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1920 Village Cir - Building
Fire Permit 1920 Village Cir 12 - 1159 ui i r yr run,i ,uNurLr,J FIRE DEPARTMENT PERMIT 321 East 5" Street, Port Angeles, WA 98362 Application Number . . . . . . 12-00001159 Date 9/06/12 Application pin number . . . 743614 REPORT SALES TAX Property Address . . . . . . 1920 VILLAGE CIR ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0210-0000- on your state excise tax form Application type description FIRE SPRINKLER SYSTEM to the City of Port Angeles Subdivision Name . . . . . . Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY Application valuation . . . . 2075 ---------------------------------------------------------------------------- Application desc RESIDENTIAL FIRE SPRINKLER SYSTEM ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GEIGER, AMANDA INNOVATED FIRE SPRINKLERS 707 E LOPEZ 81 NEW HAVEN LANE PORT ANGELES WA 983626710 PORT ANGELES WA 98362 (360) 452-7583 ---------------------------------------------------------------------------- Permit . . . . . . FIRE SPRINKLER RESIDENTIAL Additional desc . . RESIDENTIAL FIRE SPRINKLER SYS Permit Fee . . . . .00 Plan Check Fee .00 Issue Date . . . . 9/06/12 Valuation . . . . 2075 Expiration Date . . 3/05/13 ---------------------------------------------------------------------------- Special Notes and Comments A full acceptance test will be required for the fire sprinkler system. Public Works Utility Engineering has no requirements for this plan review. ---------------------------------------------------------------------------= Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total .00 .00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total .00 .00 .00 .00 0 dolop• QThis permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or abandoned for a period of 180 days afer the work has commenced,or if required inspections have not been requested with 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 recognized standards, laws and ordinances governing this type of work will be compied •4ft with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the rovisions of any state or local law regulating the work specified in the permit. A Signature of Contractor or Authcleized Agent Date Signature of Owner (if Owner is builder) Date FIRE PERMIT INSPECTION RECORD Call 360-417-4655 for fire"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 Passed Comments FIRE SPRINKLER Underground piping hydrostatically tested Underground piping flushed Interior piping hydrostatically tested Interior piping inspection Dry system air tested at 40 psi (24 hours) Sprinkler final FIRE ALARM Rough-in inspection Alarm final LP-GAS Completed by Contractor: Underground piping inspection/pressure test Test#1 Above ground piping inspection/pressure test Piping pressure test psi Tank(container) inspection Time initiated Test#2 Appliance inspection Piping pressure test psi Time initiated LP-gas final UNDERGROUND STORAGE TANK (UST) ABANDONMENT ` Removal of flammable/combustible liquids Tank appropriately abandoned UST abandonment final O PERMIT OTHER(specify) permit final GENERAL COMMENTS: 2/15/00 n, Kf.11 FIRE—RELATED PERMIT APPLICATION CITY OF PORT ANGELES For City Use Only: =- = Attn: Building Permit Technician Date Received °�' 4� 321 E. Fifth St., Port Angeles, WA 98362 Permit# (360)417-4815 fax(360)417-4711 i Applicant r S2,1c- Q Y-` Phone L/ Property Owner wt l:�_v` G 2i Q Phone L-I - 1 — "1 ZO Property Owner's Address a d V ' ) Ze, C `,r-c L Contractor 11VA1611/1-�"�� ;�-1 &4 F_.- P Z, Fhone 2 7,5- Contractor's Address 1 le' L„,^ License # Expires 12 113 E-mail i PROJECT ADDRESS 1 2- ' Project Business Name I Fire Alarm Svstem ❑ Residential _ .❑ Multi-family i Commercial ❑ Industrial Check all that apply Briefly describe the proje 11 One addressable loop �IV ❑ One zone ❑Additional zones oFp _ 5 2 List quantity of additional zones PROJECT VALUATION(labor& materials) $ OF PORT AN B �2esidential ❑Multi-family ❑;Commercial ❑ Industrial Fire Sprinkler System Check all that.apply Briefly describe the projeft Installing backflow protection device(s)? s ❑ yes )(no <2 inch waterline (list quantity of devices) y >2 inch water line (list quantity of devices) PROJECT VALUATION(labor& materials) $ f Flood/ Duct Fire Suppression System ❑ Residential ❑Multi-family -- ❑ Commercial ❑ Industrial Check all that apply Briefly describe the project: Will only the fire suppression system be installed or altered? ❑ yes ❑ no Will a hood and/or ductwork be installed or altered? ❑ yes" ❑ no *If yes, a mechanical permit will also be needed. PROJECT VALUATION(labor& materials) $ 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 esponsibility to determine what permits are required, d to obtain permits prior working on projects. Date Print Name �C Q�,"�� �✓rSignature �� T:Forms/Building/Fire-related permit application PREPARED 4/01/13, 15:04:37 INSPECTION HISTORY REPORT PAGE 1 PROGRAM BP521L 0/00/00 THRU 0/00/00 CITY OF PORT ANGELES --- --------------------------—---- -- APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR ------------------------------------------------------------------------------------------------------------------------------------ 12 00001159 1920 VILLAGE CIR 06-30-13-5-7-0210-0000- 063013570210 000 000 FSPK 00 FIRE SPRINKLER RESIDENTIAL FFNL 0001 FIRE FINAL 3/28/13 APPROVED KDD REQ COMM: March 28, 2013 10:02:01 AM kdubuc. RES COMM: March 28, 2013 10:02:19 AM kdubuc. RES COMM: fire final Electrical Permit 1920 Village Cir 12 - 1082 ELECTRICAL PERMIT CITY OF PORT ANGELES 1 360-417-4735 Application Number . . . . . 12-00001082 Date 8/20/12 Application pin number 025794 Property Address . . . . . 1920 VILLAGE CIR REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0210-0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc New home ---------------------------------------------------------------------------- Owner Contractor GEIGER, AMANDA OWL ELECTRIC 707 E LOPEZ PO BOX 536 PORT ANGELES WA 983626710 CARLSBORG WA 98324 (360) 582-0833 - ------------------------------ ----------------------------------- Permit ELECTRICAL NEW RESIDENTIAL Additional desc t Permit Fee . . . . 