HomeMy WebLinkAbout129 W 1st St - BuildingCERTIFICATE OCCUPANCY
•-c
City of 'Port Angeles. 'Bijilding'Divosion
H.
This certificate is issued/pursuant to the requirements of Section 110. ofthe 200International Building Code
4U`g,.7'177R IV
certifying that at the tzme‘oftssuaneethmstiTicture was in compliance with the various ordinances of the City
kol
regulating building consti240FOlvusefor
Business name r 12411bVs l(O:Wri' e'.' r ort2611
•Npw Toc
Business address 129 1s St.
.t 0,45tV'',
Property owner i Trudy Haversat Sresdhini.
-1---„„..
Property owner s address :41 PO Box 10801k ..„eli.i3)el':gQp9'390z
Automatic fire sprznkler,system. Per BO*
Use occupancy classi :Cation Mercantile
e'
„1,, ,kt.,.. sti, ,zoiri- 1.1&_, ,a`4.-
Building permit numI 09 9
kr: 57
i
"i
Type of construction. VAIENC' VW
Occupant load
Pet-Nit:A.:
Post on the premises in a conspicuous place. Thiet not be removed except by the Building Official.
IY aiwyc 10 2:7 0
PREPARED 9/18/09 8 25 33 INSPECTION TICKET PAGE 11
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 9/18/09
ADDRESS 129 W 1ST ST SUBDIV
CONTRACTOR PHONE
OWNER TRUDY HAVERSAT GARY BRESCHIN PHONE
PARCEL 06 30 00 0 0 1545 0000
APPL NUMBER 09 00000957 CO CHANGE OF OCCP /USE
PERMIT CO 00 CHANGE OF OCCUP /USE
REQUESTED INSP DESCRIPTION
TYP /SQ COMPLETED RESULT RESULTS /COMMENTS
C099 01
9/18/09
BLDG C/O FINAL TIME 01 00
OVERRIDE TAKEN BY LPANGRLE DATE 09/18/09 TIME 08 16 24
September 18 2009 8 15 21 AM 1pangrle
DON 477 4913
C OF 0 FINAL ZELLER S ANTIQUES
AFTERNOON
COMMENTS AND NOTES
Print in ink
ACTION
v
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
I hereby apply for a Certificate of Occupancy
supplied is correct to the best of my knowledge
For City use only:
Department
Building
Fire
PBIA
Planning
City Clerk
[Public Works
Date /7/ �I
T -orms,r g 'livision /Cerlifi ale of Occup cy P
CERTIFICATE OF OCCUPANCY APPLICATION
CITY OF PORT ANGELES
Attn Building Permit Technician
321 E Fifth St. PortAngeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
BUSINESS NAME ZE LLB 5 /-I-1v j (QuE S
BUSINESS ADDRESS y of w 6 /RST T (4-re&F- (e,, d no+ b enn;yt
Business mailing address Phone
Opening date /0// /o q Days hours of operation CI —6 '1 .I c,, s
Washington State Tax I D 6 3 71 3 1 If known list the name of the previous
business at this location
Cent'k rrBGLT°i Se1I 'na
r
Phone# 4 or q17- 114'(3
I. Business owner's home address 6 ri Nun A44,o%
PLEASE NOTE. Ft -Y1SOtn
A Business License is also required for the following businesses. Taxi Peddlers, Second -hand dealer Pawnbroker
Motel, Fireworks, Ambulance Tattoo shop Contact the City Clerk at 417 -4634 for additional information.
Brief description of proposed business il-tvr l ¢u FS
1 Business owner's name Vow 2e_lk.r
r
Approved Rejected
Initials dat f Initials date
Vidal It
itcgCfl 11 /4)1h
9-0 -09 kill
1q 7- 09_3_ii
WILL THERE BE ANY OF THE FOLLOWING? I NO/ I YES/ 1 IF YES
Electrical changes
New orrelocated signs biscosS be
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 gutter in front of this business?
