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HomeMy WebLinkAbout114 E Front St - BuildingELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . .
11-00000716 Date
12/23/11
Application pin number . . .
778432
Property Address . . . . . .
114 E FRONT ST
ASSESSOR PARCEL NUMBER:
06 -30 -00 -5 -1 -1615 -0000 -
Application type description
ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . ... .
CENTRAL BUSINESS DISTRICT
Application valuation . . . .
0
----------------------------------------------------------------------------
Application desc
10 circuits to take over for
----------------------------------------------------------------------------
revoked permit
Owner
Contractor
LESTICE ENTERPRISES, LLC
ANGELES ELECTRIC
1729 W 7TH ST
524 E. 1ST ST.
PORT ANGELES WA 98363
PORT ANGELES
WA 98362
(360) 417-0964
(360) 452-9264
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL
ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 96.90
Plan Check Fee
.00
Issue Date . . . . 7/14/11
Valuation . . . .
0
Expiration Date . . 3/21/12
Qty Unit Charge Per
Extension
1.00 73.5000 ECH EL
-BRANCH CIRCUIT WO/FEEDER
73.50
9.00 2.6000 ECH EL-ECH
ADDNT BRANCH CIRCUIT
23.40
-----------------------------------------------------------------------------
Fee summary Charged
Paid Credited
------------------------------
Due
---------------------------
Permit Fee Total 96.90
96.90 .00
.00
Plan Check Total .00
.00 .00
.00
Grand Total 96.90
96.90 .00
.00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
V P'V_T tP, L_ -7)2,-,->11 W_" 7*P
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH -IN �I23 /l ITPP
FINAL 2— D
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date: ` 2./
G:\EXCHANGE\BUILDING
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
V
Application Number . . . . . 11-00000505 Date 6/06/11
Application pin number . . . 841690
Property Address . . . . . . 114 E FRONT ST
ASSESSOR PARCEL NUMBER: 06 -30 -00 -5 -1 -1615 -0000 -
Tenant nbr, name . . . . . . LESTICE ENTERPRISES
LLC
Application type description COMM REMODEL
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 50000
----------------------------------------------------------------------------
Application desc
REMODEL INTO CAPTAIN T'S & THE BEANERY
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
LESTICE ENTERPRISES, LLC OWNER
1729 W 7TH ST
PORT ANGELES WA 98363
(360) 417-0964
--- Structure Information 000 000 REMODEL INTO CAPTAIN T'S /BEANERY
Construction Type . . . . . UNKNOWN
Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST
----------------------------------------------------------------------------
Permit . . . . . BUILDING PERMIT - COMMERCIAL
Additional desc . .
Permit pin number 186312
Permit Fee . . . . 670.25 Plan Check Fee
435.66
Issue Date . . . . 6/06/11 Valuation . . . .
50000
Expiration Date . . 12/03/11
Qty Unit Charge Per
Extension
BASE FEE
417.75
25.00 10.1000 THOU BL -25,001-50K (10.10 PER K)
252.50
----------------------------------------------------------------------------
Permit . . . . . MECHANICAL PERMIT
Additional desc .
Permit pin number 186320
Permit Fee . . . . 134.35 Plan Check Fee
.00
Issue Date . . . . 6/06/11 Valuation . . . .
0
Expiration Date . . 12/03/11
Qty Unit Charge Per
Extension
BASE FEE
50.00
4.00 14.8000 EA ME-FURN/HP/FAU < OR = 5 TON
59.20
2.00 7.2500 EA ME -VENT FAN (SINGLE DUCT)
14.50
1.00 10.6500 EA ME -VENT SYSTEM (NON -HVAC)
10.65
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit pin number . 186338
Permit Fee . . . . 135.00 Plan Check Fee
.00
Issue Date . . . . 6/06/11 Valuation . . . .
0
Expiration Date . . 12/03/11
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 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 thepeFformance of
construction.
- �.
Date Print Name Signature of Contractor or Authorized Agent
T:Forms/Building Division/Building Permit
Xignature of Owner (if owner is builder)
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
I Date
Accepted By
I Comments
FOUNDATION:
417-4653
Planning
Footings
Building
Stemwall
Foundation Drainage / Downspouts
Piers
I I
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor / Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow / Water
I FINAL Date Accepted by
AIR SEAL:
i
Walls
Ceiling
FRAMING:
Joists / Girders / Under Floor
I
Shear Wali / Hold Downs
Walls / Roof / Ceiling
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall / Floor / Ceiling
MECHANICAL:
Heat Pump / Furnace / FAU / Ducts
1
Rough -In
j
Gas Line
Wood Stove / Pellet / Chimney
Commercial Hood / Ducts
(FINAL
Date Accepted by
MANUFACTURED HOMES:
Footing / Slab
Blocking & Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s
SEPA:
Parking / Lighting
I
ESA:
Landscaping
I
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical
417-4735
Construction - R.W. PW I Engineering
417-4831
Fire
417-4653
Planning
417-4750
Building
417-4815
T:Forms/Building Division/Building Permit
i
- CITY OF PORT ANGELES
1� DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION
._ 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page
2
Application Number . . . . . 11-00000505 Date
6/06/11
Application pin number . . . 841690
Qty Unit Charge Per
Extension
BASE FEE
50.00
6.00 7.0000 EA PL -PLUMBING TRAP
56.00
1.00 7.0000 EA PL -WATER LINE
7.00
1.00 15.0000 EA PL -SEWER LINE
15.00
1.00 7.0000 EA PL -WATER HEATER
----------------------------------------------------------------------------
7.00
Special Notes and Comments
May 24, 2011 8:03:55 AM rbecker.
The mop sink has to be equiped with Atmospheric Vacuum
Breaker in the faucet. I will need to inspect this when it
is installed.
If you have any questions please contact Ron Becker at
417-4686, E-mail:rbecker@cityofpa.us or Fax me at 452-4972.
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.
A minimum 2A-10BC fire exinguisher is required.
Extinguishers must be mounted, with the top no more than 5'
off the floor. Suggested extinguisher placement is
adjacent to an exit.
May 27, 2011 9:21:27 AM kdubuc.
Rear exit must be maintained.
May 27, 2011 9:22:22 AM kdubuc.
If basement is to be utilized, two exits must be provided.
June 2, 2011 5:05:37 PM sroberds.
Project will result in remodel of a commercial building in
the CBD zone. No land use issues anticipated.
Public Works Utility Engineering has no requirements for
this plan review.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE SURCHARGE
----------------------------------------------------------------------------
4.50
Fee summary Charged Paid Credited Due
-----------------
----------------------------------------
Permit Fee Total 939.60 939.60 .00
.00
Plan Check Total 435.66 435.66 .00
.00
Other Fee Total 4.50 4.50 .00
.00
Grand Total 1379.76 1379.76 .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 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
T:Forms/Building Division/Building Permit
Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
'
I
I
I
-- PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS --
to
`'
Building Inspections 417-4815 Electrical Inspections 417-4735
\
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
�—
-1=
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type
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
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 I
Wall / Floor / Ceiling
MECHANICAL:
Heat Pump / Furnace / FAU / Ducts
Rough -In
Gas Line
Wood Stove / Pellet / Chimney
Commercial Hood / Ducts
MANUFACTURED HOMES:
Footing / Slab I
Blocking & Hold Downs
Skirting
Date I Accepted By I Comments
1
I
I
I
��Qsfi 5�de, 5'1-rezt leve(
'
I�f 6 ���
Q�23-II
I FINAL Date Accepted by c�Z,L
I
I I
(�-� Rough_t h St'airS 7La. ?;_12-1k
I
�—
-1=
I I
I I
I I
I
�
S
5�^{Z' I1 TLL 1
,�asfi S+cQ2� 541,4es(' (e-t'ejl
l FINAL Date 9--1'3-1 (Accepted by
F
lj w
I
1�,77t�
PLANNING DEPT. Separate Permit #s SEPA:
Parking / Lighting I I ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type
Electrical
Construction - R.W. PW / Engineering
Fire
Planning
Building
T:Forms/Buildinq Division/Buildinq Permit
Date Accepted By
417-4735 (b
417-4831
417-4653
417-4750 �� IIF
r4h� --
417-4815 q;->�
(For- T&4 --Q P y Fe r The' f3'Q .tj�)I)
` Or `i' l,e Bearietr OOL'ileA to -2 -4 -II
2 let I 1:L JYLL
PREPARED 2/09/12, 9:22:02 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 2/09/12
------------------------------------------------------------------------------------------------
ADDRESS . : 114 E FRONT ST SUBDIV:
TENANT, NBR: LESTICE ENTERPRISES LLC
CONTRACTOR : PHONE
OWNER LESTICE ENTERPRISES, LLC PHONE (360) 417-0964
PARCEL 06-30-00-5-1-1615-0000-
APPL NUMBER: 11-00000505 COMM REMODEL
---------- - -------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
----- ------- ------------------- ---- --
BL3 01 6/07/11 JLL BLDG FRAMING
6/07/11 AP June 8, 2011 4:45:53 PM 1pangrle.
FRAME
June 8, 2011 4:46:22 PM 1pangrle.
BL3 02 8/12/11 JLL BLDG FRAMING
8/12/11 AP August 12, 2011 8:15:43 AM 1pangrle.
JAMES 477-0972
"ROUGH-IN STAIRS"
August 12, 2011 4:40:15 PM jlierly.
BL99 01 9/23/11 JLL BLDG FINAL TIME: 01:00
9/23/11 AP September 22, 2011 11:25:53 AM 1pangrle.
JAMES 477-0972
BUILDING FINAL - FOR THE BEANERY SIDE ONLY
JAMES STATED THAT THIS PROJECT IS BEING COMPLETED IN THREE
PHASES.
AFTERNOON
September 23, 2011 4:29:11 PM jlierly.
Partial final on street level of the 116 e front side
(beanery) temp occupancy ok for this unit only/jll
October 20, 2011 11:01:44 AM 1pangrle.
BL99 02 2/09/12 BLDG FINAL
February 9, 2012 8:18:34 AM pbarthol.