120.00 Plan Check Fee .00 v Issue Date . . . . 8/20/12 Valuation . . . . 0 Expiration Date . . 2/16/13 ` Qty Unit Charge Per Extension �J 1.00 120.0000 ECH EL-MANF HOME SERVICE & FEEDER 120.00 ----------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 120.00 120.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 120.00 120.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE rz— ROUGH-IN 1 t z FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:AEXCHANGE\BUILDING CITY OF PORT ANGELES PERMIT APPLICATION AUG 2 0 20 12 Building Division/Electrical Inspectionsder ELECTRICALS M 321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362 INSPECTIONS ." Ph: (360)417-4735 Fax: (360)417-4711 Date: �^ Zf Z- _1 &2 Single family Dwelling *Plan Review%,BeRequ're�,Please Complete Electrical Plan Review Information Sheet Job Address: I �r A Building Square Footage: fu 41 C Description of above { r Owner InfQ�mation n Contractor 1 for ti° Name: t"LVR4 r `l4kji&4,4 /'Fj4 r4 q Name: Ty I rl Mailing ddress: ' S' F sQ cm Mailing ddre s: d City: l r State: Zip: City: r ✓f Apt State: 4 Zip: I rL j 2- Phone:Y T Z-00Fax: Phone:474-01 Fax: L License#1 Exp. License#I Exp. Vt ff 0 6 0 C- Item knit Charge gty Total(Qty Multiplied by Unit Charge) Service/Feeder 200 Amp. $120.00 $ Service/Feeder 201-400 Amp. $146.00 $ Service/Feeder 401-600 Amp $205.00 $ Service/Feeder 601-1000 Amp. $262.00 $ Service/Feeder over 1000 Amp. $373.00 $ Branch Circuit W/Service Feeder $ 5.00 $ Branch Circuit W/0 Service Feeder $ 63.00 $ Each Additional Branch Circuit $ 5.00 $ Branch Circuits 1-4 $ 75.00 $ Temp.Service/Feeder 200 Amp. $ 93.00 $ Temp.Service/Feeder 201-400 Amp. $110.00 $ Temp.Service/Feeder 401-600 Amp. $149.00 $ Temp.Service/Feeder 601-1000 Amp. $168.00 $ Portal to Portal Hourly $ 96.00 $ Signal Circuit/Limited Energy-1 &2 Family Dwelling $ 64.00 $ Manufactured Home Connection $120.00 $ Renewable Electrical Energy-5KVA System or Less $102.00 $ Thermostat $ 56.00 $ Note:15.00 for each additional T-Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. $120.00 Each Additional 500 Square Ft.or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $ Each Swimming Pool or Hot Tub $110.00 $_ $z_Total 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 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.I am making the electrical installation or alteration in compliance with the electrical laws,N.E.C.,RCW.Chapter 19.28,WAC.Chapter 296-46B,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner,el tri I contracto or electrical administrator: ❑ cash ❑ Check 7 ❑ Credit Card# X Dated: �`�� / 0110112012 ELECTRICAL PERMIT a CITY OF PORT ANGELES 360-417-4735 �+ Application Number . . . . . 12-00000824 Date 6/28/12 Application pin number . . . 249904 �- Property Address . . . . . . 1920 VILLAGE. CIR REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0210-0000- on our excise tax form Application type description ELECTRICAL ONLY Y Subdivision Name . . . . . . to the City of Port Angeles Property use . . . . . . (Location Code 0502) Property Zoning RESIDENTIAL HIGH DENSITY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc New home ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GEIGER, AMANDA OLYMPIC WIRING INC 707 E LOPEZ 9601 PROVOST ROAD NW. PORT ANGELES WA 983626710 SILVERDALE WA 98383 ------------ ---------------------- ---- (360) --------692-0134...3_�>2_� z_ 6YO Permit . . . . . . ELECTRICAL NEW RESIDENTIAL Additional desc . . Permit Fee . . . 120.00 Plan Check Fee .00 Issue Date . . . 6/28/12 Valuation . . . . 0 Expiration Date 12/25/12 Qty Unit Charge Per Extension 1.00 120.0000 ECH EL-R-SQFT FIRST 1300 120.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 120.00 120.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 120.00 120.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH �► �cl Z SERVICE ROUGH-IN FINAL COMMENTS: gj �Z (G�c�IL LL PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING JUN-27-2012 11:25A FROM:OLYMPIC WIRING (360)692-3680 TO: 13604174711 P. 112 i I G � �;i t� ih!� of ti•pkr�,t, � A1� r CY CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections RI��� 2 7 K") 321 East Fifth Sheet—P.O.Box 1150/Port Angeles Washington,98362 PII: (360)417.4735 Fax: (360)417-4711 ELECTRICAL INSPECTIONS Date: G—z7— /Z _1 itingle Family Dwelling `Plan Review Ma Be Required, Please.Complele Electrical Plan Review Information Sheet Job Address: (9�O V(LLA(a E- C 11Q C LE POrZT AN&C LES. WA (LO T -2-1 Building Square Footage: ll 2.'e �A- / --' Description of above Slv�ale -trmlflLj tnov+ne_ 0_ pev,.v)$Lka_ village.. Owner Informatlon Contractor Information Name: Name: o IR.IV) 'SNC Mailing Address:2 b o3 S- Fra c r s St . Mailing Addr ss: Lo 1 P Ro VO S T RD t4'Vj. CIty:Port Aw,geles Stale / _Zip: 9 S(36Z Clty:51lucr�cl�.le, State: WA Zip: 983 R 3 Phone:'3or. x(12-- 00 1 q ( 8 rutc 1 Phone:3609.97_0i34 Fax:344o 07- 362A License#/Exp. License#I Exp.0 Ly M P w T 3 1 o KQ Item Unit Charge (qty Total(Qtv Multiplied by Unit Charge) $120.00 $ $ $205.00 b a r ec�d c+ o vi $262.00 $ $373.00 $ $ 5.00 $ $ 63.00 $ �U'tcL $ 5.00 $ $ 75.00 $ $ 93.00 $ $110.00 $ T cL vt.Ic q o L . $149.00 $ $168.00 $ $ 96.00 $ Jwelling $ 64.00 $ Manufactured Home Connecllon $120.00 $ Renewable Electrical Energy-5KVA System or Less $102.00 $ Thermostat $ 56.00 $ Note:$5.00 for each additional T-Slat NEW CONSTRUCTION ONLY: First 1300 Square Ft. $120.00 1 $ 12a Each Additional 500 Square Ft.or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $ Each Swimming Pool or Hot Tub $110.00 $ $ 120 — Total 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 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.I am making the electrical installation or alteration in compliance with the electrical laws,N.E.C.,RCW.Chapter 19.28,WAC.Chapter 296-46B,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: ❑ Cash ❑ x \L...�i� Dated: L-27^ /2 0110112012: t - ,D)RUI CITY OF NGELES P A WASHINGTON, U S A DEPARTMENT OF COMMUNITY DEVELOPMENT RE .