HomeMy WebLinkAbout216 E 5th St Suite A - Building o -o
CERTIFICATE OF OCCUPANCY
City of Port Angeles Building Division
sf
This certificate is issued, pursuant to the requirements of Section 111 of the 2009 International Building
Code certifying that at,he time of issuance this structure was in compliance with the various ordinances
t�,
of the City regulating; building construction or use for the following:
Business name: Pixel Perfect Imaging
Business address: 216 E 5 Street Suite A
Property owner: John Consuelo White
Property owner'saddress: 216 E 5 Street Port Angeles, WA 98362
Automatic fire sprinkler system: Not Required
Use occupancy classification: Business
Building permit number: 12 427
Occupant load: Per2009�`IBC, Table 1004 1:=1
V B
-Y�
l
Type of construction:
Sue Roberds, /1 nning Manager Date
Post on the premises in a conspicuous place. This certificate shall not be removed except by the
Building Official
CERTIFICATE OF OCCUPANCY APPLICATION Permit#
w
CITY OF PORT ANGELES FEES
s $50 Certificate Inspection
Attn: Permit Technician
321 E. Fifth St., Port Angeles, WA 98362 $100 Parking Business Improvement Area (PBIA)
(360) 417 4815 fax (360) 417 4711 fee charged for Downtown locations
1 `x'•
PLEASE PRINT IN INK O03 0 00 GZo C
Check one: New business in P.A.? Change of ownership only? Moving location from within P.A.? 1?Y Zoning CO5
BUSINESS NAME Q N -f',( C-Ce. CJr I Mk 1 VW
Business address 1 h S� tl A. it Ma g address 5aVY\ J
Phone number 452- el Opening date 411 1p l' -Days hours of operation
Business owner's name (I 1'1 Y\ A tr' Contact phone
Business owner's address t55 i -t'V\l i i A. cc 3t 3
Brief description of business &bgtP I A 1A6 Y' 1 I
Property owner's name inn (COv\ Ue.,tO `��/1 Contact phone
Property owner's address /contact i {1,
BUILDING DEPARTMENT phone 417 -4815 Bldg approval by J u. on (.04.011'2.-
Is the business a restaurant or bar that will seat 50 or more people? Yes No Nr
Construction changes planned (moving walls, adding /enlarging windows or doors, roofing, siding, foundation work,
adding /altering stairways, ramps, bathrooms, electrical, heating /cooling /ventilation systems, etc).
Work planned:
FIRE DEPARTMENT phone 417 -4653 Fire approval by 4)0 on
Changes to a fire sprinkler system or fire alarm system? Yes No X
Work planned:
PBIA (Parking Business Improvement Area Downtown) phone 417 4623 1
Square footage of business? PBIA notified o/n
Is business moving within the PBIA? Yes NoX
CITY CLERK phone 417 -4634 City Clerk approval by II 1y K 1 -1- 75.
Second -hand dealer /pawnbroker business? Yes No
V10 CDPAP(\eiNte r
Will there be dancing at this business? Yes No
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750 CED approval by f 2-- on 1
Number of off street parking spaces available for employees and No corn /n n1
customers? 1
(A parking plan may be required.)
Signs? (wall- mounted, freestanding, projecting, awning, A- frame, etc
Signs planned:
-1 (e.p,1 n'h Qy.t S jrt
PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles.
PWE approval by SNACA,Man 6.
PUBLIC WORKS DEPARTMENT .ENGINEERING phone 417 -4812
Is site work planned (new or re- located sewer or water service, 14 COM Mie
excavation, grading or filling, work in City right -of -way,
new driveway openings, site drainage, parking lots, downspouts,
irrigation system backflow devices, etc.). Yes NoX
Work planned:
PUBLIC WORKS WASTEWATER phone 417 4845 PWW approval by V-Ov 1 e-C'' on 14:'61
Will waste, other than domestic household waste, be discharged into the sewer system? Yes No,
If yes, what will be discharged:
Call for Certificate of Occu anc ins ections BEFORE o enin b E 1 V E
Building Department Inspection 417 -4815
Fire Department Inspection 417 -4653 APR 2 3 2012
Please sign up for utility services at the cashiers' counte
g P Y CITY OF PORT ANGELES
BUILDING DIVISION
I hereby apply for a Certificate of Occupancy. I acknowledge that I have read this application and state that the
information I have supplied is correct to the best of my knowledge. Incorrect informatio may result in revocation of
permit.
