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Home My WebLink About720 N St - BuildingCITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 04 00000139 Date 2/19/04 Pin number 882316 Property Address 720 S N ST ASSESSOR PARCEL NUMBER 06 30 00 4 8 0130 0000 Tenant nbr name WAVE BROADBAND Application description PUBLIC WORKS UTILITES Subdivision Name Property Use Property Zoning RS9 RESDNTL SINGLE FAMILY Application valuation 0 Owner Contractor KEDISH STEWART AND MARGIE OWNER P 0 BOX 507 PORT ANGELES WA 98362 (360) 457 -5005 Permit RIGHT OF WAY Additional desc RIGHT OF WAY USE 04 -03 Permit Fee 60 00 Plan Check Fee 00 Issue Date 2/19/04 Valuation 0 Expiration Date 8/17/04 Qty Unit Charge Per Extension BASE FEE 60 00 Fee summary Charged Paid Credited Due Permit Fee Total 60 00 60 00 00 00 Plan Check Total 00 00 00 00 Grand Total 60 00 60 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 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. p N L6 Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T•\PLANNING \FORMS \1102.15 [11/14/2003] N c BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BU:[LDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL 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 FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN 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 HEAT PUMP GAS LINE WOOD STOVE PELLET CHIMNEY HOOD DUCTS PW UTILITIES SITE WORK (Engineering Div ision) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING/LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO ELECTRICAL LIGHT DEPT 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4£07 PW ENGINEERING FIRE 417 -4653 I I I I FIRE DEPT PLANNING DEPT 417 -4-'50 I I I I PLANNING DEPT BUILDING 417 -4115 I I I I BUILDING T•\PLANNING\FORMS \1102.15 [11/14/2003] Application Number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Zoning Application valuation Owner REDISH STEWART AND MARGIE P 0 BOX 507 PORT ANGELES (480) 551 -7272 Structure Information Construction Type Occupancy Type Other struct info Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date Qty 1 00 3 00 Other Fees Unit Charge 70 8000 22 7000 Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total Signature of Contr T• \PLANNING \FORMS \1102.15 [4/2002) CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98362 Charged ctor or Authorized Agent 03 00000618 720 S N ST 06 30 00 4 8 0130 0000 RES NEW SFR 120101 Contractor OWNER NEW 1805 SF SFR W /ATTACHED 552 GARAGE TYPE V NON RATED SINGLE FAM CONGREGATES NUMBER OF UNITS ELECTRICAL NEW RESIDENTIAL SFR THE ELECTRIC 138 90 9/17/03 3/16/04 COMPANY Plan Check Fee Valuation Per Extension ECH EL -R SQFT FIRST 1300 70 80 5C EL -R SQFT ADDITIONAL 500 68 10 SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE Paid Credited 138 90 138 90 00 00 00 00 1774 50 1774 50 00 1913 40 1913 40 00 Date 9/17/03 745 00 4 50 1025 00 Due 1 00 00 00 00 00 00 0 Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Date Signature of Owner (if owner is builder) Date t„, CALL 417 -4815 FOR BUILDING 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 FOUNDATION FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH-IN PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE GAS LINE BACK_ FLOW WATER I AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL WALLS ROOF CEILING DRYWALL T -BAR INSULATION SLAB WALL FLOOR CEILING INSPECTION TYPE DATE ELECTRICAL LIGHT DEPT 417 -4735 CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 I FIRE 417 -4653 PLANNING DEPT 417 -4750 BUILDING 417 -4815 T \PLANNING \FORMS \1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE YES NO MECIIANICAL HEAT PUMP WOOD STOVE PELLET CHIMNEY 1 -1001) DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING /LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO //o%O /1)y ACCEPTED COMMENTS I I I I I I I I I El.ECTR1CAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING FIRE DEPT PLANNING DEPT BUILDING I I I I I I I I I Pony, L U Additional desc Permit Fee Issue Date Expiration Date Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total OA) 7=74_, L_ T\PLANNING \FORMS \1102.15 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Zoning Application