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REQUEST
Date l r ? I
CITY OF PORT ANGELES I/~-Vv/-~~v /
DEPARTMENT OF PUBLIC WORKS
. . INSPECTION REPORT. /
/
-t1~ Time I;;' ()O I *'1 Received by 7 e J? ;e Y /41. (phone, person)
Location of Work to be inspected I i () If + I )~.c ftIt/ A J? IE 1/ IE tv jJ Ie.-
Name of person requesting inspection T E /? X r Ur .
Address of person requesting inspection I? ~ ~ P. Phone No
Type of Inspection (circle appropriate one) AJ O~nellll;l ...N6- 1:>3 '7
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
!J Iv ;; PV 7
INSPECTION NOTES
2. ( -tll/
Inspected Date -
Remarks f( E. ~ LA C E /l
,
VN/pN"J' IN I....I#f
J ~ E~T
Time /1 Of) ArM By If v,v
5 c- It 1/1 t: E t.... I AI ~ 5 , .., 0 1'1 e IE j? ,
II),). ~ ).. / rtt O;t, J14C I< (/ r C vI( t$
/'v T
IN
RESTORATION REQUIRED
YES V NO
~z
/-) 1~/I1f1cL
---------
<-
~
~ I ~
~ 'Q~1-x~ _
1\7-)( - -
( ~-I '<:-'/ .
cs 0 f ......
. "<.
~ ~
......
/11 /J ;( I e 'II few
PI?
~
~
J
.J
SURFACE RESTORATION
SURFACE ~E 0 Unimproved 0 Gravel
/r ( ~V'-V O~ Repaired by City
/IV) ~ \ ,.))v 0 Repaired by Permittee
1'\ ~ 0 No Damage Found
IB1Gphalt [B1S"cc
Work Order #
o Other
IS- )7
o COMPLETE
[B1NCOMPLETE
}.1e-~pS' T, Ge HI' .I'11.x.€,P I> Cf/~IS I'JlT J5Ac/c
Mil r liE EX P p'se p /'J (i 1'1 r;~e T Ptf~ /t r;~ IN D~/~~ iliA ~
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
OlJ~DO?-/sa?
City of Port Angeles
Public Works Department
Water Distribution Repair Report
'Work Order No: {7 } '7
Reported: 1)} 1/ t/ ()
Repaired: .2) -L/ fl C/
Repair Location:
Component Repaired:
Main:
Service:
Line Valve:
Hydrant:
Other:
I Crew: j( viti,' (}(~N /1111; /fAI p r f
Condition.
Source.
l--
Emergency Routine
Citizen Complaint
Leakage Survey _ Other
Address
Loc. Description.
'7t''t 1- ()e; b l1A/(/~ V/EW F/C.
I, I" ,
jc~lIiCE LEAl( 11--). FA'vA? CfI;?(} IN Sr,;(eeT
I
Main Line ID#:
Joint Cir Break
Long. Break _ Hole
Split Bell _
Clamp _
Other
Tap _ Corp Stop_
Flange Nuts, Bolts
Branch Valve
Pipe v'
Stem
Barrel
Curb Stop ~
Bonnet
Repair Type: Clamp _
Dresser
OtherVP/ON. f'E ~ Ae'e,f .s'F~?
,
Site Condition: Surface
Curb
Gravel Roadway _ Asphalt Street V' Sidewalk
Top Soil Area ~ Soil Type _
Damage:
I I I
Cuts: Street Cut: Ft. Cfx !() Curb Cut: Ft. e1 Sidewalk Cut: Ft.
Main Condition:
Apparent Cause of Leak:
5/19/98
Diameter' Inches
Material.
Depth of Cover' Ft. .J
Internal Lining:
"
,.- (
Joint Type:
External Prot:
Tuberculation. N/ A Minor
External Corrosion. N/ A Localized
Special Conditions. Bedding: r;. J( A fie '-
Other Structures.
Severe
Extensive
Samples Taken. Pipe Section _
Coupon _
Water Off: From , / 31 / p" To I). v "I'M
From I / J ( /Pv To ~PfM
rJl..(l
Ii i.. I/E
TI/g~
I:E*
Page 1
PW-902.09
,
.
SCANNED
CITY OF PORT ANGELES LIGHT DEPARTM9f!te \ ~\":')lo e
321 E. Fifth Street Initials M( ,
.
Port Angeles, WA 98362 /
(206) 457-0411 PERMIT NO. oS..:? e;-- l:::>
'7/20 /';f
, t-
DATE
ELECTRICAL PERMIT
Site Address:
o READY FOR
INSPECTION
License Number:
o Will CAll FOR
INSPECTION
Phone:
Installed By:
Owner/Business:
Phone:
Owner/Business Address:
Sq. Ft.
ELECTRIC HEAT
o BASEBOARD KW _
o FURNACE KW
o HEAT PUMP KW_
o FAN/WALL KW
o RESIDENTIAL
o COMMERCIAL
o NEW CONSTRUCTION
o REMODEL
o ADD/ALTER CIRCUITS
o SERVICE UPGRADE/REPAIR
o TEMPORARY SERVICE
o RISER
o OVERHEAD SERVICE
o UNDERGROUND SERVICE
VOLTAGE:
019\ 039\
SERVICE SIZE
FEEDER SIZE ~ D
AMPS
AMPS
Details/Description:
.
W.S. No. SERVICE SIZE
CAPACITY:
o O.K. 0 NOT O.K.
ACTION REQUIRED: 0 CHANGE TRANSFORMER
o INSTALL SERVICE POLE
DATE
ENGR.
o OVERHEAD SERVICE APPROVED
o CHANGE SERVICE WIRE
o OTHER
o Ditch Inspection O.K.
~,JIi~ Rough-in/cover O.K.
o O.K. to connect service
~rp..,Final O.K.
Installer:
Date:
.
Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered
before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report
or on the ~g Permit. PHONE 457-0411, EXT. 224. .;#
L~ NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ r..3 0
lectricallnspector Permit Fee
WHITE - File by address
PINK - Top: Eng, Bottom, Customer
GREEN - Top: Meter Dept., Bottom: City Hall
~
OLYMPIC PRINTERS INC.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16118
j- / r ;;d
Port Angeles, WasbJngton.....m ..000.0001...._000.000..000000.000000.......000000.. 19........
In accordance with the City Ordinance to regulate the installation, extension. or repair of elec-
trical equipment in, on, or about any building or other structure In the City of Port Angeles. per-
mission is hereby granted to d6 electrical work as liste~. .." (,
Address ...It!!ef~~~....~.~-<1'~.,..::::................... OCCUpanCy....~.:~.....m....mm.
Owner ..m.mm.mm......mm...........~.~..!.....m.. Tenant.............m....._m...m....m.............m.....m...........
Wiring Contractor ..~.!.~....m~..................... By...........mmm..m......mmm............m..mm.......
Light outlets.............~..J~~............ Service. volts ../..~f:/...:?::f.::2... Type of Wiring:
Receptacle Outlets.......~__~.....__........ No. wIres ...".~.....m----........--fi..... Armored Cable ............................-.
r.: Sl I y/~ a.Y Non.Metallic .................................
Dryer, KW mm..m..""".......................... ze w res..,k..:........A.................
/;;1. /-1'......, t) Knob & Tube.........._..............__....._
Range, KW........h..C..........h........ MaIn fuse ....~.........................
S
Enclosure .....00..........____....__.__.........
Water Heater:
y.)
KW...........__......!..........n..........__...
Heat Kw.....2.;;?~......8..!.9..............
Type of wiring:
Entrance Cable ...............__............
Motors: size, volts and phase:
j/...~~p.................................
. ,
I /':e.. -..
..:........._.....-.~....--._..........................
Rigid ConduIt .~:__................m.......
Metallic Tubing ....__
Current transformers:
No. & Size......................__...............
Scr. No.........__....._____.____..____..............
Scr. No. ....u.......................................
Ser. No. ....__..............:........................
RIgid Conduit ...............................
Metallic Tubing ...........................
Raceway .~....X...--.............-......-
CIrcuits, LIghT--............................
:::~:...?:~~::.:::.:..:::::::::..:.::.:...:
Q
Water Heater ....................___...__...
Motor ........~............__..__..__..____........
Dryer __.n~...........................__..__..._
Furnace .........................'_...................
<(;
Total Load....__..____................. Ser. No.................--........--.._............. Total __;-:::...____.__.....__.................
Remarks: ____._n_...___n~.:!..!:?.~.~nn:::.uuuu~.~'k.~.!._.nn._.nnnunnn...n...nn.nnnn.n._~n.~..n..~.nn..uu
".m"m.".....m..mmu....m....muh.uh"h"""...m..........".."...m...mm......m.h....""u............;7....m...-=,.;;............... ..
:::=Z.~~..m......u... ::~.~.~:..~.~.~.~~~.~........ By 79i...t....ti..~2:~
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con.
cealed due notice must be given the Inspector so that work may be Inspected berore concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
16118
Address.._................................................._...................................................................................Date..._......_.._.._.._._........_...____......_.........
Owner..................................._.........__......_......_.._...........................................................Tenant............_..................................................._...
Wiring Contractor ...................................._......................._............................................................. By..............................................................
NOTICE-Current must not, be turned on until CertIfIcate of Inspection has been issued. It work Is to be con-
cealed due notice must be given the Inspector so that work may be inspected before concealment.
1M Olympic Printers, Inc.
CITY OF PORT ANGELES
LIGHT DEPARTMENT
ELECTRICAL PERMIT
N? 16049
Port Angeles. washlngton.....m.ll-=L~.mm.mmm.....mm. 19..~./
In accordance with the City Ordinance to regulate the installation. extension. or repair of elec-
trical equipment in. on. or about any building or other structure in the City of Port Angeles, per-
mission is hereby granted to dO electrical work as listed below,
'I '; ''1{, /31: {. ~ . '*
Address __.in~:m___~._____u__________m-::.mm___..~:::..!L.m_I::~-=-_m'__h Occupancy.___..~~h_~m_mn_m.______h_.._..
~::~~.:~~::~:::?~~~:~;1~2r;::~:::.h.~~:~~~;:::::::::::::...:.....~::::::::::=:::::::::::::::::::::::::::::::::::::::
IlO I:tO/~(/6
Light Outlets........._n..h.....h..:;:....._.._..... ServIce, volts ......m........._.._.................
Receptacle Outlets....;-_Y-..;?.._....._._...... No. wIres __.....3.........h.h....CL_...
. C' Y/t1,-;, (.'
Dryer, KW........__n._,._............_.......___.._ Size wlres__..._....._.._h...n_............_..
/ r;-! 'i;c;o#-
Range, KW _.._..__________._____n_____._.__n..___. Main fuse ..;.~...............---..-..........-
Water Heater: /" Enclosure ..__:~_5.....___..m..n....n.....
KW.___.nn._~...?...:......___h___.h__ Type or wiring:
Heat: Kw..__...../..!...d..I2............._...... Entrance Cable ........m.....___....
Motors: size, vQIts and phase:
/c!2.eA~
:::::;::;i:::::;;:::::::::::::.:::::::::::::::
I
Rigid ConduIt ...............................
Metallic TUbing ......__m....
Current transformers:
No. & Size............._..........._.__.
Ser. No....._......................._..._........._...
Ser. No.............._..............._...............
Type 01 Wiring:
Armored Cable .................__........._.
Non.Metalllc ..............n.................
Knob & Tube.._............................._
RIgid Conduit .....n........................
Metallic Tubing ..........._h.............
Raceway ....._........................_..._....~
Circuits, LI9ht....(.........h...h............h.
C.
Utlllty ....'h..................................n..
/tY'
::tge -~:2::::::::::::::::::::::~::::~::::::
Water Heater ..;;L.__................_._.
Motor ___........................................
Dryer_.......fff!......._..._...........................
Fllrnace .........................'_................__.
Ser. No...____....................................._. r
Total Load________m______............ Ser. NO.._.......___m_._____....._____.___........ Total .:2....__...........................
Remarks: .__.;.::::''-.Lf.n-:::_::__~':'Uh__._r:._:~~__l.:__~~_:g_(._.h_n......__.__Uh__u..__..___.u.........__...U.__n_.....uu.__........uu.___..__u
....m.............mh.m.h.................mmmm......mm........m.m......m........................m.......ym......;.m..mm.m...m.m..m
Permit ~ee Treas. Receipt l cP ~~: 'Ie. L
$:..3..flfL.................... No............................. By p...~.t.~m/E:,,:m..m0.:?m::..:::..:.':~
NOTICE--Current must not be turned on until Certificate of Inspection has been Issued. If work is to be con.
cealed due notice must be given the Inspector so that work may be inspected before concealment.
NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION
ELECTRICAL PERMIT
N?
16049
Address.__.....___...._____..........__.__...._..._.___......._....._..___.._____._._______...____.._._._.....___......__......................Date____.______.___._.._........_._......_...____.___._....
Owner ............_......................_....___..__....._......_.._..............................._.___........__.....____.... Tenant..............._.............__........_n_._..........._.._........
Wiring Contractor......__..._______.................___...__......_......._..............................__.....__._.__.___..._____.___. By .___........._...__......_.......__........_.............___..
NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work ia to be con.
.cealed due notice must be given the Inspector so that work may be inspected before concealment.'
1M Olvmcic Printers, Inc.