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Home My WebLink About809 S Pine St - BuildingL o r 4 e if fl ag5� g' g ik _A /fl Glr S i PqA ASSEMBLY 141 A 177 1 V ,9 Pg Manufacturer Model Size IS THIS AN APPROVED ASSEMBLY? YES @'NO 0 IS ASSEMBLY INSTALLED CORRECTLY' DATE OF INSTALLATION 1. b,V, NAME OF PREMISES SERVICE ADDRESS. LOCATION OF DEVICE. Initial Test Repairs Details Final Test AIR GAP INSPECTION REQUIRED MINIMUM SEPARATION YES NO COMMENTS Initial Test Repairs Final Test REDUCED PRESSURE PRINCIPLE ASSEMBLY DOUBLE CHECK VALVE ASSEMBLY CHECK VALVE #1 CHECK VALVE #2 Leaked Held at g. Cleaned Replaced Replaced I DateTime Tester 7 8t c, e 7 gr CA rr7 WHITE CUSTOMER COPY Backflow Assembly Test Report City of Port Angeles Public Works and Utilities Department Water/Wastewater Collection Division Leaked 0 Closed Tight m/ Held at psi Cleaned Cleaned Signature Replaced RELIEF VALVE Did Not Open en Opened at 7. 7psi 76$re, P45Ye.P 3 psi Buffer YES NO Closed Tight L9' Held at 8 psi Held at psi Opened at psi Cert. Line Pressure YELLOW PURVEYOR COPY PINK TESTER COPY Official Use Only Asscm.# Received .3397 Serial No YES L9 NO 0 RP Er RPDA DC DCDA PVB Air Gap SVB AVB AIR INLET Did Not Open Opened at psi Replaced PVB /SVB CHECK VALVE Leaked Held at psi REPAIRS Cleaned AIR INLET Opened at psi CHECK VALVE Held at psi BACK PRESSURE NO YES TYPE OF HAZARD .57®� .72:A/fe, 7G psi Held Backpressure YES NO #2 Shutoff Held YES Er NO Relief Valve Exercised YES BT NO Test Kit Passed Failed /9114i it M/ f Pg" c ?5' I/ ft efi r Initial Test Repairs Details Manufacturer DOUBLE CHECK VALVE ASSEMBLY CHECK VALVE #1 Leaked Held at 8 3 psi Cleaned Replaced AIR GAP INSPECTION REQUIRED MINIMUM SEPARATION YES NO COMMENTS Initial Test Repairs Final Test Date'Time Tester Backflow Assembly Test Report City of Port Angeles Public Works and Utilities Department Water/Wastewater Collection Division NAME OF PREMISES L ,9 4 l/ I2 g g of SERVICE ADDRESS U e i4/ .J 0 4 L' 4� 1 LOCATION OF DEVICE. 1 2 5/8 q41 44 O, IS P,Ald—i tejc ASSEMBLY 14 //9 TY /7 I e 7r'/ Model Size IS THIS AN APPROVED ASSEMBLY? YES 0'? O 0 IS ASSEMBLY INSTALLED CORRECTLY' YES El-NO 0 DATE OF INSTALLATION /fre a?1/ UNKNOWN O REDUCED PRESSURE PRINCIPLE ASSEMBLY CHECK VALVE #2 Leaked Closed Tight ¢I/ Held at psi Cleaned Cleaned Replaced Replaced Final Closed Tight GY Test Held at 3 psi Held at psi Opened at 3 l 7 psi ..7#1r c re e- 9' d Signature RELIEF VALVE Did Not Open Opened at 33 psi 3 psi Buffer YES NO WHITE CUSTOMER COPY YELLOW PURVEYOR COPY PINK TESTER COPY Official Use Only Assem.# Received Serial No RP RPDA DC DCDA PVB Air Gap SVB AVB PVB /SVB AIR INLET Did Not Open Opened at psi CHECK VALVE Leaked Held at psi REPAIRS Cleaned Replaced AIR INLET Opened at psi CHECK VALVE Held at psi BACK PRESSURE NO YES TYPE OF HAZARD 5 I �C� Line Pressure psi Held Backpressure YES 0/NO #2 Shutoff Held YES I_� Relief Valve Exercised YES LW NO Cert. Test Kit Passed Failed /C" rI f 11 ,2, 4 I Ej" /C G S�L'C /c'rae 1P546 /17 i 1, S: 0 Application Number 10 00000714 Application pin number 211612 Property Address 809 S PINE ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 6416 0000 Tenant nbr name MOOSE LODGE Application type description PLUMBING REPAIR Subdivision Name Property Use Property Zoning Application valuation 1100 Application desc INSTALL TWO BACKFLOW DEVICES Owner PORT ANGELES LODGE 996 LOYAL ORDER OF MOOSE 809 S PINE ST PORT ANGELES (360) 452 2157 Permit PLUMBING PERMIT Additional desc TWO BACKFLOW DEVICES Permit pin number 169037 Permit Fee 64 00 Issue Date 7/12/10 Expiration Date 1/08/11 Qty Unit Charge Per 2 00 7 0000 EA Fee summary Charged Permit Fee Total 64 00 Plan Check Total 00 Grand Total 64 00 T:FormsBuilding Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 98362 Bevrt2 Mathi nes) Contractor ANGELES PLUMBING INC PO BOX 1151 PORT ANGELES (360) 452 8525 BASE FEE PL- BACKFLOW PROTECTION <OR =2 Paid Credited Due 64 00 00 64 00 00 00 00 Date 7/12/10 WA 98362 Plan Check Fee 00 Valuation 0 Extension 50 00 14 00 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 7 -16 -I Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) FOUNDATION Footings Stemwall IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs PLUMBING Under Floor Slab I Rough -In Water Line (Meter to Bldg) Gas Line I Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling I Drywall (Interior Braced Panel Only) T -Bar I INSULATION. Slab Wall Floor Ceiling I MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney I Commercial Hood Ducts I MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting PLANNING DEPT Separate Permit #s Parking Lighting Landscaping 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 Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T Forms /Building Division /Building Permit FINAL Date 7-16 I Accepted by Roi FINAL Date Accepted by SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By 07/08/2010 09 36 3604528580 ANGELESPLUMBING PAGE 02/02 tic NNW Applicant or Agent ANGELES .PLUMBING. INC. Property Owner LOYAL fmnFR OF MOOSE LODGE #996 Property Owners Address 809 S Pine St Contractor /Engineer ANGELES PLUMBING. INC. Contractor /Engineer's Address P 0 BOX 1151, Port License ANGELP1077KP PROJECT ADDRESS Parcel Number BUILDING PERMIT CITY OF PORT ANGELES Attn: Building Permit Technician 321 E Fifth St. Port Angeles. WA 98362 (360) 417.4815 fax (360) 417 -4711 Project Tice Brief Description. a Residential c Commercial Check all that apply o New Construction n Addition Remodel o Repair Re -roof Demolition o Heat System Other Date 7 -5 -10 Print Name