HomeMy WebLinkAbout222 N Chambers St - Building "°�'""t CITY OF PORT ANGELES
L��� PUBLIC WORKS UTILITIES
IL IIGII 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 10- 00001381 Date 11/24/10
Application pin number 489355
Property Address 222 N CHAMBERS ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-8-1-0300-0000- your state excise tax form
Application type description PUBLIC WORKS UTILITES on y
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning COMMERCIAL OFFICE
Application valuation 0
Application desc
RCP #10 -35 Curb Cut and Driveway Approaches
Owner Contractor
VERNON D. PETERS OWNER
222 N CHAMBERS ST
PORT ANGELES WA 98362
(360) 477 -1053
Permit CONCRETE CURB GUTTER
Additional desc RCP #10 -35
Permit pin number 177964
Permit Fee 180.00 Plan Check Fee .00
Issue Date 11/24/10 Valuation 0
Expiration Date 5/23/11
Qty Unit Charge Per Extension
BASE FEE 180.00
Permit DRIVEWAY INSTALLATION
Additional desc RCP #10 -35
Permit pin number 177956
Permit Fee 180.00 Plan Check Fee .00 Issue Date 11/24/10 Valuation 0 trj
Expiration Date 5/23/11
Qty Unit Charge Per Extension
BASE FEE 180.00
Special Notes and Comments
Traffic control plan per attached plan. No material to
enter the City's storm drain. Copies of concrete delivery (Th
tickets shall be provided to the City. Asphalt patch to be
made by licensed and bonded contractor approved by the City.
Work materials per City Standards. Call City Inspector
prior to start of work at 360)417 -4831. No obstruction of I
any traveled lane allowed.
Fee summary Charged Paid Credited Due
Permit Fee Total 360.00 360.00 .00 .00
Plan Check Total .00 .00 .00 .00 r
Grand Total 360.00 360.00 .00 .00 �VI
..:%t
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
constr ction.
r
7/.2— v /v
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T: \Policies \1102.15 [10/08]
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 1 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
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W. PW/ CONSTRUCTION R.W.
ENGINEERING 417 -4831 PW ENGINEERING
FIRE 417 -4653 FIRE DEPT.
PLANNING DEPT. 417 -4750 PLANNING DEPT.
BUILDING 417 -4815 BUILDING
T: \Policies \1102.15 (10/081
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00001373 Date 12/02/11
Application pin number 133892
Property Address 222 N CHAMBERS ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-8-1- 0300 -0000-
Application type description RES REPAIR on your state excise tax form
Subdivision Name
Property Use to the Cit y g of Port Angeles
Property Zoning COMMERCIAL OFFICE (Location Code 0502)
Application valuation 500
Application desc
8' fence 6'solide /2' 25% open.
Owner Contractor
VERNON D. PETERS OWNER
222 N CHAMBERS ST
PORT ANGELES WA 98362
(360) 477 -1053
Permit BUILDING PERMIT RESIDENTIAL
Additional desc FENCE PERMIT
Permit Fee 65.00 Plan Check Fee .00
Issue Date 12/02/11 Valuation 500
Expiration Date 5/30/12
Qty Unit Charge Per Extension
BASE FEE 65.00
Other Fees STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 65.00 65.00 .00 .00
Plan Check Total .00 .00 .00 .00 ,r/,�
Other Fee Total 4.50 4.50 .00 .00 as (p.1
Grand Total 69.50 69.50 .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
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 la lating con ion •e performance of
construction.
i
VI i?;7 --7 An,
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
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
M Public Works Utilities 417 4831 Backflow Prevention Inspections 417 -4886
N. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
M POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
N.
1
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
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
,\O Fire 417 -4653
l Planning 417 -4750 t"
`v Building 417 -4815 '1 1 JI
T:Forms /Building Division /Building Permit
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PROJECT STATUS UPDATE
Permit# 11'1121 2 Gh aM be IS 5T
Date: (0 I/
I phoned the: Applicant at
Property Owner V .f/rY1 ()offs at (0 6 3
Contractor at
I (left a phone message, or discussed):
The permit (has expired, r will expire soo What is the status of this project?
Please call and schedule a final inspection.
Or
Submit a "permit extension request" letter.
Or
Let me know if the project is abandoned.
T:Forms /Building Division/Project Status Update
BUILDING PLUMBING MECHANICAL PERMIT APPLICATION SHORT FORM
(To be used for projects that do not require plan review.)
Date Receive+ fj. 11
Permit 11,„
City of Port Angeles Please print in ink. Date Approve. I �I
Attn: Building Permit Technician Approved b
321 E. 5 St., Port Angeles, WA 98362
360- 417 -4815 fax: 360- 417 -4711 Credit card payments are accepted Mon -Fri 8 -5 pm (no Am:!ican Express)
Hours: Mon through Fri 8 5 pm Cash checks are accepted Mon -Thurs 8:30 -4 pm Fri 8:30 -12:30 pm
Contact person: Phone:
G✓'✓l 1 cd'
Property owner:
V �ri G s Phone: 4 /77 0 6 3
Propert owner's mailing address:
e(2, IC 2 p l y i !y "Ira mi l' .e z
Contractor's business name: Phone:
(or property owner's name if he /she is doing /overseeing the work)
Contractor's mailing address:
Contractor's L &I license number. Expiration date:
Project Address:
2_2 2 Ai 6'Aa Acr-s
Project Type: g_Residential Q Commercial to Industrial D Multi- family
Project Business Name:
(for commercial, industrial, or multi family projects)
The following permits are usually issued over the counter immediately, without the need for plan review.
Complete only the portions of this permit that are relevant to your project.
house garage other e sr fe vt G 4 m riep o pe .7
tear off re -roof lay over one layer
Licensed contractor: Submit) of your re roof bid.
Project Valuation rpo (labor materials, not including sales tax)
Re -side: house garage other
Project Valuation (labor materials, not including sales tax)
Repair: (explain the project)
Project Valuation
*Homeowner: If you will be doing overseeing the work, then the project valuation will be determined by doubling the
cost of materials, to reflect the value the repair adds to your property.
Cost of materials x 2 Project Valuation
T:Forms /Building Division /Building /Plumbing /Mechanical Permit Application Short Form (Revised 2011)
Page 1of2
Swimming Pool or Spa 24" deep): For prefabricated swimming pool or spa projects that
do not require plan review:
r .:1 Obtain the City of PA handout entitled "Pools Spas" follow the requirements.
Flroject Valuation
Demolition:. A demolition permit is needed when an entire building gets demolished.
What will be demolished? house garage other
Note: some demolition permit applications need to be reviewed by various City departments, and may take
approximately two weeks to obtain.
Agree to ensure that all utilities are /will be properly turned off (and capped off if needed)
prior to demolition.
Obtain (from the City of PA) an aerial view map of the parcel and put an "x" over the structure(s) to
be demolished. Submit the map with this application.
Obtain (from the City of PA) a copy of the Olympic Region Clean Air Agency (ORCAA)
Demolition Permit Application.
Contact ORCAA at 360- 417 -1466 to discuss whether or not an ORCAA Demolition Permit will also
be needed.
yes no Will the debris be going to the Regional Transfer Station in Port Angeles?
yes No If yes, will a licensed contractor be taking it there?
If yes, obtain (from the City of PA) a copy of the Waste Disposal Application.
Complete and submit the waste disposal application to the Building Permit Technician, now
(or later if asbestos testing is needed).
Plumbing Permit: (explain the project)
Project Valuation
Mechanical Permit: (explain the project)
Project Valuation
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 d termine what grmit are required, and to obtain permits prior to
working on projects.
