HomeMy WebLinkAbout4121 S C St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362 6 q - ~l3
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Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000873 Date 11/09/04
.692536
4121 S C ST
06-30-09-5-0-9080-0000-
RES MANUFACTURED HOME
Owner
Contractor
4/;\1 S 'll! 3, efr
AzmSfro TV1
RS9 RESDNTL SINGLE FAMILY
35000
1296SF MANUFACTURED HOME
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE 10.10
EXISTING LOT COVERAGE 1.00
LOT SIZE 12717.25
PROPOSED LOT COVERAGE 1296.00
TOTAL LOT COVERAGE 1296.00
N~BER OF UNITS 1.00
---1------------------------------------------------------------------------
Permit PUBLIC WORKS RES WATER SERV
Additional desc
Permit Fee
Issue Date
Expiration Date
SWEET DREAMS PROPERTIES
255566 HWY 101 EAST
PORT ANGELES
(360) 460-3765
Structure Information
Construction Type
occupancy Type
Other struct info
LLC
OWNER
WA 98362
1
640.00
11/09/04
5/09/05
Plan Check Fee
valuation
.00
35000
________=~~~___~:~;:~~~~~~_E;::__~~_~~M_'"_:~~~_:~::_~~:~~_______~~:~~
Permit RIGHT OF WAY
Additional desc
Permit Fee
Issue Date
Expiration Date
45.00
11/09/04
5/09/05
plan Check Fee
Valuation
.00
35000
Qty Unit Charge Per ~xt ns.i-en=:;-.
1.00 45.0000 ECH RIGHT OF WAY PERMIT 45.00
-----------~---------------~-------------------------------------- ------
Permit SANITARY SEWER HOOK UP
Additional desc
Permi t Fee
Issue Date
Expiration Date
95.00
11/09/04
5/09/05
plan Check Fee
Valuation
.00
35000
--------=~~~---~:~::~~~~~~-~;::__:~_:~~~~-~~~~~----------------~~;~~
Special Notes and Comments
Building address sign shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color they are mounted on. (Ord. 14.36.050-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or conslruclion aulhorized is not commenced wilhin 180 days, if construction or work is suspended or abandoned
for a period of 180 days a!terthe work as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify Ihat I have read and examined Ihis application and know the same 10 be true and correc!. All provisions of
laws and ordinances governing this Iype of work will be complied wilh whether specified herein or no!. The granling of a perrnil does nol
presume to give authorily to violate or cancellhe provisions of any stale or local law regulating construction or the performance of
construclion.
Signature of Owner (if owner is builder)
Date
Signature of Contraclor or Authorized Agent
Date
T:\PLANNING\FORMS\IIQ2.15 (l11I4/2oo3J
dI'OIlr~.
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 04-00000873
pin number . . .692536
Page 2
Date 11/09/04
Special Notes and Comments
Manufactured home must be pit set so that no more than 12"
of skirting is visable above grade.
The legal and address are incorrect. The legal is Lot 2 of
SHP 04-04 and the address is 4119 if drawing is correct.
Setbacks and lot coverage are good. No other land use issues
are noted.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public works prior to back fill of ditch.
-----~~~~~-;~~~--~-~-~-~-~-~-~-~-~--~~~;;-~~~;;~-~~~;-~~;;--~745~--
STATE SURCHARGE ~~~50
PW WATER SYSTEM USE FEE~
Fee summary Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
780.00
.00
1774.50
2554.50
780.00
.00
1774.50
2554.50
.00
.00
.00
.00
.00
.00
.00
.00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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 a!terthe 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 violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\II02.15 [11/14/2003]
, .....
. "
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date / Z. -?5 - () '-f
Time
7,.l/"",--
Received by Dr:~V\: 5 r::: .(phone. person)
r
. \,... u
Location of Work to be inspected Lf ( Z ( C. "St. c-;,e +-.
Name of person requesting inspection [) ( .... ""-; s e...
Address of person requesting inspection L-oirf -(",-,J
Type of Inspection (circle appropriate one):
Sewer 'Foundation Framing Chimney Plumbing Final
Phone No. </ {'7-'f,?NO,
Permit NO~ 73
Sewer Excav. Ot~ . . .