DALE BRUNTZ I:Forms/Bui ding Division/Bldg Permit Appl. 2006 Code.doc 809 S PINE ST Heat pump o wood-burning stove o gas fireplace o pellet stove other Install 2 backflow devices Floor Areas Evistmo (so, f) used 0s. fLl Basement 1 Floor 2' Floor 3` Floor Garage Carport Covered Porch Deck Shed Other APPLICATION Print in ink Phone 452 -8525 Angeles, WA 98362 Expires 5 -15 -2012 g e.V2V71A Q- per sq. ft. TOTAL VALUATION 1,100 00 Total footprint of structures sq. ft Lot size sq. ft. Lot coverage Max. height of proposed structures ft. Occupancy group of bedrooms Will a lawn sprinkler system be installed? Occupant load of full baths Wit a fire sprinkler system be Installed? Construction type of half baths I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Signature 1:21(A, For City Use Only: Date Received- S -16 Permit 10 -1214 Date Approved Phone 452 -8525 Phone 452-2157 Lot Zonin9 d Muff-family n Industrial Clallam County Assessor Treasurer Property Details 99 PORT ANGELES LODGE Page 1 of 5 Clallam County Assessor Treasurer 58399 PORT ANGELES LODGE 996 for Year 2010 2011 Property Account Property ID Geographic ID Type. Tax Area: Open Space: Historic Property Multi Family Redevelopment: Township Range Location Address. Neighborhood: Neighborhood CD Owner Name Mailing Address. Year 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2009 2009 2009 2009 Statement ID 41348 41348 41348 41348 41348 41348 41348 41348 41348 41348 41348 41348 583992008 583992008 583992008 583992008 58399 0630000264160000 Real 0010 N N N PA 121 PORT ST CNTY H2 L Land Use Code DFL Remodel Property 809 S PINE ST PORT ANGELES WA Cycle 5 Comm 20953140 PORT ANGELES LODGE 996 LOYAL ORDER OF MOOSE 809 SOUTH PINE PORT ANGELES WA 98362 Taxes and Assessment Due Property Tax Information as of 07/08/2010 Amount Due if Paid on. M. Taxing Jurisdiction ST SCH STATE SCHOOL CC -GEN COUNTY PORT PORT PORT ANG PORT ANGELES SD #121 SCHOOL DISTRICT #121 NTH OLY LIB NORTH OLYMPIC LIBRARY HOSP #2 HOSPITAL #2 WSMET PK DIST WILLIAM SHORE MET PARK CITY STORMWATER CITY STORMWATER FIRE_PATROL FIRE PATROL WEED_CONTROL WEED CONTROL FP Fee FIRE PATROL COUNTY FEE 2010 41348 TOTAL. ST SCH STATE SCHOOL CC -GEN COUNTY PORT PORT PORT ANG PORT ANGELES Legal Description. Agent Code Section. Mapsco Map ID Owner ID Ownership Exemptions: First Half Base Due $450 69 $239 85 $33 71 $555 31 $583 76 $69 70 $98 39 DIST $31 30 $192.96 $8 70 $0 82 $0.25 $2265.44 $525 97 $266 19 $37 70 $583 85 LOTS 5 -10 NLY 45' LTS 1113 &ALL LOT 14 BL 264 69 N N 46758 100 0000000000% Second Half Base Due Penalty Interest Base $450 69 $0 00 $0 00 $46 $239 84 $0 00 $0 00 $2: $33.71 $0 00 $0 00 $Z $555 32 $0 00 $0 00 $56 $583 77 $0 00 $0 00 $5E $69 69 $0 00 $0 00 $E $98 39 $0 00 $0 00 $31 31 $0 00 $0 00 $C $192.96 $0 00 $0 00 $1E $8 70 $0 00 $0 00 $0 81 $0 00 $0 00 $0.25 $0 00 $0 00 9 $2265.44 $0.00 $0.00 $226 $525 96 $0 00 $0 00 $106 $266 19 $0 00 $0 00 $5Z $37 71 $0 00 $0 00 $7 $583 86 $0 00 $0 00 $116 http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =58399 7/8/2010 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Security system Owner PORT ANGELES LODGE #996 LOYAL ORDER OF MOOSE PORT ANGELES WA 98362 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary Permit Fee Total Plan Check Total Grand Total INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS ELECTRICAL ALTER COMMERCIAL 145185 75 00 5/04/09 10/31/09 Charged 75 00 00 75 00 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 09 00000390 203110 809 S PINE ST 06 30 00 0 2 6416 0000 ELECTRICAL ONLY Paid 0 Contractor HI TECH SECURITY INC 723 E FRONT ST PORT ANGELES WA 98362 (360) 452 2727 8(s.0_ Qty Unit Charge Per 1 00 75 0000 ECH EL LIMITED 1ST 1500 SQ FT 75 00 00 75 00 Plan Check Fee Valuation Credited Due 00 00 00 Date 5/04/09 DATE RESULTS 00 00 00 00 0 Extension 75 00 Signature of owner or Electrical Contractor X Date INSPECTOR. brvoP yr 0 ..0 0 FROM HI —TECH ELECTRONICS City of Port Angeles Permit Application Building DrvlslonlElecaiial Inspections 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 Ph: (360) 417.4735 Far: (3801 417.4711 Date: 5 J AP I 8 1 8 2 Single Family Dwelling Multi- Family a Commercial' Commercial Addition f Alteration Remodel Repair Unit Chart* S 93.75 $113.75 5160.00 5205.00 5291.25 S 2,00 S 57.50 2.00 5 12.50 5 66.25 $116.25 5131.25 S 75,00 5 69.00 S 75.00 S 50.00 S 50.00 S 93.75 S 80.00 S 88.25 S 27,6 S 57.50 S 66.25 S 43.75 a Signature of owner, electrical contractor or electrical administrator Date: 5!1 J o Q FARE COI VE MAY 12009 LIGHT DEPT Plan Review May as Required. Please Complete Electrical Plan Review Information Sheet Job Address' 909 Se Ar Building Square Footage: Description of above _12W31?-044- S is l►46 C. 6s t~t S1ycT Owner Information Contractor Information Name: MoreSi GDbo2 Name: Hi Tech Security Inc Mailing Address: 8 So- Mats Mailing Address: 723 East Front St City' Pae+or Pitt-La L. State A Zip: 48562 Cily Port Angeles State: WA Zip: 98362 Phone: 3[.o 4Vz- 2 .1- Phone: 360- 452 -2727 License 4IExp, License #1 Exp. HITECTS955E6 Total (Qty Mulbpliec bvUnit Charge S Service/Feeder 200 Amp. S ServicafFeeder 201.400 Amp. 5 Service/Feeder 401 -600 Amp. S Service/Feeder 601.1000 Amp. S ServieelFeeder over 1000 Amp. S Branch Circuit W/ Service Feeder S Branch Circuit W10 Service Feeder S Each Additional Branch Circuit Temp. Service/ Feeder 200 Amp. S Temp_ Service/Feeder 201-400 Amp. 5 Temp. SerxicerFeeder 401.600 Amp. S Temp. Service/Feeder 601 -1000 Amp. S Portal to Portal Hourly S SigniDutline Lighting g ts• OC Signal Chun Limited Energy Commercial S Signet