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825 E 5th St - Building
B2-~ ~ 5' st-. tilE .., 'I Letter of Transmittal April 27,2007 Cmtnrticn Revie.v Services 310 I S"aJ1 RCl3d SE T UThVater, WA ffiBJ1 POBo< 47852 Oym~a, WaSirgtcn 98504-7852 WIMN.ftl1.wag:Nic rs lei. 2ro-226-2944 fax. 2ro-226-BJ1 Proj eel Into: CRS# 9223 Port Angeles Care Center Chapter 388-97 WAC Nursing Homes Care Tracker Kiosks Project location: 825 E 5th St Port Angeles WA 98362 Local Permit #: Key People: Assi gnoo DOH ReJi eNfr Fa::ilily Admi ni slraor: Dougl <5 T cyl or CEO dougl <5.lcyl or@:loh.wagov ExI61di cere HeB th S3"vi ces -I ,~(X J€SS6i I 111 WMidhigal 3 MilW::JlkmiMII ~203 L (414) 908-8496 ~ Fa::ilily Conlai: ExI61dicere HeBlh S3"vices Brial DaJidson 111 WMidhigal3 MilwaJkee ttNl 53203 (360) 452-6213 bdaJidson 161dicereoom Sui I di ng . Oty of Fbrt Angel e; Offidcl: Mr. Jim Lia1y FOBox 1150 Fbrt Angele;, WA 98362-0217 (360) 417-4816 j I i erl y@cilyofpa.us OJ ~ Ardhilai / Engi nl33": HDI Ardhilais Ma1in Huisinga FO Box 4087 BelleJue WA 98009 (425) 455-4997 hdiadh@sEmet.com rtl . Sprinkler / Conlraior: RreAlam Conlraior: 01 * CfJ cf- Other : Other: CqJies T a IZI Local BLildrg Official: City d Poi Arg3Iffi o Wa9irgoo Slate Patrd, Fire Prdecticn BLTeau t8:I Archtect / Ergmer-: HDI Ardhilais o Slb-Ccntracta": o Slb-Ccntracta": ~ L& I, Bill Eckrcth, Bectrica Secticn o L& I, , Faclay ASBlljjaj Structu"es o DOH Chid Birth C€rIter LicenSrg o DOH Office d Accanmcdaticn s& Res Care Suvey o DOH exfice d Health Care Suvey IZI DSHS, ..emfer Bras:;her, Agrg & AdUt Services Actniri9raticn o DSHS, , Div. ex Alcctti and Sl.l:ffin;e Ab..fe o ether: t8:I CRS File Page 1 of 4 Plan Review Comments for Project #9223 -~-, ~.. Port Angeles Care Center Chapter 388-97 WAC Nursing Homes Care Tracker Kiosks Memo: - Authorized to Begin Construction - The construction docummts have been reviewed per Chapter 388-97 WAC Nursing Horms (NH) and found acceptab Ie. The starrped approved copy of the docu rmnts shall be kept and available for the licensing staff on site. Please note the following: . The local building official is responsible for bu ilding construction permitting and occupancy. I nstallation work may begin upon receipt of any perm its as deemed necessary by the local building official. . Any changes/deviatio ns (incl. change orders or addenda) from the approved documents must be submitted to the Department for review and approval. Please include your CRS number on all communications to Construction Review Services. . You must notify the department when construction is complete, either by the included notification of construction complete (pink card) or by completing the form on the CRS website. Additional instructions may be printed on the pink card. When we receive notification, we will notify Department of Social & Health Services (DSHS) Nursing Home licensing that you have completed the review process and are ready for an on-site inspection. Nursing Home regulations do not allow activation of the touch-screen monitor system until authorized by Department of Social & Health Services (DSHS) Nursing Home Licensing. Final licensing approval is subject to a site inspection by DSHS Nursing Home Licensing and the Office of the State Fire Marshal to verify compliance with Nursing Home regulations and your approved documents. If you have any questions please feel free to contact Construction Review Services. You can rronitor project status and fill outouronline survey at wvvw.doh.wa.qovfcrs. Page 2 of 4 Plan Review Comments for Project # 9223 1[(4/27/2007) James Lierly = 9223.pdf Pag~1 Facility Data Certificate: Facility Name: Port Angeles Care Center DOH Facility ID: 007717 Site Address: 825 E 5th St Port Angeles WA 98362 Critical Access Facility: 0 Yes ~No Estimated Date of Occupancy:Currently Occupied Occupancy Group: 1-2 Construction Type: Applicable Code: 2003 IBC Added: Removed: Total: No Type No Smoke Control System Provided: I8J Yes DNo Location: DYes DNo CON Approval Granted: DYes DNo CON Number: rn ~ Number of Beds: Current: >- ~ Automatic Fire Sprinkler System: j Automatic Fire Alarm System: ~ Compartmentation req'd: u.. j Special Delayed Egress Control: <l: Certificate of Need Required: Number of units: Private occupanCy: Based on size of rooms used for sleeping Residents Based on size of common rooms Residents Two person occupancy: w ct:>- <l:...J UZ ...Jo <l:rn i=!!:! Maximum allowable licensable beds: zl- ~ ~ Qualifies for Assisted Living Funding -u ~ Program DYes DNo Number of qualifying units: rn W I- o Z The data above is based on the information presented to CRS. Any change in the facility or facility program that causes the above information tobe incorrect is subject to review by CRS. Approval for construction is not approval for licensure. A copy of the facility data certificate will be senUo the licensing agency. Page 3 of 4 Plan Review Comments for Project # 9223 Port Angeles Care Center Chapter 388-97 WAC Nursing Homes Care Tracker Kiosks Plan Review Comments ! .. o J 1il 15 8: <( 1il 15 8: <( t5 z o Approved 04/18/07 - Per an explanation letter received from Ms. Donna Maassen, Privacy Officer with Extendicare Health Services, I nc., and a follow-up telephone conversation with Ms. Maassen, the installation of the Care Tracker kiosks is accepted provided the time before the monitor shuts itself off because of non- activity is programmed at one minute instead ofthe two noted in the letter, and the monitor goes to a "picture" instead of a black screen. Be advised the facility may be cited if licensing inspections find staff using the kiosks when non-staff individuals are in the kiosk area, a complaint is made concerning misuse of the touch-screen monitors, or monitors do not function as described by Extendicare. 2 Construction and renovation may create conditions that compromise the health and safety of patients, staff, and visitors. Facility planning must include provisions for infection control and safety of the facility's occupants during any renovation or new construction. The facility's infection control practitioner (I CP) and safety and security personnel (S&SP) should be involved with facility planning, design, construction, and commissioning ohny new or renovated area. The design professional should incorp orate the specific construction-rei ated requirements of the I CP and S&SP in the contract documents to require the constructor to implement these specific requirements during construction. WAC 388-97-365 Carpiaxe with the carrrents cixJve {TCNided IJ/ the Depa1rrenl ciHecit/J, Crntru::lia/ Ravirm arvi~ eye I'lOCeS9y frr ttis foci/ily torr-eet the req.iretrenls dthe Cf:Picctie lica1Srg regJcija/S farrj in the 'Mdirgm S<te Mririm-ative C<:re arrJ a=i<ted rwerr:es Tte!B carrrents cD rei relieve the f<dlily fran the re<pcnStilily to rre fJ. the reqirerrerts ci a1y citer Cf:Picatie fed:!r<i, s<te a /X<i regiwa/S Inthe evert dcxnlfids refween citer jlTi:nctia/S arrJ tres:; written carrrents, the rmi m-ingert !iJci/ cppy. Page 4 of 4 Plan Review Comments for Project # 9223 CITY OF PORT ANGELES FIRE DEPARTMENT PERMIT 321 East yh Street, Port Angeles, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr. name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 06-00001295 Date 12/05/06 308360 825 E 5TH ST 06-30-00-0-1-7590-0000- FIR LANE TERRACE FIRE ABANDON TANK INSPECTION RS7 RESDNTL SINGLE FAMILY 9000 Owner Contractor PORT ANGELES ASSOCIATES PRTSHP ATTN: TAX DEPT WILWAUKEE WI 53203 CANNON DOZING & TRUCKING PO BOX 7972 OLYMPIA OLYMPIA WA 98507 (360) 790-4306 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date . UNDERGROUND TANK COMM 91819 100.00 12/05/06. 6/03/07 plan Check Fee Valuation .00 9000 Qty Unit Charge Per Extension 100.00 BASE FEE Fee summary Charged Paid Credited Due ---------------- ---------- ---------- ---------- ---------- permi t Fee Total 100.00 100.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 100.00 100.00 .00 .00 ~ , -- ~ ~ /.;;~ t /;:: eej1 p~ ~06 k' f) () ~ 'S\ \'1 \j) 11 ~ This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with 180 days from the last inspection. I hereby certify that I have read and examineJ this application and know the same to be true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compied with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating the work specified in the permit. /0-; S7o~ Contractor or Authorized Agent Date Signature of Owner (if Owner is builder) Date "" FIRE PERMIT INSPECTION RECORD Call 360-417-4655 for fire inspections. Please provide a minimum 24-hour notice. It is unlawful to cover, insulate or conceal any work before inspected and accepted. Post permit in a conspicuous location. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE FIRE SPRINKLER Underground piping hydrostatically tested Underground piping flushed Interior piping hydrostatically tested Interior piping inspection Dry system air tested at 40 psi (24 hours) Sprinkler final FIRE ALARM Rough-in inspection Alarm final LP-GAS Completed by Contractor: Underground piping inspection/pressure test Test #1 Above ground piping inspection/pressure test Piping pressure test pSI Tank (container) inspection Time initiated Test #2 Appliance inspection Piping pressure test psi Time initiated LP-gas final UNDERGROUND STORAGE TANK (UST) ABANDONMENT Removal of flammable/combustible liquids Tank appropriately abandoned UST abandonment final 1'2-/ZOO6 l<.b1) PERMIT OTHER (specify) permit final Inspection Type I Date Passed I Comments GENERAL COMMENTS: 2/15/00 LUUO/VVI/ 1L/lI1U Uj: It! YM L:IlY Uf PA tlLVC; VEPT HX No, 360 417 4711 p, DOl/DOl j. . e. BUILDING PER~I~ ~APPLlCATIOJ\i I Fill out COMPLETELY and in INK. Your application and site plan MUST BE . L. COMPLE'l'E to be accepted fo(" review. . If you have any questioDs, call f .- '_~"'_-_'-::-~'"7:'---:-'~"':'--:;"_;~-~'_1.~~~~..!V-~-~_._~~(~~~>-~2:~!E._.___ ...--.:---...-..;.-- "-'-'-."--'---' "'.".'-' ...--.. 1 ... ..--..... _...n --..... ... .... . I. TYl'EOFWO:RK: . SlZENALUATION: o Residential. 0 :New Constr. 0 R.e-roof 0 Stove SF. @'$ /SF. = $ o Multi-family 0 Addition 0 MOveO Garage SF. @ $ /SF. = $ o Col:nmercial 0 Remodel 0 Demolition 0 Deck SF. @$ /SF. := $ . o Repair 0 Sign &YOther vlS-r. . TOTAL VALUATION $~, #60 BlUEFDESCRIPTIONOFtHEt}.RoJECT:. 2enuJve ~. l)()O al1de/tJy"tb~d.- .tbffJ, ~ f'*" F- . . .' Occupant Load: Constructio:u Type: . & Proposed Sq. .Ft. ~ TOTAL Sq. Ft COMMERClALIRESIDENTIAL: Occupancy Group: No. of Stories: _ Lot Size: ~ting Sq. Ft. . Total.1ot covera~ % !. PLANNING USE ONLY: APPROVALS: l'LAN: BLDG: D~WU: ESAlWetland(s): 0 Yes 0 No SEP A Checklist required'? 0 Yes 0 No Other: FIRE: OTBEa: ~ o J' VALUATION OF CONST,RUcTION: In all cases, a valuation amount must be enter~d by the applicant. . . . .. . _ ~~_~~~ ~ .~~ !evi~ and may be xev.ised by the Buildixlg Division to compl~ with current fee schedules. Contact the Permit I' CoordiDatora.t417481SfOiaisistaiilie................. ..... -......-...... ..........-.... ...............-.. ...- .... ... ..............--.............. ......... PLAN CB:EC~ FEE: IF a plan check tee is due it mUSt be submitted at the time the building pexmit application and construction plans are sub.m:itted. All other permit fees are due at the time of permit iSSWIIlce. . EXPIRATION OF PLAN REVIEW: If no permit is isSlled within 180 days of the date of application, the application will expire. The Building Official can extend the time for action oy the applicant up to 180 day~ upon written .request by the applicant (see Section lU05.3.2 of the lntema.tional BuildingIReside.ntial Code, 2003): No applica.tion can be extended more than once. . . I hereby certify that J have read and examined this application and know the same to be .true and correct. I am authorized to apply for this permit and understand that it Is my responsibility to determine what permits are required ,not the City's, and that I must obtain SU~h permits Pn.o~to ~ork. .~. .. . . , . .T:\fORMS\BldgPermiU'o,Ol1.~ApplicBDt _~ . D~; /...:::v/ s-:/ t:J6 . . . , . . . '"..~. $~cI~~ D!i .....~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION :m 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 07-00000899 Date 902720 825 E 5TH ST 06-30-00-0-1-7590-0000- ELECTRICAL ONLY 7/30/07 RS7 RESDNTL SINGLE FAMILY o Owner Contr,actor PORT ANGELES ASSOCIATES PRTSHP ATTN' TAX DEPT WILWAUKEE WI 53203 OLYMPIC ELECTRIC 4230 TUMWATER PORT ANGELES (360) 457-53'03 WA 98363 Permit Addl.tional desc Permit pin number Sub Contractor Perml.t Fee Issue Date Expl.ration Date ELECTRICAL ALTER COMMERCIAL OLY. EL./ NURSING K):,OSH-'?" 108050 OLYMPIC ELECTRIC 58 00 7/30/07 1/26/08 \ ',~ Plan:Check Fee valuation 00- o ~ '-l\ Qty 1 00 Unit Charge Per' 580000:ECH EL-COMM ALT <5 CIRCUITS Extension 58 00 ~J, , ,-\ ~ , ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 58 00 58 00 00 00 Plan Check Total .00 00 .00 00 Grand Total 58 00 58 00 00 .00 ~ lA ,., COMMENTS/ACTION NEEDED ELECfRICAL PERMIT INSPECfION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLA WFUL TO COVER. INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE COMMENTS NO GENERAL COMMENTS: PW-ll02.1S [41961 '-~-.~~.-- Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO. '. ELECTRICAL PERMIT DATE c2:J~/ 9h4t Site Address: D READY FOR INSPECTION License Number: D WILL CALL FOR INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: Sq. Ft. o Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction o Remodel o Service update/alter/repair o Overhead o Underground Voltage o 10 030 Service size o Temporary o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) Amps Details/Description: t:'~ !?~ . W.S. No. Service Size Capacity: 0 O.K. 0 Not O.K. Comments o Ditch inspection O.K." .rP"/~O.: 0 1/M ~ Rough-in/cover O.K. ,c:...p"<r~ o O.K. to connect service 1- Final O.K. . Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Site Address: g;;2& (, fc Installer: Permit/Receipt No. ....... New Meters e" Notify the De rtm nt of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. T ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT # .:3 D ~ Inspector Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMPIC PRINT".R<:;. IN'-' \. ELECTRICAL PERMIT , PERMIT NO. ~ I ;) ? DATE Y'p/ /i?9 / , Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT Site Address: o READY FOR 0 WILL CALL FOR INSPECTION INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: Sq. Ft. o Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial ioad Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction o Remodel o Service update/alter/repair o Overhead o Underground Voltage 01003.0 Service size o Temporary o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) Amps .. DetailslDescription: / L- S( f~d 1-)llr /lk/!-.f~ citl4-.0.e /f2/}~ f/ 8 7tfU~~ '51,<1- W.S. No. Service Capacity: 0 O.K. 0 Not O.K. o Ditch inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ~Final O.K. ~ Size Comments Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Notify the Department of City Light by Street Address and Permit Number when ready for in pection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. ------\ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT Jf... ,UJ..O PNJ\ / tf lY'" \ rnspe~r Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall . OLY/olPIC PRINTERS. INC. Installed By: CITY OF PORT ANGELES LIGHT DEPARTMENT .~ ELECTRICAL PERMIT PERMIT NO. .Q./61.s-- y //.J~/ DATE Site Address: Owner/Business: , ~/c- OAk o READY FOR 0 WILL CALL FOR INSPECTION INSPECTION License Number: Phone: , Phone: Owner/Business Address: Sq. Ft. D New Construction D Remodel D Service update/alter/repair ,)g Add/aiter circuits D Auxiliary power (list below) D Special equipment (list below) D Overhead D Underground Voltage D 10 D 30 Service size D Temporary D Residential Heat KW D Baseboard D Furnace/Boiler D Heatpump D Other D Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) Amps Details/Description: . /J7m; lL/uUE"J a/l s4lt1--r 'J2c.e-p:~s At'c; '/1 0;r~ , ~/f I ~ f.Lt/ /,t'L.r; ~ W.S. No. Service Capacity: D O.K. D Not O.K. D Ditch inspection O.K. D Rough.in/cover O.K. D O.K. to connect service ~Final O.K. ~ Size Comments Date Hold for: D Easement D Letter D Signed up for service/meter D Meter Department notified for installation D Fire Department notified of inspection D Pian Review approved/pending Site Address: 9,;J..s- ~, s- I( Ck Permit/Receipt No. 62/;1.S o New Meters . J i' , I t))){O FEE RECEIPT NUMBEA CITY OF PORT A~GELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A 000196 PERMIT NUMBER . TOTAL FEE 31- 13 .;z..i>Se ( 'IJ-I /- VA/.-J;SC ""(1/-;-' q..-rJ! CONT. Lie. NO. TIMETQCOMPLETE NO. STORIES LEGAL O~CUPANCY Owner FA-. ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT 2>zs G. S--r::e CORRECT ADDRESS IS RESPONSIBILITY OF APPLICANT HEAl- TH C!Al2-J;. . $2.-~ E- STIt H<;;7 -,'is; 1/ PERMITS WITH WRONG ADDRESSES ARE CANCELLED Installation By <9f-rf1'Y/ pic: GI-Sorr/~ Installers Address - , t./S7 - 5" ~f)J:, Installers Phone sa / $0 '- Li NCfJ/-N J2-L:: {)A-; r G~", IU.4"J"'IlY Site Address Owner's Address Day Phone Ap~lication is hereby made for Permit to inst!lII.Electrical Equipm~nt as follows: FEED, WiriQg Method euN{)J \'1"'" .' NUMBER AMP -120V 240V NUMBER AMP 120V 240V USE OF CIRCUIT CIRCUITS PER 10 100A FEE USE OF CIRCUIT CIRCUITS PER 10 100R FEE CIR 30 CIR 30 LIGHT SIGN , , LIGHT 50 VOLTS OR LESS CONVEN I ENCE , MOTOR CONVENIENCE. MOTOR - APPLIANCE , , MOTOR - DISHWASHER , _. FI RE ALARMS , . , DISPOSAL BURGLAR ~LARM RANGE MISC. , .