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HomeMy WebLinkAbout111 E 3rd St - BuildingOwner 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 alteration in compliance with the electrical laws, N,E,C„ RCW. Chapter 19.28, WAC, Chapter 296-463, The City of Port Angeles Municipal Co 2� and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature o vvger tical contractor or electrical administrator: © Cash I A 0 Check El Credit Card g 7�. 3-1 X bated: 0110112012 RECEIVED I ]JUL 2 4 2013 0 V pc5rar kff� . c CITY OF PORT ANGELES PERMIT APPLICATION + Building Division/Electrical Inspections 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, � #NSPECITOS 98362 Ph: (360) 417-4735 Fax: (360) 4174711 Date: 7-23--k3 -k Multi -Family or Commercial* * Plan Review May Be Required, Please Complete Electrical Plan Review Information Street Job Address: N rAS`T--' _?P.0 Building Square Footage: Description of above _ Owner Information Contractor Information Name: /.. V PO e_6x1.5 7-)ZVG Ti*?)rJ Name: ffr) Mailing Address: Mailing Address: City: State: Zlp: City: State: Zip: Phone: Fax: Phone Fax: License # / Exp. License # I Exp, CSF C:G e,3 �f. 2 - Item Unit Charae (-it Total (Qtv Multiplied by Unit Chane), ServicelFeeder 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 VVIO Service Feeder $ 74,00 �_ $ -_7�.- 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. $121,40 Temp Service/Feeder 401-604 Amp. $164.00 $ Temp Service/Feeder601-100O Amp. $185.00 $ Portal to Portal Hourly $ 96.00 $ SignlOutlino Lighting $ 88.00 $ Signal Circuig Limited Energy- Multi -Family $ 64.00 $ Signal Circuit/ Limited Energy l First 1500 sf -- Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - SKVA System or Less $ 113.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat j $ 7 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 alteration in compliance with the electrical laws, N,E,C„ RCW. Chapter 19.28, WAC, Chapter 296-463, The City of Port Angeles Municipal Co 2� and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature o vvger tical contractor or electrical administrator: © Cash I A 0 Check El Credit Card g 7�. 3-1 X bated: 0110112012 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 13-00000851 Date 7/30/13 Application pin number . , , 954352 Property Address , . , . , , 111 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -0 -5445 -0000 - Application type description ELECTRICAL ONLY Subdivision Name , , . . , Property Use Property Zoning . . . , . , , COMMUNITY SHOPPING DISTR Application valuation , , . . 0 ---------------------------------------------------------------------------- Application desc 1 circuit to move photo eye ---------------------------------------------------------------------------- Owner Contractor CLALLAM COUNTY BLACK DIAMOND ELECTRICAL CONTR 223 E 4TH ST 502 BLACK DIAMCND RD PORT ANGELES WA 98362 PORT ANGELES WA 98363 (360) 565-1035 ---------------------------------------------------------------------------- Permit . . . . , . ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Pee 74.00 Plan Check Fee .00 Issue Date 7/30/13 valuation . . , , 0 Expiration Date 1/26/14 Qty Unit Charge Per Extension 1.00 74.0000 ECII EL -COMM BRANCH CIR WO/ SIP 74,00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due Permit Fee Total 74.00 74.00 .00 00 Plan Check Total .00 .00 .00 .00 Grand Total 74.00 74,00 .00 .00 INSPECTION TYPE DATE: RESULTS: DITCH SERVICE ROUGH -IN r� P`INAI, COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM IAST INSPECTION Signature of owner or Electrical Contractor X GAIEXCHANGEIBUILDING REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Date: �i W ELECTRICAL PERMIT CITY OF PORT .ANGELES 360-417-4735 Application Number 13-00000851 Bate 7/30/13 Application pin number 954352 Property Address , . . . . . 111 E 3RD ST ASSESSOR PARCEL NUMBER, 06 -30 -00 -0 -0 -5445 -0000 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . Property Use Property Zoning . . . . . . , COMMUNITY SHOPPING DISTR Application valuation . , . , 0 ---------------------------------------------------------------------------- Application desc 1 circuit to move photo eye ---------------------------.- . ----------_-----_------------------------------ Owner Contractor ------------------------ ------------------------ CLALLAM COUNTY BLACK DIAMOND ELECTRICAL CONTR 223 E 4TH ST 502 BLACK DIAMOND RD PORT ANGELES WA 96362 PORT ANGELES WA 98363 (360) 565-1035 . ---------------------------------------------------------------------------- Permit . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee 79.00 Plan Check Fee .00 Issue Date . . . . 7/30/13 Valuation . , , , 0 Expiration Date 1/26/14 Qty Unit Charge Per Extension 1.00 74.0000 ECH EL -COMM BRANCH CIR WO/ SIP 74.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 74.00 74,00 00 .00 Plan Check Total .00 ,00 ,00 .00 Grand Total 74.00 74.00 .00 .00 INSPECTION TYPE DATE: DITCH SERVICE ROUGH -IN FINAL. COMMENTS: PERMIT WILL EXPIRE SIX (G) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X G:IEXCIIANGEIBUILDING RESULTS: REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR: Date: Electrical Permit 11 1 E 3rI St 12-1381 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE N ELECTRICAL PERMIT FINAL CITY OF PORT ANGELES I,;_ W 360-417-4735 UO Application Number . . . . . 12-00001381 Date 10/18/12 Application pin number . . 126487 Property Address 3Mp REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00•-V-or-�- Application type description ELECTRICAL S�¢5 on your excise tax form ONLY � ��• Subdivision Name . . . . . . to the City of Port Angeles Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . PUBLIC BUILDINGS & PARKS Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1-4 circuits , Replace HVAC unit ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLALLAM COUNTY ANGELES ELECTRIC 223 E 4TH ST 524 E. 1ST ST. �- PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 417-2429 (360) 452-9264 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS �} Permit Fee . . . . 86.00 Plan Check Fee .00 Issue Date . . . . 10/18/12 Valuation . . . . 0 INS Expiration Date 4/16/13 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: INSPECTOR: DITCH SERVICE ROUGH -IN FINAL COMMENTS:QL�P_ I,;_ PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X G:\EXCHANGE\BUILDING Date: 10/17/2012 12:47 FAX 360 452 9265 Angeles Electric CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — P.O. Boz 1150 / Port Angeles Washington, 98362 _ Ph: (360) 417-4735 Fag: (360) 417-4711 ELdC'lri;;/,� NISPECT101,:� Data: % �y _ Multi- amily or Commercial* Zcommercial Additi n / Alteration / Remodel / Repair* ' Plan Review May Be Required, Please Complete Electrical Plan Revieyy Irpfo tion Sheet Job Address: �/OD i5ke X d Y .3" Building Square Footage: Lii1/11) Description of above c� " .�K�► C�l�.ottif� tAel� NA10 ZACX "17- O'/ LO 0001/0001 srX"t_ Owner Info ti Contractor Information Name: �• Name: —=� Mailing Address: X2 S j_ 40�J% Maill Add iz1X7- City: State: P4 -A' Zip: 69"69" L City: oE� state: i►- Zie Phone: - Z—�s Fax: Q ;one* one: - 2� License 0 / Exp. Lioerisa p / Exp. A66j2C Item Unit Charqe Total f0ty Multiplied by Unit Charcel 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 Circuits 1.4 $ 86.00 $'Fj� Branch Circuit W/ 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. Servioe/Feeder 401-6W Amp. $164.00 $ Temp. Service/Feeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuill Limited Energy - Multi -Family $ 64.00 $ Signal Circuill 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 $ $ Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the strucWre 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 pf 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 Pern)it Applications. Signature of.owner, electrical contractor or electrical administrator: O Y'" ❑ Cheat CrCredit Card rr F'�l t � %�/ / 7�� //2012 X yunand: 0110 _ Building Permit 1 1 1 E 3'd St 12-1538 12-1361 Prepared 12/11/12,14:57:12 Application Inquiry-(BPN200I001) Page 1 Program HTDFTAL Screen detail for Program: BP BPN200I, Inspection history User ID PBARTHOL Application 12-00001538 Property Information Address: 111 E 3RD ST PORT ANGELES, WA 98362 Location ID: 89776 Owner name: CLALLAM COUNTY ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -0 -5445 -0000 - ALTERNATE ID: 063000005445 Zoning: CSD COMMUNITY SHOPPING DISTR Subdivision: Application Information Application status: COMPLETE Status Date: 12/03/2012 Application type: MECHANICAL APPL. PERMIT Application date: 11/21/2012 Valuation: 0 Square footage: 0 Public building: NO Reviewed by: JLL JAMES L LIERLY Pin number: 366960 Entered by: PERMITS Contractor Information Contractor Name: ANDGAR CORPORATION Contractor Number: 905 Type: GENERAL Status: ACTIVE Contractor Requirements Doc Number Exp Date STATE LICENSE ANDGAC'19102 7/11/2013 BOND 7/11/2013 LIABILITY INSURANCE 7/11/2013 Outstanding Inspections Insp Schedule Confirmation Permit Pmt Type ID Date Number Description Seq Min Max -- ------ ---------- ------------ --------------- ----' No outstanding inspections exist Work Description Code Description Quantity ------ ------------------------- -------- CO Information CO Issue Str/seq Date Status Description ------- ---------- -------------------------- Str/Seq Permit/Seq Inspection type Insp Seq Inspector Schedule date Results Results date Confirmation Nbr 000 000 ME 00 MECHANICAL FINAL 0001 JLL 11/29/2012 AP 11/29/2012 387654 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION - 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . Application pin number . . . Property Address . . . . . . ASSESSOR PARCEL NUMBER: Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . Application valuation . . . . 12-00001538 Date 11/30/12 366960 111 E 3RD ST 06 -30 -00 -0 -0 -5445 -0000 - MECHANICAL APPL. PERMIT COMMUNITY SHOPPING DISTR 0 Owner Contractor CLALLAM COUNTY ANDGAR CORPORATION 223 E 4TH ST PO BOX 2708 PORT ANGELES WA 98362 FERNDALE FERNDALE WA 98248 (360) 366-9900 Permit . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 64.80 Plan Check Fee .00 Issue Date . . . . 11/27/12 Valuation . . . . 0 Expiration Date . . 5/28/13 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 14.8000 -------------------------------------------- EA ME-FURN/HP/FAU c OR = 5 TON 14.80 Fee summary ----------------- Charged ----------------------- Paid Credited -------- Due Permit Fee Total -------------------- 64.80 -------------------- 64.80 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 64.80 64.80 .00 .00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) �-� II1 ►� 3�-'t � t/3a j, y (01 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 Ins pectidns 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. 