HomeMy WebLinkAbout510 E Park Ave - Engineering
~ CITY OF PORT ANGELES C\W ?Uf)-ICc::'?(}
, \1) DEPARTMENT OF PUBLIC WORKS v /
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date q -- /J.- - 0 1)
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
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INSPECTION NOTES
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Inspected
Remarks
Date
~ ~ Time . /J~
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RESTORATION REQUIRED
YES
NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
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o Repaired by City
[] Repaired by Permittee
D No Damage Found
o Asphalt 0 PCC ! / 0 Other
~ork .9Jder # 6 70
~OMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
s
~~
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
/
PUBILlC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
/-lOCI! COhS;
PW'CITY, PW State PW.Zip
000/000-0000
PROJECT INFO
Work is
Plans Required
Contractor'
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
1/28/2000
Permit No
Work Order'
1037
o
PROPERTY LOCATION
510 PARK AVE E
Lot: SEE BELOW Block.
Subdivision MAGUIRES ADD, GRANTS ADD
Parcel No 063015509170100 [gI. Long Legal
D Install
D Repair
D Watermain
PROJECT NOTES
Start Date
Amount:
Value Work
/ /
Finish Date
000/000-0000
$000
D Mise
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
$000
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C)
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/ /
.
-PM1 /11 D eRJ 50/1
FEES ASSESSMEN"f
1 ) R/W Excav'
2.) Sidewalk
3 ) Curb/Gutter'
4 ) Driveway'
5 ) Dwy Culvert:
6 ) Street Cut:
7 ) Other R/W
8 ) Fire Hydrant:
9) Res Water Servo
10) Comm Water Servo
11 ) Other Water Service
12.)Water System Dev'
13 ) San Sewer SFR
14) San Sewer MFR
add unit: 0
Receipt No 5817
Inspection Fee $0 00
R/W SANIT AR Y WATER
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
15 ) Other San Sewer'
16) Sew Tap Wye/Man Tap
17) Sew Cap/ W/M Removal
18 ) Alter Repair Sewer'
19 ) Storm Drain
20) Catch Basin per ea.
21 ) Sewer System Dev'
22.) Milwaukee Dr Sew Ass
23 ) R/W Use Perm
24 ) Admin Cost (D RA)
25 ) D RA.
26 ) Misc.
TOTAL FEE.
Amount Paid
$000
$000
$0.00
(~
$000
$000
$000
$000
$000
$000
$000
$000
$35.00
$35 00
DWY
Balance Due
STORM
DRA
$0.00
OTHER
Separate Permits are required for electrical work. 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
vi late or <;ancel the provisions of any state or local law regulating construction or the performance of construction
Si nature of Owner (if owner is builder)
Date
--, - ---~ -- ~_._. --- ~-~--.
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. .
. . . . .
REQUEST
Date / /:;2f hooo
. /
Time
Received by
-;;:-
/
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing
;;;;;f~ -
INSPECTION NOTES / - I /
Inspected Date .111 ~f? /no Time ~
Remarks ,r / 1("''' (';' -. : (' J' Jde ~l Ie .
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Phone No
Permit No
Fin0wer EX~ Other
/037
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RESTORATION REQUIRED
YES
NO
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SURFACE RESTORATION A
SURFACE TYPE 0 Unimproved/ 0 Gravel i 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 1YPE DATE ACCEPTED COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
WALU;
FOUNDATION DRAINAGE
ELECTRICAL (liGHT DEn)
ROUGH-IN I
PLUMBING
UNDER FLOOR I SlAB
ROUGH-IN
WAlER liNE
BACK FLOW I WATER
AIR SEAL
WALLS
CEIliNG I I I
FRAMING
JOISTS I GIRDERS
SHEAR WAlL
WALLS I ROOF I CEIliNG
DRYWAlL
T-BAR
INSULATION
SlAB I I
WAlL I FLOOR I CEIUNG I I
MECHANICAL
CHIMNEY
WooDSTOVE I PEllET
DUCTS
PW UfU..ITIES I SITE WORK (Ens ineerinS Division)
WA TERl1NE I MElER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTIIER
FINAL INSPECTIONS REQUIRID PRIOR TO OCCUPANCYIUSE
RFSIDE1ITIAL DATE YES NO COMMERCIAL DATE ACCD'TED
YES NO
ElECTRICAL liGHT DEPT 417-4746 ElECTRICAL
liGHT DEPT
CONSTRUCTION R. W I PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MULTI-FAM. ONLY) 4 I 7-4654 FIRE DEPT
BUIillING 417-4815 BUIlDING
GENERAL COMMENTS:
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