HomeMy WebLinkAbout321 N Chambers Street Address:
321 N Chambers Street
PREPARED 12/14/16, 8:26:20 INSPECTION TICKET PAGE 4
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 12/14/16
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ADDRESS . : 321 N CHAMBERS ST SUBDIV:
CONTRACTOR HANSON SIGN CO INC PHONE (360) 613-9550
OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE
PARCEL 06-30-00-8-1-0125-0000-
APPL NUMBER: 16-00000920 SIGNS
------------------------- ------------------------------------------------------------------
PERMIT: SIGN 00 SIGN
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-------- --- ---------- -------
BL1 01 12/14/16 LDG FOUNDATION FOOTING
December 13, 2016 8:36:10 AM jlierly.
December 13, 2016 4:19:49 PM jlierly.
360-979-748 Brandon
-------------------------- ----------- COMMENTS AND NOTES --------------------------------------
C
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY 8c ECONOMIC DEVELOPMENT- BUILDrNG DIVISION
:r 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 1G-00000920 Date 7/12/1G
Application pin number . . . 868160
Property Address . . . . . . 321 N CHAMBERS ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-8-1-0125-0000- on your state excise tax form
Application type description SIGNS
Subdivision Name . . . . . . to the City of Port Angeles
Property Use . . . . . . . .
Property Zoning . . . . . . . UNKNOWN (Location Code, 0502)
Application valuation . . . . 0
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Application desc
Free standing, 2 sided 30ft2 per side site plan#20
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Owner Contractor
------------------------ ------------ -----------
CLALLAM CO PUB HOSPITAL DIST 2 HANSON SIGN CO INC
DBA OLYMPIC MEDICAL CNTR PO BOX 928
PORT ANGELES WA 983623909* SILVERDALE WA 98383
(360) 613-9550
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Permit . . . . . . SIGN
4 Additional desc
Permit Fee . . . . 115,00 Plan Check Fee .00
Issue Date . . . . 7/12/1G valuation . . . . 0
Expiration Date 1/08/17
Qty Unit Charge Per Extension
1.00 115.0000 PER S-FIS OR PROJ SIGN > 25 SF 115.00
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Special Notes and Comments
July 12, 201G 11:30:11 AM pbarthol.
project will result in the replacement of-a monument sign.
the new sign is limited to a height of 51 . site is 14,00Ssf
allowable signage is 100sf total signage. Verify no more
that 40sf of existing signage will remain for a total of
100sf.
pb
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
------------7---- ---------- ---------- - ---------- ----------
Permit Fee Total 115.00 115.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 115.00 115.00 .00 .00
Separate Permits are required forelectrical 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 has 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 co d with whether specified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the prov* ions any state or local law regulating construction or the performance of
construction.
Date 4rint Name Signature Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permft
BUILDING PERMIT INSPECTION RECORD
— PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS—
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspec tion Type Date Accepted By Comments
FOUNDATION:
Footings
Sternwall
Foundation Drainage/Downspouts
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/Under Floor
Shear Wall/Hold Downs
Walls/Roof/Ceiling
Drywall(Interior Braced Panel Only)
T-Bar
INSULATION:
Slab
Wall/Floor/Ceiling
MECHANICAL:
Heat Pump/Furnace I FAU/Ducts
Rough-In
Gas Line
Wood Stove/Pellet/Chimney
Commercial Hood/Ducts
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
,Skirting
PLANNING DEPT. Separate Permit#s ---ISEPA:
Parking/Lighting ESA:
Landscaping ISHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY1 USE
Inspection Type Date Accepted By
Electrical 417-4735
Construction -R.W. PW I Engineering 417-4831
Fire 417-4653
Planning 417-4750
1 Building 417-4815
?OR T.4,A%,C�
SIGN PERMIT APPLICATION Print in ink
CITY OF PORT ANGELES - For City U�e Only-
Attn: Building Permit Technician
321 E. Fifth St., Port Angeles, WA 98362 Date Received b
(360)417-4815 fax (360)417-4711 Permit# 1'�- q.Lo
Date Approved!:�Ja
Ir I -T
Applicant or Agent Craig Sheets /The Robinson Company Phott' 206.786.5549
Property Owner Olympic Medical Center Phone 360.417.7235
Property Owner's Address 939 Caroline Street Port Angeles, WA 98362
Contractor Hanson Sign / GSI Signs Phone 360.613.9550
Contractor's Address PO Box 928 Silverdale, WA 98383
License # 4493S134 th PL Seattle, WA 98168 Expires 05/8/2018
5 ,0 --- 10/28/2017
n- �_-,T
Project Address 321 North Chambers Street, Port Angeles, WA 98362
Business Name Olympic Medical Center
Parcel Number 0,/0�W_&0-g-1 _v j?
