HomeMy WebLinkAbout102 W Front St - Building RECEIVED
CITY OF PORT ANGELES PERMIT APPLICATION V I
Building Division/Electrical Inspections
MAY
321 East fifth Street—P.O. Sox 11501 Port Angeles Washington,9$362
Ph: (360) 417-4735 Fax: (360) 417-4711 ��CZRICA�
Date: , 4— —Multi-Family or Commercial INSPECTIONS
*Plan Review M.ay e R� �qu[{ed, Phase Complete Electrical Plan Review Information Sheet
Job Address: -
Building Square Footage:
Description of above_ � r
Owner I f rmation Contractor Information
Name ckJ Name: _lest.Z'c .
Mailing ress, Malling ddress:%;3k
City: State:AV& Zip: s City: state: WA Zip: ga g�(o
Phone: Fax: Phone: 1X005562 Fax:
License#!Exp. License#I Exp._JF��j
Item Unit Charge Qtv Total(Qty Multiplied by Unit Charge)
Service/Feeder 200 Amp. $132.00 $
SenricelFeeder 201-400 Amp. $16000 $
Service/Feeder 401-600 Amp $225.00 $
SenricelFeoder 601-1000 Amp. $288.00 $
Service/Feeder over 1000 Amp. $410,00
$
Branch Circult WI Service Feeder $ 5,00 $
Branch Circuit W!0 Service Feeder $ 74,00 �_ $
Each Additional Branch Circuit $ 5.00 _ $16
Branch Circuits 1-4 $ 86.00 $ _
Temp.Service/Feeder 200 Amp. $102.00 _ $
Temp.SonricelFeeder 201-400 Amp, $121.00 $
Temp,Service/Feeder 401-600 Amp. $164.00 $
Temp Service/Feeder 601-100D 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 I First 1500 sf—Commercial $ 96.00 $
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-5KVA System or Less $113.00 $
Thermostat $ 56.00 $ _
Note $5.00 for each additional T-Stat
$ Total
Owner as defined by RCVV.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 296-4613,The City of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14.05.060 regarding Electrical Permit Applications
Signature of owner,electrical contractor or electrical administrator: ❑ cash ,1/Check
(�/ ❑ Cred'st Card#
0110712012
ELECTRICAL PERMIT
f/
CITY OF PORT ANGELES
360-417-4735
Application Number 14-00000513 Date 5/02/14
Application pin number . . . 645254
Property Address . . , . . , 102 W FRONT ST REPORT SALES T/.iX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1500-0090-
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name . . . . . . to the City of Port Angeles
Property Use , , . , , , .
Property Zoning , . , , , . , CENTRAL BUSINESS DISTRICT (Location Code 0502)
Application valuation , , . . 0
----------------------------------------------------------------- -__
Application desc
New Day Cafe
---------------------------------------------------------------------_-------
Owner Contractor
TURCO DARLENE RAE JEDI ELECTRIC
PO BOX 87 331 FORS RD.
JOYCE WA 98343 PORT ANGELES WA 98362
( 36) 417-2220 (360) 450-0556
- -----------; --- - _°_ ---------- ----- ---------- - ------ ----------
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc . ,
Permit Fee . . . . 84,00 Plan Check Fee 00
Issue Date 5/02/14 Valuation , . . . 0
Expiration Date 10/29/14
Qty Unit Charge Per Extension
1100 74,0000 ECH EL-COMM BRANCH CIR WO/ S/F 74.00
2.00 5,0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 10.60
.------------------------------------------------------___---_-__-- --------
Fee summary Charged Paid Credited Due
----------------- ---------- ------- -- ----------
Permit Fee Total 84.00 84.00 .00 .00
Plan Checic Total 00 .00 00 .00
Grand Total 84.00 84.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN i Ail
FINAL. )
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS P'IZOM LAST INSPECTION
Signature of owner or Electrical Contra_ctor X Date:
G:IEXCHANGEIBUILDING
o- o
C E FIT I F,ICATE, ,Q, F City of Port Angeles Building D ivision
This certificate is issuedpursuant to the requirements of Section 111 'of the 2009 International Building
Code certing that at the tame `o issuance this structure was in compliance with the various ordinances
of the City regulating M a „,__,:,,,„„..,..,-7,,,,77,...„..,, ontriction r use for the following
L f ,3 r A 3x
Y
a,� t
t
Business name: Ca Ne D ay s A
0
Business ad 102 W" Fron ,,T
p Property owner: Darlene Rae Tur k-i 1
Property owner's PO Box 8 7 Joyc WA98 3 x
Automatic fare sprinkler s y s te m: N ot<�Required ,..s
Use occupancy classification: Busine
Building permit number 12 -340
Occupant load: P 2009 IBC, Table 1004 1 "1
Type of construction. V Bp c 4 I
�'n twvJ`�.. .z.1.:...41,,,, sbF'.:�. L� d tai I N ✓.%"Y.1 =vY ,'S,j'
6 -22 -12
SRo
ue beres lanntng Man Date
Post on the premises in a conspicuous place ;y This., certificate shall not be removed except by the
Building Official.
.�.o
n 'ORTq c CERTIFICATE OF OCCUPANCY APPLICATION Permit I it �(V
FEES
g 161008 CITY OF PORT ANGELES $5o Certificate Inspection
t.... Attn: Permit Technician
I MP" 321 E. Fifth St., Port Angeles, WA 98352 1 $10r Parking Business Improvement Area (PBIA)
(360) 417 -4815 fax (360) 417 -4711 fee charged for Downtown locations
t I61 t/ 0'210I(1 a.
PLEASE PRINT IN INK 1
Check one: New business in P.A. Change of ownership only? Moving location from within P.A.? Zoning
BUSINESS NAME6CZCG Pc
Business address 0 �-w, 4, !6 Mailing address I 1 t. 5 111A crK 2,
Phone number 115-531 Opening dates' Days hours of operation ti,—
Business owner's name Av\ k i \AAt'...v -end Contact phone
Business owner's address 1).1 10 (t P,14 (p A. X362. I�h b tt�
Brief description of business o�c_..� 1 'rte r t'y) Scc1a� dup'�r ,5 1 hec`
L
Property owner name ar evle u Il p Co ntact phone
Property owner's address /contact`` MT/L /M I' r ties 462"' x) 20
B ldg approval by 3 �n 0 hI I 1 y
BUILDING DEPARTMENT phone 417 -4815 ®E
Is the business a restaurant or bar that will seat 50 or more people? Yes No R
RECEIVED
MAR 212012
Construction changes planned (moving walls, adding /enlarging windows Dr doors, roofing, siding, f5undation wor
stairways, ramps, bathrooms, electrical, heating /cooling /vEmtilation systems, etc). CITY OF PORT ANGELES
Work planned: c5 ∎rCk ciczu aimnINIP- fir!ON
FIRE DEPARTMENT phone 417 -4653 Fire approval by 154 'ZW
Changes to a fire sprinkler system or fire alarm system? Yips C❑ No Pi
Work planned: i
PBIA (Parking Business Improvement Area Downtown) phone 417 4623
Square footage of business? PBIA notified VA +�/6 """l 3'210'1 z.
Is business moving within the PBIA? Yes L7 No
CITY CLERK phone 417 -4634 City Clerk approval by n 7 F s 'LO
Second -hand dealer /pawnbroker business? Yes No I9f Will there be dancing at this business? Yes O No
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1, of 2
COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750 CED approval by i� 74 I •a.1
Number of off- street parking spaces available for Employees and 1 Pro td e5 r t
customers?
(A parking plan may be required.)
Si Signs? freestanding, �Sr �+>t
g g, projecting, awning, A- frame, etc
Signs planned:
vofzik as� ibirn 0-12- 2
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PWE approval by ��k/ 5 d��f
PUBLIC WORKS DEPARTMENT- ENGINEERING phone 417 -4812 y
Is site work planned (new or re- located sewer or water service, no S
excavation, grading or filling, work in City right -of -way,
new driveway openings, site drainage, parking lots. downspouts,
irrigation system backflow devices, etc.). Yes
Work planned:
PUBLIC WORKS WASTEWATER phone 417 485 PWW approval by f� Ytsska i
Will waste, other than domestic household waste, be discharged into the sewer system? Yes No L
If yes, what will be discharged:
Call for Certificate of Occupancy inspections BEFORE opening business.
Building Department Inspection 417 -4815
Fire Department Inspection 417 -4653
Please sign up for utility services at the cashiers' counter.
1 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 m. -sult in revocation of
permit. i
Date t k rint Name At1 ■tRooCJL Signature 1 1
T: \Forms \Building Division\Certificate of Occupancy Application (2010).doc
Page 2of2
OF p_R7q4
PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT
QUESTIONNAIRE and DISCLOSURE FORM
0 KS ANO
Complete all applicable sections. Information must be typewritten or clearly printed. Attach requested information as needed. Signing
official must have the authorization to provide such information on behalf of the company, corporation, or partnership.
Company .Name:
Mailing Address: 1 `x`1 1,--,, 1s e.F, t
Address of facility in Port Angeles (if different than above): to lo", t`� 1�3 ()31A- c? 5 S36
Contact Person: l v\--(r-tc Phone: o `I75 -531 9
1. Type of Industry: Standard Industrial Classification number (4 digit SIC code)
2. Type of Product(s) or Service(s) produced; rate of production; process used:
Type of product Rate of production Process
3. Product Volume: 4. Number of Employees: L
5. Operation Pattern: (hr /day) (days /yr) (mo /yr) 6. Water Usage (gpd): Average Maximum
7. WASTEWATER DISCHARGE TO SEWERS: [List the principal materials (cleaning agents, solvents, plating solutions, catalysts, process
chemical, etc) by their generic name and principal chemicals that are regularly used in your facility and that will or might be discharged to the City sewer
system]
AVERAGE DISCHARGE MAXIMUM DISCHARGE
TYPE OF MATERIAL
OR CHEMICAL GAL. TIME CONC. GAL. DURATION CONC.
PER DAY DURATION (MG /L) PER DAY (MG /L)
a) Process
b) Cooling
c) Sanitary
d) Others listed below
f
ex ample Deg1"easei (Trychloroethylene)_ 1 ..3_. .f 3PM,`30= mm /daya= 0., s 3...,;_ 10_AM„ fO mlNday i _.0.00tI
Gr r r c n r' S l .�P \1 V3 p
i� V r.C4' `l )''6)k t\- ',ve
QA/ okeli\ V\
Total Discharge
9. Are there seasonal variation to the above discharges? RECEIVED
PW- 804_02 page 1 MAR 2 2012
CITY OF PORT ANGELES
BUILDING DIVISION ,J
PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT
QUESTIONNAIRE and DISCLOSURE FORM (continued)
10. Does your company sample and analyze your wastewater? Yes E'No If yes, what is the nature of that sampling
program?
11. Discharge to sewerage system: Attach as "Exhibit 1" a plan of your property showing accurately the site plan, floor
plan, mechanical and plumbing plans and details showing all sewers, connections to the City systems, inspection
manholes,_sampling manholes, and.appurtenances by size, location.and_elevation.
a) How many wastewater discharge points does your company have that are connected to the City's sewer collection system? 6Y\ e—
b) Where are your discharge points located? `i'\e Nei.
12. Does your company have any plans for expansion? Yes Flo If yes, when and how would expansion alter your
industrial wastes?
13. Do you provide any pretreatment of wastewater streams that occurs prior to discharge to a sanitary sewer? des
No 1AcE_ w cc. C.tid� T J� SQ
14. Do you have a spill prevention, containment and control plan (SPCC) for your company? Yes C�IV.
15. Does your company have or plan to provide a parking lot, with a drain system to collect run off? Yes 1:1-tao
16. Do you dispose of any chemicals, solvents or hazardous materials to other than the sewer? Yes TI-1'4
17. If yes, provide a description of each material, giving the composition, solids content, annual quantity, means of
disposal, and ultimate disposal location:
18. Does your company have the necessary Material Safety Data Sheets (MSDS) on file? E'1'es No
19. List any prohibited pollutants being discharged as regulated by the City's Industrial Pretreatment Ordinance:
Pollutant Daily Max. Conc. (mg /I) Daily Avg. Conc. (mg /I)
20. List any environmental control permits that are held by or for your facility.
21. If additional pretreatment and /or operation and maintenance activities are required in order to comply with the City's
Industrial Pretreatment Ordinance, then the discharger shall provide a compliance schedule attached to this form which
describes how the facility will conform to the requirements.
The information contained in this questionnaire and disclosure statement is familiar to me and to the best of my
knowledge and belief, such information is t complete and a curate..
r
DATE:�"v�•�i2— Signaturo. I� L Title: OW`vQJ /(1))&.4-
NOTE: Attach additional pages, if n-eded.
RETURN TO:
City of Port Angeles Wastewater Treatment Plant
Attn: Superintendent
321 E. 5 Street
P. O. Box 1150
Port Angeles, WA 98362
PW- 804_02 page 2 [Revised 7/05)
Heather Catuzo
From: Alisha Hicklin
Sent: Tuesday, March 27, 2012 9:25 AM
To: Heather Catuzo
Subject: RE: Certificate of Occupancy -Cafe New Day
Yes Cafe New Day, and McMillan's as Jim called me yesterday and spoke to me about them. He said they had a GRS
installed so they is good also. Thank you!
