HomeMy WebLinkAbout1115 E Front St - BuildingUse Classification:
Group: B
Owner of Business:
Building Address:
CERTIFIGATEO'FOQCUPANCY
City of Port Angeles
Building Division
This Certification issued pursuant to the requirements of Section,109 of the
Uniform`Building Code certifying that at the time of issuance this structure was
in compliance with the various ordinances of the City regulating Building
construction or use. For the following
Offices Building Permit No. 03 -1092
Type of Construction:
Gase Nichols Properties
1115 East Front Street.
Business Name: Coldwell Banker
Use Z:ti ne:
CA
Address: 330 East Front Street, Port Anweles. WA 98362
Port Angeles4 WA 98362
V -N
3 4 4
Po o rheppemises„
Shall not be rem,gys&exce
a
entern`6er 16.2004
bate
onspicuous place
wilding Official
Group: M
Building Address: 1115 gas
CERTIFICATEOFOCCUPANCY
Buildtfit DivisiOt
f Construction:
is•
This C'qrtificittiottissuedpursuant to the requirements of Section 109 of the
Uniform. B daingke5oaarcqrtihtngethatqt the tiptempirslfance this structure was
,fr
in cOmphaitoeTwilitithe iktriOus-ordmance&Ofthe etty4;egultitips Building
..const se FoXethefollowt 0.
ittr‘A
Use Classification: EsnreSi6,`
4:1
ne: CA
Coffee Doc
Owner of Business/Residence:: 'Carrie Shelmidine Kaago StreetpPort Angeles, WA 98362
A.98362
March 15. 2002
Date
atidi
Post on the pittious place
Shall not be renibveasexcept.bV Official
4
Group
CERTIFICATE OP OCCUPANCY
City of Port Angeles
Building Division
This Certification iSslid.pursuant to the require.me_rgs of Section 109 of the
Uniform Building Code certifying that at:the time 110;$101eg, this sfructure was
in compliance with the various ordinances f)rthe-Cily. reguldttrig BUilding
construction or use. For the following:
Use ClassificatiorCompi it RP a; r-R an& Service
Type of Construction VN Use Zone CA
Address 1113 E Front, PA WA 98362
Pert Angeles, WA 98362
jAnnAYy 12 20Q1
-Buildog Qffiriar i r, ilr Date
Post o e penisesin acoflspkuous place
Shall not be renjOited;x00tby Pei chng Official
Owner of Business/Residence Allen Coleman
BuildingPermkNo.
4
DATE I/
Address of Pro osed Business
Applicant ..e ,R
Address ji
Phone business ,-?/n0 '01!ome
Brief description of proposed business.
Legal Description Lot JY'
Cry Block
Current Use of Property V4-e/4--/z/r
Zoning Classification of Property
WILL THERE BE ANY OF THE FOLLOWING?
Construction changes
Electrical changes
Mechanical (heating, cooling, stoves)
Plumbing changes
New or relocated signs
New septic tanks
New sewer service
Admission charged to patrons
Is this a home occupation?
Excavation of filling of lots
Work done in City right -of -way
Is there sufficient off street parking?
New driveway openings
A grading plan for site drainage
(parking lots, downspouts, etc.)
Are the existing streets paved?
Are there existing sidewalks?
Is there curb and gutter?
Other
hereby apply for a Certificate of Occupancy and acknowl
I
edge that I have read this application and state that the? -Date
information I have supplied is correct to the best of my
knowledge RCSigned
APP';) REJECTED
ROUTING SLIP
Certificate of Occupancy
$47 00 Certificate /Inspection Fee
New Business
Transfer of Business Location
Change of Ownership
�o► AI1e& (6 wttlow Building
to Remodel
Temporary Business
4i0- 1 /..5- 7)q. C hange of Use
CZ) f4 ecx `c-?
tl
YES NO
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
PB I.A.
THE FOLLOWING WILL BE REQUIRED
PERMITS
1) Building
2) Plumbing
3) Electrical
4) Mechanical
5) Sewer
6) Sidewalk installation
7) Driveway installation
8) Curb installation
9) Sidewalk obstruction
10) Water meter installation
11) Fire
12) Occupancy
13) Sign
14) Shoreline
15) Home occupation
16) Conditional use
17) Other
Comments Conditions
Subdivisiorieel4r t00
BUSINESS LICENSE
1) Taxi
2) Peddlers
3) 2nd Hand Dealer
4) Pawn Broker
5) Dance
6) Hotel Motel
7) Fireworks
8) Ambulance
9) Tattoo shop
10) Other
CITY OF PORT ANGELES
DEPARTMENT OF COMMUN]TY DEVELOPMENT - BU~LDgqG DWISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Applicat ion Number ..... 03-00001092 Date 12/03/03
Property Address ...... 1115 E FRONT ST
ASSESSOR PARCEL NUMBER: 06-30-00-8-1-0445-0000-
Application description . . . CO~94 NEW CONST
Subdivision Name ......
Property Zoning ....... CO~4ERCIA~ ARTERIAL
Application valuation .... 589610
Owner Contractor
GASE NICHOLS PROPERTIES LBR CONSTRUCTION
330 E FRONT ST 618 SO PEABODY
PORT ~/~GELES WA 983620104 PORT ANGE~S WA 98362
(36) 452-5403 (360) 452-1232
- ..... Structure Information NEW 8531SF OFFICE BLDG .....
Construction Type ..... TYPE V NON-~AT~D
OcCupancy Type ...... BUSINESS:OFF/PRO/MED/REST
Other struct info ..... NUMBER OF UNITS 1.00
Permit ...... BUILDING PERMIT - COMMERCIAL ~
Additional desc . .
Permit Fee .... 3684.75 Plan Check Fee . . 2395.09 ~ ~~
Issue Date .... 12/03/03 Valuation .... 589610
E~piration Date . . 6/01/04 ~
Qty U~it Charge PerBASE FEE Extension3257.25 ~ ~[
90.00 4.7500 THOU BL-500,001-1M (4.75 PER K) 427.50
Additional desc . .
Permit Fee .... 174.00 Plan Check Fee . . .00 .
Issue Date .... 12/03/03 Valuation .... 0 ~
Z~iration Date . . 6/01/04 --%--
Qty Unit Charge Per Extension
E~E FEE 47.00
14.00 7.0000 ECH Pt- EA.FIXTURE ON OWE TPJtP 98.00
1.00 7.0000 ECH Pt- EA. INSTALL WATER PIPE 7.00
1.00 15.0000 EUN Pt- EA. BLDG SEWER 15.00
1.00 7.0000 ECH Pt- EA.WATER HEATER 7.00
Permit ...... MECHANICAL PERMIT
Additional desc . .
Permit Fee .... 116.05 Plan Check Fee . . .00
Issue Date .... 12/03/03 Valnat ion .... 0
F~iration Date . . 6/01/04
Qty Unit Charge Per Extension
BA~E FEE 47.00
2.00 14.7000 ECH ME- INSTALL 1OO- FAU 29.40
4.00 7.2500 ECH ME-VENT FAN 29.00
1.00 10.6500 ECH ME-GAS PIPE 1 TO 5 10.65
Special Notes and Comments
Address numbers shall be plainly visible from the street.
Address numbers shall be a minimum of six inches high and be ~ ~
in contrast in color of there background. -
Other Fees ......... STATE SURCHARGE 4.50
Senar~t~erm ts are reeuired for electrical work, SEPA Shoreline, ESA, utilities, private and public improvements. This permit becomes
nu~ ar~'.~d if work or c~nstruction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a peri0~ of '180 days after the work as commenced or if required inspections have not been requested within ~ $0 days from the last
inspection. I hereby ced fy that I have read and examined this application and know the same to be true and correct. All provisions of
aws 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 previsions of any state or local law regulating construction or the performance of
Sfg}~atfi?e of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
:\PLANNING\FORMS/1102.15 [11/14~003]
BUILDING PERMIT INSPECTION RECORD
CALL 4I%4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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.
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR/SLAB
ROUGH-IN
WATER LINE (M~ER 7'0 BLDG)
GAS
LINE
RAcK FLOW ~ w^~l~,,~ ~
WALLS I
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Page 2
Application Number ..... 03-00001092 Date 12/03/03
Fee sua~nary Charged Paid Credited Due
Permit Fee Total 3974.80 3974.80 .00 .00
Plan Check Total 2399.09 2395.09 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 6374.39 6374.39 .00 .00
!Separate Permits are required for e~ectrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 1SO days, if construction or work is suspended or abandoned
for a per od of 180 days after the work es 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 comptied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORMS\I I02.15 [I 1/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 I DATE I YEsACCEPTEDI NO COMMENTS
FOUNDATION DRAR~AGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT:g
ROUOH-IN I
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
SHE^RWALL,HOLD DO S
W~LLS / ROOP / CEIEINa ,q J.
DRYWALL (rNTER~OR BRACED PANEL ONLY)
INSULATION
WALL, FLOOR/CEILINO - 3 l-'~ q ,,).1-,
WOOD STOVE / PELLET / CEIIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PE~IT
SEWER CO~ECTION
YES NO
ELECT~CAL - LIGHT DEPT. 4~7-4735 ELECT~CAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W,
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST: ~ L// (phone, person
Date ~- I~) "- 0 ~ Time Received by
Location of Work to be inspected i / / ~- ~ F~Oz~t?
Name of person requesting inspection 'BO ~:>
Address of person requesting inspection Phone No. ~7/~/- / ~ ~ ~
Type of Inspection (circle appropriate onel: Permit No. / 0~.
Sewer~;h~raming Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date Time By
Remarks:
RESTORATION REQUIRED ...... YES, NO
We& ci' ~O,~m. o:,-- to, o^m'
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel {-]Asphalt F]PCC [~Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
I('~nntJn,,e nn r~.verse side if necessary) RTREET SUPERINTENDENT (DATE)
FOR O/~FICIAI. US}i ONLY:
BUILDING PERMIT - APPLICATION I_t-q-oT,
~ill out COMPLeTeLY and in INK. Your application and site plan ~UST B~
Date Approv~:~
COMPL~T~ to be aeeeptefl for re~iew. If you have any que~ions, call
(360) 417~815 Date IsSUe:.
Applicant or Agent: t_ i~'-~-, t-2_ (-~A3%-~ ,4, ct. c-TLO.O Phone: 4:~ -2 - I -L% ~
Owner: [D/3}4~"t~$C, O¢.,.ta~ ),)tc~+vcs F_~,_,o~,.~z~ )~6~Jl~ Phone: ~'2 - '7~/
Address: '~O ~A~T FROST %V Ci~: ~o~r ~-~ ~ Zip:. Q~3~
~chitecffEngineer:~5~ ~CO~ 0~SI4~f~C~}c}~55oC Phone:
Con~actorC~ ~ ~5~c~D State License ~: Exp: Phone:
Address: G(~ ~- 0C~&~,0'~ Ci~: ~o~7 ~w~ LOA Zip: c]~go~
PRO~CT ~D~SS: 1 [ [ ~ E ~rO ~5 ~ ZONING:
LEG~DES~TION: ~t: ':> t 14, I~ Block:~,~r %~, Subdivision: ~A.~'~ ~ c¢~,~<~
CL~L~ CO~ P~CEL ~BER:
Credit Card Holder Name:
Billing Address: City:.
Credit CardType VISA __ MC __ g Exp. Date:
TYPE OF WORK: SIZE/VALUATION:
.El Residential Ef/NewCon~tr. El Re-roof [] Stove .... ~-<o-2~-J SF.~$ 1~t~ /SF.=$
rn Multi-family [] Addition 13 Move ~ Garage SF. ~ $ /SF.--$
I:~ommercial [] Remodel [] Demolition I~ Deck SF. ~ $ /SF. -- $
121 Repair 13 Sign [] Other TOTAL VALUATION $
BRIEF DESCRIPTION OF TIlE PROJECT:
2_ s,'m .c-ma
COMMERCIAL/RESIDENTIAL: Ol:cupancy Group: Occupant Load: Construction Type:
rqo. o~bmries: d~ LotSize:.-aOXl~rO Existing Sq. Ft. ~ & Proposed Sq. Ft.~';~}$--~ =TOTALSq. Ft.--~O~"~
Existing lot coverage '~ % & Proposed lot coverage t ceo % = Total lot coverage~ 2.~ %
APPROVALS:
PLANNING IJSE ONLY: PLAN:
BLDG:
DPWU:
FIRE:
ESA/Wetland(s): El Yes [] No SEPA Checklist required? [] Yes [] No Other: OTHER:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 4174815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building perrmt application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct. I am authortzed to apply for this permit end
understand that it is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permits prior to work.
SITE PLAN
DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION
APPLICANT: PHONE:
PROJECT/DEVELOPMENT ADDRESS:
See Page 4 for instructions on completing the site plan. For more information, call 417-4815.
