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HomeMy WebLinkAbout417 Vista View Dr - Building ELECTRICAL PERMIT CITY OF PORT ANGELES 4 �J 360- 417 -4735 Application Number 11- 00001326 Date 11/28/11 Application pin number 881008 REPORT SALES TAX Property Address 417 VISTA VIEW DR on your excise tax form ASSESSOR PARCEL NUMBER: 06-30-15-5-5- 0160 -0000- Application type description ELECTRICAL ONLY to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc Security system Owner Contractor CAROL J HATHAWAY ADT SECURITY SERVICES INC. PO BOX 637 11824 NORTH CREEK PKWY PORT ANGELES WA 98362 BOTHELL WA 98011 (360) 460 -3836 (425) 489 -3668 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit Fee 63.90 Plan Check Fee .00 Issue Date 11/28/11 Valuation 0 Expiration Date 5/26/12 Qty Unit Charge Per Extension 1.00 63.9000 ECH EL- SINGLE CIR LIMITED RES 63.90 s Fee summary Charged Paid Credited Due \�(\v Permit Fee Total 63.90 63.90 .00 .00 Plan Check Total .00 .00 .00 .00 °T A Grand Total 63.90 63.90 .00 .00 c-- INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN. FINAL COMMENTS: ����-Z iV I7 Cam, PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Z Signature of owner or Electrical Contractor X Dale: G: \EXCI -IANGE \BUILDING RECERI/0 c' k CITY OF PORT ANGELES PERMIT APPLICATION NOV 201 a Building Division/Electrical Inspections 2 1 flmiiiu�io �VI; 321 East Fifth Street P.U. Box 1150 Port Angeles Washington, 98362 ELECTRICAL 1 Ph: (360) 417 -4735 Fax: (360) 417 -4711 INSPECTIONS Date: 11/22/2011 _l1 1 2 Single Family Dwelling MI Multi Family or Commercial* 0 Commercial Addition Alteration Remodel Repair* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 417 Vista View Dr Building Square Footage: 2500 Description of above INSTALLING LOW VOLTAGE BURGLAR ALARM SYSTEM Owner Information Contractor Information Name: Carol Hathaway Name: ADT Security Services Mailing Address: 417 Vista View Dr Mailing Address: 11824 N CREEK PKWY N, SUITE #105 City: Port Angeles State: WA Zip: 98362 City: BOTHELL State: WA Zip: 98011 Phone:360 Fax: Phone:206- 774 -9499 Fax: 888 -400 -0383 License Exp. License Exp Item Unit Charge Glly Total (Qty Multiplied by Unit Charge) Service /Feeder 200 Amp. 119.90 Service /Feeder 201 -400 Amp. 145.50 Service /Feeder 401-600 Amp 204.60 Service /Feeder 601 -1000 Amp. 262.20 Service /Feeder over 1000 Amp. 372.50 Branch Circuit W/ Service Feeder 2.60 Branch Circuit W/0 Service Feeder 73.50 Each Additional Branch Circuit 2.60 Temp. Service! Feeder 200 Amp. 92.70 Temp. Service /Feeder 201 -400 Amp. 110.30 Temp. Service /Feeder 401 -600 Amp. 146.70 Temp. Service /Feeder601 -1000 Amp 167.90 Portal to Portal Hourly 95.90 Sign /Outline Lighting 88.20 Signal Circuit/ Limited Energy First 1500 sf Commercial 95.90 Note: $5.00 for each additional 1500 sf Signal Circuit/ Limited Energy 1 2 Family Dwelling 63.90 I G39d Signal Circuit/ Limited Energy Multi-Family Dwelling 63.90 Manufactured Home Connection 119.90 Renewable Electrical Energy 5KVA System or Less 102.30 Thermostat 56.00 NEW CONSTRUCTION ONLY: First 1300 Square Ft. 110.30 Each Additional 500 Square R. or Portion of 35.20 Each Outbuilding or Detached Garage 73.50 Each Swimming Pool or Hot Tub 110.30 4,3` 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 Check Jennifer Digitally signed by Jennifer Burgess Credit Card It DN: cn Jennifer Burgess, o =NORTHWEST PERMIT, X oue NORTHWEST PERMIT, Dated: 11/22/2011 01101/2010 u r y e 6 5 �matteDate: 2011eh1nr en57:39 