The URL can be used to link to this page

Home My WebLink About1034 Caroline St - Building CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number ..... 03-00000715 Date 7/24/03 Property Address ...... 1034 CAROLINE ST ASSESSOR pARCEL LrOFIBER: 06-30-00-8-1-0205-0000- Application description . . . DUBLIC WORKS UTILITES S~bdiviston Name ...... Property Zoning ....... Application valuation .... , 35000 Owner Contractor OLYMPIC MEMORIAL HOSPITAL HOCH CONSTRUCTION 939 OAROLINE ST 4201TUMWATER TRUCK T~AIL PORT 'ANGE~S WA 983623909 PORT ANGELES WA 98363 (360) 452-5381 Permit ...... BUILDING PRRMIT - C0~4ERCIAL Additional desc . . 4 LIGHT STANDARDS Permit Fee .... 120.75 Plan Check Fee . . 78.49 Issue Date .... 7/24/03 Valuation .... 4000 ~xpiration Date . . , 1/21/04 Qty Unit Charge Per Extension BASH FEE 92.75 2.00 14.0000 THOU BL-2001-25K (14 PEk K) 28.00 Permit ...... DEMOLITION Issue Date .... 7/24/03 Valuation .... 0 Additional desc ~xpiration Date . . 1/21/04 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes r~uJJ and void if work or cor~struction authorized is not commenced within 180 days, if constructioe or work is suspended or abar)doned Ifor 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 appiicatfon and know the same to be true and correct. All provisions of I 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 [aw regulating construction or the performance of i construction. · t Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\ 1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COV~R; INSUL~4TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 1N 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) SEPAP,~TE PERMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN, WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / (~IRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PWUTILITIES/ SITEWORK (EnglneedngDivision) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STOP. M PLANNING DEPT~ SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIREB PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:~PLANNING\FORMS\ 1102.15 [4/2002] FOR OFFICIAL USE DNLY: BUILDING PERMIT - APPLICATION Date Rec.: 7--/a/ ~'~,~ permit.: ~r t ~"- Fill out COMPLETELY and in INK. Yoar application and site plan MUST BE Date Approved: COMPLETE to be accepted for review. If yon have any qnestions, call Date Issued: {360) 417-4815 Applicant or Agent: &l UO~ff'~-~ x~,/.~/~11'~& ~ I ~ Phone: O~er: ~q~b ~1 /j'~ ~ Phone: ~lO- Address: ci : Zip: ~chitecffEngineer: ¢~ ~ ~ ~ ~l ~ Phone: ~' Con,actor ~o~¢ ~C~, StateLicense~:~otfl~'lbO~p: ~]1~ Phone: Address: q~[ C~~ City: ~o~ ~.~ Zip: ¢ ~3~ zoning: LEGAL DESC~ION: Lot: Block: Subdivision: CL~L~CO~'TYP~CEL~MBER: 5~ C_~ O~ ~~ 0~ Credit Card ~older Name: Billing Address: City: Credit CardTy~e ~SA~MC ~ Exp. Date: T~E OF WO~: SIZE~UATION: U Residential O New Cons~. U Re-roof u Stove SF. 0 $. /SF. = $ u Multi-fa~ly ~ Addition ~ Move ~ Garage SF. (~ $ /SF. = $ n Co~ercial ~ Remodel U Demolition u Deck SF. (¢ $ /SF. = $ D Repair D Sign U Other TOT~ VALUATION $ OESCmeT~ON oF TH~ PRO.CT: ~~) ~ ~q ~ ~ ~O~ ~q fi B~EF COMMERCI~SIDENTI~: Occupancy Group:. Occup~t Load: ~ Cons~ction T~eL No. of Stories: Lot Size: ~ Existing Sq. Ft. & Proposed Sq. Ft. = TOTAL Sq. Ft. Existing lot coverage f~O % & Proposed lot coverage ~% = Total lot coverage % ~ . , , APPROVES: PIING USE ONLY: ~ BLDG: E~Wetland(s): ~e~o SEPA Che~list required?