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HomeMy WebLinkAbout430 W 2nd St - Building Clallam County Assessor Treasurer Property Details 56042 RICHARD AND MAR... Page 1 of 1 Clallam County Assessor Treasurer Property Search Results 56042 RICHARD AND MARY SMITHTON for Year 2011 2012 Property Account Property ID: 56042 Legal Description: LOTS 7 8 BL 50 Geographic ID: 0630000050300000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 65 Open Space: N DFL N Historic Property: N Remodel Property: N Multi Family Redevelopment: N Township: Section: Range: Location Address: 430 W SECOND ST Masco: PORT ANGELES, WA 98362 Neighborhood: PA West Comm Map ID: 2 Neighborhood CD: 5155000 Owner Name: RICHARD AND MARY SMITHTO Owner ID: 53241 Mailing Address: 220 MOONLIGHT DR Ownership: 100.0000000000% SEQUIM, WA 98382 Exemptions: Taxes and Assessment -tails l (6 101, a` Values Taxing Jurisdiction Improvement Building Sketch Property Image Land Roll Value History Deed and Sales History Payout Agreement Website version: 9.0.32.2200 Database last updated on: 6/26/2012 3:48 2012 True Automation, Inc. All Rights AM Reserved. Privacy Notice http: /websrv8.clallam. net propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =56042 6/26/2012 4 CITY OF PORT ANGELES .At DEPARTMENT OF COM MUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 VI Application Number 12- 00000438 Date 4/18/12 Application pin number 699700 Property Address 430 W 2ND ST N 4 ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -0 -5030 -0000- REPORT SALES TAX Application type description COMM REPAIR on your state excise tax form Subdivision Use iU Name t Property to the City of Port Angeles r Property Zoning INDUSTRIAL LIGHT (Location Code 0502) OP Application valuation 1000 Application desc ■e141e NEW DOOR /REPAIR 0* Prope at tt Owner Contractor FRANKLIN TTE RAY M /JUDITH D OWNER RAY M FRANKLIN RETRMT TRS PORT ANGELES WA 98362 Permit BUILDING PERMIT COMMERCIAL Additional desc REPLACE DOOR REPAIR DECK Permit Fee 65.25 Plan Check Fee 42.41 Issue Date 4/18/12 'Valuation 1000 Expiration Date 10/15/12 Qty Unit Charge Per Extension BASE FEE 50.00 5.00 3.0500 HND BL- 501 -2K (3.05 PER C) 15.25 Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 65.25 65.25 .00 .00 Plan Check Total 42.41 42.41 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 112.16 112.16 .00 .00 ftVIaI 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 an rate or local law regulating construction or the performance of .construction. I. Y /2 )4 /2 /I inlorin i f Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) 'T:Forms /Building Division /Building Permit Uit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 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 Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts FINAL Date Accepted by 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 D Electrical 417 -4735 6 �J Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 (p �a (LLB T /Riiilrtinn Ilivisinn /Ri iilriinn Permit N N H w w C F U a q 0 O 'O ro v ro 0 0 0 ro 0 0 N w O O 0 0 .0 0 a u G 0 45 -H 0 m 0 H H U A t U F qz z x a .0 wco moo w ii f1 a a U c F a N 0 F rj o u M 0 +n 0 z o z oa <r 0 0 H Q Ul d� O C F F F 0 (0 U U 2 0) 0) 0 w w w M 0 M 2 a CL (0 N N N 0 N 0 w 01 cn 2£ H O H w H O E Z z o o a o o a o I 0 H H 0 H U N /-C N r` 0 O F\ Z r- H 2 0) U 2 V] F d' 0 H d' x H F 0,H 0 0 0,0) H p 0 q [7 4 4 0 .0 0 0 0OH 00)01 n>.