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HomeMy WebLinkAbout200 W 1st St - Building RECEIVED
CITY OF PORT ANCELES PERMIT APPLICATION '� .rrr...
Buildling llivision/Electricaal Inspections °�'�y �
321 East Filth Street—P.O.Box 1150/Port Angeles Washington,98362 ELECTRICAL,
Ph: (360)417-4735 Fax: (360)41.7.4711 INSPECTIOW V
Bate: I Multi-Family or Commercial*
Pian Review May Be Required Plea e o I to E1ec 'cal Flan view fofmatio Sheat
Job Address; ��a'3 � p --
Building Square Footage: _
Description of above__ �
p �_-..�� +�� ._�rZ.f[f.� ..._._!___...__.., trr�— A
ownContractar In or matlap
Name:�. � �11 Name;
Halling dregs: 1�-�>�R Mailing dre s;
City; City; State: Zi
Ph" p:
Ph �`.Q _Fax:._� Phone:���tiFax;
License#/Exp �.—_-- License#11 xp,. 31"t KEEL I
Item Unit Charoa fit rr Total t Multi Ip led by Unit Chargo
ServlcelFeeder 200 Amp. $132.00 120 40%o f
ServicelFeeder 201-400 Amp. $160,00 $
ServlcelFeeder 401-600 Amp $225,00 ,. $
Service/Feeder 601.1000 Amp, $286.00 $
Service/Feeder over 1000 Amp. $410,00 $
Branch Circuit W!Service Feeder w 6.00 $
Branch Circuit W/O Service Feeder $ 74.00
Each Additional Branch Circuit $ 5.D0 µ $
Branch Circuits 1.4 $ 86.00 — $—
Temp.Service/Feeder 240 Amp. $102.00
Temp.Service/Feeder 201-A00 Amp. $121.00 $�
Temp.Service/Feeder 401-600 Amp. $164.00 $
Temp.ServlcelFeeder 601-1000 Amp, $185.00 $
Portal to Portal Hourly $ 96,00 $
SignlOutline Lighting $ 88.00 $
Signal Circuit!Limited Energy-Multi-Famlly $ 64.00 _ $_
Signal Circuit!Limited Energy/First 1500 sf-Commercial $ 96.00
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-5KVA System or Less $113.40 $„
Thermostat $ 56.00
Note:$5,00 for each additional T-Stat
$ .001T0taI
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 mire 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,!am making
N electrical Installations or alteration in compliance with the electrical laws,N.E,C RCW,Chapter 18.26,WAC.Chapter 296-468,The City of Pori
Angeles Municipal Cade,and Utility Specifications and PAMiC 14.05-050 regarding Electrical Permit Applications,
Signa a of owner,electrical contra" or electrical administrator: © cash © cheek
Credit Card#
ted: f0110112012 _ _w
ELECTRICAL PERMIT
CITY OF PORT ANGELES V
360-417-4735
Application Number 13-00000453 Date 5/01/13
Application pin number 632985
Property Address . . 200 W IST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER 06-30-.00-0-0-3300-0000- on your excise tax form
Application type description ELECTRICAL ONLY
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning , . . . , . . CENTRAL BUSINESS DISTRICT
Application valuation , , . . 0
Application desc
sub panel and 5 circuits
Owner Contractor
JOHN J & ROBIN K MILETICH SIMPSON ELECTRIC
312 RED DEER DR 243036 W HWY 101
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360) 452-7176 ------------- (360 457_9270
Permit , . , , . . ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee 157.00 Plan Check Fee .00
Issue pate 5/01/13 Valuation . . . , 0
Expiration Date 10/28/13
Qty Unit Charge Per Extension
5.00 5.0000 ECN EL-BRANCH CIRCUIT W/FEEDER 25.00
1100 132.0000 ECB BS,-COM 0-200 SRV FEEDER 132.00
Fee summary Charged Paid Credited Due
Permit Fee Total 157.00 157,00 ,00 ,00
Plan Check Total .00 .00 ,00 .00
Grand Total 157.00 157,00 00 .00
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:
GAEXCHANGRIBUILDING -
Electical Permit
200 W 1St
13 -48
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . . 13-00000048 Date 1/11/13
Application pin number . . . 106592
Property Address . . . . . . 200 W 1sT ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000-
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name . . . . . .
Property Use to the City of Port Angeles
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT (Location Code 0502)
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Extending exterior lts. Outlet kitchen
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH SIMPSON ELECTRIC
312 RED DEER DR 243036 W HWY 101 ^ `
PORT ANGELES WA 98362 PORT ANGELES WA 98363 'v
---- (360) 452-7175------------------------ (360) 457-9270
----------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . . 1-4 CIRCUITS
Permit Fee . . . . 86.00 Plan Check Fee .00
Issue Date . . . . 1/11/13 valuation . . . . 0
Expiration Date 7/10/13
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 .00 .00 .00 .00
Grand Total 86.00 86.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN 3 �►
FINAL !
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
WEXCHANGEWILDING
d
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 Cast Fifth Street—P.O. Box 1150/Port Angeles les Washington,
gc gton,98362
Ph: (360)417-4735 Fax: (360)417-4711 EiE�i iyJCP�
Date; —/0'/ k Multi-Family or Cortt�mercial* INSPECTIONS
*Plan Review May Be Required, Please
�m I to Elec al Plan Review formation Sheet
Job Address;2 Q
6ullding Square Footage: -
Descrlption of above
Owner Info at' n Contrac Information
NamM,-A-_y/y`C�A Name:
Mailing
Mailing Addrgs : p d
CityState: Zip:! City:
Phone;'-W—7i.7.SrFax: Phone: -q
License#/Exp, License!f I Exp, C
I em Unit Charge (tel TQtaI(tate Multia died by Unit Charge)
Servlce/Feeder 200 Amp. $132.00 $
Service/Feeder 201.400 Amp, $160.00 $ .-
Service/Feeder 401-600 Amp $27,5.00 $
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 Clrcult $ 5.00
Branch Circuits 1-4 $ 86.00 ✓
Temp.Service/Feeder 200 Amp, $102.00 $
Temp.Service/Feeder 201.400 Amp, $121.00 $
Temp,Servlce/Feeder401-600 Amp. $164.00
Temp,Servlce/Feeder 601-1000 Amp. $185.00
Portal to Portal Hourly $ 96,00 $
Sign/outline Lighting $ 88.00
Signal Circull/Limited Energy-Multi-Family $ 64.00 $T
Signal Circuit/Limited Energy/First 1500 sf-Commercial $ 96.00
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-51NA System or Less $113.00 $
Thermostat $ 56.00 $
Note:$5.00 for each additional T-Stat
s��'metal
Owner as defined by RCW,19.28.261:(1)Owner will occupy the structure for two years after this electrical permit is tlnalized.(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 Conti actor.l am making
the electrical installation or alteration in compliance with the electrical laws,N.E.C.,RCW,Chapter 19.28,WAC.Chapter 296-46 3,The City of Port
Angeles Municipal Code,and Utility Specifications and PAMIC 14,05.050 regarding Electrical Permit Applications.
Signat f owner,electrical co ctor or electrical administrator: D Cash ❑ Check
Credit Card 1 `
Dated:_� _ a /3 0110112012
Electrical Permit
200 W Is' St
12- 1442
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735 �L
tiPpiication Number . . . . . 12-00001442 Date 11/05/12
Application pin number . . . 140230
Property Address . . . . . . 200 W 1ST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000- on your excise tax form
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . . . . (Location Code 0502)
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
2 circuits for cooler
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH SIMPSON ELECTRIC
312 RED DEER DR 243036 W HWY 101
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360) 452-7175 (360) 457-9270 (�
------------- ---- --- ------------------------------------ ) v
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . . 1-4 CIRCUITS
Permit Fee . . . . 86.00 Plan Check Fee .00
Issue Date . . . . 11/05/12 valuation . . . . 0
Expiration Date 5/04/13
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 .00 .00 .00 .00
Grand Total 86.00 86.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN V151
FINAL (2—
COMMENTS:COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date: _
G:\EXCHANGE\BUILDING
%.r-e
FORT ANGELES PERMITApmxCATJON
CITY Or
Building JDMsionnEleddcal In-SpectiOns
37.1.Fast Vifth Street-P-0-1801 I1150 1 Fort Angeles Washiugl*ln,99362
ph: (360)417-4735]Fax:(360)417-471,1 ELECTRICAL
INSPECTIONS
Date Multi-Family or Commercial* Commercial Addition/Aftration I Remodel 1 Repair'
Plan Review May 13e Required,Pl aseCc mpNe E e
I chi I Plan Revlew�lrhffnatlion Sheet
Job Address: bu�W" .. -
Building Square Footage. �45
Description of above r
Contracto iformift, n
Owner Infortnaflon r- Lo- C-A-it C-
.0 Name.!=Tm 12
Name: 0 h K a- z .1 j7 c7i
MaMing AM
Magg-A+,X
zip'.
ct, MON:
S Ar
Cli)r. Slater
:Wr Phon8;.N;t51E--1j ax:
Phone,m4�1�75 i
lJcense# LiCaMeM
i9m Unit Chama Total M MtjKIj!fied by Unit Charge)
Sefy1ce/Feeder 200 Amp. $132.00
servicoFeeder 201-400 Amp. $160.00
Servfce/Feeder 401-600 Amp $225.00
SWcelFeeder 6014 000 Amp, $288.00
Serviceffieeder over 1000 Amp. $410.00
Branch Circuits 14 $ 86.00
Branch Circuit W/Service Feeder $ 6.00
Branch Circull W/o Service Feeder $ 74.00
Each Addilkinal Branch Circuit $ 5.00
Temp.Serviml Feeder 200 Amp. $102.00
Temp.ServicelFeeder 201400 Amp. $121.00
Temp.Servlcefeecler401-600 Amp. $164.00
Temp.Servlce/Feeder 601-1000 Amp $185.00
Portal to Portal Hourly $ 95.00
SIgn9M0ne Lighting $ 88.00
Signal Circulil Urrilted Energy-MuIll-Family $ 64-00
Signal Circuit/Limited Energy/First 1500 sf-Commercial $ 96,00
Note: $5.00 for each additional IBM sf
Renewable Electrical Energy-5KVA System or Less $113.00
Themmstat $ 56.00
$-5 6 Total
Owner as defined by RGW-1 9.28-261:(1)Owner Will occupy the structure for two years after this electrical perrnit Is finalized. 1,2)Owner is required
to hire an electrical contractor 9 above said property is for sale,rent or lease.Permit expires after six months of last inspectioi i.
After reading The above statement I hereby certify that I am the owner of The above named.pmperly or a licensed electrical cx atractor.I am malting
the electrical installation or alteration in compliance with the elecbical laws,N.E.C.,RCW,Chapter 19.28,WAC.chapter 296.1'168,The City of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
--1
Sign—'re�-k owner,electrical c rorelectrical admInish r 0 cah 13 check
CmdItCardf!
Dated:
Fire Permit
200 W Ist St
12 - 150
CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East 5`h Street, Port Angeles, WA 98362
Application Number . . . . . 12-00000150 Date 2/22/12
Application pin number . . . 515100
Property Address . . . . . . 200 W 1ST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000- on our state excise tax form
Application type description FIRE ALARM SYSTEM Y
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . . (Location Code 0502)
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 5000
----------------------------------------------------------------------------
Application desc
INITIATING DEVICES ./ POWER SUPPLY
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH HI TECH SECURITY INC
312 RED DEER DR 723 E FRONT ST
PORT ANGELES WA 98362 PORT ANGELES WA 98362
(360) 452-7175 (360) 452-2727
----------------------------------------------------------------------------
Permit . . . . . . FIRE ALARM SYSTEM
Additional desc . . INITIATING DEVICES
Permit Fee . . . . 40.00 Plan Check Fee .00
Issue Date . . . . 2/22/12 Valuation . . . . 0
Expiration Date 8/20/12
Qty Unit Charge Per Extension
4.00 10.0000 ECH FIRE ALARM EA ZONE 40.00
----------------------------------------------------------------------------
Special Notes and Comments
This project will require a seperate permit and fire alarm
plans for review.
A full acceptance test will be required for the fire alarm
system.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40.00 40.00 .00 .00
Plan Check Total .00 .00 .00 .00'
Grand Total 40.00 40.00 .00 .00
This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced,or if required inspections have not been requested with
180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be
true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled
with hether sp cified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the r visions o any state or local law regulating the work specified in the permit.
Signature o R ontractor or Authorized Agent Date Signature of Owner(if Owner is builder) Date
FIRE PERMIT INSPECTION RECORD
Call 360-417-4655 for fire inspections. Please provide a minimum 24-hour notice. It is unlawful to cover, insulate
or conceal any work before inspected and accepted. Post permit in a conspicuous location.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
Inspection Type Date Passed Comments
FIRE SPRINKLER E
Underground piping hydrostatically tested 1� 1
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough-in inspection
Alarm final
LP-GAS Completed by Contractor:
Underground piping inspection/pressure test Test#1
Above ground piping inspection/pressure test Piping pressure test psi
Time initiated
Tank(container) inspection Test#2
Appliance inspection Piping pressure test psi
Time initiated
LP-gas final
UNDERGROUND STORAGE TANK(UST) ABANDONMENT
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER(specify)
permit final
GENERAL COMMENTS:
c�
2/15/00 ��
poRrqFIRE-RELATED PERMIT APPLICATION
CITY OF PORT ANGELES For City Use Only:
Attn: Building Permit Technician Date Received
'i 321 E. Fifth St., Port Angeles,WA 98362 Permit#
(360)4174815 fax(360)4174711
Applicant F%r e a rd S cc U r Phone 3 6 0 '4 S 2 -
Property Owner 7o e, c� co h �-� %r Phone 3Epo S o E? 16go
Property Owner's Address
Contractor "T'esSN Firms a^ e_c.u_r% Phone 360 4f5;L a'1 a7
Contractor's Address '7a3 E 'F ro n S_ o r
License# 1A IT E 5 9 55 S Expires I o 1 13 11 E-mail kIV Re^ -cc rVi
PROJECT ADDRESS _a00 1NI � St5 r �cS Uckt
Project Business Name
Fire Alarm Svstem ❑Residential ❑ Multi-family )(Commercial ❑ Industrial
Check all that apply
Bri ly desFFvibe he pro) t: 1
❑One addressable loop f�� "t �� EV1Ce5 �o e*fla T V1
❑O,ne zone G SSo� t�� rm ane
dditional zones MA rN C e.S
List quantity of additional zones_ Seen
PROJECT VALUATION labor&materials $
Fire Sprinkler Svstem ❑ Residential ❑ Multi-family ❑Commercial ❑ Industrial
Check all that apply
Installing backflow protection device(s)? Briefly describe the project:
❑yes ❑ no
<2 inch water line(list quantity of devices)
>2 inch water line(list quantity of devices)
PROJECT VALUATION 0abor&materials $
Hood/Duct Fire Suppression Svstem ❑ Residential ❑ Mufti-family
_. ❑Commercial ❑ Industrial
Check all that apply
Briefly describe the project:
Will only the fire suppression system be installed or altered?
❑yes ❑no
Will a hood and/or ductwork be installed or altered?
❑yes* ❑no
*If yes,a mechanical permit will also be needed.
PROJECT VALUATION labor&materials
i have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand
that it is my responsibility to determine what permits are required,and to obtain permits prior t working n p
Date_" 4 12- Print Name Gew.P-tr rA �pL%T V-AA, Signatur OVLA
T:Forms/Building Division/Fire-related permit application
PREPARED 4/04/13, 14:21:55 INSPECTION HISTORY REPORT PAGE 1
PROGRAM BP521L 0/00/00 THRU 0/00/00
CITY OF PORT ANGELES
-- ----- ------------------------------- -----
APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID
STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR
------------------------------------------------------------------------------------------------------------------------------------
12 00000150 200 W 1ST ST 06-30-00-0-0-3300-0000- 063000003300
000 000 FALM 00 FIRE ALARM SYSTEM FFNL 0001 FIRE FINAL 4/03/13 APPROVED KDD
REQ COMM: April 3, 2013 4:01:34 PM kdubuc.
REQ COMM: fire final
RES COMM: April 3, 2013 4:01:57 PM kdubuc.
RES COMM: fire final
t �
CERTIFI , E;'-,0`F.,,.ftCU PAN CY
City of Port Angeles B,tj ;I j g Dwision
This certificate is issiced�,'fi�scant to the requirement s'`of Section 111 of th"e 2009 International Building
,s�
Code certifying that atttheltime hof issuance this structure was in compliance with the various ordinances
of the City regulating�building construction or zcse for the following
Business name: i CountryAire, Inc , ' 3�� "� �
Business address 200 U1/ 1 Street Y
Property owner.• flJohn& Robyn Mihetich
Property owner's address 312 Red Deer Dr ue Port Angeles,.WA 98362
Automatic fire sprin kler system: Non`=Spnrikl`er
Use & occupancy classification: Business
Buildingpermit number 11-672
Occupant load: M k P0,2009 IBC"Table 1004¢1 1{ Z �r "
Type of construction. ' B/BHT _ r`
IU
5/2/12
"SueRoberds, Ianntng Manager
Date
t =
Post on the premises in a conspicuous place ITh ertficate shall not be removed except by the
Building Official.
a
o�?ORT. ;ioF CERTIFICATE OF OCCUPANCYAPPLICATION .1lo Permit#
glIV T
FEES
rni
CITY OF PORT ANGELES ;aJo''�°nJ
Attn: Permit Technician $50 Certificate / Inspection
321 E. Fifth St., Port Angeles, WA 98362 Parking Business Improvement Area (PBIA)
N�ap�WesF (360 417-4815 fax (360)417-4711 fee charged for Downtown locations
J-
P Rom
AS S <a41111PA clue +o mov4i.5 wl•N,tyi PBMA
AV
eta SIS �a�Kr►®w)h PLEASE PRINT IN INK phi„���+�ta R�y r,IeA Pm P�`� p/� A�
Check one: New business in P.A.?❑ ChangeEl of ownership only? Moving location from within P.A.? J� Zoning Cl/l
BUSINESS NAME d I4n7ril
Business address M�aililiina address St
Phone number ISD S — Opening date_/Z//j Days & hours of operation �9 S
Business owner's name c -t- o e ,c. Contact phone(3�D 1!e S 7 j. tX L
Business owner's address 3l
Brief description of business 25edL ^
Property owner's name J k r .c. Contact phone( #S2—,9.3V3'
'
Property owner's address/contact e /e
BUILDING DEPARTMENT phone 417-4815 [;Wapproval by eT on
"TYPE DTI �4T b(,cv any ,M
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No Q�
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering s ' ays, raps, bathrooms, electrical heating/co lin /ventilation systems, etc).
ta
Work planned: Va m — r, ; c
Ia s. r,/ »
FIRE DEPARTMENT phone 417-4653 Fire approval by1!5=_on g 15 11
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No ❑
Work planned:
PBIA (Parking Business Improvement Area -Downtown) phone 417-4623
Square footage of business? �0 D ti u -S64 PBIA notified on �' l
Is business moving within the PBIA? Yes o ❑
CITY CLERK phone 4174634
City Clerk approval by on —T 1*4 11
Second-hand dealer/pawnbroker business?Yes ❑ No ❑
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 eo� �
COMMUNITY& ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on
Number of off-street parking spaces available for employees and T
customers?