~'Yes fi No Other: ~ /E~ o ~r~d~ j ~ / / t OTHER: B~LDING PE~IT ~PLICATION SUBM[TT~: The Build~g Division can provide you with i~omtion on the application ax plan sub~Ral requiremenB if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be review~ and ~y be revised by the Building Division to comply with cu~ent fee schedules. Contac t the Pe~t Coordinator at 417-48 [ 5 for assistanc PL~ CHECK FEE: IF a plan check fee is due it must be submRed at the ~e ~e building pe~t application and cons~tction plans a sub. Red. All other pe~t fees are due at ~e time ofpe~t issuance. EXPIATION OF PL~ ~VIEW: If no pe~it is issued within 180 Oays of the date of application, the application will expire. TI Buil~g Official can extend the time for action by the applicant up to 180 days upon ~i~en request by the applic~t (see Secli0n 107.4 the Unifom Building Code, cu~ent edition). No application can be extended more than once. I hereby ce~ify that I have mad and examined this application and know the same to be true and correct. I am authorized to apply for this permit at unde~tand that it is my mspons/bi/ity to dete~ine ~at pe~its am mquimd ,not the City's, and that I must obtain such pe~its prior to wo~. r:XFO~S~PPSXBuildin~e~itwpd Applica.t:~ Date: ~ J~[~ pORTANGELES WASHINGTON, U.S.A. PUBLIC WORKS & UTILITIES DEPARTMENT July 7, 2003 Olympic Medical Center Jim Paapke 939 Caroline Street Port Angeles, WA 98362 RE: Port Angeles Landfill Waste Disposal Application, WDA 03-14; Building demolition at 1034 Caroline Street We have received your application for disposal of building demolition debris from the referenced site and reviewed the testing results for asbestos content. Based on the testing results the debris appears to be acceptable for use in the landfill. A copy of your approved application is attached. This approved application must be shown to the landfill scale attendant at the time of disposal. Please be advised that this disposal application is only for the materials and quantities listed in the application. Materials not listed or in excess of the quantities noted may require separate applications and approval Please call if you have questions. Very truly your.s, Gary W. Kenworthy, P.E. City Engineer Deputy Director of Engineering Services 321 EAST fiftH STREET · P. O. ~3OX 1150 · PORT ANGELES, WA 98362-O217 PHONE: 360~417-4805 ® FAX: 360-417-4542 · TTY: 360-417-4645 E-MAIL: PU BWO R KSQCI. PO RT-ANG E LES.WA. U S To: City of Port Angeles, City Engineer Phone: (360) 417-4803 321 E Fifth Street FAX: (360) 417-4709 P.O. Box 1150 Port Angeles, Washington 98362 NOTE: All questions must be answered for waste to be approved. 1. Generator Information: Company Name: Mailing Address: '/~'~ ~--~:}~,)/V~ ~"'. Contact: Phone: Project Name: Project Location: 2. Other Contacts (if applicable): Consulting Firm: Contact: Phone: Contractor Name: Conta~: Phone: Laborato~: Conta~: Phone: City of Port Angeles - Landfill Waste Disposal ApPlication Page - 1 3. Source of Waste: Check the appropriate box below and briefly describe the project, process, and/or cleanup thai will or has produced the waste requiring disposal. Include the gasoline serVice station number (if applicable). CERCLA/MTCA Remediation Agency Contact: Independent Remedial Action ~ UST Removal Unused Chemical Product Spill ~ Other Source: 4. Waste Material Composition; (check all that apply and include percent of total) Soil % ~ Foundry Slag __% ~ Concrete/Asphalt ~"o % __ Dredge Sediments ~% PreserVed Wood % ~ Debris "~ ~ % Coal Ash ~% ~ Other (list) Wood Ash % % % NOTE: Total must equal 100%. [5~ Waste Material Contaminant~: (check all that apply) Gasoline Metals Diesel Solvents ~ Heating Oil ~ PCBs Unused Motor Oil Used Motor Oil/Waste Oil Other Other Petroleum Product Unknown NOTE; Supply any MSDS information with application, if available. City of Port Angeles - Landfill Waste Disposal Application Page - 2 Estimated Quantity of Waste for Disposal: ,~j~'::~'~ Cubic yards / ~ '7~-, Tons (estimate both) Drams / Tons (estimate both) Other NOTE: Estimated quantity for disposal must be within 20% of the quantity actually disposed. (10% for projects over 7,500 tons or 5,000 cubic yards.) 