> C Cq CJ O o< 0, w a N w 0 0 a 0 w hoa 00: !A(0 (h(( h( o w E o H N O F 0 o n o W W N U a N F 0, o z o w E H o0) 0a aq v q a M 0) z zoa 9 V N H O O a O O a q 0, 10 N N N Nw ZMO ZIFF r H H C7 0 N w M t0 N O w a H H l0 S J 0 2. o 01 O .7 a. M O O O an E w O in 0 io U 0; U 0 •x a a o w w q F a0 a� az E O+ 0 0 a r g 2 0''wua H m m a U g U O a< 0) E aW f0A LO N H m N W W a a q V 1 s x U H N N F 2 H g 2Z .0 u) in 1 t u x aa o LL C H z U F a 0 0 z F F V n� e a i U U Z 00 0 N S [4 41 w r, z a s 0 0 W HH 0 a z00 O Y Q P4 H H //\��1 x H N W H H i t 000 0 H ll lll�� �l C:1 o U 0 0 Q N 0 boa i q w ro£ o0 E 1 a F o H o X N r 0 0 0 000 U W N N W 0 0 0 O 1 H 0 Z zoo og N (1) H00 3 x00 0 0 0 0 0 0 0 0. N0 W F N H H O 0 Zi 00 H p< cN O O H 0 00 M 0 00 F W 0 0n 0 0 0 UAL) o •x •w a a 0 0 fA 0 a' O 0...4 0 0 00 H 0 0 0 F O 2 Z a a 0 a 0 a U g O U o a a 0 F 0 6.p❑xr4,tc! BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES or Attn: Building Permit Technician For City Use Only: Date Received S.Zmmir 321 E. Fifth St., Port Angeles, WA 96362 Permit 1 (360) 417 -4815 fax (360) 417 -4711 Pate Approved 3I 1 Applicant a�c, Pho 83 4 r 5 Property Owner (J, y Pho e 601 ill ©O Property Owner's Address Contractor K-3 3 AL, .1 4ett, Phone 93 4o 93 Contractor's Address 49, n ,e0 `3f335 xa.e- vl, I.�r¢ 983$ License K3 C Nc q+g IG- Expires l /7 f �a E -mail K 3caN§I parTT'iau 8 evakvk N Efi PROJECT ADDRESS 430 W 40 li Port A4 a w-a, 9$36,2 Parcel Number Lot Zoning 11- Project Type Brief Description: Residential Multi family XCommercial Industrial Check all that apply NewConstruction RECEIVED Addition Remodel APR 1 7 2012 )(Repair Demolition CITY OF PORT ANGELS Re -roof House garage other tear off re -roo N Heat System Heat pump wood- burning stove gas fireplace pellet stove other o Other Floor Areas Existing (sq, ft.) Proposed (sq. ft) Basement eame, /ao0, OD per sq, ft. 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck 6'$(6' replaee De c-16:ticl total is ci btve. Shed ON eK Stiyci ecK Other Rouke NrrC o1O t5T 1 6k h9 l yam ,t V \j� 7 TOTAL VALUATION Q ©D tile Total footprint of structures Same J sq, ft. "r Lot size N iAC t'�Cs 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 Nome_ ft. Occupancy group of bedrooms Will a lawn sprinkler system be installed? Occupant load of full baths Will a fire sprinkler system be installed? Construction type of half baths I have read and completed this application and know it to be true and correct. 1 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 t. orking on pro'ects. Date '`�/1'�f lv'� Print Namekdrby ONG e Signatur I T:Forms /Buliding Division /Building permit application 0 M Larry A Undsderfer C P.O. Box 3835 &ono `�a Sequim, WA 98382 (360) 683 -4059 Lic K3CONC *949RG Fax: 1- 360- 683 -1778 E-mail:k3construction@earthlink.net www.k3construction.com 'r3r GHTBU LDER �OR rQl 4 till il I 1,) ,J 1) 1 I 1 April 13, 2012 City of Port Angeles Re: 430 W Second St. Port Angeles, WA To Whom it May Concern: I am applying for a building permit for 430 W Second St, Port Angeles, WA. 1. Replace entry door with the same size door with a Stanley steel door using the existing door locks. There will be no special framing to replace this door. 2. Replace entry wrought iron railing with treated wood 2 x 2 pickets to take the place of the existing wrought iron. 3. Replace 6' x 6' 1" x 4" decking with 5/4" x 6" Trex decking as wood is slimy and mossy and needs replacing and Trex decking is more moss resistant. Best Regards, VU Larry Undsderfer K -3 Construction, Inc P.O. Box 3835 Sequim, WA 98382 360 683 -4059 www.k3construction.com k3construction @earthlink.net 'I77 n, :c 1 -1 p �'V�' "tea,` f W 9 w ia.; r F JJf) yy ��ff i �o.� ter' j .