�g- Lot Zoning 1!�o
Submit an 8 x 11 "site plan & three sets of plans that include:
• Type of sign (wall-mounted, projecting, freestanding, illuminated, other...
• Placement and sq. ft. area
• How the sign will be securely attached (Engineering specs may be required for freestanding signs)
• Separation distance between the bottom of projecting and freestanding signs and the surface below
See "Chapter 14.36 Sign Code"of the City of Port Angeles Municipal Code for sign requirements.
Sign Type &Brief Description: (Type, location, sq. ft.)
Sign #1 20, Free Standing, Site Plan#20, 30 SF Each Side Total=60 SF
Sign #2
Sign #3
Sign #4
Totals(Unit charges Sign(s)
Unit Chang Quantit multiplied by quantities) Type of Sign Valuation$ dO' q<J&a
$47.00 x = $ All signs less than or equal to 25 sq. ft.
$85.00 x = $ Wall sign or marquees, over 25 sq. ft.
$115.00 x 1 = $115 Freestanding sign or projecting sign, over 25 sq. ft.
GRAND TOTAL Make Checks Payable to: City of Port Angeles
$115 Credit Cards (Except American Express) are accepted
Existing sign(s)area sq. ft. +Proposed sign(s)area_sq. ft. = Total sign(s)area_sq. ft.
Building tagade area (height _ft. X width ft.) = _ sq. ft. (if a building has more than one
business in it, only measure the area of the building fagade that is used by the business applying for this permit.)
I have read and completed this application and know it to be true and correct. I am authorized to
apply for this permit and understand that it is my responsibility to determine �(,� permits are
required, and to obtain permits prior to working o projects.
Date Print Name Z Signature aoe�z
T:Forms/Building Division/Sign Permit Application.doc
IV 7-AL-t-
/&a
CITY OF PORT ANGELES—Construction Plans
mi� -nit based upon these plans
The ISSLIancc or this perl
specifications and other data shall not prevent the
FILt building offilcial frorn thereafter requiring the
correction of errors in said plans,specifications.and
other data. or froin preventing building operations
being carried on thereunder when in violation of all
jurisdiction.
es of this j
codes and ordinanc
-JELD.APPROVAL
K SU JECT TO
A
125/8 LLLWO
BY
VIM�Z4
SIGN TYPE21.5
Exterior Wayrinding Signs
90 5/16" LOCATION 20
APCO Series 4.4 1 OCP
72' Non Illuminated MuItiPzmLI Post
Mounted PolySign With Cu�Panel.
SPCT20D Contour Posts.
Natural Satin Aluminum.
Install With Vh Mow Strip
External Illumination
T Logo Background: AO I White
24" 19.. Background:A28 Orbit Blue
Log-: 3630-246 Teal Green PSV
OLYMPIC Logotype: 2S-02M Matte Black PSV
MEDICAL CENTER Copy:AO I White Intaglio
Logo: 19"OD
Copy: Myriad Pro Bold Condensed,
S"&3",Inc.