Alisha
From: Heather Catuzo
Sent: Tuesday, March 27, 2012 9:22 AM
To: Alisha Hicklin
Subject: RE: Certificate of Occupancy -Cafe New Day
So we're ok on that one with you? O
From: Alisha Hicklin
Sent: Tuesday, March 27, 2012 9:21 AM
To: Heather Catuzo
Cc: Jeff Young
Subject: RE: Certificate of Occupancy -Cafe New Day
Oh....l actually talked to Kelli last week. I didn't realize this was the name of the place she was talking about. It is where
the old Rick's Place was, and yes they do have a grease trap. I also spoke to John's son Gallen who owns Sabai Thai and
Barg. Rick's place does have a grease trap in their basement. It needed to be cleaned more often, but it seemed to be
adequately sized. I will talk with them as Gallen asked Jessica Pankey if she could meet with them at the location and
then I could just go with her.
Alisha C>
Alisha Hicklin MNS
Wastewater Source Control Coordinator
City of Port Angeles Wastewater Treatment Plant
1509 E. Columbia St.
Port Angeles, WA 98362
Office: 360 417 -4845
Cell: 360- 461 -3396
E -mail: ahicklin @cityofpa.us
Always working for a safer and healthier City of Port Angeles
All e -mail sent to this address has been received by the City of Port Angeles e -mail system and is therefore subject to the
Public Records Act, a state law found at RCW 42.56. Under the Public Records law the City of Port Angeles must release this e-
mail and its contents to any person who asks to obtain a copy (or for inspection) of this e -mail unless it is also exempt from
disclosure under state low, including RCW 42.56.
CONFIDENTIALITY NOTICE
This e -mail message, including any attachments, is for the sole use of the intended recipients) and may contain confidential and
1
privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e -mail and destroy all copies of the original message.
From: Heather Catuzo
Sent: Tuesday, March 27, 2012 8:44 AM
To: Alisha Hicklin
Subject: RE: Certificate of Occupancy -Cafe New Day
The address is 102 E Front Street. I've attached the C of 0 application so that you can contact them. I've also put the
wastewater questionnaire response in Jeff Young's box.
From: Alisha Hicklin
Sent: Tuesday, March 27, 2012 7:20 AM
To: Heather Catuzo
Subject: RE: Certificate of Occupancy -Cafe New Day
Hello Heather,
With facilities that say they have a grease interceptor I still need to make sure that they have one and that it is
connected. I have been to a few places that have said they have had them, and they had but it was not properly
installed or is not properly installed. What is the address and I will stop by to check it out.
Thanks Heather! I hope things are going well in your new position!
Alisha O
Alisha Hicklin, MNS
Wastewater Source Control Coordinator
City of Port Angeles Wastewater Treatment Plant
1509 E. Columbia St.
Port Angeles, WA 98362
Office: 360- 417 -4845
Cell: 360- 461 -3396
E -mail: ahicklin @cityofpa.us
Always working for a safer and healthier City of Port Angeles
All e -mail sent to this address has been received by the City of Port Angeles e -mail system and is therefore subject to the
Public Records Act, a state law found at RCW 42.56. Under the Public Records law the City of Port Angeles must release this e-
mail and its contents to any person who asks to obtain a copy (or for inspection) of this e -mail unless it is also exempt from
disclosure under state law, including RCW 42.56.
CONFIDENTIALITY NOTICE
This e -mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and
privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e -mail and destroy all copies of the original message.
From: Heather Catuzo
Sent: Monday, March 26, 2012 9:54 AM
To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds; Edith Parker; Rick Hostetler; Alisha Hicklin; Jeff Young;
ipankey @co.clallam.wa.us
Subject: Certificate of Occupancy -Cafe New Day
2
Hi all,
Here is the application for Cafe New Day. Please respond via email by April 4, 2012.
There are applications in house for sign permits and a minor remodel project. We have provided the Wastewater
questionnaire for them and they say they have a grease interceptor.
Thank you,
Heather Catuzo
Building Permit Technician
City of Port Angeles Building Division
321 East 5th Street
Port Angeles, WA 98362
(360) 417 -4817
hcatuzo @cityofpa.us
3
Heather Catuzo
From: Sue Roberds
Sent: Thursday, May 24, 2012 11:49 AM
To: Heather Catuzo
Subject: RE: Certificate of Occupancy Cafe New Day
No land use issues noted. The site is in the CM zone where restaurant/food service uses are expected. PBIA provides parking.
Sue Roberds
Planning A4anager
('in- q/Port Angeles
P.O. 13os 1150
Port Angeles, IV'A 98362
sroberds(8citvofpa.us
360 -417 -4750
From: Heather Catuzo
Sent: Wednesday, May.23, 2012 3:54 PM
To: Roger Vess; Sue Roberds; Janessa Hurd
Subject: Certificate of Occupancy Cafe New Day
Hi all,
Please comment on the attached as soon as possible. Thank you.
Heather Catuzo
Building Permit Technician
City of Port Angeles Building Division
321 East 5th Street
Port Angeles, WA 98362
(360) 417 -4817
hcatuzopcityofpa.us
1
CERT /FlC TEf OF OCCUPANCY APPLICATION
0` ?OR TA NG.. rt Permit l2 NO
Ar~ FEES
Ir I CI 5 ORT ANGELES $50 Certificate Inspection
Attn: Permit Technician
'fit" 321 E. Fifth St., Port Angeles, WA 98352 l $10 Parking Business Improvement Area (PBIA)
(360) 417 -4815 fax (360) 417 -4711 fee charged for Downtown locations
it 4 7 4 1.i01(7 al
PLEASE PRINT IN INK
Check one: New business in P.A. ?l4' hange of ownership only? .11 Moving location from within P.A.? Zoning
BUSINESS NAME Ct_c•2 ■Cu
Business address efi_ 4t 1 A. 56 Mailing address I VI Z. 'Sl 1 Gg3
Phone number -n5 1c-k Opening dates- Days hours of operationjN,—
Business owner's name hA e{e_.1l`► \AR i, nO` Contact phone 11 5386
Business owner's address 1).:1, l G G'14. ''%.--36'7.\,
L G j 3
Brief description of business c 1
a res vozsro q 53L-1-: s et. c •L� kv
Property owner's name Oar (evie .f u rCo Concact phone
Property owner's address /contact ,-opr -11 e s X52-' 1 20
BUILDING DEPARTMENT phone 417 -4815 Bldg approv I by nn__
RECEIVED di
Is the business a restaurant or bar that will seat 50 or more people? Yes 'No L�
Construction changes planned (moving walls, adding/enlarging /enlarc: in windows ar doors, roofing, siding, flu dation�worko' 2012
9 P 9 9 19 9. 9.
adding /altering stairways, ramps, bathrooms, electrical, heating /cooling /v:mtilation systems, etc).
CITY OF PORT ANGELES
Work planned: O' derv t./._ loa r BUILDRAIGDIVIEION
FIRE DEPARTMENT phone 417 -4653 Fire approval by_ Gbi J'Z3 V
Changes to a fire sprinkler system or fire alarm system? Yes No Pl
Work planned:
`t
PBIA (Parking Business Improvement Area Downtown) phone 417 4623 f
Square footage of business? 2�`� ,CO -�-ci PBIA notiriedV �,Saon` 3-2.6'1 z..
Is business moving within the PBIA? Yes I P1 No
CITY CLERK phone 417 City Clerk approval by O 7 on g1/1
Second -hand dealer /pawnbroker business? Yes No Lf
Will there be dancing at this business? Yes No UV
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
=CITY OF PORT ANGELES
w DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
IL- 1113=-17
'I 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 12- 00000467 Date 5/09/12
Application pin number 865310
Property Address 102 W FRONT ST
ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -0- 1500 -0000- REPORT SALES TAX
Application type description COMM REMODEL on your state excise tax form
Subdivision Name
Property Use to the City of Port Angeles
Property Zoning CENTRAL BUSINESS DISTRICT (Location Code 0502)
Application valuation 415
Application desc
ADDING WINDOWS TO EXTERIOR OF BAR
Owner Contractor
TURCO DARLENE RAE OWNER
PO BOX 87
JOYCE WA 98343
36) 417 -2220
Structure Information 000 000 RESTAURANT
Construction Type UNKNOWN
Occupancy Type BUSINESS:OFF /PRO /MED /REST
Permit BUILDING PERMIT COMMERCIAL
Additional desc ADD NEW WINDOWS TO BAR AREA
Permit Fee 50.00 Plan Check Fee 32.50
Issue Date 5/09/12 Valuation 415
Expiration Date 11/05/12
Qty Unit Charge Per Extension
BASE FEE 50.00
Permit MECHANICAL PERMIT
Additional desc PROPANE GAS APPLIANCES
Permit Fee 71.30 Plan Check Fee .00
Issue Date 5/09/12 Valuation 0 11" /f I
Expiration Date 11/05/12 Vb
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 10.6500 EA ME- STOVE /FIREPLACE /MISC. APP. 10.65
1.00 10.6500 EA ME -FUEL GAS PIPING,1 -5 OUTLETS 10.65
Other Fees STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 121.30 121.30 .00 .00
Plan Check Total 32.50 32.50 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 158.30 158.30 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work 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 g nting of a permit does
not presume to give authority to violate or cancel the provisions of any stat- or local law regulating constructiGn or the performance of
construction. I
Date Print Name Signature of Contractor or Authori. ed Agen Signatur of Owner (if owner is builder)
T:Forms /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 COVE =R, 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:
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 FINAL Date J Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists Girders Under Floor
Shear Wall Hold Downs
ty9 alls Roof Ceiling G? DI'
Drywall (Interior Braced Panel Only)
T -Bar
INSULATION:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line Gj I (p I a- T fr L-
Wood Stove Pellet Chimney V r
Commercial Hood Ducts FINAL Date x •31 ta by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit I#s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750 T
Building 417 -4815 �8 c1
lA r- woVl (j, a I la-
NUndr t.Is
T•Fnrmc /Riiilriinn nivisinn /Riiilriinn Permit
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CITY OF PORT ANGELES
321 E 5TH STREET,
P.O. BOX 1150
PORT ANGELES WA 98362
C E R T I F I C A T E O F O C C U P A N C Y
T E M P O R A R Y
Issue Date 6/01/12
Expiration Date 7/03/12
Parcel Number 06-30-00-0-0- 1500 -0000-
Property Address 102 W FRONT ST
PORT ANGELES WA 98362
Subdivision Name
Legal Description LOT 1 BL 15 UND 1/3 INTEREST E
ACH
Property Zoning CENTRAL BUSINESS DISTRICT
Owner TURCO DARLENE RAE
Contractor
Application number 12- 00000340 000 000
Description of Work CO- CHANGE OF OCCP /USE
Construction type
Occupancy type
Flood Zone
Special conditions
June 1, 2012 9:48:37 AM pbarthol.
Issuing temp CO so business can open on 6 -3 -12 prior to all
corrections being made.Items in question are handrails, exit
signage, emergency lighti g.
Approved
Building Official
VOID UNLESS SIGNED BY BUILDING OFFICIAL
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BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
Attn: Building Permit Technician For City Use Only:
321 E. Fifth St., Port Angeles, WA 98362 Date Received
Nerga (360) 417 -4815 fax (360) 417 -4711 Permit
Date Approved if ra
Applicant _J -t- K ,6 -t-i nfY1 YY10 t'Z.ol Phone S--Gj" j
Property Owner V- 1- Le r1'1 -5r p0Cr e,t 5Phone
Property Owner's Address 'IDa(i -e \e -770
Contractor Phone
Contractor's Address
License Expires E -mail
PROJECT ADDRESS C( W FiDe S` ?o r-t Ainey(eS W-Ar
Parcel Number 0( 50 0 OCD 1OQ Lot Zoning
Project Type Brief Description; o Residential Multi family i=tCommercial Industrial
Check all that apply
o New Construction
Addition
)(Remodel A.6A new )c4evior w rd ows ID bar are&-
Repair
o Demolition
Re -roof House garage other o tear off re -roof lay over one layer
Heat System Heat pump o wood- burning stove o gas fireplace pellet stove other
Other Pro i)c re.'J elk" {h'ilc/ Ve..fy r, r itzb
Floor Areas Existing (sq. ft.) Proposed (sq. ft.)
Basement per sq, ft,
1 Floor
2 Floor
3` Floor
Garage
Carport
Covered PI r.
Deck
Shed��
Other AP'
67 7 57 `;7 7 1 7 TOTAL VALUATION
Total footprint of struc urn e sq. ft. T Lot size sq. ft. Lot coverage oh
Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exernptions) Site coverage
Max. height of proposed structures ft. Occupancy group of bedrooms
Will a lawn sprinkler system be installed? Occupant load of full baths
Will 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.
Date Print Name Signature
T :Forms /Building Division /Building permit application
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mutv CITY OF PORT ANGELES
(74
DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
J
Application Number 12- 00000314 Date 3/29/12
Application pin number 150016
Property Address
v ASSESSOR PARCEL NUMBER: 06-30 -00-0- 0-1500 -0000- REPORT SALES TAX
A,.,/ t Application type description COMM REMODEL on your state excise tax form
Subdivision Name
ellOWP Property Use to the City of.Port Angeles
Property Zoning CENTRAL BUSINESS DISTRICT
(Location Code 0502)
Application valuation 3494
Application desc
v COMM REMODEL. REMOVE 2 WALL SECTIONS
t
Owner Contractor
TURCO DARLENE RAE OLYMPIC RESTORATIONS INC
.p 'r PO BOX 87 1604 E 4TH ST
JOYCE WA 98343 PORT ANGELES WA 98362
36) 417 -2220 (360) 460 -0463
Structure Information 000 000
Construction Type UNKNOWN
Occupancy Type BUSINESS:OFF /PRO /MED /REST
Permit BUILDING PERMIT COMMERCIAL
Additional desc REMOVE 2 WALL SECTIONS
Permit Fee 123.75 Plan Check Fee 80.44
Issue Date 3/29/12 Valuation 3494
Expiration Date 9/25/12
Qty Unit Charge Per Extension a t t5 1?
BASE FEE 95.75
2.00 14.0000 THOU BL- 2001 -25K (14 PER K) 28.00
Special Notes and Comments
March 28, 2012 3:47:59 PM kdubuc.
Kitchen hood and duct fire suppression system (including
fire extinguisher) must be within service periodicity at
time of opening.
March 27, 2012 8:28:44 AM sroberds.
The proposal is to place 2 signs in the CBD for a total of
48 sq.ft. of signage. 106 sq.ft. possible. No land use
issues anticipated.
March 27, 2012 10:03:03 AM banders. OK
Other Fees STATE SURCHARGE 4.50
Fee summary Charged Paid Credited Due
Permit Fee Total 123.75 123.75 .00 .00
Plan Check Total 80.44 80.44 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 208.69 208.69 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
fgr 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
It not presume to give authority to violate or cancel the provisions of any state or local law reg lating construction or the performance of
t construction.
-R9-la Xdl 1' nmo�r� J(41 El ti
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /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
N t�
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:
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 FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING: 15 )9 31/(/
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 FINAL Date Accepted by
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
�vr= f fi
Building 417 -4815 2 -1 1 2- �LL
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p°l:'.,.v BUILDING PERMIT APPLICATION Print in ink
(s Cr
CITY OF PORT ANGELES For City Use Only:
If >,,.„:4
Attn: Building Permit Technician Date Received '5 -201Z
321 E. Fifth St., Port Angeles, W. 98362 10
'NEW (360)
(360) 417 -4815 fax (360) 41 7 -4711 Date Approved
*I Applicant 1 keit,, r„ e l Ph e `M
Property Owner 121- 14 Lei'h St PO AN des, wA q %9e
Property Owner's Address "j r o Y(.end pO e,px.,gi c u( 0 1343
Contractor 01
1 Phone 4-..00�'0!-Cr3
Contractor's Address' I (Dog. b 51" Po tr+ An es I Ar 3 (per
License OLyMpg $o, 61e., Expires V 9I E -mail
PROJECT ADDRESS 162. V) .1 y 5-1' Po 14 An9. 1es1 W ol 9E30- 4,
Parcel Number Lot Zoning
Project Type Brief Description: Residential Multi- family mmercial Industrial
Check all that apply
New Construction (Gwtau� c9 IA 04,41-4?(41 r�c� c�n
n rh\t l pia L 414.o✓iA.�., nem\
Addition t
ten. mcxoe., @or_.11:■ 1A,{eke.cn ak.v.r- A
Remodel o� u»h: o l w o •3 ''e ?a:04- We.�S
Repair
Demolition
Re -roof House garage other tear off re -roof lay over one layer
Heat S Heat pump wood- burning stave o gas fireplace pellet stove other
Other
Floor Areas Existing (sq. ft.) Proposed (sg. ft.)
Basement per sq. ft.
1 Floor 17 L4 1 Met-. ��4—
2 Floor
3rd Floor
Garage
Carport RECEIVED-
Covered Porch
Deck pecrri :2_0V-
Shed MAR 2 01012 V10
Other
CITY OF PORT ANGELES
BUILDING DIVISION TOTAL VALUATION 3 clLt
J
Total footprint of structures sq. ft. Lot si >e sq. ft. Lot coverage
Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage
Max. height of proposed structures ft. Occupancy group of bedrooms am.
Willa lawn sprinkler system be installed? Occupant load of full baths
Will a fire sprinkler system be installed? Construction type of half baths e
I have read and completed this application and know it to be true and :.orrect. I am authorized to apply for this permit nderstand
that it is my responsibility to determine what permits are required, and io obtain permit.; prior o ag on projects.
Date 2_0- Print Name a- Z 5y�\-�
Signature i 1
41
T:Forms /Building Division /Building permit application
\A
Properties by
LAFIDNAR
Inc.
330 E. 1st Street, Suite 1 Port Angeles, WA 98362
Ph. (360) 452 -1326 Fax: (360)457 -3212
Website: portangeleslandmark.com Email: info @portangeleslandmark.com
LEASE AGREEMENT— COMMERCIAL PREMISES
This lease made this 16th day of March 20 12 by and
between Properties bv Landmark, Inc. (hereinafter called
Lessor), agent of Robinson Warren Building Company, and
John Kelli Hammond dba Cafe New Dav
(hereinafter called Lessee):
WITNESSETH:
1. PREMISES: Lessor does hereby lease to Lessee, those certain premises
commonly known as:
102 W Front Street, Port Angeles, WA 98362
As shown on Exhibit A attached hereto, (thereafter called "premises being
situated upon land described in Exhibit A, attached hereto.
2. TERM: The term of this lease shall be for five (5)
commencing the 1st day of April 20 12 and
shall terminate on the 31st day of March 20 2017
3. RENT: Lessee covenants and agrees to pay Lessor, at the office of Lessor,
Properties bv Landmark, Inc.. 330 E 1st Street. Suite 1. Port Angeles, WA 98362
or to such other party or at such other place as Lessor may hereafter designate,
monthly rent in the amount of One thousand three hundred fiftv
dollars ($1.350.00) in advance, on the first day of each month of the lease
term. If Lessee is in possession of the premises for a portion of a month, the
monthly rent shall be prorated for the number of days of Lessee's possession
during that month. Any rental payments received eleven or more days after the
beginning date of each rental period will be subject to a service charge of
$10.00 on the 6th plus 1% of monthly per day thereafter until paid in full.
4. UTILITIES AND FEES: Lessee agrees to pay all charges for light, heat, water,
sewer, garbage, drainage, metro and all other utilities and services to the premises
during the full term of this lease. Above items, if any, included in the rent payment
are water All other items including all license fees
and other governmental charges levied on the operation of Lessee's business on
the premises will be paid directly by Lessee. In the event the leased premises are
ZLO /Z00'd 800# 9£:5L ZLOZ /0Z /£0 LLLtLLb09£L :Ol :wojd
a part of a building or larger premises to which such charges are charged as a
whole, with the consent of the Lessor, then Lessee agrees to pay, upon demand, a
proper and fair share of said charges.
Should there presently be in effect or should there be enacted during the term of
this lease any law, statute or ordinance levying any tax (other than Federal or State
income taxes) upon rents, Lessee shall pay such tax or shall reimburse Lessor on
demand for any such taxes paid by Lessor.
5. COMMON AREAS: If the premises are part of a building occupied by other
tenants, Lessee agrees to conform to Lessor's rules and regulations pertaining to
the parts of the building that are in common use by tenants.
6. REPAIRS AND MAINTENANCE: Premises have been inspected and are
accepted by Lessee in their present condition. Lessee shall, at its own expense
and at all times, keep the premises neat, clean and in a sanitary condition, and
keep and use the premises in accordance with applicable laws, ordinances, rules,
regulations and requirements of governmental authorities. Lessee shall permit
no waste, damage or injury to the premises; keep all drain pipes free and open;
protect water, heating, gas and other pipes to prevent freezing or clogging; repair
all leaks and damage caused by leaks; replace all glass in windows and doors of
the premises which may become cracked or broken and remove ice and snow
from sidewalks adjoining the premises. Except for the roof, exterior walls and
foundation, which are the responsibility of the Lessor, Lessee shall make such
repairs as necessary to maintain the premises in as good condition as they now
are, reasonable use and wear and damage by fire and other casualty excepted.
7. SIGNS: All signs or symbols placed by Lessee in the windows and doors of the
premises, or upon any exterior part of the building, shall be subject to Lessor's
prior written approval. Lessor may demand the removal of signs which are not so
approved, and Lessee's failure to comply with said request within forty-eight (48)
hours will constitute a breach of this paragraph and will entitle Lessor to terminate
this lease or, in lieu thereof, to cause the sign to be removed and the building
repaired at the sole expense of the Lessee. At the termination of this lease,
Lessee will remove all signs placed by it upon the premises, and will repair any
damage caused by such removal. All signs must comply with sign ordinances
and be placed in accordance with required permits.
8. ALTERATIONS: After prior written consent of Lessor, Lessee may make
alterations, additions and improvements in said premises, at Lessee's sole cost
and expense. In the performance of such work, Lessee agrees to comply with all
laws, ordinances, rules and regulations of any proper public authority, and to save
Lessor harmless from damage, loss or expense. Upon termination of this lease
and upon Lessor's request, or Lessor's approval, Lessee shall remove such
improvements and restore the premises to its original condition no later than the
termination date, at Lessee's sole cost and expense. Any improvements not so
removed shall be removed at Lessee's expense provided that Lessee shall pay for
any damage caused by such removal.
9. CONDEMNATION: In the event a substantial part of the premises is taken or
damaged by the right of eminent domain, or purchases by the condemner, in lieu
ZLOICOO'd 800# 9£ :S1 ZIOZ /OZ /£0 LLLVLlb098 :01 :moaj
thereof, so as to render the remaining premises economically untenantable, then
this lease shall be canceled as of the time of taking at the option of either party. In
the event of a partial taking which does not render the premises economically
untenantable, the rent shall be reduced in direct proportion to the leased property
taken. Lessee shall have no claim to any portion of the compensation for the
taking or damaging of the land or building. Nothing herein contained shall prevent
the Lessee from his entitlement to negotiate for his own moving costs and his
leasehold improvements.
10. PARKING: Lessee understands that parking is apportioned in conformity with
controlling zoning ordinances and that Lessor shall have the right to make such
regulations as Lessor deems desirable for the control of parking automobiles on
the real property described in Exhibit "A" or property under Lessor's control,
including the right to designate certain areas for parking of the Lessee, employees
of Lessee, his customers and other Lessees of said building.
11. LIENS AND INSOLVENCY: Lessee shall keep the premises free from any liens
arising out of any work performed for, materials furnished to, or obligations
incurred by Lessee and shall hold Lessor harmless against the same. In the
event Lessee becomes insolvent, bankrupt, or if a receiver, assignee or other
liquidating officer is appointed for the business of Lessee, Lessor may cancel this
lease at its option.
12. SUBLETTING OR ASSIGNMENT: Lessee shall not sublet the whole or any part
of the premises, nor assign this lease without the written consent of Lessor, which
will not be unreasonably withheld. This lease shall not be assignable by operation
of law.
13. ACCESS: Lessor shall have the right to enter the premises at all reasonable
times for the purpose of inspection or of making repairs, additions and alterations
and to show the premises to prospective tenants for sixty (60) days prior to the
expiration of the lease term.
14. POSSESSION: If for any reason Lessor is unable to deliver possession of the
premises at the commencement of the term of the lease, Lessee may give Lessor
written notice of its intention to cancel this lease if possession is not delivered
within (30) days after receipt of such notice by Lessor. Lessor shall not be liable
for any damages caused by delay, and Lessee shall not be liable for any rent until
such times as Lessor delivers possession. A delay of possession shall not extend
the term or the termination date. If Lessor offers possession of the premises prior
to the commencement date of the term of this lease, and if Lessee accepts such
early possession, then both parties shall be bound by all of the covenants and
terms contained herein, including the payment of rent during such period of early
possession.
15. DAMAGE OR DESTRUCTION: In the event the premises are rendered
untentantable in whole or in part by fire, the elements or other casualty, Lessor
may elect, at its option, not to restore or rebuild the premises and shall so notify
Lessee, in which event Lessee shall vacate the premises and this lease shall be
terminated; or, in the alternative, Lessor shall notify Lessee, with thirty (30) days
after the notice of such casualty, that Lessor will undertake to rebuild or restore the
?I.O /1700'd 800# Lc :sI. ZIOZ /OZ /£0 IILt7L11709£1 :01 :woJd
premises, and that such work can be completed within one hundred eighty (180)
days from date of such notice of intent, and Lessee may elect, at its option, to
terminate this lease. If Lessor is unable to restore or rebuild the premises with the
said one hundred eighty (180) days, and Lessor did not earlier elect to terminate,
then the lease may be terminated at Lessee's option by written ten (10) day notice
to Lessor. During the period of untenantability, rent shall abate in the same ratio
as the portion of the premises rendered untenantable bears to the whole of the
premises.
16. ACCIDENTS AND LIABILITY: Lessor or its agent shall not be liable for, and
Lessee agrees to defend and hold Lessor and its agents harmless from, any claim,
action and /or judgment for damages to property or injury to persons suffered or
alleged to be suffered on the premises by any person, firm or corporation unless
caused by Lessor's negligence.
Lessee agrees to maintain public liability insurance on the premises in the
minimum limit of $100,000 for property damage and the minimum of
$300,000/$300,000 for bodily injuries and death, and shall name Lessor as an
additional insured. Lessee shall fumish Lessor a certificate indicating that the
insurance policy is in full force and effect, the Lessor has been named as an
additional insured, and that the policy may not be canceled unless ten (10) days
prior written notice of the proposed cancellation has been given to Lessor.
17. SUBROGATION WAIVER: Lessor and Lessee each herewith and hereby
releases and relieves the other and waives its entire right to recovery against the
other for loss or damage arising out of or incident to the perils described in
standard fire insurance policies and all perils described in the "Extended
Coverage" insurance endorsement approved for use in the state where the
premises are located, which occurs in, on or about the premise, unless due to the
negligence of either party, their agents, employees or otherwise.
18. DEFAULT AND RE- ENTRY: If Lessee shall fail to keep and perform any of the
covenants and agreements herein contained, other than the payment of rent, and
such failure continues for thirty (30) days after written notice from Lessor, unless
appropriate action has been taken by Lessee in good faith to cure such failure,
Lessor may terminate this lease and re -enter the premises, or Lessor may, without
terminating this lease, re -enter said premises, and sublet the whole or any part
thereof for the account of the Lessee upon as favorable terms and conditions as
the market will allow, for the balance of the term of this lease and Lessee
covenants and agrees to pay to Lessor any deficiency arising from a re- letting of
the premises at a lesser amount than herein agreed to, Lessee shall pay such
deficiency each month as the amount thereof is ascertained by Lessor. However,
the ability of Lessor to re -enter and sublet shall not impose upon Lessor the
obligation to do so.
19. REMOVAL OF PROPERTY: In the event Lessor lawfully re- enters the premises
as provided herein, Lessor shall have the right, but not the obligation, to remove all
the personal property located therein and to place such property in storage at the
expense and risk of Lessee.
20. COSTS AND ATTORNEY'S FEES: If, by reason of any default or breach on the
Zl0 /GOO'd 800# L£ :5[ ZLOZ /OZ /£0 L LLtL1.t709£1 1uoad
part of either party in the performance of any of the provisions of this lease, a legal
action is instituted, the losing party agrees to pay all reasonable costs and
attorney's fees in connection therewith. It is agreed that the venue of any legal
action brought under the terms of this lease may be in the county in which the
premises are situated.
21. SUBORDINATION: Lessee agrees that this lease shall be subordinate to any
mortgages or deeds of trust, placed on the property described in Exhibit A,
provided that in the event of foreclosure if Lessee is not then in default and agrees
to attorn to the mortgagee or beneficiary under deed of trust, such mortgagee or
beneficiary shall recognize Lessee's right of possession for the term of this lease.
22. NO WAIVER OF COVENANTS: Any waiver by either party of any breach hereof
by the other shall not be considered a waiver of any future similar breach. This
lease contains all the agreements between the parties; and there shall be no
modification of the agreements contained herein except by written instrument.
23. SURRENDER OF PREMISES: Lessee agrees, upon termination of this lease, to
peacefully quit and surrender the premises without notice, leave the premises neat
and clean and to deliver all keys to the premises to Lessor.
24. HOLDING OVER: If Lessee, with the implied or express consent of Lessor, shall
hold over after the expiration of the term of this lease, Lessee shall remain bound
by all the covenants and agreements herein, except that the tenancy shall be from
month -to- month.
25. BINDING ON HEIRS, SUCCESSORS AND ASSIGNS: The covenants and
agreements of this lease shall be binding upon the heirs, executors,
administrators, successors and assigns of both parties hereto, except as
hereinabove provided.
26. USE: Lessee shall use the premises for the purpose of:
fnnrl, rnvPragP R havPra0P sarvina as a nafe, light raining
and for no other purpose, without written consent of Lessor. In the event Lessee's
use of the premises increases the fire and extended coverage of liability insurance
rates on the building of which the premises are a part, Lessee agrees to pay for
such increase.
27. NOTICE: Any notice required to be given by either party to the other shall be
deposited in the United States mail, postage prepaid, addressed to the Lessor at:
Properties by Landmark. Inc., 330 E 1st Street. Suite 1. Port Angeles. WA 98362
or to the Lessee at: 102 W Front Street, Port Angeles, WA 98362
or at such other address as either party may designate to the other in writing from
time to time.
28. RIDERS: Riders, if any, attached hereto, are made a part of this lease by
reference and are described as:
see attached addendum which becomes part of lease terms.
Z L0 /900'd 800# 8£:51_ ZLOZ /OZ /£0 LLLVLLb09£1 :tuo.J
29. TIME IS OF THE ESSENCE OF THIS LEASE
30. If Lessee is a corporation, each individual executing this lease on behalf of said
corporation represents and warrants that he is duly authorized to execute and
deliver this lease on behalf of said corporation in accordance with a duly adopted
resolution of the Board of Directors of said corporation or in accordance with the
By -laws of said corporation and that this lease is binding upon said corporation in
accordance with its terms. If Lessee is a corporation Lessee shall, within thirty
(30) days after execution of this lease, deliver to Lessor a certified copy of a
resolution of the Board of Directors of said corporation authorizing or ratifying the
execution of this lease
IN WITNESS WHEREOF, the parties hereto have hereunto set their hands the
date first above wri en.
I
LESSEE: 4 f►FI i.� LESSEE: A a (4 d
(si. J (signature)
LESSEE: n LESSEE: Ki 1 f rittn ?f714/14
(print) (print)
LESSOR: DATE:
Properties by Landmark, Inc.
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Exhibit A
Property address /legal description as taken from assessor's website of property:
102 W FRONT ST
PORT ANGELES, WA 98362
RESTAURANT DIST 010
0010 PA 121 PORT ST CNTY H2 L WMP
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Properties by
LAN.DMARK Inc.
330 E. 1st Street, Suite 1 Port Angeles, WA 98362
Ph. (360) 452 -1326 Fax: (360)457 -3212
Website: portangeleslandmark.com Email: info @portangeleslandmark.com
Addendum
To
Lease Agreement
Dated
March 14, 2012
Between
Properties by Landmark, Inc.
And
John KeIIi Hammond
Dba
Cafe New Day
The following terms and conditions are mutually agreed upon between Lessor and Lessee
and become a part of the commercial lease agreement.
1. Lessor grants permission to Lessee to:
a. Replace and rehabilitate the flooring in the kitchen area at Lessee's expense.
b. Install a propane tank outside the building in the alley and fuel lines through the
building to the unit for use in food preparation in the kitchen. Location of tank
and fuel lines to be determined by the fire marshal) and city building inspector.
This work to comply with all codes and at the Lessee's expense.
c. Open the north wall of the existing lounge area facing Front Street to possibly
expose covered windows or create a space to install new windows. This
expenditure completed at Lessee's cost.
d. Relocate the restrooms to be near each other at some point in the future. This
construction to be performed according to city codes and completed at
Lessee's expense.
e. Reside on the second level (space above the commercial unit) for residential
occupancy as long as they are Lessor's of the business at 102 W Front Street.
Lessor agrees to upgrade the space to make it tenantable at Lessor's expense
and agrees to meet all required codes. Any extra expense or cost charged to
Lessor will be passed onto the Lessee. Otherwise, Lessee is allowed to
reside without an increase in rent because Lessee is assuming all costs to
improve the space for residential occupancy.
2. Lessor agrees to ensure the existing tenant leave the following in place when they
vacate:
a. Kitchen hood system.
b. Corner booth in bar.
c. Compressor for walk -in cooler.
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Cafe New Day
Lease Addendum
Page 2
3. Lessor agrees to remove the bar from the lounge area or will split the cost for
Lessee to remove it upon possession.
4. Lessor agrees to allow Lessee to:
a. Remove carpet in the dining and bar areas.
b. Install new floor coverings in the same.
c. The cost of which will be divided equally between both parties. The Lessee
will front the cost and is entitled to take their half investment off in monthly rent
payments with a maximum reduction of 50% of monthly rent until covered in
full. Expected total outlay of cost is about $5,000 of which the tenant can
recoup half or about $2,500 by monthly deductions in rent not more than
$675 /month until fully recouped, or about three to four (3-4) months.
5. Lessor grants a 5 (five) year renewal option once the original 5 (five) year lease
expires. Terms to be negotiated at least 90 (ninety) days in advance of lease
expiration. Notice to accept renewal option must be in writing. Lessor given the
right to increase the rent at option renewal with a cap of 10% of monthly rent.
IN WITNESS WHEREOF, the p es hereto have hereunto set their hands the date first
above wri
i
LESSEE: I, i LESSEE: 1
1 ignatu (signature)
4
LESSEE A l4AG'va LESSEE: <1 I �kY�1 fl 00
l C
(print) (print)
DATE: 3- D 1 DATE: 3` ao 1
LESSOR: DATE:
Properties by Landmark, Inc.
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STATE OF \N\ aJY \.Y\-
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COUNTY OF C___\ ((v1 p,�
On this day personally appeared before me \(1Q,1kl. �'UcJI.VMAv\
to me known to be the individual described in an who executed the within a9d
foregoing instrument, and acknowledged that kX \o,w,v.,o
signed the same as \,\X x .-ko, vN.n .-s�o free and voluntary act
and deed, for the uses and purposes therein mentioned.
Given under my hand and official seal this 7Q "day of 20 I
N omilliw o 41,"
.A` Q,EN Po
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EXP. 08/25/2015
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STATE OF 015 l eiV\
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On this day personally appeared before me J On V, C�C01\1\Wl. O
to me known to be the individual described in an who executed the within nd
foregoing instrument, and acknowledged that Al.. ko.Ann
signed the same as c 0.lnn free and voluntary act
and deed, for the uses and purposes therein mentioned.
Given under my hand and official seal this �,eday of �v �UPrTAA. 20 12.
��`•�Q.�N E PO 1
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44 i
PROPERTY MAN AGEMENT, INC
501 E. FIRST 329 S. THIRD, SUITE B
PORT ANGELES, WA 98362 P.O. BOX 906 SEQUIM, WA 98382
(360) 452 -1326 Fax (360) 457 -3212 (360) 683 -3338 a Fax (360) 683 -3556
LEASE AGREEMENT COMMERCIAL PREMISES
This lease made this 10th day of April 19 97 by and
between Landmark Property Management, Inc., (hereinafter called Lessor),
agent of Robinson Warren Building Company, and Rickey D. Mathis
(hereinafter called Lessee):
WITNESSETH:
1. PREMISES: Lessor does hereby lease to Lessee, those certain premises
commonly known as
Harrington Building. 102 W Front Street, Port Angeles, WA
Legally described as Lot 1 Block 15 of the original Townsite
of Port Angeles, Clallam County, WA. Except the 1800 sf
occupied by North Light Gallery.
as shown on Exhibit B attached hereto, (thereinafter called "premises being situated
upon land described in Exhibit A. attached hereto.
2. TERM: The term of this lease shall be for five (5) y ear commencing the
1 day of August 19 97 and shall terminate on the 31st day
of July ,20 02
3. RENT: Lessee covenants and agrees to pay Lessor, at the office of Lessor,
Landmark Property Mgnt, Inc. 501 E`1st, Port Angeles, WA 98362
or to such other party or at such other place as Lessor may hereafter designate,
monthly rent in the amount of Dollar;
in advance, on the first day of each month of the lease term. If Lessee is in
possession of the premises for a portion of a month, the monthly rent shall be prorated
for the number of days of Lessee's possession during that month. Any rental payments
received eleven or more days after the beginning date of each rental period will be
subject to a service charge of n/a
4. UTILITIES AND FEES: Lessee agrees to pay all charges for light, heat, water,
sewer, garbage, drainage, metro and all other utilities and services to the premises
during the full term of this lease. Above items, if any, included in the rent payment are
water All other items including all license
fees and other governmental charges levied on the operation of Lessee's business on
the premises will be paid directly by Lessee. In the event the leased premises are a
part of a building or larger premises to which such charges are charged as a whole,
Harbor.Ise 1
N
I
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CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East 5'h Street, Port Angeles, WA 98362
Application Number 12- 00000567 Date 5/17/12
Application pin number 762740
Property Address 102 W FRONT ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0- 1500 -0000-
Application type 'description HOOD /DUCT SUPPRESSION SYSTEM on your state excise tax form
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 1800
Application desc
NEW SUPPRESSION FOR EXISTING HOOD
Owner Contractor
TURCO DARLENE RAE PENINSULA FIRE INC
PO BOX 87 PO BOX 1744
JOYCE WA 98343 POULSBO WA 98370
36) 417 -2220 (360) 598 -3300
Permit HOOD DUCT SUPP SYSTEM
Additional desc NEW SUPPRESSION IN EXISTING HO
Permit Fee 40.00 Plan Check Fee .00
Issue Date 5/17/12 Valuation 0
Expiration Date 11/13/12
Qty Unit Charge Per Extension
1.00 25.0000 ECH HOOD /DUCT INSPECTION /TESTING 25.00
1.00 15.0000 ECH HOOD /DUCT PLAN REVIEW 15.00 fi N n s✓` 1 y
Special Notes and Comments 1 l`(''"Y C/
A FULL ACCEPTANCE TEST WILL BE REQUIRED FOR THIS HOOD AND
DUCT FIRE SUPPRESSION SYSTEM. THE TEST WILL INCLUDE A
BALLOON TEST, AS WELL AS A TEST OF THE FUSIBLE LINK, MANUAL
PULL STATION AND UTILITIES SHUT -OFF.
Fee summary Charged Paid Credited Due
Permit Fee Total 40.00 40.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 40.00 40.00 .00 .00
This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
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 recognized standards, laws and ordinances governing this type of work will be compied
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the provi r s of any state or local law regulating the work specified in the permit.
gnatu /of ontractor or Authorized Agent Date Signature of Owner (if Owner is builder) Date
FIRE PERMIT INSPECTION RECORD
Call 360 417 -4655 for fire inspections. Please provide a minimum 24 -hour notice. It is unlawful to cover, insulate
or conceal any work before inspected and accepted. Post permit in a conspicuous location.
KEEP PERNIIT CARD AND APPROVED PLANS AT JOB SITE
Inspection Type: Date Passed Comments
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough -in inspection
Alarm final
LP -GAS Completed by Contractor:
Underground piping inspection /pressure test Test #1
Above ground piping inspection /pressure test Piping pressure test psi
Time initiated
Tank (container) inspection Test #2
Appliance inspection Piping pressure test psi
Time initiated
LP -gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Removal of flammable /combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER (specify)
permit final Fj.a3 ��r Z
1
GENERAL COMMENTS:
2/15/00
c)12 r FIRE-RELA TED PERMIT T P LICA TOOK
CITY OF PORT ANGELES For City Use Only:
f Attn: Building Permit Technician Date Received-578//Z-
321 E. Fifth St., Port Angeles, WA 98362 Permit l9 6
(360) 417 -4815 fax (360) 417 -4711
Applicant fi t 14,5 CA lc?, 7, Phone L36a 5 -G7 7n
Property Owner Phone
Property Owner's Address 4' fovcf St tJ 'J
Contractor Phone
Contractor's Address
License p/AlI /d to Q Expires)/, E mailpul -Fireau1 f °r►r, gvtnai
V
CC) Al
PROJECT ADDRESS 6-Q
c KJ fa. i LS-4
Project Business Name AfTc
Fire Alarm System Residential Multi- family Commercial Industrial
Check all that apply
Briefly describe the project:
One addressable loop
One zone
Additional zones
List quantity of additional zones
PROJECT VALUATION (labor materials)
Fire SprinklerSystern Residential Multi- family Commercial Industrial
Check all that apply
Briefly describe the project: IRECEIVED
Installing backflow protection device(s)?
yes ❑no MA`( 8 2012
<2 inch water, line (list.quantity of devices)
>2 inch water line (list quantity of devices)
PROJECT VALUATION (labor materials) C
Hood Duct Fire Suppression System Residential Multi- family
Commercial Industrial
Check all that apply
Briefly describe the project:
Will only the fire suppression system be installed or altered?
-eyes no
Will a hood and /or ductwork be installed or altered?
yes* no
If yes, a mechanical permit will also be needed.
PROJECT VALUATION (labor materials) ti
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 ring on projects.
Date b �i �er,9 Print Name gCriSCA Signature
T: Forms /Building /Fire related permit application
c-nt,
CITY OF PORT ANGELES
ft DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 12- 00000313 Date 3/27/12
Application pin number 828591
Property Address 102 W FRONT ST
ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -0- 1500 -0000- REPORT SALES TAX
Application type description SIGNS on your state excise tax form
q..
Subdivision Name
Property to the City of Port Angeles
Property Zoning CENTRAL BUSINESS DISTRICT (Location Code 0502)
Application valuation 200
Application desc
*1.5. 2 -24 SF SIGNS
Owner Contractor
TURCO DARLENE RAE OWNER
PO BOX 87
9 JOYCE WA 98343
36) 417 -2220
Permit SIGN
Additional desc 2 -24 SF SIGNS
Permit Fee 94.00 Plan Check Fee .00
Issue Date 3/27/12 Valuation 200
Expiration Date 9/23/12
Qty Unit Charge Per Extension
2.00 47.0000 PER S -ALL SIGNS OR TO 25 SF 94.00 1ha `r� Q
Special Notes and Comments
March 27, 2012 8:27:52 AM sroberds.
The proposal will result in interior remodel of an existing
restaurant. No land use issues anticipated.
Fee summary Charged Paid Credited Due
Permit Fee Total 94.00 94.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 94.00 94.00 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work 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
fp
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
R-7 I
Ki 1 HH h'1 rn0r1r)
L►vwl.d►1 d
w Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
7:Forms /Building Division /Building Permit
czumim
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS _3
Building Inspections 417 4815 Electrical Inspections 417 4735
Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886
cue ntr
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: avnitx rL
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 FINAL Date Accepted by
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 FINAL DateteNEWecepted b
MANUFACTURED HOMES:
Footing Slab
Blocking Hold Downs
Skirting
PLANNING DEPT. Separate Permit #s SEPA:
Parking Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE
Inspection Type Date Accepted By
Electrical 417 -4735
Construction R.W. PW Engineering 417 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815 L'at t?
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SIGN PERMIT APPLICA TION Print in ink
CITY OF PORT ANGELES
.rtr F or City Use Only:
t z Attn: Building Permit Technician Date R eceived 3'ZF� I
321 E. Fifth St., Port Angeles, WA 98362 k
Z w
(360) 417-4815 fax (360) 417-4711 Permit 1 ate Approved 40.0ir
Applicant or Agent 3 e .„2,` LA 1AA Phone :3(c0-77.5_531t9 Property Owner A, CO t Phone
Property Owner's Address U 1( 10A g V oyCe, v\t.A q834--
Contractor N/A Phone
Contractor's Address
License Expires
Project Address ‘p r Qta ■-e 9t 32
Business Name c tv&p
4
Parcel Number 0Lp�0007 CSC- @C7Lot LOA O Zoning
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.
Sign Type Brief Description: (Type, location, sq. ft.)
RECEIVED
Si #1 "n��.r-\-erk pl`.�i�x 2`-t s�-a
Sign #2 MAR 2'0,7017
Sign #3
Sign #4 CITY OF PORT ANGELES
BUILDING DIVISION
Totals (Unit charges Sign(s)
Unit Charge Quantity multiplied by quantities) Type of Sign Valuation 2-00
$47.00 x X Lt All signs less than or equal to 25 sq. ft.
$85.00 x Wall sign or marquees, over 25 sq. ft.
$115.00 x Freestanding sign or projecting sign, over 25 sq. ft.
GRAND TOTAL Make Checks Payable to: City of Port Angeles
✓i Credit Cards (Except American Express) are accepted
Existing sign(s) area sq. ft. Proposed sign(s) area ti 6 sq. ft. Total sign(s) area -LAB sq. ft.
Building fagade area (height IC 2_ ft. X width H5 ft.) 530 sq. ft. (If a building has more than one
business in it, only measure the area of the building facade 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
apply for this permit and understand that it is my responsibility b 'ie rmine what .-rmits are
required, and to obtain permits prior to working on projects. ewe
Date Print Name 3a 1 Signatu a ,,fIJ
T:Forms /Building Division /Sign Permit Application.doc
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CITY O pC T A laps, sp cifi
Issuance of t th p official
The fssu his permit based upon a shell ,e vent the building
}r, rorrect;on of errors in said
p
cations are other eats ing not p or freers preventing
lan thereafter requiring ,ata,
specifications and other do v,hen in
building R �,a;ried or thereunder
operations beta urisdicho
building p s and ordir oes of this 1
violation of all codes 1 ab�
By
Approval Date
ill `''i
i's. rt. �D
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4e 44-4- il,r(it 6164
4-0 '.Jo[t 0 p9ore
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CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East 5th Street, Port Angeles, W A 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
08-00000053 Date
620707
102 W FRONT ST
06-30-00-0-0-1500-0pOO-
FIRE ABANDON TANK INSPECTION
1/14/08
CENTRAL BUSINESS DISTRICT
o
Owner
Contractor
TURCO DARLENE RAE
PO BOX 87
JOYCE
( 36) 417-2220
WA 98343
3 KINGS ENVIRONMENTAL INC
PO BOX 280
BATTLE GROUND WA 98604
(360) 666-5464
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
UNDERGROUND TANK COMM
TNK REMVL WTR MN PRJCT UN SKWK
119057
100.00 Plan Check Fee
1/14/08 Valuation
7/12/08
.00
o
Qty Unit Charge Per
BASE FEE
Extension
100.00
Fee summary Charged Paid Credited Due
----------------- --------...- ---------- ---------- ----------
Permit Fee Total 100.00 100.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total :1.00.00 100.00 .00 .00
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This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with
180 days from the last inspection. I hereby certify that I have read and examine:! this application and know the same to be
true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compied
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the provisi~any state or local law regulating the work specified in the permit.
~ ~ }r/'-1-0V'
Signature of Contractor or Authorized Agent Date Sjgnature of Owner (if Owner is builder) Date
- '.--.--- -------
. -
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Call 360-417-4655 for fire inspections. Please provide a minimum 24-hour notice. It is unlawful to cover, insulate tJ1
or conceal any work before inspected and accepted. Post permit in a conspicuous location. ~
FIRE PERMIT INSPECTION RECORD
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough-in inspection
Alarm final
LP-GAS Completed by Contractor:
Underground piping inspection/pressure test Test # 1
Above ground piping inspection/pressure test Piping pressure test pSI
Time initiated
Tank (container) inspection Test #2
Appliance inspection Piping pressure test pSI
Time initiated
LP-gas final
UNDERGROUND STORAGE TANK (UST) ABANDONMENT
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final 'l15"/08 Kbt
I ,
PERMIT OTHER (specify)
permit final
Inspection Type
I Date Passed I
Comments
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GENERAL COMMENTS:
,----
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BUILDING PERMIT APPLICA TION 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
For City Us~ pnly'
Date Received ((l1/0B
Permit # ~e. - tt)("3
Date Approved I.//~/ p.
Applicant or Agent ~u\tV ~ I L;" Phone g 60 .6 b /;, - S-'1 b~
Property Owner CJ 6~ ea.-+-)IIiV s- /A-) Phone
Property Owner's Address ;lj), t. (;;- ,>1"h 5+- I p<P~-r f:}--<.J) 1$ /&4S J,J l4-
Contractor/Engineer "3 I<-I,v~ S. _ Phonr
Contractor/Engineer's Address c ()o'j. J..8"6 f3,i4ff-L<J )!..bv-6 wY-+- 9%66'-/
License # Expires
PROJECT ADDRESS
~ fD 2- \...) ~~ tV
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Lot
(...../ f.1-
Parcel Number
Zoning
Proiect Tvpe & Brief Description: o Residential ~mmercial o Multi-family o Industrial
Check all that apply
o New Construction
o Addition
o Remodel
o Repair
oRe-roof
o Demolition
o Sign o wall-mounted o projecting o freestanding Dawning o other
Total sian area sq. ft. Maximum allowed siqn area sq. ft.
o Heat System o Heat pump 0 wood-burning stove 0 gas fireplace 0 pellet stove 0 other
o Other
Floor Areas Existinq (Sq. ft.) Proposed (sq. ft.)
Basement @$ per sq. ft. = $
151 Floor
2nd Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALVA TlON $
sq. ft.
ft.
Lot size
sq. ft. = Lot coverage
# of bedrooms
# of full baths
# of half baths
%
Total footprint of structures
Max. height of proposed structures
Will a lawn sprinkler system be installed?
Will a fire sprinkler system be installed?
Occupancy group
Occupant load
Construction type
I have read and completed this application and know it to be true and correct.
understand that it is my responsibility to determine what permits are require
projects0 ~ ('... ~ J 1 \
Date [] i oY' Print Name 'viAl) e -11-\4...... vc. l"...)
.
T:Forms/Building Division/Bldg Permit Appl.-2006 Code.doc
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PORT ANGELES FIRE DEPARTMENT
Permit Attachment
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Abandonment or Removal of Commercial Underground
T ariks
Applicant is required to funlish the following information before a perm# may
/ LJ / . be processed..
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Removal of all flammable or combustible liquid from the tank and all
cormecting lines shall be pwnped out. Use a hand pump or other means
to remove remaining flammable liquid as far as practical. Liquid shall
be placed in a tank truck or suitable containers for removal.
'I-, ~ ~ 4. Disconnect the suction, inlet, gauge, and vent lines. Cap or plug open
ends of lines which are being removed and those which are not to be
used any further.
Dat~ Initial
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Size and number of tanks to be removed. S-o 0 ~ 1+-1 )0 r-
Fill out tank closure work ~l1eet (attached). ~
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Submit diagram of tank. location.
Section II ~ Requirements and Limitations
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Issuance of permit subject to compliance with recognized standards, listed
requirements and approval by a field inspection from the Port Angeles Fire
Department.
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Provide one fire extinguisher with a minimwn rating of 40-B-C.
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There shall be no welding or other sources of ignition in the area while
abandoning operations are in progress. Welding or cutting on tank
requires a permit from the Port Angeles Fire Department.
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FP - 25 (Revised 2/22/00) Page 1 of 2
Date Initial
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5.
When capping or p~ugging all tank openings, use screwed plugs and
leave 1/8 inch vent Ii~le in one plug to allow for temperature expansion.
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Tanks should be conditioned and flammable vapors removed by adding
dry ice in the amount of 1.5 pounds per 100 gallons of tank capacity.
. The dry ice should be crushed and distributed evenly over the greatest
possible area to secure rapid evaporation. NOTE: Removal of ignition
sources from the vicinity of the tank or container before venting
operations are started shall be considered including all ,electrical
eq,~ipment it1 the vicin.i!y.
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This process does not ensure a gas free tank and the tank shall not be
welded upon unless certified by a qualified engineer after a test. " '.
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If the tank must be stored on site, the tank shall be placed in a secure
location and blocked to prevent movement. The tank would also be
required to be inerted a second time before ~eing allowed to 1?~..
transported.
Refill bole with suitable material (earth, sand, etc.)
Tank is to b~ inspected by a Fire Department inspector prior to bejng
transported.
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If the tank is to be abandon in place, remove all flammable and
combustible liquids, fill the tallk completely with an inert solid
material. Cap remaining underground piping.
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Additional comments and/or requirements
I have read and understand the requirements of this application.
App6cant's signature ~
Date: \ I \ 'I t b Y
FP - 25 (Revised 2m/DO)
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To be completed by City of Port Angeles:
Permit #
Page 2 of 2
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TANK CLOSURE WORKSHEET
Tank Owner C 1 \--1 1) F pu.....-\.- '~qc) 14-5
Address 1 b '2. V..I €J t- r::u..o.#}- 5' f- -
Regulating AgeD cy(ies)
Department of Ecology 1-800-826-7716
, Port Angeles Fire Department 360-417-4653
P. A. Public Works Dept. 360-417-4803
Phone No.J6o 907 L) If>l tJ
Notified
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[ ]
Permit Issued
[ ]
[ ]
[ ]
Contr~_ctQr Q.!lm~(s) .J()b
~3 ~I(VJ 5 f?vvvl/1..0~r-srVtJ4:-L
(excavation, de-gassing, sludge disposal, tank disposal, cleanup, transport, other - describe)
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Tank closure start date ~( 1->.
Tank. c10sure completion date ) 11 ~
TANK CLOSURE INlTIAL PROCEDURES:
Follow safety measures
[Obtain recom~ended safety equipment
[t[ Avoid contact with product
[~ond or ground equipment
[q-lJrain product from piping
[ V Disconnect, then cap or remove piping
[~e!llove product and residuals from tank
[ i- Excavate to tank top
[V Remove drop tube, fill pipe, gauge pipe, vapor
rec<lvery tank connections, submersible
pumps and other tank fixtures
[Vlemporarily plug all other tank openings
except the vent line Purge tank of flammable'
vapors
ABANDONMENTIN~LACE
(see below if tank is removed)
I )n~ Cut holes in tank top if necessary
lV Clean and inspect tank
Fill tank as full as possible with inert
mixture until filling overflo'ws tank opening
[ ] Plug or cap all openings
[ ] Disconnect ana cap or remove vent line
[ ] Diagram of tank locati~m
Site specific requirements:
[ J
[ ]
[ ]
OA TH: I certify that the information concerning the removal or abandonment oftank(s) is true to the best of
my belief and knowledge.
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Name Date
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT
OWNER/APPLICANT
RICK D. MATHIS
102 W. FRONT
Port Angeles, W A 98362
360/452-8683
T:
S:
ISSUED: 10/22/2002 PERMIT NO: 13797
PROPERTY LOCATION
102 FRONT W
Lot: 1
Block: 15 J:g] Long Legal
Subdivision: TPA
Parcel No:
CONTRACTOR
OWNER
VARIOUS
Port Angeles, W A 99360
206/000-0000
PROJECT INFO
Project Value: $1,700.00
Project Type: AWNING
Occupancy Type: COMMERCIAL
Occupancy Group:
Construction Type:
Zoning Use: CBD
ARCHITECT
N/A
, 98360-0000
360/000-0000
SFD Units: 0
SFD sa FT: 0
MFD Units. 0
MFD sa FT: 0
Commercial:
Industrial:
Garage:
o
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PROJECT NOTES
INSTALL NEW AWNING & REFACE EXISTING SIGNS
RECEIPT#9835
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving.
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$60.10
$0.00
$4.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
II
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Misc Fee 1:
Misc Fee 2:
Misc Fee 3:
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$0.00
$0.00
$0.00
TOTAL FEE:
AMOUNT PAID:
BALANCE DUE:
$64.60
$64.60
$0.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined thiS application and know the same to be true and correct All provisions of
laws and ordinances governing thiS type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the proviSions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or AuthOrized Agent
T \PLANNING\FORMS\1102 15 [4/2002]
Date
/0 ~ 2- '7-0 '2-
Date
BUILDING PERMIT INSPECTION RECORD
, .
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN \ II 1
WATER LINE
GAS LINE
BACK FLOW /WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION I
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engmeenng DIVISIon) SEPARATE PERMIT #'s
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARATE PERMIT #'s SEPA
PARKING/LIGHTING ESA
LANDSCAPING SHORELINE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES 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 / ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 PLANNING DEPT
BUILDING 417-4815 i~/b-o~ J-El-/ BUILDING
T \PLANNING\FORMS\1102 15 [4/2002]
Port Angeles. VVa hington
360-417 -9548 . Fax 360 52-6778
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360-417 -9548 . Fax 360-452-6778
we.. AlZe AppL'(~3 For- A pel'fh~T 70 puT
Up fli1l IIw,.;r,.;!J fiT /02 W Fro,.;, 51 P.fl. {jIO\f'bDf'
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ouT CJP / /I S9V~f'€- 5~-e-L 7Ulob/~g W'f!.-Lled 7OgB-~el' WI17..
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]A/FbI'(YJu-Ti~ Fe~/ F/'ee... 70 Co../I Jv11k-e-. Ar Lf/7-95''I8 '
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . .
REQUEST:
DateJ - IS-- OS
Time
Received by
12L1
(phone, person)
INSPECTION NOTES:
c'
Inspected: Date /;, f; ~,' () ,
Remarks:
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one): Permit No. l ~1rt:r1
Sewer Foundation Framing Chimney Plumbing ~ewer Excav. Other ~ [':~~:'""~):::L--:
.A\AJ~"uf.Q r ;
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Phone No. ~52 -~6 93
Time
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, /" . ('
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved DGravel D Asphalt D PCC
D Other
D Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
~TRFFT ~lJPFRINTFNnFNT
(DATE)
. . CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
OWNER/APPLICANT PROPERTY LOCATION
102 FRONT W
RICK D. MATHIS Lot: 1
102 W. FRONT
Port Angeles, WA 98362 Block: 15 [] Long Legal
360/452-8683 Subdivision: TPA
T: S: Parcel No:
CONTRACTOR ARCHITECT
OWNER N/A
VARIOUS
Port Angeles, WA 99360 , 98360-0000
206/000-0000 360/000-0000
PROJECT INFO
Project Value: $6,000.00 SFD Units: 0 Commercial: 0
Project Type: INT. REMODEL SFD SQ FT: 0 Industrial: 0 "~
Occupancy Type: COMMERCIAL Garage: 0
Occupancy Group: MFD Units: 0 ~
Construction Type: MFD SQ FT: 0
Zoning Use: CBD ~
PROJECT NOTES
INTERIOR REMODEL, ADD PUMBING, FIRE SPRINKLER ADDITION
RECEiPT/t~9976 ~
FEES ASSESSMENT
Building Permit: $125.25 Misc Fee 1: FIRE INSPECTIO $100.00
Plan Check: $0.00 Misc Fee 2: PLAN REVIEW $50.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0,00 TOTAL FEE: $306.75
Plumbing: $27.00 AMOUNT PAID: $306.75
Mechanical: $0.00 BALANCE DUE: $0.00
Radon: $0.00
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
[or a period of t 80 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
construction.
Signature of Contractor or Authorized Agent Date Signature of Owner (if 0w~er is builder) Date
:~,?LA]qN[NGLFOI~M~I 102,15 [4/~002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-481 $ FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
INSPECTION TYPE I DATE IyEsACCEPTED[ NO COMMENTS
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
:::: I I I
FOROFFICI. ALI QUSE NLY:
Date Rec.:
BUILDING PERMIT - APPLICATION
Dat~ Approved:
Date Issued:
T~e Building Permit dpplication must be ffdled out completely.
Please type or print in ink. If you have any questions, please call 417-4815
Architect/Engineer: Phone:
Contractor License #: Exp: Phone:
Address: City:. Zip:,
PRoJZCT n n ss:, /0 ,2 co' s 7- zola:
LEGAL DESCRIPTION: Lot: Block: Subdivision:
CLALLAR4 COUNTY PARCEL NUl~BER: Credit Card Holder Name:
Billing Address: City:.
Credit Card #: Exp. Date: VISA MC
TYPe: OF WORK: SIZE/VALUATION:
[] Residential [] New Cons~. El Re-roof [] Wood-stove 7~a GF. ~ $. /BF.
E1 Multi-family [] Addition [3 Move [] Garage SF. ~ $ /SF. = $
~ Commercial ,~ Remodel [] Demolition El Deck SF. ~ $. /8F.
[] Repair [] Sign [] TOTAL VALUATION
COMMERCIAIdRESIDENTIAL: Occupancy Group:. Occupant Load: Comtmction Type:.
No. of Stories: ~ Lot Size: %. Lot Coverage: %
Existing Lot Coverage: /sq. It. + Proposed Lot Coverage: /sq. ft. = TOTAL LOT ~OVERAGE: /sq. ft.
PLANNING USE ONLY: .. APPROVALS: - PLAN
Notes: BLDG.
DPW
ESA/Wetland(s): El Yes El No SEPA Checklist required? El Yes [] No Other: OTHER
BUILDING PER.MIT APPLICATION SUBMITTAL: Your ap~lieation and siteplan must befilled out completely to be accepted for
review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your
completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division.
VALUATION OF CONSTRUCTION: In all eases, a valuation amount must be entered by the applicant. 2'his figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and constmctian plans are submiRed. All other
permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this 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, and [ am authorized to apply for
this permit. 1 understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's
responsibility to determine what permits are required and to obtath such.
Applican~/'P'-~ ( _a ate: //-/~"-'0~
T:~FORMGL~PPS'~uildingpermJt
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date / ~ -//~ ~ ~ ~ Time Received by {phone, person)
Location of Work to be inspected ~~
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one)~ Permit No.>,:,~, ,~, ,-~".,~ ~ -
Sewer Foundation Framing Chimney(~,.Plum~//Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date [ ~ Time By
Remarks:
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel []Asphalt E~]PCC []Other
~-1 Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
~1 No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT {DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST: ,
Date /;/' //~/~ Time ~) ~'O/// Received by
*~- (phon~, person)
Name of person requesting inspection
Address of person requesting inspection /~ ~-~
Type of Inspection (circle appropriate one): Permit No.
Plumbing Fina~l~ewer Excav.
Sewer Foundation Framing Chimney ~...-~ Other
INSPECTION NOTES:
Inspected: Date /~ '~ ~'~ Time_ By
Remarks:
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved [~Gravel [~Asphalt [~PCC []Other
[] Repaired by City Work Order #
~-] Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
PORT ANGELES FIRE DEPARTMENT
102 East 5th, Port Angeles, WA 98362
360-417-4653
Fire Sprinkler System Plan Review
Project Name: Harbor Caf6 Address: 102 W Front
Installer: The Fire Guys Telephone: 417-0505
Type of System: Wet R-3 [] R-1 [] Corn []
Date: November 27, 2002 Permit #02-14
We have checked this plan and find that it conforms to thc requirements of our ordinance.
Additionally:
1. All systems including underground mains, shall be installed by a state licensed and certified
company as prescribed in WAC 212-80 and the system shall be installed as per NFPA 13.
2. System will require witnesscd hydrostatic test and inspection by the Port Angeles Fire
Department prior to being covered.
3. Before final acceptance of the system, an inspection will conducted by the Port Angeles Fire
Department to ensure the system installation complies with NFPA 13.
[] Contractor Reviewed by
[] Building Department
[] Fire Copy Date
FP-9 Pagelof 1
CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000425 Date
768925
102 W FRONT ST
06-30-00-0-0-1500-0000-
RICKS PLACE
6/24/05
SIGNS
~0~
4/~I/Uo
CENTRAL BUSINESS DISTRICT
1500
Owner
Contractor
TURCO DARLENE RAE
PO BOX 87
JOYCE
( 36) 417-2220
OWNER
<0
~
WA 98343
50526
132.00
6/24/05
12/21/05
E
permi t . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SIGN
Plan Check Fee
valuation
.00
1500
~
\)
Z
-i
Qty
1. 00
1. 00
Unit Charge Per
85.0000 PER S- SIGN WALL 25 SF+
47.0000 PER S- SIGN LES THAN 25 SF
Extension
85.00
47.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 132.00 132.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 132.00 132.00 .00 .00
~
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
nu II 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
construction.
or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:IPolicicsll102 \ 5 building pcm1it inspecbon record05.wpd [1/4/2005]
BUILDING PERMIT INSPECTION RECORD
CALL 4]7-48]5 FOR BUILDING INSPECTIONS. CALL 4]7-4735 FOR ELECTRICAL INSPECTIO',3.
CALL 4] 7-4807 FOR PUBLIC WORKS UT]LITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
.,...,~
FOUNDATION:
FOOTINGS
WALLS
FOUND A nON DRAINAGE / DOWN SPOUTS
.",--.....'.....
PIERS
POST HOLES (POLE BLDGS.) r~ . ~
PLUMBING
UNDER FLOOR 1 SLAB .
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
.:''''~';;.'r'llL11<:!
AIR SEAL
WALLS
CEILING ,",,_:r,-..,~.....
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF 1 CEILING
DR YW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR ""''''',-:'ll
INSULATION
SLAB
WALL / FLOOR 1 CEILING I I ~_""~,-...:o
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
P ARKING/LIGHTING ESA
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W 1 PWI CONSTRUCTION - R.W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT 417-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
T IPoliciesll102_15 buildingpennit inspection record05.wpd [1/4/2005]
FOR OFFICIAL USE ONLY:
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY and in INK. Your application and site plan MUST
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711
Applicant or Agent: -1?ick:S.'PlA.-Cr;~r;:- S'&Js'
Owner: 12Jc....K- /IifJTt/~-'-
Address: 102- W F~ Sf
.
Phone:
~s:-'c~~,~~
.'-\g:z.... 'R.6 ~ ~ ..
.iip~ tnr 2
I
.' .
. · Photf~.
city:f,/l.7i9~~G. t..8. ",
Architect/Engineer:
Contractor N I'Jt-+h
Address:
. ..
~ Phone'::"", ,.:
~,t1 h7EXP: . '\
. ,
Phone;
\ -
. t, 1
. 4.;::-r-
"
... .
Zip.: '
.
. .
ZONING~. C
,; 'f
. .
PROJECT ADDRESS:
tOG-
.
".1
LEGAL DESCRIPTION: Lot: Block:
CLALLAM COUNTY PARCEL NUMBER:
Subdivisi'tm:
.' '. . . ."
,4...,,: "'
',r "
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA MC - #
TYPE OF WORK: SIZEN ALUATION:
D Residential D New Constr. D Re-roof D Stove SF. @ $ /SF. = $
D Multi-family D Addition D Move D Garage SF. @ $ /SF. = $
D Commercial D Remodel D Demolitio,' D Deck SF.@$/SF.=$
D Repair ,..Sig{ / D Other TOTAL VALUATION $
BRIEF DESCRIPTION OF THE PROJECT: <~ A::;) -.9Gre-..l ou ~Q.o...T\ ~.
~ ~ (2) :?b"~?t'" (J) 18''';'' 3>(;,~ ~
2.4 I:g ..., ,S"
OccutJ~t Load: ConstructiOn Type:
City:
Exp. Date:
VAI\.J.$- i €06
(
\SA.-Cc. ~ _
COMMERCIAL/RESIDENTIAL: Occupancy Group:
No. of Stories: Lot Size:
Total lot coverage
Existing Sq. Ft.
& Proposed Sq. Ft.
= TOTAL Sq. Ft.
%
APPROVALS:
PLAN~
BLDG:
DPWU:
FIRE:
OTHER:_
~
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -48] 5 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application andconstruction plans are
submitted. All other pemlit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno p~mlit is issued within 180 days of the date of application, the application will expire. The
Bui]ding Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section RI05.3.2
of the. I~temational BuildinglResidential Code, 2003). No application can be extended more than once. .
I hereby ceFtify that I have read and examinee! this applicatio; and know the same to be true and c~rrect. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are requir~d ,n~s, 8~~ that I ,t obtain such permits prior to work.
T:\RVES'S\BLDG-forms-brochures\2004-Buildingpermit.wpd Applicant: -' /~--~ / r-S::.:~ Date: 5 ~ 22 ---C) 5
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CITY OF PORT ANGELES - Constructio Plans
The Issuance of this permit based upon these pia specifi.
cations and other data shall not prevent the buildi official
from thereafter requiring the correction of err 'n said
plans, specifications and other data, or from pre enting
bUilding oper~tions being carried on thereunder w n in
via tlO oJraIl a ordinances of this ju ction.
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R\c.~ NATfoI/$ PIlOPRIl!1"oR - Pn, 452. - 8693 . ._-~~~~.}
._--~
---'
CITY OF PORT ANGELES - CO!'l~'-" ..
C!9 Produced by
lI:.QrapbJ...
I'I>rt AnceJa. WI.
457-3703
e $Suan ase un.--
cations and other data shall not .'
from thereafter requiring the
plans, spec/fications an'
building oper~tior.,
...
0"
~'l
I
Area Map
Th"a This map is not intended 10 be used as a legal description. "'.~,":':.~...,;;,'~.);;.'
II is mapll rawing is produced by the City of Port Angelesfor its own use and purposes. ~ ~
Any other use of this map/drawing shall not be the responsibi/i~v of the City. '~~'
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT
OWNER/APPLICANT
RICK D. MATHIS
102 W. FRONT
Port Angeles, W A 98362
360/452-8683
T:
S:
ISSUED: 10/22/2002 PERMIT NO: 13797
PROPERTY LOCATION
102 FRONTW ~
Lot: 1 S -11-'
Block: 15 IZI Long Legal
Subdivision: TPA
Parcel No:
CONTRACTOR
OWNER
VARIOUS
Port Angeles, W A 99360
206/000-0000
PROJECT INFO
Project Value: $1,700.00
Project Type: AWNING
Occupancy Type: COMMERCIAL
Occupancy Group:
Construction Type:
Zoning Use: CBD
ARCHITECT
N/A
, 98360-0000
360/000-0000
SFD Units: 0
SFD sa FT: 0
MFD Units: 0
MFD sa FT: 0
Commercial:
Industrial:
Garage:
o
o
o
-
Q
\'J
G
PROJECT NOTES
INSTALL NEW AWNING & REFACE EXISTING SIGNS
RECEIPT#9835
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$60.10
$0.00
$4.50
$0.00
$0.00
$000
$0.00
$0.00
$0.00
1\
"'"
d
.:s
-t
Mise Fee 1:
Mise Fee 2:
Mise Fee 3:
cJ
,...
$0.00
$0.00
$0.00
TOTAL FEE:
AMOUNT PAID:
BALANCE DUE:
$64.60
$64.60
$0.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. ThiS permit becomes
null and void If work or construction authorized is not commenced within 180 days, If construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work Will be complied with whether specified herem 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.
Signature of Contractor or AuthOrized Agent
T IPLANNINGIFORMSIII02 15 [4/2002]
Date
/o~ 2-'7-0'2-
Date
BUILDING PERMIT INSPECTION RECORD
, .
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH-IN
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN \ II j
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION I
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS -
PW UTILITIES / SITE WORK (Engmeenng DIVISIOn) SEPARATE PERMIT #'s
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARATE PERMIT #'s SEPA
PARKING/LIGHTING ESA
LANDSCAPING SHORELINE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES 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 / ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT. 4 I 7-4750 PLANNING DEPT
BUILDING 417-4815 i---/b-o~ I-El-J BUILDING
T \PLANNINGlFORMS\1102 15 [4/2002]
Port A.ngeles. VVa hington
360-417 -9548 . Fax 360 52-6778
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Port Angeles, \Nashington
360-417 -9548 . Fax 360-452-6778
we.. Al<.e AppL1~3 For- A pe('fYl~T 70 puT
Up All! AWfIJ(,v.j fiT 102 W Fro,J/ 51 Pf!. (!t(/\l'bDf'
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JA/RPI'I>1G-Ti0V Fet,1 Free- 70 Co../ { /V11k~ AT '-1/7- 95''18 '
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT.
REQUEST:
Datej - IS-- 0$
Time
Received by
12i1
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one): Permit No. l *?1''1
Sewer Foundation Framing Chimney Plumbing ~ewer Excav. Other (h4cr'<i;~'~,-c
~ . ,
A'-'U~"utq /.)
q.. .../ '''- ~~
:S ;'SII\. ,---.L
By ~ ~ ~
IDG U/
t2..;~k
FrovL -l-
Phone No. ~5Z - 9693
INSPECTION NOTES:
(I ~,' (']I (:,~
Inspected: Date (;' -
Remarks:
Time
=z 1/
f ,/ IV ~rVr
\,fi ,{
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
.
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
ELECTRICAL PERMIT
Site Address:
PERMIT NO. s-<:; 7'
DATE r /2./ 'T?-.
Installed By:
o READY FOR
INSPECTION
License Number:
o
Owner/Business:
It- J)C~'
Owner/Business Address:
ELECTRIC HEAT
o BASEBOARD KW _
o FURNACE KW
o HEAT PUMP KW
o FAN/WALL KW
o RESIDENTIAL
~ COMMERCIAL
o NEW CONSTRUCTION
!?!. REMODEL
~ ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o TEMPORARY SERVICE
o WILL CALL FOR
INSPECTION
Phone:
Phone:
Sq. Ft.
o RISER
o OVERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
D1!6 D3!6
SERVICE SIZE
FEEDER SIZE
AMPS
AMPS
Details/Description:
C-/f
,
0/,e./AJ f/
1
4~ ~c/c/
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
o Rough-in/cover O.K.
o O. K. to connect service
~ Final O.K.
Site Address;
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
, before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
~or on the BU~ir;~mit. PHONE 45~~o:,~~~A~~:A:~:~STABLlSHEDUNDEATHISPEAMIT $ I 3c9 ~ /-:::: ,~
/ EI.ct;;callnsp~cto. Pe'm;t Fee I
WHITE - File byedd,ess PINK - Top, Eng, Bottom, Custome. GREEN _ TW Mete, Dept., /,/ ............
)LYMPIC PRINTERS INC ~
J
Installer:
~.
00<
w,
Permit/Receipt No.
srl7~
New Meters
~.."- -----
CITY OF PORT ANGELES LIGHT DEPARTMENT
321 E. Fifth Street
Port Angeles, WA 98362
(206) 457-0411
u),
ELECTRICAL ~ERMIT
JD
Site Address:
PERMIT NO. J 6 9/
DATE ,~/t,ft 2:
o READY FOR
INSPECTION
License Number:
~WILL CALL FOR
INSPECTION
Phone:
Installed By:
Owner/Business:
Owner/Business Address:
o RESIDENTIAL
o COMMERCIAL
o BASEBOARD KW _
o FURNACE KW _
o FAN/WALL KW _
o HEAT PUMP KW
o SIGN
o TEMPORARY SERVICE
o PERMANENT SERVICE
o NEW CONSTRUCTION
o REMODEL
"g:" ADD/ALTER CIRCUITS
/0' SERVICE UPGRADE/REPAIR
o SPECIAL EQUIPMENT
(LIST BELOW)
Details/Description:
Phone:
Sq. Ft.
B\JvERHEAD SERVICE
o UNDERG'}'N~~ICE
VOLTAGE: 20~' D
o SINGLE PHASE'
o THREE PHASE..... _
3E:l'r~E ~c>LtfLO AMPS
-Tb. d-T-
"feU c;cis 7,
2~cA/ .~ ZJc~
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
~Rough-in/cover O.K.
o O.K. to connect service
,;(pt^-tfJ. Final O. K.
Site Address;
Notify Port Ange s City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the BUil~ding P '\. PHONE 457-0411, EXT. 224.
~ NO OCCUPANCY OR USE ESTABLISHED UNDER THrs PERMIT $ ~D .~
Elec ricallnspector Permit Fee
Installer;
.
WHITE - File by address
YELLOW - file by number
PINK - Top: Eng, Bottom, Customer
OLYMPIC PRINTERS INC.
New Meters
-
GREEN - Top: Meter Dept., Bottom: City Hall
FROM: ..Electric-3>S
. "-
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FRX NO. : 4526424
Nov. 21 2002 09:06RM Pi
ELECTRICAL PERMIT APPLICATION
PO!\. {lfi'ICIAI. ;.j:>>F. (JNL. Y
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r=.(". --...-..... .-.-. .
D.~AP'!ltt>~q;J; ....-.---
0,1(: [:IJIUW; _n__. --_.
The E:\ectrit;.8[ Permit Appli.:ation '!'IUlit bl tilllK!l,.")(jt comDlehtlV,
$']913
Pi.... type Of f'OIlrlnt In Inl. lIyou hlVllln~ qUIstlons, pi~a.. call (160) .17~135
1'81 numbor: (3all)417-171\
REQUEST INSPECTION 0
/
=1 ~ L P ~~"'--o\j'2" I'Bll: 4r~-"'.....u
Owner or Elee. ';"ntJa<f'jAgent: '17..A~~< . .~. :<- ~ IIone: Phone: -
Property Owner. .t!ct,bor __ C_
Addres. ip2- \A) 'F7~ City: ~l..1h8'.k Zip: 9~3[...,2
r- "'. 11<l"'" of / 4f
Electrlce, Contractor. \?-IR '-'<"1<-\<" ~ .....t.- Li<.""e"'~' ", n"" Exp: t::(/ (~/.... Phone: '2..-6<(,
Address: 'tJ'L ~ '(~ ~J. I _City: \~"-I ~ .I.-J~ ( Zip: '1';:I..\..,
INSTALLATiON WIRED BY: 0 OWNER ~L CONTRACTOR
~
{JAr- . City:
Credit Clint Holder Name:
Credit Card Number: _ Exp. Date;
~
Zlp:
VISA;~,.
BIlling Address:
PROJECT ADDRESS:
\ 0'2- W.. "F~
TYPE OF WORK'
Check kill that apply: C New
o Altera~on/Addttion
.-
o Resldental 0 Multi-family
PC Commerciill 0 Mobile Home
SQ. Ft
Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
o Low Voltaga 0 Telecom. [
Number of Circuits added or altered: 7
.0 tu'+n~ccl {OG
.n-7#-TA"/~,- ,r-7~
N-uJ q r- ~ l.}
DESCRIPTION OF THE ELECTRICAL PROJECT:
/ CTZJ 56< E? - PA7~.;t.& ;C/UJrv7
4'7' ~o .,. ~'1:-1-o t- 1>'.;.0 t-s;.;.o r~~'.IO
PERMIT FEE: SaNtee Information
f<tal(>r #= 19.J.B VOltage!'29L'fO
o Ovemead Service Phase: ~
o Temp Service Service Size: i OOG>. ~I"
w Underground Service Feeder Size: . ,
Electrical Heat load Additions
o Baseboard
Q Fumace
[j Heat Pump
'lilLFan.Wall
KW
-KW
-TON
~KW
LRA
PAMC 14.05.D60(B):For Industrial, commercial, & residantlal projacts larger than a duplex, a onB -lina drawing of the Electrical 5ervlc
Feeder>;. building siza (sQ. ft,), load calClllations, and the typtl & of conductOr>; andlor racewa~ is required and shall accompany the Ele
Permit appllaltlon,
I hereby certify that I have read and examined this application and know that same to be true and correot, and
authorized to apply for th is not the City gal responsibility to determine what permi
required; it remains the i:lppffcants responsibility to determine what permits are required and to obtain such,
Credit Card HOld"r'" Slgn..tur",
~~
Date:
Owner or Elee. Co'nt, Signature:
/J p7C:lELECTRICALPERMIT APPLICATION
~ C~ //-Z/-,,:><:..
Cate;
.'
FROM; Electri C-1-S
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'to,.
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FRX NO. : 4526424
Nov. 21 2002 09:06RM Pi
ELECTRICAL PERMIT APPLICATION
i'():< ..lI'"rlel,!,l. :.::>~. (J"":l Y
DaWf,~~
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C:r.ll;.'I~~r;"~; .."_._.____
D\I~ rl$~e.:I;__,.___.
./
Tne Electrical Permit Ap~I.::ation mUlit 1:111 tillHl ~t eamDletlllv.
Pi.... type or F'O\lrint In 'nl. tlfou h.ve any qu.stlon., Ploa.. .ail (360) 417-4135
.... numbo" (3&0)417-47\ \
REQUEST INSPECTION 0
r.:l ~ L P I..1.~L-o\j'2\J Fax: l..\ t"'<.-I....'Z.u
Owner or Elac. ConlJactfri.AQenl: 1L.-\-~lC . .~. .-<. ~ lion.: Phone:
PrupertyOwnec ttQ,bOL-_ C_
Addre.. ip2- 'v...) 1="""",.)1 City: ft:v-i.J\^8" k Zip: 9 li3{." '2
.- C""". :i'O""" .I I 4'1-
ElectrlcelContractoc \Z.\~'-"""'l"- ~ ~._ LiC'MeirQ,.;l{f'S'jl E.p: ~f';"'" Phone: -<-..
Addres.: <t?J'L ~ \(~ t<.J. ' _City: \~ft.\ ~ ,/.#'-. Zip: <1Y~'\...
INSTAlLATION WIRED BY: 0 OWNER :]"K~TR;;;L CONTRACTOR
Billing Address:
Credit Card Humber:
(yv'-
0~
City:
_ Exp, Date:
Zlp:
CTtJdlt CllrrJ Holder Harne;
VISA:_Mt
PROJECT ADDRESS:
\ 0'2-- lV.. 'f"~
TYPE OF WORK' Check ~ that apply: C New 0 AlterationlAdditlon
o Rasldenllll 0 MulU-lamily K Commarcilll 0 Mobile Home Sq. Ft
Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump 0 Low Voltage 0 Telecom. [
Number of Circuits added or altered: 7
.Q lU+rL~QJ {Ol
/n.e..rK:/~r p~
f\O-\.:J q I e. I.)
DESCRIPTION OF THE ELECTRICAL PROJECT:
/tnJ 5p..B-PA7~~ ?~n-?
[] Baseboard
C Furnace
[j Heat F>ump
~Fan-Wall
KW
.KW
-TON
~KW
lRA
o Overl1aed Service
Cl Tamp Service
::1 Undergrol,lnd Service
Service Information
VOltege!'2.,i"f 0
Phase: '\<[J . 0 3
Service Size: I 00"'- -I'>
Feeder Size: . ,
Electrical Heat Load Additions
PERMIT FEE:
PAMC 14.05.060(B): For Industrial, commercial, & residential prOjects larger than a duple~, a one - line drawing of the Electrical Servlc
Feeders, building size (sQ. Ii,), load calculations, and tha tYPfl & of conductors andlor raceway is required and shall accompany Ihe Ele
F>ermil application,
I hereby certify that I heveread and examined this application and know that 513me to be true and correct, and
authorized to apply for this permit. I underst13nd It is not the City's legal responsibility to determine what parmi
required; it remains the applicants responsibility to determine what permits are required and to obtain such,
H
L ~_/ Owner or Elee. Cont. Signature:
/7,?C:IELECTRICALPERMIT APPLICATION
~ C ~ //-Z/--:7<::.
Credit Card Holder'" Signature,
ot&~
Date:
Date:
FROM FAX NO.
Jul. 29 2015 7:42AM P1
Name CI
RECEI ED
Mailing Add Pw�
1r1fT"Y OF PORT ANGELES PEit1VIiT APPLItCAT&O1V•
Phone: ax:
; ;�`•' "• ;,,," �„ � �a.
LI%n9e I Ex p.
Bui[drng Division/Electrical 1<>aspestians
JUL
�
Few—ice/Feeder 204 Amp.
321 East Fifth Street —P.O. Box 1150 I Port Angeles Wasbington, 98362
SeMcelFeeder 20144 Amp.
$160,00
Service/Feeder 40400 Amp
Ph: (360) 417 -4735 Fax: (360) 417 -4711
EIR RI
SehrieelFeeder aver 1000 Amp.
$ 410.00
lS;Ih
$ 5.00
Branch Circuit W10 Service Feeder
Date: 2 — Mufti - family or Commercial'
Each Additional Branch Clrcuit
$ 5.00
branch Circuits 14
' Plan Review May Be Required, Please Co mpl to ElWrical Plan Review Information Sheet
Job Addrm; �. 6 2, Ohl . E.N m. �
Bullding Square Footage:
AeWpbOn of above
Owner Information
r'iL
Name CI
MaNing Adcla;
Mailing Add Pw�
City: Ssgte: s R zip: °
Phone: ax:
Phone; 2
LI%n9e I Ex p.
hem
Unk
Few—ice/Feeder 204 Amp.
$132.00
SeMcelFeeder 20144 Amp.
$160,00
Service/Feeder 40400 Amp
$ 225.00
ServlcelFeeder 601.1000 Amp.
$ 288.00
SehrieelFeeder aver 1000 Amp.
$ 410.00
Branch Circuit WI Service Feeder
$ 5.00
Branch Circuit W10 Service Feeder
$ 74.00
Each Additional Branch Clrcuit
$ 5.00
branch Circuits 14
$ $6.00
Temp. Service/ Feeder 200 Amp_
$102,00
Temp, 5ervlcelFeeder 20140D Amp.
$121.00
Temp. Servi Oueder401 -SW Amp.
$164.00
Tamp. ServieWFeeder 601 -1000 Amp .
$185.00
Portal to Portal Noudy
S 96.00
Sign /0: ine Ughung
$ 68.00
Signal Circuit! limited Energy - Multffamliy
S 64.00
Signal ClrwW t.imlted Energy I First 1500 sf- Commercial
$ 96.00
Nola: $5.00 for each additional 1500 sf
Renewable ElecMcai Energy -SKVA System or less
$113.00
Thermostat
$ 56.00
Note; $5.00 for each additional T -Stat
Contractor 1fo rm on
Name;
r'iL
S 9LY-kj'r-V>
MaNing Adcla;
Phone; 2
Fax:
License # /
1-1$ 6-'4„
S, t„ IS
gty
Total
(Qty Mukialied by Unit Champ)
3
$
$
$
$
$-SLL---A� Total
Owner as defined by RCW.19,28.261: (1) Owner will occupy the structure for two years alter this electrical permit is finalized. (2) Owner is required
to hire an electrical oonlractor if above sold property is for sale, rent or tease. Permit expires alter six months of last inspection.
After reading the above statement, I hereby eerttly 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.B.C., ROW. Chapter 19.25, WAC, Chapter 296-4613, The City of Port
Angeles Municipal Code, and Utility 5pecificcarfions and PAMC 14.05.050 regarding Bectfical Permit Applioations.
Signature of ovmar, ai"eal contractor or alactricai administrator. Q axh ❑ matt
q, ❑ CredrtCera 16 ��
x ,!J _ poled
-22/ f ot►ou2otz
5 'e, G i i o17� sZ/
p
a`V I/iNV) i
P�;4'40�5
�T'
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Application Number . , . . .
15- 00000942 Date
7/29/15
Application pin number
087626
DITCH
Property Address
102 W FRONT ST
ASSESSOR PARCEL NUMBER:
06-30-00-D-0-1500-0000-
Application type description
ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use
FINAL
Property Zoning., . . , . . .
CENTRAL BUSINESS DISTRICT
Application valuation . . . .
0
Application desc
Ductless heat pump
Owner
Contractor
--------------- -- - - --- --
TURCO DARLENE RAE
------------------------
ELECTRIC SERVICE
PO BOX 87
503 RHODES RD
JOYCE WA 98343
PORT ANGELES
WA 98362
( 36) 417-2220
(360) 452 -6424
Permit . . . . . . ELECTRICAL
ALTER COMMERCIAL
Additional desc 1 -4 CIRCUITS
Permit Fee 86,00
Plan Check Fee
00
Issue Date 7/29/15
Valuation
0
Expiration Date .. 1/2.5/16
Qty Unit Charge Per
Extension
'BASE
FEE
B6, 00
Fee Summary Charged
Paid Credited
Due
Permit Fee Total 86.00
86.00 .00
.00
Plan Check Total '00
Do .00
.00
Grand Total 86.00
86.00 ,00
.00
cS�
REPORT SALE'S TAX
on your excise fax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contra_ ctor X Date:
G:IEXCHANGRSUILDING
Fif
RECEIVED
�\ it
CITY OF PORT ANGELES PERMIT APPLICATION 14AR 2 5 201
Building 1Division/Eleetrical Inspections
321 East Fiffix Street — P.O. Box 11501 Port Angeles Washington, 98362 ELECTRICAL
Ph: (360) 4174735 f'a'x: (360) 417 -4711 INSPrnohl5
Date; 3 � Mutti•Farnily or Commercial
" Plan Review Ma lie Requi! Kil ase Complete Electrical Plan Review Information Sheet
lob Addrw&: rd saf-
e ullding Square Footage:
Description of above G
Owner Infot tatiorl
Name:.
Malting Add 9
City: 5ffite: 2fp:
Phone' ax:
Ueente0 /Exp.
]tam
ServiWIFeWer200 Amp,
Servic0eeder 201 -00 Amp,
Service/Feeder 401 -500 Amp
Servi*Feed er 691 -1000 Amp,
ServicelFeeder over 1000 Amp,
Branch 0rouitW1 Service Feeder
Branch Circuit WID Service Feeder
Each Additional Branch Circuit
Branch Circuits 14
Temp, Service! Feeder 200 Amp,
Temp. ServicelFeeder 201-400 Amp.
Temp, SorviowFeeder401-600 Amp -
Temp. SonrioelFeeder 601.1000 Amp
Portal to Portal Houdy
SignlOubine Lighting
Signal Circuit/ Limited Energy— MuftWamily
Signal Circuill Limited Energy 1 First 1500 sf — Commercial
Note; $5,00 for each addfttal 1500 sf
Renewable Electrical Energy - 5KVA System or I.=
Thermostat
Note, $5.00 for each additional TStet
Unit.�,. Charge
$132,00
$160,00
$ 225.00
$ 288.00
$ 410.00
$ 5,00
$ 74.00
$ 5,00
$ 86.00
S102.00
$121.00
$164 -00
$185.00
$ 96.00
$ $8.00
$ 64.00
$ 96.00
$113.00
$ 56.00
Conftdor IreforovAon
Narne; 1v
v- G r fy icx.
Mailing Address:
City:
gyp:
Phone:
max!'%
License # I Exp,
F L 7L 2 f)z
�Y
7211112ty. Multiplied by Unfit Charnel
$
$
—
$�
$
S
S9 Total
Owner as defined by RCW,19.28.261: (1) Owner wril 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 Wa*c81 contractor. I am matting
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 1.4,05,050 regarding 8"cal Permit Applications.
Signature of owner, electrical contractor or electrical adminlatrator: ❑ C\. 1) 0** )
tSY Cr dlrCard# e,
zd WUSt7:8 OTOE LT '0aQ . 'ON XlJd : lONJ
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Application Number
15- 00000297 Date 3/26/15
Application pin number , , ,
181425
INSPECTOR:
Property Address . . , .
102 W FRONT ST
ASSESSOR PARCEL NUMBk'R1
06- 3p- 00 -0 -0
SERVICE
Application type type description
ELECTRICAL ONLY
Subdivision Name , , . . .
ROUGH -IN
FINAL
Property Use
Property Zoning
CENTRAL BUSINESS DISTRICT'
Application valuation
0
Application desc
3 new outlets
Owner
Contractor
TURCO DARLENE RAE
ELEC'T'RIC SERVICE
PO 30X 87
82 DRAPER RD
JOYCE WA 98343
PORT ANGELES
WA 98362
( 36) 417 -2220
(360) 452 -6424
Permit , , , , , , ELECTRICAI,
ALTER COMMERCIAL
Additional desc 1 -4 CIRCUITS
Permit Fee 86100
Plan Check Fee
.00
Issue Date 3/26/15
Valuation . . , .
0
Expiration Date 9/22/15
Qty Unit Charge Per
Extension
,BASE
FEE
86.00
Fee Summary Charged
Paid Credited
Due
Permit Fee Total 86100
86,00 .00
,00
Plan Check Total 'Co
.00 00
.00
Grand Total. 86.00
86.00 .00
00
REPORT SALES TAX
on your excise tax form 'Q
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
w^
W.
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:TEXCHANGETBUILDING
Application Number . . . . . 24-00000456 Date 5/14/24
Application pin number . . . 963616
Property Address . . . . . . 102 W FRONT ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1500-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Add two circuits for ovens
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
ROBIN POOLE SYNERGY ELECTRICAL CONTRNG LLC
PO BOX 351 910 W 10TH ST
BEAVER WA 98305 PORT ANGELES WA 98363
(360) 461-3954
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 95.10 Plan Check Fee . . .00
Issue Date . . . . 5/14/24 Valuation . . . . 0
Expiration Date . . 11/10/24
Qty Unit Charge Per Extension
1.00 95.1000 ECH EL-COMM BRANCH CIR 1-4 95.10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95.10 95.10 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 95.10 95.10 .00 .00
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 | www.cityofpa.us | electricalpermits@cityofpa.us
ELCOM MULTI-FAMILY / COMMERCIAL
ELECTRICAL PERMIT APPLICATION
Project Address:
Project Description: □Multi-Family Residential □ Commercial / 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
Unit Charge Quantity Total (Quantity x Unit Charge)
$237.75 $
$237.75 $
$332.85 $
$427.95 $
$523.05 $
$5.60 $
$95.10 $
$47.55 $
$95.10 $
$190.20 $
$237.75 $
$285.30 $
$332.85 $
$95.10 $
$142.65 $
$190.20 $
$190.20 $
$190.20 $
Item
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: $5.60 for each additional 1500 sf)
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5.60 for each additional)$95.10 $
$ 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 (□Owner □Electrical Contractor / Administrator)
Pe
r
m
i
t
#
:
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711]
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
CORRECTIONS NEEDED:
1. Secure flexible Metal conduit. NEC 348.30
2. Install breaker blank. NEC 110.3
3. Bushings required for #4 or larger. NEC 300.4.G
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
5/14/24 24-456 TAP
OWNER
Contractor
Synergy Electric
ADDRESS
102 W Front St
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN / COVER
SERVICE
FINAL
CORRECTIONS NEEDED:
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
10/4/2024 24-456 TMC
OWNER
Contractor
Synergy Electrical Contracting
ADDRESS
102 W Front St