�'4� r �,y; r i f •t` a sx a s i v$ a 'Z�,' J/ T a r c 8 B+�'+�, r•' k i 'xr w k fs •`C fQt. 3• ��i. xi "e �",y'4S i�`" ry 2�„ 4X' i 7 s�ro fir. fV� 4 f4 +r a: `".x i ,y. t� a R Y Y r w dy, 3 r3 S a• u Y� M+'I� u ws fJ iF•r}` 'Y,dv P -A f i +O �g„,�* a,,, r' �^3 'w .f `�a� 7 t W a5°, �yN",+�,,t yak h r r *r. 1�;+� r 4, '\..,,f„. y'� a k �iR� a% y r �,,a .n',�,r s a, s,. v ^o ^s a j' /ti. f x s �'a,��t >r` ��2Caa*}`,y t y Ah a' `'^w,, 4 k� yh a 3 n�"�d w. 9 f mil✓ o e t��p yy ,:a ,fie' ^Fh.: a ,•'r',Z 3. fi a `y w^ f 3v *m aF a a�� !t' ti ta' "qua C a� .a x YS." .•�A a 3` t Xi i da v'aw�r w ��r s z p c� r a t k'" s ,t 'C, .,m�� y k '4� �y�f` A' 1 'k` w+�, 0. 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Nr1.11S Dia tivAio reg 7 'eamuo Inot4DAN'Aulatitu00 anti. ulnsulued 0041410 Act 11` ..11r-la, IN .:,,,o.;, ,,,,,7,,' .,.w.„:21,- isa.-1 77-7M.,,,,, '..-fgit 1 10, .,'1, ct i.---0111 ;,1.4 (I 1 1; .1„,,, 0 4 .,4.4 N '44,..... „:,...i.....„,,,,:t1 -.4-1...a"\ M-11- 4 ..1 4 zr 4 1 -4/4 '4, '4:14 :i nk j CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Application Number 09 00000326 Date 4/14/09 Application pin number 813500 Property Address 430 W 2ND ST ASSESSOR PARCEL NUMBER 06 30 00 0 0 5030 0000 Tenant nbr name RICHARD /MARY SMITHTON Application type description RE ROOF Subdivision Name Property Use Property Zoning INDUSTRIAL LIGHT Application valuation 7530 Application desc TEAR OFF RE ROOF CLASS A GRANULATED TORCHDOWN Owner Contractor RICHARD /MARY SMITHTON RAINMASTER ROOFING 220 MOONLIGHT DR 1205 S 0 ST SEQUIM WA 98382 PORT ANGELES (360) 681 7100 (360) 452 3213 Structure Information 000 000 TEAR OFF RE ROOF WA 98363 Permit BUILDING PERMIT NO PR FEE Additional desc TEAR OFF RE ROOF Permit pin number 144246 Permit Fee 179 75 Plan Check Fee 00 Issue Date 4/14/09 Valuation 7530 Expiration Date 10/11/09 Qty Unit Charge Per Extension BASE FEE 95 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 179 75 179 75 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 184 25 184 25 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned fora 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 performance of construction. Date Print Name iiiikure of ontractor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building Division/Building Permit FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts T:Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 -4815 Electrical Inspections 417 -4735 Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments Inspection Type Electrical 417 -4735 Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting I PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By -14-to I I'LL C Vv C) PREPARED 4/14/10 8 29 17 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/14/10 ADDRESS 430 W 2ND ST SUBDIV TENANT NBR RICHARD /MARY SMITHTON CONTRACTOR RAINMASTER ROOFING PHONE (360) 452 3213 OWNER RICHARD /MARY SMITHTON PHONE (360) 681 7100 PARCEL 06 30 00 0 0 5030 0000 APPL NUMBER 09 00000326 RE ROOF PERMIT BNOP 00 BUILDING PERMIT NO PR FEE REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESUL,$ RESULTS /COMMENTS BL99 01 4/14/10 BLDG FINAL TIME 01 00 April 13 2010 3 16 53 PM 1pangrle I CALLED THE OWNER DICK AT 681 7100 TO FINAL THIS PERMIT BLDG FINAL RE ROOF AFTERNOON COMMENTS AND NOTES Applicant or Agent 72,giiv A/143re ROOF /Ass Owner 4 0 C k S +A to,v Owner's Address y 30 IAL Contractor Engineer R 1 -/4 lt,�" po./ J Contractor/Engineer's Address /2.0_4 S,a (4 fit 0 PROJECT ADDRESS q30 W. 2 LEGAL DESCRIPTION Lot: Block: CLALLAM COUNTY PARCEL NUMBER. Residential Multi family Commercial Repair COMMERCIAL/RESIDENTIAL. Occupancy Group Existing