Date Signature 1, K
Print Name e•
Page 2 of 2
Application Number 10 00001372
Application pin number 500880
Property Address 222 N CHAMBERS ST
ASSESSOR PARCEL NUMBER 06 30 00 8 1 0300 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning COMMERCIAL OFFICE
Application valuation 0
Application desc
200 amp service and 3 circuits
Owner
VERNON D PETERS
222 N CHAMBERS ST
PORT ANGELES
(360) 477 1053
WA 98362
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc
Permit pin number 177832
Permit Fee 127 70 Plan Check Fee 00
Issue Date 11/19/10 Valuation 0
Expiration Date 5/18/11
Qty
3 00
1 00
Unit Charge
2 6000
119 9000
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Contractor
BOB S ELECTRIC INC
2293 DEER PARK RD
PORT ANGELES
(360) 457 6887
Date 11/19/10
WA 98362
y SZ 'fig 3
Per Extension
ECH EL BRANCH CIRCUIT W /FEEDER 7 80
ECH EL 0 200 SRV FEEDER 119 90
Paid Credited Due
127 70 127 70 00 00
00 00 00 00
127 70 127 70 00 00
DATE.
RESULTS
(1/./IJ
REPORT
STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
Acos
ACO
Date.
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NOU -18 -2010 17 13 FROM BOBS ELECTRIC
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical T.nspections
321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 95362
Pb (3/6/'0) 41747,35 Fax: (360) 417 -471I
ae „U J 1 C Q'
k ,1 2 Single Family Dwelling
Plan Review: Ma Be Required Please complete Electrical Plan Review Information Sheet
JabAdoress: Om t ..3
Building Square Footage:
Description 01 above `X
Owner Informatio
Name: 2C/ r✓ Ll
Malin dd
City �R Stets: f't Lp: f-36 �7
Phon Fax
Licerwo 1; Exp.
Item
Service/Feeder 200 Amp.
Service/Feeder 201 400 Amp,
Service/Feeder 401 600 Amp
Service/Feeder 601 1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W1 Service Feedor
Branch Circuit W/0 Service Feeder
Each Additional. Branch Circuit
Tamp. Service/ Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 401 -600 Amp.
Temp. Service/Feeder 601 -1000 Amp
Portal to Portal Hourly
Sign /Outline Lighting
Signal Circuit/ Limited Energy! First 1500 cf— Commercial
Note: $5.00 tar each additional 1500 sf
Signal Circuit/ Limited Energy 1 2 Family Dwelling
Signal Circuit/ Limited Energy Multi- Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5KVA System or Less
Thermostat
NEW CQNSTRIJCTION ONLY.
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Multi Family or Commercial" Commercial Addition Alteration Remodel Repair
Unit Charge
119.90
145.50
$204.60
262,20
372.50
2.60
73.50
5 2.60
92.70
110.30
146.70
167.90
95.90
96.20
S 95.90
53.90
63.90
5 119.90
102.30
56.00
$110.30
35.20
5 73.50
110.30
3604529943
in 4 40 1
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AMIN
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ELECTRIC:,S. t rim
INS2ECT y,
Contra r f• r atlon
Name: i w C
Maui •s: 3'x
City
Phone
License !I exp.
State:
Fax:
TO 360417711
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Total/ Multi lied bv,Unit Charm
5
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/27
Total
Ify
Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two years after this electricat 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 1 am making
the electrical installation or alteration in compliance with the electrical taws, N.E.C. RCW Chapter 19,28, WAC, Chapter 296 -465, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14,05.050 regarding Electrical Permit Applications.
Signature of owner, electrical contractor or electrical administrator 0 Carl) 0 Check
Crom Can/ s C $faff� f
Dated: ll Ijs),a 0110112010
PREPARED 7/08/10 8 06 28 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 7/08/10
ADDRESS 222 N CHAMBERS ST SUBDIV
TENANT NBR HSBC BANK USA NATIONAL
CONTRACTOR PHONE
OWNER VERNON D PETERS PHONE (360) 477 1053
PARCEL 06 30 00 8 1 0300 0000
APPL NUMBER 10 00000297 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 4/20/10 JLL BLDG FRAMING TIME 01 00
4/20/10 AP April 20 2010 8 34 56 AM 1pangrle
VERN 477 1053
FRAMING
AFTERNOON
April 20 2010 4 48 40 PM jlierly
BLWS 01 4/27/10 JLL BLDG INSULATION WALL /FLOOR
5/03/10 AP April 27 2010 11 17 05 AM jlierly
May 3 2010 8 08 57 AM jlierly
BL99 01 7/08/10 iL BLDG FINAL TIME 01 00
July 7 2010 2 54 15 PM 1pangrle
VERN 477 1053
BUILDING FINAL ADD A DORMER AND A BATHROOM
AFTERNOON
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 7/08/10
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
VERN 477 1053
PLUMBING FINAL
AFTERNOON
COMMENTS AND NOTES
MECHANICAL FINAL TIME 01 00
July 7 2010 2 56 14 PM 1pangrle
VERN 477 1053
MECHANICAL FINAL
AFTERNOON
PL2 01 4/20/10 JLL PLUMBING ROUGH IN TIME 01 00
4/20/10 AP April 20 2010 8 35 35 AM 1pangrle
VERN 477 1053
ROUGH IN PLUMBING
AFTERNOON
April 20 2010 4 48 40 PM jlierly
PL99 01 7/08/10 J PLUMBING FINAL TIME 01 00
July 7 2010 2 56 39 PM 1pangrle
DATE
71Bit°
OWNER/CONTRACTOR
�T� S
ADDRESS
e7 Tom{
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
PERMIT
tb 03 2 y
6 -IP"R 4
I NSPECTOR
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER
0. SERVICE
FINAL
CORRECTIONS NEEDED: 12lre.0 S0 LQ r k Orl 6
U Fi (IV ‹t, rq, k
ICC ct 2PIEi.(
V 2 Q,rss ts7c4nir RCP3- uu c'
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
PREPARED 7/08/10 8 06 28 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 7/08/10
ADDRESS 222 N CHAMBERS ST
TENANT NBR VERN PETERS
CONTRACTOR BARNES CONSTRUCTION INC
OWNER VERNON D PETERS
PARCEL 06 30 00 8 1 0300 0000
APPL NUMBER 10 00000335 RE ROOF
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL99 01 7/08/10
SUBDIV
PHONE (360) 683 5796
PHONE (360) 477 1053
BLDG FINAL TIME 01 00
July 7 2010 2 45 17 PM 1pangrle
VERN 477 1053
BUILDING FINAL RE ROOFED THE HOUSE
AFTERNOON
COMMENTS AND NOTES
PREPARED 7/08/10 8 06 28 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 7/08/10
ADDRESS 222 N CHAMBERS ST
TENANT NBR VERN D PETERS
CONTRACTOR DAVE S HTG COOLING SRVC INC
OWNER VERNON D PETERS
PARCEL 06 30 00 8 1 0300 0000
APPL NUMBER 10 00000318 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
SUBDIV
PHONE (360) 452 0939
PHONE (360) 477 1053
ME99 01 7/08/10 MECHANICAL FINAL TIME 01 00
July 7 2010 2 50 24 PM 1pangrle
VERN 477 1053
MECHANICAL FINAL FURNACE
AFTERNOON
COMMENTS AND NOTES
PREPARED 7/08/10 8 06 28 INSPECTION TICKET
CITY OF PORT ANGELES
ADDRESS 222 N CHAMBERS ST
CONTRACTOR
OWNER
PARCEL
APPL NUMBER
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01 4/27/10 JLL
5/03/10 AP
ME99 01 7/08/10
VERNON D PETERS