CircuN.Limited Energy 182 Famly Dwelling Signal Circuit? Limited Energy Muhi-Femiy Dwelling Mendactured Home Connection S Renewable Electrical Energy 5KVA System or Less S Fort 1300 Square Ft S Elich Addieonal 500 Square Ft. or Portion of S Each Outbuilding or Deteched Garage 5 Each Swimming Pool or Hot Tub S. Thermostat yS DO Total May. 01 2009 11 28AM: P1 P) 0 Owner a5 defined by RC W.19.28.261. (1) Ownerwi9 occupy the structure for two years after this electrical permlr is finalized. (2) Owner is require0 to like an electrical conbecto►ll above said property is tor sale, rent o► lease 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 Instaeadon or alteration in compliance with the electrical laws, N.EC. RCW. Chapter 1928, WAC. Chapter 296.469, The City of Pon Angeles Municipal Code, end utiItty Specifications. ..:r-, Lasered CED ~~~~ 0" RT:'PlNG~~":E'L' E~;Si : ~ ,.r/ I l yP' ~ / i : f ,'" ~ 1 i ~~ '1 ' ~~n , #," ~ , /' ,~, '"""~ ' ,~, ," ",~,: ,- u ,-,' WAS H I N G TON, U. S. A. DEPARTMENT OF COMMUNITY DEVELOPMENT January 24,2002 Lasered ,..r-f) RE: Moose parking areas Dear Mr. Potter: I have researched your request to eliminate one of the parking areas associated with the Moose Lodge activity. City records indicate that the Moose Lodge activity, located at 809 South Pine Street requires 77 off-street parking spaces. Those parking spaces were identified as being located at the northeast comer of West Eighth and Pine (18 spaces), the Lodge itself and the area south and east of the Lodge (59 spaces), at the comer of the 8/9 Alley and Pine Street (18 spaces) on property owned by the Lodge for a total of 95 off-street parking spaces in the three locations. (I am including the site drawing you submitted for your information.) You indicated that the Lodge no longer has ownership of the 8/9 Alley and Pine Street site, which contained a total of 18 spaces, reducing the number of available spaces to 77. You said that the Lodge is now interested in selling the 18-space site at the northeast comer of Eighth and Pine Street and possibly converting a portion of the lower parking area to a play area. I am not sure why the lower lot has not previously been required to be improved as it is needed to fulfil the 77 space parking requirement. At this time, particularly with the elimination of the 8/9 and Pine Street location site, both the lower and the northeast lots are needed to meet the minimum parking requirements. Your compliance with the parking requirements is marginal and sale of the northeast lotwouldjeopardize continued operation of the Lodge at this point. I have referred your inquiry as to needed improvements of the lower lot to Ron Johnson, in the City's Engineering Division, to answer questions you have with regard to necessary improvements of the lower lot and why it was not improved earlier. EAST FIFTH STREET · PO BOX 1150 · PORT ANGELES, WA 98362-3206 3E;;0-417-4750 · FAX: 360-417-4711 · TTY: 360-417-4645 PLANNING@CI.PORT-ANGELES.WA.US OR PERMITS@CI PORT-ANGELES.WA US ~\} ~ \D , \J z: \tt V\ -:-\ oS .....~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 BUILDING PERMIT 13057 OWNER/APPLICANT MOOSE LODGE # 996 809 PINE Port Angeles, WA 98362 360/452-2157 T: S: ISSUED: 11/07/2001 PROPERTY LOCATION 809 PINE S Lot: Block: Subdivision: Parcel No: PERMIT NO: L TS5-10&N45'L TS11-13&L T14 264 ~ Long Legal TPA 063000026416000 CONTRACTOR OWNER VARIOUS Port Angeles, WA 99360 206/000-0000 PROJECT INFO Project Value: $700.00 Project Type: HOOD/DUCT Occupancy Type: COMMERCIAL Occupancy Group: Construction Type: Zoning Use: CSD ARCHITECT N/A , 98360-0000 360/000-0000 SFD Units: SFD SO FT: Commercial: Industrial: Garage: o o o o o ~ 4::: \/' ~ L M. MFD Units: MFD SO FT: o o PROJECT NOTES INSTALATION OF KITCHEN HOOD AND EXHAUST SYSTEM WHIC A FIRE SUPRESSION SYSTEM ON A SEPERATE PERMIT RECEIPT # 8231 FEES ASSESSMENT Building Permit: Plan Check: State Surcharge: House Moving: Manufactured Home: Sign: Plumbing: Mechanical: Radon: NO ri t-LAi-- $29.60 $0.00 $4.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Misc Fee 1: Misc Fee 2: Misc Fee 3: $0.00 $0.00 $0.00 TOTAL FEE: AMOUNT PAID: BALANCE DUE: $34.10 $34.10 $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private a;1d public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether speCified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of constructi n. //1 // , Date I Signature of Owner (if owner is builder) , FOR OFFICIAL USE ONLY: Dale Rec.: IO~/'1-o1 Permit #: Dale Approved: The Building Permit - Pre-application must be fUted out completely. Dale Issued: Please type or print in ink. Uyou have any questions, please caD 417-4815 \ /SP'" I So \;7 _ _ r' . L ' T 1/1. ,,j am, ("hUrI"'!f1.) . r / 1 !.?:5-0~ Applicant and/or Agent: l:ry~-'l .'" I rd i r ~ Phone: <9-Vd c~v ;:!. i Y1:/ Owner: /;;; < ~ : oir' -kI, :Jt Phone: #~~:2 -;21 ~? Address: _ _0_ ~ /1n_ Clty: 1~';!77Y!f,.ok > ZlP: 9%'~~2- s w 1~ ,,12 /2 ;;(.;/01 0 F j-!tJ(t r/ ;:;..... nwf 'pYf'j?2 N I" ~CCDY~n"o" 1A//T1t HelJ/4- ;",,/,,,/;1;- BUILDING PERMIT - APPLICATION 0'" Architect/Engineer: Contractor Phone: License #: Exp: Phone: Address: City: Zip: PROJECf ADDRESS: ;yO S- s;, un p; Jo1 r<' 5" r ZONING: LEGAL DESCRIPTION: Lot: g-.r 'i' Block: '2 IJ~ Subdivision: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: BiUingAddress: 809 5'00/7" P/j""" City: po,cIJ::I"''l"bs Credit Card #: Exp. Date: VISA MC SlZElVALUATION: .r o Woodstove SF. @ $ ISF. =/$: o Garage SF. @ $ ISF. = $ o Deck SF.@$ ISF. = $ )f H.d I", .,tt/hl/", WTAL VALUATION $ . ;; . J1 . I f';1) ,.......