7. Frequency of Disposal: X One time ~ Monthly ~ Annual Other 8. Waste Sampling: Proper characterization of the waste for disposal requires the collection of representative samples. The methods and equipment necessary for obtaining representative samples of a waste, and the frequency of sampling, will vary with the type and form of the waste. Check the appropriate box and briefly describe how and where the waste was sampled. Include site maps with sampling locations if possible. i Number of COMPOSITE samples & number of discrete samples per composite Number of DISCRETE samples , NOTE 1: Unless prior approval has been granted by Port Angeles, the following sampling frequency will be used: 0 - 25 cubic yards = 1 composite sample 25 - 100 cubic yards = 3 composite samples 101 - 500 cubic yards = 5 composite samples 501 - 1000 cubic yards = 7 composite samples 1001 - 2000 cubic yards = 10 composite samples >2000 cubic yards = 10 plus one sample for each additional 500 cubic yards NOTE 2: One composite sample shall contain a minimum of three/maximum of five discrete samples. ~ity of Port Angeles - Landfill Waste Disposal Applical~on Page ~ 3 g. Waste Analysis: The "Dangerous Waste Regulations= (WAC 173-303) shall be utilized to determine the appropriate analytical requirements for waste characterization. Ecology Publication #91-30 (Revised Apdl '1994) "Guidance for Remediation of Petroleum Contaminated Soils" shall also be used to characterize petroleum contaminated soils from UST releases. Submit all laboratory analytical resu)ts, OA/OC data, and Chain of Custody sheets along with this application. (NOTE: The laboratory must be accredited by the Washington State Department of ECology.) a) List all analytical test methods used: b) Provide a narrative as to why the above analytical methods were selected: NOTE: Additional sheets attached: __ YES ~ NO 10. Soil Classification: (**FOR PETROLEUM CONTAMINATED SOILS ONLY**) Based on the analytical data and Ecology Publication #91-30, the soil classification is: (check one) Class 1 __ Class 2 __ Class 3 __ Class 4 Calculated Hazard Index 11. Dangerous Waste Affidavit: Based on a review of the analytical test results, site history, and the applicable regulations, thi= waste is classified as: (check one) X Waste Extremely Hazardous Waste (EHVV) Neither Dangerous (DW) nor Dangerous Waste (DW) and Waste Code: Extremely Hazardous Waste (EHVV) and Waste Code: City of Port Angeles - Landfill Waste Disposal Applicalion Page - 4 · 12. Certification: We, THE UNDERSIGNED, certify that this application is true to the best of our knoWledge. All information provided is correct and the enclosed analytical results represent the proposed waste material to the best of our abilities. Waste Printed Name Company ! N.'~POLICY_F~1000_SW~1009_01 .WPD City of Port Angeles - Landfill Waste Disposal Applica~on Page - 5 Northwest Asbestos Consultants 406 Reed St. Port Townsend, WA 98368 360-385-0584 :~ huggybear~olympus.net ~.:. ' :.'?ff~%~ Building #1 6/19/03 1034 Caroline St. Port Angeles, WA 98362 Owner. Olympic Medical Center 939 Caroline St. Port Angeles, WA 98362 Conmo: Charles D. Smith, Architect 319 S. Peabody, Suite b Port Angeles, WA 98362 Bob Witheridge AHERA - Building inspector / Management Planner WAMOA - 0042-02 Expires - 11/01/03 1) Inspect for asbestos containing building materials (ACBM). 2) Survey, sample and record suspect materials. 3) Report to Charles Smith of L'mnberg and Smith Architects with results of testing by Clayton Services. 