James 477-0972
-------------------- -----
---------------------- - -------- COMMENTS AND NOTES --------------------------------------
11//,, L
V�
PREPARED 2/14/12, 8:51:27 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 2/13/12
-------- —---------------------------------- ---------------------------------------------------
ADDRESS . : 114 E FRONT ST SUBDIV:
TENANT, NBR: LESTICE ENTERPRISES LLC
CONTRACTOR : PHONE
OWNER LESTICE ENTERPRISES, LLC PHONE (360) 417-0964
PARCEL 06-30-00-5-1-1615-0000-
APPL NUMBER: 11-00000505 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
----------------------------------------- ----------------
BL3 01 6/07/11 JLL BLDG FRAMING
6/07/11 AP June 8, 2011 4:45:53 PM 1pangrle.
FRAME
June 8, 2011 4:46:22 PM 1pangrle.
BL3 02 8/12/11 JLL BLDG FRAMING
8/12/11 AP August 12, 2011 8:15:43 AM 1pangrle.
JAMES 477-0972
"ROUGH -IN STAIRS"
August 12, 2011 4:40:15 PM jlierly.
BL99 01 9/23/11 JLL BLDG FINAL TIME: 01:00
9/23/11 AP September 22, 2011 11:25:53 AM 1pangrle.
JAMES 477-0972
BUILDING FINAL - FOR THE BEANERY SIDE ONLY
JAMES STATED THAT THIS PROJECT IS BEING COMPLETED IN THREE
PHASES.
AFTERNOON
September 23, 2011 4:29:11 PM jlierly.
Partial final on street level of the 116 e front side
(beanery) temp occupancy ok for this unit only/jll
October 20, 2011 11:01:44 AM 1pangrle.
BL99 02 2/09/12 JLL BLDG FINAL
2/09/12 DA February 9, 2012 8:16:34 AM pbarthol.
James 477-0972
February 9, 2012 4:54:58 PM jlierly.
electrical final reqd/jll
BL99 03 2/13/12 BLDG FINAL
February 13, 2012 10:18:22 AM permits.
PERMIT: ME 00 MECHANI PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
ME1 01 8/12/11 JLL MECHANICAL ROUGH -IN
8/12/11 AP August 12, 2011 8:14:03 AM 1pangrle.
JAMES 477-0972
"HEATING"
August 12, 2011 4:40:15 PM jlierly.
ME99 01 9/23/11 JLL MECHANICAL FINAL TIME: 01:00
9/23/11 AP September 22, 2011 11:37:21 AM 1pangrle.
JAMES 477-0972
MECHANICAL FINAL - FOR THE BEANERY SIDE ONLY
JAMES STATED THAT THIS PROJECT IS BEING COMPLETED IN THREE
PHASES.
AFTERNOON
September 23, 2011 4:30:26 PM jlierly.
----------------------------------- CONTINUED ONTO NEXT PAGE -----------------------------------
PREPARED 2/14/12, 8:51:27 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 2/13/12
--- - - — ------ __
ADDRESS . : 114 E FRONT ST SUBDIV:
TENANT, NBR: LESTICE ENTERPRISES LLC
CONTRACTOR : PHONE
OWNER LESTICE ENTERPRISES, LLC PHONE (360) 417-0964
PARCEL 06-30-00-5-1-1615-0000-
APPL NUMBER: 11-00000505 COMM REMODEL
------------------------------------------------------------------------------------------------
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
--------------------------------------------------------------------------
ME99 02 2/13/12 Ao MECHANICAL FINAL
February 13, 2012 10:18:43 AM permits.
PERMIT: PL 00 PLUMB NG ERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
— - — ----------------------- —----------------- ------------------------ — ---------
PL2 01 6/07/11 JLL PLUMBING ROUGH -IN
6/07/11 AP June 7, 2011 8:43:16 AM 1pangrle.
MARK 477-0626
ROUGH -IN PLUMBING
June 7, 2011 4:40:14 PM jlierly.
PL2 02 8/12/11 JLL PLUMBING ROUGH -IN
8/12/11 AP August 12, 2011 8:15:14 AM 1pangrle.
JAMES 477-0972
"PLUMBING"
August 12, 2011 4:40:15 PM jlierly.
PL99 01 9/23/11 JLL PLUMBING FINAL TIME: 01:00
9/23/11 AP September 22, 2011 11:38:27 AM 1pangrle.
JAMES 477-0972
PLUMBING FINAL - FOR THE BEANERY SIDE ONLY
JAMES STATED THAT THIS PROJECT IS BEING COMPLETED IN THREE
PHASES.
AFTERNOON
September 23, 2011 4:30:31 PM jlierly.
PL99 02 2/13/12 PLUMBING FINAL
4February 13, 2012 10:18:54 AM permits.
------------------------,------------ COMMENTS AND NOTES
PREPARED
9/23/11, 8:42:07
INSPECTION
TICKET PAGE
7
CITY OF
PORT ANGELES
INSPECTOR:
JAMES LIERLY DATE
9/23/11
-----------------------------
ADDRESS
114 E FRONT ST
SUBDIV:
TENANT,
NBR: LESTICE
ENTERPRISES
LLC
CONTRACTOR :
PHONE
OWNER
LESTICE
ENTERPRISES,
LLC
PHONE (360) 417-0964
PARCEL
06-30-00-5-1-1615-0000-
APPL NUMBER: 11-00000505 COMM REMODEL
----
PERMIT:
---------------
BPC 00 BUILDING PERMIT
- COMMERCIAL
REQUESTED
INSP
DESCRIPTION
TYP/SQ
COMPLETED
RESULT
RESULTS/COMMENTS
----- —-------------
BL3 01
6/07/11
— -- —---------
JLL
— -----------
BLDG FRAMING
-' -----
6/07/11
AP
June 8, 2011 4:45:53
PM 1pangrle.
FRAME
June 8, 2011 4:46:22
PM 1pangrle.
BL3 02
8/12/11
JLL
BLDG FRAMING
8/12/11
AP
August 12, 2011 8:15:43
AM 1pangrle.
JAMES 477-0972
BL99 01
9/23/11
JLL
"ROUGH -IN STAIRS"
August 12, 2011 4:40:15
BLDG FINAL TIME:
PM jlierly.
01:00
Iko
IK
September 22, 2011
11:25:53 AM 1pangrle.
rV"!/�►i5`�'.�. •V
( e
JAMES 477-0972
6
BUILDING FINAL - FOR
JAMES STATED THAT
THE BEANERY SIDE ONLY
THIS PROJECT IS BEING COMPLETED IN
THREE
PHASES.
PERMIT:
- AFTERNOON
ME 00 MECHANICAL PERMIT
ace—
#4%L w
REQUESTED
INSP
DESCRIPTION
t•/j�,(!
TYP/SQ
COMPLETED
RESULT
RESULTS/COMMENTS
�(
ME1 01
--------------------
8/12/11
JLL
------
MECHANICAL ROUGH -IN
8/12/11
AP
August 12, 2011 8:14:03
AM 1pangrle.
JAMES 477-0972
"HEATING"
August 12, 2011 4:40:15
PM jlierly.
ME99 01
9/23/11
MECHANICAL FINAL
TIME: 01:00
September 22, 2011
11:37:21 AM 1pangrle.
JAMES 477-0972
MECHANICAL FINAL -
FOR THE BEANERY SIDE ONLY
JAMES STATED THAT
THIS PROJECT IS BEING COMPLETED IN
THREE
PHASES.
AFTERNOON
------------------------------------------------------------------------------------------------
PERMIT:
PL 00 PLUMBING PERMIT
REQUESTED
INSP
DESCRIPTION
TYP/SQ
COMPLETED
RESULT
RESULTS/COMMENTS
— -----------------
PL2 01
6/07/11
—---------
JLL
—-----------------------
PLUMBING ROUGH -IN
— -------------------------------------
6/07/11
AP
June 7, 2011 8:43:16
AM 1pangrle.
MARK 477-0626
ROUGH -IN PLUMBING
June 7, 2011 4:40:14
PM jlierly.
PL2 02
8/12/11
JLL
PLUMBING ROUGH -IN
8/12/11
AP
August 12, 2011 8:15:14
AM 1pangrle.
-----------------------------------
CONTINUED ONTO
NEXT PAGE -----------------------------------
PREPARED 9/23/11, 8:42:07 INSPECTION TICKET PAGE 8
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 9/23/11
-------------------------------------------------------------------------------------
ADDRESS . : 114 E FRONT ST SUBDIV:
TENANT, NBR: LESTICE ENTERPRISES LLC
CONTRACTOR : PHONE
OWNER LESTICE ENTERPRISES, LLC PHONE (360) 417-0964
PARCEL 06-30-00-5-1-1615-0000-
APPL NUMBER: 11-00000505 COMM REMODEL
--- ------------- -------
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
--- -----------
JAMES 477-0972
"PLUMBING"
o August 12, 2011 4:40:15 PM jlierly.
PL99 01 9/2 111 PLUMBING FINAL TIME: 01:00
September 22, 2011 11:38:27 AM 1pangrle.
PON JAMES 477-0972
PLUMBING FINAL - FOR THE BEANERY SIDE ONLY
JAMES STATED THAT THIS PROJECT IS BEING COMPLETED IN THREE
PHASES.
AFTERNOON
-------------------------------------- COMMENTS AND NOTES --------------------------------------
PREPARED 8/12/11, 8:17:19 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 8/12/11
------------------------------------------------------------------------------------------------
ADDRESS . : 114 E FRONT ST SUBDIV:
TENANT, NBR: LESTICE ENTERPRISES LLC
CONTRACTOR : PHONE
OWNER LESTICE ENTERPRISES, LLC PHONE (360) 417-0964
PARCEL 06-30-00-5-1-1615-0000-
APPL NUMBER: 11-00000505 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCL?1L
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-----------------_
BL3 01 6/07/11 JLL BLDG FRAMING
6/07/11 AP June 8, 2011 4:45:53 PM 1pangrle.
FRAME
June 8, 2011 4:46:22 PM lRangrle.
BL3 02 8/12/11 J L BLDG FRAMING
August 12, 2011 8:15:43 AM 1pangrle.
