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Home My WebLink About939 Caroline St - Engineering ~I'ORT~ "....O~~"" "r..tiiii . ~~ ~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description subdivision Name Property Use Property zoning . . . Application valuation 04-00000789 Date .061547 939 CAROLINE ST 06-30-00-1-0-3325-0000- PUBLIC WORKS UTILITES 9/07/04 PUBLIC BUILDINGS & PARKS o Owner Contractor PUBLIC HOSPITAL DISTRICT #2 939 CAROLINE ST PORT ANGELES WA 983623909 PRIMO CONSTRUCTION PO BOX 296 CARLSBORG,WA SEQUIM WA 98382 (360) 683-5447 permi t RIGHT OF WAY Additional desc SLOPE SLIDE REPAIR Permit Fee 45.00 Plan Check Fee .00 Issue Date 9/07/04 valuation 0 Expiration Date 3(07(05 Qty Unit charge Per .1 Extenslon 1. 00 45.0000 ECH RIGHT OF WAY PERMIT 45.00 Fee surrunary Charged Paid Credi ted Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 45.00 45.00 .00 .00 plan Check Total .00 .00 .00 .00 Grand Total 45.00 45.00 .00 .00 04-791 13qC~ ~ )h,u~ 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 as 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 con&a / . / Si pature of Contr,actor Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\IIOZ.15 [11114/2003] 't;'(:~~~:'~'~ '<, ','. ~1l..:"~' -.,')~;'::~ ',"', C5~~:,:,'":,-,,,<;":;" CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT -BUILDING DNISION ;.::.:.:t . 321 EAST 5TH STREET, PORT ANGELES, WA 98362 . 4'~/'. D"'L;{-"~:'.:r\' , 0_ P";""";""",::,, :" -.. '.;: ~-il>.. ,; -, . . - ,-,' : ' . - ,'. " -' .' .' Application Number -~' ,;., "~}'~-~~~;{;:,:~-~:;::"':;:~~~~~~~;~~~~'~~:': . ' -., "'.,.;, ASSESSOR PARCEL NUMBER: -+';''','_~~;~,f'''::';'Appl ication: description" ~;:~_~lg';i.',~;~~~~~if~~::~:~:: ._: ',1 .,~,,: ;' ,'. ,,', Applicatio~ valuation 04-00000183 .477707 -". 9 3 9 CAROLINE ST . , 06 -3 0 - 00 -1- 0 -332'5- 0000- COMM REMODEL '. -, ~ - <- . ,~ Date 3/11/04 e' ,~ -';-yt,~~~__~" it: '~... "'5-" ' ~ '/?/J~ ~;'~~;;:!~'wl(h,~( ""f-..">k. ~ff/,G!tv~~.,>,)......-"", .: '-' _ ~ '-",.<>_:".,-:-".::.,,~'i.'~,:,.':__~O\f~'. .:t' :'>';,,:;'.t~;""t.~, 'i '..;:i'~, .:/ ;':; > '\,t\", "~ 'i ~", <, "'-,...:','r."; pe~it'. ~~e_'Totai _ _,J?l.:in 'Chec~" Total' Grand Total 1027.00 '.00 ' 1027.00 1027.00 . aD> 102'7'.00 .00-:, ".00 '" '''I, -. DO'..,:" . .00 '-00 .00 .,', PUBLIC:,B.UILDINGS,_,&. PARKS 507777 ::::::~ ,\.+~:~:;:r;-":~~~'~' _ _':' _ _ _ _ _ _ _ _ _-'~ ~~' ~ __ Contractor' " "<."\ ,,',' \" I, "j:-',., 'PUBLIC HOSPITAL ~.)< ........93'9 cAROLINE' ST PORT 'ANGELES ", ,.-" DISTRICT #2 STIRRETT/JOHNSEN'INC. , , 5555 WESTGATE RD. NW' WA 983623909 SILVERDALE .' ,. _. '.. (360) 692-6128 NEW 6", BUILDING"WATER: LINE. " TYPE I FIRE RESISTIVE NURSERIES, NuRSING'HOMES " WA 98383 ~'," .-" "'.,'- " ,PUBLIC WORKS ,COMM }'TATER SERV, \;,- i 'fti.~, " 71.'" .,J ,",,,^-,, " Plan Check 'Fee" "". Va~u~tiori:,i' ,00 o ".~ - '0' " 950.00-> , 3/1l:/04' "," ,.::,c_,-," Expirati'on Date; ,9/07/04"'- .' _ """" ':',:"1., ~ .- -"~'i,' . -- -.. ,. . _ .-'.> ' ~. .:;::-:L;'~Y::~i':j:;.t.~!,~:~2~:.,~," QtyX: urii't;_C~arg'~- Per ,J-:.: Extens'ion . fe',,,,.,,, : ,'t:';','i,,' ". "1.00 950.0000 ECH HOT/TAP: 6X6 950.00' :~ : ~<I:~~~~;c:~:\;, ~ - - ;~~~ ~ -,,- ~ -': ~ :;:- :,- ~ - ~',~ - ;~~~~~ -, ;;~~;~: - -, - - - - - - - -: - ~ - - ~",:' ~ ~ -, -.-.- - - _.:-:-.0 - - - - -,: ./ ~_.: .Mclit-l.orial:....d~Bc:..... '..' -, '-d',_ .;.- ',;:\~::<\.;;;;>.-,: :'~::~~-~,:~f _ :. :.~ '. 3/~~i~~ ~, ~;~a~~~~k' Fee '" . ,E;~irat,io~ j)'ate-'- . 9/07/04" "'''\'- . 00, o . "..,.-' . ,~.., : " --.,', ,'" E~tens~on. '" 47.00 ' 30.00' 15.0000 ECH BASE FEE PL-OTHER BACKFLOW2 I: + 'L~ Paid . " , ( . Credited' :~ Due ". ~:.~':~::..::,;:,>. ,.,.""" ';'. ::--~;:: "" , "._'" -- - ~-- '"~or"~ -",\".-,' '", , ':,,\ , " ," . .,;' ::~:<:;~l"",,:iC:'-'.:,:<:':' :>t:'.~,;.',..:',:,'.:,",',~.?,;,~;'l;E~~ ~~, . ,t," '~._ .."' 'A~-:'0.:'~-;:-.C;-::'_""'.:_ -",.!.~:,.,\;'\'~t~J(;-' .- ,\. . ~': ,:' , -.~ ~eparate _Permits are required for electrical wo'rk, SEPA, Shore,line, ESA, utilities, private and public improvements. !his perrl1ifbecomes ~'iJlr~ri~"y.~i,div\jo'rk or cpnstru~tion authorized is'not _commenced within ,1'80 days, if,construction or !V'ork is syspel1ded or aba,~~on~:d . fo~_a period,'Q,f 18:0 days after the work as commenced, or if requi,red'ins'pections have not been requested within 180-daysfrom the last' fn,sPf:!c~(on. 