-``Temporary Use Pertrrt- TUP 05-01 1920 Village Circle APPLICANT Richard Chambers, Habitat for Humanity REQUEST Temporary Use Permit to allow the placement of one fob trailer and a 40' shipping container on Lot 21 of Peninsula Village DATE June 19, 2009 ACTION Use of a fob shack during housing construction activities on Lot 21 of Peninsula Village is --� hereby approved until June 19, 2010 or final construction activity, whichever comes first, with the following conditions CONDITIONS C r 1 The fob trailer must be on a lot that has an active building permit for habitat (� developments. (a 2 Placement of the temporary unit shall be in compliance with all pertinent local and state development regulations. Location shall be no less than 3' from side yard and 10' from rear 1/3 of lot. Inspection and approval of the placement and utility hookup shall be inspected by the Fire Department and Electrical Inspector prior to occupancy of the trailer Use of a 40' shipping container is denied. This decision is based on the following findings and conclusions included in this report. PROPOSAL The applicant has requested a temporary use permit to place one fob trailer and one 40' shipping container on a residential property during house construction activities in a PRD Planned Residential Development. FINDINGS 1 A request to utilize a construction trailer and storage unit during residential construction at 1920 Village Way was received on June 11, 2009 from Mr Richard Chambers. The temporary unit is desired for storage of tools and to construction supplies during construction activity 2 Storage containers are listed as permitted uses in the IL zone, but not in residential zones. 3 A building permit is required for the residential construction. 4 Accessory structures are permitted to be located within 3' of side and 10' of rear yards in the rear 1/3 of lots in RHD zones per section 17 15 050 of the Port Angeles Municipal Code 5 Section 17 95 060 of the Port Angeles Municipal Code allows for the Planning Manager to issue permits for the occupancy of temporary buildings used in conjunction with construction or reconstruction projects for a period not to exceed one year Such temporary buildings may be located in any zone provided that sufficient setbacks are maintained to protect the public health, safety, and welfare Decisions on temporary uses exceeding one year must be made after a public hearing on the matter has been held. 6 Placement of the temporary unit must be inspected and approved by the City's Fire Department and Electrical Inspector to ensure that all relevant local and state regulations are followed prior to occupancy CONCLUSIONS 1 As conditioned, the use complies with Section 17 95 060 (Temporary Buildings) of the Port Angeles Municipal Code and with development standards of the RHD zone and PRD approval. 2. Ultimate use of the site as a residential unit is in compliance with the City's Comprehensive Plan and Zoning Ordinance 3 As conditioned, the use as proposed does not endanger the public health, safety, or welfare and is in the public interest. Z � Sue Roberds,Pl nnmg Manager to Department of Community Development Building Permit 1920 Village Cir 12 -260 -- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Application Number . . . . . 12-00000260 Date 5/11/12 Application pin number . . . 812840 Property Address . . . . . . 1920 VILLAGE CIR REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0210-0000- Application type description RES NEW SFR on your state excise tax form Subdivision Name . . . . . . to the Cit of Port Angeles Property Use s y 9 Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY (Location Code 0502) Application valuation . . . . 107396 ---------------------------------------------------------------------------- Application desc 1548 SF SFR W/ATTACHED GARAGE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GEIGER, AMANDA OWNER 707 E LOPEZ PORT ANGELES WA 983626710 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT -RESIDENTIAL Additional desc . . 1548 SF SFR W/ATTACHED GARAGE Permit Fee . . . . 1065.05 Plan Check Fee 692.28 Issue Date . . . . 5/11/12 Valuation . . , . 107396 Expiration Date 11/07/12 Qty Unit Charge Per Extension BASE FEE 1065.05 .00 5.6000 THOU BL-100,001-500K (5.60 PER K) .00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . 1548 SF SFR Permit Fee . . . . 104.45 Plan Check Fee .00 Issue Date . . . . 5/11/12 Valuation . . . . 0 Expiration Date . . 11/07/12 Qty Unit Charge Per Extension BASE FEE 50.00 .4.00 7.2500 EA -.ME-VENT FAN (SINGLE DUCT) 29.00 1.00 10.6500 EA ME-HOOD/DUCT-MECH, EXHAUST 10.65 .00 '10.6500 EA ME-STOVE/FIREPLACE/MISC. APP. .00 1.00 14.8000 EA ME-HEATER(SUSP/WALL/FLOOR-MTD) 14.80 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . 1548 SF SFR Permit Fee . . . . 142.00 Plan Check Fee .00 Issue Date 5/11/12 Valuation . . . . 0 Expiration Date 11/07/12 Qty Unit Charge Per Extension BASE FEE 50.00 6.00 7.0000 EA PL-PLUMBING TRAP 42.00 1.00 7.0000 EA PL-WATER LINE 7.00 3.00 7.0000 EA PL-DRAIN VENT PIPING 21.00 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. RJelf- /h 0 e ppm 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 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 INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-In Water Line(Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b 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 Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /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 Fire 417-4653 Planning 417-4750 Building 417-4815 T-Fnrmc/Riiilriinn niviginn/Riiilriinn Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Page 2 Application Number . . . . . 