~ .._~ TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof o Muhi-family 0 Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRlYI'ION OF THE PROJECf: -" V 01-1 c:- ;- ciTy""l 5;"'1',.. J "'1" Q.TI ""' COMMERClALlRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: Lot Size: ' % Lot Coverage: % Existing Lot Coverage: Isq. ft. + Proposed Lot Coverage: Isq. ft. = TOTAL LOT COVERAGE: Isq.ft PLANNING USE ONLY: APPROVALS: PLAN Notes: BLDG. DPW FIRE ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER BUILDING APPLICATION SUBMl'ITAL: Your applklllion and site plan must beJ1lkd out completely to be aa:eptedfor review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. BUILDING PERMIT APPLICATION SUBMl'ITAL: Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. V ALUA TION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant This figure wiD be reviewed and may be revised by the Building Div. to comply with current fee schedules. Conlact the Pennit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of pennit issuance. EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application. this application will expire by limitations. The Building Official can extend the time for aclion hy the applicant up to 180 days, on written request by the applicant (see Section 107.4 of the Uniform Building Code. current edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. and I am authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are requi"ld; it remains the applicant's responsibility to determine what permits are required and to obtain such. 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C1[l;d E....OJ_2 'l;l:;::: .0 it::! ~'3<=uur..r.;lr:.:l...z~E-<!-<j>':S <II ~<=uur..r.;l .g:~f;-:~-;~"".. 7.!",'~ ~o3zs~.~sa ~~<'" '" Q) .~ H S B o Cl! H H i.L<..8 ... Cl! ~...) Q) -w ~ H ~J ~ .~ H ~ H Q) "0 !':: ::J 'l!! .. c .. u .l! j; " o .~ o :x: c :> 'it , .. ~ ~ ~ U !':: >--< >< Q) "0 !':: ...... ~ r-. ~ >--< ~ ~ ;;j H ... ~ w !':: ...... t<l w..., Q) P:::--g Q) ... H t<l .- Q i.L< .. 3CG /,i\)ii 1)'; LJU{ i:,'i,j ~:{)()'l ~;f!\ I ':1 'vV) gf ;?1..',:!')O WASHINGTON SURVEYING AND RATING BUREAU _....,., .~ ~'."~-_.. "",. '11~..O ,. C\_ .....4',.,...:..,.;..,.. nlri',rio.~.;."ri".-+.......:_--;;:.,...~.C)",-:bIiII RESTAURANT HOOD & VENT In order to obtain Bureau approval for fire insurance rate credit, it is necessary to submit the following for review: 1. Hood & Duct plan or diagram (similar to the one shown on Page 2) installed in conformance with N.F.P.A. Pamphlet No. 96. 2. 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(~ A ./ '-~). j' ;" _ . V ~;tj, / - t - , ' ., -~L-"-...L- ~~~L"",'L- _t~~---"" .#- I __ -"-f.:.__ L..- Sue Roberds AssIstant Planner cc Ron Johnson s..,;,,. , " MEMO DEPARTMENT OF COMMUNITY DEVELOPMENT Brad CollIns, Drrector 417-4751 Sue Roberds, Assistant Planner 417-4750 Lou Haehnlen BUIldmg Official 417-4816 Roger Vess Perrmt Technician CSW Coordmator 417-4712 Ed Eastwood BUIldmg Intern 417-4815 no. :R" T AN 1: ,G'V 'E>:LE: :,S' , I=- y .n" ~~ " . .~ WAS H I N G TON, U. S. A. January 25, 2002 TO: Ron Johnson, Engineering FROM: Sue Roberds, Assistant Planner RE: Moose Lodge - 809 South Pine Street Attached is a letter that I drafted to Mr. Dennis Potter who IS representing the Moose Lodge. The questions are, can the lower lot be improved to provide a playground and the northeast lot sold? Mr. Potter also said that the Moose no longer owns the lot across (west) Pine at the 8/9 alley, thereby eliminating those 18 spaces. I informed hIm that the northeast lot cannot be sold without putting the Moose in violation of the City's parking reqUIrements I have no idea why the lower lot, which is reqUIred for the parking, was not paved. I can see that the lower lot is environmentally sensitive and I also remember that we discussed the fact that there previously was a structure just over the bank which is no longer there. The lot should have been improved just the same as we reqUIred the northeast lot to be improved. (?) Do you know any more of the history on this? Maybe it's best at this time to leave it be so as not to encourage more impervious surface on the hillside? We need to put somethmg in the file for future reference partIcularly with your imminent departure. Thank you for your assistance. Attachment (1' v'~ "4 i..d ~Jl ~ 'j ',' !t''ij f~J' ~, ~)t/rt.J'", f4~Jr."", "., ... ,~~~~, Pr"fb6f'd ./~".t1'I'~ \ II , Sc.a Co... 1,::0 ~() '. fE~ls* i,,~ ,..~ f'l,MO ~'''Qrc ~()~t . .s-t rlld\1ve p . , n e . s ....,! . ',-1- ~1h';)~; .. '.'!ll!';' : t. :/,;",/1 "" t< 1 ;~. e e" I 1:- I ',: I , -----------.----- ::- ~th. st....eet ;~ .~ "':;:;'_t<,,, . i '., ''''''.' ." ... ~~~>l~'f~~_ , r ,..,- ,", < "?iI, tJ <." '~"Miilir-', ,.......' ~, ,..... '.' ..... ,~,l ,.....:'f.'":y:.' V-<" :........... ".....' .......1 ..........." .......'" ,...... " ... ... ~'" .........., ,,,.,..........', , " ..... '...........1 "~".....,.....,,......,....,..... ... ...... " , =" "..... :.....' ,..........", ,.... '" ,"" ..' ,,'''''' ,........ ';l ........ ,......... ,..... '"I''''' ,..... ~ ,~......"""""''' .....'......"'1 ,,'...... ,,,................,,........ ...., ,,,,, ~" ~ ......".....'........" "....., ....."..... "" ..... """,' .....::- '...' ....,,, ".....' " ,............... I "'" ,,',....' 1~(1' , I " .'1 , ! '1 . , " ' , , 'I ' . " . "1 " . , ,:, ~ , . 1 N ~ ':)- ...... '<' " ;! ' ," , LEGAL South 1/2 of lots 11 & 12 Bne ,::~11 of 13: ; n Block 235, TPA ;~,'" . " ,'j- ,-....}o;: Lots 5-10 inclusive and lots 13 & 14 Block 264, TPA South 1/2 of Lots 19 & 20 Block 263, TPA North 30' of Lots 11 & 12 Block 264, TPA Ii . "'", " '-, ~ ,,, ',.'f" -", ,: .' f~(;' "f;- ;;l' "?,', d"f , .