JAMES 477-0972
"ROUGH -IN STAIRS"
------- ---------------
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
--------------------- --------------------- ------------
ME1 01 8/12/11 J MECHANICAL ROUGH -IN
August 12, 2011 8:14:03 AM 1pangrle.
JAMES 477-0972
"HEATING"
------------------------------------------------- - ---
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
PL2 01 6/07/11 JLL PLUMBING ROUGH -IN
6/07/11 AP June 7, 2011 8:43:16 AM 1pangrle.
MARK 477-0626
ROUGH -IN PLUMBING
June 7, 2011 4:40:14 PM jlierly.
PL2 02 8/12/11 J PLUMBING ROUGH -IN
August 12, 2011 8:15:14 AM 1pangrle.
JAMES 477-0972
"PLUMBING"
-------------------------------------- COMMENTS AND NOTES --------------------------------------
PREPARED 6/07/11, 8:44:22 INSPECTION TICKET PAGE 6
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 6/07/11
------------------------------------------------------------------------------------------------
ADDRESS . : 114 E FRONT ST SUBDIV:
TENANT, NBR: LESTICE ENTERPRISES LLC
CONTRACTOR : PHONE
OWNER LESTICE ENTERPRISES, LLC PHONE (360) 417-0964
PARCEL 06-30-00-5-1-1615-0000-
APPL NUMBER: 11-00000505 COMM REMODEL
-- ---- —
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ _ COMPLETED RESULT RESULTS/COMMENTS
PL2 01 6/07/11 ja,
19 PLUMBING ROUGH -IN
June 7, 2011 8:43:16 AM 1pangrle.
MARK 477-0626
ROUGH -IN PLUMBING
-------------------------------------- COMMENTS AND NOTES --------------------------------------
v
----------------------------------
Flu COPY
E RTI FISA.Y.TE • ,VN C . .
Cityf,,of: Port Angeles - wilding iivision
This certificate is issued -,pursuant to the requirements of Section 117 of the 2009 International Building
Code certifying that atthe:time_of issuance this structure was in compliance with the various ordinances
of the City regulating:"building construction or use for the following,,..
Business name: Captain
Business address`! :114 .,East Front Street. '
Property owner. < L:estice Enterprises LLC
Property owner's>:`address; 1729 W. 7�".Stt`eet -;.
Automatic fire spt nkler=system: N/A i.
Use & occupancy classification: Business..
Occupant load. " Per 2009:;I:B,C; Table 1.0.04.1; :;1.-
� �
Buildin number
g permit
Type of construction:
12/15/11
:�»j!��`�^ '1'a]� ��6�`'�@h`�u'i^.'�'k: {:k<. ��MidP' •bz�zq ✓z£;i`..n."S$k`.r
1llanager Date
-z
Post on the premises in a conspicuous place."" This.-cer Mc Wilo"t be removed except by the Building Official.
1
Flu COPY
6
M
e P,
CERTIFICATEF OCCUPANCY
City of Port Angeles -- Building :Division
This certificate is issued'
pursuant to the requirements of Section H] of the 200 International Building Code
certifying that at the tiineo(,issuance,.this structure was in compliance with the various ordinances of the City
regulating building cons'truction: or.usefior.ihefoilowin g-,
Business name: ..The'�Beanery� n o )
_Nv 6r* �j hnnie' Im ontice
Business address.-,' -1,1::6.-E: Front St.
Property owner: Lestice Ehter ri' es LLC
Property owner's address-: 1729 W. 7t`.St.,_,`Pott Ang6les,WA .98362
Automaticfire sprinkler, -system: Not Required
Use & occupancy classification: Business
Building permit number.tF-.---
-?,,
Occupant load: P&K-2,00OB' _T,a bidI �-"'C'
Type of construction: V&,
10-20-11
anning Manager Date
Post on the premises in a conspicuous place. This cerfificfte`slmll not be removed except by the Buildin- Official.
M
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CERTIFICATE OF OCCUPANCY APPLICATION Permit # 1 `-354
CITY OF PORT ANGELES
Attn: Permit Technician
321 E. Fifth St., Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
ouk4`'FEES \• rj��
Certificate / Inspection
$100 arking Business Improvement Area (PBIA)
ee charged for Downtown locations
;p,,z0 PLEASE PRINT IN INK
Check one: New business in P.A.?Change of ownership only? ❑ Moving location from within P.A.?. Zoning C6D
BUSINESS NAME �a Phi ✓� `�S /�`a rte
Business address 1 I y 4 111 �'c ' -)l-- -S-�- Mailing addfess P6 F�5x L1Q - PA
Phone number OpeningdateT5 b Days & hours of operation
Business owner's named��-t -rtrl i VY'10y�'t ' c e Contact phone 4-,a -05`iq
Business owner's address l`T;L_GI GAJ — f�A
Brief description of business Ct(-4c5- yl -5co2e I�_'Cl A,1 n9 fe4a,% I
Property owner's name Lt -L
Property owner's address/contact 1-7 2-9 VJ --7-+1--) RA
BUILDING DEPARTMENT phone 417-4815
Is the business a restaurant or bar that will seat 50 or more people?
Contact phone
Bldg approval bye' on
Yes ❑ No �(
rt
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering stairway , ramps, bathrooms, electrical, heating/cooli g/v n ilation systems, etc).
Work planned: ZG4 I Y) 1A) (� S Ct In<LCD /C�f ► h /ado i
G�.1
FIRE DEPARTMENT phone 417-4653
Fire approval by
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No
Work planned.-
PBIA
lanned:
PBIA (Parking Business Improvement Area - Downtown) phone 417-4623
Square footage of business? (00002—
Is
DDg2—
Is business moving within the PBIA? Yes ❑ No
1-h-2 i3e&hn
CITY CLERK phone 417-4634
PBIA notified R, H
City Clerk approval by "
Second-hand dealer/pawnbroker business? Yes ❑ No ❑
Will there be dancing at this business? Yes 11 No,
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel -Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page I of 2
on
on 4--2-2-- 1 l
on —1 —Zl- II
COMMUNITY & ECONOMIC DEVELOPMENT phone 417-4750
Number of off-street parking spaces available for employees and
customers? 1 in P& 1 A
(A parking plan may be required.)
Signs? (wall -mounted, freestanding, projecting, awning, A -frame, etc?)
CED approval by15 K on
Signs planned:
I to
5
W) LL_ G �T A, -5 (CA Fl�-�I—F
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PUBLIC WORKS DEPARTMENT- ENGINEERING phone 4417-4812
Is site work planned (n lk,,or re -located sewer or water-�ice,
excavation, grading or filling; work in City right-of-way,
new driveway.openings, site drainage, parking lots, downspouts,
irrigation system backflow devices, etc.). Yes ❑ No ❑
Work planned: `JC S t b I _ uDo
i
PUBLIC WORKS WASTEWATER phone 417-4845
PWE approval by on
PWW approval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No
If yes, what will be discharged: IjO G/2�_--> 6;, PATS
A-&"& -f - --4,� PJUYh�_+ #((-505
Call for Certificate of Occupancv inspections BEFORE opening business.
Building Department Inspection 417-4815
Fire Department Inspection 417-4653
Please sign up for utility services at the cashiers' counter.
I hereby apply for a Certificate of Occupancy. I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of
permit.
Date�'a� "� Print Name�dY1V111 le h�GVk CO__ Signature �
T:\Forms\Building Division\Certificate of Occupancy Application (2010) doe
Page 2 of 2
NOTES
Permit # Lt
+cu
The �e�nex-� (��� shc��r�-�ac.l
4e5?yt%,o
he-
4e5?yt%,o cs
�
IAJQ Z I" h CIS
T:Forms/Building-Division/Notes
CL
CLALLAM TITLE CORWANY
204 South Lincoln/P.O. Box 248, Port Angeles, WA 98362
Phone: (360) 457-2000 Fax: (360) 457-9330
Escrow File No.1 10811 MS
Title Order No.: 110811
Purchasers:- James -R; Lesterand Johnella -Montice
Sellers: Port Angeles Development Company
CLOSING AGREEMENT AND ESCROW INSTRUCTIONS
For Purchase and Sale Transaction
The undersigned buyer and seller (referred to herein as "the Clients") hereby designate and appoint
Clallam Title Company
(referred to herein as "the closing agent") to act as their closing and escrow agent according to the following agreements and
instructions,
IT IS AGREED, AND THE CLOSING AGENT IS INSTRUCTED, AS FOLLOWS:
Terms of Sale. The terms and conditions of the transaction which is the subject of these instructions (referred to herein as
"the transaction") are set forth in the Clients' Purchase and Sale Agreement, Earnest Money Agreement, or other written agreement,
and any attachments, amendments or addenda to that agreement (referred to herein as "the Clients' agreement"), which is made a part
of these instructions by this reference. Any changes to the Clients' agreement will be made a part of these instructions, without further
reference, when signed by the Clients and delivered to the closing agent. These instructions are not intended to amend, mod ' ify or
supersede the terms and conditions of the Clients' agreement with regard to the rights and obligations of and between the Clients and if
there is any conflict or inconsistency between these instructions and the Clients' agreement with regard to their respective rights and
obligations, the terms and conditions of the Clients' agreement shall control. However, as to the rights and obligations of and between
the Clients and the closing agent, this agreement shall control.
Z�
Description of Real Property. The real property which is the subject of the transaction (referred to herein as "the property")
is identified in the Clients' agreement, The documents required to close the transaction must contain the "legal description" of the
property. If the Clients' agreement does not yet contain the correct legal description, the Clients or the real estate agent shall obtain an
addendum setting forth the legal description as soon as possible and deliver it to the closing agent,
Closing Date, The date on which the documents required to close the transaction are filed for record (referred to herein as
"the closing date") shall be on or before the date for closing of the transaction -specified in the Clients' agreement or in an addendum
extending that date.
Documents. The closing agent is instructed to select.
, prepare, complete, correct, receive, hold, record and deliver documents
as necessary to close the transaction. The closing agent may request that certain documents be prepared or obtained by the Clients or
their attorneys, in which case the Clients shall deliver the requested documents to the closing agent before the closing date. Execution
of any document will be considered approval of its form and contents by each Client signing such document.