Structure(s) basement 1s' floor 2 "d floor 3rd floor Accessory Structures Existing Structure(s) TOTAL TYPE OF WORK New Constr Re -roof Stove Addition Move Garage Remodel Demolition Deck Sign Other LOT COVERAGE Lot size Sq Ft. Existing Structure(s) Sq. Ft. Footprint Proposed Structure(s) Sq. Ft. Footprint TOTAL Structure(s) Sq. Ft. Footprint Total Lot Coverage BUILDING PERMIT APPLICATION Fill out COMPLETELY and in INK. Your application, prescriptive energy form, plans, specs, and a 8'/i" x 11" site plan MUST BE COMPLETE to be accepted for review (360) 417 -4815 FAX (360) 417 -4711 Residential projects: submit two sets of plans Commercial projects: submit three sets of plans Phone Ye 3?-13 Phone (481 WOO) FOR OFFICIAL USE ONLY Date Rec. 11-14-01 Permit lJ -3 _o_ Date Approved: Date Issued: State License A9/,v44/1 Ab91 Mk Expires lo a8 #0 Phone q5 ZONING Subdivision. SF SF SF TOTAL VALUATION SIZE/VALUATION Sq. Ft. Proposed Structure(s) basement Sq. Ft. 1 floor Sq. Ft. 2 floor Sq. Ft. 3r floor Sq. Ft. Accessory Structures Sq. Ft. Proposed Structure(s) TOTAL TOTAL of existing proposed structures Maximum Height of Proposed Structure(s) Are you planning to install a lawn sprinkler system? (Divide Total Structure(s) Sq. Ft. Footprint by Lot Size Sq. Ft.) /SF /SF /SF 7.536 BRIEF DESCRIPTION OF THE PROJECT' i ex,stwv,,, re- roo-P 011474 Cfr ss 4 cgradufat {d �ofcAdOsAl4p J Occupant Load: Construction Type: Sq. Ft. Sq. Ft. Sq. Ft. Sq. Ft. Sq. Ft. Sq. Ft. Sq. Ft. Ft. 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 The plan check fee must be paid at the time the building permit application is submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW An application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing unless such application has been pursued in good faith or a permit has been issued, except that the building official is authorized to grant one or more extensions of time for additional periods not exceeding 180 days (90 days for commercial projects) each. The extension shall be requested in writing and justifiable cause demonstrated. (IRC /IBC 2006 105.3.2) I hereby certify that I have read and examined this application and know the same to be true and correct. 1 am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and that I must obtain such permits prior to work. Date 'l 1- O 9- Applica i ,0- Jv� T• \FORMS \BUILDING DIVISION \BldgPermitAppl. -2006 CODE backup.wp(l II (66/ -21ri) 35 <t E X 2 s k> b res 7 1 ti y PG A' Zilzav T:4 c 4 AI N �d®dti`d t'*' (SeZ 93 53) 7 9Z /trot 8 /8 r/ /8s fry N ;f G /eY j`• r c� t�T P '(I 'fir durrrp {r. e (�7 32 s !Cie- I- 2 ,C(; /jf7 1 3'`I/ e r- f /Lts 4' y 7 3i 50o° 2o°O 2 to° L13 oere IpOn" 3SO`� 5 y.0— `,o p /LcS co 7, A. 7, 91-`f p /vstax. Nud4 �i Son ti, fort 30 ^A41 e i 5,7.t 'kia 7ox3 icl 6. 7/ CO) 1'76 /o,i l�p 6 d s g icIY.c g9 v l r Adownt e_ 75tiv- 34316 /3 s y-E5{-r ex, sr+ bye -I-de../ cd f v s c_rewQC.,4 e 3CC2: '[b air coAld Ver 'ahoy-0 2. /0 "dr°ios F A cz� Y 'Pcivq f RV' 38' �e•v -fe x 3oa' 7.V2 erw•,rF a C phe fix 4 CERTIFI,CA E'dr OCPUPANCY City of Port Angeles Building Division Use Classification Trainina Center Group This Certification iSsiiedpursuant to the requirements of Section Tp9 of the Uniform Building Code certifying that at time xifiSV this stitActure was in compliance with the various ordinances orthe-Civ regidadrig Building construction or use. For the following: Type of Construction Post oft tfief, Shall not be teoov J 4 t 2 ).t..t.,. Building:Permit No. VN Use Zone T Owner of Business/Residence Ray Franklin Building Address 430_West. See,u 4 3tSeter u.. ,fs..