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Home My WebLink About920 Caroline St - Building4t> Use Classification. Group B Owner of Business: Building Address: CERTIFICATE OF OCCUPANCY City of Port Angeles Building Division This CerttficatiOnptssued pursuant to the requirements of Seetio*109 of the Uniforrn:Buildifig that at the time this structure was in compliance with the various ordinances of the City regulating Building construction or use. Forr'tliefollowing Office qiiiilding Permit No. Business Name: Family Medieme of P.A. Type of Construction FamilyMedicine of P.A. 920 Caroline Street. Building OffiCiai Use.Zone: CO Address: 303 Wesf.8 Street. Port Anaeles, WA 98362 POtt-Aneeles. WA 9862 rIlt" Date 74- An'a'nst 2004 Post on' premises ih, place Shall not be ienloied excerit by Official I DATE 1— 21 0 0 Address of Proposed Business C I 4, 0 01 I r .S t° Applicant rY, rtb lL c. ti N'6, Address (A) e c"%' t 0 r Phone business l k 1 home Brief description of proposed business 's -Qw r c C e C.-+. c. cJ.. via. o4 Legal Description Lot Block Current Use of Property' a\ `-`c J C)rc\C Zoning Classification of Property WILL THERE BE ANY OF THE FOLLOWING? Construction changes Electrical changes Mechanical (heating, cooling, stoves) Plumbing changes New or relocated signs New septic tanks New sewer service Admission charged to patrons Is this a home occupation? Excavation of filling of lots Work done in City right -of -way Is there sufficient off street parking? New driveway openings A grading plan for site drainage (parking lots, downspouts, etc.) Are the existing streets paved? Are there existing sidewalks? Is there curb and gutter? Other YES I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge APPROVED REJECTED ROUTING SLIP r Certificate of Occupancy Certificate /Inspection Fee 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 Subdivision THE FOLLOWING WILL BE REQUIRED PERMITS BUSINESS LICENSE 1) Building 1) Taxi 2) Plumbing 2) Peddlers 3) Electrical 3) 2nd Hand Dealer 4) Mechanical 4) Pawn Broker 5) Sewer 5) Dance 6) Sidewalk installation 6) Hotel Motel 7) Driveway installation 7) Fireworks 8) Curb installation 8) Ambulance 9) Sidewalk obstruction 9) Tattoo shop 10) Water meter installation 10) Other 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other Date al—W4 Signed Comments Conditions _AA 0,1) c rr 1 Nn I n c a. n ]Yl r T 11 A i l DATE 2 '"Cs 1 Address of Proposed Business C I a,O Q€ si Applicant �cAYtN Addres 3 W e J� o rt— Phone business 1851 home Brief description of proposed business. -e- C CX ea. SO k %iL a t 0 Legal Description Lot Block Current Use of Property r) Zoning Classification of Property WILL THERE BE ANY OF THE FOLLOWING? Construction changes Electrical changes Mechanical (heating, cooling, stoves) Plumbing changes New or relocated signs New septic tanks New sewer service Admission charged to patrons Is this a home occupation? Excavation of filling of lots Work done in City right -of -way Is there sufficient off street parking? New driveway openings A grading plan for site drainage (parking lots, downspouts, etc.) Are the existing streets paved? Are there existing sidewalks? Is there curb and gutter? Other ROUTING SLIP Certificate of Occupancy VMS Certificate /Inspection Fee YES 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 APPROV REJECTED 0 Building Section Public Works Department Planning Department Fire Department 1 -ZI of-t0 City Clerk PB I.A. New Business Transfer of Business Location Change of Ownership New Building Remodel Temporary Business Change of Use Signed Subdivision THE FOLLOWING WILL BE REQUIRED 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 Date Comments Conditions BUSINESS LICENSE 1) Taxi 2) Peddlers 3) 2nd Hand Dealer 4) Pawn Broker 5) Dance 6) Hotel Motel 7) Fireworks 8) Ambulance 9) Tattoo shop 10) Other V PORT,M I f Application Number Property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Zoning Application valuation Owner CLALLAM CO PUB HOSPITAL DIST 2 DBA OLYMPIC MEDICAL CNTR PORT ANGELES WA 983623909 Permit Additional desc Sub Contractor Permit Fee Issue Date Expiration Date Fee summary Permit Fee Total Plan Check Total Grand Total T• \PLANNING\FORMS \1102.15 [11/14/2003] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 03 00001104 920 CAROLINE ST 06 -30 -00 5 8 0085 0000 ELECTRICAL ONLY COMMERCIAL OFFICE 0 ELECTRICAL ALTER COMMERCIAL 5 CIRCUITS ADDED ANGELES ELECTRIC 59 40 11/19/03 5/18/04 Qty Unit Charge Per 1 00 59 4000 ECH EL -COMM ALT <5 Charged Paid 59 40 59 40 00 00 59 40 59 40 Contractor ANGELES ELECTRIC 524 E 1ST ST PORT ANGELES (360) 452 9264 Valuation Date 11/19/03 WA 98362 Plan Check Fee 00 0 Extension CIRCUITS 59 40 Credited Due 00 00 00 00 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT ROUGH -IN PLUMBING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL /HOLD DOWNS WALLS ROOF CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE PELLET CHIMNEY HOOD/ DUCTS PW UTILITIES SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT 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 YES I NO FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE 417 -4735 ELECTRICAL LIGHT DEPT SEPA. i5 o ESA. SHORELINE. DATE YES NO COMMERCIAL p «r0 DATE ACCEPTED I YES I NO I CONSTRUCTION R.W PW/ CONSTRUCTION R.W ENGINEERING 417 -4807 PW ENGINEERING FIRE 417 -4653 I I I I FIRE DEPT PLANNING DEPT 417 -4750 I I I I PLANNING DEPT I I BUILDING 