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Home My WebLink About1322 W 15th St - Engineering ,~ ~ ; ~~ CITY OF PORTANGELES ... DEPARTMENT OF COMMUNITY DEVEU)pMENT -BUlLDlNG DIVISION 321. EAST 5TH STREET/ PORT ANGELES, WA 98362 WILSON, DONALD 1631~ST5TH ST PORT ANGELES (360.) .417-1195 ----:..:- Structure Inforlllation Construction Type . Occupancy Type Other. struct info. . . . Application Number . . J;>in number .. . . property Address ASSESSOR PARCEL NUMBER: Application description , SUbdivision Name property Use Prop~rt:Y Zoning. , . Application valuation Owner 0.4:'0.0.0.0.1071 .190.665 1322 W 15TH ST D6-3o.-aa-a-4~3326-ao.o.a- RES MANUFACTURED..' HOME, \ Date 11/24/0.4 RS7 RESDNTL SINGLE FAMILY 70.0.0.0 Contractor -----------'-------~---~- OWNER 'WA9S363 1320. SF MANUFACTURED HOME TYPE V NON:":RATED , SINGLE FAM.& CONGREGATES TOTAL'%. LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE. NUMBER OF UNITS lS.sa 1.0.0. 70.0.0.0..0.0. '1320..0.0. 1320..0.0. 1.0.0. -------------~----~-~-----~~-----~--~~~----~---------~--~~-----------'-------- Permit . . . . Additional desc Permit Fee Issue Date Expiration Date PUBLIC' WORKS RES WATER I:l:ERV 640..0.0. 11/24/0.4 5/24/0.5 Plan Check. Fee . valuation - .0.0 7000.0. ul ~. !,~ ~ t ~ Extension ,640..00 Qty. Unit Charge Per 1.00. 640..0.0.0.0. EA PW WiMP SERV5/SftMETER - - ~ - ~ -- -, - - ~.... - - - -~- - - - - .--: .-.. - - .--------.- -- ------ - ."- ._~- -. - - - .,- - - - - ~ - - -,- - - - - - -- . Permit .. . . . Additional desc Permit, Fee Issue.Date Expiration Date Qty 1.0.0 RIGHT OF WAY 45.0.0. 11/24/0.4 5/24/0.5 Plan Check Fee Valuation .. .0.0. 70.000 Unit Charge Per 45.0000. ECH , ' RIGHT OF WAY PERMIT Extension 45.0.0. , -', - ,,' ~ -----,-------~-------~--------------------------~---------'---------~---------- Permit Additional desc Permit.Fee . Issue Date , Expira.tion Date SANITARY SEWER HOOK. .UP 95.0.0. 11/24/04 5/24/0.5 Plan Check Fee Valuation .00 70.0.0.0, Qty Unit Charge Per 1. 0.0. 95.0.0.0.0 EA SAN SEWER HOOKUP Ext:ension 95.0.0. . -" . , ,-,~ , . -------------~-~---------------~------,---------~--.---------~-----~-~-------- . -' . Permit .'. .. Additional desc PerinitFee . . Issue Date Expiration Dat.e BL MANUFACTURED HOME I I I 230..0.0. 11/24/0.4 S/24/D5~ plan Check Fee. Valuation. . . .0.0. 70.0.0.0. Unit .Charge Per Extension S8parat~Pe"!'its;are requiredf()r~I~C#icalwork.~EPJ\,.Sh()tEllir1e.ESA, utiliti~..priV~:and P\JbUCirnPI;qV~rp~Q~~~:m~.;.. .J~~om~ null and void if work or construction auth~~edl~t:\otcom"'el1~tf w!thln180da~~IfCOhstrlJctlonorYlp~f.,.us~n~~" ,1ql':'21'!)8rld~ned for a periqdbf180 days after the workes commenCedlorjf'requlr~hlspectionshflve not been request8d\Yiftiin ,~~(Hl4Y~Jroril.the last Inspectlcin.lhereby CElrtify that I have read and e~minedthlsiappncatlon andknClw the $ameto be true.alidcol'rec.t::~~n.pfC)vislonsof laws and ordinances govemlngtf1is.tYpeof wo~lJVillbt:) complied wittrwhether s~cifie(fhereinornotlllegranting:~ra'p~rm.ltdO~ not presume to . give authorltyto violate. orcan~ltheprOvlsions of any .state.or local law. regulating' cOnstruction'.btlheperformanceof construction. .' . ' ~O~uJ~' Signature of Contractor or AuthorizeCIAgent Signature of Owner (if owner is builder) ( ,~ -----.--- BUH..DING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDINOINSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASEPROVIDEA.MI1'lIMUM 24HOURNonCE./TISUNLAWFUL TOCOYER,llVSULATEOR CONC/JALAlY'yWORx1JJjEORE . lNSPECTEDAND4CCEPT-QI). .,qsTPERMITINA.C()~~PIc;tlOUSLOCATION. . KEEP PERMIi'CARD AND ApPROVED PLANS AT JOB SITE .. '. .. '. .. ..'