Call for Certificate of Occupancv inspections before opening business
Building Department Inspection 417 -4815 Fire Department Inspection 417 -4653
Please provide a minimum 24 -hour notice for inspections
Print Name 4703,, Z e (.er
al;on
Signature
Comments Conditions
Type of construction Occupant Load
Automatic fire sprinkler system required no
yes
Permit 1 9 5 7
FEES
Certificate Inspection
Parking Business Improvement Area (PBIA)
fee charged for downtown locations
Zoning C 'D
Dance Hotel-
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
I acknowledge that I have read this application and state that the information I have
1
e
ion
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Freight Elevator
Owner
TRUDY HAVERSAT GARY BRESCHIN
2328 DEER PARK RD
SALINAS
Permit
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per
1 00
Fee summary
ELECTRICAL PERMIT AND INSPECTION RECORD
CITY OF PORT ANGELES
360- 417 -4735
Permit Fee Total
Plan Check Total
Grand Total
CA 939127881
ELECTRICAL ALTER COMMERCIAL
125195
58 00
4/24/08
10/21/08
08 00000484
873912
129 W 1ST ST
06 30 00 0 0 1545 0000
ELECTRICAL ONLY
CENTRAL BUSINESS DISTRICT
0
Contractor
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457 9270
58 0000 ECH EL COMM ALT <5 CIRCUITS
Charged Paid Credited
58 00 58 00 00
00 00 00
58 00 58 00 00
Date 4/24/08
WA 98363
Plan Check Fee 00
Valuation 0
Due
Extension
58 00
00
00
00
INSPECTION ELECTRICAL
TYPE DATE RESULTS INSPECTOR
DITCH
SERVICE
ROUGH
Ili
FINAL
COMMENTS:
-7/21 /Q9
04/23/2008 19 37
Job wired by l Electrical Contractor ia Owner
Ele ri cal lc contractor tam License number Date Expires
Pt,te per go, l d 2,r�d cl t��"�'1 Pi 9'7 3 /Z
_9 y.3 03 i o/ /4.)
City �m,�f les SuttiDZA_IP
ef3b3
Telephone number
PAX number
-9 .2 -7 0 549->
Premises owner's natl1 /T e
Address of inspection
City
Li
9 cut
00- An.r4 ices
4579270
Phone rube to s hed Inspection:
Owner as defined by RCW19.28.26117) Owner will occupy the structure for two
year after this electrical permit Is finalized. (2) Owner R,s regnlred fo hire an electrical
eontroctor if above said property Is J,r salt renl or lease.
After reading the above slatcmcnt, I hereby certify that I am the owner of the above
named property or a licensed electrical contractor, I am making the eleetricti instal-
lation or alteration in compliance with the electrical Taws, N.E.C. RCW Chapter
19.28, WAG. Chapter 296 -46B, The Ci of Port Angeles Municipal Code, an
Utility Specifications, 7-/ and
"Slgnntnr of •veneer, electrical •o. rector or electrical
Electrical •AdditionsandgL
NO LOAD CHANGES
O Baseboard KW
Fumace KW
O Heat Pump Ton LAIR
0 Fan -Wall KW
l0.
Inspection
Date
Dote
FINAL
Date:
Lactlaks.
ADrtr•vcd By
Date Approved By
administrator
Area, Building or Equipment Inspected
SIMPSON ELECTRIC
ELECTRICAL WORK PERMIT APPLI CATION
/Installation description
Commercial D Residential
0 New
d(9 ,o
Ou- IL .v
p
gliig1ci
p as,✓ f
Q Overhead Service
O Temp Service
O Underground Service
SAME DAY INSPECTION. CALL BEFORE 7 :00 AM 360 417 4735
ROUGH -1N T1EERMOSTAT
Date Approved By J
DITCH
Date Approved Hy
3:0Altered/Addldon
PAGE 01
4( t
/n 4 i Oa 4>C n) i5 L r
Cash O Check
Credit Card
Card
Expiration Date
0 g. J <feara
Mastercard
Voltage
Phase)t 1 S
Servi Slze_
Feeder Size:
SERVICE
Date ADpreved By
Date Aperfoved Dy
Action Taken
/Inspection fcc
O
Sarylkeintoctuttm
Discover
Electrical
Inspector
~..ORT~
...O~<'O
?~~
L~
~
'0:.-
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
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
07-00001051 Date 9/11/07
561358
129 W 1ST ST
06-30-00-0-0-1545-0000-
TRUDY HAVERSAT & GARY B.