4) Copies for owner, City of Port Angeles Pes~iiit Center and Olympic Region Clean Air Agency. The inspection started with a visual survey looking for Asbestos Containing Building Material (ACBM). The suspect materials were: ~ Various rooms and bathroom / office space. Floor vinyl with mastic. Orange and brown. ~ Cove base with mastic. Dark brown. ~]XlII2LC_#~ Sheet rock, mud and finish coat. Homogeneous to building. All samples were 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 ~ 1034 Caroline St. Port Angeles, WA 98362 Owner. Olympic Medical Center 939 Caroline St. Port Angeles, WA 98362 Contacn Charles D. Smith, Architect 319 S. Peabody, Suite b Port Angeles, WA 98362 ~ Various rooms and bathroom / office space. Floor vinyl with mastic. Orange and brown. ~ Cove base with mastic. Dark brown. ~ Sheet rock. mud and finish coat. Homogeneous to building. ~ Bob Witheridge AHERA - Building inspector / Management Planner WAMOA- 0042-02 Expires - 11/01/03 Please call with test results when completed. Thank you, Bob Witheridge, EFM CUent: No~hw~t .~bestos Consultants Log ~ 34221 Lo~tlon: 1~34 CarHne S~, Po~ ~gel~, WA 98362 Jo~ / ~ ~ SAMPLE L~ATION: Va~ous R~ ~nd ~a~room / ~ee Space ~UA~: ~0er Vinyl Asb~tos Conta~ing Ma~fi~ Laye~ Homogen~ for An~y~s (AC~ LAYERED non-Mb~os % 0~ nonn~u~ '" ~besto$ Asb~tos % .flbe~ ..... Ch~o~le ~ 0 c~3os~ ~0 v~a~ ~ ~ma~ ..... ~ ~c~ption: O~e ~d ~ v~yl ~ whi~ fib~ns ba~n~ and m~c NO~; U~b~ W ~p~te ~c from asb~ ~n~i~g flb~us bang 3AMPLE ~:2 ~2ZI,~A SAMPLE L~ATION:No~ Glv~ ~URCE: ,C~e Base LA~D S~; ~ and ~ r~a~ons require byers be analyzed and reported separat~y. No ~bestos Deleted ~R t D~ption: Brown cove b~e vinyl ~AMP~ ~:Z 342~1,2B S~LE LOCATION:No~ Olv~ - SOURCE: ~tlc N0 Asbes~ De~ect~ LA .on-u~t~ ....... % o~er n0nfibr~s " ~b~tos ~b~tos o~ ~Hulo~ fi~ fl~ ~m~ooents nonflb~s 2 F ;er & ~ .... jP~t D~c~ptio.: OH-wht~ mas~ ~ w~ite pai~ and white compr~ powdc~ ma~l ' L~or~o~ Da~ ~h~ ~ for I~ use and f~g o~y. ~e~ r~p~rt ~ill fo~o~ ~ t~ mag. l~e J'U~-lS-2003 08:49 CLAYTON GROUP SERUICES Settees L~F~ ( A~nfloa: Bob Wi~eridge ClaSh G~up Client: No.west .~b~tos Consui~auU Log ~ 34221 L~afion: ~034 Carl~ne St, Po~ Aagel~, WA 98362 ~ / POs SAM~g ~3 34121~A [~Lg L~ATION:Thmugbou~ bulling SOURC~: Mud an~ ~sh Coat ..~__~D S~LE, ~$H~ ~d ~ reg~a~ons r~re la~rs be an~ and repo~fl separa~y, ~ No ~b~tos Det~ed LAiR 1 ~ Asbes~s ~b~tos % ~.. _ eo~n~ nonfib~u~ ~F[~I~ ~ Bin~ 7~ ..... ~L~ ~:3 3~221~B ~LE LOCATION:~ot Glv~ ~CE: Sh~ ~ck No ~b~tos D~ected '] ~R ~ 'non-~b~s % other ' ~0nflbm~ Asb~to~ .~st~ o~ nonflb~u~ .... · .J _ fibers .... ~ compo~_ C~llal~ '" 3~ ' "Filler & Binder .... D~edp~on: T~ pape~ on pale p~k c~ky PRI~ARY I~EPORT ^NALYZ~D BY: £aborato~ Data Ske~ is for lab use al~d fi~l~g only, ~'h~ flnal rcport wiIl foIIow ln the rdatL vergl~l by: ~ C... ~ ow Summary_ of Inspection: This survey includes all areas of inspection with the report results from Clayton Services Testing Labs. ~ Various moms and bathroom / office space. Floor vinyl with mastic. Orange and brown. 10°,6 chrysotile asbestos. ~qlng[.edt~ Cove base with mastic. Dark brown. No asbestos detected. ~ Sheet rock~ mud and finish coat~ Homogeneous to building. No asbestos detected. The total square footage of asbestos containing building material nccding abatement prior to demolition is approximately 847 sq. ft. All flooring with a reading of 1% or greater is to be removed by a certified abatement contractor which follows the rules of the EPA and governed by Olympic Region Clean Air Agency. 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. After the facility is completely cleaned out a walk through and inspection is required by the original AHERA building inspector (NW Asbestos) after abatement, then a copy of the letter certifying that abatement has been completed needs to be received by the City of Port Angeles and Olympic Region Clean Air Agency. Thank you, Bob Witheridge, E.F.M. lWASHINGTON ASSOCIATION of 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 WAMOA-0042-02 Certificate Number Colin MacRae Course Administrator Northwest Asbestos Consultants 406 Reed St. Port Townsend, WA 98368 360-385-0584 huggybear~olympus.net Date'. 6/19/03 ~ 1034 Caroline St. ,. Port Angeles, WA 98362 Buildings #1 and #2 Owner. Olympic Medical Center 939 Caroline St. Port Angeles, WA 98362 Contac~ Charles D. Smith, Architect 319 S. Peabody, Suite b Port Angeles, WA 98362 Regards to survey inspection and testing. 