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Home My WebLink About719 S Laurel St - BuildingPREPARED 12/09/10 8 09 47 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 12/09/10 ADDRESS 719 S LAUREL ST SUBDIV TENANT NBR WRAPSODY MASSAGE CONTRACTOR EXTREME BUILDERS INC PHONE (360) 417 0679 OWNER CAMILLE HEADRICK PHONE PARCEL 06 30 00 0 2 3145 2001 APPL NUMBER 10 00000216 SIGNS PERMIT SIGN 00 SIGN REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RES RESULTS /COMMENTS BL99 01 12/09/10 JL BLDG FINAL December 8 2010 4 48 04 PM 1pangrle I SCHEDULED THIS TO FINAL THIS PERMIT BUILDING FINAL WALL SIGN (WRAPSODY MASSAGE) COMMENTS AND NOTES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 10 00000216 Date 3/09/10 Application pin number 214632 Property Address 719 S LAUREL ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 3145 2001 Tenant nbr name WRAPSODY MASSAGE Application type description SIGNS Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 40 Application desc 7 SQ FT WALL MOUNTED SIGN Owner Contractor CAMILLE HEADRICK 915 GLENBROOK CIR PORT ANGELES EXTREME BUILDERS INC 50 PERCY LN WA 983626736 SEQUIM (360) 417 0679 Permit SIGN Additional desc 7 SQ FT WALL MOUNTED SIGN Permit pin number 161851 Permit Fee 47 00 Plan Check Fee 00 Issue Date 3/09/10 Valuation 4000 Expiration Date 9/05/10 Qty Unit Charge Per 1 00 47 0000 PER S ALL SIGNS OR TO 25 SF Special Notes and Comments March 8 2010 5 14 28 PM sroberds The proposalis to install a 7 sq ft wall mounted sign for a total of 19 sq ft of signage on a structure located in the CSD zone No land use issues anticipated Fee summary Permit Fee Total Plan Check Total Grand Total T:Forms/Building Division/Building Permit Charged Paid Credited WA 98382 Due 47 00 47 00 00 00 00 00 00 00 47 00 47 00 00 00 Extension 47 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granti r s es not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performaq Date Print Name Signature o Contractor or Authorize Agent Signature of Owner (if owner is builder) 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 Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting T /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments Inspection Type Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 PLANNING DEPT Separate Permit #s SEPA. Parking Lighting I I ESA. Landscaping I I SHORELINE. FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By 12- cl9,10 Applicant or Agent Property Owner x. Property Owner's Addres Contractor /Engineer Contractor /Engineer's License TA_ Project Address Business Name Parcel Number Sign #2 Sign #3 Sign #4 $47 00 $85 00 $115 00 SIGN PERMIT APPLICATION Print in inK CITY OF PORT ANGELES Attn Building Permit Technician 321 E Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 e,($4A/ A) C FI e— Totals (Un charaes Unit Charge Quantq multiplied by quantities) x t 00 x x GRAND TOTAL $Z." For City Use Only ate Received 3 -3. -10 ermit# 16 -2 Date Approved Phone Z..7 4/6 7 Phone Phone 360 `i 17 -067q SPu vn, Rz `'xpires t, ,i l 2v 11 I h� f I/Vl A-SS4 6 I Lot Submit an 8 "x 11 "site plan three sets of plans that include. Type of sign (wall- mounted projecting freestanding illuminated other Placement and sq ft. area How the sign will be securely attached(Engineering specs may be required for freestanding signs) Separation distance between the bottom of projecting and freestanding signs and the surface below See "Chapter 14 :36 Sign Code of the City. of Port Angeles Municipal' Code. for sign requirements. Sian Type Brief Description. (Type, location, sq. ft.) Sign #1 7 /z s� e')cc67 /1Dh- Il uMihdlCAt W yyiaunied lk be of Sig Zoning Sign(s) Valuation All signs less than or equal to 25 sq ft. Wall sign or marquees, over 25 sq ft. Freestanding sign or projecting sign, over 25 sq ft. Make Checks Payable to City of Port Angeles Credit Cards (Except American Express) are accepted Existing sign(s) area Z sq. ft. Proposed siggn(s) area sq. ft. Total sign(s). area I sq. ft. Building 'facade area (height .eft. X width ft:). 6036 sq. ft. (lf .a building has more than one business in: it, only measure the-area of the- building that is used by the:business- ,applying for this; permit:) 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 Data-0- nt Name,Stq, .-A/ T Forms /Building Division /Sign Permit Application.doc /CI C Sign ture CITY OF PORT At1!t'A J Constellation rs The Issuance of this permirdase upon these plans, q,.ecifi- cations and other dat: shall no prevent the buildinr official feprn thereafter re Uiririg-.ih correction of erro in said .ilar specificetifrns and her data, or from preventing building operat', ns bein carried on thereu der when in :;niation of ag`,ardes d ordinances of is jurisdiction. u j n Approvalpate 464k Vie„ -FQ I v55 tr5(101) «Z 5 Cr d w 77 6 L 7 0 v y c wd pivy Clallam County Assessor Treasurer Property Details 58023 CAMILLE HEADRICK. Page 1 of 3 Clallam County Assessor Treasurer Property Search Results 58023 CAMILLE HEADRICK for Year 2010 2011 Property Account Property ID Owner Name Mailing Address. 1 Taxes and Assessments Due Geographic ID 0630000231452001 Type Real Property Tax Information as of 03/04/2010 Amount Due if Paid on: 58023 Legal Description S2 LOT 10 BL 231 TPA 1/2 INT Tax Area. 0010 PA 121 PORT ST CNTY H2 L Land Use Code 65 Open Space N DFL N Historic Property N Remodel Property N Multi Family Redevelopment: N Location Address. 719 S LAUREL ST Mapsco PORT ANGELES Neighborhood: Cycle 5 Comm Map ID Neighborhood CD 20953140 CAMILLE HEADRICK 915 GLENBROOK CIR Ownership: PORT ANGELES WA 98362 -6736 First I Second 1 I, Half Half Statement Base i Base Amoy Year I ID Taxing Jurisdiction I Due Due i Penalty Interest Paid Due 2010 40998 ST SCH STATE SCHOOL $113 86 $113 86 $000 $0 00 $0 00 $22" 1 2010 4 CC -GEN COUNTY $60 59 $60 59 $0 00 $0 00 $0 00 $12 i 2010 40998 PORT PORT mm $8.52 $8 51 $0 00 $0 00 $0 00 $1 12010 40998 PORT ANG PORT ANGELES $140.28 $140.29 $0 00 $0 00 $0 00 $28( 1 2010 40998 SD #121 SCHOOL DISTRICT #121 $147 47 $147 48 $0 00 $0 00 $0 00 $29 2010 40998 NTH OLY L_ LIB NORTH OLYMPIC LIBRARY $17 60 $17 61 $0 00 $0 00 $0 00 $3: 2010 40998 HOSP #2 HOSPITAL #2 $24 86 $24 85 $0 00 $0 00 $0 00 $4i 2010 40998 WSMET PK DIST WILLIAM SHORE MET PARK DIST $7 91 $7 91 $0 00 $0 00 $0 00 $1: 1 2010 40998 CITY_STORMWATER CITY STORMWATER $18_ $18 $0 00 $0 00 $0 00 $3( 2010 40998 TOTAL. $539.09 $539.10 $0.00 $0.00 $0.00 $1071 2009 580232008 Si STATE SCHOOL $132.87 $132.88 $0 00 $0 00 $265 75 $l 2009 580232008 CC -GEN COUNTY $67.25 $67.24 $0 00 $0 00 $134 49 $1 2009 580232008 PORT PORT $9 53 $9 52 $0 00 $0 00 $19 05 $1 1 2009 580232008 PORT ANG PORT ANGELES $147 50 $147 49 $0 00 $0 00 $294 99 $1 L2009 580232008 SD #121 SCHOOL DISTRICT #121 2009 580232008 NTH OLY LIB NORTH OLYMPIC LIBRARY 12009 580232008 HOSP #2 HOSPITAL #2 12009 580232008 CITY_STORMWATER CITY STORMWATER 2009 580232008 TOTAL. Agent Code Owner ID Exemptions. 29674 100 0000000000% $16431 $164 33 $0 00 $0 00 $328 64 $19 54 $19 54 $0 00 $0 00 $39 08 $l $27 58 $27 58 $0 00 $0 00 $55 16 $18.00 $18 00 $0 00 $0 00 $36 00 $586.58 $586.58 $0.00 $0.00 $1173.16 $1 http. /vpn.clallam. net. 8084 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =58023 3/4/2010 .