -7 5 oa0e, Lot Zoning I Proiect Type & Brief Description. o Residential o Commercial o Multi-family o Industrial Check all that apply o New Construction o Addition ❑.Remodel- �. o Repair + o Re-roof o Demolition �. o Sign o wall-mounted o projecting o freestanding o awning o other Total`si'h area sq. ft. Maximum allowed sign area'- sq ft. o Heat System o Heat!pump ood-burning stove o gas fireplace o pellet stove o other o Other I Floor Areas Existing(sq._ft.). Proposed.(sq. ft.) Basement @$ per s ft. _ $ 1st Floor q 2nd Floor t 3`d Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION '$ 00 Total footprint of structures - f 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 install'd? 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, and to btain permits prior t working on projects. _ Date � 3 /49 Print Namel/ /-70/0CY/L3 t�az�- Signatur T.Forms/Building Division/Bldg Permit Appl.-2006 Code.doc I I Clallam County Assessor I Treasurer - Property Details - 61764 ANDREA MOTYKA A. Page 1 of 8 Clallam County Assessor & Treasurer Property Search Results > 61764 ANDREA MOTYKA AND TAMARA SMITH for Year 2010 2011 Property Account Property ID- 61764 Legal Description. P S CO-OP COLONY SUBDIVISION E2 LT16&W2 LT17 BL 1 Geographic ID- 0630005301750000 Agent Code Type Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 Open Space. N DFL N Historic Property, N Remodel Property- N Multi-Family Redevelopment: N Location Address. 1229 E COLUMBIA ST Mapsco PORT ANGELES WA 98362 C�4 Neighborhood Cycle 5 Res Map ID- < Neighborhood CD- 10955130 (� Owner Name ANDREA MOTYKA AND TAMARA SMITH Owner ID- 42194 Mailing Address: 1229 E COLUMBIA ST %Ownership: 100 0000000000% PORT ANGELES WA 98362 Exemptions: Taxes and Assessments D'ue Property Tax Information as of 03/08/2010 Amount Due if Paid on . First Second Half Half Statement Base Base Base Amoi Year ID Taxing Jurisdiction Due Due Penalty Interest Paid Due 2010 44459 ST SCH STATE SCHOOL $18577 $18577 $000 $000 $000 $37 2010 44459 CC-GEN COUNTY $9885 $9886 $000 $000 $000 $19' 2010 44459 PORT PORT $1390 $1389 $000 $000 $000 $2' 2010 44459 PORT AN'G PORT ANGELES $22889 $22889 $000 $000 _ $000 $45' 2010 44459 SD#121 f SCHOOL DISTRICT#121 $24062 $24063 $000 $000 $000 $48 2010 44459 NTH OLY�LIB NORTH OLYMPIC LIBRARY $2872 $2873 $000 $000 $000 $5- 2010 44459 HOSP#2 HOSPITAL#2 _ $4056 $4055 $000 $000 $000 $8 2010 44459 WSMET PK DIST WILLIAM SHORE MET PARK DIST $12.90 $12.91 $000 $000 $000 $2! 2010 44459 CITY_STORMWATER CITY STORMWATER $3600 $3600 $000 $000 $000 $7' 2010 44459 WEED_CONTROL WEED CONTROL $082 $081 $000 $000 $000 $_ 2010 44459 TOTAL. $887.03 $887.04 $0.00 $0.00 $0.00 $177 2009 617642008 ST SCH-STATE SCHOOL $212.90 $212.90 $000 $000 $42580 $( 2009 617642008 CC-GEN{COUNTY $10775 $10774 $000 $000 $21549 $( 2009 617642008 PORT PORT $15.26 $15.26 $000 $000 $3052 $( 2009 617642008 PORT ANG PORT ANGELES $23633 $23634 $000 $000 $472.67 $( 2009 617642008 SD#121 j SCHOOL DISTRICT#121 $263.29 $26329 $000 $000 $526.58 $( 2009 617642008 NTH OLY LIB NORTH OLYMPIC LIBRARY $31 31 $31 30 $000 $000 $62.61 $( 2009 617642008 HOSP#2-HOSPITAL#2 $4419 $4419 $000 $000 $8838 $l http.//vpn.clallam.net.808 l/ propertyaccess/Property aspx?cid=0&year=2010&prop_id=61764 3/8/2010 PREPARED 2/24/10 8 24 37 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/24/10 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR ALPHA BUILDERS CORPORATION PHONE (360) 775 0759 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 477 5170 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 10 00000033 RES REMODEL - --- -- -- - --- -- -- PERMIT BPR 00 BUILDING PERMIT RESIDENTTAT, REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 2/12/10 JLL BLDG FRAMING 2/12/10 AP February 9 2010 3 39 08 PM 1pangrle KEN 775 0404 FRAMING February 12 2010 4 44 43 PM jlierly Partial inspection of ceiling and walls beam requires positive connection at floor and post and beam connection verify during insulation inspection/jll BLI 01 2/24/10 JLL BLDG INSULATION TIME 01 00 February 24 2010 8 18 31 AM 1pangrle KEN 775 0404 INSULATION AFTERNOON BL3 02 2/24/10J L BLDG FRAMING TIME 01 00 February 24 2010 8 16 47 AM 1pangrle —� KEN 775 0404 FRAMING AFTERNOON COMMENTS AND NOTES PREPARED 2/12/10 8 46 23 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/12/10 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR ALPHA BUILDERS CORPORATION PHONE 360) 775 0759 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 477 5170 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 10 00000033 RES REMODEL PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 2/12/10 ,L _ BLDG FRAMING February 9 2010 3 39 08 PM 1pangrle KEN 775 0404 FRAMING COMMENTS AND NOTES -- ' � �s VC7 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES,WA 98362 Application Number 10 00000033 Date 1/12/10 Application pin number 798466 Property Address 1229 COLUMBIA ST ASSESSOR PARCEL NUMBER 06 30 00 5 3 0175 0000 Tenant nbr name �. ANDREA MOTYKA Application type description RES REMODEL Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 5000 Application desc REMOVE A KITCHEN WALL & INSTALL A BEAM Owner Contractor ANDREA MOTYKA / TAMARA SMITH ALPHA BUILDERS CORPORATION 1229 COLUMBIA ST 105 1/2 E 1ST ST PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 477 5170 (360) 775 0759 Structure Information 000 000 REMOVE KITCHEN WALL INSTALL BEAM Permit BUILDING PERMIT RESIDENTIAL Additional desc REMOVE WALL INSTALL BEAM Permit pin number 159392 Permit Fee 137 75 Plan Check Fee 89 54 Issue Date 1/12/10 Valuation 5000 Expiration Date 7/11/10 Qty Unit Charge Per Extension BASE FEE 95 75 3 00 14 0000 THOU BL-2001 25K (14 PER K) 42 00 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 137 75 137 75 00 00 Plan Check Total 89 54 89 54 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 231 79 231 79 00 00 [ ^n q I e4 z6, 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 lis 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. �- I,- , Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:FormsBuilding Division/Building Permit Ca BUILDING PERMIT INSPECTION RECORD ` W — 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. 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 21- 112- (Q L.C_ oL-Zq-I0 FV�t% -SL — Joists/Girders/Under Floor ✓ { v Shear Wall/Hold Downs \ v Walls/Roof/Ceiling , v Drywall(Interior Braced Panel Only) T-Bar INSULATION 2——?—Lj—I bt,L Slab Wall/Floor/Ceiling Q MECHANICAL. �- C Heat Pum /Furnace/FAU/Ducts S Rough-In s Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b 9 MANUFACTURED HOMES C Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT Separate Permit#s SEPA. Parkin /Lighting ESA. Landscaping SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By tU Electrical 417-4735 Construction R.W PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit B(JIILD/NG PERMIT APPLICATION Print in ink CITY OF PORT ANGELES LDateAppro�,e�d ty Use Only Attn Building Permit Technician 321 E.1 Fifth St. Port Angeles WA 98362 ed (360)417-481.5 fax (360) 417-4711 Applicant Phonq' _3Lo—4 1'1-5.1-7o Property Owneri'" Phone Property Owner's Address Contractor L_J6 _ � ,_ Phone Lir —mac,^ Contractor's Address _Lv!�- i _ ) Licensp # _AL�> Expires E-mail I PROJECT ADDRESS Clzo Parcel Number. Lot Zoning Project Type & Brief Description. XResidential ❑ Multi-family c Commercial o Industrial Check all that apply ❑ New Construction ❑ Addition - ARemodel — - ❑ Repair - ❑ Demolition ❑ Re-roof _❑ House ❑ garage ❑ other ❑ tear off& re-roof ❑ lay over one layer ❑ Heat System ❑ Heat pump ❑ wood-burn,ng stove ❑ gas fireplace ❑ pellet stove ❑ other ❑ Other I Floor Areas Existing(sq. ft.) Proposed(sq. ft.) Basement @ $ per sq ft. = $ 1 st Floor 2nd Floor 3 I Floor Garage Carport Covered Porch Deck _ Shed Other TOTAL VALUATION $ Total footprint of structures ,A)A_ sq ft. - 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, y A ft. Occupancy group #of bedrooms _ Will a lawn sprinkler system be insalled? cs Occupant load #of full baths Will a fire sprinkler system be installed? AL_jC� Construction type #of half baths I have read and completed this application and know it to be true and correct. I am a rhorized to apply for this permit and unuerstand that it is my responsibility to determine I what permits -e required and to obtain permits pno. to wo ing on projects , Date! Print Nan-e c Q ala,,c S gnature T FornisrB, ;ding Division/Building permit application uiatlarn t-ounty Assessor m treasurer- rroper y 1JeIa11S- 01/04 A1V1J1Cn1-V WSJ1 ILA rage 1 OI 3 Clallarn County Assessor & Treasurer Property Search Results > 61764 ANDREA MOTYKA/TAMARA SMITH for Year 2009 -2010 Property Account Properly ID- 61764 Legal Description: P S CO-OP COLONY SUBDIVISION E2 LT16&W2 LT17 BL 1 Geographic ID- 0630005301750000 Agent Code: Type: Real Tax Area: 0010 PA 121 H2 L Land Use Code Open Space: N DFL N Historic Property N Remodel Property N Multi-Family Redevelopment: N Location Address: 1229 E COLUMBIA ST Mapsco- PORT ANGELES WA 98362 Neighborhood: Cycle 5 Res Map ID- Neighborhood CD- 10955130 Owner Name: ANDREA MOTYKA/TAMARA SMITH Owner ID- 42194 Mailing Address: 1229 E COLUMBIA ST %Ownership 100.0000000000% PORT ANGELES WA 98362 Exemptions: Taxes and Assessments Due Property Tax Information as of 11/16/2009 Amount Due if Paid on.