613/8'
5" Sign Area:30 sq ft per face 60 total sf
24'
Comour B-5/32'
17-1/2'
Radius
12"
V 3"
f WA
ZZ--
4p�il� 04.26.16
Removed"Services"
6-
SIDEA&B
Page 26 of 26
PROJECT DATE SCALE COORDINATOR/DRAWN BY.-
Olympic Medical Center 10.13.15 1'.=I., Nicole Hamilton/nhamilton@gsisign,.,.m
Port Angeles Campus Carrie Siadak/carTit,s(ftsisigns.com
0 This d—Ing is the Property of GSI Sign�-d�hlf not be reproduced or distributed without expren written permissi—
90 1/2"O.D.(Ref)
.4 74 7/16"Cabinet width
Aluminum
cabinet housing 72"Sign panel width
(Full perimeter) 13/32"Reveal --s- .4 85/32"
Connector (Typ.left&right)
7 3/4
Changeable sign faces
mechanically secure to Fiber reinforced polyester(FRP)
adjustable"fastener slides molded to aluminum frame
(Not shown) SECTION:"21.5fl"
Scale:3/16"=1"
72"
5.34"
1/8"Thick WJ CURVED PANEL PLATE
aluminum Scale:1/2"=V-0"
(2 per curved panel)
-P-418.154" 74.188"
7.75" 7.75"
/4"Thic
21.5fl ------------------ aluminum 1/4"Thick
WJ POST CAP WJ CABINET TOP PLATE aluminum
Scale:112"=V-0" Scale:1/2"=V-0"
(1 per post) (1 per sign)
FRONT VIEW
Scale:3/16"=1'4' 74.188"
7.75"
1/4"Thick
WJ CABINET BOTTOM PLATE aluminum
Scale:1/2"=V-0"
(1 per sign)
Location(s)
19, 20
NOTES: APPROVAL BY:
1.Refer to Graphic Systems,Inc.'s drawings for colors and graphics specifications. REQUIRED DATE:
Atlanta,Georgia USA e Phone: (404)688-9000 9 Web:vAvw.apcosigns.com Al Design Rights Reserved
Customer: Graphic Systems, Inc. Date: 04/18/16
Project: Olympic Medical Center Port Angeles,WA Drawn: RCB
Sign '21.5-Plan Section&WJ Parts Scale: As Shown 21.5f
apcosigns.corn Product: 4310CP MultiPanel PolySign Coord.: JIN Sheet
Double Post Mount, Non-Illuminated W.O.#: 449039
1R' 73/4" 1/4"Thick aluminum
WJ cut top plate
secured to cabinet
t - a
7/8" head screws
Aluminum
cabinet housing
(Full perimeter)
See
No e 1
61
Cat inet
height
21.5el
IU Aluminum divider
___JJ bar between
each sign panel
3/4"
(Typ)
FRONT VIEW
Scale:3/16"=V-0"
Fiber r inforced
molded to face of
polyester(FRIP)
if 7/8" aluminum frame
1/4"Thick aluminum WJ cut
1/4" bottom plate secured to cabinet
with#10-24 flat head screws
SECTION:"21.5el"
Scale:3/16"=1"
Location(s)
19, 20
NOTES: APPROVAL BY:
1.Refer to elevation views for raised sign panel heights.Refer to Graphic Systems,Inc.'s
drawings for colors and graphics specifications. REQUIRED DATE:
Atlanta,Georgia USA e Phone: (404)688-9000 a Web:www.apcosigns.com All Design Rights Reserved
Customer: Graphic Systems, Inc. Date: 04/18/16
Project: Olympic Medical Center Port Angeles,WA Drawn: RCB
Sign'21.5-Side Section Scale:As Shown 21.5e
apcosigns.com Product: 4310CP MultiPanel Po1ySign Coord.: JN Sheet
Double Post Mount, Non-Illuminated W.01: 449039
SPCT200 Contour 8"aluminum 2"x 3/8"Bar x 3/4"
support post(APG#400) long welded into each
connector profile&
threaded 3/8-16 at
Aluminum sign bolt locations
cabinet(APG#405) Aluminum filler
(APG#1 09,24"
0 long,1 per post)
3/8-16x 1-1/2"Long slides into post
(Min)hex bolt, below sign cabinet
washer&lock washer
#10-24x 1/2"Long( in)
countersunk screws Aluminum
connector profile
(APG#404)
SECTION:"21.5dl" SECTION:"21.5d2"
Scale:3/16"=1 Scale:3/16"=l"
73/4"
Post
--------- 7 Aluminum 61/2'
connecto�._M
profile_
(APG#404,
3 per post)
—121.5dl
61"
Ca inet
he ht
&—SPCT200 3"
Contour (Typ) 58"
aluminum
support post
(APG#400)
------------
116"
_'__J21.5d2 Support
Ost
length
FRONT VIEW: POST INSIDE VIEW: POST
Scale:112"=V-0" Scale:1/2"=V-0"
Location(s)
19, 20
APPROVAL BY:
REQUIRED DATE:
Atlanta,Georgia USA & Phone: (404)688-9000 Web:www.apcosig ns.com All Design Rights Reserved
Customer: Graphic Systems, Inc. Date: 04/18/16
Project: Olympic Medical Center Port Angeles,WA Drawn: RCB
Sign '21.5-Post/Cabinet Assembly Details Scale: As Shown 21.5d
apCosigns.corn Product: 4310CP MultiPanel PolySign Coord.: JN Sheet
Double Post Mount, Non-Illuminated W.O.#: 449039
7/8"Dia.hole
in top of lifting
bracket 'J'J
21.50
2"
1 115/16"
1.885"Channel leg(Ref)
_1`7
Modified 5"structur-'
aluminum channel
4"Cabinet (1.885"leg x.325 web) -1 2"
angle clip
3/4-10 UNC Threaded z
Connector profile hole in bottom 5/8"bar
(APG#404)below
SECTION:"21.5c2"
PLAN SECTION @ LIFTING BRACKE Scale:1/4"=1"
Scale:1/4"=1"
2
3 4"Lifting bolts(provided)are
serviced by removing post caps.