(A parking plan may be required.)
Signs? (wall-mounted, freestanding, projecting, awning, A-frame, etc?)
Signs planned:
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PINE approval by on
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 ❑
Work planned:
PUBLIC WORKS WASTEWATER phone 417-4845 PWW approval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No ❑
If yes, what will be discharged:
. r �
Call for Certificate of OccupancV inspections BEFORE open 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 I 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.
Date Print Name 2 Signature `
X X
T:\Forms\Building Division\Certificate of Occupancy Application(2010).doc
Page 2 of 2
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ni.wi4..n:a.,....ONE
OMB No,2502-0265
ESTIMATED B. TYPE OF LOAN
A- SETTLEMENT STATEMENT (HUD-1) 1. ❑ FHA 2. ❑ FHMA 3. [X_1 COWUNINS.
& 4. VA 5.
JCONV.INS.
(i*L*Y* M*PIC PENINSULA 6.FILE NUMBER: 7.LOAN NUMBER
-Title Company- 96821-JM
ME MURMCE,ESGRQW3 S.NIORTGAGE INS.CASE NO.:
C.NOTE This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items
marked"(p.o.c.)"were Paid OLItSidv the closing;they are shown here fur informational pUrpOSCS and are 1101 included in the totals.
D. NAME&ADDRESS John J.Miletich and Robyn K.Miletich
OF BORROWER: 312 Red Deer Drive,Port Angeles,WA 98362
E. NAME, &ADDRESS K.O. Erick-son Charity Trust Fund of Port Angeles
OF SELLER: 3005 W. 18th,Port Angeles,WA 98363
F. NAME&ADDRESS K.O.Erickson Charity Tnist Fund of Port Angeles
OF LENDER: 3005 W. 18th,Port Angeles,WA 98363
G. PROPERTY LOCATION: 200 West I st Street,Port Angeles,WA 98362
11. SETTLEMENT AGENT: Olympic Peninsula Title Company
PLACE OF SETTLEMENT: 319 S.Peabody,Suite A,Port Angeles,WA 98362(360)457-4451
1. SETILEMENTDATE: 7/01/2011
J. Summary of Borrower's Transaction K Summary of Seller's Transaction
100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller:
101. Contract sales price 650.000.00 401. Contract sales price 650,000.00
102. Personal property 402. Personal property
103. Settlement charges to borrower:(line 1400) 1,410.68 403.
104. 404.
105. 405.
Ad*ustiments For Items Paid By Seller In Advance: Adiustments For Items Paid By Seller In Advance:
106.City/town taxes to 406.City/iovm taxes to
107.County taxes to 407.COL111tV taxes to
108.Assessments to 408.Assessments to
109. 409.
110. 410.
411.
112, 412.
113. 413.
114. 414,
115. 415.
116. 416.
120. Gross Amount Due From Borrower: 651,410.68 420. Gross Amount Due To Seller; 650,000.00
200. Amounts Paid By Or In Behalf Of Borrower: 500.Reductions In Amount Due To Seller:
201. Deposit or earnest money 10,000.00 501. Excess deposit(sea instructions)
202. Principal amount of new loan(s) 550,000.00 502. Settlement charges to seller(line 1400) 47.305.82
203. Existing loan(s)taken subject to 503. Existing loan(s)taken subject to
20+ Additional Deposits To Escrow 91181.61 504. Payoff I st Mtg.Ln.
205. 505. Payoff 2nd Mig.Ln.
206. 506. Payoff City Electricity 75.00
207• 507. Seller Carryback 550.000.00
208. 508.
209. 509.
Adjustments For Items Unpaid By Seller; Adjustments For Items Unpaid By Seller;
210.City/town taxes to 510.City/town taxes to
211,County taxes toto
511.Cotilitv taxes
212. Assessments to 512.Assessments to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. Total Paid By/For Total
520, Toa652,181.61 Reductions
Borrower: 597.380.82
In Amount Due Seller:
300. Cash At Settlement From/To Borrower: 600. Cash At Settlement From/To Seller: -
301. Gross amount due from borrower(line 120) 651 410.68 601. Gross amount due to seller(line 420) 650,000.00
302. Less amount paid by,for borrower(line 220) 652,181.61 602. Less reductions in amount due seller 597.380.82
303. Cash(LIFROM) LkITO) Borrower: 770.931 603. Cash ixlro) LIFROM) Seller: 52:619.18
Previous Edition Is Obsolete
Forni No. 1581 SB-4-3539-000.1
3/86 HUD-1(346)
Page I of 3 RESPA,11B 4305.2
CERTIFICATE OF OCCUPANCY APPLICATION -\-v Permit# 1 [— (n-72
C�~ `•s tee, ;.
�
CITY OF PORT ANGELES FEES
t,._ unr_ � $50 Certificate /Inspection
o Attn: Permit Technician
321 E. Fifth St., Port Angeles, WA 98362 Parking Business Improvement Area (PBIA)
N j�1a`�'` �eqf (360 417-4815 fax.(360) 41.7-4711 fee charged for Downtown locations
�
p -` res J-S UIV� ALP *0 �'✓�19b'tYl�! l.i f4,tv� {�S=f�
h <0
PLEASE PRINTIA1INK ph��,��8��;{ 9r,y , 1P_w �/� A�
Check one: New business in P.A.?[] Changfr
e of ownership.only? ❑ Moving location om within P.A.? ' Zoning GiD
BUSINESS NAME G-l�L9��Y►q— �✓ ., �j�G
Business addressMailing address Sf
Phone number lrG' q3-,2- 2119's- Opening date� Days & hours of operation
Business owner's name c M1 c�i —Contact phone( )1i S Z
Business owner's address 3i
Brief description of business
Property owner's name J h 1 ,' .'c. Contact phone4ahi-A) 3V 3,
Property owner's address/contact e'el beer D Al r�tr/e -
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No N/
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering sta Ways, ra� ?ps, bathrooms, electrical; heating/co lin /ventilation systems, etc).
Work planned: ,✓� r, ac c,/S —
a
FIRE DEPARTMENT phone 417-4653 Fire approval by %U-rj_on m-lS Zo%I
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No ❑
Work planned:
PBIA (Parking Business Improvement Area - Downtown) phone 4174623
Square footage of business? ; D 1) 'l ih esir)YS PBIA notified on
Is business moving within the PBIA? Yes o ❑
CITY CLERK phone 417-4634 City-Clerk approval'by on
Second-hand dealer/pawnbroker business? Yes ❑ No ❑
Will there be dancing at this business? Yes ❑ No ❑
A City of Polt Angeles Business License is required for:
Taxi, Peddlers, Second-Hand Dealer, Pawnbroker, Dance,
Hotel-Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
CERTIFICATE OF OCCUPANCY APPLICATION �,, Permit# 1 �— ��
CITY OF PORT ANGELES 00OS FEES
d $50 Certificate / Inspection
Attn: Permit Technician
321 E: Fifth St., Port Angeles, WA 98362 Parking Business Improvement Area (PBIA)
Wei" .(360 417-4815 fax.(360) 41.7-4.711 fyee charged for Downtown locations
P�� � , rt�5 s-S '� W4'IVeol �lu� `t-e, �navi'n� wit4rtn �'a-1`l
+Is �r�Ki�cin PLEASE PRINT ININKy ph�n ,�s� � .ri A�
Check one: New business in P.A.?❑ Change of ownership only? ❑ Moving location fi•om within P.A.? ZOning
BUSINESS NAME_ ;fl 64yl-A-i4-A i`z r�-
Business address_ D 0 Mailing address
Phone number?. Ir " — j� Opening date .. Days & hours of operation AL S
Business owner's name o c! „/ e Contact phone(314)
Business owner's address i c
Brief description of business
Property owner's name --30Iin Contact phoneUhb) 9'3V,5r
Property owner's address/contact : e r"e,
BUILDING DEPARTMENT phone 417-4815Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people?. Yes ❑ No
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering sta)'Tways, rapps, bathrooms, electrical, heating/co lin /ventilation systems, etc),
Work_ planned: .i 0,77 ^, 4:
S /-.
a
FIRE DEPARTMENT phone 417-4653 Fire approval by on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No ❑
Work planned:
PBIA (Parking Business Improvement Area - Downtown) phone 417-4623
Square footage of business? '�7 01) _l IA,,
7PBIA notified on
Is business moving within the PBIA? Yes o ❑
CITY CLERK phone 417-4634
City Clerk approval.by on
Second-hand dealer/pawnbroker business? Yes ❑ No ❑
Will there be dancing at this business? Yes ❑ No ❑
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second-Nand Dealer, Pawnbroker, Dance,
Hotel-Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
o,yaer:;;:v� - CERTIFICATE OF OCCUPANCY APPLICATION Permit#
- - tee. .
� rn,
FEES
CITY OF PORT ANGELES $50 Certificate / Inspection
Attn: Permit Techriician
321 E. Fifth St., Port Angeles, WA 98362 Parking Business Improvement Area (PBIA)
(360 41.7-4815 . fax.(360) 41.7
<a-4711 X.,fee charged for Do.wntown,locatio(n�s 4�
�dils v�Kr►c; yin PL EASE PRINT IN INK phoneck 8+v1a (Lcb n Int` ;Y` A)
Check one: Newbusinessin P.A.?❑ Change of ownership only? ❑ Moving location from within P.A.? XZoning
BUSINESS NAME -e klr7
Business address� Mailing address
Phone number hC 7- %� , Opening date Days & hours of operation s
Tr
Business owner's name c ' r�i / e ;', Contact phoneL3i•P)�q 5 9.3! Sf
Business owner's addressi ^^ k
Brief description of business l
Property owner's name :L477 AV,' "'A Contact phone��/0) —IS 2.3 V,'
Property owner's address/contact
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering staays, rappps, bathrooms, electrical, heating/co lin /ventilation systems,etc).
Work planned: 14 I' cL/S — foe 5 P ti i
a
FIRE DEPARTMENT phone 417-4653 Fire approval by on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No ❑
Work planned:
PBIA (Parking.Business Improvement Area - Downtown) phone 417-4623
Square footage of business? Z&O D "7 t4 s ►,YS FPBIA notified on
Is business moving within the PBIA? Yes o ❑
CITY CLERK phone 417-4634 City Clerk approval by on (c
Second-hand dealer/pawnbroker business? Yes ❑ No ❑
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 �4'�`r�l�
�1
COMMUNITY& ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on "21zz
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: .
PLEASE N07-E:E: IVO flashing, intermittent, or chasing signs are permitted in the City of Hort Angeles.
pin1E approval by on
11WILIG VVUHnZ Utf'HKI MtNl- EIVGflVEERWG 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 ❑
Work planned:
PUBLIC WORKS WASTEWATER phone 417-4845 Pwwapproval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No ❑
If yes, what will be discharged:
Cal/ 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 I 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.
Date^% J Print Name 2 Signature ! /
x x
T%FormslBuilding DivisionlCertiricate of Occupancy Application(2010).doc
' 1
Page 2 of 2
COMMUNITY& ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on
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:
PLEAS NGTE:C: NV flashing, intermittent, or chasing signs are permitted in the City of Fort Hnge)es.
PAJE approval by k V or,_-7_6
PUBLIC: 0VORKS DEPARl MENl EIVGINEEKINCi phone 417-481Z 1V6'
"1 fb CC:-Mf 1-t e,L4 f-5Is 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 ❑
Work planned;
PUBLIC WORKS WASTEWATER phone 417-4845 Pwwapproval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No ❑
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 I 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. r
DatePrint Name Signature
� � X
T:\Forms\Building Division\Certificale of Occupancy Application(2010).doc
Page 2 of 2
PREPARED 4/27/12, 9:05:41 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 4/27/12
------------------------------------------------------------------------------------------------
ADDRESS . : 200 W 1ST ST SUBDIV:
TENANT, NBR: COUNTRY-AIRE, INC
CONTRACTOR : PHONE
OWNER JOHN J & ROBIN K MILETICH PHONE (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 11-00000672 CO- CHANGE OF OCCP/USE
--------------- --- - ---
PERMIT: CO 00 CHANGE OF OCCUP/USE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
----------------------- --------------------
CO99 01 4/27/12 L BLDG C/O FINAL '
I ' OVERRIDE TAKEN BY HCATUZO DATE: 04/26/12 TIME: 08:35:47
-------------------------------------- COMMENTS AND NOTES --
CITY OF PORT ANGELES
�. J
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION
.�/ 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . 11-00000841 Date 8/17/11
Application pin number . . . 101504
Property Address . . . . . . 200 W 1ST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000-
Tenant nbr, name . . . . . . COUNTRY-AIRE on your state excise tax form
Application type description COMM ADDITION to the City of Port Angeles
Subdivision Name . . . . . .
Property Use . . . . . . . . (Location Code 0502)
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 270000
----------------------------------------------------------------------------
Application desc
TI & ADD 490,SF MAIN ENTRY & 1,350 SF SOUTH ROOF
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH OWNER
312 RED DEER DR
PORT ANGELES WA 98362
(360) 452-7175
Other struct info . . . . . HARD SURFACE AREA
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT - COMMERCIAL
Additional desc . .
Permit pin number . 190629
Permit Fee . . . . 1972.25 Plan Check Fee 1281.96
Issue Date . . . . 8/17/11 Valuation . . . . 270000
Expiration Date 2/13/12
Qty Unit Charge Per Extension
BASE FEE 1020.25
170.00 5.6000 THOU BL-100,001-500K (5.60 PER K) 952.00
------------------------- ------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . .
Permit pin number . 191080
Permit Fee . . . . 143.95 Plan Check Fee .00
Issue Date . . . . 8/17/11 Valuation . . . . 0
Expiration Date . . 2/13/12
Qty Unit Charge Per Extension
BASE FEE 50.00
2.00 14.8000 EA ME-FURN/HP/FAU < OR = 5 TON 29.60
3.00 7.2500 EA ME-VENT FAN (SINGLE DUCT) 21.75
2.00 10.6500 EA ME-HOOD/DUCT-MECH. EXHAUST 21.30
1.00 10.6500 EA ME-STOVE/FIREPLACE/MISC. APP. 10.65
1.00 10.6500 EA ME-FUEL GAS PIPING,1-5 OUTLETS 10.65
----------------------------------------------------------------------------
Permit. . . . . . . PLUMBING PERMIT
Additional desc . . fi n /1 6. I • 19/
Permit pin number . 191106
Permit Fee . . . . 219.00 Plan Check Fee .00
Issue Date . . . . 8/17/11 Valuation . . . . 0
Expiration Date 2/13/12
Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Jai [.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS—
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footincls
Stemwall
Foundation Drainage/Downspouts
Piers
Post Holes(Pole Bldgs.)
PLUMBING:
Under Floor/Slab
Rough-in
Water Line(Meter to Bldg)
Gas Line
Back Flow/Water FINAL Date Accepted by
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists/Girders/Under Floor
Shear Wall/Hold Downs
Walls/Roof I Ceiling
D all Interior Braced Panel Onl )
T-Bar
INSULATION:
Slab
Wall/Floor/Ceiling
MECHANICAL:
Heat Pum /Furnace/FAU/Ducts
Rou h-In
Gas Line
Wood Stove I Pellet/Chimney
Commercial-Hood/Ducts FINAL Date Accepted by
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
Skirting
PLANNING DEPT. Separate Permit#s SEPA:
Parkin /Li htin ESA:
Landscaping
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
Inspection Type Date Accepted By
Electrical 417-4735
Construction - R.W. PW /Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
-r-Cn—c/Rnilriinn nivisinn/Ruildina Permit
sz�..
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page 2
Application Number . . . . . 11-00000841 Date 8/17/11
Application pin number . . . 101504 REPORT SALES TAX
Qty Unit Charge Per Extension on your state excise tax form
BASE FEE 50.00 to the City of Port Angeles
20.00 7.0000 EA PL-PLUMBING TRAP 140.00
1.00 7.0000 EA PL-WATER LINE 7.00 (Location Code 0502)
1.00 15.0000 EA PL-SEWER LINE 15.00
1.00 7.0000 EA PL-WATER HEATER 7.00
----------------------------------------------------------------------------
Special Notes and Comments
August 9, 2011 8:05:27 AM rbecker.
I will inspection building later to see if backflow assembly
is needed on the plumbing system. If you have any question
please contact Ron Becker at 417-4855 or E-mail:
rbecker@cityofpa.us
August 10, 2011 11:23:19 AM kdubuc.
Existing fire alarm system must be maintained and altered
where necessary in order to continue functioning.
Address numbers shall be plainly visible from the street.
Address numbers .shall be a minimum of six inches high and be
of contrasting color from the background.
August 10, 2011 11:27:26 AM kdubuc.
Fire alarm system will need to be extended into new
mezzanine office areas.
August 10, 2011 11:27:57 AM kdubuc.
A fire extinguisher will be required at the top of the
mezzanine stairs.
August 11, 2011 10:25:33 AM sroberds.
The proposal is a remodel of an existing structure in the
CBD with 87% lot coverage. No new footprint is proposed.
Interior and facade improvements only. No land use issues
are anticipated.
August 9, 2011 11:13:24 AM banders. New roof on south side
must provide minimum of 3-1/2 feet clearance under
electrical service conductor
Right of Way Use permit is required for installation of roof
structures if sidewalk is to be used for work area.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE SURCHARGE 4.50
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 2335.20 2335.20 .00 .00
Plan Check Total 1281.96 1281.96 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 3621.66 3621.66 .00 .00
Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS-- �—
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage/Downspouts
Piers
Post Holes(Pole Bldgs.)