FIRE DEPARTMENT
PLANNING DEPARTMENT
PUBLIC WORKS/ENGINEERING DIVISION -[ r ~L'q ~ CC
LIGHT DIVISION
[~/ ENERGY
[~ ENGINEERING
POLICE DEPARTMENT
ADMINISTRATION
~ CITY CLERK
~1 RISK MANAGEMENT
FROM: PUBLIC WORKS/BUILDING DIVISION
~[' NEW CONSTRUCTION
~1 ADDITION/ALTERNATION
COMMENTS/CONDITIONS:
/[~REVIEW/RETURN [~l FILE
1997 Washington State Nonr~iclential Energy Code Comld~anoe Form
[ See _Sed_ u~ 1421 for full ~.dl:~3a of [~x Cooling Only: [-I Split system?
[ S~ S~ ~,,~.
JDecision ~owch~ I ~ th~ ~ to ~e~ ~ ~ qu~i~ f~ S~e S~tem 0~. If ~, e~r ~ C~Hex
I swt~ = s~t~ ~ o~ m~= ~.
~ t - '".~eaUn~Coo~
u~ em/~e... ~:~li~ .... ~' .V~umeT 'no
',
no) ~
-... ......
<~,000 B~
,
no' ;yes ~ S~. 1423 ..] '~r 1000 dm?~
~.'
~e Comdex ~ Refere~e
Complex Systems
lgg4 Code
S~ S~ qualir~um=. .. Ill He~i~ On¥ ~ (~ cfm? ~ <70% o~
Decision ~owch~ u~ this fl~ to d~i~ if pr~ qualifl, f~ S~ S~tem O~. If ~. e~r I~ C~plex
S~em ~ S~ems A~is O~s ~t ~ u~.
T ".~ea~n~Cool~ ..~ CO~
S~tem ~.. ~li~ ..... Volume~ 'no
He~g ONy //'
I
/
', .~ Co,ed?
<5000 ~m?~ ..... no . .'
* <~,000 B~
' ~/''ud.~ ~--~ ' 900~ ~m,ye. ~? n~
no ~ yes ~'S~. 1423 ) ~1900~m~
Simple S~tem
~owed
[ Refere~e ~
( S~. 1420 )
O~ Complex Refere~e
IComplex Systems
Product 38YKC (60 Hz)
Data Heat Pump
HEATING & COOLING
Sizes 018 thru 060
The 38YKC Outdoor Sections of
Split-System Heat Pumps are designed
for quiet, reliable heating during the
winter and cooling during the summer.
These heat pump systems provide
economy of operation through energy
conservation. These units provide
SEER ratings up to 11.5 and HSPF up
to 8.5 when used with components
designated by manufacturer. They
recover heat for indoor comfort from
outdoor air during the heating season
and, by automatically reversing the
refrigerant cycle, remove indoor heat
and excess humidity during the
cooling season. All models are
listed with ARI, UL, c-UL, CEC, and
CSA-EEV. All models are offered in
208/230v.
FEATURES/BENEFITS
Compressor -- Each compressor is
mounted on rubber isolators for
additional sound reduction.
Continuous operation is approved
down to -30°F (-34.4°C) in the
heating mode and down to 55°F
(12.8°C) in the cooling mode. (See
heating and cooling performance
tables.)
Built-In-Reliability Components --
Includes a suction accumulator that
minimizes the amount of liquid
refrigerant that reaches the
compressor; loss of charge protection;
start thermistor and crankcase heater
on 018-042 sizes; and defrost board for
time/temperature defrost function. All
units are equipped with a discharge
muffler to minimize gas pulsation in
heating mode.
Defrost Control Board (048 and 060)
-- Incorporates a built-in 5-minute
Dimensions
CERTIFICATION APPLIES ONLY CERTIFICATION OF
WHENTHE COMPLETE SYSTEM MANUFACTURING SITE
IS LISTEO WITH ARL
Physical data
OPERATING WEIGHT'i'L'b) ...... 139 165 I I I"' 199 215 229 268 " 293
COMPRESSOR MFR Tecumseh Reci Copeland Recip Copeland Soroll
REFRIGERANT 22
Control Piston
Charge(Lb)* 4.13 I 4.38 I 4.88 I 7.13 ] 8.13 I 11.51 J 12.38
CONDENSER FAN
Air Dlechar~l~ I I Vertical
Air Qty (CF 1900 2400 3100 J 2900 J 3100
Motor Rpm (60 Hz) 1100 825 1100
CONDENSES COIL
Face Area (Sq Fi) 8.79 I 10.99 I 12.17 I 18.25 I 12.17 I 15.21 J 18.25
CONNECTION (tn. rD) Sweat
Vapor 5/8 I 3/4 I 7/8
Liquid 3/8
REFRIGERANT TUBESt (in. OD)
Vapor 5/8 I 3/4 ] 7/8 J 1-1/8
Liquid 3/8
· The factory refrigerant charge is for 15 ft of infer-connecting tubing. For tubing lengths other than 15 ft, consult Long-Line Application Guideline for
additional refrigerant requirements.
' Tube sizes are for runs up to 50 ft. For tube set over 50 ft, consult Long-Line Application Guideline.
See unit Installation Instructions for proper installation.
METERING DEVICE
OUTDOOR INDOOR
SIZE SERIES PISTON PISTON*
018 30 42 55
024 30 46 65
030 30 52 70
036 30 61 76
048 : 30 70 88
060 30 78 98
Piston shipped with outdoor unit and must be installed in approved
indoor coil.
539
· Electrical data Dime
V-PH Max MIn LRA RLA FAN FLA MCA SIZEt SlZEt IFtl.~ (Ft)~ BKR AMPS
oi~0
'"' "02~3 49,0 8.9 0.8 11.9 14 14 66 62 20
g 61.0 11.2 0.8 14.8 14 14 53 50 25
84.0 14.4 0.9 19.0 14 14 41 39 30
208/230-1 253 187 96.0 16.2 1.4 21.7 12 12 57 54 30
102.0 20.9 1.4 27.5 10 10 71 68 40
048-~0 129.0 28.7 1.4 37.3 8 8 82 78 60
I1~ 169.0 31.1 1.4 40.3 8 8 78 74 60
· Permissible limits of the voltage range at which the unit will operate satisfactorily. Operation outside these limits may result in unit failure.
1' ~f wire is applied at ambient greater than 30°C (86°F), consult Table 310-16 of the NEC (ANSI/NFPA 70).
The ampacity of non-metallic-sheathed cable (NM), trade name ROMEX, shalr be that of 60°C (140°F) conductors per NEC (ANSI/NFPA 70}
Article 336-30.
If other than uncoated (non-plated), 60 or 75°C (140 or 167°F) insulation, copper wire (solid wire for 10 AWG and smaller, stranded wire for large'
than 10 AWG) is used, consult applicable tables of the NEC (ANSI/NFPA 70).
-1: Length shown is as measured 1 way along the wire path between the unit and the service panel for a voltage drop not to exceed 2%.
· ' Time-delay fuse.
NOTES:
1. Control circuit is 24v on all units and requires external power source.
2. Copper wire must be used from service disconnect to unit.
3. All motors/compressors contain internal overload protection.
FLA -- Full Load Amps
HACR -- Heating, Air Conditioning, Refrigeration
LRA -- Locked Rotor Amps
MCA -- Minimum Circuit Amps
RLA -- Rated Load Amps
542
Combination ratings continued
ARI STANDARD RATINGS'i'
Coolln~ Heatln~l
OUTDOOR
UNIT Seasonal Efficiency
AND Factory-
SOUND Supplied Field. Supplied Seeaonai
RATtNG' INDOOR Enhance- Stendat~ Acceeeor~ HI,Ih-Tamp Low-Tamp
(dBAI UNIT TC merit Ratln~l TDR TXV TC COP TC COP HSPF
CJ5A/CK5A/CK5BN048 46,000 NONE 10.30 10.60 10.60 49,500 3.22 32,200 2.38 7.50
048-30 CJ5AICK5A/CK5BN060 47,000 NONE 10,50 10.70 10.70 49,500 3.22 32,200 2.40 7.50
CJ5NCK5NCK$BW048 46,000 NONE 10.30 10.60 10.60 49,500 3.22 32,200 2.38 7.50
CJ5A~CK5NCKSBX060 47,500 NONE 10.70 11.00 11.00 50,000 3.36 32,400 2.46 8.00
78/78 CK3BA048 46,000 NONE 10.30 10.60 10.60 49,500 3.22 32,200 2.38 7.50
CK3BA060 47,000 NONE 10,50 10.70 10.70 49,500 3.22 32,200 2.40 7.50
F(A,B)4AN(RB)060** 56,500 TDR 10.60 -- 10.80 61,000 3.26 39,500 2.40 7.60
~'~F FB4ANB070 58,000 TDR 11.00 -- 11.00 61,000 3.42 39,000 2.48 8.00 -4'
C4BN(F,B)060 56,500 TDR &TXV 10.60 -- -- 61,000 3.28 39,500 2.40 7.80
FC4BNB070 58,000 TDR & TXV 11,00 61,000 3.42 39,000 2.48 8.00
FG3AAA060 56,000 NONE 10.60 11.~0 1~.~0 59,500 3.18 38,500 2.38 7.60
FK4BNB006 57,500 TDR & TXV 11.00 -- -- 60,500 3.46 39,000 2.52 8.00
FK4CNS006 57,000 TDR & TXV 11.50 -- 60,000 3.44 38,500 2.56 8.00
CC5NCD5A/CD5BA060 54,500 NONE 10,20 10.60 1~'~0 59,000 2.98 38,000 2.30 7.20
CCSA/CD5A/CDSBW060 56,000 NONE 10.60 11.00 11.00 59,500 3.22 38,500 2.40 7.60
CD3(A,B)A06O 54,500 NONE 10,20 10.60 10.80 59,000 2.g8 38,000 2.30 7.20
CE3AA060 57,000 NONE 10,60 11.00 11.00 60,000 3.24 38,500 2.42 7.50
CJ5A/CK5A/CK5BA060 55,500 NONE 10,50 11.00 11.00 59,500 3.16 39,000 2.40 7.50
CJ5A/CK5A/CKSBN060 55,500 NONE 10,50 11.00 11.00 59,500 3.16 39,000 2.40 7.50
CJSNCK5NCKSBX060 57,000 NONE 10.60 11.00 11.00 60,000 3.28 39,000 2.46 7.70
CK3BA060 55,500 NONE 10.50 11.00 11.00 59,500 3.16 39,000 2.40 7.50
* Rating shown without/with sound hood. Sound hood is standard on 036 size.
1' Ratings are net values reflecting the effects of circulating fan heat. Supplemental electric heat is not included. Ratings are based on:
Cooling Standard: 80°F (27°C) db 67°F (19°C) wb indoor entering air temperature and 95°F (35°C) db air entering outdoor unit.
High Temperature Heating Standard: 70°F (21°C) db indoor entering air temperature and 47°F (8°C) db 43°F (6°C) wb air entering outdoor unit.
Low Temperature Heating Standard: 70°F (21 °C) db indoor entering air temperature and 17°F (-8°C) db 15°F (-11°C) wb air entering outdoor
unit.
~ In most cases, only 1 method should be used to achieve TDR function. Using more than 1 method in a system may cause degradation in perfor-
mance. Use either the accessory Time-Delay Relay KAATD0101TDR or a furnace equipped with TDR. All Carrier furnaces are equipped with TDR
except for the 58GFA. Requires hard shutoff TXV; based on computer simulation.
** Outdoor section/indoor section combination tested in accordance with DOE test procedures for heat pumps. Ratings for other combinations are
determined under DOE computer simulation procedures.
COP -- Coefficient of Performance
HSPF -- Heating Seasonal Performance Factor
TC -- Total Capacity (Btuh)
TDR -- Time-Delay Relay
TXV -- ThermostaYm Expansion Valve
]!
547
FA4A~
Product ~ · FB4A
FC4B.
Data Direct Exl_pansion ~
'~ ,ran Coil"
'Sizes 018 thru 070
Air Handling Technology At
Its Finest' ..
Cawier's FA4A,']F~4A' a~d FC~B
direct expa~sioa m~/fipoise
sp~, a~c, u~H~ ~ or clout.
~1 u~ come ~ mHd*s~ ".
wi~ ~ R v~ue of 4.2,
m~s~ mo~n, ~d ~y wc~b~
coils, U~ c~ ~
or field*ins~ h~ ~m 3
' 30 ~w. '
~e FA4A is'~ ~i~u~
co~c~on (~C) m~l in
~e-up. It is arable ~ or
n~. It ~ ~ em~s~
g~v~ s~l ~ing, 2-s~
moto~ ~ 018 ~Sh 036
~d 3-s~ motor ~ ~2 ~u~
~ s~S. ~e FA4A is ~p~
~e ~4A is ~ s~ of
~ fm ~ It ~s ~ a
wi~ fo~-f~ ~s~a~0n md
3-s~ motor ~ ~e ~ ~ge of s~s
~uip~ wi~ ~ Acc~mr
~vi~ ~d ~ ~so ~p~ ~.a
cl~ble, ~e~t ~ ~1~...