®_ First Second Half Half Statement Base Base Base Amount Year ID Taxing Jurisdiction Due Due Penalty Interest Paid Due 2009 617642008 ST SCH STATE SCHOOL $212.90 $212.90 $0.00 $0.00 $425.80 $0.00 2009 617642008 CC-GEN (COUNTY $10775 $10774 $0.00 $0.00 $215.49 $0.00 2009 617642008 PORT PORT $15.26 $15.26 $0.00 $0.00 $30.52 $0.00 2009 617642008 PORT ANG-PORT ANGELES $236.33 $236.34 $0.00 $0.00 $472.67 $0.00 2009 617642008 SD#121 .SCHOOL DISTRICT#121 $263.29 $263.29 $0.00 $0.00 $526.58 $0.00 2009 617642008 NTH OLY LIB NORTH OLYMPIC LIBRARY $31.31 $31.30 $0.00 $0.00 $62.61 $0.00 2009 617642008 HOSP#2 HOSPITAL#2 $4419 $4419 $0.00 $0.00 $88.38 $0.00 2009 617642008 CITY-STORMWATER CITY STORMWATER $36.00 $36.00 $0.00 $0.00 $72.00 $0.00 2009 617642008 WEED CONTROL WEED CONTROL $0.81 $0.82 $0.00 $0.00 $1.63 $0.00 2009 617642008 TOTAL. $947.84 $947.84 $0.00 $0.00 $1895.68 $0.00 2008 617642007 ST SCH STATE SCHOOL $226.09 $226.08 $0.00 $0.00 $452.17 $0.00 2008 617642007 CC-GEN (COUNTY $109.40 $109.39 $0.00 $0.00 $218.79 $0.00 2008 617642007 PORT PORT $15.98 $15.98 $0.00 $0.00 $31.96 $0.00 2008 617642007 PORT ANG PORT ANGELES $235.59 $23557 $0.00 $0.00 $47116 $0.00 2008 617642007 SD#121 SCHOOL DISTRICT#121 $263.71 $263.71 $0.00 $0.00 $52742 $0.00 2008 617642007 NTH OLY LIB NORTH OLYMPIC LIBRARY $3179 $31 78 $0.00 $0.00 $6357 $0.00 2008 617642007 HOSP#2 i HOSPITAL#2 $1086 $1086 $0.00 $0.00 $2172 $000 2008 617642007 CITY_STOIRMWATER CITY STORMWATER $36.00 $3600 $0.00 $0.00 $72.00 $000 http.//vpn.clallam.net.8084/propertyaccess/Property aspx?cid=0&yea1=2009&prop id=6 11/16/2009 E M 13'-6"-Quick Beam g,lneering Inc. Page 1 Project: 1229 E' COLUMB1411ST PORT ANGELES 15 35 32 11/24/09 Job- MOTYKA/SMITH Designed by- Donna Petersen P E. Client:_MO_T_Y_KA/SMITH Checked by- Input Data D'es,�grioaf' .3/4'"x1,3'1/2" V� l,r .Qa arw.r Fad': Y p lulari .-VEst Left Cantilever-None Main Span: 13'6' Right Cantilever-None Check for repetitive use? No Tributary Width:0' Slope:0 Dead Load:0 psf I Live Load:0 psf Snow Load: 0 Allow LL Deflection. U360 Allow TL Deflection:L/240 DOL.0.900 (3 in Maximum) Eb. 1800000 psi F 240 psi Fb.2400 psi User Defined Loads Lot. Cass .: i:R id' Qi tai�ce;{si)=ta. Lod L+u ii,at, t oai at. I'Yp Stsrt 4engtii Stark >end.: ff:. ft; p1f i21�.. Dead Uniform 0' 15'6' 1463 Design Checks "R01,6 ii 0 ;Ber►lir► ; ; ;Shear Li';l) t1, T e I,ip Ib_ Pik] !?si in rn, Max.Value 9875.25 1950.67 135.463 0 -04389 Allowable 997544 2160 216 0.45 0 675 %of Allow gg le 90 It 63 V 0 tie 65 ilk Location 0' 6'9' 1'11/2' 6'9' 6'9' Reactions and i bearing Suppart';Lgcatioin Min„S.g�rirtig, Rsactjon: 'f,EA iri. Ib: 2.273 9875.25 13'60'I 2.273 9875.25 Self-weight of member is not included. �� Member has an actual/allowable ratio in span 1 of 9000%. Design is governed by bending fb/Fb. Governing load combination is Dead. Maximum hanger forces.9875.25 Ib(Left)and 9875.25 Ib(Right). CITY OF PORT ANGELES—Construction Plans The Issuance of this permit based upon these plans,specifi- cations and other data shall not prevent the building official Program Version 8.2-12/17/2004 from thereafter requiring the correction of errors in said plan specifications and other data, or from preventing building operations being carried on thereunder when in `4 violation of all codes and ordinances of this jurisdiction.r Approval Date By a t F-tte I � I ———————— ———— ----- --- L-—j ------- BATH OFFICE BEDROOM L------------ ----J Upper Floor Plan Sonia 118 , o 32'-0 --------- MUD RM. _ NOOK O BEDROOM F 9. W KETCH O � N CD V'C�GREAT ROOM 28-0 4-0' Main Floor Plan - ba k PREPARED 5/07/09 8 17 30 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/07/09 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR C A DOTSON CONSTRUCTION PHONE (360) 928 9535 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 457 5890 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 09 00000106 RES REMODEL PERMIT BPR 00 BUILDING PERMIT RESIDENTTAT• REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 5/06/09 BLDG FRAMING TIME O100 May 6 2009 6 24 12 AM 1p 1pangrle CHRIS 460 3490 FRAMING AFTERNOON BAIR-01 Sf�Y7/-09-JLL BLDG-AIR-SEAL-TI-ME--01--00 May 6 2009 4 55 45 PM 1pangrle CHRIS 460 3490 AIRSEAL AFTERNOON COMMENTS AND NOTES PREPARED 5/06/09 8 27 58 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/06/09 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR C A DOTSON CONSTRUCTION PHONE (360) 928 9535 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 457 5890 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 09 00000106 RES REMODEL PERMIT BPR 00 BUILDING PERMIT RESIDEN'T'IAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 5/06/09 J BLDG FRAMING TIME O1 00 May 6 2009 8 24 12 AM 1pangrle 1A ju CHRIS 460 3490 FRAMING AFTERNOON COMMENTS AND NOTES PREPARED 5/05/09 8 25 24 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/05/09 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR C A DOTSON CONSTRUCTION PHONE (360) 928 9535 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 457 5890 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 09 00000106 RES REMODEL PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL1 01 4/21/09 JLL PLUMBING UNDER SLAB TIME 09 00 4/21/09 AP April 21 2009 8 18 40 AM 1pangrle JOHN 460 6902 UNDERSLAB PLUMBING MORNING INSPECTION THEY PLAN_TO_POUR_THIS AFTERNOON April 21 2009 4 07 00 PM jlierly PL2 01 5/05/09 J Lam„ PLUMBING ROUGH IN May 4 2009 4 22 37 PM 1pangrle -�� JOHN 460 6902 ROUGH IN PLUMBING COMMENTS AND NOTES r ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 09 00000394 Date 5/04/09 Application pin number 289172 Property Address 1229 COLUMBIA ST -� ASSESSOR PARCEL NUMBER 06 30 00 5 3 0175 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Bathroom Addition in shop Owner Contractor Motyka Andrea EXTRA MILE TECH & ELECT LLC 1229 Columbia street 418 N RACE ST 1Jv PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 477 5170 1 (360) 457 0198 p if Permit ELECTRICAL ALTER RESIDENTIAL Additional desc !f Permit pin number 1451235 Permit Fee f 63 50 Plan Check Fee 00 Issue Date 5/04/09 Valuation 0 Expiration Date Ili/31/09 Qty Unit Charge Pier Extension 1 00 57 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 57 50 3 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT 6 00 �{ Fee summary Charged Paid Credited Due Permit Fee Total 153 50 63 50 00 00 Plan Check Total , 00 00 00 00 Grand Total 63 50 63 50 00 00 a I I INSPECTION TYPE DATE RESULTS INSPECTOR. DITCH SERVICE ROUGH IN �(6 6 FINAL Z 7 sw COMMENTS Signature of owner or Electrical) Contractor X Date MAY-03-2009 08 52 PM E JANSSEN R EC E I V E D 360 452 2982 P 01 w. 1 MAY 4 2009 Clly of Port Angeles Permit Application itQHT DEPT pom �� Building"1910006drloal hrspuftne '" '°�1�'�► 321 EM FWM Street-P.O.Box 1180 PW2Aep W WaehhWN.9IM Ph:(=)4174M Fax:(3W)W-4711 Date: VI&7 Single Family Dwelling —..Mui arnily or Commercial' ,,,,,_Cominerclal Addition I Alteralon-I Remodel I Repair` Plan Review May Be Required,Please Complete Electrical Plan Review Information Sheet Job Addr6u:. _,j ,�j�.Ltd r f ,r 61 nb i 4 SulMing Square Footage: Description of above_ u-�' E.I r:E er Je.. 7O-P Koc701. Owner Infonption Contractor Information Name: A N Dt{ r-& �V �' � Ti, Name: K!Cl'r��,_IN1t�. �fcti EIS rt Mailir�Address- r r• Marling Address: K is h - Ik aces -ST. City: State: Zip: !?it 3 ry City: 1P." State: I-1 rt ZIP: ulff. . Phone: , Phone: ?b o- c45L7 . 5-Aa s- -aGo-yet-r97g License 91 ExP• . . .__.� _. License#I Exp...L-KI'J31 r# 9 7 3 R,lr M 12Lf f eel Unit Chem c,� Total(Qtv MuNpiied by Unit Chergel 3 93.75 $ SeMc Rader 200 Amp. $113.75 $-- ServloarFeWer 201-400 Amp. .$180.00 — $ _Service/Feeder 401-800 Amp. $205.00 _ $ Service/Feeder 601-1000 Amp. $29126 'S Servlce/Feeder over 1000 Amp. $ 2.00 $ Branch Circuit W1 Service Feeder $ 57.50 1 _ $ _ Branch Circuit W/O Service Feeder $ 2.00 $ auw Each Additional Branch Clrcult S 72.50 _ $__,_�Temp.Service/Feeder 200 Amp. $ 8625 $ Temp.Service/Feeder 201400 Amp. $116.26 $_ Temp.ServicelFeeder401-600 Amp, $131.26 I—Temp.-. Temp.ServicelFeeder 601-1000 Amp. $ 75.00 , $ Portal lo Portal Hourly $ 89.00 $_ SignlOulline Lighting $ 75.00 _ $ Signal Circuit!Limited Energy Commercial 160.00 $ Signal Circuit)limited Energy 1&2 Famlly DwelBng S SO-01) $_,,_„--SlgrW ClrculV Umlled Energy Mule-Fomlly DwellIng 193.75 $ Manufactured Home Connection $ 80.00 S_Renewable Electrical Energy 5KVA System or lees $ 86.2.6 $_—First 1300 Square Ft. 127-50 _ $_—..- Each Addidorra1500 Square Ft.or portion of $ 67.50 $__,Each Outbuilding or Detached Garage :$ 66.25 $ Each Swimming Pool or Hot Tub $43.75 $_ Thermostat '$_.Jt1 ' Yout OwnW a$darted by RCW.19 M.MI.-(1)Owner udli occupy the structure for We years after this electrical penult Is WnallmW.(2)Ownar ls requliad to hire an eMe61CaP deaftwor Kobit"Weld property is for sola rent or lease. I After reeding on above stetomen%I hereby ce ft that i am the owner of 1ho above named property or a licensed electrical conlraciw.I am malting On derdrleal Ine4dleWrn or Aeration In compilence with the eled&al haws,N.E.C. RCW.Chapter 1928,WAC.Chapter 296•ABB,The City of Port Antplea Munldpal Code,and U014 Specllteetions. slgnswmi r owner.electrical contractor or oleeWcal administrator PREPARED 4/21/09 8 24 13 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/21/09 ADDRESS 1229 COLUMBIA ST SUBDIV TENANT NBR ANDREA MOTYKA CONTRACTOR C A DOTSON CONSTRUCTION PHONE (360) 928 9535 OWNER ANDREA MOTYKA / TAMARA SMITH PHONE (360) 457 5890 PARCEL 06 30 00 5 3 0175 0000 APPL NUMBER 09 00000106 RES REMODEL PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL1 01 4/21/09PLUMBING UNDER SLAB TIME 09 00 %I April 21 2009 8 18 40 AM 1pangrle JOHN 460 6902 UNDERSLAB PLUMBING MORNING INSPECTION 'Y-PLAN-TO-POUR-THIS-AFTERNOON--- COMMENTS AND NOTES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION i 321 EAST 5TH STREET PORT ANGELES WA 98362 1 Application Number 09 00000106 Date 4/08/09 Application pin number 354206 Property Address 1229 COLUMBIA ST ASSESSOR PARCEL NUMBER 06 30 00 5 3 0175 0000 Tenant nbr name �. ANDREA MOTYKA Application type description RES REMODEL Subdivision Name Property Use Property Zoning I. RS7 RESDNTL SINGLE FAMILY Application valuation (. 