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HomeMy WebLinkAbout106 W Lauridsen Blvd - Building OF..„.4,C CITY OF PORT ANGELES 4 ^F 0 p�� PUBLIC WORKS UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 10- 00001103 Date 11/08/11 Application pin number 834930 Property Address 106 W LAURIDSEN BLVD REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 09 -5 -2 -0788 -0000- on your state excise tax form Tenant nbr, name BOULEVARD NATURAL WLLNSS Application type description, COMM ADDITION to the City of Port Angeles Subdivision Name (Location Code 0502) Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 43520 Application desc ADD 400 SQ. FT. OF MEDICAL TREATMENT SPACE Owner Contractor CITY LIGHTS HOLDINGS LLC OWNER C/O FRANK SPRINGOB 106 W LAURIDSEN BLVD PORT ANGELES WA 98362 (360) 452 -2920 Structure Information 000 000 ADD 400 SF OF MEDICAL TREATMENT SPACE Permit PW ENGINEERING REVIEW STORM Additional desc Permit Fee 300.00 Plan Check Fee .00 Issue Date 1/07/11 Valuation 0 Expiration Date 5/01/12 Qty Unit Charge Per Extension 6 BASE FEE 300.00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments October 12, 2010 4:21:54 PM sroberds. the proposal will result in a 400 sq.ft. addition for total lot coverage of 20% in the CSD. No land use issues. October 6, 2010 8:50:15 AM Brian 417 -4708. Wiring for addition will require electrical permits and calculations for added load. Any modifications to the City's electrical facilities will :5, be at the customer's expense. All construction work within the City right of way requires a separate Right of Way Construction application to be completed by the contractor and approved by Public Works !i Engineering prior to the start of work. A pedestrian or traffic control plan is to be submitted for approval with the application as necessary. All connections to City storm drain facilities require an inspection by Public Works and Utilities Engineering prior cover. Notice will be given 48 hours in advance of commencing work. r"• Other Fees STATE SURCHARGE 4.50 9- 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 I w regulating construction or the performance of construction. 8.. H Signature of Contractor or Authorized Agent Date Signatur f Owner (if ner' builder) Date T \Policies \1102.15 [10/08] PERMIT INSPECTION RECORD CALL 417 -4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PIN UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. PW/ CONSTRUCTION R.W. ENGINEERING 417 -4831 PW ENGINEERING FIRE 417 -4653 FIRE DEPT. PLANNING DEPT. 417 -4750 PLANNING DEPT. BUILDING 417 -4815 BUILDING T: \Policies \1 102.15 [10/08] °flT ""�F CITY OF PORT ANGELES PUBLIC WORKS UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number 10- 00001103 Date 11/08/11 Application pin number 834930 REPORT SALES TAX Fee summary Charged Paid Credited Due on your state excise tax form to the City of Port Angeles Permit Fee Total 300.00 300.00 .00 .00 (Location Code 0504 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 304.50 304.50 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T: \Policies \1 102.15 [10/08] PERMIT INSPECTION RECORD 4 CALL 417 -4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. PW/ CONSTRUCTION R.W. ENGINEERING 417 -4831 PW ENGINEERING FIRE 417 -4653 FIRE DEPT. PLANNING DEPT. 417 -4750 PLANNING DEPT. BUILDING 417 -4815 BUILDING T. \Policies \1102.15 [10/081 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 10- 00001103 Date 1/07/11 Application pin number 834930 Property Address 106 W LAURIDSEN BLVD REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-09-5-2- 0788 -0000- Tenant nbr, name BOULEVARD NATURAL WLLNSS on your state excise tax form Application type description COMM NEW CONST Subdivision Name to the City of Port Angeles Property Use (Location Code 0502) Property Zoning COMMUNITY SHOPPING DISTR Application valuation 43520 Application desc ADD 400 SQ. FT. OF MEDICAL TREATMENT SPACE Owner Contractor CITY LIGHTS HOLDINGS LLC OWNER C/O FRANK SPRINGOB 106 W LAURIDSEN BLVD PORT ANGELES WA 98362 (360) 452 -2920 Structure Information 000 000 ADD 400 SF OF MEDICAL TREATMENT SPACE Permit BUILDING PERMIT COMMERCIAL Additional desc ADD 400 SF MED TREATMENT SPACE Permit pin number 174441 Permit Fee 609.65 Plan Check Fee 396.27 Imo^ Date 1/07/11 Valuation 43520 Expiration Da e 7/06/11 Qty Unit Charge Per Extension BASE FEE 417.75 19.00 10.1000 THOU BL- 25,001 -50K (10.10 PER K) 191.90 o Permit MECHANICAL PERMIT Additional desc S Permit pin number 174474 k Permit Fee 109.20 Plan Check Fee .00 Issue Date 1/07/11 Valuation 0 Expiration Date 7/06/11 Qty Unit Charge Per Extension V� BASE FEE 50.00 4.00 14.8000 EA ME- HEATER(SUSP /WALL /FLOOR -MTD) 59.20 Special Notes and Comments The Fire Department has reviewed the project application and has no comments October 12, 2010 4:21:54 PM sroberds. the proposal will result in a 400 sq.ft. addition for total lot coverage of 20% in the CSD. No land use issues. October 6, 2010 8:50:15 AM Brian 417 -4708. Wiring for addition will require electrical permits and calculations for added load. Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Date I Print Name Signature of Cont actor or u thorized Agent Si ature 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 Commercial Hood Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit. #s SEPA: Parking Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 T:Forms /Building Division /Building Permit %414P46 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 1 Page 2 Application Number 10- 00001103 Date 1/07/11 Application pin number 834930 REPORT SALES TAX Special Notes and Comments on your state excise tax form Any modifications to the City's electrical facilities will t o the City of Port Angeles be at the customer's expense. y g All construction work within the City right of way requires (Location Code 0502) a separate Right of Way Construction application to be completed by the contractor and approved by Public Works Engineering prior to the start of work. A pedestrian or traffic control plan is to be submitted for approval with the application as necessary. All connections to City storm drain facilities require an inspection by Public Works and Utilities Engineering prior cover. Notice will be given 48 hours in advance of commencing work. Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due Permit Fee Total 718.85 718.85 .00 .00 Plan Check Total 396.27 396.27 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 1119.62 1119.62 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. 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 O Building Inspections 417 4815 Electrical Inspections 417 4735 W 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: 3r 21-1i 7L-L dff 96 -44 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 O AIR SEAL: Walls Ceiling FRAMING: L1-11-1 SO-- Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION: Lf -2,13--11 ":11. 4-- Slab Wall Floor Ceiling MECHANICAL: S� Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney j Commercial Hood Ducts FINAL Date t 1� Accepted by t�, �j X177 �I MANUFACTURED HOMES: Footing Slab Blocking Hold Downs Skirting PLANNING DEPT. Separate Permit Its SEPA: "O Parking Lighting ESA: Landscaping SHORELINE: rte -i FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By q Electrical 417 -4735 Construction R.W. PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 �f/ Pa F Ll T:Forms /Building Division /Building Permit PROJECT STATUS UPDATE Permit# 1 1103 Date: I phoned the: Applicant n 3 1' G' 06 at Lt 52=29 Zo Property Owner at Contractor at (left a phone message ,rdiscus x The permit (has expired, will expire soon). 'that is the status of this project? Please call and schedule a final inspection. Or Submit a "permit extension request" letter. Or V"o~ Let me know if the project is abandoned. 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Fifth St., Port Angeles, WA 98362 W (360) 417 -4815 fax (360) 417 -4711 Permit d Date Approved Applicant am< 5)%0/6l3 P one z/s ,I.,2,0 it Property Owner sG,44# Phone Li j 75.,) 7 Property Owner's Address I L 1 E,(/ i I e Contractor FRA J1( S p •1.41 3 Phone Contractor's Address S ,04 License Expires E-mail A A 1 G am PROJECT ADDRESS /D(o W. k j32-11a PA- 82.7 gbu ell O+A teN Parcel Number rOo Al�'T'S a L21' .AI .4L /2/ )/4,d' t Lo 27 f i CS]) N vi ne'S Project Type Brief Description: Residential Multi- family kCommercial Industrial Check Ne all that w Construction NI 4 t v O 4' New �,�J f �R�" �,�,1 G �j A L (ter Addition Remodel i MinnariMilligrAME. O r i Repair 1 P 4// ..5-/ &j Demolition Re roof House garage other tear off re -roof lay over one layer Heat System Heat pump wood- burning stove gas fireplace pellet stove other Other e i4 -'S AO F turnbi' j C.i1@,h lies Floor Areas Existing (sq. ft.) Proposed (sq. ft) J Basement per sq. ft. 1 Floor !4/7© y °I) 1Q3, SO L '3 cj fLD 2 Floor 3` Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION Li' 5 Zv Total footprint of structures I. _7d sq. ft. Lot size 9 r ,2 /"3 sq. ft. Lot coverage^ ),.0_ Site Coverage the amount of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage •C 9 Max. height of proposed structures /o ft. Occupancy group 6 of bedrooms ii Will a lawn sprinkler system be installed? Occupant load of full baths i Will a fire sprinkler system be installed? jA0 Construction type .37 J(/ V e, of half baths Al I have read and completed this application and know it to be true and correct I am authorized to ply for t• is permit a nd understand that it is my responsibility to determine what permits aree required, and tto obtain permits prior to on o ests: Date Print Name )4 '1/X' /j/t9VJ Signature /.A.,.! 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I 1 8 11) ke 1 ,,;i. t i i m i i i I /N .',..k i /1 N Clallam County Assessor Treasurer Property Details 64400 CITY LIGHTS HOLDI... Page 1 of 6 Ciailam County Assessor Treasurer Property Search Results 64400 CITY LIGHTS HOLDINGS LLC for Year 2010 2011 ;Property Account Property ID: 64400 Legal Description: FOGARTY DOLAN'S ADDITION LOTS 27 -29 BL 7 Geographic ID: 0630095207880000 Agent Code: Type: Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 65 Open Space: N DFL N Historic Property: N Remodel Property: N Multi Family Redevelopment: N Township: Section: Range: f t Location Address: 106 W LAURIDSEN BLVD Mapsco: PORT ANGELES, WA Neighborhood: Cycle 5 Comm Map ID: 3 N. \1\ CL *sb A Neighborhood CD: 20953140 Owner Name: CITY LIGHTS HOLDINGS LLC Owner ID: 18259 Mailing Address: %FRANK SPRINGOB Ownership: 100.0000000000% 106 W LAURIDSEN BLVD PORT ANGELES, WA 98362 Exemptions: Taxes and Assessment Details i Property Tax Information as of 09/29/2010 Amount Due if Paid on: L NOTE: If you plan to submit payment on a future date, make sure you enter the click RECALCULATE to obtain the correct total amount due. First Second j Half Half Base Base Year i Statement ID i Taxing Jurisdiction Amt. i Amt. Penalty Interest i Base Paid t 2010 46723 ST SCH STATE SCHOOL $209.84 $209.84 $0.00 $0.00 $209.84 2010 46723 CC -GEN COUNTY $111.68 $111.67 $0.00 $0.00 $111.68 2010 46723 PORT PORT $15.70 $15.69 $0.00 $0.00 $15.70 2010 46723 PORT ANG PORT ANGELES $258.55 $258.55 $0.00 $0.00 $258.55 2010 46723 SD #121 SCHOOL DISTRICT #121 $271.80 $271.79 $0.00 $0.00 $271.80 2010 46723 NTH OLY LIB NORTH OLYMPIC LIBRARY $32 45 $32 45 $0 00 $0.00 $32 45 2010 46723 HOSP #2 HOSPITAL #2 $45.81 $45.81 $0.00 $0.00 $45.81 2010 46723 WSMET PK DIST WILLIAM SHORE MET PARK DIST $14.58 $14.57 $0.00 $0.00 $14.58 2010 46723 CITY STORMWATER CITY STORMWATER $47.16 $47.15 $0.00 $0.00 $47.16 2010 46723 WEED CONTROL WEED CONTROL $0.82 $0.81 $0.00 $0.00 $0.82 2010 46723 TOTAL: $1008.39 $1008.33 $0.00 $0.00 $1008.39 2009 644002008 ST SCH STATE SCHOOL $244.89 $244.89 $0.00 $0.00 $489.78 2009 644002008 CC -GEN COUNTY $123.94 $123.93 $0.00 $0.00 $247.87 2009 644002008 PORT PORT $17.56 $17.55 $0.00 $0.00 $35.11 2009 644002008 PORT ANG PORT ANGELES $271.85 $271.83 $0.00 $0.00 $543.68 http: /vpn. clallam. net: 8084 /propertyaccess /Property. aspx ?cid =0 &year 2010 &prop_id =64... 9/29/2010 October 12, 2010 Frank Springob 106 W Lauridsen Blvd. 1 l Port Angeles, WA 98362 0 Dear Mr. Springob: A review of construction plans recently submitted for a new addition at 106 W. Lauridsen Blvd. will require more information. Per City of Port Angeles Urban Services Standards and Guidelines Chapter 5, requires a small project drainage plan for sites that disturb less than 1 acre. Please submit an engineered drainage plan meeting the requirements for section 5.05 of this chapter. If you have any questions or concerns, please contact Terri Partch at 417 -4811 or tpartch(a�cityofpa.us Thank you, Sincerely, Roger Vess Assistant Civil Engineer I t N: \PWKS \ENGINEER\Building Permits \106 W Lauridsen Blvd.doc XI D I O O -v —I r— Z 0 Z p 14 E""`° ad 1 if) m 0 •=1 z -J m c_ LIMITS I p p 1- m p O o Goan*" ae Z m o Z 0 0 0 Z �a M D r1 ae O Z Q 1- O m m G d a Ga mma+ °z -P- A —1 -'I 0 p o Sr AZ 0 Z Z 5�q 6 R m L Re r �a t‘6 sr _IC_.71 Q a O O O C7 --1 n U) a a CT) U) I !I r iijl I 1 O I m (n rn r -8 N (n I m 0 I �*e a0 O x C7 m J c m_ D 5 O gg R, corn z m oo m 11©® li®' o 0 ;4; o ta e F i i -7 z z IV o fir q s s c0 C Z o 0 o CO D 16 Ve WI Tgit o Q o Z c a>:c" D wf A s L 0 T1 o o a f kil TV ir r) O Z Gk!. d to" PEA goo. CREEK Port M C 7► 'S q 8 8 p 1. eat .‘4. N.,' x Pi m '3/4 06 .0 g il 104, oitiliViiP,P i c.fit7 1 Z (n N y r# ks 7 3 m N '•-1 p 1� pea' 4 g 1 i rr A y -I l —volt r 2 X Z Nom' D t OFo- i T j a, W_ q ft jj F sr Rao. l'ili i Ai 0- w I gn err sr Its, W S 4) i d ea. a e u a m D D� M <2 ae PI ��s� D Z Z c? N O r c,,,.. ae s r D O D 3 C7 p so I3 t .rtemo M 1 0 0 z 7D DZ o i m= Z 0 Z x r D A Z X D D D r z—� O 0 x 0 Z O a) co r9 —a co D "I3 >4 c m r —H CO 0 f SD r 3 0 C 7' CD --e -a t t...._,A j 0 0 -I Q. to z_a- N (F Z II Z n ow CD c h. a 0 1' m 5. CD o y o 1"lTl r CO c19 m o 0.5 -0 -0 W O 1=°., d r a w ?.gib C� D O gu o O p�� a in O r ci• ((.1) co m CD 41111 if ce ti f W N I c rt TITLE: S.W. SITE PLAN FOR BUILDING. PARKING EXPANSION 0 106 W. LAURIDSEN BLVD. G o m p S z rn m n (PARCEL #06- 30 -09- 520788) i mi S44 l e, 1 p p r N ��N o (w N 1 w o COVER SHEET W y -I 1.4 I 01 'i W yo w I o u.) 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U I c A o 0 ,m v v m1� m 4. o m O m o m 0 0s ZAa D CO rm* m z M >r z m C O N 'O 7 N Z1mD r Z M r C A r. x D N m x tN o o r a C O O A c? N o y u) TITLE: S. W. SITE PLAN FOR BUILDING. PARKING EXPANSION 106 W LAURIDSEN BLVD. m W N m a (PARCEL #06-30-09-520788) p S z 01 m Si- T FA o (w F y o 1 DRAINAGE AND EROSION CONTROL PLAN N Oa G, (j4 c y n N 0 II CLIENT: 301 E. 6TH STREET. SUITE 1 0 p 0 N o CITY HOLDINGS LLC E NOV I C PORT ANGELES, WA 98362 'I' N 7`�. I 106 W. LAURIDSEN BLVD. ASSOCI ATES FAX: (360 >360) 514 -0501 o PORT ANGELES, WA 98362 INCORPORATED EMAIL: ZENOVICOZENOVIC.NET 12" MIN. i 2' MIN. 0 v O D 0D I 17 ti. I 0Or 0Z x, _0 V ZK Z fA* 1 )>N R O I I T Mrr x tZi __Im *z r x i(, s g o 2 ril -0 r 0 4=• u) I' =nQD I /j 10 o Z Z N O o I 12 MIN. 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EA Z o vi LAURIDSEN BLVD. °D nI TITLE: S W, SI T E FO DK W. m r*I (PA RCEL #06- 30 -09- 520PLAN BUIL 788) ING. T F z rn m' cz 1 y Sgroz� DETAILS EXPANSION ®106 r te 0 /q I O O CLI ENT: 5 G. 301 E. 6TH STREET, SUITE 1 y�? 0• p j 0 n CITY HOLDINGS LLC E NOV I C PORT ANGELES. WA 98362 a �c `F R 7� I 106 W. LAURIDSEN BLVD I PHONE: (360) 417 -0501 Z o r n PORT ANGELES, WA 98362 AS SOCIATES F AX: (360 417 i j INCORPORATED EMAIL: ZE ELECTRICAL PERMIT. CITY OF PORT ANGELES 360- 417 -4735 h� Application Number 11- 00000314 Date 4/12/11 Application pin number 539818 REPORT SALES TAX Property Address 106 W LAURIDSEN BLVD ASSESSOR PARCEL NUMBER: 06- 30- 09 -5 -2 -0788 -0000- on your excise tax form Application type description ELECTRICAL ONLY to the City of Port Angeles Subdivision Name Property Use (Location Code 0502) Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Application desc Addition 4 circuits, new panel Owner Contractor p CITY LIGHTS HOLDINGS LLC OWNER T C/0 FRANK SPRINGOB 106 W LAURIDSEN BLVD PORT ANGELES WA 98362 (360) 452 -2920 Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 183624 Permit Fee 130.30 Plan Check Fee .00 C Issue Date 4/12/11 Valuation 0 Expiration Date 10/09/11 Qty Unit Charge Per Extension 4.00 2.6000 ECH EL- BRANCH CIRCUIT W /FEEDER 10.40 G 1.00 119.9000 ECH EL -0 -200 SRV FEEDER 119.90 Fee summary Charged Paid Credited Due Permit Fee Total 130.30 130.30 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 130.30 130.30 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH -IN ii FINAL P 0 COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G: \EXCHANGE \BUILDING RE il E ti CITY OF PORT ANGELES PERMIT APPLICATION -4. d Building Division/Electrical Inspections APR 2 321 East Fifth Street P.O. Box 1150 Port Angeles Washington, 98362 l'risiumr Q• Ph: (360) 417 -4735 Fax: (360) 417 -4711 ELECTRICAL NIIIIIIIPP. 1 (INSPECTIONS Date: l( /70tr 1 2 Single Family_ Dwelling Multi Family or Commercial* Y Commercial Addition Alteration Remodel Repair* *Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: IC, I. I- AO12 -1 QSCA) B L, JO Building Square Footage: 4e)r) Description of above A Oo c•T'lox) To e )t tsti 0 G Ni t2MPA4I C e q Q 1(,e.. A O D A)G C71)1 r. fI C E 4/0 Q PxrAn2OcrJ+o Yt o c2o�t -C.. e L- �c�, ALS0cg ti pee..AD N6 TN se (2.-) 1 c.=e.. 't„....)1.4 t Cc A 001,1 G A OD k Jk G1 tzc (TS Owner Information Contractor Information Name: 12-4. S' 1 60 1 4' f Name: Mailing Address: 1 IV i i 1 11) Mailing Address: City: Q State: 1, Zip: 7 City: State: Zip: Phone: t■ S 2 ZZ`' S Fax: 5,9 Phone: Fax: License Exp. License 41 Exp. Item Unit Charge aty 1 Total (Qt"�It lied by Unit Charge) Service /Feeder 200 Amp. $119.90 Service/Feeder 201-400 Amp. 145.50 Service/Feeder 401 -600 Amp 204.60 Service /Feeder 601 -1000 Amp. 262.20 Service /Feeder over 1000 Amp. 372.50 4 0 Branch Circuit W/ Service Feeder 2.60 I/ Branch Circuit W/O Service Feeder 73.50 Each Additional Branch Circuit 2.60 Temp. Service/ Feeder 200 Amp. 92.70 Temp, Service /Feeder 201 -400 Amp. 110.30 Temp. Service /Feeder 401 -600 Amp. 148.70 Temp. Service /Feeder 601 -1000 Amp 167.90 Portal to Portal,Hourly 95.90 Sign /Outline. Lighting 88.20 Signal Circuit/ Limited Energy First 1500 sf Commercial 95.90 Note: $5.00 for each additional 1500 sf .Signal Circuit/ Limited Energy -1 2 Family Dwelling 63.90 Signal Circuit/. Limited Energy Multi Family Dwelling 63.90 Manufactured Home Connection 119.90 Renewable Electrical Energy- 5KVA System or Less 102.30 Thermostat 56.00 NEW CONSTRUCTION ONLY: First 1300 Square Ft, 110.30 Each Additional 500 Square Ft. or Portion of 35.20 Each Outbuilding or Detached Garage 73.50 Each Swimming Pool or Hot Tub 110.30 Total i 3c).3 o 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 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 -468, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical administrator: Cash Check Credit Card C 01/01/2010 X ►i .J_ Dated: "r""G CITY OF PORT ANGELES a PUBLIC WORKS UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 10- 00001103 Date 1/07/11 Application pin number 834930 Property Address 106 W LAURIDSEN BLVD REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06- 30- 09 -5 -2 -0788 -0000- on your state excise tax form Tenant nbr, name BOULEVARD NATURAL WLLNSS Application type description COMM NEW CONST to the City of Port Angeles Subdivision Name (Location Code D502) Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 43520 Application desc ADD 400 SQ. FT. OF MEDICAL TREATMENT SPACE Owner Contractor CITY LIGHTS HOLDINGS LLC OWNER C/O FRANK SPRINGOB 106 W LAURIDSEN BLVD PORT ANGELES WA 98362 (360) 452 -2920 Structure Information 000 000 ADD 400 SF OF MEDICAL TREATMENT SPACE 0 Permit PW ENGINEERING REVIEW STORM Additional desc Permit pin number 180117 Permit Fee 300.00 Plan Check Fee .00 Issue Date 1/07/11 Valuation 0 Expiration Date 7/06/11 Qty Unit Charge Per Extension BASE FEE 300.00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments October 12, 2010 4:21:54 PM sroberds. the proposal will result in a 400 sq.ft. addition for total lot coverage of 20% in the CSD. No land use issues. October 6, 2010 8:50:15 AM Brian 417 -4708. Wiring for addition will require electrical permits and calculations for added load. Any modifications to the City's electrical facilities will be at the customer's expense. All construction work within the City right' of way requires �c� a separate Right of Way Construction application to be completed by the contractor and approved by Public Works Engineering prior to the start of work. A pedestrian or traffic control plan is to be submitted for approval with the application as necessary. All connections to City storm drain facilities require an inspection by Public Works and Utilities Engineering prior cover. Notice will be given 48 hours in advance of commencing work. 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. A.., Ai s l f Signa ure of C• "tractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T: \Policies \1102.15 [10/08] PERMIT INSPECTION RECORD CALL 417 -4831 FOR UTILITY 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 F'ERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS I YES I NO PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER a DRIVEWAY APPROACH BACK -FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. PW/ CONSTRUCTION R.W. ENGINEERING 417 -4831 PW ENGINEERING FIRE 417 -4653 FIRE DEPT. PLANNING DEPT. 417 -4750 PLANNING DEPT. BUILDING 417 -4815 BUILDING T: \Policies \1 102.15 10/08] °pr""° CITY OF PORT ANGELES °Ar�j PUBLIC WORKS UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application. Number 10- 00001103 Date 1/07/11 Application pin number 834930 REPORT SALES TAX Other Fees STATE SURCHARGE 4.50 on your state excise tax form to the City of Port Angeles Fee summary Charged Paid Credited Due (Location Code 0502) Permit Fee Total 300.00 300.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 304.50 304.50 .00 .00 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 T: \Policies \1102.15 [10 /08] PERMIT INSPECTION RECORD CALL 417 -4831 FOR UTILITY 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. I KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PW UTILITIES (Engineering Division) WATERLINE METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB GUTTER DRIVEWAY APPROACH BACK -FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. PW/ CONSTRUCTION R.W. ENGINEERING 417 -4831 PW ENGINEERING FIRE 417 -4653 FIRE DEPT. PLANNING DEPT. 417 -4750 PLANNING DEPT. BUILDING 417 -4815 BUILDING T: \Policies \1102.15 [10/08] . CITY OF PORT ANGELES LIGHT DEPARTMENT PERMIT NO. .1 ELECTRICAL PERMIT DATE .;;2t/70 1.2/;Z:2./<fP Site Address: K5lcA o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Installed By: Owner/Business: b .D.c... Phone: Sq. Ft. o Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction o Remodel o Service update/alter/repair o Overhead o Underground Voitage 01.0 03.0 Service size o Temporary o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) Amps Detai i slDescri pt ion: 'lev r- Iv cY/J41) . W.S. No. Service Capacity: 0 O.K. 0 Not O.K. o Ditch inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ~alo.K. Size Comments Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Pian Review approved/pending Install New Meters - Site Address: . Notify the Department of City Light by Street 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 ~~ Inspector Amount paid WHITE - file by address YELLOW - file by number PINK - Top: Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall OLYMPIC PRINTERS. INC. EL]aCMCAL PERMIT CITY OF PORT ANGELES 360-417-47 5 Application Number . 18-00001689 Date '10/31/18 Application girl number, . 987913 REPORT STATE SALES TAX Property Adar�a,�a 106 w LAURIDSEN BLVD on your excise tax form ASSESSOR PARCEL NUMBER: 06-30-09-5-2-0788-0000- Applicatiorl type"description ELECTRICAL ONLY to the City of Port AngeleS Subdivision Name (Location Code 0502) Property Use . Property Zoning:. COMMUNITY SHOPPING DISTR: Application valuation 0 ---------- ---- ----------- -------- ----------------------------------- Application dear Sign circuit ---------------------- --------------------- --------------------------------- Owner- - Contractor ----------------------- STAMPDIGGITY HOLDINGS LLC APS BLSCTRIC , 106 W,LAURIDSEN BLVD 546 BENSON RD. PORT ANGELES WA 98362 PORT ANGELES WA 98363 . (360) 452-6753 ----------- :-.-- -------------------------------------------------------- Permit ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee 88.00 Plan Check Fee .00 Issue Date 10/31/18 Valuation . 0 Expiration Date 4/29/19 4ty Unit Charge Per Extension 1.00 88.0000 BCH EL-COMM-SIGN 88.60 ------ ----- --------- ------- --- _ ---- - ----- - ------------- r Fee summary Charged Paid Credited Due ----------------- ---------- ---- ---------- =--------- Permit Fee Total 88.00 88.00 .00 .00 Plan Check Total. 00 .00 00 .00 Grand Total 98.00 88.00 .00 .00 i 3 . t i F : INSPECTION TYPE DATE: RESULTS: INSPECT OP— DITCH SERVICE ROUGH-IN I FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION j Signature of owner or Electrical Contractor X Date: i '+ ��` '°' ,� �;:�. i I i � I i i i i I i i i _ ,, � - i .MULLRECEIVED A M ER 1A EL 'R AL PER MIT APPLICATION'—" r. Public Works and Utilities.Department ILECTRWAI_ 321E 5th Street, Port Angeles,WA 98362 360.4I 7.4735 ; .cit.Yofpa us eiectricalpermits@citycfpa.us rt Project Address: D Project Description: II Mufti-Farnlly Restdentia! "mmereq!Industrial/Public Building Square footage: Name: c dot N, t r, "Email:.. S t rn ?^ C t ox" c hl Mailing Address: I Phone3 L •"� ' Name: C';d }fi ucertse: . L Mailing Address: n e � Expiration Date: ��— Email: k, i r ( 5 6,4 Phone: Q 53-b?�3 IkM Unit Charge Quaaft Taw(Quanfily x Untt Charge) Service/Feeder 200 AnV. $132.00 $ ServicetFeedet 201-400 Amp. $160.00 $ ServicetFeeder 401-600 Amp. $225.00 $ ServicafFeeder 601-1000 Amp. $2W.00 $ .Service/Feeder over 1000 Amp. $410.00 $ ;Branch Circuit Wf Service!F $5.00 $ 'Branch Circuit WO Service Feeder $74.00 __,� -Each Additional Branch Circuit $5.00 $ 'Branch Circuits 1-4 $86.00 $ Temp.servicetFeeder•200 Amp. $102M $ Temp.Service/Feeder 201.400 Amp. $121;00 $ Temp. 1F 401-600 Amp. $164.00 $ Temp.Serv" er 601-1000 Amp. $186.00 $ Portal to Portal Hourly $96.00 $ 'Signal Circuitkimited Energy-Muffi-Family $88.00 $ Signal Circuit/Limiled Energy/First 1500 of-Corn Tierclat $96.00 $ (Mote:$5.00 for each additional 1500 sf) Renenrab4e Elec.Energy:5KVA System or less $113.00 $ Thermostat(Note:$5 for each additional) $56.00 $ $ TOTAL Owner as defined by RCW.19.28.261:(1)Owner v iff occupy the structure for two yew after this eledrir:el permit is fraseliaed.(2)Owner is required to Hire an electrical contracW if above sa d property is for sale,rent or lean.Permit expires after six months of last inspection. After reading the above statement l hereby certit than l am the owner of the above named property or a licensed electrical contrador.l am maidng the electrical installation or alteration i compliance with the electrical laws,N.E.C.,RCW.Chapter 19.28,WAC.Chapter 296- 46S,The City of Port Angle Municipal Code,an I UtAt Spa*R no and PAMC1114.06.06 and Electrical Permit Application. 1� Date Paint NameJ Signature(❑ Owner E3 Electrical Contractor l Administrator) VIAA via 'e f- -f' - u r-e jElec i al Permit Applications may be subrTifted to City Hall or electricalpermitsCcity0pa.us or fazed to 360.417,4711 i Application Number . . . . . 22-00000540 Date 5/10/22 Application pin number . . . 860100 Property Address . . . . . . 106 W LAURIDSEN BLVD ASSESSOR PARCEL NUMBER: 06-30-09-5-2-0788-0000- Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMUNITY SHOPPING DISTR Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Heat pump system ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ STAMPDIGGITY HOLDINGS LLC ALL WEATHER HTG & COOLING INC 106 W LAURIDSEN BLVD 302 KEMP ST PORT ANGELES WA 98362 PORT ANGELES WA 98362 (360) 452-9813 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . Permit Fee . . . . 56.00 Plan Check Fee . . .00 Issue Date . . . . 5/10/22 Valuation . . . . 0 Expiration Date . . 11/06/22 Qty Unit Charge Per Extension 1.00 56.0000 ECH EL-LVT-THERMOSTAT 56.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 56.00 56.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 56.00 56.00 .00 .00 CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Street – P.O. Box 1150 / Port Angeles Washington, 98362 Ph: (360) 417-4735 Fax: (360) 417-4711 Date: ________________ ___ Multi-Family or Commercial* * Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet Job Address: ____________________________________________________________________________________________________________________________ Building Square Footage: __________________________________________________________________________________________________________________ Description of above ______________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ Owner Information Contractor Information Name: ________________________________________________ Name: ______________________________________________ Mailing Address: ________________________________________ Mailing Address: ______________________________________ City: __________________ State: _______ Zip: _______________ City: __________________ State: _______ Zip: _____________ Phone:_________________Fax: ___________________________ Phone:_________________Fax: _________________________ License # / Exp._________________________________________ License # / Exp._______________________________________ Item Unit Charge Qty Total (Qty Multiplied by Unit Charge) Service/Feeder 200 Amp. $ 132.00 _________ $____________ Service/Feeder 201-400 Amp. $ 160.00 _________ $____________ Service/Feeder 401-600 Amp $ 225.00 _________ $____________. Service/Feeder 601-1000 Amp. $ 288.00 _________ $____________ Service/Feeder over 1000 Amp. $ 410.00 _________ $____________ Branch Circuit W/ Service Feeder $ 5.00 _________ $____________ Branch Circuit W/O Service Feeder $ 74.00 _________ $____________ Each Additional Branch Circuit $ 5.00 _________ $____________ Branch Circuits 1-4 $ 86.00 _________ $____________ Temp. Service/ Feeder 200 Amp. $ 102.00 _________ $____________ Temp. Service/Feeder 201-400 Amp. $ 121.00 _________ $____________ Temp. Service/Feeder 401-600 Amp. $ 164.00 _________ $____________ Temp. Service/Feeder 601-1000 Amp . $ 185.00 _________ $____________ Portal to Portal Hourly $ 96.00 _________ $____________ Sign/Outline Lighting $ 88.00 _________ $____________ Signal Circuit/ Limited Energy – Multi-Family $ 64.00 _________ $____________ Signal Circuit/ Limited Energy / First 1500 sf – Commercial $ 96.00 _________ $____________. Note: $5.00 for each additional 1500 sf Renewable Electrical Energy - 5KVA System or Less $ 113.00 _________ $____________ Thermostat $ 56.00 _________ $____________ Note: $5.00 for each additional T-Stat $__________ 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. Signature of owner, electrical contractor or electrical administrator:□Cash □ Check □Credit Card # ______________________________________ X ___________________ Dated: _____________________________________ 01/01/2012 x All Weather Heating & Cooling, Inc. 302 Kemp Street Port Angeles WA 98362 452-9813 452-5177ALLWEWH934MU 9/18 1 56.00 56.00 5/5/22 106 West Lauridsen Blvd.1696 Install like for like heat pump system Stamper Chiropractic2609 South Cherry Street Port ANgeles WA 98362360-452-7827 5/5/22