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HomeMy WebLinkAbout832 Georgiana St - Building / PUBILle WORKS & R/W PERMIT OWNER/APPLICANT 0 Attached Notes DR MARGARET BAKER 832 GEORGIANA Port Angeles, WA 98362 000/604-7703 PROJECT INFO Work is Plans Required Start Date Contractor' HORIZON EXCAVATING Performance Bond Required Amount: Proof of Insurance Work to Perform: Issued 6/28/2000 Permit No Work Order' 1075 o PROPERTY LOCATION 832 GEORGIANA E Lot: 1,2,3 Subdivision NR SMITH Parcel No Block: 38 D Long Legal Value Work: $000 1 1 Finish Date. 3601452-9976 1 1 $000 D Install D Repair D Watermain D Sanitary Sewer D Storm Drain D Underground Tele/Elec D Misc DWY/PARKING PROJECT NOTES TAP INTO STORM DRAIN IN GEORGIANA STREET FEES ASSESSMENT 1 ) R/W Excav' $45 00 15 ) Other San Sewer' $000 2 ) Sidewalk: $000 16) Sew Tap Wye/Man Tap $000 3 ) Curb/Gutter' $000 17 ) Sew Capl W/M Removal: $000 4 ) Driveway' $145 00 18 ) Alter Repair Sewer' $000 5 ) Dwy Culvert: $000 19 ) Storm Drain $000 6 ) Street Cut: $230 00 20 ) Catch Basin per ea. $50 00 7 ) Other R/w' $000 21 ) Sewer System Dev' $000 8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $000 9 ) Res Water Servo $000 23 ) R/W Use Perm. $000 10 ) Comm Water Servo $000 24 ) Admin Cost (D RA) $000 11 ) Other Water Service $000 25 ) D RA. $000 12.)Water System Dev' $000 26 ) Misc: $000 13 ) San Sewer SFR $000 TOTAL FEE. $470.00 14) San Sewer MFR $000 add unit: 0 Amount Paid $47000 Receipt No 5858 Inspection Fee $000 Balance Due. $0.00 CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . / REQUEST 11 / Date /0 tJhm ( , I Time Received by (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No Type of Inspection (circle appropriate one) Permit No ~oundation Framing Chimney Plumbing Final Sewer Excav Other ~eor"/<fn"'--' /iJA-/ ___ /D75 ~ ~ ~ '\ \) ~ ~ ~. ~ INSPECTION NOTES Inspected Date Remarks Time By RESTORATION REQUIRED YES ~ NO ~~~~~ ~ ~ r?71~ ~ ~/~ SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel ~alt 0 PCC o Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # ~ COMPLETE /0-5-00 /Ij!f o INCOMPLETE ~ ~ JI;d Iv~/Zfrorr~/ (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) REMOVE EXISTING SIDEWALK AT DRIVEWAY CONSTRUCT NEW DRIVEWAY APPROACH AND SIDEWALK PER CITY STANDARDS (SEE DETAIL) MATCH_EXISTING GRADE AT REAR OF SIDEWALK DEMO EXIST CONC. STAIRWAYS (2) INSTALL 90 L.F 8 "O ADS STORM DRAIN LINE S -0.02 FT /F1 (MIN) 2:1 FILL SLOPE_ MAX. EP 3' j —4 I ter.. MATCH EXISTING GRADE AT EDGE OF PAVEMENT CONNECT TO EXISTING 24 0 ADS STORM DRAIN LINE IN GEORGIANA STREET AS DIRECTED BY THE CITY ESTIMATED DEPTH TO TOP OF PIPE IS 6 FEET CDF (CONTROLLED DENSITY FILL) ACKFILL REQUIRED IN STORM DRAIN TRENCH WITHIN CITY RIGHT -OF -WAY PARKING CONFIGURATION 1N THIS AREA MAY BE ADJUSTED IN FIELD TO SAVE EXISTING TREE SITE PLAN KEY 1 STALL CONC. BARRIER rr uRR. 47 I F t WOMIPOMIMMIMMIWOMI 1 `INSTALL CONC. BARRIER `LIMITS OF t;URB, 28 L.F NEW SIDEWALK TO BE DETERMINED BY OWNER CONSTRUCT 2" CLASS 8 ASPHALT --CONCRETE OVER 2" CSTC OVER 6" BALLAST PROOF -ROLL SUBGRADE AND COMPACT BALLAST AND CSTC TO 95% MAXIMUM DRY DENSITY AS DETERMINED BY ASTM -D- 1557 -4 i r c'5 i I 87.8 X '3 DEMO E�(I TING CONCRET PLANTER SLAB TAS DIRECTED BY OWNER i 1 ti. DEM0 EXIST SLAB CONC. WALL a 87 1" 30 PROPERTY LINE NEW 4 0 PVC TIGHTLINE PROPOSED FLOWLINE PROPOSED STORM SEWER LINE EXISTING STORM SEWER LINE PROPOSED CATCH BASIN PROPOSED A -C PAVEMENT PROPOSED CONCRETE DRIVEWAY SIDEWALK --p-59 1 89\7 Oa' 1 All workmanship and materials shall be in accordance with the City of Port Angeles Standards, the current edition of X90.7 the State of Washington Standard Specifications for Rood. Bridge and Municipal Construction, and any project specific special provisions or conditions and requirements. 2. Temporary erosion /water pollution measures ore required and shall comply with the City Clearing and Grading Ordinance and WSDOT /APWA Specification 1 -0715 os follows: 3. A preconstruction meeting shall be held with the city I f prior to the start of construction. 4 Horizontal and vertical controls /datum os adopted by the city shall be used, unless approved otherwise 5. All approvals and permits required by the city shall be obtained by the contractor prior to the start of construction, unless otherwise approved by the City Engineer 6. The contractor shall be fully responsible for the location and protection of all existing utilities. The contractor shall verify all utility locutions prior to construction by calling Underground Locate of 1- 800 424 -5555 a minimum of 48 hours prior to any excavation work. EXPIRES. 8/12/00 NOTE. GRADES GIVEN ARE RELATIVE TO TOP OF CATCH BASIN IN PARKING LOT FINAL ELEVATIONS TO BE SET BY ENGINEER AT CONCLUSION OF DEMOLITION WORK. CITY OF PORT ANGELES CONDITIONS GENERAL 7 All non ferrous pipe and services shall be installed with continuous tracer tope installed 12" to 18" under the finol ground surface. The marker tope shall be 4 wide minimum plastic non- biodegrodoble, metal core or backing marked and color coded for the utility to be morked and which con be detected by a standard metal detector Tope shall be Terro Tape "D or approved equal. In addition, to trocer tope, force mains and curved mains shall olso hove a 14 gauge coated copper wire, wrapped oround the pipe, brought up, cooting stripped, and tied off of the valve stem or manhole ring. The tape and wire shall be furnished and installed by the contractor 8. Temporary street patching may be allowed with the approval of the City Engineer Temporary street patching shall be provided by placement and compaction of 1 inch maximum asphalt concrete cold mix.The contractor shall be responsible for the maintenance of the patch until the permanent repoir is mode. 9 The contractor shall provide o traffic control plan(s) for review and opprovol by the City Engineer in occordonce with the Monuol on Uniform Traffic Control Devices (MUTCD). 10. The contractor shall have a copy of the approved pions of the construction site of all times. 11 Special structures shall be installed per plans and manufacturers recommendations. 12. All disturbed areas shall receive temporary and permanent erosion control in the form of vegetation establishment such os gross seeding. A means shall be established to protect the permanent storm drain system prior to establishment of the permanent erosion control measures. These methods shall be included in the erosion and sediment control pions in occordonce with Chapter 6 of these standards. 