6800 Application desc ADD BATHROOM INSIDE EXISTING GARAGE Owner Contractor ANDREA MOTYKA / TAMARA SMITH C A DOTSON CONSTRUCTION 1229 E COLUMBIA ST 1013 LILJEDAHL PORT ANGELES WA 98362 PORT ANGELES WA 98363 (360) 457 5890 (360) 928 9535 Permit BUILDING PERMIT RESIDENTIAL Additional desc BATH ADDITION Permit pin number 141127 Permit Fee 1165 75 Plan Check Fee 107 74 Issue Date 4/08/09 Valuation 6800 Expiration Date 16/05/09 Qty Unit Charge Per Extension BASE FEE 95 75 5 00 14 0000 THOU BL-2001 25K (14 PER K) 70 00 I i Permit MECHANICAL PERMIT Additional desc i Permit pin number 141135 Permit Fee 72 05 Plan Check Fee 00 Issue Date 4/08/09 Valuation 0 Expiration Date 10/05/09 Qty Unit Charge Per Extension �\ BASE FEE 50 00 1 00 7 2500 EAI ME VENT FAN (SINGLE DUCT) 7 25 00 10 6500 EAI ME HOOD/DUCT MECH EXHAUST 00 1 00 14 8000 EA ME HEATER(SUSP/WALL/FLOOR MTD) 14 80 Permit PLUMBING PERMIT 3 -26 - 10 Additional desc Permit pin number 141143 Permit Fee 114 00 Plan Check Fee 00 Issue Date 4/08/09 Valuation 0 Expiration Date 10/05/09 Qty Unit Charge Per Extension BASE FEE 50 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. 9 o ANVc65A Mato-A f Date Print Name 1 Signat re of Contractor or Authorized Agent Signature of Owner(if owner is builder) I T:FormsBuilding Division/Building Permit BUILDING PERMIT INSPECTION RECORD 1 - PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS- Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING Under Floor/Slab Rough-in Water Line(Meter to Bldg) Gas Line Back Flow/Water 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 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 /Lighting ESA. Landscaping SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction R.W PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T.Forms/Building Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION °` — 321 EAST 5TH STREET PORT ANGELES WA 98362 vv Page 2 Application Number 09 00000106 Date 4/08/09 Application pin number 354206 Qty Unit Charge Per Extension 5 00 7 0000 EAI PL-PLUMBING TRAP 35 00 1 00 7 0000 EAi PL WATER LINE 7 00 00 7 0000 EA, PL-DRAIN VENT PIPING Do 1 00 15 0000 EA PL-SEWER LINE 15 00 1 00 7 0000 EA PL-WATER HEATER 7 00 Special Notes and Comments February 5 2009 5 39 47 PM sroberds The improvements appear to result in the ability to provide another living unit on site The applicant has indicated no residential occupancy of the garage will take place A Limitation of Use will be required for the development Otherwise no land use issues exist Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 351 80 351 80 00 00 Plan Check Total 107 74 107 74 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 464 04 464 04 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. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit 03 z BUILDING PERMIT INSPECTION RECORD C7 — PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS-- Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type 7 Date Accepted By Comments FOUNDATION Footings Stemwall Foundation Drainage/Downspouts Piers "— Post Holes(Pole Bldgs.) N PLUMBING Rl Under Floor/Slab —2-1 \ _ Rough-in --� Water Line Meter to Bldg) Gas Line Back Flow/Water FINAL Dal:3 0 Accepted by AIR SEAL. — LV Walls Ceiling FRAMING Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall(Interior Braced Panel Only) i T-Bar INSULATION Slab Wall/Floor/Ceiling MECHANICAL. Heat Pum /Furnace I FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney3 Z6—IdAccepted b z-�.L' Commercial Hood/Ducts FINAL Date MANUFACTURED HOMES J Footing/Slab /0/c Blocking&Hold Downs Skirting PLANNING DEPT Separate Permit#s SEPA. Parkin /Lighting ESA. Landscaping SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspecltion Type Date Accepted By Electrical 417-4735 Construction R.W PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 �vTZ�� l0 Llr O T Forms/Building Division/Building Permit 2009-1234294 l Page 1 of 1 Agreement Andrea Motyka Clallam County Washington 03/23/2009 03 41 24 PM NW AVIOINV SL Wl hh ftl«j M Mij 11111 AFTER RECORDING RETURN TO. RECEIVED A01D'40-4, n°TvV-A' APR 0 8 2009 l L>s1 Co".#491A 5T CITY 0LMNG T ANGELES DM9tOA1 "POWAMa�S j� q,$3tOZ DOCUMENT LIMITATION ON USE GRANTOR. Andrea Motyka/Tamara Smith GRANTEE City of Port Angeles ADDRESS 1229 Columbia Street ASSESSOR S PARCEL NO 0630005301750000 1 The undersigned, being the Owners and entitled to possession of the described real property, hereby acknowledges, states, and declares that use of the property is subject to restriction and limitation. The limitation is more particularly described as follows.On January 30 2009 Owners were granted building permit No. 09-106 for remodel of an accessory structure (garage) on the described real property The Owners understand and declare that the use of that structure is subject to limitation as an accessory use. The Owners understand, intend, agree, and acknowledge that residential occupancy of the accessory structure (garage) is not permitted. The structure does not meet criteria for residential occupancy This limitation is an encumbrance on and runs with the described real property described as follows. Property address. 1229 Columbia Street Assessor's Parcel No. 0630005301750000 Dated this 7 day of 111AA6N 2009 OWNER. �Aa_�yl— OWNER. Ajo -P Name A _DIZ4W Btq Nk/k Printed Name W1A1'Gl SA4( STATE OF WASHINGTON) )ss. County of Clallam ) On this 7 day of MAro f1 2009 before me, the undersigned, a Notary Public in and for the State of Washington,duly commissioned and sworn,personally appearedv Tq p rH x to me known to be the individual,who executed the foregoing instrument, and acknowled ed the said instrument to be his/her free and voluntary act and deed for the uses and purposes therein mentioned. ota I'izbl' o W s n f resi ing at P6V:,Angeles. My commission a pires: Nbkoy hi* s�ro�ajtm" t ,p ,. MVACADocuments and SettingAlpangrleWy DocumentsVJTER RECORDING RETURN TO.wpd L4* NV0N 1�nrnt*Nft Apr 14;X01 0 j.r BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES �. Attn: Building Permit Technician For City Use Onlyp 3211 E Fifth St. Port Angeles, WA 98362 Date Receive 09 - ' (360)417-4815 fax(360)417-4711 Permit# 5 e Date Approve 1 Applicant or Agent one q�: � ^ S� Property Ownergyp. ly�y)44 'I�A1�rA_ �i A Phone Property Owner's Address GD MgC - S �eT Contractor/Engineer 6,A -Pa 0 CvN 5-ow-In 00 Phone 3&a X128 q s-35 Contractor/Engineer's Address 10( z., P R 9363 License # C Dorisc*qq(Q t Expires 1 PROJECT ADDRESS 22G�Lll�t s� Parcel Number 0(P p rJ 0DLot Zoning i Proiect Type&Brief Description. olResidential ❑ Commercial ❑Multi-family ❑ Industrial Check all that apply ❑ New Construction t,)6,1k5Poff, Tvio 1.6,�e;� Si n K o H C& LCIO PASnAl S 4, ii ❑Addition UJCA Hee_": o RemodelS ❑ Repair -A-P on N3, wasr e,,- w, )( be ❑ Re-roof , & o i ( ►t ve, t e. elo cu nty- • Demolition 015r-I-h,er � �, do a_ A0 Ke c ea.h up ; 4'e ❑ Heat System ❑ Heat pump ❑wood-burning stove❑gas fireplace ❑ pellet stove ❑ other ] ❑ Other 4 e: V4 me_ I Floor Areas Existing(sq. ft.) Proposed(sg. ft.) Basement @$ g o per .. ft. $ p oD I o 2nd Floor I 3`d Floor I Garage Carport Covered Porch Deck Shed Other +� TOTAL VALUATION $ gaa a 0 Total footprint of structures sq. ft. T 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 1 have read and completed this application and know it to be true and correct. I am authorized to apply for this permit-and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Date 1130101 Print Name AAl'DSO, Mo 'I14-A Signature T:Forms/Building Division/Bldg PermitlAppl.-2006 Code.doc i ~ / 1226 - 1220 J 522 1219 1225 /// 1229 \ Y235# , z� / 1235' � f /! ! 507 1 � / s 1232 j� 1234 � � Keynotes FMLi1B4O mu bk EXISTING % ASSOCIATES qAfl�/ GE / ��,W A: / EXISTW{{��. / RESIpENCl Resdence ith \ // 1228 Columble Street \ / Port Angeles,We \`GM� \ DATE Lot Coverage me No.sNO.2008 LOT nREk 7"0 \ dN(WN W. XWBE ARFA(IMOER RaOf); gp6 Omi \ DIRw naw(urmm R00n: 1w OHM Site Plan T&AREA(U OFR ROOK: BSB /lG e n 1 LOf CWFAAG OF CITY OF.PORT-ANGELES DEPARTMENT CONDOUNITY DEVELOPMENT -BUILDING DIVISION 321 EAST 5TH STi2i3ET, PORT ANGMXS,WA 98362 Application 04-00009846 Date 10/14/04 Pin number '. . . . . . .$33400 Property Address .. . 12'29 COW N STA ST ASSESSOR PAS+ . 06-30-00-5-3-017.5-0000- Application description. am Nzw sFR Subdivisioa,xame Property use Property zonning, 7 RRSitM s PAWLY Application valuate . m-4 13000 owner, trl*ctor CTACTUCii, ------------------ -W. 113 SOUTH VALLSY PORT ANGWAS WA 04362 ( 36) 417-1110 ------ structure Information T20H MCAD ON SSE - - -Construction'Type . _. TM- V IM-RATZD Occupancy Type . . Permit . r PERMIT -RESIDENTIAL Additional desc W=R T1 REPAIR Permit idea . r 274.73; Plan Check Fee 199.90' Issue Date . . . . 10/14/04 Valuation 15000 .`.. Upiration Date */33/" {sj Qty Unit crsars per- Rxtensic;n SAM 1 92.75 13.00 14.0000 TOM BL-2001-25R (14 PER R)- 182.00 -_---- -----------------------. ..-------- ----•----•--------` 1 � Special Notes and Coftsents, Building address sign $hall not be less than 6" s not more than 12* in height. r6 colors must contrast with wall color they are wountod on. tord. 14.36.050-EI When root meters are instal, (rains will located in dry wells or piped to approved st dar4alu locations: The proposal will result in the replacement of a burned residential structs with x 00wo.On residential structure. The proposed foundation mots residential setback AA requirements iA th4 - 7 sme. No land use issues f" noted. Electrical load cal alati , spall elotrical permits are required. Any modifications to the City'$ 'electrical facilities will be at the matowris ; Sanitary sewer connebti0ft i i*4 is mired by Public works prior to fill of ditch. ,Otherl - - - Fees . .