HomeMy WebLinkAbout1717 W 15th St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DfVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
08-00000447 Date
279109
1717 W 15TH ST
06-30-01-6-9-0160-0000-
LYNDA POZARZYCKI
RE-ROOF
4/16/08
RS7 RESDNTL SINGLE FAMILY
4998
Application desc
TEAR OFF/INSTALL COMP
Owner
Contractor
LYNDA L PO ZARZYCKI
1717 W 15TH ST
PORT ANGELES
(360) 417-0288
WA 983636848
COZI HOMES CONSTRUCTION INC
324 E 9TH ST
PORT ANGELES WA 98362
(360) 452-9906
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
BUILDING PERMIT - NO PR FEE
TEAR OFF & RE-ROOF
124677
137.75 Plan Check Fee
4/16/08 Valuation
10/13/08
.00
4998
Qty Unit Charge Per
Extension
95.75
42.00
BASE FEE
3.00 14.0000 THOU BL-2001-25K (14 PER K)
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 137.75 137.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 142.25 142.25 .00 .00
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Separate Permits are required for electrical work, SEP A, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
"- (;- 0 >-,-
Date
Signature of Owner (if owner is builder)
T:Forms/Building DivisionlBuilding Permit (10101/07).wpd
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. IT IS UNLA WFUL TO COVER, INSULA"[E OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
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INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLOGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS I GIRDERS
SHEAR W ALLIHOLO DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULA TION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY FINAL DATE ACCEPTED BY:
COMMERCIAL HOOD I DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT "'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSI'ECTIONS REQUIHED I'RIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YI~S 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 Ii~- z.~ -0 Jt :T Ll-- BUILDING
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T: Forms/Building Division/Building Permit (10/01/07). wpd
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Item
Tearoff
Roofmg & Materials
Description
Remove existing roofing, hauling'& disposal of
debris.
Apply 30lb felt, 30yr Architectural roof shingles,
(says use 3 tab on paper work), new roof vents, drip
edge, metal flashing against walls and skylight.
Subtotal
Sales Tax (0.0%)
Total
Thank you for the opportunity to bid your project
. .
Total
1,450.00
3,548.00
$4,998.00
$0.00
$4,998~00
BUILDING PERMIT - APPLICATION
FOR OFF1ClAL USE ONLY:
DateReco:~- I b -0 2
Pennit #: C> 9.; - 4 Y r
Duw Approved:
Date Issued:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMI'LETE to be accepted for review. lfyou have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent:
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L7' "uA-A p"z.". r"ZYck+
III? LV /5o-f-k-
Phone:
Owner:
Phone:
L( .c;:;;L 190 0
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Zip: ? ~t:. ~
Address:"
City:
purr- ~~k~
Phone:
~ ~ Phone:
! (( 'P'
ZONING:
~
ArchitectlEngineer:
Contractor C 0 :Zor.
Address:
H--~s
State License #: ~-'i )
City: {/ A-/
UJ /5
PROJECT ADDRESS:
'11"
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
_ l).!E OF WORK:
~esidential D New Constr. ~e-roof D Stove
. D Multi-family D Addition D MoveD Garage
o Commercial D Remodel D Demolition 0 Deck
o Repair D Sign D Other
BRIEF DESCRIPTION OF THE PROJECT:
V-b-U :3.o#-';? n.../J~ f
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ftf, '1'1'2(,-~
SIZENALUATION:
SF. @$ /SF. = $
SFo@$ /SF.=$
SF. @ $ /SF. = $
TOTAL VALUATION $
"Te-Kf eM=- Ex.; <::, + RaL5'}=(~
~..) y~r 14-1-+. :ed~ .
"F'
R.... f ~"
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size: Existing Sq. Ft.
Total lot coverage %
Occupant Load:
& Proposed Sq. Ft.
Construction Type:
= TOTAL Sq. Ft.
PLANNING USE ONLY:
APPROVALS:
PLAN:
BLDG:
DP\VU:
FIRE:
OTHER:_
ESAlWetland(s): DYes 0 No SEP A Checklist required? DYes D No Other:
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417-4815 for assistance.
. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: IiE-o 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 .
RI05.3.2 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 iUs my responsibility to determine what permits are required ,not the City's, and that I
must obtain such permas prior to WOrl</:;;? / .
T,\FORMS\BIdgP=ilif~.wpdAppli<=t /U"'VI 4-_ 3~ Date: Lf - 11- 0 Y