~e FC4B is ~e ~l~e d~i~
· e f~ coil ~up. It ~
~on, it has a h~ shutoff ·
~e~os~c,~sion ~ve
v~ves for mve~ow b~
~spabili~, ~ FC4B is av~labl~
s~s 024 ~ough ~0.
Accessory,. D~onn~ot YdtKits Description Suggested and Required Use
~ ~ ia used to disconnect electz~caJ ~ ~ ~ f~ coil ~o ~ ~ ~n~ ~y ~ ~ffo~ ~ly.
SU~ USE: ~4, ~,~ FA4 ~U f~ 3~ ~ugh 10~ el~c ~sis~nce ~a~n ~d c~Ung connh,
~ US~t ~ ~t =t ~ ~ w~v~ F~, ~4, ~ FA4 f= co~s = u~ in downflow appfica~o~,
~U~ U~ ~ ~t = ~ ~ w=~ ~. ~, ~ FA4 r= coils = u~ in down,ow app~cadw.
~U~ USE: FA4A m~ ~ wi~t ~c ~. '
FA~ORY ~STALL~ ~R O~IONS
10
Accessory electric' heaters . '
I~ERNAL
' ' H~T~ KW CIRCU~ F~ COIL ~ H~O
~ N~ ~ ~V ~L~ KWIST~E PR~E~N US~ W~ ~ ~V
KF~I ~ 8 23~1 8 Nonet 01 ~70 ~,1
~ N10 10 23~1 10 Nonet 01 ~70 31
~1~ 20 23~1 10, 10 Fuse 03~70 ~,~
~A~1~18 18 23~ 6, 6, 6 Nonet ~2~70 ~,~
KF~I~I ~ 24 23~* 8, 8, 8 Fuse ~, ~, 070 78,3~
KFA~I ~1 C10 10 2~1 10 Ciruuil Bre~ 01 ~70 31
KFA~I ~ 9 ~/1 ? 3, 6 Nonet 03~70 28,2~
~1F15 15 ~1 5, 10 Fuse 02~70 47,1~
~1815 15 23~1 5, I0 Fuset 02~70 47,1~
Smart, heat
I~ERNAL
H~R ~ CIRCU~ F~ COIL ~ H~NG
~ N~ ~ ~V ~L~PH KWIST~E P~E~ON ~ W~ ~ ~V
~A~I H10 10 230/1 4, 6 Nonet 01 ~36 31
KFA~1H15 15 23~1 3,8,4 Fuse 02~ 47,1~
~ m~n~n a ~im~ of 36 in, from ~e unit, Use an a~sso~ ~wntlow base to maintain proof ;learan~ on ~nfl~
U~ f~9 ~om ~een du~o~ a~ unit ~ print transmission of vibration. When eJe~ric hea~r is In8~l~, u~ heat re~is~t
~r finite ~or ~een du~rk ~ unit at di~harge ~nn~ion. Du~ork ~ssing through u~ndidoned s~ must ~ i~la~
SHOEMAKER 350 SERIES FLOOR REGISTERS
Oode De~ioa Ust
SHO 350 21/4 10 2 1/4' x 10' $7.89
$HO 350 21/4 12 2 1/4' x 12' 8.13
SHO 350 2114 14 2 114' x 14' 8.81
$HO 350 4 10 4' xl0' 6.81
SHO 350 4 12 4' x12' 8.09
SHO 350 4 14' 4' x14' 10.45
SHO 3504 8 4'x8" 8.97
SHO 350 6 10 6' X 10' 12.58
SHO 350 6 12 6' X 12' 12.98
$HO 350 6 14 6' X 14' 13.49
~ 360~N 21/4 10 2 1/4' x 10' 7.89
$HO 350W 2114 12 2 1/4' x 12' 8.13
$HO 350W 21/4 14 2 1/4' x 14' 8.81
SHO 350W 4 10 4' xl0' 6.81
~HO 35(]W 4 12 4' x12" 8.09
$HO 350W 4 14 4' x14' 10.45
8HO 350W 6 10 6- X 10- 12.58
SI.lO 3r)0w 8 12 6' X 12' 12.98
$HO 350W 6 14 6' X 14' 13.49
...... 850 Series
Sidewall Register
· 1/2" Fan-shaped louvers
· Heavy construction - .032 prime
· All col~ponent parts, rivets, linka!
enclosed in the valve to assure tr
· Countersunk mounting holes for
matching Phillips posi-drive scre'
~ ""'~'~tandard - Steel Multi-shutter da
~ ~- 1/2
,.nj[FI ] i ~,,~IxX\\\,i"ii////×,,.,.--r o Foam Gasket
--:~ N0'I~L -1/" ~ ~1 - ,~,~ +, */~ ~ ' Steel Opposed Blade Damper (8
,o,,~,~ +, ~/~ · Finishes B, C* & D (see page I)
For Pricing see Page P5. For Engineering and Complete Pedormance Data see page E14.
RIO
CLALLAM COUNTY DRAINAGE DESIGN [ ZENOVIC & ASSOCIATES
PROJECT: derry Nichols & Dan Gase 519 S, PEABODY SUITE #22
Caldwell Banker- Front St (between WA & Chambers) PORT ANGELES, WA 98362
PARCEL NO: DATE: 9/24/2003
JOB NO. 03242
AUTHOR: KC
Mean Recurrence Interval = 2 Years
Rainfall Duration (T) = 30 Minutes
Design City = Port Angeles
I = 0.711 Inches/Hour = m/(T^n)
m = 4.310
n -'-- 0.530
BEFORE DEVELOPMENT RUNOFF
AREA ACRE COEFF.'
SQ. FT. "A .... C" Q=C*I*A
1 Pasture <2% slope 21000 0.482 0.25 0.086
0.000 0.00 0.000
0.000 0.00 0.000
0.000 0.00 0.000
TOTALS 21000 0.482 0.086 CFS
* = INCREASED 10% FOR 25 YEAR STORM (.90 MAX./
~,FTER DEVELOPMENT RUNOFF
AREA ACRE COEFF.*
SQ. FT. "A .... C" Q=C*I*A
1 Office Building & Porte Cochere 5798 0.133 0.900 0.085
2 Paved Parking & Sidewalks 12168 0.279 0.900 0.179
3 Landscaping 3034 0.070 0,100 0.005
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
TOTALS 21000 0.482 0.269 CFS
· = INCREASED 10% FOR 25 YEAR STORM (,90 MAX,)
iNCREASE IN SITE RUNOFF = 0.183
ALLOWABLE = 10 % 0.009 CFS
REQUIRED ON SITE RETENTION/DISPOSAL = 0.175 CFS
REQUIRED VOLUME FOR 30 MIN. STORM = 314 CU. FT.
RUNOFF COLLECTED TO MEET REQUIREMENT % CONTROLLED
AREA CONTROL Q=C*I*A RUNOFF
1 Office Building & Porte Cochere 5798 100.00% 0.085 0.085
2 Paved Parking & Sidewalks 12168 100.00% 0.179 0.179
3 Landscaping 3034 100.00% 0.005 0.005
0.00% 0.000 0.000
0.00% 0.000 0.000
0.00% 0.000 0.000
0.00% 0.000 0.000
21000 0.2687 CFS
CaldwellBanker-2yr.xls Page 1 of 2 Intensity
[:)ETENTION TRENCH/PIPE
TRENCH DIMENSIONS
WIDTH = 0 FT.
DEPTH = 0 IN. = 0 FT
ROCK VOID RATIO = 0
PIPE DIMENSIONS
PIPE DIAMETER = 30 IN. = 2.5 FT
P~PE # 1 AREA tL.F. = 4.909 SQ. FT.
PIPE #2 AREA/L.F. = 0.000 SQ, FT.
ROCK VOID AREA/L.F, = 0.00 SQ. FT.
TOTAL VOID PER LF. = 4.909 SQ. FT.
ESTIMATED TRENCH / PIPE LENGTH = 64 FT.
CaldwellBanker-2yr.xls Pago 2 of 2 Intensity
CLALLAM COUNTY DRAINAGE DESIGN I ZENOVIC & ASSOCIATES
PROJECT: Jerry Nichols & Dan Case 519 S~ PEABODY SUITE #22
LOCATION: Caldwell Banker- Front St (between WA & Chambers) PORT ANGELES, WA 98362
PARCEL NO: DATE: 9/24/2003
JOB NO. 03242
AUTHOR: KC
Mean Recurrence Interval = 25 Years
Raie~al~ Duration (T) = 30 Minutes
Design City = Port Angeles
1 = 1.207 Inches/Hour = m/(TAn)
m = 7.370
n = 0.532
BEFORE DEVELOPMENT RUNOFF
AREA ACRE COEFF.*
SQ. FT. "A .... C" Q=C*I*A
1 Pasture <2% slope 21000 0.482 0.275 0.160
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0 0.000 0.000 0.000
TOTALS 21000 0.482 0.160 CFS
* = INCREASED 10% FOR 25 YEAR STORM (.90 MAX.)
AFTER DEVELOPMENT RUNOFF
AREA ACRE COEFF.*
SQ. FT. "A" "C" Q=C*I*A
1 Office Building & Porte Cochere 5798 0.133 0,900 0.145
2 Paved Parking & Sidewalks 12168 0.279 0.900 0.303
3 Landscaping 3034 0.070 0.110 0.009
0,000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
TOTALS 21000 0.482 0.457 CFS
* = INCREASED 10% FOR 25 YEAR STORM (.90 MAX.)
INCREASE IN SITE RUNOFF = 0.297
ALLOWABLE = 10 % 0.016 CFS
REQUIRED ON SITE RETENTION/DISPOSAL = 0.281 CFS
REQUIRED VOLUME FOR 30 MIN. STORM = 506 CU. FT.
:IUNOFF COLLECTED TO MEET REQUIREMENT % CONTROLLED
AREA CONTROL Q=C*I'A RUNOFF
1 Office Building & Porle Cochere 5798 100.00% 0.145 0.145
2 Paved Parking & Sidewalks 12168 100.00% 0.303 0.303
3 Landscaping 3034 100.00% 0.009 0.009
0.00% 0.000 0.000
0.00% 0.000 0.000
0.00% 0.000 0.000
0.00% 0.000 0.000
21000 0.4572 CMS
CaldwellBanker.25yr.xls Page 1 of 2 Intensity
:)RIFICE #1
2 YEAR STORM Head 1.490 17,88"
FLOWRATE (Q1) =I~CFS
ORIFICE #1 DIAMETER :~IN. -->USE[ 1,625]1N, ORIFICE
3RIFICE #2 1-5/8"
25 YR STORM
H2 (TOTAL HEIGHT ABOVE ORIFICE #1) = ~FT.
FLOWRATE (Q out 2yr orifice) =~CFS
FLOWRATE (Q out 25yr orifice) =~CFS
H25(HEIGHT ABOVE ORIFICE #2) ~
ORIFICE #2 DIAMETER =~IN. -->USEI 1.50OliN. ORIFICE
~ET£NTION TRENCH/PiPE
TRENCH DIMENSIONS
WIDTH = 0 FT.
DEPTH = 0 tN. = 0 FT
ROCK VOID RATIO = 0
PiPE DIMENSIONS
PIPE DIAMETER = 30 IN. = 2.5 FT
PIPE # 1 AREA/L.F. = 4.909 SQ. FT.
PIPE #2 AREA/L.F, = 0,000 SQ. FT.
ROCK VOID AREA/L.F. = 0.00 SQ. FT.
TOTAL VOID PER L.F. = 4.91 SQ. FT.
ESTIMATED TRENCH I PiPE LENGTH = 103 FT.
CaldwelIBanker-25yr.xls Page 2 of 2 Intensity
~ .... CiTY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Applicat ion Nunber ..... 03-00001092 Date 12/23/03
Property Address ...... 1115 g FRONT ST
ASSESSOR pARCEL NUMBER: 06-30-O0-S-l-0445-O000-
Application description . . . CO~94 NEW CONST
Subdivision Name ......