RE-ROQF
CENTRAL BUSINESS DISTRICT
34000
Owner
Contractor
TRUDY HAVERSAT&GARY BRESCHINI
PO BOX 10881
SALINAS CA 939127881
(831) 241-1861
STRAIT WAVE SERVICES
2020 W. 5TH STREET
PORT ANGELES WA 98362
(3601 452-5962
Permit BUILDING PERMIT - NO PR FEE
Additional desc TEAR OFF & RE-ROOF
Permit pin number 110817
Permit Fee 508.65 Plan Check Fee
Issue Date 9/11/07 Valuation
Expiration Date 3/09/08
Qty Unit Charge Per
BASE FEE
9.00 10.1000 THOU BL-25,001-50K (10.10 PER K)
.00
34000
Extension
417.75
90.90
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ---------
Permit Fee Total 508. 65 508 .65 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4 .50 4 .50 .00 .00
Grand Total 513 . 15 513 .15 .00 .00
~
/'
'0 2"[
~~
"-
~
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 orwork 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 pecmit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
con:2tn
Signature Signature of Owner (if owner is builder) Date
T:\Policics\1102 15 b\l11dmg penml inspectIon rccordO~ \\pd f1/4/200S]
BU~DING PERMIT INSPECTlON RECORD
o
--J
1
WOIU( fJEFORE.-
o
\ll
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A !vlI)\,llivlUM 24 HOUR NOT1CE. jT is UNLA H'FUL TO COVER, iNSULATE OR CONCEAL AN}'
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT .lOB SITE
lNSl'ECTJ08 T\'I'E I>ATE I ACCEI'TE/J COMMENT~
I YES NO
FOUNDATION,
FOOTINGS I
SHEAR WALLS I WALLS
FOUNDA TiOt.: DftAU\I'/lGE / rX1WN SI'OllTS I
PIERS I I
POST HOLES (POLE SLDGS.) I
I'LUI\'111ING
UNDER FLOOR I SLAB
RQUGH-fN .-.
WATER LINE (METER TO BLDG)
GAS LINE FINAL DATE ACCEPTED BY:
BACKFLOV,'/WATER
AIR SEAL
WALLS I
CEILING I I
FRAMING
{GISTS / GIRDERS
SHEAR W ALl1HOLD DOWNS
WALLS I ROOF I CEILING
DR'{\V.A..LL (fNTERJOR BAACED PAJ'\TEL ONLY)
T~BAR
INSULATION .
SLAB
WALL! FLOOR I CEILING I I
J\lECHAN1CAL
ROUGH-IN
HEATPUNIT/FURNACE/DUCTS
GASLTNE FiNAL DATE ACCEPTED 13Y:
WOOD STOVE / PELLET / CH1JvlNEY
MANUFACTURED HOMES
FOOTrNG j SLAB
BLOCKJNG & HOLD DOWNS
SKlRTING
J'LANNING DEl'T. SEPARATE PERMIT#'s SErA:
T'ARKING/LlGHTING ESA:
LANnSCAPING SHORELINE:
FINAL INSI'ECT]~NS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTIUCAL - UGHT DErT. .:117-4735 ELECTRICAL
LlGHT DEPT
CONSTRUCTION R.W./PWI CONSTRUCTION - R.W.
ENGINEERrNG 417-4807 PW I ENGINEERrNG
FIRE 417-4653 FIRE DEPT.
