HomeMy WebLinkAbout118 W 1st St - BuildingO
CERTIF
UPANCY
Cit of1Port Angeles;= gBu:iildi;ng =WD
This certificate is issued) ursuant to the requirements of Section ll of ihe. A09 International Building
Code certifying that atjthe4imeOissuance this structure was in compliance with the various ordinances
of the City regulatzn iu lding nst bor use for the following
Business name IVlark d 'B ody
Business address 18V1/` 1S St.
Property owner Housing Authoritylof'':C.101$0,
Not=Require'ti
Use occupancy classjcation. Business
Building permit nu'b'er
11 -203
Occupant load.
Type of construction.
Property owner se ss 2603 S FraT,lelS St: ,PortrAtlgOies
Automatic fire sprtnkterWstem.
irist'opher ar�cus Tanner)
':-98362 -6710
04/14/11
Date
Post on the premises in a conspicuous place: This,certificateshail iiot be removed except by the Building Official.
fro:LW oi-t-
-5 Ron
CERTIFICATE. OF OCCUPANCY APPLICATION
CITY OF PORT ANGELES
Attn. Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
Check one New business in 7
?Z G nership only? Moving location from within P.A.? Zoning Bt
BUSINESS NAME cLr' v Ui 1' S di r'r
Business address ilq t„) Mailing address \5 L.)
Phone number 360 477'7-7 54 Opening date' Days hours of operation101" PP) M -Se
Business owner's name G \,,,ri4an\er na.re5 ,,,,u?r Con:act phone `36U L 177- -75
Business owner's address 5 'E 1\ S'( 96 r�r r
Brief description of business �a
Property owner's name \RC -c: J 1-ex. 0\ Contact phone! "560-
Property owner's address/contact i I12_.
BUILDING DEPARTMENT phone 417 -4815
Is the business a restaurant or bar that will seat 50 or more people? Yes No NI'
Construction changes planned (mdving walls, adding /enlarging windows or doors roofing siding foundation work,
adding /altering stairways ramps bathrooms, electrical heating /cooling /ventilation systems etc)
Work planned /�I,,
FIRE DEPARTMENT phone 417-4653
Changes to a fire sprinkler system it fire alarm system? Yes No
Work planned
Square footage of business?
CITY CLERK phone 417-4634
Is business moving within the PBIA? Yes No 1
PLEASE PRINT IN INK
PBIA (Parking Business Improvement Area Downtown) phone 417 -4623
I
Second -hand dealer /pawnbroker business? Yes CI No 25
Will there be dancing at this business? Yes 0 No X
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
FEES
$50 C i'tificate Inspection
270 Permit U U
arking Business Improvement Area (PBIA)
fee charged for locations
Bldg approval by on
Fire approval by on
PBIA notified on
City Clerk approval by on
COMMUNITY ui ECONOMIC DEVELOPMENT phone 417 4750
Number of off street parking spaces available for employees and
customers?
(A parking plan may be required.)
Signs? (wall) mounted freestanding projecting, awning A- frame, etc
Signs planned:
i
•1
Date '7 )'7 I
Work planned:
T'1Forms\Building Division \Cert ficate of Occupancy Application (2010).doc
aNDvuP ZCl o_ A sal""
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
r
PUBLIC WORKS DEPARTMENT ENGINEERING phone 417 4812
Is site work planned (new or re- located sewer or water service
excavation grading or filling work in City right -of -way
new driveway openings, site drainage, parking lots downspouts,
irrigation system backflow devices, etc.) Yes No'`
PUBLIC WORKS WASTEWATER phone 417 4845
Print Name a r\a -two
Page 2 of 2
Signature
CED approval by
v/Na
■"tP
PWW approval by
Please sign up for utility services at the cashiers' counter
on
o
PWE apnrovaiby gV on "l
/(jU „014 fin. e v i,
on
Will waste other than domestic household waste be,discharged into the sewer system? Yes El No (X
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
I hereby apply for a Certificate of Occupancy acknowledge that have read this application and state that the
information I have supplied is correct to the best of my knowledge Incorrect information may result in revocation of
permit.
PREPARED 3/10/11 8 45 46 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/10/11
ADDRESS 118 W 1ST ST SUBDIV
CONTRACTOR PHONE
OWNER HOUSING AUTHORITY OF CLALLAM PHONE
PARCEL 06 30 00 0 0 3205 0000
APPL NUMBER 11 00000203 CO CHANGE OF OCCP /USE
PERMIT CO 00 CHANGE OF OCCUP /USE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
C099 01 3/10/11 J_L i BLDG C/O FINAL
OVERRIDE TAKEN BY LPANGRLE DATE 03/10/11 TIME 08 39 25
March 10 2011 8 38 33 AM 1pangrle
MARCUS 477 2754
C OF 0 FINAL
IQ- I vz ee
Phone.
OR r i
1
W A S H 1 N G T N .0
CITY MANAGER .S OFFICE
Applicant's Name ivw4X'
Last
Applicant's, Street AddreSS Co
Horne Phone. q
Birthdate: 10 17°1
Mo. D Year
Owner's Name .1.eaWraz,\Kr!-
Street Address 'NW^
N.GELES
A Fee 's 690
TATTOO LICENSE APPLICATION
4
1104 Ig 13(4y X(A
M
First
90k77A,:e4N ciP36
bity. State. 'Zip.
Business Phone,. il?"
Driver's :License
Mcut ''■1
A
,rr A I■cpke'') Q-31 I TS r)
City State 'Zip
Company Name
Street Address: W1 OP* N N.AT\e)
Phone ')3k
City State
477-
Applicant's Length of Employment withthis 'Company. eikr 7
Description of.Business (Please be specffic) Tet*S
Please anyi'51aCe(s) of residence of appliCant duting:the fast twelve (12) months.
16 11 Lc&a 6)7 Vo (TV \I e A q:
Please list any ,place(s) of employment of applicant during the last twelve (12) months (include
address and telephone number)
4 6?S\665 \X S a\ 0 v)
7-2,- (-3 I CP c\f
V'
36o 61 29)
321- EAST FIFTH STREET P 0 .80X 1150 pokT AN WA 9,8362-0217
PH:0NE 360-417 4500 FAX 360-4,17 4509 TTY. .360-417 4.645
E MAIL CiTY.MGR@C1 PORT AN.GEEE'S WA tis
Zip
1, woe--
(Over)
Refer' ence: nameSof at least three persons v;12b: have Icr19Wil. •appliCant afleast One year'
and whom the:City maY irifOrmationiiven:
Name
Street Address:'$ Pter
Name:
Street,AddieSS We4 54.4
Phone:
Naine*: C'vsn, WIC 6\5. b
Street Address V6
Phone -144
'City ti 'State Zip
Is the to he.registered ihe Secretary of st4fe?