Property aoning ....... COMMERCIAL ARTERIAL
Application valuation .... 589610
Owner Contractor
GA~E NICHOLS PROPERTIES LBR CONSTRUCTION
330 E ERO~T ST 618 SO PEABODY
PORT ANUELES WA 983620104 PORT ANGELES WA 98362
( 36} 452-5403 (360) 452-1232
...... Stz~cture Information NEW S531SF OFFICE BLDG
ConstIuction Type ..... TYPE v NON-P~TED
Occupancy Type ...... BUS INES S: OFF/PRO/MHD/REST
Other struct info ..... TOTAL % LOT COVERAGE 24.00
CONSTRUCTION TYPE V-N
NUMBER OF STORIES 2.00
EXISTING LOT COVERAGE 1.00
LOT SIZE 21000.00
PROPOSED LOT COV~RAGE 5058.00
Permit ...... ELECTRICAL TEMPORARY SERVICE
Additional desc. .
Sub Contractor . . SHAMP ELECTRICAL C0~TRACTING
Permit Fee .... 40.90 Plan Check Fee . . .00
Issue Date .... 12/23/03 Valuation .... 0
Expiration E~te . . 6/21/04
Qty Unit Charge Per ~xt ensign
1.00 40.9000 ECH EL-T~MP SRV - 0-60 SRV FOR 40.90
............................................................................Addressi~,.~~trastAddressSpecial Notes numbers numberSin and color shallShallC°mments of be be there plainly a minimum background.visible of six frOminches the high street.and be
Other Fee~ ......... STATE SURCHARGE 4.50
_ Fee suna~ary Charged Paid Credited Due
Permit Fee Total 40.90 40.90 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 45,40 45.40 ,00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, E SA, ulilities, 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 a~ler the work as commenced, or Jf 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 hereio or not. The 9ranting of a permit does not
presume tq.~y~e ,~u. tl~. '~t~40 violate or cancel the provisions of any state or local law regulating construction or the performance of
construction."' - ' ' ,
Signat~E~_{Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING~FOKMS\1102.15 ii 1/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOP, BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 I DATE I¥~ACCEPTEDI NO COMMENTS
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (L1GHT DEPT) SEPAKATE PERNHT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
BACK FLOW ! WATER
AIR SEAL
MING
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number ..... 03-00000632 Date 7/02/03
PrOperty Address ...... 1115 E FRONT ST
ASSESSOR ~ARCEL NUMBER: 06-30-00-8-1-0445-0000-
Application description . . . DEMOLITION
SubdivisionName
Property Zoning .......
Application valuation .... 1750
Owner Contractor
...... Str~cture Information D~MO EXISTING OFFICE .....
Occupancy Type ...... BUSINEEE:OFF/PRO/M~D/REST
Additional desc.
Expiration Date . . 12/29/03
Qty Unit Charge Per ExtEnsion
Fee ~ummary Charged Paid credited Due
Pla~ Check Total .00 .00 ,00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
nuJJ and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended Dr 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 cer[ify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNING\FORMS\1102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-481 $ FOR BUILDING INSPECTIONS~ PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE, ITI$ UNL,4 WFUL TO COVER,
[NSUL.~ITE OR CONCEA£ ~!NY WORK BEFORE INSPECTED AND ~iCCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ] ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
FRAMING
}OISTS / 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 (Englnccdng Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORJM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKINGtLIGHTING ESA:
LANBSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEFT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - RW.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 4[7 4750 PLANNING DEPT.
BUILDING 417-4815 /~ff)-~'-~ j~'~ff BUILDING
T:\PLANN INGWORMS\ 1102.15 [4/2002]
~,,.~.¢ '~'~ CITY OF PORT ANGELES
~----~" DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number ..... 03-00000630 Date ?/02/03
Property Address ...... 1113 E FRONT aT
~SESSOR PJ~CEL I~ER~ 06-30-00-8-1-0440-0000-
Application description . . . DEMOLITION
Subdivision Name ......
Property Zoning,. ......
Application valuation .... 1750
Owner Contractor
03%SE-NICHOLS PROPERTIES DON LOVE TRUCKING
930 ~ laT 431 LISEL LANE
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360i 452-5403 (360) 457-4071
...... Structure Information DEMO EXISTING OFFICE .....
Construction Type ..... TYPE V NON-RATED
OccuDancy Type ...... BUSINESS:OFF/PRO/MED/REST
Permit ...... DEMOLITION
Additional desc , .
Permit Fee .... 47.00 Plan Check Pee. . .00
Issue Date .... 7/02/03 Valuation .... 0
Expiration Date . . 12/29/03
Qty unit Charge Per Extension
BASE FEE 47.00
Fee ~uanmary Charged Paid Credited Due
Per~it Fee Total 47.00 47.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 47.00 47.00 .00 .00
T
Separate Permits are required for electrical work, SEPA, Shoreline, E SA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
o/¢
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4515 FOR BUILDING iNSPECTION S. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEA£ ~4NY WORK BEEORE INSPECTED AND ACCEPTED, POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE I DATE IYEsACCEPTEDI NO COMMENTS
FOUNDATION:
FOOTINGS
WALLS
FOUNDATIO~q DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
PINAL INSPECTIONS REQU1RED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL BATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERJNG 417-4807 PW / ENGINEE RING
FIRE 417-4653 FIRE DEPT.
PLANq'qlNG DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 v~' BUILDING
T:\PLANNING\FORMS\1102.15 [4/2002]
FOR OFFICIAL USE ONLY:
BUILDING PERMIT - APPLICATION Date Rec.:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE Date Approved: "~ - t ~(~'~
COMPLETE to be accepted for review. If you have any questions, call Date Issued:
(360) 417-4815
'" / ' * Phone: ¢
Owner: .
' ~ ~ ~ ~ ~f~'/ ~ Zip'
Address: ~ O ~, ¢,'~ ~A4~ CiW:(~P ~,d0
~chitecffEngineer:
Phone:
('g~ ~, ) r ....
/
LEGAL DESC~TION: Lot: Block:~ Subdivision:
CLALL~CO~P~CEL ~BER: 063o 10 q
Credit Card .older Name: ~
BillingAddress:33o ~ ~,,~ s~ City: ~t~ i!~f~/~,
Credit CardType VISA ~ MC g ?~g-- G0 3/-,~O3g ~6 2~ '
Exp. Date:
TYPE OF WO~: SIZE~UATION:
~ Residential ~ New Cons~. ~ Re-roof ~ Stove SF. ~ $ /SF. - $
~ Multi-truly ~ Addition ~ Move ~ Garage SF. ~ $ /SF. = $
U Comercial ~ Remodel ~Demolition u Deck SF. ~ $ /SF. = $
D Repak ~ Si~ ~ Other TOTAL VALUATION $
COg~CI~/~SI~E~TI~: Occupancy Oroup: Occupant Eoad: __ Cons~ction T~e:
No. of Stories: Lot Size: Existing Sq. Ft. & Proposed Sq. Ft. = TOTAL Sq.~t.
Existing lot coverage ~ % & Proposed lot coverage % = Total lot coverage_
APPROVES:
BLDG:
DPt:
FI~:
ES~Wetland(s): = Yes ~ ~o SEPA Checklist required? ~ Yes Q ~o Other:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application ant
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewer
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 o:
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that / have read and examined this application and know the s~me to be tree and correct. I om authorized to apply for this permit ant
understand that it is my responsibility to determine what permits are required/d'c~ the City~, and that I must obtain such permits prior to work,
Notification of Demolition Permit
It b unhwfal for mty person to ,.-use or tilow the demolition (or major renovation) of any structure unle~ all asbestos.
eonMfnlnf nmterbb have ben removed f~om the area to be demolbbed. Wor~ almJl not cammenee on an atbeat~ pro, Jeet
or d~molition ubs the owner or operator kns obtained written tppruval feom ORCAA. A vfl-~Xeu ipplieatiou for ·
demolition disll Include a certification that thet, e b no known ~b~too. eonttlninf mt~rbd remafnin; in the meca of the
at~tture.
..... '
Pro.p..erty Owner: cq~ /~.~ Telephoue~~
City: ~" ~cc[~,-3~ State:. ~0~ Zip:~_.
Demolitlon Contractor. ~ .. r,~ c~nse #: I . · ~ ~ . ~.
ci,: ~,,Y'~,~/~, ,, ~_/~/_
YES NO ~~/~......_,
..... ~ 'Demolition by Wrecking or Dismantling? ($25.00 f~) check #.
. ~ Training F~re Demolition? (If y~, attach fir~ department r~que~t for tmlnlng fire)
Renov~on, ^Iteration, Remodeling, Maintenance, or oth*r Constm?tlon?
, Asbestos found or suspected*
*An ORCAA "Notice of Intent to Rffnove or Er~,,~mlate Ad~to~* form and et,~,,priate fcc must bc submi~d ~or to any asbestos
removal work. Asbe~os removal l~.~s tflvotv~ng demolition mus~ be preformed by a Certffie~l Asb~o~ Couuan~r a~d all friab~
fxt. efltiaHy friable asbesto~ mus~ b~ removed befor~ any d~molRiofl begins. Refer to O~CA^ Rc~ulation I A~¢lc 1,~ for a~lifioml
F~lu~fcmcn~e tha~ may apl~y.
Asbestos Stu-~ey Completed by
AHERA Certified InsPeCtor /~0~ ~/'~/.//~°~/~r ~
Ce~n~flo~ # /.,0 /t ~0,4 - oo q z -o F_~ .......
"' I'" "" "'
[ be available at the job site Proee~ming Fee accompany this form
2940 B Limited Laae NW, Olympia, Wa~hingnoa
360-586-1044 * 800-422-3623 ' fax360-491-6308
homepage: www.orcaa, org * ertmil:
Rev 07/1
Northwest Asbestos Consultants
406 Reed St.
Port Townsend, WA 98368
360-385-0584
huggybear~olympus.net
Date: 6/18/03
~ 1113 E. Front St.
Port Angeles, WA 98362
Owner: Daniel E. Gase
Jerry Nichols
Coldwell Banker
330 E. First St. Suite 1
Port Angeles, WA 98362
Contacts: Zenovic and Associates, Inc.
Tmcy Gudgel, P.E.
519 S. Peabody St.
Port Angeles, WA 98362
~ Bob Witheridge
AHERA - Building inspector / Management Planner
WAMOA- 0042-02
Expires- 11/1/03
1) Inspect for asbestos containing building materials (ACBM).
2) Survey, sample and record suspect materials.
3) Report to Daniel Gase and Jerry Nichols from Coldwell Banker and
Tracy Gudgel of Zenovic and Associates, Inc. with results of testing by
Clayton Services.
4) Copies for owners, City of Port Angeles, Olympic Region Clean Air
Agency and on site for demolition.
The inspection started with a visual survey looking for Asbestos
Containing Building Material (ACBM).
The suspect material was:
~t~agz!.edL~ Ceiling tile
Sample was sent to lab, See results.
ASBESTOS BULK SAMPLE DATA
Northwest Asbestos Consultants
406 Reed St.
Port Townsend, WA 98368
360-385-0584
huggybear~olympus.net
To Clayton Services
Date: 6/9/03
~ 1113 E. Front St.
Port Angeles, WA 98362
~ Zenovic and Associates, Inc.
Tracy Gudgel, P.E.
$19 S. Peabody St.
Port Angeles, WA 98362
Daniel E. Case
Coldwell Banker
330 E. First St. Suite 1
Port Angeles, WA 98362
Ceiling tile
~ Bob Witheridge
AHERA - Building inspector / Management Planner
WAMOA- 0042-02
Expires - ! 1/01/03
Please call with test results when completed.
Thank you,
Bob Witheridge, EFM
J[JN-iB-2~03 09:~8 CLAYTON GROUP SERU!CES 206?654189
Clayton Group Se~lces ...... L~FAX ( Attention: ~ob Witheridge
Client: No~hwestAsbestos ConsuLtants Logo 34218
Loca~oa: 1113 E. Front St., Port Angeles, WA 98362 ,to~ / po ~
S~PLE g:l ~1Ig,1 SAMPLE LOCATION:NO~ G~
sOuRC~: Ceiling TBe
No Asbestos Detected Layers Homo~en~d for A~al~i~ ....
LAYERED
Asbestos .Asb~to~ o~ fi~rs, flbe~ j componeu~ uonfibrous
Cellulose 80 ~ & Binder
Paint t 2
~ote:
PRELIMINARY REPORT ^NALYZ~D BY:
£abo~tory Deta Shett ls fo~ lab use gnd f~ing only, ~ e final repo~ ~dl fo~o~ m the mail, ~ude
Verlfl~ by: .~ ~' ~ ON
Summary_ of Inspection:
This survey includes all areas of inspection with the report results from
Clayton Environmental Testing Labs.
Sample results are as follows:
~ Ceiling tile was found to be of non asbestos material.
This report is not a guarantee that all suspect of A.C.B.M. were found. The
possibility of concealed material exist and may be found during demolition.
Feel free to contact me if I can be of further assistance.
Thank you,
Bob Witheridge, E.F.M.
WASHINGTON
ASSOCIATION o!
