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HomeMy WebLinkAbout303 E 9th St - Building ,OF PORT 4 CITY OF PORT ANGELES PUBLIC WORKS UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 12- 00000577 Date 5/15/12 Application pin number 429341 Property Address 303 E 9TH ST ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -2- 7066 -0000- REPORT SALES TAX Application type description PUBLIC WORKS UTILITES on your state 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 Relocate building sewer RCP #12 -17 Owner Contractor DELORES J LESKINOVITCH CLALLAM BUILDERS EXVTNG INC 82 HENRY BOYD RD 2353 E 6TH AVE PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 417 -0255 (360) 808 -4225 Permit RIGHT OF WAY Additional desc RELOCATE SEWER RCP #12 -17 Permit Fee 150.00 Plan Check Fee .00 Issue Date 5/15/12 Valuation 0 Expiration Date 11/11/12 Qty Unit Charge Per Extension 1.00 150.0000 ECH PW RW CONST EXCAVTION OTHER 150.00 Special Notes and Comments Applicant responsible for erosion, sediment, and traffic control, surface restoration and trench safety. Contact City inspector prior to start of work at 417 -4831. Fee summary Charged Paid Credited Due Permit Fee Total 150.00 150.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 150.00 150.00 .00 .00 'Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced; or if required inspections have not been requested within 180 days from the last i,ispection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of 9 taws 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 r construction. 10090 s/15 Sign u oftractor Or Authorized Agent Date Signature of Owner (if owner is builder) Date T:Forms /Building Division /Public Works Permit PERMIT INSPECTION RECORD CALL 417 -4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE w RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED 1 YES NO CONSTRUCTION R.W. PW/ CONSTRUCTION R.W. ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 FIRE DEPT. PLANNING DEPT. 417 -4750 PLANNING DEPT. BUILDING 41-7- BUILDING 4815 T:Forms /Building Division /Public Works Permit I-ppllcaclon mumoer Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc REBUILD REAR EXTERIOR STAIRS Owner DELORES J LESKINOVITCH 82 HENRY BOYD RD PORT ANGELES (360) 417 0255 Qty Unit Charge Per 5 00 Other Fees Fee summary Charged Permit Fee Total Plan Check Total Other Fee Total Grand Total Date Print Name 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 WA 98362 65 25 42 41 4 50 112 16 10 000012S/ 986956 303 E 9TH ST 06 30 00 0 2 7066 0000 DELORES J LESKINOVITCH RES REPAIR RS7 RESDNTL SINGLE FAMILY 1000 Contractor CLALLAM BUILDERS EXVTNG INC 2353 E 6TH AVE PORT ANGELES WA 98362 (360) 808 4225 Permit BUILDING PERMIT RESIDENTIAL Additional desc REBUILD REAR STAIRS Permit pin number 176354 Permit Fee 65 25 Plan Check Fee 42 41 Issue Date 11/02/10 Valuation 1000 Expiration Date 5/01/11 BASE FEE 3 0500 HND BL -501 2K (3 05 PER C) STATE SURCHARGE 4 50 Paid Credited Due 65 25 42 41 4 50 112 16 00 00 00 00 Pate 11/02/10 Extension 50 00 15 25 00 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 1 Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities private and public improvements This permit becomes null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work 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 //0 2 114 yoz construction n �f Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) 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 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 MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping I SHORELINE. 