Date 7,712Erint Name L Rirignature
l_
T: \Forms \Building Division \Certificate of Occupancy Application (2010).doc
Page 2 of 2
ti °o� PoRrgN��`
PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT
QUESTIONNAIRE and DISCLOSURE FORM
/c ORKS
Complete all applicable sections. Information must be typewritten or clearly printed. Attach requested information as needed Signing
official must have the authorization to provide such information on behalf of the company, corporation, or partnership.
Company -Name: P m it
Mailing Address: S1 it r-i g i
Address of facility in Port Angeles If differe t than above):
Contact Person: J 7 (A,Y11r�..e. F U V pn reiy Phone: 7 too 45)2- cgYo q
1. Type of Industry: phO IrG7ha Standard Industrial Classification number (4 digit SIC code)
2. Type of Product(s) or S. (s) rod d; rate of production; process used: prpCeSS rc k k QU l d
Type of product Rate of production Process -C ,S uS�d
3. Product Volume: 4. Number of Employees:
5. Operation Pattern: (hr /day) 1 (days /yr) JS (mo /yr) i2 6. Water Usage (gpd): Average Maximum
7. WASTEWATER DISCHARGE TO SEWERS: [List the principal materials (cleaning agents, solvents, plating solutions, catalysts, process
chemical, etc) by their generic name and principal.chemicals that are regularly used in your facility and that will or might be discharged to the City sewer
system)
AVERAGE DISCHARGE MAXIMUM DISCHARGE
TYPE OF MATERIAL
OR CHEMICAL GAL. TIME CONC. GAL. DURATION CONC.
PER DAY DURATION (MG /L) PER DAY (MG /L)
a) Process "j t
b) Cooling
c) Sanitary
d) Others listed below:
Y
example. Degrease(Tryctiloroethylene} 3_. =3P.M, 30:min /day; 0 3 10_AM, 1.0= m�n/day ,0:001 N
Total Discharge
9. Are there seasonal variation to the above discharges?
R E C
PW- 804_02 page 1
APR 2 3 2012
CITY OF PORT ANGELES
BUILDING DIVISION
PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT
QUESTIONNAIRE and DISCLOSURE FORM (continued)
10. Does your company sample and analyze your wastewater? Yes No If yes, what is the nature_of that sampling
program?
11. Discharge to sewerage system: Attach as "Exhibit 1" a plan of your property showing accurately the site plan, floor'
plan, mechanical and plumbing plans and details showing all sewers, connections to the City systems, inspection
manholes,_sampling manholes, and.appurtenances. by size, location .and elevation.
a) How_many wastewater. discharge points does your, company have that are connected to the City s sewer collection system?
b) Where are your discharge points located?
12. Does your company have any plans for expansion? Yes fX No If yes, when and how would expansion alter your
industrial wastes
13. Do you provide any pretreatment of wastewater streams that occurs prior to discharge to a sanitary sewer? Yes'
No
14. Do you have a spill prevention, containment and control plan (SPCC) for your company? Yes Vf No
15. Does your company have or plan to provide a parking lot, with a drain system to collect run off? Yes [X
16. Do you dispose of any chemicals, solvents or hazardous' materials to other than the sewer? Yes ,No
17. If yes, provide a description of each material, giving the composition, solids content, annual quantity, means of
disposal, and ultimate disposal location: NV,Q
18: Does your company have the necessary Material Safety Data Sheets (MSDS): on file? )i Yes No
19. List any prohibited pollutants being discharged as regulated by the City's Industrial Pretreatment Ordinance:
Ppllutant Daily Conc. (mg /I) Daily Avg. Conc. (mg /I)
20. List any environmental control permits that are held by or for your facility. 0
21. If additional pretreatment and /or operation and maintenance activities are required in order to comply with the City's
Industrial Pretreatment Ordinance, then the discharger shall provide a compliance schedule attached to this form which
describes how the facility will conform to the requirements. 0 1 Pr
The information contained in this quest:ionnair= and disclosure statement is familiar to me and to the best of my
knowledge and belief, such information true co► plete and accurate.
