Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
110 E 3rd St - Building
MAY -21-2013 09:30 FROM:80YER ELECTRIC 2063674575 70:13604174711 CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — P.O. Box 1.1.501 Port Angeles Washington, 98362 MAY r � Ph: (360) 417-4735 Fax: (360) 4174711 Cate. —5rZ\I- Vb ELLC Zmultl-Famfly or Commercial' kmSiI ' •; Pian Review May BMe hired, aseom let ledrical Plan Review Information Sheet Job Address; -- Building Square Footage: P.1/1 boacriQtlon of above V4--,)('--) ' 1r:(' F- r LO Omer Info I Gontra�to Infonnattsan` Name, , �1_ Mallin dross:►ass: iG 'iJr '' �` Nam �G�iYt t MailingAAkin) + City; Slate; � 7�p: �t1S� City;e. AState: 71 Phon , Phone: LicensY# I Exp. license # 1 Exp. Item Unit CharasL�,ty T211[LO&Y Multiolied by Unit Charnel ServicaNeeder 200 Amp. $132.00 Serviee/Peeder 201-000 Amp. $180.00 $ ServicelFeeder 401.600 Amp $ 225.00 ServicelFeeder 601.1000 Amp, $ 280.00 $ ServicelFeeder over 1000 Amp. $ 410,00 $ Branch Circuit WI Service Feeder $ 5.00 $ Branch Circuit W10 Service Feeder $ 74,00 $ Each Additional Branch Cinoult $ 5,00 $ Branch Circuib 1.4 $ 86-00 5—aQ--L-o Temp. Service! Feeder 200 Amp. $102.00 .r $ Temp. ServicelFeader 201-400 Amp, $121.00 $ Temp. ServicelFeeder401-600 Amp, $164.00 $ Temp. ServloWFeeder 601-1000 Amp , $185,00 $ Portal W Portal Hourly $ 58,00 SlgnlOudne lighting $ 88.00 $ Signal Circuit/ Limited Ermrgy - Multi -Family $ 64.00 $ Signal Circuit/ Limited EmrgY 1 First 1500 sf-Commercial $ 96.00 $ Note: $5.00 for each additional 1500 of Renewable Electrical Energy - SKVA System or less $113.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat 5�. Tote! Owner as defined by RCW.19.26.20: (1) Owner will occupy the structure for two years after this electrical permit is finalized, (2) Owner is required to hire an electrical Contractor if above said property 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 matting the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAG, Chapter 296-468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding ElectricaS Permit Applications, Sigknatu of owner, electrical contractor or electricol administrator; C1 Ceeh Q Check �. SZ—f r�au Cara a opted: ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 13-00000546 Date 5/22/13 Application pin number 258208 Property Address . , 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06-30-99-0-0-6910--0000- Application type description ELECTRICAL ONLY Subdivision Name , , , . . . Property Use . . . , , . . . Property Zoning . . , , . . . COMMUNITY SHOPPING DISTR Application Valuation . . . . 0 ----------------------------------------------------------------------------- Application desc 1-4 circuits ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SAFEWAY STORES INC BOYER ELECTRIC C/O CPTS 830-A N.127TH ST, 13TI OAKLAND BLVD, STE 240 -SEATTLE WA 98133 WALNUT CREEK CA 94596 (206) 367-4575 (425) 201-6420 . ;•o4__�7 __ ------------------------------------------------------ Permit ELECTRICAL ALTER COMMERCIAL Additional desc 1-4 CIRCUITS Permit Fee 86.00 Plan Check Fee .00 Issue Date 5/22/13 Valuation , , . . 0 Expiration Date 11/18/13 Qty Unit Charge Per Extension SASE FEE 86.,00 ------------------------,_--- ------ Fee summary Charged Paid Credited Due Permit Fee Total 86,00 $6.00 .00 .00 Plan Check Total C0 .00 .00 ,00 Grand Total 86.00 86,00 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) 2 Kl-Q 50-37, INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN� .� FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: GAEXCHANGE\BUILDING il 1 p ermlt Electrica Ta t 11100 �3 S 130031(). ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 13-00000370 Date 4/11/13 Application pin number . . . 407950 Property Address . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1-4 circuits for fire alarm Owner Contractor SAFEWAY STORES INC ANGELES ELECTRIC C/O CPTS 524 E. 1ST ST. 1311 OAKLAND BLVD, STE 200 PORT ANGELES WA 98362 WALNUT CREEK CA 94596 (360) 452-9264 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee .00 Issue Date . . . . 4/11/13 Valuation . . . . 0 Expiration Date . . 10/08/13 Qty Unit Charge Per Extension BASE FEE 86.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 INSPECTION TYPE DATE: RESULTS: DITCH SERVICE ROUGH -IN I I �'�+�✓ 1"�j FINAL I I CONEVIENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X G:\EXCHANGE\BUILDING A .4 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Date: D 1i OR V 04/10/2013 08:05 FAX 360 452 9265 Angeles Electric to0001/0001 RECEIVEU APR 10 2013 dTA" a CITY OF PORT ANGELES PERMIT APPLICATION ELECTRICAL Building Division/Electrical Inspections INSPECTIONS (ru="D 321 East Fifth Street - P.O. Boa 1150 / Port Angeles Washington, 98362 0 Ph: (360) 417-4735 Fag: (360) 417-4711 Date: ALL _ Multi- ami or Commercial* Commercial Addition / Alteration / Remodel / Repair* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet �`Q 3 ��- Job Address: es Building Square Footage: .Ctrs (xl y' Description of above i 7-f,&[,h / ZO V*C__L1t QG"T pat. 1-II9W A11 ta4,ZA1. TD _in*A& -ATA16L_ NP Owner Info ati n Contractor Information Name: U Name: AA694S AU-0 =— IIJG Mailing Ad�jcess: ° .e� .S % -,-g MaiG Add R_> City: !� State: �� Zip: Phone:' Fax: city �—State: WA— Zi Phone: ax: �—� License 9I Exp. _ Liceme p / Exp V Item unit charge QtY Total 10ty MuKiolied by Unit Charnel Service/Feeder 200 Amp. $132.00 $ Service/Feeder 2014100 Amp. $160.00 $ Service/Feeder 40100 Amp $ 225.00 $ Service/Feeder 601-1000 Amp. $ 288.00 $ Service/Feeder over 1000 Amp. $ 410.00 $ Branch Circuits 1A $ 86.00 �_ $fQ_ Branch Circuit W/ Service Feeder $ 5.00 $ Branch Circuit W/0 Service Feeder $ 74.00 $ Each Additional Branch Circuit $ 5.00 $ Temp. Service/ Feeder 200 Amp. $102.00 $ Temp. Service/Feeder 201.400 Amp. $121.00 $ Temp. Service/Feeder 401-6W Amp. $164.00 $ Temp. ServioelFeeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuil/ Limited Energy — Multi-Family $ 64.00 $ Signal CircuiV Limited Energy I First 1500 sf — Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 $ Thermostat $ 56.00 $ $H_Q3otal Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electric:70 KA pplications. Signature of owner, electrical contractor or electrical administrator: ❑ Check x i't���'��� � � oemd: V/1,0 / % CJ�t:redK Cera rf c�J FI L � ! ,0 / / 011012012 6` Electrical Permit 110E3rdSt 13--253 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 13-00000253 Date 4/23/13 Application pin number . . . 609127 Property Address . . . . . 110 E 3RD ST ROUGH-INry-N,T ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Signature of owner or Electrical Contractor X Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Replacing existing fire alarm ---------------------------------------------------------------------------- panel Owner Contractor ----------------------- SAFEWAY STORES INC ------------------------ FIRE CHIEF EQUIPMENT CO INC C/O CPTS PO BOX 659 1371 OAKLAND BLVD, STE 200 REDMOND WA 98073 WALNUT CREEK CA 94596 (425) 641-2127 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 96.00 Plan Check Fee .00 Issue Date . . . . 4/23/13 Valuation . . . . 0 Expiration Date 10/20/13 Qty Unit Charge Per Extension 1.00 96.0000 ECH EL -LIMITED IST 1500 SQ FT 96.00 ---------------------------------------------------------------------------- Fee summary. Charged Paid Credited Due Permit Fee Total 96.00 96.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 96.00 96.00 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) IINSPECTION TYPE I DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-INry-N,T IFINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING G I►i 0 Job# 12-1310 CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections ELLEC.RICAL 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 INSPIECTIONS Ph: (360) 417-4735 Fax: (360) 417-4711 3/11/13 Date: C Multi -Family or Commercial* * Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 110 East 3rd Street, Port Angeles, WA 98362 Building Square Footage: N/A Description of above We will be workine in a central area and only replacing the control panel. Owner Information Contract FCie gr Inf rmtion Name: Safeway RFSC Name: ire Equipment Mailing ftdress: YU Box 1,9004 Mailing Address: 7661 159th PI NE City oenix State: AZ Zip: 85038 City: Redmond State: WA Zip: 98052 Phone: 623/869-3110 Fax: Phone: 206/930-5003 Fax: 425/562-6662 License # / Exp. License # / Exp. FIRECCE938TR Exp. 4/19/2013 Item Unit Charge 9!y Total (Qtv MuKiolied by Unit Charae) Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201.400 Amp. $160.00 $ Service/Feeder 401-600 Amp $ 225.00 $ Service/Feeder 601-1000 Amp. $ 288.00 $ Service/Feeder over 1000 Amp. $ 410.00 $ ✓ �k �1 v Branch Circuit W/ Service Feeder $ 5.00 $ 5.00 I A Branch Circuit W/O Service Feeder $ 74.00 $ �p Each Additional Branch Circuit $ 5.00 $ / Branch Circuits 1-4 $ 86.00 $ Temp. Service/ Feeder 200 Amp. $102.00 $ Temp. Service/Feeder 201-400 Amp. $121.00 $ Temp. Service/Feeder 401-600 Amp. $164.00 $ Temp. Service/Feeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuit/ Limited Energy — Multi -Family $ 64.00 $ Signal Circuitl Limited Energy / First 1500 sf — Commercial $ 96.00 �— $. Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat i $ S,A� Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical pe is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Mun' ' and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature f owner, ele trical contractor or electrical administrator: ❑ Cash N Check ❑ Credit Card # X �_ �i"�'�� Dated: D ( 01/0112012 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 12-00000797 Date 6/20/12 Application pin number . . . 222679 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name Property Use . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Low voltage camera spirits section ---------------------------------------------------------------------------- Owner Contractor ------------------------ SAFEWAY STORES INC ------------------------ RFI COMM. & SECURITY SYS C/O CPTS 636 INDUSTRY DRIVE 1371 OAKLAND BLVD, STE 200 TUKWILA WA 98188 WALNUT CREEK CA 94596 (206) 575-2020 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee . . . . 101.00 Plan Check Fee .00 Issue Date . . . . 6/20/12 Valuation . . . . 0 Expiration Date . . 12/17/12 Qty Unit Charge Per Extension 1.00 96.0000 ECH EL -LIMITED 1ST 1500 SQ FT 96.00 1.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 5.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 101.00 101.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 101.00 101.00 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE I DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN FINAL COMMENTS: J PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING p I u� a CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: 5 Z(1 Multi -Family o ommercial* E r ELECTRICAL INSPECTIONS * Plan Review May B Reqquired, Please Complete Electrical Plan Review Information Sheet Job Address: 0 rd � . Building Square Footage: .1 Goo Description of above 5407 IN419. CC T/ &OLA -Wr SD Ii r 1 }S�� 1!!H;& 04 �d A�.44— Lo I r,-7 Owner I orm 'on Name: Mai lin Addres 0� S+ City: tate: �� Zip: 5k3 Phone: �c�1 License # / Exp. Service/Feeder 401-600 Amp I —'j ContracJDrInformat&BBn Name: l.�A M V In L C.A.7hyyti�0 � Mailing Address: 1 A 11 '1 k}INA PV4-%A G V 103 City: State.{— Zip: q %0 ; Wil. Phone tu License # / xp.1C co � 9 OW1C. % // 3 Item Unit Charae QtV Total (Qtv Multiplied by Unit Charae) Service/Feeder 200 Amp. $ 132.00 $ Service/Feeder 201-400 Amp. $ 160.00 $ Service/Feeder 401-600 Amp $ 225.00 $ Service/Feeder 601-1000 Amp. $ 288.00 $ Service/Feeder over 1000 Amp. $ 410.00 $ Branch Circuit W/ Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 74.00 $ Each Additional Branch Circuit $ 5.00 $ Branch Circuits 1-4 $ 86.00 $ Temp. Service/ Feeder 200 Amp. $ 102.00 $ Temp. Service/Feeder 201-400 Amp. $ 121.00 $ Temp. Service/Feeder 401-600 Amp. $ 164.00 $ Temp. Service/Feeder 601-1000 Amp . $ 185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuit/ Limited Energy – Multi -Family $ 64.00 $ Signal Circuit/ Limited Energy / First 1500 sf – Commercial $ 96.00 + 5 ��� — $T' . OO Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat $ Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-4613, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: ❑ Cash ❑ Check r M % .�.,w i Credit Card # ' C.:1 w e 1 rr/ r�� .;► r X Dated: C.% 0110112012 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 12-00000281 Date 3/14/12 Application pin number . . . 011169 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . .. COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1-4 circuits Liquor lock and wine ---------------------------------------------------------------------------- lights Owner Contractor ------------------------ SAFEWAY STORES INC ------------------------ AC ELECTRIC SERVICE, INC. C/0 CPTS 804 W MEEKER ST SUITE 102 1371 OAKLAND BLVD, STE 200 KENT WA 98032 WALNUT CREEK CA 94596 (253) 852-0225 (425) 201-6420 -------------------------------------------------- -8 1-5 ------ - 1 _ Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee .00 Issue Date . . . . 3/14/12 Valuation . . . . 0 Expiration Date . . 9/10/12 Qty Unit Charge Per Extension BASE FEE 86.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 I& REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN � 14-41 -z- ZFINAL FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X fk G:\EXCHANGE\BUILDING Date: �io�pOR7gNC�` �II �O�LI U�I:JUtil� �ll VNJ��O��OU V �nM RNR REPORT RKS & 417-4735 DATE: PERMIT k INSPECTOR 5-�71 ► Z OW R CONTRACTOR �G �.L��.►. r__ 5�_ ¢.191 car S ADDRESS HE) IWC 3 �r APPROVED NOT APPROVED ❑ ....................DITCH.................... ❑ ❑................ ROUGH IN/COVER ............... ❑ ❑ ....................SERVICE................... ❑ ❑ .....................FINAL.................... ❑ CORRECTIONS NEEDED: 91-L& A L IQ LL 1.2�I 1) Li)�i V 6� tT-1_ll t u..l !o ,���.�,jD r�►Qs �=o t�F'2i� M C- S N PfL\- TS Iz tv orpo JZ' m -v rz x' riu, #-' QOM AKAR, 99zI l`I t�zc.- 33CI. MOTIFY OMSIP[ECTOR WHEM CORRECTIOMS ARE COMPLETED Wft THPM 95 DAYS DO MOT REMOVE MAR -12-2012 16:12 FROM -AC ELECTRIC 2538135817 T-713 P,001/001 F-899 voRr+t r. o) CITY OF PORT ANGELES PERMIT APPLICATION -!j J; j Building Division/Electrical Inspections 321 East Fifth Street - P.O. Box 1150 / Port Angeles Washington, 98362 r"!i if�� 0 Ph: (360) 417-4735 Fax- (360) 417-4711 ELECTRICAi, Date; 3- 1-L-1 -L — Multi -Family or Commercial* INSPECTIONS * Plan Review May Be Required, Plea$e Complete Electrical Plan Review Information Sheet Job Address- C-3 Building Square Footage: Description of above P6L-%a m -VL -t n CtUi!3� LD 4-V- [IS Owner InformattAn W Contractpr Information Name, lt't� PO4 14012- Name: H C. I— L$:- af). 4- Mailing Address- i 1 X 9-d St Mailin9Aqdress:----0e)n4 L0 CityPtai AL3q'&6-- State L --3N Zip: of Ci�6L City KC 1163t , State: LxDf1 Zip - Phone: Fax. PPone`151-'&S'1^ 61Zpax: U�`91 -A - License 81 Exp License #/Exp. TIN 2S!) --r Item Unit Charae C& Total (Qty Multiplied by Unit Charas! Service/Feeder 200 Amp, $132.00 $ Service/Feeder 201400 Amp. $160-00 $ Service/Feeder 401.600 Amp $225-00 $ Service/Feeder 601.1000 Amp. $288-00 $ Service/Feeder over 1000 Amp. $410.00 $ Branch Circuit W1 Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 74-00 $ Each Additional Branch Circuit $ 5.00 1% Branch Circuits 14 $ 86.00 $ 46" n Temp. Service(Feeaer 200 Amp. $102.00 $ Temp. Service/Feeder 201-400 Amp. $121.00 $ Temp, Service/Feeder 401-600 Amp $16400 $.... Temp Service/Feeder 601-1000 Amp. $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuit/ Limited Energy - Multi -Family $ 64,00 $ Signal Circuit/ Limited Energy I First 1500 sf - Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KvA System or Less $113.00 $ Thermostat $ 56.00 $ Note: $5,00 for each additional T-Stat $ Qb- 00 Total Owner as defined by RCW.1 9.28,261; (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., IRCW Chapter 19.28, WAC, Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05-050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: 0 cash 0 Check creoit card a F- 4.P, LL I'C' 17— 0110112012 L-4) V� CA UT 1Gt� /moo fNn CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 11-00001053 Date 10/07/11 Application pin number . . . 983056 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06-30-99-0-0-6910-0000- REPORT SALES TAX Tenant nbr, name . . . . . . SAFEWAY 1492 PHARMACY on your state excise tax form Application type description COMM REMODEL to the City of Port Angeles Subdivision Name . . . . . . Property Use . . . . . (Location Code 0502) Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 70000 ---------------------------------------------------------------------------- Application desc REMODEL THE PHARMACY / ADD A BATHROOM ---------------------------------------------------------------------------- Owner ------------------------ Contractor SAFEWAY STORES INC ------------------------ S D DEACON CORP OF WASHINGTON C/O CPTS 2375 130TH AVE NE #200 1371 OAKLAND BLVD, STE 200 BELLEVUE WA 98005 WALNUT CREEK CA 94596 (425) 201-6420 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . UNKNOWN Occupancy Type . . . ---------------------------------------------------------------------------- . . . MERCANTILE Permit . . . . . . BUILDING PERMIT - COMMERCIAL Additional desc . . REMODEL THE PHARMACY Permit pin number . 193177 Permit Fee . . . . 810.25 Plan Check Fee 526.66 Issue Date . . . . 10/05/11 Valuation . . . . 70000 Expiration Date . . 4/02/12 Qty Unit Charge Per Extension BASE FEE 670.25 20.00 7.0000 THOU BL -50,001-100K (7.00 PER K) 140.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit pin number 193193 Permit Fee 79.30 Plan Check Fee .00 Issue Date . . . . 10/05/11 Valuation . . . . 0 Expiration Date . . 4/02/12 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 14.8000 EA ME-FURN/HP/FAU < OR = 5 TON 14.80 2.00 7.2500 ---------------------------------------------------------------------------- EA ME -VENT FAN (SINGLE DUCT) 14.50 Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit pin number . Permit Fee . . . . 193201 86.00 Plan Check Fee .00 112101 l Ji Issue Date . . . . 10/05/11 Valuation . . . . 0 f 4t/�• Expiration Date . . 4/02/12 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. / i 0 1 ' 1 �2 (/'t 1 74 , Date Print Name Signature of Cont actor or Authorized Agent Signature of Owner (if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD -- PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS — Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type I Date FOUNDATION: Footings Stemwall Foundation Drainage / Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING: Under Floor/ Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow / Water AIR SEAL: Walls Ceiling FRAMING: Joists / Girders / Under Floor Shear Wall / Hold Downs Walls / Roof / Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab Wall / Floor / Ceiling MECHANICAL: Heat Pump / Furnace / FAU / Ducts Rough -In Gas Line Wood Stove / Pellet / Chimney Commercial Hood / Ducts MANUFACTURED HOMES: Footing / Slab Blocking & Hold Downs Skirting Accepted By FINAL Date I I I I IFINAL Date Comments Accepted by Accepted by PLANNING DEPT. Separate Permit #s SEP& Parking / Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417-4735 Construction - R.W. PW / Englineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T.Forms/Buildinq Division/Building Permit s .J. CITY OF PORT ANGELES 1� DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION V - 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 11-00001053 Date 10/07/11 Application pin number . . . 983056 Qty Unit Charge Per Extension BASE FEE 50.00 2.00 7.0000 EA PL -PLUMBING TRAP 14.00 1.00 7.0000 EA PL -WATER LINE 7.00 1.00 15.0000 EA PL -SEWER LINE ---------------------------------------------------------------------------- 15.00 Special Notes and Comments September 26, 2011 1:31:19 PM rbecker. Are you going to extend your fire system. Ron Becker 417-4886, email:rbecker@cityofpa.us September 29, 2011 3:32:06 PM kdubuc. If remodel requires changes in locations of fire sprinkler heads, such changes shall be in accordance with the applicable provisions of NFPA 13. September 29, 2011 3:33:04 PM kdubuc. Recommended location of fire extinguisher is adjacent to doorway entry into Pharmacy Waiting room 111B. September 26, 2011 4:02:22 PM tamiot. Separate electrical permit will be required. 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 975.55 975.55 .00 .00 Plan Check Total 526.66 526.66 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 1506.71 1506.71 .00 .00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 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 Signature of Contractor or Authorized Agent T:Forms/Building Division/Building Permit Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD -• PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS Building Inspections 417-4815 Electrical Inspections 4117-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type FOUNDATION: Footings Stemwall Foundation Drainage / Downspouts Piers Post Holes (Pole Bidgs.) PLUMBING: Under Floor / Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow / Water AIR SEAL: Walls Ceiling FRAMING: Joists / Girders / Under Floor Shear Wall / Hold Downs Walls / Roof / Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Slab Wall / Floor / Ceiling MECHANICAL: Heat Pump / Furnace / FAU / Ducts Rough -In Gas Line Wood Stove / Pellet / Chimney Commercial Hood / Ducts MANUFACTURED HOMES: Footing / Slab Blocking & Hold Downs Skirting Date I Accepted By I Comments I I I i I C7LC— I ' I I I FINAL Date �/�� Accepted by I I i %2- -r-.� AV 1 CO a ME I FINAL Date ly4 /12 -Accepted by �✓ �L �t_ PLANNING DEPT. Separate Permit its SEPA: Parking / Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417-4735 Construction - R.W. PW / Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 ^y i' 1 -2— T:Forms/Buildinq Division/Building Permit C X �Z4 PREPARED 1/26/12, 12:32:01 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 1/26/12 ------------------------------------------------------------------------------------------------ ADDRESS . : 110 E 3RD ST SUBDIV: TENANT, NBR: SAFEWAY 1492 PHARMACY CONTRACTOR S D DEACON CORP OF WASHINGTON PHONE OWNER SAFEWAY STORES INC PHONE (425) 201-6420 PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 11-00001053 COMM REMODEL ------------------------------------------------------------------------------------------------ PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS -- — --- —-------------------------------------- ---- — ------- — ------------------ -- BL3 01 11/18/11 JLL BLDG FRAMING 11/18/11 CA November 18, 2011 9:33:20 AM pbarthol. CHUCK 206-856-1253 November 18, 2011 3:38:02 PM jlierly. builder cancelled due to electrical rough not being ready/jll BL3 02 11/23/11 PB BLDG FRAMING 11/23/11 AP November 23, 2011 11:48:19 AM pbarthol. CHUCK 206-856-1251 November 28, 2011 8:40:55 AM pbarthol. BLCG O1 12/22/11 JLL BLDG CEILING GRID 12/22/11 AP December 21, 2011 3:26:41 PM pbarthol. CHUCK 206-856-1251 December 22, 2011 3:47:14 PM jlierly. BL99 01 1/26/12 JLL BLDG FINAL January 26, 2012 12:31:09 PM pbarthol. --------- -v ---- COMMENTS AND NOTES -------------------------------------- PREPARED 1/17/12, 10:53:02 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 1/17/12 -- ------------------- ADDRESS . : 110 E 3RD ST SUBDIV: TENANT, NBR: SAFEWAY 1492 PHARMACY CONTRACTOR S D DEACON CORP OF WASHINGTON PHONE OWNER SAFEWAY STORES INC PHONE (425) 201-6420 PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 11-00001053 COMM REMODEL ----- ----------- ------------------- PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ ME1 01 12/22/11 JLL MECHANICAL ROUGH -IN 12/22/11 AP 206-856-1251 December 22, 2011 3:47:14 PM jlierly. MEI 02 1/06/12 JLL MECHANICAL ROUGH -IN 1/06/12 AP January 5, 2012 4:02:20 PM pbarthol. Chuck 206-856-1251 January 6, 2012 3:55:52 PM jlierly. ME99 01 1/17/12 J MECHANICAL FINAL elf January 17, 2012 9:03:51 AM pbarthol. 206-856-1251 (no name) PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ PL1 01 11/08/11 JLL PLUMBING UNDER SLAB TIME: 09:00 11/08/11 AP November 7, 2011 3:04:05 PM 1pangrle. BRIE 683-8336 UNDERSLAB PLUMBING SHE REQUESTED AN INSPECTION AS SOON AS POSSIBLE. November 8, 2011 5:01:53 PM jlierly. PL2 01 11/15/11 JLL PLUMBING ROUGH -IN TIME: 01:00 11/15/11 AP November 15, 2011 8:46:09 AM 1pangrle. JOHN 477-9484 ROUGH -IN PLUMBING AFTERNOON November 15, 2011 4:37:46 PM jlierly. PL99 01 1/17/12 JLL PLUMBING FINAL January 17, 2012 9:04:29 AM pbarthol. () 206-856-1251 (no name) ----a'- Y -- COMMENTS AND NOTES PREPARED 1/06/12, 10:34:32 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 1/06/12 -- --------------------------------- — — -- — ------- ADDRESS . : 110 E 3RD ST SUBDIV: TENANT, NBR: SAFEWAY 1492 PHARMACY CONTRACTOR S D DEACON CORP OF WASHINGTON PHONE OWNER SAFEWAY STORES INC PHONE (425) 201-6420 PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 11-00001053 COMM REMODEL ------------------------------------------------------------------------------------------------ PERMIT= ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ ME1 01 12/22/11 JLL MECHANICAL ROUGH -IN 12/22/11 AP 206-856-1251 December 22, 2011 3:47:14 PM jlierly. MEI 02 1/06/12 MECHANICAL ROUGH -IN January 5, 2012 4:02:20 PM pbarthol. Chuck 206-856-1251 COMMENTS AND NOTES PREPARED 12/22/11, 10:19:09 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 12/22/11 ------------------------------------------------ ADDRESS . : 110 E 3RD ST ----------------------------------------------- SUBDIV: TENANT, NBR: SAFEWAY 1492 PHARMACY CONTRACTOR S D DEACON CORP OF WASHINGTON PHONE OWNER SAFEWAY STORES INC PHONE (425) 201-6420 PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 11-00001053 COMM REMODEL ------------------------------------------------------------------------------------------------ PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 ------------------------------`------------------------------ 11/18/11 JLL BLDG FRAMING 11/18/11 CA November 18, 2011 9:33:20 AM pbarthol. CHUCK 206-856-1253 November 18, 2011 3:38:02 PM jlierly. builder cancelled due to electrical rough not being ready/jll BL3 02 11/23/11 PB BLDG FRAMING 11/23/11 AP November 23, 2011 11:48:19 AM pbarthol. CHUCK 206-856-1251 November 28, 2011 8:40:55 AM pbarthol. BLCG 01 12/22/11 BLDG CEILING GRID EE / q December 21, 2011 3:26:41 PM pbarthol. (. \ CHUCK 206-856-1251 PERMIT: ME 00 MECEANI ERMIT REQUESTED INS DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ---------------------------- ------------------------------------------------------------------ ME1 01 12/22/11 L MECHANICAL ROUGH -IN 206-856-1251 l ---------------------- - ----------- COMMENTS AND NOTES & ASSOCIATES, INC. GEOTECHNICAL ENGINEERING • ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION December 23, 2011 Jerry Gibbs SD Deacon 2375 130'h Avenue NE Suite 200 Bellevue, WA 98005 RE: Safeway Pharmacy Remodel Port Angeles, WA KA Project No: 106 - 11205 Building Permit No: 193177 FILE Dear Mr. Gibbs: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: November 10, 2011 Cylinder Report No. 32303 — 28 Day Break Referenced concrete reports and compressive strength data will be mailed following 28 -day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted, w&a, r) +&Z William D. Ugolini, ICC Certified Projects Manager Peninsula Division WDUIaw Enclosures cc: City of Port Angeles: rkorcz(@citvofna.us With Offices Serving The Western United States 1230 Finn Hill Rd NW Ste. A • Poulsbo, Washington 98370 • (360) 598-2126 • Pax. (360) 598-2127 C3� 4� Remarks PLACED BY WHEEL BARROW W/C=.420 Field Test Methods X ASTM C143 ASTM C138 X ASTM C1064 ASTM C173 ASTM C31 Other Inspector LOWELL DAVIS Krazan & Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370, (360) 598 2126 Project No. 106-11205 Cyl. Code P20209 Pour Date 11/10/2011 Report No. 32303 Weather CLOUDY Jurisdiction PORT ANGELES Permit No. 193177 Date Specimens Recd. 11/11/2011 Project SAFEWAY 1492 Engineer Location PORT ANGELES, LINCOLN ST. Architect Comp. Tested Break Laboratory Client SD. DEACON Contractor SD. DEACON Age Field Data CYLINDER REPORT Reported Batch Data Str. (psi) Concrete X Other Design Actual 4X8 12.56 Weights Weights Supplier ANGELES Plant No. 1 Site Mix Mix No. 400OPSi 6SACK 4X8 12.56 Cem. lbs. 563 Mix Air Unit F. Ash lbs. 28 Slump Temp. Temp. Wt. C. agg. Ibs.1 3/411 1640 Time Truck# Ticket # %Air (in.) (F) (F) (pcf) C. agg. lbs. 2 28 6:40 A61 33916 4.75 61 43 C. agg. lbs. 3 6,020 OB 3 X ASTM C1231 