0 Date Print Name Signature of Contractor 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 IN CONSPICUOUS 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 I I I I I I (FINAL Date I I I - IFINAL Date I I PLANNING DEPT. Separate Permit #s SEPk Parking / Lighting ESA: Landscaping I I SHORELINE: Comments Accepted by Accepted by 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 T:Forms/Building Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 60 3Z) Application Number . . . . Application pin number . . Property Address . . . . . ASSESSOR PARCEL NUMBER: Application type description Subdivision Name . . . . . Property Use . . . . . . . Property Zoning . . . . . . Application valuation . . . 2-00001538 3 60 111 3 ST 06-30- 0-0-0-5368-0 MEC I APPL. PE UNKNOWN 0 Date 11/27/12. REPORT SALES TAX T on your state excise tax form to the City of Port Angeles (Location Code 0502) Owner C htractor -------IESG ---------- ----------------------- C TA PHANDGAR CORPORATION 111 3RPO BOX 2708 PORT G WA 983622824 FERNDALE - - ---- Pe it . . . . . . <MECH Additional desc . Permit Fee Issue Date' Expiration Date ; Qty Unit Cha 1.00 ------------------- Fee su • ary Permit ee iT Plan Ch ck/ T Grand To al 000 EA / FERNDALE W 98248 -- (360) 366-9900 ------------ -------------- CAL PERMIT 80 Plan Check F .00 ,12 Valuation . . . . 0 13 0 � ✓�/ Extension B S FEE 50.00 E-FURN/HP/FAU 0 = 5 TON 14.80 --------------- ------------------------- Pai � / Credited Due /—64.80 6 .8 l/ 00 .-00 00 .00 .00 J 64.80 64.80 0 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required. inspectidns 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. itl7-7l2,::,ty i�94,lr� Date Print Name Signature of Contractor or Authorized gent 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 IN CONSPICUOUS 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 I 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 I I I I I FINAL Date I I I FINAL Date !I I Comments Accepted by Accepted by PLANNING DEPT. Separate Permit its SEPA: Parking / Lighting ESA: Landscaping I I 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 T:Forms/Building Division/Building Permit 0 THE -"-3'ORT C TY OF NGELES WASHI N Gi T O N, U.S. 321 East 5a' Street Port Angeles, WA 98362 P: 360-417-4817 F: 360-417-4711 permits@cityofpa.us Project Address: For City Use Permit# 13 (S 3 Date Received: I I) a( Date Approved Building Permit Application ori (1—;V Main Contact: !,1 u t D/f_�= Property Name Owner Mailing Address `Y a'.i3 City Po0-7- P411 A CICI UA Contractor Name A x3 i> 67 A 2_ Mailing Address City / Contractor License # 24 Phone # E -Mail: 4(_7 - 2.3 qO Phone �1� -23 qC) Email State Zip 1,,1 A 1 S3 2 Phone Email State Zip WR q83 Expiration: Project Value: I Zoning: I Tax Parcel # Lot # $ rp, Ooa Type of Residential ❑ Commercial ❑ Industrial ❑ Public I$) Permit Demolition ❑ Fire ❑ Repair ❑ Reroof (tear off/lay over) ❑ For the following, fill out both pages of permit application: New Construction ❑ Remodel ❑ Addition ❑ Tenant Improvement ❑ Mechanical Plumbing ❑ Other ❑ Existing Fire Sprinkler System? I Maximum height of structure I Proposed Bedrooms I Proposed Bathrooms Yes ❑ No ❑ Project �e l� I � �� �x �� -i• l w l�u�k ?,�....� o cA �; Description I have read and completed the application and know it to be true and correct. I am authorized to apply for this permit. I understand that it is my responsibility to determine what permits are required and to obtain permits prior to working on projects. I understand that the plan review fee is not refundable after plan review has occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the permit is issued. I understand that if the permit is not issued within 180 days of receipt, the application will be considered abandoned and the fees forfeit. Date Print Name Signature -)AQ ��Y-c �vl�� I►�TLs -Z--z 1-1 2 Area Description (SQ FT) Basement First Floor Second Floor Covered Deck/Porch/Entry Deck Garage Carport Other (describe) Area Totals Area Descriptions (SQ FT) Existing Structure (s) Proposed Addition Tenant Improvement? Other work (describe) Area Totals Residential Structures For Office Use Existing Proposed $$ value Commercial Structures , For Office Use Existing Proposed $$ Value Lot/Site Coverage Calculations Footprint (SQ FT) of all Structures: Lot Size: % Lot Coverage SQ FT Site coverage (all impervious + % Site Coverage structures) Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Nan-Haz Piping # of Outlets: Appliance Vent # Heater (Suspended, Floor, Recessed wall) # Boiler/Compressor Size: # Heating/Cooling appliance # repair/alteration Evaporative Cooler (attached, not # - ' Pellet Stove/Wood-burning/Gas # portable) Fireplace/Gas Stove/Gas Cook Stove/Misc. Fuel Gas Piping # of Outlets: Ventilation Fan, single duct # Furnace/Heat Pump/ I Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # Fuel gas piping # of Outlets: Water Heater # Medical gas piping # of Outlets: Water Line # Vent piping # Sewer Line # Industrial waste pretreatment # interceptor - Other (describe): T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX PREPARED 10/18/12, 9:59:04 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 10/18/12 -- ---- ADDRESS . : 111 E 3RD ST SUBDIV: CONTRACTOR ANDGAR CORPORATION PHONE (360) 366-9900 OWNER CLALLAM COUNTY PHONE : PARCEL 06-30-00-0-0-5445-0000- APPL NUMBER: 12-00001361 MECHANICAL APPL. PERMIT --------------------------------------------- - ----------- PERMIT: ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------- — -- — -------- —--------- --' ----- — --------------- ME99 01 10/18/12 L MECHANICAL FINAL October 18, 2012 9:31:51 AM pbarthol. keith360-201-6538 ------------------------ -------- -------------------- COMMENTS AND NOTES-------------- LIMl_ , CITY OF PORT ANGELES i� DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 12-00001361 Date 10/17/12 Application pin number . . . 453503 Property Address . . . . . . 111 E 3RD ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -0 -0 -5445 -0000 - Application type description MECHANICAL APPL. PERMIT Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . ---------------------------------------------------------------------------- 7000 Application desc REPLACE ROOF MOUNTED HEAT PUMP ---------------------------------------------------------------------------- WITH LIKE UNIT Owner ------------------------ Contractor CLALLAM COUNTY ------------------------ ANDGAR CORPORATION 223 E 4TH ST PO BOX 2708 PORT ANGELES WA 98362 FERNDALE WA 98248 ---------------------------------7------------------------------------------ (360) 366-9900 Permit . . . . . . MECHANICAL PERMIT Additional desc . Permit Fee . . . . 64.80 Plan Check Fee .00 Issue Date . . . . 10/17/12 Valuation . . . . 0 Expiration Date 4/15/13 Qty Unit Charge Per Extension BASE FEE 50.00 1.00 14.8000 EA ME-FURN/HP/FAU ---------------------------------------------------------------------------- < OR = 5 TON 14.80 Fee summary Charged --------------------------- Paid Credited Due Permit Fee Total 64.80 ------------------------------ 64.80 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 64.80 64.80 .00 .00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) 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 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 regu I�ruction or �tthhe�,!rformance of construction. l Date Print Name Signature of Contractor 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 I Stemwall I Foundation Drainage / Downspouts I Piers I Post Holes (Pole Bldgs.) I 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 PLANNING DEPT. Separate Permit #s Parking / Lighting Landscaping Accepted By I FINAL Date I I FINAL Date SEPA: ESA: SHORELINE: Comments Accepted by Accepted by 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 ������ j�-f� G / T-Fnrmc/Ruilriinn niuicinn/Rnilriinn Parmit OCT -12-2012 11:26AM FROM-ANDGAR THE CITY OF -✓,:ORTNGELES WASH I N G T O N. U.S. +3603665800 T-737 P.001 F-669 For City Use Permit# 7-- r- t Date Received: 321 East S"' street Port Angeles, WA 98362 Date Approved P: 360-417-4817 F: 360-417-4711 permits@cityofpa.us Building Permit Application Project Address: Main Contact: Property Name CL&LAM Crwn)T,1 WdS_ Owner j MailingAddress 711 S : Contractor Name Malling Address 5&44:! 44&) pRo A -10a city Contractor License # rPhone # 310- 3�3 - &65' ( (---2 E -Mail:_ �e5vl1i–/N� \4 LCA f1-/N�11D60.Cb1M Phone 3� _ `� I ! Email — - State ZIP Plu 366)–;5, , –Civ--.,-� cr- [imall - j�� f'�C�� Gx i �L CoM St to I ZIP Expiration: Project value: I Zoning: I Tax Parcel # Lot # $ _ Type of Residential 13Commercial Industrial 13 Public 13 Permit Demolition ❑ Fire ❑ Repair ❑ Reroof (tear off/lay over) ❑ For the following, fill out both pages of permit application: New Construction ❑ Remodel 13 Addition ❑ Tenant Improvement ❑ Mechanical( Plumbing ❑ Other ❑ Existing Fire Sprinkler System? 1 Maximum height of structure I Proposed Bedrooms I proposed Bathrooms Yes ❑ No [3 Project Description RVPLAe 5x� S?rn RboF mol,fi_)T;5A jLJC-R-i" A)M ja /j'I©Jn7T�p a-lrcR� �Jn�l P �L (kFD/z f� i <r�A✓�' o�ir I have read and completed the application and know it to be true and correct. l am authorized to apply for this permit- I understand that it is my responsibility to determine what permits are required and to obtain permits prior to working on projects. 1 understand that the plan review fee is not refundable after plan review has occurred. 1 understand that I will forfeit the review fee if I cancel or withdraw the application before the permit is issued. I understand that if the permit is not issued within 180 days of receipt, the application will be considered abandoned and the fees forfeit. Date Print Name Signature OCT -12-2012 11:26AM FROM-ANDGAR Area Description (SQ FT) Basement First Floor Second Floor Covered Deck/Porch/Entry Deck Garage Carport Other (describe) Area Totals Area Descriptions (SQ FT) Existing Structure (s) Proposed Addition Tenant Improvement? I Other work (describe) Area Totals +3603665800 Residential Structures Existing Proposed $$ value Commercial Structures Existing I Proposed $$ Value Lot/Site Coverage Calculations T-737 P.002 F-669 For Office Use For Office Use Footprint (SQ FT) of all Structures: Lot Size; I % Lot Coverage SQ FT Site coverage (all impervious + — %Site Coverage structures) Water Line # Vent piping — Mechanical Fixtures Indicate how many of each type of f-ixtureto be installed or relocated as part of this Qroiect. Air Handler I Size: # Haz/Non-Haz Piping Appliance Vent # Heater (Suspended, Floor, Recessed wall) Boiler/Compressor Size: # Heating/Cooling appliance re pair lalterati on Evaporative Cooler (attached, not # Pellet Stove/Wood-burning/Gas portable) Fireplace/Gas Stove/Gas'CoolcStove/Misc. Fuel Gas Piping # of Outlets: Ventilation Fan, single duct Furnace/Heat Pump/ Size: # h Ventilation System Forced Air Unit p Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated # of Outlets: Plumbing Traps # I Fuel gas piping I # of Outlets: Water Heater # I Medical gas piping # of Outlets: Water Line # Vent piping — # Sewer Line I itIndustrial waste pretreatment I # interceptor Other (describe): T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX PREPARED 2/09/11 8 09 24 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 2/09/1 ADDRESS 111 E 3RD ST SUBDIV TENANT NBR 3RD ST PROF BLDG (COUNTY) CONTRACTOR FERRELLGAS LP PHONE (816) 792 1600 OWNER CLALLAM COUNTY PHONE PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00001028 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME6 01 10/26/10 JLL MECHANICAL GAS LINE TIME O1 00 10/26/10 AP October 25 20 0 3 47 51 PM 1pangrle DAVE 670 9423 GAS LINE AFTERNOON October 26 2010 4 43 03 PM jlierly February 8 2011 3 39 30 PM pbarthol ME99 01 2/09/1} J L MECHANICAL FINAL (/ February 8 201 3 42 41 PM pbarthol DAVE 670 9423 PERMIT IS IN HIS OFFICE IN THE COURT HOUSE COMMENTS AND NOTES CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number 10 00001028 Date 10/06/10 Application pin number 943484 Property Address 111 E 3RD ST REPORT SALES TAX ASSESSOR PARCEL NUMBER 06 30 00 0 0 5445 0000 Tenant nbr name 3RD ST PROF BLDG (COUNTY) on your state excise tax form Application type description MECHANICAL APPL PERMIT to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning COMMUNITY SHOPPING DISTR Application valuation 5000 Application desc PROPANE TANK SET & GENERATOR SET Owner Contractor CLALLAM COUNTY FERRELLGAS LP 223 E 4TH ST 1 LIBERTY PLAZA PORT ANGELES WA 98362 ATTN OPERATING TAX DEPT LIBERTY MO 64068 (816) 792 1600 Permit MECHANICAL PERMIT Additional desc PROPANE TANK SET & GENERATOR Permit pin number 173468 Permit Fee 71 30 Plan Check Fee 00 Issue Date 10/06/10 Valuation 0 Expiration Date 4/04/11 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 10 6500 EA ME STOVE/FIREPLACE/MISC APP 10 65 1 00 10 6500 EA ME FUEL GAS PIPING 1 5 OUTLETS 10 65 Special Notes and Comments The Fire Department has reviewed the project application and has no comments Fee summary Charged Paid Credited Due Permit Fee Total 71 30 71 30 00 00 Plan Check Total 00 00 00 00 Grand Total 71 30 71 30 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 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. to - fo-Io IAS I D 141-1 -P, Date Print Name T Forms/Building Division/Building Permit s../H%3 1 D \ A71 bF Signature of Contractor or Authorized Agent 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 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 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 Date I Accepted By FINAL Date Comments Accepted by C> N w I ' OT-01 n� �7li , a1� 11 � �~ FINAL Date V Accepted by ,r1 PLANNING DEPT Separate Permit #s SEPA. Parking / Lighting ESA. Landscaping I I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date I Accepted By ' Electrical 417-4735 Construction R W PW I Engineering 417-4831 I C - Fire 417-4653 I+ Planning 417-4750 Building 417-4815 T.Forms/Building Division/Building Permit l/ BUILDING PERMIT GAS »'+.rK`t,, '�,s�4*��,,rJ• , Ask - CITY OF PORT ANGELES p�- Attn Building Permit Technician 321 E Fifth St. Port Angeles WA 98362 (360) 417-4815 fax (360) 417-4711 Applicant C a11A n Co,,,, Property Owner Glp/44M a,,,,,,�-� Property Owner's Address ZZ3 e TI -11) ct Contractor ,�=eRegc L(i4s Contractor's Address (cKto S, 3►-�,a�e Sg��,,,,,,, License # Expires PROJECT ADDRESS 1h E 3 Parcel Number APPUCA TION Print in Ink For City Use Only �YN \,Date Receivedq—l1,,-1Q �`�� Permit #lis -102 / (� ri a e Approved_ Phon - ,qZq Phonal y l -]- Zy.29 S+- Proiect Tvpe & Brief Description. ❑ Residential ❑ Multi -family Check all that apply ❑ New Construction ❑ Addition ❑ Remodel i C� p� a +c_ h k ❑ Repair J ❑ Demolition Phone §'3((,- I-ZL 1519 E-mail Lot ` Zoning (Commercial ❑ Industrial ❑ Re -roof ❑ House ❑ garage ❑ other ❑ tear off & re -roof ❑ lay over one layer ❑ Heat System ❑ Heat pump ❑ wood -burning stove ❑ gas fireplace ❑ pellet stove ❑ other AOther Ada( pr„ -2&Ae moo- 4� rws J6Z#JSFT' 75-6Ae ,C4.nlfado PoOe.— Floor Areas Existina (sq. ft.) Basement 1 St Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck / Shed / Other Proposed (sq. ft.) per sq ft. = $ S'600 OCTAL VALUATION Total footprint of structures sq ft. TZpaincluding Site Coverage = the amount of impervious surface c a structu and other impervious surfaces (see PAMC 17 94 1 ptions) Max. height of proposed structures ft ccupancy group Will a lawn sprinkler system be installed? 0crupant load / , Will a fire sprinkler system be installed? Con uction �e sq ft.ea�rg4 0 aveddoo6ways sidewalks patios Site coverage % # of bedrooms # of full baths �vf half baths I have read and completed this application and know it to be true and correct. I am authorized to apply for tins permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Datecl-i lb Print Name IAV Ir. JX -,.v Signature/1> (,4i?S- T.Forms/Building Division/Building permit application kv ; -aJV5 '. -Is, .04re I" poperprintout.com I J INN. L II I -�I I I.I paporprin.tout.com Ic 14, M Grainger Industrial Supply (GRANGER 1111 i.t'i L'SH•3_Ck a','l. t� K%3i}i.-tf�L Additional Info Page I of 3 Standby Generator, 10 LP/ 9NG kW Standby Generator Air -Cooled 10 LP/ 9NG kW Amps @ 120/240V 1 Phase LP 83 3/41 6 NG 75/37 5 NG Load Consumption 156 Cu-Ft/Hr Propane Load Consumption 70 Cu-Ft/Hr Propane Load Consumption 1 93 GPH Min Gas Pressure @ Generator 10-12 In WC Engine Size 530cc, Battery Requirements Min Amp Hr 525 Battery Requirements Group 26R, Battery Requirements 12 Volts Includes 1 Ft Flexible Fuel Line Connector And Composite Mounting Pad For Easy Installation Grainger Item # 2ZMG5 Your Price (ea.) $2,605.50 Brand GEN ERAC Mfr Model # 5520 Ship Qty 1 Sell Qty (Will -Call) 1 Ship Weight (lbs.) 4490 Usually Ships 1 3 Days Catalog Page No 1040 Air and Liquid -Cooled Automatic Standby Generators Feature mainline circuit breaker and solid-state frequency -compensated voltage regulation All input connections are in a single area. 525 CCA minimum amp hours Include 2 amp static battery charger battery rack for 12V battery and built-in 7 -day exerciser Group 26 battery required (not included) Require local permits for gas piping concrete foundation and electrical inspection ■ For residential or commercial applications ■ Run on natural or LP gas ■ Require RTS transfer switch (sold separately) Air -Cooled Include 1 -ft. flexible fuel line connector and composite mounting pad for easy installation Electrostatically -applied powder paint. Models equipped with aluminum housing are designed to withstand highly -corrosive environments ■ Generac OHVI(R) industrial engine ■ True Power Technology (TM) for smooth consistent power ■ Protect priority circuits or the entire panel Tech Specs Optional Accessories printer httn_//www vram¢er cnm/(-rramuer/wwor/itPmnp.tnilc chtml Q/161M1() Grainger Industrial Supply Item: Automatic Standby Generators Type. Air -Cooled kW 10 LP/9 NG kVA Rating 10 LP/9 NG Voltage: 120/240 Amps @ 120/240V 1 Phase. LP 83.3/41 6 (NG 75/37.5) Phase. 1 Hz: 60 Fuel Natural Gas/LP Vapor Engine RPM 3600 Engine Size 530cc Length (In) 48 Height (in) 29 Width (in.) 25 Fuel NPT Pipe Connection Sz. 3/4 NG Load Consumption (Cu.-Ft./Hr)- 156 Propane Load Consumption (Cu.-Ft./Hr) 70 Propane Load Consumption (GPH) 1 93 Min. Gas Pressure @ Generator (In WC) 10- 12/5-7 Engine Brand Generac Engine (Cooling) Air Engine (Block Heater) Optional Automatic Volts Regulation Yes Battery Requirements (Volts) 12 Battery Requirements Min. Amp Hr 525 Battery Requirements Group- 26R 12VDC Battery Charger- Yes Fault Indicator Lights Yes Repeat of Exercise Cycle Weekly Low Coolant Level Yes High Temp. Yes Low Oil Pressure Yes Over Crank Protection Yes Over Speed Yes Circuit Breaker- Included Main Circuit Breaker- Included Power Factor- 1 0 Run Time Hour Meter- Yes c Sound Level dBA. 63 Inlet: 3/4 Includes 1 Ft Flexible Fuel Line Connector And Composite Mounting Pad For Easy Installation Page 2 of 3 Transfer Switch, Standby 100 Amps, 240 V Item #• 2ZMH1 Brand GENERAC Usually Ships. Today Your Price (ea). $332.10 Transfer Switch, Auto 100 Amps, 240 V Item #• 2ZMH9 Brand- GENERAC Usually Ships. 1 3 Days Your Price (ea). $422.10 Cold Weather Kit, Air -Cooled Mfg April 08 Item #• 2ZNX7 0;1111111' Brand- GENERAC Usually Ships. From mfr w/in 8 bus days Your Price (ea) $301 05 Alternate Products There are currently no alternate products for this item. Repair Parts A Repair Part may be available for this item. Visit our Repair Parts Center or contact your local branch for more information httn.//www gramger cem/CTramaer/wwu/itPmT)Ptnilc chtml 0/1 r'ilnt n Grainger Industrial Supply Function Standby Power Housing. Steel Application All Standby Power Applications Installation Requires Local Permits For Gas Piping Concrete Foundation, Electrical Inspection And Approval Standards UL, CSA, NEMA, EGSA Agency Compliance- UL cUL Notes & Restrictions go California Proposition 65 Warning. This product contains a chemical known to the State of California to cause birth defects or other reproductive harm. MSDS This item does not require a Material Safety Data Sheet (MSDS). Required Accessories There are currently no required accessories for this item. Page 3 of 3 http.//www gratnger com/Gram2er/wwsi/itemDetails.shtml 9/16/2010 1-�- 1C) m 1( T 1 C E RTZ F ATIE'0F, 0SCC U PA N CY Cit, of, Port An jeles, B'uii,digg.Di�ision p This certificate is issued rsuant to the requirements of Section 110-o, f the 20,06 International Building Code certifying that atthelimeo..fbissuance this structure was in compliance with the various ordinances of the City regulatingtbulding3consiru tioneor. use for the followin_grr t Business name /,`"I nH ' p.Clalla: County Fealfl Departrrieit .u; " as t Business address. 111'1 =E` `3 St. Property owner , : Clallam C:gyf }-y'a< Property owner s;'a ness 223 E 4th St Port;Angeles, e1NA`9$3.62` Automatic fire sprinkler system. Per -IBC --m � - _ �. Use & occupancy classifcation. Busin�:ess- 1�F1 3 Occupant load. Per 2.00;6�'I Qj-'Table '1.004;.x1 1 Building permit numbe 'UJ- Type of construction.' 06/17/10 'ntrtger Date Post on the premises in a conspicuous place his if te�shall not be removed except by the Building Official. 1 1 O� -AM �0 1-�- 1C) m 1( PREPARED 6/11/10 8 21 06 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/11/10 ADDRESS 111 E 3RD ST SUBDIV TENANT NBR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00000062 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCTAT• REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 3/26/10 JLL BLDG FRAMING TIME 01 00 3/31/10 AP March 26 2010 8 28 43 AM 1pangrle CHUCK 360 731 0210 FRAMING AFTERNOON March 31 2010 8 37 45 AM jlierly BLI 01 3/30/10 JLL BLDG INSULATION TIME 01 00 3/31/10 DA March 30 2010 8 57 32 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION AFTERNOON March 31 2010 8 38 16 AM jlierly finish items required or correct issues and recall jll BLI 02 3/31/10 JLL BLDG INSULATION 3/31/10 DA March 31 2010 8 06 39 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION March 31 2010 4 14 44 PM jlierly not ready recall when complete/jll BLI 03 4/01/10 JLL BLDG INSULATION 4/01/10 CA April 1 2010 8 08 14 AM 1pangrle CHUCK 360 731 0210 INSULATION April 1 2010 4 26 59 PM jlierly contractor called and canceled JLL BLI 04 4/02/10 JLL BLDG INSULATION TIME 01 00 4/02/10 AP April 2 2010 8 08 03 AM 1pangrle CHUCK 360 731 0210 INSULATION AFTERNOON April 2 2010 4 38 22 PM jlierly BLTB 01 4/30/10 JLL BLDG T BAR 5/03/10 AP April 29 2010 3 35 49 PM 1pangrle CHUCK 731 0210 T BAR May 3 2010 8 08 57 AM jlierly BL99 01 6/11/10 LL BLDG FINAL June 10 2010 9 09 02 AM 1pangrle CHUCK 360 731 0210 BUILDING FINAL PLEASE INSPECT AS EARLY AS POSSIBLE HE HAS TO LEAVE AT 3 30 PM COMMENTS AND NOTES PREPARED 4/30/10 8 16 01 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/30/10 ADDRESS 111 E 3RD ST SUBDIV TENANT NSR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00000062 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 3/26/10 JLL BLDG FRAMING TIME O1 00 3/31/10 AP March 26 2010 8 28 43 AM 1pangrle CHUCK 360 731 0210 FRAMING AFTERNOON March 31 2010 8 37 45 AM jlierly BLI 01 3/30/10 JLL BLDG INSULATION TIME O1 00 3/31/10 DA March 30 2010 8 57 32 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION AFTERNOON March 31 2010 8 38 16 AM jlierly finish items required or correct issues and recall jll BLI 02 3/31/10 JLL BLDG INSULATION 3/31/10 DA March 31 2010 8 06 39 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION March 31 2010 4 14 44 PM jlierly not ready recall when complete/jll BLI 03 4/01/10 JLL BLDG INSULATION 4/01/10 CA April 1 2010 8 08 14 AM 1pangrle CHUCK 360 731 0210 INSULATION April 1 2010 4 26 59 PM jlierly contractor called and canceled JLL BLI 04 4/02/10 JLL BLDG INSULATION TIME O1 00 4/02/10 AP April 2 2010 8 08 03 AM 1pangrle CHUCK 360 731 0210 INSULATION AFTERNOON April 2 2010 4 38 22 PM jlierly BLTB O1 4/3 Q_/10 J BLDG T BAR April 29 2010 3 35 49 PM 1pangrle CHUCK 731 0210 T BAR COMMENTS AND NOTES PREPARED 4/02/10 8 10 22 INSPECTION TICKET PAGE CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE ADDRESS 111 E 3RD ST SUBDIV TENANT NBR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 0 00000062 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCTAT• REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 3/26/10 JLL BLDG FRAMING TIME O1 00 3/31/10 AP March 26 2010 8 28 43 AM 1pangrle CHUCK 360 731 0210 FRAMING AFTERNOON March 31 2010 8 37 45 AM jlierly BLI O1 3/30/10 JLL BLDG INSULATION TIME O1 00 3/31/10 DA March 30 2010 8 57 32 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION AFTERNOON March 31 2010 8 38 16 AM jlierly finish items required or correct issues and recall jll BLI 02 3/31/10 JLL BLDG INSULATION 3/31/10 DA March 31 2010 8 06 39 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION March 31 2010 4 14 44 PM jlierly not ready recall when complete/jll BLI 03 4/01/10 JLL BLDG INSULATION 4/01/10 CA April 1 2010 8 08 14 AM 1pangrle CHUCK 360 731 0210 INSULATION Apri 1 20 0 4 26 59 PM jlierly contractor called and canceled JLL BLI 04 4/02/10 JLL BLDG INSULATION TIME O1 00 April 2 2010 8 08 03 AM 1pangrle CHUCK 360 731 0210 INSULATION AFTERNOON COMMENTS AND NOTES 3 4/02/10 PREPARED 4/01/10 8 12 09 INSPECTION TICKET PAGE 8 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 4/01/10 ADDRESS 111 E 3RD ST SUBDIV TENANT NBR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00000062 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 3/26/10 JLL BLDG FRAMING TIME 01 00 3/31/10 AP March 26 2010 8 28 43 AM 1pangrle CHUCK 360 731 0210 FRAMING AFTERNOON March 31 2010 8 37 45 AM jlierly BLI 01 3/30/10 JLL BLDG INSULATION TIME 01 00 3/31/10 DA March 30 2010 8 57 32 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION AFTERNOON March 31 2010 8 38 16 AM jlierly finish items required or correct issues and recall jll BLI 02 3/31/10 JLL BLDG INSULATION 3/31/10 DA March 31 2010 8 06 39 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION March 31 2010 4 14 44 PM jlierly not ready recall when complete/jll BLI 03 4/01/10yFL+Q BLDG INSULATION Opt April 1 2010 8 08 14 AM 1pangrle CHUCK 360 731 0210 INSULATION COMM TS AND NOTES PREPARED 3/31/10 8 12 10 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/31/10 ADDRESS 111 E 3RD ST SUBDIV TENANT NBR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00000062 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 3/26/10 BLDG FRAMING TIME 01 00 March 26 2010 8 28 43 AM 1pangrle CHUCK 360 731 0210 FRAMING AFTERNOON BLI O1 3/30/10 JLL BLDG INSULATION TIME O1 00 . March 30 2010 8 57 32 AM 1pangrle '1 CHUCK 360 731 0210 WALL INSULATION AFTERNOON BLI 02 3/31/10 JL`F"" BLDG INSULATION March 31 2010 8 06 39 AM 1pangrle CHUCK 360 731 0210 WALL INSULATION COMMENTS AND NOTES . *A ;?�/ . C-OAL t,t)L-C-7-6\k C,,V 1, L PREPARED 3/30/10 8 59 03 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR JAMES LIERLY ADDRESS 111 E 3RD ST SUBDIV TENANT NBR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00000062 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCTAT• REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 3/26/10J%yL „ BLDG FRAMING TIME O1 00 March 26 2010 8 28 43 AM 1pangrle CHUCK 360 731 0210 FRAMING AFTERNOON BLI 01 3/30/10 JAL, _ BLDG INSULATION TIME O1 -�'�\J'j/'� March 30 2010 8 57 32 AM 1p1pangrle CHUCK 360 731 0210 WALL INSULATION AFTERNOON COMMENTS AND NOTES TyrLe, ✓ ,a ( ( pa/1- F-1 I ( C-510�3 s PAGE 1 DATE 3/30/10 r�� f�q �d` ��, s sf -.musj; PREPARED 3/26/10 8 38 46 INSPECTION TICKET PAGE 10 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/26/10 ADDRESS 111 E 3RD ST SUBDIV TENANT NBR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00000062 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 3/26/10 L BLDG FRAMING TIME 01 00 41 March 26 2010 8 28 43 AM 1pangrle CHUCK 360 731 0210 FRAMING AFTERNOON COMMENTS AND NOTES A /1 PREPARED 3/19/10 8 05 57 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/19/10 ADDRESS 111 E 3RD ST SUBDIV TENANT NBR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00000062 COMM REMODEL PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL2 01 3/05/10 JLL PLUMBING ROUGH IN TIME 04 00 3/05/10 AP March 5 2010 8 30 30 AM 1pangrle DALE 452 8525 ROUGH IN PLUMBING? (HE DIDN T SPECIFY WHAT KIND OF INSPECTION HE WANTED ) LATE AFTERNOON INSPECTION J March 5 2010 4 07 18 PM jlierly PL2 02 3/19/10 PLUMBING ROUGH IN TIME 01 00 March 19 2010 8 04 15 AM 1pangrle MARK 477 0626 ROUGH IN PLUMBING AFTERNOON COMMENTS AND NOTES PREPARED 3/05/10 8 57 32 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/05/10 ADDRESS 111 E 3RD ST SUBDIV TENANT NBR COUNTY HEALTH OFFC/CLINIC CONTRACTOR DRURY CONSTRUCTION CO INC PHONE (206) 842 5644 OWNER CLALLAM COUNTY PHONE (360) 417 2429 PARCEL 06 30 00 0 0 5445 0000 APPL NUMBER 10 00000062 COMM REMODEL --- - ---- -- ---- PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL2 01 5/10 PLUMBING ROUGH IN TIME 04 00 March 5 2010 8 30 30 AM 1pangrle DALE 452 8525 ROUGH IN PLUMBING? (HE DIDN T SPECIFY WHAT KIND OF INSPECTION HE WANTED ) LATE AFTERNOON INSPECTION COMMENTS AND NOTES (2/18/2010) Linda Pangrle Re Clallam County 3rd St Building HVAC plans From Linda Pangrle To, Kevin Wight Date: 2/18/2010 9 06 AM Subject: Re Clallam County 3rd St Building HVAC plans Hi Kevin, I printed your two e-mails and attachments and gave them to the Building Inspector Jim Lierly for his review He ok'd them. Linda Pangrle Permit Technician City of Port Angeles 321 E. 5th St. Port Angeles, WA 98362 360-417-4815 360-417-4711 FAX Ipangrle@cityofpa.us >>> 'Kevin G. Wight' <kevinw(a)andaar.com> 2/18/2010 8:45 AM >>> Good morning Linda, Thank you for all your help, attached are our drawings for the HVAC system, I'll be sending the submittals shortly Let me know if you have any questions or need more information. Thanks, Kevin Gene Wight Commercial HVAC Design/Build Estimator 6920 Salashan Pkwy A106 Ferndale, Wa 98248 Office 360.366 9900 Ext 168 Fax 360.366.5800 What Else Can Andgar Do For You? Click here <httD.//www.andoar.com/andaar-comoany.DhD> to find out. Confidentiality Notice The content of this email is intended solely for the individual or destination of which it is addressed, and may contain information that is privileged, confidential, and/or exempt from disclosure under state and federal laws. If you are not the intended recipient, or are not authorized to receive this in their behalf, you are hereby notified that you may not use, copy, distribute, or disclose to anyone this message or the content contained herein. If you have (2%18/2010) Linda Pangrle Re Clallam County 3rd St Building HVAC plans Page 2 n received this message in error notify the sender by reply and delete it immediately 0 -- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc REMODEL EXISTING BASEMENT Owner 10 00000062 Date 2/17/10 585328 111 E 3RD ST 06 30 00 0 0 5445 0000 COUNTY HEALTH OFFC/CLINIC COMM REMODEL COMMUNITY SHOPPING DISTR 304500 Contractor CLALLAM COUNTY DRURY CONSTRUCTION CO INC 223 E 4TH ST 19302 POWDER HILL PL N E PORT ANGELES WA 98362 STE 100 (360) 417 2429 POULSBO WA 98370 (206) 842 5644 Structure Information 000 000 REMODEL EXISTING BASEMENT Construction Type UNKNOWN Occupancy Type BUSINESS OFF/PRO/MED/REST Permit BUILDING PERMIT COMMERCIAL Additional desc REMODEL BASEMENT Permit pin number 159756 Permit Fee 2168 25 Plan Check Fee 1409 36 Issue Date 2/17/10 Valuation 304500 Expiration Date 8/16/10 Qty Unit Charge Per Extension BASE FEE 1020 25 205 00 5 6000 THOU BL -100 001 500K (5 60 PER K) 1148 00 Permit MECHANICAL PERMIT Additional desc Permit pin number 159764 Permit Fee 75 15 Plan Check Fee 00 Issue Date 2/17/10 Valuation 0 Expiration Date 8/16/10 Qty Unit Charge Per Extension '/..•,l'l�`� BASE FEE 50 00 v� c 1 00 10 6500 EA ME AIR HAND <OR=10 000 CFM 10 65 2 00 7 2500 EA ME VENT FAN (SINGLE DUCT) 14 50 Permit PLUMBING PERMIT Additional desc �{ Permit pin number 159772 (J Permit Fee 198 00 Plan Check Fee 00 Issue Date 2/17/10 Valuation 0 Expiration Date 8/16/10 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 per rmhhance of construc 'on. z) 11 Ila CAL- 1,A Do,,J IrAq Date Print Name Signature of Contractor or Auth dA ent Signature of Owner (if owner is builder) TTormsBuilding 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 I Accepted By Comments 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 I FINAL Date Accepted by AIR SEAL. Walls I Ceiling FRAMING Joists / Girders / Under Floor I j Shear Wall / Hold Downs Walls / Roof / Ceiling I Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab I I 1 Wall / Floor / Ceiling MECHANICAL. Heat Pump / Furnace / FAU / Ducts Rough -in Gas Line Wood Stove / Pellet / Chimney Commercial Hood / Ducts FINAL Date Accepted by MANUFACTURED HOMES Footing / Slab 1 Blocking & Hold Downs Skirting PLANNING DEPT Separate Permit #s SEPA. Parking / Lighting I ESA. ISHORELINE. Landscaping 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 T.Forms/Building Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION _ 321 EAST 5TH STREET PORT ANGELES WA 98362 Page 2 Application Number 10 00000062 Date 2/17/10 Application pin number 585328 Qty Unit Charge Per Special Notes and Comments January 26 2010 7 48 52 AM rbecker I need to know the use of the water for this remodel If the water is being used only for sinks and tolets or drinking water you will not need a backflow assembly If water is serving anything other than the above I will have to know what else the water is going to so I can determine if it needs backflow protection If you have any questions contact Ron Becker at 417 4886 E mail rbecker@cityofpa us or Fax 360 452 4972 A full acceptance test will be required for the fire alarm system January 26 2010 11 15 42 AM kdubuc This project will require a seperate permit and fire alarm plans for review Address numbers shall be plainly visible from the street Address numbers shall be a minimum of six inches high and be of contrasting color from the background A minimum 2A 1OBC fire exinguisher is required Extinguishers must be mounted with the top no more than 5 off the floor Suggested extinguisher placement is adjacent to an exit A KNOX locking keybox will be required Contact the Fire Department at 360 417 4653 for KNOX keybox ordering information and mounting location Labeling is required for doors leading to spaces containing fire alarm control panels and fire sprinkler risers February 12 2010 4 02 41 PM sroberds The proposal is an interior remodel of a basement of a bldg for County Health Dept administrative office staff 10 11 employees and a part time nurse will occupy the remodeled space NO doctors will be in the clinic The nurse will provide overseas travel shots to the public The site provides required pkg at the rear of the structure Given the info provided no land use issues are anticipated January 26 2010 8 14 52 AM rlarson Call Jim Klarr at 417 4731 to schedule removal of power lines if not already removed from house Public Works Utility Engineering has no requirements for this plan review Other Fees STATE SURCHARGE Fee summary Charged Paid Credited Extension 50 00 112 00 7 00 15 00 14 00 Due 4 50 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 Signature of Owner (if owner is builder) T:FornsBuilding Division/Building Permit BASE FEE 16 00 7 0000 EA PL -PLUMBING TRAP 1 00 7 0000 EA PL -WATER LINE 1 00 15 0000 EA PL -SEWER LINE 2 00 7 0000 EA PL -WATER HEATER Special Notes and Comments January 26 2010 7 48 52 AM rbecker I need to know the use of the water for this remodel If the water is being used only for sinks and tolets or drinking water you will not need a backflow assembly If water is serving anything other than the above I will have to know what else the water is going to so I can determine if it needs backflow protection If you have any questions contact Ron Becker at 417 4886 E mail rbecker@cityofpa us or Fax 360 452 4972 A full acceptance test will be required for the fire alarm system January 26 2010 11 15 42 AM kdubuc This project will require a seperate permit and fire alarm plans for review Address numbers shall be plainly visible from the street Address numbers shall be a minimum of six inches high and be of contrasting color from the background A minimum 2A 1OBC fire exinguisher is required Extinguishers must be mounted with the top no more than 5 off the floor Suggested extinguisher placement is adjacent to an exit A KNOX locking keybox will be required Contact the Fire Department at 360 417 4653 for KNOX keybox ordering information and mounting location Labeling is required for doors leading to spaces containing fire alarm control panels and fire sprinkler risers February 12 2010 4 02 41 PM sroberds The proposal is an interior remodel of a basement of a bldg for County Health Dept administrative office staff 10 11 employees and a part time nurse will occupy the remodeled space NO doctors will be in the clinic The nurse will provide overseas travel shots to the public The site provides required pkg at the rear of the structure Given the info provided no land use issues are anticipated January 26 2010 8 14 52 AM rlarson Call Jim Klarr at 417 4731 to schedule removal of power lines if not already removed from house Public Works Utility Engineering has no requirements for this plan review Other Fees STATE SURCHARGE Fee summary Charged Paid Credited Extension 50 00 112 00 7 00 15 00 14 00 Due 4 50 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 Signature of Owner (if owner is builder) T:FornsBuilding 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 1 1 Date I Accepted By I Comments FOUNDATION 417-4653 Footings 417-4750 Stemwall 417-4815 Foundation Drainage / Downspouts Piers I I Post Holes (Pole Bldgs.) PLUMBING Under Floor / Slab Rough -in Water Line (Meter to Bldg) Gas Line I Back Flow/ Water I FINAL Date Accepted by AIR SEAL. Walls Ceiling 1 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 I I 1FINAL Date Accepted by MANUFACTURED HOMES Footing / Slab Blocking & Hold Downs I ,� Skirting I PLANNING DEPT Separate Permit#s SEPA. Parking / Lightingl I ESA. Landscaping I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417-4735 Construction R.W PW I Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit 9 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES. WA 98362 Page 3 Application Number 10 00000062 Date 2/17/10 Application pin number 585328 Permit Fee Total 2441 40 2441 40 00 00 Plan Check Total 1409 36 1409 36 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 3855 26 3855 26 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 fora 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 Signature of Owner (if owner is builder) T:FomtsBuilding 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 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Footings Stemwall Foundation Drainage / Downspouts 417-4735 Piers I Post Holes (Pole Bldgs) I PLUMBING 417-4653 Under Floor / Slab I Rough -In I Water Line (Meter to Bldg) Gas Line I Back Flow / Water AIR SEAL. Walls Ceiling FRAMING 3-2(6—t0 Joists / Girders / Under Floor Shear Wall / Hold Downs Walls / Roof / Ceiling Drywall (Interior Braced Panel Only) T -Bar 1_3 0 — 110 I INSULATION Li —Z— 1 b Slab I Wall / Floor / Ceiling I 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 PLANNING DEPT Separate Permit#s Parking / Lighting Landscaping Accepted By Comments R2 PiuM�lnS 3-19-10 T[-�- 1 � LL IFINAL Date Accepted by .LL/ 1 FINAL Date I 1 SEPA. ESA. SHORELINE. Accepted by T:Forms/Building Division/Building Permit 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 Building 417-4750 417-4815 T:Forms/Building Division/Building Permit Flle Commands Help stNIam-uBtic secroa N3 iUn Save -moi Cancel , E� E=tl� Spell check j � Time clamp Application number type: 10 00000062 COMM REMODEL Property eddrea 111 E 3RD February 16 2010 10 39.19 All 1pangrle. -i 02 01 10 PER JOEL. THERE WILL NOT BE ANY _ DOCTORS THERE. A NURSE WILL BE THERE TO SIVE SHOTS FOR OVERSEAS TRIPS ETC THE REST WILL BE SECRETARIAL -TYPE EMPLOYEES SOME PEOPLE WITS, CCME TO THE SITE FOR HEALTH INFOR'MATICN 4 TRANSMITTAL To Fire Department I ❑ Other Department Date 1 — - ( D Project Address 1 )1 E, 34 S� Contact �)70d W Y\borVI Phone number(s) 3 G b - 41-7 , 2L" Zq Permit number Z Project !description Re rYIo�I '4'�xe- e Xt s+� r)q 60-!>--e-MtyJ+ -( aFloor B � �, � ?VLCIA ❑ New Construction hea�+�, ,�D W,, AdditionAlteration �10c&"� + 3� 10 o r I emp [oy ep-S . Please review & return to the Building D10sion, PermifTchnician T corms/Building Divisior,/Transmit`a lyO, VORr&,, g ea.w, &v. }1 t--cA,� 1-4e z+- m) I_ -t& michael geaxna.n 5o3_7 -3(a-3300 Pb r3 ox g 6 o 3a vhb e be&ma_n ctt-ck corn, PO v -°H W ) o P_ `x`12 BUILDING EPRMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 417-4815 fax (360) 417-4711 For City Use Only - Date Received ld�.. �d ermit # 10 — ' ate Approve Applicant I OA Phone :5 60 4L r IA2.S Property Owner ��htl t�,�-�„� Phone 271.0 A - v* 2.q2 -� Property Owner's Address 7_z3 E&e - Aw `, t 5��-rt �- Contractor PV -V z."Gc�,nS CClcarJ _ 1r�, c-.., Phone (266) Sy Z.-564 Y Contractor's Address 19302- Pow der H i l l FL (V >< * I oo , Po v i s to o 3 W A Q $3 -7 o License # Ru RY C *2, 3'25 L Expires 41 3 'E-mail PROJECT ADDRESS 11-4 MA i 3Y'c� Ct IPory �. ec,> tjP.-toZ-- D iv'� �v o0 5 s�efc Parcel Number3Ojv, 2 G w Lot (2% ('A2 Zoninq sip L4 11.t -cid, - 4 Proiect Tvve & Brief Description: ❑ Residential ❑ Multi -family Commercial ❑ Industrial Check all that apply ❑ New Construction �L� i►e G ��nsF�r�v`� ❑ Addition —� `.Remodel ,,c_�V­.b FOL_ coJtiM AeA4_114 C M(CES # cu -Irl IC_ ❑ Repair Demolition Cla.11am COUY144 3V -d, S+V'e!'AC- 13UMUn9 > Level I RehovaM"OK /❑ Re -roof ❑ House ❑ garage ❑ other ❑ tear off & re -roof ❑ lay over one layer ❑ Heat System ❑ Heat pump ❑ wood -burning stove ❑ gas fireplace ❑ pellet stove ❑ other ❑ Other Floor Areas Existina (so. ft.) Proposed (so. ft.) Basement per PIM5 I, p,aSi f PARKING LOT EXISTING BUILDING AREA OF WORK a-a.m LEVEL ONLY) PARKI16 LOT us& PMM � MOM 00"" WCUM 3. T3ft MW LOISU!S Ito= 6+ zomma EAST 3RD STREET SITE PLAN SCALE= 1/S'•P-O' c L` Clallam County Assessor & Treasurer -Property Details - 56110 CLALLAM COUNTY f Page 1 of 5 Property Search Results > 56110 CLALLAM COUNTY for Year 2010 2011 Property Account Property ID- 56110 Legal Description LOTS 12 & 13 BLOCK 54 SURVEY V66 P4 Geographic ID- 0630000054450000 Agent Code. Type Real Tax Area. 0010 PA 121 PORT ST CNTY H2 L Land Use Code 97 Open Space N DFL N Historic Property N Remodel Property N Multi -Family Redevelopment: N Location Address. 111 E THIRD ST Mapsco PORT ANGELES `� a n � Neighborhood. Exempt All Exmpt & Reference Map ID- �VV Neighborhood CD- 50110030 Owner 11 Name CLALLAM COUNTY Owner ID- 18273 Mailing Address. 223 E 4TH STREET % Ownership: 100 0000000000% PORT ANGELES WA 98362 Exemptions: EX Taxes and Assessments Due Property Tax Information as of 01/20/2010 Amount Due if Paid on F , Statement Taxing First Half Base Second Half Base Amount Year ID Jurisdiction Due Base Due Penalty Interest Paid Due NOTE. If you plan to submit payment on a future date make sure you enter the date and RECALCULATE to obtain the correct total amount due Values (+) Improvement Homesite Value + N/A (+) Improvement Non-Homesite Value + N/A (+) Land Homesite Value. + N/A (+) Land Non-Homesite Value + N/A Ag / Timber Use Value (+) Curr Use (HS) + N/A N/A (+) Curr Use (NHS) + N/A N/A (_) Market Value = N/A (—) Productivity Loss — N/A (_) Subtotal: = N/A (+) Senior Appraised Value + N/A (+) Non -Senior Appraised Value + N/A (_) Total Appraised Value = N/A (—) Senior Exemption Loss. — N/A (—) Exemption Loss. — N/A http.//vpn.clallam.net• 8084/propertyaccess/Property.aspx?cid=0&year=2010&prop_id=56 1/20/2010 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 10 00000413 Date 4/28/10 Application pin number 799094 DITCH Property Address 111 E 3RD ST 2A ASSESSOR PARCEL NUMBER 06 30 00 0 0 5445 0000 FINAL Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning COMMERCIAL OFFICE Application valuation 0 Application desc 3 CIRCUITS REPAIR WIRING Owner Contractor CLALLAM COUNTY SHAMP ELECTRICAL CONTRACTING 223 E 4TH ST PO BOX 383 PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 452 1689 Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 164376 Permit Fee 78 70 Plan Check Fee 00 Issue Date 4/28/10 Valuation 0 Expiration Date 10/25/10 Qty Unit Charge Per Extension 1 00 73 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 73 50 2 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT 5 20 Fee summary Charged Paid Credited Due Permit Fee Total 78 70 78 70 00 00 Plan Check Total 00 00 00 00 Grand Total 78 70 78 70 00 00 INSPECTION TYPE I DATE DITCH SERVICE ROUGH IN 4/26 /io FINAL COMMENTS Signature of owner or Electrical Contractor X RESULTS IINSPECTOR. Date o - Q 04/27/2010 11 05 FAX OQ1/002e APR 2 7 2009 ELECTRICAL rt�kr, oY 1� City of Port Angeles Permit Application INSPECTIONS Building DlvlsionlElectrical Inspections 321 East Fifth— P.O. Box 1150 `► Port Angelos Washington, 98362 0 Ph- (360) 417.4735 Fax: (360) 417.4711 tr Dale: ��20 ► b � \ _ 1 & 2 Single Family Dwehng Multi-Famlly or Commercial' v �[ Commercial Addition / Alteration I Remodel I Repair" Plan Review k lease Co II? a Electrical Ian Review Information Sheet Job Addre65: r" ;tsar Building Squareage Description of aboveftl 1 Owner infor tiit {Pad .,�,C(r ontraclorI r lion r ha Off Name ,A; v Name Maili 7. Mailing r s: — city State. lip, _` C tY State: Zip: —G�� Ph( — I Fax- Phone. Wlea I bfA Fax, J License tt' x - License >k / xp. Y, Unit Charge ON Total (Otv MulBphgd by unit Charoe) $119 90 $ Service/Feeder 200 Amp S 145.50 S ServlcelFeeder 201.400 Amp. $ 204 50 _ $ Service/Feeder 401-800 Amp. $ 262 20 _ $ Service/Feeder 601.1000 Amp $ 37250 - $ Service/Feeder over 1000 Amp. $ 260 $ Branch Circuit WI Servlce Feeder $ 73 50 = $ ) Branch Circuli W/0 Service Feeder S 260 $ 2 Each Addillonal Branch Circuit $ 92.70 $ Temp. Service/ Feeder 200 Amp �I _ GVG�1 n �, I / V (/�/j 1�DlAk $ 11030 _ $ Temp. 5ervicelFeeder 201-400 Amp. 'lV $ 1400 S Temp. Service/Feeder 401.500 Amp. S 16790 $ Temp. Service/Feeder $01.1000 Amp. $ 95.90 8 Porta( to Portal Hourly I S 66.20 S Slgn/0udlne Lighting S 95.90 S Signal Circuit/ Limiled Energy— Commercial. Additional 1500 $5 00 I/ S 63.90 Signal Circuit( Limited Energy 1 & 2 Family Dwelling S 63,90 $ Signal Clrcultl Limited Energy Multi -Family Dwelling S 119.90 $ Manufactured Home Connection $102.30 $ Renewable Electrical Energy 5KVA System or LOSS S 110.30 $ First 1300 Square Ft S 35.20 $ Each Additional 500 Square F(. or Portion of S 73.50 S Each outbuilding or Detached Garage $110.30 $ Each Swimming Pool or Hot Tub $ 56 00 T, $ Thermostat $ Total DA+jx A�vteAceikriCirCcaiJ 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 oflast Inspecllon. After reading the above statement, I hereby certify that I am the owner of the above named property ora 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, Signature of owner electrical contractor o t►Ical administrator j O Cash ❑ Cn5 V�S� `Date: CredltCard r G)� EXP 4112 VG�° � Vi a 1Qj Z'l29108 1 � C E FZT ATE AGF -01-0,- {U P�► N CY tr :. _ yPort Anes Buu1.c�=�ngDr Sion This certificate is issued pu suanAto the requirements of Section 110 of the 200",International Building Code : ._ certifying that at the t' e,o - issuance th s struct re was in com =ranee with the v"=, ious ordinances of the City `.T'z..__ts�i� .k'i: �ms,>,. RIM- regulating building c-nsufzotoruser.te 'b I.tollowtrg . Business name Ten�ForwardWfiftbl.rffetsJ(Own,ergAsk;uan etworks LLC) rg �d-Ml iJa}iRui Business address 1= 1E 3 St. eb fit,, Property owner Sheila S 1sx � C'Leri¢& 1.03 elci Q r , Property owner s " gess$: ' PO Box 172; A. ortAngeles;,04 :A9:$f`2:. Fire sprinkler systezired. Per IB ' Use & i ation. Business:. occupancy c ss°F µ taw,. .... . Building permit num . r.- .Type Typeof construction. P I Occupant load. - „;, 02-20-08 :xnager Date Post on the premises in a conspicuous place. This a 1 not be removed except by the Building Official. 1 Vi a 1Qj Z'l29108 i st>kr��� CERTIFICATE OF OCCUPANCY APPLICATION Permit# (DIE)" �03 V. CITY OF PORT ANGELES /JO CA(P*,Z9E FEES Attn Building Permit Technician +y� Certificate / Inspection 321 E. Fifth St. Port Angeles WA 98362 (360) 417-4815 fax (360) 417-4711 — Parking Business Improvement Area (PBIA) Print in ink fee charged for downtown locations BUSINESS NAME AS lua, 06�vjnckS LA -C _ DBA TF&J F012ctl&G -b ZIU—CF— - 0r 56 "JCfS BUSINESS ADDRESS C3 r1 r,e — Zoning CBS Business mailing address Phone # .3;5p 4 ,57-9'01.3 Opening date I If is lo 0 Days & hours of operation � 30 AAA Brief descrition of proposed business 1�h--eriqeV SPrutrFs CotMrJ-P,- Pevoo4-e Business owner's name \,J kla v\ Q_,)1-1_ • I Phone # 416 7 — 9O 23 Business owner's home address 307 L -a n e Po r- i A te s i,cJ/k- q9_363 I PLEASE NOTE. A Business License is also required for the following businesses Taxi Peddlers Second-hand dealer Pawn broker Dance Hotel - Motel, Fireworks Ambulance Tattoo shop Contact the City Clerk at 417-4634 for additional information ACTION ✓ WILL THERE BE ANY OF THE FOLLOWING? NO✓ YES✓ IF YES, CONTACT Electrical changes ✓ Electrical Dept. at 417-4735 New business New or relocated signs i ✓/ Building Division at 417-4815 Construction changes V/ Mechanical changes (heating, cooling, stoves) Transfer of business I ✓/ � Plumbing changes location from a I ✓� i I I PBIA location Fire sprinkler system changes Fire alarm system changes I ✓ / I I Transfer of business Is this a home occupation? I i/ I I Planning Division at 417-4750 I location from a Second-hand dealer or pawn broker? I I City Clerk at 417-4634 non-PBIA location I New or relocated sewer or water service I ✓ I I Public Works at 417-4807 Excavation or filling of lots I ✓ I Change of ownership I I Work done in the City right-of-way I I New driveway openings I ✓/ I I I Remodel I Grading site drainage (parking lots, downspouts, etc.) I ✓ I i Landscape irrigation system (backflow devices) I y/ I Water Dept. at 417-4886 Temporary business I I Off-street parking Existing streets paved ✓ / I I I Change of use ` I Existing sidewalks I I Curb and gutter I ✓ I I Call for Certificate of Occuvancv inspections before opening business. Building Department Inspection 417-4815 Fire Department Inspection 417-4653 Please provide a minimum 24-hour notice for inspections I hereby apply for a Certificate of Occupancy I acknowledge that I have read this application and state that the information I have supplied is cPrrect to the best of my knowledge %� 'Pe Date �Ly/03 Print Name �(%tl ✓1 (` J1 Z Signature For City use only n Approved 1 Rejected Department 406 'als & dat Initials & date Comments /Conditions Building , �Type of construction Occupant Load - Fire 2 R7 Automatic fire sprinkler system required no yes PBIA Rv_ 2I1 109 Planning City Clerk I 131J ZI�I d Public Works T:Forms/Building Division/Certificate of Occupancy Application d•w'� CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321 FAST 5TH STREET PORT ANGELES, WA 98362 Application Number 06 00000845 Application pin number 264665 Property Address 111 E 3RD ST ASSESSOR PARCEL NUMBER 06 30 00 0 0 5445 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Owner Contractor SHATTERFIELD GLEN ANGELES ELECTRIC PO BOX 172 524 E 1ST ST PORT ANGELES WA 98362 PORT ANGELES (530) 365 1904 (360) 452 9264 Permit ELECTRICAL ALTER COMMERCIAL Additional desc ANGELES/ MTR REPAIR Permit pin number 84186 Sub Contractor ANGELES ELECTRIC Permit Fee 66 90 Plan Check Fee Issue Date 8/07/06 Valuation Expiration Date 2/03/07 Qty Unit Charge Per Date 8/07/06 1 00 66 9000 ECH EL COMM ALT REPAIR METER/MAST Fee summary Charged Paid Credited Permit Fee Total 66 90 66 90 00 Plan Check Total 00 00 00 Grand Total 66 90 66 90 00 COMMENTS/ACTION NEEDED WA 98362 00 0 Extension 66 90 Due 00 00 00 ELECTRICAL PERMIT INSPECTION RECORD CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE iNSPECTION TYPE DATE ACCEPTED commrNm YES i NO DITCH RUUUH-IN / COVER SERVICE FINAL i t -.,z - o (j 4::a ( % i GENERAL COMMENTS: pw-s 102.1314%] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Ra� Application Number . . . . . 03-00000079 Date 2/04/03 Property Address . . . . . . 111 E 3RD ST ASSESSOR PARCEL NUMBER: 0630000054450000 Application description . . . ELECTRICAL ONLY Property Zoning . . . . . . . Application valuation . . . . 0 Property owner . . . . . . . BREEN RICHARD W/KARYA Owner address . . . . . . . . PO BOX 65123 PORT LUDLOW WA 983650123 ( I Contractor . . . . . . . . . HALVORSEN ELECTRIC ----------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 59.40 Plan Check Fee .00 Issue Date . . . . 2/04/03 Valuation . . . . 0 Expiration Date . . 8/03/03 Qty Unit Charge Per 1.00 59.4000 ECH EL -COMM ALT <5 CIRCUITS Fee summary Charged Paid Credited ----------------- ---------- ---------- ---------- Permit Fee Total 59.40 59.40 .00 Plan Check Total .00 .00 .00 Grand Total 59.40 59.40 .00 Extension 59.40 Due -------.00 .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\1102 15 [4/2002] Date Signature of Owner (if owner is builder) Date u�1 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 - " �) 7 7 INSPECTION TYPE DATE I ACCEPTED YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE 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 HEAT PUMP WOOD STOVE/PELLET/CHIMNEY HOOD/DUCTS PW UTILITIES/ SITE WORK (Engmeenng Drv�s�on) SEPARATE PERMIT N's. WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT N's I SEPA: PARKING/LIGHTING I ESA: LANDSCAPING I SHORELINE: RESIDENTIAL ELECTRICAL - LIGHT DEPT. CONSTRUCTION R W / PW/ ENGINEERING FIRE PLANNING DEPT BUILDING T:\PLANNING\FORMS\1102.15 [4/20021 FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE DATE YES NO COMMERCIAL 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION - R W. 417-4807 PW / ENGINEERING 417-4653 FIRE DEPT. 417-4750 PLANNING DEPT 417-4815 BUILDING COMMENTS DATE ACCEPTED YES NO -Yi'7`o3 I c ROUTING SLIP Certificate of Occupancy $�:�Certificate/Inspection Fee DATF Address of Pro$osed Business ApplicantE.raDa�C/CG4� Address ///Z5 Phone: business home ,4s �%s2- New Business ............................ ( ) Transfer of Business Location ................ ( ) Change of Ownership ...................... ( ) New Building ............................. ( ) Remodel................................. ( ) Temporary Business ....................... ( ) Change of Use ............................ ( V ) Brief description of proposed business: Zkc)W9 L LAM . Legal Description: Lot f 3 Blocky Subdivision 7P/1 Current Use of Property:_ Zoning Classification of Property: WILL THERE BE ANY OF THE FOLLOWING?Y THE FOLLOWING WILL BE REQUIRED: Construction changes ............... ........... PERMITS BUSINESS LICENSE Electrical changes .............................. 1) Building 1) Taxi Mechanical (heating, cooling, stoves) .......... 2) Plumbing 2) Peddlers Plumbing changes .. ...... .............. .. 3) Electrical 3) 2nd Hand Dealer New or relocated signs ........... . ............ 4) Mechanical 4) Pawn Broker New septic tanks ................ ............. 5) Sewer 5) Dance New sewer service .......... .................. 6) Sidewalk installation 6) Hotel - Motel Admission charged to patrons ..... .............. 7) Driveway installation 7) Fireworks Is this a home occupation? ...... I ............ 6) Curb installation 6) Ambulance Excavation of filling of lots .......... ........... 9) Sidewalk obstruction 9) Tattoo shop Work done in City right-of-way . . ............... 10) Water meter installation 10) Other Is there sufficient off-street parking? .......... .. 11) Fire New driveway openings ......................... 12) Occupancy A grading plan for site drainage .............. 13) Sign (parking lots, downspouts, etc.) ............. 14) Shoreline Are the existing streets paved? .................. 15) Home occupation Are there existing sidewalks? ........ .... .. .. 16) Conditional use Is there curb and gutter? .. ..................... 17) Other Other I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the Date: / �/ 0, G information I have supplied is correct to the best of my knowledge. Sign �:M` REJECTE Building Section Public Works Department Planning Department Fire Department City Clerk P.B.I.A. Comments / Conditionp R� a CERTIFICATE OF OCCUPANCY Buildi is" :° : Y This Certification issued pursuant to the requirements of Section 109 of the Uniform Building Code certifylltg that at the time of ftWance this structure was in compliance with the various ordinances of the City regulating Building construatiok4lityse. For the ftillowi Use classification. Office BuiL4" Permit No.: — '-� ' " ntic Lab Inc. Group B onstruction: , Owner of Business/Residence: 8.4 EvrernanS Aadt ];, Street. POrt:."g1Ples. WA 98362 Budding Address: III I. 3rd - 1 .2002 Build! n Date Post on the WpiOuous place. Shall not be removed except by Building Official. ING SLIP Certif at of Occupancy V 7.00 Ce tel Fee DATE 5C ©v. d r --;� Cn 3 Address of Proposed Business I I I F_ _M'] rd 5t, Su f te- �- Applicant Pfin1+hu IrimiIIes 5fCIaII0FY1CO Address Phone: business X home -a-qZ-_�; J�. New Business ............................ ( ) Transfer of Business Location ................ ( X ) Change of Ownership ...................... ( ) New Building ............................. ( ) Remodel ................................. ( ) Temporary Business ....................... ( ) Change of Use ............................ ( ) Brief description of proposed business: Non- pro F7 f 5oc p o I Service_ Legal Description: Lot Block Subdivision Current Use of Property: Zoning Classification of Property: WILL THERE BE ANY OF THE FOLLOWING? Construction changes ........... ... ... ....... Electrical changes .... ........................ Mechanical (heating, cooling, stoves) .............. Plumbing changes ............................. New or relocated signs ....... .. .. .......... New septic tanks .................... ......... New sewer service .............. ..... .... Admission charged to patrons ............. ... . Is this a home occupation? .................. Excavation of filling of lots ......... . . ....... Work done in City right-of-way ...... .. ... . Is there sufficient off-street parking? ........ .. New driveway openings ............... ..... A grading plan for site drainage ................... (parking lots, downspouts, etc.) ........ .. .. . Are the existing streets paved? ................... Are there existing sidewalks? .............. ... . Is there curb and gutter? ........................ Other............. ... ...................... I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge. APPROVED REJECTED Building Section Public Works Department Planning Department Fire Department City Clerk P. B.I.A. provider" 14) THE FOLLOWING WILL BE REQUIRED: PERMITS BUSINESS LICENSE 1) Building 1) Taxi 2) Plumbing 2) Peddlers 3) Electrical 3) 2nd Hand Dealer 4) Mechanical 4) Pawn Broker 5) Sewer 5) Dance 6) Sidewalk installation 6) Hotel - Motel 7) Driveway installation 7) Fireworks 8) Curb installation 8) Ambulance 9) Sidewalk obstruction 9) Tattoo shop 10) Water meter installation 10) 11) Fire _ YOtther ,.r(' I I)r)- [ _0 2) Occupancy) �L1'(!� �, Y 3) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other Date: Signed: Comments / Conditions CERTIFICATE ©F -OCCUPANCY City of Port Angeles,e Ie Building Division This Ce tification issued pursuant to the requirements of Sectio 109 of the Uniform{Building Code certifying that at the time of issuance this s ucture was in compliance with the various ordinances of the City regulating $wilding construction or use. For the following: Use Classification: OffiCe Building Permit No.: _ Business Name: Healthy Families of Clallam County 9 j Group B Type of Construction: V -N Use Zone: CSD Owner of Business: Healthv Families of Clallam County Address: 111 East 3`d. Street. Port Aneeles. WA 98362 'e Building Address: 111 Eas3`d. Street. Port Aneeles. WA 98312 I�"'�?---� ` - Tanuary 15th. 2004 By7f�in OMr-cial_ ; o., e . Date �``��$:'i"":_,::;fir ,F P the premises.m a°conspicuous place. Shall not be r`bptt4y'ed exce'p, py-B'uilding Official. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 9a� BUILDING PERMIT ISSUED: 8/05/2002 PERMIT NO: 13606 OWNER/APPLICANT PROPERTY LOCATION MARY ANN BREEN 111 3RD ST E PO BOX 65123 Lot: 12,13 Port LUDOW, WA 98365 Block: 54 ❑ Long Legal 360/437-9386 Subdivision: TPA T: B. E. ORTHO LAB S: 1-A Parcel No: 063000005445000 CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 98360-0000 206/000-0000 360/000-0000 PROJECTINFO Project Value: $500.00 SFD Units: 0 Commercial: 0 Project Type: INT. WALLS SFD SQ FT: 0 Industrial: 0 Occupancy Type: Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: CSD 01) PROJECT NOTES CLOSE OFF TWO DOORS RECEIPT#9496 FEES ASSESSMENT Building Permit: $23.50 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $28.00 Plumbing: $0.00 AMOUNT PAID: $28.00 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signat oner (if owner is builder) Date T \PLANNINGTORM$\ 1102 15 14/20021 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 IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ( ACCEPTED I COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE I ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH -N PLUMBING UNDERFLOOR/SLAB ROUGH -IN WATER LME 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 J HEAT PUMP WOOD STOVE/PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES/ SITE WORK (Engmeenng Drvsion) SEPARATE PERMIT #'s: WATERLINE / METER I SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s I SEPA: PARKING/LIGHTING I I ESA LANDSCAPING ' SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCV/USE RESIDENTIAL DATE I YES NO I COMMERCIAL DATE I ACCEPTED YES I NO ELECTRICAL - LIGHT DEPT. 417-4735 I I LIGHT IGHT ENGINEERING CONSTRUCTION R. W / PW/ 417-4807 I CONSTRUCTION - W I PW / ENGINEERING FIRE 417-4653 I I I I FIRE DEPT I 1 PLANNING DEPT. 417-4750 I I I I PLANNING DEPT.4715- I BUILDING 417-4815 I I I BUILDING l[n/YL I NV T:\PLANNING\FORMS\1102 15 [4/20021 FPORrgy J'S. BUILDING PERMIT - APPLICATION The Building Permit application must befilled out Completely. Please type or print in ink. If you have any questions, please call 417-4815 Applicant or Agent: ✓,0Q C Owner: /1177'heS .%EF0./'�ZdGJ Address:/// 4=r-3' d �(U/✓� City: '4-4 ArchitectlEngineer: Contractor License #: Address: / City: PROJECT ADDRESS: ��/ E 3�5�/� /—.19 LEGAL DESCRIPTION: Lot: Block: CLALLAM COUNTY PARCEL NUMBER: Billing Address: Credit Card #: FOR OFFICIAL USE ONLY: Date Rec.:7 Pernut#: / Date Approved: Date Issued Phone: "�$2— S"9 Phone: Phone: Zip:�Z Exp: Phone: Zip: ZONING: Subdivision: Credit Card Holder Name: City: Exp. Date: VISA MC TYPE OF WORK: SIZE/VALUATION: ❑ Residential ❑ New Constr. ❑ Re -roof ❑ Wood -stove SF. @ $ /SF. = $ ❑ Multi -family ❑ Addition ❑ Move ❑ Garage SF. @ $ /SF. = $ �4 Commercial ❑ Remodel ❑ Demolition ❑ Deck SF. @ $ /SF. = $ ❑ Repair ❑ Sign ❑ TOTAL VALUATION $ 1 "' BRIEF DESCRIPTION OF THE PROJECT: �OsE OxF o2°� SAi94c S COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type No. of Stories: Lot Size: % Lot Coverage: % Existing Lot Coverage: /sq. ft. + Proposed Lot Coverage: /sq. ft. = TOTAL LOT COVERAGE: /sq. ft. PLANNING USE ONLY: APPROVALS: PLAN Notes: BLDG. DPW .FIRE ESA/Wetland(s): ❑ Yes ❑ No SEPA Checklist required? ❑ Yes ❑ No Other: OTHER BUILDING PERMIT APPLICATION SUBMITTAL: Your application and site plan must be felled out completely to be accepted for review. The Building Division can provide you with more detailed information on the application and plan submittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's responsibility to determine what permits are required and to obtain such Applic l J�� `— Date: 7-5--02 T\FORMSWPPS\Buildingpermtt 5cc.i t S7Zt' 2XGtsMI; E„ � Loun'�Gr oAec- ,)cry, ccrec, avAP•n 'i'�.a elAmra}a�t sb)ta Core aboc w.rK G rw ter spa4a / rle,.� o4C;te ��. .f p;�fr'ereK� Re,.�4b.1 un;i. L,sorX c..c-ea, 'r'F� 5..4prls d � � �erK cre4 s *rti SuQfbr� 9� i i t pA A �Q. lnkl'rcc $p>Lm ti+�s deermy Sel:rii core daeC ��;"' CITY OF PORT ANGELES Ir DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION Uwl 321 EAST 5TH STREET, PORT ANGELES, WA 98362 4 BUILDING PERMIT ISSUED: 12/30/2002 PERMIT NO: 13930 OWNER/APPLICANT MARY ANN BREEN PO BOX 65123 Port LUDOW, WA 98365 360/437-9386 T: B.E. ORTHO. S: CONTRACTOR owner VARIOUS Port Angeles, WA 99360 206/000-0000 PROJECTINFO Project Value: $3,000.00 Project Type: INT. REMODEL Occupancy Type: COMMERCIAL Occupancy Group: Construction Type: Zoning Use: CSD PROPERTY LOCATION 111 3RD ST E Lot: 12,13 Block: 54 ❑ Long Legal Subdivision: TPA Parcel No: 063000005445000 ARCHITECT N/A .� 1#e tell$ SFD Units: SF,D $Q FT: MFD Units: MFD SQ FT: 0 0 Commercial: 0 Industrial: Garage: 0 PROJECT NOTES OFFICE SPACE/ REMOVE THREE INTERIOR WALLS MAKE ONE WALL HALF RECEIPT#10028 FEES ASSESSMENT Building Permit: $83.25 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 TOTAL FEE: $87.75 Sign: $0.00 Plumbing: $0.00 AMOUNT PAID: $87.75 Mechanical: $0.00 BALANCE DUE: $0.00 Radon: $0.00 0 0 t 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 1 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. � n VW_ Signallure�lf Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date ,\ `` T.TLANNNETORM91102.1514120021 BUILDING 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. INSPECTION TYPE KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE DATE I ACCEPTED YES I NO FOUNDATION: I FOOTINGS I WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT. # ROUGH -IN I I I PLUMBING UNDERFLOOR/SLAB ROUGH -IN WATERLINE y�J GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS/ GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T -BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEATPUMP WOOD STOVE/PELLET/CHIMNEY HOOD/ DUCTS PW UTILITIES/ SITE WORK (Engineering Division) SEPARATE PERMIT #'s. WATERLINE / METER SEWER CONNECTION SANITARY 1 STORM PLANNING DEPT SEPARATE PERMIT#'s SEPA: PARKING/LIGHTING I 1 ESA. LANDSCAPING I SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYNSE RESIDENTIAL DATE YES NO COMMERCIAL COMMENTS 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 PLANNING DEPT. BUILDING 417-4815 BUILDING T.\PLANNING\FORMS\1102.15 [42002] DATE ACCEPTED YES NO U- I —r 0 -trek Kv CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date Time Received by (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No. ^11 Type of Inspection (circle appropriate one): Permit No. ;� 3 �U Sewer Foundation Framing Chimney Plumbing Final Sewer Excay. OtheF-a'l1- INSPECTION NOTES: !/ Inspected: Date u - Time By Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: ❑ Unimproved ❑ Gravel ❑ Asphalt ❑ PCC ❑ Repaired by City Work Order # ❑ Repaired by Permittee ❑ COMPLETE ❑ No Damage Found ❑ INCOMPLETE ❑ Other (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ELECTRICAL PERMIT OWNER/APPLICANT---- MARY ANN BREEN Port Angeles, WA 98360 360/000-0000 T: CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 121 EAST 5TH STREET, PORT ANGELES, WA 98162 Issued: 9/03/99 Permit No: --------PROPERTY LOCATION ---------------- Ill 3RD ST E Lot: Block: Long Legal: Sub: S: Parc No: 6734 CONTRACTOR-----------------------------DESIGNER--------------------------------- BOB'S ELECTRIC 1227 DEER PARK RD. PORT ANGELES, WA 98362 360/457-6887 000/000-0000 PROJECTINFO -------------------------------------------------------------------- Prj Type: COML. MISC. Prj Value: $0.00 Occ Type: $44.25 Cnstr Type: SEWER PUMP $0.00 Occ Grp: Occ Load: Land Use: -------------------------- TOTAL FEE: Electrical Heat -------------------------- Balance Due: $0.00 Service Type Baseboard KW: 0 Riser Voltage: 0 Furnace KW: 0 Overhead Service Diameter: -1 -3 Heat Pump KW: 0 Underground Service Service Size: 0 AMPS Fan/Wall KW: 0 Temp Service Feeder Size: 0 AMPS PROJECT NOTES ---------------------------- PUMP TO STORM SEWER FOR BUILDING RUNOFF PROJECT FEES ASSESSMENT --------------------------------------------------------- Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $44.25 Temp Service: $0.00 TOTAL FEE: $44.25 Misc $0.00 Amount Paid: $44.25 -------------------------- TOTAL FEE: $44.25 -------------------------- Balance Due: $0.00 COMMI'.NTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 4174735 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 SITE INSPEC71ON TYPEI DATE I ACCEPTED COMMENTS YES I NO DITCH ROUGH -IN / COVER SERVICE FINAL 1 9%il417ft`� GENERAL COMMENTS: M.1101.1514%1 CITY OF PORT ANGELES FEE RECEIPT NUMBER DEPARTMENT OF LIGHT A PERMIT NUMBER APPLICATION AND ELECTRICAL PERMIT {ZiE1N6US TOTAL FEEZ- I% 4 P q / I Cs-fJ w I CONT LIC NO. I TIMETOCOMPLETE NO.STORIES LEGALOCCUPANCY ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT -T IJ T,r.Q $ _� .1 7 R Site Address _ , ,a+�._ k'1/I�c_s Ecr�tr-� �N�J �(- ��. l I I �, J CA, A�L� CORRECT ADDRESS'S RESPSSIBILITY OF APPLICANT PERMITS WITH WRONjyADO±E$SARANC,ELLD \ � Owner YI 1�'r/c%Y/NOG//nom G� Installation By tTJ�{(\1-- /nln\1n1nG�( C�pJN,1 rrJ I� pp /n1 Owner's Address - 1 I fir_ 7<✓ - 22,5 j 't'7tt�T� 1�, l—moi' 1 Installers Address , Day Phone % - Installers Phone 4SZ— 3Z% -'U' _ Application is hereby made for Permit to install Electrical Equipment as follows: S 1 (-;Q Wiring Method C&O D V 1 = USE OF CIRCUIT NUMBER AMP 240V AMP 240 PER 120V 1 0 O FEE USE OF CIRCUIT NUMBER PER - 120V 1 COP V VFEE CIRCUITS CIR 10 30 CIRCUITS CIR 10 30 LIGHT I I SIGN I I �-r 3x I / 1� LIGHT 50 OR LESS ESS CONVENIENCE I I I I MOTOR CONVENIENCE I MOTOR APPLIANCE I I I I l I MOTOR ( DISHWASHER I FIREALARMS DISPOSAL I I I I I BURGLARALARM RANGE MISC OVENI I I lI I WATER HEATER (LAUNDRY I I I I II I I I Ij DRYER I I I I I I I REINSTALLATION LIGHT FIXTURE k FGAS -URNACE SUB TOTAL FEE ELECTRIC - I -I I I I II FURNACE ENERGY FEE ELECTRIC HEAT I I I I I I� BASIC FEE TOTAL FEE o.� ELECTRIC HEAT I I L SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER A.0 UNIT I I I I AMP PHASE FEEDER Ij I I I I I SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICE I I I I I I A.W.G SUB -TOTAL ' I I SIZE OF GROUND SIZE OF ENTRANCE SWITCH I certify that the work to be performed under this permit will be done by the Installer andUcorancewit�e N. . Electrical Code. DateApplication made Z w 19B IX!/I �A /CONTRACTOR OR OWNER (OR AUTHORIZED AJffNT) Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. DIRECTOR OF CITY LIGHT t1 Date Permit Issued B'r i8� PLANS APPROVED r i Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in Writing on Permit Placard. A. - Permits Phone: 457-0411 Ext. 158. WARNING I PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK — SEE OVER — WHITE -Original CANARY - Duplicate PINK - Triplicate WHITE CARD - Inspector's Report OLYMPIC PRINTERS, INC REPORT OF INSPECTOR DATE OF VISIT •MADEBY REMARKS I . cr r a r I Z W _ R�I I >® r O 2 l0 D I 1 I _ - vA. ruH WV6HING j NFINAL O.K. l /_ L] El T1 f / CITY OF PORT ANGELES A+� FEE RECEIPT NUMBER DEPARTMENT OF LIGHT PERMIT NUMBER APPLICATION AND ELECTRICAL PERMIT iv J-�a� �llc fP P I I I C 0�j�"7 TOTAL FEE }' f + �'�� �- � CONT LIC.NO. TIMETOCOMPLETE I NO STORIES LEGALOCCUPANCY ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER TWS PERMIT Site Address /// [> - CORRECT/ADDRESS IS RESPONSIBILITY OF APPLICANT Owner r ij T 1 t t n) Owner's Address E t Ji; - h PERMITS WITH WRONG ADDR SES ARE CANCELLED Installation By ()/)_r n_r a N A/ 4 A1'S C /IFC I c' Installers Address 2t, -RFS' 1-1 � 9%A f u �T Day Phone I`t nstallers Phones S 11> '��90 Application is hereby made for Permit to install Electrical Equipment as foliowP' USE OF CIRCUIT ' LIGHT LIGHT CONVENIENCE ICONVENIENCE (APPLIANCE DISHWASHER DISPOSAL RANGE OVEN WATER HEATER LAUNDRY DRYER FURNACE GAS - OIL FURNACE ELECTRIC ELECTRIC HEAT ELECTRIC HEAT IAC. UNIT 1 FEEDER ISERVICE NUMBER AMP I 120V CIRCUITS CIR 7 0 7 TO Wiring Method Kei llvLF k 240V 10 OR FEE USE OF CIRCUIT 1 AMP PER 1100V 1 240V t 00R FEE CIRCUITS CIR 30 30 SIGN 50 VOLTS OR LESS MOTOR 11 MOTOR �IMOTOR 1 FIRE ALARMS BURGLARALARM 1 1 I MISC. 1i l i) I REINSTALLATION LIGHT VI%TURE # SUB TOTAL FEE 17D. 0011 lop( W,_01I 1 SUB -TOTAL I/I.T;0011 ENERGYFEE BASIC FEE f'}� TOTAL FEE O SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER `}Ql; AMP / 1.:( PHASE SIZE OF SERVICE ENTRANCE CONDUCTORS SIZE OF GROUND SIZE OF ENTRANCE SWITCH A.W.G. I certify that the work to be performed under this permit will be done by the installer and eriniin,.'r�nnfoorrjmanncccee with the N.E.C. Electrical Code. Date Application made 14 tet? G ,19 ! vx ! CONTRACTOR O OWNER (OR AUTHORIZED AGENT) Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. CT OF CITY LIGHT B, Date Permit issued .t y v / PLANS Ae V Notify Department of City Light by Street Address and Permit Number when ready for Inspection. Work must not u tl be covered or current turned on before inspection and O.K. for covering or service has been given by Inspector in Writing on Permit Placard. A. - Permits Phone: 457-0411 Ext. 158. WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK — SEE OVER — WHITE -Original CANARY - Dupiicaie PINK, TnpUaate WHITE CARD- Inspectors Report OLYMPIC PRINTERS, INC. DATE OF VISIT I REPORT OF INSPECTOR MADEBY REMARKS 0k- /_'adLK u®TsTA Rs 1—,Fxc-ePT NNRPs IG'NH ok 4 C,i L P 0�c, .tel n G (�o4leA /,�oa),Ys7-A R � sGu7-4 44ST Al F«(�L e9k eN AA c4Nl -P/65�"j SKY 9f',fl 0 K (/3 JCC MDRTAG � Nae Al .4 � I",( t i( 0 A/ SGe e a � NPeo /YA,L /�z4-res A f STuOs Z//P ft"T' i i!( X, 'No ANHC!/<e Pf T Ioo{/s (`'Lose O.K. FOR COVERING O.K. TO CONNECT SERVICE FINAL O.K. 11 B-02-206 8:03AM FROM ANGELES ELECTRIC INC 360 AS2 926S P.1 a.�. t ELECTRICAL WORK PERMITAPPLICATION \/'11nstal on description Job wired by lectrical Contractor ❑ Owner mercial ❑ Residential Electrical contractor name hiconsc number Date Expires ❑ New 05, I[eredlAdditioo Pureltaser's mailing address City Telephone number ANGELES ELECTRIC, INC. E21 �1£T F�J�J PORT ANGE1t S,41 98362 FAX number 'Premise nsm�A�` �, T Address of in>pe`tion� , •zY r� �fJJ 7 7 // /e✓ City fy l�o—IZ Phone number to scheduulleeNiypcction: Owner as defined try RCW.l9.28..220:o(�(1) Owner will occupy theseseruOure`f>r twn years afier this eleclrieal permit a finalized. (2) Owner is required to hire an rkcirical conlrzwlor whore rind property is for Yale. ren( nr lease. After reading the above statement 1 hereby certify that I am the owner of the above 9i✓ /�lEi -.� J��Pc�. ❑ Cash 0 Check 0 named property or a licensed electrical contractor. I am making the electrical instal- redit Card VISA Mastercard Discover lation or alteration in compliance with the eieciricdl laws, N,R.C., RCW Chapter 19.26. WAC. Chapter 296-46B. The City of Port Angeles Municipal Codc, and Card # Utility Specifications. r"Signature of own dean 1 ontractor or electrical administrator Expiration Ddlt4 - - ,,// Q ( inspcction fee X� I%ate: j.�/Z/�O l of card `aa'l Load Addltionrand o subtr ictlons ttt Swir-e Information IKN0 LOAD CHANGES ❑ Baseboard _ KW voltage��K� ❑ Fumaoe KW ❑ Overhead Service Phase U 3, ❑ Heat Pump _ Ton _ LAR ❑ Tamp Service Service Size: O Fan -Wail —KW O Underground Service Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-4'17-4735 CROUGH -IN 1 r THERMOSTAT / Datc ___ npp.aved ny \J I` Dnm nrPmvcJ ev J D e `FIlVAL >ea_S2.5iK ) � nam D�n�n.ra ny / inspection Area, Building orfquipmcnt inspected Date CSERVICE ` Dar nwm..d By CFEEDER Dete Aae w BY , Action raken Electrical Inspector