083-9'1 '00' mama .11.22 12Lnwp:4 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00001078 Date 9/29/11 Application pin number 977648 Property Address 417 VISTA VIEW DR REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-15-5-5- 0160 -0000- Tenant nbr, name CAROL J HATHAWAY on your state excise tax form Application type description MECHANICAL APPL. PERMIT Subdivision Name to the City of On Angeles Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 6495 Application desc DUCTLESS HEAT PUMP SYSTEM W/2 INDOOR UNITS Owner Contractor CAROL J HATHAWAY DAVE'S HTG COOLING SRVC INC PO BOX 637 PO BOX 413 PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 460 -3836 (360) 452 -0939 Permit MECHANICAL PERMIT Additional desc DUCTLESS HEAT PUMP SYSTEM Permit pin number 193557 Permit Fee 79.60 Plan Check Fee .00 Issue Date 9/29/11 Valuation 0 Expiration Date 3/27/12 Qty Unit Charge Per Extension BASE FEE 50.00 2.00 14.8000 EA ME- FURN /HP /FAU OR 5 TON 29.60 Fee summary Charged Paid Credited Due Permit Fee Total 79.60 79.60 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 79.60 79.60 .00 .00 CIA1/4°1' Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of 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 VC 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 L 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 1 Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab .r- Wall Floor Ceiling Q MECHANICAL: Heat Pump/ Furnace FAU Ducts Rough -In Gas Line I Wood Stove Pellet Chimney i Of i Commercial Hood Ducts FINAL Date Accepted by LAS MANUFACTURED HOMES: Footing Slab IJ Blocking Fiold Downs II— Skirting 7 PLANNING DEPT. Separate Permit #s SEPA: Parkin Lioptin ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electric:al 417 -4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 3 T:Forms /Building Division /Building Permit M0 N 1 0 1 H I I 0 1 H 1 1 I 14114 OH a 1 1 1 1 00 1 m 1 mw 1 co, 1 1 N O 1 M ko 1 a d' d' N 1 N I N a 00 1 0 00 1 r E n 0 n N 0 a i .10 w 0 oH—x w 1 m 1 H 00 0 C41141 o mm E W ZZ 1 <ow w W (4 W 0 0 1 1,1 w x w q x x 1 100E E H w a s 1 H C] z E h 1 E U' 0 0 O a 1 m z H O E E 1 F a 0 w W 00 X 1 Z z-- z E 14151 0 1 W 00411-1 Z 0.1104 w 1 X 001> a W (AU] a 1 z E X Z Z 0 1 00 a 0 a X 00 Z 1 00 <w--<Z 0 0 al E 0 00 u 01 00 -1 W H O C.) 01 H P Z v Z z 0 t a i 00 x (A a 1 A M O i, U P o 1 w w 00000 O 001 F g a E 0 D Z OHIH I H I C4 a O 1 q <ON 1 0 w� a Q a n a 0 >F F 1 V 00 III M <0 <MN I H a h O F x x x 0 4 M (11h b1-101 W H (11 0 1 a a- a o 0 1 W w w H H O O W 0 m o l E E H HO >a 1 1 mw Z H<<< W H 1 0 w a 0 O O' 0 0 0 0 H 1 0 0 0 H 1 1 OX \E. 1 M O 0 01,4 a a 1 I H HO 1 0 1 1 4• 0 at O Z O 0 a. O E •X 1 a 0 W E. a z 1 E q o 01 0003<0 1 0 0 00 <10000<10 E -E Sep 29 11 08:16a Dave's Heating Cooling 3604520939 p.1 BUILDING PERMIT APPLICATION Print in ink j.+ CITY OF PORT ANGELES For City Use Only: Attn: Building Permit Technician Date Received -1 321 E. Fifth SL, Port Angeles, WA 98362 permit l (360) 417 -4815 fax (360) 417 -4711 Date Approved Applicant ave.,' 5 Ke0-4 r Phone y a Property Owner Casa 0 4-1 'Naw Phone 4 f r 3 g3 Property Owner's Address (1 E. V 1.s t o 2r1./2. 