12-00000260 Date 5/11/12 Application pin number 812840 REPORT SALES TAX Qty Unit Charge Per Extension on your state excise tax form 1.00 15.0000 EA PL-SEWER LINE 15.00 to the Cit of Port Angeles 1.00 7.0000 EA PL-WATER HEATER 7.00 Y 9 --------------------------------------------------------------- (Location Code 0502) Special Notes and Comments March 9, 2012 10:58:39 AM tamiot. Electrical service will be from pedestal at northeast corner of property. March 16, 2012 8:31:49 AM rbecker. Peninsula Housing Authority On the follering permit numbers: 12-261,12-260,12-257, 12-256,12-255,12-251,12-59,& 12-258. You will need to install a double check vave assembly,if the fire systems are closed systems. If they are open systems, you do not need to install a backflow assembly. If you have any questions call Ron Becker at 360-417-4886, E-mail:rbecker@cityofpa.us, or Fax:360-452-4972. Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. All homes in new subdivisions that are outside of the Fire Department four-minute response area shall be equipped with residential fire sprinkler systems that comply with the International Fire Code (IFC) and National Fire Protection Association (NFPA) . March 14, 2012 1:01:25 PM sroberds. The proposal will result in a new sfr in the RHD for total lot coverage of 29t and site coverage of 42t. No land use issues anticipated. All connections to City storm drain facilities require an inspection by Public Works and Utilities Engineering prior cover. Notice will be given 48 hours in advance of commencing work. Public Works Inspection request line 417-4831 Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Public Works Inspection request line 417-4831 Construct driveway to City Standards. Concrete with exposed aggregate or other non-standard finishes(including colors or dyes)are not allowed in the City road right of way. Broom finish only. An inspection by Public Works Engineering is required prior to pouring concrete. Public Works inspection request line' 417-4831 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . RES UNDERGRND SERVICE FEE 770.00 SEWER SYSTEM DELV CHARGE 2260.00 STATE SURCHARGE 4.50 PW WATER SYSTEM USE FEE 2260.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due 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) 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 INCONSPICUOUS 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 Rou h-In Water Line Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b 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 Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood I Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction- R.W. PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T-FnrmORuildinn nivisinn/Ri ildinn Parmit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Page 3 Application Number . . . 12-00000260 Date 5/11/12 Application pin number _ 812840 REPORT SALES TAX Permit Fee Total 1311.50 1311.50 .00 .00 on your state excise tax form Plan Check Total 692.28 692.28 .00 .00 Other Fee Total 5294.50 5294.50 .00 .00 to the City of Port Angeles Grand Total 7298.28 7298.28 .00 00 (Location Code 0502) Separate Permits are required forelectrical 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) T:Forms/Building Division/Building Permit + r BUILDING PERMIT INSPECTION RECORD — PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS — Building Inspections 417-4815 Electrical Inspections 417-4735 r 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 INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. L9 Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab (D Rough-in Water Line Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor e Hold Downs a Walls/Roof/Ceiling Drywall Interior Braced Panel Only) "Z T-Bar INSULATION: Slab Wall/Floor/Ceiling —/a— MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rou h-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit its SEPA: Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By N Electrical 417-4735 I Construction- R.W. PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T-Fnrmc/Rnilrlinn nivisinn/Riiildinn Permit CITY OF PORT ANGELES �w F PUBLIC WORKS & UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 12-06000260 Date 5/11/12 Application pin number . . . 812840 Property Address . . . . . . 1920 VILLAGE CIR REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0210-0000- Application type description RES NEW SFR on your state excise tax form Subdivision Name . . . . . . Property Use to the City of Port Angeles Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY (Location Code 0502) Application valuation . . . . 107396 ---------------------------------------------------------------------------- Application desc 1548 SF SFR W/ATTACHED GARAGE ---------------------------------------------------------------------------- Owner Contractor ------------------------- -------•----------------- HOUSING AUTHORITY OF CLALLAM OWNER 2603 S FRANCIS ST PORT ANGELES WA 983626710 (3 60) 452-7631 ---------------------------------------------------------------------------- Permit . . . . .. . DRIVEWAY INSTALLATION Additional desc . . DRIVEWAY INSPECTION Permit Fee . . . . 55.00 Plan Check Fee .00 Issue Date . . . . 5/11/12 Valuation . . . . 0 Expiration Date . . 11/07/12 Qty Unit Charge Per Extension BASE FEE 55.00 ---------------------------------------------------------------------------- Permit . . . . . . PUBLIC WORKS RES WATER SERV Additional desc . . 3/4" DROP IN METER Permit Fee . . . . 420.00 Plan Check Fee .00 Issue Date . . . . 5/11/12 Valuation . . . . 107396 Expiration Date 11/07/12 Qty Unit Charge Per Extension 1.00 420.0000 EA PW WATER METER DROP IN 420.00 ---------------------------------------------------------------------------- Permit . . . . . . PUBLIC WORKS STORMWATER Additional desc . Permit Fee . . . . 135.00 Plan Check Fee .00 Issue Date . . . . 5/11/12 Valuation . . . . 107396 Expiration Date . . 11/07/12 Qty Unit Charge Per Extension 1.00 135.0000 EA SAN SEW / STM CON OTHER 135.00 ---------------------------------------------------------------------------- Permit . . . . . . SANITARY SEWER HOOK UP Additional desc . . Permit Fee . . . . 150.00 Plan Check Fee .00 Issue Date . . . . 5/11/12 Valuation . . . . 