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HomeMy WebLinkAbout101 E 2ND ST - Building (2)ELECIM— cAL PERMIT CITY OF PORT ANGELES 360417-4735 Application Number . . 18-00001222 Date 8/06/18 Application pin number . . 723954 Property Address . . . . . . 101 E 2ND ST REPORT STATE SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-5-1-3145-0000- on our excise tax form Application type description ELECTRICAL ONLY y Subdivision Name . . to the City of Port Angeles Property use . . . Property Zoning .UNKNOWN (Location Code 0502) Application valuation . . . 0 Application desc Permanent wiring for over head light ---------------------------------------------------------------------------- Owner Contractor UPTOWN INVESTORS, LLC OWNER 7320 SW HUNZIKER STE 320 PORTLAND OR 97223 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 74.00 Plan Check Fee .00 Issue Date . . . . 8/06/18 Valuation 0 Expiration Date 2/02/19 , r,e ,fp ::- / `+_ _� Qty Unit Charge Per Extension 1.00 74.0000 ECH EL -COMM BRANCH SIR WO/ SIP 74.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 74.00 74.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 74.00; 74.0.0 .00 .00 Date: 14ALITJ lei ■ i , r,e ,fp ::- / `+_ _� � . � � III Date: T rn 3 rt it ❑ Multi -Family Residential Commercial / Industrial / Public Building Square footage: Mailing Address: L U 1 ?—KSOCCOL K014 / ^} -f t e, f d -A L Phone: �0 7 70-7 ©`Z L/,i ELECTRICAL CONTRACTORINFORMATION Name: License: Mailing Address: Expiration Date: Email Phone: Item Unit Charge Quantity Total (Quantity x Unit Charge) Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201-400 Amp. $160.00 $ Service/Feeder 401-600 Amp. $225.00 $ Service/Feeder 601-1000 Amp. $288.00 $ Service/Feeder over 1000 Amp. $410.00 $ Branch Circuit W/ Service Feeder $5.00 $ Branch Circuit W/O Service Feeder $74.00 _� $ Each Additional Branch Circuit $5.00 $ Branch Circuits 1-4 $86.00 $ Temp. Service/Feeder 200 Amp. $102.00 $ Temp. Service/Feeder 201-400 Amp. $121.00 $ Temp. Service/Feeder 401-600 Amp. $164.00 $ Temp. Service/Feeder 601-1000 Amp. $185.00 $ Portal to Portal Hourly $96.00 $ Sign / Outline Lighting $88.00 $ Signal Circuit/Limited Energy - Multi -Family $88.00 $ Signal Circuit/Limited Energy/First 1500 sf - Commercial $96.00 $ (Note: $5.00 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less $113.00 $ Thermostat (Note: $5 for each additional) $56.00 $ $ 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- 466, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (N Owner ❑ Electrical Contractor / Administrator) [Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417.4711 ] N lo, Nlho e' :,have you informed about this unsafe condition/practice'? (Mark all that apply) ❑Employer ® Other Government Agency (specify) ❑ Other Individual Please indicate the name of the person who was informed, job title and the date he/she was notified -T- 11. Are you acurrent employee or employee representative of this a ployce? YES ISNO If you are a current employee or employee representative, please indicate your desire: _❑Do not reveal my name to the Employer. GMy name may be revealed to the Employer Q —CA CONFIDENTIALITY NOTE: 10SH wilt ,mlv marmum cunTdenauhh regardnre the source of a complaint Lr e n rmp/uvee w em lnyee rrnre.vrntatnt Char /ilea a lX :1 and health iomplann the emplrr).ee or erriplovee nnprt,tentative muvi spe<r/ieully request conlidennahty !l the uonfidenijoHiv vection ul rhe complaint form ha.% onor been <nmplered, or there are quevoonv regarding the complannartr, requev /or , unlydennahn. 