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Home My WebLink About707 S Chase St - Building CITY OF PORT ANGELES A FIRE DEPARTMENT PERMIT 321 East 5th Street, Port Angeles, WA 98362 Application Number 11- 00000331 Date 4/15/11 Application pin number. 343567 Property Address 707 S CHASE ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30- 00 -0 -2- 2925 0000 on our state excise tax form Application type description FIRE ABANDON TANK INSPECTION Y Subdivision Name to the City of Port Angeles Property Use Property Zoning COMMERCIAL OFFICE (Location Code 0502) Application valuation 2000 Application desc ABANDON TANK :IN PLACE Owner Contractor LOCKE SANDRA K D H ENTERPRISES 9701 11TH AVE CT PO BOX 631 TACOMA WA 98445 FORKS WA 98331 Permit UNDERGROUND TANK COMM Additional desc ABANDON TANK IN PLACE Permit pin number. 183814 Permit Fee 100.00 Plan Check Fee .00 Issue Date 4/15/11 Valuation 2000 Expiration Date 10/12/11 Qty Unit; Charge per Extension BASE FEE 100..00 Fee summary Charged Paid Credited Due Permit Fee Total 100.00 100.00 .00 .00 Plan Check .Total .00 .00 .00 .00 Grand Total 100.00 100.00 .00 .00 1 1 This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled with whether specified herein or not. The granting of this permit oes of ume to give authority to violate or cancel the /provisions of any state or local law regulating the work specifi- a i 4 nit. Signature of Contractor or Authorized Agent Date ignature 1 Owner (if Owner is builder) Date FIRE PERMIT INSPECTION RECORD Call 360 417 -4655 for fire inspections. Please provide a minimum 24 -hour notice. It is unlawful to cover, insulate Q or conceal any work before inspected and accepted. Post permit in a conspicuous location. -J KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE Inspection Type Date Passed Comments FIRE SPRINKLER �c Underground piping hydrostatically tested I t Underground piping flushed Interior piping hydrostatically tested Interior piping inspection Dry system air tested at 40 psi (24 hours) Sprinkler final FIRE ALARM Rough -in inspection Alarm final LP -GAS Completed by Contractor: Underground piping inspection /pressure test Test #1 Above ground piping inspection/pressure test Piping pressure test psi Time initiated Tank (container) inspection Test #2 Appliance inspection Piping pressure test psi Time initiated LP- gas final UNDERGROUND STORAGE TANK (UST) ABANDONMENT Removal of flammable /combustible liquids Tank appropriately abandoned UST abandonment final 5/q/ PERMIT OTHER (specify) permit final GENERAL COMMENTS: 2/15/00 ,o‘s it 35\ „cc, PORT ANGELES FIRE DEPARTMENT Abandonment or Removal of Commercial Underground Tanks 70 5 c Permit Attachment Date Initial Section I Information Required Applicant is required to furnish the following information before a permit may be processed. beakyvviSWeA 1. Size and number of tanks to be•r �.L.� roWAS eiVA^4 2. Fill out tank closure work sheet (attached). �1- 3. Submit diagram of tank location. Section II Requirements and Limitations Issuance of permit subject to compliance with recognized standards, listed requirements and approval by a field inspection from the Port Angeles Fire Department. 1. Provide one fire extinguisher with a minimum rating of 40 -B -C. 2. There shall be no welding or other sources of ignition in the area while abandoning operations are in progress. Welding or cutting on tank requires a permit from the Port Angeles Fire Department. 3. Removal of all flammable or combustible liquid from the tank and all connecting lines shall be pumped out. Use a hand pump or other means to remove remaining flammable liquid, as far as practical. Liquid shall be placed in a tank truck or suitable'eonfainers for removal. 4. Disconnect the suction, inlet, gauge, and vent lines. Cap or plug open ends of lines which are being removed and those-which e are not to be used any further. FP 25 (Revised 2/22/00) Page 1 of 2 r i Date Initial 5. When capping or plugging all tank openings, use screwed plugs and leave 1/8 inch vent hole in one plug to allow for temperature expansion. 6. Tanks should be conditioned and flammable vapors removed by adding dry ice in the amount of 1.5 pounds per 100 gallons of tank capacity. The dry ice should be crushed and distributed evenly over the greatest possible area to secure rapid evaporation. NOTE: Removal of ignition sources from the vicinity of the tank or container before venting operations are started shall be considered including all electrical equipment in the vicinity. 7. This process does not ensure a gas free tank and the tank shall not be w,elded,ipon unless certified by a qualified engineer after a test. n. .I .:r).' '41' -C. 4'• ,7 ''An d ..If the tank:must be stored on site, the tank shall be placed in a secure location and blocked to prevent movement. The tank would also be required to be inerted a second time before being allowed to be transported. 9. Refill hole with suitable material (earth, sand, etc.) 10. Tank is to be inspected by a Fire Department inspector prior to being transported. 11. If the tank is to be abandon in place, remove all flammable and combustible liquids, fill the tank completely with an inert solid material. Cap remaining underground piping. Additional comments and/or requirements I have read and understand the requirements of this application. Applicant's signature: Date: `S To be completed by City of Port Angeles Permit FP 25 (Revised 2/22/00) .Page 2 of 2 TANK CLOSURE WORKSHEET Tank Owner i r)•,1 L Address ot( 5+ 3 Phone No _A /I Regulating Agency(ies) Notified Permit Issued Department of Ecology 1- 800 826 -7716 Port Angeles Fire Department 360 417 -4653 J( ["c ee P. A. Public Works Dept. 360 417 -4803 Contractor name(s) Job (excavation, de- gassing, sludge disposal, tank disposal, cleanup, transport, other describe) Tank closure start date H-kq- Tank closure completion date kSr I TANK CLOSURE INITIAL PROCEDURES: ABANDONMENT IN -PLACE Follow safety measures (see_below if tank_is_removed)- Obtain recommended safety equipment Avoid contact with product Cut holes in tank top if necessary Bond or ground equipment Clean and inspect tank Drain product from piping Fill tank as full as possible with inert Disconnect, then cap or remove piping mixture until filling overflows tank opening Remove product and residuals from tank Plug or cap all openings Excavate to tank top Disconnect and cap or remove "vent line Remove drop tube, fill pipe, gauge pipe, vapor Diagram of tank location recovery tank connections, submersible pumps and other tank fixtures Site specific requirements: Temporarily plug all other tank openings except the vent line Purge tank of flammable vapors OATH: I certify that the information concerning the removal or abandonment of tank(s) is true to the best of belief and knowledge. 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AulepedS w AlunoD oleo puedsnS 1.££86 diZ £LOZ /S /1. ales uol ;endx3 VM ale3S 666171.1./1. alea aALpaJf svo3 AID Jol32Jluo' uoL pnalsuop edi(1 asuaoil ldV /a4LnS 191. 'oN asuaoil 1.£9 xog od ssaJppV anlhV snlelS OOS6bL£09£ auoyd 050805009 •oN I9f1 S3S121d2131N3 H 1 3 a aweN uopewJojul gulsuaD l pue ssaulsng •aaueansul'llllgell leaaua5 AJJPD pue lunoDpe jo luawu5lsse Jo puoq a ulelulew lsnw iopeiluoD'uollpnilsuo3 /lleluadS JO leaaua0 V •AlleLDads sll Jo dos ayl ulylLM mJoM uollan.nsuoD waojaad of 1 gIIM JO132110OJ uollan.ilsuoj e se paialsl5ai ssaulsnq V JopeaquoD AlleLDadS /leJauaO Z Jo 1 30ed 3aed zalui Ld aldoadsapeil 10 saoTae.Lluo3 71i 1131 Application Number 10 00001095 Application pin number 389160 Property Address 707 S CHASE ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 2925 0000 Application type description ELECTRICAL ONL Subdivision Name Property Use Property Zoning COMMERCIAL OFFICE Application valuation 0 Application desc Replace exterior lights 1 circuit Owner LOCKE SANDRA K 9701 11TH AVE CT TACOMA Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 98445 Contractor ELECTRICAL ALTER COMMERCIAL 174367 73 50 9/29/10 3/28/11 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 APS ELECTRIC 546 BENSON RD PORT ANGELES PORT ANGELES (360) 452 6753 Plan Check Fee Valuation Qty Unit Charge Per 1 00 73 5000 ECH EL BRANCH CIRCUIT WO /FEEDER Charged Paid Credited Permit Fee Total 73 50 73 50 00 Plan Check Total 00 00 00 Grand Total 73 50 73 50 00 Signature of owner or Electrical Contractor X DATE. t z /zq /t o PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Date 9/29/10 RESULTS WA 98363 00 0 Extension 73 50 Due 00 00 00 INSPECTOR. Date. REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) FROM A P S. ELECTRICAL CONTRACTOR FAX NO 360 452 6753 CITY OF PORT ANGELES PERMIT APPLICATION Building Division./Electrical Inspections 321 East Fifth Street P.0 Box 1150 Port Angeles Washington, 98362 Ph (360) 417 -4735 Fax: (360) 417 -4711 Date: q 97 3 1 2 Single Family Dwelling Plan Review Mav Be Requfred, Please Complete Electrical Plan Review Information Sheet Job Address: Building Square Footage: Description of above Imo YYt 1 G `1 X47 •c1 >i' Q 1� Owner lnf rmati n Name' Mailing Address: 70 y 4e, C-t City 1 State: w A 4:13 k;;A Phone: X Fax' License Exp LorAk1 Item 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 Crcuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Temp_ Service/ Feeder 200 Amp. Temp. ServicelFeeder 201-400 Amp. Temp. Service/Feeder 401-600 Amp. Temp. Service/Feeder 601 -1000 Amp Portal to Portal Hourty Sign /Outline Lighting Signal Circuit/ Limited Energy First 1500 sf Commercial Note: $5,00 for each additional 1500 sf Signal Circuit/ Limited Energy -1 2 Family Dwelling Signal Circuit/ Limited Energy Multi -Family DweWng Manufactured Home Connection Renewable Elec4ricel Energy 5KVA System or Less Thermostat NEW CONSTRUCTION ONLY: First 1300 Square Ft Each Additional 500 Square Ft or Portion of Each Outbuilding or Detached Garage Each Swimming Pool or t'lot Tub Unit Chard 119.90 145.50 204.60 262.20 $372.50 2.60 73.50 2.60 92.70 110.30 14870 167.90 95.90 88.20 95.90 63.90 63.90 119.90 $102.30 56.00 110.30 35.20 73.50 11030 Al Credit Card: erg newt: q 7 rzcy, la Sep 28 2010 01 36PM P1 RECEE! SEP 2 9 200J ELECTRICAL. INSPECTIONS Multi;- Family or