Oopypfthe regi:stratioil.
1 A (to
_TakhillgtOn St f ate Tax
with Depci;tment of .16vnu4
StateRetunlqi.led. Morittily. 4 Quarterly Annually
NOTE 'The:total retail sales tax to:be ColleCted the:City of Pott A11$61e4 TS 4%.
In the event *here are anyfake,statemetits contained in this application, the may be
denied. 1
Signature.of Applicant:
Date: 4'577-
'4 'yity tate •Zip'
State
(Plea:se attpch,a,q0py bfPegistration
if SO, p70(2.5 attach
l
PORTA,�, CERTIFICATE OF OCCUPANCY APPLICATION
Property owner's name N'N RtC,C.
Property owner's address /contact
CITY OF PORT ANGELES
A:tn Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
BUILDING DEPARTMENT phone 417 -4815
Changes to a fire sprinkler system or fire alarm system? Yes No
Work planned
Square footage of business?
Is business moving within the PBIA? Yes No SI
CITY CLERK phone 417 -4634
Second -hand dealer /pawnbroker Business? Yes No 71
Will there be dancing at this business? Yes No
A City of Port Angeles Business License is required for
Taxi, Peddlers, Second -Hand Dealer Pawnbroker Dance
Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
PLEASE IN INK
Check one New business in P.A. ??3 Change of ownership only? Moving location from within P.A.? Zoning ■Bt>
BUSINESS NAME I Cki f 1 (F) vy.:idy t\--(`
Business address \1cd 5t 5 Mailing address 1 L.) 1 5fi 5)'
Phone number 360 -'i77-2754 Opening date? Days hours of operationleIV■ nPN1 /4-Sak owner's name C-Lei'`5 )\¢r /_lajc g ‘.A vu r Con act phone `36d
Business owner's address ,5'*6 'E 1\'S" 5'1" Pa r\ #U L..):A K
Brief description of business .'I\ 5\ o
PBIA (Parking Business Improvement Area Downtown) phone 417 -4623
1005
FEES
rtificate Inspection
arking Business Improvement Area (PBIA)
fee charged for Downtown locations
fee i.,,,,:\eJ Copttact phon 'S(vc) `'i 57 7715
1 12 t.) 1 h� �k- �1 st f v.0.o\e.3 ./J cI
Bldg approval by LL on 3
Is the business a restaurant or bar that will seat 50 or more people? Yes No
Construction changes planned (Toying walls adding /enlarging windows or doors roofing siding
adding /altering stairways ramps, bathrooms, electrical heating /cooling /ventilation systems etc)
Work planned
FIRE DEPARTMENT phone 417-4653
Fire approval by KM on 4- 5 -)1
Permit 3
foundation work,
PBIA notified Kit t on 5 15-t(
City Clerk approval by 3" H on 3-15-1(
COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750
Number of off i street parking spaces available for employees and
customers?
(A parking plan may be required.)
Signs? (wall- mounted freestanding projecting, awning A -frame etc
Signs planned: `2c�
s vv1.0‘4A40 UV V� 53 'VW -mP vl c ,n�`
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles
PUBLIC WORKS DEPARTMENT ENGINEERING phone 417 -4812
Is site work planned (new or•re- located sewer or water service
excavation grading or filling' 'Work in City right -of -way
new driveway openings, site drainage, parking lots, downspouts,
irrigation system backflow devices, etc.) Yes NoK'
Work- plarined•,
T 1Forms\Building Division \Certificate of Occupancy Application (2010):doc
CED approval by on J —144(
PWE approval by V on
PUBLIC WORKS WASTEWATER phone 417 -4845 PWW approval by J( on
w
Will waste, other than domestic household waste be discharged into the sewer system? Yes No X
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
I hereby apply for a Certificate of Occupancy I acknowledge that have read this application and state that the
information have supplied is correct to the best of my knowledge Incorrect information may result in revocation of
permit.
Date x'7' k Print Name C I"°f-u°, ■Nv.e2J' Signature
Page 2 of 2
3� k' tI
0 2
.118;
C:
C E RTI FICA-T Of PAN CY
Cit Ang4i;11§mijiii:64,131Vsion
This certificate is issued,pursuant to the requirementk of Section 1.111.-ofilie 10,96 International Building
Code certifting that atithe4iMelei this structure was in compliance with the various ordinances
of the City regulating ui ngco„nstructtop or .use,for the following-
idi
Business name 4, '(Own e0, 3,0i el'-:&, a ri. fafti.da)
Business address i3, 1 t8 W 1s St
Property owner Housing iNtifilbrityttqa114rit i
Property owner siaddresS' 2603 S .fariolt4§.t.„ Afigeie§
Automatic fire spriinkkr-syStem. Pe (48
Use occupancy cl4sifiCation. M e r•oriti le
Occupant load. load. :,,t Per 2,006aC, Table 4004A: 4
Building permit numbe
Type of construction.
05/12/10
ger Date
Post on the premises in a conspicuous place. This,certificate,shalInot be removed except by the Building Official.
0
PREPARED 3/30/10 8 07 03 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/30/10
ADDRESS 118 W 1ST ST SUBDIV
TENANT NBR SICKKTEES
CONTRACTOR PHONE
OWNER HOUSING AUTHORITY OF CLALLAM PHONE
PARCEL 06 30 00 0 0 3205 0000
APPL NUMBER 10 00000197 CO CHANGE OF OCCP /USE
PERMIT CO 00 CHANGE OF OCCUP /USE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
C099 01 3/30/10
BLDG C/O FINAL TIME 01 00
OVERRIDE TAKEN BY LPANGRLE DATE 03/30/10 TIME 08 06 52
March 30 2010 8 05 39 AM 1pangrle
SHERIE 360 477 3608
C OF 0 FINAL SICK TEES
AFTERNOON
COMMENTS AND NOTES
Print in ink
BUSINESS NAME S c,-Cee S
BUSINESS ADDRESS \Z W R r+ 5-d- e e Tor+ Axo� s vJ °9 g-3� 4i- 3 G �7 1...) Business mailing address (Sck 4 Phone* 3 (:e0 1
Opening date. :prk t tS, a yotb Days hours of operation rf\Oh �,�SIA.f, gl 11' 00Q�--
Washington State Tax I D If known list the name of The previous
(Q (p(Q -(07� business at this location
Brief description of proposed business 5 .pr T shtrks,kotir, h1r
I Business owners name .�'Y\Ic\i et d S��r �r,-� r L* Phone# 3G0- t- }1 -3G08`
Business owner's home address a.2S� 1QMI e s; Yo rk R,IP S, Wk ?r3G2
0
`PLEASE NOTE:
A Business License. is also. required for the following businesses Taxi Peddlers Second -hand: dealer Pawnbroker Dance Hotel
Motel Fireworks, Tattoo shop Contact the City Clerk at 417 -4634 for additional information.