417 -4815 I I I I BUILDING I I I T•\PLANNING FORMS \1102.15 [11/14/2003] d.OIIT~ CITY OF PORT ANGELES S DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION rWiii ~ -- 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ~ "'<<:;:it' , - Application Number 03-00000732 Date 10/06/03 Property Address 920 CAROLINE ST ASSESSOR PARCEL NUMBER: 06-30-00-5-8-0085-0000- Application description COMM ADDITION Subdivision Name Property Zoning . Application valuation 50000 Owner Contractor ------------------------ ------------------------ CLALLAM CO PUB HOSPITAL DIST 2 HOCH CONSTRUCTION DBA OLYMPIC MEDICAL CNTR 4201TUMWATER TRUCK TRAIL PORT ANGELES WA 983623909 PORT ANGELES WA 98363 (360) 452-5381 ------ Structure Information INT REMODEL, NEW ENTRY ----- Construction Type . TYPE V NON-RATED Occupancy Type BUSINESS:OFF/PRO/MED/REST ---------------------------------------------------------------------------- Permit BUILDING PERMIT COMMERCIAL Additional desc Permit Fee 667.25 plan Check Fee 433.71 Issue Date 10/06/03 Valuation 50000 Expiration Date 4/04/04 Qty Unit Charge Per Extension BASE FEE 414.75 '-C 25.00 10.1000 THOU BL-25,001-50K (10.10 PER K) 252.50 ~ ---------------------------------------------------------------------------- Permit .~ MECHANICAL PERMIT Additional desc Permit Fee 54.25 Plan Check Fee .00 Issue Date 10/06/03 Valuation 0 Expiration Date 4/04/04 f Qty Unit charge Per Extension 1(1 BASE FEE 47.00 1. 00 7.2500 ECH ME-VENT FAN 7.25 fQ ---------------------------------------------------------------------------- :::-- Permit PLUMBING PERMIT ,l; Additional desc i\ Permit Fee 61. 00 Plan Check Fee .00 Issue Date 10/06/03 Valuation 0 '1 Expiration Date 4/04/04 ~ ~ Qty Unit Charge Per Extension BASE FEE 47.00 2.00 7.0000 ECH PL- EA. FIXTURE ON ONE TRAP 14.00 ---------------------------------------------------------------------------- Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 782.50 782.50 .00 .00 Plan Check Total 433.71 433.71 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 1220.71 1220.71 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned fora period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify thall 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 w er specified h in or not. The granting of a permit does not presume to give authority to violate or cancel the p~ovisions of any tate or local ulating construction or the performance of construction. \ (j f(J02- Sigvre of Own Signature of Contractor or Authorized Agent Date owner is builder) I Date T:\PLANNlNG\FORMS\1102.15 {4nOO2] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING 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 I INsrF,CTION TYPE I DATE I ACCEPTED I COMMENTS I VES I NO I FOtlNOATION: t-o"Yld (...+",;'/ yll~ /{'j 11- 6-05, I FOOTINGS I WALLS ] I FOlJNDA TION DRAINAGE I FLF:CTRICAL (LIGHT DEPT) SErARA TE PERMIT: 11 I I ROUr.II-1N I I I I I PUIM8INr. I UNDER FLOOR I SLAB Itller/03 dLL I I ROUGII-IN I I WATER LINE I I GAS LINE I I I BACK FLOW I WATER I AIR SEAL I WALLS I I I I CEILING I FRAMING I JOISTS I GIRDERS I SHEAR WALL I WAIJ-S I ROOF! CEILING /I-ll>- 03 I DRYW~Lh I I T-BAR . I IINSllLATlOrJ I SLAB I I I I I WALL I FIDPJ{ I CEILING I MECHANICAl: I ilEA T POMP .' I I WOOD STOVE I PELLET I CHIMNEY I I HOOD I DUCTS I PW 11TILlTIF:S I SITE WORK (Engineering Division) SEPARATE PERMIT #'s: I W ^ TERLlNE I METER I SEWER CONNECTION I SANITARY I STORM I PLANNING DEPT. SEPARATE PERMIT #'s SErA: I PARKING!I.IGUTING I I I ESA: I LANDSCAPING SHORELINE: I" FINAL INSPECTIONS REQlIIRED PRIOR TO OCCUPANCYIUSE I I RESIOF:NTIAI, DATE YF.$ NO COMMF.RCIAL DATE I ACCEPTED 1 v,s I NO I I ELECTRICAL - LIGHT DEPT. 4]7-4735 EI,ECTRICAL I LIGHT DEPT I CONSTRllCTlON R.W.! PW! CONSTRUCTION - R.W. ENGINEERING 4]7-4807 PW ! ENGINEERING I FIRE 417-4653 FIRE DEPT. I PLANNING DEPT. 417-4750 PLANNING DEPT. I nUILDlNG 417-4815 - BUILDING I ~ - T:\PLANNING\FORMS\1102.15 [4/2002J PREPARED 11/19/03, 13:04:58 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 11/19/03 ----------------------- ------------------------------------------- ------------- ADDRESS 920 CAROLINE ST SUBDIV: CONTRACTOR HOCH CONSTRUCTION PHONE (360) 452-5381 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE PARCEL 06-30-00-5-8-0085-0000- APPL NUMBER: 03-00000732 COMM ADDITION ------------------------------------------------------------------------------------------------ PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ---- ----- ------------------------------------------------------- PL2 01 11/19/03 ~ PLUMBING ROUGH-IN TIME: 17:00 Rough plumbing Call ahead 417-7000 page Scott Bower he will meet you there to let you l-n. ------------------- COMMENTS AND NOTES -------------------------------- PREPARED 11/06/03, 12:08:21 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 11/06/03 - - - - - ~ - - - - - - - - - - - - -- --._---- ---------------------------------------------------.---- ADDRESS 920 CAROLINE ST SUBDIV: CONTRACTOR HOCH CONSTRUCTION PHONE (360) 452-5381 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE PARCEL 06.30-00-5-8-0085-0000- APPL NUMBER: 03-00000732 COMM ADDITION -------------------------------------------- .