Commercial* Commercial Addition Alteration Remodel Repair Contractor) on Pha<na -A 6 /e ch P4 Mailing Address eft. City State: ____►_Zip: Phone' Fax: License I Exp c., Total (9 r Multiplied by Unit Charge,. $73, c> 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 inspectiori_ After reading the above statement, I hereby certify that I am the owner of the above named property or a Licensed elecbtcal contractor lam making the electrical installation or alteration in compliance with the electrical laws, N.E.0 RCW. Chapter 1928, WAC Chapter 296 -46R, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner electrical contractor or electrical administrator Cash Cheek 010/2010 construction Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Owner LOCKE SANDRA K 9701 11TH AVE CT TACOMA Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge 4 00 10 1000 Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 WA 98445 BUILDING PERMIT TEAR -OFF TORCH 53777 455 15 7/05/05 1/01/06 Per BASE FEE THOU BL -25 001 -50K Charged Paid 455 15 00 4 50 459 65 05 00000559 367126 707 S CHASE ST 06 30 00 0 2 2925 0000 OLYMPIC SKATE CENTER RE ROOF 'COMMERCIAL OFFICE 28635 NO PR FEE DOWN STATE SURCHARGE 455 15 00 4 50 459 65 (T \Policies \1 102_15 building permit inspection record05 wpd 1/4/2005] Contractor EMERALD ROOFING INC P 0 BOX 879 PORT ANGELES (360) 452 -4681 Plan Check Fee 00 Valuation 28635 (10 10 PER K) Credited 00 00 00 00 Date 7/05/05 WA 98362 Extension 414 75 40 40 4 50 Due 00 00 00 00 Do vo 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 t of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to vio e or ..ncel the provisions of any state or local law regulating construction or the performance of of Contractor or Author Agent Date Signature of Owner (if owner is builder) Date FOUNDATION FOOTINGS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR /SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL /HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP FURNACE DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY COMMERCIAL HOOD DUCTS MANUFACTURED FOOTING SLAB BLOCKING HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT FIRE 417 4653 I PLANNING DEPT 417 -4750 I 1 BUILDING 417 -4815 T \Policies \1102_15 building permit inspection record05 wpd [1/4/20051 BUILDING PERMIT INSPECTION RECORD CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. CALL 417 -4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES 1 NO FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES I NO 417 -4735 ELECTRICAL LIGFIT DEPT CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING SEPA. ESA. SHORELINE. FIRE DEPT PLANNING DEPT BUILDING C( Y 21 I I 1 1- ►a 1 i 1 01-011-06i 90 O912 7 JOA) S cat., SANDY LOCKE 118 SOUTH CHAMBERS APT #3 PORT ANGELES, WA 98362 HALF ON DELIVERY OF MATERIAL, BALANCE ON COMPLETION Oft( RtL i 7 rs 3 rx X (3�S C A1'STht,i, (K(--( -g s 457 -4392 3/26/2004 OLYMPIC SKATE CENTER 707 SOUTH CHASE STREET PT ANGELES WA 98362 ,LL cool 00 PAGE 1 OF 1 REROOF BARREL ROOF AND WALLS TEAR OFF EXISTING ROOFING TO SHEETING PREP DECK FOR REROOF, POUND DOWN AND PULL EXISTING FASTENERS REMOVE ALL EXISTING DRAINS INSTALL MINERAL SURFACED BASE SHEET TO ROOF AREA (MALARKEY 501) INSTALL SMOOTH TORCH DOWN TO ALL THROUGH WALL DRAINS INSTALL CUSTOM 24 GAUGE METAL DRAINS WITH 4" DOWN DROPS INSTALL GRANULATED TORCH DOWN (12YR RATED) REPLACE ALL EXISTING VENTS WITH NEW RV038 METAL VENTS (INCLUDES COVERED UP VENTS (14 TOTAL) REPLACE EXISTING TURDO VENTS WITH NEW ROOF ALL PARPET WALLS WITH GRANULATED TORCH DOWN INSTALL NEW 24gauge CAP METAL TO ALL PARPET WALLS (ALL SEAMS TO USE METAL DRIVERS) CLEAN UP AND REMOVE ROOFING DEBRIS FROM JOBSITE (%2150Q„..00+ TAX 1763 00 $23263 00 MANUFACTURERS WARRANTY ON MATERIAL, FIVE YEAR WARRANTY ON WORKMANSHIP *ALL WORK NOT ABOVE TO BE A CHANGE ORDER (TIME AND MATERIAL) *INCLUDES ALL DUMP AND PERMIT FEES REROOF NORTH SIDE ROOF TEAR OFF EXISTING ROOFING TO SHEETING, PREP DECK FOR REROOF, POUND DOWN AND PULL EXISTING FASTENERS, R &R ALL DRAINS WITH NEW, INSTALL 501 BASE SHEET, INSTALL GRANULATED TORCH DOWN TO ROOF AREA, REPLACE. EXISTING VENTS WITH NEW, FLASH CHIMNEY WITH TORCH DOWN FLASHINGS, INSTALL NEW 24gauge CAP METAL,CLEAN UP AND REMOVE ROOFING DEBRIS FROM JOBSITE $7135 00 TAX 585 07 $7720 01 INCLUDES ALL DUMP AND PERMIT FEES INCUDES CAS 3/ S 90 j /6z° apak $y? o b 831 PORT CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 05 00000016 Date 1/12/05 Pin number 085696 Property Address 707 S CHASE ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 2925 0000 Tenant nbr name OLYMPIC SKATE CENTER Application description SIGNS Subdivision Name Property Use Property Zoning COMMERCIAL OFFICE Application valuation 2950 Owner Contractor LOCKE SANDRA K 9701 11TH AVE CT TACOMA Permit Additional desc Permit Fee Issue Date Expiration Date ignalre o Vn`t'ractor or Authorized Agent T 1JAANNING\FORMS\ 1102.15 [11/14/2003] WA 98445 11?y 0 E THE SIGN STORE 22 MILL RD SEQUIM WA SEQUIM (360) 383 6655 SIGN 12 X 3 WALL MOUNTED SIGN 85 00 Plan Check Fee 1/12/05 Valuation 7/11/05 Qty Unit Charge Per 1 00 85 0000 PER 5 SIGN WALL 25 SF+ Fee summary Charged Paid Credited Date WA 98382 Due Permit Fee Total 85 00 85 00 00 00 Plan Check Total 00 00 00 00 Grand Total 85 00 85 00 00 00 00 2950 Extension 85 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 constructi Signature of Owner (if owner is builder) Date 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 DATE ACCEPTED COMMENTS YES 1 NO FOUNDATION: FOOTINGS I WALLS I I FOUNDATION DRAINAGE/DOWN SPOUTS 1 ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN 1 PLUMBING UNDER FLOOR SLAB 1 ROUGH -IN 1 I, WATER LINE (METER TO BLDG) 1 GAS LINE I I BACK FLOW WATER AIR SEAL WALLS yy I CEILING I 1 FRAMING JOISTS GIRDERS 1 1 SHEAR WALL/HOLD DOWNS I WALLS ROOF CEILING 1 DRYWALL (INTERIOR BRACED PANEL ONLY) 1 T -BAR 1 INSULATION SLAB 1 I WALL FLOOR CEILING I MECHANICAL HEAT PUMP 1 GAS LINE 1 I WOOD STOVE PELLET CHIMNEY HOOD /DUCTS 1 PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION RW PW/ ENGINEERING 417 -4807 FIRE 417 -4653 I PLANNING DEPT 417 -4750 I BUILDING 417 -4815 1 T•\PLANNING\FORMS \1102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD SEPA. ESA. SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES 1 NO 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION RW PW ENGINEERING I FIRE DEPT I PLANNING DEPT 1 BUILDING LEGAL DESCRIPTION Lot: Block: CLALLAM COUNTY PARCEL NUMBER. Credit Card Holder Name: Billing Address: Credit Card Type VISA MC TYPE OF WORK. Residential New Constr Re -roof Stove Multi family Addition Move Garage Commercial Remodel Demolition Deck Repair Sign Other BRIEF DESCRIPTION OF T PROJECT i 2.. x 3 COMMERCIAL/RESIDENTIAL. Occupancy Group No. of Stories. Lot Size Existing Sq. Ft. Total lot coverage PLANNING USE ONLY BUILDING PERMIT APPLICATION Fill out COMPLETELY and in INK. Your application and site plan MUS COMPLETE to be accepted for review If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4711 Applicant or Agent: 04 yfn P 0417 Phone eFVS.3 Owner Owner I ocXi Phone 36 U-= 5VS 7 Address -4 9& y S., (7,44tribeFsty 3 hr-T ,A "t je /i Zip 4 k36 Architect/Engmeer. Phone Contractor 'TA E, S /g'h .S'TOrc_ State License _IC N OCr 27 Exp ii-4,- O Phone- 36 0 G g. ?-6c S 3 bra T2_ Address. -22. 1'}7 R� City Ss'c..l Zip S',3 PROJECT ADDRESS '7/, `7 5,, 5e ZONING ZONING CD City. Subdivision. T \RVESS\BLDG- forms brochures \2003- Buildingpermit.wpd Applicant: r Exp. Date: SIZE/VALUATION 36n SF /SF SF /SF SF /SF TOTAL VALUATION 9SO Cr-N. Occupant Load: L/ Construction Type: Proposed Sq Ft. TOTAL Sq. Ft. 3 f, ESA/ etland(s) Yes o SEPA Checklist required? Yes Other. FOR OFFICIAL USE ONLY Date Rec. .S" OS Permit O Date Approved: Date Issued. APPROVAL PLAN G APPROVAL. BLDG DPWU FIRE. OTHER. BUILDING PERMIT APPLICATION SUBMITTAL. The Building Division can provide you with mformation 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 at the time of pernut issuance. EXPIRATION OF PLAN REVIEW If no pemut 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 R105.3.2 of the Intemational Building/Residential Code, 2003) 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 authorized to apply for this permit and 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. X Date: A-6--as— S r d /ri jarli ?i73)? "Pit )3d14/ Nz cf 1 enter "Skating F for .Eve 452_g45 I2 th�e Q y!r i triAa.... 1 (SECTION 303(c) U ifo Approval Date j CITY OF PORT ANGELES Construction Plans The issuance of this permit based upon these plans, specifi- cations and other data shall not prevent the building official from thereafter requiring the correction of errors in said plans, specifications and other data, or from preventing building operctions being carried on thereunder when in violation of ail code: a ordinances of this jurisdiction. Buiidi g Code.) By FIP Store Peninsula Sign Service Olympic Skate Center 707 S. Chafe Port Angeles, WA 98362 ESTIMATE Work to be completed, Build and install Install a new 3'X12' electrical back lit sign The Layout is attached. The sign shall be flush mounted All electrical will be hooked up and the sign will be in compliance to current code. Sign Can and Face $24 00 Installation of new Sign $400.00 150 set of 4" Readerboard letters. $150.00 Sub Total $2950.00 Tax 8.2% $244.85 Total $3194.85 $1200 00 needed to start project, with the balance due upon completion Costs do not include sign and electrical permits. Extra costs may include getting power to the site of sign F Tom Parkwell 22 MRI Rd. Sequlm, WA 98382 «683 -6655 If the term are acceptable please indicate by signing below Name Date Use Classification: Group: A 2.1 Owner of Business /Residence: Building Address: 707 S.. Chase Street. CERTIFICATE OF OCCUPANCY City of Port Angeles Building Division Type of Construction: Vlv Sandy Locke Address: 707 S. Chase. 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: Assembly Building Permit No.: Business Name: Ska.tin2 Rink Use Zone: CO Street. Port Atweles. WA 98362 st 1 .2002 Date Post on the picuous place. Shall not be removed except by Building Official. . --- ., ~..' - . .