HomeMy WebLinkAbout2210 S Peabody St - Engineering ELECTRICAL PERMIT i k)
CITY OF PORT ANGELES �J't
360- 417 -4735
Application Number 12- 00000572 Date 5/11/12
Application pin number 682920
Property Address 2210 S PEABODY ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06- 30- 10 -5 -0 -9150 -0000- on your excise tax form
Application type description ELECTRICAL ONLY
Subdivision Name to the City of Port Angeles
Property Use
Property Zoning COMMERCIAL OFFICE (Location Code 0502)
Application valuation 0
Application desc
1 -4 circuits Counter
Owner Contractor
NORTH OLYMPIC LIBRARY SYSTEM ANGELES ELECTRIC
2210 S PEABODY ST 524 E. 1ST ST.
PORT ANGELES WA 983626536 PORT ANGELES WA 98362 \\N".3
(360) 452-9264 4
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc 1 -4 CIRCUITS
Permit Fee 86.00 Plan Check Fee .00
Issue Date 5/11/12 Valuation 0
Expiration Date 11/07/12
Qty Unit Charge Per Extension
BASE FEE 86.00
Fee summary Charged Paid Credited Due
:e
Permit Fee Total 86.00 86.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 86.00 86.00 .00 .00
IV
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
0
ROUGH -IN 51i li 2- AL oi- o r
FINAL fz3/i2—. COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
05/09/2012 10:24 FAX 360 452 9265 Angeles Electric U0001 /0001
I of tar
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections F!.1:-.CItlC,,
321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 l'4SPECTIt1!N
Ph: (360) 417 -4735 Fax: (360) 417 -4711
Date: 5/0 Z A
Multi Famil or Commercial Comm t Addition Alt l R
Commercial Alteration Remodel Repair*
Review May Be Required, Please Complete Electrical Plan Review Information Sheet 22/0 /4
Job Address: Y
Building Square Footage: c OW
Description of above
4r.. iIII4M1Trg t. iti ar t j
Owner Information Contractor Information
Name: ....k. =1* 1 s Name: A�A lEt �L 247 JC, /NG
Mailing Address: JArT�a Maili ddress �f�C..ST
City: State: Zip: ;X City: cxt/4J,4U -8 State: Wit Zip: 2�
Phone: Fax: Phone: 1 -02 9'aZ(,�' Fax: +T
License 1 Exp. License Exp.
Item Unit Charge g.. Total IQty Multiplied by Unit Charge)
Service /Feeder 200 Amp. 132.00
Service/Feeder 201 -400 Amp. 160.00
Service/Feeder 401 600 Amp 225.00
Service/Feeder 601 -1000 Amp. 288.00
Service/Feeder over 1000 Amp. 410.00
Branch Circuits 1-4 86.00 l f(�
Branch Circuit W/ Service Feeder 5.00
Branch Circuit W/0 Service Feeder 74.00
Each Additional Branch Circuit 5.00
Temp. Service/ Feeder 200 Amp. 102.00
Temp. Service/Feeder 201 -400 Amp. $121.00
Temp. ServicelFeeder 401 -600 Amp. 164.00
Temp. Service/Feeder 601 -1000 Amp 185.00
Portal to Portal Hourly 96.00
Sign /Outline Lighting 88.00
Signal Circuit/ Limited Energy Multi- Family 64.00
Signal Circuit/ limited Energy First 1500 sf Commercial 96.00
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy 5KVA System or Lass 113.00
Thermostat 56.00
t T otal
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 -46B, The City of Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owner, electrical contractor or electrical administrator: 0 ash El ChSck
D and c�I FI L Je
x Dated: /L 01/01/2012
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUE~T 3> ~
Date /u-- V7
Time
Recei~d fl ' (phone, person)
~Jq 2> l~~
Ve w L,f) Jrc~ry U 11. B/ liD (
-,- ( ^-) ,{ G 'y/
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing
Time By
l( -<?::.: V -e. lIy :: %~ ' U-<< +-e ~
~V-Lh I-r6)~ ~ (ill'
INSPECTION NOTES
Inspected
Remarks
Date
Phone No
JluZ
'D
~
Permit No
Final Sewer Excav Other
--
L u ct-f-e J- \'
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RESTORATION REQUIRED.. . YES
NO V"
I yfo J~ ' (. Z
RJi 12 vU'
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved DGravel 0 Asphalt
/!7/vO
,-t UZ
j:c"Y
, >J'i3t <
~_.__.__._- L
o Repaired by City
o Repaired by Permittee
o No Damage Found
l,'i ~
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~)\
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OPCC
Wor~rder #
cg...-tOMPlETE
o INCOMPLETE
o Other
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(Continue on reverse side if necessary)
(DA TE)
STREET SUPERINTENDENT
.PU.K 1 AN lr~L~~ .11 J..Kh Uhl' A.K J.IVllA~ 1
Fire Sprinkler Acceptance Inspection & Tests
L,' bray--
((e1 r c,n c- e
Addre s s "1)D0 s. Lan cQ.,z,-
Installer
{ trl-- 0
Sj -Sea ~ e.
Telephone
Pea b
rr,8;;2 -bfc, 3 G
Project
Permit #
1 Underground piping flushed per NFPA 13
Witnessed By
1<-
-
Date
2
hydrostatically tested at not less than
J- f/ S rfrakler vnafh
3
piping for installation in accordance with approved plans
Witnessed By
4 Inspection of plplng being hydrostatically tested at 200 psi for two hours (includes
all piping not previously tested) Wet/dry system
, Witnessed By ! Area Date I
! Witnessed By I Area Date I
I Witnessed By i Area Date I
5 Inspection
drop
II Wi tnessed By
of piping being air tested at 40 psi for 24 hours with less than 1~ psi
I Date
I Start Pres
I End Pres
II
6 Dry pipe valve trip test
II Wi tnessed By
I Time
I Date
II
7 Inspection of back flow preventor (to be inspected by Public Works)
Ilwitnessed By I Date
II
8 Sprinkler alarm components tested
II Wi tnessed By
I Date
II
9 Two-inch drain test
Ii Witnessed By
I Date
I Static
I Residual
II
10 Final inspection with control valves locked in open position,
connection capped, and system in service
i wi tnessed By I Date
FP 10
Fire Department
II
Revised 1/29/97
d_T~_
~
VI
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBLIC WORKS CONSTRUCTION Issued: 4/25/97 LC Permit No: 637
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION-----------------------_
NOLS 2210 PEABODY S
2210 S.PEABODY Lot: 1-6
Port Angeles,WA98362 Block: 22 Long Legal:
360/000-0000 Sub: PSCC-2ND ADD
PROJECT INFO-----------------------_____________________________________________
Work is INSIDE traveled road Value Work: $0.00
Plans Required: YES
Contractor:
Start:
Finish:
/ /
/ /
Performance Bond Required: N/A
Proof Insurance:
Amount:
$0.00
Work to Perform: INSTALL * Watermain
* Sanitary Sewer
* Storm Drain
Underground Tele/Ele
* Misc
PROJECT NOTES---------------------______________________________________________
BT test for H20 $125.00, TV inspect san sew $162.00 back flow test for
fireline $27.00, backflow test for irrigation line $27.00, san sew is
considered as alter to existing, cut H2o/cap sew ea house @ $225.,R/W
to inc sW/dwy approachs,2" dropin comp $1100.00/2" dropin turbo $375.
PROJECT FEES ASSESSMENT-------------------______________________________________
R/W Excav: * $40.00 San Sewer SFR: * $0.00
Sidewalk: $0.00 San Sewer MFR: $0.00
Curb/Gutter: $0.00 Add Unit: 0
Driveway: $0.00 Other San Sewer: $0.00
Dwy Culvert: $0.00 Sew Tap Wye/Man Tap: * $125.00
Street Cut: * $200.00 Sew Cap/ W/M Removal: * $450.00
Other R/W: $0.00 Alter/Repair Sewer: * $30.00
Fire Hydrant: $0.00 Storm Drain Tap: $0.00
Res Water Serv: $0.00 Catch Basin per ea: $0.00
5/8" Sewer System Dev: $0.00
3/4" Milwaukee Dr. Sew Assess: $0.00
1" R/W Use Perm: $0.00
Comm Water Serv: * $1,100.00 D.R.A.: $0.00
1" Admin Costs (D.R.A): $0.00
1 1/2" Misc: BTh20 & TV san $341.00
* 2" ==============================
Oth Water Serv: * $375.00
Water Sys Dev: $0.00
Receipt No: 2906
Inspection Fee:
TOTAL FEE:
AMT PAID:
$2,661. 00
$2,661. 00
-----------------------
R!W
SANITARY
$0.00
WATER
BAL DUE:
$0.00
DWY
STORM
DRA
OTHER
Separate Permits are required for electrical work, 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 com~d 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.
I ('- _________ , ,
/ -,...,c/.. \ /. _ '- (_~ - _" /,
.
Si ure of Contractor or Authorized A ent Date Si nature of Owner if owner is builder
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STATE. OF WASHINGTON
DEPARTMENT OF HEALTH
'WATER BACTERlOlOGICAL ANALySIS
SAMPLE COlLECTION: READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
If. Instructions ant not followed, sample will be nt'ectecI.