06 30 00 8 1 0300 0000
10 00000410 MECHANICAL APPL PERMIT
INSPECTOR JAMES LIERLY
SUBDIV
PHONE
PHONE (360) 477 1053
MECHANICAL GAS LINE
April 27 2010 11 16 12 AM jlierly
May 3 2010 8 08 57 AM jlierly
MECHANICAL FINAL TIME 01 00
July 7 2010 2 46 47 PM 1pangrle
VERN 477 1053
MECHANICAL FINAL GAS LINE TO BBQ RANGE
AFTERNOON
COMMENTS AND NOTES
PAGE 6
DATE 7/08/10
PREPARED 6/28/10 8 18 05 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/28/10
ADDRESS 222 N CHAMBERS ST
TENANT NBR VERNON D PETERS
CONTRACTOR DAVE S HTG COOLING SRVC INC
OWNER VERNON D PETERS
PARCEL 06 30 00 8 1 0300 0000
APPL NUMBER 10 00000454 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME99 01 6/28/10
5.�
SUBDIV
PHONE (360) 452 0939
PHONE (360) 477 1053
MECHANICAL FINAL TIME 01 00
June 25 2010 2 39 44 PM 1pangrle
JEANNIE 452 0939
MECHANICAL FINAL HEAT PUMP
AFTERNOON
COMMENTS AND NOTES
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
HEAT PUMP INSTALLATION
Owner
VERNON D PETERS
PO BOX 2461
PORT ANGELES
(360) 477 1053
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge
1 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
14 8000 EA
T:Forms/Building Division/Building Pennit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
WA 98362
MECHANICAL PERMIT
INSTALL A HEAT
164988
64 80
5/10/10
11/06/10
Per
Charged
64 80
00
64 80
10 00000454
019224
222 N CHAMBERS ST
06 30 00 8 1 0300 0000
VERNON D PETERS
MECHANICAL APPL PERMIT
COMMERCIAL OFFICE
4540
Contractor
DAVE S HTG COOLING SRVC INC
PO BOX 413
PORT ANGELES WA 98362
(360) 452 0939
PUMP
BASE FEE
ME FURN /HP /FAU OR 5 TON
64 80
00
64 80
Plan Check Fee
Valuation
Paid Credited
00
00
00
Date 5/10/10
00
00
00
00
0
Extension
50 00
14 80
Due
F ri4 /0-6
Zg -►o
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 co uction
a —0.Z24
l eelW
Da {e Print Name 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 I
Water Line (Meter to Bldg)
Gas Line I
Back Flow Water I FINAL Date
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
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
BUILDING PERMIT INSPECTION RECORD
T.:Forms /Building Division /Building Permit
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Accepted by
FINAL Date (0.-20 -I Accepted by Si/
Date Accepted By
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
2 5 ton heat pump t stat
Owner
VERNON D PETERS
PO BOX 2461
PORT ANGELES
(360) 477 1053
Permit
Additional desc
Permit pin number 165050
Permit Fee 56 00
Issue Date 5/10/10
Expiration Date 11/06/10
Qty Unit Charge Per
1 00 56 0000 ECH EL LVT
Fee summary Charged
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 98362
ELECTRICAL ALTER COMMERCIAL
56 00
00
56 00
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
10 00000460
429320
222 N CHAMBERS ST
06 30 00 8 1 0300 0000
ELECTRICAL ONLY
COMMERCIAL OFFICE
0
Contractor
DAVE S HTG COOLING SRVC INC
PO BOX 413
PORT ANGELES WA 98362
(360) 452 0939
THERMOSTAT
Plan Check Fee
Valuation
Paid Credited Due
56 00
00
56 00
00
00
00
Date 5/10/10
00
00
00
DATE RESULTS
ilehO
7 1 9 1 0
00
0
Extension
56 00
Signature of owner or Electrical Contractor X Date
INSPECTOR.
May 0710 11 38a Dave s Heating Cooling
City of Port Angeles Permit Application
Building DivisionlElectrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 417.4735 Fax: (360) 417 -4711
Date:
1 2 Single Family Dwelling
Multi Family or Commercial"
Commercial Addition I Alteration Remodel I Repair`
Plan Review May Be Required, Please Complete Electrical.P an Review Information Sheet
Job Address: a N C ke184. r.. to v s Str e_ e+
Building Square Footage:
Description of above sf cw csT o ?f a {v►. otAvv.,p -it,
vs v. ex V L V`Y�4G.1:Lr 1/1�CfI 1 "5
t
Owner lnforrn 1' n 0 Contractor Information
Name: �V r- ri .f rS Name Dam 1 S tk� n �cl1 vrck S.��l t c-a 1
Mailing,Address• f 0 ..fi0 c Mailinyddres t'.0. "4 3
City err Arto Stale: l. �'1Q3h
A- Zip: S City O r*T Q State: Zip: 7
Phone: f1'?- /o.53 Fax: Phone- (.J g:_16,
Fax 4e5P•
License 4 Exp. License 4/ Exp 1vA t=. H -e 1 V.C.
Unit Charae
$119.90
45.50
204.60
5 26220
37250
2.60
73.5D
2.60
S 92.70
110.30
148.7D
167.90
95.90
8820
95.90
63.90
S 63.90.
119.90
S 102.30
S 110.30
5 3520
S 73.50
5 110.30
S 56.00
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for Iwo years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor it
above said property is for sale, rent or lease. Permit expires after six months of last inspection.
Atter reading the above statement, I hereby certify that lam the owner of the above named property ora licensed electrical contractor. I am making the electrical installation or
alteration in compliance with the electrical laws, N. E.C. RCW. Chapter 19.28, WAC. Chapter296-46B, The City of Port Angeles Municipal Code, and Utility Specifications.
Signature of owner, electrical contractor or electrical administrator Cash
S
S
S
S
S
S
S
S
�)60„7A✓T 1:1 Check
Date: 5f 7 flo
RECEITEti
V<<102Q
ELECTRICAL
INSPECTIONS
Total ION 1ilultiolied by Unit Charoe)
Service/Feeder 200 Amp.
Serv:celFeeder 201.400 Amp.
Service/Feeder 401 -600 Amp
Sery ceIFeeder 601 -1000 Amp.
ServicelFeeder over 1000 Amp.
Branch Circuit WI Service Feeder
Branch Circuit W/0 Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 401 -600 Amp.
Temp. Service/Feeder 601 -1000 Amp,
Portal to Portal Hourly
Sign/Outline Lighting
Signal Circuit/ Limited Energy Commercial. Additional 1503 55.00
Signal Circuit/ Limited Energy 18 2 Family Dwelling
Sgnal Circuit/ Limited Energy Mrlb -Famly Dwelling
Manufactured Home Connection
Renewable Electrical Energy 5I VA System or Less
First 1300 Square Ft.
Each Addition 500 Square Ft or Portion of
Each Outbulding or Detached Garage
Each Swimming Pool or Hot Tub
-.57.-.0o Thermostat
Sro. z2OTotal
Credit Card It
3604520939
p1
May 0710 10 19a
Dave s Heating Cooling
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
Applicant J) a J-e- s 4' cz
Property Owner
Property Owner's Address Po RO,c `f A0,-,
Contractor .3)6\ v
Contractor's Address o 4
License �,4 VE s Expires .5/d1
Phone
Phone
raS
Phone
PROJECT ADDRESS a a N ch
Parcel Number
Project Tyne Brief Description:
Check all that apply
o New Construction
o Addition
o Remodel
o Repair
in Demolition
e Re -roof
,Heat System
o Other
Residential o Multi family
o House a garage o other o tear off re -roof a lay over one layer
''Heat pump o wood burning stove a gas fireplace o pellet stove a other
Floor Areas Existina (so. ft.) Proposed (se. fL)
Basement per sq. ft.
