HomeMy WebLinkAbout824 W 10th St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . .
REQUEST
Date -.J )7- 0 S-
Time JI) ',1 5 1}1'h. Received by AI () tv~M ~
(phone-, person)
Location of Work to be inspected 13 J.. L/ W / 0 ~
Name of person requesting inspection (>>ttt~r 01(./
Address of person requesting inspection /7c.>.3 S ,') is 'S'-- Phone No t II 7 - tl { L/1
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~ ~7tfe r
INSPECTION NOTES
Inspected Date ".:)- 3- 7 - C> <)
Remarks
Time / 1< 3 0> q ~
By 7/)
.'J \ \ GI I'YltV",- /3/ e#f f
I ejJPtN<e. ~ t.A-{I1.. S.5 l~jlAI/ betl<1 J
, / '
RESTORATION REQUIRED . . YES V NO
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All ... -"""
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
D No Damage Found
D Asphalt D PCC r;l1 Other 1 O! S".., 1/
Work Order # 3> L 3 f.~ - C0S-
o COMPLETE
~ INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CIty of Port Angeles
Public Works Department
Water DIstribution Repair Report
IWork Order No
'30-3 'il - (--:J s-
,
ICrew 117J 7/6J 7/ <1
,
DATE REPORTED
3-). )- "s
CONDITION E1'v1ERGENCY ~ ROUTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 OTHER 0
D ATE OF REP AIR.
,) r ). 7- i) S TIME J 0 " :x.:J
ADDRESS ~J (/ fA/ I aT/....
frA.M. OP.M.
REP AlR LOCATION
DEPTH OF MAIN
c-x
4'
SIZE ~ \\
TYPE OF MAIN
CLOSEST VALVE DEPTH.
]\
COtvfPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK;}( SPLIT BELL 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE 0 CURB STOP 0 FITTING 0
1'v1ETER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTHER.
COIvlPONENTS OF REPAIR. CLAMPO DRESSERO OTHER 5.5 f €PC4.f,/ &tA J
,
SITE CONDITION GRA VEL 0 ASPHALT 0 SIDEWALK 0 CURB 0
TOP SOIL AREA)( SOIL TYPE
CUTS ASPHAL T CUT _FT CURB CUT _FT SIDEW ALK _FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING /l,/ A TIJBERCULATION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAlv1PLE ...JJ P P M.
WATER OFF FROM J O')v AM. TO II ')0 I} M.
r
FROM M. TO M.
APP.'\RENT CAUSE OF LEAK n I 0 fJp.L
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FEE REceIPT NUMBER
CITY OF PORT ANGELES .
DEPARTMENT OF LIGHT
APPLICATION AND ELECTRICAL PERM.IT
A
281
~
PERMIT NUMBER
.
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~; _pD, . . ,. ,. . ", '.
TOTAL FEE
., " CONT. LIe. NO. TIM~ TO COMPLETE' .NO. STORIES -LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT
8Zfci. WE$///d!J. .
.:rc:PA.RORR cr ADDRESS IS RESPONSIBILITY OF APPLICANT PERMITS WITH WRONG ADDRESSES ARE CANCELLED
Owner ~ ,<J.'€'-''( . :J)C)YLC Inst~lIation By . ,N,7(" .AnAh9/./) . 8 ,,-ccT.e,c..
Owner's Address 7!CJ, <!fAX/I;? "7' ~/J, Installers Address /326 ~ L/:Hi
DayPhone. ~S7- ~'7latp '.. . Installers Phone _ 14-7-7601-:
ApplicaHo~ is hereby made for Permit to install Electrical E.quipment as follows: A/e:- CA) /-,Ir'I'WC {,.;/,e MJcr--
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Site Address
Wiring Method
t( 1,,1 e
.,
NUMBER AMP . 120V 240V NUMBER AMP 120V 240V
USE OF CIRCUIT PEA' 100R FEE USE OF CIRCUIT PER 100R FEE
CIRCUITS CIR 10 30 CIRCUITS CIR 10 30
LIGHT SIGN
.. n 50 VOLTS ,
LIGHT OR LESS
CONVENIENCE - ,. MOTOR
CONVENIENCE .. - MOTOR . ..
APF:lLlANCE . . . . . . MOTOR. ..
DISHWASHER FI RE ALARMS
DISPOSAL BURGLAR ALARM
- .
RANGE MISC.
. . .
OVEN
WATER HEATER
LAUNDRY .. .
DRYER . . REINSTALLATION LIGHT FIXTURE #
FURNACE SUB TOTAL FEE
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC - -
- <I- :::iP" BASIC FEE
ELECTRIC HEAT -/7,] <7L TOTAL FEE "'10, C '"
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BREAKER
.. - ..
A.C. UNIT AMP PHASE
FEEDER SIZE OF SERVICE ENTRANCE CONDUCTORS
SERVICE ..... ja,> 11- ~ . --- kfoA'l .
A.W.G.
'1 SUB-TOTAL . .
SIZE OF GROUND SIZE OF ENTRANCE SWITCH
1 certify that the wo-rk to be performed under this permit will be done by the'installer and in conformance with the N.E.C, Electrical Code,
Date Application made
...4~ ,21
,1985"" By
"7n~
specifications pertaining thereto, subject to compliance with the Ordinances of
T
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/-7~ 2( /Y6';, APPRO D
Notify Department of City Light by Street Address and Permit Number when ready for inspection. Work must not
be cove.~ed or 9urrent turned on before inspection and O.K. for covering. or service has been given by Inspector in
Writing on Permit Placard, A, - Permits Phone: 457-0411 Ext. 158.
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.
Date Permit Issued
WARNING
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER _
WHITE. Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
OLYMPIC PRINTERS, INC.
r
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
f>rJ-J- f)". /ll /"J S7/tL t-U o/? j( 0(' C- o/If !louse
'1-)- 75S- 1!f'~ 570t'iPe p Py /{J,/L fl~ r;,n(flt V<J,{ e /\I
5DLiJ
S-J..~ -1fS- 4l ~~ O.K. FOR COVERING
J. 2~~ 0) /J1. '51 O.K. TO CONNECT SERVICE
'1r')- 'tS- /i1;: J FINAL O.K.
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FEE RECEIPT NUMBER
CITY OF PORT ANGELES
DEPARTMENT d'F LIGHT
APPLICATION AND ELECTRICAL PERMIT
A
/SL!
PERMIT NUMBER
.
... h .. ..
TOTAL FEE It., .. ~
00 CONT. lie. NO. TIMETQCOMPLETE NO. STORIES LEGAL OCCUPANCY
ELECTRICAL PERMIT ONLY
0< J- I I I ,.1 .. . "" (Ji n'T
Site Address C1' , L-1../.. W'-. d I~
~ _ _ CORRECT ADD~S IS RES~ONSIBIL1TY OF A PL CANT
Owner ...d..2 H "J fI1 ~ cD 0,/ l_<: Installation By
Owner's Address 110' B"..,te / -::2-,:)<I~ ;J.,4. Installers Address
Day Phone. Lf. r "7'-:'-f 9. b j, Installers Phone
Application is he~eby made for P~rmit to in.st.al! EI.ectrical Equipment as follows:
I GH1P' St5P-V ICE
,. -
oS t.V}9-,
ODRESSES ARE CANCELLED
.t.r '3' :<Ooy U
PO B ",( I AS-'I
~J."7~1I96 h
~-A
. Wiring Method
.
NUMBER AMP 12QV -- 240V NUMBER AMP 120V 24QV ..
USE OF CIRCUIT CIRCUITS PEA 10 '100A FEE USE OF CIRCUIT CIRCUITS PEA 10 100R FEE :
CIA 30 CIA 30
LIGHT SIGN
LIGHT .. 50 VOLTS
OR LESS
CONVENIENCE .. MOTOR .. .. ,.
CONVENIENCE MOTOR ~i
APPLIANCE .. MOT,?~ '\.\1 - , ..
:
DISHWASHER .. . ~-:::::::--" F.iI"E~~S \ .,
j \ ~
" ,r-\ .\Vi ,.l..X, U A~M
DISPOSAL . i:.J.'
--~ '\;... r' , ::J\\ I \l SC.
RANGE I',"~'.
..
OVEN 1;-:;;'\ ~~ \\ \\\ \ \,,;
WATER HEATER \ .\- l\! V
LAUNDRY ~ I.--
- . , \
DRYER .. REINSTALLATION LIGHT FIXTURE #
FURNACE - .. SUB TOTAL FEE ..
GAS - OIL
FURNACE ENERGY FEE
ELECTRIC ..
BASIC FEE
ELECTRIC HEAT .. .. ..
TOTAL FEE
ELECTRIC HEAT SIZE OF SERVICE SWITCH OR CIRCUIT BAEAKER
.. ..
A.C. UNIT AMP _ PHASE
FEEDER , SIZE OF SERVICE ENTRANCE CONDUCTORS
.. .. ..
SERVICE AW.G.
T SUB,TOTAL SIZE OF GROUND SIZE OF ENTRANCE SWITCH
1-- ;;L...3
,19'J"S'
rical Code.
I certify that the work to be performed under this permit will be done by the installer and in conformance
Date Application made
By
CONTRAC R OR OWNER (OR T QAllED AGENT)
Permis~ion is hereby given!o <to the al;)Qve described work, according to the conditions hereon and according t the approved.plans and
specifications pertaining thereto, subject to compliance with the Ordinances of the City of Port Angeles. /' ........ \ \
01 TO!, OF CITY LiGHT "
T
I: WARNING
i/;;3)6>i-" .
Notify Department of City light by Street Address and Permit Number when ready for inspection. Work must not
be coverec;J or current turned on before inspection and O.K. .for covering or ser.vice has been given by Inspector in
Writing on Permit Placard. A.. Permits Phone: 457-0411 Ext. 158. .
,
'\
.
Date Permit Issued
PERMIT PLACARD MUST BE KEPT POSTED ON THE WORK - SEE OVER -
WHITE - Original CANARY. Duplicate PINK. Triplicate WHITE CARD. Inspector's Report
OLYMPIC PRINTERS, INC.
REPORT OF INSPECTOR
DATE OF VISIT MADE BY REMARKS
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!-')...'?,-t[T '-.. 'O.K. FOR COVERING
/ - 7-3- '(T ~ /}J~'y O.K. TO CONNECT SERVICE
'/- 2?-~) FINAL O.K. ,
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