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HomeMy WebLinkAbout1015 E 1st St Ste B - Building O Cityof Port Angele Building Division This certificate is issuedpursuant to the requirements' of Section 111 of the 2009 International Building Code certifying that at t he t issuance this structure was in compliance with the various ordinances of the City regulatinii uilding const r ruction or use for the following r n Business name: Willy'�s Laun Business address i 1015E 1s Street Suite B r f l t Property owner: Priest Z ie g ler Property owner 's #address fizz PO Box 2281 ,Port Angeles,WA 98362 h Automatic fare sp s Not Require w• T Use occupancy cllassafacation: Business 2 e s' Building permit nu 12 Occupant load: Per X 2009 IBC Table 1004. V B Type of construction ice ia i;�;'_;: i '.a 8 -28 -12 v %,y ;3 P °Sue Roberds' arming Manager,., Date R,,,' "4 4,�.t s r s� a 4 fir Post on the premises in a conspicuous place his certificat shall not be removed except by the Building Official. O ^4 y4' f-a S y a e V r i icy S' yr Q eG a ..Na) o 1 r, aZ x. s,i r. s s t,t. x `Df s� <,:st, si y F ry 0\ ti Rr''t�F CERTIFICATE OF OCCUPANCY APPLICATION Permit# t2-- 7 0 1149 CITY OF PORT ANGELES FEES .a... .31 x $50 i ernficate Inspection Attn: Permit Technician f 321 E. Fifth St., Port Angeles, WA 98362 Parking Business Improvement Area (PBIA) (360) 417 4815 fax (360) 417 4711 fee charged for Downtown locations LFASE PRINT IN INK N 30 0 0 &2 0 9 Check one: New business in P.A. h nge of ownership only? oving location from within P.A.? Zoning CAA BUSINESS NAME :5 L aufld rn r iccf LLC Business address 1 Mailing address IqO q E. first s(-- Phone number ,r 2Z -l(0 Open.n date //12. Days hours of operation `7 J. yEcz- D Business owner's name k 0 f _kA i I Contact phone (EN) ZZI- -1(oS Business owner's address' Il rSB Brief description of business flIAN Property owner's name Pr' ,',e c--1, Z .i j 1p/- Contact phone 4'57' $831 Property owner's address /contact P. o 130x 2. 2. -R 1 P©'? Ifini gleS 60)10Y BUILDING DEPARTMENT phone 417 -4815 Bldg approval by Ott, on ?12 I Is the business a restaurant or bar that will seat 50 or more people? Yes No -g-- 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 9 on o0\ t I Changes to a fire sprinkler system or fire alarm system? Yes No I:1 W, tk N(a\ vZ 4140Vl l/GUty-1 Work planned: vQ 0 VInV GI'� e1 (2 lU> P (Parking Business Improvement Area Downtown) phone 417 4623 Square footage of business? PBIA notified VA on--- Is business moving within the PBIA? Yes No 7 ERK phone 417 -4634 City Clerk approval by `yI (o I St I,- I T Second -hand dealer /pawnbroker business? Yes No li 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 -v on '7 6 l e Number of off street parking spaces available for employees and customers? (A parking plan may be required.) Signs? (wall-mounted, freestanding, projecting, awning, A- frame, etc Signs planned: PLEASE NOTE: NO flashing, intermittent, or chasing signs are permitted in the City of Port Angeles. PWE approval byRi YJy MR' Wll p PUBLIC WORKS DEPARTMENT- ENGINEERING phone 417 -4812 I Is site work planned (new or re- located sewer or water service, \d COO hl 5 excavation, grading or filling, work in City right -of -way, new driveway openings, site drainage, parking lots, downspouts, irrigation system backflow devices, etc.). Yes No Work planned: k PUBLIC WORKS WASTEWATER phone 417 -4845 PWWapproval by, Will waste, other than domestic household waste, be discharged into the sewer system? Yes J No If yes, what be discharged: Form -s wastewakei Call for Certificate of Occupancy inspections BEFORE opening business. Building Department Inspection 417 -4815 Fire Department Inspection 417 -4653 Please sign up for utility services at the cashiers' counter. 