� `. aft - ra as - 4.$0- I+se Credited ',Due ... .... .......... ......... ----- ..... Permit Pee Total 274.73 274.73 09 .00 Plan Check Total 10.to lot.to .00 .00 Cather Fee Total 4." 4,50 .99 .00 Grasp Total. 88l1.7.S 34.9.11; 49 .OA Separa%Permits areMulmdforeiecWcei work,Si=P Shoreline,ESA,utilities,private and public improvements.This permit becomes null and void f work or construction authorized Is not commencedwithin 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 WithI6, 80 da'''from1he last Inspection. t hereby car*that I have read and examined this application and know the same to be true and correct-Ali:provisions of laws and ordinances govemlrV this type of work will be complied with whether specitieed herein or not. The-granting of a"pormit.does not presume to give authoft to violate or cancel the provisions,of any state or I law regulating construdion or the performance of cor1structlorL` Signature of Contractor or Authored Agent: Date re of Owner(If owner is.builder). I�te J BUILDING PERMXr INSPECTION RECORD t CALL 4174815 FOR BLU DING INSPEC noNs CALL 417-4735 FOR ELECTRICAL IN PBMONS. MEASS PROVIDE A MINIMUM`74 HOUR NOTICE. ITIS UNI.WFU1L TO COLTER,INSULATE OR CONCEAL ANY WOR,, 'SOPORS INSPECTED AND ACCEPTLA POST PERMIT IN A CONSPICUOUS LOCATION. KEEP-PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPFCnON SPS DATE ACCEMI) CONNIEN`i'S YES' ATO FOUNDATION: FOOTINGS O-- 1 1I WALLS EOUNDAMN DRAINA(DOWNSPOUTS IMCTRICAL (LIGHT DEPT) SEPARATE PERMIT:# ROUGH-IN PLUMBING UNDERFLOORISLAII �r ROUGH-IN W: TER LfldE(METERTO D1. GAS LING BACK FLOW!WATER AM SEAL WALLS CEILING YPAMtNC SSI G> RS SHEAR WALL/HOLD DOWNS WALLS/ROOF/CRILIM DRYWALL ANTERIOR BRACED PANEL ONLY) T.BAR ' INSULATION SLAB WALL/FLOORICEE.1NG MECHANICAL HEATPUMP GAS LINE r WOOD STCIVEJ PELLET l CHNNiEY HoOD/DUGTS PW UTILITIES I SITE WORIC M*rtderinR Division) SEPARATE PERMIT#'s: 4. WATERLINE I METEA SEWER CONNECTION SANITARY STOW PLANNING DEPT. SEPARATE PERMIT#'s SEPAL PAItKI MIGHT(!G ESA: L NusCApnNc SHORELJN& MNAL;INSPECTIONS'ltSQvmm PRIOR TO OCCUPANCYAISS RESM TIAL '. DATE YRS NO COMMERCIAL DATE ACCIIrM YU _ NO LCO LIGHT DEPT, 4174735' LIDEPT� N R.W.1*1 CONSTRUCTION-R.W.PW/ENGINEERING 47,453 ETRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. DE)H DING ;. 417-481S " " L► BUII UIN TMANNINGMUUMIMIS(11114!2003] _ PREPARED 10/14/04, 12:45:43 INSPECTION TICKET PAGE 13 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 10/14/04 ------------------------------------------------------------`----------------------------------- ADDRESS . : 1229 COLUMBIA ST SUBDIV: CONTRACTOR : PHONE : OWNER CIACIUCH, JAMES W. PHONE ( 36) 417-1110 - PARCEL 06-30-00-5-3-0175-0000- APPL NUMBER: 04-00000846 RES NEW SFR ----- PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL _ REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ---------------------------------------------------------------------------------------------`-- BLHD 0.1 1014/ 4 JLL BUILDING FRAMING HOLD DOWNS - chuck 461-2717 --------- ----------- ----�----------- COMMENTS AND NOTES CoLt —qo 7J h o fc r a .s I i✓x�S� k Iz �Q� ze ` b- V � d ;ts VA its I m low gas S f ` Fl F � e a � ._ r \ C 1 F PISf 1 f}. i � f Y l D R S � f% \. \. E � I CLTY OF PORT A_IVGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST: Date ' ` 7 me Received by (phone, person) f Location of Work to be inspected 12 29 � Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer foundation raming Chimney Plumbing Final Sewer Excay. Other INSPEC OTE Inspected: Date G r r Time By Remarks: - RESTORATION REQUIRED . . . . . . YES. NO V--' SURFACE RESTORATION: SURFACE TYPE: `❑ Unimproved ❑Gravel 0 Asphalt ❑PCC ❑Other ❑Repaired by City Work Order [}Repaired by Permittee ❑ COMPLETE No Damage Found ❑ INCOMPLETE BUIL©IN 'DI ISION CITY OF PORT ANGELES Crlrrir it�tic _1 F, ated,at jo +,dry Inspection of your Wdrk revealed that the following is not ifl.accordanoe with the codes governing,the work in Z 'r jrriscfi f c,->4 Lep L acla=i C A r 0 These, porrectione must be made and are not to be covered until rainepection is made. When corrections have been mads, please call I i 11ki .z for inspection: n " nate Lt_ Impector#or Building Division ,. .. _ 00 t tOT REMOVE 7H �TAG1 ClilTY'..OF,IPO.-IR-T," A"N"IGIELEIS DEPARTMENT OF PUBLIC.WORKS . . . . . INSPECTION REPORT .- . . . REQUEST: Date �- � Time Received by (phone, person) Location of Work to be inspected 2 2 f' Name of person requesting inspection Address of person requesting inspection Phone No. A40 477- 6!26,S- Type of Inspection(circle appropriate one): Permit No. ©q- la Sewer FV raming Chimney Plumbing Final Sewer Excay. Other INSPECTS• Inspected: Date Time By Remarks: RESTORATION REQUIRED YES NO SURFACE RESTORATION: SURFACE TYPE: ❑ Unimproved ❑Gravel ❑Asphalt E PCC M Other ❑Repaired by City Work Order ❑Repaired by Permittee ❑ COMPLETE No Damage Found ❑ INCOMPLETE PREPARED 1/24/05, 12:56:33 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/24/05 ------------------------------------------------------------------------------------------------ ADDRESS . : 1229 COLUMBIA ST SUBDIV: CONTRACTOR : PHONE : OWNER CIACIUCH, JAMES W. PHONE ( 36) 417-1110 - PARCEL : 06-30-00-5-3-0175-0000- APPL NUMBER; 04-00000846 RES NEW SFR ----------------------------- ------------------ --- PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BLHD O1 10/14/04 JLL BUILDING FRAMING HOLD DOWNS 10/15/04 CA chuck 461-2717 this inspection was to consult about hold downs for the moved house at this site/jll BL3 01 1/24/P5 JLC L BUILDING FRAMING JIM - 417-1110 ----------- --- ------ --- COMMENTS AND NOTES A-b.O tdKkea-es 4 G,5� 71-wooeA Z>C:A�-s ls�J r 640 L� PREPARED 3/03/05, 12:40:43 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 3/03/05 ------------------------------------------------------------------------------------------------ ADDRESS . : 1229 COLUMBIA ST SUBDIV: CONTRACTOR : PHONE : OWNER CIACIUCH, JAMES W. PHONE ( 36) 417-1110 PARCEL 06-30-00-5-3-0175-0000- APPL NUMBER: 04-00000846 RES NEW SFR ------------------------------------------------------------------------------------------------ PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BLHD 01 10/14/04 JLL BUILDING FRAMING HOLD DOWNS 10/15/04 CA chuck 461-2717 this inspection was to consult about hold downs for the moved house at this site/jll BL3 01 1/24/05 JLL BUILDING FRAMING 1/25/05 DA JIM 417-1110 electrical rough required before frame, use plate washers to code on A.B/jll BL99 01 3/ JLL BUILDING FINAL -------------------------7777------------ COMMENTS AND NOTES FOR OFFICIAL USE ONLY: got vORTq,%, Date Rec.: "Z�"'O �~ �s BUILDING PERMIT - APPLICATION Permit#: (5 Fill out COMPLETELY and in INK.Your application and site plan MUST BE Date Appr1 COMPLETE to be accepted for review. If you have any questions,call Date Issue . PERMITS(360)417-4815 FAX(360)417-4711 60 Applicant or Agent: ��• '�rGaCG Phone: Phone: Owner: Ir— Zip: Address. l � 1 L �� City: /`'/ Architect/Engineer: � F��—"':j Phone: Contractor__ G�j4J/� State License#: Exp: Phone: Address: City: Zip: ZONING: PROJECT ADDRESS: ��� S �'�e-,r .�-.s/�i�j� -f r � Subdivision:LEGAL DESCRIPTION:DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: City: Billing Address: Exp.Date: Credit Card Type VISA MC # SIZE/VALUATION: TYPE OF WORK: /SF.=$ residential ❑ New Constr. 11 Re-roof El Stove SF. @$ ❑ Multi-family ❑ Addition )9'-Move ❑ Garage SF. @$ /SF.=$ [I Commercial El Remodel . El Demolition ❑,1jeck SF. @$ /SF._$ ❑ Repair /3736E5 C—yCZ ❑ Sign �.--� TOTAL VALUATION $ BRIEF DESCRIPTION OF THE PROJECT" �` �'� �, a t"FC+VG ,1r�rC�v� 32�/ N s�c�ee —I-� 1ZZ`� Co�u�,+� � `a St CO RMME CIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No.of Stories:— Lot Size: __C> Existing Sq.Ft.�—_&Proposed Sq.Ft. 000 =TOTAL Sq.Ft.(q-6j�)— Total lot coverage__ % APPROVALS: PLAN: PLANNING USE ONLY: 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 R105.3.2 of the International Building/Residential Code,2003). 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 c ect. 1 am authorized to A ly for this permit and understand that it is my responsibility to determine what permits are required,not the City's,and th mus aIN4ucl�perm' r to work. T:IRVESSIBLDG-forms-brochures12003-Buildingpermit.wpd Applic Date:' '_ U CITY OF PORT ANGELES DEPARTMENT OF COMM[ NrrY DEVELOPMENT -WELDING DIVISION 321 EAST 5TH STIZAAT, PORT ANGELES,WA 98362 Application mer . . 04-00000847 Date 9/10/04 Pin number .316736 Property Address . . . . . . 1229 COLUMBIA ST ASSESSOR PARCEL NUMBER: 06-30-00-5-3-0175-0000- Application description DEMOLITION Subdivision Name . . . Property use . . . Property Zoning -.; . . RS7 RESDNTL SINGLE FAMILY Application valuation . k, . . 2800 Owner Contractor _ CIACIUCH, JAMES W. OWNER 113 SOUTH VALLEY PORT ANGELES WA 58362 (360) 417-1110 _ --- Structure Information DEMO SPA ----- Construction ---Construction Type TYPE v MON-RATED Occupancy Type SINGLE PAM & CONGREGATES ------------------------------------------ Permit DEMOLITION Additional desc . Permit.Pee 47.00 Alan Check Pee .00 Issue Date 0/10/04 valuation . . . 0 Expiration Date10/05 Oty unit targe Per Extension EASE FEE 47.00 _ ------------------------------------------------I------------------------ .