107396 Expiration Date 11/07/12 Qty Unit Charge Per Extension 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. J Signature of ContractUor Authorized Agent Date Signature of Owner(if owner is builder) Date, T:Forms/Building Division/Public Works Permit PERMIT INSPECTION RECORD .1 t 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 INA CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES 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 417-4807 PW/ENGINEERING FIRE 4174653 FIRE DEPT. PLANNING DEPT. 4174750 PLANNING DEPT. BUILDING 417- BUILDING 4815 T:Forms/Building Division/Public Works Permit �A+OF PORT qM1,e �w CITY OF PORT ANGELES PUBLIC WORKS & UTILITIES v 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 12-00000260 Date 5/11/12 Application pin number . . . 812840 REPORT SALES TAX Qty Unit Charge Per Extension on your state excise tax form 1.00 150.0000 EA SAN SEWER HOOKUP 150.00 ---------------------------------------------------------------------------- to the City of Port Angeles Special Notes and Comments (Location Code 0502) March 9, 2012 10:58:39 AM tamiot. Electrical service will be from pedestal at northeast corner of property. March 16, 2012 8:31:49 AM rbecker. Peninsula Housing Authority On the follering permit numbers: 12-261,12-260,12-257, 12-256,12-255,12-251,12-59,& 12-258. You will need to install a double check vave assembly,if the fire systems are closed systems. If they are open systems, you do not need to install a backflow assembly. If you have any questions call Ron Becker at 360-417-4886, E-mail:rbecker@cityofpa.us, or Fax:360-452-4972. Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. All homes in new subdivisions that are outside of the Fire Department four-minute response area shall be equipped with residential fire sprinkler systems that comply with the International Fire Code (IFC) and National Fire Protection Association (NFPA) . March 14, 2012 1:01:25 PM sroberds. The proposal will result in a new sfr in the RHD for total lot coverage of 29W and site coverage of 42%. No land use issues anticipated. All connections to City storm drain facilities require an inspection by Public Works and Utilities Engineering prior cover. Notice will be given 48 hours in advance of commencing work. Public Works Inspection request line 417-4831 Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Public Works Inspection request line 417-4831 Construct driveway to City Standards. Concrete with exposed aggregate or other non-standard finishes(including colors or dyes)are not allowed in the City road right of way. Broom finish only. An inspection by Public Works Engineering is required prior to pouring concrete. Public Works inspection request line 417-4831 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . RES UNDERGRND SERVICE FEE 770.00 SEWER SYSTEM DELV CHARGE 2260.00 STATE SURCHARGE 4.50 PW WATER SYSTEM USE FEE 2260.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- 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 T:Forms/Building Division/Public Works Permit PERMIT INSPECTION RECORD t 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 INA CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES 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 4174807 PW/ENGINEERING FIRE 4174653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 41.7- BUILDING 4815 T:Forms/Building Division/Public Works Permit °F,°RT4, CITY OF PORT ANGELES �^,`N ���� PUBLIC WORKS & UTILITIES v 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 3 Application Number . . . . . 12-00000260 Date 5/11/12 Application pin number . . . 812840 REPORT SALES TAX Permit Fee Total 760.00 760.00 .00 .00 Plan Check Total .00 .00 .00 .00 on your state excise tax form Other Fee Total 5294.50 5294.50 .00 .00 Grand Total 6054.50 6054.50 00 00 to the City of Port Angeles (Location Code 0502) Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned for a period of*180 days after the work 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 T:Forms/Building Division/Public Warks Permit PERMIT INSPECTION RECORD •• - N 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 INA CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES 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 417-4807 PW/ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 41-7- BUILDING 4815 T:Forms/Building Division/Public Works Permit LO &%0 Yeti.pnar.g4� BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES For City Use Only: Attn: Building Permit Technician Date Rece'ved 321 E. Fifth St., Port Angeles, WA 98362 ermit# (360) 417-4815 fax (360)417-4711 ate Approved%q fell 10— Applicant QG-7•ltKtSu�.�A �DttStnlc� Tti-69-�Ni Ph Property Owner �M utRO q G�CD Phone Q Property Owner's Address R0� E LDPEc..E3A- q8.bd Contractor p�NEdt1Q�U,1,L©�R 5�.� L,1eulp Phone Contractor's Address License# Expires E--mail, PROJECT ADDRESS Lqao I.LL-AC%G ( Ru-6 IPOrLr Nlc�-95. �UA- X3102 Parcel Number 0 b-30 - ) 3 - S? 0- a Lot Q Zoning P,N Q Project Type & Brief Description: ¢LResidential ❑ Multi-family ❑ Commercial ❑Industrial Check all that apply ,K New Construction 010fisTaur=14 0- ONE 5 NG.s STpt1 (La wE"CZ ❑Addition s NCA,E C-IVL 14*Wms C-O Ck A4_A. LC- ❑ Remodel ❑Repair •Demolition ❑ Re-roof mp Wouse )(garage ❑ other ❑tear off& re-roof ❑ lay over one layer p(Heat System ❑ Heat pump ❑ wood-burning stove ❑gas fireplace ❑ pellet stove ❑ other ❑Other $ Q 1 L Pv W*,*R-- Floor Areas Existing(sq. ft.) Proposed(sq. ft.) Basement @$ per sq. ft. _ $ 1s1 Floor 1 1 a4 B S 4 S"S 2nd Floor 3rd Floor Garage 3`1(0 30 Carport ` Covered Porch 1{ / cL S17 Deck Shed Other TOTAL VALUATION $ 101 c3Q (D Total footprint of structures ICJ 4 8 sq. ft. T Lot size SLl 13 sq. ft. = Lot coverageA a(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 y1I(p % Max. height of proposed structures 1 ft. Occupancy group #of bedrooms 3 Will a lawn sprinkler system be installed? N Occupant load #of full baths off— Will a fire sprinkler system be installed? �— Construction type #of half baths -�- i have read and completed this application and know it to be true and correct. i am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Dat C W Signat T:Forms/Bui 7MARu-',, p i t o 2012 CITY OF PORT ANGELES RI III nlNr NVICInni a t F x f s x # x CRY CE PORT W �a F p��14OIRI qy b �(/!