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage °!o
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 ft. Occupancy group
Will a lawn sprinkler system be installed? Occupant load
Will a fire sprinkler system be installed? Construction type
3604520939 p1
For City Use Only
Date Received
Perrnit# (O —LLgU
Date Approved
s
4 45 -093 9
4 117 (0 5•
E -mail elaui.5 ,n
�yczc J�r1C be 2 .Cc� l,►,,
.Sfr� o
-f
Lot Zoninv
a Commercial a Industrial
TOTAL VALUATION $7, S i
of bedrooms
of full baths
of half baths
l have read and completed this application and know it to be true and conect lam authorized to apply for this permit and understand
that it is my responsibility to determine what permits are required, and to obtain permits pri to working on projects.
Date Print Name 01ket■ .P Signatur (J
T:FortnslBuilding Division/Bldg Permitdoc
V
a
PREPARED 4/27/10 11 18 04 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/27/10
ADDRESS 222 N CHAMBERS ST SUBDIV
CONTRACTOR PHONE
OWNER VERNON D PETERS PHONE (360) 477 1053
PARCEL 06 30 00 8 1 0300 0000
APPL NUMBER 10 00000410 MECHANICAL APPL PERMIT
PERMIT ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
ME6 01 4/27/10
MECHANICAL GAS LINE
April 27 2010 11 16 12 AM jlierly
COMMENTS AND NOTES
PREPARED 4/27/10 11 18 04 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/27/10
ADDRESS 222 N CHAMBERS ST SUBDIV
TENANT NBR HSBC BANK USA NATIONAL
CONTRACTOR PHONE
OWNER VERNON D PETERS PHONE (360) 477 1053
PARCEL 06 30 00 8 1 0300 0000
APPL NUMBER 10 00000297 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 4/20/10 JLL BLDG FRAMING TIME 01 00
4/20/10 AP April 20 2010 8 34 56 AN 1pangrle
VERN 477 1053
FRAMING
AFTERNOON
April 20 2010 4 48 40 PM jlierly
BLWS 01 4/27/10 L BLDG INSULATION WALL /FLOOR
April 27 2010 11 17 05 AM jlierly
COMMENTS AND NOTES
Owner
VERNON D PETERS
PO BOX 2461
PORT ANGELES
(360) 477 1053
1 00
1 00
L c7
/Date Print Name
T:FormsBuilding Division/Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Qty Unit Charge Per
10 6500 EA
5 0000 EA
WA 98362
Fee summary Charged
Permit Fee Total 65 65
Plan Check Total 00
Grand Total 65 65
10 00000410
131690
222 N CHAMBERS ST
06 30 00 8 1 0300 0000
MECHANICAL APPL PERMIT
COMMERCIAL OFFICE
0
Contractor
OWNER
Permit MECHANICAL PERMIT
Additional desc ADD LPG COOK STOVE AND LINE
Permit pin number 164335
Permit Fee 65 65
Issue Date 4/27/10
Expiration Date 10/24/10
Plan Check Fee
Valuation
BASE FEE
ME STOVE /FIREPLACE /MISC APP
ME FUEL GAS PIPE EA >5 OUTLETS
Paid Credited
65 65 00
00 00
65 65 00
Date 4/27/10
Due
00
0 0
00
00
0
Extension
50 00
10 65
5 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 I cal law regulating construction or the performar}pe f constru n.
Signature of Contractor or Authorized 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 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
T Forms /Building Division /Building Permit
4-2'1- 10
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I I ESA.
Landscaping I I SHORELINE.
FINAL Date Accepted by
FINAL Date I Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
Date Accepted By
Applicant f�
Property Owner
Property Owner's Address
Contractor vet
Contractor's Address
License
PROJECT ADDRESS
Parcel Number
Project Type Brief Description.
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
Re -roof
Heat System
.i'Other
Floor Areas
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
BUILDING PERMIT
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
222 N. C.4�,,d0,--‹
Residential
House garage other
Heat pump wood- burning stove
Existing (sq. ft.) Proposed (sq. ft.)
Total footprint of structures 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
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
I have read and completed this application and know it
that it ism responsibility to determine what perm
Date ij 27/x/ Print Name de
T Forms Building Division /Building permit application
9.
ft
to be true and correct. I am authorized
required, and to obtain permits prior to
Expires
APPLLQA TION Print in ink
Multi- family
gas fireplace
Occupancy group
Occupant load
Construction type
Signature
Phone
Phone
Phone
E -mail
Lot
TOTAL VALUATION
For City Usse
Date Received 7 Z7
Permit #j 2 7
Date Approved
Zoning
Commercial Industrial
per sq ft.
of bedrooms
of full baths
of half baths
to apply for this
orking on
tear off re -roof lay over one layer
pellet stove other
it and understand
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Kitchen remodel 4 circuits and furnace
Owner
VERNON D PETERS
PO BOX 2461
PORT ANGELES
(360) 477 1053
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 98362
10 00000324
203448
222 N CHAMBERS ST
06 30 00 8 1 0300 0000
ELECTRICAL ONLY
COMMERCIAL OFFICE
0
Contractor
BOB S ELECTRIC INC
2293 DEER PARK RD
PORT ANGELES
(360) 457 6887
ELECTRICAL ALTER RESIDENTIAL
163279
107 30
4/06/10
10/04/10
Signature of owner or Electrical Contractor X
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
Plan Check Fee
Valuation
Qty Unit Charge Per
8 00 2 6000 ECH EL BRANCH CIRCUIT W /FEEDER
1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
5 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT
Charged Paid Credited
107 30 107 30 00
00 00 00
107 30 107 30 00
DATE RESULTS
q[v110
'111 1 1 o
7f ?Jl,
Date 4/21/10
WA 98362
00
0
Extension
20 80
73 50
13 00
Due
00
00
00
Date
INSPECTOR.
PREPARED 4/20/10 8 39 21 INSPECTION TICKET PAGE 5
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/20/10
ADDRESS 222 N CHAMBERS ST SUBDIV
TENANT NBR HSBC BANK USA NATIONAL
CONTRACTOR PHONE
OWNER VERNON D PETERS PHONE (360) 477 1053
PARCEL 06 30 00 8 1 0300 0000
APPL NUMBER 10 00000297 RES REMODEL
PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
BL3 01 4/20/10 L BLDG FRAMING TIME 01 00
April 20 2010 8 34 56 AM 1pangrle
VERN 477 1053
FRAMING
AFTERNOON
PERMIT PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
PL2 01 4/20/10 J L PLUMBING ROUGH IN TIME 01 00
April 20 2010 8 35 35 AM 1pangrle
VERN 477 1053
ROUGH IN PLUMBING
AFTERNOON
COMMENTS AND NOTES
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number 10 00000335
Application pin number 673505
Property Address 222 N CHAMBERS ST
ASSESSOR PARCEL NUMBER 06 30 00 8 1 0300 0000
Tenant nbr name VERN PETERS
Application type description RE ROOF
Subdivision Name
Property Use
Property Zoning COMMERCIAL OFFICE
Application valuation 9477
Application desc
TEAR OFF RE ROOF THE HOUSE
Owner Contractor
VERNON D PETERS BARNES CONSTRUCTION INC
PO BOX 2461 258852 HWY 101 W
PORT ANGELES WA 98362 SEQUIM WA 98382
(360) 477 1053 (360) 683 5796
Structure Information 000 000 TEAR OFF RE ROOF THE HOUSE
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF RE ROOF THE HOUSE
Permit pin number 163410
Permit Fee 207 75 Plan Check Fee 00
Issue Date 4/07/10 Valuation 9477
Expiration Date 10/04/10
Qty Unit Charge Per Extension
BASE FEE 95 75
8 00 14 0000 THOU BL -2001 25K (14 PER K) 112 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 207 75 207 75 00 00
Plan Check Total 00 00 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 212 25 212 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 constructi the perform nc of constructi
a V-e"•h -r
Date Print Name
T:Forms/Building Division/Building Permit
Date 4/07/10
7-
g-1
Signature of Contractor or Authorized 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 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.