Once sign is installed,lifting bolts 7/8"Dia.hole
are removed and post caps are 2" in top 1/4"bar
re-attached. 15/16"
Post caps secured 4" 4" 1/4"Thick PLAN VIEW
x x
with non-corrosive x 1-15/16"long Scale:1/4"=1
#10-24 flat head welded structural
screw angle corner clip 2" -P-! 2" - 2"x 2"x 1/4"
sl Bar welded
to channel
T
3 5/8
41/2" Modified
cha�_nel
lenoth
61/2"
1 3/4-10 1 J
I Threaded 21 5c2 2.1x 2"x 5/8"
hole hru
bottom of Bar welded
lifting to channel
bracketv, IF
END VIEW FRONT VIEW:
Scale:1/4"=1" LIFTING
Lifting bracket BRACKET
welded to cabinet Scale:1/4"=l"
qConnector profile
SECTION:"21.50"
Scale:1/4"=1"
Location(s)
19, 20
APPROVAL BY:
REQUIRED DATE:
Atlanta,Georgia USA e Phone: (404)688-9000 Web:www.apcosigns.com All Design Rights Reserved
Customer: Graphic Systems, Inc. Date: 04/18/16
Project: Olympic Medical Center Port Angeles,WA Drawn: PCB
cm Sign '21.5-Lifting Bracket Details Scale:As Shown 21.5c
alocosigns.com Product: 4310CP MultiPanel PolySign Coord.: JN Sheet
Double Post Mount, Non-illuminated W.O.#: 449039
Lifting bracket(0ty.2)
welded to cabinet
74 7/16"Cabinet width
_J _J
61/2
4"x 4"x 1/4"x 1-15/16"
Long structural angle
corner clip
297/8"
Aluminum sign 7/16"Dia.,
cabinet(APG#405, hole
full perimeter) (3 each end) 61
Cat inet
61" height
Cat inet
height 58"
I
r, CABINET SIDE VIEW
Scale:1/2"=V-0
CABINET FRONT VIEW
Scale:1/8"=1"
Screw holes using cabinet
bottom plate as template
BOTTOM VIEW
Scale:1/8"=1'
Location(s)
19, 20
APPROVAL BY:
REQUIRED DATE:
Atlanta,Georgia USA Phone: (404)688-9000 Web:www.apcosigns.com All Design Rights Reserved
Customer: Graphic Systems, Inc. Date: 04/18/16
Project: Olympic Medical Center Port Angeles,WA Drawn: RCB,
Sign'21.5-Cabinet Details Scale: As Shown 21.5b
apcosigns.corn Product: 4310CP MultiPanel PolySign Coord.: JN Sheet
Double Post Mount, Non-Illuminated W.O.#: 449039
1/4"Thick aluminum
post caps secure with 73/4"
#10-24 non-corrosive
countersunk screws
15"
PLAN VIEW (Ref)
Scale:3/8"=V-0"
901/2"(Ref) 1/4" 1/4"
72"Sign panel width
231/4"
3/4 Papel
SPCT200 Contour (T p) heipht
aluminum support
post
231/4" 611/2"
Panel
(R 9f) 116"
P s
11 1A,, length
Panel
hei ght
Concrete"mow 6"(Ref)
curb"by others Grade
(Ref)
(See Note 2) 12"
gr-----------------------------------------
1/4111: :P1
363/4"
Concrete (R f)
footings
installer�_y
(See Note 2)
825/16"O.C. 18"Dia.(Min)
FRONT VIEW END VIEW
Scale:3/8"=V-0" Scale:3/8"=V-0"
(Side'A'shown,
Side'B'typical)
Location(s)
19, 20
NOTES:
1.Refer to Graphic Systems,Inc.'s drawings for colors and graphics specifications. APPROVAL BY:
2.Footings/mow curb shown is for reference only.Actual design and installation by others. REQUIRED DATE:
Atlanta,Georgia USA * Phone: (404)688-9000 9 Web:www.apcosigns.com All Design Rights Reserved
Customer: Graphic Systems, Inc. Date: 04/18/16
Project: Olympic Medical Center Port Angeles,WA Drawn: RC13
Sign '21.5-Elevation Views Scale: As Shown 21.5a
apcosigns.com Product: 4310CP MultiPanel PolySign Coord.: JIN Sheet
Double Post Mount, Non-Illuminated KOX: 449039
APCO NON ILLUMINATED MULTIPANEL - L20 --SPR100
4"Radius
support post
Post filler(30"long)
extends from bottom
of sign panel to
below grade
F-11 Elmo
DeeignSiSales
RO.BOX928
9438WILLAMETrE MERIDIAN RD.NW
^o
OLYMPIC SILVERDALE WA 98383
MEDICAL CENTER
PHONE(360)613-9550
FAX(360)613-9515
www.honsonsigns.com
I MIr ft�ft� CUSTOMER:
Lvj 1 zup to,
72
GSI
-ezz�b� OLYMPIC MEDICAL CENTER
24"
DATE:5/11/201 L
SCALE OPTION REVISION
3/4"= A 0
SALES:RANDY HANSON
SIDE A&B DESIGN:MICHAEL BRASIER
MONOLITHIC POUR COMMENTS:
A
20"
24"
...d1h
100'R �1—iq.1,at-d,d to be ln,W�d
11 .1th th,
Aniel,6001fthIN,11...I El,cW,,l Coda
7�k- -&—th—ppli-bl,1-1-d—
(R�0 No —N,h,, Thl'1,,I,d.,pmp,,qm.,dl,q ad
oll, SPI b-dl.g of th,,19,.
T old If 11g,panel 118-POW alha,�—b—, 4
T IT I.P&M11— t.11h Ilde
SPR10 @2016
0 a THISSIGNBESIGN ISTHEPROPERTYOF
ln.qnp—1 C.'ad slon Pa.,%F,1,a, 4"R.di.
(47-W long, ano'laa(APG9.205 ainf—d.1y., al�PPDd Poon HANSON SIGNS I NC.&IS NOT TO BE
cay'2) 207,47-N'loap,ach) SECTION,"11.bl" 101dad W,1,aan'U�M"f'1P`,PL k REPRODUCED IN ANYWAYWITHOUT
S—Wla-� PERMISSION OR TRANSFER BY SALE.
Address:
321 N Chambers Street
PREPARED 7/11/17, 9:25:42 INSPECTION TICKET 115AGE 3
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 7/11/17
------------------------------------------------------------------------------------------------
ADDRESS . : 321 N CHAMBERS ST SUBDIV:
CONTRACTOR : PHONE
OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE
PARCEL 06-30-00-8-1-0125-0000-
APPL NUMBER: 17-00000185 COMM REMODEL
------------------------------------------------------------------------------------------------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
13LI 01 3/31/17 PB BLDG INSULATION
3/31/17 AP April 3, 2017 9:05:33 AM pbarthol.
April 3, 2017 9:06:57 AM pbarthol.
BL3 01 3/31/17 PB BLDG FRAMING
3/31/17 AP March 31, 2017 10:21:43 AM pbarthol.
Rob 460-1284
April 3, 201-7 9:06:57 AM pbarthol.