~ -'-,,-,'_r "- > . . elflORr.... ROUTING SLIP 'l~\ Certificate of Occupancy ~~ ~... $~ Certificate/Inspection Fee ~~ ...' DATE ~ - I ;(- 0 J- New Business ............................ ( ) - . Address..of Proposed Business " Transfer of Business Location. . . . . . . . . . . . . . .. ( ) . :~07\'S(.J- r~ Change of Ownership . . . . . . . . . . . . . . . . . . . . .. (;>< ) Applica"r ..I,.~ ~~~ New Building ............................. ( ) Address" r ' Remodel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:. ( ) Temporary ~usiness ....................:.. ( ) business J.,IS;J.. . ,fltt~ &6 Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) Phone: home .. J-I - Brief description of proposed business: ~ ~ Legal D~riPtion: Lot S- - q _ . ~ rPA - .' Block ?Zq Subdivision L. ~ " Current Use'''of Property: ~ p /10, Zoning Classification of Property: , Will THERE BE ANY OF THE FOllOWING? YES ~ T(iE FOLLOWING WILL BE REQUIRED: Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . . PERMITS BUSINESS LICENSE Electrical changes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1- 1) Building 1) Taxi, Mechanical (heating, cooling, stoves) . . . . . . . . . . . . . . .../ 2) Plumbinlt 2) Peddlers Plumbing changes ............................. -.{ 3) Electrical 3) 2nd Hand Dealer New or relocated signs. . . . . . . . . . . . . . . . . . . . . . . . . . 'I- 4) Mechanical 4) Pawn Broker New septic tanks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . --I 5) Sewer ._ 5)' Dance New sewer service ................ .,t"''; . . .: . . . . . . - 'i. 6) Sidewalk installation 6) Hotel - Motel Admission charged to patrons . . . . . . . -. . . . . .'. . . . . . . 'f.. .,... 7) Driveway installation 7) Fireworks Is this a home occupation? ...................... 'f..... 8) Curb installation . 8) Ambulance Excavation of filling of lots ....................... -..L 9) Sidewalk obstruction 9) Tattoo shop Work done in City right-of1Wa:y . .. . . . . . . . . . . . . . . . . . -.. "- 1 0) Water meter installation 1 0) Other . ,Is there sufficient off-street parking? . . . . . . . . . . . . . . . .'/.- 11) Fire . New driveway openings . . . . . . . . . . . . . . . . . . . . . . . .. T 12) Occupancy A grading plan for site drainage. . . . . . . . . . . . . . . . . . . 13) Sign , (~kjng lots, downspouts, etc.) ......... .:. .':. . . . . ~ 14) Shoreline Are the existing streets paved? ....;.............. 15) Home occupation -. -- ______u--- Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . . r- 16) Conditional use Is there curb and gutter? ........................ 17) Other Other. . .. . . .'. . . .. . . . . ... . . . ... . . .. . . . . . . " . . . . I hereby apply for a Certificate of Occupancy and acknowl- ..1-1 f- Or' edge, that I have read this application and state that the Date: , information I have supplied is correct to the best of my Signed: ~,Lf' ~crJ~ knowledge. , ~ APPROVED' REJECTED f . Comments I ~ondlllon. ." ~ ~ ~ Building sect!~n 10 '~.A . ~()^ ~ ^~O-4 ~ Public Works Department. ~ ,v...J.J.!2Q ~ . ~ Planni{lg Department .A dl)J\U o..t.f.~ ~ . Fire Department , City~lerk .. P.B.I.A. ... .'- .'.' /- ~-....--. f 7'~ ~~ \' . "" "- . . f,ORT "'<\t ROUTING SLIP $o~G'<(CI' Certificate of Occupancy o~. .... --==:..JJ.... $4"""'00 Certificate/Inspection Fee ~/. 1.1Cwo'i"~ _. DATE ~ _ i Y J;'" New Business ............................ ( ) - ;.= Address of Proposed Business Transfer of Business Location. . . . . . . . . . . . . . .. ( ) .,~C? SJ (-')~ /'~ Change of Ownership . . . . . . . . . . . . . . . . . . . . .. (>-- ) Applicant /,1 '/A to r ~ l2.-. New Building ............................. ( ) .s. '-'1 fL.. 'I Address -, V' Remodel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) f -- , Temporary ~usjness ....................... ( ) Phone: business ""1:; 2 - J I~ ? -i~ ,. k" C ( ) home ... '_ ' "" ::: i>::ti hange of Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . H':' l-,./3 72. Brief description of proposed business: /.,7 " t' '/J (] Legal Description: Lot $""....9 Block ;?"2.q Subdivision IPA Current Use of Property: ) -~ , Lv _ ""./_..4' rf , Zoning Classification of Property: WILL THERE BE ANY OF THE FOLLOWING? YES NO THE FOLLOWING WILL BE REQUIRED: Construction changes. . . . . . . . . . . . . . . , . . . . . . . . . . , PERMITS BUSINESS LICENSE Electrical changes. . . . . . . . . . . . . . , . . . . . . . . . . . . . . . , 1) Building 1) Taxi Mechanical (heating, cooling, stoves) . . . . . . . . . . . . . . ... 2) Plumbing 2) Peddlers Plumbing changes ....,....,...........,..,.... 3) Electrical 3) 2nd Hand Dealer New or relocated signs . . . , . . . . . . . . . . . . . . . . . . . . . . 4) Mechanical 4) Pawn Broker New septic tanks. . . . . . . . . . . . . . . . . . . . . . . . '. . . . . , . 5) Sewer - 5) Dance New sewer service ............................. 6) Sidewalk installation 6) Hotel - Motel Admission charged to patrons. . . . . . . : . . . . .-<. . . . . . . ......... -::;;:r 7) Driveway installation 7) Fireworks Is this a home occupation? .,.................... -..;. 8) Curb installation 8) Ambulance Excavation of filling of lot~ ....................... --.. 9) Sidewalk obstruction 9) Tattoo shop Work done in City right-of~way . . . . . . . . , . . . . . . . . . . . ~ .... 10) Water meter installation 10) Other Is there sufficient off-street parking? . . . . . . . . . . . . . . . ~' '- 11) Fire New driveway openings . . . . . . , . . . . . . . . , . . . . . . . , . ....... 12) Occupancy A grading plan for site drainage. . . . . . . . . . . . . . . . . . . "- 13) Sign (parking lots, downspouts, etc.) ............ .'. . . . . 14) Shoreline Are the existing streets paved? ................... ~. 15) Home occupation Are there existing sidewalks? . . . . . . . . . . . . . . . . . , , . . , -... 16) Conditional use Is there curb and gutter? ........................ 17) Other Other. . . . . . . . . . . . . . . . . . . , . . . , . . . . . , . . . . . . . . . . . I hereby apply for a Certificate of Occupancy and acknowl- ~. I f- edge that I have read this application and state that the Date: .r information I have supplied is correct to the best of my I 1 knowledge. Signed: - .t// A /' ":../,z, N!..- ,- I' Comments / Conditions L~ 0 I APPROVED REJECTED f V"I, ..fit ./ (7.;.-1 fr-f./l /tYI -,I ~ -Vex. jJllLP?t ~ J..- Building Section ... fl.J! _ _~ ~ ~ ~ - h D_"_~~ ~lVl( Public Works Department Planning Department ~/\ ~l. _-l{' ~-e _ ~'O-LD1-b.l I~'L~ t Fire Department f'v. ffY1 ;~L /eui,_;" Z:/> ~.I'/i City..clerk I 7. 'I (J. /) 'If) ( c:; '). "77 A ~./J ~ .2- . " P.B.I.A. ~ '-1irn-r /) j, - / I " , - -- - t. - ROUTING SLIP fVOFlT ~'" r':J~O~Q~(I' Certificate of Occupancy h.. . ..., -=-:w $~ Certificate/Inspection Fee ~: '''' W<:t# DATF '.{ - I ;r- 0 d- New Business ............................ ( ) Address of Proposed Business Transfer of Business Location. . . . . . . . . . . . . . .. ( ) '701 So- cI~ Change of Ownership. . . . . . . . . . . . . . . . . . . . .. (?< ) Applicant _~ d'~ ; New Building ............................. ( ) Address 'r Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) ~ Temporary Business ....................... ( ) business J..IS J.. - M3 .., ,~' Phone: home-4l~ )j~ Change of Use. . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) 1-I~7- 392 Brief description of proposed business: ~~ &~ 0 Legal Description: Lot ~-q Block ?Zq Subdivision ,TA- Current Use of Property: A~ &~ ~/ Zoning Classification of Property: 0 WILL THERE BE ANY OF THE FOLLOWING? YES N!f THE FOLLOWING WILL BE REQUIRED: "'-3 Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . . PERMITS BUSINESS LICENSE ~ Electrical changes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1- 1) Building 1) Taxi .......::l Mechanical (heating, cooling, stoves) . . . . . . . . . . . . . . " 2) Plumbing 2) Peddlers Plumbing changes ............................. '-t 3) Electrical 3) 2nd Hand Dealer ~ New or relocated signs. . . . . . . . . . . . . . . . . . . . . . . . . . 'f- 4) Mechanical 4) Pawn Broker () New septic tanks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f 5) Sewer 5) Dance New sewer service ............................. '-/. 6) Sidewalk installation 6) Hotel - Motel Admission charged to patrons. . . . . . . . . . . . . . . . . . . . ''f-. ~ 7) Driveway installation 7) Fireworks G Is this a home occupation? ...................... y.... 8) Curb installation 8) Ambulance ~ Excavation of filling of lots ...... . . . . . . . . . . . . . . . . . ~ 9) Sidewalk obstruction 9) Tattoo shop ~ 'S "I- tJ\ Work done in City right-of-way. . . . . . . . . . . . . . . . . . . . Y- 10) Water meter installation 10) Other ~ Is there sufficient off-street parking? . . . . . . . . . . . . . . . , 11) Fire New driveway openings . . . . . . . . . . . . . . . . . . . . . . . . . '::(: 12) Occupancy A grading plan for site drainage. . . . . . . . . . . . . . . . . . . 13) Sign (parking lots, downspouts, etc.) .................. , 14) Shoreline Are the existing streets paved? ........... . . . . . . . . ~ 15) Home occupation Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . . 1- 16) Conditional use Is there curb and gutter? ........................ 17) Other Other........................................ . I hereby apply for a Certificate of Occupancy and acknowl- .1-1 f- 0;)- edge that I have read this application and state that the Date: information I have supplied is correct to the best of my ~ ~~ knowledge. Signed: - ~ 'A~ REJECTED Comments / Conditions C Pf:/ Building Section Public Works Department JilD Planning Department Fire Department City Clerk P.B.I.A. I ~ ~ .. . CERTIFICATE"'O'F;"6C.CUP ANCY ,,/.\)"'~:~" City of Port Angel~'~\""\:.. .' ,:-" Building Division "\~", ., ;,. ". :!~: This ciftijica(1.bhjssw:d. pursuant to the requirements ofSectioi1!J 09 of the .' ,_., .. '. 1J UnifonflBuilding Code certifYing',(hq( at the timeoftssufIlJce this s(ltycture was in cJmpliance with the variot!s ordinancesl!I(M/;:ity~;f~kftlq!in$. f3,'filding :~ construction or use. For the fc>.lldJliihg: '. ~\ . ,-. ~ '. : ;.. Use Classification Skat ina Rink Building Pennit No. '?, A- 3 Type of Construction VN Use Zone CN ~ ~r 'Nickie Pederson Address P. O. Box 3726i- Seauirn WA 98382 Building Address 707 So~1:th Chase . / ....