DATE: L 1"23-- 1: tip 9
SI natureL_ Title: (91.71\ o
NOTE: Attach additional pages, if nertied.
RETURN TO:
_•City of Port Angeles Wastewater Treatment Plant
Attn_ Superintendent
321 E. 5' Street
P. O. Box 1150
Port Angeles, WA 98362
PW- 804_02 page 2 [Revised 7/05]
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Heather Catuzo
From: Janessa Hurd
Sent: Monday, April 23, 2012 11:58 AM
To: Heather Catuzo
Subject: RE: Certificate of Occupancy -Pixel Perfect Imaging
No comment. JH
From: Heather Catuzo
Sent: Monday, April 23, 2012 11:34 AM
To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds
Subject: Certificate of Occupancy -Pixel Perfect Imaging
Please review the attached application and respond to me by April 30, 2012. I have routed a hard copy of the
questionnaire to wastewater.
Thank you,
Heather Catuzo
Building Permit Technician
City of Port Angeles Building Division
321 East 5th Street
Port Angeles, WA 98362
(360) 417 -4817
hcatuzo @cityofpa.us
1
Heather Catuzo
From: Roger Vess
Sent: Tuesday, April 24, 2012 8:20 AM
To: Heather Catuzo; Janessa Hurd; Ken Dubuc; Sue Roberds
Subject: RE: Certificate of Occupancy -Pixel Perfect Imaging
Engineering has no comments.
Roger
From: Heather Catuzo
Sent: Monday, April 23, 2012 11:34 AM
To: Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds
Subject: Certificate of Occupancy -Pixel Perfect Imaging
Please review the attached application and respond to me by April 30, 2012. I have routed a hard copy of the
questionnaire to wastewater.
Thank you,
Heather Catuzo
Building Permit Technician
City of Port Angeles Building Division
321 East 5th Street
Port Angeles, WA 98362
(360) 417 -4817
hcatuzoPcityofpa.us
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CERTIFICATE OF OCCUPANCY APPLICATION Permit#
FEES
CITY OF PORT ANGELES
$50 Certificate Inspection
Attn: Permit Technician
321 E. Fifth St., Port Angeles, WA 98362 $100 Parking Business Improvement Area (PBIA)
(360) 417 -4815 fax (360) 417 -4711 fee charged for Downtown locations
11 L
PLEASE PRINT IN INK
Check one: New business in P.A. Change of ownership only? Moving location froth within P.A.? 1 Zoning CO5
BUSINESS NAME p-ekr-ee. vt"
Business address 2 Lo ST 11 A n- Mailing address YYNCJ
Phone number 452 O Opening date 411 4, I 13 Days hours of operation
Business owner's name Ol Yl Yl.� r V VYl pVl, lr-F.71 Contact phone
Business owner's address 5?� i4 1 2.. P MD 3
Brief description of business ill PAtP .11111•41 0 4 0 1
Property owner's name 34\1111 KU11 Uei1 1 1/1,14 Contact phone
Property owner's address /contact _1 "r
BUILDING DEPARTMENT phone 417 -4815 Bldg approval by on
Is the business a restaurant or bar that will seat 50 or more people? Yes No Ni
Construction changes planned (moving walls, adding /enlarging windows or doors, roofing, siding, foundation work,
adding /altering stairways, ramps, bathrooms, electrical, heating /cooling /ventilation systems, etc).
Work planned:
FIRE DEPARTMENT phone 417 -4653 Fire approval by •O2, on 5-2 Zol2
Changes to a fire sprinkler system or fire alarm system? Yes No
Work planned:
PBIA (Parking Business Improvement Area Downtown) phone 417 -4623
Square footage of business? PBIA notified 1\-V\
Is business moving within the PBIA? Yes NoX
CITY CLERK phone 417 -4634 City Clerk approval by on
Second -hand dealer /pawnbroker business? Yes No
Will there be dancing at this business? Yes No
A City of Port Angeles Business License is required for:
Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance,
Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses.
Page 1 of 2
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