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124 E 5th St - Building
C � J � CE RTI FWAT, GF�,0CC U PAN CY City`W,Tbrt Angeles- B iiadiiir g �iyision �4:di. t�SM V�l• -.. This certificate is issued�pursuant to the requirements of Section 11,016f the2006 International Building Code certifying that atwthe�,i* of issuan.,ce this structure was in compliance with the various ordinances of the City regulating' uilding3cons iitclion.:or use for the follo vinp , fs �, 'ti Business name i' L 1 F s s �t ♦ J.ub.ilan't Nutrition. Qwi er nus Efnt6rpnses; Business address.. I'24�E 5th St t °,.. . _ Y`g 5 =' sanF Property owner ' . Vernon D Peter" Property owner " gry e s'� �dress= PO Box 2'4'6;1% �?.o,>�r�An eles�,111/4:X9$3'62=0315 Automatic fire sprzn7ler system e `IBC- Use & occupancy elassifcation. Businessw Occu ant Zoad. P _ Per=2006IBC; Tab,le"1`0041; 1:u; Building permit num°be - F Type of construction. N$ Nk- 06/28/10 ager' Date Poston the premises in a conspicuous place. ' -14L,, be removed except by the Building Official. 1 1 _2 � 1, Io R� T PREPARED 6/22/10 9 02 03 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/22/10 ADDRESS 124 E 5TH ST SUBDIV TENANT NBR JUBILANT NUTRITION CONTRACTOR FEELEY CONSTRUCTION INC PHONE (360) 452 7559 OWNER VERNON D PETERS PHONE PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER 10 00000346 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 5/03/10 JLL BLDG FRAMING 5/03/10 AP May 3 2010 9 38 52 AM 1pangrle JIM 460 0632 FRAMING May 3 2010 4 45 49 PM jlierly BL99 01 6/04/10 PB BLDG FINAL TIME 01 00 6/07/10 DA June 3 2010 112 55 PM 1pangrle DEBBIE 452 5575 BUILDING FINAL AFTERNOON June 7 2010 8 29 49 AM pbarthol Health Department final approval Secure point source water heater to wall and drip pan to brackets Secure plumbing cover under sink BL99 02 6/22/10 JLL0 BLDG FINAL TIME 01 00 June 22 2010 8 57 51 AM 1pangrle DEBBIE 452 5575 BUILDING FINAL JUBILANT NUTRITION AFTERNOON PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL2 01 5/03/10 JLL PLUMBING ROUGH IN 5/03/10 AP May 3 2010 9 39 31 AM 1pangrle JIM 460 0632 ROUGH IN PLUMBING May 3 2010 4 45 49 PM jlierly PL99 01 6/04/10 PB PLUMBING FINAL TIME 01 00 6/07/10 DA June 3 2010 1 15 54 PM 1pangrle DEBBIE 452 5575 PLUMBING FINAL AFTERNOON June 7 2010 8 29 49 AM pbarthol Health Department final approval Secure point source water heater to wall and drip pan to brackets Secure plumbing cover under sink PL99 02 6/22/10 L PLUMBING FINAL TIME 01 00 June 22 2010 8 58 14 AM 1pangrle DEBBIE 452 5575 PLUMBING FINAL JUBILANT NUTRITION AFTERNOON COMMENTS AND NOTES PREPARED 6/22/10 9 02 03 INSPECTION TICKET PAGE 6 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/22/10 ADDRESS 124 E 5TH ST SUBDIV TENANT NBR JUBILANT NUTRITION CONTRACTOR PHONE OWNER VERNON D PETERS PHONE PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER 10 00000351 SIGNS PERMIT SIGN 00 SIGN REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL99 01 6/04/10 PB BLDG FINAL TIME O1 00 6/07/10 DA June 3 2010 1 16 44 PM 1pangrle DEBBIE 452 5575 BUILDING FINAL SIGN AFTERNOON June 7 2010 8 29 49 AM pbarthol Health Department final approval Secure point source water heater to wall and drip pan to brackets Secure plumbing cover under sink BL99 02 6/22/10 JLL BLDG FINAL TIME O1 00 June 22 2010 8 57 08 AM 1pangrle DEBBIE 452 5575 BUILDING FINAL SIGN AT JUBILANT NUTRITION AFTERNOON COMMENTS AND NOTES PREPARED 6/22/10 9 02 03 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/22/10 ADDRESS 124 E 5TH ST SUBDIV TENANT NBR JUBILANT NUTRITION CONTRACTOR PHONE OWNER VERNON D PETERS PHONE PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER 10 00000347 CO CHANGE OF OCCP/USE PERMIT CO 00 CHANGE OF OCCUP/USS REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS C099 01 6/22/10 JLL BLDG C/O FINAL TIME 01 00 OVERRIDE TAKEN BY LPANGRLE DATE 06/22/10 TIME 08 57 23 June 22 2010 8 56 16 AM 1pangrle DEBBIE 452 5575 C OF O FINAL JUBILANT NUTRITION AFTERNOON COMMENTS AND NOTES PREPARED 6/04/10 8 21 54 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/04/10 ADDRESS 124 E STH ST SUBDIV TENANT NBR JUBILANT NUTRITION CONTRACTOR FEELEY CONSTRUCTION INC PHONE (360) 452 7559 OWNER VERNON D PETERS PHONE PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER 10 00000346 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 5/03/10 JLL BLDG FRAMING 5/03/10 AP May 3 2010 9 38 52 AM 1pangrle JIM 460 0632 FRAMING May 3 2010 4 45 49 PM jlierly (� BL99 01 6/04/10 JLL BLDG FINAL TIME 01 00 / June 3 2010 1 12 55 PM 1pangrle d' DEBBIE 452 5575 BUILDING FINAL AFTERNOON PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL2 01 5/03/10 JLL PLUMBING ROUGH IN 5/03/10 AP May 3 2010 9 39 31 AM 1pangrle �� _ JIM 460 0632 ROUGH IN PLUMBING "ice May 3 2010 4 45 49 PM jlierly PL99 01 6/04/10 J L PLUMBING FINAL TIME O1 00 June 3 2010 1 15 54 PM 1pangrle DEBBIE 452 5575 PLUMBING FINAL AFTERNOON �.� Q WO � COMMENTS AND NOTES1.�-moi +Q � Co�`�' I'W PREPARED 6/04/10 8 21 54 INSPECTION TICKET PAGE 5 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 6/04/10 ADDRESS 124 E 5TH ST SUBDIV TENANT NBR JUBILANT NUTRITION CONTRACTOR PHONE OWNER VERNON D PETERS PHONE PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER 10 00000351 SIGNS PERMIT SIGN 00 SIGN REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL99 01 6/04 10 JLL BLDG FINAL TIME O1 00 �— June 3 2010 1 16 44 PM 1pangrle DEBBIE 452 5575 BUILDING FINAL SIGN AFTERNOON COMMENTS AND NOTES ..-.pw"^'" -�. v'7..n,-s.. :�;,--e—.si,.^•'....•isvw�r"� �L _z. .. .. .. ,,r:. BUILDING DIVISION CITY OF PORT ANGELES Correction Notice Job ,Located at 574 Inspection of your work revealed that the following is not in accordance with the codes governing the work in this jurisdiction t1Z.Art Z D4,-d fi t/ 7o These corrections must be made and are not to be covered until reinspection is ade. Wh�,n1 co ections have been made, please call - t for inspection ;r� Date Inspector for Building Division DO NOT REMOVE THIS TAG (5/19/2010) Linda Pangrle Re Fwd C OF O'#10-347 Jubilant Nutrition 124 E 5th'St.' Page 1 From Jeff Young TO, Linda Pangrle Date: 5/19/2010 1149 AM Subject: Re Fwd C OF O #10-347 Jubilant Nutrition 124 E 5th St. Yes this one can be approved.thx jeff >>> Linda Pangrle 05/17/2010 3.39 PM >>> Hi Jeff, I haven't heard back from you regarding this C of 0 application. Are you ok with my issuing their C of 0? Linda >>> Linda Pangrle 4/12/2010 3.22 PM >>> Hi Jeff Please see the attachment below A new business will be putting in a 3-compartment sink,handwash sink,and a mop sink. They don't plan on doing any cooking, but will be making shakes,teas,and other drinks. I don't