1 X)SH wilt contact the t omplanaw prior ro inrnanng a complaint in.vpectton SFl• 1 ) )NH Rewr ec{lve 'WRI )/ ! 9-5 ",Sq(gy &Health ('ottrplatnt Handling and (lam i<anon for more gualance Al� j imp 12. The Undersigned believes that a violation of an Occupational Safety or Health standard exists which is a job safety or health hazard of the establishment named on this form: (Mark -X- in one box) DEPT OF L&j ❑Employee C1 Representative of Employees ❑ Other (specify) SE0UIM 13. Nam (type or print) 14. Telephone Number 61id-t-114 VA I5,A�Idress — Street City State ZIP+4) 16. Signature: 17. Pate 18. If you are an authorized representative of employees affected by this complaint, please state the name of the organization that you represent and Your title. Organization/Union Name: I Your Title: OFFICIAL USE ONLY 19, Reporting ID 20. Previous Activity? Yes DNo 21. Optional Complaint If yes. Enter Type: Number: Number Identification 22, 23. Site 24. Account ID 25. 1 `131 Establishment ❑ Address ❑ Name Change" Change? Receipt 27. Received by: 28, Date Received 29. Time AM 30. Supervisor(s) assigned Information PM a. b. 32. Primary 33. Ownership (Mark "X•• in one box) Industry & Ownership SIC•NAICS a. ❑Private Sector h Local ❑. State Government ;ovetnment d. ❑Federal Agency Code Evaluation 34. Evaluated by: (CSHO ID) 35. Subject and Severity Discrimination ❑ 36. Is this a valid complaint'? []Yes ❑ No Imminent Danger ierious General Safety ❑ ❑ ❑ 37. Is this a valid referral') E] Yes ❑ No Health ❑ ❑ ❑ Action Taken 38 Q El Transferred to another jurisdiction: ❑ Other L&1 Division/Department Date ❑ State/Local (iovemment Date ❑ Federal OSHA Date ❑ Other Federal Agency Date ❑ Other Date ❑ Phone and Fax Person Letter Sent 'To Date sent Date response due 13 Inspection Planned Number of days to inspect. ,-Assigned to CSHO) ❑ No Action "Taken Reason no action was taken Comments F418-052-000 alleged safety or health hazards -English 11-2011 5. Name of ManagemenUSupervisory Official +-3 LZO at -y- 6. Business Telephone Number b 1-7 ,, , t<� cj �s21a� _t -t L.t�h � �L �..�,t� �' +� t J u.1��ti � � � " �` ci 7. Description of Business 8. Hazard Description. Describe the hazard(s) which you believe exist. Include the approximate number of employees exposed to or threatened by each hazard -1 v j i l~t� }�U`'r, A.�1+� -'��-it... G=�-jt�i.�, `SNAG '� �`�C��%.► "'int -1 C. C��.L.�.l¢l.� r t` 1 s{ - �t 3iC'i �'iL iN+�fi�z'Catt'1 r I j JLe'- 6 1._ �{rr t-) klE- 1 Ln 4-4 ....- _ .�, . ir`3C9� ti� tLX0 (r{It� C) � AU, .1 LSF c� t 'j v!E_ --r H CI � .��; t5 L ac-)1E.%I C_,1) Aar) lC,r k `� "i+v �t rS , i o '�iSl�,� V J c.._,4� ;(� be+ate a ''�+�e._ i� t..; r Lp t ��,(�� ;, t►�. tom; �-t 4,t'_� � ' i r� � � + ,� fit tµ 9? b t apT� r y t, fi—+ � r :-ice L� ty� -C- 5 , }{ A� ,:, I L f') _� t �fi �; J� to i. L L> i 1 .� a t r) tL i' €7 r� + } C i C.1Z-+6y !_IAC)�Co+C_€i L�CIliir.t .' �? S r -)C L L ki=.. ( � �'lj{C, ! f C} t 15 •-'1 (3t �L?s�ttif C �[ '� I>r+_7ltj' �` -10TY t-1 1I[CiZ i ti.t r!' i % 1 • E= t.L. tr"L� (.t� G �, i rim 1 400 ,t- LA t� ��'�� � SX �t �k t I w�+ _ -• 'r+��L 'f�I✓ L`te'atf4-1 .. r � t ' `t l �� t_ '- �t +i `- %`,`, �"-4L LV' itc('t 1 C 1gat I_7C� t Aej i� t'ei: �'.) 1L��a t 1 I > 9. Hazard Location. Specify the particular buildingAvork site and the work �-4 L,--� r where the alleged hazard is occurring. 