- Other Fees ., STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 41.00 47.00 ----- .0 -- 0 .00 Plan Check Total .00 .00 .00 .00 r� Other-Fee Total 4.SO 4.50 00 .00 71G\V Grand Total 51.sQ 51.50 .00 .00 jf 1 Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements.,Th]s 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 fast inspection. I hereby certify that I have read and examined this appiication.and know the same to be true and correct. Ail provisions of laws and ordinances governing this type of work wile 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 loca law requiating,cons"ction o the performance of construction. �C - Signature of Contractor or Authorized Agent Date nature of Owner(if owner is builder) Date T.WLANNINGTORMSV 103.15[11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 4174815 FOR BUILDING INSPECTIONS.CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER;INSULATE OR C NCEAL ANY WORKBrEFORE INSPECTED AND ACCEPTED. POST PERMIT INA 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 UNDERFLOOR/SLAB ROUGH-IN WATER LINE(METER TO BLDG) GAS LINE BACK FLOW/WATER AM SEAL WALLS I 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 GAS LINE li WOOD STOVE/PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES I SITE WORK (Enginaming Division) SEPARATE PERMIT#'s: WATERLINE/METER SEWERCONNECTION SANITARY STORM PLANNING DEPT:.SEPARATE PERMIT#'s SEPA: PARI4ING/LIGHTING ESA: LANDSCAPING SHORELINE: 1 FINAL;INSPEC IONS REQUIRED PRIOR TO OCCUPA14CYMM RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL-LIGHT DEPT. 417-4735 � D EPT ENSTRUCTION R.W.!PW/ CONSTRUCTION-R.W. NGINEERING 417-4807 PW/ENGINEERING FIRE 417-4653FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 4174815 -D J-L— BUILDING T\PLANNINGWORMSM)MIS 11 1114a003] PREPARED 9/15/04, 13:17:59 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 9/15/04 ------------------------------------------------------------------------------------------------ ADDRESS . : 1229 COLUMBIA ST SUBDIV: CONTRACTOR : PHONE : OWNER CIACIUCH, JAMES W. PHONE : (360) 417-1110 PARCEL 06-30-00-5-3-0175-0000- APPL NUMBER:- 04-00000807 DEMOLITION -------------------------------------------- ----------------- PERMIT: DEND 00 DEMOLITION REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS _ ------------------------------------------------------------------------------------------------ BLDE 01 9 � J,j,L BUILDING DEMOLITION JIM 417-1110 HOUSE IS KNOCKED DOWN -------------------------------------- COMMENTS AND NOTES -------------------------------------- 1 �`k oxr,i,�C, FOR OFFICIAL USE ONLY: BUILDING PERMIT - APPLICATION Date Rec.8 �-© Permit#: C1 Ll'$�� IL_ a ' Fill out COMPLETELY and in INK.Your application and site plan MUST BE Date Approved: COMPLETE to be accepted for review. If you have any questions,call Date Issued: PERMITS (360)417-4815 FAX(360)417-4711 Applicant or Agent: J AWd,(_ Lc, �/'/�G/lrtGc�/ Phone: Yl Owner: r Gt,9�=/L2C,� Phone: Y/7— / Address: lOr&j�f �S> City: Ai'/�+�6Xly Zip: Architect/Engineer: � 207P^kf t'5 6(JI6,J Phone: -Y- Contractor CO"W662 State License#: Exp: Phone: Address: City: Zip: PROJECT ADDRESS: / SL9t G24_a,11200 d'i' ZONING: ���� LEGAL DESCRIPTION: Lot-�of —Block: 2 Subdivision: P 6 1 c%"'-" cr CLALLAM COUNTY PARCEL NUMBER: �s —,Z-'O Credit Card Holder Name: Billing Address: City: Credit Card Type VISA MC # Exp.Date: j TYPE OF WORK: SIZE/VALUATION: ❑ Residential ❑ New Constr. ❑ Re-roof ❑ Stove SR @$ /SF._$ ❑ Multi-family ❑ Addition ❑ Move ❑ Garage SR @$ /SF._$ ❑ Commercial ❑ Remodel . XDemolition ❑ Deck SF. @$ /SF._$ Repair ❑ Sign ❑ Other TOTAL VALUATION $ cQ BRIEF DESCRIPTION OF THE PROJECT: r� �rrny Qr— � r� .�a�vJ`i3 cf-1�eaivD�Tll7.d� COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: _ Lot Size: Existing Sq.Ft. &Proposed Sq.Ft. =TOTAL Sq.Ft. 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 R105.3.2 of the International Building/Residential Code,2003). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required,not the City's, and t I'mu-at obtain su c,permits p for to work. T:IRVESS\BLDG-forms-brochures\2003-Buildingpermit.wpd Aimhc Date: L_ Y 0,RK,T N G_ EEP A- WASHINGTO N, U. S. A. PUBLIC WORKS & UTILITIES DEPARTMENT September 13, 2004 Friendswood Builders, Inc: 113 S. Valley Street Port Angeles, WA 98362 RE: Port Angeles Landfill Waste Disposal Application,WDA 04-22 Building demolition at 1229 East Columbia,Port Angeles, Washington We have received your application for disposal ofbuilding demolition debris from the referenced site and reviewed the testing results for lead and asbestos content. Based on the testing results the debris appears to be acceptable for use in the landfill. A copy of your approved application is attached. This approved application must be shown to the landfill scale attendant at the time of disposal. Please be advised that this disposal application is only for the materials and quantities listed in the application. Materials not listed or in excess of the quantities noted may require separate applications and,approval. Please call if you have questions. Very truly yours, Gary W. Kenworthy,P.E. City Engineer Deputy Director of Engineering Services GWK:tf Encl.: WDA 04-22 Copy: Ken Loghry Zenovic&Assoc. N.\PWKS\ENGINEER\W DAPPLIC\04-22.WPD FILE:Landfill Solid Waste Disposal Applications 321 EAST FIFTH STREET • P. O. BOX 1 150 • PORT ANGELES, WA 98362-0217 PHONE: 360-417.4805 • FAX: 360-417-4542 • TTY: 360-417-4645 E-MAIL: publicworks@cityofpa.us JORT 41�GELES ►*., WASH I N GTO N,• U. S. A. �'—'— PUBLIC WORKS & UTILITIES DEPARTMENT December 2, 200 James W. Ciaciuch C/o Friendswood Builders, Inc: 113 S. Valley Street Port Angeles, WA. 98362 Subject: Easement for New Electric Service Address: 1229 E. Columbia Street Dear Jim: Enclosed is the easement form.required to allow the new electric service wire to cross the neighbors' porperty comer. Please have the form signed, notarized and returned prior to applying for electric service. If the service application is'requested after January 1, 2005,the New Residential Electric Service Connection Fee may apply. (See enclosure). If you have any questions or concerns, feel free to contact me. Sincerely, J hn G. Hebner Electrical Engineering Specialist ` jhebner@cityofpams v x, 360.417.4706 ry � CC: James Harper,Electrical Engineering Manager Al Oman,Electrical Inspector Roger Vess,Permit Tech File Enclosures:2 321 EAST FIFTH STREET • P. O. BOX 1 150 ! PORT ANGELES, WA 98362-0217 PHONE: 360-417-4805 • FAX: 360-417-4542 • TTY: 360-417-4645 E-MAIL: publimorks@cityofpa.us d tar CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 FAST STH STREET. PORT ANGELES.WA 98362 Application Number 04-00000846 Date 2/06/05 Pin number . . . . .933800 Property Address . . . . . 1229 COLUMBIA ST ASSESSOR PARCEL NUMBER: 06-30-00-5-3-01750000- Application description . . RES NEW SFR Subdivision Name . . . . . . Property Use . . . . . . . Property Zoning . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 15000 Owner Contractor NJ --------- ------------------------ CIACIUCH JAMES W. OWNER \ 113 SOUTH VALLEY PORT ANGELES , WA 98362 ( 36) 417-1110 ---- Structure Information FOUNDATION FOR MOVED ON HOUSE ----- Construction Type . . . . TYPE V NON-RATED Occupancy Type . . . SINGLE FAM & CONGREGATES ---------------------------------------------------------------------------- Permit . . . ELECTRICAL ALTER COMMERCIAL Additional desc NEW200ASVC. Sub Contractor SHAMP ELECTRICAL CONTRACTING \ Permit Fee 78.70 Plan Check Fee .00 Issue Date . . . . 11/15/04 Valuation . . . . 0 Expiration Date 8/03/05 J Qty Unit Charge Per Extension 1.00'' 78.7000 ECH EL-COM ALT 0-200 SRV FDR 78.70 ------------ --------------------------------------------------------------- S ecial Notes and Comments (\ Building address sign shall not be less than 6" & not more (`yl than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Ord. 14.36.050-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. The proposal will result in the replacement of a burned residential structure with a move-on residential structure. The proposed foundation meets residential setback requirements in the RS- 7 zone. No land use issues are noted. Electrical load calculations and elctrical permits are required. Any modifications to the City's electrical facilities will be at the customer's expense. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch, ---------------------------------------------------------------------------- Other Fees . . . .. STATE SURCHARGE 4.50 Fee-summary Charged Paid Credited Due Permit Fee Total 78.70 78.70 .00 .00 Plan Check Total .00 .00 .00 00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 83.20 83.20 .00 .00 COMME'NNTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTJON RECORD . CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMI M 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE ITIS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE 9479 T[ON TYPE DATE ACCEPTED COMMENTS YES NO DITCH ROUGH-IN COM L? -05 gaeg SERVICE ZU TINALO GENERAL COMMENTS: Pw-1102.13(4rsa1 P Def-- 2Z WPA PORT ANGELES LANDFILL WASTE DISPOSAL APPLICATION 1.22-19 To: City of Port Angeles, City Engineer Phone: (360)417-4803 321 E Fifth Street FAX: (360)417-4709 P.O. Box 1150 Port Angeles, Washington 98362 NOTE: All questions must be answered for waste to be approved. 1. Generator Information: Company Name: �2►�N�JSWodJ /Jl>l C 'S/LSt ��yC Mailing Address: ( 1! 3 S, t1At.Lv-y 5'7 pop—r 1J.