- ~ Port Anqeles} WA 98362 ~2~;-~'~~ ,,-.-~-;'> '-~--"-'S~'. 11 2001 / }J.U1ldlng OffICIal ," .' '. '"" . '. ,..', ' Pllte '~\:\'" "'. .;.~.'--_. ....~~-;7.:..".:.:-.-V;/;.:. Post on,J,he,preml~eSIf)a,c,Qn.~plcI!Pus place. Shall not be're.~oved'ex~~pt 'by '<~unding Official. . "~'~';;:~'j \......:;:l.:}.':~.~;~l.b;.,_,~~~:.ft-~:t~.. ,\~, " :~ ,:)~::.~..- ......~''"'' '--'~ . G CJe.1 i ~ c3;(<.ULf:}-, <7 -2'-00 -- / () /1 /YJ ., .. .,. ROUTING SLIP ~ ~~~~ . Certificate of Occupancy " '1IiiiSIII ,_ -=-:Jr $47.00 Certificate/Inspection Fee ~. DATE q.-/5-o 0 New Business ............................ ( ) Address of ProlJosed Business Transfer of Business Location. . . . . . . . . . . . . . .. ( ) 707 $a. {2H/iSe; Change of Ownership . . . . . . . . . . . . . . . . . . . . .. t.....~ Applicant Yjc..K/~ .PebE12S0^, New Building ............................. ( ) Address ,.LJ/J 6/1,>< _.=> '7Zb Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) 2:T12Q U J JV1 Temporary Business ....................... ( ) business 2 -f{4 5" -"') home &>&-3....7t7ro~ ~ ) Phone: Change of Use . . . . . . . . . . . . . . . . . . . . . . . . . . .. ( Brief description of proposed business: oc:;:Sk A7/d c.:; "e; /1/ /r - Legal Description: Lot Block Subdivision Current Use of Property: ?)R- /VJ 1---:- Zoning Classification of Property: Will THERE BE ANY OF THE FOLLOWING? YES N~ THE FOLLOWING WILL BE REQUIRED: Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . . PERMITS BUSINESS LICENSE Electrical changes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./ 1) Building 1) Taxi Mechanical (heating. cooling, stoves) . . . . . . . . . . . . . . /' 2) Plumbing 2) Peddlers Plumbing changes ............................. ./ 3) Electrical 3) 2nd Hand Dealer New or relocated signs. . . . . . . . . . . . . . . . . . . . . . . . . . t/ 4) Mechanical 4) Pawn Broker New septic tanks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............- 5) Sewer 5) Dance New sewer service ............................. "......, 6) Sidewalk installation 6) Hotel - Motel Admission charged to patrons. . . . . . . . . . . . . . . . . . . . 1/ ./ 7) Driveway installation 7) Fireworks Is this a home occupation? ...................... 8) Curb installation 8) Ambulance Excavation of filling of lots ....................... / 9) Sidewalk obstruction 9) Tattoo shop Work done in City right-of-way. . . . . . . . . . . . . . . . . . . . /'" 1 0) Water meter installation 1 0) Other Is there sufficient off-street parking? . . . . . . . . . . . . . . . ,/ 11) Fire New driveway openings . . . . . . . . . . . . . . . . . . . . . . . . . ./ 12) Occupancy A grading plan for site drainage. . . . . . . . . . . . . . . . . . . ./ 13) Sign (parking lots, downspouts, etc.) .................. / 14) Shoreline Are the existing streets paved? ....... . . . . . . . . . . . . ./ 15) Home occupation Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . . ./ 16) Conditional use Is there curb and gutter? ........................ /"" 17) Other Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I hereby apply for a Certificate of Occupancy and acknowl- Date: tiB '00 edge that I have read this application and state that the information I have supplied is correct to the best of my Signed:' c- ~ ~LMuvfAJ..J knowledge. WF REJECTED Comments / Conditions Building Section Public Works Department ~-/~~ Planning Department CJ ~ 1./-\)0 ~~ Fire Department - City Clerk P.B.I.A. rt ~ORT ~ CITY OF PORT ANGELES . ~...o~"':.., ~ha~ DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION .. .:;;;;..or 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ~' Application Number 03-00000051 Date 1/30/03 Property Address 707 S CHASE ST ASSESSOR PARCEL NUMBER: 0630000229250000 Application description ELECTRICAL ONLY Property Zoning . Application valuation 0 Property owner LOCKE SAIlIDRA K Owner address . 9701 11TH AVE CT TACOMA WA 98445 , ( ) Contractor OWNER ---------------------------------------------------------------------------- Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit Fee 59.40 Plan Check Fee .00 Issue Date 1/30/03 Valuation 0 Expiration Date 7/29/03 Qty Unit Charge Per Extex\.sioh 1.00 59.4000 ECH EL-COMM ALT <5 CIRCUITS 59.40 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 59.40 59.40 .00 .00 '-:::J Plan Check Total .00 .00 .00 .00 <::J Grand Total 59.40 59.40 .00 .00 ~ t/) Q ~ ~ V\ ~ ~ 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 construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner IS builder) Date T IPLANNINGIFORMSII102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULA TE 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 ACCEPTED COMMENTS , YES I NO FOUNDATION: FOOTINGS , WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I I I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS I , I I CEILING FRAMING JOISTS 1 GIRDERS I SHEAR WALL WALLS 1 ROOF 1 CEILING DRYWALL T-BAR , INSULATION , , SLAB I I I I ' w' ALL! FLOOR 1 CEILING MECHANICAL I HEAT PUMP WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engmeenng DIVISIon) SEPARATE PERMIT #'5 WATERLINE 1 'METER I SEWER CO~CTION I SANITARY I STORM PLANNING DEPT SEPARATE PERMIT #'5 SEPA PARKINGILIGHTING I J L ESA LANDSCAPING I SHORELINE. " - FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT 417-4735 //31/03 ko ELECTRICAL LIGHT DEPT CONSTRUCTION R W.I PWI / t CONSTRUCTION - R W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT I PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T.\PLANNING\FORMS\I 102 15 [4/2002] flu.. 1/ okf)e.5' IDATE //,;)..//03 :;-1 r X" ENTER APP. I J/~J/lC>3 . X TO PLAN REVIEW 'I/:;? j03 X RETURN FROM PLAN REVIEW(APPROVED) ,", ? 1/27 0:;:> I )(. IRECEIPT TO CASHIER 1'- 2:'S--C '3 I ,.,/ IPAID I v' /PERMIT ISSUED I - 3'0<>5 . I I FAXED TO CONTRACTOR I A- IINSPECTIONS U7 o:{ ~ I ~IFINAL \ ~-S-c3 '-, / fV'J q ( , .0 . i ! I t-- ~r ..~ ROUTING SLIP ff'ORT ~-\o <,O~O. <>~_":. Certificate of Occupancy II~ L -=:-lr ,,- $,~.;:J Certificate/Inspection Fee ~. '........ DATF "'.? - ( ;j- () J- New Business ............................ ( ) Address of Proposed Business Transfer of Business Location. . . . . . . . . . . . . . .. ( ) '701 So- r~ Change of Ownership. . . . . . . . . . . . . . . . . . . . .. (,/< ) Applicant ~ ~~ New Building ....................... . . . . .. ( ) Address Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ( ) $~ Temporary Business ............... . . . . . . .. ( ) Phone: business J.fSJ.. -m3 home~""J {~ Change of Use. .......................... ( ) H~7-#392. Brief description of proposed business: ~ ~ 0 Legal Description: Lot -;--q J3lock ?Ze; Subdivision ,FA- Current Use of Property: ~ ~./ Zoning Classification of Property: 0 WILL THERE BE ANY OF THE FOLLOWING? YES N!; THE FOLLOWING WILL BE REQUIRED: '"'l Construction changes . ...... . .... . PERMITS BUSINESS LICENSE <::J Electncal changes. . . . . . . . . . . . ...... . + 1) BUilding 1) Taxi ~ Mechanical (heating, cooling, stoves). ....... ... 2) Plumbing 2) Peddlers Plumbing changes 'f 3) Electncal 3) 2nd Hand Dealer . ...... ...... .. . . New or relocated signs. . . . . . . ..... . . . 'f- 4) Mechanical 4) Pawn Broker U\ New septic tanks .. ..... . .......... i 5) Sewer 5) Dance ~ New sewer service 1- 6) Sidewalk installation 6) Hotel - Motel . . . . . ..... .... Admission charged to patrons ''f-. "':#IF 7) Dnveway Installation 7) Fireworks ~ ..... . * Is thiS a home occupation? ....... . .. . 8) Curb installation 8) Ambulance ~ Excavation ot tilling ot lots ... . . . .. . .,.- "I- 9) Sidewalk obstruction 9) Tattoo shop ~ Work done In City right-ot-way . 10) Water meter Installation 10) Other '^ . . .... . Y- ~ Is there sufficient off-street parking? . . ...... .-{; 11) Fire New driveway openings . . ... .. "f- 12) Occupancy A grading plan tor site drainage . . - 13) Sign (parking lots, downspouts, etc) ...... . .' 14) Shoreline Are the eXisting streets paved? .... . ..... . * 15) Home occupation Are there eXisting Sidewalks? . . . .. . . . . . 16) Conditional use Is there curb and gutter? . ...... . r- 17) Other Other, . .. . . ..... ........ I hereby apply for a Certificate of Occupancy and acknowl- .1- / f- OJ- edge that I have read this application and state that the Date: information I have supplied is correct to the best of my ~ o(~@ knowledge. Signed: ~ A~D REJECTED Comments / Conditions ~ 7P7 Building Section Public Works Department Planning Department Fire Department City Clerk P.B.I.A. -<II' _ ....... . ,.~.., CERTIFICATE. OF OCCUPANCY f~4-"~;-~--r:"'-<..!..~,:,'...\ ~ "::: r"i'ty' r;-r ,,( D;:'~~'~''''''u't,,,, '-I "~~",,, '0 :i~D.1" ,!bUJ' e e /. }-"<i:; " '~"i:'::~'tl:,H,+"-" ~~_a /)' \1e:..'''S ..'~.. :;; ~ ,~ ''L"> :',,,,~_~'l\~\~-&t" \ ~. ,~"" ,'< ',;l"-~ ,,''\._ ~;;.),~., Buildilf})tmvifioif;:~\~L, ~t;,:;, -'-~;"~l;~(:~*"" This Certification issued pursuant to the requirements of Section 1 09 of the Uniform Buil4irig (JodiJ cer'(ifYing that at the tiffllt,ofiss-u,ance this structure was in compliance' with the various ordinances,oft~e pty re~l~ting Building constructiiJtlrt~~use. For the jolldv.ffhg ",~i"'-PfOf.*?' <~, '~.k:~<&~\%\.~~~ - '..- -,,", ;J~"1~.?l~i' ,,~.:;: l\1"~~if-j! Use ClaSSIficatIOn Assembly" ,x~aqildmg Pernlit Nai(U';j,{~.'i!_\. ,-,'; ~'.~'"""':7'I""~:~~JlItSk>atifil! Rink , ,"'"'-; J\1/~-? t~\"";.i~~ib,i.l""" ~""'" ,l~:t~!;l\:~lf1"'tflrl~; . : ,,'t;t~:p~ ih .' it", i:-"~~l~;'~i;~ ' '"P,~. j'i:'Jf;" ~'t!~h!;ll'/ ~!"Il; ~~~~~~' ofConstrucl1on l~g=~~~;~~:Y~!i1r~~~CO Owner of BusmesslResidence Sandy, Locke Address;,'flf)'1,iSli'1@lrase:- Street. 'PoEt~AnQeles. W A 98362 Y.,i~~(1 ':~,~::,"i:'.!f. 'w ,_ ,_,__ "'i';;;~~7 . \. \, ~l f ~~Cc' . " ~{,.~;r,0"''>i ;;r~U<,', ji!"- .;~~?!!