HomeMy WebLinkAbout817 W 12th St - Building THE ORT l 1 V ELE
CITY C?F For City Use
Permit I a g'41
W A S H I N G T O N U.S. Z W
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Date Received: 7. i' 61- a Q
321 East 5`h Street o 4%.
Port Angeles, WA 98362 Date A •_.r -•ved: 0 ci
P: 360 417 -4817 F: 360-417-4711 t W m
hcatuzo @cityofpa.us l
Building Permit Application
Project Address: 1 -t 1
Main Contact: Phone
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Property Nam Phone
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Owner Mailing Address Email
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City) Sta Z�3�
Contractor Nam Phone
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Mailing Address Email
City State Zip
Contractor License Expiration:
Project Value: Zoning: Tax Parcel Lot
v 0L9-5.0 0
Typd of Residential Er Commercial Industrial Public
Permit Demolition Fire Repair Reroof (tear off /lay over)
For the following, fill out both pages of permit application:
New Construction Remodel Addition Tenant Improvement
Mechanical Plumbing Other
Existing Fire Sprinkler System? Maximum height of structure Proposed Bedrooms Proposed Bathrooms
Yes No lir /Air. C" v
Project
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I have read and completed the 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. I understand the plan review fee is not refundable after review has
occurred. I understand that I will forfeit 20% of the review fee if I cancel or withdraw the application before
plan review has occurred. I understand that if the permit is not issued within 180 days of receipt, the
application will be considered abandoned, and the fees forfeit.
Date. Print Name 2 S ig natu, w 4
0. R d Ai -mil'
Residential Structures
Area Description (SQ FT) Existing Proposed Minimum For Office Use
value
Basement
First Floor 11+4(i
Second Floor
m'.' Y
Covered Deck /Porch /Eritiry f; 1
".ate
Deck tl vkm
s.s
Garage
Carport L YYI/
Other (describe)
Area Totals 241.8 2 1 L l
Commercial Structures
Area Description (SQ FT) Existing Proposed Minimum For Office Use
value
Structure (s)
Addition
Tenant Improvement
Other (describe)
Area
Lot /Site Coverage Calculations
Footprint (SQ FT) of all Structures: Lot Size: Lot Coverage
P 2-2A -C.0 4 32.1
SQ FT Site coverage (all impervious Site Coverage
structures) k ‘55fiS2-tt3O1i(o (0
Mechanical Fixtures
Indicate how many of each type of fixture to be installed or relocated as part of this project.
Air Handler Size: Haz /Non -Haz Piping Outlets:
Appliance Vent Heater (Suspended eor ssed wall)
Boiler /Compressor Size: mg/Cooling appliance
repair /alteration
Evaporative Cooler (attached, not Pellet Stove /Wood- burning /Gas
portable) Fireplace /Gas Stove /Gas Cook Stove /Misc.
Fuel Gas Piping of Outlets: Ventilation Fan, single duct
Furna eat Pump/ Size: Ventilation System
Forced Air Unit
Plumbin Fixtures
Indicate how many of each type of fixture to be installed or relocated
Plumbing Traps Fuel gas pipit': of Outlets:
Water Heater edical gas piping of Outlets:
Water Line Vent piping
Sewer Line Industrial waste pretreatment
interceptor
Other (describe):
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RECEIVED
JUL .9 2012
t CITY OF PORT ANGELES
BUILDING DIVISION
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