Electrical 417 -4735
Construction R W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
T /Building Division /Building Permit
FINAL Date Accepted by
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Date Accepted By
7-g kr)
Applicant (It. rI'J
Property Owner
Property Owner's Address
Contractor 6� eh y s
Contractor's Address 2 5 ,g,c
Parcel Number
Basement
1St Floor
2nd Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
Max. height of proposed structure
Will a lawn sprinkler system be i stalled?
Will a fire sprinkler system be stalled?
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
Phone
Phone
71 PO box 1 tt,t P1 L Pr '1836,2
vf Phone
Z 36 2
License R hec. 1 (4 Expires v E -mail
PROJECT ADDRESS 2 2_2 l4J 7-f ‘a r
Project Type Brief Description. Residential Multi family
Check all that apply
New Construction
Addition
Remodel
Repair
Demolition
'Re -roof House garage other *tear off re -roof lay over one layer
Heat System Heat pump wood- burning stove gas fireplace pellet stove other
Other
Floor Areas Existing (sq. ft.)
Total footprint of structures
Site Coverage the amount of impervious
and other impervious surfaces (see P
sq ft. T Lot size sq ft. Lo coverage
s rface on a parcel including structures p- ed driv ays sidewalks patios
C 17 94 135 for exemptions). Site coverage
Proposed (sq. ft.)
Occupancy group
Occupant load
Construction type
Lot
TOTAL VALUATION
For City Use Only
Date Received 4 I
Permit# 10 335
Date Approved
y?7 --/o5
Zoning
Commercial Industrial
of bedrooms
of full baths
o alf baths
9
I have read and completed this application and know it to be true and correct. I am authorized to a ply for this permit an understand
that it is my responsibility to determine what permits are re uired, and to obtain permits prior to ing on projec
Date 1 -//6 /6 Print Name Signature
T FormiBui1'ding Division /Building permit application
Barnes Construction Inc
258852 Hwy 101 W
Sequin, WA 98382
Name Address
Vern Peters
222 Chambers
Port Angeles, WA 98362
Description Qty
30yr GAF/Elk Timberline Natural Shadow 17 75
Elk Starter Strip 3
Felt 5
Valley Metal 2
Step Flashing 150
Drip Edge Metal 17
Eve Metal 9
Galv Ridge Cap
roofing nails 2
Ridge Vent 12
Labor 18.75
Tear Off Labor 17 75
Prep Time
Dump
returns 11
Optional sheeting and installing sheet is $1640.10
Phone Fax
360 683 -5796 360 683 -7570
Ca l (eI at)._
3 3 o i 0 Ch et
r�-
Estimate
Date Estimate
3/1/2010 1010
Project
BID GOOD FOR 30 DAYS ANY QUESTIONS PLEASE CALL OR FAX US AT PHONE
NUMBERS AT BOTTOM OF PAGE THANKS Subtotal $7,837 00
Sales Tax (8.4 $658.31
olc
Signature
Total
$8,495.31
/0, 213,17
APR -20 -2010 15 17 FROM BOBS ELECTRIC
Data;
City of Port Angeles Permit Application
Building DlvlelonlElactrIcal Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Waehington,98382
Pht (360) 417.4795 Fax: (960) 417.4711
1 2 Single Family. Dwelling
Multi-Family or Commercial'
Commercial Addition I Alteration I Remodel Repair'
Plan Review May Be Required, lease Cone le Elecjp✓;aI Ian Revi Information Sheet
Job Address:
.Building Square Footage:
Description of above 45
Unit Charge
3119.90
145.50
204,60
262.20
5 372.50
S 2.60
73.50
2.60
3 92.70
3 110.30
149.70
167.90
S 95.90
5 8820
95.90
63.90
63.90
119.90
102.30
110.30
S 35.20
73.50
110.30
58.00
Owner Info
Name:
Malting Address:
City:
Phone:
license 0 Exp.
State:
Fax:
glX
Zip.
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3604529943
APR 21 2009
ELECTRICAL
INSPECTIONS
01)<-010 r
on actor Informs
e a,4.-444"/
D.O3 µ4
Name:
Mailing Address:
City. State: Zip:
Phone: Fax:
License of I Exp. 4 Z 02.Z.T 9
Tote! (Qty Myliioligd by Unit cilium
Sorvice/Foodor 200 Amp.
Service/Feeder 201.400 Amp.
Service/Feeder 401 -600 Amp.
Service/Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Temp. Service/ Feeder 200 Amp.
Temp. Service/Feeder 201 -400 Amp.
Temp. ServiCe/Feeder 401.600 Amp.
Temp_ SeMce/Feeder 601.1000 Amp.
Portal to Penal Hourly
Sign/Outline Lighting
Signal Circuit/ Limited Energy— Commercial. Additional 1500 $5,00
Signal Circuit/ Limited Energy I a 2 Family Dwelling
Signal Circuit) limited Energy Mulufamay Dwelling
Manufactured Home Connection
Renewable Etoceicel Energy SK /A System or Less
First 1300 Square Ft
Each Additional 500 Square FL or Potion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Thermostat
Total
TO CITY PERMIT
MO- 9 -95'46
Owner of defined by RCW.19.28.211: (1) Owner will occupy the structure for two years alter this olectrkal permit in finalised. (2) Owner le required to hire an electrical contractor M
above sold properly Is bridle, font arlasss. Permit expires after six months of lest inspection.
After reading the above statement, I rummy certify that I em the owner of the above named property ore licensed electrical contractor. I am making the electrical Installation or
alteration In compliance with the electrical laws, N,E.C, RCW, Chapter 10.26, WAC. Chapter 296466, The City of Port Angeles Municipal Code, and Utility Specifications.
Signature of owner electrical contractor or electrical administrator 0 Cash
0 Check
X astAd A Data: 4 16224 1 .23
j Credit Card 0 61,01
cf-
APR -5 -2010 12 50 FROM BOBS ELECTRIC
City of Port Angeles Permit Application
Building Division/Electrical Inspections
321 Emit Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360) 4174735 Fax: (360) 4174711
Date:
5,1 2 Single Family Dwelling
Multi Family or Commerdar
Commercial Addition I Alteration I Remodel Repair
Plan Review May Be Required Noose Complete I ctricel P an Review Information Sheet
Job Address:
Building Square Footage:
Description of above —r
Owner Infornoatlon
Name:
Malll
Ci
Phone:
License d 1 Exp.
)nil Chng
119.90
5145.50
204.60
S 282.20
S 372.50
S 2.60
73.50
3 2.80
S 92.70
S 110.30
148.70
S 167.90
95.90
88.20
S 95.90
83.90
63.90
119.90
102.30
110.30
5 35.20
S 73.50
110.30
56.00
Stela t� 9'9 Flo li
Fax
4d. 1 Ib
Owner as defined by RCW. 9.28.26 her wit a
above said properly is torsato, rent or Vase. Permit ea
After reading the above detriment. I hereby certify that
alteration In compliance with the electrical laws, N.E.C.
Signature of owner, electrical contractor or electrical a iminletrator
Check
S
Thermo tat
846 /Total
Ope
3604529943 TO 4174711
s
APR 5 2009
ELECTRICAL
C•ntractor Info 'on
•r
Name:
Maiti
City l State: Zip:
Phone: Y rte!:- Fax: 41 Ci't%g!ut
License d Exp.
Total (Qty Multiolipd by Unit Chars
S $eMc&Feeder 200 Amp.
S Service/Feeder 201-400 Amp.
S
Service/Feeder 401600 Amp.