BL99 01 7/11/17 L BLDG FINAL TIME: 17:00
Rob Gale 460-1284
---------------------- -- ---------------------------------------------------------------------
N
PERMIT: ME 00 MECHA i� ERMIT
REQUESTED INS DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
-------------------------- --------------------------------------------------------------------
ME99 01 7/11/17 L MECHANICAL FINAL TIME: 17:00
----------------------JW--- ---------------------------------------------------------------
PERMIT: PL 00 PLUMBING P MIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
PL1 01 3/31/17 PB PLUMBING UNDER SLAB
3/31/17 AP - OVERRIDE TAKEN BY PBARTHOL DATE: 03/31/17 TIME: 10:16:57
March 31, 2017 10:22:09 AM pbarthol.
rob 460-1284
April 3, 2017 9:06:57 AM pbarthol.
PL2 01 3/31/17 PB PLUMBING ROUGH-IN
3/31/17 AP - OVERRIDE TAKEN BY PBARTHOL DATE: 04/03/17 TIME: 09:00:33
April 3, 2017 9:05:49 AM pbarthol.
April 3, 2017 9:06:57 AM pbarthol.
PL99 01 7/11/17 PLUMBING FINAL TIME: 17:00
--------------------- --------- COMMENTS AND NOTES --------------------------------------
1_11 ' -jr ruK I ANUtLt6
DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOP.MENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 99362
Application Number . . . . . 17-00000185 Date 3/29/17
Application pin number . . . 442055 REPORT SALES TAX
\rJ*- Property Address . ' * * ' * 321 N CHAMBERS ST
ASSESSOR PARCEL NUMBER: 06-30-00-8-1-0125-0000- on your state excise tax form
Application type description COMM REMODEL to the City of Port Angeles
Subdivision Name . . . . . .
Property Use . . . . . . . . (Location Code 0502)
Property Zoning . . . . . . . UNKNOWN
Application valuation 165000
----------- --------- - - - - ------
Application desc
Remodel Space into Tenant exam rooms
------- ----- ---- ------ ---- -----
Owner Contractor
------------------------ ------------------------
CLALLAM CO PUB HOSPITAL DIST 2 OWNER
DBA OLYMPIC MEDICAL CNTR
PORT ANGELES WA 983623909
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT - COMMERCIAL
Additional desc . . REMODEL SPACE INTO TENANT EXAM
Permit Fee . . . . 1384.25 Plan Check Fee 899.76
Issue Date . . . . 3/29/17 Valuation . . . . 165000
Expiration Date 9/25/17
Qty Unit Charge Per Extension
BASE FEE 1020.25
65.00 5.6000 THOU. BL-100,001-SOOK (5.60 PER K) 364.00
----------------------------------------------------------------------------
Special Notes and Comments
March 29, 2017 11:14:32 AM pbarthol.
A separate submittal will be required for any changes to the
I fire alarm or fire sprinkler systems.
No land use problems anticipated. All work is interior to
to building,
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE SURCHARGE 4.50
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 1384.25 1384.25 .00 .00
Plan Check Total 899.76 899.76 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 2288.51 2288.51 .00 .00
Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes
null and voidifwork orconstruction authorized is notcommenced within 180 days,ifconstruction orwork is suspended orabandoned
for a period of 180 days after the work has 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.
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
TForms/Building Division/Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDEA MINIMUM 24-HOUR NOTICE FOR INSPECTIONS–
Building Inspections 417-4815 Electrical Inspections 417-4735
Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage/Downspouts
Piers
Post Holes(Pole BIdgs.)
PLUMBING:
Under Floor/Slab
Rough-in
Water Line(Meter to Bldg)
Gas Line
Back Flow/Water
AIR SEAL:
Walls
Ceiling
FRAMING:
Joists/Girders/Under Floor
Shear Wall/Hold Downs
Walls/Roof/Ceiling
Drywall(interior Braced Panel Only)
T-Bar
INSULATION:
Slab
Wall/Floor/Ceiling
MECHANICAL:
Heat Pump/Furnace FAU Ducts
Rough-in
Gas Line
Wood Stove/Pellet/Chimney
Commercial Hood/Ducts
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
ISkirting
PLANNING DEPT. Separate Permit#s ISEPA:
Parking/Lighting JESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY1 USE
Inspection Type Date Accepted By
—Electrical 417-4735
Construction -R.W. PW /Engineering 417-4831
—Fire 417-4653
Planning 417-4750
Building 417-4815
THE A� For City Use
CITY OF V L�—1vt s Permit#
V ,
P ermit.