Sand lbs. 1493 4X8 Water lbs. HOT 28.45gal Placement Area air Ent. (oz) Location SLAB: PHARMACY RETROFIT other (oz) POLY997 20 REINFORCEMENT INSPECTED/CONFORMS other(oz) POZZNC534 1%/66.67 other (oz) FIBERMESH 1 PER YD other (oz) Water Added on Job (gals.) 5 Remarks PLACED BY WHEEL BARROW W/C=.420 Field Test Methods X ASTM C143 ASTM C138 X ASTM C1064 ASTM C173 ASTM C31 Other Inspector LOWELL DAVIS Laboratory Data Design Strength 4,000 @ 28 days Date Specimens Recd. 11/11/2011 Cyl. Test Field Max. Comp. Tested Break Laboratory Code Date Cure Age Dim. Area C.F. Load Str. (psi) Set # By Type Test Methods P20209 11/17/2011 7 4X8 12.56 51620 4,470 OB 5 X ASTM C39 P20209 12/8/2011 28 4X8 12.56 62570 4,980 OB 3 ASTM C109 P20209 12/8/2011 28 4X8 12.56 78785 6,230 OB 3 ASTM C617 P20209 12/8/2011 28 4X8 12.56 75570 6,020 OB 3 X ASTM C1231 P20209 12/8/2011 H 4X8 ASTM C780 P20209 Other P20209 P20209 Test Results Remarks FIELD REPORT NO. 144922 X Conforming Results Reviewed By W A, Date Reviewed Non -Conforming Codes for Break Types: 1: Cone 2: Cone & Split 3: Cone & Shear 4: Shear 5: Columnar (Split) Measurement Uncertainties: ASTM C-39 +1- 8% Form 03101 Revision 2 EHocli" Oete 12/02102 The information provided on this report is prepared for the exclusive use of the client This report may not be reproduced in any format wdhout the wrtlen permission of the client and Krazan 8 Associales. PREPARED 11/08/11, 8:29:18 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 11/08/11 -------- ADDRESS — --------------- — -------------- . : 110 E 3RD ST — ----------- -------------- SUBDIV: --- — -------------------- TENANT, NBR: SAFEWAY 1492 PHARMACY CONTRACTOR S D DEACON CORP OF WASHINGTON PHONE OWNER SAFEWAY STORES INC PHONE (425) 201-6420 PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 11-00001053 COMM REMODEL ------------------------------------------------------------------------------------------------ PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS --------------------------- - ------------------------------------------------------------------ PL1 01 11/08/11 J L PLUMBING UNDER SLAB TIME: 09:00 `-p November 7, 2011 3:04:05 BRIE 683-8336 PM 1pangrle. UNDERSLAB PLUMBING -------------------------------------- SHE REQUESTED AN INSPECTION COMMENTS AND NOTES — AS SOON AS POSSIBLE. ---- — - — ----------- — � ----- III PREPARED 11/23/11, 11:49:43 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 11/23/11 ------ ADDRESS ---- . : 110 E 3RD ST ------- - SUBDIV: ------ TENANT, NBR: SAFEWAY 1492 PHARMACY CONTRACTOR S D DEACON CORP OF WASHINGTON PHONE OWNER SAFEWAY STORES INC PHONE (425) 201-6420 PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 11-00001053 COMM REMODEL ------------------------------------------------------------------------------------------------ PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BL3 01 11/18/11 JLL BLDG FRAMING 11/18/11 CA November 18, 2011 9:33:20 AM pbarthol. CHUCK 206-856-1253 November 18, 2011 3:38:02 PM jlierly. builder cancelled due to electrical rough not being ready/j11 BL3 02 11/23/11 JLL BLDG FRAMING i November 23, 2011 11:48:19 AM pbarthol. CHUCK 206-856-1251 ------------------------------------- ---------------------------------------- COMMENTS AND NOTES PREPARED 11/15/11, 8:46:47 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 11/15/11 ------------------------------------------------------------------------------------------------ ADDRESS . : 110 E 3RD ST SUBDIV: TENANT, NBR: SAFEWAY 1492 PHARMACY CONTRACTOR S D DEACON CORP OF WASHINGTON PHONE OWNER SAFEWAY STORES INC PHONE (425) 201-6420 PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 11-00001053 COMM REMODEL ------------------------------------------------------------------------------------------------ PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS - — - --------------- PL1 01 11/08/11 JLL PLUMBING UNDER SLAB TIME: 09:00 11/08/11 AP November 7, 2011 3:04:05 PM Ipangrle. BRIE 683-8336 UNDERSLAB PLUMBING SHE REQUESTED AN INSPECTION AS SOON AS POSSIBLE. November 8, 2011 5:01:53 PM jlierly. PL2 01 11/15/11L PLUMBING ROUGH -IN TIME: 01:00 November 15, 2011 8:46:09 AM 1pangrle. JOHN 477-9484 ROUGH IN PLUMBING AFTERNOON -- COMMENTS AND NOTES ----------------------- PREPARED 11/18/11, 10:35:25 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 11/18/11 ----------------------------------------------------- ADDRESS . : 110 E 3RD ST SUBDIV: TENANT, NBR: SAFEWAY 1492 PHARMACY CONTRACTOR S D DEACON CORP OF WASHINGTON PHONE OWNER SAFEWAY STORES INC PHONE (425) 201-6420 PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 11-00001053 COMM REMODEL ------------------------------------------------------------------------------------------------ PERMIT= BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 11/18/11 L BLDG FRAMING IN November 18, 2011 9:33:20 AM pbarthol. / CHUCK 206-856-1253 COMMENTS AND NOTES - -k" A T-epx) { -_ y ¢�_f" ;� gBUILDING DIVISION TRANSMITTAL To: Fire Department ❑ Other Department Date Project Address , 3 rA Contact B ( I � I R Gl h Jou 11, S+_ Phone number(s) 60 — 9 6q— Q 23 Permit number N-1053 Project Description Re'moj_e'l `Hne-1- �7 alA a "rte) r-, �harm� GENERAL CONTRACTOR ❑ New Construction Jerry Gibbs S.D. DEACON CORP. OF WASHINGTON Project Manager 2375 130th Avenue NE, Suite 200 Addition Alteration Bellevue, WA 98005 /K jerry.gibbs@deacon.com T. 425.284.4000 M: 206.856.1253 www.deacon.com F: 425.284.4100 Please review & return to the Building -Division, Permit Technician. T:Forms/Building Division/Transmittal BUILDING / PLUMBING / MECHANICAL PERMIT APPLICATION - LONG FORM (To be used for projects that require plan review.) City of Port Angeles Attn: Building Permit Technician 321 E. 5" St., Port Angeles, WA 98362 360-417-4815 fax: 360-417-4711 Hours: Mon through Fri 8 - 5 pm Contact person: Bill AA164 I1 Please print in ink. Date Receive ?,$ 11 Permit # 5 Date Appro t d i Approved b Credit card payments are accepted Mon -Fri 8-5 pm (no AmlVicin Express) Cash & checks are accepted Mon-Thurs 8:30-4 pm & Fri 8:60-12,30 pm Property owner: SQi y lrvr`-. Property owner's mailing address: h-21 eve 1a Contractor's business name: jr;�f (*K.., (or property owner's name if he/she is doing/oeeing the work) Contractor's mailing address: Phone: 3W- 90— y3a 3 Phone: y99 -T- dR0/- & Yao ,ISO z3ax f1S00/ 7900„S1 Phone: - PO ,dox I $(00 s0/8WO ) Contractor's L&I license lnumber: L 9Oo^?09 I Expiration date: a01a 10_7 -I I Felr Pad', kuu : S co" of W Project Address: sakwaY 1Y9o2 /10 94p'-- 3 roc &-. dr^t A qew 2315 136-* Ave_ N L�,-'h t.✓/+ C1&'.3cooZ 6ellevve WA . 6) gags' Project Type: ❑ Residential p(Commercial ❑ Industrial Project Business Name: ,5akwrI 0- /y9A (for commercial, industrial, or multi-familiproiects) Parcel # Complete only the portions of this permit that are relevant to your project. ❑Multi-fam' bbt_--A CW (a4NT- Zoning: eye Lot # 0 (C'2A/IZ (✓) Pay the plan check fee (based on the valuation of the project) at the time of submittal Residential Projects submit: (✓) Two sets of plans* (including engineering calcs, geotech reports, etc. if applicable) (✓) Prescriptive Approach - Simple Form (confirming conformance to the Energy Code) Commercial P ojects submit: (✓) Three sets of plans* (including engineering calcs, geotech reports, etcif applicable) (✓) _V0 Paperwork confirming conformance to the Energy Code (✓) U4 For large projects, a pre -construction meeting with various City department personnel is highly recommended. To schedule a pre -construction meeting, contact the Planning Manager at (360) 417-4750. (✓) Additional information may need to be submitted including: landscape plan, parking plan (including ADA spaces, ramps, etc.), utilities (existing & proposed), curbs, sidewalks, storm water plan, etc. For Additions & New Structures also submit. (✓) _W Site plan (8 1/2" x 11") showing all structures (existing & proposed), setbacks, & new driveways * If an architect or engineer drew the plans or calculations, include at least one "wet -stamped" set of plans and/or calculations. T:Forms/Building Division/Building/Plumbing/Mechanical Permit Application — Long Form (Revised 2011) Page 1 of 4 Reoair I Solar Panels I Miscellaneous: (exDlain the oroiectl Project Valuation $ Remodel: (explain the Droiect, includina how the building space is currently beina used and what the new. remodeled use will be) tX iNS D//GrM t/ WaV 7rva d/Ga�, GtDI/'� A2,4- �Project Valuation $ -7V 000 (✓) If the space will change from commercial to residential, submit: "Checklist — Converting Commercial Space into Residential Space" Addition: (explain the oroiect and complete & submit Daae 31 Maximum height of the new addition feet Project Valuation $ New Structure: (explain the Droiect and comolete & submit Daae 31 Maximum height of the new structure feet Project Valuation $ PLUMBING PERMIT: Will there be ANY plumbing changes (items moved, added, replaced, or altered) Check one: / No Yes ✓ (✓) If yes, complete & submit page 4 "Plumbing Changes" MECHANICAL PERMIT, Will there be ANY mechanical changes (items moved, added, replaced, or altered) Check one: No Yes (✓ } If yes, complete & submit page 4 "Mechanical Changes" Occupancy group # of bedrooms Will a lawn sprinkler system be installed? Occupant load # of full baths Will a fire sprinkler system be installed? Construction type # of half baths *Homeowner: If you will be doing / overseeing the work, then the project valuation will be determined by doubling the cost of materials, to reflect the value the repair adds to your property. Cost of materials x 2 = Project Valuation $ 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. DateC)-a?J-1I/ Signature / Print Name ,pill Page 2 of 4 Floor Areas Basement 1,9t Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck (> 39' high)* Deck (:5 30" high)* Shed Other Other Existina sauare foots -a * Walking surface of the deck above ground For residential building projects the minimum Dwelling $85-00 per sq. ft, garage/utilityy K*j New sauare Price per now foot a sauare foot X Remodel project valuation TOTAL VALUATION $ Auare foot valuation we accept is: iisc.structure $30.00 per sq. ft. porch/deck/carport $12.00 per sq. ft. VERAGE & SITE COVERAGE Lot coverage is the amount or per&nt of ground area on which buildings are located. It includes: houses, garages, carpo, covered patios, cantilevered portions of buildings, roof overhangs that are longer than 30 -inches, uncovered decks r porches having walking surfaces higher than 30 -inches off the ground, etc. Total footprint of structures sq, ft. + lot size sq.ft, = Lot coverage % Site Coverage is the a ount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other imperv* us surfaces. (see Port Angeles Municipal Code 17.94.135 for exemptions) Does the project inclu e a new driveway? ayes m no other e im is pth ee rya u' project inclu e a n 11 the ivewa) feet I If yes, what will the iveway be made of? o cement c3 asphalt m gravel c3 other (NOTE.- feet is the recommended minimum driveway length for residential projects) r Does this proj t include a new parking pad? m yes o no . t par i g c cement m asphalt o gravel o other If yes what w' the parking pad be made of? a) Total footprint of structures sq. ft. (existing & new) b) Total concrete, asphalt, & other impervious surfaces sq. ft. (existing & new) Add lines "a" & "b" above to get the total impervious sq, ft, (existing & new) Total Impervious sq.. ft. + lot size sq. ft. = Site coverage % 3 of 4 J PLUMBING CHANGES I.1 Check "No" or "Yes" (and enter quantities) for each line Item. Type Sink (hand, mop, floor etc.) Toilet Bathtub Shower Washing Machine Hot Water Heater Water Line (meter to structure) Re -plumb the structure Sewer Line Backflow Prevention Device Tvaes: Beverage Machine Landscape Watering System Fire Sprinkler System 5 2 inch line Fire Sprinkler System > 2 inch line Plumbina Channaes No V Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes (Moved. Added. Replaced. or Altered) _J, -,_Quantity I _Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Please list all other planned plumbing changes or additions that aren't listed above. MECHANICAL CHANGES Check "No" or "Yes" (and enter quantities) for each line Item. Tvue Mechanical Chanaes Furnace, heat pump, or forced air units 5 tons No V Yes Furnace, heat pump, or %-Yes forced air unit > 5 tons No Ductless heat pump No Yes Wall (recessed) heater No Yes Baseboard heater No Yes Steffes room heater No Yes Wood -burning stove No Yes Pellet stove No Yes Radiant floor heat No Yes Gas fireplace or freestanding stove No Yes Gas cooking stove No Yes Propane tank set No Yes Gas line No Yes Boiler No Yes Clothes Dryer No Yes Ventilation fan (single duct) No =Yes Hood & duct mechanical exhaust No Yes Ventilation system (not part of a heating or air conditioning system) No Yes Air handler No Yes Evaporative cooler (non-portable) No Yes (Moved. Added. Replaced. or Altered) k I Quantity V) A0` (I Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity Quantity `Quantity Quantity Quantity Quantity Quantity Please list all other planned mechanical changes or additions that aren't listed above. Page 4 of 4 pQr Clallam County Assessor & Treasurer - Property Details - 70397 SAFEWAY STORES I Clallam County Assessor & Treasurer Property Search Results > 70397 SAFEWAY STORES INC for Year 2011 - 2012 Property Account Property ID. 70397 Legal Description: SAFEWAY SP#95-03- 01 V27 P52 LOT 1 Geographic ID: 0630990069100000 Agent Code: Type: Real Base Amt. Tax Area: 0010 - PA 121 PORT ST CNTY H2 L WMP Land Use Code Open Space: N DFL Historic Property: N Remodel Property: Multi -Family Redevelopment: N Township: $31251.47 Section: Range: Location Address: 110 E THIRD ST Ma sco: Sketch PORT ANGELES, WA Neighborhood: PA East Comm Map ID: Neighborhood CD: 5005000 Owner Name: SAFEWAY STORES INC Owner ID: Mailing Address: C/O CPTS % Ownership: 1371 OAKLAND BLVD,STE 200 WALNUT CREEK, CA 94596 Exemptions: 54 N N Page 1 of 1 Ak6p"U 2 50083 100.0000000000% Taxes and Assessment Details Property Tax Information as of 09/23/2011 Amount Due if Paid on: ff7ig. NOTE: If you plan to submit payment on a future date, make sure you enter the date and click RECALCULATE to obtain the correct total amount due. Click on "Statement Details" to expand or collapse a tax statement. _.___..,.,, __.__________..�-•- First Half Second Half Year Statement ID Base Amt. Base Amt. Penalty Interest Base Paid Amount Due Statement Details 2011 163189 $31434.67 $31434.59 $0.00 $0.00 $31434.67 $31434.59 Statement Details 2010 51493 $31251.47 $31251.49 $0.00 $0.00 $62502.96 $0.00 Values Taxing Jurisdiction Improvement I Building Sketch Property Image Land Roll Value History Deed and Sales History j Payout Agreement This year is not certified and ALL values will be represented with "N/A". Website version: 9.0.32.2200 Database last updated on: 9/23/2011 4:10 AM © 2011 True Automation, Inc. All Rights Reserved. Privacy Notice http://websrv8.clallam.net/propertyaccess/Property.aspx?cid=0&year=2011&prop_id=70397 9/23/2011 Contractors or Tradespeople Detail Page 1 of 2 Washington State Department of Labor & Industries Contractors or Tradespeople Detail Return to List > Start a New Search > 0 Printer friendly Verify Workers' Comp Premium Status Check for Dept. of Revenue Account About General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name TRICON ENTERPRISES LLC UBI No. 603042179 Phone No. (907) 644-8804 Status Active Address Po Box 1860 Suite/Apt. License No. TRICOEL90209 City Hamilton License Type J) Construction Contractor State MT Effective Date 9/29/2010 Zip 59840 Expiration Date 9/29/2012 County Out Of State Suspend Date J Business Type Limited Liability Company Parent Company Specialty 1 A) General Specialty 2 i) Unused 9 Business Owner Information 0 Hide All Name Role HANCOCK, JOEL D JR Partner/Member SAYERS, STANLEY P Partner/Member CATRON, JASON L Partner/Member 0 Bond Information Effective Date Expiration Date 09/29/2010 09/29/2010 09/29/2010 Bond Bond Company Bond Account Effective Expiration Cancel Impaired Bond Received Name Number Date Date Date Date Amount Date 1 AMERICAN 6733795 09/20/2010 Until $12,000.00 09/29/2010 STATES INS CO Cancelled 2 Assignment of Savings Information https://fortress.wa.gov/lni/bbip/Result.aspx 9/23/2011 Contractors or Tradespeople Printer Friendly Page Genera [/Specialty Contractor A business registered as a construction contractor with LF11 to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name S D DEACON CORP OF WASHINGTON UBI No. 601259893 Phone 4252844000 Status Active Address 2375 130Th Ave Ne #200 License No. SDDEACW108NT Suite/Apt. License Type Construction Contractor City Bellevue Effective Date 8/30/1990 State WA Expiration Date 6/20/2012 Zip 98005 Suspend Date Active County King Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company General Unused 2/9/2009 Other Associated Licenses Pagel of 3 I. License Name Type Specialty Specialty 2 Ef a ExpirationDat Status Date S D DEACON SDDEADD890NW CORP OF Construction General Unused 8/16/2011 8/16/2013 Active CALIFORNIA Contractor ISAVOYL"911C7 SAVOY/DEACON Construction General Unused 2/9/2009 2/9/2013 Active LLC Contractor AXIOM AXIOMCC997NH COMMERCIAL Construction General Unused 10/16/2001 11/6/2013 Active CORP Contractor S D DEACON SDDEAC0011JB CORP OF Construction General Unused 4/2/1999 6/8/2013 Active OREGON Contractor ISDDEAE1088BS S D DEACON Construction General Unused I 1/10/1992 I 14/24/2013 Active ENTERPRISES INC Contractor 1DEACOCC011JB DEACON CONST Construction CORP -OREGON Contractor I Genera( Unused I 4/2/1999 I 16/1/2001 Archived 1DEACOTJ041J3 DEACON TURNER Construction General lUnused 4/23/1996 16/1/2000 Archived JOINT VENTURE Contractor DEACON Construction DEACOCC130Q5 CONSTRUCTION Contractor Concrete Carpentry/ Framing 11 /25/1987 11/17/1992 Archived CO SDDEA'"19202 S D DEACON Construction 1General, lUnused 19/22/1981 16/1/1999 Archived CORP Contractor AXIOM Construction AXIONCS995KJ CONSTRUCTION Contractor General Unused 5/11/2001 6/28/2006 Expired SRVCS LTD Business Owner Information Name Role Effective Date Expiration Date DEACON, STEVEN DOUTHITT (Member 01/01/1980 SMITH, RICHARD GREGORY Member 01/01/1980 JOLSON, SCOTT J 'Member 06/29/1990 https://fortress.wa.gov/1ni/bbip/Print.aspx 10/7/2011 Contractors or Tradespeople Printer Friendly Page jBURRESS, NANCY L Member 06/29/1990 Effective DEACON, DONNA J Cancel Impaired Amount Received 01/01/1980 07/20/2010 IGALASH, STEPHEN J Date 01/01/1980 07/20/2010 Bond Information Page 2 of 3 Bond Company Bond Effective Expiration Cancel Impaired Bond Received Bond Name Account Date Date Date Date Amount Date Number 6 SAFECO INS CO 6346304 08/16/2005 Until $12,000.0008/15/2005 OF AMERICA Cancelled Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Policy Effective Expiration Cancel Impaired Amount Received Name Number Date Date Date Date Date Date: 09/02/2009 ZURICH 21 AMERICAN GL0297913509 11/01/2010 11/01/2011 $2,000,000.00 10/28/2010 Open INS CO Amount: $0.00 Amount: ZURICH Bond(s): 6346304 InterPlead: No 20 AMERICAN glo297913508 11/01/2007 11/01/2010 $2,000,000.0011/02/2009 INS CO Date: 03/30/2009 ZURICH GL02979135- Date: 19 AMERICAN BENTON 11/01/2007 11/01/2008 $2,000,000.0011/02/2007 INC INS CO 07 Amount: $0.00 Amount: ZURICH InterPlead: No 18 AMERICAN GL0297913506 06/01/2005 11/01/2007 $2,000,000.0011/01/2006 INS CO 1SEA Date: 01/05/2009 ZURICH GL02979135- Date: 11/12/2010 Date: 12/21/2010 17 AMERICAN Amount: $0.00 06/01/2005 06/01/2006 $2;000,000.00 06/01/2005 INS CO 05 Amount: $542,230.80 Summons/Complaint Information Cause County Complaint Judgment Status Payment Paid By 09-2-32230- 9KNT Date: 09/02/2009 Date: Date: FARMERS KING Amount: $205,459.60 Open ELECTRIC INC Amount: $0.00 Amount: Bond(s): 6346304 InterPlead: No 09-2-00849-1 Date: 03/30/2009 J Et E MEZA Date: Date: PLASTERING BENTON Amount: $6,248.91 Open INC Amount: $0.00 Amount: Bond(s): 6346304 InterPlead: No 08-2-41543- 1SEA Date: 01/05/2009 Date: 11/12/2010 Date: 12/21/2010 WEST COAST FABRICATORS KING Amount: $0.00 Closed/Satisfied Contractor LLC Amount: $542,230.80 Amount: $542,230.80 Bond(s): 6346304 InterPlead: No 08-2-26066-6 https://fortress.wa.gov/lni/bbip/Print.aspx 10/7/2011 Contractors or Tradespeople Printer Friendly Page EN DE RI S Date: 08/12/2008 COMPANY INC Date: Date: KING Amount: $75,738.98 Dismissed InterPlead: No Amount: $0.00 Amount: Bond(s): 6346304 07-2-07547-8 Date: 01/25/2008 WEST Date: Date: ELECTRIC LLC SNOHOMISH Amount: $359,798.00 Open Amount: $0.00 Amount: InterPlead: No 07-2-00441-3 Date: 03/08/2007 Date: Date: DEACY MECHANICAL BENTON Amount: $5,297.69 Dismissed Amount: $0.00 Amount: InterPlead: No Warrant Information No unsatisfied warrants on file within prior 6 year period https://fortress.wa.gov/lni/`bbip/Print.aspx Page 3 of 3 10/7/2011 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 12-00000180 Date 2/22/12 Application pin number . . . 558680 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1-4 circuits pharmacy ---------------------------------------------------------------------------- Owner Contractor ------------------------ SAFEWAY STORES INC ------------------------ MCMULLEN ELECTRIC INC C/O CPTS 203 STEWART W 1371 OAKLAND BLVD, STE 200 PUYALLUP WA 98371 WALNUT CREEK CA 94596 (253) 845-7593 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee .00 Issue Date . . 2/22/12 Valuation . . . . 0 Expiration Date . . 8/20/12 Qty Unit Charge Per Extension BASE ------------------------------------------------------ FEE 86.00 Fee summary Charged Paid Credited Due Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 INSPECTION TYPE DITCH DATE: RESULTS SERVICE ROUGH -IN 2 lag I1 '2- PW FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contract r G:\EXCHANGE\BUILDING REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Date: Z ZZ I Z— W CITY OF PORT ANGELES PERMIT APPLICATION RECOVED Building Division/Electrical Inspections FEB 2 2011 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 ELECTRICAL f INSPECTIONS Date: �t 1 �'2.1 _ Multi -Family or o mercial* * Plan Review May Be Re uired� PLleas C pl . Electr' I n ev ew In)ormation S get Job Address: 1D CX�I Dl ��3 Building Square Footage: Description of above A r,vvUn,c�— Owner Information Name: Maili Ad ress: City: State Phon Fax: License / Ex. :kA— Zip: VIr X V U V) P Item Unit Charge Service/Feeder 200 Amp. $132.00 Service/Feeder 201400 Amp. $160.00 Service/Feeder 401-600 Amp $ 225.00 Service/Feeder 601-1000 Amp. $ 288.00 Service/Feeder over 1000 Amp. $ 410.00 Branch Circuit W/ Service Feeder $ 5.00 Branch Circuit W/O Service Feeder $ 74.00 Each Additional Branch Circuit $ 5.00 Branch Circuits 1-4 $ 86.00 Temp. Service/ Feeder 200 Amp. $ 102.00 Temp. Service/Feeder 201-400 Amp. $121.00 Temp. Service/Feeder 401-600 Amp. $164.00 Temp. Service/Feeder 601-1000 Amp . $185.00 Portal to Portal Hourly $ 96.00 Sign/Outline Lighting $ 88.00 Signal Circuit/ Limited Energy — Multi -Family $ 64.00 Signal Circuit/ Limited Energy / First 1500 sf — Commercial $ 96.00 Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 Thermostat $ 56.00 Note: $5.00 for each additional T-Stat Contra I o m 'on _ Name: / Mailing ress: City: State: - Zip: , Phone: ;�' e # Licens/ Exp. �013 Qty Total (Qtv Multiplied by Unit Charge) $p , t $'@� Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296466, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: ,❑_l Cash ❑ Check Credit Card # X ``/__ Dated: li` �' ' I C� I \ 0110112012 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 12-00000069 Date 1/26/12 Application pin number . . . 527935 Property Address . . . . . . 110 E 3RD ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-99-0-0-6910-0000- on your excise. tax form Application type description ELECTRICAL ONLY Subdivision Name . . . . . . to the City Of Port Angeles Property Use .. . . . . . . . (Location Code 0502) Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . . 0 ---------------------------------------------------------------------------- Application desc Low voltage permit -------- ---------------------------------------------- a Owner Contractor ------------------------ SAFEWAY STORES INC ------------------------ MCMULLEN ELECTRIC INC C/0 CPTS 203 STEWART W 1371 OAKLAND BLVD, STE 200 PUYALLUP WA 98371 WALNUT CREEK CA 94596 (253) 845-7593 (425) 201-6420 --------- ----- ----- ---------253- g`�� -z`�--- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 96.00 Plan Check Fee .00 Issue Date 1/26/12 Valuation . . . . 0 Expiration Date 7/24/12 Qty Unit Charge Per Extension 1.00 96.0000 ECH EL -LIMITED 1ST 1500 SQ FT 96.00 ---------------------------------------------------------------------------- Fee summaryCharged ---------- Paid Credited ------------------------------ Due ----------------- Permit Fee Total 96.00 96.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 96.00 96.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner- or Electrical Contractor X Date: G:\EXCHANGE\BUILDING 9y3_ y05;-- 355 CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: /- RV - /2 ,2L Multi -Family or Commercial* R E C EL �i\ V, E JA(3 2 412011 ELECTRICAL INSPECTIONS * Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 1/0 Pncv Angles (.JA 493e_; - Building Square Footage: Description of above X= au ' A d8pa 60.-v_Ac .: 4 -d- c i zRa W.0 =#arm, .-)u,A. "r) n s Owner Information Name: S1qF9_w4 `t. Tlvc- Mailing Address: clot) - 41C- i,Vti."Iw i3t-✓ice Name: /✓!e/�%u//ten City: State: i�14 Zip: Lb vO Phone: Fax: City: y0j.) I I. Cp License # / Exp. Phone: Item Unit Charqe Service/Feeder 200 Amp. $132.00 Service/Feeder 201400 Amp. $160.00 Service/Feeder 401-600 Amp $ 225.00 Service/Feeder 601-1000 Amp. $ 288.00 Service/Feeder over 1000 Amp. $ 410.00 Branch Circuit W/ Service Feeder $ 5.00 Branch Circuit W/0 Service Feeder $ 74.00 Each Additional Branch Circuit $ 5.00 Branch Circuits 14 $ 86.00 Temp. Service/ Feeder 200 Amp. $102.00 Temp. Service/Feeder 201400 Amp. $121.00 Temp. Service/Feeder 401-600 Amp. $164.00 Temp. Service/Feeder 601-1000 Amp . $185.00 Portal to Portal Hourly $ 96.00 Sign/Outline Lighting $ 88.00 Signal Circuit/ Limited Energy - Multi -Family $ 64.00 7 Signal Circuit/ Limited Energy / First 1500 sf - Commercial $ 96.00 Note: $5.00 for each additional 1500 sf : Renewable Electrical Energy - 5KVA System or Less $113.00 Thermostat $ 56.00 Note: $5.00 for each additional T-Stat Contractor Information Name: /✓!e/�%u//ten ��rc�;.c Mailin Address: &b3 t,Je54 SA-t)c r 1 City: y0j.) I I. Cp State: ter Zip: Phone: Fax: a4- -j, - 4A 4C) - e)54yt License # I Exp. A lc,44v le;,g-A 8F ��o to QtV Total (Qtv Multiplied by Unit Charae) $ $ $ 96. p° • Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: X (!� Dated: ❑ Cash ❑ Check 175�Credit Card #'% ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 G Application Number . . . . . 11-00001201 Date 10/25/11 Application pin number . . . 422816 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 10 circuit remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ SAFEWAY STORES INC ---------------- -------- MCMULLEN ELECTRIC INC C/O OPTS 203 STEWART W 1371 OAKLAND BLVD, STE 200 PUYALLUP WA 98371 WALNUT CREEK CA 94596 (253) 845-7593 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit pin number . 195206 Permit Fee . . . . 96.90 Plan Check Fee .00 Issue Date . . . . 10/25/11 Valuation . . . . 0 Expiration Date 4/22/12 Qty Unit Charge Per Extension 1.00 73.5000 ECH EL -BRANCH CIRCUIT WO/FEEDER 73.50 9.00 2.6000 ECH EL-ECH ADDNT BRANCH CIRCUIT 23.40 ---------------------------------------------------------------------------- Fee summary Charged ---------------------------- Paid Credited ------------------------------ Due Permit Fee Total 96.90 96.90 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 96.90 96.90 .00 .00 INSPECTION TYPE DITCH SERVICE ROUGH -IN FINAL COMMENTS: DATE: I RESULTS f �1-7, a17 PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION REPORT SALES TAX ,on your excise tax form] to the City of Port Angeles (Location Code 0502) INSPECTOR: Signature of owner or Electrical Contractor X 4' �' f Date: G:\EXCI-IANGE\BUILDING 0FcpORT 4�Y ELECTRICAL INSPECTION �—� WIRING REPORT U N r � 417-4735 RKS & DATEPERMIT # INSPECTOR szl2Z(, i , i OWNER/CONTRACTOR — ll,�- i11�1-Ly`11���1a, l� ADDRESS — /I Q- '3 S� APPROVED NOT APPROVED ❑ ....................DITCH.................... ❑ ROUGH IN/COVER ............... ❑ ❑ ....................SERVICE................... ❑ ❑ .....................FINAL.................... ❑ CORRECTIONS NEEDED: -1�;C'ny oLs NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS — DO NOT REMOVE — OLYMPIC PRINTERS, INC. (360) 452-1381 O' pORTANCF LEC lJ MICti L INSPECTION ��® M T U N 9 � ar 69 y CORKS & 417-4735 DATE PERMIT # INSPECT OWNER/CON`fRACTOR PAGt%of IF -1 %L ADDRESS APPROVED NOT APPROVED ❑ ..................... DITCH .................... ❑ -`.f'*?