HomeMy WebLinkAbout2417 W 19th St - Building CITY OF PORT ANGELES
r DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00001250 Date 11/03/11
Application pin number 773750
Property Address 2417 W 19TH ST
ASSESSOR PARCEL NUMBER: 06- 30- 00 -1 -1 -1900 -1000- REPORT SALES TAX
Application type description MECHANICAL APPL. PERMIT
Subdivision Name on your state excise tax form
Property Use to the City of Port Angeles
Property Zoning INDUSTRIAL LIGHT
Application valuation 2800 (Location Code 0502)
Application desc
STEFFES HEATER
Owner Contractor
PORT OF PORT ANGELES PENINSULA HEAT INC
PO BOX 1350 782 KITCHEN -DICK RD
PORT ANGELES WA 983620251 SEQUIM WA 98382
(360) 681 -3333
Permit MECHANICAL PERMIT
Additional desc
Permit Fee 64.80 Plan Check Fee .00
Issue Date 11/03/11 Valuation 0
Expiration Date 5/01/12
Qty Unit Charge' Per Extension
BASE FEE 50.00
1.00 14.8000 EA ME- FURN /HP /FAU OR 5 TON 14.80
Fee summary Charged Paid Credited Due f9 n 1 1 17-
Permit Fee Total 64.80 64.80 .00 .00 r
Plan Check Total .00 .00 .00 .00
Grand Total 64.80 64.80 .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 cified herein or not. The granting of a permit does
not presume to give authority to violate or cancel the provisio of any stet: o' oc -I I. I regulating construction or the performance of
construction.
//3r CA4 rk ilde
Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder)
T:Forms /Building Division /Building Permit
BUILDING PERMIT INSPECTION RECORD
PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS
Building Inspections 417 -4815 Electrical Inspections 417 -4735
Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886
IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED.
POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE.
Inspection Type Date Accepted By Comments
FOUNDATION:
Footings
Stemwall
Foundation Drainage Downspouts
Piers
Post Holes (Pole Bldgs.)
PLUMBING:
Under Floor Slab
Rough -In
Water Line (Meter to Bldg)
Gas Line
Back Flow Water FINAL Date Accepted 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:
Slab
Wall Floor Ceiling
MECHANICAL:
Heat Pump Furnace FAU Ducts
Rough -In
Gas Line
Wood Stove Pellet Chimney Jae"
Hood Ducts FINAL Date 6' 11' 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 -4831
Fire 417 -4653
Planning 417 -4750
Building 417 -4815
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PROJECT STATUS UPDATE
Permit 120
Date: (o 1
I phoned the: Applicant ChCkn e--- W Pe✓t 2l*" at f 1 3�3�
Property Owner at
Contractor at
I (left a phone message, or discussed): evy)cula
The perm' (has expir- or will expire soon). What is the status of this project?
ease call and schedule a final inspectio
Submit a "permit extension request" letter.
Or
Let me know if the project is abandoned.
(WIlr I I?f
T:Forms /Building Division/Project Status Update
Nov 03 11 09:35a PENINSULA HEAT 3606812086 p.1
BUILDING PLUMBING MECHANICAL PERMIT APPLICATION SHORT FORM
(To be used for projects that do not require plan review.)
Date Received tt'� t.
Permit 1V (2-50
City of Port Angeles Please print in ink. Date Approved
Attn: Building Permit Technician Approved by 2
321 E. 5 St., Port Angeles, WA 98362
360- 417 -4815 fax: 360 417 -4711 Credit card payments are accepted Mon -Fri 8 -5 pm (no Amerscan Express)
Hours: Mon through Fri 8 5 pm Cash checks are accepted Mon -Thurs 8:30 -4 pm Fri 8 :30 -12:30 pm
Phone:
L. :HZ:6., L e ,4 1
Contact person i s�'r✓ 3
Property owner
e:* Phone:
Property owner's mailing address: 1I
Contractor's business name: it Y i �[L��y Phone:.
(or property owners name if he/she is doing /overseeing the work) kl 3.3 3
Contractor's mailing ad ress:
Contractor's 1 license number Expiration date'
tv 4) L /zio ti 6� i s
Project Address:
sV-«
Project Type: o Residential o Commercial ileKdustrial o Multi- family
Project Business Name:
(for commercial, industrial, cr multi family projects) C.- n /CI ileir1 /27rai i'/? Si 7 /9/:=
The following permits are usually issued over- the counter immediately, without the need for plan review.
Complete only the portions of this permit that are relevant to your project.
Re- roof: o house garage other
o tear off re -roof o lay over one layer
(d) Licensed contractor: Submit a copy of your re-roof bid.
Project Valuation (labor materials, not including sales tax)
Re -side: o house a garage o other
Project Valuation (labor materials not including sales tax)
Repair: (explain the project)
Project Valuation
`Homeowner: If you will be doing /.overseeing the work, then the project valuation will be determined by doubling the
cost of materials, tc reflect the value the repair adds tc your property.