� t ? r }L d q 3 rx i +� d x m . Sf 3 3 1 �04 PC�1iT AN PRESCRIPTIVE APPROACH-SIMPLE FORM III- 11110,law For the Washington State Energy Code(2006 Edition) ., , Climate Zone 1 cY SWAM T Site Information: Building Department Use Only: Lot: „�/ 1�f�J/n/�Sy�/d yl L Permit# Address: V1,4 �g� Cr��� Notes: City: I°olAr &Ls-c -E-& State: t-tlk Zip: Contact: C0(1S-T'SU.PF' Phone: 360— Phone 2: 3CO— /�/� X307 FAX: 3 `O — cltu/ Table 6-1 PRESCRIPTIVE REQUIREMENTS FOR GROUP R OCCUPANCY CLIMATE ZONE 1 (Unlimited Glazing Option Only) y n9 Unlimited Group R-3 IV and R-4 0.35 0.58 0.20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 Occupancies �9 Only7 ADV This Project complies with the following: The project is a single-family residence or duplex. The project is a wood frame OR all of the insulation is interior or exterior of the framing. All building components meet the requirements listed above. The project will meet all other provisions of the WSEC and VIAQ. The Project will take advantage of the following exceptions to the prescriptive option. 602.6 Exception 2. One unlabeled or untested exterior swinging door,24 sq.ft. or less, may be installed per unit for ornamental, security, or architectural purposes. Location of the door taking this exception: ❑ 602.6 Exception 2. If a door is mostly glass, it should meet the requirement of the vertical glazing U-factor listed above. Location of the door(s) taking exception: Type of Heat Source: /161?e �Q VI T:Forms/Buiidin Division/Prescriptive tive A CJ 1 C A,WQ,_� kAeA`� 9 p Approach-Simple Form Q CD Electrical Information Form Public Works&Utilities Department(360)417-4700 m City Electrical Inspector(360)417-4735 3 ritpyKS a�S _ Please complete and return to Public Works& Utilities Department xt Permanent service: Name: Name and address of party Street: responsible for permanent City/ State/ ZIP: service billing? Daytime Phone: Home Phone: 7Site • • (if other than above) ontact: Name: JTwc2_ .o C6 ,-sV Title',.,., P V� 6CWS'/—' Svlofa2Vrsol2 Daytime Phone: 36 0- Y 77- 19-Y3 1z 3(_0 is- 007 9 Contractor: Name: Com pan : Daytime Phone: Electrician: Name: Company: aL m/13/c C-d itLi d r Daytime Phone: `j&a - _f8 _ p�')i Excavator: Name: Company: CCT' 0,A -A-VAITI d t lAle. Daytime Phone: 77Y/ ' + ' • ❑Existing TTew Ingle-family residence ❑Multi-family residence;#of units ❑Commercial El Subdivision;#of lots ❑Oprhead service El General service Underground service ❑Other. • am ' • Description of work: S le£ £c./ S �/�L� F.8►�/L £sr0"ei_ Street address/lot number: 02 Q (//Lk46-t e/ CAS o Nearest cross street: r/Q8%6 Desired connection date: Electrical transformer serving property is: ❑on a pole [ the ground Totalsquare footage: /S'Y F sq.ft. Main disconnect size: O amps Voltage: (91L0/240 1 p ❑120/208 3ph ❑277/480 3ph ❑12 /240 3ph ❑480 3W 3ph ❑ Other tandard residential loa s(Lighting, refrigerator, dishwasher, washer) Check all that apply: El (_ton) [ j /Oven El Hot Tub l. 0 thes Dryer Ly'Heating ElPumps (_Hp) ❑No Load Change L'7Water Heater ❑Elevator(_Hp) ❑Other ' ' ' • • Please provide a copy of the following: *Detailed plot plan (.dwg or.dxf format mandatory for subdivisions). *Electrical one-line drawing showing the service entrance panel and location. *Connected load data. *Size and locked rotor ams f all moto s over 50hp. Applicant's Signature: Date: 67, a3 /a MAIL OR DELIVER COMPLETED FORM TO: 321 E 5TH STREET; PORT ANGELES, WA 98362 FAX TO: 360-417-471? WS WF Information form.xis Prescriptive Energy Code Compliance for Single Family and Duplex Housing:Zone 1 Project Information Contact Information Peninsula Village HACC Kay Kassin er Aspen 1124 Plan 2603 South Francis Street Port Angeles, WA 98362 This set of forms has been developed to assist permit applicants documenting compliance with the Washington State Energy Code, (2009 edition). This set is for structures built under the IRC and located in Climate Zone 1. The following forms provide much of the required documentation for plan review.The details noted here must also be shown on the drawings(WSEC 104.2). This form is not a substitute for the energy code itself. To obtain a copy of the energy code, go to the following web address. http://www.energy.wsu.edu/code Glazing Glazing U-Factor Door 9 z Vaulted WallrZ Wall-into Wall-ext° s Slab6 Option Area : Ceiling 3 Above Below Below Floor on %of Floor Vertical Overhead" U-Factor Ceiling Grade Grade Grade Grade R-49 or R-21 R-21 R-10 I 13% 0.34 0.50 0.20 R-38 R-38 Int 7 TB R-10 R-30 21 Adv. R-49 or R-21 R-21 R-10 Oil 25% _ 0.32 0.50 0.20 R-38 R-38 Int.7 TB R-10 R-30 21 Adv. R-49 or R-21 R-21 R-10 O III Unlimited 0.30 0.50 0.20 R-38 R-38 Int 7 TB R-10 R-30 21 Adv. See WSEC table 6-1 for footnotes Glazing Schedule Attached to Document ❑ Does not apply. (SEE INSTRUCTIONS) Using Prescriptive Option Ill.All glazing and doors meet maximum U-factor.Alternate heating size method submitted. 0 Option I or II,Glazing to floor area limit(WSEC 602.7.2) ❑ Area weighted window,skylight or door U-factor(WSEC 602.7.2) ❑ As part of the heating system sizing calculation(IRC M1401.3&WSEC 503.2.2) Radiant slab: ❑ R-10 foam insulation, continuous with thermal break(WSEC 502.1.4.9) Chapter 9 Options Total of 1 Credit Required Opt. Opt. Description 1a High Efficiency HVAC Equipment 1 ❑ lb High Efficiency HVAC Equipment 2 ❑ 1c High Efficiency HVAC E ui ment 3 ❑ 2 High Efficiency HVAC Distribution System ❑ 3a Efficient Building Envelope 1 ❑ 3b Efficient Building Envelope 2 ❑ 3c Super-Efficient Building Envelope 3 ❑ 4a Air Leakage Control and Efficient Ventilation ❑ 4b Additional Air Leakage Control and Efficient Ventilation ❑ 5a Efficient Water Heatin ❑ 5b High Effieciency Water Heatin ❑ 6 Small Dwelling Unit 1.0 7 Large Dwelling Unit ❑ 8 Renewable Electric Ener *1200 kwh ❑ Total Credits 1.00 WSEC Prescriptive Worksheet(2010 edition)Zone 1 WSUEEPIO-010 Copyright 2010 Glazing Schedule Project Information