\
INSPECTION NOTES:
Inspected: Date 12-'''if -o<{-
Remarks: 'IKS+",,{( Z I Y-
(Jro;oe-r+y.
, f
Time I 1'/tA.. By iJe.i4.vt.,'<) E.
5%1' ~""V('c..e.s C;:cvo<;", C S+- c'-I.r 7-0
c..702?
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I 7
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RESTORATION REQUiRED...... YES X' NO
SURFACE RESTORATION: 2 t >< 'lo'
SURFACE TYPE: 0 Unimproved DGravel liQ,Asphalt 0 PCC 0 Other
o Repaired by City Work Order # N K 5 - 3 7 ()
o Repaired by Permittee Bf COMPLETE ~ ~"'-'f:a(H"<SJ~
o No Damage Found 0 INCOMPLETE W\t\A ~~ ~ V
. I
ff) S+rE'.6DX: (uler 11)1'
G~ \l-()~\
' '~
''''--''-'--
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . .
REQUEST: J
Date 1/ (fJ,hf. Time
Received by
..(phone, person) _
//
Location of Work to be inspected -f./ t2/ 5 C # c5T e 4T
Name of person requesting inspection "'""../~)5'd ~ffi-'c///i (J'19S~-"7~)
Address of person requesting inspection Phone No. ..cj'??-//"7/
Type of Inspection (circle appropriate one): Permit No. ZJ4 -57-3'
~oundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
By
RESTORATION REQUiRED...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
.
.,;('
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date I Z -C; -6'-/ Time 7 A (,<." Received by De",~ I '<, ~ - (phone, personl
,
Location of Work to be inspected <{ (17 C ,5T: Ei<'r-.
Name of person requesting inspection DeiAV{, 5 F.
Address of person requesting inspection 0, ,- f y",Id.
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final
Phone No. '{11 - <./ fN"I
Permit No.
Sewer Excav. Oth~""+0
INSPECTION NOTES:
Inspected: Date /2 -'7 ~o<-( Time
Remarks:~,o 8" A. C-. c:i.:t- <( i 'f/eel'
C 5 i- e tc+ '2" (Ju iJ -f-,!) I1A..e 1- e :-
,
(: 50 PM. By j)e",.~ : s E-.
(")<:'f-eV\d (I< f-F +vbi"-j t.<:cross
ho/<. $e.+ e:<-+ ProOert-"
I I t
'1.
RESTORA TION REQ~RED . . . . " YES NO
3'7' .. W"E"S~"'TJ
~ ~
po 1'1'...z '/Jeer t<-
v 1./111
,
( '=-ofrJr..)
'II 1'1
"
~g ~
~ x
tu
~ Lf ( 7..-1
\J
j/1/tAd r c> _'1.""- ~
10
2 ',><:z.o '
J&J' Asphalt 0 PCC 0 Other
Work Order # N1~"-08~ ?C\lL.\7--t\-l
~ COMPLETE I ~'Cs2>.. ~I{A, ~
o INCOMPLETE w\ '\'~~ C)1' \ ':I
\ 0
" lC
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
,,..__...:_.._ __ __..____ _,....._:.0: __ _________.
~ Trenia~ Funston ~ Re: Pro~!!y on "E S\r<;~LExtensi2'l O:,vned b{Josh ~Arm~tr2'lg__~
~
Page 111
,
..
From:
To:
Date:
Subject:
Gary Kenworthy
Gudgel, Tracy
11/16/044:17PM
Re: Property on "C" Street Extension owned by Josh Armstrong
Tracy
Gary
Gary W. Kenworthy, PE
Deputy Director of Engineering Services/City Engineer
City of Port Angeles
321 East Fifth Street
P.O. Box 1150
Port Angeles, WA 98362~0217
Voice: 360-417-4803
FAX: 360-417-4709
E-mail: gkenwort@cityofpa.us
q
JellS)
I {} let-i
D4/fB
Per our phone call, responses included in bold below.
>>> "Tracy Gudgel" <tracy@zenovic.net> 11/15/04 02:38PM >>>
Gary,
I talked with Trenia about some issues on property owned by Josh Armstrong
on "C" Street Extension. Here are the issues that I need to discuss with
you:
1. There is fill on the site and Trenia told Josh Armstrong that he
would need an engineered drainage plan forthe first lot that they have a
permit on. Would it be acceptable to use standard drywells on the one lot
that they have a permit for provided the drywells where placed into the
native soil below the fill?
