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121 1/2 W 1st St - Building
CERTIF,IrC TE "OF -O�cCUPA CY City'`of Port Angeles - Building Division This certificate is issued;ptgiiu nt to the requirements,'of Section 171.of th'e 2009 International Building Code certifying that atAd"4iofissilance this structure was in compliance with the various ordinances of the City regulating biiiiding.constriiction or tine for the following:,-. Business name: iF Rocco.'s%Cyberlounge, Business address,r� ,12,1 '/"VVest'115t'Street` Property owner: ' Lisa -Delguzzi Property owner's-.addresk, ,� 4016 Old Mill`Roa'drAngelese.„WA"9K Automatic fire sprinkler system: NotRequired '~ - --_J ifi Use & occupancy classcation: Business Building permit number: 12-382 Occupant load: . Pier 2Q:09'IBC Table 1:004::1 1” ;;' r Type of construction: X� 4-19-12 � Yd Roberds;+ ening IVlanager Date Post on the premises in a conspicuous"place.--Th'is:certificate"shall not be removed except by the Building Official. O, 0RT,�.�. CERTIFICATE OF OCCUPANCY APPLICATION Permit# L .✓°�'=.�,�.�� Fir CITY OF PORT ANGELES FEES $50 ertificate / Inspection Attn: Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 $100 arking' Business Improvement Area (PBIA) (360) 417-4815 fax (360) 417-4711 fee charged for Downtown locations d15n PLEASE PRINT IN INK Check one: New business in P.A.?1YChange of ownership only? ❑ Moving location from within P.A.? ❑ Zoning BUSINESS NAME go r—CD my-,tje Business address 17-1 d � t�3. ��S Mailing address C t'�, Tf r ems- i^ Phone number 3C © 91? 2 L{22 Opening date / i I t *7— Days & hours of operation L)A known Business owner's name Contact phone 21(130- 9 1 2- 2W--22 Business owner's address 2 +h Sk C PnVk AAJPAeS-, wb% CW)(172 Brief description of business Co 'Pep Av-,,4ar•a,z-j 1®0r`ye .t Property owner's name L I S Ia� prec) 2Z I Contact phone q 4 'i ' y 6()4 Property owner's address/contact Li c 16 G t ) B"v, t % I 12 ci , BUILDING DEPARTMENT phone 417-4815 I Bldg approval by D (-(i on Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No CiY 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 v V 1&, q. l D. ( Changes to a fire sprinkler system or fire alarm system? Yes ❑ No V Work planned: * PBIA (Parking Business Improvement Area - Downtown) phone 417-4623 Square footage of business? Is business moving within the PBIA? Yes Z No ❑ CITY CLERK phone 417-4634 Second-hand dealer/pawnbroker business? Yes ❑No/1V Will there be dancing at this business? Yes El No U A City of Port Angeles Business License is required for: Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance, Hotel -Motel, Fireworks, Ambulance, and Tattoo Businesses. 00t55A- Page 1 of 2 d��poo 0(k ,\ PBIA notified _ on_2-! City Clerk approval by_j T COMMUNITY & ECONOMIC DEVELOPMENT phone 417-4750 CED approval by� 10y W Number of off-street parking space; available for employees and customers? , (A parking plan may be required.) Signs? (wall -mounted, freestanding, projecting, awning, A -frame, etc?) Signs planned pi jid �x,r��v� fie.-,, PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles. PUBLIC WORKS DEPARTMENT- ENGINEERING phone'4174812 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, n irrigation system backflow devices, etc.). Yes ❑ No l Work planned: A-1 o PUBLIC WORKS WASTEWATER phone 417-4845 PWE approval by rV PWW approval by on Will waste, other than domestic household waste, be discharged into the sewer system? Yes ❑ No C✓J� If yes, what will be discharged: -MO A.�,JT tH3 [ t 7 - Call for Certificate of Occupancv 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 I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of permit. Datef'. Print Name- I Signature v k<AT \Forms\Budding Division\Certificate of Occupancy Application (2010).doc Page. 2 of 2 OPORTq, -k; PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT QUESTIONNAIRE and DISCLOSURE FORM Complete all applicable sections. Information InUS1 be rjpewritten or clearly printed. Attach requested information as needed. Signing official must have the authorisation to provide such information on behalf of the company, corporation, or partnership. r I vtv' 6hCIZ Company Name.- V�-()CCO 5 r'I Mailing Address: CK -76 &I �+- '�t-'rgo_4 Address Of facility in Port Angeles (if different than above): Contact Person: Jcf4l�-0,4 i�a_htje_ll Phone: Z 1- Type of Industry: S'ev'llir it --e 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 co 3. Product Volume: 4. Number of Employees: __'6 I 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 systeml AVERAGE DISCHARGE I MAXIMUM DISCHARGE TYPE OF OR CHEMICALMATERIAL GAL. TIME & CONC.II GAL- DURATION C 0 N C. PER DAY DURATION (MG/L) PER DAY (MG/L) a) Process b) Cooling c) Sanitary d) Others listed below: IN '0" 4, V_ _V -110 P -Mr1_6Mi1n1 50 -_0011=' -D d lid, eqre7a,§er-_ rychlordeth 5._' Total Discharge 9. Are there seasonal variation to the above discharges? PW -80402 page 1 PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT QUESTIONNAIRE and DISCLOSURE FORM (continued) � � 1O.Does your connpanysample and analyze your wastewater? OYes /uUvo |fyes, vvhatisthe nature ofthat sannpUng program? ' ~ 11. Discharge tosewerage system: Attach os"Exhibit I^oplan ufyour property showing accurately the site plan, floor plan, mechanical and plumbing plans and details showing all aowera, connections to the City syaharns, inspection nnanhu/es.'sannphngrnenbb|es.andappurtenanoesbvsbn.|ooabon,and-a|aYahon' a) How many wastewater discharge points does your company have that are connected tothe City's sewer collection system? WWhere are your discharge poin located? 12- Does your company have any plans for expansion? OYes XNo |fyes, when and how would expansion alter your industrial wastes? 13, Doyou provide any pretreatment ofwastewater streams that occurs prior todischarge bzusanitary sewer? OYes �� No /� 14. Doyou have a spill containment plan OYas�r�v�o . ' = ��� 15. Does your company have orplan toprovide oparking lot, with adrain system hocollect run off? OYes VNo . 16. Do you dispose ofany chemicals, solvents orhazardous materials boother than the sewer? OYas 9 N 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? 'Kes 0 N 18. 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 tworfor 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. /~7 . DATE ^f~��/ � Signature.-u� Title: Q4< �M��2 0V0meV NOTE: Attach additional pages, if needed. RETURN TO: City ufPort Angeles Wastewater Treatment Plant Attn: Su'h te dent 321 E.5"Street P�O.Box 115O Port Angeles, VVA 98362 PW-Bn4_ozpage c[Revised r/0o Zt 001 co � NN. MO) SO IN, Op" map e mot 14 MY, V`R sm-, _QM Tun 11,; 01 Ank tam" 01 V, A ""4a TVA > ANO _1 Xl!, TER TWS LEASE made this , i y L't day of �'�� 1 � by and between (Names and Addresses): , L1... , : i'.Ii { . (frerefuaffer called Lessor). and` f Ahsrainaitsr called Lessee);: , 1. PRS Lagers• does hereby lease to Lessee, those certain pramses conono* 3MOW32 as (ILI�. C '?5 -3 - as shown on Exhibit $ attached hereto. (hereinafter called. "premises -I being situated upon land described in Exhibit A attached lierato. 2. TERM: The term of this Lease shall be far cominsucing the. . ' " Of �� t . and ALA fermiaats on th6 l t � -� t/ y ---RW?P Lessee commls g and agrees to M LOSS r, at &a offices of Lasser, 4b) i q� ortosuch otherparty r such'alharplacsasLessorIn"hevasf ardes Inav ay rent In. the ampunt of t jC :.V I .kAhrN (3LY`,ed -: "l q Dollars($ "i advance, on the first e )>_in day of each month of the lease. term Lessor hemi * acknowledges receipt of S �. SC. �'1,1A-A Yr. months rent, ifLessee is: in P of rile prmnisag frit a p of a the nzunbar ofdays of Pusession., rentalisrsrsivedit or more days ager dZeeginning b Of each rental period will besub�Ct to a sexviea. .