HomeMy WebLinkAbout1607 E Front St B - Building ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
Application Number 11 00000478 Date 5/18/11
Application pin number 637838
Property Address 1607 E FRONT ST B REPORT SALES TAX
ASSESSOR PARCEL NUMBER 06 30 00 1 0 2740 0000
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning COMMERCIAL ARTERIAL
Application valuation 0
Application desc
1 circuit for lighting change
Owner Contractor
LADD FAMILY LMTD LIABILITY CO EXTRA MILE TECH F. ELECT LLC
3620 100TH ST SW #A 418 N RACE ST
PO BOX 98922 PORT ANGELES WA 98362
LAKEWOOD WA 98498 ( 60) 457 0198
Permit ELECTRICAL ALTER COMMERCIAL •�
Additional desc
Permit pin number 185884 O
Permit Fee 73 50 Plan Check Fee 00
Issue Date 5/18/11 Valuation 0
Expiration Date 11/14/11
Qty Unit Charge Per Extension �
1 00 73 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 73 50 1 `
Fee summary Charged Paid Credited Due
Permit Fee Total 73 50 73 50 00 00
Plan Check Total 00 00 00 00
Grand Total 73 50 73 50 00 00 C+
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o 0 h)Wz__ +-'LV 1
INSPECTION TYPE DATE RESULTS INSPECTOR.
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS ?J d
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date•
G\EXCHANGE\BUILDING �Y '
°Fp°AT� ELECTRICAL INSPECTION
uN WIRING REPORT
Glis"motilmE
F 417-4735
DATE: PERMIT# INSPECTOR
1 !/—C ��
OWNER
),AN>v / S
CONTRACTOR
IE `t'2A Off,l
ADDRESS -7
6 J
APPROVED NOT APPROVED
❑ DITCH ❑
❑ ROUGH IN/COVER
❑ SERVICE ❑
❑ FINAL ❑
CORRECTIONS NEEDED- -r/WT U V_VF_ #,�D
U�PD "ls t�� +
C-A F3 L'- 'To G� 5�� v►2 C��--
11-1 17-11
►�I I�� `319 H
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
MAY-16-2011 04 23 PM E JANSSEN 360 452 2982 P 01
ECEVD
CITY Or, PORT ANGELES.PI Rm APPLICATION MAY 17 2011 r
Building Division/tliectricai inspectiours
.321 East Fifth Street—P.O. Box 1.150/Port Angeles Washington,98362r � .
ELECTRICAL
Ph-(360)417.4735 Fnx: (360)41"-4711
INSPECTIONS �
Date: a� / (o 11
1 8 2 Single Family Dwelling MUlti-Family or Commercial' COmmerriai Addition/Alteration!Remodel/Repair'
'Plan Review May Be Required, Please COm lets Electrical Plan Review Information Sheet
Job AddMds:-- !� LG_ c i r
autlding Square Footage:_ __ c_�• -7 ( I.)-- -
Desc4ptlon of above
�•'1�—` Ld�idllLl+,jiZd
Owner Informations w f.. 1 ! {? I -� ______ ._..-_ _— .__.- _-_--• --
Name•. nn o ` Contractor Information
MS11INAddress: 1 r_< <� ��, �! Nemo: ExTA'1r rvlr(_E %Ecce0, eU;r Cr2rC_r•i•L
c' .k , --:- Maifin_Address:_ 0 J`'�'�Ca.. SLG -s r
r7.-1+ Stam: .! _�:p `1SZJ`.Ly
Zlp:�g i 6 i
—J� State:�•rr
Phone:•/S 7TS�a�
License#IExp_r' 177 ,P:C_ _
am
Service/Feeder 200 Amp. $119.90 .Q( Total L9hC Multiplied by Unit Ctlsrtie�
Servic eVFeeder 201-400 Amp. $145.50 --
ServWFeeder 401-600 Amp $204.60Service/Feeder 601.1000 Amp. $262.20 _—