..... .............'. ,. '. '.' .' . INSPECI'IO~ TYPE DATE ACCEPTED . .... COMMENTs .. . . .., .. " """ YES NO I' . ." . . ... ...... '" .... .' .. C'. , .' .... .' .' roUNDATION:. . .. ...... FO()TlNGS ":;: '. .' '. WAL~. / ..... . FouNDATION.' . DlwNAQEIDOWN SPOl)tS ... .'" '. . ." ELEC'J'RI<:AC {(LiGHTDEl'T) SEPARATE PERMlT: # '. ...... ../.. .' ,. .. ROUGH-IN . ,. . . I ", I . I ..... . . .. '. '. . .... PLUMBING .' I UNDERij:oQRI SI.AB .. , ". '. .... ROtJGH~IN,,'.:r,. ,. ,........ .. .... ..... '. .... I WATERtJNg~TO BLOG) . '. GAS LINE ;0;'.!,. .'. , '. ..' . BACKfOO\\'lwATER . .. . . ,. . '. , AIR SEAL .' ...... ...... ..... . '. .. WALLS . '. '. CF.1l.I:NG . . FRAl\UNG. . ., '.' . . . JOISTSI GIRJ)ERS ". .'. .. '. SlIEARWAl.UHOLD DOWNS ....... : .' .'. . . WALLS/RQOF'iCElLlNG ..... , . ... '. , - - - - - - . ..... DRyWALL(INTERlO~BRACED PANEL ONLY) . T,BAR '."" . . .' .. ............., ...... ',. . ..... . . ... INSULATI()N..... . ..' .. '. . SLAB , ..... '. WALLlnPOR!.CElLING ..... . .... .' .. . MECIf.N\fI~ ..... /.. . '. . ....... HEAT PUMP . ." '. .. .' GASLlNE ..' . .... . ". WOOD~TQVE! PELLET! CHlM!'EY .' . ,....... . '. ." HOOD/DUCTS' .' ,."....... '.. . . .. ,.' " '. ..'> SITE woRK' . ."" ..... "'. '.. ., .' .... '. , PW UTILI'1'IESJ (EIlsiaecqllS,~Yi.sioitl.. ~~~-ryP~II's: W ATERuNE/MBTE~ . .... .' .... '. .' " SEWER CONNECTION . '... .. " .. ... , ..... '.' .' . .. SANItARY . . . .'. ..... . .. STOR1l!f '., ...,>........, ..." '.' . .,.'., -.... '. .... PLANNING DEPT. . SEPARATE PERMIT#'s ','. .... '" SEPA: , PARKINGlLlGHTING '. . , ..... ...... I ESA: . ". . . .................... .......... .,...., .... " -:;-,', .~~.: ..........'. ~IN~'.. , . . .... ..........,..; ,.............". ~.-. " -"~i-~ ," ,.-.' '.- .C.,: '. ..' ", ~-~. .' ',,;;C' ;.. ".' .. 'FpiNJm~I,'~Q~ImVJRItDPJq()RTpOC~~~!R~.;\:!! .,. .... ....,.;......, i.....;-... '. .. ',' RESIDENTIAL ". , -,.; .'. DATE::,;':' t>'YES ,. NO. ... CO~: 'j~.~...... i... ''c /i ii, .... . .. '. '. ..c,' .'.' .. ~ )'<YE~L<, c:';;NO ". .... '. ," '. ." EI.EcTIuCAL ......... 'f.', ;'L.'/' ELECTRICAL- LIGHT DEPT. 417-4735 ".. Z ,;': ., LlGI!f DBPT " .,; .'..... ;sf . . . . . . .,. CONSTRUCI'lON R;W./ PW! . CONsnWcriON.- R;W'.>:' ....,. ..;'; ....,\/..'. '.~, . ....... ENGINEERING 417-4807 .' PW/ml~' i{.,'" '. , FIRE ........ 4174653 > ...... .....,...;. 'c . FlREI?~.''''''::';~i'''4 .....i'} fl:t;"..... ~.., . ". .' - . .' '. I'. .i' .. ";.>:.' PLANNING DEPT. . . .. PLANNING DEPT. . .... ./,' ',/";",, i,;'" 417-4750 . . .... .}//..... . .c' .....,. --.< . . ..... " Inin.DINo' . ..""77:.'" .'r; ". :.,"'; :......". BUILDING 417-4815 . ';' : ORMS\U02.15 1 4J2003 ...... ". . '. .. , [ 1/1 ~':: . €I......~. ".....~..... ..~........'................... .. ........ :~~:t;;.:. . ,'. . .... .. '. ci'J:'y' OFl?,ORTANGELES DEPARTMENT9:FCO~'DEYW-OPMENT - BUIlDING DMSION 321BASTSnlS'IREEt, PORT ANGELES, WA 98362 <',:, . Page 2 Date 11/24/04 h,...., ,. Appl ica}: ion Number Pinntmiber . . . . . . 04-00001071 .190665 Qty Unit Charge Per Extension 230.00 BASE FEE -. " -. ." - - - - - - - - --:_-~, ~ -;-,:-::-::.-;'-,-- ~,~. -,- - -- -,:'- - - - - -...; - - - - - -..;, - - - - - -..;, - - -.. - - - - - - -..;. -- - - - - - - - - - - - -- speci.-al\N()I::~l:}aDd.comments Buildingadcfress sign sball not be less .thlm 6ft & not more tha:rii2~ in height... Numbers ..colors DII.lst contrast with wall co!.()?; they ar~ lIIOu,nted OIi~. (Ord.14 .36. 050-E) . '.' .' ...... Whenroof.guttersare installed,.cfrainswilllocatea'in dry wells or.piped,toapproV'edstormdrainlocat.