PLAtfNTNG DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING \ 2-- Z-7--f\- "p,
~
z
\f\
T
V)
+
I\:)
(D
I
T:\Polici(:s\I1U2 15 building pcmllllllopeetlOn reeonW5.wpd [J/4f2fJQ5J
d
o
--t)
~
a'
"a
,
,
N
,
N
"
ww
~e
<<
'"
N"
ow
moo
0"
N"
o.
.N
~
~
~
W
~
e
woo
~W
U~
H<
eo
z
0"
HO
ee
uu
ww
"
woo
3~
a"
WH
MOO
>
8
ro
o
00
ww
zz
00
""
"
00
a
~
"
U
00
ill ('1
"0
~ wo
"00 0
<l.;w:;...or<.
0U~ 10
H.o;LIlQ
clI:>0-:r!l':
""0
f-<W!-<r-IW
<tCl}-t'~
....w UlO
Ull:%:rLlO::'.-I
W:>WOLIl
E-<:><t> '0
Ul<t3:<tOrl
.-;::r: :too
e '0
:3:><H:><OO
O1g6i8~'7
NO::E-<O::ID[,-
.-4!-<CDE-<OO
H
N
o
"00
W
- "'
'w
o~
;::~
N
,e
N"
"0
,
"
we
"0
<
,~
we
"H
'u
"
w
w
.~
UlE-<<( ,..:rz
~~~~1':J,..:r
(:1zzzo::p<
P"'O;;:<'l;P<
.o.:E-<UOp.,.o::
"
. ro"
zo
e
00 -u
00
e
z
w
~
wz~
~oo
"HU
e,
"'00
'He
""'
ouo
Zww
ww
'""
"
-
~ "
"'"'
cwo
ZOO
~HW
Z "
-
~
_0"
OWW
wee
ww
ow",
00'
a~
cwo
O"U
m
"
~
"
,
o
o
><
"
w
w
~
W
H
"
m
"
~
~
H
~~
uo
"0
""
w
oz
00
o
-0
w~
>
HW
~w
~<
<u
oz
OH
~
"
""
""
0"
e<
w~
w
<
~
,
H
0"
o
.. 0
" a
o
e
. ow
OWW
WI" P::!-<:>
Z 0 I::> <t
1-10 wz::r:
!-<N\j)O::H
o ~~
_I'- 'H
\Dr-< 0-
...elN ...'1<<1W
<t r-I<t ::r:z
ZIY\DZ:S 0
HO!~HH 0
~ iLiJ ~::r: r<i i2
<.'J QJ Z (,),...:11'''; i:i1
ClU><O,..:rWE-<
,..:r0!<t...:l<t::r:~
rIlClSIIlUE-<<:C
~~
~ I~
~f--
'---
a
w
,
,
><
"
"
o
m
m
"'
w
w
w
"
o
z
"
~
w
e
z
w
~
o
u
:f~
:~
,
,
,
,
,
,
,
,
BUILDING PERMIT - APPLICATION
Fill out COMPLETELY aud iu INK. Your applicatiou, prescriptive euergy
form, plansl,specs, and a 8 ~l! x 11" site plan MUST BE COMPLETE to be
acceptedIor review. (360) 417-4815 FAX (360) 417-4711
FOR OFFICIAL USE ONL V:
Date Reo.:---.S -1(- 07
Penn;t# (), - 1051
DateAppcoved 0'1-[ {-07
Date Issued: (I
Residential projects: submit two sets of plans
Commercial projects: submit three sets of plans
Applicant or Agent
Owner Tali;
Owner's Address
ContractorlEngineer
ContractorlEngineer's Address [)../) ;)0
PROJECT ADDRESS: /ol-f W
IA/l( / ~
I
I/t(v 0- S" I
Phone
Phone
300
'63/
c;6/
,.,1..;//
/7ht,
;U/
'f- Gc'-.n/ tJre ~c..A;'}/1('
sl
(j)
jsl
,-
State License # SIt< 11.7 UJ$ '1 W;;tf!xpires 5^/lU .:U'bf
!)fr't S -/ Phone .5'6J c; _b ''::,7''( 2-
ZONING:
LEGAL DESCRIPTION: Lot:
CLALLAM COUNTY PARCEL NUMBER:
Block:
Subdivision:
TYPKOFWORK
o Residential 0 New Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
f. Repair 0 Sign 0 Other
BRIEF DESCRIPTION OF THE P,RO~CT: f/.