✓lK&eS0 WA 9s3(,Z Contact: Phone: Project Name: ocr z) 0'J n /� Project Location: 2. Other Contacts (if applicable): Consulting Firm: 7-f. oo Contact: Phone: Contractor Name: Contact: Phone: Laboratory: Contact: C t-(4s 70 A'&Z Phone: J City of Port Angeles - Landfill Waste Disposal Application Page - 1 v 3. Source of Waste: I Check the appropriate box below and briefly describe the project, process, and/or cleanup that will or has produced the waste requiring disposal. Include the gasoline service station number (if applicable). CERCLA/MTCA Remediation Agency Contact: Independent Remedial Action UST Removal Unused Chemical Product Spill _ Other Source: 06'elu0 ` tS k wSY1'-)C-' �c��s� �o � � ►�u s�1�o 4. Waste Material Composition: (check all that apply and include percent of total) Soil % Foundry Slag % Concrete/Asphalt % Dredge Sediments % Preserved Wood % _ Debris 0 % Coal Ash % Other (list) Wood Ash % % NOTE: Total must equal 100%. 5. Waste Material Contaminants: (check all that apply) Gasoline Metals Diesel Solvents Heating Oil PCBs. Unused Motor Oil Used Motor Oil/Waste Oil Other Ak� �� ' 61,40 Other Petroleum Product ,po,,�. 3y obis Unknown NOTE: Supply any MSDS information with application, if available. City of Port Angeles- Landfill Waste Disposal Application Page-2 16. Estimated Quantity of Waste for Disposal: I Cubic yards Tons (estimate both) Drums / Tons (estimate both) Other NOTE: Estimated quantity for disposal must be within 20% of the quantity actually disposed. (10% for projects over 7,500 tons or 5,000 cubic yards.) 7. Frequency of Disposal: _ One time Monthly Annual Other 8. Waste Sampling: Proper characterization 'of the waste for disposal requires the collection of representative samples. The methods and equipment necessary for obtaining representative samples of a waste, and the frequency of sampling, will vary with the type and form of the waste. Check the appropriate box and briefly describe how and where the waste was sampled. Include site maps with sampling locations if possible. Number of COMPOSITE samples �_ & number of discrete samples per composite Number Too� / of DISCRETE samples _ L4 A ` C , I< 41144 K ©f &EA `Aa4-C 57,41A J��IwJh � lDG k 561#,064.,4 SEo ( y YUa tk /4>z-r�o4 y2c� A 2Y- /C- NOTE 1: Unless prior approval has been granted by Port Angeles, the following sampling frequency will be used: 0 - 25 cubic yards = 1 composite sample 25 - 100 cubic yards = 3 composite samples 101 - 500 cubic yards = 5 composite samples 501 - 1000 cubic yards = 7 composite samples 1001 - 2000 cubic yards = 10 composite samples >2000 cubic yards = 10 plus one sample for each additional 500 cubic yards NOTE 2: One composite sample shall contain a minimum of three/maximum of five discrete samples. City of Port Angeles-Landfill Waste Disposal Application Page-3 Y 9. Waste Analysis: �► The "Dangerous Waste Regulations" (WAC 173-303) shall be utilized to determine the appropriate analytical requirements for waste characterization. Ecology Publication #91-30 (Revised April 1994) "Guidance for Remediation of Petroleum Contaminated Soils" shall also be used to characterize petroleum contaminated soils from UST releases. Submit all laboratory analytical results, QA/QC data, and Chain of Custody sheets along with this application. (NOTE: The laboratory must be accredited by the Washington State Department of Ecology.) a) List all analytical test methods used: PA b) Provide a narrative as to why the above analytical methods were selected: LA-)-AS Z-J NOTE: Additional sheets attached: -- YES NO 10. Soil Classification: (**FOR PETROLEUM CONTAMINATED SOILS ONLY"*) Based on the analytical data and Ecology Publication #91-30, the soil classification is: (check one) Class 1 Class 2 Class 3 Class 4 Calculated Hazard Index 11. Dangerous Waste Affidavit: Based on a review of the analytical test results, site history, and the applicable regulations, this waste is classified as: (check one) Neither Dangerous Waste (DW) nor Extremely Hazardous Waste (EHW) Dangerous Waste (DW) and Waste Code: Extremely Hazardous Waste (EHW) and Waste Code: ----- City of Port Angeles - Landfill Waste Disposal Application Page -4 r 12. Certification: We, THE UNDERSIGNED, certify that this application is true to the best of our knowledge. All information provided is correct and the enclosed analytical results represent the proposed waste material to the be of our abilities. qWaeenerator nature Printed Name Company Date City of Port Angeles Approval: City Engineer Date / I A Appro 1 E pirati n Date C ADATA\W P\FORMS\W DAapp.wpd City of Port Angeles - Landfill Waste Disposal Application Page - 5 SEP-11-2004 95 :26 PM NVL Lakes 4257781537 P. 02 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 AIN Tel: 206.547,0100, Fax; 206,834.1936 wwW.nvllebs,com AIHA-IH « t ORV Analysis Report #10,861 1~.AeRE/D TEDD Toxicity Characteristic Leaching Procedure - Lead (Pb) If Client: Zenovic & Associates, Inc. Batch #: 2412716.00 Address: 519 South Peabody Street, Suite 22 Matrix; Bulk Port Angeles, WA 98362 Method: EPA 1311/70008 Attention: Mr. Tracy Cudgel Client Project #:04299 Project Location: 1229 E. Columbia St., Port Angeles Samples Received: 1 Total Samples Analyzed:1 Lab ID Client Sample # mRL Results Results in In m /L„ m 24079283 04299A 0.5 c 0.8 Sampled by: Client r Analyzed by: Cheston Perry Date Analyzed: 09/11/2004 � ;�z.•,. Revlewed by: Nick Ly Gate Issued: 09111/200464 mg/L=Milligrams per Iver RL = Reporting Limit ppm parts per million ' ' = Below the reporting Limit Note ; Method QC results are acceptable unless stated otherwise. Sench Run No:24-0909.6 Page 1 of 1 �App�tiossRcccivrrd a► �� $ RECEIVED A O SSW ��, SCA Z9a0 9 UMdW t.s NW.ObwPia WA lsss2 ""M F'=p"014as immummulamO R C A�l AMJC TW�MWGItM AN� MA- 4 r L z 3. Maiowmme 'o""� -. S. �da�roa6. T.a s Pbmw G fps C SL Ea S+onx wA 95362 FA A GS ino" Jt. Address~ 16214 31*Aremrc Stpae A 03-54-3011 • Samoa WA 93375 Tic 2S3-i36�g D. Stte A�dtreas: 1229 L Cohmbis SL .Fort Ps ax or 1MA 2 Com Parson. Q mo4ft wNo.ofSmr upe� 3 hese Aobrslos Snrsey m FoUW? 3-1-04 ' ,au.weaa,ns�aar ..ras isaoworsnar►- Na: 3oos012 —X-P ass xoft >: ncsoNtioo -No.ofSkacbmW. soraliar -i Dow0 F as icmo6eio.`°°Rmar°r lkm9�ip� N�u�slws�wrw�R�Y•oh�wl�/�i�j�,y��yll�+aw��s�/1N��r DowbTfin C01fh'meloo/". Pbmm Ci" Asbelfts NO,ors (sae SWKDala ( back 1�3) 1 3`�$� �jC Sa sn l.brasstlaae � wmm 3 am-4 pm Total w be Romorv�ei336 Foot Ikoerr Feet �1 ala articarrstenerist Die by Thamw lesatadoa las Deet Ira. >+� p`� Yes ON* S lMlatl Pias Ptasaer Todsod 06W' I ase Mat's: 1-MM Ba p son 1„�'l • s7i T/ ' I�IdREAltlffafli E' 1. 3. lass thrn!0 l>near loot or =?S 4. 10-259 lloear fba os I i-IS9sawn holiorsee StS 5 Q9 260-999 feat or 160-4 999 IUML 6Dmz � t 000-9 feet or S -49 10 W ' 7. 10 lineatr lbet ar 3000} 10 W • SSOD 8• teamit S1OpiD 9. 00v comes !riot b Yaar 10. fee for 1 std 3+ricr L i de bseby twit arc m e isl6ta msft Cobb"in 0*0xwosliora si Poor No6oc daartbad bogie.t+r a►ae ecu of�bnocrladaraeeoeree and 1 dIY tayscat�zrei „ °c Pe°!�ar deanlldoo seRcifier tti laaiw oeoi t laltlsue+Aeordbw ue�•rsea.� Z .elepsai 'PMe�n°b gain`tom"&M lteshaieibg-. r �w�airl�to"fer: � s'd'c�a.e+eV1r�sediei,s i.�ta,tisMsms .s.scs Aaousr r-a4, Aft.34%2w A Labor and Industries NOTICE OF Industrial Hygiene CaumpRawa . ASBESTOS ABATEMENT (Regional addresses and phow PROJECT nw nbem on page 2) THIS NOTICE MUST BE RECEIVED NO LATER THAN I0 CALENDAR DAYS PRIOR TO THE START DATE. COMPLETE ALL APPLICABLE BOXES4womPLETE OR IIT ABLE NOTICES WILL NOT BE ACCEPTED MAIL OR FAX TO THE REGIONAL OFFICE–CIRCLE CHANGES ON AMENDED NOTICES Node a Date: 3/19/04 Imdai ® Am m&d ❑ Site W=k Boors So 1140 To We Th Fr Sa 8 An 1130 am X X X X X Start DO-- 3-29-M on bold ❑ OffH�I❑ to 4 pm 4,2-04 ❑ Project Dates and Work Homs must be exact zt — 9 ):Yjkla CONI'RACI'O PROPERTY OWNER compimyWame F.S.and GS ServkM Imo. ICmt Coamatuor Ca d ication Nnmbw Ow mes AgeMt -- 1022 Northe i lghmaW Hygjw,hic. Panted Nim Adm MiCIVA Lawrence 1229 E.CobwdAn SL Phone Numbs city State Zip ' 153-548-1011 PwAsift WA 98362 .lob site C.A.S. Phare Number pouzMenscidng JOS SITE FAcnxry Adam Type 1229 H Co1eu"SL Residential DwIdiog Name Room Age Size 50+ 1400 sf city Remodel U Demolition Part Angeles WACOWAY Rqxdr r Zip+4 CLliom ® ❑ Mix IIANTITY OF ASBESTOS TO BE: RBMOVED U ENCAPSULATED Boller COMMOL b1EASURES [I Popeorn Cis DM paper Neg.PM&Emdocare wrap&cut CAB 0 VAT Gkrm bag wet methods Sheet viral on wood Roofing Mini cnelosore A gkA vactwin Asbestos paper Other (kraamc tile`sink 0 critical Barriers Maud moods Quantity linear feet 0 Otber Oeizex Mag Pipe insdafion Ll Cement asbestos pipe RESPBUTORY PROwenON Ll Air cell pipe insnlstioa LJ Mudded pipe ins A mask APR U Type C c ontinoans flow Ll Duct eWduet instdation El Dud tape Ll Fuff face APR 0Type C presme denm d Ll Other Otba 0 PAPR 0 Colter i F4 9 �J^,/�\ -� FAXFA: TIML• 02Il? y AM INDUSTRIAL HYONENE, INC, Billings,Montana Helena,Montana Seatle Washington PROJECT CLOSEOUT REPORT Service Master of the Olympic Peninsula Melberg Residence 1229 East Columbia Street Port Angeles,Washington 98368 REPORT Melberg Residence 1229 East Columbia Street Port Angeles, Washington 98368 PERFORMED FOR: Evelyn Brown Service Master of the Olympic Peninsula P.O. Box 69 Carlsborg, Washington 98324 ASBESTOS ABATEMENT CONTRACTOR: F.S. & G.S. Services, Inc. 16214 57th Avenue Northeast Puyallup, Washington 98375 CONSULTANT: Northern Industrial Hygiene, Inc. 215 SW 153'' Street Burien, Washington 98166 5/26/2004 Project# 227-002 i INDUSTRIAL NYGIKNE,INC. Billings,Montana•Helena,Montana•Seatie Washington EXECUTIVE SUMMARY Service Master of the Olympic Peninsula Melberg Residence 1229 East Columbia Street Port Angeles, Washington 98368 Project#227-002 On March 290, 2004 the project began by Lance Kiblinger of Northern Industrial Hygiene, Inc. (Northern) arriving onsite meeting with the contractor (F.S. & G.S.). After reviewing the scope of work and schedule with the contractor the contractor began