PLUMBING:
Under Floor/Slab
Rough-in -
Water Line(Meter to Bldg)
Gas Line �7�- N
Back Flow/Water FINAL Date b�' IVAccepted b
AIR SEAL: G
Walls
Ceiling
FRAMING:
Joists/Girders/Under Floor
Shear Wall/Hold Downs _
Walls/Roof/Ceilin �—
D al! Interior Braced Panel Only)
T-Bar
INSULATION:
Slab
Wall/Floor/Ceiling ^
MECHANICAL: q
Heat Pump/Furnace/FAU/Ducts
Rough-In \
Gas Line
Wood Stove/Pellet/Chimney �.a� ,
Commercial Hood/Ducts FINAL Date ccepted b
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
Skirting
PLANNING DEPT. Separate Permit#s SEPA:
Parkin /Li htin ESA:
Landscaping ]SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
Inspection Type Date Accepted By
Electrical 417-4735
Construction - R.W. PW /Engineering 417-4831
Fire 417-4653
Plannin 417-4750
Building 417-4815
T-F—me/Ruilriinn nivisinn/Auildino Permit
PREPARED 5/01/12, 14:39:55 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/01/12
-------------------------------------------------------------------------—-------—--------
ADDRESS . : 200 W 1ST ST SUBDIV:
TENANT, NBR: COUNTRY-AIRE
CONTRACTOR : PHONE
OWNER JOHN J & ROBIN K MILETICH PHONE (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 11-00000841 COMM ADDITION
-----------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-—----------—-----—--------------------------------------- - ---------
BL3 01 1/23/12 JLL BLDG FRAMING
1/23/12 AP January 23, 2012 9:04:31 AM pbarthol.
AO John 808-1690
January 23, 2012 3:50:11 PM jlierly.
BLI O1 1/31/12 JLL BLDG INSULATION
2/01/12 AP January 31, 2012 8:38:19 AM pbarthol.
John 808-1690
February 1, 2012 10:48:54 AM jlierly.
BL99 01 4/27/12 JLL BLDG FINAL
4/27/12 DA April 26, 2012 8:37:06 AM hcatuzo.
April 27, 2012 4:38:12 PM jlierly.
verify hold down on tractors / seal bath tile and clean out
caps/jll
BL99 02 5/01/12 JLL BLDG FINAL
Ir
-------—------------------- COMMENTS AND NOTES --------------------------------------
PREPARED 4/27/12, 9:05:41 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 4/27/12
-----------------------------—-----------
ADDRESS . : 200 W IST ST SUBDIV:
TENANT, NBR: COUNTRY-AIRE
CONTRACTOR : PHONE
OWNER JOHN J & ROBIN K MILETICH PHONE (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 11-00000841 COMM ADDITION
------------------------------------------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCTAT•
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-------------------------------------------------------------------------------------------------
BL3
--------------------
BL3 01 1/23/12 JLL BLDG FRAMING
1/23/12 AP January 23, 2012 9:04:31 AM pbarthol.
John 808-1690
January 23, 2012 3:50:11 PM jlierly.
BLI 01 1/31/12 JLL BLDG INSULATION
2/01/12 AP January 31, 2012 8:38:19 AM pbarthol.
John 808-1690
February 1, 2012 10:48:54 AM jlierly.
BL99 01 4/27/12BLDGFINAL
Api1262012 8-37,06 AM he
----- ----� --------
-------------- ----__--
---------- -
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-- ----------------!-ki ---- -
-------------------------- - - --- � .
ME99 01 4/27/12 �D ---MECHANICAL-FINAL
-------------('�- ------ --- -----------
PERMIT: PL 00 PLDNIDING ERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
---——-------------------——---------------------------
PL2 01 1/13/12 JLL PLUMBING ROUGH-IN
1/13/12 AP January 13, 2012 8:46:36 AM pbarthol.
Doug 460-3839
please call
January 13, 2012 4:27:33 PM jlierly.
PL99 01 4/27/12 PLUMBING FINAL
C
-------------------------------------- COMMENTS AND NOTES --------------------------------------
PREPARED 1/31/12, 9:01:08 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 1/31/12
------—---------------------------—-----------—----------------------------------------------
ADDRESS . : 200 W 1ST ST SUBDIV:
TENANT, NBR: COUNTRY-AIRE
CONTRACTOR : PHONE
OWNER JOHN J & ROBIN K MILETICH PHONE (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 11-00000841 COMM ADDITION
------------ ------- ---
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-------------------- ---------------------------------------------------------------------
BL3 01 1/23/12 JLL BLDG FRAMING
1/23/12 AP January 23, 2012 9:04:31 AM pbarthol.
John 808-1690
January 23, 2012 3:50:11 PM jlierly.
BLI 01 1/31/12 LL BLDG INSULATION
-� January 31, 2012 8:38:19 AM pbarthol.
John 808-1690
--------------- -- -----—-- COMMENTS AND NOTES --------------------------------------
PREPARED 1/13/12, 9:33:46 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 1/13/12
--------------------------- --
ADDRESS . : 200 W 1ST ST SUBDIV:
TENANT, NSR: COUNTRY-AIRE
CONTRACTOR : PHONE
OWNER JOHN J & ROBIN K MILETICH PHONE (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 11-00000841 COMM ADDITION
------------------------------------------------------------------------------------------------
PERMIT: PL 00 PLUMBING PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
--------—-------------------------- ------------------------—------------
PL2 01 1/13/12PLUMBING ROUGH-IN
L
January 13, 2012 8:46:36 AM pbarthol.
Doug 460-3839
please call
---------- COMMENTS AND NOTES
PREPARED 1/23/12, 11:10:27 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 1/23/12
--- --------
ADDRESS . : 200 W 1ST ST SUBDIV:
TENANT, NBR: COUNTRY-AIRE
CONTRACTOR : PHONE
OWNER JOHN J & ROBIN K MILETICH PHONE (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 11-00000841 COMM ADDITION
--- ------ ------------------------------------
PERMIT: SPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-- ----------------------------------—-----' -—--------
BL3 01 1/23/12 JL BLDG FRAMING
January 23, 2012 9:04:31 AM pbarthol.
John 808-1690
-------------------- --------- COMMENTS AND NOTES --------------------------------------
'6116111 Per owher ©6x- CO'
r1C�ir► KeF- 'o M now On
.
r +t, BUILDING PERMIT APPLICATION Print in ink
�►e►401►- CITY OF PORT ANGELES
Attn: Building Permit TechnicianDate Received `6-?i,
For City Use Only:
�(
321 E. Fifth St., Port Angeles, WA 98362 ��1ho
Permit# 1t-
(360)417-4815 fax(360)417-4711 ate Approved !
Applicant Crohn a- Robyn IT),'I.ef-ich O-y57- 3 1
Property Owner Soh + r-Z(DbvnfIc --k Phone Bu,5 -H52-'7/7$
Property Owner's Address 31 6 2
Contractor (%une4T, i1d�t : �Ohr, y��'�+icG, Ph eceI( -, 3loo-foq !Z0 .
l4sen� /� 'ohcee/ T. t;er�try
Get-%±rW Ar--j);4-ec4zcrg CD/Ie(,nreL+,Ve—
f
ileo — 445`7- '7550 �— E-mail q\-f)
car .c
PROJECT ADDRESS 2-00 to
Parcel Number Lot Zoning �QD
Proiect Twe&Brief Description: ❑Residential ❑ Multi-familyMCommercial ❑Industrial
Check all that apply T�rl4 m - rrnp rr�
oven-P-"+s Cts w.9
WS
❑ New Construction lq j
❑Addition � ) n�AAJ /y 3 y s rueux- _ d
(Remodel
i°�'�epair s e ? haw wo
❑ Demolition
❑ Re-roof
Qf ��'Fera'or w•alFs ir�-Fe a cros ►; se' =Vhl
�- Heat System
�0� ❑Other s f 1 P1.►, C ,er fis �--1-h is - ww-- wi 1 aw- strae+ eve C .
oor Areas '� Existina(sa. ft.1 Pro osed s . ft. i 1 I CAS d: a W phi n5 S a'r� N a r�
Basement East Sides o'� 9 + � wi Il
@$ , per sq. ft. =$
1" Floor Law-et-Leve 1 1%6 00 C'IVn dt dvel Q rij int Of w
2nd FIOOfSfiYcet-1-¢Ve1 17
, loto0 fon 1004000
3`d Floor Ath'e 1, 000 CL -f,'ve a
Garage C��1
Carport -16,I
Covered Porch �U
Deck--S�re+;k.fych�- �� in �,�� 1 ,p �
OtherMezzan%Yv, S?1 rin1, 0.dv �c) ?C O
WeA tea TOTAL VALUATION $ 2-70, 0000-1
Total footprint of structures '-L{ 64T sq.ft. T Lot size Z'Tr169 sq. ft. = Lot coverage %
Site Coverage=the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage %
Max. height of proposed structures ft. Occupancy group 1111 #of bedrooms
Will a lawn sprinkler system be installed? >o h. Occupant load #of full baths
Will a fire sprinkler system be installed? t4o Construction type #of half baths
I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand
that it is m/y responsibility to determine what permits are required, and to obtain permits prior to working pr 'ects.
Date �6���� Print Name *ktC�L——V 6" Signature
T:Forms/Building Division/Bldg Permit.doc
NOTES
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023.8
200 W. FIRST ST. PORT ANGELES, WASHINGTON ENTRY
m` COUNTRY- AIRE C0L F iECi 1RE
" A 0 L L A B 0 RCA i R E
N NATURAL FOODS 115 E.RAILROAD AVE.SUITE 308.PORT AIIOELES.WA 98352/457-7550
E . E � VEGene :E.
MAY 161 2012 . Engineering, Inc.
14 May 2012-l'. CITY^OF PORT ANGELES
BUILDING DIVISION Civil � Structural ,• Management
John Miletich 1401 west 7th street +
312 Red'Deer Dr 'Port, Washington 98363 '
Port Angeles,_WA 98362 - 5
Office•(360)452-2098-
Fax
452 2098.
Fax (360) 4172098'
Subject: -inspectlon-of Tractor Tie down
COUntry Air
E--;�ail:'ungele@msn.com
Dear Mr: Miletich
Y .I cond:ucted'an Inspection at Country Air, in-PortM'geles, Washington :Your ,
installation of hold,down.devices*on the,two platform mounted,tractor's.was'I y`task: ..l
observed '/4'inch swaged.cables on'.each.wheei with".equivalent eye-bolt screw-anchors -
attaching each.wheel to=the`platform. You also installed 4x4 blocking on both sides of
each wheel so that the!tractors cannot move in'what we would call the design load
event:
,1 am:-therefor advising with this letter�that the-platform mounted-tractors are now In
_ compliance.with',generally,accepted principles�in relation.to hold downs.for their position
rn`your,facility;at Country:Air: The attached:photographs .exemplify my findings ;
TbiS concludes: my obser.v tlonsycOncerning.:the.Tractom mounted.in Country:Air store
on-West Flrst.;in Bort A. ngeles. 'The.conclusions'and.recommendations contained in.thls
'report are laaped on site�cor ti-ps, as they existed at the time of my �risi and<.
inspection Awlsual inspection was made;,the configuration was analyzed, and
conclusions vvere,d:rawn from-this information. :if the conditions are..defined'further in
any way`or if changes to-the site occur, different conclusions can be anticipated I; ,
should�be_advised of changes so fiat I-can review.these.conditions'and,reco'nSider;
further..r'ecommendatlons
This report has,been for.the:exclusive,use of John Miletich:and hi`s assigns.
The recommendations and conclusions`are, ase d on the site materials'observed'and
on pre ion�s,experierice vyith,bui!dings with slm�lar obseni concitions. TIER
conclusions and recommendations are,professional opinions in accordance with
�curren#-standards.of practice'within the.limited scope of my,services No warranty. is'
expressed,o.r.implied s
Sincerely, -
:> uy
:Gene H_ Un0er., PE
Lnc. Photographs:
44
CC:,< City of Port Angeles, Build Department
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CITY OF PORT ANGELES
al DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION
+� 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 11-00001351 Date 12/06/11
Application pin number . . . 454783
Property Address . . . . . . 200 W 1ST ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000- REPORT SALES TAX
Application type description SIGNS on your state excise tax form
Subdivision Name . . . . . .
Property Use . . . . . . . . to the City of Port Angeles
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT (Location Code 0502)
Application valuation 3800
Application desc
3 WALL MOUNTED SIGNS OVER 25 SQ FT
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH OWNER
312 RED DEER DR
PORT ANGELES WA 98362
(360) 452-7175
----------------------------------------------------------------------------
Permit . . . . . . SIGN
Additional desc .. . 3 WALL MOUNTED SIGNS
Permit Fee . . . . 255.00 Plan Check Fee .00
Issue Date . . . . 12/06/11 Valuation . . . . 3800
Expiration Date 6/03/12
Qty Unit Charge Per Extension
3.00 85.0000 PER S-WALL SIGN OR MARQUEE > 25 SF 255.00
----------------------------------------------------------------------------
Special Notes and Comments
December 5, 2011 3:00:28 PM sroberds.
Three face mount signs are proposed on three building faces
per requirements of the CBD zone. Total of all three signs
is 318 sq.ft. No land use issues anticipated.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 255.00 255.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 255.00 255.00 .00 .00
final S� � • 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 has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any s to or to aijaw regulating construction or the performance of
construction, j III
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS -
I�I Building Inspections 417-4815 Electrical Inspections 417-4735
l� Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IN. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
-7
I Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage/Downspouts
Piers
Post Holes(Pole Bldgs.)
PLUMBING:
Under Floor/Slab
Rough-In
Water Line(Meter to Bldg)
Gas Line
Back Flow/Water FINAL Date Accepted b
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists/Girders/Under Floor
Shear Wall/Hold Downs
Walls/Roof/Ceiling
Drywall(Interior Braced Panel Only)
T-Bar
INSULATION:
Slab
Wall/Floor/Ceiling
MECHANICAL:
Heat Pump/Furnace/FAU/Ducts
Rough-In
Gas Line
Wood Stove/Pellet/Chimney
Commercial Hood/Ducts FINAL Date Accepted b
MANUFACTURED HOMES: .
Footing I Slab
Blocking& Hold Downs.
Skirting
PLANNING DEPT. Separate Permit#s SEPA:
Parkin /Li htin ESA:
`; .. Landscaping SHORELINE:
V �
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
sol
Inspection Type Date Accepted By
Electrical 417-4735
Construction- R.W. PW /Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
PREPARED 5/01/12, 14:39:55 INSPECTION TICKET PAGE 2
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/01/12
-------------------------—--------------------------------------------—--------—-------------
ADDRESS . : 200 W 1ST ST SUBDIV:
CONTRACTOR : PHONE :
OWNER JOHN J & ROBIN K MILETICH PHONE : (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 11-00001351 SIGNS
------------------------------------------------------------------------------------------------
PERMIT: SIGN 00 SIGN
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
---------------------------—----------------------------------------------------—------------
BL99 01 4/27/12 JLL BLDG FINAL
4/27/12 DA April 27, 2012 4:38:47 PM jlierly.
not installed yet/jll
BL99 02 5/01/12 JLL BLDG FINAL
-------------f/-------4-- - COMMENTS AND NOTES
PREPARED 4/27/12, 9:10:45 INSPECTION TICKET PAGE 1
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 4/27/12
------------------------------------------------------------------------------------------------
ADDRESS . : 200 W IST ST SUBDIV:
CONTRACTOR : PHONE :
OWNER JOHN J & ROBIN K MILETICH PHONE : (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 11-00001351 SIGNS
------------------------------------------------------------------------------------------------
PERMIT: SIGN 00 SIGN
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------ --------- -------------------------------------------- ----
BL99 01 4/27/12 JLL BLDG FINAL
--------------------- --------- ___ lz�_______ 1 .
COMMENTS AND NOTES -----
I,''�J/��
J VL
E
l
SIGN PERMIT A PLICATI rint in ink
�- CITY OF PORT ANGELES
For City Use Only:
Attn: Building Permit Technician D to Received
- � 321 E. Fifth St., Port Angeles, WA 983 2NOV 3 ®,:20�� P r t# -13
(360) 417-4815 fax (360) 417-4711 N
ID proved
CITY OF PORT ANGELES
Applicant or Agent -JOVft4-+ Q01�/�f MIL"Jfr(c NJln � INGDIVISION q
Property Owner J K-- I4 IYIILeTi CDUNi"IZ A1126 Phone (�
Property Owner's Address ;JI?_ )2W ,OW12 Vg_jNrr _I���
Contractor ��H dY1 }� I Q -�-- Phonem D
Contractor's Address M Il.� �✓I N ►L C _
License # 11°10 CAP_I 609L1 ROAV c irn VJ+ Expir IMI
'06 5eTOf)eo 130,d
Project Address 20i� i(\!. 1c-r
Business Name _CjWN-r- y
Parcel Number cl tp� Lot ��>� 1�L 3- Zoning C p IM M .
Submit an 8 % "x 11 "site plan & three sets of plans that include:
■ Type of sign (wall-mounted,, projecting, freestanding, illuminated, other...)
■ Placement and sq. ft. area
■ How the sign will be securely attached (Engineering specs may be required for freestanding signs)
• Separation distance between the bottom of projecting and freestanding signs and the surface below
See "Chapter 94.36 Sign Code"of the City of Port Angeles Municipal Code for.sign requirements.
Sign Type & Brief Description: (Type, location, sq. ft.)
W ftA,M NI'E1� to I-V' W A' '/ r�►��
Sign #1 (�185th F-r� 019 X 2Z,ly� #VF DAM�0►14 O�i WM 7z1 -J'H'ILiL iNb, (,�7ft-IeS
Sign 42,`�—tF—arm 11 X ►o IZ&10 /r�2 - (cp 5QT-rl Polzy rny�mtyir4n_
Sign #311UgU-MUVt4MA9 Poow�mdy�a yet. I)umy.
Sign #4
Totals (Unit charges Sign(s)
Unit Charge Quantity multiplied by quantities) Type of Sign Valuation
$47.00 x = $ All signs less than or equal to 25 sq. ft.
$85.00 x 3 = $ ,215Wall sign or marquees, over 25 sq. ft.
$115.00 x = $ Freestanding sign or projecting sign, over 25 sq. ft.
GRAND TOTAL Make Checks Payable to: City of Port Angeles
$ 2r55 , j20 Credit Cards (Except American Express) are accepted
Existing sign(s) area 'D sq. ft. +Proposed sign(s) area 1gS4- sq. ft. = Total sign(s) area �1$. sq. ft.
c�l � f #PZIi?n -t-
Building
r
Building fagade area (heightft. X width ft.) = qV2- sq. ft. (if a building has more than one
business in it, only measure the area of the building fagade that is used by the business applying for this permit.)
`2114N 4 � V�GI�V (;O N0 WKL4, ftOCr,1f� AU. ,Y--II 'T- �
I have read and Completed this application and know it to be true and correct. I am authorized to
apply for this permit and understand that it is my. responsibility to determine what permits are
required, and to obtain permits prior to working on projects.
Date Wt Print Name ►�I'V Yin, -`�� �T Signature
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- CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 12-00000013 Date 1/06/12
Application pin number . . . 739998
Property Address . . . . . . 200 W 1sT ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000-
Application type description MECHANICAL APPL. PERMIT on your state excise tax form
subProperty
Name . . . . . . to the City of Port Angeles
Pro ert Use
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT (Location Code 0502)
Application valuation . . . . 20000
------------
Application desc
FOUR 5 TON HEAT PUMPS
----------------------------------------------------------------------------
Owner Contractor
JOHN J & ROBIN K MILETICH ANGELES HEATING INC.