valuation 120101 Owner Contractor KEDISH STEWART AND MARGIE OWNER P 0 BOX 507 PORT ANGELES WA 98362 (480) 551 7272 Structure Information NEW 1805 SF SFR W /ATTACHED 552 GARAGE Construction Type TYPE V NON RATED Occupancy Type SINGLE FAM CONGREGATES Other struct info NUMBER OF UNITS Permit ELECTRICAL NEW RESIDENTIAL Qty Unit Charge Per 1 00 35 3000 EC EL -LOW VOLTAGE 35 30 Plan Check Fee 00 10/07/03 Valuation 0 4/05/04 Charged 35 30 00 1774 50 1809 -80 03 00000618 720 S N ST 06 30 00 4 8 0130 0000 RES NEW SFR SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE Paid Credited 35 30 00 1774 50 1809 80 00 00 00 00 Date 10/07/03 1 00 Extension 35 30 745 00 4 50 1025 00 Due 00 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 inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date Pt) 0 FOUNDATION• FOOTINGS WALLS T- \PLANNING \FORMS \1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING 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 NO FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT H ROUGH -IN PLUMBING UNDERFLOOR /SLAB ROUGH -IN WATER LINE GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL WALLS ROOF CEILING DRYWALL T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP WOOD STOVE PELLET CHIMNEY HOOD DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT N's: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT 1/'s SEPA. PARKING /LIGHTING ESA. LANDSCAPINC SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED ,a YES I NO ELECTRICAL LIGHT DEPT 417 -4735 1 ELECTRICAL y� LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 I FIRE DEPT PLANNING DEPT 417 -4750 I I I I PLANNING DEPT I I I BUILDING 417 -4815 I I I I BUILDING BUILDING PERMIT - APPLICATION FOR OFFICiAL USE ONLY: Date Rec" IO~b'c>s' Pennit #, 618 Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 Date Approved: Date Issued: Applicant or Agent: Owner: 'S+-ew (..;J.'-! :Dave.- OlJenko.""f (nc,ve.,(5 t{eQ-("'il"\~ I Ked-Ish C;;Vo. '" 'S A v-e<\u..Z Phone: "f5;')....o93"1 Phone: 457-560"5 PO~k- .An"':f-t~s {vA Zip: 0(<6363 Address: City: Architect/Engineer: ? Phone: 1;/ , 9- (..o<>~I""'1\ ~<li=,-;z;..,,<..., I Contractor Do. ve 6 n -e 0. -h,,'8 State r,icense #: DAV6<5.{(;'1<JI\<.C- Exp: OS ;;Joo5 Phone: Address: PO. BDx '-f13 City: for~ Ah~/~ 0+ Zip: PROJECT ADDRESS: 7;10 SO'-A+h. tV Sfy'..e.e.+ Po.,....\-A.-,"1~ ZONING: LEGAL DESCRIPTION: Lot: I "3 Block: Subdivision: f'vI; \WCl u. ~ f{--QA' <;JIJ-s CLALLAM COUNTY PARCEL NUMBER: '-f5"d--6 <1"3"'1 q'l<;.:3"~ Credit Card Holder Name: :\)"viJ L. 6lJenkct",,- Billing Address: Box '-{ I 3 Credit Card Type VISA V- MC TYPE OF WORK: o Residential riew Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: 777-PJhUJSW # " Exp.Date: SIZEN ALUATION: SF. @ $ /SF. = $ SF. @ $ /SF. = $ SF. @ $ . /SF. = $ TOTAL VALUATION $ .3a?Q (R~~,~ ~ ~'5~) Occupant Load: Construction Type: /.LIrf\i COMMERCIAL/RESIDENTIAL: Occupancy Group: No. of Stones: Lot Size: Existing Sq. Ft. E . sting lot coverage ~ & Proposed lot coverage & Proposed Sq. Ft. 0/, - Total lot coverage Xl - 0 - 0- 0 APPROVALS: PLANNING USE ONLY: PLAN: BLDG: DPWU: FIRE: ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER: - BIDLDlNG PERMIT APPLICATION SUBMITTAL: The Building Divisi ve question ALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-48 I 5 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: Ifno 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 107.4 of the Uniform Building Code, current edition). No application can he extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are requi~ ,ot the City's, and at I must obtain such permits prior to walk. kJ It. itJ"? I ' Applicant: Date: T\FORMS\APPS\Buildingpermi t. wpd FOR OFFlCIA.L USE ONLY ELECTRICAL PERMIT APPLICATION ~" [hie AplWn~cJ; Oau:luuN: The Electrical Penn;' Application must be filled Dut comoletelv. ;I~ . Please type Of' reprint in ink. "~u have any questiDns, please call {36G. 417-4735 tt= 6,;?-. 5"" Fax number: (360) 417-4711 Phone: 1'57-7/~ Fax: Phone: ,qr:;--;-SOOcs-- Zip: ~"56 L..- S+t'fuJAf'l-J Address: 6ZLf. ::::(h1ttJ~ Ei eelrieal Contractor: tz Lt:Fc-ne,'c Property O\NOer: ~.ef /I~/e s 00 license #: Exp: Phone: INSTALLATION WIRED BY: DOWNER City: ~CTRICAL CONTRACTOR Zip: Address: Credit Card Holder Name: Blfling Address: PO. RO"f S7:rf City: ~IZI /ltvr1f"'5: Exp. Date' Zlp.tj'r?"3,C''L- Credit Card Number: VISA: MC PROJECT ADDRESS: ?~O G, S,H'",sr. TYPE OF WORK: Check all that apply: ~w o Alteration/Addition o Residental 0 Multi-family o Commercial 0 Mobile Home .. Sq. Fl o Remote MeIer 0 Detached garage 0 Hot Tub 0 Swim Pool . 0 Septic P,ump 0 Low Voltage 0 Telecom. 0 : Number of Circuits added or altered: J ' DESCRIPTION OF THE.El.ECTRICAL PROJECT: 71Un? ( 5U1//('--€- A/lE-lJ .H~~ "? Electrical Heat Load Additions ..t tjO ,90 Service Information o Overhead Service IHf emp Service ~nderground Service Vollage: Phase: 0 1 0 3 Service Size: Feeder Size: o Baset>oard a;;r'Furnace o Heat Pump o Fan-Wall _KW _KW _KW _KW PAMC 14.05.D6O{B): For industrial, commercial, & residential projects larger than a duplex. a one -line drawing of the Electrical Service Feeders. building size (sq. fl.), load calculations, and the type & of conductors and/or raceway is required and shall accompany the Electrical Permit application. I hereby certify that I have read and examined this application and know that same to be true and correct, and I <- authorized to apply for this permit. , understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants responsibility to determine what permits are required and to obtain such. PW-9019 Credit Card Holder's Signature: Owner or Elec. Cont.. Signature:. ~ad ~ ~ Date: Date: o/<i~3 / ~ C 0--. 1-7- ()3 o. ~- ,- )f~(J ;;/0 / {~ /o?:o> !fL/().9.o ~. .' \ ELECTRICAL PERMIT APPLICATION FOR OFFIC!.-'U. USE ONLY DateIRec" Permil#; Pate Approvcd: Datclssuc:d: \ ~ The Electrical Permit Application must be filled out comDletelv. Owner or Elec. Contractor Agent: -rR/if ~t:.- Property Owner: ~~ ~J... ~)..., Please type or reprint in ink. if you have any questions, please call (360) 417-4735 Fax number: (360) 417-4711 ~ ff~ j/It <f:I: ~ f f3 Phone: 11S? /,J;u) Fax: Phone: Address: " ~... ;.-"7 Electrical Contractor: I //t::. c..:;:;,~ Address~~ IJ ~ /'t'?J City: 6.0 License#:/4~/<9Exp: ~'-'I City: ~A.\.. '~w~~~ _So ~TRICAL CONTRACTOR Zip: Phone: ~~/" r Zip 9f):?~'2. INSTALLATION WIRED BY: DOWNER Credit Card Holder Name: Bitting Address: City: Zip: Credit Card Number: Exp. Date: VISA:_ MC: PROJECT ADDRESS: 7;2..1) <;::J AI , ~~~ 1J1~~s _. .'_ , ~w o Alteration/Addition /805 r ~-S"L.:: ;).357 Sq. Ft ISOD 5.-0 ~ o Mobile Home TYPE.OF WORK: ~idential Check all that apply: o Multi-family o Commercial o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump o Low Voltage 0 Telecom. 0 Sign Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT: S r ...e. , /805 r ,5;5"2.' ~r> Electrical Heat Load Additions and or Subtractions Service Information o Baseboard o 9tIrnace ~eat Pump o Fan-Wall JOKW ~.n~N_ KW lRA o Overhead Service o T eJJ1P"5ervice ~derground Service VOllage:~ ?J}&J Phase: 0 3 Service Size: ~ Feeder Size: I hereby certify that I have read and examined this application and know that same to be true and correct, and I am authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants responsibility to determine what permits are required and to obtain such. Credit Card Holder's Signature: ~ " . Owner or Elec. Cant. Signature: c.~r/!? tJ~ Date: Date: defT L 03'- ff, U-IA D''C-~~~ / /. - /_" PERMIT FEE: $ /38 '10 .--.--. C:/ELECTRICAlPERMIT APPLICATION ~~ORT~ $~O~~<iJ, r.. L ,.;;;..or_ ~ 'tOl"~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 0 ~ -u / E:J Application Number Property Address ASSESSOR PARC~L NUMBER Application description Subdivision Name Property Zoning Application valuation Owner 6/26/03 03-00000618 Date 720 S N ST 06-30-00-4-8-0130-0000- RES NEW SFR 120101 Contractor KEDISH STEWART AND MARGIE OWNER POBOX 507 PORT ANGELES WA 98362 (480) 551-7272 Structure Information NEW 1805 SF SFR W/ATTACHED 552 GARAGE Construction Type TYPE v NON-RATED Occupancy Type SINGLE FAM & CONGREGATES Other struct info NUMBER OF UNITS 1 00 Permit Additional desc Permit Fee Issue Date Expiration Date DRIVEWAY INSTALLATION ~ ~ ~ 145 00 6/26/03 12/23/03 Plan Check Fee Valuation V\ 00 o Qty Unit Charge Per BASE FEE Extension 145 00 ~ Pez;mit Additional desc Permit Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV DROP IN METER 150 00 Plan Check Fee 6/26/03 Valuation 12/23/03 ~ 00 120101 Qty Unit Charge Per BASE FEE Extension 150 00 Permit Additional desc Permit Fee Issue Date Expiration Date RIGHT OF WAY 45 00 6/26/03 12/23/03 Plan Check Fee Valuation 00 120101 Qty Unit Charge Per 1 00 45 0000 ECH RIGHT OF WAY PERMIT Extension 45 00 Permit Additional desc Permit Fee Issue Date Expiration Date SANITARY SEWER HOOK UP Ej I ~52 ~ WOKs 95 00 6/26/03 12/23/03 Plan Check Fee Valuation 00 120101 Qty Unit Charge Per 1 00 95 0000 EA SAN SEWER HOOKUP Extension 95 00 ------------------------------------------------------------------- ~ SEWER SYSTEM DELV CHARGE 74~-~~----- ~\/ 1 ~~J ~~ STATE SURCHARGE 4 50 ~ ~ I' "'J PW WATER SYSTEM USE FEE 1025 00 / Fee swnmary Charged Paid Credited Due if2: W ~ ~ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes I 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 specif(ed herein or not. The grantingG,f a permit does not presume to give authority to violate or cancel the provisions of any state or local Jaw regulating construction or the performance of construction ! Other Fees 'Iv I 0-2(a-O Signature of Contractor or Authorized Agent Date Signature Date T-\PLANNING\FORMS\II02.15 [4/2002] (iO~'" iJ'-~~ ~ ~ ---~ ~<:;~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number 03-00000618 Date 6/26/03 ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 435 00 435 00 00 00 Plan Check Total 00 00 00 00 Other Fee Total 1774 50 1774 50 00 00 Grand Total 2209 50 2209 50 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction Signature of Owner (if owner is builder) Date Signature of Contractor or Authorized Agent Date T-\PLANNING\FORMS\1102.15 [4/2002] I -+:: ~ c 0 0 +:J .~ ~ 0 ~ :l: ~ < ;> fz (1\ ~ r .., w ~ ~<)~ ~ \J\ "" a.. 1~~ a: 0 rA J- u. t- ~a ~ en V)f f w ::J 0 W 0 a: t- ~ '" c IIJ e 8 ~ u .. ~ ..5 tJ :3 0 0 u g ~ X VI ~ qt'f ? ot.r ?t.'i ~3 3 .., ~~ APPLICATION FOR WATER City Water Department Port Angeles, Wash. t\-~ wt' 58~ zc.c>3 c - c::26 ,~ I hereby apply for water to be furnished in accordance with rates and rules of the City for the following premises Si ze of Servi ce f-w40~-rfID25~ 'f/O tJP- Remarks IU .e-re ~ ::It ~(+y ~ 8 ( ~ Fo..L+--18Z38~t.f ( R13- ~OaDO s ::I w ~ ~ - '5+ v ;:;~ ~ Nt. .... ~ \i' - 'i I~tf ' ,fi. 2 \'-.. N CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . INSPECTION REPORT. . REQUEST Date Cfl103 .. _ Time ___________ Received by (phone, person) Location of Work to be inspected __ {Lv. ~( S-n2.-~T Name of person requesting inspection ?~ Address of person requesting inspection Phone No Type of Inspection (circle appropriate one) Permit No {) '3 - /tJ/8 e? Foundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES Inspected Date q /7 !o ; / / Remarks (_O....lt--IC:.VT lO K)((S,....tb---l <.=. LA.\~~ fl..,-L Time Cj AM By b72/c- l~jM.-,z..*77-1 6 \<:..- RESTORATION REQUIRED YES NO \ lJ I 6~(l-I>~iZ --------------~-~- t-1 0 """ " J I ~~~ I d" J-- ~ N I:; V' 2. SURFACE RESTORATION SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC o Other [] Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO CJ)VER, INSULA TE 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 NO FOUNDATION FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYW ALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING T I T MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW VTlLlTlES / SITE WORK (Engineering Division) SEPARATE PERMIT #'5: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'5 SEPA. PARKING/LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/VSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W / PW/ CONSTRUCTION R.W ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T-\PLANNING\FORMS\1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO (JJVER, INSULA TE 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 NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL WALLS 1 ROOF 1 CEILING DRYWALL T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING MECHANICAL HEAT PUMP WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING/LlGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W 1 PWI CONSTRUCTION R.W ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \PLANNING\FORMS\1102.15 [4/2002]