S Service/Feeder 601 -1000 Amp.
S Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Ti Branch Circuit W/0 Sonia Feeder
t +K 010 Each Additional Branch Circuit
S Temp Service/ Feeder 200 Amp.
Temp. ServlcelFeeder 201.400 Amp.
S Temp. Senice/Feeder 401.800 Amp.
Temp. Service/Feeder 601 -1000 Amp.
Penal to Portal Hourly
S sign/Outline LIgnung
S Signal Circuit/ Limited Energy Commercial. Additional 1500 $5.00:
S Signal Circuit/ Limited Energy 1 2 Family Dwelling
S Signal Circuit/ Limited Energy Mutti•Famlty Dwelling
S Manufactured Home Connection
S Renewable Electrical Energy 6KVA System or Lees
S First 1300 Square FL
Each Additional 500 Square FL ar Portion of
S Each Outbuilding or Detached Garage
S Each Swimming Pool or Hot Tub
Credit Caro it
upy structure for two years after this electrical permit is finalized. (2) Owner is required to Ali. an electrical contractor it
urea alter six months of last Inspection.
I am the owner of the above named property ore licensed electrical contractor. I am making the electrical Installation or
RCW, Chapter 19.28, WAC. Chapter 296 -468, The City of Port Angeles Municipal Code, and Utility Specifications,
O Cash
P 1'1
h
5
Owner
VERNON D PETERS
PO BOX 2461
PORT ANGELES
(360) 477 1053
1 00
Fee summary
Permit Fee Total
Plan Check 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
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
INSTALL AN ELECTRIC FURNACE
WA 98362
Permit MECHANICAL PERMIT
Additional desc INSTALL AN ELECTRIC FURNACE
Permit pin number 163212
Permit Fee 64 80
Issue Date 4/02/10
Expiration Date 9/29/10
Qty Unit Charge Per
14 8000 EA
Charged
64 80
00
64 80
10 00000318
174616
222 N CHAMBERS ST
06 30 00 8 1 0300 0000
VERN D PETERS
MECHANICAL APPL PERMIT
COMMERCIAL OFFICE
2745
Contractor
DAVE S HTG COOLING SRVC INC
PO BOX 413
PORT ANGELES WA 98362
(360) 452 0939
64 80
00
64 80
Plan Check Fee
Valuation
BASE FEE
ME FURN /HP /FAU OR 5 TON
Paid Credited
00
00
00
Date 4/02/10
00
0
Extension
50 00
14 BO
Due
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 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 the performance of construction.
n//e/ 2- 0/J kof„
Print Name Signature of Contractor or Authorized Agent
1
7-
/Signature of Owner (if owner is builder)
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
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
PLANNING DEPT Separate Permit #s SEPA.
Parking Lighting I ESA.
Landscaping I SHORELINE.
Inspection Type
FINAL Date Accepted by
1 FI Date o Accepted by Z
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Date Accepted By
Electrical 417 -4735 I 11
Construction R W PW Engineering 417 -4831 I
Fire 417 -4653 I
Planning 417 -4750
Building 417 -4815 I (1
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES WA 98362
Application Number 10 00000297 Date 4/02/10
Application pin number 009179
Property Address 222 N CHAMBERS ST
ASSESSOR PARCEL NUMBER 06 30 00 8 1 0300 0000
Tenant nbr name HSBC BANK USA NATIONAL
Application type description RES REMODEL
Subdivision Name
Property Use
Property Zoning COMMERCIAL OFFICE
Application valuation 4165
Application desc
ADD A DORMER AND A BATHROOM
Owner Contractor
VERNON D PETERS OWNER
PO BOX 2461
PORT ANGELES WA 98362
(360) 477 1053
Structure Information 000 000 ADD DORMER BATHROOM
Permit BUILDING PERMIT RESIDENTIAL
Additional desc ADD DORMER BATHROOM
Permit pin number 162891
Permit Fee 137 75 Plan Check Fee 89 54
Issue Date 3/29/10 Valuation 4165
Expiration Date 9/25/10
Qty Unit Charge Per Extension
BASE FEE 95 75
3 00 14 0000 THOU BL -2001 25K (14 PER K) 42 00
Permit MECHANICAL PERMIT
Additional desc WALL HEATER VENT FAN
Permit pin number 162909
Permit Fee 72 05 Plan Check Fee
Issue Date 3/29/10 Valuation
Expiration Date 9/25/10
T:FormsBuilding Division/Building Permit
0 0
0
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 7 2500 EA ME VENT FAN (SINGLE DUCT) 7 25
1 00 14 8000 EA ME HEATER(SUSP /WALL /FLOOR MTD) 14 80
Permit PLUMBING PERMIT
Additional desc BATHROOM
Permit pin number 162917
Permit Fee 93 00 Plan Check Fee 00
Issue Date 3/29/10 Valuation 0
Expiration Date 9/25/10
Qty Unit Charge Per Extension
BASE FEE 50 00
ime t
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 t Volate or cancel t visig s of any
state or local law regulating constructio or/the performance of construction.
Date Print Name Signature of Contractor or Authorized Agent Signature of O ner Of owner is builder)
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
T /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
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
Inspection Type
Electrical 417 -4735
Construction R W PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
Date Accepted By
Application Number
Application pin number
T:FormsBuilding Division/Building Permit
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
10 00000297
009179
Page 2
Date 4/02/10
Qty Unit Charge Per Extension
3 00 7 0000 EA PL- PLUMBING TRAP 21 00
1 00 7 0000 EA PL -WATER LINE 7 00
1 00 15 0000 EA PL -SEWER LINE 15 00
Other Fees STATE SURCHARGE 4 50
Fee summary Charged Paid Credited Due
Permit Fee Total 302 80 302 80 00 00
Plan Check Total 89 54 89 54 00 00
Other Fee Total 4 50 4 50 00 00
Grand Total 396 84 396 84 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)
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
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
1 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
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
LA I
t -1 l b
PLANNING DEPT Separate Permit #s
Parking Lighting
Landscaping
Accepted By Comments
SEPA.
ESA.
SHORELINE.
N
N
FINAL Date7 to Accepted by J L' N
z
to
FINAL Date Accepted by
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By (D
Electrical 417 -4735
Construction R.W PW Engineering 417 -4831
Fire 417 -4653 I
Planning 417 -4750 I i
Building 417 -4815 I 1- k 3 t--
V
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
15 KW furnace
Owner
HSBC BANK USA NATIONAL ASSOC
4828 LOOP CENTRAL DRIVE
HOUSTON TX 77081
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
1 00
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
163196
56 00
4/02/10
9/29/10
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
10 00000316
073160
222 N CHAMBERS ST
06 30 00 8 1 0300 0000
ELECTRICAL ONLY
COMMERCIAL OFFICE
0
Contractor
ELECTRICAL ALTER RESIDENTIAL
56 0000 ECH EL LVT THERMOSTAT
DAVE S HTG COOLING SRVC INC
PO BOX 413
PORT ANGELES WA 98362
(360) 452 0939
Plan Check Fee
Valuation
Charged Paid Credited
56 00 56 00 00
00 00 00
56 00 56 00 00
Date 4/02/10
DATE RESULTS
k lilto
l'lco
00
0
Extension
56 00
Due
00
00
00
Signature of owner or Electrical Contractor X Date
INSPECTOR.
TP
Apr 01 10 04 Dave s Heating Cooling
Untt Charoe
S 119.90
S 145.50
S 204.60
S 26220
372.50
S 2.60
S 73.50
S 2.60
S 92.70
S 110.30
S 148.70
167.90
S 95.90
S 8820
S 95.90
S 63.90
S 63.90
S119.90
$102.30
110.30
S 3520
S 73.50
110.30
S 56.00
Q
f 0 Check
x a to Date: `0
T.;f1
2
ELECTRICAL
IMP CT90NS
As Credit Card ft
f
c_aic RD,
l bw S
3604520939
City of Port Angeles Permit Applicati on
Building DivislonlElectrical Inspections
321 East Fifth Street P.O. Box 1150
Port Angeles Washington, 98362
Ph: (360)417-475 FT 417.4711
Date: r
4.1 2 Single Family Dwellinc
Multi Family or Commercial`
Commercial Addition 1 Alteration !Remodel !Repair*
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address. N. c: k cx ker. i s S� e 'i'
Building Square Footage:
Description of above /OW ✓c? I a e to v m s GO( ✓`e
n S 1(ev r r ri ekk f 5 K VV pzke_c- 4,--0" c- 'fi v- h
Owner Information Contractor Information
Name: V e r r l r c fi e r s Name: J7- a k1 S .e ei.-4-1 r. g
Mailing,Qddress: t 0. (Sol( .T `f I Mailing dress: P 0. .6r 'P( 3
City Para- A euvr a._SState: /1)A Zip: '1 V d City _PDr -•f State: (aJ#1 Zip: `7 -3b3.
Phone: 4 11i- r0 53 Fax: Phone 01 ex: �Sa -d4.3
License Exp. License 1 Exp. Z 1/-E.S Gf c-9 9 C.
Total (otv Multiplied by Unit Charge)
5 Seivic&Feeder 200 Amp.
Service/Feeder201-400 Amp.
SeiviceiFeeder401.600 Amp.
5 Service/Feeder 601 -1000 Amp.
ServicelFeeder over 1000 Amp.
Branch Circuit W! Service Feeder
Branch Cicuit W/0 Service Feeder
Each Additional Branch Circui:
Temp. Service! Feeder 200 Amp.
g Temp. ServicelFeeder 201400 Amp.
g Temp. ServicelFeeder 401-600 Amp.
Temp. Service/Feeder 601 -1000 Amp.
Portal to Portal Hourly
5 Sign/OutlineLighting
Signal Circuit/ (.invited Energy Commercial. Additional 1500 S5.00
Signal Circuit/ Limited Energy t 8 2 Family Dwelling
Signal Circuit/ Limited Energy Multi -Family Dwelling
Manufactured Home Connection
Renewabe Electrical Energy 5KVA System or Less
First 1300 Square Ft.
Each Additional 500 Square Fl. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or HotTub
Thermostat
Sh. Q2Total
Signature of owner, electrical contractor or electrical administrator Cash
p1
‘-appr
Owner as defined by RCW.19.28.261. (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 sir 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 making the electrical installation or
alteration in compliance with the electrical laws, N.E.C. RCW Chapter 19.28, WAC. Chapter 296.468, The City of Port Angeles Municipal Code, and Utility Specifications.
Apr 01 10 03
Roar Areas
Parcel Number
Dave s Heating Cooling
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
Applicant I) av� `s iiea-m r sr Phone
Property Owner 1/e ?e -,r 5 Phone
Property Owner's Address P 0 x g 4 i. �oye qa-(
Contractor cLu -e..t s 4e,. v.. 5 Plione
Contractor's Address P o 60)‹- A#(3. r ,4,.,
License )A Vas t-t c.11'1 K c. Expires 5 Jag ci E -mail
Project Type Brief Description.
Check all that apply
New Construction
o Addition
o Remodel
o Repair
o Demolition
o Re -roof
(Heat System
'o Other
)7i Residential o Multi- family
Existing (se. ft.) Proposed (se. ft.)
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
3604520939
Basement Q per sq. ft.
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
p1
For City Use Only
Date Received 'if l b
Permit# t O -31$
Date Approved
�.sa —a 9a 9
`f 7 7 -(O
�LSa -0 93 9
d a L ce_r G.n.
to ii a•�1 iL_.
PROJECT ADDRESS a a N CA u PT
t o
1 s y cL
r f Zorfn I1
Sn� -�i 7�+ ry,c, rOGf- Y
o Commercial a Industrial
o House a garage a other a tear off re -roof o lay over one layer
o Heat pump a wood- burning stove o gas fireplace a pellet stove B other )5 Kw
ele�fin� -6v cs4.1
TOTAL VALUATION
Total footprint of structures sq. ft. Lot size sq. ft. Lot coverage !o
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
of bedrooms
*of full baths
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 sponsibility to determine what permits are required, and to obtain permits prior working on projects.
Date 1 J Print Name 1- 0 U k q► Signature kt
T:Form uniting Division /Bldg Permit.doc (f
Applicant
Property
Property
Contractor
Contractor's
License
PROJECT ADDRESS
Parcel Number
WOdilikITT
de�lc�t.G�
Repair
Demolition
Re -roof
Heat System
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
I)
Pe-le
Owner r� 71z f s
Owner's Addres 2-,
I) v. .0
Address
"7I 2 s
7 2 2 /V CAid-7ia.e. v
Project Type Brief Description. y( Residential
Check all that apply
New Construction
411 d(),e'reC2
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement
1 Floor
2 Floor
3 Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
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
Phone
Expires E -mail
nc Y P�1
*(4,4,000)
For City Use Only
Date Received ;--25
Permit 16—
Date Approved
Phone ')-W77-/3
Phone
Lot Zoning
Multi- family Commercial
House garage other tear off re -roof lay over one layer
Heat pump wood- burning stove gas fireplace pellet stove other
per sq ft.
of bedrooms
of full baths
of half baths
Industrial
TOTAL VALUATION I A I 6 5
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
I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit a understand
that it is my responsibility to determine what permits are requi ed, and to obtain permits prior to rking on projects
rr
Date 3/25 Print Name /i.�✓ ytoy 5 Signature ifi.,L !A f Si nature 1�
f
T Forms /Building Division /Building permit application
t)epartrru:nr rn
C evenue
n,.
REAL ESTATE EXCISE TAX AFFIDAVI3' This form is your receipt
PLEASE TYPE OR PRINT CHAPTER 82.45 RCW CHAPTER 458 -61 A WAC when stamped by cashier
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED
(See back of last page for instructions)
Check box if partial sale of property
Name: HSBC Bank USA, National Association, as
Trustee for Ownit Mortgage Loan Trust, Mortgage
O nan Accat.Rartvarl CPrtifiratac Ca rjuc •�ll
Mailing Address 1670 Broadway, Suite 700
City /State/Zi Denver, CO 80202
Phone No. (including area code)
Send all property tax correspondence to:
a F
z
w
Name
Street
City /State Zip
Phone No, (including area code)
Street address of property.
This property is located in I I unincorporated County OR within City of Port Angeles
Check box if any of the listed parcels are being segregated from a larger parcel,
Legal description of property (if more space is needed, you may attach a separate sheet to each page of the affidavit)
Lot 1, Block 3, Hart and Cookes Subdivision of Suburban Block No. 31 of the Townsite of Port Angeles, according to the
Plat thereof recorded in Volume 2 of Plats, page 70, records of Clallam County, Washington.
Situate in the County of Clailam, State of Washington
ma Select Land Ilse Code(s)•
11
enter any additional codes: I a
(See back of last page of instructions) YES 1 NO
Is this property exempt from property tax per chapter 1 XI
84.36 RCW (non profit organization)?
Is this property designated as forest land per chapter 84.33 RCW?
Is this property classified as current use (open space, farm and
agricultural, or timber) land per Chapter 84,34 RCW?
Is this property receiving special valuation as historical property
per Chapter 84.26 RCW?
if any answers are yes, complete as instructed below
(1) NOTICE OF CONTINUANCE (FOREST LAND OR CURRENT USE)
NEW OWNER(S): To continue the current designation as forest land or
classification as current use (open space, farm and agriculture, or timber) land, you
must sign on (3) below The county assessor must then determine if the land
transferred continues td qualify and will indicate by signing below If the land no
longer qualifies or you do not wish to continue the designation or classification, it
will be removed and the compensating or additional taxes will be due and payable
by the seller or transferor at the time of sale. (RCW 84.33.140 or RCW
84,34 108). Prior to signing (3) below you may contact your local county assessor
for more information.
This land
Signature of
Grantor or Grantor's Agent
does I 1 does not qualify for continuance.
(3) OWNER(S) SIGNATURE
PRINT NAME
i CERT Y UND
ff
Name (print): Stacy A. Tilson A&A9
Date city of signing: 03/29 /2010
Same as Buyer /Grantee
222 North Chambers Street, Port'Angeles, WA 98362
Spokane
II
YES NO if claiming an exemption, list WAC number and reason for exemption,
I 1
1
1
X
1 xl
DEPUTY ASSESSOR DATE
(2) NOTICE OF COMPLIANCE (HISTORIC PROPERTY)
NEW OWNER(S): To continue special valuation as historic property sign (3)
below if the new owner(s) do not wish to continue, all additional tax calculated
pursuant to chapter 84.26 RCW shall be due and payable by the seller or transferor
at the time of sale.
If multiple owners, list percentage of ownership next to name
fl Name: Vernon D Peters, a single person
Mailing Address 222 North Chambers Street
City/State/Zip Port Angeles, WA 98362
Phone No. (including area code)
List all real and personal property tax parcel account
numbers check box if personal property
063000 810300
cos)
as
x l
WAC No, (Section /Subsection)
Reason for exemption,
Gross Selling Price
*Personal Property (deduct)
Exemption Claimed (deduct)
Taxable Selling Price
Excise Tax, State
Local
*Delinquent interest: State
Local
*Delinquent Penalty
Subtotal
*State Technology Fee
*Affidavit Processing Fee
Total Due
REV 84 000la (02/I3/07) THIS SPACE TREASURER'S USE ONLY
First American Title Insurance Company
S
S
n
n
n
n
List assessed value(s)
List all personal property (tangible and intangible) included in selling
price,
Type of Document Bargain and Sale Deed
Date of Document March 8 2010
110,000.00
110000.00
1408.00
550.00
1958.00
5.00
1963.00
R PENALTY OF PERJURY THAT THE FOREGOING iS TRUE ANR..CORRECT
Signature of
Grantee or Grantee's Agent
110000.00
0.00
A MINIMUM OF $10.00 IS DUE IN FEE(S) AND /OR TAX
*SEE INSTRUCTIONS
Name (print) Vernon D Peter S tacy A. Tilson As Agent
Date and Place of signing: 03/29/2010 Spokane
Perjury. Perjury is a class C felony which is punishable by imprisonment in the state correctional institution for a maximum term of not more than five years, or
by a fine in an amount fixed by the court of not more than five thousand dollars ($5,000.00), or by both imprisonment and fine (RCW 9A.20.020(1C)).
COUNTY TREASURER
Clallam County Assessor Treasurer Property Details 62557 HSBC BANK USA NA. Page 1 of 4
Clallam County Assessor Treasurer
Property Search Results 62557 HSBC BANK USA NATIONAL ASSOC for Year 2009 2010
Property
Account
Property ID 62557 Legal Description. HART COOKES
SUBDIVISION LOT 1 BL 3
Geographic ID 0630008103000000 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: 222 N CHAMBERS ST Mapsco
PORT ANGELES WA 98362
Neighborhood Cycle 5 Comm Map ID
Neighborhood CD 20953140
Owner
Name
Mailing Address:
Taxes and Assessments Due
Property Tax Information as of 03/25/2010
Amount Due if Paid on. ;p.•
HSBC BANK USA NATIONAL ASSOC Owner ID 31518
4828 LOOP CENTRAL DRIVE Ownership 100 0000000000%
HOUSTON, TX 77081
Exemptions:
First Second
Half Half
Statement Base Base Base Amoy
Year ID Taxing Jurisdiction Due Due Penalty Interest Paid Due
2010 45164 ST SCH STATE SCHOOL $154 66 $154 67 $0 00 $0 00 $0 00 $30I
2010 45164 CC -GEN COUNTY $82.31 $82 31 $0 00 $0 00 $0 00 $16
2010 45164 PORT PORT $11 57 $11 57 $0 00 $0 00 $0 00 $2:
2010 45164 PORT ANG PORT ANGELES $190 57 $190 57 $0 00 $0 00 $0 00 $38
2010 45164 SD #121 SCHOOL DISTRICT #121 $200 33 $200 34 $0 00 $0 00 $0 00 $401
2010 45164 NTH OLY LIB NORTH OLYMPIC LIBRARY $23 92 $23.91 $0 00 $0 00 $0 00 $4
2010 45164 HOSP #2 HOSPITAL #2 $33 76 $33 77 $000 $0 00 $0 00 $6
2010 45164 WSMET PK DIST WILLIAM SHORE MET PARK DIST $10 74 $10 75 $0 00 $0 00 $0 00 $2
2010 45164 CITY_STORMWATER CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $0 00 $7'
2010 45164 WEED_CONTROL WEED CONTROL $0 82 $0 81 $0 00 $0 00 $0 00
2010 45164 TOTAL. $744.68 $744 70 $0.00 $0.00 $0.00 $1481
2009 625572008 ST SCH STATE SCHOOL $180 50 $180 50 $0 00 $0 00 $361 00
2009 625572008 CC -GEN COUNTY $91 35 $91 34 $0 00 $000 $182.69
2009 625572008 PORT PORT $12.94 $12.94 $0 00 $0 00 $25 88
2009 625572008 PORT ANG PORT ANGELES $200 36 $200 38 $0 00 $0 00 $400 74 $l
2009 625572008 SD #121 SCHOOL DISTRICT #121 $223.21 $223.21 $0 00 $0 00 $446 42
2009 625572008 NTH OLY LIB NORTH OLYMPIC LIBRARY $26 54 $26 55 $0 00 $0 00 $53 09
2009 625572008 HOSP #2 HOSPITAL #2 $37 46 $37 47 $0 00 $0 00 $74 93
2009 625572008 CITY_STORMWATER CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $72 00
http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2009 &prop_id =62 3/25/2010
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Ct` Y t OM' ANGELES Construction Plans
The Isanc of this permit tLased upon these plans, specifi-
cat ons and other data shall not prevent the building official
fro fter requiring t ie correction of errors in said
pli r e+ ifications and .ther data, or from preventing
buldi g operations being tarried on thereunder when in
vi elation o all codes and ordinances of this jurisdijtion.
Foproval 4
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A dormer is a framed structure projecting from a gable, and hip (see 17 1). Shed dormers cant
sloping roof to house a window or ventilating lou- made very long and run almost the entire leii
ver. This admits light and ventilation into the area of the house with roof overhang or no overhari j
under the roof (the attic). Dormers make it pos-
sible to have satisfactory living space in the attic SHED DORMERS
area. 4.-
The style of dormer depends on the style of the The roof of shed dormers may run to the ridge (see,
house. The common types of dormer are the shed, 17 2) or fall short of the ridge (see 17 -3)
7 1 Dormers provide light and ventilation
3 rooms built in the attic.
CHAPTER I 7
DORMERS
f
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RIDGE BOARD
17 -2 The roof of this shed dormer runs from the ridgeboard of the main roof.
DORMER
RAFTERS
BLE
RAFTERS
WALL STUDS
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17 3 The cool
The rafter
common raf
framed the
roofs. The c
rests must
nailed to t
across the a
side (see 17
The end
plate of the
case, the a
enough to c
area to carr
are framed