- , OVEN WATER HEATER - LAUNDRY DRYER REINSTALLATION LIGHT FIXTURE # FURNACE SUB TOTAL FEE .. ' . GAS. OIL FURNACE ENERGY FEE ELECTRIC. BASIC FEE . ELECTRIC HEAT .3~ ~ TOTAL FEE ELECTRIC HEAT Slj OF SERVICE SWITCH OR CI,RCUIT BREAKER i - A.C, UNIT t"D AMP:S I ^' G '-it PHASE FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS , .# 2- SERVICE AW.G. 1 SUB,T'OTAL' SIZE OF GROUND SIZE OF ENTRANCE SWITCH /tfiJ I certify that the work to-be performed under this permit will be done'by the installer and inconformance with the N.E.C. Electrical Code.' Date Application made ~- I - 1>5 19$5 By "7'9-H-N '/TJe-J<;J:;.V" CONTRACTOR OR OWNER (OR AUTHORIZED AGENT) Permission. is here~y given to do ~!1e above qescribed work, according to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinances of the CiW of Port Angeles. - DIRECTOR OF CITY LIGHT BY' '(li.~~-/" PLANS APPR VED ," Date Permit Issued . r~(~ t'f) WARNING Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or current turned on before inspection and O.K. for covering, or service has been given by Inspector in Writing on Permit Placard, A, . Permits Phone: 457-0411 Ex!. 158, PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ WHITE - Original CANARY. Duplicate PINK. TrlpUcate WHITE CARD - Inspector's Report n, vu.",... .,C,..IT!:C~ 1..1(' 07/26/2007 15:42 3604523498 OLYMPIC ELECTRIC PAGE 02 f" I: I I ! !, j, "J,," I":' j ',,' 1\- ..... . ELECTRICAL WQRKPERr&I' APPLICATIlilN JDb wed by rilectrJcal Coatractor a OWller I.51.nallon dcaciription GK:DlIllDerclllI IJ ll..ldeatlal Elcetric:.1 oontrlc:lOr J\lm~ U,eo'lI number Dale 'Expires r?!t...~/", aLI??,-- {/Lmp~~2%'T"'/?/ p",~"')I "0\11"$ .dcInI.. / I./;z. ?/? 7VmWA'17r Citro ~ d_ / /'m/'T ~l'f"J Tel~bo"e number ON"", o Mlered/Addltlo. Sian ZIP iJd FAX n~ber 7/?6f h., ri?/I .;; Ibr .//vn /~r /?r/ f/,..h /(I05/fs rrtmhc, owaer'J ume /" j? h' L~r/:- ~ij7Ir,r Addrell of 1a..peeCloa .ffl g.zC; r- <;""'~ CitrO ~ / rOrT: cf,,:"r PboDe Dumber 10 Ie edull la.lpecUoD!. 'I~,;z.-G,,2/J O.,/IU IU d'JI.,d b)I RCW.19.1B.26/:(I) Cwou wflt .<<."" ,h, ,/"'<1..../., IWO ""'" oJI<r .hlir ckcJrlcol ,....vllir j/luJllir'd. (2) Ow"... /J rttjwrtJ ,. hi" on el<<1rlC<lI COftlracror V GbcM SJJJd fJ"D,vt)' l.J for ,,011, nnl or J~t.. After _tnl tbc above Itallll'4tnl" J hereby certify dun l em die ownet of the above IlOIIl<ll "",pony or . Ii...,. cl.,lri.rJ _"or. I om msklnJ lb. .l.ct,l<allnltal. 'I1Ion or alteration in.cOmplilnce wilh the eleCffl'DlIIW1. N.S.C., RCW, Chapter 19.28. WAC. CIIop'O' 296-468. Th. City or Pori Ana.l.. Munl,ipol Cod.. and Utlllly Specln"rioDO. Slcasturt of awaltr, elec.trlul "contractor or eJ.elrlcal Id.lldolslr..or o Cash 0 O1ecktl ~it Card VIS8 Mastercard Discover Cerdtl - - . --------:------_._-~ x Date: ?Z7b7 Expiration Dal. of card IllJpeellotl .r~ $ ~. ==-" Sflrvlcelnfom1llltlon EIItt:&leBI LOB6Addltlon8 end or Ruhtrlllctlons lJ NO ~OAC CHANQES C Baseboard _ KW o Fumace _ KW 0 evomeed Sa"""" C Haal pump _ Ton _ LAR a Temp ServlCe lJ Fan-Wall _ KiN 0 Underground Service SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 , ROUGB-IN THERMOSfAT Voltage Ph.....CIC3 Serme 612:a:_ Foeller SIze: SERVICE .... Appr'ned o~ .... ~Br DlTCH FEEDER ... 0.\.1 ,In,,,"o,l.. ' Dlte. Area, Building or Eqllipmenl InapcctOd Aclion Toke. 1!1.c:trl..1 Inlpec~r R AUG /13 /2014/WED 12A0 M FAX No. P. OR ' t Cm oE' Pb1dT ANr.E ,zs P1r 1Y. T .I cA ioii futtdtrlg Y' rtvIksoWMleetrIW InVecdome RECE-1 321 East FMh Street— P-O- AOx 1150 / Port Angeles Washhagtdn, MCZ Ph: (360) 417 -4735 Fax: (364) 4174711 AUG. a 20144 oats: rR,- / _Malta- FttmVor Comm exeisl" Ir T is l " Flan F evlew Play a ulred, Please C Ike Ele Flan Review In€ormatu Shoat dab Addr"% Ouil" aquae: Moab. fMxori &n of shove Dtiwlerl ahan CooWcWrlml an Wine e-AA Be-k" ___rr,•ert Name Mah'aAddreea Me IngAd6a ! W. Stale: — 7qx "' alffi&____.`21Fe —� Phm FGX AM@!__. Fmc: LIMU e#1FXP tJCdia� #1E%p bm Unit 2M Tate! 11lult f a WF�r200 Amp 0132.00 9rrrvl mAxdrr201.4OOAmp. $ 160.00 &Veadc401 -60D Amp $ 225A0 1 g� s�orVtaalFeaadareot�ft)QOAmp. $ 288,00 g 5trtifaeiFeadar over 1tio0 AmP E 410,00 S AMic l 009 W1 Aen&A FWar - BrtAnCt1 LYrddt Y!b►7 5bfv106 i�e6det b 74,00 ,�,;,,,,,�, �,�,,,.� FAO AQa OWW BMW Circe BrUgh gmvk 1- moo s Tamer 5ervloel Faader 20q Aml+1 S 102AD Tramp, SeryioaFrsed020140DArne. 3121 Tartgd• su►r iFe ao1 �a0 env. t 164,Q0 To", Amp . $165,06 $ Pored to Patel Flowiy $ moo 3 Gl o/Odlne Lt Mog S @8,00 $ ebnW MOW LNniW EMW — MuUFFamly $ 64.09 5{ Carnrnen3a! 366,99 0rtalgrwdltimltsdErsergyfFir5t9500sf— 000 1� WG#6: 56.001'vraachadditbrral i50Qs! Reneyvs6te�trlcalEararptr- 6KVASystcrnort.as9 3h1�0o 3 S M OO Nab; $6.00 for 6KII MUN MI TStat � r�l Dmv *6 clefiltsd by RCW,10,2B.261: (1) OMerA occupy the Sbu(ure !0r to yanaftrthla eteotr W AWM t I1c f+nalhedr (4 Cwtrar as required to hi►e art electrioei carttraolat if shave said prapei(yr is forsala rent or lease- Perms# ex0aa afiarsix mmohe of )r+9t Ingp4don, M ar reading the-4m stahrnent, I hereby 09* that I am the awnar of !be above named propxr f or a Fbensed atedM contr"r. I am rrlskng the eleftal Wbablfon or skralon In oompllarm ah the atscM IAWs, N-E.C,, RM Chapter 19.26, WAG Chapter 29&49, The ft of Par l AngeIc4Munfclpal Code, and Ui ty epeoifiaoWna and PAMC 1405.450 r®Qarding lelecticel Permt Applledarls, SJgnalura of oww, r lentrleal 90Ktra otor or elad6C*l administrator. © rash ❑ Chmr I © I O"Ma"I , -A F 17— tip: �°�' / 41lov�olx Owner as defired by RCW.1918,261: (1) Owner will occupy the structure for two years after this electrical permit is finalized_ (2) Owner is required to hire an electrical contractor it above said property is for sale, rent or lease. Permit expires after six months of last inspection. *1; 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 electtcal installation or alteration in compliance with the electrical laws, N,E.C,, RCW. Chapter 19,28, WAC. Chapter 296 -466, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator', ❑ cash ❑ Check L 'zk - I f ❑ Gradi #Gardik gat9d: 01101(2012 RECEIvE, On OF PORT ANGELES PERMIT APPLICATION � � 16 2014 13ulJ0ng J)lv�s1ou /E1eetJricaj Inspections 321 East Filth Street -. P.O. Box 1150 / Fort Angeles Washington, 98362 Pb: (360) 417 -4735 Fax: (360) 417, -4711 INSPEt` ONO Date; � rt ___. Multi - Family or Commercial* * Plan Review May Be Required, Pleas Qmplete Electrical Plan Review Information Sheet Job Address: R'.y 5 _ `� Building Square Footage; D of above ation Owner Information Contractor Infoation Name! Name: K,_� Mailing Address: Mailing Address: City: 51ate,_Zlp:� city' Seale: Elp: Phone' Phone; Fax: License # 1 Exp .,........,.._ ., . _ License # 1 Exp_ Item Unit Charge Qty 'total (Qtv Multiplied by Unit Charge) ServicelFeeder 200 Amp. $132.00 �� $ 3a2 Service /Feeder 201400 Amp. $160.00 $ 5ervicelFeeder 401600 Amp $ 225,00 $_, ServicelFeeder 601 -1000 Amp. $ 288.00 $ 5ervice/Feadsr over 1000 Amp. $ 41100 $ Branch Circuit Wl Service Feeder $ 5.00 $ Branch Circuit W10 Service Feeder $ 74.00 $ Each Additional Branch Circuit $ 5,00 $ Branch Circuits 14 $ 86,00 $ Temp, Service/ Fauder 200 Amp. $ 102.00 $ Temp, ServicelFesder 201-400 Amp, $121.00 $ Temp. Service /Feeder 401 -600 Amp. $ 164.00 $ Temp. Service /Feeder 601 1000 Amp, $ 185.0e $ Portal to Portal Hourly $ 96,00 $ Sign /Outllhe Lighting $ 80.10C — $ SignalCircuillLimitedEnergy — MA-Family $ 64.00 $ Signal Circuit/ Limited Energy 1 First 1500 sf— Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Reneweble Electrical Energy- 5KVASystem or Less $113,00 $ Thermostat Note: $5.00 for each additional T•5tat $� Total Owner as defired by RCW.1918,261: (1) Owner will occupy the structure for two years after this electrical permit is finalized_ (2) Owner is required to hire an electrical contractor it above said property is for sale, rent or lease. Permit expires after six months of last inspection. *1; 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 electtcal installation or alteration in compliance with the electrical laws, N,E.C,, RCW. Chapter 19,28, WAC. Chapter 296 -466, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator', ❑ cash ❑ Check L 'zk - I f ❑ Gradi #Gardik gat9d: 01101(2012 r5xcroi°r r ., FIRE PROTECTION WREAL -- FIRE AND LIFE SAFH7Y JNSFEC7110NS PO Box 42500 0 M Qz 9� Olympia WA 98504-260C Tim r �r� �Ft1A9v oy� i�I- (360) 596 -3900 PAX: (36D) 59543934 u- GENERAT ®R INSPECTION REPORT ANNUAL GENERATOR TEST AND CERTIFIC MN Name of Facility Licensed As�ii, " 1121z'i, %cic.FAdrninistrator' (Boarding Home, Nursing kome; etc.) to Address ' Cityy ZIP Inspected By ry;,v „ „��� Title Inspecting Irian '�._ .