Cost of materials x 2 Project Valuation
T :Forms /Building Division /Building /Plumbing/Mechanical Permit Application Short Form (Revised 2011)
Page 1 of 2 f
i i� riYl/ ior, /2Ce5 S
�`i 3' efiv_ 44 i f-
Nov 03 11 09:35a PENINSULA HEAT 360681.2086 p.2
Swimming Pool or Spa 24" deep): For prefabricated swimming pool or spa projects that
do not require plan review:
Obtain the City of PA handout entitled "Pools Soas" follow the requirements.
Project Valuation 5
Demolition: A demolition permit is needed when an entire building gets demolished.
What will be demolished? house o garage other
Note: some demolition permit applications need to be reviewed by various City departments, and may take
approximately two weeks to obtain.
Agree to ensure that all utilities arelwill be properly turned off and capped off if needed)
prior to demolition.
Obtain (from the City of PA) an aerial view map of the parcel and put•an "x" over the•structure(s) to
be demolished. Submit the map with this application.
Obtain (from the City of PA) a copy of the Olympic Region Can Air Agency (ORCAA)
Demolition f enmit Application,
Contact ORCAA 'at 360- 417 -1466 to discuss whether or rot an ORCAA Demolition Permit will also
be needed.
o yes no Will the debris be going to the Regional Transfer Station in Port Angeles?
o yes o No If yes, will a licensed contractor be taking it there?
If yes, obtain (from the City of PA) a copy of the Waste Disposal Application.
Complete and submit the waste disposal application to the Building Permit Technician, how
(o- later if asbestos testing is needed).
Plumbing Permit: (explain the project)
Project Valuation
Mechanical Permit: (explain the project)
,13/ 1/ ��-0 kilPf
Project Valuation 2,
1 have read and completed this application and know it to be true and correct. l am authorized to apply for this permit
and understand that it is my responsibJlit o determine what .ermits are required, and to obtain permits prior ro
working on projects.
Date /1/ Signature �L�
Print Name CLe--/- fi�c aF
Page 2 of 2
ELECTRICAL PERMIT I
CITY OF PORT ANGELES VJ
360- 417 -4735 0
Application Number 11- 00001325 Date 11/28/11
Application pin number 790600 REPORT SALES TAX
Property Address 2417 W 19TH ST our excise tax form
ASSESSOR PARCEL NUMBER: 06-30-00-1-1-1900-1000- 017 y
Application type description ELECTRICAL ONLY to the City of Port Angeles
Subdivision Name
Property y Use (Location Code 05 02)
Property Zoning INDUSTRIAL LIGHT
Application valuation 0
Application desc
demand heater circuit
0
Owner Contractor
PORT OF PORT ANGELES OLYMPIC ELECTRIC CO INC
N
PO BOX 1350 4230 TUMWATER
PORT ANGELES WA 983620251 PORT ANGELES WA 98363
(360) 457 -5303 1115- Z 3L 5
Permit ELECTRICAL ALTER COMMERCIAL l ........3
Additional desc
Permit Fee 73.50 Plan Check Fee .00
Issue Date 11/28/11 Valuation 0
Expiration Date 5/26/12 El
.Qty Unit Charge Per Extension
1.00 73.5000 ECH EL- BRANCH CIRCUIT WO /FEEDER 73.50
Fee summary Charged Paid Credited Due
Permit Fee Total 73.50 73.50 .00 .00 f
h ill i
Plan Check Total .00 .00 .00 .00 V
Grand Total 73.50 73.50 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH IN Iz lgl 1 6)
FINAL a l g I i „I. -X?
COMMENTS: f''�'
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G: \EXCHANGE \BUILDING
11/22/2011 11:07 FAX 360 452 3498 Olympic Electric Co. PA CITY INSPECT a 001/001
CITY OF PORT ANGELES PERMIT APPLICATION REed
Building Division/Electrical Inspections r: A 1
321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 u
Ph: (360) 417 -4735 Fax: (360) 417 -4711
ELECTRICAL -7
data /Z/Z„.27/// INSPECTIONS
_'1$ 2 Single Family Dwelling Multi- Family or Commercial` �mmercial Addition Alteration 1 Remodel Repair*
Plan Review May De Required a Complete Electrical Plan Review Information Sheet
Job Addrue�z zy 4,/ T;$
Building Spare Feotegs
Dasaippon of thew f,/ i►' ;'y —C
Ownerinfontptlon Contractor Information
Name: l /,7//7 -r7 72' 7 Name: ciLYNP2c gI Ecrxzc
Melling Addreee
Melling Address: 4230 TUNHATER
City e,< r Stems L../(7 bp: 2,0,<T Cir..�QBZ/MOLES State: WA Zjp: 9 9 363
Phone: Far: Phone; g57 53o3 Fex: 452 -3499
Unease F1p. license Exp. O1,1I.PEC2 p5D1
Item r tCh a Total (Qty Multiplied by link Chargel
Service/Feeder 200 Amp.