1) 3 hr's. labor @ $60.00 per hr. $180.00 2) Sample, handling, postage 5 samples at $32.50 ea. $162.50 $342.50 Tax 8.2% $ 28.09 Balance due upon receipt: $370.59 *This billing does not include the time for the required re inspection after abatement. Thank you, Bob Witheridge, E.F.M. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DWISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Property A~dress ...... 1034 CAROLINE aT ~gSESSOR PARCEL ~JMBER: 06-30-00-8-1-0205-0000- /~D~lication description . . . pLrBLIC WORKS UTILITES Subdivision Name ...... Application valuation .... 35000 OLYMPIC b~dORIAL HOSPITAL HOCH CONSTRUCTION PORT ANGELES WA 983623909 PORT ANGELES WA 98363 (360) 452-5381 Permit ...... PLUMBING PERMIT Additional desc . . Permit Fee .... 54,00 Plan Check Fee . . .00 Issue Date .... 8/25/03 Valuation .... 0 Expiration Date . . 2/22/04 Qty Unit Charge Per Extension ~ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements, This permit becomes, null and void if work or construction authorized is not commenced within 180 days, if construction or work is sue pended or abandoned' for a period of '180 days after the work as commenced, or if required inspections have not been requested within '180 days from the last inspection. I hereby certify that I have read and examined this applicatlon and know the same to be true and correct. All provisions of, [laws and ordin~_nces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not [presume.t.' ve suthority/o"}iolate or cancel the provisions of any state or local law regulating construction or the performance of /constru. giion. / / / / T:\PLAt~qG\FORMS~1102.15 [4t2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITI$ UNLAWFUL 2'0 COVER, INSUL,4TE OR CONCE.4£ ANY WORK BEFORE INSPECTED AND ACC£PTED, POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE I DATE IyEsACCEPTED[ NO COMMENT~ 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 c;: :so ,, I,, I I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED i YES NO ELECTRICAL - LIGHT DEPT. 41%4735 ELECTRICAL .~'~ ~ .~ CITY OF PORT ANGELES PUBLIC WORKS . ELECTRICAL DIVISION :\21 EAST 5TH STREET. PORT ANGELES. WA 98J62 ELECTRICAL PERMIT Issued: 11/17/97 Permit No: 6118 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ OLYMPIC MEMORIAL HOSPITAL I 1034 A CAROLINE 939 E CAROLINE Lot: 1, E 1/2 OF 2 Port Angeles, WA 98362 I Block: 2 Long Legal: 360/000-0000 I Sub: HART & COOKE T: S: I ParcNo: CONTRACTOR-----------------------------DESIGNER--------------------------------- OLYMPIC ELECTRIC I --.-=-" 1805 TUMWATER PORT ANGELES, WA 98362 I , 360/457-5303 I 000/000-0000 PROJECT INFO-------------------------------------------------------------------- prj Type: TEMPORARY SVC. prj Value: $0.00 Occ Type: Cnstr Type: Occ Grp: Occ Load: Land Use: CO Electrical Heat Service Type Baseboard KW: 0 Riser Voltage: 120,240 Furnace KW: 0 X Overhead Service Diameter: X-1 -3 Heat Pump KW: 0 Underground Service Service Size: 100 AMPS Fan/Wall KW: 0 X Temp Service Feeder Size: 0 AMPS PROJECT NOTES-------------~----------------------------------------------------- TEMP POWER FOR JOB SHACK IN PARKING LOT I "i I PROJECT FEES ASSESSMENT--------------------------------------------------------- service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $0.00 Temp Service: $41.00 $0.00 Misc TOTAL FEE: Amount Paid: $41.00 $41.00 --------------------------------- --------------------------------- TOTAL FEE: $41. 00 Balance Due: $0.00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPKCTION TYPE DATE I ACCKI'TIW COMMENTS I YES I NO Ulll..-t1 RUUGH-IN / CUVER , 00 Iii TtfHVI I t'1l'IAL I I GENERAL COMMENTS: PW.II01.U!4'96] CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Nt? 16682 /tJ .. / /r' Port Angeles, Washlngton.n___.