Deposits and Disbursement of Funds. Before the closing date, each Client shall deposit with the closing agent all funds
required to be paid by such Client to close the transaction, less any earnest money previously deposited. The closing agent is
authorized, but not required, to consider a lending institution's written commitment to deposit funds as the equivalent of a deposit of
such funds, if all conditions of the commitment will be met on or before the closing date. All funds received by the closing agent shall
be deposited in a trust account with any bank doing business in the State of Washington and may be transferred to any other such
accounts. The closing agent shall not be required to disburse any funds deposited by check or draft until it has been advised by its
bank that such check or draft has been honored. All disbursements shall be made by the closing agent's check,
SPECIAL NOTE: If this escrow has not been placed in a condition to close by 4/18/2011, the above items deposited by us
are to be returned to us upon written demand, at which time we will pay all your charges in connection herewith, but in the absence of
such written demand, you will proceed with these instructions as soon as practicable.
Settlement Statement, The closing agent is instructed to prepare a settlement statement showing all funds deposited for the
account of each of the Clients and the proposed disbursements from such funds. No funds shall be disbursed until the Clients, have
examined and approved the settlement statement. Some items may be estimated, and the final amount of each estimated item will be
adjusted to the exact amount required to be paid at the time of disbursement. The settlement statement will be subject to audit and any
errors or omissions may be corrected at any time. If any monetary error is found, the amount will be immediately paid by the Client
liable for such payment to the Client entitled to receive it.
c.,IrAXES op
STATE
tic of
adto"
'*ta MA,
•i,'oVa �'�, A A • n2 5Q6
Secretar"Y of State
I, SAM REED, Secretary of State of the State of Washington and custodian of its seal,
hereby issue this
CERTIFICATE OF FORMATION
to
LESTICE ENTERPRISES, LLC
'VIgr
�O
a/an WA Limited Liability Company. Charter documents are effective on the date
indicated below.
Date: 4/4/2011
UBI Number: 603-101-775
APPID: 2001670
STATS
Given under my hand and the Sea] of the State.
of Washington at Olympia, the State Capita]
O y.
a � �
Sam Reed, Secretary of State
0
`L1889� 0
Clallam County Assessor & Treasurer - Property Details - 61409 P A DEVELOPMENT ... Page 1 of 2
Clallam County Assessor & Treasurer
Property Search Results > 61409 P A DEVELOPMENT CO for Year 2011 - 2012
Property
First
Account
Property ID:
61409
Legal Description: SMITH,
NORMAN R
Half
Half
W44 OF E 45 LT 6 BL
16
}
Geographic ID:
0630005116150000
Agent Code:
Base
Type:
Real
Tax Area:
Open Space:
0010 - PA 121 PORT ST
N
CNTY H2 L WMP Land Use Code 59
DFL N
,
Historic Property:
N
Remodel Property: N
ST SCH - STATE SCHOOL
Multi -Family Redevelopment: N
Township:
Section:
f
Range:
$204.41
$204.41 i
2011
Location
CC -GEN - COUNTY CLALLAM
$112.86
$112.82
Address:
114 E FRONT ST
Mapsco:
$112.82
2011
PORT ANGELES, WA
SD #121 - SCHOOL DISTRICT #121
$267.20
Neighborhood:
Cycle 5 Comm
Map ID: 2
$267.20
Neighborhood CD:
20953140
( l
CITY PORT ANG - CITY OF PORT ANGELES
Owner
$260.50
!\\'9J'
$0.00
Name: P A DEVELOP/,WA98362
O Owner ID: 44693
Mailing Address: 1021 E. 2ND S % Ownership: 100.0000000000%
PORT ANGEL
Exemptions:
Taxes and Assessment Details
Property Tax Information as of 04/20/2011
Amount Due if Paid on: *t 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.
http://websrv8.clallam.net/propertyaccess/Property.aspx?cid=0&year=2011&prop_id=61409 4/20/2011
First
Second
Half
Half
}
Base
Base
Year Statement ID Taxing Jurisdiction
Amt.
Amt.
PenaltyInterest
Base Paid Amount Due
2011
155846
ST SCH - STATE SCHOOL
$204.41
$204.41
$0.00
$0.00
$204.41
$204.41 i
2011
155846
CC -GEN - COUNTY CLALLAM
$112.86
$112.82
$0.00
$0.00
$112.86
$112.82
2011
155846
SD #121 - SCHOOL DISTRICT #121
$267.20
$267.19
$0.00
$0.00
$267.20
$267.19'
2011
155846
CITY PORT ANG - CITY OF PORT ANGELES
$260.50
$260.50
$0.00
$0.00
$260.50
$260.50
2011
155846
PORT - PORT OF PORT ANGELES
$15.88
$15.88
$0.00
$0.00
$15.88
$15.88 `
2011
155846
NTH OLY LIB - NORTH OLYMPIC LIBRARY
_$47.33
$47.32
$0.00
$0.00
$47.33
$47.32
2011
155846
HOSP #2 - HOSPITAL #2
$46.32
$46.32
$0.00
$0.00
$46.32
$46.32!
2011
155846
WSMET PK DIST - WILLIAM SHORE MET PARK DIST
$14,08
$14.08
$0.00
$0.00
$14.08
$14.08'
2011
155846
CITY STORMWATER - CITY STORMWATER
$55.34
$55.33
$0.00
$0.00
$55.34
$55.33
2011
155846
WEED CONTROL -WEED CONTROL
$0.82
$0.81
$0.00
$0.00
$0.82
$0.81 i
2011 -155846 TOTAL:
$1024.74
$1024.66
$0.00
$0.00
$1024.74
$1024.66
2010
44122
ST SCH - STATE SCHOOL
$209.42
$209.41
$0.00
$0.00
$418.83
$0.00
2010
44122
CC -GEN - COUNTY CLALLAM
$111.45
$111.44
$0.00
$0.00
$222.89
$0.00:
2010
44122
SD #121 - SCHOOL DISTRICT #121
$271.24
$271.25
$0.00
$0.00
$542.49
$0.00'
2010
44122
CITY PORT ANG - CITY OF PORT ANGELES
$258.02
$258.03
$0.00
$0.00
$516.05
$0.00
2010
44122
PORT - PORT OF PORT ANGELES
$15.66
$15.67
$0.00
$0.00
$31.33
$0.00:
2010
44122
NTH OLY LIB - NORTH OLYMPIC LIBRARY
$32.38
$32.39
$0.00
$0.00
$64.77
$0.00
2010
44122
HOSP #2 - HOSPITAL #2
$45.72
$45.71
$0.00
$0.00
$91.43
$0.00'
2010
44122
WSMET PK DIST - WILLIAM SHORE MET PARK DIST
$14.54
$14.55
$0.00
$0.00
$29.09
$0.00 +
2010
44122
CITY STORMWATER - CITY STORMWATER
$55.34
$55.33
$0.00
$0.00
$110.67
$0.00
2010
44122
WEED CONTROL -WEED CONTROL
$0.82
$0.81
$0.00
$0.00
$1.63
$0.00
2010 -44 122 TOTAL:
$1014.59
$1014.59
$0.00
$0.00
$2029.18
$0.00
http://websrv8.clallam.net/propertyaccess/Property.aspx?cid=0&year=2011&prop_id=61409 4/20/2011
Clallam County Assessor & Treasurer - Property Details - 61409 LESTICE ENTERPRIS... Page 1 of 1
Clallam County Assessor &. Treasurer
Property Search Results > 61409 LESTICE ENTERPRISES LLC for Year 2011 - 2012
Property
Account
Property ID: 61409 Legal Description: W 44 OF E 45 LOT 6
BL 16 NORMAN R
SMITH SUBDIV
Geographic ID:
0630005116150000
Agent Code:
Second Half
Type:
Real
Base Amt. Penalty Interest Base Paid Amount Due
Statement Details
Tax Area:
0010 - PA 121 PORT ST CNTY H2 L
WMP Land Use Code
59
Open Space:
N
DFL
N
Historic Property:
N
Remodel Property:
N
Multi -Family Redevelopment:
N
Taxing Jurisdiction
Township:
Improvement / Building
Section:
Range:
- . - -
Property Image
Location
Land
Address:
114 E FRONT ST
Mapsco:
Deed and Sales History
PORT ANGELES, WA 98362
Payout Agreement
Neighborhood:
PA East Comm
Map ID:
2
Neighborhood CD:
5005000
Owner
Name
LESTICE ENTERPRISES LLC
Owner ID:
209722
Mailing Address:
1729 W 7TH ST
% Ownership:
100.0000000000%
PORT ANGELES, WA 98362
Exemptions:
Taxes and Assessment Details
Property Tax Information as of 10/20/2011
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 155846
$1024.74
$1024.66 $0.00 $0.00 $1024.74 $1024.66
Statement Details
2010 44122
$1014.59
$1014.59 $0.00 $0.00 $2029.18 $0.00
Values
Taxing Jurisdiction
Improvement / Building
Sketch
- . - -
Property Image
q
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: 10/20/2011 3:48 AM © 2011 True Automation, Inc. All Rights
Reserved. Privacy Notice
http://websrv8.ciallam.net/propertyaccess/Property.aspx?cid=0&year=2011 &prop_id=61... 10/20/2011
�C,; T,j"t� CERTIFICATE OF OCCUPANC.YAPPLICATION Permit # 1
`fit �aklrj. `FEES
_ CITY OF PORT ANGELES "'j 011
_ Attn: Permit Technician Certificate /Inspection
321 E. Fifth St., Port Angeles, WA 98362 arking Business Improvement Area (PBIA)
(360) 417-4815 fax (360) 417-4711 �C:!)
ee charged for Downtown locations
PLEASE PRINT IN INK
Check one: New business in P.A.?Change of ownership only? ❑ Moving location from within P.A.? Zoning
BUSINESS NAME �a P�`i ✓� ��j ��-a���/
Business address 11 y 111,, 15- S4 Mailing addiess P6 P
Sox 99- - PA
Phone number Opening date -T 3 -r) Days & hours of operation
Business owner's name-U-�k r)ni e VY)oAi C C Contact phone -U5-1
Business owner's address VJ -7+i ) -- 1:!'>A
Brief description of business C-U-4am SLC' �Y't YA) of i f-e_4a'j I C(3F-We Skop
I ) I
Property owner's name LL -C- Contact phone
n__--..�.. s_ 1.____�__._� 1 1� n
riopeILy v-wi-la s adUIessicuflLauL 1 / 2_ I VV _. ('rj-, r—/-\ cfd36-3
BUILDING DEPARTMENT phone 417-4815 I Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No �(
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering stairway , ramps, bathrooms, electrical, heating/cooli g/v- n ilation systems„ etc).
Workrr planned: r) C,- VE iDco I
LO I LL) 6_7 1�-_T P� RAn 1 i
FIRE DEPARTMENT phone 417-4653 Fire approval by on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No
Work planned: \
PBIA (Parking Business Improvement Area - Downtown) phone 417-4623 /
Square footage of business? g2- I PBIA notified��- on
Is business moving within the PBIA? Yes ❑ No f
-Th-e, P_)e,& 1P�r'U
CITY CLERK phone 417-4634 J
City Clerk approval by on
Second-hand dealer/pawnbroker business? Yes Q No ❑
Will there be dancing at this business? Yes ❑ No,
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel -Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1of2
i
/ 7;411
CERTIF/CA TE OF OCCUPANCY APPLICATION Permit # I
�} CITY OF PORT ANGELES "'l %3
uk FEES
Attn: Permit Technician Certificate /Inspection
321 E. Fifth St., Port Angeles, WA 98362 $100 arking Business Improvement Area (PBIA)
(360) 417-4815 fax (360) 417-4711 ee charged for Downtown locations
PLEASE PRINT IN INK n 22
Check one: New business in P.A.?Change of ownership only? ❑ Moving location from within P.A.? Zoning
BUSINESS NAME P-1�i ✓� `T���� (-ani
Business address i ► y 111 1 1=c ons S� Mailing add ess P6 P>,,x '99 -'FSA
Phone number Opening date T3 Days & hours of operation
Business owner's name_7-mak on i,-- V),On�Vi C E Contact phone 4ha
Business owner's address L`77 --a-9 Vd
Brief description of business C�Sf ,4c�,m SLC Y'j h+1 og % f-eia'� I
1 ) 1
Property owner's name i�S-} ILS �✓1�2+��i'iSe�, LLL Contact phone
1.. _ _f_ _ I _ _ IA A
rOUPCILy vvvilCl a aUUrCJJ/GU11LdCL 1 ( 4 J VV t- k"V r—/-\
BUILDING DEPARTMENT phone 417-4815 I Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No Ix
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering stairway , ramps, bathrooms, electrical, heating/cooli g/v- n ilption systems, etc).
Work planned: CCi n r -S-E�I TS I �'? e L to
UD I LLL- C,_ AA 1
FIRE DEPARTMENT phone 417-4653
Fire approval by on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No
Work planned: \
PBIA (Parking Business Improvement Area - Downtown) phone 417-4623
Square footage of business? � 0 002-
Is business moving within the PBIA? Yes ❑ No
1 h -p— f3e_&V\n
CITYCLERK phone 417-4634
PBIA notified on
City Clerk approval by =on 4 y
Second-hand dealer/pawnbroker business? Yes ❑ No ❑
Will there be dancing at this business? Yes ❑ No —
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel -Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1of2
COMMUNITY & ECONOMIC DEVELOPMENT phone 417-4750
Number of off-street parking spaces available for employees and
customers? '1 i-, F & 1 A
(A.parking.plan may be required.)
Signs? (wall -mounted, freestanding, projecting, awning, A -frame, etc?)
CED approval by
Signs planned:
5 � �
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PWE approval by 'R V on V-2 5 11
PUBLIC WORKS DEPARTMENT- ENGINEERING phone 417-4812 PW Pia 0-4s wvx
Is site work planned ilnr re -located sewer or wat�ice,
excavation, grading oar _frilling, work in City right-of-way,
a— r' End � -�.t� 'tra v- � wv�,Sf•>
new driveway openings, site drainage, parking lots, downspouts,
irrigation system backflow devices, etc.). Yes ❑ No ❑ 5, 'I :r— `��0A PA M—ALini Q
(d� pr -R � s cove mPm�hs .
Work planned,' Q�S.� X17 I6'� i�o��\ G�6� 11 l C��
. ie
Corytmetn S.D She'll Ao Ctw-rilrj
PUBLIC WORKS WASTEWATER phone 417-4845 I PWW approval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No ccb `` s
If yes, what will be discharged: /\)o GR:_�-k�_ C-R
iv.
CZ
Call for Certificate of OccuAancv inspections BEFORE opening business.
Building Department Inspection 417-4815 %� d0�Sq`�
Fire Department Inspection 417-4653Y%p IV
Please sign up for. utility services at the cashiers' counter.. •tiV.
I hereby apply for a Certificate of Occupancy. I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of
permit.
f
Date a� �� I Print Name T6�hl) t e t \GvIkk CL Signature 0 �0
TAForms\Suilding DivisionTertificale of Occupancy Application,(2010).doc ' ` -
Page 2 of 2
r
on
PWE approval by 'R V on V-2 5 11
PUBLIC WORKS DEPARTMENT- ENGINEERING phone 417-4812 PW Pia 0-4s wvx
Is site work planned ilnr re -located sewer or wat�ice,
excavation, grading oar _frilling, work in City right-of-way,
a— r' End � -�.t� 'tra v- � wv�,Sf•>
new driveway openings, site drainage, parking lots, downspouts,
irrigation system backflow devices, etc.). Yes ❑ No ❑ 5, 'I :r— `��0A PA M—ALini Q
(d� pr -R � s cove mPm�hs .
Work planned,' Q�S.� X17 I6'� i�o��\ G�6� 11 l C��
. ie
Corytmetn S.D She'll Ao Ctw-rilrj
PUBLIC WORKS WASTEWATER phone 417-4845 I PWW approval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No ccb `` s
If yes, what will be discharged: /\)o GR:_�-k�_ C-R
iv.
CZ
Call for Certificate of OccuAancv inspections BEFORE opening business.
Building Department Inspection 417-4815 %� d0�Sq`�
Fire Department Inspection 417-4653Y%p IV
Please sign up for. utility services at the cashiers' counter.. •tiV.
I hereby apply for a Certificate of Occupancy. I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of
permit.
f
Date a� �� I Print Name T6�hl) t e t \GvIkk CL Signature 0 �0
TAForms\Suilding DivisionTertificale of Occupancy Application,(2010).doc ' ` -
Page 2 of 2
COMMUNITY & ECONOMIC DEVELOPMENT phone 417-4750 CED approval by 1_ on
Number of off-street parking spaces available for employees and
customers? It i-) P & 14 .
(A parking.plan may be required.)
Signs? (wall -mounted, freestanding, projecting, awning, A -frame, etc?)
Signs planned: ct I
Sforvl/��Ca�T�
� K co J Ctn")e t'1+
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PUBLIC WORKS DEPARTMENT- ENGINEERING phone 417-4812
Is site work planned (n or re -located sewer or wat',r'seL"ice,
excavation, grading or filling, work in City right-of-way,
new driveway openings, site drainage, parking lots, downspouts,
irrigation system backflow devices, etc.). Yes ❑ No ❑
Work planned: 00,5S 1 a X11 I b1
PUBLIC WORKS WASTEWATER phone 417-4845
PWE approval by
PWW approval by on
on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No
If yes, what will be discharged: No �R�_ �� FATS
Call for Certificate of Occupancv inspections BEFORE openinq business.
Building Department Inspection 417-4815
Fire Department Inspection 417-4653
Please sign up for utility services at the cashiers' counter.
I hereby apply for a Certificate of Occupancy. I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of
permit.
Date-oZ0'� me��YlV11 l i�Gi% '1 C� Signature
� Print Na 1 '� 9 _
T:Torms\Building Division\Ceriiftcale of Occupancy Application (2010).doc !
Page 2of2
PREPARED 11/28/11, 11:00:14 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 11/28/11
------------------------------------------------------------------------------------------------
ADDRESS . : 114 E FRONT ST SUBDIV:
TENANT, NBR: CAPTAIN T'S / THE BEANERY
CONTRACTOR : PHONE
OWNER LESTICE ENTERPRISES, LLC PHONE (360) 417-0964
PARCEL 06-30-00-5-1-1615-0000-
APPL NUMBER: 11-00000354 CO- CHANGE OF OCCP/USE
------------------------------------------------------------------------------------------------
PERMIT: CO 00 CHANGE OF OCCUP/USE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------ -- -- --------- -----------------
C099 O1 11/28,{11 BLDG C/O FINAL
* OVERRIDE TAKEN BY PBARTHOL DATE: 11/28/11 TIME: 09:47:45
November 28, 2011 9:47:30 AM pbarthol.
------------------------- COMMENTS AND NOTES
•
CERTIFICATE OF OCCUPANCY APPLICATION Permit#
CITY OF PORT ANGELES
Attn: Permit Technician
321 E. Fifth St., Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
FEES
Certificate / Inspection
$100 arking Business Improvement Area (PBIA)
ee charged for Downtown locations
PLEASE PRINT IN ZAIK Zoning
Check one: New business in P.A.?Xchange of ownership only? El Moving location from within PA.?
BUSINESS NAME '
Business address I I ► 11(t, i S i Mailing addtess P0 Rox 9q
Phone number qua -!c"54` Opening d ' ate Days & hours of operation
Business owner's name—Jc-3rk r)r)i en\<
-- )WVk CC Contact phone
Business owner's address t-7*�_9 VAI �A
Brief description of business CkS-4:�-m n j Chi 3't 19'(+) / Cd r" ��aFJ
-
Property owner's name LLC_- contact phone 0; \1 -09 bLl
A
P rope �My owaar's ad d ressiuwn iacL .1 1 :2�1 \i\.J' !'r R'1
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes El No 1�q/
7\
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering stairway,,ramps, bathrooms, electrical, heating/cook 'g/v- nflOonsystems,etc).
11 �5 (_( �21M
Work planned: i IA,) I k��Ci t) I � V'1� // ne L-0
/,41 _,It, !:�. . - I :Z, ', � yy� e
FIRE DEPARTMENT phone 417-4653
Fire approval by Ala, on 3-6- I:L
Changes to a fire sprinkler system or fire alarm system? Yes IFD Na
L1111\'
Work planned:
PBIA (Parking Business Improvement Area - Downtown) phone 417-4623
Square footage of business? 6 0'?)'2—
PBIA notified on
is business moving within the PBIA? Yes 0 No•x
Rx,_dLV-\n
CITY CLERK phone 417-4634
City Clerk approval by on
Second-hand dealer/pawnbroker business? Yes 0 No ❑
Will there be dancing at this business? Yes 0 NOA`�
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel -Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
TRANSMITTAL
To: XFire Department
❑ Other Department -
Date 5-Z34
Project Address
Contact Fynd�1
Phone number(s)
I � 4 14 (1 (:1 E HYD ri-t—
S
Permit number ► —
Project Description—COM, Remoa-e I
❑ New Construction
[Addition Iteration
Please review & return to the Building Division, Permit Technician.
T.-Forms/Building Division/Transmittal
BUILDING PERMIT APPLICATION Print in ink
-:3�. , CITY OF PORT ANGELES For City Use On]
.
Attn: Building Permit Technician
Date Received _ - J�- I
321 E. Fifth St., Port Angeles, WA 98362 � Permit #
1�h� (360) J 17-4815 fax (360) 417-4711 \P��—�\� �.,� Date Approve
filf�+
Applicant �a vyl Leo4ePho � L4-7-7 —(3q7�
Property Owner Phon ' t 1 --O9 jo4
Property Owner's Address 1-7-2-9 \K1-� -4 (n' �-` , PA 91?�, 310
Contractor Phone
Contractor's Address
License # - - Expires E=mail
PROJECT ADDRESS 11 `10 (LE, 'Ft'otn�- (G i -a(nTT f IBeane i
Parcel Number a 10 3 o0©5116150 o 0 o Lot Zoning C-5 t5
Prosect Tvpe & Brief Description: ❑ Residential ❑ Multi -family VCqmmercial ❑ Industrial
Check all that apply jM� Z2e�
&New Construction
❑ Addition '
Remodel ;n+P_ ► or i Alla`, � c'e p1ACe V�-, - -lj CC) c ms I i n -;Si at 1 -5 v -x- ks
❑ Repair I
❑ Demolition
-�ir OWU14PoU'�- SGVpPe4-s
❑ Re -roof ❑ House ❑ garage `yother a_ w Iq I (tear off & re -roof ❑ lay over one layer
Heat System t4eat pump ❑ wood -burning stove ❑ Os fireplace ❑ pellet stove ❑ other
❑ Other
Floor Areas Existing (sq. ft. Proposed (sq, ft.)
Basement @ $ per sq. ft. _ $
1 St Floor
2"d Floor
3`d Floor / 1_�_^
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION $
Total footprint of structures � T Lot sizeXstrur�s�,eft
sq. Lot cov e %
Site Coverage = the amount of impervious son a parcel, includindrivewa sid asks, patios,
and other impervious surfaces. (see P C17.9.35 for exemptions)e coverag %
Max. height of proposed structures ft. Occupancy group # of bedrooms
Will a lawn sprinkler system be installed? 1J Occupant load # of full baths
Will a fire sprinkler system be installed? Construction type # of half baths
/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 my responsibility to determine w t permits are required, and to obtain permits prior to � ing on projects.
Date �� o? S'- t Print Name /1 C7' r e tj / (l:� C 'Signature
T:Forms/Building Division/Building permit application L j 60
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A L
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 11 00000716 Date 7/14/11
Application pin number 778432 REPORT SALES TAX
Property Address 114 E FRONT ST
ASSESSOR PARCEL NUMBER 06 30 00 5 1 1615 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 CENTRAL BUSINESS DISTRICT
Application valuation 0
Application desc
10 circuits to take over for revoked permit
Owner
DATE.
Contractor
INSPECTOR.
LESTICE ENTERPRISES
LLC
ANGELES ELECTRIC
1729 W 7TH ST
524 E 1ST ST
PORT ANGELES
WA 98363
PORT ANGELES
WA 98362
(360) 417 0964
(360) 452 9264
Permit
ELECTRICAL
ALTER COMMERCIAL
Additional desc
Permit pin number
189050
Permit Fee
96 90
Plan Check Fee
00
Issue Date
7/14/11
Valuation
0
Expiration Date
1/10/12
Qty Unit Charge
Per
Extension
1 00 73 5000
ECH EL
BRANCH CIRCUIT WO/FEEDER
73 50
9 00 2 6000
ECH EL
ECH ADDNT BRANCH CIRCUIT
23 40
Fee summary Charged
Paid Credited
Due
Permit Fee Total
96 90
96 90 00
00
Plan Check Total
00
00 00
00
Grand Total
96 90
96 90 00
00
INSPECTION TYPE
DATE.
RESULTS
INSPECTOR.
DITCH
SERVICE
ROUGH IN
D�3 1
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST
INSPECTION
Signature of owner or Electrical Contractor X
Date:
G \EXCHANGE�BUILDING
07/13/2011 10 37 FAX 360 452 9265
City-60ortMples Pirml Applicallon
DO:
-&'2 Si Vli FaMiDwelft
- 0imardw*
✓ 1MOrOblAdOMM /AbMUon I RWOM I ROW
Angeles Electric
• Plan -RWOWMO,8qRKuW'PIM9 Complete EJNWW Plan Review Inbmedm-Shad
Job- ddf&t
.DeWpHanal.a1mve
-UW Ai(Imbm
.No x
Phoney Fax
I 6AWII.Exp,
4.."
Name:
Jr.
.Mfilfchame
Tale! (Cly MuMdW by Unit Chame)
`;
SemberFeader�DAnip:
UWaMader 4014M MO.
26220
;
SaMoaftedwOM4000Amp.
OmbaFeeder wArtMOArm.
BmnchCkmkiWSnftFn*
.2-60
.73.50lbaid
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$
z40 Eah AdEbW k4mb Ck=k
.S. 970
$
- -Temp 8errkdFeerler700Amp
$
Temp SeMoelFeedr201�00Anp
:$148.70
Temp. Smofthr.401-1110Amp.
$167,90
a
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Trent Peppard
From Andrew Slack [apselectrical@msn com]
Sent: Monday July 11 2011 7.08 PM
To Trent Peppard
Cc: hbower@kitsapbank.com
Subject: AP S Electrical and 114 & 116 East Front St.
Attachments. CaptT Trent.doc
Hello Trent
I am attaching a letter as you requested for Captain Ts and have provided a copy to Kitsap Bank also
We are requesting your inspection of our work as soon as possible, you have the contact info for the owners. If there is
anything we can do to assist, we trust you will let us know
Respectfully,
Sheryl (and Andy)
°Fp0Rr44,,F ELECTRICAL INSPECTION
WIRING REPORT
G L r
KS & 417-4735
DATE: PERMI #
X17 ! 111 �36�
OWNER
CONTRACTOR
ADDRESS
APPROVED
❑ DITCH
P- Tl. , Z:.7 T A L,. -.-ROUGH IN/COVER
❑ SERVICE
❑ FINAL
INSPECTOR," `0
CORRECTIONS NEEDED- t"\W+t N f:,LDO fZ 2
NOT APPROVED
11
11'
❑,
e-.dV,IF_- C—;,
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 11 00000368 Date 4/25/11
Application pin number 522064
Property Address 114 E FRONT ST
ASSESSOR PARCEL NUMBER 06 30 00 5 1 1615 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 0
Application desc
320 amp service 30 circuits Sign
Owner
DATE. RESULTS
Contractor
LESTICE ENTERPRISES
LLC
APS ELECTRIC
1729 W 7TH ST
ROUGH IN
546 BENSON RD
PORT ANGELES
WA 98363
PORT ANGELES
(360) 417 0964
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
PORT ANGELES
(360) 452 6753
Permit
ELECTRICAL
ALTER COMMERCIAL
Additional desc
Permit pin number
184390
Permit Fee
311 70
Plan Check Fee
Issue Date
4/25/11
Valuation
Expiration Date
10/22/11
Qty Unit Charge
Per
30 00 2 6000
ECH EL
BRANCH CIRCUIT W/FEEDER
1 00 145 5000
ECH EL
201 400 SRV FEEDER
1 00 88 2000
ECH EL
COMM SIGN
Fee summary Charged
Paid Credited
Permit Fee Total
311 70
311 70 00
Plan Check Total
00
00 00
Grand Total
311 70
311 70 00
WA 98363
00
0
Extension
78 00
145 50
88 20
Due
00
00
00
INSPECTION TYPE
DATE. RESULTS
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTOR.
71 i�;/ I) )744:�
Signature of owner or Electrical Contractor X Date
G \EXCHANGE\BUILDING
RECEIVE
J
l
MITI' OF PORT ANGELES PERMIT APPLICATION.".�..h
a
Builclinb Di0sian/Electrical InspectionAPR
v
2 52n�1 I
W
321 East Fifth Street — P O Box 1150 / Port Angeles Washington,
98362 tic£
Ph (360) =117-1735 Fac. (360) 417-4711
ELECTRICAL � �_•��
Cid
! 9 y�® aQ 1I
`7
INSPECTIONS
Date
1 & 2 Single Family Dwelling y Multi -Family or ommercial*
—Commercial Addition / Alteration / Remodel/ Repair*
*Plan Review Ma Be Re aseC, mel e Electfical Plan Reviewipformation Sheet
�" 6- n
Jcb Address: F-0
KAP]e
Building Square Footage. r C.e (' ��
Description of above � 1 lar'A. VCS-" .hcr i l3 ii V15 -4-13 e,
Owner Igformation,
Name: 1 5' a G�-
Contr ct In rmion t
Name:.
