HomeMy WebLinkAbout420 E 1st St 1st Floor - Building
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Print in ink
CERT/FICA TE OF OCCUPANCY APPLlCA T/ON Permit # 0 c;s- -I, '=to
CITY OF PORT ANGELES
Alln: Building Permit Technician
321 E. Fifth St., Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
$50.00
$100.00
FEES
Certificate / Inspection
Parking Business Improvement Area (PBIA)
fee charged for downtown locations
, .
BUSINESS NAME
BUSINESS ADDRESS
\5+ rloor
ill- Phone #
Zoning
Business owner's name
Business owner's home address
lE:
'llil
PLEASE NOTE:
A Business License is also required for the following businesses: Taxi, Peddlers, Second-hand dealer, Pawn broker, Dance, Hotel~
Motel, Fireworks, Ambulance, Tattoo shop. Contact the City Clerk at 417-4634 for additional information.
ACTION ./
New business l/
Transfer of business
location from a
PBIA location
Transfer of business
location from a
non-PBIA location
Change of ownership
Remodel
Temporary business
Change of use
Will THERE BE ANY OF THE FOllOWING? NO"" YES"" IF YES, CONTACT
Electrical channes -=-= Electrical Dept. at 417-4735
New or relocated SlOns -\ 'V Buildina Olvislon at 417-4815
Construction chanaes ~,_ .1_. "
Mechanical chanaes (heatinn, coolina, stoves) . "'" "
Plumbinn channes y "
Fire snrinkler svstem channes '>d "
Fire alarm svstem chanaes .>6 "
Is this a home occuoation? '>J Plannina Division a1417-4750
Second~hand dealer or Dawn broker? 1>< Cilv Clerk al 417-4634
New or relocated sewer or water service to. Public Works at 417-4807
Excavation or fiIIinn of lots ... "
Work done in the CitVi-ight-of-wav Iv "
New drivewavooeninas ""- "
Gradina site drainaae (oarkina lots, downsoouts, etc.) , "
Landscane irrination svstem (backflow devices' Water Dent. at 417-4886
Off-street narkinn
Existrna streetsoaved ilII 0/
Existina sidewalks -<
Curb and utter ,>
Call for Certificate of Occupancy inspections before openinq business:
Building Departmenl Inspection 417-4815 & Fire Department Inspection 417-4653
Please provide a minimum 24-hour notice for inspections
Please sign up for utility
services at the cashier counter.
I hereby apply for a Certificale of Occupancy I acknowledge thai I have read thIS appltcation and state Ihal Ihe i'f\maltOn I have
supplied is correcl 10 the besl of my knowledge. \ I )
Date~ Print Name \/'A..1E:fUe. ~'::C~(" Signature V~ ~s.eJ~
For Cit use onl .
Department
Rejected
Initials & date
Comments / Conditions
Building
Type of construction
Occupa nt Load
Fire
Automatic fire sprinkler system required
no
yes
Planning
~I '0&51<
(" 10'0& r3U
~-lo-o~RV
i)t~tTF\L ~ss2.roM - ssror ":f-o~ q; \)~Y'-rs
NON -c.omP~ ~ut5<;.o5 up 10 M~ek:?O\
N~~~ ,::tc..c.uyA~,tC\1' ~:C)N~_
PBIA
City Clerk
Public Works
T:Forms/Building Division/Certificate of Occupancy Application
0"
Print in ink
CERTlFICA TE OF OCCUPANCY APPLlCA TlON Permit# 0 ~ -I, '10
CITY OF PORT ANGELES
Attn: Building Permit Technician
321 E. Fifth St, Port Angeles, WA 98362
(360) 417-4815 fax (360) 417-4711
$50.00
$100.00
FEES
Certificate I Inspection
Parking Business Improvement Area (PBIA)
fee charged for downtown locations
r=~,-. I'
~ J-Z-~I-'
s+ flOG r
-t'(?J.!iL Phone #
Zoning
5("O-tf~7.::- 'Yf()"iS
Business owner's name
Business owner's home address
PLEASE NOTE:
A Business License is also required for the following businesses: Taxi, Peddlers, Second-hand dealer, Pawn broker, Dance, Hotel-
Motel, Fireworks, Ambulance, Tattoo shop. Contact the City Clerk at 417-4634 for additional information.
ACTION ./
New business V
Transfer of business
location from a
PBIA location
Transfer of business
location from a
non-PBIA location
Change of ownership
Remodel
Temporary business
Change of use
Will THERE BE ANY OF THE FOllOWING? NO,;' YES,;' IF YES, CONTACT
Electrical chanaes '^^^, .ho Electrical Oept. at 417-4735
New or relocated sians '\ 'V Buildino Division at417-4815
Construction chanaes ""^. .I^" "
Mechanical chanaes (heatina, coolino, stoves) . 'l><::. "
Plumbina chanqes X "
Fire sprinkler system chanoes )1:1 "
Fire alarm system chanQes )6 "
Is this a home occupation? "'- P!anninq Division at 417.4750
Second-hand dealer or pawn broker? tx" City Clerk at 417-4634
New or relocated sewer or water service r>I Public Works at 417-4807
Excavation or fillina of lots ',( "
Work done in the Citv riaht.of~way t><' "
New drivewaY oDeninQs '>i.. "
Gradina site drainaqe (parkinq Jots, downspouts, etc.) '" "
Landscape irrigation system (backflow devices) ')l. Water Depl. at 417-4886
Off-street parkinq
Existing streets paved '" 0./
Existing sidewalks ~ <><'
Curb and autter "
Call for Certificate of Occupancy inspections before openinq business:
Building Department Inspection 417-4815 & Fire Department Inspection 417-4653
Please provide a minimum 24-holJr notice for inspections
Please sign up for utility
services at the cashier counter.
I hereby apply for a Certificate of Occupancy
supplied is correct to the best of my Imowledge.
Date~ Print Name \/'AItF:fUE.
I acknowledge that I have read this application and state that the rT"mation I have
, '
*-to~~( _ . Signature Vo...~ ~b.MS,'(/~
For City use only:
Department Approved Rejected Comments I Conditions
Initials & date Initials & date
Building Type of construction Occupant Load
Fire \'.OQ 7-2 'C8 I Automatic fire sprinkler system required no yes
PBIA ~ :il(\)I~llA'L ~s.se.rotY\ - S6l1Jf '.f'o~ q; \.)Q0'TS .
Planning " NON -CO;'l1.Pl.5F2P- ~utSr;-6S vp 10 l'VI""1eE:?O\
City Clerk /
Public Works ( N~'Y \) cc..\J'f AN C-'1 If.l...A nN\:,-=;
T:Forms/Building DivisionlCllr1ificRle of Occupancy Application --- 1 .--/
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