~.,. CERTI FICA=FE~:e:F~t;~lCCU P ANCY ,- "'.,1;:~" City'of-Port, Angele Building Division This C,. ifi~C!1fori i~sue.d pursuant to the requirements of Sectio .~109 of the Unifor"f)fButid.fng Cole' i:~'rtifying that at the time of issuance this ;t~ucture was in compliance with the various 'ordinances of the City regulating Building ~.l'>J I ' ?i construction or use. For the following: - ;~ Use ClassificatIOn CliNic Building Permit No: B~siness Name. Olympic Chirdpractic Clinic ~t 13 Group --IL- tl Type of Construction' - VN - ,- Use Zone: ~ CSD II T ownerofBUSmeSS/ReSideJ~: Dr. Paul Kendrick D.C. Address. 719 So. LaureL PortKngeles. W A 98362 ~ ~ ~ I Building Address '9"19 So. Laurel Street Port- Angeles. W AI.98362 ~\ ~~I > J:j:{J ~j- ~ I,r).:' ., anbary 14. 2004 .~ ii' . ~F Date '. P' '. '~"'''''''h<,''> l1fI:.;f"'7<. :,~"~:,,_,,_,,pspg~uous place. at be rem.QV~cffexee'pfJ)y;-a-uilding Official. :@.;.:~~rll;..JJ.~~_I':'\I"'I~:.lIJ)l4:l'r...~1'-;!'Jt."~.:Jlij.,~' ~ 'y(.t1d)f C I J 0 P f"<:i " I( P Vf I G- ~ ROUTING SLIP ~ 1"ORT ~'" lo~o<(t Certificate of Occupancy ~- L -=-.Jf =- ~ Certificate/Inspection Fee ~ "tSL1C wo'il:f.~ DATE lAAJV(- ~ La , l:xJ~ New Business .... ..... ..... .............. ( ) Adm;S of Proposed Business l \ Transfer of Business Location. . . . . . . . . . . . . . . . ( L-7 { 9 'S ~ J\--~ LA.-; ,,^- Change of Ownership . . . . . . . . . . . . . . . . . . . . . . ( ) Applicant \JI\.....L \<rLY'\.~l'-" ~ 0, L - New BUilding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( ) Address of I q ";':).....\-~ ~..J~<-\ Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( ) Vert ~,"",'p...\,,->. '--"--'~ C:;~) t L Temporary Business . . . . . . . . . . . . . . . . . . . .. . ( ) Phone: business 4~7-'%"2.<f'2... home {Sl-4'1s-13, Change of Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( ) Brief description of proposed business: C~ :r~~J'4-'--V\. L C.l =--""'\, l' L. Legal Description: Lot 10 Block L~\ Subdivision Current Use of Property: D~ D-<t:i(!JC" Zoning Classification of Property: C. 5. ];> WILL THERE BE ANY OF THE FOLLOWING? YES ~ THE FOLLOWING WILL BE REQUIRED: Construction changes . . -- PERMITS BUSINESS LICENSE Electrical changes . . _--L 1) BUilding 1) TaxI Mechanical (heating, cooling, stoves) . . . . _/ 2) Plumbing 2) Peddlers Plumbing changes _ ----L- 3) Electrical 3) 2nd Hand Dealer New or relocated signs ..... . --L- - 4) Mechanical 4) Pawn Broker New septic tanks _ ----L- 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? ---..L- - 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? . . .. . -L_ 15) Home occupation Are there eXisting sidewalks? . z== 16) Conditional use Is there curb and gutter? 17) Other Other ........ . -- I hereby apply for a Certificate of Occupancy and acknowl- 3~ edge that I have read this application and state that the Date: information I have supplied IS correct to the best of my knowledge. Signed: <~-- - ;:p~r; REJECTED Comments / Conditions Building Section '0/21./03 SR. Public Works Department Planning Department K0D Fire Department B J?-U./63 g \) City Clerk I I P.B.I.A. 01 C ti ( -J.' Ct , 11 ;0 1<6 0 "3 if~o~r""'q ~-l,~l'( <:rra'fp ~~ ~ "".~ CITY OF PORT ANGELES DEP AR TMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr. name Application description Property Zoning . . . Application valuation 03-00000302 719 S LAUREL ST 0630000231452001 PAUL KENDRICK Date 3/20/03 SIGNS 500 Owner Contractor HEADRICK CAMILLE 915 GLENBROOK CIR PORT ANGELES WA 983626736 EXTREME BUILDERS 632 LOPEZ PORT ANGELES (360) 417-0679 WA 98362 Permit Additional desc Permit Fee Issue Date Expiration Date SIGN 30.00 3/20/03 9/16/03 plan Check Fee Valuation .00 500 Qty Unit Charge Per 1.00 30.0000 PER S- SIGN LES THAN 25 SF Extension 30.00 ": - Fee swnmary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 30.00 30.00 .00 .00 Plan Check Total .QO .00 .00 .00 Grand Total 30.00 30.00 .00 .00 ......c f{ ...,.. ~ (. ~ ...... v -... Separate Permits are required lor 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 sarne 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 latin truction or e performance of construction. 7-- Signature of Contractor or Authorized Agent Date T:\PLANNING\FORMS\1102.15 [4/2002} BffiLDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE IJ','SPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOCNDA TION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE , BACK FLOW / WATER AIR SEAL WALLS I I CEILING I T I FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYWALL T-BAR I!\'SULA nON SLAB I T I WALL I FLOOR I CEILING I I I MECHANICAL HEAT PUMP WOOD STOVE I PELLET / CHIMNEY HOOD I DUCTS I'W llTlLlTlES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'5: WATERLINE I METER SEWER CONNECTION SANITARY STORM: PLAN~ING DEPT. SEPARA IE PERMlT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL JNSPECTlO~S REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE VES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGI]\;EERlNG FIRE 417-4653 FIRE DEPT. PLAJ'.;'NING DEPT. 417-4750 PLANNING DEPT. BUILDING 4174815 BUILDING T:\PLANNING\FORMS\1102.15 [4/2002] FOR OFFICIAL USE ONLY, BUILDING PERMIT - APPLICATION Date Rec.: Pennit #, f5(!) J Date Approved: Date Issued: Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for rey;ew. Uyou haye any qnestions, call (360) 4174815 Applicant or Agent: VA,uL "<Z.(.VI~J'\<-\::.., f'J. (. - Phone: Owner: f-;,-~",.r-D, ~4..i46../"~0.c... I <:\.,\.0;,01, ~\.'-"1..-W\=." ~.I'~~. Phone: Address: C( IS' (,\-t.",'v:,ro:.:>~ Cn.\.1... City: \>."A' \l.""'t....\"-~ ArchitectlEngineer: ~Contractor G .qj\~ Ci+ \ L '~ddress: SO Q./..J''-j L..q-'\,,-L- U>ROJEOf ADDRESS: It q LEGAL DESCRIPTION: Lot: I 0 t(s/ - ~) 1..<1'- 4")(- 1'Z..'S1.... Zip: <i~) ">6 '- ....~ Phone: Sta~ 'License #: L'f- \,(t.~ t.~x~~i..f" (.jut 1:>'" i, . -- . ..: City: <) ~ ~,--- S-A~ LAvr-G-..\ S, Block: '- ~ \ "I~1l, - Phont ~'\:lc 'f\ \ ~ i"~:-::i Zip:' 9 A. \ <6 '"L . ZONING: ... .l.. -. CLALLAM COUNTY PARCEL NUMBER: , Subdivision: " " .!. ....; .......... ...0' .J .*'1 ,...~ Credit Card Holder Name: Billing Address: CreditCardType VISA MC # TYPE OF WORK: SIZENALUATION: o Residential D NewCon~. E.~~-roQf 0 Stoye'SF.@$: '.. ISF..",,$. o Multi-family 0 Addition 0 Move 0 ,Garage SF. @ $ ISF. = $ [J Commercial 0 Remodel' 0 Demolition 0 Deck ~F. @ $ '/SF. = $ . . 0 Repair. 0 Sign 0 Other :TOTAL VALUATION $ ")~cc BRIEIWESCRIPTION OF THE PROJECT: LA";!, ""AA....<;;"1"'. ~b-fc\~..lt... lu'"'-\.\. """'- W"~\ . ,,>, ')',llc. ~ OV\.-L Ie> i'\'-V"'.A.'J Or-. & ~ ">T. SIAL- ,....., COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load: . Construction Type: ,. = TOT AIl Sq. Ft. % ...q~:... " Exp, Date: No. of Stories: _..1-ot Size~. __ Existing Sq. Ft. Existing roj co'{ral;; % 4= Proposed lot coyerage & Proposed S'2 .Ft. :-' % - Total lot coyerage " . ~. 0 - 0- -- . . \ . . .' . .(\P~E.%~~: A 1;2. 'to. ~rn .~ 4J.. , L -If) PLANNING USE ONLY: --f~A_6'-1~.f--~C PLAN, . ., - 100, . "fJo~ ( J b, BLDG: 1\ . ~ c..;y .~ I , ;, .1. Dl'wtJ:".' ~ , ESNWetland(s): 0 Yes 19"No Yes ~o . . FIRE: SEP A Checklist required? 0 Other: OTHER: - 0', . BillLDING PERMIT APPLiCATION SUBMITTAL: The Building Division can provide you with infonnatrlln on the application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a yaluation amount must be entered by the applicant. This figure will be reyiewed and may be reyised by the Building Division to comply with current fee schedules. Contact the Peimit Coordinator at'41T48 IS fm- assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building pennit .pplica,tion and construction plans are submitted. All other permit fees are due at the time of permit issuance. . . , EXPIRATION OF PLAN REVIEW: Ifno pennit 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 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. I am authorized to apply for this permff and understand that it is my responsibility to determine what permffs are required ,not the . ,a d that I such permits pr, to wf)P<' . BFORMSIAPPSlBuildingpenniLwpd Applicant: Date: 3 i!..."1 ( 0 3 ~ ,"aRT "'~ f~ iJ ~ '& ~<' ~ ~.'" DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION APPLICANT: ~ A-v~ ~~ 1'; LY-.... I () - C - PROJECT/DEVELOPMENT ADDRESS: "( ~ q c::,- PHONE: 4 '5/ - B '2- C) 1.... LAv-J'''-\ "S '\ See Page 4 for instructions on completing the site plan. For more information, caI/417-4815. , " IO/~ / / / f/, / '; V/ '1/ /1. /( /1 11/ /"'// , // //1// V; (VI ~ '; I /1// ,I 1/ I / f; 6 a Tf : L i\ \l. ~ I~ L S \. \.J.:' \'"" c\t 'U3~ . (i, "'A. (. t) Ib~ t/' . ~ ~ ..., . . ~ x. 14 S" x. 4- Y,- . . . . .~ v/ /, " la /) 1/ r. 1 ~ \. 'i "b ..'" . &~ 11 It. '" . ~ I'L :+. 8 1111 ~~. W . ~~ '. -;- 'll. 4- Y'l.. ~~ \....~o h ilr,;:r . ~ ')C.., . ., \ , t (0 (.' /! l C 1,,';, (j pr-cl,I,( C j, -'( I I 101"60 U1yt.t1t1'), C C ROUTING SLIP ,.MT~>\, !o~""'<,. Certificate of Occupancy ~~-.~ it' :;~+. L~ ~ ; "" Certificate/lnspection Fee - 't,""cw$~~ --- I /lA..V'( \", '71\ l~':)'~ DATE '-'-...J I New Business .. . . . . . . . . . . ........... ..... ( ) Ad~S of propos~ Business. ~ Transfer of Business Location. . . . . . . . . . . . . . . . ( '--l {<=1 -:.. '\-'\...'. llA.J~.-L- Change of Ownership. . . . . . ... ... ... ....." ( ) Applicant ~I\_A It(''-'''~J,~ 6 <- New Building ( ) . ........... . .......... ...... Address ''-1 I"" <:;:,>\-~ L..r.....J~<....\ Remodel. . . . . . . . . . . . . ................, '.. ( ) VV\ ~.'---.)',\~> , '-'--'\ c"1lS-3VL Temporary Business ........., ..... ........ ( ) Phone: business 4~7-~2."1'l home +s 2- "i~ Change of Use. . . . . . . . . . '.. ........,. ..... ( ) Brief description of proposed business: C~.\, .r",p" i,J-, L C L~'L Legal Description: Lot 10 Block Let., \ Subdivision r).(l.;; (I t1C . Current Use of Property: Dr- Zoning Classification of Property: C. <;. P WILL THERE BE ANY OF THE FOLLOWING? YES ~ THE FOLLOWING WILL BE REOUIRED: Construction changes. .......... - PERMITS BUSINESS LICENSE Electrical changes. . . . . -~ 1) Building 1) Taxi Mechanical (heating, cooling, stoves) . -~ 2) Plumbing 2) Peddlers Plumbing changes ............................. _-L. 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= 7) Driveway installation 7) Fireworks Is this a home occupation? ....... ........ -~ B) Curb installation B) Ambulance Excavation of filling of lots ............... _ ...L 9) Sidewalk obstruction 9) Tattoo shop Work done in City right-of-way. ....... ............ _ --L... 10) Water meter installation 10) Other Is there sufficient off-street parking? . --L_ 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? ...... ... --L_ 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: information I have supplied is correct to the best of my knowledge. Signed: ;~p~~ REJECTED Comments / Conditions Building Section Public Works Department Planning Department Fire Department City Clerk PB.I.A. 11 -'3 ..J J) ( [\ c> ~. ~ (C --