�;x_: Phone Address ; ri�', tir City a^ 7 � ZIP Generator Manufacturer Engine leaks f=uel Type ❑ Gasoline ❑ Diesel LPG ❑ CNG Engine RPM Rated KN /A Hour Meter . 1. Starts on power failure ❑ Yes ❑ No Seconds to Start ..A: 2. Do transfer switches operate correctly? ❑ Yes ❑ No 3. Velts: Loaded - -' Unloaded '2,J HERTZ: Loaded Unloaded 4. Amps: Phase A ! °; Phase B !' Phase CI 5. Battery voltage while cranking _ _, %7 6. Generator "RUN” light on? a Yes ❑ No ❑ N/A 7. Generator stops when power restored? 0 Yes ❑ No - ” Time 8. Does primary and/or backup fuel come from on -site source and have a minimum Nvo -hour fuel supply? "<__Yes ❑ No 9. Amount of fuel: Primary supply - Backup supply 10. Does automatic transfer to on -site fuel supply work properly? [] Yes ❑ No 11. _a Cociant Level: ❑ Full ❑ Low Protected to y ? ✓ -�~ ❑ N/A 3830- 4514 31 . 3/02} Page 1 �}µiRGIGH „f,� �y FIRE PROTEC710N BUREAU m FIRE AND LIFE SAFETY iaeiSP C TIQ (r f PO Box 42500 ® ®nrrrrr�r� WMHINGMH SPATE PATROL Olympf a WA 98504 -266 n Inl rT� �rmwl (360) 596-3900 FAX: (360) 596-3934 9F 193 ry.L' ?"�F,4 12. Does all required fire and life safety equipment on the generator operate properly? A. F Yes ❑ No Illumination of means of egress D. ❑ Yes ❑ No Exit signs C. Yes ❑ No l=ire alarm and alerting systems D. i,. Yes ❑ No Communications systems, telephones, etc. E. Yes ❑ No Large assembly rooms F. Yes ❑ No ❑ Yes ❑ No Generator set locations Elevator lighting ,.I G. cab and controls 13. Is any non- emergency equipment connected to the generator? ❑ Yes ❑ No If yes, list: _ 14. Emergency circuit breaker panels and circuits clearly identified and labeled? 01 Yes ❑ No 15. Does connected load exceed generator capacity? ❑ Yes ❑ No 16. Deficiencies found: 17. Corrections made: 18. Corrections made by: This is to certify that this emergency generator system has been properly inspected for reliability, covering all items listed on this forma. T - (Srgnature of person conducting this inspection) da #e (Signature of facility owner /representative) Date This -form is to remain on the prernises with the gane�ator records. I Do not send it to the Stete i'ire , Fage 2 Lighting 220.42 Notes 22100 ft2 X 2VA FTz= 42000VA 50% @100% 50 % @40% =29400 Recpts. 10 Small App Circuits @1500 =15000 193 existing Recpts. @ 180VA =34740 X .40 = 13896 may not apply Special Use Recpts. 2 @ 208V 10 = 60A X 208 X.40 = 4992 Laundry Dryers 3 @ 208V 10 = 29.8A = 6198 Washers 2 @ 208V 30 = 16.1 = 5793 Hot Water 1- Electric @ 208V 30 50A = 17992 5 Gas @ 120V 10 72A = 8640 2 Boiler @ 120V 10 = 9A = 1890 Kitchen Range 1 @ 208V 10 50A = 10400 Hood 1 @ 208V 10 5.3A = 1102 Steam Table 1 @ 208V 10 19.2A = 3993 Steamer 1 @ 208V 10 33A = 6864 Cold Table 1 @ 208V 10 = 5.3A = 1102 Walk in fans 2 @ 120V 10 = 4.3A = 516 Walk in comp. 2 @ 208V 10 =19A = 3952 Disposal 1 @ 208V 10 = 5.7A = 1186 Heat /AC Forced Air 1 @ 208V 30 = 4.1 = 1475 Kitchen Heat I'@ 120V 10 = 2.4 = 288 Baseboard 1 @ 208V 10 — 17 — 3536 Heat Pump 1 @ 208V 10 = 7.8 X 1.18 = 8.97 = 1866 Ex Fans 7 @ 208V 10 37.2 — 7737 Lighting 29400 Recpts. 54732 Laundry 11991 Hot Water 28552 Kitchen 29115 Heat/Ac 14902 SUB TOTAL 168692 25% Future 42173 TOTAL 210865120811.73 = 586 We are bidding the service @ 208V 600A 30 � ��� ®~ ! ;e# 2 k|E»! » 2 7 N R %2 \ \ E \ k R \ \ 2 & ® �R \ / \) 9c,, !,!2 < CA -V §/\ 2 \00 / \ \/ O / ® ƒ / ` / E J co 2 \ /. \ � / w \ \ \ / / 4 ® CL / 5i \ / cz � \ k « � > / \ & \ ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 14- 00000780 Date 8/14/14 Application pin number . . . 111640 Property Address . , . 1 825 E 5TH ST ASSESSO(2 PARCEL NUMBER: 06-34-04-0-1- 7590 -000Q- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use Property Zoning . . . . . . . RS? RESDNTL SINGLE FAMILY Application valuation r . . . 0 Application desc Remodel Owner Contractor ---- --- -------- -- ---- - -- ------------------------- CRALI PROPERTIES L74C KIRSCH ELECTRIC INC. 17009 N HIGHLAND LN P, 0. BOX 3396 SPOKANE WA 99405 SEQUIM WA 98382 (360) 683 -6819 -------------------------------------------------------------- �? Permit . . . . , . ELECTRICAL ALTER COMMERCIAL�++J - Additional desc 1 -4 CIRCUITS Permit Fee 696.00 Plan Check Fee 00 Issue Date . . . . 7/01/14 Valuation . . . . 0 Expiration Date , . 1/28/15 Qty Unit Charge Per Extension BASE FEE $6.00 1.00 96,0000 ECH EL- LIMITED 1ST 1500 SQ FT 96.00 5.00 5.0000 ECH EL -ADDNT LIMITED 1500 SQ•FT 25.00 2.00 132.0000 ECH EL -COM 0 -200 SRV FEEDER 264.00 1.00 225.0000 ECH EL-COM 401 -600 SRV PFEDER 225.00 Fee summary Charged Paid Credited Due Permit Fee Total 696,00 696.40 .00 00 Plan Check Total 00 00 .OD 00 Grand Total 696,.00 696,00 .00 .00 REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE F3 G0 ROUGH -IN L FINAL COMMENTS: PERMIT WILL EXPIP E SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date:. G: IEXCHANGEIBUILDING dir! e. I?ORTAN , 4�0, 'Q. ELECTRICAL INSPECTION i lz WIRING REPORT -4735 RKS 417 DATE, 41-37/1 � PERMIT 9 f Lf- 712)D INSPFCTOF�- OWNER CONTRACTOR 9 1 a<--� C, �i ADDRESS 5; ��AP'�PROV�ED NOT APPROVED ❑ .................... DITCH ......... - I El ❑ ................ ROUGH IN/COVER .... -- ....... ❑ 0 ............. ..... SERVICE . p ............... .'- 0 ❑ ... ................. FINAL .... ............... ❑ CORRECTIONS NEEDED: h L NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OtF01174,V� ELECTRICAL INSPECTION WIRING REPORT `rte sKS 417 -4735 m DATE: PJERMI I R INSPECTOR OWN Fl CONTRACTOR ADDRESS 245- APPROVED NOT APPROVED ® ...... ..a........... DITCH .................... El ROUGH IN /COVER ............... ® ................ ....SERVICE................... 0 ............... ......FINAL.................... IJ CORRECTIONS NEEDED: 1J fh�-T R-C)o )-% CAD rl 3`7— 1 14- —Ll . � 6Z--I y -`7 NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS — DO NOT REMOVE — p &pnarqVc ELECTRICAL Iti7PGVTI®IV WIRING REPORT 417-4735 �fiKS � DATE; PERMIT # INSPECTOR -z r r - G ER - CqnnL.1 R,o f�Ti i L CONTRACTOR ADDRE$S 2-!9- K-- 5 J APPROVED NOT APPR 0 ................ ....DITCH.................... 0 ................ ROUGH IN/COVER ............... 0 .............. ......SERVICE......,........... ❑ ............... ......FINAL.....,,....,........ I� CORRECTIONS NEEDED: � 9,?i IMAo U w- Caw r j pf- - a L.�.CY -ICA L- [� 2)�Sr�.R,�LG�z. Irz�V �. ►�TmLL C�,w�''L.Y uJ g`i'rl N rzf-, LX)A - t 1 sle- C. 3) m go vrvrt-lz I r- a % � I v v - -, 1 L&� - r Sri^ Lj- 4) �AnL ty�05'. e7s�r� NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS — DO NOT REMOVE — OR Tq,,,Q ELECTRICAL INSPECTION ■ WIRING REPORT 417-4736 DATE: PERMIT INSPECTQR ttaiA4 OWNER (:rLA, w CONTRACTOR 14 k (Z I,- WW ADDRE$S le APPROVED NOT APPROVED 0 .......... - ....... DITCH .................... 11 El ................ ROUGH IN/COVER. , , ............ 0 0 .... SERVICE ................... 0 0 ..................... FkAL- . ........... k- conRECTIONS NEEDED: frAf-famf A441LC- 200.3 7) fzvlL4wXim 'f9!92-TftLc--�A -194 QV I AAAX—t- r W rr NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS — DO NOT REMOVE — A q-ORT,4,V Q ELECTRICAL INSPECTION WIRING REPORT ho *ORKS 417-4735 DATE, PERMIT 4 INSPECTOR ,q lil� h Ll ' jq -7 W OW ER cgp*w CONTRACTOP �o m4l c k ADDRESS f2 NOT APPROVED Ci........ .......... , DITCH ............ ....... 0 ............... ROUGH IN/COVER ................ 11 [3 .................... SERVICE ............ ...... 11 D ............. ....... Fl NAL .............. CORRECTIONS NEEDED: -br4ki Igo." ( 1w . S'K^W�) SQj"f.M %ko.LaJ20 I-L A. 2)- 1.314Lw..pjM o-% 4KJt.Aq-m wu"'ma T�ajfi 4F5 '94-m- tO lfi:S- L-C, c- §tTl b -4 - A&L -1-2 NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS I ! I rl 11011 , IT rel d i., 14 & NITA r Application Number . , . . . Application pin number . . . Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use , , . . . . . . Property Zoning . , , , , . . Application valuation , . , ELECTRICAL PERMIT CITY OF PORT ANGELES 360- 417 -4735 16- 00000191 pate 2/23/16 321675 825 E 5TH ST 06- 30- 00- 0- 1 -7S90- 0000 -. ELECTRICAL ONLY RS7 RESDNTL SINGLE FAMILY 0 Owner Contractor CRALI PROPERTIES LLC ELECTRIC AMERICA 17009 N HIGHLAND LN PO BOX 3523 SPOKANE WA 99005 SILVERDALE WA 98383 (360) 912 -5550 ----------------- --------------------------------------------------------- Permit . , . . . . ELECTRICAL ALTER COMMERCIAL Additional de,sc , . ELECTRIC AMERICA / DISHWASHER Permit Fee . . . . 86.00 Plan Check Fee 00 Issue Date 2/23/16 Valuation 0 Expiration Date 8/21/16 Qty Unit Charge Per Extension BASE FEE 86.00 Fee summary Charged paid Credited Dtle Permit Fee Total 86.00 86.00 00 .00 Plan Check Total ,00 .00 00 00 Grand Total 86.00 86,00 00 00 S s � REPORT SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN .FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contra_ ctor X Date: - GAIEXCHANG1 ✓\BUILDING CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street - P.O. Box 1150 / Port Angeles Washington, 95362 Ph: (360) 417 -4735 Fax: (360) 417 -4711 Cate: 8 Feb 2016 C Multi- Family or Commercial* * Plan Review May Be Re uired, Pleas*rnplete Electrical Plan Review Information Sheet Job Address: S` Building Square Footage: Description of above Owner Information Name: Sppollality Serviceg„II __- Mailing Address: 825 E. Fifth $t.. City: Eaft.Awelea State: WA. Zip: _ 98562 Phone:36 ® -47 -4701] Fax: License # ! Exp, ItgBr Unit Char e Service /Feeder 200 Amp, $132.00 Service /Feeder 201 -400 Amp. $160.00 Service /Feeder 401 -600 Amp $ 225.00 Service /Feeder 601 -1000 Amp. $ 288.00 Service /Feeder over 1000 Amp. $ 410.00 Branch Circuit W/ Service Feeder $ 5.00 Branch Circuit W10 Service Feeder $ 74,00 Each Additional Branch Circuit $ 5.00 Branch Circuits 14 $ 86.00 Temp, Service/ Feeder 200 Amp. $102.00 Temp, Service /Feeder 201 -400 Amp. $121.00 Temp, Service/Feeder 401.600 Amp. $164,00 Temp. Service /Feeder 601 -1000 Amp, $185.00 Portal to Portal Houriy $ 96.00 Sign /Outline lighting $ 88.00 Signal Circuit/ Limited Energy - Multi - Family $ 64.00 Signal Circuit/ limited Energy / First 1500 sf — Commercial $ 96.00 Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - SKVA System or less $113.00 Thermostat $ 56.00 Note: $5.00 for each additional T-Stat Contractor information Name: Electric America Mailing Address: P.O. B x 2 City: Seauim State: WA Zip: 98883 Phone:-360-91 2-55§0 Fax: license # / Exp. , ELECTAL856600 111 -18.17 t yt JQJAI (Qjy MultIRII@d by Unit G e $ $� 8600 $ $ 86A0 Total Owner as defined by RGWA 9.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized, (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296 -46B, The City of Port Angeles Muni ipal Code, and l)tlAy Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature or eleArlaWAdministrator: ❑ cash © check -^� ❑ credit card �k _ ��� " & I b 4110112012 F fay. j, INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN`mss FINAL r COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 17-00001848 Date 12/15/17 Application pin number . . . 230056 Property Address . . . . . . 825 E 5TH ST REPORT STATE SIDLES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7590-0000- on, em*q tax form Application type description ELECTRICAL ONLY your Subdivision Name to the c ty oil AngeleS Property Use . . . . . . (Locatfon CQ& 0502) Property Zoning RS7 RESDNTL SINGLEFAMSLY Application valuation . . . . 0 Application desc - Heat pump and roof.conduit repair ------------------------------------------------------------ --------------- owner Contractor CRALI PROPERTIES LLC ELECTRIC AMERICA 1.1QO 9.N HIGHLAND LN PO BOX 3523 SPORkNE WA 99005 SEQUIM WA 98382 (360) 912-5550 ------------------------------------------------------------- Permit . . . . . . ELECTRICAL ------------- ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 124.00 Plan Check Fee .00 Issue Date . . . . 12/15/17 Valuation 0 Expiration Date 6/1-3/18 Qty Unit Charge Per Extension 1.00 74.0000 ECH EL -COMM BRANCH CIR WO/ SIP 74.00 10..00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 50.00 ---------------------------------------------------------------------------- Fee summary Charged Paid. Credited Due , Permit Fee Total 124.00 124.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 124.00 124.00 .00 ..00 fay. j, INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN`mss FINAL r COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: 0,-13 _2oi% V Multi -Family or Commercial* * Plan Review M� Requir j Plepse Complete Electrical Plan Review Information Sheet Job Address: JJtt Building Square Footage: i J Description of above A4dad,X 4d CirCe-1 r for Heo' t,, t�,9 >♦aXir- GU' 4K f't)' -,-,n rpt Owematio�n� Contratiormati n Nam Name: # Mailing Address: City: State: Zip: Mailing Address: YO 5 eZip: lir'fk-2 Phone: J60 -y'11'W%ax: Phone:M"- ,y, License # I Exp. License # / Exp. L4Z CrALJS- Q Item Unit ChargeQ�rt Total (Qtv Multiplied by Unit Charae) Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201-400 Amp. $160.00 $ Service/Feeder 401-600 Amp $ 225.00 $ Service/Feeder 601-1000 Amp. $ 288.00 $ Service/Feeder over 1000 Amp. $ 410.00 $ Branch Circuit W/ Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 74.00 ( $ r�`( Each Additional Branch Circuit $ 5.00_ $ 5� Branch Circuits 1-4 $ 86.00 $ Temp. Service/ Feeder 200 Amp. $102.0 $ Temp. Service/Feeder 201-400 Amp. $121.00 $ Temp. Service/Feeder 401-600 Amp. $164.00 $ Temp. Service/Feeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuit/ Limited Energy — Multi -Family $ 64.00 $ Signal Circuit/ Limited Energy 1 First 1500 sf — Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - SKVA System or Less $113.00 $ Thermostat $ 56.00 $ Note: $5.00 for each additional T-Stat $ Total Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-466, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: X4 Dated: it A —Ioi / ELECTRICAL PERMIT CITY OF PORT ANGELES 360417-4735 Application Number 17-00001023 Date 8/03/17 Application pin number . . 914644 Property Address 825 E 5TH ST REPORT STATE SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7590-0000- on your excise tax form Application type description ELECTRICAL ONLY Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning RS7 RESDNTL SINGLE FAMILY Application valuation . . . 0 Application desc Generator room fan / Server RCPT Owner Contractor CRALI PROPERTIES LLC ELECTRIC AMERICA 17009 N HIGHLAND LN PO BOX 3523 SPOKANE WA 99005 SEQUIM WA 98382 {360} 912-5550 Permit ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee . . . 74.-00 Plan Check Fee . . .00 Issue Date . . . 8/03/17 Valuation . . . . 0 Expiration Date . 1/30/18 Qty Unit Charge Per Extension 1.00 74.0000 ECH EL-COMM BRANCH CIR WO/ S/F 74.00 Fee summary Charged Paid Credited Due I 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: INSPECTOR: / DITCH SERVICE ROUGH-IN $/311`7 —f_ 1110 FINAL ei3/J7 COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: Off.¢oRr1,y_ G��~.°" Ff 'j S CITY OF PORT ANGELES PERMIT APPLICATION ;k• � , Building Division/Electrical Inspections .' ' . '`, .a ;: } 321 East Fifth Street-Port Angeles Washington,98362 „i :r (�1 Ph: (360)417-4735 Fax: (360)417-4711 Date: '1-ail --2017 / .- ; , Multi Family or Commercial* V Commercial Addition/Alteration/Remodel/Ref)ge *Plan Review May equired, P g se Complete Electrical Plan Review Information Sheet Job Address: 2 E• s r� s • Building Square Foota.e: J-' Descriptioq of Ark i ' ' 4 - ,LALL' • •• : w Wiri� (J C ,), g 4 & &d 20 94p circ,,,i i tC (letter raad ,,L0 I I Owner Informatip,n Contra09r I formation , ames w i g f/.:, I t Name: riG it ll f 1 MailingAd ess: I ;, Si I �T Mailin ddress: PO. 433( j�. City: P•A• State: W R Zip: I " City: C 11 State: R Zip: q ' .2 Phone:S(a0 'llr(.0 Fax: Phone: �Iffpp�- 75-- ax: License#1 Exp. License#1 Exp. (.t !2- ')qv Item Unit Charge Total(Qty Multiplied by Unit Charge) Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201-400 Amp. $160.00 $ Service/Feeder 401-600 Amp $225.00 $ Service/Feeder 601-1000 Amp. $288.00 $ Service/Feeder over 1000 Amp. $410.00 I Tlctl $ Branch Circuits 1-4 $ 86.00 Branch Circuit W/Service Feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 74.00 1 $ Each Additional Branch Circuit $ 5.00 $ Temp.Service/Feeder 200 Amp. $102.00 $ Temp.Service/Feeder 201-400 Amp. $121.00 $ Temp.Service/Feeder 401-600 Amp. $164.00 $ Temp.Service/Feeder 601-1000 Amp . $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline Lighting $ 88.00 $ Signal Circuit/Limited Energy I First 1500 sf—Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Renewable Electrical Energy-5KVA System or Less $113.00 $ Thermostat $ 56.00 $ $ T Total Owner as defined by RCW.19.28.261:(1)Owner will occupy the structure for two years after this electrical permit is finalized. (2)Owner is required to hire an electrical contractor if above said property is for sale,rent or lease.Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws,N.E.C.,RCW.Chapter 19.28,WAC. Chapter 296-46B,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature f owner,electrical contractor or electrical administrator: 0 Cash 0 Check I / ❑ Credit Card#[ x / / r .. Dated: 1'021'2011 01/0112012 ELECT UCAL PERMIT ,. CITY OF PORT ANGELES c 360-417=4735 Application Number . . . . . 17-00001108 Date 8/08/17 Application pin number . . . 999756 Property Address . . . . 825 E STH ST REPORT STATE SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7590-`0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name . . . . . to the City of Port Angeles. Property Use . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY (Location Code 0502) Application valuation 0 -- - ---------------------------------------------------------------------- y Application desc 20 Network drops ---------------------------------------------------------------------------- I Owner Contractor ------------------------ ------- ---------------- i CRALI PROPERTIES LLC OLYPEN INC 17009 N HIGHLAND IN 314 E STH ST SPOKANE WA 99005 PORT ANGELES WA 98362 (360) 683-1456 Permit . . . ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee . . . 116.00 Plan Check Fee .00 Issue Date . . . . 8/08/17 Valuation . . . . 0 Expiration Date 2/04/18 Qty Unit Charge Per Extension 1.00 96.0000 ECH EL-LIMITED IST 1500 SQ FT 96-00 4.00 5.0000 ECH EL-ADDNT LIMITED 1500 SQ FT 20.00 Fee summary Charged Paid Credited Due d Permit Bee Total 116.00 116.00 .00 100 Plan Check Total .00 .00 .00 .00 Grand Total 116.00 116.00 :00 .00 INSPECTION TYPE DATE: _ RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN FINAL CONflVIENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECWN 1 _* Signature of owner or Electrical Contractor X Date: o*go" ELECTRICAL INSPECTION ��� WIRING REPORT at)e 417-4735 DA PERMIT# INSPECT OW R CONTRACTOR ADDRESS Z APPROVED NOT APPROVED ❑ . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑ ' I)r J_,, . ROUGH IN/COVER . . . . . . . . . . . . . . . ❑ ❑. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . ❑ ❑. . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . ❑ CORRE01ONS NEEDED: Tin-07 Cbz j L �(7-0ll ,i NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE-- �~ CITY OF PORT ANGELES PERMIT APPLICATION Building Division/ElectricmKKnmpmctions 321East Fifth Strmet—D^wnt Angeles Washington,98362 Ph: (360) ' ' ' Date Mu|U'Fa0i| or Commercial* Commercial Addition/Alteration/RamOdel'j Plan Review May BeRequired, Please Co lete Electrical Plan Review InfoSheet Building Square Footage: :7Eg;.Q Description of work Owner Information Contractor Information Name: Name:- Mailing Addres Mai|in0Addmo : wain City: State: Zip: City: Phone: : Pxnn License#/Exp. uoone#/ Item Unit Change (XY Total(Qty Multiplied by Unit Charge) Service/Feeder 2OUAmp. $132.00 $_________ Service/Feeder 2O14OOAmp. s160.00 --_---_- $--_-----_- Service/Feeder 4O1-6C0Amp $225,00 $________ Service/Feeder 8O1'1OOOAmp. $288.00 $__________ Service/Feeder over 1OOOAmp. $41080 $__________ Branch Circuits 14 $ 86.00 $_________ Branch Circuit N8Service Feeder $ 5.00 $_________ Branch Circuit W/O Service Feeder $ 74.00 $_________ Each Additional Branch Circuit $ 5.00 �___ Temp.Service/Feeder 2OOAmp. $102.00 $_________ Temp.Service/Feeder 2O140OAmp. $121.00 $__________ Temp.Service/Feeder 4U1-60OAmp. $164'00 $__________ Temp.Service/Feeder 001'1000Amp. $185.00 $_________ Portal toPortal Hourly $ 90.00 $__________ SignK}uUinoUghUng o 88.00 Signal Circuit/Limited Energy/First 15OOsf-Commercial $- 96.00 _�� Note: $5.00for each additional 15OUsf Renewable Electrical Energy'5KVASystem orLess $113.00 $_________ Thermostat $ 56.00 $_________ $_________Total Owner amdefined byRCK1O.28.2G1:(1)Owner will occupy the structure for two years after this electrical permit iufino|izod./2\Owner iorequired to hie an o|eotrioo|contractor ifabove said property is for sale, rent or|oeoo.Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28,WAC.Chapter 296-4613,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature ofowner,electrical contractor orelectrical administrator: O oavx O Credit Card w Dated: 0110112012 ��/�/� (\/-/\ \ ��v�^� -,xr�� ELB,CWCAL PERMIT d� MYOOORT ANGELES 3 "17-4735 Application Number 18-00001906 Date 1/03/19 Application pin number . . . 972100 REPORT STATE SALES TAX Property Address . . . . 825 E 5TH ST on our excise tax form ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7590-0000- y Application type description ELECTRICAL ONLY to the City of Port Angeles Subdivision Name (Location"Code 0502) Property Use . Property Zoning . . . . . { RS7 RESDNTL SINGLE FAMILY Application valuation . . 0 ----------------------------------------------------------------------------- Application desc Dishwasher Owner Contractor ----- ------------- --------------- ------ CRALI PROPERTIES LLC ELECTRIC AMERICA 17009 N HIGHLAND IN PO BOX 3523 SPOKANE WA 99005 SEQUIM WA 98382 (360) 912-5550 ------------------------------------- ------ -- ------------------------ Permit . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc 1-4 CIRCUITS Permit Fee . . ., . 75.00 Plan Check Fee .00 Issue Date . . . 1/03/19 Valuation 0 Expiration Date 7/62/19'" Qty Unit Charge Per Extension BASE FEE 75.00 Fee summary Charged Paid Credited Due Permit Fee Total 75.00 75.00 .00 .00 Plan Check Total .00 00 .00 .00 Grand Total 75.`06 75.00' .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR DITCH SERVICE ROUGH-IN . FINAL COMMENTS: PERMIT WML EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: 1 - 2 SINGLE-FAMILY ECEIVED ELECTRICAL PERMIT APPLICATION - �� Public Works and Utilities Department ELECTRICAL � 321 E. 5th Street, Port Angeles, WA 98362 INSPECTIONS 360.417.4735 1 www.cityofpa.us I electricalpermits@cityofpa.us Project Address: Speciality Services II Project Description: Wire dishwasher ❑ Single-Family Residential ❑ Duplex/ARU Building Square footage: OWNER INFORMATION Name: Email: Mailing Address:825 E 5th St Port Angeles Wa Phone: 360-477-4790 ELECTRICAL CONTRACTOR INFORMATION Name: Electric America License: Mailing Address: P.O. Box 3523 Seguin WA. 98362 Expiration Dater Email: info@electricamerica.us Phone: PROJECT 1tl3m Unit`Charae Quantity Total(Quantity x Unit Charge) Service/Feeder 200 Amp. $120.00 $ Service/Feeder 201-400 Amp. $146.00 $ Service/Feeder 401-600 Amp. $205.00 $ Service/Feeder 601-1000 Amp. $262.00 $ Service/Feeder over 1000 Amp. $373.00 $ Branch Circuit W/Service Feeder $5.00 $ Branch Circuit W/O Service Feeder $63.00 $ Each Additional Branch Circuit $5.00 $ Branch Circuits 1-4 $75.00 �_ $ 75 00 Temp.Service/Feeder 200 Amp. $93,00 $ Temp. Service/Feeder 201-400 Amp. $110.00 $ Temp.Service/Feeder 401-600 Amp. $149.00 $ Temp.Service/Feeder 601-1000 Amp. $168.00 $ Portal to Portal Hourly $96.00 $ Signal Circuit/Limited Energy-1&2 DU. $64.00 $ Manufactured Home Connection $120.00 $ Renewable Elec.Energy:5KVA System or less $102.00 $ Thermostat(Note:$5 for each additional) $56.00 $ first 1300:Square Feet "� $12000 $ , Each Addi6ona1500 syq�u�are�feet $40 00$ $ y Each Outiuildi�tg/J� IPN�CLT�ra� j$ 4 7, 77"gar ,4 Fact►Swimming BocSl/HoTub .$11600 $ TOTAL Owner as defined by RCW 19.28.261:(1)Owner will occupy the structure for two years after this electrical permit is finalized,(2)Owner is required to hire an electrical contractor if above said property is for sale,rent or lease.Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws,N.E.C., RCW.Chapter 19.28,WAC.Chapter 296- 46B,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05 50 regard g I ctrical Permit Applications. 12/18/18 Stuart Duff �> Date Print Name Signature(❑ Owner® Electricaf dontractor/Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711] a Address: 825E 5th Street PREPARED 5/01/15, 8:33:16 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 5/01/15 ------------------------------------------------------------------------------------------------ ADDRESS . : 825 E 5TH ST SUBDIV: CONTRACTOR BAKER CONSTRUCTION & DEV INC PHONE (509) 535-3668 OWNER CRALI PROPERTIES LLC PHONE PARCEL 06-30-00-0-1-7590-0000- APPL NUMBER: 14-00000599 COMM REMODEL ------------------------------------------------------------------------------------------------ PERMIT: BPC 00 BUILDING PERMIT - COMMERCLAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ' ------------------------------------------------------------------ ---------------------- BL3 01 7/31/14 JLL BLDG FRAMING 7/31/14 AP July 31, 2014 8:52:36 AM pbarthol. Dave 509-496-1080 July 31, 2014 4:25:08 PM jlierly. BL99 01 8/25/14 JLL BLDG FINAL 8/25/14 DA August 25, 2014 9:10:16 AM pbarthol. Sally 310-770-2520 August 25, 2014 4:47:47 PM jlierly. not ready this inspection was a walkthrough consult to identify outstanding items and ask questions pertaining to a partial final or temp CO BL99 02 9/04/14 JLL BLDG FINAL 9/04/14 AE September 4, 2014 9:07:06 AM pbarthol. Sally 310-770-2526 September 4, 2014 4:14:32 PM jlierly. Temp CO for 30 days for the west 1/3 of the building and kitchen only/jll BL99 03 9/09/14 JLL BLDG FINAL 9/10/14 DA September 9, 2014 9:16:38 AM pbarthol. SALLY 310-770-2526 PARTIAL FINAL ON WEST END September 10, 2014 8:50:45 AM jlierly. finish hand rail /jll BL99 04 5/01/15 LL BLDG FINAL May 1, 2015 8:31:15 AM jlierly. Shawn 477-4790 -------------------------- ---------- COMMENTS AND NOTES -------------------------------------- CITY OF PORT ANGELES s DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES,WA 98362 �l Application Number . . . . . 14-00000599 Date 6/24/14 Application pin number . . . 309544 Property Address . . . . . . 825 E 5TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7590-0000- REPORT SALES TAX Application type description COMM REMODEL Subdivision Name . . . . . . on your state excise tax form �^ Property Use . . . . . . . . to the City of Port Angeles r Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 150000 (Location Code 0502) ------------------ Application desc REMODEL BATHROOMS ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CRALI PROPERTIES LLC BAKER CONSTRUCTION & DEV INC 17009 N HIGHLAND LN 2711 E SPRAGUE AVE SPOKANE WA 99005 SPOKANE WA 99202 (509) 535-3668 / ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT - COMMERCIAL Additional desc . . INTERIOR REMODEL BATHROOMS Permit Fee . . 1300.25 Plan Check Fee 845.16 Issue Date . . . . 6/24/14 Valuation . . . . 150000 Expiration Date 12/21/14 Qty Unit Charge Per Extension BASE FEE 1020.25 50.00 5.6000 THOU BL-100,001-500K (5.60 PER K) 280.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . BATHROOM REMODEL Permit Fee . . . . 79.00 Plan Check Fee .00 Issue Date . . . . 6/24/14 Valuation . . . . 0 Expiration Date . . 12/21/14 Qty Unit Charge Per Extension BASE FEE 50.00 4.00 7.2500 EA ME-VENT FAN (SINGLE DUCT) 29.00 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . BATHROOM REMODEL Permit Fee . . . . 377.00 Plan Check Fee .00 Issue Date . . . . 6/24/14 Valuation . . . . 0 Expiration Date 12/21/14 Qty Unit Charge Per Extension BASE FEE 50.00 22.00 7.0000 EA PL-PLUMBING TRAP 154.00 10.00 7.0000 EA PL-WATER LINE 70.00 4.00 7.0000 EA PL-DRAIN VENT PIPING 28.00 5.00 15.0000 EA PL-SEWER LINE 75.00 --------------------------------------------------------------- Q Special Notes and Comments V May 27, 2014 8:38:20 AM tamiot. Separate Permits are requited 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: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 Date 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 i Back Flow/Water FINAL Date Accepted b 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 Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking i£Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: f% Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction-R.W. PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 T:Forms/Building Division/Building Permit . ;. CITY OF PORT ANGELES r DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 14-00000599 Date 6/24/14 Application pin number . . . 309544 ---------------------------------------------------------------------------- REPORT SALES TAX Special Notes and Comments On our state excise tax form ELECTRICAL PERMIT IS REQUIRED. Y IF ANY CHANGES TO THE ELECTRICAL SERVICE ARE REQUIRED, ALL to the City of Port Angeles COSTS TO ANY CHANGES TO THE city's FACILITIES WILL BE REQUIRED TO BE PAID BY THE OWNER. (Location Code 0502) June 4, 2014 12:26:44 PM rbecker. There is backflows in the building for fire system, boiler, and premise protection. These backflows all have to be tested and put back in service, before the building can be occuplied. If you have any questions call Ron Becker at 360-417-4886, Fax:360-452-4972, or E-mail:rbecker@cityofpa.us This project will require a seperate permit and fire alarm plans for review. A full acceptance test will be required for the fire alarm system. owner is responsible for ongoing fire alarm system inspection and maintenance per the current addition of NFPA 72. Owner is responsible for ongoing fire sprinkler system inspection and testing per the current addition of NFPA 25. This project will require seperate permit and fire sprinkler plans for review. June 12, 2014 12:05:12 PM sroberds. The proposal is to create a 32 bed treatment use in the CO zone in a pre existing nursing/convalescent home structure. Off street parking is required for the use per conditional use permit CUP 14-05. Public Works Utility Engineering has no requirements for this plan review. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- -------- ---------- Permit Fee Total 1756.25 1756.25 .00 .00 Plan Check Total 845.16 845.16 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 2605.91 2605.91 .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. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permft 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 Date 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 FINAL Date Accepted b 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 Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPA: Parkin /Li htin ESA: Landscaping 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 THE ORT NGELES CITY OF For City Use WASH I N G T O N , U . S. Permit# S Date Received: �� Z3 321 East 5�' Street / d pa- P: Approve (��3 Port Angeles, WA 98362 Da _ P: 360-417-4817 F: 360-417-4711 permits@cityofpa.us Building Permit Application Project Address: 825 E 5TH STREET, PORT ANGELES, WA Main Contact: SAM BUTLER Phone # 509-535-3668 E-Mail: sbutler@bakerconstruct.com Property Name CRAIG PHILLIPS Phone 509-951-9157 Owner Mailing Address Email 12715 East Mission Avenue abhs@aol .com city Spokane Valley state WA Zip 99216 Contractor Name BAKER CONSTRUCTION & DEVELOPMENT, INC. Phone 509-535-3668 Mailing Address 2711 E SPRAGUE AVE Email sbutler@bakerconstruct.com City SPOKANE State WA Zip 99202 ` Contractor License# BAKERCD 0 6 6 CZ Expiration: 4/08/2016 Project Value: Zonin : Tax Parcel# Lot# $ 150, 000 Type of Residential ❑ Commercial ® Industrial ❑ Public ❑ 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? Maximum height of structure Proposed Bedrooms Proposed Bathrooms Yes ® No 13 Project Renovations for (4) shower rooms to consist of shower stalls, Description toilets & sinks in each with new floor covering, finishes, lighting, ventilation & fire sprinkler modifications. Project will also consist of upgrades to the fire alarm system. 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 Si Residential Structures For Office Use Area Description(SQ FT) Existing Proposed $$value Basement First Floor Second Floor Covered Deck/Porch/Entry Deck Garage Carport Other(describe) Area Totals Commercial Structures For Office Use Area Descriptions(SQ FT) Existing Proposed $$Value Existing Structure(s) Proposed Addition Tenant Improvement? Other work(describe) Area Totals Lot/Site Coverage Calculations Footprint(SQ FT)'of all Structures: Lot Size: %Lot Coverage Bas t- SQ FT Site coverage(all impervious+ %Site Coverage structures <�/98 v Mechanical Fixtures Indicate how many of each type of fixture to be installed or relocated as part of this project. Air Handler Size: # Haz/Non-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 # . 4 Furnace/Heat Pump/ Size: # Ventilation System # Forced Air Unit Plumbing Fixtures Indicate how many of each type of fixture to be installed or relocated Plumbing Traps # 22 Fuel gas piping #of Outlets: Water Heater i # Medical gas piping #of Outlets: Water Line # 10 Vent piping _ # 4 Sewer Line # 5 Industrial waste pretreatment # interceptor Other describe T:\BUILDING\APPLICATION FORMS\BUILDING PERMIT 081212.DOCX 810 m 820 828 t 805 t .!' 834 r ,ter-•, � �� A _ 410 , " r 825 a: 410 825 j } IM - A 81 , 814 ` t 415 x�r o � r 818 824 si f 826i °; 423 aL� � ' ACCESSIBILITY employee work stations within a courtroom is not type of fixture,element,control or dispenser in each accessi- required at the time of initial construction, provided a ble toilet room and bathing room shall be accessible. ramp, lift or elevator can be installed without requiring Exceptions: reconfiguration or extension of the courtroom or exten- sion of the electrical system. 1. In toilet rooms or bathing rooms accessed only 1108.4.1.5 Other work stations. The litigant's and through a private office, not for common or public counsel stations, including the lectern,shall be accessi- use and intended for use by a single occupant,any of ble. the following alternatives are allowed: 1108.4.2 Holding cells. Central holding cells and court- 1.1. Doors are permitted to swing into the clear floor holding cells shall comply with Sections 1108.4.2.1 floor space, provided the door swing can be and 1108.4.2.2. reversed to meet the requirements in ICC A117.1; 1108.4.2.1 Central holding cells.Where separate cen- 1.2. The height requirements for the water closet tral holding cells are provided for adult males,juvenile in ICC A117.1 are not applicable; males, adult females or juvenile females, one of each type shall be accessible.Where central holding cells are 1.3. Grab bars are not required to be installed in a provided and are not separated by age or sex, at least toilet room, provided that reinforcement has one accessible cell shall be provided. been installed in the walls and located so as 1108.4.2.2 Court-floor holding cells. Where separate to permit the installation of such grab bars; court-floor holding cells are provided for adult males, and juvenile males, adult females or juvenile females, each 1.4. The requirement for height, knee and toe courtroom shall be served by one accessible cell of clearance shall not apply to a lavatory. each type.Where court-floor holding cells are provided 2. This section is not applicable to toilet and bathing and are not separated by age or sex,courtrooms shall be rooms that serve dwelling units or sleeping units that served by at least one accessible cell. Accessible cells are not required to be accessible by Section 1107. shall be permitted to serve more than one courtroom. 3. Where multiple single-user toilet rooms or bathing 1108.4.3 Visiting areas.Visiting areas shall comply with rooms are clustered at a single location, at least 50 Sections 1108.4.3.1 and 1108.4.3.2. percent but not less than one room for each use at 1108.4.3.1 Cubicles and counters. At least 5 percent each cluster shall be accessible. but no fewer than one of the cubicles shall be accessi- 4. Where no more than one urinal is provided in a toilet ble on both the visitor and detainee sides. Where coun- room or bathing room, the urinal is not required to ters are provided, at least one shall be accessible on be accessible. both the visitor and detainee sides. 5. Toilet rooms that are part of critical care or intensive Exception: This requirement shall not apply to the care patient sleeping rooms are not required to be detainee side of cubicles or counters at noncontact accessible. visiting areas not serving accessible holding cells. 6. Where toilet facilities are primarily for children's 1108.4.3.2 Partitions. Where solid partitions or secu- use, required accessible water closets, toilet com- rity glazing separate visitors from detainees, at least partments and lavatories shall be permitted to com- one of each type of cubicle or counter partition shall be ply with the children's provisions of ICC A117.1. accessible. 1109.2.1 Family or assisted-use toilet and bathing rooms.In assembly and mercantile occupancies,an acces- SECTION 1109 sible family or assisted-use toilet room shall be provided OTHER FEATURES AND FACILITIES where an aggregate of six or more male and female water closets is required. In buildings of mixed occupancy, only 1109.1 General. Accessible building features and facilities those water closets required for the assembly or mercantile shall be provided in accordance with Sections 1109.2 through occupancy shall be used to determine the family or 1109.15. assisted-use toilet room requirement.In recreational facili- Exception: Accessible units, Type A units and Type B ties where separate-sex bathing rooms are provided, an units shall comply with Chapter 10 of ICC A 117.1. accessible family or assisted-use bathing room shall be 1109.2 Toilet and bathing facilities. Each toilet room and provided. Fixtures located within family or assisted-use bathing room shall be accessible. Where a floor level is not toilet and bathing rooms shall be included in determining required to be connected b an accessible route the only toi- the number of fixtures provided in an occupancy. q Y Y let rooms or bathing rooms provided within the facility shall Exception: Where each separate-sex bathing room has not be located on the inaccessible floor. At least one of each only one shower or bathtub fixture, a family or assisted-use bathing room is not required. 290 2012 INTERNATIONAL BUILDING CODE® CITY OF PORT ANGELES 321 E 5TH STREET P.O. BOX 1150 PORT ANGELES WA 98362 v'1 C E R T I F I C A T E O F O C C U P A N C Y T E M P O R A R Y Issue Date . . . . . . 9/04/14 Expiration Date . . . . 10/06/14 Parcel Number . . . . . 06-30-00-0-1-7590-0000- Property Address . . . 825 E 5TH ST PORT ANGELES WA 98362 Subdivision Name . . . Legal Description . . . LOTS 12-18 BL 175 SURVEY V33 P 1 Nm Property Zoning . . . . RS7 RESDNTL SINGLE FAMILY Owner . . . . . . . . . CRALI PROPERTIES LLC ! 1 Contractor . . . . . . BAKER CONSTRUCTION & DEV INC 509 535-3668 Application number 14-00000599 000 000 Description of Work COMM REMODEL Construction type . . . t� Occupancy type . . . . Flood Zone . . . . . . Special conditions . . September 4 , 2014 4 : 18 :42 PM jlierly. this temp CO is for the west 1/3rd of the building and the kitchen only. Re stripe ADA parking per code/ finish hand rail per code/ one anti scald boot missing from drain in room/ ADA signage for restrooms/ remove temp lock on back door to court yard/JLL Approved . . . . . . . Building ficial VOID UNLESS SIGNED BY BUILDING OFFICIAL P P lJ PA IV CY CERTIFIC TE OF`® Cit hof Port Angeles -:Building vision This certificate is issued�, rsuant to the requirements of Section I1L of the2009 International Building Code certifying that at.'the ttme of tssuance this structure was in compliance with the various ordinances of the City regulatin zitlding constrictton or useor theollowi g a ,r, "-,ld .' Business name: Spec�afy Se�lees t� . Th 8 E 5 Stre ` � Business address ,� ��-��F WA Business owner: IkPropertiesI, i Business owners �ds 17009 N I argil k '� Automatic fire sptem: N/A b,. . Use &occupancy asst tcation: Bustles5` / Occupant load: ' x2:0 .2 IBC, Table Type of construction. § 05-12-2015 , y '.ajii AI Date S Post on the premises in a conspicuous place. •lnis�ce tificale-halt of be removed except by the Building Official. 1 .sl t-Ir vl 0O Application Number . . . . . 23-00000711 Date 7/10/23 Application pin number . . . 480332 Property Address . . . . . . 825 E 5TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-1-7590-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc AC unit ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CRALI PROPERTIES LLC ELECTRIC AMERICA 17009 N HIGHLAND LN PO BOX 3523 SPOKANE WA 99005 SEQUIM WA 98382 (360) 912-5550 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee . . .00 Issue Date . . . . 7/10/23 Valuation . . . . 0 Expiration Date . . 1/06/24 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 Public Works and Utilities Department 321 E. 5th Street, Port Angeles, WA 98362 360.417.4735 | www.cityofpa.us | electricalpermits@cityofpa.us ELCOM MULTI-FAMILY / COMMERCIAL ELECTRICAL PERMIT APPLICATION Project Address: Project Description: □ Multi-Family Residential □ Commercial / Industrial / Public Building Square footage: OWNER INFORMATION Name: Email: Mailing Address: Phone: ELECTRICAL CONTRACTOR INFORMATION Name: License: Mailing Address: Expiration Date: Email: Phone: PROJECT DETAILS Item Unit Charge Quantity Total (Quantity x Unit Charge) Service/Feeder 200 Amp.$132.00 $ Service/Feeder 201-400 Amp.$160.00 $ Service/Feeder 401-600 Amp.$225.00 $ Service/Feeder 601-1000 Amp.$288.00 $ Service/Feeder over 1000 Amp.$410.00 $ Branch Circuit W/ Service Feeder $5.00 $ Branch Circuit W/O Service Feeder $74.00 $ Each Additional Branch Circuit $5.00 $ Branch Circuits 1-4 $86.00 $ Temp. Service/Feeder 200 Amp.$102.00 $ Temp. Service/Feeder 201-400 Amp.$121.00 $ Temp. Service/Feeder 401-600 Amp.$164.00 $ Temp. Service/Feeder 601-1000 Amp.$185.00 $ Portal to Portal Hourly $96.00 $ Sign / Outline Lighting $88.00 $ Signal Circuit/Limited Energy - Multi-Family $88.00 $ Signal Circuit/Limited Energy/First 1500 sf - Commercial (Note: $5.00 for each additional 1500 sf) $96.00 $ Renewable Elec. Energy: 5KVA System or less $113.00 $ Thermostat (Note: $5 for each additional)$56.00 $ $ TOTAL Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296- 46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (□ Owner □ Electrical Contractor / Administrator)Permit #: [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711] PREPARED 7/06/23, 7:39:20 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:23-00000711 825 E 5TH ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER COMMERCIAL 86.00 TOTAL DUE 86.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 7/10/2023 23-711 TAP OWNER CONTRACTOR Electric America PROJECT ADDRESS 825 E 5th St