MAINTENANCE and
OPERATIONS
ADMINISTRATORS
THIS IS TO CERTIFY THAT
Bob Witheridge
Participated in the
EPA AHERA
BUILDING INSPECTION I MANAGEMENT
PLANNER
Refresher course offered by the
WASHINGTON ASSOCIATION of MAINTENANCE
and OPERATIONS ADMINISTRATORS
The full day training program
covered all topics specified in the
Model Accreditation Plan under
Section 206 of Title II of TSCA
The refresher course was taken on November 1, 2002
In Silverdale, Washington.
in combination with the Individual's initial certification, this certificate extends
accreditation for the above named person through '~'~/0'~/03
WAMOA-O042-02 ~
Certificate Number Colin MacRae Course Administrator
Notification of Demolition Permit
It is unlawful for any person to cause or allow the demolition (or major renovation) of any ~trueture unless all asbestos-
containing materials have been removed from the area to be demolished. Work shall not commence on an asbestos project
or demolition unless the owner or operator has obtained written approval from ORCAA. A writ~n application for a
demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the
structure.
Project ~te Addre~: ~/J'~ ~"',~ ~"~AJ'~- ~ , Coullty:~
Starting Date: _~-~ /[r~ 2'o'~--T~ . Completion Date:
*(There is a 10 working day advance notification per/od from receipt of permit application)
State: t~, B Zip: ~
Demolition Contractor: ~/~o~ Ao~r~ _~ ~.~,.~I_ State IJcense #: (J ~.if'- ~. ~ } g
Mailin~ Address: . ~)Z fi [ /- ? X d [ /. ~ ,~ ~ v
YES NO
~ 'Demolition by Wrecking or Dismantling? ($25.00 fee) check # ~ ~
~ Training Fire Demolition? (If yes, attach £~e department request for training fire)
~' Renovation, Alteration, Remodeling, Maintenance,. or other Construction?
~x. Asbestos found or suspected*
*An ORCAA "Notice of Intent to Remove or Encapsulate Ad>estoz" form and appropriate fee must be submitled prior to any ~sbestos
removal work. Asbestoz removal projects involving demolition must be preformed by a Certified Asbestos Conhaetor and all friable or
potentially friable asbestos must be r~mov~d before any demolition begins. Refer to ORCAA Regulation ! AFdcle 14 for additional
requirements that may apply.
Asbestos Survey Completed by
AHERA Certified Inspector ./"~o Of O
Certification # ~ tt~9~O~O - OD t./Z --D 2
I'"'" "l I "" I I"
This approved permit mast Enclose $25 ~ Certification of the Asbestos Survey must
be available at the job site Processing Fee accompany this form
29qO B Limited Lane Nh3/, Olympia, Washington 98502
360-.586-I044 * 800422-3623 * fax360491~o308
homepage: ww',v~orcaaorg * emai[: info~5~orcaa.orq
Northwest Asbestos Consultants
406 Reed St.
Port Townsend, WA 98368
360-385-0584
huggybear@olympus.net
Date: 6/18/03
~ 1115 E. Front St.
Port Angeles, WA 98362
Owner. Daniel E. Gase
Jerry Nichols
Coldwell Banker
330 E. First St. Suite 1
Port Angeles, WA 98362
Contacts: Zenovlc and Associates, Inc.
Tracy Gudgel, P.E.
519 S. Peabody St.
Port Angeles, WA 98362
~ Bob Witheridge
AHERA - Building inspector / Management Planner
WAMOA- 0042-02
Expires - 11/1/03
1) Inspect for asbestos containing building materials (ACBM).
2) Survey, sample and record suspect materials.
3) Report to Daniel Gase and Jerry Nichols from Coldwell Banker and
Tracy Gudgel of Zenovic and Associates, Inc. with results of testing by
Clayton Services.
4) Copies for owners, City of Port Angeles, Olympic Region Clean Air
Agency and on site for demolition.
The inspection started with a visual survey looking for Asbestos
Containing Building Material (ACBM).
Sample results are as follows:
~3~21l[fldLl~ Living room 9"x9" floor tile with mastic. Shades of brown.
~ Kitchen floor vinyl with mastic. Red, black and cream.
F:~allltl.e._~_~ Bedroom floor vinyl with mastic. Top layer. Brown, gold.
SalIllzle,._g_~ Laundry room floor vinyl with mastic. Multi shades of brown.
~ Attic insulation. Red fiber material.
Sample was sent to lab. See results.
ASBESTOS BULK SAMPLE DATA
Northwest Asbestos Consultants
406 Reed St.
Port Townsend, WA 98368
360-385-0584
huggybear~olympus.net
To Clayton Services
Date: 6/9/03
lob Location: 1115 E. Front St.
Port Angeles, WA 98362
Owner: Daniel E. Gase
Jerry Nichols
Coldwell Banker
330 E. First St. Suite 1
Port Angeles, WA 98362
Contacc~; Zenovic and Associates, Inc.
Tracy Gudgel, P.E.
519 S. Peabody St.
Port Angeles, WA 98362
SallxI2l.e,_~ Living room 9"x9" floor tile with mastic. Shades of brown.
~ Kitchen floor vinyl with mastic. Red, black and cream.
~ Bedroom floor vinyl with mastic. Top layer. Brown, gold.
~ Laundry room floor vinyl with mastic. Multi shades of brown.
Sanlp. le~_~ Attic insulation. Red fiber material.
Inspector; Bob Witheridge
AHERA - Building inspector / Management Planner
WAMOA - 0042-02
Expires - 11/01/03
Please call with test results when completed.
Thank you,
Bob Witherid~e. EFM
JtJN~ 18-2003 08:47 CLAYTON GROUP SERb~_~CES ~676~41~9 P. 01
ClaTton Group se~iee~ L~ (' A~e~tion: Bob Witheridge
Client: No~hwest Asbestos Consulters Log ~ 342'17 '
L~ation: Ili5 E. Fron~ St, Port ~geles, WA 98362 Job / ~o ~
SAMPLE g:l 34217AA SAMPLE LOCATION~ Living Room
SOURCE:
LAYE~D S~MPLE: ~SH~ and AHE~ r~lattons require lavers be analyzed and repo~d separately~
- ~o .~beato~ Detected LAiR 1
Asbestos Asbestos ~ fiber~ ..... ~ben components aoaflbroa~ %
Cellulose ~ -~iller & Binder ...... ~'5 '~
! Description: Tae mastic
Note:.
SA1VI~LE ~:1 34217,1B SAMPLE LOCATION:LIving Room
SOURCE: 9'X9" Floor Tile
~o Asbestos Detected LAYER 2 .......
non-asbestos '~{ sen fibrous
._As_.besto~_. Asbestos % ,qbe,,__. nben__ components .onnbrous % !
Asphalt Filler & Bin&r 40
I Vinyl ~Fille:' and Binde~ 30
i Description: Tan vinyl wi~h fibrous black asphalllc fibrous material
Note:
SAMPLE #:1 .......
34217.1C SAMPLE LOCATION;Living Room ')
No ~bestos Detected
non-asb~tos
Cellulo~ 6 Fill~ & BiM~r
I Description: Brown mastic
[ N'ote: ..........
PR. ELLMINARY REPORT ANALYZED
Lgborator), D~a She~r is for lab u.ve and ftw. lng only, 2r~¢ fin~l nrpon ~ill follaw in the m~ Jud~ Cu~mg~
~UN-18-2003 0~:48 CLAYTON GROUP SERU!CES 2067634189
Cla~n Gronp Se~ces L~F~ ~ Attention: Bob Witheridge
C~ent: Northwest~b~tos ConsuLtants Log~ 34217
Loca~on: 1115 E, Front SL, Po~ Angeles, WA 98362 Job / ~o ~
SAMPLE ~:$ 3nal?.2A SAM pLE L~ATION: Kitchen
SOURCE:
LA~D S~LE: NES~P and ~ reg~ations require layers be anal~d and reported separat~y.
~b~tos / Asbestos % fibers ~e~ component~ nonfib~u~ %
~ ................ }'C~i~i~]C .............. ~ ~i~% ai~d=~ ...... ~7 ........
Deacription: Tan mastic
Note:
SAMPLE ~,:2 34217,~B ~MPLE L~ATION:KIt~hen
SOURCE: ~oor Vinyl
No ~be~Det~ LA~R 2
--
Asbestos Asbestos °/o . ~ .... fibers compo_nents
Ceilulosc 30 Aaphalt Fi{let & Binder
Vinyl FiUcr and Binder
{ D.eriptiuu: Multi-colored vinyl with black aaphalZ{c fibrous backio~
Note:
SAMPLE #:2 34217.gC SAMPLE LOCATION: Kitchen
SOURCE: Mastic
........ No Asbestos Detected L~,Y~'~-
...... non-asbestos 5/~ other i nonfibrous
Asbestos Asbestos o,,~ fib#rs fibers ~ components nonfibr'o~s %
..................... C~ii~ ..... 12 Fiiier &'Binder --- ~S ........
I Description: Brow~ and blue mastic
PRELIMINARY REPORT ANALYZED BY;
Lnboratory Data Sheet is for lab use a#d faxing only. Th~ flnM report will follow in the ma~l. ~udeC~s
V~fi~by: ~ ~' ~ O~
JUN-18-2~03 .~)8:48 CLATTON GROUP SERL)ICES 2~67654189 P.03
LABF-~ ~" A~en~on: Bob Witheridge
Clayton
Group
Se~jces
CUent: No.west ~bestos Consultants Log ~ 34217
Location: 1115 E. Front St., Po~ ~geles, WA 98362 zo~ / Po ~
/'~ ~L~: ..........
SAMPLE ~:3 34Zl%3A SAMPLE L~ATION~ Bedroom, ~op layer
SOURCE:
~LA~ S~LE: NgSR~ and ~g~ regulatioas require l~yer~ be analyzed and reported separately.
[ No ~bestos Detected LAiR ~
~bcstOs
Asbestos
%
- CelluIoac 4 ~i[[er & Binder 96
i DescriptIon: Tan mastic
Nete:
" SAMPLE #:3 34~1~ SAMPLE LO~TIO~ ~dr~om, Top lay*r
$O~CE: ~oor Vinyl
No ~bestos De~cted ~YER 2
-- non-a~be~tos --% other nonfibrous
] ~ nonfibrous
flbera _~_ components
Asbestos Asbestos °/o ~ cvjl~o~ _fib,ers .....
:Vmy F,Iler md Bmd~
~sc~pflon: Va~0us colom of vinyl wi~ black fibrous a~baffic material and r~ coating
Note:
5~LE ~4 34217.4A SAMPLE L~ATION:Laund~ Room
SOURCE: ~r
LA~D g~ N~SH~ ~d .~ regulafio~ require layers be analyz~ and reported separately.
~o ~bestos Deteet~ ....... ~ Ln~R 1
....... o/~ n~n-a~b~os ~ °~er ~ nonflbrous
Asbestos Asbestos nbe~ ~fibe~ com~n~ ~ uonflbrous
I D~cripfion: Rgd, wh}t* and b~ck material with whltewovea ~bers
Note:
labor~o~ D~a Sh~ ~ for lab us* and f~ing one. The flnM report will follow in the mail Jade Cummings
~,~ ~,, ~ ON 6/17/2003
V~ed by:
JUN-18-208~ 88:48 CLAYTON GROUP SERUICES 206~Z6~4:L89 P,04
Client: Northwes~ Asbestoz Consul~nts Log ~" ~4217
Loca~on: 1115 E. Front S~, Port Angeles, WA 98362
SAMPLE LOCATION: Laund~ Room
SOURCE ~ ~oor Vinyl
.... N 'e~cted - '
o .~bestos D } ~R Z
........ ~ "~n-~sbgs~o~ % ot~er ~ non~bro~s
Asbestos ~ ~bestos °/o fibeo ._ flbe~ [ componenls, no,fibrous %
~vi~y! Filler ~d Binder
' .......................... D~eflp~on: MHht-c01o~ v~yI with black ~ph$1tic Ilbroas bae~g iai m~fie _
Note;
SAMPLE ~ ~ll~,~ SAMPLE L~ATION:A~
SO.CE ~ l~ulstion
No Asbestos Det~d ~
I HOMOGENEOUS
~' no~-~bestos ~ o~er nonf~ rous
Asbestos ~bestos °/o fiheo_ ........ ~[ fibe~ compononts ~onflb~us %
Cellulo~ 93 Mi~ell~eo~s Pa~iales
Filler & Bind~
Description: Red fibrous material
Note:
PRELIAIINARy P~PORT ANALYZED
L~tboratory l)attt Sheet is for lab use and faxing only. The final report witl follo~, in the :~ail, Jude Cummings
Verified lay: . ~.~,.;~ 0.-, O_~ =, ~ ON 6/17/2003
Summary of Inspection:
This survey includes all areas of inspection with the report results from
Clayton Environmental Testing Labs.