7 -f- Contractor .Dav�l Phone <Fsa ca�y3 Contractor's Address P. 0 t {r 3, ti°ov License j� V HGq K c Expires S' ao r 3 E -mail PROJECT ADDRESS L (1 E i s +a V r Parcel Number Lot Zoning Project Type Brief Description: 'Residential o Multi- family o Commercial o Industrial Check all that apply New Construction o Addition o Remodel o Repair o Demolition o Re -roof House o garage o other o tear off re -roof o lay over one layer Meat System Nfrkl-leat pump o wood burning stove o gas ce pellet stove o other o Other c- rind 00 f c K i 4-$ Floor Areas Existing (sq. ft) Proposed (sq. ft.) Basement per sq. ft. 1 S Floor 2 Floor 3' Floor Garage Carport Covered Porch Deck Shed Other q 3' TOTAL VALUATION l -D 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 ft. Occupancy group of bedrooms Will a lawn sprinkler system be installed? Occupant load of full baths Will a fire sprinkler system be installed? Construction type of half baths 1 have read and completed this application and know it to be true and correct t 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 orking on rojects. Date ////(1 .J. Print Name 0 e k m It Signature 0 T:Forms/Building Division/Bldg PermiLdoc Clallam County Assessor Treasurer Property Details 68059 CAROL J HATHAWA... Page 1 of 1 Clallam County Assessor Treasurer Property Search Results 68059 CAROL J HATHAWAY for Year 2011 2012 Property Account Property ID: 68059 Legal Description: VISTA VIEW LOT 5 EXCW10' Geographic ID: 0630155501600000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L WMP Land Use Code 11 Open Space: N DFL N Historic Property: N Remodel Property: N Multi- Family Redevelopment: N Township: Section: Range: A Location Address: 417 E VISTA VIEW DR Mapsco: PORT ANGELES, WA Neighborhood: PA South Res Map ID: 2 Neighborhood CD: 4151000 Owner. Name: CAROL J HATHAWAY Owner ID: 29461 Mailing Address: P O BOX 637 Ownership: 100.0000000000% PORT ANGELES, WA 98362 Exemptions: Taxes and Assessment Details Property Tax Information as of 09/29/2011 Amount Due if Paid on: Ey NOTE: If you plan to submit payment on a future date, make sure you enter the date and click RECALCULATE to obtain the correct total amount due. Click on "Statement Details" to expand or collapse a tax statement. First Half Second Half Year Statement ID Base Amt. Base Amt. Penalty Interest Base Paid Amount Due Statement Details 2011 161506 $1055.64 $1055.58 $0.00 $0.00 $1055.64 $1055.58 Statement Details 2010 49791 $1011.04 $1011.02 $0.00 $0.00 $2022.06 $0.00 Values Taxing Jurisdiction Improvement Sketch Property Image Land I Roll Value History Deed and Sales History Payout Agreement This year is not certified and ALL values will be represented with "N /A Website version: 9.0.32.2200 Database last updated on: 9/29/2011 3:59 AM ©2011 True Automation, Inc. All Rights Reserved. Privacy Notice http: /websrv8.clallam. net/ propertyaccess /Property.aspx ?cid =0 &year =2011 &prop_id =68059 9/29/2011 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 -4] 7 -4735 0 Application Number 11- 00001086 Date 10/03/11 v Application pin number 524728 REPORT SALES TAX Property Address 417 VISTA VIEW DR on your excise tax form ASSESSOR PARCEL NUMBER: 06- 30- 15 -5 -5- 0160 -0000- y Application type description ELECTRICAL ONLY to the City of Port Angeles Subdivision Name Property Use e (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation 0 Application desc 1 circuit Owner Contractor CAROL J HATHAWAY EXTRA MILE TECH ELECT., LLC PO BOX 637 418 N. RACE ST. PORT ANGELES WA 98362 PORT ANGELES WA 98362 x..1.1 (360) 460 -3836 (360) 457 -0198 457 85_1.5 Permit ELECTRICAL ALTER RESIDENTIAL T Additional desc X111 Permit pin number 193672 Permit Fee 73.50 Plan Check Fee .00 Issue' Date 10/03/11 Valuation 0 Expiration Date 3/31/12 Qty Unit Charge Per Extension 1.00 73.5000 ECH EL- BRANCH CIRCUIT WO /FEEDER 73.50 r Fee summary Charged Paid. Credited Due awl Permit Fee Total 73.50 73.