312 RED DEER DR 2114 W 8TH ST
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360) 452-7175 (360) 457-0111
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . . 4- 5TON HEAT PUMPS
Permit Fee . . . . 122.80 Plan Check Fee .00
Issue Date . . . . 1/06/12 Valuation . . . . 0
Expiration Date 7/04/12
Qty Unit Charge Per Extension
BASE FEE 50.00
4.00 18.2000 EA ME-FURN/HP/FAU > 5 TON 72.80
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 122.80 122.80 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 122.80 122.80 .00 .00
Separate Permits are required forelectrical 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 has commenced, or if required inspections have not been.requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
A�1-2==
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
y:Forms/Building Division/Building Permit
BUILDING PERMIT INSPECTION RECORD
— PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS —
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage/Downspouts
Piers
Post Holes(Pole Bldgs.)
PLUMBING:
Under Floor/Slab
Rough-in
Water Line(Meter to Bldg)
Gas Line
Back Flow/Water FINAL Date Accepted b
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists/Girders/Under Floor
Shear Wall/Hold Downs
Walls/Roof/Ceiling
Drywall Interior Braced Panel Only)
T-Bar
INSULATION:
Slab
Wall/Floor/Ceiling
MECHANICAL:
Heat Pum /Furnace/FAU/Ducts
Rough-in
Gas Line
Wood Stove/Pellet/ChimneyLL V
Commercial Hood/Ducts FINAL Dates*1 ' I T Accepted b ✓�
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
Skirting
PLANNING DEPT. Separate Permit#s SEPA:
Parking/Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
Inspection Type Date Accepted By
Electrical 417-4735
Construction- R.W. PW /Engineering 417-4831
Fire 417-4653 \
Planning 417-4750 W
Building 417-4815
T:Forms/Building Division/Buildinq Permit
PREPARED 5/01/12, 14:39:55 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/01/12
'- --- ----------------- ------------- --- -------- ------
ADDRESS . : 200 W IST ST SUBDIV:
CONTRACTOR ANGELES HEATING INC. PHONE (360) 457-0111
OWNER JOHN J & ROBIN K MILETICH PHONE (360) 452-7175
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 12-00000013 MECHANICAL APPL. PERMIT
--- ----- ------------
-- -------------------- ------- ------
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
' ----------------------------------------- -------------------------------
ME99 01 5/01/12 JLL MECHANICAL FINAL
�r A
--------------------------------------
------'-------------------------- COMMENTS AND NOTES --------------------------------------
BUILDING PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES
fr „ For City Use Only:
Attn: Building Permit Technician Date Received j-,&
321 E. Fifth St., Port Angeles, WA 98362 Permit#
(360) 417-4815 fax (360) 417-4711 Date Approved - -�
Applicant A/ Phone /-I _d /Z/
Property Own d J, ,✓ 1 Phone r�� T � —
Property Owner's Address
Contractor () Phone
Contractor's Address
License # 4N xpires 3 2--E-mail
PROJECT ADDRESSp s t-
Parcel Number Lot Zoning
Project Type & Brief Description: ❑ Residential ❑ Multi-family ❑ Commercial ❑ Industrial
Check all that apply
❑ New Construction
❑Addition 5
o-Remodel
❑ Repair
❑ Demolition
❑ Re-roof ❑ House ❑ garage ❑ other ❑ tear off& re-roof ❑ lay over one layer
❑ Heat System e-Moat pump ❑ wood-burning stove ❑ gas fireplace ❑ pellet stove ❑ other
❑ Other
Floor Areas Existing (sq. ft.) Proposed(sq. ft.)
Basement @ $ per sq. ft. _ $
15' Floor
2nd Floor
3rd Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION $
Total footprint of structures sq. ft. T Lot size sq. ft. = Lot coverage %
Site Coverage = the amount of impervious surface on a parce), including structures, paved driveways, sidewalks, patios,
and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage %
Max. height of proposed structures ft. Occupancy group #of bedrooms
Will a lawn sprinkler system be installed? Occupant load #of full baths
Will a fire sprinkler system be installed? Construction type #of half baths
1 have read and completed this application and now it to be true and correct. 1 am authorized to applZtor this permit and understand
that it is my r sponsibility to determine w itrequired, and to obtain permits prior to wor i'on pro'
Date ,Pfr4a-`F?te --Signature
T:Forms/Building Division/Building permit application
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CITY OF PORT ANGELES
PUBLIC WORKS & UTILITIES
321 EAST 5TH STREET, PORT ANGELES; WA 98362
Application Number 11-00000926 Date 8/26/11
Application pin number 624774
Property Address . . . . . . 200 W 1ST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000- on your state excise tax form
Application type description PUBLIC WORKS UTILITES
Subdivision Name . . . . . . to the. City of Port Angeles
Property Use . . . . . . . . (Location Code 0502)
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Use sidewalk to install awning RUP# 11-21
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH OWNER
312 RED DEER DR
PORT ANGELES WA 98362
(360) 452-7175
----------------------------------------------------------------------------
Permit . . . . . . RIGHT OF WAY
Additional desc . . RUP# 11-21
Permit pin number . 191684
Permit Fee . . . . 75.00 Plan Check Fee .00
Issue Date . . . . 8/26/11 Valuation . . . . 0
Expiration Date . . 2/22/12
Qty Unit Charge Per Extension
BASE FEE 75.00
----------------------------------------------------------------------------
Special Notes and Comments
No work on weekends, holidays, or during any event. 4 foot .
clear space to be maintained on 1st Street sidewalk.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
-
---------------- ---------- ---------- ---------- ----------
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00G.}--
V V
Grand Total 75.00 75.00 .00 .00 t '
"
l
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
construc
e of Contractor or Authorized Agent Date Signature of Owner(if owner is builder) Date
T:Forms/Building Division/Public Works Permit
PERMIT INSPECTION RECORD
CALL 417-4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL A-NY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE/METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL .
PARKING
SIDEWALK'..,
CURB&'GUTTER
DR I V E W AY'APPR OACH
-',BACK-FLOW DEVICE.
777777
y
:
s
FINAL INSPECTIONS,REQUIRED PRIOR,TO OCCUPANCY/USE
RESIDENTIAL . DACE IES NO COMMERCIAL DATE ACCEPTED
YES NO
EOG NEERINIO_4 R W /;PW/; 417 480T'` CONSTRUCTION:-R W
PW/ENGINEERING
FIRE 4174653 FIRE DEPT.-
PLANNING DEPT. 4174750 PLANNING DEPT.
BUILDING 4)] BUILDING
4815
T Porins/Budding Division/Publ�c
ELECTRICAL PERMIT
N
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . . 12-00000050 Date 1/20/12
Application pin number . . . 266700
Property Address . . . . . 200 W 1ST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000- on excise tax form
Application type description ELECTRICAL ONLY y
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . . (Location Code 0502)
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation . . . . . 0
----------------------------------------------------------------------------
Application desc
store remodel
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH SIMPSON ELECTRIC
312 RED DEER DR 243036 W HWY 101
PORT ANGELES WA 98362 PORT ANGELES WA 98363 (� \
(360) 452-7175 (360) 457-9270
-------------- ---------------------------- ---------------
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 1363.00 Plan Check Fee .00
Issue Date . . . . 1/20/12 Valuation . . . . 0
Expiration Date 7/18/12
Qty Unit Charge Per Extension
72.00 5.0000 ECH EL-BRANCH CIRCUIT W/FEEDER 360.00 v
1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00
4.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 20.00
4.00 132.0000 ECH EL-COM 0-200 SRV FEEDER 528.00
1.00 288.0000 ECH EL-COM 601-1000 SRV FEEDER 288.00
1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00
3.00 5.0000 ECH EL-LVT-ADDITIONL THERMOSTAT 15.00
----------------------------- ---------- -- ---
Fee summary Charged Paid Credited Due r
a -------------- ---------- ---------- v
Permit Fee Total 1363.00 1363.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 1363.00 1363.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE 2 Z
ROUGH-IN
i
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X f Date:
G:\EXCHANGE\BUILDING
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ADDRESS
APPROVED NOT APPROVED
❑ . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑
ROUGH IN/COVER . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . ❑
,-"^o.. . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . ❑
L�CORR�,ECTPONS NEEDED: I"C 'Tb Gz D ✓ -(Z �rsfzs Si-7-
a Pit,IT- 4 4 Q U 1 E_f-17 "�76-tz. t oW LkLyh�.0 .
3� 3Z*r-mo v PF- PrIL-i— -111A 115 fFL;r-�(cjk C.
w-n
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHON 95 DAMS
DO MOT REMOVE —
OFp0RTA" ELECTRICAL INSPECTION
ai /wcF!
�—� WIRING REPORT
U N
R- 417-4735
DAT PERMIT# INSPECTOR
1 I2- I 6-Z ��C�
OWNER/CONTRACTOR
ADDRESS
2,00 Li S
APPROVED NOT APPROVED
❑ . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑
�-
. . . . ROUGH IN/COVER . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . ❑
CORRECTIONS NEEDED: 5j� izAc g- ��©� yc r-
104 S H 0 AU- 63)Yi �'a 6DI)Eta
e 0
C.0611y-rz- S`Tp-r i,)19-L-1- a v 96Z —
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
OLYMPIC PRINTERS,INC.(360)452-1381
OF VOR744,C� ELECTMAL NBPECTM
d ay Mn/Mma REPORT
417-4735
Ks
DATE PERMIT# INSPECTOR
l� 12-
OWNER/CONTRACTOR
r'j
ADDRESS
APPROVED NOT APPROVED
❑ . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . .
CORRECTIONS NEEDED: S 1 r7,-R t--s c- ?)Pr III,)ML - L` 1
L-R k n 944 V t tRln 0 r-1 1 n.1 6-
cuf�Do
S� LV-'o1T#4-0 z o�T
151 14 t 5 H rA
7) ?�IjNjmc—e,
Got,L DISC—'� i5 c7 '7 e� t4-'rti (� A u-(�t�' �+5
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 95 DAYS
— DO NOT REMOVE —
OLYMPIC PRINTERS,INC.(360)452-1351
0 VORT4N ELECTRICAL INSPECTION
�''-� WIRING REPORT
U N
G` r
FR?KS& ��a 417-4735
DAT PERMIT a INSPECT R
7/
12--005D
OWNER/CONTRACTOR r` '
ADDRESS
APPROVED NOT APPROVED
❑ . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . .
ORRECTIONS NEEDED: 5*-PvPv ►
I Z) S SL e
Au— 2T3n'A j'e=� C'6 k4 3?p Lfi- bj
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
OLYMPIC PRINTERS,INC.(360)452-1381
.0) rc�ar,it,/
CIfX OF PORT ANGELUS P]EAtNI[T]C APPi.,iCATIOly1°" t
Building Division/ElectricalInspections I Or
321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362 +e
Ph: (360)417-4735 Fax: (360)417-4711 ELECTRICAL C
Date: /—I?-- INSPECTIONS
Multi-Family or Commercial" ,�(Commercial Addition/Alteration/Remodel!Repair
*Plan Review May Be Required, Please Compe Elactricallan Review Information Sheet
Job Address: -�`'�'
Building Square Footage:
Description of above ' -5'
ok r
Owner Infoation Contractor Information
Name; / r e c cLL-Ci
MailiA �2.67 !
MailingA
I . 6) .�LL
City; Stalo; " Pip: J/ City: J, Slate:,L) Zip�'-
�h�no: Fax: Phone; 14.5 .0 Fax:
License#I Exp. License#t Exp.
Item Unit Chargef3ty Total(Qty Mull iplied by Unit.Chargel
Servlce/Feeder 200 Amp. $132.00 _ $., ac)
Service/Feeder 201400 Amp. $160"00 _
Service/Feeder 401600 Amp $225.00 $
ServlcefFeeder 601-1000 Amp. $288.00 $ —
Service/Feeder over 1000 Amp. $410.00 $
Branch Circuits 1.4 $ 86.00 $
Branch Circuit W1 Service Feeder $ 5.00
Branch Circuit W/0 Service Feeder $ 74.0006
Each Additional Branch Circuit $ 5.00
Temp.Servicel 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 S 96.0D $
Slgn/Outline Lighting $ 88.00 $ __
Q �p�iJ
Signal Clrcullf Limited Energy-Multi-Family $ 64.00 9 loop $
Signal Circull/Limited Energy/First 1500 sf—Commercial $ 96.00 A7
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-5KVA System or Less $113,00 �j $
Thermostat $ 56.00 — r , coo —7T-
$ ^
If.crr>
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 Inspectio u.
After reading the above statement,I hereby certify that I am the owner of the above named.property or a licensed electrical c,ntractor.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 City of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signat of owner,electrical cont or or electrical administrator. ❑ Cash ❑ Check
R] Credit CeM#
�7�f iter-� Dated:
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IF
ELECTRICAL PERMIT E '
CITY OF PORT ANGELES
360-417-4735
Application Number . . . . . 12-00000063 Date 1/24/12
Application pin number . . . 047245
Property Address . . . . . . 200 W 1sT ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000- on your excise tax form
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . . . (Location Code 0502)
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Low Voltage permit (Owner )
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH OWNER
312 RED DEER DR
PORT ANGELES WA 98362
(360) 452-7175
-------------------------------------------------------------
Permit . . . . . ELECTRICAL ALTER COMMERCIAL 1 v
Additional desc (((
Permit Fee . . . . 146.00 Plan Check Fee .00
Issue Date . . . . 1/24/12 Valuation . . . . 0
Expiration Date . . 7/22/12
Qty Unit Charge Per Extension
1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00
10.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 50.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 146.00 146.00 .00 .00
Plan Check Total .00 .00 .00 .00•
Grand Total 146.00 146.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN A 41'q
f Z
FINAL Z
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:\EXCHANGE\BUILDING
O : .pt yeahr,t,tc� N
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections ,� ' 2
321 East Fifth Street—P.O.Box 1150/Port Angeles Washington,98362
Ph: (360)417-4735 Fax: (360) 417-4711 ELECTR(CgL
INSPECTIONS
Date: /'d 3 '/ _Multi-Family or Commercial*
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: goo
Building Square Footage: ;t7�C9
Description of above
Owner Information ly1��"� Contractor Information
Name: _��(r.1U �l��tGV" / Name:
Mailinq Address: Mailing Address:
City: State: ,0 4 Zip:QjjA.(,2 City: State: Zip:
Phone: Fax: Phone: Fax:
License#/Exp. License#I Exp.
Item Unit Charge Qty Total(Qty Multiplied by 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 $ 64.00 $
Signal Circuit/Limited Energy/First 1500 sf-Commercial $ 96.00 �— $ .
Note: $5.00 foreach additional 1500 sf /0
Renewable Electrical Energy-5KVA System or Less $113.00 $
Thermostat $ 56.00 $
Note:$5.00 for each additional T-Stat '/ ov
$ 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.
Signature of owner,electrical contractor or electrical administrator: ❑ Cash ❑ Check
ElCredit Card#
Dated: l 0110112012
ti 1-IS
ELECTRICAL PERMIT d
CITY OF PORT ANGELES U
360-417-4735
Application Number . . . . . 12-00000381 Date 4/04/12
Application pin number . . . 883991
Property Address . . . . . . 200 W IST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000- on your excise tax form
Application type description ELECTRICAL . ONLY
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . . . . (Location Code 0502)
Property Zoning . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . 0
Application desc
Camera termination
----------------------------------------------------------------------------
Owner Contractor
JOHN J & ROBIN K MILETICH HI TECH SECURITY INC
312 RED DEER DR 723 E FRONT ST
PORT ANGELES WA 98362 PORT ANGELES WA 98362 {�
(360) 452-7175 (360) 452-2727 1+;
----------------------------------------------------------- YJ �J O
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc Q
Permit Fee . . . . 96.00 Plan Check Fee .00
Issue Date . . . . 4/04/12 Valuation 0
Expiration Date 10/01/12
Qty Unit Charge Per Extension J
1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00 IV!
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 96.00 96.00 .00 .00
Plan Check Total .00 .00 .00 .00 11
Grand Total 96.00 96.00 .00 .00
c '
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-lN
FINAL Z
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor,X Date:
G:\EXCHANGE\BUILDING
;�l}pi33trILI, lJ
CITY OF PORT ANGELES PERMIT APPLICATION00
Building Division/Electrical Inspections ''
321 East Fifth Street—P.O.Bos 1150/Port Angeles Washington,98362 '""""
Ph: (360)417-4735 Fax: (360)417-4711
Date: 4-3-2D+2 ✓� Multi-Family or Commercial*
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 200 w-s.
Building Square Footage:
Description of above TcimI.WW suweame ae —marc•Tce T-1—F,-Nam Sys ,
Owner Information Contractor Information
Name: c-fty Are Name: K Tom+S—^M.h-
Mailing Address: 200w tat st Mailing Address: 723—Front St
City: Pon A.0- State: wA Zip: 06362 City: —AV— State: wA Zip: 9630
Phone:36P49434a Fax: Phone:36--2727 Fax: 360-rW.&%D
License#/Exp. License#I Exp.HfTEcTssuws
Item Unit Charge QtV Total(Qtv Multiplied by Unit Charge)
Service/Feeder 200 Amp. $132.00 $
ServicelFeeder 201.400 Amp. $160.00 $
ServicelFeeder 401-600 Amp $225.00 $
Service/Feeder 601-1000 Amp. $288.00 $
ServicafFeeder over 1000 Amp. $410.00 $
Branch Circuit W/Service Feeder $ 5.00 $
Branch Circuit W10 Service Feeder $ 74.00 $
Each Additional Branch Circuit $ 5,00 $
Branch Circuits 14 $ 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 $
Tetnp.Service/Feeder 601-1000 Amp. $185.00 5
Portal to Portal Hourly $ 96.00 $
SigNOutline Lighting $ 88.00 $
Signal Circuit/Limited Energy-Multi-Family $ 64.00 S
Signal Circuit/Limited Energy/First 1500 sf-Commercial $ 96.00 t $
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-SKVA System or Less $113.00 $
Thermostat $ 56-00 $
Note:$5.00 for each additional T-Stat
$%.Do 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 certity 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.
