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HomeMy WebLinkAbout1924 Village Cir - Building Fire Permit 1924 Village Cir 12 - 1158 Li i x yr run i Hivv�l r� FIRE DEPARTMENT PERMIT v 321 East 5`h Street, Port Angeles, WA 98362 , ism Application Number . . . . 12-00001158 Date 9/06/12 Application pin number . . . 661868 REPORT SALES TAX Property Address . . . . . . 1924 VILLAGE CIR Wj ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0220-0000- 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. . . . 2200 ---------------------------------------------------------------------------- Application desc -- RESIDENTIAL FIRE SPRINKLER SYSTEM ft --------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KREAMAN, SHIRLEY INNOVATED FIRE SPRINKLERS 811 W 15TH ST 81 NEW HAVEN LANE PORT ANGELES WA 98363 PORT ANGELES WA 98362 (360) 452-7583 -- Permit . . . . . . FIRE SPRINKLER RESIDENTIAL Additional desc . . RESIDENTIAL FIRE SPRINKLER SYS 0000 Permit Fee . . . . .00 Plan Check Fee .00 Issue Date . . . . 9/06/12 Valuation . . . . 2200 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 This 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 compled with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel th provisions of any state or local law regulating the work specified in the permit. r Signature of Contractor or A horized Agent ate Signature of Owner(if Owner is builder) Date FIRE PERMIT INSPECTION RECORD V S. 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. VKEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE Inspection Type Date Passed Comments afto 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 Time initiated Tank(container) inspection 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 PERMIT OTHER(specify) permit final GENERAL COMMENTS: 2/15/00 LIN rc,Rr�, FIRE—RELATED PERMIT APPLICATION w W CITY OF PORT ANGELES For City Useply: Attn: Building Permit Technician Date Received ' la' � .� 321 E. Fifth St., Port Angeles, WA 98362 Permit# (360)417-4815 fax(360)417-4711 ApplicantV ` yvc_Q9_ J Q �r�- Phone t'l Property Owner a VYL0'.VN, Phone L S?_ -? a(-/ Property Owner's Address a- Contractor /N A, 1W1! e5 ''" r S K =�/Z Phone 2 — Contractor's Address ,Q,� �-,^ License # d?/,� p Z �f j�' Expires �2 E-mail PROJECT ADDRESS Project.Business Name Fire Alarm Svstem ❑ Residential ❑ Multi-family ❑ Commercial ❑ Industrial Check al/that apply ® Briefly describe the prof ci>i_EC 1EE.1V E ❑ One addressable loop ❑ One zone SEP _ ❑Additional zones List quantity of additional zones CITY OF PORT PROJECT VALUATION(labor& materials) $ DING DIVISION Fire Sprinkler.System Residential ❑ Multi-family ❑ Commercial ❑ Industrial Check all that.apply Briefly decrib xhe rglect: I l Installing backflow r tection device(s)? / �— ❑ yes ono - <2 inch waterline (list quantity of devices) >2 inch water line (list quantity of devices) PROJECT VALUATION(labor&materials) $ C'J &CJ Hood/ 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. /am authorized to apply for this permit and understand that it is m71W1.2, nsibility to determine)what permits are required, and to obtain permits prior t working on projects. Date Print Name V 1 VLC__% t� ) ,i` Signature c T.-Forms/Building/Fire-related permit application PREPARED 4/01/13, 15:05:29 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 00001158 1924 VILLAGE CIR 06-30-13-5-7-0220-0000- 063013570220 000 000 FSPK 00 FIRE SPRINKLER RESIDENTIAL FFNL 0001 FIRE FINAL 3/28/13 APPROVED KDD REQ COMM: March 28, 2013 10:36:22 AM kdubuc. RES COMM: March 28, 2013 10:36:40 AM kdubuc. RES COMM: fire final Electrical Permit 1924 Village Cir 12- 1083 ELECTRICAL PERMIT ' N CITY OF PORT ANGELES 360-417-4735 Application Number . . . 12-00001083 Date 8/20/12 Application pin number . . . 151511 �V Property Address . . . . . . 