mobilizing equipment and supplies. The contractor began the project by demolition of interior walls removing the material as general debris. While removing wallboard the vermiculite insulation was placed in plastic bags for disposal as ACM waste. The contractor placed critical barriers on all windows and doors.Negative air machines were placed throughout the structure venting to the outside through windows and doors. Scope of work for this project was to remove all interior walls leaving the wood studs, remove all vermiculite insulation and ACM flooring leaving the sub floor. The reason for the interior demolition and flooring removal was due to a fire that caused damage to the entire interior of the structure. The first part of the week was going to be removal of all non-ACM material which would be placed in large containers placed in the back and front yard. The contractor supplied the containers and each one was picked up daily for disposal. During the ACM removal process the contractor will use personal protective equipment, and HEPA vacuum along with water. All debris generated during the project will be disposed of at a certified land fill site. Once the area was cleaned of all ACM debris an encapasulant was used to seal the interior of the structure. The tub is the only fixture left in place and was cleaned after the project. All work was performed in accordance with applicable local, state, and federal regulations and was completed without incident on April 2°a, 2004. Lance Kiblinger of Northern performed all air sampling and over site of all work performed during this project. Upon visual clearance, Mr. Kiblinger collected air clearance samples. The results of the clearance air sample were below the EPA established clearance level of 0.010 f/cc. Based on these results as well as visual clearance, the area was released for re-occupancy. All air samples taken were analyzed utilizing the NIOSH 7400A method This document is meant only to summarize the project performed at the Melberg Residence located in Port Angeles, Washington. If you have questions regarding any of the provided information,please do not hesitate to contact our office at(206)988-1746. Respectfully, Lance K.iblinger, Project Manager _. Northern Industrial Hygiene, Inc. ' I F�On� ^win —2'C"> ———B-Q, ——— — 1 406 f E. _ERFth�SPA-u= 1RD9 �- i. —— —— — ——— — —— —————— 07 12 X 6 CONCRETE FOOTING 3 X 36 CONCK6TE 5TEMN,'ALL I I ',7#45ARCa48"OC VERT _ 'JJ/(2)_=5AR CONT. x ^ (1)HOF.TOP BKK a 1/2 X 10 A 5.W/a,. r' W/,5�ER X 43"O.C. _ O I ' o ril I ' -- - T-0" -_ ---. ---T-0" -- "-'----- 7-0"---�- ---'—7-0t$--It The lssva, i ..._ _ � � cations an, from there, 4 X 12 G==2 BEAMS _ _— _ Plans,spec j, re m- --------- - - --- - ------ -- - - - -- --�r.,8 buildingo - :Jnof(SECTION Of' te Li C12AWL 5f ACE 997 oq ft i - 7-0" 7-0 -- -- 7-0° - �'-0" _ - - -- - - 4 - - -- - - Ze _ --- X12 : 28EAM5 _ �_ _ '-� - - --- -- - -- ----- 24 X 8 CO:CKETE PIER IAD - � d A. "3)#4 BAF E.W. �y 1 V. =X 4 Dr#2 P05T ON ASPHALT 5HI 4C-_E 1 N i &'05.CONN.9 P05T/SEAN;; I ' { 44.1 s b /L n_ ✓ /// ppp ����L y�p f7 X05. M__ ii �� __ • 1 drh 'c F_ cY.Tr-Ws"'.'.� ✓ ! --1R'� i l 16X5FOUNDATION VENT i .77 NFSF ACH;TYF.=Op - -— — MIN.9 FEOUIREE) — — —————1— — `— — — — ---— -'--——_9C————— ——— — —— ——— — ——— — — —— 1408-— -"— FOUNDATION / SUBFLOOK FLAT I I J i I � I L I I I I � I L ------------ ,I _ I- C I REAR NORTH 1/4" - 1' f FRONT- 5OUTH 1/4" = 1' RIGHT - EAST 1/4" = 1' GE'jEPAL NOT-5: AFEA�: 50.PPT. =--PIOR NOTE5: EMERG- LEFT- WE5T 1/4" = 1' i i CONT'.—U61 R:cGE'iEr.- —— —— — ——— — —EX15`iNG GLULA,','SEAM 0:12 PITCH I - I 5 she,- R-'S iN5ULATION �.L ROOP SH.THING w/ted: To \ i - X45LOCKIrr �EPNEEN rRL 5 R TO 2XFl, sC+. Ci �?L55/WP.LL N CTION: i � N 3,16d NAIL, ., 1 H., 'ER TRU55 ' t OVERHA.- 1 50FR j 2X+5XK,,F F W GARAGE - < 29'0"x WW z04 2 X 6 15 C..:;. 4X6 ,NG r/16 HE.T', RI5TING(AG-EJFefED) EX15 fNG:(AS UME.` e'H?PPI Arrc 12 X 16 MONOL!-HIC FOOTING I 3 1/2 C CNCRETE 5L.=.3 W/(3)k4 5AR�ONT. OVER SAND &1/2"X 10"A.S.2 48"O.C.8.VIN 12' 6 MIL.POLY.VAPCR RRIER - OF EACH END-F MUD5ILL I COMPAC`FILL A5 NEEDED 1 2 r. 6 UND'5T'R5ED NArl'.-SOIL OV FR C MIL PC ' APOR 5ARP:_R I u COMPA;, ,NATIVE 5CIL I 12 X 15 hi-.OLITHIC G^?ICR_z FOCT...•.0 CON': I CR055 SECTION 1/4" - 1' -- ----- - - - -- -- 3068 ----- -- -- 30'-01, ---- MAIN FLOOR PLAN �PORr�� CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Application Number . . . . . 05-00000467 Date 6/13/05 0 Application pin number . . . 078407 i Property Address . . . 1229 COLUMBIA ST ASSESSOR PARCEL NUMBER: 06-30-00-5-3-0175-0000- Application type description RE ROOF Subdivision Name . . . . . . Property Use . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY J` V Application valuation . . . . 8000 V 1� Owner Contractor L/ ------------------------ ------------------------ CIACIUCH, JAMES W. REDI-CONSTRUCTION 113 SOUTH VALLEY 1032 E'. 4TH PORT ANGELES WA 98362 PORT ANGELES WA 98362 ( 36) 417-1110 (360) 452-4582 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT - NO PR FEE Additional desc . . TEAR-OFF,SHEET, FELT, COMP Permit pin number . 51730 Permit Fee . . . . 176.75 Plan Check Fee .00 _ Issue Date . . . . 6/13/05 Valuation . . . . 8000 Expiration Date 12/10/05 Qty Unit Charge Per Extension BASE FEE 92.75 6.00 14.0000 THOU BL-2001-25K (14 PER K) 84.00 , Other Fees STATE SURCHARGE 4.50 ---------------------------------------------------------------------------- Fee summary------ Charged -- Paid Credited - Due ----- ---------- ---------- Permit Fee Total 176.75 176.75 .00 .00 .ccs Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 �. Grand Total 181.25 181.25 .00 .00 V� 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 athorized Agent Date Signature of Owner(if owner Is builder) Date T\Policies\1 102_15 building permit inspection record05 wpd[1/4/2005] BUILDING PERMIT INSPECTION RECORD 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. ITIS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY 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 FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS PIERS POST HOLES(POLE BLDGS) PLUMBING UNDERFLOOR/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 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./PW/ CONSTRUCTION-R.W. ENGINEERING 417-4807 PW/ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT. 417-4750 PLANNING DEPT BUILDING 417-4815 V L� 1 BUILDING T\Policies\1 102_15 budding permit inspection record05 wpd[1/4/20051 f _ 13-- v�"� ��� /�'.%,�, � ��S-fi�e.�..�-� ter-► TUS LAC COD S �j Y vt r ��d PREPARED 6/14/05, 13 35 55 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 6/14/05 ------------------------------- - ADDRESS 1229 COLUMBIA ST SUBDIV CONTRACTOR REDI-CONSTRUCTION PHONE (360) 452-4582 OWNER CIACIUCH, JAMES W PHONE ( 36) 417-1110 PARCEL 06-30-00-5-3-0175-0000- APPL NUMBER OS-00000467 RE-ROOF --------- -------------- ------- PERMIT: BNOP 00 BUILDING PERMIT - NO PR PEE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS --------------------------------- ------------------------------------------------------- BL99 01 05/14/05 JLL BUILDING FINAL 06/14/2005 01 15 PM JLIERLY ---------------------------- 460-9491 -------------------------------------- COMMENTS AND NOTES -------------------------------------- 0f0RT,*FAN CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Ra� Application Number . . . . . 04-00000872 Date 9/28/04 Pin number . . . . . . .644904 Property Address . . . . . . 1229 COLUMBIA ST ASSESSOR PARCEL NUMBER: 06-30-00-5-3-0175-0000- Application description MOVING PERMIT Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ CIACIUCH, JAMES W. NICKEL BROS. HOUSE MOVING LTD 113 SOUTH VALLEY 2060 MILLS RD PORT ANGELES WA 98362 VICTORIA BC V8P2K7 ( 36) 417-1110 (866) 606-2237 ------ Structure Information MOVE FROM 324 S RACE TO 1229 COLUMBIA ----- Construction Type . . . . . TYPE V NON-RATED Occupancy Type . . . . . . SINGLE FAM & CONGREGATES ---------------------------------------------------------------------------- Permit . . . . . . M- MOVING PERMIT Additional desc . . 324 S RACE TO 1229 COLUMBIA Permit Fee . . . . 115.00 Plan Check Fee .00 Issue Date . . . . 9/28/04 Valuation . . . . 0 Expiration Date . . 3/28/05 Qty Unit Charge Per Extension BASE FEE 115.00 _ -----------------_---------------------------------------------------------- Other Fees . . . . . . . STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 115.00 115.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 119.50 119.50 .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 ave read and examined this application and know the same to be true and correct. All provisions of laws and ordinances gover 'n is pe of work will be complied with whether specified herein or not. The granting of a permit does not presume t 've a o iolat or cancel the provisions of any state or local law regulating construction or the performance of constru on. n �, Signatu i of Coo/tractor or"Ailhorized Agent Date Signature of Owner(if owner is builder) Date T\PLANMNG\FORMS\1102 15(11/14/2003] SEF,';I� 'hfi1 0%;40 �.1� CiT'l OF PA E�LDt:, DEPT F"-'r: N. �K 41" 4"11 roxrx� HOUSE MOVING APPLICATION and PERMIT CITY OF PORT ANGELES-BUILDING DIVISION PERIJIT NO. The following materials are hereby provided in application tot'a House Move Permit: 1. Name of applieatit:�l� � I'�rl�S J��)r)�P /� )✓ln/�r r 2 Address of Applicant:_ ;jQL1 t-le ire nn _) �, �Q in �1�>r _y�l 1j 11 3 -Telephone ot Applicant:bl.0-3-18- t___ — tate-of proposed moue and duration.