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 FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417 -4735 I Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 1 t I tx lb ILL. PREPARED 11/16/10 8 31 11 INSPECTION TICKET PAGE 8 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 11/16/10 ADDRESS 303 E 9TH ST SUBDIV TENANT NBR DELORES J LESKINOVITCH CONTRACTOR CLALLAM BUILDERS EXVTNG INC PHONE (360) 808 4225 OWNER DELORES J LESKINOVITCH PHONE (360) 417 0255 PARCEL 06 30 00 0 2 7066 0000 APPL NUMBER 10 00001257 RES REPAIR PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 11/16/10 COMMENTS AND NOTES BLDG FINAL November 15 2010 11 54 25 AM 1pangrle JEFF 808 4225 BUILDING FINAL RE BUILT REAR EXTERIOR STAIRS LANDING Applicant V t Lg Property Owner Property Owner's Address Contractor ;�'ef rt p Contractor's Address License Proiect Type Brief Description. Check all that apply New Construction Addition Re model epair Demolition Re -roof Heat System Other Floor Areas Basement 1 Floor 2 Floor 3 Floor Garage Carport Covered Porch Deck Shed Other T:Forms /Building Division /Bldg Permit.doc 2s BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn. Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 tr\o 1,,Ltx te a' H eimv- Expires PROJECT ADDRESS 3 Parcel Number e sidential e ti c) c- IL w „I, .s Multi- family Commercial Industrial e a c eocg c J Existing (sq. ft.) lo posed (sa. ft.) For City Use Only Date Received/0 ....913-0 ermit /d -t— 7 ate Approved Phi e y/ 7 Ph ne 1/r)— C Phone House garage other tear off re -roof lay over one layer Heat pump wood burning stove gas fireplace pellet stove other E -mail Lot TOTAL VALUATION Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage Site Coverage the amount of impervious surface on a parcel, including structures paved driveways, sidewalks, patios and other impervious surfaces (see PAMC 17 94 135 for exemptions) Site coverage ok Max. height of proposed structures ft. Occupancy group Will a lawn sprinkler system be installed? Occupant load Will a fire sprinkler system be installed? Construction type I have read and completed this application and know it to be true and correct. I am authorized to apply f.r this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to or ing o projects. Datelti /G' Print Name T .PP T 0 Signature V JLLLe) Zoning per sq ft. of bedrooms of full baths of half baths II 1 1 'Ft tr 4 4s. 0 ,s4. :V, 1.„ "it,44.44 4 11. 7.1 cav oF;portt A The Issipmcetf cations and vilier dati„440 n�t from :ther6affOr pt° spepiti4ttenS 'bOgirrg oftipn ;s. being liq6tion Of Aft I i• e e ()OP(' )i xx 1 1 PREPARED 10/21/10 9 48 37 INSPECTION TICKET PAGE 8 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/21/10 ADDRESS 303 E 9TH ST SUBDIV TENANT NBR DELORES J LESKINOVITCH CONTRACTOR PHONE OWNER DELORES J LESKINOVITCH PHONE (360) 417 0255 PARCEL 06 30 00 0 2 7066 0000 APPL NUMBER 10 00000924 SIDING PERMIT BNOP 00 BUILDING PERMIT NO PR FEE REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 10/21/10 JLL BLDG FINAL TIME 01 00 n October 20 2010 4 47 39 PM 1pangrle JEFF 808 4225 BUILDING FINAL RE SIDED THE HOUSE GARAGE AFTERNOON COMMENTS AND NOTES Date Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc RE SIDING THE HOUSE GARAGE Owner DELORES J LESKINOVITCH 82 HENRY BOYD RD PORT ANGELES WA 98362 (360) 417 0255 Structure Information 000 000 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 3 00 14 0000 THOU Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total 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 10 00000924 Date 8/26/10 925032 303 E 9TH ST 06 30 00 0 2 7066 0000 DELORES J LESKINOVITCH SIDING RS7 RESDNTL SINGLE FAMILY 4989 Contractor OWNER RE SIDE THE HOUSE GARAGE BUILDING PERMIT NO PR FEE RE SIDE THE HOUSE GARAGE 172213 137 75 Plan Check Fee 00 8/26/10 Valuation 4989 2/22/11 BASE FEE BL -2001 25K (14 PER K) STATE SURCHARGE Charged Paid Credited 137 75 137 75 00 00 00 00 4 50 4 50 00 142 25 142 25 00 Due Extension 95 75 42 00 4 50 00 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 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. /O 2 L TA flee 1 Print Name Signature of Contractor or Autho ized Agent Signature of Owner (if owner is builder) 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 I 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 MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T Forms /Building Division /Building Permit Inspection Type 'FINAL Date Accepted by PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I ESA. Landscaping SHORELINE. FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By o lo ov FOR rgq, P Applicant hoIhQeS (XS n►1%L'c' L Property Owner Sp� ,,,,,_e Property Owner's Address $2 Contractor