HomeMy WebLinkAbout622 E. Front Street Address:
622 E Front Street
CERTIFICA OF OCC
UPANCY
City-of Port Angeles: Budding Division
This certificate is issued" t to the requirements,of Section 111 of the 2009 International Building
Code certifying that atthe time:of issuance this structure was in compliance with the various ordinances
of the City regulating building construct on or use for the following
Business name: Caregivers HomeHealthr wv
t lr'� ['
Business address. 62f24 rout Streeter w K
9
Business owner: Rhonda Carrell
Business owner'sYaddress= 2406 W 14th:StPort Angeles 'W}A 98363
$
Automatic fire sprinkler-system: N/A
. -
Use & occupancy classification: Business
Occupant load. Fer.20-0.9 IBC, Tab.�le
Type of construction:- VUB �`�t
12-5-2014
`Sue Robe-rdsOT
;�Plan "` fia ger Date
Post on the premises in a conspicuous place. This ce, tiitems,-hall=nob removed except by the Building Official.
1 j
?0RT.q,4Cf CERTIFICATE OF OCCUPANCY APPLICATION Permit#
c` `mss
FEES
CITY OF PORT ANGELES
$50 Certificate/ Inspection
Attn: Permit Technician
321 E. Fifth St., Port Angeles,WA 98362 $100 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 P.A.?❑ Change of ownership only? ❑ Moving location from within P.A.? ❑ Zoning
BUSINESS NAME
Business address02-1 _ F [oo,-r Sr Mailing address =01�- 3l s 7 A-- `��3
Phone number -,,Goq 7- Icy Opening date '21'75 1-701'-( Days & hours of operation' '(Z7
Business owner's name 2 �,wa C.P-et( Contact phone 3�° `��7-fG Y-�
Business owner's address -2 14 v w i Ll f�" 5r O0-
Brief description of business 40-r"p CQ Q
Property owner's name Sa rA In C,1U" a v Contact phone
Property owner's address/contact
BUILDING DEPARTMENT phone 417-4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ Nol/❑
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 C0
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 f
CITY CLERK phone 417-4634 City Clerk approval by on
Second-hand dealer/pawnbroker business? Yes ❑ No\rA
Will there be dancing at this business? Yes ❑ No 60
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
Number of off-street parking spaces available for employees and
customers?
(A parking plan may be required.)
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.
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 L
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/V
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 1 have supplied is correct to the best of my knowledge. Incorrect information may resu revocation of
permit.
Date 'J�2 loPrint Name � " �D �� �( � Signature
T:\Forms\Building Division\Certificate of Occupancy Application(2010).doc
Page 2 of 2
Address:
622 E Front Street
PREPARED 7/22/14, 13:24:57 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 7/22/14
------------------------------------------------------------------------------------------------
ADDRESS . : 622 E FRONT ST SUBDIV:
CONTRACTOR THE SIGN STORE PHONE (683) 6655
OWNER CAREGIVERS HOME HEALTH INC PHONE (360) 457-1644
PARCEL 06-30-01-7-0-6200-3010-
APPL NUMBER: 14-00000533 SIGNS
------------------------------------------------------------------------------------------------
PERMIT: SIGN 00 SIGN
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
BL6 01 7/01/14 JLL BLDG POST/COLUMN FTG
7/01/14 AP July 1, 2014 12:13:11 PM pbarthol.
Scott 477-2234
July 1, 2014 3:48:24 PM jlierly.
BL99 01 7/22/14 JBLDG FINAL
July 22, 2014 8:41:45 AM pbarthol.
—V Rhonda 457-1644
----------------------------- -------- COMMENTS AND NOTES --------------------------------------
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT- BUILDING DIVISION
`® 321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 14-00000533 Date 5/12/14
Application pin number . . . 649115 f�1
Property Address . . . . . . 622 E FRONT ST W
ASSESSOR PARCEL NUMBER: 06-30-01-7-0-6200-3010- REPORT SALES TAX W
Application type description SIGNS
Subdivision Name . . . . . . on your state excise tax form
Property Use . . . . . . . . to the City of Port Angeles
Property Zoning . . . . . . . UNKNOWN
Application valuation . . . . 1500 (Location Code 0502)
----------------------------------------------------------------------------
Application desc
INSTALL NEW SIGN ON EXISTING POLE
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
CAREGIVERS HOME HEALTH INC THE SIGN STORE
PO BOX 3157 335 WEST PINE STREET
PORT ANGELES WA 98362 SEQUIM
(360) 457-1644 SEQUIM WA 98382
(683) 6655
Permit . . . . . . SIGN A�
Additional desc . . NEW SIGN ON EXISTING POLE \v
Permit Fee . . . . 115.00 Plan Check Fee .00
Issue Date . . . . 5/12/14 Valuation . . . . 1500 .
Expiration Date 11/08/14
Qty Unit Charge Per Extension
--- -- 1.00 -115.0000-PER-- S-FIS-OR PROJ SIGN > 25 SF -- ----115.00
------------------
Special Notes and Comments
May 9, 2014 5:05:35 PM sroberds.
Proposal will result in new sign face on existing sign pole.
The sign face MAY NOT extend over City/State right of way.
Sign face must be entirely on private property.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
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 for electrical 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 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 N me Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
�I •
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.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage/Downspouts
Piers
Post Holes(Pole Bldgs.)
PLUMBING:
Under Floor/Slab
Rough-in
Water Line Meter to Bldg)
Gas Line
Back Flow/Water FINAL Date Accepted b
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 Pum /Furnace/FAU/Ducts
Rough-In
Gas Line
Wood Stove/Pellet/Chimney
Commercial Hood/Ducts FINAL Date Accepted b
MANUFACTURED HOMES:
Footing/Slab
Blocking&Hold Downs
Skirting
PLANNING DEPT. Separate Permit#s SEPA:
Parkin /Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
Inspection Type Date Accepted By
Electrical 417-4735
Construction-R.W. PW I Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
T:Forms/Building Division/Building Permit
QR7^^ SIGN PERM T APPLICATIO Print in ink
CITY OF PORT ANGELES
- Attn: Building Permit Technician For City Use Only:
321 E. Fifth St., Port Angeles, WA 98362 Date Received ?��
(360)417-4815 fax(360)417-4711 Permit#
Date it
alrwm
Applicant or Agent �,.c��er� d��S -�n ,n e Ik eco (��1 P on 3(QO -H 5 -7 - 1 l0 Ll t-1
Property Owner C6oTs Phon 3Gb - yS9—` A6`1
Property Owner's Address D. ?6 V
Contractor 'I C IIaDQ t�( Sf' (-LC- (6r- S«,,,i Phone 65'3-(66S-5
Contractor's Address 33S w. P4-� -S 5!-!
License # S,'�C6- ri-c;SaS(oH t 5 Expires !YZ/ S-
Project Address 2- EAerr-c,,r•+S
Business Name Rcllrne 2a� � �nLPA,1C7
Parcel Number Lot Zoning
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 �/�c 2) 0 ,v i�vl-c
Sign #2
Sign #3
Sign #4
Totals(Unit charges Sign( l���o
Unit Charge uantit multiplied by quantities) Type of Sign Valuatio
$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 _� _ $ 115-00 Freestanding sign or projecting sign, over 25 sq. ft.
GRAND TOTAL Make Checks Payable to: City of Port Angeles
$ I . 00 Credit Cards (Except American Express)are accepted
Existing sign(s)area sq. ft. +Proposed sign(s)area S�L, _sq. ft. = Total sign(s)area 2 sq. ft.
Building fagade 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 determin hat permits are
required and o obtain permiiits prior to inking on projects.
Date ; , Print Name^J e VSignature
T:Forms/Buil ing.Division/Sign Permit Applicationadc
625
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CITY CSE PORT ANGELES=Conct?b6;ory f'Ia,r,
i
The Issuance of this Per►n'`! a 1pon these pans spe r.;fi• t ,
catians aril other,dat9 ti :'kpnot I)t the building official
thereafter reou1*ag Me correctimn of errors in said
plans, -sp ecificatian and other data; or from preventing
.from
ations being_
carded o -t;ereunder when inbuilding o e
violation of all codes anr hien,, of
this jurisdiction
Approval Date BY.
All Soa
MecaWind Pro v2 . 2 . 3 . 5 per ASCE 7-10
Developed by MECA Enterprises, Inc. Copyright www.mecaenterprises.com
Date 4/24/2014 Project No. 14099
Company Name Zenovic & Associates Designed By SRH
Address : 301 East 6th Street, Suite #1 Description NEW SIGN FOR CAREGIVERS
City Port Angeles Customer Name CAREGIVERS
State WA Proj Location 622 E. FRONT STREET, PORT ANGE
File Location: C:\Users\SRH\AppData\Roaming\MecaWind\Default.wnd
Input Parameters: Other Structures & Building Appurtances MWFRS (Ch 29)
Basic Wind Speed(V) = 130.00 mph
Structural Category = II Exposure Category = C
Natural Frequency = N/A Flexible Structure = No
Importance Factor = 1.00 Kd Directional Factor = 0.85
Damping Ratio (beta) = 0.01
Alpha = 9.50 Zg = 900.00 ft
At = 0.11 Bt - 1.00
Am = 0.15 Bm - 0.65
Cc = 0.20 1 - 500.00 ft
Epsilon = 0.20 Zmin = 15.00 ft
B - Horizontal Dim. = 8.00 ft Ht- Grade to Top of Sign= 19.00 ft
W - Sign Depth = 0.50 ft S - Vertical Sign Dim. = 4.00 ft
Bs- Ratio of B / S = 2.00 Sh- Ratio of S / Ht = 0.21
E - Solidity Ratio = 100.00 °s
Gust Factor Calculations
Gust Factor Category I Rigid Structures - Simplified Method
Gustl: For Rigid Structures (Nat. Freq.>l Hz) use 0.85 = 0.85
Gust Factor Category II Rigid Structures - Complete Analysis
Zm: 0.6*Ht = 15.00 ft
1zm: Cc*(33/Zm)^0.167 = 0.23
Lzm: 1*(Zm/33)^Epsilon = 427.06 ft
Q: (1/(1+0.63*((B+Ht)/Lzm)^0.63))^0.5 = 0.95
Gust2: 0.925*((1+1.7*lzm*3.4*Q)/(1+1.7*3.4*lzm)) = 0.90
Gust Factor Summary
Not a Flexible Structure use the Lessor of Gustl or Gust2 = 0.85
Design Wind Pressure - Other Structures
Elev Kz Kzt qz W_Pres_Cf( 1.80)
ft psf psf
------- ------- ------- -------- -----------------
19.00 0.89 1.00 19.686 30.12
16.00 0.86 1.00 18.987 29.05
14.00 0.85 1.00 18.730 28.66
12.00 0.85 1.00 18.730 28.66
10.00 0.85 1.00 18.730 28.66
8.00 0.85 1.00 18.730 28.66
6.00 0.85 1.00 18.730 28.66
4.00 0.85 1.00 18.730 28.66
2.00 0.85 1.00 18.730 28.66
Note: W Pres Cf is Wind Pressure based on Cf(Force Coefficient)
Figure 29.4-1: Wind Loads for Solid Signs & Freestanding Walls
Case A Case B
i
� ! 9
1
F
F
0- 0.28 0.2B-p
tlradd P=3C
Cf - Force Coefficient = 1.80
Rd - Reduction Factor (1-(1-E)^1.5) = 1.00
Kz = 0.89
Kzt = 1.00
Qz = 19.686 psf
Wind Pressure at Elevation 19 ft = 30.120 psf
Notes: 1) Signs with openings comprising < 30% of gross area are considered solid signs
2) Force Coefficients for solid signs with openings shall be multiplied by Rd
3) Case C only applies when Bs >= 2
Case C
S s S Balwee Balance s s s
LL
T
AInd F F F �t�zud
F
Distance from Cf Kz Kzt Qh Wind—Pressure @ Distance
leading edge ft Force Coeff. Psf Psf
----------------------------------------------------------------------------
From 0 to 4.0 2.25 0.89 1.00 19.69 37.65
From 4.0 to 8.0 1.50 0.89 1.00 19.69 25.10
From 8.0 to 8.0 1.15 0.89 1.00 19.69 19.24
RdC - Reduction Factor for Case C (1.8 - S / Ht) = 1.00
Note: When S / Ht > 0.8 then Cf must be multiplied by RdC.
u -
X
5421b
ppt
o /
W /
a.
r
i
I
J
I
f
t
® -3941.8
0
W
a-
n n
3399.8
197.9
Loads: LC 1, D+W
Results for LC 1, D+W
Z-moment Reaction units are Ib and Ib-ft
ZENOVIC &ASSOCIATE... SK- 1
SRH CAREGIVERS EX. POLE Apr 28, 2014 at 9:26 AM
14099 unfitled.r2d
Column: M2 —
Shape: PIPE_5.0
Material: A36 Gr.36 170.564 at 0 ft
Length: 12.5 ft
Joint: N2 ````
J Joint: N3 A Ib
LC 1: D+W
Code Check: 0.556 (bending)
Report Based On 100 Sections
543.962 at 0 ft
42.535 at 0 ft
fa psi
V Ib
15862.387 at 0 ft 6799.524 at 0 ft
fc khaki, psi M Ib-ft
ft -'- Psi D - in
PPP
-15862.387 at 0 ft -2.165 at 12.5 ft
AISC 13th(360-05):ASD Code Check
Direct Analysis Method
Max Bending Check 0.556 jell Max Shear Check 0.021
Location Location 0 ft
Equation H1-1b Max Defl Ratio L/69
Bending Flange Compact Compression Flange Non-Slender
Bending Web Compact Compression Web Non-Slender
Fy 36000 psi Out Plane In Plane
Pnc/om 62012.106 Ib Lb 12.5 ft 12.5 ft
Pnt/om 86443.114 lb KL/r 79.432 79.432
Mn/om 12269.461 lb-ft
Vn/om 25932.934 Ib L Comp Flange 12.5 ft
Cb 1.656
EX. 5" DIAMETER SCH. 40 STEEL POLE,
SEE SHEET 2 FOR SIGN DIMENSIONS
12" DIAMETER (MIN.)
CONCRETE COLLAR FROM EX. SPLICE PLATE
TOP OF NEW FOOTING TO TOP
OF EX. STEEL SPLICE PLATE
(4)#4 'J' BARS EMBED 4" EX. GRADE (APPROX.)
INTO EX. CONCRETE
W/SET-XP EPDXY
LOCATE ON EA. SIDE OF Approx 1 prox 12"
EX. FOOITNG AS SHOWN
r-----
�o 10"
■■ ■■r ■ son ■■■
BACKFILL W/2,500 •
PSI CONCRETE r ■
• z_
Approx 22" A
�0
N
z
EX. CONC. BACKFILL A-1 ,f
1-- r
N7 7
" MI[ ,— 1>1
Pipe burled to Unknown depth l
�w
RF4t36 C, v
c S'SlQNAL `
NEW SIGN INSTALLATION ON AN EXISITNG POLE AT 622 E.
FRONT STREET, PORT ANGELES, WA FOR CARGIVERS
SHEET 1
l
Bracket to mount frame
to Foie
14"steel date
Bracket
=rarne constructed of
4 2"X 2"square steel
t tubing, .120 thick;.
3
NORTH
Bracket x
659�
G�sV
Fasting C pipe a a = NAIL
2 Feet to alloy for
set back from
sidel,valk
Support rod welded to pole bracket
and vertical tubing, top and bottom
=rarne constructed of
2"X 2"square steel
tubing, .120 thick 12 ,.
33 inches
Address:
622 E Front Street
PREPARED 5/02/17, 14:03:18 INSPECTION TICKET �; _� ' PAGE 6
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/02/17
------------------------------------------------------------------------------------------------
ADDRESS . : 622 E FRONT ST SUBDIV: _
CONTRACTOR ANGELES HEATING INC. PHONE (360) 457-0111
OWNER CAREGIVERS HOME HEALTH INC PHONE (360) 457-1644
PARCEL 06-30-01-7-0-6200-3010-
APPL NUMBER: 17-00000538 COMM MECHANICAL PERMIT
------------------------------------------------------------------------------------------------
PERMIT: ME 00 MECHANICAL PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
--------------------- --------------------------------------------------------------------------
ME99 01 5/02/17 L MECHANICAL FINAL
May 2, 2017 8:21:26 AM jlierly.
Bob DHP
-- ---------—------------ ---------- COMMENTS AND NOTES --------------------------------------
' CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 17-00000538 Date 4/27/17
Application pin number . . . 156664
Property Address . . . . . . 622 E FRONT ST
ASSESSOR PARCEL NUMBER: 06-30-01-7-0-6200-3010- REPORT SALES TAX
Application type description COMM MECHANICAL PERMIT
Subdivision Name . . . . . . on your state excise tax form
Property Use . . . . . . . . to the City of Port Angeles
Property Zoning . . . . . . . UNKNOWN
Application valuation . . . . 4500 (Location Code 0$02)
Application desc
ductless heat pump
----------------------------------------------------------------------------
Owner Contractor
CAREGIVERS HOME HEALTH INC ANGELES HEATING INC.
PO BOX 3157 3322 E HWY 101
PORT ANGELES WA 98362 PORT ANGELES WA 98362
(360) 457-1644 (360) 457-0111
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . . DHP
Permit Fee . . . . 64.80 Plan Check Fee .00
Issue Date . . . . 4/27/17 Valuation . . . . 0
Expiration Date 10/24/17
Qty Unit Charge Per Extension
BASE FEE 50.00
1.00 14.8000 EA ME-FURN/HP/FAU < OR = 5 TON 14.80
----------------------------------------------------------------------------
=� Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 64.80 64.80 .00 .00
' Q Plan Check Total .00 .00 .00 .00
Grand Total 64.80 64.80 .00 .00
vMMV
11`J
^V 1
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 isnot 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. 1 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. j
Ja J3 --
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder)
T:Forms/Building Division/Building Permit
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.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
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/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 SEPA:
Parkin /Lighting ESA:
Landscaping SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
Inspection Type Date Accepted By
Electrical 417-4735
Construction - R.W. PW I Engineering 417-4831
Fire 417-4653
Planning 417-4750
Building 417-4815
THE
CITY OF
1` ANG Es For City Use
Permit# `) 3
W A S H I N G T O N, U. S. Date Received: r 7-�7
321 E 51h Street Date Approved
Port Angeles,WA 9836
P:360-417-4817 F:360-417-4711
Email:permits[a cityofpa.us BUILDING PERMIT APPLICATION
Project Address:
ss
.(� Phone: �6 D
Primary Contact: Z6 U ; Email:
Name Phone
Lao
Property Mailing A resEmail
Owner - t 4ACGvurv}-;;v e ie �/i e_
City State Zip
Or-f-
Nam J Phone
�-
Contractor Address lNEmail
Information city a State . w zip 3
L-1,
Contractor License# Exp.Date: 6,
Legal Description: Zoning: Tax Parcel# Project Value: (materials and labor)
Residential ❑ Commercial ❑ Industrial Public ❑
Permit Demolition ❑ Fire ❑ Repair ❑ Reroof(tear off/lay over) ❑
'Classification For the following,fill out both pages of permit application:
(check New Construction ❑ Exterior Remodel ❑ Addition ❑ Tenant Improvement ❑
appropriate) Mechanical ❑ Plumbing ❑ Other ❑
Fire Sprinkler System Proposed Irrigation System Proposed or Proposed Bathrooms Proposed Bedrooms
or Existing? Yes 0 No 0 Existing? Yes 0 No D
In addition to standard hard copy submittals please send a PDF copy of all Stormwater plans and Engineering to
www.stormwater(&citvo a.us
Project Description ti
W
Is project in a Flood Zone: Yes ❑ N 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
obtain 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.
Date Print Name Sign
Residential Structures
Existing Proposed Construction For Office Use
Area Descriptions(SQ FT) Floor area Floor area $Value new area
Basement
First Floor
Second Floor
Covered Deck/Porch/Entry
Deck(over 30"or 2" floor)
Garage
Carport
Other(describe)
Area Totals
Commercial Structures
Area Descriptions(SQ FT) Existing Proposed Construction For Office Use
Floor area Floor area $Value new area
Existing Structure(s)
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
Indicate how many of each type of fixture to be installed or relocated as part of this project.
Air Handler Size: # Haz/Non-Haz Piping Outlets:
v
Appliance Exhaust Fan # Heater(Suspended,Floor,Recessed wall) #
Boiler/Compressor Size: # Heating/Cooling appliance #
repair/alteration
Evaporative Cooler(attached,not # Pellet Stove/Wood-burning/Gas #
portable) Fireplace/Gas Stove/Gas Cook Stove/Misc.
Fuel Gas Pipin #of Outlets: Ventilation Fan,single duct #
Furnac eat Pum Aize: # Ventilation System #
Forced Air Unit r 66X) PY ; f
Plumbing Fixtures
Indicate how many of each type of fixture to be installed or relocated
Plumbing Traps # Water Heater #
Plumbing Vent piping # Medical gas piping #of Outlets:
Water Line # Fuel gas piping #of Outlets:
Sewer Line # Industrial waste pretreatment
interceptor Grease Trap) Size
Other describe):
T:\Forms\2015 CED Form Updates\Building&Permitting\BP\Building Permit 20150415.docx