--';:JlJj BUlldm Address, 707 s... ChaJ~;;€.l)rr~ ti,;...;.;.',::!;;NI",~,'j\!;~/jI~~;;;.,"",p~' ,( ,'l"'t"'fJi.;J!JfY:,c'5ii;""W A 98362 g , ~ '~".!l.o."""J;." ,'-..... _f. _ ~ st1.2002 Post on the,) > picuous place. Shall not be removed ,exc.ept 'by"Building Official. ~s CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION L -=- 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ~ .....;;;>' - - BUILDING PERMIT ISSUED: 12/05/2002 PERMIT NO: 13882 OWNER/APPLICANT PROF>ERTY LOCATION 707 CHASE S JOHN LOCKE Lot: 5-9 707 SO, CHASE Block: 229 ~ Long Legal Port Angeles, WA 98362 000/000-0000 Subdivision: TOWNSITE T: S: Parcel No: 0630000229250 CONTRACTOR ARCHITECT HELGELSON CONSTRUCTION N/A ANGELES LAIR LANE PORT ANGELES, WA 98363-0000 , 98360-0000 360/928-9588 360/000-0000 PROJECT INFO Project Value: $45,929.00 SFD Units: 0 Commerciill: 0 -J Project Type: ADDITION SFD sa FT: 0 Industrial: 0 0- Occupancy Type: COMMERCIAL Garage: 0 .j Occupancy Group: MFD Units: 0 Construction Type: MFD sa FT: 0 (f' Zoning Use: CN '> . PROJECT NOTES NEW ADDITION FOR STORAGE AND LOBBY (. r p i/I RECEIPT#9979 ~ FEES ASSESSMENT Building Permit: $603.85 Misc Fee 1: $0.00 Plan Check: $362.31 Misc Fee 2: $0,00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 TOTAL FEE: $970.66 Sign: $0.00 Plumbing: $0.00 AMOUNT PAID: $970.66 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construc1ion 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 vioiate or cancei the provisions of any state or local law regulating construction or the performance of constr~tion>7 '--' / , ,I L, ,r-<A-,./) dtk.....-/ /~/O?_ Sig?fiture of Contractor or A'uthorized Agent / Date 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. 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 ACCEPTED COMMENTS I YES I NO FOUNDATION: i\~ cme) 0\o.'~ FOOTINGS IEl1 WALLS 1 12:--'3-02 1 . FOUNDA nON DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT; # ROUGH-IN I I I I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATERLINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS I I I 1 CEILING I FRAMING JOISTS I GIRDERS SHEAR WALL WALLS / ROOF / CEILING -))--6" J-n/ DRYWALL T-BAR INSULATION I SLAB I I I 1 WALL I FLOOR I CEILING MECHANICAL HEAT PUMP WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARA IE PERMIT #'5: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKINGILIGHTING I I I ESA: LANDSCAPING SHORELINE; I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE 1 I RESIDENTIAL DATE YES NO COMMERCIAL DATE I ACCEPTED YES NO I I ELECTRICAL. LIGHT DEPT, 417.4735 ELECTRICAL 1 LIGHT DEPT I CONSTRUCTION R. W, ! PW! CONSTRUCTION. R. w, 1 ENGINEERING 417.4807 PW ! ENGINEERING I FIRE 417-4653 FIRE DEPT, I PLANNING DEPT. 417.4750 PLANNING DEPT. I BUILDING 417.4815 BUILDING I T:\PLANNING\FORMS\1102.15 {412002] ~ pORT -'\~ FOR OFflCIA US, ONLY, 0___ C', Dale Rec.. /) o?- t~ BUILDING_PERMIT - APPLICATION Permit #: 1 - Date Approved: Date Issued: ~ The Building Permit Application must be filled out completely. $<1,0, <00 - 't-iii/C wd'-'" Please type or print in ink. If you have any questions, please call 417-4815 Lf60 - :z b -0 Jgfl-{) tl-Ek4C~CYJ H Applicant or Agent: Phone: '/'2 t!J -'75 ?t?- Owner: 0011..0 1-- () c./c E: Phone: ~i-S-;). - 4:S- 6 cJ Address: -/0, So C!J\ A-SE" . City: fbeT 4.0 Zip: Architect/Engineer: Phone: Contractor HEIJ;/:WAJ ~I't,,:/ License#:;,tEL6ESc.91~~ ~/z/ 03 Phone: 7'60-24>7') - Address: 13~ ffnG E/ S I L~J R WI City: Di'J/2T If.v (3 de:;, Zip: qR3",~ -'--PROJECT ADDRESS: 10/ So Cfl-n.sE ZONING: LEGAL DESCRIPTION: Lot: Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: Billing Address: . City: Credit Card #: . Exp. Date: VISA MC TYPE OF WORK: SIZ~~UATION: .'--/5,729, JO o Residential o New Constr. ORe-roof o Wood-stove 1 ~_ SF, @ $C:.j.6/ /SF. =$ o Multi-family qvAddition o Move ' o Garage SF.@$ /SF, =$ IlJ'""'Commercial o Remod~l" o Demolition o Deck SF.@$ /SF. =$ o Repair o Sign 0 TOTAL VALUATION $ '--I572'7.oQ BRIEF DESCRIPTION OF THE PROJECT: t'lOO/-hiYU /;12 oS TCJ /J.,A.<; i= 'I- !.-oelSt.! COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No, of Stories: ( Lot Size: .1,<)//X /40 % Lot Coverage: ,?.;;z % , ;4rrc~ /?~/I/:V,-" 3:?..s ~ Existing Lot Coverage:.LQ, '16) /sq, ft. + Proposed Lot Coverage: '-(Z/) /sq, ft. = TOTAL LOT COVERA9E: /(3%2- /sq. ft. PLANNING USE ONLY: APPROVALS: PLAN Notes: .BLDG. DPW FIRE ESAlWetland(s): 0 Yes 19"No SEPA Checklist required? 0 Yes EVNO Other: OTHER BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must befilled out completely to be accepted for review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. 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 CWTent fee schedules. Contact the Permit Coordinator at417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the building pennit application and construction plans are submitted. All other permit fees are due at the time of pennit issuance. EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application. this 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, and I am authorized to appiy for this permit. I understand it is not the City's legal responsibility to determine what permits are required,. it remains the applicant's responslbihty to determme what pernuts are required and to obtam sllch A""'~'?i, ~~-J- Date: //-.22-CJ 2 T \FORMS\APPS\BUJldmgpcrmll r ' - , I I ( ....." ';::' . ~t ~ '-J~ I ~ C> l1'i ~~ C) ! rv Q ~ 1) ~ " t~ ("\ r; ~~ [ -~ t ~ 1- l~ ~ tJI , I ..t i I , I I . 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I \) (>, I .c- :tl I r --- ~ fJ\ , ~ "- ~( - I) I I). :::::. . ~ r ~ ~ ~.::: I ~~ '- .. ~~ , t: I '1 '-\ I Y ~ r ~ ~ -t I ~ ~ ~ "- ~~ l' f ~1 fb<:s -=B I, I . - iTl I, I ~ lD ~ . - l 1 I 49 /~I~s/i'/~:/' 171; bs e;; , {). <'-j t , )- v' ~". ~ \~~\~~"~\ .r ~ I'- -T K , 0 , ~ /,,/ ~ /"/.'1",/ - .r ~ - --9 " II) c- '~J r '\ ::r ~ :'<;- "- ~~~Z/---.} @) }" ~ ~ ,- ;- - 'cJ- /,,").~"Z" ~t I') 5-<:- " <; t" x Of' J' l!}- I sc ~ ~,7. S Y' ----,} I --.. <i Q J - - .. -- ~ ~- /_- r Q( -.--------... ~ ,- ~ 51 _ _ ~__ 1 ; - "1t - r " " / () VJ ;r- .1 - . y \'( r 1 l)- t: IV) II ~ I, ,t'; -- :::- Vi -h.- / ~ \1:l ,~ , r\ \-: .v - <" t- , ~ /' I' [1J W c' (V) q: lZ \J ~ ~ ~ V) ~~ . IlJ Y ~ '::::::: "" \::'-- <:J \/) \i( y (VI ~ C!! 0 7" <:l - cP ,..-, \: \l g . Q , Y ~ Q.r.--- _ '] <t~ r'--~ (j' ci "J- o~ Jill -". ",/ t" IJJ ~ VI \..() - UJ )( - C) . , - Q: Vl... QGCC~ t/l Cl Q~ 1..0 'bO-9 Cl <...J - ~~- tlt o - <:> Q - (V1 - I ~) ~ I " \ 'Y J I "-r- is' Gt- e-' J ~ I.l.\.ll Y ::t- x 0-::> r \i. \-ll ~ <5 c-' I:l I -r H' --v ,LS / -- I -0 l.e - It lU . .j.,. - J.rJ9 \!j' ;-1 &. ~, -'..--_.-'-' '-'~'-'--'------ ,Q;.'n -J.S ::.::r;;iT /7':) - Ken Dubuc - Skate Rink Page 1 ---- From: Ken Dubuc To: Lou Haehnlen Subject: Skate Rink Lou - I met with the contractor at the skate rink this morning. I looked at what they are doing and I have the following comments: The existing lighted exit sign over the east exit doors will have to be relocated to a position over the entrance to the exit discharge in the northeast corner, An emergency exit illumination device will have to be located in the new exit vestibule, A sign stating "This door to remain unlocked during business hours" must be posted over the new front exit doors in the new exit vestibule, As stated before, the lighted exit sign over the old east exit doors must be relocated, as well as the panic hardware, A sign must be placed on these doors that reads "Not an Exit." The interior half-door leading into the rink area must swing out - in the direction of exit travel. I will be forwarding a set of marked, stamped plans for you, Thanks! Ken . , I t I ~ . ~l ~ ~ t:j ",tsl I " Cl. f11 ~ :> ~> \:> Go> l'ti t:<:l p...,Z ?tl ~ b ~ .. >'" ";:j , ~~ ("\ Oz> l' ~~ ~'"tl ~~~ t -~ ' ~--'I 0 t ~ - t....1 ~ 1> l~ N - .-, v'" ...... . 't:<:l ~ - ;-"1:) lJI rJ ~..~ '"~ "';j ~ i . ,,-.' \.. I I e. L".J -< f ~ . "'" ~ -). ~ , "'1 r\ " ! . t , , ~ ~ """- 1 ~ Lfl -l- D -t QJ~ , ?'i) ~' .....j <. 1: ~ ::t:> ('" D - (j'> \ -...I :j 11""1 - "" +--u~ I (D I) ; l/l Q ~F::::\ , 11"\ t. <;:,. ~ () (f) 0 ,0 ~,..\ ~ Cf?\) "\ ~l ~ ~ ~ C> CJ> ~ l~ ~ 1\'\ '::' f\\ ~ }9. ~ i\ ' ' , tP [II ?V Q, ~ s ~ t ::s-"\ M - \\~~~ rfl 't c;, '9 ^ - \ q~ 0 <', t ~ t ~' - ~ ('I ::s '\. 1>., ~'t ~ " ~ \ (\ " ~ ~ ~\ -.>.. ' ~f 1: 10' "'"1;..... ", .ti , I> ..DJ: C'l, ~ ,; l J,~ '" ~ ~~ ~ ~l" ~ra ~~ [\ " <1\(5- t,\ r" t: /~ &. ~~ ~ 1i'~ II t 1 ~ 1 ~ ~ fT1 ~ 0\ ~ ~ ' r:J Gs~ o<lVl :~ J- ,0 ('\X ?-J I:) E.. ~ . -t: -l: ex:> f, ~ ['7[1 1=> l~ I OQ ::::: ~ - . , p ~ u;. lI> C\ ~ -c. POI.lEY wIN/S +- 1'1. O~.es ---r- f ~ G ?- ~ .I. I ~ 'A ce; cA.... '/ .-i. '< - - . 'i - - 1: ~, (\ j _ex-r 1 / ~6' . '~x() y ~, 1,>. <.- , rtf · ~, t (~ n. () '-~ , ~ ,. t~oq, \ 0\' A ,'f ~' li\~~<iA~ f{}'f [;;, EvrE~ ~~~~~ ~I r\1 b l' \- 'l,'t, ~, 1 '\ ~O-" {l , 1\ \\. \. \. - \ ,,\ ,\ \ \ \' \' \- \ I - 1\ . CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . ~ . REQ~ST: ~ ,./ Date 2 ._{; - C'L- Time Received bY.~ (phone. person) Location of Work to be inspecterl 7nI!J cltr.5"F._ Name of person requesting inspection I Address of person requesting inspection Phone No. Type of Ins ircle appropriate one): Permit No. j -::? (.,--- SOW", FO"Od"!:":";O' Chimney Plumbing Final Sewer Excav. Other / l, I ., /.. / --,. - - ,- " _. -:. ,', ~ f INSPECTION OTES: /' .. / , Inspected: Date , Tim'" By , _. Remarks: /, j.- I f ~"""'c I RESTORATION REQUIRED . . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel o Asphalt Dpcc o Other o Repaired by City Work Order # o Repaired by Permittee o COMPLETE D No Damage Found o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATEl CITY OF PORT ANGELES 1--/ DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Oat.. I - '),-'7- - D ow, Time q:~ J Received by - ~--tk.~ (PhOne,~rs'o::? . . Location of Work to be inspected 7/)."> -'\ ~ ~~D Name of person requesting inspection Ji}h- ~J-h (!-',A"~ . Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. /., f('t'n- Foundatit Fra:SJChimney . - Sewer Plumbing Final Sewer Excav. Other INSPECTION NOTES: ~ Inspected: Date / -2-;L-03 Time By Remarks: ~/ - RESTORA TION REQUIRED. . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved o Gravel o Asphalt Opec o Other o Repaired by City Work Order # o Repaired by Permittee o COMPLETE [] No Damage Found o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) O~".9!!!...'4JI... ".J.. ." I -..\?~ CITY OF PORT ANGELES LIGHT DEPARTMENT <;,..... ~ -r 321 E. Fifth Street L.~ Port Angeles. WA 98362 "'- PERMIT NO. Slf)qS . C'/l'y L\G~"\ (206) 457-0411 3/:.~ ~.L;"" OAT" ELECTRICAL PERMIT , , . 