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819 Georgiana St Ste B - Building
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"..", . ~,c; E: 0-":"",,,,,,,,0) ~'-.-- ."F"*~ 0) .~ ~ I..l ~";g''''':'''i!'''''''''''- ~ CJ ~ ;S.S 4-< .~ 0\ ~ 0 0,...., ....,; ....:l 00 c P=l1 ~ ~ ,S; " C;J .~ ~ "0 (j '" "0 <.::: al ~ 'Vi '- bD '" 0 oj i:i. .... c 0 " :g '" c " :: ~ ':; ::3 0 0 al '7 o o 01 ,.l::i ...... Ir) ,...., . .m (1) .- o .~ ca- -- nO .~ g> o .- "0 ;u ..' j u...~~ (e r-ri:.r~ 'e. (SI " e.<'-\.\t" v "'-~ ROUTING SLIP ,- Certificate of Occupancy ~ Certificate/Inspection Fee DATE R..-I ~, I) Addres(.6f Proposed Business r ~ , ness/Sd ,,7~home ~~fJ. x~f:\/ Brief description of proposed business: legal Description: lot /? Current Use of Property: ~ DJ.UI'~.R Zoning Classification of Propert~: C.C) Will THERE BE ANY OF THE FOllOWING? Construction changes. . . . . . . . . . . . . . . . . . . . . . . . . . . Electrical changes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mechanical (heating, cooling, stoves) . . . . . . . . . . . . . . Plumbing changes ............................. New or relocated signs. . . . . . . . . . . . . . . . . . . . . . . . . . New septic tanks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New sewer service ............................. Admission charged to patrons. . . . . . . . . . . . . . . . . . . . Is this a home occupation? ...................... Excavation of filling of lots ....................... Work done in City right-of-way. . . . . . . . . . . . . . . . . . . . Is there sufficient off-street parking? . . . . . . . . . . . . . . . New driveway openings. . . . . . . . . . . . . . . . . . . . . . . . . A grading plan for site drainage. . . . . . . . . . . . . . . . . . . (parking lots, downspouts, etc.) .................. Are the existing streets paved? ................... Are there existing sidewalks? . . . . . . . . . . . . . . . . . . . . . Is there curb and gutter? ........................ Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YES N~ - v' -~ -~ V'?" == ::; - --,;T" - V ~ V ::z- -~. /7- /7'- ~- New Business ............................ ( Transfer of Business location. . . . . . . . . . . . . . ., ( )<' Change of Ownership . . . . . . . . . . . . . . . . . . . . .. ( New Building", . . . . . . . . . . . . . . . . . . . . . . . . . . .. ( Remodel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., ( Temporary Business .,. . . . . . . . . . . . . . . . . . . ., ( Change of Use. . . . , . . . . . . . , . . . . . . . . . . . . . .. ( THE FOllOWING Will BE REQUIRED: PERMITS 1) Building 2) Plumbing 3) Electrical 4) Mechanical 5) Sewer 6) Sidewalk installation 7) Driveway installation 8) Curb installation 9) Sidewalk obstruction 10) Water meter installation 11) Fire 12)-\)ccupancy /13),Aign '-r4) Shoreline 15) Home occupation 16) Conditional use 17) Other BUSINESS LICENSE 1) Taxi 2) Peddlers 3) 2nd Hand Dealer 4) Pawn Broker 5) Dance 6) Hotel - Motel 7) Fireworks 8) Ambulance 9) Tattoo shop 10) Other I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the Date: information I have supplied is correct to the best of my knowledge. EJECTED Comments / Conditions Building Section Public Works Department Planning Department Fire Department City Clerk P.B.I.A. t;--2/-()3 -~ kDO) '5 --ZTJ --03- ~J Application Number . . . . . 25-00000012 Date 1/10/25 Application pin number . . . 610928 Property Address . . . . . . 819 GEORGIANA ST B ASSESSOR PARCEL NUMBER: 06-30-00-5-1-3773-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . UNKNOWN Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Security Cameras ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ VOLUNTEERS IN MEDICINE JOHNSON ELECTRIC COMPANY 819 GEORGIANA ST 3129 S REGENT PO BOX 639 PORT ANGELES WA 98362 PORT ANGELES WA 983623511 (360) 728-4327 (360) 457-4431 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 201.40 Plan Check Fee . . .00 Issue Date . . . . 1/10/25 Valuation . . . . 0 Expiration Date . . 7/09/25 Qty Unit Charge Per Extension 1.00 190.2000 ECH EL-LIMITED 1ST 1500 SQ FT 190.20 2.00 5.6000 ECH EL-ADDNT LIMITED 1500 SQ FT 11.20 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 201.40 201.40 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 201.40 201.40 .00 .00 Public Works and Utilities Department 321 E. 5th Street, Port Angeles, WA 98362 360.417.4735 | www.cityofpa.us | electricalpermits@cityofpa.us ELCOM MULTI-FAMILY / COMMERCIAL ELECTRICAL PERMIT APPLICATION Project Address: Project Description: □Multi-Family Residential □ Commercial / Industrial / Public Building Square footage: OWNER INFORMATION Name: Email: Mailing Address: Phone: ELECTRICAL CONTRACTOR INFORMATION Name: License: Mailing Address: Expiration Date: Email: Phone: PROJECT DETAILS Unit Charge Quantity Total (Quantity x Unit Charge) $237.75 $ $237.75 $ $332.85 $ $427.95 $ $523.05 $ $5.60 $ $95.10 $ $47.55 $ $95.10 $ $190.20 $ $237.75 $ $285.30 $ $332.85 $ $95.10 $ $142.65 $ $190.20 $ $190.20 $ $190.20 $ 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 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: $5.60 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5.60 for each additional)$95.10 $ $ TOTAL Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296- 46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (□Owner □Electrical Contractor / Administrator) Pe r m i t # : [Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711] ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: 1. Fitting and connectors shall only be used with specific wiring methods NEC 300.15 2. Secure cables in office NEC 300.11 NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 1/10/25 25-12 TAP OWNER CONTRACTOR Johnson Electric PROJECT ADDRESS 819 Georgiana St B ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN / COVER SERVICE FINAL CORRECTIONS NEEDED: NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 01/13/2025 25-12 TMC OWNER Contractor Johnson Electric Company ADDRESS 819 Georgiana St Unit B