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HomeMy WebLinkAbout1703 W 5th St - Building PREPARED 10/26/11 10 48 14 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/26/11 ADDRESS 1703 W 5TH ST SUBDIV CONTRACTOR PHONE OWNER FEDERAL NATIONAL MTG ASSOC PHONE PARCEL 06 30 00 0 1 4195 0000 APPL NUMBER 11 00001209 RES REPAIR PERMIT BPR 00 BUILDING PERMIT RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL99 01 10/26/11 BLDG FINAL October 26 2011 10 32 59 AM permits COMMENTS AND NOTES c ` CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 11 00001209 Date 10/26/11 Application pin number 592443 Property Address 1703 W 5TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER 06 30 00 0 1 4195 0000 Application type description RES REPAIR on your state excise tax form Subdivision Name Property Use to the City of Port Angeles Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 1620 Application desc DECK REPAIR Owner Contractor FEDERAL NATIONAL MTG ASSOC OWNER 350 HIGHLAND DR LEWISVILLE TX 75067 Permit BUILDING PERMIT RESIDENTIAL Additional desc DECK REPAIR Permit pin number 195321 Permit Fee 86 60 Plan Check Fee 56 29 Issue Date 10/26/11 Valuation 1620 Expiration Date 4/23/12 Qty Unit Charge Per Extension BASE FEE 50 00 12 00 3 0500 HND BL-501 2K (3 05 PER C) 36 60 Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 86 60 86 60 00 00 Plan Check Total 56 29 56 29 00 00 V� Other Fee Total 4 50 4 50 00 00 Grand Total 147 39 147 39 00 00 Separate Permits are required for electrical work,SEPA,Shoreline ESA,utilities private and public improvements This permit becomes null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whet sp ified herein or ot. The grang of a permit does not presume to give ority to violate or cancel the provisions of any state or local w regulati c nstru on or the performance of constructio . 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 4174886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION. Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING Under Floor/Slab Rough-In Water Line(Meter to Bldg) Gas Line Back Flow/Water 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 "cl Inspection Type Date Accepted By �.l Electrical 417-4735 Construction R W PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T.Forms/Building Division/Building Permit q -� ) � � 3 I BUILDING PERMIT APPLI N TIOPrint in ink fs _ CITY OF PORT ANGELES Attn Building Permit Technician #hone For veity Use,�pnly / -J te Receivec f0'36�fl 321 E Fifth St. Port Angeles WA 98362 rmit# (360)417-4815 fax(360)417-4711 te Approved_ �t7ff Applicant _ ul Property Owner _ gun j le / Property Owner's Address 1�7©3 Contractor ,�,,..— 10th p(Qh PX' Phone Contractor's Address License# Expires E-mail PROJECT ADDRESS 03, W F2 44` S� Parcel.Number Lot Zoning Project Type 8,Brief Description. ❑ Residential ❑Multi-fa . m Industrial Check all that apply (� ❑New Construction ❑Addition ❑ Remodel ❑ Repair i ❑ Demolition ❑ Re-roof ❑ House ❑garage ❑other ❑tear off&re- ay over one layer ❑-Heat System .❑ Heat pump ❑wood-burning stove ❑gas firep ac stove ❑other her Floor AreasE n s . ft Pr osed s . ft Basement @$ per sq ft. _$ 1s'Floor L 2nd Floor O\ y 1�0 3`d Floor Garage ky Carport l� Ccwered Porc _ Other TOTAL VALUATION $ 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^K 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 I ha a read and completed this application and it to be true and correct. I am auth rued to a ply for this p it rid,117d tand that it is my responsibility to de me ermits are fired, and to obtain permrrs pi'or to g on Date t Na ��LO S�Signatur