--------------------------------------------------- PERMIT: BPe 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS - - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - - - - -. - - ~- ------------------ -._--------------- BLPT 01 11/06/03 JLL BUILDING PLINTHS fsr John Frasier for Rick Hoch has two small Plinths for inspection this afternoon. Ph1l461-3220 ----------------------------- --._- COMMENTS AND NOTES -------------_______________________ PREPARED 1/30/04, 10:47:32 INSPECTION TICKET PAGE 7 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/30/04 "--------------- ------------------------------------------------------------------- ADDRESS 920 CAROLINE ST WATER SUBDIV: CONTRACTOR HOCH CONSTRUCTION PHONE (360) 452-5381 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE PARCEL 06-30-00-5-8-0085-0000- APPL NUMBER: 03-00000732 COMM ADDITION ------------------------------------------------------------------------------------------------ PERMIT: SIGN 00 SIGN REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS --------------------- ------------------ ---------------------,---- BL99 01 ~ JLL BUILDING FINAL ____~_ ___ __ _ __~__ * OVERR:::M::::N~: :~:::LY DATE: 01/30/04 TIME: 10:13:31 ---------------------- ~ ~-4L @ DOl>tl.-- ~~~l ~'30 (VI l',..tU~~ / Lie? -p J ~4(LJ OJI--i De~ PREPARED 2/02/04, 12:24:36 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 2/02/04 ----- ---------------------- - - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - ADDRESS 920 CAROLINE ST WATER SUBDIV: CONTRACTOR HOCH CONSTRUCTION PHONE (360) 452 5381 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE PARCEL 06-30-00-5-8-0085-0000- APPL NUMBER: 03-00000732 COMM ADDITION -------------------- ---------------------------------------------------------- -~--------------- PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS --------------- - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - -. - . - - - - - - - - - - - - - - - - - - - - BLPT 01 11/06/03 JLL BUILDING PLINTHS 11/06/03 AP John Frasier for Rick Hoch has two small Plinths for inspection this afternoon. PhII461-3220 BL3 01 11/19/03 JLL BUILDING FRAMING 11/20/03 AP BL99 01 1/29/04 JLL BUILDING FINAL 1/30/04 CA Rick 452-5381 bldg manager wanted to have inspection on friday ay 12:30 pm jim BL99 02 1/30/04 JLL BUILDING FINAL 1/30/04 DA 12:30pm waited 30 min for building mangage to show left card on door call for reschedule/jim BL99 03 2/02/04 JLL BUILDING FINAL ~ 12:30 pm rick hoch ----------..---------------------.- COMMENTS AND NOTES -------------. BUILDING DIVISION CITY OF PORT ANGELES * * Correction Notice Job Located at 4ZD Cilltuz>/ juG Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction: S.t/'2~ s.~ ,.:) / ~I ( $'Z:('2."""':C I ('A-ll 1-o/L- if 11Ct"-. F: U>6-J These corrections must be made and are not to be covered until reinspection is made. When corrections have been made, please call 4/1 - J.j.!iJr :~t~nspeQT;l e 12~ IL~ - '4 'f1""~o""'""""""'''," DO NOT REMOVE THIS TAG PREPARED 1/29/04, 11:22,07 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/29/04 ------------...--------------- ---- ----------.------------------------------ ADDRESS 920 CAROLINE ST WATER SUBDIV, CONTRACTOR HOCH CONSTRUCTION PHONE (360) 452-5381 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE PARCEL 06-30-00-5-8-0085-0000- APPL NUMBER: 03-00000732 COMM ADDITION ------------~------------------------------- -------------~~~---~------------------------------- PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------ BLPT 01 11/06/03 JLL BUILDING PLINTHS 11/06/03 AP John Frasier for Rick Hoch has two small Plinths for inspection this afternoon. Ph#461-3220 BL3 01 11/19/03 JLL BUILDING FRAMING 11/20/03 AP BL99 01 .~.~~ BUILDING FINAL Rick 452 5381 COMMENTS AND NOTES - - - .. - - - - - - - - - - - - - - - - - - - - ~- ~~V\\~d" ([9 \~o fP\\ ~ PREPARED 1/30/04, 10:47:32 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/30/04 ----------------------------- -----------.----------- -------------------------------------- ADDRESS 920 CAROLINE ST WATER SUBDIV: CONTRACTOR HOCH CONSTRUCTION PHONE (360) 452-5381 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE PARCEL 06-30-00-5-8-0085-0000- APPL NUMBER, 03-00000732 COMM ADDITION ---------------------------------------------~-------------------.------------------------------ PERMIT: BPC 00 BUILDING PERMIT - COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ---.----------------------------- -------- ------------------------ --------------._---- BLPT 01 11/06/03 JLL BUILDING PLINTHS 11/06/03 AP John Frasier for Rick Hoch has two small Plinths for inspection this afternoon. Ph#461-3220 BL) 01 11/19/03 JLL BUILDING FRAMING 11/20/03 AP BL99 01 1/29/04 JLL BUILDING FINAL 1/30/04 CA Rick 452-5381 bldg manager wanted to have inspection on friday ay 12:30 pm jim BL99 02 ~~i' BUILDING FINAL " ' '-\ 12:30pm I -, ~ ______n_""___.._._ CONTINUED ONTO NEXT PAGE -------------- PREPARED 1/30/04, 10:47:32 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/30/04 - - - - - - - - ~- - - ~- ---------------------------------------------------------- ADDRESS 920 CAROLINE ST WATER SUBDIV: CONTRACTOR HOCH CONSTRUCTION PHONE (360) 452-5381 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE PARCEL 06-30-00-5-8-0085-0000- APPL NUMBER: 03-00000732 COMM ADDITION -------------------------------------~----- - ._---------------------------~--------------------- PERMIT; ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------ ---------------- -----------------._------------------ ------- ME99 01 ~~ MECHANICAL FINAL TIME: 17:00 - - - - - - - - - - - - - - ~ - - - - -- CONTINUED ONTO NEXT PAGE -----_ "____________________________ PREPARED 1/30/04, 10:47:32 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 1/30/04 u_ ---------..