Servico/Feeder over 1000 Amp, $372.50 ---
Branch Circuit WI Service Feeder $ 2.60 --
Branch Circuit W/0 Service Feeder $ 73,.50 - $-
Each Additional Branch Circuit 3 2,60 `� $--Z.2 S"0
Tornp.Service/Feeder 200 Amp, $ 92.70 -`- $--
Temp.Servloe/Feeder 201400 Amp. $'110.30 —
Temp.So*e/Feeder 401.600 Amp. $146.70 --
Temp•Servloe/Feeder 601-1000 Amp S 167 90 — -- $— —
Portal In Portal Hourly S 95.9n - $_
SIgrMitllne Ughfing $ 80,20 --` S —
Signal Circuit/Limited Energy/First 1500 sl Commemb.;i S, q.5.90 --' $ -- —
Nota: $5.00 for earh additional 1500 s' — - $-- .—
Signal Clltuil/Umlted Energy 1&2 Familv Dwelling $ 63.90 _
Signal CircuiU Limned Energy Multi-Famliy,)welling $ 63.90 -
hUnufaMured Home Connection $119.90 t-
Renewable Electrical Energy 5KVA Sysiern or 1.13IS9 S 102.30 --
Thermostat $ 56.00 " $ --�
Flrat 1300 Square FL $110.30
Each Additional 500 Square Ft.or Portior,0 $ 35.20Each Outbuilding or Detached Garage S 73.50 $ -Each Swimming Pool or Hot'rub
$-7-L S"!_Total 70
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.
Afler 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.0 RCW Chapter 19.28. WAC Chapter 296.466 The City of Port
Angeles Municipal Code,and Utility Specifications and PAMC 14 05.050 regarding Electrical Permit Aoolicalions
810rtature of owner electrical contractor or electrical administrator 17 Galin U
L7 Credltcerdo _
--115 --
0,,*°°RT4p,, ELECTRICAL INSPECTION
u'kN
«_ y WIRING REPORT
���OwpR-s�y� 417-4735
DATE. PERMIT# INSPECTO
V i'Z
OWNER -,A A
v �L
CONTRACTOR
ADDRESS
APPROVED NOT APPROVED
❑ DITCH ❑
❑ ROUGH IN/COVER ❑
❑ SERVICE ❑
❑ FINAL ❑
CORRECTIONS NEEDED- KLA—c f, (Z tt-P L-
Front St.Ste.B. Port Ang,
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
- DO NOT REMOVE -
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BUILDING DIVISION
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CERTI F,IC-�A- TE. DF, OC,.CUPANCY
City-of'Port AngOes NBMildinlg,_Division
This certificate is issued pursuant to the requirements"6fSection JIT6f the 1009 International Building
Code certifying that arthe',finie',cfi -issuance this structure was in compliance with the various ordinances
of the City regulating,' uildi �hAi�-wqefiq folloi4�i '
qk,,- use r the. ,
Business name `�V,,J,,*,,S`a;'Vb Bodfiq,L�0� -,,(OWhe��',"D��,-.vid,JeW&11)-
-Al
Business address 'TGOTE Front.St,#B
Property owner . Ladd
a
Property owner sg'add)-`eiS, 3620 1 00Pst SWW�' -BOX L; k6wood WA 98498
Automatic fire spFUnkler system. NoVR,'e'q'u'ire"d-
Use & occupancy classification Mercantile
Building permit number 11-122 A
Occupant load PI&K-20,09'"MC42T
Type of construction.
W 03/28/11
144-
r Date
Post on the premises in a conspicuous place', 4all4f6t be removed except by the Building,Official.