All samples were found to be of non asbestos material.
~ Living room 9"x9" floor tile with mastic. Shades of brown.
~ Kitchen floor vinyl with mastic. Red, black and cream.
~ Bedroom floor vinyl with mastic. Top layer. Brown, gold.
~ Laundry room floor vinyl with mastic. Multi shades of brown.
Si~rtP_l.¢__~ Attic insulation. Red fiber material.
This report is not a guarantee that all suspect of A.C.B.M. were found. The
possibility of concealed material exist and may be found during demolition.
Feel free to contact me if I can be of further assistance.
Thank you,
Bob Wither~dge, E.F.M.
ASSOCIATION of
MAINTENANCE and L. , r
OPERATIONS ~ .' ~,~ .......
ADMINISTRATORS
THIS IS TO CERTIFY THAT
Bob Witheridge
Participated in the
EPA AHE~
BUILDING
Refresher
WASHINGTON
and
The full day training p, ~r~gram
covered all topicshe
Model
Section 2~ of
The refresher coume wa~ taken on November 1, 2002
In Sllv®rdale, Washl~.
In combination with the Individual's initial certification, this certificate extends
accreditation for the above named person through 1'1101103
WAMOA-O042-02
Certificate Number
~l~orat~prles~. inc. CHAIN of CUSTODY BATCH ID
lei' 206547 01~ E~rg, Pa~ ~.~4,1878
Ca~ Zeno~c & ~iates~ Inc. ~ ~h N~ ~ ~.
3
14 {
TOTAL P.~3
J 4708 Aurora Ave. N., Seattle, WA 91~103 ~ ~ ~-~ :~:AIHIk ~
~Tel: 206'547 0100, Fax: 206,.6-34~1936 - AI~ - IH COR~DITE
Lead (Pb) TCLP
c~: 'Z~ & ~ci~ I~ Batch ~: 2307672.00
Address: 519 So~ Pea~Gy Street, Suite 4 Ma~x: TCLP
Po~ Angeles Method: EPA 131117000B
A~ntion: Mr. Tra~ Gudgel . ~l~nt Proje~ ~:03116
Project L~etion: 1113 & 1115 E, F~nt SI. Po~ Angeles Sampl~ Receive: 2
. Tot~ ~mples ~alyzed:2
~ ~ Results Resul~ in
Lab ID Client Sample ~ m~l L in m~L ppm
23051179 03166A 0,5 <0.5 ~ < 0.5
23051180 03166B 0.5 < 0.5 ~'< 0.5
Analyzed by: Holly Tuttte Date: 0611212003 --~
J
mB/L =Milligrams p~r liter RL = Reporting Limit
13bm = parts per million '<' = Be!ow the reporting Llrnil
Note: Method QC results are acceptable unless stated otherwise
Bench Run No: 23~0611~3 Page 1 of I
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application 5h~nber ..... 03-00001092 Date 2/23/04
Pin nun~er ....... 6268
Property Address ...... 1115 E FRONT ST
ASSESSOR PARCEL NL~BER: 06-30-00-8-1-0445-0000-
Application description . . . COMM NEW CONST
Subdivision Name ......
Property Use ........
Property Zoning ....... COMMERCIAL ARTERIAL
Application valuation .... 589610
O~ner Contractor
GASE NICHOLS PROPERTIES LBR CONSTRUCTION
330 E FRONT ST 618 SO PEABODY
PORT ANGELES WA 983620104 PORT ANGELES WA 98362
(36) 452 5403 (360) 452-1232
.... Structure Information NEW 8531SF OFF~CE BLDG -- -
Construction Type ..... TYPE V NON-RATED
Occupancy Type ...... BUSINESS:OFF/PRO/MED/REST
Other struct info ..... TOTAL ~ LOT COVERAGE 24,00
CONSTRUCTION TYPE V-N
HARD SURFACE AREA
NL~4BER OF STORIES 2.00
EXISTING LOT COVERJ~GE 1.00 ~.--
LOT SIZE 21000.00
PROPOSED LOT COVERAGE 6058.00
TOTAL LOT COVERAGE 5058.00 ~"
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements, This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of '180 days after the work as commenced, or if required inspections have not been requested wi/Din 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 viola~ or cancel the provisions q~ any state or local law regulating construction or the performance of
construction./ // // / /
Signatu[e/o/C Oontr, a~tor or'~,uthorized Agent / r~ate Signature----'--'~f O'--~ner (if ow------~er is bui~der'--------~ Date
/ / /
T:\P/L/ANN INGX3F CY~M S\ 14 ~)2.15 [11/14/2003]
BUILDING PE~'IIT INSPECTION RECORD ~ '~''
CALL 417-4815 FOR BUILDING iNSPECTIONS. CALL 41%4735 FOR ELECTRICAL INSPECTIONS.
PLEASE ?ROV[DE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED A.ND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
iNSPECTION TYPE BATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / KOOF / CEIL1NG
DRYWALL (INTERIOR BRACED PANEL ONLYI
T~BAR
INSULATION
SLAB I
WALL / FLOOR ! CEILING
MECHANICAL
HEAT PLrMP
GAS LINE
WOOD STOVE / PELLET / CHiMNEy
HOOD/ DUCTS
FOR OFFICIAL USE ONLY:
BUILDING PERMIT - APPLIC
I
~he Building Pe~it - ~p~lica~n mug ~d e~ ~mpl~ely. ] ~ ~:
~i~ ~ or p~t in ~ If you have ~y qumflo~ ple~e e~ 417~81~
~~~ Phone:
~G~ ~ON. ~ Block: -- Sub~:
~ ~ ~ ~ Cr~it Ca~ HoM~ N~:
~ ~: Cl~:
~t C~ ~ ~p. Daa: ~ MC
~ O~ WO~ StT. t~UA~ON:
~ M~-~y '~ ~ ~ Move o ~ge SF..~ S /SF.' $
O ~ O ~1 ~ D~hfion ~ D~k ~.~'$' ~ /SF.~$ . ,
= a TOT S
~O~C~~: Occup~y ~: ~u~t Lo~: ~ ~:
N0. of S~: ~t S~: % ~t Cov~g~: , % , ..
~ ~t ~v~gs: /~. ~ + ~sed Lot Cov~ge: /~q. fi. ~ ~T~ L~ ~GE: /~.fi
P~G U~ 0~Y: ~PROV~:
N~
D~W
,
ES~0: ~ Y~ ~ No S~A ~c~t ~ ~ Y~ ~ No 0~: O'r~,
r~i~. ~ B~ ~vb~ ~ ~ you ~ mo~ ~ ~on on ~ a~on ~ pl~ su~ ~n~.
c~l~ ~ ~i~ p~ (f~ ~) ~d bu~g com~c~on p~ ~e to be subbed ~ ~e B~ ~on.
~ ~y ~ ~ by ~ B~ai~ Di~i~ ~ ~ly ~ ~t fee schemes. Contact ~e P~t ~r at 417~815 f~ ~.
P~ c~ ~: Y~ p~ ~ f~ ~ ~ at ~c ~ ~ ~ ~t ~on ~ ~ pl~-, ~ s~ AU o~
~t f~ ~ ~ a~ ~ ~ of ~t ~s~ce.
E~ON OF P~ ~W: ~ no p~t is ~ued ~ 180 days of ~e ~ of a~cago~ ~ appU~Uoa.~ ~ ~c
Bu~ Offi~ ~ ~ ~ ~ for ~gon by ~c applic~t up to 180 days upon ~n request by ~c a~lic~t (see Secgon 107.4 of
· e U~o~ Bu~d~ C~, ~t e~on). No a~hcagon c~ bc extended more ~ once.
I h~ ~ that l ~ ~ a~ ~ :h~ appl~a~on and ~ow the ~ame to be ~e and co.ct, and I ~ au~ ~ ~p~r
th~ pe~it. I u~tand it ~ not the Ci~ legal r~po~ibili~ to dateline what pe~tU are required; It remal~ the applicant's
r~mibtlt~ w det~ine w~' P~ are required ~d t° °b~u:h' ~' r ~~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
,321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Appl1cat1on type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000478 Date
250058
1115 E FRONT ST
06-30-00-8-1-0445-0000-
MECHANICAL APPL. PERMIT
6/14/05
COMMERCIAL ARTERIAL
1000
Owner
Contractor
GASE NICHOLS PROPERTIES
330 E FRONT ST
PORT ANGELES WA 983620104
( 36) 452-5403
THURMANS SUPPLY
1807 EAST FRONT STREET
PORT ANGELES WA 98362
(360) 457-8591
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
MECHANICAL PERMIT
2 PROPANE FIREPLACES,RANGE
51987
57.65 Plan Check Fee
6/14/05 Valuation
12/11/05
.00
o
~Xp/ho~
I' l.f
Y/ II
/05
\Ji
rn
Qty Unit Charge Per
Extension,
47.00
10.65
11
7J
~
-,
BASE FEE
1.00 10.6500 ECH ME-GAS PIPE 1 TO 5
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 57.65 57.65 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 57.65 57.65 .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 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 correcf. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the proviSions of any state or local law regulating construction or the performance of
construction.
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T \Pohcles\1102_15 bUlldmg pemnt mspectlOn record05 wpd [1/4/2005]
r::1~ORT"""G'
!::.J..~~~
~r'Eiii~
'L ~
~
~<:~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number . . . .
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use . . . .
Property Zoning . . .
Application valuation
04-00000051 Date
.673546
1115 E FRONT ST
06-30-00-8-1-0445-0000-
COMM NEW CONST
2/05/04
COMMERCIAL ARTERIAL
20942
Owner
Contractor
------------------------
------------------------
~
,
'1,..
~
GASE NICHOLS PROPERTIES
330 E FRONT ST
PORT ANGELES
( 36) 452-5403
Structure Information
Construction Type . . . .
Occupancy Type . . . . .
WA 983620104
KNIGHT FIRE PROTECTION INC
2509 WEST 19TH STREET
OLYMPIA WA 98512
(360) 417-0505
2 STORY OFFICE, FIRE SPRINLKER SYSTEM
TYPE V NON-RATED
BUSINESS:OFF/PRO/MED/REST
----------------------------------------------------------------------------
Permit FIRE SPRINKLER COMM
Additional desc
Permit Fee 458.75 plan Check Fee 233.19
Issue Date 2/05/04 valuation 20942
Expiration Date 8/03/04
Qty Unit Charge Per Extension
BASE FEE 92.75
19.00 14.0000 THOU BL-2001-25K (14 PER K) 266.00
1. 00 100.0000 ECH FIRE INSPECTION & TESTING 100.00
Other Fees
STATE SURCHARGE
4.50
-
\r1
rr\
~ Tl
, -,
\)
t
----------------------------------------------------------------------------
Fee summary Charged Paid credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 458.75 458.75 .00 .00
Plan Check Total 233.19 233.19 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 696.44 696.44 .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 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
c u tion.
b h)oi
tor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 4] 7-4815 FOR BUILDING INSPECTIONS. CALL 4] 7-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDA TlON DRAINAGEIDOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD I),OVf'Nt."
WALLS / ROOF / CEILING t
DRYW ALL (INT_a.~RACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE / PELLET / CH1MNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R. W. / PW/ CONSTRUCTION - R.W.
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 417-4653 ~-23-o" ~OO FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003]
BUILDING PERMIT - APPLICATION
FOR OFFICIAL USE ONLY:
Date Rec.: J - 2 3 0,-/
Permit #: (!) 'i - 5 I
Date Approved:
Date Issued:
Fill out COMPLETELY and in INK. Your application and site plan MUST BE
COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
Applicant or Agent:~..;L ~J""'{
Owner: k v""'\ C' ~SQ...
Address: ~D E ( ~I
Phone: ~ )(-cS6S'
City:~t A4{:>J~s
Phone:
wA- Zip: 99~ '2
Architect/Engineer:
Contractor \t...,hhl-tl 'KI.2.i? '-.::p~. State License #:
Address: Z><?c; tA.)e;r \t'fh ~r City: '\7cn'f
PROJECT ADDRESS: III C;; t3 ~1Jl S'/
LEGAL DESCRIPTION: Lot: is, ;'-1. J~-Block: '-/
, J
CLALLAM COUNTY PARCEL NUMBER: 0 b 30 00 8 I c:> 4"'15' ~O
Phone:
Exp:
t\w b ts\.LS
Phone: dn~S'6')
Zip: t1&~ k~
ZONING:
Subdivision: Ha. rl (,2. ~ C rY"'\ ke.....
