HomeMy WebLinkAbout1029 Columbia St - Building4
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This certificate is issued pursuant to the requiremen s of Section 70 of`the.
imero 'issuance this structure was in compliance wt
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CERTIF
Cit
Code certing that a
of the City regulatin
1 'x` a)
Business-name--- ormat►.o
Business address''10
Property owner Clallam Co
Property owner s add 939 Caroline
Automatic fare sprznYi stem Per' IB
Use occupancy laViJ ation. Bu "ir es
Building permit nutak
Type of construction
Occupant load.
Post on the premises in a conspicuous place
UPANCY
ision
6 International Building
h the various ordinances
mptc Medical Center)
-3909
05/05/08
Re -issue date
be removed except by the Building Official.
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CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Zoning . . .
Application valuation
03-00000847 Date 8/29/03
1029 COLUMBIA ST
06-30-00-5-3-0345-0000-
ELECTRICAL ONLY
o
Owner
Contractor
OLYMPIC MEMORIAL HOSPITAL
939 CAROLINE ST
PORT ANGELES WA 983623909
SIMPSON ELECTRIC
243036 W HWY 101
PORT ANGELES
(360) 457-9270
WA 98363
Permit
Additional desc
Sub Contractor
Permit Fee
Issue Date
Expiration Date
ELECTRICAL NEW COMMERICAL
CHANGE SERVICE PANEL
SIMPSON ELECTRIC
94.80 Plan Check Fee
8/29/03 Valuation
2/26/04
.00
o
Qty Unit Charge Per
1.00 94.8000 ECH EL-COM 101-200 NEW SRV FEEDER
Extension
94.80
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ----------
----------
Permit Fee Total 94.80 94.80 .00 .00
Plan Check Total .00 .00 .00
.00
Grand Total 94.80 94.80 .00 .00
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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
construction.
Signature of Owner (if owner is builder)
Date
Signature of Contractor or AuthOrized Agent
Date
T \PLANNING\FORMS\1102 15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED, POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: #
ROUGH-IN 1
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS I
CEILING I
FRAMING
JO]STS / G]RDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T.BAR
]NSULATlON
SLAB
WALL / FLOOR / CE]LING
MECHAN]CAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILlT]ES / S]TE WORK (Engmeenng DIVIsIOn) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'5 SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL ]NSPECT]ONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL e/;.rJo3 Ar:o
LIGHT DEPT
CONSTRUCTION R W / PW/ CONSTRUCTION - R W. 1/ ,
ENGINEERING 417-4807 PW / ENGINEERING
F]RE 4 I 7-4653 F]RE DEPT.
PLANNING DEPT. 4 I 7-4750 PLANNING DEPT.
BUILDING 417-48]5 BUILDING
08/27/2003 20:05
4575270
SIMPSON ELECTRIC
PAGE 01
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El.ECTRICAL PERMIT APPLICATION
-;;;;;~~, ,JRll MJ.;--.-/
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!)RIlI AnJlllfl/{lll: '_-..,..-_....,
CI~Ir.l~I"lrll ".___.___
........_....,-~~
ft7E '"8c-/7
Th. 'ol.ctrlool F.rm/l Appllcellon m.l!lLlllJlllDd lI\~1 aom~~.
PI.....Iyp. 0' ,sprlnlln Ink. "you h_ sny q....llo"... plCl.80 ..11 (360. ~rr.41m5
,... numlJer: (aeo) 417--4711
Own., or IiiIGo. Qonlrlllato, Ag.nl:.~~J. t>" /;-1 e <_:t- _ Phon., 'iS7 -?2...7?;}~~.: ._........f.~ , ...
~rap.rty Owns,: 0 f1IL1t..____- _ ____.. Phon. ...ti2:;:,..,2L.2Q.
10 2..'1 C..a..L~........b JJ~ Clly: fA .._..._..___ZIP:..7'f',?,l,?,..,._.
~looI""'" Oom'sOlor: .t::;, '"", -f~.1:::>.... tC;. J r-("- -f- LIa""...: ._____,_.. !'p'.. .____....___.,1"/,0110:
A<:!drees:.. L Lf ~....o.Z6...,..tt-:t-'.y I f) I IN' Cllyl P A . __,_.._,_....._.".........llll: ._._'-:-_.~._.
IN5TALI.J\T10N WIRED !IV: D ()WN~Fl ~LECTRIOiIJJCONTAACTOfl
CredIt Cllrd Holder Hamil: L1 I V- e w r .s:. \ h-../O ,) .<l..,h_......_."'_.............___
_.~- 18 I
ElII/InS ArldreS8: 2.S:s. a;?'_~Jt'C/r /O.l.P-' eny: ~ ..--_..__..."._._....lIP:..1 V.f ~ 30m
CrlldU Cli!rd Hum"",:, __.____.__._ EKP. 08ts: _______,___........ VISA,__._MC,__..._.
Actdtallfl:
PROJeCt ^.DllFl~III1:
I 0 2;.'1_C--12..L~:&>-
._.__....--.~...."_.........,...,...,.",...,,,...."'~-..."'--
1Y1'! QII WORK; Check i/JJ fhe1apply: f.J New 0 Alt9r/iil/qn/Addltlon
o Resldenl&1 0 MlIltl-fl>mlly )( Commerolal 0 Mobile Horn!! Sq, H_..."._...,.______...
[J Remote Meter !J Detachllld gerags 0 Hot TUb 0 Swim Pool
N"ml>l\l' of Clra"lta added" or allllmd: __..__._
DESCRIPTION OF THE liLECTRICAk '>P10~!CT:_ C. h.~ ~_
-2......-u "u A "-J
rr ---- -'-
o Septic Pump q I.ow 'lolt~g" 0 Tllllllcom. CI 81g1'1
oS C tA:.u.L~.j?-~!.2.'::...L..(C:i.f2 fb.ifJ
-......--.--..-....-.-...-.......-....,...-.-.........--
,--.-'"..-
o 6aeeboard
o Furnaoe
o Heet Pump
o Fen,W'lff
-_KW
-._KW
--KW
~K"W
n 61'} el.A/ I C>Q..l.....
o OverhfilBd SElNlne
o T 4lmp Servloe
~ llnCl'f'/iIround SEII\Ilol!l
IfJYlamfw::~~~"--& .~.
1!<,ltagp.: ~1:-"Ph~.!iJ
Phm~e: IJ 1 1.,1:3
SeNIC., ~)I.?.: 2..,~_.
feedor *IIZ~:._,".,
1I...'rI.aII.H811t Lolld AdllliIQOll!
f'AMC 14,05.0eO(e): Por Iflduotrlel. ,/ommQrol.I, a m.ld~ntl~1 projllota IllTl/ertl18ln e d~Jplex, e l;>ne . line 1.!111Iwlrlg III II'I~ f,lsr.trlcal SaMet.' a,.
Feedere, building slZ$ (eq. ~.), IQ~d calclJlmllons. /lna the tVPII a. of conductors Mdlo, rao8111111y Ie reqlllmcJ 11111,1 "h.11 eQC(lmpMy Ih.
Electrical Permit "Pplleat/on.
PW.9()!Q
, 1
I hl!lfeoy o&l1lfy that I hilWJ read anet IiIxamlned this applloatlon I!mr:J know that Barn/}) 101m frVflMI)/ cr:>rrefJf, end f 8m
IIW/horlZer:J to apply for thllJ permit. I unrJerstsnd It Ie nor rile City's IlJga/ reSfJons/blllly to d/l/ermlnl$ Wf/at parmlt,
F.Ire req~I/r:J; It remaIns tile ilppllc"nts responsibility to determine whelt p(lrmltlflsre required ~Ild to obtsln such.
8("1" ;I, c..J(,ZI ..,( €~d IJ),~ O~"'o S7~'TCc,.J,L
A;I- """'eo" .......-, ~_, -lL::2r==X:iS
QJwn"'~' '"'~ I!leo, COI!I~,. Illlllnllture: __.~.__._'_,,____.__._..,..."'...._._.., ~lmtll:. _
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