Contact Information Peninsula Village HACC Kay Kassin er Aspen 1124 Plan 2603 South Francis Street Port Angeles, WA 98362 Conditioned Floor Area 1124 Sum of UA for Heating System Sizing 54.6 Sum of All Glazing Areas From Below 137 Glazing to Floor Area Ratio 12.19% 602.7.2 Exception Ratio(not to exceed 1%) Exterior Doors Plan Component Door Percent Width Height Glazing Door Door ID Description Ref. U-factor Glazed Qt. Feet inch Feet inch Area Area UA Garage Door 0.200 1 3 6 8 20.0 4.0 One Exempt Swinging Door<24 Square Feet 0.2001 1 1 3 1 61 e 20.0 4.0 Sum of Glazing Area, Door Area, and UA (do not include exempt door) 20.0 4.0 Area Weighted U=UA/Area 0.20 Sum of Area and UA for Heating system size only(include exempt door) 40.0 8.0 Vertical Glazing(Windows,Glazed doors using Exception 602.6#1) Plan Component Glazing Width Height Glazing ID Description Ref. U-factor Qt. Feet " ' Feet "a' Area UA 3x5 Single Hung Window 0.340 6 3 5 90.01 30.60 2x3 Single Hung Window 0.340 1 2 3 6.01 2.04 4x4 Horizontal Slider 0.340 2 4 4 32.0 10.88 3x3 Single Hung 0.340 1 3 3 9.0 3.06 f7f---H Sum of Area and UA 1 137.0 46.58 Area Weighted U= UA/Area 0.34 WSEC Prescriptive Worksheet(2010 Edition) WSUEEPI O-010 Copyright 2010 Simple Heating System Size:Climate Zone 1 Project Information. Contact Information Peninsula Village HACC Kay Kassin er Aspen 1124 Plan 2603 South Francis Street Let 2k Port Angeles, WA 98362 Indoor Design Temperature 70 Outdoor Design Temperature 28 Design Temperature Difference(AT) AT=Indoor-Outdoor Design Temp 42 Conditioned Floor Area 1 1124 Conditioned Volume 1 8992 Glazing Copy Sum of UA from Glazing Schedule 1 55 Attic U-Factor X Area - UA R-49 0.027 R-38 Advanced 0.026 1124 29.2 Single Rafter or Joist Vaulted Ceilings U-Factor X Area = UA R-38 Vented 0.027 Above Grade Walls U-Factor X Area = UA R-21 0.056 1248 69.9 Floors U-Factor X Area = UA R-30 0.029 1124 32.6 Below Grade Walls U-Factor X Area = UA 2'Depth Walls 0.042 3.5' Depth Walls 0.041 7' Depth Walls 0.037 Slab Below Grade F-Factor X Length = UA 2' Depth 0.59 3.5' Depth 0.64 7' Depth 0.57 Slab on Grade F-Factor X Length = UA R-10 2' perimeter 0.54 R-10 Full-Heated 0.55' Sum of UA 186 Envelope Heat Load 7824 Btu/Hour Sum of UA X AT Air Leakage Heat Load 40791 Btu/Hour ((Volume X 0.6)X AT)X.018)) Building Design Heat Load 11903 Btu/Hour Air Leakage+Envelope Heat Loss Building and Duct Heat Load Btu/Hour If ducts are located in unconditioned space:Sum of Building Heat Loss X 1.15 If ducts are located in conditioned space:Sum of Building Heat Loss X 1 Maximum Heat Equipment Output 150% 178R Btu/Hour Building and Duct Heat Loss X 1.50 WSEC Prescriptive Worksheet(2010 Edition) WSUEEPIO-010 Copyright 2010 Peninsula Housing Authority Serving Clallam and Jefferson Counties 2603 S. Francis Street, Port Angeles WA 98362 (360)452-7631 Ext 41 • (360) 452-9468 Fax Email: kkassingerPpeninsulapha.org D May 14, 2012 MAY 15 2012 Nathan A. West AICP CITY;7F PORT ANGELES Director Deat,o!community Development Community and Economic Development City of Port Angeles P.O. Box 1150 Port Angeles, WA 98362 y/1 � Subject: Permit Application Refund Request Dear Nathan; The Peninsula Housing Authority requests a refund of the following fees paid for the Peninsula Village III building permit applications: 10-676 1906 Village Circle Lot 15 Building Permit Fee $1,109.85 Mechanical Permit Fee $208.05 Plumbing Permit Fee $142.00 P W Res Water Sery Fee $420.00 Sanitary Sewer Hook up Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Dely Charge $1,980.00 PW Water System Use Fee $1,980.00 $6,124.90 10-678 1005 Golf Course Road Lot 16 Building Permit Fee $1,042.65 Mechanical Permit Fee $208.05 Plumbing Permit Fee $142.00 Sanitary Sewer Hookup Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Dely Charge $1,980.00 $3,657.70 12YEQUAL HOUSING OPPORTUNITY BARRIER FREE 10-679 1015 Golf Course Road Lot 19 Building Permit Fee $1,042.65 Mechanical Permit Fee $208.05 Plumbing Permit Fee $142.00 Sanitary Sewer Hook up Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Delv Charge $1980.00 PW Water System Use Fee $1,980.00 $5,637.70 10-680 1920 Village Circle Lot 21 Building Permit Fee $1,065.05 Mechanical Permit Fee $208.05 Plumbing Permit Fee $142.00 P W Res Water Sery Fee $420.00 Sanitary Sewer Hook up Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Delv Charge $1,980.00 PW Water System Use Fee $1,980.00 $6,080.10 10-681 1924 Village Circle Lot 22 Building Permit Fee $1,042.65 Mechanical Permit Fee $208.05 Plumbing Permit Fee $142.00 P W Res Water Sery Fee $420.00 Sanitary Sewer Hook up Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Delv Charge $1,980.00 PW Water System Use Fee $1,980.00 $6,057.70 10-682 1928 Village Circle Lot 23 Building Permit , Fee $1,042.65 Mechanical Permit Fee $208.05 Plumbing Permit Fee $142.00 P W Res Water Sery Fee $420.00 Sanitary Sewer Hook up Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Delv Charge $1,980.00 PW Water System Use Fee $1,980.00 $6,057.70 121EQUAL HOUSING OPPORTUNITY BARRIER FREE 10-683 1932 Village Circle Lot 24 Building Permit Fee $1,065.05 Mechanical Permit Fee $208.05 Plumbing Permit Fee $142.00 P W Res Water Sery Fee $420.00 Sanitary Sewer Hook up Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Delv Charge $1,980.00 PW Water System Use Fee $1,980.00 $6,080.10 10-684 1936 Village Circle Lot 25 Building Permit Fee $1,065.05 Mechanical Permit Fee $208.05 Plumbing Permit Fee $142.00 P W Res Water Sery Fee $420.00 Sanitary Sewer Hook up Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Delv Charge $1,980.00 PW Water System Use Fee $1,980.00 $6,080.10 Driveway installation fees are not included in the request as they were not charged. I am not certain if this is due to the drives accessing private streets or not. I have attached a copy of the City receipts for each permit application used to calculate the request. Thank you for your assistance and if you need any additional information, please do not hesitate to contact me. Regards, tec assinger or of Acquisiti s and Development Cc Annette Dotlich 121EQUAL HOUSING OPPORTUNITY BARRIER FREE D - (ot-0 PREPARED 10/19/10, 16:50:39 PAYMENTS DUE RECEIPT CITY OF PORT ANGELES PROGRAM BP820L ---------------------------------------------------------------------------- APPLICATION NUMBER: 10-00000680 1920 VILLAGE CIR LoT 2 � FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- PLAN CHECK FEES 692.28 ✓BUILDING PERMIT - RESIDENTIAL 1065. 