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 information may result in revocation of permit. Date 0 5)),2 Print'Name t,� U'' 1 /9 /P/ lI c j Ni► Signature T: \Forms\Building Division\Certificate of Occupancy Application (2010).doc Page 2 of 2 o f Poar.44, N PORT ANGELES INDUSTRIAL WASTEWATER PRETREATMENT QUESTIONNAIRE and DISCLOSURE FORM rnKS A 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: i 1 (IMAM YO rVIcI f Mailing Address: ]f C}Q U h h ye i" Address of facility in Port Angeles (if different than above): 1015 .F" h r5 i 7 Ltri /�-y Contact Person: JcIQ 1- 1U(kt.i/Vdakt Phone: (20Ct�27. 1(D 3 1. Type of Industry: LalA.r IG+ (V t4-�- Standard Industrial Classification number (4 digit SIC code) 2. Type of Product(s) or Servic produced; rate of production; process used: Type of product Rate of production Process 3. Product Volume: 4. Number of Employees: 0 5. Operation Pattern: (hr /day) l (days /yr) o S (mo /yr) fl' 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 b) Cooling c) Sanitary d) Others listed below: fi r f 4 Y 't- pss e S ";.'r f `u A '4 y -Pt' b3. 'ii p er r i 4` -t 4 .'S-4 x� m,,, example`3Degreasr, 0- ronioroettiylene) _a z ..y ,3PM, 30 mintday� Os .:y..,,3 i 1� .M ,_10 mintd'ay w Total Discharge 9. Are there seasonal variation to the above discharges? PW- 804_02 page 1 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 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 No 15. Does your company have or plan to provide a parking lot, with a drain system to collect run off? Yes No 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: 18. Does your company have the necessary Material Safety Data Sheets (MSDS) on file? Yes No 19. List any prohibited pollutants being discharged as regulated by the City's Industrial Pretreatment Ordinance: Pollutant Daily Max. Conc. (mg /I) Daily Avg. Conc. (mg /I) 20. List any environmental control permits that are held by or for your facility. 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. The information contained in this questionnaire and disclosure statement is familiar to me and to the best of my knowledge and belief, such information is true, complete and accurate. DATE: f'1( 1 S —,„z I Signature: Jai J T itle: o q '7 L' 1 NOTE: Attach additional pages, if needed. RETURN TO: RECEIVED City of Port Angeles Wastewater Treatment Plant Attn: Superintendent 321 E. 5 Street JUN 15 2012 P. O. Box 1150 Port Angeles, WA 98362 CITY OF PORT ANGELES BUILDING DIVISION PW- 804_02 page 2 [Revised 7/05] 1:1' 4." i ..4„,,,,' ''7:7.7. y p t ://.7, i M k Y "Y r a fi o 1 J x Y a Y Y� y� `k n f 3a. G r i x A f.'"?. tiI4 xv 0 V U p a IN in C y ;C: r„, Gr M .e.i: g CV Y x. t L, t— a r v s i Y y s$ -1 r. a g ts h 0, i.r ax „91 4 ct Y ,#i+ �.g g r a d s f l y a 7 G i h f7 1 4 d.N I 4 if wY'P i n y n G G 4 t r Y .2. 4. f •psi z. d1" i "1+ '"y k .:.ice t Heather Catuzo From: Janessa Hurd Sent: Friday, June 15, 2012 2:29 PM To: Heather Catuzo Subject: RE: Certificate of Occupancy Willy's Laundromat No comments From: Heather Catuzo Sent: Friday, June 15, 2012 1:35 PM To: Jeff Young; Alisha Hicklin; Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds Subject: Certificate of Occupancy-- Willy's Laundromat Hi all, The routing packet can be found: G: \EXCHANGE \Building Routings File Name: CO Willys Laundromat LLC Please provide comments on this to me by June 22, 2012. The WW Questionnaire was filled out and is in the box to go to Jeff /Alicia. Please let me know if there will be any special requirements for them for this. Heather Catuzo