'j here.by cer!ffy that I have read and examined this application-'and know the same to be true and correct. Ali pr~visicins of 8WS and ci'rdinances overning this type ofwo'rk will be cornpliedwith whether specified herein or not The granting of a'perrnifdbesnot pr ume a rity to violate or cancel the provisions of any state or local law regulatin'g construction 'or the performance .of cgns uc' . - ;, ';., Signature of Owner (if owner is builder) Date ING\FORMS\1102.15 [11114/2003] ~\,ORT "" ....O~~ $~~ L~ ~ "'<~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 oL/-,;2.J1 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use property Zoning Application valuation 04-00000284 Date .581656 702 CAROLINE ST 06-30-00-5-1-3645-0000- PUBLIC WORKS UTILITES 4/07/04 70Z{J~ RS7 RESDNTL SINGLE FAMILY o Owner Contractor WIGGINS GLENN R 702 CAROLINE ST PORT ANGELES WA 983623502 HORIZON EXCAVATING PO BOX 3248 PORT ANGELES WA 98362 (360) 452-9976 Permit RIGHT OF WAY Additional desc WEEP HOLE AT CURB Permit. Fee 45.00 plan Check Fee .00 Issue Date 4/07/04 Valuation 0 Expiration Date 10(04(04 Qty Unit Charge Per Extension 1. 00 45.0000 ECH RIGHT OF WAY PERMIT 45.00 Fee summary Charged Paid Credited Due ------------ ---------- ---------- ---------- -------- Permit Fee Total 45.00 45.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 45.00 .00 .00 UNijJ Aw he-- ~ r d;i (Wh If tjC 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 as 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 appiication 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 locai law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date ----j- 7Jtt&ut.-----;(J,!/rJ;1~?J ~/4~ t/ - 7 - ot.f Signature of Owner (if owner is))~cler) Date ' T:\PLANNING\FORMS\II 02.15 [1111412003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 32] EAST 5TH STREET, PORT ANGELES, WA 98362 :.,:~. \1;~ t, <, ~'~~;~" ~' "t Iv:t., \ . . ~1l0RT "\.y $4.0~~~ ~ "-~ ~ ~~ .~.; 51. Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation 04-00000183 Date .477707 939 CAROLINE ST 06-30-00-1-0-3325-0000- COMM REMODEL 3/11/04 <& ~ ./ :5 PUBLIC BUILDINGS & PARKS 507777 tkPf~ 4/~/o~ DJ Owner Contractor PUBLIC HOSPITAL DISTRICT #2 STIRRETT/JOHNSEN INC. 939 CAROLINE ST 5555 WESTGATE RD. NW PORT ANGELES WA 983623909 SILVERDALE WA 98383 (360) 692-6128 Structure Information NEW 6" BUILDING WATER LINE Construction Type . . .. TYPE I FIRE RESISTIVE Occupancy Type . . . .. NURSERIES, NURSING HOMES Permit Additional desc Permit Fee Issue Date Expiration Date PUBLIC WORKS COMM WATER SERV 950.00 3/11/04 9/07/04 Plan Check Fee Valuation .00 o -0 w j} Qty Unit Charge Per 1.00 950.0000 ECH HOT TAP 6X6 Extension 950.00 (::> ~ ~ () Permit PLUMBING PERMIT Additional desc Permit Fee 77.00 Plan Check Fee .00 Issue Date - . 3/11/04 Valuation 0 Expiration Date 9/07/04 Qty Unit Charge Per Extension BASE FEE 47.00 2.00 15.0000 ECH PL-OTHER BACKFLOW2"+ 30.00 ~.. ~ j ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1027.00 1027.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 1027.00 1027.00 .00 .00 { c:: " -......:---:-. -: ".... ~- '.-::.r""'l-.-.~_ ,..,...,.. -:.....,....w..... ,.... r- Separate Permits are required forelectncal work, SEPA, Shoreline, ESA, utilities, pnvate and public improvements. This permit becomes null and void If work or construction authonzed IS not commenced Within 180 days, if constructIOn or work is suspended or abandoned for a period of 180 days after the work as 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 aws and ordinances overnlng thiS type of work Will be compiled With whether speCified herein or not. The granting of a permit does not pr ume a nty to Violate or cancel the proVisions of any state or local law regulating construction or the performance of cons uc Signature of Owner (If owner is builder) BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION FOOTINGS WALLS FOUNDA TION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT. # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN IAI-J-O-&1 J,J.,. 4-'~ 6-/J-t>>i J,LI ~f WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DRYW ALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES I SITE WORK (Engmeenng DIVISIOn) SEPARATE PERMIT #'s WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA PARKING/LIGHTING ESA LANDSCAPING SHORELINE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R W / PW/ CONSTRUCTION - R.W ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \PLANNING\FORMS\1102 15 [11/14/2003] fPORT~ (.~...{O~~~ ~ L -=o..:Ir ~ ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 c::, J; \ -:3 ~ Applicatlon Number pin number Property Address ASSESSOR PARCEL NUMBER: Applicatlon description Subdivislon Name Property Use Property Zoning . . . Application valuation 8/31/04 04-00000757 Date .251754 939 CAROLINE ST 06-30-00-1-0-3325-0000- PUBLIC WORKS UTILITES PUBLIC BUILDINGS & PARKS o Owner Contractor PUBLIC HOSPITAL DISTRICT #2 939 CAROLINE ST PORT ANGELES WA 983623909 OWNER Permlt Additional desc Permit Fee Issue Date Expiratlon Date RIGHT OF WAY RUP#04-35 60.00 8/31/04 2/28/05 .00 o Plan Check Fee Valuation Qty Unit Charge Per Extension 60.00 BASE FEE Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permlt Fee Total 60.00 60.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 60.00 60.00 .00 .00 / / -Q eN ....() ~ ,. c::, -, .:s r Cf) -:t 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 as 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 ordma ces governing thiS type of work will be complied with whether speCified herem or not. The grantmg of a permit does not presume to glv' authority to violate or cancel the provisions of any state or local law regulating construction or the performance of constr tion. Signature of Owner (if owner IS builder) Date T \PLANNING\FORMS\1102 15 [11114/2003] ", ~ OLYMPIC MEDICAL CENTER Working Together to Provide Excellence in Health Care 939 Caroline Street. PonAngeles. Washington 98362-3997 . (360) 417-7000 - Fax Transmittal Date: .f / I '>"10 s""" To: (",...., , - (0 r ((')<2--( ~NbII L,t ~ -0 ()..) -0 Attn: -- ~ I (V\.. Fax#: '-r\l- 4-111 ~t ~ "1 () Message: From: ~ - o Jim Paapke - Director, Facility Management o Scott Bower - Supervisor, Plant Operations ~d Wegener - Construction Project Manager o Lorna Knight - Assistant, Facility Management/Safety o (360)-417 - (360)-417-7170 (360)-417-8628 (360)-417-7479 Fax#: 360-417-8627 Facility Management ./ This is page 1 of ~ Pages The documents accompanying this fax transmissibn contain confidential information, belonging to the sender that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party and is required to destroy the infonnation after its stated need has been fulfilled. Olympic Memori.l H"'piw Olympic Medical Im.glng Center Olympic Medical R.>d,.llon Oncology Cenrer Olympic Medical Ph)".ol TI,enpy & Rchab.lir.rion OlymplC Medial Home Hcalrh Olympic Medical Labo<2cory Olympic Case & Rch.bilir.rion Center 1 . d lo29B lol? 09E sal~lI10ej JWO dS0=10 SO SI Inr FROM : HOCH CONSTRUCTION INC FAX NO. 360 452 5382 Ma~. 17 20B5 10:B3AM P10 . . . . . .. ::.:/!"itrox InG . Medicol Coses . Medical Cas Line Verlfica(lons · Analgesia Etfuipmenr Lab name: Certified Medical Testing Nitrox Client 10: Olympic Collected: 04/05105 Analysis date: 04/06/2005 10.10:58 Method' Valve Injection Oescnption: FIO Data file: C"PEAKW95\lph2848 CHR 0 Sample: Air Operator: Gail Comments: Total Hydrocarbons as Methane Results \ lah n::tme: Certified Medical Testing Nitrox Client 10: Olympic Collected. 04/05105 Analysis date. 04/061200510:10:58 Method; Valve Injection Description: DELCD Data file; C.\PEAKW95\tce2847.CHR 0 Sample: Air Operator: Gall Comments: Total Halogenated Hydrocarbons Results -O.801mV ,..-.-.\. . - ._..~.- -- -----....--..-.. -. .. ,.. ----. \ il 1 ~ il MelttanelO.832SJPPM I I, I 2~ I . 1 8.964mV ..-- -"-1 I I I 1 I 48. 359mV . .. T-'" -_._.~- - . \ I I I I _ .....__..__ _. 40Q,~O~Yi 2 I 3r I I 4r I I 5~ I 1 L..l..__ ----.-- . . 3. 4\. I 5 . ...~ -.-.., ---..- ..... ....-.--.. -..-. \. _ _ ..l.._.__._________... --- ,.. -- Component Area E)Cfema! Units component Area Eldemal Units Methane 4 9670 0.8325 PPM 0??oo 0.0000 4.9670 0.8325 ~@1p'yr 2706 164th Street S.w., Lynnwood. WA. 98037 (125) 741-8807 . 1.800-736.7047 · Fax: (425) 741-2500 2-d 1.298 1.1to 09~ sat~tIt:Je.:l ::JWO dOl:l0 50 51 Inr FROM : HOCH CONSTRUCTION INe FAX NO. 360 452 5382 Ma~. 17 20135 10:03AM P9 . . :"/if! IIftrox Ine. . Medical Cases . Medical Cos Une Verlf,CQf/ons · AnalgeSIa EquIpmenT Lab name' Certified MedIcal Testing Nitrox Client 10: Olympic Collected: 04105/05 Analysis date: 04106/2005 10:16:27 Method: Valve Injection Description: FID Data file: C:\PEAKW95\tph2849.CHR () Sample: 02, Operator. Gail Comments: To~al Hydrocarbons as Methane Results ::9'~I.~mY-_.-.... - I I I I L I' Methane/O.8081/PPM 11 I , I ')! .. , ___fl964mV 3~ \ 4t I \ 5' I I L _.-._... Lab name: Certified Medical Testing Nitrox ClIent 10' Olympic Collected: 04/05/05 Analysis date. 04106/2005 10:16:27 Method: Valve Injection Desaiption: DElCO Data file: C:\PEAKW95\tce2848. CHR () Sample' 02 Operator: Gail Comments: Total Halogenated Hydrocarbons Results 48.3S9mV --.1'---------..'..-. ----.--- .- .._... ....~09.69Om~ , 2 ,I " I I I 1 3 4 5 __ _. _____1_1_____. Componenl Area External UnItS Methane ".8215 0.8081 PPM 4.8215 0.8081 Component Area Extemal Units 0.0000 0.0000 ~ I~. - '-,' \ ~ \ \_0'7 \...z,;.; ,'.. vI' ~ ~I ~... 2706 164th Street S.w., Lynnwood. WA. 98037 (425) 741-8807 . 1-800-736-7047 . Fax: (425) 741.2500 E-d l.~SB 1.1~ OSE sat+tItoe.::l ~WO dO 1 : 10 50 51 I nr FROM HOCH CONSTRUCT I ON I NC FAX NO. 350 452 5382 Ma~. 17 2085 10:03AM P8 . . . .:. :.:.:!!lIitrox Inc. . Medical Gases . Medical Gas Lme Veri(icQtlOftS . Ano/gesla Equipmenr .------~~! r~r I, I 2 l I I I Lab name: Certified Medical Testing Nitrox Client 10: Ol~mpic Collected: 04~05/05 Analysis date: 04/06/200509:57:07 Method; Valve Injection Description: FIO Data file: C:\PEAKW95\tph2846.CHR () Sample: Sd,uroe Operator: Gall Comments: Total Hydrocarbons as Methane Resuns .o.801mV i \)M~=~M 1 t- : I . 2~ I 3L I J I I sl I_L___._ .P Component Methane Area Elltemal UnItS 5.5445 0.9293 PPM 5.5445 0.9293 Lab name: Certified Medical Testing Nittox Client 10: Olympic Collected: 04/05/05 Analysis date: 04/06/200509:57:07 Method: Valve Injection Description: DELCD Data file: C:\PEAKW95\tce2845.CHR () Sample: Source Operator: Gail Comments: To(al Halogenated Hydrocarbons Results .,._ _400,69~~ 3 I · I 5 1 I ..1 .. ----.... --_......._--_.~......_--_.......-. i -.-.o. Component Area External Units 0.0000 0 0000 ~C;;:;" ~-\ '\ \ ~J ~~J '\? 2706 164th Street S.W., LynnwoOd, WA. 98037 (425) 741-8807 . 1.800-136-7047 .. Fax: (425) 741-2500 tp.d lo~S8 lolto OSE sat+~It:Je.:l :JWO dOl:l0 50 51 Inr / FROM : HOCH CONSTRUCTION INC FAX NO. 3GB 452 5382 Ma~. 17 2eeS 1B:e2AM P7 . . :')jllltrox Inc. . Medical Case.s . MedIcal Cas Line VerIfications . AnalgeSIQ EqUIpment 8, """"'l .:1!l59!!!.IL.._.... --.. -- ... 1 - Lab name- eertifled Medical Testing Nitrox Client 10: 01ympic Collected: 04/05105 Method: Valve InjectIon Description: J::IO Data file; C:\PEAKW95\tph2844.CHR 0 Sample: Calibration Run Operator: Gail Comments: Total Hydrocarbons as Methane Results I ~~~"!'I:..:.~~ 1r ' I :l I 41- Sf I Ll_h .._.__. r I -> Tnchlorethylenef1.1700IPPM I .' I' J 51. . __.__.__.__ I Component Methane Trichlorethylene Area EJCtemal Units 7 1000 1.1900 PPM 15.2710 1.1700 PPM 223710 2.3600 Lab name: Certified Medical Testing Nitrox Client 10: Olympic Collected: 04/05/05 Method: Valve Injection Description: DELeD Data file: tce1002.CHR () Sample: CalibratIOn Run Operator. Gail Comments: Total Halogenated Hydrocarbons Results 400.690mV 2.- 3 1--:..., Total HaIogenated/1.1700IPPM 'I ,( , I . 4 Component Area External Untts TotalHalogenated 515.3560 1.1700 PPM 515.3560 1.1700 ~ ai=',"\~V7 \87~\( 2706 J 64th Street S.W, Lynnwood. WA. 98037 C425) 741.8807 . J -800-736-7047 . Fax' (425) 741-2500 S.d l..298 l..1t> 09E sal~lIloe.::l JWO dOl =10 SO Sl Inr - :'.itrox Inc. · Medical Gases · Medical Gas Lme Verifications . Analgesia Equipment - *** MEDICAL GAS LINE VERIFICATION ** fP6 ~ (I; [[nilE lDJ APR 1 8 2005 CITY OF PORT ANGEL Dept. of Community Devel ES 8 APRIL 2005--"-.'---'" opment CONTRACTOR: SHAY'S PLUMBING DATES / TIMES OF TESTING: 19 NOVEMBER 2004 /10:15 A.M. 2 APRIL 2005/8:15 A.M. FACILITY: OLYMPIC MEDICAL CENTER 939 CAROLINE St. PORT ANGELES, WA. 1. GENERAL FINDINGS: A. MEDICAL GASES AND VACUUM ARE IN COMPLIANCE WITH NFP A 99 (2002ed.). LEVEL 1, HOSPITAL B. NO CROSSED LINES WERE FOUND IN MEDICAL GASES OR VACUUM IN TESTED AREAS ON THE DAY OF TESTING. C. MEDICAL GASES MEET MINIMUM CONCENTRATION. D. MEDICAL GASES MEET MINIMUM FLOWS AND ARE AT NORMAL PRESSURE. E. MEDICAL VACUUM MEETS MINIMUM FLOW AND IS AT NORMAL VACUUM LEVEL. F. MEDICAL GAS SYSTEM COMPONENTS IN AREA TESTED ARE IN COMPLIANCE WITH NFPA 99 (2002ed.). * (See Note) & (Attachments) G. MEDICAL GAS LINE PURITY: PASS H. MEDICAL GAS AND VACUUM LINE PRESSURE TEST FOR 24 HOURS: PASS / CITY OF PORT ANGELES. -Q (J.) ...J) (\ ? ~ AREA: REMODEL OF LABOR & DELIVERY AND NURSERY. CUT 'ISO VALVES' AND LINES INTO MAINS. NEW ALARM AND ZONE VALVE.. - - .:s ~ ~ OLYMPICMEDCTRll-19.04 Pg 1 of 3 I~::::\ ,/.::-......\ ~ -. ... ..-'" , j \ ! [ /""7' \\_~r, ~ t l'! '~_'~, l' '-..:./ ~~~:~. / U--- ~, 2706 164th Street S.W., Lynnwood, WA. 98037 (425) 741-8807 · 1-800-736-7047 . Fax: (425) 741-2500 \1 , ~ ,-, '..,j/Nitrox Inc. · Medical Gases . Medical Gas Lme Verifications . Analgesia EqUipment NOTE: NFPA 99 #5.1.1.3 - AN EXISTING SYSTEM THAT IS NOT IN STRICT COMPLIANCE WITH THE PROVISIONS OF THIS STANDARD SHALL BE PERMITTED TO BE CONTINUED IN USE AS LONG AS THE AUTHORITY HAVING JURISDICTION HAS DETERMINED THAT SUCH USE DOES NOT CONSTITUTE A DISTINCT HAZARD TO LIFE. II. MEDIC AL GASES: A. OXYGEN: 1. STATIC LINE PRESSURE: 55 PSIG. 2. DYNAMIC OUTLET FREE FLOW: >3.5 SCFM. 3. OXYGEN CONCENTRATION AT OUTLET: >99.0 %. 4. DELTA FLOWS: PASS B. MEDICAL AIR: 1. STATIC LINE PRESSURE: 53 PSIG. 2. DYNAMIC OUTLET FREE FLOW: >3.5 SCFM. 3. CONCENTRATION OF OXYGEN: 20.8% III. VACUUM: A. MEDICAL / SURGICAL VACUUM: 1. STATIC LINE VACUUM: 28"HgV. 2. DYNAMIC INLET FREE FLOW: >3.0 SCFM. 3. DELTA FLOW: PASS IV. PARTICULATE LINE TEST: PASS. V. ODOR: NONE VI. OUTLET BRAND: 'CHEMETRON' WALL QUICK CONNECT A.OUTLET STYLE: 'CHEMETRON' VII. ZONE VALVES: 'CHEMETRON' WITH DOWN LINE GAUGES. VIII. ALARM BRAND: 'CHEMETRON' AREA OL YMPICMEDCTRll-19.04 Pg 2 of 3 \ .Y7 2706 1 64th Street S.W., Lynnwood, WA. 98037 (425) 741-8807 · 1-800-736-7047 · Fax: (425) 741-2500 q \ ,~,)~.itrox Inc. · Medical Cases . Medical Cas Line VenftcatlOns · Analgesia EqUipment NOTE: NFP A 99 #5.1.1.3 - AN EXISTING SYSTEM THAT IS NOT IN STRICT COMPLIANCE WITH THE PROVISIONS OF THIS STANDARD SHALL BE PERMITTED TO BE CONTINUED IN USE AS LONG AS THE AUTHORITY HAVING JURISDICTION HAS DETERMINED THAT SUCH USE DOES NOT CONSTITUTE A DISTINCT HAZARD TO LIFE. II. MEDICAL GASES: A. OXYGEN: 1. STATIC LINE PRESSURE: 55 PSIG. 2. DYNAMIC OUTLET FREE FLOW: >3.5 SCFM. 3. OXYGEN CONCENTRATION AT OUTLET: >99.0 %. 4. DELTA FLOWS: PASS B. MEDICAL AIR: 1. STATIC LINE PRESSURE: 53 PSIG. 2. DYNAMIC OUTLET FREE FLOW: >3.5 SCFM. 3. CONCENTRATION OF OXYGEN: 20.8% III. VACUUM: A. MEDICAL / SURGICAL VACUUM: 1. STATIC LINE VACUUM: 28"HgV. 2. DYNAMIC INLET FREE FLOW: >3.0 SCFM. 3. DELTA FLOW: PASS IV. PARTICULATE LINE TEST: PASS. V. ODOR: NONE VI. OUTLET BRAND: 'CHEMETRON' WALL QUICK CONNECT A.OUTLET STYLE: 'CHEMETRON' VII. ZONE VALVES: 'CHEMETRON' WITH DOWN LINE GAUGES. VIII. ALARM BRAND: 'CHEMETRON' AREA OL YMPICMEDCTRll-19.04 Pg 2 of 3 y( 2706 164th Street S.w., Lynnwood, WA. 98037 (425) 741-8807 · 1-800-736-7047 . Fax: (425) 741-2500 ff'ORr~ t::4.0~~(lI: ~,.~ "-~ ~ 'ti~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 04-00000608 Date .164864 939 CAROLINE ST 06-30-00-1-0-3325-0000- CLEARING & GRADING 8/27/04 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Appl~cation description Subdivision Name Property Use Property Zon~ng . . . Application valuation PUBLIC BUILDINGS & PARKS o Owner Contractor PUBLIC HOSPITAL DISTRICT #2 939 CAROLINE ST PORT ANGELES WA 983623909 OWNER Structure Information BLUFF SLIDE REPAIRS Construction Type . . . . . TYPE V NON-RATED Occupancy Type . . . . . . FENCES, TOWERS Permit Additional desc Permit Fee Issue Date Exp~rat~on Date CLEAR & GRADE CG #04-06 30.00 8/27/04 2/24/05 Plan Check Fee Valuation .00 \0 Qty Unit Charge Per 1.00 30.0000 MIN CLEAR & GRADE Extension 30.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Perm~t Fee Total 30.00 30.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 30.00 .00 .00 <0 t- o , ~ ~ -Q eN ~ ~ ~ :::---. s ~ ~~ 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 orwork is suspended or abandoned for a period of 180 days after the work as 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 pe it does not presume to give authority to violate or cancel the proVIsions of any state or local law regulating construction or the pe rmance of construction. Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) Date T \PLANNING\FORMS\1102 ]5 [] 1/]4/2003] C&GAPPLlCATIONNo. 04 -00 CLEARING AND GRADING PERMIT APPLICATION CITY OF PORT ANGELES ~~I~~ Cel\-L~ ~ ro I J Y\ ~ ,urreey Ai TI K 0 be.rl- L-ea.~ PREPARER ADDRESS & PHONE #: '1/1 ;)/H1..j.!, ~~ LOCATION OF PROPOSAL(Street address or lot & block #): C":3 (P ~ OWNER OF P Page 1 NTE 0::.> '-i ~ ~D<2. APPLICANT: C9 (y VY1 P J ~ APPLICANT MAILING ADDRESS: APPLICANT PHONE NUMBER: -J1'J'Y1 Pt2t2~(2" PLAN PREPARER (ArchItect/Engineer): - (M015Z-~49/ . '/lJ~ SEE A77t\-GH=71') D~cR~P770,N of ?JWJEGT foJo DRAWt/J6 S Estimated amount of material, in cubic yards, to be excavated, imported, or exported: If the answer to any of the following questions is yes, an ESA application with a SEPA check list is required to be submitted with this application and will be processed according to the City's consolidated permit procedures. 1. Is the excavation or fill associated with the development of a parking lot for more than 20 vehicles? 2. Does the total amount of excavation or fill exceed 100 c.y ? 3. Will any portion of the grading, excavation or filling occur within 200 feet of any of the following; X Shoreline, Stream, ~ 40% or grater slope? If the answer to yes, please check the prOP,riate condition. - The applicant hereby affirms and commits that the info atl sub' t i permit application is accurate and that the applicant will comply with the terms and conditions of the permit and the Ci of Port A el learing and Grading Ordinance. The following pages are for City use only: ~ (ate) //~ PERMIT EXEMPTION DUE TO: ~OT EXEMPT: C & G PERMIT REQUIRED o A. Land clearing, grading, filling, sandbagging, diking, ditching, or similar work during or after periods of extreme weather or other emergency conditions that present immediate danger to life or property, as authorized by the City Engineer. Land clearing order by the City Council for abatement of a public nuisance. Removal of dead, diseased, or damaged trees which might constitute a hazard to life or property. Clearing by a public agency of a franchised utility WIthin a public right-of-way or upon an easement, for the purpose of installing and maintaining water, storm, sewer, power, cable, or communications lines. o E. Cemetery graves. o F. Non-destructive vegetation trimming with proper removal and disposal of debris. NOTE: EXEMPTIONS "G" THRU "J" SHALL NOT APPLY IN SITUATIONS WHERE PROPERTIES INCLUDE ENVIRONMENTALLY SENSITIVE AREAS. ~ - D G. Land is one acre or less, except where an adjacent area under the same ownershIp or chain of ownership has been similarly exempted so that the combined area is a greater than one acre and erosion control has not been re-established. If a building permit is issued, no additional c1eanng, grading, or filing permit or assocIated fee will be required; provided that the standards established In thIS manual shall be applied to the Issuance of said building permit. Developments larger than one acre in improved areas served by paved streets, curbs, gutters, storm drains, and other drainage facil ities, as authorized by the City engIneer. o J Work, when approved by the City Engineer, In an isolated, self-contained area, if there is no danger to private or public property, The proposed action has been determined to be exempt from a Clearing and Grading Permit based upon the information provided by the applicant. The basis for this exemption is as checked above. DB. DC. DO. oH. 01. Associate/Senior Planner PW-9020 Date City Engineer Date Page 2 Permit No. () If-Db Clearing and Grading Permit PERMIT CONDITION REVIEW ROUTING: o To Public Works for Engineenng requirements Date o To Planning Department (with engineering's requirements) For ESA and SEPA requirements. Date o Return to Engineering Permitting. Date o Copy of conditions to applicant Date , PERMIT FEE CALCULATIONS: , A. Gradmg and Filling - Plan review and permit fee - 0-250 cy and less then 4' of cut or fill $ $ $ $ ~ - $ $ $ -251-1,000 cubic yards ($22.50) -1001 -10,000 cubic yards ($30) -10,OOO+cy ($30+$15/10,000 cy) B. Clearing and Drainage - Plan review and permit fee -Less then one acre ($30) -One acre-5 acres ($50) -Over 5 acres ($10 per acre) C. Additional plan review for changes, addillons or revisions to approved plans at $30 per hr. reg. and $60 per hr. overtime. D. SEPA review ($100) $ $ $ E Total Permit & SEA Review Fees III. PERMIT APPROVAL: This certifies that the named applicant is granted a Clearing and Grading Permit for the work described and the purpose shown in the application. This permit is granted subject to the terms of the agreement contained in the application, subject to the terms of the provisions of the City of Port Angeles Municipal Code and subject to all special conditions which are attached to this permit or as noted in sections IV thru VIII follOWing. Nothing permitted hereunder shall be deemed to override the provisions of any applicable law of the City, County, State or Federal Government. This permit expires one year from the date of issuance, unless otherwise specified by the City Engineer 83 ~jZ- -l>L Date ~<zf74 f&:.\J l~~ t~1+ Crr'....,A 1~-6 Con..b; 'r7()'AJ-":::; SEE REVERSE SIDE FOR PERMIT CONDITIONS NO. 1082 CITY OF PORT ANGELES DETERMINATION OF NON SIGNIFICANCE Description of Proposal: construction of a drainage system including a curtain drain and tight line, grading a slide area and stabilization of the marine bluff to reduce future landslide potential. Location of Proposal (including street address, if any): 939 E. Caroline St., Port Angeles WA. APPLICANTS: Olympic Medical Center Lead Agency: City of Port Angeles The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the environment. An environmental impact statement (EIS) is not required under RCW 43.21C.030(2)(c). This decision was made afterreview ofa completed environmental checklist and other information on file with the lead agency. This information is available to the public on request. [ ] This DNS is issued under WAC 197-11-340(2); the lead agency will not act on this proposal for 14 days from the date of issuance. Comments must be submitted by at which time the DNS may be retained, modified, or withdrawn. [ ] There is no comment period for this DNS. [ X ] This DNS is issued per WAC 197-11-355. There is no further comment period. August 16.2004 Date ~-.t ~ Brad Collins, Director Department of Community Development You may appeal this determination to the Port Angeles City Council through the Department of Community Development, 321 East Fifth Street, Port Angeles, W A, 98362, by submitting such written appeal to the Department no later than August 30.2004. You should be prepared to make specific factual objections. Responsible Official: Brad Collins, Director, Port Angeles Department of Community Development, 321 East Fifth Street, Port Angeles, WA 98362, phone (360) 417 - 4750. Pub Post' Mail: 8/16/04 ESA 04-10 1f1JORT' ANG,EL,E,S, 1~ .l-~ WAS H I N G TON, U. S. A. Environmentally Sensitive Area Decision Date: August 16,2004 File Number: ESA 04-10 Applicant: Olympic Medical Center Owner: Same Proposed Action: Slope stabilization and drainage system construction to mitigate an area along the marine bluff that has experienced a recent land slide. Location: Olympic Medical Center located at Caroline Street and Race Street. SEPA: A Determination of NonSignificance (#1082) has been issued for the proposal. DECISION: Approval with the following conditions: Conditions: 1. The applicant shall follow all the recommendations provided in the geotechnical report submitted for the project on July 15, 2004, authored by Northwestern Territories, Inc. 2. A right-of-way use/construction permit from City of Port Angeles Public Works and Utilities Department is required for any work or pipe in the public right-of-way. 3. Best Management practices, including the use of silt fencing shall be incorporated into the project during the. construction phase and left in place until such time as revegetation has occurred to stable condition. 4. The site shall be revegetated with native plant materials after installation of drainage system and erosion control fabric is in place. Findings: 1. An application for review under Chapter 15.20 P AMC (Environmentally Sensitive Areas) was received on June 29, 2004, from Olympic Medical Center for the installation of a storm Department ofCommulllty Development ESA 04-10 -OlympIc MedIcal Center August 16, 2004 Page 2 drain system and bluff stabilization to protect facilities and structures at the top of the marine bluff. 2. The subject property is located at 939 Caroline Street, the Olympic Medical Center in POli Angeles. The specific location on the work is at the top ofthe marine bluff on the north side of the shop building, approximately 150 feet east of Rase Street. 3. The project consists of the installation of approximately 55 feet of curtain drain parallel to the marine bluff at a depth of approximately 8 feet to intercept subsurface water. The water collected by the curtain drain will be directed by tight line to the base of the bluff. The area of the previous slide will be graded smooth and covered with erosion control matting and the area replanted with native vegetation. 4. A Clearing and Grading permit application dated May 19,2004, was submitted to the City of Port Angeles Public Works and Utilities Department. The application materials were reviewed by Public Works and Utilities Department staff. 5. The subject site is zoned PBP, Public Buildings and Parks. The site is in the City's East planning area and designated Commercial on the city's Comprehensive Plan Land Use Map. 6. Portions of the subject property meets the definitions of an environmentally sensitive area as defmed by P AMC 15.20 (Environmentally Sensitive Areas Ordinance). The purpose of the Chapter is to protect environmentally sensitive areas in accordance with the Growth Management Act. The intent of the Chapter is to use a function and values approach and establish minimum standards for properties containing environmentally sensitive features in order to protect the public health, safety and welfare which includes: a) avoiding disturbance ofthese areas, b) mitigating such impacts, c) protecting the public from personal injury, loss of life or property damage due to erosion and landslides, etc., and d) protecting against publicly fmanced expenditures from misuse of environmentally sensitive areas. Undisturbed buffers of 50 feet are required for marine bluffs and included as a portion of the environmentally sensitive area. 7. PortIOns of the area at the top of the bluff are developed with a paved parking lot, large propane tank, and frre hydrant. The area meets the criteria as being a previously altered environmentally sensitive area per PAMC 15.20.080(A)(3). 8. All development proposals in environmentally sensitive areas shall comply with the requirements and provisions of Chapter 15.20 P AMC. The responsibility for administration and enforcement ofthe provisions ofthe Chapter shall rest with the Community Development Director or his designee. 9. The application included an environmental checklist as required under RCW 43.21C and P AMC 15.04. A Mitigated Determination of Non significance (#1082) was issued on April 8,2002, by the City's SEP A Responsible Official in compliance with RCW 43.21 C, WAC 197-11 and PAMC 15.04. " Department of Commulllly Development ESA 04-10 -OlympIc Medical Center August] 6, 2004 Page 3 Conclusions: 1. As conditioned, the proposal is consistent with the requirements for development adjacent to a regulated environmentally sensitive area as defined in PAMC 15.20.030. 2. As conditioned, the proposal will result in the least impact to the sensitive area and take into consideration site constraints associated with the subject property. 3. The Community Development Director concluded that the applicant's environmental information satisfies the requirements ofPAMC Sections 15.20.040(E) and 15.24.040.C. 4. The letter describing the bluff condition and recommendations for bluff stabilization written by Northwestern Territories, Inc., dated July 15, 2004 and submitted as a part of the environmentally sensitive areas application provide a basis for conditioning the activity such that it will be in the public interest, safety, and welfare. 5. As conditioned, the proposal is consistent with the Port Angeles Comprehensive Plan and the City's Zoning, and Environmentally Sensitive Areas Ordinances. ~ 8'/'~ /6 Y Bra Collins, Director Department of Community Development Date Staff review: Scott K. Johns, Associate Planner cc: Public Works and Engineering