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Home My WebLink About620 E. Front Street Address: 620 E Front Street T ®� MW= �® CERTIFICATE O xCCUPA CY City;of Port Angeles - Building Dw,lsion �� This certificate is issuedpursuant to the requirements of Section 111 of the 2009 International Building Code cer*ing that at the time:of issuance this structure was in compliance with the various ordinances of the City regulatangp�btiilding constritctaon.°or use for the following Business names :Northwest Massage,and Holistic°Heallhg Center 1 0 Business address g$ 620-E-Front Street ,, Business owner: &vin'Perrey ` .= � Business owner'siadcdress- 420 Strait Vie w.Dr.Port=An eles WA.9$3 2 Automatic fare sprinkler-system: N/A - - Use &occupancy classification: Business Occupant load: Per`-200.9 IBC, Table.1004 1.:1 fl Type of constructionIN, UB , 3/29/2013 Sie Rob'era'sd Plann g ManageY° Date ., u; Post on the premises in a conspicuous place This cert�s}ficate shall of be removed except by the Building Official. a.. CERTIFICATE OF OCCUPANCY APPLICATION Permit# Z' ��✓ w _ CITY OF PORT ANGELES50 rti r FEES i ... $ Ce f cn to / nspect'on Attn: Permit Technician R E. Fifth St., Port Angeles, WA 98362 100 Pnrking Business Improvement Area (PBIA) ( 60)417-4815 fax (360) 417-4711 fee charged for Downtown locations AUG 2 7 2012 PLEASE PRINT IN INK 6fi't§?RTl4h* nes in P.A.?'Change of ownership only? ❑ Moving location from within P.A.? ❑ Zoning BUSINESS NAME 1 n¢T�v�,-r I�+ssa5e �+o ilo�.S�c.. i'Itat.v►C C @„�+�2 Business address�-Z® �, �n crrr s� Mailing address S,a•�L Phone number LAri cogs( Opening date So 9T h'^ Days & hours of operation nn-F - Business owner's name 1( e�3 v1 Contact phone �-7-, 5 S +� 3 Business owner's address N oz s`c 2�n;-r Vtcw DSZ bn t�5 (, \ o� S Brief description of business Nt�sp� 1000055 Property owner's name 1(14a:% N Q I SO tV Contact phone 9-15-7_o 44S-7 Property owner's address/contact 7o3 C; Ti o�N'c 5-r,1C__� ?oK2-r A.r.S e .&L, Lk-'a, x+'33 CC)---> 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: -rhi,ug 64r-2.A .s�s+-i str�V_ -4 !j✓.aa s[� � 2-111 4 FIRE DEPARTMENT phone 417-4653 Fire approval bye u> on C Changes to a fire sprinkler system or fire alarm system? Yes ❑ No ❑ Work planned: NIA PBIA (Parking Business Improvement Area -Downtown) phone 417-4623 Square footage of business? 1,J/4 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 ❑ No Will there be dancing at this business?Yes ❑ No.A 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 r!. y� . � -�� I t ' A COMMUNITY& ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on Number of off-street parking spaces available for employees and customers? to (A parking plan may be required.) Signs? (wall-mounted, freestanding, projecting, awning, A-frame, etc?) Signs planned: KeeitC?d eyc IS41 !M SI t h PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles. PWE approval by on ' PUBLIC WORKS DEPARTMENT- ENGINEERING phone 417-4812 Is site work planned (new or re-located sewer or water service, () C�YV11(�P 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: N/a 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: N/a Quesfl m m iye -b P ol 27-• l2. 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. 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. o - 2 7-I .n Date Z Print Name � '`�'7 Signature T:\Forms\Building DivisionlCertificate of Occupancy Application(2010).doc Page 2 of 2 a p e F�� PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT QUESTIONNAIRE and DISCLOSURE FORM Ks AN�J Complete all applicable sections. Information must be typewritten or clearly printed. Attach requested information as needed. Signing official must have the authorization to provide such information on behalf of the company, corporation, or partnership. Company Name.- hyclips-i MAxom;& 4-7oktisT.c �1�c��,n� C`'.,k•� Mailing Address: - c,z c� r, xz,?o,-vt 3-,cjq_P_-r X02 r a-r.r.&,-05 C_'Az- Address of facility in Port Angeles (if different than above):- _5 AWL - A's- - Contact Person: Phone: 1. Type of Industry: Standard Industrial Classification number(4 digit SIC code) 2. Type of Product(s) or Service(s) produced; rate of production; process used: Type of product Rate of production Process S• .e 3. Product Volume: 4. Number of Employees: 5. Operation Pattern: (hr/day) (days/yr) (mo/yr) 6. Water Usage (gpd): Average Maximum 7. WASTEWATER DISCHARGE TO SEWERS: [List the principal materials(cleaning agents,solvents,plating solutions,catalysts,process chemical,etc)by their generic name and principal chemicals that are regularly used in your facility and that will or might be discharged to the City sewer system] AVERAGE DISCHARGE MAXIMUM DISCHARGE TYPE OF MATERIAL OR CHEMICAL GAL. TIME& CONC. GAL. DURATION CONC. PER DAY .DURATION (MG/L) PER DAY MG/L) a)Process b)Cooling c)Sanitary d)Others listed below: exam Ie-De teaser , ehloroetti;lene .} 3 ;: 3PM,30minlda0 ,n3_ 10A�MtOmiiUda", 0.00.1.;'; 4 Total Discharge r 9. Are there seasonal variation to the above discharges? PW-804_02 page 1 PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT QUESTIONNAIRE and DISCLOSURE FORM (continued) 10. Does your company sample and analyze your wastewater? ❑Yes,�No If yes, what is the nature of that sampling program? 11. Discharge to sewerage system: Attach as"Exhibit 1"a plan of your property showing accurately the site plan, floor plan, mechanical and plumbing plans and details showing all sewers, connections to the City systems, inspection manholes, sampling manholes, and appurtenances by size, location and elevation. a) How many wastewater discharge points does your company have that are connected to the City's sewer collection system? b) Where are your discharge points located? 12. Does your company have any plans for expansion? ❑Yes XNo If yes, when and how would expansion alter your industrial wastes? 13. Do you provide any pretreatment of wastewater streams that occurs prior to discharge to a sanitary sewer? ❑ Yes-i!9 No 14. Do you have a spill prevention, containment and control plan (SPCC)for your company? ❑Yes ❑ No 15. Does your company have or plan to provide a parking lot, with a drain system to collect run off? ❑Yes ❑ No 16. Do you dispose of any chemicals, solvents or hazardous materials to other than the sewer? ❑ Yes JIR No 17. If yes, provide a description of each material, giving the composition, solids content, annual quantity, means of disposal, and ultimate disposal location: 18. Does your company have the necessary Material Safety Data Sheets(MSDS) on file? ❑ Yes I.K No 19. List any prohibited pollutants being discharged as regulated by the City's Industrial Pretreatment Ordinance: Pollutant Daily Max. Conc. (mg/1) Daily Avg. Conc. (mg/1) 20. List any environmental control permits that are held by or for your facility. 21. If additional pretreatment and/or operation and maintenance activities are required in order to comply with the City's Industrial Pretreatment Ordinance, then the discharger shall provide a compliance schedule attached to this form which describes how the facility will conform to the requirements. The information contained in this questionnaire and disclosure statement is familiar to me and to the best of my knowledge and belief, such information is true, complete and accurate. DATE: S-7�-7-'7iSignatu ��~ —�=j' J Title: 0 � je— NOTE: Attach additional pages, if needed. RETURN TO: City of Port Angeles Wastewater Treatment Plant Attn: Superintendent 321 E. 5t Street P. O. Box 1150 Port Angeles, WA 98362 PW-804_02 page 2[Revised 7/05] 611 / 621 625 602 �. 625 Y 78 t` 616 to 0 629 618 620 f ;t 622 s` �Y 630 636 JJ`G� 619 r 115 S�tS'� 633 ; PREPARED 12/11/12, 9:19:54 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 12/11/12 ------------------------------------------------------------------------------------------------ ADDRESS . : 620 E FRONT ST SUBDIV: TENANT, NBR: NW MASSAGE CONTRACTOR : PHONE OWNER NELSON KARL L PHONE PARCEL 06-30-00-5-1-2120-0000- APPL NUMBER: 12-00001115 CO- CHANGE OF OCCP/USE ------------ -------------------------------------------------------------------- PERMIT: CO 00 CHANGE OF OCCUP/USS REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS --------------------------------------—--- ----------------------------------------------- 0099 01 9/18/12 JLL BLDG C/O FINAL 9/18/12 AP * OVERRIDE TAKEN BY JLIERLY DATE: 09/18/12 TIME: 09:49:36 September 18, 2012 9:50:03 AM jlierly. Kevin, 477-8553 3pm September 18, 2012 3:53:22 PM jlierly. FFNL 01 9/18/12 JLL FIRE FINAL 9/20/12 AP * OVERRIDE TAKEN BY JLIERLY DATE: 09/20/12 TIME: 08:25:00 September 20, 2012 8:25:46 AM jlierly. September 20, 2012 8:26:10 AM jlierly. C099 02 12/11/12 J L BLDG C/O FINAL * OVERRIDE TAKEN BY PBARTHOL DATE: 12/11/12 TIME: 08:26:27 December 11, 2012 8:27:19 AM pbarthol. Kevin 477-8535 --------------------- -------- COMMENTS AND NOTES ------------------ ------------------- L ----------------