WIT-
To Roj �er
pyo,poRT.4 CERTIFICATE OF OCCUPANCYAPPLICATIONI, Permit#
gr CITY OF PORT ANGELES FEES
w
r__L.—.�III� Attn. Permit Technician $ Certificate/Inspection
Rww321 E. Fifth St. Port Angeles, WA 98362 $ Parking Business Improvement Area (PBIA)
(360)417-4815 fax(360)417-4711 fee charged for Downtown locations
PLEASE PRINT IN INK
Check one:New business in VP.Ai0°.?❑ Change of ownership only?'Moving location from within P.A.? El Zoning�-
IEUVi�!ESS DAME \(i SA l�yu�l/��
EusineEs address I607 r frDurT 57-/ ''8 Mailing address 54'-frLe-
Phonenumber 3&0-1-457 -7oL7o Opening date 0i /0.73ll Days&hours of operation 14—S H- 7
7
Business owner's name 'r�c,\1;d Jewe.d _ Contact phone 360 c,"w -z,3-zz ,
Business owner's address_ q zI S Trr I/-- View D--. 1--3vr4 �. 34,-57
Brief description of business gc/s /;kIyu- �lle��+
7
Property owner's name LakxlFa ,�� LLC Contact phone
Property owner's address/contact 3Zd I06t"i' s , sv,,r -*I}.,Po zot `59 ZZ, Lake-wond Wn
48�I9�
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering stairways, ramps, bathrooms, electrical heating/cooling/ventilation systems, etc)
Work planned.
FIRE DEPARTMENT phone 417-4663 Fire approval by_on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No
Work planned
PBIA (Parking Business Improvement Area Downtown) phone 417-4623
Square footage of business?.4,,,,r• 0000 1-7
notified on
Is business moving within the PBIA? Yes ❑ No)(
CITYCLERK phone 417-4634
City Clerk approval by on
Second-hand dealer/pawnbroker business?Yes ❑ No Y
Will there be dancing at this business?Yes ❑ No W
A City of Port Angeles Business License is required for'
Taxi, Peddlers, Second-Hand Dealer Pawnbroker Dance,
Hotel-Motel, Fireworks,Ambulance, and Tattoo Businesses.
Page 1 of 2
i
ti
3
7
COMMUNITY&ECONOMIC DEVELOPMENT phone 417-4750 CED approval by________on
Number of off-street parking spaces available for employees and
customers?Rtrl_uo Fr -o 41 Shared
(A parking plan may be required.) `R&
Signs?(wall-mounted,freestanding, projecting, awning,A-frame, etc?)
Signs planned:
PLEASE'NOTE: NO flashing, intermittent,or chasing signs are permitted in the City of Port Angeles.
PWE approval by^,;iz_on 2—2-'Z—
PUBLIC
ZZ—PUBLIC WORKS DEPARTMENT ENGINEERING phone 417-4812 A10 C.b4,y at,—
Is site work planned(new or re-located sewer or water service,
excavation, grading or filling,work in City right-of-way
new driveway openings, site drainage parking lots,downspouts,
irrigation-system backflow devices, etc.). Yes ❑ No g'
Work planned
PUBLIC WORKS WASTEWATER phone 417-4845 PWW approval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No
If yes,what will be discharged.
Call for Certificate ofOccupancy inspections BEFORE openinq business.
Building Department Inspection 417-4815
Fire Department Inspection 417-4653
Please sign up for, utility services at the cashiers' counter
I hereby apply for a Certificate of Clccupanoy 1 acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of
permit. / I
Date LA 3;2,011 Print Name��Vip� yJgA, 1/`
Signat
TVortns'Building Division\Cenificate of Occupancy Application(2010).doc
Page 2of2
l S' 1 '
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t
CERTIFICATE OF OCCUPANCYAPPLICATION Permit#
FEES
CITY OF PORT ANGELES Certificate/Inspection
Attn. Permit Technician
321 E. Fifth St. Port Angeles,WA 98362 $ Parking Business Improvement Area (PBIA)
(360)417-4815 fax(360)417-4711 fee charged for Downtown locations
=ownersh�ipp
NK
Check one:New bus�inness in P.A.?
Cving location from within P.A.? ❑ Zoning�-
BUSINESS NAMc Y SA f 1 i4 —
Business address_ 1Coo7 h�- Frogyr STr 013 Mailing address Same
Phone number 3W)-1-157 -7000 Opening date o /03/11 Days&hours of operation M-5 U- 7
Business owner's name Z>ay;d Jewell Contact phone '3100 (P-To Z32z
Business owner's address512 STi' ���� 98 (�
Brief description of business s C& u
Property owner's name La( LLC _ Contact phone
Property owner's address/contact 36 20 ivo s s -WA 11Do; x'89 2Z Laker
a6X. WA
BUILDING DEPARTMENT phone 417-4815 Bldg approval by nja,.j o
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No X
Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding, foundation work,
adding/altering stairways, ramps, bathrooms, electrical heating/cooling/ventilation systems, etc)
Work planned:
FIRE DEPARTMENT phone 417-4653 Fire approval bye_on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No
Work planned:
PBIA (Parking Business Improvement Area Downtown) phone 417-4623
Square footage of business?4,, 200th PB/Anotified on
Is business moving within the PBIA? Yes ❑ No)
CITY CLERK phone 417-4634 City Clerk approval by_ on�'
Second-hand dealer/pawnbroker business?Yes ❑ No t'
Will there be dancing at this business?Yes ❑ No V
A City of Port Angeles Business License is required for
Taxi, Peddlers, Second-Hand Dealer Pawnbroker Dance,
Hotel-Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
C�
COMMUNITY&ECONOMIC DEVELOPMENT phone 417-4750 CED approval by_.*�on 21-24-11
Number of off-street parking spaces available for employees and
customers?''i�itr/ct�F6t- r.�-t1� J�o L_p!fz T/_S kat-e6((A parking plan may be required.)
Signs?(wall-mounted,freestanding, projecting, awning,A-frame, etc?)
Signs planned:
1n1�ll it's SkiQ al�F&Sri'AJr. T;re�5Ta„�l(I,K.Da S«w
PLEASE NOTE. NO flashing, intermittent,or chasing signs are permitted in the City of Port Angeles.
�_
PUBLIC WORKS DEPARTMENT ENGINEERING phone 417-4812 PWE approval by on
Is site work planned(new or re-located sewer or water service,
excavation, grading or filling,work in City right-of-way
new driveway openings, site drainage, parking lots,downspouts,
irrigation system backflow devices, etc.). Yes ❑ No
Work planned'
PUBLIC WORKS WASTEWATER phone 417-4845 PWWapproval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No
If yes,what will be discharged:
Call for Certificate of Occupancy inspections BEFORE openinq business
Building Department Inspection 417-4815
Fire Department Inspection 417-4653
Please sign up for utility services at the cashiers' counter
I hereby apply for a Certificate of Occupancy I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of
permit.
Date FA .3;ZDII print Name / ctV iGII Signat
TAFonnslBuilding Division\Certificate of Occupancy Application(2010).doc
Page 2 of 2
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CE RTI F,,ICATE�O�F =O U PAlV CY
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Cit,of`Port Angeles:.="B:uilding D"Imision
Y " ,
This certificate is issuedpursuant to the requiremenis4 of Section 11;1'of the 2009 International Building
, • 1,
Code certifying that at,,thetimeiofissuance this structure was in compliance with the various ordinances
of the City regulating blding consir�ucti6n orruse for the followin` '
g•
Business name �r `. 'ln,
Ui,sa�Ve Boutique (®wne`r• Kevin�Pedrey)� 'k
?
Business address, ' ,16.074E FrontS,,'t �#B
Property owner Ladd FarnilyLmtdLbility'.C'o {
Property owner ad res's 3620 100Jr
'Sf=SW;,#A;.PO'Box:9$922;.eLak wood WA 98498
Automatispill
i •;�.J �� ..j .�. ��'"' � _� •
c fire spznkler.system. Not Required -'
Use &occupancy 14 s-fKication. Mercantile wig
;'
Building permit number 1, 10-1; -67:,,,,144 — —,*
Occupant load. fi
Type of construction. U,
01/20/11
3 ue er, Date
Post on the premises in a conspicuous p %47..„Iihis cet ifcat ..sbail ii't be removed except by the Building Official.
V-N
tP
PREPARED 12/30/10 8 27 52 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 12/30/10
ADDRESS 1607 E FRONT ST B SUBDIV
TENANT NBR VI SA VE BOUTIQUE
CONTRACTOR PHONE
OWNER LADD FAMILY LMTD LIABILITY CO PHONE
PARCEL 06 30 00 1 0 2740 0000
APPL NUMBER 10 00001507 CO- CHANGE OF OCCP/USE
PERMIT CO 00 CHANGE OF OCCUP/USE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
CO99 01 12/30/10
L BLDG C/0 FINAL TIME O1 00
OVERRIDE TAKEN BY LPANGRLE DATE 12/30/10 TIME 08 21 40
December 30 2010 8 20 24 AM 1pangrle
DAWN 457 7000
C OF O FINAL VI SA VE BOUTIQUE
AFTERNOON
COMMENTS AND NOTES
fo Re) �cr
�.saar�;4�F CERTIFICATE OF 0 CCUPA NC Y A PPLICA TION Permit# 16—
FEES
CITY OF PORT ANGELES $Z
cate / Inspection
Attn Permit Technician
321 E. Fifth St. Port Angeles WA 98362 Business Improvement Area (PBIA)
(360)417-4815 fax (360)417-4711 rged for Downtown locations
PLEASE PRINT IN INK
Check one: New business in P.A:4 Change of ownership only? ❑ Moving location from within P.A.? ❑ Zoning
BUSINESS NAME Ali SQ c4-h q,--K-t-�
Business address 1 U W? E-Frbij F Mailing address SA A-t,
Phone numberSLeD ql,7, '/aov Opening date I i Days & hours of operation W-S /D-Le
Business owner's name iK>°Uln Contact phone-5bD-i(UcQ 07?
Business owner's address �(o a �-(]C��� �1evU�l-'I�t� r��y� VIn�P ds wH Gj ECIn_
Brief description of business D S i I)
Property owner's name L Gtdd F VO-M i LH L m+d, Lt Abi�Contact phone
Property owner's address/contact 3 2 oo*i, S SW #fl 0 Box; 91 597,2 L a int
21
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No
Construction changes planned (moving walls adding/enlarging windows or doors roofing siding foundation work,
adding/altering stairways, ramps bathrooms electrical heating/cooling/ventilation systems etc)
Work planned
FIRE DEPARTMENT phone 417-4653 Fire approval by on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No
Work planned
PBIA (Parking Business Improvement Area Downtown) phone 417-4623
Square footage of business? PBIA notified on
Is business moving within the PBIA? Yes ❑ No
CITY CLERK phone 417-4634
City Clerk approval by on
Second-hand dealer/pawnbroker business? Yes ❑ o
Will there be dancing at this business? Yes ❑ N
A City of Port Angeles Business License is required for
Taxi, Peddlers, Second-Hand Dealer Pawnbroker Dance
Hotel-Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
COMMUNITY& ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on fi
Number of off-street parking spaces available for employ es n
customers? _. � a�
(A parking plan may be re 4 ired.)
Signs? (wall-mounted freestanding projecting awning A-frame etc?)
Signs planned.
will re-SKih cwl max' s+ ' n
PLEASE NOTE. NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PWE approval by
LT !C WORKS /l EI/AR7711 111T ,111(_`111 ICCCIRI^ PF-c— A47 •Oqn
Is site work planned (new or re-located sewer or water service,
excavation grading or filling work in City right-of-way
new driveway openings, site drainage parking lots' down
spouts,
irrigation system backflow devices etc.) Yes El No
Work planned
PUBLIC WORKS WASTEWATER phone 417-4845 PWW approval by on
Will waste other than domestic household waste be discharged into the sewer system? Yes ❑ No�—
If yes, what will be discharged-
Call for Certificate of Occupancy inspections BEFORE opening business.
Building Department Inspection 417-4815
Fire Department Inspection 417-4653
Please sign up for utility services at the cashiers' counter
1 hereby apply for a Certificate of Occupancy I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge Incorr mation may result in revocation of
permit. 0P6VdbC)P5 V'ilav►4�Ce1^
Date* 0 Print Name � (,(� ��C�i!��� Signature
T,TormsTuilding Division\Certificate of Occupancy Application(2010).doc
Page 2 of 2
Y—pORTaCERTIFICATE OF OCCUPANCY APPLICATION Permit# o- � 50—I
$' CITY OF PORT ANGELES FEES
tom z:M $Ze
cate /Inspection
Attn Permit Technician
�r 321 E. Fifth St. Port Angeles WA 98362 Business Improvement Area (PBIA)
(360)417-4815 fax (360) 417-4711 rged for Downtown locations
PLEASE PRINT IN INK
Check one- New business in P.A:4 Change of ownership only? ❑ Moving location from within P.A.? ❑ Zoning
BUSINESS NAME—Vi a j>
Business address I U o1( r FYnnf �jRU Mailing address Sa rn_t,
Phone number 34D. qS-7. '?oo(D Opening date / l Days & hours of operation M—S ID-t-p
Business owner's name re in �(jy�e_v Contact phone_5bD-Lke0 07?
Business owner's address y oa 5-T,�Lt 0 ZtN�! 'I kt J9�y� W H-Q 2
Brief description of business D S U.)
Property owner's name L 0.dd �yn i �� L.Yyt+d, L1 ab; Contact phone
Property owner's address/contact 3 -W, S 5 gfl po Box 9 8922 L a W
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on -30--1
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No y
Construction changes planned (moving walls adding/enlarging windows or doors roofing siding foundation work,
adding/altering stairways, ramps bathrooms electrical heating/cooling/ventilation systems etc)
Work planned
FIRE DEPARTMENT phone 417-4653 Fire approval by on
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No
Work planned
PBIA (Parking Business Improvement Area Downtown) phone 417-4623
Square footage of business? PBIA notified ><lon
Is business moving within the PBIA? Yes ❑ No
CITY CLERK phone 417-4634 City Clerk approval by_s_�on
Second-hand dealer/pawnbroker business? Yes ❑All o
Will there be dancing at this business? Yes ❑ N
A City of Port Angeles Business License is required for
Taxi, Peddlers, Second-Hand Dealer Pawnbroker Dance
Hotel-Motel, Fireworks, Ambulance and Tattoo Businesses
Page 1 of 2
COMMUNITY& ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on 1
Number of off-stree parking spaces ava'lable for employ esAnd
customers? ��
(A parking plan may be re fired.)
Signs? (wall-mounted, freestanding projecting awning A-frame etc?)
Signs planned:
W, I II
re-sKih stn E x I S41,V1 7EY-y e s n
PLEASE NOTE. NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles
PWE approval by KV on 1-5 111
PUBLIC WORKS DEPARTMENT ENGINEERING phone 417-4812
Is site work planned (new.or-re-located sewer or water service
excavation grading or filling work in City right-of-way
new drivewayopenings site drainage parking lots down pouts
irrigation system backflow devices etc.) Yes ❑ No LTJ
Work planned /
PUBLIC WORKS WASTEWATER phone 417-4845 PWW approval by on
Will waste other than domestic household waste be discharged into the sewer system? Yes ❑ No�1
If yes what will be discharged
Call for Certificate of Occupancy inspections BEFORE opening business.
Building Department Inspection 417-4815
Fire Department Inspection 417-4653
Please sign up for utility services at the cashiers' counter
t
1 hereby apply for a Certificate of Occupancy I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge Il7corr mation may result in revocation of
permit. �oPe�}-i�=YDS f(lah4�e1^ _
Date4/ (] Print Name (,(� (,C)V�i�� Signature
T'\Forms\Building Division\Certificate of Occupancy Application(2010).doc
Page 2 of 2
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