HomeMy WebLinkAbout110 E 1st St - BuildingCng ionThis certificate is issitedpKirsitant to the requiremems"of Section TH q�the �609 International BuildingCode certij�ing that ati -`ii fissitance this structure was in compliance with the various ordinancesBusiness name: i -I ':��OV66,`SOoonfyl"Property owner: MarkleyProperty owner'§1addr`es Box 28 4,AngeUse & occupancy Bus'in'iess,Type of construction:5-8-12ehn( in,. ana.qer Datepbler -n
Post onthe premises |nacons p|ouo6`si�` a]|not boren�ovedexcept bythe
Building Official. ------�
Oj,0RT.q,V. CERTIFICATE OF OCCUPANCY APPLICATION Permit#
�~ FEES
1.. s -�,�.:.;
CITY OF PORT ANGELES Attn: Permit Technician $50 Certificate/ Inspection
�-
321 E. Fifth St., Port Angeles, WA 98362 $100 Parking Business Improvement Area (PBIA)
(360) 417-4815 fax (360) 417-4711 fee charged for Downtown locations
PLEASE PRINT IN INK �jC �t V15 ((SYl �(� y� �j(,{�1 ne.z
Check one: New business in P.A.?❑ Change of ownership only? IXMoving location from within P.A.? ❑ ZonitYg
BUSINESS NAME c : e'Q
Business address 1 1 C> E FIR,5`F Mailing address I.b3 1/a, E FI RiST v a �,A,
Phone number 1 , SA44q Opening date Days & hours of operation -� — 7 i dlgy a k
Business owner's name Contact phone�n
Business owner's address__ �k)(Atr��i� �1F53�o
Brief description of business
Property owner's name NI A,\j C- - /Vvc, t,p Contact phone S<v3c/
Property owner's address/contact
BUILDING DEPARTMENT phone 417-4815 I Bldg approval by JU.
Is the business a restaurant or bar that will seat 50 or more people? Yes ❑ No "A
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:
T
FIRE DEPARTMENT phone 417-4653 Fire approval by VDO by i L4- Ii-• rr,
Changes to a fire sprinkler system or fire alarm system? Yes ❑ No). -
Work planned:
PBIA (Parking Business Improvement Area -Downtown) phone 417-4623
Square footage of business?
PBIA notified 4. `" 1-a-
Is business moving within the PBIA? Yes ❑ No tN
CITY CLERK phone 417-4634
City Clerk approval b}3 R "%Y % lK , j'' LO Iy
Second-hand dealer/pawnbroker business? Yes ❑ No1X
Will there be dancing at this business? Yes ❑ No V
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel -Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page I of 2
COMMUNITY & ECONOMIC DEVELOPMENT phone 417-4750
Number of off-street parking spaces available for employees and
customers?
(A parking plan may be required.)
Signs? (wall -mounted, freestanding, .projecting, awning, A -frame, etc?)
Signs planned:
1�i0VIP. Pia Ki Yl>°,_
CED approval by -Vk/ 4. ( 0 • tr
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PUBLIC WORKS DEPARTMENT- ENGINEERING phone 417-4812
Is site work planned (new or re -located sewer or water service,
excavation, grading or filling, work in City right-of-way,
new driveway openings, site drainage, parking lots, downspouts,
irrigation system backflow devices, etc.). Yes ❑ ,No
Work planned:
PUBLIC WORKS WASTEWATER phone 417-4845
PINE approval bya VN 1���#/ 0, ko-J
A D C ,D M I(Y1 P�1/�'iG7
PWW approval by on
Will waste, other than domestic household waste, be discharged into the sewer system? Yes_, No ❑
If yes, what will be discharged: Guo C- mnaL rc-1 n 'PW IN W 4.q+ J5 -
Call for Certificate of Occupancv inspections BEFORE opening business.
Building Department Inspection 417-4815
Fire Department Inspection 417-4653
Please sign up for utility services at the cashiers' counter.
I hereby apply for a Certificate of Occupancy. 1 acknowledge that I have read this application and state that the
information 1 have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of
permit.
Dated Print Name C v �?, n; c� Signatures'
T:\Forms\Building Division\Certificate of Occupancy Apphration (2010).doc
Page 2of2
pORiq
1P
PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT
QUESTIONNAIRE and DISCLOSURE FORM
Complete all applicable sections. Information mus, be tvpewritten or clearIP printed. Attach requested information as needed Signino,
official must have the authorization to provide such information on behalf of the company, corporation, or partnership.
Company.Name: Ove—V
n
Mailing Address: 02-' /---7 2.C31 �}4P�{P�i.. W A— "_1 V
Address of facility in Port Angeles (if different than above): I U -R I 'z>T S -T -J
Contact Person: K101 Phone: LR-00—q�901
1. Type of Industry: 05-1-Y?1550 lbek kq4-ft-WArd 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
3. Product Volume: 4. Number of Employees: 1`4
5. Operation Pattern: (hr/day) 1'7' (days/yr) (mo/yr) 12 6. Water Usage (gpd).- Average Maximum
7. WASTEWATER DISCHARGE TO SEWERS: [List the principal materials (cleaning agents, solvents, plating solutions, catalysts, process
chemical, etc) by their generic name and principal chemicals that are regularly used in your facility and that will or might be discharged to the City sewer
system]
TYPE OF MATERIAL
OR CHEMICAL
a) Process
b) Cooling ,
AVERAGE DISCHARGE
GAL. TIME &
PER DAY DURATION
CONC. I GAL.
(MG/L) PER DAY
MAXIMUM DISCHARGE
DURATION CONC.
I (MG/L) I
Total Discharge
9. Are there seasonal variation to the above discharges?
PW -844_02 page 1
PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT
QUESTIONNAIRE and DISCLOSURE FORM (oontinued)
1(lDoesyouroonnpanysannpleandonolyzeyourwastawabar?OYesk~No/fyes'whatksUhenetureofdhatsempUng
11. Discharge bosewerage system: Attach as "Exhibit 1 " a plan of your property showing accurately the site plan, floor
pksn, mechanical and plumbing plans and details showing all sewens, connections to the City systernn, inspection
manholes,. sampling manholes, and appurtenances i mahon.and-e}exaUon.
a) How many wastewater discharge points does your coml5any have that are connected u,the City's sewer collection system?
b) Where are your discharge points located? '
12. Does your company have any plans for expausion?O Yes Nojfye�w�nand �ww�d���o alter your
industrial wastes?
^ '
13. Do you provide any pretreatment of wastewater streams that occurs prior to discharge to a sanitary O
No ~,���-_-�^._.. -~^
._
14. Do you have a spill prevention, containment and control plan (SPCOfor your company? 0 Yes �No
15, Does your company have or plan to provide a parking lot, with a drain system to collect run off? 17 Yes
18. Doyou dispose ofany chemicals, solvents orhazardou'smaterials +oother than the sewer? OYes 2 -No
17. If yes, provide 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 ([\ASDS) on file? 7 Yes D No
10. Listany ibdedpnUuta�sbeingdischargedasregulabadbvtheCitv's)nduntria|Pnetreabneni0ndinanoe
Pollutant Daily Max. Conic. (mg/1) Daily Avg. Conc. (mg/1)
20. List any environmental control permits that are held by or for your facility.
21. If additional pretreatment and/or operation and maintenance activities are required in order to comply with the City's
Industrial Pretreatment Ordinance, then the discharger shall provide a compliance schedule attached to this form which
describes how the facility will conform to the requirements.
Theinformationoonteinedihthisquestionnaireanddisclosurestabameot/sfamUiartonneandtothebastofmy
knowledge and belief, such information is true, complete and accurate.
�
�
DATE: 'v '^ / )-\ Signature - ' Title� ` /--
NOTE: Attach additional pages. if needed. -^-^—�
RETURN TO:
City ufPort Angeles Wastewater Treatment Plant
Attn-. Supehntendent
321 E.6~Street
P.O. Box 1150
Port Angeles, VVA 98362
pW-8n4Vzpage u[Revised 7m51
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t
Heather Catuzo
From: Janessa Hurd
Sent: Tuesday, April 10, 2012 9:11 AM
To: Heather Catuzo
Subject: RE: Certificate of Occupancy --Oven Spoonful
No comments
From: Heather Catuzo
Sent: Monday, April 09, 2012 3:25 PM
To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds
Cc: Edith Parker; Rick Hostetler; Alisha Hicklin; Jeff Young; ioankevC0)co.clailam.wa.us
Subject: Certificate of Occupancy --Oven Spoonful
This is a change of ownership/expansion of an existing business. The Oven Spoonful has been a tenant in the space with
the Itty Bitty Buzz (already subscribed to PBIA) and is now taking over the entire space of what was Itty Bitty Buzz. We
did not charge a fee for this Certificate of Occupancy application since the business currently exists in the same space,
has PBIA membership, and an existing C of O. 1 understand they will be applying for a permit for a grease trap. I've
routed the original wastewater questionnaire via interoffice mail.
Please comment by April 16, 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
1
Heather Catuzo
From: Roger Vess
Sent: Tuesday, April 10, 2012 7:06 AM
To: Heather Catuzo
Subject: RE: Certificate of Occupancy --Oven Spoonful
No comments
Thank you,
Roger
From: Heather Catuzo
Sent: Monday, April 09, 2012 3:25 PM
To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds
Cc: Edith Parker; Rick Hostetler; Alisha Hicklin; Jeff Young; ipankevCcbco.clallam.wa.us
Subject: Certificate of Occupancy --Oven Spoonful
This is a change of ownership/expansion of an existing business. The Oven Spoonful has been a tenant in the space with
the Itty Bitty Buzz (already subscribed to PBIA) and is now taking over the entire space of what was Itty Bitty Buzz. We
did not charge a fee for this Certificate of Occupancy application since the business currently exists in the same space,
has PBIA membership, and an existing C of O. 1 understand they will be applying for a permit for a grease trap. I've
routed the original wastewater questionnaire via interoffice mail.
Please comment by April 16, 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
1
Heather Catuzo
From:
Sue Roberds
Sent:
Monday, April 09, 2012 4:21 PM
To:
Heather Catuzo
Subject:
RE: Certificate of Occupancy --Oven Spoonful
This use is expanding within the same building in the CA /one, No new sign is anticipated. Business is already within the 1`131A, No land use
issues anticipated.
Thank, you for the opportunity to coimnerW
Sue Roberds
Planting Alunager
Citv of Port Angeles
P.O. Boa- Ilio
Port Angeles, WA 93362
sroberds(r6.citvofna.us
360-417-4750
From: Heather Catuzo ,
Sent: Monday, April 09, 2012 3:25 PM
To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds
Cc: Edith Parker; Rick Hostetler; Alisha Hicklin; Jeff Young; i1)ankev@co.cla1lam.wa.us
Subject: Certificate of Occupancy --Oven Spoonful
This is a change of ownership/expansion of an existing business. The Oven Spoonful has been a tenant in the space with
the Itty Bitty Buzz (already subscribed to PBIA) and is now taking over the entire space of what was Itty Bitty Buzz. We
did not charge a fee for this Certificate of Occupancy application since the business currently exists in the same space,
has PBIA membership, and an existing C of 0. 1 understand they will be applying for a permit for a grease trap. I've
routed the original wastewater questionnaire via interoffice mail.