Service/Feeder 201 -400 Amp. 14550
Service/Feeder 401-600 Amp 204.60
Servlce&Feeder 601 -1000 Amp. 2 220
ServicalFeetler over 1000 Amp. 372.50
Branch Circuit W/ Sevice Feeder 2.60
Branch await Wl0 5avice Feeder 73.50 _I__ 73 4.1i'
Each Adc6tlonal Branch Circuit 2.60
Temp. Sevioe/ Feeder 200 Amp. 9270
Temp. ServioalFeeder 201-400 Amp. 110.30
Temp. Service/Feeder 401 -600 Amp_ 148.70
Temp. Sen s/Feeder 601 -1000 Amp 1167.90
Portal to Patel Hourty 95.90
SignlOulfine Lighting ::.20
Signal C l/ Limited Energy Fast 1500 sf Commercial 95.90
Note 35.00 for each addltimat 1500 sl
Signal Circuit/ United Energy -162 Feely Dwelling 63.90
Signal Giro.g/ Limited Energy Multi-Panay Welling 63.90
Manufactured Home Cannecgan 119.90
Renewable Electrical Energy 5KVA Sysfan or Less $102.30
Themoslat 56.00
NEW CONSTRUCTION ONLY:
First 1300 Square FL $110.30
Each Additional 500 Square Ft orPorten of 35.20
Each Outbuilding or bate tied Garage 73.50
Each Swimming Pool ar Hot Tub 110.30
77 Total
Owner as defined by RCW.19.28.261: (1) Owner will occupy the struchue for two years alter this electrical permit Is finalized, (2) Owner Is required
to hire an electrical contractor if abuser sad property i4 for sale, rent or lease. Permit expires after six months of lest inspection.
After reading the above statement l hereby certify that 1 am the owner of the above named property or a licensed electrical contractor. I am making
the elscbirwl installation or alteration in compliance with the electrical laws, N.E,C., RCW. Chapter 19.28. WAC. Chapter 298 -498, The City of Port
Angeles Itbmicipal Code, and U6ity Speaficatlons and PAMC 14.05.050 regarding Electrical Permit Applications.
Slgnatraa of owner, electrical contactor or electrical administrator: D cash D chest
Ill Credit Card 0
fwd: oiiut 010
4
0
0
C E RTIFICATE OF OCCU PA N CY
City of Angeles'- 'BuildrgpiivIslon
This certificate is issued ursuant of Section 111 of the 2009eternational Building Code
certib,ing that at the tiine(q 04tanee in compliance; with the various ordinances of the City
fo
regulating building
ral lain:Trangdaystem ,(0\10Pit
241M 19 St
,4 .4.
Business name
Business address
Property owner
Property owner s PO Box 185.CPoittAngelesAZ*98"464402:51
Automatic fire sprinkler?syStem. Not Required;
Use occupancy crasSifidation. Business m.
Building permit numbcrst
Occupant load. Per;
0: ■■..T
Type of construction.
03
anzung imager Date
Post on the premises in a conspicuous place. CeitificafeVall not be removed except by the Building Official.
P
ck'
4
ORrA CERTIFICATE OF OCCUPANCY APPLICATION Permit
CITY CLERK phone 417 -4634
CITY OF PORT ANGELES
Attn. Permit Technician
321 E. Fifth St. Port Angeles, WA 98362
(360) 417 -4815 fax (360) 417 -4711
PLEASE PRINT INK
Check one New business in P. A.. ❑'Changee of ownership only ?X oving location from within P.A.? Zoning
BUSINESS NAME d(ALA `"1 ci/— T /VS /T_
Business address oW 17 1l1 FST J? E_1 Mailing address 830 WWS7T Jk/A )4611 4
Phone number 44S /S Opening date S .b/IDays hours of operation H-F /'4i -1-5M4
Business owner's name C /31 -1— CopOct phone 5 S
Business owner's address 830 WEST /2/4A1 jr-40 "40 &/,S 9K3-.5
Brief description of business Ot' Sri CE. 72)e-. 7'A 17 ..17U /7 ":".A S CP 2f1
Property owner's name 6F ir' t 'TkU s E S Contact phone .-34:
Property owner's address /contact 3 8 11.*S7' e_SrSTE .e0T, PileT CS tIPS
1-011.-q
BUILDING DEPARTMENT phone 417 -4815 Bldg approval by on
/go C H ES
Is the business a restaurant or bar that will seat 50 or more people? Yes No
Construction changes planned (moving walls adding /enlarging windows or doors roofing siding foundation work,
adding /altering stairways ramps, bathrooms electrical, heating /cooling /ventilation systems, etc)
Work planned
FIRE DEPARTMENT phone 417 4653
Changes to a fire sprinkler system or fire alarm system? Yes No
Work planned
PBIA (Parking Business Improvement Area Downtown) phone 417 -4623
Square footage of business?
Is business moving within the PBIA? Yes No
Second -hand dealer /pawnbroker business? Yes No
Will there be dancing at this business? Yes No
A City of Port Angeles Business License is required for
Taxi, Peddlers, Second -Hand Dealer Pawnbroker Dance,
Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
FEES
Certificate Inspection
Parking Business Improvement Area (PBIA)
fee charged for Downtown locations
Fire approval by on
PBIA notified
City Clerk approval by S I{ on 11
Pr
COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750 CED approval by SR. on --114-1(
Number of off street parking spaces available for employees and
customers?