Credit Card Holder Name:
Billing Address:
Credit Card Type VISA
TYPE OF WORK:
o Residential 0 New Constr. 0 Re-roof
o Multi-family 0 Addition 0 Move
o Commercial 0 Remodel 0 Demolition
o Repair 0 Sign
BRIEF DESCRIPTION OF THE PROJECT:
CYyY1n1l;Yl.-\t.~ '_ 1=1\2-~
City:
MC
#
Exp. Date:
o Stove
o Garage
o Deck
o Other
SIZEN ALUATION:
SF. @ $ /SF. = $
SF. @ $ /SF. = $
SF.@$ /SF. =$
TOTAL VALUATION $
'Z-O) 9' L}l..-
<1 tl h )\L:...~
COMMERCIALIRESIDENTIAL: Occupancy Group: Occupant Load:
No. of Stories: Lot Size: Existing Sq. Ft. & Proposed Sq. Ft.
Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage
Construction Type:
APPROVALS:
PLAN:
BLDG:
DPWU:
FIRE:
OTHER:_
PLANNING USE ONLY:
ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417...4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due atthe time of permit issuance.
EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days ofthe date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and kno the same 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 req' ,not the City's, nd that I st obtain such permits prior to work.
T:\FORMS\APPS\BuildingpermiLwpd Applicant: Date: ~
PORT ANGELES FIRE DEPARTMENT
102 East 5th, Port Angeles, WA 98362
360-417-4653
Fire Sprinkler System Plan Review
Project Name: Coldwell Banker Address: 1115 E Front
Installer: Knight Fire Protection Telephone: 417-0505
Type of System: Wet/l3 R-3D R-1 0 Com lXI
Date: January 29,2004 Permit #04-01
We have checked this plan and find that it conforms to the requirements of our ordinance with the
following exceptions:
1. If areas under stairs are accessible and/or available for storage, sprinkler protection must be
provided.
Additionally:
1. All systems including underground mains shall be installed by a state licensed and
certified company and the system shall be installed as per applicable NFPA 13.
2. All controlling valves shall be provided with tamper supervision consisting of devices
that will cause a trouble alarm on the fire alarm panel and/or annunciator.
3. All electrical components shall be compatible with the fire alarm system voltage and as
per P AMC and Washington Administrative Codes.
4. In all occupancies that require the fire alarm zones and/or annunciation, the extinguishing
system shall cause a water flow indication in conjunction with zone of origin.
5. All systems will require witness underground flushing, hydrostatic tests for system, and
underground pipe schedule inspection by the Port Angeles Fire Department prior to being
covered.
6. Before final acceptance of the system, an inspection will conducted by the Port Angeles
Fire Department to ensure the system installation complies with NFPA 13.
o Contractor
~ Building Department
o Fire Copy
Reviewed by
raG' ~Q
Date
I. 2. 't . flJ'./
FP - 9
Page 1 of 1
EJ
TEl
o
o
o
o
o
I DATE: I -2-:,-0'-1 ~
FIRE DEPARTMENT \<12. Y\.. ]) tl... 6 k c...-
PLANNING DEPARTMENT
PUBLIC WORKS/ENGINEERING DIVISION
LIGHT DIVISION
o ENERGY
o ENGINEERING
POLICE DEPARTMENT
ADMINISTRATION
o CITY CLERK
o
RISK MANAGEMENT
I FROM: PUBLIC WORKSIBUlLDlNG DMSION I
RE: ADDRESS: III S- E 1=.'0 f\i
NAME/CONTACT: KV\..~'3k-\- f-; Ie ::P('O+eCJ'fl~'\i..A
PHONE: 4/ 7 - '{"s''C'\ S
PERMIT NUMBER: 0 Y - 5: t
"'-, \ j~l . ~J
PROJECT DESCRIPTION: C~ \l\.-UAA.. r- w y- ~ Sp r- ~ VlJ.... fI f- Sy5- Ie u\.
AS! NEW CONSTRUCTION
o ADDITION/ALTERNATION
COMMENTS/CONDITIONS:
I2i REVIEW /RETURN
o FILE
(J'1-QJI
l< ~ORr ~
$4.0~~~
~
'L ~
~
~<:~
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
32] EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000517 Date
.929734
1115 E FRONT ST
06-30-00-8-1-0445-0000-
SIGNS
8/02/04
COMMERCIAL ARTERIAL
2500
Owner
Contractor
GASE NICHOLS PROPERTIES
330 E FRONT ST
PORT ANGELES WA 983620104
( 36) 452-5403
ADVEHTISING SALES & MORE
1327 E. 1ST STREET
PORT ANGELES
PORT ANGELES WA 98362
(360) 452-7785
Permit . . . .
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL SIGN PERMITS
FREE-STANDING SIGN
SIMPSON ELECTRIC
36.40 Plan Check Fee
8/02/04 Valuation
1/30/05
.00
2500
............
"-
........
~
Qty Unit Charge Per
1.00 36.4000 ECH EL-COMM-1ST SIGN
Extension
36.40
~:
t~
~ '\
\;l
~ 'I
~
~
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 36.40 36.40 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 36.40 36.40 .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 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 cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:IPLANNING\FORMSIII02.15 [11/14/2003]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOT]CE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW I WATER
......~
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS I ROOF I CEILING
DR YW ALL (INTERJOR BRACED PANEL ONL Y)
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING I I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE I PELLET I CHIMNEY
HOOD I DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LlGHTlNG ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL ~~;'h'" hi)
LIGHT DEPT
CONSTRUCTION - R.W. I
CONSTRUCTION R.W. I PWI
ENGINEERING 417-4807 PW I ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\PLANNING\FORMS\1102.15 [11/14/2003]
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
~21 EA,'qT 5TH STREET. PORT ANGELES. WA 98362
ELECTRICAL PERMIT ISSUED: 7/30/2001 PERMIT NO 7351
OWNER/APPLICANT PROPERTY LOCATION
1115 FRONT E
LARRY SHELMIDINE
1115 E FRONT ST Lot:
Block: [] Long Legal
Port Angeles, WA 98362
360/452-7194 Subdivision:
T: S: Parcel No:
CONTRACTOR ARCHITECT
COLEMAN ELECTRIC N/A
PO BOX 1326
PORT ANGELES, WA 98362 , 98360-0000
360/452-7594 360/000-0000
PROJECT INFO
Project Type: COML. MISC. Project Value: $0.00
Occupancy Type: Construction Type: OUTBUILDING
Occupancy Group: Zoning Use: "J~
Electrical Heat:
[] Baseboard 0 KW [] Riser [] Underground Service
[] Furnace 0 KW [] Overhead Service Voltage: 120,240 t'"'t,
[] Heat Pump 0 KW [] TempService Phase: [] 1 [] 3
[] Fan Wall 0 KW Service Size: 100
Feeder Size: 0
PROJECT NOTES ~,,
service to mobile trailer
FEES ASSESSMENT Service: $74.30
Additional Feeders: $0.00
Circuit Wiring: $0.00
Temp Service: $0.00
Misc Fee: $0.00
TOTAL FEE: $74.30
AMOUNT PAID: $74.30
BALANCE DUE $0.00
('()Mi~LNTS/ACTION NEEDED
ELECTRICAL PERMIT INSPECTION RECORD
CALL ,417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUIvi 24 HOUR NOTICE. IT IS UNLAWFUL TO COl ER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
I
DITCH
ROUGH-IN / COVER
SERVICE
FrNAL
GENERAL COMMENTS:
pw-i io2.1514,96]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUiLDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number ..... 04-00000517 Date 6/18/04
Pin number ....... 929734
Property Address ...... 1115 E FROSFP ST
ASSESSOR PARCEL NUMBER: 06-30-00-8-1-0445-0000-
Application description . . . SIGNS
Subdivision Name ......
Property Use ........
Property Zoning ....... COMMERCIAL ARTERIAL
Application valuation .... 2500
O~er Contractor
GASE NICHOLS PROPERTIES ADVERTISING SALES & MORE
330 E FRONT ST 1327 E. 1ST STREET
PORT /dgGELES WA 983620104 PORT /~NGELES
( 36) 452 5403 PORT /%NGELES WA 98362
(360) 452-7785
Permit ...... SIGN
Additional desc . 24SF FREE STANDING SIGN
Permit Fee .... 30.00 Plan Check Fee . . .00
Issue Date .... 6/18/04 Valuation .... 2500
Expiration Date . 12/15/04
Qty Unit Charge Per Extension
1.00 30.0000 PER S- SIGN LES THA~ 25 SF 30.00
Fee smnmary Charged Paid Credited Due
Permit Fee Total 30,00 30.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 30.00 30.00 .00 .00
ISeparate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This perm it 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 cedify that I have read and examined this application and know the same to be true end 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
cPresume~.tc~ auth~olate or cancel the previsions of any state or local law regulating construction or the performance of
on~ction. ")
.. _.__ _ ,,&--
Signature Date-- of Owner (if owner is builder) Date
of
Contractor
or
Authorized
Agent
Signature
T:\PLANNINGLFORMS\I 102.15 [ I 1 / 14/2003 ]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT 1S UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES ] NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE/DOWN SPOUTS
ELECTRICAL (LIGHT DEPT) SEPARATE PEPdVI1T: #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE (METER TO BLDG)
: BUIEDINO P'ERMIT. 'APPLICATION
CO~ to be seceded for review. U you hsve ~u~ qu~fisn~
PE~S (B60) 417~81~ F~(360~1~711
~t~c~:, ~ ~ ~ Q ~ ~ ~ ~ Phons:
Con~cW3: ~ ~ ~ ~ ~ ~ ~ 8~;e License ~:~ ~-~ ~xp; Ph~e:
~s~ ....... ~--..~ ...... ~; ..... ~p2
P~O~CT~D~SS: ~ ~, ,,.,~. ~T ZO~6:
~O~D~TION'.~t~ ~ ~ Block.,. ~ Subregion:
Credit Card Holder Name:
Bfl~Z Addres~.
Crsdlt CardType ~C_ ~ ~. bate:.,.
~E OF WO~
~ ~ ~ ~ ~ ~ . TO~ V~UA~ON $ ....
No, of S~: ~ Lot S~: B~ Sfl, Ft ~ ~ Sq, Ft
To~ lot cov~
B~GP~CA~ONS~: ~l~v~ion~provideyo~th~m~onon~c ~afi~d
p~ su~ mq~e~ ffyou b~
V~UATION OF CON~U~ON'. ~ ~ ~, a w[ua~on amount m~t be ente~ by
~ybe :~tsed by~ B~g Die,ion m ~ly ~ *~ f~e ~che~le=. Co~ ~e~t CoorH~tor at ~ 17~ 15 f~ ~sis~,
P~ C~ ~E: · a pl~ ~e~ fee ~ due it ~t ~ ~ub~d ~t ~e ~
B~ O~ci~ c~ ~ ~e ~e ~ aofl~by~e ~c~ ~ 180 days~o~ ~nrcqu~by ~ ~p]i~t (~ Sec~ 107.4 o~
~e U~m B~ Co~, c~t e~fion). Na application c~ b~ ¢~mdcd
/ h~y cs,~ ~ / hays ~ad ~ ex~m~ ih~ ~ppJl~t/o~ ~d ~w the s~~co:~.
z 7_.
September 14, 2004
Coldwell Banker
Property Management Division
Terry James
1115 E. Front Street, Suite B
Port Angeles, WA 98362
Re: 213 E. Vashon Avenue Rental House
Dear Temj,
I am writing this letter to follow up on the past week's events in our
rental house at 213 E. Vashon Avenue. We have experienced a (~
critically dangerous situation with our hot water.
On Wednesday, 918104, I was scalded by hot water in the master
bath shower. The following rooming, 919104 we woke up to no hot
water. I called to report this, and by the time I'd returned from workon ~"
Thursday, you had sent your maintenance person to fix it, and the hot
water was working again.
On Friday, 9/10/04, as guest was scalded by hot water at the kitchen
sink, while washing dishes after dinner. I am very thankful that none
of our four children were the ones who were scalded with this
extremely hot water.
I thought that this second occurance might be a warning of another
hot water outage, and I was correct. On Saturday night when
attempting to wash dinner dishes, there was once again no hot water.
For the second time this week, I had to report a problem to you about
the hot water heater.
This is the second time that my family has been put at dsk with
inadequate, unsanitary living condifitions. We were once again
unable to wash dishes, and wash ourselves.
After paging the Coldwell Banker Property Management pager, my
phone call was returned, and you stated that eadier in the week the
are-set button' was pressed and the problem was fixed, and you
suggested that I do that, as it is difficult to locate your maintenance
parson on the weekends.
My son and I initially looked for the ute-set button" but could not
locate it. So I called you to tell you this, and within thirty minutes or
so you returned my call and instructed me to remove the upper metal
plate, and insulation, and that i would find the button there. You told
me to push the button and that I would hear a click, which means it
started. You instructed me to be very careful as there is a 220 volt
wire there, and if I do not know what I am doing it could be very
dangerous.
I did what I was instructed. I went outside to the unvented, tiny room
where the hot water heater is located. I noticed there were supposed
to be two screws holding this metal plate on, but there was just one.
As I placed the metal plate and the one screw on top of the water
heater, as you instructed me to, I was very surprised to find that the
hot water heater had a pool of water across the top. I was able to
remove the upper cover, and push the insulation to the side to see
the "re-set button.'
Then I activated the "re-set button,' waited for a click but nothing
happened. So I pushed it again. Upon the second touch of the
button there was an explosion of flames and smoke and hissing
sounds. I jumped back quickly out of the way, and removed my cell
phone from my pocket to call 911. The flames eventually slowed, but
smoke continued to pour out, and flames continued to flicker out of
the opening every minute or so.
The dispatcher of 911 instructed me to get everyone out of the
house. I was the only one home at this time. They instructed me to
return to the electric panel box and shut off the power to the hot
water heater.
I would like to point out that I was unable to do so specifically, as our
electdc panel box has no complete detailed listing of which breaker
goes to which room or item in the house.
As I started down the hallway of the house, I heard a terdble hissing
and buzzing noise, and realized that it was coming from the electdc
panel in my daughter's bedroom~ There was also a horrible electdc
fire smell in the room. I was able to shut off all the breakers, shutting
power off to the entire house. I then went outside to wait for the Fire
Department to ardve.
The Fire Department was able to put out the fire in the hot water
heater. They also examined the electric panel box inside the house.
The fireman in charge informed me of several things that you should
be aware of.
1. The Ground W~re was not attached to the hot water heater. It was
in fact, 'live,' pointing up on the top of the hot water heater, right next
to where I placed that metal plate and screw into a puddle of water.
2. Too much rust and corrosion has accumulated around the
thermostat and re-set button, which showed the hot water heater had
been leaking for quite some time.
3. The hot water heater had not been installed properly and was
directly against a wall.
4. There is an exposed outlet directly beside the hot water heater.
5. The hot water heater breaker did not trip, upon the start of the tire.
I have pictures of the above mentioned items if you are interested in
seeing them.
I am completely stunned, having been told by my uncle, Major
George Bawden, who was on the scene with me after the fire truck
arrived, that I had been placed into extreme risk of severe bodily
injury or electrocution. I could have easily shorted out the 220 volt
exposed electrical line on the hot water heater. And I had to return to
the house and shut off the breaker to the hot water heater, which was
not tripped, meaning there was still power surging from the electrical
fire to the breaker box.
If there had been a major fire in this house, this house would not
have enough water pressure to even begin to fight it. When
someone uses one of the bathrooms, the washer, the hose, the
dishwasher, the kitchen sink, there is little to no water in any other
part of the house. We have been renting this house for 10 months
and have never had adequate water pressure, in my opinion, to meet
the basic health and sanitation requirements for our family.
We have dealt with it as best wa could, but I feel the need to now
express my fTustration, in know~ng that this very serious fire could
next time be much worse, compounded by our lack of water
pressure.
As an employee at the Clallam County Health Department I am fully
aware of the need for sanitary conditions in the home. We are living
below standard in a house where water pressure is so Iow that if the
water in the kitchen sink is running a toilet will not properly flush. If it
does flush, then water in the kitchen sink is reduced to a trickle.
We have faithfully made our regularly monthly rental payment, and
enjoy living in this house and taking good cam of it. But having
experienced the problems listed above has brought me to the
decision to write to you, asking for an acceptable resolution to these
cdtical situations.
I would greatly appreciate a response from you, and welcome a visit
from you to our home.
Sincerely,
Cherilee Rameey
cc: Fire Chief Dan McKean
ti
~: -':. \: ~
07/25/2004 20:40 4579270
SIMPSON ELECTRIC
I!Li1OTFtIOAL P!AMIT APPLICATION
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1..orv1f ' ~{/IY\i F.. .umber: 13601417-4711
SHAMP ELEC
PAGE 01
.
ELECTRICAL PERMIT APPLICATION
F'(tt'.('lFFlr:!Al..'JSI;ONLY ..
Ll~I-:1Rox: ........_
P=nil!l: "'_'__'
thle.ArfV'(lv~l1' ___
O.11c I.uued __.__ _.._
Thp. FtF!r.trir.:lt Pprmit Arf"lI~ti"" mll;t b", fillDd out C'Dmf'JctDIv.
Owner or Elec. Contractor Agent: 3II/rmP ELmTR ICl'rLC DN 7l:/IC]1 Nl;~1!l.!:.:... Phon.:
Property Own.c ('.is\d.w-e 9J ~A'\ \u.(""
Addross: l \ \ r.; E. t1&\-IT"ST,
FIAt:;I::-.;:l1 r."ntr;lett'lr' ~O \;L~Tt tUiL Cf\ \.l'TVk:n~) I:.
%Z-/tgq
Fa.: .3;.>m.e..
C;ty: PGttAN~ , l.l)oA.
~ <5HA lI'\p Eco2~B'3 .
I \..l~, lIe.n.. h, Exp: I ' 23.0'\
City: .p~] AN.l<E:LES W./\,
Phone: 't5'l-1.~3;;l,
ZiP:SIr.3blL
<'hooo: 4S'1. IIo~i
2;p: '1 Z,3 H..
Address:~)( :,;B:,
INSTAllATION WIRED BY:
r.1 OWNER
~leCTRICAl CONTRACTOR
Cred/rCardHolderName: f'v\fl-I<I( IrJ. :::'~flrnp
Billing Address:-3J.o_.W "H ji)1tJ JIY'rC/'
Credit Card Number:
. Ci(V: -Po-e..T it~c,-aES WA.
Erp. Date: ~ ::)
Zip: '1830:)
VISA:A MC:
PROJeCT ADDRESS: \ lISt:. ~tl N\ <:iT,
TYPE OF WORK:
Check all that apply: IJ New
o AlteraUon/Addition
u Residential r.J MUltr-famlly
'l2(" l;ommercial 0 Mobile Home
Sq. Ft
o Remote Meter 0 Detached garage 0 Hot Tub 0 Swim Pool 0 Septic Pump
o Low Voltage n Teler.nm. 0 S
Number of Circuits added or .llered:
DESCRIPTION OF THE ELECTRICAL PROJECT: 1"'(AV\.Q.
Electrical Heal Load Addllions and or Subtractions
~ Ot-J
Service Information
o Baseboard _ KW Voltage:
CI Furnace KW 0 Ova,haad Service Phase: 0' rJ 3
r:1 Heal &~9? - TON lRA 0 Temp Service Service SILe: ..
;Z1Jif)::;b~( K;(:-f:r1JW\ III ( E... F;~~rg~~orv~p O(l./e'(:/::e: 'i'
do;; Oro~ A+IG:.~ fI€..(~"',+- c;J- Te-.~~.{ IJIAJ ft'4f &"'~ ~k...J
Illemby cerlily /llJt 1"llale read' e)((J,/IIilltJ& Ihis (J,ppliv(J,lion and k.now that same to be true and correct, and I a
authorized to apply for this pe~ . I understand it is not the City's legal responsibility to determine what permits
are required; it remains the plicants responsibility to determine what permit.~ R/'P. rp.q/Jif'Prll'lnrl to obtain such.
--rr l "dil Card Holder's Signature: ~ ~~ Date:l'Z.-.:f1-::Q2.
~;c..e Owner or Elec. Cont. Signature: ,/Z",~..... ~~ Date:.~5
t2.~.D
PERMIT FEE: $~
C :/EI,ECTRI CALPERMIT APPLICATION
;/aJ /Yto;;3
ELECTRICAL PERMIT APPLICATION
FOR OFFICIAL USE ONLY:
DatcR.cc.:
Permit N: -;7 -1 S (
Date Approved:
O.lclJsw:d; tV> /~I
The Electn"cal Permit Application must he filled out completely.
Please type or print in ink. Uyou have any quesdoDS, please call (360) 417-4735
Fax number: (360) 417-4711
Applicant and/or Agent: (j,km Jh( ~j('~ Phone:
Property Owner:
Fax # 4t~-"" - 7:51''/
Phone:
Address:
Contractor
City:
License #:
Exp:
Zip:
Phone:
Zip:
Address:
City:
Credit Card Holder Name: So h 6~ O. CJk.m 11-1../
Billing Address: SZz.-W. lIP .;1/,
CreditCardNumberLit;
7?/. 30
CilJ'.Ib€I-At~F'C. Zip:9".1'Y6<....
.
up. Date:
Permit Fee:
PROJECT ADDRESS:
LEGAL DESCRIPTION: Lot:
/ / / 5" ~ r /cJlA-T-
{ (. ,
Block: Subdivision:
ZONING
CLALLAM COUNTY PARCEL NUMBER:
TYPE OF WORK:
o Residential 0 Multi-family 0 Commercial 0 Mobile Home
Elcctrical Permit fees are based on WAC 296-46-910
BRIEF DESCRIPTION OF THE PROJECT:
/,1/) /l ~~ 4
a, 0. /~
Elcctrical Heat Load Additions
Service Information
o Baseboard
o Furnace
o Heat Pump
o Fan-Wall
KW
_KW
KW
KW
o Riser
o Overhead Service
o Temp Service
o Underground Service
Voltage:
Phase: 0 1 0 3
Service Size:_
Feeder Size:
Comments:
J hereby certifY that J have read and examined this application and know the same to be true and correct, and J am authorized to apply
for this permit. J understand it is not the City's legal responsibility to determine what permits are required; it remains the applicants
responsibility to determine what permits are required and to obtain si.f~ ~ ~t~ "
PW-II02_2J (revJ/.OO) Credit Card Holder's Signature: ('v~ A 1..-1<. (!.Q. ~ Date: ~ 1:>/00
Application Number . . . . . 23-00000763 Date 7/31/23
Application pin number . . . 031357
Property Address . . . . . . 1115 E FRONT ST
ASSESSOR PARCEL NUMBER: 06-30-00-8-1-0440-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . COMMERCIAL ARTERIAL
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
Furnace / Heat pump
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
GASE-NICHOLS PROPERTIES BLACK DIAMOND ELECTRICAL CONTR
330 E 1ST 502 BLACK DIAMOND RD
PORT ANGELES WA 98362 PORT ANGELES WA 98363
( 36) 452-5403 (360) 565-1035
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc . .
Permit Fee . . . . 74.00 Plan Check Fee . . .00
Issue Date . . . . 7/31/23 Valuation . . . . 0
Expiration Date . . 1/27/24
Qty Unit Charge Per Extension
1.00 74.0000 ECH EL-COMM BRANCH CIR WO/ S/F 74.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 74.00 74.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 74.00 74.00 .00 .00
MULTI-FA MILY/ COMMERCIAL
ELE CTRICAL PERMIT APPL ICATION
Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:--------------------------------------
Project Description:--------------------------------------□Multi-Family Residential D Commercial I Industrial/ Public Building Square footage: __________ _
OWNER INFORMATION
Name: ________________________ Email: ______________ _
Mailing Address: ________________________ Phone: ___________ _
ELECTRICAL CONTRACTOR INFORMATION
Name: License: ___________ _
Mailing Address: ________________________ Expiration Date: ________ _
Email: Phone: ___________ _
PROJECT DETAILS
llim!
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Sign / Outline Lighting
Signal Circuit/Limited Energy -Multi-Family
Signal Circuit/Limited Energy/First 1500 sf -Commercial
(Note: $5.00 for each additional 1500 sf)
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Unit Charge Quantity
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
$113.00
$56.00
Total (Quantity x Unit Charge)
$ ____ _ $ ____ _$ ____ _$ ____ _
$ ____ _
$ ____ _ $ ____ _
$ ____ _ $ ____ _$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _
$ ____ _ $ ____ _
$ ____ _
$ ____ _
$ _____ TOTAL
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I
am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-
46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us]
lJ CD
PREPARED 7/19/23,12:36:30 PAYMENT DUE
CITY OF PORT ANGELES PROGRAM BP820L
---------------------------------------------------------------------------
APPLICATION NUMBER:23-00000763 1115 E FRONT ST
FEE DESCRIPTION AMOUNT DUE
---------------------------------------------------------------------------
ELECTRICAL ALTER COMMERCIAL 74.00
TOTAL DUE 74.00
Please present reciept to the cashier with full payment
ELECTRICAL INSPECTION WIRING REPORT
APPROVED NOT APPROVED
DITCH
ROUGH IN/COVER
SERVICE
FINAL
COMMENTS
NOTIFY INSPECTOR at (360) 808-2613
WHEN CORRECTIONS ARE COMPLETED
WITHIN 15 DAYS
DATE PERMIT # INSPECTOR
11/23/2023 23-763
TAP
OWNER
CONTRACTOR
Black Diamond Electric
PROJECT ADDRESS
1115 E Front St