Signature of owner,electrical contractor or electrical administrator: 0 cash 0 check
O Credh Card 4 on Fre
x Mike Shirley/ Gary Politika Dated: 4.S-t2 01101rzat2
Application Number 08 00001538 Date 9/02/09
Application pin number 807500
Property Address 200 W 1ST ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 3300 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 0
Application desc
Fire alarm panel and devices
Owner Contractor
K O ERICKSON TRUST MVMCGHEE
234 WHIDBY AVE 35905 3RD AVE SW
PORT ANGELES WA 983626542 FEDERAL WAY WA 98023
(206) 571 2969
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit pin number 139170
Permit Fee 194 00 Plan Check Fee 00
Issue Date 12/19/08 Valuation 0
Expiration Date 8/05/09
Qty Unit Charge Per Extension
1 00 40 0000 EL-LOW VOLT SYS <=2500 SQFT 40 00
14 00 11 0000 EL-LOW VOLT SYS >2500 SQFT 154 00
Fee summary Charged Paid Credited Due
Permit Fee Total 194 00 194 00 00 00
Plan Check Total 00 00 00 00
Grand Total 194 00 194 00 00 00
Application Number 08 00000373 Date 9/02/09
Application pin number 515130
Property Address 200 W 1ST ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 3300 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 0
Application desc
HVAC circuits
Owner Contractor
K O ERICKSON TRUST ANGELES ELECTRIC
234 WHIDBY AVE 524 E 1ST ST
PORT ANGELES WA 983626542 PORT ANGELES WA 98362
(360) 452 9264
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc ANG EL / HVAC EQUIP
Permit pin number 123588
Permit Fee 116 00 Plan Check Fee 00
Issue Date 3/31/08 Valuation 0
Expiration Date 11/16/08
Qty Unit Charge Per Extension
2 00 58 0000 ECH EL-COMM ALT <5 CIRCUITS 116 00
Fee summary Charged Paid Credited Due
Permit Fee Total 116 00 116 00 00 00
Plan Check Total 00 00 00 00
Grand Total 116 00 116 00 00 00
Application Number 07 00001376 Date 9/02/09
Application pin number 000480
Property Address 200 W 1ST ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 3300 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 0
Owner Contractor
K O ERICKSON TRUST HSM ELECTRIC
234 WHIDBY AVE 2700 RICHARDS RD #202
PORT ANGELES WA 983626542 BELLEVUE
BELLEVUE WA 98005
(425) 957 7008
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit pin number 116202
Permit Fee 40 00 Plan Check Fee 00
Issue Date 11/26/07 Valuation 0
Expiration Date 5/24/08
Qty Unit Charge Per Extension
1 00 40 0000 EL-LOW VOLT SYS <=2500 SQFT 40 00
Fee summary Charged Paid Credited Due
Permit Fee Total 40 00 40 00 00 00
Plan Check Total 00 00 00 00
Grand Total 40 00 40 00 00 00
Application Number 07 00001427 Date 9/01/09
Application pin number 645804
Property Address 200 W IST ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 3300 0000
Tenant nbr name GOTTSCHALKS
Application type description COMM MECHANICAL PERMIT
Subdivision Name
Property Use
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 50000
Application desc
REPALCE EXISTING / INSTALL NEW HVAC EQUIPMENT
Owner Contractor
K O ERICKSON TRUST SEA AIRE INC
3005 W 18TH ST 340 UPLAND DR
PORT ANGELES WA 98363 TUKWILA WA 98188
(206) 604 1582
Permit MECHANICAL PERMIT
Additional desc REPLACE & ADD NEW HVAC
Permit pin number 117317
Permit Fee 64 80 Plan Check Fee 00
Issue Date 12/11/07 Valuation 50000
Expiration Date 11/17/08
Qty Unit Charge Per Extension
BASE FEE 50 00
1 00 14 8000 EA ME FURN/HP/FAU < OR = 5 TON 14 80
Fee summary Charged Paid Credited Due
Permit Fee Total 64 80 64 80 00 00
Plan Check Total 00 00 00 00
Grand Total 64 80 64 80 00 00
P
�A°�, �F ELECTRICAL INSPECTION �`��✓
N
WIRING REPORT
417-4735
DATE PERMIT q JINSPECTOR
C
Ow14CRICONTRACTOR
9E,L�
ADDRESS
2-60 "'-
APPROVED NOT APPROVED
❑ DITCH ❑
❑ ROUGH IN/COVER ❑
❑ SERVICE ❑
❑ FINAL ❑
CORRECTIONS NEEDED:
Ear;F---A KV--iz SrzJ20-5
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE --
OLYMPIC PRINTERS,INC.(360 452 1381
;4!16/2008} Robert Larson Gottschalks
From Terry Dahlquist
To Robert Larson
Date: 4/10/2008 3 18 PM
Subject: Gottschalks
Gottschalks main meter is#E822C. Location 151844
Peak demand was 124kW in November 2006.
Average usage is 35000-45000 kWH/Month
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(4/3/2009) Linda Pangrle Gottschalk's permit — _Page 1
From Ken Dubuc
To: Linda Pangrle
Date: 4/2/2009 3 23 PM
Subject: Gottschalk's permit
Linda
I took a call today from the Fire Alarm folks who did the Gottschalk's job.
They told me that you called them because the permit was never picked up I have offered to pick the permit up for them.
I will pick it up from you, sign it where appropriate and get the copies to where they need to go, including you and them.
This was a bit screwed up because of the timing of the job. We asked them to rush everything because of the number of
false alarms that were being generated by the old system.
So, next time I'm there,III take care of it. They did us a huge favor, so I want to save them from making a special trip
over to pick it up.
Thanks,
Ken
CITY OF PORT ANGELES
FIRE DEPARTMENT PERMIT
321 East 5`h Street, Port Angeles, WA 98362
Application Number 09 00000118 Date 2/04/09
Application pin number 227392
Property Address 200 W 1ST ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 3300-0000
Tenant nbr name GOTTSCHALKS
Application type description FIRE ALARM SYSTEM
Subdivision Name
Property Use
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 12931
Application desc
FIRE ALARM SYSTEM UPGRADE
Owner Contractor
K O ERICKSON TRUST STANLEY SECURITY
3005 W 18th St 6000 NATHAN LANE NORTH STE#300
PORT ANGELES WA 98363 MINNEAPOLIS MN 55442
(360) 452 4571 (877) 476 7968
Permit FIRE ALARM SYSTEM
Additional desc
Permit pin number 141309
Permit Fee 150 00 Plan Check Fee 00
Issue Date 2/04/09 Valuation 0
Expiration Date 8/03/09
Qty Unit Charge Per Extension
1 00 100 0000 ECH FIRE INSPECTION & TESTING 100 00
1 00 50 0000 ECH FIRE ALARM PLAN REVIEW 50 00
Special Notes and Comments
A full acceptance test will be required for the fire alarm
system
Fee summary Charged Paid Credited Due
Permit Fee Total 150 00 150 00 00 00 d4m,
Plan Check Total 00 00 00 00Grand Total 150 00 150 00 00 00
0?-
66
This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or
abandoned for a period of 180 days afer the work has commenced,or if required inspections have not been requested with
180 days from the last inspection I hereby certify that I have read and examined this application and know the same to be
true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled
with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel
the provisions of any state or local law regulating the work specified in the permit.
Q� 4 (c O ct
Signatu e of Contractor or Authorized Agent Date Signature of Owner(if Owner is builder) Date
FIRE PERMIT INSPECTION RECORD
Call 360-417-4655 for fire inspections. Please provide a minimum 24-hour notice It is unlawful to cover insulate
or conceal any work before inspected and accepted. Post permit in a conspicuous location.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
Inspection Type Date Passed Comments
FIRE SPRINKLER
Underground piping hydrostatically tested
Underground piping flushed
Interior piping hydrostatically tested
Interior piping inspection
Dry system air tested at 40 psi (24 hours)
Sprinkler final
FIRE ALARM
Rough-in inspection
Q
Alarm final
LP-GAS Completed by Contractor-
Underground piping inspection/pressure test Test#1 _
Above ground piping inspection/pressure test Piping pressure test psi
fiTank(container) inspection Time initiatedTest#2
Appliance inspection Piping pressure test psi
Time initiated
LP-gas final 11
UNDERGROUND STORAGE TANK(UST) ABANDONMENT
Removal of flammable/combustible liquids
Tank appropriately abandoned
UST abandonment final
PERMIT OTHER(specify)
permit final
t�
GENERAL COMMENTS
�c
2/15/00
2 �'cL rt i Wk S�a�e 5 . o E- ►S: ,K O R VI C�Sovi TUU s_� 3005 W 19A
S t:� �R�W� g8
?0Rrq,%, . BUILDING PERMIT APPLICATION Print in ink 3�
s
CITY OF PORT ANGELES For City Use Only
Attn: Building Permit Technician Date Received �,_ 3°-ol
321 E. Fifth St. Port Angeles,WA 98362 Permit# M--11 a
(360)417-4815 fax(360)417-4711 Date Approved
Applicant or Agent j NLS Phone op
Property Owner J�` Phone
Property Owner's Address 200 !16977
Contractor/Engineer Phone
�ontractor/Engineer's Address
17License# S'rAExpires 16P E-mail
PROJECT ADDRESS
Parcel Number Lot Zoning
Project Ty
pe&Brief Description: ❑Residentialommercial ❑Multi-family ❑Industrial
Check all that apply
❑New Construction
❑Addition 7p
❑Remodel
❑ Repair
❑ Re-roof P M A I a-,r f n
❑ Demolition
❑H ystem ❑ Heat pump ❑wood-burning stove ❑gas fireplace ❑ pellet stove ❑other
Other
Floor Areas Existing(sa.ft) Proposed(sa. ft.)
Teresa Otto �_ @$ per sq.ft._$
Security Consultant
Security Solutions
Stanisy Convergent Security Solutions,Inc. F
2700 Richards Rd,Suite 202
Bellevue,WA 98005
Phone 425.957.7000 Direct 425.957 7006
Lax25.746.0084 Cell 425.591.6886 _nleyworks.com■www.stanleycss.com
TOTAL VALUATION $
Total footprint of structures sq.ft. T Lot size sq.ft. = Lot coverage %
Max. height of proposed structures ft. Occupancy group #of bedrooms
Will a lawn sprinkler system be installed? Occupant load #of full baths
Will a fire sprinkler system be installed? Construction type #of half baths
I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and
understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on
projects.
Date l Print Nam rC' QX Signa
8*,,44&I 7,. 18
. ����,5�-'�,d�-ice
1l 6
�/, � X0
ELECTRICAL PERMIT AAD INSPECTION RECORD
CITE'OF P®RT ANGELES
360-417-4735
Application Number 08 00001538 Date 12/19/08
Application pin number 807500
Property Address 200 W 1ST ST
ASSESSOR PARCEL NUMBER 06 30 00 0 0 3300 0000
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning CENTRAL BUSINESS DISTRICT
Application valuation 0
Application desc
Fire alarm panel and devices
Owner Contractor
K 0 ERICKSON TRUST MVMCGHEE
234 WHIDBY AVE 35905 3RD AVE SW
PORT ANGELES WA 983626542 FEDERAL WAY WA 98023
(206) 571 2969
Permit ELECTRICAL ALTER COMMERCIAL
Additional desc
Permit pin number 139170
Permit Fee 194 00 Plan Check Fee 00 A
Issue Date 12/19/08 Valuation 0 IJ\Vl
Expiration Date 6/17/09 O
Qty Unit Charge Per Extension O
1 00 40 0000 EL LOW VOLT SYS <=2500 SQFT 40 00
14 00 11 0000 EL LOW VOLT SYS >2500 SQFT 154 00
Fee summary Charged Paid Credited Due
Permit Fee Total 194 00 194 00 00 00
Plan Check Total 00 00 00 00
Grand Total 194 00 194 00 00 00
V
INSPECTION ELECTRICAL
TYPE DATE. RESULTS INSPECTOR.
DITCH
SERVICE
ROUGH - IN
Lo
FINAL
Lb
OMMENTS:
0��°°RT4,g ELECTRICAL INSPECTION
11
WIRING REPORT
KS
�,s�"� 417-4735
Rb
DATE PERMIT N INSPECTOR
148 1
OWN CONTRACTOR
ADDRESS
APPROVED NOT APPROVED
❑ DITCH ❑
❑ ROUGH IN/COVER Ak
❑ SERVICE ❑
❑ FINAL ❑
CORRECTIONS NEEDED-
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
OLYMPIC PRINTERS,INC.(360)452-1381
�Porsr,N.��r RECEIVED s
m� ELECTRICAL WORK PERMIT APPLICATION
DEC 16 2008
Installation description
Job wired by Electrical Contractor ❑Owner LIGHT ID ommercial ❑ Residential
Electricaj contractor name _ License number Date Expires
mi 1 ,*,' q U LJ New ❑Altered/Addition
Purchaser's arlin address V
3570 S� -3e-LO A-V'0- 56,-) �� AZ�-�-� GO
City State ZIP
PLA -E
TelIhone number FAX number
ULQ �� � _. .0 9 �� CSS
Premises owner's name �P
G U -r T S y'I ILS 73 NC°W Ct'LN IS (3 ES W
Address of inspection
9,0 O AePLAec OLD &,j 12r wSl"
city
Phone umber to schedule inspection
Ca 17 1 2-
Owner as defined by RCW 19 28 261 (1) Owner will occupy the structure for two
vears 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. ❑ Cash ❑ Check#
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 instal- Credit Card Visa Masterca Discover
lation 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
$Sp� 'on fee
__j
Electrical Load ti Service Information
❑ NO LOAD CHANGES
❑ Baseboard _KW Voltage
❑ Furnace —KW ❑ Overhead Service Phase❑ 1 ❑ 3
❑ Heat Pump _Ton LAR ❑ Temp Service Service Size:
❑ Fan-Wall i KW ❑ Underground Service Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7.00 AM 360-417-4735
THERMOSTAT SERVICE
da
Date Approved By Date Approved By
DITCH Date App, ed By Date Appr ed By
Inspection Area,Buildingor Equipment Ins ected Action Taken Electrical
Date
Inspector
BUILDINtrS PERMIT ARRLI CATION' isrint in ink
' CITY OF PORT ANGELES For City Use Only:
Attn: Building Permit Technician Date Received t}-S_-e-7
321 E. Fifth St., Port Angeles, WA 98362 Permit# a i 2
(360) 417-4815 fax
,(360) 4'�117-4711 Date Approved
Applicant or Agent ��/, . c' , r1 C?cl LLL ', L n Pho e a66 - Coy 11U)_
Owner (7Phone
Owner's Address
Contractor/Engineer „-� _ Phone
Contractor/Engineer's Address4_ ,� � CWLFe '�,�:.y,\ gvi88
License # 5C *_0 C3(, ExpiresA/-,6/
PROJECT ADDRESS
Parcel Number Lot Zoning
Project Type& Brief Description: ❑ Residential ❑ Commercial ❑ Multi-family ❑ Industrial
Check all that apply
❑ New Construction
❑Addition Y
o Remodel s ",
❑ Repairo)O\<�_- \G
❑ Re-roof Lc
❑ Demolition
❑ Sign ❑wall-mounted YlprojectAg ❑freestanding ❑ awning ❑ other
Total sign area sq. ft. Maximum allowed sign area sq. ft.
VHeat System g Heat pump ❑wood-burning stove ❑ gas fireplace o pellet stove ❑ other
❑ Other
Floor Areas Existing(sq. ft.) Proposed(sg. ft.)
Basement @ $ per sq. ft. _ $
1"Floor
2n Floor
3`tl Floor
Garage
Carport
Covered Porch
Deck
Shed
Other
TOTAL VALUATION $
Total footprint of structures sq. ft. T Lot size sq. ft. = Lot coverage %
Max. height of proposed structures ft. Occupancy group #of bedrooms
Will a lawn sprinkler system be installed? Occupant load #of full baths
Will a fire sprinkler system be installed? Construction type #of half baths
/have read and completed this application and know it to be true and correct. /am authorized io apply for this permit and
understand that it is my responsibility to determine what permits are required, and to (obbtaaiin permits prior to working on
projects. ��\� �+ ��v111r�C7 Si '��L]�- \4 _`
Date�6l� Print Name � Signature
Web Version 10-01-07
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�.....................
EXISTING CYCLONE FENCE
SHIPPING RECEI ,vNG
/
AREA
}
)
\ } � } UPPER LEVEL FLOOR .
........................................... ..— ------------
PIPING FROM (
UPPER LEVEL TO MECHANICAL ROOM - Equipment
_
CEILING 2L
\ . ( EXISTING &R
/ HANDLER
i
WITH HOT
\ . )
WATER COIL
\ HOT WATER m.
\ , • ;
LOWERLEVEL s OR E .
!
------ \NEWCOOLING . !
\ -
) . .
SIDE VIEW OF PROPOSED PIPING RUN .
^F, CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
ji
321 EAST 57H STREET, PORT ANGELUS, WA 98362
Application Number . . . . . 07-00001427 Date 12/11/07
Application pin number 645804
Property Address . . . . . . 200 W IST ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000-
Tenant nbr, name . . . . . . GOTTSCHALKS
Application type description COMM MECHANICAL PERMIT
Subdivision Name . . . .
Property Use . . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 50000
Owner Contractor
------------------------ -__---------------------
K O ERICKSON TRUST SEA AIRE INC
3005 W. 18TH ST. 340 UPLAND DR
PORT ANGELES WA 98363 TUKWILA WA 98188
(206) 604-1582
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . . REPLACE a ADD NEW HVAC
Permit pin number 117317
Permit Fee . . . . 64.80 Plan Check Fee .00
Issue Date 12/11/07 Valuation . . . . 50000
Expiration Date 6/08/08
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 14.8000 ECH ME- INSTALL 100- FAN 14.80
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 64.80 64.80 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 64.80 64.80 .00 .00
�j
Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned
for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the
last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions
of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Fanns/Building DivisimdBuilding Permit(10/01/07).wpd
BUILDING PERMIT INSPECTION RECORD
G
CALL 417-4815 FOR BUILDING INSPF,CFIONS. CALL 417-4735 FOR F,LEC"I'RICAL INSPECTIONS. 1
CALL. 417-4807 FOR PUBLIC WORKS UTILITIES 'tel
PLEASE PROVIDEA MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECFIO.N TYPE DA FE ACCEPTED COMMENTS
ves No .�
FOUNDATION:
FOOTINGS
SHEAR WALLS/WALLS
FOUNDATION DRAINAGE/DOWNSPOUTS
PIERS
POST HOLES(POLE BLDGS.)
PLUMBING
UNDERFLOOR/SLAB
ROUGH-IN
WA FER LINE(METER'FO BLDG)
GAS LINE. FINAL DATE ACCEPTED BY:
BACK FLOW/WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS/ GIRDERS
SHEAR WALLMOLD DOWNS
WALLS/ROOF/CEILING
DRYWALL(INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB 1
WALL/FLOOR/CEILING
MECHANICAL
HEATPUMP/FURNACE/DUCTS
GAS LINE
WOOD STOVE/PELLET/CHIMNEY FINAL DATE ACCEP'I'EDBY:
COMMERCIAL HOOD/ DUCTS
MANUFACTURED HONIES
FOOTING/SLAB
BLOCKING&HOLD DOWNS
SKIRTING
PLANNINGDEPT. SEPARATEPERMI'L'A's SEPA:
PARKING/LIGHTING ESA:
LANDSC\P ING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR'FO OCCUPANCYNSE
RF,SIDENTLAL DATE YES NO COMNIERCIAL DATE ACCEPTED
YES NO
ELECTRICAL-LIGHT DEPT. 417-4735 ELECTRICAL.
