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Home My WebLink About126 W 1st St - Building .. . , '- C ERTI FICkTE"OF'OCCU P ANCY "",J';';'''''' "''''''q", . /,4'" City of Port Angeles"''''", if' Building Division'\~\O ~' ~ This Certification issued pursuant to the requirements ofSectidlt;301 of the lntematiorf~l Building Code certifying that at the time of issuance thi.i.structure was in clfnpliance with the various ordinances of the City regulating Building U" construction or use. For the following: \~ Use Classification: Business Building-Permit No.: 05-] 0 Business Name: Fiddleheads . ~ 1'1 ~"! ~ ~ Group: ~ ~~ TypeofConstnJction: V-N Use Zone: CBD Owner of Business: Katrin~ Berg Address: 153] Towne Road. Sequim, W A..~8382 l. l Building Address: ]26 West':First Street Port Angeles:W A. 98362 Ii:\" ~.',1~C.~ ...........'.n::...7~;r~Ji'!l~i: .. '^ .,.,I.,:~ ~ >llf~ ;:g;~'" _ " ", )Wj'l"'/ '"', . <<' ,~Y.ii ugust8. 2005 . ~_~." _._._ . _ :!;.,,.. ','M<;... .d' But~!n.g&~~,~~II...:..~.'u.,'_~....."'~~<<.rt.:l~.~Ci~j~i!4;~~;'.,~:1~..;.....~~.: ..."....;'.il. .}:;~,~~-ti:JIDate "~~ ,~~!ttfJ..f~~:~~~,~~.#.\i!~'t~/2'7,~~ft,~<.r~?,1t11i' Post on th~~Pr:EUg4Z~L~J~jJ.~:f~JJ~PJ~tJ~US pla~:. Shall not be removeCl"exceptbyBulldmg Official. '''''~~'i:;l<;._i:'(':lt'f.'1',>1\!ll',~l.''''.'''' . . c::::-- , . , CE-I<Tocc-e>/e>/os- 13 ./ 05-10 " ROUTING SLIP @f-<itVlII'tL :3- .r>)O Certificate of Occupancy 1 trlaf 6> Y $47.00 Certificate/Inspection Fee ~ I-I'ddl / ~ h~4d~ DATE If- :( , --- .-/ (),<; Address of Proposed Business /~ (p // /u<; ~ I::::; k<.r ~pplicant .J:;;.f/,Ji/:..:....._&r<:). '"\ Address ~"'j J --k2u.JxY t2d r-,. """wI Jhyn u//I Phone: business home 6-R"'! -/.-Jkj' f.OR'A>\< ~o~oO'<;. o~~'" ~~ ~ - ~",Wo<<'-'" ? New Business............................ ( ~) Transfer of Business location. . . . . . . . . . . . . . .. ( ) Change of Ownership. . . . . . . . . . . . . . . . . . . . .. ( ) New Building ............................. ( ) Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) Temporary Business ....................... ( ) Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) /) ") / Brief description of proposed business: )f~" /-6' , . .1\ t?YY7 P , / .r CJr.; :::::1...r7 legal Description: lot Current Use of Property: (" -<'" 1-..-;-, ') Zoning Classification of Property: Block WILL THERE BE ANY OF THE FOLLOWING? YES NO Construction changes. . . . . . . . . . . . . . . . . . . . . . . Electrical changes. . . . . . . . . . . . . . . . . . . . . . Mechanical (heating, cooling, stoves) . Plumbing changes ................. New or relocated signs. . . . . . . . . . . . . . . . New septic tanks. New sewer service _ --iL - ---L --L ~ Z_ _ ----L -~ - ---L -~ -~ _ ---L - ....."L _ ---L. _ --.L _--L _ ---L Admission charged to patrons. Is this a home occupation? ...................... Excavation of filling of lots ....................... Work done in City right-ot-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. . -~ _ -----1L Subdivision 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 ( 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 I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the frDate: I" 7'- (), ,,/ information I have supplied is correct to the best of my // / knowledge. ~igned:. / -- /-- ~ J~ /' ;.