- ..... date (g l to c n r addiiibnal notiraes, 'a' and ham exists, siad loss of u� of frurds Lessee .. has iced. the sutra of d i " (� U :.... Dalliers �. resat a>,ta; wlrt,�h sum security .. Leasee s fuIl the obligericr�s lider and tl�s; ... of lnanc+e of . pu tt Chapter rs Revised Code OfWashington, Oras such may be silbseqently axnende& r K mme�tl cm clams papCWash#n r �t B'% iaa-.I,p�aL WA Fu=Na 43o IW9s tdA7fltiAL AlL MBB nrxru 4 — D(WHMs oR ttv PARS IN ANY Point WHATst3r�'itg[t fire, the elements, or other casualty, Lessor may elect, at its option, not to restore or rebuild the premises and shall so. notify Lessee; in which event Lessee shall vacate the premisesand this, Lease shall be terminated: or, to the alternative, Lessor shall notify Lessee, withinthirty (30): days alter such casualty, that Lessor will undertake to rebuild or restore.th: prelnises,'and°that such�woriccan'be completed within one:hundred eighty (180) days from date of such notice cif -intent. If Lessor is unable to restore or rebuild:the.premises. Within the said,one.hundred eighty (1 80) days, than the Lease may ' be teiminated at Lessee's optionby written ten (10) day notice to Lessor. During time period of untenantability, 'rant shall abate in the same: ratio. as the portion of the premises rendered untenantable bears to the whole of'the preintses 17. ACCIDENTS AND I.IABIi.I`ff. Lessor or its agent shall not be. liable for any injury or damage to. persons or property sustained by Lessee or oilier, in and about the ' premises. Lessee agrees to defend and hold Lessor and its agents ham sss frons any 61 action and/or judgirie it for'dalnages to property or injury to persvns.suffered oir, alleged o be suffered on the greniises`by any person, firm' or; corporation, unless caused by Lessor's negligence s=ee agrees. to main tatn=`public'general liability insurance on the premises with broad form ... property damage and contractuil,:.lialrility endorsements. and -in,the .minimum combined single ..11mlt of $1,000,000 and deductible of not mare than $5,000 for'bodily. injuries and death, and shall name -Lessor as, an, additional insured. Lessee shall furnish Lessor a certificate indicating that the insurance policy is in full force and effect, the Lessor has been named as an'addlilo'nal insured,.and that the policy may not be cancelled unless ten (14days prior'written notice of the proposed cancellation -liar been given to Lessor. Is. SUBROGATION WAIVER: Lessor and, Lessee each Herewith and hereby releases and relieves the other and waives Its entire right of recovery. against'(lie other'for loss or damage arising out of or incident to the perils described' In "standard'fire Insurance policies'and::gll `peritsfdescritied iii- the "Extended Coverage" insurance endorsement approved for use iii the state where the'prenilses are located which occurs In, on or about the Premises, unless due to the negligence of, either party, their agents, employees or otherwise. 10. DEFAULT AND RE-ENTRY: If Lessee shall"fall to` eeg and perforin any of the covenants and agreements. heMi contained, other than the pay rienti ofrent, and such failure continaes for thirty (30) days after written notice Erases` Lesser, unless appropriate action has been takeil- by"Lessee in good' fait%to cure such failure; Lessor, -may terminate the Lease and re-enter the premises, or Lessor may, without terminating this Lease, re-enter said premises, and sublet the whole or any part thereof for the account of the Lessee upon as favorable terms and conditions as the market will allow fair the balance of the teals: of this Lease end Lessee covenants and agrees to pay to Lessor any deficiency arising from a re-letti ig'of'the pr6rais6g at a lesseramoant than herein agreed b. Lessee shallpay such . deficiency each'mooth asthe amount thereof is asr.eitained by Lessor: However, the ability of Lessor to m -enter and sublet shall not impose upon Lessor the'abligaflon to do so: 26.: i VAL OF PROPERTY: iii he event Lessor lawfully re�4oters°the premises as provided herein, Lessor shall Bove the right; but ii6l the;obllgati6ii; to remove `all the personal property located -therein and to place such' property to stofage at the expense and risk of Lessee. Lessee agrees that- a landlord's lien'shall continue to attach to the property whether or not removed from the leased premises - - - - 22....(=T ANI) ATf'ORNErs FEES: if, reason of an default or breach on the of either in the by y P�5' PAY � . performance' cif any of the provisions "of.this Lease, a 'legal action is instituted, . the losing party agrees to pay .ail reasonable cogs and attorney's fees in connection; therewith, including cost 'and fees to collecu any judgment it= is agreed that the venue of any legal action brought under the terms of this Lease may be in the county In which ' premises are'situated. Interest on unpald sums shall accrue at the`rate of 12 percent per annum from due date, even if unilquldated at that time. = ` SUBORDINATION: Lessee agrees that this I:ease shall be suboidinate . to any mortgages or deeds of trust, placed on the property described iri Exhibit Ili provided, 'that In the: event of. foreclosure, if Lessee is not,. there in:`default and agrees to attorn to the mortgagee or'beneficlary'under Deed of Trust, such mortgagee beneficiary shall recognize Lessee's right of possession for the terns of this Lease. 23. NO WAIVER OF COVENANTS: No conduct of a party shall constitute accord and satisfaction unless contained' in a writing to such effect and signed by the partles: Any waiver by either party of any breach hereof 14— A —ad t arda3) With CPI Clams Mr4of9 CWmhftxSWn b*d Blank. Inc.. Issaquah. WA Form No. 436 10M MATERIAL MAY NOT HE REPRODUCED IN WHOLE OR IN PART IN ANY FORM WHATSOEVER. by the other shall not be considered a waiver of my future similar breach. This Lease contains all tate agreements between the parties; and there shall be no modification of the agreements contained herein excerpt by written instrem mt 24. asu*w �qura.OFPREbbIISM- Lessee agrees, upon termination of this Lease, to peacefully quit and surrender the premises without notice, leave the premises neat and clean and to deliver all keys to the premises to Lessor. 25. HOLDING OVER: If Lessee. with the implied or express consent of Lessor. shall hold over after the expiration of the term of this Lease, Lessee shall remain bound by all the covenants and agreements herein, except that the tenancy shalt be from month to month and shall be for a monthly rate of 125 percent of the last rental rate under the lease. 28. BINDING ON HEMS, SUutd*�.&S AND ASSIGNS. The covenants and agreements of this Lease shall be binding upon the beirs,-executors, administrators, successors and assigns ofboth parties hereto, except as hereinabove provided. ' i t x 7�. IIS Lessee s e the premises for the pines of . S �pj. ' � and for no other purposes, without written .consent of Lessor. In the event Lessee's use of the pi� the fire and mmmded coverage or liability insurance rates on the building of which the premises arc a part. Lessee agrees to pay rmr such increase. 28. i4u i et tz: Any notice required to be given by either party to the other shall be de ted in Uni r States .snail, postage prepaid, addressed to the Lessor at � �� i � � 1 or to the Lessee at or at such other address as either party may dw0gnbte to the other in writing hi an_ time to time. A facsimile transmission will suffice in lieu of mail if receipt is confirmed as to date and time. 28, RMERS; Riders. if any, attached hereto. are made a part of this lease by reference and are described as follows: 31. If Lessee is a corporation, each individual executing. this Lease on beba)f of said corporation represents and warrants that he is duly authorized to execute and deliver this Lease ort Behalf of said Corporation in accordance witlx a duly adopted resolution of the Board of Directors of said corporation or in accordance with . the By-laws of said corporation, and that this Lease is binding upon said' corporation in accordance with its terms. If Lessee is a corporation, Lessee shall, within thirty (30) days after execution of this Lease, deliver to Lessor a certified Copp of a resolution of the Board of Directors of said corporation authorizing or ratifying the execution of this Lease. IN VM7MSS Wxw a rur, the parties hereto have hereunto set their hands and seals , first abov LESSOR(S).