ACTION 1
New business
Transfer of business
location from a
PBIA location
Transfer of business
location from a
non -PBIA location
Change of ownership
Remodel
Temporary business
Change of use
For City use only
Department
Building
Fire
PBIA
Planning
Cty Clerk
Public Works
CERTIFICATE OF OCCUPANCY APPLICATION
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
Call for Certificate of Occupancy.. inspections before opening business
Building Department Inspection 417 -4815 Fire Department Inspection 417 -4653
Please provide a minimum 24 -hour notice for inspections
I .hereby'apply for a Certificate .of Occupancy
supplied is correct to the best of my knowledge.
Date ei 1 Q Print Name 51\ T
Approved Rejected
Initials date Initials date
13- 30- 0 -I
4 -9 -10 KDs
3 RN
3 10 -10 5(
3 -11-it TN(
3- X1--10 S
r -r gyms /Building Division /Certif -,le of Occupy .:y App!
u �I
Type of construction
$50 00
$10000
WILL THERE BE ANY OF THE FOLLOWING?
Electrical changes
New or relocated signs
Construction changes
Mechanical changes (ventilation, heating, cooling, etc.)
Plumbing changes
Fire sprinkler system changes
Fire alarm system changes
New or relocated sewer or water service
Excavation or filling of lots
Work done in the City right -of -way
New driveway openings
Grading site drainage (parking lots, downspouts, etc.)
.Landscape irrigation system (backflow devices)
Is this a home occupation?
Is this a second -hand dealer or pawnbroker business?
Is there off- street parking for this business?
Is the street in front of this business paved?
Is there a sidewalk in front of this business?
Is there a curb putter in front of this business?
0 •1j k.L2 tn c�u3
FEES
Certificate Inspection
arkirig Business Improvement Area (PBIA)
fee charged for downtown locations
NO/
7 7
V
V
V
YES/
Comments Conditions
Occupant Load
Automatic fire sprinkler system required no
Permit /0 /97
IF YES CONTACT
Electrical Dept. at 417 -4735
Building Div at 417 -4815
Public Works at 417 -4807
Water Dept. at 417 -4886
Planning Div at 417 -4750
City Clerk at 417 -4634
How many spaces?
Please sign up for utility services
at the cashier counter
yes
I acknowledge that have read this application and state that the. information I have
✓V 1.
Signature Ir
V U
140
Clallam County Assessor Treasurer Property Details 55944 HOUSING AUTHORIT Page 1 of 4
Ciailam County Assessor Treasurer
Property Search Results 55944 HOUSING AUTHORITY OF CLALLAM for Year 2010 2011
Property
Account
Property ID" 55944 Legal Description LOT 5 BL 32 SURVEY V40
P40
Geographic ID" 0630000032100000 Agent Code
Type Real
Tax Area. 0010 PA 121 PORT ST CNTY H2 L Land Use Code 97
Open Space: N DFL N
Historic Property" N Remodel Property N
Multi Family Redevelopment: N
Location
Address. 118 W FIRST ST 120 Mapsco
PORT ANGELES
Neighborhood Exempt All Exmpt Reference Map ID
Neighborhood CD" 50110030
Owner
Name HOUSING AUTHORITY OF CLALLAM Owner ID 31369
Mailing Address. 2603 S FRANCIS ST Ownership 100 0000000000%
PORT ANGELES WA 98362 -6710
Exemptions. EX
Taxes and Assessments Due
Property Tax Information as of 03/08/2010
Amount Due if Paid on. M.
Statement
Year ID Taxing Jurisdiction
2010 39014 ST SCH STATE SCHOOL
2010 39014 CC -GEN COUNTY
2010 39014 PORT PORT
2010 39014 PORT ANG PORT ANGELES
2010 39014 SD #121 SCHOOL DISTRICT #121
2010 39014 NTH OLY LIB NORTH OLYMPIC LIBRARY
2010 39014 HOSP #2 HOSPITAL #2
2010 39014 WSMET PK DIST WILLIAM SHORE MET PARK DIST
2010 39014 CITY_STORMWATER CITY STORMWATER
2010 39014 WEED CONTROL WEED CONTROL
2010 39014 TOTAL.
2009 559442008 ST SCH STATE SCHOOL
2009 559442008 CC -GEN COUNTY
2009 559442008 PORT PORT
2009 559442008 PORT ANG PORT ANGELES
2009 559442008 SD #121 SCHOOL DISTRICT #121
2009 559442008 NTH OLY LIB NORTH OLYMPIC LIBRARY
2009 559442008 HOSP #2 HOSPITAL #2
2009 559442008 CITY_STORMWATER CITY STORMWATER
First Second
Half Half
Base Base Base Amount
Due Due Penalty Interest Paid Due
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$36 00 $36 00 $0 00 $0 00 $0 00 $72 00
$0 82 _$0 81 $0 00 $0 00 $0 00 $1 63
$36.82 $36.81 $0.00 $0.00 $0.00 $73.63
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
$36 00 $36 00 $0 00 $0 00 $72.00 $0 00
http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =55944 3/8/2010
CERTIFICATE OF OCCUPANCY
City of Port Angeles
Building Division
This Certification issued pursuant 10 the requirements of Seclinn 301 of the
International Building Code certiIving that al the time of issuance this structure was
in compliance with the various ordinances of the City regulating Building
constructip}l.pr use. For the fallowing:
Use Classification Business Bui,lding Pennit No.: 06-159 Business Name: Art Suoolies Unlimited
",""
"",-
Type of Construction: \TN .-
., -,.