(A parking plan may be required.)
Signs? (wall- mounted freestanding projecting awning A- frame, etc
Signs planned
PLEASE NOTE. NO flashing intermittent, or chasing signs are permitted in the City of Port Angeles.
PUBLIC WORKS DEPARTMENT ENGINEERING phone 417 -4812
Is site work planned (new or re- located sewer or water service
excavation grading or filling, work in City right -of -way
new driveway openings site drainage parking lots, downspouts,
irrigation system backflow devices etc.) Yes No
Work planned
PUBLIC WORKS WASTEWATER phone 417 4845 PWW approval by
Will waste, other than domestic household waste be discharged into the sewer system? Yes
If yes, what will be discharged
I hereby apply for a Certificate of Occupancy I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge Incorrect information may result in revocation of
permit.
1 1 y Wee=d'
T \Forms \Building Division \Certificate of Occupancy Application (2010) doc
Date Print Name
Call for Certificate of Occupancy inspections BEFORE openina business.
Building Department Inspection 417 -4815
Fire Department Inspection 417 -4653
Please sign up for utility services at the cashiers' counter
Page 2 of 2
Signature
PWE approval by V on 3 II
No
Clallam County Assessor Treasurer Property Details 61107 PORT OF PORT ANG Page 1 of 3
Clallam County Assessor Treasurer
Property Search Results 61107 PORT OF PORT ANGELES for Year 2011 2012
Property
Account
Property ID'
Geographic ID
Type.
Tax Area
Open Space
Historic Property
Multi- Family Redevelopment:
Township:
Range
Location
Address.
Neighborhood
Neighborhood CD
Owner
Name:
Mailing Address.
N
Taxes and Assessment Details
Property Tax Information as of 03/14/2011
Amount Due if Paid on. E.
61107
0630001119001000
Real
0010
N
N
1402 AIRPORT RD
PORT ANGELES WA 98362
Exempt Ref Region 5
50985200
PORT OF PORT ANGELES
PO BOX 1350
PORT ANGELES WA 98362 -0251
Legal Description.
Agent Code.
PA 121 PORT ST CNTY H2 L WMP Land Use Code
DFL
Remodel Property
Section:
Mapsco
Map ID'
Owner ID'
Ownership
Exemptions:
NOTE. If you plan to sub
click RECALCULATE to
Ili Clallam Transit System
Year Statement ID Taxing Jurisdiction
I, 2011 155589 ST SCH STATE SCHOOL
2011 155589 CC -GEN COUNTY CLALLAM
2011 155589 SD #121 SCHOOL DISTRICT #12
1 2011 155589 CITY PORT ANG CITY OF PORT ANGELE
2011 155589 PORT PORT OF PORT ANGELES
2011 155589 NTH OLY LIB NORTH OLYMPIC LIBRARY
2011 155589 HOSP #2 HOSPITAL #2
2011 155589 WSMET PK DIST WILLIAM SHORE MET PARK DIST
2011 155589 CITY_STORMWATER CITY STORMWATER $27.69
2011 155589 WEED CONTROL WEED CONTROL
2011 155589 TOTAL.