~.nn..___.__.._._.n........m..m__m_.___..___' 19.___.___ In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment In, on, or about any building or other structure In the City of Port Angeles, per- mission Is hereby granted to d6 electrical work as listed below. J () 3',1 " # Address L. . 00_" nL.n. .___.m.mnn.n___m. OccupancY.m~mnn_____.______ n.~..;____________..n_____.__.______n. . Owner ___n__n_______.. __noon 0000___0000 nn___.'-<I.An..__.n Tenant..___.___n___nn_____n;:n. n___n___n___nn.n_.___________~ Wiring Contractor n__~~~n----.----nnn~..nnn By..____nn.nnn_'__Z:Ji:I..f?..~__. LIght outletsm~u%u..Ou_.._m.. Service, v~s~.~~~pe of WIring: .:J!J'~'fi) Receptacle Outlets...._.......................... No. wires ....................................... Armored Cable ........-........-.........~ Non-Metallic ................................_ Dryer _............._......_...........__..........__ :l7~~.3-F..uu Total wad............................. Ser. NO...n............._.......................... Total ............h_.....h................. ve-r- ~ .-1 Remarks: __n__n.nnn___nnA:n.nn.___n.n.___nnnn___n____n.___n___.~__.__n__n__n__.nn______.______.___00_________00___00:00____00___00_00___ Dryer, KW unn....:__....................___...... Size wlres........_............._............_.. Range, KW...................._.............. Ma[n tuse ....................................... Water Heater: Enclosure ....................................... KW.nuu.u.u.___________n.nn___ Type of ~irlng; Entrance Cable ..................... Heal: KW....................:....................... Motors.": size :v~lts. and Pha? ~ ~=~Z{~ :J )(ii!!'::fF:::::~t~:::::::: Rigid Conduit u.U____U.m.U. Metallic Tubing ................. Current transformers: No. & Size............._......................... Ser. No......................_........................ Ser. No.............................................. Ser. No.............................................. Knob & Tubem_____mmuumuu.nuu_ Rigid Conduit mmummmu'mum__. Metallic TUbing ................_.......... Raceway ..............................._.__._ CIrcuits. L1ght.-f-~num--mm.n-__u ~ :~ltl ty -.~:~~~::~1.~~~~~~~~~~~~~~~~~~~~~~~= Range ~"'.m..~n.u___nuu Water ~z.~;.:~~~......................_.... Motor ..._........................................ -_..._~._.____________._....__________________..._~__..~_.._____.__._____u________________._......_____.____._______________..._.__.....__.__._______.__________..._.__........ .:~.~in~~~.~~~~~~._~.~~~~__..---n~n::~.~.~:__~.~.~.~~~_~__~-~___..------.mn------:;--~~~.:--::--.::::::::::::::::.::::::::::::: NOTICE-Current must not be~turned on until Certificate of Inspection has been issued. If work is to be con. cealed due notice must be given the "Inspector so that work may be inspected before concealment. ,. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ~"-~ ........,.~._.~-.,.,_._..'......-.-'--- ELECTRICAL PERMIT N? \ ) 16682 ( \ " Address......................_.........................__.__...................................................................................Date...........____.._.._......~..._.._.._......___....._ " Owner................h................._......_.._......_......_.._...........................................................Tenant............................_........j........_..................... Wiring Contractor...................................... ....................._...............................__........_......_...........By...............................;............................... -. i (,"" NQTIC~urrent must not be turned on untl1 Cert1f1cateof Inspection has been issued. If work 1fJ to be con~ e.ealed due'noUce must be given the Inspector so that work<may be Inspected before concealment. \ ~ / /" '; ", 1M Olympic "'in,.... In/ ' .' \