--------- --------------------------- ---- --------._----------- ADDRESS 920 CAROLINE ST WATER SUBDIV: CONTRACTOR HOCH CONSTRUCTION PHONE (360) 452-5381 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE PARCEL 06-30-00-5-8-0085-0000- APPL NUMBER: 03-00000732 COMM ADDITION ------------------------------- --------- ------------------------------------------------------ PERMIT: PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------- ---- ---------- -------------------------------------------------.. PL2 01 11/19/03 JLL PLUMBING ROUGH-IN TIME: 17:00 11/19/03 AP Rough plumbing Call ahead 417-7000 page Scott Bower he will meet you there to let you in. PL99 01 1/30/04 ~ PLUMBING FINAL TIME: 17:00 --------------------- CONTINUED ONTO NEXT PAGE -----. - FOR OFFICIAL USE ONL v, BUILDING PERMIT - APPLICATION Date Rec '7-'1-d ~ I Permit #: -i.5' G - Fill out COMPLETELY and in INK. Your application and site plan MUST BE Date Approved" J COMPLETE to be accepted for review, If you have any questions, call Date Issued" (360) 417-4815 Applicant or Agent: Olympic Medical Center DBA Phone: 417-7000 Owner: Olympic Medical Center DBA Phone: 417-7000 Address: 939 Caroline Street ~ City: Port Angeles ~Zip: 98362-3909 Architect/Engineer: winborn Architects Phone: 360-452-7895 Contractor 1-1 cx...~ (li'lIA.-'i: 't State License #: Exp: Phone: Address: City: Zip: PROJECT ADDRESS: 920 Caroline ZONING: OC LEGAL DESCRIPTION: Lot: 17&18EXC Block: Subdivision: Perkin's CLALLAM COUNTY PARCEL NUMBER: - -~ .. 0630005800850000 I Credit Card Holder Name: Billing Address: . City: Credit CardType VISA MC # . Exp. Date: TYPE OF WORK: SIZENALUATION: o Residential o New Constr. ORe-roof o Stove SF.@$ /SF. = $ o Multi-family o Addition o Move o Garage SF.@$ /SF. =$ ~ Commercial Xl Remodel Gl: Demolition o Deck SF.@$ /SF. =$ o Repair q{ Sign o Other TOTAL VALUATION $ $50.000.00' BRIEF DESCRIPTION OF THE PROJECT: Demo of existina restroom and add ADA compliant restroom. General Construction & addition of a new entry canopy &new,~~~n'l I .- ,. '~J COMMERCIAL/RESIDENTIAL: Occupancy Group: B Occupant Load: 218 Construction Type: VN ~,._ No. of Stories: -L Lot Size: 2QX.l 40 Existing Sq. Ft. 2 1 8 1 & Proposed Sq. Ft. same =TOTALSq.Ft. 2181 Existing lot coverage ---bl.lI.- % & Proposed lot coverage ~ ~....~ = Totallat coverage C':::lmo % PLANNING USE ONLY: ~:Z?P?~ . Y".-'l--">t : -J-:T-;-.J , ;"If) I A1 . .f ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: I 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. Conlactthe Permit Coordinator at4 I 7-4815 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 written request by the applicant (see Scction 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I hereby certify thaf 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 thaf it is my responsibility to detennine whaf pennits are re uired ,no fhe Cify' ,~xust obtain such penn"frior ~ work. HFORMSIAPPSIBuddingpennit.wpd ApplIcant Date: 7 '1/ ~ . f I -..----- ,-- ----_._~-~.__._._---~,-_._-_._~--- I ~N I DEPARTMENT OF PUBLIC WORKS. BUILDING DIVISION . APPLICANT: Olympic Medic~l Center DBA PHONE: 417-7000 PROJECT/DEVELOPMENT ADDRESS: 920c~roline Street See Page 4 for insfrucfions on completing the site plan, For more information, calf 417-4815. I I I I I I I I I I I I ......-#. ---, .......,...,. I I- I- I 7 . I I . I / '\ / / '-.... l;w >1111.; ) I O'A oft " , , , 'j I".,:' , ( 1/ / I., !-d. "\ or 0 ~ '"- 1/ \. i--.J ~ ""',., ,I / ~, ~" , I, " o?r . . <!<: nor '/ 1 - / V " .j - , "T .1: iii ~ 1 v .~ .. / / " , ',"L... ,~J.. I I'. Il I~; ...""",~ ':". ~" I--- I - - H.c., '/ ", \.--1- ~ r It .~ h. r I L./ / .~. ,-, ll- l""" I '. - -c- I '[ll rl'IVIr>\- ,..'" ~.'" ,t-lr~r "jIofN/>o.[...!L., Saw cutJ for notches shall not ~heiabt from citbCII' top of benotcbed. ptovided without use ofahiml ClauneltUd. -~~~ , All futeniogs per U.B,C. table 1.1. for the '"Application and I lOlDplianccwitbmanuficturesh . ttrlm. Futento framill8per thCl"-$tripped to limit air ,and shall bejll5talJed in , ",po..,,. "W~""', F1uhi",' I rindoors,withintS'.offloors ~r:.rnt--\{,. P'AjiJ:::..IH::r . n.lcd safety g!ass must mect IlI1inated glass with an anfOTlempered g1as.!l with an ilIintorstainperArchitects primetwith suitablctop coat e and two finish coa1l of latex lWli-gIou / / / / " I , "- : 1998 WSEC ! / \ \ ,lions, I tJJ;-v\J fN11 L..'( i rily show all ~CS' ntractor shall Af<FA 1 ~ f..>1O' s together as a j<:.E;noI?8L-lOI..> / Id, and notifY / ~ 1 this contract ~_1_, f/ ~ceooly. r~' 1m wnting to I ~~ -}. twn, ''-'''"'iJ,_ F' , llholls and f.....' .)1 ~, ,._ ~~ ~~ I efFic{;. , I ES ~[;lV N<ad; PINfJtDt' ,tmctlOn--- ciAit,.Jl,.AJ.-,;, c:: E:l<Hl ) / llld located , Nbi\':-1Hi r /'u' I"~r I ~....-,. I I amed at , m_ ~ ~---~" I t~ f-i< : :~.~". , '" i ~ _i~)l:l'J,I\l.~ ! ~eombllstible -'-~ -~ -', m JI, .'kf rlJ , ' ~tw 6.Jl-lv I ' Plf~,;J I _:: "" ~ 'p~nnNt.; I I shutd~wn 12/0 j Lr-L..,\ ',' i/ y - I Ix -p t--"~i1Ai!" areao! , ; '/ t f 6&" ~ ~~(p" 1'-?'(/.(,/fl;iY;" 1"'-"," 1'/",' ecessal)'_ 1 H,G, :,// }I.C- I =~~ '~VAN , " a _" -" 'w Il~'"9''' ,-c i ~fib' IC~o iQ:>fffi.;>l(,T l)' ! v91I<i~1 , ~ I ~I , I / I Iud \':' Gl~ DF ---P A- i/ - // ,J-Q "11 I Y ,,~ - - . - ,;!'" ~ ,CRr ~o\I . ROUTING SLIP S'O~(;~(f' (J~~u> Certificate of Occupancy (..