1924 VILLAGE CIR REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0220-0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name . . . . . . to the City of Port Angeles Property Use . . Property Zoning . . . . . . RESIDENTIAL HIGH DENSITY (Location Code 0502) Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc New home Owner Contractor ------------------------ ------------------------ PENINSULA HOUSING AUTHORITY OWL ELECTRIC 2603 S FRANCIS ST PO BOX 536 PORT ANGELES WA 98362 CARLSBORG WA 98324 (360) 582-0833 (� ---- ------------- - -------------------------------- ------ ------ --------- N 1 Permit ELECTRICAL NEW RESIDENTIAL Additional desc . . (� 1 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 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 v INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE 41011h2— ROUGH-IN 4.7 Ithz_ FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING N W ,it AUG 2 0 20$2 ELECTRICAL u r. CITY OF PORT ANGELES PERMIT APPLICATION INSPECTIONS ,, 1 Building Division/Electrical Inspections 321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362 „ Ph: (360)417-4735 Fax: (360)417-4711 Date: g - 74- / "-' _I &2 Single Family Dwelling *Plan Review M Be equl-r�jd, Please Complete lectrical Plan Review Information Sheet Job Address: - tz Y 14 U� PL< e Building Square Footage: Description of above o III 14 04 Owner[Djormation Contractor nor aCName: LIuidl WON � O33ru Name: d d ll e Mailin AddsA - B` ` Fkyyc /J Mailin Addr jo, 11AI State:WA- Zip: City: lA State: Zip: Z Phone: ! Fax: Phone: ��O Fa : Aati1G License#/Exp. License#I Exp. 9 G Item Unit Charge 0 Total(Qty Multiplied by Unit Charge) Service/Feeder 200 Amp. $120.00 $ Service/Feeder 201400 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/O 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:$5.00 for each additional T-Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft. $120.00 l� 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 $_�_ $- / 7 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 296-466,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner electrical ontractor or electrical administrator: ❑ cash ❑ Check �A e, ❑ Credit Card#, X "`�� Dated: ®f ` .01 10112012 i C w 1 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 s Application Number . . . . . 12-00000841 Date 7/06/12 Application pin number . . . 596420 . Property Address . . . . . . 1924 VILLAGE CIR REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0220-0000- 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 PENINSULA HOUSING AUTHORITY OLYMPIC WIRING INC 2603 S FRANCIS ST 9601 PROVOST ROAD NW. PORT ANGELES WA 98362 SILVERDALE WA 98383 (360). 692-0134 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 120.00 Plan Check Fee .00 Issue Date . . . . 7/06/12 Valuation . . . . 0 Expiration Date . . 1/02/13 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 7/1 I Z SERVICE ROUGH-IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING JUL-6-2012 07:23A FROM:OLYMPIC WIRING (360)692-3680 TO: 136041747,11 P.2/2 y �� tit Pr)kYa^�4r' t CITY OF PORT ANGELES PERMIT APPLICATION. '- Building Division/Electrical Inspections ELECTRICAL 321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362 INSPECTIONS Plu(360)417-4735 Tax: (360)417-4711 Date: 17- 6, o"? _1"&2-SitfoNr.FaM'llyDwelling= *Plan Review Ma Be Required,Please Complete Electrical Plan Review Informati n Sheet Job Address: 4 to F : Building Square Footage: Description of above r Q. Owner In Imation Contractor nforma ion Name: G /.rl+ �Yt=- Mailln Address: p::4�5 5f MallingAddre s: 1 (' ✓ o Phone: d Stale: 9Q"7 Phone: :3 /�: �r.