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 73.50 73.50 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN P2/10/1) FINAL 4o Ito l 1 COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING OCT -02 -2011 09:45 PM E.JANSSEN 360 452 2982 P. 6.1 ECEVIED 1 OCT 3 G0li1 ,11_„. tr.1 CITY OP PORT ANGELES' PERMIT APPLICATION B.ECTRICik O0 Building Division /Electrical Inspections I.NSI+'ECfIaR9S` 321 East Fifth Street P.O. Box 1180 Port Angeles Washington, 98362 Ph: (360) 417 -4735 Pax: (360) 417 -4711 1 2 ,.in le F mily Multi Family or Commercial' Commercial Addition Alteration Remodel Repair' Plan Review May Be Required. F.).lease Complete Electrical Plan Review Information Shee; Job Address: 7. ..1/J5 ri'•».. l i C r r Building Square Footage: Deacrletion of .above Owner Information Contractor Information Name: .L,. it y,.._ A- t. L. '`....7.• '_r Name: C■ ;Y1 i C6 r e r..6 G i (.r l. Mailing Address; LA Ck.. 7 Mailint P r. L u r Ci 1 7> 4- 3 stela: 3 Tp: ;i 34:. cit a, i- r r state _k w..._.. P Fax 4-7-,7.;,a P �3i_�.�.t Phone: 1 r�r bi 5t Fax: License it Exp. License Exp i'.'q.v, T q �3 ,-.14, fle Unit Charge fib( Total (Qty Multip by U nli Chan, J Service/Feeder 200 Amp. 3119.90 Service/Feeder 201.400 Amp, 145.50 Service/Feeder 401.600 Amp 204.60 Service /Feeder 601 -1000 Amp. 26220 ServhtalFeede r over 1000 Amp, P 372.50 Branch Circuit W/ Service Feeder 2,60 Branch Circuit W/O Service Feeder 73.50 l_ Each Additional Branch Circuit 2.60 Temp. Service/ Feeder 200 Amp. 92. 70 Temp. Service/Feeder 201-400 Amp 110.30 Temp. ServicelFeeder 401.600 Amp 148.70 Temp. Service/Feeder 601-1000 Amp 3 167.90 Portal to Portal Hourly Y 95.90 SIgNQulline Lighting 66.20 Signal Circuit/ Limited Energy First 1500 sl Cemme,ciai 3 tl5 !;./.0 Note: 55.00 for each additional 1500 s! Signal Circuit/ Limited Energy 1 2 Farnl!I Dwelling 63.90 Signal Circuit/ Lim 63.90 Limited Energy Multi- Family Dwelling 4 Manufactured Home Connection 119,00 5KVA S Rter•1 or 1.c Renewable Electrical Energy r9Y Y s 102,30 Thermo9lbt Ss.on NW CONSTPUCT10N QNI First 1300 Square Fl. 5 110,30 Square Fl. or Portion a Each Additional 500 S U 35.20 Each Outbuilding or Detached Garage 3 73.50 Each Swimming Pool or Hot Tub 110.30 S_...I c Total Owner as defined by RCW.19,20.261: (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,G, 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 Acrplications. Signature of owner, electrical contractor or electrical administrator: [1 Cash LI ec,k it gg ti Credit Garde cc_ 01/8+12010 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Owner CAROL J HATHAWAY PO BOX 637 PORT ANGELES (360) 452 2757 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Fee summary Permit Fee Total Plan Check Total Grand Total CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98362 Per 07 00001192 813152 417 VISTA VIEW DR 06 30 15 5 5 0160 0000 CAROL HATHAWAY MECHANICAL APPL PERMIT 1 00 50 0000 ECH ME WOOD BURNING Charged Paid 50 00 00 50 00 )C) i r o 1a+ha vvct T.Forms /Building Division/Building Permit (10 /01 /07).wpd RS7 RESDNTL SINGLE FAMILY 4500 Contractor EVERWARM 257151 HWY101 PORT ANGELES (360) 452 3366 50 00 00 50 00 APPL Credited 00 00 00 Date 10/12/07 WA 98362 MECHANICAL PERMIT WOODSTOVE INSERT 113241 50 00 Plan Check Fee 00 10/12/07 Valuation 4500 4/09/08 Due Extension 50 00 00 00 00 re) 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 