W A S H I N G T 0 N , U. S. Date Received: Z -21 - FI
1
321 E 51b Street Date Approved
Port Angeles,WA 9836
P:360-417-4817 F:360-417-4711
Email:Vermits(WciWfpa.us BUILDING PERMIT' ICATION
Is. A&
Project Addres t\)Ot-+� Cka,% ber.S I Port,Anj�k5 L,,)A 9YJ
Phone:
Primary Contact: go b GC'L Email:
Name Phone J
014ynn�c MC&c-ed Cc,-�4rr 3 6o 417 1 q17-7 00 0
Property Mailing.,edd�ess Email
Owner 131 car'[;m Sf. tv OIVVV�9�( f"eJt-(_C-( -oir
city f0'r VV9 State LJA zip J
Name Phone
Contractor Email
Information -city -State�.. zip
coUqaCtUrJAeeweW-' Fxp.Date:
Legal Description: Zoning: Parcel# Project Vc-due: (materials and labor)
$ ,k'spo C>'—
Residential El Commercial [K Industrial 11 - Public D
A Permit Demolition El Fire El Repair 11 Reroof(tear off/lay over) 11
Classification For the following,fill out both pages of perinit application:
(check New Construction 11 Exterior Remodel 1:1 Addition El Tenant Improvement
appropriate) Mechanical El Plumbing 11 Other El
Fire Sprinkler System Proposed Irrigation System Proposed or Proposed Bathrooms Proposed Bedrooms
or Existing? Yes 0 No ff I Existing?. Yes 0 No
In addition to standard hard copy submittals please send a PDF copy of all Stormwater plan and Engineering to
www.stormwater(&cjg�a_u�s
Project Description -ruf 'iA,, Nk�w 71r-"C,
A I 't
LJOA\ (a A T'
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ADA -�b U,+4-o S&4"
Is project in a Flood Zone: Yes 14olU Flood Zone Type:
If in a Flood Zone, what is the value of the structure before proposed improvement? $
I have read and completed the application and know it 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 and to
obtami permits prior to work. I understand that plan review fees are not refundable after review has
occurred. I understand that I will forfeit review fees if I withdraw the application before the permit is
issued. I understand that if the permit is not picked up/issued within 18o days of submittal,the application
will be considered abandoned and the fees will be forfeited.
C' -MCI)
Date Print Name Sig
Residential Structures
Existing Proposed Construction For Office Use
Area Descriptions(SQ FT) Floor area Floor area $Value new A—area
Basement
First Floor
Second Floor
Covered Deck/Porch/Entry
Deck(over 3o"or 2nd floor)
Garage
Carport
Other(describe)
.Area Totals
Commercial Structures
Area Descriptions(SQ FT) Existing Proposed Construction For Office Use
Floor area Floor area S Value new area
Existing Structure(s) O-LI-10 <?
Proposed Addition
Tenant Improvement?
Other work(describe)
Site Area Totals
Lot/Site Coverage Calculations
Lot Size(sq ft)] Lot Coverage(sq ft)foot print of %Lot Coverage(Total lot cov lot size) Max Bldg Height
all structures sq ft
Site Coverage(Sq Ft of all impervious) %of Site Coverage(total site cov-- lot size)
Mechanical Fixtures
1pdicate how maii:��Eeach type of fixture to be installed or relocated as part of this project.
Air Handler # Haz/Non-Haz Piping Outlets:
Appliance Exhaust Fan Heater,(Suspended,Floor-Recessed-,Waill) #
Boiler/Compressor Size: # Re #
_AdngX g appliance
--pair/alteration
Evaporative Cooler(attarih-A nnt Pell-R-Ste�ood-burning/Gas #
leL—.. - e/Mis
portab Fireplace/Gas Stove agC--e�oy�
Fuel 76a-s Piping #of Outlets: Ventilation Fan,single duct
Furnace/Heat Pump/ Size: # Ventilation System #
Forced Air Unit I I I
Plumbing Fixtures
Indicate how ma-ny-Qf ach_type of fixture to be installed or relocated
Plumbing Traps # Water Heater
4�
Plumbing Vent piping Medical gas piping of Outlets:
Water Line # Fuel a i g_- #of Outlets:
Sewer Line # Industrial waste pretreatment
interceptor(Grease Trap) Size
�Mluerjdescribe):
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