LIGHT DEPT mac"
CONSTRUCTION R.W./PW/ CONSTRUCTION R.W. /
ENGINEERING 417-4807 PW/ENGINEERINGG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING 5•'.
T.Fo,ms/Budd,,,,Divislon/13ui1di,,g Permit(10/0I/07).wpd
L
PREPARED 5/21/06, 8:49:00 INSPECTION TICKET PAGE 9
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/21/08
------------------------------------------------------------------------------------------------
ADDRESS . : 200 W 1ST ST SUBDIV:
TENANT, NBR: GOTTSCHALKS
CONTRACTOR : SEA AIRE INC PHONE (206) 604-1582
OWNER K 0 ERICKSON TRUST PHONE
PARCEL 06-30-00-0-0-3300-0000-
APPL NUMBER: 07-00001427 COMM MECHANICAL PERMIT
------------------------------------------------------------------------------------------------
PERMIT: ME 00 MECHANICAL P® IT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
________________________________________________________________________________________________
ME99 01 5/21/08
/ JLL MECHANICAL FINAL TIME: 03:30
May 21, 2008 8:40:03 AM 1pangrle.
20
GREG 206-604-1988
MECHANICAL FINAL
LATE AFTERNOON
_________________________---- ----------
__ ________ COM S AND NOTES
rA /_ ______________________________________
i s�2
Application Number . . . 08-00000373 Date 3/31/08
Application pin number . . . 515130
Property Address . . . . 200 W IST ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000-
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
--------- ---—---------------------—
A lication desc
HVAC circuits
----------------------------------------------------------------------------
Owner Contractor
_ ------------------------
K 0 ERICKSON TRUST ANGELES ELECTRIC
234 WHIDBY AVE 524 E. 1ST ST.
PORT ANGELES WA 983626542 PORT ANGELES WA 98362
(360) 452-9264
-------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . . ANG. EL./ HVAC EQUIP
Permit pin number . 123588
Permit Fee . . . . 116.00 Plan Check Fee .00
Issue Date . . . . 3/31/08 Valuation . . . . 0
Expiration Date . . 9/27/08 n '�
Qty Unit Charge Per Extension (�7
2.00 58.0000 ECH EL-COMM ALT <5 CIRCUITS 116.00
Fee summary Charged Paid Credited Due (v�
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 116.00 116.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 116.00 116.00 .00 .00 ("
NI
SPECTION ELECTRICAL
TYPE DATE: RESULTS : INSPECTOR:
DITCH
SERVICE
ROUGH - IN
z 7
FINAL
S 2D
COMMENTS :
Application Number . . . . 07-00001376 Date 11/26/07
Application pin number . . . 000480
Property Address . . . . . . 200 W IST ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000-
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
Owner Contractor
________________________ ________________________
K 0 ERICKSON TRUST HSM ELECTRIC
234 WHIDBY AVE 2700 RICHARDS RD 4202
PORT ANGELES WA 983626542 BELLEVUE
BELLVUE WA 98005
(425) 957-7008
____________________________________________________________________
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit pin number 116202
Permit Fee 40.00 Plan Check Fee .00
Issue Date . . . . 11/26/07 Valuation . . . . 0
Expiration Date . . 5/24/06
Qty Unit Charge Per Extension
1.00 40.0000 EL-LOW VOLT SYS <=2500 SOFT 40.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
Permit Fee Total 40.00 40.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 40.00 40.00 .00 .00
n�-
u
SPECTION ELECTRICAL
TYPE DATE: RTS:
ESULINSPECTOR:
DITCH
SERVICE
ouGx - IN
FINAL
COMMENTS :
O-
CERTIFICATE OF. OCCUPANCY o
City"off I'ort`Angeles
Buildinga)ivjm,0,i ,
This Certification issued pursuant to the requirements of Section 109 of the
Uniform Building Codecertifying that at the time of issuance this structure was
in compliance with the various ordinances of the City regulating Building
e construction or use. For the following:
Use Clnsai(icution D2UdrtrtleRt Store
s
Bmldmg Permit No
Group T"] '- fype ofcoustruction
Use Zone CBD
OHnerofgiuinesJResidence Gottsghalks Inc. Address 7 R1V2r Park es Ir'c35t F 'eSRO CA 93')22
Building Add nss 200 West - t Stree -Port Angeles WA 98362
Jan, 11, 2001
Post on thel1��s;��r a ar�seuous place.
Shall not be rer�ot��re�$e���: �,gy�'�ui9sisng pgfcial.
O�
-`� -
e 6-27-00; t :55PVI:CiL cf PA FRN'T CNT? 1 O 417 4711 # 1/ 1
ROUTING SLIP
Certificate of Occupancy
$47.00 Certificate/Inspection Fee
DATE '7" 7 100 New Business . . . . ( )
Address of Proposed Business Transfer of Business Location. . . . . . . . . . . . . . . . ( )
Z o D GUe_j'G 1 �C _ Change of Ownership . . . . . . . . . . . . . . . . . . . . . . ( )
Applicant _ 4!45-r,1..A I L,; New Building . . . . . . . .
Address RNer-C pluf' ALA
c& NQS Remodel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
gge_fND /74 �z2 . Temporary. Business . . . . . . . . . . . . . . . . . . . . . . . ( )
Phone: business V7 44ot- 1907 home frf -V40744 L Change of Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
Brief description of proposed business:
Legal Description: Lot Block Subdivision
Current Use of Property: _Ae� )L
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)....... . . . .. . . JL 2) Plumbing 2) Peddlers
Plumbing changes . ... . . ..... . ............ .... . 3) Electrical 3) 2nd Hand Dealer
New or relocated signs. . . ..... ..... ... ..... ... .. ✓ 4) Mechanical 4) Pawn Broker
New septic tanks.. . ............... .... .... . .... __ ✓ 5) Sewer 5) Dance
New sewer service ..... . .......... ... . ..... ... . ✓ 6) Sidewalk Installation 6) Hotel-Motel
Admission charged to patrons.. . .... .... ........ . Ll _ 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-ot-way... .... ........ . . . . . _ 10) Water meter installation 10) Other
Is there sufficient off-street parking? .. . ... .... . . .. . ✓ ie3 11) Fire
New driveway openings .. ...... .... . ... .... . . ... G 12) Occupancy
A grading plan for site drainage.. . ... . ........ .... ✓ 03))Sigh
(parking lots, downspouts, etc.) . ..... ... . ... . .... Z 14) Shoreline
Are the existing streets paved? . . . ..... .. . .. . . .... 15) Home occupation
Are there existing sidewalks?....... . . ... . ..... ... 16) Conditional use
Is there curb and gutter? . .......... . ... . ....... . "� 17) Other
Other....... . ..... ..... ........ .. . ... .........
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the Date:
information I have supplied is correct to the best of my
knowledge. Signed: r>L�_
AP V REJECTED Comments / Conditions
Building Section
Public Works Department
Planning Department _
Fire Department
_ City Clerk
P.B.I.A.
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DIVISION
321 EAST STH STREET, PORT ANGELES,WA 98362
gn�
BUILDING PERMIT ISSUED: 7/29/2002 PERMIT NO: 13596
OWNER/APPLICANT PROPERTY LOCATION
GOTTSCHALKS 200 1ST ST W
200 W 1ST STREET Lot: 14
PORT ANGELES, WA 98362 Block: 33 Long Legal
206/374-0833 Subdivision: TPA
T: S: Parcel No: 063000003300000
CONTRACTOR ARCHITECT
SANDPIPER CONSTRUCTION N/A
303 JOHN JACOBS RD
Port Angeles, WA 98362 98360-0000
360/452-7542 360/000-0000
PROJECTINFO
Project Value: $17,000.00 SFD Units: 0 Commercial: 0
Project Type: RE-ROOF SFD SQ FT: 0 Industrial: 0
Occupancy Type: Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use: CBD
PROJECT NOTES
TEAR OFF, TORCH DOWN, SOUTH SIDE 2000 SQ. FT.
r
RECEIPT#9482
FEES ASSESSMENT
Building Permit: $279.25 Misc Fee 1: $0.00
Plan Check: $0.00 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $283.75
Plumbing: $0.00 AMOUNT PAID: $283.75
Mechanical: $0.00 BALANCE DUE: $0.00
Radon: $0.00
Separate Permits are required for electrical work,SE PA,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 permit does not
presume to give authority to violate or a provisions of any state or local law regulating construction or the performance of
construction.
12�r-G
Si ure o ntractor or Authorized A t Date Signature of Owner(if owner is builder) Date
TdP[,ANNING\FORMS\1102.15[4/20021
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATEPERMIT:#
ROUGH-IN
PLUMBING
UNDERFLOOR/SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW/WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS/ GIRDERS
SHEAR WALL
WALLS/ROOF/CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL/FLOOR/CEILING
MECHANICAL
HEATPUMP
WOOD STOVE/PELLET/CHIMNEY
HOOD/ DUCTS
PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT#'s
WATERLINE/METER
SEWERCONNECTION
SANITARY
STORM
PLANNINGDEPT. SEPARATE PERMIT#'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
ELECTRICAL-LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W./PW/ CONSTRUCTION-R.W.
ENGINEERING 417-4807 PW/ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 7` PLANNING DEPT.
BUILDING 417-48IS BUILDING
T:\PLANNING\FORMS\1102.15[4/20021
R CITY OF PORT ANGELES
FEE RECEIPT NUMBER DEPARTMENT OF LIGHT A �TQ
PERMIT NUMBER
APPLICATION AND.ELECTRICAL PERMIT
rron1EVx
TOTAL FEE - QT0 C.
CONT.UC.NO.(, TIMETOCOMPLETE NO.STORIES LEGALOCCUPANCY
n ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address /•-llo �,��� ��
A CORRECT ADDRESS IS ESPONSIBILITY OF APPLICANT PERMITS WITH WRO ADDRESSES ARE CANCELLED
v2
Owner ,v SRye p(7p Installation By
Owner's Address - - - Installers Address 2 �~ r _ 7'•
Day Phone -�L, — ile,qq - Installers Phone r� - :2-.
Application is hereby made for Permit to install Electrical Equipment as follows_j?DL .0.1 Al2. A 1.PA2 ii�,A
- - -
Wiring Method
NUMBER AMP D - 120V 240V - NUMBER AMP 120V 240V
USE OF CIRCUIT PER 1 0OR FEE - USE OF CIRCUIT PER 1 0 0R FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT SIGN
LIGHT 50 VOLTS I -
OR LESS
CONVENIENCE MOTOR
CONVENIENCE - - MOTOR
APPLIANCE MOTOR
DISHWASHER FIREALARMS
DISPOSAL BURGLARALARM
RANGE MISC.
®' OVEN
WATER HEATER '
LAUNDRY
DRYER REINSTALLATION LIGHT FIXTURE M
FURNACE SUB TOTAL FEE r
GAS-OIL
FURNACE ENERGY FEE I
ELECTRIC -
BASIC FEE I i
ELECTRIC HEAT _
TOTALFEE ,
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 SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I certify that the work to be performed under this permit will be done by the instal r and In confy ante with the N.E.C. Electrical Code.
/0Date Application made � — '19
g�
By
�/�
CONTRACTO R OWNER(OR AUTHORIZED AGENT)
Permission is hereby given to do the above described work,according to the conditions hereon and according to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles.
DIRECTOR OFF CITY LIGHT
Date Permit Issued By &b
PLANS APPROVED
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.
WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK — SEE OVER —
WHITE-Original . CANARY-Duplicate PINK-Triplicate WHITE CARD Inspector's Report
01 YMPIC PRINTFRR INC
REPORT OF INSPECTOR
DATEOFVISIT MADEBY REMARKS
- `� - Q J7 s7VAr Co.,'ZP /VoT
'Oa fe/l T
A19 LT 4VA-5 131J/v0
S GN2O 7
z
Q
a
x
r
z_
W
r
O
z
O
O
O.K.FOR COVERING
O.K.TO CONNECT SERVICE
FINAL O.K. <
CITY or POAT ANGELES
LIGHT DBPAan= ELECTRICAL PERMIT N? 17 419
Port Angeles, Washington_.... ...
.. ------•--•---------•-•-•-------•- 19 Y
In accordance with the City Ordinance 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 do electrical work as listed /below. /.�,�� ,
Address / Y ' �� -W [CJOccupancy r" '""�,,---------------------
Owner Tenant - -
WiringContractor- --- ----- -�---------- By---------------------------------------------------------------------
(If �'�O`.�..... .. Type of Wiring:
Light Outlets..............................._._...... Service, volts .....L...,._.......--
Receptacle Outlets..--...-._.............. No. wires ..._7...-..._....... Armored Cable ..-...............-.--....._-
Dryer. KW.......................................... Size wires..................._.
Non-Metallic .................................
............._.. Knob & Tube.................................
Range, KW--------------------------- -------------- Main fuse ....................................... Rigid Conduit ---'---...---...._...--_
Water Heater: Enclosure ....................................... Metallic Tubing ...........................
KW_--------------------------------------------- Type of wiring: Raceway ....----........-....------....__
Heal: KW................................................... Entrance Cable............................. Circuits, Light................................._...
Motors: size, volts and phase: Rigid Conduit ............................... Utility
MetallicTubing ........................... Heat ......_-...................-....---...._...---
...........................................................
Current transformers: Range .............................................
--------------------......................................
No. & Size....................................... Water Heater ..............................
...........................................................
Ser.No...................-......................... Motor .............................................
...........................................................
Ser. No..............................................
.........................................................-
Furnace.............................................
Total Load............................. __.._-.Ser.No................... Total
......-_-__.___-___-_.__-.._____
Remarks _!�'��s- "'p ---ca.-_ +'1 -•--.=r•`.-�-------'14----_----------------��.a✓--d^
---•--;;;-----dff'- :'-QCs'.,?—' -'Brt--Ae--------------- -------------------------------------...---•------------------------•----•--------------------......_-
�� --
Permit Fee Treas. Receipt
$-------------------------------------- No---------------------------- By - -----t- ----- ----- •--•----------------
NOTICE
J 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° 17419
Address ........................................................................................................................................ Date.........................................-__.........
Owner ..................................._......_-........_......_.._.............._........................................... Tenant..................................................................
WiringContractor..........................................._.............._.................................--------................... By-....................................-........................
NOTICE—Current must not be turned on until Certificate of Inspection has been issued. If work is to be con-
eealed'due-notice must be given the Inspector so that work may be inspected before concealment.
1M Olympic Printers, Inc.
it �
0"ORT" ELECTRICAL INSPECTION
WIRING REPORT
417-4735
ORHS 6
DATE PERMITK INSPECTOR
Oz C6 -03 7
OWNEERICON RACTOR
A SL.
ADDRESS
200
APPROVED NOT APPROVED
❑ . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . ❑
❑. . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . ❑
CORRECTIONS NEEDED:
15r-- AL- �i-i (IH7
�`IL6hIT�-I Sga�9fki}IT Co>`f -
VS00121E; UNI U5f—E12 41E eTo)LrS7
r-A Kr-1Z
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
OLYMPIC PRINTERS,INC.(360)452-1381
ELECTRICAL W ORK PER.NIIT APPLICATION
Instal n description
Job wired by aflectrical Contractor ❑Owner Commercial O Resfdestiel
Electrical contractor name License number Date Expires
Ll New AI(3 tered/Additioo
Purchaser's mailing address ANGELES ELECTRIC, INC.
524 EAST FIRST M /. �
city 62
Telephone number FAX number
z 9z
-
'Premises owner's name
Address of inspection � ryry n,� *10
City
Phone numberto schedule Io cotton: �� /L
Owner as defined by RCW 19.18.161:(1) Owner will occupy the struclurejor two
years after this electrical permit is finalized. (1)Owner is required to hire an electrical
contractor if above said property is for sale, rent or lease. ❑ Cash ❑Check#
After reading the above statement, I hereby certify that.1 am the owner of the above
named property or a licensed electrical contractor. I am making the electrical instal- ❑Credit Card Visa Mastercard Discover
Iation 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 Card N - - -
----------------
Utility Specifications.
Signature of 9pner, electrical contrecto or electrical admini trato Expiration Date
InspectiO�fce
X Date: of card
El :al Load and-oru 'ons Service Information
❑ NO LOAD CHANGES ��,.p-
❑ Baseboard _KW / PhaseVoltag
3
❑ Furnace KW erhead Service PAese❑ 1 3
❑ Heat Pump WTon LAR ❑ Temp Service Service Size:
❑ Fan-Wall KW ❑ Underground.Service Feeder Size: _
SAME DAY INSPECTION,.CALL BEFORE 7:00 AM 360-417-4735
^La ROUGH.-IN
��,v THERMOSTAT SERVICE
Daic F AppmvW By nau AppoviA By Dne Appmvcd By
FINAL DITCH FEMER
5'naie4 App Dam Appmvcd By Dew Appmvcd By
Inspection Area,Buildingor Equipment Ins ected Electrical
Date Action Taken
Inspector
-2 - l
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(4/16/2008) Robert Larson Gottschalks _ Page 1 '
From: Terry Dahlquist
To: Robert Larson
Date: 4/10/2008 3:18 PM
Subject: Gottschalks
Gottschalks main meter is #E822C. Location 151844
Peak demand was 124kW in November, 2006.
Average usage is 35000-45000 kWH/Month
// $FLIEVfS T)hs wl" A)er 5� A r>�ZMAP
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FROM (TUE)NPR 6 2006 13:07/ST. 13:O7/N-.7S24372O60 P l
3c'o L l
Phone: (206) 575-8051 Incorporated Fax: (206) 575-0653
Trent Peppard
This is in regards to the new electrical circuits that were installed at Gottschalk Port
Angeles for the new equipment installed.
The Large unit right outside the receiving/shipping area is a 20 Ton A/C unit 208/230
Volt 3 phase attached identified, as#I for the electrical requirements.
The Rooftop Outdoor Unit is a 4 Ton Heat Pump 208/230 Volt 3 phase, identified as#2
on the electrical requirements and the matching Air Handler unit mounted in the
shipping/receiving is identified as#2A on the electrical requirements.
I hope this is the information needed feel free to call with any questions(206) 575-8051
SEA-A1RE,INC.