2010 43866 ST SCH STATE SCHOOL
2010 43866 CC -GEN COUNTY CLALLAM
2010 43866 B D :#121 SCHOOL DISTRICT #121
2010 43866 CITY PORT ANG CITY OF PORT ANGELES
2010 43866 PORT PORT OF PORT ANGELES
2010 43866 NTH OLY LIB NORTH OLYMPIC LIBRARY
2010 43866 HOSP #2 HOSPITAL #2
LTS 119 -126 141
150 VAC STS
ABTG SURVEYS V14
P11 V25 P99 V27
P17•V42 P70'V44
P49 P54
SURVEY V69 P7
89
N
N
3
46786
100.0000000000%
EX
830 W Lauridsen Blvd.
Port Angeles, WA 98363
mebower@clallamtransit.com
MARY E BOWER
Office Manager
Clerk to the Board
360.452•1315
FAX 360•452•1316
$0.00 $0.00 $0 00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0.00 $0.00 $0 00
$27.69 $0 00 $0.00 $55 38 $0 00
$0 82 $0 81 $0.00 $0 00 $1.63 $0 00
$28.51 $28.50 $0.00 $0.00 $57.01 $0.00
$0.00 $0.00 $0 00 $0 00 $0 00 $0 00
$0.00 $0.00 $0 00 $0 00 $0 00 $0.00
$0.00 $0 00 $0 00 $0 00 $0 00 $0.00
$0 00 $0.00 $0 00 $0 00 $0 00 $0 00
$0.00 $0.00 $0 00 $0.00 $0 00 $0.00
$0 00 $0 00 $0.00 $0 00 $0 00 $0 00
$0 00 $0 00 $0 00 $0 00 $0 00 $0 00
http. /websrv8 clallam. net propertyaccess /Property.aspx ?cid =0 &year= 2011 &prop_id =61107 3/14/2011
sRT,�� CERTIFICATE OF OCCUPANCY APPLICATION Permit#
PLEASE PRINT INK
Check one. New business in P.A.? ❑(Change of ownership only ?X oving location from within P.A.? Zonings
BUSINESS NAME &-46-6-4/4 T ST
Business address ,R v>/ 57 7t Mailing address X13 WF l C�Itik/ASO/U l/D�r
Phone number 4'S /3 /.S Opening date S/ >OLDays hours of operation H F /S/4M 3
Business owner's name &(JCL �L!/V7 Co act phon e 5� /3
Business owner's address B3C) YL S L,Mi2/a A_ 6L0/3 L5 v S 9E(.,p3
Brief description of business O,' r/CE. f ST U /CF S .64
Property owner's name 75F MkSE.CFS Contact phone 260P-A57 7
Property owner's address /contact 33' WA,% -.ST h /f 3(��
IOW/ E« `i- 3V:sit1
BUILDING DEPARTMENT phone 417 -4815
,4Q
Is the business a restaurant or bar that will seat 50 or more people? Yes No
Construction changes planned (moving walls adding /enlarging windows or doors roofing siding foundation work,
adding /altering stairways ramps bathrooms electrical heating /cooling /ventilation systems, etc)
Work planned
FIRE DEPARTMENT phone 417 -4653
Changes to a fire sprinkler system or fire alarm system? Yes No
Work planned
PBIA (Parking Business Improvement Area Downtown) phone 417 -4623
Square footage of business?
Is business moving within the PBIA? Yes No
CITY CLERK phone 417 -4634
CITY OF PORT ANGELES
Attn. Permit Technician
321 E. Fifth St. Port Angeles WA 98362
(360) 417 -4815 fax (360) 417 -4711
I
Second -hand dealer /pawnbroker business? Yes No
Will there be dancing at this business? Yes No
A City of Port Angeles Business License is required for
Taxi, Peddlers, Second -Hand Dealer Pawnbroker Dance,
Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
FEES
Certificate Inspection
Parking Business Improvement Area (PBIA)
fee charged for Downtown locations
Bldg approval by on
Fire approval by on
PBIA notified on
City Clerk approval by on
COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750
Number of off street parking spaces available for employees and
customers?
(A parking plan may be required.)
Signs? (wall- mounted freestanding projecting awning A -frame etc
Signs planned:
PLEASE NOTE. NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PUBLIC WORKS DEPARTMENT ENGINEERING phone 417 -4812
Is site work planned (new or re- located sewer or water service
excavation grading or filling work in City right -of -way
new driveway openings site drainage parking lots, downspouts
irrigation system backflow devices etc.) Yes No
Work planned
PUBLIC WORKS WASTEWATER phone 417 -4845
PWE approval by RV on 3 —J -a
)V 0- r .4%.:1/6"
CED approval by on
PWW approval by on
Will waste, other than domestic household waste be discharged into the sewer system? Yes No
If yes, what will be discharged
Call for Certificate of Occupancy inspections BEFORE opening business.
Building Department Inspection 417 -4815
Fire Department Inspection 417 -4653
Please sign up for utility services at the cashiers' counter
I hereby apply for a Certificate of Occupancy I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of
permit.
Date Print Name ej"f'y 1 °ee'c0
T\Fonns \Building Division\Certificate of Occupancy Application (2010).doc
Page 2 of 2
Signature
v
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER
Application type description
Subdivision Name
Property Use
Property Zoning
Application valuation
Application desc
Ballast replacment t12 t8
Owner
PORT OF PORT ANGELES
PO BOX 1350
PORT ANGELES
Permit
Additional desc
Permit pin number 148023
Permit Fee 69 50
Issue Date 6/09/09
Expiration Date 12/06/09
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
INSPECTION TYPE
DITCH
SERVICE
ROUGH IN
FINAL
COMMENTS
WA 983620251
ELECTRICAL ALTER COMMERCIAL
Charged
69 50
00
69 50
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 417 -4735
09 00000559
127568
2417 W 19TH ST
06 30 00 1 1 1900 1000
ELECTRICAL ONLY
INDUSTRIAL LIGHT
0
Contractor
OLYMPIC ELECTRIC
4230 TUMWATER
PORT ANGELES
(360) 457 5303
69 50
00
69 50
Plan Check Fee
Valuation
Qty Unit Charge Per
1 00 57 5000 ECH EL BRANCH CIRCUIT WO /FEEDER
6 00 2 0000 ECH EL ECH ADDNT BRANCH CIRCUIT
Paid Credited Due
00
00
00
DATE RESULTS
4 2,6 i AV
Signature of owner or Electrical Contractor X Date
Date 6/09/09
WA 98363
00
0
Extension
57 50
12 00
00
00
00
INSPECTOR.