-'(",b LESSIE{S): E ; 40D ((,-�. ' I FOPLT AAkce5 Pap goes t�A� Mr; IN WROM JN PART iN ANY FORM WAATSQEVa STATE OF WASHINGTON, /�' f (�IVIDUAL ACKNOWLEDGEMENT) COUNTY OF C L& �La vn I certify that I know or have satisfactory evidence that 7� e;�—'-4 v- r, ? M A vi wat b Is the person who appeared before me, and said persdn acknowledged that _.he signed instrument and acknowledged it to be hl.-;.. free and voluntary act for the uses and purposes mentioned in the instrument. %%%I i I I I I j(111, e• gZSc't, i Print r9i'1. Y1 L +GL' L � 4OTA j• Notary blic in and for the S,pat�af = • t My appointment expires rh #, 7 / 41 STATE OF WASHHM=N, sa (CORPORATE ACKNOWLEDGEMENT) COUNTY OF On this day of before me personally. appeared i to me known to.be of the corporation that executers . the within and foregoing instrument, and acknowledged said instrument to be the free and voluntary act and. deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that be was authorized to execute said instrument and that the seal affnred, if any, is the corporate seal of said corporation. IN WITNESS WHEREOF I have hereunto, set my hand and affixed my official seal the day and year first above written. Print name Lu— A ml t0m=ncinti with CPI Clam Po�a 8 oib MhTBRIe ytl�lY t20T SLtiffiRO IN PWH 80R IN PARTIN ANY POtM WHAi501M Heather Catuzo From: Sue Roberds Sent: Tuesday, April 03, 2012 3:56 PM To: Heather Catuzo Subject: RE: Certificate of Occupancy--Rocco's Cyberlounge The site is located in the City's Central Business District and, os such, the business will need to belong to the 11M.1. The retail use is permitted in (lie Cull and with parking through the 11131.A, no land use issues are anticipated. Sign permits will he required iesignage is desired. Thank you Ibr the opportunity to cornnient. Sue Roberds Planning Mk mager Cii , o/'Port Angch.,s P.O. Box 1150 Port Angeeles. VI 98362 sroberdsnci tvofoa. us 360-417-4750 From: Heather Catuzo Sent: Tuesday, April 03, 2012 2:11 PM To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds; Edith Parker; Rick Hostetler Subject: RE: Certificate of Occupancy--Rocco's Cyberlounge And here is the attachment. Sorry! From: Heather Catuzo Sent: Tuesday, April 03, 2012 2:03 PM To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds; Edith Parker; Rick Hostetler Subject: Certificate of Occupancy--Rocco's Cyberlounge Please see attached C of O. This site was previously used as "Swank Boutique". The address does not show in GIS mapping. Please make comments by April 10, 2012. Thank you, Heather Catuzo Building Permit Technician City of Port Angeles --Building Division 321 East 5th Street Port Angeles, WA 98362 (360) 417-4817 hcatuzo@cityofpa.us Heather Catuzo From: Roger Vess Sent: Monday, April 09, 2012 7:09 AM To: Heather Catuzo Subject: RE: Certificate of Occupancy--Rocco's Cyberlounge Engineering has no comments Roger From: Heather Catuzo Sent: Tuesday, April 03, 2012 2:11 PM To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds; Edith Parker; Rick Hostetler Subject: RE: Certificate of Occupancy--Rocco's Cyberlounge And here is the attachment. Sorry! From: Heather Catuzo Sent: Tuesday, April 03, 2012 2:03 PM To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds; Edith Parker; Rick Hostetler Subject: Certificate of Occupancy--Rocco's Cyberlounge Please see attached C of 0. This site was previously used as "Swank Boutique". The address does not show in GIS mapping. Please make comments by April 10, 2012. Thank you, Heather Catuzo Building Permit Technician City of Port Angeles --Building Division 321 East 5th Street Port Angeles, WA 98362 (360) 417-4817 hcatuzo(@citvofpa.us Heather Catuzo From: Janessa Hurd Sent: Tuesday, April 10, 2012 8:56 AM To: Heather Catuzo Subject: RE: Certificate of Occupancy--Rocco's Cyberlounge No comments. From: Heather Catuzo Sent: Tuesday, April 03, 2012 2:11 PM To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds; Edith Parker; Rick Hostetler Subject: RE: Certificate of Occupancy--Rocco's Cyberlounge And here is the attachment. Sorry! From: Heather Catuzo Sent: Tuesday, April 03, 2012 2:03 PM To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds; Edith Parker; Rick Hostetler Subject: Certificate of Occupancy--Rocco's Cyberlounge Please see attached C of O. This site was previously used as "Swank Boutique". The address does not show in GIS mapping. Please make comments by April 10, 2012. Thank you, Heather Catuzo Building Permit Technician City of Port Angeles --Building Division 321 East 5th Street Port Angeles, WA 98362 (360) 417-4817 hcatuzo@citvofoa.us PREPARED 4/16/12, 8:21:56 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 4/16/12 ------ ADDRESS . : 121 1/2 W 1ST ST SUBDIV: TENANT, NBR: ROCCO'S CYBERLOUNGE CONTRACTOR : PHONE OWNER DELGUZZI LISA PHONE PARCEL 06-30-00-0-0-1554-0000- APPL NUMBER: 12-00000382 CO- CHANGE OF OCCP/USE ------------------------------------------------------------------------------------------------ PERMIT: CO 00 CHANGE OF OCCUP/USE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------ — ----- —--------------- -- 0099 01 4/16/12 Jt�o BLDG C/O FINAL * OVERRIDE TAKEN BY HCATUZO DATE: 04/13/12 TIME: 08:53:21 �lI April 13, 2012 8:53:23 AM hcatuzo. JEFFREY. CALL WHEN ON THE WAY. 912-2422 -------------------------------------- COMMENTS AND NOTES ----------- — ------- cq a 1- �- PoRT,CERTIFICATE OF OCCUPANCY APPLICATION Permit # FEES CITY OF PORT ANGELES •l-.._ $50 ertificate / Inspection Attn: Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 $100 arking Business Improvement Area (PBIA) (360) 417-4815 fax (360) 417-4711 fee charged for Downtown locations 150 f PLEASE PRINT IN INK Check one: New business in P.A.?Vchange of ownership only? C-1 Moving location from within P.A.? Zoning BUSINESS NAME :d CC (,; �jyw. Business address t Z_ G, .. � t e } Mailing address Phone number 31b C' 7 `9,7-'L Opening date A% I ` t . Days & hours of operation VA k) Y-\, Business owner's name 3_.( im 4'�r1t,, r, i�f i1 Contact phone -A(pt)--9 Business owner's address; �C=::3`i t., S1 pnYk,nr�n�eS , t>v Dc x.9,102 Brief description of business C c: (-tee- Property owner's name i 5 rs, (c v %' z i Contact phone ` "7 _ `( ool `i Property owner's address/contact `-i C- I t? (, k d VV ; i tZ ct . BUILDING DEPARTMENT phone 417-4815 I Bldg approval by on Is the business a restaurant or bar that will seat 50 or more people? Yes D 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: FIRE DEPARTMENT phone 417-4653 Fire approval byY!M on 4- l S • 701 Z Changes.to afire sprinkler system or fire. alarm,. system? Yes D No IV Work planned: * PBIA (Parking Business Improvement Area - Downtown) phone 417-4623 Square footage of business? , j Is business moving within the PBIA? Yes ,�,J No ,'1 CITY CLERK phone 417-4634 Second-hand:dealer/pawn broker. business? Yes No'%-, Will.there-be dancing at this business? Yes No A City of Port Angeles Business License is required for: Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance, Hotel -Motel, Fireworks, Ambulance, and Tattoo Businesses. ob3000 00 tPage 1 of 2 �5�- PBIA notified on City Clerk approval by on °° T�'40CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc 17 7 SQ FT WALL -MOUNTED SIGN Owner 08 00000803 Date 7/14/08 419117 121 1/2 W 1ST ST 06 30 00 0 0 1554 0000 SWANK BOUTIQUE SIGNS CENTRAL BUSINESS DISTRICT 800 Contractor LISA DELGUZZI LIVING TRUST LEWAN CONSTRUCTION 4016 OLD MILL RD 303 RAINTREE LANE PORT ANGELES WA 983621905 SEQUIM WA 98382 (360) 457 4004 (360) 460 1238 Permit SIGN Additional desc 17 7 SF WALL -MOUNTED SIGN Permit pin number 129585 Permit Fee 47 00 Plan Check Fee Issue Date 7/14/08 Valuation Expiration Date 1/10/09 Qty Unit Charge Per 1 00 47 0000 PER S SIGN LESS THAN 25 SF Special Notes and Comments July 11 2008 11 05 11 AM sroberds The proposal will result in a building mounted sign (18 sq ft in area) in the CSD Fee summary Charged Paid Credited Permit Fee Total 47 00 47 00 00 Plan Check Total 00 00 00 Grand Total 47 00 47 00 00 00 800 Extension 47 00 Due 00 1` 00 Bust Ness i s c Lt /I/ 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 Name Signatur+f Contractor or Authorized Agent Signature of Owner (if owner is builder) T Forms/Building Division/Building Permit (10/01/07).wpd BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPEI DATE yI ACCEPTED COMMENTS I YES I NO FOUNDATION - FOOTINGS SHEAR WALLS / WALLS FOUNDATION DRAINAGE/ DOWNSPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDERFLOOR/SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS/ GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF [CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP/FURNACE/DUCTS GAS LINE I` WOOD STOVE/PELLET/CHIMNEY COMMERCIAL HOOD/ DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING FINAL j FINAL I PLANNING DEPT SEPARATE PERMIT N's SEPA. PARKING/LIGHTING I I I ESA. LANDSCAPING I SHORELINE. FINAL INSPECTIONS REQUIRED PRO TOOCCUPANCY/USE RESIDENTIAL DATE YES „^, NO COMMERCIAL ELECTRICAL LIGHT DEPT 417-4735 ` � ) �`( krrCTRICAL �� LIGHT DEPT CONSTRUCTION R. W / P W/ I �/� �7' �(� CONSTRUCTION R. W ENGINEERING 417-4807 ��// { PW / ENGINEERING FIRE 417-4653 I ��(��J�.