(-4(/ Stale: �)g Zlp:_ Za.213 - Phone: - i (�D 9 Phone: -o/ ax: O•l/9a (fD License#/Exp. Llcensa#I Exp, //i m 2 w / - /O G Item Unit Charge fay Total(Qty Multlpiled by Unit Charge) Service/Feeder 200 Amp. $120.00 $ Service/Feeder 201.400 Amp. $146.00 $ ServicelFeeder 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 NO 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:$5.00 for each additional T-Stat NEW CONSTRUCTION ONLY: First 1300 Square Ft, $120.00 Each Additional 600 Square Ft.or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $ Each Swimming Pool or Hot Tub $110.00 $ $�rotat 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 alter 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 296-469,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: 0 Ceeh 0 Chock �/ 10 Credit Cord# Electrical Permit 1924 Village Cir 12 - 590 ELECTRICAL PERMIT _ a CITY OF PORT ANGELES r 360-417-4735 d Application Number . . . . . 12-00000590 Date 5/15/12 Application pin number . . . 693880 Property Address . . . . . . 1924 VILLAGE CIR REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0220-0000- onour 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 Temp pole ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PENINSULA HOUSING AUTHORITY OLYMPIC WIRING INC 2603 S FRANCIS ST 9601 PROVOST ROAD NW. PORT ANGELES WA 98362 SILVERDALE WA 98383 (360) 692-0134 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL TEMPORARY SERVICE Additional desc . . Permit Fee . . . . 93.00 Plan Check Fee .00 Issue Date . . . . 5/15/12 Valuation . . . . 0 1 Expiration Date 11/11/12 J V Qty Unit Charge Per Extension 1.00 93.0000 ECH EL-TEMP SRV 0-200 SRV FDR 93.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 93.00 93.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 93.00 93.00 .00 .00 `— r INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ! -z ROUGH-IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING MAY-14-2012 01:14P FROM:OLYMPIC WIRING (360)692-3680 TO:13604174711 P.4/4 P0Krr.1.% Cl'CY OF.P012T ANC,FLFS PERma APP1,11CA'I'10N I3nilding Division/Elect0cal Inspections 321 :East Fifth St1•cet-.P.O. 13ox 1150/Port Angeles Washington,98362 3w ELECi�ctC�,1_ Ph: (360)417-4735 Fax: (360)417-4711 1NSPEC110NIS Date: 5- 14— 12 1 &2 Single Family Dwelling Plan Review May Be Required,Please Complete Electrical Plan Review Information Sheet Job Address: lg2/4 Vt Ilay' _le- P6r-4-An�c e,les VVA ( 1 Building Squarc Footage: Description of above S t vlq l e_ t 51 0- v,t e s t&0'-. V i Ua4 e. Owner Information Contractor Information Name: 14ou s t ng A u+4^e-rr t4-•t.,` Name: . o L vn 5O• F2rclS T. 91.01Mailing Address: ZtO3 t P R oV oST R N,W City:PortA%g9e.teSSlale: lW4 Zip: R Sr"A( 2z City:StUVERDALC-- State:WA Zip: 'A?:A Phone: a t a --q-L 2 -'�Q0-19 (B_P-uAcg PhonejLo bg t-DI'S yFax:(3W1 fa92-16 TO License p I Exp:. License q/Exp. O LV M P\61"I 3 1 o R U Item Unit Charge oty Total(Qty Multiolled by Unlit Charge) Service/Feeder 200 Amp. $1.20.00 $ Service/Feeder 201-400 Amp. $146.00 $ Service/Feeder 401-600 Amp $205.00 $ ServicelFeeder 601-1000 Amp. $262.00 $ Service/Feeder over 1000 Amp. $373.00 $ Branch Circuit W/Service Feeder $ 5,00 $ Branch Circuit W/O Service Feeder $ 63,00 $ Each Additional Branch Circuit $ 5,00 $ Branch Circuils 1-4 $ 75.00 $ JTemp,Service/Feeder 200 Amp. $ 93,00 �_ $ T3.0 Temp.Service/Feeder 201-400 Amp. $110,00 $ Temp.ServicelFeeder 401-600 Amp. $149.00 $ Temp,Service/Feeder 6014000 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:$5,00 for each additional T-Stat NEW CONSTRUCTION ONLY: First 1300 Square Fl. $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 $ $ 473. oo 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 hirean electrical contractor if above said property is for sale,rent be 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 adminlstrator: O cash ❑ chock O creducardp.4gf'DZ• i IS-10.91-34 • 8 2-1.5 % ii.d•�J �QJ Dated: ..._S`�y-f Z __.— 0110112012 Vf SA Building Permit 1924 Village Cir 12 -261 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST STH STREET, PORT ANGELES,WA 98362 Application Number . . . . . 12-00000261 Date 5/11/12 Application pin number . . . 908274 Property Address . . . . . . 1924 VILLAGE CIR ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0220-0000- REPORT SALES TAX Application type description RES NEW SFR on your state excise tax form Property Name . . . . . . to the City of Port Angeles Pro ert Use .,I Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY (Location Code 0502) Application valuation . . . . 