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Home My WebLink About819 Georgiana St - Building S 'IL -- ....<;;;i<' CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application description Property Zoning . . . Application valuation 03-00000511 Date 5/28/03 819 B GEORGIANA ST 0630005137720000 CERTIFIED HEARING SIGNS o Owner Contractor PENINSULA NEUROPSYCHIATRIC ASN B19 GEORGIANA ST 8TE A PORT ANGELES WA 983623511 OWNER Permit Additional desc Permit Fee Issue Date Expiration Date SIGN 30.00 5/28/03 11/24/03 plan Check Fee valuation .00 o Qty Unit Charge Per 1.00 30.0000 PER S- SIGN ALL 25- Extension 30.00 ~ - Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 30.00 30.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 30.00 .00 .00 -Q ~ fr () "1 ae p :::. p ~ 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 locai law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date ,- T:\PLANNING\FORMS\1102.J5 [4/2002] BUILDING PERMIT - APPLICATION Fill out COMPLETELY aud in INK. Your applicatiou and site plan MUST BE COMPLETE to be accepted for review. If you bave auy questions, call (360) 417-4815 FOR OFFICIAL USE ONLY Date Rec.: 5. LD ...u~ Permit#, 5/( Date Approved: Date Issued: tjI/)-,:! d;7:;:..r Phone: Phone: u) H Zip: 9K a h/L Credit Card Holder Name: Billing Address: City: Credit Card Type VISA MC # Exp. Date: TYPE OF WORK: SIZE/V ALUATION: o Residential 0 New Constr. 0 Re-roof 0 Stove SF. @ $ /SF. = $ o Multi-family 0 Addition 0 Move 0 Garage SF. @ $ /SF. = $ o Commercial 0 Remodel D Demolition 0 Deck SF. @$ /SF. ~ $ o Repair )( Sign 0 Other TOTAL VALUATION $ ~ BRlEFDESCRlPTIONOFTHE'~l'tOJECTk7 Mo'~",:f- OM F){ls+,~ . J::re; <;:Ict:;rJ:"'3 ?ac,-{- Lr' X -5 .= 12 ) Jl16V,:j' .f.-OIM. ex.'s{;f5 ~cc._.bt.'. COMMERCIAL/RESIDENTIAL: Occupancy Group: Occupant Load: Construction Type: No. of Stories: Lot Size: Existing Sq. Ft. & Proposed Sq. Ft. ~ TOTAL Sq.Ft. Existing lot coverage _ % & Proposed lot coverage _% = Total lot coverage % City: Architect/Engineer: Phone: Contractor State License #: Exp: Phone: Address: City: Zip: PROJECT ADDRESS: [rl l' A. ~4= /.,. ~ J-i. #- B ZONING: LEGAL DESCRIPTION: Lot: J ~ BlockU ~ 1 Subdivision:c1 ~ ~ CLALLAM COUNTY PARCEL NUMBER: CD J<~ ~-nA, APPROV s: PLAN?f BLDG: DPWU: FIRE: OTHER:_ \ BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on tbe 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 tbe Building Division to comply with current fee scbedules. 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 ofthe 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 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. I am authorized to apply for this permff and understand that ff is my responsibility to determine what permffs are required ,nolJ the City's, and that I must obtain such permits prior to work. T:\FORMSIAPPSlBuildingperrnit.wpd APPlican:.>;;;;':'-~ L?j7.~~ Date: ,")- -c~ - (/ ~q , / J~v"\.ti2.. l ST (e ,-1--,:.r~"t e.,c..'.J-\l''^-~ o TING SLIP Ce "fi te of Occupancy 1m Iflcate/lnspection Fee , I I I ! 'J 1 DATE d' ..J~ - I) Addres f Proposed Business ~ J. ' bu ness -j/ S.-:;l d?,Mg-- home ~ '}(J ~>~ s-/ New Business ..... .,. . ................ Transfer of Business Location.. ...... Change of Ownership . . . . .. ............. . New Building ..... ............. ... ..... Remodel. . . . . . .. . ............ ......... Temporary Business .. ............ Change of Use .......... ............. ( (/ ( ( ( ( ( Bnef descnption of proposed business: legal Descnption: lot I? Current Use of Property' c..--m p It,(I'..(! 1! Zoning Classification of propert~: C.CJ YES NO ,./ -- v - -----;;7' --7 V== - ~/ -vr - ----vr -- V == [/ -L=9 Will THERE BE ANY OF THE FOllOWING? Construction changes Electncal 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 01 Iilllng 01 lots Work done In City nght-ol-way Is there sufficient off-street parking? New dnveway openings A grading plan lor site drainage (parking lots, downspouts, etc ) Are the eXisting streets paved? Are there eXisting sidewalks? Is there curb and gutter? Other --,;r - V ;T- V-- THE FOllOWING Will BE REQUIRED' OJ -D PERMITS 1) BUilding 2) Plumbing 3) Electncal 4) Mechanical 5) Sewer 6) Sidewalk Installation 7) Dnveway installation 8) Curb Installation 9) Sidewalk obstruction 10) Water meter Installation 11) Fire - 12l-Qccupancy 113) Algn L/' 14) Shoreline 15) Home occupation 16) Conditional use 17) Other 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) OtDer ..... , ro ,. f ~ (? (t\ o 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. Signed,:- Ar:rED ~EJECTED ~ , t~' BUilding Section Public Works Department Planning Department Fire Department City Clerk P.B.I.A. Comments / Conditions CE RTI FIC,krl!~O~e"C~Qu P ANCY City of Port Angeles - Building Division Use Classification. -/ Group --1L- Owner of Business' BUlldmg Address - -Y'. ous place. I.elailding Official. ~ ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ;?,fl$'G'~~~.~ -, CORRECT A9DRESS IS R.ESPONSIBILlTY OF APPLICANT Owner :1-1.J..J0'; <;:';'\.d. +. e. Installation By Owner's ~diJress\iJ..D.?;"\()'3:2J ~ ~lJ ()/' S W~,~A!n.stallers.AddreSS Day Phone 7'1 r -(') d. t:; 7 . ..' ". Installers Phone' APPlicat'{Ofl is hereby made for Permit to instalJElectrlcal.EquiPnienfas follows:. h!o 0 k. I) t::J S er-LJ It, q.... C-roS!::: ---.fX.1()d lJl~ O#vu__ 'ii6ddd...~ r .. - \1 TOTAL FEE I Site AdJess .' USE!OF CIRCUIT - L1GHTI LIGHT I CONV~NIENCE CONvENIENCE , APPLIANCE I DISH~ASHER I , DISPOSAL , RANG~ . OVEN I WATE~ HEATER LAUNDRY , DRYER , FURNACE GAS. OIL FURNACE ELECliRIC ELEC~RIC HEAT ELECijFUC HEAT A.C. U~IT FEED~R SERViCe , CITY OF PORT ANGELES DEPARTMENT OF LIGHT APPLICATION AND ELECTRICAL PERMIT 000257 A PERMIT NUMBER e~~. lEGAL OCCUPANCY e.../ e 7 L(t, oi-6 C<!lMM NT. Lie. NO. TIME TO COMPLETE NO. STORIES (~t.J~ 'Uo'( C~"YI vi (U... 'h ~ .pr) ( IJ F .Il/I~iring Method (1') r e- NUMBER CIRCUITS AMP PER CIR FEE 240V , 00R 30 AMP PER CIR : 240V 100R 30 120V 10 NUMBER CIRCUITS 120V 10 FEE USE OF CIRCUIT SIGN 50 VOLTS OR LESS MOTOR ;- , MOTOR MOTOR FIRE ALARMS BURGLAR ALARM MISC. I J 5"00 "'DO ao~ Sd.':!!. fl~ /rt t)~ /P REINSTALLATION LIGHT FIXTURE # SUB TOTAL FEE ENERGY FEE BASIC FEE . R .:7f,E 1"1. SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER I"""" 'rOO AMP / <b v SIZE OF SERVICE ENTRANCE CONDUCTORS TOTAL FEE PHASE A.W.G. I - I SUB-TOTAL SIZE OF GROUND (p SIZE OF ENTRANCE SWITC~:;l 00_':> A):;lAj I certify that the work to be performed under- this per~it w'i11 be done by the installer a~d in conformance' ith the N.E.C. Electrical Code. Date)Plicatlonmade. J./-'~/lfS' - - ,19' By . r . - - , - . -. -. . . CONTRACTOR OR OWNER/R AUTHORIZED AGENT) . Permission is hereby given to do the above described work, according to the conditions hereon and according to the approved plans and specifitations pertaining thereto, subject to compliance with the Ordinances of the ,City of Port Angeles. I . . . :r!7~~YGHT - .. Date Permit Issued .q ~,z )- r) ~~NSA~ . ~ ' ./ I Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not , be covered or Current turned on before inspection and O,K. for covering or service has been given by Inspector in Writing on Permit Placard, A. - Permits Phone: 457-0411 Ext. 158, -:' WARNING OlYMPI PRINTERS, INC. PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER - WHITE - Original CANARY - Duplicate PINK. Triplicate WHITE CARD -Inspector's Report ., . ... " ,. j- "-':!~'f :. (,-',~':'}{,.\j REPORT OF INSPECTOR ". ,.r. , , \ .J , , DATE OF VISIT MADE BY REMARKS \ - - - S'.q.5<5\i" ~ :4/0 \ :2~, lij"r<, I?" ~ ^'. -rePtl{..., Fol{ til,,,, ,,,,, \ - \ I'CI'/N/lr . .... , /:;- f7-n l1LV I'I<.rJ~re ofr{c~,I",~-r( 1, fr!. r cA)GK ('ol'ftYecr,oIV, - A71P ~p ,-rd. ~ Uj7 J ,tJep"wrJ IN r:;.Y'A"1 Reo II<\, I - <{/.2(/1:> 'f'lfjJ suJ,td, S r3,./.. NP f}OD ~ '/N ~ of.f^"i If 00 ^" ;1-.' , ~/tL L . 5,(... L Il iJc fllY ,NoRrL. '.\!' I ~, .. .. . I - - - .. z . Cl a: , ,cC :!! -- ;. !!1 :J: .... , z w -- .... , . -- , .... , 0 , z - , 0 - - , -- . , - , C : ! - - - . , , .. . .. .. . : , , " -- '. , ' " , .. ,- . , .. ' ' O.K. FOR COVERING s-/ -'D'S- /!!. e'.2 "\ " , ~ .- O:K. !9 f.ON~Ep~ERVICE ~r J..,L- Dj' .. IJ/ ~ft ' - , \ " - >- , FINAL O.K. ' , " ( . \ ,\ . \ .. ", .. , " - .. ,