T Foirns/ uilding ivisiontBldg Permit.doc C Clallam County Assessor& Treasurer - Property Details - 56946 FEDERAL NATIONA Page I of 1 Clallam County Assessor &Treasurer Property Search Results> 56946 FEDERAL NATIONAL MTG ASSOCIATION for Year 2011 2012 Property Account Property ID 56946 Legal Description: LOT 20 BL 141 MAP G4 Geographic ID 0630000141950000 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: At Location Address 1703 W FIFTH ST Mapsco ✓/ PORT ANGELES,WA 98363 Neighborhood: PA West Res Map ID 3 ✓X n f Neighborhood CD 5151000 \�J/ Owner Name: FEDERAL NATIONAL MTG ASSOCIATION Owner ID198161 T Mailing Address: 350 HIGHLAND DR %Ownership: 100 0000000000% LEWISVILLE,TX 75067 Exemptions: Taxes and Assessment Details Property Tax Information as of 10/25/2011 Amount Due if Paid on. 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 151673 $700.66 $700.59 $0 00 $000 $1401.25 $0.00 Statement Details 2010 39964 $671 60 $67158 $000 $000 $1343 18 $0.00 Values Taxing Jurisdiction Improvement/Building Sketch Property Image Land 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:10/25/2011 3 49 AM ©2011 True Automation,Inc.All Rights Reserved.Privacy Notice http.//websrv8 clallam.net/propertyaccess/Property aspx?cid=0&year=2011&prop_id=56 10/25/2011 BUILDING PERMIT APPLICATION I Print in ink o CITY OF PORT ANGELES ` For City Us rhl r� Attn Building Permit Technician Date Received --� 321 E Fifth St. Port Angeles WA 98362 d (360)4174815 fax(360)417-4711 Permit# Date Approved Applicant P one 3�, go'-3dzZ Property Owner Phone $'09 Property Owner's Address 0 3 w y74 - Contractor -- Phone Contractor's Address License # Expires E-mail PROJECT ADDRESS p 3 Parcel.Number Lot Zoning Project Type&Brief Description o.Residential ❑ Multi-fa7. •�Industrial� Check all that apply ❑ New Construction ❑Addition ❑ Remodel %Ak5 ❑ Repair , 11-7 ❑ Demolition ❑ Re-roof ❑ House ❑ garage ❑ other ❑ tear off& re- ay over one layer ❑-Heat System ❑ Heat pump ❑wood-burning stove ❑gas firep a stove ❑ other; her Floor Areas E " tin (sq. ft. Pro ed(sq. ft. Basement @$ per sq ft. = $ 15`Floor L 2nd Floor 3rd Floor � O Garage ,� Carport V Qoyar.ed Por h Deck Other TOTAL VALUATION $ Q7 Total footprint of structures s ft. _ Lot size s ft. _ ° Lot coverage /o P q q 9 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 11 I ha a read and completed this application and kno it to be true and correct. l.am authorized to apply for this permit and.mderstand that it is my responsibility to de ine w ermits are r aired, and to obtain permas prior to g on ects.',I Date Print Na Signatur T Fcirns/Building Division/Bldg Permit.doc � u NOTES Permit#1 ® q-3-79 to_ _ll 0V-,4-0 f c. r- -a rn L Rec UV-VeCA- `fife& e, -rrni-� U '-k- "(0,- `fie. �\CWo cj on-P-A— CO dnCi— 15,5 Ue,. :this t nv� ba-AK-ateV\-pal gyp9-e- - -t-ha+- ►s -fir sal-p. L:l e-cAyiC-° C `4- bar n. ;S Oe a IL E-- chAn2iq=� &LLL-Y��� 4JYN T Forms/Building Division/Notes ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 11 00000851 Date 8/10/11 Application pin number 364514 REPORT SALES TAX Property Address 1703 W 5TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 4195 0000 on your excise tax form 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 200 AMP SERVICE Owner Contractor RONALD L SCHROMEN WAWRIN ALASKAN ELECTRIC 375 WESTRIDGE RD 237 ROBERSON RD PORT ANGELES WA 983639438 PORT ANGELES WA 98362 (360) 582 3874 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc Permit pin number 190744 V Permit Fee 119 90 Plan Check Fee 00 Issue Date 8/10/11 Valuation 0 Expiration Date 2/06/12 Qty Unit Charge Per Extension 1 00 119 