Please comment by April 16, 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
1
Heather Catuzo
From: Ken Dubuc
Sent: Tuesday, April 17, 2012 1:44 PM
To: Heather Catuzo
Subject: RE: Certificate of Occupancy --Oven Spoonful
Good afternoon Heather —
You can consider this approved by the Fire Department, since there have been no changes other than ownership.
Thanks,
Ken
From: Heather Catuzo
Sent: Monday, April 09, 2012 3:25 PM
To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds
Cc: Edith Parker; Rick Hostetler; Alisha Hicklin; Jeff Young; iDankev(&co.clallam.wa.us
Subject: Certificate of Occupancy --Oven Spoonful
This is a change of ownership/expansion of an existing business. The Oven Spoonful has been a tenant in the space with
the Itty Bitty Buzz (already subscribed to PBIA) and is now taking over the entire space of what was Itty Bitty Buzz. We
did not charge a fee for this Certificate of Occupancy application since the business currently exists in the same space,
has PBIA membership, and an existing C of 0. 1 understand they will be applying for a permit for a grease trap. I've
routed the original wastewater questionnaire via interoffice mail.
Please comment by April 16, 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
CERTIFICATE OF OCCUPANCY APPLICATION Permit #
d al ....... ......
FEES
CITY OF PORT ANGELES $50 Certificate/ Inspection
Attn- Permit Technician
321 E. Fifth St., Port Angeles, WA 98362 $100 Parking Business Improvement Area (PBIA)
(360) 417-4815 fax (360) 417-4711 fee charged for Downtown locations
No ffl't--
PI-EA.5E PRINT IN INK E�A pq Vj 5 (CM 0-� f5(
(5;
llIl
Check one: New business in P.A.?..] Change of ownership only? X Moving location from within P.A.? Zoniig
rN
BUSINESS NAME
Business address [I C�- E F_tMailing address V-�, E
, - F1 IZ3T 3C
Phone number 44�(D i 5=4-iq 'Opening date Days & hours of operation 7 ~ -7
Business owner's name Contact phone
Business owner's address -D�y3L4
Brief description of business
Property owner's name "'M C-, mi \_k -K Contact phone
Property owner's address/contact
BUILDING DEPARTMENT phone 417-4815 1 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes � No 'X
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 4cm on 4-(I.LOM
'XI
Changes to a fire sprinkler system or fire alarm system? Yes 0 No,
Work planned:
PBIA (Parking Business Improvement Area - Downtown) phone 417-4623
Square footage of business?
Is business moving within the PBIA? Yes :1 No
CITY CLERK phone 4174634
PBIA notified on
City Clerk approval by on
Second-hand dealer/pawnbroker business? Yes D No_X
Will there be dancing at this business? Yes NoX
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel -Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 2 of 2
PREPARED 5/03/12, 9:22:14 INSPECTION TICKET PAGE 7
CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/03/12
-------------------------
ADDRESS . : 110 E IST ST SUBDIV:
TENANT, NBR: OVEN SPOONFUL
CONTRACTOR : PHONE
OWNER DIANE MARKLEY PHONE
PARCEL : 06-30-00-5-1-3130-0000-
APPL NUMBER: 12-00000406 CO- CHANGE OF OCCP/USE
-------------------------------------------------------------------------------------
PERMIT: CO 00 CHANGE OF OCCUP/USE
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
---------------- ----------------------------------------------------------- - --------------- --
0099 01 5/03/12 JLL BLDG C/0 FINAL
n\ - * OVERRIDE TAKEN BY HCATUZO DATE: 05/03/12 TIME: 08:20:48
COMMENTS AND NOTES
CERTIFICATE:OF OC.�CUPANCY
City of Port Angeles
' Building Division
This Certification issued pursuant to the requirements of Section.109 of the
Uniform0Building Code certifying that at the tune of issuance this structure was
in connpliance with the various ordinances of the City regulating Building
construction or use.- For the following: - 1
Sst
Use Classification: Coffee Shop Building Permit No. Business Name ltty Bl tt BUZZ
♦
Fy
El F�
_
Group: B e Type of Conswction: V -N � - Use Zone: CBD
n
t
Owner of Business Sandra W. Lone Address: 2935 East Bav Street. Port An2elles. WA 98362
Port Angeles. WAt98362
Building Address- 110 Eastt+ls` Street.
August 27.
2004
tDate
Po he premises.in a=consplcuous place.
Shall not be remoVed`exceprbyl6uilding Official.
IN
Nov IS'
i -H -y br++y BbiZZ
ROUTING SLIP
Certificate of Occupancy
$47.00 Certificate/Inspection Fee
DATF 10131 o --�
Address of Proposed Business
110 F F1 izs;- 6Tv2L- Er
Applicant 10 • LChC(s
Address �k613.';-- C - 6A ST
Phone: business NA home q5-2--9610
Oj- q-1 g-
New Business ............................
Transfer of Business Location ................
Change of Ownership ......................
New Building .............................
Remodel .................................
Temporary Business ..................../..
Change of Use ............................
Brief descriptioq of proposed business- IC_'FA-fA f .S L0e-e*S f c04f_2 C_'n
CLrNA L YA kFrr,�
Legal Description: Lot Block Subdivision
Current Use of Property VArA.l r _( firmer IQ MUT RRL_ L, 3/k('LP:_�-rQV/
Zoning Classification of Property
WILL THERE BE ANY OF THE FOLLOWING?
YES
NO
THE FOLLOWING WILL BE REQUIRED:
Construction changes ..........................
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 ......................
9)
Sidewalk obstruction
9)
Tattoo shop
Work done in City right-of-way ..................
10)
Water meter installation
10)
Other
Is there sufficient off-street parking9 .. ...... . ...
✓
11)
Fire
New driveway openings ......... ...............
12)
Occupancy
A grading plan for site drainage ..................
13)
Sign
(parking lots, downspouts, etc.) ................
14)
Shoreline
Are the existing streets paved? ............ ......
V
15)
Home occupation
Are there existing sidewalks? .. ..................
✓
16)
Conditional use
Is there curb and gutter? ............. .......
✓
17)
Other
Other
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.
APP4i/ REJECTED
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
P. B.I.A. Pcor j
Date: 10 13 D 3
Signed: lJGt/�-
Comments / Conditions
II L I—f—L�� �i 1�✓F�D�C�� • 5 �
CERTIFI
This
nifor
in c
Use Classification Kel
Group: B I
Owner of Business/Resider,
Building Address: 110
�Buildin Permit Nor
(Construction
,Susan Oden Ad
V ..L
Post on th
Shall not be
CUPANCY
f Port
ant to the requirements of SectiA109 of the
that.at the time ofsi suance this strecture was
�.Kr�din6n sof of -City -regulating Building
oruse. For the followi n_ -r
v �B` Bisi�essN� I7ie'Nut Roll i
VN -=y
se Zone:
CBD
-P.-O- ox'312 POft Arieei `' rA 98362
w� f�Edtiruary 6, 2002
� � . Date
Fijiises,.in a�p icuous place.
ym''tsv
eed excepts y Building Official.
ocf,� J Afj
1R6UTING
SLIP
Certificate of
Occupancy
ti•�1
$47.00 Certificate/Inspection Fee
DATE ' y �a� Jo /
New Business
Address of Proposed Business
Transfer of Business Location ................
( )
p /
Change of Ownership
Applicant/LS�n( �/g�
New Building .............................
( )
Aress 10r n 69X �7/ Z
Remodel .................................
( )
112T <, WA_ 98�(Q'`�
.......................
Temporary Business(
)
Phone: usi�Oly5'7/39ho
Change Change of Use ............................
( )
Brief description of proposed business DESSERT
&A KEIZy %q:
A/ UT fZOl-C
Legal Description: Lot _7 Block
S1 Subdivision N4 SFI�iFf
Current Use of Property: ✓AccA N -T
Zoning Classification of Property: C
WILL THERE BE ANY OF THE FOLLOWING? YES NO
THE FOLLOWING WILL BE REQUIRED:
Construction changes . ..................... ✓
PERMITS
BUSINESS LICENSE
G
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 .................. .......... r/
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 .......................
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? ...
7
11) Fire
New driveway openings . .......................
12) Occupancy
A grading plan for site drainage ...... ............
13) Sign
(parking lots, downspouts, etc.) ......... ........
14) Shoreline
Are the existing streets paved? ................... ✓
15) Home occupation
Are there existing sidewalks? ....... . .. ...
16) Conditional use
Is there curb and gutter? ........................ ✓
17) Other
Other
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the Date:
information I have supplied is correct to the best of my
knowledge. Signed: CJLLaZLI/ll� C �iJI
i
AE
4D REJECTED Comments / Conditions
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
P.B.I.A. ��;rl
BUILDING PERMIT
OW N ERIAPPLICANT
DIANE MARKLEY
PO BOX 2835
Port Angeles, WA 98362
360/457-5678
T:
CONTRACTOR
OWNER
VARIOUS
Port Angeles, WA 99360
206/000-0000
PROJECTINFO
CITY OF PORT ANGELES
PUBLIC WORKS -BUILDING DMSION
321 EAST STH STREET, PORT ANGELES, WA 98362
ISSUED: 2/02/2000 PERMIT NO: 11732
PROPERTY LOCATION
110 1ST ST E
Lot: 7
Block: 31 ® Long Legal
Subdivision: NR SMITH
S: Parcel No: 0630005131300
Project Value: $500.00
Project Type: HANDICAP BATH
Occupancy Type:
Occupancy Group:
Construction Type:
Zoning Use: ca
PROJECT NOTES
INSTALL H.0 BATH
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$23.50
$0.00
$4.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
ARCHITECT
N/A
, 98360-0000
360/000-0000
SFD Units: 0
SFD SQ FT: 0
MFD Units: 0
MFD SQ FT: 0
Misc Fee 1:
Misc Fee 2:
Misc Fee 3:
TOTAL FEE:
AMOUNT PAID
BALANCE DUE
Commercial: 0
Industrial: 0
Garage: 0
$0.00
$0.00
$0.00
$28.00
$28.00
$0.00
RW SANITARY_ WATER DWY STORM DRA OTHER
Separate Permits are required for electrical work, utilities, private and public improvements. This permit becomes null and void if work or
construction authorized is not commenced within 180 days, d construction or work is suspended or abandoned for a period of 180 days after
the work as commenced, or d required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have
read and examined this applicaUcn and know the same to be true and correct A I 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 coTrucbon
lfl'LtL� L� 7ate
Signature of Contractor or Authorized Agent Date Signatu a of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A NNIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORKBEFORELVSPECTEDANDACCEPTED.
POST PERMIT INA LOCATION.