1 Site Address: 707 &; rfAdJ o READY FOR o WILL CALL FOR I INSPECTION INSPECTION I Installed By: 1M.; r:O~ I License Number: Phone: I I Owner/Business ~ ~/~jp ((J",;Ju Phone: I I Owner/Business Address: Sq. Ft. I ELECTRIC HEAT o RESIDENTIAL o RISER o BASEBOARD KW ;s- COMMERCIAL o OVERHEAD SERVICE o FURNACE KW o NEW CONSTRUCTION o UNDERGROUND SERVICE o HEAT PUMP KW ~ REMODEL VOLTAGE: o FAN/WALL KW o ADD/ALTER CIRCUITS D1rp o 3 rp o SERVICE UPGRADE/REPAIR SERVICE SIZE AMPS o TEMPORARY SERVICE FEEDER SIZE /t.u1 AMPS DetailslDescription: /YltJ4..P /t2<J ~ //;A ~ I , , .e1AA-u ,c;i,. h..... E (' . W.S. No. SERVICE SIZE DATE ENGR. CAPACITY: o O.K. o NOT O.K. o OVERHEAD SERVICE APPROVED ACTION REQUIRED: o CHANGE TRANSFORMER o CHANGE SERVICE WIRE o INSTALL SERVICE POLE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. o O.K. to connect service At~Final O.K, I Site Addre70 7 , fUJ. ~, I ~,.~<<- ~ Ilnstalter: pf)t,.~ , . I New Meters 1.r;;J3/io/t ...C'f)AA.H~. NotifY Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered . before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT I' 40 . $ Electrical Inspector ..- Permit Fee WHITE - File by address PINK - Top: Eng, Bottom. Customer GREEN - Top: Meter Dept., Bottom: City Hall OL'Y'MPIC PflINTEAS INC, I I CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 16734 " ) M '; '>'7 -1"" Port Angeles, Washlngton___m___mm_m:.:......._...__..._.._mmm____...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 her~ granted to do elec 'eftl work as listed below. ~ ~ .': :;). , c.....,1....!S1 , . Address '-.--'..i5t'i::ii::"W(::..-~..h...'n..'m..---------.-.-nn.. OccUpancyh._....'~_m__hn__mn._____.. Owner ..m__.mm..mm_..__~'mmmm_nn..___nn_=_m::1.. Tenant..mn____h___..____..____m__mm__nn_____m,m__m_..m_m Y/ ',."", Wiring Contractor,.4x~~~-:!V,U.r'-:!;m- "_____m_ By___._.____h_..___hh..mmm__mm____h____m_.....__m__.. I,lght Outlets,__,_______,...______..., Service, volts nnunnnon........................ Type 01 WIring: Receptacle Outlets.........._...._..__.._.n..... No. wires ......................................_ Armored Cable ..nh..........n....._.____, Dryer, KW _._....n___nnO__._nnn__________...__ Size wiresn..nm_nnmmm...nn....._.. Non-Metallic .........mn_n................ Knob & Tub.____......,...,_____________,.... Range, KW nhunO nO.._._.._n". ._n_n.. un.. Main fuse nunn.nnn......m............... Rigid Conduit ...______m'......__...'...__, Water Heater: Enclosure mmmnnnn......_............... Metallic Tubing ......._.mm............ Heat~:~:::::Z2.::::'_::7.ir~:,'__::,:::~~ Type of wiring: Raceway ___.___.................... Entrance Cable __..n......____..........___ Circuits, Llght._......._m.._..______............... Motors: size, volts and phase': Rigid Conduit ...m..........___.__. hn_.. Utility'...m_m_____..______..___,..,.....,...___ Metallic Tubing .....n..._....... ........ Heat -----------............................-..-.. ...--.-..-.-...---------.---------------.-------.---------- Current transformers: Range .__.......................__...._____.__..... ._--------------.-..----------_._-------------------.-.-... No. & Size............n..__n.__....._ ___n_'" Water Heater ............._....nm_m_... -------..---..------.-.......--.---........-.-----.-.--..-- Motor __......................____.____...___...... Ser. NO._n.n_..............................__...... ._.........n............._......._..........___...._._.... Dryer______________....._...........__......___.____... Ser. No. ...._......_........................_u_n... ....--.----..............-................................. Furnace __.n_n.u_.............'_n....n......_.n, Ser. NO..__...._nnn_n._.n__n___nnn___n__nn T~ta] Load''''''''''''''':'''A2Q;:;j/m--''a~'''V:____ Total _____m'....___....__'........__mm Remarks. _m...__m___m._n....__'___''''=___._n______'._.m_._n__'___n'.m__=''__.._m......._____.______________________n__________n___m.......___ .~--.--...-----------------------.--------.-----.--.----~_~~:__._.______.___.~.__..._.__._____.__._.._.__.._.______._______._____.___.__.___._._______.__..__._.________~_n__ .'.> _h__....nn___________.___n_,n___..n..m...h____________.___nn____hh______nn_nn'..n___nn'n.-n'..n.-.------:;z:;-~m---m---.------m..---n Permit Fee Treas. Receipt (~~ ~ /~? , A "{;'~.. ,(. a. .>'!!.e...-r. ...~/~ $._...,.__._...._..______.m____.m._ No.______...______________._... By __.~_.mm__m___mm"---n----:---:-----m------.""-----::--- NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It 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 \ .--- '~'""- -.'- -- .- , , , '''-' t \ ELECTRICAL PERMIT N? 16734 -'"", _-./'........, ., -'Address._____________________.________._.___......____......__....____._______________.________.__.__.._________..._._..__n______.....___....Date..._.....__.....__.._.........._......_......______.... " \ -- Owner._n_.__.._........................_n...._.._......:.._..._______....._......_.__....__........______..__________-...___.Tenant...._______._______________....._________________.______.._.____._.. WiringContractor________.____________u_...._...___........n....................__.___n____.._..u__.______________.____._______.___....BY.....___.n___._______._...................................... NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work l!i to be con- cealed due no~ce must be given the Inspector so that work may be inspected before concealment. '" .--...---"" ...,,- . ~ ._~~. 1M Olympic Printers, Inc. ELECTRICAL PERMIT APPLICATION FOR OFFICIAL U~E ONLY (tD [btel'll<<: PcnMIt. &' Dale Apprtlvcd: The Electrical Permit Application must be filled out camoll!telv. Daeluutd: Please type or reprint In Ink. II you hava any questions, please call (360. 417-4735 O:S - 5 I Fax number: (360) 417-4711 ;--tr.t:#: Owner or Elee. Contractor Agent. Phone: 4-I; '7 -Q SO"?ax: 1'5 c. - 9 {, I'J- '? Property OWner: CoO 't:IfI.G /I-UR!2.! <:)4--J() Sf ~ .r1-- ,J.;; Phone: ,_ ~,9Tt ~ Address: 707 St? c!f-fi S (;; , City: PrY/.<.. r /) ~t?tfj!Ef.-{Z" Zip: ,9;9 c'7 & -a Electncal Contractor: //- A- 1-1./ /J R cS f?;U S" ELJ?7/T/l / C 1I1l( Vc!.2LtJ1"1 C'- Ii. / .." Phone: 4C:/)--?~90; Ucense #: Exp: C! /::3 0 Address: / '1 -Z II> 1M IJ /;/ City: PolL., /+f//atJ::.DE-5. Zip: 98, ";U,) ::, INSTALLATION WIRED BY: DOWNER ~LECTRICAL CONTRACTOR Credit Card Holder Name: ;-ltri 1/1') /lC;;;itJC j;J / IGf'1J? i C Billing Address: /4--"2. 14 1.1/ lJ II- City: PO!?., A/VrP l?-i Fe, Zip: ,9 1'~ (.. "3 Credit Card Number: Exp. Oat,.,. / - VISA- ./ MC:_ PROJECT ADDRESS: I')tJ'7 SU /"!UI'I---,<::' ;;;- TYPE OF WORK:, Check all that apply: o New ~lterationlAddition o Residental o Multi-family <ZL Commercial o Mobile Home ,Sq. Fl. o Remote Meter o Detached garage o Hot Tub 0 Swim Pool o ~ptic Pump o Low Voltage 0 Telecom. DSigl Number of Circuits added or altered: _ <1 4-- ..1--1--: /1; k //1/ 5;J:1 J c.J kcU/rc;: , DESCRIPTION OF THE ELECTRICAL PROJECT: '" u _, .. .. Electrical Heat Load Additions fY9'10 Service Information o Baseboard _KW Voltage: o Fumace _KW o Overhead Service Phase: 0 1 03 o Heat Pump _KW o Temp Service Service Size: o Fan-Wall 'S..:L KW o Underground Service Feeder Size: PAMC 14,05.060(B): For industrial, commercial, & residential projects larger than a duplex, a one -line drawing of the Electrical Service & Feeders, building size (sq. ft.), load calculations, and the type & of conductors and/or raceway is required and shall accompany the Electrical Permit application, I hereby certify that I have read and examined this application and know that same to be true and correct, and I an authorized to apply for this permit. I 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 such. '/ L%-/ ~ -n.<. c,e... 1'< If 5/<<1< .,-/ ".(' ii.o.<. S.. ~ c< uJ,,, - a. 4, /, ']:; It - ...tdl.... , Credit Card Holder's Signature: ~ ~~~ Date:L)?J {:::J3 Owner or Elec. Cont._ Slgnature~/1" ~/ .tJ~_-, .. ' _ Date: )/7/ / ~ PW-9019 . ~ c R I?J/~3 Application Number . . . . . 22-00001269 Date 10/10/22 Application pin number . . . 787311 Property Address . . . . . . 707 S CHASE ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2925-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL OFFICE Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Generator and water treatment ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NORTHWEST KIDNEY CENTERS NORTHSTAR ELECTRICAL LLC 700 BROADWAY PO BOX 1909 SEATTLE WA 981224302 BOTHELL WA 98041 (206) 329-1596 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL NEW COMMERICAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 506.00 Plan Check Fee . . .00 Issue Date . . . . 10/10/22 Valuation . . . . 0 Expiration Date . . 4/08/23 Qty Unit Charge Per Extension BASE FEE 86.00 1.00 132.0000 ECH EL-COM 0-200 SRV FEEDER 132.00 1.00 288.0000 ECH EL-COM 601-1000 SRV FEEDER 288.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 506.00 506.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 506.00 506.00 .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 10/07/22, 9:30:16 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00001269 707 S CHASE ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL NEW COMMERICAL 506.00 TOTAL DUE 506.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: RO system NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 10/10/2022 22-1269 TAP OWNER CONTRACTOR Northstar Electric PROJECT ADDRESS 707 S Chase St 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 5/31/2023 22-1269 TAP OWNER CONTRACTOR Northstar Electric PROJECT ADDRESS 707 S Chase St POWER SYSTEMS Authorized Kohler Representative Performing Startup Telephone Company Name Address City State ZIP/Postal Code Country Owner Name/Unit Location Telephone Company Name/Owner Address of Unit Location City State ZIP/Postal Code Country Round-trip miles from nearest authorized Kohler servicing distributor/dealer to the power system equipment: Generator Set and Engine Nameplate Information Generator Set. No 1 Engine No. 1 Generator Set No. 2 Engine No. 2 Serial No. Model No. Spec. No Application Information (one item in each column must be checked) q Industrial q Residential/Commercial q Mobile/Towable/Trailer-Mounted q Stationary q Prime q Rental q Standby Transfer Switch and Switchgear Nameplate Information ATS No. 1 ATS No. 2 ATS No. 3 ATS No. 4 Switchgear Serial No. Spec. No Contractor Serial No. Model No. Kohler Representative’s Name (print)Owner Representative’s Name (print) Kohler Representative’s Signature and Date Owner Representative’s Signature and Date mo. _______ day _______ yr. _______mo. _______ day _______ yr. _______ Form Distribution: Warranty Department, MS 072, Kohler Co., Kohler, WI 53044 PINK copy: Distributor YELLOW copy: Owner’s Representative K-625 (1/13) Follow the startup checklist on the back of this form. Then complete the form. This form is required for coverage under the Kohler limited warranty and must be completely filled out at the time of initial startup. Representatives of the distributor/dealer and owner must sign the notification form. Signing this form represents acceptance of the unit and that all information on the startup form is correct. Please submit registration to Kohler Co. using the online warranty processing system. Users that do not have access to the online warranty site should mail a copy to Kohler. Startup Notification Startup Date mo. __________ day __________ yr. __________ Generator Set/Transfer Switch Installation Checklist Generator Set/Transfer Switch Installation Checklist CUSTOMER: YES SITE ID: MAKE: MODEL: SERIAL NO: SPEC. NO.: DATE: JOB #: A/B B/C C/A A B C 11:05AM 120 60 206 209 207 263 263 266 71 167 0.4 11:20AM 120 60 206 209 207 263 262 266 60 181 0.6 11:35AM 120 60 206 208 207 263 262 266 60 181 0.8 11:50:AM 120 60 206 208 207 262 262 266 60 181 1.1 12:05PM 120 60 206 208 207 262 262 266 60 181 1.4 12:20PM 120 60 206 209 207 262 262 265 59 181 1.6 12:35PM 120 60 206 209 207 262 261 265 58 181 1.8 12:50PM 120 60 206 209 207 262 262 265 58 181 2.1 1:05PM 120 60 206 209 207 262 262 265 57 181 2.4 TECHNICIAN ACCEPTED REMARKS Billings, Montana (800) 389-9991 RESISTIVE LOAD BUILDING LOAD (800) 247-5899 KOHLER 150REOZJF NW Kidney Center LOAD BANK REPORT (800) 354-6767 The Power Professionals- Industrial Engines, Generator Sets and Equipment GM81645-GA1 WATER TEMP HR METERAMPSTIMEKWVOLTSHERTZOIL PRESSURE 6/1/2023 3379GMLF0023 SC234001479 YOUR INDUSTRIAL POWER SOURCE AN EQUAL OPPORTUNITY EMPLOYER Portland, Oregon (800) 452-1511 Salt Lake City, Utah (800) 462-3370 Boise, Idaho Auburn, Washington Aurora, Colorado (800) 678-3673 C:\Users\tameras\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\UPHDME9K\NW Kidney Center LB Print Sheet E-mail Sheet Clear Sheet C:\Users\tameras\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\UPHDME9K\NW Kidney Center LB 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 6/2/2023 22-1269 TAP OWNER CONTRACTOR Northstar Electric PROJECT ADDRESS 707 S Chase St Application Number . . . . . 22-00000674 Date 6/03/22 Application pin number . . . 260370 Property Address . . . . . . 707 S CHASE ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2925-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL OFFICE Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Low voltage ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NORTHWEST KIDNEY CENTERS AMERICAN TECH CORP 700 BROADWAY PO BOX 10 SEATTLE WA 981224302 TACOMA WA 98401 (253) 922-7522 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL NEW COMMERICAL Additional desc . . Permit Fee . . . . 121.00 Plan Check Fee . . .00 Issue Date . . . . 6/03/22 Valuation . . . . 0 Expiration Date . . 11/30/22 Qty Unit Charge Per Extension 1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00 5.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 25.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 121.00 121.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 121.00 121.00 .00 .00 ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: TV and speakers NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 6/29/2022 22-674 TAP OWNER CONTRACTOR American Tech Corp Electric PROJECT ADDRESS 707 S Chase St ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: Kidney center NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 8/8/2022 22-674 TAP OWNER CONTRACTOR American Tech PROJECT ADDRESS 707 S Chase St Application Number . . . . . 22-00000551 Date 5/09/22 Application pin number . . . 205922 Property Address . . . . . . 707 S CHASE ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2925-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL OFFICE Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc DDC Low Voltage ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NORTHWEST KIDNEY CENTERS EC COMPANY 700 BROADWAY PO BOX 10286 SEATTLE WA 981224302 PORTLAND OR 97223 (503) 224-3511 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL NEW COMMERICAL Additional desc . . Permit Fee . . . . 101.00 Plan Check Fee . . .00 Issue Date . . . . 5/09/22 Valuation . . . . 0 Expiration Date . . 11/05/22 Qty Unit Charge Per Extension 1.00 96.0000 ECH EL-LIMITED 1ST 1500 SQ FT 96.00 1.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 5.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 101.00 101.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 101.00 101.00 .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 707 S Chase St Port Angeles WA 98362 DDC Low Voltage ECCOM**148BA 981 Powell Ave SW Suite 200 Renton WA 98057 6/30/22 206-503-0992 1 5/6/22 Asher Swissa asher swissa 1 4 EC Electric asher.swissa@ecpowerslife.com 4 96 101.00 ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: T-stat wall cover NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 5/9/2022 22-551 TAP OWNER CONTRACTOR EC Company PROJECT ADDRESS 707 S Chase St 77 _ 9LEMOCpL yam. Mjr � A CITY o -PoRT ANGELES 360 417-4735 Application Number . . . . . 21-00000827 Date 9/14/21 Application pin number . . . 356669 Property Address F 707 S CHASE ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2925-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . Property Use . . . . . . . . Property Zoning . . . . . . COMMERCIAL OFFICE Application valuation . . . . 0 __ _ _- _ _ --- _ _ _ _ _ _- Application desc Plan review ---------------------------------------------------------------------------- Owner Contractor NORTHWEST KIDNEY CENTERS NORTHSTAR ELECTRICAL LLC 740 BROADWAY PO BOX 1909 SEATTLE WA 981224302 BOTHELL WA 98041 (206) 329-1596 ---------------------------------------------------------------------------- Permit . . ELECTRICAL PLAN REVIEW Additional desc . . PLAN REVIEW FINAL FEE Permit Fee . . . . 1093.65 Plan Check Fee .00 Issue Date . . . 7/08/21 Valuation . . . . 0 Expiration Date . Qty Unit Charge Per Extension BASE FEE 493.65 600.00 1.0000 ECH EL-PLAN REVIEW 600.00 --------- -- -- - - - -- - -- Fee summary Charged Paid Credited Due Permit Fee.Total 1093.65 1093.65 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 1093.65 1093.65 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN FINAL COMMENTS: titT :t~XPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: WEXCHANGEIBUMDING ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . 21-00000827 Date 7/08/21 Application pin number . . . 356669 Property Address . .. 707 S CHASE ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2925-0000- APplication type description ELECTRICAL ONLY Subdivision Name . . . . Property Use . . . . . . . Property Zoning . . . COMMERCIAL OFFICE Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Plan review Owner Contractor NORTHWEST KIDNEY"CENTERS NORTHSTAR ELECTRICAL LLC 700 BROADWAY PO BOX 1909 SEATTLE WA 981224302 BOTHELL WA 98041 (206) 329-1596 Permit . . . ELECTRICAL PLAN REVIEW Additional desc Permit Fee . . . 600.60 Plan Check Fee .00 Issue Date . . . . 7/08/21 Valuation . . 0 Qty Unit Charge Per Extension 600.00 1.0000 ECH EL-PLAN REVIEW 600.00 ------------ --- ---- --- ----- -------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 600.00 600.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 600.00 600.00 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE l ROUGH-IN FINAL COMMENTS: PERMIT WILL E56W S X(6)MONTHS FROM LAST INspwnON Signature of owner or Electrical Contractor X Date: WEXCHANGESUELDING PREPARED 9/13/21, 8 : 08 : 07 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER: 21-00000827 707 S CHASE ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL PLAN REVIEW 493 . 65 TOTAL DUE 493 . 65 Please present reciept to the cashier with full payment i i • NGELES ORT WASHINGTO N, U. S. A. Public Works & Utilities Department w{f 7/7/2021 r� a Northstar Electrical Attn: Tim Stidham m P.O. Box 1909 Bothell WA, 98041 Subject: Electrical Plan Review. NWKC M �-14 k Nng Tim, The estimated cost for your electrical plan review is $600.00 this estimate is good for 180 days from the date of this letter. The City requires that you deposit an amount equal to the estimate with the City as part of your permit application. The actual fee will be the City's labor and material cost plus a 15% administrative fee. . If the actual cost exceeds the deposit amount,the City will bill you for the overage. If the actual cost is less than the deposit,the difference will be refunded. If you have any questions or concerns, feel free to contact me at the phone number, or e-mail, listed below. ` Sincerely, Trent Peppard Senior Electrical Inspector tpeppard@citvofpa.us Wk 360 417 4735 Cell 360 808 2613 Phone: 360-417-48001 Fax: 360-417-4542 Website: www.cityofpa.us I Email: publicworks@cityofpa.us 321 East Fifth Street- P.O. Box 1150/Port Angeles, WA 98362-0217 9/13/2021 Invoice No. 21 -827 To Northstar Electrical Attn:Tim Stidham P.O. Box 1909 Bothell WA 98041 Electrical plan review final fee. NWKC Quantity Description Unit Price Total 1 WC3 consultant fee Is'plan review 412.50 412.50 1 WC3 consultant fee 2nd/ 3rd plan review 467.50 467.50 1 Labor City of Port Angles 71.00 71 M 15% Administrative fee 142.65 Sub Total 1093.65 Cost estimate deposit 600.00 Balance Total 493.65 Due upon receipt Thank you for your business! City of Port Angeles VOR T Tel 360 417 4735 tpeppard@cityofpa.us Fax 360 417 4711 109 *��, Wlv 19109 36th -k,,e NX, Suite 207 * Lynnv-vo od, NVA 98036 3 (425) 582-1719 August 19, 2021 FINAL REVIEW WC3 Project#: 221-PAN-004 Port Angeles Project#: 21-0877 City of Port Angeles 321 E 5th St. Port Angeles, WA 98362 Attention: Trent Peppard Subject: Northwest Kidney Center—Electrical