know whether or not you'll require them to have a grease trap(in case of future cooking). I wanted you to know about this. Please e-mail me back with your approval or any requirements you have for them. Thanks, Linda (5%17/2010) Linda Pangrle Fwd C OF 0#10-347 Jubilant Nutrition 124 E 5th St. Page 1 From Linda Pangrle TO. Jeff Young Date: 5/17/2010 3 39 PM Subject: Fwd C OF O #10-347 Jub�utrition ant Nutrition 124 E 5th St. Attachments: C OF O #10-347 Jubilant 124 E 5th St. pdf Hi Jeff I haven't heard back from you regarding this C of 0 application. Are you ok with my issuing their C of 0? Linda >>> Linda Pangrle 4/12/2010 3 22 PM >>> Hi Jeff Please see the attachment below A new business will be putting in a 3-compartment sink,handwash sink,and a mop sink. They don't plan on doing any cooking, but will be making shakes,teas,and other drinks. I don't know whether or not you'll require them to have a grease trap(in case of future cooking). I wanted you to know about this. Please e-mail me back with your approval or any requirements you have for them. Thanks, Linda PREPARED 5/03/10 9 43 37 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/03/10 ADDRESS 124 E 5TH ST SUBDIV TENANT NBR JUBILANT NUTRITION CONTRACTOR FEELEY CONSTRUCTION INC PHONE (360) 452 7559 OWNER VERNON D PETERS PHONE PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER 10 00000346 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL3 01 5/03/10 BLDG FRAMING May 3 2010 9 38 52 AM 1pangrle JIM 460 0632 FRAMING PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL2 01 5/03/10 V PLUMBING ROUGH IN �C _ —th May 3 2010 9 39 31 AM 1pangrle JIM 460 0632 ROUGH IN PLUMBING COMMENTS AND NOTES . s ELECTRICAL PERMIT o CITY OF PORT ANGELES 360-4]7-4735 Application Number 10 00000411 Date 4/27/10 Application pin number 635418 Property Address 124 E 5TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 6715 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Application desc 5 circuits Hot water Rcpt Switches Owner Contractor VERNON D PETERS SIMPSON ELECTRIC PO BOX 2461 243036 W HWY 101 PORT ANGELES WA 983620315 PORT ANGELES WA 98363 �a (360) 457 9270 Permit ELECTRICAL ALTER COMMERCIAL Additional desc Permit pin number 164343 Permit Fee 83 90 Plan Check Fee 00 Issue Date 4/27/10 Valuation 0 Expiration Date 10/24/10 ( Qty Unit Charge Per Extension IV�1 1 00 73 5000 ECH EL BRANCH CIRCUIT WO/FEEDER 73 50 1 4 00 2 6000 ECH EL ECH ADDNT BRANCH CIRCUIT 10 40 Fee summary Charged Paid Credited Due Permit Fee Total 83 90 83 90 00 00 (�\ Plan Check Total 00 00 00 00 V \1 Grand Total 83 90 83 90 00 00 Vl �H -z�� D INSPECTION TYPE DATE RESULTS INSPECTOR. DITCH SERVICE ROUGH IN FINAL COMMENTS Signature of owner or Electrical Contractor X Date SN01103dSNl �l 10813313 60QZ r_, Gd, 0 ro � CITY OF P0RT.ANG1;LEs PERM>CT APPLICAT1r0N 03r, � B"ildling Divistlon i.ectriCAI Inspecl'Aons A3 3 a1 11 p, 321 F,APii st >Tth Street-P.O. ltiox 11511/Part Angeles Washington,98362 I'"- .,G Ph:(360)417-4735 Fax:(360)417-4711 Date: 0 —1 &2 Single Family Dwelling AUMI-f=amily or Commercial" V Commercial Addition/Alteratlo~i Remodel I Repair *Plan Review May Be R�Qulmd,Pleas mplete Electrical Plan Review Information Sheet .bb Address /v� 1 � Building Square Footage: Descripllon of above e4e� _�aJ /y(+9 B�i--La, ie.6C,M.�� Su7 I-- Owner Inn anon Name: Contractor Inforrnatilan Mailing ddress: Nama r Cay ce- �� State: �pY! � C alling Ad __P �r—/z,A Phone: GSI Lrcettse#/E-r.�_ Fax: phvrre y2 _Fara -- License#/ Ite�t �t C-fie Service/Feeder 200 Amp. $119,90 TdgLL1;I� U Cht#I�ta) Service/Feeder 2D1400 Amp, $14.5.50 $ — Sorvice/Feeder 401-600 Amp $20460 $� ServlcelFeader601-1000 Amp. $262,2n $_ Service/Feeder over 1000 Amp. $372.50 — Branch Circuit W/Service Feeder $ 2.60 — Branch Circuit W/O Service Feeder $ 73,50 Each Additional Branch Circuit $ 2.60 Temp,Servlce/Feeder 200 Amp. $ 92.70 - /a-4 O Temp.Sen4ce/Feeder2D1400Amp. $110.30 — - Temp.Service/Feeder 401.600 Amp, $148,70 g Temp.Servlca/Feeder 601-1000 Amp $167.90 Portal to Portal Hourly $ 95.90 ' Sign/Outline Lighting $ 68.20 Signal Circuli/Limited Energy/First 1500 sf -Commerdal $ 95.90 �" $--- -- Note: $5.00 for each additional 1500 9f -- $_ Signal Circuit/Limited Energy 1&2 Family Dwelling $ 63,90 Signal Circuit/Limited Energy MUM-Family Dwelling $ 6320 $- Manufactured Home Connection $11990 Renewable Electrics►Energy SKVA System or Less $107,.30 Thermostat 1�.. $ 56,00 a First 1L3 0 gquam��f-t1.tJ 0 Y• -- -,�. - Each Additional 500 Square Ft.or Portion of �� 0 $ 35,20 1 Each Outbuilding or Detached Garage S 73.73r0 -- Each Swimming Pool or Hot Tub $ $110,330 - $ ;513771. Total Owner as defined by RCW 19.28,261.(1)Omer will occupy the struchue for two years after he electrical permit Is finalized. t fawner is re uired to hire an electrical contractor if above said property is for sale,rent or lease.Permit expires after six monthis of last Inspectior q Atter reading the above statement.I hereby cerlify that I am the owner of the above named pmpetty or a liaansed elecMcal ca�r 11lctor.I am making the electrical installation or alteration in compliance with the elechiw laws,N.E,C, RCW Chapter 19.2a,ic'msWACChapter al cc�t a,The I am of Port Angeles Municipal Code,and Uglily S clflca8ons and PAMC 14.05.050 regarding Electrical Permit Appikedluns Sign of owner,electrical co ctor .or elemcal admin ftstor• I;1 each 0 Cho* antes: .2, _�o CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION _ 321 EAST 5TH STREET PORT ANGELES WA 95362 Application Number 10 00000346 Date 4/22/10 Application pin number 660218 Property Address 124 E 5TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 6715 0000 Tenant nbr name JUBILANT NUTRITION Application type description COMM REMODEL Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 3000 Application desc TI BUILD INTERIOR WALLS & ADD 3 SINKS Owner Contractor VERNON D PETERS FEELEY CONSTRUCTION INC PO BOX 2461 2606 DEER PARK RD PORT ANGELES WA 983620315 PORT ANGELES WA 98362 (360) 452 7559 Structure Information 000 000 BUILD INTERIOR WALLS & ADD 3 SINKS Construction Type TYPE V NON RATED Occupancy Type BUSINESS OFF/PRO/MED/REST Permit BUILDING PERMIT COMMERCIAL Additional desc ADD INT WALLS & 3 SINKS Permit pin number 163543 Permit Fee 109 75 Plan Check Fee 71 34 Issue Date 4/22/10 Valuation 3000 Expiration Date 10/19/10 Qty Unit Charge Per Extension BASE FEE 95 75 1 00 14 0000 THOU BL-2001 25K (14 PER K) 14 00 Permit PLUMBING PERMIT Additional desc Permit pin number 163550 Permit Fee 100 00 Plan Check Fee 00 Issue Date 4/22/10 Valuation 0 f�MtI4 Expiration Date 10/19/10 Qty Unit Charge Per Extension BASE FEE 50 00 300 7 0000 EA PL-PLUMBING TRAP 21 00 1 00 7 0000 EA PL-WATER LINE 7 00 1 00 15 0000 EA PL-SEWER LINE 15 00 1 00 7 0000 EA PL-WATER HEATER 7 00 Special Notes and Comments April 14 2010 7 30 27 AM rbecker If the mop sink has a hose connection it should have an atmospheric vacuum breaker on the faucet If you have any questions contact Ron Becker at 417 4886 or 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. 7I'22�/0 ��bb J'usoh AOU-4 Date Print Name Signature of ontractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD — PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT INCONSPICUOUS 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 b 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 Pum /Furnace/FAU/Ducts Rough-In Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT Separate Permit#s SEPA. Parkin /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 CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Page 2 Application Number 10 00000346 Date 4/22/10 Application pin number 660218 Special Notes and Comments E mail me at rbecker@cityofpa us A minimum 2A 1OBC fire exinguisher is required Extinguishers must be mounted with the top no more than 5 off the floor Suggested extinguisher placement is adjacent to an exit April 19 2010 11 29 51 AM kdubuc Applicant will make minor interior modifications in order to reduce the square footage of the main assembly area so that only one exit is required April 14 2010 3 03 52 PM sroberds The proposal will result in the interior remodel of an existing commercial structure in the CSD The use is supported by 10 additional cooperative parking spaces immediately south of the site No land use issues anticipated Electrical load calculations and electrical permits are required Any modifications to the City s electrical facilities will be at the customer s expense Public Works Utility Engineering has no requirements for this plan review Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 209 75 209 75 00 00 Plan Check Total 71 34 71 34 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 285 59 285 59 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:FormsBuilding 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 1� POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. v 1 Inspection Type Date Accepted By Comments FOUNDATION. Footings Stemwall 1 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 6"Z-Z loAccepted b 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 Pum /Furnace/FAU/Ducts Rough-In 7 Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT Separate Permit#s SEPA. Parkin /Lighting ESA. Landscaping SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Q 1 Inspection Type Date Accepted By Vv Electrical 417-4735 Construction R.W PW /Engineering 417-4831 Fire 417-4653 Planning 417-4750 Building 417-4815 'L S(iL- L T.Forms/Building Division/Building Permit CITY OF PORT ANGELES 1 DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES,WA 98362 Application Number 10 00000351 Date 4/22/10 Application pin number 074383 Property Address 124 E 5TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 6715 0000 Tenant nbr name JUBILANT NUTRITION Application type description SIGNS Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 85 Application desc 32 SQ FT WALL-MOUNTED SIGN Owner Contractor VERNON D PETERS OWNER PO BOX 2461 PORT ANGELES WA 983620315 Permit SIGN Additional desc 32 SF WALL-MOUNTED SIGN Permit pin number 163618 Permit Fee 85 00 Plan Check Fee 00 Issue Date 4/22/10 Valuation 85 Expiration Date 10/19/10 Qty Unit Charge Per Extension 1 00 85 0000 PER S WALL SIGN OR MARQUEE > 25 SF 85 00 Special Notes and Comments April 14 2010 3 24 49 PM sroberds The proposal is to mount a 32 sq ft vinyl sign on a commercial facade in the CSD zone No land use issues anticipated Fee summary Charged Paid Credited Due Permit Fee Total 85 00 85 00 00 00 Plan Check Total 00 00 00 00 Grand Total 85 00 85 00 00 00 6 16 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:FormsBuilding 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 t 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. 0 Inspection Type Date Accepted By Comments FOUNDATION Footings Sternwall Foundation Drainage/Downspouts ,\ Piers fvJ,�J Post Holes(Pole Bldgs.) PLUMBING Under Floor/Slab Rough-in Water Line Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b 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 Pum /Fumace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT Separate Permit#s SEPA. Parking/Lighting ESA. Landscaping SHORELINE. n FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE V J Inspection Type Date Accepted By ` t Electrical 417-4735 1"1 Construction R.W PW I Engineering 417-4831 1� Fire 417-4653 Planning 417-4750 Building 417-4815 T•Forms/Building Division/Building Permit c �ON n°Hr.t�< CERTIFICATE OF OCCUPANCY APPLICATION Permit# 10 —3�-I� 9 CITY OF PORT ANGELES -, � Attn Building Permit Technician 321 E Fifth St. Port Angeles WA 98362 $50 Cerrlrlcat / Inspection (360)417-4815 fax (360)417-4711 0 00 Parking.Business Improvement Area (PBIA) Print in ink fee charged for downtown locations BUSINESS NAME Lnfc p, 1sc.s LLC C/6< .5I io let ,& /V11 Al _/_iun BUSINESS ADDRESS 1,?-VZ- Th Zoning 05D Business mailing address /.Q-/, 512, 4 ii /es wa Phone# Opening date Das & hours of operation d►)-F 7-3G✓enn5s 6v -pp t Washington State Tax I D # If known list the name of the previous Sege fy'e_P (wmi''rn C� Oa -79,V-G 7> business at this location S �5 A ulu�dv�►�Ks Brief description of proposed business N4./,- /-,o,, CIL d s -F u ' Qvx VV Business owner's name Dbvy �ws�y.� Phone# 3&0 -'J,5-7-&-1J07_ Business owner's home address /es /0,9. 943�;_� PLEASE NOTE. A.Business License is also.required for the following businesses Taxi Peddlers Second-hand dealer Pawnbroker Dance .Hotel- Motel, Fireworks,Ambulance Tattoo shop .Contact the City Clerkat 417-4634 for additional information. ACTION ✓ WILL THERE-BE ANY OF THE.FOLLOWING? NOV YES✓ IF YES CONTACT Electrical than es ✓ Electrical Dept. at 417-4735 New business New or relocated signs_5e�. n Pt�r`mjf- to— 5I ✓ Building Div at 417-4815 ✓ Construction changes / Transfer of business Mechanical changes(ventilation, heating,cooling,etc.) ✓ location from a Plumbing changes ✓ PBIA location Fire sprinklers stem changes Fire alarms stem changes ✓ Transfer of business New or relocated sewer or water service Public Works at 41.7-4807 location from a Excavation or filling of lots ✓ non-PBIA location Work done in the City right-of-way ✓ New driveway openings i Change of ownership Grading site drainage(parking lots,downspouts,etc.) ✓ Landscape irrigations stem(backflow devices) i Water Dept. at 41.7-4886 Remodel Is this a home occupation? ✓ Planning Div at 417-4750 Is this a second-hand dealer or pawnbroker business? City Clerkat 417-4634 Temporary business Is there off-street parking for this business? ✓ How many spaces? /W . Is the street in front of this business paved? ✓ Change of use Is there a sidewalk in front of this business? P— Is there a curb&gutter in front of this business? ✓ Call for Certificate of OCCupancV.inspections before opening busineSS. Please sign up for ufility.secVices Building Department Inspection 417-4815 & Fire Department Inspection 417-4653 at rhe cashier counter Please provide a minimum 24-hour notice for inspections I hereby apply for a Certificate of Occupancy / acknowledge that I have read this application and state that the information /.have supplied is correct to the best of my knowledge Date'y//Z--//'O Print Name DIb O -h Signature For City use only- Department Approved Rejected Comments/Conditions Initials&date Initials&date Building Type of construction Occupant Load Fire Automatic fire sprinkler system required no yes L PBIA r l—Planning �PbVeJ UJ l*k IC) OL1 T— S1t'� PtrJJV'K1 njj i ,/ Clty Clerk I _ Qr�e 05rep'(Y en+ 0 YL -R[e) Public Wor' I td T.Forms/Building DiN;sion/Cenir :e of G, ancv Application 3 412 1 £ 41 r r o- 416 } 1 102 '7 s es 120lY �- L 504 �/ t 113 aY; t1' 'r "'• t. "d p¢ 509 C'x' m 511 ~� 526 41 Yr 513 212 { PARKING AGREEMENT An.Agreement is hereby entered into in favor of the owner of property legally described as: (provide legal description address of subject property requiring additional parking) /-DTs 34�L/ 6L iL7 12o, E F4fh S The purpose of this agreement is to establish and allow parking rights and privileges for/cam off-street parking spaces which are located at S-20 S. ).,o-46--/n S"1� (address where additional parking is located)including the necessary ingress and egress to access the parking spaces in order to satisfy the off-site parking requirements for uses within the City ofPortAngeles per Parking Ordinance#1588,as amended,for property located at 1245 r .s 2—ks l - (address of property needing additional parking). This parking agreement without serving prior notice of such intended action upon the City of Port Angeles and obtaining the City's written approval. Such revocation or modification may result m the limitation of the activity located at /20 'rS �S% This agreement is made between: Propert} ;,Wra _ Property address .�...��, 2c) f. T Property Owner(Grantee) Property address Dated this (-,, day of2010 STATE OF WASHINGTON ) ss: COUNTY OF CLALLAM ) ,�, BEFORE ME,`a P'Notary Public in and for the County and State aforesaid, personally appeared ��6'I1�V1 kr) and known tome to be the persons who executed the within Agreement, and who acknowledged the same to beJffieir free and voluntary act and deed for the uses and purposes therein mentioned. GIVEN under my hand and official seal this�day of 20_ OST NOTARY PUBLIC in and for the State ashington. 01 A k My commission expires Jan 3 2013 Ecoe *00 1 A- y,Q�nWA 1411311.o Kern � l 3 i —o`,V"oA of f y sv&A +ar us -6 Issue- i►i S 1 1 BUILDING PERMIT APPLI A ION Print in ink CITY OF PORT ANGELES For City Use Only Attn Building Permit Technician Date Received — A0 321 E. Fifth St. Port Angeles WA 98362 Permit# (360) 417-4815 fax (360) 417-4711 Date Approved Applicant EroTE2 Pz t5E5, LLC di VCtb,/Qn t� /V" Pro / P ert Owners -qN r"' G-rcm s o�0-�lsa-ss�s Property V eone 340- 4-7-1- io53 Property Owner's Address P 0 8 oX .7414/ P A W A 19 56Z,—6 3 1 Contractor Q/LL i,=EEL.E y Corl4vve, Phone Contractor's Address . Go46c /��Y-V,4 4 /e s, Wry qk3(.Q License # Eez I �� Expires E-mail PROJECT ADDRESS q E .5 S� Parcel Number 04 30000 iL7 /.TO 00o Lot 3g4anieZoning C3D Project Type & Brief Description. ❑ Residential ❑ Multi-family WCommercial ❑ Industrial Check all that apply ❑ New Construction ❑Addition r,a�o-tl K.�ctien +aI 3 Coin ar +rnc,-�t sink. / Remodel har,ds,ti/c �co�h-k,e.s 4: fnoe S' ❑ Repair _ NO two . ❑ Demolition ❑ Re-roof ❑ House ❑ garage ❑ other ❑ tear off& re-roof ❑ lay over one layer ElHeat System ❑ Heat pump ❑ wood-burning stove ❑ gas fireplace ❑ pellet stove ❑ other ❑ Other Floor Areas Existing(sq. ft.) Proposed(sq. ft.) Basement @ $ per sq ft. _ $ 1" Floor 19741 same 2nd Floor 3rd Floor Garage Carport Covered Porch Deck hoc�6d5 Shed Other LO�bo►^ 00 TOTAL VALUATION $. 3 C7 Total footprint of structures sq ft. T Lot size sq ft. = Lot coverage % 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 % Max. height of proposed structures ft. Occupancy group #of bedrooms Will a lawn sprinkler system be installed? Occupant load #of full baths Will a fire sprinkler system be Installed? Construction type #of half baths /have read and completed this application and know it to be true and correct l am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Date'/r//Z//6 PrintName2�e6or•ah 0'—U.S.,7 Signature IV�lr.nal,_ C'"�' T Forms/Building Division/Building permit application laws IPA .'t f .�"-u ,•� � � .tom �. �' twop-N AP kl- ^f- a ', x t 1 SIGN PERMIT APPLICATION Print in Ink *. CITY OF PORT ANGELES Atte Building Permit Tech-iician For City Use Only Date Received ` 321 E fifth St. Port Angeles WA 98362 Permit# 0-351 (360) 417-4815 fax (360) 417-4711 Date Approved tt'4rI)., Applicant or Agent /=us0� ��/r_.p, ,sass , L,-C db,- -Jub Phone 3&0 -Lt52-ss 7S— Property Owner Veen --Pz+e-vz.s Phone Property Owner's Address Po 3oK 60rl- 'f,3 Contractor/Engineer t/e-ro P"I-a,es 4�o wn«) Phone Contractor/Engineer's Address License # Expires Project Address Business Name .Su b /a n Nu-fir 4-D-i Parcel Number 0630-000 i e 7 i sd o 0 o Lot Luh v a4 i&7 Zoning 0,54 Submit an 8 %"x 11 "site-plan & three sets of plans that.include ■ Type of sign (wall-mounted projecting, freestanding illuminated, other ) ■ Placement and sq ft. area ■ How the sign will:be securely'attached (Engineering specs may be required for freestanding signs) ■ Separation distance between the bottom of prof cting and freestanding signs..-and the surface below See "Chapter 14.36 Sign:Code of the City o Port Angeles Municipal Code for-sign requirements. Sign Type & Brief Description. (Type, location, sq. ft.) f Sign #1 ��.��e� .3Q' ,V /yy 32- S� 14 Sign #2 �o�.z 2�fr �g w/ h ourzs Sign #3 Sign #4 Totals(Unit charges Sign(s) Unit.Charge, Quantit multiplied.by quantities) Type of'Sign Valuation,$ /00 Od $47 00 x = $ All signs less than or equal to 25 sq ft. $85 00 x / = $ GSOc--� Wall sign or marquees, over 25,sq ft. $115 00 x = $ Freestanding sign or projecting_sign, over 25 sq ft. GRAND TOTAL Make Checks Payable to City of Port Angeles $ g5 0a Credit Cards (Except American Express):are,accepted Existing sign(s) area sq. ft. +Proposed sign(s)area 3a. sq. ft. = Total sign(s).area. sq ft. Ig` qV1 -756 -Building fagade:area .