103474 ---------------------------------------------------------------------------- Application desc 1483 SF SFR W/ATTACHED GARAGE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KREAMAN, SHIRLEY OWNER 811 W 15TH ST PORT ANGELES WA 98363 ---------------------------------------------------------------------------- Permit . . . . . BUILDING PERMIT -RESIDENTIAL Additional desc . 1483 SF SFR W/ATTACHED GARAGE Permit Fee . . . 1042.65 Plan Check Fee 677.72 Issue Date . . . . 5/11/12 Valuation . . . . 103474 Expiration Date 11/07/12 Qty Unit Charge Per Extension BASE FEE 1042.65 .00 5.6000 THOU BL-100,001-500K (5.60 PER K) .00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . 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 . . 1483 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 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 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 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 As 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/Ruilrlinn nivieinn/Rnilrlinn Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 Page 2 Application Number . . . . . 12-00000261 Date 5/11/12 Application pin number . . . 908274 REPORT SALES TAX Qty Unit Charge Per Extension on your state excise tax form 1.00 15.0000 EA PL-SEWER LINE 15.00 1.00 7.0000 EA PL-WATER HEATER 7.00 to the City of Port Angeles ------------------------------------------------=-------------- (Location Code 0502) Special Notes and Comments March 9, 2012 10:55:49 AM tamiot. Electrical service from pedestal and northwest corner of property. March 16, 2012 8:21:56 AM rbecker. If your fire system is a closed system, you will need to install a double check valve assembly. If it is an open system, you do not need a backflow assembly. .If you have any questions,call Ron Becker at 417-4886, Fax:360-452-4972, E-mail:rbecker@cityofpa.us 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 1:00:22 PM sroberds. The proposal will reault .in a new sfr w/,att garage for total lot coverage of 30t and site coverage of 38W in the RHD. 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 ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1289.10 1289.10 .00 .00 Plan Check Total 677.72 677.72 .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 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 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 its 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/Ruilriinn nivisinn/Rnilriinn Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY &ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 3 Application Number . . . . . 12-00000261 pate 5/11/12 Application pin number . . . 908274 Other Fee Total 5294.50 5294.50 .00 .00 REPORT SALES TAX * Grand Total 7261.32 7261.32 .00 .00 on your state excise tax form to the City of Port Angeles (Location Code 0502) A� F � 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 ..Sl BUILDIIVG 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 IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. -T Inspection Type Date Accepted By Comments FOUNDATION: , Footings ti 3 Stemwall r 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 Co ear WjjD Hold Downs 1• a s/Roof/Ceiling _Drywall Interior Braced Panel Onl %ilk��—/� G.L• T-Bar INSULATION: Slab Wall/Floor/Ceiling ► V` MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footin /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 1 Construction- R.W. PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 4 T-Fnrmc/Riiilriinn nivicinn/Riiildinn Parmit U<oF poRi aN�F! �w F CITY OF PORT ANGELES PUBLIC WORKS & UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 12-00000261 Date 5/11/12 Application pin number . . . 908274 Property Address . . . . . . 