Mailing Address: 1-7;2 q 113 %
Mailing Address:
City P -A State. Zip. _F,:4,3
q 11 -ai Fax:
City State: Zip:
Phone Fax:
Phone:
License # / Exp.
License # / Exp.
Item Unit Charge
Qtv Total (Qtv Muftialied by Unit Charge)
ServicelFeeder 200 Amp. $119.90
Service/Feeder 201-400 Amp $145.50
$T
$' �•�.. ��
T
Service/Feeder 401-600 Amp $ 204.60
_
$
Service/Feeder 601 1000 Amp. $ 262.20
$
Service/Feeder over 1000 Amp. $ 372.50
$ dp
$ l �+
Branch Circuit WI Service Feeder $ 2.60
Branch Circuit W/0 Service Feeder $ 73.50
$
Each Additional Branch Circuit $ 2.60
$
Temp Service! Feeder 200 Amp. $ 9230
$
Temp. Service/Feeder 201400 Amp $110.30
$
Temp Service/Feeder 401-600 Amp. $148.70
$
Temp Service/Feeder 601 1000 Amp $167.90
$
Portal to Portal Hou y $ 95.90
88.20
$
�— $ SQ
Sign/Outline Lighting $
Signal Circuit! Limited Energy / First 1500 sf - Commercial $ 95.90
$
Note. $5.00 for each additional 1500 sf
Signal CirGuit/ Litnitted 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 CONSTRUCTION ONLY.
First 1300 Square Ft. $110.30
$
Each Additional 500 Square Ft or Portion of $ 35.20
$
Each Outbuilding or Detached Garage $ 73.50
$
Each Swimming Pool or Hot Tub $110.30
$
$ i © Total 5`1
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 contactor 1 am making
the electrical installation or alteration in compliance with the electrical laws, N.E.0 RCW Chapter 19.28, WAC Chapter 296-4613, 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 cash n chscr:
credit Card # ItA
Dared: y a O U(Q r!
(f
Ot101/20to
X `\ J�
•
To Trent Peppard, City of Port Angeles Senior Electrical Inspector
From. A.P S Electrical Contractor, Inc.
Re 114 and 116 East Front Street
As of June 29, 2011 we have installed two 400 amp services, labeled all panels and traced
out all existing circuits.
We have run conduit and circuits for four forced air furnaces, we have run new circuits
for espresso kitchen area, we have roughed in and trimmed out all outlets and switches
and installed 22 new 8' fluorescent fixtures plus three 4' fluorescent fixtures along with
re -installing several of the light fixtures that were removed for demo We roughed in and
trimmed out the new baths along with replacing fan in employee bath for 114
We have run circuits through the ceiling into the projection booth with spares for the
future for 116, this side is 100% complete.
Circuits for the showroom for 114 window lighting are in the function box in the attic, it
was at this point Randy told us he could figure out the rest.
Remaining items misc. conduit strapping; meter protection, address labeling (we have
possession of the placards)
Please let us know if you want further detail, and do not hesitate to let us know if you
have any questions.
Respectfully,
Andy and Sheryl Slack
A.P S Electrical Contractor, Inc.
546 Benson Road
Port Angeles WA 98363
(360)452-6753, phone and fax
apselectrical(iDmsn.com
119
COMMERCIAL - SINGLE VOLTAGE
120/208 VOLT
CONTINUOUS.
INTERIOR LIGHTING 3 W X S.F =
PER 220-3 OR WA. ENERGY CODE
EXTERIOR LIGHTING. CONNECTED LOAD
SIGN (PER 600-6(B)&(C)) 1500 W MINIMUM ! 5tb
SHOW -WINDOW -(220=12) 2 0 0 W =X _494_;'_r - _3r
------------------------------------------------------ ---- ---------------------------------
SUB-TOTAL /& 13 5;D A ) - ZS .0c),4 3S
NON -CONTINUOUS.
HEAT
AIR CONDITIONING
COPIER
WATER HEATER
ELEVATOR
FAN
COFFEE OUTLET
DISH`JdASHER
lo%YXJZ-
LARGEST MOTOR X 25 %
SUB -TOTAL
0866
_rr
i:�j� __
J)3�1
CONDUCTOR SIZE = CONTINT JOUS +NON -CONTINUOUS e,14
OVERCURRENT = (CONTINUOUS X 125%)+ NON -CONTINUOUS
PREPARED 7/21/06 8 15 52 INSPECTION TICKET PAGE 12
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 7/21/06
ADDRESS 114 E FRONT ST SUBDIV
TENANT NBR PA DEVELOPMENT CO
CONTRACTOR AFFORDABLE SERVICES PHONE (360) 683 9619
OWNER P A DEVELOPMENT CO PHONE
PARCEL 06 30 00 5 1 1615 0000
APPL NUMBER 06 00000493 RE ROOF
PERMIT BNOP 00 BUILDING PERMIT NO PR FEE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
BL99 01 7/21/06L,�7 L� BUILDING FINAL TIME 13 00
JANE NO PHONE #
07/20/2006 02 06 PM DYASUMUR
COMMENTS AND NOTES
CITY OF PORT ANGELES
VN+O�N
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
v 321 EAST 5TH STREET PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr name
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Owner
66 00000493 Date 5/11/06
928195
114 E FRONT ST
06 30 00 5 1 1615 0000
PA DEVELOPMENT CO 14—
RE ROOF I X��
CENTRAL BUSINESS DISTRICT
22330
Contractor
P A DEVELOPMENT CO
AFFORDABLE SERVICES
C/O DAVID L HAGUEWOOD
258663 HI WAY 101
PORT ANGELES
WA 98362
SEQUIM
WA 98382
(360) 683 9619
Permit
BUILDING PERMIT NO PR FEE
Additional desc
Permit pin number
77396
Permit Fee
389 75
Plan Check Fee
00
Issue Date
Valuation
22330
Expiration Date
11/07/06
Qty Unit Charge Per
Extension
s
BASE
FEE
95 75
21 00 14 0000 THOU BL 2001 25K (14 PER K)
294 00
Other Fees
STATE SURCHARGE
4 50
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
389 75
389 75 00
00
Plan Check Total
00
00 00
00
Other Fee Total
4 50
4 50 00
00
Grand Total
394 25
394 25 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 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 a o viol or cancel the provisions of any state or local law regulating construction or the performance of
construction.
ure of Co ractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T-\Policies\l 102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPEI DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
SHEAR WALLS / WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
FINAL DATE
ACCEPTED BY.
BACK FLOW / WATER
AIR SEAL
WALLS
I
I
CEILING
Ij
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
I
I
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
FINAL DATE
ACCEPTED BY.
COMMERCIAL HOOD/ DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT SEPARATE PERMIT #'s
SEPA.
PARKING/LIGHTING
LANDSCAPINGI
I
I SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES
NO COMMERCIAL DATE
ACCEPTED
YES NO
ELECTRICAL LIGHT DEPT 4174735
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W /PW/
CONSTRUCTION R.W
ENGINEERING 417-4807
PW / ENGINEERING
FIRE 417-4653
FIRE DEPT
PLANNING DEPT 4174750
PLANNING DEPT
BUILDING 417-4815-7�� VZ
BUILDING
j•\Policies\1102_15 building permit inspection record05 wpd [1/4/2005]
I
L �<. roxr y�I FOR OFFICIALSE PNL
�� BUILDING PERMIT - APPLICATION Date Rec. ✓ilD�o
s 11�.! Permits. 07— 4-q3
� Fill out COMPLETELY and in INK. Your application and site plan MUST BE Date ApprovedI
� COMPLETE to be accepted for review If you have any questions, call
PERMITS (360) 4174815 FAX(360)4174711 Date Issued. -
Applicant or Agent: I Yi �a_ rV/� Phone. 36(`/ t/4y L7& q
Owner- w. 479vry ri L ilp Phone: t4c7Z— 67gl
Address l Z L YJ5 Z, 3 city. 1�ws f. j* Zip �Z
ArchltectJEngmeer-
Phone.
p�/�q���
Contractoria- \1 E IGeh c c rh State License #• 'Ex— 'iZ3 I a` l Phone:3606 0�,?&fq
Address.Z ►(� Nwy/n( W City. 5-, c m W A zip IV2-74 2
E
PROJCT ADDRESS i���i� 6 >cro�n�c5+- (/ ZONING
LEGAL DESCRIPTION Lot: Block: Subdivision.
CLALLAM COUNTY PARCEL NUMBER.
TYPE OF WORK.
SIZE/VALUATION
❑ Residential ❑ New Constr.
0"Re-roof
❑ Stove
SF @$ /SF = $
❑ Multi -family ❑ Addition
❑ Move
❑ Garage
SF @ $ /SF = $
Cr'Commercial ❑ Remodel
❑ Demolition. ❑ Deck
SF @$ /SF = $
El Repair
❑ Sign
❑ Other
TOTAL VALUATION $ Z �5 5 —
BRIEF DESCRIPTION OF THE PROJECT
h a, , 7r3YGh W(/l
COMMERCIAL/RESIDENTIAL. Occupancy Group: Occupant Load: Construction Type:
No. of Stories: _ Lot Size: Existing Sq Ft. & Proposed Sq. Ft. = TOTAL Sq Ft.
Total lot coverage %
PLANNING USE ONLY APPROVALS.
PLAN
BLDG.
DPWU
FIRE.
ESA/Wetland(s)- ❑ Yes ❑ No SEPA Checklist required? ❑ Yes ❑ No Other: OTHER.
VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and maybe revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE IF a plan check fee Is due it must be submitted at the time the -building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R105.3.2
of the International Building/Residential Code, 2003). No application can be extended more than once.
1 hereby certify that 1 have read and examined this application and know the same to be true and correct. 1 am authorized to apply for this permit and
understand that it is my responsibildy to det ' e wha i s re requi d, not the City's, and that I must obtain such permits prior to work.