"use-'~onc~~ CA
Owner of Business: Sally Erlendson
Address: 118 W. First Street
Port Anl:!eles. W A. 98362
Port Anl:!eles. W A. 98363
Building Address: 118 W. First Street
7J1.~1. 7Y;", A2;cc~:~:~.:",".-~':,"'i~~;:~arCh 71. 7006
( Building Jfficial "<;t-','.~'~<-"t', "-:--("~ -. '~'"~)r."'r:'-''7''''''''"'"""'':-'''~'''''''"'"~'~-: '" Date
, . '<!/i~d~~;~'k;.:,'?/::'~/f} ":",>"
Post on the preinises.~ina conspicuous place.
Shall not be removed except by Building Official.
DATE ~ - I 4' - 0 (0
Address of Proposed Business
Ll8 W I s+ s t
Applicant Art- 5 U bP ( ,- e>
Address 11 ~ liJ I tt sf"
...
Phone:
business J,too - fS7-7ir?tIome
Brief description of proposed business:
legal Description: lot
Current Use of Property:
Zoning Classification of Property:
Will THERE BE ANY OF THE FOllOWING?
Construction changes.
Electrical changes. . .
Mechanical (heating, cooling, stoves) .........
Plumbing changes. . . . . . . . . . . .
New or relocated signs .
New septic tanks . .
New sewer service.
Admission charged to patrons
Is this a home occupation? .
Excavation of filling of lots.
Work done in City right-af-way .
Is there sufficient off-street parking? . .
New driveway openings
A grading plan for site drainage
(parking lots, downspouts, etc.) .
Are the existing streets paved? .
Are there existing sidewalks? .
Is there curb and gutter?
Other.......... .
Jt-~-I91
ROUTING SLIP
ificate of Occupancy
ertificate/lnspection Fee
L1J I'm: fE.4
New Business. . . . . . . . . . . . . . . . . . . . . . . .
Transfer of Business location . . . . . . . . . . .
Change of Ownership .. . . . . . . . . . . . . . . . . . . .
New Building ............................
Remodel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Temporary Business. . . . . . . . . . . . . . . . . . . . . . .
Change of Use . . . . . . . . . . . . . . . . . . . . . . . . .
M. <;OPPI-t E s
Block
YES NO
_ -.:'>L
v
-~
-~
y
'"
Subdivision
THE FOllOWING Will BE REQUIRED:
PERMITS
1) Building
2) Plumbing
3) Electrical
4) Mechanical
5) Sewer
6) Sidewalk installation
7) Driveway instaJJation
8) Curb installation
9) Sidewalk obstruction
10) Water meter installation
11) Fire
12) Occupancy
13) Sign
14) Shoreline
15) Home occupation
16) Conditional use
17) Other
BUSINESS LICENSE
1) Taxi
2) Peddlers
3) 2nd Hand Dealer
4) Pawn Broker
5) Dance
6) Hotel - Motel
7) Fireworks
8) Ambulance
9) Tattoo shop
10) Other
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the Date:
information I have supplied is correct to the best of my
knowledge. Signed:
~D
2 - /Lf))lo ,y<.
2/h-olo'")(I,
j-fI.{- tJ&-f.J)
REJECTED
Building Section
Public Works Department
Planning Department
Fire Department
. City Clerk
P.B.I.A.IAlt!:.J.m", .""
~CV"W
:2-l4-0~
Comments / Conditions
,JijOO
)
)
')<)
)
)
)
)
. 'Ih~ r 01 D\J...(" 1> a., I 0 .+h:> _
ROUTING SLIP ~ rOA,."
<-o~o~
<1~_<;';'
Certificate of Occupancy C1'~
~~
~
'In .., Certificate/Inspection Fee -
....<;<P'
DATE 03,ho/0<f New Business .., ,. ,. ,......., "...... .... ( )
Address of PWosed Busin~s Transfer of Business location. . . . . . . . . . . . . . . . ( )
II;;? ...1-,<)1 '[ LUMeNS Change of Ownership. . . . . . . . . . . . . . . . . . . . . . ( )
Applicant Rob>RT {II. New Building ... ,. ",................ ..... ( )
Address 7S R~ FM/V\ RD Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
'Po-R.1- AN Gc;L.lCS \;J-A- "'r 8':'1 t, 2.. Temporary Business ............. ..... ..... ( )
Phone: business l..f ~7 - 7 9 Co 7 home Lf-tJ2-1o=)bZ- Change of Use. . . . . . . . . . . . . . . . . . .. .. ...... ( ./)
Brief description of proposed business: R~L {; A-L!3 tJ-f' fH<-t- 511PPu:E5 4,
C-LA-S'7t:: 5 TI\) r.?i+-mJ 'frtJ (,;, <L {t-{2.. T
legal Description: lot Block Subdivision
Current Use of Property: ()FF-.rrr,:::
Zoning Classification of Property:
Will THERE BE ANY OF THE FOllOWING? YES N~ THE FOllOWING Will BE REQUIRED:
Construction changes. ........... -- PERMITS BUSINESS LICENSE
Electrical changes. ...... .... ........... .. _ ---.L.. 1) Building 1) Taxi
Mechanical (heating, cooling, stoves) . . ........... if 2) Plumbing 2) Peddlers
Plumbing changes ..... ... ....... ..... - V 3) Electrical 3) 2nd Hand Dealer
New or relocated signs. . .. ............ :::z:: = 4) Mechanical 4) Pawn Broker
New septic tanks. . . . . ............. V 5) Sewer 5) Dance
New sewer service .............. ........... -7 6) Sidewalk installation 6) Hotel - Motel
Admission charged to patrons. ..... =-L 7) Driveway installation 7) Fireworks
Is this a home occupation? .... ...... ==i= 8) Curb installation 8) Ambulance
Excavation of filling of lots ......... ............. 9) Sidewalk obstruction 9) Tattoo shop
Work done in City right-of-way. .. .............. 10) Water meter installation 10) Other
Is there sufficient off-street parking? . ........ 2-7:' 11) Fire
New driveway openings ... ...................... -~ 12) Occupancy
A grading plan for site drainage. . . .............. 13) Sign
(parking lots, downspouts, etc.) ....... ..... ..... -~ 14) Shoreline
Are the existing streets paved? ...... .......... + 15) Home occupation
Are there existing sidewalks? . .............. 16) Conditional use
Is there curb and gutter? ......... ..... ....... -L_ 17) Other
Other.. . ........... ...... ........