1924 VILLAGE CIR ASSESSOR PARCEL NUMBER: 06-30-13-5-7-0220-0000- REPORT SALES TAX Application type description RES NEW SFR on your state excise tax form SubProperty Name . . . . . . to the City of Port Angeles Pro ert Use Property Zoning . . . . . . . RESIDENTIAL HIGH DENSITY (Location Code 0502) Application valuation . . . . 103474 ---------------------------------------------------------------------------- Application desc 1483 SF SFR W/ATTACHED GARAGE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KREAMAN, SHIRLEY OWNER 811 W 15TH ST PORT ANGELES WA 98363 ---------------------------------------------------------------------------- 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 . . . . 103474 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 103474 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 . . . . 103474 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 1 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. AIJI� Signature of Contractor r uthorized Agent Date Signature of Owner(if owner is builder) Date T:Forms/Building Division/Public Works Permit PERMIT INSPECTION RECORD CALL 417-4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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 417-4653 FIRE DEPT. PLANNING DEPT. 4174750 PLANNING DEPT. BUILDING 4b7- BUILDING 4815 T:Forms/Building Division/Public Works Permit r r+r �°`vo ""QF CITY OF PORT ANGELES �C�a PUBLIC WORKS & UTILITIES v 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 12-00000261 Date 5/11/12 Application pin number . . . 908274 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 10:55:49 AM tamiot. Electrical service from pedestal and northwest corner of property. March 16, 2012 8:21:56 AM rbecker. If your fire system is a closed system, you will need to install a double check valve assembly. If it is an open system, you do not need a backflow assembly. If you have any questions,call Ron Becker at 417-4886, Fax:360-452-4972, E-mail:rbecker@cityofpa.us 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 1:00:22 PM sroberds. The proposal will result in a new sfr w/att garage for total lot coverage of 30W and site coverage of 38% in the RHD. 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 ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 760.00 760.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 5294.50 5294.50 .00 .00 Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and voidif 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 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. 4174750 PLANNING DEPT. BUILDING. 41-7- BUILDING 4815 T:Forms/Building Division/Public Works Permit +oP edRrgq,C�(11 �w CITY OF PORT ANGELES ' -N PUBLIC WORKS & UTILITIES � v 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 3 .Application Number . . . . . 12-00000261 Date 5/11/12 Application pin number . . . 908274 Grand Total 6054.50 6054.50 .00 .00 REPORT SALES TAX on your state excise tax form 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 Works Permit PERMIT INSPECTION RECORD CALL 417-4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEi17ORE 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 BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Vne3bQ City Use Only: _ r Attn: Building Permit Technician eived 2 321 E. Fifth St., Port Angeles, WA 98362 (360)417-4815 fax (360)417-4711 � roved n nn �w Sam Applicant PQ- \t11S uLA � uS m GL t�•L lel OUI!( Ph Property Owner vreaff)ay).<5htYA-QV Phone Property Owner's Address pt \N 15iln S Contractor D to r.1Crt.�(3ttlL6� C-2.- S c�-F' `tf£-1-1° Nnone Contractor's Address CV License# Expires Email �. PROJECT ADDRESS I.Qa� � tLL.�C �tR�c-E �astr�(�A! c +, �9- Q836a Parcel Number O(o-30 - 13 —S 7 0 — o:e;0 Lot Zoning R94) Proiect Tyne &Brief Description: )!(Residential ❑Multi-family ❑ Commercial ❑ industrial Check all that apply r New Construction C S keTlo O e 51G,LC STD2 £�1 D CY�Lt� ❑Addition t .3 E-0 S L N Cn� C—& IN-0-NAE ❑ Remodel ❑Repair ❑ Demolition ❑ Re-roof ICHouse 0(garage ❑other ❑tear off& re-roof ❑ lay over one layer AHeat System ❑ Heat pump ❑ wood-burning stove ❑gas fireplace ❑ pellet stove a other $Dther L IN W fAcYT Floor Areas Existing(sq. ft.) Proposed(sq. ft.) Basement @$ per sq. ft. _ $ 15`Floor l DQ to 8 S 3 (0 0 2nd Floor 3rd Floor Garage 3 1 S q,4SD Carport Covered Porch Deck Shed Other TOTAL VALUATION $ ID 3 Total footprint of structures L�15� 3 sq. ft. T Lot size _ysq. ft, = Lot coverage aq'i 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 33.3 % dpmr Max. height of proposed structures r ft. Occupancy group #of bedrooms .3 Will a lawn sprinkler system be installed? N. Occupant load #of full baths a 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 l� Print Name ft- • MVJt 1`e Sign 049 D T:FormslBuilding Division/Building permit application MAR - 5 2012 CITY OF PORT ANGELES BUILDING DIVISION r L /Iz i r- u- �= ti \I i FF-C-. 5°I,D' Nei `2q 1,24, ---------- 2D,121 hn 2 ill P� L D CS 21 12- 4-/V 2- 4X PRESCR.IPTIVEtAPPROACH-SIMPLE FORM 1 -- For the Washington State EnergyCode 2006 Edition) Climate Zone 1 cmv CKWERUMMT Site Information: Building Department Use Only: Lot:. -A- 2 Permit# Address: Notes: City: IJbk'T /�}%✓Gc/�- State: G/�, Zip: Contact: qkw� Qbec'-T spv ' ' �JcC niCCbpr0r--r/ Phone: `x177-- t a Y- Phone 2: 3 6 0 - FAX: Table 6-1 PRESCRIPTIVE REQUIREMENTS FOR GROUP R OCCUPANCY CLIMATE ZONE 1 (Unlimited Glazing Option Only) a s<.:... .:�`+i::�;.,rt .,t.�+�,. ... '„... .:..tu.. ., ` i���. -��FF". �,�� ? d�B��...,t� �:..:�•^ rp�'r.7,;.:�si��,+'.. 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 0 l 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. 02.6 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 xception:Type of Feat Source: FC90 EC7 /1(9 gg&I-e-(2TR/C yhv U/V T- �3 (evi3 ru Ge T:Forms/Building Division/Prescriptive Approach-Simple Form e(-(- o, wail- hea vowr k., CD J Electrical Information Form M. A= Public Works&Utilities Department(360)417-4700 0 RCity Electrical Inspector(360)417-4735 ��r1Yp�F Please complete and return to Public Works& Utilities Department Permanent service: Name: Name and address of party Street: responsible for permanent City I State I ZIP: service billing? Daytime Phone: Home Phone: • • ,• (if otharfh�n_..ti...._._ _ .. Site contact: Name: �,Ue� CC n £•,/ Title: P i k(9 Covus • S'ul0&%V Sot Daytime Phone: 15 360 - 9/0-db'7 Contractor: Name: bc.Jn1 U/ Company: Daytime Phone: Electrician: Name: Company: DL /C w I d Ir Daytime Phone: 6v' Excavator: Name: Com an Daytime Phone: Gv- 03— 77 - ❑Existing evv Single-family residence ❑Multi-family residence; #of units ❑Commercial F-1 Subdivision;#of lots ❑Overhead service El General service Underground service ❑Other. • • Description of work: .5�/Ll Cf- O /1/�S11J f_ 151,n)-- 26Si p 24c Street address/lot number: / C/izei-g- Nearest cross street: 1-4 r�D £(LG'. oll-f-) Desired connection date: Electrical transformer serving property is: ❑on a pole on the ground Total square footage: y�3 sq.ft. Main disconnect size: e o amps Voltage: 20/240 1p ❑120/208 3ph ❑277/480 3ph 012W240 3ph ❑480 3W 30h ❑ Other Standard residential to,4ds(Lighting, refrigerator, dishwasher, washer) Check all that apply: ❑�Cl (_ton) �ge/Oven ❑Hot Tub hes Dryer Heating ❑Pumps `_Hp) ❑No Load Change VWater Heater ❑Elevator(_Hp) ❑Other • ' • Wfuluggggag lease 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 ames of all motors over 50hp. Applicant's Signature: Date: a3. ho� MAIL OR DELIVER COMPLETED FORM TO: 321 E 5TH STREET; PORT ANGELES, WA 98362 FAX TO: 360-417-4711 WS WF Information form.xls N'P'JVKSH.IGHT'.