Signet of Contractor or Autho gent Signature of Owner (if owner is builder) CALL 417 -4815 FOR BUILDING INSPECTIONS CALL 417 -4735 FOR ELECTRICAL INSPECTIONS CALL 417 -4807 FOR PUBLIC WORKS UTILITIES 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 FOUNDATION. FOOTINGS SHEAR WALLS /.WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED HOMES FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING ELECTRICAL LIGHT DEPT 417 -4735 ENGINEERING 417 -4807 FIRE 417 -4653 PLANNING DEPT 417 -4750 I I BUILDING 417 -4815 I T Forms /Building Division /Building Permit (10 /01 /07).wpd BUILDING PERMIT INSPECTION RECORD YES NO n N(f) 17°A I I Z3 F_-_1O I FINAL FINAL PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING /LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W PW ENGINEERING FIRE DEPT PLANNING DEPT BUILDING DATE ACCEPTED BY. DATE ACCEPTED BY. DATE ACCEPTED YES 1 NO a Applicant or Agent l f Owner r�-� w i n Owner's Address 4// 1/) V� ct V Contractor/Engineer e'WlA1'VYl 'N-. J State License sG Contractor/Engineer's Address '1 1, v ,Jt 0 0257 1 PROJECT ADDRESS 4 -11 V tS �V 1' LEGAL DESCRIPTION Lot: Block: CLALLAM COUNTY PARCEL NUMBER. I Residential Multi family Commercial Repair TYPE OF WORK New Constr Addition Remodel Sign BRIEF DESCRIPTION OF THE PROJECT --i'reiQAac -e-- COMM)RCIAL/RESIDENTIAL. Occupancy Group: Existing Structure(s) basement 1 floor 2nd floor 3' floor Accessory Structures Existing Structure(s) TOTAL LOT COVERAGE Lot size Sq Ft. Existing Structure(s) Sq. Ft. Footprint Proposed Structure(s) Sq. Ft. Footprint TOTAL Structure(s) Sq. Ft. Footprint Total Lot Coverage BUILDING PERMIT APPLICATION Fill out COMPLETELY and in INK. Your application, prescriptive energy form, plans, specs, and a 8'A" x 11" site plan MUST BE COMPLETE to be accepted for review (360) 417 -4815 FAX (360) 417 -4711 Residential projects: submit two sets of plans Commercial projects: submit three sets of plans Re -roof Move Garage Demolition Deck Other T' \FORMS \BUILDING DIVISION \BldgPermitAppl. -2006 CODE backup.wpd Subdivision. SF SF SF TOTAL VALUATION Phone 4. Phone SIZE/VALUATION Occupant Load. Construction Type: Sq. Ft. Proposed Structure(s) basement Sq. Ft. 1 floor Sq. Ft. 2 floor Sq. Ft. 3r floor Sq. Ft. Accessory Structures Sq. Ft. Proposed Structure(s) TOTAL TOTAL of existing proposed structures Maximum Height of Proposed Structure(s) Are you planning to install a lawn sprinkler system? (Divide Total Structure(s) Sq. Ft. Footprint by Lot Size Sq Ft.) FOR OFFICIAL USE ONLY Date Rec. 1 1,Z -07 Permit 01 1197_ Date Approved: Date Issued: Expires Phone4 3'36' ZONING /SF /SF /SF 4L7 cU u Labe iMD E .s V Sq Ft. Sq Ft. Sq. Ft. Sq. Ft. Sq. Ft. Sq Ft. Sq. Ft. Ft. VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE The plan check fee must be paid at the time the building permit application is submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW An application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing unless such application has been pursued in good faith or a permit has been issued, except that the building official is authorized to grant one or more extensions of time for additional periods not exceeding 180 days (90 days for commercial projects) each. The extension shall be requested in writing and justifiable cause demonstrated. (IRC /IBC 2006 105.3.2) I hereby certify that 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 required, and that l must obtain such permits prior to work. Date 10 1 v7 Applicant 0