rf.'eiY/f1I!e, 6Xrc,-!jJ1Cj rOO 'S rof^re;..
v /
--me 0\0.. ggq. s+o IJ . OLU e he"
COMMERCIALfRESIDENTIAL: ccupancy Group: Occupant Load:
Existing Structure(s) basement Sq. Ft. & Proposed Structure(s) basement
1" floor Sq. FI. & 1" floor
2" floor Sq. FI. & 2" floor
3" floor Sq. Ft & 3" floor
Accessory Structures Sq. FI. & Accessory Structures
Existing Structure(s) TOTAL Sq. Ft & Proposed Structure(s) TOTAL
TOTAL of existing & proposed structures
Maximum Height of Proposed Structure(s)
o Stove
o Garage
o Deck
SIZENALUATION
SF.@$ /SF.~$
SF. @ $ /SF. ~ $
SF. @ $ /SF. ~ $
TOTAL VALUATION $
~~ tJUJ
Sq. Ft.
Sq. Ft
Sq. Ft
Sq.Ft.
Sq.Ft
Sq..Ft.
Sq. Ft
FI.
Are you planning to install a lawn sprinkler system?
(Divide Total Structure(s) Sq. FI. Footprint by Lot Size Sq. Ft)
V ALUA TION OF CONSTRUCTION: In all cases, a valuation amount must be eutered 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 417-4815
for assistance.
PLAN CHECK FEE: The plan check fee must be paid at the time the building permit application is submitted. All other permit fees are
due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: An application for a permit for any proposed work shall be deemed to have been abandoned 180
days after the date of filing unless such application has been pursued in good faith or a permit has been issued; except that the building
official is authorized to grant one or more extensions of time for additional periods not exceeding 180 days (90 days for commercial
projects) each. The extension shall be requested in writing and justifiable cause demonstrated. (IRe/IBC 2006 105.3.2)
f hereby certify that f have read and examined this application and know the same to be true and correct. f am authorized to
apply for this permit and understand that it is my responsibility to determine what permit~ and that f must obtain
such permits prior to work.
Date ~/ 1/ / ;2,jJ 7 Applicant Ii ) Il~ .-J.~""":'" f
T:\FORMS\BUILDING DIVISION\BldgPermitAppl.-2006 CODE - backup.wpd" j
rl
y
:
.
.' ROUTING SLIP ,.0"'.."
~ lO~o",<;.
~-"'
. Certificate of Occupancy r1.~
~~
. ~
$47.00 Certificate/Inspection Fee ".."
, ~'C;;;O\,.:"
DATE New Business ............................ ( )
Address of Wosed Business Transfer of Business location. . . . . . . . . . . . . . . . ( :::::-:;-r
--l 29' . I "S.~ ~+ Change of Ownership . . . . . . . . . . . . . . . . . . . . . . ( )
Applicant MAVV rI2-EDEf"'IC./,<- New Building ............................. ( )
Address {D?p,f=-, , -s -t- '5'T Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
f< . Temporary Business .............. ... .. ", ( )
Phone: business home .4-/7 - 1%3 Change of Use. . . . . . . . . . . . . . . . . .. .. ... .. ( )
Brief description of proposed business: N.ev-l -t U5EP GIFTS I A"nIQuE:$"'
,
legal Description: lot Block Subdivision
Current Use of Property: RE7AIL 5A-LES
Zoning Classification of Property:
WILL THERE BE ANY OF THE FOLLOWING? YES NO THE FOllOWING Will BE REQUIRED:
Construction changes. ....... ..... . . . . . . . . . ... .. - ./ PERMITS BUSINESS LICENSE
Electrical changes. ....................... .... .. -~ 1) Building 1) Taxi
Mechanical (heating, cooling, stoves) . ,/ 2) Plumbing 2) Peddlers
............ --
Plumbing changes -- 3) Electrical 3) 2nd Hand Dealer
New or relocated signs. ........ ......... ....L... 4) Mechanical 4) Pawn Broker
New septic tanks. .... -~ 5) Sewer 5) Dance
New sewer service ...... ....... ........ ... -~ 6) Sidewalk installation 6) Hotel - Motel
Admission charged to patrons. _.....L.... 7) Driveway installation 7) Fireworks
Is this a home occupation? ............... - /' 8) Curb installation 8) Ambulance
Excavation of filling of lots . - -- 9) Sidewalk obstruction 9) Tattoo shop
Work done in City right-of-way. ............ ..L.. 10) Water meter installation 10) Other
Is there sufficient off-street parking? . ./ 11) Fire
New driveway openings. .... - ,/ 12) Occupancy
-
A grading plan for site drainage. ......... ./ 13) Sign
(parking lots, downspouts, etc.) ... =/ 14) Shoreline
Are the existing streets paved? . ..L_ 15) Home occupation
Are there existing sidewalks? . ........... -L-_ 16) Conditional use
Is there curb and gutter? .... .......... /- 17) Other
Other. ...... .............. .....
Da~bc'AL //
I hereby apply for a Certificate of Occupancy and acknowl. ~~J/A~;L
edge that I have read this application and state that the
information I have supplied is correct to the best of my q- LD --cD
knowledge. Signed:
~P~J6 REJECTED Comments / Conditions
'~//
-, Building Section
jl
Public Works Department
~;~ Planning Department
Fire Department
-
. -{Xl City Clerk .
~~ PB.IA W~
'(i
"'.;;;0'
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
121 EAST 5TH STREET. PORT ANGELES. WA 98162
ELECTRICAL PERMIT
Issued: 1/20/98
Permit No:
6188
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
DARREL VINCENT 129 1ST ST W
129 W. 1ST ST Lot: 13 El/2 & 14 Wl/2
Port Angeles, WA 98362 Block: 15 Long Legal:
360/457-3213 Sub: TPA
T: OLD 88 CENT STORE S: Pare No:
CONTRACTOR-----------------------------DESIGNER---------------------------------
DAVIS ELECTRIC
453 WILLIAMSON RD.
SEQUIM, WA 98382
360/683-3842
,
000/000-0000
PROJECT INFO--------------------------------------------------------------------
prj Type: COML.REMODEL prj Value: $0.00
Occ Type: Cnstr Type: FEEDER
Occ Grp: Occ Load: Land Use: CBD
Electrical Heat
Baseboard KW:
Furnace KW:
Heat Pump KW:
Fan/Wall KW:
o
o
o
o
Service Type
Riser
Overhead Service
Underground Service
Temp Service
voltage:
Diameter:
Service Size:
Feeder Size:
120,240
X-I -3
o AMPS
60 AMPS
PROJECT NOTES-------------------------------------------------------------------
60 AMP FEEDER AND WIRE CIRCUITS
PROJECT FEES ASSESSMENT---------------------------------------------------------
Service: $67.00
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
$0.00
Misc
TOTAL FEE:
Amount Paid:
$67.00
$67.00
---------------------------------
---------------------------------
TOTAL FEE:
$67.00
Balance Due:
$0.00
COMMENTS/ACTION NEEDED
~
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COI'ER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPEC110N TYPE DATI< I ACCKP'I'ED COMMENTS
I YES INO
UnUi
n~ -IN / CUVER / /UJfqf ~
SERVICE
~ .
1.2../.2S7 vK"1
GENERAL COMMENTS:
rw.lI01.ISI4'96l
~
j,F;' S-
FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT OF'L1GHT'
APPLICATION AND ELECTRICAL PERMIT
A
/ 1J3eJ
. PERMIT NUMBER
.
TOTAL FEE
d(,,'OCJ
'Htl'r Nasi
5'z
NO. STORIES
LEGAL OCCUPANCY
ELECTRICAL PERMIT QNL Y NO OCCUPANCY OR' USE ESTABLISHED UNDER THIS PERMIT
~eA+- IS+-
ADDRESS ~S ~.ESPONSIBIUT~ ?F APPLlCA~T J,. p~~ ~ITH WRONG AD~R~SSES AR.E C:NCElLED ._
Owner I\"'.-:F+j eR e...",.j.. -t..-.l).otlf1>,.. ~stallationBY 'R.~.^bo,-,-, t'\eOA.
Owner's Address , ~'., ...., ,s.... ... "lnstallersAddress:2. ':1..<:"1 f''''-,\ 'e, 'RJ.
Day Phone '-I ~ 7 Lf q I ::l.. I nstallers Phone "I s:- :l - ';\ ;)..:;). '-l
Appli.cati~n is hereby.made for Pe~m.it to install Electrical.Equipment as follows: -n {~ ^ c...-l.r~ \ l",,~""-o
f-t : ( }...- "-~
Site Address
s: \1 VI
?<"'~""'-.....rj
Wiring Method
( t> Art",,:-I::.-
.'
NUMBER AMP 120V 240V NUMBER AMP 120V 240V
- USE OF CIRCUIT PEA 100R FEE USE OF CIRCUIT PEA 1'00R FEE
CIRCUITS CIA 10 30 CIRCUITS CIA 10 30
LIGHT "L SIGN C>Ni... 1../ X' lf~'!:!.
LIGHT .. . - 50 VOLTS . . ,
OR lESS
CONVENIENCE . MOTOR .
CONVENIENCE MOTOR
APPLIANCE . MOTOR , .. -
DISHWASHER .. .' FIR.E ALARMS
DISPOSAL BURGLAR ALARM
RANGE MISC.
OVEN
-
WATER HEATER
LAUNDRY .
DRYER REINSTALLATION LIGHT FIXTURE #
FURNACE .. . SUB TOTAL. FEE
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC - - .-
BASIC FEE
ELECTRIC HEAT .I?/~.t!>"
TOTAL FEE
ELECTRIC HEAT . SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
. , . .,
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
.. .
SERVICE AW.G.
I SUB-TOTAL .' .
SIZE OF GROUND ~IZE OF ENTRANCE SWITCH
I certify that the, work to be perfo~~er_lhi;;-p"rmrill be d'cne by the instailer an,4~~ #~~ with ~Xctrical Code.
Date Application made .A.2;/ ,19<(7 By' 'u. ~
- CONTRACTOR OR OWNER (OR AUTHORIZED AGENT)
Perm!_ssion is hereby given to dg the abov~ describeq w9rk, accqrdilJg tq the conditions hereon and accordjng to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances f t e City of Port Angeles.
. --:11t AU.-L .' ,.1~DIRECTOR OF. ~ITY LIGHT
,'.
. ,....
.
Date Permit Issued
I~:':';j
......... '....
. . \. " . .
Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
be .c~vered or current turned.o~ before.insp~ction 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. Tripiicate WHITE CARD - Inspector's Report
rll vuolr OOI"IT!:OC;: Il\Jr
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
,
.
O.K. FOR COVERING
, -=:#f O.K. TO CONNECT SERVICE
~//f. If'? FINAL O.K.
{ v ,
.
z
o
a:
<C
::E
~
::t:
I-
Z
w
;.
l-
e
z
e
Q
.