>' i ,~, \ "~"!:': Z "~~, ~~( ,,,,,;: ~ '~..f", \ "', , t~, ~~ . ., 1 t.:~' '" ;"'< ~rfc ..' ~ CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Site Address: Inst lied By: Own' r/Business: OwnrrfBuSiness Address: o Residential Heat KW C; Baseboard 0 Furnace/Boiler C Heatpump 0 Other C; Commercial/Industrial load I Total Connected load I (attach breakdown) Total Motor load i (attach breakdown) DetllilslDescription: I . o New Construction o Remodel o Service update/alter/repair o Add/alter circuits o Auxiliary power (list below) ~ Special equipment (list below) PERMIT NO. ;;;J~bO DATE-L02.,//J' ~ D READY FOR WILL CALL FOR INSPECTION INSPECTION License Number: Phone: Phone: Sq. Ft. o Overhead o Underground Voltage o 10 03JZ1 Service size o Temporary Amps ... -I I 1 J w.sl No. Service Cap:acity: 0 O.K. 0 Not O.K. o ~itCh Inspection O.K. ,-0 ~ough-in/cover O.K. o O.K. to connect service I ~~inal O.K. I Size Comments Date Hold for: 0 Easement 0 Letter o Signed up for service/meter D Meter Department notified for installation D Fire Department notified of inspection D Plan Review approved/pending Installer: ~ ~ I. Nolify the Department 01 City Light by Street Ad ress and Permit Number when ready lor inspection. Work mu~t not be covered or electricaliy energized before inspection and O.K. for covering or service has been given by ~h~ector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. .f: ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT c:::;;;;!.tJ ~ ,; . Inspector Amount paid WI-{ E - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLY~IC PRINTER~. INC. Sitd Address; I . W Cap~clty: 0 O.K. 0 Not O.K. o ~itCh inspection O.K. -1;. ~ ~ough-in/cover O.K. '""'" "1iJ <j>.K. to connect service ~1J. ~inal O.K. sitddress go Ins aller: .' '. .' ...--- -.. CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO. .;:?3 413 '? ~,8>/cf'P ELECTRICAL PERMIT DATE Site ; ddress: I Inst II led By: o READY FOR 0 WILL CALL FOR INSPECTION INSPECTION License Number: Phone: Own r/Business: Phone: Owner/Business Address: Sq. Ft. . Residential I Heat KW Baseboard 0 Furnace/Boiler Heatpump 0 Other 'I Commercial/Industrial load Total Connected load (attach breakdown) I Total Motor load . (attach breakdown) o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) o New Construction o Remodel o Service update/alter/repair o Overhead o UndergrQu.nd / Voltage /ci<o,&Off' o 10 0 3~ Service size (7't90 Amps o Temporary Det ilslDescription: I' -, i I '. J I I .S No. Service Size Date Hold for: 0 Easement 0 Le tter Comments o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending I Notify the Department 01 City Light by Street Address and Permit Number when ready lor inspection. Work mu#t not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT.158 or EXT. 224. - II (~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT , / 7~ !:!' ~ Inspector Amount paid WHljE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLY"'~C PRINTERS. INC. CITY OF PORT ANGELES DEPARTMENT OF LIGHT .APPLICATION AND ELECTRICAL PERMIT. A /.33 . PERMIT NUMBER . II J.- t, (J0 Rtflt.//JtIS/1'i- f'f e p/VI N1 TO~AL FEE CONT. Lie. NO. TIMETOCQMPLETE NO. STORIES LEGAL OCCUPANCY . II Site Add 55 NO OCCUPANCY OA USE ESTABLISHED UNDER THIS PERMIT o $'V7 CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT PE~MITS WITH WRONAADDRE~~ES.RE CJCE~if~ .......... 1 Owner Installation By ~.,\--t~ iSth N~ Owner's ddress ~ c> q p., ~€ Installers Address 2- 'Z-'f>7 p~ ___12.-4.. DaYPhO~r 45"2-:2-J ~. InstallersPhone~~:?-~~l' APPllcatlffn is hereby made for Permit to install Electrical Equipment as follows: r t..) ) ....rdltJ"~ q"'-- ~ ~ x: I E-T""l t..) rr e A tee -l} ,,.... ---il- Wiring Method C0-N .o01~ . USEibF CIRCUIT NUMBER AMP 120V 240V NUMBER AMP 120V 240V PER - 100R FEE USE OF CIRCUIT PER 100R FEE CIRCUITS CIR 10 30 CIRCUITS CIR 10 30 LIGHT SIGN (h..Jf. L-l& I1J, a ' I LIGHT I . 50 VOLTS OR LESS CONve~IENCE - MOTOR I CONVa' IENCE MOTOR APPLI~ CE MOTOR DISHW, SHEA FIRE ALARMS DISPO Al BURGLAR ALARM RANG MISC. OVEN WATE~,HEATER LAUND lY DRYER' .. . REINSTALLATION LIGHT FIXTURE ## " FURN CE SUB TOTAL FEE GAS- I'l FURN ;E ENERGY FEE ELECT IC ~IC HEAT BASIC FEE ELECT -. . ~IC HEAT TOTAL FEE ELECT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.C. U IT AMP PHASE FEEDE~ SIZE OF SERVICE ENTRANCE CONDUCTORS SERVI~E A.W.G. I SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH . I certif~lthat the work to be perfo;med under this permit will be done by the installer and in conformance with the N.E.C. Electrical Code. Date AP~iication made . , 2.-- / 2-1 ,19 .::g-y By ~Qj . - II . -. . -I CONTRACTOR OR OWNER (OR A ORIZED AGENT) _ Permission Is hereby giv.en to do the above described work, according to the conditions hereon and according to the approved plans and specifldations pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles.' - , II DIREC OR OF CITY LIGHT Date Permit Issued k:2/3/;f> 1" ~~ANS I . II WARNING " Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be c:overed or current turned on before inspection and O.K. for covering or service has been given by Inspector in Writing on Permit Placard. A. . Permits Phone: 457-0411 Ext. 158. PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ II OL YMPlqpRINTERS, INC. WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD - Inspector's Report , , ..... REPORT OF INSPECTOR ". ,. \ . , \..... DATE OF VISIT MADE BY REMARKS .. .. . " , . , , " J , , , .. ".j t :'.1' , . < '. . ; \ '. . , . I , " .. ,". , .. - . - . . , I '>" - ~ - , .. d' - . '" " . I. \. '" . . . d , . .. .. , .. ,',. . , ..... - '! , ,\ .: . (-(( -{):J 4l/d .. O.K. FOR COVERING , O.K. TO CONNECT SERVICE I -II-'$" , .11tY FINAL O.K. . , .' I . Z <:l a: <t :::E ~ J: I- Z W l- . l- e z e c . <? <!90 CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A~ '. FEEA'II EIPT NUMBEA II TO~AL FEE II Site Addrjess I Owner Owner's ~ddress .. 