`7NGR\-4C ;istinforrri. f nr: Prescriptive Energy Code Compliance for Single Family and Duplex Housing:Zone 1 Project Information Contact Information Peninsula Village HACC Kay Kassin er Hickory 1096 Plan 2603 South Francis Street THS-1- 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 2 aulted Wa1112 Wall- into Wall-exta s Slab Option Area Ceiling 3 Above Below Below Floor on %of Floor Vertical Overhead" U-Fact r eiling Grade Grade Grade Grade R49 orR-21 R-21 R-10 I 13% 0.34 0.50 0.2 R-38 R-38 Int.7 TB R-10 R-30 21 Adv. R49 or R-21 R-21 R-10 O II 25% 0.32 0.50 0.2 R-38 R-38 Int 7 TB R-10 R-30 2, Adv. R49 or R-21 R-21 R-10 0 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 III.All glazing and doors meet maximum U-factor.Alternate heating size method submitted. 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 ❑ —1b High Efficiency HVAC Equipment 2 ❑ 1c High Efficiency HVAC Equipment 3 ❑ 2 High Efficiency HVAC Distribution System ❑ 3a Efficient Building Envelope 1 ❑ 3b Efficient Building Envelope 2 ❑ 3c Su er-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 Heating ❑ 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 WSUEEP10-010 Copyright 2010 Glazing Schedule Project information Contact Information Peninsula Village HACC Kay Kassin er Hickory 1096 Plan 2603 South Francis Street Port Angeles, WA 98362 Conditioned Floor Area 1096 Sum of UA for Heating System Sizing 52.9 Sum of All Glazing Areas From Below 132 Glazing to Floor Area Ratio 12.04% 602.7.2 Exception Ratio (not to exceed 1%) Exterior Doors Plan Component Door Percent Width Height Glazing Door Door ID Description Ref. LI-factor Glazed Qt. Feet 'r'ch Feet inch Area Area UA Garage Door 0.200 1 1 3 61 81 20.0 4.0 One Exempt Swinging Door<24 Square Feet 1 0.2001 1 6 e 20.01 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 "`" Area UA 4x4 Horizontal Slider 10.340 6 4 4 96.01 32.64 4x3 Horizontal Slider 0.340 1 4 3 12.0 4.08 6x4 Horizontal Slider 0.340 1 6 4 24.0 8.16 Sum of Area and UA F132.5T 44.88 Area Weighted U= UA/Area 0.34 WSEC Prescriptive Worksheet(2010 Edition) WSUEEPIO-010 Copyright 2010 II Simple Heating System Size: Climate Zone 1 Project Inlbrmadon Contact Information Peninsula Village HACC Kay Kassin er Hickory 1096 Plan 2603 South Francis Street 2 Port An eles, WA 98362 Indoor Design Temperature 70 Outdoor Design Temperature 28 Design Temperature Difference(aT) AT=Indoor-Outdoor Design Temp 42 Conditioned Floor Area 1 1096 Conditioned Volume 8768 Glazing Copy Sum of UA from Glazing Schedule 53 Attic U-Factor X Area = UA R-49 0.027 R-38 Advanced 0.026 1096 28.5 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 1184 66.3 Floor U-Factor X Area = UA R-30 0.029 F 1096 31.8 Below Grade Walls U-Factor X Area = UA 2'Depth Walls 0.042 3.5' Depth Walls 0.041 T 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 179 Envelope Heat Load 75371 Btu/Hour Sum of UA X AT Air Leakage Heat Load 3977 Btu/Hour ((Volume X 0.6)X AT)X.018)) Building Design Heat Load 11515 Btu/Hour Air Leakage+Envelope Heat Loss Building and Duct Heat Load l-"J 11515 Btu/Hour If duds are located in unconditioned space:Sum of Building Heat Loss X 1.15 If duds are located in conditioned space:Sum of Building Heat Loss X 1 Maximum Heat Equipment Output 150% 17272 Btu/Hour Building and Dud Heat Loss X 1.50 WSEC Prescriptive Worksheet(2010 Edition) WSUEEPI 0-010 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: kkassingerp_pieninsulapha.org DD May 14, 2012 MAY 1 .5 12012 Nathan A. West AICP Director CITY OF PORT'ANGELES Dept.of Community;Development Community and Economic Development City of Port Angeles P.O. Box 1150 Port Angeles, WA 98362 y// 2. 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 Hook up Fee $150.00 Public Works Stormwater Fee $135.00 Sewer System Delv 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 51.980.00 $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 'll EQUAL HOUSING OPPORTUNITY BARRIER FREE i 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, tK � assinger Di ec or of Acquisiti s and Development Cc Annette Dotlich C EQUAL HOUSING OPPORTUNITY BARRIER FREE PREPARED 10/19/10, 15:55:06 PAYMENTS DUE RECEIPT CITY OF PORT ANGELES PROGRAM BP820L -------- ------- ------------------- APPLICATION NUMBER: 10--00000681 1924 VILLAGE CIR LoT Z2- FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- PLAN CHECK FEES 677.72 vBUILDING PERMIT - RESIDENTIAL 1042. 