Building Permit Technician City of Port Angeles Building Division 321 East 5th Street Port Angeles, WA 98362 (360) 417 -4817 hcatuzoPcityofpa.us 1 Heather Catuzo From: Roger Vess Sent: Monday, June 18, 2012 11:02 AM To: Heather Catuzo Subject: RE: Certificate of Occupancy-- Willy's Laundromat Engineering has no comments. Roger From: Heather Catuzo Sent: Friday, June 15, 2012 1:35 PM To: Jeff Young; Alisha Hicklin; Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds Subject: Certificate of Occupancy Willy's Laundromat Hi all, The routing packet can be found: G: \EXCHANGE \Building Routings File Name: CO Willys Laundromat LLC Please provide comments on this to me by June 22, 2012. The WW Questionnaire was filled out and is in the box to go to Jeff /Alicia. Please let me know if there will be any special requirements for them for this. 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 Heather Catuzo From: Jeff Young Sent: Tuesday, June 19, 2012 1:05 PM To: Heather Catuzo; Alisha Hicklin; Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds Subject: RE: Certificate of Occupancy Willy's Laundromat Ok, I looked at Wiilys CO and questionnaire and it looks good. He will have a few machines and be open to the public but is not going to do bulk washings of greasy rags or uniforms. I okayed it at my level. Thx Jeff From: Heather Catuzo Sent: Friday, June 15, 2012 1:35 PM To: Jeff Young; Alisha Hicklin; Janessa Hurd; Ken Dubuc; Roger Vess; Sue Roberds Subject: Certificate of Occupancy-- Willy's Laundromat Hi all, The routing packet can be found: G: \EXCHANGE \Building Routings File Name: CO Willys Laundromat LLC Please provide comments on this to me by June 22, 2012. The WW Questionnaire was filled out and is in the box to go to Jeff /Alicia. Please let me know if there will be any special requirements for them for this. 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 CERTIFICATE OF OCCUPANCY APPLICATION Permit# Ii 7•7( I i 71 CITY OF PORT ANGELES FEES Attn: Permit Technician $50 ertificate Inspection 321 E. Fifth St., Port Angeles, WA 98362 00 Parking Business Improvement Area (PBIA) (360) 417 -4815 fax (360) 417 -4711 fee charged for Downtown locations _..P_LEA._SE PRINT IN INK Check one New business in P.A.? LI C'hange of ownership only? F Moving location from within P.A.? Zoning e•I BUSINESS NAME l r Business addre I t 'Firs °,t. Mailing address 14061 Phone numberi7.. PI)2 ZL( Openin date 1/12 Days hours of operation 7 J R (.4 1I r.) Business owner's name (M, •r\ O kJjAJc* (/1, Contact phone 12.04)724-1- S• rr- Business owner's address jt-t`s /j I- t qt r ?)1 Brief description of business :IVY;\ Property owner's name Pr 'p 1p f Contact phone '$7. 8,8,331 Property owner's address /contact f. CO 5c:),( z.- /P P p j BUILDING DEPARTMENT phone 417 -4815 Bldg approval by on Is the business a restaurant or bar that will seat 50 or more people? Yes .1 No A 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 KM, on (e• 18•2412 Changes to a fire sprinkler system or fire alarm system? Yes -L1 No Work planned: 9\10 t o (2 Ci■4+swG 6 el'F o€2 Sti t r cat 0 P> A (Parking Business Improvement Area Downtown) phone 417 4623 Square footage of business? PBIA notified f.)i on -e° Is business moving within the PBIA? Yes 7..1 No Z Gt' o CI_T -Y CLERK phone 417 -4634 City Clerk approval by on Second -hand dealer /pawnbroker business? Yes Li No Will there be dancing at this business? Yes No No Jam. A City of Port Angeles Business License is required for: Taxi, Peddlers, Second -Hand Dealer, Pawnbroker, Dance, Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses. 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