By: Bke t: -
Bill Kukahiko
Title: Service/General Manager
Date: March 27,2008
340 Upland Drive
HVAC SPECIALISTS Tukwila,Wa 98188
FROM ,a1 (TUE)APR 0 2008 13:08/ST. 13:07/No. 7524372080 P 3
rAWAff
General
Data
ni .� k�o✓ uV�. c�1rV
Product Specifications 1L
Modell No.O 2TWA3042A3 2TWA3042A4 2TWA3018A3 2TWA300BA4
Electrical Data V/P1vHz OO 200230/3/60 48013160 20000" 46pfir60
Min Cir Ampadly 13 7 16 9
Max Fuse Size(Amps) 20 15 25 15
Compressor CLIMATUFFe CUMATUFFe CUMATUFFe CUMATUFFe
RL Amps-LR Amps 9.5-86.6 5.1.43.1 11.7-100.1 6.4.49.8
Outdoor Fan FLAmps 1.3 0.7 1.3 0.7
Fan HP 116 116 1/5 15
Fan Dia(itches) Z7.6 27.6 27.6 27.6
Coll Spine FinTM Spine Rn91 Spine FinT" Spine Finn'
Refrigerant R-22 9/09-L8/OZ 9/09•LWOZ 9/094WOZ 9/09-LB/OZ
Line Size-(in)O.D.Gas O 7/8 78 1.1/8 1-1/8
Line Size-(in)O.D.Liquid OO 3/8 3/8 3/8 3'8
Dimensions H x W x D(Crated) 46A x 35.1 x 38.7 46.4 x 35.1 x 38.7 46A x 35.1 x 38.7 46.4 x 35.1 x 38.7
Weight-Shipping 304 305 309 310
Weight-Nei 269 265 274 275
Start Components NO NO NO NO
Sound Erldowre NO NO NO NO
Compressor Sump Heat YES YES YES YES
Oplional accessories:o
An6-JMCycle Tinter TAYASCT501A TAYASCT501A TAYASCT501A TAYASCT501A
Evaporator Defrost Control A/C AY28X084 AY28XO84 AY28XD84 AY28X084
Electronic Head Pressure Control ELAYLOAM103 BAYL.OAM103 RAYLOAM103 BAYLOAM103
Rubber Isolator Kit RAYISLT101 BAYISL7101 BAYISLT101 BAYISLT101
Snow Leg-Base 6 Cap 4'High BAYLEGS002 BAYLEGS002 BAYLEGS002 BAYLEGS002
Snow Log-4'Exlerxsion BAYLEGS003 BAYLEGS003 BAYLEGS003 BAYLEGS003
Extreme Condition Mounting Kit BAYECMT001 BAYECMT001 BAYECMTool BAYECMT001
Seacoast Kt BAYSEACW1 SAYSEAC001 BAYSEAC001 BAYSFAC001
Refrigerant Unew(D TAYREFLN3' TAYREFLN3' TAYREFLN4' TAYREFLN4'
Accessory Description and Usage ARI Standard Capacity Rating Conditions
Anti-Short Cycle Tlmer—Solid state timing device that ARI STANDARD 21W240 RATING CONDITIONS—
prevems compressor recycling until 5 minutes have elapsed (A) Coding 80"F DB,67"F WB air entering indoor coil,
after satisfying call or power interruptions. Use in area with 95°F DB air entering outdoor coil.
questionable power delivery,commercial applications,long (B) High Temperature Heating 47-F DB,43°F WB air entering
lineset,etc. outdoor coif,70°F DB air entering indoor coil.
Evaporator Defrost Control—SPST Temperature actuated (C) Low Temperature Heating 17'F DB, 15°F WB air entering
switch that cycles the condenser off as indoor coil reaches outdoor coil,70°F DB air entering indoor coil.
freeze-up conditions. Used for low ambient cooling to 30"F (D) Rated indoor airflow for heating is the same as for cooling.
with TXV. ARI STANDARD 270 RATING CONDITIONS—(Noise rating
Rubber Isolators—5 targe rubber donuts to isolate con- numbers are determined with the unit in cooling operation.)
densing unit from transmitting energy into mounting frame or Standard Noise Rating number is at 95°F outdoor air.
pad. Use on any application where sound transmission
needs to be minimized.
Hard Start kit—Start capacitor and relay to assist compressor
motor startup. Use in areas with marginal power supply,an long ��, ��
tinesets,low ambient conditions,etc.
Exinerrre Condition Mount Kit—Bracket kits to securely mount
condensing unit to a frame or pad without removing any panels. SNJr sretEY
Use in areas with high winds,or on commercial roof tops,etc.
22-2]7501-1205(EM 5
PROM (TUE)APR B 2008 13:OB/ST. 13:O7/Mo.-162<3'12O69 P A
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FROM (TUE)MPR 8 2008 13:08/ST. 13:07/Mo.752<372000 P 2
1 y • i
c.
Electrical Data Lc�lr�
oui�.i•I�� S��Pp`^7I
Table 81. Unit Wiring-Condensing Units 1
Maximum Fuse
Unit Operating Minimum Circuit or NACR Cireuit
Tons Unit Model Number Voltage Range AmpadtV Breaker Size(l) 1
TTA090A3 187-253 34.5 50
7% TTAD90A4 414-506 18.1 25 J
TTA090AK 342-418 21 3D
TrA090AW 518-632 14.5 20
TTA120A3 187-253 48.1 70
TFA120A4 414-506 23.3 35
TTA120AK 342-418 26 40
TTA120AW 518-632 18.8 25
TTA120B3 187-253 47.9 60
10 TTA120B4 414-506 23.9 30
TTA090BK 342-418 32 40
TTA120BW 518-632 19.1 25
TTA120C3 187-253 49.4 60
T'rA120C4 414-506 25.2 30
TVA120CW 518-632 19.8 25
TTA15063 187-253 55.5 70
1214 TTA15084 414-506 28.1 35
TTA150BK 342-418 33.3 40
T'rAl50BW 518.632 21.6 25
TTA18053 187-253 62.7 80
TTA38054 414-506 32.9 45
TTA180BK 342-418 38.2 50
TTA180BW 518.632 26.3 35
l5TTA180C3 187-253 62.7 80
TTAISOC4 414-506 32.9 45
TTA180CW 518-632 26.3 35
TTA24053 187-253 87.8 100 1&-
TTA24084 414-506 42.5 50
TTA240B( 342-418 47.5 6D
20 TTA240BW 518-632 34.2 45
rrA240F3 107-253 89.4 110
rrA240F4 414-506 46.6 60
TTA240FW 518-632 36.0 50
Nam: Electrical charaaerlstics reflect nameplate values and are calculated in aawdance
vdth UL and ARI specifications.Tri and 10 ton values are system rated; 12%, 15 and 20 ton
values am condensing unit Only rated.
10 MACR type circuit breaker per NEC.
SS-PRC002-EN 47
/ twwrvo' ELECTRICALWORKPERNUTAPPLICATION'
Inst Ilation dcscriptiun
Job wired by El Electrical Contractor ElOrCommercial ❑ Residential
Eleclrjcyl contra c)or n9n c / License nu�ber HS Date Expires '"�
S y Seeu 2� �_a3_ ❑ new ❑ Altered/Addition
Purchaser's mailin address
'?"700 (Zr��a�ns ep/r�tE �itp6RAU�
rty State ZIP eo ld S—
F,
V ,? >- A /AP
Tele hone number
FAX number
Premises owner's name
�� NSCFia_IS
Address of inspection
oqccl w . 1 �-' s1 r
pit' s M�
Phone number to schedule inspection:
Owner as defined by.RCW.19.28.261:(1) Owner will occupy the strucnu'e for nvo
years after this electrical pernnit is finalized. (2) Owner is required to hire an electrical
contractor if above.said property is for sale, rent or lease. ❑ Cash ❑ Check#
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 instal- ❑ Credit Card Visa astcreard Discover
lation 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 Card#
Utility Specifications. +++------
Signature of mrnen, electrical contractor or electrical administrator EXP' Ion Date �0—
Inspectio fee
X Date: card $ �Q , O p
Electrical Load Additions and or subtractions Service Information
❑ NO LOAD CHANGES
❑ Baseboard _KW Voltage
❑ Furnace _KW ❑ Overhead Service Phase❑ 1 ❑ 3
❑ Heat Pump _Ton LAR ❑ Temp Service Service Size:
❑ Fan-Wall _KW ❑ Underground Service Feeder Size:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735
ROUGH-IN THERMOSTAT SERVICE
Woe Approved By Dam Approved Hy Uale Approved By
FINAL DITCH FEEDER
Dine Approved By Ume Approved By Dam Approved By
Inspection Area;Buildin or Equipment Ins ected Action Taken Electrical
Date
Inspector
Nov. 26. 2007 8: 57AM HSM Electronic Protection Svcs No. 0595 P. i
JL
3Ce-
r.
a ELECTRICALWORICPERMITAPPLICATION
le Ins Ilation dneription
Job wired by O'ieetrical Contractor 0 Owner ?Commercial 0 Residential
Electrical eontricror name License monist 4 Date Expires Clew 0 AlteredlAdditlon
gl< 6 i{S11i rC 1y "f
Purchaser's ma, ng aadross 6/ `�-'$
Cil�j i State ZIY �
iJS�.� � Lir Ctn —
le
Premises owner's name 1 (;
Address of inspection •?
9
Ci'
Pbone Dumber o c dole ins a n: r
Owner as defined by RCW.19.28.261:(]) Owner will occup)-the stricture for two
years niter this electrical permil is finalised.(1)Owntr Is required to hire on electrical
contractor if above said property it for sale, rent or lease. O Cash O Check#
After reading the above statement 1 hereby certify that I am the owner of the above
named property or a licensed electrical contractor. I am making the electrical instal- I'Credit Card Visa Mastercard,.: Discover .
lation or•ltaration in compliance with the electrical laws. N.E.C., RCW Chapter
Utility Specifications.
Signature of pwaer, electrical foolractor or dectrlcal admioistratpr
$ ►+ (� QQ
Flectrical Lclad Additions and or subtractions Service Infocamilicln
0 NO LOAD CHANGES
0 Baseboard _KW Voltage
0 Furnace —KW 0 Overhead Service Phaee 0 10 3
0 Heat Pump _Ton_LAR 0 Temp Service Service Size:
0 Fan-Wall KW 0 Underground Service Feeder Site:
SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-4174735
ROUGII-IN THERMOSTAT SERVICE
tea- Aoiwm By Duo A,,n..d By Daft Append Br
e1� FINAL aanyA^L Dn)M F.®ER
nw.-W Br — .� Ape er Deis apwo,aa Br
InspectionElectrical
Dale Arra,Building or Equipment[ttsptx[tdd Action Taken Inspector
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A business licensed by L81 to contract electrical work within the scope of its specialty. Electrical
Contractors must maintain a surety bond or assignment of savings account. They also must have a
designated Electrical Administrator or Master Electrician who is a member of the firm or a full-time
supervisory employee.
License Information
License HSMELEP9441-2
Licensee Name HSM ELECT PROTECTION SVCS INC
Licensee Type ELECTRICAL CONTRACTOR
UBI 602404981 Verify Workers Comp Premium
Status
Ind. Ins. Account
Id
Business Type CORPORATION
Address 1 2700 RICHARDS RD STE 202
Address 2
City BELLEVUE
County KING
State WA
Zip 98005
Phone 4259577000
Status ACTIVE
Specialty 1 LIMITED ENERGY
Specialty 2 UNUSED
Effective Date 6/23/2006
Expiration Date 6/23/2008
Suspend Date
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Master Electrician Information
j License KRACHDE976JZ
Name KRACHT, DONALD E
} Status ACTIVE
i Business Owner Information
Effective Expiration
Name Role Date Date
CAPITOL CORPORATE
SERVICES INC AGENT 06/21/2006
WHALL, TIMOTHY J PRESIDENT 06/21/2006
STERN, DENNIS M SECRETARY 06/21/2006
,FORREST, SEAN P TREASURER 06/21/2006
VICE
STERN, DENNIS M PRESIDENT 06/21/2006
Bond Information m
! Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
SAFECO
INS CO
OF Until
N3 AMERICA 6404031 05/25/2007 Cancelled $4,000.00 04/30/2007
RLI INS Until
Jit CO CMS232697 06/23/2006 Cancelled 05/25/2007 $4,000.00 06/21/2006
RLI INS Until
N1 CO CMS232697 07/09/2006 Cancelled 05/25/2007 $4,000.00 06/21/2006
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2007-1211379
Page 1 of 2 Easement
City Of Port Angeles
Clallam County Washington 10/29/2007 01:32:23 PM
RETURN ADDRESS :
City of Port Angeles
P. O. Box 1150
Port Angeles, WA 98362
DOCUMENT TITLE : Temporary Construction Easement
Grantor (S) : K.O. Erickson
Grantee (S) : City of Port Angeles
STREET ADDRESS : 200 West First Street
ASSESSOR' S PROPERTY TAX PARCEL: 0630000033000000
City of Port Angeles
Public Works Engineering Division
PO Box 1150
Port Angeles, WA 98362-0217
TEMPORARY CONSTRUCTION EASEMENT
The Grantor(s), k.O, , for and in consideration of
mutual benefits, grant(s) to the City of Port Angeles, a municipal corporation (hereinafter referred to as the
"City"),a temporary construction easement over and along the full width and length of the premises situated in
Clallam County, Washington, and described as follows:
Tax Parcel Number 0630000033000000
200 West First Street, City of Port Angeles, WA
The tempora y construction easement hereby granted shall include the right,privilege and authority,to
said City and its contractor(s), of ingress and egress to and over said described premises during the
construction of water main, sidewalk, fire sprinkler piping, and related facilities as part of the Downtown
Water Main Project, Phase III.
The City or its contractor shall, upon completion of said facilities, restore the premises of the
Grantor(s), which are disturbed by the City or its contractor, to as good condition as they were in prior to any
such construction of facilities. The City and its contractor shall indemnify the Grantor(s)against,and hold the
Grantor(s) harmless from, all claims, damages, and lawsuits related to the construction of said facilities.
In consideration of the City's construction of fire sprinkler piping for the benefit of the Grantor(s),
which the City is undertaking in the interest of public safety and to take advantage of the cost effective
opportunity made available by the Downtown Water Main Project, the Gramor(s)hereby agree that the City
shall have no legal responsibility or liability for the fire sprinkler piping constructed pursuant to this easement.
Grantor(s)further agree to indemnify the City against, and hold the City harmless from,all claims,damages,
and lawsuits related to the operation of the fire sprinkler piping following completion of construction.
This temporary construction easement shall expire one year from the date of signature of the
antor(s). —
Grantor 1r..r. t7a"Zta Date Grantor Date
STATE OF WASHINGTON)
) ss.
County of Clallam )
On this date, before me the undersigned Notary Public in and for the State of
personally appeared to me known to be the i i al(s)who ekecuted .
yi
the foregoing Temporary Construction Easement and acknowledged to me tha ey v d the same for the
uses and contents therein mentioned.
r Qj
DATED this day of 2007.
NOT Y P LI mano the State of ;.
Washington, residing at c ✓' p t� ' It '
My commission expires:
N:WROIECTSNOO-19 DOWNTOWN WATE1U WN PHASE 309 RIGHT OF WAvEASEMENTS\200 WEST FIRST.DOC
ROUTING SLIP a°`' '"°N.
Certificate of Occupancy
$47 00 Certificate/Inspection Fee
DATE_ �7 v v New Business ( )
Address of Proposed Business Transfer of Business Location ( )
.2-0o tu&l-y 1 �' , Change of Ownership ( }
Applicant _ ,LA I LS New Building ( )
Address �7 R Nero ,V4A c Lz &A Sr Remodel ( )
�G,zesNo 14 WX2- Temporary Business ( )
Phone: business DY aq-1-907 home fes' 440 Change of Use ( )
Brief description of proposed business.
Legal Description Lot Block Subdivision
Current Use of Property- _-4:e� j�
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) L_ 2) Plumbing 2) Peddlers
Plumbing changes 3) Electrical 3) 2nd Hand Dealer
New or relocated signs ✓ 4) Mechanical 4) Pawn Broker
New septic tanks 5) Sewer 5) Dance
New sewer service 6) Sidewalk Installation 6) Hotel Motel
Admission charged to patrons Ll _ 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-otway 10) Water meter installation 10) Other
Is there sufficient off-street parking? e3 11) Fire
New driveway openings 12) Occupancy
A grading plan for site drainage 33)Sigh
(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? 17) Other
Other ---
I hereby apply for a Certificate of Occupancy and acknowl- 12/7/190
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:
AP V REJECTED Comments / Conditions
Building Section
1
Public Works Department
Planning Department
Fire Department
City Clerk
PB I.A,
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH-IN
PLUMBING
UNDERFLOOR/SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW/WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS/ GIRDERS
SHEAR WALL
WALLS/ROOF/CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL/FLOOR/CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE/PELLET/CHIMNEY
HOOD/ DUCTS
PW UTILITIES/ SITE WORK (Engineering Division) SEPARATE PERMIT#'s:
WATFRLINE/METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARATE PERMIT#'s SEPA.
PARKING/LIGHTING ESA.
LANDSCAPING SHORELINE.
FINAE INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGHT DEPT 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W /PW/ CONSTRUCTION R.W
ENGINEERING 417-4807 PW/ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 r` PLANNING DEPT
BUILDING 417-4815 BUILDING
T\PLANNING\FORMSU 102.15(4/2002]
REPORT OF INSPECTOR
DATEOFVISIT MADEBY REMARKS
C o al p
I rh
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CITY OF PORT ANGELES
_ PUBLIC WORKS ELECTRICAL DIVISION
321 FAST STH STREET PORT ANGELES WA 99.362
LrM�
ELECTRICAL PERMIT ISSUED' 3/09/2000 PERMIT NO 6895
OWNER/APPLICANT PROPERTY LOCATION
ERICSON TRUST 202 IST ST W
Lot: 1,2,3,4 11
Port Angeles, WA 98360 Block. 33 ❑ Long Legal
360/000-0000 Subdivision TPA
T LAMONT'S STORE S Parcel No. 06300000330000
CONTRACTOR ARCHITECT
ANGELES ELECTRIC N/A
524 E FIRST ST
PORT ANGELES WA 98362 98360-0000
360/452-9264 360/000-0000
PROJECTINFO
Project Type- COML. MISC Project Value $0.00
Occupancy Type Construction Type ADD AIR COND
Occupancy Group Zoning Use.
Electrical Heat:
❑ Baseboard 0 KW ❑ Riser ❑ Underground Service
❑ Furnace 0 KW ® Overhead Service Voltage 120,208
❑
Heat Pump 0 KW ❑ Temp Service Phase- ❑ 1 ® 3
Fan Wall 0 KW Service Size 0
Feeder Size 0
PROJECT NOTES
REMOVE 10KW HEAT FROM EACH OF TWO EXISTING 25KW FURNACES
INSTALL 5KW AIR CONDITIONING UNIT TO EACH FURNACE/AIR HANDLER.