Drywells ok if in native soils. Provide for drywell overflows to detention system to be covered in
drainage plan.
The other two lots must have an engineered drainage plan for the subdivision
that he ;s in the process of doing.
2. I need to discuss the drainage design for the two lots due to
possible downstream issues to the east.
Ditches along C St ex!. are overloaded with resultant problems downstream of the site. Need to
provide detention and release to the east to avoid adding to the problems.
3. Does the City of a standard trench detail for putting water service,
ITrenia Funsto~ - Re: Prop..~y~6:"c" Street Extension owned~by Josh Armstr2!2g
,--~,
Page 21
,
,
,~
~
secondary power, and! or sewer service in the same trench for a single
family residence, On the subject property above we are looking at running a
single pressurized sewer service line and at least secondary power in one
trench, if possible, since the power pole and sewer manhole are in the same
general area,
Sewer and power or power and water could use same trench. Discuss with Gail per our
conversation. Do not want sewer and water in same trench.
Please give me a call when you get a chance. 417-0501
Thanks,
Tracy Gudgel
cc:
Funston, Trenia
nEe 1 3 2004
FAX TRANSMITTAL
CITY OF PORT ANGELES
ENGINEERING DIVISION
321 E 5th St
PORT ANGELES, W A 98362
(360) 457-0411
~)Jpf j)12.LA~ ./
(J/Pi /~<-- -
45/- ,-'57-:=55
COMPANY NAME:
CONTACT NAME:
FAX:
CITY /STATE:
SENT BY:
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DESCRIPTION:
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~
NUMBER OF PAGES (INCLUDING COVER SHEET):
RETURN FAX NO,: (360) 417-4709
IF THERE ARE ANY PROBLEMS WITH TRANSMISSION
CALL: (360) 417-4807
.~
1
TRANSMITT AL
CITY OF PORT ANGELES
ENGINEERING DIVISION
321 E 5th St 1 A
PORT ANGELES, W A 98362 \) (J /
(360) 457-0411 \ I ~ '0
~eJSU0 Qv\"
~~o?)eV
7-072-4
COMPANY NAME:
CONTACT NAME:
FAX:
CITY / STATE:
SENT BY:
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DESCRIPTION:
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IF THERE ARE ANY PROBLEMS WITH TRANSMISSION
, , CALL: (360) 417-4807 ,-,/J A , 'ylj;[l/a/7?J j)
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I Trenia Funston - Re: Pro~rty on "C" Street Extension owned by Josh Armstrong
Page 11
From:
To:
Date:
Subject:
Gary Kenworthy
Gudgel, Tracy
11/16/044:17PM
Re: Property on "C" Street Extension owned by Josh Armstrong
Tracy
Per our phone call, responses included in bold below.
Gary
Gary W. Kenworthy, P.E.
Deputy Director of Engineering Services/City Engineer
City of Port Angeles
321 East Fifth Street
P.O. Box 1150
Port Angeles, WA 98362-0217
Voice: 360-417-4803
FAX: 360-417-4709
E-mail: gkenwort@cityofpa.us
>>> "Tracy Gudgel" <tracy@zenovic.net> 11/15/04 02:38PM >>>
Gary,
I talked with Trenia about some issues on property owned by Josh Armstrong
on "C" Street Extension. Here are the issues that I need to discuss with
you:
1. There is fill on the site and Trenia told Josh Armstrong that he
would need an engineered drainage plan for the first lot that they have a
permit on. Would it be acceptable to use standard drywells on the one lot
that they have a permit for provided the drywells where placed into the
native soil below the fill?
Drywells ok if in native soils. Provide for drywell overflows to detention system to be covered in
drainage plan.
The other two lots must have an engineered drainage plan for the subdivision
that he is in the process of doing.
2. I need to discuss the drainage design for the two lots due to
possible downstream issues to the east.
Ditches along C St ex!.. are overloaded with resultant problems downstream of the site. Need to
provide detention and release to the east to avoid adding to the problems.