(height ft. X width: `�ft.) = `� t sq ft., (If a building has more-than one business:in it;:onlymeasure the--area of:the buil in-gfagade t atiss;used;bythe:business applying for this.permit.)- -I haV.e read and- completed this application and know It to be true -and, correct. ram authorized. to. .apply .for this permit and understand that .it .Is m.y responsibility to determine what permits are required and to obtain permits prior to working on projects Date,V//Z/,o Print Name Reba -4 fZfxon Signature AL-,-e., �✓ a"—� T:Forms/Building Division/Sign Permit Application.doc A E .r E i 3 a' � f Ct 3 y r 9 Z h Z 2 \KY X 0 g FILE CITY OF PORT ANGELES—Construction Plans � ) The Issuance of this permit based upon these plans,specifi- cations and other data shall not prevent the building official from thereafter requiring the correction of errors in said plans, specifications and other data, or from preventing building operations being carried an thereunder when in violation of all codes and ordinances of this . risdiction., e 7ApprovalDateWBy 1•, CERTIFICATE OF OCCUPANCY APPLICATION Permit# CITY OF PORT ANGELES �' u� � ' PriFEES Attn Building Permit Technician $50 CerTITICotd/inspection 321 E Fifth St. Port Angeles WA 98362 (36'0)417-4815 fax (360)417-4711 $ 0 00 Parking.Business Improvement Area (PBIA) Print in ink fee charged for downtown locations BUSINESS NAME ses L. LC elbh .I'ctil�� laon BUSINESS ADDRESS lay E 5 rh J Zoning C� Business mailing-address la 572, 6 4 n .e..te5 GJa Phone# 4�-45a--5s7S Opening date Das & hours of operation 0-F- 7-3 E✓e15CLt 6y ezppt Washington State Tax I D # If known list the name of the previous 5elV2 mac -(w,%rh & 0A -79,2-6 '7> business at this location 25 .4 a.lAriP'Ks Brief description of proposed business IVli le, t.�•, C/4 b S of ` Oki w _ -rj Business owner's name De-vay Fws�� Phone# 3&o -q,5-7-(,yo Business owner's home address 6S.,9 .vle�-),o 4S jPa,,- R,, zf,,-s A,)4- 'PLEASE-NOTE. A Business License is also required for the following businesses Taxi :Peddlers, Second-hand:dealer Pawnbroker Dance Hotel- Motel, Fireworks,Ambulance Tattoo shop Contact the City Clerk.at 4.17-4634 for additional information. ACTION ✓ WILL THERE BE ANY OF THE FOLLOWING? NOV YES✓ IF YES CONTACT Electrical changes __ ✓ Electrical Dept. at 417-4735 New business New or relocated signs $ep, ��� P rA 1- 10- 1 ✓ BuildingDiv at 417-4815 ✓' Construction changes ryy�=F - ✓ Transfer of business Mechanical changes ventilation, heating,cooling,etc.) ✓ location from a Plumbin changes ✓ PBIA location Firesprinkler system changes Fire alarms stem changes Transfer of business New or relocated sewer or water service Public Works at 417-4807 location from a Excavation or filling of lots ✓ non-PBIA location Work done in the City right-of-way ✓ New driveway openings ✓ Change of ownership Gradin site-drainage(parking lots,downspouts,etc.) ✓ Landscape irrigation system(backflow devices) Water Dept.at 41.7-4886 Remodel Is this a home occupation? ✓ Planning Div at 417,4750 Is this a second-hand dealer or pawnbroker business? City Clerk at 417-4634 Temporary business Is there off-street parking for this business? ✓ How many spaces? /4, Is the street in front of this business paved? Change of use Is there a sidewalk in front of this business? 4r_ Is there a curb&gutter in front of this business? Call for Certificate of Occupancy.inspections before opening business. Pease sign up for utility services Building Department Inspection 417-481.5 & Fire Department Inspection 417-4653 at the cashier counter Please provide a minimum 24-hour notice for inspections I hereby apply for a Certificate-of Occupancy F acknowledge that.I have read this application and state that.the information I have supplied is correct to the best of my knowledge Date Print Print Name �¢bv, h /Ci.soh Signature For City use onl Department Approved RejeCl'!?d Comments/Conditions In ial &date Initials&date Building l 2 Type of construction Occupant Load FireK /Automatic fire sprinkler system required no yes PBIA p-- — "t''I9/10 Petr {D bomk Fusoi-\0.fp-r` Iger d1scVss�oh Planning 4 14 lQ wt'+k W-4- bubuG — she-11 have a (e55 S2 - City y ClerkLi �! Public Wor +q - i�T:Fvr,,s/Building Lig ion/Cerci .e o L: . -ncy Application Wo.'C'Vewa)er Sy 5lla) ID �'i 412 162 TO 120 � „"�� ,` ,gin`„ s�, .�� � 1►�+�" � ' .'� '' `'a. = � j 113 z' •v% C'� Si) �`�, `� '�, ,�:. ,, �' gym., ' 509 l; 1ky t 511 r, ' ter 513 "...�.,. 212 f „�,: °A- °sem .1iea-,�•'' ., aX �r .' p'% '`d 4 PARKING AGREEMENT An.Agreement is hereby entered into in favor of the owner of property legally described as: (provide legal description/address of subject property requiring additional parking) 1-6fS --54 -/ 6L1&--7 i-2v E F47AS?' The purpose of this agreement is to establish and allow parking rights and privileges for/_off-street parking spaces which are located at dS-2 0 $e)-a Y74Q' l;,S7— (address where additional parking is located)including the necessary ingress and egress to access the parking spaces in order to satisfy the off-site parking requirements for uses within the City of Port Angeles per Parking Ordinance#1588,as amended,for property located at 12 Q .s s1 (address of property needing additional parking). This parking agreement without serving prior notice of such intended action upon the City of Port Angeles and obtaining the City's writtgti approval. Such revocation or modification may result in the limitation of the activity located at /20 , X57 This agreement is made between. Prope caner ra Property address Property Owner(Grantee) Property address Dated this day of e 20 I o STATE OF WASHINGTON ) ss COUNTY OF CLALLAM ) BEFORE ME,`a Notary Public in and for the County and State aforesaid, personally appeared Vern QY1 Wk rS and aw C 6 A 114 4n known to me to be the persons who executed the within Agreement, and who acknowledged the same `to beJffieir free and voluntary act and deed for the uses and purposes therein mentioned. GIVEN under my hand and official seal this day of AKI 20_ qg" 9 OST ���.` .•Nl t1k�,••9�y,� NOTARY PUBLIC in and for the State ashington. ��. • My commission expires �l p3 o(OJ3 N Jan 3 2013 "1411"11*A Clallam County Assessor& Treasurer - Property Details - 57282 VERNON D PETERS f Page l,of 4 Clallam County Assessor & Treasurer Property Search Results > 57282 VERNON D PETERS for Year 2009 - 2010 Property Account Property ID- 57282 Legal Description. LOTS 3&4 BL 167 Geographic ID- 0630000167150000 Agent Code Type Real Tax Area: 0010 PA 121 PORT ST CNTY H2 L Land Use Code 59 Open Space. N DFL N Historic Property- N Remodel Property- N Multi-Family Redevelopment: N Location Address. 120 E FIFTH ST Mapsco PORT ANGELES WA 98362 Neighborhood: Cycle 5 Comm Map ID- Neighborhood CD- 20953140 Owner Name. VERNON D PETERS Owner ID- 45941 Mailing Address: PO BOX 2461 %Ownership 100 0000000000% PORT ANGELES WA 98362-0315 Exemptions: Taxes and Assessments Due Property Tax Information as of 04/12/2010 NOc Amount Due if Paid on M First Second Half Half Statement Base Base Base Arr Year ID Taxing Jurisdiction Due Due Penalty Interest Paid Du 2010 40285 ST SCH STATE SCHOOL $48542 $48541 $000 $000 $48542 $� 2010 40285 CC-GEN COUNTY $25833 $25831 $000 $000 $25833 $: 2010 40285 PORT PORT $3630 $3631 $000 $000 $3630 2010 40285 PORT ANG PORT ANGELES $59808 $59811 $000 $000 $59808 V 2010 40285 SD#121 SCHOOL DISTRICT#121 $62874 $62875 $000 $000 $62874 $f 2010 40285 NTH OLY LIB NORTH OLYMPIC LIBRARY $7506 $7506 $000_ $000 $7506 2010 40285 HOSP#2 HOSPITAL#2 $10597 $10597 $000 $000 $10597 $' 2010 40285 WSMET PK DIST WILLIAM SHORE MET PARK DIST $3372 $3372 $000 $000 $3372 2010 40285 CITY STORMWATER CITY STORMWATER $12381 $12381 $000 $000 $12381 $' 2010 40285 WEED CONTROL WEED CONTROL $082 $081 $000-- $000 $082 2010 40285 TOTAL. $2346.25 $2346.26 $0.00 $0.00 $2346.25 $2: 2009 572822008 ST SCH STATE SCHOOL $566 49 $56650 $000 $000 $1132.99 2009 572822008 CC-GEN COUNTY $28669 $28670 $000 $000 $57339 2009 572822008 PORT PORT $4061 $4061 $000 $000 $81.22 2009 572822008 PORT ANG PORT ANGELES $62885 $62883 $000 $000 $125768 2009 572822008 SD#121 SCHOOL DISTRICT#121 $70056 $70056 $000 $000 $1401 12 2009 572822008 NTH OLY LIB NORTH OLYMPIC LIBRARY $8330 $8331 $000 $000 $166.61 2009 572822008 HOSP#2 HOSPITAL#2 $11758 $11757 $000 $000 $23515 2009 572822008 CITY STORMWATER CITY STORMWATER $12381 $12381 $000 $000 $24762 http.//vpn.clallam.net.8084/propertyaccess/Property.aspx?cid=0&year=2009&prop_ld=57 4/12/2010 PREPARED 5/04/09 9 24 14 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/04/09 ADDRESS 124 E STH ST SUBDIV TENANT NBR VERN PETERS CONTRACTOR PHONE OWNER VERNON D PETERS PHONE (360) 477 1053 PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER 08 00001199 COMM REMODEL PERMIT BPC 00 BUILDING PERMIT COMMERCIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL99 01 5/04/09 JLL /n BLDG FINAL TIME O1 00 —/.f/w�-I7V/\r—/ May 1 2009 8 56 53 AM 1pangrle VERN 477 1053 BLDG FINAL AFTERNOON PERMIT ME 00 MECHANICAL PERMIT -- REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ME99 01 5/04/09 JLL MECHANICAL FINAL TIME 01 00 May 1 2009 8 57 32 AM 1pangrle VERN 477 1053 V MECHANICAL FINAL AFTERNOON PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL1 01 10/16/08 JLL PLUMBING UNDER SLAB TIME 03 30 10/16/08 AP October 16 2008 8 59 42 AM 1pangrle VERN 477 1053 UNDERSLAB PLUMBING LATE AFTERNOON INSPECTION October 16 2008 4 26 58 PM jlierly PL2 01 3/20/09 JLL PLUMBING ROUGH IN 3/20/09 AP March 19 2009 4 46 55 PM 1pangrle VERN 477 1053 ROUGH IN PLUMBING AS EARLY AS POSSIBLE March 20 2009 3 53 01 PM jlierly PL99 01 5/04/09 J L PLUMBING FINAL TIME O1 00 May 1 2009 8 57 58 AM 1pangrle VERN 477 1053 PLUMBING FINAL AFTERNOON COMMENTS AND NOTES PREPARED 3/20/09 8 29 42 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 3/20/09 ADDRESS 124 E 5TH ST SUBDIV TENANT NBR VERN PETERS CONTRACTOR PHONE OWNER VERNON D PETERS PHONE (360) 477 1053 PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER 08 00001199 COMM REMODEL PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL1 01 10/16/08 JLL PLUMBING UNDER SLAB TIME 03 30 10/16/08 AP October 16 2008 8 59 42 AM 1pargrle VERN 477 1053 UNDERSLAB PLUMBING LATE AFTERNOON INSPECTION October 16 2008 4 26 58 PM jlierly PL2 01 3/20/09 J PLUMBING ROUGH IN March 19 2009 4 46 55 PM 1pangrle VERN 477 1053 ROUGH IN PLUMBING AS EARLY AS POSSIBLE COMMENTS AND NOTES PREPARED 10/16/08 9 22 50 INSPECTION TICKET PAGE 9 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 10/16/08 ADDRESS 124 E 5TH ST SUBDIV TENANT NBR VERN PETERS CONTRACTOR PHONE OWNER VERNON D PETERS PHONE (360) 477 1053 PARCEL 06 30 00 0 1 6715 0000 APPL NUMBER O8 00001199 COMM REMODEL PERMIT PL 00 PLUMBING PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS PL1 01 10/16/08 JLL PLUMBING UNDER SLAB TIME 03 30 October 16 2008 8 59 42 AM 1pangrle VERN 477 1053 UNDERSLAB PLUMBING LATE AFTERNOON INSPECTION COMMENTS AND NOTES ,{°°°°"'^"° CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES,WA 98362 Application Number 08 00001199 Date 10/01/08 Application pin number 241971 Property Address 124 E 5TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 6715 0000 Tenant nbr name VERN PETERS Application type description COMM REMODEL Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 8000 Application desc ADD TWO BATHROOMS/DIVIDE ONE RENTAL UNIT INTO TWO Owner Contractor VERNON D PETERS OWNER PO BOX 2461 PORT ANGELES WA 98362 (360) 477 1053 Structure Information 000 000 ADD TWO BATHROOMS & DIVIDING WALL Construction Type UNKNOWN Occupancy Type UNKNOWN Permit BUILDING PERMIT COMMERCIAL Additional desc TWO BATHROOMS DIV WALL Permit pin number 134924 Permit Fee 179 75 Plan Check Fee 116 84 Issue Date 10/01/08 Valuation 8000 Expiration Date 3/30/09 Qty Unit Charge Per Extension BASE FEE 95 75 6 00 14 0000 THOU BL-2001 25K (14 PER K) 84 00 Permit MECHANICAL PERMIT Additional desc VENT FANS HEAT PUMP Permit pin number 134940 Permit Fee 79 30 Plan Check Fee 00 Issue Date 10/01/08 Valuation 0 Expiration Date 3/30/09 Qty Unit Charge Per Extension BASE FEE 50 00 1 00 14 8000 ECH ME INSTALL 100- FAU 14 80 2 00 7 2500 ECH ME VENT FAN 14 50 � Permit PLUMBING PERMIT �Q Additional desc ADD TWO BATHROOMS Permit pin number 134932 Permit Fee 114 00 Plan Check Fee 00 Issue Date 10/01/08 Valuation 0 O Expiration Date 3/30/09 o Qty Unit Charge Per Extension 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 provision of any st r o law regulating construction or the performance of construction /o g D e I Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T.Forms(Building DivisioidBuilding Pennit BUILDING PERMIT INSPECTION RECORD -- PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS — Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4807 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type 7 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 Bid Gas Line Back Flow/Water FINAL Date: Accepted by- 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 I Furnace/Ducts 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. Parkin /Lighting ESA. Landscaping SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE Accepted By• Commercial Date Accepted By- Electrical 417-4735 Electrical Construction R.W Construction R PW /Engineering 417-4807 PW/Engineering IFire 417-4653 Fire Planning 417-4750 Planning Building417-4815 Buildin T•Forms/Building Division/Building Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Page 2 Application Number 08 00001199 Date 10/01/08 Application pin number 241971 Qty Unit Charge Per Extension BASE FEE 50 00 5 00 7 0000 ECH PL- EA FIXTURE ON ONE TRAP 35 00 1 00 7 0000 ECH PL- EA INSTALL WATER PIPE 7 00 1 00 15 0000 ECH PL- EA BLDG SEWER 15 00 1 00 7 0000 ECH PL- EA WATER HEATER 7 00 Special Notes and Comments September 26 2008 1 45 41 PM tdahlqui Submit load calculations with electrical permit application All modifications required to City owned facilities to be at customer s expense Address numbers shall be plainly visible from the street Address numbers shall be a minimum of six inches high and be of contrasting color from the background A minimum 2A 1OBC fire exinguisher is required Extinguishers must be mounted with the top no more than 5 off the floor Suggested extinguisher placement is adjacent to an exit October 1 2008 9 43 08 AM permits The proposal is to split a 5000 sq ft single use into 3 suites Total uses on site are 4 Total pkg on site is 26 spaces Parking stalls shall be clearly delineated to meet minimum width & length to current City standards Other Fees STATE SURCHARGE 4 50 Fee summary Charged Paid Credited Due Permit Fee Total 373 05 373 05 00 00 Plan Check Total 116 84 116 84 00 00 Other Fee Total 4 50 4 50 00 00 Grand Total 494 39 494 39 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 s P J. BUILDING PERMIT INSPECTION RECORD G - PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS Building Inspections 417-4815 Electrical Inspections 417-4735 Public Works Utilities 417-4807 Backflow Prevention Inspections 417-4886 �9 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT INCONSPICUOUS 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 Bidgs.) PLUMBING Under Floor/Slab. i o _ 6 c>? 1019 Rough-In 3-2-0-0S Water Line Meter to Bldg) Gas Line g Back Flow/Water FINAL Date: Accepted by- AIR SEAL. Walls Ceiling FRAMING N Joists/Girders Shear Wall/Hold Downs Walls/Roof/Ceiling Drywall Interior Braced Panel Only) Bar INSULATION- Slab Wall/Floor/Ceiling MECHANICAL. Heat Pump/Furnace I Ducts Gas Line Wood Stove/Pellet/ChimneyC /f Commercial Hood/Ducts FINAL Date.J_ `-6 /Q Accepted by- -Tw MANUFACTURED HOMES Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT Separate Permit#s SEPA. Parking I Lighting ESA. Landscaping SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE Accepted By- Commercial Date Accepted By, Electrical 417-4735 Electrical Construction R.W Construction RW PW /Engineering 417-4807 PW/Engineering Fire 417-4653 Fire 77) Planning 417-4750 Planning Building 417-4815 BuildingS -0 LZ tl T.Forms/Building Division/Building Permit �-- BUILDING DIVISION CIT"'Y OF PORT ANGELES TRANSMITTAL`' � � ,A�\�' e� To XFire Department ❑ Other Department q � Date— Project Pro ect Address 4 '�S � - Contact Ver Vr - V&iw-s Phone number(s) L-f i7 7-- ( 0 Permit number Project Description Ci K�`Yl �'�►� u 0 of one- Corn rn,e)rCi o luni+ . A4,k kA� q. v('d In eA ui I o of:fi-� Y'©0m S ❑ New Construction X A49P&M-/ Alteration Please review & return to the Building Division, Permit Technician T Forms/Building Division/Transmittal C. BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES For City Use Only ` Attn Building Permit Technician Date Received -09 - 321 E. Fifth St. Port Angeles WA 98362 Permit# 09,_1111119 011 (360) 417-4815 fax (360) 417-4711 ate Approved Applicant or Agent ,- Phon I y7 7-/a S-3 Property Owner G� Phone 5a� Property Owner's Address Contractor/Engineerloc.. Phone Contractor/Engineer's Address License # Expires l3uilsilnj W l commerc]IOLL Unt PROJECT ADDRESS t ,21 '-1 E 5 1,r11 1ZO► 122 k-2-Lt, ULS G- 15 �' Parcel Number Lot Zoning C Pro/ect Type & Brief Description. ❑ Residential XCommercial ❑ Multi-family ❑ Industrial Check all that apply ❑ New Construction ❑Addition �f Remodel OF V ❑ Repair t ❑ Re-roof. IQ 4 ❑ Demolition A 1.1 eW ❑ Heat System ❑ Meat pump]❑wood-burning stove ❑ gas fireplace ❑ pellet Istove ❑ other , ❑ Other Floor Areas Existing(sq. ft.) Proposed(sq. ft.) Basement @$ per sq ft. _ $ 1 St Floor 2nd Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other TOTAL VALUATION $ vU�� Total footprint of structures sq ft. T Lot size sq ft. = Lot coverage % Max. height of proposed structures ft. Occupancy group #.of bedrooms Will a lawn sprinkler system be installed? Occupant load #of full baths Will a fire sprinkler system be installed? Construction type #of half baths I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits pr r to working on projects Date 0 k Print Name Ve✓�✓n a 4 c +'S Signature T Forms/Building Division/Bldg Permit Appl.-2006 Code.doc MW Al 16 Ol IN 4,4 w Application Number 08 00000991 Date 8/13/08 Application pin number 399101 Property Address 124 E 5TH ST ASSESSOR PARCEL NUMBER 06 30 00 0 1 6715 0000 Application type description ELECTRICAL ONLY Subdivision Name Property Use Property Zoning UNKNOWN Application valuation 0 Application desc 200 amp service for new space AP by Bob Owner Contractor PETERS VERNON D BOB S ELECTRIC INC 1034 E 8TH ST 2293 DEER PARK RD PORT ANGELES WA 983626623 PORT ANGELES WA 98362 (360) 457 6887 Permit ELECTRICAL NEW COMMERICAL Additional desc Permit pin number 132118 Permit Fee 91 00 Plan Check Fee 00 Issue Date 8/13/08 Valuation 0 Expiration Date 2/09/09 Qty Unit Charge Per Extension 1 00 91 0000 ECH EL COM 101 200 NEW SRV FEEDER 91 00 Fee summary Charged Paid Credited Due Permit Fee Total 91 00 91 00 00 00 Plan Check Total 00 00 00 00 Grand Total 91 00 91 00 00 00 / V ,1 INSPECTION ELECTRICAL TYPE DATE RESULTS INSPECTOR DITCH SERVICE 13 b8 ROUGH - IN 0 FINAL 110 COMMENTS: Y�� �°c C3 Request Inspection Tical Contractor aM,+�°`� ❑Annual Permit O Alarm ❑ Carnival ❑Commercial D Residential 11 Residential Maint. D Signs D Thermostat ❑ Telecom. Installation description Job wired by O Electrical Contractor Cl Owner ectrical contra r none.-, License nut ber Gq FurchsScr'S rt►silittg ress city state GIP Telephone number FAX number G �r 7 0� 'Prem f s o cr's name Addr s o laspect" n City aA&A&.e�z 1& 0 ) 2— I �- 0 Cash D Check# I hereby certify that I am the owner of the above named property or a ltceni:ecl 0 Credit Card Visa Mastercard Discover electrical contractor-(or-the.-f'irm's_authorized_agent)-and.am.making_the_clectneal. installation or alteration in compliance with the electrical law,Chaptcr 19.28 RCW Card# - - __,� � Sign a of owner, electri 1 contractor or electrical administrator Expiration Date inslrcctfon fecEL) of card $ WALLS CIEU.ING THERMOSTAT SERVICE lnsulatfon O ly Insulatio Only 3 -� Date Approved By Da d By Date A Date ApprovrA By Pero Y Cover Cover Dom FMER Dale Approved By Date Approved ay Daae Approved By bate Aptpvtved By Electrical Load AddlNon.S and or subtractions Service JE&Mation ❑ NO LOAD CHANGES ❑ Baseboard _KW Voltage 0 Furnace _KW ❑ Overhead Service Phase 0 1 ❑3 / 0 Heat Pump _Ton_LAR ❑ Temp Service Service Size: ❑ Fan-Wall _KW ❑ Underground Service Feeder Size: Inspection Electrical Date Area,BuildingorEquipment inti ected Action Taken TTtispcetor 43 IZ-08 O/C ^10 CoJ.jL-Z i Fc'F" 18/--_�/9_ a t. i Td Wd6T Ta 800? 90 6nU EV66 ESV 092 T ON XUd 3?a13a18 S 30S 1'0B3 cA'-s FILE CITY OF PORT ANGELES Construct!on-jlanq 'CID qa Z 7—z F 9J The Issuance of this permit based upon these plans,specifi. 'Z 41 cations and other data shall not prevent-the building official from thereafter requiring the correction of errors in said plans, specifications and other data, or from preventing building operations being carried on thereunder when in violation of all codes and ordinances of this jurisdiction. JSEeffm ses" Approval Date y ale ��.. ���- eK I i.,i,ii o f, r) iii 1014 Wt'tO PORT A\GI:A,ES I IRE DEPT DATE. U _4L_fT cg'* V 00 oe hdoe t AC)". .t' ovzow� f&a#"I. ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 16-40001707 Date 3/02f17 Application pin number 642028 Property Address 124 E STH ST &PORT STATE ULES TAX ASSESSOR PARCEL NUMBER: 06-30-06-0-1-6715-0000- Application type description ELECTRICAL ONLY on-your excise tax form Subdivision Name t0 the City of Port Angeles Property Use . . Property Zoning . . COMMUNITY SHOPPING DISTR (Location Code0502) Applicationvaluation 0 - -- -- -- - -- ---- -- Application deac Sign ---------------------------------------------------------------------------- Ownez Contractor VERNON D PETERS OLYMPIC ELECTRIC CO INC PO $OX 2461 4230 TUMWATER PORT ANGELES WA 983620315 PORT ANGELES WA 98363 (360) 457-5303 ---------------------------------------------------------------------------- Permit . . . ELECTRICAL-ALTER COMMERCIAL - Additional'desc . Permit Fee 88.00 Plan Check Fee .00 Issue Date 11/15/16 Valuation . , . . 0 Expiration Date 8/29/17 Qty Unit Charge Per Extension 1.00 88.0000 ECH EL-COMM-SIGN 88.00 Fee summary Char9ed _ Paid Credited Due Permit Fee Total 88.00 88.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 88.00 88.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR DITCH SERVICE. ROUGH-IN FINAL COMMENTS: SIT WILL EXPIIME SIX(6)MONTHS FROM LAST INSPEC nON J Signawe of owner or Electrical Contractor X Date: ELECTRICAL PERMIT CITY OF PORT ANGELES j 364-417-4735 c Application Number 16-00001707 Date 3/02/17, Application pin number 642028 Property Address 124 E 8TH STRrS'�A + jUES TAX ASSESSOR PARCEL NUMBER; 06-30-00-0-1-6715-0000- an your excise fol`%I7 Application type description ELECTRICAL ONLY subdivision Name . . , to the City of Port Angeles Property Use Aen Property Zoning . COMMUNITY SHOPPING DISTR (Location Code 0502) Application,valuation 0 ---------------------------------------------------------------------------- Application;desc Sign ---------------------------------------------------------------------------- Owner Contractor VERNON D PETERS OLYMPIC ELECTRIC'CO INC PO BOX 2461 4230 TUMWATER PORT ANGELES WA 983620315 PORT ANGELES WA 98363 (360) 457-5303 Permit . . . . ELECTRICALALTERCOMMERCIAL Additional desc Permit Pee . . 88.00 Plan Check Fee .00 Issue Date . .-. 11/15/16 Valuation . . . . 0 Expiration Date 8/29/17 Oty Unit Charge Per Extension ✓ 1.00 88.0000 ECH EL-COMM-SIGN" 88.00 Fee summary Charged Paid Credited Due Permit Pee Total 88.00 88.00 .00 00 Plan Check Total .00 .00 .00 .00 Grand-Total 88.00 88.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR DITCH SERVICE W ROUGWIN 2 G FINAL COMMENTS: P M1T.*gLL BX ME SIX(6)MONTHS FROM LAST,INSPECTION S g t=of owner or Electrical Contractor X Date: o�Q°flrM i ELECTRICAL INSPECTION 4' �4��N �mt ' WIRING REPORT ms bae' 417-4735 DATE. PERMIT# 1 PECTO z �`7 OWNER CONTRACTOR 15 L� � ADDRESS I APPROVED NOT APPROV ❑ . . . . . . . . . . . . . . . . . . . . DITCH . . . . . . . . . . . . . . . . . . . . ❑. . . . . . . . . . . . . . . . ROUGH IN/COVER . . . . . . . . . . . . . . ❑. . . . . . . . . . . . . . . . . . . . SERVICE . . . . . . . . . . . . . . . . . . . ❑ ❑. . . . . . . . . . . . . . . . . . . . . FINAL. . . . . . . . . . . . . . . . . . . . . ❑ CORRECTIONS NEEDED: ��--- Z� K 'IZ cl (10 -3- NOTIFY INSPECTOR WHEN CORRECTIONS ARE COMPLETED WITHIN 15 DAYS -- DO NOT REMOVE-- Nov 14 2016 04:31 PM HP Fax page 1 d� dFr,r<q, J CITY OF PORT ANGELES PERIVIIT APPLICATION Building Division/Electrical Inspections >� 321 East Fifth Street-P.Q. Boa 1150/Port Angeles Washington,98362 Ph: (360)417-4735 Fax: (360)417-4711 Dace:Ill-i -1(z a Muiti Farnuy cr Commerdar 6+16 "Plan Review May Be Required, Please Complete ElecWW Pian Review Irdomiation Sheet ,lob Address: "- TW T 8u'Iding Square Footage: Description of above 1-cr*- 4- V A S i CrA? Owner Information Contractor Informirtion Nanre: > 1�{n �— Name: aL,�c�cTR�c ms MA%Adds:1'ZM Wr S 74 Sii rVWIN AddreW 4730 TUMWATER City: PA State:'WAN. Zip: 4?4k'%j a City; noaTnnca:LEs State: zip: WW3 Phone: Fax: Phare:XGAWis Fax: •3495 License#1 Exp. License#1 Exp.0LY—mFw son Item! Chi �y Tatar(Qty MuIMM by Unit gh j Servios/Feeder 200 Amp. $13200 $ Servica/Feeder 201400 Amp. $160.00 $ Serms Feeder 401.800 Amp $225.00 $ Service/Feeder 601-1000 Amp. $288.00 $ Servk*tFeeder over 1000 Amp. $410.00 $ Branch Circuit WI Service Feeder $ 5.00 $ Branch Circuit W/0 Service Feeder $ 74.00 $ Each Additional Branch Circuit $ 5.00 $ Branch Circuits 14 $ 86.00 $ Temp.Serviced Feeder 200 Amp. $102.00 $ Temp.Service/Feeder 201400 Amp. $121.00 $ Temp.Service/Feeder 401.600 Amp. $164.00 $ Temp.ServicelFeeder 601-1000 Amp. $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Oudine Lighting $ 88.00 $q Signal Circuit)Limited Energy-Multi-Family $ 64.00 $ Signai Circ Wtr Limited Energy I First 1500 sf-Commercial $ 96.00 $ Note: $5.00 for each additional 1500 sf Ren wable Elec ticall Energy-SKVA System or Less $113.00 $ Thermostat $ 56.00 $ Note:$5.00 for each additional T-Stat �i $ls� Total Owner as defined by RCW.18.28.261:(1)owner w1l occupy the structure for two years after this electrical permit is finalized.(2)Owner is required to hire an electrical contractor N 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 el Cal administrator: 0 cash D Check ® Croft Card 0