-0daber6,aioLAoav-A-%apt 4. Name of insuranpe company and agent a:d copy of certificate of insurance: 5. Original location(address)of building,�3 LA e r_ � �n�i &�Ie��if1._ Legal description of original location of building' 6. New proposed location of building I ('c�lUrv�bia y 03r+ 1 o (me'<2 _ yy R__ Legal description of new proposed location of building: ____ T Route to be taken from old location to riew location. PeALL } 5ht nv-, G.coli�eft p"e� eis -'p5h1 or Columb:o�. 8 Description of current building,_�1 � ^ 9. INfit e-n confirmation that the following have been contacted including individual's rl,ame, telephone and date. AGENCY _ _ CONTAC IF PER ON — �1AT PHONE NO Palre De artrnent Fire Department �Il� ' y(9J�)� Pu01;c Works Engineering tzar Signals,\,Vater,Sewer a Build] Division ep Cr Gi `tt Da artment 77 1) LLY / 04140 470(— ®(—�I U S West Communications Wave aroadbandTelecable Othars,State Dept.of Tramp, `I I heraby acYnowledge that I am raspopat ato inp.irivs,aaniagas,and any expensee Ptcurrad by the Cdv or cther ageneses during 11'a moving of*his structure and that the structure is to ere tired to minirrrum Building Code r6yulremcnts at its new location and ruddy fei u�6 within one(1)year from Ihz: date of mciAng the structure. In c nettle ion of the granting of this permit,it is furlres agreed by the applicant that the City of PA Angeles gird any of its officers cr em ees 11 d har IasS to the applicant from any isiblllty ot responsibility for any accicerit,loss or dartzge to persom or p.upert,r, happening oc,u np' tt roxlmat rt>suit of any work undertakan under the terms of this appiicat(in and the pefmil or parrnit5 which may be giani6d in respo a the 0,a` t I a lities arra heraby assumed by the appilca-A Slg atur Date �{-t '"*OFFICIAL USE ONLY:'*' Data move took place,,__6 Treasures s Receipt No Bldg,Permit# Right of way Corstr.Permit# Damage and or nncidente on route and comments.____ Or ginai Site Rest"bon compiatcd: Date ok for u:x,t,Pancy._ Refund Date: Refund Amount.,`,-_ ChEck I1c _ APPROVED BY BUILDING INSPECTOR: _ DATE:— BL-1 105102 ATE:—BL-110502 [1102) 11/11/2004 16: 36 FAX R002/002�,_ •,of pOFrq^,Or O ,r.7k oa9n,J.'JSr UT:Y ELECTRICAL PERMIT APPLICATION y6 D'p`i"v C' D9,L- dred-- The Electrical Permit Application must be filled out completely. Please type or reprint in ink. Ryou have any questions,please call(36D)4171735 I a Fax number: (360)4171711 L� p Owner or Elec.Contractor AgenL•,7��11 f1j jMP FLr�!iR 1Cf+LP ON l ,qt`,p NG ll.:iC. Phone: 452'lK$�1 Fax: . Property Owwpner: , - �U L C f Phone: `�S 1—�r'td� Address: U 2,� C(il✓dI L tti L S"�"Ce-'� city: PO Rzip: 906�11 _-, �i73n1P�co23a3 : ElecMcal Contractor. 2411 13-CL, eI.H°YL(A'LCpeCj2'}t71tiE. ]kIC License Exp: j CH Phone: �Q., (bn Address: iso X 38?) City: PC1-F Atv t r1tS _.µi 9• zip: qs3LrL- INSTALLATION WIRED BY: ❑OWNER Y ELECTRICAL CONTRACTOR Credit Card Holder Name: h1.0K Vv �uflTY1V Billing Address: G,t11" 0 Yt + City: SEI" ANf $ A Zip; Credit Card Number., VISA; MC: PROJECT ADDRESS: I Uq CO E-�YY In— TYPE TYPE OF WORK: Check all that apply: ❑New O Alteration/Addition t GC �11\Residential (7 Multi-family ❑ Commercial ❑ Mobile Home Sq. Ft CI Remote Meter ❑Detached garage ❑ Hot Tub ❑Swim Pool ❑Septic Pump ❑ Low Voltage C]Telecom. O Sic Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT: qc—v Electrical Heat Load Additions and or Subtractions Service Information o Baseboard _ KW Voltage:__ o Furnace _ KW ❑Overhead Service Phase: O 1 n G Heat Pump TON LRA 0 Temp Service Service Size: Fl Fan-Wall KW 0 Underground Service Feeder Size: I hereby certify that I have read and examined this application and know that same to be true and correct, and I at authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants responsibility to determine what permits are required and to obtains ch. Credit Card Holder's Signature: .+^ �--I-moo• Date: 2t C�- Owner or Elec. Cont. /Signattuure: ��✓�- C Date: ` W f t G�G� V 1(<` E A7MCN&D /WAWflo ' t C:lELECTRICALPERMITAPPLICATION "tf,,,JiPERMIT FEE: �� , Fa'u or/ Par/S-Ir — Ole.T92ENet+ 772; POLE- L)A II--r , -ja�,�, i ELECTRICAL INSPECTION �e ® MRING REPORT 417-4735 CS �T 11GN DATE PERMIT 1 INSPECTOR x o� O-/ 8 146 A� QYPNEP/CONTRACTOR ADDR SS APPROVED NOTAPPROVED ❑ . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . ❑ Cl . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . . ❑ ❑ . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . ❑ ❑ . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . ❑ CORRECTIONS NEEDED: / % / �f5eeO IQ A07-PGE 1 /.- za NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS — DO NOT REMOVE — OLYMPIC PRINTERS,INC.(38M 452-1381 ELECTRICAL INSPECTION ® WIMNIG REPORT 417-4735 car-i DATE PER A INS77 0 f5 OWNERICONTRACTOR AD DR" }SS APPROVED NOTAPPROVED ❑ . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . ❑ ❑ . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . . ❑ ❑ . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . ❑ ❑ . . . . . . . . . . . . . . . . . . .. FINAL . . . . . . . . . . . . . . . . . . . . ❑�� /�� /� CORRECTIONS NEEDED: M !�D c, x-'1'1 0 1 &AtelX WA NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS — DO NOT REMOVE — OLYMPIC PRINTERS,INC.(350)452.1381 ELECTRICAL PERMIT °3 CITY OF PORT ANGELES 't d 360-417-4735 Application Number 14-00000404 Date 4/02/14 Application pin number . . 663600 Property Address . . . . . 1229 COLUMBIA ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-5-3-0175-0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name . . . . . Property Use to the City of Port Angeles Property Zoning . . . . . . RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation . . . 0 -- -------------- --- - - APPlication desc - New wiring and expired permit Owner Contractor ANDREA MOTYKA & TAMARA SMITH EXTRA MILE TECH & ELECT., LLC 1229 COLUMBIA ST 418 N. RACE ST. PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 477-5170 (360) 457-5222 Permit . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc 1-4 CIRCUITS Permit Fee 75.00 Plan Check Fee 00 Issue Date 4/02/14 Valuation . „, 0 Expiration Date 9/29/14 Qty Unit Charge Per Extension BASE FEE 75.00 Fee 'summary Charged Paid Credited Due Permit Fee Total 75.00 75.00 100 100 Plan Check Total .00 .00 .00 .00 Grand Total 75.00 75.00 :00 „00 INSPECTION TYPE DATE: RESULTS INSPECTOR: DITCH SERVICE ROUGH-IN J J FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date, G:\EXCHANGE\BUILDING NF Pi (f t wzas� _G a l' CITY OF PORT ANGELES PERMIT APPLICATION ' � �� � �� "r ��" �,�, , gra aim y,a �, Building Division/Electrical Inspections 321 East Ph-(360)41fth Street—17 4735 Fax:(360) Port A (36)417 471AngelesWashington,98 03i Date: ..f ^: I SingleIl"arnily fiwell'in, 1 E,(' ����M Plan Review May Be Required,Please,Comglefe Electrical Plan Review Information Sheet Job Address: Building Square Footage Description of Amu �� ,.�:�-����,r, aw.. �a r��.� r'ri.� �°a. ��a;P r'":.)r!. Owner infomiati n ` Contractor Information Name: �, ✓" �.. ,., ,,. ,.�. . ....� PMaiiingAddress: .. lnddrsst Ch e C zip: ne. Phone; License#/Exp. License#/Exp. w� Item gait1a, 9�C T r'lpt t-M Ifilrrtted by tfntt Ctlaraei ServlcelFeeder 200 Amp. $120,00 $— ServicelFeeder 201400 Amp. $146.00 $ ServicOeader401-600 Amp $205.00 Service/Feeder 601-1000 Amp. $262.00 Service/Feeder over 1000 Amp. $373,00 $_ Branch Circuit W1 Service Feeder $ 5.00 Branch Circuit W/0 Service Feeder $ 63.00 Each Additional Branch Circuit $ 5.00 $ Branch Circuits 14 $ 75.00 i $ Temp.Service/Feeder 200 Amp, $ 93.00 Temp.Service/Feeder 201400 Amp. $110,00 $.._....... Temp.Service/Feeder401-600 Amp. $149.00 $-- Temp. ,-Temp.ServicelFeeder 6014000 Amp. $168.00 $- Portal to Portal Hourly $ 96.00 $ Signal Circuilf Limited Energy-1&2 Family Dwelling $ 64.00 $ Manufactured Home Connection $120.00 $ Renewable Electrical Energy-5KVA System or Less $102.00 $ _. Thermostat $ 56.00 $ Note:$5.00 for each additional T-Slat KEW CONSTRU.CTION ONLY. First 1300 Square Ft. $120.00 $ Each Additional 500 Square Ft.or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $-— Each _ Each Swimming Pool or Hot Tub $110.00 $��� $ , . Total Owner as defined by RCW+ 19.2&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 irtsking the electdcal installation or alteration in compliance with the electrical laws,N,I,C,,RCW.Chapter 19.28,WAC,Chapter 296 465,The City of Port Angeles Municipal.Code„and Utlllty Specifications and PAMC 14.06,050 regarding Electrical Permit Applications. Signature of owner,electrical contractor or electrical administrator: ❑ Cash ❑ check r ❑ credncard#—— .. +� oatsd: .e ..:/R _... 0110112012 S c� 0 Extra Mile Tech & Electric LLC 418 N. Race Street 1101, ------_----- ........... .. ...------ ----...._ 10 DAY NOT CE� OF PERMIT EXPIRATION DATE: April 29, 2015 ADDRESS: 1229 Columbia Street PERMIT NUMBER / DESCRIPTION 14-00000404 Electrical — Residential The above referenced permit(s) is/are about to expire. Please call 417-4735 within 10 days from the date of this notice to arrange for one of the following: 1. If work has been completed, call to schedule an inspection. 2. Request cancellation of the permit if work was never started. 3. Request an extension if work is not complete. City of Port Angeles Electrical inspections - (360) 417-4735 Thank you for your cooperation Trent Peppard Electrical Inspector vcr�ar,� ELECTRICAL WIRING r r� 417-4735 �hit. � 0"ICnN�iI'i�� p7m.7c7ur, Olffil"JI T',7,P i FTn 1117 .................... ......... �...� .._ ........��_ .W_...��....�..........�. ADDIR:ESS APPROVED NOT IF'I E 0 . . . . . . . . . . . . . . . . . . . . NN...rui . . . . . . . . . . . . , . . ,. „ ROUGH NNS/COV R . . . 0. . e . . . . , . . � a . , . M . . . . EERA E . . . . . , 11 N°;;;;;,N . . , . m ry , a . NNN,,,,. , , CORRECTQNS NEEDED:: NOTIFY INSFNEc r M-111EN CORREC TIONS