65 „MECHANICAL PERMIT 208.05 „PLUMBING PERMIT 142.00 .,PUBLIC WORKS RES WATER SERV 420.00 vPUBLIC WORKS STORMWATER 135. 00 vSANITARY SEWER HOOK UP 150. 00 VSEWER SYSTEM DELV CHARGE 1980. 00 STATE SURCHARGE 4.50 VW-•WATE9-SYSTEM' USE 'FEE 198D:0-0 - TOTAL DUE 6739.92 Please present this receipt to the cashier with full payment. �i�ti� 5P PREPARED 4/01/13, 11:47:38 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 00000261 1924 VILLAGE CIR 06-30-13-5-7-0220-0000- 063013570220 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BL1 0001 BLDG FOUNDATION FOOTING 5/31/12 APPROVED PB REQ COMM: May 30, 2012 8:33:24 AM hcatuzo. REQ COMM: BETWEEN 1-2 PM IS IDEAL. BRUCE 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 8:32:48 AM hcatuzo. REQ COMM: BRUCE. 912-0079. PLANS NOT ON SITE TODAY. RES COMM: June 4, 2012 4:07:18 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BFF 0001 BLDG FLOOR FRAMING 6/14/12 APPROVED JLL REQ COMM: June 14, 2012 9:05:41 AM hcatuzo. REQ COMM: BRUCE 912-0079. UNDERFLOOR FRAMING. RES COMM: June 14, 2012 4:30:51 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL DSD 0001 BLDG DOWN SPOUT DRAINS 6/29/12 APPROVED RV REQ COMM: June 29, 2012 12:31:22 PM rvess. RES COMM: June 29, 2012 12:32:20 PM rvess. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BLFD 0001 BLDG FOUNDATION DRAINAGE 6/29/12 APPROVED RV REQ COMM: June 29, 2012 12:31:44 PM rvess. RES COMM: June 29, 2012 12:32:11 PM rvess. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BL9 0001 BLDG SHEARWALL 8/21/12 APPROVED JLL REQ COMM: August 21, 2012 8:37:13 AM hcatuzo. REQ COMM: EXT 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 9/20/12 APPROVED JLL REQ COMM: September 20, 2012 8:33:47 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: September 20, 2012 4:00:12 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BAIR 0001 BLDG AIR SEAL 9/20/12 APPROVED JLL REQ COMM: September 20, 2012 8:34:03 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: September 20, 2012 4:00:12 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL BLI 0001 BLDG INSULATION 9/21/12 APPROVED JLL REQ COMM: September 21, 2012 9:02:31 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 10/03/12 APPROVED JLL REQ COMM: October 3, 2012 9:28:02 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: October 3, 2012 3:59:57 PM jlierly. 000 000 BPR 00 BUILDING PERMIT - RESIDENTIAL PW99 0001 PUBLIC WORKS FINAL 3/22/13 APPROVED RV REQ COMM: March 22, 2013 11:52:09 AM rvess. PREPARED 4/01/13, 11:47:38 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 00000261 CONTINUED 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 BL99 0001 BLDG FINAL 3/28/13 APPROVED JLL REQ COMM: March 28, 2013 9:14:45 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 10:37:20 AM kdubuc. RES COMM: March 28, 2013 10:37:38 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 11:52:27 AM rvess. RES COMM: March 22, 2013 11:54:17 AM rvess. 000 000 ME 00 MECHANICAL PERMIT ME99 0001 MECHANICAL FINAL 3/28/13 APPROVED JLL REQ COMM: March 28, 2013 9:15:01 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: March 28, 2013 4:26:44 PM jlierly. 000 000 PL 00 PLUMBING PERMIT PL6 0001 PLUMBING WATER SUPPLY 7/06/12 APPROVED PB REQ COMM: July 5, 2012 8:24:52 AM hcatuzo. REQ COMM: JOHN JP PLUMBING. 460-6902 RES COMM: July 6, 2012 8:02:56 AM pbarthol. 000 00o PL 00 PLUMBING PERMIT PL2 0001 PLUMBING ROUGH-IN 8/23/12 APPROVED JLL REQ COMM: August 23, 2012 8:53:40 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 9:15:12 AM pbarthol. REQ COMM: Bruce 912-0079 RES COMM: March 28, 2013 4:26:44 PM jlierly. 000 000 PWSW 00 PUBLIC WORKS STORMWATER PW4 0001 PUBLIC WORKS STORM 6/29/12 APPROVED RV REQ COMM: June 29, 2012 12:31:02 PM rvess. RES COMM: June 29, 2012 12:32:30 PM rvess. 000 000 SSHU 00 SANITARY SEWER HOOK UP PW2 0001 PUBLIC WORKS SEWER CONNEC 7/10/12 APPROVED RV REQ COMM: RES COMM: