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Home My WebLink About433 E 8th St - Building YET - OCT 2 2,. CITY OF PORT ANG-ELFS PERMrr APPLICATION J Building Division/ElectTical Inspecdons INSPECTIom", 321 Ea.Rt Filth Street—P.O.Box 1.150/Port Angeles Washingwa,98362 r Ph: (360)417-4735 Fax:(360)417-4711 ty Date: 10—2 3--13 Multi-Family or Commerular Commercial Addition I Alteration/Remodel I Repair" Plan Review May Be Req *ed,p1jease Complete Elgeyical Plan Review Information Sheet Jab Addms& U BtAlding Square Footage: Description of above Owner Info at' Contrp%pr Information Nam . Nsme., L-Lc MallIngAdrrs- Mallin dd clly: State"UJ-6---Alp., CIV. . Fax: phone' Fmc =,Zigzag State;l t� 21p ucensQ;f_Fxp- Llcen 9 19 1&Expm to Unit ghamige Total OyMy lied_b UnlitCharge) y SaMcefFeeder 200 Amp. $132,100 SeMcelFwder 201400 Amp, S MGM ServiceFeeder 40100 Amp $225-00 Service/Feeder 601-1000 Amp. $288.00 Siarvice/Feeder over 1000 Amp. $410.00 $ Branch Circuits 1-4 $ 66,00 Branch CIMult VVI Service Feeder $ 5100 Branch CArcull VV/0 Service Feeder $ AM Each Addltional Branch Circuit $ 5.00 Temp.ServlW Feeder 200 Amp, $102.00 Temp.Service/Feeder 201.400 Amp. $121.00 Temp.ServIce[I'Mer 401-1500 Amp. $164M Temp,Service/Feeder 601-1000 Amp $185.00 Portal to Portal Hourly $ 96,00 Slgn/Outline Lighting $ 88.00 Signal Circuit/Limited Energy–Muill-Famlly $ 64,00 $ Signal Gircullt Limited Energy/First 1600 sf–Commercial $ 96.00 Note: $5.00 for each additional 1500 sf Renewable Electrical Energy-5KVA System or Less $113.00 Thermostat $ 560 Owner as defined by ROW,19,28.261,(1)Owner will occupy the structure for two years after this electrical permit is In al!zed, 2)Owner is required to hire an electrical contractor if abm said property is for sale,ran[or lease.Permit expires after six months of last Inspector. After reading the above statement,I hereby certify that I am the owner of the above named.properly or a licensed electrical cc ilitractor. I am making the electrical installation or alteration in compliance with the electrical lows,NEC,,RCW.Chapter 19.28,WAC.Chapter 2964.15B,The C4 of Part Angeles Municipal Code,and Utility Specificatlons and PAMC 14,05.050 ragording Flectrical Permit Applications. Sign re of owner,electrical ractor or electrical administrator: C3 ciAb 0 check Cmdk Card*—4t3ft- ELECTRICAL PERMIT �ja CITY OF PORT ANGELES 360417-4735 Application Number . . . . . 13-00001242 Date 10/25/13 Application pin number , , , I95764 Property Address , , , , , 433 E 8TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2895-0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name to the City of Port Angeles Property Use , • . . , • • , Property Zoning . . , . . . COMMERCIAL NEIGHBORHOOD (Location Code 0502) Application valuation . 0 Application deSc Reception desk outlets Owner Contractor CLALLAM COUNTY PUBLIC HOSPITAL SIMPSON ELECTRIC 939 CAROLINE ST 243036 W HWY 101 PORT ANGELES WA 98362 PORT ANGELES WA 98363 (360) 457-9270 --------------- , ,S Permit , . . ELECTRICAL ALTER COMMERCIAL 4 i� Additional desc 1-4 CIRCUITS V_ Permit Fee 86.00 Plan Check Fee .00 Issue Date 10/25/13 Valuation . , , 0 Expiration Date 4/23/14 Qty Unit Charge Per Extension BASE FEE - 86.00 Fee summary Charged paid Credited Due ---------- --- -- ---------- OJ�J Permit Fee Total 86,00 86.00 .00 .00 Plan Check Total ,00 ,00 .00 .00 Grand Total 86.00 86.00 .00 .00 A INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-TN FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: GA1EXCHANGRBUILDING �QC)itr,tt r Crry or PORT ANIGFLrs PERvu ArPLICA ION - BuildzingDtiligotrlClechicatl °, . r- 321 East Fit1h Street—P-0.Box 1150/rart Angeles Washington,98362 M(360)417 4735 Fax.(360)417-4711 FEB 2 bake, 1 EJ EC TRIM �.,Multi-Family or Commercial' ._.YCommercial AddiHoa I Altera6on:I Remodel I Repaid` t l't I'tO�tS Plan Review May Be Rejig, Please Comple Electrical Plan Revie Ink- ' Sheet Job Address: z-. -�' Weg Square Footage: t?escrtption of above Owner Information Contractor Iinfinnnallon 1 . Name. Name: Naft dress: Lo tl. G , State: Tip 6 Pba>ta –'?+f7 afc Phone Dc-�l� � �– t�ChaMe W.�L Total IQ�l'Wiled-!V Unit-Ch e ServtmfFeeder 200 Amp. $182.00 SenAcelFeeder 201.400 Amp. $160.00 - SetvtoelP2eder 401-600 Amp $225.00 $ _. SvMuOFeWer 601-1000 Amp. $298,00 $ Spry oWeeder aver 1000 Amp. $410.00 grano Circuits 1-4 $ 86.00 Drench Circuit W15ervics Feeder $ 3.00 Stancb Circuit W/O SeM as Feeder $ 74.00 $ „_ Each Addifional Blanch Circuit $ 6.00 $. Temp.Service!Feeder 200 Amp. $102.00 Temp.ServicelFeeder201400 Amp. $121.00 $ Temp.SeNkefeWer 401-M Amp. $164.00 Temp.$Woell;eeder 601-1000 Amp. $185.00 Portal to Portal Hourly $ g6.00 Sign/oulline Lighting $ 88.00 Signal Circultl t.kidted Energy–MullWamily $ 64.00 SlgnalClrcu llfUmiled Energy I First 1500sf--Commercial $ 96.00 $...... NoW, $5.00 for eachaddlttonal1500sf Renewrat do ElecMcal Energy-SKYA System or Less $113.00 $^,--. Thermostat $ 56100 $ . ...-- --.- � otal Ovmr as defined by RGWA 9.2&261:(1)Owner will occupy the structure Tnr two years aftr this electrical permit is finalized. (2)Owner is required to hire an electrical contractor it above said property is for sale,rant or lease.PermH expires alter six months of last Inspectic n. After reading the above statement,I hereby cedl that I am the owner of the above named.property or a Incense electrical c;rrrtractm I am making the electrical installation or alteration in camptiance with the electrical taws,N.E.C,,RCW_Chapter 19.28,WAC.Chapter 296 46S,The City of Port Angeles Munidpal Code,and Utility SpeciTrcaWns and PAMC 14.05.050 regard'mg Electrical Penult Applicallons. Sign of Omar,electrical co ctor or electrical administrator. ❑ cash ❑ chock -• & creartcaras. . �,. . ELECTRICAL PERMIT k CITY OF PORT ANGELES O 360-417-4735 ^= Application Number 14-00000117 pate 2/03/14 Application pin numbe.r 862750 Property Address . , , . , . 433 F 8TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2895-0000- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name to the City of Port Angeles Property Use Property Zoning . . . . , , COMMERCIAL .NEIGHBORHOOD (Location Code 0502) Application valuation , , , , 0. Application desc -- - -add outlet 7 Owner Contractor CLALLAM COUNTY PUBLIC HOSPITAL SIMPSON ELECTRIC 939 CAROLINE ST 243036 W HWY 101 PORT ANGELES WA 98362 PORT ANGELES WA 98363 (360) 457-9274 -------------------------------------------------- --- ----------- ------- Permit . . , , . . ELECTRICAL ALTER COMMERCIAL Additional desc 1-4 CIRCUITS Permit Fee 86,00 Plan Check Fee 00 Issue Date 2/03/14 valuation , . , . 0 Expiration Date 8/02/14 Qty Unit Charge Per Extension BASE FEE 86.00 -------------- .._-__-------------------------_. _-------------------- ------ Fee summary Charged Paid Credited Due Permit Fee Total B6.00 86.00 00 DO Plan Check Total .00 00 .00 .00 Grand Total 86.00 86.00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN .z Z FINAL Lf COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: GAEXCHANGEIBUILDING CITY of PoRT.A NGE:E,S.PERwr A]PPuCA.TIO $ne7�ng PiivisitvnlElectri,r�1�sPeetiouns � .,.j 321 East Fifth Street—P.O.Box 11.501 Fort Angeles Washington,98362 'Ph:(3641)413-4735 Fam(3+60)417-1711 w ,,..Y..,MW&Farnity or Commeroiar Comrwrtid AddibDn 1 Atlraration I l;temodel 1 Repair's Plan Rev"sew May Be R uIredd P�C:o. hb EWIricai Plan Review Inforrnafion Sheet Job Wrm$WMF Desatpiion of shove zCZA a m '� i 0wher lnfannation Contracto lrrflormatt n td e: C>m i?. g" t' fame: _ � y+ LIZ. Maium+Carr States mv. �j 5tafelj� ip: Phone: r i,icense#lF.xp, t.icedse#I6rp.„, N G[„�., �• ��._..... font UnItCharge Trta iNalt'i lied llnikCharge) reeler 200Amp $132 SaMceffeeder 2D1400 Amp, $1610D ------ � %vireFeeder 401-600 Arnp $225A Service/Feeder 5014000 Amp. S 288.00 � SwykaFeeder over 1000 Amp $41#)0 � Branch Circuits 1.4 $ 86.00 Dawh Circuit WI Service Feeder $ 5.00 � Bra*6 Clrcuil W10 Service Feeder $ 74.00 EachAdditicntal Branch Circuit $ 5.00 -- - Temp-ServW ReMr2DOAmp. $102.00 Temp.SMtdFaeder2Uf•4UUAmp. $121_UU $ TWV.Serval der 401-6WAmp $164.00 � Temp.SarwlceiFeeder 601-10DD Amp. $18&W Pbdat to Portal dourly $ 9600 $ uigrtif)trHinaUglding $ 8800 $ Sal CirsxWt im W Energy—t4tulti-F ily $ 64.00 $-- Signal ClrcW l imiled Energy/First 1500 sf—Coo mrdal 5 %.00 we'. $5.00 toreach additionm 15MSf fienewale#driest i:nergy-MA System or Law $115.00 $ Thermostat $ MOD $ $ `�'P_Total Owner as defined by RCW.19.28.251:(1)Owner will occupy the stucfure for two years after this electrical permit is finalized.(2)Owner is required to dire all electrical contractor if above said pvpwty Is for sale,rent:or lam.Pentdt expires after six months of last inspefdon_ Alter reading the above staftmt;l hereby ramify Ihmt I am the owner of the abm nareledpopeq or a licensed eiectical crultsar lam making the electdcat instailadon or alteration in compliance witty the electrical laws,N,F.C.,RCW,Chapter 19.28,WAC.Chapter 295466,The aly of part Angeles Municipal Cade,and Utl'rty Specifications and PAMC 14.05-11511 regarding Electrical permit Applications. Sign owner,etectdcat re or electrical adalhtwh*or: 0 cast, © Check 01101rmt2 oFp4RT.4N ELECTRICAL INSPECTION WIRING REPORT wQRKS& GATE; PERMIT# INSPECTOR OWNER f1� d CONTRACTOR ADDRESS APPROVED NOT APPROVED © . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑ ®. . . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . . . ®. . . . . . . I . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . 0. . . . . . . . . . . . . . . . . . . . . FINAL . . . . . . . . . . . . . . . . . . . . CORRECTIONS NEEDED: Co ra NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS ® DO NOT REMOVE -- ELECTRICAL PERMIT CITY OF PORT ANGELES -- 360.417-4735 41 Application Number 12-00001479 Date 11/13/12 Application pin number . . . 500438 Property Address . . . , , . 433 E 8TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-Q-2-2.895-000Q- on your excuse tax farm Application type description ELECTRICAL ONLY to the City of Part Angeles Subdivision Name , , , . . . Property Use (Location Code 0507) Property Zoning , . . . . , . COMMERCIAL NEIGHBORHODD Application valuation , , , . 0 Application desc 2 outlets computer room Owner Contractor ------------------------ CLALLAM COUNTY PUBLIC HOSPITAL SIMPSON ELECTRIC 939 CAROLINE ST 243036 W HWY 101 PORT ANGELES WA 98362 PORT ANGELES WA 98363 '� � (36Q) 457-9270 ____-__---- ----------------- ____________._ Permit , , , , . , ELECTRICAL ALTER COMMERCIAL --' if - • Additional desc 1-4 CIRCUITS Permit Fee 86,00 Plan Check Fee .00 C ■ Issue Date 11/13/12 Valuation 0 Expiration pate 5/12/13 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 .00 100 Grand Total 86100 86.00 00 .00 INSPECTION71TE DATE: RESULTS: INSPECTOR: DITCH SERVICE FINAL 6 COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of UWiler oz.•Electrical Contractor X _ Date: _ G,IEXC HAN GEIBU ILD IN G CITY OF PORT ANGELES 0,- DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 11111.' 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 11- 00001462 Date 1/05/12 Application pin number 499542 Property Address 433 E 8TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-2- 2895 -0000 Application type description SIGNS on your state excise tax form Property Use Subdivision Name Property t the City of Port Angeles Code Zoning COMMERCIAL NEIGHBORHOOD (Location Code 0502) Application valuation 0 Application desc FREE STANDING SIGN Owner Contractor CLALLAM COUNTY PUBLIC HOSPITAL OWNER 939 CAROLINE ST PORT ANGELES WA 98362 Permit SIGN Additional desc Permit Fee 115.00 Plan Check Fee .00 Issue Date 1/05/12 'Valuation 0 Expiration Date 7/03/12 Qty Unit Charge Per Extension 1.00 115.0000 PER S -F /S OR PROJ SIGN 25 SF 115.00 Fee summary Charged Paid Credited Due Permit Fee Total 115.00 115.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 115.00 115.00 .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 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. C Signature of Contractor or Authorized Agent Si nature of Owner (if owner is Date Print Name Si builder 9 9 9 T:FormslBuilding Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS 0 Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 I� 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 Date Accepted By Comments I r 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 by AIR SEAL: Walls Ceiling FRAMING: Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Stab 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 Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit #s SEPA: Parking Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY USE Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W. PW Engineering 417- 483144N,� Fire 417 -4653 Planning 417 -4750 Building 417 -4815 g T:Forms /Building Division /Building Permit N H CO O i w CD a q 0 N N a 0 w N H U 7 H w w C F F q z 2 w [n w cn moo w w x w U x x d F cnaa 0 H 0 Z F h o E M z q OO En r.0 H O l (0 N RC FF F ••u c0 U U 1 z m GI w w z a s N d W cn !n i a 0 X H Co X H F\ z u Lk 0 Cr) H O cn HF wwio O as x u a 0 m o (0 (1) q Gm H 0 q P. m 0 (k .7 0 m 5 Lr, CO a m 0 CO C7 F M N N H a s EF �Cii u� m ,I [0 c a N N H W of M 00 a o; x U w m F o f cn ro o o w o C7 q q 0 w .0 0 0 H W w N N w M O (0E F H H 0 M CO w (O H 0(0(0 co m e.4 d' U o H O ,7 LL o o Od F Z00 LO �a x t7au 0 !k w H a 0 m q F E w w cn u 0 H Q z O w z o H (0 W H zzaa z W m a u a uo(0 a H w SIGN PERMIT APPLICATION Pr.. in ink RECEIVED I 1 CITY OF PORT ANGELES 7 1 M Attn: Building Permit Technician Dat ceiMM 321 E. Fifth St., Port Angeles, WA 98362 Per' i U ZU11 (360) 417 -4815 fax (360) 417 -4711 1 fitt. Da roved et, CITY OF PORT ANGELES ION Applicant or Agent 61 Phone Property Owner OLVA// /c /VE C 72 Phone Property Owner's Address I C-/ uA9r `J� r4A)Ct 1 L-'c 'v /L Contractor SEZ i� Phone Contractor's Address License Expires Project Address t4' 6 RSP,7 Business Name f'/whey (42E L./A) lC Phi imu Parcel Number 663660 ©ZZ8`fiS Lot Zoning ‘N Submit an 8 x 11 site plan three sets of plans that include: Type of sign (wall- mounted, projecting, freestanding, illuminated, other...) Placement and sq. ft. area How the sign will be securely attached (Engineering specs may be required for freestanding signs) Separation distance between the bottom of projecting and freestanding signs and the surface below See "Chapter 14.36 Sign Code" of the City of Port Angeles Municipal Code for sign requirements. Sign Type Brief Description: (Type, location, sq. ft.) Sign #1 f12L 5774 -A) ,A) C? ZO SF x z 6 /0 Es 4/66F Sign #2 Sign #3 Sign #4 Totals (Unit charges Sign(s) Unit Charge Quantity multiplied by quantities) Type of Sign Valuation $47.00 x All signs less than or equal to 25 sq. ft. $85.00 x Wall sign or marquees, over 25 sq. ft. $115.00 x /45 Freestanding sign or projecting sign, over 25 sq. ft. GRAND TOTAL Make Checks Payable to: City of Port Angeles //5 Credit Cards (Except American Express) are accepted Existing sign(s) area 4` sq. ft. Proposed sign(s) area 4) sq. ft. Total sign(s) area 4/6 sq. ft. k Cash 6/5q to b Se nol tSk d Building facade area (height ft. X width ft.) sq. ft. (If a building has more than one business in it, only measure the area of the building facade that is used by the business applying for this permit.) I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Date 12 /2, /1 Print Name /4F' 62 /0 G7 Signature A ftiot /k T:Forms /Building Division /Sign Permit Application.doc 2 g 0 co 4 '-'0' e T, 6 E S 4 kt E E 9'' i 0 f.12 ki gi... E -.4 (.3 E i 40', g :'t' '5 a 4 2-= 7,- o 2 j3 0. 7, 1 c E 13 E g° i 0 Z, 21 2 'f;' co° „8" d Ti 1 g.' .1 1.1==. t2'llir, Oa dEB., 1,1 Folg 6.. L378...0 ;',3 '1] 8 6L',:- q ",),zIgi ..k- 0 ,,1: 09 1 i62 `;`T,§ .t°,-.' 2-1-.P.Au>.160 r=f:,i-ri a 0 CI NI zi L'''21.,L t t.:3.§g6.— =c,°.- N.. 0I- -s-2 -0 .c-,-,-zu -00 _gd„,5 61.,4. '8 ,IL° L+,' '-".<'..-dtt 6Z)111.1 2A vit E. 0 c a 0., 1.1 0 'e 2' .--'2'''Cigg'..E in sC 27 t "=6 ""Thl; U ...I .0 141 .7.-m—To >0 ,Z3 r.:3 03 a .7,- 'S .g g :2 N a -1-T; 4. 9- w co .4 1 '67, c...) E 'a ca ma& 2 s *-:c; 101816 5 r, 7j, 2 2, g iE -t 1 1 H H --,====1 W<"41: 4 4 „7": -N ‘w,,.,,,,,,„,,,, 1 ‘10 7- ";,=e4714" ".4744:r4Z 4 4 61.■ C ''W tkA r '44 $0 ie l 'ilW4 c..) Z: h.,>% tri c 1 a, 'a CIA 1,11 '-4A+V"""4744...1 Ell li W x 4.3 i n ''''''r,,,eit.:A'' gli 7 i..A .._1' b= .......aj V4.41-' 02tAli ,.0 fa 1..— 4m. C2C) E nI 2 e.4t,'":i3N4j Al P 3 P4' CD WI 'At■ 'A Cm -4333:43334giq 1 8 ii '44:=;'" i 11,4 .1.• ,tt,,:::A;V/sk,,'A ''S',1 ZE 1-----1 ,..4.,.. 1 '''H ,-4 T a Oo Ho 1 :1-i *tkT- ;:11 1/4" Thick aluminum top cap 12y;is," mechanically secured with (R i6 non corrosive countersunk screws 130° R PLAN VIEW Scale: 3/8 =1' -0" Ho 66 z" (Ref) I-41-- 48" Sign panel width ••-•1$2.- 231/4" I A paw I. c See Sheet A (Qt 2 F48 f 12.''DiHO T 7_________ ...T7. Flourescent lamp i- 9 I f j (Qty. 11) ,I I i 1 r i:. n Raise panel i I I P SPCT200 Contour alraminurn support 1 I i post (Qty. 4) i 8 d f t i i I I' Rai ed 1 H u pa el I 1 3 (a 3 I7 I b P ost Out See 4 1 76 length Sheet B 3 (TYp. 4) Cabinet TBD j i heiht t i 9 %;i6' j E 6 "x 2.034 "x .314" Q.C. R I Structural (Ref) r panel aluminum channel insert (1 per post) I 77 r—HIL Concrete 'mow (Ref) Grade R I )2.s. curb" by others r i 1, l r External o >�C disconnect e. j sw itch cover J i 3 t Rpff Concrete footings by installer (See Note 3) J 585.16" Q.C. k -04 18" Dia. (Min) 6' PVC Conduit preassambled (Ref) to inside of post (Electrical FRONT VIEW others, See Note r2) by END VIEW Scale: 3/8" Scale: 3/8"=-1'-0" (NorthElevation Shown, South Elevation Typical) Location: NOTES: 7 1. Refer to presentation drawing and /or work order for colors, graphics specifications and sign panel size and location. 2. 110V Electrical supply, associated conduit and connection by certified electrician. Installer to increase footing size as required to route conduut. APPROVAL BY: 3. Footings are shown for reference only. Actual design and installation by certified REQUIRED DATE: persons based on local codes and geographic practices. Atlanta, Georgia USA Phone: (404) 688 -9000 Web: www.apcosigns.com All Design Rights Reserved APCO Customer: Graphic Systems, Inc. Date: 03/16/10 Project: Olympic Medical Center, Sequim Campus, Sequim, WA Drawn: WWD Location 7 Elevation Views Scale: As Shown 7 apcosigns.com Product 4420CP MutliPanel PolySign Coord.: JN Double Post Mount, Illuminated W.O. 406702 Sheet ,01 =,.I VI x 310d .OZ NO x x 30010Hd '8 (3a T1 51+1 iHon 13TH O .A A 3NI1 dOdd o_ ,2108 £'trkl V/ V r girl. O 9'Ot'l •1 d 3A 0 NUN .S 0' i►L 31V -4 13/13 £0' Al tt 131NI 0N00 1SVO3Nd 1.1- 1:10'5 0 d VIO N o l --80 i o 0 .0 4801= .S X S' C. 1 1 008 i'• l 1f1O811f O lb NO1.1.03S 1 XTVM3QIS ONO) .a M3N MO i. 3NI1 IMO Eaf10 ONV INVIS b IHM �yl 1WAd l #1 u 'V 03du13 I 4. <=1 008 GI. 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V '3 00 NU 00218 ..9 l /J 134 134 L Z14 0'£i,l NO3 l3 514-00 N 20N w A, 9C 1+141C 111\ o I H 13 51 160-.K O'Zbl N ELECTRICAL PERMIT I d CITY OF PORT ANGELES nS 360 -417 -4735 N Application Number 12- 00000221 Date 2/29/12 Application pin number 563508 Property Address 433 E 8TH ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2895-0000- 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 COMMERCIAL NEIGHBORHOOD Application valuation 0 Application desc Relocate sign circuit Owner Contractor CLALLAM COUNTY PUBLIC HOSPITAL OLYMPIC ELECTRIC CO INC 939 CAROLINE ST 4230 TUMWATER PORT ANGELES WA 98362 PORT ANGELES WA 98363 (360) 457 -5303 Permit ELECTRICAL ALTER COMMERCIAL Additional desc RELOCATE SIGN CIRCUIT Permit Fee 88.00 Plan Check Fee .00 q Issue Date 2/29/12 Valuation 0 1 Expiration Date 8/27/12 Qty Unit Charge Per Extension 1.00 88.0000 ECH EL -COMM -SIGN 88.00 Fee summary Charged Paid Credited Due Permit Fee Total 88.00 88.00 .00 .00 Gran Check Total .00 .00 .00 .00 Grand Total 88.00 88.00 .00 .00 (5 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH IN 31Z2,)/2._ FINAL J` 1(Z- SF COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGEBUILDING 02/28/2012 14:32 FAX 360 452 3498 Olympic Electric Co. PA CITY INSPECT II001 /002 N :K t I: iA,If-- F w I CITY OF PORT ANGELES PERMIT APPLICATION ELECTRICAL ?:q.. Building Division /Electrical Inspections 9NSPECTIONS I 1. 241l! l' 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 Ph: (360) 417 -4735 Fax: (360) 417 -4711 Date: 02 [✓1 Multi Family or Commercial* I Plan Review May Be Required, Please Complete Electrical plan Review Information Sheet Job Address: '33 E erN Building Square Footage: Description of above RELOCATE OUTCOOR SIGN AND EXTEND CIRCUIT Owner Information Contractor Information Name: OLYMPIC MEDICAL CENTER Name: OLYMPIC ELECTRIC Mailing Address: 1339 CAROLINE ST Mailing Address, 4230 TUMWATER City, PORT ANGELES State: WA Zip: 98363 City: POR TANGELES State: WA Zip: 99363 Phone: 3E0.417-7090 Fax; Phone: 360-074303 Fax: 360.452 -3498 License Exp. License Exp. oLVMPecz86o, Item Unit Charge f� 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 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 e6 co Signal Circuit/ Limited Energy Multi Family 64.00 Signal Circuit/ Limited Energy First 1500 sf Commercial 96.00 Note: $5.00 for each additional 1500 sf Renewable Electrical Energy 5KVA System or Less 113.00 Thermostat 56.00 Note: $5.00 for each additional T-Stat moo 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. 1 am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAG. Chapter 296 -46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: 0 Cash CI Check El Credit Card X Dated 0 2 i 38/2012 0110112012 !C(6/1/2009) James 7 1erly60012659 doc Letter of Transmittal May 29, 2009 Project Info: Assigned DOH Reviewer Facility Administrator Architect Engineer Sprinkler Contractor Other N/A Page 1 of 6 12-12z-ho Y.o builat,03 porm 14 oTetICo±w was 5ubry ii for i s tom. sg (bei 6/ itoi roject 433 E 8 St location. Port Angeles, WA 98362 Local Permit CRS# 60012659 Key People: Steve Pennington steve.pennington@doh.wa.gov Olympic Medical Center Mr Eric Lewis 939 Caroline St Port Angeles, WA 98362 (360) 417 7000 elewis@olympicmedical.org CollinsWoerman Mr Michael Juenke 710 2nd Ave N Ste 1400 Seattle, WA 98104 (206) 245-2087 mjuenke@collinswoerman.com N/A Copies To: Local Building Official: City of Port Angeles Washington State Patrol, Fire Protection Bureau Architect Engineer CollinsWoerman Sub Contractor N/A Sub Contractor N/A Other CRS File u Facility Contact: Building Official Fire Alarm Contractor 1 Other N/A (360) 417 -4816 jlierly @cityofpa.us N/A DOH Child Birth Center Licensing DOH Office of Accommodations Res. Care Survey DOH Office of Health Care Survey DSHS, Div Of Alcohol and Substance Abuse DSHS, Aging Adult Services Administration L &I, Bill Eckroth, Electrical Section L &I, Factory Assembled Structures 4/Hea lt'i Washington State Department of Construction Review Services 310 Israel Road SE Tumwater WA 98501 PO Box 47852 Olympia, Washington 98504 -7852 Olympic Medical Center Mr Jim Paapke 939 Caroline St Port Angleles, WA (360) 417 7148 JHPaapke@olympicmedical.org City of Port Angeles Jim Lierly www.doh.wa.gov /crs tel. 360 236 -2944 fax. 360 236 -2901 Plan Review Comments for Project #60012659 Pagel ;1 (6/1/2009) James Lierly 60012659 doc Page2_ Olympic Medical Center Chapter 246 -320 WAC Hospitals 433 E 8th St Tenant Improvement Memo Authorized to Begin Construction This project has not been approved for licensure This project cannot be approved until the following comments labeled as `not approved' have been resolved. These comments may be resolved by providing a written response, or by a construction inspection to verify compliance The documents have been reviewed and a determination has been made that construction can begin without any further delay Any changes during construction shall be submitted to the department for review of compliance with applicable codes. Approval for licensure cannot be given until all construction documents and changes have been reviewed and approved. Proceeding with construction pnor to resolving the attached comments will constitute the facility's acknowledgement that you are preceding at your own risk. If we do not receive written responses to the attached comments, we will automatically schedule a site inspection. Failure to address non approved comments prior to occupancy could potentially delay the opening of the affected area for patient care Page 2 of 6 Plan Review Comments for Project 60012659 I; (6/1 /2009) Jamei Lferly 60012659 doc Facility Data Certificate Facility Name: Olympic Medical Center Site Address: Estimated Date of Occupancy. Currently occupied Y Ai Occupancy Group. B L L Number of Beds. Current: F N/A 4 Automatic Fire Sprinkler System: Yes No Type II Automatic Fire Alarm System: Compartmentation req d. I f Special Delayed Egress Control. II Certificate of Need Required. T P C T E S Yes No ❑Yes ❑No Yes ❑No Yes ❑No 433 E 8th St Critical Access Facility. Yes Port Angeles, WA Construction Type. 5 -B Added. Removed. Licensee UBI 054003327 Applicable Code 2003 IBC Total. RES Number of units. Private occupancy Two person occupancy IDE Based on size of rooms used for sleepmg Residents NTI AL Based on size of common rooms Residents CAR Maximum allowable licensable beds E FA C Qualifies for Assisted Living Funding Program Yes ❑No Number of qualifying units. ILIT IES ONL No Smoke Control System Provided. Yes ❑No Location. CON Approval Granted. Yes ❑No CON Number P age 3 (6/1/2009) James Lierly 60012659 doc The data above is based on the information presented to CRS. Any change in the facility or facility program that causes the above information to be incorrect is subject to review by CRS. Approval for construction is not approval for licensure. A copy of the facility data certificate will be sent to the licensing agency Page 4 of 6 Plan Review Comments for Project 60012659 P age_ 4'] 11(6%1/2009) JamesLiedy_ 60012659doc Olympic Medical Center Chapter 246 -320 WAC Hospitals 433 E 8th St Tenant Improvement Plan Review Comments Corn Approv' Not ment ed Approv ID ed 1 2 3 El locations as noted on sheet A2.02 Construction and renovation may create conditions that compromise the health and safety of patients, staff, and visitors. Facility planning must include, in addition to space and operational needs, provisions for infection control and safety of the facility's occupants during any renovation or new construction. The facility's infection control practitioner (ICP) and safety and security personnel (S &SP) should be involved with facility planning, design, construction, and commissioning of any new or renovated area. The design professional should incorporate the specific construction- related requirements of the ICP and S &SP in the contract documents to require the constructor to implement these specific requirements during construction. WAC 246- 320- 505(2)(a)(ii), WAC 246- 320- 405(1), NFPA 101 Approved 7/16/07 Based on ICRA on sheet G1.02 and the work that disrupts the existing patient care will be conducted during the weekends and at night. Obtain approvals for Radiation Shielding from DOH Radiation Protection. Please include your CRS on your submission to Radiation Protection. CRS must obtain a copy of the radiation approval letter before construction approval can be given. WAC 246 320- 785(3)(f) Contact (360) 236 -3230 or 1- 800 299 -9729 Approved 8/13/07 Based letter from Office of Radiation Protection. Provide an ADA accessible changing room in the X -ray area per WAC 246 320 -785 (1)(c)(ii) Approved 8/13/07 Based on sheet ASK -2 that added an ADA accessible changing room. 4 Note Portable vacuum per owner will be stored with the portable oxygen bottles at (6/1/2009) James Lierly 60012659 doc 6 5 I Two complete plans and specifications for the fire alarm system installation or modification shall be submitted for review and approval prior to system installation. The department reserves the nght to defer plan review and inspections to the local authority having jurisdiction (AHJ). Plans and specifications shall include, but not be limited to a floor plan, location of all alarm- initiating and alarm signaling devices, alarm- control and trouble signaling equipment; annunciation, power connection, battery calculations, conductor type and sizes, voltage drop calculations, name, address, and phone number of the agency receiving off premises transmission of alarm, and the manufacturer model numbers, and listing information for all equipment, devices, and materials. Incomplete plans and specifications will be returned without review Plans and specifications may be submitted separately from construction documents during the construction of the project. For small renovation projects in which devices are only to be relocated or very few devices are to be added, provide two plans that shows the relocation of devices may be submitted for review in lieu of the above requirements. This information can be included on the electrical or architectural plans. Verify with Department staff to determine if the scope of your project meets this criteria. Section 907 1 International Fire Code Not Approved 8/13/07 Drawings to be submitted after design/ build is completed. Not approved 4/27/09 based on fire alarm as -built plans received 4/14/09 Provide strobe devices in all exam rooms. Section 907.10.1.1, International Fire Code rb Relocate exhaust fans 5, 3 and 4 along with HP 5 who s, make up air is to close to the parking stall, within the minimum 30 foot separation from the main air intakes per WAC 246 320 -525 (3)(f)(i)(A) Response. The electric fans are relocated to ensure the minimum distance of 30 feet clearance as outline in the WAC HP 5 located near the parking lot is unable to be relocated without significant modifications to the design. Per our conversation on site we are proposing a metal panel fence 6 feet high and 32 feet long that will extend to the ground. The parking stalls are H/C and therefore the vehicles should never be parked with the exhaust next to the fence. The closest the exhaust should be given that information above, is approximately 26 from HP 5 The fence will act as a barrier With these precautions the exhaust should dissipate prior tot the introduction of HP 5 fresh air intake. Approved 8/13/07 Based on comment response, and that the intake air is on a different exposure with the fence in place. Page 6 of 6 Plan Review Comments for Project 60012659 Page 1= (6/1 /2009) James Lierly 60012659 doc 7 IN Provide ventilation for the existing manager's office in the basement and the comdor outside of it, per the International Mechanical Code, Section 403 1 and Table 403 3 Approved 8/13/07 Based on comment response that supply air has been added to these two areas. 8 Provide a positive pressure relationship in the procedure room per WAC 246- 320 -525 Page 7 of 6 and Table 525 -3 Approved 7/16/07 Based on conversation with mechanical engineer and red -line drawing that increased the supply CFM to 220. Compliance with the comments above provided by the Department of Health, Construction Review Services, are necessary for this facility to meet the requirements of the applicable licensing regulations found in the Washington State Administrative Code and associated references. These comments do not relieve the facility from the responsibility to meet the requirements of any other applicable federal, state or local regulations. In the event of conflicts between other jurisdictions and these written comments, the most stringent shall apply Plan Review Comments for Project 60012659 Page 7 1 (67172009 Jame s Lierly Olympic Medical Center #60012659 From 'Sanders Leah N (DOH)' <Leah Sanders @DOH WA.GOV> To 'Eckroth William M (LNI)' <ECKB235 @LNI WA.GOV> 'Foss Linda (DOH)' <L. Date 5/29/2009 1 52 PM Subject: Olympic Medical Center #60012659 Attachments. 60012659 doc The attached project has been authorized to begin construction Please contact Construction Review Services (CRS) at (360) 236 -2944 if you have any questions regarding this letter Thank you for letting CRS be of service to you! Leah Sanders Permit Technician Department of Health Construction Review Services Phone 360- 236 -2944 Fax: 360- 236 -2901 Email leah.sanders @doh wa gov <mailto leah.sanders @doh wa gov> Please fill out our Customer Service Survey <https. /fortress wa gov /doh /opinio /s ?s =2902> located on our website at www doh wa gov /crs <http. /www doh wa.gov /crs> 'Construction Review Services protects and improves the health and safety of people in Washington by providing professional consultation and review for the design and construction of licensed or certified care facilities for our customers Public Health Always working for a safer and healthier Washington This message may be confidential If you received it by mistake please notify the sender and delete the message. All messages to and from the Department of Health may be disclosed to the public DAT OW ER/C0 t TRACTOR ADDRESS APPROVED 0 0 PERMIT fit- ll 1433 ELECTRICAL INSPECTION WIRING REPORT 417 -4735 DITCH ROUGH IN /COVER SERVICE FINAL 9ORRECTIONS NEEDED: Kum t.\iIR• WiA IVf Pal Oliz, S) /`J c- 216 y b 1 s ALL 0v.3 I nt veiv �Z OS "E fa Z Geo Ft'46 fll> 2 It 1 1 n feoPF tote la& md Dn WAY_ 517, DI NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DO NOT REMOVE INSPECTOR NOT APPROVED 0 0 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc 4 circuits front counter Owner VIRGINIA MASON MEDICAL CENTER ATTN LISA TAN SEATTLE WA 98111 Permit Additional desc Permit pin number 156786 Permit Fee 63 50 Issue Date 11/18/09 Expiration Date 5/17/10 Fee summary Charged Permit Fee Total Plan Check Total Grand Total INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS 09 00001199 374659 433 E 8TH ST 06 30 00 0 2 2895 0000 ELECTRICAL ONLY COMMERCIAL NEIGHBORHOOD 0 Contractor OLYMPIC ELECTRIC 4230 TUMWATER PORT ANGELES (360) 457 5303 ELECTRICAL ALTER COMMERCIAL ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Plan Check Fee Valuation Qty Unit Charge Per 1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER 3 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT 63 50 00 63 50 Paid Credited 63 50 00 00 00 63 50 00 Date 11/18/09 WA 98363 DATE RESULTS 2.223/1 0 0 0 Extension 57 50 6 00 Due 00 00 00 Signature of owner or Electrical Contractor X Date INSPECTOR. ylsip City of Port Angeles Permit Application Building Division/Electrical inspections 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98382 Ph: (360) 417 -4735 Fax: (360) 417.4711 Date: 1 8 2 Single Family Dwelling Multi- Family or Commensal' Commercial Addition Alteration 1 Remodel Repair' Plan Review May Be Required, Please Compleie Electrical Plan Review Information Sheet Job Address: a .3 3 E s1- FH Building Square Footage: Description of above A/5 h// 4 f Ale 14 v le IOTmr r^ /P r Owner Information Name; 0 i/1 Mailing Address: q 3 R G 6 rn %roe, city; port angelee State: we Zip: Phone: KJ7 Fax: License Exp, Unit Charoe 93.75 $113,75 $160.00 5205.00 $291.25 2.00 57.50 2.00 72.50 5 86.25 $116.25 $131.25 75.00 69.00 75.00 50.00 50.00 93.75 80.00 86.25 27.50 57.50 86.25 43.75 II Wil 211 1 3 Contractor Information Name: Olympic Electric Mailing Address: 423 0 Tumwater 96362 City' Port Angeles State: WA Phone: 457' 5303 Fax: 452 License 1 Exp, OLYMPEC26 5D1 Total (Qtv Multiplied by Unit Chergel ServlcelFeeder 200 Amp. Service/Feeder 201.400 Amp. Service /Feeder 401.600 Amp, Service /Feeder 601.1000 Amp. Service/Feeder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W/0 Service Feeder Each Additional Branch Circuit Temp. Service/ Feeder 200 Amp. Temp, Service/Feeder 201 -400 Amp, Temp. Service/Feeder 401.600 Amp, Temp. Service/Feeder 601 -1000 Amp. Portal to Portal Hourly Sign /Outline Lighting Signal Circuit/ Limited Energy Commercial Signal Circuit/ Limited Energy 1 2 Family Dwelling Signal Clrcuil/ Limited Energy Multi•Family Dwelling Manufactured Home Connection Renewable Electrical Energy 5KVA System or Less First 1300 Square Ft, Each Additional 500 Square Ft, or Portion of Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Thermostat Total Signature of owner, electrical contractor or electrical administrator Cash Q Check 1 Credit Card ti L00 /L00 ll 133dSNI AlI3 tld F 03 3ti.38I3 3tdWKIO RECEIVED NOV 18 2009 ELECTRICAL INSPECTIONS C,,P/.viff o✓ Tr Zip: 3498 98363 Owner as defined by RCW.19.28.261: (1) Owner wm occupy the sfructuro 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 orlease. 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 attention In compliance with the electrical lava, N.E.C. RCW. Chapter 19.28, WAC. Chapter 298-46B, The City of Port Angola. Municipal Coda, and UtUlty Specifications. ti 8810E Z4t' 09E XVd 90 EL SOOZ /LL /LL Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc Circuit for door openers Owner Olympic Medical Center 939 Caroline st PORT ANGELES Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Fee summary INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA 98362 09 00000840 773200 433 E 8TH ST 06 30 00 0 2 2895 0000 ELECTRICAL ONLY COMMERCIAL NEIGHBORHOOD 0 Contractor ANGELES ELECTRIC 524 E 1ST ST PORT ANGELES (360) 452 9264 ELECTRICAL ALTER COMMERCIAL 151969 57 50 8/19/09 2/15/10 ELECTRICAL PERMIT CITY OF PORT ANGELES 360 417 -4735 Plan Check Fee Valuation Qty Unit Charge Per 1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER Charged Paid Credited Permit Fee Total 57 50 57 50 00 Plan Check Total 00 00 00 Grand Total 57 50 57 50 00 g/20/6 ,4 412D .tyv Date 8/19/09 _L DATE. RESULTS WA 98362 00 0 Extension 57 50 Due 00 00 00 fit.6bQ' e 191 Lei Signature of owner or Electrical Contractor X Date INSPECTOR. 08/14/2009 11 24 FAX 360 452 9265 Ange1n City. of Port Angeles Permit Application BUi ding DtvithonlEteeb`kaI inspectlOns '321 Fait fl thStreet P.O. Box 1150 PortAngaletr.Waah pton,98362 P11:4360) 4174735 Fax: (360) 41_ 7 711 Date: �.s4:. Lire 1.02. Ingle iy or Commercial' merci am l' ity or Comercal CommerciialAddiition Alteration Remodel 1 Repair' Owner Information Name: Mailing. City: Phone: License Exp. Unit Charge 93.75 5113.75 $160.00 5205.00 $29125 2.00 57.50 2.00 3 72.50 $:86.25 511625 $131.25 75.00 69.00 75.00 $50.00 50.00 93.75 $80.00 8625 27.50 57.50 0 86.25 43.75 QL State: Zip: ff 4 Signature of owner, electrical contractor or electrical administrator AUG 1 9 2009 ELECTRICAL INSPECTIONS Plan Review May Be Required Plea Come Electrical Plan Review Information Sheet ;lob Address: Footage. 3ato 4-- Description of above 440 tiliWAOW bogie $km ED eI0001 /o00n Contractor Info r ation Name: Mailing Address: City State: Zip:, Phone: License Exp. Total (Qty Multi9lied by Unit Chars Service!Feeder 200 Amp. Service/Feeder 201-400 Amp. Service/Feeder401 -600 Amp. Service/Feeder 601 -1000 Amp. Service/Feeder over 1000 Amp. Branch Cir uit W/ Service Feeder Circuit W/O Service Feeder Each Additional Branch Circuit Temp. Service/ Feeder 200 Amp. Temp. Service/Feeder 201-400 Amp. Temp. Service/Feeder 401.600 Amp. Temp. Service/Feeder 601 -1000 Amp. Portal to Portal Hourly Sign /Outline Lighting Signal Circuit/ Limited Energy Commercial Signal Circuit/ Limited Energy 1 2 Fatuity Dwelling Signal Circuit/ Limited Energy Multi- Family Dwelling Manufactured Home Connection Renewable Electrical Energy 5KVA System or Less First 1300 Square Ft. Each Addthonal 500 Square Ft. or Portion of Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Thermostat TI. Motel 0 C7 Owner as defined by RCW.11► 2&261: (1) Owner will occupy the structure fort two years after this elecbleal penn/t Is finalized (2) Owner is required to hire an electrical contractor iabove said property is for sale, rent or lease. After reading the above statement, 1 hereby certify that I am the owner of the above named property or a licensed electrical contractor. l am making the electrical installation alteratbn In compliance with the electrical taws, N.E.C. RCW. Chapter 19.28, WAC. Chapter 296-468, The City of Port Angeles Municipal Code, and Utility Specifications. Application Number 07 00001336 Date 11/26/07 Application pin number 028000 Property Address 433 E 8TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 2 2895 0000 Tenant nbr name, '8TH ST OMC CLINIC Application type description FIRE ALARM SYSTEM Subdivision Name Property Use Property Zoning COMMERCIAL NEIGHBORHOOD Application valuation 12700 Owner Contractor CLALLAM CO PUB HOSPITAL DIST 2 COSCO FIRE PROTECTION INC DBA OLYMPIC MEDICAL CENTER 13 RUTH S PLACE 939 CAROLINE ST SEQUIM WA 98382 PORT ANGELES WA 98362 (360) 457 3308 (360) 452 3373 Permit FIRE ALARM SYSTEM Additional desc FIRE ALARM SYSTEM Permit pin number 115436 Permit Fee 150 00 Plan Check Fee 00 Issue Date 11/26/07 Valuation 12700 Expiration Date 5/24/08 Qty Unit Charge Per Extension 1 00 100 0000 ECH FIRE INSPECTION TESTING 100 00 1 00 50 0000 ECH FIRE ALARM PLAN REVIEW 50 00 Special Notes and Comments Call for cover inspection for all sprinkler installations A full acceptance test will be required for all fire alarm systems Fee summary CITY OF PORT ANGELES FIRE DEPARTMENT PERMIT 321 East 5th Street, Port Angeles, WA 98362 Charged Paid Credited ,Due Permit Fee Total 15 00 150 00 00 00 Plan Check Total 00 00 00 00 Grand Total 150 00 150'00 00 00 It /a6 /a This permit becomes null and void if work authorized is not commenced within 180 days, if work is suspended or abandoned for a period of 180 days afer the work has commenced, or if required inspections have not been requested with 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of recognized standards, laws and ordinances governing this type of work will be compled with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating the work specified in the permit. Signature of-C• ractor or. Authorized. Agent._. Date Signature of Owner (if Owner is builder) Date Removal of flammable /combustible liquids Tank appropriately abandoned UST abandonment final PERMIT OTHER (specify) permit final GENERAL COMMENTS 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. V KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE Inspection Type FIRE SPRINKLER Underground piping hydrostatically tested Underground piping flushed Interior piping hydrostatically tested Interior piping inspection Dry system air tested at 40 psi (24 hours) Sprinkler final FIRE ALARM Rough -in inspection Alarm final LP -GAS Underground piping inspection /pressure test Above ground piping inspection /pressure test Tank (container) inspection Appliance inspection LP gas final UNDERGROUND STORAGE TANK (UST) ABANDONMENT Date Passed I -Z2-OS KD Completed by Contractor- Test #1 Piping pressure test Time initiated Test #2 Piping pressure test Time initiated Comments 2/15/00 psi psi 0 rJ J,� Project Name OMC 8 Street Clinic Address 433 East 8th Plan 07 -19 PORT ANGELES FIRE DEPARTMENT FIRE ALARM SYSTEM PLAN REVIEW Installer• Cosco Date 11.21.2007 We have checked this plan and find that it conforms to the requirements of our codes and ordinances. ,1336 If this system is monitored by an off -site central station monitoring company, then the building must be equipped with a KNOX locking keybox. Contact the Fire Department at 417 -4653 for a KNOX order form and for mounting location information. The following comments apply to all systems. 1 All systems shall be installed per NFPA 72. 2 A final field acceptance test will be conducted before final approval. The field acceptance test will be a test of ALL system components. NOTE Prior to the issuance of a Certificate of Occupancy compliance with the above conditions must be met. Reviewed by ■-s Date Zl 07 VQ Building Department Copy Contractor/ Owner Copy Fire Department Copy Light Department Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4711 Apphcant or Agent: \Ar A-i,- I—JA -1 Ete Phone a P9 4 5 7 0 3 3 c P Owner (D/ ynt.t Pr C M S4 (c..41- C0C,,,/ 4 IZ_ n Phone 340.' 3 3 3 Address. 33 E. 8 5 City 6 rt 1 1 0G F cis Zip ?836 Z. Architect/Engmeer• Phone: Contractor Crnrn^.0 F.R..c P2o;^E n (DA) State License CoscfP93sMS Exp m '1/co q 4 9 Phone 4s 3308 Address. 13 ku n4 s RA-c45 City E Q (..1 i y C,)voc Zip 9 8 2 PROJECT ADDRESS LEGAL DESCRIPTION Lot: Block: Subdivision. CLALLAM COUNTY PARCEL NUMBER. Credit Card Holder Name: Billing Address. Credit Card Type VISA TYPE OF WORK. Residential V' New Constr Multi- family Addition 'a Commercial Remodel Repair BRIEF DESCRIPTION OF THE MC COMMERCIAL/RESIDENTIAL Occupancy Group No. of Stories Lot Size. Total lot coverage PLANNING USE ONLY BUILDING PERMIT APPLICATION T• \RVESS\BLDG- forms brochures\ .004- Buildingpermit.wpd Applicant: City. ZONING FOR OFFICIAL USE ONLY D:.te Rees 1 1 5 o� Permit 0 13'3f Date Approved. Date Issued: Exp. Date: SIZE/VALUATION Re -roof Stove SF /SF Move Garage SF /SF D Demolition Deck SF /SF Sign Other TOTAL VALUATION 2___ ?lam o3a5 PROJECT lc (2,' IQ- L,A.,a_AA S t/s Existing Sq Ft. ESA/Wetland(s). Yes No SEPA Checklist required? Yes No Other Occupant Load. Construction Type. Proposed Sq Ft. TOTAL Sq Ft. APPROVALS. PLAN BLDG DPWU FIRE OTHER. VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 8105.3.2 of the International Building /Residential Code, 2003) 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. 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 .rid that 1 must obtain such permits prior to work. `J Date. /I i` s 7- Look Up a Contractor, Electrician or Plumber License Detail Look Up a Contractor Electrician or Plumber Printer Friendly Version Electrical Contractor IA business licensed by L£tI to contract electrical work within the scope of its specialty Electrical Contractors must maintain a surety bond or assignment of savings account They also must have a designated Electrical Administrator or Master Electrician who is a member of the firm or a full time supervisory employee License Information LicenselCOSCOFP935MS Licensee Name I COSCO FIRE PROTECTION INC Licensee Type I ELECTRICAL CONTRACTOR 601198501 Verify Como Premium Status UBI Ind Ins. Account Id Business Type Address 1 Address 2 City County State Zip Phone Status Specialty 1 Specialty 2 Effective Date Expiration Date Suspend Date Separation Date Parent Company Previous License Next License 28702405 CORPORATION 501 W SOUTHERN AVE ORANGE OUT OF STATE CA 92865 7149748770 ACTIVE LIMITED ENERGY HVAC /RFRG LTD ENERGY 7/2/2007 7/2/2009 Associated License BARKRR *184P2 Search 1 Home .1 Safety I Claims Et Insurance Workplace Rights Trades Licensing Find a Law or Ruled Get a Form or Publication Topic Index I Contact Info Page 1 of 2 https. fortress. wa. gov /lni/bbip/Detail.aspx ?License= COSCOFP935MS 11/15/2007 1--- I .~. CERTIF ~.;r'E-o~F-.g~. UPANCY c. ~~ rtit A'.I B~'.I'd"'" ~. . . I . ~o nge es.-u.I.lng....,"lon This certificate is issue rpursl/ant to the reql/ire:;;;.,}~ec;;:;.,'l.o..o~e 2~6 International Building Code certifying that a her:---....,~i.l.n.... .".oti. '.'ifs.uqne. e t.h. i.S.... st...r. u.e..,..ur'. was. in co..n.l.'P. ..../i...an.ee Wl..S\ t.he various ordinances of the City regulatin Jldi1'f:gLcCQnVu\fio'n:qr;usr:-~~ . Bus~ness name: 1\:9Mp'Pnmal7i: . ~I~IC (Owner~G.lyr.nple..rte .Ical Center) Busmess address '..'~33...E:.'8Ih St. ...'\---- . .. ""\) Property owner:,.,. .. Clallam q? jRpDllG~pitaIDistrict#2 1 Property owner '(l1dnfiss~'1 939 Caroline St., Port"~Qgel~, WA 98i6 '~3909 Automaticfire sp'Vi,nk7er..;System: Pe~-IB~ ~ - . Use & occupancy r:idssijication: Bu~iness"f' . '). " Buildingpermit num~'et. L ,~:: ~ " Type of construction. Pet..,J,m,. Occupant load: ~.IBG ~ ..-e: \Y vJ r-\ '"l 1 ~ 6- Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use. . . . . Property Zoning . . . Application valuation 08-00000083 Date 588856 433 E 8TH ST 06-30-00-0-2-2895-0000- ELECTRICAL ONLY 1/18/08 COMMERCIAL NEIGHBORHOOD o Owner Contractor VIRGINIA MASON MEDICAL CENTER ATTN: LISA TAN SEATTLE WA 98111 MAJOR ELECTRIC 18538 142ND AVE NE WOODINVILLE WA 98072 Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW COMMERICAL MAJOR EL. NURSE CALL DEVICES 119453 MAJOR ELECTRIC 51.00 1/18/08 7/16/08 Plan Check Fee Valuation .00 o ~ ~ LN EL-LOW VOLT SYS <=2500 SQFT EL-LOW VOLT SYS >2500 SQFT Extension 40.00 11.00 ~ Qty 1. 00 1. 00 Unit Charge 40.0000 11.0000 Per Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 51.00 51.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 51.00 51.00 .00 .00 OJ ~ ~( INSPECTION ELECTRlCAL TYPE DA TE: RESUL TS: INSPECTOR: DITCH SERVICE -~ -- - -- -" ROUGH - IN I /J~ /og cAy - ..-c-:::> ~. FlNAL COMMENTS: =0=- ,= cc= ,_~~ === =='" ~ =0--_ -~ =-= ===- ~ -:""c~~= ~ = =....,...,.,=~__.._._.__. ~ f ",'^ " Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00000675 Date 1/17/08 414450 433 E 8TH ST 06-30-00-0-2-2895-0000- 417-7148 OLY. MED CNTR COMM REMODEL COMMERCIAL NEIGHBORHOOD 709000 Owner Contractor OLYMPIC MEDICAL CENTER 939 CAROLINE ST PORT ANGELES (360) 417-7148 Structure Information Construction Type . . Occupancy Type OWNER WA 98362 000 000 OLYMPIC MEDICAL CENTER TYPE V NON-RATED HEALTH CARE Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW COMMERICAL OLY EL./ 4- 200A PNL+CIR. 112045 OLYMPIC ELECTRIC 300.00 10/09/07 7/14/08 Plan Check Fee Valuation .00 o Qty 1. 00 3.00 1. 00 Unit Charge 91.0000 58.0000 35.0000 Per ECH ECH PER EL-COM 101-200 NEW SRV FEEDER EL-COM 101-200 NEW ADD SRV FDR EL-PARTIAL INSPECT Extension 91.00 174.00 35.00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments 06/12/2007 10:36 AM SROBERDS - The proposal will result in interior remodel in the CO zone for a public hospital use. No land use issues anticipated. MAINTAIN CLEARANCES FROM SERVICE WIRES Electrical load calculations and elctrical permits are required. Any modifications to the City's electrical facilities will be at the customer's expense. 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 300.00 300.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 304.50 304.50 .00 .00 .~-. , ,~ INSPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE - " ROUGH - IN I)L 7/o~ ~?' ~ FINAL COMMENTS: ~-- - === .., ,= = ---:-- - = == ='=~ ~ ~ ~ ""'=-=-= -__,;..:___" -=- ....,,;,-,- -=:-.,..,. =="" =="='= =--=.-c- =~--==c -, =- ~ = "'''' o ...... '" o ...... .... C>lC>l DE-< ..:..: "'Q >< ...:I ~ C>l H ...:I E-< C>loo :><:C>l ~~ E-<.., Z .. O~ HO E-<E-< UU C>lC>l "'''' 0000 ~~ M Ltl '" 0'1 01 00 C>l -...:I "'C>l oD ~~ o ......E-< ....~ o '" Q C>lC>. ~O ..: "'>< C>lE-< ~H "'U '" '" .... I'- , I'- .... 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H 01 <: '" Po .... ~ '" 0'1 \D M ~ ~t .... o 01 01 ...:I '" 00 C>l E-< o Z Q ~ 00 E-< Z C>l :E :E o U CML ENGINEERING LAND SURVEYING EN OVI C & ASSOCIATES 301 East 6th Street, Suite 1 Pan Angeles,Washington 98362 (360) 417-0501 Fax (360) 417-0514 INCORPORATED E-mail: zenovic@olympus.net December 6,2007 Mr. Jim Lierly City of Port Angeles Department of Community Development 321 East Fifth Street Port Angeles, W A 98362 SUBJECT: Special Inspections of OMC Building - 433 East 8th Street, Port Angeles, Washington Dear Mr. Lierly: This office has performed special inspection on the project noted above. These inspection covered the following items: 1) The shear wall anchor bolt retrofitting and holdown epoxy anchors were inspected by this office for the various shear walls retrofitted throughout the building. The shear wall nailing on the retrofitted interior and exterior shear walls was inspected by this office. The strap holdowns located in various portions of the building were inspected prior to cover on the main floor plan. The connections of these straps below the main floor level were not inspected by this office. The post framing and positive connections at the roof level were inspected by this office on the west wing where the new roof beam was installed to support the new roof framing. C)() ~ ~ 2) 3) -1=' ~ ~ 4) [\\ Based on these inspections, the items inspected as noted above are in general conformance with the approved plans and are acceptable to this office. :::::e;" me irOU ~ any further questions on this mailer. /0/~~ FILE Tracy Gudgel, P.E. ! ~ b\ (\ "1 Fc: IN 07228 Cc: Olympic Medical Center, Attn: Jim Paapke ELECTRICAL PERMIT AND INSPECTION RECORD CITY OF PORT ANGELES 360-417-4735 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00001157 Date 11/16/07 367185 433 E 8TH ST 06-30-00-0-2-2895-0000- ELECTRICAL ONLY COMMERCIAL NEIGHBORHOOD o Owner Contractor VIRGINIA MASON MEDICAL CENTER ATTN: LISA TAN SEATTLE WA 98111 SCHMITTS SHEET METAL INC. 3341 HIGHWAY 101 E. PORT ANGELES WA 98362 (360) 457-6452 permi t . . . . . Additional desc . Permit pin number Sub Cpntractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER COMMERCIAL SCHMITTS SHEET/ 5 STATS 112573 SCHMITTS SHEET 79.00 11/16/07 5/14/08 METAL INC. 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'" 1M >< . ..:I E-< . <II 00 E-< ~ ~ M :I: E-< :.'i ~ ::> o >< ~ o :I: 00 OJ .-< '"' 01 C <1l '" .-< M ..:I I>: l'J ~ '" ..:I E-< M M ::;: o E-< ~ ..:I ..:I'" ..,..; ..:I ..:I"; "'0 r-r- 00 ............ ........ 00 ............ 00 ........ r-r- 00 ............ 0000 00 ............ ........ ........ .... o N o .... ..:I <II M ..:I <II ::> o >< E-< M M ::;: 6 M :I: o 00 M ::;: H E-< '" o ~ M ~ OJ .-< '"' 01 C <1l '" .-< ::;: '" .... .... ..:I ..:I'" ..,..; ..:I ..:I'" ..,..; r-r- 00 ............ "'''' 00 ............ ........ ........ r-r- 00 ............ "'''' ........ ............ ........ ........ M o ... o M ..:I <II M ..:I <II 00 E-< Z M z~ 00 HU E-<...... "'00 HE-< 1>:..:1 u::> 0000 MM !-oOI>: IH :~ ~~~~~~ ~iDHMi&- . J ~ ~: OOQ: ~ ~~~:~ ......... U)[ij.......... '<1' 0 M H lo:t' o 0 ~ 0.. to ...... O:E I...... n tilO I r-l I>:U, ~ : , ..... 0'0 00' ...... , '" '" , '" >. .-< '"' OJ .... .-< .n OJ .-< ... 01 C <1l '" .-< ~ ::;: '" ~ III N III o III .... '" ... o M ... M .... o '" '" ..:I <II OJ .-< '"' 01 C <1l '" .-< ~ N III III M 00 ..:I ..:I ";00 ..; zo Z HOl""lH ~N<qttI.,. o H ..0 H (-l .:t:..;t I -< (I) u .-lUP: H>.\DHH ~~...~'" :I:~M:I:..:I UC..:IU..:I M<1l><M"; ::;:"'~::;:u !-o i '" Ul E-< Z M z~ 00 HU E-<...... "'en HE-< 1>:..:1 u::> UlUl MM 01>: !-o H ~o..~ "'00::> ZOO tl)HM Z I>: ioo ..:IMM p.,E-<E-< OOM OM..:I 0::>'" 0::;: MO I>:U ..:I '" !-o i '" o 00 ...... '" >< E- Z H E-< Z o U 00 M r- III <II .. ";00 ..:I oor- o 1>:0 MN t,; l'J ... Z OJ ~i1 ?i ~ ..:I 0 "'Z ..:I ..:I"; ..,0 r-r- 00 ............ 0000 00 ............ .... .... .... .... .... o .... ..:I '" r \..~ ELECTRICAL PERMIT AND INSPECTION RECORD CITY OF PORT ANGELES 360-417-4735 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00000675 Date 10/09/07 414450 433 E 8TH ST 06-30-00-0-2-2895-0000- 417-7148 OLY. MED CNTR COMM REMODEL COMMERCIAL NEIGHBORHOOD 709000 Owner Contractor OLYMPIC MEDICAL CENTER 939 CAROLINE ST PORT ANGELES (360) 417-7148 Structure Information Construction Type . . Occupancy Type OWNER WA 98362 000 000 OLYMPIC MEDICAL CENTER TYPE V NON-RATED HEALTH CARE permi t . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW COMMERICAL OLY EL./ 4- 200A PNL+CIR. 112045 OLYMPIC ELECTRIC 265.00 10/09/07 4/06/08 Plan Check Fee Valuation .00 o Qty 1. 00 3.00 Unit Charge Per 91.0000 ECH 58.0000 ECH Extension 91.00 174.00 EL-COM 101-200 NEW SRV FEEDER EL-COM 101-200 NEW ADD SRV FDR Special Notes and Comments The Fire Department has reviewed the project application and has no comments 06/12/2007 10:36 AM SROBERDS - The proposal will result in interior remodel in the CO zone for a public hospital use. No land use issues anticipated. MAINTAIN CLEARANCES FROM SERVICE WIRES Electrical load calculations and elctrical permits are required. Any modifications to the City's electrical facilities will be at the customer's expense. 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 265.00 265.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 269.50 269.50 .00 .00 ~ ~ '" \ ~ ~ "^ ,\ r ..i ~ [INSPECTION ELECTRICAL TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE /tJ/t /0 7 ./IfJ AcD , / ROUGH - IN 1 /17/-o!:. ~ ~ FINAL COMMENTS: fti!1 I "'r- o --- .... o --- o .... 0000 t7Eo< <>:<>: "'0 >< ..:I 0>: 00 >-< ..:I Eo< 00 en :<:00 8~ Eo< " Z .. 00>: >-<0 Eo< Eo< UU 0000 "'''' en en ~~ N li1 '" li1 '" en 00 -..:I r-oo ot7 ::.~ o ___Eo< 00>: ....0 '" o 00'" 0>:0 <>: "'>< 00 Eo< 0>:>-< "'U <Xl .,. .... r- , r- .... .,. o '" <'I ;': o '" ::> en 0000 ZZ 00 :I::I: 0..0.. 0>: Eo< 15 ..:I '00 0>:00 0000 Eo<o:E Zooo 00 , 0>: Uli1 "':E ..:I<Xl:E <>:NO U'U >-<N o , li1 000r- :E ' '" 00 UOO >-< , 0 0..00 :E<'IO >< , , ..:I",r- 000 o 00 :E >< ..:I Eo< 0 en :I: Eo< <Xl <Xl.,. .... oor- , <'Ir- <'I.... .,..,. 0>: om 0>: ZO !-< en - U enEo<<>: ..:IZ ~~~&l[L OZZZO>:'" 00003<>:'" <>:Eo<UO"'<>: 0>: 000 '" 0?5 en Eo< Z 00 ~Z~ ....00 ~~~I ~>-<Eo< 8~5 en en 0000 '00>: Eo< .... ~"'~ "'en::> zen t!l>-<oo :z: 0>: .... 9 5fHl III Eo< Eo< en 00 000..:1 0::>0.. 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I>: HE-< tx...........,.H~U , E-< ..:I 1>:..:1 .-< E-< ~ , a ,~ 8U~ ~N:><:I>:..:Io. , 1>:00 UlUl O.........Ul'tHC/) , ~OO ~~ ~O'\H04or::(Z , E-<0:E '01>: ~oll::= UH , 0 Zo~ , ~ ~ 'I>: E-< , :E UOJ) 1-1 , "':E ~o.~ .~ , ..:I<Xl:E i~ M >< <(NO N ..:I U , U o.Ul~ E-<O HN ZUl OJ) Ul o , OJ) ~H~ M ~Ol' :z: I>: :z: :E , '" 1-1 0 E-<<Xl 00 9 .-<Ul <Xl.. Uoo ~ .-< H , 0 1-100 ~~ -..:I ~I' 0.00 t:l~~ I'~ , :EMO 1llE-<E-< o~ MI' ><, , Ul~ :;-~ M'-< ..:1"'1' O~..:I .... 000 o~o. N O:E 'E-< ~o "'I>: I>: I>: UI>:U 0 . <'ll>: .~ '" 0. ZO III III 0 E-< ~~ ~'" Ul -u .-< ~O UlE-<<( E-< 0 0 gj~~~tJ..:I 1-1 Ul 0.>< ~ , ~E-< OZZZI>:o. 0. M I>:H ~~03<(o. >< ..:I o.u E-<UOo.<( '" E-< III ~ l' 't ~ \ o ~ ~ ~ Of ,ORT ~C ~.~~<" ha~ 1!::.-- 'ltO:~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 o --l \ 0- .-J \.fl Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00000675 Date 9/17/07 414450 433 E 8TH ST 06-30-00-0-2-2895-0000- 417-7148 OLY. MED CNTR COMM REMODEL COMMERCIAL NEIGHBORHOOD 709000 Owner Contractor OLYMPIC MEDICAL CENTER 939 CAROLINE ST PORT ANGELES {360} 417-7148 Structure Information Construction Type . . Occupancy Type OWNER WA 98362 000 000 OLYMPIC MEDICAL CENTER TYPE V NON-RATED HEALTH CARE Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date PUBLIC WORKS COMM WATER SERV 110395 2785.00 9/17/07 3/15/08 Plan Check Fee Valuation .00 o -+= vJ vJ Qty Unit Charge Per 1.00 2785.0000 EA PW W/M COM 2" Extension 2785.00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments 06/12/2007 10:36 AM SROBERDS - The proposal will result in interior remodel in the CO zone for a public hospital use. No land use issues anticipated. MAINTAIN CLEARANCES FROM SERVICE WIRES Electrical load calculations and elctrical permits are required. Any modifications to the City's electrical facilities will be at the customer's expense. Public Works Utility Engineering has no requirements for this plan review. [T\ 00 j: Other Fees STATE SURCHARGE 4.50 ::f- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 2785.00 2785.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 2789.50 2789.50 .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. Date Signature of Owner (if owner is builder) Date T:\Policies\1102.1SR [1/05] PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15R (1/05] fPORT~ _ t~O~~~ . r-Gii ...~ ~ 'l.O;c~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 C3 --J I (j' .-J 0\ Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 07-00000675 Date 6/29/07 414450 433 E 8TH ST 06-30-00-0-2-2895-0000- 417-4148 OLY. MED CNTR COMM REMODEL COMMERCIAL NEIGHBORHOOD 709000 Owner Contractor OLYMPIC MEDICAL CENTER 939 CAROLINE ST PORT ANGELES (360) 417-7148 Structure Information Construction Type . . Occupancy Type OWNER WA 98362 000 000 OLYMPIC MEDICAL CENTER TYPE V NON-RATED HEALTH CARE Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT - COMMERCIAL INTR RMDL / HVAC IMPROVE 104216 4253.00 Plan Check Fee 6/29/07 Valuation 12/26/07 2764.45 709000 Qty Unit Charge Per Extension 3260.25 992.75 BASE FEE 209.00 4.7500 THOU BL-500,001-lM (4.75 PER K) Permit MECHANICAL PERMIT Additional desc Permit pin number 104232 Permi t Fee 159.75 Plan Check Fee .00 Issue Date 6/29/07 Valuation 0 Expiration Date 12/26/07 Qty Unit Charge Per Extension BASE FEE 50.00 5.00 14.7000 ECH ME- INSTALL 100- FAU 73.50 5.00 7.2500 ECH ME-VENT FAN 36.25 .00 18.2000 ECH ME-INSTALL 100+ FAU .00 permi t . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date PLUMBING PERMIT 104224 128.00 6/29/07 12/26/07 Plan Check Fee Valuation Qty Unit Charge Per BASE FEE 6.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP 1. 00 7.0000 ECH PL- EA. INSTALL WATER PIPE 1.00 15.0000 ECH PL- EA. BLDG SEWER 2.00 7.0000 ECH PL- EA.WATER HEATER Extension 50.00 42.00 7.00 15.00 14.00 Special Notes and Comments /1; 'y ?~ "'0 ~r ~ -C:. vJ ~ \"'t'\ 00 3= .00 o V) :1- Separate Permits are required for electrical work, SPA, Shore me, 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 T:IPolicieslll02_15 building pennil inspection rccord05.wpd [1/4/2005J o :3 A> ~ d ~ ~ Date " BUILDING PERMIT INSPECT10N RECORD CALL 417-48]5 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRlCAL INSPECTIONS. CALL 4] 7-4807 FOR PUBLIC WORKS UT]LITIES PLEASE PROVIDE A h1INIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULATE OR CONCEAL ANY WOFJ( EEFORE · INSPECTED A.ND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA TION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNOA TlON: FOOTINGS SHEAR WALLS I WALLS FOUNDA TJON DRAINAGE I DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMlllNG UNDER FLOOR I SLAB ROUGH.IN WATER LINE (METER TO BLDG) GAS UNE FINAL DATE ACCEPTED BY: BACI~ FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS I GIRDERS SHEAR W ALlJHOLD DOWNS WALLS I ROOF I CEILING DRYWALL (lNTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB W ALL I FLOOR / CEILING MECHANICAL ROUGH-IN HEATPUMY/FURNACE/DUCTS GAS LINE FINAL DATE ACCEPTED BY: WOOD STOVE I PELLET I CHlMNEY MANUFACTURED HOMES FOOTING I SLAB .. BLOCYJNG & HOLD DOWNS SKJRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSI'ECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W. I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\I102 15 buildmg pennlt mspectlon record05.wpd [1/4/2005] f"ORT "',4;. A...-4.0~t( J~~~ if 'EiII .. ~ ~ "t,;[",~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number . . . . . 07-00000675 Application pin number 414450 Page 2 Date 6/29/07 Special Notes and Comments has no comments 06/12/2007 10:36 AM SROBERDS - The proposal will result in interior remodel in the CO zone for a public hospital use. No land use issues anticipated. MAINTAIN CLEARANCES FROM SERVICE WIRES Electrical load calculations and elctrical permits are required. Any modifications to the City's electrical facilities will be at the customer's expense. 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 4540.75 4540.75 .00 .00 Plan Check Total 2764.45 2764.45 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 7309.70 7309.70 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. . Signature of Owner (if owner is builder) Date Signature of Contractor or Authorized Agent Date T:\Policies\l102_15 building pennit inspection rccord05.wpd [1/4/2005] BUILDING PERMIT INSPECTION RECORD . CALL 417-4815 FOR BUILDING INSPECTIONS. CALL4J7-4735 FOR ELECTRICAL INSPECTIONS. CALL 417-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UN LA WFUL TO COVER, INSULATE OR CONCEAL ANJ' WOR};: BEFORE ~ I.II/SPECTED AND ACCEPTED. POST PERMIT 11'\ A CONSPICUOUS LOCATJON. KEEP PERMIT CARD AND APPROVED PLANS AT .lOB SITE. INSPECTION TYPE DATE ACCEJ'TED COMMENTS YES NO FOUNDA TlON: FOOTINGS IO-i-Ot ILL SHEAR WALLS / WALLS FOUNDA nON DRAINAGE / DOWN SPOUTS I PIERS I POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR / SLAB .t , -~ -e)7 'dLL ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL \ -t.j"og DATE :r L.L ACCEPTED BY: BACI: FLOW I WATER AIR SEAL WALLS CEILING FRAMING q-ZY-67 f~ 11-1-07 haVY\tnj JLL JOISTS / GIRDERS Ll-f(,-o'Z ~' SHEAR VI' ALUHOLD DOWNS (OJ JLL. WALLS / ROOF / CEILING DRYWALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL ROUGH-IN HEAT PUMY I FURNACE (?UCT]) I 1- 1',,-01 TL.L. GAS LINE FINAL l-'1-0 g DATE J LL- ACCEPTED BY: WOOD STOVE / PELLET / CHlMNEY MANUFACTURED HOMES FOOTING / SLAB BLOCKING & HOLD DOWNS SKJRTING PLANNING DEPT. SEPARATE PERMlT#'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LlGHT DEPT. 417-4735 ELECTRJCAL 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 \ .... Lj-O'ir '3'L-L . . T:IPollclesll J 02 15 bUlldmg pennll mspeclion record05.wpd [1/4/2005] r--- BUILDING PERMIT - APPLICATION Fill out COMPLETELY and in INK. Your application and site plan MUST Bj COMPLETE to be accepted for review. If you have any questions, call \ PERMITS (360) 417-4815 FAX(360)417-4711 Address: C13Q C CN cJ( A r ..Q Arcbitect/Engineer: ~ Co) \ \ \'h ~ Jim Applicant or Agent:~Cc.,,, V\i'ed,~ C CQ.u\4er Phone: 20D. Ll J7. 1/ LI.8 Owner: ()L~/M.plG ~ICDG C,p~ _ Phone:SG,o.YUJL~ c;tyee CityYcrt {)r7~ Zip: q8~~?.. \N Oev' VV\ en Phone: ~()f.a. al./~ 2CJ7<"!J Contractor State License #: Exp: Phone: Zip: ZONING: Address: PROJECT ADDRESS:-.Y33 City: ~"D cstraet -PGft- (2r7PJaS LEGAL DESCRIPTION: Lot: Jl., - )<6' Block: ;)~8 CLALLAM COUNTY PARCEL NUMBER: O~3 ()()()()J;t8cyC;- Subdivision: TYPE OF WORK: SIZEN ALUATION: o Residential D New Constr. D Re-roof 0 Stove SF. @$ /SF. = $ o Multi-family D Addition 0 MoveD Garage SF. @ $ /SF. = $ " Commercial ~Remodel 0 Demolition 0 Deck SF. @$ /SF. = $ o Repair D Sign D Other TOTAL VALUATION $ ~t1? # BRIEF DESCRll'TION OF THE PROJECT: 7It/~ /M&O(/~~~r- -.LA/~./q'~;a t7 .o~A.- Construction Type: = TOTAL Sq. Ft. COMMERClAL/RESIDENTIAL: Occupancy Group: No. of Stories: Lot Size: Existing Sq. Ft. Total lot coverage % Occupant Load: & Proposed Sq. Ft. AFPROV ALS: PLAN: BLDG: DPWU: FffiE: OTBER:_ PLANNING USE ONLY: ESAlWetland(s): DYes DNo SEPA Checldistrequired? 0 Yes D No Other: VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days oftbe date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more tban once. I hereby cerlify that I 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 t it is my responsibility to determine what permits are required ,not the City's, and that I must obtain such permits prior to wo . Date: ~/B/01 T:\FORMS\BldgPennitform. wpd Applicant: VI fVORT ""'" cS~O~~~ hiii 1!:.-- ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name p'roperty Use Property Zoning . . . Application valuation 04-00000121 Date .409610 433 E 8TH ST 06-30-00-0-2-2895-0000- COMM REMODEL 2/17/04 COMMERCIAL NEIGHBORHOOD 18393 Owner Contractor VIRGINIA MASON MEDICAL CENTER ATTN: LISA TAN SEATTLE HOCH CONSTRUCTION 4201TUMWATER TRUCK TRAIL PORT ANGELES WA 98363 (360) 452-5381 Structure Information INT WALLS & DOORS, REC & BLOOD DRAW Construction Type . . . . . TYPE V NON-RATED Occupancy Type . . . . . . BUSINESS:OFF/PRO/MED/REST WA 98111 permi t . . . . Additional desc Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL ALTER COMMERCIAL 5 CIR. ADD OR ALTER ANGELES ELECTRIC 59.40 Plan Check Fee 2/17/04 Valuation 8/15/04 .00 o ~ v.i Qty Unit Charge Per 1.00 59.4000 ECH EL-COMM ALT <5 CIRCUITS Extension 59.40 ~ .. Other Fees STATE SURCHARGE 4.50 ~ Fee sununary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 59.40 59.40 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 63.90 63.90 .00 .00 tI\ ~ --"I;......"" Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work 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 Owner (if owner is builder) Date Signature of Contractor or Authorized Agent Date T:\PLANNING\FORMS\1I02.15 [11/14/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4 I 7-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGElDOWN SPOUTS ELECTRICAL (LIGHT DEPn SEPARATE PERMIT: # ROUGH-IN I I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS / GIRDERS SHEAR W ALL/HOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING I I MECHANICAL HEAT PUMP GAS LINE " WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY .ej$ STORM ;2." /:1 -,/)1 N..~ 'f7 - PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 1/ ).1., ot../ KJ ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. / PW/ I" 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\I 102.15 (11/14/2003] d.....'~ $~ ELECTRICAL PERMIT CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION .12\ EAST 5TH STREET. PORT ANGELES. WA 9R]62 ISSUED: 3/17/2000 PERMIT NO 6898 OWNER/APPLICANT VIRGINIA MASON CLINIC 433 E 8TH Port Angeles, W A 98362 360/452-3373 T: S: ARCHITECT N/A CONTRACTOR SHAMP ELECTRICAL CONTRACTING INC. P.O. BOX 383 Port Angeles, WA 98362 360/452-1689 PROJECT INFO Project Type: Occupancy Type: Occupancy Group: Electrical Heat: o Baseboard D Furnace D Heat Pump o Fan Wall COML. MISC. PROPERTY LOCATION 433 8TH ST E Lot: 12 -18 Block: 228 [g] Long Legal Subdivision: TPA Parcel No: , 98360-0000 360/000-0000 Project Value: $0.00 Construction Type: FEEDER Zoning Use: CSD C1 o KW o KW o KW o KW D Riser 0 D Overhead Service D Temp Service Underground Service Voltage: 0 Phase: 0 1 D 3 Service Size: 0 Feeder Size: 70 PROJECT NOTES INSTALL NEW X-RAY MACHINE (REPLACES OLD UNIT) NO ADDED LOAD FEES ASSESSMENT' Service: Additional Feeders: Circuit Wiring: Temp Service: . Misc Fee: TOTAL FEE: AMOUNT PAID: BALANCE DUE COMMENTS/ACTION NEEDED $72.25 $0.00 $0.00 $0.00 $0.00 $72.25 $72.25 $0.00 ELECI'RICAL PERMIT INSPECI'ION 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 I ACCKPTED COMMENfS I YItS I NO >>m :.H-lN / CUVER ~VII:F t'lNf\L L:5/ll I GENERAL COMMENTS: pw.IJO::Z.l~14l961 . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ::::'TN~;~-::;#J_ ~ ELECTRICAL PERMIT o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Site Address: Phone: Installed By: 1IiJ. Sq. Ft. Owner/Business: M o RISER o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: 019'> 039'> SERVICE SIZE FEEDER SIZE ..fl) *. ELECTRIC HEAT o BASEBOARD KW - o FURNACE KW - o HEAT PUMP KW_ o FAN/WALL KW - o RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION o REMODEL /1; ADDIALTER CIRCUITS o SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE k AMPS AMPS Details/Description: ..sO . DATE ENGR. W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER Installer: g. . New Meters -- Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covere' before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Repol or on the Building yit. PHONE 457-0411, EXT. 224. 11 1""'"1 ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ <P ..-<;tJ Eleclricl'lnspector Permit Fee GREEN _ Top: Meter Dept., Bottom: City l- PINK _ Top: Eng, Bottom, Customer WHITE - File by address OLYMPIC PRINTERS INC . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 ELECTRICAL PERMIT Site Address: PERMIT NO ~.] / :3 9"/23 It 3 I ' DATE o READY FOR INSPECTION License Number: Installed By: Owner/Business: Owner/Business Address: o RESIDENTIAL .-g COMMERCIAL 1:J BASEBOARD KW _ o FURNACE KW o FAN/WALL KW o HEAT PUMP KW_ o SIGN o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION f REMODEL ADD/ALTER CIRCUITS SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) DetailslDescription: o WILL CALL FOR INSPECTION Phone: Phone: Sq. Ft. o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: o SINGLE PHASE o THREE PHASE SERVICE SIZE AMPS . W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. .-18M'Ell: Rough-in/cover O.K. o O.K. to connect service o Final O.K. Site Address: Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on eitherthe Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. 'f ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ I . EleclncallnspeClor .' . WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom. Customer OLYMPIC PRINTERS INC. PermitlRe~~Pt No. y.,;;? ;3 BfJ .:?D-- Permit Fee GREEN - Top: Meier Dept., Bottom: City Hall o Ditch Inspection O.K. M Rough.in/cover O.K. o O.K. to connect service .AJ~ Final O.K. ,. . ~. CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 PERMIT NO. '1z C'. 7' 7hzJ>h3 DATE ELECTRICAL PERMIT Site Address: Sq, Ft. Installed By: 1'33 Bob '5 o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Owner/Business: Phone: Owner/Business Address: o RESIDENTIAL o COMMERCIAL o BASEBOARD KW ~ o FURNACE KW ~ o FAN/WALL KW ~ o HEAT PUMP KW ~ o SIGN o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION o REMODEL ';g' ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: o SINGLE PHASE o THREE PHASE SERVICE SIZE AMPS DetailslDescription: l?&vvttJdr: I C!t~II'C-- W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER Site Address: 3.1 [. Installer: & b '5 Permit/Receipt No. cf~ cE/~ f/t~;r New Meters Notify Port Angeles City Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on th~ing Permit. PHONE 457-0411, EXT. 224. . I ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ ;;J 0 & Eleclricallnspector Permit Fee WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept.. Bottom: City Hall OLYMPIC PRINTERS INC . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 Site Address: ELECTRICAL PERMIT ,E. 6' ~ /do6:.s ~~ ?cJ-r/ '135 DATE E//.;z / s/Ztl hs , , PERMIT NO. o READY FOR INSPECTION License Number: 'I. Installed By: Owner/Business: ...) OwnerfBusiness Address: o RESIDENTIAL -a COMMERCIAL o BASEBOARD KW _ o FURNACE KW _ o FAN/WALL KW _ o HEAT PUMP KW_ o SIGN o TEMPORARY SERVICE o PERMANENT SERVICE o NEW CONSTRUCTION J8l REMODEL ~. ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o SPECIAL EQUIPMENT (LIST BELOW) Details/Description: o WILL CALL FOR INSPECTION Phone: Phone: Sq. Ft. o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: o SINGLE PHASE o THREE PHASE SERVICE SIZE AMPS Rc:mtJdc./ ,f-rc.P/)v~ /' / kUtfl,ec/5 /J;evJ . W.S. No. SERVICE SIZE CAPACITY: o O.K. NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. 1r-~ROUgh-in/cover O.K. o O.K. to connect service /1Y'ItJ Final O.K. Site Address: Permit/Receipt No. e;';';, 'c.. Lj/ d. / Notify Port Angeles City Light by Street Address and Permit Numberwhen ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on eitherthe Wiring Report or on the Building Permit. PHONE 457-0411, EXT. 224. ~ ~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT , $ Electrical Inspector <f. ~ [/~ Installer: New Meters . WHITE - File by address YELLOW - file by number PINK - Top: Eng, Bottom, Customer OLYMPIC PAINTERS fNC MJ ~O- Permit Fee GREEN - Top: Meier Dept., Bottom: City Hall ( Fie ~C~l~MBER ,,' ,CITY,OF-PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT A /2-2.-::> PERMIT NUMBER .. " r - .. (I TOTAL FEE /b 00 .. ;vAI1. ~ CONT. Lie. NO. TIME TO COMPLETE NO. STORIES \"...- LEGAL OCCUPANcY Site Address ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT Cl -1 3" ~ORRE~ ADD Si' ?R::ONSIBILlTY OF APPLlCAN".. . PERMITS WITH WRONG ADDRESSES ARE C~CELLED /. 'I' Ll (VI C. Installation By 0 ['/. ill c T!!. ( L Installers Address Owner Owner's Address Day Phone Installers Phone Application is hereby made for Permit to install Electrical Equipment.a.s.follows: RfMDJfl [fe-fe.lItH.!" fJflAeL Lt1l-t+r- t /N:rdvJ-l1... \{\w pJr:;i'-tL Alil.J. RSC..f T. . INiring Method N[w . NUMBER AMP 120V 240V NUMBER AMP 120V 240V USE OF CIRCUIT PEA 100R FEE USE OF "CIRCUIT PEA 100A- FEE CIRCUITS CIA 10 30 CIRCUITS CIA 10 30 LIGHT SIGN LIGHT .. .' 'SO VOL TS .. OR LESS CONVENIENCE .. MOTOA .. .. , - , CONVENIENCE . MOTOR . APPLIANCE MOTOR DIS.HWASH.ER - FIRE ALARM~ , DISPOSAL BURGLAR ALARM RANGE MISC. OVEN WATER HEATER LAUNDRY .., , DRYER REINSTAllATION LIGHT FIXTURE # ' - FURNACE ~U.B TOTAL FEE , GAS - OIL FURNACE ENERGY FEE ELECTRIC' .. .. BASIC FEE ELECTRIC HEAT - - - .. TOTAL FEE ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER .. A.C. UNIT i AMP PHASE FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS SERVICE AW.G. I SUB. TOTAL .. . . . SIZE OF GROUND SIZE OF ENTRANCE SWITCH I certify that the work to be performed under this. permit will be d"one by the installer and in conformance with the N.E.C. Electrical Code. Date Application made ,19 By . Date Permit Issued CONTRACTOA OR OWNER (OR AUTHORIZED AGENT) Permission is hereby given to do the above described work, according to the con_ditlons hereon and according to the,approve_d plans and specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. ' BY,' <ILYr;;C;~HT. PLANsApp VED - . 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 givef'! by Inspector in Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158. . 7/2L/77 WARNING 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 MADE BY REMARKS \ , c . , , '. . , . : .. . . . . O.K. FOR COVE~ING , O.K. TO CONNECT\S,ERVICE , " " .. Mr-' ,-0.0. , \ . z CI IX: < :!: ~ J: I- Z W . I- o Z o C . CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N~ 17778 Port Angeles, washlngtonmm_.J::___-==____~_.._m_m_m__..mm___, 19_<:';:: ..:?, In accordance with the City Ordinance to -regulate the Installation, extension, or repair of elec- trical equipment In, on, or about any building or other structure In the City of Port Angeles, per- mission Is hereby granted to d6~lectrlcal work as listed below. ,/ 73 3 E>>:f! A'---"--o Address ___mn-_mmnmm________m_._mm______nnnmn_____nmn_m___n_. Occupancy_n___________________m_m________________n ~::~~~~~::~:-::~~~__14:~~___~:::~~~:::::::::::::::::.-.-.::::::::::::::::::::::::::::::::::::::::::::::::::: V Light Outlets________.._...................._..___... Receptacle Outlets....m_...__m..._.._...._... Dryer, KW.....n......___.._.___.......__.______._. Range, KW _._._..___________.._...___..__00__.___... Water Heater: KW_n.. mr!!'.m..__mm______mm Heat: KW.............___.___....._......nn..........__u Motors: size volts and phase: .;f ~n.2/__~~c.<..."-'"'~/,:>.-. //lJ;j:...__v./_. _.' --" ,-, _"'--- / {A "'--' :.r-.-.:.---.-.-.....-....-.-........... . ? /: 'Y- ~ p;' L-'I- "'--.."'~...._-<,.{?~"."'e.~."::.-.~.:........._ .//Jkrb~ .7 r Ilf~lJ..~--....--......-.........-m..:....... 0"-d,1trl-;;://w-J!.jI...~~....-.. Service, volts ......._.0000....00...........00....... No. wires ..._....0000__...............___00..... SIze wires...._....._....n__._.............._.. Main fuse ..0000___0000.......................... Enclosure m___...n......mm.m............ Type of wiring: Entrance Cable n....mm.m...m.....n Rigid Conduit m....___..m...... Metal11c Tubing ..mm.m..... Current transformers: No. & Size..............mm....nn Ser. NO..n.._._n..._............................... Ser. No. ...............__........__......._nn...... Ser. No. ..00_.....00........000000..........00....... Type of Wiring: Armored Cable ..m_...................__._ Non.Metallic ._..........._......00......._.._ Knob & Tuben............._..nn.........._ Rigid Conduit ....___.................____... Metallic TubIng ..___....mmm_.____... Raceway ............__.__..............__..._ Circuits, Llght.n.................m..___......._.. UtllltY........m.....__....__....__........m_.. lIeat _....__....._____..................._.._...... Range ....__...___.................___.....__...... Water Heater ..nm................_....... Motor ............._..______..._...._......___.___. Dryer nnn............__n___..n.n_..........n_.... Furnace ...n__...............n.._..........m...... T~tal ~ad..=:h;.__~:....... ._fJ/? Je, NOiL:~~~~=~=---=~=:__Q- Total .....__......~...h-..............h.. Remarks. -----noooom-____...___...___.___.oo____oo...__n...______oo____..___...__.__...___oooo_.oo...oooo.....____...___.oooo_____m......_....______.._..._... .r -.-.r - ", .--.--un.___u_n...nn__un.n..n.nnn.______n_nh...n...nn..._n.nnn---.nnnn--nuu.n_..n.n_n..__n__nn.....nu__...__n_n._nn____._....nu__. ", ~ .. ;~:.~~oo~~~-____:::::-_:::_:::::oo...oo--::~_~_~:_::~_~~~_~~:.::::__-m---oooo--n---:~--~-~r2:1K4~::2::-~::h_ /, . NOTICE-Current must n()t be turned on until Certificate of Inspection has been issued. If work Is to be con. cealed due notice must be given the Inspector so that 'work may be inspected betore concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FQR INSPECTIQN ELECTRICAL PERMIT N~ 1 7 77 8 Address._____...........____................_.._....................................__..._............._...........--.-.-....-............____Date_.._._._______.._.._...._............__......_....._... Owner ..n..............n__............._nnn...._..._____....._.._.........................--......_......._.......n..._..._ Tenant._.........nn__...........n..n.....nn__.nn...n__n_......n WIrIngContractor............____..........._.............__.........._._._______._..._.........__.__......__---........._.................By...................__._............................___.___..._ NOTICE-Current must not be turned on untll Certltlcate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector 80 that work may be inspected before concealment. ... \ 1M ~mplc ""nle", Inc. , Port Angeles, WashlngtOnooon..2'Z..~._..:!./..ooooooooo..........ooo.ooo, 19.!:::? ;' ;; In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment In, on, or about any building or other structure In the City of Port Angeles, per- mission is hereby granted to do' electrical work as listed below. ,. Y'7:> . C' ~/"./ Address ooon....~...:?..n.'.,.....L.!.~...........ooonooo..n.................n...... Occupancy....n...........__..........n.._......__..... o~~e;:-..oooj~:~.L?./.c.2J..E~ooo~&jp~ TenanLooo.....__n...ooo_nn......_..ooooooooooooooo..nn__ooo_ooo...... Wmng Contractor ...ooo...ooo__.:?(__.oooooon~ooonn.__......nn.n..n..nn__ By.......ooo...oooooo.nooo.nn__ooon.....nn......n__n.__......... :r- V . /1 Light Outlets...........................:::;..:;;::..... Receptacle Out1ets__..__~:;~............. CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Service. volts n...........__...._.................. No. wires n..._____...............___._......... Dryer, KW..nnnh._..._._..__..........._.__._... . Range, KW ____h__..h....h_nn_.....''O-:.-';_~___n //f/ Water Heater: J' v;1;, ,,-- HeatK:~:::~;.~.~;.:~:.~;:::..:5.::t;:..::. t/ / Motors: size, volts and phase: ___"*~.~.~~~..Zo.4j{~~..... -rz,~ 07 /,...4~'At2r..:#':;'.: /Iih.~?.r'.... /" -- 4/ / r' L---ly.t-~7//7-- ..-------... -- .~.~... trzL.a.X.emt.~.--.--...O/L.:.r.:'::': Size wiresm.nnn........._n.__m......_.. Main fuse n......__.......______................ Enclosure __....,.__........__.__.__...........__ Type of wiring: Entrance Cable nm..........hh____ Rigid Conduit ...............h.... Metallic Tubing __............... Current transformers: No. & Size......d__...__............ Ser. NO........__..................__...h........... Ser. No...................__.................__ .........................................................- Ser. No. ................h..__....__.........__...... N:: 17762 Type of Wiring: Armored Cable ..........."'__h............ Non-Metallic ................................. Knob & Tube..............__................_ RIgid Conduit \m....mhh.h_____.__m... Metallic Tubln'g ...__...................... , Raceway ............:,.................._......_ Circuits, LIght............m__...m................ Utility __.._____m__m__mhh___________________ Heat ..__..____..................................... Range ............................................. Water Heater ............................... Motor ............................................. Dryer __..n..............:.__...____................._ Furnace .........................._....__............. . ~" Rem~k:~tal__=~~.....:.~:~;,~::/;:t;.d:?:~.:'::.~~::.::.~:~~~~.:::;~.,~~~J!...~~.~:..~:::.:::.:~:~~:.:::.:::~::~.. / -- ~;~;::::::::::::::~;:;:::~;;:;z~u.:::::i'~7V~:= $........000000.......000..........000. No.ooo............ooo.......... By /.....__ooo.1oooL......ooo.....ooo!!...ooo...ooo....'.......A"'--. 1 NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. . '" . ~ NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READ'( FOR INSPECTION , ELECTRICAL PERMIT i'. ! Address ........................................................................................................................................ Owner .....__...................n......._......_.._......_......_.._.............._J..........................n.............. Tenant....__...............__..................__......................... '- , I~) N~ 1 7762 Date..._.........._......_.........._......_......_...h.... Wiring Contractor..__.:......__............................._.............._......................____..........__...........____........ By......__.................................__................... \ \ NOTICE-Current must not be turned on untU Certlflcate of Inspection has been Issued. If work Is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. ..' , \ \ ~ -, 1M Olympic Printers, Inc. ( ~. ~~... f. I It!) ',;1- F Port Angeles, WashlngtoD......____m___m__._mm..........____........_m.m. CITY OF PORT ANGELES LIGHT DEPARTMENT "A__~_ :.~ , ELECTRICAL PERMIT N~ 17133 !>J? 19_"00:" In accordance with the City Ordinance to regulate the installation. extension. or repair of elec- trical equipment in, on, or about any building or other structure In the City of Port Angeles, per- mission Is hereby granted to do electrical work as listed below. 1/ ~ 3 .-:.> r:-.-Ftf' .r :5, _ S d',t;,/f.. 0 L~j' _'1l..., ~:7:~s~:~~~:~~~b~~~i.~~:~~~>:::~~~~~~~~:::::::=::::::::::::::::=::::::=::=::::::::: e7~ II /. Light OUtletB....__.~.........._........._.._..... Service, volts h_.....__n.....__.._................. Receptacle Outlets............................... Dryer, KW.....h...........UUh...._._____n_____ Range, KW ___u___hh..._h." Water Heater: KW..__.__/,oooo.__..~m.-oo<..oo-.. ____ ______ Heat' KW.......'ti..-:....-f!':-::.~~,:""----..- Motors: Size'WIts and p~: r)fU(l;/j~A;...~tqV"""'" ..________...._..___m.......rJ1?..._________..__. No. wires ________00__..__.__.._................. SIze wires.................n_nn_......_...__. Main fuse __..____....______......_.............. Enclosure ._.._..__._..._.....................__. Type of wiring: Entrance Cable ............................. Rigid Conduit ___.._____..____.._..__.._..__. Metallic Tubing m.m.......... Current transformers: No. & Sizem..................m.._ Ser. No..................._.......................... Ser. No. ..............................._............. Ser. No. ............................................_ Type ot Wiring: Armored Cable .........m................_ Non.Metallic ................................_ Knob & Tube........._......................_ Rigid Conduit ..____________.____.....__,,__. Metallic Tubing ........................... Raceway ......................._....._._.__ Circuits, Light....................................... Utlllty ___..___________.m__._.._______.....______ Heat ......._..............................._.._.. Range ............................................. Water Heater 'mn.......m.........",'" Motor ..._......._................................ Dryer .................h...n..........._..........__ Furnace .........._..............'_......_........... Total Load............................. Ser. No.................._.......................... Total ._..................................... Remarks: 'Lno.no.h..._____m..€i.~{;:::?~...~:~.~~'.:::::..oo__oonoh......m_._nom.._no_.___..._.__m_moom_m..__...._...._....._.. ............-.................-..----------..----...............--..-.......----.....--....-..-...---.-.....-......----...--.-..---.--.....----..--..-..-...--..-------.---.-..- ::~=~~::~:~::::::..:...::.:..._.oo-mmh.::~_~.~:::~~_~_~~_~.~:..:._.___n.--ooh--.h.no:;2tY~~;;;;.~~~.::: NOTICE-Current must not be turned on until Certificate of Inspection has been issued. It work is to be con- cealed due noUce must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 17133 Address..................._............_................_.................................................._..................................Date..._..._.._.._.._.._.........._.__.__......_......._ Owner.............................._..___......_.._......_......_.._...........................................................Tenant............................_n........................._n......... Wirin~Contractorm.................___..m....m_mm_.......__.....___..__..__...."......___..__mm....m.._.._..___......._By...m...."......_________...m....__........................ N TICE--Current must not be turned on untU Certtffcate of Inspection has been issued. If work Is to be con. cealed ue noUce must be given the Inspector so that work may be inspected before concealment. 1M Olympic Printers. Inc. CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N? 15375 .;-- 9- ).- Port Angeles, Washlngtonm...mmm........m.mm......__............mmm, 19.nn~. In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, on, or about any building or other structure in the City of Port Angeles, per- mission is hereby granted to do electrical work as listed below. Jf3"] ~-o Ii" if /~~ Address .n....n...nnm.....mmn.'.mnm.n...n____..m.n__n..n__....nnmnnn Occupancy...m..nnm......mn.....m__..nn...... :::: ~.~::;.:::~~=l:~~::.:.~::~~:~:::::::::::::.....:--------:::::::::::::::::::::::::::::::::::::::::::::::::: ./'... _ / ~)" CJ Light OutletBm......m........mm.._.__.._h._ Service, volts nu.~m.....:.~:......::...mm... Type of WIring: <?L- No. wires .m.n...mmm.m_m....._..... .3 ,x Size wire'-jh~n~"-'!.C/.Y...n Main tuse .f.D..t:J..If.d!:<<:'''-n___n (" T/a Enclosure h__..._mu....unumnmn... Receptacle Outletsunmm...................u Dryer, KWI n_un_._.......n.___n.______n____.___ \ Range, KW m_n'hm'um_'" Water Heater: HeatK:~.j.i~::nn..:nn.:.n - Motors: size, volts and phase: :J [.!t~n--.jl,n1i!.ZZ.;..'4--n--- .. ,) Total Load....nn......m..____..... Type of wiring: Entrance Cable ....nnnmnm....nnn. Rigid Conduit ...nm......mmmnmn. MetalUc Tubing '''_'nmmmm___n... Current transformers: No. & Size_n.nn....nn................._..... Ser. NO............nnn.._nnn................... Ser. NO._..nn.._nnnn.nn_.nn_____.....n_.... Ser. NO.nn__n.......n_nnn_nn_n....._...... Ser. No. ..nn..n.....n_nn_.nnn___...._....... Armored Cable Non-Metallic um....mm.nnmnu."'_' Knob & Tubenm...mm......m.........._ Rigid Conduit ...nm.mnm....n'"n''' MetalUc Tubing ........m........nnm_ Of rc;::.e~::h ~;j()~~~~..~~~~~~~~~~~~~~~~~~~~~~~~~ Utility ___/Y.____n.______nn________..___n Hea' .d...J..___.___....___.___.___.___n.nnn Range nnnnnnnnnn_n......n..n..h...... Water Heater .z......_......m_m_nu Motor _...._________._____._________________......_ Dryer_m........__nun..n..._..nn..n_nnn_____ Furnace 'n"_"'''...n''''''n'__nm..nmn..__ Total ___neC:.!..___n.n______n___nn --I ,.: / ~ Remarks: n......6..AL:L<..z:;..~""'-.(~:n;.i{<.UnJ::i..~<._.~:'.(!..n......n__...._m...nm..nn.......m..m.................... .i~_~.i_:.~~;..~..~..~_..~~~~~~...~.........i~~.~_~:.~~~_~_~~.~_~_~~.~~~~..nn..m.m...::.::~Il...)l~:Z~:~:2-.~~=. / . NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be COD- cealed due notice must be given the Inspector so that work may be Inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 15375 Date called for }~rti6T-i:nfl.~12..:nnn;.~.n._...n....n.nn..nn..--.n........--..nn............nn.............___....nnn........ Prelimlnaryinsp.ediOn.~teS__.._._/~.___...:_..-_<:-::::~_.~_.__.......__.____......._....___.____..........._._.___...___....____.__...............__......._....____ InspecUoncompleted____..____......__..........__......_........___.................._.~...._......_________.........._____.___..._._.........._._._.__............_.____________......._......_ 1M 3-72 Olympic Printars, Inc. Total Load nn..............._.._.n......_.u........__..................u_.........nn.......__ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number . . . . Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use . . . . Property Zoning . . . Application valuation 04-00000121 Date .409610 433 E 8TH ST 06-30-00-0-2-2895-0000- COMM REMODEL 2/12/04 COMMERCIAL NEIGHBORHOOD 18393 Owner Contractor VIRGINIA MASON MEDICAL CENTER ATTN: LISA TAN SEATTLE WA 98111 HOCH CONSTRUCTION 4201TUMWATER TRUCK TRAIL PORT ANGELES WA 98363 (360) 452-5381 INT WALLS & DOORS, REC & BLOOD DRAW TYPE V NON-RATED BUSINESS:OFF/PRO/MED/REST -h. ~ Structure Information Construction Type . . . . Occupancy Type . . . . . Permit BUILDING PERMIT - COMMERCIAL Additional desc Permit Fee 330.75 Plan Check Fee 214.99 Issue Date 2/12/04 Valuation 18393 Expiration Date 8/10/04 Qty Unit Charge Per Extension BASE FEE 92.75 17.00 14.0000 THOU BL-2001-25K (14 PER K) 238.00 Other Fees STATE SURCHARGE 4.50 ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 330.75 330.75 .00 .00 Plan Check Total 214.99 214.99 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 550.24 550.24 .00 .00 " ~ r , e ~ , ~ ~ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. T,his permit becom 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 auY,ority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. /-1/ . / / .j I /....,/ ..../1-._/. ? - \J -C)LI \ Signature1)f co;n?actor or Authorized Agent Date Signature of Owner (if owner is builder) Date \ \ T:\PLANNING\FORMS\1102.15 [11114/2003] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. '" INSPECTION TYPE DATE ACCEPTED COMMENTS I YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN o' WATER LINE (METER TO BLDG) .# -'. , GAS LINE ., 'BACK FLOW 1 WATER ...' .. ,AiR SEAL : ""'WALLS CEILING I FRAMING :.. ~OISTS 1 GIRDERS 1/, ".~. SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING 'l-'J-~-OH \ , }., DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR f1 :lNSULATION .. SLAB . WALL 1 FLOOR 1 CEILING ,.,.. ~ MECHANICAL ,., HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS ~ PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: ., WATERLINE 1 METER J,! SEWER CONNECTION SANITARY .> STORM tI "'" PLANNING DEPT. SEPARATE PERMIT #'s SEPA: <#' RARKING/LlGHTING ESA: , LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W. 1 PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 " _A~ f\ L1 .L l , BUILDING T.\PLANNING\FORMS\1102.15 [11/14/2003] ",. .. .. .1 ~ . , 01 01 >-3 'tl ;:;~~8E; n'U , t' l~ >< ~ H'" , '" '" 'U 'U ZZt:l >-3'" , '" ---- t'n"'>-3'" ><'U , U'l H "'''''''''' :t' , 0 0 10 >-3 Zt' :t'U'l O:U , H H ~. nU'l "'''' , >-3 t:l ~"" III 01 0 'U "" ",. ",. 0 n"'rl '" "'''' 0'" >-3____ I ............................. 3:10 '" I Wl\JW 'UC::O OO<::r:~ ~~ I W W w t''''O 1f:>000HQW I ............................... "'U'l , , :UnW G'lo , 00 >-3 >-3 III QwG);:r: "'... I ~.t>o,.l::> "''''C:: OOH '" t'- , t:lt:l,.. 0' zn '" " S OQHOOO U'lH , oa;J:::lZl-3 '" , ,.., H U'l:>1 , :t''-< '" Z N03:1-3 H , t''Ut' "'HI<) H , :t''''U'l en , t' t' U'lZ WUlC.., C::U'l'tl n, on ... ~~; ONZI-3 '" 3:0:> H 3:1.03:0 ,.. en",Z >-3 '" t:l "'OH 01 01 "'t:l, 3:on 8 8 "'''' oo:t' ~i!l8 t:lot' t' t~ '" t:l t:l t''''! t' n H H >-3H '" Z Z U'l'U Z n G'l G'l ____>-3 >-3 0 nHrl '" H 3: '" '" 00,.. '" HZ 3: H '" ~Z~ ZU'l '" Z ~ U'l'U Z :t' '" 'U'" >-3 t' Z Z ",n U'l >-3 n>-3 G'l U'l >-3H ~ 00 >-3 :UZ t:l H 3: j '-<>-3 Z '" ~8 0 :~ 'U'UU'l >-3 to 1313fiJ "'~ '" H U'l'" U'l -.J ZZt:l >-3 H "''''H t' 0 .,J < 0 t' 0 H 0 '" w '" (J\ t' 0 >< ... en '" , en w 0:> H t:l'U :t':t' >-3G'l "'''' '" ---- '" w ---- 0 "'-.J I'olll BUILDING PERMIT - APPLICATION FOR OFFICIAL USE ONLY: ate Rec.: '2. - 1)- 6'1 emlit # d4 -'2../ ate APProVed:~ Date Issued: Fill out COMPLETELY and in INK. Your application and site plan MUST COMPLETE to be accepted for review. If you have any questions, call (360) 417-4815 Applicant or Agent: !-/r?CJ-/ Q.hJ~l, ~ C' Owner: ~,~ ) \fj~c.<(~)4- (V\ N:s:;.0 Phone: ~ I ? - ~C)ll() Address: .L1':\'1 ~ ~.... Sot. City: 'P()Q-:\ A,v(,.....d'iS Zip: 1~3b3 Architect/Engineer:6/fl:)1isJuLt -A-OdlU' f0u.nC-tf(/..,r" Phone:~Ob- 3t..1/-()'-/33 Contractor--1:}CCA.\ (v...::>S\' , State License #:H~hc.:]::4'lbot\TExp: fj'.4j,';)/04. Phone: LlS;;)- 5::SR I Address: '-I:::n I '01111lt 1I.c:l. City: p+-. iLhtr.-t-1' 1t.J Zip: Yx-.:,(Q 3 ~A. ZONING: C,R Phone: '-Is).- 53SV / PROJECT ADDRESS: i./ '6 ~ L... y*'" LEGAL DESCRIPTION: Lot: \ 1.0- \ Y CLALLAM COUNTY PARCEL NUMBER: Block: ~ri.)( ,PA Subdivision: Q( 0'3 C)()(")() ';} ~ rCf..:s 0(')( Y) Credit Card Holder Name: Billing Address: Credit CardType VISA TYPE OF WORK: o Residential 0 New Constr. 0 Re-roof o Multi-family 0 Addition 0 Move X Commercial ~ Remodel 0 Demolition o Repair 0 Sign BRIEF DESCRIPTION OF THE PROJECT: --t\. ,\,.1 .r In" \' 0 \f'v\n A .J; COMMERCIAL/RESIDENTlAL: Occupancy Group: Occupant Load: No. of Stories: ~ Lot Size: Existing Sq. Ft. & Proposed Sq. Ft. Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage City: MC # o Stove o Garage o Deck o Other (~(V\(")A ~ \ Exp. Date: SIZEN ALUATlON: / ;() SF. @ $ lo:J l,t ISF. = $ lEI 393 q,::-- SF. @ $ ISF. = $ SF. @ $ ISF. = $ ,.,TOTAL VALUATION $ ~ 393 c1~ jl,({.c')J U(r.kU) (j r()r...... -C~ISJ.....~t:;" \ Construction Type: APPRO V ALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW: Ifno permit is issued within 180 days of the date of application, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon WTitten 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 t 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 ity's, 'd that I must obtain such permits prior to work. T :\FO RM S\APPS\B ui Idingpermit. wpd Applicant: Date: ?- /0 -o"-J { . ~. 10/. l ~ ~~ ....0 :e" -m ZZ ~~ ,.- 'l.Z E~ C~ Z !2Gl r::;;z ~"2~ -ize: -0" zm" "'::Om n ::0 ~~ ;:;:j:Z: ::OSj :;..nz ::oo!:E ~~::o -im mn ::Om "" " ::;;::::l 00 ::oZ ^ ::::0 o o 3: m >< <..r> -i G') m >< :J> 3: filE C st uction Plans CITY OF PORT ANGELES - plans speclfi. -Y-L'" . mit based upon . , I ~ The Issuance of thiS per bUilding ololcla cations and other data shall not prevcetnl errors In said . ng the corre from thereafter reqUln . d t. r rom preventing , sand olhe, a a, plans speclllcauen d n lor "nder when In ' b g 'ame 0; . _ bUllrllng operations em L _ 0 Of ,,,s u sefld'nn d c::. nljf1 or c.!lnan......e Violation 01 all co e. - , f' i€) (SECTION 3,. : 13{c) . 1)11fGrtT' 7/0'1 ' ~,~ ~lL~ 0 ~j :> -n CJ :z: ~~:DF8~ ::IJ~3:r-:::O:I: ~-;-.,~~~~ ~ 5 \J C ,- 0 mV>S:;:;:j"lo . 9jrr1~><o - Vl - "-J :.0 "" m 6 ,- jj 0:;"00:;.. 8~;:e';~ :D~\J . V> ~~~0 ~ ;:e " ';1 V> -i :z: '" ~ F ::r:z::;;::o :;"!:E:Z:~ ~v>80 ::;;n::;;;;i ~~~';1 . 0 V> 8:z:g O~G) ::o~ ""r ::;;~z -w!:E ~~w r . .- ~~q . >< ~=E'-J :> 0 ,- ~~~ ~[OC]j~= j-r-= l~- V> 0 N /j ~ I~~~ (: 10 m I r ;g 0 -i n z I Ie: 3: I 5 V> 'e: ::0 e: !:E I~O Z':g F';~ Im~ m ^~ ,::0 Vi ~ z I g "" I "'____ -,-- I r- z I 0 g.] I 0 ::;;i 0 ~I 0 I ::0 II : )> i I I ::2: --rt', 1_____-, I L-,\___ __-' L--1------ 1 UJ j~ ~~ I ~ I I ~ ';1 I > ~ I :Z::z: I -i '" ~ ~ ~ W M ~ ~ ~ \-1 ~ '7'7 'uJ ~ ?erL Uf)c It T1 :xl - m F5 0< ;:gm ;;;:;Q l z_ '" V> 4CL~~ L ib, I. +-y i A rr fa '= .s. ~ z o m ox gj z '" 8 o ::0 o " m z :z: '" c[" ~+)^ ~ /, "\ ----- =-- G] I B :!1 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Pl.n number Property Address ASSESSOR PARCEL NUMBER: Appll.catl.on description Subdivision Name Property Use Property Zonl.ng . . . Application valuation 04-00000557 Date .158409 433 E 8TH ST 06-30-00-0-2-2895-0000- PLUMBING REPAIR 6/24/04 Owner Contractor EXPIRED 11, /11 /O~ COMMERCIAL NEIGHBORHOOD 1875 VIRGINIA MASON MEDICAL CENTER ATTN: LISA TAN SEATTLE WA 98111 SANFORD IRRIGATION PO BOX 2246 SEQUIM WA 98382 (360) 683-9807 Perml.t PLUMBING PERMIT Additional desc Perml.t Fee 54.00 Plan Check Fee .00 Issue Date 6/24/04 Valuation 0 Expiratl.on Date 12/21/04 Qty Unit Charge Per Extension BASE FEE 47.00 1. 00 7.0000 ECH PL- EA LAWN BACKFLOW 7.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Perml.t Fee Total 54.00 54.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 54.00 54.00 .00 .00 ..1:. w W 'ill ~ J ~ . Separate Permits are required forelectncal work, SEPA, Shoreline, ESA, utilities, pnvate and public Improvements This permit becomes null and void If work or construction authonzed 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 authonty to violate or cancel the prOVIsions of any state or local law regulating construction or the performance of C7~~ Signature of Contractor or Authorized Agent -0 p-'f ate Signature of Owner (if owner is bUilder) T \PLANNING\FORMS\l 102 15 [11/14/2003] 14'-2" .wu WILlI 3 .D.ECK 1 1 /1 - -I 1 1 1 I I ,I "Ii' " 2 L,_ ~AN~ Wit WIL6 35'-9" AREA OF WORK X-RAY ,----------, 1-----------1 L_________-.J X-RAY Flill ,----------, 1-----------1 L_________...J r,--, I I I I I I I I I I I I I I I I I L____,-, I I ITi I '-----------,,, L---------lJJ II II/]' I~ .EXAM...5 ? Q. Y"'- C> / 'L _ I I I ,___J e +~6____~=!::-. -.". 7l'-~-'-~- - _f - . 0~ 2 .ElWL.4 ----- 1 FIRST FLOOR DEMOLITION PLAN SCALE 1/4"=1'-0" AREA OF WORK kBAY --- I 1 I I n ,J BECill 4 DEMO GENERAL NOTES: I CONTRACTOR TO SAlVAGE & STORE ALL REW 1 AND CONSTRUCTION MATERIALS DURING CONSl 2 PATCH AND REPAIR EXISTING WALLS AND FlO, I CONSTRUCTION TO MATCH EXISTING CONDITiO! 3 THE GENERAL CONTRACTOR SHALL BE RESPOI COORDINATION OF AU WORK OF ALL TRADES 1 4 SHOULD CONTRACTOR ENCOUNTER MATERIALS CONTAINING ASBESTOS OR ANY OTHER HAZARI I DURING DEMOunON OR CONSTRUCTION, 00 N MATERIALS IMMEDIATElY CONTACT THE ARCHil OWNER'S REPRESENTATNE, FOR fURTHER INS I I 5 SEE INTERIOR ELEVATION FOR ADDITiONAl INF' OF EQUIPMENT DEVICE LOCATIONS 1 DEMO PLAN KEYNOTES: 1 <9 EXISTING FLOOR OUTlET TO REUAlN 0 REMOVE EXISTING DUPlEX OUTlET I REMOVE EXITiNG TELEPHONE/DATA OUTlET I <9 EXISTiNG TELEPHONE/DATA OUTLET TO REM! 0 RELOCATE EXITiNG UGHT AND FAN SWITCH SYMBOLS =FEC FIR[ EXllNGUi: .. PHON[ 0UTlE1 .. NEW PHONE 0, 1 .. PHON[ 0UTlE1 'V DATA OUTlET I QUAOPlEX OUTI ) @) 4 3 3 €. sr 8 1"/1 @ 14'-2' 35'-9" i lL i I - - - - #1- - -----@ _ _I .. - j .- . -.- - -. - - I i ---------- mM....2 WtU J ~ AREA OF WORK X-RAY -- DECK I I /'rll I -~- I I I I I L .( CD ~~~~Tl/~=~~OR REMODEL PLAN GENERAL NOTES I SEE SHUT A3 1 fOR WAlL IYPES 2 SCHEOOLI (f wQRl( TO BE COORllINAlID Wffil GC AND OWNER 3 AlL DASHED fURNllURE/IIDtS ON FLOOR P\JJ'lS AND ElEVATIONS TO BE FURNISHED BY OWNER AND INST.AillD BY OWNER (f 0 I 0), U 0 N lER BACKSPIASH liON hJhJhJ lJ lJlJ I ff\1 ~I nU~+ __.J..J _. .n._.'_ _ @ .EWL.5 I I I .ill!U I :0 ~ -- n $ REMODEL PLAN KEY NOTES o NEW OUPlIX OUTlET o R8..OCATID lIGHT NA fAN S\\1TCH <>> NE:W TillPHONEfOATA OUTlET o NE:W HlIX DUllfJ FLOOR PLAN LEGENDS: NEW PARTITION (NON RATED) rVI<;T1Nr. PARTITION TO RFMAlN (NON RATEDl I ~~ c~ n ::x - ( - ~ ~ 777 100TH A' SUITE 400 B8llVUEWAS T 4250889-333 COWNSWO VIRC Port .1 S MARK ~ PROJECT I ORIGINAL DRAWN B ~ pORT ~ lO~\ ". .... -=-:or ~ ~IC~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivis~on Name Property Use Property Zoning . . . Application valuation 1/11/05 05-00000015 Date .664085 433 E 8TH ST 06-30-00-0-2-2895-0000- PLUMBING REPAIR COMMERCIAL NEIGHBORHOOD 2000 EXPIRED r-pr~-s Owner Contractor VIRGINIA MASON MEDICAL CENTER ATTN: LISA TAN SEATTLE WA 98111 HOCH CONSTRUCTION 4201TUMWATER TRUCK TRAIL PORT ANGELES WA 98363 (360) 452-5381 Permit Addit~onal desc permi t Fee Issue Date Expiration Date PLUMBING PERMIT plan Check Fee Valuation .00 o 54.00 1/11/05 7/10/05 Qty Unit Charge Per Extension 47.00 7.00 BASE FEE 1.00 7.0000 ECH PL- EA.FIXTURE ON ONE TRAP Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 54.00 54.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 54.00 54.00 .00 .00 -:r... ()i Oi 1lt ~ ~ .~ 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 pr is ions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit oes not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the pertor nce of co ruc 'on. I" Signature of Owner (if owner is builder) T \PLANNING\FORMS\II02.15 [11114/2003] DEPARTMENT OF PUBLIC WORKS . . . . . . . . ..'. INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 1~.,)..8 .q'-l Time ~-: 00 A-Wl Received by (CI:.I+/JI::. w (phone. Dersonl (--- .~,.~.-"- . .'....-, Location of Work to 6'8 inspected J./ ,:>.. 3 EIl-.,+- fJ~ ::!,i,.",.,..f Name of person requestinglrispectlon ~. ~Eu"'lC-~Ub ~ "." Address of person requesting Inspection n ~ 3 (<'c.d" , '-1,41<6 1_ Phone No. I t.j- Type of Inspection (circle appropriate one): Permit No. L{8,I'Z.. Sewer Foundation Framing Chimney Plumbing Final SewEir Excav. Other A-~c., f1 60 'T.n:,o 6u.J, "2.0/7 Z 2-/f INSPECTION NOTES: Inspected: Date 1-"JPJ-9'! . Remarke:..J!Jdul."h ~ (;.FDI.I."...." (.... , \~F ./<... Time 1-.' 00 A-I-vl _ By 13, B~cJ t:i.~ (;,,1 6. +t, " ~"'Zt:- "of f-t.\ !' 'Ilell'/<!. {."~()~l~ 1. Y4" -fo 1" RESTORATION REQUiRED...... YES . '.\ 'h.1l ''fV'J.-'~ Jj 3'3 I(\~ \ Op D-T' , NO v" "}N1 o~ 01.(('14" I)I<-~"- t<'_."-$)r../b"n . , II' .-..-I.t Caw s~p /;1." c.z 38'1' 8 ~ s H2k-l.~f- :l afV---J 11!n~ !:t~11 H~ N I /;2,--(p/6 \ ~ SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved o Grllvel o Repaired by City o Repaired by Permittee o No Damage Found ?eA-&>d'( ~~et-..t- f71 dviJi=- o 70 :;57~ ,j W, () 30-333( J7~ o Asphalt 0 PCC Work Order # rrr COMPLETE o INCOMPLETE o Other '1 '1 ~~ (Continue on roverse sldo If nocessery) STREET SUPERINTENDENT (DATEI ELECTRICAL INSPECTION WIRING REPORT 417-4735 DATE PERMIT # 07-t1$'7 INSPECTOR ~ J If, 08 OWNER/CONTRACTOR , $ SH, M :rAt.. Y?3 1'L ;or APPROVED NOT APPROVED o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0 D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0 D. . " . . . . .. . . .. . . . . .. SERVICE. . . . .. . . . . . . . .. . . . . 0 D........ ............. FINAL...................~ CORRECTIONS NEEDED: C"V€.J2. "?~4 hsJZ. "itLOb hDL..$. ..r-Box- - J../'tu...T", J<.tz.1't'f) lCA--sT 5117E. N-UlZsr ~,....".-nCN, xr:z.A,oJ _ LoB\7,Y I%"-FIC.~ u>z.~<? N.1lt':4';.}E: ~ ~ ~ 1 S'I'mON, L oBl'> '1'.., T- STAT -,,,,,~~~ .flt..ONc' L0I'1LL F:>r-ID .~(1'T'T~ " ON 1.01N!>VlACl NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 --- ElECTRICAlINSPI::Il,;,','a_ WIRING REPORT -----. 417-4735 D TE PERMIT # INSPECTOR ~ I b 0'0 OWNER/CONTRACTOR OU? 7~"'75' G ~uEc..""'\ {Z.l C ADDRESS t.J~~ ,~ APPROVED. NOT APPROVED o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0 D. . . . . . . . . . . . . ... ROUGH IN/COVER. . . .. . . . .. . . . ..0 D. . . . . .. . . . . . . . .. . . . . SERVICE. . . . . . . . . . . . .. . . . . . 0 D. . . . . . . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . . .!lit- 90RRECTIONSNEEDED: O'i'IEN ;:S-p,o, ~...e::N>lS or-FICE p.~tL ..'~H~F) tt-JST"LL ~""O~;" H..NLIH"- i:'rz.o.... ,.....r:?"'.. . .. IN'Ltn.~L:n.. ~""''T'\..1) t""\uYLa::l "F"L-Usti ~1"7i-l --s,D-R."'FA.C..];: ~>ln V"'EI.~O'-V "'1Ll-"ole: _"', 1!:bH"~"",OIZ-. ~Nl:>~ J../"'''''I.ING. ON 6."E. CeRN"""'" . , \1Z.\~ --t:: rlz.- -z,c; ~ NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 ELECTRICAL WORK PERMIT APPLICATION ~ /~ 1 AElectrical Contractor 0 Owner Installation description Commercial 0 Residential \J:) \v.l o Altered/Addition Lt\l') \)O~ V1ur~ ('(1\\ C\-eVICf'_ I n~i1lL1 ~ Ca~ -p\)II<<1 Irl~ crt\ttQ;VS 5000 5Q.fT Phune ., OWner us deft cd by RCW/9.28.26/.'(( Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor !/ above said properly is for sale, renl or lease. After reading the above statement, [ hereby certify that I am the owner of the above named property or a licensed electrical contractor. ] am making the electrical instal- lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter ] 9.2R, 'WAC. Chapter 296-468, Tl1c City of Port Angeles Municipal Code, and Utility Specifications. Signature o Cash o Check # o Credit Card Card # Visa Mastercard Discover contractor or electrical administrator Date: Expiration Date of card sOSP5f :cOo Service Information Electrical L d dditi D NO LOAD CHANGES o Baseboard KW o Furnace KW Cl Heat Pump Ton o Fan-Wall KW s and or subtractions LAR o Overhead Service o Temp Service o Underground Service Voltage PhaseD 1 03 Service Size: Feeder Size: SAME DAY INSPECTION CALL BEFORE 7:00 AM 360-417-4735 , - ROUGH-lN THERMOSTAT SERVICE LblC Appf<)v~J By Dak Apr>rovcd H} "- Dale Approved By FINAL I ( DITCH I I FErnER I I Dale Appruv<:tl By "- Dale Approved By-/ "- Dale Approved By Inspection i Area, Building or Equipment Inspected Action Taken Electrical Date Inspector j{j) /7~ /8/D8 Image Viewer IIaBIIOfAmertal~IItgherStaMBrdS ,---....---.- L~,:,.~~I Panel ;.m~~,;;--OO' rotate 0 0 cantrast 0 0 brig.....ess o. sharpen o. front/back 0 0 invert 0 0 ~ .view front and back ! L. revert to orial{ut~. m___j -- ________w~..un_..._.________ .~~~.ck _Info. J Account:: AmOUrlt: 222001 1976 1 51.001 65141 01/23/20081 Chedclf: Posted Date: Page 10f2 Bank of America Direct" L--~~~::--_._--=-//:;; - ip" /, .("__ J ==~ /'. > d r rJa.-r ~.- '- ..... I , I ....... iL_ _,,- __ .-=-~_w_ "ODr.51~" il:OUZDI5J'l': ,f n If ~ ,.':I( ~fU .~ f dlhli,hilll, i mitll~lli' 'I' ~tRrf'H . '~l'. I I, " ~ii~ H ~' I I ~~~3'}L'57~ "' 0,:".10 .s 6514 I '?)IYtGd:UU $ 51.CO . 'rf1'7 ~ -f!4. DolJ~ I ; ~_~I. 1'lI000005100,," . w_.n .___ __ __ .. _u~~._,__.. _ N .... ri!l. U d . -~ 1Wa!~.. . F.. , . -'!I~ F.:I.. i~ . la fi ah: - o;olil ~ ~ Ii II! . i~lr - (.:- fJ::' ~: ~i ~~~~: ~ Ift .... '" I I .... -'''' C::"7": ~ ~~~1l A. ~ 0- C> o. .~ _ r ,. ~ Secure Area Bank of America, N.A. Member FDIC. https://direct.bankofamerica.comlImagelBofaDirecllialdisplayDebidmage.do?P ARAM=O 1 fJe45e4bfi 9dc47Oc6b868152d72fc8... 1/2412008 ~ ~ ~ ~ ~ ~ = = = = ~ OX> "" "" OX> ~ C> = n, ~ ~ CO> -< = CO> = CO> = o ~ ~ co ~ ~ co ELECTRICAL INSPECTION WIRING REPORT 417-4735 OWNE~A~~~ ADDRESS PERMIT # 07-ItG'l ~ APPROVED NOT APPROVED o .................... DITCH . . . . . . . . . . . . . . . . . . . . 0 D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . ... . . . . 0 D. . . . . . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . . 0 D.................... . FINAL ...................~ CORRECTIONS NEEDED: ..~ Bo?\ ~OOr:- --- rolZ.. 0,..1 <::.01412\.:>\1 .sTO~ NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 .. ~ ,"ORT 04~ -\,O~Q~ S,~-~ ~ :r~-' '0 L- -==-.:JI' CI.I 0::." 41 ~0~."f Itt)RKS&':s:" ELECTRiCAL INSPECTION WIRiNG REPORT 417-4735 \';?M'f'lC ADDRESS '-i~ 8 APPROVED NOT APPROVED o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0 D. . . . . . . . . . . . . . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0 D. .. . . . . . .. . . . . . . . . . . SERVICE. . . . .. . . . . . . .. . . . ..0 D.. . . . . . . . . . . . .. . . . . . . FINAL. . . . . ... . . . . . . . . . . ..fA. CORRECTIONS NEEDED: ~0'6~ COIJ,;;./2. ~\E)'2.lofZ..., /_.. ~ f'11E..71EJ2.1 '" / e,"'i"1~ l7~ ";;C.. "FO~ . > , \t)~?'T HIE}l;I ?.......\>. 69YiN. ..:::::r-~ G-t..liEr-Llo'j'e;.V , _~~c..;~., e"?l'f:...-f-..\ ~ - EZ:>'L..KO ~~ ~..n....\12IC.~k.. ~~"VC>~~"D \.1\ I,", -.: "B-~H t r4 'IJ ~'T t<.9A--I'E1R.. .I~L.:'~. "'C> ..,..."., __ :nL~,'_OVTE.R 1ri.J>i.. ~ ,C:>'i?~,.j WI'e.F':~ t-=T7 i3.P>SM1'LN"- LlbrtTC;;" ~IE)<, ~-ru~ -;:;1101-'\. W'o:\:"LL.- Iu-L ~-P6"'JL\fJ:) \ ST....le:.WC""ll J.& LI 1.-.1 t-I-Cr \ . Yw ~. ~&-T 1'7 &f/lF lImU> ri/b, ~ :S-B-z::w ~1'IIl-n:> N.~.t'J I-b.&..'" :Ptrh."? SOHlE-aJE JJJeiJ1)5,. 10 K€EI 1"1 ~ c:::# 6e 6>rl.-T: NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 ELECTRICAL INSPECTION WIRING REPORT 417-4735 INSPECTOR IS-I \. ./ ADDRESS G APPROVED NOT APPROVED o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0 ~. ,?~'~~")~(,.... . . . ROUGH IN/COVER. . . . . . . . . . . . . . . 0 D. . . . . .. . . .. . . . .... . . SERVICE. . .. . . . . . ... . . . . .. . 0 D. . . . . . . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . . . 0 CORRECTIONS NEEDED: ADD lZ~s> ~N NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 ELECTRICAL INSPECTION WIRING REPORT 417-4735 " J2..IG APPROVED NOT APPROVED o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0 ');(. :;r.-",I;2;TI~. . . ROUGH IN/COVER. . . . . . . . , . . . . . . 0 D. . . . . . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . . 0 D.....................RN~....................D CORRECTIONS NEEDED: Cnl>1Z. R "'g L rY)1) )> 'g, A 'kJ NOTIFY INSPECTOR WHEN CORRECTIONS , . ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 c ELECTRICAL INSPECTION WIRING REPORT 417-4735 DATE PERMIT II INSPEC R II 07- b7~ OWNER/CONTRACTOR c9L<(k.'?t C ~ ~\C ADDRESS '1~ 3 lL- 6 s-r- APPROVED NOT APPROVED o .................... DITCH. . . . . . . . . . . . . . . . . . . . 0 D................ ROUGH IN/COVER.............. ~ D. . . . . . . . . . . . . . . . . . . . SERVICE. . . . . . . . . . . . . . . . . . . 0 D. . . . ... . . . . . . . .. . . . . . FINAL.. . . . . . .. . . . . ... . . . . 0 CORRECTIONS NEEDED: c:..P,OOt->1 D .,..., ~At ~)(\<:, . JI'Its'TAu_ huD g\M~S. bR "Dr;:ht) Ult .1 VGClAG:,"E Eax's ,J,FT\ L ?~T'~_ 1 Y..y 1ZITLfZ- ~"h.^"L ALe...... ko 1 S. NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS - DO NOT REMOVE - OLYMPIC PRINTERS, INC. (360) 452-1381 ~ ~~~~~.. <;~r;.~ lL. t:=..JJ.. ~~:..~ -... ELECTRICAL WORK PERMIT APPLICATION' .. " Date Expires / InstaJ.lation description E:J'" Commercial 0 Residential ~tered/Addition DNew .Job wired by o Electrical Contractor 0 Owner lot State ZIP Wi4- 1'r.f'YC'L 70aS>:J ~1- -1^k--f.> FAX number Premises owner's name rf --.t211.\~(J;l ji1A.~b(cJ Address of in~pection ..L.I W 3'3 E 8.!.--'-:I >f--~...cr- JOL-.-r ~yj.. J> , Phone number to schedule inspection: qG, (/-0 -1 Lj, {fO Owner (/.\' defined hy RCWIY.28.261:(I) Owner will occupy the structure for two years afier this electrical permi/ is finalized. (2) Owner is required to hire all electrical con/rae/or if above said property is for sale, ren/ or lease. A ftcr 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 instal- lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-468, The' City of Port Angeles Municipal Code, and Utility Specifications. Signature of owner, electrical contractor or electrical administrator XtJ~~ Date: 9 2-8'-0; Electrical Load Additions and or subtractions D NO LOAD CHANGES D Baseboard KW o Furnace KW o Heat Pump Ton LAR D Fan-Wall KW o Cash 0 Check # oICredit Card <fuii) Card # 17.,.,,-~ ~,-L V"- ;- It M d D' astcrcar Iseover . - ' ., '---~ ,~' - - - ~~- --------....~-....-.. --:: " Expiration Date of card Service Information o Overhead Service D Temp Service o Underground Service Vpltage PhaseD 1 D 3 Service Size: Feeder Size: SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN THERMOSTAT SERVICE Dale Appro.'coJ By Dale Approved By Date Approved By ANAL 'JfL~ ./ DITCH FEEDER Inspection Date Date Approvc<l By Date Approved By Area, Building or Equipment Inspected Action Taken Electrical Inspector .- .. ...... "" ~. " ~ ...... . -. .' G-3-0 . ELECTRICAL WORKP.ERMlT Al'l'LIi~TlON ..... Job wind by lB'EIt:elrlcal COlltra.lor Cl OWD.r n~llI..t1on ~loriptioQ ~ollUDercIaI 0 QesldellUal Q New ~h:"'edlAddlttoa Electrical cOOfrlcsor' I\Imo W;CGse bA&mbor DIU! ~ C7}J~//-- 4,J??,-'" (?~y~p;;:/:.2%,/// Pun:*JIf llIoilrns ~ ' t/2?/? :0ml../,1k..- ' CilY 1-;1 -L d / s.... ZIP t2:!2./7~/...f"'l VrJ. '7/76"J Telephone numbor FAX J1umbcr 0/- 1', tI N~w e/u..:ty(c-,v I {J'ln ~ I r IJtJ~ N,,!N iI1 H V.r. c...- ~ ,-1_bo .-eO I{S7 SJD 3 q Cash 0 a.eelc # ~ilCard VISll Mastercard Discover Card # . . . -------------:--~ x ExpiraliOll Dale of card Service Informatton t:&LOvo'h8ad Servloo lJ Te",~ SeNlce Q UlUlorground Service VDhaUG 1;)11 / ::HO Phase 0 I eh... Service SIze: Wo" Feec18'SIzAI: ~s 3So-'" SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417-4735 RQVGB-IN THERMOSTAT '\ .)..-9 rI DlII.' ~B'i g... App~od8J SERVICE ~4/~7 REDER FINAL .~ DrrCH D... A_MdIY U.k ~B, . JnlpcOlioa . D,IC Am. Building cr llqulpmollllnapCClcd A_nOlI TakA E~.tric.l laspootot R ~ .'~ , . . . .J''''''- ~ /i\Y 417 71'.1~'.' 1 ~I~1~3l3 ~IdW^lO 85~EGS~G9E E~:LI LGGG/SG/5G . . ~ 10 39\1d PORT ANGELES FIRE DEPARTMENT ~ FIRE ALARM SYSTEM PLAN REVIEW ,n '?b o l/ -:> LI$I ~-,~ Project Name: OMC 81h Street Clinic Address: 433 East 8th Plan # 07-19 I Installer: Cosco I Date: I 1.2 I .2007 We have checked this plan and find that it conforms to the requirements of our codes and ordinances. If this system is monitored by an off-site central station monitoring company, then the building must be equipped with a KNOX locking keybox. Contact the Fire Department at 417-4653 for a KNOX order form and for mounting location information. The following comments apply to all systems: 1. All systems shall be installed per NFP A 72. 2. A final field acceptance test will be conducted before final approval. The field acceptance test will be a test of ALL system components. NOTE: Prior to the issuance of a Certificate of Occupancy, compliance with the above conditions must be met. Reviewed by: ~Q.~ Buildmg Department Copy Date: ((.ZI'07 o o o m Contractor/ Owner Copy Fire Department Copy Light Department 2-13-204 '{~~. ~~ _' n" /' '~0' ~~;~, 9.04AM FROM ANGELES ELECTRIC INC 360 452 9265 ELECTRICAL PERMIT APPLICATION P,l .4', '- r;1 Th~ EWr:lric"r "'l~;n,il ^rplicCllion muSIJ?~ filled out comDJelelx_ '''''''J'''' ,,,.. ".\t" \'''Ll lJal~IJl~,., !'tllni,." H... ..1'1'''.~t,' n.,. '. JJ"tl~",".I:___._._ f OY-/,2./ Ple~~(' IyfX' or rep,inl In Ink. If YOu hav!!, ~lIly qUf!Sllons, please cell (360. 417-4735 Fa)' numnF!r~ (360) 41 '1-4711 , REQUEST INSPECTION 0 Owne, '" ElK (;O<>II"clo, Age"I:-.ANGELE5-ELECTR I (' I NC___ rhOI1.':A.5;;> _ '1764 rlOpel1~ ()wner: \I; r... : fI 11 M a5DVl r j T /11 7C- I , i-/ 3,~ "'G 5 -r' <?(h Fax: 4'17-'171><; Phone: Address: electrical COllllf:lClor; ANGELES ELECTHIC INC. Cily:_ M~GF.LF: 14 60RS Li(;(~'I~C t/; Exp: Zip: Phone' d 1:i?_Q"h4 524 EAST FIRST Addles~: City: PORT ANGJ':!--ES. WA zip:~B362 INSTAllATION WIRED BY: I. IOWNER x\i'lECTRICAL CONTRACTOR Credit Card Holder Name: '1'",,1 <: impsoJl Billing Address: " City: Credit Card Number: Exp, Date: Zip: VISA:_MC:_ PROJECT ADDRESS: '-133 ~ Bd S-r ,/ ~/N/,4 4~" ,0 /'1 C L-t.--/1tJ Ie TYPE OF WORK: Checl, all Ihal apply: lJ New .0 Alleralion/Addition o Residenlal 0 Multi-Iamily fJ Commercial . 0 MObile Home Sq. FL o Remolc MeIer 0 Detached garage rJ Hol Tub 0 Swim Pool 0 Seplic Pump 0 Low Vollage 0 Telecom. 0 Sign Number of Circuils added or altered: -S- DESCRIPTION OF THE ELECTRICAL PROJECT: Re.- loc:- ;)-fe- Su...;",+-eAeS =r 01/ i/.el.s o Baseboard '.J Furnace ':J Heal Pump _1 Fan-Wall _KW _I<:W _KW _KW !(~t), ~~ o Overhead Service . o Temp SErvice LJ Underground Service Service Information Elecirical Heal Load Additions Voilage: Phase: 0 1 0 3 Service Size: Feeder Size: ~AMC 14.05.060{B):' F~f industrial, commercial, 8. residenlial projects larger than a duplex. a one - line drawing of the Electrical ServIce & =eeders. building size (sq. h.), load calc'Jlalions. and the type & of conduclors and/or raceway Is required and shall accompany Ihe =:Ieclncal Permil applicalion. , hereby certify that t have read and examined this application and know that same to be true and correct.' and I am lUthorized to apply for this permi/. I ,;mderstand it is not the Cily's legal responsibility to determine what permits ~re required; it remains the applican/S responsibility to determine what permits are required and to obtain such. <L!r7~4- . . 9. K\ I Credll card~'o'der'sSignature:~'li f?' ~l/.n.l ~ Dale: ?./r~/o'l 'W-galg M c:~/,o~/-c'C:"?;~7;d (/{;(;~ -al:. 4'$ ;~~~. ~r,^,b;'/ ./IV ItP 2..-/3~c><( -. ~~ ~IV'/L ,,1~.:l~-t:J,/ ~^-- ;!co Z/;f/t'l j~9r?lL9 ELECTRICAL PERMIT CITY OF PORT ANGELES 360- 417 -4735 Application Number . . , 16- 00000311 Date 3/03/16 Application pin number . . . 309139 Property Address . . . . 433 E 8TH ST ASSESSOR PARCEL NUMBER: 06- 30- 00 -0 -2 -2595 -0000- REPORT STATE SALES TAX Application type description ELECTRICAL ONLY on your excise fax form Subdivision Name . . . . . . Property Use to the City of Pori Angeles Property Zoning . . . . . . . COMMERCIAL. NEIGHBORHOOD (Location Code 0502) AppliCation valuation 0 Application desc x -RAY Owner Contractor RESULTS: CLALLAM COUNTY PUBLIC HOSPITAL SIMPSON RLECTRTC 939 CAROLINE ST 243036 W HWY 101 PORT ANGELES WA 95362 PORT ANGELES WA 98363 6 (360) 457 -9270 ---------------------------------------------------------------------------- permit , . . , , , ELECTRICAL ALTER COMMERCIAL Additional desc , . COMMENTS: Permit Fee 1E2.00 Plan Checic Fee .00 Issue Date 3/03/16 valuation , . , . C Expiration Date 8/30/16 Qty Unit Charge Per Extension 4.00 5,0000 ECH EL- BRANCH CIRCUIT W. /FEEDER 20.DC 1.00 132,0000 ECH EL -COM 0 -200 SRV FEEDER 132.00 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- Permit Fee Total - - - - -- 132.00 ---- - - - - -- ---- - -- - -- -- 152,00 Do -- - -- - -- .00 Plan Check Total .00 ,00 Do .00 Grand Total 152,00 152,00 .00 00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN 6 FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTIIS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: 1 CUT OF FORS` ANcaxs pxaWV A"UCA 1I WN Br�t `lBwg Myis l r-CM Iop,ecdom X21 stk S6"�—RM Bot X1501port RenlabAdftsm eUWMV Skpa ate_. RECEI j�t b, f 2011 � �14u��at�iy �rtml�r�ar �c�ri�� or . � ri"C'iions Cortlplete 4ecWw Plan Revert ( � i�am�e MMft It � ' �i7vo $a.oa :ie+�rOM -I�, p, 628840 � awW 9400 Atrgx $41C Loo a(c* w1sowM Feeder $ SAD Ar &Nwh °r !t�r $ 74.00 R?4ftQrCUft 1,4 $ aoe TOM Aueder2WAmp_ $ 881490 TmP - S��201 -4D0 MN $ IO'O TOW �ee�let41i9 MAmp- 4'atlal io 0114MO Amo , $ ip3a o softwwwft I $88,00 Signal CRUM Liam EhemyrFirst Igo or— GDtrmR Mm 3 Roo Nate: $ octal 9500 sl' nommft EtOlMl 1► -OVA Sys= orLNs 113,00 MOkcl&00ibrqchRdanrWT,%t - $ 1%180 TOW 6mler es Wmd by RCW.1928.a1. (1) Owner w7l s -2 raw hD lM an eleC l cones IFaNVe said tit�Cr�pyr the sktdM e w to YMrs alter this elec"zl pettntt Is fi mr&ed. (2) 4 �twttar is tSWhed P l/ K*r Bob, or tem. Aerrnit en pkw ,k afti s a#law �n 'After t�idg � a•� l �]► oer8ify # am the Owner of the tghove rtt�nnet# the ele0 t�l lnsUffa vtt oraftlaft i4 M* w1h fire �° �a � � !Mt I am Angeles Mutde I. CWO, and e � hn. N.F —C,. RM ChaPtOr 19X WA C, UM W Z9B�#66, the Cl y � C,. Sp iirans anti PitNIC 94.05 4'J5U ng het ) P�Srang4p pW ""�f i@ DF a4Mlifl�t'� � C ®F ®�C4b(ral atll'kt�r; AMWaWw v7 5"" CMdi[1a9Mto i 2r paled: " l ny►nrl2atz V� ELECTRICAL INSPECTION WIRING REPORT 417�4735 APPROVED NOT APPROVED ...... ............. DITCH ......... .......... 11 ................ ROUGH IN/COVER ... —,— ...... 11 El......... o .......... SERVICE ................. 0 0 ......... FINAL. . .... ...... —)� CQ9RECTIONS NEEDED: w NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS �p 0 �16 I 0- - Application Number . . . . . 22-00000764 Date 6/27/22 Application pin number . . . 084916 Property Address . . . . . . 433 E 8TH ST ASSESSOR PARCEL NUMBER: 06-30-00-0-2-2895-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL NEIGHBORHOOD Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Fire panel circuit ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLALLAM COUNTY PUBLIC HOSPITAL SIMPSON ELECTRIC 939 CAROLINE ST 243036 W HWY 101 PORT ANGELES WA 98362 PORT ANGELES WA 98363 (360) 457-9270 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee . . .00 Issue Date . . . . 6/27/22 Valuation . . . . 0 Expiration Date . . 12/24/22 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 MULTI-FA MILY/ COMMERCIAL ELE CTRICAL PERMIT APPL ICATION Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:-------------------------------------- Project Description:--------------------------------------□Multi-Family Residential D Commercial I 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 llim! Service/Feeder 200 Amp. Service/Feeder 201-400 Amp. Service/Feeder 401-600 Amp. Service/Feeder 601-1000 Amp. Service/Feeder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Branch Circuits 1-4 Temp. Service/Feeder 200 Amp. Temp. Service/Feeder 201-400 Amp. Temp. Service/Feeder 401-600 Amp. Temp. Service/Feeder 601-1000 Amp. Portal to Portal Hourly Sign / Outline Lighting Signal Circuit/Limited Energy -Multi-Family Signal Circuit/Limited Energy/First 1500 sf -Commercial (Note: $5.00 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5 for each additional) Unit Charge Quantity $132.00 $160.00 $225.00 $288.00 $410.00 $5.00 $74.00 $5.00 $86.00 $102.00 $121.00 $164.00 $185.00 $96.00 $88.00 $88.00 $96.00 $113.00 $56.00 Total (Quantity x Unit Charge) $ ____ _ $ ____ _$ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ _____ 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 (0 Owner D Electrical Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us] lJ CD ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS: Fire alarm panel circuit NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 7/15/2022 22-764 TAP OWNER CONTRACTOR Simpson Electric PROJECT ADDRESS 433 E 8th St