I
I hereby apply for a Certificate of Occupancy and acknowl. 03/3{]/tJtf " /
edge that I have read this application and state that the Date:
information I have supplied is correct to the best of my - I ~ ,',j""r> /
knowledge. Signed: 71'" V
-, \,/
~FFi ,~ \RE"""D Comments / Conditions
Building Section
Public Works Department
HO-DV-~ Planning Department
~f)fl Fire Department
Ho-ol/ .t8u City Clerk
Ot :J P.B.I.A.
8/, oLJ
'it)
;:>0..
ROUTING SLIP
Certificate of Occupancy
~ n , !.J!:t:"Certificate/lnspection Fee
DATE 0:3 /30/0~
Address of P~oposed Busin~~
ffg W._L~ 2),
Applicant Robe RT Nl. LUMeNS
Address 75' RA-k'"B< F~. kD
'Po-Qrt- AfJ G 0\...,~ I,;I~ or 2f '3 c; 2-
Phone: business 4- ~7 ~ 7 ? k, 7 home t.f S- 2 -lo"5'hZ-
New Business ',..........................
Transfer of Business location. . . . . . . . . . . . . . . .
Change of Ownership . . . . . . . . . . . . . . . . . . . . . .
New Building . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Temporary Business ....... . . . . .. .........
Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Brief description of proposed business: R~L bf1--Lt:=;; tf{' A-1<..1- 5IJPPl.J:t:3 $
~7e-S 'D\.) 0i+-TI\JrrNto ~ A-K--r-
legal Description: lot
Current Use of Property: () FF-.:rr ~
Zoning Classification of Property:
Will THERE BE ANY OF THE FOllOWING?
Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . .
Electrical changes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mechanical (heating, cooling, stoves) . . . . . . . . . . . . . .
Plumbing changes .............................
New or relocated signs. . . . . . . . . . . . . . . . . . . . . . . . . .
New septic tanks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New sewer service .............................
Admission charged to patrons. . . . . . . . . . . . . . . . . . . .
Is this a home occupation? ......................
Excavation of filling of lots .......................
Work done in City right-of-way. . . . . . . . . . . . . . . . . . . .
Is there sufficient off-street parking? . . . . . . . . . . . . . . .
New driveway openings . . . . . . . . . . . . . . . . . . . . . . . . .
A grading plan for site drainage. . . . . . . . . . . . . . . . . . .
(parking lots, downspouts, etc.) ..................
Are the existing streets paved? .. . . . . . . . . . . . . . . . . .
Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . .
Is there curb and gutter? ........................
Other........................................ .
Block
YES N~
--
_ ----'::C
V
- V
::z:: ==
V
--V
==~
=+
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-~
-~
~
-L_
Subdivision
THE FOllOWING Will BE REQUIRED:
PERMITS
1) Building
2) Plumbing
3) Electrical
4) Mechanical
5) Sewer
6) Sidewalk installation
7) Driveway installation
8) Curb installation
9) Sidewalk obstruction
10) Water meter installation
11) Fire
12) Occupancy
13) Sign
14) Shoreline
15) Home occupation
16) Conditional use
17) Other
BUSINESS LICENSE
1) Taxi
2) Peddlers
3) 2nd Hand Dealer
4) Pawn Broker
5) Dance
6) Hotel - Motel
7) Fireworks
8) Ambulance
9) Tattoo shop
10) Other
'l'I'ORT "1,,-
.;.o~G",
'-'.~~-(':;
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~. --~
c_
'<'u(jLJC wo~'f.-~
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)
)
)
)
/)
~
t
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\~
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the Date:
information I have supplied is correct to the best of my
knowledge. Signed:
A.fFrt JlREJECTED
..,2 0' If)
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
P.B.I.A.
Comments / Conditions
I~..~I/
~
o3l5
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERMIT
A tPoo//7
PERMIT NUMBER
.
TOTAL FEE
/'/ '00 .
~'.r
Of-.-;""r:~c-
2.~ Of
CONT. Lie. NO.
, '/JA-i
j.
/
. ,.'
2-f;TiA-i L' Ac..e
LEGAL OCCUPANCY
..,TIMETocmiPLETE. ,,': NO.'STORIES
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
/f 'b W,' I ~ 5'.. -
_ CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED .
Owner :j II-/... I'V/e. eo-!'- Installation By 1Ji--fvI1P;t:- GL-t:C-rYlv
Owner's Address 2--1 bfA}, {'-( T1+ Installers Address <;;;8 I :;:0 .' I-i /1/ UJ (..,J
Day Phone .J >d-- - 4,? bl:> Installers Phone '-1$ 7 - ;;;- ~D,;,
Application is hereby madeIor Pe~mit to install Electrical Equipment as foilows: ) Ai;; 'f7"',-/.../... (2;) i74tV/lJI tV G
~e~s
Site Address
Wiring Methqd ' Em r
e"
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT CIRCUITS PEA 10 100R FEE USE OF CIRCUIT 91RCUITS PEA 10 100R FEE
CIA 30 CIA 30
LIGHT SIGN
, ' 50 VOLTS .
LIGHT OR LESS
, ,
CONVENIENCE MOTOR
CONVENIENCE , MOTOR ,
APPLIANCE '1 ,,/. MOTOR
DISHVo{ASH~R .. f FIRE ALARMS
DISPOSAL BUAGLAA ALAAM
RANGE MISC.
.
OVEN
WATER HEATER
LAUNDRY
DRYER -- REINSTALLATION LIGHT FIXTURE #
FURNACE SUB TOTAL FEE
GAS - OIL.:
FURNACE . ENERGY FEE
'ELECTRIC BASIC FEE , Ii, 0 eJ
ELECTRIC HEAT ,.,
. TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT-.BREAKER
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE -
A.W.G.
"SUB.TOTAL IG {JO SIZE OF GROUND SIZE OF ENTRANCE SWITCH
Date Application made
ll-Z$-7;,'1
, 1L.k.~ ~y
'f\:
I certify tha.t the work to be performed under this permit will be done by the installer and i
ance with the .E.C. Electrical Code.
ONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Permission is hereby given to, do the B:bove descr.ibed work, according to the conditions h re and according to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of.the City of ort Angeles. .
_ .' DIRECTOR OF CITY LIGHT ~
By .];f..," e fi:p) fLu.~f ~ JM~ pl:
. PLANS APPROVED . '. . .
.
Date Permit Issued
WARNING
Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in'
Writing on Permit Placard. A.. Permits Phone: 457.0411 Ext. 158.
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE - Original CANARY. Duplicate PINK - Triplicate WHITE CARD - Inspector's Report
OLYMPIC PRINTERS, INC.
REPORT OF INSPECTOR
,
DATE OF VISIT MADE BY REMARKS
/1 ~ r r~ 3"" /')(}:J? Ntt> IJ Ko 'S e-/f tJ f}LJ · '/5> e>N("
(!Y, ~C<< ! r ;::'o/? t5 6 rrJ... f)< Ih
\
1,,1- J(). jUt- 41E~ O.K. FOR COVERING
I:r..- ;!..L~ ~ yd 4r/// O.K. TO CONNECT SERVICE
/1/;3 .
I:J--;?D'-'f"<.-(- FINAL O.K.
.
~
(!J
a:
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i:
I-
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.
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Q
.
CITY OF PORT ANGELES
LIGHT DEPARTMENt
ELECTRICAL PERMIT
Nt?
17130
POrt Angeles, wasbJngton.....__.,l.~__..:::.!.:2.....___.___................., 19,;~,?'"
. \
In accordance with the City OrdiriaIic'e' to regulate the installation, extension, or repair of elec-
trical equipment in, on, or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to d<rlllectrical work as listed below. .
Address ---.!f:;--L~"?.~tt;;;;...o-"---''''''''''''''''''''' occupancy.,...L~~
~:~:: ~~::~~~~~!~;~~~;::~.~::~.n;;=:::::::::::::::::...:::.:::::=::::::::::::::::::::::::::::=:::::::::
Light Outlets.......................................... Service, volts ../.::;~.c;L.~'?...'!:.C: Type of Wiring:
Receptacle Outlets___m_____m..____.._...._... No wires . ......, Armored Cable .....m_____mh_........._
S'lz'e wl.res........7~.-r...........:.~~~?:....j......... Non-Metallic .--.....--.-..-.---............--
n'ye" KW.......................................... // ~-'" . .A
~'"", -7- Knob & Tube.................................
Range, KW....._____._....._____________ Main fuse ........._........___.______..._,.......
S
Enclosure m__mm_._.......h.....m___..m
Water Heater:
Heat~:~::2..C:.:.;;;~;.;;;z:..::
Motors: size. volts and phase:
Type of wiring:
Entrance Cable ...h_.hum____m._...._.
Rigid Conduit ..m.mm...................
Metallic Tubing .h__m__..___............
Current transformers:
No. & Size._............h..______...............
Ser. No.........__..._____..__._....._..__....h_..._
Ser. No. ..................h__________............._.
Ser. No....____..._..____.................._..__......
Rigid Conduit ...............................
Metallic Tubing ...........................
Raceway ._____.____...__.........__...._._..._
Circuits. Light............__................__.......
Dllilly.............................................
l-Ieat __.____................_........n_____......
Range
Water Heater ....m___..___m____._..._...
Motor
Dryer_._.____..___.__........................__....__
Furnace ._..____._..___...........___.._..___..__..__.
Remark:~ta:..~::.~~=.~.;~.:~::...,:.~e.:..:.:f~:..~~:.:gd~..______.___.......~.~~::..~::~:::~...~..:.::~.:~::~:::~:
.__.______..__n._.__._____._____________._.______..__.....__.___..___._...__..._.__.__...__.__._____._._..__.___._______._..__________._._.__.._________._.________.____......_
............................................................................................................;;y........7/1/,.... ,.....................................
Permit Fee Treas. Receipt >t. E ~; d /./
$:............-....---.......,......... No............................. By ........___.......~....___:!::r;:......~-:::.(,~.~~..~
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
17130
Address._............______.........__..........._..___...__..........____.._............._____............____..-...........--._.............Date._._......_.._..__._.........._......_._....__........
Owner.._..._...........____............._.._..._.._......__._..._.._....................______....._____.__..__.._....----.....Tenant._._._..______.._....._....____.___.........._________.......__..___
WlringContractor._..______............_........................____._....................__._..........._____............_____.._.._....._By....._____..__._............_.._._..........____..............
\ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con-
cealed due notice must be given the Inspector So that work may be inspected before concealment. '
\
,
\
1M Olympic Printers, Inc. '
\
-
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360- 417 -4735
Application Number . . , . .
15- 00000492 Pate 7/15/15
Application pin number . , .
337072
INSPECTOR:
Property Address . . , .
118 W 1ST ST
ASSESSOR PARCEL NUMBER;
06-30-Op-0-0- 3205 -0000-
SERVICE
Application type description
ELECTRICAL ONLY
Subdivision Name , . . , , .
ROUGH -IN
FINAL
Property Use . . . . . . . .
Property Zoning . . .
CENTRAL BUSINESS DISTRICT
Application valuation . . . ,
0
Application de8c
2 circuits
Owner
Contractor
----- ------------- - - - - --
HOUSING AUTHORITY OF CLALLAM
------------------ - - - - --
BOTERO & SON ELECTRICAL
2603 S FRANCIS ST
940 TAMARACK WAY
PORT ANGELES WA 983626710
PORT ANGELES
WA 98362
(360) 457 -7785
(360) 452 -4766
Permit , , , , , . ELECTRICAL
ALTER COMMERCIAL
Additional desc , .
Permit Fee 9.9.00
Plan Check Fee
00
Issue Date 5/07/15
Valuation , . , .
0
Expiration Date 12/29/15
Qty Unit Charge Per
Extension
1100 74.0000 ECH 'EL-COMM
BRANCH CIR WO/ S/F
74.00
5.00 5,0000 ECH EL -ECH
ADDNT BRANCH CIRCUIT
25.00
Fee summary Charged
Paid E Credited
Due
Permit Fee Total 99.00
99.00 .00
,00
Plan Check Total Oo
.QO .00
.00
Grand Total 99,00
99.00 .00
.00
REPORT SALES TAX
on your excise tax 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 Contractor X Date:
GAEXCHANGE1BUILDING
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -473.5
Application Number . . , . .
15-- 00000492 Date
5/07/15
Application pin number , , ,
337072
DITCH
Property Address , . . , , .