Only—Final Plan Review Comments Mr. Peppard: West Coast Code Consultants, Inc. (WC3)has completed the final review (Electrical Only) of the proposed Northwest Kidney Center project located in Port Angeles,WA. Please consider our review in regards to this project to be complete. This review was based upon the following: 1. Revised Electrical drawings dated 8/16/2021 by Case Engineering, sealed and signed by Michael S. Chase, Professional Engineer. The 2018 International Codes,2020 NEC, as adopted by the State of Washington, were used as the basis of our review. If you have any questions regarding this review,please contact me. Sincerely, Doug Smith , CBO Plans Examiner \orih�%esi Kidne� Center '107 South ChawSt, Paue 1 of 1 West Coast Code Consultants,Inc. 19109 36th Ave W,Suite 207 Lynnwood,WA 98036 E�*ft-5 Federal Tax ID#20-4707579 Trent Peppard,Senior Electrical Inspector Date Sege! berIO 2021 City of Port Angeles Invoice No.: 321 E 5th St. Terms: Net JU Port Angeles,WA 98362 Project: Plan Review WC3 Employee:Doug Smith,Marty Gillis,Katie Conrad Type of Service:Electrical Plan Review Begin Date:August 1,2021 End Date:August 31,2021 WC-3 Plan City Plan Check Name and Type of Project Address of Project Units Rate Amount Billed Check Number Number 221-PAN-004 21.0877 Northwest Kidney Center-2nd&3rd(Final)Plan Review-Doug Smith,Marty Gillis{ 707 South Chase St. 4.25 $l 10.00 $ 467.50 Katie Conrad i i I l ; I i I 1 € i f i 3 l i t _ $ 467.50 West Coast Code Consultants,Inc. 19109 36th Ave W,Suite 207 Lynnwood,WA 98036 (425)582-1719 ri-4*3 Federal Tax ID#20-4707579 Trent Peppard,Senior Electrical Inspector Date: August 10 2021 City of Port Angeles Invoice No.: 21121-PAN-JUL 321 E 5th St. Terms:I Net JU Port Angeles,WA 98362 Project:Plan Review WC3 Employee: Doug Smith,Marty Gillis,Katie Conrad Type of Service:Electrical Plan Review Begin Date:July 1,2021 End Date:July 31,2021 WC-3 Plan City Plan Check Name and Type of Project Address of Project Units Rate Amount Billed Check Number Number i 221-PAN-004 1 21-0877 Northwest Kidney Center-Ist Plan Review-Doug Smith,Marty Gillis Katie Conrad # 707 South Chase St. 3.75 sI 10.00 � s 41150I ! 1 1 ? i i._.._.__..__..___._.._...._..__.-__...._.......... I I ! I I I L__.._..._.._._.._--._.. j s 412.50 fj 19109 36th AN e NN, Suite 207 Lynnwood, WA 98036 (425) 582-1719 August 5, 2021 SECOND REVIEW WC3 Project#: 221-PAN-004 Port Angeles Project#: 21-0877 City of Port Angeles 321 E 5th St. Port Angeles, WA 98362 Attention: Trent Peppard Subject: Northwest Kidney Center—Electrical Only—2nd Plan Review Comments Mr. Peppard: West Coast Code Consultants, Inc. (WC3) has completed the second review (Electrical Only) of the proposed Northwest Kidney Center project located in Port Angeles, WA. This review was based upon the following: 1. Revised Electrical drawings dated 7/30/2021 by Case Engineering, sealed and signed by Michael S. Chase, Professional Engineer. 2. Letter from Randy Thompson, Director of Facilities to City of Seattle Department of Construction& Inspection re Optional Standby System The 2018 International Codes, 2020 NEC, as adopted by the State of Washington, were used as the basis of our review. Specific comments regarding this project are enclosed with this cover letter. If you have any questions regarding this review,please contact me. Sincerely, Doug Smith , CBO Plans Examiner Attachment: Comments SFCOND REX*AN" Port Angeles#: 21-0877 u"C3 Project #: 221-PAIN-004 JW August 5, 2021 Plan Review Comments Project Name: Northwest Kidney Center Electrical Review by: Doug Smith Location(s): 707 South Chase St., Port Angeles, WA GENERAL INFORMATION: The submitted documents for the above-mentioned project, as outlined in the cover letter, have been reviewed. The following comments address areas of concern, non-compliance with the governing code, potential errors,or omissions in the proposed design.The appropriate design professional must address each comment below and submit a written response in addition to revised plans and calculations if necessary. Please cloud any revisions made to the construction drawings and provide the date of the latest revision on each revised sheet. ELECTRICAL COMMENTS: El. Resolved. E2. Resolved. E3. Per NEC 110.9 and 110.10, please provide complete and detailed available fault current calculations and show the following on the plans: a. In order to determine the starting fault current at the service equipment, please specify the KVA rating and impedance of the utility transformer. If the information cannot be obtained from the power company, base the calculations on the worst-case scenario per the infinite bus method using the largest KVA rated transformer required for the service and figure such transformer with an impedance of 2% or less. As an alternate, please provide documentation from the power company clearly noting what the starting fault current is on the secondary side of their transformer. b. Please show lengths and types of all conductors in the calculations and specify the resistance of such conductors. c. Based on the calculations, please specify the amount of available fault current which could be provided to each panel and each piece of electrical equipment. d. Please show the fault current rating of each switchgear and each panelboard. e. Please specify on the plans the short circuit current ratings of all overcurrent protection devices or add a note on the plans indicating all overcurrent protection devices will have the same fault current rating as the rating of the panel or switchgear they are located within. Northwest 1 idner Center " 0` So+nth Chase St, Page '- of'3 `ECC)`s'1) RE ItAN r� Port Angeles#: _'1-08 77 WC' Project #: 221-PAN-004 August 5 2021 f. Please indicate on the plans the calculated available fault current which could be provided to the service equipment will be field marked, as required by NEC I I0.24(A). 2nd Review: Thank you for providing fault current calculations. However, some of the original above noted plan review comments have not been addressed for the calculations. Please address each of the following items: 1. The calculations do not note the KVA and impedance of the utility transformer. Such information is required to justify the starting fault current noted in the calculations. If the KVA and impedance of the transformer is unknown, then documentation must be provided from the electric utility to specify what the starting fault current is on the secondary side of the utility's transformer. Again, the starting fault current must be justified, it cannot be assumed. 2. The fault current values shown on the line diagram do not match the values shown at the fault current calculation table added to the plans. Please update the plans so to not have conflicting information. 3. Please specify on the plans the fault current rating of all panelboards and disconnects. The fault current ratings of equipment must meet or exceed the calculated fault current that each equipment could see. NEC 110.9 and 110.10. 4. Panel `MDP' shows a fault current rating of only l4kA. However, the calculations show fault current for `MDP' to be more than 14k. This is a violation of NEC 110.10. Please correct this on the plans. 5. Please specify on the plans the short circuit current ratings of all overcurrent protection devices or add a note on the plans indicating all overcurrent protection devices will have the same fault current rating as the rating of the panel or switchgear they are located within. 6. Please indicate on the plans the calculated available fault current which could be provided to the service equipment will be field marked,as required by NEC I I0.24(A). If you have any questions regarding the above comments, please contact Doug Smith at dougs@wc- 3.com or by phone at(801) 547-8133. [END] N; rtt»sest KidneN Center '0' South Chase St. Application Number . . . . . 22-00001381 Date 11/03/22 Application pin number . . . 819905 Property Address . . . . . . 707 S CHASE ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2925-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL OFFICE Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Sign ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NORTHWEST KIDNEY CENTERS HANSON SIGN CO. 700 BROADWAY PO BOX 928 SEATTLE WA 981224302 SILVERDALE, WA. SILVERDALE WA 98383 (360) 613-9550 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL NEW COMMERICAL Additional desc . . Permit Fee . . . . 88.00 Plan Check Fee . . .00 Issue Date . . . . 11/03/22 Valuation . . . . 0 Expiration Date . . 5/02/23 Qty Unit Charge Per Extension 1.00 88.0000 ECH EL-COMM-SIGN 88.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 88.00 88.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 88.00 88.00 .00 .00 PREPARED 11/02/22, 7:31:45 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00001381 707 S CHASE ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL NEW COMMERICAL 88.00 TOTAL DUE 88.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: Kidney Center Sign NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 11/7/2022 22-1381 TAP OWNER CONTRACTOR Hanson Sign PROJECT ADDRESS 707 S Chase St Application Number . . . . . 23-00001266 Date 11/30/23 Application pin number . . . 605234 Property Address . . . . . . 707 S CHASE ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2925-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL OFFICE Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Load bank ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NORTHWEST KIDNEY CENTERS SEQUOYAH ELECTRIC LLC 700 BROADWAY 15135 NE 92ND ST SEATTLE WA 981224302 REDMOND WA 98052 (425) 814-6000 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 132.00 Plan Check Fee . . .00 Issue Date . . . . 11/30/23 Valuation . . . . 0 Expiration Date . . 5/28/24 Qty Unit Charge Per Extension 1.00 132.0000 ECH EL-COM 0-200 SRV FEEDER 132.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 132.00 132.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 132.00 132.00 .00 .00 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 12/05/2023 23-1266 TAP OWNER CONTRACTOR Sequoyah Electric PROJECT ADDRESS 707 S Chase St