{on~. .Ml!A\1~aci~i1:r~dhomell\Ust b~pit!let S9 that no m()re than 12" 'o.f' skirting. is visable . above . grade. . The.Fire Depa:r;pnent hasreviewedtne project application and has no eOllUllents The proposal wiU result in the placenteotof a manufactured home in the RS-7 zone fora total lot coverage of. 19%. Se,tbacks are good. No land use issues are noted. Any modifications to theCity'selectricalfaciHties will be at the customer's expense. ,EIE!ct:r;ic;:<1-1 loadcalculations.and elctrical permits are required. Sanita:rysewer connection inspection is required by Public Works prior to back fill of ditch. - - - - - - --- - - - - - - - - - - - - - - - - - - -- - -',- - - - - - - - - - -;... -- - - ';"-";'.- -- - -: - - - - - - - -,- - - - - - - - -.. - -..- Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE.FEE 745.00 4.50 1025.00 .. . . . . -. '.. . . Fee. swmna:ry Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit .Fee Total 1010.00 1010.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 2784.50 2784.50 .00 .00 SeparatePermltS are requiredforelecbicalW9rk,~E:P""iShoreline,~SA, utilities, private and publlcimproveme~ts.Thispermltbe.comes null.an.~ vol~ If Yi9rk. or construction a~rtzedis'lOt commenced within 180 days, If constr1Jction or work Is SU$p'l\~ed Qr Ilbandoned fora. periQdof180 days after the work as commenced; or If requlredlrispections have not been requested within 180 'cIaysfrQmthe last hispectlQn. 'I"~~reby cel1ifythat I haye reaci.anfl eXam1nec:i this alJpli~13tion and know the same to be true and correct. AU provisions of la.wsandordinances governing this type of WOrk will be compiled withWllether specified herein or not The granting ofapennit does not presume to give authority to violate or cancel theprovisions.ofany'state oriocallaw regulating construction or the per.forn'1ance of cOnstruction. - . SigriatIJre(ofConlractOr orAuthorized Agent Signature of Owner(1f owner Is builder) Date Date T:\PLANNING\FORMS\1102,1S[11I14I2OO3] "'" BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS.' CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNI4WFfIL TO COVER, INSULATEOR,c.Oftigpa ANyJfORJ( BEFORE INSPECl'ED AND ACCEPTED. POST PERl\fiT ~A;.CONSPICUOUS LOCATIol't . . KEEP PERMIT CARD AND APPROVED PlJANS AT JOB SITE '. INSPECTION TYPE DATE I ACCEPTED COMMENTS . ,\ .YES . 1 NO .. '. .' Blbc,k.4-7i- rJ....-.3 '-7-Do ~ FOUNDATION: .,).L.I- FOOTINGS WALLS FOUNDATION DRAlNAGEIOOWN SPOUTS a..-,7-o .~ J~ EU:C-riUCAL .....' (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I \ I , PLUMBING ; . IVl'rH , ''J- -17 -OS-' JJ.t- M UNDER FLOOR 1 SLAB ROUGH-IN' . WATER LINE (METER TO BLOG) Z. -/7-nr- J I.. GAS LINE BACK FLOW 1 WATER AIR SEAL .' . W Al.LS CEILING . I \ I FRAMING ... '.. '. JOISTS I. GIRDERS .. SHEAR WMUHOLD DOWNS . WALLS 1 ROOF 1 CEn.ING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR '. , INSULATION . SLAB ..' , I WALL 1 FLOORI CEn.lNG \ I MECHANICAL . HEAT PUMP , GAS LINE WOOD STOVE 1 PELLET 1 CHJM1'lEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Divillion) SEPARATE PERMIT I/'s: WATERLINE 1 ME1'ER SEWER CONNECTION SANITARY STORM " PLANNING DE.,-. . SEPARATE PERMIT #'s SEPA: PARKINGlLIGHTlNG , ESA: LANDSCAPING SHORELINE: , , FINAL.INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE' " , , RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED " '. YES NO ELECTRICAL - UGHT DEPT. 417-4735 ELECTRICAL I UGHT DEPT" CONSTRUCTION R. W.I PW/. , CONSTRUCTION - RoW. ENGINEER.lNG 417-4807 PW 1 ENGlNEERING , FIRE 417-4653 . FIRE DEPT. , PLANNING DEPT. 417-4750 . PLANNING