7't E-- Day PhO~B' . Installers Phone ~~? - ~ /0 '7 \ =jf" is hereby made for Permit to install Electrical Equipment as follows: ey -- - /' ~ - {2..-.J ~ ... Wiring Method ~- ':. / 6.'~)(J \. CONT.lIe. NO. TIMETO COMPLETE NO. STORIES NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ,'7" e..- RESPONSIBILITY OF APPLICANT c. Ie USE[pF CIRCUIT AMP 240V - . USE OF CIRCUIT NUMBER AMP 120V 240V NUMBER PER 120V 100A FEE PER 100R FEE CIRCUITS CIR '0 30 CIRCUITS CIR 10 30 LIGHT!; SIGN L1GHTI' 50 VOLTS OR LESS CONV~~NIENCE :I &: ^ -,. MOTOR CONV~NIENCE - MOTOR - , APPLl~NCE MOTOR. - - DISHvJ"SHER FIRE ALARMS " DISPc#AL BURGLAR ALARM RANG# MISC. OVENII WAlE" HEATER LAUNDRY ,. OAYE~ - REINSTALLATION LIGHT FIXTURE # FURN~CE SUB TOTAL FEE GAS -IDIL FUR~.!I~E ENERGY FEE ELEqBIC BASIC FEE ELEctRIC HEA~ TOTAL FEE ELECilRIC HEAT - SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER " AC. Y~IT AMP PHASE FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS " " SERVICE A.W.G. " I SUB-TOTAL I5::- SIZE OF GROUND SIZE OF ENTRANCE SWITCH I certif~ that the work to be performed under this permit will be don~' by the installer and in confo~manc~~ N.E.C. Electrical Code. Date lPlication made 7 - / 2... ,19 ?<:j By, :/1;7 A I .- -. ONTRACTOA OR OWNER -(OR AUTHORIZED AGENT) . Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. II . . DIR,ECTOR2Y LIGHT . By ~d10-~ ~~. Date 11 rmll Issued PLANSAPPROVED'.. ";, "-: ,'~ I - Notify Department of City Light by Street Address and Permit Number when reaey tor inspection. Work must not ,("2-: J:= be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in 'I Wilting on Permit Placard. A.. Permits Phone: 457.0411 Ex\. 158. W~RNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ II WHITE - Original CANARY - Duplicate PINK - Triplicate WHITE CARD -Inspector's Report {)I.YMP~ PRINTERS. INC. . r '. -'l f) ,:;' L \1 \) '." \/ REPORT OF INSPECTOR DATE OF VISIT MADE BY A REMARKS . . 7 kdl;:<! /1!,A,L> InO /) 4" ,','trh- .;.. 11 'J/ .J . '&;- II. o~n' , /. ( , or-VI 'f (/ . . . . \ )~ \ . .' . . ~ .. \ . \ . . . , . - , .. . . . .. ., . 0 , , . \ . 0 I , . , . - . 0 .. 0 . . , , . . . 0 . - .. 0 .' . - .. .. - 0 : '. -. - , .. , , O.K. FOR COVERING O.K. TO CONNECT SERVICE 7/; dltf t / /?,. .' "',,1/ , .< , FINAL O.K. /. .I :1 . \ . , '. . . '. " . .. .. z Cl a:: <C :e ~ J: I- Z ~ I- o Z o C . 2007-1211381 Page 1 of 4 Easement City Of Port Angeles Clal1am County Washington 10/29/200701:32:23 PM 1III ~11'1'j,N~~VlHI\~~1ljll~!III.al'II~'lrl'llrlr.~tI!ll~11I11111 RETURN ADDRESS: City of Port Angeles P . O. Box 1150 Port Angeles, WA 98362 DOCUMENT TITLE: Temporary Construction Easement Grantor(S): Loyal Order of Moose Lodge #996 Grantee(S): City of Port Angeles STREET ADDRESS: 90.9- South pine Street ASSESSOR'S PROPERTY TAX PARCEL: 0630000235550000/23567 1F .. upon the final acceptance of the project by the City Council. -, ~'?+I-~ Grantor Governor .-/ ,8 } 6 Date -- ......., STATE OF WASHINGTON ) ) ss. ) County of Clallam iYO~ Grantor Administrator 1;-16~O> Date On this date, before me the undersigned Notary Public in and for the State of b<:Z- ......-ClF-') \)j~v-)c;.-m..., , personally appeared 11~c.... ~M." 00 It.~\ , to me known to be the individual( s) who executed the foregoing Temporary Construction Easement and acknowledged to me that they signed the same for the uses and contents therein mentioned. DATED this -Lb.- day of \)(U<d.J5\ \\\\\llllillfl//. ,\\\ ;...t'\t:. R1NC. f/>/ .;::.' '!v~....... ".~<J /// ~.:r-.... OlAR).;"?""%. :::0' '" ,- :: :......1'11 200B :z= :: . "" . . 0 '0 = ~~... PUB\..\ ..0/--2 ~"1.. .___IP::: -:.; ri..........0.~,~ ~~~~I OF W",'O \\\" 11"lIllt~\\\\\ , 2005. ~;'L"-V Qu-~~'o.:;\ NOTARY PUBLIC in and for the State of I ()~~IO-rD /J Residing at My commission expires: 3. \ - DE N:\PROJECTS\02-15 8th St. Bridges\Right alWay - Easements\Port Angeles Moose Lodge #996\EASEFORM (Parking Lat).doc r.'77'77'-0""-:--;;-- .f'~ .......... ... ...:; t< I: 0 .m::~ I: '" ,I I: '. I:' I' :I "......... . ......... ..\. .,1 I: .. :1 1\ llrl9S .;;0;.,0 E2 r~:: I~ (/~qlDOnO~qO )-0 ....1 8:1 I. l1/OSI'lV'.; S31'1Vr "' f--"-' I I: '.... - . . ,. . 'I: ::::::?:::::::::::::::::::.:::::::......M 1\ ~'~O .~'~~~"q I: co -:e, I :1 1'1: - 3 ~- @''l-.~:I . ...... 10 r:. -............ : I- g ~. .- \ (.........~ 1ll.....:'1: .... . ~ ~. .... ~ '1 1-: S 0 ~ I :1 r.:;' ~ to- . . I :~ ~ I- - '" I :1 \ n '.. " <3 ''''' ~:: I:.... .-:. . . \. '>..0."0'" ...:1 : 1h. '" . '1 I: ~<P.u...o :1 I' ~'o"" O. : I. 0-, ........' '"" <P IQ 'I I. 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Box 1150 Port Angeles, WA 98362 2007-1211380 Page 1 of 5 Easement City Of Port Rngeles Clallam County Washington 10/29/2007 01 :32 23 PM 1111 ~I\j, l't~lllA ,H'j,lolli ,lltlUJoal',I\Il!: Irj~lI',!/,'ij,r'I,m'IIII" I DOCUMENT TITLE: Temporary Construction Easement Grantor(S): Loyal Order of Moose Lodge #996 Grantee(S): City of Port Angeles STREET ADDRESS: 809 South pine Street ASSESSOR'S PROPERTY TAX PARCEL: 0630000264160000 IF , City of Port Angeles Public Works Engineering Division PO Box 1150 Port Angeles, W A 98362.0217 TEMPORARY CONSTRUCTION EASEMENT The Grantor(s), Loy"'] OrcJ"r of Moos" Lod;:" 11996 , for and in consideration ofthe benefits derived herefrom and for other good and valuable consideration, receipt of which is hereby acknowledged, grant(s) to the CITY OF PORT ANGELES, a municipal corporation, (referred to herein as the "City") an easement across, over and along the premises situated in Clallam County, Washington, and described as follows: Tax Parcel Number 063000026416, 809 S. Pine Street, City of Port Angeles, W A This easement is subject to the following conditions: 1. This easement grants to the City and its contractor(s) the right, privilege and authority of ingress to and egress from the north 13' of the west 20' and the north 5' of the east 30' of Lot 10, the north 10' ofthe west 26' and the north 2' of the east 24' of Lot 9, the north 2' of the west 8' and the north 20' of the east 42' of Lot 8, and the north 20' of Lots 5-7 all in Block 264 ofthe Townsite of Port Angeles, Clallam County, Washington during the construction of the following facilities: Bridge reconstruction, sidewalk, storm drainage, sanitary sewer revision, signal installation, and other appurtenances. 2. Work performed by the City of Port Angeles or its contractor(s) shall be conducted in such a manner as to keep any interruption of access to the shortest time practicable including, but not limited to, scheduling any interruption of access to minimize the impact to the Grantor(s) property. 3. Grantor(s) property shall not be used by the City or its contractor(s) to store materials or equipment during construction without prior approval of the Grantor(s). 4. In the event any of the Grantor's property is damaged during construction of the facilities described above, the City shall, upon completion of said facilities, restore the premises of the Grantor(s), that were damaged during construction, to as good condition as it was in prior to construction of the facilities. 5. This Temporary Construction Easement, including all rights and obligations of the Grantor(s) and of the Grantee that arise from or as a result of the Easement, shall expire and terminate N:IPROJECTSI02-15 8th St. BridgeslRight of Way. EasementslPort Angeles Moose Lodge #996IEASEFORM (Building Lots).doc , upon the final acceptance of the project by the City Council. f;~ 4~ Grantor Governor ,8/r:Oc,- Date ~~ Grantor Administrator g--/tl,,-oS Date STATE OF WASHINGTON ) ) ss. County of Clallam ) On this date, before me the undersigned Notary Public in and for the State of ~,,"",\.c...J..<"> \D~\..'c~-ra,.U , personally appeared ICY_ 1="~R6l1:lD~\ , to me known to be the individual(s) who executed the foregoing Temporary Construction Easement and acknowledged to me that they signed the same for the uses and contents therein mentioned. DATED this \ 1.0 day of ~Q:5T \\\\1111'"", ,"'\>,,,-R1Nl: III, ~ ~ ......."i>/A.'.-,. ~CJ... .,~" ~ ." "'or. ""~-:" ~ :. " .<1-9'" ~ ::cn.I\{I''' J- .1JJ:: :::--1: ""T.1 :--1= --...() .200'8' :: -~. ,. . ~(\'\'.. v8l'C .:~g ~O... .'~O~ ..../ ^",A:...... G" ,.... ///I/VASH\~ \\".... 1111/11\1\\\\\ , 2005. ~'~\2~\ NOTARY PUBLIC in and for the State of :U:::o^"'l4u..J(~~) Residing at My commission expires: ::,- 1 - 0 '2> N:IPROJECT5\02-15 8th 51. BridgeslRight of Way - EasementslPort Angeles Moose Lodge #996\EA5EFORM (Building Lots).doc , ~ I\.) /r:..~~ 1. ~ . I'....' . ., .. . , . . .. ... ,... .~.. I: DAVID E. HASSEL 0 iil. I' ( 06.50QUU2b.JUU) IJ &. I'. AF 696249 ~ I' I: L.:.:...:.:.:...:.:.:...:.:.:...:.:..... - 26+84.48 N 33U'54" E 369.77' . - -.-r-'j:; -l; hI or::,:,::,:,'''''::''::''''''''''''''''''''''''' . ............... ..; I' - : I: 0 27+7.....flJ I' I: I l\........... !.8..i.'S..~. I I' ~ I: 5' I: '" ",+30." I: r l' \ " : 2.B~~~3...e. I:.... .., ., . . "0' . ., .~.. .'7...... 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I 1 1 ~20'1- _.I~ <5',;-,0.....!.15" IB4.BB5' PINE 1:, 27+.54.48 '~f.:"~~- ""&:~" ~<i' I. ill I' + ~ r F . . . , . . . . . . . . . . "; "J~' PARCEL. 2 ' KIL 17 t:F SHORT PlAYS, PG. 7IJ BRANDO S. BlORE . B (Al~JD':i;~tl~~3b :1' ~\~ J <01 '....... .~....... ..... J I + 8 26+&4.46 2 +lg.~ STREET ~ IB4.905' 7+54.45 o ';'x ~ '~ . ) . T<, .HHHHHH~I.-11 :I :I " .. .. .. " ....\I I :1 I :I :1 :I :I I I " . ~ ; rg to I ITH' <iH"'HH:H~' rH :' 5',,<p I: ~:a.. ::' I: r-~ . I: I:; ~l;; I:'" ~ '" "u> :.~... .", '" . I' IS '" "'r- I:" = '" ,,8. : ~ ~ ""lc;): I: ,,"" 1= 02: .~. gP: ' '" .' "'. . ~ ~: ................ I' . .10' 'porii" 'ANiiEiiS' LOOGE' NO:' 996: I 1 L 21l+71.02 LOYAL ORDER OF"MOOSE : I ---1 Q-r---2O" ( Ub,jU()OU2,jtJbl ) :1 I \;j I AF 555505 :I f~ ~I::::::::~:::::::::~.:\! \ I: ...." . ,..-::1 '" : .fl,. o. ~ ~ I: I ~:I I" I: '" :1 lo c1Dl: "Y\ .. . ~~~ .. . ~. \\ : I.: ~'I f)o.' ",' 01 I . '!., d>~ d>~ ('):1 I: I ~ ~'~.. A: :1>1 I:.........~. ." ....:I~ I, 1:0'10,0", .:1-< I: BCD"" ' t...I:1 I: wi' o~' "'. r~ "1 : (IIi 0.. ...... ~ VI: I \' ;; ? ~'Ocf' ~".c.~"'S 'bll I ' .. ~ ~. . 1\" . ~'.. 0."': 'O:;'~ . .' ~,; .. . )1 , ~ ' \' I &, ~ g . '0, ~~A I \:.. .I~.~S ,.. .. ~~ ~.... ~~.. '1 \ k o~ t..l ~ :r ~~~ ~'~ g)o. =1 1: . -o~ .... O"l ~ ,I lj 1 ~ CI) ~ :1 I: 31+62.74 0 u> ,I !: HA &, :1 , r;i-{.:;';;'\I.i:: l 1]1 't. .... ( OojOUUU2,j!:J~1 J :1 I:!; I <c O~AF 567J17 ;1 I:.i--J is "'. : I ~ I: \ '" :1 " J)!',dd.\\ <> [,,;;,Jt,;;,..;.;:.:.::,;;,.,;;,.;a,... .,;;,.,;;,Q.,;;,.,;;,.j'~ !!l <;') '" :t 8l1:t! ~I~ -. 8 '" Vl '" !jl~ ~'I~ I ~l ~ORTANGELES WAS H I N.G TON, U. S. A. Public Works & Utilities Department August 8, 2005 Port Angeles Lodge No. 996 Loyal Order of Moose 809 S. Pine Street Port Angeles, W A 98362 Attn: Mr. Jorgen W. Bogdanoff RE: Construction Easement for Slh Street Bridge Replacement Project No. 02-15 Dear Mr. Bogdanoff: Design of the 8th Street Bridge Replacement project is progressing very well. Since my last letter to you of April 13,2005, the consultant has been able to refine the construction easements n~eded for the project. A drawing indicating the construction easements needed for the project is enclosed for your review. Also enclosed are two temporary construction easements for your execution. One is for the property on the north side of Eighth Street (Parking Lot area) and the other is for the property on the South. side of Eighth Street. The construction easements are needed in order to install a traffic signal pole on the back of the sidewalk, allow room to excavate deep enough to install a detention system for the storm drainage and reroute your sanitary sewer (with a clean out assembly) to make room for the new storm sewer system. During construction, every effort will be taken to insure that the maintain access to the property. At the end of the construction, the contractor will be required to completely restore the site with the same vegetation as you currently have. Granting the City the temporary construction easement is required in order to relocate your existing sanitary sewer connection, make the project safer and provide ease of the construction. If you are the legal owner of the property, please review the document, sign, and return it to me. Your signature must be witnessed by a Notary Public for the document to be legally binding. Notary service is available to you for this temporary easement at no charge at City Hall in the Engineering Department. Should you wish to utilize this service, please contact Cate Rinehart at 417-4700 to confirm her availability. The City will record the document with the Clallam County Auditor's Office at no expense to you" If you are not the legal owner of the property, please forward this information to the legal owner. I know that a construction project of this nature is always a concern to the local residents and businesses. I want to assure you that the City is committed to make every effort to minimize the impact of this project. I do encourage you to attend any open houses, read the Peninsula Daily News, and listen to the radio for information concerning the project timelines. If you have any questions, comments, or concerns, please feel free to contact me at any time. My email address, phone number, and mailing address are noted below. SinCerelYt ~ ~ ames M. Mahlum, Civil Engineer . ahlum(cilcitvo a.us 360-417-4701 PO Box 1150, Port Angeles, W A N:\PROJECTS\02-15 8th St. Bridges\Right of Way - Easements\Port Angeles Moose Lodge #996\Revised Easement.doc Phone: 360-417 -4805 / Fax: 360-417-4542 Website: www.cityofpa.us / Email: publicworks@cityofpa.us 321 East Fifth Street - P.O. Box 1150/ Port Angeles, WA 98362-0217 Application Number . . . . . 22-00001313 Date 10/17/22 Application pin number . . . 044637 Property Address . . . . . . 809 S PINE ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-6416-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Hood fan and kitchen circuits ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PORT ANGELES LODGE 996 JOHNSON ELECTRIC COMPANY LOYAL ORDER OF MOOSE 3129 S REGENT 809 S PINE ST PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 728-4327 (360) 452-2157 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 91.00 Plan Check Fee . . .00 Issue Date . . . . 10/17/22 Valuation . . . . 0 Expiration Date . . 4/15/23 Qty Unit Charge Per Extension BASE FEE 86.00 1.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 5.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 91.00 91.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 91.00 91.00 .00 .00 MULTI-FA MILY/ COMMERCIAL ELE CTRICAL PERMIT APPL ICATION Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:-------------------------------------- Project Description:--------------------------------------□Multi-Family Residential D Commercial I Industrial/ Public Building Square footage: __________ _ OWNER INFORMATION Name: ________________________ Email: ______________ _ Mailing Address: ________________________ Phone: ___________ _ ELECTRICAL CONTRACTOR INFORMATION Name: License: ___________ _ Mailing Address: ________________________ Expiration Date: ________ _ Email: Phone: ___________ _ PROJECT DETAILS llim! Service/Feeder 200 Amp. Service/Feeder 201-400 Amp. Service/Feeder 401-600 Amp. Service/Feeder 601-1000 Amp. Service/Feeder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Branch Circuits 1-4 Temp. Service/Feeder 200 Amp. Temp. Service/Feeder 201-400 Amp. Temp. Service/Feeder 401-600 Amp. Temp. Service/Feeder 601-1000 Amp. Portal to Portal Hourly Sign / Outline Lighting Signal Circuit/Limited Energy -Multi-Family Signal Circuit/Limited Energy/First 1500 sf -Commercial (Note: $5.00 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5 for each additional) Unit Charge Quantity $132.00 $160.00 $225.00 $288.00 $410.00 $5.00 $74.00 $5.00 $86.00 $102.00 $121.00 $164.00 $185.00 $96.00 $88.00 $88.00 $96.00 $113.00 $56.00 Total (Quantity x Unit Charge) $ ____ _ $ ____ _$ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ _____ TOTAL Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296- 46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us] lJ CD PREPARED 10/14/22, 7:33:15 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00001313 809 S PINE ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER COMMERCIAL 91.00 TOTAL DUE 91.00 Please present reciept to the cashier with full payment