DATE COllECTED TIME COlLECTED. COUNTY NAME
MON1H DAY YEAR G'S tf'1.
/ \ \ /9 ~ DPM c...LA'-Vl N
lYPE OF SYSTEM IF PUBLIC SYSTEM, COMPLETE:
!:8:PUBUC ~ CIA~ROUP
o INDIVIDUAL 11.0. No.1 3 5 .,Q.. \4." ." '''~'B
<_ only 1 residence)
NAME OF SYSTEM --~~,.. (\
C \~ ~"~ ~ - \--\~S
SPECIFIC LOCATION WHERE SAMPLE COLLECTED TELEPHONE NO.
~,,:=.~......... ~'-"''V" (1 DAY (3L1> 4-..5f - 0 II
o ~~ c...O\J ~ '- \
iJ
SAMPLE ECTED BY' (Name)
EVENING ( )
SYSTEM OWNER/MGR.. (Name)
((." ~u-suX\(~,,\- .--
SOURCE lYPE 0 GROUND WATER UNDER SURFACE INFLUENCE
o SURFACE I5<1'WELL or 0 SPRING 0 PURCHASED or 0 COMBINATION
~EllFIELD INTERTlE or OTHER
SEND R'PORI.ID: (Print FuU Name, Address and Zip Code)
\~ t::..\.J....SWO~-,~
0,. *", ,-U
'QOC\l;;- .:r~~",$
WASHINGTON
L
lYPE OF SA PLE (check only QrlIl in this column)
o "~~~~~ WATER 0 Chlorinated (Residual:_ TOtal~ Free)
check treatment . 0 Rltered
Q Untreated or Other
o REPEAT SAMPLE
Previous coliform presence Lab,
Date
o RAW SOURCE WATER Source' ~ CD ~TotaI Coliform
Gd NEW -CONSTRUCTION or REPAlR~ ill "Fecal Coliform
o OTHER (Specify) f=',~ LIt.x:::: ~ ~O<'V 0..;.0 L,-~
REMARKS:
(lAB USE-ONl'Y) DRINKING WATER RESULTS
o UNSATISFACTORY, Corlforms present o SATISFACTORY,
CoIiforms absent
REPEAT o E. Coli present o E. Coli absent
SAMPLES
REQUIRED o Fecal present o Fecal absent
OlHER LABORATORY RESULTS
TOTAL COLIFORM -D- 1100 ml E. COLI _ 1100m1
FECAL COlIFORM ~ /100 ml PlATE COUNT- Iml
ANOTHER SAMPLE REQURED -
-
SAMPLE NQTTESTED BECAuSE: ., T'ES!\JNSUrT:ABLEBECAUSE:
o Sample too old o Confluent growth
o Wrong container o MC
o Incomplete form o Turbid culture
0 o Excess debris
SEE REVERSE SIDE OF GREEN copy FOR EXPlANATION OF RESULTS
lAB 00.1;1 DIGITS) DATE. TIME RECEIVED RECEIVED BY
/0 ~
REMARKS
DOH ~2 (REV. 4112)
IAI^TCD CIIDD. ICD (,~DV
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST' .
Date t - c;--- (I
II>
/
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney
5- f
Received by (phone, person)
h.-:7 Jt: -;:;:. r? ...' - ,
~~ ..:C-'--' "'~.. ,.' ., J
c" C1 ffl&- fJJ tJ/J 1: 1<-ecu:Jc d '/
Ie U I I Lt Y ,
/ 7-f!~ t- 8 Phone No
7
Time
~9/
/
W Jctf-"?J/'
Permit No
Plumbing Final Sewer Excav Other
INSPECTION NOTES:
Inspected Date
Remarks
Time By
<{ ~ 6 !+1J + t c(l7 ~ (IV /2/ .<c<-)
[..., h r <1 1'7 {'~: +-VCU+ (, l-- ,; LI r> /) I, -,/
Ct1r ~ v
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RESTORATION REQUIRED .fij/^ YES
'1
/
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NO i/
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SURFACE RESTORATION:
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
D Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
[2JCOMPlETE
o INCOMPLETE
o Other
'xC; '7
l- i5
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST'
Date ~ - b-
1-1
Time
Receivft,d by
oz,CZ-J 0 S t(-~/~<-1
_ I) tL s--z ~. ~-e c( ~{)lll. __-
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
- A.J I \ ( c
i ~) +~/I 'I- C
Phone No
Permit No
Sewer Excav Other
(phone, person)
()}~(~()
INSPECTION NOTES
Inspected Date
Remarks
lc <"{ -f-g;- I ~
, n _'
r -e' t{ /'1 C..J (j '-/
/
RESTORATION REQUIRED iU if, YES
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SURFACE RESTORATION'
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
~~/
o Other
~l?:
o Repaired by City
o Repaired by Permittee
o No Dama Found
Work Order #
o COMPLETE
~OMPlETE
)(
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STREET SUPERINTENDENT
-fh
(DATE)
~~ ~"~~
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Q><o'\ lJ 1~ STATE 0 WASHINGTON
DEPARTM NT OF HEALTH
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION: READ INSTRUCTIONS ON BACK OF GOLDENROD COpy
If Instructions are not followed, sample will be rejected.
DATE COLLECTED TIME COLLECTED COUNTY NAME
MO;7 / () o;y / C/;R I - (i;/I(~(
--
DAM ~PM
TYPE OF SYSTEM IF PUBLIC SYSTEM, COMPLETE,
~ PUBLIC II.D No.1 I 0/ ~ 151:; I () IMI C~ROUP
D INDIVIDUAL A B
(serves only 1 residence)
NA~2S:S7 fcPI ~ [ t 5
SPECIFIC ATlON WHERE SAMPLE CTED TELEPHONE NO.
~/() 5V ~1'-/-' ~ DAY(?{dJ ~I/
S's-
EVENING ( )
SYSTEJM OWfER/MGR., (NamJ)
,{ ( {T;--IZI rJ (fJy7 /Jh11 If<'-)
SOURCE TYPE D GROU~D WATER UNDER SURFACE INFLUENCE
D SURFACE EA. WELL or ' D SPRING D PURCHASED or D COMBINATION
WELL FIELD INTERTIE or OTHER
SEND REPORT TO: (Print Full Name, Address and Zip Code)
. (Name)
J "
II i
WASHINGTON
u
;2
TYPE OF SAMPLE(check only one in this column)
D ~2~~~~ WATER D Chlorinated (Residual: _ Total_ Free)
check treatment . D Filtered
D Untreated or Other
D REPEAT SAMPLE
Previous coliform presence Lab #
Date
o RAW SOURCE WATER Source # ~ rn
W NEW CONSTRUCTION or REPAIRS
/[J OTHER (Specify)
o Total Coliform
D Fecal Coliform
REMARKS:
(LAB USE ONLY) DRINKING WATER RESULTS
D UNSATISFACTORY, Cofifonns present ~ SATISFACTORY
Coliforms absent
REPEAT D E. Coli present D E. Coli absent
SAMPLES
REQUIRED D Fecal present D Fecal absent
OTHER LABORATORY RESULTS
TOTAL COLIFORM _ 1100 ml E. COU _ 1100m1
FECAl COLIFORM _/100 ml PlATE COUNT _ Iml
ANOTHER SAMPLE REQURED
SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE,
o Sample too old D Conftuentgr~
D Wrong container o TNTC
o Incomplete form o Turbid culture
D o Excess debris
SEE REVERSE SIDE OF GREEN COpy FOR EXPLANATION OF RESULTS
lAB NO. (7 DIGITS) DATE, TIME RECEIVED RECEIVED BY
-), / C S
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REMARKS
DOH 305-002 (REV 4/92)
WATFR <:'1 IPrr IFR ('OPY
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APPLICATION FOR WATIR
City Water Department
Port Angeles, Wash.
~/; &Y
, 19~
Name of Appll cant
Address
Renewal 0 New Service 8 Blk~ Lot~ Add ?SCC ~d
Size 0;- Service 2. ~ t"t'.hp Wr~ /n) Meter Number
Service Left On 0 Service Left Off ~ Signed
Installed by
~rh-,/r ~ cP37
Remarks: ;:Pee. -#- ;?q ~6
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APPLICATION FOR WATER
City Water Department /
Port Angeles, Wash. c:::'2-/ I B
,19 98
Address
Signed
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date <)-)- fg
Time
Received by (phone, person)
~/OSd:.~4
Location of Work to be inspected Jj-eLtJ}-, blr4 Vi:... ,,<<h~ ~ 811/0
Name of person requesting inspection / W f { c ~.?C
Address of person requesting inspection I '1 M 1-/5 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other IA.J ~
Acd*l ;2 SI S
INSPECTION NOTES'
Inspected Date
Remarks
Time By
ft -e-)11 v.i/'-<"-<! 1'9 . 5 ~ J--u / C -e C{ T-
/J<~ J-,.,hir-"cA.r.Y 6ltuf Clr-F- A-r-C.OIrI
<; + or CZ h ~ if/lit ~V~ FJ--6lt-1Z '~~ I ~
RESTORATION REQUIRED , ,
YES
NO~-
AI~
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.
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
D Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC. 0 Other
Work Order # / ( ~ b
~LETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
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