~1 w;_ -==-.lI' 1 n ~ Certificate/Inspection Fee , ~~ DATE 1-21-cLf New Business, . . , , , , , . , , , : ' ~ " ". .' _ ( /') Address of Proposed Business Transfer of Business location, S<:-~~ ! ,-Ie G{t\(~ ) q ~ 0 Q..O.roll ~ .s r Change of Ownership , . . . ... . ......., ( ) Applicant f' t\~\\"" N\JJ.Ac...\'~ o~~Nt"h.~ New BUilding ,. .'. ....... ..... ... " , .... ( ) AddresQ 3.n6 W ~'D.7 ~r Remodel. , , , , , . , , , , , , , , . , , , , , , , , ....., ( ) O"t- ~ Temporary Business .. " . . . ... .. ... .. ( ) Phone: business ttS:t -j gc" \ home Change of Use, , . . ... .... ...... . ( ) , ~\.CJ.... - ~c:t~ D~ w Bnef descnption of proposed business: ~~ t..t:t2 legal Descnption. lot Block Subdivision Current Use of Property: ~(-t,ll')~\~ Zoning Classification of Property, Will THERE BE ANY OF THE FOllOWING? YES I'f9- THE FOllOWING Will BE REQUIRED: Construction changes PERMITS BUSINESS LICENSE ~ Electncal changes - 1) BUilding 1) TaXI Mechanical (heating, cooling, stoves) v 2) Plumbing 2) Peddlers t; Plumbing changes - " . 3) Electncal 3) 2nd Hand Dealer New or relocated signs ."., 4) Mechanical 4) Pawn Broker ~ New septic tanks --> 5) Sewer 5) Dance " , New sewer service / 6) Sidewalk Installation 6) Hotel - Motel Admission charged to patrons ..,; 7) Dnveway Installation 7) Fireworks r Is this a home occupation? ,./ 8) Curb Installation 8) Ambulance . . . .... Excavation of filling of lots .., 9) Sidewalk obstruction 9) Tattoo shop Work done In City nght-of-way ./ 10) Water meter Installation 10) Other Is there sufficient off-street parking? ./ 11) Fire New dnveway openings ... . .. - 12) Occupancy A grading plan for site drainage /' 13) Sign (parking lots, downspouts, etc ) - 14) Shoreline Are the eXisting streets paved? ./ 15) Home occupation Are there eXisting sidewalks? - 16) Conditional use Is there curb and gutter? - 17) Other Other ..... . ---- I hereby apply for a Certificate of Occupancy and acknowl- J - 2\-a"f edge that I have read this application and state that the Date. _ information I have supplied IS correct to the best of my Slgned~ ~ \(~~v.n knowledge, ~1T~ REJECTED Comments / Conditions ,0 i] 1 BUilding Section Public Works Department Planning Department Fire Department City Clerk P.B,I.A, CERTIFICATE .OF"-0CCU P ANCY ~~/f/' City of Port Angeles~~~e;, 4 ~ ,ill Building Division "':;~~~ ~f.1' :::.;:, Thzs CJifigatiqiYis~ued pursuant to the requirements of Secti~'1z~J 09 of the Un iform;'Building t:qde certifying~that at the time-Of issuance this structure was [ -. - -'I in compliance with the various 'ordinances of the City regulatzng lluzlding construction or use;, For the following. Use ClassIfication Office BUlldmg PermIt No Bu~;nessName Familv Medicine ofP.A. "' 1~1 Group B ~ Type of ConstructIOn V-N Use Zone cd; ,.1 ,;} q 1'" Owner of Busmess Famil~~Medicii1e ofP.A. Address )03 'West 8th Street. Port Jfu.geles. W A 98362 -i:, hi' 7" no Car6line Street. 'V BUlldmg Address - - Port Anlle1eS. W A 988'62 e' -- - -- -- ~- -- " ~,,.~ " ""-'- ~ __" -.-,- 't ~. .~ < -,. -/ -- ,"-'. J.!. ~ j ~AlH!O:sV27. 2004 " ii,~~~,~~t"I~'?:;!)'~ <, I-e i>:;,;>iD,,, . Post on ~th~"premises,ih-:Cl!hQhspi9Uhus place. Shall not be rem.Qyed'exce,pt J~y'B'uilding Official. ~ -.' 0-"___ _~__~ ,l.;,_ ".,. N -', . --'--~- - ~--~-- ---- -~- .- --- ---~---- ----~- ----------- <- -I --- - -- , , ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION . ~ 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ~ Application Number . . 03-00001171 Date 12/10/03 Property Address 920 CAROLINE ST ASSESSOR PARCEL NUMBER: 06-30-00-5-8-0085-0000- Application description SIGNS Subdivision Name Property Zoning . . . COMMERCIAL OFFICE Application valuation 2010 owner Contractor ------------------------ ------------------------ CLALLAM CO PUB HOSPITAL nrST 2 MILLER SIGNS DBA OLYMPIC MEDICAL CNTR 30 CHILDERS LN PORT ANGELES WA 983623909 SEQUIM WA 98382 (360) 683-6790 ---------------------------------------------------------------------------- Permit SIGN Additional desc 44.5SF WALL MOUNTED SIGN Permit Fee 85.00 plan Check Fee .00 Issue Date 12/10/03 Valuation 2010 Expiration Date 6/0S/04 Qty Unit Charge Per Extension ~ 1. 00 85.0000 PER S- SIGN WALL 25 SP+ 85.00 ~ Fee summary Charged Paid Credited Due ..5) -- ----------------- ---------- ---------- ---------- ---------- r0 Permit Fee Total 85.00 85.00 .00 .00 -k plan Check Total .00 .00 .00 .00 0 Grand Total 85.00 85.00 .00 .00 N - ~ ~ ~ ~ C> - -, ~ r> --~ "Vu_ ,,-., ~----~--- 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. ~~~~ / ';7. (0.0''7 Ilfe-bf tontracto~ Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1102.15 [11/14/2003] PREPARED 3/24/05, 12:53:20 INSPECTION TICKET PAGE 1 CITY OF PORT ANGELES INSPECTOR JAMES L LIERLY DATE 3/24/05 - - - - - - - ~- --~------------------------------------------------------------------------------ ADDRESS 920 CAROLINE ST WATER SUBDIV: CONTRACTOR MILLER SIGNS PHONE (360) 683-6790 OWNER CLALLAM CO PUB HOSPITAL DIST 2 PHONE , PARCEL 06-30-00-5-8-0085-0000- APPL NUMBER: 03-00001171 SIGNS ------------------------------------------------------------------------------------------------ PERMIT: SIGN 00 SIGN REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS -------------------- ------------- --------------------- ---------- BL99 01 3/24/05 ~ BUILDING FINAL ~ 683-6790 -------------------------------------- COMMENTS AND NOTES -------------------------------------- ,.-?//../..<' (,"'':// /.//(~ -;::.'.),.: ',' '.'-' fi FOR OFFIC~ USE ONLY: BUILDING PERMIT - APPLICATION Date Rec.. -11)-t:f:S ()" ~ Permit#: 1171 r""~ Date Approved: 'lL~ Date Issued- ~ The Building Permit Application must be filled out completely. Please type or print in ink. If you have any questions, please call 417-4815 Applicant or Agent: Phone: Owner: ~'.L w1 , <-"t' 1,AII~7'>I"-(i\"l F_ Phone: '-/5~-1<'?9{ Address: 303 LV, '6h ST City: 7D~-{- jI~" -e..~"" Zip: Architect/Engineer: WI VI3'<9fZ-lL) lARLt-+l\E'L--r5 Phone: Contractor 1M. I L-c..-6IZM c., t--> ') License #: MI<-<-l:S.-t~Exp: Phone: (" 9. ')~c., '1 '10 l-d! c tf( <.--be IZS '-'-' C1...~..1L'''- b--'''''t. Address: ~..;.~~~~":'~. ~ City: ':E:-____\.~ -' Lo(J.-.-r-- Zip: Cf 'ts g '"2... q":2-0 :?iiu......"'.""\.( <...-Jo-,J'~ PROJECT ADDRESS: Ci"I-R-l <-,.vc;; sr WNING: cO LEGAL DESCRIPTION: Lot: Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: Credit Card Holder Name: Billing Address: City: Credit Card #: Exp, Date: VISA MC TYPE OF WORK: SIZ~ ALUATION: /SF.~.$ 1 dO t I:> :::- o Residential o New Constr. ORe-roof o Wood-stove -.!:i!., 5' SF. @ $ o Multi-family o Addition o Move o Garage SF.@$ /SF. =$ o Conunercial o Remodel o Demolition o Deck SF.@$ /SF. ~$ o Repair XSign 0 TOTAL VALUATION $ BRIEF DESCRIPTION OF THE PROJECT: BUt '-- D i/I.)(" .5jb~ COMMERClAL/RESIDENTIAL: Occupancy Group:~ Occupant Load: ConstructioD Type: No. of Stories: Lot Size: % Lot Coverage: % Existing Lot Coverage: /sq. fl. + Proposed Lot Coverage: /sq. ft. = TOTAL LOT COVERAGE: :lsq. ft. PLANNI~G USE ONLY: . ),),::sl: c APPWV~: PLAN //I/cj;;.: 2// N~tes~ /- " ( I ,) {:'-:.A .,J, j'.-y,f,~" ! 0 x.." .?t'i/c = ki <:; - r 10.-;:'><0",", tL BLDG, I f\ 1 kl q . t, . DPW .) ~ -- ~\' . / FIRE ESNWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: OTHER BUILDING PERMIT APPLICATION SUBMI]'T AL: Your application and site plan must be filled out completely to be accepted for review. The BUiiding Division can provide you with more detailed information on the application and plan submittal requirements. Your completed application, site plan (for additions) and building construction plans are to be submitted to the Building Division. VALUATION OF CONSTRUCTION: In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of "pennit issuance. EXPIRATION OF PLAN REVIEW: Ifno.permit is issued within 180 days of the date of application, this application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section 107.4 of the Uniform Building Code, current edition). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct, and I am authorized to apply for this permit. I understand it is not the City's legal responsibility to determine what permits are required; it remains the applicant's responslblhty to determme what permIts are requIred and to obtam such. APPlicant.~~~# Date: Dr3:C- /0,0 S T \FORMS\APPS\Bulldmgpenmt /~? ~ l ( BUD )- roCZ3-(Pr cro . . . .. . I t I . . I ." I .f. . I . , . ... , I.' ~ iI : , '_u._, FaqIiJy , Medlcme of Port Angeles , . ~ ~(ll ~ <, -'7 \)",,~,,''''''' [t ( t I ~3'1 "iS~; lJ."-~ D;~, r - "" ~-" \~ ==~:=~_ _~___C . 0 'I '\ .~.~~c.~.. ~. . I I _ ",' c ' '! hiI d . C --'! . /l _ t'''Jti\:' b~I@)W;m~ ~ . . ..e l! /iI),~.' ,."..1 II / / ..2. cmc.. II" ' I .~ . ~ ,/ . A ;(1,'" ",,~~"- \' . ?JIg __ Jl-b '7 H fly/oj 4 (,<Ab;7 , i CITY OF PORT ANGELES /6<17 LIGHT DEPARTMENT PERMIT NO ELECTRICAL PERMIT DAT" tk::J/J'? . I Site Address: Ct-IZO l"ue. ~EADY FOR o WILL CALL FOR I C;~O INSPECTION INSPECTION I Installed By: UZr_k'L 01. I License Number: Phone: I I OwnerfBusiness: th. 7'tO/M-{)SIf}v1 Phone: I I Owner/Business Address: I Sq. Ft. I o Residential o New Construction o Overhead Heat KW o Remodel o Underground o Baseboard 0 Furnace/Boiler o Service update/alter/repair Voltage o Heatpump 0 Other o 10 03.0' o Commercial/lndustrial load o Add/alter circuits Service size Amps Total Connected load o Auxiliary power o Temporary (attach breakdown) (list below) Total Motor load o Special equipment (attach breakdown) (list below) DetailslDescriptlon: . - cJLt (/r;-~5t-,~ / . W.S. Nn ~ervice Si7~ nata. Hoid for: 0 Easement 0 Letter Capac;ity: 0 O.K. 0 Not O.K. CommentF o Ditch inspection O.K. o Signed up for service/meter o Rough-in/cover O.K. o Meter Department notified for installation o O.K. to connect service o Fire Department notified of inspection ~K. o Plan Review approved/pending Site Adtess q,;LO Cw.rJ !t'tJ L 0/2, ~ f5t1-v'I I permitlR;i?i Installer: C/[dfLfC- ~ '/hAvt ~ INewMeto I Dat'8h3/?P . Notify the Department of City Light byls:reet ,Address and Permit Number when ready for inspecti~n. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457-0411, EXT. 158 or EXT, 224. T~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ;,cP;f2 /, Inspector Amount paid WHITE ~ file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMPIC PJtINTERS. INC:. /2. J l' CITY OF PORT ANGELES A 7 f-/ FESRECEIPr"UMBER DEPARTMENT OF LIGHT PEl::TNUMBER .;. APPLICATION AND ELECTRICAL PERMIT : " /,; . . ~ ~ . ;OTALFEE t 2 ~ /~~~7. TIMETOCOMPLETE . NO.STORIES LEGA~~NCY >>TRICAl PE5M1T ONLY. NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT Site Address 9..2.0 (;&/CO//;t/b , ~CT AD~RESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH ~RONG ADDRESSES ARE pANCElfED& ./'J Owner ~"'J(", /).,l)j/VI.D<:rJ~ Installation By "7.7?e 6;1~~.J < c..::-o. owner'SAddre~s / . .... InstallerSAddres" .?~.8hx /07/- Day Phone Installers Phono ~5 "/-71'::< 0 Application is hereby made for permJt ,to Insfall EI_ec.trical Equipment as follows' lhJ SfA...u/.-ct 'fJ 7f'UI/' , ~ ('" ., I . / i - JAA. 'rU' A (( I/,(C, r 14-1 I I M H, ('.t vtplJ vi. TS ,1:/ r 7b -'_J ~.MA.wiring Method I ('~ ,<.4 v I 7I AMP 240V ~ AMP :l240V 1 USE OF CIRCUIT NUMBER PER 120V 10 OR FEE USE OF CIRCUIT NUMBER PER 120V - 10 OR .FEE CIRCUITS CIA 1 0 30 CIRCUITS CIA 1 0 : 30 LIGHT I SIGN LIGHT j) ft [R.I./ I L 3 oRv~NJ""'" '5. dO CONVENIENCE II MOTOR ' I I . I CONVENIENCE II MOTOR I I I APPLIANCE II MOTOR I ~ I I I DISHWASHER / J I FIRE ALARMS I I I I I DISPOSAL ~;; i II BURGLAR ALARM I I I I I . I RANGE I I II MISC I I II I I OVEN .28J ~ II J1Y 2itO I I I I 14)'0 I WATER HEATER .5t.--,4.t~lb II //'{/ 7:YO I I I tC,- I LAUNDRY >>/~ ~ ~i - t2 .4Idf' vJ #1"47 ? I I DRYER I I -j-l REINSTALLATION L! GHT FIXTURE # I I FURNACE I I II sue TOTAL FEE I I GAS-OIL I FURNACE I I I ENERGY FEE I ELECTRIC I BASIC FEE I ELECTHIC HEAT I 1.1 I I TOTAL FEE I ELECTRlC HEAT, I I I SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER I A.C. UNrT I I I AMP PHASE I FEEDER I I I II / SJi'E OF SERVICE ENTRA,NCE CONDUCTORS I SERVice I I 1//#' / RCO tI1ttn /~ #r"~-I. AW.G. 'SUB-TOTAL- I - SIZEO(GROUND SIzt6F~TRANCESWITCH I certify tha~ the work to be performed under th" permit will be done by the ins.t~"er.and i~r;nance with the ~~trical Code. Date Application made .. . ,19' ,-' BY.u.!~.J;? ~ ~ CONTRACTOR OR OWNER (OR AUTHORIZED AGENT) ....1. Permission is ~er~by given to do the above described W9r~, ae.cording tO'the cori.ditions hereon and according to the approved plans and specifications pertaining thereto, SUb;iect to c~mPliance with the ordinance;;/:J~Sr L1~ I Date permlt.'~sued ~ l.J '!.I ~,"ANSAPPAO""O' _ _ 'I . . Notify Department of City Light by Street Address and Permit Number when ready for inspection Work must not be covered or current turned on before inspection and O.f<. for covering or service has been given by Inspector in I I I Writing on Permit Placard. A.. Permits Phone: 457.0411 Ext. 158. . WARNING PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _ 1 WHITE. Original CANARY. Duplicate PINK Triplicate WHITE CARD -Inspector's Report , OLYMPICPRrHERS,tNC. _~ __ _ __ -- \ -- .------ REPORT OF INSPECTOR DATE OF VISIT MADE BY REMARKS I . I I I I I I I z <:) I a: <I: I I~ I J: l- I z w I ~. I l- I 0 z I 0 c I I I I I I I I I I I I {/,~Je. I ~J.-. ~ Cl-~ I V1l\!. h. f-<1 vw-r I I / . Mr 9J' c...." ~i _..".d t I I i/ lo!f! I O.K. TO CONNECT SERVICE I , . , , I ~~ . I I CITY OF PORT ANGELES N ~ 1 7 8 9 3 LIGHT DEPARTMENT ELECTRICAL PERMIT -5' --.5 7' r< Port Angeles. Washlngton......m_mnmn__._.........m...._mmm..mmn.. 19.<:!.n~ In aocordance 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. Address n'Z.#.Qn.(;~a.~?:~.~.n.m~..n.n______mnn.mn....__n Occupancy._:.~..m..n....~_.nmmm. ~:~=~~.~1:~~~~~~~:::.~:~:::V~:::::.m~~:~~~;::::::::::::::~.-.-.~.-:::::::::=::::::::::::::::::::::::::::::::::::::: Light Outlets......................__.....__........... Service, volts .............___....__nmn.......... Type or Wiring: Receptacle Outlets............................... No. wires __n._un_...............____.._....._ Armored Cable .._n........_..__............ Dryer, KW __.uu.._...................._....__.____ Size wires........___.................__..h._n Non.MetalUc ............----.....--......-.-- Knob & Tube.__..______.....__................ Range, K\V.__.____..__......_________..__uu.._ Main fuse ___.___m___._........................ Rigid Conduit ....................__..._..... Water Heater: Enclosure __..__nn.................m___ ..... M talll T bI e c u ng huh.n___.n......___... KW......._____u_......._____un___n_ ___00___ Type of wiring: Raceway ............._...............___......_ Heat: KW.............n.....n_.................n ..m... Entrance Cable 00."___00 ..00-....... -.... Circuits, Light...................__n_.....n_....... Motors: size, volts and phase: Rigid Conduit n__..........m......__ ..... Utility .__..m______._....._....................... ..000000___......___..00..____00_.............._..0000..... Metallic Tubing 00..00_.................... I-Ieat 0000........................................... Current transformers: Range ....._______._.._____________.00____.__._.... .------.----..-..___._________._..........._h_______...... No. & Sizenn____....__.......nn....n___.___. Water Heater ............._................. .....00.00000000..............___...._..._................. Ser. NO.__......___.nn_.._._._.....n.___.....n.n Motor ..._........._...............00..______...._ _...__..........000000_.__........00.....00................ Ser. No. ...........00.00.._......._.............00... Dryer -..00---.....--.........................00.00...- 00-.00.-.........---.000000-.................-0000.......- Ser. NO...._nnn_nn.................____.._____... Furnace ...........-----..-......._......_.._._...... Total Load..n_..__..__._.............. Ser. No. ......__........._.000000__..............00. Total .....................00_......00_..0000 Remarks: .~n...c-...f:.-'".'..""dl.-1?kn..~'J.'n'./'c!:.J!.nn~.L.!:.eLn'!:~.Cnnn:-:m.nm,{.:~~(n'~.;::;::[{:..n.mrJ!...i!!!d/' -=> .--a_:?-":.\.....-.._...___.~:.:_~o::f,;;-_-;:.L.ee._4..q!...._..__.__~..__..'.._......_.h____.~~....._____.............._._._..___.__.....___.....___..__.....__..._:..__...........__ .~~~;~..;~~mn.m~.n.