3. Does the City of a standard trench detail for putting water service,
I Trenia Funston - Re: Pro~erty on "C" Street Extension owned by Josh Armstrong
Page 21
secondary power, and! or sewer service in the same trench for a single
family residence. On the subject property above we are looking at running a
single pressurized sewer service line and at least secondary power in one
trench, if possible, since the power pole and sewer manhole are in the same
general area.
Sewer and power or power and water could use same trench. Discuss with Gail per our
conversation. Do not want sewer and water in same trench.
Please give me a call when you get a chance. 417-0501
Thanks,
Tracy Gudgel
cc:
Funston, Trenia
.
~~
\':1>
CITY OF PORT ANGELES
DEPARTMENTOFCOMMUNlTY DEVELOPMENT - BUILDING DMSION
321 EAST 5TH S1REET, PORT ANGELES, WA 98362
Applica~ion ~umoer
Pin, number .. . .
Property Address
ASSBSSORPARCEL NUMBBR: .
Application description,
Subdivision Name" .
Property Use ,," "
property ZOning ; . .' . ..,', .
Application valuation,
04-00000873
.692536
4121 S C ST
06~30~09-5-0-9080-0000-
RES MANUFACTURED HOME
Owner
-.-------------------~~~.
SWEET DREAMS I?ROPERTIESLLd
255566 HWY 101 BAST
PORT ANGELES
(360) '460-3765
Structure Information
'",;.i;/' Construction Type . .~
,'; )"', Occupancy Type . ..
. ", ,;';"Other structinfo . '"
'-,,:<""-;"-
_"j r ,,;'
,,-;:>:.,....
-;-,-
,.:';..;
PUBLIC WORKS RES WATER SBRV
';'-::'-',,;1(-
Permit . , . .
Additional desc
Permit Fee
,Issue Date '
,Expiration Date
. ~o. 00
, .11/09/04
5/09105
';.;t;-,,\~f"
,;~;:
',;;:.":';':r;J;~i.[~;j~):~;;-
c,::r-.;:,< .:~'
., -:~~~::..;-:2:~\:':'" .' '
';';~1.~/_
'.~.....: -""':~~
-.,.11
";,"/,,.;
,;::})~'~-:tt~~!,;~!/:,!,:
; ,~,__r__>:?'-?:Z;f:->
RS9 RBSDNTL SINGLE FAMILY
35000
Contractor
OWNER
Date
11/09T~C
1296SF MANUFACTURED HOME
TYPE V NON-RATED
SINGLE FAM & CONGREGATBS
TOTA!, t LOT COVERAGB 10.
EXISTING LOT COVERAGB 1,00,
LOT SIZB 12717.25
PROPOSED LOT COVERAGB 1296.00
TOTAL LOT COVERAGB 1296.00
NUMBER OF UNITS 1.00
. 'l,'":!:'~/- "':'-"':.~ - - - ---- - - - - - - ---- - - -- - --;;;;;.-~~:_-~ -... - ----- - - -'.- - - --- -- - -- - - - - - - - - _._._._.-.-....~-- - ..-- ~
;:'~::,:.;,.;,,(':,-~.-:::~,
~~*:'> . Qty Unit Charge::p.;lt " Ext~~s.ion ", '
;~~~G_~_::~~_.. ____~~~:~~~~..~~~_..~_~~~_=:_~~~~_=~~:_~~~___'___C. I> o. O~
'r.-. ~~ .:, '1
Permit RIGHT OF WAy,
Additional desc .
Permit Fee 45.00
Issue Date 11./09/04
Expiration Date.SIQ~/05
'..'.j-.
-..-..-....,1
>'~:\N~
-:_-i:;~~/1~~;-i.~\~ .'. i'.
.-if;"-'''';
Plan Check Fee
Valuation
Plan Check
valuation
.00
.aSOOO
---- '
/
/~{}
~1'#O~rI
.' 17~'bI:J"
UOt- ,,"
r
,:~'-::-;-L,
SANITAR~ SEWER HOOK UP
Permit . . . .
Additional desc
permit Fee
Issue Date
Expiration Date
9~.M".
U!09/04
5/09/0$
Plan Check Fe'a..
Valuation
...2:.
'-
,~
..........
.00
35000
(0
Qty unit Charge Per
1.00. 95.0000 EA SAN SEWER HOOKUP
T:\P
RMS\1102.IS [111141.2003]
________=~~~___~:~:~~~~_~~:__~~~~~~~_~:_:~::______~~~~___~e::~~
Special Notes and Comments
Building address sign shall not be less than 6" & not more
than 12" in height. NWIlbers colors must contrast with wall
color they are mounted on. (Ord. 14.36.050-B)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
O?
~
Separate Permlts,are required for electrical work, SEPA, Shorelihe, ESA, utilities, private and public improvements. This pe~mlt becomes
null and void If work or construction authorized Is not commenced within 180 days, If construction or work Is suspended ()!" Cibandoned
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 ordinanc governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume 'to giv. a ri vlolat cancel the provisions of any'state or local law regulating construction or the performance of
constructio
(
Signature of Owner (/fowner Is builder)
Date
BUILDING PERMIT INSPECTION RECORD
't ~.
, ' ,
. ' . . .
CALL 417-4815 FO~'BUlLDING INSPECTIONS. CALL 417-4735 FOR ELECfRlCAL INSPECTIONS:
PLEASE PROVIDE A MOOMUM i,rHOuRNOtICE. ITlS UNf.A,W,FUL ,TOCOVER,INSllLATE.qRpONCEALANY WORKBEFORE
lNSPECTEDAND ACCEP.TED. ,POST PERMIT IN A CONSPIQ10USLOcATION. . '
KEEP PERMIT CARD AND APPROVED PLANS ATJOB SITE.
.
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO " , ,
FOUNDATION:
FOOTINGS
WALLS "
FOUNDATION DRAINAGElDOWN SPOUTS
ELECTRICAL (UGlIT DEPT) SEPARATE PERMIT: 1#
ROUGH.IN I
.
PLUMBING
UNDER FLOOR 1 SLAB "
ROUGH-IN
Vo(A TER LINE (METER TO BLOG)
dAs LJNE
BACK FLOW 1 WATER
AIi!sEAi. ,
"
W Al.LS I
CEILING I I
FRAMING ,
JOISTS 1 GIRDERS
SHEAR WAiLmOLD DOWNS
WALLS 1 ROOF 1 CEILING .
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION "
SLAB I '"
WALL 1 FLOOR 1 CEILING , I I
MECHANICAL ,
HEAT PUMP )
GAS LINE
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCtS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT "'a:
WATERLINE I METER
SEWER CONNECTION ,,' .
SANITARY
STORM
PLANNING D,EPT. SEPARATEPERMIT"'s SErA:
PARKINGlLIGHTlNG ESA:
LANDSCAPING SHORELINE: ' "
FINAL ~Sp'E<;TIQ~S REQUIRED PRIOR TO OCCUPANCYIVSI: c-:c= '..
" ' '
RESIDENTIAL pATE YES NO COMME~CIAL DA* " ACCEPTED
YES NO
"
ELECTRICAL -UGlIT DEPT. 417-4735 ELECTRICAL
UGlIT DEPT, . " '
CONSTRUCTION RoW. 1 PWI CONSTRUCTION. RoW.
ENGINEERING 417-4807 " PW 1 ENGINEERING
FIRE 417-4653 , - FIRE DEPT. " "
PLANNING DEPT. 417-4750 PLANNING DEPr.' ,
BUILDING 417-4815 BUILDING ' ,
T:\PLANNING\FORMS\II02.15 (11/1412003)
f-
~FJI., ,~.:~~
.;
o?,::/-':,~",/'O"',';:,.:::,_' '
'<!l
" , ."CITY OF PORT/ANGELES
DEPARTMENT OF C()MMUNITY DEvpLOPMENT - BUll.DING DlVISION
321 EAst 5TH STREET,PORTANGELES, W A 98362
~)<:/ -'
- -. -_._-~--,'- -.------_.--- -~._.._-~---~ -~....._---'.._.-.:._~.~-
ApplicationNumber . 04-00000873
piD: :number". . . . . . . 692536
Page 2
Date .n/09'/04
sp~cialNCltecsandCollUllents
Manufactured home must be pit set' so that no more thari 12"
of skirtillgis visable above grade.
The,legal and.address are incorrect. The legal is Lot 2 of
S~'04-~4 and. the address is 4119 ifdr~wingiscorrect.;
s'E!t~acksand lot coverage are good. No 'other land use issues
arc:! no,ted ~ :,. " '. ' " '
Electrical load calculations and.elctrical permits are
reqUired. '
San~tary'" sewer connection inspection is ,required by
PublicWClrksprior'to back fill of ditch.
-----~~~;~-;;;~--~-~-~-~-~-~-~-~-~--;~~-;~~~-~;~~-~~;---8~~:6D--
::A:T~~~ USE FEE 002:~
Fee summary Charged Paid Credited Due
~: ~------~--------- ---------- /
---------- ---------- ----------
: ~ermi t Fee Total 780.00 780.00 .00 .00
Plan Check 'Total .00 ;00 .00 .00
:~I . Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 2554.50 2554.50, .00 .00
Separate Permits are required for electrical wofk,SEB~,~horellne, E~%!-Jtillti~s,private and public improvements. Thl~g~rmj!~~!?lFes
null andV91dlfwork or construction authorlz~~isinotoomm~l'!(:e~VJIt!}:j~:.1~9\~~ys;i.feon.structiQI1 or worklssuspen~~~;.9f~~~~dC:)ned
for a perio,tl of 180 days after the work as commence~lorifreql.llredlri~pe.ctlons have not been requested within180~a~trom the last
Inspecti!?...,II1~reby Certify that I have read and eXl;irninec;ttl1ls l:Ippli~tion~nd know thesamEl to be true and ~rrect.",IP'P."isiollsof
raws and ordinances governing this type of work wnl~C()mplied with.whl:l~erspecjfje~ herein ornol ' The grantingofapernl1tdo~ not
presume to give authority to violate or' cancel the provisions of any'stateor local law regulating construction or the performance of
construction. ' ' ' .
Signature of ContractOr or Authorized Agent
Date
Signature of Owner (if owner Is builder)
Date
T:\PLANNlNG\FORMS\1102,15 [11/1412003)
I
I
I
; ;L
\;.Yh'-:>:'~" r"~",''t~ l"i,f:;l!,' ,r:'\,!i\"_~l'.;"':'::"-"'.J
BUILDING PERMIT INSPECTION RECORD
~,,' \,
~. ~
; "
CALL 417-4815 FOR BUILDING INSPECflONS. CALL 417-4735 FOR ELECfRlCALINSPECflONS.
- ---_._--~- ,--
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER,INSULA.'FE ORCOltiCEALANY WORK BEFORE
INSPECTED AND ACCEPTED~ POST PERMIT IN A CONSPIc.u()U~ LOCATION. '
KEEP PERMIT CARD AND APPROVED PLANS AT iOBSITE.
INSPECTION TYPE DATE ACCEPTED .. COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAlNAGEIOOWN SPOUI'S
ELECTRICAL . (LIGHT DEPT) SEPARATE. PERMIT: #I
ROUGH-IN I I '.
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE (METER TO BLOG)
GAS LINE
BACK FLOW I WATER
AIR SEAL
WALLS J
CEll.ING I
FRAMING
JOISTS I GIRDERS
SHEAR W ALUHOLD DOWNS
WALLS I ROOF I CEILING
DRYWALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB . I
WALL I FLOOR I CEll.ING T I I
MECHANICAL
HEAT PUMP
GAS LINE
WOOD STOVE I PELLET I ClDMNEY
HOOD I DUCTS
PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT #I'a:
WATERLINE I METER
,.
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT. SEPARATE PERMIT #I', SEPA:
PARKlNGlLIGHTlNG ESA:
LANDSCAPING .
. , SHORELINE:
FlNJ\L INSPECTIONS REQUIREDJ'RlOR TO OCCUPAlIfQ;lpSE .
.'
RESIDENTIAL . " DATE VIS NO COMMERCIAL DATE ACCEPTED
..... YES NO
ELECTRICAL - LIGHT DEPT. 417-473S. ELECTRICAL
.UGHTDEPI'
CONSTRUCTIONR. W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE ..... 417-4653 FlREDEPT."
PLANNING DEPT. 417-4150 PLANNING DEPT.
BUILDING 1 417-4&IS BUILDING .
T:\PLANNING\FORMS\1102.IS {1111412003]