FltP
0
-a
DATE PERMIT
ADDRESS
ELECTRICAL INSPECTION
WIRING REPORT
417 -4735
0L -05
INSPECTOR
APPROVED NOT APPROVED
DITCH
ROUGH IN /COVER
SERVICE
FINAL
CORRECTIONS NEEDED: S CE ALL, ONLV ItiPC It! 46S
u D V LEO GZ.4
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
DO NOT REMOVE
OLYMPIC PRINTERS, INC. (360) 452 -1381
06/08/2009 10 59 FAX 360 452 3488
City of Post Angeles Permit Application
Building DivblonlEledoial Inspections
321 East Filth Street— P.O. Box 1160
Port Angeles W lisingtonn MOM
Ph: 0) 417-4735 Fax: (360) 417 -4711
Date: W"://',
Owner Inform
Name: 7 /r (7 T
Mailing Address: .P i ll
Cit e A r c State:1A/A 3p: •f74s
Phone Fax:
License Exp.
Signature of owner, atoddeal contractor or electrical administrator
Oly IV E D PA CITY INSPECT
JUN 2009
LIGHT DEPT
1 2 Single Family Dwelling
Multi Family or Comnrerciar
Commercial Addition Alteration Remodel Repair'
Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: h/ 7 9 CO g7, T 7.*
Building Rio t*: IJ4
Description of above 14..4'i: /1'�ii R f 57,-0 7 17?
Contractor Information
Name: D /y,)i#r' �r�1 r
Mailing Adds se! kZ Ti7
City: Pr fr9., i Status f/ 6
Phone:y,�`7 -e,3 Fax yr` 4/{p
license Exp._,/,CdA' I' Z
Unit Charge ftr Total (Qt► Mullipled by Unit Charge),
93.75 .5 ServicalFaeder 200 Amp.
$113.75 Service/Fooder201-400Amp.
$160.00 Service/Feeder 401.600 Amp.
$205.00 ServicelFeeder 601 -1000 Amp.
$291.25 Service/Feeder over 1000 Amp.
200 Branch Circuit W/ Service Feeder
57.50 (i7 SO Branch Circuit W/O Service Feeder
2.00 4' $._,/j._ Eeoh Additional Branch Circuit
72.50 Temp. Service/ Feeder 200 Amp.
8625 Temp. Senrice/Feeder 201.400 Amp,
$116.25 Temp. Servio&Feeder 401600 Amp.
$131.25 Temp. Service/Feeder 601.1000 Amp.
75.00 Portal to Portal Hourly
69.00. Sign /Outline Lighting
75.00 Signal Circuit/ Limited Energy Commercial
50.00 S Signal Circuit/ Limited Energy 1 2 Family Dwelling
$10.00 Signal Circuit/ Limited Energy Multi-Family Dwelling
93.75 5 Manufactured Home Connection
80.00 Renewable Electrical Energy 5KVA System or Less
86.25 First 1300 Square FL
27.50 Each Additional 500 Square Ft or Portlan of
57.50 Each Outbuilding or Detached Garage
86.25 Each Swimming Pool or Hot Tub
5 43.75 Thermostat
g Total
Owner as defined by RCW.1928.161. (1) Owner win occupy the structure for two firers elterthls electrical permit rs &mum (2) owner/ rcquhsd to hhe en
rex Dice( cantrsctorlfdbore said pruperry ls for sere, rent or lease.
Mar reading the show statement, I hereby certify that I am the owner of the show named property or a Ileeneed electrical contractor. l am making the slaabfcal
Installation or alteration in compliance wills the electrical laws, N.E.C. RCW. Chapter 19.28, WAC. Chapter 206468, TM City of Port Angeles Municipal Coda, and
Utility epeolllat ens.
Cash
D cheek
lCVCredu Curd a
IJ0 01 /001
Use Classification: Of Zit
Group: S-3
CERTIFICATE' CUPANCY
ei
Buil
Owner of Business/Residenc P flanSit
Building Address: 241 -,We
e of Construction:
Post on t
Shall not be re
This C ti.g.0a iii,*:asued,pyrsuant to the requirements of SectioliJ09 of the
w
C odc t hat at the time- stri icture was
in cqmpliakie
tonst se. '479:rthefollOwt''
rat Services
Zone:
Services ,,mog '241.T Aneeles. WA 98362
98362
ous place
Building Official
IL
x 14 .eG
DATF NOVOt(h 3-9 2C01
Address of Proposed Business
2� 11- cf"- i iPerrk Artq� 5
co T e_rytc'S
Applicant
Address 6c,-J2s
Phone business A5I 53A5 home
Brief description of proposed business
YrK
Legal Description Lot I b Atroor l T,�lu r calf lo
Current Use of Property Vc-c -ct �f
Zoning Classification of Property 1 L.
WILL THERE BE ANY OF THE FOLLOWING?
Construction changes
Electrical changes
Mechanical (heating, cooling, stoves)
Plumbing changes
New or relocated signs
New septic tanks
New sewer service
Admission charged to patrons
Is this a home occupation?
Excavation of filling of lots
Work done in City right -of -way
Is there sufficient off street parking?
New driveway openings
A grading plan for site drainage
(parking lots, downspouts, etc.)
Are the existing streets paved?
Are there existing sidewalks?
Is there curb and gutter?
Other
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the
information I have supplied is correct to the best of my
knowledge
O J' D REJECTED
Job
12,-s -Ot
ROUTING SLIP
Certificate of Occupancy
$47 00 Certificate /Inspection Fee
)1? mac. di Zt?i(
YES
NO
ve
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
PB I.A.
New Business
Transfer of Business Location
Change of Ownership
New Building
Remodel
Temporary Business
Change of Use
'tra4 T%CI^
Date
Signed
PERMITS
1) Building
2) Plumbing
3) Electrical
4) Mechanical
5) Sewer
6) Sidewalk installation
7) Driveway installation
8) Curb installation
9) Sidewalk obstruction
10) Water meter installation
11) Fire
12) Occupancy
13) Sign
14) Shoreline
15) Home occupation
16) Conditional use
17) Other
Comments Conditions
Subdivision
THE FOLLOWING WILL BE REQUIRED
BUS
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
(NESS LICENSE
Taxi
Peddlers
2nd Hand Dealer
Pawn Broker
Dance
Hotel Motel
Fireworks
Ambulance
Tattoo shop
Other
(\Io %nAbxr 29 2001
4 C� $0..1\
1
DATE 14(M) x.* kl I C O
Address of Proposed Business
1c14t' irk N1101.'5
O r E 1 I `.+f' Y v c
Applicant
Address
Phone business A`'1 home
Brief description of proposed :business
Legal Description Lot JvtlimeiniBlock
Current Use of Property Ve- r t. t
Zoning Classification of Property 1 L
WILL THERE BE ANY OF THE FOLLOWING?
Construction changes
Electrical changes
Mechanical (heating, cooling, stoves)
Plumbing changes
New or relocated signs
New septic tanks
New sewer service
Admission charged to patrons
Is this a home occupation?
Excavation of filling of lots
Work done in City right -of -way
Is there sufficient off street parking?
New driveway openings
A grading plan for site drainage
(parking lots, downspouts, etc.)
Are the existing streets paved?
Are there existing sidewalks?
Is there curb and gutter?
Other
QPR RO Y fD REJECTED
1,I7. to,
ROUTING SLIP
Certificate of Occupancy
$47 00 Certificate /Inspection Fee
ac� ;7 0 yc ;v IC
YES NO
if
s"
I hereby apply for a Certificate of Occupancy and acknowl-
edge that I have read this application and state that the
information I have supplied is correct to the best of my
knowledge
Building Section
Public Works Department
Planning Department
Fire Department
City Clerk
PB I.A.
New Business
Transfer of Business Location
Change of Ownership
New Building
Remodel
Temporary Business
Change of Use
Date Kin
Signed
PERMITS BUSINESS LICENSE
1) Building 1) Taxi
2) Plumbing 2) Peddlers
3) Electrical 3) 2nd Hand Dealer
4) Mechanical 4) Pawn Broker
5) Sewer 5) Dance
6) Sidewalk installation 6) Hotel Motel
7) Driveway installation 7) Fireworks
8) Curb installation 8) Ambulance
9) Sidewalk obstruction 9) Tattoo shop
10) Water meter installation 10) Other
THE FOLLOWING WILL BE REQUIRED
11) Fire
12) Occupancy
13) Sign
14) Shoreline
15) Home occupation
i6) Conditionapuse
17) Other
Comments Conditions a)t--4rn
V MJ) s VM o
r n
j t J e l�7
r
-L_ L CI
Subdivision
?9 2001
1 c Ce1„ti.X 1J k
1
/1 J n p or
CITY OF PORT ANGELES
PUBLIC WOKKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
BUILDING PERMIT ISSUED: 1/15/2002 PERMIT NO: 13147
OWNER/APPLICANT PROPERTY LOCATION
2417 19TH ST W
CLALLAM TRANSIT SYSTEM
2417 W 19TH STREET Lot: 16
PORT ANGELES, WA 98363 Block: 1 [] Long Legal
3601457-5345 Subdivision: AIRPORT INDUSTRIAL
T: S: Parcel No:
CONTRACTOR ARCHITECT
BUILDING BROKERS CONSTRUCTION N/A
PO BOX 3831
SEQUIM, WA 98382-0000 , 98360-0000
360/683-6216 360/000-0000
PROJECT INFO
Project Value: $8,000.00 SFD Units: 0 Commercial: 0
Project Type: COMM/ADDITION SFD SQ FT: 0 Industrial: 0
Occupancy Type: COMMERCIAL Garage: 0
Occupancy Group: MFD Units: 0
Construction Type: MFD SQ FT: 0
Zoning Use:
PROJECT NOTES
add new pole building to northside of existing (~0x30)
RECEIPT #8709
FEES ASSESSMENT
Building Permit: $153.25 Misc Fee 1: $0.00
Plan Check: $91.95 Misc Fee 2: $0.00
State Surcharge: $4.50 Misc Fee 3: $0.00
House Moving: $0.00
Manufactured Home: $0.00
Sign: $0.00 TOTAL FEE: $249.70
Plumbing: $0.00 AMOUNT PAID: $249.70
Mechanical: $0.00
BALANCE DUE: $0.00
Radon: $0.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, pdvate and public improvements. This permit becomes
null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned
for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days fi'om the last
inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent / Date Signature of Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITI$ UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
INSPECTION TYPE I DATE ]YEsACCEPTED] NO COMMENTS
FOUNDATION:
Poo os /--2-Oz z_E/-/ qote$
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT~ #
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
IOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
T-BAR
INSULATION
WALL / FLOOR / CEI LING
MECHANICAL
HEAT PUMP
WOODSTOVE / PELLET/CHIMNEY / INSERT
HOOD/DUCTS
PW UTILITIES / SITE WORK (Eh gineering Divlsion ) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL BATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
C:La. PPL WPD
FOR OFFICIAL U~E ON
BUILDING PERMIT- APPLICATION
TI~ Buita~ng P~/Tnit - ~l~n ~ ~ ~ o~ co~l~e~.