DEPT. . . Bun.DlNG 417-4815 ~ -Q -IJ ,I:;" lu Bun.DlNG T:\PLANN1NG\FORMS\1102.15 (1111412003) PREPARED 3/09/05, 12:38:33 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 2 3/09/05 ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 1322 W 15TH ST SUBDIV: PHONE PHONE : (360) 417-1195 WILSON, DONALD 06-30-00-0-4-3326-0000- 04-00001071 RES MANUFACTURED HOME PERMIT: BLM 00 BL MANUFACTURED HOME REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BLBT 01 2/07/05 JLL 2/07/05 AP DRW 01 2/17/05 JLL 2/17/05 AP DSD 01 2/17/05 JLL 2/17/05 AP PL6 01 BUILDING BLOCK AND TIEDOWNS DON417-1195 BUILDING DRYWELL Don 417-1195 BUILDING DOWN SPOUT DRAINS Don 417-1195 Jim do this one 1st on list, back hoe ready to cover PLUMBING WATER SUPPLY 2/17/05 JLL 2/17/05 AP :~::_::__~~~~_____~:~~~:N::::~:::5AND NOTES -------------------------------------- PREPARED 2/07/05, 12:44:03 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 6 2/07/05 ------------------------------------------------------------------------------------------------ ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 1322 W 15TH ST SUBDIV: PHONE PHONE : (360) 417-1195 WILSON, DONALD 06-30-00-0-4-3326-0000- 04-00001071 RES MANUFACTURED HOME ------------------------------------------------------------------------------------------------ PERMIT: BLM 00 BL MANUFACTURED HOME REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ------------------------------------------------------------------------------------------------ BLBT 01 ~ ..tp.-- -------------------------------------- COMMENTS BUILDING BLOCK AND TIEDOWNS DON417-1195 AND NOTES ------------------------------------__ PREPARED 2/17/05, 13:22:32 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 3 2/17/05 ------------------------------------------------------------------------------------------------ ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER: 1322 W 15TH ST SUBDIV: PHONE PHONE : (360) 417-1195 WILSON, DONALD 06-30-00-0-4-3326-0000- 04-00001071 RES MANUFACTURED HOME ------------------------------------------------------------------------------------------------ PERMIT: BLM 00 BL MANUFACTURJID HOME REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BLBT 01 ------------------------------------------------------------------------------------------------ DRW 01 DSD 01 2/07/05 JLL 2/07/05 AP h\\~r ~L 2/C/05 JLLf' ?- -l1l<e s--: J4. f BUILDING BLOCK AND TIEDOWNS DON417-1195 BUILDING DRYWELL Don 417-1195 BUILDING DOWN SPOUT DRAINS Don 417-1195 Jim do this one 1st on list, back hoe ready to cover -------------------------------------- COMMENTS AND NOTES ---------------------------___________ vJ#l~ J~ "rJ ltue 1}Yt- (~lt- ~~ w~ dct ----.- CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 01-)07/ Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property zoning . . . Application valuation 04-00001071 Date .190665 1322 W 15TH ST 06-30-00-0-4-3326-0000- RES MANUFACTURED HOME 1/19/05 /32 Z wJ5-tA RS7 RESDNTL SINGLE FAMILY 70000 DtJvt.--wd~ Owner Contractor WILSON, DONALD 1631 WEST 5TH ST PORT ANGELES (360) 417-1195 Structure Information Construction Type Occupancy Type Other struct info OWNER WA 98363 1320 SF MANUFACTURED HOME TYPE V NON-RATED . SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS 18.80 1. 00 70000.00 1320.00 1320.00 1. 