13. Construction work hours shall be restricted to 7 A.M. to 10 P.M. unless otherwise approved in writing. 14 The city construction inspector shall be notified o minimum of 48 hours in advance of the need for on inspection, unless otherwise informed. ENOVIC Li ASSOCIATES INCORPORATED SITE IMPROVEMENTS AT 832 GEORGIANA ST PORT ANGELES DRAWING: *IN/or /00065 /065E -1 DRAINAGE PLAN NOTES CLIENT. DR. MARGARET BAKER 832 GEORGIANA STREET PORT ANGELES, WA 98362 (360) 457 -7003 519 S. PEABODY ST. STE. 4 PORT ANGELES, WA 98362 PHONE. (360) 417 -0501 FAX: (360) 417 -0514 STORM WATER 1 All storm drain mains shall be high velocity cleaned and low pressure tested in accordance with WSDOT /APWA Specifications prior to final paving. 2. Prior to bockfilling, all storm drains and appurtenances shall be inspected and approved by the citys inspector Approval shall not relieve the contractor for correction of any deficiencies and /or foilure os determined by subsequent testing and inspections. It shall be the contractor s responsibility to notify the city for the required inspections. 3. Special structures, oil /water separators and outlet controls shall be installed per plans and manufacturers recommendations. 4 The city construction inspector minimum of 48 hours in advance existing storm main. The inspector time of the top. NOTE. TOPOGRAPHIC INFORMATION SHOWN HEREON WAS COMPILED FROM THE MARCH 1995 AERIAL MAPPING FOR THE CITY OF PORT ANGELES AS COMPLETED BY DAVID SMITH AND ASSOCIATES. VERTICAL DATUM IS NORTH AMERICAN DATUM OF 1988 (NAD88) AS SHOWN ON THAT SURVEY FILED IN VOLUME 34 OF SURVEYS. PAGE 22, RECORDS OF CLALLAM COUNTY WASHINGTON. HORIZONTAL DATUM IS WASHINGTON COORDINATE SYSTEM, NORTH ZONE, DATUM OF 1983, 1991 ADJUSTMENT AS PER SAID SURVEY NO FIELD VERIFICATION OF THE TOPOGRAPHIC DATA HAS BEEN MADE. .108 NO. SHEET 00065 DATE MAY 2000 SCALE 1 30 shall be notified a of o top connection to on shall be present at the aF 1 6" MIN. OVERLAP NOTES PAVEMENT BARRIER CURB DETAIL NOT TO SCALE C.0 BACKFILL L I• i��JJ ��JJ��// /CUTS =It 4111- I I I-. I1.1I F- :1 2 -ill.- If I 111.. ..I 7 d) 7t rt -7.:1 1 1......_ a c 111 =I I i 1 I 1=711 i..- 11==111 =11 vI 1 •1 I:71 II: 1 3 1 BEDDING 5 1/2" 1 R 0 i0 NOT TO SCALE ASPHALT CONCRETE PAVEMENT OR CLASS B PCC PAVEMENT (HIGH EARLY) MATCH EXISTING PAVEMENT TYPE AND DEPTH. SEE NOTE D SHALL BE SAWCUT C.D TRENCH DETAIL NOT T O SCALE SEE NOTE C. 1/2R-N�_ N A. ACP PATCH SHALL BE ROLLED AND NOT VIBRATED. B. TO BE USED FOR ALL PAVED STREETS AND ALLEYS. BACKFILL LOCATION TO 1 -0" BEHIND CURB OR EDGE OF PAVING UNLESS OTHERWISE APPROVED IN ADVANCE BY CITY ENGINEER. C. WHERE CONCRETE PAVEMENT JOINT IS LESS THAN 4' -0" FROM SAWCUT THE PAVEMENT SHALL BE REMOVED TO THAT JOINT D. TEMPORARY PATCHING WITH ASPHALT OR PLACEMENT OF STEEL PLATES IS REQUIRED WHEN TRAFFIC WILL CROSS COF FOR MORE THAN 24 HOURS WITHOUT PERMANENT RESTORATION. STEEL PLATES SHALL HAVE COLD PATCH WEDGES ON TRAFFIC EDGES. TOP OF CURB AT DRIVEWAY 5 1/ 1 "R 18" C D BACKFILL SPECIFICATIONS 2600 LBS. OF 0.375 IN. AGGREGATE 800 LBS. OF STANDARD CONCRETE SAND 94 LBS. OF PORTLAND CEMENT APPROX. 14 GAL. OF WATER THE AMOUNT OF WATER IS A CRITICAL FACTOR TO SET UP TIME AND SHOULD BE ADDED AT THE SITE. I EXPIRES. 8/12/00 CEMENT CONCRETE BARRIER CURB AND GUTTER PER WSDOT STANDARD PLAN F -1 CURB GUTTER DETAIL TITLE. INCORPORATED Z ENOVIC ASSOCI ATES EXPANSION JOINTS NOTES. NOTES 1 DRIVEWAY LOCATION TO BE APPROVED BY CITY ENGINEER. 2. SIDEWALK CROSS SLOPE SHALL NOT EXCEED 2% IN DRIVEWAY AND BYPASS AREAS. 3. DRIVEWAY APRON AND SIDEWALK SHALL BE CONCRETE AND SEPARATED FROM OTHER CONCRETE WORK USING EXPANSION JOINTS. 4 HERBICIDE TO BE PLACED UNDER PAVING, CURB AND SIDEWALK PRIOR TO PLACING OF MATERIALS. 5. SIDEWALKS, CURB AND GUTTER PER CITY STANDARD PLANS. 6. EXPOSED AGGREGATE WORK OR SPECIAL SURFACE TREATMENT NOT ALLOWED IN RIGHT -OF -WAY WITHOUT APPROVAL. 7 LONGITUDINAL DUMMY JOINTS. 1/8" THICK AND 1 DEEP SHALL BE AT INTERVALS NOT TO EXCEED 15 FEET AND BE EQUALLY SPACED IN DRIVEWAY APRONS. 8. CONCRETE SHALL BE CLASS 3000. 9. DRIVEWAY PAVING MATERIALS, OTHER THAN CONCRETE. MAY BE USED BETWEEN THE SIDEWALK AND THE R/W WITH CITY ENGINEER APPROVAL. 10. EXPANSION JOINTS SHALL BE 1/4 THICK, FULL DEPTH, ASPHALT IMPREGNATED JOINT MATERIAL. SIDEWALK AND DRIVEWAY DETAILS NOT TO SCALE ADJUSTING RING AS NECESSARY 1 OIL SEPARATOR "T" REQUIRED AT OUTLET UNLESS OTHERWISE APPROVED BY CITY ENGINEER. 2. CONCRETE CLASS 3000 3. CATCH BASIN BASE TO BE SET LEVEL. GRATE FRAME TO BE SHIMMED TO MATCH LONGITUDINAL SLOPE. 519 S. PEA80DY ST. STE. 4 PORT ANGELES, WA 98362 PHONE. (360) 417 -0501 'AX: (360) 417 -0514 R/W NOT TO SCALE EXPANSION JOINT NOT TO EXCEED 1/2" RISE 6" COMPACTED SUBGRADE ro N SECTION B —B SITE IMPROVEMENTS AT 832 GEORGIANA ST PORT ANGELES DETAILS CLIENT: DR MARGARET BAKER 832 GEORGIANA STREET PORT ANGELES. WA 98362 (360) 457 -7003 REPLACE SIDEWALKS WITH 6 CONCRETE IN DRIVEWAY AREA. ,3'MIN. i 5 MIN. SECTION C —C CAST IRON FRAME GRATE 8 "0 PVC PIPE MEET SIDEWALK OR FUTURE SIDEWALK GRADE 2% MAX. 2% MAXIMUM SLOPE IN SIDEWALK AREA SEE NOTE #9 MANHOLE ADAPTOR CATCH BASIN DETAIL USE CATCH BASIN TYPE 1L BASE WITH 6 REDUCER SECTION AND RISER SECTIONS AS NEEDED DRAWING. w1N/DT /00065 /Des€ -2.owG J08 NO. SHEET 00065 DATE 2 MAY 2000 SCALE AS NOTED or 2 . CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO / '1 g, /,;U!::lt9 It Ii' I I ELECTRICAL PERMIT DATE Site Addiessg,3';< Installedl By: OwnerIBus;ness: I Owner/B"usiness Address: I o Rbsidential H'eat KW o Blaseboard 0 Furnace/Boiler o Heatpump 0 Other 1"i Commercial/Industrial load , , Tetal Connected load (attach breakdown) Tjotal Motor load (attach breakdown) DetaillJDesCriPtion: I SO ,. )<:(READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: , Phone: Sq. Ft. o Overhead o Underground Voltage 01111 03,0' Service size o Temporary o New Construction o Remodel o Service update/alter/repair ~ Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) Amps AlPY :J , P / DA---tVS { I s ~. hf.-l1-f ;&00 U)fJ.-I!s c.id,IJu J W.S. No. Service Size Capacity: 0 O.K. 0 Not O.K. Comments o Ditch inspection O.K. ~~VI. \&l Rough-in/cover O.K, o 0.K, to connect service .Jof^-.fjJ Final O.K. Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for instaliation o Fire Department notified of inspection o Plan Review approved/pending Sit~ Address: . G.e..e- ("" ~ ~~~ Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electrically energized before inspection and O.K. for covering or service has been given by the Inspector in Writing on the Wiring Report or the Building Permit. PHONE 457.0411, EXT. 158 or EXT. 224. '/thN\. . NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ;is ,;;)(;;, !l-O Inspector Amount paid WHITE _ file by address YELLOW _ file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall , · 8362 Installer: }../, (\1 2, .scJL CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N<? 15474 Port Angeles, washlngtonnm.(C{.-.:..r:1...nm.nfA..9!......m....m..... 19?.~ (/ 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- :~:::s: 1~.:;T:J;:~.tf:..~.:2{=:::~,:~.~~..::IO:~cupancy........k~~~~~;~~~... Owner n.n/2!/..n.....,ik::/i.,..k:."".....,2/!If..i;(;~ Tenant..... .......h..hmh.......~..mnmn.....n..m..hh........... :/ I ,..,~ Wi;-ing Contractor .:2/1fdd.1Ln.(..(.'.:....~~"l':d,,~~~.'-"m. By.. hmnn....nn.nnnn.m........nnnm..nmnn......n. Light OUtletB.........t...~.o..... .y...... Service, volts ..../~.?/2..r y.... I '1'yp:::::~n;~hle................ Retleptacle Outlets........mmm_m_nm_._. Ns'l~z.eWwlrl.erses.........o../.~...y...........~...:.....~..............'.:..............._..... II Non. Metallic ..._..... ......mm........... Dryer, KWlm.....___...nm....nn.....m....... .'- . Ran3e, KW mnm .munm..u Main fuse .m;?;.(?..t?..I!.m.mmn I Knob & Tube_ .....m..mmmum....m <..:... Rigid Conduit um....m..mnunmnm wa~~:ea~e"i~...(..................... TYP::;l:j:~:~:....."'.................... I MetalUc Tubing L d n 9- Entrance Cable n....mm..._+nmmnu Heat: RW". ..tJ.......{t...~A.~~""'.. Motors: size, volts and phase: Metallic Tubing m......_ C!rc~:~~~~~~:::l::::..:::::::::::.::::::.. Heat ..../.:::!............................._. Rigid Conduit uuunmnmnu.........__ Current transformers: No. & Size....n.n..._....u..n..n_____n.n.. Ser. NO...............n....u....................... Range ...........n................n.............. 'Vater Heater .m~....m.u....m.m.. Motor ......._......_................._............ Ser. NO.....................n............nn...n... Dryer...nn.nn...........nnn..........nnn..._ Furnace .........................._n................ ')S( Total ....2....L........................ Ser. NO.....n....nn.....n_..nn..n..........n.. Total Load Ser. No. n.nnn.nnnunn_...n...............n Remarks: .~..~n__~.u_~n:':.~~~n.~:__:.(h~h.~_n.__.n_-{~.~:_:..:~::'__~:~-;.~__u~UU__.__nnnn..~nn_..~.n..hnnnn.n.nn.n~..___.nn..nUU. i.~~i~;~:.~~~~~~....~.~..~~~........m.i~~.~.~~.~~~.~.~~.~.~...~.~..~~.m....mm....:~.::..~~.:Z::~:.~~~.(~.~=:=;L:::= NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work Is to be con. cea ad 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 If / /, '/ {., r /c 1~ Y' "Co( ,. .,. ... ELECTRICAL PERMIT N? 15474 "S"0~ r ~~'. .. ::::~:~:r: f;~:Wn :;~)~~:.:~r;r~+.{~~~7~~::::..::::::::::::.::.:::...:.::..:.:..::::::::::::::..:::::::::::::::::::::::~::::::.:::::::::::::: O~'1:"f~',,:' .t.....,.~_~~ -'_" InsI'ectioncompleted..._..................__c.............................................-..................-...............................................--.-..................---........-......... Tot:ll Load .....................n............................_.............. 1M 3~72 Olympic Printers, Inc. Application Number . . . . . 23-00000113 Date 2/03/23 Application pin number . . . 294865 Property Address . . . . . . 935 GEORGIANA ST ASSESSOR PARCEL NUMBER: 06-30-00-5-8-0195-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL OFFICE Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Exterior light ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ OLYMPIC MEDICAL CENTER JOHNSON ELECTRIC COMPANY AKA CC PUBLIC HEALTH SERV #2 3129 S REGENT 939 CAROLINE ST PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 728-4327 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee . . .00 Issue Date . . . . 2/03/23 Valuation . . . . 0 Expiration Date . . 8/02/23 Qty Unit Charge Per Extension BASE FEE 86.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 MULTI-FA MILY/ COMMERCIAL ELE CTRICAL PERMIT APPL ICATION Public \Yorks and Utilities Department 321 E. 5th Street, Port Angeles. WA 98362 360.417.4735 I www.cityofpa.us I electricalpermits(s/.cityofpa.us Project Address:--------------------------------------­ Project Description:--------------------------------------□Multi-Family Residential D Commercial I Industrial/ Public Building Square footage: __________ _ OWNER INFORMATION Name: ________________________ Email: ______________ _ Mailing Address: ________________________ Phone: ___________ _ ELECTRICAL CONTRACTOR INFORMATION Name: License: ___________ _ Mailing Address: ________________________ Expiration Date: ________ _ Email: Phone: ___________ _ PROJECT DETAILS llim! Service/Feeder 200 Amp. Service/Feeder 201-400 Amp. Service/Feeder 401-600 Amp. Service/Feeder 601-1000 Amp. Service/Feeder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Branch Circuits 1-4 Temp. Service/Feeder 200 Amp. Temp. Service/Feeder 201-400 Amp. Temp. Service/Feeder 401-600 Amp. Temp. Service/Feeder 601-1000 Amp. Portal to Portal Hourly Sign / Outline Lighting Signal Circuit/Limited Energy -Multi-Family Signal Circuit/Limited Energy/First 1500 sf -Commercial (Note: $5.00 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less Thermostat (Note: $5 for each additional) Unit Charge Quantity $132.00 $160.00 $225.00 $288.00 $410.00 $5.00 $74.00 $5.00 $86.00 $102.00 $121.00 $164.00 $185.00 $96.00 $88.00 $88.00 $96.00 $113.00 $56.00 Total (Quantity x Unit Charge) $ ____ _ $ ____ _$ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _$ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ ____ _ $ _____ TOTAL Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296- 46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Date Print Name Signature (0 Owner D Electrical Contractor/ Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us] lJ CD PREPARED 2/02/23, 9:13:59 PAYMENT DUE CITY OF PORT ANGELES PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER:23-00000113 935 GEORGIANA ST FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------------- ELECTRICAL ALTER COMMERCIAL 86.00 TOTAL DUE 86.00 Please present reciept to the cashier with full payment ELECTRICAL INSPECTION WIRING REPORT APPROVED NOT APPROVED DITCH ROUGH IN/COVER SERVICE FINAL COMMENTS NOTIFY INSPECTOR at (360) 808-2613 WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS DATE PERMIT # INSPECTOR 3/14/2023 23-113 TAP OWNER CONTRACTOR Johnson Electric PROJECT ADDRESS 832 Georgiana St