~.m.mm...;~~~~,n;~~~;~~.~m..mmnm...mmnn.n--T7j"'ir"znmmmn;~:.m.m. $:m.m..._.nmnnnu_._mnm. NO.._..._mm.nnn._....... By-'...,.~:.h..m-:..m~_::...~~_~.~.~.~CJ::?m.n::.::..?..~_(.mn NOTICE--Current must not be turned on until Certificate of Inspection haa been issued. It work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION N~ 1 7 8 9 3 ELECTRICAL PERMIT Address.__.__.._.........__..__...____....................._.__............................______........_..___.--.....-.........._________....Date..._.....__..__.____.........._......_.....____....... Owner..__.__.___._._...................._.__.__..___......_......_.........................__..._........_..______n____........_Tenant....__..___.___._....._n._._________........._.....________........ WiringContractor...........________.___................................_.....__..._..__.__.__............._____.._..............___._.___.By.______.............__.______.___.................__________.. ~OTICE-Current must not. be turned on until Certificate of Inspection has been issued. It work is to be con. L cealed due notice must be gIven the Inspector so that work may be Inspected before concealment. . 1M Olympic Printers. Inc. ~4.0~~<t<- FOROFFlCIAL USE ONLY: o~. ELECTRICAL PERMIT APPLICATION DateRec.: it 'IIol & Permit II: '7/ t;, 9' \'h "." Dale Approved: /, h ~'~., l7ze Electrical Permit Application must he filled out completely. Date Issued: ,,j.. ~' { Please type or print in ink. Uyou have any questions, please call (360) 417-4735 Fax number: (360) 417-4711 Applicant and/or Agent: ~g 2-4> diW'1tL./UI'c.4.f/@$'hone: Fa]( # <<s- 7 -D2/ Z Property Owner: .Phone: Address: ,City: Zip: Contractor License #: Exp: Phone: Address: _City: Zip: Credit Card Holder Name: &trl,/:C, C1W1MU.A/"('AI-,'OIf/~ L./t!.. Billing Address: 102... R.os,,<,. Vi,l/. ,City (kf~'l'kc Zip: 9'&":S"6~_ Credit Card Number~ Exp. Date: / / VISA MC 15- )('7.> . - Permit Fee: ~ - PROJECT ADDRESS: 'l2!J (l ~/;I/JL ZONING LEGAL DESCRIPTION: Lot: Block: Subdivision: CLALLAM COUNTY PARCEL NUMBER: . TYPF OF WORK: o Residenti o Multi-family o Commercial o Mobile Home Electrical Permit fees are based on WAC 296-46-910 CJ4/, BRIEF DESCRIPTION OF THE PROJECT; ikAA ~, EleC'trical Heat 1.o:HI Addition} Serviee Information o Baseboard - KW o Riser Voltage: o Furnace - KW o Overhead Service Phase: 01 03 o Heat Pump - KW tJ Temp Service Service Size: o Fan-Wall - KW o Underground Service Feeder Size: Comments: --.- ..-... 1 hereby certify thar I have read allci examined Ihll' appliClJl;On and know the same /0 be true and correel, and 1 am authorized to oPP!V for this permll. f under,rli/fld it is fIot the Cil)ls legal responsihilily to rletemltno wilat permits are reql/l'r"d; it remail1S tne applicants re,(pOIl.<lbility 10 deferm;/le what p"'mit.\~ are required alld to obtain such. rW~llol.?, 1'''''',001 Credit Card Ho!del"'s Signature: ~ ~ /': Date: 7 -I {r; ~ OJ . FROM ANGELES ELECTRIC INC 350 .152 9255 P~ 1 11-13-203 3,02PM IUI< lJl-j.!, ''''1. ll~:', O~l.'t' . ~~: ELI::CTf-JICAL PEI1Iv1JT .APPLiCATION n~IIi'k~,: __', l'cII"j,., _ -~ rJ~" ^I""n~c,!: _.,~~_._._._ . ." 1\)\ Th,~ E!(.ctlic"f Pennil I\pplic:ltion !.!2Y~\._1?C:_I.j.!!~5tOtJl c:.Qfn~elely, 1l;1'1\'ll"l:..~~.._, "1 ~')~~,.,r:,~~' ""~. . ~ PIe-;:ISe l}'p~ or reprinlln ink. r1 you h:w(" ;lIlV qtl~~'lons, please call (31)0. 417-4735 jl1?l- .~ 1/ () 1.-/ F.xnumbp,,(360J417~711 . ~ '. REQUEST INSPECTION Own", or [I"C~ (;onheclor Ayont-ANGEL ,'J;LU~lli:..- Pr.on.e:4 C,J-47f.4 Fax:-1I5 7_ Q? F.. r::;, . 1fz ~ Proper1f' O...vncr: ~, - _ a."."LV/ Phone: Md'e" (1/htt-fUAlE- '<i.y: / Zlp~ ANGELES ELECTHIC INC_ l\NGELF:1460RS Phone:~A t:;,") - Q.26A..... Electric8! COlltr'8C1Ol. Lic:CI1SC#:~ Exp: Addrcs:?' 524 EAST FIHST ~Ily PQwr l\NG[l"ES. WI\ _Zlp:~lfi) INSTALLATION WIRED BY IIOWNEA xJ.flECfRIC/'L CONTRACTOR Credit Card Halder Name: 'T''O.{1 ';..mp..s...on Billing Address' "ity' _ Zip: Credit Card Number: ~ //- Exp. Date: _ VISA.- MC:~ PROJECT ADDRESS: 7..;).0 ~LVN~ TYPE OF WORK: Check icl~ Ihal apply: UNew [I Alteration/Addition o Resrdental o Multi-family r~mmercia[ '0 Mobile Home Sq. FI. o Remote Meier o De/ached garage Ci HOI Tub [J Swim Pool o Septic Pump o Low Vollage 0 Telecom. o Sign Numbet of Circuils added or altered: ~ Af-./l3I?i'[J (J~ DESCRIPTION OF THE ELECTRICAL PROJECT: "'- ,on.. 5'1..t~ - -~ Eleclrical Heat Load Additions V~ Service Information D Baseboard _KW Voitage: / ~'/i) '] Furnace _KW lJ Overhead Service Phase: ~ 0 3 J Heal Pump _KW o Temp Service Service Size: ~4 J Fan'Wall _KW U Underground SBrvice Feeder SJze: :lAMe 14.05.060(8): Fer industrial. commercial. &. residential projecls larger than a duplex, a one -line drawing ollhe Electrical S€lrvice & :eeders, building size (sq. f1.), load calc'Jlalions, ~nd the lype & of conductors and/or raceway 1s required and shall accompany the :Ieclrical Permit application. hereby certify that I have read and examined this application and know that same to be true and correct, and I am 'uthorized /0 apply for this permit. I understand it is not the City's legal responsibility to determine what permits '(e required; it remains the applicants responsibility to determine what permits are required and fa obtain such. Credit car~Yolder's Signature; ~A~} __?;~ '\~.::' + Oate: Id~~ (,(, fC1~ OWner or EII'c~ ConI. Signature: ~ ~~,. ~ Oate: I/) If''~ N.9019 I'll ~.(;(.~I- fAJ!l!W ()f,t~ - O.6,,y~ I~ . Ti.r ~