���L-... ROUGH IN/COVER ............... ❑ ❑ ....................SERVICE................... ❑ ❑ .....................FINAL.................... ❑ CORRECTIONS NEEDED: 2 NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 pOR7gN O. EL ECTMICAL Btl �9 CTI C WMNO REPORT _ h CwORKS &�~ 417-4735 D1 TI i I I I) I zo PERMIT/ I INSPECTOFj.1 OW Nt R/CONTRACTOR ADD ESS HD APPROVED NOT APPROVED ❑ ....................DITCH.................... ❑ ROUGH IN/COVER ............... ❑ ❑ ....................SERVICE................... ❑ ❑ .....................FINAL..................... ❑ CORRECTIONS NEEDED: (� C-01) NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS OLYMPIC PRINTERS, INC. (360) 452-1381 A OF p0R7 qh,, ELECTMAL N E tN � I 1l� U V g IJ U g ll V M REPORT Gm W 1, "F KS b 417-4735 -4Y 35 COR� DATE: PERMIT # INSPECTOR 1�2o'=�Z n -lit OWNER p�y� !!lq w CONTRACTOR Mr41C ADDRESS ADDRESS )-10 APPROVED NOT APPROVED ❑ ....................DITCH.................... ❑ ❑................ ROUGH IN/COVER ............... ❑ ❑ ....................SERVICE................... ❑ ❑ .....................FINAL................... . CORRECTIONS NEEDED: 96mo s U/"CUSdF—D � — C) I lrt rz-f4 Z� S`3'►2 �� ML LJ L-rq ( 4 Z2 /) D F 'K L–oc->c' 1-10 t -j - Cn h) ip u lT hv,6 0 v- e::�04L/ Aj e - NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 95 DAYS ® DO NOT REMOVE CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: I D/ Z- I l j I 1 & 2 Single Family Dwelling Job L t Z - 71000 f pORT4 OCT 2 4 2011 ® N c ELECTRICAL INSPECTIONS Multi -Family or Commercial* /Commercial Addition / Alteration / Remodel / Repair* * Plan Review May Be Rouire -Please Complete_�Iectrical Plan Review Information Sheet Job Address: Building Square Footage: Description of above A- I-jr I i r.,Irc wL+5 Owner�nfforJJ��??ation Cont r or for atio Name: '_'�(TGl�ll 1_ Gl N (:-:-'j G Name: i Mailin A ress: ) Mailing ddress. City: State.." Zip:6M66S City: State: Zip: Phone4r'Z6 Fax: Phone: Fax: fAn.()5 01 License # / Exp. License I Exp. I2 Item Unit Charge Qty Total (Qtv Multiplied by Unit Charcle) Service/Feeder 200 Amp. $119.90 $ Service/Feeder 201-400 Amp. $145.50 $ Service/Feeder 401-600 Amp $ 204.60 $ Service/Feeder 601-1000 Amp. $ 262.20 $ Service/Feeder over 1000 Amp. $ 372.50 $ / Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder $ 2.60 $ 73.50 $ S $ 3 —� Each Additional Branch Circuit Temp. Service/ Feeder 200 Amp. $ 2.60 $ 92.70 $(�X [.�, $ Temp. Service/Feeder 201-400 Amp. $110.30 $ Temp. Service/Feeder 401-600 Amp. $148.70 $ Temp. Service/Feeder 601-1000 Amp . $167.90 $ Portal to Portal Hourly $ 95.90 $ Sign/Outline Lighting $ 88.20 $ Signal Circuit/ Limited Energy / First 1500 sf — Commercial $ 95.90 $ Note: $5.00 for each additional 1500 sf Signal Circuit/ Limited Energy -1 & 2 Family Dwelling $ 63.90 $ Signal Circuit/ Limited Energy - Multi -Family Dwelling $ 63.90 $ Manufactured Home Connection $119.90 $ Renewable Electrical Energy - 5KVA System or Less $102.30 $ Thermostat $ 56.00 $ NEW CONSTRUCTION ONLY: First 1300 Square Ft. $110.30 $ Each Additional 500 Square Ft. or Portion of $ 35.20 $ Each Outbuilding or Detached Garage $ 73.50 $ Each Swimming Pool or Hot Tub $ 110.30 $ / $ 2_(1-':)) ( .1- ':)) Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the ctrical laws, N.E.C., RCW. Chapter 19.28, WA�ha 96-466, The City of Port Angeles Municipal Code, and Utility Specifications and P 14.05.050 regarding Electrical P t Applications. S natu a of ow , ele rical contractor or elect . I administrator: ❑can neck ��� � Ob ❑ Credit h: .Z ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 11-00001441 Date 12/27/11 Application pin number . . . 387387 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Data Voice addition ---------------------------------------------------------------------------- Owner Contractor ------------------------ SAFEWAY STORES INC ------------------------ TELESYSTEMS WEST INC C/O CPTS 11232 120TH AVE NE 1371 OAKLAND BLVD, STE 200 KIRKLAND WA 98033 WALNUT CREEK CA 94596 (425) 968-4000 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . ... . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 95.90 Plan Check Fee .00 Issue Date . . . . 12/27/11 Valuation . . . . 0 Expiration Date 6/24/12 Qty Unit Charge Per Extension 1.00 95.9000 ECH EL -LIMITED 1ST 1500 SQ FT 95.90 -------------------------------------------------------- Fee summary Charged ------------------- Paid Credited Due Permit Fee Total 95.90 95.90 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 95.90 95.90 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING TESESYSTEMS WEST PAGE 01/01 12%22;`2011 15:43 4259686000 •,� ffW CITY OF PORT ANGIJLES PFRMTT APPLICATION Building Division/Electrical Inspections /r 321 East Fifth Street = PBox I.O.150 / fort Angeles Washington, 98362 � 2 Ph: (360) 4174735 Fax: (360) 417-4711 ELECTRICAL Date: 1• Z i % INSPECTIONS 1 & 2 Single Family Dwelling — Multi -Family or Commercial* ),r_ Commercial Addition /Alteration / Remodel/ Repair * Plan Review May 6e R5pr d, Please Complete Electrical Plan Review Information Sheet Job Address: • ILO � �f r, Building Square Footage: toxo' JDescription of above 1� f + i..7f+2K t �N ,�' f� p _ +s* n M� R4eA, j nrCfn lr ti,� o C1�'Lt 4) f t 10 r ce /)w.4 W -f n/ b !I, K. � Owner inf rmation Name: A!t Wlhj w Malll Address: i o i�, r City: orf.•t State: �_ Zlp: � i�2 Phone: J Faxwgq License P / Exp Item Unit Charae Servlce/Feeder 200 Amp. $119.90 Service/Feeder 201-400 Amp. $145.50 Service/Feeder 401-600 Amp $ 204.60 Service/Feeder 601.1000 Amp. $ 262.20 ServicetFeeder over 1000 Amp. $ 372,50 Branch Circuit W/ Service Feeder $ 2,60 Branch Circuit W/O Service Feeder $ 73"50 Each Additional Branch Circuit $ 2,60 Temp. Service/ Feeder 200 Amp. $ 92.70 Temp. Servlce/Feeder 201400 Amp. $110.30 Temp. Service/Feeder401.600 Amp. $148.70 Temp, Service/Fender 601.1000 Amp. $167.90 Portal to Portal Hourly $ 95,94 Sign/Outline Lighting $ 88.20 Signal Circult/ Limited Energy / First 1500 sf— Commercial $ 95.90 Note: $5.00 for each additional 1500 sf Signal Circuit/ Limited Energy -1 8 2 Family Dwelling $ 63.90 Signal Circuit/ Limited Energy- Multi -Family Dwelling $ 63.90 Manufactured Home Connection $119.90 Renewable Electrical Energy - 5KVA System or Less $102.30 Thermostat $ 56.00 NEW CONSTRUCTION_ ONLY; _ First 1300 Square Ft" $110,30 Each Additional 500 Square Ft. or Portion of $ 35.20 Each Outbuilding or Detached Garage $ 73.50 Each Swimming Pool or Not Tub $110.30 Contractor Information Name: Til � s Nsfe.mt L•! c y" Mailing Address: City: -I"F; Jay P_ State: l rptA _Zlp:,V0F3 Ph :} D Fax: x(25 - 4 -Ono License # / Ex=R L ..�2� J.il 6/So TZ .. . t t t Total flay Muitioiied by Unit Charael $ $ $ $ $ $ $ $ $ $ $ $ $ 4S". Total Owner as defined by RCW.19,26.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is far sate, 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 the electrical installation or alteration in compliance with the electrical laws, N,E•C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code and Utility Specifications and PAMC 14,05.050 regarding Electrical Permit Applications. Signature=4�ectrical contractor or electrical administrator: p Cash O credit ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 11-00001391 Date 12/12/11 Application pin number . . . 992837 Property Address . . . ... . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc CCTV security ---------------------------------------------------------'------------------- Owner Contractor ------------------------ SAFEWAY STORES INC ------------------------ RFI COMM. & SECURITY 'SYS C/O CPTS 636 INDUSTRY DRIVE 1371 OAKLAND BLVD, STE 200 TUKWILA WA 98188 WALNUT CREEK CA 94596 (206) 575-2020 (425) 201-6420 ------------------------------------------------- - --9g---- �b Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee . . . . 95.90 Plan Check Fee .00 Issue Date . . . . 12/12/11 Valuation . . . . 0 Expiration Date 6/09/12 Qty Unit Charge Per Extension 1.00 95.9000 ECH EL -LIMITED 1ST 1500 SQ FT 95.90 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 95.90 95.90 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 95.90 95.90 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN z 12-:z �) FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:),EXCFIANGE\6U I LDING 253-981-9996 Line 10:01:15 12-09-2011 1/1 na CITY OF PORT ANGELES PERMIT APPLICATION J i�1�•� , - ` Building Division/Electrical Inspections FT -C 12 2011 --- 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 4174711 ELECTRICAL Date: Q — �3- —11 INSPECTIONS 1 & 2 Single Family Dwelling _ Multi -Family or Commercial* Commercial Addition 1 Alteration / Remodel I Repair* Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: J ho F 3rd SA - Building Square Footage- _U)MA/- a"-&- I S00 Description of above Cu _ 1 0. %k-C-C�1 a J Owne=Z� Name:Name: Contractor Information - LA^t C aAa-9 Mailingf Address: 0-441^ ( c110 �- 0 Mailing ddress: I q—I I -1 (O1 n 1c-. 4L S • til 01003� City: LI -e- State:% 0 At— Zip: S_ City. State:cilA--Zip: Phone:yas 441) 1o344Fax: Phone3S7A q$ I tel O&x:.1 S?i `I B I 9CI19 License # I Exp. License # / Exp. (Zf � Cs7 S 4�-"l cl A 1ti 4 -113 l 13 Item Unit Charge QtV Total (Qtv Multiplied by Unit Charael Service/Feeder 200 Amp. $ 119.90 $ Service/Feeder 201400 Amp. $145.50 $ ServicelFeeder 401-60D Amp $ 204.60 $ ServicelFeeder 601-1000 Amp. $ 262.20 $ Service/Feeder over 1000 Amp. $ 372.50 $ Branch Circuit WI Service Feeder $ 2.60 $ Branch Circuit W/O Service Feeder $ 73.50 $ Each Additional Branch Circuit $ 2.60 $ Temp. Service/ Feeder 200 Amp. $ 92.70 $ Temp. Service/Feeder 201400 Amp. $110.30 $ Temp. Service/Feeder 401-600 Amp. $148.70 $ Temp. Service/Feeder 601-1000 Amp . $167.90 $ Portal to Portal Hourly $ 95.90 $ Sign/Outline Lighting $ 88.20 $ Signal Circuit/ Limited Energy / First 1500 sf - Commercial $ 95.90 _� $ °f S - GI O . Note: $5.00 for each additional 1500 sf Signal Circuit] Limited Energy -1 & 2 Family Dwelling $ 63.90 $ Signal Circuit/ Limited Energy - Multi -Family Dwelling $ 63.90 $ Manufactured Home Connection $119.90 $ Renewable Electrical Energy - 5KVA System or Less $102.30 $ Thermostat $ 56.00 $ NEW CONSTRUCTION ONLY: First 1300 Square Ft. $ 110.30 $ Each Additional 500 Square Ft. or Portion of $ 35.20 $ Each Outbuilding or Detached Garage $ 73.50 $ Each Swimming Pool or Hot Tub $110.30 $ $ Uf S•`IDfotal Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46 The i f Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: ❑ Cash ❑ cher ED< Credit Card X. Dated: 9, 1 la I l k U 1 3a 3LA e>D15°I �s_�o ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 11-00001234 Date 11/02/11 Application pin number . . . 331458 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . .. Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 circuit freezer container ---------------------------------------------------------------------------- REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) Owner Contractor ------------------------ SAFEWAY STORES INC ------------------------ ANGELES ELECTRIC C/O CPTS 524 E. 1ST ST. 1371 OAKLAND BLVD, STE 200 PORT ANGELES WA 98362 WALNUT CREEK CA 94596 (360) 452-9264 (425) 201-6420 ---------------------- /u� �j K?_ " I Z G� Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee 73.50 Plan Check F �.` .00 Issue Date . . . . 11/02/11 Valuation 0 Expiration Date 4/30/12 Qty Unit Charge Per Extension 1.00 73.5000 ECH EL -BRANCH CIRCUIT WO/FEEDIR 73.50 ------------- -------------------------------------------)----------------- Fee summary Charged Paid Credited Due Permit Fee Total 73.50 73.50 .00 .00 Plan Check Total .00 .00 ;/00 .00 Grand Total 73.50 73.50 /x.00 i .00 INSPECTION TYPE DATE: RESULTS DITCH SERVICE ROUGH -IN (- _ / !�/�✓E,Q FINAL COMMENTS: PERMIT WILL EXPIRES IX(6) MONTI-IS FROM LAST INSPECTION Signature of owner or Electrical Contractor- X G:\EXCHANGE\BUILDING INSPECTOR: Date: N W r1 10/31/2011 13:32 FAX 360 452 9265 City;p[PottAnpelet hrmltApplkdon ":�aAdlyd•�lyls(orilElradNat,Mlrpapflorre :.32t:!<att��l'���fri•1'tyP.0:8aot 1160 . PpR Mge1g 11Vip111ff�toe; iw Ph:j3BOjd1T173SfWD)4174711 •.•.Data :•� � � `/ ' •18 2 Slr>Ble Far* Dwelling ernly a Corrmerdel' CommWetAddl 1 Akerallon 1 Remodel/ Repoli Angeles Electric OCT ELECTRICAL INSPECTIONS PlanRevlew May Be Kqu;W, Please Complete Electrical Plan Review Inbcrmdpn ShW AA .. A10 Z0001/0001 Job n� . �BuIldltig Squere.Foobpe: 11 / ' Desalptlon d above •¢AA C[.?tml )Gie— S&4i,2,v — � 4v7,*VVE-IA -.148 MG:�4 :::MIOnt�p�Qdress: t�q r ` CIIj� Kl't Stets ap: jh6 L Phone: Fax .Uce�e�l.t:xr ft�C arae . ;j204.80 .. .$26210 ..:3372.50 •73.60 $ .. 2.60 .. ' ..5•.92,70 ' <i•rlo4o. 9148.70 • •2187,,00:; , . S 95.90 t 88:20 $ 11110 ' ti 102.30 . ucen6§ 01 EV Total(City M� by unk Chemet SavkaJFoeder200 Nnp.. Servtoe1Feed9r20t4W Amp. SeMatFaeder401�00Amp. BenlesrF"eder eot-1000 Amp. serylcdFWder.orer 1000 Mrp. Bremch CliwAWSavlce Feeder ; Brarch C@ddt M Sentra Feeder Each Addl6ond kw Ai CkW Tamp. Savlod FWdar2Do Amp. Turd. Sev1WFae6a20140D.Mq. Temp, SardoelFa"dor40t�b00Amp. Twij 9WwFWdar601400DAmp. Portal to P+orSelFtoaa�r ; SIpNOuen"tl�ht4p SOW MW UMW ftW - 4rnhrardd. Addl =W 1600 t SAO amid ChW Wdbd Eherpy -142 Fx* Dweanl . %ad CY W Uedted•ErM - MWx* Dm ft MvdaArr"d Fond Colin *n Renewdli -SecCW EwV- SKVA Sy*m or L@u Rit 1300 S oM FL . I r 1::15 20 i EMM AdrrftM 600 3*M FL a P010w Of " S ` 7350 i Each Oubuldbp or DoWW GapEld :. _.. . a3 .30 i11"fmgil�gFtfaLTub ,.: _ Tool I �3, " ONm�rardadMdbrRCN:11.laZiOt:ry)tfrmerwlNooavOrtheebr�ehrnAortroyaaraaRaalYlaNaee�ealvaraltkAfna/fled.A►OwMrNeep�l+�dahkeanobetdodeontractorN '' . a6otaaldpdpltQ! hriaklantwiwLPermit eeaAraOraian0reofhafbnpe�brl. 1' .j stdlnp the ibow.drabrn"nt; l be* Gwft that ism IM o"m"r of fM above named props y er a kmelal d ebebamftcbor. l ern Ronal tle "bclrfealfreb0atlon or ;ilbbiatl6riln obnipli�litat talrhtM abeArlcll•1ern, NEC, RCW. Chapbr 11.26, WAC. Chapbr296 M The MOW PortAnSalW ltunklpat Codednd 1tlDk► �eelk�oM• Alpn"if+irr.o1 oro obW d oonfnobr or 4wCM i adminh*dvr D GaA 4AChwk. �� Z�� "Card! �'! ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 11 00000153 Date 2/17/11 Application pin number 040496 Property Address 110 E 3RD ST ASSESSOR PARCEL NUMBER 06 30 99 0 0 6910 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Application desc 4 circuits bakery Ovens and fans Owner Contractor NECA/PBTF WESTERN PROPERTIES ANGELES ELECTRIC 1125 15TH ST NW 524 E 1ST ST WASHINGTON DC 200052707 PORT ANGELES WA 98362 (360) 452 9264 J liJZ q�s- Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 181586 Permit Fee 81 30 Plan Check Fee 00 Issue Date 2/17/11 Valuation 0 Expiration Date 8/16/11 Qty Unit Charge Per Extension 1 00 73 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 73 50 3 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT 7 80 Fee summary Charged Paid Credited Due Permit Fee Total 81 30 81 30 00 00 Plan Check Total 00 00 00 00 Grand Total 81 30 81 30 00 00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE. RESULTS INSPECTOR. DITCH SERVICE ROUGH -IN ^/ Z FINAL 5 j Z I` t 4;f? COMMENTS { PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPE T N Signature of owner or Electrical Contractor X Date- 7,1 t / G:\EXCHANGE\BUILDING C V 02/15/2011 09 43 FAX 360 452 9265 -Off Nd-Appin ftmikApokdn U9, Angeles Electric 1 & .2 804* Pw*-Dwvft P1m,!Review Vaj,6j PaqopdW 0Jt�Add106 EWPOW Plan ReWow Inbmdm -8h - 99 144% I'M ciao FEB 15 2011 - ELECTRICAL INSPECTIONS 00001/0002 r, Tow 3 -0 - =$MOWN 1p ok wallonoodalubw., A—lam 11aha dwhinflubs"W -419"hopf"W,aNaldeNoorrhad,, wdm*kW&dmbdgbdw O Cub Y 2' C ev Kean �9w1now Lt Clip $tato; AO- Z%K 94'-X6Z Mr A - per. MUZ-07 #z yugs 41MAD 42"Jo ftvWFW0w2D14MA* 6a*W"W4Q1,=mv. $=20 # ftVbWWft801-1=A* '5372.60 ft*GftWW#1W18Q0AffqL In kw4CkvAW$VMFdWw s. fro # $ E"AdUMd*oWCkW Tv1p.ftftFmdw=Aff# TOIL fWdWF*WW2M4*0ATp. TO* SM61:6MV.401400 Alp. mo &M -G, It m,,"AddftWi6MUW $-Up , ftWCktmUftdfiwW-i&2FW&/DwdkV -— U0-fo $ SOW Ck"U*O-EmW- UWo*Dmft $ fil" f - mmftmwftft*mfid-m ,$Ikm b.. $ R '0h81WW&WW-SWA*ftowLm I 4 144M# 4 -AM $ Eadr AddMonM M$*MFt. wPm1b of 4.73A0 $ EwhaaftowWWWOmp S - $ - bm :...Imp, wpA@FffdTqb yhmrmm 00001/0002 r, Tow 3 -0 - =$MOWN 1p ok wallonoodalubw., A—lam 11aha dwhinflubs"W -419"hopf"W,aNaldeNoorrhad,, wdm*kW&dmbdgbdw O Cub Y 1 (3�G� Ivo-���� �Mal'/Z z (� v S -T U fn C, pq ja� s- , 3 0 A-,— -- f/ 3(::� vk-c� RECEOVED MAR 12 2010 CITY OF PORT ANGELES BUILDING DIVISION 0 n L C?I� yy k9�-�nge �e��elNaY Mike wl i h.�dle sal I -N�e OR Census 2010 News I Media Advisory - 2010 Census Road Tour Comes to Portland, Ore. Page 1 of 2 You are here: Census.gov > 2010 Census > News > Press Kits > Media Advisories > Road Tour > Media Advisory 2010 Census Road Tour Comes to Portland, Ore. FOR IMMEDIATE RELEASE WEDNESDAY, FEB 24, 2010 Contacts Samantha O'Neil Public Information Office 202-450-9556 e-mail Samantha O'Neil Ping Khaw-Sutherland Seattle Regional Census Center 971-322-7253 e-mail Ping Khaw-Sutherland Media Advisory - 2010 Census Road Tour Comes to Portland, Ore. What: The 2010 Census Portrait of America Road Tour is part of the largest civic outreach and awareness campaign in U S history -- stopping and exhibiting at more than 800 events nationwide From local parades and festivals to major sporting events the Road Tour will attempt to motivate America's growing and increasingly diverse population to complete and mail back the 10 -question census form when it arrives in mailboxes March 15-17 Traveling for a total of 1 547 days and more than 150 000 miles across the country 13 road tour vehicles will provide the public with an educational, engaging and interactive experience that brings the 2010 Census to life At each event across the country attendees will have the opportunity to learn about the 2010 Census and understand the benefits a complete count can bring to communities everywhere view a sample 2010 Census form and learn how the collected information is used, and contribute stories and photos to the Portrait of America project to explain why "I count!" and view messages from other road tour participants. When Tuesday March 2, 2010, noon to 3 p m. Who Nick Fish Portland city commissioner Deborah Kafoury Multnomah County commissioner Ralph -Lee director Seattle Regional Office, U S Census Bureau Where Pioneer Courthouse Square 715 SW Morrison St. Portland OR 97205 For more information about the 2010 Census and the Road Tour please visit 2010census.gov and follow us on Twitter ((6 201 Facebook, MySpace Flickr and YouTube (/uscensusbureau) hitn-//201 O.census.gov/news/press-kits/road-tour/rt-Dortland.html 2/26/2010 °FP°"ria ELECTRICAL INSPECTION U ��N a ILI-y WIRING REPORT b Ks & - 417-4735 DATE PERMIT kIINSPECTO j �R I—� OWNR/CIRt IkC 253 8G7 2 r)z2. ADDRESS 7n � t A 116 �s APPROVED ❑ CORRECTIONS NEEDED: t a z= DITCH ROUGH IN/COVER SERVICE FINAL NOT APPROVED O S-�cviz� ���c.s a ►�` Li 12" al::- oQm�c, 33:0 -3C� NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS — DO NOT REMOVE — ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 09 00001129 Date 10/29/09 Application pin number 031764 Property Address 110 E 3RD ST ASSESSOR PARCEL NUMBER 06 30 99 0 0 6910 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Application desc 3 circuits for self check out Owner DATE Contractor DITCH .NECA/PBTF WESTERN PROPERTIES AC ELECTRIC SERVICE INC 1125 15TH ST NW ROUGH IN 804 W MEEKER ST SUITE 102 WASHINGTON DC 200052707 KENT WA 98032 (253) 852 0225 X Permit ELECTRICAL ALTER COMMERCIAL Additional desC Permit pin number 155879 Permit Fee 61 50 Plan Check Fee 00 Issue Date 10/29/09 Valuation 0 Expiration Date 4/27/10 Qty Unit Charge Per Extension 1 00 57 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 57 50 2 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT 4 00 Fee summary Charged Paid Credited Due Permit Fee Total 61 50 61 50 00 00 Plan Check Total 00 00 00 00 Grand Total 61 50 61 50 00 00 INSPECTION TYPE DATE RESULTS DITCH SERVICE ROUGH IN FINAL COMMENTS Signature of owner or Electrical Contractor X Date INSPECTOR. r City of port Angeles Permit Application Building hlvisianit lectrtcat Inspections 921 East Fifth Street— P.O. Box 1150 Port Angeles YWashingbon. 98382 Ph: (364) 417-0739 Fax: f380) 417.4711 Date: t D -2a - C�9 _ 1 & 2 Single Family Dwelling Multi-Famlly or Commercial' Y-Commerdal Addition / Alteration 1 Remodel / Repair Plan Review May BeE? aired, Please Compete �I Plan Review lnforrla#ian Sheet Job Address: 1 l o . IF Building Square Footage: Description of above R&NC06 xla� IQ,:i— '-- 44k -44"t a QLD ( KI: tri Q 6; W Owner information � Name: Mailing Address. City State: _ ifp: Phone: Fax: _ License # ! Exp. UniS Charge S 93.75 $113.75 $160.00 $205.00 $291.25 $ 2.00 $ 57.50 S 2.00 $ 72.50 $ 66.25 $116,25 $'131.25 $ 75,00 $ 59.00 $ 75,00 $ 50.00 S 50.00 $ 93.75 $ 80.00 $ 86 25 S 27,50 $ 57.50 $ 8625 $ 43.75 Contractor Information Name: R C. KIM qm::C 6tn l Mailing Address-CnK LL), MECZtm :2T city Kea state: L..)N zip: c1dLS ,L Phone.. Fax: =- n t As -5 19 i 7 License 4 / 1:xp�5 5 p i 0Zai Total-(WMultiplied by Unit Charce $ Service/Feeder 200 Amp, S_ %Nice/Feeder 201-400 Amp, $ Servioeireeder 401-600 Amp. $ Service/Feeder 601-10010 Amp. $ SehncelVeeder over 1000 Amp. $, Branch Circuit Wi Service Feeder $ t Branch Circuit W/O Service Feeder $ Each Additional Branch Circuit $ temp. Service/ Feeder 200 Amp. $ _ Temp. ServicerFeeder 201.400 Amp. $ Temp ServicelFeeder,101.600 Amp. S_ Temp. ServicWFeeder 601 1000 Amp. $ Portal to Postal Hourly $ Sign/Outline Lighting $ Signal Circuilt Limited Energy Commercial $ _ Signal CincuW Limited EnoV 18 2 Family Owoliing $ Signal Clrcuid Limited Energy Mulfi.Family Dwelling $ Manufactured Home Connection S RenewsUe Electrical Energy 5KVA 5ysteM or Less $ First 1300 Square Ft $ Each Additional 500 Square Ft. or P(Alon of $ Each Outbullding or Detached Garage $ Each Swimming Pool or Hot Tub $ Thermostat S 115 total Ownar as detrned by RCW.i9.Z8, 261- (1) owner w#1 occupy the stntc8rm for two years ager this elechfcal permit is tinetFzed. (2) Owner is mgWted to hire an electrical cohbactarffabove said property is for sate, rent ortaaw- After reading the above statement, I hereby certify that t am the owner of the above named property or a licensed elaetricsi contractor. I am making the electrical Installation at alteration in compliance with the elechtcal laws. iJ.E.C. RCW. Chapter 1928, WAC. chapter 2%40, The Cay of Port Angeles Municipal Code, and Utility Specifications. Signature of ow or electrical cc ctor or electrical administrator X date I L7 '`L5 £t9 -d 100/100 d 991-1 1189£1££91 d cash C1 Check )16 cre it rd t /ALL POIL KF-,)iu 13?3-s S57, nl-21S OINIO313 OV -1010H 81 91 6002-9Z-100 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 09 00000758 Date 7/31/09 Application pin number 853790 Property Address 110 E 3RD ST ASSESSOR PARCEL NUMBER 06 30 99 0 0 6910 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Application desc DVR rack upgrade Owner Contractor NECA/PBTF WESTERN PROPERTIES RFI COMM & SECURITY SYS 1125 15TH ST NW 636 INDUSTRY DRIVE WASHINGTON DC 200052707 TUKWILA WA 98188 (206) 575 2020 Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 150920 Permit Fee 75 00 Plan Check Fee 00 Issue Date 7/31/09 Valuation 0 Expiration Date 1/27/10 Qty Unit Charge Per Extension 1 00 75 0000 ECH EL LIMITED 1ST 1500 SQ FT 75 00 Fee summary Charged Paid Credited Due Permit Fee Total 75 00 75 00 00 00 Plan Check Total 00 00 00 00 Grand Total 75 00 75 00 00 00 INSPECTION TYPE DATE RESULTS INSPECTOR. DITCH SERVICE ROUGH IN FINAL �0*` 7/0g COMMENTS Signature of owner or Electrical Contractor X L� Date 01 w JUL/28/2009/TUE 07 17 AM DEPT OF COMM DEV 'ECEI E 604174711 P 001/_00 Y� JULCity of Port Angeles Permit Application J 3 12009 Building oivision/Electrical Inspection# 321 East Fifth $treat- P.O. Box 1150 ELECTRICAL PortArigeles Washington, 98382 INSPECTIONS Ph: (380) 4117p7-47Fa�x,- (?60) 417.4711 Date: /,-ebq _ 1 & 2 Single Family Dwelling _ Mu&Famfly or Commercial` �f1 Commercial Addition / Alteration I Remodel / Rep�irx * Plan Review May B Required Please ease Comp)6te Electrical Plan Review information Sheet Job Address: F - � Building Square Footage: C�o Des ' tion of bov Owner info�, n- f Contractor I ormation Name; �"( Name: Maflln Address: l2]. YZ Ai Maiiin dress: "f e FE" City: State: _ j,�� Z!p: `� `FZC�F� City' ' State, p: Phone Fax: Phone. ax, 75?5 Licanse # / Exp. License # 1 Exp. Unit Charas Qtv Total (4tv MulSpiied by unit Charnel $ 93,76 Q Service/Feeder 200 Amp, $113.75 $ -- Service/Faeder201-400 Amp, $160,00 $ Service/Feeder 401-600 Amp. $205.00 $ Service/Feeder 601-1000 Amp. $291.25 $ Service/Feeder over 1000 Amp. $ 2,00 $ Branch Circuit W/ Service Feeder $ 57.50 $ Branch Circuit W/O Service Feeder $ 2.00 $ Each Additional Branch Circuit $ 72,50 $ Temp. Service/ Feeder 200 Amp. $ $6,25 $ Temp. Service/Feeder 201-400 Amp. $116,26 $ Temp, Service/Feeder 401-600 Amp. $131.25 $ Temp, Service/Feeder 6011000 Amp. $ 75.00 $ Portal tol Portal Hourly $ 69.00 $ Sign/Outline Lighting $ 75,00 $ Signal Circuit/ Limited Energy Commercial $ 50.00 $ Signal Circuit/ Limited Energy 1 & 2 Family Owelling $ 50.00 $ Signal Circuit/ Limited Energy Multi -Family Dwelling $ 83.75 $ Manufactured Home Connection $ 80.00 $ Renewable Electrical Energy 5KVA System or Less $ 86,25 $ First 1300 Square Ft. $ 27.50 $ Each Additional 500 Square Ft. or Portion of $ 67,50 $ Each Outbuilding or Detached Garage $ B6.25 $ Each Swimming Pool or Hot Tub $ 43,75 $ Thermostat $Q 4' (U Total Owner as daffned by RCW.19.2$.261 (1) Owner will occupy the structure for two years offer this electrical permit IS finalized (2) Owner is required to h ire an electrieal Contractor if above said property IS for sale, rent orle88e, After reading the above statement, I hereby certify that I ant the owner of the above named property or a licensed electrical contractor Iam making.ths electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296468, The City of Port Angeles Municipal Code, and Utility Specifications. Signature of owner 01001cal contra or electrical administrator ❑ Cash W"'heck Date: ❑ Credit Card # ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 09 00000333 Date 4/15/09 Application pin number 063225 Property Address 110 E 3RD ST ASSESSOR PARCEL NUMBER 06 30 99 0 0 6910 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Application desc Circuit for dog food cooler Owner DATE Contractor NECA/PBTF WESTERN PROPERTIES ANGELES ELECTRIC ROUGH IN 1125 15TH ST NW 524 E 1ST ST FINAL WASHINGTON DC 200052707 PORT ANGELES WA 98362 (360) 452 9264 Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 144329 Permit Fee 57 50 Plan Check Fee 00 Issue Date 4/15/09 valuation 0 Expiration Date 10/12/09 Qty Unit Charge Per Extension 1 00 57 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 57 50 Fee summary Charged Paid Credited Due Permit Fee Total 57 50 57 50 00 00 Plan Check Total 00 00 00 00 Grand Total 57 50 57 50 00 00 INSPECTION TYPE DATE DITCH SERVICE ROUGH IN FINAL COMMENTS Signature of owner or Electrical Contractor X RESULTS INSPECTOR. Z] P 04/14/2009 12 43 FAX 360 452 9265 City of Port AnDeles.Permit Application Bulldinp DlWelonlElee _ l Inspections 32T°Eiist:FlRb $beet i P.O. Boit l lse fort Ange)es Washington, 99362 ph: 436111) 447 Fax -or) 4174711 Date:. ,_1.& 2 Singlefamily Dwelling amily or Commercial' _VCommercial Addition / Alteration / Remodel 1 Repair' A RECEIVED APR 14 2009 LIGHT DEPT ' Plan: Review May Be Required, Pie plate EigWca_l Plan Review Information Sheet Job Address:. Building Square Footage: .Cldf� Description of above �lol.!'�c�.tvG ,4-9 ./VJ D06 4WC) O)PA=44. Owner Information Name:' r Mailing Address: City: Phone: Uoense # / Exp Unit Charoe $ 93.75 $113.75 $160.00 $205.00 .$291.25 $ 2.00 .$57.50 $ zoo S 72.50 $ :86.25 $116.25 $131.25 $ 75.00 $ 69.00 $-75.00 $ 50.00 $ 50.00 $ 93.75 $ 80:00 $ 86.25 $ 27.50 $ 57.50 $ 86.25 $ 43.75 IA State: Trp: Q0001/0001 Contracbr I*zon Name: A Mailing Address: City: State: Zip: Phone: License # / Exp. Total (Otv Multiolied by Unit Charael $ Service/Feeder 200 Amp. $ Service/Feeder 201400 Amp. $ Service/Feeder 401600 Amp. $ ServioeJFeeder 601-1000 Amp. $ Service/Feeder over 1000 Amp. $ Branch Circuit W/ Service Feeder $��Branch Circuit W/0 Service Feeder $ Each Additional Branch Circuit $ Temp. Servlcel Feeder 200 Amp. $ Temp. Service/Feeder 201-400 Amp. $ Temp. Service/Feeder 4014;00 Amp. $ Temp. Service/Feeder 601.1000Amp. $ Portal to Portal Hourly $ Sign/Oulline Lighting $ Signal Circuill Limited Energy Commercial $ Signal Circuit/ Limited Energy 1 & 2 Family Dwelling $ Signal Circuid Limited Energy Multi -Family Dwelling $ Manufactured Home Connection $ Renewable Electrical Energy 5KVA System or Less $ First 1300 Square FL $ Each Additional 500 Square Ft. or Portion of $ Each Oulbuitft or Detached Garage $ Each Swimming Pool or Hot Tub $ennostat $ Z-7-5 &Taota/ Owner.as defined by RCW.112a261: (1) Owner will occupy the structure for taw years agar this ebeftal permit is fnallsed. (2) Owrw is required to hire an electrical contractor Nahove said property Is for sale, rent or lease. 1 0 Atter reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am Oaking the electrical installation or alteration in compliance with the electrical laws, N.E.C. RCW. Chapter 1918, WAC. Chapter 2"13, The City of Port Angeballmunlcipal Code, and Way Specifications. Signature of owner, electrkal eontrector or electrical administrator x �9 OCITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST5THSTREET, PORT ANGELES, WA 98362 Application Number . . . . . 03-00000369 Date 4/11/03 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 0630990069100000 Application description . . . ELECTRICAL NEW COMMERCIAL Property Zoning . . . . . Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ NECA/PBTF WESTERN PROPERTIES RAVEN ELECTRIC INC 1125 15TH ST NW 8147 MIDWAY AVE WASHINGTON DC 200052707 INDIANOLA WA 98342 (206) 391-1909 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL NEW COMMERICAL Additional desc . . Sub Contractor . . RAVEN ELECTRIC INC - - Permit Fee . . . . 178.60 Plan Check Fee .00 Issue Date . . . . 4/11/03 Valuation . . . . 0 Expiration Date . . 10/08/03 Qty Unit Charge Per Extension - 1.00 178.6000 HCH EL -COM 201-400 NEW SRV FEEDER 178.60 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 178.60 178.60 .00 .00 Plan Check Total .00 .00 .00 .00 - - Grand Total 178.60 178.60 .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 T \PLANNING\FORMS\I 102.15 (4/2002] 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. IT a UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMITINA 'CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPEI DATE I ACCEPTED COMMEN'T'S YES NO FOUNDATION: FOOTINGS WALLS III` FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) -SEP, PERMIT: # ROUGH -IN PLUMBING UNDERFLOOR/SLAB ROUGH -IN WATER LINE ' 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 HEATPUMP I __ WOOD STOVE/PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT M's: WATERLINE / METER SEWER CONNECTION SANITARY STORM ' PLANNING DEPT. SEPARATE PERMIT g's I SEPA: PARKING/LIGHTING LANDSCAPINGI I SHORELINE: - - - FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL ELECTRICAL - LIGHT DEFT. CONSTRUCTION R.W. / PW/ ENGINEERING FIRE PLANNING DEPT. BUILDING T:\PLANNING\FORMS\1102.15 [4/2002] 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION -R.W. 417-4807 PW / ENGINEERING 417-4653 FIRE. DEPT. 417-4750 PLANNING DEPT. 417-0815 BUILDING DATE ACCEPTED I YES NO Ij l CITY OF PORT ANGELES DEPARTMENT OF COT\AMUNITY DEVELOPMENT -BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 03-00000370 Date 4/07/03 Property Address . . . . . . 110 E 3RD ST j/y S ldme"e> ? ASSESSOR PARCEL NUMBER: 0630990069100000 Application description . . . ELECTRICAL ONLY Property Zoning . . . . . Application valuation . . . . 0 Owner Contractor ------------------------ --__________ NECA/PBTF WESTERN PROPERTIES RAVEN ELECTRIC INC 1125 15TH ST NW 8147 MIDWAY AVE WASHINGTON DC 200052707 INDIANOLA WA 98342 (206) 391-1909 ___--""-------------------------- Permit . . . . . . ELECTRICAL TEMPORARY SERVICE Additional desc . . Permit Fee . . . . 40.90 Plan Check Fee .00 Issue Date . . . . 4/07/03 Valuation . . . . 0 Expiration Date . . 10/04/03 Qty Unit Charge Per Extension 1.00 40.9000 ECH EL -TEMP SRV - 0-60 SRV FOR 40.90 Fee summary Charged ---------------- ---------- Permit Fee Total 40.90 Plan Check Total .00 Grand Total 40.?0 Paid Credited Due 40.90 .00 .00 .00 .00 .00 40.90 .00 .00 71 cf, 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. Sig nat a of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T 'PLANNING\FORMSU 102 15 [4/20021 BUILDING PERMIT INSPECTION RECORD CALL 417-4515 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULT OR CONCEAL AAT $)'ORK BEFORE INSPECTED AA'D ACCLPTED. POST PERMIT INA CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE C y"�j - - ! (� INSPECTION TYPE FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHTDEPT) SEPAR..—.-..IIT.# ROUGH -IN PLUMBING UNDERFLOOR/SLAB ROUGH -IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING ILING FRAMING JOISTS/ GIRDERS SHEAR WALL WALI S / ROOF / CEILING DR}'WALL 143^.R INSULATION SLAB WALL / FI OOR i CEILING MECHANICAL HEAT PUMP WOOD STOVE/PELLET/CHIMNEY HOOD/DUCTS DATE I ACCEPTED YES I NO PN'UTILITIES/ SITE WORK (Engmeenng......On) SEPARATE PERMIT#'s: N'ATF.RLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT k's PARKING/LIGHTING LANDSCAPING I RESIDENTIAL ELECTRICAL - LIGHT DEPT. CONSTRUCTION R W. / PW/ ENGINEERING FIRE PLANNING DEPT. BUILDING T \PLANND4G\FORMS\1102.15 [4/20021 1 I SEPA. ESA SHORELINE FINAL 1NSPEC'TIONS NEQUIRED PRIOR TOOCCUPANCI'/USE DATE I'ES NO COMMERCIAL 417-4735 417-4807 417-4653 417-4750 417-4815 ELECTRICAL LIGHT DEPT CONSTRUCTION - R W PW / ENGINEERING FIRE DEPT PLANNING DEPT. BUII-DING COMMENTS DATE ACCEPTED YES NO ELECTRICAL PERMIT CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 121 BAST 5TH STREET, PORT ANGELES. WA 98162 OWNER/APPLICANT SAFEWAY 110 E 3RD STREET Port Angeles, WA 98362 360/417-0551 T: S: CONTRACTOR SPARTAN ELECTRICAL SRVC INC. 6263 ELLIS AVE. SO. SEATTLE, WA 98108-0000 206/763-1144 ISSUED: 12/19/2001 PERMIT NO 7490 PROPERTY LOCATION 110 3RD ST E Lot: 3-18, VACATH ST,ALLEY Block: 69 ® Long Legal Subdivision: TPA Parcel No: 063099006910000 ARCHITECT N/A , 98360-0000 360/000-0000 PROJECTINFO Project Type: SIGN Project Value: $0.00 Occupancy Type: Construction Type: SIGN C Occupancy Group: Zoning Use: CSD Electrical Heat: ❑ Baseboard 0 KW ❑ Riser ❑ Underground Service 17j ❑ Furnace 0 KW ❑ Overhead Service Voltage: 0 ❑ Heat Pump 0 KW ❑ Temp Service Phase: ❑ 1 ❑ 3 VL ❑ Fan Wall 0 KW Service Size: 0 Feeder Size: 0 S PROJECT NOTES SRR-cicouit 4•`t /' FEES ASSESSMENT Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $34.40 Temp Service: $0.00 Misc Fee: $0.00 TOTAL FEE: $34.40 AMOUNT PAID: $34.40 BALANCE DUE $0.00 CONINILNTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE ITIS UNLAWFUL TO COVER INSULATE OR CONCEAL ANY WORK BEFORE ITIS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE2 l/ �� � INSPECTION TYPEI DATE I ACCEPTED I COMMENTS YES 1 NO DITCH ROUGH -IN / COVER 5�/Z3�zooz a/� SERVICE FINAL 1 <L/z3/o2 1 .7,q I GENERAL COMMENTS: PW -I Im IS [Awl ELECTRICAL PERMIT OWNERIAPPLICANT SAFEWAY 110 E 3RD STREET Port Angeles, WA 98362 360/417-0551 T: CONTRACTOR TANDEM ELECTRIC INC. 5836 S. 228 th. kent, WA 00009-8032 253/395-8806 PROJECTINFO S: CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 121 EAST 5TH STREET, PORT ANGELES. WA 98162 Project Type: COML. MISC. Occupancy Type: Construction Type: FEEDER Occupancy Group: Zoning Use: CSD Electrical Heat: ❑ ❑ Baseboard 0 KW ❑ Furnace 0 KW ❑ Heat Pump 0 KW ❑ Fan Wall 0 KW PROJECT NOTES 70 a. feeder for bank ISSUED: 3/12/2002 PERMIT NO 7565 PROPERTY LOCATION 110 3RD ST E Lot: 3-18, VAC.4TH ST,ALLEY Block: 69 ® Long Legal Subdivision: TPA Parcel No: 063099006910000 ARCHITECT MCCLIER , 98360-0000 415/362-0300 FEES ASSESSMENT Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $74.30 Temp Service: $0.00 Mise Fee: tele $39.80 TOTAL FEE: $114.10 AMOUNT PAID: $114.10 BALANCE DUE $0.00 UO—NINILNTS/ACTION NEEDED IT 3 Project Value: $0.00 Construction Type: FEEDER Zoning Use: CSD ❑ Riser ❑ Underground Service ❑ Overhead Service Voltage: 120,000 ❑ Temp Service Phase: ❑ 1 ❑ Service Size: 0 Feeder Size: 70 FEES ASSESSMENT Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $74.30 Temp Service: $0.00 Mise Fee: tele $39.80 TOTAL FEE: $114.10 AMOUNT PAID: $114.10 BALANCE DUE $0.00 UO—NINILNTS/ACTION NEEDED IT 3 ELECTRICAL PERMIT INSPECTION RECORD CALL 417-0735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE ITIS UNLAWFUL TO COI TR, INSULATE OR CONCEAL ANY WORK BEFORE ITIS INSPECTED AND ACCEPTED. f KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE ', .� DJSPEC7ION TYPEI DATE I ACCEPTED I COMMENTS YES I NO DITCH ROUGH -1N / COVER I SERVICE FINAL I I- I 7a- I GENERAL COMMENTS: Pw-11021514W BUILDING PERMIT OWNER/APPLICANT SAFEWAY 110 E 3RD STREET Port Angeles, WA 98362 360/417-0551 T: CONTRACTOR FIRE SYS. WEST 219 FRONTAGE RD N. B PACIFIC, WA 00000 000/833-1248 PROJECTINFO CITY OF PORT ANGELES FIRE DEPARTMENT PERMIT 321 East 5" Street, Port Angeles, WA 98362 ISSUED: 12/07/2001 PERMIT NO: 13088 PROPERTY LOCATION 110 3RD ST E Lot: 3-18, VACATH ST,ALLEY Block: 69 ® Long Legal Subdivision: TPA S: Parcel No: 063099006910000 ARCHITECT N/A , 98360-0000 360/000-0000 Project Value: $0.00 SFD Units: 0 Commercial: 0 Project Type: FIRE SUPR. SYS. SFD SQ FT: 0 Industrial: 0 Occupancy Type: COMMERCIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: CSD $100.00 PROJECT NOTES ADD (2) NEW SPRINKLERS TO STARBUCKS COFFEE KIOSK RECEIPT # 8243 FEES ASSESSMENT Building Permit: $030 Misc Fee 1: F.D. TEST/INSP $100.00 Plan Check: $000 Misc Fee 2: $0.00 State Surcharge: $030 Misc Fee 3: $0.00 House Moving: $030 Manufactured Home: $000 Sign: $000 TOTAL FEE: $100.00 Plumbing: $000 AMOUNT PAID: $100.00 Mechanical: $030 BALANCE DUE: $0.00 Radon: $000 This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with 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 recognized standards, laws and ordinances governing this type of work will be compled with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating the work specified in the permit. Signature of Contractor or Authorized Agent Date Signature of Owner (if Owner is builder) Date FIRE PERMIT INSPECTION RECORD Call 360417-4655 for fire inspections. Please provide a minimum 24-hour notice. It is unlawful to cover, insulate or conceal any work before inspected and accepted. Post permit in a conspicuous location. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE Inspection Type Date Passed Comments FIRE SPRINKLER Underground piping hydrostatically tested Underground piping flushed Interior piping hydrostatically tested Interior piping inspection Dry system air tested at 40 psi (24 hours) Sprinkler final FIRE ALARM Rough -in inspection Alarm final LP -GAS Underground piping inspection/pressure test Above ground piping inspection/pressure test Tank (container) inspection Appliance inspection LP -gas final STORAGE TANK (UST) ABANDONMENT Removal of flammable/combustible liquids Tank appropriately abandoned UST abandonment final PERMIT OTHER (specify) permit final GENERAL COMMENTS: Completed by Contractor: Test #I Piping pressure test psi Time initiated Test #2 Piping pressure test psi Time initiated 2/15/00 I1- 1 -UI 11:51 A" Z1-- ITS POPT o11GELES :3604174711 far BUILDING PERMIT - APPLICATION nm Beildbig Permit - Pre-gIoplicanor most beflkd ent compkiety. Please type or print in ink. If you have my gaestioss, please call 4174815 Applicant and/or Agent: Owner.- Address: wner:Address: ArchitecbEogineer: F) C -r= 5-yS . V-1, City - Phone: ZSR $"z�-1214 Phone: Zip: Phone: Contractor FIS J15"TeM5 VieS 1Liceave#FIPESvlI 44�F 9A!o2 An'e3: 1&3'� 924", Address: 219 W't'I-iT1k4a PP, f4.4'6 City: PRo.IEcr ADDR&4e- 1 N C) F--A,$T LEGAL DESCRIPTION: Loft- Bloch CLALLAM COUNTY PARCEL NUMBER- B88og Addmr Credit Card t: TYPE OF WORE;: D Residential o New CMM. o Re -roe o Multi-famiy XAddition o Move )4,Comraercid o Remodel a Demolition o Repair o Sign BRIEF DESCRIPTION OF THE PROJECT: �yr7�>`�uc_1cS 'PACt1C W� s�vlabn• - Credit Card Holder Norse: City: Esp. Data: Zip: 011u04-1 VMA__ MC SEKIWALUATION: o Woodstsve . SF. @ S_/SF. - f o Garage SF. ®S /SF. - $ o Deck SF. @ S W--$ C) TOTAL VALUATION S Af�T7 C 2�EXkt-5fe-4y-L-I -S v" �1.fl CO1ttDIERC1Af/RESIDENTLIL:.Occupancy Group: Occapsuitii i1.s.. Construction Type: No. of Stories Lot Sire: %Lot Coverage % Existing Lot argaagea /sq. B + Proposed Lot Coves'. * /sq.R::A TOTAL LOT COVMUOF PLANNING U5E ONLY: APPROVALS: PLAN Notes: BLDG. DPW ESA/Wetlsnd# o Yes o No SBPA Checklist required? o Yes o No Other OTHW__ BUDDINGAPPIWATIONSUBMITTAL: F.arepptkralosresmephmmv eigJ mwcmirlmeyabeaorep[djarmlew: 7lm Building Division an provide you with more detai W information on the application and plan submittal regavements. BUILDING PBRbIIT APPLICATION SUBNIITPAL: Your completed applicamon, site plan (far adddlons) and building construction plans are to besabmined to the Building Division. VALUATION OF CONS-ri-' ...... m: In all cases, evaluation amount mustbe entered by the applicant. This figure will be reviewed and maybe revised by the Building Div, to comply with current fee schedules. Cermet the PermitCoordinator et4174815 for assistance. PLAN CHECK FEE: Your plan chalk fee is due at the time the butld"mg permit application and conshvcliou plans ate submitted. Mother permit fees we 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 eipire by limitations. The Building Official can torted the time for action by time applicant up to 180 days, an written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application cm be wdended more than once. I hereby cleI Net I have read and esannowd this application and know the same to beesu' and torrent, and I am aathorlmd to apply for this permit I umferstand it is not the CA" legal responsibility to determine what permits are regeoet!• it scalar the applicant's responsibility to determine what permits am required and to obtain such M-1102_13[msroq Applicant Fire Systems West, Inc. 219 Frontage Road North, Suite B • Pacific, Washington 98047 • (253) 833-1248 LETTER OF TRANSMITTAL DATE: 1 1 /1 /01 I JOB #02-11-8409 TO: CITY OF PORT ANGELES ATTENTION: BUILDING DEPARTMENT 321 EAST 5TH STREET RE: STARBUCK'S COFFEE KIOSK PORT ANGELES, WA. 98362 @ SAFEWAY 110 EAST 3RD STREET 3 1]/1/01 1/1 SPRINKLER DRAWINGS THESE ARE BEING TRANSMITTED as checked below: ® For approval ❑ Approved as submitted ❑ Revised Copies for approval ❑ For your use ❑ Approved as noted ❑ Submit Copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return Corrected prints ® For review and comment ❑ ❑ For bids due ❑ PRINTS RETURNED AFTER LOAN TO US REMARK PLEASE RETURN (1) COPY WITH APPROVALS AND/OR COMMENTS COPY TO File SIGNED: James Ruark Special Projects Designer IVP �t `'C!F Fi.-iKL:iT TAFIpS-� r �NEl4 2: x I" GEI LI ti C, MELH,-Tj r:..EGESSE:n S�P i ol N� ~µ^ `Y 131Aral rvJk�F� Le�E!JD SPRIAK.LEL'S USEpAPPFOVPLS ZEOU ZED GENERAL- NOES h=FWEE_ i e' -'T SrM �T_i P- MF2./MODEL $IZE TEMP. FINISH LA�bp>' puAnLI1C:Ty oG r --Z AwU - B,GP:% F: -:w -FO TIE-INTD EXT,,; -- I 1 /�� NEW SF�11i}_LE(LS INTO FeE-FAS, �5—F�UIL,"i Illllol r:ar�E f 110 E. 3Q= s-, Fo RT A�yE'L-E'�- Co hTZ� WrTF4�ELITE=cMMEP11ALt�'-'T i(4zs�zsl-3141 Fire Systems West (11 Fla n;aye Fo.]J, NII, -."i N;e. B•Parf ,WA 98N7 -� PHO14E 29C -933 -1248•F1>206 -'r35 -C113 Dub, 6Y- "- paw Jo61-Jo. SHF�r T I 0 D� ,I "ORAIu -- I VE= - x.vLa= `ra�=1,_0 s�� .d r4S uiliol A,Vn w Oennn [muH "�uN`�UnME. No — ✓uE G7 ul �/ 'I °�•� it +j NEW .. �iyy �[ phfiRAG'r �I.ilTfi-:c LITE �oMNER-CSF}-co`+ 2- 1" F �QZS� 251-8\ 4\ NEW c_ Fire Systems West sPa.wel.ees usev nPPeoveLs eEouleEPI FF.EISE. a-FFE __ MFS /f'IGbEL SIZE IN oy� FIl115N I i -_-{ =viE% F5W TO TIE-!N'i¢ FTTEt. '9=mMye Pwd none• We B - PwTv WA 9M47 AM •Y. I/2 S' GHQ. 0 — G OVFP-I+aP,p g121b AN, LCWI� N N1 I i I w•.> aEz �E��tio � .=_e. s�wT S1N TfPE w. ea I LEI V hl y CcGE55 E'7 5/ P 0 D� ,I -- -13 PJtLT x.vLa= `ra�=1,_0 s�� .d r4S uiliol Oennn [muH "�uN`�UnME. G7 °�•� k -�A FEVJA`( Si0(CE 4�I4�'L �iyy �[ phfiRAG'r �I.ilTfi-:c LITE �oMNER-CSF}-co`+ �QZS� 251-8\ 4\ Fire Systems West sPa.wel.ees usev nPPeoveLs eEouleEPI �e,�v-.v_ NnrEs __ MFS /f'IGbEL SIZE TEMPI FIl115N L/4bP1>�OUAAI GI OF TY PoRT .4NCs. -_-{ =viE% F5W TO TIE-!N'i¢ FTTEt. '9=mMye Pwd none• We B - PwTv WA 9M47 AM •Y. I/2 S' GHQ. rEG C{{ - G OVFP-I+aP,p g121b AN, LCWI� -� PHOhE 2:,5-933-1^^<[0 •?At 906-]]5-OIP :z% HEW SPoINKLERS lwJ FSE-pA6. KIOSIL, PIP K 050kOWW FEK fiLl(a. EY OHT£ Ij,&A10. I SHED{ JANFs �. ul Z-II-a'ic �. I of /\ J J - CITY OF PORT ANGELES PUBLIC WORKS -BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 10/11/2001 PERMIT NO: 13026 OWNER/APPLICANT PROPERTY LOCATION Building Permit: 110 3RD ST E Misc Fee 1: $0.00 SAFEWAY $0.00 Misc Fee 2: $0.00 110 E 3RD STREET Lot: 3-18, VACATH ST,ALLEY Port Angeles, WA 98362 Block: 69 ® Long Legal 360/417-0551 Subdivision: TPA $0.00 T: S: Parcel No: $145.00 CONTRACTOR ARCHITECT $0.00 HANSON SIGN CO N/A $0.00 1533 SHOREWOOD DR Radon: $0.00 BREMERTON, WA 98312 98360-0000 360/613-9550 360/000-0000 PROJECTINFO Project Value: $0.00 SFD Units: 0 Commercial: 0 Project Type: SIGN/FREESTAND SFD SQ FT: 0 Industrial: 0 Occupancy Type: COMMERCIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: CSD PROJECT NOTES INSTALL 36" DIA SIGN TO BLDG, ADD 2'6"X8'2 SIDED SIGN UNDER PYLON RECEIPT # 8173 FEES ASSESSMENT 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: $145.00 TOTAL FEE: $145.00 Plumbing: $0.00 AMOUNT PAID: $145.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $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 construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date BUII.DING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. 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 ACCEPTED YES I NO FOUNDATION: J FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH -IN PLUMBING UNDERFLOOR/SLAB ' ROUGH -IN 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 ' HEATPUMP WOODSTOVE/PELLET/CHIMNEY /INSERT HOOD/DUCTS PW UTILITIES/SITE WORK (Engineering Division) SEPARATE PERMIT#'s WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s I SEPA PARKING/LIGHTING I I ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYNSE RESIDENTIAL DATE YES NO I COMMERCIAL ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R W ENGINEERING 4174807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT. DEPT BUILDING 4174815750 , y /1 70 J✓ BUILDING / / CWPPL WPD COMMENTS DATE ACCEPTED YES NO FROM : HANSON SIGNS FAX NO. : 360 613 9515 9.,0 BUILDING PERMIT - PREAPPLICATION W. The Builduhg Permit - Pmapplteatlon must be/Arad out eonyletely. Please type or print In Ink. If ,you have any questions, please call 417-4815 Applicant and/or Agent: Oct. 04 2001 11:54AN P2 FOR OFFICIAL USE ONLY: Data Rao.: /®-4-6 Permit #' Pro AP cmrydeta�t' "v Deto Approved: 9 P:A t 3o? - Phone: 360-613 - q s o U Owner _� ��w. y Toe.. Phone: ?40- q4 -7-0'7P? 9'PP Address: //o 65" 3 sT City: �s'&+ OZu�t Zip: 9836 5 Architect/Engineer Phone: //4�3�scloSHP/ Contractor 'LA,OSo-Aj � a Qm License#: Exp:l Phone:%* -Io 13-gi3b Address: / 6, _ r 92,9 City: Chi t/ts. a`c Zip: 93 83 PROJECT ADDRESS: /in � ei ST ZONING LEGAL DESCRIPTION: Lot: block: Subdivision: TYPE OF WORK: SIZENALUATION: o Residential o New Constr. ❑ Reroof ❑ Woodstove SF. @ $ /SF. _ $ ❑ Multi -family ❑ Addition o Move ❑ Garage SF @ $ /SF. = $ o Commercial ❑ Remodel ❑ Demolition ❑ Dock sF. @ $ /SP. _ $ ❑ Repair )(Sign o 'TOTAL VALUATION $ 4 ::{ o0o = BRIEF DESCRIP'T'ION OF THE PROJECT COMMERCIAIJRESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: Lot Size- % Lot Coverage: % Existing Lot Coverage, /sq, ft. a• Proposed Lot Coverage: /sq. ft. = TOTAL LOT COVERAGE: /sq.ft PLANNING US OIVL.Y: APPROVALS: PLAN/%r/ ��C Notes, I '34 'DIAf'1O-7ee. L.— vl:— tyy_C. BLDG DPW rl4A.).FIRE ESA/Wetland(s): ❑ Yes ❑ No SEPA Checklist required? ❑/Yes ❑ No /// Other: OTI•IER PREAPPLICATION SUBMITTAL: Your app9cdian and sire plan mast befd/ed out comp&005, 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 casts, 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 The is due at the time the building per application and oonsuuction plans are submitted. All other permit fees arc due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: If no permit is issued wiUlin 180 days of the date of application, this upplicapon will expire by limitations. The Building OlTicial can extend the time for action by the applicant up to I S0 days, on written request by the applicant (sec Section 304(d) of the Unifonn Building Code, curcenl edition). No application can be extended more than once, I hereby cerl�& that / have read and ecunrnred this application and brow rhe same n, be hve and connect, and 1 art outhorized to apply for this permit. I undersland it a not the City's legal responsibility to determine what pernhlls are required; It remains the appbcan/rs responsibility to deter•rutne what pernrlls am required and to obtain such. Applicant: / Date: & I' W. 1102 _ 13 (rev.1/961 FROM : HANSON SIGNS FAX NO. : 360 613 9515 Oct. 04 2001 10:48RM P1 FACSIMILE HANSON SIGN COMPANY, INC Mailing Address; PO Box 928 Silverdale WA 98383 Plant Address: 9438 Willamette Meridian Silverdale WA 98383 Voice Phone (360) 613-9550 Fax(360)613-9515 Date. 16,61- 01 Time: To: rrr, a V p!''fxAttn: �D�• Phone # Fax # Number of pages (including this cover sheet): Comments: 44�iLe !s r o J14 I ,44d .44 r3 4 2044 011--WZICI-T- "Ye-- k.� &'J / 4 /D/4 9SV, 6e00, A&C ( '.LCC.. CJ/. 6-v 44('C'-ro- D Signed r If this fax has reached you in error, please call (360) 613-9550. Thank You! N d E 03 m CD CD m N V m U 0 0 Z X Q LL Z O U� Q m CL LL Ir s><xr s I a � PARTIAL EAST BUILDING ELEVATION 3/32" =V-0" Swma Vises NIS G— EMYew 36, -- lasmrtuasm.rlo, X1-4 m 9 M STARBUCKS COFFEE TO EXISTING OF PYLON LOGO DISK sdurassaraaprseanr SPECIFICATIONS: Q MLLE kwa imomely ih"mama euc�sntledwlidwt bran disk Logo dit a.n bed'daep /do" 8 padcflWhoo. esh§dW woHt setln dnbla Bledc pdyvatPlune OF Wbe 9116'N1aW ecrytc, I'BIeoY idmapvAlh savors Med scaysnmlirer e�lrq- Gmp•1a of Ingo W Da lcl aaMae 9N TreruWoant?c>WhslvlmA. COffb snow gam Whks d Rab Greer. 93M76laec5,gmuW Lugo W slaw that VAIm c161a: tl3 M boa Q a•G ® [ro IYMM Mo logo dek•MM BrIft N500 N0 EGL Mie. 30 m. wn pas gdd P rwih 12ts Eh[ W lbs5EhL w'amdln l'111IN e11al:1in, ('>!68U h0U61ljt b [a Rlmery wirem mnd•na lri'nyatl mdUlb xd RisA maum 1n udI ahh 3R' Yg bdm es mau red TITLE: ELE10At1011s211EAM 91R NJ1N DaL: APPm�� Styr ,M oq,m A by the Er.b lCoati, gMVMt6rs I eRrebry, eULpM nr eipianm local ads Ck%"Wi swbih in frkr®y to bs Wthn a3ht C eian (van Lxgudes F..- .,,I, andasu,) REF NEC 110-318]800-2 BOD< 8lgnnge Cmeulting (1Permits /Aulanaee PdawiyemMraleoron tl oaaduA ntNmumd REF Deslga NEC 0D 6. SOOdI Pasat ie, Peojeei Limagemenl C.B. Blgn Corporation 91011 N. W J6th St. Brattle, W! BO 1 L9 Volae: (905) 0409090 Pea: (2D6)983$401 L Ln M W CD w M O CE LL (n to +J7 2 O z Z Q S E: G a LL a m 1W j fr EMISTINGASIS 1 rr DEEM ' / am � � P�190VfefY r.f H"MitV } MDR 90 FOADOA{ 3(AE 114%)-V f.P R90Va" 1 fgoNTWWW fro--"" FAMCAIEPNDWM NEW ImiNkm 00A19LE FACEILLLN CABIlFT510N ov E%t91u3i OF PiLIXi suuA ALGA CANNER FARM V MNC x x0tLY CIYiEN Y�NYL.IGYr.1a Fl.0 ORFACEN7ItUA1 AB BEAI�IPE0 400YE lEXA.V 51GN FACE VA M 3Y1AYTid FgLLY OREEAINNTI OVEAI.AV mini GIGNimmzTINaontu G F4E9CAYENEWRE5 S rswr touxTCNEasnxa V FV nmmQ0x9 Rrrt3: PYLONSFON 6lg"re Cr ..thug Permit. / P.rl.00ei 1 umhw Pro)egt LLtlBgume Gt C.B. 91gn C.FPgrett . 8109 N.W.VBth 9t. 98,111., WA Bei t7 vmq.: (400) 040 VUa 0 raw; (209) 7895401 BUILDING PERMIT OWNER/APPLICANT SAFEWAY 110 E 3RD STREET Port Angeles, WA 98362 360/417-0551 T: CONTRACTOR CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ISSUED: 10/11/2001 PERMIT NO: 12945 PROPERTY LOCATION 110 3RD ST E Lot: 3-18, VACATH ST,ALLEY Block: 69 ® Long Legal Subdivision: TPA S: Parcel No: ARCHITECT ELITE COMMERCIAL CONTRACTORS 274 SW 43RD STREET RENTON, WA 00009-8055 425/251-8141 PROJECTINFO Project Value: $25,000.00 Project Type: ESPRESSO STAND Occupancy Type: COMMERCIAL Occupancy Group: Construction Type: Zoning Use: CSD N/A , 98360-0000 360/000-0000 SFD Units: SFD SQ FT: MFD Units: MFD SQ FT: 0 PROJECT NOTES INSTALL A FREE-STANDING COFFEE KIOSK receipt#8174 FEES ASSESSMENT Building Permit: Plan Check: State Surcharge: House Moving: Manufactured Home: Sign: Plumbing: Mechanical: Radon: $391.25 $234.75 $4.50 $0.00 $0.00 $0.00 $63.00 $0.00 $0.00 Misc Fee 1: Misc Fee 2: Misc Fee 3: 0 Commercial: 0 0 Industrial: 0 Garage: 0 0 $0.00 $0.00 $0.00 TOTAL FEE: $693.50 AMOUNT PAID: $693.50 BALANCE DUE: $0.00 Separate Permits are required forelectrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized 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 constru (� D Signature of Corftractor 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 INSPECTION TYPE DATE I ACCEPTED VES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATEPERMIT k ROUGH -IN PLUMBING UNDERFLOOR/SLAB ROUGH -IN WATERLINE GAS LINE BACK FLOW / WATER AIR SEAL LS 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 (EngjnenglAvision)SEPARATE PERMIT N's WATERLINE / METER SEWER CONNECTION SANITARY STORM SEPA LANDING SEPARATE PERMIT N's PARKING/LIGHTING I I I I SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCVNSE RESIDENTIAL DATE VES NO COMMERCIAL COMMENTS ELECTRICAL- LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEFT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 4174807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 41 750 L / PLANNING DEPT. BUILDING 41 ,2—/ BUILDING C \APPL WPD DATE ACCEPTED YES NO tae% BUILDING PERMIT -APPLICATION Ro-it��ty_ llet ANe�t TrMeBud&gPenmir-Pre-eWicaton~ be)VW out conrieldy. orelsww 'we+ewas Please type or print in irk. uyoo have dry questions, please can 4174815 - can and/or eat: - N C Phone:L—�`�� ♦� i :.v . 'e1 a V•2, L_iv r w., " • � . � _ � PROJECTADDRNSS: jay_ - lio .1= LEGAL wW..wk-a:t ....c c: Lot: Blink CLALLAM COUNTY PARCEL. NUMBER f redk Card Holder Nave: BBQ Addre s: Cldy- zip:98-cis- Phone:3�2'sL�'/Yf Zip:!Z&05 ZONING: Credit Card* FaµlkNe: VISA-q��[[ MC nfV�`f SIZEIVAL.UATION- a Woodstave SF. @ s lSp. - y" W a Geroge SF. @ S tSF. - S a Deck SF. @fJSF-=f a TOTAL VALUATION f ZNSMU. R FAQt ez74:.aryc cbFVE� tr, +A x, CkErfn' m fad-I'rn�r TYPE OF WORK: a Raideadef a NewConstr. a Re -roof a Multi -dimity a Addition a Move c cammacw o Remodel a Daenuinioo a Repair a Situ BRIEF wM..r.,o." ♦h'..: a OF THE PROJECT: n i. �, dd llhJG31 DEN 1IAL: y F: Type No. of Stories Lot Size: % Lot Coverage: % Existing LoiC /sq.IL+pmposedLet Covecege: /sq.ft. - TOTAL LOT COVERAGI /sq-* PLANNING UM ONLY: APPROVALS: PLAN Nota: BLDG. DPW InRR— ESMwalm l(s): 0 Yes o No SEPA Checklist tequbed7 a Yes o No Otho GTHER,T BUU NGAFPLiCATMIRY AVITAL. Tht Building Division can provide you with mote detailed irfa nabon an the application and plan aobmitlal requirements. BV"ING PURMIT APPLICATION SUBMl7"1'AL: Your aanple ad application, site plan (for additions) and building aaustniction plain me to be snbmitmd to du Building Division. VALUATMt;N OF CONSTRUCI'M: In all coca, avaluxboamecamt nuud be entecedby the applicant. 710111im willbe mvkaaed and may be revised by the Building Div. to comply with ecumat fee schadalm. Contact the Pamit Caerdlanew at 417-4815 for assistance. PLAN CHNCK FEE: Your plan check faa is due at the time tha building permit application scut conheeti n plans are Submitted All other permit fees we due at the time of permit is mance. EXPIRATION OF PLAN REVIEW: if no permit is Wood within 188 days of the duos of appl)ataioa, this application will expire by limltaticna. The Building OMcW can onctead the time for woos by the applicant np to 180 drys, ore wren request by the apldicaa(sve Section 107A of d o 11aifoom Building Code, cutrmt edition). No appHoaim caa bo examdod mote than once. I hereby caro ora I have rend and awnepeddds agopllcatsm and beow dee sante to be two and cared, erred f an aukwke,dto aPPIY16r this Pers& t wa*rstand k is rant dee CA" kgol reVensiNfity to doewtae who Ns are ruqubed it rexwh a des appt&mu's respassi6dity to detwoebw who permits are requbed ad to obars such rw-tloi t3(w5Ati Applicant, :=- Once: o O �y�rrVECgvc - aWK709-S 4/n61NC Cs>Nr y Soo & KP f L ttHl F[�Uttz� �f� �zr�� 24-0 C,.., )l L .23(/& U1+31ar Ivo l69--70 Sra.2� OF Sw y3kb ,Pv,�, y.25 -251-6007y City of Port Angdts Applicant Project Review Sheet AWkaut ZTrr- C..,.,.,,.� ad&= : //fo O, nw. -1�4t=t5tusry &C, PropmWon: Is me prepared use lined as a ^p smided roe^ or an "necessary use in this move? ❑ yea: fie o no: req#m PD Is this the Only use ftsidess, msideex. etc.) fm this site? ❑ ark '°°"" ❑ yes: aa: requites PD Has them ever ban a pkat been submided and is mppraval�'1 ' or PRF) gyswad for this site, err hes one ❑ YCL m9ukes FD review ❑ no: ok Does do popommd use require a newbamess hatim e9 review ❑ yes: mq#m CC O mo: ok Does do project extend iota any required sabaelo Or erasreview axtaiar)? anY bt Baas (inteiar ar ❑ yer requires PD ❑ no. alk Donp�o�cct pmm�t�d Fou *0thia atlmvaaceormneethepmpatymexceed crrverw in none? renew ❑ Yes:1egYO°s PD 11no, ok proj m es tt a l � � addiiimat "dun a mma desigdFmdsupe unpovemmts mvaew [3 yes:PD ❑ no: ark Does the project dimmete any existing pselong spacaal renew ❑ Yes: reqiumms PD lQ no: ok Is the Project located vvdbm 200' dthe abardirr67 renew ❑ yes: lOgmres PD Rl na: ok Are alae my commnmeaWly sms t" arses an at within 200' of the pmpety, Vi s: renew . ❑ yes: requura PD no: ok • tacltmds or areas �standivg vera (yea tared oraessooal); • adems (year round at aenaodk a slope of 40% or yes+' . ' pressor,aees ma att haw vidgee a pea gmmmd movement or aadm7 Have all Ove required xubmittds been provided by dw apph art? D site Plan ❑ Yes: ok ❑no: D Construction Drswinp mak 13 a le ioW Plea rc•) o Eumv o �r a • Laadsespol igffias Plan o Other Ptwutirr9 DVarOMrrt review it requirmi( Ute promssibW Mm may be cd mdad {f it is determdned a separate Plamla. POWHO(+J b annded, rM PtomwwDspmatmntpmiWs) was be app om of pstar to of ttaumrce ofay aMrpermaL .. ......::: ...':.: i-. .-..... ...Orr. .. .N.�v.� Y Permit Calgary A (an reverse arae) Buming permit K Maga Tracking M Route to: O BD O CC O FD O FD O PD O PW O File O Other staff halide Date Comrpkdm of alae fww a requkvd for art carrgory lb, 2 d 3 pvmft rrgmaedfa►ategorylepenmttrmAusemyraadtnraposmsfoleh War oaag�mncyy •tmL� fibll W+rsl CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: / Date J/) `� —�' / Timp �� 3C� Received by e (phone, person) Location of Work to be inspected Name of person requesting inspection ✓ t.. Address of person requesting inspection Type of Inspection (circle appropriate one): Phone No. 06t- ss0-55� Permit No. / ` :' 4i/.S Sewer Foundation Framing Chimney uming Final Sewer Excay. Other -�1 INSPECTION NOTES: /�'/ Inspected: Date /G/6�O) Time �•�S'�s+ By /e Remarks: t r /ltl�CrSCtsa/ytLGc�•�9 /� ) J L/ RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: ❑ Unimproved ❑ Gravel ❑ Asphalt ❑ PCC ❑ Other ❑ Repaired by City ❑ Repaired by Permittee ❑ No Damage Found (Continue on reverse side if necessary) Work Order # ❑ COMPLETE ❑ INCOMPLETE STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date lf' �r Timp 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 / :j _ •- — , f Timp By Remarks: r � 1 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) A P I II PL L?f I� � /I / I A SOF 16- 1.111 CZE GUARD T I OPTIONAL WHENl.t I(C FACE Cc) FACE / ! Y._7 �.,Ly, ILII�� III _ I�.— II LY.ILRGP 6b L J & lops 3 C IPL2 _ - C7 }.� _ ,I 1 - (PL2 CABINETS P!' P_Cl FACF SNEE'E GUARD I OPTGNA1. WHEN_ 2 RFOUIRFD / ✓ EXT[, RIOR _ P 1 I ■ OP I: -Li'lIJ--I, LL' -ASE fit, o , CORI) Se _ _ POS d — COUNTFR t, TOF /` --- Pil'FACE t— PF ACE PL? TOP . FACE C ,, 109T ANGELES- Consaucfion Elnns CONSTRUCTION N(ITw 1 DUMPER IS TO BE PLACE? ON ALL OUTS10k CABINETS AT A CENTERUNL OF b" FROM TnE F.CCR. THESE MUS; BE rNS-,A�LED TO PROTECT BAR 2 BROWN ANGLF MUST BE PLACED ON UNPROTECIID SIDE OF ENTRANCE AND ON ANY VIII C11h5MIN Id 4pCn p�SACC(] !r,m t'emitter AIMINAnd perch Am, WiMmgaK rad .r m mereaher ayul4W to INIM.pn It emms Eq eerd Glan; ipeclll.y�p�� dMl pNm dab, m Imrn pave qng III IW Slid GR1YIf W 1fi4P fi I'.mLCn pf ell ¢�N qqd OfdNgpIXS � C11CM1 ISiC11oN 30iIW-ilnbn&Wdingfadnt 1.1\ noPlaval DAR 111- !' ,I A, E'f,'II I'1.1�P11 ..-Cl lln J - ITIII' STNV C AIF ICT, E - COPFdE GRINDER ?., ..ES G - ICE MACHIM H - CUP HGLDFF' G:PPT ` NL;; LCESPRE= J - UNDER COUNTER REFR jL,lra:" L - SYPUP OISP'I AY M - PASTRY CASE N - MCCHA PUMP CONT4INi'2 C - POS REUSTCR - �,', X it - PAPER TOWI.L DISH T - ELECTRICAL PANEI V - UNDER COUNTER kFFRCUC41D4'i X - WATER SOFIWER " - W:rp 73 A°„ L - WATER FILTER LOX 1 THIS MERCHANDISER LS ROUT 'Al COMi'L'AXC£ WITH NSY STANDARD SO MU IJS;ING. 2 UNDER COUNTER OP•Y FTORACE 23' LAMIXATJF 'FIA. -SH MA: ERIALS i r rC7 STAINLESS STEEL N as 03 FINISH P-1 ABET LAMINATI - PRINT 1030 FIBER PL2 PIONITE JAT121-S' "MOROCCAN FRESCO' l PA'Df POWDER :.OAT - .NETALIL COPPER SATIN_ CORE CORIAN - DUNE DFSICN PORTFOLIO 4 wa HALL COVERING HCS sLYYL WDLL C�VPFLNC M1 OCTANORM FXTROD ALUM PAD) FINISH ui rmwuAna cUN*aura 1.4 oP ogzoKo er nrs Uavr.N, _ UNPROTECTED BOTiOMB 1HA- ARE EXPOSED TO PREVENT D'AMA0F a.xse�-am,.,e,-,a; uc>p .L-u+�;?v_u vc ! tit'.A11TINC AF -PR, --;'AL RFath Fitt') 3. ALL STORAGE AREAS TO HE SFALED TO COMPLY WITH NSF I arc L ANT Al oTG1, ueuurnMANC. UK REEMMUCnpN I mp uA vus M.0 ARF E K'&e REgA. p) AVU V SIGN, DATE AND RETURN TO LOAD KING NTC,, INC 4. BLACK VIN YL TO BE WPAPPED AROUND EN LIRE BAR AE TER INSTALLATION mw unc arc CRMT Aro c QNCATw rc w11 NFOR_ w e;. 21_eIS a ..,I_ .1) .T Tm FSX N ,m -w ,'omr. AP, reva; Doe rn� I csnn or U)A, zinc AICT �c.11 PROPRIETARY I INFORMATION PART 11- LO -�1 D � G DIME NSIONS ARE IN INCHES P09pt b5W Ire) WRf AVfR 17 JAA:S}N'.II R ]::C' T --- — i --� --- TOLE_R ANCEs UNLESS NOTED STIFRQUISKS ESPRE`rSC TjVl__ - y_ )�•: ca+.mr ISrCM•WP-t I--,tNnN. wvO PP(PW[ieP.N tr, L"Ituuty. ��.[aa +arvv,=a[ruaa.c v¢ w4:�a I.No Al[ sAtr[ Plo, n, c?r cFrvr.A. Pcxovn p ,µ,[c'�. -q..—A..-....� 7'-0!/E" B c u:,, :cu:u+x u.D v,wuularnnau v r� wt<v- �' ---- - u�au�'rc amcYs Is racvlelTEu wluv+' ws o>;n �:t�, c. _ STAREJUCKS ! r' tl v F rt a ^'moi -a• 1-.---I--.--._ NON-,, LUM,NA:L_ It'=- '_; Illi s>e aeuc r.E� _irii nI�;V� I� / � AA9ULK'� it —� 1 Hft'EP ILt' l I F000 HOAkD' : 7 jED, TOP t [ C1 FACE 1� , =�:j FACE 1 r I I I�� III ��II I�� IIII V l ELEVATION'l�z �J CABWET 12' 11 13p6` .n" • ,.y_,• L UVINAT G S'SK"s I Ml -- z"—Ih- 1 Iii i — I erxnsae:t� ii s-Akv�^rs .� SNEEZE ad HrvrkAcr �— — 1fooD HonkD SNEE/E C.VAVD / / I 4h�, —{I .Si 1Z 4--r GUARD (PPTIONAL) ��� -- — T'&� riOa — -'_T-'-- I vl2 r AC: SII'— tOP Co]r w Tr Tnll-rTT-r-r tTlmlmTrI._-- 1 lr-1 till III Y_ til n Ti �m 1 - n m IIII ��iII I VIII II �� I�++�IlIi�� 1 IIII 9p m in m S''a Ili IIII+!I IIII I III I[I'L21 rL_l P'� I 0,h I 6 III IIS IIII � �i�I�I � I� I�II�III��II�T� I .ry '.'., I I %I: -ti _I m ILII IIII IIIii�Ill IIII I �' j �1— iwlnlllllUillllitll `_— —.—! dlI II iI IIIIIAi III / I i l I l l Illuilll lltl I i i II I I I I IIIIII,1(l�,l i..�1'. )}J FA^i ��-'/ r„�:Ei f_I- G i FAf.E F al.Acrc HNr. ensE ELEVATION /� ] % / "�— � r0(jt�{.P,I[iyq� IilFn5MA1rJN �y cLL. A i�i :� L..T 1999 iFAo on NOT nus JCATE I\^ (y� — — t DIMENSIONS ARf IN INCHES I P .' 'Ill[ ": +nwssmm. 0.:EmA — ---- _ _ _-- — T:_ERP;USNSE5: N'-0, SiARBi1C 5 ES rtESSO UNIT — LIT iSHr 2 r J -_-----_--_-.---.--.-----_— - -� iRAC TOL t 1,. 3? kojj.� r. _. .._. - I I I � m 3z 11 i l ,,-18 23132-}- -14----i- -14-- 23/32-4 _�ITEEMM OTv ' ^575821 �3?7582 CAPINEi r.6- 2 1 I 1392251 339.1251 SINK TOP A -S7 4 1 _ 1 L339'5-6 I. 33953'6 LAM KT' -- ..1:2 SKI5 OPbA r 1S � L..� yr wr» A ; ^aussEJ #, MAP`N_ aOGt ON FNCIIT AND SIDES Vl11T1 A A" BACKSPLA;,H 15SA E,'S 63 E-US� W,Tn 6-0 b -F WAIL PARTITIONS AND `IaMP[ID DEPRESSIONS FOR GRAIN OUTLETS. ALL ARE WELDED ,NTEGR A_ :D SrNK TOP CABINET 18GA S/S #S POLISH W 1H A 1 .1. /2 S/S CRAVE, 1 LHG WELDED 'NTEGHAL TO GATT{ER FRONT PANELS LAMINATED W/ PIONITE #AT121 S -MOROCCAN FRESCO-. 1-5/8 ROUND S/S TUBING #180 POLISH WI I' ROUND S/S CROSS 'AILS W[1 OED TO FRONT AND BACK LEGS, SUPPORTED MTH L/S GUSSETS AND IEGSOCKETS B.A'-ET FEET CORROSI0,9 RESISTANT MATERIAI WITH ADJUSTABLE HEIGHT, FIXTURES AND PLUMBING 79 75/32 1FISHER Ft UCET #3751 LK # 131036B PLUMS WTH i;2' CGz_R T'JB.NG C('MPCNEIT 4AP7NARi _ -14 j r -5/S SINK TOP j (EVER DRAINS WO7A10PLUMB WITH 2" COPPER TUBING X�-S/5 APRON t V S/S SOON FRAME_ '.59TH tL \ LAMINATED INSERT �,� - FRONT INSERT PANELS LAMINATED ` J J PION`E #AT521_S ij'I "MAROCCAN FRESCO" LS/S FRAME PANEL _ S/S nw=,=.:PAVE S/S SIDE FRAME --.,� C.:P ON r11 TOE KICK TIC -I �h X 8 CUT OUT �6 X 6 CUT CUT , ,I,ry _nM1\AEC NSE;. - m Nrmunnd T.KU N OR rn°a. Br Mrs ooau.1 - -- - - _ IIs cdooExsn CdJDE0Y .wo PRCS c r SIT wAo 6NE DRAWING APPROVAL REQUIRED VEE CCMGNT Y1 pE9Wl YANIUA�:MPINE UY GE^a UllClld x o t..1uFS a:o-n wt l TWs IN�x a lure v i S'G4, DA-- At{O NE^„Ph TO _: AC ',Kih Mi G. INC. lON X TO MGC COYPM'x µE) AlIIWT FN fF MI5 WFgG- Y.nd tE oW. 11 vaomel1 w.l ra Parc' xrurtcu Customer A rovah cdstxr aF W. arc vrc couPAxv pi+ Dote I SR:N'P:ETARv NFGRMA ;ON ,! T) 7 T PARI NO — -- DO NOT DUPLICATE 104'11/ r�l �' %> j r'_ prMr NCION_ ARE :N INfNE� �.s \ >vuax asor rvl rse.vp n_ yp;,;r,�mr,. ,L •ae: _ TGuPA!iCES LNLFS' NDiE �'w t CIN!lC rAPINCT I -- LEC'END: "A" -- L7.ECTRICAL STUB -UP "B" - (72•'x1:;") FLOOR SINK STUD- UP COLD AND HOT WATER "D', -- STUB -UP COLD WATER STUB -UP "POS" REGISTER & DATA (PA'R CUSTOMER SPECIFICATION) NOT F: ALL PLUMBING AND ELECTRICAL MUST BE DONE IN -ACCORDANCE WITH LOCAL CODES. I W-2 I JS r I +LL xuwnna.:a:axm �ry � sacs: ^� rvs L�4n- ' : CJ1PultAG GMIYT'P4 M9 hR.YWE:Mt . aO+P qx ufc CWP.wx nll OE9ta1 4M'u,nciUMtx4 uY, xm4N'�,nvr u+0 A:1 Y1ES PIIJli( taE {YPxE9.Y xE9iY4P Bi uln Ip -x +o It. 1 vaoxa- Rrvw- mz Pwa. +cl^nn __ [M:Ext V Lcu, KmL PF I 1.1 NO I -- P PRIEIARY INNRMAiION ^ {j r T 7 T T� F<kt Na _ OAD DIMENSIONS ARE IN INCHES �— Pnem .asm us; xtlnrew s, uo saw.Lc rt. - i � iT01.ERANCES UNLESS N_OtE6p I QT n IY,�r„�c c CPu_c�n I v— a ,''x'L' W,17A RAW STI,IP—Uo IAS. 'NATER FROM —°TOB—L'P I I I I ►i NATER FLTER I Iw L - PI UVBING CHART WATER AFTER Flt —.Lf'S AND DESCAI ER IWATER SOFTENER M►I ' — ESPRESSO MACHINE I— i'— I % j I uG An ------ —00.0 PLJYR;NG BY CONTRACTOR --- — — — — — — HOT PLUMEING BY CON7RACIOR PLUMBING BY I OAD KING 3 COMPARTMENT SINK i -Ff+ P.I r), I I�An, y -.f, WA`:� iROM WFTco FJLTER S S',II IES 3 cCmc AF'rmr NT SIN! HAND SINK, DINPLR WEE L (ESPRESO) 2 FRESH COLD FII TERED CONNET,TIONS TO COFFEE BPEWE! — FRESH CDID Fn T7PFD TO WATER SOFT & ESPP,ESSO M,CHI'vE 4 FRE':H COLD FILTEWF7C TO WATER'OW=R 5 FRESH HOT WRIER CONNECIIONS FROM 12"r12" STUB -JP: 3 UMPARTMENT S,NK LAND S!NK 6, DRAIN CONNECTIONC FROM 1HE FOLLOWING EQUIPMENT TO CLOSEST i.RAfN FLOOR SINK ESPFrSSO MACHINE .CE MACHINE SW/C DIPPER WELL (ESPRESSO) 7 CONIRACTOR IS P,EoPONSeLf: FOR ANY OTHER ITEMS NECESSARY RD CONFORM TO ALL COORS (IOC.AL OR STAIE) EXAMPLES WOULD BE BACK FLOW PRECENTOR OR SPECIAL DRAIN REOUIVEMENTS HAND SINK i�----- --- —, I I I I I DRA:N TDROJOH "B" (12" X 12") FLUOR SINK u arm.xnm cw-uvo m m auw>� ei Ime oow�a' i a cwmrwm cavr;own.0 we magl[rxx+ ev to � arvc. Ix" camw- a or.a uu�xncnn+.•v, us;, xmax;..na xrvn xu vus a;ta;rs. .w[ rzraf mr �Zn�D a+ xno ;n +ar., ,,,xc urc. uvaon 1. mryo ms ry=v- uxnw ra Cl Is raonie;-m wwN)cRT 1rns rre rF w -n —Icici NL+ ----_—— j � ; [IDNnTDUPLICATF I,O1-'1-D DIMENSIONS ARE IN INCdES _C -- -- — I , URANc[- N--Ee l � �. e',gqg �] FLUIJILING ASST FRAC TOL f If'S2 WATER TOWER t — ! --�I►' COFFEE BREW%R � I DRAIN THROUGH "B" (12" X 12") FLUOR SINK I ----}Irl ICE MACHINE --- � —1 ' I DIPPER WELL (ESPRESSO) L uG An ------ —00.0 PLJYR;NG BY CONTRACTOR --- — — — — — — HOT PLUMEING BY CON7RACIOR PLUMBING BY I OAD KING 3 COMPARTMENT SINK i -Ff+ P.I r), I I�An, y -.f, WA`:� iROM WFTco FJLTER S S',II IES 3 cCmc AF'rmr NT SIN! HAND SINK, DINPLR WEE L (ESPRESO) 2 FRESH COLD FII TERED CONNET,TIONS TO COFFEE BPEWE! — FRESH CDID Fn T7PFD TO WATER SOFT & ESPP,ESSO M,CHI'vE 4 FRE':H COLD FILTEWF7C TO WATER'OW=R 5 FRESH HOT WRIER CONNECIIONS FROM 12"r12" STUB -JP: 3 UMPARTMENT S,NK LAND S!NK 6, DRAIN CONNECTIONC FROM 1HE FOLLOWING EQUIPMENT TO CLOSEST i.RAfN FLOOR SINK ESPFrSSO MACHINE .CE MACHINE SW/C DIPPER WELL (ESPRESSO) 7 CONIRACTOR IS P,EoPONSeLf: FOR ANY OTHER ITEMS NECESSARY RD CONFORM TO ALL COORS (IOC.AL OR STAIE) EXAMPLES WOULD BE BACK FLOW PRECENTOR OR SPECIAL DRAIN REOUIVEMENTS HAND SINK i�----- --- —, I I I I I DRA:N TDROJOH "B" (12" X 12") FLUOR SINK u arm.xnm cw-uvo m m auw>� ei Ime oow�a' i a cwmrwm cavr;own.0 we magl[rxx+ ev to � arvc. Ix" camw- a or.a uu�xncnn+.•v, us;, xmax;..na xrvn xu vus a;ta;rs. .w[ rzraf mr �Zn�D a+ xno ;n +ar., ,,,xc urc. uvaon 1. mryo ms ry=v- uxnw ra Cl Is raonie;-m wwN)cRT 1rns rre rF w -n —Icici NL+ ----_—— j � ; [IDNnTDUPLICATF I,O1-'1-D DIMENSIONS ARE IN INCdES _C -- -- — I , URANc[- N--Ee l � �. e',gqg �] FLUIJILING ASST FRAC TOL f If'S2 � .>>T >` i�� —.. _ _ I Y, 3n, mow,, /„��'- _ _ \i� �, �i l' n �y Lam..! e f.. � .l'� �/” ��. � / LEGEND "A" - ELECTRICAL STUB -UP "B" - (12"x12") FLOOR SINK "C" - STUB -UP COLD AND HOT WATER - STUB -UP COLD WATER - STUB -UP "POS" REGISTER & DATA (PER CUSTOMER SPECIFICATION) NOTE. ALL PLUMBING AND ELECTRICAL MUST BE DONE IN ACCORDANCE WITH LOCAL CODES. NO I E. C NO onncines it - 14'-1 112" J 2 5/8 Il'\ wtr I —1'-6"— 9,-2 7/6„ .vi mmwunw cwrNXm m . Rsn el TMls omlurn: Is cwsowm carvnownu rw mEnuerxr ar mn arvc urE couv.wr .w. u.wurNcnrmlc ug. vr➢Xooucnory u�o nu :un nlw,x .wc sxvXcgr a�nscE er wxE ro T% �L.o rcwc urc co .wE rnwlwunnv ar wc�xrw- unnw ro mxws Is Is vNaem*so wmwr me vww ww*Iw T-- PROPRIETARY INFORMAPON { DO NOT DUPI ICATF T'4Xi (f LO.UI XWL T O �I Tl TIT T r/'� L !-i D S � 1 1 V h NfL CWFA4Y ppaT No 'I _ n n�UYiU Irl 1 I,I DIMENSIONS ARE IN INCHES vaeox asa usr wecn�cn sr uaxxxu[ a shat 1 ._ r0l T— - TOLERANCES UNEEss1/3z NorEo RAC TOE } STARBUCKS ESPRESSO UNIT—LH, 11'x14' sHT 3 of 3 REO DECTOE } 01 STUB- UP LOCATIONS ANGULULA{�TQ�.-} S_ _ E., f, T 1 oocuracxr rva 1 , ISOLATO :POUND RCPI FOR FOS AREA R_,^.[PT=CLE `Ori SCE VA"C"ME --)115V ICA AMPS — ENeh 4.A' f." FOR POS AREA' —�J (2S') /(17j RECEPTACLE FOR REFRIG`RATOR 115V 4 J AMPS_ E.------_ --- RECEPTACLE FOR COFFEE GRINDER 1'OV 116 AMPS~ ¢-__-_.---- _-.._---_ (8') N12 L �� D I) LOAD CENTER ' I •zc/ 2Cs r 30 4w ; �J (6') y12 RECEPTACLE FOR REFRIGERATOR rI I 1 �Ll _2 ,3 AUMbN I _ _ _1 cV 4-0 A4PS-y C RECEPTACLE FOR COFFEE BREWER �1 1 / I I I j — — - .-- -" " o I--�120/240V 30-0 AMPS (NEMA'# L14_307 ,I�"=- I { f ' L O in S �_ ♦--._- --_ --- - -� 1' �.. f)f 12 1 (43') #12 �' ( I RECEPTACLE FOR ESPRESSO MACHINE 6#10-1 7 115 AMP f Fi ( ) I I�I - - - -- - — —! -I 208V 4p.0 AMPS (NEMAry� 6-50) Twist-Lo IcI� y1 I I ISO AME{ �.`...� 15 utG LT X2 I LLQ M- .�.. § ,� I + -�— 50 Al 1 (4.3') k8 �X1 TII IT' I N RECEPTACLE FOR BLENDER I I _ _ _ II 1! 5 °'"?I ---I I 1 '20V 13 0 AMPS — -- J = I a i' �- - - - - ~- - - - _---- =---moi r II 11 5 AMPI X30 - 11 M.( 4 XX3T// I I 3II I .. --� i 'i (25) R12 — J Li O `-EN I LM'EN TFOO5fOFm2r .�I 3 I 15 _—� 11 Track lights (60') #12� I I I (�L-- I L0°J I 171 I G4YNJ _.PEN .J" OOX J // L. tfx' 1 air x 4 4X4 2 d�-I}�}= _. P "dent fights (60*) hM2 L3 J r --I 24 .. BOX-, .1 .I i �aPfr-1 I �x� I t 2X4 L — —' —Pendent lights IWRI-3 I I i1� I L----- - - -- - L--------------- --j I rGL¢ Nt wrawAnax mxt.uxm w a+ asaasEo eY mrt .0" B-B ACKSHDI MINIMUM GAUGE WIRE 5 fW9LFAtD Ctl1FlC{Nn4 u10 PNpNdffAeY 9Y LOM RwG R-CO `NDi3 8 CAU FOR 40/50 AMP CIRCUIT m r.p.Y .Ul OF.. ueNlKe[nWNY uY V''R."a, _-8I I E (HOT) '0 -AUIE F'34 30 AMS CIRCUIT A"D A:E W fS ¢iwiS +4E E"RES4Y Vf 5EA1FJ 8. + rO OAD xw. VL , Is S" CWwM.tt9' p 1115 rFM G-O Ir,E (GROUND) 17 GAUGE FOR I5/20 AMP CIRCUIT u0,' ro ' PROG CW wMtll1 mE Pwlw maTmu _ W-W.IITE (COMMINJ) [MSE-_i OF CO.LOM kINC MFG CgAP.WY 'DIMENSIONS :NIORMAICIC _ �,�'.�^ T� T;' (PARI NO. _. --I 1 SO NOT Dl1Pi KATE jI `4.o LOA1.) IZ �1 X'C� -Z DIMENSIONS ARE IN INCHES I "FI /// Pa MOX wsa 1157.anxn sr Has~ n nzm ._i 17RANCES 0 -ES NCE) FRAC TOL 21/32 r`_LECTRiChL I.kYOU 5117;I or 4 1 N A, ELIMINATED RCPT FOR FILTER ALARM 12/21/00 HJ DEC TDL. t 01 xC:wEN; No ANG./;A(ZE DRN ev JA c- 'scAL� t' 1 I 4Sa-i62i N0' ECR. rt01 RLb1S10N DATE BY DO NO Ni� HJ I 1/31/00 1 -n" -----------"--- 1_ jJ)E S�.O. v Application pin number . . . Property Address . . . . . . ASSESSOR PARCEL NUMBER: Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . Application valuation . . . . CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 FAST STH STREET, PORT AMOELES. WA 98.362 914568 110 E 3RD ST 06 -30 -99 -0 -0 -6910 -0000 - ELECTRICAL ONLY COMMUNITY SHOPPING DISTR 0 Owner Contractor NECA/PBTF WESTERN PROPERTIES OWNER 1125 15TH ST NW WASHINGTON DC 200052707 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . TRUE TEMP/ HVAC CONTROLS Permit pin number 46755 Sub Contractor TRUE TEMP N.W.- .W-Permit PermitFee . . . . 179.00 Plan Check Fee .00 Issue Date . . . . 4/14/05 Valuation . . . . 0 Expiration Date . . 10/11/05 Qty Unit Charge Per Extension 12.00 11.4000 ECH EL-LVT-ADD THERMOSTAT 136.80 1.00 42.2000 EL -LOW VOLT SYS <=2500 SQFT 42.20 ---------------------------------------------------------------------------- Fee summary Charged Paid ---------- Credited ---------- ---------- Due ----------------- Permit Fee Total 179.00 179.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 179.00 179.00 .00 .00 C0MME-NTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTJON RECORD CALL 417-4735 FOR ELECTRICAL, INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE tNsPECTION TYPEDATE I ACCSPTKD COMMENTS I I` YES I NO DITCH ROUGH -IN / COVER SERVICE FINAL 81� /�>s 1,het-) I E GENERAL COMMENTS: 7w-1102.1514"%1 CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 FAST 5TH STRr..ET, PORT ANGELES. WA 98362 Application Number 05-00000257 Date 4/12/05 Pin number . . . . . . .262638 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application description . . . ELECTRICAL ONLY Subdivision Name . . . . . . Property Use Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ NECA/PBTF WESTERN PROPERTIES OWNER 1125 15TH ST NW WASHINGTON DC 200052707 ---------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc CARTER/ Sub Contractor CARTER ELECTRIC Permit Fee 98.40 Plan Check Fee .00 Issue Date .. . 4/12/05 Valuation . . . . 0 Expiration Date . . 10/09/05 Qty Unit Charge Per Extension 1.00 61.3000 ECH EL -COMM ALT <5 CIRCUITS 61.30 7.00 5.3000 ECH EL -COMM ALT-ADDTNL CIRCUITS 37.10 Fee summary Charged Paid credited Due Permit Fee Total 98.40 98.40 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 98.40 98.40 .00 .00 COMME-NTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417A735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COYER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPBC77ON TYPE DATE ACCIl COMMENTS YES I NO DITCH ROUGH-1N / COVER SERVICE FINAL GENERAL COMMENTS: PW-1102.15141 n � 11y7 tic eri"�£-� L� <i��r r- '� .��F �'/f i l /.c✓ Ciii, 14— /0 'J • PORTANGELES a W A 5 14 1 G I , U S a i Public 'Works & Utilities Department Alan Oman Senior Electrical Inspector/ Traffic Signal Technician Phone: 360-417-4735 Email: aoman@cityofpa.us Website: www.cityofpa.us Fax: 360-417-4711 321 Fast Frfth Street - PO Box 1150 Port Angeles. WA 98362-0217 HL ffROUP INC. JOHN W. J))HNtiON Co-PresIdenr Principal BIa1.AN F Z1'IA Co -President Principal () H N B. H I l K ti lice President Principal CF(It R. SPFNCER I'Icr President Prtnclpal ROY W. PFI)Iilt Rr,tiottal .l/unater 014 N W S I RO13F 1 Rcgional Alana,ter A S. 10' i a t e IF,\s F. E MA( IAti Re,Qional Alana.�ct As.l ciate AI A N K S H I M.AHUh U R 11 Re,tional Alanager Associate lit VHF. R. WILtiON Re,tioIla I ALtaa. er A:Il date ARCHITE C TURE • E NGINEERING • E NVIRO NMENTAL S ERVI CES 1550 140th Avenue ,N" E., Suit, 100, Bellerue, IVA 98005-4516 Telephone: (425) 746-4677 Facsimile. (425) 746-6836 John II' Johnson, A"hitert September 10, 2002 Trina Sunstan City of Port Angeles, Public Works and Utilities PO Box 1150 Port Angeles, WA 98362 E s t a b l i s h e d 1 9 6 6 360.417.4807 RE: Safeway Fueling Station # 1492 110 E 3rd Street \ Port Angeles, Washington RHL #1041.40 Dear Ms. Sunstan: We are proceeding with plans to build a Safeway fueling facility at the above location. The existing site is currently two businesses and a parking lot. Our proposal includes construction of a 94'x45' canopy with 4 pump islands and a 400 square foot kiosk. Attached are two copies of the proposed site plan showing the facility. We would appreciate receiving one marked -up print indicating thereon the service route, and a written response to the following items for developing our Construction Documents by September 25. Regarding Sanitary Sewer Service: 1) Please review the enclosed plan and verify our proposed point of connection at both the off-site sewer main extension and the lateral shown to our building. 2) Please identify the divisions of responsibility for a complete installation (i.e. who does trenching, installs sewer lines, patch paving of street, etc...). 3) Do you have requirements for boring for new sewer laterals instead of trenching? 4) Please outline the costs and connection fees involved and separate costs for sewer main extension and side sewer lateral. 5) Please forward any application forms in order for our client to initiate service to the subject site. BELLEVUE, WA LA HABI11A, CA MARTINEZ, CA PE I.AI UNIA, CA SACRAMENTO, CA SC OT7Sl)ALE, AZ VANCOUVER, WA IHL fGR01U-1Y- INC. Regarding Storm Water Service: If this site has an existing storm sewer lateral now serving it, can we tie into the lateral, assuming it is in good condition? If known, what is the size of the lateral according to your records? 2. If a new storm sewer lateral from the main should be required, please indicate where the facility would be served from and what are the divisions of responsibility for a complete installation (i.e. who does trenching, installs sewer lines, patch paving of street, etc.)? 3. Please provide any requirements for boring new storm sewer laterals (instead of trenching). 4. If a new storm sewer lateral is required, what is the storm sewer connection fee, if any? 5. Please provide any additional pertinent information or requirements. We anticipate starting construction in November 2002. Please advise as to how much lead- time you require for new service installations. Thank you for your time and attention to this project. Sincerely, RHL DESIGN GROUP, INC. Ma in D. Lakey Job Captain Attachments: site plans BELLEVUE, WA LA HABR2, CA MARTINEZ, CA PETALUMA, CA SACRAMENTO, CA SCOTTSDALE, AZ VANCOUVER, WA L GROUP INC. ARCHITECTURE ENGINEERING E NVIRONMENTAL SERVICES 1550 140th Avcnue N.E., Suire 100, Bellevue, IVA 98005-4516 Telephone: (425) 746-4677 Facsimile: (425) 746-6836 John 11'. /ohrr.orr, AfChiteet E s ( a b I i s h e d 1 9 6 6 JOHN W. JOHNSON September 10, 2002 Co- P1 ,, Iden t Principal Doyle McGinley City of Port Angeles, Public Works and Utilities PO Box 1150 Port Angeles, WA 98362 B Ii l A N F. Z I T.A 360.417.4855 Co - President Principal RE: Safeway Fueling Station # 1492 New Water Service Request 110 E 3rd Street JOHN B. HICKS Port Angeles, Washington Vice President RHL#1041.40 Principal Dear Mr. McGinley: We are proceeding with plans to build a Safeway fueling facility at the above location. The CECIL R. SPENCER existing site is currently two businesses and a parking lot. Our proposal includes Vice P r e s i d e rr t construction of a 94'x45' canopy with 4 pump islands and a 400 square foot kiosk. Principal Attached are two copies of the proposed site plan showing the facility. We would appreciate receiving one marked -up print indicating thereon the service route, and a written response to the following items for developing our Construction Documents by September 25. ROY W. PEDRO Regional Alanagcr Regarding Water Service: 1) Please verify the size & location of the water line? JOHN W. s T R 0 Il E L 2) What is the static water pressure and gallons per minute available through that line? Rc••s;tonal .Llanas!rr .'iesnrla tr 3) What would be the cost for installation of a new 1-1 /2" meter with 2" service lateral? Please verify this and any other pertinent fees. 4) What would be the cost for installation of a new I" meter with 2" service lateral? Rctianal llanatrr J L o E. 11 A IAS Please verify this and any other pertinent fees. . A,.eelate 5) What is the division of responsibilities (i.e. who installs & sets the meter, digs the trenches, connects the lateral, provides the materials)? ALAN K. S H I M A Ii U K U R e 1 Rc,yioual .1lanaper .-1 starlate BLYTHE R. W I I ti e> N \\beIRsys\project\1 k\1 k.4\1041 .40\doc\uti1ities\02-0910util-water.doc Regeonal .1/analcr BELLEVUE, WA LA HAB11A, CA MARTINEZ, CA PETALUMA, CA .-i �sorrate SACRAMENT[, CA SCOTTSDALE, AZ VANCOUVER, WA 1HL GROUP INC. 6) Is a separate meter required for irrigation? What would be the costs to re -use or relocate the existing 3/4" meter for irrigation purposes? Can the proposed facility use a private meter down from the domestic meter for deduction purposes? If so, what can go on the deduction meter? 7) Please forward any application forms in order for our client to initiate service to the subject site. We anticipate starting construction in November 2002. Please advise as to how much lead- time you require for new service installations. Thank you for your time and attention to this project. Sincerely, RHL DESIGN GROUP, INC. Martin D. Lakev Job Captain Attachments: site plans \\be11\sys\project\1 k\1 k.4\1041.40\doc\utilities\02-0910util-water.doc BELLEVUE, WA LA HABR2, CA MARTINEZ, CA PETALUMA, CA SACRAMENTO, CA SCOTTSDALE, AZ VANCOUVER, WA CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION j 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000908 Date 10/19/04 Pin number ** * * * * .475648 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Tenant nbr, name . . . . . . AMERICAN MARINE BANK Application description . . . COMM REMODEL Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 50000 Owner Contractor ------------------------ ------------------------ NECA/PBTF WESTERN PROPERTIES ELITE COMMERCIAL CONTRACTING 1125 15TH ST NW 804 W MEEKER ST WASHINGTON DC 200052707 KENT WA 98032 (253) 893-3100 ------ structure Information AMERICAN MARINE BANK ----- Construction Type . . . . . TYPE V NON -RATED Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST ---------------------------------------------------------------------------- Permit . . . . MECHANICAL PERMIT Additional desc HEAT PUMP Permit Fee . . . . 61.70 Plan Check Fee .00 Issue Date . . . . 10/19/04 Valuation . . . . 0 Expiration Date . . 4/18/05 Qty Unit Charge Per Extension BASE FEE 47.00 1.00 14,7000 ECH ME- INSTALL 100- FAU 14.70 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT - COMMERCIAL Additional desc . . TENTANT IMPROVMENTS Permit Fee . . . . 667.25 Plan Check Fee 433.71 Issue Date . . . . 10/19/04 valuation . . . . 50000 Expiration Date . . 4/18/05 Qty Unit Charge Per Extension BASE FEE 414.75 25.00 10.1000 THOU BL -25,001-50K (10.10 PER K) 252.50 ---------------------------------------------------------------------------- other Fees . . . . . . . . . STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 728.95 728.95 .00 .00 Plan Check Total 433.71 433.71 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 1167.16 1167.16 .00 .00 �l n 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 r Date Signature of Owner (if owner is builder) Date T:\PLANN1NG\FORMS\1 102.15 [11/1412003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS 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 TYPEDATE ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH -IN 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 (0 , _5__C4 av DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB I ( I 1 WALL / FLOOR / CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT ft's: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING! ( { ESA: LANDSCAPING SHORELINE: F FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL ELECTRICAL - LIGHT DEPT, 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417.4750 I PLANNING DEPT. BUILDING 417-4815 I 1 BUILDING T:\PLANNING\FORMS\1102.15 [11/14/2003] DATE ACCEPTED YES NO PREPARED 11/16/04, 13:03:27 INSPECTION TICKET PAGE 12 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 11/16/04 ------------------------------------------------------------------------------------------------ ADDRESS . : 110 E 3RD ST SUBDIV: TENANT, NBR: AMERICAN MARINE BANK CONTRACTOR ELITE COMMERCIAL CONTRACTING PHONE (253) 893-3100 OWNER NECA/PBTF WESTERN PROPERTIES PHONE PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 04-00000908 COMM REMODEL -------------------- PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BL3 01 10/25/04 RV BUILDING FRAMING 10/25/04 AP BL99 01 11/� JL i BUILDING FINAL TIME: 17:00 Scott 206-351-3054 American Marine Bank in safeway store -------------------------------------- COMMENTS AND NOTES ----------- PREPARED 11/10/04, 12:32:53 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 11/10/04 --- ------------------- --------------------- ------'-------- ------ ------------------------- - ADDRESS . : 110 E 3RD ST SUBDIV: TENANT, NBR: AMERICAN MARINE BANK CONTRACTOR ELITE COMMERCIAL CONTRACTING PHONE (253) 893-3100 OWNER NECA/PBTF WESTERN PROPERTIES PHONE PARCEL 06-30-99-0 0-6910-0000- APPL NUMBER: 04-00000908 COMM REMODEL - ------------------------------------- --------------------- ----------------------------------- PERMIT-. ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 1 f/04 JLL mO MECHANICAL FINAL -A-�jSall bank i. Safeway store l ri w- Scott - 206-351-3054 ---------- ------------------ -------- COMMENTS AND NOTES PREPARED 10/25/04, 13:04:06 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR ROGER VESS DATE 10/25/04 ---------------- --------------------- --------- --------- -------- -- ------------------------ ADDRESS . : 110 E 3RD ST SUBDIV: TENANT, NER: AMERICAN MARINE BANK CONTRACTOR ELITE COMMERCIAL CONTRACTING PHONE (253) 893-3100 OWNER NECA/PBTF WESTERN PROPERTIES PHONE PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER: 04-00000908 COMM REMODEL ------ ------------------------------- -------------------------------- ----- -- -------- ----- PERMIT; BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS -------------------- -- ------ ------------------------- -- -- ------ --------- --------- - BL3 01 10/25/04 RV BUILDING FRAMING A 1—%%�f Don 206 351-3054 f 2004/SEP/14/TUE 11;08 AM CITY OF PA BLDG DEPT FAX No.360 417 4711 P. 002 dy rorv,i,� •FOR OFF1CIAi USE 47dLX= X% BUILDING PERMIT - APPLICATION � �Datel�.: Permit - Fill out COMPLETELY and in RM Your application and site plan MUST B7 r, Da Approved: 1121 COMPLETE to be accepted for review. If you hive any questi'on's; call ,mate Issued: PERMITS (360) 417-4815 FAX(360)417-4711 y AN�foQ1caiJ V—Lv..,KlE -9AP4It t--JusY AEvhr�s A-15plidaiftUrAgent.' LL--1-TE F;,pv,rertc,,4,.- c��►�rza,c-rrvc;+Phone: r Owner: '5m Phone: Address: 591B S"Ta4B4t0(,E HhLL Ro_ City: PLEASAnrT014 _CA. Zip: q`!8fs ArchiteetlEngineer. A- Phone: Co!atractor�L'%-F_ Lom. CoN"tRA�-T�"�4 StateLlCenSe#: L%-E((_dz0,oExp:, a,L /OS Ph0ne:2S3-8%%-11 ..._ ..Address:-`e�zO!�-.. _111.�..n�r�>�Q.. S -r. Q.c�T_Cit`i� yCFn►�r ; WA . � _ ZiQ: 9�Q32 . PROJECTADDRESS: W) QST 'TN_1tLU s�2 E -r, PA. W01 9003(.2' ZONING: LEGAL DESCRIPTION: Lot: V 2-7 Blook- PS2- Subdivision: t eT 1 CLALLAM COUNTY PARCEL:. NnSER: 0Q,50-190ak ►I _QLW - - -- - Credit Card Holder Nance: _ Bulling Address: city - Credit Card Type VISA MC # ___ Exp. Date: TYPE OF WORIK: SIZEIVALUATION: ❑ Residential ❑ New Constr. ❑ Ile -roof ❑ Stove SF. @ $ /SF. = $ . ❑ Multi -family ❑ Addition o Move ❑ Gauge SF. @ $ /SF. = $ ?Q Commercial X Remodel . A Demolition 0 Deck SF. @ $ /SF. = $ BRMFDESCWTIONOFTBEPROJECT: 2ews JAr-rjMC% Pkr-., e�.s v►oEo F� Qin ,..sra t_t_ cp R -p, 4� Foe._ A � S e �hlea COM.MERCLALMESIDENTIAL: Occupancy Group: Occupant Load Construciaon Type: No. of stories; _ Lot Size: Existing Sq. Ft. - & Proposed Sq. Ft. = TOTAL Sq. Ft. Total lot coverage % APPROVALS: PLANMG USE ONLY: PLAN: BLbG: ESA/Wetland(s): Q Yes 0 No SEP.A Checklist r OT11. equired? C] Yes ❑ No Other: OTHER: - BUILDING PERAM 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 vrill be reviewed and maybe revisedby1he BuildingDivision to comply with curreat fee schedules. ContactthePermit Coordinator at417-4815 for assistance. PLAN CMCK FEE: IF a plan check fee is due it must be submitted at the time the budding permit application and construction plans are submitted. All othEUeamit fees are due at the time of permit issuance. EX'IIt ATZON OF PLAN REVIEW: if no permit is issued vntlun XSU clays oIe dale oi"app�ieatiori� the application wiII esplx=ea'e _ ......_ 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 ce. I hereby certify that I have read and examined this application and know the same to be true and co am authorized to apply for this permit and understand that ft is my responsibility to. determine what permits are required ,not the City's, aat obtain such permits prior to work T:IRVESSIBIDG-forms-brochures12003-Buildin$p=7Wt.wpd Applicant: y Date: 14 V CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION -i321 EAST STH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000908 Date 11/12/04 Pin number . . . . . . .475648 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Tenant nbr, name . . . . . . AMERICAN MARINE BANK Application description . . . COMM REMODEL Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 50000 Owner Contractor ------------------------ NECA/PBTF WESTERN ------------------------ PROPERTIES ELITE COMMERCIAL CONTRACTING 1125 15TH ST NW 804 W MEEKER ST WASHINGTON DC 200052707 KENT WA 98032 (253) 893-3100 ------ Structure Information AMERICAN MARINE BANK ----- Construction Type . . . . . TYPE V NON -RATED Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL I Additional desc DATA CABLES Sub Contractor OLYMPIC TELEPHONE INC Permit Fee . . . . 42.20 Plan Check Fee .00 Issue Date . . . . 11/12/04 Valuation . . . . 0 Expiration Date . . 5/12/05 Qty Unit Charge Per Extension 1.00 42.2000 EL -LOW VOLT SYS <=2500 SQFT 42.20 ---------------------------------------------------------------------------- Other Fees . . . . . . I . . STATE SURCHARGE 4.50 Fee summary ----------------- ChargedPaid Credited ---------- ---------- ---------- ---------- Due Permit Fee Total 42.20 42.20 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 46.70 46.70 .00 .00 4_1 k _Z) Q3 A Separate Permits are required forelectrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized 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:\FLANNING\FORMS\1102.15 [11/14/20031 rig a BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. i INSPECTION TYPE DATE ACCEPTED COMMENTS YES ( NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN(F— 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 DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CHIMNEY HOOD/ DUCTS PW UTILITIES! SITE WORK (Engineering Division) SEPARATE PERMIT#'s: WATERLINE f METER SEWER CONNECTION SANITARY 4 STORM i PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING I ESA: LANDSCAPING , SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL I DATE YES NO COMMERCIAL ELECTRICAL - LIGHT DEPT. 417-4735 CONSTRUCTION R.W. f PW/ ENGINEERING 417-4807 FIRE 417-4653 PLANNING DEPT. 417-4750 BUILDING 417-4815 T:IPLANNING\FORMS11102.15 (11/14/2003) ELECTRICAL LIGHT DEPT CONSTRUCTION - R.W. PW / ENGINEERING FIRE DEPT. PLANNING DEPT. BUILDING DATE ACCEPTED Y NO O.�°CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST STH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000888 Date 9/29/04 Pin number . . . . . . .052216 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Application description . . . ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ NECA/PBTF WESTERN PROPERTIES OWNER 1125 15TH ST NW WASHINGTON DC 200052707 Permit . . . . . . ----------------- ELECTRICAL SIGN PERMITS Additional desc . . 1 Permit Fee . . . . 53.70 Plan Check Fee .00 Issue Date . . . . 9/29/04 valuation . . . . 0 Expiration Date . . 3/29/05 Qty Unit Charge Per Extension 1.00 36.4000 ECH EL -COMM -1ST SIGN 36.40 1.00 17.3000 ECH EL -COMM -ADD SIGN 17.30 Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total 53.70 ------------------------------ 53.70 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 53.70 53.70 .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. ture oContractor or Authorized Agent D to Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1102.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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. INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: H ROUGH -IN 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 I WALL / FLOOR / CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE/PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT tt's: WATERLINE / METER SEWER CONNECTION I SANITARY STORM PLANNING DEPT. SEPARATE PERMIT ti's SEPA: PARKING/LIGH LANDSCAPING TING i SHORELINE: RESIDENTIAL ELECTRICAL - LIGHT DEPT. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL DATE ACCEPTED YES NO 417-4735 CONSTRUCTION R. W_ / PW/ ENGINEERING 417-4807 FIRE 417-4653 PLANNING DEPT, 417-4750 BUILDING 417-4815 T:\PLANNING\FORMS\1102.15 [11/14/20031 ELECTRICAL LIGHT DEPT CONSTRUCTION - R.W. PW / ENGINEERING FIRE DEPT. PLANNING DEPT. 1 BUILDING CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION <' 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000908 Date 11/12/04 Pin number . . . . . . .475648 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Tenant nbr, name . . . . . . AMERICAN MARINE BANK Application description . . . COMM REMODEL Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 50000 Owner Contractor NECA/PBTF WESTERN PROPERTIES ELITE COMMERCIAL CONTRACTING 1125 15TH ST NW 804 W MEEKER ST WASHINGTON DC 200052707 KENT WA 98032 (253) 893-3100 ------ Structure Information AMERICAN MARINE BANK ----- Construction Type . . . . . TYPE V NON -RATED Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc SECURITY SYSTEM Sub Contractor DIEBOLD INC. Permit Fee . . . . 42.20 Plan Check Fee .00 Issue Date . . . . 11/12/04 Valuation . . . . 0 Expiration Date . . 5/12/05 Qty Unit Charge Per Extension 1.00 42.2000 EL -LOW VOLT SYS <=2500 SQFT 42.20 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 42.20 42.20 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 46.70 46.70 .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 T:\PLANNrNG\FORMS\1102.15 [11/14/2003] 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. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A 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 ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH -IN PLUMBING UNDERFLOOR/SLAB ROUGH -IN WIkTER LINE (METER TO BLDG) AS LINE BACK FLOW / WATER AIRISEAL WALLS I 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 GAS LINE WOOD STOVE/PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM (( - i S-C�f _ (°�&� r PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING I I LANDSCAPING I SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE IRESIDENTIAL DATE YES NO COMMERCIAL ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 I FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING +I 417-4815 I BUILDING T:\PLANNING\FORMS\1102.15 [11/14/2003] DATE ACCEPTED L YES NO CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000908 Date 11/12/04 Pin number . . . . . . .475648 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Tenant nbr, name . . . . . I AMERICAN MARINE BANK Application description . . . COMM REMODEL Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 50000 Owner Contractor ------------------------ ------------------------ NECA/PBTF WESTERN PROPERTIES ELITE COMMERCIAL CONTRACTING 1125 15TH ST NW 804 W MEEKER ST WASHINGTON DC 200052707 KENT WA 98032 (253) 893-3100 ------ Structure Information AMERICAN MARINE BANK ----- Construction Type . . . . . TYPE V NON -RATED Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . THERMOSTAT Permit Fee . . . . 36.40 Plan Check Fee .00 Issue Date '* * ' 11/12/04 valuation . . . . 0 Expiration Date 5/12/05 Qty Unit Charge Per Extension 1.00 36.4000 EC EL -LOW VOLTAGE 36.40 -------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE -- 4.50 Fee summary Charged Paid Credited ----------------- Due ---------- ---------- ---------- ---------- Permit Fee Total 36.40 36.40 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 40.90 40.90 .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:kPLANNrNG\FORMSN 1102.15 [11/14/2003] M BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL To COVER, INSULATE OR CONCEAL ANY WORKBEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS I I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH -IN PLUMBING UNDERFLOOR/SLAB ROUGH -IN W//INTER LINE (METER TO BLDG) S LINE BACK FLOW / WATER AIRISEAL 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 GAS LINE WOOD STOVE / PELLET / CHIMNEY HOOD/ DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS IOR TO OCCUPANCY/USE RESIDENTIAL DATE f YES NO COMMERCIAL ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W. PW / ENGINEERING ENGINEERING 417-4807 FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANNING\FORMS\1102.15 [11/14/2003) DATE ACCEPTED YES NO pF ppRT,M1,CF CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000908 Date Pin number . . . . . . .475648 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Tenant nbr, name . . . . . . AMERICAN MARINE BANK Application description . . . COMM REMODEL Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 50000 10/25/04 Owner Contractor ------------------------ NECA/PBTF WESTERN ------------------------ PROPERTIES ELITE COMMERCIAL, CONTRACTING 1125 15TH ST NW 804 W MEEKER ST WASHINGTON DC 200052707 KENT WA 98032 (253) 893-3100 ------ Structure Information AMERICAN MARINE BANK ----- Construction Type . . . . . TYPE V NON -RATED Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST ---------------------------------------------------------------------------- f Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc AMER. MARINE BANK Sub Contractor RAVEN ELECTRIC INC Permit Fee . . . . 78.70 Plan Check Fee .00 Issue Date . . . . 10/25/04 Valuation . . . . 0 Expiration Date . . 4/24/05 Qty Unit Charge Per Extension 1.00 EL -COM ALT 0-200 SRV FDR- --- --- -- 78.70- - -78.7000-ECH - ------------------------------------------------------ Other Fees . . . . . . . . . STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 78.70 78.70 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 83.20 83.20 .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 T:\PLANNINGTORMS\1102.15 [11/14/20031 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. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE { ACCEPTED COMMENTS j` YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # J / ROUGH -IN PLUMBING �\ UNDER FLOOR / SLAB ' ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS I CEILING FRAMING l` JOISTS/ GIRDERS SHEAR WALL/HOLD DOWNS WALLS / ROOF / CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL/ FLOOR/ CEILING I I MECHANICAL HEAT PUMP I GAS LINE WOOD STOVE/PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION I SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGH LANDSCAPING TING I I I 1 SHORELINE: FINAL INSPECTIONS F SQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL /c _3_5-0(( U-)nXk (?A-4-' �'-< ELECTRICAL - LIGHT DEPT CONSTRUCTION R.W. / PW/ ENGINEERING FIRE PLANNING DEPT. BUILDING T:\PLANNING\FORMS\1102.15 [11/14/20031 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION - R.W. 417-4807 PW / ENGINEERING 417-4653 FIRE DEPT. 417-4750 PLANNING DEPT. 417-4815 BUILDING DATE ACCEPTED I;( NO ,FP�0RT*%0FAN CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION s� 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000954 Date 4/07/05 ��� Pin number . . . . . . .479484LII,ihY� Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06-30-99-0-0-6910-0000- Tenant nbr, name . . . . . . SAFEWAY Application description . . . COMM REMODELr^�� Subdivision Name . . . . . . ` Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR t O /-�J / i}� V✓ Application valuation . . . . 250699 Owner Contractor ------------------------ ------------------------ NECA/PBTF WESTERN PROPERTIES GRAHAM CONTRACTING LTD 1125 15TH ST NW 9709 3RD. AVE NE SUITE 208 WASHINGTON DC 200052707 SEATTLE WA 98115 (206) 729-8844 ------ Structure Information INTERIOR REMODEL ----- Construction Type . . . . . TYPE V NON -RATED Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT - COMMERCIAL Additional desc . . INTERIOR FINISHES,& FIXTURES Permit Fee . . . . 1862.85 Plan Check Fee 1210.85 Issue Date . . . . 4/07/05 Valuation . . . . 250699 Expiration Date . . 10/04/05 Qty Unit Charge Per Extension BASE FEE 1017.25 151.00 5.6000 THOU BL -100,001-500K (5.60 PER K) 845.60 "`-• ---------------------------------------------------------------------------- Special Notes and Comments O Electrical load calculations and elctrical permits are required. ----------------------------------------------------- - R Other Fees . . . . . . . STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 1862.85 1862.85 .00 .00 Plan Check Total 1210.85 1210.85 .00 .00 1 Other Fee Total 4.50 4.50 .00 .00 �. Grand Total 3078.20 3078.20 .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 ppoverning this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give a horit to violate or cancel the provisions of any state or local law regulating construction or the performance of cn�lstruction. 4 /7 Signature of Conttracto ornzed Agent Date Signature of Owner (if owner is builder) Date T \Policies\1102_15 building pent inspection record05 wpd [1/4/2005] 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 ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE / DOWN SPOUTS PIERS POST HOLES (POLE BLDGS ) PLUMBING UNDERFLOOR/SLAB ROUGH -IN I` WATER LINE (METER TO BLDG) GAS LINE I 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 WOOD STOVE/PELLET/CHIMNEY COMMERCIAL HOOD / DUCTS MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT #'s PARKING/LIGHTING LANDSCAPING i RESIDENTIAL 44-� /,.-- j a- SEPA ESA - SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL ELECTRICAL - LIGHT DEPT. 417-4735 CONSTRUCTION R W / PW/ ENGINEERING 417-4807 FIRE 417-4653 PLANNING DEPT. 417-4750 BUILDING 417-4815 T.\Policies\1102_15 budding permit inspection record05,wpd [1/4/2005] ELECTRICAL LIGHT DEPT CONSTRUCTION - R.W. PW / ENGINEERING FIRE DEPT. PLANNING DEPT BUILDING DATE I ACCEPTED YES NO /D -?-©S .lkl. PREPARED 10/07/05, 12 44 37 INSPECTION TICKET PAGE 3 CITY OF ------------------------------------------------------------------------------------------------ PORT ANGELES INSPECTOR JAMES L LIERLY DATE 10/07/05 ADDRESS . . 110 E 3RD ST SUBDIV TENANT, NBR: SAFEWAY CONTRACTOR GRAHAM CONTRACTING LTD PHONE (206) 729-8844 OWNER NECA/PBTF WESTERN PROPERTIES PHONE PARCEL - 06-30-99-0-0-6910-0000- APPL NUMBER. 04-00000954 COMM REMODEL PERMIT: - BPC 00 BUILDING PERMIT ------------------ --------- - COMMERCIAL -- ----- REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ---------------------- BL3 01 4/28/05 JLL -------------------------------- BUILDING FRAMING 4/29/05 AP DARRYL 206-571-1843 04/27/2005 01.53 PM JLIERLY 04/29/2005 12 01 PM JLIERLY ---------------------------- BL99 01 10/ 7/05/ L BUILDING FINAL TIME. 17.00 10/06/2005 11 50 AM PBARTHOL NATE 206-571-3356 PERMIT: --------------------------------- ME 00 MECHANICAL PERMIT --- REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME6 01 -------- - ---- 4/28/05 JLL -------------------------------- MECHANICAL GAS LINE 4/29/05 AP * OVERRIDE TAKEN BY JLIERLY DATE 04/27/05 TIME- 14 23 38 DARRYL 206-571-1843 04/27/2005 02 22 PM JLIERLY REFRIGERATION GAS LINES 04/29/2005 12:02 PM JLIERLY -------------- PERMIT: - - PL 00 PLUMBING PERMIT ---------------------------------------------------------------- REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------- PL2 01 4/28/05 JLL ---------- PLUMBING ROUGH -IN TIME 17:00 4/29/05 AP * OVERRIDE TAKEN BY JLIERLY DATE: 04/27/05 TIME 14:30 16 DARRYL 206-571-1843 04/27/2005 02:28 PM JLIERLY FLOOR DRAINS 04/29/2005 12 03 PM JLIERLY ------------------ ----- COMMENTS AND NOTES ---- PREPARED 4/28/05, 13 09.18 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 4/28/05 -- - ---- ------------- ADDRESS 110 E 3RD ST SUBDIV TENANT, NBR- SAFEWAY CONTRACTOR GRAHAM CONTRACTING LTD PHONE (206) 729-8844 OWNER NECA/PBTF WESTERN PROPERTIES PHONE . PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER 04-00000954 COMM REMODEL ---------- ------------------- PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ----- - --- ------------------------------------- - - ------- - --- ------------------------ BL3 01{x/28/05 17 j� //�� BUILDING FRAMING yl29j10� io DARRYL 206-571-1843 04/27/2005 01 53 PM JLIERLY CONTINUED ONTO NEXT PAGE PREPARED 4/28/05, 13 09 18 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR• JAMES L LIERLY DATE 4/28/05 ADDRESS 110 E 3RD ST - - ---- SUBDIV -------------- TENANT, NBR. SAFEWAY CONTRACTOR GRAHAM CONTRACTING LTD PHONE (206) 729-8844 OWNER NECA/PBTF WESTERN PROPERTIES PHONE . PARCEL 06-30-99-0-0-6910-0000- APPL NUMBER 04-00000954 COMM REMODEL PERMIT: ---------------------------------------------------------------------- ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ ME6 01 28/ 5 J- MECHANICAL GAS LINE * OVERRIDE TAKEN BY JLIERLY DATE 04/27/05 TIME: 14 23 38 DARRYL 206-571-1843 04/27/2005 02 22 PM JLIERLY REFRIGERATION GAS LINES CONTINUED ONTO NEXT PAGE----------------------------------- PROJECT DATA BUILDING CONSTRUCTION AND CLASSIFICATION: BUILDING CODE: IBC 2000 ZONE: CSD - COMMUNITY SHOPPING DISTRICT BUILDING TYPE: III -N FULLY SPRINKLERED OCCUPANCY GROUP: B2 (RETAIL) GROUND FLOOR: 55,186 SF MEZZANINE: 551 SF TOTAL FLOOR AREA: 55,737 SF EXIT WIDTH PER IBC 2000 1003.2.3.2 & TABLE 10-9 AREA/EXIT WIDTH CALCULATIONS: SALES/SERVICE AREA: 46,668 SF/30 = 1556 STOCKROOM/FREEZER & COOLER AREA: 8,518 SF/300 = 28 1584 x .2 = 317"/12 = 26.4' NUMBER OF EXITS PROVIDED: SE EXIT = 6' SW EXIT = 6' ENTRY #1 = 12' ENTRY #2 = 6' TOTAL EXIT WIDTH PROVIDED = 30' > 26.4' EXISTING PARKING: 233 SPACES TOTAL (NO CHANGE TO EXISTING) SCOPE OF WORK: TENANT IMPROVEMENTS FOR NEW INTERIOR DECOR INCLUDING NEW WALL & CEILING PAINT COLORS, NEW FLOOR COVERING, REPLACEMENT OF EXISTING GRAPHICS WITH NEW GRAPHICS PACKAGE (BY OTHERS). RELOCATION OF EXISTING FIXTURES & REFRIGERATED CASES AS WELL AS OLD FIXTURE REPLACEMENT WITH NEW STATE OF THE ART CASES. ALTERATION AND ADDITION OF NON BEARING INTERIOR WALLS AND CEILING FASCIA WALLS AS INDICATED ON DRAWINGS. NEW PAINT COLORS TO EXTERIOR ELEVATIONS. LEGAL DESCRIPTION LOTS 3 THROUGH 18, BOTH INCLUSIVE OF BLOCK 69 OF THE TOWNSITE OF PORT ANGELES; TOGETHER WITH ALL OF THAT VACATED ALLEY IN BLOCK 69, AS VACATED UNDER CITY ORDINANCE NO. 2044; AND ALSO LOTS 2 THROUGH 9, BOTH INCLUSIVE, AND LOT 14 IN BLOCK 168 OF THE TOWNSITE OF PORT ANGELES. SITUATE IN CLALLAM COUNTY, WASHINGTON. NOTE: EASEMENTS CR89ED OR RESCINDED AFTER THIS DATE ARE NOT NOTED HEREON. PARCEL NOS. 063000 016880 0000 063099 006910 0000 063099 006920 0000 063000 006900 0000 4, n j , F, '; i E U _ 4 r,� C I TYF FIABLur DEFT41 " ] i OC ptlRt,q�,G� pt FOR OFFICIAL USE ONI Y- fr ----BUILDING-FERMi4 -T—APPLACIATIO --- - - --bate-itew 6`Y or -- -� - %fli ouYt (iii F TI,-anciin lT'K 's�nz applie�{ivn anci site-pi�n�4liiST .' r U6te "Aprxovcc ' C'04TTLE FE to be accepted for re'c•i vw. of you have ary questious, call r PERM TS (360) 4I74R15 FAX(360)417-4711 `'et` abst.r-d. Applicant or Agc l: Owtarr 5 ti _ S _l N G- — Phoue C �0 3 '_ 22 o 2 - Address:_ � -_ z� lyse me t ixyJJ _��.t�A[_ �S %S►_ . _ LiIx- Anchitect/Engirieer V T T ��TN�� fir J�Phone;�� �8 -,50C>0 ContractorTV �4A i t""4s State T.me-ase i -T. Exp. Phone, Address: Zip: - PROJECT ADDRESS: =-fo� � �� ' - _-- � ZONING: _ -- - LEGAL DRSCRIPTION: Lot- 3 " t � �3lor.)�, - � Q---- ---- `ubdiviswn: CLALLAM COUNTY PARCEL NU`,MBER- 0 G ?j 0 op -b 1(08$0- 00oc� o�c �. 00(a0 - odoc� Credit Card Holder Nlaiue; Ming Address: _�- rt Credit Card Type VIS, r me _ _ --_ #�! � � (_� -- TYP,E+ OF WOK: SIMAIALUATION: D Itesidantisl, L7'•hxew Corsu•: r Rr-rouf ' ❑ Stove SP. @ $ r'SF. = $ ❑inti -family ❑ Ad&twa LlMove ❑ GRrate SF. @ $ 1SF. = S ornmeiaial ' R emocicl ©berai�litioi�'- ❑ I3 c t _'___----=- 5 "_ Q' $" ASF O� 46 i3. Repair - . . ;"❑" S��n,•i Gi; Urger w . 1' l iAL";V i 1 gTICati: ' $ ; _ RRTEF' I_'tF,SCR1F7TON 0 F OJ EC . A1+.!T-Ad, 0 „'� s • � � 4.. � d j C()M MV,- CLkL/RFSIDEN'IL4L: Oroupzocy Group° Occupant Load: 8� Co,zsttuctioa,Typs::,_--U— No, of Stoves: i Lot Size: 1q4, W T�,x)st g sq. kt, �5 h-oposed Sq. Ft.- d_„— = TOTAL Sq. Ft. �5 3 total lot dSAMedand(s). l:a Yes 0 No SEPA C'hecic? st required? 10 Yes ❑ No Other -- — -� APPROVAL& PIAN: DLI30: T -- PERE: OT]I R: — -- BUIT_,DfrW i'.�,<:l T1T' AT'PLICATION SIITI 11TTAL : The Bi:ildhp, Division ; a-,.: provilt yot �i�lth infumatiou of The. appIicatiQa and plan subai-tt.d tqt irements if you b ave questions, VALUATION OF CONSIRLIC'TION. In all eases, a valust•ion Amount Must be a?titeret, ay Cie aprbcanit. T `as fjo IT V 111ba revlO'A'esi a7�dmayberetdc_edbytL-el3ui?ding,>;ivisl�ntocampl�•�zrllrurr�,nti'ee�r.:urd.�-ies- GonT`ctru•�3'ezio;.tG'aoz:3i.natosa2417-2ET5foras�is;�.u,;e. PLAN CRECK FEE, IF a pizzi checl; fee is due it roust be submitted at fy- tzrz tike buiid; g; e; ,,z,t application dad constluction plems are E 'T tz,4'1ION Or FLAN REVWW, if xio pe aft ;s :sued zr a� zs 180 days of tlae dlte of ar,�phcltlott the :application will mire. T1:e BiLlaig Chffilclal caa oxteud tLP rmqc for aetk-jzby the 'Ago days vp,n11 appacart (tee Sectiou R1 OS 3 2 of tae int�-,&ILoval Code. 200,3), No aj,p)icatix; csz, }:e:a�7e � is � upom that once, he ehy ced#= theit 1 agave read end oxommed this appi1G�t7an:an4-Pnz w the t:tn' tD pP �'uC,F�+CI Gtl7�;?,,l.an► auihcrizer! t ap�1� for rte's perrnrt and z hdci'rSta-',d Oat it is my ratpenslbitity to dotormine wtv, perml.s arc mquked, not jt;i c1y's, arra. `hat'�,� istst cbtoin Such perr,7'ts pror to suork. ' T:V.4'ESuS�7 T,Ci f� tnl-�;oCttureSl�OD3 Hu ddin,eattuz �7KJ lal�pAcat7t: _ . _� N - -- , bate. REMITTANCE ADVICE SAFEWAY INC U S Corporate VENDOR NUMBER 357249 CHECK NUMBER 270.0002119 5918 Stoneridge Mall Road VENDOR NAME DATE 10/18/2004 AMOUNT $******3,078 20 Pleasanton, CA 94588 CITY OF PORT ANGELES PAGE 0001 OF 0001 INVOICE NUMBER INV DATE I PO NUMBER I INV AMOUNT DISCOUNT NET AMOUNT PERMIT FEES 10/15/2004 3,078 20 0.00 3,078 20 27-1492-9 KH 3002422 PAGE TOTAL 3,078 20 RUNNING TOTAL 3.078 20 CORNERSTONE ARCHITECTURAL GROUP letter of transmittal l� ori" S 5,z t tasY S-4, ATTENTION: uQ �+ir'fT TRANSMITTAL OF: ❑ SHOP DRAWINGS ❑ PRINTS OORIGINALS ❑ CHANGE ORDER ❑ REPORT ❑ SAMPLES DATE: _{_., 2 ' U PROJECT #: Cra 5 �D 1 PROJECT:. tt 2 REFERENCE: ❑ SPECIFICATIONS []CORRESPONDENCE ❑ COMPUTER MEDIA ❑ COPIES DATE NO. DESCRIPTION I °40--,(1-1� 4'fIIIA h - TRANSMITTAL FOR: ❑ APPROVAL ❑ YOUR USE DELIVERY METHOD: ❑ US MAIL ❑ COURIER ❑ AS REQUESTED ❑ HAND DELIVERED /REVIEW AND COMMENT ❑ FED EX ❑ REMARKS: (C"10 4 - zo -Ls cc- ®File n n Signed- --�V u 1904 THIRD AVENUE, SUITE 500 SEATTLE, WA 98101 TEL 206 682 5000 FAX 206 621 7717 WWW CORNERSTONEARCH COM SWY 1492 Subject: SWY 1492 Date: Thu, 14 Oct 2004 15:4305 -0700 From: Richard Utt <rutt@cornerstonearch.com> To: cynthia.ostermiller@safeway.com CC: ron.troyer@safeway.com, honda.cherng@safeway.com, scott.kido@safeway.com Cynthia, RE: Safeway 1492 Please provide a check for the permit fee of $ 3078.20 Made out to : City of Port Angeles 321 East 5th. Street Port Angeles, WA. 98362 Mail check to the Attention of: Roger Veff Building Department Thank you, Rick I've stopped 22,006 spam messages. You can too! One month FREE spam protection at www.cloudmark.com Jain flat fight againstspaml % ^Oo 1 of 2 10/15/2004 6,36 AM f 2002 Seattle Nonresidential Energy Code lance Form Note new automatic davliohtino, occugancv sensor, and other control reouirements of Section 1513, as applicable June 2002 - Project Info IProjectAddress Safeway 1492 POC Date 9/2/2004 110 3rd Street For Building Department Use Port Angeles, Washington 96382 Applicant Name Applicant Address Applicant Phone KJM/MAK Project Description ❑ New Budding ❑ Addition ❑ Alteration❑ Bldg. >5,000 sq.ft. (auto shutoff req'- ❑ Plans Include Refer to SEC Section 1513 for controls and commissioning requirements 0 Prescriptive 0 Lighting Power Allowance 0 Systems Analysis Compliance Option (See Qualification Checklist (over) Indicate Prescriptive & LPA spaces clearly on plans ) Alteration ExceptionsI ❑ No changes are being made to the lighting (check appropriate box) ❑ < 60% of fixtures new, installed lighting wattage not increased, and Table 15-1 use is not Maximum Allowed Lighting Wattage (Interior) Location Allowed (floor/room no Occupancy Description Watts per ft2 " Area in ft2 Allowed x Area 1 Retail Grocery - gross building area 1.50 41682.0 62523.0 Retail Grocery - Sales Area accent and display 1.50 41682.0 62523.0 1 ** From Table 15-1 (over) - document all exceptions on form LTG -LPA Totals 83364.0 125046.0 Notes on Proposed Lighting Wattage 1 Use manufacturer's listed maximum input wattage For hard -wired ballasts only, the default table in the NREC Technical Reference Manual may also be used 2 Include exit lights exceeding 5 0 watts per fixture Proposed Lighting Wattage (Int.) 3 List all fixtures For exempt lighting, note exception on applicable fixtures Location Number of Watts/ Watts (floor/room no Fixture Description Fixtures Fixture Proposed AC 180 93.0 16740.0 B 50 70.0 3500.0 1 c 180 79.0 14220.0 1 cl 4 45.0 180.0 1 c2 28 79.0 2212.0 1 c4 8 79.0 632.0 1 n 42 68.0 2856.0 F1 87 50.0 4350.0 FP 1 114.0 114.0 FPA 3 62.0 186.0 IFPB 1 11 31.01 31.0 1FPC 1 41 31.01 124.0 1G 1 161 89.01 1424.0 1G1 1 251 47.01 1175.0 1HA 1 2011 62.0 1240.0 1HB 1 21 62.01 124.0 1HBI1 101 114.01 1140.0 11 1 81 20.01 160.0 1K 1 451 50.01 2250.0 1M 1 381 76.01 2888.0 1R 1 10 1 1 50.01 500.0 2002 Seattle Nonresidential Energy Code Compliance Form Total Proposed Watts may not exceed Total Allowed Watts for Interior Total Proposed Watts 56046.0 Maximum Allowed Lighting Wattage (Exterior) Allowed Watts Area in ft` Allowed Watts Location Description per ft2 or per If (or If for perimeter) x ft2 (or x If) (Covered Parking 02 W/ft2 Note- 2001 SEC does not allow trading between covered oarkmo and ext. Ito. Total Allowed Covered Parking Watts (Open Parking 0 15 W/ft2 (Outdoor Areas 0 15 W/ft2 (Bldg (byfacade) 0 15 W/ft2 Bldg (by perm) 7.5 W/If Note choose either the facade area or the Derimeter method. but not both Total Allowed Bldg. Exterior Watts Use mfgr listed maximum input wattage For fixtures with hard -wired ballasts only, Proposed Lighting Wattage (Exterior) the default table in the NREC Technical Reference Manual may also be used Location Fixture Description No of Fixtures Watts/Fixture Watts Proposed Total Proposed Watts may not exceed Total Allowed Watts for Exterior Total Proposed Watts 2002 Seattle Nonresidential Energy Code Compliance Form Note new automatic davliahtina. occuoancv sensor, and other control requirements of Section 1513, as aoolicable June 2002 - KJM/MAK Prescriptive Spaces Occupancy, O Warehouses, storage areas or aircraft storage hangers 0Other Qualification Checklist Lighting Fixtures ❑ Check here if at least 95% of fixtures in the space meet all four criteria Note If occupancy type is "Other" and (W/sf) fixture answer is checked, the number of 1 Only one or two lamp fixtures, 2 Luminaires have reflector or louver assemblv directing light fixtures in the space is not limited by Code 20 Clearly indicate these spaces on plans If 3 Fitted with T-1, T-2, T-4, T-5, T-6, T-8 or compact fluorescent lamps from 5 to 60 60 watts, and not qualified, do LPA Calculations 4 Ballasts are hard -wired fluorescent electronic dimming ballasts with photocell or programmable Aircraft repair hangars dimming control for all lamps in all zones (non -dimming electronic ballasts and electronic ballasts that screw into medium base sockets do not comply with this section) TABLE 15-1 Unit Lighting Power Allowance (LPA) Use' LPA` (W/sf) Painting, welding, carpentry, machine shops 2.3 Barber shops, beauty shops 20 Hotel banquet/conference/exhibition hall°'° 20 Laboratories 2-0 1 8 Aircraft repair hangars 1 5 Cafeterias, fast food establishments' I 1 5 Factories, workshops, handling areas 1 5 Gas stations, auto repair shops' 1 5 Institutions 15 Libraries' 15 Nursing homes and hotel/motel quest rooms 1 1 5 Wholesale stores (pallet rack shelving) 1 5 1 Mall concourses Schools buildings (Group E occupancy only), school classrooms, day care centers Laundries 14 4-351 2 4-312 Office buildings, office/administrative areas in 4-210 facilities of other use types (including but not limited to schools hospitals, pitals, institutions, museums, banks, churches) 6, 7,11 Footnotes for Table 15-1 Use' Medical office, clinics" Police and fire stations° Atria (atriums) Assembly spacesy, auditoriums, gymnasiay, heaters Group R-1 common areas Process plants Restaurants/bars' Locker and/or shower facilities Warehouses'', storage areas Aircraft storage hangars Retail'°, retail banking Parking garages Plans Submitted for Common Areas Only' Main floor building lobbies' (except mall concourses) Common areas, corridors, toilet facilities and washrooms, elevator lobbies LPA` (W/sf) 12 4-21 0 10 10 10 10 10 08 05 �04 115 See Section 1532 iia 08 1) In cases in which a general use and a specific use are listed, the specific use shall apply In cases in which a use is not mentioned specifically, the Unit Power Allowance shall be determined by the building official This determination shall be based upon the most comparable use specified in the table See Section 1512 for exempt areas 2) The watts per square foot may be increased, by two percent per foot of ceiling height above twenty feet, unless specifically directed otherwise by subsequent footnotes 3) Watts per square foot of room may be increased by two percent per foot of ceiling height above twelve feet 4) For all other spaces, such as seating and common areas, use the Unit Light Power Allowance for assembly 5) Watts per square foot of room may be Increased by two percent per foot of ceiling height above nine feet 6) Includes pump area under canopy 7) ,asSs - %'.41'Gh a lighting pIaR is subm fted to - eRly a portion of a fleeF, a IJR1t Light— A I1,anGe of 1 36 may be used f6r --sableoff-A-e fleerarea _and 0 90 watts peF srquare feet shall be used for the ne --- --- . spaGe, lobby aFea and Fast FOOFFIS Commen aFeaG, as heFein defined do not indude mall GOAGGUFses For conference rooms and offices less than 150 sauare feet with full -height Dartitions. a Unit Liahtino Power Allowance of 1 20 W/sa ft may be used. 8) For the fire engine room, the Unit Lighting Power Allowance is 1 0 watts per square foot 9) For indoor sport tournament courts with adjacent spectator seating, the Unit Lighting Power Allowance for the court area is 2 6 watts per square foot 10) Display window illumination installed within 2 feet of the window, Drovided that the dlsDlav window is separated from the retail space by walls or at least three-quarter height partitions (transparent or ooaaue). and lighting for free-standing display where the lighting moves with the display, are exempt An additional 1.5 w/ftz of merchandise display luminaires are exempt provided that they comply with all three of the following a) located on ceiling -mounted track or directly on or recessed into the ceiling itself (not on the wall) b) adjustable in both the horizontal and vertical axes (vertical axis only is acceptable for fluorescent and other fixtures with two points of track attachment) c) fitted with tungsten halogen, fluorescent, or high intensity discharge lamps This additional lighting power is allowed only if the lighting is actually installed 11) Provided that a floor plan, indicating rack location and height, is submitted, the square footage for a warehouse may be defined, for computing the interior Unit Lighting Power Allowance, as the floor area not covered by racks plus the vertical face area (access side only) of the racks The height allowance defined in footnote 2 applies only to the floor area not covered by racks 12) Medical and clinical offices include those facilities which. although not providing overniaht patient care. do orovide medical. dental. or Dsvcholoaical examination and treatment These spaces include. but are not limited to. laboratories and treatment centers CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 'U 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00000866 Date 9/29/04 Pin number . . . . . . .504970 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99 -0 -0 -6910 -0000 - Tenant nbr, name . . . . . . SAFEWAY Application description . . . SIGNS Subdivision Name . . . . . . ���/J Property Use . . . . . . Property Zoning COMMUNITY SHOPPING DISTR Application valuation . . . . 5700 Owner Contractor ------------------------ ------------------------ NECA/PBTF WESTERN PROPERTIES THE SIGN FACTORY 1125 15TH ST NW 815 STH STREET WASHINGTON DC 200052707 KIRKLAND WA 98033 (425) 822-1200 ---------------------------------------------------------------------------- Permit . . . . . . SIGN Additional desc . . 1-33SF WALL/1-14SF FREE STAND Permit Fee . . . . 115.00 Plan Check Fee .00 Issue Date . . . . 9/29/04 Valuation . . . . 5700 Expiration Date . . 3/29/05 Qty Unit Charge Per Extension 1.00 85.0000 PER S- SIGN WALL 25 SF+ 85.00 1.00 30.0000 PER S- SIGN ALL 25- 30.00 Fee summary Charged Paid Credited ---------------------------------------- Due �- ----------------- Permit Fee Total 115.00 115.00 .00 .00 (� Plan Check Total .00 .00 .00 .00 v Grand Total 115.00 115.00 .00 .00 0 rt 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. /te/V Sig re ofCont ctor or Au orized Agent Signature of Owner (if owner is builder) Date T \PLANMNWORMSU 102 15 [1 1/14/20031 2004/SFP/16/THU 07:23 AM CITY OF PA BLDG DEPT FAX No. 360 417 4711 P'001 FOR OFFICIAL USF_ ONLY- -7 BUILDING PERMIT - APPLICATION Date Rec 9 1 Fill out COAMETELY and in Mc Your ap0cation and site plan MUST BE Date Approved- COAVLET1 to be accepted for review. IS you have any questions, call Date Issued: PERMITS (360) 417-4815 FAX(360)417-4711 Applicant or Agent:- j-) P S I -C ►F4 Cjo,- c— Phone- Attme f i YV) : f4f PhozLe Address: 0 l� 3 h Z S cit, A,A,, it Zip- ArobiteebSngineer. Phone: -A e . nl� Contractof] -S _StateLicense#:S� Phone: 4�y- Address:' 't5 _';+ City- Zip: 9S-033 PROJECT ADDRESS: I re -7 r I- S -- __ , - —ZONING: T) LEGAL DESCRIMON: Lot Block SubdivisiozL: CLAL LAM COUNTY PARCEL NUN SEIL Credit Card Folder Name: ]Billing Address: City. Credit Card Type VISA 9C — # Exp. Date-. TYPE OF WORK' SlUfVALUATION: M Residential M NcConstr. 0 Re -roof 0 Stove I a k"' a 1 6 It sp. @$ /SF. -3600_� Nemo 0 Wti-f=ily 0 Addition 0 move 0 Garage I I C, Y T,IUF. @ S /SF.=$ 9L-700' 0 commercial L1 Remodel 13 Demolition 0 Deck sp. @$ /SF, = S r) Ropair ip A Other TOTAL VALUATION $ 57 00 �Ws- BR11F DIsCWTION OF TIM PROJECT, j- 0- LA COABIERCLUAZESIDENTL4L.- Occupancy Group: Occupant Load: L Congtxuction Type: No. of Stories: — Lot Size' Existing Sq. FL & Proposed Sq. Ft. = TOTAL Sq, Ft. Total lot coverage % APPROV Is - PLAN: FLANMGU-. SEONLY�'�_ xx BLDG, DPVM. F1RE: t�Maa=ud(s'o esot"OCheeldiftre Oil 1`1' BUILDING PERMIT AP;L10AON sUBAMTAL- The Building Division can provide you with information on the application and plan submittal requirements if you have questions. VAL'UATxON OF CONSTRUCTION: Iii an cases, a valuation amount must be entered by the applicant Tbis figure will be -reviewed andmayberevisedbythe Building Division to comply vift current fee scliedules- ContacttheParmil Cooidinatorat417-4815 for assistanep, PLAN CHECK FEE: IF a plan chock fee is due it must be submitted at the time the building permit application and construction plans are ------subniittrd.-All -ptheT-pkln?it fees are due at the 2fpemut issuance. EXPIRATION OF PLAN REVIEW: If no permit i-s-iigE�eaw—IOZE-ISO-days-of'tht-date-of-applicatiot;-the-application-wM-expir,�—, zae_ Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section RI 05.12 of the imtcrmtonal Building/Residential Code, 2003). No application can be extended more than once. I hereby ceiflf that I have read and examined this application and know the same to be true and cormct I am authorized to apply for this permit and understand that it is myresponsibifflYto determine what permits are required,nof the GjVs, and that I must obtain such permits prior to work: T TvBsg)RLDG-fom-s-b=buTci\203-)3uildmpcmt--Pg �--mat'- y 12'-6" ---- — - ----- -- - — -- _- I EXTRUDED ALUMINUM CABINET - WI a BAN FACE � I 2' 8 ' (®( HIGH OUTPUT FLUORESCENT LAMPS American Marione Bank I 911 WIREWAYFIX 4.0 Y � BALLAST I TO PRIMARY POWER I -- --- - ---- -- ----- ---- --- ------------ --- ----- --- --- -- - - POWER REQ -120V SCALE. 1/2" = 1'-O" DISCONNECT SWITCH ON SIDE OF CABINET ALL MANUFACTURING & COMPONENTS TO BE U L LISTED ' SINGLE INTERNALLY ILLUMINATED WALL MOUNT DISPLAY SAF EWAY I FOOD & DRUG 9" DEEP EXFRUDEDALUMINUM CABINET WITH 2" RETAINERS PAINTED BLUE (PMS 072) WHITE LEXAN FACE WITH APPLIED 3M VINYL GRAPHICS fOPENT244 HOURS BLACK, CARDINAL RED (3630-53) & ROYAL BLUE (3630-87)CABINET INTERNALLY ILLUMINATED WITH HIGH OUTPUT FLUORESCENT LAMPS I ALLWIRING & BALLASTS CONTAINED WITHIN CABINET op --- l-, CABINET CENTERED IN DESIGNATED WALL AREA rr\OLA VvLe� w 1 t►h 3`g" 7c'1 TY -- -- WT.-Fl - PORT ANGELES, WA Representative: 1R REVISION: THISDRAWiNGAND ORUSEDEM PT THE E ICHOF MSHE51GNAND ph 425 Strep firkhnd,WR98o" American Marine Bank I I Design No: SF 040836-1 SHALLNOTBECSIE,COLORDE�EWORiHEPUTEfELORWKKHRIECrTHEINtEGRrrYOFTFSLYFURNISHED ph4t5872R00 G458171D74 Date:B/24/04 — 9/ //DY THE DRAW NG AND CANY RCOMES TTHEREOF SHW FBE RETUFNED TO SWNFAROR 800-585-2066 MADE IN USA 1'-9" 5 5/8" 8'-1 1/2" I� American Marine Bank I DOUBLE FACE ILLUMINATED CABIENT 14" DEEP EXTRUDEDALUMINUM CABINET WITH 2" RETAINERS PAINTED BLUE (PMS 072) WHITE LEXAN FACE WITH APPLIED 3M VINYL GRAPHICS BLACK, CARDINAL RED (3630-53) & ROYAL BLUE (3630-87) CABINET INTERNALLY ILLUMINATED WITH HIGH OUTPUT FLUORESCENT LAMPS ALL WIRING & BALLASTS CONTAINED WITHIN CABINET CABINET CENTERED IN DESIGNATED WALL AREA ✓ a,,,� eC w T A -h -/rr N X I IJL Seip +cpp ,et -3d HV6 SCALE 3/4" =1'-0" 14 I ® D RUDEDALUMINUMCABINET ® (— HIGH OUTPUT FLUORESC:NTtAMPS O 3/16.OM FAC: 4— WIREWAY ® _ BAHT f TO PRIMARY POWER POWER REQ -120 V DISCONNECT SWITCH ON SIDE OF CABINET ALL MANUFACTURING & COMPONENTS TO BE U L LISTED PORTAN G E LES WA Representatne: IR REVISION: H S OR4W NG AND ALL IN ORM4 bN THEREON IS THE PR07EH Y OF THE SAN FPC OR AND BIS B(A SIf� CAW' WA 98033 SIGN Tlll DI TBEC7fl , USEDEKEPf1ORTHE PUfPoSEFOR'NMCH"IS E%PItPSS1YFURN6HED Qj.B�IN(I hQS.glT 1014 American Marine Bank I Design No: SF 040836 6 Ph AITEAAT10NS IN Slff, COUJROR MATERIALS DD NOT EFFECT THE IMEGMYOF THE B451C DESIGN Date: 9/7/04 THE DPAW NG ANO ANY COP EST 4REOF SH4LL BE RE UTNEO TO THE S GN FACTORY 804-585-1066 MACE LN USA a a CXMI LMN 3rd ST. (FULL (FULL TURNING) TURNING) I L2 J i u f u u u -iR I—.- 0 99.IV44k If �Kl �3 Ile L CD :3 is to TPAW 25V IT 4 cm — CD 4 6-38'50'E %7' (.n (FULL TURNING= L.Li KLP nCP. SKEM mic'p. PttON CD NCP -XA Ln (FULL 3 Ci aEanacc OVER" - IF 4th ST. 4th V�ST, SAFEWAY STORE N 56.37'51Y W 344.618' fk"-NO'E It ' S poor, afiSIOENEE KARO-w 5th ST° L FmTs � CL aND TITLE SAFEWAY STORE N 56.37'51Y W 344.618' fk"-NO'E It ' S poor, afiSIOENEE KARO-w 5th ST° j aND TITLE REST A"r IMR SHW' OLYWIC LAWC11y Permits - Safeway 1492 Correction to Permit drawings Page 1'I From: 'Richard Utt" <rutt@cornerstonearch.com> To: <permits@cityofpa us> Date: Tue, Sep 21, 2004 3:45 PM Subject: Safeway 1492 Correction to Permit drawings ATTN• Roger Vess Permit Technician SAFEWAY 1492, 110 E. 3rd. Street, Port Angeles, WA Our drawings as submitted for permit review need the following corrects. Permit Drawings Corrections. 9-21-2004 Sheet T 0.1 Project Data Occupancy Group is M The code used shall read per the 2003 International Building Code (IBC) Exit width shall be per IBC section 1005.1 Under the General Notes: 1.0 item D.,last paragraph delete reference to ICB 2000 and replace with 2003 IBC. 8.0 item shall read as: gazing per IBC 2406.1 15.0 itm C. shall read: per IBC 712.3.1 & 712.3 2.2 Sheet A 5.2 this sheet may have not been corrected before submittal if not please see below. Details 7,8,9 &10: The note shall read : Conform to IBC 2003 sections 803.9.1.1 & 2506.2.1 as per ASTM C-635-00 and 636-96. Rick Utt Architect Cornerstone Architectural Group FILE WAAF CORNERSTONE MAIN ARCHITECTURAL GROUP letter of transmittal (�A 'T P-1 ATTENTION: N-' TRANSMITTAL OF: ❑ SHOP DRAWINGS RINTS ❑ ORIGINALS ❑ CHANGE ORDER ❑ REPORT ❑ SAMPLES COPIES I DATE NO. DATE: C� — 3,o S PROJECT #: qDPROJECT:---�' +/" REFERENCE: !J --_ S ❑ SPECIFICATIONS ❑ CORRESPONDENCE ❑ COMPUTER MEDIA ❑ DESCRIPTION L TRANSMITTAL FOR: `�/ ❑ APPROVAL [-]YOUR USE [:1 AS REQUESTED REVIEW AND COMMENT DELIVERY METHOD: US MAIL E:1 COURIER ❑ HAND DELIVERED [:1 FED EX ❑ REMARKS: I 1" "-._....... (7-0 cel cc: NFile ❑ ❑ Signed------f�7 "—� u TT 1904 THIRD AVENUE, SUITE 500 SEATTLE, WA 98101 TEL 206 682 5000 FAX 206 621 7717 WWW CORNERSTONEARCH COM 11 OF PORT 4NC CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 c T�t (206) 457-0411 PERMIT Nn G Site Address: Installed By: Owner/Business: ELECTRICAL PERMIT Owner/Business Address: DATE ❑ READY FOR INSPECTION License Number: ELECTRIC HEAT ❑ RESIDENTIAL ❑ BASEBOARD KW ❑ COMMERCIAL ❑ FURNACE KW ❑ NEW CONSTRUCTION ❑ HEAT PUMP KW ❑ REMODEL ❑ FAN/WALL KW ❑ ADD/ALTER CIRCUITS ❑ SERVICE UPGRADE/REPAIR TEMPORARY SERVICE Details/ Description W.S. No. CAPACITY: ❑ O.K. ❑ ACTION REQUIRED: ❑ RISER ❑ WILL CALL FOR INSPECTION Phone: Phone: Sq. Ft �G OVERHEAD SERVICE UNDERGROUND SERVICE VOLTAGE: �ZD �1❑3� SERVICE SIZE AMPS FEEDER SIZE AMPS 00 SERVICE SIZE NOT O.K. ❑ CHANGE TRANSFORMER ❑ INSTALL SERVICE POLE ❑ Ditch Inspection O.K. ❑ Rough-in/cover O.K. O.K. to connect service ❑ Final O.K. DATF ENGR. ❑ OVERHEAD SERVICE APPROVED ❑ CHANGE SERVICE WIRE ❑ OTHER Site Address: Permit/Receipt No. Installer: New Meters Date: s���l Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report ® or on the Building Permit. PHONE 457-0411, EXT. 224. //7 �7 NOOCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT-/� Elebtricac Permit Fee WHITE — File by address PINK — Top: Eng, Bottom, Customer GREEN — TopMeter Dept., Bottom City Half OLYMPIC PRINTERS INC O F'ORTg4,0 ELECTRICAL RICAL MS EV Y YOGA �/� F<F , A.� �®WIRING REPORT W"; F, 417-4735 ORKS� �D/F/T/�_j PERMIT N INSPF/.ITO/R, /JWNE�+ONTRACT09 Y ADDRESS APPROVED NOT APPROVED ❑ .................... DITCH .................... ❑ ❑.............. . ROUGH IN/COVER ............... ❑ ❑ ....................SERVICE................... ❑ ❑......... ...........FINAL.................. . ❑ CORRECTIONS NEEDED: 6/ N e__ 4�'6, �'vG 'J. ofC 0 / C%i /'; / � X- Q NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC (360) 452-1381 8 ELECfR-'IcAL INSPECTION I"" bus"�' WIRING REPORT 417-4735 DATE PERMIT 0 INSPECTOR Cs- OYJNTRACTOR ADDRESS //0 f .3'-'6 -.- APPROVED NOT APPROVED ❑ ................... DITCH ................... ❑ ❑ .............. ROUGH IN/COVER ........ -... ❑ ❑ .................. SERVICE .................. ❑ ❑ .................... FINAL .................... CORRECTIONS NEEDED:O_��T'�C (.X-X.ci4 S .h?/_<_• �.e. L-. rl�a>b r_c� inl�_ /...si4i 6 NOTIFY INSPECTOR WHEN CORRECTION'S ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC (380) 4524381 SING REPORT 417-4735 TY LIGN h!5/ P� Ili INSPECTOR Aclo OW,:ERICANTRACTOR ADDRESS .//C /� / .f' _ / c/ -n;T, , ! APPROVED NOT APPROVED ❑ ................... DITCH ................... ❑ ❑ .............. ROUGH IN/COVER .............. ❑ .......... SERVICE .................. ❑ ❑ ..L ...... FINAL .................... CORRECTIONS /"t/ % kzji-j .F'6%a.��sY/ .< ( /�/�e'. % ^Jim-a✓L``' I / 5 � i.t/ Si7-iirL �� %1'Ir- /lt"/✓E/. /2/✓rb'U ! j /r�Jc'J4r<":5 /✓d.sL.?i.� fTiiv �i� .� �/�: n�ii",.�z� f.-_.viii f _C i�,r + l /�' 9^,.t1 t..i A' U�. "i.'.+ / G"Ja7 J?n z, ! _ K .•` ,'r'..� . .✓ . -.%, NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 1E DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC (380) 9 -1 W1 Hpr 11 05 09:28a Jake Carter 2534351510 p.2 CUU7/Ar G/ 11/MUI1 UO.L3 AM W I I UP I'M DLUU urrI rhA 11U, JOU 411 4111 f. UUL i E1ECTk1C 4 L W0PKPERMITAPPLICATION -- --------_...---�------ -------'-----❑Reauestlnsuecttou---------------- 0 Electrical Coatraetor ❑ Owaer -- 0 Annual Peaade 0 Alarm 13 Carnival 0 Commltatal 0 Residential 0 Residential Maint. 0 Signs 0 Thermoset 0 Telecast. - `�Janallsnoo description. .. _ Job wired by ❑ Electrical Contractor 0 0weler - lej?"ol-oo�retraemr-name _� '.'r. -s_ weber -- �aLP.1r`Pt-1 Y1 ( !-1 .4i T7Jl Purchaser's mailing address o-zA • LU21 Ara N_ ct' Stdh Telephone lamely ely PAR number -� %--LiZu--...-- premUes o \WP e nn s f 1 Address of}papeatiion Ii 2 -(, k i n F, City ` Dr7��'� 0 Checks m I bemby certify that I athe owocr of the above owned property or a liebused qr L:remlCard 's W Vwa aslercard Discover authorized agent) and smaking the electrical electrical contractor (or the firmen in with the electrical lay. O3apttr 1928 RCW � r Signatart or owIriul t� r tleclneal sdwi.ist.st*r ExpiretlonDam `X �,of card % ,nape/ of 7 e ell) ( $( Q I,� — WALLS t�a�vG ` THERMOSTAT 1._.._-.. 1..( sERVICE Insulation Only Inaolatio , only Il J ow ♦wr..d ay JI ]yru aan•ay .sd esw. No�+s err ty... awn*'° a> 1117TH FEmFB Cpver Cover C Dws App " By ` � � � Dwr Ayps.M�S— Dw yyprM 6y Eloctrical Load Additions and or subtractlIlm Son" information 0 NO LOAD CHANGES 0 Baseboard _ KW voltage 0 Furnace _ KIN 0 Overhead Service Masi, 0 1 0 3 0 Heat Pump _ Ton _ LAR 0 Temp Service Service Sure: 0 Fan -Wall —KW 0 t1M6raround Service Feeder Sue: lmpectroa _ I Airs. Buildingor ent la P9mPm� Ancon Taken I Electrical Data ins pector Mz/�� I /i V, 1 /)�p I /1crc I I 1_ II L I 1 P 1 LUUJ/AYH/uvrrcl 0:44 Hbl 6111 Ut M bLU4 UCrl CAA NO. ,i0u 411 4111 Y. UU3 I Electdcalcontnetor Cl Owner �. .. �'D����tinsp'echom 0TtKPERMII'AI?PI.I,C�7'IQN .• 0 Agm ml Permit ❑ Alcan O CrrAMl XComoneregnl 0 Readnedd 13 Reddeallal mast. O Sips 0 Thermostat O TAW#= / .. ..__.... ll.tion descnp!loo _........ ......._... ... ..__._...._.. ..- _.. __—_ _.. _............._.. -._- - - ...giy. ._.. . .._ .. �Eleetrkdl Coutractoc Ootwer Au"hun, s auding adduce i6,;2 5t" h'i.t City state ZIP q� 5L4vntNjtl - W TelepOme_muoboT FAX number rr this Fe°wta� e C 7.53 - r`3 Z61 97-%• Add,,,, of I.rpectloo City Pc r -r fht cT -.L.e IAI�TW 1) jL S l L/`. FT- 1�2, 6 q ser Fr 3.z 3 /6 O Cash 0 Check 0 I hemby e«ttly that I am 0e oumm of rise above named property or a ficcmcd O Credit Card Visa Mastorcud Discover elocainl contactor (w the firm's authorized Actor) and = making the dmbia - iomlladed m altomtioo in raoplimte with me el"olol law, ChAPM 19.28 P.M. Card k - - �slgnaldr of owner. leerrlee eAnveploe a electrical Administrator \-ErprflonD -- Y. /, 771 /Nofdard ie.pe oAe re ��� e WAITS CEIIING TBXRMOSTAT SERVICE Insulation Only Inwl.sfm Only Cover Cover "rr�--"6%`— r DITC9 FFiDFR ' " � o.. Aor..w V on. E%cVfCW Lgg tAddidona and or suttrectbns O PID LOAD C "FS 0 6aseboaM _KW 0 Furnnde ,KW O Ovoradad Service 0 ileal pump l Ton ___- LAP 0 Tornio Service ❑ Fen -Wal _KW O Underground Service leapectron Am, Building or PquWmrmt hapnemd Dere lZ iTr� / S«pE2 Voltage phWo 0 1 O 3 Service Size: Feeder Sire: Action Tale. 8loctrlc.l lnep..mr I-t7� rd}9e7 MW 2-d OSLG 928 ES2 M W dW313f1211 eEO:OT SO 10 idd ELECTRICAL PERMIT APPLICATION — °r�.�®..; The Electrical Pei mtl Apphcahon must be filled out completeh, Please type or reprint In ink. If you have any questions, please call (360) 417-5735 Fax number (360) 4174711 D hone all(o—�'2�� '3/ppoFax:,;?(Jla—�r%� ��.5 % Owner or Elec Contractor Agent J.�i(sD �� r vl CaA.O/if�FAr - Property Owner e Z�n/9'K'`-+'�-� jJ�'�." .,L Phone Address: //d �i43% 3 FO City /" o��/ 3 Zip v Electrical Contractor Q/G,do Ld License #,115`1eo/#/ 79§-Y_ 106, Phone L Address:Ti 3/S S. ///ice S � $vi?° 2 /S/� City AIL_/ Y -e— Gci� . Zip INSTALLATION WIRED BY 0OWNER ELECTRICAL CONTRACTOR Credit Card Holder Nam— -T�� 5'eLLn oeS Billing Address: City: Zip: Credit Card Number: Exp. Date: VISA: PROJECT ADDRESS: //0 I 3A -.,O TYPE OF WORK: Check all that apply)4New ❑ Alteration/Addition ❑ Residential ❑ Multi -family V, Commercial ❑ Mobile Home Sq Ft /s -vv ❑ Remote Meter ❑ Detached garage ❑ Hot Tub ❑ SWIM Pool ❑ Septic Pump kLow Voltage ❑ Telecom Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT:w�—�� Q / Electrical Heat Load Additions and or Subtractions Service Information -I Baseboard _ KW Voltage: i Furnace KW ❑ Overhead Service Phase: ❑ 1 ❑ 3 :1 Heat Pump LRA E)Temp Service Service Size -3 Fan -Wall _TON KW ❑ Underground Service Feeder Size MC: X I ❑ Sign rrQ� 10 I hereby certify that / 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. c/ Credit Card Holder's Signature: �%%�1�/ / Date: Owner or Elec. Cont. Signature: /' /< �� Date:/ f� r PERMIT FEE: $ /ELECTRIC4.LPERIV,1TAPPLICAT101J roa orl2;,� ELECTRICAL PERMIT APPLICP.TION %Q The Jecincal Permit G,pplmalion must be titled ou: completely WIY.S P�� Please type or reprint in ink. If you have any questions, please call (360) 417 2 5 Fax number (360) 417-4711 Owner or Elec Contractor AgenrC/C-y�Lf Or �ez_ eji�N4vXIak- Phone Property Owner Sl�F��hU✓f'c/ - Phone Address: l �� b�FSl t ��Q City: y'/l /"1 u- ISZ ��"j Zip: i Du'o' �I�ihir.c REPORT417-4735 GATE � PERMIT 0 OWNERICONTRACTOR ///% ADD"/ APPROVED NOTAPPROVED ❑ ................... DITCH ................... ❑ .............. ROUGH INICOVER .............. ❑ SERVICE .................. ❑ ❑ .................... FINAL .................... L`(100CCTlnus NPPnIZ 4 NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (350) 152-1381 ►� - ��l so Folk o.. .,,-, ... u6c (11.! ELECTRl AL PERIAT APP ICATIOPJ �" — Tne Eleelncal Permit Appheahon mus; be filled ou; Completely SMAS PNS Please type or reprint in ink. If you have any questions, please call (360) 417-4735 Fax number: (360) 417-4711 Ownei or Elec. Contiractor Agent, \�/^�1 v {�� I AI C' C TA phone \ Fax tr Property Owner 1161�.e�L`- IMA iriCV1irl� TJttM/ V— lIF_IJn1 kxj 7 1NA19, �iu-�%}F'`_u/fi4r z' 1 Phone Address. �A��wt�i IID £. 3Rp s( Qty CA • zip %'S36Z ' I? � �� Q rp 1200 2k�_ Electn cal CConn`tr1a1ctttor I1UVe-vt `CSA tr;O —Jqc- LicAense# Ix�`UCvte1C7 Exa, %z ( D Phmn�3bV) Address: aI`f 1 lof illGF r City lua/24 v/Q we( Zip 98312— INSTALLATION J8f31L INSTALLATION WIRED BY: ❑ O—WNECR2 $ELECTRICAL CONTRACTOR F-NVF\M F—'-0Itoo Credit Card Holder Nam-' c//I✓f?AI I�(t VLCCL( <%�i�t/�(1=�Cl�t�J �I `f7 ti� ,u (Dt) j A v City: iGt�l l icM �(Gt w zip. q�3 Billing Address: Exp. Date: VISA: kMC: 1 Q PROJECT ADDRESS: TYPE OF WORK: Check all that apply: ❑ New LiAlteration/Addition ❑ Residential LIMulti-family I/Commercial ❑ Mobile Home Sq. Ft OO ❑ Remote Meter ❑ Detached garage ❑ Hot Tub ❑ Swim Pool 7 Septic Pump O Low Voltage ❑ Telecom. ❑ Sign Number of Circuits added or altered: DESCRIPTION OFTHE ELECTRICAL PROJECT: 1e,1AttIJ tV11IDYbVt?�a�--1 ) rn5`�K.�I CUN-J 1 Pe�P'�� Qr<,UvYEw�( t�f'Lv�i7 4Tl'��S I 'YDC Q I�INI"�k�,t-tf%—• i -Electrical Heat Load Additions and or Subtractions �:j Baseboard KW !f f 'Furnace KW �i�Ta'��tiKi D Heat Pump _TON LRA -1 Flan -Wall KW ❑ Overhead Service ❑ Temp Service ❑ Underground Service Service Information Voltage: 1C©/2,OT Phase: ❑ 1 In :i Service Size EAt rel - Feeder Size qo ps I hereby certify that l 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: Owner or Elec. Cont. Signature: ::/FLE CTR ICALPE RMITAPPLI CATI ON Date: OoDwkda4, Date: 0 /40 PERMIT FEE- $ A MRING REPORT ®t 417-4735 QTY 11G� DATE PERMIT N IN ECTOR OWNERICONTRACTOR �.;4h..�:t.i die /•'/�'L:.i G.l ADDRES Ho � : S%� APPROVED NOTAPPROVED ❑ ................... DITCH ................... ❑ ❑ .............. ROUGH IN/COVER .............. ❑ ❑ .................. SERVICE .................. ❑ ❑ .................... FINAL .................... ❑ CORRECTIONS NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC (380(152-1381 09/29/2004 09:07 4258271074 THE SIGN FACTORY PAGE 01/01 2004/SEP/29/WiGD C7: 40 AI4 CITY OF PA BLDG DEPT PAX Ila.'6u 41'1 4ili r. uuvuui e .. .. PDA uns "j4:Us5 c+'6v Ww", .-.,_..,-. - �4E�TplCAL PERMIT AP.PLICPTION _. .. WleAryee+N { ... .. .. _. - U. W j F The Electrical Parmll APPllcallon mmol be fined out CofnDletely. , Pinmetype:ne reprint.in.ink-If you have any -questions, pleaeP call (3601,417-473S Fax number: (360) 417.4711 l�10 i OwnPs or EJea Contractor Agent //la �rS� I GGiW� /'Yv>r' Phcne: yd25 iC��-l�CX7 Fmc 4/I t7-/y7�i PJnpetl•Avmer. .. PJB -- ..--- =--_PJ1ono:. - .. _... ,.. _ odcity: .. ...-Is> .... _ ._ _ 7JP; �i S'3ti 2 Electical Contmotor. I nr �re,., c Lire uDoTs- EIW:•-7'o?''O(c' PhoneLS9!E�a _i CIO I Addrevs: INSTAL'L•ATiUNwIREC"BYi ' ' TfOWNaR .. ...... ... j_4j!C€CTRICAL CONTRACTOR ........... .. Credlt Card Holder NamP • ' BifffnB Addressr - .. Date: city. .. - VISA:_ MC; y Crsdlf Card Number F. PROJECT ADORESS: I J U /— 4' S TYPE or wawCheck g that apply: 0 New O Alteration/Addltion 7 ❑ Residential O Multi -family 0 Commerclal ❑ Mobile Home Sq. Ft i O Remote Mater ❑Detached garage 0' Hot Tub'v Swim Pool . 0 Septic Pump 0 Low Voltage 0 Telecom. %R:$)pn Number of Circuits added or altered: Z DESCRIPTIDNOFTHEELECTRICAL PROJECT: Lhc'��4 e2•- 'Z /IN..••�'�.r.l-e"� �15t,-, A Electrical Heat Load Additions and or Subtractions Service Information Baseboard ._ KW Voltage: Fumace KIN 0OverhoodService Phase: 01 0 3 7 Heat Pump TON_ LRA 0 Temp Service Servlce Size: 7 Fan -Wall _KW 0 Underground Sar0ce Feeder Size - hereby certify that f have read and examined this application and know that same to ba true and correct, and I am iuthorfzed to apply thrthls permit I understand Itis not the City's legal responsibllfty to determine what permits ire required; it remains the applicants responsibility to determine what permits are required and to obtain such. I Credit Card Holder's Signature: pate: Owner or Elea Cont SI 0 'PERMIT.FEE: $�5�3.. !MLECTRICALPERWAPPLICATION voeTMgN I PON Or!9CL4 U< NLY Of C a��aN ELECTRICAL PERMIT APPLICATION I DaeiNn )o 6 Date Approve The Electrical Permit Application must be filled out com Dleteiv. Da" ivu`e _ `^MS PtryV ��/� _ Please type or reprint in ink. If you have any questions, please call (360) 417.4735 X17 X010 �9 Fax number: (360) 417-4711 Owner or Elec. Contractor Agent: M& S D/'ATA/COM M Phone 20(,-�0-9,� Fes; 2 `t C6- GS 3 Property Owner: SPS FE W Pat _( ( ZI 9 2 Phone: Address: f O Ef�S I 3AB S; I City: ?C)ZT /tOGC-LES zip: -((] �a? ;, _ Electrical Contractor. MCS DAT ^ C 0 M r -A - �Licens O#Ac-l- '14 o }�f _\S',, Ep �� �_ �" City:Lx-7[_)00 (-Phone: - 6 q3X Address: 1a Zip: INSTALLATION WIRED BY: ❑ OWNER ELECTRICAL CONTRACTOR Credit Card Holder Name y LE C1,4Lt_A wj / M VS O,c,--,4, C, N\ LLC_ b'• Lo L Billing Address: 'Lc( W.1 AJG S. City: Zip: vary Credit Card Number: - PROJECT ADDRESS: , O - 1 3 as _ T UkZ SZ Z O V,,� TYPE OF WORK: Check all that apply: ❑ New ❑ Alteration/Addition VISA: '< MC: ❑ Residential O Multi -family t' Commercial ❑ Mobile Home Sq. Ft �e=0 U ❑ Remote Meter ❑ Detached garage ❑ Hot Tub ❑ Swim Pool ❑ Septic Pump (§:Low Voltage ❑ Telecom. ❑ Sig Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT: D Aa- s, -f S-t:tMM Electrical Heat Load Additions and or Subtractions ❑ Baseboard _ KW ❑ Furnace KW ❑ Heat Pump —TON LRA 0 Fan -Wall KW Service Information / hereby certify that l have read and examined this application and know that same to be true and correct, and I an 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: 144 f k (r Date: to`2 9 / 0 3 Owner or Elec. Cont. Signature: lt�A p Date: (ob oz Vt , PERMIT FEE: $ . 0 ,00 C:/E LECTR I CALPER MI TAP PLI CATI ON Voltage: ❑ Overhead Service Phase: ❑ 1 ❑ 3 ❑ Temp Service Service Size: ❑ Underground Service Feeder Size:- / hereby certify that l have read and examined this application and know that same to be true and correct, and I an 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: 144 f k (r Date: to`2 9 / 0 3 Owner or Elec. Cont. Signature: lt�A p Date: (ob oz Vt , PERMIT FEE: $ . 0 ,00 C:/E LECTR I CALPER MI TAP PLI CATI ON r PDR OFf1QAL USE ONLY ELECTRICAL PERMIT APPLICATION Prima r. Fti.:� Dae �tup : The Electrical Permit Application must be out eomoletely. Dae Is,uN: Please type or reprint in ink It you have any questions, please call (360.4174735 Fax number: (360) 417.4711 Owner or Elec. Contractor Agent J ap-ADLI Dv0''JkIl I Phone: `7o6)3`1) lclvq 3Alf bo A?-5-5Db Property Owner: St ` c� Atl�j Address: I I Q F tT`�I�I rzib I )' Electrical Contractor: f�AU£IWnni...,,Er,t �?d �-- Address: 'KI ` -7 hh t ��P1 -1 'rail INSTALLATION WIRED BY: ❑ OWNER Credit Card Holder Name: �� 6f2i9 bl 14 ax Phone: City: t' . r1, _ Zip: �2 e r ZtYc.> 4 30 a License N:I 1g �CAJ . Exp; 2�1�r �0%t Phone: 217- /ter Clty:.i-t�IDiAMOL 4 �� ZZp: gf3547_ ELECTRICAL CONTRACTOR , ` ` p b11 Ak-4N t Y1 r� U GNC.(�.l L- �.-sG,.- Bitting Address. �styVI it$ E�bt1;�- City: Credit Card Number: 775ExP pate: PROJECT ADDRESS: + 10 E . I P, P r"t , TYPE OF WORK: Check all that apply: KNew O AfterationlAddition O Residental O Mule -family - X Commercial O Mobile Home Sq. Ft. Zip: VISA: Mc� O Remote Meter O Detached garage O Hot Tub O Swim Pool O Septic Pump O Low Voltage [ I Telecom. O S Number of Circuits added or altered: DESCRIPTION OF THE ELECTRICAL PROJECT: & XD CA-, eo nn P5 t Ih >PEaJ i23 , S+rta•,7 a~n trJc w t^+E ,1 E.rl F . �aw�&L 170, 66 Electrical Heat Load Additions f YD "70 OBaseboam _KW 4'x17'-,ry O Fumace _KW LJ Heat Pump _KW OFan-Wall _KW ( KJFi 1 Cti 15 t�E�in>a �71fZ r�C i 1011) yao A "e- 7i"ra Service information , O Overhead Service . Jemp Service Underground Service Voltage: t 20 �08 Phase: O 1 fg' 3 Service Size: -400 k(,&19 Feeder Size: FAAA1- eL 3/0 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. ft.), 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 1; lauthorized to apply for this permit. 1 understand it is not the City's legal responsibility to determine what permits ,ire required, it remains the applicants respo sibility to determine what permits are required and to obtain such. Ar _ j2 cob `� wF 31II — d l� Credit Card Holder's Signature: PW -9019 Owner or Elec. Cont. Signature: t CuMpL_iE-rE pF T'` Uji QCt ,5 0�1 Date://fa3 Date: CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — P.O. Box 11501 Port Angeles Washington, 95362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: S/ZOf/ 3 Multi -Family or Commercial* * Plan Review May Be Required PI e se omplete Electrical Plan Review Information Sheet Job Address: ®IO 640 3 S rt AAo..leS . W,9 q&3.12- Building &3d'2- Building Square Footage: �2-5/0010 Description of above ate( . �ve�e ✓ Owner Info m tion ✓ Contractor Information Name: IY4,-y Name: S'ek-t4- e_ Mallin Address: rV $ / Mailing Address: 70-76 � • 2�dA 5� City: plee-S &,fr>7 State; 6.4Zip: 7W-OT' City: Ye,&.�-- State: 4,1A Zip: 9e832 - Phone: Fax: Phone:" !/3r U t Fax: 263 9'727471-2— License '7274f l! -License # ! Exp. License # 1 Exp. - Item Unit Charge Qty Total (Qty Multiplied by Unit Charnel ServicelFeeder 200 Amp. $ 132.00 $ ServicelFeeder 201400 Amp. $160.00 $ ServicelFeeder 401-600 Amp $ 225.00 $ ServicelFeeder 601-1000 Amp. $ 268.00 $ Service/Feeder over 1000 Amp. $ 410.00 $ Branch Circuit WI Service Feeder $ 5.00 $ Branch Circuit WIO Service Feeder $ 74.04 $ 7 cl Each Additional Branch Circuit $ 5.00 ®Ia $ Branch Circuits 1-4 $ 86.00 _ice $. Temp. Service/ Feeder 200 Amp. $102.00 $ Temp. Service/Feeder 201-400 Amp. $121.00 $ Temp. Service/Feeder 401-600 Amp, $164.00 $ Temp. Service/Feeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuit/ Limited Energy- Multi -Family $ 64.00 $ Signal Circuit/ Limited Energy 1 First 1500 sf - Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 $ Thermostat $ 56.00 $ a Note: $5.00 for each additional T-Stat 00, $ b Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-4613, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: x _ _ Dated: (0,(\ -e t -.t v-\ c,L k. I 6 v\ rr Cash ■ Check - -77 18 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 13-00000945 Date 8/21/13 Application pin number 489810 Property Address 110 E 3RD ST ASSESSOR PARCEL NUMBER; Q6 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRTCAL ONLY Subdivision Name Property Use Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation , . . 0 ---------------------------------------------------------------------------- Application desc 11 circuit remodel ---------------------------------------------------------------------------- Owner Contractor INSPECTION TYPE SAFEWAY STORES INC DATE:: SEA TAC ELECTRIC INC C/O CPTS SERVICE 7056 S 220TH ST 1371 OAKLAND BLVD, STE 200 KENT WA 98032 WALNUT CREEK CA 94596 (253) 8'72-5553- 72-5553(425) (425)241-6420 PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTIOi? ---_---------------------------------___--------------------------_-------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional- dose . . Permit Fee . . . . 124.00 Plan Check Fee 00 Issue Date 8/21./13 Valuation . . . . 0 Expiration Pate 2/17/14 Qty Unit Charge Per Extension 1.00 74,0000 HCH EL -COMM BRANCH CIR WO/ SIF 74.00 10,00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 50,00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 124.00 124.00 .00 .00 Plan Check Total .00 Op ,00 .00 Grand Total 124.00 124.00 .00 '00 RESULTS: I REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Signature of owner or Electrical Contractor X Date: GAEXCHANGEIBUILDING i7k INSPECTION TYPE DATE:: DITCH �Cj '(I •l SERVICE ROUGH -IN FINAL - COMMENTS.'i'1� B PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTIOi? RESULTS: I REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Signature of owner or Electrical Contractor X Date: GAEXCHANGEIBUILDING i7k 0 . venrq,, 0 ELECTRICAL INSPECTION 67, WIRING REPORT 417-4735 071(9 DATE: PERMIT 9 PEc,roR -)Ci Ll INS OWNER — CONTRACTOR 'S'SiN, c— ADDRESS APPROVED NOT APPROVED DITCH. . .... ............. 13 'R'O'L''JGH IN/COVER ....... 0 0 .................... SERVICE ..... ....... 0 . ............... FINAL .................... 0 CORRECTIONS NEEDEID:C; /-?-I r.7--jSr� NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - ELECTRICAL INSPECTION WIRING REPORT Ks 417-4735 DAT, t);�Tl _ PER JNSPECTOR Z OWNER CONTRACTOR AooREss APPROVED NOT APPROVED DITCH ... - ......... - . . 0 0 ................ ROUGH IN/COVER .............. .O 0.., .. SERVICE ................... 0 0 ..................... FINAL .................... 0 CORRECTIONS NEEDED: L) L- 1. L2 C, -V - NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 16-00000118 Date 1/25/16 Application pin numher 513514 Property Address , , , 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06-30-99-0-0-6910 0000 Application type description ELECTRICAL ONLY Subdivision Name , , . , . . Property Use Property Zoning . , . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . , 0 ---------------------------------------------_------------------------------ Application desc Produce cut fruit room Owner Contractor SAFEWAY STORES INC D&R ELECTRICAL, CONTRACTORS C/C CPTS 2598 SW PINE RD 137.1 OAKLAND BLVD, STE 200 PORT ORCHARD WA 98367 WALNUT CREEK CA 94596 (360) 493-2207 (41,5) 201-6420 __ ___ ________ ___------------------------------------------------------ Permit . . . I ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee 94,00 Plan Check Fee DO Issue Date 1/25/16 Valuation , . , . 0 Expiration Date 7/23/16 Qty Unit Charge Per - Er.tenaicn 1.00 74,0000 ECH EL -COMM BRANCH CTR WO/ S/F 74.00 4.00 5.0000 BCH EL-ECH ADDNT BRANCH CIRCUIT 20,00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 94.00 94.00 00 OD Plan Check. Total OD ,00 00 ,00 Grana Total 94.00 94.00 .00 .00 INSPECTION TYPE DITCH I SERVICE ROUGH -IN FINAL COMMENTS: DATE: I RESULTS: PERMIT WILL EXPIRE SIX (6) MON'T'HS FROM LAST INSPECTION . Signature of owner or Electrical Contractor X G:IEXCIIANGEWILDING REPORT SALES TAX on your excise fax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Date: 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-4613, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14,05,050 regarding Electrical Permit Applications, Sigat to of owner, electrical contractor or electrical administrator: ❑ Cash ❑ Check \1 1 1 -.%o ❑ Credit Card # X kjG1QSJW0'V-�- Dated: � r 0110112012 RECEIVED JAN 2 5 DIN CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections �����,����� 321 East Fifth Street - P.O. Box 11501 Port Angeles Washington, 98362 INSPECTIONS ....... Ph: (360) 417-4735 Fax: (360) 417-4711 Date:/ " 2-5` l6 )CMulti-Famlly or Commercial* * Plan Review May Be Required Please Complete ,lec�l I Plan Review Information Sheet Job Address: Building Square Footage: Description of above Owner Infor Name; c� I ` F -�^, Contra, or Infor- atio. Name: " \ �e�n �a Mailing Address: Mail g ddress �� � � �� tee - 44FFG ] City: State: Zip: City:P—d�cL-t'+DStato: Zip: Phone: Fax: Phonezgk o —a-7 l E9:VT-z::7 License # ! Exp. License # ! Exp. (\ i:! r _6'' 1'- r— ex—' & Item Unit Charae GIyt Total (Qtv Multiplied by Unit Charae) Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201-400 Amp. $16000 $ Service/Feeder 401-600 Amp $225,00 $ Service/Feeder 6C1-1000 Amp. $288,00 $ Service/Feeder over 1000 Amp. $410,00 $ Branch Circuit W1 Service Feeder $ 5,00 $ Branch Circuit W/O Service Feeder Each Additional Branch Circuit $ 74.00 $ 5,00 $ $ Branch Circuits 1-4 Temp. Service/ Feeder 200 Amp. $ 86.00 $102.00 r v� $ // $ Temp, Service/Feeder 201400 Amp. $121,00 $ Temp, Service/Feeder 401-600 Amp, $164.00 $ Temp. Service/Feeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuit/ Limited Energy — Multi -Family $ 64.00 $ Signal Circuit/ Limited Energy I First 1500 sf — Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat (90 qq Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is fiin��al`izeed. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-4613, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14,05,050 regarding Electrical Permit Applications, Sigat to of owner, electrical contractor or electrical administrator: ❑ Cash ❑ Check \1 1 1 -.%o ❑ Credit Card # X kjG1QSJW0'V-�- Dated: � r 0110112012 ELECTRICAL PERMIT CITY OF PORT ANGELES 3604174735 Application Number 18-00000480 Date 4/03/18 Application pin number . . . 776000 Property Address . , . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: .06 -30 -99 -0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 --- - -- ------- Application desc Relocate deli hot / cold case. Wing Bar ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SAFEWAY STORES INC AC ELECTRIC SERVICE, INC. C/O CPTS 804 W MEEKER ST SUITE 102 1371 OAKLAND BLVD, STE 200 KENT WA 98032 WALNUT CREEK CA 94596 (253) 852-0225 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . , 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee .00 Issue Date . . . . 4/03/18 Valuation . . . . 0 Expiration Date . . 9/30/18 Qty Unit Charge Per Extension BASE FEE 86.00 - ------- - - - - - - - - - - - - - - - - - - - - - ---- ------ ---- -- ------ --------------- --- ---- - - Fee summary Charged Paid Credited Due Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 k e "f e—N s, 416- rc3 r•t L j �* ►Z '-Yr)14 INSPECTION TYPE TYPE DITCH SERVICE ROUGH -IN FINAL. COMMENTS: DATE: RESULTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION . Signature of owner or Electrical Contractor X 0 -0 ti P c# REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) � t i INSPECTOR Date: MULTI—FAMILY / COMMERCIAL a -4 ELECTRICAL PERMIT APPLICATION' Public Works and Utilities Department 321 E. 5th Street, Port Angeles, WA 98362 360.417.4735 j www.cityofpa.us i electri.calpermits@cityofpa.us Project Address: Safeway #1492: 110 E. 3rd Street Port Angeles, WA 98362 Project Description: relocate the existing deli hot/cold case and replace with wing bar O Multi -Family Residential El Commercial / Industrial / Public Building Square footage; Name: Safeway Inc Email: Mailing Address: 110 E 3rd St Port Angeles, WA 98362 Phone: Name: AC Electric Service, Inc. License: ACELESI025DF Mailing Address: 804 W Meeker Street Suite 102 Kent, WA 98032 Expiration Date: 3/31/19 Email: ac.ele hotmail.com Phone: v 3 1 Ulm Unit Charge Quantity Totat (Quantity x Unit Charge) Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201-400 Amp. $160.00 $ Service/Feeder 401-600 Amp. $225.00 $ Service/Feeder 601-1000 Amp. $288.00 $ Service/Feeder over 1000 Amp. $410.00 $ Branch Circuit W/ Service Feeder $5.00 $ Branch Circuit W/O Service Feeder $74.00 $ Each Additional Branch Circuit Branch Circuits 1-4 $5.00 $86.00 $ d� $ ` ip Temp. Service/Feeder 200 Amp. $102.00 $ Temp. Service/Feeder 201-400 Amp. $121.00 $ Temp. Service/Feeder 401-600 Amp. $164.00 $ Temp. Service/Feeder 601-1000 Amp. $185.00 $ Portal to Portal Hourly $96.00 $ Sign / Outline Lighting $88.00 $ Signal Circuit/Limited Energy - Multi -Family $88.00 $ Signal Circuit/Limited Energy/First 1500 sf -Commercial $96.00 $ (Note: $5.00 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less $113.00 $ Thermostat (Note• $5 for each additional) $56 00 $ $ 2592l:UU TOTAL. Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296- 46B; The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. 4/2/18 Katie Johnson - Manager Date Print Name mature (LV,0wneT-[TElectrical C or/Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.47111 l ELECV- AL Pmtmrr IL A.2. CY O �.T ANGELES 3"7-4735 Application Number . . . . . 16-00000435 Date 3/28/16 Application pin number . . . 468400 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06-30-99-0-0-6910-0000- REPORT SALEM T"Application type'description ELECTRICAL ONLY on your excise tax form Subdivision Name . . . . . . Property Use . . . . . . . . to the City Of Port Angeles Property Zoning . . . . . . COMMUNITY SHOPPING DISTR (Locaf on Code 0502) Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Cooler Owner Contractor SAFEWAY STORRS INC D&R ELECTRICAL CONTRACTORS C/0 CPTS 2598 SW 71NE:.RD 1371 OAKLAND BLVD, STE 200 PORT ORCHARD WA 98367 WALNUT CREEK CA 94596 (360) 443-2207 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMURCIAL Additional desc Permit Fee . . . . 74..00 Plan Check.Fee'. .00 Issue Date . . . . 3/28/16 Valuati*lft . . . . 0 Expiration Date 9/24/16 Qty Unit Charge Per Extension 1.00 74.0000 ECH EL -COMM BRANCX CIR:t6O/ S/F 74:00 Fee4ummary Charged Paid •Cr"ited Due Permit Fee Total 74...0.0 74.00 90 .06 Plan Check Total .00 .00 QO .00 Grand Total 74.00 7.00 „_�a_t�l .00 I INSPECTION TYPE DATE; RE.SMTS: INSPECTOR SERVICE ROUGH -IN FINAL COMMENTS: PMMU WILL EXi'M SIX (6) MONTHS FROM LAST Morr v -i "4 Signature of owner or Electrical Contractor X 0at6; . G:'IEXCHANGMUILDING CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street - P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: 2oD"- 1� Multi -Family or Commercial* =: }4r1rr 1.� t klo * Plan Review May Be Re uired, Pase Complete Electrical Plan Review Information Sheet Job Address: 170 7 ':V Building Square Footage: Description of above Owner In€ormation �l Name: �f / Contra or In€mma 'o Name: 1� ��L 1 Z / r S'Y Y SW AAS Mailing Address: City: State: /Zip: Mailirig Address: . City: State:& -i Zip: 9r367 Phone: Fax: Phone:&L-pPi- 1112- Fax: License # / Exp. License # / Exp.fZCLE Item Unit Charge Qty Total (Qtv Multiplied by Unit Charge) Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201-400 Amp. $160.00 $ Service/Feeder 401-600 Amp $ 225.00 $ Service/Feeder 601-1000 Amp. $ 288.00 $ Service/Feeder over 1000 Amp. $ 410.00 $ Branch Circuit WI Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 74.00 1 $ -9q'�' Each Additional Branch Circuit $ 5.00 $ Branch Circuits 1-4 $ 86.00 $ Temp. Service/ Feeder 200 Amp. $102.00 $ Temp. Service/Feeder 201-400 Amp. $121.00 $ Temp. Service/Feeder 401-600 Amp. $164.00 $ Temp. Service/Feeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuit/ Limited Energy - Multi -Family $ 64.00 $ Signal Circuit! Limited Energy I First 1500 sf- Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $113.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat $ j Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Sign re of owner, electrical contractor or electrical administrator: ❑ Cash ❑ Check ❑ Credit Card # x l . Dated: CX / 0110112012 ELECTRICAL -PERMIT CITY OF FORT ANGELES 360417-4735 Application Number . . . . . 17-00000079 Date 1/25/17 Application pin number . . . 849081 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -99=0 -0 -6910 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0- ---------------------------------------------------------------------------- Application desc Self check stands -------------------------------•-------------------------------------------- Owner ------------------------ Contractor SAFEWAY STORES INC ------------------------ MERIDIAN CENTER ELECTRIC INC C/O CPTS 11109 66TH AVE E 1371 OAKLAND BLVD, STE 200 PUYALLUP WA 98373 WALNUT CREEK CA 94596 (253) 848-5595 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee .00 Issue Date . . . . 1/25/17 Valuation . . . . 0 Expiration Date . . 7/24/17 City Unit Charge Per Extension BASE FEE 86.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 INSPECTION TYPE DATE: RESULTS: REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: DITCH SERVICE ROUGH -IN FINAL Y PERMrr WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Chp j�^ tof Signature of owner, electrical contractor or electrical administrator: C cash D check '� credo caro #14 r� \ I ?'? Deed: , '2'� �i 1�' 01t011202 RECEI .1 Zti •ir � +f `R`~tY.�t (Y{)�r ,4.,�'(�`�� It CITY OF PORI' ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 'NSt(/�� , . 321 East Fifth Street – Port Angeles Washington, 48362 ` W Ph: (360) 417-4735 Fax: (360) 4174711 Date: — Multi -Family or Commercial* Commercial Addition / Alteration ! Remodel 1 Repair' * Plan Review Mary Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: 11'x} � t�'Pt . t�Gtt Pw' cPt�. i0Yiyl BuiAkV Square Footage: DescriptionYwork ill soot OwnerInformation Contractor Information Name: ,:4 �A,:',, ;X)"(ZRn Name: NYlIaO Mailing Address `3137f \ I ,01, %,AtY. City: Law i, res State:_ Zip: t� iG�fi Mail' Address itli� i :,tr 1§Jf r~. CitXU State: Zip: A�. }? Phone: Fax: Phone:'! z - VI Fax License # 1 Exp. License # I Exp.t.4-.a-tQ CE )L-% item Unit Charae gty Total Multiplied by Unit ChwvW Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201.400 Amp. $160.00 $ Service/Feeder 401-500 Amp $ 225.00 $ Service/Feeder 601-1000 Amp. $ 288.00 $ ServiceTeeder over 1000 Amp $ 410.00 $ Branch Circuits 1-4 $ 86.00 ��_ $ Branch Circuit Wi Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 74.00 $ Each Additional Branch Circuit $ 5.00 $ Temp. Service/ Feeder 200 Amp. $102.00 $ Temp. Service/Feeder 201-400 Amp. $ 121.00 $ Temp. Service/Feeder 401-600 Amp. $164A0 $ Temo. ServicetFeeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ SigntOutline Lighting $ 88.00 $ Signal Circuitt Limited Energy i First 1500 sf — Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or gess $113.00 $ Thermostat $ 56.00 $ $ Total Owner as defined by RCW.1918.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property 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 the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Chp j�^ tof Signature of owner, electrical contractor or electrical administrator: C cash D check '� credo caro #14 r� \ I ?'? Deed: , '2'� �i 1�' 01t011202 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-4.17-4735 Application Number. . . 17-00001396 Date 9/29/17 Application-pin_Attlaber554352 Property. Ae#Cse$s : . . . 110 E 3RD ST ASSESSOR k4RCEL NUMBER:' 06-30-99-0-0-6910-0000- Applicatioi"i=-.type description ELECTRICAL ONLY Subdivision Name . . . . Property Use . . . . . . Property Zoning . . . . . . COMMUNITY SHOPPING DISTR Application valuation .; 0, -----------------------------= Application desc Starbucks remodel . --------------------------' -------------------------------------- Owner Contractor INSPECTION TYPE DITCH SERVICE ROUGH -IN FINAL CON04ENTS: DATE: RESULTS: ,w WA EJX _,�� PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X 29 t REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0302) d INSPECTOR: Rr Date: SAFEWAY STORES INC SEA TAC ELECTRIC INC C/O CPTS 7056 S 220TH ST 1371 OAKLAND BLVD, STE 200 KENT WA 98032 WALNUT CREEK CA 94596 (253) 872-5553 (425) 201-6420, ---------------------------------7------------------------------------------- Permit . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . .-. . 86.00 Plan Check Fee ..00 Issue Date . . . . 9/29/17 Valuation . . . . 0 Expiration Date . . 3/28/18 Qty Unit Charge Per Extension BASE FEE 86.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 INSPECTION TYPE DITCH SERVICE ROUGH -IN FINAL CON04ENTS: DATE: RESULTS: ,w WA EJX _,�� PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X 29 t REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0302) d INSPECTOR: Rr Date: ypF pcNtrq� �rr CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: ?1Z0) % Multi -Family or Commercial* Commercial Addition / Alteration / RemodL4-R6pair* * Plan Review May Be R Ir d, Ple se C lete Electrical Plan Review Information Sheet Job Address: 110 C 7�� Building Square Footage: _ De�cp ion of work %1 ,_ � �l C) nJ X I /iU(T�F Ul(F� tAJ I f �7APRCFL �'S i05K Owner Inffgm4:io� Name: H �� M it V1 Address: 1 t (� a D t� City: �Y(S L'( AiN(�U State: inS Zip: Phone: Fax: License # / Exp. Item Service/Feeder 200 Amp. Service/Feeder 201400 Amp. Service/Feeder 401-600 Amp Service/Feeder 601-1000 Amp. Service/Feeder over 1000 Amp. Branch Circuits 1-4 Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Temp. Service/ Feeder 200 Amp. Temp. Service/Feeder 201400 Amp. Temp. Service/Feeder 401-600 Amp. Temp, Service/Feeder 601-1000 Amp . Portal to Portal Hourly Sign/Outline Lighting Signal Circuit/ Limited Energy / First 1500 sf - Commercial Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less Thermostat Unit Charge $132.00 $160.00 $ 225.00 $ 288.00 $ 410.00 $ 86.00 $ 5.00 $ 74.00 $ 5.00 $102.00 $121.00 $164.00 $185.00 $ 96.00 $ 88.00 $ 96.00 Contractgr Information Name: eSFA-(AC ELE�7>QI� )lU� Mailing Address: City: -U/U 7 State: Zip: Phone: 2 2, 87 5/ / % License # ( Exp. X -A A F ZZ. OY77 C (O Q�t Total (Qtv Multi)lied by Unit Charge) / $ $ S $113.00 $ $ 56.00 $ AV Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, f hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electric ntractor or electrical administrator: 11 Cash 11 Check j�, 1 ElCredit Card # x a4/ Dated. / r 0110112012 «.1 INSPECTION TYPE DITCH SERVICE i ROUGH -IN FINAL COA+iII 'WS: DATE: RESULTS: '16111. 7 PERMIT WILL EXPIRE SII{ (6) MONTHS FROM LAST MSPECTION Signature of owner or Electrical Contractor X I INSPECTOR: Date: ELE MCAL FERMff _ { CITY OF PORT ANGELES 360-417-4735 _ X Application Number .. . . . , 17-00000845 Date 6/22/17 1 Application pin number . . . 875215 property PARCEL AS,BESSCIR llo E 3RD ST REPORT STATE SALES TAX SS PARCEL NUMBER: 06-30-99-0-0-6910-0000- Application type description ELECTRICAL ONLY on your excise tax form subdivision Name . . . . . . to the Cit of Port Angeles Property flee . . Y 9 Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR (Location Code 0502) Application valuation . . . . ---------------------------------------------------------------------------- 0 Applicakion desc Circuit for fresh pet refer ---------------------------------------------------------------------------- Owner ------------------------ Contractor SAFEWAY STORES INC --------- -------------- ANGELES ELECTRIC C/O CPTS 524 E. IST ST. 1371 OAKLAND BLVD, STE 200 PORT ANGELES WA 98362 WALNUT CREEK CA 94596 (360) 452-9264 (425) 201-6420 ------------------- ----------------------------------w--------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . , . . 86.00 Plan Check Fee .00 Issue Date 6/22/17 Valuation . . . . 0 Expiration Date 12/29/17 .Qty Unit Charge Per Extension BASE FEE 86.00 Fee summary Charged ----------------------- ---------- Paid Credited Due ----------------- ---------- -------------------- ---------- Pe it Fee Total 86.00 86.00 .00 .00 Plan"Check Total .00 .00 .00 .00 Grand 'Total 86.00 86.00 .00 .00 INSPECTION TYPE DITCH SERVICE i ROUGH -IN FINAL COA+iII 'WS: DATE: RESULTS: '16111. 7 PERMIT WILL EXPIRE SII{ (6) MONTHS FROM LAST MSPECTION Signature of owner or Electrical Contractor X I INSPECTOR: Date: 06/21/2017 09:53 FAX 360 452 9265 Angeles Electric CITY OF -PORT ANGELES PER UT APPLICATION BUBdin D1vWomMecftjW Juspftdo= . .9- 321 Eastlift Street – P.O. Box 1150 / port Anj#jex Wad&&#, 98362 Ph: (360) 411-4735 F= (360) 417-4711 Date:._ - In ----r- 160001/0001 'Plan Review. May Be Required, Please Complete EkCWCW Flan &Mgw k&=dM Sheol JohAddrew &"-Q Sqoro-Foatogr. Dou&— ---- .. "on of Am 3L C', . . ......... Ownerinformadon khMadeft Nome: Marv. An Mr. 2r,-Rpk��7 ftw ptww FIX Lkem#/Exp, UMft#1 Item Unk charal 8wike17eeder200Amp. $132.00 S~eoder201400MIL $160A0 $ Swvk*Feo&r 4014M Amp $ 225.00$ Service "der 60140D0Amp. $29A $ SwWcalFwler over 1000 Amp. $410.00 $ Branch Circult-W/Serybe Feeder $ 5.00 41 Branch Circuit W10 Servios Feeder $ 74A Each AddWorAd Branch, CkvA $ 5A Branch C-1mift 14 $ KA Temp. Sonficel Feeder 200 Amp. $ 1MA TMT. SonloWeeder 2014M Amp. $121.00 Temp. SeMoolFooder 4014M Amp. $ IRA Tamp. SaMoolhodgrODM000 Amp . $ IMA Porw to Porti Hourly $ KOO $ SWnftft Ughft $ KOD $ Signa[ CkvjW tbd Energy — Mu*Famly $ "A $ SOW CkcuWUmbd Energy /First 15M d—CmmrcW $ KM $ Note: 0A foresM addftW 1500 sf Renoralk SoWcol Energy - SWA System or Law $ II&OD $ Thermostat $ KM $ tie SUD for each aNdonal T-Stat Tow Owner as defined by RCW.192&Wl: (1) Owwwl occupy the *%An for too yon after tale ded" p@M* k Andwd. (4 Owfw ls M*qWW to hire art elmAdcal contractor I above vaW propotly Is for sade, rort or Wase. Pwmk,wom WW as monft of kot hwocft. After reading the abw * statement I hereby ow* OW I am the awnsr of the stove named property or a koved okekW ox*sdw. I am mW ft the electrical Instal don or atteradon In conVilance with ta oWcWW tows, "t, RCW- amptv 19A WAC. Chapter 29$4% The City of Pod Angeles Mu khW Code, and Uft SpoWcefions and RAMC 14.05.060 regarding BK%W Pwftfie. -signaturwof Owner, olechical coviftdor or. GIUMC&I afthd*ator. E3 C" 13 chux Application Number . . . . . 22-00000868 Date 7/13/22 Application pin number . . . 081980 Property Address . . . . . . 110 E 3RD ST ASSESSOR PARCEL NUMBER: 06-30-99-0-0-6910-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Upgrade fueling points ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SAFEWAY STORES INC MASCOTT EQUIPMENT CO INC C/O CPTS 435 NE HANCOCK ST 1371 OAKLAND BLVD, STE 200 PORTLAND OR 97212 WALNUT CREEK CA 94596 (503) 282-2587 (425) 201-6420 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1=4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee . . .00 Issue Date . . . . 7/13/22 Valuation . . . . 0 Expiration Date . . 1/09/23 Qty Unit Charge Per Extension BASE FEE 86.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 PREPARED 7/12/22,14:24:57 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:22-00000868 110 E 3RD ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER COMMERCIAL 86.00 TOTAL DUE 86.00 Please present reciept to the cashier with full payment