118 W 1ST ST
ASSESSOR PARCEL NUMBER;
06-30-00-0-0 -3205- 0000 -
Application type description.
ELECTRICAL ONLY
Subdivision Name , . . , . .
Property Use
FINAL
Property Zoning . . .
R87 RESDNTL SINGLE FAMILY
Application valuation . . . .
0
Application deac
2 circuits
----------------------------------------------------------------------------
Owner
Contractor
HOUSING AUTHORITY OF CLALLAM
BOTERO & SON ELECTRICAL
2603 S FRANCIS ST
940 TAMARACK WAY
PORT ANGELES WA 983625710
PORT ANGELES WA
98362
(360) 457 -7785
(360) 452 -4766
----------------------------------------------------------------------------
Permit . , , . , , ELECTRICAL
ALTER COMMERCIAL
Additional desc , ,
Permit Fee 79.00
Plan Check Fee
.00
Issue Date 5/07/15
valuation , . . .
0
Expiration Date 17./03/15
Qty Unit Charge Per
Extension
1100 7,1,0000 ECH EL -COMM
BRANCH CIR WO/ S/F
74.00
1.00 5,0000 ECH EL -ECH
ADDNT BRANCH CIRCUIT
5.00
Pee summary Charged
Paid Credited Due
Permit lee Total '79.00
79.00 .00
,00
Plan Check Total .e0
.00 .OD
00
Grand Total 79.00
79.00 .00
,00
REPORT SAL7ES on your excise to the City of Po(Location Cod)
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTIiS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAIEXCIIANGEIBUILDING
-
e 6-
�� o CC
cl (o 0
U Z- 0
3 z-- c>
q 6,
yY,
QA
2-1 C)
1C-)2C,
LO
4- ciov, , "—) u v% ti-
(, cL�,f
r ee z- e Y-
41—a,5
k.� v4 ef co uA t �e-
e—A .5 p re 5,*,> ac
<.-,.Vvko%'AA (oaf
� c�
I-C) vc,� to o '/a k 81 3 C)
Co 57,0 t ( t ct 3 Lf
Mcx) cu ��04-
12 e p
8 ko)
�160
A-ry\ p 5
A_) C-, t_g_D
-1 L7 Cap
Aj
6AP
[CCU L(q_�.��A �o
CITY OF PORT ANGELES PERNIIT APPLICATION
Building Uivfsion0ectrical
f
RECE,
V D
�ti1 ]kf I�F
Y
.e�
C
1
Inspections
$
$ 225.00
$
321 East Fifth Street- P.Q. Box 1150 I Port Angeles Washington,
98362 MAY
$ ;20
Ph: (360) 417.4735 Fax: (360) 417 -4711
tit
$ 6.00
I "
� RECYRICA1
Date; Multi-Family or Commercial` WSPg rjoi
$
Plan Review May Be equired, Plea Complete Electrical Plan Review Information Sheet
Job Address; [ [ 5 ,-
Building Square Footage;
Description of above r t, U A•t
s
Owner Inf rmation Contract; r Information
Name: 4 v , Name: °te—'3 rra
Mailing Addressr j 4&L-
Mailing Ad ress; C-) °'
City: Stale: Zip; City: ri 1 o Slate' f �Z Zip;
Phone: Fax: Phone;_ Fax;
License # I Exp. License # I Exp.
item
Service /Feeder 200 Amp.
Service /Feeder 201.400 Amp.
Service /Feeder 401.600 Amp
ServicelFeeder 601.1000 Amp,
Service /Feeder over 1000 Amp,
Branch Circuit WI Service Feeder
Branch Circuit W10 Service Feeder
Each Additional Branch Circuit
Branch Circuits 1.4
Temp, Service! Feeder 200 Amp,
Temp. Service /Feeder 201.400 Amp,
Temp, ServicelFeeder 401 -600 Amp.
Temp. ServicelFeedar 601.1000 Amp ,
Portal to Portal Hourly
SignlOutline Lighting
Signal Circuit] Limited Energy - Multi - Family
Signal Circuill Limited Energy l First 1500 sf- Commercial
Note; $5.00 for each additional 1500 sf
Renewable Electrical Energy - 5KVA System or Less
Thermostat
Note; $5.00 for each additional T -Stal
Unit Cilarpe g„yt
Total (Qty Multiplied by Unit gtn9l
$132.00
$
$160.00
$
$ 225.00
$
$ 288.00
$
$ 410.00
$ 5.00
�
$ ;20
$ 74.00
$ �1 �i� _
$ 6.00
$ 86.00
$
$121.00
$
$164.00
$
$195.00
$
$ 96,00
$
$ 88.00
$
$ 64.00
$
$ 96.00
$
$ 113.00 $
$ 56.00 $
r� �
$�� Total 2-0
od
Owner as defined by RCW.19.28-251: (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, l hereby cerlify 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 -466, the Cityof Port
Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications,
Signature of owner, electrical contractor or electrical administrator, ❑ cash 0 Check
Credit Card k 6v\
x— -- Dated; 0118112012
ELECTRICAL PERMIT
CITY OF PORT .ANGELES
360 -417 -4735
Application Number 16- 00000312 Date 3/03/16
Application pin number 384088
Property Address . , . . . , 118 W 1ST ST A
ASSESSOR PARCEL NUMBER! 06- 30- 00 -0 -0 -320.5 -0000- REPORT STATE SALES TAX
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name
Property U,se . , . , . . . . to the City of Port Angeles
Property Zoning . . . . . . . CENTRAL 3USINESS DISTRICT (Location Code 0502)
Application valuation . , . , 0 /
Application deac
NeW Freezers
------------------------------------------------------------- ------- -- - - - - --
Owner
Contractor
- --- ---- ---- ---- --
HOUSING AUTHORITY
- - - - --
OF CLALLAM
---------- - ----- -- -
ANGELES ELECTRIC
- - - --
2603 S FRANCIS ST
524 E. 1ST ST.
PORT ANGELES
WA 963626710
PORT ANGELES
WA 98362
[360} 457 -7785
3- Lf_ k
(360) 452 -9254
Permit , . , . ,
I ELECTRICAL ALTER
COMMERCIAL
Additional desc .
, 1 -4 CIRCUITS
Permit Fee . . .