{CONSPICUOUS
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE
I DATE I ACCEPTED
COMMENTS
I YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT)
I ROUGH4N
PLUMBING
UNDERFLOOR/SLAB
ROUGH -IN
WATERLINE
BACK FLOW / WATER
AIR SEAL
WAUS
CEILING
FRAMING
JOISTS/ GIRDERS
SHEAR WALL
WALLS/ROOF/CEILING
DRYWALL
T -BAR
INSULATION
SLAB
WALL/FLOOR/CEILING
MECHANICAL
CHIMNEY
WOODSTOVE/PELLET
DUCTS
PW UTD.ITIES / SITE WORK (EngmeamS Dma,m)
WATERLINE/METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE / EROSION CONTROL
PARKING
OTHER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL
DATE YES NO
COMMERCIAL DATE. ACCEPTED
YES NO
ELECTRICAL -LIGHT DEPT
4174746
ELECTRICAL
LIGHT DEPT
CONSTRUCTION RW /PW/
CONSTRUCTION -RW
ENGINEERING
4174807 p
PW/ENGINEERING
FIRE(MULTI-FAMONLY)
I BUILDING
4174654 ,,�ss.4yktl; pJ5 �� /xFIRE
4174815// /-
DEPT
BUI DFAO
' J
GENERAL COMMENTS:
_ PW-110215IN%)
BUILDING PERMIT - PREAPPLICATION
The Building Permit - Preapplication must beflled out COmpletely.
Please type or print in Ink If you have any questions, please call 4174815
Applicant and/or Agent: ;li, t' t
,I Owner: K t_-
1 Address: ' 3 5 City: �c
i
Architect/Engineer:
Contractor �� u : k; 1 = License #.
Address: City:
PROJECT ADDRESS: 1 L F a s .11 rSt
LEGAL DESCRIPTION: Lot,.- Block: Subdivision:
Phone:
Phone:
j Phone:
Exp:
FOR OFFICIAL USER
Date Rea.: L - Z "`
Fermat il:l) —1 -3 v
Pre-Ap Compiew
Date Approved:
yS7-S67Y
�.m�.
Zip: 3 (0 2 -
ZONINGS
Phone:
Zip:
TYPE OF WORK:
SIZE/VALUATION:
o Residential
o New Constr.
❑ Reroof
❑ Woodstove
SF. @ $ /SF. = $ ! r`
o Multi -family
❑ Addition
❑ Move
o Garage
SF. @ $ /SF. = $
o Commercial
o Remodel
❑ Demolition o Deck
SF. @ $ /SF. = $
❑ Repair
❑ Sign
❑
TOTAL VALUATION $
BRIEF DESCRIPTION
OF THE PROJECT:
1-\1 tj (At
C
COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type:
No. of Stories: Lot Size: % Lot Coverage: %
Existing Lot Coverage: /sq. ft. + Proposed Lot Coverage: /sq. ft. = TOTAL LOT COVERAGE:----._/sq.ft
PLANNING USE ONLY: APPROVALS: PLAN
Notes: BLDG
DPW -— —
FIRE
ESA/Wetland(s): ❑ Yes ❑ No SEPA Checklist required? ❑ Yes ❑ No Other: OTHER
PREAPPLICATION SUBMITTAL: Your application and site plan must beftded out completely to be accepted for review. The Building
Division can provide you with more detailed information on the application and plan submittal requirements.
BUILDING PERMIT APPLICATION SUBMITTAL: Your completed application, site plan (for additions) and building construction
plans are to be submitted to the Building Division.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and
may be revised by the Building Div. to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other
permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this application will expire by
limitations. The Building Official can extend the time for action by the applicant up to 180 days, on written request by the applicant (see Section
304(d) of the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for
this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's
responsibility to determine what permits are required and to obtain sue.
1
Applicant. 1 'i /,-( i/ .%,.<;/- ¢-!`- :'�-.0-�r-{-�rrrjll.ate:
1.
PW-1162_17lrev 2/961 / �
BUILDING PERMIT
OWNER/APPLICANT
DIANE MARKLEY
110E IST ST
Port Angeles, WA 98362
360/000-0000
T:
CONTRACTOR
OWNER
VARIOUS
Port Angeles, WA 99360
206/000-0000
PROJECTINFO
CITY OF PORT ANGELES
PUBLIC WORKS -BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
ISSUED: 10/22/2001
PROPERTY LOCATION
110 1ST ST E
Lot: 7
PERMIT NO: 13054
Block: 31 ® Long Legal
Subdivision: NR SMITH
S: Parcel No: 0630005131300
ARCHITECT
N/A
, 98360-0000
360/000-0000
Project Value: $1,500.00 SFD Units:
Project Type: INT. REMODEL SFD SQ FT:
Occupancy Type: COMMERCIAL
Occupancy Group: MFD Units:
Construction Type: MFD SQ FT:
Zoning Use: ca
PROJECT NOTES
RENEW EXPIRED PERMIT AND ADD EXHAUST FAN
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
0 Commercial: 0
0 Industrial: 0
Garage: 0 O
0
0 M
$54.00 Misc Fee 1:
$0.00
$0.00 Misc Fee 2:
$0.00
$4.50 Misc Fee 3:
$0.00
$0.00
$0.00
$0.00 TOTAL FEE:
$58.50
$0.00 AMOUNT PAID:
$58.50
$0.00 BALANCE DUE:
$0.00
$0.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work 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. \I
'k_jL'( )lL��_:._� /o-zZ -ol
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) / Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. 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 l 3�
INSPECTION TYPE DATE I ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH -IN
PLUMBING
UNDERFLOOR/SLAB
ROUGH -IN
�I-6 �G�
�,1+
WATERLINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS/ GIRDERS
SHEAR WALL
WALLS/ROOF/CEILING
DRYWALL
T -BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOODSTOVE/PELLET/CHIMNEY /INSERT
HOOD/DUCTS
PW UTILITIES/ SITE WORK (Engineng Division) SEPARATE PER MIT N's
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNINGSEPARATE PERMIT#'s
DGHTIry
PARKING
A:
ESA
LANDSCAPING
I I
SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYNSE
RESIDENTIAL
DATE
YES
NO COMMERCIAL DATE
ELECTRICAL - LIGHT DEPT.
CONSTRUCTION R.W. / PW/
ENGINEERING
IRE
PLANNING DEPT.
BUILDING
C WPPL WPD
4174735
417-4807
417-4653
417-4750
417-4815/�%
r
ELECTRICAL
LIGHT DEPT
CONSTRUCTION - R.W.
PW / ENGINEERING
FIRE DEPT.
PLANNING DEPT
BUILDING
ACCEPTED
YES NO
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date Time Received by (phone person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): — Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excay. Other
INSPECTION NOTES:
Inspected: Date Time By
Remarks:
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: ❑ Unimproved ❑ Gravel []Asphalt ❑ PCC
❑ Repaired by City Work Order #
❑ Repaired by Permittee ❑ COMPLETE
❑ No Damage Found ❑ INCOMPLETE
❑ Other
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST: ,
Date i II&1/01 Time Received by
Location of Work to be inspected //0
0
Name of person requesting inspection /%N cn j
Address of person requesting inspection
Type of Inspection (circle a ropriate one):
Sewer FoundationFraming ChimneyPlumbing Final
INSPECTION NOTES:
Inspected: Date 1 f 'f Time
Remarks:
C�901
person)
Phone No. —
Permit No. / O
Sewer Excay. Other
By ,
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: ❑ Unimproved ❑ Gravel ❑ Asphalt ❑ PCC ❑ Other
❑ Repaired by City
❑ Repaired by Permittee
❑ No Damage Found
Work Order #
❑ COMPLETE
❑ INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
vac of
BUILDING PERMIT
OWNER/APPLICANT
dIANE MARKLEY
110E 1ST ST
Port Angeles, WA 98362
360/000-0000
T:
CONTRACTOR
MILLER SIGNS
1190 CARLSBURG RD.
SEQUIM, WA 98382-0000
360/683-6790
;c14111xt91zIMe
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
ISSUED: 12/21/2001 PERMIT NO: 13152
PROPERTY LOCATION
110 1ST ST E
Lot: 7
Block: 31 ® Long Legal
Subdivision: NR SMITH
S: Parcel No: 0630005131300
Project Value: $0.00
Project Type: SIGN/PROJECTING
Occupancy Type: COMMERCIAL
Occupancy Group:
Construction Type:
Zoning Use: ca
PROJECT NOTES
INSTALL 32" X 42" PROJECTING SIGN
FEES ASSESSMENT
ARCHITECT
N/A
, 98360-0000
360/000-0000
SFD Units: 0 Commercial: 0
SFD SQ FT: 0 Industrial: 0
Garage: 0
MFD Units: 0 O
MFD SQ FT: 0
f�►
Building Permit:
$0.00 Misc Fee 1:
$0.00
Plan Check:
$0.00 Misc Fee 2:
$0.00
State Surcharge:
$0.00 Misc Fee 3:
$0.00
House Moving:
$0.00
Manufactured Home:
$0.00
Sign:
$30.00 TOTAL FEE:
$30.00
Plumbing:
$0.00 AMOUNT PAID:
$30.00
Mechanical:
$0.00
Radon:
BALANCE DUE:
$0.00
$0.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
fora 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
constru ' n
'J"
.
Signature of Contra for or Authorized Agent Date Signature of Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUCTOCO ER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE r 3 / 5
INSPECTION TYPE
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: q
ROUGH -IN
PLUMBING
UNDERFLOOR/SLAB
ROUGH -IN
WATERLINE
GAS LME
BACKFLOW/WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS/ GIRDERS
SHEAR WALL
WALLS/ROOF/CEILING
DRYWALL
T -BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOODSTOVE/PELLET/CHIMNEY/INSERT
HOOD/DUCTS
DATEIACCEPTED
YES I NO
PW UTILITIES/ SITE WORK (Engineering Division) SEPARATE PERMIT W's
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM jI
PLANNING DEPT SEPARATE PERMIT W's SEPA.
PARKING/IAGHTING ESA
I ISHORELINE:
LANDSCAPING
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL
ELECTRICAL - LIGHT DEPT
CONSTRUCTION R.W. / PW/
ENGINEERING
FIRE
PLANNING DEPT.
BUILDING
C(APPL WPD
417-4735
417-4807
4174653
417-4750 '/�f/
417-4815 / / Ig laz- �)V
ELECTRICAL
LIGHT DEPT
CONSTRUCTION - R.W.
PW / ENGINEERING
FIRE DEPT.
PLANNING DEPT.
BUILDING
COMMENTS
DATE I ACCEPTED
YES NO
lilt pO^T FOR OMCtAL USE ONL`
BUILDING PERMIT - APPLICATION ��'
Dee ____ _
The Building Permit - Pre-aMicathue nmst be fl&d ort eompktety.
Please type or print In ink. I you have any questions, please call 417-4815
Applicant and/or Agent: 12c'41 t�'r n heW Phone:
Owner:
Address-
Architect/Engineer
Contractor
City:
,*/i GL 6-5 *
License #: 15P—i k cr l
Phone*
Zip:
Exp: phone:
Address: /!Cv (-jq.z 6,5i;x,11C =i 12 City: <e- Zvrtl�7 vt-7 . Zip: -71 -3 d
PROJECT ADDRESS- //G' G �jS% / �(� f A, G. ZONWG:
LEGAL DESCRIPTION: Loh Block• Subdivision:
CLALLAM COUNTY PARCEL NUMBER: Credit Card Holler Name:
BMkg Address• City:
Credit Card N: Exp. Date: VISA MC
TYPE OF WORK: SIZEIVALUATION:
o Residential a New Constr. o Ro roof o Woodstave SF. @ S_ JSF. = t
o Muth -family a Addition O Move o Garage SF. B
o Commercial o Remodel o Demolition o Deck SF. ® $ /SF. m l
o Repan o Sign o . TOTAL VALUATION $
BRIEF DESCRIPTION OF THE PROJECT: "S
ra
C0h0SI£RCIAira.,.smn.4 i.AL: , Occupancy Group' Occupani f a _ _.Construction Type:
No. of Stories Lot Sia: % Lot Coverage: °h
Existing Lot Covetsgen /sq. & +Proposed Lot Coverage:' rl /sq_it-., It TAL LOT COVERAOB: /sit
PLANNING 115E ONLY: APPROVALS: PLAN
Notes:
1RLDG.
LPW
1111tir__
ESA/Wedand(s): D Yes o No SEPA Checklist required? o Yes o No Other.
BUILDING APPLICATION SUBbITTAL: Your appbicadw mid sheplor mast beJBled out cmnplatety to be oces pied far reWew. 7h
Building Division can provide you with more detailed information on the application and plan submittal Lequirements.
BUILDING PERMIT APPLICATION SUBMITTAL: Your completed application, site plan (for mond) and building conatructior
plans are to be submitted to the Building Division.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant Ibis figure will be reviewed am
may be revised by the Building Div. to comply with current fee schedules. Contact The Permit Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and conshttctirm plans are submitted. All othe
permit fees an due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no pormit is issued within 184 days of the date of application, this application will expire b3
limitations. The Building Official can extend the time for action by the applicant up to 189 days, on written request by the applicant (sa
Section 147.4 of the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that / have read and examined this application and know the same to be true and correct, and I am authorized to apply for
this permit. 1 understand it is not the City's legal responsibility to determine what permits are requtre4 it remains the opplicam's
responsibility to determine what permits are required and to obtain such
Date:
twv
-minx tsi,evStotl ApplicantcApplicant� r,'��f � %J err of
161�
fob
I
The
N 1, UI! t
ZI) v
ELECTRICAL PERMIT
OWNER/APPLICANT
diane halsey
110E 1ST ST
Port Angeles, WA 98362
360/000-0000
T: S:
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
121 BAST STH STREFT. PORT ANGELES. WA 99162
ISSUED: 10/18/2001
CONTRACTOR
APS GENERAL & ELECTRICAL CONT
546 BENSON RD.
PORT ANGELES, WA 98363-0000
360/452-6753
PROJECTINFO
Project Type: COML.REMODEL
Occupancy Type:
Occupancy Group:
Electrical Heat:
❑ Baseboard
0 KW
❑ Furnace
0 KW
❑ Heat Pump
0 KW
® Fan Wall
10 KW
PROJECT NOTES
all new branch circuits for comm. remodel.
PERMIT NO 7434
PROPERTY LOCATION
110 1ST ST E
Lot: 7
Block: 31 ® Long Legal
Subdivision: NR SMITH
Parcel No: 0630005131300
ARCHITECT
N/A
, 98360-0000
360/000-0000
Project Value: $0.00
Construction Type: COMMERTIAL
Zoning Use: ca
❑ Riser ❑
® Overhead Service
❑ Temp Service
FEES ASSESSMENT Service: $0.00
Additional Feeders: $0.00
Circuit Wiring: $92.30
Temp Service: $0.00
Misc Fee: $0.00
TOTAL FEE: $92.30
AMOUNT PAID: $92.30
BALANCE DUE $0.00
CONIMI.NTS/AC'TION NEEDED
Underground Service
Voltage: 120,240
Phase: ❑ 1
Service Size: 200
Feeder Size: 0
3
ELECTRICAL PERMIT INSPECTION RECORD
CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A NM49AUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COI FR
INSULATE OR CONCEAL ANY WORK BEFORE ITIS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE ? /13
INSPECTION TYPEI DATE I ACCEPTED I COMMENTS
YES I NO
DITCH
ROUGH -IN / COVER
I SERVICE
I FINAL
I
I
I
GENERAL COMMENTS:
�QInla l l 2 c�-
t./e -214-
z. :a F,
S
PW.1102.15 (4'961
V
Z -z-
ROUTING SLIP
Certificate of
Occupancy
$47.00 Certificate/Inspection Fee
DATE 3 -J)
New Business ... .....
...... V/
Address of Proposed Business
Transfer of Business Location
/1C, F 5-1 ISE u
r
Change of Ownership ..... .............
..
Applicant tv l7 It t -' - L_
el 1\i 01
New Building .......
Address 1 5r5l-\`4
'5T
Remodel . . . .......... . .....
Temporary Business . . . , . . . .
....... ... -
Phone: business —home
Change of Use . ......
........ .....
Brief descriptioq of proposed business:
A bak_(�_ 1-tk
Legal Description: Lot
Block
Subdivision
Current Use of Property: VA, -A PJ T-
QL(T Rol L -
Zoning Classification of Property,
WILL THERE BE ANY OF THE FOLLOWING?
YES NO
THE FOLLOWING WILL
BE REQUIRED:
Construction changes. .
PERMITS
BUSINESS LICENSE
Electrical changes.
1 ) Building
1 ) Taxi
Mechanical (heating, cooling, stoves).
V
2) Plumping
2) Peddlers
1-5
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?
_jo�_
8) Curb installation
8) Ambulance
Excavation of filling of lots ...... .......
. ..
9) Sidewalk obstruction
9) Tattoo shop
Work done rn City right-of-way , _ . . . . ....
-1/—
10) Water meter installatior,
10) Other
is there sufficient off-street parking?
11) Fire
New criveway open;.qgs
12) Occupancy
A grading plan for site drainage .......
—\e—"
13) Sign
(parking lots, downspouts, etc.) .... ........
14) Shoreline
Are the existing streets paved?
15) Home occupation
Are there existing sidewalks?.....
16) Conditional use
Is there curb and gutter?
171 Other
Other,. ..... ..... .. ......
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.
APPROVEDj REJECTED
3120 71"
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
P131A. P4,j
Date: 1013 C 3
Signed:
Comments / Conditions
O-
-I - -O
CERTIFICATE OF OCCUPANCY
City of Port Angeles
Building Division
This Certification issued pursuant to the requirements of Section 109 of the
Uniform Building 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:
Use classification: Coffee Shot) Building Permit No. Business Name: Ittv Bitty BUZZ
♦
Group: B Type of construction: V-N Use Zone: CBD
owner of Business Sandra W. Lone Address. 2935 East Bav Street, Port Angeles, WA 98362
Building Address: 110 East'4' Street. Port Aneejleys. WA 98362
-Bl}MMlltn"t uiM�.� tNN)1'.�Y'iL1 �� st 2 / 2004
.
itil w LL L.:�iDate
a .
Po a pr : s =on;sp�cuous place.
Shall not be remove _ xcep't'by Building Official.
O CITYMUN OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
9a�
Application Number . . . . . 03-00001185 Date 12/15/03
Property Address . . . . . . 110 E 1ST ST
ASSESSOR PARCEL NUMBER: 06 -30 -00 -5 -1 -3130 -0000 -
Application description . . . ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 0
Owner Contractor
________________________
________________________
MARELEY, TTE DIANE L OLYMPIC ELECTRIC
PO BOX 2835 4230 TUMWATER
PORT ANGELES WA 983620333 PORT ANGELES WA 98363
(360) 457-5303
____________________________________________________________________________
Permit . . . ELECTRICAL ALTER COMMERCIAL
Additional desc ADD/ALTER 9 CIRCUITS
Sub Contractor OLYMPIC ELECTRIC
Permit Fee . . . . 80.20 Plan Check Fee .00
Issue Date . . . . 12/15/03 Valuation . . . . 0
Expiration Date . . 6/13/04
Qty Unit Charge Per Extension
1.00 59.4000 ECH EL -COMM ALT <5 CIRCUITS 59.40
4.00 5.2000 ECH EL -COMM ALT-ADDTNL CIRCUITS 20.80
Fee summary Charged
__________
Permit Fee Total 80.20
PlanCheckTotal .00
Grand Total 80.20
Paid Credited Due
80.20 .00 .00
.00 .00 .00
80.20 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work 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 Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\PLANNINGTORMS\ 1102.15111/14/2003]
"
' CITY OF PORT ANGELES
4
DEPARTMENT OF COMMUNITY DEVELOPMENT -BlJILDINGDIVlQD]N
3%|EAST 5TH STREET, PORT ANGELES, WA98362
Application Number . . . . .
Property Address . . . . . .
euonaaoa PARCEL mcmBoR.
Tenant obr' name . . . . . .
Application description . . .
Subdivision mane . . . . . .
Property Use . . . . . . . .
Property 000ios . . . . . . .
Application valuation . . . .
n*-000nonso Date z/za/ou
110 E IST ar
06'30-00-5-1-3130-0000-
zrzn BITTY BUZZ
SIGNS
CENTRAL BUSINESS DISTRICT
zoon
Owner
------------------------
Contractor
muanLns' rrE DIANE
L
---'--''--------'''-----
mzLLma azoma
eo BOX zoas
30 oazzDoaa IN
»oar ANGELES
WA 983620333
aoQozm WA yoaoc
------'---'-------------
(aso) oos'sroo
oeomit . . . . . .
-----'- -----'--
azGm
----- -- --'-'-------- - - -----
Additional deoc . .
eaozmczzmo arem
11.5 Sp
Permit nae . . . .
30.00
Plan Check Fee � . oo
Issue Date . . . .
z/��/n«
vazma��oo . . . z^'oo
'
Expiration Date . .
r/zz/u«
Qty Unit cuazee per
1.00 30.0000 PER o- ozeN ALL 25 -
Fee summary
-----------------
Permit Fee Total
el*u Check Total
Grand Total
Extension
30.00
Charged Paid Credited Due
______ _____ _____ ----------
30.00 30.00 .on .00
.00 .ou .ou .uo
30.00 30.00 .ou .00
Separate Permits are required forelectricalwork, 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 pmvioi6noof
laws and ordinances governing this type cfwork will becomplied with whether opeoifiadhere/nornoL The granting ofapermit does not
presume to give authority to violate or cancel the provisions of any state urlocal |avv regulating construction or the performance of
construction.
S nature o1Contractor orAuthorized Agent Dobe Signature ofOwner (if owner hybuilder) Date
T \PLANNING\FORMS� 1102 15 [11/14/2003)
1-1
°
v
1v 13027-
I�
P0v:cv
tom`►� `�
13AN 4S'V- revS, orhAtER141 , 5r
(�
SCC*fk.
CE CSE
ICE T0-T-
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v� shat �,irF
BUILDING PERMIT - APPLICATION
=— Fill out COMPLETELY and in INK. Your application and site plan MUST BE
-=� COMPLETE to be accepted for review. If you have any questions, call
(360) 417-4815
Applicant or Agent: Phone:
Owner: Drals Flap -r-? slot"J / '` Phone:
Address: City: 7014 A v�',/ F S
Architect/Engineer: Phone:
Contractor K4 t c.1-EE-PS16QS State License #: Exp:
Address: 1 (q O ;2V City:
PROJECT ADDRESS: (/0 -r— ST'f'-t E �`
LEGAL DESCRIPTION: Lot: Block: Subdivision:
CLALLAM COUNTY PARCEL NUMBER:
Credit Card Holder Name:
Billing Address:
Credit CardType VISA
MC #
Construction Type:
TYPE OF WORK:
No. of Stories: _ Lot Size: Existing Sq. Ft.
& Proposed Sq. Ft
❑ Residential ❑ New Constr.
❑ Re -roof
❑ Stove
❑ Multi -family ❑ Addition
❑ Move
❑ Garage
❑ Commercial ❑ Remodel
❑ Demolition ❑ Deck
❑ Repair
jpPtign
❑ Other
BRIEF DESCRIPTION OF THE PROJECT:
A�A� 47 l r-16
Score, 1�p6v%� 1120u?< 2.117`/= 2654P
City:
FOR OFFICIAL USE ONLY
Date Rec
Permit #
Date Approved
Date Issued
Zip: 99 �s 9 -,—
Phone:
Phone: �7 9'a
Zip:
ZONING:
Exp. Date:
SIZE/VALUATION: _
�1. s' SF. @ $ /SF. _ $ i *.;Zc7o
SF. @ $ /SF. _ $
SF. @ $ /SF. _ $
TOTAL VALUATION $
COMMERCIAL/RESIDENTIAL: Occupancy Group:
Occupant Load:
Construction Type:
No. of Stories: _ Lot Size: Existing Sq. Ft.
& Proposed Sq. Ft
= TOTAL Sq.Ft.
Existing lot coverage % & Proposed lot coverage
% = Total lot coverage
%
�?
APPRO ALS:
PLAN:Z
PLANNING USE ONLY: ,� , �, ti, .` ,�
-
y �–. ��
,� �r\
K
BLDG.
11
DPWU:
ESA/Wetland(s): ElYes ❑ No SEPA Checklist required? ElYes
13 No No Other:
OTHER:
BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and
plan submittal requirements if you have questions.
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed
and maybe revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of
the Uniform Building Code, current edition). No application can be extended more than once.
I hereby certify that 1 have read and examined this application and know the same 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 ,not the City's, and that I must ob in such permits prior to work.
T•\FORMSWPPS\Buildmgpermitwpd Applicant: /�l�i Date:
G1,l '
W
CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
321 EAST 5TH STREET. PORT ANGELES. WA 98362
Application Number
06-00001085 Date 10/03/06
Application pin number . . .
552750
Property Address
110 E 1ST ST
ASSESSOR PARCEL NUMBER
06 -30 -00 -5 -1 -3130 -0000 -
Application type description
ELECTRICAL ONLY
Subdivision Name
Property Use . . .
Property Zoning . . . .
CENTRAL BUSINESS DISTRICT
Application valuation
0
Owner
Contractor
------------------------
MARRLEY, TTE DIANE L
------------------------
OLYMPIC ELECTRIC
PO BOX 2835
4230 TUMWATER
PORT ANGELES WA 983620333
PORT ANGELES
WA 98363
(360) 457-5303
----------------------------------------------------------------------------
Permit . . . . ELECTRICAL
ALTER COMMERCIAL
Additional desc OLY EL /
1-5 CIRCUITS
Permit pin number 88237
Sub Contractor OLYMPIC ELECTRIC
Permit Fee 61 30
Plan Check Fee
.00
Issue Date 10/03/06
Valuation
0
Expiration Date 4/01/07
Qty Unit Charge Per
Extension
1 00 61 3000 ECH EL -COMM
ALT <5 CIRCUITS
61.30
----------------------------------------------------------------------------
Fee summary Charged
----------
Paid Credited
Due
-----------------
Permit Fee Total 61.30
---------- ---------- ----------
61 30 00
.00
Plan Check Total .00
.00 .00
.00
Grand Total 61 30
'-61-.301' — —.-00
.00
COMMENTS/ACTION NEEDED
r
4 ,Q
M
ELECTRICAL PERMIT INSPECTION RECORD
CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTEDD,
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPPMON TYPEI DATE I ACCEPTED COMMENTS
I` YES 1 NO
DITCH
ROUGH -1N / COVER /O -y-o6 ADA
vA
SERVICE
FINAL 1/6, - / / - o $ 1 i4ro 1
GENERAL COMMENTS:
Pw-1102.151 1
Of pORT,µ,O CITY OF PORT ANGELES
fi+ Te�N
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 . . . .
06-00000864 Date 9/01/06
406048
110 E 1ST ST
06 -30 -00 -5 -1 -3130 -0000 -
DEBORAH FERGUSON j..�
COMM REMODEL
CENTRAL BUSINESS DISTRICT �
5000 (Olt (/� /"�i/ � /61f�
Owner
------------------------
MARKLEY, TTE DIANE L
PO BOX 2835
PORT ANGELES WA 983620333
Contractor
------------------------
RETROVILLE RENOVATION & DESIGN
232 W 4TH ST.
PORT ANGELES WA 98362
-------------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE II NON -RATED
Occupancy Type . . . . . BUSINESS:OFF/PRO/MED/REST
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT - COMMERCIAL
Additional desc CUT HOLE CONCRETE WALL
Permit pin number . 84467
Permit Fee . . . . 137.75 Plan Check Fee
89.54
Issue Date . . . . 9/01/06 Valuation . . . .
5000
Expiration Date . . 2/28/07
Qty Unit Charge Per
Extension
BASE FEE
95.75
3.00 14.0000 THOU BL -2001-25K (14 PER K)
42.00
----------------------------------------------------------------------------
Special Notes and Comments
Building address sign shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color they are mounted on. (Ord. 14.36.050-E)
Building Division has no requirements.
Public Works Utility Engineering has no requirements for
this plan review.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE SURCHARGE
----------------------------------------------------------------------------
4.50
Fee summary Charged Paid Credited
-------------------------------------
Due
--------------------
Permit Fee Total 137.75 137.75 .00
.00
Plan Check Total 89.54 89.54 .00
.00
Other Fee Total 4.50 4.50 .00
.00
Grand Total 231.79 231.79 .00
.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work 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 gov type of work will be complied with whether specified herein or not. The granting of a permit does not
presumeve aut rity to violat er�ancel the provisions of any state or local law regulating construction or the performance of
Of
T:\Policies\1102_15 building penmt inspection record05.wpd [1/4/2005]
f, i- 06
Date Signature of Owner (if owner is builder)
Date
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. IT IS 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 I ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH -IN
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS/ GIRDERS
-` SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
I DRYWALL (INTERIOR BRACED PANEL ONLY)
T -BAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP/FURNACE/DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
COMMERCIAL HOOD/ DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
I SKIRTING
FINAL
FINAL
DATE
DATE
PLANNING DEPT. SEPARATE PERMIT #'s SEPA-
ESA-
LANDSCAPING TING I I I SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE
ELECTRICAL - LIGHT DEPT.
417-4735
ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/
CONSTRUCTION - R.W.
ENGINEERING
417-4807
PW / ENGINEERING
IFIRE
417-4653
FIRE DEPT.
PLANNING DEPT.
417-4750
PLANNING DEPT.
BUILDING
417-4815
BUILDING
T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005]
ACCEPTED BY:
ACCEPTED BY:
V ,I
r
V
ACCEPTED �
YES NO
PREPARED 10/13/06, 10 22 13
INSPECTION
TICKET
PAGE 14
CITY OF
PORT ANGELES
INSPECTOR
JAMES L LIERLY
DATE 10/13/06
ADDRESS
--'
110 E IST ST
----------------------------------------------------
SUBDIV
TENANT,
NBR DEBORAH FERGUSON
CONTRACTOR RETROVILLE RENOVATION
& DESIGN
PHONE
OWNER
MARKLEY, TTE DIANE
L
PHONE
PARCEL
06-30-00-5-1-3130-0000-
APPL NUMBER 06-00000864 COMM REMODEL
PERMIT:
---
BPC 00 BUILDING PERMIT
------------------------------------------------------------
- COMMERCIAL
REQUESTED INSP
DESCRIPTION
TYP/SQ
COMPLETED RESULT
RESULTS/COMMENTS
-- — ---
BLFW O1
— -- — --------
9/27/06 JLL
----------------------------
BUILDING FTG/WALL
— -----------------------
TIME 13 00
------
9/27/06 DA
DAVID 460-2595 THIS
INSPECTION IS FOR HOLE CUTTING THROUGH
AN EXISTING WALL
09/26/2006 01 20
PM DYASUMUR ---------------
09/27/2006 03 10
PM JLIERLY ----------------------------
lintel covered by finish
material on one side,
uncover or
provide an engineer
letter of acceptance, also
contact
electrical inspections
for rough in/711
BL99 01
10/13/06 J,�,L ^
BUILDING FINAL
�`
david 460-2595
-,i(`d�- (�—
10/13/2006 08 33
AM PERMITS ----------------------------
- ------------------
COMMENTS AND
NOTES --------------------------------------
PREPARED 9/27/06, 10 54.07 INSPECTION TICKET PAGE 3
CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 9/27/06
_'- `----------------- --------------- ` - -----
ADDRESS 110 E 1ST ST SUBDIV
TENANT, NBR DEBORAH FERGUSON
CONTRACTOR RETROVILLE RENOVATION & DESIGN PHONE
OWNER : MARKLEY, TTE DIANE L PHONE
PARCEL 06-30-00-5-1-3130-0000-
APPL NUMBER 06-00000864 COMM REMODEL
--- `-------' ---- - --------------'---------
PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
BLFW 01 9/27/06 L BUILDING FTG/WALL TIME 13 00
DAVID 460-2595 THIS INSPECTION IS FOR HOLE CUTTING THROUGH
AN EXISTING WALL
09/26/2006 01:20 PM DYASUMUR ----------------
-------------------------------- - - -- COMMENTS AND NOTES -------------------------------`
l
ANGLE IRON LINTEL EA. SIDE
— 38" WIDE AREA TO BE REMOVED
:ll ll ll ll ll
i0
4i
N
PLAN
EXISTING CONCRETE WALL
SEE CONNECTION DETAIL A/1
(TYP. EA. SIDE)
• Q
MIN. /
j
INSTALL (3) %"x3r
NOTE, WEDGE ANCHOR W/2%"
LINTEL TO BE INSTALLED = MIN. EMB. EO. SPACED
ON EA. SIDE OF OPENING ao o R.
to Z SAWCUT EX. CONCRETE
WALL TO CREATE ROUGH
OPENING AS SHOWN
PROVIDE FURING STRIPS AS
REQUIRED TO HANG DOOR
ELEVATION
SCALE: Y: = 1'
/_ EX. ROOF FRAMING
STRUCTRAL STEEL NOTES
0
2.
3.
EXISTING 12" THK.
CONCRETE WALL 4
5.
All structural steel construction shall conform with the Eigth Edition
of the A.I.S.C. Specification for the Design, Fabrication and Erection
of Structural Steel for Buildings.
All rolled structruol steel shall conform with ASTM Standard A36. All
pipe shall conform with ASTM Standard A53.
All welding shall be done with the electrical arc process using E70XX
electrodes and conform with the A.W.S. Specifications. Welding shall
be performed by A.W.S. Certified welders. All welding except welding
performed in ICBO Approved shops shall recieve special inspection as
required by UBC Section 306.
All bolts, except anchor bolts embedded in concrete, shall conform
with A.S.T.M. A 325. Bolts may be tightened by the "turn—of—nut" method.
All wedge anchors shall be installed per manufacturers specs. and torqued to
the appropriate published value.
6. All holes shall be drilled Yis" larger than nominal diameter of bolt.
5x3xY4 ANGLE IRON LINTEL / \
EA. SIDE OF OPENING / \
/ 2"
MIN, MIN. MIN,
I_
NEW OPENING ON /
CONCRETE WALL \
EDGE OF CUT
CONCRETE WALL
CONNECTION
SCALE: 1" = 1'
(4) 1/2"0x7 WEDGE ANCHOR
4 1/2" MIN. EMB.
INSTALL PER MANUF. SPECS
(SOFT—# TOROUE)
DETAIL
1
4i Z
LJ
L) --
SCALE: •
AS NOTED
AUGUST 2006
FILE:
osx�e-�txa�/owR�smucnwK
/mee-+.arc
JOB NO:
06216
SHEET
1
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_-:11
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SCALE: •
AS NOTED
AUGUST 2006
FILE:
osx�e-�txa�/owR�smucnwK
/mee-+.arc
JOB NO:
06216
SHEET
1
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—
'
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'
___---1'LC_
---------- —` - ------------------- '�-1C----
cations and other data shall not prevent the building officiallill AL
'
—1,60
-------------- being- -comod
violation of ail codes and ordinances of this
jurisdiction.---�--------'------
^ xvvmv^ivu�
�
�| "''�"""°
----___- ��
� r��---------------------'------''-----------------
to
--- --�--� =J-
_l_��-^�~--��—�1~�----
�.;� ~l��f��k.~�—f�^T\�^('~y�� _
_ — __��L_L-Jv�
— 'T----------�---------- -----------------'----------'- -
3 "X ��� � ��� ' � ���� � f� �//?��
--'— ---�---�—�������' �V�^ � ~ �
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__----------______------____ -_-_----_--___
------------------- --
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1.37 5--
57
- (�/Z-t- 116 _ _l2 l • �� �_------- _ --------__- _-- - -
--------------
-
---- - ---- ---
z-
'1'�CHNICAL
104
The Wedge -Ail is a non -bottom bearing, wedge style expansion anchor for use
In solid concrete or grout filled masonry. A one-piece clip ensures uniform holding
capacity that increases as tension Is applied. The threaded stud version Is available in
nine diameters and multiple lengths. A single size be -wire version Is available for wire
supported fixtures. Threaded studs are set by lightening the nut. Tie -wire anchors are
set with the claw end of a hammer.
• One piece wrap around clip
• Threaded end Is chamfered for ease of starting nut
• Most sizes feature full thread for added versatility.
�', Carbon and stainless steel
Carbon steel anchors are available zinc plated or mechanically galvanized.
ICC/iCBO ER -3631; City of L.A. RR24682;
Dade County 01-0820.06; Factory Mutual 3017082; Florida FL 402.4;
Underwriters Laboratories File Ex3605' Meets requirements of Federal
Specifications A -A -1923A, Type 4. & The Load Tables list values based upon results
from the most recent testing and may not reflect those in current code reports. Where
code jurisdictions apply, consult the current reports for applicable load values.
M+".l�0 The Wedge -All anchor has been tested In accordance with ICBO's
Acceptance Criteria for Expansion Anchors in Concrete and Masonry Elements (AC01).
ICBG report ER -3631 recognizes the carbon and stainless steel Wedge -Ali for the following:
• Static Tension and Shear Loading.
• Seismic and Wind Loading.
• Combination Tension and Shear Loading.
• Critical and Minimum Edge Distance.
• Holes in metal fixtures to be mounted should exceed nominal anchor diameter
by'Ae" for 1/4" thru W diameter anchors, and by 1/6" for all other diameters.
• Do not use an impact wrench to set or tighten the Wedge -All.
Caution: Oversized holes In the base material will
make it difficult to set the anchor and will reduce
the anchor's load capacity.
Threaded studs:
• Drill a hole in the base material using a carbide drill bit the same diameter as
the nominal diameter of the anchor to be installed. Drill the hole to the specified
embedment depth and blow it clean using compressed air. Overhead Installations
need not be blown clean. Alternatively, drill the hole deep enough to
accommodate embedment depth and dust from drilling.
• Assemble the anchor with nut and washer so the top of the nut is flush with
the top of the anchor. Place the anchor in the fixture and drive into the hole
until washer and nut are tight against fixture.
• Tighten to the required installation torque.
Tie -Wire:
• Drill a hole at least 11A" deep using a 1/4" diameter carbide tipped bit.
• Drive the anchor into the hole until the head is seated against
the base material.
• Set the anchor by prying/pulling the head with the claw end of the hammer.
Wedge: -Ail Tie -Wire
(zinc plate only)
Wedge -Alt Installation Sequence
I A low
W° esa ;°s °
o:°' • �1 a :. ;:o',` o :� Sao''•
:o o b
o a
o co s ono •. e ° oo b b
Tie -Wire installation Sequence
Wedge anchors shall be a threaded stud with an integral cone
expander and a single piece expansion clip. The stud shall be carbon
steel with a minimum 70,000 psi tensile strength, or type 303, 304 or
316 stainless steel, as called for on the drawings. Anchors shall meet
Federal Specification A -A -1923A, Type 4. Anchors shall be
Wedge -Ails from Simpson -Strong Tie, Dublin, CA. Anchors shall be
Installed following Simpson Strong -Tie's instructions for Wedge -Ails.
Length Identification Head Marks on Wedge -All Anchors (corresponds to length of anchor — Inches).
From 11A J 2 21A 1 3 1 31A 1 4 1 41A ! 5 1 51A f 6 61A 7 1 TA 1 8 81A 1 9 19% 110 111 112 4 13 14 115 1 16 1 17 1 `18
UTO
But Not 2 212 3 1 31A 1 4 1 41A 1 5 1 51A 1 6 161A 7 7'A AB81h 9 1 91A 1 10 1 11 1 12 1 13 1 14 15 1 16 1 17 1 18 1 19
V.
;
aoo°$o°
;�
Oroop
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Wedge anchors shall be a threaded stud with an integral cone
expander and a single piece expansion clip. The stud shall be carbon
steel with a minimum 70,000 psi tensile strength, or type 303, 304 or
316 stainless steel, as called for on the drawings. Anchors shall meet
Federal Specification A -A -1923A, Type 4. Anchors shall be
Wedge -Ails from Simpson -Strong Tie, Dublin, CA. Anchors shall be
Installed following Simpson Strong -Tie's instructions for Wedge -Ails.
Length Identification Head Marks on Wedge -All Anchors (corresponds to length of anchor — Inches).
From 11A J 2 21A 1 3 1 31A 1 4 1 41A ! 5 1 51A f 6 61A 7 1 TA 1 8 81A 1 9 19% 110 111 112 4 13 14 115 1 16 1 17 1 `18
UTO
But Not 2 212 3 1 31A 1 4 1 41A 1 5 1 51A 1 6 161A 7 7'A AB81h 9 1 91A 1 10 1 11 1 12 1 13 1 14 15 1 16 1 17 1 18 1 19
V.
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Wedge anchors shall be a threaded stud with an integral cone
expander and a single piece expansion clip. The stud shall be carbon
steel with a minimum 70,000 psi tensile strength, or type 303, 304 or
316 stainless steel, as called for on the drawings. Anchors shall meet
Federal Specification A -A -1923A, Type 4. Anchors shall be
Wedge -Ails from Simpson -Strong Tie, Dublin, CA. Anchors shall be
Installed following Simpson Strong -Tie's instructions for Wedge -Ails.
Length Identification Head Marks on Wedge -All Anchors (corresponds to length of anchor — Inches).
From 11A J 2 21A 1 3 1 31A 1 4 1 41A ! 5 1 51A f 6 61A 7 1 TA 1 8 81A 1 9 19% 110 111 112 4 13 14 115 1 16 1 17 1 `18
UTO
But Not 2 212 3 1 31A 1 4 1 41A 1 5 1 51A 1 6 161A 7 7'A AB81h 9 1 91A 1 10 1 11 1 12 1 13 1 14 15 1 16 1 17 1 18 1 19
Wedge -Ail Product Data
Carbon Steel, Zinc Plated and Mechanically Galvanized Finishes Material Specifications
1/4 x 11/23 TWD2511,'
1/4 x 13/4 WA25134
1 1/4 x 21/4 WA25214
114 x 3114 i WA25314
Hole dia is 9/32 100
15/16 100
17/16 100
1/2 x 2 3/4
WA50234
I WA50234MG 1
15/16
1 25
1 125
1 1/2 x 3 3/4
WA50334
j WA50334MG
25/16
25
125
1/2 x 4114
WA50414
( WA50414MG
213/16
25
100
1/2 x 51/2
WA50512
I WA50512MG !
41/16
I 25
I 100
1/2 x 7
WA50700
I WA50700MG 1 112 I
49/16
25
100
11/2 x 81/2
( WA50812
( WA50812MG I
6
25
j 50
1/2 x 10
WA50100
t WA50100MG
6
25
50
1/2 x 12
1 WA50120
I WA50120MG 1 I
6
I 25
I 50
3/4 x 41/4
WA75414
1 WA75414MG i
23/8
10 1 40
3/4 x 4 3/4
WA75434
( WA75434MG I
27/8
10 40
1 3/4 x 51/2
WA75512
WA75512MG { 3
35/8
10 J 40
! 3/4 x 61/4
WA75614
WA75614MGj 3/4 1
4 3/8
10 i 40
3/4 x 7
WA75700
WA75700MG
51/8
10 40
1 3/4 x 81/2
WA75812
WA75812MG
6
10 20
1 3/4 x 10
WA75100
WA75100MG
6
10 20
1 3/4 x 12
j WA75120
WA75120MG
6
5 10
1 x 6 I WA16000 I WA16000MG I
1 x 9 WA19000 I WAI9000MG 1 I
1 x 12 WA11200 WA11200MG
Material Carbon Carbon Carbon
Meets
Steel Steel Steel
minimum
ASTM A
70,000 psi
563,
tensile
Grade A
strength
Application: Interior environment, low level
of corrosion resistance desired.
21/4 5 20
21/4 5 10 1 Material Specifications
21/4 5 10
11/2x12 I WA15012 1 0 1 11/2 1 31/4
1. The published length is the overall length of the anchor. Allow one
anchor diameter for the nut and washer thickness plus the fixture
thickness when selecting the minimum length.
2. Special lengths are available on request Load values are valid as long
as minimum embedment depths are satisfied.
3 Tie -Wire Wedge -All, overall length is 2'.
4. Tie -Wire Wedge -All also available in bulk quantity of 2,000, model TWD25112B.
5. Bulk packaged Wedge -Ails available, call Simpson for details.
5 1 10
Material Carbon Carbon Carbon
Meets Steel Steel Steel
minimum ASTM A
70,000 psi 563,
tensile Grade A
strength
1. Mechanical Galvanizing meets ASTM B695,
Class 55, Type 1
Application: Exterior unpolluted environment,
low to medium level of corrosion resistance
desired. Well suited to damp, humid
environments and coastal areas.
Shear Loads for Carbon Steel Wedge -Ail (and Tie -Wire) Anchors In Normal -Weight Concrete X m--
11/8
2112
15/8
920
47
OU
zdu
zau
2� g}
64
di
d.1
0.2
1.0
i.0
1.0
2114
2112
3118
i
23p
- 28p
280
(571
(64)
(79)
t
(1.0)
(1.0)
(1.01
1/4e8
(6.4) (10.8)
1 The allowable loads listed are based on a safety factor of 4.0.
2. Allowable loads may be increased by 33%% for short term loading due to wind or seismic forces
where permitted by code.
3. Refer to allowable load adjustment factors for spacing and edge distance on pages 112,113 & 115
4. Drill bit diameter used in base material corresponds to nominal anchor diameter
5. Allowable loads may be linearly interpolated between concrete strengths listed.
6. Allowable loads for'*Inch size at 1 Winch embedment appy to both the Wedge -All and Tie -Wire anchors.
Installation torque does not appy to the Tie -Wire anchor.
7. The minimum concrete thickness is 1 % times the embedment depth.
108
*See page 5 for an
explanation of the
load table Icons
2;
E,
Load Adjustment Factors for Carbon Steel and Stainless Steel Wedge -All Anchors in Normal -Weight Concrete:
Edge Distance and Shear Load Applied Parallel to Edge
Load adjustment factors for critical and minimum edge distance have been determined
by testing. The following tables have been created using linear interpolation.
How to use these charts:
1. The following tables are for reduced Edge Distance.
2. Locate the anchor size to be used for a shear load application.
3. Locate the edge distance (Cali) at which the anchor is to be installed.
Edge Distance Shear (fcl )
with End hear Distance lied DIED Iio)Edge
Size 1/4 3/8 1/2 5/8 3/4 7/8 1 11/4
Edge E 21/4 S 3/8 41/2 51/2 5 3/4 7 7/8 9 91/2
Diet. EDmm 9 131/2 18 22 27 811/2 36 38
Cull Cmti 21/2 33/4 5 61/4 71/2 8 3/4 10 121/2
1. Table is not applicable to anchors with ED < EDmm. Factors from this table
may not be combined with load adjustment factors for shear loads applied
perpendicular to edge,
2 Cwll - actual edge distance (measured perpendicular to direction of shear load)
at which anchor is installed (inches).
3. Cell = critical edge distance (measured perpendicular to direction of shear load)
for 100% load (inches).
4. Cminli = minimum edge distance (measured perpendicular to direction of shear load)
for reduced load (inches).
5. ED - actual end distance (measured parallel to direction of shear load)
at which anchor is installed (inches).
6. EDmm = minimum edge distance (measured parallel to direction of shear load).
7. fql - adjustment factor for allowable load at actual edge distance.
8. fccnl - adjustment factor for allowable load at critical edge distance.
fcc41 Is always =1.00.
9. fcmmll = adjustment factor for allowable load at minimum edge distance.
10. fcli - femme + ((1 - fommp) (Cacgi - Cmmll) / (Ccgl - Cnanll)l•
4. The load adjustment factor (fcll) is the intersection of the row and column.
5. Multiply the allowable load by the applicable load adjustment factor.
6. Reduction factors for multiple edges are multiplied together.
*See page 5 for an
explanation of the
load table Icons
113
Load Adjustment Factors for Carbon Steel and Stainless Steel Wedge -All Anchors In Normal -Weight Concrete:
Spacing, Shear Loads
Load adjustment factors for critical and minimum spacing have been determined by
testing. The following tables have been created using linear interpolation.
How to use these charts:
1. The following tables are for reduced Spacing. 5. The load adjustment factor (fa) is the intersection of the row and column.
2. Locate the anchor size to be used for a tension load application. 6. Multiply the allowable load by the applicable load adjustment factor
3. Locate the anchor embedment (E) used for a tension load application. 7. Reduction factors for multiple spacings are multiplied together.
4. Locate the spacing (S,d) at which the anchor is to be installed.
Spacing Shear (is)
Dla.(In.)
0.99 1 0.88
1/4
E (in.)
11/8
21/4 13/4
AmOR.) 5,(In.)
15/8
31/8 23/8
S,,,. (in.)
5/8
11/8 718
fes, J
0.79
0.79 0.79
3/4 WROU
0.82
1 0.84 1
See Notes Below
0.94 # 0.88
0.99 1 0.88
0.83
1
j 0.93 1
0.83
1 0.80 1
0.99 # 0.91
3/8
0.86
1 0.97 1
1/2
-
1.00 0.95
5/8 "See page 5 for an
1 0.88
1 1.00 1
0.88
1 0.84 1
W= 0.98
0.98
1 0.91
explanation of the
25/8
33/8
21/4
33/8
41/2
23/4
41/2
51/2 load table Icons
1
13/8
13/4
11/8
13/4
21/4
13/8
21/4
23/4
0.79
0.79
0.79 (
0.79
0.79
0.79
0.79 J 0.79
0.94 # 0.88
0.99 1 0.88
0.83
1
j 0.93 1
0.83
1 0.80 1
0.99 # 0.91
1.00 1 0.91
0.86
1 0.97 1
0.86
1 0.82 1
1.00 0.95
" ' F_ 0.95
1 0.88
1 1.00 1
0.88
1 0.84 1
W= 0.98
0.98
1 0.91
R8 �.
0.91
t 0.86 1
Spacing Shear (is) ~PUN
# Dia. (in.) 3/4 7/8 1 11/4 1112
E (in.) 33/8 5 63/4 37/8 77/8 4112 9 55/8 91/2 91/2
S„a{in.) I SQ(In.) 43/4 7 91/2 53/8 11 01/4 125/8 77/0 131/4 131/4
j Sft (in.) 13/4 21/2 3 818 2 4 21/4 41/2 27/8 43/4 13114
1. E = embedment depth (inches).
2. Sm = actual spacing distance at which anchors are installed (inches).
I3 , 3. Scr = critical spacing distance for 100% load (inches).
t ° 4. Sn„ = minimum spacing distance for reduced load (inches).
5 fs = adjustment factor for allowable toad at actual spacing distance.
6 fscr = adjustment factor for allowable load at critical spacing distance.
fscr is always =1.00.
7 fannn = adjustment factor for allowable load at minimum spacing distance.
a. fs = fww + ((f - fs,mn) (Sacs - Smm) / ($cr - Smm)j.
Load Adjustment Factors for Carbon Steel Wedge -Ali Anchors in Lightweight Concrete:
Edge Distance, Tension and Shear Loads
Load adjustment factors for critical and minimum edge distance
have been determined by testing. The following tables have been
created using linear interpolation.
How to use these charts:
1. The following tables are for reduced Edge Distance. 4. The load adjustment factor (fc) is the Intersection of the row and column.
2. Locate the anchor size to be used for either a tension and/or 5. Multiply the allowable load by the applicable load adjustment factor,
shear load application. 6. Reduction factors for multiple edges are multiplied together
3. Locate the edge distance (Cad) at which the anchor is to be installed.
1
* Edge Distance Shear (fc)
Edge Distance Tension (fc) (Shear Applied Perpendicular to Edge)
*
Edge I Size 1/4 1/2 5/8 3/4 j Edge Size 1I4 1/2 618 3/4 �
Dist. Cc, 33/8 63/4 83/8 10 Dist. Ccr 33/8 63/4 83/8 18
CadL'_1C.:O:r4
13/8 23/4 3 318 4 Cad Caja 13/8 23/4 33/8 4 *gee page 5 for an
(In) 0.70 0.70 0.70 0.70 pn) 6ia 0.30 0.30 0.30 0.30 explanation of the
1 Mn 7n 13/8 _ 0.30 -a load table icons
Load Adjustment Factors for Carbon Steel Wedge -Ail Anchors in Face of Wall Installation
in 8" Grout-Fliled CMU. Edge Distance, Tension and Shear Loads
®*
Edge Distance Tension (fc)
Edge Distance Shear (it)
Edge Size 3/8 1/2
5/8 3/4
Edge Size 3/8 1/2
5/8 3/4 1
Dist. C. 12 12
20 20
Dist. C. 12 12
20 20
Cad C.I. 4 4
4 4
Cad Cmin 4 4
4 4
(in) forma 1.00 1.00
0.80 0.80
(in) 0.79 0.52
0.32 0.32
4 1.00 1.00
0.80 0.80
4 _ a,1 0.79 _ 0.52
0.32 0.32
7= 0.87 0.70 0.45 0.45
8 0.90 0.76 0.49 1 0.49
i
Load Adjustment Factors for Reduced Spacing:
Critical spacing is listed in the load tables. No adjustment
in load is required when the anchors are spaced at critical
spacing. No additional testing has been performed to
i determine the adjustment factors for spacing dimensions
i 116 less than those listed in the load tables.
I
1. Cad = actual edge distance at which anchor
Is Installed (inches).
2. Ccr - critical edge distance for 100% load i}nc
3. Caen = minimum edge distance for reduced
load (inches).
4. fe = adjustment factor for allowable load at
actual edge distance.
S. fcc, = adjustment factor for allowable load at
critical edge distance. 1. is always =1.00
6. ilcro = adjustment factor for allowable load
at minimum edge distance.
7. fc = femur + ((1 - fawn) (Gad - Cmm) / (C« - Cmm
/i
0j PORTAAA,
FOR OFFICIAL USE ONLY
'�`'`'BUILDING PERMIT - APPLICATION � Date Ree ogc-s-o6
IV IL_%"
--.-�����. INPermit# — �
®i Fill out COMPLETELY and in K. Your application and site plan MUST B pate Approved
lm*
COMPLETE to be accepted for review. If you have any questions, call
PERMITS (360) 417-4815 FAX(360)417-4711 Date Issued
Applicant or Agent:_ ~& k mss„ {� , Phone: Sb2,- R&p
Owner: b t a w VAA- & L�" Phone: 4S I - 5i61 �
I
Address: P.D. 16e v_2.1 i3 S City:_?''+- w A Zip: [� Z
Architect/Engineer: �.eA4,,.,, .,'��, ,�,�� _ 1w. Phone: All -dS—f:,l
Contractor 4ye "V ilei, s"A State License #: ae-r QZ,41oD3 Exp: Phone: _2K
Address 2 3 2 G. t . t f' `rid City: fa. -"1 -e- Zip: 'i%' 3 L 2 -
PROJECT
PROJECT ADDRESS: i 1 o V:i..%4 %A-. ZONING: CbD
LEGAL DESCRIPTION: Lot: "1 Block: i3 4 Subdivision: ►aww.,%vt e. 16w, 4L
CLALLAM COUNTY PARCEL NUMBER: Ola - ?fin - M - 51 t bo
TYPE OF WORK: SIZEIVALUATION:
❑ Residential ❑ New Constr. ❑ Re -roof ❑ Stove SF. @ $ /SF. = $
❑ Multi -family ❑ Addition ❑ Move ❑ Garage SF. @ $ /SF. = $
❑ Commercial ❑ Remodel ❑ Demolition ❑ Deck SF. @ $ /SF. = $
❑ Repair ❑ Sign ❑ Other TOTAL VALUATION $_�000
BRIEF DESCRIPTION
tOFTHE PROJECT:
1 %4 lV 6l. '. KCet 1 t - 1 A.S ✓�G4 Nl ✓«ti7 .
COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type:
No. of Stones: _ Lot Size: Existing Sq. Ft. & Proposed Sq. Ft. = TOTAL Sq. Ft.
Total lot coverage %
PLANNING USE ONLY: APPROVALS:
PLAN:
BLDG:
DPWU:
ESA/Wetland(s): ❑ Yes ❑ No SEPA Checklist required? ❑ Yes ❑ No Other: FRE:
OTHER:
VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant.
This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit
Coordinator at 417-4815 for assistance.
PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are
submitted. All other permit fees are due at the time of permit issuance.
EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the application will expire. The
Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section
R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once.
l hereby certify that l have read and examined this application and know the same 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 ,not the City's, and that l
must obtain such permits prior to work.
T TORMS1131dgPermitAppl. wpd Applicant: .--~"'"' Date:
EPORr4, ELECTRICAL FRICAL
INSPECTION,
U{L1f� N
r' ®�
WIRING
REPORT
m°
cWOflKS &O�
417-4735
DACE
PERMIT.+
IPIS�P ^ATO�
`a - �- a �
r -V F/L4F
OWNEPIGCNTRACTOR
ADDRESS
APPROVED NOT APPROVED
❑ . ..................DITCH.................... ❑
❑................ ROUGH IN/COVER ............... ❑
❑....... ............ SERVICE ................... ❑
❑..... ...............FINAL...................
CORRECTIONS NEEDED /�u�0
��',� ����� ,o✓.¢tet l �6f�J
3n A tlt X44C 17-5- A,// 77Y' )"'L /ty
/N 3�j S•uI' Q2w/ .. a l min ester
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
— DO NOT REMOVE —
OLIMP!C PRINTERS, IND (360)152-1381
Job wirer! by Q�Electrical Contractor 0 Owner
+ Electrical Contractor name License number Aute Expires
UL�m,+r-C A;/eO :c, a4'n_&C�s3sr�1
Purchaser's mailing address
11.130 Tdm wayw
City State ZIP
AifT Am .0le,5 WA- g83d3
Tel one number FAX number
457 5303 45,�_ 31188
"Freulisca owner's name
ELECTRICAL WORK PERiVATAPPLICATION
/Installation description
;,Commercial U Residendal
❑ :Yew ;11 Altered/Addition
Ve, rt 9 ' e 71rj' cC d
.addressof in pectian
//o !s?"
City
Phone number to sebedole inspection: i7 ,G'�b 5
Owner as defined by RCW19.28.261:(1) Owner will occupy the itruclure for two
€ years afrer this rtmineal permit ii rmaleed. f2) Owner is required to hire an eleeuual
contractor if above said property is ]or ale, rent or tease. ❑ Cash ❑ Check. #
s
L
I
After reading the above statement, I hereby terrify that 1 am the owner of the above
named preptny or a licensed electrical contractort am making f is electrical instal- O Credit Card Visa
MasterCard
Discover
lation or alteration in compliance with the electrical 13ws, N.E-C., RCW. Chapter
19 28, WAC. Chapter 296-4611, The City of Port Angeles Municipal Code, and Card# ,__— ---
—_,-__7,_,,,___
Utility Specifications.
-'Signature o ter, electrical contractor or electrical administrator Expiration Date
of cardce
y
044 /$ospj
S\
30
flat: cal Load A&j6ongilind orsutstractLm
Service Information
O NO LOAD CHANGES
Q Baseboard _ KW
Voltage
❑ Furnace _KW ❑ Overhead Service
Phase Q 1 D 3
❑ Heat Pump Ton LAR ❑ Tease Service
Service Size:
_ _,„,_
❑ Fan -Wall _KW ❑ Undutground Service
Feeder Size:
'a
SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735
t
r ROUQIH-N 1
TiS>NRMOSIAT
SERVICE
dpDwN by JI Dew AVluaveY BY
Aperovl Hr
FINAL �
� DITCH
Pnc Aune+voY aY Pm¢ Aopmvea by D,w
AopmvW aY
Inspection Arca, Building or Equipment Inspected
Date
Action Taken
InspeElectctor
inapectur
10-41-e1, -. /L /r
DA
l
10 39Cd / !f
0IaLD3_13 0IdWA-U BSVEESP096 51:10 9002;,Z0/G1
r= :=,nr lrh-4E1,cc .r a-i-rr a
_ 2 \ i.
ELECTRICAL PERMIT APPLICATIONti
Dove.`
Tire E Iacirr"i PC" It APCllcarrort must be filled our cornalatelr.
P levee type or reprint In Ink H y oa have any Question, plea4e cell (350) 417-4735 %�%/ . Mir
-
Fai num Dar: (360) 4174711 /
Owner orElec- Contracicr Agent: 0
/1 y m p i c Electric Co . , Inc , Phai ; 457-5303 Far: 452-3498 L%
Property 0ar: / 1l %7 T <'/If,/, v/1 Phone: 6/1�3- 7 So3
Addrwa: J,)J ✓.,n Air city S/
Eleetd01 contractor Olympic Electric Co., Inc. Llcensett J-�T B501E.p• 3/31/03
Addrs 4230 Tumcrater c7 Pert Anoeles
INSTALLATION WIRED B7; ❑ OWNER 6 ELECTRICAL CONTRACTOR
Credit Card Molder Name: Charles T. Burkhardt, Olympic Electric Co., Inc.
BlNing Address: Same City.1
Credtt Card Number: Exp, Date:
// /J
PROJECT ADDRESS: / l (% / ( l / j V L F- \ 1
ZIT:
Phone: 457-5303
210: 96363
Zip:
VISA: X AiC:
T7PE OF WORK: Check all that apply: 0 New p Alteratlori/Addition
O Resldentlal ❑ Multi-famiy Commercial 0 Mobile Home Sq. R.
❑ Remote Meter o Detached garage ❑ Hot Tub ❑ Swim Pool 0 Septic Pump 0 Low Voltage o Telecom- o Sig
Number of Circuits added or altered. f 1 3�L� L
DESCRIPTION OF THE ELECTRICAL PROJECT: Clime///L3 fk %/3 fC>' �D/f'L shod
dMone and or subtractlons $eryloe Intormntion
CD Baseboard KW Voltage:
❑ Femece —KW 0Overhead Service Phase: ❑ 1 Cl 3
❑ Heat Pump TON LAR ❑ Temp Service Service Size: �D
❑ Fan -Wall KW ❑ Underground Service Feeder Slze:
PAMC 14.D5.0 i0(Bj: For Industrial, com merc)al, b residential projects larger than a duptax. a one - line drawing of the Ei9cRical Srafvleg 8
Feeders, building size (sq, ft.), bad calculations, and the type 8 of cunduclors and/or raceway is required end shall accom perry ft1e
Electrical Permit Rppllcation.
I hereby certify that I have reed and examined this application and know that same to be tnre and correct, artd if ar
authortzed to apply For this permit- I understand it is not the City's legal responsibility to determine what permits
are requked; it remains the applicants responsibility to determine what permits are required and to obtain such_
CrodN Card Holders 91gruture: k '4 l� one:
n
owner or Elea. Com. signature: "lam Dsa:
Pw-9o,enm3 L PERMIT FLEE:
z,yo
TO In JI2ISD= DiaNSIO 96ECZStM SV3 Lt:ST COOZ/SO-ZT
FROM : A.P.S. GEN&ELC CONTRACTOR FAX NO. : 360 452 6753
ELECTRICAL PERMIT APPLICATION
The Electrical Permit Application must be filled out sompleteiv.,
Oct. 17 2001 05:45PM PI
IwROFFt'inLL�SE 9n�r—i
DRo
�..
Il.ee l.w'J
Please type or reprint In Ink. It you nhow umber: 1.1 questions, call (360.4174735
NS'ta REQUEST. INSPECTION ❑
Owner or Elec. Contractor Agent' . Phone' Fe-
' –ae I a o.t - , Phone' 457 5fi7Y
Property Owner: 1 Lt n
ll isfi 5'ree city, QQ;1' -4 noeI�s ap:_ 7,
Alkide a: Cp ,Ci-taet'G r•"• J
. P.S . Ae,n e�ctalg" Qf. l eco s i to - License #:Aph GSECtF7CIKxp: o� 403 PnonF� 6753
Electrical contractor. C...Ga�
Addresr' c' 4 b d�.e,n San ;xy Part A,&D 4? 1 p 5 Z,p: X1$363
4
INSTALLATION WIRED BY: DOWNER XELECTRICALCONNTRACTOR t
Credit card tfolder Name- A . - 6 - Cpm e i a I w�(,1 ,e ��f,, t la
BillingAddress�6 �r) cait �city;PQ �`B zip: 6�36,3
/ WSA:_ MC
PROJECT ADDRPce. I tjCO a-5 { ( 1 I P{15frev 1}
TYPE OF WORK: Check all that apply, C New k Alteration/Addition
❑ Residental ❑ Multi4amily V Commercial ❑ Mobile Home Sq. Ft. J7 0 CI -�
❑ Remote Meter ❑ Detached garage C1 Hot Tub ❑ Swim Pool ❑ Septic Pump ❑ Low Voltage ❑ Telecom. XSign
Number of Circuits added or altered: tt.� [� ,
DESCRIPTION OF THE ELECTRICAL PROJECT- � n 5Ta l la Iy r m n (sT Cl r C U' Y�S IAS i n 0
,P -X f 5+1 n a00 A, 41%t-" ,Nt�a,; , pan d . `)
Electrical Heat Load Additions r4. - � g ,;Z • 3 Q Service Information
0 Baseboard —KW Voltage: a O
0 Furnace _KW Overhead Service Phase: ❑ 1 3
n Heal Pump KW O Temp Service Service Size: Doo pm P
1$Fan-Wall 10 KW ❑ Underground Service Feeder Size:57-�
PAMC 14.05.060(8): For industrial, commercial, & residential projects larger than a duplex, a one -line drawing of the Electrical Service &
Feeders, building size (sq. it.), load calculations, and the type & of conductors and/or raceway is required and shall accompany the
Electrical Permit application.
I hereby certify that I have read and examined this application and know that same to be true and correct, and I am
authorized to apply for this permit I understand it is not the City's legal responsibility to determine what permits
are required, it remains the applicants responsibility to determine what permits are required and to obtain such.
Credit Card Holder's Signature: t .. Dy: - 0 - 17.Of
Owner or Efec- Cont. Signature: � ' ` Datc- 10, 17 -01
PW -9019