6 ( H I f a CO:'WIDEN•TULITYHOTE. ROSH will only maintain conftdentialu) regarding the source ofa complaint for an gWlovee or em)lo •eye represenhgtve thatfile.s a DOSH work place sgfeq and health complaint. The eniplovee or emplovee representative mast spec ficall)• request confidenttaltn-. If the confidentiality section of the complaint form has not been completed or there are questions regarding the complainants request for cotifidenualay. DOSH €rill contact the complainant prior to initiating a complami irtspectiat, phi" t N),SH Hel'Wnaf 1)11•ecave i WR/)i i Y5 "Safety & Haalm t 'on)plaav Hondlune and ('iacsilicairon' for more guidance S FANDARDS and INFORMAI'ION'CASE FILE COPY DOSI1-7-2 F418-052-000 alleged satety or health hazards English I I -?A 1 1 Complaint or Referral # Department of Labor and Industries sTnTFo� RECEIVED ALLEGED SAFETY OR Division of Occupational Safety and I lealth ��y o 4 HEALTH HAZARDS (DOSII) � = s � �� AUG I j ++�� iicy L�1� �yz tees �°y 1. Dto DEIN OF L&I SEQJIM 2. Employer Name 3. Site Location - Street City State ZIP+4 l'l �- , ���� , S i �G�I�i >A►..ij�ii,l..�-S �,a�-�,. �'�'�� i� 2._ 4. Mai ling Address( if different) Street City State ZIP -4 5. Name of ManagemenUSupervisory Official +-3 LZO at -y- 6. Business Telephone Number b 1-7 ,, , t<� cj �s21a� _t -t L.t�h � �L �..�,t� �' +� t J u.1��ti � � � " �` ci 7. Description of Business 8. Hazard Description. Describe the hazard(s) which you believe exist. Include the approximate number of employees exposed to or threatened by each hazard -1 v j i l~t� }�U`'r, A.�1+� -'��-it... G=�-jt�i.�, `SNAG '� �`�C��%.► "'int -1 C. C��.L.�.l¢l.� r t` 1 s{ - �t 3iC'i �'iL iN+�fi�z'Catt'1 r I j JLe'- 6 1._ �{rr t-) klE- 1 Ln 4-4 ....- _ .�, . ir`3C9� ti� tLX0 (r{It� C) � AU, .1 LSF c� t 'j v!E_ --r H CI � .��; t5 L ac-)1E.%I C_,1) Aar) lC,r k `� "i+v �t rS , i o '�iSl�,� V J c.._,4� ;(� be+ate a ''�+�e._ i� t..; r Lp t ��,(�� ;, t►�. tom; �-t 4,t'_� � ' i r� � � + ,� fit tµ 9? b t apT� r y t, fi—+ � r :-ice L� ty� -C- 5 , }{ A� ,:, I L f') _� t �fi �; J� to i. L L> i 1 .� a t r) tL i' €7 r� + } C i C.1Z-+6y !_IAC)�Co+C_€i L�CIliir.t .' �? S r -)C L L ki=.. ( � �'lj{C, ! f C} t 15 •-'1 (3t �L?s�ttif C �[ '� I>r+_7ltj' �` -10TY t-1 1I[CiZ i ti.t r!' i % 1 • E= t.L. tr"L� (.t� G �, i rim 1 400 ,t- LA t� ��'�� � SX �t �k t I w�+ _ -• 'r+��L 'f�I✓ L`te'atf4-1 .. r � t ' `t l �� t_ '- �t +i `- %`,`, �"-4L LV' itc('t 1 C 1gat I_7C� t Aej i� t'ei: �'.) 1L��a t 1 I > 9. Hazard Location. Specify the particular buildingAvork site and the work �-4 L,--� r where the alleged hazard is occurring. 6 ( H I f a CO:'WIDEN•TULITYHOTE. ROSH will only maintain conftdentialu) regarding the source ofa complaint for an gWlovee or em)lo •eye represenhgtve thatfile.s a DOSH work place sgfeq and health complaint. The eniplovee or emplovee representative mast spec ficall)• request confidenttaltn-. If the confidentiality section of the complaint form has not been completed or there are questions regarding the complainants request for cotifidenualay. DOSH €rill contact the complainant prior to initiating a complami irtspectiat, phi" t N),SH Hel'Wnaf 1)11•ecave i WR/)i i Y5 "Safety & Haalm t 'on)plaav Hondlune and ('iacsilicairon' for more guidance S FANDARDS and INFORMAI'ION'CASE FILE COPY DOSI1-7-2 F418-052-000 alleged satety or health hazards English I I -?A 1 1 ELECTRICAL INSPECTION WIRING REPORT4 Itw_s Rv 417-4735= DATE:PERMIT # INSP TOR �-7 OWNER �? a ►.11XI CONTRACTOR ADDRESS 10, 0-- 2 LAv5-- APPROVED�QT_APPRO ❑ ....................DITCH.................... ❑ ❑................ ROUGH IN/COVER ............... ❑ ❑.................... SERVICE ................... ❑ ❑ .....................FINAL.................... ❑ ,/ CORRECTIONS NEEDED: C-dwI -12S SHA(J. /Vo'T' S-0- (1l J �wl►- - 7 .R . � � L . 12 NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS — DO NOT REMOVE --