Application Number . . . . . 23-00000811 Date 8/01/23
Application pin number . . . 992951
Property Address . . . . . . 129 W 1ST ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1545-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Lighting retrofit
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
TRUDY HAVERSAT / GARY BRESCHIN JOHNSON ELECTRIC COMPANY
2328 DEER PARK RD 3129 S REGENT
SALINAS CA 939127881 PORT ANGELES WA 98362
(360) 728-4327
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . . 1-4 CIRCUITS
Permit Fee . . . . 96.00 Plan Check Fee . . .00
Issue Date . . . . 8/01/23 Valuation . . . . 0
Expiration Date . . 1/28/24
Qty Unit Charge Per Extension
BASE FEE 86.00
2.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 10.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 96.00 96.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 96.00 96.00 .00 .00
MULTI-FA MILY/ COMMERCIAL
ELE CTRICAL PERMIT APPL ICATION
Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:--------------------------------------
Project Description:--------------------------------------□Multi-Family Residential D Commercial I Industrial/ Public Building Square footage: __________ _
OWNER INFORMATION
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRICAL CONTRACTOR INFORMATION
Name: License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
llim!
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Sign / Outline Lighting
Signal Circuit/Limited Energy -Multi-Family
Signal Circuit/Limited Energy/First 1500 sf -Commercial
(Note: $5.00 for each additional 1500 sf)
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Unit Charge Quantity
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
$113.00
$56.00
Total (Quantity x Unit Charge)
$ ____ _ $ ____ _$ ____ _$ ____ _
$ ____ _
$ ____ _ $ ____ _
$ ____ _ $ ____ _$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _ $ ____ _
$ ____ _
$ ____ _
$ _____ TOTAL
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I
am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-
46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
lJ CD
PREPARED 7/31/23, 7:39:14 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
---------------------------------------------------------------------------
APPLICATION NUMBER:23-00000811 129 W 1ST ST
FEE DESCRIPTION AMOUNT DUE
---------------------------------------------------------------------------
ELECTRICAL ALTER COMMERCIAL 96.00
TOTAL DUE 96.00
Please present reciept to the cashier with full payment
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
9/14/2023 23-811 TAP
OWNER
CONTRACTOR
Johnson Electric
PROJECT ADDRESS
129 W 1st St
Application Number . . . . . 23-00001149 Date 10/25/23
Application pin number . . . 087482
Property Address . . . . . . 129 W 1ST ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1545-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Heat pumps
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
TRUDY HAVERSAT / GARY BRESCHIN BLACK DIAMOND ELECTRICAL CONTR
PO BOX 10881 502 BLACK DIAMOND RD
SALINAS CA 939127881 PORT ANGELES WA 98363
(360) 797-3602 (360) 565-1035
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 172.00 Plan Check Fee . . .00
Issue Date . . . . 10/25/23 Valuation . . . . 0
Expiration Date . . 4/22/24
Qty Unit Charge Per Extension
2.00 86.0000 ECH EL-COMM BRANCH CIR 1-4 172.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 172.00 172.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 172.00 172.00 .00 .00
MULTI-FA MILY/ COMMERCIAL
ELE CTRICAL PERMIT APPL ICATION
Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:--------------------------------------
Project Description:--------------------------------------□Multi-Family Residential D Commercial I Industrial/ Public Building Square footage: __________ _
OWNER INFORMATION
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRICAL CONTRACTOR INFORMATION
Name: License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
llim!
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Sign / Outline Lighting
Signal Circuit/Limited Energy -Multi-Family
Signal Circuit/Limited Energy/First 1500 sf -Commercial
(Note: $5.00 for each additional 1500 sf)
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Unit Charge Quantity
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
$113.00
$56.00
Total (Quantity x Unit Charge)
$ ____ _ $ ____ _$ ____ _$ ____ _
$ ____ _
$ ____ _ $ ____ _
$ ____ _ $ ____ _$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _ $ ____ _
$ ____ _
$ ____ _
$ _____ TOTAL
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I
am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-
46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
lJ CD