■Pairit:VAngel 4S WA 98362 Address 1728 W. 4th. Port Anaeles. WA 983i r oiatitary 17, 2001 3 4"'Fr Date 0 place Building Official i DATE 2 /4 a C) Address of Proposed Business Applicant Fs-' 014 r 'rev k Address t 72. SR (.t 4.1. Phone business 34/5 4 57 V5 Vortle Current Use of Property 0 41 Zoning Classification of Property 77 WILL THERE BE ANY OF THE FOLLOWING? Construction changes Electrical changes Mechanical (heating, cooling, stoves) Plumbing changes New or relocated signs New septic tanks New sewer service Admission charged to patrons Is this a home occupation? Excavation of filling of lots Work done in City right -of -way Is there sufficient off street parking? New driveway openings A grading plan for site drainage (parking lots, downspouts, etc.) Are the existing streets paved? Are there existing sidewalks? Is there curb and gutter? Other I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge APPROVED REJECTED Y/ 7 e91( ROUTING SLIP Certificate of Occupancy $47 00 Certificate /Inspection Fee New Business Transfer of Business Location Change of Ownership New Building Remodel Temporary Business Change of Use Brief description of proposed business. 7724 7 1 01 2 Legal Description Lot Block r GN' YES X X X X Building Section Public Works Department Planning Department Fire Department City Clerk PB I.A. Date Signed t Q Y..r'l.r 1 Comments Conditions V-/ 'j 1 L n J_c_Ji --p_ e a /P_, _is-i t L n ,>11 _c_.f n c?, p i IL 'V66 0 A-1 44.,0 D THE FOLLOWING WILL BE REQUIRED PERMITS BUSINESS LICENSE 1) Building 1) Taxi 2) Plumbing 2) Peddlers 3) Electrical 3) 2nd Hand Dealer 4) Mechanical 4) Pawn Broker 5) Sewer 5) Dance 6) Sidewalk installation 6) Hotel Motel 7) Driveway installation 7) Fireworks 8) Curb installation 8) Ambulance 9) Sidewalk obstruction 9) Tattoo shop 10) Water meter installation 10) Other 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other Subdivision V-/ eza DATE t 171 aC-) Address of Proposed Business I7 2 tiL). Applicant `t c L, �f Address 1 72_ f 1) L[ a Phone business36b 457 f55 o e Brief description of proposed business Legal Description Lot Current Use of Property Zoning Classification of Property WILL THERE BE ANY OF THE FOLLOWING? Construction changes Electrical changes Mechanical (heating, cooling, stoves) Plumbing changes New or relocated signs New septic tanks New sewer service Admission charged to patrons Is this a home occupation? Excavation of filling of lots Work done in City right -of -way Is there sufficient off street parking? New driveway openings A grading plan for site drainage (parking lots, downspouts, etc.) Are the existing streets paved? Are there existing sidewalks? Is there curb and gutter? Other I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge APT` ED REJECTED ROUTING SLIP Certificate of Occupancy $47 00 Certificate /Inspection Fee /E4//0/4)7 YES N Block Building Section Public Works Department Planning Department Fire Department City Clerk PB I.A. VAJ New Business Transfer of Business Location Change of Ownership New Building Remodel Temporary Business Change of Use T/- Subdivision THE FOLLOWING PERMITS 1) Building 2) Plumbing 3) Electrical 4) Mechanical 5) Sewer 6) Sidewalk installation 7) Driveway installation 8) Curb installation 9) Sidewalk obstruction 10) Water meter installation 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other WILL BE REQUIRED BUSINESS LICENSE 1) Taxi 2) Peddlers 3) 2nd Hand Dealer 4) Pawn Broker 5) Dance 6) Hotel Motel 7) Fireworks 8) Ambulance 9) Tattoo shop 10) Other Date V 7 l rr Signed I "1 j l ��1.c,�— --1;�� I -I Comments Conditions