~ PIm~ or p~t h ~ ff~u ~e ny qu~ns, ~ ~O 417-~1S
A~s: ~/7 ~ }~r~ Ci~: ~ ~ ~p:~¢~
~n~n~: ~ ~5~ P~n~:
Ad'ss: ~p ' ~ ~ ~ Ci~: ~'~ Zip:
~GAL D~ON: ~ / ~ BI~:
~g Add~: ~:
C~ C~ ~: ExK ~ ~~ MC ,
~ OF WO~: S~UA~ON: ~
P~G ~ O~Y: '~ '* <~: ~RO~: ~ ....
Norm: - '... ,
p~ m m be ~d m ~o Bui~g ~.
V~UA~O~ OF ~U~-nON: ~ ~ ~ a ~h~ m~ m~ ~ m~ ~ ~ ~.
may ~ ~v~ by ~e Buil~g Div. m c~ w~ c~t ~ ~he~. ~ ~e P~ ~r ~ 417~815 ~ m~.
~t fe~ m ~ at ~e ~ of ~it ~m~.
E~TION O~ PL~ ~W: If no ~ ~ ~ ~ 18~ da~ of ~ ~ of
~on 107.4 0f ~e U~ Bufl~ CMe, ~t ~). No app~cafion ~ ~ ~d~d mo~ ~m on~.
this ~it. 1 ~st~ · ~ not t~ Cl~ le~ ~pomibil~ to ~i~ w~ ~ ~ ~u~; ~ ~ ~ ~.
r~po~ib~i~ to ~mine ~t ~t~ ~e ~qu~ed a~ to obta~ ~
PORT ANGELES FIRE DEPARTMENT
PLAN REVIEW
Project Name: Paratransit Addition
Address: 2417 W 19th
Plan #01-18 [ Corn [] R-1 [] Date: December 20, 2001
I
We have check this plan and find that if conforms to the requirements of our codes and ordinances
with the following exceptions.
1. If this addition increases total building square footage to over 6250, a two-hour separation
wall must be installed.
2. If this addition increases total building square footage to over 7500, a fire alarm system must
be installed throughout.
3. Provide a 2Al 0BC fire extinguisher for the building.
Reviewed by [~'l~,-%g~' -~_L Date [ ~-' ?_cb - ~
] Building Department
[] File Copy
FP - 22 Page 1 of 1
Engineering & Technical Services Inc.
Duane Boice P.E.
President
December 27, 2001
Building Brokers
P.O. Box 3831
Sequim, WA 98382
Dear Gary:
This letter is in regards to the Para Transit project. The initial design required 4' pole
embedment on 18" diameter footings; with sand backfill and 16" treated 2x6 uplift
blocks. An alternate design would be 3' pole embedment on 24" diameter x 6" footings
with 24" diameter concrete backfill around the column. Also, the original plans show
dimensions of 20' long x 30' wide. The design of the addition does not change if another
10' bay is added to the length. Keep the same size and spacing of the materials and
continue on one more bay.
Please call if you have any questions.
U n . ~ . ., ldent
Engineering & Technical Services
27121 469th Ave. Tea, SD 57064-8100
Phone: (605) 498-1290 Fax: (605) 498-1299
E-maih etsl@dtgnet, com· www. engtecsrv, com
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST: r~//~
Date ~---/-~- ~ ~ Time Received by ~-~ (phone, person)
Location of Work to be inspected 2 ~7~ 7 ~'~.~)/~-~:~,2
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): ~ Permit No. / ~'/* (~/7
Sewer Foundation Framing Chimney Plumbin(F~nal~ewer Excav. Other
INSPECTION NOTES:~; ~'-Y ~--. /~~
Inspected: Date ~" Time By
Remarks:.
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel []Asphalt []PCC []Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date /~ ~ ~-----(~ / Time Received by ~' ~-~ ~erson)
Location of Work to be inspected ~-~' I'~ ~) I ~ ~ ~>'~
Name of person requesting inspection t°~>l¢~o~ I~?.~ {~j~ c~
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. 1'5 / ~"-7
Sewer ~Foundation~l~' Framing Chimney Plumbing Final Sewer Excav. Other ~pl~ ~i~
INSPECTION NOTES: ~
Inspected: Date I '- ~'--~ Time By
Remarks:
RESTORATION REQUIRED ...... YES. NO
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved [-~Gravel [~Asphalt []PCC [~Other
[] Repaired by City Work Order #
I--]Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)