INSTALL 20 TON/40KW AIR CONDITIONER,WITH 5HP AIR HANDLER.
TOTAL ADDED LOAD 50KW OF AIR CONDITIONING
FEES ASSESSMENT Service $8975
Additional Feeders $000
Circuit Wiring. $000
Temp Service $000
Misc Fee $000
TOTAL FEE $8975
AMOUNT PAID- $8975
BALANCE DUE $000
(_OMMI-NTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417A735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MWIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE ITIS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
WSPEMON TYPE DATE ACCEPTED coMMmwTS
YSS NO
DITCH
SERVICE
GENERAL COMMENTS:
Pw•1102.1514''96)
CITY OF PORT ANGELES Q ©cy �j
FEE REC PT NUMBER DEPARTMENT OF LIGHT A �
PERMIT NUMBER
APPLICATION AND ELECTRICAL PERMIT
t alf-Ai C
� u �r
TOTAL•FEE Cyy � S l _+ � Z`f
CONT LIC.NO. TIME TO COMPLETE NO.STORIES LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR i,14V ESTABLISHED UNDER THIS PERMIT
Site Address '
pad 4L
ORE T ADDRESS ISR SPONSfBILITY OF APPLICANT P RMITS TH ONG ESSES ARE CANCEL EO y
Owner InstallationBy C`D/
Owner's Address S� L" ei:�—e---installers Address
Day Phone installers Phone _ I
App
lication Is hereby made f Permit to install Electrical Equipment as follows: J
_ Wiring Method
NUMBER AMP 120V 240V _ NUMBER RMP 120V 240V
USE OF CIRCUIT PER 10 OR — FEE'- USE OF CIRCUIT PER 10 OR FEE
GIRCUITS CIR 1 0 3 0 CIRCUITS CIR 10 30
LIGHT SIGN
LIGHT 50 VOLTS ) all
OR LESS
'CONVENIENCE MOTOR +
CONVENIENCE - MOTOR - +
APPLIANCE _ MOTOR
DISHWASHER FIRE ALARMS
DISPOSAL BURGLAR ALARM
RANGE MISC
OVEN
WATER HEATER
LAUNDRY
DRYER - - REINSTALLATION LIGHT FIXTURE iY
FURNACE SUBTOTAL FEE i i
GAS OIL
FURNACE ENERGYFEE
ELECTRIC
BASIC FEE
ELECTRIC HEAT
-- " - TOTAL FEE (�
ELECTRIC HEAT
SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C.UNIT AMP . PHASE
FEEDER -ze,�d SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE A.W G.
SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
1 certify that the work to be performed under this permit will be done by the installer conforma with the N E.C, trical Code.
Date Application made Id 19
ONTRACTO R O ER(OR AUTHORIZED AGENT)
Permission is hereby given to do the above described work,according to the conditions h eon and a or ng to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Por nge
t ' DIRECTOR OF CITY LIGHT '
Date Permit Issued , By
PLAN APPROVED * +
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.
WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK — SEE OVER —
WHITE Original CANARY Duplicate PINK Triplicate WHITE CARD Inspector's Report
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
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CITY OF PORT ANGELES ©O
FEE RE EIP UMBER DEPARTMENT OF LIGHT °FMTNUMBER
APPLICATION AND ELECTRICAL, PERMIT "
TOTAL FEE
CONT LIC.NO. TIMETOCOMPLETE NO.STORIES LEGALOCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
Site Address 20117- ��`:� /ST �TiP��'7 �. �'4vE'T 4 l zC Ltx!
,,��// '/�rCCOORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRON gDDRESSES ARE CANCELLED
Owner 144/6 /Yl I—I&I ly .2w. Installation By
Owner'sAddress /ilk +BAST A/ /1O2 Inst�ers Address �2 _ _ awb
Day Pho��� �� Installers.W--* 'one. � '�`"3r
Application is hereb�'rriabe'fd'r Permit to ingtall eoctricakEquipment-as:follows: �/
1 n\
– 1y Wiring Method C. had(
AMP 240V AMP 240V
USE OF CIRCUIT NUMBER PER 120V 1 0 OR FEE USE OF CIRCUIT NUMBER PER 120V 1 O OR FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT SIGN /
LIGHT 50 VOLTS
OR LESS
CONVENIENCE MOTOR
CONVENIENCE MOTOR
APPLIANCE MOTOR
DISHWASHER FIRE ALARMS
DISPOSAL BURGLAR ALARM
RANGE MISC.
OVEN
WATER HEATER
LAUNDRY
DRYER REINSTALLATION LIGHT FIXTURE N
FURNACE SUB TOTAL FEE
GAS OIL
FURNACED ENERGY FEE
ELECTRIC
BASIC FEE
ELECTRIC HEAT
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
A.C.UNIT �n
6C./ AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONbUCTORS
SERVICE
�o2D- A.W G.
SUB-TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
I certify that the Work to,beperformedunder this permit will be done by the Installer and In conformance with the N .0 Electrical Code.
Vate Application made
NTRACTO OR WNER(OR AUTHO ED AGENT)
Permission is hereby given to do the above described Work,according to the conditions h Borland ding to the approved plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Po es.
IRECTO7f CIT%y.f JGHT
Date Permit Issued By
PLANS APPFfOVED
Notify Department of City Light by Street Address and Pe it 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.
WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK— SEE OVER—
WHITE Original CANARY Duplicate PINK Triplicate WHITE CARD Inspector's Report
REPORT OF INSPECTOR f
GATE OF VISIT MADE BY REMARKS
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Job Locoiion FIZs-r -1 Project No. WS. FPC::�6
CF 62.%,L - !A�ti 1C.P.S-r`� EngineerChecked
�on for Work -�P L2 Oraftsmc pale isw =�ed
Foreman Revised
Grid It) Start date C
ompbte date
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Pay Corporation
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CITY OF PORE'AlAmmwrS PE,RMiT APP]LiCAT[ON
Building-DivisionTolectriicatl inspections `" �"..
Alt
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321 East Fifth Street.•-P.O.BOX 11501 Port Angeles Washington, 98362 4? 1�
Ply: (360) 417-4735 Fax: (360)417-4711 � o
l d
Date: Y(
^,3 13 X Multi-Family or Commercial*
Pian ReviewM� a �tluiredIt:a �Com fakelectricaf Pian Review Information Sheet
Job Address: U Co
Building Square Footage; --
Description of above (j
Owner Informatl n —• "'" �-
Name: h 4 1fo bait �1'}1 fE04� Contracto Information
Mailindr s: s Name;
City,_ f 2i Name-
Mallin dd ss; _ _.l
Rhone,Y '7�Fax; p' — City: J �. Sfata, � Z�;_�b
License#1 Exp,_ _ - Phone; X
item Unit Charge Licensp
S ervice/Feeder 20C Amp, 5132 a0 Total(Qty M.ultic ted by llnik Cha
Service/Feeder 201.400 Amp, $160,00 a
Service/Feedor 401.600 Amp $275.00 ___
Service/Feeder601-1000 Amp. $288.00 $
--
Service/Fender over 1000 Amp, $410,00 $--�--
Branch Circuit WI Service Feeder $ U0
Branch Circuit WiG Service Feeder $ 74,00
Each Additional Branch Circuit $ 5,04 --- $
Branch Clrcuita 1-4 $ 80,00 -
Temp.Service/Feeder200 Amp, $102,00 's —
Temp,Service/l=eader 701400 Amp, $121.00 '---
Temp.Service/Feeder 401.600 Amp. $161,00 ;R
Tornp,ServicelFeeder 601 1000 Amp. $185.00
Portal to Portal Hourly $ 96,00 5--
SignlOutline Lighting $ 88.00
Signe)Circuit!Limited Energy-Multi-Family $ 64.00 �'-- --,
Signal Drcuitl Limited Energy(First 1500 sf Commercial $ 96.00 $T�---
Note; $5,00 for each additionaE 1500,9f
Renewable Electrical Energy-5KVA System or Less $193,00
Thermostat $ 56,00 '` $—
Note;$5,00 for each additional T-Stai fi
$ 1, 3�. p t1 trofal
Owner as defined by KWA 9,28.261:(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 irispectton.
Atter reading the above statement,I hereby certify that I am the owner of the above named property or a licensed electrical contrc ctor. I am making
the electrical installation or alteration In compliance with the electrical laws,N,E.C„ CCW,Chapter 19,28,WAC,Chapter 296.468 The City of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14.05,050 regarding Electrical Permit Applications.
Xalowner,electrical contra is or electrical admiinistrakor: CI Cesh C] check
Credit Card# q•`;a
oatodr /0— -f �„ a1�n91za1z
ELECTRICAL PERMIT �1
CITY OF PORT ANGELES
360-417-4735 �
Application Number , . . . 13-00001166 Date 10/09/13
Application pin number . , , 920134
Property Address , , , , , , 200 W IST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBIR: 06-30-00-0-0-3300-0000
Application type description' ELECTRICAL ONLY on your excise tax form
subdivision Name . . . , . ,
Property Use to the City of Pod Angeles
Property Zoning , . . . , . . CENTRAL BUSINESS DISTRICT (Location Code 0502)
Application valuation . , , . 0
-----------------------------------------------------------------------------
Application desc
Feeder for kitchen cooker
----------------------------------------------------------------------------
Owner Contractor
JOHN J" & ROBIN K MILETICH SIMPSON ELECTRIC
312 RED DEER DR 243036 W HWY 101
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360 4.52-7175 (360.) 457--9270
_ -__---- --------------------- _-______------------------------- ----_--__ _----
Permit . , . . , . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Pee . . . . 132.00 Plan Check Pee .00
Issue Date , . . . 10/09/13 Valuation . . . , 0
Expiration Date . , 4/07/14
Qty Unit Charge Per Extension
1.00 132.0000ECH EL-COM 0-200 SRV FEEDER 132.00
- Fee summary Charged Paid Credited Due
Permit Fee Total 132.00 1.32.00 00 00
Plan Check Total ,00
Grand Total 132,00 232.00 00 .00
.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:
G:IEXCHANGEWILDING
ELECTRICAL PERMIT
CITY OF PORT ANGELES
03
360-417-4735 W
Application Number . . . . . 16-00000836 Date 6/09/16
Application gain number 635916
Property Address . . . 200 W 1ST ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER; 06-30-00-0-0-3300-0000 on your excise tax form
Application type description ELECTRICAL ONLY
Subdivision Name to the City of Port Angeles
Property Use . . . . Location Code 0502)
Property Zoning . . . . . CENTRAL BUSINESS DISTRICT
Application valuation 0
Application desc
Move circuits
Owner Contractor
JOHN J & ROBIN K MILETICH SIMPSON ELECTRIC
31.2 RED DEER DR 243036 W HWY 101
PORT ANGELES WA 98362 PORT ANGELES VIA 98363
(360) 452-7175 (.360) 457-9270
Permit ELEC'T'RICAL ALTER COMMERCIAL
Additional desc 1-4 CIRCUITS
Permit Fee 86.00 Plan Check Fee �00
Issue :Date 6/09/16 valuation 4
Expiration Date 12/06/16
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 .00 .00 .00 .00
Grund Total 86.00 86.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN rQ
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Date:
G1�EXCHING
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321 East FM Strom-W$"»' .BOX 1150/POO AngrfmWmbi n,9062
ph:(36U)4117-4735 Fm:(350)417-4711
lWt*alrtifY or
Conomlar
x Plan Review Mas►Be le ,iTQd.PleeeColllllalete w Man Review Information Sheet
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Owner "ran r7 *"
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phone; tt 4rtx
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To ,m Mel t n- a
eed 2W ATM. $132..00 ---- _ $
ServRWFee&r2DI40Q RmR_ $180.00
qem�mFemkr401-60DAmp $225.00
Sar mW,ec4w691-1D0D Amp. $288.00 $
SW0cIF aver 1000 Amp. $410.00 - —
Branch Circum W/SaMce Feeder $ &no $ �-
Branch Ckcua W/O SaMce Feeder $ 74,00 $
Each Branch Chu& $ 5.00 $
Branch Otuft 1-4 S 80.00 --- $
Temp.Service!Feeder 200 Amp. $102.00 $'temp.SaMoWeWar2014W Amp. $121.00
TOM,SmWFOedw401MG Amp, $164.00
Tamp.So 0-10M Amp. $185.00 $------�--
Portai to"I Howly $ 1U.00 $ --
S e $ 88,00
�� -has-Foey $ 84.00 $
819"A CkWWLW0gd EneMy/FW ISM sf- + rc 1 $ 96.00
Nom. $&00foreac#ad tfioW 1500 Sf
Renewable Meekkai Ene SWA System or Less $113.00 $� -
Tnannoshat $ 56.00
NOW-$5.00foreachadditionalT rac $ fo+tal
Owner as defined by R=1'9.28 1':(1)Vie""11 o=Py the Mrodm fort"ymrs after Oft t4se it l pem Is fimlb 2c.(2)Omer is required
to hire an a rxarftctor if ahorre sMd prrafaer)y is for safe,rpt or Imn.P"enAit+etcpims alter S*Moriftaf last inspec o in_
After reacfing the above statement,t hereby cerllyr thea 1 am the owner of the above named property or a I" electrical 1 rontrmCb r r 1 am making
the electrical insulation or alteration in campllan©e with the electrical haws,NEC,,RCW-Chapter 1928,WAC,Chapter 2911.4613,The of Port
Angeles Municipal Dade,and Ut7$y a " and PAMC 14.05.050 regarding Electrical Pemd Applications.
owner,elechical or electrical administrator. ❑ CWh CJ 7--�t4n
Caen# .
,P
ELECTRICAL PERMIT
CITY OF PORT ANGELESr
360-417-4735
Application Number 15-00001482 Date 11/23/15
Application pin number 073866 REP -
ASSESSOR PARCEL 200 w IST ST
-0 ORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000-
Appl.:i.cat.ion type description ELECTRICAL ONLY on your excise tax form
Subdivision Name
Property Use to the City of Port Angeles
Property Zoning , . CENTRAL BUSINESS DISTRICT (Location Code 0502)
Application valuation , . . . 0
Owner Contractor
JOHN .J & ROBIN K MILETICH SIMPSON ELECTRIC
31.2 REL} DEER. DR 243036 W HWY 101.
PORT ANGELES WA 98362 PORT ANGELES WA 9836.3
(360) 452-7175 (360) 457-9270
Permit ELECTRICAL ALTFP COMMERCIAL
Additional. desc 1-4 CIRCUITS
Permit Fee 86.00 Plan Check Fee 00
Issue Date 11/23/15 valuation 0
Expiration Date 5/21/16
Qty Unit Charge 11e:xExtension
BASE: FEE 86.00
Fee summary Charged Paid Credited Due
Permit Fee Total B6.00 86.00 00 .00
Plan Check Total .00 .00 .00 00
Grand Total 86.00 86.00 00 00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL o
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAEXCHANGE\BUILDING _ �' _-
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/ElectricnlInspections
321 East Fifth Street--P.O.Box 1.150/Port Angeles Washington,98362
Ph: (360)417-4735 Tax: (360)417-4711
Date: Multi-Family or Commerclal*
x Y Inf rmatton Sheet
Jab Addresevlew May Be ulcers,PI ase Co+p 'iete Electrical Plan Iewri
Building Square Footage:
Descriptlon of above d '
11 U
Owner Info anon T
Name:—-. Name: dress, LE.C
on raC car n orimation
MaWrag ddgs;
city, o Slate: Zip: city: rete; 2i1, -
Phone: - ax Phone - �, Fax: 7'-
Llcenso /Ex ~~ ~ �
Exp ..,_. License# Exp.,.,,�bnI p ,
Item Unites C�is(tr f-5 0n To$ Q� ultl"Iiedrb I Clta
ServicelFeeder 200 Amp, $132.00
$ _
Service/Feeder 201-400 Amp. $160.00 $
Servlce/Feeder 401.600 Amp $225.00
Servlce/Feeder 601.1000 Amp. $288.00 w, $
Service/Feeder over 1000 Amp, $410.00
Branch Circuit W/Service Feeder $ 5.00
Branch Circuit W/O Service Feeder $ 74.00
Each Addilional Branch Circuit $ 5.00 $
Branch Circuits 1-4 $ 86.00 :'
Temp.Service/Feeder 200 Amp. $102.00 $
Temp,Service/Fooder 201-400 Amp. $121.00
Temp,Service/Feeder401.600 Amp, $164.00 $
Temp,Servlce)Feader 601-1000 Amp, $185.00 $ -
Portal to Portal Hourly $ 96,00 $
Slgn/Outline Lighting $ 88,00
Signal Circultl Limited Energy-Multi-Family $ 64.00 $
Signal Circuit/Limited Energy/First 115000-Commercial $ 96,00 $�
Note: $5.00 for each additional 1500 sf
Renewable Electrical Energy-SKVA System or Less $113.00
Thermostat $ 56.00
Note:$5.00 for each additional T-Stat $
Total
Owner as defined by RCW,19.28.261:(1)Owner will occupy the structure for two years after this electrical permit is finalized. )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 con r9ct0L I am making
the electrical installation or alteration in compliance with the electrical laws,N.E.C.,RCW.Chapter 19,28,WAC.Chapter 296-41;B,The City of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14,05,050 regarding Electrical Permit Applications.
Sigamowner,electrical con r or electrical administrator: Cl cash ❑ Chock
C Credit Card#__..(�'�
gid. ���9.��...�� ..q r►trot►zolz ..,,�
Application Number . . . . . 23-00000258 Date 3/15/23
Application pin number . . . 319894
Property Address . . . . . . 200 W 1ST ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-0-3300-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Coolers
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JOHN J & ROBIN K MILETICH OLYMPIC ELECTRIC CO INC
312 RED DEER DR 4230 TUMWATER
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360) 452-7175 (360) 457-5303
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 79.00 Plan Check Fee . . .00
Issue Date . . . . 3/15/23 Valuation . . . . 0
Expiration Date . . 9/11/23
Qty Unit Charge Per Extension
1.00 74.0000 ECH EL-COMM BRANCH CIR WO/ S/F 74.00
1.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 5.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 79.00 79.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 79.00 79.00 .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 3/14/23,11:42:32 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
---------------------------------------------------------------------------
APPLICATION NUMBER:23-00000258 200 W 1ST ST
FEE DESCRIPTION AMOUNT DUE
---------------------------------------------------------------------------
ELECTRICAL ALTER COMMERCIAL 79.00
TOTAL DUE 79.00
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
3/16/2023 23-258 TAP
OWNER
CONTRACTOR
Olympic Electric
PROJECT ADDRESS
200 W 1st St