9000 ECH EL 0 200 SRV FEEDER 119 90 Special Notes and Comments August 10 2011 8 04 35 AM banders Must obtain 12 foot minimum clearance over deck and provide guy kit for mast support c Fee summary Charged Paid Credited Due v \ Permit Fee Total 119 90 119 90 00 00 Plan Check Total 00 00 00 00 (1 Grand Total 119 90 119 90 00 00 \V1 INSPECTION TYPE DATE. RESULTS INSPECTOR. DITCH SERVICE g l/lit ROUGH IN FINAL COMMENTS PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date. G\EXCHANGE\BUILDING RUINED CITY OF PORT ANGELES PEIt1VIl'L'APPLICATION AUG 9 2011 pp Building Division/Electricul Inspections 321 East Fifth Street--P O.Box 1150/ Wort Angeles W ashington;98362 ELECTIR:IDAL Ph (360)417-4735 Fax. (360)4174711 INSPECT1100 Date, " ~ I I — 1 &2 Single Family Dwelling —Multi-Family or Commercial* —.,_Commercial Addition 1 Alteration!Remod Repair' Plan Review May Be Required, Please Com le y, lectrical Plan Review Information Sheet Job Address: .170 Building Square Footage:_ P,A:r(� Description of above—.. Z Owner InformationContractor Information e 7'aKSo� Name:�SxaN 6r-cse.T,�,e�_� SSR-Y�c�S Name; 4 �G'. Melling Address- O Z Mailing Address:,j 7 b 3 ���^ City, 3�P, K}__ State: �^�p ---- City. State:WA—Zlp:_,�>s.?=_ Phone: 823' 7 Fax: 7Z=�-�-- Phone: AO'9 3g2Z Fax: - -- Llcanse#I Exp r:/1t5k 9y�.��ZCt�iZ License#I Exp. Item Unit Charge f t( Total t Multi lied b Unit Char e 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 $- ServlcelFeeder over 1000 Amp. $372.50 — Branch Circuit W/Service Feeder $ 2.60 — $— Branch Circuit WIC Service Feeder $ 73.50 $ Each Additional Branch Circuit $ 2.60 - $— Tamp,Service/Feeder 200 Amp. $ 92.70 $— ^ Temp.Service/Feeder 201.400 Amp. $110.30 $ Temp.ServicelFeeder 401-600 Amp. $148.70 — $ Temp.Service/Feeder 6011000 Amp $167,90 $ Portal to Portal Hourly $ 95.90 — $— Sign/Outline Lighting $ 88.20 $— Signal Circuli/Limited Energy/First 1500 sf—Commercial $ 95.90 $ Note: $5,00 for each additional 1500 of $ Signal Circuit/Limited Energy 1 &2 Family Dwelling $ 63.90 $ 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 CONSTRl1CTIO ONLY. First 1300 Square Fl. $110.30 — Each Additional 500 Square Ft.or Portion of $ 35.20 — $ Each Outbuilding or Detached Garage S 73.50 �— $---Each Swimming Pool or Hot'rub $110.30 — $— g- � .4Ofotal 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,NEC, 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 0 Clio& _TXCreditCard AWW"Now Dated:�! Y- -- --^ 0110112010 ZO/T0 39Vd SAS 10313 NVNS 1VV £££SZGV096 ST 80 TTOZ/60/80 MuellerCompany 2032 0 Street Service CoPort s Angeles,WA 98362 ASSESSMENT•MAINTENANCE•INSTALLATION 360-565-7250 i —y } WORK ORDER Date: Electric MeterWater Meter it Meter Number, Location Number- Address: �`"7(�3 �.�' ��7 S T Owner Name: ('Z! 0 Installation Technician: Problem Description: ; !6P6JZV) L (by Installer) A.Electric Repairs Authorized Permit# City Representative: Repairs Required check/ Unit price Ext Price Socket Replacement [/ $265.20 $ Conductor Socket to Masthead $318.00 $ Other Socket Repair Other Riser and Weatherhead Replacement Other Description: 9-,vPL-p-LiE 1 .J5_ r&_JZ_ F—_Ve 2, TO ?X7_.0"7 V r I Other Time&Materials Form Attached: $ Repair Total Cost $ Owner's Cost(if Repair Total Cost exceeds$750) $_��rJ Repairs Completed Satisfactorily Yes No If no correc' c ion required Inspector Signature Date: 1 B.Water Repairs Authorized City Representative: i Repairs Required check Unit price Ext Price + Replace Meter Box $55.00 $ Replace Lid $5.00 $ Other Setter Repair Other Connection Repair Other Pressure Reducing Valve Repair i Other (Time&Materials) Description: Other Time&Materials Form Attached: $ Repair Total Cost $ Owner's Cost(if Repair Total Cost exceeds$750) $ Repairs Completed Satisfactorily Yes No If no corrective action required Inspector Signature Date: Owner Authorization I Based on the extent of repairs required,is owner consent required? Yes >Owner consent required No >Vendor may proceed with repairs Consent to proceed with City required repairs and Owner's Cost(if any identified above) 3 to the Owner not Owner Name Owner Signature Date Distribution: MSC Owner Project Manager Electrical Inspector Water Superintendent A.Database Date/Initials: B.Database Date/Initials: VORT ELECTRICAL INSPECTION �A r, WIRING REPORT o L ry y RKS 417-4735 e � b � DATE: PERMIT# INSPECTO Q v t 1 1L OWNER &9-0YZ6 2Z CONTRACTOR ADDRESS 1 -70 3sY— APPROVED NOT APPROVED ❑ DITCH ❑ ❑ ROUGH IN/COVER ❑ ❑ SERVICE ❑ FINAL ❑ CORRECTIONS NEEDED' 1�_ L-v Gjc�T rm— STrL1 u rz— -f-b fit-LCA 1.� Foil 1?o*z c- c-.. PtC-C 5 'moi a L T3 �Ly l 21�D NOTIFY INSPECTOR WHEN CO IONS ARE COMPLETED WITHI =DAY§S — DO NOT REMOVE — June 24 2011 1 28 24 PM Ipangrle PERMIT#09-379 1703 W 5T" ST THIS PERMIT HAS BEEN READY TO PAY FOR AND PICK UP SINCE 05-07-09 THE OWNER NEVER PICKED IT UP ON 05-07-091 LEFT A PHONE MESSAGE FOR THE OWNER TO PICK UP THIS PERMIT ON 05-27-091 LEFT ANOTHER PHONE MESSAGE FOR THE OWNER TO PICK UP THIS PERMIT ON 07-28-091 PHONED THE OWNER GEORGE HE SAID HE FINISHED BUILDING THE DECK BUT ISN'T GOING TO PAY FOR THIS PERMIT HE SAID JIM LIERLY "KNOWS HIS SITUATION AND THAT HE WILL PROBABLY LOSE THE HOUSE" LATER THAT DAY I TALKED WITH JIM L. ABOUT THIS JIM L TOLD ME TO "KEEP THIS ON HOLD" UNTIL TRENT GETS HIS ELECTRICAL ISSUES RESOLVED ON 09-22-09 JIM L. TOLD ME TO "PARK THIS" ON 01-21-10 JIM L LOWERED THE PERMIT FEE TO $147 39 ON 01-03-11 JIM L TOLD ME TO "PARK THIS" SINCE GEORGE'S MOM DIED RECENTLY ON 06-20-11 1 TALKED WITH SUE ROBERDS AND JIM LIERLY ABOUT THIS UNISSUED PERMIT SUE TOLD ME TO WRITE A NOTE FOR THE FILE AND TO EXPIRE THIS PERMIT ON 06-24-11 1 TOLD TRACY ROOKS ABOUT THE ELECTRICAL HAZARDS OVER THE UNPERMITTED DECK. SHE PUT A NOTE IN HTE FOR THE CASHIERS TO NOT SIGN UP ANYONE FOR UTILITIES UNTIL ELECTRICAL AND BUILDING ISSUES ARE RESOLVED PREPARED 5/07/09, 9 22 48 PAYMENTS DUE RECLIPT CITY OF PORT ANGELES ��Y-(�(;_ ��'� � P OGRAM BP8,,20L ------------------------------------------------------------------------ APPLICATION NUMBER 09-00000379 1703 W 5TH ST FEE DESCRIPTION AMOUNT DUE ------------------------------------------------------- ------------------- PLAN CHECK FEES 38 84 BUILDING PERMIT - RESIDENTIAL 109 75 STATE SURCHARGE 4 50 TOTAL DUE Please present this receipt to the ca ier with full payment Application Inquiry sir N.a ADplit ahun u9-300003'r f Bona• r Property Information Application Information Q ntr clot µddres 17n3 W 5TH ST iApplication de�c 2200 SF DFCK Pe PORT ANGELES W 98362 1 i Applicatinn -tatus PLAN RBtIBN ;tubal hdla; du. Location TD• 9139ZI !i °tatus Date 4/29/2009 j ®'nspectron htsbury Owner name RONALD L DFOMEN-WAWRI ; Applicatiun type RLL REMODEL Q Miscellaneru,infe ASSESSOR PARCEL NUHSER. 06-30-00-0-1 4195-0000- ( Application date 4,'29,2009 Ndme ALTERNATE ID 063000014195 Tenant name/number GEORGE PETERSEN Permit. (1 li »- »T Valuation 2400 Plan bdt,king t Receipts Contractor Information ry Outstanding Inspections Square footage calf ✓ ✓ Structures Contractor Name OWNER Insp bchedule Confirmation I valuallon calculatic Contractor Number Type ID Date Number I Type, Status No outstanding inspections exist Contractor Requirements Doc Number i .I Ll 0 PLAN -HECK FEES -1.34 36 84 1 00 1000000 BPR 00 PERMIT FEE° 109 75 109.75 000000OU BPR 00 "TATE SURCHARGE 4 50 4 SO .00 Total.. 