o e f; gJe1 Contractor's Address License Addition Floor Areas Basement 1 Floor /36 2 Floor 3 Floor Garage 7_4 </T 0 Carport Covered Porch Deck Shed Other BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 Expires Existing (sq. ft) Posed (sq. ft.) Total footprint of structures sq. ft. T Lot size Site Coverage the amount of impervious surface on a parcel, including structures, and other impervious surfaces. (see PAMC 17 94 135 for exemptions) pa ck*Nye Max. height of proposed structures ft. Occupancy group Will a lawn sprinkler system be Occupant load Will a fire sprinkler system be installed? Construction type 12.-1 Date .J Print Name J LCSKtnoi fL L Signatur T:Forms /Building Division /Bldg Permit.doc 20 E -mail For City Use Only Date Received c t O Permit I t) ct 24 Date Approved Phone Phone '//7 0255 P A WAS- Phone PROJECT ADDRESS 3o3 E 9' Po2-f lip.4040.5 /OA- ,e16 7 Parcel Number "30000 2 70 00600 Lot Zoning Proiect Type Brief Description: /Residential Multi- family Commercial Industrial Check all that apply 1) New Construction I o k P p k o v5e I PA- a i 1 ul v2 R Side e irPo5v`g e_ N e edi a goo, p d Remodel Lpp Repair J Demolition Re -roof r4 -louse garage other Heat System Heat pump wood burning stove gas fireplace pellet stove other kher tear off re -roof lay over one layer per sq. ft. :3`1'31, oa TOTAL VALUATION 10 Te g, r Q sq. ft. Lot coverage paved driveways, sidewalks, patios, Site coverage Z of bedrooms of full baths of half baths 0 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 obtain permits rYiG[to working on projects. -46114 1 I Clallam County Assessor Treasurer Property Details 58501 DELORES J LESKINO Page 1 of 4 Clallam County Assessor Treasurer Property Search Results 58501 DELORES J LESKINOVITCH for Year 2010 2011 Property Account Property ID Geographic ID Type Tax Area. Open Space Historic Property' Multi Family Redevelopment: Township Range Location Address. Neighborhood: Neighborhood CD Owner Name Mailing Address: Taxes and Assessment Due Property Tax Information as of 08/26/2010 Amount Due if Paid on Year 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2009 2009 2009 2009 2009 2009 2009 Statement ID 41435 41435 41435 41435 41435 41435 41435 41435 41435 41435 585012008 585012008 585012008 585012008 585012008 585012008 585012008 58501 Legal Description. S 85' LT 10 BL 270 303 E 9TH ST 0630000270660000 Real 0010 N N N Agent Code. PA 121 PORT ST CNTY H2 L Land Use Code DFL Remodel Property 303 E NINTH ST PORT ANGELES WA Cycle 5 Res 10955130 DELORES J LESKINOVITCH 82 HENRY BOYD RD PORT ANGELES WA 98362 Taxing Jurisdiction ST SCH STATE SCHOOL CC -GEN COUNTY PORT PORT PORT ANG PORT ANGELES SD #121 SCHOOL DISTRICT #121 NTH OLY LIB NORTH OLYMPIC LIBRARY HOSP #2 HOSPITAL #2 WSMET PK DIST WILLIAM SHORE MET PARK CITY STORMWATER CITY STORMWATER WEED CONTROL WEED CONTROL 2010 41435 TOTAL. ST SCH STATE SCHOOL CC -GEN COUNTY PORT PORT PORT ANG PORT ANGELES SD #121 SCHOOL DISTRICT #121 NTH OLY LIB NORTH OLYMPIC LIBRARY HOSP #2 HOSPITAL #2 Section Mapsco Map ID Owner ID Ownership Exemptions: First Half Base Due $107 84 $57 38 $8 06 $132.87 $139 68 $16 68 $23 54 DIST $7 49 $36 00 $0 82 $530.36 $123 48 $62.50 $8 85 $137 08 $152.70 $18 16 $25 63 11 N N 2 j s,g 36918 100 0000000000% Second Half Base Due Penalty Interest Base $107 84 $0 00 $0 00 $1C $57 39 $0 00 $0 00 $t $8 07 $0 00 $0 00 $132.88 $0 00 $0 00 $1 $139 68 $0 00 $0 00 $1 $16 67 $0 00 $0 00 $1 $23 55 $0 00 $0 00 $2 $7 49 $0 00 $0 00 9 $36 00 $0 00 $0 00 $Z $0 81 $0 00 $0 00 $530.38 $0.00 $0.00 $52 $123 49 $0 00 $0 00 $24 $62.49 $0 00 $0 00 $12 $8 85 $0 00 $0 00 $1 $137 07 $0 00 $0 00 $27 $152.71 $0 00 $0 00 $3C $18 16 $0 00 $0 00 $Z $25 63 $0 00 $0 00 $E. http. /vpn.clallam. net: 8084 /propertyaccess /Property.aspx ?cid =0 &year 2010 &prop_id =58 8/26/2010 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 07 00000673 Date 6/08/07 Application pin number 004212 Property Address 303 E 9TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 7066 0000 Tenant nbr name DELORES LESKINOVITH Application type description RE ROOF Subdivision Name Property Use Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 