- /= I~I~:< REJECTED /'- Building Section Public Works Department Planning Department Fire Department City Clerk P.B.I.A. Pc,J~ 3-7'~S" Jrfl ,00 J. ?-(}5 -!Iv Jr.. Comments / Conditions L, .lV. ~ ,...............1 CERTI F~;v;~e>'f~,?ICCU P ANCY /'~;~i~f~rri~~f:~~:~..:.. L---_. This C'j{tif.cFtl<jn is:~ued fursuant to the requir:fI1ents of Sectim't!.09 of the Unijor"ljBf''cld1'1$ C.odeic~;tilY.'hg thatgt!~e tt~I'ei?f":su~ng~_thls st~ucture was In co.mpltwJce wtth the.varlOus o(dlnancesofth{i:Cltyr~gulrltlng QUlldlng I ! ;\: '.:~,;ronstrf':tion, or ~~~:for th~follo.;vii1g:.<\ l ::,:~':". T"';~~:::" 'IVN"j ,""",,,...,s~;~~q ~::"=oo Own" nf Bus;nesslRes;denc~; Shelly Woodward Address: 8 i 7 'South Liurd Street. Port Angeles, W A. 98362 \, " " . ,'I Bu;ld;ng Address; '1,26 West I Sf Street Port Angeles, W Ai 98362 '~--I tober 2 2003 Date OJ?. -I <'/-/)1, legal Description: lot Current Use of Property: Zoning Classification of Property: WILL THERE BE ANY OF THE FOLLOWING? YES NO -)LX -~ ---X- _ -L =t =-x- X~ -Z t *= 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. . Se \ cd" New Business ........................ Transfer of Business location. . . . . . . . . . . . . . . . Change of Ownership. . . . . . . . . . . . . . . . . . . . . . New Building .............................. Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Temporary Business ............ . . . . . . . . . . . Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . Subdivision THE FOllOWING Will BE REQUIRED: PERMITS BUSINESS LICENSE 1) Building 1) Taxi 2) Plumbing 2) Peddlers 3) Electrical 3) 2nd Hand Dealer 4) Mechanical 4) Pawn Broker 5) Sewer 5) Dance 6) Sidewalk installation 6) Hotel - Motel 7) Driveway installation 7) Fireworks 8) Curb installation 8) Ambulance 9) Sidewalk obstruction 9) Tattoo shop 10) Water meter installation 10) Other 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) 01her 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. LJ Signed: ~REJEC'ED Building Section Public Works Department Planning Department Fire Department City Clerk f'B.I.A. liDt[) 3-/11-03-6.) X / ..O"T." lO~<>(O<;. ~-' rJ'~ ~~ ~ - ~IC~<O (~) ( ) ( ) ( ) ( ) ( ) ( ) ~ . '-'. '.'-I~.. '__~._ _T____. -.:! -- -..-..~..,~; - , T- - ,- --'r - . ~'~'$:e..\~h C?;fis tr E51Y~ .. -, '!:, . , > ,; ~, .',' ~ ROUTING SLIP ~ _, I ' ", \ Ge,:tif!f~te '<Jf, <?ccupancy C;:;:;.oo Certificate/Inspection Fee -, ..Y" ~-J '.. - . ( '. I ~I .....' .~..... 02 ;"I'-/~trs'" DATE Address of Proposed Busi!l~sS + ('" J.._ . L \ ?J '" \ l \K+ hV'<" - ::'<Jy'1l::r Applicant <hJlll U \ A ),~: ...,.{ l",cYU/ r() Address "'X 1"1- '.) I fA j .lY1i...v ,'.-+. ~r.{ (1fY.L.e '2; ~. lAy:) _ qRZ~~ Ph~ne: 'busi~ess\ liS).,<:;2Qi.n home /..IS1.:'.<."qSL, New Business ".'"."""....."......., Transfer of Business location., " . . . . . , , , ' . Change of Ownership. . . . . . . . . . . . . , , . . . . . . . New Building ... . . . . . . . , . . . . ' , , ", . . , , , . Remodel, . Temporary Business ... , . . . . . . . . . , , ' , , , . . . . Change of Use, . . . . , . , , . , ., ,'..",.". ii' Brie] description of proposed business: rf}..{ll i P ,(2!W..R ~1(Lj1d ru'7d. 'Ik'n j 1'//.J1/1 .i legal" Description: lot E:. 2 l6:t:L3-,' Block .~2. Current Use of Property: P .!./flIJl '..J.Gr,p Zoning Classification of Property: (l ~ . . WILL THERE BE ANY OF THE FOLLOWING? YES NO ~ ~x= )( -A '~ --'--)( -c-+ '-y -y -y x- =L X y- --x- - X - 'X= Construction changes. ... . Electrical changes. Mechanica! (heating, cooling, stoves) . Plumbing changes . New or relocated signs. New septic tanks....~...; . . New sewer service Admissio~ charged to patrons. Is this a ho'me occupation? Excavatio~ 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? ..............."l.. Are there existing sidewalks? . Is there curb and gutter? Other. ..-t.. I hereby apply for a.Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge. APPROVED REJECTED }!~k~ I , --- Building Section Public'Works Department Planning Department Fire Department City Clerk P.B.I.A. .., 1 Ilwr./...u d /('\ f1 , J . .... ( ..;:a<) ( ) ( ) ( ) ( ) ( ) ( ) , l.J,V)(../SY--, --kM~~ [" 01 f12-Jl/. o'i)., . Signed: ~7J~u.j((CI! iVL111J J' \....J'~ 1\ \......-.... commen~s / C(:md~tions ryTIA":'? \::)1-,n 0 ..~. ::-:'(yAJ(Vo..,+b-,,~~ ,'.(' +-~o_ c:. p-, \:::ll, )/ 1Jf^W, ':1Q:\U~1t~t T;~: ~ : ~ A. ~<5) ./ ~~:J~~:t ",r;,:t~~ Subdivision THE FOllOWING Will BE REQUIRED: PERMITS 1) Building 2) Plumbing 3) Electrical ..' 4) Mechanical 5) Sewer 6) ')Sidewalk iAstaJlation 7) Driveway installation 8) Curb installation 9) Sidewalk obstruction ',1 10) \ Water meter installation . 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) 01her BUSINESS LICENSE 1) Taxi 2) Peddlers 3) 2nd Hand Dealer 4) Pawn Broker 5) Dance I : - . 6) Hotel - Motel ~. 7) Fireworks 8) Ambulance \ 9) Tattoo shop \ 10) 01her Date: . . " "- '\, '\ ~ . ~. .-- J__ -~ -- A''O''''G .Q Se ~ C( h DATE f72-1'I-Ifs Phone: 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 oft-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...... . YES NO -X-~ =:i: --2L _ --2L t --X- X~ iX "re.S"':.C; New Business ' , , , , , , , . , , , , , , , ' Transfer of Business Location, , , , , , . , Change of Ownership , , , , , . . , , , , , , , , , ' , , , , , New Building , ' , , , , , , , , , ' , , , , ' , , , , , , , , , , , ' Remodel, , , , , , , , , . , , ' , , , , , , , , , ' , , , , , , , , , ' Temporary Business "", , . , , , , , , , ' , , , , , , ' , Change of Use, , , , , , , . " """"""",.. 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 1 0) 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 I knowledge. Signed: ~~R,"'C"D Building Section Public Works Department Planning Department Fire Department City Clerk f'B.IA / O,.O"T..... (J~~G"C.. -"""-." ~ Ii!l:T'S?4,,< ...~,. ~ - """"ICW#~ (~) ( ) ( ) ( ) ( ) ( ) ( ) ? IS'- c -- ~ c ~. . iO~ditions ;j ~ . . '~ ;fur, ~ W\l-V4Wo ~ ~ cJi .ORT ~ l~~ na '"- ~ ~ ~Wi<fi' CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00000065 Date 2/07/05 .237620 126 W 1ST ST 06-30-00-0-0-3220-0000- FIDDLEHEADS Owner Contractor EXPIRED 'b/fI/or; ~ ~ ~ 'J" SIGNS CENTRAL BUSINESS DISTRICT o KEN TOBIAS PO BOX 2261 PORT ANGELES ( 36) 452-4856 WA 983620169 MILLER SIGNS 30 CHILDERS LN SEQUIM (360) 683-6790 WA 98382 Permit SIGN Additional desc 36 SF WALL MOUNT SIGN Permit Fee 85.00 Plan Check Fee .00 Issue Date 2/07/05 Valuation 0 Expiration Date 8/06/05 Qty Unit Charge Per Extension 1. 00 85.0000 PER S- SIGN WALL 25 SF+ 85.00 N 6" Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 85.00 85.00 .00 .00 plan Check Total .00 .00 .00 .00 Grand Total 85.00 85.00 .00 .00 <: Ij\ i Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work Is suspended or abandoned for a period of 180 days after the work 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 b~C-- A~' Signature of Owner (if owner T \Pohcles\1102_15 bwldmg penm! mspecl10n record05.wpd [1/4/2005] \ FOR OFFICIAL USE ONLY BUILDING PERMIT - APPLICATION Date Rec 1'- ZS- -C)$""'"" Permlt d5~ Date Approved ~ Date Issued ti Fill out COMPLETELY and in INK. Your application and site plan MUST B COMPLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 Apphcant or Agent: Owner: ff.....t1 rJ r .F;!J/,) it ) ()~~ )') /V/J ra /~ JO h) .c;:: 5 Phone: & ~ s -& /- tr-- 5/ Phone: CIty: ZIp: Address: ArchItect/Engmeer: Contractor /~ /!/y (' I5 rJ c:; Address: Ie:? 0 {{/ r /',/5 -J PROJECT ADDRESS: LEGAL DESCRIPTION: Lot: CLALLAM COUNTY PARCEL NUMBER: Phone: State LIcense #: Exp: City: ~/)/'-f4(5P/us Phone: ZIp: 7' If: -? C;;; ?/ ZONING: ~I3-D Block: SubdIVIsIOn: Credit Card Holder Name: Billing Address: Credit Card Type VISA TYPE OF WORK: o ResIdentIal 0 New Constr. 0 Re-roof 0 Stove o Multi-farmly 0 AddItIon 0 Move 0 Garage o Commercial 0 Remodel 0 DemohtIon 0 Deck o RepaIr lV"'SIgn 0 Other BRIEF DESCRIPTION OF THE PROJECT: .5{.~,.e.. ~oV\:t- ~c)"'-v'\"\;ed ~i~~,^ 3~9 COMMERCIAL/RESIDENTIAL: Occupancy Group' City: MC # Exp. Date: SIZEN ALUATION: ~~ SF. @ $ /SF. = $ SF. @ $ /SF. = $ SF. @ $ /SF. = $ TOTAL VALUATION $ (.c.2.4~ ''-II X '2~1 "-Jaw 3X/'?i/ Wa...I\ Occupant Load: & Proposed Sq. Ft. ConstructIOn Type: No. of Stones: Lot Size: Total lot coverage EXIstmg Sq. Ft. = TOTAL Sq. Ft. % J~~;~~~~~\ f}:f;))-''''' ~ APPRO~Z : PLAN: BLDG: DPWU: FIRE: OTHER:_ ESAlWetIand(s): 0 Yes 1id'N~ SEPA Checkhst required? 0 Yes rio Other: VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the apphcant. ThIS figure wIll be revIewed and may be revIsed by the Bmldmg DlVlslOn to comply With current fee schedules. Contact the Perrmt Coordinator at 417 -4815 for aSSIstance. PLAN CHECK FEE: IF a plan check fee IS due It must be subrmtted at the trme the bmldmg permit apphcatIOn and constructIOn plans are submitted. All other perrmt fees are due at the trme of perrmt Issuance. EXPIRATION OF PLAN-REVIEW: lfno perrmt is Issued WIthm 180 days of the date ofapphcatIOn, tIle application will expire. The BUIlding Official can extend the trme for actIOn by the apphcant up to 180 days upon wrItten request by the apphcant (see SectIon Rl 05.3.2 of the InternatIOnal BUIldmg/ResIdentlal Code, 2003). No apphcatIon can be extended more than once. . I hereby certify that I have read and examined thiS appltcatlOn and know the same to be true and correct I am authorized to apply for thiS permit and understand that It is my responsibility to derennine what penn.s are reqUIred ,not the ~ must obtain such pennits prior to wolk. T IRVESS\BLDG-fu=-brooh,=\2004-Bmldmgp'>=1 wpd APPh<=t:~ L,. 17 Date, lb~J3::-" CITY OF PORT ANGELES - constructi~' Plans The Issuance of this permit based upon these plans, s 'fi. - cations and other data shall not prevent the building officla -'-"/ from thereafter requinng the correction of errors in said plans, specifications and other data, or from preventing bUilding operdions being camed on thereunder when in violatIOn of all codes and ordinances 0 IS JUriS IC Ion. (SECTION 303(c) . Uniform BUilding Code.) ./" Approval Date J~(\ 05' By j\...L- -Efl s:: ~ 0 Q) ~ O::l a. ~ 0. a. "0 -. ~ . -< ~ 0 ~a: ~ 0 c.n o c 0 o Q) 0 0...., 0' Q) C'" -. .., Q) (J) CD (') CD 3 ,,0. 0 CO - < a~ Q) c,.... 0 ::J ~ -ft 0.(J) 0 a. :E 0 en -.::l ,.... CO ::r::l ::J -+.CD S20 -Efl c.:~ ::J 0."0 en (J) ::r r+ I\J CD Q) -. - ~ Q) :J ::J 0.(D CD . 0-0.. ~ (X) 0 CO 0 I L J:: .. >( - G' I I [11 . -" I '. '" . 1 ,U-l I 1 II ~~T~:'f.l j "J, ~t1~\ j : ! ! ; 'I ! I I ; I I , I 1, "<, . \! i."W ,j [,< (L.',.1 (f) '.! ---------, , , , 'f . --n: ", i ; , ~ ;. 5'4! r~~,~l hS~~4J'~ \~11 :J;f- /~{1 ll'~~ '",1)~ 'j. , c r l-i<;"tt~l ; ~~,;~n i , ~-r.."';:'i '1 t 1{y,1. ~.t~:J1~ I · : it.,....\.- ~i ~~)M f LU : '~'.CL._: , '(j) ":j . ";j v< -_1.\...""-'" .......,"'....""'V ~ .. >( - ~ ~ .~s. Flt~. 4. Sh.~~ ~ \:C '""'- Ii b'<Lh t.J pl:( {\(.,JraiL.....-l ...1b ~() 0\'1. ou \2.~~ j)...~'L F-.,c:;~en>:..... lV 360-883-41790 1190 CBrtsborg Rd. Sequirn. We. 98382 Att: Roger Vess Installation plan for Flddleheads 3' X 12' l:!...-._~ crews front ~,: \t;) t~~! ~ ri;": I · ,.': """ l' ,it! H~t I h!" ~:!':f: screws I'''~~' " - l11:1~ I,;, I, (:\ I~!. ~ side US6" ~~+.g U~ c:;..., --1 +'^ 4,~ \.....\~U<5 5,^e,g.~ . J { ~.A I a --. 1/ ,..,.1' -:')1 UO - 6w6 Q1.. l)4':'> A1:-I \'-_,..u......L r-D~ 6:","'']'"1<:'' 1:. -"-'d-I"<d 1/2" MD plywood sig screwe t fascia with r;~ exterior coated wood scr ound perimeter of sign every 24". Foam letters will be attached to plywood with silicone adhesive. Thank You, Rob Campbell 683-6790 -_._-_....._~ SN~IS"~31IIW Wd Lt:sa saa~-L~-N~r ta"d a6L9~89 c1 vOItT & l~ . r....a I!. -- ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST'STH"S1'R.EET, PORT ANGEL'€S, WA 98362 Lasered CEO Appllcation Number Applicatlon pln number Property Address ASSESSOR PARCEL NUMBER: Application type descriptlon Subdivision Name Property Use Property Zoning . . . Application valuation 06-00000978 Date 9/08/06 062498 126 W 1ST ST 06-30-00-0-0-3220-0000- PUBLIC WORKS UTILITES Owner Contractor ~ I ~ ~ CENTRAL BUSINESS DISTRICT o SMITH, WILLIAM F PO BOX 967 PORT ANGELES (360) 457-4737 OWNER WA 98362 Permlt . . . . . Additlonal desc . Permit pin number Permit Fee Issue Date Expiratlon Date RIGHT OF WAY R/W USE #06-25 86405 35.00 9/08/06 3/07/07 Plan Check Fee Valuatlon .00 o Qty Unit Charge Per BASE FEE Extenslon 35.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35.00 35.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 35.00 35.00 .00 .00 ~~ t~ ~~ . 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 -Date T:\Pohcles\1 J.()2.1SR [1105] PERMIT INSPECTION RECORD CALL 417-4807 FOR U'flLITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE 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 I ACCEPTED COMMENTS I YES I NO PW UTILITIES (Engineering Division) WATERLINE / METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE I I 1 T FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W./ PW/ CONSTRUCTION - R. W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\l1 02.\ 5R 11105] HTE" # Dro-978 Lasered CEO CITY OF ~ORTANGELES '~~. . I~ WAS H I N G TON, U. S. A. ~Ir:am,-<w;''''rim~-~ff()l~(~:::~:': ",~~~;~:-~"-'<-y:~ ~~~tl! " i !';! ~ A'" ~'r-"';"'" ] C^, ',- 7 :'~ ,_, d" " ,~" - NAME OF APPLICANT I::; de) (./ i i7 42-( ds . MAILING ADDRESS k2 It r'/ ) ~ I r~ f-- ( <; ;;~1 ;/-- PHONE NUMBER <f ~c::> ~ / / Y STREET ADDRESS OF PROPOSED STREET USE /~~ W, /~~",+5h~ + , DATE 6"/~1{~ / DESCRIPTION OF REQUEST (include drawings required for clarity): [If street closure is requested, please state the name of th street and Iimitlj of closure, together with t e dur~tion of closure.] I f r .I", CJ &I r ff1 c::; //. HOLD HARMLESS and INDEMNIFICATION AGREEMENT In compliance with the Port Angeles Municipal Code, and in consideration of the issuance by the City of Port Angeles of a Right Of Way Use Permit to the undersigned allowing the placement of the above described street use or obstruction, the undersigned for himself and for his successors in interest, hereby agrees to indemnify, hold harmless, and defend the City of Port Angeles against any claims or lawsuits for personal injury or property damage arising out of, or in any way connected with, the placement of the use or obstructio{\f\".~~ity street, sidewalk, planting strip, or right f way \" ..IE ~ 'I, :-." t':.~\I" rllA/P.'''6 ~ ~v ......... c.......~~.."-" .. ~.,.,.................~ .~. ..."",. TA .\0<'\,.' S(]~. ~O ~~ ..~~ = ~ ~ ~ - ':MAR 4 2008' . - ,^.. , " .- - v..: .2 ~ ~:-\ ~ ,61J~ :O:t ~ "'57,;1'. .." ~ ~(f'....' ...=-,0~ ~ ........;, O~ .... ~\""",,~ : ?/II WAS \\' : :....!.{J.ILllll.U~~............: i nt SUBSCRIBED and sworn to before me this 2...2:.. day of W5b~-r:- ,20~ o ~r,'~~ ~L~ NOTARY PUBLIC in and or the State of Washington residing a~Q. '\ ~c L.:k,<:' (This permit if approved, may be terminated by the City of Port Angeles without cause and at any time) ,200~ [OFFICE USE ONLY] ReView copies sent to: Police Fire Street Date: Date application received g -- t1-!Jf;? Fee paid $ $!?:!2- Receipt# Certificate of Insurance per PAMC 11.12.140(8) Agreement to Remove Encroachment signed and on N/A recorded on N/A ************* A,/ _ Application reviewed and recommendation by City Engineer /~ ~Date ~/-.,(I "''' is to ~e and with the following conditions: Pi 4_ 4- -. _ s ,....... 5 f7c:L-. ~" c:...'.- ~tz." f -'D' (.c;- a d~ by the Director of Public Works D~7s~b ................................................................................................................................................................................................................................................. o Address file 0 RUP file 0 R UP # t/ ~ ,.- 2..5 Approved copies to Apphcant 0 Fire 0 Pohce 0 Street 0 Other N IPWKS\LIGHT\CONSICATEIROWPER wpd 1.- ELECTRICAL PERMIT CITY OF PORT ANGELES LIGHT DEPARTMENT Site Address: /:< C:> Installed By: !V/~ Owner/Business: o Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Totai Motor load (attach breakdown) o New Construction o Remodel ~servlce update/alter/repair )1 Add/alter circuits o Auxiliary power (list beiow) o Special equipment (list below) Details/Description: PERMIT NO. <:)89~ /.9/st/q 0 / DATE o READY FOR INSPECTION License Number: ~WILL CALL FOR INSPECTION Phone: J/ 8'~5;l5 D Sq. Ft. o Overhead o Underground Voltage o 10 03.0 Service size o Temporary Amps . W.S. No. Service Capacity: 0 O.K. 0 Not O.K. o Ditch inspection O.K. o Rough-in/cover O.K. o O.K. to connect service 'fJ Final O.K. ~ Date Hold for: 0 Easement 0 Letter Size Comments o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Notily the Department 01 City Light by S eet Address and Permit Number when ready lor inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspect r in Writing on the Wiring Report or the Building Permit. PHONE 4~0411, EXT. 158 or EXT. 224. NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT -If>;;2 () Inspe or Amount paid YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall Site Address: w/,af ,.J. Installer: . OlYMPIC PRINTERS. INC. perm~ReceiPt ~ New Meters Date: DATE 1, ()y NE QNTRACTOR ~c. INSPECTOR L I I I I I ELECTRICAL INSPECTION WIRING REPORT 417-4735 ~J/,c..f_ ADDRESS /.,2b &u / $+ APPROVED NOT APPROVED o ............."".".. DITCH ..."..."........... 0 o .............. ROUGH IN/COVER.. ...... ...... 0 o .................. SERVICE .................. fit: CORR~T:~~S~~~~~Dt[/"" FINAL.. .........:.~.. .~D 7l?4:!... ,'-II:) ~5fO;1:1 ~~ "(',1 V\NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 AUG-13-133 113:23 PM ~ 3.53287,2/7378423 37441313 P.01 {\\J ELECTRICAL PERMIT APPUCATION FU-' i,)ff It'JAJ. '-iU OM. Y , O.~""R.. . _, '_'_. .... rcnnil", _ 0"" Apprm..$. _._.= o.:.ratw.<!...___~ The El&c.lric.a: Permit App!k:al:on must M flUid Qut CO~ ~8cr REQUEST INSPECTION 0 ()!;ner or Elec. Con~.c1orAgent' -...El~.-.1,~ 5..:,..., 'u, _ ,../.L.--. Phone: 1.0. '~'i.2Y- Fe.: l\ rL-"~ ';L " Ke,VI 101 i ~ ',- . Phone: 'L.J ') 2, L.f8Sfo Ad~r..'_(p() ~"7 ,120;>1 City:. P.url n\~~Qb.~ l' """ Zip: CfR.3C-:L elliotrleal COn~.ctor. (Z:\,l! '-.",., '- ~~ I 0==---- Lico".eU:_u2.(_, ' ?p: "Y""/., Phon.: 4r l..--6V2 AdQ......: ~"L ~- I.(~ R..& C,,,_ \~n., Avr~ /I...J---.' Zip 'fT~" INIlTALLATJON WIRED BY: Ci OWNER ~L CONTRACTOR /".. I C8dlt C.rd Holder N.me:_. ~ ~LA 4:-( ""ln9 Adrire$s._______ ~ _ City: Ptel..type or ..print In Ink, If fOU he.... .n~ qUIIllonl, pl.... .-all (360) 41704736 F.. number: (3I01.17~71 1 l"tOper1y Qwr,., ofjdlt Card Number: Zip: . VISA: IIC - ~fCT ADDREss: . OF WORK: o Resldental 0 Mul~-famlly 12 (0 w ls+ Check !ill that apply: CJ New o ~ommerclal o Mobila Home Sq.Ft_. At/no\e Meter [1 Detached gerage [l Hot Tub [] Swim Pool Nujl\ber of Circuits added or eltered. ,_. .--D....-.__ .RIPTION OF THE ELECTRICAL PR9JECT: . If! q V) V.' l l n n o Septic Pump o Low Voltage [1 Telecom. D! t..~l\. ft/ 2r;:] ~;) ~ ~ai~ (Iu;" ,+() --\." 0<1> \" t/14-sl) \, iJJif2R y; ~ Service Information ___ .1:81 Helt LOlel Additions PERMIT FEE: I 01'. board :) , ce O' ", Pump ~n.Wall KW KW -TO~ LRA -KW ---- -A9verheeo Service . :J T ..mp Service .:J Underground Service Voltage: I J 0 /':1..,-<, Pheee: ~1 0 3 S......lce Size: :0.00 fI."( Feeder Size: Pi" ',,14.05.060(8): For Industrial, co,emerc!al, & residential prOjects larger then e ~uplex, a one -line dra'h1ng of the Electrical Service F (8, building size (sq. ft.), load calculat,ons, and thelype & of conductor. andlor raceway I. ra<julred and shell accompany the Eieclr 1"8 application. 3h '~by certify that I have read and examined this applic;arion and know that same to be true and correct, and / a . fJ/1zad to apply for this permit I understand If is not the City's legal responsibility to detarmine what permIts I~d,' it remains the applicants responsibility to determine what permits are required and to obtain such. fJllqo 11( dJ ~.rf,c-;(-dbA3 ~-7Z~ ~ c..,,, C." H.,.,,'. "'''''''' (;.. /. ~~ 0... . ~j,3/'" . Owner or Elec, ConI. Signature: C::-rL _. Dete: rs/':3 /~3 C :/ELECTRICALPERM IT APPllCA TION ~c~ S - It$" · O~ $Oj"t.60