. 86.00
Plan Check Fee
.00
Issue Date
3/03/16
Valuation
0
Expiration Date
6/30/16
Qty Unit Charge Per
Extension
BASE
FEE
86.00
----------------------------------------------------------------------------
Fee summary
Charged
-
Paid Credited
Due
----------- - - - - --
Permit Fee Total
---- - - - -- ----
86.00
- - - - -- ---- - - - - -- - ---
86.00 .00
- - - - --
.00
Plan Check Total
.p0
.00 00
.00
Grand Total
86.00
86.00 .00
.00
INSPECTION TYPE
DATE:
RESULTS:
INSPECTOR:
DITCH
SERVICE
ROUGH -IN
3- Lf_ k
AP
FINAL
-„ C4
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X _ Date:
W
03/03/2016 07:49 FAX 360 452 9265 Angeles Electric
REn .
AR 3
WZTWAL,
CITY OF PORT ANGELES PERMIT APPLICATION il8li13M1 f l08
Building Dlvision/EleetHcal Inspections
321 East Fifith Street— P.O. Box 11:50 /Port Angeles Washington, 98;362
Ph: (360),41 47 7. 5 Fax: (360) 417-4711 /Mufti-F&rnl1y.vr,Com'rno'rc1a1*
Date:
Z0001/0001
4A M
"Plan Review.May Be Required, Please Complete Elect d Alan Review Infomlation Sheet
Job Address:
P"
Building $quarefootage:.
C3
_•�
Description ofebove .
_......._.
�,.:.... _.�•_ ,
Owner.ln atian/�
Contra r Information
Name. , f_lrft�t. f.�l�tu °r�.
Name:
Mailing Address;
Mailing d e:
State: Zip: �
City:
stale'
94�:-
Phone; Fa
Phone:
eX
License N / Up.
�
Ucense #f Exp
775--12-7-1
Item
Unit CbaWo
a
roMf kilter Iifiaal lied by unit One)
ServicOeederMAmp.
$12.00
$_
Servicefeeder 201 400 Amp.
$150.00
#
ServicaiFeedet4011•600 Amp
$ 225.00
3ervlce/Feeder601 -1 D00 Amp.
$ 288.00
Servimfeeder over 1000 Amp,
$ 410.00
$
Branch Circuit WI Service Feeder
$ SAO
$—
Branch .CircuitW10 Service Feeder
$ 74,00
Each Additional Branch Circuit
Branch t frcults 1.4
$ 5.00
$ 86;00
-,, Y
$ '
$�
Temp. Service/ Feeder 200 Amp.
$102.00
3
Temp. Sprvice/Feeder 201.400 Amp.
$121.00
$
Temp. ServioelFeeder 401 -600 Amp.
$164.00
$-
Temp. Service /Feeder 601.1000 Amp ,
$185.00
.„ ,, .,
$
Portal to Portal Hourly
$ .96.00
$—
Sign /04ine Lighting
$ 86.00
Signal Circuit/ Umited Energy Multi-Famly
$ 600
$.. .
Signal Circuit/ Llemad Energy! First 1500 of — Commercial
$ 96.00
S�...
Note: $5.00 for aaeh additional 7500 of
Renewable SecVcal Energy -SKVA System or Leas
$113.00
$-
Thermostat
$ 56.00
$—
NO: $6.00 for each additional T-Stat *;P
Owner as defined by RCW,19.28.261: (j) Owner will occupy the stm*re for two years after this electrical permit is finalized. i2? Owner is required
to hire art electrical contractor if above said property is for sale, rent or lease. Permit-expires after six months of last inspectEon.
After reading the above statement, I hereby certlfy that I am the Darner of the above named property or a licensed electrical contractor. I am ma[dnp.
the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 299468, The City of Port
Angeles Municipat Code, and Utility Specifications and PAMG 14.05,060 regarding Electrical ParmitAppiications.
Signature•of Owner, eleaWcal contractor or ele+ctrics -1 adminiskator: 13 cuh G ctw *
Application Number . . . . . 22-00001351 Date 10/26/22
Application pin number . . . 624601
Property Address . . . . . . 118 W 1ST ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3205-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
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Application desc
DHP
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Owner Contractor
------------------------ ------------------------
Peninsula Housing Authority OLYMPIC ELECTRIC CO INC
2603 S Francis St 4230 TUMWATER
PORT ANGELES WA 98363
(360) 452-7631 (360) 457-5303
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Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 74.00 Plan Check Fee . . .00
Issue Date . . . . 10/26/22 Valuation . . . . 0
Expiration Date . . 4/24/23
Qty Unit Charge Per Extension
1.00 74.0000 ECH EL-COMM BRANCH CIR WO/ S/F 74.00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 74.00 74.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 74.00 74.00 .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
Item Unit Charge Quantity Total (Quantity x Unit Charge)
Service/Feeder 200 Amp.$132.00 $
Service/Feeder 201-400 Amp.$160.00 $
Service/Feeder 401-600 Amp.$225.00 $
Service/Feeder 601-1000 Amp.$288.00 $
Service/Feeder over 1000 Amp.$410.00 $
Branch Circuit W/ Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $74.00 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 1-4 $86.00 $
Temp. Service/Feeder 200 Amp.$102.00 $
Temp. Service/Feeder 201-400 Amp.$121.00 $
Temp. Service/Feeder 401-600 Amp.$164.00 $
Temp. Service/Feeder 601-1000 Amp.$185.00 $
Portal to Portal Hourly $96.00 $
Sign / Outline Lighting $88.00 $
Signal Circuit/Limited Energy - Multi-Family $88.00 $
Signal Circuit/Limited Energy/First 1500 sf - Commercial
(Note: $5.00 for each additional 1500 sf)
$96.00 $
Renewable Elec. Energy: 5KVA System or less $113.00 $
Thermostat (Note: $5 for each additional)$56.00 $
$ 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)Permit #: [Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711]
PREPARED 10/25/22,11:13:46 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
---------------------------------------------------------------------------
APPLICATION NUMBER:22-00001351 118 W 1ST ST
FEE DESCRIPTION AMOUNT DUE
---------------------------------------------------------------------------
ELECTRICAL ALTER COMMERCIAL 74.00
TOTAL DUE 74.00
Please present reciept to the cashier with full payment
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS:
DHP
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
11/9/2022 22-1351
TAP
OWNER
CONTRACTOR
Olympic Electric
PROJECT ADDRESS
118 W 1st St