05 ,MECHANICAL PERMIT 208.05 PLUMBING PERMIT 142. 00 ,,PUBLIC WORKS STORMWATER 135. 00 • vPUBLIC WORKS RES WATER SERV 420.00. vSANITARY SEWER HOOK UP 150.00 vSEWER SYSTEM DELV CHARGE 1980.00 STATE SURMARGE 4.50 v PW' WATER,SYSTEM USE FEE 19,80. 00 TOTAL DUE 6776.88 I Please present this receipt to the cashier with full payment. �n � i "PREPARED 4/01/13, 11:47:44 INSPECTION HISTORY REPORT PAGE 1 PROGRAM BP521L 0/00/00 THRU 0/00/00 CITY OF PORT ANGELES ------------------------ --------------- APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR ------------------------------------------—-—--—----------------------------—------------------------———---------------- 12 00000260 1920 VILLAGE CIR 06-30-13-5-7-0210-0000- 063013570210 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BL1 0001 BLDG FOUNDATION FOOTING 5/31/12 APPROVED PB REQ COMM: May 30, 2012 8:32:51 AM hcatuzo. REQ COMM: BETWEEN 1-2 PM IS IDEAL. 912-0079 RES COMM: May 31, 2012 8:37:39 AM pbarthol. RES COMM: UFR ground ok 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BL2 0001 BLDG FOUNDATION STEM WALL 6/04/12 APPROVED JLL REQ COMM: June 4, 2012 8:32:11 AM hcatuzo. REQ COMM: BRUCE 912-0079. NO PLANS ON SITE TODAY. RES COMM: June 4, 2012 4:07:06 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BFF 0001 BLDG FLOOR FRAMING 6/15/12 APPROVED JLL REQ COMM: June 15, 2012 8:25:38 AM hcatuzo. REQ COMM: BRUCE 912-0079. AS LATE AS POSSIBLE. RES COMM: June 15, 2012 4:43:22 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL DSD 0001 BLDG DOWN SPOUT DRAINS 7/02/12 APPROVED RV - REQ COMM: July 3, 2012 7:46:49 AM rvess. RES COMM: July 3, 2012 7:47:48 AM rvess. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BLFD 0001 BLDG FOUNDATION DRAINAGE 7/02/12 APPROVED RV REQ COMM: July 3, 2012 7:47:14 AM rvess. RES COMM: July 3, 2012 7:47:34 AM rvess. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BL9 0001 BLDG SHEARWALL 8/21/12 APPROVED JLL REQ COMM: August 21, 2012 8:36:42 AM hcatuzo. REQ COMM: EXTERIOR SHEARNAIL. BRUCE 912-0079 RES COMM: August 21, 2012 4:55:30 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BL3 0001 BLDG FRAMING 9/13/12 APPROVED PB REQ COMM: September 13, 2012 9:25:19 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: September 13, 2012 4:28:46 PM pbarthol. 000 '000 BPR 00 BUILDING PERMIT - RESIDENTIAL BAIR 0001 BLDG AIR SEAL 9/13/12 APPROVED PB REQ COMM: September 13, 2012 9:25:38 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: September 13, 2012 4:28:46 PM pbarthol. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BLI 0001 BLDG INSULATION 9/20/12 DISAPPROVED JLL REQ COMM: September 20, 2012 8:34:55 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: September 20, 2012 3:59:50 PM jlierly. RES COMM: not complete recall when ready/jll 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BLI 0002 BLDG INSULATION 9/21/12 APPROVED JLL REQ COMM: September 21, 2012 9:02:06 AM pbarthol. REQ COMM: bruce 912-0079 RES COMM: September 21, 2012 4:29:16 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BLDR 0001 BLDG DRYWALL IBWP 9/27/12 APPROVED JLL PREPARED 4/01/13, 11:47:44 INSPECTION HISTORY REPORT PAGE 2 PROGRAM BP521L 0/00/00 THRU 0/00/00 CITY OF PORT ANGELES -----------------—------------------------------------------------------—---------—----------—-----------------——--------- APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR ------------------------------------------------------------------------------------------------------------------------------------ 12 00000260 CONTINUED REQ COMM: September 27, 2012 8:57:16 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: September 27, 2012 4:15:40 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL PW99 0001 PUBLIC WORKS FINAL 3/22/13 APPROVED RV REQ COMM: March 22, 2013 11:50:35 AM rvess. RES COMM: March 22, 2013 11:51:10 AM rvess. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BL99 0001 BLDG FINAL 3/28/13 APPROVED JLL REQ COMM: March 28, 2013 9:13:09 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: March 22, 2013 11:54:03 AM rvess. RES COMM; March 28, 2013 4-26:32 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL FFNL 0001 FIRE FINAL 3/28/13 APPROVED KDD REQ COMM: March 28, 2013 10:08:47 AM kdubuc. RES COMM: March 28, 2013 10:09:34 AM kdubuc. RES COMM: fire final 000 000 DWY 00 DRIVEWAY INSTALLATION PW6 0001 PUBLIC WORKS DRIVEWAY 3/22/13 APPROVED RV REQ COMM: March 22, 2013 11:50:55 AM rvess. RES COMM: March 22, 2013 11:51:20 AM rvess. 000 Goo ME 00 MECHANICAL PERMIT ME99 0001 MECHANICAL FINAL 3/28/13 APPROVED JLL REQ COMM: March 28, 2013 9:13:19 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: March 22, 2013 11:54:03 AM rvess. RES COMM: March 28, 2013 4:26:32 PM jlierly. 000 000 PL 00 PLUMBING PERMIT PLG 0001 PLUMBING WATER SUPPLY 6/27/12 APPROVED JLL REQ COMM: June 27, 2012 8:41:02 AM hcatuzo. REQ COMM: JOHN 460-6902 RES COMM: June 27, 2012 4:17:50 PM jlierly. 000 000 PL 00 PLUMBING PERMIT PL2 0001 PLUMBING ROUGH-IN 8/23/12 APPROVED JLL REQ COMM: August 23, 2012 8:53:14 AM hcatuzo. REQ COMM: JOHN 460-6902 RES COMM: August 23, 2012 4:17:06 PM jlierly. 000 000 PL 00 PLUMBING PERMIT PL99 0001 PLUMBING FINAL 3/28/13 APPROVED JLL REQ COMM: March 28, 2013 9:13:33 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: March 22, 2013 11:54:03 AM rvess. RES COMM: March 28, 2013 4:26:32 PM jlierly. 000 000 PWSW 00 PUBLIC WORKS STORMWATER PW4 0001 PUBLIC WORKS STORM 7/02/12 APPROVED RV REQ COMM: July 3, 2012 7:46:26 AM rvess. RES COMM: July 3, 2012 7:48:00 AM rvess. 000 000 SSHU 00 SANITARY SEWER HOOK UP PW2 0001 PUBLIC WORKS SEWER CONNEC 7/03/12 APPROVED RV REQ COMM: July 3, 2012 1:04:32 PM rvess.