165 59 153.19 1 00 I Print Cancel J(Exit 1: Refresh Land Inquiry g Documents C t''Aft Application Inquiry 1pFli ahon o�-n[iJUiJ7,t� ---- .._....«»,»....»....».,..,....�.�....-. ....-_.._...,....._. �. Bunro i i property Information !I Application Information 0 untr ctora, W AddrP 1703 W STH ST Application desc 200 SF DECK j. Q FP PORT ANGELES, WA 98362 Application status PLAN REVIEW ® 3lobalbala� due Location ID 91390 �-j Itatua Date 4/29/2009 Q Inspection h story Owner name RONALD L 3CHROMEN-WAWRI I Application type RES REMODEL i Miscellaneous info ASSESSOR PARCEL NUMBER: 06-30-00 Application Application date 4/29/2009 ®Names ALTERNATE ID- 063000014195 i�l Tenant name/number GEORGE PETERSEN Permits (11 Valuation 2400 Plan baOing - ,/Receipts Contractor Information 1 Outstanding Inspections j Square footage cal ?' I Structures Contractor Name OWNER i1 Insp Schedule Confirmation I Valuationcalculato Contractor Number ( Type ID Date Number I Type Status a No outstanding inspections exist contractor Requirements Doc Number I AJ10 41..9/090458 1 CAS HA Jk it SU 00 Total :. 50 .00 .y Print Cancel �!Exit Refresh Land Inquiry Documents - � 'n • BUILDING PERMIT APPLICATION Print in ink '^�•"�"- CITY OF PORT ANGELES For City us I Attn Building Permit Technician r 321 E Fifth St. Port Angeles WA 98362 �` Date Received (360) 417-4815 fax (360)417-4711 , Permit# I Date Approved Applicant — P onel 3(.0 so) f1 Property Owner Phone $p q -3$Z2 Property Owner's Address 0 3 w r74— Contractor �,,,,.,-- Phone Contractor's Address License # Expires E-mail PROJECT ADDRESS Parcel.Number Lot Zoning Project Type & Brief Description. a ❑.Residential ❑ Multi-fa mme Industrial Check all that apply ❑ New Construction ❑Addition C. ❑ Remodel S ❑ Repair [lT 1i ❑ Demolition ❑ Re-roof ❑ House ❑ garage ❑ other ❑ tear off& re- ay over one layer ❑ Heat System .❑ Heat pump ❑wood-burning stove ❑ gas firep ac stove ❑ other her Floor Areas Existing(sq. ft.) Proposed(sq. ft.) Basement @ $ per sq ft. _ $ 15' Floor L 2nd Floor O\ 3rd Floor � p Garage Carport V Cove ed Porch Deck Other TOTAL VALUATION $ 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 I ha e read and completed this application and it to be true and correct l am authorized to apply for this permit and,ioderstand that it is my responsibility to de in w ermits are r wired, and to obtain permrrs prior to w ' g on ro'ects. Date Print Na Signatur T Fcrrns/Building Division/Bldg Permit.doc CXoiLQ� Jr� . 1702 ;.,11 ..q i.�,,• a?^ � `f '1,702 t'r• � Y" ot�llo-�Ik ON All `a. r � a � • a sr . 1705 • Yrx 1703 a :wg ,� � s i. ger',,,�• b IA. a 16$5 „ L 415 " d v t i' C (Y\ 12r s LA P)e-r' CITY OF PORT ANGELES—Construction Plant; The Issuance of this permit based upon these plans,speciri• cations and other data shall not prevent the building official from thereafter requiring the correction of errors in said �{,( / T ,(9Q s--7 r Plat's specifications and other data, or from preventing (� building operations being carried on thereunder when in violation of all codes and or finances of thisjunZ'sdi Approval Date By �- V--i,c_ (a Cl- PLY y �cst i ON 4 y�-g3 r CITY OF PORT ANGELES—7- construction Plans The issuance of this permit based upon these plans,sp c P,.ifi- cations and other data shall not prevent the building official / from thereafter requiring the correction of error fein said g pia" specifications and other data, or from p building operations being carried on thereunder when in violation of all codes and ordinances 1 this juri� ` {approval Date By vnq � !S — WPe