00 Qty Unit Charge Per Extension ________=~~~______:~~~~~~~_~____~~_~~~_=:_~~~~_=~~:_~~=~~________~640~~ / n~ ~0t~JtO ~\ 6;(; ./ xotD A Permit PUBLIC WORKS RES WATER SERV Additional desc Permit Fee 640.00 Plan Check Fee .00 Issue Date 11/24/04 Valuation 70000 Expiration Date 5/24/05 Permit Additional desc Permit Fee Issue Date Expiration Date RIGHT OF WAY 45.00 11/24/04 5/24/05 plan Check Fee Valuation .00 70000 Qty Unit Charge Per Extension 1.00 45.0000 ECH RIGHT OF WAY PERMIT /45. O~ -------------------------------------------------------------------~ Permit SANITARY SEWER HOOK UP Additional desc Permit Fee Issue Date Expiration Date 95.00 11/24/04 5/24/05 plan Check Fee Valuation .00 70000 Qty Unit Charge Per E~ 1.00 95.0000 EA SAN SEWER HOOKUP C~ ~ ---------------------------------------------------------------------------- special Notes and Comments Building address sign shall not be less than 611 & 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 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 riot 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 Date Signature of Owner (if owner is builder) T:\Policies\II02.15R {lIDS] <1\'ORt,-l+ "...~",:~ "~- . fI"'...:1:lo .... ~-.. ~;dP CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 04-00001071 pin nwnber . . .190665. Page Date 2 1/19/05 Special Notes and Comments Manufactured home must be pit set 50 that no more than 12" of skirting is visable above grade. The Fire Department has reviewed the project application and has no comments The proposal will result in the placement of a manufactured home in the RS-7 zone for a total lot coverage of 19%. Setbacks are good. No land use issues are noted. Any modifications to the City's electrical facilities will be at the customer's expense. Electrical load calculations and elctrical permits are required. Sanitary sewer connection inspection is required by Public works prior to back fill of ditch. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE Fee summary Charged Paid Credi ted Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 780.00 780.00 .. 00 .00 plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 2554.50 2554.50 .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 construclion authorized is not commenced wilhln 180 days, if construction or work is suspended or abandoned fora 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 permil does not presume 10 give aulhority to violate or cancellhe 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) Dale T;\Policies\11 02.15R [1/05 J vmf'-,'n IfJ A.LLe'f \~II~ APPLICATION FOR WATER City Water Division \~705 - 015 Port Angeles, Washington 1/12A , 20.Q1 I hereby apply for water to be furnished in accordance with rates and rules of the City for the following premises:. /77/9/L;~ Nameo/Applicant: VOI'7t1/rI Mis,,/'} /t?f!/ h/6 a Address: /"72-7.--- W /G77i ~/7-//9S- Renewal 0 New Servi~lk. 4~~ Lot ~ Add 774- .S% ~ . rAG1.~o>t:rLO"" Size 0/ Service I -I 7 t? Meter N~ I ~ ~ ~ Service Left On 0 Service Left~ Signed" ~ l 2 If' '-- installed by Remarks: f/'frht// *,t?4 -)~7 J ../ M-tJPr;+ ~ / OZS"~ N f~ 132.Z W, l;-t~ 00 W ., pvc:. ,'.: /1'- Al\~i E 2"3' If S CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: /; Date ~ 1/tl~ Time Received by .(phone, person) ZZ- -tA . Lo,.';o" of Wo,k" b, ;"",,"d -,;;/;!!fi, JIll';' - -,O~ /tI~ Name of person requesting inspection ' '1r..&Ve,Xt!~ -c7f~r~ Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. #-107/ Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: I /) /' Inspected: Date I 'l'J O~ Time Remarks: he. f1/J' ///1 IDS- By ---'>.1 . W~re..w, RESTORATION REQUiRED...... YES NO ~ B["'D~ l' } 2-' '"'1- 1.\" puG y"xe" ~'\.rvtO Mf\ \ -~ K ::32 10'-\;'\ 1~C. - ( e D!i':- (? I 0 12.: ,f'- ~.~W"r; i u,~"".( ~ I " /1& 411i ---- 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