T-Tolicies\BL 1102_13.wpd Applican . Date:
AFFORDABLE ROOFING
258663 Hwy 101 West
Sequim, WA
PROPOSAL
(360) 683-9619 (360) 385-2724 (360) 452-0840
Name n D Cvl�2le-(\� Cd Phone #1 _
Addres Phone #2
Cl t Y� (ANC P e.'S State Zip Code
arp house perimeter to protect landscaping
Remove old roofing and haul to landfilll
t --4,S- 7_ - (9
C1'63 (o Z-
�0 L 2— .
Install
Plywood OSB
Install
Roofing Felt
Install
Dnp Edge Metal
Install
'Pipe Flashing
Install
Metal W -Valleys
Install
Exhaust Vents
Install
Roof to Wall Flashing
Instal l
Ridge Vei is
Install
Roof to Wall Step Flashing
Install
Attic Vents
Cut In
Clumney Counter Flashing
Install_
Sun Tube
Install
Chimney Step Flashing
Install
T Skylights
Install
Skylight Flashing
�_ rn �-� t� �.
�lY
t CjW (�rv�cae�. A A�
�Instal
InstaYl_rk�
C�`f1m e,� ©1r e r
\/O d S CULj
-� Install —':�aCC I,--
Inst l e17ra r C,rr a St nr .P R r Orad` 1�V e `r
Secure / Locate Septic / Drain Field Location a
Price Includes Building Permit 01" of `�
n r JA S .e A 171
Customer to Secure Building Permit
Description �C t t�( i� 2V,,iln NC� W e,!�;t
Payment in full upon completion of project,
unless other arrangements accepted.
We propose hereby to furnish material and labor,
a Ir Z —i4 0 c r,,, Ir
c mplete In accordance with the a ove specifications.
'� e
Al my.cna! s uarantced he ads cd. AJl work to be competed in profess oval
manner according to standard practices. Any alteration or deviation from the above
specificatioas involving extra costs will be executed only upon written orders and will
become an extra charge over and above the estimate. All agreements contingent upon
strikes, accidcnm or delays beyond our control. Owner to carry Fire, tornado, and other
necessary insurance. Our workers are fully covered by Worker's Compensation Insurance.
Acceptance of Proposal the above prices, specifications and conditions
are satisfactory and are hereby accepted. You are authorized to do the
work as specified. Payment will be made as outlined above.
Affordable Roofing's Representative
Customer's Signature of Acceptance
See attached Warranty Statement_
qVe,V- f�
SUBTOTAL 4-L7 2a. j /� 3 00
SALES T�
TOTAL .
te: this proposal may be withdrawn by us if not
accepted within 30 days.
TOtn�. Iv &A 4w�
ip,r m t -
Brand -PC lil"AYear 1-5_
Color Workmanship --
10 Year Warranty
Lifetime Warranty
Date,
Date:
k
CERTIFIC. lil:-QqPUPANCY
This C
ta�epkez:sred, pursuant to the requirements of Sectio' :109 of the
S
Use Classification:
Group: m
Owner of Business/Reside
Building Address: 114
A
isPermit NoV _
Construction:
Wo &- Frederick
Post on to
Shall not be
4em 2-,xvow
7Y-W�
CBD
�s, WA 98362
!
--JA[uary 4.2042
Date -Zjs place
uilding Official
1
ROUTING SLIP °m
ate of Occupancy
$47 0 Ce ificate/Inspection Fee
DATF Q' 1 New Business
Address of Proposed Business Transfer of Business Location ( )
1 ( " C Y-Y—G1rN N-- Change of Ownership ( )
Applicant )_ .rlL New Building ( )
Address `7L? (sem Remodel ( )
�bC11I- ikvci fl A �N Temporary Business ( )
Phone business home Change of Use ( )
Brief description of proposed business. f '/0�f 4 ���//V6
&1j a S'G-
Legal Description Lot Block Subdivision
Current Use of Property- Q6-7141 4 S/`iG.15-�,
Zoning Classification of Property- 01/131)
WILL THERE BE ANY OF THE FOLLOWING? YES NO THE FOLLOWING WILL BE REQUIRED
Construction changes PERMITS BUSINESS LICENSE
Electrical changes 1) Building 1) Taxi
Mechanical (heating, cooling, stoves) 2) Plumbing 2) Peddlers
Plumbing changes 3) Electrical 3) 2nd Hand Dealer
New or relocated signs 4) Mechanical 4). Pawn Broker
New septic tanks 5) Sewer 5) Dance
New sewer service 6) Sidewalk installation 6) Hotel Motel
Admission charged to patrons 7) Driveway installation 7) Fireworks
Is this a home occupation? 8) Curb installation 8) Ambulance
Excavation of filling of lots 9) Sidewalk obstruction 9) Tattoo shop
Work done in City right-of-way 10) Water meter installation 10) Other
Is there sufficient off-street parking? 11) Fire
New driveway openings 12) Occupancy
A grading plan for site drainage 13) Sign
(parking lots, downspouts, etc.) 14) Shoreline
Are the existing streets paved? 15) Home occupation
Are there existing sidewalks? 16) Conditional use
Is there curb and gutter? 17) Other
Other
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the Date l 2I 0
information I have supplied is correct to the best of my
knowledge Signed
APP REJECTED
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
PB 1. A. -24, J
Comments / Conditions
CITY {)FPORT ANGELES
DEPARTMENT OF COMMUNITY DB\/EL(}9D&IN[ - BUILDING DIVISION
32lEAST 5TH STREET, PORT ANGELES, WA98362
Application Number . ' . . . 04-00000924 Date
10/08/04
Pin uonmcr . . . . . . .er4oso
Property Address . . . . . . 114 o ruomr ac
ayoEaooa eaoCoL moMamn. 06-30-00-5-1-1615-0000-
o so-uo-5z zu1s-oouoAppliration
Applicationdescription . . . COMM REMODEL
Subdivision Name. . . . . .
Property Use . . . . . . . .
�� /_
/,��_7//.
ezpnezty Zoning . . . � . . . CENTRAL noozmoao ozaTozcr
' ^~
Application valuation . . . . sou
Owner Contractor
------------------------ ------ - -
A DEVELOPMENT co owmmo
-p
C/O oavIo L. eAoUEWoon
Ponr ANGELES mx 98362
- Structure Information RETAIL Sxnao
-
Construction Type cvne . . . . . rrPo v NON -RATED
Occupancy Type . . . . . . aUazm000.orr/eno/moo/oEor
Other atrnct info . . . . . mmnano on nmrro
1.00
- -- -- ' -- ' - - -- - -
/| rermit . . . . . . aozLuzmo poomzr commoaczez
- - -
Additional ueac . . NO uoao mauL WALL oeomzmG
Permit pee . . . . 47.00 pzao Check Fee
30.55
zoone Date . . . . zo/oo/o« Valuation . . . .
son
~^�
Expiration nate . . 4/07/05
Qty Unit Charge Per
Extension
BASE FEE
47.00
r-�
^ ./
- - - - -- ' -' '- ' - - -- - -- - -
otuez r+eo . . . . . . . . . STATE aoacaAnoE
- -' -' -
«.so
Fee summary Charged Paid credited
Due
----------------- - - -- - - - -- ---------- -
-
pezmit Fee Total 47.00 «r.on .on
.ou
ezao Check Total � �
. 30.55 so ss oo
� on
�
Other Fee Total 4.50 ^ su . oo
.
.00
'
Grand Total 82.05 82.05 .on
.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 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 nfapermit does not
presume to give authority to violate or cancel the provisions of any state orlocal law neOu|n��A construction or the performance of
construction./
Signature ofContractor orAuthorized Agent Date Date
102.15 (11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 I DATE I ACCEPTED COMMENTS
I` YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH -IN I I I
PLUMBING
UNDER FLOOR / SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
I WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE/PELLET/CHIMNEY
HOOD/ DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING � I I
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE
ELECTRICAL - LIGHT DEPT
CONSTRUCTION R.W. / PW/
ENGINEERING
IFIRE
PLANNING DEPT.
BUILDING
T:\PLANN NG\FORMS\1102.15 [11/14/2003j
417-4735
417-4807
417-4653 I I
417-4750 +I
417-4815 I I I
ELECTRICAL
LIGHT DEPT
CONSTRUCTION - R.W.
PW / ENGINEERING
FIRE DEPT.
PLANNING DEPT.
BUILDING
ACCEPTED
YES NO
ON 1'{]R7 qAX,
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan :MUST BE
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: M(I i— le— FCad,Q r i c_ -I,,-
Owner:
irOwner: Dn(lr
Address: [ 0 'L ► C Z''cj City:_-BrI
Architect/Engineer:
Contractor
Phone:
Phone:
nial e, -r
Phone:
State License #: Exp
R OFFICIAL USE ONLY:
ADattc
,ppp
roved:
Date Issued:
Ht -7- (C'► CZ 3
Zip: 6 Z
Phone:
Address: City: Zip:
PROJECT ADDRESS: [ t'A 4- 'Frn� +-s `Ci: ZONING:
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA MC #
TYPE OF WORK:
❑ Residential ❑ New Constr.
❑ Re -roof
❑ Multi -family ❑ Addition
❑ Move
f4` Commercial ❑ Remodel
❑ Demolitio
❑ Repair
❑ Sign
BRIEF DESCRIPTION OF THE PROJECT:
Vw" r Ltvw--+ (4 1%04- t
Block:
City:
Subdivision:
Exp. Date:
SIZE/VALUATION:
El Stove SF. @ $ /SF. = $
11 Garage SF. @ $ /SF, = $
Demolition ❑ Deck SF. @ S /SF. = $
❑ Other It TOTAL V DATION
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: ' Lot Size:
PLANNING USE ONLY:
Existing Sq. Ft.
Total lot coverage
Occupant Load:
& Proposed Sq. Ft.
ESA/Wetland(s): ❑ Yes ❑ No SEPA Checklist required? ❑ Yes ❑ No Other:
Construction Type:
= TOTAL Sq. Ft.
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R105.3.2
of the International Building/Residential Code, 2003). No application can be extended more than once.
I hereby certify that t have read and examined this application and know the same to be true and correct. 1 am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required, not the City's, and that 1 mustobta' such permits prior to work.
T:\RVESS\BLDG-forms-brochures\2.003-Buildingpermit,wpd Applicant: ate:10 -S- 04
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