�` FIRE DEPT PLANNING DEPT 417-4750(- �` PLANNING DEPT BUILDING 417-4815 [V \ i` BUILDING T Forms/Building Division/Building Permit (10/01/07).wpd DATE ACCEPTED BY.. C> Q W DATE ACCEPTED BY. __- l DATE ACCEPTED YES NO e_ PREPARED 4/09/10 8 46 57 CITY OF PORT ANGELES ADDRESS 121 1/2 W 1ST ST TENANT NBR SWANK BOUTIQUE CONTRACTOR LEWAN CONSTRUCTION OWNER LISA DELGUZZI LIVING TRUST PARCEL 06 30 00 0 0 1554 0000 APPL NUMBER 08 00000803 SIGNS PERNIT SIGN 00 SIGN INSPECTION TICKET INSPECTOR JAMES LIERLY SUBDIV PHONE (360) 460 1238 PHONE (360) 457 4004 PAGE 1 DATE 4/09/10 REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL99 01 4/09/10 JLL BLDG FINAL April 6 2010 4 44 28 PM 1pangrle I LEFT SUMMER A MESSAGE AT (461 4554) TO FINAL THIS PERMIT BUILDING FINAL SIGN (SWANK BOUTIQUE) COMMENTS AND NOTES SIGN PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 417-4815 fax (360) 417-4711 Applicant or Agent su1^ nwn M C gr; d_Q Property Owner Lisa . od-6027 I For City Use Only - Date Received -7--7 - 0 $7 Prmit # () 9 - 80� ate Approved to Phone Phone t-/,&7 -Lloc)q Property Owner's Address LIN dd yn,II rd PwI-Ara,#&4 W4 19,162 Contractor/Engineer LpxjApj Phone Contractor/Engineer's Address 303 A.!,1-7 License# Le_VjA)yr_ 951,pt4 Ex res 3-31 -09 Project Address IZI J/Q W ) & � S hvr}-An�,e� WA 9,93%a- Business ,92%a- Business Name �[A) On K got -Ai q\)-Q— Parcel Number Lot Zoning Submit two sets of plans & a site plan that includes 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. Siqn Type & Brief Description. (Type, location, sq. ft.) 1-1:7 $a Ft vy-a Sign #1 Lq ILj f7iji)i &jjor Cr0_Qb1c -dV) kAllk r_ylawuo vo-qct aiIA/-0�1A er4rewte4 Q 14 k e_4 Sign #2 A44� kl�& i G Ya.� I _�Oj C, 4 C_ Sign #3 \,,,j 4.1, 0,pr_:0 i rJ40 sj I L 5e 1 P " Sign #4_1V__Suvy)mp �ZA Ir A ryx P_ e G? 0..11' 1,01A -"-e- iullnflautc 9T 44�n_ roof-) _Ftt_�tlQ 15j- <+- I C_J Totals (Unit charaes Sign(s) Unit Charge Quantity multiplied by Quantities) Iffe of Sictn Valuation $ goo $47 00 x = $ $85 00 x = $ $115 00 x = $ GRAND TOTAL Total sign area 17,-7 sq ft. All signs less than 25 sq ft. Wall or marquees, over 25 sq. ft. Freestanding and projecting, over 25 sq ft. 00K X11 V.; (AN 0 e it- -1tilbs Make Checks Payable to City of Port Angeles Credit Cards (Except American Express) are accepted Maximum allowed sign area sq. ft. 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 what permits are required and to obtain permits prior to working on projects Date --7—'07- 09 Print Name %MmV" 9C),7r1eU Signature T'Forms/Building Division/Sign Permit Application.doc IN, re : s w o'nK Boum vt, Old '76 Ma'tI � C,he,C'l� -� o Ec�ovEFle,&Se- D JUL 3 1' 2008 1?-2-3 �.th S-t- CITY OF PORT ANGELES Dept. Of Community Development Po rt 019 363 Application inquiry 6, StMi"=PUBLIC SECTOR � %✓� WE N-ib— Application 08-OOODv `. Bonds property Information x-1 Application Information Contractor escrow Address: 121 1/2 W IST ST Application desc:20 SQ, FT, STORE FRONT AWNIe —' Fees PORT ANGELES, WA 98362 Application status: APPROVED Global balance du, LocationI0: 148034 s Status Date: 7/14/2008 - Inspection history :;. Owner name: DELGUZZI LISA _; Application type: COMM ADDITION I Miscellaneous info - ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1554-0000- Application date: 6/27/2008 ® Names ALTERNATE ID: Tenant nameinumber: 9WAW BOUTIQUE Permits .:,... ►..1 - 4 i ! ► Plantracking ..... ....-. ......_.... ..-_..... ...__.. _._ ._._. ....... ...... .......... Reaaif1isContractor Information } Outstanding Inspection@ 3 ® Square footage cal �" r structures Ct. Contractor Name; AAWNINGS /SUNIMMS /OISTNCT\.-, Insp Schedule ConfirmatiorfZ Valuation calculatio Contractor Number: 2408 Type ID Date Number Type: GENERAL ---•-- — -------• ...... .� Status: ACTIVE — O. BLDG FOUNDATION Contractor Requirements Doc Number Q' BLDG POST/COLUM .� -•--- --------• ---- ---- (., BLDG FRAMING { 6/? 0/08 - 067233 ,9CORDERY -- *+ - 7.07 .DO _ I._. Total.. „�, Ill I—i► tend kgdry , ) Duouments �.✓✓/ ..... _.............. ..._.__ I.. I fie- a u)ne4- J Su m mevr (1) C 13t-I Ale C4h ce4 14 f ► i S �ek-mii- �e`Fvt�e i+ uu&c� . i ss uYee( . SIS e_ aA Pc-'i d -P6 r Vie- end ►^e am®un* wIne-V1 ShQ- su6M(fwditle_ Pli Locks o Y) s S he. c Axl Ge eA 6 e cau s e s h, i S 0 ver b y d� i YevieLe iW cL S c ©wee- In 1"7,07 3 6, X -1 Plan f✓h See a`i��� � S� Application Inquiry SUNGARW PUBLIC SECTOR ? HTE K-itim, 0`, �r > Application 08.000007` Property Information Bonds P y tir� Application Information' Contractor escrow Address: 121 1/2 W IST ST i Application desc: 20 SQ. FT, STORE FRONT AYtlNIP V Feet PORT ANGELES, WA 98362 Application status: PERMIT ISSUED Global balance du( Location ID: 148034 Status Date: 7/14/2006 Inspection history Owner name: DELGUZZI LISA Application type: COMM ADDITION Miscellaneous info ASSESSOR PARCEL NUMBER: 06-30-00-0-0-1554-0000- Application date: 6/27/2008 [ Names ALTERNATE ID: - Tenant name/number: 94ANK BOUTIQUE Permits ! t IN ,.>.,_,..-..F�....,...._�......,....._. .. .. .._...:...... ......._.._.. 1.►J _...__ ED Plan tracking Receipts Contractor Information y Outstanding Inspections 0 Square footage cal Structures 4 Contractor Name: AANNINGS /SUNROOMS /OISTNCT\Insp Schedule Confirmation- Valuation caiculatit Contractor Number: 2406 Type ID Date Number ' Type: GENERAL ............... ...... .......... ................. Status: ACTIVE –. BLDG FOUNDATION i Contractor Requirements Doc Number Ck BLDG POST/COLUM -•--- ------ ------- -- ----------- TI; l rt t• ..� Q BLDG FRAMING u.. ► ... ........ K. FC PI, 11 CHECK FEES 36.47 .00 .00 ODOOb1 F FF PERMIT FEES .56.10 .00 .QD J I1 tDCI� A 3T iTATj SURCHARGE 4.`;0 .f0 _ 13 97.07 .00 .TOOT Print Cancel 'Y Ex it Refresh Lard Inquiry Doc umenta ..._-.._._____.....,.._...._..._,.;. 131 /Al— Z- A( / ri O�w",Oa (i;A13rzi c.) 9 '/ T U-21tj6l () i/yi1 � tl ro ev}-�b n Arvv\ �j- �f-, 1 r•a rte- ".'1 c',e �`^a r� „k� .,- CITY OF PORT ANGELES — Constrac,eon marts The Issuance of this permit based upon these plans, spscifi- cations and other data shall not prevent the building official^ a� from therea+ter requiring the correction of errors in, said pls.s, specifications and other data, or from preventing building operations being carried on thereunder :vhm is violation of all codes and ordinances of this juris��i�cn. 4i 1 node.) Approval Date By , I --t 12— 0 I /n V __ D 131, 0 // '7' 4- S 6P�t51er- 5 c��r& pap 'TV Looz42,e�reF wxL-i UJir-�Gi (4> Sleeves ►��o� ba1 mix, 3Co" a , c_J Coe- A- - 2A -C k ProJe&4-ibn A7 -v\ _.._ .__.. _CITY OF PORT ANGELES — Const!r c;ron Piens F11' The Issuance of this permit based upon these plans, specifi- cations and other data shall not prevent the building official from thereafter requiring the correction of errors in said pla .s, specifications and other data, or from preventing building operations being carried on thereunder when in violation of all codes and ordinances of this jurisdiction. e.rn-oval Date 1 By T y BUILDING PERMIT APPLICATION Print in ink lam•+- CITY OF PORT ANGELES For City Use Ong ly: Attn: Building Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 Date Received_70 g (360) 417-4815 fax (360) 417-4711 Permit # d S - ate Approved:I�� Applicant or Agent AlvMW45 SUM10OWS v �Is7;`le`�7c��1 Pho a .3ko &0/ -z 7--27 Property P rtY Owner S tvicen k ,�ov � ,,, :,- PhO�e Property Owner's Address rte/ (ContractgtlEngineers4H� v��. Phone (C;ontractorJEngineer's Address License # e Expires PROJECT ADDRESS /,7-/ /y 6r,� /ILI_ SA Parcel Number Lot Zoninq Proiect TVpq & Brief Descri tp Ion: ❑ Residential kCommercial ❑ Multi -family ❑ Industrial Check all that apply ❑ New Construction ❑ Addition ❑ Remodel ❑ Repair ❑ Re -roof ❑ Demolition ❑ Heat System ❑ Heat pump ❑ wood -burning stove ❑ gas fireplace ❑ pellet stove ❑ other t„�2 #Other . �,� ,1¢r�rYru� - li�� �a' ��ir., ,lr�i/ i 4-P - Floor Areas Basement 1st Floor 2nd Floor 3'd Floor Garage Carport Covered Porch Deck Shed Other Existing (so. ft) Proposed (sa. ft.) $ per sq. ft. = $ TOTAL VALUATION $ Total footprint of structures 0 rf �- �2 _ sq. ft. . Lot size 1D w rP .it = Lot coverage ""'7' % inclre 5 Max. height of proposed structures 16 /a Occupancy group d # of bedrooms Will a lawn sprinkler system be installed? Occupant load # of full baths Will a fire sprinkler system be installed? ,�Ja Construction type 7/,,, &AA,Oe. # of half baths 1 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 what permits are required, and to obtain permits prior to working on projects. / l Date ����/z'� Print Name C//liWXJ Signature T:Forms/Building Division/Bldg PermkAppl.-2006 Code.do ��I s 7 11_1 /0 � CMA4 awh; 6\1-&,( bdq e � SU rnno �,,�-- � IAC lel C(,�, ��-�`^-' CERTIF cit This certificate is is; Code certifvrng that of the City regulatrn Business name' Business address Property mvner: Property utivrter's Aruonutiic,fire sior Use & occupancyi Building permit in, Type of constructic Occupant load. -.a x u=>s Rort Angeles..<�Buflding,D� inion .., ,. �.s: to the requnenrenfs of section 11(I) iftlie 2 O6 International Building issuance this structure uas in compliance w/h the various ordinances istiiarctionaotause.for the JP/loyi;117zr.,,, 'W. T Lisa 1 -4016 Post on the premises in a conspicuous 905 07/23/08 Dale be removed except by the Building Official. I PREPARED 7/15/08, 10:51:22 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 7/15/06 ________________________________________________________________________________________________ ADDRESS : 121 1/2 W 1ST ST SINDIV- TENANT, NBR: SWANK BOUTIQUE CONTRACTOR . PHONE OWNER LISA DELGUZZI LV TRUST PHONE (360) 457-4004 PARCEL 06-30-00-0-0-1554-0000- APPL NUMBER 08-00000670 CO- CHANGE OF OCCP/USE PERMIT TYP/SQ C099 01 --------------------------- CO 00 CHANGE OF OCCUP/USE REQUESTED INSP DESCRIPTION COMPLETED RESULT RESULTS/COMMENTS ________________________________________________________________________________________ 7/15/08 JLL /I BLDG C/0 FINAL TIME 00 + OVERRIDE TAKEN ANGNGRLE DATE. 07/15/00 TIME: 08:43:04 Illy 15, 2008 8'911:: 499 AM 1pangrle SUMMER 461-4554 C OF 0 FINAL - SWANK BOUTIQUE AFTE 0 OM14AENTS AND NOTES ______________________________________ i iLy- CERTIFICATE OF OCCUPANCY APPLICATION Permit #09-670 CITY OF PORT ANGELES =M Attn Building Permit TechnicianCertificate/ FEES 321 E Fifth St , Port Angeles, WA 98362 $50 00 Certificate /Inspection (360) 417-4815 fax (360) 417-4711 $100 00 Parking Business Improvement Area (PBIA) Print in ink `11,,,,,,..LL `- 11 fee charged for downtown local ions FbVrnQirtfic Ni*ons VJQS i+,e- Py�v,ouS {�VSi FleSi fi_T Il'ii Iccscfi'ch� BUSINESS NAME SWArlr PAA; C, e 1 /� Yf BUSINESS ADDRESS I'L I l�2 �l/. /0 0 O-AyiQ -I wA 100l 2 Zoning Business mailing address It Sp Ill!,. Avv s� o Phone # pening date JU fpays & hours of operation /Darn - li, '30Jltn mon - CX 41- can l2 PM- ZOOMBrief description of proposed busmes0r'i&dj lJ il Iylj {pAAf11l1 P Business owner's name Ck)myylf/L MGQrT[IIQ Phone# 3laU• /(y/,�ISS�J Business owner's home address L9-2 R_I tl- ,;l K+ Il Ari q P kL( ►•vii} 98.71v2' P LBusi C Su�hs,1jf ABusiness License Is also required for the following businesses. Taxi, Peddlers, Second-hand dealer, Pawn broker, Dance, Ho Motel, Fireworks, Ambulance, Tattoo shop Contact the City Clerk at 417-4634 for additional Information. 6(f ley ACTION ✓ I WILL THERE BE ANY OF THE FOLLOWING? NO✓ YES/ IF YES, CONTACT I Electrical changes I/ Electrical Dept at 417-4735 New businessI New or relocated signs will n2H rytt(td Rn m; i1 V Building Division at 417-4815 Construction changes Transfer of business Mechanical changes (heating, cooling, stoves) location from a Plumbing changes PBIA location Fire sprinkler system changes Fire alarm system changes ,/ •' Transfer of business Is this a home occupation Planning Division at 417-4750 location from a Second-hand dealer or pawn broker? City Clerk at 417-4634 non-PBIA location New or relocated sewer or water service Public Works at 417-4807 I Excavation or filling of lots i/ " Change of ownership Work done in the City right-of-way r/ New driveway openings t/ l Remodel Grading site drainage (parking lots, downspouts, etc) Landscape irrigation system (backflow devices) 1/ Water Dept at 417-4886 Temporary business Off-street parking tang Ct,472ir�hr4el lei I- / Existing streets paved Change of use Existing sidewalks q/ Curb and gutter %/ Call for Certificate of OccunanCV inspections before opening business: Please sign up for utility Building Department Inspection 417-4815 & Fire Department Inspection 417-4653 services at the cashier counter. Please provide a minimum 24-hournotice for inspections I hereby apply for a Certificate of Occupancy. I acknowledge that l have read this application and state that the information I have supplied is correct to the best of m�+y� knowledge Date iJAl Q5 Print Name )I"Will- I'll"IGpp 1r161 -e, Signature —J" For City use only Department Approved Rejected Initials & date Initials & date Comments I Conditions Building Pb -7-15103 Type of construction Occupant Load Fire �D 1 Automatic fire sprinkler system required no yes PBIA AH G-L+_r z Planning R /-Ir1-0 City Clerk h��) 6-q-69, Public Works �u 6-1 T Forms/ButUng DmisionlCarificale of Occupancy Application el ^r CERTIFICATE OF OCCUPANCY APPLICATION Permit# d3- Hi, CITY OF PORT ANGELES FEES Alin Building Permit Technician 321 E Fifth St., Port Angeles, WA 98362 L$50.00 ertificate I Inspection (350) 417-4815 fax (360) 417-4711 $100.00 Parking Business Improvement Area (PRIA) Print in ink fee charged for downtown locations BUSINESS NAME /V0_pT /� TI!� t� T SNI 1-} j I1.JY' r .� tfli967 ',t �%_N �# `��li Il (S / IIP=` BUSINESS ADDRES101tsrrill 60 l�G� 5-t— li i o� ) �/y t4 4-5,-t- 5, ) J� Zoning _ Business mailing address 15A,nn G Opening date o2,101log Days & hours of operation M ^Sad j/ -,� 30 Brief description of proposed business c _ BusineowTn2e}Sr's nameJnrJtonciri-- 'f , +Ffo� #K_f t t(Cft=7t 'Business owner's home address PLEASE NOTE: 73-V-XZr A -A) (PZE3� cj`FC310 A Business License is also required for the following businesses: Taxi, Peddlers, Second-hand dealer, Pawn broker, Dance, f iotel- Motel, Fireworks, Ambulance, Tattoo shop. Contact the City Clerk at 417-4634 for additional information. ACTION ✓ ( WILL THERE BE ANY OF THE FOLLOWING? I NO ( YES✓ ( IF YES, CONTAC-I I Electrical changes I ✓ Electrical Dept. at 417-4735 New business i New or relocated signs i Building Division at 417-4815 Construction changes Transfer of business Jf ( Mechanical changes (heating, cooing, stoves) y" location from a �1f// Plumbing changes PRIA location I Fire sprinkle, system changes 1/ Fire alarm system changes Transfer of business ' is this a home occupation? t/" I Planning Division at 417-4750 location from a Second-hand dealer or pawn broker? Y, I { City Clerk at 417-4634 non-PRIA loeaton I New or relocated sewer or water service I V' I I Public Works at 417-4807 I Excavation or filling of lots 1/ Change of ownership I Work done in the City right-of-way I y/ I New driveway openings Remodel Grading site drainage (parking lots, downspouts, etc) I Landscape irrigation system (backflow devices) ✓ - Water Dept at 417-4886 Temporary business I Off-street parking"" 1% I Existing streets paved Change of use I Existing sidewalks I I 1X I Curb and gutter Call for Certificate of Occunancv inspections before opening business: Please sign up for utility Building Department Inspection 4174815 & Ftf'e Department inspection 417-4653 services at the cashier counter. Please provide a minimum 24-hour notice fortrispechons I hereby apply for a Certificate of Occupancy I acknowledge that I have read this lication and stat at the inforn'iation 1 ave supplied is c reef to the best of my knowledge - Date ^ , Date i )Z$ 0$' Print Name F8 Bei.. M " Litt Signature For City use only Department Approved Re)ectea p I Initials &date Initials & date Comments I Conditions Building I0�/-1 �U� ��L.. Type of construction Occupant Load `ire tC li Q 1 2.�-f Y Q Automatic fire sprinkler system required no yes PRIA , ©�„�".``r^�L _"4`l� SlJ Planning !n`iR eA City Clerk Ll}k OVi ._7";O !1 0! rl7.4l� PublicWorks r \ S /J T Pormsleuiltling orviuonleerlJ¢ale of Occupancy AppLcalron \\v V I It L_ PREPARED 2/04/08, 9 47 06 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/04/08 ------------------------------------------------------------------------------------------------ ADDRESS 121 1/2 W 1ST ST SUBDIV TENANT, NBR ROBERT M. LUMENS CONTRACTOR ., PHONE OWNER LISA DELGUZZI LIVING TRUST PHONE PARCEL 06-30-00-0-0-1554-0000- APPL NUMBER: 08-00000111 CO- CHANGE OF OCCP/USE ------------------------------------------------------------------------------------------------ P6 IT: GO 00 CHANGE OF OCCUP/USE REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ 0099 O1 2/04/08 JLL BLDG C/O FINAL TIME 01 00 OVERRIDE TAKEN BY LPANGRLE DATE: 01/28/08 TIME 11 57:20 January 28, 2008 11:46:14 AM 1Pangrle ROBERT 460-6830 C OF 0 FINAL - NORTHWEST FUDGE & CONFECTIONS (IN THEIR NEW TEMPORARY LOCATION FOR ONE OR TWO MONTHS) ----------------------------- COMMENTS AND NOTES --- ---------------------------------- r CERTIFIC,ATEOFOC.CUPAN CY City of Port Angeles Building`"Division A" 4 This Certificdton!issued pursuant to the requirements of Section 109 of the Uniform�Btiilding'Code certifying that at the time of issuance this st,�uchme was in compliance ii�itli the v`ahous'ordinances of the City regulating Building ♦ construction or use. For the following: Use Classification: Retail Building Perini[ No.: Business Name Romantic Notions r `. ♦ GroupM Type ofConsWction. V -N '+? - Use Zone: " CBD Owner of Business Barb Weeks'- : Address. 867N6r[h Lee's -Creek Rd.. Port Angeles, WA 98362 Building Address 121'/z West'111. Street,_ ."_.-.:. _�-Port-Aneeles:'WAt98362_ =ia, vim; ; ;.;? J� ry l5th. ?004 _a' Gil ng nicial x �,Date 41=�ih�ti�48'J 6„�•� r.Y y��A YYY Po heµprem sesnaconspcuousplace. Shall not beremovedtexc�eptbyB'uilding Official. r : 1t DATF G - 8 -o') ROUTING SLIP Q Certificate of Occupancy $47.00 Certificate/Inspection Fee Address of Proposed Business I al I/a U-). Ft Rs s -in it Applicant AAi26 IcIF�FS Address Pb -7 n - LA'S M 46 P-I-AlIv1L-S LSI} u 83(ad Phone: business AIA home c4S7-11-73 Brief description of proposed business: Ccl F T ,S WDP New Business ............................ ( 5� Transfer of Business Location ................ Change of Ownership ...................... New Building ............................. Remodel................................. Temporary Business ....................... Change of Use ............................ Legal Description: Lor Block Current Use of Property: L (mics Qft r1 -t I (lir S—jzyz-C— Zoning Classification of Property ?91 A WILL THERE BE ANY OF THE FOLLOWING? YES NO Construction changes . ... ... . 1) _)( Electrical changes.... . ..... . . Plumbing A— Mechanical (heating, cooling, stoves) .............. 3) —X— Plumbing changes .................. .......... 2nd Hand Dealer _X_ New or relocated signs 4) Pawn Broker New septic tanks ............ ............... ..— 5) New sewer service ... .. 6) "L Admission charged to patrons . . . ....... ..... Hotel - Motel 7) Is this a home occupation? ...................... 7) Fireworks Excavation of filling of lots ....................... Curb installation K Work done in City right-of-way . . ............ .. 9) Is there sufficient off-street parkingv ...... Tattoo shop 10) New driveway openings ... .. ............. 10) —X A grading plan for site drainage .............. .... Fire X (parking lots, downspouts, etc.) ........... 12) Occupancy Are the existing streets paved? .. ....... 13) Are there existing sidewalks? ..................... Is there curb and gutter? ........................ Shoreline Other......................................... 15) Home occupation I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge. nt,E REJECTED Building Section Public Works Department Planning Department Fire Department City Clerk P.B.I.A� part%, Subdivision THE FOLLOWING WILL BE REQUIRED PERMITS BUSINESS LICENSE 1) Building 1) Taxi 2) Plumbing 2) Peddlers 3) Electrical 3) 2nd Hand Dealer 4) Mechanical 4) Pawn Broker 5) Sewer 5) Dance 6) Sidewalk installation 6) Hotel - Motel 7) Driveway installation 7) Fireworks 8) Curb installation 8) Ambulance 9) Sidewalk obstruction 9) Tattoo shop 10) Water meter installation 10) Other 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other Date: Q - 8 — U 3 Signed: l CJ_Ft-.KerJ Comments / Conditions ROUTING SLIP Certificate of Occupancy $47.00 Certificate/Inspection Fee DATF q - R _G �) New Business ..... ..... ................ ( ) Address of Proposed Business Transfer of Business Location ................ ( ) 1 ;1I f/a co, Ft2S Change of Ownership . . .. .............. ( ) Applicant f3Ao/3 t t=kF(�' New Building ............................. ( ) Address P)b-7 /1- Remodel ................................. ( ) PT twV-1-i Temporary Business ...... .. ............. ( ) Phone: business All home yS 7 --Lq -73 Change of Use ... ............... ... .. . ( ) Brief description of proposed business `n F T �S f -bio - Legal Description: Lot Rlock Subdivision Current Use of Property: CAO ICS ?%I Q Zoning Classification of Property WILL THERE BE ANY OF THE FOLLOWING? YES N`O/ THE FOLLOWING WILL BE REQUIRED: - Construction changes ...................... .... —.a.— PERMITS BUSINESS LICENSE Electrical changes . ....... ..... ... ... . .... 1) Building 1) Taxi - Mechanical (heating, cooling, stoves) .. 2) Plumbing 2) Peddlers Plumbing changes ... ... .. .. ... .. 3) Electrical 3) 2nd Hand Dealer New or relocated signs .. . .... ............. 4) Mechanical 4) Pawn Broker New septic tanks 5) Sewer 5) Dance - New sewer service .. .................... .... 6) Sidewalk installation 6) Hotel - Motel Admission charged to patrons . . . . ........... 7) Driveway installation 7) Fireworks Is this a home occupation? .. ......... ... 8) Curb Installation 8) Ambulance Excavation of filling of lots ... ....... X 9) Sidewalk obstruction 9) Tattoo shop ' Work done in City right-of-way .. 10) Water meter installation 10) Other Is there sufficient off-street parking? ............... _ 11) Fire - New driveway openings ... ... .. .. X 12) Occupancy A grading plan for site drainage. .. .. X 13) Sign (parking lots, downspouts, etc I ...... . .. ... Z 14) Shoreline Are the existing streets paved° 15) Home occupation Are there existing sidewalks? . .. ... —1L 16) Conditional use Is there curb and gutter? .......... ..... ...... 17) Other Other. . ... . . .............. . .......... I hereby apply for a Certificate of Occupancy and acknowl- R- 8 edge that I have read this application and state that the Date: O3 information I have supplied is correct to the best of my knowledge. Signed: _ APPROVED REJECTED Building Section Public Works Department Planning Department Fire Department City Clerk PB.I At ROUTING SLI O, ��aWa Certificate of Occup a cy �� $47.00 Certificate/Inspecti n F e, DATE New Business ( ) Address of Proposed Business Transfer of Business Location ................ ( ) a LL -)• F1 QST 5 1nA—ZT Change of Ownership ..... ( ) Applicant .RAIL Lktl;k(!�S�^ New Building ............................. ( ) Address f�-i n- ill' U 40 Remodel ................................. ( ) OT M(sru S G_R c3 Temporary Business ....................... ( ) Phone: business A lt'l home LISA -� q -13 Change of Use ............................ ( ) Brief description of proposed business: (sl F T S 11C>10 Legal Description: Lot Flock Subdivision Current Use of Property: L(-AioICS C(-ti—,H I nCc Zoning Classification of Property: ?2. I A WILL THERE BE ANY OF THE FOLLOWING? YES NO Construction changes .......... 1) Taxi Electrical changes .. . ............... Plumbing X Mechanical (heating, cooing, stoves) ..... 3) — Plumbing changes .. ...... .. ...__ 2nd Hand Dealer 4) New or relocated signs ..... ..... 4) Pawn Broker New septic tanks ........ .. ... ........... Sewer — New sewer service . ........ .. 6) Sidewalk installation Admission charged to patrons .. ... ........ Hotel - Motel — Is this a home occupation? ................ 7) Fireworks Excavation of filling of lots ... ... . ..... Curb installation X Work done in City right-of-way .......... .. 9) Sidewalk obstruction Is there sufficient off-street parking? .............. Tattoo shop 10) New driveway openings ........ ... 10) Other A grading plan for site drainage........ ... Fire —.Z (parking lots, downspouts, etc.) ... ............ 12) Occupancy Are the existing streets paved? ........ ........ —Y 13) Are there existing sidewalks? ............. ...... Is there curb and gutter? ..... ... . ......... Shoreline Other. . ............. ................... .. Home occupation I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the Information I have supplied Is correct to the best of my knowledge. nREJECTED D� Building Section Public Works Department Planning Department Fire Department City Clerk P.B.I.At �a�r� THE FOLLOWING WILL BE REQUIRED PERMITS BUSINESS LICENSE 1) Building 1) Taxi 2) Plumbing 2) Peddlers 3) Electrical 3) 2nd Hand Dealer 4) Mechanical 4) Pawn Broker 5) Sewer 5) Dance 6) Sidewalk installation 6) Hotel - Motel 7) Driveway installation 7) Fireworks 8) Curb installation 8) Ambulance 9) Sidewalk obstruction 9) Tattoo shop 10) Water meter installation 10) Other 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other Date: C1" 8//" v.3 Signed: /100 Comments / Conditioni t\i <_ L VI �r CERTIFICATED OCCUPANCY City of Port Angeh Building Division This C tification issued pursuant to the requirements of Sectionp 109 of the Uniforu} wilding Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating Building construction or use. For the following: 1 Use Classification: Retail Building Permit No.: Business Name: Romantic Notions Group: M Type of Construction: V -N Use Zone: CBD Owner of Business, Barb Leks Address 807 North Lee's Creek Rd.. Port Anne les. WA 98362 Building Address: 121 1/z West 1st. Street, Port Anseles. WAs8362 7anuary 15th. 2004 l J nt4e,bremises,'inta ial Date Po/ µ'ji.�rP<ai?�i .; ;rrvs:,;t"zii'.ri ��:. Hi`":y'�✓" conspicuous place. Shall not be e'tn 'ye'd except by Building Official. ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 1$-00000040 pate 1/22/15 Application pin number 925360 Property Address , . . 121 1/2 W IST ST ASSESSOR PARCEL NUMBER; 06 -30 -00 -0 -0 -1554 -0000 - Application type description ELECTRTCAL ONLY Subdivision Name Property Use . . . . . , , . Property Zoning . . . . . . , CENTRAL BUSINESS DISTRICT Application valuation , . . , o ---------------------------------------------------------------------------- Application desc Remodel for pizza place ---------------------------------------------------------------------------- Owner Contractor DELGUZZT LISA EXTRA MILE TECH F. ELECT_ LLC 4016 CLD MILL RD 418 N. RACE ST, PORT ANGELES WA 983621905 FORT ANGELES WA 98362 (360) 457-5222 __-___--------------------------------------------__------___-____--------- Permit . . , . , . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . 1.62,00 Plan Check Fee 00 Tssue Date 1/15/15 Valuation 0 Expiration Date 7/14/15 Qty Unit Charge Per Extension .00 74.0000 ECH EL -COMM BRANCH CTR WO/ SIF .00 6.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 30.00 1.00 132.0000 BCH EL -COM 0-200 SRV FEEDER 132.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 162,00 162.00 p0 .00 Pian Check Total 00 .00 .00 ,00 Crand Total 162.00 162,00 p0 DU REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:IPXCIIANGEIBUILDING 11 Plan Review May Be R hired, Plea Cornpl� fe fecirlral F'Ia Revie InformationSheet Address: 1A1 l/7, i %f it,tr 3uttding Square Fuolage: _ T l3sscrrpft of above . _!ci %#J .� Contract r information Mme. n � � +G 2 j M . i.5 'F^�GFf Address: r9t r �7r_.! wrlEf 1Q Name: 4 —,6 _ — Nlaittn Address: 4 t� Pisan AC f" � . t" .IEET' State. �J2ip: 9 vm :z Cs r: - AK4 etas State; ML&_ rip: JV 5 3htsns : Fart: Thane: .tcrose#/Exp. License#!Exp. r-/L4xlr-,Y 7 r P.& tem Unit Chame ! 7r$tat &ri t ultiolied lav Unit Chair e Service/Feeder 200 Amp. $132.00 �$ /?Z-10 3ervicelFeeder201.400Amp. $160.00 $ _ 3ervlceff-eedar 401.600 Amp $ 225.00 $ 3arvIce/Feeder 601-1000 Amp. $ 286.00 $ 3arvice/Feederover 1000 Amp. $.410.00 Branch Circuit W/ Service Feeder $ 5.00 $ 3ranchCircuit W/O Service Feeder $ 74.00 - $ 'ach Additional Branch Circuit $ Ho f _ $��• °�� irancb Circaiits 14 $ 86.00 $ emp. Service/ Feeder 200 Amp. $142.00 temp. Service/Feeder 241-400 Amp. $121.00 _ $ Temp. Service/Feeder 401-600 Amp. $164,00 Temp. ServlceXeader 601 -1000 Amp . $165.00 $ Portal to Portal 1- oWy $ 96.00 $ )ign/Outline Lighting $ 813.0/7 � $ )!gnat Circutll limited Energy — Multi -Family $ 54.00 $ 'ignal Circuill limited Energy 1 First 1500 sf— Commercial $ 96,00 Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5Kt1A System or tees $113.00 $ Thermostat $ 56.00 _ $ !Nate: $5.00 for eacb additional T-Stat $ i bTtrial {� )wrier es deflned by RCW.19.26.261: (1) Owner will 13cearpy the structure for two years after this electrical permit is finallzed. (2 Owner is required Wire on electrical contractor if above said proparty is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making he electrical installation lir alteration in compliance with the electrical laws, id,E.C., RGW. Chapter 19.20, WAG. Chapter 29646B, The City of Part kngeles Municipal Cade, and utility Specifications and PANIC 14.03,050 regarding Electrical Permit Applications, signature of owner, electrical contract" or electrical administrator: © Cub © ch X* d�71 "•, Dated., /—,` ® -�� 01FD11"12 RECEIVED "i JAN 2 2 2015 ffT t CityoFPORT ANGELES PIERiNit'i.�IPPLiCAnoN ELECTRICAL � O 3aildiing DivisionXiectrical linspmfions .� $21 East Fifth Street -a-P.O.Box 11501 Port Angeles Washington, 98362 P.h: (360) 417-4735 Fax: (360) 4174711 1-15— )ate. _ _,_, Multi -Family or Commercial* Plan Review May Be R hired, Plea Cornpl� fe fecirlral F'Ia Revie InformationSheet Address: 1A1 l/7, i %f it,tr 3uttding Square Fuolage: _ T l3sscrrpft of above . _!ci %#J .� Contract r information Mme. n � � +G 2 j M . i.5 'F^�GFf Address: r9t r �7r_.! wrlEf 1Q Name: 4 —,6 _ — Nlaittn Address: 4 t� Pisan AC f" � . t" .IEET' State. �J2ip: 9 vm :z Cs r: - AK4 etas State; ML&_ rip: JV 5 3htsns : Fart: Thane: .tcrose#/Exp. License#!Exp. r-/L4xlr-,Y 7 r P.& tem Unit Chame ! 7r$tat &ri t ultiolied lav Unit Chair e Service/Feeder 200 Amp. $132.00 �$ /?Z-10 3ervicelFeeder201.400Amp. $160.00 $ _ 3ervlceff-eedar 401.600 Amp $ 225.00 $ 3arvIce/Feeder 601-1000 Amp. $ 286.00 $ 3arvice/Feederover 1000 Amp. $.410.00 Branch Circuit W/ Service Feeder $ 5.00 $ 3ranchCircuit W/O Service Feeder $ 74.00 - $ 'ach Additional Branch Circuit $ Ho f _ $��• °�� irancb Circaiits 14 $ 86.00 $ emp. Service/ Feeder 200 Amp. $142.00 temp. Service/Feeder 241-400 Amp. $121.00 _ $ Temp. Service/Feeder 401-600 Amp. $164,00 Temp. ServlceXeader 601 -1000 Amp . $165.00 $ Portal to Portal 1- oWy $ 96.00 $ )ign/Outline Lighting $ 813.0/7 � $ )!gnat Circutll limited Energy — Multi -Family $ 54.00 $ 'ignal Circuill limited Energy 1 First 1500 sf— Commercial $ 96,00 Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5Kt1A System or tees $113.00 $ Thermostat $ 56.00 _ $ !Nate: $5.00 for eacb additional T-Stat $ i bTtrial {� )wrier es deflned by RCW.19.26.261: (1) Owner will 13cearpy the structure for two years after this electrical permit is finallzed. (2 Owner is required Wire on electrical contractor if above said proparty is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making he electrical installation lir alteration in compliance with the electrical laws, id,E.C., RGW. Chapter 19.20, WAG. Chapter 29646B, The City of Part kngeles Municipal Cade, and utility Specifications and PANIC 14.03,050 regarding Electrical Permit Applications, signature of owner, electrical contract" or electrical administrator: © Cub © ch X* d�71 "•, Dated., /—,` ® -�� 01FD11"12 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 15-00000040 pate 1/15/15 Application pin number . , . 925360 Property Address . , . . . , 121 1/2 W IST ST ASSESSOR PARCEL NUMBER; 06 30 -00 -0 -0 -1554 -0000 - Application type description ELECTRICAL ONLY Subdivision Name , , , , , . Property Use Property Zoning , , , , . , . CENTRAL BUSINESS DISTRICT Application valuation . , , . 0 ---------------------------------------------------------------------------- Application desc Remodel for pizza place ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ DELGU441 LISA EXTRA MILE TECH & ELECT,, LLC 4016 OLD MILL RD 419 N, RACE ST. PORT ANGELES WA 983621905 PORT ANGELES WA 98362 (36D) 457-5222 ---------------------------------------------------------------------------- Permit . . . . , , ELECTRICAL ALTER COMMERCIAL Additional desc , , Permit Fee 99.00 Plan Check Fee 00 .Issue Date 1/15/15 Valuation 0 Expiration Date 7/14/15 Oty Unit Charge Per Extension 1.00 74.0000 ECH EL -COMM BRANCH CIR WO/ S/F 74.00 5.00 5.0000 BCH EL-ECH ADDNT BRANCH CIRCUIT 25,06 ---------------------------------------------------------------------------- Fee summary Charged paid 'Credited Due ----------------- ---------- --- ------ ------- ._ -___--_-_- Permit Fee Total 99.00 99.00 ,00 .00 Plan Check Total ,00 .00 .00 .00 Grand Total 99.0D 99.00 .00 .00 INSPECTION TYPE DATE: DITCH SERVICE ROUGH -IN COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X GAEXCHANGEIBUILDING RESULTS REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Date: I .... .... ..... ... RECEIVEV, CITY of PoRT ANGELES PERmtT AppucAmN Building Inspections JAN OF Division/Electricall 20jj 321 East Fifth Street - P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (369) 417-4735 Fax. 417-4711 (360) INSPECTIONS zMal-Familly or Commercial* Plart Review May Be Rei red, Please Com to Eleptrical Plan R iew Information Sheet JobAddrins: /9 / Building Square Footage, Dascdpvon of above 9, -Z Owner latorMation Contract rinformation Name 4-15 Ai- WEE 1-,Qt+ t Va&'1t'j Malang — ------ = (5 4, Name: 4, If 'VAe,9 Addy -4ZG 'Oev Mat Orem: -9 1 MWO'L f7 City State, Zip: 'T Ak4 -146tL- City: ?0- e(—ec State: U0z phone! Fax: Phone.,- ex., License i#! Exp. License 4 1 Eaxp, 4 *4rq 7,f Item Unit Charae Total f0tv MultiDlied by UnitkfLarge Sarvloeffieeder= Amp. $132,00 $-- ServIce/Fesder 201-400 Amp, $160,00 $ Setviceirendor401-600 Amp $225.00 ServicefFeeder 601-1000 Amp. $ 2884D $ Sarvice/Feeder over 1000 Amp, $410.0D $ Branch Circuit W/ Service Feeder $ 5,00 Branch Circuit VV/0 Service Feeder $ 74,00 Each Additional Branch Circuit $ 5.00 Branch Circuits 14 $ 88,00 $ Temp. Seryloal Feeder 200 Amp, $102-00 $ Temp, Service/Feeder 201-400 Amp. $121.00 Temp. ServlcelFeeder 401-500 Amp, $164,00 Temp. BervicelFeeder 601 -1000 Amp. $185,00 Portal to Portal Hourly $ 96.00 Gign/Outhre Lighting $ 68.00 $ Signal CircddUmlted Energy -Mulff-Family $ 64.00 $ Signal Circult/ Limited EnMy I First I 5DO sf - Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Eleoldca) Energy- 5KVA System or Less $113.00 $ Thermostat $ 56,00 $ Note, $5.00 for each additional T-Stat $' V Total Owner as defined by RM19.28,261: (1) Owner will occupy the structure for two years after this electrical permit is linalized. (2) Owner is required to hire an elactricat contractor If above said property is for sale, rerittir lease. Permit expires after aix months of last Inspection. After reading the above statement, I hereby certify that I am the owner of the above named properly or a licensed electrical contractor. t am making the electrical installation or alteratlan in complianoD with the ektried laws, N.E.C., RCK Chapter 19,28, WAC. Chapter 296468, The City of Part Angeles Municipol Code, and Utility Specifications and PAMG 14.05.050 regarding Electrical Permit Applications, Signature of towner, electrical contractorer electric all administir&or., 0 cash 0 chaa; Load Calculation for: The Strait Slice PZA Owner.: Scott Sullivan 121 %2 West 1" Street Port Angeles Square Footage: 712.5 71.2.5 SQ FT x2 Pizza Oven Hot Water x2 Prep Station Conveyer oven Table Cooler Mixer Subtotal of General load Total general load at 65% SQ FT Meat Show Window Total Load Total: Calculated Load for Service 1,425 VA 5,750 VA 8,000 VA 996 VA 1,704 VA 612 VA 1,000 VA 1,392 VA 19,454 VA 12,645 VA 1,425 VA 5,760 VA 1,000 VA 20,530 VA 20,830 VA / 240V=86.79A 87 AMPS ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 15-00000040 Date 1/15/15 Application pin number , , . 925360 Property Address . . . . , . 121 1/2 W IST ST ASSESSOR PARCEL NUMBER; 06 -30 -00 -0 -0 -1554 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . , . Property Use Property Zoning CENTRAL BUSINESS DISTRICT Application valuation . . , . 0 ---------------------------------------------------------------------------- Application desc Remodel for pizza place ---------------------------------------------------------------------------- Owner Contractor DELGUZ7:r LISA EXTRA MILE TECH & ELECT_ LLC 4016 OLD MSLL RD 418 N. RACE ST, PORT ANGELES WA 983621905 PORT ANGELES WA 96362 (360) 457-5222 ---------------------------------------------------------------------------- Permit . , , , , . ELECTRICAL ALTER COMMERCIAL, Additional desc , . Permit Fee 99.00 Plan Check Fee 00 Issue Date 1/15/15 Valuation , . , . 0 Expiration Date 7/14/15 Qty Unit Charge Per Extension 1100 74.0000 ECH EL -COMM BRANCH CIR WO/ SIP 74.00 5100 5,0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 25.00 ---------------------------------------------------------------------------- Fee summary Charged Paid 'Credited Due Pea:mit Fee Total 99.00 99,00 .00 00 Plan Checlt Total .00 .00 .00 00 Grand Total 99.00 99.00 .00 ,00 INSPECTION TYPE DATE: DITCH SERVICE ROUGH -IN FINAL COMMENTS: PERMIT WILT, EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X G:IEXCHANGEIBUILDIiNG RESULTS: REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Date: ELECTRICAL PERMIT CITY OF PORT ANGELES 360-4174735 Application Number 15-00000040 Date 1/22/15 Application pin number . . . 925360 Property Address . . . . . . 121 1/2 W 15T ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -0 -1554 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . Property Use . . . . . . . . Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Remodel for pizza place ---------------------------------------------------------------------------- Owner Contractor DELGUZZI LISA EXTRA MILE TECH & ELECT_ LLC 4016 OLD MILL RD 418 N. RACE ST, PORT ANGELES NIA 983621905 PORT ANGELES WA 98362 (360) 457-5222 -------------------------------__------_---_-----------------------------_-_ Permit , , . . , . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee 162,00 Plan Check Fee 00 Issue Date 1/15/15 Valuation 0 Expiration Date 7/14/15 Qty Unit Charge Per Extension ,00 74.0000 ECH EL -COMM BRANCH CIR WO/ SIF QO 6.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 30.00 1.00 132.0000 ECH EL -COM 0-200 SRV EEEDER 132.00 ----------------------------------------------------------------------------- Fee summary Charged ---------- Paid Credited -------------------- Due --------------------------- Permit Fee Total 162,00 162.00 ,0o .00 Plan Check Total 00 .00 .00 .00 Grand Total 162.00 162.00 ,00 .00 INSPECTION TYPE DATE: DITCH SERVICE ROUGH -TN COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST WSPECTION Signature of owner or Electrical Contractor X G:IEXCHANGEIBUILDING RESULTS: REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Date: