HomeMy WebLinkAbout819 Georgiana Street Address:
819 Georgiana Street
CERTIFICATE OF OCCUPANCY
CITY OF PORT ANGELES - BUILDING DIVISION
This certificate is issued pursuant to the requirements of Section 111 of the 2015 International
Building Code certifying that at the time of issuance this structure was in compliance with the
various ordinances of the City regulating building construction of use for the following:
Business Name: Volunteers in Medicine, VIMO
Business Address: 819 Georgiana St
Business Owner: Volunteers in Medicine
Business Owner's Address: PO Box 639 Port Angeles, WA 98362
Automatic Fire Sprinkler System: 0 Yes 0 No
Use and Occupancy Classification: B
Occupant Load: Per Code 2015 IBC
Typeof, nstruc io V
2-24-2017
Allyson Br6kke, Planning Mangager Date
Post on the premises in a conspicuous place.This certificate shall not be removed except by the Building Official.
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VORTj,t,. CERTIFICATE OF OCCUPANCY APPLICATION Permit# I `7 1-5-c O
'aim" FEES
CITY OF PORT ANGELES
Attn: Permit Technician $50 Certificate / Inspection
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321 E. Fifth St., Port Angeles, WA 98362 $100 Parking Business Improvement Area (PBIA)
(360) 417-4815 fax (360) 417-4711 fee charged for Downtown locations
PLEASE PRINT IN INK
Check one: New business in P.A.?❑ Change of ownership only? ❑ oving location from within P.A.? Zoning
BUSINESS NAME VO Lu AI 5 /A/ *V41 CINE lJ1G m
Business address 7/`I Gaa && 4A/ D( W7 r'10 Mailing address /13,fx 6,
Phone number(55-z — V q3z Opening date�Days & hours of operationy9Z/'0.S
Business owner's name VO CUAJ �; t 3 /Ay W of/C/w� Contact phone AIS-7— V 5/31
Business owner's address lid A3oX Coag' pull r AMTS, 64M
Brief description of business jF�--/UP C L/til C
Property owner's name VdLtl,-j 1-W5 1/U WOet/C/-,O Contact phone
Property owner's address/contact /,:�b ;K (a 3�. � � 14i✓ iDS, CAM
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No x
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering stairways, ramps, bathrooms, electrical, heating/cooling/ventilation systems, etc).
Work planned:
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? PBIA notified on
Is business moving within the PBIA? Yes ❑ No ❑
CITY CLERK phone 417-4634
City Clerk approval by on
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.
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COMMUNITY& ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on
Number of off-street parking spaces available for employees and
customers?
(A parking plan may be required.)
Signs? (wall-mounted, freestanding, projecting, awning, A-frame, etc?)
Signs planned:
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PINE approval by on
PUBLIC WORKS DEPARTMENT- ENGINEERING phone 417-4812
Is site work planned (new or re-located sewer or water service,
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:
PUBLIC WORKS WASTEWATER phone 417-4845 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:
Call for Certificate of Occupancy inspections BEFORE openin_g 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 Print Name Signature
T:\Forms\Building DivisionTertificate of Occupancy Application(2010).doc
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