1635 Owner Contractor LESKINOVITCH DELORES J 82 HENRY BOYD RD PORT ANGELES WA 98362 LARRY S ROOFING 352 AVIS ST PORT ANGELES PORT ANGELES (360) 452 2215 WA 98362 Permit BUILDING PERMIT NO PR FEE Additional desc TEAR OFF RE ROOF Permit pin number 104190 Permit Fee 86 60 Plan Check Fee 00 Issue Date 6/08/07 Valuation 1635 Expiration Date 12/05/07 Qty Unit Charge Per Extension BASE FEE 50 00 12 00 3 0500 HND BL -501 2K (3 05 PER C) 36 60 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 86 60 86 60 00 00 Plan Check Total 00 00 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 91 10 91 10 00 00 Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities private and public improvements This permit becomes null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work as commenced or if required inspections have not been requested within 180 days from the last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinanc:s ..verning this type of work will be complied with whether specified herein or not. The granting of a permit does not presume o give audio 'ty to violate or cancel the provisions of any state or local law regulating construction or the performance of constructi l n. Signature of Contractor or Authorized Agent T \Policies \1102 15 building permit inspection record05 wpd [1/4/20051 E x p t teio f g -1 Date Signature of Owner (if owner is builder) Date INSPECTION TYPE FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS 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 SHEAR WALL /HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL ROUGH -IN HEAT PUMP /FURNACE /DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT 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 k MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER IA'SULATE OR CONCEAL 4NI' WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT .JOB SITE. DATE I ACCEPTED YES NO CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I I I PLANNING DEPT 417 -4750 I I. I I e4 I el/ I BUILDING 417 -4815 I reA I 61 b 1 in T Policies \l 102 15 building permit inspection record05.wpd [I/4/201051 I FINAL FINAL SEPA. ESA. SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE DATE YES NO COMMERCIAL 41 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING FIRE DEPT PLANNING DEPT BUILDING COMMENTS DATE ACCEPTED BY. DATE ACCEPTED BY. DATE I ACCEPTED I YES I NO I I I I I I I I I I P2iore, wessow) Owner Architect/Enaineer• 1 0 Contractor Or6"�LJ< �Cfo��A Address: TYPE OF WORK. Residential New Constr Multi family Addition Commercial Remodel Repair Sign BRIEF DESCRIPTIOI,F THE PROJECT 4 1 )4 l-ez 0. md W Pic: RCIAL/RESID NTIAL. Occupancy COMME pan 5 G r oup I hereby certify that I have read and e apply for this permit and understand th must obtain such permits prior to work. T• \FORMS\B1dgPermitform.wpd Applicant: e .sK\v\o BUILDING PE MIT APPLICATION Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for view If you have any questions, call PERMITS (360) 417 815 FAX(360)417 -4711 Re -roof Stove Move Garage Demohtion Deck Other h1a R- Existing Sq Ft. n Applicant or A ent: Lo TY1 \V' J3 IS A oG'1Sd,1(1ZoUid Address. I k11 riA 604 W Cit r State License 5 City PROJECT ADDRESS q I LEGAL DESCRIPTION Lot: Block. CLALLAM COUNTY PARCEL NUMBER. 1 r1 No. of Stones: Lot Size: Total lot coverage PLANNING USE ONLY ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other Phone. S Phone `T) O Zip n 'I Subdivision. Phone: Exp FOR OFFICIAL USE �OyyNLY Date Rec, C,(c1"'O 75 0-7 Permit o (:27'g Dat., Approved: O(c) sljR O Date Issued. Phone: Zip 963Q ZONING STZE/VALUATION SF /SF SF /SF SF /SF TOTAL VALUATION P 1 1 c of Occupant Load. Construction Type: Proposed Sq Ft. TOTAL Sq Ft. APPROVALS PLAN BLDG DPWIJ FIRE. 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 Coordmator at 417 -4815 for assistance. PLAN CHECK FEE IF a plan check fee is due it must be submitted at the time the building permit 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. mined this 'cation and know the same to be true and correct. I am authorized to my �p:: ibility to determine what permits are required ,not the City's, and that I Date: t