HomeMy WebLinkAbout2211 S Cherry St - Building CITY OF PORT ANGELES
'CM) DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00001367 Date 12/01/11
Application pin number 265519
Property Address 2211 S CHERRY ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-09-5-2- 1840 -0000-
Application type description RE -ROOF on your state excise tax form
Subdivision Name to the City of Port Angeles
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation 6976
Application desc
TEAR OFF /INSTALL COM
Owner Contractor
CAMPBELL DALLAS W BARNES CONSTRUCTION INC
202 W 10TH ST 258852 HWY 101 W
PORT ANGELES WA 983627708 SEQUIM WA 98382
(360) 452 -6465 (360) 683 -5796
Permit BUILDING PERMIT NO PR FEE
Additional desc TEAR OFF /INSTALL COMP
Permit Fee 165.75 Plan Check Fee .00
Issue Date 12/01/11 Valuation 6976
Expiration Date 5/29/12
Qty Unit Charge Per Extension
BASE FEE 95.75
5.00 14.0000 THOU BL- 2001 -25K (14 PER K) 70.00
Other Fees STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 165.75 165.75 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 170.25 170.25 .00 .00
fiOal
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. f 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.
191 4
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
(N C 0 0 Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
Walls Roof Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat PumeFurnace FAU Ducts L
Rough -In
Gas Line
Wood Stove Pellet Chimney
Commercial Hood Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
\A Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
\r> Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Plannir29 417 -4750
Building 417 -4815 6' A. IT-. ��lL
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BUILDING PLUMBING MECHANICAL PERMIT APPLICATION SHORT FORM
(To be used for projects that do not require plan review.)
Date Received 11,--A—
t
L1- t36
City of Port Angeles Please print in ink. Date Approved Z— t
Attn: Building Permit Technician Approved by �l
321 E. 5' St., Port Angeles, WA 98362
360- 417 -4815 fax: 360- 417 -4711 Credit card payments are accepted Mon -Fri 8 -5 pm (no American E E. s)
Hours: Mon through Fri 8 5 pm Cash checks are accepted Mon -Thurs 8:30 -4 pm Fri 8:30 -12:30 pm
Contact person: Phone:
Property owner:
0/.9 C M p' ELL Phone:
Property owner's mailing address:
Contractor's business name: 8 h% S c crsy C Phone:
(or property owner's name if he /she is doing /overseeing the work) 79 6,
Contractor's mailing address:
c'8S'S'-. w ✓/e I 5 En
L 1 1
Contractor's L &I license nu Expiration date:
Proje Address: r �7 �p �/y^�/
r'7,r 1 e. 1 l� 'R s--� /I v l rU 9 c E
Project Type: XResidential o Commercial a Industrial o Multi- family
Project Business Name:
(for commercial, industrial, or multi family projects) ,8 c. CJ S lY G
The following permits are usually issued over the counter immediately, without the need for plan review.
Complete only the portions of this permit that are relevant to your project.
Re -roof: grhouse garage other
cYsi tear off re -roof lay over one layer
i< Licensed contractor: Submit a copy of your re -roof bid.
Project Valuation J (labor materials, not including sales tax)/ c)-1(
Re -side: house garage other G l�
Project Valuation (labor materials, not including sales tax)
Repair: (explain the project)
Project Valuation
*Homeowner: If you will be doing overseeing the work, then the project valuation will be determined by doubling the
cost of materials, to reflect the value the repair adds to your property.
Cost of materials x 2 Project Valuation
T:Forms /Building Division /Building /Plumbing /Mechanical Permit Application Short Form (Revised 2011)
Page 1 of 2
Swimming Pool or Spa (2. 24" deep): For prefabricated swimming pool or spa projects that
do not require plan review:
Obtain the City of PA handout entitled "Pools Spas" follow the requirements.
Project Valuation
Demolition: 1 A demolition permit is needed when an entire building gets demolished.
What will be demolished? house garage other
Note: some demolition permit applications need to be reviewed by various City departments, and may take
approximately two weeks to obtain.
Agree to ensure that all utilities are /will be properly turned off (and capped off needed)
prior to demolition.
Obtain (from the City of PA) an aerial view map of the parcel and put an "x" over the structure(s) to
be demolished. Submit the map with this application.
Obtain (from the City of PA) a copy of the Olympic Region Clean Air Agency ORCAA)
Demolition Permit Application.
Contact ORCAA at 360- 417 -1466 to discuss whether or not an ORCAA Demolition Permit will also
be needed.
yes no Will the debris be going to the Regional Transfer Station in Port Angeles?
yes No If yes, will a licensed contractor be taking it there?
If yes, obtain (from the City of PA) a copy of the Waste Disposal Application.
Complete and submit the waste disposal application to the Building Permit Technician, now
(or later if asbestos testing is needed).
Plumbing Permit: (explain the project)
Project Valuation
Mechanical Permit: (explain the project)
Project Valuation
I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit
and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to
working on projects.
Date ARV 1) Signature s ,PAC
Print Name ))4 V/ A) I. W
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